DISQUISITION ON THE AUTHENTICITY OF THE DIFFERENT TREATISES
WHICH HAVE BEEN ATTRIBUTED TO HIPPOCRATES.
There can scarcely be a doubt that Hippocrates followed the practice
which we know to have been adopted by almost all the great writers of
antiquity with regard to the publication of their works, namely, that
of publishing them separately, at the time they were composed. We know,
for example (to begin with a distinguished author, regarding whom our
information is particularly ample), that Horace published his books of
satires, epistles, odes, and epodes separately, and at different times;
and that the collection of them in its present form was not compiled
until after his death.[65] We have every reason for concluding that
the same rule was followed by Martial,[66] Cicero,[67] and other Roman
authors. It is further well ascertained (to come to a period not far
removed from the age of Hippocrates) that Plato[68] and Aristotle[69]
likewise gave their works to the literary world upon the same plan. We
have every reason, therefore, to suppose that Hippocrates published
several of his works separately, in his life time; and indeed Galen
often expresses himself so as to leave little or no ground for doubt
on this point.[70] It would be most interesting and important then to
know, were this possible, in what order the different works of our
author were published. But unfortunately this is a question which we
have no proper data for solving satisfactorily, only as the “Aphorisms”
are evidently made up in a great measure of conclusions drawn from the
results of discussions and observations recorded in other of his works,
we have every reason to infer that this important work was among that
latest of his literary labors.[71] But although we may not be able to
determine the order in which the different pieces were composed and
published, we need have no hesitation in deciding with all the best
authorities, ancient and modern, that all the following treatises
were composed by him, and, from the first, obtained the sanction of
his name, viz.: the “Prognostics;” the “First and Third Epidemics;”
“On Regimen in Acute Diseases;” “On Airs, Waters, and Places;” “On
Wounds of the Head;” the “Aphorisms.” It is in so far satisfactory,
then, to know, that respecting the authorship of these works there has
never been any reasonable question, and that whoever entertains doubts
on this point of literary history, ought, on the same principles of
criticism, to dispute the authenticity of the “Protagoras” and “Phædo”
of Plato; of the “History of Animals” and “Politics” of Aristotle; and
of the “Olynthiacs” and “Philippics” of Demosthenes. In a word, nothing
but the most lawless spirit of scepticism can lead any one to challenge
the genuineness of the works which I have just now enumerated. These,
however, it will be seen, constitute but a very small portion of the
treatises contained in the Hippocratic Collection; and with regard
to a very great number of the others, it is unfortunately not only
impossible to bring any competent evidence of their genuineness, but it
is also quite apparent that they betray marks of an entirely different
authorship; and this is abundantly obvious, whether we look to the
matters which they contain, or the manner in which these are given.
Thus in some of the treatises we discover hypothetical doctrine and
rules of practice utterly at variance with those which are contained in
the works of acknowledged authenticity; and in some of them, instead
of that nervous conciseness which, as we have already stated, has
always been held to be characteristic of the style of Hippocrates, we
find an insipid verbosity and vagueness of expression, which clearly
stamp them as being productions of a very different hand. But, besides
this internal evidence which we have to assist us in forming a correct
judgment on these works, we fortunately still possess a considerable
number of ancient Commentaries, written expressly in illustration of
them, from which, in many instances, modern critics have been enabled
to draw very satisfactory data for forming a correct judgment on
the points at issue. Before proceeding further, it is but fair to
acknowledge that I have freely availed myself of the labors of Vander
Linden, Ackerman, Gruner, Littré, and other learned men, who have
preceded me in this field of investigation, but at the same time I may
venture to assure the reader that there is scarcely a passage in any of
the ancient authorities, bearing on the points in discussion, which I
have not examined carefully for myself.
The oldest commentator of whom we have any mention, is the
celebrated Herophilus, who flourished about the year 300 A.C.[72] But
of his Commentaries we have no remains, nor of those of the other
commentators down to Apollonius Citiensis, a writer of the first
century A.C. His Scholia on the Hippocratic treatise, “De Articulis,”
along with those of Palladius, Stephanus, Theophilus, Meletius, and
Joannes Alexandrinus, all writers of an uncertain date, but certainly
much later than the Christian era, were published by the late Dr.
Dietz, at Konigsburg, in 1834. To these we have to add two others, of
much higher celebrity, namely, Erotian, who lived during the reign
of Nero, and the famous Galen, who, it is well known, flourished in
the latter part of the second century, P.C. It is from the works of
these two writers that the most important facts are to be elicited,
for forming a correct judgment respecting the authenticity of the
Hippocratic treatises. As we shall have occasion to quote their
opinions on the different heads of our inquiry, it would be useless to
occupy room by giving their entire list in this place. Suffice it to
say, that Erotian rarely assigns any reason for admitting the treatises
into his list of genuine works, and that Galen generally rests his
judgment, when he assigns any grounds for it, upon the evidence of
preceding authorities, and upon what he holds to be the characteristics
of the doctrines and style of Hippocrates. These, assuredly, are most
sound and legitimate principles of criticism; but it has been often
supposed, that in applying them the great commentator is at times very
dogmatic, and not always consistent with himself. But, upon the whole,
all must allow that Galen is our best guide on the subject of our
present inquiry. And, moreover, it is from his works especially that we
are enabled to glean whatever information we possess with regard to the
opinions of the earlier commentators, from Herophilus down to his own
times.
I will now proceed to give a brief sketch of the labors of modern
critics in this department.
The earliest modern authority is Lemos, whose work was published in
the end of the sixteenth century. It appears that he follows almost
entirely the opinions of Galen, and seldom or never ventures to
exercise an independent judgment of his own.
The work of Mercuriali is a much more elaborate and important
performance, and his principles of judgment appear to me most
unexceptionable, being founded entirely upon ancient authority and
peculiarity of style; only it may, perhaps, be objected, that he rather
exaggerates the importance of the latter at the expense of the former;
for it must be admitted that very contradictory conclusions have
sometimes been founded on imaginary peculiarities of style. I cannot
agree with M. Littré, however, that the whole system of Mercuriali is
founded on a _petitio principii_; as if, before describing the
style of his author, he ought to have decided which were his genuine
writings.[73] For, as already stated, any one is perfectly warranted in
assuming that certain of the works which bear the name of Hippocrates
are genuine, and from them, and the general voice of antiquity,
Mercuriali was further justified in deciding what are the peculiarities
of the style of Hippocrates, and in applying them as a test of the
genuineness of other works which had been attributed to the same
author. Mercuriali divides the Hippocratic treatises into four classes,
as follows: The first comprehends those which bear the characters of
his doctrine and style. The second comprises those which are composed
of notes taken from memory, and published by Thessalus, Polybus, or
other of his disciples, and contain foreign matter interpolated with
them. The third class consists of those which have not been composed by
Hippocrates, but are the work of his sons or disciples, and represent
his doctrines with greater or less exactness. The fourth includes those
tracts which have nothing to do with the school of Hippocrates. As
the views and principles of Mercuriali accord, in the main, very well
with my own, I think it proper to set down his classification of the
treatises.
CLASSIS I.
1. De Natura Humana.
2. De Aëribus, Aquis, et Locis.
3. Aphorismi.
4. Prognostica.
5. De Morbis popularibus.
6. De Morbis acutis.
4. De Vulneribus Capitis.
8. De Fracturis.
9. De Articulis.
10. De Officina Medici.
11. Mochlicus.
12. De Alimento.
13. De Humoribus.
14. De Ulceribus.
CLASSIS II.
1. De Locis in Homine.
2. De Flatibus.
3. De Septimestri Partu.
4. De Octimestri Partu.
5. De Ossibus.
CLASSIS III.
1. De Carnibus seu Principiis.
2. De Genitura.
3. De Natura Pueri.
4. De Affectionibus.
5. De Affectionibus internis.
6. De Morbis.
7. De Natura Muliebri.
8. De Morbis Muliebribus.
9. De Sterilibus.
10. De Fœtatione et Superfœtatione.
11. De Virginium Morbis.
12. De Sacro Morbo.
13. De Hemorrhoidibus.
14. De Fistulis.
15. De Salubri Diæta.
16. De Diæta, tres Libri.
17. De Usu Liquidorum.
18. De Judicationibus.
19. De Diebus Judicatoriis.
20. Prædictionum Libri.
21. Coacæ Prænotiones.
22. De Insomniis.
CLASSIS IV.
1. Jusjurandum.
2. Præceptiones.
3. De Lege.
4. De Arte.
5. De Arte Veteri.
6. De Medico.
7. De Decenti Ornatu.
8. De Exsectione Fœtus.
9. De Resectione Corporum.
10. De Corde.
11. De Glandulis.
12. De Dentitione.
13. De Visu.
14. Epistolæ.
15. De Medicamentis purgantibus } Latinè tantum.[74]
16. De Hominis Structura }
Perhaps we may venture to affirm, without much risk of challenge, that
the works of no ancient author owe more to the exertions of a single
individual than those of Hippocrates due to the labors of Foës. Of his
excellencies as an editor, and expositor of the meaning of his author,
I will have occasion to speak afterwards; and here I shall merely state
regarding him, that as a critic called upon to decide with regard to
the authenticity and spuriousness of the different works, his merits
are by no means proportionally high. He rarely or never ventures to
differ from Galen, and everywhere evinces so easy a disposition to
recognize the works in question as being the productions of his beloved
author, that his opinion on any point connected with their authenticity
is not deserving of much weight.
Haller arranges the Hippocratic treatises in the following classes:
The first contains those which in all ages have been admitted as being
genuine.[75] The second embraces those which contain doctrines at
variance with those “of the divine old man,” or inventions of a later
date, or vices which Hippocrates disclaims. The third embraces those
which are manifestly spurious, as is obvious from their being mere
compendia of the works of Hippocrates, or which betray a manner totally
at variance with his. The fourth embraces a certain number of pieces
not contained in the preceding classes. Such is Haller’s arrangement,
which, however, is not entitled to much consideration; for the
illustrious author himself seems to admit, candidly, that his critical
knowledge of the language was too slender to warrant him in trusting
his own judgment when it came into collision with any high authority,
such as Foës; and, moreover, it would appear, that his edition of the
works of Hippocrates had been got up in a very slovenly manner, by some
incompetent person, after his death.
Gruner is one the most learned and original of our authorities on the
literature of the Hippocratic works.[76] His decision, with regard to
the authenticity of the different pieces, is made to rest mainly on
internal evidence, that is to say, upon their possessing the proper
characteristics of the language and style of Hippocrates. These he
is at great pains in showing to be, in the first place, brevity,
approaching to the laconic, which he justly holds with Galen[77] to
be one of the most striking peculiarities of the ancient style of
writing. To conciseness and simplicity, he adds gravity of manner,
and an absence of all subtlety of reasoning. This last trait in the
literary character of Hippocrates I hold to be particularly apparent in
the works which are generally admitted to be genuine. Some stress is
also laid by him on the use of the Ionic dialect, but this is a most
fallacious criterion, and had better have been left out of the question
altogether; as there is good reason to believe that great liberties
were used with the language of Hippocrates by the ancient editors and
commentators, more especially by Artemidorus Capito, who lived a short
time before Galen.[78] And besides, as every person who is generally
acquainted with Greek literature knows, although the Ionic dialect in
the age of Hippocrates had been fused into the Attic,[79] for several
centuries afterwards it continued to be arbitrarily used by many
writers, both of prose and verse, owing to the high character which it
possessed, as being the dialect of the Homeric poems. Hence it is used
in later times, not only by the poets such as Quintus Smyrnæus, Nonnus,
and Oppian, but also by at least one great medical author, I mean
Aretæus. It would appear, however, that Gruner himself was sensible
that much stress ought not to be laid on peculiarity of dialect; for,
in resuming his conclusions as to the proper tests of genuineness
in judging of the Hippocratic writings, he determines them to be
conciseness and gravity of language, paucity of reasoning, and accuracy
of observation, along with the authority of the ancient critics, that
is to say, of the commentators. Now, it certainly must be admitted
that, taken together, these principles are most just and reasonable;
only it is apparent, that, like Mercuriali, he has ranked last what he
ought to have laid most stress upon, namely, ancient authority. For,
as remarked above, unless ancient authority had previously determined
certain works in the Collection to be genuine, the modern critic would
have had no premises from which he could have drawn conclusions as to
the characteristics of our author’s style. Starting, then, from the
principles now stated, Gruner arranges the works of Hippocrates in two
divisions, namely, the genuine and the supposititous. We shall only
give the former list, which embraces the following ten treatises:
1. Jusjurandum.
2. Aphorismi.
3. De Aëre, Aquis, et Locis.
4. Prænotiones.
5. Prædictionum, ii.
6. De Officina Medici.
7. Popularium Morborum, i., iii.
8. De Victu Acutorum.
9. De Vulneribus Capitis.
10. De Fracturis.
It will be shown below that in this list he has admitted one work
(Prædict. ii.), which certainly has not sufficient claims to the place
which he has assigned it; and, on the other hand, he has acted most
inconsistently in rejecting the work “De Articulis,” while he admitted
“De Fracturis,” for, as we shall see, there is the strongest reason for
believing that the two originally constituted one work. But the truth
of the matter is, that Gruner having hastily adopted the notion that
Hippocrates was altogether ignorant of human anatomy, the celebrated
passage in this treatise which so strikingly alludes to the dissection
of the human body[80] would decide him to reject it from his list of
genuine works.
Though Le Clerc, in his “History of Medicine” (b. iii.), shows himself
to be well acquainted with the fact that many of the treatises ascribed
to Hippocrates are supposititious, he nowhere lays down any rules for
distinguishing the genuine from the spurious, only he insists strongly
on conciseness as being one of the most striking characteristics of the
style of Hippocrates, and shrewdly remarks that the treatises which
abound most in reasoning are those which are most suspected of being
spurious.
Schulze also, in his “History of Medicine,” with much learning
and excellent judgment, enters cursorily upon the examination of
the question regarding the genuineness of the works ascribed to
Hippocrates, but he scarcely ever deviates from the rules laid down
by Mercuriali and Le Clerc. Indeed, he almost always agrees with the
latter. We shall have occasion to refer pretty frequently to his
opinions when we come to give our own judgment on the authenticity of
the particular treatises contained in the Hippocratic Collection.
Ackerman,[81] in the first place, gives an elaborate and very lucid
exposition of the labors of all preceding critics in the same line,
and then proceeds to deliver his own opinions _seriatim_ on the
different treatises. He rests his judgment generally on the authority
of the ancients, and more especially of Erotian and Galen; and in so
doing, M. Littré thinks he acted so judiciously, that he does not
hesitate to pronounce Ackerman to be the safest guide which we can
follow. Like Gruner, he divides the works into two classes, the genuine
and the spurious. The former list is as follows:--
1. Epidemica, i., iii.
2. Prænotiones.
3. Prædictorum, ii.
4. Aphorismi.
5. De Victu Acutorum.
6. De Aëre, Aquis, Locis.
7. De Vulneribus Capitis.
This, it will be remarked, is the smallest list which we have yet
encountered, and one cannot but feel saddened to find the remains of
the great Hippocrates thus reduced to so small a compass. We shall
have occasion, however, by and by, to show that Ackerman has been
too unsparing in applying the obelisk[82] to treatises of suspected
authenticity.
Grimm, the German translator of Hippocrates, professes also, like
Ackerman, to be guided principally by ancient authority, such as that
of Galen and Erotian, but he only reposes full confidence in it when
confirmed by internal evidence. The style, he says, should be simple,
brief, and expressive, and the language in accordance with the epoch.
He adds, no hypothesis, no subtlety, however ancient, no extraordinary
remedies or modes of treatment, should be found in these books.
Starting from these principles, which, it will be remarked, are rather
fancifully laid down, Grimm reduces the number of genuine works to the
following very meagre list:
1. Popularium Morborum, i., iii.
2. Prognostica.
3. Aphorismi.
4. De Victu Acutorum, p. i.
5. De Aëre, Aquis, Locis.
The reader will not fail to remark, in this result of Grimm’s inquiry,
indications of that bold spirit of scepticism for which the learned
criticism of Germany has been distinguished of late--the spirit of her
Wolfs and Lachmans, of her Asts and Schliermachers, which has deprived
the Iliad and Odyssey of their ancient authorship, and reduced the
bulky tomes of Plato to a very small volume. It is impossible not to
admire the learning, the ingenuity, and the love of truth which these
critics display, but surely the sober judgment of other scholars,
not infected with the same spirit of innovation, will pause before
acquiescing in the justness of a verdict which would deprive so many
immortal performances of the _prestige_ with which they have so
long been regarded. For my own part, I would venture to say, _pace
tantorum virorum_, that these learned critics are deficient in a
practical acquaintance with the laws of evidence, and do not properly
take into account that, in matters of common life, negative evidence is
never allowed to bear down positive, unless the former be remarkably
strong, and the latter particularly weak. When, then, the voice of
antiquity pronounces strongly and consistently in favor of any work, no
negative evidence, unless of a very remarkable character, ought to be
allowed to counterbalance the positive. In short, what I object to in
Grimm is, that he gives an undue preponderance to the internal evidence
over the external, that is to say, over the traditionary evidence of
antiquity, and that in this respect he goes to greater lengths than
even Gruner and Ackerman.
Kurt Sprengel is the author of a separate work on the Hippocratic
writings[83] which I have not seen, but I have reason to believe that
the substance of it is contained in his “History of Medicine,” where
(t. i., p. 295) he enters into a very elaborate disquisition on the
authenticity of the works ascribed to Hippocrates. He insists much, as
a test of authenticity, upon the style, which, in imitation of Galen,
he describes as being concise and laconic to a degree which sometimes
renders it obscure. Hippocrates, he adds, avoids all superfluous
discussion and unseasonable repetitions, and expresses himself as
briefly as possible, without adding conditions or restrictions. He
justly remarks, that what Celsus says of Hippocrates, namely, that he
separated philosophy from medicine, must be received with considerable
limitations, and not in too strict a sense, as if there were no
philosophical tenets in his works. On the other hand, Sprengel uses
these philosophical doctrines as a guide for determining the date of
the different treatises. This is a new, and no doubt a very important,
element in the criticism of these works; but it is one very liable to
be abused, as our information on many occasions, with regard to the
introduction of new doctrines in philosophy, is by no means such as
can be safely trusted to. Sprengel’s opinion on the various works in
question we shall have occasion to state when we come to revise them
separately.
We now proceed to the examination of the labors of two very learned
and ingenious critics, Link and Petersen, who, treading in the
footsteps of Sprengel, have expended much research in endeavoring to
solve the question regarding the date of the Hippocratic treatises, by
considering the philosophical and pathological theories which prevail
in them. I think it right to state that I have not had an opportunity
of consulting the work of Link, and therefore have been obliged to
judge of his opinions, in a great measure, from Petersen’s essay, which
is professedly based on the principles of Link. Of Peterson’s little
tract, I have no hesitation in declaring that I have seldom seen a work
of the kind which displays more critical acumen and deep research; and
although I cannot bring myself to subscribe to many of his general
conclusions, I feel bound in gratitude to acknowledge the benefits
which I have derived from many of his special investigations.[84] On
one important point, which he is at great pains to make out, I have
already stated that I am disposed to agree with him, namely, respecting
the date of our author’s birth, which I certainly think he has proved
by the most unexceptionable authorities to have been considerably
earlier than as generally stated. Petersen divides the Hippocratic
works into nine classes, in the following chronological order:--The
first contains those treatises in which the flow of bile and phlegm
is considered to be the cause of disease;[85] the second recognizes
fire,[86] and the third, air, as the principle of things;[87] in the
fourth, bile and phlegm are spoken of as the primary humors of the
human body;[88] in the fifth, spirit (πνεῦμα) and humidity are held to
be the first principles of generation;[89] in the sixth, the elements
of the body are held to be contrary to one another;[90] in the seventh,
yellow and black bile, phlegm, and blood are set down as being the
primary humors of the human body:[91] in the eighth bile, water,
phlegm, and blood are held to be the primary humors;[92] and in the
ninth, fire and water are held to be the principles of things.[93]
Now, assuredly, no reasonable person will deny to the author of this
distribution the praise of great boldness and originality of thought.
We may well apply to him the words of the poet, that if he has failed
in attaining his object, “magnis tamen excidit ausis.” For my own
part, I cannot but regret to see so much talent and research expended
upon conjectural points of criticism, which, from their nature, can
never be determined with any degree of certainty; for, after all his
labors, few scholars, I venture to predict, will prefer being guided
by his hypothetical reasoning, however ingenious, rather than by the
authority of the ancient commentators. I must also use the liberty to
remark, that M. Petersen appears to me to have no well defined ideas
regarding the doctrines which the ancient philosophers held respecting
the elements of things. For example, when he states, as the basis of
the theory which prevails in the tract “On Ancient Medicine,” that the
elements are the contraries to one another, he evidently confounds the
elements, namely, fire, air, earth, and water, with the powers, or, as
we should now call them, the qualities, hot, cold, moist, and dry. (See
the next Section.) And although, in the treatises “On the Seventh Month
Fœtus,” and “On the Eighth Month Fœtus,” much and deserved importance
is attached to heat as the prime mover of conception, and although, in
the treatise “On Airs,” the importance of air as a cause of disease
be strongly insisted upon, one is not warranted, as he contends, in
concluding that the authors of these treatises recognize respectively
fire and air as the first principle of all things. M. Littré, also, in
his candid reviews of M. Petersen’s work, points out some very striking
oversights which M. Petersen has committed in his arrangement of the
different treatises.[94]
I now come to M. Littré, who, in the Introduction to his edition of
Hippocrates, has certainly surpassed all who went before him, in the
extent of his labors on the general literature of the Hippocratic
Treatises. How highly I estimate his work I need not here stop to
declare; indeed the reputation it has already gained is so established,
that it would be vain to blame and useless to praise it. I have to
express my regret, however, in entering upon my exposition of his
opinions, that they are given in a very expanded form, and with a
degree of diffuseness, _plus quam Galenica_, so that I find it
difficult, within my necessary limits, to convey to the reader a
distinct view of the very important matters which M. Littré has brought
together to bear upon his subject.
He is at great pains to establish the following positions with regard
to the various treatises contained in the Collection which bears the
name of Hippocrates: 1st. That the Collection did not exist in an
authentic form, earlier than the date of Herophilus and his disciples,
that is to say, until nearly 100 years after the death of Hippocrates.
2d. That it contains portions which certainly do not belong to
Hippocrates; and, 3d, also Collections of Notes, etc., which would
never have been published by the author in their present form; and,
4th, Compilations, which are either abridged, or copied word for word
from other works which still form part of the Collection. 5th. As the
different treatises do not belong to the same author, so neither were
they all composed at the same time, some being much more modern than
the others. 6th. We find in the Collection mention made of numerous
treatises written by the followers of Hippocrates, which are now lost,
and which were no longer in existence when the Collection was first
published. 7th. The most ancient writers do not know, for certain,
to whom the several works forming the Collection belonged; 8th, with
the exception of a small number, which all of them, for one reason or
another, agreed in attributing to Hippocrates himself.[95]
I have now a few observations to make upon each of these positions.
The first, which is a most important one in connection with our present
subject, I regret to say, is, I think, by no means satisfactorily made
out by M. Littré. He shows, it is true, that Herophilus is the first
commentator on any of the Hippocratic Treatises of whom there is any
mention, but all we know of his labors in this line merely amounts to
this, that he had commented on certain passages in the “Prognostics,”
and probably also in the “Aphorisms,”[96] but I do not see that this
amounts to any proof either that the Collection was or was not formed
in his time. The proof of the second position is made to rest upon
a fact, which has attracted the attention of all the critics on the
Hippocratic Treatises, namely, that a memorable description of the
veins, which appears in the Hippocratic treatise “On the Nature of
Man,” is published by Aristotle, in the third book of his “History of
Animals,” as the production of his son-in-law, Polybus. Now, M. Littré
argues here, that as the publication of the Aristotelian Collection did
not take place until long after that of the Hippocratic, the persons
who made the latter could not have taken the passage in question from
the other, and the only way in which we can account for the change
of title, is by supposing that the works of Polybus had retained the
name of their true author in the days of Aristotle, but had lost it
at the time the Hippocratic Collection was made. Hence he infers that
the Hippocratic Collection must have been made subsequently to the
time of Aristotle.[97] But I must say that I do not recognize the
force of this argument; for, although the whole of Aristotle’s works
were not published in a collected form, until the time of Apellicon,
we have every reason to believe that many of his works were published
separately, in his own lifetime. The fact, then, would rather tell the
other way, and it might be argued, that the Hippocratic Collection must
have been made before the time of Aristotle, otherwise the persons
who made it would never have fallen into the mistake of attributing
to Hippocrates a passage which so high an authority as Aristotle had
referred to Polybus. But the truth is, that we are not entitled to
draw any positive inference from all this, with regard to the epoch in
question. It is well known that, in all ages, literary publications
have sometimes come abroad into the world in an anonymous shape; and it
need excite no surprise that with regard to the fragment in question,
as in many other cases, there should have been a diversity of opinion
as to its authorship.
The third we shall see fully made out in our analysis of the different
treatises given below.
The fourth will also be clearly proved, when we come to the examination
of certain treatises, as, for example, the “Officina Medici.”
The fifth is not made out to my satisfaction. M. Littré, however,
thinks it is satisfactorily proved that the latest epoch of these
productions does not come lower down than Aristotle and Praxagoras,
and none so low as Erasistratus and Herophilus. Hence he draws the
conclusion that the Collection must have been made between the time of
Aristotle and Herophilus.[98]
The sixth we shall see clearly made out, in our critique on the
separate treatises.
The seventh is abundantly evident from what has been already stated,
and will be made more apparent in the subsequent parts of this Section.
But there is nothing peculiar to the Hippocratic Collection in all
this, for there is as great uncertainty respecting many of the works
ascribed to Plato, and other collections of pieces which have come
down to us from high antiquity. Nay, every person who is conversant
with biblical criticism must be aware how difficult it has proved to
determine the authorship of many of the Psalms which bear the sainted
name of King David.[99]
In support of the eighth position, little need be said in addition
to what has been already stated. I need only repeat briefly that we
have as much certainty that some of the treatises in the Hippocratic
Collection are genuine, as we have that any other ancient works which
have come down to us are the productions of the authors whose names
they bear. But I hasten to give M. Littré’s distribution of the
different works in the Collection. He divides them into the following
classes.
CLASS I.--The Works which truly belong to Hippocrates.
1. On Ancient Medicine.
2. The Prognostics.
3. The Aphorisms.
4. The Epidemics, i., iii.
5. The Regimen in Acute Diseases.
6. On Airs, Waters, and Places.
7. On the Articulations.
8. On Fractures.
9. The Instruments of Reduction (Mochlicus).
10. The Physician’s Establishment, _or_ Surgery.
11. On Injuries of the Head.
12. The Oath.
13. The Law.
CLASS II.--The Writings of Polybus.
1. On the Nature of Man.
2. Regimen of Persons in Health.
CLASS III.--Writings anterior to Hippocrates.
1. The Coan Prænotions.
2. The First Book of Prorrhetics.
CLASS IV.--Writings of the School of Cos,--of the Contemporaries or
Disciples of Hippocrates.
1. Of Ulcers.
2. Of Fistulæ.
3. Of Hemorrhoids.
4. Of the Pneuma.
5. Of the Sacred Disease.
6. Of the Places in Man.
7. Of Art.
8. Of Regimen, and of Dreams.
9. Of Affections.
10. Of Internal Affections.
11. Of Diseases, i., ii., iii.
12. Of the Seventh Month Fœtus.
13. Of the Eighth Month Fœtus.
CLASS V.--Books which are but Extracts and Notes.
1. Epidemics, ii., iv., v., vi., vii.
2. On the Surgery.[100]
CLASS VI.--Treatises which belong to some unknown author, and form
a particular series in the Collection.
1. On Generation.
2. On the Nature of the Infant.
3. On Diseases, iv.
4. On the Diseases of Women.
5. On the Diseases of Young Women.
6. On Unfruitful Women.
CLASS VII.--Writing belonging to Leophanes.
On Superfœtation.
CLASS VIII.--Treatises posterior to Hippocrates, and composed about
the age of Aristotle and Praxagoras.
1. On the Heart.
2. On Aliment.
3. On Fleshes.
4. On the Weeks.
5. Prorrhetic, ii.
6. On the Glands.
7. A fragment of the piece “On the Nature of Bones.”
CLASS IX.--Series of Treatises, of Fragments and of Compilations,
which have not been quoted by any ancient critic.
1. On the Physician.
2. On Honorable Conduct.
3. Precepts.
4. On Anatomy.
5. On the Sight.
6. On Dentition.
7. On the Nature of the Woman.
8. On the Excision of the Fœtus.
9. The eighth Section of the Aphorisms.
10. On the Nature of the Bones.
11. On Crisis.
12. On Critical Days.
13. On Purgative Medicines.
CLASS X.--Writings now lost, which once formed a part of the
Collection:
1. On dangerous Wounds.
2. On Missiles and Wounds.
3. The first Book of Doses--the Small.
CLASS XI.--Apocryphal pieces--Letters and Discourses.
Such is the classification of M. Littré, which he professes to have
founded on the four following rules, or principles: firstly, on the
authority of direct witnesses, that is to say, of authors who preceded
the formation of the Alexandrian Library; secondly, on the consent of
the ancient critics; thirdly, on the application of certain points
in the history of medicine, which appear to him to offer a date, and
consequently a positive determination; fourthly, on the concordance of
the doctrines, the similitude of the writings, and the characters of
the style. Of these rules, the one which he professes to have been most
guided by is the first, all the others being of subordinate importance.
From what has now been stated, the reader will not fail to remark that
the principles upon which the classification of Littré is founded
scarcely differ at all from those of Ackerman. The reasonableness of
these rules, moreover, no one, I presume, will venture to call in
question, whatever may be thought of the judgment with which they
are applied in particular instances. My own opinions on this point I
need not state here, as they will come out more properly in my own
disquisition on the characters of the particular treatises.
But, before concluding this part of my task, I must not neglect to
notice the learned labors of a much esteemed friend and countryman--the
first, the last, the only, scholar (I lament to say) which England
has produced in this department of ancient criticism--Dr. Greenhill,
of Oxford, who, in his excellent article on _Hippocrates_ in
Smith’s “Dictionary of Greek and Roman Biography and Mythology,” enters
into a very elaborate disquisition on the authenticity of the various
works which compose the Collection. His general distribution appears
to me to be very ingenious, and his judgment in particular cases most
correct, but it is proper I should state that I, perhaps, am scarcely
qualified to pronounce an impartial judgment on this point, having had
the honor of being consulted by the author, as he himself candidly
acknowledges, while he was employed on this task. On the following page
is his tabular view of the different divisions and subdivisions of the
Collection.
* * * * *
Having now finished this survey of the labors of preceding inquirers,
I proceed to state the results of my own investigations in the same
department; and in doing so, I shall give _seriatim_ the evidence
for and against the authenticity of the different treatises, along
with my own decision in every instance. And, in order to add to the
value of this disquisition, I mean to give an abstract of the contents
of those works which I look upon as spurious, that the reader may be
enabled to compare the doctrines contained in them with those which are
delivered in the treatises which are recognized as genuine. Moreover,
it is my object that the present volume should contain a summary of all
the valuable matters to be found in the Hippocratic Treatises, whether
genuine or not.
Before proceeding further, I must state the _rules by which I test
the genuineness of the works in the Hippocratic Collection_:
1. All the works which are acknowledged as genuine by the ancient
commentators and lexicographers which have come down to us, and
especially by Erotian and Galen, are to be admitted as such, unless
it can be shown that still older authorities held a different opinion
regarding them, or that they contain doctrines and views decidedly at
variance with those contained in the treatises which all allow to be
genuine, or that the style and mode of handling the subject matter be
altogether different from the well-known method of Hippocrates.
2. The peculiar style and method of Hippocrates are held to
be--conciseness of expression, great condensation of matter, and
disposition to regard all professional subjects in a practical point
of view, to eschew subtle hypotheses, and modes of treatment based on
vague abstractions.
The Hippocratic Collection consists of
|
+-----------------------+------------------------+
| | |
Works certainly written Works certainly not Works _perhaps_ written
by Hippocrates, written by by Hippocrates,
Class I.[101] Hippocrates. Class II.[102]
|
+-----------------------+-----------------------+
| | |
Works earlier than Works later than Works about
Hippocrates, Hippocrates. contemporary with
Class III.[103] | Hippocrates.
| |
| +---------+-----+
| | |
| Works whose Works whose
| author is author is
| conjectured, unknown,
| Class IV.[104] Class V.[105]
|
+-------------------------+
| |
Works authentic, but Works neither genuine
not genuine, i. e. nor authentic, i. e.
not willful willful forgeries,
forgeries. Class VIII.[106]
|
+--+--------------+
| |
Works by the Works by various
same author, authors,
Class VI.[107] Class VII.[108]
3. No treatise is to be received as genuine which is not recognized
as such by any one of the ancient authorities, however strong a case
may be made out in favor of its claims by modern critics from internal
evidence.
I. Περὶ ἀρχαίης ἰητρικῆς--_On Ancient Medicine_.
Of all the treatises which are recognized as the genuine productions
of “The Great Hippocrates,” by M. Littré, this is decidedly the one
which possesses the most questionable title to that honor. The only
ancient authority that admits it as such is Erotian; it is passed
over unnoticed by Galen and Palladius; and Athenæus does not scruple
to affirm, respecting it, that some considered the one half of it
spurious, and others the whole. (Deipn., ii., 16.) Foës, Schulze, and
Zuinger,[109] are almost the only modern names in its favor; and it is
rejected by Mercuriali, Gruner, Conringius, Ackerman, and Kühn.[110]
The grounds, however, upon which Ackerman decides against its
authenticity are of little weight, namely, that as it is stated in it
(§ 1, 2) that medical works were numerous at the time it was composed,
this circumstance implies a date considerably posterior to Hippocrates.
But it is to be borne in mind, that Xenophon, who was almost
contemporary with Hippocrates, puts into the mouth of Socrates, who
was certainly nearly of the same age, the saying, that there were many
medical works then in existence (Memorab., iv.), so that at all events
the argument of Ackerman falls to the ground. M. Littré, moreover,
espouses its claims with remarkable zeal, and persuades himself that
he has settled this point by showing that a passage in the Phædrus
of Plato,[111] which is quoted by Galen, as referring to a sentiment
contained in the Hippocratic treatise “De Natura Pueri,”[112] does, in
fact, have reference to the work now under consideration. This position
he labors hard to establish, and succeeds at last so much to his own
satisfaction, that he does not hesitate to declare, as the result of
his elaborate disquisition, “that he had demonstrated the treatise “On
Ancient Medicine” to be the work of Hippocrates.”[113] Now, I must be
permitted to say, with great deference to M. Littré, that his prolix
process of argumentation, spun out as it is over twenty-six pages, does
not carry the same conviction to my mind as it does to his own.[114]
But still, as this treatise has, at all events, one ancient authority
in its favor, and as the matter contained in it appears to me to be
highly valuable, I have not scrupled to follow the example of M. Littré
in placing it at the head of the Works of Hippocrates. I shall have
occasion to say more on the contents of it in the Argument prefixed to
my translation.
II. Προγνωστικόν--_Prognostics_.
Of the genuineness of this work there has never been any question,
so far as I am aware, from the time of the earliest of the ancient
commentators, Herophilus, down to the present day.[115] That it is an
admirable specimen of the plan upon which the Hippocratic practice was
founded, there can be no doubt. The most important critical question
to be decided with regard to it is the relation it bears to two other
treatises on the same subject, namely, the “Prorrhetica,” and “Coacæ
Prænotiones,” whether the “Prognostics” be founded on them, or whether
they be made up from the “Prognostics.” This question will come more
properly to be discussed in the Argument to the “Prognostics.”
Of this treatise there have been the following translations into
English:
“The Booke of the Presages of the Divine Hippocrates, divided
into three parts, etc. By Peter Low, Arrelian Doctor in the
Faculty of Chirurgery in Paris. Lond., 1597.”
“The Prognostics and Prorrhetics of Hippocrates, translated
from the original Greek, with large annotations, critical and
explanatory; to which is prefixed a short account of the Life
of Hippocrates. By John Moffat. Lond., 1788.”
“Hippocrates on Air, Water, and Situation: or, Prognostics,
etc. By Francis Clifton, M.D. Lond., 1734.”
Of these the last is the only one which possesses the slightest claim
to consideration. It is the work of a scholar, who had evidently
paid the most studious attention to his author with the intention of
publishing a new edition of his works, a design, by the way, which
it is much to be regretted, that he did not live to execute. What
became of his literary labors in this department I have never been
able to ascertain. The greatest fault I find with his translation
is the quaintness of his style; for it cannot be alleged of him, as
of Moffat, that he often mistakes the meaning of his author. The
translations of the latter are utterly worthless, in fact, they are
disgraceful to the translator, who ought to have been ashamed to engage
in a task for which he was so utterly unqualified. The translations
by Low are done in a strangely antiquated style, and otherwise have
nothing to recommend them on the score of fidelity. Moreover, all
these translators introduce confusion into the subject by mixing up
together the contents of the “Prognostica,” “Prorrhetica,” and “Coacæ
Prænotiones.” Even Clifton is guilty of this indiscretion, although
better might have been expected from him; for, considering how well
acquainted he appears to have been with the spirit of his author,
he ought to have been able to appreciate properly the obligations
which Hippocrates had conferred on his profession by methodising
subject-matters which had previously been destitute of scientific
arrangement.
III. Ἀφορισμοί--_Aphorisms_.
That the greater part of the Book of Aphorisms is the work of
Hippocrates himself there can be little or no doubt, but that it
contains interpolations, some of which are of high antiquity, is
equally indisputable. This is distinctly stated by Galen.[116] On this
subject I would beg leave to quote the remarks of Dr. Greenhill: “Some
doubts have arisen in the minds of several eminent critics as to the
origin of the Aphorisms, and, indeed, the discussion of the genuineness
of this work may be said to be an epitome of the questions relating to
the whole Hippocratic Collection. We find here a very celebrated work,
which has, from early times, borne the name of Hippocrates, but of
which some parts have always been condemned as spurious. Upon examining
these portions, which are considered to be genuine, we observe that
the greater part of the first three sections agrees almost word for
word with passages to be found in his acknowledged works; while in the
remaining sections we find sentences taken apparently from spurious or
doubtful treatises, thus adding greatly to our difficulties, inasmuch
as they sometimes contain doctrines and theories opposed to those
which we find in the works acknowledged to be genuine. And these
facts are (in the opinion of the critics alluded to) to be accounted
for in one of two ways; either Hippocrates himself, in his old age
(for the Aphorisms have always been attributed to this period of his
life), put together certain extracts from his own works, to which were
afterwards added other sentences taken from later authors; or else,
the collection was not formed by Hippocrates himself, but by some
person or persons after his death, who made aphoristical extracts from
his works, and from those of other writers, of a later date, and the
whole was attributed to Hippocrates, because he was the author of the
sentences that were most valuable and came first in order. This account
of the formation of the Aphorisms appears extremely plausible, nor does
it seem to be any decisive objection to say, that we find among them
sentences which are not to be met with elsewhere; for when we recollect
how many works of the old medical writers, and perhaps of Hippocrates
himself, are lost, it is easy to conceive that these sentences may have
been extracted from some treatise that is no longer in existence. It
must, however, be confessed, that this conjecture, however plausible
and probable, requires further proof and examination before it can be
received as true.”[117] The fact of the matter is, that interpolation
is a mode of corruption from which few works of antiquity have escaped
altogether free, and it was, no doubt, often practised upon them in
a very innocent manner, and without any fraudulent intention. Thus,
when the subject treated of by any author came afterwards to receive
any notable improvements or alterations, the possessors of such a
work would naturally mark them down on the margins of their MS., and
these annotations in the course of transcription would often come to
be incorporated with the genuine text. Such a work as the Aphorisms,
consisting of detached sentences, was particularly liable to suffer in
the manner now adverted to. Another mode of vitiation, which has been
frequently practised upon ancient works, is the addition of appendices
to them. Every classical reader must be aware that the Odyssey of Homer
is generally admitted by the critics to have come down to us in this
state; nay, many learned divines do not scruple to admit that certain
portions of the Sacred Volume have not been exempt from this casualty.
I may mention that the last chapter of the Pentateuch, the last Psalm
in the Septuagint, and even the last chapter of the Gospel of St. John,
have been suspected, by very able critics, of being appendices. I have
stated in another place (PAULUS ÆGINETA, Vol. III., p. 437),
that an addition in this way has probably been made to the medical
works of Aëtius. On the addition of appendices to works, see further,
Galen (de Placit. Hippocrat. et Plat., vi., 3). Taking all this into
account, it need excite no wonder that an appendix should have been
added, by some unknown hand, to the seven sections of Aphorisms, and,
accordingly, it is generally admitted that the eighth section is
spurious.
I shall reserve my analysis of the contents of the genuine sections to
the Argument prefixed to the translation.
We have the following translations of the Aphorisms into English: “The
Aphorisms of Hippocrates”, translated into English:
“By S. H. Load. 1610.”
“By Conrad Sprengel. Lond. 1708.”
“By T. Coar. Lond. 1822.”
“By J. W. Underwood. Lond. 1828.”
Of these I have only carefully examined the translations by Sprengel
and Coar. That of Sprengel displays considerable pretensions to
erudition, but, upon a careful examination, it will be quite apparent
that the translator was not possessed of a competent acquaintance
either with the Greek or English language. In short, nothing can be
conceived more quaint, inelegant, and inaccurate, than the language of
this translation. Lest I should be suspected of prejudices against my
predecessor, and of exaggerating his faults, I shall subjoin a short
list of passages which I hold to be mistranslated, so that the reader
may judge for himself, whether my opinion of the work be well founded
or not. (See Aph. i., 11,[118] 15,[119] 20,[120] 23;[121] ii., 6,[122]
15,[123] 27, 31, 34, 40; iii., 16, 21.)
The production of Coar is not destitute of some merit, although it is
but too apparent that he was not fully competent for the task which
he had undertaken. He gives, separately, every Aphorism in Greek, to
which he subjoins first a Latin and then an English translation. In
the Preface, he admits that “in executing the English translation
considerable assistance had been derived from the elegant French
translation of M. de Mercy.” From this admission it will readily be
gathered, that the translator felt conscious that he did not possess
a proper acquaintance with the language of the original. I subjoin
references to a few of the passages which, upon examination, appeared
to me to be incorrectly rendered. (See Aph. i., 2,[124] 10,[125]
20;[126] ii., 49;[127] iii., 11,[128] 26, 31; iv., 1; v., 26, 44, 68.)
IV. Ἐπιδημιῶν α’ και γ’--_The First and Third Books of the
Epidemics_.
These are among the most undoubtedly genuine remains of Hippocrates,
and well sustain the high reputation of their great author. In fact, of
all the earlier records of medicine, these are about the most precious
which have come down to us. Although, as I have stated, no one has
questioned their genuineness, Galen complains that, by some mishap
or other, they had not wholly escaped from some derangement of the
subject-matters which they contain, and from additions being made to
them.[129]
The following, I believe, are the only English translations of them
which have ever been published.
“A Comment on forty-two histories described by Hippocrates in
the First, and Third Books of his Epidemics. By J. Floyer.”
“The History of Epidemics, by Hippocrates, in Seven Books.
Translated into English from the Greek, with Notes and
Observations. By Samuel Farr, M.D. Lond. 1780.”
The former of these I have not been able to see. The other, although
it appears to have been got up with considerable care, is manifestly
the work of a man not properly acquainted with the language and
doctrines of his author. In proof of this, I subjoin below a few
examples collected from the first book, near the beginning.[130]
V. Περὶ διαίτης ὸξέων--_On the Regimen in Acute Diseases_.
This work is acknowledged as genuine by Erotian,[131] Palladius,[132]
and Galen,[133] and other ancient authorities, as well as by all the
modern critics, from Mercuriali and Lemos down to Littré and Greenhill.
The authenticity of the latter part, indeed, is questioned by Galen,
who pronounces the style, theories, and language to be different from
those of Hippocrates. Yet even he admits that it is of great antiquity,
being more ancient than the time of Erasistratus, who lived within less
than a century from the death of Hippocrates.[134] Even if not genuine,
then, this part (which is published by M. Littré as an appendix)
possesses great value, not only as containing important matter, but
as furnishing us with the opinions of the Coan school at a very early
period after the time of our author. We shall have occasion to give
a fuller analysis of its contents, in the Argument prefixed to the
translation of it.
VI. Περὶ ἀέρων, ὑδάτων, καὶ τόπων--_On Airs, Waters, and Places_.
Fortunately there are no reasonable grounds for questioning the
authenticity of this highly important work. It is admitted as genuine
by Erotian, Palladius,[135] Athenæus,[136] and Galen,[137] and by
every one of the modern critics, with the exception of Haller, who
pronounces against it upon very insufficient grounds. He argues that
it is obvious, from its contents, that the author of this treatise
was a European, which cannot be said of Hippocrates, seeing that his
native place, Cos, was one of the Asiatic islands.[138] But, if Haller
had possessed any competent acquaintance with classical literature, he
must have been aware that all the inhabitants of the islands adjoining
to Asia Minor were colonists from Greece, and consequently looked upon
themselves as Europeans, and not as Asiatics.[139] Nor is this more
remarkable than that the present inhabitants of America should rank
themselves ethnologically with the Europeans, and not with the native
inhabitants of the country they now occupy.
An edition of this treatise, with a French translation, was published
at Paris by a learned modern Greek, Dr. Coray, in the beginning of this
century; the annotations to which are highly valuable. The only English
translation of it which we possess, as far as I know, is the following:
“Hippocrates upon Air, Water, and Situation. By Francis
Clifton, M.D. Lond. 1734.”
This, I am inclined to think, is the best English translation which we
have of any of the Hippocratic treatises. It is generally accurate,
and the only drawback to it which I am aware of, is the style, which
is often exceedingly quaint and obsolete. The translator, as we stated
above, was well acquainted with all the works of Hippocrates, and of
his painstaking industry the notes in this treatise bear undoubted
evidence. Of these I have availed myself, whenever I could derive any
assistance from them, but from the translation itself I have never
copied literally.
VII. Περὶ ἄρθρων--_On the Articulations_.
This work was received as genuine by all the ancient commentators,
from Bacchius and Philinus, the disciples of Herophilus, down to
Erotian, Galen,[140] and Palladius.[141] It was also admitted by
all the earlier modern critics, down to Gruner, who rejected it on
these grounds: 1. Because it contains a reference to the treatise “On
Glands,” which all acknowledge to be spurious. 2. That in the course
of the work a degree of anatomical knowledge is evinced, far beyond
what its actual state in the time of Hippocrates would warrant. 3. That
the legend of the Amazons, which is received as true history in the
treatise “On Airs, etc.” is rejected as fabulous in this work. Grimm
also agrees with Gruner in condemning it as spurious; but Littré shows
good reasons for admitting it into the list of genuine productions. He
replies in a very satisfactory manner to Gruner’s objections. Thus he
shows, in particular, what we have adverted to previously, that the
knowledge of anatomy which was possessed in the Hippocratic age, had
been much underrated by Gruner and others, and that the two passages in
which the Amazons are supposed to be referred to, are not parallel, and
do not admit of a comparison. He also very properly insists upon it, as
a strong argument in favor of the genuineness of this treatise, that it
had been commented upon by Ctesias.[142] The work, indeed, contains so
much valuable matter, of which subsequent authors (as Celsus and Paulus
Ægineta) have freely availed themselves, in handling the subjects which
are treated of in it, that I have every disposition to receive it as
genuine. We shall see, afterwards, that, taken in connection with the
next work, it is a perfect masterpiece on the subject of Fractures and
Dislocations.
VIII. Περὶ ἀγμῶν--_On Fractures_.
Tried by the tests laid down by us above, this treatise must
undoubtedly be received as genuine. It is decidedly acknowledged as
such by Palladius, Erotian, Galen, and, in short, by all the ancient
authorities, and the only modern critics who venture to question its
claim are Grimm, the German translator of Hippocrates, and Kühn; and,
in fact, the latter does so merely in deference to Grimm, for his
arguments on the question of its authenticity all tell the other way.
That the treatises “On Fractures” and “On Articulations” constituted
originally one work, is shown in a very convincing manner by Galen,
in his introductory comment on the latter.[143] This is an additional
reason for admitting the work “On Articulations” as genuine. Indeed,
I do not hesitate to declare that whoever refuses to admit these two
treatises as genuine, may consistently dispute the claims of any other
work of the same date.
IX. Μοχλικός--_On the Instruments of Reduction_.
This work is quoted by Galen as one of the acknowledged books of
Hippocrates,[144] and is admitted by Erotian into his list of genuine
works; nay, it appears from the latter that it had been commented upon
by Bacchius. Of the modern authorities, Foës and Littré concur with
the ancient in admitting its claims, but it is rejected by Lemos,
Mercuriali, Haller, Gruner, Grimm, and Kühn. No one who reads it
carefully can fail to remark that, as stated by Galen,[145] it is a
compendium of the work “On the Articulations,” so that whoever admits
the latter to be genuine must acknowledge the treatise now under
consideration to be one which embodies the opinions of Hippocrates,
whether it were actually composed by him or not. Taking all this into
account, it appears to me superfluous diligence in modern critics to
search out grounds for questioning its authenticity.
X. Περὶ τῶν ἐν κεφαλῇ τρωμάτων--_On Injuries of the Head_.
This work is acknowledged as genuine by all the authorities, ancient
and modern. The only objection to its genuineness is the appearance of
certain interpolations towards the end of it.[146] This, however, as we
have remarked above (No. III.), is a mode of vitiation from which few
ancient works are altogether exempt.
XI. Ὂρκος--_The Oath_.
This interesting little piece is quoted as genuine by Erotian,[147]
Theodore Priscian,[148] Soranus Ephesius,[149] St. Jerome,[150]
Gregory Nazianzen,[151] Suidas,[152] and Scribonius Largus.[153] It
is also received as such by Foës, Gruner, and Littré, but is rejected
by Mercuriali, Schulze, Haller, Kühn, Ackerman, and other modern
authorities, as quoted by Ackerman. The only reasonable grounds which I
can see for questioning its authenticity is the silence of Galen with
regard to it; but when we take into account that Galen has nowhere
given an entire list of what he considers to be the genuine works of
Hippocrates, this omission on his part may be merely incidental, and
is not of much weight. On the other hand, the argument which M. Littré
seeks to establish in favor of its authenticity on fancied allusions
to it by Aristophanes[154] and Plato,[155] appears to me to have no
weight; indeed, he himself gives up the former in another place.[156]
I have met with the following English translations of this piece, and
no doubt there may be others:
“The Protestation which Hippocrates caused his Scholars to
make, by Peter Low; Lond. 1597.”
“----, by Francis Clifton, M.D.; Lond. 1734.”
The translation by Low is in a quaint and antiquated style; that by
Clifton is carefully done.
XII. Νόμος--_The Law_.
This little piece is noticed by Erotian, and admitted as genuine
by M. Littré, but Mercuriali, Gruner, Ackerman, Kühn, and Greenhill
incline to reject it. It is well written, but the style is rather too
scholastic for the age and taste of the great Father of Medicine. At
the same time, it has so many points of accordance with “The Oath,”
that it seems inconsistent to admit the one as authentic and reject the
other as spurious.
XIII. Κατ' ἰητρεῖον--_On the Surgery_.
All the ancient commentators which have come down to us, such as
Erotian, Galen, and Palladius, admit it to be genuine; but it would
appear from Galen that some of the older commentators were not
satisfied upon this point, some doubting whether it was the production
of the great Hippocrates or of Thessalus, and some referring it to
Hippocrates, the son of Gnosidicus.[157] It is received also by Foës,
Gruner, and, after a good deal of hesitation, by M. Littré. Schulze
expresses himself on this point doubtfully,[158] and the work is
rejected by Grimm, Ackerman, and Kühn. Beyond all doubt, it is a
compendium of the treatises “On Fractures” and “On the Articulations,”
so that, whether the composition of Hippocrates himself or not, there
can be no question that the subject-matter of it is derived from him.
Galen appears to have been remarkably fond of this treatise, and
makes frequent reference to it in his great work “On the Dogmata of
Hippocrates and Plato.” It would appear that Diocles, Philotimus, and
Mantias had written treatises bearing the same title.
There is some difficulty in determining accurately what was the nature
of the ancient _Iatrium_ ιητρεῖον. See an interesting disquisition
on this subject in Littré’s edition of Hippocrates, t. v., p. 25. It
most probably was an establishment kept by the physician, in which
were contained not only all sorts of medicines, but also all kinds of
surgical apparatus. Mention of the _Iatrium_ is made by Plato
(Legg. iv., p. 720, and i., p. 646; ed. Tauch.) Aristotle is said to
have possessed an _Iatrium_, which, if the story be true, he had
no doubt acquired from his father, who was a medical practitioner.[159]
From what is stated by Plato, it would appear that the assistants
were qualified to administer professional assistance in the absence
of their superior, and were also called doctors. (Legg. iv.) So it
appears that the modern abuse of this title was sanctioned by classical
usage! It must be recollected that, in the time of Hippocrates, eminent
physicians were _periodeutæ_, that is to say, wanderers from
place to place, and consequently they would stand in need of such
an establishment as we have described the _Iatrium_ to be. See
further the Argument to this work.
XIV. Περὶ φύσεως ἀνθρώπου--_On the Nature of Man_.
Erotian, Galen, Palladius, and Macrobius[160] do not hesitate to
quote the doctrines contained in this treatise as being those of the
great Hippocrates, but its authenticity has long been considered
very questionable, owing to the circumstance that a passage in it of
considerable length, relative to the anatomy of the venous system, is
quoted by Aristotle[161] as being the production of Polybus, and it
is accordingly received as such by Haller,[162] Gruner, Littré, and
most of our recent authorities on ancient medicine. Galen, however,
contends that the passage quoted by Aristotle is not the work either
of Hippocrates or of Polybus, but an interpolation, and that the rest
of the treatise is genuine.[163] But Galen, at the same time, admits
that Dioscorides, the Commentator (he must not be confounded with
the celebrated author of the Materia Medica), had marked the first
part of this treatise with the sign of the obelisk, as indicating his
suspicion of its being spurious, and that he held it to be the work
of Hippocrates, the son of Thessalus, that is to say, of a grandson
of the great Hippocrates. But, whatever may be decided regarding its
authorship, a careful perusal of the treatise will satisfy any one that
it is a piece of patchwork; made up of several fragments, which do not
cohere properly together. It certainly also appears to me that many of
the philosophical dogmata which are delivered in it do not accord well
with the doctrines contained in those treatises which are universally
admitted to be genuine.
After alluding briefly to the opinions of those philosophers who held
that the human body is formed from the four elements, that is to say,
fire, air, water, and earth, the writer proceeds to state his own
doctrines regarding the four humors, namely, blood, phlegm, yellow and
black bile, and the diseases which are occasioned by the prevalence of
one or other of them, according to the seasons of the year, and other
circumstances. The doctrines, as herein stated, are very hypothetical,
and certainly, as already hinted, not in accordance with those
delivered in the genuine works. It is proper to mention, however,
that Galen, in several parts of his works, makes Hippocrates to be
the author of the theories of the elements and of the humors.[164]
The treatise contains certain general truths and rules of practice
not unworthy of some consideration, such as this, that diseases are
cured by their contraries, that is to say, that diseases arising from
repletion are removed by evacuation, and _vice versa_; and that
diseases in general are occasioned either by the food we eat, or the
air we breathe, those which prevail epidemically being produced by the
latter cause. All sudden changes of diet are held to be attended with
danger, and to be avoided. It is also an important rule of practice
that, in venesection, blood should be abstracted from a part as
distant as possible from the seat of the pain and of the collection
of blood. There can be no doubt, in a word, as we have stated in the
preceding section, on the authority of Galen, that Hippocrates was
well acquainted with the principle of revulsion in the practice of
medicine. The natural heat, or, as it is now called, the animal heat,
is stated to be greater the younger the body is--a physiological
doctrine strenuously advocated by Galen in several parts of his works,
but more especially in the treatise “Against Lycus.”[165] The theory
of the formation of urinary calculi is also discussed. The same occurs
in the treatise “De Aëre,” etc., and in the work “De Morbis” (iv.,
28). Allusion is likewise made to the occurrence of substances in the
urine resembling hairs.[166] The last fragment of which this treatise
is composed relates to fevers, the greater part of which are held to be
occasioned by bile. It is said that there are four varieties of them,
namely, synochus, quotidian, tertian and quartan; that the synochus
is formed from the most intense bile, and comes soonest to a crisis,
and the others in the order we have stated them. This is very unlike
the doctrines of fever laid down in the genuine works, and accordingly
this portion of the treatise was a great stumbling-block to those among
the ancient commentators who contended for the genuineness of the
treatise.[167] Altogether, then, I must say, that a careful perusal
of the work leads me to the conclusion that, notwithstanding the high
authorities in its favor, it does not deserve to be received as a
genuine production of Hippocrates.[168]
XV. Περὶ διαίτης ὑγιεινῆς--_On Diet in Health_.
This work is passed over unnoticed by Palladius and Erotian; and
Galen, although he wrote a commentary on it which still remains,
informs us that some of the elder commentators had assigned it to
Polybus, the son-in-law to Hippocrates.[169] He further mentions
that it had been variously referred to Euryphon, Phaon, Philistion,
and others; ancient authority in its favor is, therefore, very
equivocal. The modern critics are pretty unanimous in rejecting it;
indeed, Littré, improving on the hint cast out by Galen, does not
scruple to refer it and the preceding treatise to Polybus. Though
the subject-matters of it are not, in the main, of much importance,
it contains some directions for the regulation of the diet, which
are by no means injudicious. One of his directions, with regard to
clothing, is very different, however, from what we might have expected,
considering the fondness of the ancients for the use of oil to
counteract the effects of cold.[170] The author of this work directs
oily garments to be used in summer, but clean ones in winter. Emetics
are recommended to be taken by persons of a gross habit of body, but to
be avoided by those who are slender. This rule is expressed by Celsus
in the following terms: “Vomitus inutilis gracilibus et imbecillum
stomachum habentibus, utilis plenis et biliosis omnibus, si vel nimium
se repleverint vel parum concoxerint.”[171] The author of this treatise
recommends hyssop as an emetic, and we find its use in this way not
infrequently noticed in the Hippocratic treatises, but not in the works
of subsequent authorities, as far as I am aware. The work concludes
with a passage on diseases of the brain, which also occurs, “De Morbis”
(ii.), and seems much out of place here. It is said that they are first
manifested by stupor of the head, frequent passing of urine, and other
symptoms of strangury; and it is added, that a discharge of water or of
mucus by the nose or ears relieves these complaints.
Altogether, considering how slender the evidence is, both external and
internal, in favor of the authenticity of this treatise, I can have no
hesitation in rejecting it as spurious.
XVI. Προρῥητικον, α’--_First Book of Prorrhetics_.
XVII. Κωακὰι προγνώσεις--_Coan Prognostics_.
These two works are so evidently allied to one another, that I have
judged it expedient to treat of them together. The greatest difference
of opinion has prevailed among the critics, both ancient and modern,
with regard to them. Erotian declares expressly that the “Prorrhetics,”
both first and second, are not genuine; and Galen, although he writes
a commentary on the first book, complains of the difficulty he
experienced in explaining certain vocables of dubious meaning contained
in it,[172] and elsewhere states that the treatise is composed of
extracts from the “Prognostics,” “Epidemics,” and “Aphorisms.” Foës
is almost the only modern scholar of any note who stands up for the
genuineness of the first book of the “Prorrhetics;” and it is decidedly
rejected by Grimm, Ackerman, Haller, Littré and nearly all the other
modern authorities. The “Coacæ Prænotiones” have very little ancient
authority in their favor, and even Foës rejects the work with greater
disdain than it would seem to merit. Of late years, the opinion has
gained pretty general assent that these two treatises are more ancient
than the days of Hippocrates;[173] that, in fact, they constitute
the materials out of which he composed the “Prognostics,” and are
the results of the observations made by the priest-physicians in the
Asclepion, or Temple of Health, at Cos. This idea is followed out with
great ability by Dr. Ermerius, in his “Specimen Historico-Medicum
Inaugurale de Hippocratis doctrina a Prognostice oriunda,” where, by
a most ingenious and convincing process of comparison, he appears
clearly to make out that the “Coacæ Prænotiones” are formed from
the first book of the “Prorrhetica,” and the “Prognostics” from the
“Coacæ Prænotiones.” These positions, I repeat, he seems to me to have
established most satisfactorily, and I cannot hesitate to declare it
as my opinion that Dr. Ermerius has thereby thrown great light on
this department of the Hippocratic literature. M. Littré has justly
appreciated the labors of Dr. Ermerius, and adopted his views without
reserve. (v. i., p. 351.) As I shall have occasion to compare the
contents of these two treatises now under consideration with the
subject-matters of the “Prognostics” in my Argument to the latter, I
shall confine myself at present to a few observations, selected in a
good measure from M. Littré’s argument to the “Coacæ Prænotiones.”
In the first place, M. Littré makes some interesting remarks on
vomicæ of the chest after pneumonia and pleurisy; but this subject
will come to be treated of in the notes on the “Prognostics.” He next
gives some important observations on the following passage in the
“Coacæ Prænotiones,” § 418: “All sprains are troublesome, and cause
intense pains at the commencement, and in certain cases occasion
after-consequences; the most troublesome are those about the breast,
and the most dangerous are those in which there is vomiting of blood,
much fever, and pain about the mammæ, chest, and back; when all these
occur, the patients quickly die; but in those cases in which they
do not all occur, nor are severe, they are longer protracted; the
inflammation at farthest is protracted to forty days.” He relates,
in illustration of this passage, a case very much in point, from the
“Journal de Médecine,” Juillet, 1843, of a healthy person who, in
lifting a log of wood, strained the parts about the chest so as to
experience a cracking sensation about the breast; it was followed by
intense inflammation, which, in spite of plentiful depletion, ended in
an empyema which opened by the fifth intervertebral space. The patient
recovered. This case is a good illustration of a species of accident
frequently described in the Hippocratic Collection. He then briefly
considers the question whether or not Hippocrates was acquainted with
_the croup_, on which he does not give any decided opinion. In
my opinion, the term _croup_ is now used in a vague sense, being
applied to cases of angina, in which the inflammation spreads down to
the glottis and trachea, and also to cases of bronchitis attended with
a croupy cough. I am confident that pure _cynanche trachealis_,
that is to say, acute disease originating in the trachea, is of very
rare occurrence, at least, it certainly is so in the north of Scotland.
That the ancients were well acquainted with that species of cynanche in
which the disease spreads down to the windpipe there can be no doubt.
See the Commentary on §§ 26, 27, Book III., of PAULUS ÆGINETA.
It may reasonably be doubted whether they were not fully as well
acquainted with diseases of the fauces and windpipe as the moderns are.
M. Littré’s observations on sphacelus of the brain do not at all accord
with the opinions of Dr. Coray,[174] nor with those advanced in the
Commentary on PAULUS ÆGINETA, B. III., § 7. He thinks that
Hippocrates meant by it necrosis of the cranium. Although I still so
far adhere to my former opinion that by sphacelus was generally meant
_ramollissement_ of the brain, I must admit that some of the
passages in the Hippocratic Collection, where it is described, would
bear out M. Littré’s ideas regarding it. On the subject of sphacelus,
see “De Morbis,” near the beginning.
M. Littré draws, from a variety of sources, much interesting matter
in illustration of § 500 of the “Coacæ Prænotiones:” “Amaurosis is
produced by wounds in the eyelash, and a little above it; the more
recent the wound, they see the better; but when the cicatrix becomes
older the amaurosis increases.” Plattner[175] held that in this case
the amaurosis is connected with lesion of the frontal nerve. Beer[176]
shows that the affection of the sight is not connected with injury
of the nerve, but is rather the result of concussion of the ball of
the eye. Walker, and Littré himself, are rather disposed to question
altogether the truth of the statement made by Hippocrates.
M. Littré concludes his argument with some observations on the
lethargus of the ancients, which he holds, and correctly, as I think,
to be a pseudo-continual fever. My own opinion, as delivered in the
Commentary on Book III., § 9, of PAULUS ÆGINETA, will be
found to be very similar. Lethargus is there stated to have been a
species of remittent fever, resembling the causus. M. Littré, further
in illustration of this subject, gives from the works of Mr. R. Clark,
an English physician at Sierra Leone, an interesting account of a
sleepy-dropsy, to which the Negroes there are subject.
The greater part of the contents of these treatises are mixed up by
Clifton with his translation of the “Prognostics;” and Moffat gives a
complete translation of this book of the “Prorrhetics.” The latter,
like all the other translations by the same hand, is utterly worthless.
Clifton is only culpable for having introduced confusion into the
contents of works which had been so admirably arranged by Hippocrates.
XVIII. Προῤῥητικόν, β’--_The Second Book of Prorrhetics_.
The reception which this work has met with from the critics, ancient
and modern, appears rather singular. Erotian and Galen, who, in
general, are too facile in admitting the claims of suspected works,
in the present instance reject a work which many modern authorities
acknowledge as genuine; as, for example, Haller, Gruner, Grimm, and,
with certain qualifications, Ackerman and Kühn. I must say, however,
with Foës, Littré, and Greenhill, that I cannot see how we can
consistently recognize as genuine a work which has so large an amount
of ancient authority against it, and none in its favor. At the same
time, all must admit that the treatise in question contains nothing
unworthy of the name of Hippocrates, and that, if estimated by the
value of its contents, it is one of the most important works in the
whole Collection. I will, therefore, give an abstract of its contents,
along with my translation of the “Prognostics.” It is deserving of much
attention, as being the only work we possess which gives us an insight
into the method taken by the ancient physicians to gain the confidence
of their patients by their mode of conducting the preliminary
examination of every case. In my younger days I knew an old physician,
who was an adept in this art of conciliating the confidence of his
patients by anticipating their histories of their own complaints.
XIX. Περὶ ἑλκῶν--_On Ulcers_.
This treatise is decidedly admitted as genuine by Galen,[177] Erotian,
Celsus, and by Foës, Lemos, Mercuriali, Schulze,[178] and Vidus
Vidius,[179] but is rejected by Haller, Gruner, Ackerman, and Kühn,
on internal evidence, the nature of which we shall presently examine.
M. Littré in so far concurs in the judgment of the authorities who
reject it, although he does not admit the grounds of their decision.
Gruner’s principal, indeed I may say his sole, argument against the
authenticity of this work is founded on the nature of the substances
recommended by the author for the treatment of ulcers; namely, such
acrid and (as Gruner chooses to call them) _absurd_ medicines as
arsenic, black hellebore, and cantharides. But how does it appear that
these are “absurd” applications to ulcers, when even at the present
day the two strongest of them, namely, arsenic and cantharides, are
the means often resorted to for the cure of indolent and malignant
ulcers? The same articles are recommended by Celsus (v.), and by Paulus
Ægineta.[180] It is true that the titles given to certain of the
prescriptions contained in this treatise are not appropriate, such as
_emollient_ (μαλθακώδεα), applied to applications which contain
many acrid ingredients. But in this case, as is remarked by Foës, we
should consider the text to be in so far corrupt, for certainly this
does not constitute a legitimate reason for rejecting the treatise
_in toto_.
Vidus Vidius, in his interesting commentary on this work, mentions,
as a proof of its authenticity, that most of the principles laid down
by Galen for the treatment of ulcers, are taken from this part of the
works of Hippocrates. In a word, agreeably to the rules laid down by me
for testing the authenticity of these treatises, I do not see that I am
warranted in refusing to admit the claims of this work to be considered
genuine. I hold myself bound, therefore, to give a translation of it.
It may be proper in this place to mention that the term ulcer (ἕλκος)
is used in this treatise to signify both a wound inflicted by an
external body, and a solution of continuity from any internal cause.
This usage of the word is sanctioned by the older poets, as, for
example, Homer (Iliad, ii., 723; Ib., xiv., 130); Pindar (Nem., viii.,
50; Pyth., iii., 84); and Bion (Adonis).
XX. Περὶ συρίγγων--_On Fistulæ_.
Though this work be acknowledged as genuine by Erotian, Dioscorides,
Celsus, Paulus Ægineta, and by Foës and Vidus Vidius, it is set down
for spurious by Haller, Gruner, and Ackerman; and even by Littré and
Greenhill its claims are not fully recognized. I can see no good
reason, however, for rejecting it, since, as I have stated, the ancient
authority in favor of it is very strong, and I can detect nothing
in the doctrines and rules of practice delivered in it which are at
variance with those laid down in the treatises which all admit to be
genuine. Ackerman, indeed, pretends that the theory of bile and phlegm,
as being the cause of disease, does not belong to Hippocrates or his
school. But this is evidently begging the question; and, moreover,
Galen, who must be admitted to be a high authority in such a case,
decidedly holds Hippocrates to be the author of the Theory of the
Humors.[181] Galen seems to say that this treatise, and the following
one on hemorrhoids, constituted one work in his time; and he does not
throw out the slightest suspicion against the genuineness of either, as
the words of Ackerman would lead one to suppose.[182]
Vidus Vidius, although he acknowledges Hippocrates as the author of
this work, holds that it had not been published by him, but had been
left in an unfinished state. The argument, however, which he uses in
proof of this opinion, is by no means convincing; he contends that the
part which relates to inflammation of the anus is quite out of place in
a work devoted to the consideration of fistulæ. But few who have much
practical acquaintance with the subject will agree with him on this
point, for it is well known that fistulæ, for the most part, originate
in inflammation and abscess about the verge of the anus.
XXI. Περὶ αἱμοῤῥοιδων--_On Piles_.
This little tract has experienced the same reception from the critics
as the preceding one, that is to say, it is acknowledged as genuine
by ErotianΠερὶ αἱμοῤῥοιδων and Galen, and by Foës and Vidus Vidius,
but is decidedly rejected as such by Mercuriali, Gruner, Grimm, and
Ackerman. I can remark nothing in it, however, which appears to me at
all inconsistent with the doctrines contained in the genuine works,
unless it be that in this tract the author appears to direct that in
operating upon hemorrhoids they should be all extirpated, whereas in
one of his Aphorisms, which is quoted by Paulus Ægineta, in his chapter
on this subject, he recommends that one should be left, as an outlet
to the superfluous blood. (vi., 79.) I do not know how this divergence
of opinion is to be explained, but, at all events, such an apparent
contradiction would not warrant us in rejecting the treatise altogether.
XXII. Περὶ ίερῆς νούσου--_On the Sacred Disease_.
This work is acknowledged as genuine by Erotian, Galen,[183] and
Cælius Aurelianus,[184] but is rejected by Lemos, Mercuriali, Haller,
Gruner, Ackerman, Kühn, and even by M. Littré, although the last of
these admits that the grounds upon which it had been refused a place
among the genuine works are very equivocal. I feel very much at a
loss what to decide with regard to it. It is unquestionably the work
of a man possessed of a highly cultivated mind, free from the popular
superstition of his age, and familiarly acquainted with comparative
anatomy, and having no contemptible knowledge of human physiology.
There is, in fact, no name, whether in ancient or modern times, to
which it might not do honor. That it is not unworthy, then, of the
great Hippocrates, all must allow, but whether or not he be the actual
author of it, there is much difficulty in determining satisfactorily.
That, in certain respects, it is very unlike his other works, must
be admitted; the talent which it displays is more of a reflective
than of a perceptive nature, which is the reverse of the common
character of Hippocrates, who, in his genuine works, evidently evinces
a disposition to trust to accurate observation rather than to acute
ratiocination. The style, too, I must admit, is more diffuse than the
true Hippocratic style generally is. All this might, no doubt, be
accounted for, upon the supposition that the work was addressed to the
general reader, and not to the professional. Other reasons might be
imagined, to account for the diversity of style and matter, but these
I shall not occupy time in discussing, as I have decided upon giving a
translation of it, so that the English reader may be enabled to judge
for himself as to its genuineness. Whether the tract in question be the
work of Hippocrates, or, as some have supposed, of his philosophical
friend Democritus,[185] there can be little or no doubt that it is a
production of that age, for it appears to me that their contemporary,
Plato, has evidently made reference to it. Thus, in that portion
of his “Timæus” which treats of the causes of diseases, he clearly
seems, in accounting for epilepsy, to have had in view the doctrines
contained in this treatise. For although he uses the term “sacred
disease,” and applies “most divine,” as an epithet to the cavities
(_ventricles_?) of the head, he still, in imitation of the author
of this work, accounts for the disease upon natural causes, that is to
say, from derangements of the pneuma and phlegm.[186]
XXIII. Περὶ φυσὠν--_On Airs_.
This treatise deserves, in many respects, to be put in the same
category as the last; that is to say, it is generally admitted by
the ancient authorities, but rejected by the modern. Thus it is
noticed as genuine by Erotian and Galen, and by Gregory Nazianzen and
Stobæus.[187] On the other hand Mercuriali, Le Clerc,[188] Haller,
Gruner, Ackerman, and Kühn reject it. M. Littré, also, in deference
to the opinion of later critics, refuses it a place in his list of
genuine works, but, at the same time, expresses himself doubtfully on
this point. Le Clerc, although, as we have stated, he inclines to the
opinion of those who reject it, does not hesitate to declare, “that
this book, upon reading it, seems to be one of the most rational and
coherent of all Hippocrates’s works.” And I in so far agree with Le
Clerc, that the contents of it are of great importance for the right
understanding of the ancient theory of medicine, whether we refer the
tract in question to Hippocrates or not. I shall now give a summary of
the doctrines contained in it, which I must say appear to me to smack
rather of the school of philosophy, than of the practical good sense
for which the author of the First and Third Epidemics, and of the
Prognostics, is so remarkable.
The author sets out with stating “that there are certain arts
which are of laborious acquisition, but are profitable to those who
practise them; of general utility to the common people, but painful to
those who exercise them. Of such a nature is the art of medicine. The
physician contemplates dreadful things (δεινὰ), comes in contact with
what are unpleasant, and reaps sorrow to himself from the afflictions
of others; but the sick are freed from the greatest evils by the art,
namely, from diseases, pains, sorrow, and death; for medicine has been
found decidedly to be a cure for all these. In the manual parts of
medicine (surgery) practice is necessary. For in all that relates to
manipulation, usage is the best teacher. But with regard to the most
obscure and difficult diseases, a judgment is to be formed rather from
opinion than art; and it is in such cases that experience differs
much from inexperience. And it is a most important consideration to
determine what is the cause of diseases, and what the beginning and
fountain-head, as it were, of the evils in the body; for if one be
acquainted with the cause of the disease, he may be able to apply the
suitable remedies to the affections of the body, judging of diseases
from their contraries: for this mode of cure is that which is most
in accordance with nature. Thus, for example, hunger is a disease;
for whatever afflicts man is called a disease. What, then, is the
cure of hunger? Whatever will allay hunger, that is to say, food,
and by it the other is to be cured. Again, drink cures thirst; and,
moreover, evacuation cures repletion, and repletion evacuation, and
rest labor, and labor rest; and, in a word, _the contraries are
the cure of contraries_. For medicine consists of addition and
subtraction--the subtraction of what is redundant, and the addition
of what is deficient. And he that does these things best, is the best
physician; and he that is most removed from this system, is the most
removed from a knowledge of the art. The manner of all diseases is the
same, but they differ in place; and hence diseases appear to have no
resemblance to one another, owing to the diversity and dissimilarity
of situations. For there is but one form (ἰδίη) of all disease, and
the cause is the same. What that is I will attempt to explain in
the following discourse. The bodies of men and of other animals are
nourished by three kinds of aliment, namely, food, drink, and airs;
and those winds in the body are called spirits, which are named airs
out of it. This it is which exercises the greatest power over the
symptoms, and it is worth while to attend to the power of it; for the
wind is a current and stream of air. When, then, much air makes a
strong current, trees are torn from their roots by the force of the
blast, and the sea is raised in billows, and ships of immense size are
tossed aloft. Such power it possesses, and yet it is invisible to the
sight, and is manifest only to the understanding. And what would there
be without it, and from what thing is it absent? and with what is it
not present? For the whole space between the earth and heaven is full
of air, and it is the cause of winter and of summer; in winter becoming
condensed and cold, and in summer mild and tranquil. The path also of
the sun, moon, and stars is through air--for air is the pabulum of
fire, and fire deprived of air could not live.... And with regard to
the sea, that it contains a portion of air is obvious to everybody.
For water-animals could not exist if they did not participate in the
air; and how could they participate in it otherwise, except by means
of the water, and by drawing in the air along with it. And the moon’s
foundation is upon it, and this it is which supports the earth,[189]
and nothing is void of it. And why the air is possessed of such power
in other things has been now stated; but in men this is the cause of
life, and of disease to those who are in ill health. And all bodies
stand so much in need of air, that whereas if deprived of everything
else, such as food and drink, a man may subsist for two, three, or more
days; if the passage of air into the body be stopped, he will perish in
a short part of a day, so necessary is air to the body. And, besides,
there is some intermission of every other operation which men perform,
for life is full of change; but this operation alone living animals
perform incessantly, sometimes inspiring, and sometimes expiring. That
all living animals, then, are closely connected with air has now been
shown. After this we must forthwith declare what infirmities probably
arise in an especial manner from this source--when it is redundant
or deficient in quantity, or when polluted with morbific miasmata it
enters the body. That diseases are the offspring of air I will show
from the most common of all diseases, I mean, fever; for this disease
accompanies all others, and most especially inflammations. This is well
illustrated by the accidents which befall the feet; for along with the
inflammation a bubo and fever speedily supervene. There are two kinds
of fever (that I may touch upon that subject); the one common to all,
which is called the plague, and the other being connected with vitiated
food in those who use it. The air, then, is the cause of both these.
A common fever (epidemic?) therefore is such, because all draw in the
same breath (pneuma).” The author afterwards attempts an explanation
of the phenomena of rigors, which, however, is not very intelligible,
and then of the febrile heat and sweats which succeed them. The latter
he compares to the condensed steam of boiling-water. He afterwards
proceeds to explain that when the blood is mixed up with vitiated air
(gases?), it occasions diseases in various parts of the body; for
example, pain in the eyes, when it fixes there; when in the ears, the
disease is seated there; when in the nose, coryza is the consequence;
and when in the chest, branchus (bronchitis?), and so forth. To the
same cause he ascribes the origin of dropsy, namely, to the prevalence
of airs, and the melting down of the flesh. He also accounts for the
formation of apoplexy, by supposing that it arises from the flesh of
the parts being filled up with gases; and in the same way he explains
the origin of epilepsy very elaborately, and most ingeniously, but
at too great length to suit my limits in this place. Altogether the
treatise is one of the most interesting pieces of medical philosophy
which has come down to us from antiquity. It shows very decidedly what
a talent for dealing with abstract ideas the ancient Greeks were endued
with.
XXIV. Περὶ τόπων τῶν κατ’ ἄνθρωπον--_On the Places in Man_.
The ancient authority in favor of this treatise is pretty strong. It is
included in Erotian’s list, is quoted by Cælius Aurelianus,[190] and
by Ruffus Ephesius,[191] and is incidentally noticed by Galen in two
places of his Glossary.[192] That it is further quoted by Athenæus, as
stated by Gruner and Ackerman, would appear to me to be a mistake.[193]
It is admitted to be genuine by Le Clerc, Schulze, Haller, Triller,
Sprengel, Zuinger, Petersen, and others. It is rejected, however, by
Lemos, Mercuriali, Duret, Reinsius, Gruner, and Ackerman. M. Littré
does not venture to assign it a place among the genuine treatises,
and yet he evidently inclines to the opinion that later critics
had rejected it on very doubtful grounds, and leaves the question
undecided. The following summary of its contents will show that it is
not destitute of valuable matter.
The author of it commences with announcing this important
physiological principle, which microscopical observations on the
development of the chick have amply confirmed: “It appears to me
that in the body there is no beginning, but that all parts are alike
beginning and end; for in a described circle no beginning is to be
found.” He goes on to remark that, in consequence of this, diseases
affect the whole body; that when seated in the dry parts of it they are
more permanent, but when in the fluid, more changeable: that one part
of the body imparts disease to the other parts, namely, the stomach to
the head, and the head to the stomach; and that if the very smallest
part of the body suffer, it will impart its suffering to the whole
frame. He afterwards enters into a lengthened anatomical description
of the parts of the body which, although quoted by Galen,[194] and
not unfavorably noticed by Gruner,[195] cannot now command much
interest. He then describes seven defluxions from the head, namely, to
the nose; to the ears; to the eyes; to the chest--producing empyema
and phthisis; to the spine--producing another species of phthisis
(_tabes dorsalis_?); to the fleshy parts--inducing dropsy; and to
the joints--occasioning ischias and kedmata (_morbus coxarius_?)
All this seems very hypothetical, and does not appear to savor of the
strict process of induction which we remark in the genuine treatises
of Hippocrates. When the disease is seated in the head, he directs
numerous and deep incisions to be made in the scalp, down to the bone.
He notices pleurisy, and its termination in empyema; the latter, he
further remarks, may originate in ruptures (_sprains_?), and in
this case, on succussion, an undulatory sound may be heard. He also
states decidedly that empyema forms in phthisical persons, and that,
in their case, too, a sound like that of water in a bladder may be
heard on succussion. The symptoms accompanying empyema are given
very graphically. He also describes the _tabes dorsalis_. He
afterwards gives the treatment of pleurisy and pneumonia, in which it
is remarkable that no mention is made of venesection, notwithstanding
that, in the work “On Regimen in Acute Diseases,” Hippocrates
recommends bleeding _ad deliquium_ in these diseases; and Galen
accounts for his silence respecting venesection in his treatment of
fevers on the supposition that he did not notice it, because he took it
for granted, as a general rule, that the operation was performed.[196]
This consideration, as much as any other, inclines me to doubt the
authenticity of this treatise. Ischiatic disease he directs to be
treated by cupping-instruments and heating medicines, administered
internally. Anasarca, in a young person, he treats by scarifications.
In the brief notice of injuries of the head here introduced, much the
same views are advocated as in the work on that subject, of which a
translation is given in this volume. The treatment of callous ulcers,
as here laid down, is deserving of great attention; “remove the
indurated parts by a septic medicine, and then produce reunion of the
parts.” Every practical surgeon must recognize this as a very sound and
important rule of practice.
The treatment of suicidal mania appears singular:--“Give the patient
a draught made from the root of mandrake, in a smaller dose than will
induce mania.” He also, in like manner, recommends mandragora in
convulsions, applied by means of fires lighted around the patient’s
bed. Pains of the head he directs to be treated by opening the veins
of the temples, or by applying the cautery to them. He then insists,
in strong terms, that, under certain circumstances, purgatives will
bind the bowels, and astringents loosen them. And he further makes
the important remark that, although the general rule of treatment be
“contraria contrariis curantur,” the opposite rule also holds good
in some cases, namely, “similia similibus curantur.” It thus appears
that the principles of _Allopathy_ and _Homœopathy_ are recognized by
the author of this treatise. In confirmation of the latter principle,
he remarks that the same substance which occasions strangury will
also sometimes cure it, and so also with cough. And further, he
acutely remarks, that warm water, which, when drunk, generally excites
vomiting, will also sometimes put a stop to it by removing its cause.
He estimates successful and unsuccessful practice according to the
rule whether the treatment was rightly planned or not; for he argues
what is done in ignorance cannot be said to be correctly done, even
if the results are favorable. The work concludes with a short passage
on the diseases of women, all of which are said to be connected with
the uterus. We find here the first mention that is anywhere made of
the globus hystericus; indeed, I do not remember to have met with
the term in any of the ancient medical works, with the exception of
the Hippocratic treatises. He recommends fetid things to be applied
to the nose, and aromatic and soothing things to the genital organs.
The process of fumigating the uterus is fully described; and likewise
suppositories and pessaries are mentioned. In the treatment of
uterine hemorrhage the rules here laid down are most important. All
heating things, diuretics, and purgatives are to be avoided; the foot
of the patient’s bed is to be raised, and astringent pessaries are
to be introduced. My own opinion of the work may now be given in a
few words. It undoubtedly contains much valuable matter which would
be no discredit to Hippocrates, nor to any of the greatest medical
authorities, whether of ancient or modern times. I desiderate in it,
however, a proper unity of design, and think I see too much of a
speculative disposition to suit with the character of the Coan sage.
That it is to be referred to the Cnidian school, as suggested by
Gruner, seems doubtful; for, as we are informed by Hippocrates himself,
the Cnidian physicians only gave the most obvious symptoms, while their
practice was very inert, consisting entirely of drastic purgatives,
whey, and milk, whereas in this work the diagnostic symptoms are more
profoundly stated then they are in most of the Hippocratic treatises,
and the practice, in many instances, is very bold and decided. The
knife, the actual cautery, the use of strong purgatives and narcotics,
are freely recommended in various diseases. Altogether, then, although
I would hesitate to ascribe the present work to Hippocrates himself,
I must admit myself inclined rather to refer it to the Coan than the
Cnidian school. I see no proper data, however, for forming a decided
opinion on this head, more especially as we are but very imperfectly
acquainted with the tenets of the Cnidian school.[197]
XXV. Περὶ τέχνης--_On Art_.