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grand rule of practice was not contraria contrariis, or similia similibus curantur, but follow Nature, that is, imitate her operations in effecting first a proper coction, then a favourable crisis. His was, however, the very reverse of what is now called the expectant method; or, "the contemplation of death." The drugs he used were of frightful, often fatal, virulence; and these terrible weapons were employed, as we see, not in accordance with any legitimate deduction, but in obedience to a figment about humours which existed only in his imagination. We shall now adduce the proof of this by continuing the examination of his writings.

III. The treatise whose title is rendered by Dr. Adams, Regimen in Acute Diseases, should rather be called the management of such: for, besides the diet proper for these cases, it also mentions drugs and venesection. It is true that the principal part is devoted to barley-water, so that by some it is quoted under this title, and yet the acute diseases included "Pleurisy, Pneumonia, Phrenitis, and Apoplexy." It looks like a burlesque upon medicine to write a book upon barley-water as a cure for apoplexy and inflammation of the lungs and brain! Yet it is a serious treatise, giving the most minute directions how it is to be made and administered. Barley-water, then, appears to me to be justly preferred before all the other preparations from grain in these diseases, and I commend those who made this choice; for the mucilage is smooth, consistent, pleasant, moderately diluent, quenches thirst, if this be required, and has no astringency." It was his great remedy in acute disease, but he had recourse to the powerful auxiliary of blood-letting, when a case was obstinate, and the administration of black hellebore, the favourite purgative in his days. In the treatment of pneumonia or inflammation of the lungs, he recommends bleeding from the arm till the patient faints, if the pain pass upwards to the clavicle.

On the use of water he makes the following observations:-"I have nothing further to add as to the effects of water when used as a drink in acute diseases; for it neither soothes the cough in Pneumonia, nor promotes expectoration, but does less than the others in this respect, if used alone through the complaint. But if taken between Oxymel and Hydromel in small quantity, it promotes expectoration from the change which it occasions in the qualities of these drinks; for it produces, as it were, a certain overflow. Otherwise, it does not quench the thirst, for it creates bile in a bilious temperament, and is injurious to the hypochondrium; and it does the most harm, and does the least good when the bowels are empty, and it increases the swelling of the spleen and liver when they are in an inflamed state; it produces a gurgling noise in the intestines, and swims on the stomach; for it passes slowly downwards, as being of a coldish and indigestible nature, and neither proves laxative nor diuretic."

Now it is quite certain that many of the statements here made are incorrect, not being inductions from experience, but inferences from notions then prevailing about things being in their nature hot or cold, moist or dry. Water was held to be cold, therefore injurious as repressing the process of "coction," hence indigestible, and the fertile source of all sorts of discomforts. Now, we know, by ample experience, that water does not produce all these calamitous consequences, and, in fact, that it is safely substituted for barley-water; and we also know that the pain in Pneumonia, going upward to the collar-bone, has no special significance, and, therefore, cannot, when present, justify the bleeding of the patient to fainting. These are examples of the hypothetical indications which Hippocrates allowed to mislead him.

To do him justice, however, we should observe that it is evident he, himself, seems to have been fully aware of the

immense superiority of his knowledge of the symptoms, course, and termination of the various disorders he describes over his ability to treat them, as we shall see by continuing the catalogue of his writings.

IV. The First and Third Books of the Epidemics.There are in all seven books which have come down to us under this title, but of these only two are recognized to be genuine; and most remarkable productions they are. They consist of forty-two admirably drawn-up cases, and out of this number no less than twenty-five ended in death. This, in itself, presents a striking contrast to the cases now generally published, which too often seem intended rather to advance the interest of the narrator than the art of medicine. Still more extraordinary is it to find that, with one exception,' there is no mention whatever made of the treatment of all

these cases. The exception cannot possibly be related in order to illustrate his successful treatment, but because it was a departure from his ordinary routine; for after describing an acute fever, attended with dry cough, delirium, and which did not abate under the use of warm applications, he says: "I opened a vein on the eighth day, and much blood of a proper character flowed; the pain abated, but the dry cough continued." The case went on for thirty-four days, when "he sweated all over." "It is possible," he adds, "that the evacuation of the sputa brought about the recovery on the thirty-fourth day." It was not a cure by blood-letting on the eighth, but a recovery by a natural crisis on the thirty-fourth day. It is suggested by Galen, that the reason of mention being made of venesection in this case is, that the ordinary practice of Hippocrates was to bleed upon the fourth day, and that in this particular instance, for some reason or other, he delayed it to the eighth. It may be so; but surely it is most worthy of observation, that this-the

1 Case VIII. Book 3.

wisest of physicians, ancient or modern, who was so thoroughly impressed with the difficulties of his art, and who, therefore, we may suppose was most anxious to ascertain, and lay down rules for its practice, should be almost entirely silent in reference to the use of such powerful appliances as bleeding and purging to the verge of destruction. This was not his way when he knew what to teach, as we learn from his surgical papers: for example, take the following:

V. On Injuries of the Head.-Besides giving a description of the different forms of the skull, the accidents to which it is liable, the means the physician must take to ascertain the precise place and kind of fracture or wound, Hippocrates gives exact directions for the treatment, both medical and surgical. After describing how the preliminary examination is to be made, and an incision, so as to expose the bone supposed to be fractured, he proceeds :"If you perceive an indentation left in the bone by the blow, you must scrape the dint itself and the surrounding bones, lest, as often happens, there should be a fracture and contusion; or a contusion alone, combined with the dint, and escaping observation. And when you scrape the bone with the raspatory, and it appears that the wound in the bones requires the operation, you must not postpone it for three days, but do it during this period, more especially if the weather be hot, and you have had the management of the case from the commencement." "If you suspect, but do not know, the bone is broken or contused, then apply to the scraped part a black pigment (the technical name is given), and having wiped it off, you will distinguish the contused part by its absorbing the colour, while the surrounding bone can be cleaned. You must again scrape more deeply at the black part, and by thus doing, you may remove the fissure which has been caused by the fracture. But if the fracture extends deep, and does not seem likely to disappear

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when scraped, such an accident requires trephining.' Then we have minute directions as to how the trepan is to be applied, and delineations of the instruments. Now, no one will maintain that Hippocrates thought it was an easier thing, or one less requiring full instructions, to treat an acute disease, such as inflammation on the lungs or brain, than a blow on. the head. Indeed, he says, "I would more especially commend the physician who, in acute diseases, by which the bulk of mankind are cut off, conducts the treatment better than others." 2 It could not then be indifference, as to the best method of treating these forty-two cases of deadly pleurisies and fevers, which he so graphically describes, that induced Hippocrates to abstain from uttering a word upon therapeutics, and confined him to pathology alone. His reticence must be from a different cause, and this cause will disclose itself when we analyze the greatest of all his works-his famous Aphorisms. Between them and the works just quoted, intervene books VI. "The Surgery," in which all surgical apparatus is minutely catalogued and described; VII. "Fractures ;" VIII. "Articulations;" and IX. "Mochlicus." These are all either anatomical or surgical treatises, admitted, even at the present day, to be masterpieces of exact and exhaustive descriptions of the accidents to which bones and joints are liable. The marvellous thing about them is, how Hippocrates contrived to acquire such accurate knowledge of the human frame. It has been a question keenly debated by the learned, whether or not the father of medicine ever prosecuted the study of anatomy by dissecting the bodies. of men. On the one hand, it is urged that the feeling of his age would have been so outraged by a violation of the dead, that he could not have ventured to do it, even had he been so disposed; while on the other hand, we have proof positive of his possessing knowledge so minute, as could

1 Injuries of the Head, 14. 2 Regimen in Acute Diseases, 2.

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