The genuine works of Hippocrates, Vol. 1 (of 2)

by Hippocrates

SECTION I

ON THE ORIGIN OF GRECIAN MEDICINE, WITH A SKETCH OF THE LIFE OF HIPPOCRATES.

It is well known that the oldest documents which we possess relative to the practice of Medicine, are the various treatises contained in the Collection which bears the name of Hippocrates. Their great excellence has been acknowledged in all ages, and it has always been a question which has naturally excited literary curiosity, by what steps the art had attained to such perfection at so early a period. This investigation, however, is attended with peculiar difficulties, and has never been marked by any very satisfactory results. At one time, indeed, it was usual to solve the question by supposing that Greece had derived all the arts and sciences, in a state of considerable advancement, from the oriental nations, who are admitted to have possessed a considerable degree of civilization before the Hellenic race became distinguished for intellectual development.[2] The question with regard to the origin of Medicine was thus supposed to have met with a satisfactory solution. For, it being generally admitted that the Hippocratic Medicine had emerged from the schools of philosophy, and it having been assumed as incontrovertible that the early philosophy of the Greeks had been derived from the East, the inference appeared to be quite legitimate that medicine, in a state of considerable advancement, had been imported from the same quarter. Recent research, however, has cast great doubts on the supposed descent of Grecian philosophy from a foreign source, and it is now pretty generally admitted that the Orientals, in early times, had never made any considerable progress in mental science.[3] Instead, then, of looking upon philosophy as having been an exotic production in the land of Hellas, we have every reason to believe that it was, what its inhabitants, in the noble pride of political freedom and intellectual superiority, boasted that their forefathers had been, namely, “the offspring of their own soil.”[4] Since the philosophy of the Greeks was indigenous, there is every reason to suppose that their medicine was so in like manner. How long the union between medicine and philosophy had subsisted before the time of Hippocrates, has not been determined upon any contemporary evidence, but the disciples of Pythagoras, in after ages, did not hesitate to ascribe to him the honor of effecting this alliance.[5] However this may be, it appears to me very doubtful whether these philosophers ever practised medicine as a craft. Indeed, it is much more likely that they merely speculated upon the phenomena of disease. Thus we shall see afterwards, that Plato himself did not discard speculative medicine from his system of philosophy, although we are quite sure that he never practised it as an art. But this connection between medicine and philosophy was by no means regarded, in after times, as having been favorable to the advancement of the former, for we find Hippocrates complimented by Celsus for having brought about a separation between them.[6]

It is clearly established that, long before the birth of philosophy, medicine had been zealously and successfully cultivated by the Asclepiadæ, an order of priest-physicians that traced its origin to a mythical personage bearing the distinguished name of Æsculapius. Two of his sons, Podalirius and Machaon, figure in the Homeric poems, not however as priests, but as warriors possessed of surgical skill in the treatment of wounds, for which they are highly complimented by the poet. It was probably some generations after this time (if one may venture a conjecture on a matter partaking very much of the legendary character) that Æsculapius was deified, and that Temples of Health, called Asclepia, presided over by the Asclepiadæ, were erected in various parts of Greece, as receptacles for the sick, to which invalids resorted in those days for the cure of diseases, under the same circumstances as they go to hospitals and spas at the present time. What remedial measures were adopted in these temples we have no means of ascertaining so fully as could be wished, but the following facts, collected from a variety of sources, may be pretty confidently relied upon for their accuracy. In the first place, then, it is well ascertained that a large proportion of these temples were built in the vicinity of thermæ, or medicinal springs, the virtues of which would no doubt contribute greatly to the cure of the sick.[7] At his entrance into the temple, the devotee was subjected to purifications, and made to go through a regular course of bathing, accompanied with methodical frictions, resembling the oriental system now well known by the name of shampooing. Fomentations with decoctions of odoriferous herbs were also not forgotten. A total abstinence from food was at first prescribed,[8] but afterwards the patient would no doubt be permitted to partake of the flesh of the animals which were brought to the temples as sacrifices. Every means that could be thought of was used for working upon the imagination of the sick, such as religious ceremonies of an imposing nature, accompanied by music, and whatever else could arouse their senses, conciliate their confidence, and in certain cases, contribute to their amusement.[9] In addition to these means, it is believed by many intelligent Mesmerists of the present day, that the aid of Animal magnetism was called in to contribute to the cure;[10] but on this point the proof is not so complete as could be wished. Certain it is, however, that as the Mesmerists administer medicines which are suggested to the imagination of patients during the state of clairvoyance, the Asclepiadæ prescribed drugs as indicated in dreams. These, indeed, were generally of a very inert description; but sometimes medicines of a more dangerous nature, such as hemlock and gypsum, were used in this way,[11] and regular reports of the effects which they produced were kept by the priests in the temples. It is also well known that the Asclepiadæ noted down with great care the symptoms and issue of every case, and that, from such observations, they became in time great adepts in the art of prognosis. When we come to an analysis of the different Hippocratic treatises, it will be seen that there is strong reason to believe we are still possessed of two documents composed from the results of observations made in the ancient Temples of Health. It would also contribute much to the increase of medical knowledge in this way, that the office of priesthood was hereditary in certain families, so that information thus acquired would be transmitted from father to son, and go on accumulating from one generation to another.[12] Whether the Asclepiadæ availed themselves of the great opportunities which they must undoubtedly have had of cultivating human and comparative anatomy, has been much disputed in modern times; indeed, the contrary is expressly maintained by some eminent authorities, such as Gruner[13] and Sprengel.[14] But it will be shown in another place, that there is good reason for believing that these two scholars have greatly underrated the amount of anatomical knowledge possessed by Hippocrates, and his predecessors the priest-physicians in the Temples of Health. Moreover, it is worthy of remark, that Galen holds Hippocrates to have been a very successful cultivator of anatomy.[15] Galen further states, upon the authority of Plato,[16] that the Asclepiadæ paid no attention to dietetics; but this opinion would require to be received with considerable modification, for, most assuredly, whoever reflects on the great amount of valuable information on this subject which is contained in the Hippocratic treatises, will not readily bring himself to believe that it could have been all collected by one man, or in the course of one generation. It is worthy of remark, moreover, that Strabo, whose authority I need scarcely say stands deservedly high in all literary matters, does not hesitate to affirm that Hippocrates was trained in the knowledge of dietetics, from documents preserved in the Asclepion of Cos.[17] That gymnastics, as stated by Galen,[18] wire not recognized as a regular branch of the healing art, until the age of Hippocrates, is indeed not improbable, and this perhaps is what Plato meant when he says that the Asclepiadæ did not make any use of the pedagogic art until it was introduced by Herodicus. But at the same time there can be no doubt, as further stated by Galen,[19] that exercise, and especially riding on horseback, constituted one of the measures used by the Asclepiadæ for the recovery of health, having been introduced by Æsculapius himself.

Of the Asclepia we have mentioned above, it will naturally be supposed that some were in much higher repute than others, either from being possessed of peculiar advantages, or from the prevalence of fashion. In the beginning of the fifth century before the Christian era, the temples of Rhodes, Cnidos, and Cos were held in especial favor, and on the extinction of the first of these, another rose up in Italy in its stead.[20] But the temple of Cos was destined to throw the reputation of all the others into the background, by producing among the priests of Æsculapius the individual who, in all after ages, has been distinguished by the name of the Great Hippocrates.[21]

Before proceeding, however, to give a brief sketch of his biography, I may state, partly by way of recapitulation, and partly in anticipation of what will be found in a subsequent part of this work, the leading facts which are known relative to the state of medicine before his time.

1. The origin of Grecian medicine is involved in impenetrable darkness, being anterior to all authentic history, and nothing being known either as to its rise or the steps by which it grow up to be a regular art.

2. There is no reason to suppose that the germs of medical science, any more than those of philosophy, had been originally imported into Greece from the East.

3. The earliest practitioners of medicine concerning whom we have any authentic information, were the Asclepiadæ, or priest-physicians, who endeavored to cure the sick partly by superstitious modes of working upon the imagination, and partly by more rational means, suggested by observation and a patient study of the phenomena of disease.

4. Though the men of letters who directed their attention to the phenomena of disease, as constituting a branch of philosophy, may in so far have improved the theory of medicine by freeing it from the trammels of superstition, it is not likely they could have contributed much to the practice of medicine, which is well known to be founded on observation and experience.

5. Though there can be little or no doubt that the priest-physicians, and the philosophers together, were possessed of all the knowledge of medicine which had been acquired at that time, it is not satisfactorily ascertained by what means the art had attained that remarkable degree of perfection which we shall soon see that it exhibited in the hands of Hippocrates. But I must now proceed with my Sketch of his Life.

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That Hippocrates was lineally descended from Æsculapius was generally admitted by his countrymen, and a genealogical table, professing to give a list of the names of his forefathers, up to Æsculapius, has been transmitted to us from remote antiquity. Although I am well aware that but little reliance can be put on these mythical genealogies, I will subjoin the list to this section, in order that it may be at hand for reference, as many allusions will have to be made to it in the subsequent pages.[22]

Of the circumstances connected with the life of Hippocrates little is known for certain, the only biographies which we have of him being all of comparatively recent date, and of little authority. They are three in number, and bear the names of Soranus Ephesins, Suidas, and Tzetzes. Of the age in which the first of these authors flourished, nothing is known for certain; the second is a lexicographer, who lived in the beginning of the eleventh century; and the third flourished in the twelfth century. The birth of Hippocrates is generally fixed, upon the authority of Soranus, as having occurred in the first year of the 80th Olympiad, that is to say, in the 460th year before the vulgar era. On this point, however, I must say that I see no good grounds for the unanimity of opinion which has generally prevailed among modern scholars. In fact, the counter-evidence of Aulus Gellius has always appeared to me to be unjustly overlooked, as I cannot but think that his authority ought to rank much higher than that of Soranus, of whom nothing is known, not even the century in which he lived. Aulus Gellius, then, in an elaborate disquisition on Greek and Roman chronology, states decidedly that Socrates was contemporary with Hippocrates, but younger than he.[23] Now it is well ascertained, that the death of Socrates took place about the year 400 A.C., and as he was then nearly seventy years old, his birth must be dated as happening about the year 470 A.C. This statement would throw the birth of Hippocrates back several years beyond the common date, as given by Soranus. There is also much uncertainty as to the time of his death: according to one tradition he died at the age of 85, whereas others raise it to 90, 104, and even 109 years. These dates of his birth and death, although vague, are sufficient to show that the period at which we may reasonably suppose he had practised his profession with the greatest activity and reputation, must have been the latter part of the fifth century A.C. It will readily occur to the reader, then, that our author flourished at one of the most memorable epochs in the intellectual development of the human race. He had for his contemporaries, Pericles, the famous statesman; the poets Æschylus, Sophocles, Euripides, Aristophanes, and Pindar; the philosopher Socrates, with his distinguished disciples Plato and Xenophon; the venerable father of history, Herodotus, and his young rival, Thucydides; the unrivalled statuary, Phidias, with his illustrious pupils, and many other distinguished names, which have conferred immortal honor on the age in which they lived, and exalted the dignity of human nature. Nor was Greece the only region of the earth remarkable at this time for moral and intellectual improvement; for, if we may believe oriental chronology, Confucius and Zoroaster had gone off the stage of life only a very few years before the dawn of this celebrated age of Grecian superiority in the arts and sciences. Hippocrates, it thus appears, came into the world under circumstances which must have co-operated with his own remarkable powers of intellect in raising him to that extraordinary eminence which his name has attained in all ages. From his forefathers he inherited a distinguished situation in one of the most eminent hospitals, or Temples of Health, then in existence, where he must have enjoyed free access to all the treasures of observations collected during many generations, and at the same time would have an opportunity of assisting his own father in the management of the sick.[24] Thus from his youth he must have been familiar with the principles of medicine, both in the abstract and in the concrete,—the greatest advantage, I may be permitted to remark, which any tyro in the healing art can possibly enjoy. In addition to all this, he had excellent opportunities of estimating the good and bad effects resulting from the application of gymnastic exercises in the cure of diseases, under the tuition of Herodicus, the first person who is known for certain to have cultivated this art as a branch of medicine.[25] He was further instructed in the polite literature and philosophy of the age, by two men of classical celebrity, Gorgias and Democritus; the latter of whom is well known to have devoted much attention to the study of medicine, and its cognate sciences, comparative anatomy and physiology.

Initiated in the theory and first principles of medicine, as now described, Hippocrates no doubt commenced the practice of his art in the Asclepion of Cos, as his forefathers had done before him. Why he afterwards left the place of his nativity, and visited distant regions of the earth, whither the duties of his profession and the calls of humanity invited him, cannot now be satisfactorily determined. The respect paid to him in his lifetime by the good and wise in all the countries which he visited, and the veneration in which his memory has been held by all subsequent generations, are more than sufficient to confute the base calumny, invented, no doubt, by some envious rival, that he was obliged to flee from the land of his nativity in consequence of his having set fire to the library attached to the Temple of Health, at Cnidos, in order that he might enjoy a monopoly of the knowledge which he had extracted from the records which it had contained.[26] Certain it is, that he afterwards visited Thrace, Delos, Thessaly, Athens, and many other regions, and that he practised, and probably taught, his profession in all these places.[27] There are many traditions of what he did during his long life, but with regard to the truth of them, the greatest diversity of opinion has prevailed in modern times. Thus he is said to have cured Perdiccas, the Macedonian king, of love-sickness; and although there are circumstances connected with this story which give it an air of improbability, it is by no means unlikely that he may have devoted his professional services to the court of Macedonia, since very many of the places mentioned in his works as having been visited by him, such as Pella and Acanthus, are situated in that country; and further, in confirmation of the narrative, it deserves to be mentioned, that there is most satisfactory evidence of his son Thessalus having been court physician to Archelaus, king of Macedonia;[28] and it is well ascertained that another of his descendants, the Fourth Hippocrates, attended Roxane, the queen of Alexander the Great.[29] Our author’s name is also connected with the great plague of Athens, the contagion of which he is reported to have extinguished there and in other places, by kindling fires.[30] The only serious objection to the truth of this story is the want of proper contemporary evidence in support of it. It is no sufficient objection, however, that Thucydides, in his description of the circumstances attending the outbreak of the pestilence in Attica, makes no mention of any services having been rendered to the community by Hippocrates; while, on the contrary, he states decidedly that the skill of the physicians could do nothing to mitigate the severity of this malady. It is highly probable, that, if Hippocrates was actually called upon to administer professional assistance in this way, it must have been during one of the subsequent attacks or exacerbations of the disease which occurred some years afterwards. We know that this plague did not expend its fury in Greece during one season, and then was no more heard of; but on the contrary, we learn that it continued to lurk about in Athens and elsewhere, and sometimes broke out anew with all its original severity. Thucydides briefly mentions a second attack of the plague at Athens about two years after the first,[31] attended with a frightful degree of mortality; nor is it at all improbable that this was not the last visitation of the malady. Though the name of Hippocrates, then, may not have been heard of at its first invasion, it is not at all unlikely that, after he had risen to the head of his profession in Greece, as we know that he subsequently did, he should have been publicly consulted regarding the treatment of the most formidable disease which was prevailing at the time.[32] What adds an appearance of truth to the tale is, that several of the genuine works of Hippocrates, which were probably published in its lifetime, relate to the causes and treatment of epidemic and endemic diseases.[33] That the magistrates of Athens, then, should have applied to him as the most eminent authority on the subject, to assist them in their sanitary regulations[34] during the prevalence of this great pestilence, is so far from being improbable, that I think it would have been very extraordinary if they had omitted to consult him, seeing that he was undoubtedly looked up to as the facile princeps among the physicians of the day. That his services in this way have been exaggerated by the blind admiration of his worshipers, both at that time and in after ages, may be readily admitted; but this circumstance ought not to make us reject the whole story as being fabulous. I repeat, then, that although this part of the history of Hippocrates be not vouched by any contemporary evidence, it is by no means devoid of probability, while the objections which have been started to it by modern authorities have not so much weight as is generally supposed.

Another circumstance in the life of Hippocrates, for the truth of which Soranus, Suidas, and a host of ancient authorities concur in vouching, namely, that he refused a formal invitation to pay a professional visit to the court of Persia, is rejected with disdain by almost all the modern scholars who have touched upon this subject. But was it an uncommon thing for the king of Persia to manœuvre in this way with Grecian talent in order to attract it to his court? So far is the contrary known to be the case that, as every person who is familiar with the early history of Greece must be well aware, the manner in which “the Great King” rendered himself most formidable to the Grecian Republics after the humiliating defeats which the military forces of Persia had sustained at Marathon, Salamis, and Platæa, was by intriguing with all those distinguished persons in Greece who would render themselves accessible to his bribes and flatteries, and thus endeavoring to detach them from the cause of their country. Of this we have notable examples in the case of two illustrious individuals, who were nearly contemporary with Hippocrates—I mean Pausanias and Themistocles. Moreover, it is well known that Grecian physicians at all times were in high repute at the court of Babylon;[35] witness Ctesias, the contemporary and kinsman of Hippocrates,[36] who was court physician to the king of Persia, and was employed in that capacity in the most serious emergencies.[37] What more natural, then, or more likely to happen, than that the king of Persia, when he saw his country overrun by the plague,[38] should seek advice from a neighboring people, whose superiority to his own subjects in all the arts of war and peace he and his predecessors had learned from sad experience? I readily admit that the letters in the Hippocratic Collection which relate to this story can scarcely be received as genuine; but does this prove that the event upon which they are made to turn is also devoid of truth? I can see no probability in this supposition; for whether we regard these documents as willful forgeries, executed with the fraudulent intention of palming them on the literary world as genuine productions, or whether we look upon them as mere exercises made on given subjects by the Sophists or Scholiasts to display their ability in sustaining an assumed character, it would have been preposterous to make them relate to stories of which every person of that age must have been able to detect the falsehood. Were any person at the present day, from whatever motive, desirous of palming upon the public certain letters said to have been written by the celebrated John Hunter, he would surely not be so imprudent as to endeavor to pass off as genuine a correspondence purporting to have taken place between him and the king of France, as every one at all acquainted with professional biography, would at once perceive that the authenticity of the documents in question was completely disproved by the falsity of the narrative upon which they are founded. Seeing, then, that these letters are admitted on all hands to be very ancient, that is to say, of a date not much later than the time of Hippocrates, we may rest assured that the main facts to which they allude were believed at the time to be of an authentic nature.

For the like reasons I am disposed to think that, although the letters in the Collection which refer to a pretended correspondence between him and Democritus are most probably to be regarded as spurious, it is far from being improbable that the physician may have rendered the services of his profession to the philosopher. Had there been no grounds whatever for this story, why so many ancient authors should have agreed in giving credit to it I cannot imagine.

According to all the accounts which have come down to us of his life, he spent the latter part of it in Thessaly, and died at Larissa, when far advanced in years. The corruptions with regard to numbers which, in the course of transcription, have crept into all works of great antiquity, sufficiently account for the differences already mentioned in the statements respecting his age at the time of his death.

These are all the particulars of any importance which can now be gathered regarding the life of him who has been venerated in all ages as “The Father of Medicine.” That they are scanty and rather unsatisfactory, must be admitted; but yet what more, in general, can we desire to know respecting the biography of a physician than the manner in which he was educated, how he was esteemed by his contemporaries, and what he did and wrote to reflect credit on his profession? The approbation and gratitude of those who have consulted him for the cure of their maladies are the best testimony to the public character of a physician, and the estimation in which his writings are held by the members of his own profession is what constitutes his professional reputation. I need scarcely say that, as a medical author, the name of Hippocrates stands pre-eminently illustrious. In this way he has left monuments of his genius more durable than the marble statues of Phidias, his contemporary, and as enduring as the tragedies of Sophocles, or the Olympian odes of Pindar.

In the next section I intend to give a careful analysis of all the writings which have come down to us from antiquity under the name of Hippocrates, and to state clearly the grounds upon which some are to be received as genuine, and others rejected as supposititious. I shall conclude the present section, although it may appear that I am anticipating some things which had better have come after the succeeding one, with a brief account of our author’s general principles, both as regards the theory and the practice of medicine; and in doing this I mean not to confine myself strictly to the treatises which are acknowledged to be genuine, as they are unfortunately so few in number, that we are often obliged to guess at the tenets of our author from those held by his immediate successors and disciples.

The opinions which he held as to the origin of medicine, and the necessities in human life which gave rise to it, are such as bespeak the soundness of his views, and the eminently practical bent of his genius. It was the necessity, he says,[39] which men in the first stages of society must have felt of ascertaining the properties of vegetable productions as articles of food that gave rise to the science of Dietetics; and the discovery having been made that the same system of regimen does not apply in a disordered as in a healthy condition of the body, men felt themselves compelled to study what changes of the aliment are proper in disease; and it was the accumulation of facts bearing on this subject which gave rise to the art of Medicine. Looking upon the animal system as one whole, every part of which conspires and sympathizes with all the other parts, he would appear to have regarded disease also as one, and to have referred all its modifications to peculiarities of situation.[40] Whatever may now be thought of his general views on Pathology, all must admit that his mode of prosecuting the cultivation of medicine is in the true spirit of the Inductive Philosophy; all his descriptions of disease are evidently derived from patient observation of its phenomena, and all his rules of practice are clearly based on experience. Of the fallaciousness of experience by itself he was well aware, however, and has embodied this great truth in a memorable aphorism,[41] and therefore he never exempts the apparent results of experience from the strict scrutiny of reason. Above all others, Hippocrates was strictly the physician of experience and common sense. In short, the basis of his system was a rational experience, and not a blind empiricism, so that the Empirics in after ages had no good grounds for claiming him as belonging to their sect.[42]

What he appears to have studied with particular attention is the natural history of diseases, that is to say, their tendencies to a favorable or fatal issue; and without this knowledge, what can all medical practice be but blind empiricism?—a haphazard experiment, which perchance may turn out either to cure or to kill the patient? In a word, let me take this opportunity of saying, that the physician who cannot inform his patient what would be the probable issue of his complaint, if allowed to follow its natural course, is not qualified to prescribe any rational plan of treatment for its cure.

One of the most distinguishing characteristics, then, of the Hippocratic system of medicine, is the importance attached in it to prognosis, under which was comprehended a complete acquaintance with the previous and present condition of the patient, and the tendency of the disease. To the overstrained system of Diagnosis practised in the school of Cnidos, agreeably to which diseases were divided and subdivided arbitrarily into endless varieties, Hippocrates was decidedly opposed; his own strong sense and high intellectual cultivation having, no doubt, led him to the discovery, that to accidental varieties of diseased action there is no limit, and that what is indefinite cannot be reduced to science.[43]

Nothing strikes one as a stronger proof of his nobility of soul, when we take into account the early period in human cultivation at which he lived, and his descent from a priestly order, than the contempt which he everywhere expresses for ostentatious charlatanry, and his perfect freedom from all popular superstition.[44] Of amulets and complicated machines to impose on the credulity of the ignorant multitude, there is no mention in any part of his works. All diseases he traces to natural causes, and counts it impiety to maintain that any one more than another is an infliction from the Divinity. How strikingly the Hippocratic system differs from that of all other nations in their infantine state must be well known to every person who is well acquainted with the early history of medicine.[45] His theory of medicine was further based on the physical philosophy of the ancients, more especially on the doctrines then held regarding the elements of things, and the belief in the existence of a spiritual essence diffused through the whole works of creation, which was regarded as the agent that presides over the acts of generation, and which constantly strives to preserve all things in their natural state, and to restore them when they are preternaturally deranged. This is the principle which he called Nature, and which he held to be a vis medicatrix. “Nature,” says he, or at least one of his immediate followers says, “is the physician of diseases.”[46] His physical opinions are so important, that I have resolved to devote an entire section to an exposition of the ancient doctrines on this head. (See Sect. III.)

Though his belief in this restorative principle would naturally dispose him to watch its operations carefully, and make him cautious not to do anything that would interfere with their tendencies to rectify deranged actions, and though he lays it down as a general rule by which the physician should regulate his treatment, “to do good, or at least to do no harm,”[47] there is ample evidence that on proper occasions his practice was sufficiently bold and decided. In inflammatory affections of the chest he bled freely, if not, as has been said, ad deliquum animi,[48] and in milder cases he practised cupping with or without scarification.[49] Though in ordinary cases of constipation he merely prescribed laxative herbs, such as the mercury (mercurialis perennis),[50] beet,[50] and cabbage,[50] he had in reserve elaterium,[51] scammony,[52] spurges,[53] and other drastic cathartics, when more potent medicines of this class were indicated. And although when it was merely wished to evacuate upwards in a gentle manner, he was content with giving hyssop,[54] and other simple means, he did not fail, when it was desirable to make a more powerful impression, to administer the white hellebore with a degree of boldness, which his successors in the healing art were afraid to imitate.[55] A high authority has expressly stated that he was the discoverer of the principles of derivation and revulsion in the treatment of diseases.[56] Fevers he treated as a general rule, upon the diluent system, but did not fail to administer gentle laxatives, and even to practise venesection in certain cases.[57] When narcotics were indicated, he had recourse to mandragora, henbane, and perhaps to poppy-juice.[58]

In the practice of surgery he was a bold operator. He fearlessly, and as we would now think, in some cases unnecessarily, perforated the skull with the trepan and the trephine in injuries of the head. He opened the chest also in empyema and hydrothorax. His extensive practice, and no doubt his great familiarity with the accidents occurring at the public games of his country, must have furnished him with ample opportunities of becoming acquainted with dislocations and fractures of all kinds; and how well he had profited by the opportunities which he thus enjoyed, every page of his treatises “On Fractures,” and “On the Articulations,” abundantly testifies. In fact, until within a very recent period, the modern plan of treatment in such cases was not at all to be compared with his skillful mode of adjusting fractured bones, and of securing them by means of waxed bandages. In particular, his description of the accidents which occur at the elbow- and hip-joints will be allowed, even at the present day, to display a most wonderful acquaintance with the subject. In the treatment of dislocations, when human strength was not sufficient to restore the displacement, he skillfully availed himself of all the mechanical powers which were then known.[59] In his views with regard to the nature of club-foot, it might have been affirmed of him a few years ago, that he was twenty-four centuries in advance of his profession when he stated that in this case there is no dislocation, but merely a declination of the foot; and that in infancy, by means of methodical bandaging, a cure may in most cases be effected without any surgical operation. In a word, until the days of Delpech and Stromeyer, no one entertained ideas so sound and scientific on the nature of this deformity as Hippocrates.

But I must not allow my enthusiastic admiration to carry me too far. I will therefore conclude the present section by making a few observations on the peculiar style of our author’s writings. According to Galen, whose extensive acquaintance with Greek literature rendered him a most competent judge, the characteristics of his style are extreme conciseness, precision, and, in certain cases, obscurity, as the natural result of labored brevity.[60] To these traits of character he adds, elsewhere, that Hippocrates makes it a rule to avoid all superfluity of discussion and unnecessary repetitions, and never says more than what is indispensable.[61] Now, it is no proper objection to this general view of the character of his style, as stated by M. Littré, that it is not the same in all his works; as, for example, in his treatise “On Airs, Waters, and Places,” where the style is certainly not so laconic as in some of his others; although, even with regard to it, I must be permitted to say that I agree with a most competent authority, the late Dr. Coray, that its style is remarkable for conciseness.[62] And, indeed, if brevity of expression, bordering at times upon obscurity, be not the characteristic of the style of Hippocrates, we must admit that his mode of composition is not in accordance with the taste of his age. There can be no doubt that the style of Hippocrates is nearly akin to that of his contemporary, the historian Thucydides, which is thus described by a very acute and original critic: “The most obvious and characteristic of his peculiarities is an endeavor to express as much matter as possible in as few words as possible, to combine many thoughts into one, and always to leave the reader to supply something of his own. Hence his conciseness often becomes obscure.”[63] I would beg leave to add that other peculiarities in the style of Thucydides, which are severely animadverted upon by Dionysius, may be clearly recognized also in the writings of Hippocrates, especially irregularities of syntax, with a somewhat rude and inartificial mode of constructing his sentences. I mention this the rather that the English reader may not expect to find in my translation any of those well-turned periods and graceful modes of construction by which elegant composition is now distinguished. I wish it to be known that in making this translation, I have followed the example of the modern authority lately referred to, that is to say, I have been more studious of fidelity than of elegance, and have endeavored to give not only the matter, but also the manner, of my author.[64]

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As promised above, I here subjoin that Mythical Genealogy of Hippocrates from Tzetzes.

Æsculapius was the father of Podalirius, who was the father of Hippolochus, who was the father of Sostratus, who was the father of Dardanus, who was the father of Crisamis, who was the father of Cleomyttades, who was the father of Thedorus, who was the father of Sostratus II., who was the father of Theodorus II., who was the father of Sostratus III., who was the father of Nebrus, who was the father of Gnosidicus, who was the father of Hippocrates I., who was the father of Heraclides, who was the father of Hippocrates II., otherwise called the Great Hippocrates. (Chiliad. vii., 155.)

I may also add a few particulars, deserving to be known, respecting the family of Hippocrates. As Galen relates, he had two sons, Thessalus and Draco, each of whom had a son who bore the name of Hippocrates. (Comment. ii., in Lib. de Nat. Human.) It thus appears that there were in the family four persons of the name of Hippocrates, closely related to one another. First, the father of Heraclides, and grandfather of Hippocrates II.; second, Hippocrates II., our author; third and fourth, his grandchildren, the sons of Thessalus and Draco. Besides these, three or four other members of the family bearing the name of Hippocrates are enumerated by Suidas. Of Thessalus, it is related by Galen (l.c.) that he adhered strictly to the principles of his father, and became physician to Archelaus, king of Macedonia. Of Draco little mention is made, only it is well known that he also followed his father’s profession. But of all the family of Hippocrates the Great, Polybus, his son-in-law, is the most celebrated. Galen calls him the disciple of Hippocrates and successor in his school, and adds, that he made no innovations on the doctrines of his teacher. (Comment. i., in Libr. de Nat. Hum.)

SECTION II.
DISQUISITION ON THE AUTHENTICITY OF THE DIFFERENT TREATISES WHICH HAVE BEEN ATTRIBUTED TO HIPPOCRATES.

There can scarcely be a doubt that Hippocrates followed the practice which we know to have been adopted by almost all the great writers of antiquity with regard to the publication of their works, namely, that of publishing them separately, at the time they were composed. We know, for example (to begin with a distinguished author, regarding whom our information is particularly ample), that Horace published his books of satires, epistles, odes, and epodes separately, and at different times; and that the collection of them in its present form was not compiled until after his death.[65] We have every reason for concluding that the same rule was followed by Martial,[66] Cicero,[67] and other Roman authors. It is further well ascertained (to come to a period not far removed from the age of Hippocrates) that Plato[68] and Aristotle[69] likewise gave their works to the literary world upon the same plan. We have every reason, therefore, to suppose that Hippocrates published several of his works separately, in his life time; and indeed Galen often expresses himself so as to leave little or no ground for doubt on this point.[70] It would be most interesting and important then to know, were this possible, in what order the different works of our author were published. But unfortunately this is a question which we have no proper data for solving satisfactorily, only as the “Aphorisms” are evidently made up in a great measure of conclusions drawn from the results of discussions and observations recorded in other of his works, we have every reason to infer that this important work was among that latest of his literary labors.[71] But although we may not be able to determine the order in which the different pieces were composed and published, we need have no hesitation in deciding with all the best authorities, ancient and modern, that all the following treatises were composed by him, and, from the first, obtained the sanction of his name, viz.: the “Prognostics;” the “First and Third Epidemics;” “On Regimen in Acute Diseases;” “On Airs, Waters, and Places;” “On Wounds of the Head;” the “Aphorisms.” It is in so far satisfactory, then, to know, that respecting the authorship of these works there has never been any reasonable question, and that whoever entertains doubts on this point of literary history, ought, on the same principles of criticism, to dispute the authenticity of the “Protagoras” and “Phædo” of Plato; of the “History of Animals” and “Politics” of Aristotle; and of the “Olynthiacs” and “Philippics” of Demosthenes. In a word, nothing but the most lawless spirit of scepticism can lead any one to challenge the genuineness of the works which I have just now enumerated. These, however, it will be seen, constitute but a very small portion of the treatises contained in the Hippocratic Collection; and with regard to a very great number of the others, it is unfortunately not only impossible to bring any competent evidence of their genuineness, but it is also quite apparent that they betray marks of an entirely different authorship; and this is abundantly obvious, whether we look to the matters which they contain, or the manner in which these are given. Thus in some of the treatises we discover hypothetical doctrine and rules of practice utterly at variance with those which are contained in the works of acknowledged authenticity; and in some of them, instead of that nervous conciseness which, as we have already stated, has always been held to be characteristic of the style of Hippocrates, we find an insipid verbosity and vagueness of expression, which clearly stamp them as being productions of a very different hand. But, besides this internal evidence which we have to assist us in forming a correct judgment on these works, we fortunately still possess a considerable number of ancient Commentaries, written expressly in illustration of them, from which, in many instances, modern critics have been enabled to draw very satisfactory data for forming a correct judgment on the points at issue. Before proceeding further, it is but fair to acknowledge that I have freely availed myself of the labors of Vander Linden, Ackerman, Gruner, Littré, and other learned men, who have preceded me in this field of investigation, but at the same time I may venture to assure the reader that there is scarcely a passage in any of the ancient authorities, bearing on the points in discussion, which I have not examined carefully for myself.

The oldest commentator of whom we have any mention, is the celebrated Herophilus, who flourished about the year 300 A.C.[72] But of his Commentaries we have no remains, nor of those of the other commentators down to Apollonius Citiensis, a writer of the first century A.C. His Scholia on the Hippocratic treatise, “De Articulis,” along with those of Palladius, Stephanus, Theophilus, Meletius, and Joannes Alexandrinus, all writers of an uncertain date, but certainly much later than the Christian era, were published by the late Dr. Dietz, at Konigsburg, in 1834. To these we have to add two others, of much higher celebrity, namely, Erotian, who lived during the reign of Nero, and the famous Galen, who, it is well known, flourished in the latter part of the second century, P.C. It is from the works of these two writers that the most important facts are to be elicited, for forming a correct judgment respecting the authenticity of the Hippocratic treatises. As we shall have occasion to quote their opinions on the different heads of our inquiry, it would be useless to occupy room by giving their entire list in this place. Suffice it to say, that Erotian rarely assigns any reason for admitting the treatises into his list of genuine works, and that Galen generally rests his judgment, when he assigns any grounds for it, upon the evidence of preceding authorities, and upon what he holds to be the characteristics of the doctrines and style of Hippocrates. These, assuredly, are most sound and legitimate principles of criticism; but it has been often supposed, that in applying them the great commentator is at times very dogmatic, and not always consistent with himself. But, upon the whole, all must allow that Galen is our best guide on the subject of our present inquiry. And, moreover, it is from his works especially that we are enabled to glean whatever information we possess with regard to the opinions of the earlier commentators, from Herophilus down to his own times.

I will now proceed to give a brief sketch of the labors of modern critics in this department.

The earliest modern authority is Lemos, whose work was published in the end of the sixteenth century. It appears that he follows almost entirely the opinions of Galen, and seldom or never ventures to exercise an independent judgment of his own.

The work of Mercuriali is a much more elaborate and important performance, and his principles of judgment appear to me most unexceptionable, being founded entirely upon ancient authority and peculiarity of style; only it may, perhaps, be objected, that he rather exaggerates the importance of the latter at the expense of the former; for it must be admitted that very contradictory conclusions have sometimes been founded on imaginary peculiarities of style. I cannot agree with M. Littré, however, that the whole system of Mercuriali is founded on a petitio principii; as if, before describing the style of his author, he ought to have decided which were his genuine writings.[73] For, as already stated, any one is perfectly warranted in assuming that certain of the works which bear the name of Hippocrates are genuine, and from them, and the general voice of antiquity, Mercuriali was further justified in deciding what are the peculiarities of the style of Hippocrates, and in applying them as a test of the genuineness of other works which had been attributed to the same author. Mercuriali divides the Hippocratic treatises into four classes, as follows: The first comprehends those which bear the characters of his doctrine and style. The second comprises those which are composed of notes taken from memory, and published by Thessalus, Polybus, or other of his disciples, and contain foreign matter interpolated with them. The third class consists of those which have not been composed by Hippocrates, but are the work of his sons or disciples, and represent his doctrines with greater or less exactness. The fourth includes those tracts which have nothing to do with the school of Hippocrates. As the views and principles of Mercuriali accord, in the main, very well with my own, I think it proper to set down his classification of the treatises.

CLASSIS I.

1. De Natura Humana.
2. De Aëribus, Aquis, et Locis.
3. Aphorismi.
4. Prognostica.
5. De Morbis popularibus.
6. De Morbis acutis.
7. De Vulneribus Capitis.
8. De Fracturis.
9. De Articulis.
10. De Officina Medici.
11. Mochlicus.
12. De Alimento.
13. De Humoribus.
14. De Ulceribus.

CLASSIS II.

1. De Locis in Homine.
2. De Flatibus.
3. De Septimestri Partu.
4. De Octimestri Partu.
5. De Ossibus.

CLASSIS III.

1. De Carnibus seu Principiis.
2. De Genitura.
3. De Natura Pueri.
4. De Affectionibus.
5. De Affectionibus internis.
6. De Morbis.
7. De Natura Muliebri.
8. De Morbis Muliebribus.
9. De Sterilibus.
10. De Fœtatione et Superfœtatione.
11. De Virginium Morbis.
12. De Sacro Morbo.
13. De Hemorrhoidibus.
14. De Fistulis.
15. De Salubri Diæta.
16. De Diæta, tres Libri.
17. De Usu Liquidorum.
18. De Judicationibus.
19. De Diebus Judicatoriis.
20. Prædictionum Libri.
21. Coacæ Prænotiones.
22. De Insomniis.

CLASSIS IV.

1. Jusjurandum.
2. Præceptiones.
3. De Lege.
4. De Arte.
5. De Arte Veteri.
6. De Medico.
7. De Decenti Ornatu.
8. De Exsectione Fœtus.
9. De Resectione Corporum.
10. De Corde.
11. De Glandulis.
12. De Dentitione.
13. De Visu.
14. Epistolæ.
15. De Medicamentis purgantibus |Latinè tantum.[74]
16. De Hominis Structura     |

Perhaps we may venture to affirm, without much risk of challenge, that the works of no ancient author owe more to the exertions of a single individual than those of Hippocrates due to the labors of Foës. Of his excellencies as an editor, and expositor of the meaning of his author, I will have occasion to speak afterwards; and here I shall merely state regarding him, that as a critic called upon to decide with regard to the authenticity and spuriousness of the different works, his merits are by no means proportionally high. He rarely or never ventures to differ from Galen, and everywhere evinces so easy a disposition to recognize the works in question as being the productions of his beloved author, that his opinion on any point connected with their authenticity is not deserving of much weight.

Haller arranges the Hippocratic treatises in the following classes: The first contains those which in all ages have been admitted as being genuine.[75] The second embraces those which contain doctrines at variance with those “of the divine old man,” or inventions of a later date, or vices which Hippocrates disclaims. The third embraces those which are manifestly spurious, as is obvious from their being mere compendia of the works of Hippocrates, or which betray a manner totally at variance with his. The fourth embraces a certain number of pieces not contained in the preceding classes. Such is Haller’s arrangement, which, however, is not entitled to much consideration; for the illustrious author himself seems to admit, candidly, that his critical knowledge of the language was too slender to warrant him in trusting his own judgment when it came into collision with any high authority, such as Foës; and, moreover, it would appear, that his edition of the works of Hippocrates had been got up in a very slovenly manner, by some incompetent person, after his death.

Gruner is one the most learned and original of our authorities on the literature of the Hippocratic works.[76] His decision, with regard to the authenticity of the different pieces, is made to rest mainly on internal evidence, that is to say, upon their possessing the proper characteristics of the language and style of Hippocrates. These he is at great pains in showing to be, in the first place, brevity, approaching to the laconic, which he justly holds with Galen[77] to be one of the most striking peculiarities of the ancient style of writing. To conciseness and simplicity, he adds gravity of manner, and an absence of all subtlety of reasoning. This last trait in the literary character of Hippocrates I hold to be particularly apparent in the works which are generally admitted to be genuine. Some stress is also laid by him on the use of the Ionic dialect, but this is a most fallacious criterion, and had better have been left out of the question altogether; as there is good reason to believe that great liberties were used with the language of Hippocrates by the ancient editors and commentators, more especially by Artemidorus Capito, who lived a short time before Galen.[78] And besides, as every person who is generally acquainted with Greek literature knows, although the Ionic dialect in the age of Hippocrates had been fused into the Attic,[79] for several centuries afterwards it continued to be arbitrarily used by many writers, both of prose and verse, owing to the high character which it possessed, as being the dialect of the Homeric poems. Hence it is used in later times, not only by the poets such as Quintus Smyrnæus, Nonnus, and Oppian, but also by at least one great medical author, I mean Aretæus. It would appear, however, that Gruner himself was sensible that much stress ought not to be laid on peculiarity of dialect; for, in resuming his conclusions as to the proper tests of genuineness in judging of the Hippocratic writings, he determines them to be conciseness and gravity of language, paucity of reasoning, and accuracy of observation, along with the authority of the ancient critics, that is to say, of the commentators. Now, it certainly must be admitted that, taken together, these principles are most just and reasonable; only it is apparent, that, like Mercuriali, he has ranked last what he ought to have laid most stress upon, namely, ancient authority. For, as remarked above, unless ancient authority had previously determined certain works in the Collection to be genuine, the modern critic would have had no premises from which he could have drawn conclusions as to the characteristics of our author’s style. Starting, then, from the principles now stated, Gruner arranges the works of Hippocrates in two divisions, namely, the genuine and the supposititous. We shall only give the former list, which embraces the following ten treatises:

1. Jusjurandum.
2. Aphorismi.
3. De Aëre, Aquis, et Locis.
4. Prænotiones.
5. Prædictionum, ii.
6. De Officina Medici.
7. Popularium Morborum, i., iii.
8. De Victu Acutorum.
9. De Vulneribus Capitis.
10. De Fracturis.

It will be shown below that in this list he has admitted one work (Prædict. ii.), which certainly has not sufficient claims to the place which he has assigned it; and, on the other hand, he has acted most inconsistently in rejecting the work “De Articulis,” while he admitted “De Fracturis,” for, as we shall see, there is the strongest reason for believing that the two originally constituted one work. But the truth of the matter is, that Gruner having hastily adopted the notion that Hippocrates was altogether ignorant of human anatomy, the celebrated passage in this treatise which so strikingly alludes to the dissection of the human body[80] would decide him to reject it from his list of genuine works.

Though Le Clerc, in his “History of Medicine” (b. iii.), shows himself to be well acquainted with the fact that many of the treatises ascribed to Hippocrates are supposititious, he nowhere lays down any rules for distinguishing the genuine from the spurious, only he insists strongly on conciseness as being one of the most striking characteristics of the style of Hippocrates, and shrewdly remarks that the treatises which abound most in reasoning are those which are most suspected of being spurious.

Schulze also, in his “History of Medicine,” with much learning and excellent judgment, enters cursorily upon the examination of the question regarding the genuineness of the works ascribed to Hippocrates, but he scarcely ever deviates from the rules laid down by Mercuriali and Le Clerc. Indeed, he almost always agrees with the latter. We shall have occasion to refer pretty frequently to his opinions when we come to give our own judgment on the authenticity of the particular treatises contained in the Hippocratic Collection.

Ackerman,[81] in the first place, gives an elaborate and very lucid exposition of the labors of all preceding critics in the same line, and then proceeds to deliver his own opinions seriatim on the different treatises. He rests his judgment generally on the authority of the ancients, and more especially of Erotian and Galen; and in so doing, M. Littré thinks he acted so judiciously, that he does not hesitate to pronounce Ackerman to be the safest guide which we can follow. Like Gruner, he divides the works into two classes, the genuine and the spurious. The former list is as follows:—

1. Epidemica, i., iii.
2. Prænotiones.
3. Prædictorum, ii.
4. Aphorismi.
5. De Victu Acutorum.
6. De Aëre, Aquis, Locis.
7. De Vulneribus Capitis.

This, it will be remarked, is the smallest list which we have yet encountered, and one cannot but feel saddened to find the remains of the great Hippocrates thus reduced to so small a compass. We shall have occasion, however, by and by, to show that Ackerman has been too unsparing in applying the obelisk[82] to treatises of suspected authenticity.

Grimm, the German translator of Hippocrates, professes also, like Ackerman, to be guided principally by ancient authority, such as that of Galen and Erotian, but he only reposes full confidence in it when confirmed by internal evidence. The style, he says, should be simple, brief, and expressive, and the language in accordance with the epoch. He adds, no hypothesis, no subtlety, however ancient, no extraordinary remedies or modes of treatment, should be found in these books. Starting from these principles, which, it will be remarked, are rather fancifully laid down, Grimm reduces the number of genuine works to the following very meagre list:

1. Popularium Morborum, i., iii.
2. Prognostica.
3. Aphorismi.
4. De Victu Acutorum, p. i.
5. De Aëre, Aquis, Locis.

The reader will not fail to remark, in this result of Grimm’s inquiry, indications of that bold spirit of scepticism for which the learned criticism of Germany has been distinguished of late—the spirit of her Wolfs and Lachmans, of her Asts and Schliermachers, which has deprived the Iliad and Odyssey of their ancient authorship, and reduced the bulky tomes of Plato to a very small volume. It is impossible not to admire the learning, the ingenuity, and the love of truth which these critics display, but surely the sober judgment of other scholars, not infected with the same spirit of innovation, will pause before acquiescing in the justness of a verdict which would deprive so many immortal performances of the prestige with which they have so long been regarded. For my own part, I would venture to say, pace tantorum virorum, that these learned critics are deficient in a practical acquaintance with the laws of evidence, and do not properly take into account that, in matters of common life, negative evidence is never allowed to bear down positive, unless the former be remarkably strong, and the latter particularly weak. When, then, the voice of antiquity pronounces strongly and consistently in favor of any work, no negative evidence, unless of a very remarkable character, ought to be allowed to counterbalance the positive. In short, what I object to in Grimm is, that he gives an undue preponderance to the internal evidence over the external, that is to say, over the traditionary evidence of antiquity, and that in this respect he goes to greater lengths than even Gruner and Ackerman.

Kurt Sprengel is the author of a separate work on the Hippocratic writings[83] which I have not seen, but I have reason to believe that the substance of it is contained in his “History of Medicine,” where (t. i., p. 295) he enters into a very elaborate disquisition on the authenticity of the works ascribed to Hippocrates. He insists much, as a test of authenticity, upon the style, which, in imitation of Galen, he describes as being concise and laconic to a degree which sometimes renders it obscure. Hippocrates, he adds, avoids all superfluous discussion and unseasonable repetitions, and expresses himself as briefly as possible, without adding conditions or restrictions. He justly remarks, that what Celsus says of Hippocrates, namely, that he separated philosophy from medicine, must be received with considerable limitations, and not in too strict a sense, as if there were no philosophical tenets in his works. On the other hand, Sprengel uses these philosophical doctrines as a guide for determining the date of the different treatises. This is a new, and no doubt a very important, element in the criticism of these works; but it is one very liable to be abused, as our information on many occasions, with regard to the introduction of new doctrines in philosophy, is by no means such as can be safely trusted to. Sprengel’s opinion on the various works in question we shall have occasion to state when we come to revise them separately.

We now proceed to the examination of the labors of two very learned and ingenious critics, Link and Petersen, who, treading in the footsteps of Sprengel, have expended much research in endeavoring to solve the question regarding the date of the Hippocratic treatises, by considering the philosophical and pathological theories which prevail in them. I think it right to state that I have not had an opportunity of consulting the work of Link, and therefore have been obliged to judge of his opinions, in a great measure, from Petersen’s essay, which is professedly based on the principles of Link. Of Peterson’s little tract, I have no hesitation in declaring that I have seldom seen a work of the kind which displays more critical acumen and deep research; and although I cannot bring myself to subscribe to many of his general conclusions, I feel bound in gratitude to acknowledge the benefits which I have derived from many of his special investigations.[84] On one important point, which he is at great pains to make out, I have already stated that I am disposed to agree with him, namely, respecting the date of our author’s birth, which I certainly think he has proved by the most unexceptionable authorities to have been considerably earlier than as generally stated. Petersen divides the Hippocratic works into nine classes, in the following chronological order:—The first contains those treatises in which the flow of bile and phlegm is considered to be the cause of disease;[85] the second recognizes fire,[86] and the third, air, as the principle of things;[87] in the fourth, bile and phlegm are spoken of as the primary humors of the human body;[88] in the fifth, spirit (πνεῦμα) and humidity are held to be the first principles of generation;[89] in the sixth, the elements of the body are held to be contrary to one another;[90] in the seventh, yellow and black bile, phlegm, and blood are set down as being the primary humors of the human body:[91] in the eighth bile, water, phlegm, and blood are held to be the primary humors;[92] and in the ninth, fire and water are held to be the principles of things.[93]

Now, assuredly, no reasonable person will deny to the author of this distribution the praise of great boldness and originality of thought. We may well apply to him the words of the poet, that if he has failed in attaining his object, “magnis tamen excidit ausis.” For my own part, I cannot but regret to see so much talent and research expended upon conjectural points of criticism, which, from their nature, can never be determined with any degree of certainty; for, after all his labors, few scholars, I venture to predict, will prefer being guided by his hypothetical reasoning, however ingenious, rather than by the authority of the ancient commentators. I must also use the liberty to remark, that M. Petersen appears to me to have no well defined ideas regarding the doctrines which the ancient philosophers held respecting the elements of things. For example, when he states, as the basis of the theory which prevails in the tract “On Ancient Medicine,” that the elements are the contraries to one another, he evidently confounds the elements, namely, fire, air, earth, and water, with the powers, or, as we should now call them, the qualities, hot, cold, moist, and dry. (See the next Section.) And although, in the treatises “On the Seventh Month Fœtus,” and “On the Eighth Month Fœtus,” much and deserved importance is attached to heat as the prime mover of conception, and although, in the treatise “On Airs,” the importance of air as a cause of disease be strongly insisted upon, one is not warranted, as he contends, in concluding that the authors of these treatises recognize respectively fire and air as the first principle of all things. M. Littré, also, in his candid reviews of M. Petersen’s work, points out some very striking oversights which M. Petersen has committed in his arrangement of the different treatises.[94]

I now come to M. Littré, who, in the Introduction to his edition of Hippocrates, has certainly surpassed all who went before him, in the extent of his labors on the general literature of the Hippocratic Treatises. How highly I estimate his work I need not here stop to declare; indeed the reputation it has already gained is so established, that it would be vain to blame and useless to praise it. I have to express my regret, however, in entering upon my exposition of his opinions, that they are given in a very expanded form, and with a degree of diffuseness, plus quam Galenica, so that I find it difficult, within my necessary limits, to convey to the reader a distinct view of the very important matters which M. Littré has brought together to bear upon his subject.

He is at great pains to establish the following positions with regard to the various treatises contained in the Collection which bears the name of Hippocrates: 1st. That the Collection did not exist in an authentic form, earlier than the date of Herophilus and his disciples, that is to say, until nearly 100 years after the death of Hippocrates. 2d. That it contains portions which certainly do not belong to Hippocrates; and, 3d, also Collections of Notes, etc., which would never have been published by the author in their present form; and, 4th, Compilations, which are either abridged, or copied word for word from other works which still form part of the Collection. 5th. As the different treatises do not belong to the same author, so neither were they all composed at the same time, some being much more modern than the others. 6th. We find in the Collection mention made of numerous treatises written by the followers of Hippocrates, which are now lost, and which were no longer in existence when the Collection was first published. 7th. The most ancient writers do not know, for certain, to whom the several works forming the Collection belonged; 8th, with the exception of a small number, which all of them, for one reason or another, agreed in attributing to Hippocrates himself.[95]

I have now a few observations to make upon each of these positions. The first, which is a most important one in connection with our present subject, I regret to say, is, I think, by no means satisfactorily made out by M. Littré. He shows, it is true, that Herophilus is the first commentator on any of the Hippocratic Treatises of whom there is any mention, but all we know of his labors in this line merely amounts to this, that he had commented on certain passages in the “Prognostics,” and probably also in the “Aphorisms,”[96] but I do not see that this amounts to any proof either that the Collection was or was not formed in his time. The proof of the second position is made to rest upon a fact, which has attracted the attention of all the critics on the Hippocratic Treatises, namely, that a memorable description of the veins, which appears in the Hippocratic treatise “On the Nature of Man,” is published by Aristotle, in the third book of his “History of Animals,” as the production of his son-in-law, Polybus. Now, M. Littré argues here, that as the publication of the Aristotelian Collection did not take place until long after that of the Hippocratic, the persons who made the latter could not have taken the passage in question from the other, and the only way in which we can account for the change of title, is by supposing that the works of Polybus had retained the name of their true author in the days of Aristotle, but had lost it at the time the Hippocratic Collection was made. Hence he infers that the Hippocratic Collection must have been made subsequently to the time of Aristotle.[97] But I must say that I do not recognize the force of this argument; for, although the whole of Aristotle’s works were not published in a collected form, until the time of Apellicon, we have every reason to believe that many of his works were published separately, in his own lifetime. The fact, then, would rather tell the other way, and it might be argued, that the Hippocratic Collection must have been made before the time of Aristotle, otherwise the persons who made it would never have fallen into the mistake of attributing to Hippocrates a passage which so high an authority as Aristotle had referred to Polybus. But the truth is, that we are not entitled to draw any positive inference from all this, with regard to the epoch in question. It is well known that, in all ages, literary publications have sometimes come abroad into the world in an anonymous shape; and it need excite no surprise that with regard to the fragment in question, as in many other cases, there should have been a diversity of opinion as to its authorship.

The third we shall see fully made out in our analysis of the different treatises given below.

The fourth will also be clearly proved, when we come to the examination of certain treatises, as, for example, the “Officina Medici.”

The fifth is not made out to my satisfaction. M. Littré, however, thinks it is satisfactorily proved that the latest epoch of these productions does not come lower down than Aristotle and Praxagoras, and none so low as Erasistratus and Herophilus. Hence he draws the conclusion that the Collection must have been made between the time of Aristotle and Herophilus.[98]

The sixth we shall see clearly made out, in our critique on the separate treatises.

The seventh is abundantly evident from what has been already stated, and will be made more apparent in the subsequent parts of this Section. But there is nothing peculiar to the Hippocratic Collection in all this, for there is as great uncertainty respecting many of the works ascribed to Plato, and other collections of pieces which have come down to us from high antiquity. Nay, every person who is conversant with biblical criticism must be aware how difficult it has proved to determine the authorship of many of the Psalms which bear the sainted name of King David.[99]

In support of the eighth position, little need be said in addition to what has been already stated. I need only repeat briefly that we have as much certainty that some of the treatises in the Hippocratic Collection are genuine, as we have that any other ancient works which have come down to us are the productions of the authors whose names they bear. But I hasten to give M. Littré’s distribution of the different works in the Collection. He divides them into the following classes.

Class I.—The Works which truly belong to Hippocrates.

1. On Ancient Medicine.
2. The Prognostics.
3. The Aphorisms.
4. The Epidemics, i., iii.
5. The Regimen in Acute Diseases.
6. On Airs, Waters, and Places.
7. On the Articulations.
8. On Fractures.
9. The Instruments of Reduction (Mochlicus).
10. The Physician’s Establishment, or Surgery.
11. On Injuries of the Head.
12. The Oath.
13. The Law.

Class II.—The Writings of Polybus.

1. On the Nature of Man.
2. Regimen of Persons in Health.

Class III.—Writings anterior to Hippocrates.

1. The Coan Prænotions.
2. The First Book of Prorrhetics.

Class IV.—Writings of the School of Cos,—of the Contemporaries or Disciples of Hippocrates.

1. Of Ulcers.
2. Of Fistulæ.
3. Of Hemorrhoids.
4. Of the Pneuma.
5. Of the Sacred Disease.
6. Of the Places in Man.
7. Of Art.
8. Of Regimen, and of Dreams.
9. Of Affections.
10. Of Internal Affections.
11. Of Diseases, i., ii., iii.
12. Of the Seventh Month Fœtus.
13. Of the Eighth Month Fœtus.

Class V.—Books which are but Extracts and Notes.

1. Epidemics, ii., iv., v., vi., vii.
2. On the Surgery.[100]

Class VI.—Treatises which belong to some unknown author, and form a particular series in the Collection.

1. On Generation.
2. On the Nature of the Infant.
3. On Diseases, iv.
4. On the Diseases of Women.
5. On the Diseases of Young Women.
6. On Unfruitful Women.

Class VII.—Writing belonging to Leophanes.

• On Superfœtation.

Class VIII.—Treatises posterior to Hippocrates, and composed about the age of Aristotle and Praxagoras.

1. On the Heart.
2. On Aliment.
3. On Fleshes.
4. On the Weeks.
5. Prorrhetic, ii.
6. On the Glands.
7. A fragment of the piece “On the Nature of Bones.”

Class IX.—Series of Treatises, of Fragments and of Compilations, which have not been quoted by any ancient critic.

1. On the Physician.
2. On Honorable Conduct.
3. Precepts.
4. On Anatomy.
5. On the Sight.
6. On Dentition.
7. On the Nature of the Woman.
8. On the Excision of the Fœtus.
9. The eighth Section of the Aphorisms.
10. On the Nature of the Bones.
11. On Crisis.
12. On Critical Days.
13. On Purgative Medicines.

Class X.—Writings now lost, which once formed a part of the Collection:

1. On dangerous Wounds.
2. On Missiles and Wounds.
3. The first Book of Doses—the Small.

Class XI.—Apocryphal pieces—Letters and Discourses.

Such is the classification of M. Littré, which he professes to have founded on the four following rules, or principles: firstly, on the authority of direct witnesses, that is to say, of authors who preceded the formation of the Alexandrian Library; secondly, on the consent of the ancient critics; thirdly, on the application of certain points in the history of medicine, which appear to him to offer a date, and consequently a positive determination; fourthly, on the concordance of the doctrines, the similitude of the writings, and the characters of the style. Of these rules, the one which he professes to have been most guided by is the first, all the others being of subordinate importance. From what has now been stated, the reader will not fail to remark that the principles upon which the classification of Littré is founded scarcely differ at all from those of Ackerman. The reasonableness of these rules, moreover, no one, I presume, will venture to call in question, whatever may be thought of the judgment with which they are applied in particular instances. My own opinions on this point I need not state here, as they will come out more properly in my own disquisition on the characters of the particular treatises.

But, before concluding this part of my task, I must not neglect to notice the learned labors of a much esteemed friend and countryman—the first, the last, the only, scholar (I lament to say) which England has produced in this department of ancient criticism—Dr. Greenhill, of Oxford, who, in his excellent article on Hippocrates in Smith’s “Dictionary of Greek and Roman Biography and Mythology,” enters into a very elaborate disquisition on the authenticity of the various works which compose the Collection. His general distribution appears to me to be very ingenious, and his judgment in particular cases most correct, but it is proper I should state that I, perhaps, am scarcely qualified to pronounce an impartial judgment on this point, having had the honor of being consulted by the author, as he himself candidly acknowledges, while he was employed on this task. On the following page is his tabular view of the different divisions and subdivisions of the Collection.

---

Having now finished this survey of the labors of preceding inquirers, I proceed to state the results of my own investigations in the same department; and in doing so, I shall give seriatim the evidence for and against the authenticity of the different treatises, along with my own decision in every instance. And, in order to add to the value of this disquisition, I mean to give an abstract of the contents of those works which I look upon as spurious, that the reader may be enabled to compare the doctrines contained in them with those which are delivered in the treatises which are recognized as genuine. Moreover, it is my object that the present volume should contain a summary of all the valuable matters to be found in the Hippocratic Treatises, whether genuine or not.

Before proceeding further, I must state the rules by which I test the genuineness of the works in the Hippocratic Collection:

1. All the works which are acknowledged as genuine by the ancient commentators and lexicographers which have come down to us, and especially by Erotian and Galen, are to be admitted as such, unless it can be shown that still older authorities held a different opinion regarding them, or that they contain doctrines and views decidedly at variance with those contained in the treatises which all allow to be genuine, or that the style and mode of handling the subject matter be altogether different from the well-known method of Hippocrates.

2. The peculiar style and method of Hippocrates are held to be—conciseness of expression, great condensation of matter, and disposition to regard all professional subjects in a practical point of view, to eschew subtle hypotheses, and modes of treatment based on vague abstractions.

The Hippocratic Collection consists of | +-----------------------+------------------------+ | | | Works certainly written Works certainly not Works perhaps written by Hippocrates, written by by Hippocrates, Class I.[101] Hippocrates. Class II.[102] | +-----------------------+-----------------------+ | | | Works earlier than Works later than Works about Hippocrates, Hippocrates. contemporary with Class III.[103] | Hippocrates. | | | +---------+-----+ | | | | Works whose Works whose | author is author is | conjectured, unknown, | Class IV.[104] Class V.[105] | +-------------------------+ | | Works authentic, but Works neither genuine not genuine, i. e. nor authentic, i. e. not willful willful forgeries, forgeries. Class VIII.[106] | +--+--------------+ | | Works by the Works by various same author, authors, Class VI.[107] Class VII.[108]

3. No treatise is to be received as genuine which is not recognized as such by any one of the ancient authorities, however strong a case may be made out in favor of its claims by modern critics from internal evidence.

I. Περὶ ἀρχαίης ἰητρικῆς—On Ancient Medicine.

Of all the treatises which are recognized as the genuine productions of “The Great Hippocrates,” by M. Littré, this is decidedly the one which possesses the most questionable title to that honor. The only ancient authority that admits it as such is Erotian; it is passed over unnoticed by Galen and Palladius; and Athenæus does not scruple to affirm, respecting it, that some considered the one half of it spurious, and others the whole. (Deipn., ii., 16.) Foës, Schulze, and Zuinger,[109] are almost the only modern names in its favor; and it is rejected by Mercuriali, Gruner, Conringius, Ackerman, and Kühn.[110] The grounds, however, upon which Ackerman decides against its authenticity are of little weight, namely, that as it is stated in it (§ 1, 2) that medical works were numerous at the time it was composed, this circumstance implies a date considerably posterior to Hippocrates. But it is to be borne in mind, that Xenophon, who was almost contemporary with Hippocrates, puts into the mouth of Socrates, who was certainly nearly of the same age, the saying, that there were many medical works then in existence (Memorab., iv.), so that at all events the argument of Ackerman falls to the ground. M. Littré, moreover, espouses its claims with remarkable zeal, and persuades himself that he has settled this point by showing that a passage in the Phædrus of Plato,[111] which is quoted by Galen, as referring to a sentiment contained in the Hippocratic treatise “De Natura Pueri,”[112] does, in fact, have reference to the work now under consideration. This position he labors hard to establish, and succeeds at last so much to his own satisfaction, that he does not hesitate to declare, as the result of his elaborate disquisition, “that he had demonstrated the treatise “On Ancient Medicine” to be the work of Hippocrates.”[113] Now, I must be permitted to say, with great deference to M. Littré, that his prolix process of argumentation, spun out as it is over twenty-six pages, does not carry the same conviction to my mind as it does to his own.[114] But still, as this treatise has, at all events, one ancient authority in its favor, and as the matter contained in it appears to me to be highly valuable, I have not scrupled to follow the example of M. Littré in placing it at the head of the Works of Hippocrates. I shall have occasion to say more on the contents of it in the Argument prefixed to my translation.

II. Προγνωστικόν—Prognostics.

Of the genuineness of this work there has never been any question, so far as I am aware, from the time of the earliest of the ancient commentators, Herophilus, down to the present day.[115] That it is an admirable specimen of the plan upon which the Hippocratic practice was founded, there can be no doubt. The most important critical question to be decided with regard to it is the relation it bears to two other treatises on the same subject, namely, the “Prorrhetica,” and “Coacæ Prænotiones,” whether the “Prognostics” be founded on them, or whether they be made up from the “Prognostics.” This question will come more properly to be discussed in the Argument to the “Prognostics.”

Of this treatise there have been the following translations into English:

“The Booke of the Presages of the Divine Hippocrates, divided into three parts, etc. By Peter Low, Arrelian Doctor in the Faculty of Chirurgery in Paris. Lond., 1597.”

“The Prognostics and Prorrhetics of Hippocrates, translated from the original Greek, with large annotations, critical and explanatory; to which is prefixed a short account of the Life of Hippocrates. By John Moffat. Lond., 1788.”

“Hippocrates on Air, Water, and Situation: or, Prognostics, etc. By Francis Clifton, M.D. Lond., 1734.”

Of these the last is the only one which possesses the slightest claim to consideration. It is the work of a scholar, who had evidently paid the most studious attention to his author with the intention of publishing a new edition of his works, a design, by the way, which it is much to be regretted, that he did not live to execute. What became of his literary labors in this department I have never been able to ascertain. The greatest fault I find with his translation is the quaintness of his style; for it cannot be alleged of him, as of Moffat, that he often mistakes the meaning of his author. The translations of the latter are utterly worthless, in fact, they are disgraceful to the translator, who ought to have been ashamed to engage in a task for which he was so utterly unqualified. The translations by Low are done in a strangely antiquated style, and otherwise have nothing to recommend them on the score of fidelity. Moreover, all these translators introduce confusion into the subject by mixing up together the contents of the “Prognostica,” “Prorrhetica,” and “Coacæ Prænotiones.” Even Clifton is guilty of this indiscretion, although better might have been expected from him; for, considering how well acquainted he appears to have been with the spirit of his author, he ought to have been able to appreciate properly the obligations which Hippocrates had conferred on his profession by methodising subject-matters which had previously been destitute of scientific arrangement.

III. Ἀφορισμοί—Aphorisms.

That the greater part of the Book of Aphorisms is the work of Hippocrates himself there can be little or no doubt, but that it contains interpolations, some of which are of high antiquity, is equally indisputable. This is distinctly stated by Galen.[116] On this subject I would beg leave to quote the remarks of Dr. Greenhill: “Some doubts have arisen in the minds of several eminent critics as to the origin of the Aphorisms, and, indeed, the discussion of the genuineness of this work may be said to be an epitome of the questions relating to the whole Hippocratic Collection. We find here a very celebrated work, which has, from early times, borne the name of Hippocrates, but of which some parts have always been condemned as spurious. Upon examining these portions, which are considered to be genuine, we observe that the greater part of the first three sections agrees almost word for word with passages to be found in his acknowledged works; while in the remaining sections we find sentences taken apparently from spurious or doubtful treatises, thus adding greatly to our difficulties, inasmuch as they sometimes contain doctrines and theories opposed to those which we find in the works acknowledged to be genuine. And these facts are (in the opinion of the critics alluded to) to be accounted for in one of two ways; either Hippocrates himself, in his old age (for the Aphorisms have always been attributed to this period of his life), put together certain extracts from his own works, to which were afterwards added other sentences taken from later authors; or else, the collection was not formed by Hippocrates himself, but by some person or persons after his death, who made aphoristical extracts from his works, and from those of other writers, of a later date, and the whole was attributed to Hippocrates, because he was the author of the sentences that were most valuable and came first in order. This account of the formation of the Aphorisms appears extremely plausible, nor does it seem to be any decisive objection to say, that we find among them sentences which are not to be met with elsewhere; for when we recollect how many works of the old medical writers, and perhaps of Hippocrates himself, are lost, it is easy to conceive that these sentences may have been extracted from some treatise that is no longer in existence. It must, however, be confessed, that this conjecture, however plausible and probable, requires further proof and examination before it can be received as true.”[117] The fact of the matter is, that interpolation is a mode of corruption from which few works of antiquity have escaped altogether free, and it was, no doubt, often practised upon them in a very innocent manner, and without any fraudulent intention. Thus, when the subject treated of by any author came afterwards to receive any notable improvements or alterations, the possessors of such a work would naturally mark them down on the margins of their MS., and these annotations in the course of transcription would often come to be incorporated with the genuine text. Such a work as the Aphorisms, consisting of detached sentences, was particularly liable to suffer in the manner now adverted to. Another mode of vitiation, which has been frequently practised upon ancient works, is the addition of appendices to them. Every classical reader must be aware that the Odyssey of Homer is generally admitted by the critics to have come down to us in this state; nay, many learned divines do not scruple to admit that certain portions of the Sacred Volume have not been exempt from this casualty. I may mention that the last chapter of the Pentateuch, the last Psalm in the Septuagint, and even the last chapter of the Gospel of St. John, have been suspected, by very able critics, of being appendices. I have stated in another place (Paulus Ægineta, Vol. III., p. 437), that an addition in this way has probably been made to the medical works of Aëtius. On the addition of appendices to works, see further, Galen (de Placit. Hippocrat. et Plat., vi., 3). Taking all this into account, it need excite no wonder that an appendix should have been added, by some unknown hand, to the seven sections of Aphorisms, and, accordingly, it is generally admitted that the eighth section is spurious.

I shall reserve my analysis of the contents of the genuine sections to the Argument prefixed to the translation.

We have the following translations of the Aphorisms into English: “The Aphorisms of Hippocrates”, translated into English:

• “By S. H. Load. 1610.”
• “By Conrad Sprengel. Lond. 1708.”
• “By T. Coar. Lond. 1822.”
• “By J. W. Underwood. Lond. 1828.”

Of these I have only carefully examined the translations by Sprengel and Coar. That of Sprengel displays considerable pretensions to erudition, but, upon a careful examination, it will be quite apparent that the translator was not possessed of a competent acquaintance either with the Greek or English language. In short, nothing can be conceived more quaint, inelegant, and inaccurate, than the language of this translation. Lest I should be suspected of prejudices against my predecessor, and of exaggerating his faults, I shall subjoin a short list of passages which I hold to be mistranslated, so that the reader may judge for himself, whether my opinion of the work be well founded or not. (See Aph. i., 11,[118] 15,[119] 20,[120] 23;[121] ii., 6,[122] 15,[123] 27, 31, 34, 40; iii., 16, 21.)

The production of Coar is not destitute of some merit, although it is but too apparent that he was not fully competent for the task which he had undertaken. He gives, separately, every Aphorism in Greek, to which he subjoins first a Latin and then an English translation. In the Preface, he admits that “in executing the English translation considerable assistance had been derived from the elegant French translation of M. de Mercy.” From this admission it will readily be gathered, that the translator felt conscious that he did not possess a proper acquaintance with the language of the original. I subjoin references to a few of the passages which, upon examination, appeared to me to be incorrectly rendered. (See Aph. i., 2,[124] 10,[125] 20;[126] ii., 49;[127] iii., 11,[128] 26, 31; iv., 1; v., 26, 44, 68.)

IV. Ἐπιδημιῶν α’ και γ’—The First and Third Books of the Epidemics.

These are among the most undoubtedly genuine remains of Hippocrates, and well sustain the high reputation of their great author. In fact, of all the earlier records of medicine, these are about the most precious which have come down to us. Although, as I have stated, no one has questioned their genuineness, Galen complains that, by some mishap or other, they had not wholly escaped from some derangement of the subject-matters which they contain, and from additions being made to them.[129]

The following, I believe, are the only English translations of them which have ever been published.

“A Comment on forty-two histories described by Hippocrates in the First, and Third Books of his Epidemics. By J. Floyer.”

“The History of Epidemics, by Hippocrates, in Seven Books. Translated into English from the Greek, with Notes and Observations. By Samuel Farr, M.D. Lond. 1780.”

The former of these I have not been able to see. The other, although it appears to have been got up with considerable care, is manifestly the work of a man not properly acquainted with the language and doctrines of his author. In proof of this, I subjoin below a few examples collected from the first book, near the beginning.[130]

V. Περὶ διαίτης ὸξέων—On the Regimen in Acute Diseases.

This work is acknowledged as genuine by Erotian,[131] Palladius,[132] and Galen,[133] and other ancient authorities, as well as by all the modern critics, from Mercuriali and Lemos down to Littré and Greenhill. The authenticity of the latter part, indeed, is questioned by Galen, who pronounces the style, theories, and language to be different from those of Hippocrates. Yet even he admits that it is of great antiquity, being more ancient than the time of Erasistratus, who lived within less than a century from the death of Hippocrates.[134] Even if not genuine, then, this part (which is published by M. Littré as an appendix) possesses great value, not only as containing important matter, but as furnishing us with the opinions of the Coan school at a very early period after the time of our author. We shall have occasion to give a fuller analysis of its contents, in the Argument prefixed to the translation of it.

VI. Περὶ ἀέρων, ὑδάτων, καὶ τόπων—On Airs, Waters, and Places.

Fortunately there are no reasonable grounds for questioning the authenticity of this highly important work. It is admitted as genuine by Erotian, Palladius,[135] Athenæus,[136] and Galen,[137] and by every one of the modern critics, with the exception of Haller, who pronounces against it upon very insufficient grounds. He argues that it is obvious, from its contents, that the author of this treatise was a European, which cannot be said of Hippocrates, seeing that his native place, Cos, was one of the Asiatic islands.[138] But, if Haller had possessed any competent acquaintance with classical literature, he must have been aware that all the inhabitants of the islands adjoining to Asia Minor were colonists from Greece, and consequently looked upon themselves as Europeans, and not as Asiatics.[139] Nor is this more remarkable than that the present inhabitants of America should rank themselves ethnologically with the Europeans, and not with the native inhabitants of the country they now occupy.

An edition of this treatise, with a French translation, was published at Paris by a learned modern Greek, Dr. Coray, in the beginning of this century; the annotations to which are highly valuable. The only English translation of it which we possess, as far as I know, is the following:

“Hippocrates upon Air, Water, and Situation. By Francis Clifton, M.D. Lond. 1734.”

This, I am inclined to think, is the best English translation which we have of any of the Hippocratic treatises. It is generally accurate, and the only drawback to it which I am aware of, is the style, which is often exceedingly quaint and obsolete. The translator, as we stated above, was well acquainted with all the works of Hippocrates, and of his painstaking industry the notes in this treatise bear undoubted evidence. Of these I have availed myself, whenever I could derive any assistance from them, but from the translation itself I have never copied literally.

VII. Περὶ ἄρθρων—On the Articulations.

This work was received as genuine by all the ancient commentators, from Bacchius and Philinus, the disciples of Herophilus, down to Erotian, Galen,[140] and Palladius.[141] It was also admitted by all the earlier modern critics, down to Gruner, who rejected it on these grounds: 1. Because it contains a reference to the treatise “On Glands,” which all acknowledge to be spurious. 2. That in the course of the work a degree of anatomical knowledge is evinced, far beyond what its actual state in the time of Hippocrates would warrant. 3. That the legend of the Amazons, which is received as true history in the treatise “On Airs, etc.” is rejected as fabulous in this work. Grimm also agrees with Gruner in condemning it as spurious; but Littré shows good reasons for admitting it into the list of genuine productions. He replies in a very satisfactory manner to Gruner’s objections. Thus he shows, in particular, what we have adverted to previously, that the knowledge of anatomy which was possessed in the Hippocratic age, had been much underrated by Gruner and others, and that the two passages in which the Amazons are supposed to be referred to, are not parallel, and do not admit of a comparison. He also very properly insists upon it, as a strong argument in favor of the genuineness of this treatise, that it had been commented upon by Ctesias.[142] The work, indeed, contains so much valuable matter, of which subsequent authors (as Celsus and Paulus Ægineta) have freely availed themselves, in handling the subjects which are treated of in it, that I have every disposition to receive it as genuine. We shall see, afterwards, that, taken in connection with the next work, it is a perfect masterpiece on the subject of Fractures and Dislocations.

VIII. Περὶ ἀγμῶν—On Fractures.

Tried by the tests laid down by us above, this treatise must undoubtedly be received as genuine. It is decidedly acknowledged as such by Palladius, Erotian, Galen, and, in short, by all the ancient authorities, and the only modern critics who venture to question its claim are Grimm, the German translator of Hippocrates, and Kühn; and, in fact, the latter does so merely in deference to Grimm, for his arguments on the question of its authenticity all tell the other way. That the treatises “On Fractures” and “On Articulations” constituted originally one work, is shown in a very convincing manner by Galen, in his introductory comment on the latter.[143] This is an additional reason for admitting the work “On Articulations” as genuine. Indeed, I do not hesitate to declare that whoever refuses to admit these two treatises as genuine, may consistently dispute the claims of any other work of the same date.

IX. Μοχλικός—On the Instruments of Reduction.

This work is quoted by Galen as one of the acknowledged books of Hippocrates,[144] and is admitted by Erotian into his list of genuine works; nay, it appears from the latter that it had been commented upon by Bacchius. Of the modern authorities, Foës and Littré concur with the ancient in admitting its claims, but it is rejected by Lemos, Mercuriali, Haller, Gruner, Grimm, and Kühn. No one who reads it carefully can fail to remark that, as stated by Galen,[145] it is a compendium of the work “On the Articulations,” so that whoever admits the latter to be genuine must acknowledge the treatise now under consideration to be one which embodies the opinions of Hippocrates, whether it were actually composed by him or not. Taking all this into account, it appears to me superfluous diligence in modern critics to search out grounds for questioning its authenticity.

X. Περὶ τῶν ἐν κεφαλῇ τρωμάτων—On Injuries of the Head.

This work is acknowledged as genuine by all the authorities, ancient and modern. The only objection to its genuineness is the appearance of certain interpolations towards the end of it.[146] This, however, as we have remarked above (No. III.), is a mode of vitiation from which few ancient works are altogether exempt.

XI. Ὂρκος—The Oath.

This interesting little piece is quoted as genuine by Erotian,[147] Theodore Priscian,[148] Soranus Ephesius,[149] St. Jerome,[150] Gregory Nazianzen,[151] Suidas,[152] and Scribonius Largus.[153] It is also received as such by Foës, Gruner, and Littré, but is rejected by Mercuriali, Schulze, Haller, Kühn, Ackerman, and other modern authorities, as quoted by Ackerman. The only reasonable grounds which I can see for questioning its authenticity is the silence of Galen with regard to it; but when we take into account that Galen has nowhere given an entire list of what he considers to be the genuine works of Hippocrates, this omission on his part may be merely incidental, and is not of much weight. On the other hand, the argument which M. Littré seeks to establish in favor of its authenticity on fancied allusions to it by Aristophanes[154] and Plato,[155] appears to me to have no weight; indeed, he himself gives up the former in another place.[156]

I have met with the following English translations of this piece, and no doubt there may be others:

“The Protestation which Hippocrates caused his Scholars to make, by Peter Low; Lond. 1597.”

“——, by Francis Clifton, M.D.; Lond. 1734.”

The translation by Low is in a quaint and antiquated style; that by Clifton is carefully done.

XII. Νόμος—The Law.

This little piece is noticed by Erotian, and admitted as genuine by M. Littré, but Mercuriali, Gruner, Ackerman, Kühn, and Greenhill incline to reject it. It is well written, but the style is rather too scholastic for the age and taste of the great Father of Medicine. At the same time, it has so many points of accordance with “The Oath,” that it seems inconsistent to admit the one as authentic and reject the other as spurious.

XIII. Κατ' ἰητρεῖον—On the Surgery.

All the ancient commentators which have come down to us, such as Erotian, Galen, and Palladius, admit it to be genuine; but it would appear from Galen that some of the older commentators were not satisfied upon this point, some doubting whether it was the production of the great Hippocrates or of Thessalus, and some referring it to Hippocrates, the son of Gnosidicus.[157] It is received also by Foës, Gruner, and, after a good deal of hesitation, by M. Littré. Schulze expresses himself on this point doubtfully,[158] and the work is rejected by Grimm, Ackerman, and Kühn. Beyond all doubt, it is a compendium of the treatises “On Fractures” and “On the Articulations,” so that, whether the composition of Hippocrates himself or not, there can be no question that the subject-matter of it is derived from him. Galen appears to have been remarkably fond of this treatise, and makes frequent reference to it in his great work “On the Dogmata of Hippocrates and Plato.” It would appear that Diocles, Philotimus, and Mantias had written treatises bearing the same title.

There is some difficulty in determining accurately what was the nature of the ancient Iatrium ιητρεῖον. See an interesting disquisition on this subject in Littré’s edition of Hippocrates, t. v., p. 25. It most probably was an establishment kept by the physician, in which were contained not only all sorts of medicines, but also all kinds of surgical apparatus. Mention of the Iatrium is made by Plato (Legg. iv., p. 720, and i., p. 646; ed. Tauch.) Aristotle is said to have possessed an Iatrium, which, if the story be true, he had no doubt acquired from his father, who was a medical practitioner.[159] From what is stated by Plato, it would appear that the assistants were qualified to administer professional assistance in the absence of their superior, and were also called doctors. (Legg. iv.) So it appears that the modern abuse of this title was sanctioned by classical usage! It must be recollected that, in the time of Hippocrates, eminent physicians were periodeutæ, that is to say, wanderers from place to place, and consequently they would stand in need of such an establishment as we have described the Iatrium to be. See further the Argument to this work.

XIV. Περὶ φύσεως ἀνθρώπου—On the Nature of Man.

Erotian, Galen, Palladius, and Macrobius[160] do not hesitate to quote the doctrines contained in this treatise as being those of the great Hippocrates, but its authenticity has long been considered very questionable, owing to the circumstance that a passage in it of considerable length, relative to the anatomy of the venous system, is quoted by Aristotle[161] as being the production of Polybus, and it is accordingly received as such by Haller,[162] Gruner, Littré, and most of our recent authorities on ancient medicine. Galen, however, contends that the passage quoted by Aristotle is not the work either of Hippocrates or of Polybus, but an interpolation, and that the rest of the treatise is genuine.[163] But Galen, at the same time, admits that Dioscorides, the Commentator (he must not be confounded with the celebrated author of the Materia Medica), had marked the first part of this treatise with the sign of the obelisk, as indicating his suspicion of its being spurious, and that he held it to be the work of Hippocrates, the son of Thessalus, that is to say, of a grandson of the great Hippocrates. But, whatever may be decided regarding its authorship, a careful perusal of the treatise will satisfy any one that it is a piece of patchwork; made up of several fragments, which do not cohere properly together. It certainly also appears to me that many of the philosophical dogmata which are delivered in it do not accord well with the doctrines contained in those treatises which are universally admitted to be genuine.

After alluding briefly to the opinions of those philosophers who held that the human body is formed from the four elements, that is to say, fire, air, water, and earth, the writer proceeds to state his own doctrines regarding the four humors, namely, blood, phlegm, yellow and black bile, and the diseases which are occasioned by the prevalence of one or other of them, according to the seasons of the year, and other circumstances. The doctrines, as herein stated, are very hypothetical, and certainly, as already hinted, not in accordance with those delivered in the genuine works. It is proper to mention, however, that Galen, in several parts of his works, makes Hippocrates to be the author of the theories of the elements and of the humors.[164] The treatise contains certain general truths and rules of practice not unworthy of some consideration, such as this, that diseases are cured by their contraries, that is to say, that diseases arising from repletion are removed by evacuation, and vice versa; and that diseases in general are occasioned either by the food we eat, or the air we breathe, those which prevail epidemically being produced by the latter cause. All sudden changes of diet are held to be attended with danger, and to be avoided. It is also an important rule of practice that, in venesection, blood should be abstracted from a part as distant as possible from the seat of the pain and of the collection of blood. There can be no doubt, in a word, as we have stated in the preceding section, on the authority of Galen, that Hippocrates was well acquainted with the principle of revulsion in the practice of medicine. The natural heat, or, as it is now called, the animal heat, is stated to be greater the younger the body is—a physiological doctrine strenuously advocated by Galen in several parts of his works, but more especially in the treatise “Against Lycus.”[165] The theory of the formation of urinary calculi is also discussed. The same occurs in the treatise “De Aëre,” etc., and in the work “De Morbis” (iv., 28). Allusion is likewise made to the occurrence of substances in the urine resembling hairs.[166] The last fragment of which this treatise is composed relates to fevers, the greater part of which are held to be occasioned by bile. It is said that there are four varieties of them, namely, synochus, quotidian, tertian and quartan; that the synochus is formed from the most intense bile, and comes soonest to a crisis, and the others in the order we have stated them. This is very unlike the doctrines of fever laid down in the genuine works, and accordingly this portion of the treatise was a great stumbling-block to those among the ancient commentators who contended for the genuineness of the treatise.[167] Altogether, then, I must say, that a careful perusal of the work leads me to the conclusion that, notwithstanding the high authorities in its favor, it does not deserve to be received as a genuine production of Hippocrates.[168]

XV. Περὶ διαίτης ὑγιεινῆς—On Diet in Health.

This work is passed over unnoticed by Palladius and Erotian; and Galen, although he wrote a commentary on it which still remains, informs us that some of the elder commentators had assigned it to Polybus, the son-in-law to Hippocrates.[169] He further mentions that it had been variously referred to Euryphon, Phaon, Philistion, and others; ancient authority in its favor is, therefore, very equivocal. The modern critics are pretty unanimous in rejecting it; indeed, Littré, improving on the hint cast out by Galen, does not scruple to refer it and the preceding treatise to Polybus. Though the subject-matters of it are not, in the main, of much importance, it contains some directions for the regulation of the diet, which are by no means injudicious. One of his directions, with regard to clothing, is very different, however, from what we might have expected, considering the fondness of the ancients for the use of oil to counteract the effects of cold.[170] The author of this work directs oily garments to be used in summer, but clean ones in winter. Emetics are recommended to be taken by persons of a gross habit of body, but to be avoided by those who are slender. This rule is expressed by Celsus in the following terms: “Vomitus inutilis gracilibus et imbecillum stomachum habentibus, utilis plenis et biliosis omnibus, si vel nimium se repleverint vel parum concoxerint.”[171] The author of this treatise recommends hyssop as an emetic, and we find its use in this way not infrequently noticed in the Hippocratic treatises, but not in the works of subsequent authorities, as far as I am aware. The work concludes with a passage on diseases of the brain, which also occurs, “De Morbis” (ii.), and seems much out of place here. It is said that they are first manifested by stupor of the head, frequent passing of urine, and other symptoms of strangury; and it is added, that a discharge of water or of mucus by the nose or ears relieves these complaints.

Altogether, considering how slender the evidence is, both external and internal, in favor of the authenticity of this treatise, I can have no hesitation in rejecting it as spurious.

XVI. Προρῥητικον, α’—First Book of Prorrhetics.

XVII. Κωακὰι προγνώσεις—Coan Prognostics.

These two works are so evidently allied to one another, that I have judged it expedient to treat of them together. The greatest difference of opinion has prevailed among the critics, both ancient and modern, with regard to them. Erotian declares expressly that the “Prorrhetics,” both first and second, are not genuine; and Galen, although he writes a commentary on the first book, complains of the difficulty he experienced in explaining certain vocables of dubious meaning contained in it,[172] and elsewhere states that the treatise is composed of extracts from the “Prognostics,” “Epidemics,” and “Aphorisms.” Foës is almost the only modern scholar of any note who stands up for the genuineness of the first book of the “Prorrhetics;” and it is decidedly rejected by Grimm, Ackerman, Haller, Littré and nearly all the other modern authorities. The “Coacæ Prænotiones” have very little ancient authority in their favor, and even Foës rejects the work with greater disdain than it would seem to merit. Of late years, the opinion has gained pretty general assent that these two treatises are more ancient than the days of Hippocrates;[173] that, in fact, they constitute the materials out of which he composed the “Prognostics,” and are the results of the observations made by the priest-physicians in the Asclepion, or Temple of Health, at Cos. This idea is followed out with great ability by Dr. Ermerius, in his “Specimen Historico-Medicum Inaugurale de Hippocratis doctrina a Prognostice oriunda,” where, by a most ingenious and convincing process of comparison, he appears clearly to make out that the “Coacæ Prænotiones” are formed from the first book of the “Prorrhetica,” and the “Prognostics” from the “Coacæ Prænotiones.” These positions, I repeat, he seems to me to have established most satisfactorily, and I cannot hesitate to declare it as my opinion that Dr. Ermerius has thereby thrown great light on this department of the Hippocratic literature. M. Littré has justly appreciated the labors of Dr. Ermerius, and adopted his views without reserve. (v. i., p. 351.) As I shall have occasion to compare the contents of these two treatises now under consideration with the subject-matters of the “Prognostics” in my Argument to the latter, I shall confine myself at present to a few observations, selected in a good measure from M. Littré’s argument to the “Coacæ Prænotiones.”

In the first place, M. Littré makes some interesting remarks on vomicæ of the chest after pneumonia and pleurisy; but this subject will come to be treated of in the notes on the “Prognostics.” He next gives some important observations on the following passage in the “Coacæ Prænotiones,” § 418: “All sprains are troublesome, and cause intense pains at the commencement, and in certain cases occasion after-consequences; the most troublesome are those about the breast, and the most dangerous are those in which there is vomiting of blood, much fever, and pain about the mammæ, chest, and back; when all these occur, the patients quickly die; but in those cases in which they do not all occur, nor are severe, they are longer protracted; the inflammation at farthest is protracted to forty days.” He relates, in illustration of this passage, a case very much in point, from the “Journal de Médecine,” Juillet, 1843, of a healthy person who, in lifting a log of wood, strained the parts about the chest so as to experience a cracking sensation about the breast; it was followed by intense inflammation, which, in spite of plentiful depletion, ended in an empyema which opened by the fifth intervertebral space. The patient recovered. This case is a good illustration of a species of accident frequently described in the Hippocratic Collection. He then briefly considers the question whether or not Hippocrates was acquainted with the croup, on which he does not give any decided opinion. In my opinion, the term croup is now used in a vague sense, being applied to cases of angina, in which the inflammation spreads down to the glottis and trachea, and also to cases of bronchitis attended with a croupy cough. I am confident that pure cynanche trachealis, that is to say, acute disease originating in the trachea, is of very rare occurrence, at least, it certainly is so in the north of Scotland. That the ancients were well acquainted with that species of cynanche in which the disease spreads down to the windpipe there can be no doubt. See the Commentary on §§ 26, 27, Book III., of Paulus Ægineta. It may reasonably be doubted whether they were not fully as well acquainted with diseases of the fauces and windpipe as the moderns are.

M. Littré’s observations on sphacelus of the brain do not at all accord with the opinions of Dr. Coray,[174] nor with those advanced in the Commentary on Paulus Ægineta, B. III., § 7. He thinks that Hippocrates meant by it necrosis of the cranium. Although I still so far adhere to my former opinion that by sphacelus was generally meant ramollissement of the brain, I must admit that some of the passages in the Hippocratic Collection, where it is described, would bear out M. Littré’s ideas regarding it. On the subject of sphacelus, see “De Morbis,” near the beginning.

M. Littré draws, from a variety of sources, much interesting matter in illustration of § 500 of the “Coacæ Prænotiones:” “Amaurosis is produced by wounds in the eyelash, and a little above it; the more recent the wound, they see the better; but when the cicatrix becomes older the amaurosis increases.” Plattner[175] held that in this case the amaurosis is connected with lesion of the frontal nerve. Beer[176] shows that the affection of the sight is not connected with injury of the nerve, but is rather the result of concussion of the ball of the eye. Walker, and Littré himself, are rather disposed to question altogether the truth of the statement made by Hippocrates.

M. Littré concludes his argument with some observations on the lethargus of the ancients, which he holds, and correctly, as I think, to be a pseudo-continual fever. My own opinion, as delivered in the Commentary on Book III., § 9, of Paulus Ægineta, will be found to be very similar. Lethargus is there stated to have been a species of remittent fever, resembling the causus. M. Littré, further in illustration of this subject, gives from the works of Mr. R. Clark, an English physician at Sierra Leone, an interesting account of a sleepy-dropsy, to which the Negroes there are subject.

The greater part of the contents of these treatises are mixed up by Clifton with his translation of the “Prognostics;” and Moffat gives a complete translation of this book of the “Prorrhetics.” The latter, like all the other translations by the same hand, is utterly worthless. Clifton is only culpable for having introduced confusion into the contents of works which had been so admirably arranged by Hippocrates.

XVIII. Προῤῥητικόν, β’—The Second Book of Prorrhetics.

The reception which this work has met with from the critics, ancient and modern, appears rather singular. Erotian and Galen, who, in general, are too facile in admitting the claims of suspected works, in the present instance reject a work which many modern authorities acknowledge as genuine; as, for example, Haller, Gruner, Grimm, and, with certain qualifications, Ackerman and Kühn. I must say, however, with Foës, Littré, and Greenhill, that I cannot see how we can consistently recognize as genuine a work which has so large an amount of ancient authority against it, and none in its favor. At the same time, all must admit that the treatise in question contains nothing unworthy of the name of Hippocrates, and that, if estimated by the value of its contents, it is one of the most important works in the whole Collection. I will, therefore, give an abstract of its contents, along with my translation of the “Prognostics.” It is deserving of much attention, as being the only work we possess which gives us an insight into the method taken by the ancient physicians to gain the confidence of their patients by their mode of conducting the preliminary examination of every case. In my younger days I knew an old physician, who was an adept in this art of conciliating the confidence of his patients by anticipating their histories of their own complaints.

XIX. Περὶ ἑλκῶν—On Ulcers.

This treatise is decidedly admitted as genuine by Galen,[177] Erotian, Celsus, and by Foës, Lemos, Mercuriali, Schulze,[178] and Vidus Vidius,[179] but is rejected by Haller, Gruner, Ackerman, and Kühn, on internal evidence, the nature of which we shall presently examine. M. Littré in so far concurs in the judgment of the authorities who reject it, although he does not admit the grounds of their decision. Gruner’s principal, indeed I may say his sole, argument against the authenticity of this work is founded on the nature of the substances recommended by the author for the treatment of ulcers; namely, such acrid and (as Gruner chooses to call them) absurd medicines as arsenic, black hellebore, and cantharides. But how does it appear that these are “absurd” applications to ulcers, when even at the present day the two strongest of them, namely, arsenic and cantharides, are the means often resorted to for the cure of indolent and malignant ulcers? The same articles are recommended by Celsus (v.), and by Paulus Ægineta.[180] It is true that the titles given to certain of the prescriptions contained in this treatise are not appropriate, such as emollient (μαλθακώδεα), applied to applications which contain many acrid ingredients. But in this case, as is remarked by Foës, we should consider the text to be in so far corrupt, for certainly this does not constitute a legitimate reason for rejecting the treatise in toto.

Vidus Vidius, in his interesting commentary on this work, mentions, as a proof of its authenticity, that most of the principles laid down by Galen for the treatment of ulcers, are taken from this part of the works of Hippocrates. In a word, agreeably to the rules laid down by me for testing the authenticity of these treatises, I do not see that I am warranted in refusing to admit the claims of this work to be considered genuine. I hold myself bound, therefore, to give a translation of it.

It may be proper in this place to mention that the term ulcer (ἕλκος) is used in this treatise to signify both a wound inflicted by an external body, and a solution of continuity from any internal cause. This usage of the word is sanctioned by the older poets, as, for example, Homer (Iliad, ii., 723; Ib., xiv., 130); Pindar (Nem., viii., 50; Pyth., iii., 84); and Bion (Adonis).

XX. Περὶ συρίγγων—On Fistulæ.

Though this work be acknowledged as genuine by Erotian, Dioscorides, Celsus, Paulus Ægineta, and by Foës and Vidus Vidius, it is set down for spurious by Haller, Gruner, and Ackerman; and even by Littré and Greenhill its claims are not fully recognized. I can see no good reason, however, for rejecting it, since, as I have stated, the ancient authority in favor of it is very strong, and I can detect nothing in the doctrines and rules of practice delivered in it which are at variance with those laid down in the treatises which all admit to be genuine. Ackerman, indeed, pretends that the theory of bile and phlegm, as being the cause of disease, does not belong to Hippocrates or his school. But this is evidently begging the question; and, moreover, Galen, who must be admitted to be a high authority in such a case, decidedly holds Hippocrates to be the author of the Theory of the Humors.[181] Galen seems to say that this treatise, and the following one on hemorrhoids, constituted one work in his time; and he does not throw out the slightest suspicion against the genuineness of either, as the words of Ackerman would lead one to suppose.[182]

Vidus Vidius, although he acknowledges Hippocrates as the author of this work, holds that it had not been published by him, but had been left in an unfinished state. The argument, however, which he uses in proof of this opinion, is by no means convincing; he contends that the part which relates to inflammation of the anus is quite out of place in a work devoted to the consideration of fistulæ. But few who have much practical acquaintance with the subject will agree with him on this point, for it is well known that fistulæ, for the most part, originate in inflammation and abscess about the verge of the anus.

XXI. Περὶ αἱμοῤῥοιδων—On Piles.

This little tract has experienced the same reception from the critics as the preceding one, that is to say, it is acknowledged as genuine by ErotianΠερὶ αἱμοῤῥοιδων and Galen, and by Foës and Vidus Vidius, but is decidedly rejected as such by Mercuriali, Gruner, Grimm, and Ackerman. I can remark nothing in it, however, which appears to me at all inconsistent with the doctrines contained in the genuine works, unless it be that in this tract the author appears to direct that in operating upon hemorrhoids they should be all extirpated, whereas in one of his Aphorisms, which is quoted by Paulus Ægineta, in his chapter on this subject, he recommends that one should be left, as an outlet to the superfluous blood. (vi., 79.) I do not know how this divergence of opinion is to be explained, but, at all events, such an apparent contradiction would not warrant us in rejecting the treatise altogether.

XXII. Περὶ ίερῆς νούσου—On the Sacred Disease.

This work is acknowledged as genuine by Erotian, Galen,[183] and Cælius Aurelianus,[184] but is rejected by Lemos, Mercuriali, Haller, Gruner, Ackerman, Kühn, and even by M. Littré, although the last of these admits that the grounds upon which it had been refused a place among the genuine works are very equivocal. I feel very much at a loss what to decide with regard to it. It is unquestionably the work of a man possessed of a highly cultivated mind, free from the popular superstition of his age, and familiarly acquainted with comparative anatomy, and having no contemptible knowledge of human physiology. There is, in fact, no name, whether in ancient or modern times, to which it might not do honor. That it is not unworthy, then, of the great Hippocrates, all must allow, but whether or not he be the actual author of it, there is much difficulty in determining satisfactorily. That, in certain respects, it is very unlike his other works, must be admitted; the talent which it displays is more of a reflective than of a perceptive nature, which is the reverse of the common character of Hippocrates, who, in his genuine works, evidently evinces a disposition to trust to accurate observation rather than to acute ratiocination. The style, too, I must admit, is more diffuse than the true Hippocratic style generally is. All this might, no doubt, be accounted for, upon the supposition that the work was addressed to the general reader, and not to the professional. Other reasons might be imagined, to account for the diversity of style and matter, but these I shall not occupy time in discussing, as I have decided upon giving a translation of it, so that the English reader may be enabled to judge for himself as to its genuineness. Whether the tract in question be the work of Hippocrates, or, as some have supposed, of his philosophical friend Democritus,[185] there can be little or no doubt that it is a production of that age, for it appears to me that their contemporary, Plato, has evidently made reference to it. Thus, in that portion of his “Timæus” which treats of the causes of diseases, he clearly seems, in accounting for epilepsy, to have had in view the doctrines contained in this treatise. For although he uses the term “sacred disease,” and applies “most divine,” as an epithet to the cavities (ventricles?) of the head, he still, in imitation of the author of this work, accounts for the disease upon natural causes, that is to say, from derangements of the pneuma and phlegm.[186]

XXIII. Περὶ φυσὠν—On Airs.

This treatise deserves, in many respects, to be put in the same category as the last; that is to say, it is generally admitted by the ancient authorities, but rejected by the modern. Thus it is noticed as genuine by Erotian and Galen, and by Gregory Nazianzen and Stobæus.[187] On the other hand Mercuriali, Le Clerc,[188] Haller, Gruner, Ackerman, and Kühn reject it. M. Littré, also, in deference to the opinion of later critics, refuses it a place in his list of genuine works, but, at the same time, expresses himself doubtfully on this point. Le Clerc, although, as we have stated, he inclines to the opinion of those who reject it, does not hesitate to declare, “that this book, upon reading it, seems to be one of the most rational and coherent of all Hippocrates’s works.” And I in so far agree with Le Clerc, that the contents of it are of great importance for the right understanding of the ancient theory of medicine, whether we refer the tract in question to Hippocrates or not. I shall now give a summary of the doctrines contained in it, which I must say appear to me to smack rather of the school of philosophy, than of the practical good sense for which the author of the First and Third Epidemics, and of the Prognostics, is so remarkable.

The author sets out with stating “that there are certain arts which are of laborious acquisition, but are profitable to those who practise them; of general utility to the common people, but painful to those who exercise them. Of such a nature is the art of medicine. The physician contemplates dreadful things (δεινὰ), comes in contact with what are unpleasant, and reaps sorrow to himself from the afflictions of others; but the sick are freed from the greatest evils by the art, namely, from diseases, pains, sorrow, and death; for medicine has been found decidedly to be a cure for all these. In the manual parts of medicine (surgery) practice is necessary. For in all that relates to manipulation, usage is the best teacher. But with regard to the most obscure and difficult diseases, a judgment is to be formed rather from opinion than art; and it is in such cases that experience differs much from inexperience. And it is a most important consideration to determine what is the cause of diseases, and what the beginning and fountain-head, as it were, of the evils in the body; for if one be acquainted with the cause of the disease, he may be able to apply the suitable remedies to the affections of the body, judging of diseases from their contraries: for this mode of cure is that which is most in accordance with nature. Thus, for example, hunger is a disease; for whatever afflicts man is called a disease. What, then, is the cure of hunger? Whatever will allay hunger, that is to say, food, and by it the other is to be cured. Again, drink cures thirst; and, moreover, evacuation cures repletion, and repletion evacuation, and rest labor, and labor rest; and, in a word, the contraries are the cure of contraries. For medicine consists of addition and subtraction—the subtraction of what is redundant, and the addition of what is deficient. And he that does these things best, is the best physician; and he that is most removed from this system, is the most removed from a knowledge of the art. The manner of all diseases is the same, but they differ in place; and hence diseases appear to have no resemblance to one another, owing to the diversity and dissimilarity of situations. For there is but one form (ἰδίη) of all disease, and the cause is the same. What that is I will attempt to explain in the following discourse. The bodies of men and of other animals are nourished by three kinds of aliment, namely, food, drink, and airs; and those winds in the body are called spirits, which are named airs out of it. This it is which exercises the greatest power over the symptoms, and it is worth while to attend to the power of it; for the wind is a current and stream of air. When, then, much air makes a strong current, trees are torn from their roots by the force of the blast, and the sea is raised in billows, and ships of immense size are tossed aloft. Such power it possesses, and yet it is invisible to the sight, and is manifest only to the understanding. And what would there be without it, and from what thing is it absent? and with what is it not present? For the whole space between the earth and heaven is full of air, and it is the cause of winter and of summer; in winter becoming condensed and cold, and in summer mild and tranquil. The path also of the sun, moon, and stars is through air—for air is the pabulum of fire, and fire deprived of air could not live.... And with regard to the sea, that it contains a portion of air is obvious to everybody. For water-animals could not exist if they did not participate in the air; and how could they participate in it otherwise, except by means of the water, and by drawing in the air along with it. And the moon’s foundation is upon it, and this it is which supports the earth,[189] and nothing is void of it. And why the air is possessed of such power in other things has been now stated; but in men this is the cause of life, and of disease to those who are in ill health. And all bodies stand so much in need of air, that whereas if deprived of everything else, such as food and drink, a man may subsist for two, three, or more days; if the passage of air into the body be stopped, he will perish in a short part of a day, so necessary is air to the body. And, besides, there is some intermission of every other operation which men perform, for life is full of change; but this operation alone living animals perform incessantly, sometimes inspiring, and sometimes expiring. That all living animals, then, are closely connected with air has now been shown. After this we must forthwith declare what infirmities probably arise in an especial manner from this source—when it is redundant or deficient in quantity, or when polluted with morbific miasmata it enters the body. That diseases are the offspring of air I will show from the most common of all diseases, I mean, fever; for this disease accompanies all others, and most especially inflammations. This is well illustrated by the accidents which befall the feet; for along with the inflammation a bubo and fever speedily supervene. There are two kinds of fever (that I may touch upon that subject); the one common to all, which is called the plague, and the other being connected with vitiated food in those who use it. The air, then, is the cause of both these. A common fever (epidemic?) therefore is such, because all draw in the same breath (pneuma).” The author afterwards attempts an explanation of the phenomena of rigors, which, however, is not very intelligible, and then of the febrile heat and sweats which succeed them. The latter he compares to the condensed steam of boiling-water. He afterwards proceeds to explain that when the blood is mixed up with vitiated air (gases?), it occasions diseases in various parts of the body; for example, pain in the eyes, when it fixes there; when in the ears, the disease is seated there; when in the nose, coryza is the consequence; and when in the chest, branchus (bronchitis?), and so forth. To the same cause he ascribes the origin of dropsy, namely, to the prevalence of airs, and the melting down of the flesh. He also accounts for the formation of apoplexy, by supposing that it arises from the flesh of the parts being filled up with gases; and in the same way he explains the origin of epilepsy very elaborately, and most ingeniously, but at too great length to suit my limits in this place. Altogether the treatise is one of the most interesting pieces of medical philosophy which has come down to us from antiquity. It shows very decidedly what a talent for dealing with abstract ideas the ancient Greeks were endued with.

XXIV. Περὶ τόπων τῶν κατ’ ἄνθρωπον—On the Places in Man.

The ancient authority in favor of this treatise is pretty strong. It is included in Erotian’s list, is quoted by Cælius Aurelianus,[190] and by Ruffus Ephesius,[191] and is incidentally noticed by Galen in two places of his Glossary.[192] That it is further quoted by Athenæus, as stated by Gruner and Ackerman, would appear to me to be a mistake.[193] It is admitted to be genuine by Le Clerc, Schulze, Haller, Triller, Sprengel, Zuinger, Petersen, and others. It is rejected, however, by Lemos, Mercuriali, Duret, Reinsius, Gruner, and Ackerman. M. Littré does not venture to assign it a place among the genuine treatises, and yet he evidently inclines to the opinion that later critics had rejected it on very doubtful grounds, and leaves the question undecided. The following summary of its contents will show that it is not destitute of valuable matter.

The author of it commences with announcing this important physiological principle, which microscopical observations on the development of the chick have amply confirmed: “It appears to me that in the body there is no beginning, but that all parts are alike beginning and end; for in a described circle no beginning is to be found.” He goes on to remark that, in consequence of this, diseases affect the whole body; that when seated in the dry parts of it they are more permanent, but when in the fluid, more changeable: that one part of the body imparts disease to the other parts, namely, the stomach to the head, and the head to the stomach; and that if the very smallest part of the body suffer, it will impart its suffering to the whole frame. He afterwards enters into a lengthened anatomical description of the parts of the body which, although quoted by Galen,[194] and not unfavorably noticed by Gruner,[195] cannot now command much interest. He then describes seven defluxions from the head, namely, to the nose; to the ears; to the eyes; to the chest—producing empyema and phthisis; to the spine—producing another species of phthisis (tabes dorsalis?); to the fleshy parts—inducing dropsy; and to the joints—occasioning ischias and kedmata (morbus coxarius?) All this seems very hypothetical, and does not appear to savor of the strict process of induction which we remark in the genuine treatises of Hippocrates. When the disease is seated in the head, he directs numerous and deep incisions to be made in the scalp, down to the bone. He notices pleurisy, and its termination in empyema; the latter, he further remarks, may originate in ruptures (sprains?), and in this case, on succussion, an undulatory sound may be heard. He also states decidedly that empyema forms in phthisical persons, and that, in their case, too, a sound like that of water in a bladder may be heard on succussion. The symptoms accompanying empyema are given very graphically. He also describes the tabes dorsalis. He afterwards gives the treatment of pleurisy and pneumonia, in which it is remarkable that no mention is made of venesection, notwithstanding that, in the work “On Regimen in Acute Diseases,” Hippocrates recommends bleeding ad deliquium in these diseases; and Galen accounts for his silence respecting venesection in his treatment of fevers on the supposition that he did not notice it, because he took it for granted, as a general rule, that the operation was performed.[196] This consideration, as much as any other, inclines me to doubt the authenticity of this treatise. Ischiatic disease he directs to be treated by cupping-instruments and heating medicines, administered internally. Anasarca, in a young person, he treats by scarifications. In the brief notice of injuries of the head here introduced, much the same views are advocated as in the work on that subject, of which a translation is given in this volume. The treatment of callous ulcers, as here laid down, is deserving of great attention; “remove the indurated parts by a septic medicine, and then produce reunion of the parts.” Every practical surgeon must recognize this as a very sound and important rule of practice.

The treatment of suicidal mania appears singular:—“Give the patient a draught made from the root of mandrake, in a smaller dose than will induce mania.” He also, in like manner, recommends mandragora in convulsions, applied by means of fires lighted around the patient’s bed. Pains of the head he directs to be treated by opening the veins of the temples, or by applying the cautery to them. He then insists, in strong terms, that, under certain circumstances, purgatives will bind the bowels, and astringents loosen them. And he further makes the important remark that, although the general rule of treatment be “contraria contrariis curantur,” the opposite rule also holds good in some cases, namely, “similia similibus curantur.” It thus appears that the principles of Allopathy and Homœopathy are recognized by the author of this treatise. In confirmation of the latter principle, he remarks that the same substance which occasions strangury will also sometimes cure it, and so also with cough. And further, he acutely remarks, that warm water, which, when drunk, generally excites vomiting, will also sometimes put a stop to it by removing its cause. He estimates successful and unsuccessful practice according to the rule whether the treatment was rightly planned or not; for he argues what is done in ignorance cannot be said to be correctly done, even if the results are favorable. The work concludes with a short passage on the diseases of women, all of which are said to be connected with the uterus. We find here the first mention that is anywhere made of the globus hystericus; indeed, I do not remember to have met with the term in any of the ancient medical works, with the exception of the Hippocratic treatises. He recommends fetid things to be applied to the nose, and aromatic and soothing things to the genital organs. The process of fumigating the uterus is fully described; and likewise suppositories and pessaries are mentioned. In the treatment of uterine hemorrhage the rules here laid down are most important. All heating things, diuretics, and purgatives are to be avoided; the foot of the patient’s bed is to be raised, and astringent pessaries are to be introduced. My own opinion of the work may now be given in a few words. It undoubtedly contains much valuable matter which would be no discredit to Hippocrates, nor to any of the greatest medical authorities, whether of ancient or modern times. I desiderate in it, however, a proper unity of design, and think I see too much of a speculative disposition to suit with the character of the Coan sage. That it is to be referred to the Cnidian school, as suggested by Gruner, seems doubtful; for, as we are informed by Hippocrates himself, the Cnidian physicians only gave the most obvious symptoms, while their practice was very inert, consisting entirely of drastic purgatives, whey, and milk, whereas in this work the diagnostic symptoms are more profoundly stated then they are in most of the Hippocratic treatises, and the practice, in many instances, is very bold and decided. The knife, the actual cautery, the use of strong purgatives and narcotics, are freely recommended in various diseases. Altogether, then, although I would hesitate to ascribe the present work to Hippocrates himself, I must admit myself inclined rather to refer it to the Coan than the Cnidian school. I see no proper data, however, for forming a decided opinion on this head, more especially as we are but very imperfectly acquainted with the tenets of the Cnidian school.[197]

XXV. Περὶ τέχνης—On Art.

This treatise is sustained as genuine by Erotian, and even by one of the older commentators, Heraclides of Tarentum, but it is nowhere noticed by Galen, and Suidas would appear to refer it to Hippocrates, the son of Gnosidicus.[198] Mercuriali, Gruner, Haller, Ackerman, Kühn, and most of the modern authorities hold it decidedly to be spurious. Foës and Zuinger, however, do not object to its authenticity; and Littré, although he excludes it from his list of the genuine works of Hippocrates admits that it is very ancient, and formed a portion of the Collection from the commencement. To me it appears that it is written in too subtle and abstract a style to admit the supposition of its being the work of a practical physician like Hippocrates. Although it contains a good deal of original thought, there is not much in it which would prove interesting to the medical reader of the present day. It is an elaborate defense of the art of medicine against the attacks of those who maintain that it is no art at all, or one of an uncertain nature. According to the author’s definition, the aim of the physician should be to remove the pains of the sick, to blunt the intensity of diseases, and not to interfere with those that are mastered by disease, as knowing that medicine can be of no avail in such a case. In conclusion, I shall merely remark that the evidence, both internal and external, is against the supposition of its being genuine, but still there appears no good reason for doubting that it emanated from the school of Cos.

XXVI. Περὶ διαιτης—On Regimen.

The evidence in favor of this large and interesting work, unfortunately, is by no means strong. It is passed by unnoticed by Erotian, and Galen expresses himself, in general, regarding the work in very equivocal terms, mentioning that some had referred it to Euryphon, some to Phaon, others to Philistion, and others, again, to Aristo.[199] In other places, however, he expresses himself less unfavorably as to the authenticity of the last two books. Haller, Gruner, Ackerman, Kühn, and, in fact, nearly all the modern authorities, reject it.[200] M. Littré, although he agrees with them, remarks justly that the work is one of great value, and exhibits many evident traces of conformity with the writings which are truly Hippocratic.

The nature of the work is as follows: The first book is altogether made up of abstract principles, which savor very much of the dogmata of Heraclitus. Thus, the author of it holds that there are in men, and in all other animals, two principles, different in power but consentaneous in use, namely, fire and water; that these together are sufficient for all others, and for themselves; that the one contains the principle of motion, and the other of nutrition; that these give rise to the separate existence of seeds and animals, of all varieties, shapes, and characters; that, in reality, none of those things which exist either perish or are created, but they are altered by being mixed together and separated from one another, but that men suppose that the one passes from Hades to light, and the other again from light to Hades. In a word, the contents of the first book savor more of philosophy than of practical medicine. For example, it is said, “The trainers of the athletæ instruct their pupils in this manner—to break the law according to law, to commit injustice according to justice; to deceive, to steal, to rob, to commit violence, in the most elegant and disgraceful manner: he who cannot do these things is bad, he who can do them is good; which is a proof of the folly of the many who, when they behold these things decide that the one of these is good and the others bad. Many wonder, but few are judges. Men going to the market proceed thus: they deceive one another in buying and selling, he who deceives most is admired. They execute these things—they drink and become mad, they run, they wrestle, they fight, they steal, they cheat; the one is preferred to all the others. Hypocrites and deceivers! Before the spectators they say one thing. and think another.[201] The same persons creep out, and they creep in not the same persons; to one man they say one thing, and do another; the same person not always the same—sometimes he has one mind, and sometimes another. In this manner all the arts have communion with human nature.” All this is too fanciful and recondite for the physician of whom Celsus says “primus ex omnibus memoria dignis ab studio sapientiæ disciplinam hanc separavit.” It is clearly the production of a philosopher and not of a practical physician, such as we know Hippocrates to have been. The latter part of this book, however, is of a more practical nature, and treats of many things relating to regimen and dietetics, such as the arrangement of meals, of exercises, etc.

The second book is a regular work on Dietetics, and exhibits this branch of medicine in a more advanced state than might have been expected, considering the time it was written. After some preliminary observations on climate, which bear a great resemblance to those contained in the treatise “On Airs,” etc., the author treats, in a very scientific and methodical manner, of the various animal and vegetable substances which are used as articles of food. It concludes with a discussion on certain matters connected with regimen, such as exercises, baths, sleep, and so forth. Foës remarks that a great portion of the opinions advanced by Celsus on the head of Dietetics is borrowed from this book.

The third book treats again of various subjects connected with Dietetics, such as exercises, the arrangement of meals, the administration of emetics, the use of venery, and the like. It is full of important matter, but looks like a distinct treatise from the two preceding books, for one cannot conceive that the author of one work would have twice resumed the consideration of the same subject. Le Clerc, with considerable appearance of reason, ascribes the book to Herodicus, the master of Hippocrates in the gymnastic art.[202]

Altogether, the work is one of the highest importance in medical literature, whether we ascribe it to Hippocrates or not. On this point the evidence, both external and internal, we have seen to be very inconclusive. The most probable conclusion that can be drawn regarding it is, that the work is a compilation of important documents from a variety of sources, but who the compiler was, whether Hippocrates or one of his successors cannot be determined.[203]

XXVII. Περὶ ἐνυπνίον—On Dreams.

This little work is generally admitted to be a continuation of the preceding one, and consequently stands upon much the same grounds as regards its authorship.[204] As Le Clerc and Gruner have well remarked, it is written with much acumen, and evinces great freedom of spirit, and exemption from popular errors and superstitions. It commences in the following strain:

“He who forms a correct judgment of those signs which occur in sleep, will find that they have a great efficacy in all respects; for the mind is awake when it ministers to the body, being distributed over many parts; it is not then master of itself, but imparts a certain portion of its influence to every part of the body, namely, to the senses, to the hearing, seeing, touch, walking, acting, and to the whole management of the body, and therefore its cogitations are not then in its own power. But when the body is at rest, the soul, being in a state of movement, steals over the organs of the body, manages its own abode, and itself performs all the actions of the body; for the body, being asleep, does not perceive, but the soul, being awake, beholds what is visible, hears what is audible, walks, touches, is grieved, reflects, and, in a word, whatever the offices of the soul or body are, all these the soul performs in sleep.[205] Whoever, then, knows how to judge of these correctly, will find it a great part of wisdom. But with regard to such dreams as are divine, and prognosticate something, either good or evil, to cities, or to a particular people, there are persons who have the art of judging of them accurately, without falling into mistakes. But such affections of the body as the soul prognosticates, namely, such as are connected with repletion and evacuation, from the excess of customary things or the change of unusual things, on these also persons pronounce judgment, and sometimes they succeed, and sometimes they err, and understand neither how this happens, that is to say, how it comes that sometimes they are right, and sometimes they fall into mistakes; but warning people to be upon their guard lest some mischief befall them, they do not instruct them how to guard themselves, but direct them to pray to the gods; and to offer up prayers is no doubt becoming and good, but while praying to the gods a man ought also to use his own exertions. With regard to these, then, the matter stands thus: Such dreams as represent at night a man’s actions through the day, and exhibit them in the manner in which they occur, namely, as performed and justly deliberated, these are good to a man, and prognosticate health, inasmuch as the soul perseveres in its diurnal cogitations, and is not weighed down by any repletion, evacuation, or any other external accident. But when the dreams are the very opposite to the actions of the day, and when there is a conflict between them—when this happens, I say, it indicates a disorder in the body; when the contrast is great, the evil is great, and when the one is small the other is small also.” For the cure of this state, as being connected with repletion, he recommends evacuation by vomiting, active exercise, and a restricted diet. The author of the treatise proceeds to state the signification of dreams which relate to the sun, moon, and stars, of which the last are said to be connected with the external parts of the body, the sun with the middle, and the moon with the cavities. This is the nearest approach to alchemy which I have met with in the works of any of the ancient physicians. But I must not proceed much further with my extracts from this work, which there is no reason to suppose a genuine production of Hippocrates, and the substance of which would not much interest the general reader nowadays, when the interpretation of dreams has been entirely abandoned by the profession. The work concludes as follows:

“He who observes these rules as laid down by us will be healthy through life.... The regimen, also, as far as it was possible for a man to find it out with the assistance of the gods, has been expounded by me.” This looks like the conclusion of a large work, and gives probability to the supposition that this treatise originally formed a part of the work “On Diet,” as stated above.[206]

It would appear that this work, although little regarded now, was highly esteemed two hundred years ago, for we find that the celebrated Julius Cæsar Scaliger wrote an elaborate commentary on it.[207] On the “Oneirocritica,” see further Vander Linden, “Manuductio ad Mediciam,” who refers to this treatise of Hippocrates, and also to the works of Scaliger, Ferrer, and Cardanus on the same subject. The only other ancient writers on this subject which have come down to us are Artemidorus, Achmet, Astrampsychus, and Nicephorus.[208] The work of Artemidorus is an elaborate production on the interpretation of all sorts of dreams; and to the sober judgment of the present generation it cannot but be regarded as a memorable instance of the misapplication of human intellect and industry. The whole subject of the “Oneirocritica,” however, may well deserve the serious consideration of the most learned philosopher as affording a most striking and lamentable proof how prone men, even of cultivated minds, are to view things exactly in the light in which they fancy them to exist. This truth is most strikingly illustrated by the work of Artemidorus, who first gives the theory, as it were, of dreams, and in the last book relates particular instances in confirmation of the principles previously laid down by him. No one, assuredly, can rise from the perusal of such a work without being strongly impressed with the great truth embodied in our author’s first aphorism, “Experience is fallacious, and decision is difficult.” The “Oneirocritica” of Achmet is the work of an Arabian, and is interesting as containing all the superstitious notions of the Orientals, that is to say, of the Persians, Egyptians, and Indians, on this subject. Allusion is also made to the dreams recorded in the Jewish Scripture. The author sets out with declaring that, from the interpretation of dreams one may acquire a certain foreknowledge of all the casualties of life, namely, of life or death, of poverty or riches, of disease or health, of joy or sorrow, of victory over one’s enemies or defeat, and this with far greater accuracy than from astronomy (astrology?), for that astronomers differed much in opinion among themselves, whereas about the interpretation of dreams there could be no doubt!!

The following list of writers on the “Oneirocritica” previous to Artemidorus will show the attention which has been paid to this subject in very early times: Artemon Milesius, Antiphon, Apollodorus Tellmissensis, Apollonius Atalensis, Aristander Telmissensis, Aristarchus, Alexander Myndius, Cratippus, Demetrius Phalereus, Dionysius Rhodius, Epicharmus, Geminus Tyrius, Hermippus, Nicostratus Ephesius, Phœbus Antiochenus, Philochorus, Panyasis Halicarnessensis, Serapion, Strabo. Mighty names once on a day! Now they are but “the dream of a shadow!”[209]

XXVIII. Περὶ παθῶν—On Affections.

This treatise being passed over in silence by Erotian, and rejected as unworthy of Hippocrates by Galen, although he acknowledges that it contains many fine things,[210] has been generally regarded as spurious by modern critics, as for example, Foës, Haller, Gruner, Ackerman, Littré, Greenhill, and others. The work is carefully written, but seemingly without a plan, or any well-defined object. It touches, in general terms, on most of the diseases to which the human body is subject, and concludes with some general observations on regimen. All diseases are said to be derived from phlegm or bile. This seems very unlike the etiology of diseases, as laid down in the true Hippocratic treatises. Pleurisy is to be treated by purgatives and soothing applications, but without any mention of bleeding. The termination of the disease in empyema is described. The symptoms of pneumonia are also given in brief but striking terms. The sputa, at first, are said to consist of phlegm, and are thick and pure, but on the sixth and seventh day they become somewhat bilious and sublivid. This disease is also said to terminate in empyema. Some of the general observations contained in this work are deserving of attention. Of all the diseases the acute are the most painful and the most fatal, and they require the greatest care and the most accurate treatment. No additional mischief should, at all events, be inflicted by the physician, but he must do the patient as much good as lies in his power; and if the physician treats the case properly, and the patient sinks under the weight of the disease, it will not be the physician’s fault; but if, while the physician does not treat nor understand the disease properly, the patient fall a victim to the disease, the physician will then be to blame. In treating ileus, when a clyster fails to relieve the bowels, they are to be inflated by means of a bladder attached to a pipe, and then the pipe is to be removed, and a clyster immediately injected, in which case, if the bowels admit the clyster, they will be opened, and the patient will recover, but if otherwise, he will die, especially on the seventh day. The treatise further contains some very interesting remarks on the causes and varieties of dropsy. When the water is not otherwise removed, an incision is to be made either at the navel, or behind at the loins. It deserves to be mentioned that, in this treatise, there are frequent references to a work of the author’s “On Medicines.” Whether it was the same as the treatise bearing that title which we possess cannot be determined. In the course of the work, the use of the cautery is freely recommended for the cure of diseases.

From the account which we have given of this treatise, and the paucity of evidence in favor of its genuineness, it will readily be understood that we have no hesitation in deciding that it is not one of the genuine productions of Hippocrates.

XXIX. Περὶ τῶν ἐντὸς παθῶν—On Internal Affections.

This treatise has but little ancient authority in support of it. Erotian has omitted it in his list of the works of Hippocrates; Palladius does not mention it; and Galen notices it in a confused manner under a variety of titles.[211] Foës, Schulze, and others, have referred it to the Cnidian school; and if this point could be made out satisfactorily, it would give the treatise a remarkable degree of interest, as furnishing us with a key to the opinions of one of the oldest sects in medicine. That the reader may be enabled to form his own opinion in this matter, we will now give a brief outline of its contents.

The work commences with a short description of hæmoptysis, which is said to originate either in ulceration or rupture of an artery of the lungs, the ordinary causes of which are held to be severe exercise, falls, blows, violent vomiting, or fevers. The symptoms are pretty well described, and a mild system of treatment recommended. Inflammation of the lungs is said to be produced principally by drinking wine, and an immoderate indulgence in eating mullets and eels. The treatment at first is like what we have described the Cnidian system to have been, consisting of milk, emetics, and purges; but if these do not answer, the actual cautery is to be applied to the breast. Erysipelas of the lungs is described in much the same terms as at “De Morbis,” i., 13; ii., 53.[212] A correct description is given of empyema as connected with tubercle of the side, for which draughts are recommended, with broth made from poppies, etc. When matter forms, it is to be let out either by the knife or the cautery.[213] Three species of phthisis are described, the first being derived from phlegm, the second from violent labor, and the third being the tabes dorsalis. The treatment in all these affections appears to be very empirical, and unlike the usual therapeutics of Hippocrates. Four diseases of the kidneys are described, of which the first is calculus, and the second abscess, in which case the writer recommends an incision to be made, in order to furnish an outlet to the pus. Now, it is deserving of remark, that, of all the ancient authorities which have come down to us, Ruffus Ephesius would appear to be the only other author who makes mention of this practice.[214] The author of the treatise states, that if the matter of the abscess find vent by the intestinum rectum the patient may recover. The disease altogether, he adds, is troublesome, and in many cases ends in renal tabes. He most probably here alludes to what is now called Bright’s disease. From disease of the kidneys is said to arise an affection of the venæ cavæ, which runs from the head near the jugulars, along the spine to the malleolus externus. He says it originates in bile and phlegm which collect in the veins. Varices, I suppose, are here meant to be described. If not cured by purging with hellebore and scammony, the actual cautery is to be applied at the shoulders, below the scapulæ, at the hip-joint, at the middle of the thigh, above the knee, and at the ankle. Now it is deserving of notice, that this disease is not mentioned by subsequent authors on medicine, so that we are warranted in concluding that the treatise was not looked upon by them as being a production of the Great Hippocrates: for if it had been so regarded, we are sure that Galen, Aretæus, Celsus, and all the worthies of the Arabian school, would not have overlooked this description. And, moreover, the description of the disease from first to last is vague and prolix, being the very reverse of that graphic style of delineation which we find in the genuine works of Hippocrates: and yet the work contains other matters of a different stamp. For example, treating of dropsy, the author says it is sometimes connected with tubercles of the lungs, which get filled with water and burst into the chest. In proof of this, he appeals to observations on cattle, sheep, and swine, which are said to be very subject to these tubercles (phymata); and he argues that men are still more liable to them. And in many cases, he adds, empyema originates in tubercles. In that case, when the collection protrudes externally, he directs that an opening should be made in it; but if not, he directs the patient to be shaken by the shoulders, when the sound of the fluid within will be heard. When the side in which the greater collection is situated has been ascertained, he recommends us to cut down to the third rib from the last, and then make a perforation with a trocar[215] (τρυπάνῳ τρυγλητηρίῳ), so as to give vent to a small portion of the fluid; the opening is then to be filled with a tent, and the remainder evacuated after twelve days. Four species of icterus are described: these would appear to be febrile affections. Five varieties of typhus are next noticed in rather vague terms; there can be little doubt that they were all cases of remittent fever. Several varieties of a disease which is called morbus crassus are described with much prolixity, and so vaguely as not convey to us a distinct idea of the disease. He says of two of the varieties, that they last for six years. Unless these were varieties of elephantiasis (and we have no evidence of its existence so early), I am at a loss to comprehend what disease is alluded to. The treatise concludes with an account of three species of tetanus.

From the analysis now given of its contents, it will be readily seen that this work abounds in interesting matter, but that, at the same time, it is clearly of a different stamp from what we find in the genuine works of Hippocrates, nay, that in all probability it does not belong to the Coan school. In conclusion, I have, then, to state that I think the presumption of its being a production of the Cnidian school is very strong.

XXX. Περὶ νοὐσων—On Diseases.

A work with this title is cited by Erotian, Cælius Aurelianus,[216] and by Galen,[217] but so confusedly that we must come to the conclusion regarding these Books, that the ancient authority in support of their genuineness is by no means satisfactory. Galen evidently inclines to the opinion of Dioscorides the Commentator, that the Second Book is the work of the younger Hippocrates, this is to say, of a grandson of our author. Almost all the modern authorities, as, for example, Foës, Haller, Ackerman, Gruner, and Littré, concur in rejecting the whole four as spurious. The Fourth Book in particular is separated by M. Littré from the other three, as being a portion of the work “On the Diseases of Women,” rather than of the work “On Diseases.” We shall be better enabled to speak decidedly on this and the other questions regarding the authenticity of these books, when we have examined the nature of their contents.

After a very striking exordium, in which it is stated that the first object of him who turns his attention to the healing art should be to consider the causes of disease, and the natural tendencies of every one of them, that is to say, of their dispositions to death, or to loss of parts, the author proceeds to deliver his doctrine as to the causes of them, which he assumes to be either internal, namely, bile and phlegm; or external, such as labor, wounds and excess in heat, cold, dryness, and humidity. The following accidents are said to be mortal: a wound of the brain, of the spinal marrow, of the liver, of the diaphragm, of the bladder, of a large blood-vessel, or of the heart. He ranks the following as fatal diseases: phthisis, dropsy, and, when they attack a pregnant woman, pneumonia, causus, pleurisy, phrenitis, and erysipelas of the womb. The issue of the following is set down as doubtful in ordinary circumstances: pneumonia, causus, phrenitis, pleuritis, quinsy, enlargement of the uvula, hepatitis, splenitis, nephritis, dysentery, menorrhagia. The following are not deadly: chronic defluxions on the joints (κέδματα), melancholy, gout, ischiatic disease, tenesmus, quartan and tertian fevers, strangury, ophthalmy, leprosy, lichen, arthritis; yet even from these patients often become maimed in particular members, such as in the limbs from arthritis, or in the eyes from ophthalmy. Diseases also have a tendency to pass into one another, as, for example, pleurisy into causus, phrenitis into pneumonia, tenesmus into dysentery, and lientery; and pleurisy and pneumonia into empyema. He makes the following curious observations on the awkward mistakes which a physician may commit in the practice of his profession: not to know when there is matter in an abscess or tubercle; not to ascertain the existence of fractures or dislocations; having probed the head in case of injury thereof, not to ascertain that there is a fracture of the skull; not to be able to introduce an instrument into the bladder, nor to be able to ascertain whether there is a stone in it or not; in the case of empyema, not to ascertain the existence of matter by succussion; and in using the knife or cautery, to apply either of them to too great or too small an extent. The treatise also contains many other general observations, which are very ingeniously stated, as, for example, the following enumeration of the untoward accidents which may occur to a medical practitioner: Having administered an emetic for the purpose of evacuating bile or phlegm upwards, to induce rupture of a vessel by the act of vomiting, although the patient had previously been sensible of no pain in the region; having given an emetic to a woman with child, to induce abortion in consequence; in curing empyema, when looseness of the bowels is superinduced, and cuts off the patient; in applying an ointment for a disease of the eyes, when acute pains supervene, which end either in rupture of the eye or amaurosis, the physician in such a case gets the blame for having applied the ointment; and when a physician gives anything to a woman in labor on account of pains in the bowels, and the woman gets worse or dies, the physician incurs censure. And in diseases and injuries, when there is a necessary succession of bad symptoms, the physician gets the blame, as men do not perceive that the aggravation of the symptoms is a necessary consequence of the nature of the disease. And if a physician visits a patient in fever, or who has met with an injury, and if the patient gets worse after the first medicine that is administered, the physician is blamed; whereas he does not get the same amount of credit if the patient improves, as the amendment is attributed to the nature of the case. This book contains what I believe is the most circumstantial detail of the phenomena of empyema that is to be met with in any ancient work on medicine. The author ascribes the disease principally to three causes: to the termination of pneumonia, to a defluxion from the head, and to the consequences of a ruptured vessel. Whoever is acquainted with the modern literature of the subject, or possesses a practical knowledge of the disease, will not fail, from the accompanying description of the last of these, to recognize a case of cavity of the lungs produced by the ulceration of tubercles. True empyema, however, as the result of chronic inflammation, is also described in distinct terms. The never-failing test by succussion is constantly adverted to in these cases. Distinct mention is also made of the râle, by which the existence of matter in the lungs is ascertained. Allusion is probably made here to the well-known gurgling sound produced by matter in a cavity. There is a good deal of other important matters in this book, but these my necessary limits oblige me to pass over unnoticed. I shall merely allude to the distinct mention which is made of ruptures, by which was meant a severe sprain or other injury ending in suppuration, or protracted pains in the part. Fever is said to be formed in this manner: when bile or phlegm is heated, the whole of the body is heated, and they are heated either by internal things, such as food or drink, or by external, such as labor, wounds, excess of heat or cold; also from the sight or hearing, but rarely from these. In the treatment of pneumonia, venesection in the arm is recommended. Altogether this book contains much valuable matter, but mixed up with hypothesis in a way not usually met with in the genuine works of Hippocrates.

The second book, at the very commencement, betrays a strong disposition to diagnosis. Eight diseases at the head are described, but in such terms that we fail to recognize the distinguishing features of each. Besides these, a little way further on the author describes several other diseases of the head, including hydrocephalus, the symptoms of which are given with great precision, namely, acute pain about the bregma and temples, alternate rigor and fever, impairment of the sight, double vision, vertigo, etc. He recommends errhines, purgatives, and even trepanning of the skull. Even of this disease several varieties are described in very striking terms; so that for once at least we are tempted to question the correctness of the judgment which Hippocrates pronounced against the rival school of Cnidos, for cultivating diagnosis to an undue extent.

Several varieties of quinsy are likewise described, including various diseases of the parts about the fauces, and among them the disease named hypoglottis, by which appears to be meant an abscess below the tongue, attended with swelling of that organ. Five varieties of polypus nasi are next described, and suitable plans of treatment recommended, namely, with the ligature, the knife, and the cautery. Pleurisy and pneumonia are described, and their termination in empyema, the symptoms of which are circumstantially described again; and, moreover, three varieties of it are noticed. Here, again, we find mention made of the diagnostic method, by succussion, and a recommendation of the operation of paracentesis thoracis, to evacuate the fluid. Next are described several varieties of phthisis, including the tabes dorsalis, of which a curious description is given. An interesting account is also given of spermatorrhœa. The treatment consists in abstinence from immoderate drinking, venery, and excessive exercises, except walking, for a year, avoiding cold and the sun, and taking the tepid bath. The description of the varieties of pulmonic disease is most interesting, although some of them are not sufficiently well defined. Hydrothorax is also described, and paracentesis recommended in the treatment of it. After describing lethargy, which was clearly a species of remittent fever, he gives descriptions of certain diseases, under the names of morbus resiccatorius (ἀυαντή), Febris mortifera, Lividus morbus, morbus ructus ciens, and morbus pituitosus. No one can fail to recognize in these descriptions the spirit of the Cnidian school of medicine, and one very different from that of Hippocrates. Indeed we have positive authority for referring this work to the Cnidian school, for Galen assigns the description of the morbus lividus to the Cnidian physician Euryphon.[218] The author describes a singular species of melancholy, which, he says, is sometimes epidemic in spring; he calls it cura, morbus gravis. It appears to have been a variety of the lycanthropia. See Paulus Ægineta, III., 16. The book concludes with a description of two species of melæna, and of sphacelotes, the latter being a variety of the other. Now what strikes one in going over this book is, that it cannot be a portion of the same work as the First Book, for we cannot conceive it probable that an author would have treated twice of the very same subjects in one work. Moreover, as we have stated, there are evidently many things in it which are not at all in accordance with the principles of the Coan school.

In the third book very much the same ground is again gone over as in the two preceding books. In the first place, diseases of the head are described under the names of tumor cerebri, plenitudo cerebri dolorem inferens, sydere icti, sphacelismus, lethargus (then intervenes a brief account of Febris ardens, quite out of place), of dolor capitis, and phrenitis. Afterwards comes a description of cynanche, and paracynanche, next of icterus, and afterwards of tetanus, for the cure of which the author recommends the cold affusion. (On the merits and demerits of this practice, see the English edition of Paulus Ægineta, III., 20.) For ileus, as in a preceding book, among other modes of treatment, it is directed to inflate the bowels by means of a pipe and bladder, and then to evacuate their contents with a clyster. Afterward, pneumonia and pleurisy are most circumstantially described, and the treatment of them laid down with a degree of prolixity very unlike the usual manner of Hippocrates. Thus, to promote the expectoration in pleurisy, he recommends the flos æris, asafœtida, trefoil, pepper, etc.[219] I am not aware that any other ancient authority recommends these medicines for the cure of this disease. The symptoms and diagnosis of empyema as the consequence of pleurisy, are given in much the same terms as in the preceding book. Succussion is particularly alluded to. For empyema, burning and incision are recommended. In performing paracentesis, he forbids all the matter to be evacuated at once. Altogether, a perusal of this book leads me to the positive inference that it is not the production of the same author as the two preceding books; for what could induce the author to go over the same ground three different times in one work?

The fourth book is manifestly the production of a different author from the others, indeed, as appears evident from the conclusion of the work, it is continuous with the treatise “On the Nature of Women.” It commences with an elaborate discussion on the four humors, blood, phlegm, water, and bile, from which all diseases are said to derive their origin. The whole book is tinged with the exposition of this doctrine; indeed all the contents of it are for the most part hypothetical, and very unlike the matter contained in the genuine compositions of Hippocrates. From first to last there is no well-defined description of disease in it. The observations on lumbrici and calculus are the portions of it which command the greatest interest.

I shall now briefly recapitulate the conclusions which I am prepared to draw from a careful examination of the contents of this work. 1. As the same diseases, for example, pleurisy, pneumonia, and empyema, are all circumstantially treated of in each of the first three books, it is impossible to suppose them all portions of the same work, or even the productions of the same author. 2. In the fourth a different hypothesis is advanced from that which is laid down in the first, and from this circumstance, joined to many other considerations already enumerated, there can be no doubt that it is the production of an entirely different author. 3. Although all parts of these books contain abundance of valuable materials, many of the principles and rules of practice which are developed in them are not akin to those of Hippocrates, but rather savor of the Cnidian school, which trusted too much to a fanciful diagnosis, instead of cultivating prognosis as the basis of its system, like the school of Hippocrates and his followers. 4. The internal evidence in the present instance against their genuineness, more than counterbalances the small amount of ancient authority which there is in support of these books.

XXXI. Περὶ ἑπταμήνου—On the Seven Months’ Birth.

XXXII. Περὶ ὀκταμήνου—On the Eight Months’ Birth.

Although the genuineness of these two works is admitted by Galen[220] and by Foës,[221] they are not looked upon as the productions of Hippocrates by almost any other of the authorities, whether ancient or modern, and in particular, Palladius, Ackerman, Gruner, Littré, and Greenhill reject them. Yet all admit them to be of very high antiquity, so that, in this respect, they are not destitute of considerable interest. The contents of them are altogether of a philosophical nature, and such as we might expect the school of Democritus to produce. The author of them holds that fœtuses born at the seventh month survive, but not those of the eighth. It is clear that he was imbued with the Pythagorean notions regarding the mystical power of the number seven.[222] Altogether, the style and matter of these treatises do not appear to me to accord well with the spirit which prevails in the true Hippocratic works, but at the same time it must be admitted that the preponderance of authority for or against their authenticity is not decided.[223]

XXXIII. Ἐπιδημών, β’, δ’, ε’, ς’, ζ’—The 2d, 4th, 5th, 6th, and 7th Books of the Epidemics.

With the exception of Erotian, who admits the whole of the seven books of Epidemics into his list of the works of Hippocrates, I am not aware that any of the authorities, ancient or modern, recognize them as genuine. Galen says that the seventh is allowed by all to be spurious; that the fifth is the work of Hippocrates, the son of Draco, that is to say, of a grandson of the great Hippocrates; and that the second, fourth, and sixth were held by some to be the productions of a son of Hippocrates, and by some they were looked upon as having been written, indeed, by Hippocrates himself, but merely as notes or commentaries. Galen himself inclines to the opinion that these four books are the production of Thessalus, the son of Hippocrates.[224]

From what has been stated respecting these books, it will be clearly seen that, although there is no reason whatever to suppose they were published by Hippocrates, it is, at the same time, highly probable that he had something to do with the composition of them, and that, at all events, they emanated from the school upon which his name has cast so much splendor. I think myself, therefore, called upon to give a condensed view of their contents; and in doing so, I shall not scruple to avail myself of the very important annotations made on them by M. Littré, in his recent edition of this portion of the Hippocratic treatises.

With regard to these books, in general, he observes that they are naturally divided into two groups, the one containing the second, fourth, and sixth books, the other the fifth and seventh. The correctness of this division is quite evident from a comparison of the contents of the different books, and, to a certain extent, it is recognized by Galen.[225]

As to the locality of these observations, M. Littré shows that the spot of their greatest activity is Thessaly and Thrace, although mention of Athens, and of certain cities of the Peloponnesus occasionally occurs. He traces with much minuteness the connection of these books with the other works in the Hippocratic Collection. For example, he shows the connection between those in the first group, with the “Aphorisms,” in particular, but also with the treatises, “On Airs,” etc., “The Mochlicus,” “The Surgery,” etc., and of those in the other group, with the work “On Wounds of the Head” in particular. I will now offer a few remarks on the contents of each of these books.

M. Littré, in his argument prefixed to the second book, treats of various matters contained in it, the most interesting of which is his elaborate disquisition on the nature of the carbuncles (ἄνθρακες) described in his book, during the course of which he brings into review various collateral passages from the works of subsequent authors, and discusses the question at considerable length whether or not they apply to smallpox. I am free to admit that it would have been to my advantage if I had seen this part of the writings of M. Littré before piling my commentary on Paulus Ægineta, B. IV., 25. I must be permitted to say, however, that I see no reason for changing my opinions with regard to the anthrax of the Greek writers on medicine. I certainly cannot agree with M. Theod. Kauser, in setting down the ancient descriptions of the anthrax and plague (λοιμὸς) as applying to the smallpox. Having diligently studied the minute descriptions which the ancient medical authors give of the different varieties of cutaneous disease, I am confident that if the smallpox had actually existed in their days, they would not have passed over the disease with a vague and casual notice, but would have given us such a sketch of its appearances that no one could have failed to recognize its features. The carbuncles, then, which are incidentally mentioned by Hippocrates at the beginning of this book, I am disposed to look upon as one of those anomalous phases of disease which are every now and then making their appearance, and I cannot persuade myself that they had anything to do with smallpox.

Among the important matters contained in this book may be noticed the remarks on deposits, an interesting subject often alluded to in the Hippocratic treatises, § 7. At § 22 a case is obscurely noticed, which M. Littré concludes, but upon very slight grounds, to have been a case of purulent infection. At § 24 spontaneous luxation of the cervical vertebræ is described, as M. Littré, in his argument, remarks, with admirable judgment. It is also alluded to at “Aphoris,” iii., 26, and “De Articulis,” tom. iv., p. 179, ed. Littré. This affection, which came afterwards to be overlooked, has been redescribed of late years. In the third section there is given an interesting account of causus, the remittent fever of hot climates, so admirably described afterward by Aretæus. The fourth section is occupied with a description of the veins of the body, which is certainly confused, and yet we find in it the distinction between the nature of the arteries and veins clearly pointed out. It is curious, moreover, that Galen, in one place, stands up for this part as being genuine and accurate.[226] See also b.v. § 46. The last two sections treat professedly of physiognomy, but contain other detached and unconnected observations on medical subjects. Altogether, the impression which a careful perusal of this book conveys to one is, that it is a compilation of the most incongruous matters, strung together without any plan; but, at the same time, one cannot fail to detect in it traces of no contemptible talent for observation and description.

The fourth book, of the whole number, is the one which is written with the least unity of design. Yet, as M. Littré remarks, it is interesting as containing the history of an epidemical causus, complicated with jaundice and ophthalmia, which would appear to have been very similar to the febrile epidemic which prevailed in Scotland a few years ago. With this opinion I entirely acquiesce, after having had a good deal of experience in the treatment of that epidemic. It was decidedly of the remittent type, was frequently accompanied with jaundice, and the patients were very subject to relapses and affections of the eyes.[227] For Hippocrates’s description of it see tom. v., p. 169, ed. Littré. M. Littré also makes the important remark that, of late years, proper attention has not been paid to the state of the urine at the epoch of a crisis in fevers. He mentions that M. Martin Solon holds that, at the resolution of diseases, the urine is apt to become albuminous; but that, in a true crisis, the precipitate is generally composed of urate of ammonia. M. Zimmerman found the urinary deposit composed of the urate of ammonia, with the triple phosphates and the crystals of uric acid. Certain observations on this critical deposit occur in this book of the Epidemics, but they are met with more frequently and more distinctly expressed in the genuine books, I mean the first and third. It appears to me most remarkable that the important observations made by Hippocrates on the state of the urine in febrile diseases should have been lost sight of in an age when the chemical characters of the urine have been so much studied; for I am fully satisfied, from my own practical acquaintance with fevers, that in most cases the febrile crisis is marked by a copious sediment in the urine. An interesting case of empyema, which was treated by the cautery, is related at § 4. A case is related at § 19 of a singular affection of the mouth in two children, attended with necrosis and exfoliation of the bones. At § 39 there is a case of metastasis of purulent matter from the hand to the lungs. At § 11 a case is related of a child who sustained an injury in the head from another child, was trepanned, and died on the twenty-fourth day. We shall see in the work “On Injuries of the Head” that the ancients were very free in the application of the trepan to the skull. Cases of nyctalopia are alluded to at § 52, and at § 58 a case is related of mania supervening on the cure of hemorrhoids. But, upon the whole, the most interesting part of this book is that which contains the narratives of febrile cases, and the remarks on relapses, § 28.

Though the fifth and seventh books of the Epidemics are pronounced by Galen to be unworthy of the Great Hippocrates, they contain detached observations of much interest, insomuch that Haller was almost disposed to admit the genuineness of the fifth. Lemos and Mercuriali, on the other hand, hold them to be wholly removed from all connection with the genuine remains of Hippocrates. It is remarkable, however, that the fifth is referred to by Celsus,[228] Quintilian,[229] and Plutarch.[230] This, in fact, is the book which contains the memorable passage in which the author admits, that in a case of injury of the head he mistook a fracture for a suture of the skull,[231] and for this candid admission Hippocrates is highly lauded by the authors we have just quoted. The Hippocratic treatises also contain many other instances in which the author admits having committed mistakes. How much might the medical art not have advanced before this time, if the example thus set of recording for the benefit of posterity, the mistakes which one commits had been more generally followed?[232] The first paragraph contains the case of a woman who had fever and took medicine which did her no good; a hard swelling, accompanied with severe pains, seized her below the navel, which were removed by strongly rubbing in oil with the hands, after which she had a copious discharge of blood downwards, and recovered. M. Littré, from a comparison of this passage with Epidem. ii., 6, 26; iv., 45, 56, draws the conclusion, that reference is here made to the practice of compressing the bowels with the hands in cases of ileus, for which Praxagoras, the master or Herophilus, is censured by Cælius Aurelianus.[233] At § 9 there is the case of a man affected with prurigo, and a condition of the skin resembling leprosy, which nobody could remove. He then went to the hot baths in the island of Melos, and was cured of his cutaneous affection, but soon after became dropsical and died. In § 10 there is related a case of cholera, treated with hellebore, which produced great evacuations upwards and downwards, and the patient recovered. This mode of practice is animadverted upon by Cælius Aurelianus. (Morb. Acut. iii., 20.) § 12th contains an instructive history of headache in a woman, which nothing relieved but free menstruation, and afterwards conception. At § 15, there is a very interesting case of necrosis or caries at the hip-joint, for the relief of which a large incision was made down to the bone and the cautery applied; on the eleventh day tetanus supervened, and proved fatal on the eighth day afterwards, although treated by embrocations, fomentations, and strong purgatives. The author remarks in conclusion, that the patient would have lived longer, if the purgative medicine had not been administered. At § 16 there is a case of injury of the head, where the surgeon at first sawed the bone down to the diploe, a practice alluded to in the treatise “On Injuries of the Head,” § 21. In this case erysipelas came on, and yet the patient recovered. It is to be regretted that the text here is in a corrupt state. At § 18 there is a case of pregnancy in which the administration of a strong purgative was followed by fatal results. At § 20 there is related a case of hemorrhoids, seemingly mali moris, which proved fatal in consequence of an operation having been performed upon them. § 24th contains the history of a case of hæmoptysis, which ended in phthisis. The author makes the shrewd remark that the patient was indisposed before the vomiting of blood commenced. I may here remark, how well this accords with the doctrine of Louis, that hæmoptysis is rather the consequence than the cause of tubercular disease. At § 38 there is another case of hæmoptysis in which the patient was choked by a large quantity of blood which he was bringing up; the spleen also, in this case, was affected, and there were bloody discharges downwards. This book contains a great variety of serious cases connected with accidents. At § 50 is a fatal case of concussion of the brain. At § 74 there is a fatal case of tetanus supervening upon a slight injury of one of the fingers and in the following section there is a case of tetanus arising from a strain of the thumb and proving fatal. In the next section there is a case of fatal tetanus from the injudicious healing of a sore on the leg.

Though Galen refuses to sustain the sixth book as genuine, he has written an elaborate commentary upon it, and mentions at the commencement that commentaries had been written upon it before his time by Zeuxis of Tarentum, the Erythræan Heraclides, and before them by Bacchius and Glaucis. It is a large work, being divided into eight different sections, which have little or no connection with one another. Upon the whole, as M. Littré remarks, the most interesting portion of it is the part in which are described the phenomena attending an epidemic cough, or influenza, which reigned in Perinthus. See § vii. It broke out in winter about the solstice, and was preceded by great changes of the winds. There was a great tendency to relapses, and it was further complicated with pulmonic affections, nyctalopia, angina, paralysis, etc. It was observed, that any member which was much exposed to fatigue was the part most liable to be attacked. All these complications occurred in the relapse, and never in the original attack. Women were less liable to be affected than men, the reason of which is supposed to have been, that they do not expose themselves so much to the air as men do. In women, too, all the attacks were mild; but in the men some were mild and others fatal. When a febrile rigor supervened, the attack speedily was mortal. The usual remedies were tried, namely, purging, venesection, bleeding by the renal vein, and emetics; but none of them did any good. M. Littré remarks, that in the course of his reading he has never met with an example of an epidemic exactly resembling the one here described. It is, therefore, an interesting picture of a disease not otherwise known. The sixth section begins with the announcement of the physiological doctrine so frequently quoted with approbation, namely, that “the fleshy parts attract both from the bowels and from without, and that the whole body inspires and expires.” This doctrine is fully expanded and illustrated in an interesting volume by Abraham Kaau.[234] The fifth section opens with another philosophical tenet, which Sydenham often quotes with approbation, namely, that “Nature is the physician of diseases.” “Nature,” the writer adds, “although untaught and uninstructed, does what is proper.” Galen’s Commentary on this passage contains much interesting matter, and is a fine specimen of the medical philosophy of the ancients.[235]

The seventh book, as we have already remarked, is closely allied to the fifth. Galen pronounces it to be universally condemned as being spurious, and of more recent origin than the others; but Littré, although of course he does not stand up for its genuineness, justly contends that it is replete with valuable matter. Grimm holds, from the nature of its contents, that it must have derived its origin from the Cnidian school, whereas the fifth sprung from the Coan. I must say, however, that I cannot see any good grounds for this opinion. According to M. Littré, it is a recueil of particular facts superior to anything of the kind left to us by antiquity, and such that its equal can scarcely be found in modern times. The cases being for the most part of an isolated nature and not susceptible of any arrangement, it is not possible within my narrow limits to give any general idea of the contents of this book. I shall be content, therefore, with a very few extracts as a specimen of it. It opens with two very interesting cases of fever, accompanied with sweats, which were treated mildly by purgatives and clysters, and terminated favorably. It strikes me as singular in reading these cases, that the characters of the urine are not distinctly given, as in the cases related in the first and third Epid. All that is said on this score is, that “the urine was like that of chronic diseases.” The tenth is a case of ardent fever proving fatal by intestinal hemorrhage. Some of the fatal cases of dropsy following fever are very instructive, as §§ 20, 21. Two cases of empyema (so they are marked by M. Littré) would appear to have been phthisis with cavities in the lungs. In both, mention is made of râles. See §§ 26, 27, and also 93, 107. In the 29th and six following sections there are reports of cases of severe wounds. Apparently they must have occurred in the time of war. The 36th, 37th, and 38th, are cases of tetanus supervening upon very slight wounds. A good many cases of phthisis are reported, as at §§ 49, 50, 51; in the last of those the pectoral râles are particularly noticed. In the 48th the disease is ascribed to the woman having been injured by succussion in order to procure the expulsion of the afterbirth. (On this case see the interesting remarks of M. Littré, tom. v., p. 359.) At § 52 are the cases of two children who died of disorder of the bowels, complicated with an affection of the head, as indicated by their constantly pressing on the part with the hand; and it is remarked, that after death there was a hollow in the seat of the bregma. Every experienced physician must have met with such cases. M. Littré refers in illustration of the disease here treated of to an analysis of a work by M. Elsæsser, in the “Archives Générales de Médecine,” March, 1845, p. 346; on ramollissement of the occiput. The cases of phrenitis, here related, are evidently febrile affections, as at §§ 79, 80. At § 102 a case is related in which serious symptoms supervened on the eating of a raw mushroom. The patient being treated by emetics and the hot bath, recovered. At § 121 is related the case of a person who had convulsive laughter, connected, as was supposed, with a wound of the diaphragm.

And now, having concluded my review of these Books of Epidemics, I will venture to affirm, without fear of contradiction, that when we look to the importance and rarity of the matters contained in them, the work, even at the present day, is perfectly unrivalled. That the books are the composition of different hands must be admitted, but altogether the contents of them bear the imprint of the mind and spirit of Hippocrates, and evince a talent for the cultivation of medicine which has never been surpassed. What a noble people the Greeks must have been in the days of Themistocles and Pericles!

XXXIV. Περὶ χυμῶν—On the Humors.

It must be admitted that there are few treatises in the Hippocratic Collection which unite such a concurrence of high authorities, both ancient and modern, in their favor as this work, and yet there seems good reason for joining the later critics in refusing its claims to be received as genuine. In favor of it may be quoted Erotian, Palladius, and Galen, among the ancient, and Foës, Zuinger, and Haller, among the modern authorities. Against it are ranged several of the older authorities, namely, Zeuxis, Heraclides, and Glaucias, some of whom refer it to a younger Hippocrates, some to Thessalus, others to Polybus, and others again to Democritus.[236] Accordingly, the highest modern authorities, as Mercuriali, Gruner, Ackerman, Kühn, and Littré, refuse to receive it into the list of genuine works; and the last of these seems to make it out pretty clearly that the treatise is composed of detached observations extracted from the other Hippocratic works. After repeated perusals of it, what strikes myself is, that it bears a close resemblance to the treatise “On the Surgery,” that is to say, that it is a recapitulation of the conclusions arrived at in certain of the other works of Hippocrates. Perhaps, then, it must be admitted that there is some inconsistency in allowing the one a place among the genuine works of Hippocrates, and refusing the similar claims of the other. That the work in question contains a most interesting summary of what were regarded, in ancient times, as great medical truths, cannot be doubted. From the condensed form in which the subject matters of it are presented, it will readily be apprehended that they do not well admit of being given in the form of an abstract, and that any specimens of its contents will afford but a very imperfect idea of its value as a whole. I would remark, at the outset, that the title of the work, “On the Humors,” appears not very applicable, since very few of the paragraphs relate to the humors; in fact, as already hinted, the treatise may be said to be a recueil of various observations gathered out of other works. I also feel at a loss to account for M. Littré’s disposition to rank it as the eighth book of the Epidemics, as it bears no resemblance either in form or matter to that work; the one consisting of isolated observations and of particular facts, and the other of general principles; and the style of the one being comparatively full, whereas the other is remarkably succinct, so as to be nearly unintelligible in many places. Take the following as a specimen of it: “The earth is to trees what the stomach is to animals; it nourishes, heats, and cools; cools when emptied, heats when filled, as the earth when manured is hot in winter, so is it with the stomach.” This important observation, that the earth, in connection with the vegetable productions, is analogous to the stomach in animals, is repeated by Aristotle and other of the ancient philosophers.[237] The author makes the important remark, (§ 14,) that we ought to study the condition of the body previous to the season in which the disease broke out; in confirmation of which M. Littré, in his arguments, gives some very interesting observations by M. Forster.[238] In the paragraph on deposits, the author remarks, that in fevers attended with a feeling of lassitude, the deposits generally take place to the joints and jaws. It is afterwards stated—and if confirmed by experience, as I think I have observed it to be in many cases, it is an important remark—that “when the feet are hot, the depositions point downwards, but when cold, upwards.” § 7. In § 12 diseases are thus classified: “with regard to the modes of diseases, some are congenital, as may be learned upon inquiry; some are connected with the nature of the locality, (for many are affected, and therefore many are acquainted with them); some with the condition of the body and the diet, the constitution of the disease, and the seasons. The localities which are ill situated in respect to the seasons engender diseases similar to the season; in like manner, irregularities as to heat and cold in the same day when it has such effects, produce autumnal diseases in the locality, and in the other seasons likewise. The diseases which are engendered by fetid and marshy waters are calculus and splenic diseases, and such are influenced by good or bad winds.” Altogether, as will be readily seen, it is a work of great ability, and will amply repay a diligent perusal. Galen esteemed it very much, and did not hesitate to declare that, not only Plato, Aristotle, and Theophrastus, but also several of the most distinguished medical authors had copied freely from it.[239]

XXXV. Περὶ χρήσιος ὑγρῶν—On the Use of Liquids.

This would seem to be the work which appears in Erotian’s list under the title of “On Waters” (περὶ ὑδατῶν); and, contrary to what is stated by Foës and Gruner, it is quoted by Galen in two places;[240] and it is further referred to by Athenæus, under the same title as that given to it by Erotian.[241] Foës pronounces it to be a mutilated work, and one which is wanting in many of the MSS. of the Hippocratic treatises; and all the modern critics, from Lemos and Mercuriali down to Littré and Greenhill, regard it as spurious. Gruner speaks of it as being a work of little importance, and Ackerman as being a mere compilation from the Aphorisms.[242] Gruner further remarks, that the title does not suit well with its contents, and this is in so far correct, for undoubtedly the title given to it by Erotian is more suitable, as it treats almost exclusively of the medicinal properties of waters; and this it certainly does in a fuller and more interesting manner than they are treated of in any other ancient, and, I may almost venture to add, any modern work with which I am acquainted. I look upon its contents, then, as being extremely valuable, even as the work has come down to us, but it is to be regretted that the text is in a very unsatisfactory state. Water the author of the treatise recommends as a fomentation to the eyes, when applied with a sponge; and further, as a general or local fomentation, for producing relaxation of any part when contracted. When poured over the head, and other parts, it is said to induce sleep, is useful in convulsions, and relieves pains of the eyes and ears. Cold water inflames ulcers, except such as have a tendency to hemorrhage, and also fractures, luxations, etc. In applying water to the body, the author recommends the feelings of the patient to be consulted, unless he be in a state of paralysis or of stupor, or be suffering from exposure to great cold, or be in great pain. In these cases, he adds, the patient may be insensible, and instances have occurred of persons having their feet congealed by cold, which have dropped off upon the affusion of hot water. The immoderate use of hot water induces relaxation of the fleshy parts (muscles?), weakness of the nerves, torpor of the understanding, hemorrhage, and deliquum animi, so as even to prove fatal; and much cold water will occasion spasms, tetanus, lividity, and febrile rigors. The parts of the body which are usually covered endure the cold water worst, and are most refreshed by hot. Cold water disagrees with the brain and its processes, the bones, the teeth, and the nerves; and hence, it is added, convulsions, distentions, and febrile rigors, which are induced by cold, are relieved by hot water. Hot water occasions delight and determination (to the skin?); cold, on the other hand, pain and determination inwardly: wherefore the loins, the breast, the back, and the hypochondriac region, are injured by cold applications, but delight in warm. Cold water, thrown on the extremities, relieves lipothymia, the reason of which he states, but the text is so corrupt that I dare not undertake to translate the passage. Ulcers, excoriated parts of the body, and burns, bear cold ill. The extremities, the bladder, and the organs of generation, delight in warm water. Salt water is proper to itchy parts, and to parts affected with pungent humors, but disagrees with burns, and abraded surfaces. Vinegar is said to have much the same properties as salt water in the cure of these complaints. Warm water, in which salt has been melted, is beneficial in lichen, leprosy, alphos, and other complaints of a like nature. The lees of vinegar (caustic potass?) also answer in these cases. The astringency of cold water is increased by having beet leaves, ivy, bramble, sumach, sage, etc. boiled in it. Red pustules, like lentils, are benefited by cold things, but eruptions arising from cold, and resembling millet, are improved by hot. There are certain cases in which both hot and cold are applicable, such as gouty affections, and most sprains: in these, cold applications deaden the pain, and warm soothe it. Indurations and ankyloses of a joint are to be removed by pouring warm water out of a vessel upon it. Rheums of the eyes are relieved by rubbing them with some fatty substance, to obtund the acrimony of the tears. In pains, suppurations, pungent tears, and deep ulcers of the eyes, hot water is most expedient; when the eyes are merely red, and free of pain, cold is to be preferred. Cold does not agree with complaints of the rectum and uterus, nor with cases of bloody urine. Cold raises pain when it is applied to ulcers, hardens the skin, renders it painful, suppresses suppuration, renders parts livid and black, is injurious in febrile rigors, spasms, and tetanus. But he adds, sometimes in a robust young man, in the middle of summer, when laboring under tetanus not connected with a wound, the affusion of cold water brings back the heat. (See Aphor. v., 21, and Paulus Ægineta, B. III., 20). Hot water does the same. It promotes ulceration in all cases, softens the skin, attenuates it, is anodyne, and soothes rigors, spasms, and tetanus, and removes heaviness of the head. It is most particularly applicable in fractures, when the bone is laid bare, and especially in injuries of the head. Hot water agrees with all ulcerations, whether innate or produced by artificial means, in herpes exedens, in blackened parts, and in diseases of the ears, anus, and womb. But cold water is inimical in all these cases, except when hemorrhage is apprehended.

The above is a brief summary of the matters contained in this little treatise. That they are highly important, and evince an extraordinary talent for apprehending the true bearing of practical points in medicine, will hardly be denied by any person who is a competent judge. Many of the rules and observations contained in it are, no doubt, the same as those found in the Aphorisms (see Section v.), but there is also no lack of valuable matter in it, which is not to be found elsewhere. Though I am disposed, then, to agree with the authorities who exclude it from the list of genuine works, I do not hesitate to declare it as my decided opinion, that it is not unworthy of the reputation of the great Hippocrates, and that, if not written by him, it must be the production of some person who thoroughly apprehended his high principles and discriminating views. How much, then, is it to be regretted, that this treatise should have come down to us in so mutilated a state that the meaning, in many places, can only be guessed at with considerable hesitation!

XXXVI. Περὶ γονῆς—On Semen.

XXXVII. Περὶ φύσιος παιδίου—On the Nature of the Infant.

That these two treatises originally constituted one work, has been remarked by Foës, Gruner, Ackerman, Littré, and others. Indeed, this will be made sufficiently obvious, upon comparing the conclusion of the one with the beginning of the other. Galen, in one place,[243] quotes the former of these as if he held it to be a genuine work of Hippocrates, but elsewhere he mentions that it had been referred to Polybus.[244] Erotian mentions, among the works of Hippocrates, a treatise bearing the title of the latter, under which he probably comprehended both treatises. It is also noticed as a Hippocratic treatise by Palladius,[245] and by Macrobius.[246] Both are rejected by Haller, Gruner, Ackerman, Kühn, Littré, and Greenhill. Indeed the story of the female musician, whom the author gravely admits that he taught the way how to get rid of a conception,[247] is so alien to the morals of Hippocrates, as declared in “The Oath,” that it is impossible for a moment to suppose him guilty of such an act of flagitiousness. Moreover the treatise so abounds in little subtleties and conceits, especially in reference to the Pythagorean doctrine of numbers, that no competent judge will hesitate for a moment in pronouncing it not to be the production of the Great Hippocrates.[248] Without doubt, however, these treatises are of great antiquity, and are valuable as containing the hypotheses with regard to the origin of the fœtus which prevailed in the schools down to the days of Harvey; that is to say, that the embryo is formed from the male semen, into which the uterine vessels enter, and form the cotyledones (or placenta). It contains, moreover, an hypothesis adopted by Aristotle in several of his physiological works regarding the semen, namely, that it is collected from all parts of the body; and hence, if any part be mutilated in the parent, it is so likewise in the fœtus.[249] The author moreover holds, that the fœtus breathes, and is nourished by the umbilicus,[250] which may be looked upon as an anticipation of the modern doctrine, that the placenta performs the function both of a lung and of an intestine. It contains a statement regarding the incubation of the egg, which has been often repeated in modern times, but which, from personal observation, I can affirm not to be true; namely, that the hen chips the shell to let out the chick.[251] Presentations in delivery are divided into those by the head, the feet, and crossways. I would mention, in conclusion, that these works abound in repetitions, and are written in a diffuse style, very unlike that of Hippocrates. Altogether, then, I can have no hesitation in pronouncing both treatises to be spurious. From what has been stated of them above, it must be obvious, however, that to the student of ancient anatomy and physiology they are very interesting, and will repay a careful perusal. Although, probably, later productions than the age of Hippocrates, there can be no doubt that they are anterior to the memorable epoch of Herophilus and Erasistratus.

XXXVIII. Περὶ γυναικείων—On the Diseases of Women.

We have already stated in our critical remarks on the fourth book, “On Diseases,” that it and the present treatise are evidently the productions of the same author. Although Erotian and Galen[252] make reference to it as if acknowledging it to be the production of Hippocrates, its claim is rejected by Foës, Schulze, Gruner, and Ackerman, and all the modern authorities of any note. Its connection with the treatises “De Genitura” and “De Natura Pueri,” is pointed out by Foës and Gruner; and Littré does not hesitate to refer to the same author the whole of the following treatises, “De Genitum,” “De Natura Pueri,” “De Morbis,” iv., “De Morbis Mulierum,” “De Morbis Virginum,” “De Sterilibus.” Although not the composition of Hippocrates, all these treatises are, without doubt, of high antiquity, and were anterior to the age of Aristotle.

The work now under consideration contains much valuable matter, and deserves a careful perusal. I feel rather at a loss what selections to make from it, as a specimen of its contents, but shall be brief on the present occasion, more especially as I have no difficulty in establishing the point, that the treatise in question is not one of the genuine works of Hippocrates.

The observations contained in the first part of it, on menstruation and the causes of sterility, are ingenious. For the cure of sterility, fumigation of the uterus is recommended, and a minute description is given of the mode of performing this process, by means of a tube introduced into the os uteri, and connected with a vessel which emits aromatic fumes. When sterility is connected with the shutting up of the os uteri, the author gives directions for expanding it by means of a wooden or leaden pipe. We need scarcely remark, that this practice has been revived of late years. A minute description is given of a malformation of the vagina, in which the passage is nearly obliterated by a membrane. Allusion is probably made here to a preternatural rigidity of the hymen. The author directs the membrane to be fairly torn, and the part dressed with wine and myrrh. In transverse and footling presentations of the child it will be best, he says, to bring it down by the head. Both cases are said to be dangerous, so that either the mother or child is lost, and sometimes both. Treating of retention of the placenta, the author remarks, that if it is not cast off it becomes putrid, and thus comes away on the sixth or seventh day, or later. To promote its expulsion, he recommends southernwood, dittany, the flowers of the white violet, and asafœtida. The process of abortion, and the unpleasant circumstances connected with retention of the placenta in this case, are given with much accuracy. Hydrops uteri is described at considerable length. For an account of it, see Paulus Ægineta, Vol I., p. 573, Syd. Soc. edition, and the modern authorities there referred to. For ulcers of the womb, he recommends applications consisting of many stimulating ingredients, such as the flos argenti, etc. The subject of difficult delivery is resumed; when the arm or leg of a living child is protruding, it is directed to be pushed back, and the child turned to the head; and if the fœtus be dead, either the same thing may be done, or the projecting part may be cut off, and the head opened with a sharp knife, and the bones thereof extracted, and the body brought along. The chest also may be opened, if there be any difficulty in extracting the body. The author expresses himself strongly in regard to the danger of abortions. All abortions, he says, are attended with more danger than deliveries at the full time. Artificial abortion never takes place without violence, whether produced by medicine, a draught, or food, or a suppository, or any other means.

The second book commences with a description of fluor albus, an affection to which the old are stated to be more subject than the young. It arises from suppression of the menses, from parturition, or a fever. Among other means which he speaks of for the cure of it, he mentions the application of cupping-instruments to the mammæ. Astringents from the vegetable kingdom are to be administered, such as sumach boiled in vinegar, mulberries, or the like. A full account of the red fluor, or uterine hemorrhage, is also given. It is said to be connected principally with parturition. The treatment which is recommended can scarcely be improved upon, even after the lapse of two thousand years: a sponge is to be wetted and applied to the pudenda; soft garments are to be moistened with cold water, and laid on the belly; and the foot of the bed is to be raised. When the hemorrhage is connected with putridity many women thus perish, indeed few recover. A long description is given of hysterical convulsions which is said principally to attack antiquated maids and widows. It is remarked that hysterical complaints bring on cough, and other pectoral complaints. A very striking and accurate description is given of procidentia uteri. Inflation of the womb is also described. On it see Paulus Ægineta, Vol. I., p. 632, Syd. Soc. edition. There is also a curious description of the mole. The clitoris is described under the name of columna.[253]

From the extracts now given, it will be seen that these Books contain a great variety of most important matter. Indeed, there are few treatises in the Collection more deserving of an attentive perusal. They furnish the most indubitable proofs that the obstetrical art had been cultivated with most extraordinary ability at an early period. Beyond all doubts the complaints of women, and the accidents attending parturition, must at that time have come under the jurisdiction of the male practitioner. But, considering the wandering life which Hippocrates led, and that during the best part of it he must have been what is now called a consulting physician, it is not at all likely that he could have acquired that acquaintance with the minutiæ of obstetrical practice which this work displays. It is not, then, at all probable that he can be the author of it.

XXXIX. Περὶ ἀφόρων—On Sterile Women.

This treatise is closely connected with the preceding one, both in matter and style. It relates to a subject which, as we have shown, is also treated of in the other work, I mean sterility, the most common cause of which is held to be the state of the os uteri, when it is oblique to the passages of the vagina, constricted from cicatrices, or otherwise diseased. Distinct directions are given for opening the mouth of the womb, after which a cleansing application, composed of cantharides and myrrh, is to be made to it. The mole, and procidentia uteri, are described in nearly the same terms as in the preceding treatise. Though it bears a great resemblance, then, to the work “On the Diseases of Women,” it is not likely, as suggested by Albertus Fabricius,[254] that it is an appendix to it, for why should an author treat twice of the same subject in the same work?

XL. Περὶ παρθενίων—On the Complaints of Young Women.

Foës looks upon this little tract as being the prelude to the greater work “On the Diseases of Women.” It is destitute of all claims to be held as genuine, and accordingly no critic, ancient or modern, stands up for it. Gruner is inclined to ascribe it to the author of the treatise “On the Sacred Disease,” but I see no grounds for this opinion, except it be that, in the two treatises, there is a certain similarity of views with regard to the nature of the hysterical convulsion. This, however, is not a sufficient reason for deciding that they both must have come from the same source, for all the ancient authorities, from Hippocrates to Actuarius, held pretty much the same ideas regarding the nature of “Uterine suffocation.” See Paulus Ægineta, III., 71. The author of this little fragment gives very naïve advice to virgins who are subject to hysterics; instead of making costly oblations of garments and the like to Diana, as recommended by the prophets, he gravely advises them ὡς ταχίστα συνοικῆσαι ἀνδρασι.

XLI. Περὶ ἐπικυήσιος—On Superfœtation.

This treatise, I believe, is not mentioned by any one of the ancient authorities, and it is almost universally rejected by the modern.

I need scarcely remark that it relates to a very curious subject, and that great doubts are now entertained whether or not superfœtation in women ever actually takes place. I can state, however, that two trustworthy persons, the one a surgeon and the other a sage femme, informed me, some years ago, that they once attended together a case in which a woman was first delivered of a fœtus about four months old, and, about thirty-six hours afterwards, of a fully grown child. The ancient savants all believed in the occurrence of superfœtation. See in particular Aristotle (Hist. Anim. vii., 5); and Pliny, (H. N., vii., 11.)

The following are a few of the most interesting observations which I have remarked in perusing this treatise. When the secundines are evacuated before the child, they cause difficult parturition, and the case is dangerous unless the head present. Presentations of the hand and foot are directed to be replaced. When the placenta is retained after the expulsion of the child, the child is to be laid upon wool, or upon two bladders, filled with water, either of which is to be pricked, so that the water may run off gradually, and thus draw down the placenta. When there is a copious discharge of blood before labor, there is a risk that the child may be dead, or at least not viable. When women with child long for coals, the appearance of these things is to be seen on the child’s head. (For the opinions of the ancients on the effect of imagination on the fœtus in utero, see the commentary on B. I., § 1, of Paulus Ægineta, Syd. Soc. edition.) Some ridiculous things are contained in this work, such as the following; when a man wishes to beget a male child let his left testicle be tied, and when a female the right.[255] The composition of suppositories for cleansing the uterus is described at considerable length towards the end of the treatise. Altogether, the work is by no means devoid of interest, but, as I have already said, it is certainly not the composition of Hippocrates. Littré, on the authority of the passage quoted from Aristotle on this head, refers the treatise to Leophanes. From the account which we have given of its contents, it will be remarked that the title and contents of it do not well accord together. This remark, however, applies to other of the Hippocratic treatises besides the one we are now treating of.

XLII. Περὶ γυναικείης—On the Female Nature.

As Foës remarks, this work is mostly made up of excerpts from the treatise “De Muliebribus.” I need not, therefore, occupy time in discussing its claims to be regarded as genuine, nor in giving an outline of its contents.

XLIII. Περὶ καρδίης—On the Heart.

Galen, in one place, appears to cite a passage in this treatise, but without naming it.[256] It is not found in Erotian’s list, and all the modern authorities, including even Foës, who is more disposed than most of the others to deal leniently with the claims of the treatises which bear the name of Hippocrates, concur in refusing to admit it as genuine. Still, however, there can be no question as to its being a work of very high antiquity. It is to be regretted, then, that the text is in a very unsatisfactory state. It contains, upon the whole, a wonderfully accurate description of all the parts about the heart—of its substance, which is said to be a strong muscle; of its pericardium, which is described as being a smooth tunic, containing a little fluid resembling urine; of its ventricles (γαστέρες); of its auricles (ὄυατα); of the origin of the veins from it; of its sigmoid valves; of its office, to be, as it were, the fountain head, from which all parts of the body are irrigated, and the seat of the understanding, which is said to be in the left ventricle. The understanding, it is added, is not nourished by the blood, but by a pure and luminous (φωτοειδὴς) superfluity from it. Altogether, this little treatise bespeaks much practical acquaintance with human anatomy, and, considering the age in which it was written, must be the production of a very superior mind. It contains an account of an experiment which has been much animadverted upon, both by ancient and modern authorities. The writer says, if a colored fluid be given to an animal, such as a sow, to drink, and if its throat be cut while it is in the act of swallowing, it will be found that part of the fluid has passed down by the gullet to the lungs. See in particular Aulus Gellius (Noctes Atticæ, xvii., 11); Macrobius (Saturnal. vii., 15); and Plutarch (Sympos. vii., 1.) Aulus Gellius says decidedly that Plato had adopted this opinion from Hippocrates. Aulus Gellius and Macrobius also quote Plutarch as having stated, in his ‘Symposiacon,’ that Hippocrates is the author of this opinion; but the text of Plutarch (l.c.) is in an unsatisfactory state. See Schulze (Hist. Med. i., iii., vi., 12.)

XLIV. Περὶ τροφῆς—On Aliment.

It must be admitted that this treatise has very high authorities in favor of its authenticity, such as Erotian, Galen,[257] Aulus Gellius,[258] Palladius,[259] Stephanus;[260] and, in modern times, Mercuriali, Foës, Haller, and Le Clerc.[261] It is rejected by Casper Hoffman,[262] Gruner, Ackerman, Kühn, Littré, and Greenhill, though, by the last two, not in decided terms. Considering the respectability of the external evidence in its favor, I should certainly not have hesitated in admitting it as genuine, had not a careful examination of its contents led me to form the unbiassed decision that it must be the production of some metaphysician, rather than of a medical practitioner, such as we know Hippocrates to have been. The physiological dogmata with which it abounds are announced in so antithetical, not to say paradoxical, a manner, that I can conceive nothing more foreign to the style and character of the true writings of Hippocrates. I shall give a few specimens:—“The species of aliment is one and many; all these (kinds of aliment?) are one nature and not one. Purging is upwards and downwards, and neither upwards nor downwards. Purging in aliment is excellent, purging in aliment is bad. Aliment not aliment, unless it conveys nourishment; it is aliment in name but not in deed; aliment in deed and no longer in name only. Sweet and not sweet; sweet potentially, as water, sweet to the taste, as honey. Things not animals are animated; animals are animated, the parts of animals are animated. It (the embryo) is and is not.” Now, I must say, that all this appears to me to savour more of the taste of Democritus than of Hippocrates himself. It may be said, indeed, that the very circumstance of Galen’s having admitted the work as genuine, and having composed an elaborate commentary on it, is a most presumptive proof of its authenticity; for where shall we find so excellent a judge of the doctrines of Hippocrates as his great commentator? But then it must be taken into account that Galen himself had a great penchant towards metaphysical subtleties, and this would lead him to believe that what was in accordance with his own tastes must have been in accordance with those of his great professional hero. But, notwithstanding the doubts which hang over the question of its authorship, it may be confidently affirmed regarding this treatise that, illustrated as it is by Galen’s commentary (even although it has come down to us in a mutilated state), few works in the Collection are more suggestive than the present one. I shall merely give a few more specimens of it:—“The root of the veins is the liver, and the root of the arteries is the heart; and from them blood and spirits are carried to all parts, and heat passes to the same.” This passage is frequently quoted and commented upon by ancient authors; as by Galen,[263] and Aretæus.[264] We have seen it stated in the preceding treatise that the heart is the place from which both veins and arteries originate. This seems a presumptive proof that these two treatises must have had a distinct authorship. “The aliment reaches to the hairs, the nails, and the outer surfaces from within; and aliment from without passes from the most external to the most internal parts, there is one conflux and one conspiration (ξύρροια μία, ξύμπνοια μία). All parts sympathize throughout the whole frame, but in so far every part has its own peculiar action.” This passage, also, is very celebrated and frequently quoted.[265] I need scarcely remark that it embraces a grand and most important view of the animal economy. “Milk is food to some with whom it agrees, and to others not. To some wine is food, and to others not; and so with flesh and many other kinds of aliment. We must look to situation and habit. Humidity is the vehicle of food. The natures (instincts?) of all things are untaught. Persons who perspire freely are weak, more healthy, and have easier recoveries than others. Those who perspire ill are stronger than others before they become indisposed, but being indisposed have more difficult recoveries. These remarks apply to the whole and to the parts.”

From these specimens it will be readily seen that the work abounds in curious matters, but of a very different stamp from those which the true Hippocratic treatises contain. Contrary, then, to my general rule, I certainly feel disposed in the present instance to reject, upon internal evidence, a treatise which has the most unexceptionable external evidence in its favor.

XLV. Περὶ σαρκῶν, ἤ ἀρχῶν—On Fleshes, or Principles.

This treatise does not appear in Erotian’s list of the Hippocratic works, and it is rejected by all the modern authorities, from Mercuriali downwards. Galen is inconsistent in his notice of it.[266] Some of the philosophical dogmata which it contains are curious, such as the following specimen: “It appears to me that what we call heat is immortal, and that it knows all, sees, hears, and perceives all things that are and will be.[267] When things, then, were thrown into confusion the greater part of this passed off to the highest circle, and this it is which the ancients called ether.” The following extract is held by Gruner, but probably without any good reason, to evince a degree of anatomical knowledge in advance of the age of Hippocrates: “There are two hollow veins from the heart, the one called the artery, and the other the vena cava. The artery has more heat than the vein.” The other veins are also described with considerable accuracy. It is stated that the fœtus in utero sucks in fluid (liquor amnii?) by its lips, and in proof of this the author remarks that the child voids fæces soon after delivery, which, it is argued, must be derived from food. The opinion thus stated has been often maintained in modern times, but does not appear to be well founded. The author mentions correctly that persons in attempting to commit suicide open the trachea, in which case, he adds, the patient lives, but loses his voice until the opening be closed. Conringius and Haller, with considerable plausibility, but yet without any direct proof, attribute this treatise to Democritus.

XLVI. Περὶ ἑβδομάδων—On Hebdomads.

This treatise exists now only in the Latin translation, which M. Littré has discovered in the Royal (National, it is now called!) Library in Paris, and will be published in his edition of the works of Hippocrates. M. Littré gives an elaborate and most interesting disquisition on it, and seems to make out clearly that it is the production of the same author as the treatise “On Fleshes,” which we last noticed. It is cited by Philo Judæus,[268] and several other writers of antiquity. Galen, however, held it not to be the production of Hippocrates. A considerable extract from it is contained in the tract “On Critical Days,” and the eighth section of the Aphorisms, which has always been looked upon as spurious, is said by M. Littré to be mostly taken from this treatise.

XLVII. Περὶ ἀδένων—On the Glands.

Erotian makes no mention of this treatise, and Galen pronounces it to be the work of the recent Hippocratists.[269] M. Littré remarks, and with great truth, that it is difficult to find out the grounds upon which the ancient critics have rejected this work. Certain it is that it contains a goodly store of interesting matters, none of which, as far as I can discover, are inconsistent with the true doctrines of Hippocrates. In it a pretty correct description is given of the glands, including those of the mesentery. The brain itself is said to be of glandular nature, and also the kidneys. An ingenious account is also given of the origin of scrofula, which is said to be produced by the lodgment of humors in the glands of the neck, which get into a state of slow inflammation. Glands, the author says, are seated mostly in parts of the body which most abound in humidities, such as the armpits and groins, and hence such parts produce hairs. In the case of the mesentery, however, no hairs are produced, because the humidities here are excessive, and choke up, as it were, the seeds of the hairs; in like manner as seeds sown in marshy grounds perish. A very ingenious account is given of the origin of phthisis, which is said to spring from tubercles in the lungs and matter (pus), which corrodes the lungs when “the patients do not readily recover.” A curious description is next given of the tabes dorsalis, “in which disease the patient does not wish to live.” How expressive this language is of the state of mind in the case of the unfortunates who are subject to spermatorrhœa! The treatise concludes with some striking remarks on the sympathy between the mammæ and uterus, and on the influence which both exercise on the development of the female character. Altogether the contents of this treatise are most valuable, and may suggest important views to the medical practitioner and physiologist, even at the present day. We need have no hesitation in pronouncing, with regard to it, that it reflects infinite credit on the school from which it emanated, and that it is not unworthy of Hippocrates, although we have reason to believe that he was not actually the author of it.

XLVIII. Περὶ φλεβῶν—On the Veins.

This is merely an excerpt from the treatise “On the Nature of the Bones.”

XLIX. Περὶ ἰητροῦ—On the Physician.

I may mention in this place, generally, that the treatises which follow have no ancient authority in support of them, and that, with very few exceptions, they are also rejected by all the modern critics. Their contents, moreover, are not of much practical importance, and therefore I shall be very brief in my analysis of them.

The treatise in question is held to be genuine by no one critic, as far as I know, with the exception of Foës, who appears, in part, to sanction its claims. The object of the author is announced to be in order to instruct the physician how to conduct matters connected with the iatrium, that is to say, with his establishment or surgery. Mercuriali, I may mention, is unjustly severe in his animadversions on the exordium. (See Conringius, Introd. p. 120.) The physician should have a healthy look himself, for the writer says, people fancy that a person who does not keep himself in good health is not qualified to take charge of the health of others. He should be of a prudent disposition and a gentleman in morals.[270] Minute directions are given respecting the site and other circumstances connected with the iatrium: clean and soft towels are to be at hand, linen is to be used for the eyes, and sponges for the sores. In supplying bandages, attention is to be paid to utility rather than to display. The surgeon should pay great attention to all matters connected with this operation: for it is attended with much disgrace when any manual operation does not succeed. Minute directions are given about the performance of venesection at the arm, and mention is made of several untoward accidents connected with it, such as the blowing up of the vein, whereby the flow of blood is stopped; and suppuration following as a consequence of the operation. In order to acquire dexterity in the treatment of accidents, the author recommends the young physician to attach himself to some foreign army; and from this Gruner infers, that the work cannot belong to Hippocrates, as domestic wars were but too common in his time; and there could have been no necessity for the surgeon’s seeking foreign service in order to gain experience. It does not occur to me, however, that there is much force in this argument; for intervals of peace were just as common during the long life of Hippocrates, as during the interval between his death and the time when the Collection was made. But, in fact, there is no necessity to seek recondite reasons for rejecting a treatise which has no proper authority in support of it.

L. Περὶ εὐσχημοσύνης—On Decorum.

This work, like the last, has not the slightest claim to be looked upon as genuine. Moreover, it has come down to us in a very unsatisfactory state as regards the text, so that the meaning is often very dark and uncertain; and I must confess that, as a general rule, I have little inclination to spend much time in searching out a meaning, in obscure writings, when, after it is discovered, it is not likely to repay the exertions made in discovering it. I am always disposed to remember the advice which Galen repeatedly gives to the student of medicine, “to concern himself more about things than about words.”[271] The object of the author seems to be to give general directions with regard to decorum in the physician’s communication with the sick. It is evidently the production of some sophist, according to Bernard, of some one belonging to the Stoical sect. I shall be brief in my abstract of it. A philosophical physician is equal to a god. In the practice of medicine all the virtues relating to wisdom are exercised; namely, contempt of money, decency, modesty, simplicity in dress, character, judgment, quietness, accessibility, purity of life, sententious maxims, knowledge of the purifications which are proper and necessary in life, abstinence from lucre, freedom from superstition, divine excellence. The physician should keep himself aloof, and not hold much converse with the common people, unless when necessary. The surgeon should be well provided with all the means required in the practice of his profession, such as dressings, medicines, instruments, and so forth, as any deficiency in these might produce serious results. Minute directions are given for the regulation of the physician’s address in entering the chamber of the sick, and his conduct while there.

LI. Παραγγέλιαι—Precepts.

This little tract stands altogether in much the same circumstances as the preceding one, that is to say, it is wholly destitute of all good authority in its favor, and the nature of its contents is what might rather be expected from a sophist than a practical physician. The text, moreover, is in a most unsatisfactory state. I shall dismiss it then with a very brief notice. It opens with an advice to the physician not to trust to speculation but to rational experience. He ought to learn remedies from all quarters, even from the vulgar, and not be avaricious in his dealings with the sick, more especially if strangers and needy. The author alludes, as Schulze thinks, to the practice then followed by the physicians of migrating from one city to another, and of making a public declaration of their pretensions at their first entry into any place. These physicians were called periodeutæ. The author of this tract advises the physician, in such a case, not to make any vainglorious or inflated profession of his abilities. He also enjoins the medical practitioner to look to the health of those who are free from disease, as well as those who was indisposed.

LII. Περὶ ἀνατομῆς—On Dissection.

This small fragment of ancient anatomical science has no claim to be regarded as the work of Hippocrates. Neither Erotian nor Galen, nor any other ancient critic, holds it as such, and the modern authorities are unanimous in rejecting it. That it may have been the composition of Democritus, as suggested by Gruner, seems not unlikely. It abounds in harsh and obsolete terms, which have never been satisfactorily explained. Some parts of the anatomical description are difficult to determine, as for example, “the large bronchia which extend from the heart to the liver;” “the vena scalena, which extends from the liver to the kidneys.” The latter passage, however, may be supposed to refer to the emulgent vein.

LIII. Περὶ ὀδοντοφυίης—On Dentition.

This little tract is destitute of any competent evidence of its authenticity. Some of the observations contained in it bespeak a familiar acquaintance with the diseases of infancy. Thus it is said, that when the bowels are loose at the term of dentition, if the digestion be good, the children thrive, and are not subject to convulsions. When children at the breast vomit up their food, the bowels are constipated. When there is fever accompanying dentition, children are seldom attacked with convulsions. But when there is heavy sleep along with dentition, there is danger of convulsions. All the children that are seized with convulsions at the time of dentition do not die. Children that take food during dentition bear vomiting best. Ulcers on the tonsils are attended with danger.

LIV. Περὶ ἐγκατοτὸμης άμβρύου—On Excision of the Fœtus.

No one stands up for the genuineness of this treatise,[272] which, however, is not wanting in interesting matter relative to the extraction of the fœtus in cross-presentations. For an abstract of the practice there recommended, see Paulus Ægineta, Vol. II., p. 389, Syd. Soc. edition. A circumstantial description is also given of the process of succussion, the dangerous effects of which, in certain cases, are related in the Epidemics.

LV. Περὶ ὄψιος—On Vision.

This little fragment is admitted by all the authorities to be spurious. It contains a description of glaucoma, for which purging of the head and the application of the actual cautery are recommended, and also in certain cases venesection. In epidemic ophthalmy, purging both of the head and bowels is recommended.

LVI. Περὶ ὀστέων φύσιος—On the Nature of the Bones.

M. Littré has very ingeniously shown that this work is a compilation made up of fragments of other works, and thus he has announced his intention of excluding it altogether from the Hippocratic Collection. Certain it is, beyond all dispute, that the treatise is not the production of Hippocrates himself. The following are a few of the most notable things which I have observed in it. “It appears to me that what we call heat is immortal, and that it understands, sees, hears, and perceives all things that are and will be.” The heat, it is further said, is the origin of all movement in animals. This will be recognized as the original of the doctrine of the Calidum innatum, which figures in the works of our earlier physiologists in modern times. See the works of Harvey and the other physiologists of the seventeenth century; also what is said on this subject in the next section. The aorta and vena cava are correctly described, the one as an artery, the other as a vein; and their origin from the ventricles of the heart is noticed. The author states (p. 440, ed. Kühn), that he had known cases of attempted suicide in which the windpipe had been opened, and yet death did not ensue; only while the opening remained the person lost the power of speaking. See No. XLV.

LVII. Περὶ κρισίων—On the Crises.

This tract has no ancient authority whatever in support of it, and Foës, Gruner, and Littré concur in holding it to be a compilation from other Hippocratic treatises, more especially the Aphorisms and Prognostics. This, indeed, must be obvious to every person who reads it with any attention.

LVIII. Περὶ κρισίμων—On Critical Days.

This treatise stands in the same predicament as the preceding one, that is to say, it has no ancient authority in support of it; indeed Galen declares against it when he says that Hippocrates had not given any work on the Critical Days. (Tom. iii., p. 440; ed. Basil.) It is manifestly a compilation from the other treatises, more especially from those “On Internal Diseases” and “On Diseases.” Still it appears to me to be an interesting and well-written compilation. For example, it would be difficult to point out in any other work, ancient or modern, a better description of pneumonia than is given towards the conclusion of it. Tetanus also is accurately described. To be sure, Gruner infers, from the circumstance that three varieties of this disease are described, that the work in question must have emanated from the Cnidian school. But Aretæus, and, indeed, all the ancient authorities that treat of tetanus, describe three varieties of this disease; and therefore this is no good reason for excluding it from the Coan school.

LIX. Περὶ φαρμάκων—On Purgative Medicines.

Though it must be admitted that this little fragment can boast of no competent authorities to establish its claim to be placed among the genuine works of Hippocrates, it bears undoubted marks of having been written by some person well acquainted with his principles, and having no ordinary acquaintance with professional matters. Thus the author states very correctly the effects of idiosyncrasy in modifying the operation both of purgatives and emetics, and advises the physician to make inquiry beforehand what effects such medicines, if formerly taken, had produced on the patient; for, he adds, it would be a disgraceful casualty to occasion a man’s death by the administration of a purgative medicine. He also interdicts the administration of purgatives during the heat of a fever, and during the very hot seasons of the year. These practical rules appear to me to be highly important, and yet how frequently do we see them disregarded! At the time we have mentioned, the author prudently remarks that it is safer to administer a clyster.

LX. Περὶ ἑλλεβορισμοῦ—On the Administration of Hellebore.

This little tract is usually published among the Epistolæ, and, as a matter of course, it has no evidence in support of its genuineness further than they have, which, as we shall presently see, is very slender. It contains, however, very acute and important observations on the administration of hellebore, to which it is well known that the Hippocratists were very partial. But these are mostly extracted from the Aphorisms, and need not be noticed in this place. The Book of Prognostics also is quoted, but seemingly by mistake.

LXI. Ἐπιστολαι—The Epistles.

No scholar can require to be informed that, since the memorable controversy in this country between the Honorable C. Boyle and the celebrated Dr. Bentley, respecting the authenticity of the Epistles which bear the name of Phalaris, the whole of the “Epistolæ Græcanicæ” have been generally condemned as spurious. Against this judgment I have no intention to protest; but I may be allowed to remark that many ancient works which are usually acknowledged as genuine have not so much external evidence in their favor as these Epistles possess. The Epistles ascribed to Plato, for example, are quoted as genuine by Cicero,[273] and by Diogenes Laertius.[274] Those of Hippocrates, too, are quoted and recognized by Erotian, Soranus, and other ancient authorities. Still, however, as I have stated, I have no intention to stand up against the general opinion of scholars from the Scaligers down to the present time, by which they have been condemned as supposititious; only I contend that, as it is admitted on all hands that they are very ancient,[275] that is to say, that they must have been composed within less than a hundred years after the death of Hippocrates, it is utterly incredible that the Sophists who wrote them, whether for a fraudulent purpose that they might derive profit from them by passing them off for the productions of the great name they bear, or whether for the purpose of displaying their own skill in sustaining an assumed character, should have made them turn upon alleged occurrences in the life of Hippocrates which every person at that early period must have been able to judge whether they were fictitious or not. I see no reason, then, to doubt that the main facts to which these Epistles relate are real, although the Epistles themselves be supposititious.[276]

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Having thus stated my opinion of these Epistles in general terms, I shall now dismiss them with a very brief notice.

They are differently arranged by modern authorities; I shall follow M. Littré in the few remarks which I have to offer upon them.

The first series of these Epistles relates to the services which Hippocrates is said to have rendered to the people of Athens during the time of the memorable plague. The spuriousness of these, it is generally held, is proved beyond all doubt by the silence of Thucydides with regard to any such professional services rendered by Hippocrates on the occasion; and no doubt if it were maintained that these took place at the outbreak of the disease in Greece, that is to say, at the commencement of the Peloponnesian war, the inference would be most legitimate. But if we be permitted to suppose that, as the plague is known to have lurked about in different parts of Greece for a considerable time, the services of Hippocrates did not take place until several years afterwards, there is nothing in the story which bears the slightest air of falsehood, even if we adhere to the common chronology respecting the birth of our author. Indeed, I repeat, if the Sophist who composed these letters had founded them on tales which everybody knew to be false, he could never have hoped to impose upon the learned men of the next generation, and make his forgeries pass for genuine.

The second series relates to Democritus, and these must be admitted to be the most interesting of the whole group. Now that Hippocrates visited Abdera, and that he was familiarly acquainted with Democritus, are facts which the most sceptical critic will hardly venture to call in question.[277] But that the Epistles themselves were not written by the physician and philosopher whose name they bear, I readily admit to be probable. Most undoubtedly the letter of Hippocrates, in which he is made to describe his visit to Democritus, however full it may be of curious matters, is written in a style and manner very unlike the well-known characters of the true writings of Hippocrates.

Third. The short letter inscribed from Hippocrates to his son Thessalus, contains nothing from which its authenticity or the contrary could be legitimately inferred, only it is destitute of all ancient authority in its favor. In it the father recommends to the son the study of geometry and arithmetic, as a proper preparation to the study of medicine.

Fourth. This series, consisting of “The Oration at the Altar,” “The Decree of the Athenians,” and “The Oration of Thessalus, son of Hippocrates,” although now generally regarded as spurious, possess more direct evidence in their favor than any of the others. In fact, they are decidedly recognized as genuine by Erotian. The documents in question have all reference to the services of Hippocrates and his disciples in the pestilence which pervaded Greece during the Peloponnesian war. These services are alluded to by many ancient authorities, as we have shown in the Commentary on Paulus Ægineta, Book II., § 35. In conclusion, I repeat that, supported as the main facts referred to in these documents are by the highest testimony which antiquity can furnish, I cannot but regard the facts as true, although the documents themselves be given up as supposititious.

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I will now briefly recapitulate the general results of the investigations on which I have been occupied in the present section:

1. That all the authorities, ancient and modern, who have investigated the question regarding the genuineness of the works which have come down to us under the name of Hippocrates, are agreed that a considerable portion of them are not the productions of the author himself.

2. That it is almost universally admitted that the following treatises are genuine, viz.:

• The Prognostics.
• On Airs, etc.
• On Regimen in Acute Diseases.
• Seven of the Books of Aphorisms.
• Epidemics I. and III.
• On the Articulations.
• On Fractures.
• On the Instruments of Reduction.
• The Oath.

3. That the following treatises may be pretty confidently acknowledged as genuine, although the evidence in their favor is not so strong as it is with regard to the preceding list:—

• On Ancient Medicine.
• On the Surgery.
• The Law.
• On Ulcers.
• On Fistulæ.
• On Hemorrhoids.
• On the Sacred Disease.

4. That as it certainly appears that the Book of Prognostics is composed, in a great measure, from the contents of the First “Prorrhetics” and the “Coacæ Prænotiones,” there can be little or no doubt that these two treatises are more ancient than the time of Hippocrates.

5. That although the exact time at which the Collection, as it now stands, was made out has never been determined in a very satisfactory manner, an examination of the contents of the different treatises leads to the conclusion that most of them represent pretty faithfully the opinions held by the family of Hippocrates and his immediate successors in the Coan school of medicine.

6. That a few of them, and more especially the two important works “On Internal Affections,” and “On Diseases,” would appear to bear distinct traces of having emanated from the contemporary school of Cnidos.

7. That although the Epistles and certain public documents usually published at the end of the Collection may justly be suspected of being spurious, there is undoubted evidence that they are of very ancient date, and were composed, most probably, within less than a hundred years after the death of Hippocrates, so that there is every reason for believing that they relate to real events in the life of our author, and not to fictitious as some have supposed.