Billeder på siden

commencement of his first, fifth, and seventh books, shows how carefully he had studied the great masters of the art, and how well he was prepared to furnish a thorough and reliable digest of their opinions; not indeed as a compiler of minute details, but as one able to grasp the philosophy of medicine, and at the same time not to overlook


facts essential to the guidance of the practitioner. While citing many authors, he holds Hippocrates, and next to him Asclepiades, in chief regard. judgment he is too independent to acquiesce in all that had been advanced by either of these. He rejects the Hippocratic doctrine of critical days, and he differs from Asclepiades in many points ; bụt whilst dissenting from those whose authority he usually respects, he gives sufficient reason for his own opinions. The delicacy of his censure in condemning others, and the caution' with which he avoids all allusion to himself, have led some to the belief that he was not a practitioner of medicine. But, as his translator Dr. Grieve has well remarked, his forms of expression are those of a practitioner, and such as would come very improperly from a mere compiler. To the careful student of his works, it must appear incredible that a production so replete with practical suggestions, and so remarkable for medical discernment, could have been the work of any other than an accomplished and skillful physician. He may not indeed, like the Greeks of Rome, have practiced for a livelihood. "The man to be trusted,” he tells us, “is hę who knows his profession, and is not much absent from his patient.


But they who practice only from views of gain * * readily fall, 'in' with such rules as do not require close attention. ** It is easy for such as seldom see the patient to count the days and paroxyms; but for him who would form a true judgment of what is alone fit to be done, it will be necessary to sit by his patient."* The inference to be derived from this passage, as well as from his literary habits and polished style, is that he may have been in easy circumstances, above the necessity of practicing for the sake of gain, and that he followed his profession as a liberal and useful occupation; as law had originally been followed by the patricians and other men of influence at Rome; who, even in the days of Cicero, would have considered it disgraceful to accept a fee from the client in whose behalf they were officiating as advocates at the forum.

The early Alexandrian division of diseases, into such as are remedial by diet and regimen alone, such as require the use of medicines, and such as call for the interference of surgery, is that which Celsus adopts as the basis of his arrangement for treating on every branch of medicine then understood. In his first book, he dwells with sufficient fullness on the general rules of health; in the second, on general pathology and therapeutics; in the third and fourth; he speaks of such individual diseases as affect the whole body, and such as occur on particular parts, and are remediable by diét; in the fifth and sixth, of such constitutional and local diseases

[ocr errors]

* Lib. iii. cap. 4.

[ocr errors]

as require the assistance of medicine ; most of the sixth book is taken up with diseases properly surgical, though not requiring operations; and in the two remaining books, he gives a systematic exposition of surgery;

the last book being occupied exclusively with diseases and injuries of the bones and joints. We have already had occasion to condense from the preface to his first book, his exposition of the opinions and arguments of the Rationalists and Empirics. The following are his own views on the merits of the whole discussion :.

“Since these points have often been and still continue to be disputed with great warmth, by physicians, in large volumes, it is proper to add some reflections that may seem to come the nearest to the truth, and which neither slavishly follow either of these opinions, nor are too remote from both, but, as it were, intermediate between these opposite extremes; which those who inquire after truth without partiality, may find to be the surest method for directing the judgment in most warm controversies, as well as in this now before us. For, with regard to the causes of health or disease, in what manner the air or food is either conveyed or dis tributed, the philosophers themselves do not attain to an absolute certainty ; they only make probable conjectures. Now, when there is no certain knowledge of a thing, a mere opinion about it cannot discover a sure remedy. And it must be owned that nothing is of greater use, even to the rational method of curing, than experience. Although, then, many things are taken into the study of arts, which do not, properly speaking, belong to the arts themselves, yet they may greatly improve them by quickening the genius of the artist; wherefore the contemplation of nature, though it cannot make a man a physician, yet may render him fitter for the practice of medicine. * * And medicine itself requires the help of reason, if not always amongst the occult causes or the natural actions, yet often, for it is a conjectural art; and not only conjecture in many cases, but even experience is found not consistent with its rules. * * A new distemper sometimes, though very seldom, appears; that such a case never happens, is manifestly false. * * Nor is similitude always serviceable in this kind of practice; and where it is, this properly belongs to the rational

* To the physician, he adds, “it makes considerable difference whether the distemper is occasioned by fatigue, or thirst, or cold, or heat, or watching, or hunger; or whether it arises from too much food or wine, or excess of venery. . And he ought not to be ignorant of the constitution of the patient, whether his body be too moist or too dry; whether his nerves be strong or weak; whether he be frequently or seldom ailing; and whether his illnesses are severe or slight, of long continuance or short; what kind of life he has led, laborious or sedentary, luxurious or frugal; for from these and such-like circumstances, he must often draw a new method of cure."

In reference to the Methodists, his censure is less guarded. . "If they assert their maxims," says he, “to hold universally, they are still more rationalists

part.” *

[ocr errors]
[ocr errors]

*:* "I

than those who pass under that name; but if, which is nearer the truth, the art of medicine hardly admits of any universal precepts, then they are in the same class with those who depend upon experience alone. * * Nor is any improvement made by them upon the profession of the empirics; but, on the contrary, something is taken from it,—the empirics attending with great circumspection, to many circumstances, whereas these regard only the easiest, and no more than the common things." am apt to think,” says he, “that he who is not acquainted with the peculiarities, ought only to consider the general; and that he who can find out the particular, ought not to neglect but to take them in too, for the direction of his practice. And thereforė where knowledge is equal, yet a friend is a more useful physician than a stranger. To return to my point, then, my opinion is, that medicine ought to be rational; but to draw its methods from the evident causes, all the obscure being removed, not from the attention of the artist, but from the practice of the art. Again, to dissect the bodies of living men is both cruel and superfluous. But the dissection of dead subjects is necessary for learners, for they ought to know the position and order of the parts, which dead bodies will show better than a living and wounded man. But as for the other things which can only be observed in living bodies, practice itself will discover them in the care of the wounded, somewhat more slowly, but with more tenderness.”

As a comment on these remarks, we might refer

« ForrigeFortsæt »