Chapter I: Part 1

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SKETCHES
FROM
THE HISTORY OF MEDICINE

Ancient and Modern.

=AN ORATION=

DELIVERED BEFORE

THE HUNTERIAN SOCIETY,

AT THE LONDON INSTITUTION,

ON THE 13TH FEBRUARY, 1867,

BY

W^M. SEDGWICK SAUNDERS, M.D.

LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS, EDINBURGH.—VICE-PRESIDENT
OF THE HUNTERIAN SOCIETY.—TREASURER TO THE NEW SYDENHAM SOCIETY.—
EXAMINING PHYSICIAN TO THE EAST INDIAN—SCINDE AND DELHI—BOMBAY
AND BARODA—GREAT SOUTHERN OF INDIA—CALCUTTA AND SOUTH EASTERN
—AND OUDE AND ROHILKUND RAILWAY COMPANIES.—MEDICAL OFFICER
TO THE CITY OF GLASGOW LIFE ASSURANCE CORPORATION AND THE
METROPOLITAN FIRE BRIGADE, &c.—AUTHOR OF THE “CAUSES
AND PREVENTION OF CHOLERA” AND “REPORTS ON
CHOLERA IN THE CITY OF LONDON, 1866.”

PRINTED AT THE REQUEST OF THE COUNCIL.

_For Private Circulation._

LONDON:

PRINTED BY M. & W. COLLIS. 50, BOW LANE, CHEAPSIDE, E.C.

1868.

ORATION.

Mr. President,

I purpose to devote the time, which your indulgence has placed at my disposal this evening, to laying before you the results of some inquiries into the origin and history of medicine and of the medical profession; regarding the subject rather from a _social_ than from a _scientific_ point of view.

My scheme will introduce you to some of your old acquaintances; not for instruction, but to remind you of those passages in their lives which may have been pressed out of your memories by the sterner realities of professional duties.

An inquiry into the origin of medicine must begin with the history of man himself, since pain and death are the inevitable conditions of his existence; and the desire to mitigate the former, and postpone the triumphs of the latter arose from, and has kept pace with, the development of the various diseases to which time and circumstances have subjected him.

The _primal man_, we know, was created pure and innocent, free from liability to pain, and possessed of unmixed capacity for the enjoyment of the pleasures that surrounded him; glowing with health, and with every emotion redolent of new delight. At sight of him,

Each hill gave sign of gratulation,
Joyous the birds; fresh gales and gentle airs
Whisper’d it to the woods; and from their wings
Flung rose, flung odours from the spicy shrub:—

Apprehension of the miseries to which his progeny were doomed, would have marred this happiness; hence his ignorance of evil, and his belief that the felicity he enjoyed would be as permanent as it was perfect. But our business is with man in his _actual_ condition; the sport of

“All maladies
Of ghastly spasm, or racking torture, qualms
Of heart-sick agony, all feverous kinds,
Convulsions, epilepsies, fierce catarrhs,
Intestine stone, and ulcer, colic pangs,
Demoniac phrensy, moping melancholy,
And moon-struck madness, pining atrophy,
Marasmus and wide wasting pestilence,
Dropsies and asthmas, and joint-racking rheums,
And over them triumphant Death his dart
Shook, but delayed to strike.”——

Undertaking to examine the subject _ab initio_, we must take into account the sources of our information, and as our knowledge of every event _antecedent to the discovery of writing_ must have been transmitted by oral or traditional agencies, we have to settle, in some degree, how far such evidence is worthy of credence.

According to popular belief, the Noahic flood destroyed the whole human race, with the exception of Noah and his family; who were therefore the sole depositories of the traditions of the events which had occurred between the time of Adam and themselves. The great longevity of these antediluvian fathers made this oral transmission easy; and we know, that the sons of Noah lived to see the birth of Abraham, whom, as the founder of circumcision, we claim as the first operative surgeon on record.

In dealing with dates, I adopt the commonly accepted chronology, unmoved by those refined speculations so much in favour at this time.

I begin with Moses, for whatever evidence may be urged upon us in the shape of marbles, or monuments, claiming an antiquity anterior to the advent of the Jewish lawgiver, it is a positive and unimpeachable fact, that no _writings_ are in existence, which in point of age reach within many centuries of the Pentateuch; indeed, as we shall presently see, the oldest of the Greek writers are, in comparison with Moses, but as the children of yesterday.

The five books of Moses were written 1500 years before Christ. Hesiod, the father of Greek literature, flourished 500 years later; and Homer, the next in succession, nearly a century after Hesiod.

Herodotus places Homer 400 years before himself; thus bringing the “father of history,” as he is termed by Cicero, to about 500 years before the advent of our Saviour, so that the difference of date between the author of the Pentateuch and the oldest Greek historian cannot be much less than 1000 years.

I pass over the pretended antiquity of the Chinese and Parsis records: these have been disposed of very satisfactorily, and however much _fancy_ may dwell upon the losses to literature inflicted by the Caliph Omar, when he destroyed the Alexandrian library,[1] in the year 640, a very little reflection will convince us that as these treasures, real or assumed, had been ransacked for ages, by the brightest spirits of Greece and Rome, everything worthy of note has been handed down to us.

-----

Footnote 1:

The library destroyed by the Caliph Omar, was situated in the temple
of Serapis, and consisted of 300,000 volumes; in addition to which
there existed in the Bruchion quarter of the city of Alexandria, a
second collection of 400,000 books, which was accidentally lost by
fire during the war with Julius Cæsar.

Alexandria (founded 332 B.C.) stood in an intermediate position
between the east and west, and united the commerce of Europe, Aralia,
and India; here came first into collision the Greek and Oriental mind;
here the Septuagint translation of the Old Testament was written; and
the collections formed by the ancient kings of Egypt were rapidly
enriched and enlarged by the interchange of ideas with the Greek
philosophers.

-----

The _learned_ talk about the writings of the Assyrians, the Babylonians, and the Egyptians; but they do not produce a single scrap of tangible evidence in support of these pretensions.

It may, however, be contended, that although there are no _writings_ extant, _traditional_ evidence is very strong; and this establishes a high antiquity for Lycurgus, who lived 900 years before the Christian era. The more, therefore, we inquire, the stronger the proof becomes, that Moses as a lawgiver flourished 600 years before the highest claimant to our veneration on the grounds of primitiveness; and thus we are entitled to assume that the Greek legislator took much that is excellent, in the laws ascribed to him, from his Jewish predecessor.

Lycurgus lived about the time that Shishak, king of Egypt, destroyed the temple of Solomon, and carried away many captives: it is therefore no very extravagant supposition, that the Pentateuch of Moses was known to the great lawgiver. During the peaceful reign of king Solomon, the intercourse between the Jews and the Egyptians was frequent and extensive, for the great monarch, needing the assistance of skilful artificers for the construction of the Temple at Jerusalem, broke down that barrier of exclusiveness that had previously isolated his people.

Now the _learned_ of that day were seekers after wisdom wherever it was to be found; and moreover, as the fame of Solomon was co-extensive with the then existing world, so acute an observer as the _founder_ of the Grecian law could not fail to use the materials which the wide spread knowledge of the Jewish kings sayings and doings had placed within his reach.

Every Jew was required to read the law, or hear it read, once a year—each individual therefore became a living depository of its truths, and, consequently, a somewhat competent teacher of those who might desire to be instructed in such matters.

_Moses_ then comes before us as the first _writer_, and the first _lawgiver_; and we shall now proceed to show that to these titles he added the still greater distinction of being the first _physician_, and promulgator of sanitary precautions.

At present, however, I will not further intrude upon your patience, but leaving his claims where I have placed them, pass on to the consideration of the character of the laws themselves;—and here we arrive at a body of enactments so excellent, so well adapted, not only to the requirements of a nomadic people wandering in a wild country, but to that _same_ people when they subsequently became dwellers in cities, and suffered all the encumbrances of a more advanced civilization. _Moses_ made laws for _all_ times and for _all_ communities, _general_ as well as _particular_, reaching the _nation_ through every individual member thereof; his rules for the preservation of health embraced the consideration of personal cleanliness enforced as a _religious_ obligation in order that he might thereby enlist the unvarying co-operation of the priesthood.

In a climate incentive to animal enjoyments he placed strict barriers for the preservation of _chastity_, and decreed that matters relating to sexual intercourse should be under the surveillance of the priest; directions were also given to the _menstruous_ woman, and for her conduct during _pregnancy_ and in _childbed_. The ordinance of circumcision was devised not alone for ablutionary purposes, but for _other well understood_ objects conducive to purity. Further, it was directed how the man should order himself in affections of the virile organs; and more emphatically, what he was bound to observe when the terrible _leprosy_ afflicted him. In such a calamity he was compelled to withdraw from his house, to be separated from society, and present himself to the priest at various periods during the progress of the disease; he was also to remain in a cheerless exclusion, where, if by chance any unwary passenger came in sight, the sufferer was commanded to cry aloud, _unclean! unclean!_ When convalescence and health returned, the _priest_ pronounced him cured of his leprosy, and he was then permitted to return to his home; but if the leprosy was supposed to cling to the _habitation_, _that_, too, was subjected to isolation, and in some instances to total destruction.

The _same precautions_ obtain in our own times, although nearly 3400 years have elapsed since they were first insisted upon by Moses.

Thus, we are told by Dr. Thompson, an eminent American writer on the Holy Land (where he resided many years), that lepers are everywhere regarded as unclean, and that at Jerusalem (where there is always a considerable number of them) a separate quarter in the city is assigned to them, to which they are rigidly confined. Dr. Thompson says: “I have seen them cast out of the villages where they resided, and no healthy person would touch them, eat with them, or use any of their clothes or utensils, and even the Arab tent dwellers cast them out of camp. The leper beggars stand apart, and never attempt to touch you, even as it was in the time of the Saviour, when the ten lepers stood afar off and lifted up their voice of entreaty.”

The same writer furnishes us with the following graphic description, which, as coming from an eye witness, we have deemed worthy of notice:—

“Sauntering down the Jaffa road, on my way to the Holy City, I was startled by the sudden apparition of a crowd of beggars, sans eyes, sans nose, sans hair, sans everything; they held up their handless arms, unearthly sounds gurgled through throats without palates, and, in a word, I stood horrified, when, for the first time, I found myself face to face with a leper.” He then goes on to say: “For many years I have sought to get at the mystery of its origin, but neither books nor learned physicians have thrown any light upon it. I have suspected that this remorseless enemy originates in some self-propagating animalcules, and thus I can conceive the possibility of the contagion reaching the walls of a dwelling. No one has spoken with authority, as to what it proceeds from or how it is generated.

“New born babes of leprous parents are often as pretty and healthy in appearance as other children, but the ‘_scab_’ comes on by degrees, the hair falls off, joint after joint of the fingers and toes shrink up, the gums are absorbed, and the teeth fall out and disappear; the nose, the eyes, the palate are slowly consumed, and finally the wretched victim sinks into the earth under a disease beyond the control of medicine, which cannot even mitigate its tortures.

“To my mind there is no conceivable manifestation of Divine power more triumphantly confirmatory of Christ’s divinity than the cleansing of a leper with a word.”[2]

-----

Footnote 2:

The contagiousness of Leprosy was held in universal belief up to the
seventeenth century, when certain writers on the subject began to
question the validity of a doctrine which had been handed down to them
through successive ages, by all the early observers of the Jewish,
Egyptian, Arabian, Grecian, and Hindoo countries, and the view then
advanced has been confirmed by the report of the Committee recently
appointed by the College of Physicians, who state that:—“The all but
unanimous conviction of the most experienced observers in different
parts of the world, is quite opposed to the belief that leprosy is
_contagious_ or _communicable_ by _proximity_ or _contact_.”

On the other hand we have to consider the testimony afforded us by the
shrewd and intelligent teachers of ancient times. Thus, Aretæus
believed it to be as contagious as the _plague_, and like _it_
communicable by respiration; and _Œtius_, following _Archigenes_,
thought that “the air became contaminated through the effluvia of the
sores.” _Avicenna_ believed leprosy to be contagious in the _general_
sense of that term; _Avenzoar_ by contact; _Haly Abbas_ and
_Alsaharavius_ through the respiration; and _Rogerius_ “_per coitum_.”

[These interesting facts are taken from an able article in the Lancet,
February 9, 1867.]

-----

The initiatory rite of circumcision was, by Divine command, first performed by Abraham in the year of the world 2107, or about 1897 years before Christ:—At the age of 99 years, Abraham, together with his son Ishmael and all his dependents were circumcised.

Ishmael at this time was thirteen years old, and, as we are informed by Josephus, was the founder of the Arabian nation, who to this day do not circumcise until after the thirteenth year.

Isaac, the child of promise, the heir who was to carry on the race of the patriarch, was circumcised on the eighth day after his birth, and this, among the Hebrews, became a law, and a statute for ever.

One of the tapestries at Hampton Court, in the time of Holbein, represents the operation being performed upon Isaac, with what appears to be a knife made of stone, which was the instrument used for many ages for this purpose.

By the kindness of my friend, the Rev. William Sparrow Simpson, the learned Librarian and Minor Canon of St. Paul’s Cathedral, I am enabled to show you some of these knives of stone; and further evidence of the employment of such implements will be found in Exodus 4th chapter and 25th verse, where it is written—“Then Zipporah took a sharp stone and cut off the foreskin of her son and cast it at his (Moses) feet.”[3]

-----

Footnote 3:

_Pliny_ tells us that the priests of _Cybele_, the mother of the gods
had sharp stones with which they cut themselves in their extasies.
_Catullus_ says, that _Atys_ emasculated himself with such an
instrument.

The Rabbinical law stands thus: “we may circumcise with anything, even
with a flint, with crystal (glass) or with anything that cuts, _except
with the sharp edge of a reed_, because the _enchanters_ make use of
that, or it may bring on a disease.” Again we have the evidence of
_Leutholf_ that the Æthopians used _stone knives_ for circumcision in
his time, 1581. Speaking of the _Alnajah_, an Æthopian race, he
says:—“Alnajah gens Æthiopum cultris lapideis circumcisionem peragit.”

Mr. E. B. Tylor in his “Researches into the Early History of Mankind,”
has suggested as the probable reason why stone was used as a cutting
instrument, that it was less likely to cause inflammation than either
bronze or iron. And _Pliny_ states that the mutilation of the priests
of _Cybele_ was done with a sherd of Samian ware to avoid the same
danger.

-----

Some writers believe that the practice of circumcision existed for ages amongst the Heathens before the time of Abraham, whilst others have not hesitated to date its origin as far back as our first fathers, asserting that Adam was taught by the angel Gabriel to satisfy an oath he had made to cut off that flesh, which after his fall had rebelled against his spirit.

Much has been written with regard to the comparative _antiquity_ of this custom among the Egyptians and Ethiopians; a point upon which the erudite Herodotus leaves us in doubt.

Circumcision of _both_ sexes exists amongst the Abyssinians, Nubians, Egyptians (both ancient and modern), Hottentots, and probably many other nations. But in Turkey, Persia, and in the South Sea Islands, and those of the Indian Seas, the practice is confined to the _male_ sex. The Mohammedans adopt the rite of circumcision, and Mahomet himself was circumcised, although no mention is made of the fact in the Koran.

Doubtless, the so-called circumcision of women, as it is practised in some countries, is a modification of what _we_ understand by the term, and involves structures other than the clitoris or nymphæ; and it is equally true that the custom is adopted by many races totally irrespective of any religious significance.

Sonnini de Manoncourt, a distinguished traveller and naturalist of the eighteenth century “having examined a young girl of Egyptian origin, about eight years old, found a thick, flabby, and fleshy excrescence, covered with skin, which grew above the commissure of the labia, and hung down half an inch, resembling in size and shape the caruncle pendent from the bill of a turkey cock.”

Conditions of a similar nature are said to exist among the women of the interior of Africa, and are probably due to climatic influences, but the more common forms of disease are those of simple hypertrophy of the external parts of generation; and it is not unreasonable to suppose that the surgical interference necessary for their removal has given rise to the general term of circumcision.

“Simple _excision_ of the _clitoris_ has been practised for very many centuries by certain nations,” and I purpose quoting some interesting observations just published by Dr. T. H. Tanner, upon the subject. His first extract is from Strabo, the geographer, A.D. 21, who, in speaking of the Egyptians, says:—“They _circumcise_ the males and _excise_ the females, as is the custom also among the Jews, who are of Egyptian extraction.” The custom appears to have been continued down to a recent period, and Mr. W. G. Brown,[4] who resided for some time at Darfour, North Africa, writing in 1779, thus alludes to it:—“The excision of females is a peculiarity with which the northern nations are less familiar; yet it would appear that this usage is more evidently founded on physical causes, and is more clearly a matter of convenience, than the circumcision of males, as it seems not to have been ordained by the precept of any inspired writer.”

-----

Footnote 4:

Travels in Africa, Egypt, and Syria, from the year 1792 to 1798, p.
347. London, 1799.

-----

“This excision is termed in Arabic ‘_chafadh_.’ It consists of cutting off the clitoris a little before the period of puberty, or at about the age of _eight_ or _nine_ years.”

Again, the Nubian traveller[5] _Burckhardt_ tells us—“The daughters of the Arabs _Ababde_, and _Djaafere_, who are of Arabian origin, and inhabit the western bank of the Nile from Thebes, as high as the cataracts, and generally those of all the people to the south of _Kenne_ and _Esne_ (as far as Sennaar) undergo circumcision, or rather _excision_ (excisio-clitoridis,) at the age of from _three_ to _six_ years: Girls thus treated are called _mukhaeyt_.”

-----

Footnote 5:

Travels in Nubia, by the late John Lewis Burckhardt, p. 332. London,
1819.

-----

But perhaps the most trustworthy account of the circumcision of females in Western Africa is that given by the late Mr. W. F. Daniel, who was a distinguished member of our own profession. He tells us that “The excisive process in Western Africa is variously performed in accordance with the usages of the different districts where it is resorted to. The operation consists either of:—

“1. Simple excision of the clitoris; 2. excision of the nymphæ; 3. excision of both nymphæ and clitoris; 4. excision of a portion of the labia pudendi, with either or all of the preceding structures.

“The history of the operation is involved in obscurity; that it was secretly inculcated as one of those gloomy rites which the female proselyte had to undergo, as a preliminary measure, prior to her initiation into those dread mythological creeds, which, in Egypt and the adjoining countries were swathed in the folds of an allegorical and almost impenetrable mysticism, is the most likely inference.” _Eventually_ the progressive decay of the religious institutions, gradually led to its promulgation and practice among the masses of the people; for the _priests_, who, independent of their scientific attainments, were also well versed in medicine, might have advocated its use both in a moral and hygienic point of view, as conducive to the welfare of the female population.

I have been led into this digression by reflecting over the barbarous and unphilosophical meddling of certain practitioners of our metropolis who are, in effect, degrading our practice of surgery to the level of that of the savages we have just described, without possessing the same claim to our consideration on the score of ignorance, barbarism, and superstition. The modern antic yclept “_clitoridectomy_” (to which I refer), is, as the “Lancet” says, “a proceeding which, if it be _useless_, is a _lamentable mistake_, and if it be _unnecessary_, _a cruel outrage_.”

The next proposition we may fairly look for will be to imitate still further the customs of these Western Africans who, in certain tribes, whenever a girl shows any very strong indication of sexual feeling (before she is betrothed), at once proceed to produce an obliteration of her vagina by the intense inflammatory action set up by the forcible introduction of a mass of the “capsicum fructescens,” or bird pepper—to my mind not one shade more inhuman or barbarous than unsexing a woman for ever, upon an assumption which grossly libels our female population.

The position taken by the early Christians in reference to the practice of circumcision was decidedly antagonistic, so far as any value, in a _religious_ point of view, should be ascribed to it; nevertheless, their apostles and teachers permitted it to continue, at the discretion or inclination of those who chose to submit to it.

It is an interesting fact to note that the Copts, whose Christianity dates back from the persecution of Diocletian (called the era of martyrs) in 303, and the Abyssinian Christians, who also reckon from the fourth century, adopt the custom to this day, from a belief that it gives them a further chance of entering Paradise, beyond the baptism they receive as Christians. It is also singular that these sects accept several other doctrines and precepts of the Mohammedans and Jews, among whom they dwell.

The precise mode of operating upon males varies in different countries. In Madagascar three separate and distinct operations are inflicted upon the individual. In the South Sea Islands the natives simply slit up the prepuce on its dorsal aspect, and in earlier times the practice was to cut the prepuce all round the corona, avoiding the frœnum. In the Fiji Islands the instrument used is a sharp splinter of bamboo.

Upon females the process of excision is performed by aged women. In Egypt the custom is still maintained; and the women of the _Said_ travel about from town to village, crying out “Circumcisor! who wants a circumcisor?” In Old Calabar, Mr. Daniel had the opportunity of witnessing the operation, which is likewise performed _there_ by aged females. The girl having been placed on the knees of a woman, with the legs apart, the clitoris was seized, _forceps-like_, by two pieces of bamboo or palm-sticks, and being gently drawn forth, was severed with a sharp razor.

Among the Jews the peculiar and distinctive mark of circumcision is perpetuated in our days, and without any material change of ceremonial. The _modus operandi_ is as follows:—The godfather being seated, takes the child on his knees, and the operator (who may be the father of the child, if capable, or some friend of the family, or a professed expert) takes up with his fingers, or a pair of tweezers, as much of the prepuce as he intends to cut off, and, on applying the knife, says—“Blessed be Thou, O God, who hast commanded us to use circumcision.” He then sucks the blood, and spits it into a cup of wine, and having applied styptics to the wound, retakes the cup, and having blessed _it_ and the child, pronounces the name of the child, and moistens his lips with the contents of the cup. Various prayers are then said, and the ceremony is concluded.

Though the modern Jews generally use a steel instrument, there is this remarkable exception—that, when a male child dies before the eighth day, it is circumcised prior to burial, and this is done, not with the ordinary instrument, but with a fragment of glass or flint.

The practice extended to the Ishmaelites, and, as we have already stated, was subsequently adopted by Mahomet, so that a very large section of the human race are to this day, participators of a rite established considerably more than 3000 years ago.

The subject cannot be dismissed without noticing the fact that the Jews under their various captivities, subjugations, and persecutions, endeavoured, in some instances, to obliterate the marks of circumcision. This is abundantly proved, not only by contemporary writers, but by the evidence of Epiphanius, Celsus, Galen, Paulus Ægineta, Fallopius, and others, who have enlarged upon the means adopted for the accomplishment of this object. It is, further, a noteworthy circumstance that the Jews _entirely_ suspended the practice of circumcision during the forty years of their wanderings in the wilderness.

In contemplating the sufferings of this unfortunate race, the heart sickens at the punishments which resulted from their resistance to foreign usurpation. Unable to discern the hand of God in their humiliation, their struggles were, indeed, hopeless, but not the less heroic. Captives in Babylon, after a long and cruel servitude, they were restored only to be again scattered by the destruction of Jerusalem, under Titus. Through the varying fortunes of the Romans, no resting-place seems to have been vouchsafed to them; plundered and disgraced, the fall of Rome only eventuated, as far as _they_ were concerned, in a change of masters. Ruthless persecutors tracked them through the dark ages, and what Heathenism spared, Christianity despoiled; our pious ancestors praising God when they had a chance of maltreating an Israelite.

For these reasons, and with such incentives, can we doubt that the timid amongst them would endeavour to remove the means of identity which circumcision afforded.

We have so refined away the simplicity of the patriarchal times, that it is almost necessary to apologise for alluding to the reverential awe with which all matters relating to the seed of Abraham were regarded. It was a solemn and impressive act when the Patriarch, believing that the time was come for his son Isaac to have a wife, sent for his chief servant, and said, “Put, I pray thee, thy hand under my thigh, and swear by the Lord that thou wilt choose a wife for my son out of mine own kindred;” and the servant, with his hand on his master’s genitals, took the required oath; and we all know how faithfully he performed it. Whilst this simple, but deeply significant ceremony was being enacted, the heart of the father of the faithful was doubtless filled with contemplations of the great purposes for the accomplishment of which the organs of generation were appropriately considered as the direct agents.

This mode of taking the oath is further adverted to in the 47th chapter of Genesis, when Jacob is taking his farewell of his children.

In our blind adoration of classical heathenism we undervalue the sublime and not less poetical incidents which mark the rise, progress, culmination, and decay of that people with whom our highest interests are identified. If, for instance, the Book of Job had not been written under inspiration, and had been accidentally discovered among the ruins of the _first_ Babylon, our antiquarians would have regarded it as the loftiest of epics; and especially so if, instead of inculcating the worship of the true God, its subject had been the glorification of whatever false deity might have been in the ascendant when this most ancient poem was composed.

The prejudices of education subjugate the judgment, and the gross and sensual attributes with which the Greek poets invested their deities, are accepted with complacency, if not with admiration; even Pope, their great panegyrist, describes their heroes thus:—

“Gods, partial, changeful, profligate, unjust,
Whose attributes were _rage_, _revenge_, and _lust_.”

This, of course, will be set down for rank blasphemy against the canons of taste. We are exuberant in our praises of the _genius_ of Homer, and not to worship his _inventive_ powers is an offence of the deepest dye; but when we are barbarous enough to critically examine this wonderful mythology, and to determine the claims to applause—say of supreme Jove—we are rather troubled by the difficulty of reconciling the ways of the first intelligence with our commonplace notions of decency. The intrigues of the father of the gods, the artifices by which he eludes the jealousy of his wife Juno, his incestuous, and, if they were not classical, we should call them filthy debaucheries, draw largely upon our faith in the beauties of these records of high Olympus; and our admiration for the poet is sadly tinctured with disgust for the images in which his creative powers are developed.

Thus much of the ceremonial laws. Of the moral law, the law of God, it becomes me not to speak; its obligations are as eternal as its author; the everlasting truths of the decalogue have been incorporated more or less into every system of religion and ethics which has been enunciated during the ages interposing between us and the period in which they were first promulgated on Mount Sinai.

In dismissing Moses and his times, I crave your particular attention to the manner in which the characters of priest and physician met in the same person. As we proceed we shall find that this junction of attributes continues through all the variations of time and circumstances. The terrors of the _unseen_, overawing the ignorant, placed them at the mercy of those daring minds which in every age have assumed the office of interpreters of the will of the _demon_, or the behests of the benign Deity. To deal as a mediator between the threats of the terrible avenger and the awe-stricken victim of his own bewildered imagination, to avert the consequences of the threatened storm, or to turn aside any other manifestation of approaching evil is the office of the _medicine-man_ of the North American Indian and the _Obeah_ doctor of the African. Shrewd observers of nature, these wretched impostors monopolize the whole of the intelligence, such as it is, of the hordes of the human race upon whom the light of reason has never dawned, or has dawned in vain.

There is yet another aspect of the medical character, infinitely more agreeable and important, and the consideration of it will bring us to the times immediately preceding the days of the father of medicine. I do not propose to penetrate into the story of Esculapius and his divine origin, which probably, in an esoteric sense, merely meant that the Giver of all good had inspired him with a knowledge of the healing art; but (with a passing glance at Homer, the greatest poet of his own or any subsequent age), proceed to offer some general observations on the position which the study of medicine acquired under the tutorship of the philosophers.

The siege of Troy is supposed to have taken place about three hundred years before the _Iliad_ was sung, and in that early time it appears that the cultivation of our art formed part of the general education of kings and warriors.[6]

-----

Footnote 6:

“As for Medicine, something of it must have been understood in that
age, though it was so far from perfection, that, according to Celsus,
(book i.) what concerned _diet_ was invented long after by
Hippocrates. The accidents of life make the search after remedies too
indispensable a duty to be neglected at any time; accordingly, he
tells us, that the Egyptians, who had many medicinal plants in their
country, were all Physicians, and perhaps he might have learnt his own
skill from his acquaintance with that nation.

“The state of war in which Greece lived, required a knowledge in the
healing of wounds, and this might make him breed his princes,
Achilles, Patroclus, Podalirius and Machaon, to the science; what
Homer thus attributes to others he himself knew, and he has given us
reason to believe, not slightly, for if we consider his insight into
the structure of the human body, it is so nice, that he has been
judged by some to have wounded his heroes with too much science; or,
if we observe his cure of wounds, which are the accidents proper to an
epic poem, we find him directing the chirurgical operations, sometimes
infusing lenitives, at other times bitter powders, when the effusion
of blood required astringent qualities.”—_Pope’s Essay on the
Character of Homer._

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Homer introduces us to Machaon the son of Esculapius, who, when Menelaus was treacherously wounded by Pandarus, is called to his aid:

“When the wound appeared in sight, where struck
The stinging arrow, from the clotted blood
He cleansed it, and applied with skilful hand
The healing ointments, which, in friendly guise,
The learned _Chiron_ to his father gave.”[7]

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Footnote 7:

Lord Derby’s Translation.

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Making due allowance for the debasing fable with which every great name or talent is overlaid, it is rational to suppose that Chiron, the teacher of Esculapius, was one of those shepherd philosophers, who like their Babylonian brethren absorbed all the knowledge of the times; but Homer gives us other examples in support of this idea. Chiron was the preceptor of Achilles, and when Machaon is himself wounded, Patroclus is sent by Achilles to his assistance; on his arrival he is urged by Eurypylus, to

“Draw the deadly dart,
With luke-warm water wash the gore away:
With healing balm the raging smart allay,
Such as sage _Chiron_, sire of pharmacy,
Once taught Achilles, and Achilles thee.”—_Pope._

He also complains that

“Of two great _surgeons_, Podalirius stands
This hour surrounded by the Trojan bands,
And great _Machaon_ wounded in his tent
Now wants the succour which so oft he lent.”

Then

“Patroclus cut the forky steel away,
And in his hand a bitter root he pressed,
The wound he washed and styptic juice infused,
The closing flesh that instant ceased to glow,
The wound to torture and the blood to flow.”

Machaon seems to have largely shared the goodwill of the Grecian hosts. Nestor, in his anxiety, says:—

A wise Physician skilled in wounds to heal,
Is more than _armies_ to the public weal.

Military leaders in our days have no such weakness as this. Studied neglect seems to them the befitting recompense of those on whom they must necessarily rely for the health and sanitary welfare of their troops.

As we are still in the age of fable, it may not be out of place to notice with what tenacity the human mind clings to those delusions which fear engenders, and weak hopes sustain: with all our boasted enlightenment, the _marvellous_ and the _incredible_ have more worshippers than the _real_ and the _true_. Let us not wonder then, that the pure monotheism enunciated in the Holy Scriptures had so little charm for the sensuous and imaginative Greeks. Socrates, who, by the simple force of reason and philosophy had reached the very portals of the temple in which was enshrined the idea of the unity of God, in his _last hour_ “sacrifices a cock to Esculapius.” The reputed offspring of an impure deity, History is unhappily more abundant in records of human folly and superstition, than in examples of purity of thought and action—simplicity is everywhere despised—facts are distorted or made subservient to sensations; for example:—It is not enough to tell us that Chiron was skilled in physic, but to suit the depraved appetites of the vulgar he is a _centaur_, and Esculapius a _god_. It is therefore with something like relief that the name of Hippocrates comes before us, for in him we have a _reality_, and in his works a remarkable record of the condition of medical science in the fifth century before Christ. He was born at Cos, a small island off the coast of Caria, not in Greece proper, in the first year of the 80th Olympiad.

Hippocrates was descended from Esculapius by his father’s side, and from Hercules by his mother’s, and was the son of Heraclides, a physician of the family of the Asclepiadæ, who furnish us with the very earliest instance of a body of philosophers devoting themselves to the healing art; for, although Pythagoras, who lived immediately before Hippocrates, and Democritus, who was his contemporary, were both learned physicians, yet, whatever fame they acquired, was ascribed to their powers as mental philosophers and rhetoricians.

It has been urged by way of apology for the mystery in which the philosophers shrouded their wisdom, that “science, like modesty, should cover itself with a veil to increase the charms of the treasure it conceals;” and this principle has been, throughout all ages, more generally acted upon than avowed.

The character of Hippocrates is at once a study for the physician and the moralist; the former will appreciate the astonishing evidences which his works afford, of a deep acquaintance with the whole subject of medicine, and his admiration will be increased by the remembrance that all the principles laid down by this great and good man, were the results of his own experience.

No treatises on disease existed anterior to his time to aid him in his investigations of the phenomena of nature, although it is true that in the Asclepion or temple of Esculapius at Cos, records were kept and votive tablets preserved commemorative of cures performed, and of the remedies by which they were effected. But if the physician admires his talents, the moralist does honour to the qualities of his mind and the goodness of his heart. Benevolent and disinterested, pious towards the gods, and incorruptibly devoted to his country, he instructed his fellow men, not by shedding maudlin tears over their follies, like Heraclides, nor by the coarse laughter of his friend Democritus, but by a calm and even walk of life, mitigating sorrow by his skill, and showing the form and beauty of virtue by his example.

His portrait of a worthy physician may well serve for his own likeness, and in its description we shall observe that the exalted principles of professional ethics therein inculcated, are as strictly applicable to our own times as they were to those which he himself enlightened and adorned. His words are:—“The physician who is an honour to his profession, is he who has merited the public esteem by profound knowledge, long experience, consummate integrity, and irreproachable life; who, esteeming all the wretched as equals in the eyes of the Divine Being, hastens to their assistance, speaks with mildness, listens with attention, bears with their impatience, and inspires that confidence which sometimes of itself restores life; sensibly alive to their sufferings, carefully studies the causes and progress of the complaint; not disconcerted by unforseen accidents, but, in emergencies, having exhausted his own resources, holds it a duty to call in his brethren of the healing art to assist him with their advice. Having struggled with all his strength against the malady, he is happy and modest in success, and in failure congratulates himself that he has, at least, alleviated the sufferings of his patient.”

One of the great obstacles to the advancement of anatomy and physiology was the universal reverence for the dead which the Greeks and Romans shared in common with all the people of antiquity. Among the Jews, to touch a dead body exposed the offender to a penance of seven days’ exclusion and privation from the ordinary comforts of life; and it is almost superfluous to add, that the Egyptians made this reverence a part of their religion.

He, then, who ventured on the dissection of the human body, did so at great personal risk, and for more than 600 years after the foundation of Rome, no instance is known of the existence of any public professor of anatomy. About that time Archagathus, a Greek, practised surgery in Rome; and it appears that his use of the knife, and the actual cautery, was so abhorrent to the general feeling, that he was saluted with the opprobrious title of “Carnifex.” Even in later days the learned Tertullian classed anatomists and butchers together in a philippic he pronounced against Herophilus, whom he charged with having tried experiments on the living body. He commences:—“Herophilus, the physician, or butcher, whichever you please, who to become better acquainted with men, ripped them up alive,” &c. &c.

Of this same Herophilus, who appears to have been a man of humour, as well as genius, there is an excellent story told:—A certain _Diodorus_, a contemporary philosopher and teacher of paradoxes, declared that there was no such thing as _motion_. “If a body _moves_,” says he, “it moves into the place where it _is_, _or_ into the place where it _is not_; now it does not move into the place where it _is_, for what is _in_ a place _remains_ there, and, consequently, one cannot say that _it moves_. It also cannot move in a place where _it is not_; and therefore, it does not move at all.” This acute gentleman having dislocated his arm, begged the services of Herophilus, who, smiling, said:—“Either the bone of your arm is moved into the place where it _was_, or into the place where it _was not_; now it cannot move, according to your principles, either in one place or another, consequently it is not displaced at all.” The poor teacher of paradoxes saw that Herophilus was laughing at him, and in an agony cried out:—“Leave, I pray you, _dialectics_ and _sophisms_ to me, and treat me according to the laws of medicine.”

The inference that dissection was not openly allowed, will be strengthened by a short reference to the subject of the embalmment of the dead—the first mention of this custom is found in the 50th Chapter of Genesis; where, at the second verse, we read:—That “Joseph commanded his servants, the physicians, to embalm his father, and the physicians embalmed Israel;” and at 26th verse of the same chapter it is written:—“So Joseph died, being an hundred and ten years old, and they embalmed him.”

The Egyptians believed that so long as the human body could be saved from putrefaction or decay, the soul of that body continued in existence; and from this feeling arose the custom of embalming, so common in remote ages. The embalmer was, in a certain sense, a _sacred_ functionary; nevertheless, it was the fashion to make a show of resistance, when he began his operation, in order to mark the innate horror of any, however necessary, profanation of the dead body. Herodotus relates that in Egypt the mummy embalmers made the incision in the side of the corpse with a sharp æthiopic stone. Of these stones two varieties have been found in the tombs in Egypt, both of chipped flint, and very neatly made. One kind is like a very small cleaver; the other has more of the character of a lancet. The account given by Diodorus Siculus of the resistance offered to the embalmer is, as follows:—“And first, the body being laid on the ground, he who is called the scribe marks on its left side how far the incision is to be made; then the so-called slitter (paraschistes) having an æthiopic stone, and cutting the flesh as far as the law allows, instantly runs off, the bystanders pursuing him, and pelting him with stones, cursing him, and, as it were, turning the horror of the deed upon him, for he who hurts a citizen is held worthy of abhorrence.”[8] Immediately after death the corpse was put into the hands of the embalmer, who in the presence of the friends of the deceased, made an incision into the left side, as above described, through which he extracted all the intestines, leaving the heart and kidneys; the intestines were then washed in palm wine, and a solution of astringent gums. The _brain_ was removed through the nostrils by means of a hooked instrument, contrived for the purpose, and the cavity filled with aromatic oils. The body was now anointed with spice-oils and balsamic gums (frankincense being prohibited), and allowed to remain for thirty days, after which it was immersed in a solution of nitre for from forty to seventy days (the latter being the extreme limit allowed); it was then enveloped in aromatised cere-cloths, and all being ready, consigned to the coffin, on which were painted emblems indicative of the condition of the deceased. The process is said to have cost £300 of our money, and was, of course, only applicable to the rich. The fee for embalmment alone, varied from a _Talent_ (which has been estimated by some as equivalent to £193 15s., and by others to £243 15s. of our present money) to a _Mina_, in value about £3 4s. 7d.

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Footnote 8:

Taken from E. B. Tylor—“Early History of Mankind,” p. 217.

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The embalmment of the middle classes was, in some degree, regulated by their means; the simplest form being, the destruction of the intestines with strong oil of tar, and after their removal soaking the body in a strong solution of nitre for a period not exceeding seventy days.

Some have ascribed the practice of embalming to the fact of the periodical inundations of the Nile rendering interment impossible at such seasons, and hence have thought that necessity had quite as much to do with the custom as the religious principle: but this idea is not well founded, for although the Nile continues to overflow, embalmings have ceased for ages.

After Hippocrates the name of Aristotle comes before us. Aristotle, the pupil and friend of the venerable Plato, whose doctrines he adopted and developed, lectured at Athens 370 years before Christ. As a physician and naturalist he was far in advance of his contemporaries, and as a mathematician and moral philosopher, his transcendent learning was, for ages, the theme of every scholar; and his “System of the Universe” adopted by the whole of the civilized world. These great qualities attracted the attention of Philip of Macedonia, who chose him as the tutor of his son Alexander (the Great). Ignorance and superstition were, however, omnipotent, and for having enunciated the doctrine of one God, and a supreme first cause, the priests of the various temples seeing their craft in danger, excited the populace, who threatened his life. Warned by the fate of Socrates, he retired to Chalcis to wear away a life embittered by personal suffering, and sorrow for the folly and ingratitude of his countrymen.

The heart’s deepest feelings are roused at the remembrance of the deeds of violence perpetrated against every benefactor of mankind who has had the courage to promulgate truths beyond the comprehension of the vulgar on the one hand, and opposed to the vested interest of established errors on the other. The fate of Aristotle is a common result, not confined to the dark ages, nor without examples amongst ourselves.

The learned Philo of Alexandria, who lived A.D. 40, has given us an interesting account of the very remarkable sect living in Egypt in his day, known as the “Theraputæ,” or “healers.” He describes them as a confraternity who, after having received a special training in the University of Alexandria, devoted themselves to the healing art; they led a secluded, contemplative life, and laid the foundation of the monastic system. Eusebius calls them Christians, but this is not confirmed by Philo, who was a member of the sect; they were, probably, Platonists, or philosophical pagans. They ascribed their cures to prayers, fastings, and incantations, eschewed all material remedies, and medicaments, but made free use of magical rites of both forms—the leucomancy, or white magic, used in invoking the gods, and necromancy when the demons were to be propitiated or coerced. St. Luke, before his conversion, is supposed to have been a Therapeut; and St. Paul denounces some of their errors. Of their faults we cannot judge, but we may admire the benevolence with which they devoted themselves alike to the physical and moral welfare of their fellow men—in this respect, no unworthy forerunners of Him who commanded his disciples, not only to “instruct the ignorant,” but to “heal the sick.”

We pass over three centuries to come to the time of Celsus, who, in the reign of Tiberius and the first century of our Lord, was established at Rome; where he acquired great honour and renown. To these he was fairly entitled by the extent of his learning and the especial attention he paid to surgery and medicine. His principles governed the medical world without a rival until the time of Galen, who divided the empire with him for centuries.

Celsus was the first native Roman physician whose name has been transmitted to us: the practice of medicine and surgery being, prior to his time, in the hands of eminent Greeks and Asiatics, excepting that there existed in Rome (at that period) a race of native practitioners, who belonged to the class of slaves[9] or persons of low degree; and to whom were entrusted only the subordinate branches of the healing art.

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Footnote 9:

See Notes and Letters of Pliny.

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The great proficiency of Celsus on the subjects of rhetoric, philosophy, military tactics, and rural economy, as mentioned by Quintilian, has induced many of our older writers to doubt whether he ever really practised medicine and surgery, or, whether, like the elder Cato, he simply studied them as a branch of general knowledge; and this scepticism has been favoured by the fact of his name being omitted by Pliny, in his “Treatise on the History of Medicine.”

On the other hand, no one, I think, can rise from the perusal of his celebrated work, “De Medicina,” without being thoroughly convinced that his intimate acquaintance with the theory and practice of medicine, surgery, and pharmacy, could only have resulted from close bedside observation.

Galen was born at Pergamos, in Asia, in the second century; his learning was great, and his literary labours enormous. Having traversed Egypt and Greece, and acquired a knowledge of every science taught in the schools there, he settled in Rome. His works have been estimated at over 300 volumes—medical, physical, and metaphysical. He practised bleeding more frequently than his predecessors, but he gave very careful directions as to the conditions under which venesection should be resorted to, as well as to the quantity of blood to be taken.

Averroes, Avicenna, and other Arabian physicians held him in great veneration; and Dr. Alison says:— “For centuries after his death his doctrines and tenets were regarded in the light of oracles, which few persons had the courage to oppose; and the authority of Galen alone was estimated at a much higher rate than that of all the medical writers combined, who flourished during a period of more than twelve centuries.”

Rome, in its decadence, was too much occupied with the intrigues and villainies of the factions by which it was ultimately destroyed, to spare any time for the culture of science. It was not until after the total disappearance of the Eastern Empire, and the hollow tranquillity which succeeded the triumphs of Mahomet, and the subsequent subjugation of Spain by the Moors, that learning reared its head in Alexandria, and the Arabian physicians came into view.