sional conduct, dignity of deportment, respect for patients, devotion to universal charity and to medicine. For, as they declared, where love of mankind is, there is also love of the Art.

The Hippocratic respect for tradition led, at the same time, to a just appreciation of the teaching of the gymnasium, much of it inherited, no doubt, from the remote past. The writings of Hippocrates "On Fractures" and "On Dislocations," which have been described (by Malgaigne) as the ablest works ever written by a physician, as well as his treatise "On Injuries of the Head," and his other surgical works, reflect the skill and wisdom resulting from long experience. He was bold in the use of the trephine and raspatory, employed ink and pitch in the manner of the Egyptians, insisted on the necessity of cleanliness and dryness in the handling of fresh wounds, mentioned healing by first intention, referred to exfoliation of the bone, and to the dangers of erysipelas, tetanus, and gangrene, noted the occurrence of fracture by contre-coup and of paralysis of the opposite side in cases of lesions of the brain, described the treatment of compound fractures, as well as various methods of bandaging and of reduction with and without apparatus. In his "Aphorisms" Hippocrates remarks that it is not well for athletes to develop tissue to the utmost limit. Once arrived at the maximum, it is impossible

to improve or to remain stationary. Instead of slowly deteriorating, it is well to reduce rapidly in order to begin again the process of repair. It is dangerous, however, to carry methods of reduction to extremes. In like manner, medicinal evacuations, if carried to an extreme, are dangerous; and, also, a restorative course, if in the extreme, is dangerous. A slender and restricted diet is always dangerous in chronic diseases, and also in acute diseases, where it is not requisite. Again, as diet brought to the extreme point of attenuation is dangerous, repletion, when in the extreme, is likewise dangerous.

The Hippocratic book "On Ancient Medicine," which ingeniously traces the origin of the Art to the practical study of diet carried on by man from the remotest past, suggests to the physician that advances are still to be made by continuing the study with full knowledge of what has already been achieved. "Wherefore those who devote themselves to gymnastics and training are always making some new discovery by pursuing the same line of inquiry, where, by eating and drinking certain things, they improve and grow stronger than they were." What must be said of those who prosecute their inquiries in the Art by hypothesis rather than by the ancient method of trial? The former procedure has its difficulties. "For if hot, or cold, or moist, or dry, be that which proves injurious to man, and if the per

son who would treat him properly must apply cold to the hot, hot to the cold, moist to the dry, and dry to the moist - let me be presented with a man, not indeed one of a strong constitution, but one of the weaker, and let him eat wheat, such as it is supplied from the thrashing-floor, raw and unprepared, with raw meat, and let him drink water. By using such a diet I know that he will suffer much and severely, for he will experience pains, his body will become weak, and his bowels deranged, and he will not subsist long. What remedy, then, is to be provided for one so situated? Hot? or cold? or moist? or dry?" Thus the treatise "On Ancient Medicine" passes from a consideration of the empirics, condemned by Hippocrates only when they went beyond their proper sphere, to a criticism of the theorists, or philosophers.

It has frequently been said that Hippocrates, in addition to repudiating the supernatural as a cause of disease, was the first to separate medicine from philosophy. That is indeed true if philosophy be identified with vain speculation. For the fantastic conjectures of Pythagoras and Empedocles, Hippocrates and his followers substituted a commonsense philosophy, still potent in our own time. They held that all general views of the nature of disease must rest on practice and the use of reason. All valid thinking is based on the data supplied by

the senses, the understanding giving meaning to these phenomena, noting the manner of their occurrence, their times, and the relation between them of cause and effect. Conclusions must be grounded in observation. The physician should, therefore, hold to facts, so as to acquire mastery in the medical Art. "Theory is the flower, not the root of experience." The famous opening sentences of the "Aphorisms" attest the power of a philosophic mind to rise to general conceptions, while still mindful of the observations and practice from which they were developed. "Life is short, and the Art long; the time is urgent; experiment is dangerous, and decision is difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals coöperate."

Diagnosis furnished a solid basis for his generalizations. He observed the color and general state of the skin and mucous surfaces, the eyes, the facial expression, the movements of the body, the quantity and nature of the dejecta and various secretions, the temperature, and, to some extent, the pulse, respiration, rash, spasm, sore throat, chills and fever, localized pains, headache, tenesmus, thirst, appetite, nausea, vertigo, lassitude, deafness, disordered vision, fear, loquacity, delirium, coma, plucking at the bedclothes. He noted the distension

of the abdomen, and by palpation determined the enlargement of the liver or the spleen. He took account of the form of the chest, the character of the voice, and, employing succussion and auscultation, detected the signs of pneumohydrothorax or of pleuritic friction. Not content with the mere determination of symptoms, Hippocrates has left us ("Epidemics," Books I and III) forty-two case histories, which remained without parallel in the history of medicine for about two thousand years. The following is one of the briefest in the collection:

"Criton, in Thasus, while still on foot, and going about, was seized with a violent pain in the great toe; he took to bed the same day, had rigors and nausea, recovered his heat slightly, at night was delirious. On the second, swelling of the whole foot, and about the ankle erythema, with distension, and small bullæ (phlyctænæ); acute fever; he became furiously deranged; alvine discharges bilious, unmixed, and rather frequent. He died on the second day from the commencement."

Hippocrates did not rest satisfied with the record of individual cases and their symptoms. In his treatise "On Regimen in Acute Diseases" he admits that the Asclepiads of Cnidus had described accurately the symptoms of various diseases, and even how certain of them terminate; but they had unduly multiplied species. The physician should