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by a circumscribed mortification. But where the crisis is not to be effected either by elimination or localization, the disease is said to be incurable, as in cancer. The critical discharges, where the disease. is general, may be effected either by perspiration by the flow of urine, by alvine dejections, by emesis, or by expectoration,
The cycle of changes by which the crisis is effected, he holds to be, usually completed within certain definite periods of time; and the days at which the crisis may be anticipated, he calls Critical Days. He dwells with much care on every circumstance likely to retard or accelerate the critical period, and on the dangers to be apprehended during those critical days, regular or irregular, in which the disease is not adjudicated. The study of the various appearances pointing to the probable result of the disease, to the character of the crisis, and to the time at which this may be expected, is summed up in his doctrine of Prognosis. By this was meant something more than is implied in the etymology of the term, and much more than is at present understood by it. In the estimation of the early Grecians, Prognosis was the crowning department of medical science; furnishing them the key for explaining the past and present, as well as the yet to be developed circumstances of disease; and pointing out to them what should be left to the efforts of nature, and what might require the interference of art, where nature, unassisted, was unable to bring the disease to a favorable issue..
It is further worthy of remark, that in the Hip
pocratic school, the condition and changes of the humors, the crisis, the critical discharges, the critical days, and above all, the prognostications, were studied in the abstract, or as connected only with the condition of the living body, without reference to the distinctive traits of individual diseases. With them, prognosis was the application of medical science for determining the value of general manifestations, not of particular morbid processes. It held the same relation to diseases in general, that diagnosis, in our use of the term, now holds to individual ailments.
In his book of Prognostics, Hippocrates dwells only on the generalities of disease. In his Epidemics he describes what he himself had witnessed, even to the progress and results of individual cases, still studied in the same spirit of generalization, without reference to the characteristic features of individual, much less of specific diseases. In his book on Regimen in Acute Diseases, he appreciates his therapeutics as subservient to the indications of nature, whose efforts it becomes the physician to assist, but never to interrupt. The teaching of Hippocrates and his disciples, is thus shown to have been theoretical, yet founded on what, at the time, appeared to them to be legitimate inferences from the observation of facts,-of facts carefully studied and cautiously generalized. And while the whole science of physiology, and nearly the whole of anatomy, remained yet to be explored, we are not so much to be surprised at their theories, as that these theories, derived almost exclusively from the
study of external appearances, should have been so very near the truth.
As already intimated, several treatises in the Hippocratic collection must have emanated from writers not of the school of Cos, but who are to be considered either among the contemporaries of Hippocrates, or of his more immediate descendants. The book on Regimen for Persons in Health, has been ascribed to Philiston, who was celebrated for his acquaintance with anatomy, and who flourished about the time of Plato. The treatise on the Seventh Month Foetus, has been attributed to Diocles of Carystus, also an early writer, compared, for ability, with Hippocrates himself. He was the first to point to the distinction between pneumonia and pleurisy; he was the ablest anatomist of his age, and the author of, numerous works; among which was a treatise on Hygiene, and another on Gymnastics as applied to the treatment of disease. About the same time also, flourished Petronas, a sort of homeopath, who, according to Celsus, treated fevers by overloading the sick with clothing, in order to increase their heat and thirst. Praxagoras, a contemporary of Aristotle, appears to have been among the first to allude' to the pulse, a circumstance, however, also mentioned by Aristotle himself, though not as furnishing any useful indications in the treatment of disease. Plistonicus, a pupil of Praxagoras, may also have contributed somewhat to the opinions promulgated in the Hippocratic writings, particularly in reference to the humors; to the study of which he and his disciples were more than
usually attentive. But the portions of the collection most at variance with the doctrines of Hippocrates, were probably derived from the Asclepion of Cnidos, the abode of many able teachers; among the principal of whom, after Euryphon, was Chrysippus.
Of the Cnidian school, we have no well-authenticated remains, and no other trust-worthy account than such as may be found in the few intimations furnished by Hippocrates himself, and by his commentator and disciple, Galen. M. Littré, however, has recently furnished some grounds for believing that the second and third book of Diseases, and the book on Internal Affections, as at present embodied in the Hippocratic collection, are in some respects not in strict harmony with the rest; and that the doctrines contained in them, tested by what is known of the Cnidian Sentences, prove to be in accordance with these, and consequently, such as may have issued from the Cnidian school.
Be this as it may, the doctrines of the two schools were not in every point alike. And the rivalry between their respective writers and teachers, during the early period of scientific progress, was carried on with much vigor. Hippocrates, in his book on Ancient Medicine, and again in that on Regimen in Acute Diseases, takes occasion to criticise the opinions and practice of Euryphon, as expressed in the Sentences. Ctesias of Cnidos, in turn, as we learn from Galen, criticises the practice of Hippo
Euvres d'Hippocrat, tome vii. p. 304.
Galen (Kuhn's edition), vol. v. p. 761; vol. xv. p. 363, 427.
crates. Chrysippus, of the Cnidian school, and his disciple Erasistratus, oppose the use of active purgatives and venesection; whilst Herophilus, at Alexandria, writes in favor of the lancet, and is a follower of the Sage of Cos..
The modes of contemplating disease in the two schools, were not alike. The Cnidians attended mainly to minute distinctions, to the characteristic. traits of individual diseases, with little regard to the bearing or mutual relations of special symptoms. Thus they enumerated seven different diseases of the biliary organs, twelve of the bladder, and four of the kidneys; they described four kinds of strangury, three kinds of tetanus, four of jaundice, and three of phthisis. Their neighbors of Cos, on the other hand, held the study of such distinctions to be of small account, and gave their special attention to the grouping of important symptoms, to what would now be called the constitutional condition, or the state of the system, without regard to the particular disease, but mainly with reference to the prognosis and indications of treatment.
In the management of acute diseases the Cnidians employed numerous remedies, and in other affections, few. The school of Cos, though at times more heroic, especially in the use of the lancet and active purgatives, were in the habit of managing acute diseases by a restricted regimen; barley-water more or less diluted, hydromel, and oxymel, being among their most frequent prescriptions. In the management of chronic diseases, they favored the medical gymnastics of Herodicus; whilst at Cnidos these dis