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Table of Contents

Age of Foundation (continued).—Anatomic Period: Influence of the Alexandrian Library. Herophilus and Erasistratus. Aretæus, f B.C. 170. Celsus, A.D. 1–65 (?). Galen.—Empiricism: Asclepiades B.C. 100 (?).—Methodism: Theinison, B.C. 50 (?).—Eclecticism. Age of Transition, A.D. 201–1400.—Greek Period: Oribasius, 326–403. Ætius, 502–575. Alexander of Tralles, 525–605. Paul us Ægineta, 625–690.

Fourth, or Anatomic, Period.—As already seen, Alexander the Great and his successors collected the intellectual and natural riches of the universe, as they knew them, and placed them at the disposal of studious men to benefit humanity; their complete value has not yet been exhausted, and never can be. This undertaking was carried out under conditions that made it one of extreme difficulty. Manuscripts were then rare and most costly; but few copies of a given work were in existence, often only one, and these were held almost priceless. Under these circumstances the establishment of a public library and of a museum was an act of philanthropy and liberality simply beyond eulogy, and did more to immortalize the founder of the collection than all his victories and other achievements.

This appears to have also occurred to two of Alexander's lieutenants—one Eumenes, Governor of Pergamos, and the other, Ptolemy, Governor of Egypt. After the death of the conqueror his generals shook of all dependence upon the central government, and endeavored to centralize their own authority. But these two were the only ones among so many leaders who did not devote all their attention to armies and invasion, but interested themselves in commerce and arts. So active were they in the enterprise that Eumenes had gathered two hundred thousand volumes for the library at Pergamos, and Ptolemy six to seven hundred thousand for that of Alexandria. The latter was divided into two parts, the greater and the lesser, the latter of which was kept in the temple of Serapis, hence known as the Serapium. These notable efforts to found enormous collections first excited praiseworthy rivalry among contemporaries and rulers, which, however, degenerated into contemptible jealousy, so that some of the rulers of Alexandria even went so far as to interdict the exportation of papyrus, in order to prevent the making of copies for the library of Pergamos. But the effect was unexpected, since it led to the invention of the paper of Pergamos, otherwise called parchment, which completely displaced the bark from which papyri were made. Be this as it was, the collection at Alexandria had a much more marked influence on the medical study of the future than that of Pergamos, and calls for our particular notice. About it sprang up first a collection of learned men, and then the inevitable result—a school of learning. It was Ptolemy Soter who called around him the most renowned men of his day. He provided them with homes adjoining the library, endowed them with salaries, and charged them with the classification and collation of manuscripts, or with the giving of instruction by lectures and discussions. Ptolemy himself sometimes took part in these feasts of reason, which became still more frequent and formal under his son Ptolemy Philadelphia. These were called the Feasts of the Muses and of Apollo—i.e., ludi musarum—and, consequently, the place where they were held came to be termed the "museum." Often the subjects for discussion were announced in advance, and those who gained the most applause received rewards in accordance with the merits of their work. Among those who enjoyed these advantages under the reign of these two Ptolemies are prominently named two physicians, Herophilus and Erasistratus, the latter said to be the grandson of Aristotle. It was under this Philadelphus that the Hebrew wise men translated into Greek the Holy Scriptures, which translation has since been called the Septuagint—so called because it is supposed to have been translated by the members of the Sanhedrim, which was composed of about seventy men, or because, according to another legend, it was translated by seventy-two men in seventy-two hours. These savants of ancient Egypt, thus supported by the dynasty of the Lagides, gave the first place to the science of medicine. As regards this study, the school of Alexandria eclipsed almost from its origin the ancient schools of Cos and Pergamos, and during its existence was the leading institution of its kind in the world. At the time of Galen it was sufficient to have studied there, and even to have resided a short time in Alexandria, to obtain the reputation of being a physician. Nearly all the scholars of these five centuries had received instruction in this school. The principal reason for its eminence in medical instruction was the practice of dissection of human bodies, which, under the Ptolemies, was allowed and recommended, and by which the science of medicine received an extraordinary impulse. Although the prejudice of Egyptians was very strong against those who touched a dead body, the Ptolemies themselves are said to have participated in this kind of anatomical study, thus destroying by their example the odium previously attached to dissection. Strange to say, however, the practice of dissection fell into disuse toward the end of this Anatomic Period, and scholars preferred to indulge in subtle metaphysical discussions rather than study human tissues. But the principal reason for giving up this practice was the Roman domination of Egypt, the Romans, inconsistently, being perfectly willing to see any amount of bloodshed in the arena, and all sorts of inhumanities practiced upon living human beings, but holding that contact with a corpse was profanation; so that not a single anatomist of reputation had his origin in ancient Rome. "If on any occasion," says Renouard, "a foreign physician attached to the king or general desired to avail himself of the occasions that were afforded to examine the structures of the internal parts of the human body, he was obliged to conceal and carry off during the night some body abandoned to the birds of prey." To complete the melancholy termination of the Anatomic Period, the labors of the writers of those days were all lost by the burning of the great library by Julius Cæsar, which was the beginning of the chain of disasters with which Egypt was accursed under Roman dominion. Although Mark Antony, induced thereto by the endearments and solicitations of Cleopatra, transported the library of Pergamos to Alexandria, even this was unavailing to restore the position of the school, since the atrocious and imbecile Caracalla took from the pensioners of the museum their privileges of common residence and every other advantage, and suppressed all public exhibitions and discussions. I can mention but few of the names most eminent during this Anatomic Period, and but a short account of the life and work of each.

The first deserving of mention was Herophilus, who was born in Chalcedon about the end of the fourth century before Christ, and supposed to be the first to undertake systematic dissection of the human body. The so-called Torcular Herophili, or common meeting-place of the sinuses at the occiput, named after him, gives evidence of his influence upon the study of anatomy. He wrote on all departments of medical science, concerning the eyes, the pulse, midwifery, etc., as well as numerous commentaries upon the Hippocratic writings—describing the membranes of the brain and its vessels, the choroid plexus, the ventricles of the brain, the tunics of the eye, the intestinal canal, and certain portions of the vascular system. He alluded to the thoracic duct without knowing its purpose, and gave a more accurate description of the genitalia than any previous writer. Strange to say, but little is known of his later life, and of his death absolutely nothing.

Erasistratus was the son of Cleombrotus, a student of Metrodorus, and lived for some time at the court of Seleucus Nicator, whose son, Antiochus, he healed of a secret ailment, which happened to be a desperate love-affair with his mother-in-law, Stratonice. He wrote extensively on fevers, hygiene, paralyses, therapeutics, and many other subjects; regarded most diseases as due to overindulgence in food, which is not digested, and consequently putrefies. Plethora was for him the prevailing disease, against which he employed not only venesection, but fasting, and bandaging of the extremities. He was a diligent student of anatomy, and carefully described the brain in many of its grosser features, regarding it as the seat of the soul and the centre of the nerves. He also described more exactly than his predecessors the valves of the heart, which organ he regarded as the origin of veins and arteries. He discovered the lymph-vessels, and maintained, against Plato and others, that the epiglottis prevents the entrance of fluids into the lungs, but he supposed digestion to be produced by mechanical trituration in the stomach, and preferred gymnastics, exercise, diet, and baths to drugs or other therapeutic measures. He died about 280 B.C.

Aretæus, who died about 170 B.C., was one of the most brilliant lights of antiquity previous to the Christian era, but, in spite of all this, of his life very little is known. He came from Cappadocia about the end of the reign of Nero, and lived in Alexandria. That he lived in Alexandria is apparent from his numerous references to its location, to the habits and therapeutics of the Egyptians, and to the geography of the country. Furthermore, references to its diseases abound in his writings, so that it is made to appear that he had had the best advantages there, although he must have traveled extensively. But a small portion of his writings remain, and these consist, for the most part, of compendiums of pathology and therapeutics. He described disease, not in anatomical order from head to foot, but under the classification of acute and chronic. With the exception of Hippocrates, he has shown himself the most free from vague, arbitrary speculation, and from the dogmatism of the schools of any writer of antiquity. He, more than any other up to his time, endeavored to found pathology upon a sound anatomical basis. For every picture of disease he endeavored to provide a suitable anatomical accompaniment. This appears particularly, for instance, in his description of intestinal ulcers due to dysentery, or the paralyses following brain affections, or his description of pharyngeal diphtherias, of which he gave a good account under the name of Syriac or Egyptian ulcers. Pulmonary tuberculosis, tetanus, and anal fistula are amply mentioned in his writings.

His therapeutics were simple and rational; he laid great stress upon dietetic treatment. His surgical writings appear to have all been lost, but there is every reason to think that he brought to bear upon external medicine the same good sense which he applied to internal affections.