“Father of Medicine” (5th to 4th centuries, B.C.) was associated with the Asclepieum of Cos, an island off the south-west coast of Asia Minor, near Rhodes. He apparently revitalized the work of the health-temples, which had before his time been showing a certain decline in vigour, coupled with a corresponding excessive tendency towards sophistry and priestcraft.

Celsus says: “Hippocrates Cous primus quidem ex omnibus memoria dignis ab studio sapientiae disciplinam hanc separavit.” He means that Hippocrates first gave the physician an independent standing, separating him from the cosmological speculator. Hippocrates confined the medical man to medicine. He did with medical thought what Socrates did with thought in general—he “brought it down from heaven to earth.” His watchword was “Back to Nature!”

At the same time, while assigning the physician his post, Hippocrates would not let him regard that post as sacrosanct. He set his face against any Pg xi tendency to mystery-mongering, to exclusiveness, to sacerdotalism. He was, in fact, opposed to the spirit of trade-unionism in medicine. His concern was rather with the physician’s duties than his “rights.”

At the dawn of recorded medical history Hippocrates stands for the fundamental and primary importance of seeing clearly—that is of clinical observation. And what he observed was that the human organism, when exposed to certain abnormal conditions—certain stresses—tends to behave in a certain way: that in other words, each “disease” tends to run a certain definite course. To him a disease was essentially a process, one and indivisible, and thus his practical problem was essentially one of prognosis—“what will be the natural course of this disease, if left to itself?” Here he found himself to no small extent in opposition with the teaching of the neighbouring medical school of Cnidus, where a more static view-point laid special emphasis upon the minutiae of diagnosis.

Observation taught Hippocrates to place unbounded faith in the recuperative powers of the living organism—in what we sometimes call nowadays the vis medicatrix Naturae. His observation was that even with a very considerable “abnormality” of environmental stress the organism, in the large majority of cases, manages eventually by its own inherent powers to adjust itself to the new conditions. “Merely give Nature a chance,” said the father of medicine in effect, “and most Pg xii diseases will cure themselves.” And accordingly his treatment was mainly directed towards “giving Nature a chance.”

His keen sense of the solidarity (or rather, of the constant interplay) between the organism and its environment (the “conditions” to which it is exposed) is instanced in his book, “Airs, Waters, and Places.” As we recognise, in our popular everyday psychology, that “it takes two to make a quarrel,” so Hippocrates recognised that in pathology, it takes two (organism and environment) to make a disease.

As an outstanding example of his power of clinical observation we may recall the facies Hippocratica, an accurate study of the countenance of a dying man.

His ideals for the profession are embodied in the “Hippocratic oath.”

Anatomy. Impressed by this view of the organism as a unity, the Hippocratic school tended in some degree to overlook the importance of its constituent parts. The balance was re-adjusted later on by the labours of the anatomical school of Alexandria, which, under the aegis of the enlightened Ptolemies, arose in the 3rd century B.C. Two prominent exponents of anatomy belonging to this school were Herophilus and Erasistratus, the latter of whom we shall frequently meet with in the following pages (v. p. 95 et seq.). Pg xiii

The Empirics. After the death of the Master, the Hippocratic school tended, as so often happens with the best of cultural movements, to show signs itself of diminishing vitality: the letter began to obscure and hamper the spirit. The comparatively small element of theory which existed in the Hippocratic physiology was made the groundwork of a somewhat over-elaborated “system.” Against this tendency on the part of the “Dogmatic” or “Rationalist” school there arose, also at Alexandria, the sect of the Empiricists. “It is not,” they said, “the cause but the cure of diseases that concerns us; not how we digest, but what is digestible.”

Greek
Medicine
in Rome. Horace said “Graecia capta ferum victorem cepit.” Political domination, the occupation of territory by armies, does not necessarily mean real conquest. Horace’s statement applied to medicine as to other branches of culture.

The introducer of Greek medicine into Rome was Asclepiades (1st century B.C.). A man of forceful personality, and equipped with a fully developed philosophic system of health and disease which commended itself to the Roman savants of the day, he soon attained to the pinnacle of professional success in the Latin capital: he is indeed to all time the type of the fashionable (and somewhat “faddy”) West-end physician. His system was a purely mechanistic one, being based upon Pg xiv the atomic doctrine of Leucippus and Democritus, which had been completed by Epicurus and recently introduced to the Roman public in Lucretius’s great poem “De Rerum Natura.” The disbelief of Asclepiades in the self-maintaining powers of the living organism are exposed and refuted at considerable length by Galen in the volume before us.

The
Methodists. Out of the teaching of Asclepiades that physiological processes depend upon the particular way in which the ultimate indivisible molecules come together (ἐν τῇ ποίᾳ συνόδῳ τῶν πρώτων ἐκείνων σωμάτων τῶν άπαθῶν) there was developed by his pupil, Themison of Laodicea, a system of medicine characterised by the most engaging simplicity both of diagnosis and treatment. This so-called “Methodic” system was intended to strike a balance between the excessive leaning to apriorism shown by the Rationalist (Hippocratic) school and the opposite tendency of the Empiricists. “A pathological theory we must have,” said the Methodists in effect, “but let it be simple.” They held that the molecular groups constituting the tissues were traversed by minute channels (πόροι, “pores”); all diseases belonged to one or other of two classes; if the channels were constricted the disease was one of stasis (στέγνωσις), and if they were dilated the disease was one of flux (ῥύσις). Flux and stasis were indicated respectively by increase and diminution of the natural secretions; Pg xv treatment was of opposites by opposites—of stasis by methods causing dilatation of the channels, and conversely.

Wild as it may seem, this pathological theory of the Methodists contained an element of truth; in various guises it has cropped up once and again at different epochs of medical history; even to-day there are pathologists who tend to describe certain classes of disease in terms of vaso-constriction and vaso-dilatation. The vice of the Methodist teaching was that it looked on a disease too much as something fixed and finite, an independent entity, to be considered entirely apart from its