History of the Intellectual Development of Europe, Volume I (of 2) / Revised Edition

by John William Draper

Origin of Greek medicine—Asclepions.

Greek medicine arose in the temples of Æsculapius, whither the sick were in the habit of resorting for the assistance of the god. It does not appear that any fee was exacted for the celestial advice; but the gratitude of the patient was frequently displayed by optional gifts, and votive tablets presented to the temple, setting forth the circumstances of the case, were of value to those disposed to enter on medical studies. The Asclepions thus became both hospitals and schools. They exercised, from their position, a tendency to incorporate medical and ecclesiastical pursuits. At this time it was universally believed that every sickness was due to the anger of some offended god, and especially was this supposed to be the case in epidemics and plagues. Such a paralyzing notion was necessarily inconsistent with any attempt at the relief of communities by the exercise of sanitary measures. In our times it is still difficult to remove from the minds of the illiterate classes this ancient opinion, or to convince them that under such visitations we ought to help ourselves, and not expect relief by penance and supplications, unless we join therewith rigorous personal, domestic, municipal Hippocrates destroys the theological theory of disease. cleanliness, fresh air, and light. The theological doctrine of the nature of disease indicated its means of cure. For Hippocrates was reserved the great glory of destroying them both, replacing them by more practical and material ideas, and, from the votive tablets, traditions, and other sources, together with his own admirable observations, compiling a body of medicine. The necessary consequence of his great success was the separation of the pursuits of the physician from those of the priest. Not that so great a revolution, implying the diversion of profitable gains from the ancient channel, could have been accomplished without a struggle. We should reverence the memory of Hippocrates for the complete manner in which he effected that object.

Writings of Hippocrates.

Of the works attributed to Hippocrates, many are doubtless the production of his family, his descendants, or his pupils. The inducements to literary forgery in the times of the Ptolemies, who paid very high prices for books of reputation, have been the cause of much difficulty among critics in determining such questions of authorship. The works indisputably written by Hippocrates display an extent of knowledge answering to the authority of his name; his vivid descriptions have never been excelled, if indeed they have ever been equalled. The Hippocratic face of the dying is still retained in our medical treatises in the original terms, without any improvement.

His opinions.

In his medical doctrine, Hippocrates starts with the postulate that the body is composed of the four elements. From these are formed the four cardinal humours. He thinks that the humours are liable to undergo change; that health consists in their right constitution and proper adjustment as to quantity; disease, in their impurities and inequalities; that the disordered humours undergo spontaneous changes or coction, a process requiring time, and hence the explanation of critical days and critical discharges. The primitive disturbance of the humours he attributed to a great variety of causes, chiefly to the influence of physical circumstances, such as heat, cold, air, water. Unlike his contemporaries, he did not impute all the afflictions of man to the anger of the gods. Along with those influences of an external kind, he studied the special peculiarities of the human system, how it is modified by climate and manner of life, exhibiting different predispositions at different seasons of the year. He believed that the innate heat of the body varies with the period of life, being greatest in infancy and least in old age, and that hence morbific agents affect us with greater or less facility at different times. For this reason it is that the physician should attend very closely to the condition of those in whom he is interested as respects their diet and exercise, for thereby he is able not only to regulate their general susceptibility, but also to exert a control over the course of their diseases.

Referring diseases in general to the condition or distribution of the humours, for he regards inflammation as the passing of blood into parts not previously containing it, he considers that so long as those liquids occupy the system in an unnatural or adulterated state, disease continues; but as they ferment or undergo coction, various characteristic symptoms appear, and, when their elaboration is completed, they are discharged by perspiration or other secretions, by alvine dejections, etc. But where such a general relief of the system is not accomplished, the peccant humours may be localized in some particular organ or special portion, and erysipelatous inflammation, mortification, or other such manifestations ensue. It is in aiding this elimination from the system that the physician may signally manifest his skill. His power is displayed much more at this epoch than by the control he can exert over the process of coction. Now may he invoke the virtues of the hellebores, the white and the black, now may he use elaterium. The critical days which answer to the periods of the process of coction are to be watched with anxiety, and the correspondence of the state of the patient with the expected condition which he ought to show at those epochs ascertained. Hence the physician may be able to predict the probable course of the disease during the remainder of its career, and gather true notions as to the practice it would be best for him to pursue to aid Nature in her operations.

The character of his practice.

It thus appears that the practice of medicine in the hands of Hippocrates had reference rather to the course or career of disease than to its special nature. Nothing more than this masterly conception is wanted to impress us with his surprizing scientific power. He watches the manner in which the humours are undergoing their fermenting coction, the phenomena displayed in the critical days, the aspect and nature of the critical discharges. He does not attempt to check the process going on, but simply to assist the natural operation.

When we consider the period at which Hippocrates lived, B.C. 400, and the circumstances under which he had studied medicine, we cannot fail to admire the very great advance he made. His merit is conspicuous in rejecting the superstitious tendency of his times by teaching his disciples to impute a proper agency to physical causes. He altogether discarded the imaginary influences then in vogue. For the gods he substituted, with singular felicity, Impersonal Nature. It was the interest of those who were connected with the temples of Æsculapius to refer all the diseases of men to supernatural agency; their doctrine being that every affliction should be attributed to the anger of some offended god, and restoration to health most certainly procured by conciliating his power. So far, then, as such interests were concerned, any contradiction of those doctrines, any substitution of the material for the supernatural, must needs have met with reprehension. Yet such opposition seems in no respect to have weighed with this great physician, who developed his theory and pursued his practice without giving himself any concern in that respect. He bequeathed an example to all who succeeded him in his noble profession, and taught them not to hesitate in encountering the prejudices and passions of the present for the sake of the truth, and to trust for their reward in the just appreciation of a future age.