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tention and disputation. When the principles of a science rest upon firm bases, there can be no sects or parties among those who cultivate it. Occasional error may have crept into mathematical science; but there are no sects of mathematicians. In physic, on the other hand, doctrines have been fluctuating in every age ; there have been as many sects as schools; and at this moment there are almost as many opinions as practitioners.
Medicine is both popular and scientific. Popular medicine is practiced in a certain degree by the whole body of the people, even by the rudest in the village. Hence it becomes contaminated by the errors, prejudices, and superstitions of the people; which must extend, in a greater or less degree, to every member of the community. Physicians can boast no exemption from these prejudices. A curious example of their extent and power may be found in a well-known and popular work. It is this: When, in the year 1760, the King of Spain determined, by a public decree, to free Madrid from the abominable custom of throwing the ordure out of the windows into the streets, it was ordered by a proclamation, that the proprietor of every house should build a proper receptacle, and that sinks, drains, and common sewers should be made at the public expense. "Every class," proceeds the relater, "devised some objection against it; but the physicians bid the fairest to interest the king in the preservation of the ancient privileges of his people, for they remonstrated, that if the filth was not thrown into the streets as usual, a fatal sickness would probably ensue, because the putrescent particles of the air, which such filth attracted, would then be imbibed by the human body."
The doctrines of scientific medicine descend from that small body of educated men, who give themselves up to it as a profession and the means of a livelihood. With these men it is a branch of philosophical science, and it, of course, becomes tinctured with the current philosophical opinions. From hence it lias been deformed by absurdities, that are at present hardly credible. Even so late as the days of our own James the First, we find the study of judicial astrology esteemed necessary to a physician. In an examination of a noted impostor by the London College of Physicians, we find, among other questions put to him, with the answers of the man, the following:
"Being asked in astrology what house he looketh unto to know a disease, or the event of it: and how the Lord ascendant should stand thereto:
"He answereth, he looks for the sixth house; which being disproved, he saith, he understands nothing therein but what he hath out of Caliman; and being asked what books he hath read in that art, he saith he hath none but Caliman."
Philosophy was, in its origin, founded more upon speculation than upon observation and experiment. And as the first reasoners in medicine were the philosophers, the principles that were thought to regulate the universe, were, by them, transferred to the phenomena of the human body. Hence the errors of philosophy were engrafted upon physiology.
Hippocrates is said to have separated medicine from philosophy. This can mean no more than that he was the first of the philosophers, who considered medicine to be a distinct branch of science. But the principles which he adopted to explain the causes and symptoms of diseases, were such as he had been taught, and found to be prevalent in the schools of philosophy in his time.
These principles were purely hypothetical, being, mostly, gratuitous assumptions with regard to the constituent principles of the animal frame. The body was thought to be composed of four humors: blood, phlegm, yellow bile, and black bile; health was supposed to depend upon the perfect mixture of these humors, each possessed of its proper qualities; disease took place when the due proportions were disturbed, or when cither of the elementary humors was separated, or not perfectly mixed with the common mass.
From this first rude notion of the analysis of the fluids have sprung the division of temperaments into the sanguineous, phlegmatic, choleric, and melancholic, which is received at this day; in each of which that humor was thought to be predominant from which it receives its denomination.
It is clear, from many passages of the-Hippocratic writings, that Hippocrates was not the inventor of these doctrines, but that they were the current opinions of his times; and had probably existed at a period anterior to that of any of the records of medicine which have reached our times. However hypothetical and ill founded are the speculations on which these doctrines rest, they were implicitly received by Boerhaave and his followers; nor is their influence wholly extinguished at present.
It cannot be supposed that opinions, which have no real foundation in nature, were at any time admitted without controversy. We find, even in the writings which are called Hippocratic, some variations from this fundamental hypothesis; and other theories, which are wholly distinct from it. Many succeeding teachers rejected it entirely, and proposed other systems. Asclepiades embraced the atomic philosophy, derir-'' from the doctrines of Democritus and Epicurus: he ascribed the production of diseases to the stopping up or relaxation of the pores. The Methodists thought that diseases were not produced by morbid alterations of the fluids of the body, but considered them as affections of the solids. They divided diseases therefore into three orders; some they considered as caused by laxity; others, as the consequence of tension; others, again, as complicated, being related by some of their symptoms to each of the other orders. Another sect denied that diseases were connected with the sensible qualities of the body. They asserted that there was a subtle matter, an ether, attached to, and pervading the system; and that diseases were affections of this matter. This sect was that of the Pneumatists.
Opinions so discordant, as it showed the evidence in behalf of each to be unsatisfactory, must have excited, in the minds of many, hesitation and discontent. Accordingly, there has ever been a sect, which has maintained, that, in medicine, evident causes were the only proper objects of inquiry; that the changes, which take place within the body, are mostly incomprehensible, and the study of them must be therefore superfluous; and that, could they even be discovered, they would throw no light on the methods of treatment. The question, they said, is not what makes a disease, but what will cure it, How digestion is performed, is of no moment; but what matter is most easily digestible, is of the greatest; it matters not how we breathe, but to determine the purest air is of the first consequence. In things of this nature, we are instructed, not by abstruse speculations and metaphysical subtleties, but by evident experience only. This is the proper guide in medicine, distinguishing the useful from the noxious, and applying them accordingly to practice. Such is the general reasoning of the sect of Empyrical physicians; a sect, the tenets of which, though disclaimed in the schools, have ever found numerous adherents among men the most versed in practice; and which, though not openly avowed, are, I am persuaded, silently assented to, and effectively acted upon, by the great body of practitioners, even at this day.
This short notice of the ancient sects demonstrates that, at the origin of medicine, the causes assigned, as immediately operative in the production of diseases, were not deduced from experience, but were the creation of the imagination. It would be an unprofitable task to examine whether the doctrines of modem teachers have been built upon a more solid foundation. I shall therefore wholly avoid them. TV vo whom they are familiar, will readily perceive, that the questions, which have exercised the ingenuity of the makers of systems, in these latter days, are very nearly the same as were discussed and disputed upon in the schools of antiquity; and that our modern sects are little more than the ancient, revived under new names. Nor will it be disputed, that no theory, which has been proposed, has had more than an ephemeral reputation; nor has contributed, hardly in the most remote degree, to the only rational object of speculation—the improvement of practice, and the consequent amelioration of social life.
It is perfectly clear, however, that human nature has been, and is, at all times, essentially the same. History depicts the same passions; the same motives of action; the same virtues and vices, adorning or darkening the human character; and the records of medicine show that the human body has been at all times (within the reach of written memorials) subject to the same diseases. With the exception of a few contagions (the effect, perhaps, of some accidental combination of circumstances), it may be doubted whether there exists any new disease. In the Hippocratic writings we meet with, not merely the same names of diseases, as those employed at this day, but, generally speaking, the same names applied to the same things; we meet with the same order and succession of events; the same accidents; the same signs, whether announcing safety or portending danger; the same divisions of diseases; in a word, as far as we can judge, the very same scene, which is at this time daily passing before the eyes of medical practitioners. It is, indeed, the perception of this striking analogy which has impressed upon these memorials the indelible character of authenticity; we feel for them a veneration like that excited by the works of Homer, being assured by our present experience that they are faithful transcripts from nature, taken at a period of very remote antiquity. As this is a fact of the first consequence in the history of human nature, I shall cite in illustration of it the account of a very common affection, as it is described in one of these ancient treatises. The disease I shall select is the common catarrh, or cold, of which the following description is found in the treatise on ancient medicine.
"Whenever any one is affected with a cold, and defluxion from the nose, the matter is commonly more acrimonious during the first days of descent from the nostril, and it makes the nose swell, and it heats and inflames it; if, when it has continued some time, you apply the hand to the part, it will be found excoriated, though it be naturally hard, and of little vascularity. This heat in the nostrils begins to diminish, not while the matter is flowing, and the inflammation continues, but when the matter has become thicker and less acrid, more concocted and mingled than at first; then it is that the heat ceases."—De veteri Medicina, xxxi.
Here we have an example of the slightest of all inflammatory complaints, which we find to have been attended with the same symptoms as the common cold, or catarrh, of the present day.
Cancer is allowed to be the most calamitous of all diseases which afflict the human frame. I do not know that any regular description of this malafly is to be found in the Hippocratic writings; but there are notices of it, which are sufficiently distinct, and which afford grounds for believing that it was well known at the era of these writings, and that the symptoms of it were essentially the same as at present. In one of the books of the Epidemics, the following short narrative occurs.
"A woman of Abdera had a cancer of the breast; it was of this nature: a bloody ichor came out of the nipple; when the discharge ceased, she died."—Popularium, vu. 50.
As then we find noticed, in the earliest records of medicine, the slightest of the acute, and the most severe of the chronic diseases, which men at present suffer, we cannot doubt that they were at this time subject to all the common forms of disease which are found existing at present. Of most of them it were easy to bring direct proof, if it were worth while. But I am unwilling to fatigue the patience of my reader by affecting to prove points which no one is likely to controvert.
How happens it then, that, while opinions have been so unsettled, and in a state of perpetual fluctuation, nature has been so uniform, and continues unchanged? The same phenomena have been occurring during a succession of ages with the same regularity as the rotation of the seasons, or the flux and reflux of the ocean. What can have produced this regularity, but the unceasing operation of regular and uniform causes?
On these subjects I have already delivered my opinions in works which have been some time before the public, and have adduced many facts in corroboration of those opinions. I have maintained that, while the predisposition to the various forms of diseased action is congenital, and dependent upon varieties in the radical organization of the frame, the more direct causes are to be looked for in the agency of foreign substances on the body, and principally of those which are used as food and as drink. From an adherence to those opinions I have not seen