Billeder på siden
PDF
ePub
[ocr errors]

have been among the early followers of Asclepiades. Though an admirer of the doctrines of this refor-mei, he was an independent observer, wedded to no exclusive hypothesis. In his practice, he inquired not merely whether the pores are bound or loose, but rather, what is the exciting cause of diseasė. When called to a patient in a fever and suffering 'excessive thirst from free indulgence in wine, he ordered him to drink plentifully of cold water; which, by weakening the force of the wine, induced sleep and perspiration, and in this way dissipated the disease. He was the author of a small work entitled “Medical Problems, "* which is still preserved, and is highly deserving of perusal, as. illustrating the style of medical logic at this epoch.

This interesting treatise consists of eighty-four distinct problems, with their solutions, all briefly handled, and most of them relating to the history and treatment of disease. In the first of these problems the author asks, 'why are round ulcers the most difficult to cure; and, in reply, cites the mathematical reason of Herophilus and his followers, as well as that of Asclepiades; who, as we here learn, had taught that ulcers of this shape may be induced to heal by: approximating their edges so as, to change their shape, or by incising their edges with a scalpel. And in the fortieth problem we learn that Asclepiades was the author of a distinct work on ulcers.

In problem sixth, Cassius inquires; why are persons with disease of the liver, spleen, or lungs, most disposed to lie on the affected side. His answer is based on anatomical reasoning, and is the same that would be given at the present day. His problems relating to diseases and injuries of the head, évince considerable anatomical and physiological acquirements. In problem fortieth, he asks why parts around the seat of injury on a limb, may remain unaffected, whilst those remote from it are apt to suffer; as the groin, for example, after injury of the

* Casšii Medici Questiones. et Problemata, Adriano Junio Homano, in. terprete. Medicinæ Artis Principes. Venetiis, folio, 1567.

S foot; the glands of the neck after wounds of the head; or axillary buboes after ulcerations of the hand. In resolving this inquiry, he differs from Asclepiades, and attributes the remote affection to the influence of the nerves; which, says he, are of all the organs the most disposed to participate in the diseases of the members with which they act in concert. In the next problem he asks why injury of the meninges on one side of the head, is followed by paralysis on the opposite side of the body; and; in reply, refers to the anatomy of the nerves; which, says he, derive their origin from the base of the brain, where those of the two sides decussate, so that those from the right side of the base pass into the left sinus of the head, and vice versa. In the forty-third, he asks whý papulæ arise from a burn on a living, and not on a dead surface;, and his reply is, that in dead bodies the spirits 'are extinct, whilst in the living, they are moving about and universally disseminated. In the fifty-sixth, he asks, why infants suffer most severely from fever; and tells us that in them there is a superabundance

[ocr errors]

.

of native heat. In the sixty-seventh, he inquires, why do fevers modify the condition of the pulse; and in reply, he states that when the equilibrium of the innate spirit is disturbed, and it is separated from the natural spirit, it superabounds and becomes attenuated and divided by the intrinsic heat, so that by its lightness it acquires increased celerity, and thus affects not only the pulse but also the respiration. Here he is foreshadowing the doctrines of the pneumatic sect, though perhaps only in exposition of the views previously advanced. by Erasistratùs, and even by Hippocrates. In the sixty-eighth problem he inquires why persons laboring under fever, are subject to superficial ulcerations on the skin. This question is remarkable, and might lead to the belief that this acute and inquisitive observer must have been familiar with the eruptive fevers.

It has been questioned whether or not the author of these problems was identical with the Cassius mentioned by Celsus. But there is nothing in the work itself to throw doubt upon this point. Its author must have been worthy of the character which his junior contemporary has bestowed upon him. There is no allusion in the work to any writer later than Asclepiades; besides, whom and Herophilus, it mentions only Andreas Carystus, an Alexandrian writer on certain articles of the materia medica.

About this time there were residing and practicing at Rome, several professors of surgery of no. small note, among whom were the elder Tryphon, Euelpistus, the son of Phleges, and Meges, who,

[ocr errors]

says Celsus, was the most learned of them all, as shown by his writings. This latter was the inventor of an instrument for incising the neck of the bladder, in the operation for vesical calculus ;, which instrument, judging from Celsus' account of it, must have been a double-cutting gorget, similar to what in this coantry has recently been described as the lithotome of Bushe, or prostatic bisector of Dr. Stevens, cutting transversely. Meges, also, contrary to the general belief, proved the possibility of anterior luxation of the tibia at the knee joint, by a successful case which he himself had treated. In the påthology of abscesses, he was in advance of his times; for while the general belief then was, that all investing coats and sheaths were nervous, he affirmed that a nerve was never generated in a disorder which destroyed the flesh; but that the pus being lodged below for a long time, became surrounded with a simple callosity, Some of the foregoing were also distinguished as oculists.*

As yet, the only two sects recognized in the profession, were the Rationalists and the Empirics ;t for, though Asclepiades had introduced important innovations, he was still classed as a Rationalist. Nor was Celsus willing that even the followers of Themison should be acknowledged as a third sect.

The Rationalists were those who declared for a theory in medicine, and held as essential to the proper management of diseases, that the physician should inquire into their occult or constituent causes, and their evident or exciting causes, and that he should be acquainted with the natural actions of the body and its internal organization. By occult or constituent causes, they understood such as are derived from the elements composing the body. By evident causes, they referred to such as are adventitious and apparent, as heat, cold, fasting, a sạrfeit, fatigue, and the like, which are operative at the incipient, if not also in the latter stages of a distemper. By natural actions they understood the functions of respiration, reception, and concoction of food and drink, and the distribution, of the nutriment throughout the body. They also investigated the causes, modifications, and indications of the pulse, and what gives rise to sleep and waking. They urged the necessity of modifying the treatment of disease in accordance with the character of the occult cause. But they differed among themselves as , to what should be considered the occult cause. Some of them, in common with Empedocles and the early philosophers, held it to consist in redundance or deficiency in one or more of the four primitive elements,-fire, air, earth, and, water. Some of them, with Herophilus and other earlier writers, maintained that it lay in a faulty condition of the four þumors—phlegm, blood, bile, and atrabile; others, with Hippocrates, attributed it to the qualities of the inspired air ;. some, with Erasistratus, ascribed it to the escape of blood from the veins (or vessels designed only for blood), into the arteries, which they believed were designed only for air and spirits; the escape of blood in this way, giving rise

* Celsus, in different places.

+ Ibid, book i., preface.

« ForrigeFortsæt »