Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/832

800 P7<ris) the appropriate remedy was indicated by a dream. Moral or dietetic remedies were more often prescribed tliari drugs. The record of the cure was inscribed on the columns or walls of the temple ; and it has been thought that in this way was introduced the custom of " recording cases," and that the physicians of the Hippocratic school thus learnt to accumulate clinical experience. But the priests of Asclepius were not physicians. Although the latter were often called Asclepiads, this was in the first place to indicate their real or supposed descent from Ascle pius, and in the second place as a complimentary title. No medical writing of antiquity speaks of the worship of Asclepius in such a way as to imply any connexion with the ordinary art of healing. The two systems appear to have existed side by side, but to have been distinct, and if they were ever united it must have been before the times of which we have any record. The theory of a develop ment of Greek medicine from the rites of Asclepius, though defended by eminent names, must accordingly be rejected. Development of Medicine in Greece. It is only from non- medical writers that anything is known of the development of medicine in Greece before the age of Hippocrates. The elaborate collections made by Daremberg of medical notices in the poets and historians illustrate the relations of the profession to society, but do little to prepare us for the Hippocratic period. Nor is much importance to be attached to the influence of the philosophical sects on medicine except as regards the school of Pythagoras. That philosopher and several of his successors were physicians, but we do not know in what relation they stood to later medical schools. We must therefore hasten onward to the age of Pericles, in which Hippocrates, already called " the Great," was in medicine as complete a representative of the highest efforts of the Greek intellect as were his contemporaries the great philosophers, orators, and trage dians. The medical art as we now practise it, the character of the physician as we now understand it, both date for us from Hippocrates. The justification of this statement is found in the literary collection of writings known by his name. Of these certainly many are falsely ascribed to the historical Hippocrates of Cos ; others are almost as certainly rightly so ascribed ; others again are clearly works of his school, whether from his hand or not. But which are to be regarded as the " genuine works " is still uncertain, and authorities are conflicting. There are clearly two schools represented in the collection, that of Cnidus in a small proportion, and that of Cos in far the larger number of the works. The latter was that to which Hippocrates belonged, and where he gave instruction; and accordingly it may be taken that works of this school, when not obviously of a different date, are Hippocratic in doctrine if not in actual authorship. Hippocratic Medicine. The first grand characteristic of Hippocratic medicine is the high conception of the duties and status of the physician, shown in the celebrated " Oath of Hippocrates " and elsewhere, equally free from the mysticism of a priesthood and the vulgar pretensions of a mercenary craft. So matured a professional sentiment may perhaps have been more the growth of time and organization than the work of an individual genius, but certainly corresponds with the character universally attri buted to Hippocrates himself. The second great quality is the singular artistic skill and balance with which the Hippocratic physician used such materials and tools as he possessed. Here we recognize the true Greek crux^pocrvrr]. But this artistic completeness was closely connected with the third cardinal virtue of Hippocratic medicine, the clear recognition of disease as being equally with life a process governed by what we should now call natural laws, which could bo known by observation, and which indicated the LUISXOKY. spontaneous and normal direction of recovery, by following which alone could the physician succeed. In the fourth place, these views of the "natural history of disease" (in modern language) led to habits of minute observation and accurate interpretation of symptoms, in which the | Hippocratic school was unrivalled in antiquity, and has been the model for all succeeding ages, so that even in these days, with our enormous advances in knowledge, the true method of clinical medicine may be said to be the method of Hippocrates. The actual science of the Hippocratic school was of course very limited. In anatomy and physiology little ad vance had been made, and so of pathology in the sense -of an explanation of morbid processes or knowledge of diseased structures there could be very little. The most valuable intellectual possession was a large mass of recorded observa tions in individual cases and epidemics of disease. "Whether these observations were systematic or individual, and how they were recorded, are points of which we are quite ignorant, as the theory that the votive tablets in the temples supplied such materials must be abandoned. Though the Hippocratic medicine was so largely founded on observation, it would be an error to suppose that dogma or theory had no place. The dominating theory of disease was the humoral, which has never since ceased to influence medical thought and practice. According to this celebrated theory, the body contains four humours, blood, phlegm, yellow bile, and black bile, a right proportion and mixture of which constitute health ; improper proportions or irre gular distribution, disease. It is doubtful whether the treatise in which this theory is fully expounded (7rf.pl <rcrios av@p<t>Trov) is as old as Hippocrates himself; but it was re garded as a Hippocratic doctrine, and, when taken up and expanded by Galen, its terms not only became the common property of the profession, but passed into general literature and common language. Another Hippocratic doctrine, the influence of which is not even yet exhausted, is that of the healing power of nature. Not that Hippocrates taught, as he was afterwards reproached with teaching, that nature is sufficient for the cure of diseases; for he held strongly the efficacy of art. But he recognized, at least in acute diseases, a natural process which the humours went through, being first of all crude, then passing through coction or digestion, and finally being expelled by resolu tion or crisis through one of the natural channels of the body. The duty of the physician was to foresee these changes, " to assist or not to hinder them," so that " the sick man might conquer the disease with the help of the physician." The times at which crises were to be expected were naturally looked for with anxiety ; and it was a cardinal point in the Hippocratic system to foretell them with precision. Hippocrates, influenced as is thought by the Pythagorean doctrines of number, taught that they were to be expected on days fixed by certain numerical rules, in some cases on odd, in others on even numbers, the celebrated doctrine of " critical days." This false precision can have had no practical value, but may have enforced habits of minute observation. It follows from what has been said that prognosis, or the art of foretelling the course and event of the disease, was a strong point with the Hip pocratic physicians. In this they have perhaps never been excelled. Diagnosis, or recognition of the disease, must have been necessarily imperfect, when no scientific nosology, or system of disease, existed, and the knowledge of anatomy was quite inadequate to allow of a precise determination of the seat of disease ; but symptoms were no doubt observed and interpreted skilfully. The pulse is not spoken of in any of the works now attributed to Hippocrates himself, though it is mentioned in other

works of the collection.