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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 surfeit, 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
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 humors-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
to inflammation, and through this, to a fever. Others again, accepting the new doctrine of Asclepiades, placed the occult cause of all diseases in the interruption or arrest of the minute corpuscles in their passage through the invisible pores. They all, too, maintained the importance of a correct knowledge of concoction; but here again, their opinions varied; some of them affirming, with Erasistratus, that in the stomach the food is concocted by attrition; others, with Plistonicus, the disciple of Praxagoras, that it is effected by putrefaction; others, upon the authority of Hippocrates, that it should be ascribed to the effects of heat; whilst the disciples of Asclepiades, looking upon all these opinions as futile speculations, maintained that there is no such function as concoction, but that the food and drink in their crude state are distributed, by means of the pores, throughout the body. They all held to the importance of anatomy and correct knowledge of the internal organization of the body, and maintained that Herophilus and Erasistrátus had taken the best means for acquiring such knowledge, in procuring criminals from the prisons by royal consent, and dissecting them alive, so as to contemplate, while yet living, those parts which nature has concealed. And they declared it was by no means cruel, by the torture of a few criminals, to search after remedies for the whole innocent race of mankind in all ages.
The Empirics, on the other hand, relied on personal experience alone. They, indeed, admitted the
advantages of occasionally studying the evident
causes; but to search after the occult causes, or the natural actions, they believed to be useless; because nature is incomprehensible, as shown even by the discussions of the philosophers; who, if reasoning were of much avail, ought to be the ablest physicians; whereas they have abundance of words, but very little skill in healing. All theories as to causes, said they, are of little account, seeing that men of opposite theories were about equally successful in the treatment of disease, and that whatever be the character of these causes, the diseases require to be differently treated in different places and different seasons. Again, even where the apparent cause is recognized, as in lippitude, a wound, or ulcer, it does of itself point to the means of cure. And if the evident cause do not suggest these means, much less can the other, which is itself obscure. They held that medicine was not the result of reasoning, but that theory was invented after the remedy had been employed, and for explaining its effects. They asked, too, whether reason prescribes the same things as experience, or different; for, if the same, it is needless; if different, mischievous. On the appearance of any new disease, instead of inquiring into its occult or apparent causes, they sought for its analogy to diseases already known, and met it by remedies analogous to such as were used in these, until the true mode of treatment could be discovered. They did not affirm that judgment is unnecessary, but that conjecture is of no use, and that it is of little consequence how the disease originates, so long as we are able to cure it. They admit
that in all discussions of this sort, much may be said on both sides; yet, that diseases are not to be cured by eloquence, but by remedies. They regarded as useless the study of the natural actions and internal organization of the body; and they denounced the dissection of living men with as much vehemence as would the moralist of modern times.
Thus stood the discussion, which had been handled with great warmth for many ages, when Themison of Laodicea, the disciple and successor of Asclepiades, entered the lists in his old age, as the leader of a third party.* Though he was influential as a teacher and reformer, his writings are not often quoted; and as they have perished in the wreck of ages, his opinions are known to us only through his reputed followers, or the critics and historians who have noticed them. According to Cælius Aurelianus, he was the first to write systematically on the management of chronic diseases, upon which subject he published a work in three books. He wrote also on acute diseases. As a practitioner he was familiar with the use of opium, hyoscyamus, and other narcotics; and his name is associated with a 'confection of poppies, which he employed in the diseases of the respiratory organs. But he is more especially worthy of notice as the founder of the Methodic Sect.
Adopting the theory of Asclepiades as to the arrest of the ultimate molecules in the invisible porès, he
* Celsus, book i. preface; Galen, and Cælius Aurelianus, at several places.
attributed all diseases to excessive tension or relaxaation; and this doctrine of Laxum and Strictum became the essential principle of the new party; who, with the Empirics, abandoned the study of exciting causes, as having no relation whatever to the method of cure; and maintained that the correct method of treating disease may be ascertained by simply observing a few of its general symptoms. Of distempers they made three kinds, the bound, the loose, and the mixture of these two, according as the excretions are too scanty, too profuse, or some particular excretions are deficient whilst the others are in excess. These several forms they subdivided into the acute and chronio, and, also, according as they were increasing, stationary, or receding. Their rule of treatment was, that the body if bound, should be opened; if relaxed, it should be astringed; and if the distemper were complex, the most urgent ailment should be the first opposed; varying the agent with the duration or stage of the disease. The observance of these rules constituted, according to their notion, the whole art of medicine; and from their own established. way of proceeding by method, they claimed for themselves the name of Methodists; for they differed from the Rationalists, in not allowing medicine to. consist in theorizing about occult or other causes, and from the Empirics, in holding personal experience to be but a small part of the art. The doctrine of the Methodists had for a time great sway. Celsus, while criticising them with his accustomed acuteness,