In summing up, then, the basis for the various systems of medicine during this period of antiquity, it is seen that the most ancient doctrine of all—Dogmatism—directs our attention especially to the animal economy in health and disease; that it took account of the union of vital forces, of sympathies in the organism, and of nature's efforts to repel both internal and external deleterious influences, which providential tendency manifests itself especially in certain acute diseases. This was the strong side of dogmatism. Its weak side consisted in this: that it was held that the causes of diseases inhere in the access of certain qualities and humors along with organic forces,—such as dryness or moisture in combination with bile or atrabile,—and the treatment was directed against these supposed causes. It was on account of this weakness that the enemies of dogmatism attacked it. The empirics opposed the idea that inaccessible and occult causes of disease could become the basis for rational treatment. They affirmed that there was no consistent relation of antagonism or similitude between the disease and the remedies which cured it.
The Methodists somewhat improved on the doctrine of empiricism, but ran wild in its improvement and erected over their fundamental theory such a superstructure of secondary and tertiary generalities as to cause the fundamental part to be entirely obscured from sight.
There were not lacking, in those days of old, certain educated physicians who more or less vaguely comprehended that the entire truth of medicine did not inhere in any one of these systems, but that there was good and evil in each. These men, not being able to establish general rules, tried to decide practical questions according to their fancy or their reason. They assumed the name of Eclectics or Episynthetics, meaning thereby that they adopted no exclusive system, but selected from each that which seemed to them best. They did not constitute a sect, because they had no precise dogmas nor theories, but they should not be confounded with the Pyrrhonians, who held to doubt as a fundament doctrine, the true eclectic doubting only that which he could not understand. True eclecticism in medicine, however, is rather the absence of fixed principles, or, as Renouard says, it is "individualism erected into a dogma, which escapes refutation because it is deficient in principle." Many became eclectics to avoid discussing principles, and made of it a shelter. In one sense, then, an eclectic is one destitute of profound convictions, who sides with no particular party, is committed to no person or doctrine, and who is often so indifferent that he cannot judge with impartiality; consequently, to be truly eclectic is different from being an adherent of a school of eclecticism.
During the historic period just reviewed, anatomy and physiology made most progress, next internal and external nosography, and next to these medical and surgical therapeutics, and although Coelius Aurelianus and Aretæus have left to us by far the best books issued up to their times, nevertheless not one of the writers of this period has achieved the distinction in which Hippocrates is held, since he, perhaps more than any other, combined intelligence, sincerity, disinterestedness, love of his art, and humanity.
Under the classification of Renouard, already alluded to, the so-called Age of Transition includes centuries commencing with the death of Galen, about A.D. 201, and ending with the revival of letters in Europe, about the year 1400. The first period of this transition age is the so-called Greek Period, which ends with the burning of the Alexandrian library, A.D. 640.
At the time when this historic period commenced all the known world was under the dominance of a single man. The power of Septimus Severus had more extent than that of Alexander the Great, and bid fair to be of a much longer existence. The Roman dominion, cemented by seven hundred years of bold and persevering government, seemed almost immovable. While the savages upon its frontiers occasionally troubled its peace, none were strong enough to penetrate its centres or place it in real peril. The great civil wars had ceased, or changed their object.
Both the people and the senate, those two eternal competitors, had gotten over the struggle for supreme power; monarchial government was accepted as a matter of fact, and the citizens contended only for choice of a master.
Similar changes had taken place in the domain of the mind; philosophical discussions, which were so essentially a part of the schools of the ancient Greeks, had nearly lost their interest and were being discontinued. Such disputes as took place related less to principle than to interpretation of the language of the teacher. In morals, Plato, Epicurus, and Zeno were followed until the principles of Christianity gradually supplanted their teaching; in physics and metaphysics the authority of Aristotle, and in medicine that of Galen, were simply undisputed.
Conditions being such as these, there was naturally but one sect in medicine, and one method of study and practice. Medical science retrograded rather than progressed, sad to say, and was undisturbed by any remarkable revolution. The scepter of medicine passed from the hands of one nation to those of another, and the language of Hippocrates and Galen was later replaced, as will duly be seen, by that of Avicenna and Albucassis. But this Greek Period, which is one of transition, offers little for our consideration more than the lives and writings of four of its most eminent physicians, who by their study in the school of Alexandria, and by their writings and teachings, left reputations which were sustained until the invasion of the Arabs. Of these it may be said that, while they did little or nothing original, and simply commented upon the writings of Hippocrates and Galen, they kept burning the torch of medical learning which else had been almost extinguished by their indolent contemporaries. Of these various commentators—for they were little more than that—the first of any importance after Galen was Oribasius, who was horn in Pergamos (328-403); he early attached himself to the fortunes of Julian the Apostate, and followed him into Gaul when he was made its governor. Julian appreciated the good qualities of Oribasius, made him an intimate friend, and after he himself became emperor appointed his friend as quæstor at Constantinople. After the emperor's untimely death, Oribasius remained faithful to his memory, but his jealous colleagues so falsely and so successfully misrepresented his fidelity that he was disgraced, spoiled of his office and property, and banished among a barbarous people. In this new field, however, he displayed such courage, effected such extraordinary cures, discoursed so eloquently, and so attached to himself the savage men around him, that he was by them regarded as a god. The fame of this homage in time reached the ears of the Emperors Valens and Valentinianus, who recalled him, reimbursed him for his losses, and permitted him to enjoy his high reputation and fortune to the end of his days. He was held to be the wisest man of his time, most skillful in medicine, and the most charming in conversation. He dedicated a collection of seventy books to Julian, his first patron, and edited, at a later period, an abridgment of this work for the benefit of his son. His principal merit consisted in reproducing the ideas of others with such clearness, order, and precision that the summaries that he gives of them are often preferable to the originals. What he has said of pregnant women, nursing, and the earliest education of the child has been copied literally by writers for twelve centuries since his time. It must be said of him, however, that his prepossession in favor of Galen was so great that he adopted servilely his ideas and even his words to such an extent that he has been surnamed "the ape of Galen."
Ætius was born in Mesopotamia in the year 502 and died in 575. He studied at Alexandria, and afterward went to Constantinople, where he became a chamberlain at court. Ætius was the first medical man of any note who professed Christianity, as is shown by such passages as this one: he said that in the composition of certain medicaments the following words should be repeated in a low voice: "May the God of Abraham, the God of Isaac, and the God of Jacob deign to bestow upon this medicament such and such virtues." In another place he recommends that to extract a bone from the throat the following words be pronounced: "Bone—as Christ caused Lazarus to come forth from the sepulchre, as Jonah came out of the whale's belly—come out of the throat or go down." But he exhibits the same credulity in not doubting the miraculous virtues attributed by the quacks of his day to most remedies.