Page:Encyclopædia Britannica, Ninth Edition, v. 15.djvu/834

802 MEDICINE [HISTORY. back to the writings of Hippocrates, are also named among its founders. The most striking peculiarity of the empirics was that they rejected anatomy, regarding it as useless to inquire into the causes of things, and thus, as they con tended, being the more minute in their observation of the actual phenomena of disease. They professed that their whole practice was based upon experience, to which word they gave a special meaning. Three sources, and three only, could experience draw from : observation, history (i.e., recorded observation), and judgment by analogy. These three bases of knowledge were known as the " tripod " of the empirics. It should not, however, be forgotten that the empirics read and industriously com mented on the works of Hippocrates. They were extremely successful in practical matters, especially in surgery and in the use of drugs, and a large part of the routine know ledge of diseases and remedies which became traditional in the times of the Roman empire is believed to have been derived from them. In the 2d century the school became closely connected with the philosophical sect of the Sceptics, whose leader, Sextus, was an empirical physician. It lived and flourished far beyond this time, when trans planted to Rome, not less than in its native Alexandria, and appears to be recognizable even up to the beginning of the Middle Ages. If we look at the work of the Alexandrian schools in medicine as a whole, we must admit that the progress made was great and permanent. The greatest service rendered to medicine was undoubtedly the systematic study of anatomy. It is clear that the knowledge of function (physiology) did not by any means keep pace with the knowledge of structure, and this was probably the reason why the important sect of the empirics were able entirely to dispense with anatomical knowledge. The doctrines of Hippocrates, though lightly thought of by the Erasistra- teans, still were no doubt very widely accepted, but the practice of the Hippocratic school had been greatly improved in almost every department, surgery and obstetrics being probably those in which the Alexandrian practitioners could compare most favourably with those of modern times. We have now to trace the fortunes of this body of medical doctrine and practice when transplanted to Rome, and ultimately to the whole Roman world. Roman Medicine. The Romans cannot be said to have at any time originated or possessed an independent school of medicine. They had from early times a very compli cated system of superstitious medicine, or religion, related to disease and the cure of disease, borrowed, as is thought, from the Etruscans ; and, though the saying of Pliny that the Roman people got on for six hundred years without doctors was doubtless an exaggeration, and not, literally speaking, exact, it must be accepted for the broad truth which it contains. When a medical profession appears, it is, so far as we are able to trace it, as an importation from Greece. The first Greek physician whose name is preserved as having migrated to Rome was Archagathus, who came over from the Peloponnesus in 218 B c, ; but there were probably others before him. When Greece was made a Roman province, the number of such physicians who sought their fortunes in Rome must have been very large. The bitter words of M. Porcius Cato, who disliked them as he did other representatives of Greek culture, are evidence of this. The most eminent of these earlier Greek physicians at Rome was Asclepiades, the friend of Cicero (born 124 B.C. at Prusa in Bithynia). He came to Rome as a young man, and soon became distinguished both for his medical skill and his oratorical power. He introduced a system which, so far as we know, was his own, though founded upon the Epicurean philosophical creed ; on the practical side it conformed pretty closely to the Stoic rule- of life, thus adapting itself to the leanings of the better stamp of Romans in the later times of the republic. According to Asclepiades all diseases depended upon alterations in the size, number, arrangement, or movement of the "atoms," of which, according to the doctrine of Epicurus, the body consisted. These atoms were united into passages (vropot) through which the juices of the body were conveyed. This doctrine, of which the developments need not further be followed, was important chiefly in so far that it was perfectly distinct from, and opposed to, the humoral pathology of Hippocrates. In the treatment of disease Asclepiades attached most importance to diet, exercise, passive movements or frictions, and the external use of cold water, in short, to a modified athletic training. He rejected the vis medicatrix nature?, pointing out that nature in many cases not only did not help but marred the cure. His knowledge of disease and surgical skill were, as appears from the accounts given by Celsus and Ca-lius Aurelianus, very considerable. Asclepiades had many pupils, who adhered more or less closely to his doctrines, but it was especially one of them, Themison, who gave permanence to the teachings of his master by framing out of them, with some modifications, a new system of medical doctrine, and founding on this basis a school which lasted for some centuries in successful rivalry with the Hippocratic tradition, which, as we have seen, was up to that time the prevailing influence in medicine. This system was known as methodism, its adherents as the methodic! or methodists. Its main principles were that it was useless to consider the causes of a disease, or even the organ affected by the disease, and that it was suffi cient to know what was common to all diseases, viz., their common qualities (communitates, KOIVOT^TCS). Of these there were three possible forms (1) relaxation, (2) con traction of the minute passages or Trdpot, and (3) a mixed state, partly lax, partly constricted. The signs of these morbid states were to be found in the general constitution of the body, especially in the excretions. Besides this it was important only to consider whether the disease was acute or chronic, whether it was increasing, declining, or stationary. Treatment of disease was directed not to any special organ, nor to producing the crises and critical dis charges of the Hippocratic school, but to correcting the mor bid common condition or " community," relaxing the body if it was constricted, causing contraction if it was too lax, and in the " mixed state " acting according to the pre dominant condition. This simple rule of treatment was the system or " method " from which the school took its name. The methodists agreed with the empirics in one point, in their contempt for anatomy ; but, strictly speaking, they were dogmatists, though with a dogma different from that of the Hippocratic school. Besides Themison, its systematic founder, the school boasted many physicians eminent in their day, among whom Thessalus of Tralles, a half-educated and boastful pretender, was one of the most popular. He reversed the Hippocratic maxim " art is long," promising his scholars to teach them the whole of medicine in six months, and had inscribed upon his tomb iVr-ponV^s, as being superior to all living and bygone physicians. In the 2d century a much greater name appears among the methodists, that of Soranus of Ephesus, a physician mentioned with praise even by Tertullian and Augustine, who practised at Rome in the reigns of Trajan and Hadrian. Soranus is known by a work, still extant in the Greek original, on the diseases of women, and also by thu Latin work of Coelius Aurelianus, three centuries later, on acute and chronic diseases, which is based upon,

if not, as some think, an actual translation of, the chief