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or downwards." In like manner he resorts to incantations and Scriptural expressions in the preparation of his medicaments, for imparting to them greater efficacy. In compiling from other writers, Aëtius is careful to give the name of the author at the head of each chapter. He has thus preserved the names and given valuable extracts from the works of several writers not elsewhere mentioned; among these may be noticed Aspasia, an able and original writer on obstetrics and the diseases of women and children, from whom many distinct chapters have been borrowed by him, and in this way preserved from oblivion.
Alexander, surnamed Trallianus, from his native city, Tralles in Lydia, flourished shortly after Aëtius, whom he takes occasion to mention. He was of a talented family; his father Stephen, and his brother Dioscurus, were of his own profession; his brother. Olympius, was distinguished in jurisprudence; his brother Metrodorus was known as a grammarian; and a fourth, Anthemias, was employed as an architect by Justinian, A. D. 532, in building the cathedral of St. Sophia, which still stands among the principal ornaments of Constantinople. Alexander had traveled extensively in Italy, Gaul, and Spain, and had resided long in Tuscany, before ultimately settling in Rome, where he rose to great distinction. His work on the art of medicine,* dedicated to his friend Cosmas, the son of his preceptor, was written
* Alexandri Tralliani de Arte Medica libri duodecim. Joanne Guinterio Andernaco interprete. See Collection of Stephanus, Venice, 1567.
after the infirmities of age had disabled him from the more active duties of the profession. This work is worthy of notice no less for the discriminating judgment and original observations of its author, than, for the order and perspicuity of his descriptions of disease, or for the simplicity, force, and elegance of his style. In point of originality, Alexander ranks next after Hippocrates and Aretæus. He speaks of Galen in higher terms than any previous writer, calling him the "most divine," and placing him even above Hippocrates, Nevertheless, he does not hesitate to dispute the authority of this great master when at variance with his own experience. His work consists of twelve books'; of which, in their present numerical order, the first eleven treat of diseases, from the head downwards. The last is mostly occupied with fevers.. But the dedication or introduction to the whole work, is at the opening. chapter of this twelfth book; where the author speaks as if at the commencement of his literary labors. It is, therefore, reasonable to infer that the twelfth book, as at present arranged, must have been originally the first; and that it was the author's object to speak of constitutional or general ailments first, and of local diseases afterwards. The work is occupied almost exclusively with the description and treatment of diseases; with little allusion to anatomy, to topics strictly surgical, or even to the materia medica, except in direct relation of remedies to the diseases in which they are employed. Under the head of each ailment, he lays down the characteristic appearances and symptoms; points out the
divisions and subdivisions; notes the diagnostic symptoms when necessary; enters occasionally into the exciting causes and the actual conditions of disease, in accordance with the humoral pathology of Galen, or sometimes with the theory of the methodists; and finally proceeds to the treatment, whether by diet and regimen, or the administration of medicines. In the management of acute diseases, he pays great attention to the influence of age, temperament, mode of life, atmospheric changes, season of the year, and above all to the effects of nature. He enjoins caution in the use of opium for the cure of diarrhoea, in consequence of its severe effects upon the brain. He is opposed to the use of astringents in dysentery, which he treats in accordance with the rational indications. His favorite remedy for dropsy was venesection, which he adopted from having seen oedema in a limb, where the movement of the blood through the part had been arrested by tight pressure above the tumefied portion, entirely overcome by removing the pressure. In chronic ailments he preferred mild aperients to drastic purgatives. He has been often commended for his skill in, diagnosis. The passage usually referred to in proof of this, is that in which he lays down the distinctive signs of pleurisy and inflammation of the liver; a passage which the modern pathologist would hardly select for the purpose; and in which, from what is stated, he appears to have confounded pleurisy with inflammation of the lung. Like Aëtius and Marcellus, this author also recognizes the use of charms. and amulets. But on the whole, considering the 'age in
which he lived, he was of sound judgment and great practical ability; and the work which he has bequeathed to us is among the most valuable relics of ancient médicine.
The reign of Justinian, from A. D. 527 to A. D. 565, was one of much vigor, and marked by success against the overwhelming inroads of barbarism, By the prowess of his generals, Belisarius and Narses, Italy was for a season delivered from the Goths, and the two portions of the empire again united. Under the supervision of his able minister, Tribonian, the whole body of Roman law was revised and reduced to system. The schools of Constantinople were rising into notice, and were under the supervision of able' men.*
The sophist and historian Procopius, who flourished in this reign, if not, educated for the practice of medicine, was well versed in every thing pertaining to the science, and is worthy of notice for his admirable description of the plague, which began in Egypt, A. D. 542, extended thence through Palestine, reached the Eastern capital in the year following; and spreading throughout every portion of the empire, continued its ravages for more than fifty years. The disease was in every respect identical with the modern plague of the Levant. The 'account of its first appearance at Constantinople, by Procopius, is worthy of special notice for his allusion to human dissections.t. The physicians, he tells us,
Freind, History of Physic from the time of Galen to the beginning of the sixteenth century., 2 vols. 8vo. London, 1726. Vol. i. p. 149.
conceiving the venom and head of the disorder to be in the plague-sores, opened the dead bodies, and, searching the sores, found huge carbuncles growing inward. Procopius has supplied much other interesting information in reference to the practice of medicine and the physicians of his time. Elpidius, archiater to Theodoric, he tells us, was the person to whom that monarch confessed his regret at having taken the lives of Symmachus and Boëtius. He states, that during the siege of Edessa, Stephen, a physician of that city, who had formerly been preceptor of Chosroes, and medical attendant upon his father, was chosen to conduct an embassy to Persia. And that Chosroes, before accepting the proposals of Justinian for peace, demanded as one of the conditions, that the physician Tribunus should be sent to him. Tribunus was accordingly sent, and after curing the king and residing a year in Persia, was permitted to depart with such rewards as he should ask. But, instead of wealth or honors, he requested that certain of his fellow countrymen, then captives among the Persians, might be set at liberty; a request with which Chosroes complied, by releasing. not only the individuals.specified, but others to the number of three thousand. The Greek physicians of this age, however, were not all so worthy of their calling. One of them, Uranus, like Thessalus in the time of Nero, supplied by self-assurance the defects of education, and the absence of real merit. Having accompanied the embassy from Edessa, he imposed himself upon Chosroes as a Chosroes as a philosopher, confronted the Persian Magi in questions of science; and after