Am.  Jour.  Pharm. ) 
Nov.,  1921.  S 
Notes  on  Ancient  Medicine. 
783 
a  surgeon  is  evidence  that  the  patient  was  required  to  possess  con- 
siderable morale :  "He  ought  to  be  young,  or  at  any  rate  not  very 
old ;  his  hand  should  be  firm  and  steady  and  never  shake ;  he  should 
be  able  to  use  his  left  hand  with  as  much  dexterity  as  his  right ;  his 
eyesight  should  be  acute  and  clear;  his  mind  intrepid,  and  so  far 
subject  to  pity  as  to  make  him  desirous  of  the  recovery  of  his  patient, 
but  not  so  as  to  suffer  himself  to  be  moved  by  his  cries ;  he  should 
neither  hurry  the  operation  more  than  the  case  requires,  nor  cut  less 
than  is  necessary,  but  do  everything  just  as  if  the  other's  screams 
made  no  impression  on  him."  Galen  was  the  most  voluminous- 
writer  on  surgical  as  well  as  medical  subjects.  He  practiced  surg- 
ery at  Pergamus,  but  when  he  moved  to  Rome  in  165  A.  D.  he 
confined  himself  to  medicine,  following,  as  he  said,  the  custom  of 
the  place.  He  believed  that  the  physician  should  not  invade  the  do- 
main of  surgery  save  in  actual  emergency. 
Blood-letting  was  a  frequent  practice,  but  there  were  many  con- 
tentions as  to'  the  conditions  under  which  it  should  be  done.  The 
phases  of  the  moon  and  aspects  of  the  planets  were  taken  into  con- 
sideration ;  the  morning  was  the  best  time  of  day  for  this  operation. 
Cupping  (dry  and  wet),  horse  leeches,  the  cautery,  and  issues 
(seton)  were  respected  surgical  procedures.  In  regard  to  blood- 
letting Sallust  Salvian  says :  "If  the  blood  abound,  which  is  dis- 
cerned by  the  fulness  of  the  veins,  his  precedent  diet,  the  parties 
laughter,  etc.,  begin  with  the  median  or  middle  vein  of  the  arm; 
if  the  blood  be  ruddy  and  clear,  stop  it;  but  if  black  in  the  spring- 
time, or  a  good  season,  or  thick,  let  it  run  according  to  the  parties 
strength ;  and  some  eight  or  twelve  days  after  open  the  .head  vein, 
and  the  veins  of  the  forehead,  or  provoke  it  out  of  the  nostrils,  or 
with  cupping  glasses."  However,  "Before  you  let  blood  deliberate 
of  it  and  well  consider  all  the  circumstances  belonging  to  it."  Hip- 
pocrates is  quoted  as  saying:  "In  melancholy  and  mad  men,  the  vari- 
cous  tumor  or  haemorrhoids  appearing  doth  heal  the  same."  N 
Something  in  the  nature  of  a  capital  operation  is  indicated  by 
the  following:  "Cauteries  and  hot  irons  are  to  be  used  in  the  suture 
of  the  crown,  and  the  seared  or  ulcerated  place  suffered  to  run  a 
good  while.  Tis  not  amiss  to  bore  the  skull  with  an  instrument  to 
let  out  fuliginous  vapors."  In  another  place  the  boring  of  the 
skull  in  two  or  three  places  is  recommended  as  it  "much  availeth  to 
the  exhalation  of  the  vapors." 
