The School of the Empirics was the outcome of the system of Scepticism, introduced by Pyrrho and extended by Carneades, who taught that there is no certainty about anything, no true knowledge of phenomena, and that probability alone can be our guide. Ænesidemus carried this scepticism into the medicine of the Empirics, but the school was originally established under the title of the Teretics or Mnemoneutics. The Empirics rested their system on what was called the “Empiric tripod,”—that is, accident, history, and analogy. Remedies have come to us by chance, by the remembrance of previous cures, and by applying them to similar cases.
The sect of the Empiricists was founded by Serapion of Alexandria and Philinus of Cos in the third century B.C. They were in opposition to the Dogmatists, professing to derive their knowledge only from experience; they held that the whole art of medicine consisted in observation, experiment, and the application of known remedies which have constantly proved valuable in the treatment of one class of diseases to other and presumably similar classes. Celsus,[421] in his account of the principles of this sect, says that “they admit that the evident causes are necessary, but deprecate inquiry into them because nature is incomprehensible. This is proved because the philosophers and physicians who have spent so much labour in trying to search out these occult causes cannot agree amongst themselves. If reasoning could make physicians, the philosophers should be the most successful practitioners, as they have such abundance of words. If the causes of diseases were the same in all places, the same remedies ought to be used everywhere. Relief from sickness is to be sought from things certain and tried, that is from experience, which guides us in all other arts. Husbandmen and pilots do not reason about their business, but they practise it. Disquisitions can have no connection with medicine, because physicians whose opinions have been directly opposed to one another have equally restored their patients to health; they did not derive their methods of cure from studying the occult causes about which they disputed, but from the experience they had of the remedies which they employed upon their patients. Medicine was not first discovered in consequence of reasoning, but the theory was sought for after the discovery of medicine. Does reason, they ask, prescribe the same as experience, or something different? If the same, it must be needless; if different, it must be mischievous.
“But what remains is also cruel, to cut open the abdomen and præcordia of living men, and make that art, which presides over the health of mankind, the instrument, not only of inflicting death, but of doing it in the most horrid manner; especially if it be considered that some of those things which are sought after with so much barbarity cannot be known at all, and others may be known without any cruelty: for that the colour, smoothness, softness, hardness, and such like, are not the same in a wounded body as they were in a sound one; and further, because these qualities, even in bodies that have suffered no external violence, are often changed by fear, grief, hunger, indigestion, fatigue, and a thousand other inconsiderable disorders, which makes it much more probable that the internal parts, which are far more tender, and never exposed to the light itself, are changed by the severest wounds and mangling. And that nothing can be more ridiculous than to imagine anything to be the same in a dying man, nay, one already dead, as it is in a living person; for that the abdomen may indeed be opened while a man breathes, but as soon as the knife has reached the præcordia, and the transverse septum is cut, which by a kind of membrane divides the upper from the lower parts (and by the Greeks is called the diaphragm), the man immediately expires; and then the præcordia, and all the viscera, never come to the view of the butchering physician till the man is dead; and they must necessarily appear as such of a dead person, and not as they were while he lived; and thus the physician gains only the opportunity of murdering a man cruelly, and not of observing what are the appearances of the viscera in a living person. If, however, there can be anything which can be observed in a person which yet breathes, chance often throws it in the way of such as practise the healing art; for that sometimes a gladiator on the stage, a soldier in the field, or a traveller beset by robbers, is so wounded that some internal part, different in different people, may be exposed to view; and thus a prudent physician finds their situation, position, order, figure, and the other particulars he wants to know, not by perpetrating murder, but by attempting to give health; and learns by compassion that which others had discovered by horrid cruelty. That for these reasons it is not necessary to lacerate even dead bodies; which, though not cruel, yet may be shocking to the sight; since most things are different in dead bodies; and even the dressing of wounds shows all that can be discovered in the living” (Futvoye’s Translation).[422]
Philinus of Cos, the reputed founder of the school, was a pupil of Herophilus, and lived in the third century B.C. He declared that all the anatomy his vivisecting master had taught him had not helped him in the least in the cure of his patients. He has been compared with Hahnemann.
Serapion of Alexandria was also of the third century B.C. He must not be confounded with the Arabian physician of this name. He wrote against Hippocrates. He discarded all hypotheses. He was the first to prescribe sulphur in chronic skin diseases; and he used some singular and disgusting remedies in his treatment. One of these was crocodiles’ dung, which in consequence became scarce and costly. Glaucias, who invented the “Empiric Tripod,” Zeuxis and Heraclides of Tarentum, lived about this period. The latter wrote commentaries on Hippocrates, and used opium to procure sleep. He mentions strangulated hernia in one of his treatises.
Many commentaries were written about this time on Hippocrates; and the art of pharmacy, especially the preparation of poisons, was much studied in the second century B.C. Botanic gardens were established, and men began to experiment with antidotes for poisons. “Mithridaticum,” so called after Mithridates the Great of Pontus, was a famous antidote which was used even to recent times. Nicander of Colophon wrote poems on poisons, and antidotes, leeches, and emetics for the first time appeared in poetry, and the symptoms of opium and lead-poisoning were not beneath the attention of the muse. Attalus III., king of Pergamos, was in constant fear of being poisoned, says Plutarch,[423] amused himself with planting poisonous herbs, not only henbane and hellebore, but hemlock, aconite, and dorycnium. He cultivated these in the royal gardens, gathered them at the proper seasons, and studied their properties and the qualities of their juices and fruits.
Cleopatra is said by Baas[424] to have written a work on the diseases of parturient and lying-in women, etc. She paid special attention, it would seem, to maladies of a specific character.
Le Clerc gives a list of the women who have exercised the profession of medicine in ancient times.[425]
Cleopatra treated the diseases of women. Artemisia, Queen of Caria, Isis, Cybele, Latona, Diana, Pallas, Angita, Medea, Circe, Polydamna, Agameda, Helen, Œnone, Hippo, Ocryoe, Epione, Eriopis, Hygeia, Ægle, Panacea, Jaso, Rome, and Aceso are the ladies of classic story who had more or less acquaintance with medicine for good or evil purposes. That women, subject to many disorders for which in any state of society their natural modesty would make it difficult for them to consult men, should become proficient in the treatment of complaints which are peculiar to their sex, is the most natural thing in the world, and it is probable that very much of our knowledge of the treatment of these cases may be due to feminine wisdom. An ancient law of the Athenians forbade women and slaves to exercise the art of medicine, so that even midwifery, which they considered a branch of it, could only be practised by men. Some Athenian ladies preferred to die rather than be attended by men in their confinements. Women acted as accoucheuses in Egypt, Greece, and Rome, and some of them in classic times wrote books on medicine. Ætius gives some fragments in his works from a doctress named Aspasia.
Although the Greek physicians did not know anything of the circulation of the blood as we understand it, they were not wholly ignorant of the phenomena of the vascular system.