Outlines of Greek and Roman Medicine | Page 9

as only her servants. He discussed medical subjects freely and without an air of mystery, scorning all pretence, and he was also courageous enough to acknowledge his limitations and his failures. When the times in which he lived are considered, it is difficult to know which of his qualities to admire most, his love of knowledge, his powers of observation, his logical faculty, or his courage and truthfulness.
The central principle of belief of Hippocrates and the Dogmatists was that health depended on the proper proportion and action in the body of the four elements, earth, water, air, and fire, and the four cardinal humours, blood, phlegm, yellow bile and black bile. The due combination of these was known as crasis, and existed in health. If a disease were progressing favourably these humours became changed and combined (coction), preparatory to the expulsion of the morbid matter (crisis), which took place at definite periods known as critical days. Hippocrates also held the theory of fluxions, which were conditions in the nature of congestion, as it would now be understood.
In his time public opinion condemned dissection of the human body, but it is certain that dissections were performed by Hippocrates to a limited extent. He did not know the difference between the arteries and the veins, and nerves and ligaments and various membranes were all thought to have analogous functions, but his writings display a correct knowledge of the anatomy of certain parts of the body such as the joints and the brain. This defective knowledge of anatomy gave rise to fanciful views on physiology, which, among much that is admirable, disfigure the Hippocratic writings.
The belief that almost all medical and surgical knowledge is modern, though flattering to our self-complacency, is disturbed by the study of the state of knowledge in the time of Hippocrates. To him we are indebted for the classification of diseases into sporadic, epidemic, and endemic, and he also separated acute from chronic diseases. He divided the causes of disease into two classes: general, such as climate, water and sanitation; and personal, such as improper food and neglect of exercise.
He based his conclusions on the observation of appearances, and in this way began a new era. He was so perfect in the observation of external signs of disease that he has never in this respect been excelled. The state of the face, eyes, tongue, voice, hearing, abdomen, sleep, breathing, excretions, posture of the body, and so on, all aided him in diagnosis and prognosis, and to the latter he paid special attention, saying that "the best physician is the one who is able to establish a prognosis, penetrating and exposing first of all, at the bedside, the present, the past, and the future of his patients, and adding what they omit in their statements. He gains their confidence, and being convinced of his superiority of knowledge they do not hesitate to commit themselves entirely into his hands. He can treat, also, so much better their present condition in proportion as he shall be able from it to foresee the future."
He wrote about the history of Medicine, a study which is much neglected at the present time. There is no generation of men so wise that they cannot with advantage adopt some ideas from the remote past, or, at least, find the teaching of their predecessors suggestive. Hippocrates was one of the first to recognize the vis medicatrix natur?, and he always aimed at assisting Nature. His style of treatment would be known now as expectant, and he tried to order his practice "to do good, or, at least, to do no harm." When he considered interference necessary, however, he did not hesitate even to apply drastic measures, such as scarification, cupping and bleeding. He made use of the narcotics mandragora, henbane, and probably also poppy-juice, and as a laxative used greatly a vegetable substance called "mercury," beet and cabbage, and cathartics such as scammony and elaterium! He was able to diagnose fluid in the chest or abdomen by means of percussion and auscultation, and to withdraw the fluid by the operation of paracentesis, and he recognized also that the fluid should be allowed to flow away slowly so as to minimize the risk of syncope. He operated also for empyema. In regard to the methods of Hippocrates for the physical examination of the chest it is reasonable to suppose that the Father of Medicine indirectly inspired Laennec to invent the stethoscope. Hippocrates prescribed fluid diet for fevers, allowed the patients cold water or barley water to drink, and recommended cold sponging for high fever. In his writings will be found his views on apoplexy, epilepsy, phthisis, gout, erysipelas, cancer and many other diseases common at the present day.
In the province of Surgery, Hippocrates was surprisingly proficient, although he lived