Outlines of Greek and Roman Medicine

by Sir James Elliott

THE FIRST AND SECOND CENTURIES OF THE CHRISTIAN ERA.

Athenæus — Pneumatism — Eclectics — Agathinus — Aretæus — Archigenes — Dioscorides — Cassius Felix — Pestilence in Rome — Ancient surgical instruments — Herodotus — Heliodorus — Cælius Aurelianus — Soranus — Rufus of Ephesus — Marinus — Quintus.

Athenæus, of Cilicia, a Stoic and Peripatetic, founded in Rome the sect of the Pneumatists about the year A.D. 69. It was inspired by the philosophy of Plato. The pneuma, or spirit, was in their opinion the cause of health and of disease. They believed that dilatation of the arteries drives onward the pneuma, and contraction of the arteries drives it in a contrary direction. The pneuma passes from the heart to the arteries. Their theories also had reference to the elements. Thus, the union of heat and moisture maintains health; heat and dryness cause acute diseases; cold and moisture cause chronic diseases; cold and dryness cause mental depression, and at death there are both dryness and coldness. In spite of these strange opinions the Pneumatists made some scientific progress, and recognized some diseases hitherto unknown. Galen wrote of the Pneumatists: "They would rather betray their country than abjure their opinions." The founder of the sect of Pneumatists was a very prolific writer, for the twenty-ninth volume of one of his works is quoted by Oribasius. The teaching of the Pneumatists speedily gave way to that of the Eclectics, of whom Galen was by far the most celebrated. They tried to reconcile the teaching of the Dogmatists, Methodists, and Empirics, and adopted what they considered to be the best teaching of each sect. The Eclectics were very similar to, if not identical with, the Episynthetics, founded by a pupil of Athenæus, by name, Agathinus. He was a Spartan by birth. He is frequently quoted by Galen, but none of his writings are extant.

Aretæus, the Cappadocian, practised in Rome in the first century of our era, in the reign of Nero or Vespasian. He published a book on medicine, still extant, which displays a great knowledge of the symptoms of disease very accurately described, and reliable for purposes of diagnosis. He was the first to reveal the glandular nature of the kidneys, and for the first time employed cantharides as a counter-irritant (Portal, vol. i, p. 62). It is not surprising that Aretæus followed rather closely the teaching of Hippocrates, but he considered it right to check some of "the natural actions" of the body, which Hippocrates thought were necessary for the restoration of health. He was not against phlebotomy, and used strong purgatives and also narcotics. He was less tied to the opinions of any sect than the physicians of his time, and was both wonderfully accurate in his opinions and reliable in treatment. Aretæus condemned the operation of tracheotomy first proposed by Asclepiades, and held "that the heat of the inflammation becomes greater from the wound and contributes to the suffocation, and the patient coughs; and even if he escapes this danger, the lips of the wound do not unite, for both are cartilaginous and unable to grow together." He believed, also, that elephantiasis was contagious. The writings of Aretæus consist of eight books, and there have been many editions in various languages. Only a few chapters are missing.

Archigenes was a pupil of Agathinus, and is mentioned by Juvenal. He was born in Syria and practised in Rome in the reign of Trajan, A.D. 98-117. He introduced new and very obscure terms into his writings. He wrote on the pulse, and on this Galen wrote a commentary. He also proposed a classification of fevers, but his views on this subject were speculative theories, and not based upon practical experience and observation. To him is due the credit of suggesting opium for the treatment of dysentery, and he also described accurately the symptoms and progress of abscess of the liver. By some authorities he is thought to have belonged to the sect of the Pneumatici.

Dioscorides was the author of a famous treatise on Materia Medica. At different times there were several physicians of this name. He lived shortly after Pliny in the first century, but there is some doubt as to the exact time. His five books were the standard work on Materia Medica for many centuries after his death. He compiled an account of all the materials in use medicinally, and gave a description of their properties and action. This entailed great knowledge and industry, and is of value as showing what drugs were used in his time. Since then practically the whole of Materia Medica has been changed. He held largely to the orthodox beliefs of Dogmatism, but a great deal of what he recommends is not comprised in the doctrines of this sect, and is decidedly Empirical. It is difficult or impossible to identify many of the drugs referred to by Dioscorides, partly because his descriptions are brief, partly because the mistakes of his predecessors are found in his book.

He exercised as much authority in Materia Medica as Galen did in the practice of medicine, and the successors of each were content, in the main, to follow blindly. A large work was published in England in 1806 to illustrate the plants of Greece described in the treatises of Dioscorides.

Cassius Felix is supposed to have lived in the first century of our era, but practically nothing is known of his history. He wrote a book on medicine consisting of eighty-four questions on medical and physical subjects and the answers to them.

In A.D. 79, after the eruption of Vesuvius, there was a great pestilence in Rome, which historians ascribed to the pollution of the air by the eruption. Fugitives crowded into Rome from the devastated part of the country, and there was great poverty and an accumulation of filth in the city, which was, doubtless, the true cause of the pestilence. Treatment of fever at that time was very imperfect at the best, and proper means of prevention and treatment were entirely absent in time of pestilence. It has been computed that ten thousand people died daily at that time in Rome and the surrounding district. Excavations at Pompeii have done a great deal to reveal the state of surgical knowledge towards the end of the first century of our era. Professor Vulpes has written an account of the surgical instruments recovered from the ruins, and there is a collection of ancient surgical instruments in the Naples museum. Vaginal and rectal specula have been found: also a forceps for removing fractured pieces of bone from the surface of the brain. There is an instrument considered by Professor Vulpes to have been used as an artery forceps. Other instruments discovered are: Forceps for removing tumours; instruments for tapping in cases of dropsy (such an instrument was described by Celsus); seven varieties of probes; bronze catheters; 89 specimens of pincers; various kinds of knives, bone-elevators, lancets, spatulas, cauteries, saws, and trephines.[1]