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period of the Middle Ages. It was the usual form of admission at Salernum, the earliest of the medieval schools of medicine. The ceremony was also the same at the school of Paris, the regulations of which were adopted in full from those of the Salernian institution. At Paris, as at the other universities, the cap or bonnet was substituted for the wreath. But even at the temples the cap may have occasionally been used. The statues of the ancients usually represent the head uncovered. And some have been at a loss to know why the head of Hippocrates is sometimes seen covered with a cap. The ceremonies of his school, if more minutely understood, might,. perhaps, be sufficient to explain this.
As a rational study, so long as medicine was taught orally, or by tradition and example only, the acquirements of its votaries could not have been extensive. Their main study in the management of acute diseases, was in regulating the regimen. Epidemic diseases they looked upon as divine dispensations, with which they did not dare to interfere. A knowledge of the general rules of health, and the influence of diet, exercise, climate, and locality, attracted much of their attention. In the management of injuries and external diseases, they were but little inferior to their descendants of modern times. Their medical agents were, the lancet, of which they made frequent use; certain active cathartics, emetics, and diuretics; cataplasms, unguents, escharotics; and mechanical instruments and appliances. Of anatomy and physiology their knowledge was limited; and as for chronic diseases, up to the
time of Herodicus of Selymbria, who is said to have been one of the teachers of Hippocrates, they did not venture to interfere with them.
This Herodicus had been a teacher of youth, and being always in delicate health, he had prolonged his life by systematic exercises and a regulated diet. The treatment which he had found useful in his own case, he recommended to others; and thus he turned the attention of medical men to a course of practice, and a group of diseases, which they had hitherto disregarded. His innovations were for a time unpopular; and even Plato undertakes to upbraid him for them, declaring "that no attempt should be made to cure a thoroughly diseased system, and so to afford a long and miserable life to the man himself, as well as to his descendants. For Esculapius," he continues, "did not think a man ought to be cured who could not live in the ordinary course, as in this case he would be of no service to himself or to the state." He goes on to deplore the necessity of using the terms then recently invented for designating chronic diseases: "Dropsies, and Catarrhs! Do not you think these abominable? Truly these are very strange names of diseases; such, I think, as existed not in the days of Esculapius."* But though not in the habit of treating chronic internal ailments, the profession were at least supposed to be acquainted with them, so far as to be able to detect them, and pronounce correctly in regard to them, in the inspection of slaves. Even Plato would hold the physician responsible for his opinion in such cases, * Republic. Book iii. c. 14.
the object of the philosopher being to guard against dishonesty in the sale or transfer of slaves from one master to another.*.
With respect, then, to the policy and ethics of the Asclepiada, we learn from the Oath and Law, as also from other passages in the Hippocratic, code, that the student was formally bound to his master by indentures; that the son of a former master; choosing to enter the profession, received his education gratuitously; that others not thus circumstanced, were expected to pay for their instruction; that the sons of the Asclepiade did not necessarily follow their fathers' employment; that, those who were employed in the temples, or in practice elsewhere, were therefore, simply a fraternity, in the modern acceptation of that word, and not, as some suppose, an exclusive caste derived from one family; that each practitioner was at liberty to follow his occu pation where and when he chose, but for honorable purposes only; and that even at this early day, there were designing men who were "physicians only in name," and who gave themselves up to disreputable practices; against whom the regularly initiated had no redress, and no other advantage than that upon which we ourselves rely, a superior education, honesty of purpose, devotion to their duties, and the confidence of a discerning public.
Many of the self-imposed restrictions of the Asclepiada had reference to the evil doings of the medical impostors of their own times. M. Littré leads us to suppose that the injunction against lithotomy
* Laws. Book xi. c. 2.
may have referred to the mutilating process of castration, which had been from time immemorial in use among the Asiatics, as it was afterwards among the Greeks and Romans, and which was in the hands of a special class of manipulators, as it is known also to have been in Southern Europe, in comparatively recent times. The remarks of Paulus Egineta in reference to this operation, are somewhat in confirmation of M. Littré's views. Again, the prohibition against the sale and administration of poisons, is clearly in reference to those who are known to have been engaged in such traffic,-particularly the Agurtæ, itinerant mountebanks,, or pedler-priests as Plato calls them, who went about imposing on the unwary, and cheating them by lying prophecies.+
But some of these restrictions doubtless arose from the suggestions of prudence. It has been remarked by Mr. Adams, that professional. virtue among the ancients never arose to the degree of disinterestedness recommended by Sydenham; who maintains that the physician ought to be always ready to serve his patient, even at the risk of his own reputation. Sydenham, however, wrote as a member of à Christian community, and knew that where his motives were unimpeachable, and his conduct that of an honorable, attentive, and skillful physician, his want of success in the management of a critical case, was not likely to injure his reputation as a man. But the physician of early Greece had
*Renouard. Histoire de la Medicine. Paris, 1846, tome 2, p. 288.. Republic. Book ii. c. 7. + Adams's Hippocrates, vol. ii. p. 641.
more at risk than reputation, sometimes even life.* By custom, if not by written law, he was in some measure personally accountable for the want of success in what he undertook. The usages of the times imposed upon him circumspection, as well as forecast. Hence the injunction which he was required to observe, not to undertake the 'care of unmanageable diseases; or, if induced to take charge of them, to give timely notice of their probable result. There was no want of liberality in this; and it is not for us to complain of that habitual caution which led to the close and attentive study of prognostics, a class of studies for which we have still reason to be thankful to the Greeks.
With regard to social rank among the Asclepiadæ, it was in proportion to personal merit, rather than to any artificial status. But owing to the great number of pretenders, the regularly initiated were, then as now, disposed to look upon themselves as sufferers by the consideration occasionally bestowed upon impostors. "Medicine," says Hippocrates, "is of all the arts, the most noble; but, owing to the ignorance of those who practice it, and of those who inconsiderately form a judgment of these, it is at present far behind all other arts. Their mistake," he adds, "appears to me to arise principally from ́this, that in the cities there is no punishment connected with the practice of medicine, and with it alone, except disgrace; and that does not hurt those
Plato. Laws, book xi. c. 12. Galen, vol. xiv., p. 602, Kuhn's edition. Corpus Juris Civilis. Julii Paulii Recept. Sentent. Lib, v. tit. xxiii., § 13.