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imitating, and their difference in this respect is one of the many contrasts between the two greatest of ancient physicians. Hippocrates tells us briefly and simply what he has observed of the natural history of various diseases, in order that others may do likewise, and that some definite knowledge may be obtained of what disease is, how it affects the human body, and its probable course in each case. But the stories which from time to time enliven the endless discussions of Galen are introduced either to show how much cleverer he was than his colleagues, or at best to exemplify and support some particular theory.

And in this, as in other matters, the mediæval physicians followed Galen and not Hippocrates. In the medical writings of the next twelve centuries, we shall find many interesting stories of patients, but we shall not find a single clinical history of the type originated by Hippocrates, and taken down daily by every modern "clinical clerk ". Why was it that our ancestors chose Galen as their guide, while the physician whom he himself acknowledges as his master, and whom all now admit to have been the grander genius, became for a time little more than the shadow of a great name? One reason was that the system of the former was adopted by the Arabs, whose greatest representative, Avicenna, may be described as more Galenic than Galen himself, but others may be found in the diversities between the two physicians, the more important of which may be briefly enumerated. Some of them lie upon the surface. Hippocrates separated medicine from philosophy; the great aim of Galen was to reunite them. Hippocrates thinks little of theory and much of observation; Galen, if he does not absolutely reverse the order, at least considers them of equal importance. To Hippocrates medicine is before all things an art, "the Art,” as he continually calls it; Galen considers this as its lowest aspect, but his object is not so much to convert it into a science as into a philosophic system, and he accepts in its fullest sense the Dogmatic motto: "The physician who is also a philosopher is godlike ".

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Other differences are connected with the spirit of the times in which they lived, and these had a still greater influence on the future fate of their doctrines. The age of Hippocrates was marked by the free development of individuals and of small independent communities, and to this his teaching corresponds. He inculcates, not hard and fast rules, but general principles, which the physician must adapt to each particular case according to his individual judgment, and with such modifications as circumstances may require. And as with the physician so with the patient. The latter is to be looked upon as an independent organism, capable of self-regulation and not to be rashly interfered with from without or forced to adapt itself to the laws of any arbitrary system. Galen, on the contrary, was the member of a vast political organisation, embracing the whole civilised world, which, while it retained the forms of the republic, was in reality an autocracy, and which gave a brief respite from internal broils at the cost of freedom and progress. And similarly the Galenic medicine, while retaining some of the language of Hippocrates, was an attempt, and a successful attempt, to establish a universal system, to which both the mind of the physician and the bodies of his patients were expected to conform themselves, and which though it put an end to the quarrels of the schools tended at the same time to hinder progressive development. The mediæval period resembled the age of the Antonines far more closely than that of Pericles, and was essentially an age of authority in all things, bodily, mental and spiritual. Hippocrates, or one of his immediate pupils, had said: "Science and belief (opinion) are two things, the one begets knowledge, the other ignorance". It was hardly likely that the "Ages of Faith" would adopt such a teacher, especially when Galen, like an infallible Pope, was ready with a fixed rule for every case, and with a theory, or at least an assertion, to explain every difficulty.

But though Galen is inferior to Hippocrates, and though his followers persisted in retaining his livery till it was

antiquated and outworn, thereby bringing ridicule both on themselves and their master, we must not let this blind us to the greatness and importance of his work. Some of it, as we have seen, is of permanent value. Much more of it was the best that could be done under the circumstances; and Galen seems to have collected together, as if by some special providence, those parts of the Greek medicine which could be most readily assimilated by his successors. It has been well said that just as the Roman Church preserved the spiritual unity of Western Europe during the middle ages, so did the writings of Aristotle and Galen prevent it from falling to pieces intellectually. Had Galen's works been lost, there can be little doubt that the dark age of medicine would have been darker and more prolonged than it was, for the mediæval practitioner could no more have appreciated the higher and freer teaching of the physician of Cos than he could have understood those grand words, "It seemed good to the Demos," which Hippocrates saw inscribed at the head of every decree, and heard proclaimed in every assembly.

XXI. THE MEDICAL PROFESSION IN ROME. IN 1723 the annual Harveian oration, delivered by Dr. Richard Mead, dealt with the early history of medicine, and gave rise to a controversy on the social state of physicians in Rome which spread throughout Europe, and lasted so long that industrious Germans have devoted special works to its history. But it will be sufficient for us to accept the judg ment of Cicero, who says that medicine, like architecture, is no dishonourable occupation "for those to whose rank in life it is suited ".2 Had the great orator been asked whom he meant, he would probably have answered, with some surprise: "Freedmen and foreigners; certainly no Roman citizen". Recollecting his own physician, Asclepiades, he might have added that other nations had other ideas, and

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that should a cultured and travelled Greek come to Rome, he (the consul) would not hesitate to meet him as an equal, though a physician, and might even invite him to the Tusculan villa to discuss Falernian wine and the Epicurean philosophy with Licinius Crassus and other consulars. But that

his own son, or the son of any other respectable Roman, should study medicine, except purely as an amateur-as that intelligent young man, Cornelius Celsus, seemed to be doing would be a calamity quam avertant Dei immortales. Crassus, indeed, was dead when Cicero became consul, and Celsus was probably yet unborn, but the above may be taken as expressing the ideas of even the more liberal-minded Republicans on the status of the physician.

In later times, when Julius had granted the citizenship; when Augustus had twice owed his life to his physicians; when Tiberius and Nero had well-nigh destroyed the old aristocracy of Rome, and slaves and freedmen had the ear of the emperors, the social position of medicine was greatly altered, and we find Quintilian 3 recommending as a subject for legal exercises a question which would probably have much disgusted the consul, whose eloquence saved his country: "Which is the most useful member of the State, the orator, the physician, or the philosopher?" Two other causes contributed to this rise of medicine in the social scale, the establishment of the Archiatrate, which deserves a chapter to itself, and the wealth acquired by some of its practitioners. We must not exaggerate the latter; the case was then much as it is now. A few able practitioners, a few notorious quacks, might obtain great possessions. Xenophon* might receive £5000 yearly from an emperor and complain that he could have got more in private practice; Charmis, the water doctor from Marseilles, might be paid £2000 by a single patient; but there was the usual crowd at the bottom of the ladder, and we hear of several physicians who were compelled to take to less honourable but more lucrative callings to escape starvation, one of whom, to the delight of the wits. of the age, became an undertaker's assistant." A large pro

portion of the profession, too, still belonged to the servile class. Nor is the reason far to seek, for, by having one or more slaves educated as physicians, their owner not only saved medical expenses, but greatly increased the value of his property, and the Justinian code estimates the servus medicus at 60 solidi (£36), just three times the value of an ordinary labourer, and double that of an artisan.

The development of specialism, and of those various medical parasites who naturally flourish in large and luxurious communities, is perhaps the most striking characteristic of professional history under the early emperors. The skirts of the medical robe have always had an unfortunate tendency to drag in the dirt, and the general character of many of these specialists was anything but reputable. Only the more prominent classes can be here mentioned, and we shall first consider the ophthalmic surgeons and drug-sellers, leaving the lady doctors and medical rubbers for a future chapter.

In the De Oratore Cicero makes Crassus observe that all arts are degraded by division; and he asks ironically: "Do you suppose that in the days of the Coan Hippocrates there were special physicians for diseases, others for wounds, and others, again, for the eyes?" We have seen that there certainly were, at any rate in Egypt, and in Greece we hear both of surgeons and ophthalmists very soon after the Hippocratic age, though it was not till the Roman period that specialism became prominent. Galen tells us that, in his time, large cities, such as Rome and Alexandria, swarmed with specialists, who also travelled about from place to place. Martial enumerates some of them in an epigram: "Cascellius extracts and repairs bad teeth; you, Hyginus, cauterise ingrowing eyelashes; Fannius cures a relaxed uvula without cutting; Eros removes brand-marks from slaves; Hermes is a very Podalirius for ruptures" (x. 56). But the most numerous and notorious were the oculists, who seem to have been further divided into a medical and surgical branch. The great occupation of the former was the invention of new