The growth of medicine from the earliest times to about 1800

by Albert H. Buck

Haller speaks of Theodorus as the inventor of a remedy which, as he claimed, cures all cases of poisoning.

The Eclectics.—Agathinus, a native of Sparta, was the teacher of Herodotus and Archigenes. His chief distinction is to be found in the fact that he gave to the offshoot from the school of the Pneumatists the name of “Eclectics,”[35] his object being, as we are assured by Neuburger, to bring the three sects (Pneumatists, Empirics and Methodists) into closer union.

Herodotus—who, it is perhaps desirable to state, is a different person from the famous historical writer of the same name—lived during the latter part of the first century A. D., and was more closely allied to the Methodists than to the Pneumatists. It appears from the text of a fragment of one of his treatises that he wrote a description of the disease now called small-pox and directed attention to its contagious character.

Magnus, a native of Ephesus in Asia Minor, is reported to have been the writer of a collection of letters on medical topics and also of a history of the discoveries made in medicine subsequently to the time of Themison.

Archigenes, the fifth member of this group of Pneumatists, was born in Apamea, Syria, and lived in Rome under the reigns of Trajan (98–117 A. D.) and Hadrian (117–138 A. D.). Le Clerc speaks of him as belonging to the Eclectics rather than to the Pneumatists. This is a matter, however, of small importance, as the sects were, at that period, very much mixed. The poet Juvenal, who was a contemporary of Archigenes, refers to him briefly as a physician who had a large practice; and the historian Suidas says that he wrote a great deal about physics as well as about medicine. That he was esteemed highly as an authority in practical surgery is shown by the fact that Galen, when he discusses surgical topics, makes frequent quotations from the writings of Archigenes. Only fragments of the latter, however, have come down to our time. His popularity as a practitioner was very great; notwithstanding which he managed to write several treatises on a variety of topics—on the pulse, on feverish diseases, on the different types of fevers, on local affections, on the diagnosis and treatment of acute and chronic maladies, on the right moment when surgical operations should be performed, on drugs, and on therapeutic procedures in general. He applied ligatures to blood-vessels and also arrested further bleeding from them by passing needles through the adjacent parts in such a manner as to exert pressure upon the vessel (a procedure which is termed “acupressure”); he operated for the removal of both mammary and uterine cancers; he employed the red-hot cautery iron for the arrest of hemorrhage and also for the relief of coxalgia, and he was familiar with the use of the vaginal speculum.

Antyllus, another prominent surgeon of that period, joined the Methodists at a considerably later date. He was also the author of an excellent treatise on surgery, the greater part of which, unfortunately, has been lost or destroyed.

Aretaeus of Cappadocia, a district of Asia Minor, lived during the second century A. D. He was a man of very broad culture. From the fact that he assigned an important rôle to the pneuma, he is usually classed among the Pneumatists. He does not appear, however, to have taken a very active interest in the doctrines of that school, and both Le Clerc and Daremberg seem disposed to call him an Eclectic, and we may therefore rank him as one of the independent physicians of that period. It is doubtful whether he ever practiced in Rome. His two treatises—one on the causes and means of identifying acute and chronic diseases, and the other on the treatment of these diseases—are written in Greek, and are characterized by the clearness and simplicity of his descriptions, which very closely resemble those of Hippocrates, and by the soundness of the advice which he gives in regard to the methods of treatment.[36] In his conceptions of what a physician should aim to be, Aretaeus maintained a very high standard. Some of his views regarding human physiology and pathology are given here very briefly: Respiration serves the purpose of cooling the warmth of the heart, and the lungs are therefore prompted by the latter organ to draw cool air into their cavities; digestion takes place not only in the stomach but also in the intestinal canal, and owes its origin to warmth; the cerebral nerves, close to the spot from which they originate, cross from one side to the other, and by the aid of this fact paralysis on one side of the body may be explained. Aretaeus has gained considerable fame, says Puschmann, from his description of the “Syriac ulcer,” the picture of which he draws agreeing perfectly with what is known to-day as pharyngeal diphtheria. In various places throughout his writings he displays a thorough knowledge of normal anatomy—as, for example, when he describes the ramifications of the vena portae and gall-ducts of the liver. He was also well informed in matters belonging to the domain of pathology, for he gives admirable descriptions of many of the diseases—for example, pleurisy with empyema, pneumonia, pulmonary consumption, cerebral apoplexy, paraplegia, tetanus, epilepsy, diabetes mellitus, gout, etc. From the character of these descriptions one is strongly tempted to believe that he must have made a certain number of postmortem examinations.

According to Neuburger, Aretaeus enters very fully into details when he discusses the subject of diagnosis; his statements in one place warranting the belief that he even auscultated the heart. His methods of treatment were based largely upon his own experience and were generally of a simple character. He attached great importance, for example, to a very careful regulation of the diet, muscular exercise, massage, etc., and his employment of remedies was confined to a very small number of such drugs as exert a mild action. When the case, however, was of such a character as to call for more vigorous interference, he did not hesitate to resort to the use of opium, emetics, cathartics, venesection, blistering, the red-hot cautery iron, etc.

Rufus, a native of Ephesus, a city of Asia Minor, about thirty-five miles from Smyrna, is reckoned by most authorities among the Eclectics; in other words, he was an independent, or one who adopted from the teachings of the different sects such doctrines as met with his approval, but who, at the same time, did not care to pose as the disciple of any one of them. He received his medical training at Alexandria, but it is not known where he practiced his profession. Almost no details concerning his life or his professional career have come down to our time. It is simply known that he flourished during the reign of the Emperor Trajan (98–117 A. D.). Ebn Ali, an Arabian physician and author, says that he was the leading medical authority of his time and that his works were highly esteemed by Galen. His treatise on anatomy (entitled “The Names of the Different Parts of the Human Body”), which is one of the few that have escaped destruction, is described as a treatise which was written for students, and which possesses great value for the history of anatomical nomenclature. The same authority says that Rufus was the first to describe the chiasma, that he came very near establishing the existence of two different kinds of nerves—motor and sensory—and that he attributed the control of all bodily functions to the nervous system. He also states that he was one of the first to furnish a description of the oriental bubonic plague. Some idea of Rufus’ style of writing may be gathered from the following quotations which have been taken from his short treatise entitled “The Questioning of Patients”:—[37]

It is necessary to question the patient, for by so doing one may gather more exact information concerning the nature of the malady, and will then be able to treat it more intelligently. In this way also one may learn whether the patient’s mind is in a normal or an excited state, and whether any change has taken place in his physical strength. Some idea regarding the nature and seat of the disease is usually obtained from such questioning. If, for example, the patient answers clearly and to the point, and does not hesitate; if his memory does not play him false; if his speech is not thick or indistinct; if, being a well-bred man, he gives his responses in a polite and cultivated manner; or if, in the case of a person who is naturally timid, the answers reflect this timidity, then you may feel confident that your patient’s mind is not affected. But if, on the other hand, you ask him about one thing and he gives you a reply about something entirely different; if, as he talks, he appears to forget what he was talking about; if he has a trembling tongue the movements of which are also uncertain; and, finally, if from a certain state of mind he passes rapidly to one of a totally different character,—all these changes are evidences that the brain is beginning to be affected.... If the patient speaks distinctly and with a fairly strong voice, and is able to tell his story without stopping from time to time in order to rest, the inference is warranted that his physical strength is not materially affected....