Soranus of Ephesus, the son of Menandrus, was educated at Alexandria. He practised at Rome in the reigns of Trajan and Hadrian. He was one of the most eminent physicians of the Methodical school, and was mentioned with praise by Tertullian and St. Augustine. He wrote the only complete treatise on the diseases of women which antiquity has given to us. We find from this work that a valuable instrument used in gynæcology, and thought by many to be of modern invention—the speculum—was mentioned by Soranus as used by him. Amongst the articles used by surgeons which have been recovered from the ruins of Pompeii, these instruments have been discovered, showing that they were in regular use in ancient times. He seems to have had a complete knowledge of human anatomy, for he describes the uterus in such a manner as to show that his knowledge was acquired by dissecting the human body, and not merely from that of animals. He explained the changes induced by pregnancy, and spoke of the sympathy existing between the uterus and the breasts, which is so important for the physician to know. He must have had a greater knowledge of the scourge of leprosy than his contemporaries.
Soranus, in his work on gynæcology, advises that midwives should be temperate, trustworthy, not avaricious, superstitious, or liable to be induced to procure abortion for the sake of gain. They were to be instructed in dietetics, materia medica, and minor surgical manipulations. Soranus did not think it was requisite for them to know much about the anatomy of the pelvic organs, but they were to be able to undertake the operation of turning in faulty presentations. Only when all attempts to deliver a living child had failed was embryotomy to be performed. Juvenal and other writers intimate that these accomplished accoucheuses often developed into regular doctresses. In difficult cases they called in the assistance of physicians or surgeons.
Julian (A.D. 140) was the pupil of Apollinides of Cyprus. He was at Alexandria when Galen studied there. He wrote an introduction to the study of medicine, and opposed the principles of Hippocrates. Like the greater number of the Methodists he was ill-read, and Galen blamed him for having neglected the humoral pathology.[471]
Cælius Aurelianus was a celebrated Latin physician, who is supposed to have lived in Rome about the first or second century. Very little is known about him, but the fact that he belonged to the Methodical school, and showed great skill in the art of diagnosis.
He wrote treatises on acute and chronic diseases, and a dialogue on the science of medicine. Next to Celsus, he is considered the greatest writer of his school. His works are based entirely on the Greek of Soranus.
He was a popular writer, as is proved by the fact that in the sixth century his works were text-books on medicine in the Benedictine monasteries. He has well described gout and hydrophobia, and, according to Baas, was the inventor of condensed milk (!). Even auscultation is hinted at in his works, and he recommends the air of pine forests in chest diseases. His suggestions for the treatment of nervous and insane patients were far in advance of his age, as he disapproves of restraint.[472]
Greek and Roman Pharmacy.
It is very difficult to decide with certainty what the ancients actually intended by the names they gave their medicines. Exact as Hippocrates and Galen usually are in their terminology, we are often at a loss to know precisely what was the nature of the remedies they employed. Alum, for example, as we understand it, is a very different thing from the alum of the ancients. What the Greeks and Romans called alumen and στυπτηρία, says Beckmann, was vitriol, or rather a kind of vitriolic earth. They were very deficient in the knowledge of saline substances. Hemlock, which is called also Conium, Κώνειον, or Cicuta, was probably not the poison employed at Athenian executions. Pliny says that the word Cicuta did not indicate any particular species of plant, but was used for vegetable poisons in general. Dr. Mead[473] considers that the Athenian poison was a combination of deadly drugs; it killed without pain, and probably opium was combined with the hemlock.[474] Hellebore was of two kinds, white and black, or Veratrum album and Helleborus niger respectively. Galen says we are always to understand veratrum when the word Ἑλλέβορος is used alone. White hellebore was used by the Greeks, says Stillé,[475] in the treatment of chronic diseases, especially melancholy, insanity, dropsy, skin diseases, gout, tetanus, hydrophobia, tic doloureux, etc. It was mixed with other drugs to moderate the violence of its action. It fell into disuse, and is now hardly ever employed internally. It is an exceedingly dangerous drug, and was doubtless used on the “kill or cure” principle. Black hellebore was given as a purgative. Healthy people took the white variety to clear and sharpen their faculties. It fell into disuse about the fifth century after Christ. A very celebrated medicine in popular use even in modern times was Theriaca. Galen says that the term was properly applied to such medicines as would cure the bite of wild beasts (θηρίων), as those which were antidotes to other poisons (τοῖς δηλητηρίυις) were properly called ἀλεξιφάρμακα.[476]
Andromachus, physician to the emperor Nero, invented the most celebrated of these preparations; it was known as the Theriaca Andromachi, and was very similar to that of Mithridates, king of Pontus, the recipe for which was said to have been found amongst his papers after his death by Pompey. This was known to the Roman physicians under the name of Antidotum Mithridatium. The composition of this medicine was varied greatly in the hands of its different preparers, and it underwent considerable alterations from age to age. Celsus first described it, with its thirty-six ingredients; then Andromachus added to it the flesh of vipers, and increased the number of ingredients to seventy-five. He described the whole process of manufacture in a Greek poem, which has been handed down to us by Galen. Damocrates varied some of the proportions of the compound, and wrote another poem upon it, also preserved by Galen.
The medicines prescribed by the Greek and Roman physicians were all prepared by themselves. At that time materia medica consisted chiefly of herbs; some of these plants were used not only for medicinal, but also for culinary purposes, and were collected by other than practitioners of medicine. Many plants were used also for cosmetic purposes and in the baths, so that there must have been numerous collectors and dealers in herbs. Just as in our time dispensing chemists and others have acquired a certain knowledge of the medicinal virtues of the things they sell, so the pigmentarii, seplasiarii, pharmacopolæ, and medicamentarii possessed themselves of medical secrets, and thus invaded the territory of the doctors.