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discovering and dériving experiments from philosophy and the knowledge of causes.” Then he says: “Our course and method, however, as we have often said and again repeat, is such as not to deduce effects from effects, nor experiments from experiments, (as the empirics do,) but in our capacity as legitimate interpreters of nature, to deduce causes and axioms from effects and experiments, and new effects and experiments from these causes and axioms." Celsus is here quoted as a precedent by Lord Bacon for his system of philosophy.
The prerequisites for a practitioner in medicine, as given by Hippocrates in his work entitled “The Law," assumes the same course for thought and duty. He says: “Whoever is to acquire a competent knowledge of medicine, ought to be possessed of the following advantages : a natural disposition, instruction, a favorable position for the study, early tuition, love of labor, leisure. First of all a natural talent is required, for, when nature opposes, every thing else is vain; but when nature leads the way to what is most excellent, instruction in the art takes place, which the student must try to appropriate to himself by reflection, becoming an early pupil in a place adapted for instruction. (Probably having in his eye his school on the Island of Cos.) He must bring to the task a love of labor and perseverance, so that the instruction taking root may bring forth proper and abundant fruits. Having brought all these requisites to the study of medicine, and having acquired a true knowledge of it, we shall be esteemed physicians, not only in name, but in reality. But inexperience is a bad treasure and a bad fund to those who possess it, whether in opinion or reality, being devoid of self-reliance and contentedness, and the nurse both of timidity and audacity; for timidity betrays a want of power, and audacity a want of skill. There are, indeed, two things, knowledge and opinion, of which the one makes its possessor really to know, the other to be ignorant."
Here we observe clearly inculcated that kind of knowledge necessary for a successful physician-experience with the aid of both talent and labor, with the advantages of the best instruction, bringing to view the germ of inductive philosophy.
At this period of time, being over 400 B. C., the philosophy of Pythagoras bore its sway among the Grecian philosophers, and had been taught by its author about a century before. The influence which his doctrines had on medicine, in connexion with the dogmas of other philosophers of this age, made it the first object of Hippocrates to break off their claims. Celsus in his preface to his eight books on medicine says, that “ Hippocrates was the first worthy of
memory who separated this science from philosophy—a man not less admired for his skill in this art, than in that of eloquence." Or, as Shulze contends in his History of Medicine, “ that what Celsus meant was, that Hippocrates discarded a priori arguments in medicine, and drew all bis inferences from actual observation."
A short extract from Plato's Timæus will present a condensed view of the philosophy of Socrates and that of Pythagoras, which has a bearing upon medicine.
“When the Creator undertook to arrange the universe, he first gave shapes with forms and numbers to fire and earth, water and air, (Pythagorean Ed.) which possessed indeed certain traces of their true essence, though, nevertheless, wholly so situated as every thing would probably be in the absence of its God. And let us above all things hold and ever hold, that the Deity made them as far as possible the most beautiful and the best, when before they were in a totally different condition," &c.
Sec. 28. “First, then, that fire and earth, water and air are bodies, is evident surely to every one. But every species of body possesses solidity, and every solid must necessarily be contained in planes; and a base formed of a perfectly plane surface is composed of triangles. But all triangles are originally of two kinds, each of them having one angle a right angle and the two others acute; and one of these has an equal part of a right angle divided by the equal sides, while in the other two unequal parts of a right angle are divided by the unequal sides. This, then, we lay down according both to probability and necessity, as the origin and principle of fire and all other bodies; but as for the heavenly principles thereof, those, indeed, are known only to the Deity, and to those among men who enjoy God's favor," &c. This triangular hypothesis is Pythagorean.
In Sec. 67 he says: “When the body, therefore, is naturally diseased by an excess of fire, it then labors under continued burnings and fever; but when through excess of air, under quotidian fevers ; under tertian through water, because water is less active than fire and air; and under quartan through excess of earth, for earth being of all of them the least active, becomes purified in quadruple periods of time, and hence introduces quartan fevers which are with difficulty dispelled."
He says of the soul : “We must admit that the disease of the soul is folly or a privation of intellect, and that there are two kinds of folly: the one madness, the other ignorance."
Sec. 69. “When a body that is large and superior to the soul in
power, is joined with a small and weak intellect,—there being naturally two classes of desires in man, one of aliment on account of the body, the other of wisdom for the sake of most divine part,-in this case the motions of the more powerful prevailing and enlarging what is their own, but making the reflective part of the soul deaf, indocile and oblivious, thus induce ignorance—the greatest of all dis
From this theory probably the old adage arose: “Little head little wit, big head not a bit.”
Having given a synopsis of the prevailing doctrines which Hippocrates had to meet with, and to separate from and destroy their influence over medicine, we shall now quote from his works to show bis method of reasoning. In his work “Ancient Medicine," Sec. 20, he says:
Certain sophists and physicians say that it is not possible for any one to know medicine who does not know what man is, (and how he was made and how constructed,) and that whoever would cure men properly, must learn this in the first place. But this saying rather appertains to philosophy, as Empedocles, a Pythagorean practitioner of Agrigentum, and certain have described what man in his origin is, and how he first was made and constructed. But I think whatever such has been said or written, by sophist or physician, concerning nature, has less connexion with the art of medicine than with the art of painting. And I think one cannot know anything certain respecting nature from any other quarter than from medicine, and that this knowledge is to be attained when one comprehends the whole subject of medicine properly, but not until then; and I say that this history shows what man is, by what causes he was made, and other things accurately—wherefore it appears to me necessary to every physician to be skilled in nature."
He then for an example and proof of his position makes mention of a fact well known to all observers that cheese is an article of diet. While it naturally agrees with some and is easily digested, “imparting strength to the body," in other cases, their constitutions are different," and as he says " differ in this respect, what in their body is incompatible with cheese is roused and put in commotion by such a thing,” &c.; and the stronger this constitutional propensity, the more intense the suffering. From this example we have his definition of what it is to be skilled in nature," and one of the means for comprehending the art of medicine and the true knowledge of man.
Our author by this illustration evidently opposes all a priori arguments in medicine, and by calling attention to the idiosyncrasies of
our nature, he argues that a knowledge from actual observation and experience should be the guide in the treatment of disease.
In Sec. 13 he refutes the hypothesis of cold, heat, moist and dry as causes of disease—a common opinion among the ancients at that time, and advocated by Plato (see Timæus, Sec. 63 and 67), making all causes of disease to consist in realities, and not in vague abstractions. He says: “I wish the discourse to revert to the new method of those who prosecute their inquiries in the art by hypothesis ; for if hot, or cold, or moist, or dry, be that which proves injurious to man, and if the person who would treat him properly must apply cold to the hot, hot to the cold, moist to the dry, and dry to the moist,” &c.
He shows the fallacy of this reasoning by giving a familiar example on supposition. If we give a man food in a raw state, for instance wheat, raw meat and water, a diet of this kind would derange the stomach and bowels and cause disease. Then the cure, be plain to every one--that the contrary must be pursued, that is a diet prepared by cookery and beverage of wine. This course, he
. says, will effect a cure, if there has not a disorganization taken place. Then he asks the question, which of the four principles cure the patient. He thinks it would be a puzzle for any one to say that either hot or cold, dry or moist, effected a cure; for in the preparation of the food most, if not all, these principles were necessarily in existence. For, he says, as far as he knows, neither of these principles have ever been found unmixed with any other quality."
By consulting Watson's Practice of Medicine at pp. 932 and 933, we shall find an account showing the similarity which exists in the doctrine of fever, as held by Hippocrates and the celebrated Chemist Liebig of the nineteenth century.
After Hippocrates had separated philosophy from medicine, he had another task to perform, equally an incubus on medicine, as is well known at the present day. We refer to superstition, or supernatural and mystical causes of disease, and cures effected by similar means. We find him combating those who hold to supernatural causes of disease, and at the same time exposing them to ridicule as charlatans or cheats. This will be found in his work called “Sacred Disease," a disease supposed to be sent by the anger of the Gods. Plato held the same opinion. (See Timæus, Sec. 66.) This disease is supposed to be the same now called epilepsy. He commences his argument as follows:
“It is thus with regard to the disease called Sacred. It appears to me to be nowise more divine, nor more sacred than other diseases, but has a natural cause from which it originates, like other affections. Men regard its nature and cause as divine from ignorance and wonder,
use it is not at all like to other diseases; and this notion of its divinity is kept up by their inability to comprehend it, and the simplicity of the mode by which it is cured, for men are freed from it by purifications and incantations. But if it is reckoned divine, because it is wonderful, instead of one there are many diseases which would be sacred; for, as I will show, there are others no less wonderful and prodigious, which nobody imagines to be sacred. The quotidian, tertian and quartan fevers seem to me no less sacred and divine in their origin than this disease, although they are not reckoned so wonderful. And I see men become mad and demented from no manifest cause, and at the same time doing many things out of place. And I have known many persons in sleep groaning and crying out, some in a state of suffocation, some jumping up and fleeing out of doors, and deprived of their reason until they awaken, and afterwards becoming well and rational as before, although they be pale and weak; and this will happen not once, but frequently."
He then proceeds to show that those physicians who hold these opinions and pretend to cure this disease by incantations and purifications, are conjurers, purificators, mountebanks and charlatans. For proof of this statement he mentions their treatment of such cases besides the mystical means, (which very much reminds us of the system of homoeopathy and spiritualism of our day). He says, they forbade the use of every stimulating and indigestible article of diet, showing conclusively that this course was founded on experience and reason. Then he proceeds to show their impiety and hypocrisy by showing that, if they were cured by these means, that is by regulating their regimen, &c., it was done in spite of the Gods, or if an improper diet should be given, the disease would be prolonged and made worse than the Gods had intended, in this way assuming to have more power than the Gods. But in case of a failure to cure, they, for the purpose of saving themselves from reproach, from some particular signs charged it upon some one of the Gods. For example, if the patient "speak in a sharp and more intense tone, they resemble this state to a horse, and
say that Posidon (Neptune) is the cause." This he considers contrary to the dignity and benevolence or character of the Gods. He says, the opinion is unworthy that the most impure (meaning man) should be polluted by the most holy (God).
Another reason given to prove that a God is not the cause of this disease, is, he says, “its origin is hereditary like that of other dis
58-VOL, V. NO. IX.