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MAY 1 1904
THE PHYSICIAN'S ESTABLISHMENT,
IN the critical notice of this treatise given in the second section of the Preliminary Discourse, I have briefly described the nature and object of the Iatrium. There seems to be no doubt that it was an establishment belonging to the periodeutæ, or traveling physicians, in which were kept all sorts of medicines and surgical apparatus required in the practice of the profession. This, then, would resemble "the surgery" spoken of by Pott,' as a place in which he received his patients for consultation. In my younger days I have visited what I regard as having been "the surgery" of a famous operator in the north, a contemporary of Pott, Dr. Thomas Livingston, of Aberdeen. It was then in the keeping of his son, and, in accordance with the spirit of the times, had ceased to be "a surgery," and was become little more than "a cabinet of antique curiosities;" it consisted, in short, of a choice collection of surgical instruments and everything else that constituted a portion of the armamentarium chirurgicum; but I was given to understand that, in former times, medicines were regularly prepared and compounded in it by the apprentices and attendants of the physician, for the purpose, no doubt, of being used by him in the practice of his profession, although I can scarcely suppose that it was patent to the public as a laboratory. Such an establishment, then, would be quite akin to the Iatrium of Hippocrates and his successors. I have ventured then to translate Iatrium by " the surgery." Galen hesitates respecting the title; he says, some named it, "On the Iatrium;" and some "On the things relating to the Iatrium," because it treats of matters connected with the Iatrium."
'Injuries of the Head, sect. 2, Case I.
? The fullest account which we possess of the ancient iatrium, is that which is contained in the Hippocratic treatise, De Medico. The author of the treatise, after giving some general directions respecting the construction of the house, namely, that it should be so constructed that neither the wind nor sun might prove
No one can read this tract attentively without being impressed with the truth of Galen's remark respecting it, namely, that it is merely a rough sketch of a work, and that it had not been finished by the author for publication. Indeed, Galen sometimes expresses himself in equivocal terms as to its authenticity, and M. Littré was at first disposed to exclude it from the list of genuine works, but afterwards decided upon admitting it. One thing, at all events, is quite clear respecting it, namely, that it is a compendium of the subject-matters which are discussed fully in the works "On Fractures," and "On the Articulations," more especially in the former of these. In a word, it is a succinct outline of surgical matters, nearly unintelligible by itself, but highly valuable for refreshing the memory and methodizing the information collected from the works we have just referred to. In execution it bears a resemblance to some of the esoteric works of Aristotle, which are composed in so condensed a style, that they would be nearly unintelligible if they were not illustrated by copious commentaries. The tract of Theophrastus "On Stones," is another work of the same class as the present one.
§ 1. The work begins with a brief enumeration of the general principles of diagnosis, or, more properly speaking, of semeiology, and of the objects and means by which diseases are to be recognized. The grand rule for discrimination is held to be the comparison of the diseased part with the corresponding part on the sound side.
§ 2. A most comprehensive statement is then given of all the matters and objects relating to the surgery,-the operator,-the patient, the assistants, the instruments,-the light,-the position of the patient and of the operator, and so forth.
§3. The circumstances connected with surgical operations are then discussed somewhat more fully, and very sensible directions are laid down in regard to the conduct of the operator and of the patient.
§ 4. Some very acute remarks are next made with regard to the operator's hand, and the means to be used in order to acquire dexterity and elegant manipulation.
§ 5. Directions are then given for the disposal of the surgical instruments, so that they may be readily got hold of when required by the
offensive to the patient, goes on to enumerate the various articles which it should contain, such as scalpels, lancets, cupping-instruments, trepans, raspatories, with bandages and medicines. That it was “an operation-room" there can be no doubt; whether it was also a public laboratory for the sale of medicines is not so clear; but it seems probable, from what we learn respecting the iatrium which Aristotle inherited from his father, Nicomachus (see Suidas, under Aristoteles), for Athenæus taunts Aristotle with having been a druggist (papuakonúng).-Deipnos, viii., 13. I ought to have stated above, that Galen, in his Exegesis, etc., explains the title of this work as follows: Kar' intpčiov tà katà tìv xɛipovpɣiav.—See further, Malgaigne, Operat. Surg., Pref. Engl. Edit.