June 25, 1892. THE HOSPITAL 195

Medical History from the Earliest Times. By E. T. Withington, M.A., M.B. Oxon.

" xiy. heraclides and the empiric Cosmetics," and On Diet in Health" (Symposium), SCHOOL. are attributed to Heraclides, both, of which are said to been the first Some readers may have found the name Heraclides, have of their kind. From the former " mentioned among typical Greek physicians in a preced- Galen has extracted two recipes for making the hair ing article, rather strange to them, but in Heraclides of stick together," the first consisting of wax, pitch, glue, Tarentum, Heraclides the Empiric (B.C. 230), we may, and gum-mastich, equal parts, to be warmed before I think, find an almost forgotten hero of medicine, using. Did the ancient Greeks wax their moustaches ? some of whose claims to remembrance shall here he For incipient baldness, Heraclides recommends a briefly repeated. His works have perished?our relics pomade of anemones rubbed up in oil, which he says ?of ancient literature are by no means survivals of all will also darken the hair. Among the scanty extracts the fittest?and what we know of him is gathered from which survive from the Symposium, we may notice the " scattered notices in later writers. Galen calls him a assertion that sheep's trotters, snails, and other if most excellent physician," giving him the high praise glutinous substances cause indigestion taken in well to eat a little before that he never preferred his party to the truth, and excess, and that it is always wrote com- Soranus considered him the only Empiric worth re- drinking. Finally, this prolific author in con- futing ; had he not been in his grave for three cen- mentaries on several Hippocratic works, where, turies, he might have given the great Methodist some- trast to other Empirics, he showed due respect to the he has received thing more to do. But Heraclides was not fond of memory of the mighty Asclepiad, and controversy, and his lukewarmness in that respect led as an appropriate reward the honourable mention of him to be accused of relapsing into dogmatism. He his successors of every school. was the ?did not, like Serapion, seek notoriety by abusing his To pass to the sect of which Heraclides a and ?colleagues, or by introducing some new and start- greatest ornament; Empiricism is now by-word ling remedy which should excel the virtues of a reproach in medicine, but the system originally so tortoise blood or crocodile dung, but devoted him- called owed its origin mainly to the teaching of one self to the humbler task of weeding the already whose name on the great roll of the Asclepiadaj pre- ?over-luxuriant garden of Empiric medicines. This he cedes even that of Hippocrates, the most scientific of " ?did in his greatest work On the Preparation and the Greeks, the grandest intellect, perhaps, of the Proving of Drugs," which he declared, in the best human race. Aristotle, son of the Asclepiad Nicoma- spirit of Empiricism, contained nothing but what he chus, probably studied medicine in early youth, and had himself observed, and which formed a rich mine may even have practised it; his anatomical discoveries for all future writers on materia medica. In this are worthy to be compared with those of Herophilus treatise Heraclides seems to have first pointed out the and Erasistratus, and his teaching, which brought great value of opium, and to have defined the indica- down the philosophy of Plato from heaven to earth, it at least more suited tions for its use. That drug, indeed, was, as we have from the ideal to the real, made seen, probably nsed from the earliest times, and though for that art which deals with human bodies. As the only once mentioned in the Hippocratic writings, was result, partly of this teaching, partly of the sceptic ?employed by Diodes (b.c. 350) as a remedy for tooth- philosophy taught about the same time by Pyrrho, ache, and is noticed by his contemporary Diagoras, who and partly of the natural reaction against the extrava- at asserts that it acts injuriously on the special senses, gant theorising of the Dogmatists, there arose of medi- and is, therefore, to be avoided in affections of the eye Alexandria, about 280 B.C., the Empiric school two and ear. Heraclides, however, disregards this, and re- cine, of which the more direct founders were pupils commends poultices containing the drug in painful of Herophilus, Philinus and Serapion. Of these the and the latter ophthalmia. We have also prescriptions of his con- former argued with the Dogmatists, even himself. taining opium for cases of sleeplessness, spasm, cough, abused them, not sparing Hippocrates "" been a sort of Greek cholera," and colic, and one with a large dose of the Indeed, Serapion seems to have notorious German, is said to drug for patients bitten by venomous serpents. His Paracelsus, and, like the " an mineral into treatment of brain fever," or phrenitis, of which he have introduced important remedy used in distinguished a cerebral and gastric form, was much medicine, and to have first sulphur chronic a praised, and consisted of a darkened room, cold to the skin diseases. The Empirics, though branch of the head, bleeding, and enemata ; while in opposition to Alexandrine School, despised anatomy. They even its the dominant school, he declared that in acute wrote treatises to prove worthlessness, and we may fevers fluids are not to be withheld from the well fancy Serapion exclaiming, in the language of " is the use thirsty sufferer. He was scarcely less distinguished as Paracelsus, What of knowing the shape a surgeon, asserted the possibility of reducing disloca- and position of the brain and liver, or whether there as brains " tions of the hip, and invented a machine for that pur- are such things and livers at all ? No less pose ; indeed it seems highly probable that it was did they reject the Dogmatic physiology and patho- who first and one of their " Heraclides conceived the idea of utilising the logy, favourite mottoes was, It is the but mechanical inventions of his contemporary and neigh- not cause, the cure of diseases that concerns bour, Archimedes, in surgery. He also invented a us; not how we digest, but what is digestible." In method for separating the eyelid from the ball, when short, they reduced the whole art and science of medi- which was cine to a of adherent after injury, practised for many system therapeutics. A person is ill, that " centuries. Two works of more general interest, On is, he has certain unpleasant feelings or symptoms; 196 THE HOSPITAL. June 25, 1892.

" surely the first thing to do is to find something which Empirics, says Galen, were terrible men for names," will remove them, and the whole duty of the physician and in this they were encouraged by Aristotle, who was is to discover what particular treatment, and espe- not only the father of natural science, but had other cially what drugs, will get rid of particular sets offspring, one of whom sprang from his marvellous of symptoms. This he may do in three ways: brain a full-grown Pallas Athene. This was Logic, (1) By his own observations and experiments? and its definitions and syllogisms were seized upon, autopsy; (2) by learning from his contemporaries and with delight by the physicians of the day, who soon predecessors?history; (3) in the case ofinew and strange showed that as much mental energy could be wasted in diseases, by drawing conclusions from those most word-splitting, definitions of the pulse, &c., as in the similar to them?analogy. Thus was established the vaguer speculations of Dogmatism. famous "tripod" of the Empirics, but being found The Empirics existed as a separate school for some rather shaky on its three legs, a fourth was afterwards centuries, and we shall find one of them among the " added, epilogism," or the process of inferring pre- teachers of Galen ; but they finally separated into two ceding events from the present symptoms. Thus, by distinct branches, one philosophical, and culminating, epilogism, the consistent Empiric might conclude from in the sceptic agnosticism of Sextus Empiricus"; while the extreme inflammation of a wound that it was the other, or practical branch, gradually degenerated poisoned, and treat it accordingly without falling into into Empiricism in its modern sense, and found its the Dogmatic heresy of looking for hidden causes. chief exponent in Marcellus the Empiric, in whose Empiricism practically resolved itself into a search for writings human credulity in matters medical seems to> specifics, and its immediate result was the introduction have achieved its utmost. Curiously enough, these two of a great number of drugs, some of very extraordinary are almost the only members of the sect of whose works, nature, such as hare's heart, camel's brain, the flesh of we possess more than fragments, and they may be con- weasles, and of human beings, and the two examples sidered in greater detail later on. given above; but doubtless there was ample evidence, Meanwhile, let us remember that the Empiric school both from "autopsy" and "history," of patients was useful in its generation in checking the extrava- of and in and recovering after taking any of them. gances Dogmatism, extending defining the use of such remedies as and and, It has been said that the sin of men of opium sulphur, besetting above all, that it produced one great physician i3 to have finished off worthy science fancy they all things to stand with the noblest round the Hippocratic throne,. in heaven and earth by giving them names. The Heraclides of Tarentum.