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THE INTRODUCTORY TREATISES OF GALEN. - Hippocrates, The Writings of Hippocrates and Galen [1846]Edition used:The Writings of Hippocrates and Galen. Epitomised from the Original Latin translations, by John Redman Coxe (Philadelphia: Lindsay and Blakiston, 1846).
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THE INTRODUCTORY TREATISES OF GALEN.Under the above distinctive title, we have sixteen books or treatises of an introductory character; but which, in interest, are scarcely surpassed by any of those that are to be found in the succeeding divisions. We give, in a connected view, the respective title of each one.
I.ORATIO SUASORIA AD ARTES.an oration in favour of the arts and sciences. (eight chapters.) In this first book of the introductory division of the works of Galen, we have a topic of much interest presented for consideration. Galen sets off by showing that man alone, of all the animal creation, is endowed with reason, by which he is qualified for the pursuit of every art and science;a that consequently, the improvement of the mind is of infinitely more importance than that of the body, or than an increase of wealth; and therefore that it is disgraceful to neglect those sciences for the mere pursuit of gain. This leads him naturally to a description of Fortune, whose inconstancy is pointed out, and exemplified by several conspicuous and familiar instances; such as Crœsus, Priam, Dionysius, Cæsar, and others; and he deduces from various circumstances, the superiority of striving to improve in the beneficial arts, to that of toiling in the mere pursuit of riches; strengthening his remarks by quoting the opinions of Diogenes and Demosthenes and others on the subject. He furthermore points out the folly of those who lay great stress on their nobility, aiding his own, by the remarks of Themistocles and Anacharsis.—Even the elegance of the body, and of furniture and dress, &c., is considered by him of little importance, unless it be at the same time united with a well-adorned mind.b He cautions all to whom his remarks apply, by no means to misapprehend him when he speaks of study or of the arts; none of which are of importance, unless they benefit society; and he supports his views, by giving some details and particulars relative to the care bestowed in the gymnastic trainings of the athletæ, in preparing for their duties of merely a corporeal character. He considers the nature of the arts as being twofold; the one is noble, from its connexion with the gifts of the mind; the other is ignoble or inferior, being dependent on corporeal labour alone; the first receives the name of liberal; the other is called mechanical. Then, as might be anticipated, he places medicine at the head of the first division, from its being superior to every other mental pursuit that classes such among the liberal arts. II.SI QUIS OPTIMUS MEDICUS EST, EUNDEM ESSE PHILOSOPHUS.a good physician must also be a philosopher. In this book Galen endeavours to prove that, which the title amply implies, viz., how greatly the medical man is improved by an intercommunion with learned men, and by a knowledge of philosophy; and it is of further interest, by the insight it affords of much of the philosophy of that period. III.DE SOPHISMATIS IN VERBO CONTINGENTIBUS.of verbal sophistry. (four chapters.) Here, he takes notice of the sophisms in conversation, giving various examples of them. It is an ingenious and amusing treatise, but is not very particularly connected with medicine. It serves to demonstrate, nevertheless, the magnitude of a mind, which seems to have embraced the whole circle of science as then pursued, both at Rome, and elsewhere. IV.QUOD QUALITATES INCORPOREÆ SINT.whether the qualities of bodies are incorporeal. (nine chapters.) In this metaphysical tract, the question is considered as to the propriety of the Stoics, in denominating the qualities and other accidents of bodies corporeal. Galen denies it, and gives a definition of a body. V.DE LIBRIS PROPRIIS GALENI.of the appropriate writings of galen. (eighteen chapters.) This book is of importance, inasmuch as it enables us, (at least to a certain extent,) to establish the writings that are his, and to point out those that are erroneously ascribed to him. A preface explains the circumstance leading to his writing it. He then proceeds to mention the works he had written on his first arrival at Rome;—next, those that were written by him and given afterwards to his friends, when he left that city. He then speaks of his anatomical writings, and adverts to twenty books on anatomy by Marinus, which he had epitomized. After this, he mentions his books on Diagnostics, Therapeutics, and Prognostics; his commentaries on Hippocrates, on Erasistratus, Asclepiades, the Empirics, and the Methodists; and of those that pertain to demonstration, or which are proper and common in the arts. Lastly, he notices such of his works as belong to Moral Philosophy, to the Platonic, Aristotelian, Stoic, and Epicurean systems; and of those that were common to grammar and rhetoric. VI.DE ORDINE LIBRORUM SUORUM.of the order in which his writings are to be placed. The title sufficiently explains the purport of this book. VII.DE SECTIS.of different sects in medicine. This book gives an interesting account, and one, probably, more accurate than is elsewhere to be found, of the different sects in medicine. From this, every writer on the subject, from the days of Galen to the present period, seems deeply to have quaffed, either directly, or as copyists, without any, or but trifling acknowledgment. No one, whilst reading the lofty pretensions and explanations of hypotheses assumed to be of modern origin; or in hearing the same detailed in learned lucubrations, ex cathedra, would suppose that the subject had ever, previously, received the slightest elucidation! Happily for these conceited and oracular exponents, Galen preceded them by ten or more centuries; and from his extensive hives, those drones have stolen the honey, if any is to be found in their asserted claims. It is but just to pay our homage in return, and rendering to Cæsar the things that are his, confess his superiority with a “detur dignissimo.” This book embodies much matter that is of a character peculiarly interesting to those who may desire to explore the discrepancies of former sectarians, and to investigate by what means the same remedies were alike employed in the practice of them all, although it was founded on principles so different! Notice has also been taken as to what has, by turns, received the opposition of them all. The Methodists receive a due share of attention, both as to their defence, and to the attacks made upon them by the Empirics and Rationalists. VIII.GALENI, DE OPTIMA SECTA.of the best sect. This is an important and interesting book, consisting of no less than fifty-one chapters, in which the pretensions of the different sects in medicine are duly canvassed. Galen sets off with the proposition that every medical precept, and every general precept, should be founded in truth as its primary recommendation; then, that it should be useful, and lastly, conformable to established principles. By these alone can a sound precept be properly judged of, and that, if deficient in either, it should not be tolerated. The whole of this book seems to base its remarks on these propositions, and an infinite variety of highly valuable matter is spread over the whole treatise. He adverts to the difficulties that spring up in considering and judging of precepts assumed from mere appearances, or which are assumed from the authority of others as having been previously demonstrated. He points to the cautions essential in such investigations, and strengthens his views by numerous cases, either actual or supposititious. By these propositions he enters into his inquiry as to the character, &c., of the three principal sects, viz., the Rationalist, the Empiric, and the Methodic; by which his judgment may be enlightened as to his selection of the best. This he fully does, and points out their respective advantages or defects, their discrepancies, and the imperfection of many of their remarks. In short, it is a valuable criticism, which may be very advantageously consulted by every medical man, who desires sincerely to arrive at truth in his researches, and not be led away by the empty and frivolous hypotheses that swell the publications and lectures of the last fifty years. IX.DE OPTIMO DOCENDI GENERE.of the best mode of education. This book is of a general character in respect to education, and is deserving attention, if merely as affording the views of a man most deeply impressed with, and who appears to have thought much, upon the subject. X.DE SUBFIGURATIONE EMPIRICA.an exposition of the empiric sect. This may be regarded as a compendious history of the sect of the Empirics. As to their origin, they themselves derive it from Hippocrates; but Galen considers them as springing from the Sceptics of the more ancient philosophers. The foundation of their art is said to be that of experience. What that consists of is considered, and an explanation given of some terms connected with it: such as αυτοψια, εμπειρια, &c. Galen adverts to the division made of the art by some of them, into two parts; by others into three, and four, and even five parts. Herophilus’s definition of medicine is stated, and the difference is pointed out between Empiricism and Dogmatism. The whole book is replete with interest, at least to those who desire to investigate the origin and diversity of the various doctrines of those distant times. XI.SERMO ADVERSUS EMPIRICOS MEDICOS.In the Venice edition of Galen’s works is a short essay which does not appear in the Basil edition of Frobinius, entitled “A Discourse delivered in opposition to the Empiric Physicians.” It is of little or no importance, and why introduced at all would be difficult to say, especially in this part of Galen’s works;—for, even in the Venice edition, it is called “Fragmentum quoddam exiguum et mendosum.” Its title gives its intent. XII.DE CONSTITUTIONE ARTIS MEDICÆ.of the art of medicine. A considerable number of Galen’s writings appear as letters, if we may so express it, addressed to different individuals, probably his disciples; and, at times, apparently under fictitious names: thus the present book is addressed in its prefatory remarks, to Patrophilus, which may, or may not be a real one. By some, the book has been divided into two parts, the first, consisting of remarks on such particulars as lead to a knowledge of bodies, either simple or compound. The second, of a notice of remedies, or those instruments of pharmacy and of aliment, in any way employed by the physician. Galen commences by assigning his reasons for writing the book, and strongly exhorts to the pursuit of useful arts, declaiming at the same time against the ignorance of the age and of its increase. He points out the arts as being of a fourfold character: 1. Contemplative; 2. Practical, or Active; 3. Effective, poetically; that is, in creating that which had no previous existence, or in correcting that which did exist. Of this description he affirms medicine to be. Lastly; 4. Acquisitive, or Accumulative, as in the various arts of hunting, fishing, &c. He then proceeds to a more particular consideration of medicine as a factitious art, and explains how it is so; its parts, and actions;—states the essence of each part to consist in its conformation, magnitude, number, sympathy, and use, with much other speculative, yet interesting matter, diversified with that of a medical character. He then remarks on the nature of remedies, their discovery; the mode of attainment of the nature of diseases, and of the part affected, especially if internal; speaks of their causes, symptoms, variety, prognosis, and divination, &c; of the selection of remedies, prevention of disease, and of convalescence. XIII.FINITIONES MEDICÆ.medical definitions. This is useful by directing attention to the importance of definitions. It adverts to physicians, anterior to the time of Hippocrates, as having written but little, and defined nothing. Hippocrates was the first to collect these scattered fragments, and add to them his own. Many after him pursued the same plan, though without any kind of order, but merely spread at random through their works, such as Herophilus, Apollonius, and others. We are now presented with a definition, of what a definition is;—then follow, definitions of a science, art, sect, medicine,—and its respective sects, &c. Man is defined, his elements, organs, humours, nature, age, respiration, sanguification, pulse, motion, senses, health, and sickness. To this, succeed that of fever and its varieties, and that of various other diseases, as of the head and other parts. He speaks of medicine as being divided into two parts, contemplative and active, that is into theory and practice. The affections of the uterus, its discharges; the hair and its diseases, of which nine varieties are enumerated, one, under the title of rhopalosis, (i. e. “velut in baculos coagmentatio,”) appears to me to be the plica, or nearly allied to it. Fractures of the skull follow; diseases of the eyes and other organs of sense; the semen and its formation,—in which is agitated the question of the female seed;—that of the fœtus, and its nourishment;—and also of monsters; of seven and eight month children, and of uterine polypi, whose excision is recommended when large. Hemorrhage;—surgery and its parts, are noticed. This book, is in fact, in many respects a very useful one; it enables us, in case of difficulty, to look into the original meaning of words; and if not practically important, it is interesting throughout, if only on this score; a good translation of it might be useful, under this consideration. XIV.INTRODUCTIO VEL MEDICUS.introduction to medicine, or the physician. This book has by some been ascribed to Herodotus, and this seems the opinion of the editor of the Junta edition. In either case, it is of great antiquity, and tends to fix the doctrines of the times. The Venice edition divides this book into nineteen chapters; that of Frobinius, into thirty. Why so, is not explained, nor is it probably of any consequence.a The whole is of sufficient interest to command attention, whoever be its author. A preface to it adverts to the manner in which medicine was discovered, and a detail is given of many of the nursery tales, and original fables on this point. Esculapius is reputed as its inventor; and the Asclepiades, (his successors,) especially Hippocrates, are mentioned as having first taught the principles of rational medicine. The author proceeds next to treat of the principles of medicine, which he regards as threefold, viz., inventive, constitutive, and traditionary or interpretative. He next mentions the three principal sects, viz., the Logicians or Rationalists, the Empirics, and Methodists, with remarks on each of them, and some account of their respective leaders. Of the Rational sect, he considers Hippocrates to be the author and the chief; then Diocles, Praxagoras, Herophilus, Calcedonius, Erasistratus, Mnesitheus, Asclepiades, and Prusias. Of the Empirics, Philinus stands foremost, as being the first who separated from the former; then Serapion, the two Apollonii, father and son; Antiochenes, Menodotus, and Sextus. Of the Methodists, Themison led the way, quitting the phalanx of the Rationalists, and followed by Thessalus, Mnaseas, Dionysius, Proclus, and Antipater. Some differed from all the preceding, and by their seceding from them gave rise to various minor sects, as the Synthetic, Eclectic, &c. An inquiry is then entered into, whether medicine is an art; and the opinions of the different sects, on the subject, are pointed out. Next we are presented with an enumeration of the parts or divisions, and the definition of medicine. Its division is into five parts, viz.: 1. The contemplation or consideration of natural things, constituting physiology. 2. A consideration of the affections, and of a knowledge of their causes, giving rise to pathology and ætiology. 3. The rationale of preserving health, or hygiene. 4. Of the observance of signs or symptoms, or semeiotics. 5. Of the mode of cure, or therapeutics. After some remarks on each of these in particular, the author considers the propriety, or necessity, of this quintuple division; then takes a view concisely of the human elements, as laid down by Hippocrates and other philosophers; some of whom enumerate four, viz., fire, air, earth, and water. Some reckon only three, a humid, dry, and aerial element, (answering to the continentia, contenta, and impetum facientia, of later writers;) the first consisting of the solids, as bones, nerves, arteries, veins, &c. The second are the fluids, that are conveyed by vessels to every part of the body. The third consist of spirits, considered by the ancients as twofold, animal and natural. Erasistratus considered three species of vessels, arteries, veins, and nerves, (omitting humours and spirits,) as the beginning, and the elements of the whole body: and Athenæus maintained, that fire, air, water, and earth, were not themselves the four primary elements; but he had great respect to their qualities, of hot, cold, dry, and moist. These and many other views of ancient philosophy respecting the elements, are noticed by Galen, which need not be here mentioned. This part is succeeded by the names of the external parts of the body, their division and etymologies; the internal parts and etymologies in like manner; and here we find various parts called by names altogether different from those to which those names are now applied. Thus stomachus, implied the œsophagus, and not the organ of digestion, as now. An enumeration of others is here unnecessary, but it is pretty fully detailed by Galen. The fluids are next adverted to, and some functions and diseases. Six species of intermittents are mentioned. Diseases are divided into febrile and non-febrile, acute and chronic; and their mode of treatment is concisely noticed. Then, a concise description of acute diseases and their treatment is given; next, of the chronic in like manner. Remedial measures are then referred to, as being internal or external. The internal are divided under twelve genera, deduced either from the affection itself or from the seat of the disease. The external are placed under eleven divisions. All this is followed up by a long chapter on the diseases of the eyes; these, by a notice of various cutaneous affections; and the remainder of the book embraces surgery and its various indications, &c., fractures, luxations, &c. This book, though replete with matter, is however very concise; and is yet deserving of attention. XV.QUOMODO MORBUM SIMULANTES SINT DEPREHENDENDI.how to detect the simulation of diseases. This is called a libellus; but is not shorter than many, dignified by the title of Liber. It would seem that in former times, the march of intellect was fully competent as at present, to direct the mind to evil; and it would admit of much reflection, before a just estimate could be drawn as to the comparative superiority of vice or virtue of that distant period, over that of present times. In this production, Galen acquaints us with the simulation of diseases, and points out the means of detection. Tumours, inflammation, spitting of blood, extreme pain and delirium, &c., all become tributary to fraudulent intentions. A case is given of feigned colic; another of a swelled knee, excited by artificial means, in a servant desirous of avoiding out-of-door work. Some instruction may be derived from this treatise, at this period. XVI.ARS MEDICINALIS.of the art of medicine. This book is divided into one hundred chapters, containing much interesting and important matter, although of infinite diversity. Some prefatory remarks are made on the triple doctrines, or modes of inquiry, as to what medicine is, &c., and replies are given to such inquiries. It is said to be the knowledge of that art or science, that teaches what is healthy, what induces disease, and of the causes and accompanying symptoms. The body is said to be the recipient; causes act and operate upon it; symptoms indicate, both the state of health, and of disease. All this is more particularly noticed under each respective head, of the healthy, unhealthy, and negative or neutral state; of healthy and unhealthy symptoms, and, of such as indicate the highest health. The difference of parts, is then considered, either as original, or derivative; thus, the brain, the heart, liver, testes, are regarded as original; whilst the nerves and spinal marrow are derived from the brain; arteries from the heart, veins from the liver, and the seminal vessels from the testes, &c., and from these, as from a centre, what respectively concerns each, is treated of; as of the signs connected with the brain, arising from its magnitude, &c., of reason, memory, and the various senses, and their organs. So of the heart and other parts, their different signs or symptoms, indicating approaching or actual disease; the various modes, or modified changes of the system; solution of continuity; most usual curative indications; obstruction as productive of disease, either in number, location, or in force, &c., and with this, the Libri Isagogici terminate. [a ]Brutes, however, he concedes that they possess somewhat of the like in common with us, some in a greater, others in a less degree—but all, with few exceptions, are deficient in art; and what these enact, man imitates—as spiders, bees, &c. From these and other enumerated causes, although reason is not wanting to other animals, yet man alone, as superior to them, is said to be endowed with it. [b ]Here he inserts a story of Diogenes, who received an invitation to dine with one whose house was splendidly furnished, in the highest order and taste, and nothing therein wanting. Diogenes, hawking, and as if about to spit, looked in all directions, and finding nothing adapted thereto, spat right in the face of the master. He, indignant, asked why he did so? Because (said D.) I saw nothing so dirty and filthy in all your house. For the walls were covered with pictures, the floors of the most precious tessellated character;—and ranged with the various images of gods, and other ornamental figures. Now (adds Galen), since we are connected with the gods by the use of reason, so are we with brutes, inasmuch as we are mortal; it is therefore more expedient to attend to the mind and its improvement, than to the body and its appendages, &c., by which we are on a par with the brutes alone. [a ]Such variations in the divisions are very frequent in the two editions. |

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