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the wounded. The development of an army medical service would thus be favoured by both bad and good rulers, and the following is a brief outline of its condition under the most warlike of the latter class, the Emperor Trajan, at the close of the first century.

The Roman army of this period may be classed under three heads: (1) The garrison of the city, comprising nine pretorian and four urban cohorts, together with the seven cohorts of the Vigiles, who acted as police and firemen. Each cohort contained 1000 to 1500 men, and each appears to have been provided with four surgeons or “medici". The pretorians seem to have even had specialists, for we hear of a "medicus clinicus," or pure physician, attached to one of their cohorts. (2) Thirty legions, each consisting of ten cohorts and about 6500 men. Here we only find mention of a "medicus legionis," but from what is known of the very liberal provision for the more stay-at-home soldiers, it would be absurd to suppose that there was only one surgeon for each legion, and we may estimate their number as at least six, or perhaps ten, though they were not attached to particular cohorts. They ranked with the standard-bearer and trumpeters among the "principales" or non-commissioned officers, and, as may be seen on Trajan's column, they wore the ordinary dress and arms of the legionary. (3) The infantry and cavalry of the allies, which were divided into cohorts and alæ respectively. Their surgeons were, perhaps, of a somewhat inferior class, and are sometimes distinguished by the title "ordinarius". Thus, the Newcastle Museum contains the tombstone of Anicius Ingenuus, "medicus ordinarius" to the first Tungrian cohort, one of those employed in building and defending the Roman wall.

With the standing army came the stationary camps, with which we may probably connect the camp surgeon, "medicus castrensis," and the “valetudinarium," or military hospital. The latter is first mentioned by Hyginus in the second century, but had probably already existed for some time. He recommends that it should be placed opposite the

"veterinarium," but at a sufficient distance to save the patients from being disturbed by the noise of the "fabrica," or blacksmith's shop. When more than three legions were in the camp, there were additional "valetudinaria," and their general arrangements were superintended by special officers, the "optiones valetudinarii," who ranked after the cen

turions.

The system thus briefly sketched was continued during the Byzantine Empire, with some slight modifications, and with the interesting additions of the deputati" and the

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nosocomi". The "deputati" are first mentioned in the Emperor Maurice's book On Tactics (about A.D. 590), but, as he modestly confesses that he knows nothing of the subject, and has copied from older writers, they may have originated somewhat earlier. In every troop or “bandon' of 200 to 400 men, eight or ten stout fellows were deputed to ride immediately behind the fighting line to pick up and rescue the wounded, for which purpose their saddles had two stirrups on the left side, while they themselves were provided with water flasks, and perhaps applied temporary bandages. They were encouraged by a reward of a piece of gold for each man they rescued. The nosocomi" were male nurses attached to the military hospitals, but not inscribed "on the strength" of the legions, and were probably for the most part of the servile classes.

The Roman navy, though considered a decidedly inferior branch of the service, was equally well provided with surgeons, and we possess the epitaphs of at least four naval “medici" of the triremes, "Cupid," Tiger," "Faith," and of one unnamed vessel respectively. Three out of the four have the epithet "duplicarius,” indicating that they received double pay, and the fourth, Lollius Valens, died a few weeks after his appointment to the "Faith". Faith". The privilege can scarcely have been due to the amount of their work, for the small "Liburnians" which composed the Roman fleet did not contain more than about 200 men, including rowers and soldiers; but we may perhaps attribute it to the

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dislike which the ancients, and especially the Romans, had of the sea, and which may have rendered it necessary to offer special inducements to candidates.

NOTE.

Simpson, Was the Roman Army provided with Medical Officers ? Edinb., 1856, and the review of this work, Med.-Chir. Rev., 1857; Briau, Du Service de Sante Militaire chez les Romains, 1866. Mommsen and Marquardt, Handbuch der Römischen Alterthümer, vol. v. The indefatigable Frohlich has collected all the references to the subject found in Latin writers at the beginning of his great work on Military Surgery.

XXIV. THE INFLUENCE OF CHRISTIANITY ON

MEDICINE.

IT must be admitted that the triumph of our holy religion, though by no means so responsible for the decline of medicine as is sometimes asserted, nevertheless tended to hasten, rather than to hinder that downfall; but by means of one great institution it has, in the long run, done far more to further the healing art than it ever did to injure it.

We have found traces of establishments for the sick in ancient India; the Greeks possessed public "Iatreia," which can scarcely be distinguished from rate-supported infirmaries; and Prescott tells us that the Spaniards met. with "hospitals" among the Aztecs of Mexico. But there is, I believe, no certain evidence of any medical institution supported by the voluntary contributions of large numbers of people, or by private munificence, till we come to Christian days. The primitive Church, as we learn from the Acts of the Apostles, cared for its poor from the earliest time, but we find no definite notice of any special buildings for the reception of the sick till the close of the fourth century. St. Jerome, writing about A.D. 400, says, that Fabiola, a noble Roman lady and his own friend, was the first to build a hospital. He tells us that she had divorced her first

husband and married again, but, being left a widow, publicly repented of her sin, sold all her possessions, and established a hospital for the sick in which she herself laboured. "How often did she carry the sick on her own shoulders! How often did she wash the putrid matter from wounds another could not have borne to look upon! With her own hands she prepared their food, and moistened with water the parched lips of the dying."

Perhaps the first hospital founded "by voluntary contributions" was that of Edessa, which traced its origin to St. Ephrem, the Syrian, a holy man who could declare on his death-bed that he had never spoken an idle word. To achieve this miracle he was obliged to pass much of his life as a hermit, but, about A.D. 372, hearing that the poor of Edessa were dying of starvation in the streets, he issued from his cave, and rebuked the rich Christians of the town for their heartlessness. They replied that it was not charity they lacked, but an honest man to take charge of their offerings. "What do you think of me?" asked Ephrem. “You are a man universally respected, and worthy of the fullest confidence." So the saint at once made a collection, and with the proceeds established a hospital of 300 beds in the public galleries. It soon, however, fell into neglect and had to be restored at the beginning of the next century by Bishop Rabboula, whom we shall meet again shortly.

But the grandest effort of early Christian philanthropy was the great" Ptochotrophion," or Almshouse of St. Basil, Bishop of the Cappadocian Cæsarea (370-379), though unfortunately we know nothing of its medical arrangements, except that it had special physicians, nor in how far the bishop was supported by the contributions of his flock. The humility of St. Basil has left us only the letters in which he defends his expenditure, and pleads for exemption from taxes, and his silence is but partially atoned for by the florid eloquence of St. Gregory Nazianzen. That enthusiastic orator bids bids his hearers go forth from the gate of Cæsarea and they will find another city, before which the

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seven wonders of the pagan world sink into insignificance. Here the saintly bishop had gathered together the poor, the fallen, the sick, and the afflicted from all parts of Christendom, nor did he hesitate to kiss and embrace the most loathsome of lepers, not out of ostentation, but in token that they also were his brothers in Christ. At a yet earlier period we hear of communities, both of men and women, "parabolani " and deaconesses, who sought out the sick and tended them in their own homes, and who in times of pestilence attracted even the notice of the heathen by their courage and devotion. But the "parabolani” unfortunately too often degenerated into body-guards of turbulent bishops, whom they assisted in asserting or refuting theological doctrines by the physical arguments of their swords and cudgels.

And this brings us to a less attractive side of our subject, the consideration of the unfavourable influences which the new religion had upon medicine. These acted in three principal ways; first, by helping to restore the primitive theories of disease; secondly, when Christianity had fully triumphed, by imposing restrictions on free-thought and investigation; and, thirdly, by giving rise to religious controversies so widespread and vehement that they sometimes seemed to absorb all the intellectual energies of the age. Of these the first was, at the time now treated of, much the most prominent, but it must always be remembered that the evil work had to a great extent already been accomplished by the Gnostics and Neoplatonists. Far be it, too, that we should in any way exaggerate this influence, or bring forward chance. references to demons, incubi, and the like, as examples of the early faith of Christendom. Let us rather confine ourselves to the writings of one of the most cultured of the Eastern fathers, the great Bishop of Cæsarea himself.

St. Basil was of a weakly constitution, much liable to illness, and had therefore paid great attention to medicine, which he declares is the noblest of all worldly professions. He had in all probability read the famous treatise on epilepsy, in which the Hippocratic writer, 800 years before St. Basil's