The following quotation is from his treatise on gout:—
If the patient complains that one of his joints is painful, he should be asked whether or not the part has received a blow. If he replies that it has not, then (you may infer that the pain is due to gout and) you should forthwith put him on a suitable diet, order a clyster and bleed him at a spot not far (from the seat of the pain).... The withdrawal of nourishment is ordered for the purpose of arresting any further formation of new blood and thus preventing the joints from growing more sluggish in their movements. The clyster is ordered because we believe that it is beneficial (in this condition) to evacuate the bowels. The bleeding will be found useful, but to a less degree in the lower than in the upper limbs.... One must be careful not to assume that the patient is cured when he has been entirely relieved of his pain, because with the lapse of time fresh attacks are liable to occur; this disease, like certain other affections, possesses a periodic character.... Therefore it is well, immediately after the bloodletting, to employ friction, to get rid of the excess of moisture in the body by some laborious form of exercise, to take such articles of food as are easily digested,—in brief, to aim chiefly at reducing as much as possible the moisture of the body.
One cannot but feel a keen regret that so few of the writings of this thoroughly practical and highly educated physician should have come down to our time. So far as I am able to learn, Rufus wrote no fewer than 102 treatises, all of which, with the exception of the seven about to be mentioned (together with a number of fragments preserved by different writers of antiquity) have either disappeared or been destroyed. The titles of the treatises which have been preserved are as follows: (1) Diseases of the Kidneys and Bladder; (2) On Satyriasis and Gonorrhoea; (3) Purgatives; (4) The Names of the Different Parts of the Human Body; (5) On the Questioning of Patients; (6) On the Pulse; (7) On Gout.
A General Survey of the Subject of Sects in Medicine.—During the sixth century B. C.,—that is, about two hundred years before the formation of the more distinctly medical sects of which mention was made in Chapter IX.,—Pythagoras of Samos and his disciples put forward certain beliefs or doctrines with regard to the mode of action of some of the functions or vital processes of the human body, and all those who accepted these teachings as affording a true and satisfactory explanation of the phenomena in question constituted what is generally termed a school or sect. Some of these individuals were physicians—that is, men who undertook to cure or at least to relieve those who were ill; but probably the majority were simply philosophers, mere “lovers of wisdom,” who by studying problems of this nature sought to satisfy their longing for a more perfect knowledge of the truth respecting the various phenomena of life.
A few years later, Heraclitus of Ephesus, who, like Pythagoras, was both a philosopher and a practicing physician, taught the doctrine that all things owe their origin to fire. One is not at all surprised to learn that he had relatively few followers, for history tells us that he was both a misanthrope and a slanderer of the medical profession, as shown by the following saying which is attributed to him: “Next to physicians the grammarians are the biggest fools in the world.”
Hippocrates attached much importance to the value of experience and to the necessity of studying disease at the bedside; at the same time he upheld what is commonly known by the name of humoral pathology—a doctrine which refers all maladies to some abnormal change in the humors or fluid portions of the body. His writings also show that he made full use of the reasoning power. The followers of this great physician did not form a sect in the ordinary sense of the term; they were his adherents simply because he was an able diagnostician, a successful teacher, an excellent therapeutist, a skilful surgeon, a man of very high moral character,—in short, a great physician. Every sect which developed in the centuries following his death contained a goodly proportion of Hippocratists.
Nearly two centuries after the active period of the professional life of Hippocrates, Erasistratus and Herophilus gathered about themselves in Alexandria (about 280 B. C.) large groups of followers, who held for their respective teachers a degree of esteem which amounted, according to Galen, almost to veneration. As there was little or no antagonism or lack of harmony between the doctrines taught by these physicians, the two groups cannot properly be classified among the sects. In fact, it would be more correct to say that Erasistratus and Herophilus contributed facts of permanent value to our stock of knowledge rather than doctrines which might prove highly popular for a few scores of years, but which would probably in due course of time be set aside as no longer of value.
The four most characteristic types of sects in medicine were the following: the Dogmatists—or Rationalists, as Daremberg calls them in one place; their great rivals, the Empirics; the Methodists; and the Eclectics. The oldest sect, the Dogmatists, did not come into prominence until after the medical schools at Alexandria had already been in operation for a long time. The development of the rival sect of the Empirics at this late period brought with it endless discussions regarding the merits of their respective teachings, and thus both of them gained a degree of prominence which seems to us moderns to have been out of all proportion to the importance of the subject-matters discussed. The Dogmatists, says one writer, insisted that it is just as necessary to be acquainted with the “hidden causes” of disease as with those which are plainly recognizable, and that it is only by aid of the reasoning power that we gain some knowledge of this class of causes. They claimed that, while a knowledge of anatomy is of very great service to the surgeon, it usually renders this service through the aid of the reasoning power; as when, in the performance of a lithotomy, the operator selects the fleshy (i.e., vascular) neck of the bladder as the spot in which to make the opening with the knife, in preference to the base of the organ, which is chiefly membranous in structure and therefore less likely to heal solidly.
The plausible but rather shallow response made by the Empirics to the arguments advanced by their rivals consisted in quoting certain maxims, as, for example: “The farmer and the helmsman do not acquire knowledge of their respective occupations from discussions, but from actual practice”; “It is not of vital importance to know what are the causes of the different diseases, but what remedies are competent to cure them”; and “Diseases are not cured by eloquence, but by remedial agents.”
Among the comments made by Celsus with regard to the differences which distinguished the Dogmatists from the Empirics we find the following statement: “The two sects employed the same remedies and pursued very much the same course of treatment, but their reasonings about such matters were different.”