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In Prognosis, he appears to have been remarkably skillful. In this department of pathology he enlarged considerably on the precepts of Hippocrates. He has with equal perspicuity treated of indications and contra indications; and in this study he demonstrates the superiority of the system and practice of the rationalists, over those of the empirics. The essential character of disease, where this can be discovered, furnishes the most reliable indications of treatment. But where this cannot be discovered, the indications may be taken from the season of the year, the state of the atmosphere, the temperament or mode of life of the patient, or, in rare and exceptional instances, from the symptoms. Health, he holds, is maintained by supplying similar with similars, whilst disease is overcome by opposing contraries to contraries. These two propositions furnish the key to his whole system of hygiene and therapeutics.
His regimen for the sick is in strict conformity with that of Hippocrates. But in his mode of managing many individual ailments, he diverges widely from his great model. The use of the lancet and of purgatives, he at times appears to have carried to extremes. Like most of the rationalists, he made use of cupping; but leeches, which were first introduced into practice by Themison, and freely used by the Methodic sect, he does not appear to have employed. Although not specially devoted to surgery, he evinces much skill as an operator; he introduced some new ideas while still officiating at the gymnasium of his native place, in reference to
the treatment of injuries of the nerves. He applied the trephine successfully to the sternum for evacuating the contents of an abscess behind that bone. He had on four occasions witnessed anterior luxation of the femur; twice he cured what was supposed to be spontaneous luxation of that bone; and, what speaks no little in favor of his humanity, he deprecates the use of caustics and the cautery, which were so generally employed and so much abused in ancient times.
In his several works on the Materia Medica, and on medicinal agents, simple and compound, he again differs widely from Hippocrates, whom he elsewhere affects to follow. For though he occasionally discountenances the custom of administering exotic medicines, and ridicules those who despise familiar plants, yet he is fond of heterogeneous mixtures, and quotes with approbation many of the complicated formulæ of his predecessors; but it is to be admitted that his own confections are not so complex as those which he borrows from other authors. The doctrine of primitive qualities he extends to his medicinal agents; and these qualities he deduces from the corresponding secondary properties: thus, bodies primarily hot are salt; and those primarily dry, are bitter. Again, each of the four primitive qualities may exist in the first,, second, third, or fourth degree: thus, chicory is cold in the first degree, and pepper is hot in the fourth. Or the agent may owe its medicinal effect to the union of two or more primitive qualities; thus, it may be hot and dry, or cold and moist. Each viscus, in consequence of the analogy between its primitive
qualities and those of certain remedial agents, exercises upon these agents a specific or peculiar attraction. Again, the qualities of agents may be actual or potential;-fire is actually hot, pepper is potentially so. This distinction is still observed in modern. times in reference to the cautery. Certain medicines, as specifics, purgatives, several of the poisons and their antidotes, act not by their primitive qualities, but by their whole substance. The art of medicine in Galen's time consisted mostly in devising or applying particular remedies to particular diseases, each ailment having, as was supposed, its own particular remedy. From the usages of his contemporaries in this respect he did not vary; and like most of them, he had his shop, in which his medicinal compounds were prepared, but only for legitimate purposes. He had a horror of charlatans of every stamp; and that branch of the apothecary's business which the moral tone of modern times no longer tolerates, the open sale of poisons, so common in former times,, he condemns in the severest terms.
Galen wrote no work expressly on the practice of medicine; bnt he has left a complete code of medical science, the only complete code of which we read among the ancients. Possessing in its individual ́parts. no great originality, made up of the doctrines of his predecessors of every sect, and disfigured by occasional incongruities, yet, as a whole, this code is remarkable for its general unity and consistency. But its fundamental doctrines are too often the creations of the imagination. In all his works Galen delights to display his erudition; and notwithstand
ing their vast number they are mostly written in polished style. He professes to be the admirer and disciple of Hippocrates. Yet no two writers on medicine were ever in style and substance more dissimilar. Hippocrates wrote with the terseness of a philosopher; Galen, with the flowing redundancy of the rhetorician, allowing nothing to remain unsaid, and adorning his discourse with criticism, biography, anecdote, sarcasm, vain-glorious boasting, personal narrative, and incidental allusions of every sort. But his brilliant errors no less than his sterner truths, gave popularity and influence to his writings. It does not appear that among the Latins he was at first received as favorably as among his own countrymen. He is mentioned neither by Serenus Sammonicus, who immediately succeeded him; nor by Marcellus Empiricus, who wrote two. centuries afterwards. But the next writer of celebrity among his own nation, Oribasius, who was a contemporary of Marcellus, appropriated nearly the whole of Galen's doctrines; and Alexander Trallianus calls him the divine. But authority, however transcendent, to be enduring must be founded on truth alone. The authority of Galen was not thus founded; and after a reign of more than twelve centuries, he has fallen from his high estate. He who looked upon himself as superior to Hippocrates, who held that the latter had merely commenced what he himself had been able to carry to completion, lies buried in the accumulations of his own labors; whilst Hippocrates, drawing his inspiration from the developments of nature, still
lives, to be studied with as much edification by the physicians of the present day as by his own immediate disciples.
WITH GALEN closes all that remains of the school of medicine at Rome, and all that was aggressive in the scientific advancement of the ancients. Most of those who had practiced or taught the art at Rome, up to this period, as we have already seen, were Grecians who had received the elements of their education at Alexandria or other eastern institutions. With the decadence of the Roman school, that of Alexandria again acquired its former rank. The intestine commotions and misrule, the religious and other wars of the empire, from the death of Marcus Aurelius to the accession of Constantine, left but little opportunity at the capital for cultivating the arts of peace. During this long interval, Italy had but few attractions for men of learning. And after the removal of the imperial court to Constantinople, the scholars that still lingered about the palace of the Cæsars, were attracted from the Latin portion of the empire; so that, from the time of Galen to the final overthrow of the empire of the West, Latin literature can boast of only four or five medical authors whose works have been deemed worthy of