The brain was considered as merely a gland which condenses the ascending vapours into mucus. The office of the nerves was to convey the animal spirits throughout the body. We must not forget that the science of anatomy was extremely imperfect even at the beginning of the present century.
“When,” says Littré,[388] “one searches into the history of medicine and the commencement of the science, the first body of doctrine that one meets with is the collection of writings known under the name of the works of Hippocrates. The science mounts up directly to that origin, and there stops. Not that it had not been cultivated earlier, and had not given rise to even numerous productions; but everything that had been made before the physician of Cos has perished. We have only remaining of them scattered and unconnected fragments. The works of Hippocrates have alone escaped destruction; and by a singular circumstance there exists a great gap after them as well as before them. The medical works from Hippocrates to the establishment of the school of Alexandria, and those of that school itself, are completely lost, except some quotations and passages preserved in the later writers; so that the writings of Hippocrates remain alone amongst the ruins of ancient medical literature.”
It is vain to inquire how Hippocrates acquired a knowledge which seems to us so far in advance of his age. Was Greek wisdom derived from the East, or was its philosophy the offspring of the soil of Hellas? Such questions have often been discussed, but to little purpose. There would seem to be every reason to suppose that Greek medicine was indigenous. We have no means of knowing how long philosophy and medicine had been united before the time of Hippocrates. The honour of affecting the alliance has been ascribed to Pythagoras.
Several of the Greek philosophers speculated about medicine. We have seen that besides Pythagoras, Empedocles and Democritus did so, although it is not probable that they followed it as a profession. The Asclepiadæ probably brought medicine to a high state of perfection, but the work these priest-physicians did is a sealed book to us. All was darkness till Hippocrates appeared.
In his treatise On Ancient Medicine, he says that men first learned from experience the science of dietetics; they were compelled to ascertain the properties of vegetable productions as articles of food. Then they learned that the food which is suitable in health is unsuitable in sickness, and thus they applied themselves to the discovery of the proper rules of diet in disease; and it was the accumulation of the facts bearing on this subject which was the origin of the art of medicine. “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.”[389]
He assiduously applied himself to the study of the natural history of diseases, especially with the view to determine their tendencies to death or recovery. In every case he asked himself what would be the probable end of the disorder if left to itself. Prognosis, then, is one of the chief characteristics of Hippocratic medicine. He hated all charlatanism, and was free from all popular superstition. When we reflect on the medicine of the most highly civilized nations which we have considered at length in the preceding pages, and remember how full of absurdities, of magic, amulet lore, and other things calculated to impose on the credulity of the people, were their attempts at healing, we shall be inclined to say, that the most wonderful thing in the history of Hippocrates was his complete divorce from the evil traditions of the past. Although he forsook philosophy as an ally of medicine, his system was founded in the physical philosophy of the elements which the ancient Greeks propounded, and which we have attempted to explain. There was an all-pervading spiritual essence which is ever striving to maintain all things in their natural condition; ever rectifying their derangements; ever restoring them to the original and perfect pattern. He called that spiritual essence Nature. “Nature is the physician of diseases.”[390] Here, then, we have the enunciation of the doctrine of the Vis Medicatrix Naturæ. In his attempts to aid Nature, the physician must regulate his treatment “to do good, or at least, to do no harm”;[391] yet he bled, cupped, and scarified. In constipation he prescribed laxative drugs, as mercury (not the mineral, of course, but Mercurialis perennis), beet, and cabbage, also elaterium, scammony, and other powerful cathartics. He used white hellebore boldly, and when narcotics were required had recourse to mandragora, henbane, and probably to poppy-juice.
He is said to have been the discoverer of the principles of derivation and revulsion in the treatment of diseases.[392]
Sydenham called Hippocrates “the Romulus of medicine, whose heaven was the empyrean of his art. He it is whom we can never duly praise.” He terms him “that divine old man,” and declares that he laid the immovable foundations of the whole superstructure of medicine when he taught that our natures are the physicians of our diseases.[393]
He was Father of Surgery as well as of medicine. Eight of his seventeen genuine works are strictly surgical. By an ingenious arrangement of apparatus he was enabled to practise extension and counter-extension. He insisted on the most exact co-aptation of fractured bones, declaring that it was disgraceful to allow a patient to recover with a crooked or shortened limb. His splints were probably quite as good as ours, and his bandaging left nothing to be desired. When the ends of the bones projected in cases of compound fractures, they were carefully resected. In fracture of the skull with depressed bone the trepan was used, and in cases where blood or pus had accumulated they were skilfully evacuated. He boldly and freely opened abscesses of the liver and kidneys. The thoracic cavity was explored by percussion and auscultation for detection of fluids, and when they were discovered paracentesis (tapping) was performed. This was also done in cases of abdominal dropsies. The rectum was examined by an appropriate speculum, fistula-in-ano was treated by the ligature, and hæmorrhoids were operated upon. Stiff leather shoes and an admirable system of bandaging were employed in cases of talipes. The bladder was explored by sounds for the detection of calculi; gangrenous and mangled limbs were amputated; the dead fœtus was extracted from the mother. Venesection, scarification, and cupping were all employed.[394]
He resected bones at the joints. In the treatment of ulcers he used sulphate of copper, sulphate of zinc, verdigris, lead, sulphur, arsenic, alum, etc. He came very near indeed to the antiseptic system in surgery when he made use of “raw tar water” (a crude sort of carbolic acid, in fact) in the treatment of wounds. Suppositories were employed.