we have already referred, of the four assumed humors, Galen considers that, beside general plenitude beyond the grade of health, as it regards the blood-vessels, there may exist a bilious, a phlegmatic or pituitous, and a melancholic plethora; but he makes this distinction between the sanguineous and the three other species of plethora: viz. that when either of the latter exists, either separately or conjointly, it mixes with the blood and causes a cachomytous condition of the humors, the morbid condition of the system which thence results being marked by excess of heat, or cold, or dryness, or humidity, or acrimony, or sharpness, or saltness, or sweetness, or any other quality. Even of general plethora he admits of two kinds-the one relative to the vessels, the other to the powers of the system the former being present when the blood is absolutely superabundant, the other existing when the forces of the body are only equal to the propulsion or management of a certain quantity of blood, and the quantity then becoming, relatively to the powers circulating it, superabundant. 145. On symptoms, diagnosis, and prognosis, Galen treats pretty largely but we do not find matter under these heads sufficient to detain our readers. Indeed, both as it respects causes and signs and distinctions, there appears to us a good deal of mere verbiage, and certainly no improvement upon his master Hippocrates. On the vaieties of pulse he is rather more interesting; but even in this particular we find fancy and conceit occasionally to take the place of observation and truth. We may understand the minuteness, however, with which Galen attended to the circumstance of pulsation, from his having pointed out among others the mouse-tail kind of beat, by which he meant to desiguate that sort of pulsation which seems as it were to slide through the fingers in the manner of a rat or mouse's tail, and which strikes the different fingers with varied degrees of power. 146. In respect to the practice of Galen we may remark, in the first place, that blood-letting was employed more generally by him than by Hippocrates. He was the first to talk of the precise quantity of blood to be taken in this and that disorder. The principles upon which he directed blood-letting were similar to those of Hippocrates: viz. to lessen fulness, to drive it from parts affected, and to cause revulsion. When the patient was in circumstances to demand bleeding and purging, at the same time, he commenced by the former-which, by the way, may be generally stated not only a good practice, but as an important principle of practice. 147. Anodynes and soporifics were in greater use by Galen than Hippocrates; internal sudorifics were not much employed by him; he occasionally gave specific medicines, or those the modus operandi of which he professed not to understand; but, for the most part, he professed to administer medicaments rather from a principle of philosophical inference than from mere observation, and in this particular, as pointed out by Le Clerc, there was a considerable difference between him and Hippocrates. 148. Galen's anatomical knowledge was of course more extensive and accurate than that of Hippocrates, inasmuch as the actual inspection of human bodies, though still effected with difficulties and obstructions, was certainly occasionally had recourse to, and we have already stated it to be a doubtful point whether Hippocrates had, even in a single instance, enjoyed the opportunity of human dissection. Galen divides the body into four parts-the abdomen, the thorax, the head, and the extremities. The containing parts of the abdomen he describes as the skin covered by the epidermis, or outer skin, the membrane under the skin, and the fat: these are the parts common to this cavity and to other portions of the body, while the parts peculiar or proper to the abdomen are the abdominal muscles, the peritoneum, the epiploon, the stomach, the intestines, the mesentery, the liver, the spleen, the kidneys, the ureters, the urinary bladder, and the generative organs. This division of the intestines is that which obtains even to this day, namely, into duodenum, jejunum, and ilium; cæcum, colon, and rectum. His physiology of assimilation is expressed in the following manner :-The mass of aliment, having arrived in the intestines, is met and received gradually by the meseraic veins, which have the power of attracting the chyle mixed with this mass, in the same manner that the roots of trees draw their nourishment from the earth; they also commence the conversion of this chyle into blood, and carry it to the liver. After the chyle has thus been separated from the alimentary mass the rest of the mass becomes excrement, and is voided by the anus. The liver Galen recognises as the organ principally destined to the formation of blood, and as the origin of all the veins of the body. The spleen is considered as a tissue of vessels like the liver, but being different in the kind of vessels of which it is composed-the latter being principally made up of arteries, while the liver is formed merely of veins: he speaks of the spleen as attracting the black blood from the veins of the liver, thence drawing its nourishment, and transmitting the superfluous portion to the stomach by means of a short vein. 149. We have a description given of the kidneys, and of their blood-vessels coming from the aorta and the vena cava; the ureters are also described as transmitted from the kidneys and terminating in the urinary bladder, which has its sphincter for preventing involuntary discharges. He speaks of the organs of generation in the male and female as being the same, with the exception of difference in size and position; and his theory of generation supposes a mixture and combination of the semen of the female with the semen of the male. 150. In describing the anatomy of the thorax, Galen speaks of the diaphragm, and of a membrane which comes from the parieties of the chest and furnishes the same covering to the lungs and heart that the peritoneum does to the abdominal viscera: he speaks also of a separating membrane between the two cavities of the chest. When describing the heart he speaks of its straight, transverse, and oblique fibres; he describes the pericardium or enveloping membrane of the organ, speaks of the auricles and ventricles of the heart, of its valves, and points out the difference between the fatal and adult heart in reference to the distribution of its vessels. He speaks of the lungs as formed of a parenchymatous substance, similar to the liver and the spleen: he mentions the trachea as of cartilaginous formation, points out the laryngeal cartilages, speaks of the situation and office of the epiglottis, describes the thymus gland, but is obscure both in his account of the mode in which respiration is performed and of the vascular connexion of the heart with the lungs. 151. When on the subject of the brain, Galen speaks of the pericranium, of the five sutures, of the dura mater and its sinuses, of a fine or choroid membrane under the dura mater, of the larger and smaller brain, of the ventricles, plexus choroides, pituitary and pineal glands, &c.; and here we have a good deal of wild speculation concerning the use of these several parts of the brain, such as the ventricles receiving and conveying away superfluous moisture, and receiving air from without and preserving the animal spirits in a proper condition. As to the general office of the brain, our author considers it the seat of the understanding, and as giving origin to the nerves. He speaks of the nerves from the cerebellum as principally appropriated to motion, while those from the larger brain are for the sentiments. He speaks of seven pairs of nerves-the optic, the motores oculorum, the lingual, the gustatory, the auditory, the sixth pair immediately following these and giving origin to the recurrents, and the seventh going mainly to the muscles of the tongue. From the spinal marrow he recognises sixty pairs of nerves; the organs of sense are described with some degree of minuteness, more especially the eye; for it is remarkable that in Galen's account of the interior of the ear he is extremely defective: he does not even describe the Eustachian tube, which was discovered and described many years previously to the time in which he lived. 152. Galen speaks of arteries, veins, and nerves as three distinct kinds of vessels; he says the nerves convey sensation and the faculty of motion through all the parts of the body; that the veins and the arteries both convey blood from the centre of the body to its circumference; but that the blood of the veins, which is the grossest, serves to nourish parts, while that of the arteries, being more subtle, is for the purpose of vivifying them. 153. Lastly, we may state in reference to the anatomy of our author, that his description of the bones and muscles is occasionally correct as well as minute; but at times there appears to be reason to suppose that he takes his account from apes and other animals whose external form comes nearest to man, for want of opportunities whence to describe the actual anatomy of the human subject. 154. The epoch of Arabian medicine is so well though briefly given by Cabanis, in his Sketch of the Revolutions of Medical Science, that we shall use the freedom of transcribing the section of that work which refers to this parti cular. 155. From Galen to the time of the Arabians, says the author just named, medicine appears to have revolved in the circle of the opinions which we have seen successively prevail among the Greeks. Its condition during the continuance of the eastern empire is little worthy of attention. We might perhaps in this interval find some observations worth collecting with respect to the hospitals which were at that time established at Constantinople, and in several other cities of Greece, in Europe and Asia; but this subject has but a remote connexion with that now under consideration. 156. The Alexandrian library, which had been formed by the unremitted care of a long succession of princes friendly to the cause of learning, was burnt during the war between Cæsar and Pompey. A violent insurrection having taken place in the city, Cæsar ordered the ships that were in the harbour to be set on fire. The fire communicated on a sudden to the buildings of the library, and not fewer than 400,000 volumes were consumed by the flames. 157. However this loss was in a short time replaced, at least as far as it could well be. Antony made a present to Cleopatra of the library of Pergamus, which contained 200,000 volumes. This stock was by degrees augmented; the books attracting men of letters, and the men of letters, on the other hand, created an influx of more books. In this manner Alexandria became again the emporium of the sciences and arts. 158. Medicine, in particular, was taught there with much success. Students from all quarters of the globe resorted to it to receive the instructions of the most celebrated masters in the world; and this school, which had been founded in the happiest age of Greece, was still enjoying an undiminished degree of credit when the conquest of Egypt by the Saracens took place. 159. Amron, who commanded the expedition, was desirous to save the library; the answer of Omar is well known. Thus a treasure of incalculable value to the whole human race perished through the barbarous fury of Mussulmans. 160. Yet the proscription was less general with respect to books of medicine, of natural history, and of natural philosophy. Some few escaped destruction either on account of the interest which the most stupid men take in the science which promises them health or an alleviation of their complaints; or, as some writers are of opinion, on account of the idea which generally prevailed in the east, that they would learn from them the art of making gold. 161. The first versions of these books which appeared were in the Syriac language; for the Arabian translations are of a later date. The works of Aristotle and Galen were those fo which the Arabians evinced the most enthusiastic admiration. They translated them with the greatest care, and commented on them in different ways and with different views. Their subtle minds were admirably adapted for the Peripatetic system of metaphysics, and for that farrago of abstract propositions which bears down the small number of just and ingenious views it contains. Their literati, who were as fond of pillage as their warriors, appropriated to themselves the ideas that were to be found in works of little note; and sometimes did not scruple to lay claim to whole books, only taking care to suppress the name of the author. Even their most celebrated writers are not altogether free from this reproach. 162. To the Arabians we are indebted for some important improvements in the art of preparing medicines. They introduced into practice the use of mild cathartics or lenitives: and Rhazes, an Arabian physician, is the first who describes the small-pox. The moderns, no doubt, have far surpassed him in the observation of the different characters it assumes, and of the appearance it exhibits according to the age, the temperament, the state of the body, and the epidemical constitution prevalent at the time when the disease occurs; but it is delineated with much accuracy in his writings; and till the time shall come when the practice of inoculation (simplified as it has been by the beautiful discovery of Jenner) shall have completely effaced it from the catalogue of diseases, Rhazes and some other Arabians who have treated of this disorder (by the way we may remark that Cabanis is not correct in saying that Rhazes was the first to describe the small-pox), will continue to be read with much profit. 163. The works of Hippocrates were translated into Arabic at the same time with those of Aristotle and of Galen. But his simplicity, his precision, his doctrines founded upon experience, that prudent philosophy and rigid method which observes with care the footsteps of nature, were far from exciting the same degree of enthusiasm as the scientific pomp and imposing luxuriancy of the two others; and indeed the Arabian systems of physic have always retained this cast, for in them we look in vain for that genius and that delicacy of discernment which are to the science of medicine what taste is to the polite arts. 164. If we regard merely the absurdity of the enterprise, and the stupid ferocity which gave birth to it, the crusades were nothing more than a cruel and superstitious disorder of barbarous times. But we must at the same time admit that they became very powerful means of weakening and diverting the force of feudal tyranny; and, above all, that they tended to enlarge the intercourse between the ignorant Europeans and the Saracens, who at that time were more enlightened. It also appears that we are indebted to them for the first notion of the municipal system of law. It was at Jerusalem that a class of citizens suddenly emerged from amid the Christian armies, and that their chiefs, by conferring upon them different functions of the magistracy, were enabled by their aid to keep in subjection those bands of turbulent nobles who till then had known no authority. 165. Besides, the better informed part of these nobles, who returned to Europe, brought with them a number of new ideas. The flourishing aspect of the towns and palaces, inhabited and embellished by the Arabian chiefs, and the luxury and conveniency which they exhibited, had naturally inspired them with new desires; and either from this circumstance, or from their connexion with the Genoese and Venetian merchants, the crusaders began first to perceive the value of the arts, and afterwards that of the sciences which elucidate them, or of the literature which enlivens them, which serves them for a guide, and forms, as it were, their necessary accompaniment; and soon diffused a taste for them through the western world. 166. The unfortunate remains of the Alexandrian school, which had escaped the fury or rapacity of the Saracens, were collected by the emperors of the east. While the Arabians endeavoured to promote the advancement of science in Asia and Spain, Greece retained some faint traces of her former splendor. The scenes of so many glorious exploits, of so many feats of genius, and of the industry of its ancient inhabitants, were still before their eyes. The first productions in the most beautiful language that ever was spoken were in the hands of every one; the monuments of which the avarice of the Romans had not been able to deprive them, and those which the luxury of the emperors of Constantinople had raised, at a vast expense, supplied their lively imaginations with ideas that favored the development of all the mental faculties; and, if it had not been for the theological disputes which the folly of princes had kindled, their genius might have shone with a lustre at least as strong as can be expected to emanate among a people that had lost its liberty. 167. It will have been observed that in the above account, taken from Cabanis, the author scarcely alludes to any other physician than Rhazes, who was indeed the great luminary of the Arabians; but, before his time, Isac, Sera pion, and Avenzoar flourished; then afterwards Avicenna wrote very voluminously, and Averrhoes, Alsaravius, and many others, become conspicuous by their works. What the Arabians principally did for medicine was the introduction of several new drugs which the east supplied; but even on this point, as well as in reference to the literature of the art, a great deal was often assumed as novelty which, as above intimated, only consisted in change of nomenclature, or in unacknowledged copies from the Greeks and Romans; nor was the plagiary detected until the time when the Europeans received back, partly by the crusaders and partly by the Saracenic invasion of Spain, that learning which had emigrated and so long been confined to the eastern part of the world. It is a curious fact that the Europeans, at the time to which we are now alluding, actually first became acquainted with the works of Hippocrates and Galen through the medium of Arabic translations. 168. Historians usually at this epoch have introduced to the notice of their readers the particulars of Jewish medicine. The Jews migrating to Spain with the Moors, and still constituting a separate and distinct people, opened schools at Toledo, Grenada, and other parts, and became celebrated as physicians. They became the subjects of persecution; but, in spite of objections raised against them, continued, for a long time, to maintain their ascendancy in public repute, especially in the northern parts of Europe. Scarcely any of their works, however, remain as memorials of the ground of distinction which they so long retained; and they at length became lost and amalgamated (we now speak of them merely as physicians) with the people among whom they sojourned and associated; and there are no particulars upon which we need at all rest, until the time when chemical medicine came into vogue. What is called alchemy was of Arabian origin. It was in the east that those dreamers first began to speculate and to operate who believed in the transmutation of different metals into gold, and in the existence of a something, could it but be found, which had the power of prolonging the duration of life to an unlimited period. In the researches set on foot to obtain these secrets, and accomplish these objects, many useful facts and principles incidentally unfolded themselves; and as the fanaticism of the crusades was followed by collateral and unlooked for good, so did the folly of the alchemists work out many of nature's secrets, which but for the extraordinary impulse now alluded to might have still remained unknown. But not only did the general fanaticism of the times, but the fanaticism and folly and rudeness of one individual, and that an unlearned man, operate a considerable change upon the character and 172. Van Helmont is the next of the chemicomplexion of medical speculation; and, like cal physicians who demands notice in this place. Brown in a later period, did Paracelsus at the This celebrated individual had consumed a great beginning of the sixteenth century effect a very part of his youth in studying the works of the material revolution in the science and art of alchemists. To him has been ascribed by some bealing. This extraordinary man, says Cabanis, the first discovery of factitious airs, and, alwhom the solitary practitioner cited by Bordeau though there is some error in this unqualified calls the greatest fool of physicians and the great- ascription, there cannot be a doubt that much est physician of fools, was unquestionably the credit is due to him for the mode in which he prototype of mountebanks-a perfect pattern of considered the doctrines of aëriform existence. pride, madness, and impudence. From the ob- He was undoubtedly an independent observer, scurity of the alehouses of Basle he practised upon and an original thinker, and we shall here take the credulity of princes, and even of some men occasion to make an extract from his writings, who were in other respects very enlightened for their which indeed we have already presented to our age. Leaving these disgraceful haunts, and at- readers in the article CHEMISTRY; but which, tended by a multitude of infatuated adherents, he as remarkably illustrative of the workings of an poured forth a volley of lies, absurdity, and abuse, ingenuous and ingenious mind, and as by no against his rivals. He proscribed every thing means inapplicable to our present purposes, we that was not his-he cried, with a frantic voice, may here not improperly again introduce. 'Away with Greek, Latin, and Arabic!' and he publicly burnt the works the fame of which he was desirous to destroy. required; and, if his natural disposition had allowed him to do justice to those whom he impudently copied, while he was abusing and reviling them; if he had not been constantly obliged to work upon the passions of the multitude which surrounded him, he no doubt would have been able to promote to a great degree that revolution which was sooner or later to effect the revival of the true science of medicine in Europe. 171. It cannot be questioned that the speculations and dogmata of Paracelsus very considerably influenced the medical doctrines and practice of the times in which he lived; and, although perhaps the most respectable portion of his contemporaries and immediate successors preserved their faith in Hippocratic and Galenic medicine; the chemical mode of reasoning on pathology, and the application of chemistry to medicinal composition, came to be very generally admitted soon after the period at which Paracelsus first announced chimerical novelties, and broached his strange compound of alchemic, astrological, and magical pretensions. 169. Such was Paracelsus, who fancied himself a great man because his name was oftener mentioned in all parts of Europe than that of his contemporaries. Since that time the severest justice has succeeded this infatuation, and there is not a single physician whose opinion is allowed to have any weight who has not perceived the inconsistency of his ideas, and the extravagance of his pretensions. How often have all the odious and ridiculous features in his conduct been exposed and detailed! and yet justice compels us to acknowledge the real services which he rendered to science; the utility of the remedies he first introduced into practice, or which he employed with more boldness and success than his predecessors; and that peculiar sort of sagacity he possessed, which, without meriting the name of real genius, prepares the mind for certain discoveries to which a more cautious mode of procedure never could have led. 170. Paracelsus had perceived the principal errors of the prevailing systems of physic, and had some distant idea of the reforms which they 173. 'In 1594,' says Van Helmont, I finished my courses of philosophy, but upon seeing none admitted to examination at Louvain who were not in gown and hood, as though the garment made the man, I was struck with the mockery of taking degrees in arts. I, therefore, thought it more profitable seriously and conscientiously to examine myself, and then I perceived that I really knew nothing, or at least nothing that was worth knowing. I had, in fact, merely learned to talk and to wrangle, and therefore refused the title of M. A., finding that nothing was sacred, nothing true; and I was unwilling to be declared master of the seven arts, when my conscience told me that I knew not one. The Jesuits, who then taught philosophy at Louvain, expounded to me the disquisitions and secrets of magic, but these were empty and unprofitable conceits; and instead of grain, I reaped stubble. In moral philosophy, when I expected to grasp the quintessence of truth, the empty and swollen bubble burst in my hands. I then turned my thoughts to medicine; and, having seriously read Galen and Hippocrates, noted all that seemed certain and incontrovertible; but was dismayed, upon revising my notes, when I found that the pains I had bestowed, and the years I had spent, were altogether fruitless; but I learned at least the emptiness of books and formal discourses and promises of the schools. I went abroad, and there I found the same sluggishness in study, the same blind obedience to the doctrines of their forefathers, the same deep-rooted ignorance.' 174. It may easily be imagined that an individual, who would think and express his thoughts in this free manner, would not be likely to subscribe to the dicta of established systems; and we find him accordingly breaking through the trammels of the schools, both Hippocratic and even chemical, and proposing dogmata, independent of either. It may be here remarked as a fact worthy observation, that Van Helmont was the first systematically to propound the principle of stomach agency in exciting sympathetic affection to an almost unlimited extent. This sympathetic doctrine has lately been propagated and talked of as something entirely novel; but the merits of the modern pathologists in reference to stomachic influence consist rather in simplification, if we may so say, than in originality; for Van Helmont threw out the idea, but he was not contented to confine himself to the simple fact, but in consistency with the tendency of the times; viz. that of imagining occult and intelligent agencies in the regulation of vital phenomena and morbid incident; he exalted the stomach influence, or rather the influence of the central nerves, into an esssential and governing principle, to which he gave the name of archæus. But we are here tempted again to extract from a modern author in reference to Helmont's views, as the mode in which the doctrine is delineated appears to us so exceedingly just, and to the English reader of the present day so particularly interesting. 175. Van Helmont, says Cabanis, had spent his youth in studying the works of the adepts. Endowed by nature with a glowing imagination, he increased its ardor by his acquaintance with them; and the fire of their furnaces had the effect of completely inflaming his mind. Yet, amid the tarnish of alchemy and superstition by which his ideas are too often obscured, vivid gleams of light are at times observed to appear. It was in pursuing the path of error that he made several fortunate discoveries, and it was in the language of quackery that he announced the sublimest truths. 175*. Van Helmont was one of the most inveterate opponents of the Galenian system, and of the schools which were most in vogue in his time. He indeed allows no opportunity of attacking the latter to escape him; and frequently combats them with great justice and discernment. Nothing could be more unlike his system of physic than that which was then generally taught; but the circumstance of thinking differently from the rest of mankind is not always a sure criterion of thinking rightly. 176. Van Helmont had the merit of being the first who demonstrated the influence which the epigastric organs exert upon the rest of the system. Some obscure hints of this influence were no doubt to be found in the writings of Hippocrates; but the latter appears to have noticed it merely for the purpose of observing the narrow limits within which he supposed it to be confined. No one, after this time, seems to have paid particular attention to the subject, till Van Helmont perceived the potent action of the stomach upon other organs of the body, and that of the digestive power upon their respective functions. He remarked, too, that the diaphragm, which is placed both as a partition and means of communication between the thorax and abdomen, becomes in consequence of its connexion with other parts, and the vicinity of some of the most important viscera, a principal centre of action in the economy of the living system. 177. Numberless facts may be added in support of this opinion. The physicians of the Montpelier school have collected those that are most striking, and have illustrated them in different works with much more method and perspicuity than Van Helmont could have done. 178. Each organ has a sensibility peculiar to itself, although closely connected with, and subordinate to, that of the whole system; particular properties serve to distinguish it from all the other organs; and certain functions are exclusively ascribed to it. Van Helmont supposed that the characteristic distinctions of the different parts of the body depend upon the causes that animate them; and believed that in each organ there resided a principle charged with its government; that a superior principle, to which the author gave the name of archæus, had the superintendence of all the rest; and that from their concurrence and systematic combination the general principle of life results, in the same way as the body itself is formed by the union of all the members. The great archæus is supposed to arise at the superior orifice of the stomach; whence, as it were from his throne, he issues orders to the inferior archæi, according to their different jurisdictions. The latter, though obliged to obey, even the caprices of the former, take care always to add something of their own, either good or bad; and it is in all these operations combined, that the regular actions of the healthy state, and the anomalous appearance of disease consist. 179. The art of medicine then, according to the above theory, consists in the faithful study of the character of the common central principle, and of the nature of the other inferior principles; in knowing when to rouse their industry or suppress their rage; and what are the proper means of governing their passions, or correcting their mistakes. All this, translated into common language, implies, that in animated bodies there exists a general cause of the operations of life; that the different organs, though constantly dependent upon this cause, have, nevertheless, certain modes of being affected and of acting peculiar to themselves, which are the necessary consequence of their peculiar structure; that the object of medicine is to trace the laws by which this cause is governed; to determine the modifications it undergoes in different parts of the system, and in different circumstances, and to ascertain the means of operating, both upon the whole system in general, and upon any organ |