CHAPTER V.ASCLEPIA AND THE ASCLEPIADES.
Many asclepia, or temples of health, were in time established throughout Greece and her colonies and elsewhere. A recent writer states that at least three hundred and twenty are known “to have existed in antiquity; so that every town of importance must have had its sanctuary.”[60]In success and length of existence they, of course, varied greatly. The one at Epidaurus has been spoken of, and others of great celebrity were those of Tricca, Cnidus, and Cos, to say nothing of some only a little less deserving of mention, such as those at Rhodes, Pergamus, Carthage, Athens,[61]and Rome.
The asclepion at Tricca, in Thessaly, was probably started by the sons of Æsculapius, Machaon and Podalirius. At any rate, according to Homer, they were attendants there. This was enough to bring it into repute, but its situation in the mountains was much in its favor as a popular sanatory resort.
The Coan and Cnidian asclepia were favorably located; the former on the island of the name, which Pliny speaks of as “flourishing and powerful in the highest degree and consecrated to Æsculapius,”[62]and the latter not far distant, on a site decidedly maritime, in Asia Minor. These temples were both very distinguished, and a degree of rivalry prevailed between them.In them there was undoubtedly much highly creditable medical knowledge in exercise. The same was probably the case in most, or perhaps all, others, especially in later times; but it is in respect to those only that we have indubitable evidence of the fact. Of the two schools, the adherents of the Cnidian paid special attention to the symptoms of individual cases, and avoided, as much as possible, powerful cathartics, bleeding, and other active means of cure.
Whatever may have been the success of the various asclepia, institutions which were finally blotted out in the early part of the fourth century by Constantine, the first Christian emperor,[63]that of Cos was destined to make the greatest impress on the medicine of the future. It was the good fortune of this institution to have in connection with it, at the acme of its career, a great author as well as physician. Hippocrates, a native of the island, rendered the fame of the Coan school imperishable, and gave to his fellow-men throughout the world, in all time to come, a legacy of incalculable value. Through this early and great medical writer hisalma materhas been made, in a manner, that of the medical man of all ages. From Cos sprang forth at the touch of a humble man, afterward called appreciatively “the divine old man,” a mass of medical knowledge, wonderfully pure and good, which constitutes the main body of the real medical science of our own day.
An asclepion[64]consisted essentially of a buildingwith a more or less hygienical site, usually in the country and near a fountain,[65]sometimes a mineral one, in which the arts of healing were practiced by priests or disciples of Æsculapius, called asclepiades. In all, the influence of the god was generally believed to be an essential factor; and hence in each an image of him was to be found. But the fully-equipped institution had many appliances, as has been shown in the account given of the one at Epidaurus. Arrangements for exercises, baths, and other means which were brought to bear to restore people to health were duly provided and were in many instances elaborate.
The asclepiades claimed that they were descended directly from the god of whom they were the disciples. They were not, at any time, mere priests; that is, ministers of religion. Indeed, it has been asserted that “there is no sign in the Homeric poems of the subordination of medicine to religion.”[66]
The asclepiades constituted a special class, and they were oath-bound to preserve the mysteries of the art from the uninitiated. The oath is preserved in the Hippocratic Collection,[67]and is usually called by his name. It begins thus: “I swear by Apollo, the physician, and Æsculapius, and Health, and All-Heal,[68]and all the gods and goddesses that, according to my ability and judgment, I will keep this oath and thisstipulation.” In it occurs this passage: “I will follow that system of regimen[69]which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.” Here is another: “With purity and with holiness I will pass my life and practice my art.” Cutting for the stone is left to those who make a special business of it. What is learned about patients, in the exercise of the art, which should be kept secret is not to be divulged. Mr. Adams well says that it is most honorable to the profession that so ancient a document pertaining to it as this, “instead of displaying narrow-minded and exclusive selfishness, inculcates a generous line of conduct, and enjoins an observance of the rules of propriety and of the laws of domestic morality.”[70]
It has been said, in a learned article[71]on ancient medicine, that “the asclepiadæ of Greece were the true originators” of scientific medicine. This claim might be questioned, but it is, doubtless, in the main just. Certainly all physicians were not connected with asclepia; and in later times the asclepiades proper were avoided by the more intelligent and rational.
Unfortunately, the records of the practice of the asclepiades have been almost entirely lost. This is to be regretted, and more especially because what is preserved is of a decidedly high order of merit.[72]However,it is probable that at least thecrêmeof the whole has been handed down to us by Hippocrates.
It seems certain that in the first “Prorrhetics” and the “Prænotiones Coacae,” which are transmitted to us in the Hippocratic Collection, we have fragments and excerpts from the histories of diseases and cures which were formerly found on the votive tablets of the Coan Temple. From these records Hippocrates drew largely in composing his highly valuable “Book of Prognostics.” In reference to the matter Adams says: “It is as clear as the light of day that Hippocrates composed this work from them.”[73]
It is more than probable that, except for a short time at first, the system of treatment pursued by the asclepiades varied within wide limits; and it is equally certain that the superstitious element lessened as time passed. Between the principles of practice of Æsculapius and those of Hippocrates[74]there is a very wide difference. Those of the former will be given later; but of those of the latter I may say here that they were essentially scientific.[75]To Hippocrates every disease had a natural cause, and was to be cured by naturalmeans. He was wont “to consult Nature herself about Nature,” as Bacon has somewhere wisely advised. He did not attribute any morbid condition to any spiritual power, good or bad, and hence in his practice did not resort to conjuration or any related means of cure. Even of epilepsy, the so-called “sacred disease,” he said: “It is thus with regard to the disease called sacred: It appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from which it originates like other affections.” And again: “Men regard its nature and cause as divine, from ignorance and wonder.”[76]As regards holding disease to be divinely inflicted, he very properly remarks: “I do not count it a worthy opinion to hold that the body of man is polluted by God.”[77]
Not only in the principles of medicine, but in its practice, Hippocrates was wonderfully sound, even when judged from the stand-point of the art in our day. In truth, for extent and profundity of medical knowledge and philosophy, between him and what modern would one think of instituting a comparison? Sydenham has been likened to him; but, although I am an admirer of the English physician, I do not hesitate to say that he was neither in breadth nor depth any such man as the Coan. As a writer on the prevention and cure of disease, Hippocrates remainsfacile princeps.
Let it not be hastily supposed that my admiration for Hippocrates is unreasonably great. His works are truly a surprise to even the well-read modern. Very many of the so-called discoveries of recent times may be learned by turning to them. I speak advisedly. I will cite instances:—
Thus, of the treatment of open sores, he says: “In these cases no part is to be exposed to the air.” Dressings of “wine and oil” and “pitched cerate[78]” are directed to be used.
Again, in treating fractures, in connection with certain splints, he advises that “a soft, consistent, and clean cerate should be rubbed into the folds of the bandage;”[79]and he says, “If you see that the bones are properly adjusted by the first dressing, and that there is no troublesome pruritus in the part, nor any reason to suspect ulceration, you may allow the arm to remain bandaged in the splints until after the lapse of more than twenty days.”[80]
Still again, in regard to the reduction of a dislocation at the hip-joint, he says, “In some the thigh is reduced with no preparation, with slight extension, directed by the hands, and with slight movement; and in some the reduction is effected by bending the limb at the joint and making rotation.”[81]
In the three preceding paragraphs we have the practical side of the germ theory of disease, the permanent dressing of fractures, and the reduction of dislocations by manipulation.
I might go on and recount numerous other matters alleged to be new, and of which we hear much; but it is not necessary. I may add, however, a few items of interest:—
“Bleed,” says the old Greek, “in the acute affections, if the disease appears strong, and if the patients be in the vigor of life, and if they have strength.” Has any modern spoken more wisely on the subject?[82]
Here is a statement worthy of the attention of unbalancedtheorists of our day: In fevers and pneumonia, heat “is not the sole cause of mischief.”[83]
He gives directions for the use of effusions with “water of various temperatures” in “cases of pneumonia,” of “ardent fevers,” and of other diseases. This treatment, he thinks, “suits better with cases of pneumonia than in ardent fevers.”[84]
In that inimitable book, his “Aphorisms,” it is said: “In general, diseases are cured by their contraries.” There is no exclusive allopathy or homœopathy, or dogma of any kind, in that statement; it is the sentiment of a scientific physician.
Medicine was evidently far advanced in the days of Hippocrates;[85]and he was certainly a learned and sensible practitioner of it, even the “Prince of Physicians,” as Galen, I think, somewhere characterizes him, as well as one who did much to make it what he pronounced it himself to be, namely, “of all arts the most noble.”[86]