CHAPTER XXV

POST-CLASSICAL MEDICINE Three representatives of post-classical medicine—Bibliographical note—Medical compendiums: Oribasius and Paul of Aegina—Aëtius of Amida—How superstitious are Aëtius and Alexander of Tralles?—Compound medicines—Aëtius merely reproduces the superstition of Galen—Occult science mixed with some scepticism—Alexander of Tralles—Originality of his work—His medieval influence—His personal experience—Extent of his superstition—_Physica_—Occult virtue of substances applied externally—Other things used as ligatures and amulets—Astrology and sculpture of rings—Incantations—Conjuration of an herb—Medieval version seems less superstitious than the original text—Marcellus: date and identity—“Marcellus Empiricus”—Superstitious character of his medicine—Preparation of goat’s blood—A rabbit’s foot—Magic transfer of disease—Pliny and Marcellus compared on green lizards as eye-cures—More lizardry—Use of stones and an herb—Right and left: number—Incantations and characters—The art of medicine survives the barbarian invasions. [Sidenote: Three representatives of post-classical medicine.] In this chapter as representatives of post-classical medicine and its influence upon medieval Latin medicine we shall consider three writers whose works date from the close of the fourth to the middle of the sixth century, Marcellus of Bordeaux or Marcellus Empiricus, Aëtius of Amida in Mesopotamia, and Alexander of Tralles in Asia Minor.[2324] They have just been mentioned in their chronological order, but although Marcellus antedates the other two by a full century, we shall consider him last, since he wrote in Latin while they wrote in Greek, and since he includes Celtic words and probably Celtic folk-lore, and since he seems to have been a native of Gaul, if not of Bordeaux,[2325] and thus is geographically closer to the scene of medieval Latin learning. Aëtius and Alexander have the closer connection not only with the eastern and Greek world but also with the past classical medicine of Galen and so will provide a better point of departure. Presumably from the places and periods in which they lived, all three of our authors were Christians, but it must be said that the chief evidence of Christianity in their works is the use of Christian or Hebrew proper names in incantations, and there are some analogous relics of pagan superstition. [Sidenote: Medical compendiums: Oribasius and Paul of Aegina.] As Tribonian and Justinian boiled down the voluminous legal literature of Rome into one _Digest_, so there was a similar tendency to reduce the past medical writings of the Greeks into one compendious work. Paul of Aegina, writing in the seventh century, observes in his preface[2326] that it is not right, when lawyers who usually have plenty of time to reflect over their cases have handy summaries of their subject to which they can refer, that physicians whose cases often require immediate action should not also have some convenient handbook, and the more so since many of them are called upon to exercise their profession not in large cities with easy access to libraries, but in the country, in desert places, or on shipboard. Oribasius, friend and physician of the emperor Julian, 361-363 A. D., had made such a compendium by that emperor’s order. In this he embodied so much of Galen’s teachings that he became known as “the ape of Galen,”[2327] although he also used more recent writers. But Paul of Aegina regarded this work of Oribasius as too bulky, since it originally comprised seventy-two books although only twenty-five are now extant, and so essayed a briefer compilation of his own. Two centuries ago, however, Friend and Milward protested against regarding Paul, Aëtius, and Alexander as mere compilers and maintained that they “were really men of great learning and experience”[2328] who “have described distempers which were omitted before; taught a new method of treating old ones; given an account of new medicines, both simple and compound; and made large additions to the practice of surgery.”[2329] Puschmann more recently states that Paul’s compendium was “composed with great originality and independence” and is of great value “particularly in its surgical sections.”[2330] After Paul, however, the Byzantine medical writers, such as Palladius, Theophilus, Stephen of Alexandria, Nonus, and Psellus, were of an inferior caliber.[2331] With Paul’s work, however, we are not now further concerned, nor with that of Oribasius, but with the somewhat similar compendiums of Aëtius and Alexander which lie chronologically between these other two. It is Aëtius and Alexander whom Payne accuses of “introducing into classical medicine the magical elements derived from the East”[2332] and whom we might therefore expect to possess an especial interest for our investigation. [Sidenote: Aëtius of Amida.] Of the life and personality of Aëtius we know very little, but inasmuch as he mentions St. Cyril, archbishop of Alexandria, and Peter the Archiater, a physician of Theodoric, while he himself is cited by Alexander of Tralles, he seems to have lived at the end of the fifth and beginning of the sixth century.[2333] And since Alexander cites him only in his book on fevers which seems to have been composed after the rest of his work, it seems probable that Aëtius was almost contemporary with him and wrote in the sixth rather than the fifth century. His _Tetrabiblos_—each of the four books subdivides into four sections and often these are spoken of as sixteen books—occupies a middle position not only in time but in length between the works of Oribasius and Paul, and resembles the latter in making a great deal of use of the former. Aëtius’ extracts from the older writers are shorter than those of Oribasius, however, and he also differs from him in combining several authorities in a single chapter, the method usually adopted by the medieval Latin encyclopedists. It has been noted that the wording of the original authorities was often preserved in the oldest medieval manuscripts of Aëtius, until the copyists of the time of the Italian Renaissance began to touch up the style in accordance with their erroneous notions of what constituted classical Greek.[2334] It may also be said that these systematically arranged handbooks of Oribasius, Aëtius, and the rest, where one could find what one was looking after, were far superior in systematic and orderly presentation to the discursive works of Galen which, like many other classical writings, often seem rambling and without any particular plan.[2335] This more logical, if somewhat cut-and-dried method, was also to be a virtue of medieval Latin learning. Whether Aëtius directly influenced the Latin middle ages is doubtful, since no early Latin translation of him seems to be known.[2336] The work of Oribasius, however, exists in Latin translation in manuscripts of the seventh century as well as in others of the ninth and twelfth.[2337] [Sidenote: How superstitious are Aëtius and Alexander?] The works of Aëtius and Alexander of Tralles do not impress me as containing an unusually large amount of superstitious medicine. Much less am I inclined to agree with Payne that they are responsible for the introduction into classical medicine of magical elements derived from the east. These elements, whether derived from the orient any more than any other feature of classical civilization or not, at any rate had been a prominent feature of classical medicine long before the days of Aëtius and Alexander, as Pliny’s review of medicine before his time abundantly proved and as is also shown by the extraordinary virtues which Pliny himself, his contemporary Dioscorides, and even the great Galen attributed to medicinal simples. [Sidenote: Compound medicines.] It is true that Aëtius and Alexander abound in recipes for elaborate medical compounds composed of numerous ingredients. Of such concoctions one example must suffice, a plaster which Aëtius recommends for tumors, hard lumps, and gout. “Of the terebinth-tree, of the stone of Asia, of bitumen three hundred and sixty drams each; of washing-soda (_spumae nitri_), calf-fat, wax, laurel berries, ammonia, and thyme three hundred and forty drams each; of the stone pyrites and quick-lime one hundred and twenty drams each; of the ashes of asps which have been burned alive one hundred and forty drams; of old oil two pounds. First liquefy the oil and wax, then the bitumen, which should have first been pulverized. Add to these the fat, and presently the ammonia and terebinth; and when these are taken off the fire mix in the lime and stone of Asia, then the laurel berries and washing-soda, and finally after the medicament has cooled sprinkle the ashes of asps upon it.”[2338] Such concoctions are to a large extent borrowed by Aëtius, Alexander, and Marcellus from earlier writers. Moreover, while Pliny had excluded such compounds from the pages of his _Natural History_, he had also made it abundantly evident that they were already in general use by his time, and they are to be found in great numbers in the works of Galen who cites many from preceding writers. [Sidenote: Aëtius merely reproduces the superstition of Galen.] Indeed, it was from Galen himself and not from the east that Aëtius at least derived his most strikingly superstitious passages. This was accidentally and convincingly proven by my own experience. It so happened that I wrote an account of the passages in the _Tetrabiblos_ of Aëtius before I had read extensively in Galen’s works. When I came to do so, I found that almost every passage that I had selected to illustrate the superstitious side of Aëtius was contained in Galen: for example, the use as an amulet of a green jasper suspended from the neck by a thread so as to touch the abdomen;[2339] the story of the reapers who found the dead viper in their wine and cured instead of killing the sufferer from elephantiasis to whom they gave the wine to drink;[2340] the tale of his preceptor who roasted river crabs to an ash in a red copper dish in August during dog-days on the eighteenth day of the moon, and administered the powder daily for forty days to persons bitten by mad dogs.[2341] Such passages are usually repeated by Aëtius in such a way as to lead the reader to think them his own experiences, a fact which warns us not to accept the assertions of ancient and medieval authors that they have experienced this or that at their face value, and which makes us wonder if Friend and Milward were not too generous in regarding Aëtius at least as more than a compiler. He also repeats some of Galen’s general observations anent experience as that the virtues of simples are best discovered thus, and that he will not discuss all plants but only those “of which we have information by experience.”[2342] He further reproduces Galen’s attitude of mingled credulity and scepticism concerning the basilisk, combining the two passages into one;[2343] also Galen’s questioning the efficacy of incantations and telling of having seen a scorpion killed by the mere spittle of a fasting man without any incantation.[2344] Like Galen again, he omits all injurious medicaments and expresses the opinion that men who spread the knowledge of such drugs do more harm than actual poisoners who perhaps cause but a single death.[2345] Like Galen he announces his intention to omit all “abominable and detestable recipes and those which are prohibited by law,” mentioning as instances the eating of human flesh and drinking urine or _menses muliebres_.[2346] But also like Galen, he devotes several chapters to the virtues of human and animal excrement, especially recommending that of dogs after they have been fed on bones for two days.[2347] Somewhat similar to Galen’s recommendation to fill cavities in the teeth with roasted earthworms is the recipe of Aëtius for painless extraction of teeth “without iron.” The tooth must first be thoroughly scraped or the gum cut loose about it, and then sprinkled with the ashes of earthworms. “Therefore use this remedy with confidence, for it has already often been celebrated as a mystery.”[2348] Such use of earthworms continued a feature of medieval dentistry. [Sidenote: Occult science mixed with some scepticism.] Of my original selections from Aëtius very few are now left, and it is not unlikely that they too might be found somewhere in Galen’s works if one looked long enough. Aëtius asserts that drinking bitumen or asphalt in water will prevent hydrophobia from developing,[2349] and recommends for wounds inflicted by sea serpents an application of lead with a slice of the serpent itself.[2350] He takes the following prescription from Oribasius. To cure impotency anoint the big toe of the right foot with oil in which the pulverized ashes of a lizard have been mixed. To check the operation of this powerful stimulant one has merely to wash off the ointment from the toe.[2351] On the other hand, an instance of a sceptical tendency is the citation of the view of Posidonius that the so-called _incubus_ is not a demon but a disease akin to epilepsy and insanity and marked by suffocation, loss of voice, heaviness, and immobility.[2352] It may also be noted that in discussing the medicinal virtues of the beaver’s testicles Aëtius does not include the story of its biting them off in order to escape its hunters.[2353] He does, however, cite several authorities, Piso, Menelbus, Simonides, Aristodemus, and Pherecydes for instances of the remarkable powers of certain animals in discovering the presence of poisons and preserving themselves and their owners from this danger: a partridge who made a great noise and fuss whenever any medicament or poison was being prepared in the house; a pet eagle who would attack anyone in the house who even plotted such a thing; a peacock who would go to the place where the dose had been prepared and raise a clamor, or upset the receptacle containing the potion, or dig up a charm, if it had been buried underground; and a pet ichneumon and parrot who were endowed with very similar gifts.[2354] Aëtius shows a slight tendency in the direction of astrological medicine, giving a list of “times ordained by God” for the risings and settings of various stars, since these affect the air and winds, and since “the bodies of persons in good health, and much more so those of the sick, are altered according to the state of the air.”[2355] But on the whole, of our three authors, Aëtius seems to contain the smallest proportional amount of superstitious medicine and occult science. [Sidenote: Alexander of Tralles.] Alexander of Tralles was the son of a physician and, according to the Byzantine historian, Agathias,[2356] the youngest of a group of five distinguished brothers, including Anthemius of Tralles, architect of St. Sophia at Constantinople, and Metrodorus the grammarian, whom Justinian summoned also to his court. Alexander had visited Italy, Gaul, and Spain as well as all parts of Greece[2357] before settling down in old age, when he could no longer engage in active medical practice,[2358] to the composition of his _magnum opus_ in twelve books beginning with the head, eyes, and ears, and ending with gout and fever. Aside from his citation of Aëtius in the book on fevers, the latest writer named by Alexander is Jacobus Psychrestus, physician to Leo the Great about 474.[2359] It seems rather strange that Alexander says nothing of the pestilence of 542.[2360] [Sidenote: Originality of his work.] Alexander embodied the results of his own practice to a much greater extent than Oribasius and Aëtius. His book is more a record of his own medical observations and experiences than a compilation from past writings, a fact recognized in the first edition which entitled it _Practica_, and “though he pays a due deference to the ancients, yet he is so far from putting an implicit faith in what they have advanced that he very often dissents from their doctrines.”[2361] Puschmann regarded him as the first doctor for a long time who had done any original thinking,[2362] and esteemed his pathology as highly as his therapeutics had been esteemed by his sixteenth century translator, Guinther of Andernach.[2363] Friend wrote of him in the early eighteenth century, “His method is extremely rational and just and after all our discoveries and improvements in physick scarce anything can be added to it.”[2364] Alexander seems to have been a practitioner of much resource and ingenuity, stopping hemorrhage of the nose by blowing down or fuzz up the nostrils through a hollow reed, and directing patients, a thousand years before the discovery of the Eustachian tube, to sneeze with mouth and nose stopped up in order to dislodge a foreign object from the ear.[2365] According to Milward, Alexander was the first Greek medical writer to mention rhubarb and tape-worms, and the first practitioner to open the jugular veins.[2366] Indeed, Alexander advises blood-letting a great deal, but Milward, whose age still approved of that practice, notes that he was “no ways addicted to those superstitious rules of opening this or that vein in particular cases which several of the ancients and some even among the moderns have been so very fond of.”[2367] Finally, Alexander’s concise and orderly method of presentation compares favorably with that of the classical medical writers. [Sidenote: His medieval influence.] Alexander’s book traveled west, as its author had done, and was current in a free and abbreviated Latin translation from an early date.[2368] In fact, it was from the Latin version that the work was translated into Hebrew and Syriac.[2369] Not only are Latin manuscripts of Alexander’s work as a whole or of extracts from it[2370] found from the ninth century on, while printed editions in Latin were numerous through the sixteenth century, but it was much used and cited by medieval writers such as Constantinus Africanus, Gariopontus,[2371] and Gilbert of England.[2372] It is not, however, always safe to assume that citations of _Alexander medicus_, encountered in thirteenth century writers on the nature of things like Thomas of Cantimpré and Bartholomew of England, have reference to Alexander of Tralles, since a treatise on fevers is also ascribed to Alexander of Aphrodisias,[2373] while a work on the pulse and urine in fevers is thought to be by some medieval Alexander.[2374] And medical treatises are sometimes ascribed even to Alexander the Great of Macedon in the medieval manuscripts.[2375] [Sidenote: His personal experience.] We have already said that Alexander is no mere compiler but embodies the results of his own observation and experience during a long period of travel and medical practice. He frequently asserts that he has tested this or that for himself, or that the prescription in question has been “approved by long use and experience,”[2376] so that it is not surprising that we find the name Alexander still associated with medical “experiments” in manuscripts dating from the twelfth to fifteenth centuries.[2377] One of his cures for epilepsy he learned “from a rustic in Tuscany” (_Thuscia?_) but afterwards often employed with success himself.[2378] “It is a marvelous and exceptional medicine which you will communicate to no one,” concludes Alexander, a rather surprising prohibition in view of the fact that it was a popular remedy to begin with. Folk-lore, however, is often supposed to be kept secret. Another general rule which holds true in Alexander’s case is that these empirical remedies are apt to be the most superstitious, and conversely that marvels are apt to be supported by solemn assurance of their experimental testing. [Sidenote: Extent of his superstition.] Two centuries ago Milward wrote of Alexander of Tralles, “But there is another objection to our author’s character which I cannot pretend to say much in defence of, and that is, his being addicted to charms and amulets. It is very surprising that one who discovers so much judgment in other matters should show so much weakness in this.”[2379] Alexander certainly devotes more space to superstition relatively to the length of his book than Aëtius does and also is hospitable to a wider range of more or less magical notions and practices. One notices, however, in his book that the treatment of certain diseases, such as epilepsy, colic, gout, and quartan fever, is more likely to involve magical and astrological procedure than that of other ailments such as earache and disorder of the spleen. This is also apt to be the case with other ancient and medieval medical works. But it is doubtful if the distinction can be sharply drawn that magic was resorted to more in those diseases which seemed most mysterious and incurable. [Sidenote: _Physica._] The chief circumstance which renders some parts of Alexander’s work more superstitious than others is that he sometimes, after concluding the usual medical description of the disease and prescriptions for it, adds a list of what he calls physical or natural medicines (φυσικά), which are for the most part ligatures and suspensions but involve also the employment of incantations and engraved images or characters. Apparently he calls these remedies _physica_, because they supposedly act by some peculiar property or occult virtue of the substance which is bound on or suspended and constitute a sort of natural magic. Alexander explains that “since some cannot observe a diet nor endure medicine, they compel us in the case of gout to employ physical remedies and ligatures; and in order that the well-trained physician may be instructed in every side of his art and able to help all sick persons in every way, I come to this subject.”[2380] This rather apologetic tone and the fact that he separates the _physica_ from his other remedies show that he regards them as not quite on the same level with normal medical procedure. He goes on to say, however, that although there are many of these “physical” remedies which are efficacious, he will write down only those proved true by long use. In discussing fevers he again justifies the inclusion of _physica_ in much the same way and says that those now mentioned were learned by him during a long-extended practice and experience.[2381] It is to be noted that some of these chapters on physical ligatures do not appear in the Latin version in three books, at least as it was printed in 1504. [Sidenote: Occult virtue of substances applied externally.] One ligature which is “quite celebrated and approved by many” and which instantly lessens the pain of ulcers in the feet, makes use of muscles from a wild ass, a wild boar, and a stork, binding the right muscles about the patient’s right foot and the left muscles about the left foot. Some persons, however, do not intertwine the muscles of the stork with the others but put them separately into the skin of a sea-calf. Also they take care to bind the other muscles about the patient’s feet when the moon is in the west or in a sterile sign and approaching Saturn. Others bind on the tendons and claws of a vulture, or the feet of a hare who should remain alive.[2382] Alexander seems to regard the carcass of the ass as especially remedial in the case of epilepsy. In Spain he learned to use the skull of an ass reduced to ashes and he recommends employing the forehead and brain of an ass as amulets.[2383] A suspension for quartan fever consists of a live beetle firmly fastened on the outside of a red linen cloth and hung about the neck. “This is true and often tested by experience,” Alexander assures us. Also excellent for this purpose are hairs from a goat’s cheek or a green lizard combined with clippings of the patient’s finger nails and toe nails. It is confirmed by the testimony of all “natural” physicians that the blood _qui primus a virgine fuerit excretus_ is naturally hostile to quartan fever. Even if the girl is not chaste, the blood will be efficacious, if applied to the patient’s right hand or arm.[2384] Alexander knew a man who treated quartan fever by giving an undergarment of the patient to a woman in childbirth to wear, after which the patient wore it again and was cured “miraculously by some antipathy and occult influence.”[2385] [Sidenote: Other things used as ligatures and in amulets.] The materials employed in Alexander’s therapeutics are sometimes those which we associate especially with magic arts, such as the hair and nail-parings already mentioned. Against epilepsy he employs nails from a cross or wrecked ship, or the blood-stained shirt of a gladiator or criminal who has been slain. The nails are bound to the patient’s arm; the shirt is burned and the patient given the ashes in wine seven times. The use of a nail from a cross is a method ascribed to Asclepiades. Other materials recommended by Alexander against gout and epilepsy include the herb night-shade, the stones magnet and aetites, blood of a swallow and urine of a boy, chameleons in varied forms, and the stones found in dissected swallows of which we have heard before and shall hear yet again. For Alexander these stones are black and white, but he states that they are not found in all young swallows but are said to appear only in the first-born, so that one often has to dissect a great many birds before one finds any. In these passages on _Physica_ Alexander cites such authors of magical reputation as Ostanes and Democritus, and tells how the latter suffered in youth from epilepsy until an oracle from Delphi instructed him to make use of the worms in goats’ brains. When a goat sneezes violently, some of these worms are expelled into his nostrils, whence they should be carefully extracted in a cloth without allowing them to touch the ground. Either one or three of them should then be worn about the epileptic’s neck wrapped in the thin skin of a black sheep.[2386] [Sidenote: Astrology and sculpture of rings.] One passage has already been cited where astrological conditions were observed. Alexander sometimes prescribes the day of the month upon which things shall be done; an oil, for instance, is to be prepared on the fifth of March.[2387] In one place Alexander advises engraving upon a copper die a lion, a half-moon, a star, and the name of the beast. This is to be worn enclosed in a gold ring upon the fourth finger.[2388] That the lion may not stand for a sign of the zodiac is suggested by another instruction concerning an engraved stone to be set in a gold ring, and which is to be carved with a figure of Hercules suffocating a lion.[2389] For gout, however, one writes a verse of Homer on a copper plate when the moon is in Libra or Leo.[2390] For colic one inscribes upon an iron ring with an octangular circumference a charm beginning, “Flee, flee, colic.”[2391] [Sidenote: Incantations.] The employment of such incantations is expressly justified by Alexander, who maintains that even “the most divine” Galen, who once thought that incantations were of no avail, came after a long time and much experience to be convinced that they were of great efficacy. Alexander then quotes from a treatise which is not extant but which he asserts is a work by Galen entitled, _On medical treatment in Homer_.[2392] “So some think that incantations are like old-wives’ tales and so I thought for a long while, but in process of time from perfectly plain instances I have become persuaded that there is force in them, for I have experienced their aid in the case of persons stung by scorpions. And no less in the case of bones stuck in the throat, which were straightway expelled by an incantation.” Alexander himself thereupon continues, “If such is the testimony of divinest Galen and many other ancients, what prevents us too from communicating to you those which we have learned from experience and which we have received from trustworthy friends?” [Sidenote: Conjuration of an herb.] Both incantations and observance of astrological conditions play an important part in the instructions given by Alexander for digging and plucking with imprecations an herb to be used in the treatment of fluxions of hands or feet. “When the moon is in Aquarius under Pisces, dig before sunset, not touching the root. After digging with two fingers of the left hand, namely, the thumb and middle finger, say, ‘I address you, I address you, sacred herb. I summon you to-morrow to the house of Philia to stay the fluxion of feet and hands of this man or this woman. But I adjure you by the great name, Iaoth, Sabaoth, God who established the earth and fixed the sea abounding in fluid floods, who desiccated Lot’s wife and made her a statue of salt, receive the spirit of thy mother earth and its powers, and dry up this fluxion of feet or of hands of this man or woman.’ On the morrow ere sunrise, taking the bone of some dead animal, dig up the root, and holding it say, ‘I adjure you by the sacred names, Iaoth, Sabaoth, Adonai, Eloi,’ and sprinkle a pinch of salt on that root, saying, ‘As this salt is not increased, so be not the ailment of this man or of this woman.’ Then bind one end of the root to the patient, taking care that it is not moist, and suspend the rest of it over the fire for 360 days.”[2393] The mention of mother earth in this charm perhaps indicates an ultimate pagan origin, but the allusions to one God, and to incidents in the Old Testament, and the use of names of spirits show Jewish or Christian influence, while the number 360 perhaps points to the Gnostics. [Sidenote: Medieval version seems less superstitious than the original text.] While in conformity with the character of our investigation we have emphasized those passages in Alexander which are suggestive of magic and its methods, it should be said that many of the passages which we have cited are apparently[2394] not found in the medieval Latin versions which seem to omit many, although not all, of the chapters devoted to physical ligatures. Here then apparently is a case where the early medieval translator and adapter, instead of retaining and emphasizing the superstition of the past, has largely purged his text of it. But we have next to consider a Latin work, written apparently about the year 400 A. D. and known to us through two manuscripts of the ninth century, in which magic is far more rampant than in any version of Alexander of Tralles. Judging, however, from the small number of extant manuscripts, it was less influential through the medieval period than was Alexander’s book. [Sidenote: Marcellus: date and identity.] The _De medicamentis_ opens in one of the two extant manuscripts with a dedicatory letter from “Marcellus, an illustrious man of the main office of Theodosius the Elder (?)” to his sons.[2395] This ascription is generally accepted as genuine, and Grimm believed this to be the same Marcellus as the physician who is gratefully mentioned, together with his sons, then mere infants, in the letters of Libanius, whose severe headaches Marcellus had alleviated, and as the _Marcellus magister officiorum_ who is mentioned twice in the Theodosian Code under the year 395. The date of the _De medicamentis_ may be further fixed from its including “a singular remedy for spleen which the patriarch Gamaliel recently revealed from proved experiments.” This Gamaliel was Jewish patriarch at Constantinople from some time before 395 on to 415 or later. The question, however, of Marcellus’ authorship is complicated by the fact that he is twice cited in the work itself. One of these passages concerns an “oxyporium which Nero used for the digestion, which Marcellus the eminent physician revealed, which we too have tested in practice.”[2396] This sounds as if some later person had had a hand in the work as it has reached us, since Marcellus himself would scarcely have cited another person of the same name without some distinguishing epithet. Furthermore Aëtius cites a Marcellus for a passage which does not appear in the _De medicamentis_ concerning wolfish or canine insanity, in which men imagine themselves to be wolves or dogs and act like them during the night in the month of February. But the _De medicamentis_ as a whole is of the character promised by Marcellus in the introductory letter to his sons and so may be taken as his work. [Sidenote: “Marcellus Empiricus.”] The empiricism which we have already noted in Alexander of Tralles becomes most pronounced and most extreme in Marcellus, who indeed is often called Marcellus Empiricus on this account, and many of whose chapter and other headings[2397] terminate with these words descriptive of their contents, “various rational and natural remedies learned by experience” (_remedia rationabilia et physica diversa de experimentis_). In his preface, too, he speaks of his book not as _De medicamentis_ but as _De empiricis_. He has, it is true, utilized “the old authorities of the medical art set down in the Latin language,” and likewise more recent writers and “the works of studious men” who were not especially trained in medicine; but he also includes what he has learned from hearsay or from personal experience, and “even remedies chanced upon by rustics and the populace and simples which they have tested by experience.” One prescription, which he characterizes as efficacious beyond human hope and incapable of being satisfactorily lauded, he purchased from an old-wife of Africa who cured many at Rome by it, while the author himself has employed it in the cure of “several persons neither of humble rank nor unknown, whose names it is superfluous to mention.” This remedy is a concoction of such things as ashes of deer-horn, nine grains of white pepper, a little myrrh, and an African snail pounded shell and all while still alive in a mortar and then mixed with Falernian wine. Very detailed and explicit directions are given as to its preparation and administration, including an instruction to drink the dose facing towards the east.[2398] In another passage Marcellus says of certain compounds, “If there is any faith, both I myself have always found them by experience to be useful remedies and I can state that others are of the same mind; and I will add this, that other medicines can not compare to this liniment, which in similar cases several of my friends, whom I trust as I do myself, have affirmed on oath they have found by experience a remarkable cure.”[2399] Of an eye-remedy he remarks, “And that we may believe the author of this remedy from experience, he states that after he had been blind for twelve years it restored his sight within twenty days.”[2400] Marcellus also frequently couples marvelousness with experimentation, saying, “You will experience a wonderful remedy.” In one passage he uses the word “experiment” as a verb rather than as a noun, coining a new expression, _experimentatum remedium_,[2401] but his commonest expressions are _de experimento_ or _de experimentis_, _expertum_, and _experieris_ or _experietur_.[2402] Some of his “experiences” really are purposive experiments, as where one discovers whether a tumor is scrofulous by applying an earthworm to it. Then put the worm on a leaf and if the tumor was scrofulous, the worm will turn into earth.[2403] The following experiment indicates that sufferers from spleen should drink in vinegar the root or dried leaves of the tamarisk. Give tamarisk to a pig to eat for nine days, then kill the animal and you will find it without a spleen.[2404] [Sidenote: Superstitious character of his medicine.] As Marcellus appeals the most to experience, so he is by far the most given to superstition and folk-lore of our three authors. Practically his entire work is of the character of the passages devoted to _Physica_ by Alexander of Tralles. He indulges in no medical theory, he does not diagnose diseases, nor prescribe a regimen of health in the form of bathing, diet, and exercise. His work is wholly composed of medicaments and for the most part empirical ones. Besides the elaborate compounds which were so frequent in Aëtius and Alexander, he is extremely addicted to absurd rigmarole and all sorts of superstitious practices in the application or administration of medicinal simples. His pharmacy includes not only herbs and gems, to which he attributes occult virtue and which he sometimes directs to have engraven with characters and figures, such as SSS or a dragon surrounded with seven rays[2405]—the emblem of the Agathodaemon, but also all kinds of animals, reptiles, and parts of the same, after the fashion of Pliny’s medicine. He is constantly calling into requisition such things as the ashes of a mole, the blood of a bat, the brains of a mouse, the gall of a hyena, the hoofs of a live ass, the liver of a wolf, woman’s milk, sea-hares, a white spider with very long legs, and centipedes or multipedes, especially the variety that rolls up into a ball when touched. But it is scarcely feasible to separate Marcellus’ materials from his procedure, so we will begin to consider them together in some prescriptions where animals play the leading part. [Sidenote: Preparation of goat’s blood.] For those suffering from stone is recommended a remedy prepared in the following fashion. In August shut up in a dry place for three days a goat, preferably a wild one who is one year old, and feed him on nothing but laurel and give him no water to drink; finally on the third day, which should fall on a Thursday or Sunday, kill him. Both the person who kills the goat and the patient should be chaste and pure. Cut the goat’s throat and collect his blood—it is best if the blood is collected by naked boys—and burn it to an ash in an earthen pot. After combining it with various herbs and drugs, there are further directions to follow as to how it may best be administered to the patient. Marcellus, by the way, affirms that adamant can be broken only by goat’s blood.[2406] [Sidenote: A rabbit’s foot.] The following prescription involves the familiar superstition that a rabbit’s foot is lucky: “Cut off the foot of a live rabbit and take hairs from under its belly and let it go. Of those hairs or wool make a strong thread and with it bind the rabbit’s foot to the body of the patient and you will find a marvelous remedy. But the remedy will be even more efficacious, so that it is hardly credible, if by chance you find that bone, namely, the rabbit’s ankle-bone, in the dung of a wolf, which you should guard so that it neither touches the earth nor is touched by woman. Nor should any woman touch that thread made of the rabbit’s wool.” Marcellus further recommends that in releasing the rabbit after taking its wool you should say, “Flee, flee, little rabbit, and take the pain away with you.”[2407] [Sidenote: Magic transfer of disease.] Of such magical transfer of disease to other animals or objects there are a number of examples. Toothache may be stopped by standing on the ground under the open sky and spitting in a frog’s mouth and asking it to take the toothache away with it and then releasing it.[2408] Even consumptives who seem certain to die and who labor continually with an unbearable cough, may be cured by giving them to drink for three days the saliva or foam of a horse. “You will indeed cure the patient without delay, but the horse will die suddenly.”[2409] Splenetic persons are benefited by imposing any one of three kinds of fish upon the spleen and then replacing the fish alive in the sea.[2410] Warts may be got rid of by rubbing them with something the moment you see a star falling in the sky; but if you rub them with your bare hand, you will simply transfer them to it.[2411] Another superstition connected with falling stars which Marcellus records is that one will be free from sore eyes for as many years as he can count numbers while a star is falling.[2412] The first time you hear or see a swallow, hasten silently to a spring or well and anoint your eyes with the water and pray God that you may not have sore eyes that year, and the swallows will bear away all pain from your eyes.[2413] With slight variations the same procedure may be employed to prevent toothache. In this case you fill your mouth with water, rub your teeth with the middle fingers of both hands, and say, “Swallow, I say to you, as this will not again be in my beak, so may my teeth not ache all year long.”[2414] Marcellus advises anyone whose nose is stuffed up to blow it on a piece of parchment, and, folding this up like a letter, cast it into the public way,[2415]—which would very likely spread the germs, if not take away the cold. [Sidenote: Pliny and Marcellus compared on green lizards as eye cures.] In his preface Marcellus refers to Pliny as one of his authorities and many of his quaint animal remedies will be found substantially duplicated in the _Natural History_. Both, for example, state that one can stop one’s nose from running by kissing a mule.[2416] Marcellus, however, adds much from other sources or of his own. This may be illustrated by comparing their accounts of the use of lizards to cure eye diseases.[2417] Marcellus omits the following portion of Pliny’s account: “Some shut up a green lizard in a new earthen pot, and they mark the little stones called _cinaedia_, which are bound on for tumors of the groin, with nine signs and take out one daily. On the ninth day they let the lizard go, and keep the pebbles for pains of the eyes.” Pliny next proceeds: “Others put earth under a green lizard that has been blinded and shut it up in a glass vase with rings of solid iron or gold. When through the glass the lizard is seen to have recovered its sight, it is released and the rings are used for sore eyes.” This recipe is in Marcellus who, however, words it differently and adds that the lizard must be blinded with a copper needle, that the rings may be of silver, electrum, or copper, that the vase must be carefully sealed and opened on the fifth or seventh day following, and that one should not only wear the rings afterwards on one’s fingers but also frequently apply them to one’s eyes and strengthen the sight by looking through them. He further cautions to leave the vase in a clean grassy spot, to collect the rings only after the lizard has departed, to catch the lizard in the first place on a Thursday in September between the nineteenth and twenty-fifth day of the moon, and to have the operation performed by a very pure and chaste man. Marcellus also states that an amulet made either of the eyes of the said lizard enclosed in a lead bull or gold coin, or of its blood caught on clean wool and wrapped in purple cloth will effectually prevent eye diseases. Meanwhile Pliny for his part has gone on to tell how efficacious the ashes of green lizards are. [Sidenote: More lizardry.] Marcellus employs green lizards in other connections which are not paralleled in Pliny. To stay colic one binds about the patient three times with an incantation a string with which a copper needle has been threaded and drawn through a lizard’s eyes, after which the reptile is released at the same point where it was captured.[2418] In another passage Marcellus recommends the drawing by a silver needle of threads of nine different colors other than black or white through the eyes of a new-born puppy before they open and _ita ut per anum eius exeant_, after which the puppy is to be thrown into the river.[2419] But to return to our lizards. For those suffering from liver complaint the liver of a lizard is to be extracted with the point of a reed and bound in purple or black cloth to the patient’s right side or suspended from his arm, while the lizard is to be dismissed alive with these words, “Lo, I send you away alive; see to it that no one whom I touch henceforth has liver complaint.”[2420] To insure a wife’s fidelity one touches her with the tip of a lizard’s tail which has been cut off by the left hand.[2421] Here again the lizard is released but apparently is not expected to survive for long, since one is instructed to “hold the tail shut in the palm of the same hand until it dies.” In a fourth example the lizard is neither mutilated nor released but hung in the doorway of a splenetic’s bedroom where it will touch his head and left hand as he comes and goes.[2422] [Sidenote: Use of stones and an herb.] One or two other prescriptions may be added where the procedure is connected with herbs or stones rather than with animals. On entering a city one is advised to pick up some of the pebbles lying in the road before the city gate, stating that they are being collected for headache. Then bind one of them on the head and throw the others behind your back without looking around.[2423] A certain herb must be gathered on Thursday in a waning moon. When it is administered in drink, the recipient must take it standing and facing the east. He receives the cup from the right hand and then, in order not to look back, returns it to the left to him who gave it. Only these two persons should touch the drink.[2424] [Sidenote: Right and left number.] Right and left, as just illustrated, are much observed in Marcellus’ medicine. When a tooth aches on the left side of the mouth, a hot cooked dried bean is applied to the right elbow for three days, a process which is reversed if the tooth is on the right side.[2425] The following exercise recommended for a stiff neck would seem to stand more chance of success than most of Marcellus’ prescriptions. While fasting the patient should spit on his right hand and rub his right thigh, and then do the same with his left hand and thigh. Thrice repeated this is warranted to work an immediate cure.[2426] A ring worn on the middle finger of the left hand is said to stop hiccough.[2427] The power of the planets or of mere number is indicated in the advice, given several times, to make seven knots in a string.[2428] Once instructions are given to make as many knots as there are letters in the patient’s name.[2429] [Sidenote: Incantations and characters.] Incantations and characters, as has already been incidentally illustrated, abound in Marcellus’ pages. Some are in Greek, some in Latin, some perhaps in Celtic; many, as we have seen, are coherent statements, commands, or requests; many others are to all appearance a jargon of meaningless words, like the jingle, _Argidam, margidam, sturgidam_,[2430] which is to be repeated seven times on Tuesday and Thursday in a waning moon to cure toothache. Marcellus well calls one of these _carmen idioticum_.[2431] For stomach and intestinal troubles he recommends pressing the abdomen with the left thumb and saying, “Adam, bedam, alam, betur, alem, botum.” This is to be repeated nine times, then one touches the earth with the same thumb and spits, then says the charm nine more times, and again for a third series of nine, touching the ground and spitting nine times also. _Alabanda, alabandi, alambo_ is another incantation, variously repeated thrice with hands clasped above and below the abdomen. Yet another consists in rubbing the abdomen with the left thumb and two little fingers and saying, “A tree stood in the middle of the sea and there hung an urn full of human intestines; three virgins went around it, two make it fast, one revolves it.” As you repeat this thrice, you touch the ground thrice and spit, but if the charm is for veterinary purposes, for the words “human intestines” should be substituted “the intestines of mules” or horses or asses as the case may be.[2432] The following is a specimen of the characters prescribed by Marcellus:[2433] ΛΨΜΘΚΙΑ ΛΨΜΘΚΙΑ ΛΨΜΘΚΙΑ [Sidenote: The art of medicine survives the barbarian invasions.] It is perhaps worth while to point out in concluding this chapter that apparently at no time during the period of barbarian invasions and early medieval centuries did medical practice or literature cease entirely in the west. We have seen that there is reason to suspect that portions of the work ascribed to Marcellus may be contributions of the centuries following him, and that there were early medieval Latin translations of the works of Oribasius and Alexander of Tralles. Furthermore, the laws of the German kingdoms, the allusions of contemporary chroniclers and men of letters, the advice of Gregory the Great to a sick archbishop to seek medical assistance, and many other bits of evidence[2434] show that physicians were fairly numerous and in good repute, and that medieval Christians at no time depended entirely upon the healing virtues of relics of the saints or other miraculous powers credited to the church or divine answer to prayer.