Hippocrates.
Hippocrates was born in Cos, as far as can be ascertained, about the year 460 B.C., and is alleged to have lived to be 99, or, as some say, 109 years of age. It is claimed that his father, Heraclides, was a direct descendant of Æsculapius, and that his mother, Phenarita, was of the family of Hercules. His father and his paternal ancestors in a long line were all priests of the Æsculapian temples, and his sons and their sons after them also practised medicine in the same surroundings. The family, traceable for nearly 300 years, among whom were seven of the name of Hippocrates, were all, it would appear, singularly free from the charlatanism which the Greek dramatists attributed to the Æsculapian practitioners, from the superstition which overlaid the medical science of so many older and later centuries, and especially from the fantastic pharmacy which was to develop to such an absurd extent in the following five hundred years.
It is not possible to distinguish with any confidence the genuine from the spurious writings attributed to Hippocrates which have come down to us. But the note which even his imitators sought to copy was one of directness, lucidity, and candour. He tells of his failures as simply as of his successes. He does not seek to deduce a system from his experience, and though he is reputed to be the originator of the theory of the humours, he does not allow the doctrine to influence his treatment, which is based on experience.
This portrait of Hippocrates, which is given in Leclerc’s “History of Medicine,” is stated to be copied from a medal in the collection of Fulvius Ursinus, a celebrated Italian connoisseur. It is believed that the medal was struck by the people of Cos at some long distant time in honour of their famous compatriot. A bust in the British Museum, found near Albano, among some ruins conjectured to have been the villa of Marcus Varro, is presumed to represent Hippocrates on the evidence of the likeness it bears to the head on this medal.
The medical views of Hippocrates do not concern us here except as they affect his pharmaceutical practice; but a very long chapter might be written on his pharmacy, that is to say, on the use he made of drugs in the treatment of disease. Galen believed that he made his preparations with his own hand, or at least superintended their preparation. Leclerc’s list of the medicaments mentioned as such in the works attributed to Hippocrates have been already quoted, and it will be found that after deducting the fruits and vegetables, the milks of cows, goats, asses, mules, sheep, and bitches, as well as other things which perhaps we should hardly reckon as medicaments, there remain between one hundred and two hundred drugs which are still found in our drug shops. There are a great many animal products, some copper and lead derivatives, alum, and the earths so much esteemed; but evidently the bulk of his materia medica was drawn from the vegetable kingdom.
Hippocrates was considerably interested in pharmacy. Galen makes him say, “We know the nature of medicaments and simples, and make many different preparations with them; some in one way, some in another. Some simples must be gathered early, some late; some we dry, some we crush, some we cook,” &c. He made fomentations, poultices, gargles, pessaries, katapotia (things to swallow, large pills), ointments, oils, cerates, collyria, looches, tablets, and inhalations, which he called perfumes. For quinsy, for example, he burned sulphur and asphalte with hyssop. He gave narcotics, including, it is supposed, the juice of the poppy and henbane seeds, and mandragora; purgatives, sudorifics, emetics, and enemas. His purgative drugs were generally drastic ones: the hellebores, elaterium, colocynth, scammony, thapsia, and a species of rhamnus.
Hippocrates describes methods for what he calls purging the head and the lungs, that is, by means of sneezing and coughing. He explains how he diminishes the acridity of spurge juice by dropping a little of it on a dried fig, whereby he gets a good remedy for dropsy. He has a medicine which he calls Tetragonon, or four-cornered. Galen conjectures that this was a tablet of crude antimony. Leclerc more reasonably suggests that it was a term for certain special kinds of lozenges, and points out that not long after Hippocrates physicians used a trochiscus trigonus, or three-cornered lozenge for another purpose.
Although he used many drugs, Hippocrates is especially insistent on Diet as the most important aid to health. He claims to have been the first physician who had written on this subject, and this assertion is confirmed by Plato, who, however, somewhat grimly commends the ancient doctors for neglecting this branch of treatment, for, he says, the modern ones have converted life into a tedious death. Barley water is repeatedly recommended by the physician of Cos, with various additions to suit the particular case under consideration. Oxymel is the usual associate, but dill, leeks, oil, salt, vinegar, and goats’ fat also figure.
Particular instructions are also given about the wine to be drunk, the kind, and the quantity of water with which it is to be diluted in spring, summer, autumn, and winter. In one place, at the end of the 3rd Book on Diet, a word is used which apparently means that persons fatigued with long labour should “drink unto gaiety” occasionally; but there is some doubt about the correct translation of that word.
V
FROM HIPPOCRATES TO GALEN.
Medicine is a science which hath been more professed than laboured, and yet more laboured than advanced; the labour having been, in my judgment, rather in circle than in progression. For I find much iteration, but small addition.—Bacon, “Advancement of Learning.”—Book 2.
The fame of Hippocrates caused naturally a great multiplication of works attributed to him. The Ptolemies when founding the Library of Alexandria, which they were determined should be more important than that of Pergamos, commissioned captains of ships and other travellers to buy manuscripts of the Greek physician at almost any price; an excellent method of encouraging forgeries. The works attributed to Hippocrates have been subject to the keenest scrutiny by scholars, but even now the verdict of Galen in regard to their genuine or spurious character is the consideration which carries the greatest weight. Even the imitations go to prove how free the physician of Cos was from superstitious practices or prejudiced theories.
Between him and Galen an interval of some six hundred years elapsed and, especially in the latter half of that period, pharmacy developed into enormous importance. Not that it necessarily advanced. But the faith in drugs, and especially in the art of compounding them, and the wild polypharmacy which grew up in Alexandria and Rome in the first two centuries of our era, of which Galen shows so much approval, add inestimably to the chronicles of pharmacy. It was during the interval between Hippocrates and Galen that the many sects of ancient medicine, the Dogmatics, the Stoics, the Empirics, the Methodics, and the Eclectics were born and flourished. Some of these encouraged the administration of special remedies. But probably a far greater influence was exercised on the pharmacy of the ancient world by the new commerce with Africa and the East which the Ptolemies did so much to foster, and by the travelling quacks and the prescribing druggists who exploited the drugs of foreign origin which now came into the market.
Serapion of Alexandria, one of the most famous of the Empirics, who is supposed to have lived in the second century, was largely responsible for the introduction of the animal remedies which were to figure so prominently in the pharmacy of the succeeding seventeen centuries. Among his specifics were the brain of a camel, the excrements of the crocodile, the heart of the hare, the blood of the tortoise, and the testicles of the wild boar.
The Empirics were the boldest users of drugs, and so far as can be judged, were the practitioners who brought opium into general medicinal esteem. One of the most famous doctors of this sect, Heraclides, made several narcotic compounds which are commended by Galen. One of these formulæ prescribed for cholera was 2 drms. of henbane seeds, 1 drm. of anise, and ½ drm. of opium, made into 30 pills, one for a dose. Another which was recommended for coughs was composed of 4 drms. each of juice of hemlock, juice of henbane, castorum, white pepper, and costus; and 1 drm. each of myrrh and opium.
Musa, a freed slave of Augustus, and apparently a sort of medical charlatan, but a great favourite with the Emperor, is alleged to have introduced the flesh of vipers into medical use especially for the cure of ulcers.
Celsus, Dioscorides, and Pliny, whose works are recognized as the storehouses of the science of Imperial Rome, belonged to the period under review. Celsus wrote either a little before or a little after the commencement of our era. He was the first eminent author who wrote on medicine in Latin. Pliny died A.D. 79, suffocated by the gases from Vesuvius, which in his eagerness to observe he had approached too near during an eruption. Dioscorides is supposed to have lived a little before Pliny, who apparently quotes him, but curiously never mentions his name, though usually most scrupulous in regard to his authorities.
Themison, who lived at Rome in the reign of Augustus Cæsar, and who is said to have been the first physician to have distinguished rheumatism from gout, is noted in pharmacy as the author of the formulæ for Diagredium and Diacodium. He praised the plantain as a universal remedy, and is also the earliest medical writer to mention the use of leeches in the treatment of illness.
Several of the writers on medical subjects of this period adopted the method of prescribing their formulas and the instructions for compounding them in verse. The most famous instance is that of Andromachus, physician to Nero, whose elegiac verses describing the composition of his Theriakon are quoted by Galen. The idea was that the formula thus presented was less likely to be tampered with. Theriakon as invented contained 61 ingredients. Its principal improvement on the more ancient Mithridatum was the addition of dried vipers. Andromachus appears to have acquired a large and lucrative practice in Rome at the time when wealth was most lavishly squandered.
Among other medical verse writers were Servilius Damocrates, who lived in the reign of the Emperor Tiberius, and who invented a famous tooth powder, a number of malagmata, (emollient poultices), acopa (liniments for pains), electuaries, and plasters; and Herennius Philon, a physician of Tarsus (about A.D. 50), whose fame rests on his philonium, a compound designed to relieve colic pains, which appear to have been specially frequent at that period. This philonium was composed of opium, saffron, pyrethrum, euphorbium, pepper, henbane, spikenard, and honey.
Menecrates, physician to Tiberius, and said to have written 155 works, was the inventor of diachylon plaster, but his diachylon was a compound of many juices (as the name implies) along with lead plaster.
The Romans were curiously badly off for regular doctors until Julius Cæsar specially tempted some to come from Greece and Egypt by offers of citizenship. Augustus, too, warmly encouraged the settlement in the city of trained medical men.