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to his brief anatomical description of the internal organs, at the commencement of the fourth book, portions of which could have been derived only from the actual dissection of the human subject.
It has been remarked by a recent critic, that Celsus paid little regard to the pulse as an index of the condition of the system. But his remarks on the variability of the pulse are perfectly just, and are intended not to show his neglect of it, but rather to put the physician upon his guard against hasty judgments. “It is the business of the skillful physician,” says he, “not to take hold of the patient's arm with his hand as soon as he comes in, but first to sit down with a cheerful countenance, and ask him how he does; and if he has any apprehension, to encourage him with plausible discourse, then to apply the hand to the wrist."
In common with the elder Greeks, he recommends caution in undertaking the management of dangerous and incurable ailments. “A physician,” says he, “should, above all things, know what are incurable, what difficult to cure, and what more easy; for it is the part of a prudent man first, not to undertake one whose case is desperate, lest he appear to have killed him whom destiny has destroyed. Next, in a case of great danger, but not quite desperate, to make known to the friends of the patient that it is a matter of difficulty, so that if the malady should prevail against the art, he may
neither seem to have been ignorant himself, nor to have deceived them. But,” adds he," as this is the proper conduct for a prudent person, so, on the contrary, it is the part of a quack to exaggerate a small matter, that he may appear to have performed the greater cure.” When the case is easy, he recommends diligence and circumspection on the part of the physician, “ that what is in itself small, may not, by his negligence, become more considerable.”
Before leaving this able author, we may notice his opinion of what a surgeon should be, and of what surgery should embrace. “Surgery, the third part of medicine,” says he, “does not discard medicines and proper regimen; but yet the principal part is accomplished by the hand, and the effect of this is the most evident of all the parts of medicine. For, as fortune contributes a good deal to the cure of distempers, and the same things are often salutary, often fruitless ; it may be doubted whether the recovery be owing to physic or the constitution. * But in surgery, it is manifest that the success, though it may be somewhat promoted by other means, is chiefly to be ascribed to this.” geon,” he continues, “ought to be young, or at
” most, but middle-aged; to have a strong and steady hand, never subject to tremble, and to be no less dexterous with his left than his right hand ; to have a quick and clear sight; to be bold, and so far void of pity that he may have only in view the cure of him whom he has taken in hand, and not in compassion to his cries either make more haste than the case requires, or cut less than is necessary; but do all as if he were not moved by the shrieks of the patient.” And then, as to the province of surgery,
be asked what peculiarly belongs to
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this branch, because surgeons assume to themselves the curing of many wounds and ulcers which I have treated of elsewhere, I can very well suppose the same person capable of performing all these ; and since they are divided, I esteem him most whose skill is most extensive. For my part, I have left to this branch those cases in which the physician makes a wound where he does not find one; and those wounds and ulcers, in which I believe manual operation to be more useful than medicine ; lastly, whatever relates to the bones."
It would here be out of place to enter further into a notice of the individual diseases of which he treats in the several divisions of his work. I may, however, mention, as particularly worthy of perusal, his chapters on diet and regimen, on blood-letting, on fevers, on poison-wounds, on the extraction of weapons from the body, on the diseases of the
his description of ranula and his mode of treating it; the chapter on diseases of the testicles and parts contiguous, including hernia, and the operations for these; and above all, his chapter on the operations for suppression of urine, and for lithotomy. In this we find all the necessary details for catheterism as still employed; and the Roman method of operating for stone by the transverse semilunar incision in the perineum, with the horns of the incision pointing towards the hips, as lately revived by Dupuytren and other modern surgeons.
In the management of wounds he advocates the use of simple and familiar, in preference to rare and expensive remedies, or the heterogeneous compositions so much in vogue among the Romans. He was aware that certain poisons, though deleterious when received into wounds, are innocuous when taken into the mouth. In the treatment of wounds thus poisoned, he recommends suction for the extraction of the poison. He applies the ligature to divided or lacerated blood vessels; he employs this same agent for the cure of varices, and for checking the loss of blood from hæmorrhoids. He enters
. somewhat fully into the pathology of injuries of the head; and, when indicated, employs the trephine and other proper means for the cure of such accidents. He enters more minutely into the consideration of injuries at the hip, than many of the early surgical writers of modern times; but in common with most of his predecessors, he fails to distinguish between fractures of the neck of the femur and dislocations at the hip joint.
Among the Latin writers practicing at Rome at this period, were Apuleius Celsus, and his pupil Scribonius Largus, the first probably somewhat the senior and the other the junior of Cornelius Celsus.
Apuleius was à native of Centuripa, in Sicily. He was long in high and deserved repute at Rome, where he was engaged in teaching, as well as practicing. Among his pupils was Vectius Valens, celebrated afterwards for his intrigue with Messalina, the wife of Claudius.* The works of Apuleius have mostly perished, though there is still extant a
* Pliny, Hist. Nat, lib. xxix. cap. v.
treatise on the virtues of herbs,* which has sometimes been ascribed to Apuleius Madaurensis, the author of the Golden Ass; but which those who have examined it with greatest care, attribute to Apuleius Celsus. The author of this treatise, De Medicaminibus Herbarum, states in his preface, that it was prepared for the benefit of the public, and to relieve the common reader from the verbose stupidity of the profession, the greater part of whom he characterizes as ignorant pretenders, more intent on the acquisition of wealth than on the cure of the sick. Much of the work is occupied with antidotes, and specifics against the bites and stings of venomous animals. It is proper to remark that some recent and able critics have questioned the authenticity of this work, and ascribed it to some unknown writer of the middle ages.
Scribonius Largus, who flourished during the reign of Claudius, and accompanied this emperor
in his expedition into Britain, was an incorrect writer of the Latin tongue, but in a professional point of view, an author of considerable merit. Though an admirer of Asclepiades, he appears to have written in the spirit of empiricism. His treatise, De Compositione Medicamentorum, t is devoted rather to the composition and uses of medicines, than to the consideration of the diseases to which these are applied. Many of his compound confections are quoted by later writers. He abounds in remedies
* Already mentioned in connection with the work of Antonius Musa, published at Bâle, 1536.
+ See the “ Medicinæ Artis Principes,” fol., Venitiis, 1567.