"2. Failing in these methods, they appeal to State Boards to regulate and fix standards of entrance, curriculum, etc., trusting thus to make some one come short.

"3. They ask Boards to state just what drugs shall be taught in a medical school, and what shall serve as a basis for examination. "4. Their council officials constantly appeal to the secular press in interview, even prior to the making of their reports to the main body, condemning and belittling smaller institutions of learning.

"5. They, in their reports, incessantly reiterate there are too many colleges and too many doctors, and seek the aid of Boards of Health and Examining Boards and others in authority to eliminate the smaller and weaker ones.

"6. Their constant cry is, 'The Boards are too lenient with the applicants.' Too many pass; there are too many physicians. (I often wonder if the examiner can pass his own examination.) The output must be curtailed.

"7. They are now publishing medical journals, considering the advisability of publishing others-a health journal for the laity, and even entering into the book-publishing business. Condemn State journals, independent journals, and exclaim, 'How holy am I! My advertisements are all censored,' yet the Journal of the American Medical Association contains advertisements for more proprietary remedies than any journal published with which I am acquainted.

"8. It is constantly by means of its organization and committees besieging the Legislatures of every State in the Union for restrictive and class legislation. Legislation favorable to its own interestswhat more can a trust do? What more does the Standard Oil, Sugar, Tobacco, or Steel Trust do? They seek to control trade, strangle opposition, control output, and regulate prices. Does not the American Medical Association do all these? One need only watch their actions, read their reports, and judge for one's self. I am afraid, notwithstanding their denial, the term fits them aptly. "No one believes for one moment that Senator Owen introduced that bill on his own initiative. It is too absurd to think that a layman would do so. The cry for the department started before Senator Owen was a senator.

"So far as "State medicine' is concerned, you have been advocating it for years. Read the Bulletin of the American Academy of Medicine for the past year for an answer. If not 'State medicine,' why the move to have State universities take all the medical colleges under the wing? Why the appropriation in Nebraska and Illinois? Why the move in Ohio, to have the State University take over the Starling?

"Ah! my friends, I am afraid you are guilty and all your actions will not bear close scrutiny or investigation."-Mundy, Eclectic Medical Journal, December, 1911.

SELECTED ARTICLES.

ARETEUS, THE FORGOTTEN PHYSICIAN.

BY VICTOR ROBINSON, NEW YORK CITY.

Whatever the final judgment may be, one thing stands out as certain-after Hippocrates, no single Greek author has equaled Aretæus, and no work in the entire literature so nearly approaches to the true spirit of Hippocratism, both in description of disease and in therapeutic principles, as the work of the Cappadocian.-Neuburger: "History of Medicine."

Aretæus is one of the most original and eloquent writers of antiquity. Starting with a thorough acquaintance with the science of his day, taking Hippocrates as his model, and repudiating all futile speculations, he details the simple results of his own experience, in a systematic treatise of eight books on the history and treatment of acute and chronic diseases, and in a manner so striking and appropriate as rarely to have been excelled.-Watson: "Ancient Medicine."

"Who is Aretaus?" asked a distinguished professor of Johns Hopkins University, on seeing the Cappadocian's name on a program.

This question could well echo answerless throughout the medical world until it reached a medical historian. For Aretæus is a forgotten physician. A name once high in medical annals has fallen low; a star which once shone next to Hippocrates has lost its luster. Who is Aretæus?

Galen, Avicenna, and other physicians of antiquity, became authorities in the Middle Ages; during this long period Aretaus was unknown, and his oblivion still survives.

It is difficult to mention a subject or author who is not indexed at the Astor Library, but Aretaus has not a single card. This means obscurity indeed.

Clio seems more solicitous of the destroyers than of the healers of men. We know when the Duke of Alva was born, and are not in doubt of the day of Attila's death. But we do not know whether the discoverer of the pulmonary circulation of the blood was born in 1509 or in 1511; we are uncertain whether the father of modern surgery came into the world in 1510 or in 1517; with regard to Paulus Ægineta, the guesses are wider: Le Clerc says he belongs to the fourth century; Van der Linden says he was born in the fifth

century; Sprengel says he lived in the seventh century; Vossius says nothing.

So far as Aretaus is concerned, there is a similar latitude of opinion; we have the consolation of knowing that he lived either in the first, the second, or the third century. One reason for this uncertainty is that Aretæus quoted no author except Hippocrates; and no authors quoted him, except Etius and Paulus Ægineta, and, as both of these writers lived considerably after the time of Aretæus, their reference to him furnishes no clew to his period. He is also mentioned in the "Euporista," formerly attributed to Dioscorides. If this were indeed the work of Dioscorides, it would practically solve the problem, as it is almost universally admitted that Dioscorides flourished in the first century. But it is now agreed that "Euporista" is not the composition of Dioscorides, but the work of a later age. According to the learned Francis Adams, the circumstance that neither Galen or Aretæus mention each other, proves they were contemporaries.

There is even a conflict as to whether he belonged to the pneumatic school, or to the school of eclectics, or to any school at all. In truth, had he founded a school, let it be as irrational as isopathy, his fame would be more secure.

It is quite certain that Aretæus lived in Alexandria, as he makes numerous references to the habits and therapeutics of the Egyptians; it is also probable that at some time he resided in Italy, as he is familiar with the various brands of Italian wine: Fundan and Falernian, Signine and Surrentine. But all the biographic data that we know with certainty can be expressed in one short sentence: Aretæus, a Greek physician of a Roman province in Asia Minor, described diseases in admirable Ionic.

As he is invariably called Aretæus the Cappadocian, we may say a word concerning this territory. In the time of Herodotus, Cappadocia occupied a considerable portion of Asia Minor, extending from Mount Taurus to the shores of the Euxine. It was originally an independent kingdom, but the Persians divided it into two satrapies, one of which became known as Pontus, while the inland province retained its name of Cappadocia. Now began sanguinary struggles, and there were endless intrigues, assassinations, murders, slaughters, cold-blooded cruelties without beginning or end. In the year 17, Cappadocia became a Roman province, grew and prospered, and produced St. Gregory, the still-celebrated ecclesiastic, and Aretæus, the physician, who is forgotten.

But though the ever-falling dust of time has almost covered him over, it can not make the name of Aretæus as if it had not been; for Aretæus has reared unto himself a monument more enduring than brass-what say you, Quintus Horatius Flaccus? His seven-arched structure was as follows: Diseases, therapeutics, fevers, surgery, prophylaxis, gynecology, pharmacy.

It is true the dome has fallen and the base has disappeared, but enough remains to demonstrate that Aretaus was one of the greatest of ancient physicians.

ARETEUS AS A DESCRIPTIVE WRITER.

It is a delight to read Aretaæus. He is not superstitious; his mind is not befuddled with outlandish theories; he is clear, rational and scientific; he does not indulge in any of those mystical speculations which disfigure the pages of Paracelsus. Moreover, he is a stylist. No doubt the strangest passage Paracelsus ever wrote was his fantastic account of the uterus: "In the middle of the flanks of women lies the womb, a female viscus, closely resembling an animal, for it is moved of itself hither and thither in the flanks, also upwards in a direct line to below the cartilage of the thorax; and also obliquely to the right or the left either to the liver or spleen; and it likewise is subject to prolapses downwards, and, in a word, is altogether erratic. It delights in fragrant smells, and advances towards them; and it has an aversion to fetid smells, and flees from them; and, on the whole, the womb is like an animal within an animal."

No medical author surpasses Aretaus in his vivid portrayal of disease. When he describes consumption, we are not obliged to read the symptoms twice to make a diagnosis. We actually seem to hear the hoarse, chronic cough, the clearing of the throat, the blood and pus spat up; we notice the sweats, the pallor, the cadaverous aspect; we see the bony fingers, the thickened joints, the curved nails, the sharp and slender nose, and the prominent Adam's apple; we see the narrow chest, the lips drawn over the teeth, the muscles of the arm gone, the ribs sticking through the skin, the shoulderblades projecting like wings of birds, and the eyes hollow and brilliant.

HE GRAPHICALLY DESCRIBES NUMEROUS DISEASES.

His descriptions of tetanus, epilepsy, hysteria, and asthma have been especially praised, but his picture of satyriasis is as powerful as any: "Satyrs, priests of Bacchus, in the paintings and statues,

have the phallus erect, as the symbol of the divine performance. It is also a form of disease, in which the patient has erection of the genital organ, the appellation of satyriasis being derived from its resemblance to the figure of the god. It is an unrestrainable impulse to connection; but neither are they at all relieved by these embraces, nor is the tentigo soothed by many repeated acts of sexual intercourse. Spasms of all the nerves, and tension of all the tendons, groins, and perineum, inflammation and pain of the genital parts, redness of countenance, and a dewy moisture. Wrapped up in silent sorrow, they are stupid, as if grievously afflicted with their calamity. But if the affection overcome the patient's sense of shame, he will lose all restraint of tongue as regards obscenity, and likewise all restraint in regard to the open performance of the act. Raving with his obscene imagination, he can not contain himself; tormented with thirst, he vomits much phlegm, and the foam sits upon his lips as in a lascivious goat, and he has a smell like that animal.” Strangely enough the author of the above had no knowledge of nymphomania, and even denied its existence.

Among other disorders which he treats in an interesting manner are: migraine, jaundice, elephantiasis, leucorrhea, hemoptysis, pneumonia, diarrhea, aortitis, cephalalgia, angina, dropsy, gonorrhea, dysentery, apoplexy, phrenitis, cachexia.

In his writings we find, for the first time, an account of diphtheria. The description is well done, except as to the etiology. There were giants in those days, but no compound microscopes, and Aretæus knew not the Klebs-Loeffler bacillus. He is the first European who wrote a systematic account of diabetes.

He was probably the first to use the trephine in epilepsy. He likewise had knowledge of tracheotomy. But his greatest claim to our consideration is his practice of auscultation. Dr. Cordell, professor of the history of medicine in the University of Maryland, believes Aretaus is the only one of the ancient writers who auscultated the heart. Rene Laennec, inventor of the stethoscope, had a renowned forerunner.

He distinguished between the paralyses of motion and of sensation, and knew that injuries to the brain produce paralysis on the opposite side. He divided mental disturbances into mania, melancholia, and settled insanity-not a bad classification.

He described lead colic and other disturbances due to lead poisoning. In obstruction of the urethra by vesical calculus,