We may therefore be satisfied that, whatever may have been the particular form of the events of which we have had occasion to speak, their order of succession was a matter of destiny, and altogether beyond the reach of any individual. We may condemn the Byzantine monarchs, or applaud the Arabian khalifs--our blame and our praise must be set at their proper value. Europe was pa.s.sing from its Age of Inquiry to its Age of Faith. In such a transition the predestined underlies the voluntary. There are a.n.a.logies between the life of a nation and that of an individual, who, though he may be in one respect the maker of his own fortunes for happiness or for misery, for good or for evil, though he remains here or goes there, as his inclinations prompt, though he does this or abstains from that as he chooses, is nevertheless held fast by an inexorable fate--a fate which brought him into the world involuntarily so far as he was concerned, which presses him forward through a definite career, the stages of which are absolutely invariable--infancy, childhood, youth, maturity, old age, with all their characteristic actions and pa.s.sions, and which removes him from the scene at the appointed time, in most cases against his will. So also it is with nations; the voluntary is only the outward semblance, covering, but hardly hiding the predetermined. Over the events of life we may have control, but none whatever over the law of its progress. There is a geometry that applies to nations, an equation of their curve of advance.

That no mortal man can touch.

[Sidenote: Arabian science in its stage of sorcery.]

We have now to examine in what manner the glimmering lamp of knowledge was sustained when it was all but ready to die out. By the Arabians it was handed down to us. The grotesque forms of some of those who took charge of it are not without interest. They exhibit a strange mixture of the Neo-platonist, the Pantheist, the Mohammedan, the Christian. In such untoward times, it was perhaps needful that the strongest pa.s.sions of men should be excited and science stimulated by inquiries for methods of turning lead into gold, or of prolonging life indefinitely. We have now to deal with the philosopher's stone, the elixir vitae, the powder of projection, magical mirrors, perpetual lamps, the trans.m.u.tation of metals. In smoky caverns under ground, where the great work is stealthily carried on, the alchemist and his familiar are busy with their alembics, cucurbites, and pelicans, maintaining their fires for so many years that salamanders are a.s.serted to be born in them.

Experimental science was thus restored, though under a very strange aspect, by the Arabians. Already it displayed its connexion with medicine--a connexion derived from the influence of the Nestorians and the Jews. It is necessary for us to consider briefly the relations of each, and of the Nestorians first.

[Sidenote: The Nestorians.]

[Sidenote: They deny the virginity of the queen of heaven.]

[Sidenote: They begin to cultivate medicine.]

[Sidenote: The Arabs affiliate with them.]

In Chapter IX. we have related the rivalries of Cyril, the Bishop of Alexandria, and Nestorius, the Bishop of Constantinople. The theological point of their quarrel was whether it is right to regard the Virgin Mary as the mother of G.o.d. To an Egyptian still tainted with ancient superst.i.tion, there was nothing shocking in such a doctrine. His was the country of Isis. St. Cyril, who is to be looked upon as a mere ecclesiastical demagogue, found his purposes answered by adopting it without any scruple. But in Greece there still remained traces of the old philosophy. A recollection of the ideas of Plato had not altogether died out. There were some by whom it was not possible for the Egyptian doctrine to be received. Such, perhaps, was Nestorius, whose sincerity was finally approved by an endurance of persecutions, by his sufferings, and his death. He and his followers, insisting on the plain inference of the last verse of the first chapter of St. Matthew, together with the fifty-fifth and fifty-sixth verses of the thirteenth of the same Gospel, could never be brought to an acknowledgment of the perpetual virginity of the new queen of heaven. We have described the issue of the Council of Ephesus: the Egyptian faction gained the victory, the aid of court females being called in, and Nestorius, being deposed from his office, was driven, with his friends into exile. The philosophical tendency of the vanquished was soon indicated by their actions. While their leader was tormented in an African oasis, many of them emigrated to the Euphrates, and founded the Chaldaean Church. Under its auspices the college at Edessa, with several connected schools, arose. In these were translated into Syriac many Greek and Latin works, as those of Aristotle and Pliny. It was the Nestorians who, in connexion with the Jews, founded the medical college of Djondesabour, and first inst.i.tuted a system of academical honours which has descended to our times. It was the Nestorians who were not only permitted by the khalifs the free exercise of their religion, but even intrusted with the education of the children of the great Mohammedan families, a liberality in striking contrast to the fanaticism of Europe. The Khalif Alraschid went so far as even to place all his public schools under the superintendence of John Masue, one of that sect. Under the auspices of these learned men the Arabian academies were furnished with translations of Greek authors, and vast libraries were collected in Asia.

[Sidenote: Their great spread in the East,]

Through this connexion with the Arabs, Nestorian missionaries found means to disseminate their form of Christianity all over Asia, as far as Malabar and China. The successful intrigues of the Egyptian politicians at Ephesus had no influence in those remote countries, the Asiatic churches of the Nestorian and Jacobite persuasions outnumbering eventually all the European Christians of the Greek and Roman churches combined. In later times the papal government has made great exertions to bring about an understanding with them, but in vain.

[Sidenote: and persecutions in the West.]

The expulsion of this party from Constantinople was accomplished by the same persons and policy concerned in destroying philosophy in Alexandria. St. Cyril was the representative of an illiterate and unscrupulous faction that had come into the possession of power through intrigues with the females of the imperial court, and bribery of eunuchs and parasites. The same spirit that had murdered Hypatia tormented Nestorius to death. Of the contending parties, one was respectable and had a tincture of learning, the other ignorant, and not hesitating at the employment of brute force, deportation, a.s.sa.s.sination. Unfortunately for the world, the unscrupulous party carried the day.

[Sidenote: They inherit the old Greek medicine.]

By their descent, the Nestorians had become the depositaries of the old Greek medical science. Its great names they revered. They collected, with the utmost a.s.siduity, whatever works remained on medical topics, whether of a Greek or Alexandrian origin, from the writings of Hippocrates, called, with affectionate veneration by his successors, "The Divine Old Man," down to those of the Ptolemaic school.

[Sidenote: Origin of Greek medicine--Asclepions.]

[Sidenote: Hippocrates destroys the theological theory of disease.]

Greek medicine arose in the temples of aesculapius, whither the sick were in the habit of resorting for the a.s.sistance of the G.o.d. It does not appear that any fee was exacted for the celestial advice; but the grat.i.tude of the patient was frequently displayed by optional gifts, and votive tablets presented to the temple, setting forth the circ.u.mstances of the case, were of value to those disposed to enter on medical studies. The Asclepions thus became both hospitals and schools. They exercised, from their position, a tendency to incorporate medical and ecclesiastical pursuits. At this time it was universally believed that every sickness was due to the anger of some offended G.o.d, and especially was this supposed to be the case in epidemics and plagues. Such a paralyzing notion was necessarily inconsistent with any attempt at the relief of communities by the exercise of sanitary measures. In our times it is still difficult to remove from the minds of the illiterate cla.s.ses this ancient opinion, or to convince them that under such visitations we ought to help ourselves, and not expect relief by penance and supplications, unless we join therewith rigorous personal, domestic, munic.i.p.al cleanliness, fresh air, and light. The theological doctrine of the nature of disease indicated its means of cure. For Hippocrates was reserved the great glory of destroying them both, replacing them by more practical and material ideas, and, from the votive tablets, traditions, and other sources, together with his own admirable observations, compiling a body of medicine. The necessary consequence of his great success was the separation of the pursuits of the physician from those of the priest. Not that so great a revolution, implying the diversion of profitable gains from the ancient channel, could have been accomplished without a struggle. We should reverence the memory of Hippocrates for the complete manner in which he effected that object.

[Sidenote: Writings of Hippocrates.]

Of the works attributed to Hippocrates, many are doubtless the production of his family, his descendants, or his pupils. The inducements to literary forgery in the times of the Ptolemies, who paid very high prices for books of reputation, have been the cause of much difficulty among critics in determining such questions of authorship.

The works indisputably written by Hippocrates display an extent of knowledge answering to the authority of his name; his vivid descriptions have never been excelled, if indeed they have ever been equalled. The Hippocratic face of the dying is still retained in our medical treatises in the original terms, without any improvement.

[Sidenote: His opinions.]

In his medical doctrine, Hippocrates starts with the postulate that the body is composed of the four elements. From these are formed the four cardinal humours. He thinks that the humours are liable to undergo change; that health consists in their right const.i.tution and proper adjustment as to quant.i.ty; disease, in their impurities and inequalities; that the disordered humours undergo spontaneous changes or coction, a process requiring time, and hence the explanation of critical days and critical discharges. The primitive disturbance of the humours he attributed to a great variety of causes, chiefly to the influence of physical circ.u.mstances, such as heat, cold, air, water. Unlike his contemporaries, he did not impute all the afflictions of man to the anger of the G.o.ds. Along with those influences of an external kind, he studied the special peculiarities of the human system, how it is modified by climate and manner of life, exhibiting different predispositions at different seasons of the year. He believed that the innate heat of the body varies with the period of life, being greatest in infancy and least in old age, and that hence morbific agents affect us with greater or less facility at different times. For this reason it is that the physician should attend very closely to the condition of those in whom he is interested as respects their diet and exercise, for thereby he is able not only to regulate their general susceptibility, but also to exert a control over the course of their diseases.

Referring diseases in general to the condition or distribution of the humours, for he regards inflammation as the pa.s.sing of blood into parts not previously containing it, he considers that so long as those liquids occupy the system in an unnatural or adulterated state, disease continues; but as they ferment or undergo coction, various characteristic symptoms appear, and, when their elaboration is completed, they are discharged by perspiration or other secretions, by alvine dejections, etc. But where such a general relief of the system is not accomplished, the peccant humours may be localized in some particular organ or special portion, and erysipelatous inflammation, mortification, or other such manifestations ensue. It is in aiding this elimination from the system that the physician may signally manifest his skill. His power is displayed much more at this epoch than by the control he can exert over the process of coction. Now may he invoke the virtues of the h.e.l.lebores, the white and the black, now may he use elaterium. The critical days which answer to the periods of the process of coction are to be watched with anxiety, and the correspondence of the state of the patient with the expected condition which he ought to show at those epochs ascertained. Hence the physician may be able to predict the probable course of the disease during the remainder of its career, and gather true notions as to the practice it would be best for him to pursue to aid Nature in her operations.

[Sidenote: The character of his practice.]

It thus appears that the practice of medicine in the hands of Hippocrates had reference rather to the course or career of disease than to its special nature. Nothing more than this masterly conception is wanted to impress us with his surprizing scientific power. He watches the manner in which the humours are undergoing their fermenting coction, the phenomena displayed in the critical days, the aspect and nature of the critical discharges. He does not attempt to check the process going on, but simply to a.s.sist the natural operation.

When we consider the period at which Hippocrates lived, B.C. 400, and the circ.u.mstances under which he had studied medicine, we cannot fail to admire the very great advance he made. His merit is conspicuous in rejecting the superst.i.tious tendency of his times by teaching his disciples to impute a proper agency to physical causes. He altogether discarded the imaginary influences then in vogue. For the G.o.ds he subst.i.tuted, with singular felicity, Impersonal Nature. It was the interest of those who were connected with the temples of aesculapius to refer all the diseases of men to supernatural agency; their doctrine being that every affliction should be attributed to the anger of some offended G.o.d, and restoration to health most certainly procured by conciliating his power. So far, then, as such interests were concerned, any contradiction of those doctrines, any subst.i.tution of the material for the supernatural, must needs have met with reprehension. Yet such opposition seems in no respect to have weighed with this great physician, who developed his theory and pursued his practice without giving himself any concern in that respect. He bequeathed an example to all who succeeded him in his n.o.ble profession, and taught them not to hesitate in encountering the prejudices and pa.s.sions of the present for the sake of the truth, and to trust for their reward in the just appreciation of a future age.

[Sidenote: His doctrine is truly scientific.]

With such remarks we may a.s.sert that the medical philosophy of Hippocrates is worthy of our highest admiration, since it exhibits the scientific conditions of deduction and induction. The theory itself is compact and clear; its lineaments are completely Grecian. It presents, to one who will contemplate it with due allowance for its times, the characteristic quick-sightedness, penetration, and power of the Greek mind, fully vindicating for its author the t.i.tle which has been conferred upon him by his European successors--the Father of Medicine--and perhaps inducing us to excuse the enthusiastic a.s.sertion of Galen, that we ought to reverence the words of Hippocrates as the voice of G.o.d.

[Sidenote: The school of Cnidos.]

[Sidenote: Is destroyed by Constantine.]

[Sidenote: Cla.s.ses of physicians.]

The Hippocratic school of Cos found a rival in the school of Cnidos, which offered not only a different view of the nature of disease, but also taught a different principle for its cure. The Cnidians paid more particular attention to the special symptoms in individual cases, and pursued a less active treatment, declining, whenever they could, a resort to drastic purgatives, venesection, or other energetic means. As might be expected, the professional activity of these schools called into existence many able men, and produced many excellent works: thus Philiston wrote on the regimen for persons in health; Diocles on hygiene and gymnastics; Praxagoras on the pulse, showing that it is a measure of the force of disease. The Asclepion of Cnidos continued until the time of Constantine, when it was destroyed along with many other pagan establishments. The union between the priesthood and the profession was gradually becoming less and less close; and, as the latter thus separated itself, divisions or departments arose in it, both as regards subjects, such as pharmacy, surgery, etc., and also as respects the position of its cultivators, some pursuing it as a liberal science, and some as a mere industrial occupation. In those times, as in our own, many who were not favoured with the gifts of fortune were constrained to fall into the latter ranks. Thus Aristotle, than whom few have ever exerted a greater intellectual influence upon humanity, after spending his patrimony in liberal pursuits, kept an apothecary's shop at Athens.

Aristotle the druggist, behind his counter, selling medicines to chance customers, is Aristotle the great writer, whose dictum was final with the schoolmen of the Middle Ages. As a general thing, however, the medical professors were drawn from the philosophical cla.s.s. Outside of these divisions, and though in all ages continually repudiated by the profession, yet continually hovering round it, was a host of impostors and quacks, as there will always be so long as there are weak-minded and shallow men to be deluded, and vain and silly women to believe.

[Sidenote: Egyptian medicine. The Museum.]

[Sidenote: Philadelphus founds medicine on anatomy.]

[Sidenote: He authorizes dissection and human vivisection.]

[Sidenote: Physicians of the Alexandrian school.]

When the Alexandrian Museum was originated by Ptolemy Philadelphus, its studies were arranged in four faculties--literature, mathematics, astronomy, medicine. These divisions are, however, to be understood comprehensively: thus, under the faculty of medicine were included such subjects as natural history. The physicians who received the first appointments were Cleombrotus, Herophilus, and Erasistratus; among the subordinate professors was Philo-Stepha.n.u.s, who had charge of natural history, and was directed to write a book on Fishes. The elevated ideas of the founder cannot be better ill.u.s.trated than by the manner in which he organized his medical school. It was upon the sure basis of anatomy.

Herophilus and his colleagues were authorized to resort to the dissection of the dead, and to ascertain, by that only trustworthy method, the true structure of the human body. The strong hand of Ptolemy resolutely carried out his design, though in a country where popular sentiment was strongly opposed to such practices. To touch a corpse in Egypt was an abomination. Nor was it only this great man's intention to ascertain the human structure; he also took measures to discover the mode in which its functions are carried forward, the manner in which it works. To this end he authorized his anatomists to make vivisections both of animals, and also of criminals who had been condemned to death, herein finding for himself that royal road in physiology which Euclid once told him, at a dinner in the Museum, did not exist in geometry, and defending the act from moral criticism by the plea that, as the culprits had already forfeited their lives to the law, it was no injury to make them serviceable to the interests of humanity. Herophilus had been educated at Cos; his pathological views were those known as humouralism; his treatment active, after the manner of Hippocrates, upon whose works he wrote commentaries. His original investigations were numerous; they were embodied, with his peculiar views, in treatises on the practice of medicine; on obstetrics; on the eye; on the pulse, which he properly referred to contractions of the heart. He was aware of the existence of the lacteals, and their anatomical relation to the mesenteric glands.

Erasistratus, his colleague, was a pupil of Theophrastus and Chrysippus: he, too, cultivated anatomy. He described the structure of the heart, its connexions with the arteries and veins, but fell into the mistake that the former vessels were for the conveyance of air, the latter for that of blood. He knew that there are two kinds of nerves, those of motion and those of sensation. He referred all fevers to inflammatory states, and in his practice differed from the received methods of Hippocrates by observing a less active treatment.

[Sidenote: Improvements in surgery and pharmacy.]

By these physicians the study of medicine in Alexandria was laid upon the solid foundation of anatomy. Besides them there were many other instructors in specialties; and, indeed, the temple of Serapis was used for a hospital, the sick being received into it, and persons studying medicine admitted for the purpose of familiarizing themselves with the appearance of disease, precisely as in similar inst.i.tutions at the present time. Of course, under such circ.u.mstances, the departments of surgery and pharmacy received many improvements, and produced many able men. Among these improvements may be mentioned new operations, for lithotomy, instruments for crushing calculi, for reducing dislocations, etc. The active commerce of Egypt afforded abundant opportunity for extending the materia medica by the introduction of a great many herbs and drugs.

[Sidenote: Decline of Alexandrian medicine.]

The medical school of Alexandria, which was thus originally based upon dissection, in the course of time lost much of its scientific spirit.

But the influence of the first teachers may be traced through many subsequent ages. Thus Galen divides the profession in his time into Herophilians and Erasistratians. Various sects had arisen in the course of events, as the Dogmatists, who a.s.serted that diseases can only be treated correctly by the aid of a knowledge of the structure and functions, the action of drugs, and the changes induced in the affected parts; they insisted, therefore, upon the necessity of anatomy, physiology, therapeutics, and pathology. They claimed a descent from Hippocrates. Their antagonists, the Empirics, ridiculed such knowledge as fanciful or unattainable, and relied on experience alone. These subdivisions were not limited to sects; they may also be observed under the form of schools. Even Erasistratus himself, toward the close of his life, through some dispute or misunderstanding, appears to have left the Museum and established a school at Smyrna. The study of the various branches of medicine was also pursued by others out of the immediate ranks of the profession. Mithridates, king of Pontus, thus devoted himself to the examination of poisons and the discovery of antidotes.

What a fall from this scientific medicine to the miracle-cure which soon displaced it! What a descent from Hippocrates and the great Alexandrian physicians to the shrines of saints and the monks!

[Sidenote: The Jewish physicians.]

To the foregoing sketch of the state of Greek medicine in its day of glory, I must add an examination of the same science among the Jews subsequently to the second century; it is necessary for the proper understanding of the origin of Saracen learning.

[Sidenote: Their emanc.i.p.ation from the supernatural.]