The contents of the entire work are as follows: Book I.—Dietetics of Pregnant Women and of Children; Children’s Diseases; Massage, Gymnastics, Sexual Hygiene, Bathing, etc.; Book II.—General Pathology, the Doctrine of Fevers, Semeiology; Book III.—Diseases of the Hair, Diseases of the Brain and Nerves, Diseases of the Eyes, Ears, Nose, Mouth, Teeth and Face; Book IV.—Leprosy, Skin Diseases, Inflammations, Swellings, Tumors, Wounds, Ulcers, Fistulae, Hemorrhage, Worms, Affections of the Joints, etc.; Book V.—Toxicology; Book VI.—Surgery; Book VII.—Materia Medica.
To furnish even a very superficial analysis of the contents of this treatise would call for more space than can well be given up here to such a purpose. I shall therefore simply mention a few points of special interest to which Neuburger calls attention in the course of his very full analysis of the work. He states, for example, that Paulus mentions several instances in which patients affected with lung disease, coughed up calculi or small stone-like masses. He also states that the same author was familiar with the fact that in the course of “phthisis,” the pus may find its way into the bladder and there cause ulceration [in other words, that pus containing tubercle baccilli may flow down by way of the ureters and cause tuberculous ulceration of the bladder]. Paulus’ theory regarding the origin of gout, adds Neuburger, is quite remarkable for that early period. He maintains, for example, that in persons who lead a rather inactive life and who are often affected with digestive disorders, there is produced, through the inadequate power of the tissues of the body to assimilate the excess of nutriment brought to them, a materies morbi which is drawn first to the parts that are weakest or least capable of resistance (the joints, for example) and then also to other structures, as the liver, spleen, throat, ears and teeth. These ideas—let it be remembered—were set down in writing in 650 A. D.
At the beginning of his analysis of Book VI., Neuburger makes this remark: “Although the description given by Paulus of the surgery of the ancients is based upon the writings of Hippocrates and Galen, as well as upon those of Leonides, Soranus and Antyllus, one finds at every step ample evidence that the writer possessed both independence of judgment and the manual skill which belongs to a physician who is familiar with surgical work.” He calls particular attention to the section (No. 88) which deals with the manner of removing the heads of arrows from wounds, and he gives special praise to Paulus for his most instructive account of the diagnostic signs to be looked for in a case of suspected wounding of a vital organ. He is extremely thorough, says Neuburger, in his teachings about fractures and dislocations, and he not infrequently differs from the views expressed by his predecessors.
In the section devoted to gynaecological operations Paulus makes it perfectly clear that he was in the habit of using a speculum of a very practical form. Here are his words:—
... and, while the operator is holding the instrument in position, an assistant turns the screw until the blades of the instrument have been separated to the distance desired.
In other chapters of Book VI., Paulus furnishes most interesting and minute descriptions of a great variety of operations in general surgery and also in obstetrics, ophthalmology, otology and rhinology. Those who desire to learn further details about these surgical matters should consult the English version mentioned on a previous page.
It is not at all unlikely that at some future day it will be found desirable—by reason of the discovery of the treatises which they are known to have written, but which have been lost—to add to this short list of ancient medical authors the names of the following men who are frequently quoted by them in their works: Antyllus, who made some really valuable additions to our knowledge of the proper manner of treating aneurysms, and who must have been a surgeon of great resourcefulness; Leonides, the Alexandrian, who lived about the time of Galen, and who appears to have been highly considered for his practical common sense in the choice of surgical measures; Hesychios of Byzantium and his distinguished son, Jacobus Psychrestus, who was highly spoken of by his contemporaries (fifth century A. D.), in whose honor a public statue was erected (Haller), and to whom is attributed the saying: “A good physician should either decline at the start to take charge of a patient, or else he should not leave him until he shall have brought about some measure of improvement”; finally, Heliodorus, and perhaps a few others who are less well known.
CHAPTER XVIII
BEGINNING OF THE ARAB RENAISSANCE UNDER THE CALIPHS OF BAGDAD
Toward the end of the sixth century A. D. the prospects for the perpetuation and further evolution of Greek medicine looked decidedly dark. In Rome and in the larger Italian towns of the Roman Empire, physicians were doubtless still to be found, but they must have led very precarious lives and they certainly could not have had any leisure or opportunity for scientific work. In these earlier years of the Middle Ages the monks conducted the larger part of whatever medical practice was required in the districts in which the monasteries were located. In Byzantium, also, the outlook at this period of Roman history was very unfavorable; and nowhere else, as a matter of fact, would it have been possible for the casual observer to discover any signs that indicated the approach of a revival in the study of the sciences. And yet, even at that seemingly darkest moment in the history of medicine, there were forces at work which would soon revive these precious seeds of Greek knowledge, and, after transplanting them to a richer soil, cause them to produce even better fruit and in larger quantities than ever before.
The rulers under whose auspices the first steps in the great Arab Renaissance were taken, belonged to what is known as the Abbaside Dynasty, the founder of which was Abbas (566–652 A. D.), the uncle of Mohammed. His descendants ruled as Caliphs of Bagdad, on the eastern bank of the Tigris, for many centuries (from 750 A. D. onward).[47] Almansur, the second Caliph of this dynasty, felt a very strong desire that his people, the Arabs, should acquire knowledge of all the useful branches of learning, and more especially of medicine and philosophy; and accordingly, as the Greeks were then universally admitted to be the only nation which possessed that knowledge, and as scarcely any scientific books written in the Arabic language existed at that early date, he directed all his efforts to the finding of Greek originals and of the men qualified to translate them into Arabic. Already as early as the sixth century A. D., Sergius, a Christian of Ras el Ain, had translated a considerable number of Greek treatises into the Syrian tongue, but his work was found to be of an inferior character, and for this reason could not be utilized to any great extent in the present undertaking. Honein (ninth century), one of the most eminent scholars of the Arabic Renaissance, revised a few of these translations and thus rendered them of some service; but by far the larger part of this gigantic task of creating Arabic versions of the classical works of Greek literature, was performed during the ninth century, a period during which the reign of the Arabs extended from the Ganges on the east to the Atlantic on the west. By the end of the eighth century the work of translating had advanced only to the point of producing a single treatise on medicine and a few relating to alchemy; but before the ninth was completed, the Arabs had in their possession, in the form of translations, nearly all the scientific literature of Greece, and, more than this, they could boast that not a few men belonging to their own nation had already become celebrated as scientists of the very first rank.