5. Those things which are sacred are to be imparted only to sacred

persons; and it is not lawful to impart them to the profane until they have been initiated in the mysteries of the science. The “Hippocratic collections” of works which have been attributed to Hippocrates, but the greater part of which were neither written by him, nor compiled from notes taken by his students, consists of eighty-seven treatises. Hippocrates believed in the influence of the imagination of pregnant women on the child in the womb. He forbad nurses to eat food of an acrid, salt, or acid nature, and observed that infants during the period of dentition were liable to fevers, bowel troubles, and convulsions, especially if there was constipation. He mentions thrush as one of the diseases of dentition (_De Dent._). He recommends friction for contracting or relaxing the body according as it is applied in a hard or soft manner. Very fully he discourses on the evil effects of plethora, and recommends purging, emetics, warm baths, and bleeding, for reducing the system (_De Dietol._, iii. 16 _et seq._). He constantly advises gentle purgatives as a means of keeping the body in health. His favourite laxative medicine was the herb mercury. The administration of clysters is recommended; this treatment was evidently derived from the Egyptians. What are called errhines or sternutatories—_i.e._, medicines which, applied to the nose, excite sneezing—were described by Hippocrates as medicines which purge the head. Though he fully describes the effects of baths, he speaks unfavourably of thermal springs as being hard and heating. He insists that the diet should be full in winter and spare in summer (_Aphor._, i. 18). He disapproves of the habit of eating a full dinner (_De Vet. Med._). He condemns the use of new bread. The nutritious properties of pulse in general are insisted upon. He calls the flesh of fowls one of the lightest kinds of food (_De Affect._, 46), and says that eggs are nutritious, and strengthening, but flatulent. He remarks that the flesh of wild animals is more digestible than that of domesticated. He objects to goat’s flesh as having all the bad qualities of beef, which he calls a strong, astringent, and indigestible article of diet. Milk, he says, sometimes causes the formation of stones in the bladder (_De Ær. Aquis et Locis_, 24). Dr. Francis Adams says this opinion was adopted by all the ancient physicians. Cheese he considers flatulent and indigestible. Fishes are light food; sea fish are lighter and better for delicate persons than fresh-water fish (_De Affect._, 46). Honey, when eaten with other food, is nutritious, but is injurious when taken alone. Hippocrates opposed all hypothesis in medicine, and grounded his opinions on disease on actual observation. He insisted that the essence of fever is heat mixed up with noxious qualities. He was the great master of prognostics. His work _Prorrhetica and Coacæ_, says Dr. Francis Adams, “contains a rich treasure of observations which cannot be too much explored by the student of medicine. His prognostics are founded upon the appearance of the face, eyes, tongue, the voice, hearing, the state of the hypochondriac region, the abdomen, the general system, sleep, respiration, and the excretions. We can do little more, in this place, than express our high sense of the value of the _Hippocratic Treatises on Prognostics_, and recommend the study of them to all members of the profession who would wish to learn the true inductive system of cultivating medicine.” (_The Seven Books of Paulus Ægineta_, by Francis Adams.) The state of the countenance which immediately precedes death is called by physicians the _Facies Hippocratica_, because Hippocrates described it, calling it πρόσωποι διαφθορή (_Coac. Prænot._, 212). The nose is sharp, the eyes hollow, the temples sunk, the ears cold and contracted, and their lobes inverted; the skin about the forehead hard, tense, and dry; the countenance pale, greenish, or dark. In fevers he was greatly attached to the importance of the critical days. Galen adopted his list of critical days with little alteration. Hippocrates does not seem to have paid much attention to the pulse, or if he did he attached little importance to it; even in describing epidemical fevers he neglects to mention the characteristics of the pulse. Galen, however, affirms that he was not altogether ignorant of it. He quite correctly described the characteristics of healthy stools, and pointed out that they should in colour be yellowish, if too yellow there is too much bile, if not yellow at all there was a stoppage of the passage of bile to the intestines. His indications from the state of the urine are not less valuable. How wise are his observations on the treatment of febrile diseases! “To be able to tell what had preceded them; to know the present state and foretell the future; to have two objects in view, either to do good or at least do no harm” (_Epidem._, i. 7). He it was who formulated the rule all physicians have since followed that a fluid diet is proper in all febrile affections. He advised cold sponging in ardent fevers—a method of treatment recently revived and of great value (_De Rat. Vict. Acut._). He laid it down that diseases in general may be said to arise either from the food we eat or the air we breathe. In cases of fever he allowed his patients to drink freely of barley-water and cold acidulated drinks. In this he was much in advance of the medical science of the time. He has described cases of “brain fever,” one of the few complaints which novelists permit their heroes to suffer from. They appear to have been cases of remittent fever rather than true inflammation of the brain. We may estimate the wonderful extent of the medical science of Hippocrates by the fact that he vigorously opposed the popular belief of the period, that epilepsy was due to demoniacal influence. He explains that the lower animals are subject to the same disorder, and that in them it is often associated with water in the brain. There is really no doubt that the _morbus sacer_ of the ancients and the cases of demoniacal possession of which we read were cases of epilepsy (_Hippoc. de Morbo Sacro_). Concerning apoplexy he says that a slight attack is difficult to cure, and a severe one utterly incurable. The cause of the attack he considered was turgidity of the veins. We know it to be often associated with cerebral hæmorrhage or sanguineous apoplexy and sometimes with effusion of serum = serous apoplexy. Hippocrates therefore came very near the truth. He advised bleeding, which is still recommended but is not often practised in England; and he very justly said that the malady occurs most frequently between the age of forty and sixty (_Aphoris._, ii. 42). In certain forms of ophthalmia he advises free purgation, bleeding, and the use of wine; and this accords with the best modern practice, if for venesection, we substitute vesication. His treatment of nasal polypus by the ligature is not unlike our own; and nothing could be better than his plan for dealing with quinsey and allied complaints, viz., hot fomentations, warm gargles and tinctures, with free purgation. He disapproves of a practice too often followed by surgeons to-day, of scarifying the tonsils when swollen and red. In cases of inflammation of the lungs he advised bleeding, purging, and cooling drinks. Laënnec, the great French physician, who invented the stethoscope, highly praises Hippocrates for his knowledge of phthisis, and the diagnostic value of his tests of the nature of the sputa in that disease. In cases of empyema, or the formation and accumulation of pus in the chest, he directs us to make an incision into the pleural cavity—an operation which has been revived in modern times under the name of “paracentesis thoracis.” He declares the loss of hair and the diarrhœa of phthisis to be fatal signs, and his description of hydrothorax, or dropsy of the chest, has been highly praised by the greatest authorities. He says that phthisis is most common between the ages of eighteen and thirty-six (see _Hippoc. de Morbis_, ii. 45; _Coacæ Prænat., et alibi_). For pleurisy his treatment is practically the same as that followed at the present day. He advised the administration of flour and milk in diarrhœa—an exceedingly useful remedy—and treated the pains of colic by warm injections, warm baths, fomentations, soporifics and purgatives, as the case might require. He was wise enough to know that stone of the bladder was a product of a morbid condition of the urine, and said that when it had fairly formed nothing but an operation for its removal was of any value. He recognised the disease known as hydatids of the liver, and directed that abscesses of that organ should be opened by the cautery. His account of the causes and treatment of dropsy is fairly accurate according to our present knowledge. He approved of paracentesis abdominis (tapping) in cases of ascites, and describes the operation. He recognised the incurability of true cancer. Many of his treatises on the disorders of women prove that they were well understood in his day, and on the whole were properly treated. Difficult labour was managed not so differently from our modern methods as might be supposed. His account of hip-joint disease is remarkably accurate. Gout was well understood by our author, and probably his treatment by purgation and careful dieting was on the whole as successful as our own. Hippocrates speaks of leprosy as more a blemish than a disease; it is probable, however, that the works in which he is supposed to allude to it are not genuine. He points out the danger of opening the round tumour on tendons, called a ganglion. In his book called _Prognostics_, he refers to the danger of an erysipelas being translated to an internal part. Cold applications, he says, are useful in this disease when there is no ulceration, but prejudicial when ulceration is present. Struma or scrofula is described by Hippocrates (_De Glandulis_) as being one of the worst diseases of the neck. In the treatise (_De Ulceribus_) on ulcers, he particularly praises wine as a lotion for ulcers, and there is good reason to believe that we might advantageously revert to this treatment. Some of the drugs which he recommends for foul ulcers, such as frankincense and myrrh, are excellent, and owe their efficacy to their “newly discovered” antiseptic action. He recommends also arsenic and verdigris. The actual cautery or burning applied freely to the head is recommended in diseases of the eyes and other complaints. He describes water on the brain in the treatise _De Morbis_, ii. 15, and even recommends perforation of the skull or trephining quite in the modern way. Opening the temporal veins is advised for obstinate headaches. Although no express treatise on bleeding is found amongst the works of Hippocrates, he practised venesection freely in various diseases. He forbids the surgeon to interfere with non-ulcerated cancers, adding that if the cancer be healed the patient soon dies, while if let alone he may live a long time (_Aph._, vi. 38). He warns us that the sudden evacuation of the matter of empyema or of the water in dropsy proves fatal. He speaks of evacuating the fluid with an instrument similar to that which we call a trochar. He approves of scarification of the ankles in dropsy of the lower extremities; this is quite modern treatment. In cases of dislocation of the hip-joint from the formation of a collection of humours, he recommends burning so as to dry up the redundant humours. He minutely describes the cure of fistula with the ligature in his work _De Fistulis_, which, even if not a genuine treatise of Hippocrates, is extremely ancient, and was considered authentic by Galen. Hæmorrhoids or piles are to be ligatured with very thick thread, or destroyed with red-hot irons. Varicose veins are to be treated by small punctures, not freely opened (_De Ulceribus_, 16). Hippocrates considered the extraction of weapons to be one of the most important departments of surgery. In his treatise _De Medico_, he says that surgery can only be properly learned by attaching one’s self to the army. Homer said,— “The man of medicine can in worth with many warriors vie, Who knows the weapons to excise, and soothing salves apply.” Hippocrates treats of fractures in his books _De Fracturis_ (_De Articulis_; _De Vulner. Capit._; _Officina Medici_). He insists that no injuries to the head are to be considered as trifling; even wounds of the scalp may prove dangerous if neglected. Fissures, contusions, and fractures of the cranium are minutely explained and appropriate treatment suggested. He describes the trephine under the name of τρύπανον, _i.e._ the trepan. He says that convulsions are the frequent consequence of head injuries, and that they occur on the opposite side of the body to that in which the brain injury is seated. One of the most valuable legacies of the ancients is this profoundly learned treatise of the Father of Medicine, and it proves to us how high a point the surgery of ancient Greece had reached. He noticed a certain movement of the brain during respiration, a swelling up in expiration and a falling down during inspiration; and although several great authorities of the past denied the accuracy of this observation, it has since been shown to be perfectly correct. (See _Paulus Ægineta_, Dr. F. Adams’ edit., vol. ii. p. 442.) In cases of fracture of the lower jaw, our author directs that the teeth separated at the broken part are to be fastened together and bound with gold wire. So accurately does he describe this fracture that Paulus Ægineta transcribes it almost word for word from the _De Articulus_. His method of treating fracture of the clavicle is admirable; in fracture of the ribs he observes that when the broken ends of the bone are not pushed inwards, it seldom happens that any unpleasant symptoms supervene. In fractures of the arm he minutely and precisely indicates the correct principles on which they are to be treated, and insists strongly on the necessity of having the arm and wrist carefully suspended in a broad soft sling, and that the hand be placed neither too high nor too low. Hippocrates could learn very little from our modern surgeons in the treatment of such injuries. In cases of broken thigh he has indicated all the dangers and difficulties attending the management of this accident; his splints and bandages are applied much as we apply them at the present time, and his suggestions for ensuring a well-united bone without deformity of the limb are invaluable. In fractures of the thigh and leg-bones he lays great stress on the attention necessary to the state of the heel. In those of the foot he warns against the danger of attempting to walk too soon. In compound fractures compresses of wine and oil are to be used, and splints are not to be applied till the wound puts on a healthy appearance. He is fully aware of the peculiarly dangerous character of such injuries, and his observations read like extracts from a modern text-book of surgery. “No author,” says Dr. Francis Adams, the learned translator of the works of Paulus Ægineta, “has given so complete a view of the accidents to which the elbow joint is subject as Hippocrates.” PLATO (B.C. 427-347) in its philosophical aspect studied medicine, not with any idea of practising the art, but merely as a speculative contemplation. The human soul is an emanation from the absolute intelligence. The world is composed of the four elements. Fire consists of pyramidal, earth of cubical, air of octagonal, and water of twenty-sided atoms. Besides these is the æther. Everything in the body has in view the spirit. The heart is the seat of the mind, the lungs cool the heart, the liver serves the lower desires and is useful for divination. The spleen is the abode for the impurities of the blood. The intestines serve to detain the food, so that it might not be necessary to be constantly taking nourishment. The inward pressure of the air accounts for the breathing. The muscles and bones protect the marrow against heat and cold. The marrow consists of triangles, and the brain is the most perfect form of marrow. When the soul is separated from the marrow, death occurs. Sight is caused by the union of the light which flows into and out of the eyes, hearing in the shock of air communicated to the brain and the blood. Taste is due to a solution of sapid atoms by means of small vessels, which vessels conduct the dissolved atoms to the heart and soul. Smell is very transitory, not being founded on any external image. The uterus is a wild beast exciting inordinate desires. Disease is caused by a disturbance of the quantity and quality of the fluids. Inflammations are due to aberrations of the bile. The various fevers are due to the influence of the elements. Mental diseases are the results of bodily maladies and bad education. Diseases fly away before appropriate drugs. Physicians must be the rulers of the sick in order to cure them, but they must not be money-makers.[398] In the _Republic of Plato_, Book III., we find that medical aid was largely in request in Greece to relieve the indolent and voluptuous from the consequences of self-indulgence. It was thought by Socrates disgraceful to compel the clever sons of Asclepius to attend to such diseases as flatulence and catarrh; it seemed ridiculous to the philosopher to pay so much attention to regimen and diet as to drag on a miserable existence as an invalid in the doctor’s hands. When a carpenter was ill, he expected his doctor to cure him with an emetic or a purge, the cautery or an operation; if he were ordered a long course of diet, he would tell his doctor that he had no time to be ill, and he would go about his business regardless of consequences. Æsculapius, it was maintained, revealed the healing art for the benefit of those whose constitutions were naturally sound; he expelled their disorders by drugs and the use of the knife, without interfering with their usual avocations; but when he found they were hopelessly incurable, he would not attempt to prolong a miserable life by rules and diet, as such persons would be of no use either to themselves or the state. Constitutionally diseased persons and the intemperate livers were to be left to be dealt with by Nature, so that they might die of their diseases.