The genuine works of Hippocrates, Vol. 1 · Hippocrates
THE ARGUMENT.
1. “By a most fortunate occurrence certain monuments of the medical art, as cultivated by the Asclepiadæ, are preserved to us in the first “Prorrhetics” and the “Prænotiones Coacæ” which books appear to be fragments and excerpts from the histories of diseases and cures which were formerly found on the votive tablets of the Coan temple. 2. This sacerdotal medicine was at first a certain medical divination, which, as it was the offspring of pure observation, so the system of prognostics of the Coans was altogether aloof from the theories and systems of the philosophers, and is therefore to be reckoned most worthy of our attention, both from the great love of observation which we admire in it, and from the exquisite and beautiful sense of the simple truth which it evinces. 3. We must keep in view the origin of these presages from individual observations gradually collected, in order that we may have a knowledge of this system of prognostic semeiology. Hence we comprehend how we meet with so many doubtful propositions, and so many uncertain and vague remarks, and that imperfect etiology which confounded causes with their effects, and again, the latter with the former.
4. The readers must particularly keep before their eyes this origin, and the antiquity of those writings, if they would pass a correct judgment on the merits of the Asclepiadæ towards the art of medicine. Whatever in their works we have the pleasure of possessing, all attest the infancy of the art; many things are imperfect, and not unfrequently do we see them, while in the pursuit of truth, groping, as it were, and proceeding with uncertain steps, like men wandering about in darkness; but yet the method which they applied, and to which they would seem to have betaken themselves of their own accord, was so excellent, that nothing could surpass it. It was the same method which Hippocrates himself always adopted, and which, in fine, Lord Bacon, many ages afterwards, commended as the only instrument by which truth in medicine can be found out. 5. As this method is founded on true induction, so are its dicta to be held the more worthy of admiration, the more they possess a universal signification. To give an example; what assiduous observation, and what abundance of rational experience, must have been required for enunciating the following admirable truth, and, as it were, law of nature: “Those things which bring alleviation with bad signs, and do not remit with good, are troublesome and difficult.”
6. Many passages bear reference to the condition of the vital powers, which they took into account at all times, both in making presages and in exercising the art. For, although they had not our theories of the vital force, they perceived its effects very well by observation; and for this very reason, that they did not search for the art in theories, but in observation alone, we owe so many excellent things to them, since they did not adapt their observation to theories, but related a trustworthy and faithful history of the operations of nature. 7. They sought after many things from a comparison of health with disease, in which also they rightly calculated the manners and customs of men. Thus they call that, in the first place, the best mode of reclining, which is adopted by the patient when in good health, and hence they estimate the other modes as being less good, or altogether unfavorable. Nor did they only compare health with disease, but they compared also the symptoms of diseases with one another, and interpreted the one from the other. Thus they first depict and pronounce a favorable opinion on the best kind of excretions, and then they described the other abnormal kinds, and pass an unfavorable judgment on them. 8. They particularly relate the operations of a _natura medicatrix_, which, in a region such as Greece is, and in athletic, strong bodies, on which they appear to have practised the art, and for the most part in acute diseases, and the few chronic ones derived from them which they have left described, might especially be looked for. Hence that doctrine of crises most deserving of attention, the rudiments, indeed, of which we only have here preserved, but a just notion of which we may easily draw from these fragments.
9. The Asclepiadæ would appear to have accommodated and directed their art to this natural Therapia. Hence the advice that convulsions arising from a great hemorrhage, forcibly stopped, should be cured by the abstraction of blood. It is to be regretted that but a few monuments of their practice remain; but these embrace admirable imitations of nature, and the most prudent caution in administering remedies. 10. Neither did they neglect surgery, but deliver many excellent remarks on things pertaining to wounds, ulcers, and fractures. 11. Although it cannot be made out for certain that everything which is preserved in these writings existed before Hippocrates, there can be no doubt that many of them are more ancient than he. And although we may attribute some things rather to Hippocrates himself, it is nevertheless certain that the method of deducing the art from observation and comparison had existed before him. Some may, perhaps, object that these books are to be attributed to the youth of Hippocrates, and that the others, more elaborate and perfect, had proceeded from the same person in his old age; but this supposition we may refute by a single argument, namely, that it would be absurd to ascribe so many observations about so many diseases to one man. 12. From the whole Coan system of cultivating medicine, the best hopes might justly have been expected; and from what follows it will be seen that the result did not disappoint this expectation.”
These deductions, I must say, appear to be most legitimately drawn; and having thus satisfactorily made out that the “Coacæ Prænotiones” are founded on the “Prorrhetics,” Dr. Ermerins proceeds to make an interesting comparison between the former and the book of “Prognostics.” Here again we can only find room for the general conclusions. 1. “We have compared together two monuments of antiquity embracing entirely the same doctrine, so that we may hold it as put out of all doubt that they must have derived their origin from the same school, only the one yields to the other in antiquity, as its more expanded mode of expression shows. 2. The more recent work is attributed to Hippocrates by all the critics and interpreters; the most ancient authors have made mention of it, and all the characteristic marks by which the genuine works of Hippocrates are distinguished from the spurious, without doubt, are found in it; for whether you look to the brevity and gravity of the language, or the paucity of the reasonings, the correctness of the observations, or the dialect in which they are expressed, or, in fine, its agreement with the whole Hippocratic doctrine,--all these attest that “the divine old man” is the author of this work. 3. From a comparison of the “Coacæ Prænotiones” with the “Prognostics,” it is as clear as the light of day that Hippocrates composed this work from them, in such a manner that he circumscribed many of the symptoms, limited the enunciations, and amplified them all by his own experience in the medical Art. Hence the Prognostics may not inaptly be called the Commentary of Hippocrates on the “Coacæ Prænotiones.”
4. With regard to the exquisite and artificial order, in which we see many things proposed in his book, we agree entirely with Sprengel, who thinks that they have proceeded from a more recent describer. This is confirmed by our comparison of both works. 5. This work exhibits the fundamental principles and originals of the Hippocratic doctrine, and although we hardly know anything as to the manlier in which Hippocrates composed his writings, and of the form which he gave them, it does not seem at all out of the way to hold this book to be the oldest of all the works which “the Father of Medicine” has left to us. 6. Inasmuch as this work is entitled the Book of Prognostics, so it turns on the _prescience_ πρόνοια, that is to say, the foreknowledge of the physician, which Hippocrates recommends to physicians for three reasons: first, for the confidence of mankind, which it will conciliate to the physician; then because it will free the practitioner from all blame, if he has announced beforehand the fatal result of diseases; and further, as being a very great instrument in effecting the cure. 7. Like the Coan priests, Hippocrates drew his Prognostics from a comparison of disease with health. This he held to be of so great importance, that he first delivers physiological semeiotics, and then adds pathological.
8. In calculating and judging of signs he neglected neither age nor sex, and, in the first place, directed his mind to the power of habit on the human body. 9. Nor did Hippocrates stop here, but directed care to be had of the attack of epidemics, and the condition of the season. 10. The Prognostics of Hippocrates are not of one time or place, but extend through every age, and through the whole world; inasmuch as the prognostic signs have been proved to be true in Libya, in Delos, and in Scythia, and it should be well known that every year, and at every season of the year, bad symptoms bode ill, and good symptoms good. 11. But he who would wish to know properly beforehand those who will recover from a disease, and those who will die, and those in whom the disease will persevere for many days, and those in whom it will last for a few, should be able to comprehend and estimate the doctrine of all the signs, and weigh in his mind and compare together their strength. The Hippocratic foreknowledge rests not only on the observation of the signs, but also on the understanding of them. 12. The Book of Prognostics exhibits observations of acute diseases, and of chronic arising from them, in which Hippocrates has diligently noted the times and modes of the crises.
13. Such is the authority of critical days and signs, that in those fevers which cease without the symptoms of resolution, and not upon critical days, a relapse is to be expected. 14. The series of critical days which Hippocrates delivers, proceeds solely upon the observation of nature. Yet neither can any of them be exactly numbered by entire days, since neither the year nor the months are usually numbered by entire days.” Dr. Ermerins, in the remaining part of his Essay, shows, in a very lucid manner, that the rules of Prognosis laid down in this treatise by Hippocrates, are manifestly those by which he is regulated in his other works, and more especially in the Epidemics and Aphorisms. We must not, however, occupy room with any further exposition of the contents of this important treatise, which does equal credit to the author himself, and to the medical system of education pursued in the learned university from which it emanated. * * * * * I will now give some remarks and reflections of my own on the treatise under consideration.
In this work, then, Hippocrates appears to have had for his object, to give such a general description of the phenomena of disease as would apply to all the disorders of the animal frame. With this intention he brings into review the state of the countenance, the position of the patient in bed, the movements of the hands, the respiration, the sweats, the state of the hypochondria, dropsies which are the consequences of acute diseases, the sleep, the urine, the alvine dejections, the vomitings, and the sputa. In doing this, his uniform practice is to contrast the healthy with the morbid appearances. Although M. Littré regards it as a treatise on special Pathology, it appears to me to be decidedly a general work on Semeiology. Certain it is that all the best commentators, such as Erotian and Stephanus,[458] decidedly regard it as a semeiological work. The class of ancient writings with which it admits of being most closely compared, are the works on the prognostics of the weather. On this subject Greek literature contains several works of a very philosophical nature, such as the Phænomena of Aratus, and several of the minor tracts of Theophrastus.
Now as the object of these authors was to connect the most striking phenomena in the sky, the earth, and the sea, with the changes in the weather, of which they are the precursors, so the intention of the medical writer of Prognostics was to point out the alterations in the animal frame, which certain preternatural symptoms usually indicate. And as the utility of an acquaintance with prognostics of the weather to the husbandman and sailor is sufficiently obvious, the benefit to be derived from a knowledge of medical prognostics by the physician is equally so. Our author, it will be seen in the Preface to this work, enumerates three objects to be attained by cultivating an acquaintance with prognostics; first, to attract the confidence of one’s patients; second, to free the physician from blame by enabling him to announce beforehand the issue of the disorder about which he is consulted; and, third, to give him a decided advantage in conducting the treatment by preparing him for remarkable changes in the diseases before they occur. And, in like manner, I may be allowed to remark, the master of a ship who shows himself prepared for all changes of the weather, will naturally attract the confidence of those intrusted to his charge; and whatever may be the result, he will be freed from blame if his ship should be damaged in a storm which he had previously predicted; and surely his knowledge of impending commotions in the sea and sky, will be of advantage to him by enabling him to make preparations for them.
Looking then to the importance of general Prognostics, I have often wondered why this branch of Semeiology is no longer cultivated by the profession. Did not the ancient physicians follow the best possible plan when they first described the general phenomena of diseased action, and then applied them to particular cases? Surely they did right in first taking a comprehensive view of the whole subject of disease before attempting to examine the different parts of it in detail. This, in fact, constitutes the great superiority of the ancient _savans_ over the modern, that the former possessed a much greater talent for apprehending general truths than the latter, who confine their attention to particular facts, and too much neglect the observation of general appearances. I trust no one will be offended if I venture to pronounce regarding the present condition of our professional literature, that (to borrow an illustration from the Logic of Kant) it is altogether Cyclopic,--that is to say, it wants the eye of Philosophy, for, although we have learned to examine particular objects with greater accuracy than our forefathers did, the sphere of our mental vision, so to speak, is more confined than theirs, and cannot embrace the same enlarged views of general subjects. Surely then we might gain a useful lesson by endeavoring to combine their more comprehensive views with our own more accurate and minute observation.
Some people may be inclined to think that we have greatly detracted from the credit which Hippocrates has long enjoyed as being the undoubted author of this work, by showing that in composing it he was so much indebted to the labors of his predecessors. But I have long been impressed with the conviction that in compositions even of the highest order, there is much less originality than is generally supposed, and that true genius frequently is displayed more in its own felicitous way of dealing with materials formerly prepared and collected for its use than in searching out new matter to work upon,[459] and hence it will be found upon examination that many of the most distinguished efforts of human intellect have consisted in the successful performance of tasks which had been frequently attempted by previous laborers in the same line. Many artists, before the time of Phidias, had acquired reputation by their attempts at making the statue of Jupiter;[460] but this did not deter him from undertaking the same task: and we may well believe that he would avail himself of every practical lesson which he could draw from the success or failure of his predecessors, in perfecting that matchless performance which completely cast all others into the background.
The sad misfortunes of Œdipus had been often represented on the Athenian stage before Sophocles made them the subject of those inimitable dramas, which still enjoy an unrivalled reputation, nor will it be often considered how much assistance he may have derived from the labors of those who had gone before him. It is well known that of all the literary performances of Aristotle, there is no one which gained him so enduring a reputation as his Categories, and yet it is admitted that his division of the subject into the ten Predicaments, was taken from the Pythagorean philosopher Archytas;[461] in short, the great merit of Aristotle on this as on many other occasions, consisted in defining and arranging a subject on which much had been previously effected by the labors of his predecessors. And, to give one example more, long before the time of Galen, the temperaments, and the facts in physiology and pathology bearing upon Hygiene, had been frequently and successfully investigated, but he, by recasting all these subject-matters into his _Ars Medica_, composed a work which posterity regarded as his master-performance, and every word and tittle of which, for a succession ages, were commented upon and admired in the Schools of Medicine. And of all our Author’s admired performances, there is perhaps no one which has exerted so great an influence upon the literature of the profession as the present work, for all the Greek, Roman, and Arabian writers on medicine, subsequent to him, make use of his terms, and copy his descriptions of morbid phenomena.
Text from Project Gutenberg, public domain in the United States.