THE SCHOOL OF GONDISAPOR.

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physician, Burzweih, to India, to examine into and report upon the state of medicine in that country. He brought back, not only medical works-probably those of Susruta and Charaka-but things yet more valuable, the game of chess, and the Hitopadesa, a collection of Hindu tales, said to lie at the base of the Arabian Nights and of half the romances of mediæval Europe. At a later period we even find Hindu physicians among the professors at Gondisapor.

Thus were gathered together in one spot the ancient knowledge of the East, the remains of Greek free-thought, and the most liberal-minded of the Christians, awaiting only the impulse of some fresher and more vigorous activity to take a new step forward in science. But the physicians and philosophers of Gondisapor would indeed have been astonished had they been told that this impulse was destined to come from the wandering hordes of the Arabian desert.

NOTE.

Gondisapor (Saporsburg) was the Persian name of the Persian town. It became in the softer language of the Arabs Jondisabur, and, through the ingenuity of modern orthographers, Djschondischahpour,

etc.

A full discussion of the various accounts of the origin of the town and the school may be found in Meyer, Geschichte der Botanik, vol. iii. See also Assemani, Bibliotheca Orientalis, vol. iii. pt. ii., and Duval, Histoire Politique, Religieuse, et Littéraire, d'Edesse, Paris, 1892.

XXVI. THE ECLECTICS AND COMPILERS. ECLECTICISM is a term attractive to the cultured mind, for it implies the essence of culture, the choice of what is best from whatever source it comes. But if the sanguine student of medical history, hearing of the rise of a school of eclectic practitioners, should fancy he has at last arrived at a golden age, when sects and systems vanished, and great and liberalminded physicians carried the healing arts to heights of

excellence unknown before, he would be grievously disappointed. Whatever eclectics may have done for other departments of knowledge, they did little for the progress of medicine. The title has, indeed, been applied to the greatest physicians, Hippocrates, Heraclides, Galen, Soranus, and to our own modern medicine; and, in some sense, it may be claimed by all who are not absolutely blinded by the fanaticism of their sect or system; but the medical eclectics, strictly so called, formed a distinct school which had many sub-divisions. Some, like our old acquaintance Archigenes, formed systems of their own, and these were the best, they had at least enthusiasm; but the liberal-mindedness of others was the result of that baser scepticism which despairs of progress, and has no wish to overcome itself, or of the ignorance which seeks a cheap reputation for knowledge by pretending to have weighed everything and found it wanting. Between these extremes the eclectic school comprised many able and excellent physicians, though most of them show an unfortunate tendency either to dilettantism or compilation. First, both in age and rank, is Aretæus of Cappadocia (A.D. 50-130 (?) ), a scholarly physician who lived apart from the controversies of his time, and composed in the old Ionic dialect word pictures of disease, the truth and vigour of which are universally recognised. But his writings, excellent as they are, had little influence on medical history, and as they are readily accessible to English readers, need not be further considered here. What the physicians of that age required was, not a reversion to Hippocrates and Nature, but to be told on good authority what they were to think, and above all what remedies they were to employ in each separate disease; and the typical products of the post-Galenic epoch are a series of compilations, varying in size and value, but having certain tendencies in common. We first meet with large compilations, which gradually supplant the works of original writers, and sometimes cause their complete disappearance. These are replaced in their turn by shorter abstracts and epitomes, in which the therapeutic part is enlarged at the expense of

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the other divisions of medical science, till we finally get to works containing merely the names of diseases, followed by long lists of drugs which will more or less certainly cure them. At the revival of science we shall be able to trace a process exactly the reverse of this, and shall find the mediæval receipt-books gradually replaced by the short compendia of the Salernitan masters, which themselves disappear before the great Arabic compilations, the Continens of Rhazes, and the Canon of Avicenna, till at last we arrive once more at original writings. At the same time, the study of the nature, diagnosis and causes of disease re-assumes its proper position, and in our modern medical handbooks we can point triumphantly to pages of pathology followed by a paragraph on treatment, a proportion which, curious as it may seem, is as much the sign of a progressive as the reverse is the mark of a decadent age in medicine.

The first and greatest of the compilers was Oribasius of Pergamus, physician and friend of the Emperor Julian (360-363), at whose suggestion he composed the seventy books of his Medical Collections. Only about a third of this work survives, but it is of great historical value, for Oribasius invariably mentions his authorities, and quotes them with exactness, and it is to him that we owe most of our knowledge of such practitioners as Antyllus and Archigenes.

Oribasius is the last of the great pagan physicians, but the first important Christian writer on medicine lived nearly two centuries later. This was Aëtius of Amida, who held the title of Count (comes obsequii) at the Byzantine Court, probably under Justinian I. (527-565), and composed the second great medical compilation, the Tetra-biblos, in sixteen books. Amida on the Tigris was one of the most easterly outposts of Greek civilisation, and it is interesting to notice that Aëtius makes the earliest mention of such eastern drugs as cloves and camphor, which were afterwards more fully introduced into medicine by the Arabs. His work is especially distinguished by its long lists of com

plicated prescriptions, and the passages which indicate his religion are of a somewhat ominous character. Thus, if a patient has a bone in his throat, it may be extracted by forceps, or he may be given a piece of raw meat on a string, to be pulled up when he has swallowed it, or thus: “Bid the patient attend to you, and say: 'Bone (or whatever it is), come forth, like as Christ brought Lazarus from the tomb and Jonah from the whale'. Then take him by the throat, and say: 'Blasius, martyr and servant of Christ, saith, Either come up or go down (ii. 4, 50). Elsewhere, in describing an ointment, he declares that it is necessary to repeat continually during its preparation: "The God of Abraham, Isaac, and Jacob give efficacy to this salve".

About a century after Aëtius, a third medical epitome. was compiled, in seven books, by Paul of Ægina, the last important product of the great school of Alexandria. Aëtius and Paul resemble one another in many respects; both are largely indebted to Galen and Oribasius; both seem to have added some original matter, but as neither hesitates to quote his predecessors, even verbally, without mentioning their names, it is impossible to decide how far this originality is genuine. While Aëtius devotes himself chiefly to medicine, the most brilliant part of Paul's epitome is the sixth, or surgical book, which was much valued by the Arabs, who estimated still more highly his work on diseases of women (now lost), and gave him the honourable title of the "Obstetrician".

Among the writers whom Paul frequently quotes, but rarely mentions, is Alexander of Tralles, a younger contemporary of Aëtius, an eclectic of the highest type, who may be considered the last of the great Greek physicians, as his brother Anthemius, builder of the church of St. Sophia, is the last of the great Greek architects. His pathology, indeed, is taken entirely from Galen, whom he never mentions without the epithet "most divine," but in questions of treatment he often contradicts his master's directions when opposed to his own experience. While adopting many of

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131 the excellent general rules of the Methodists, he insists, in truly Hippocratic language, on the necessity of considering the individual patient, and on the folly of treating diseases by a rule of thumb; and though his works show the usual tendency to long lists of prescriptions, including some of a very curious nature, he never omits to assert that careful diagnosis should precede treatment, and to point out the importance of discovering and attacking the cause of the disorder.

But he is as eclectic in his superstition as in his science, and introduces numerous charms taken indiscriminately from Homer, Orpheus, the Persian Magi, and the Christian Scriptures, as well as still more absurd prescriptions in use among the vulgar. The following is "an amulet for quartan ague which I have proved by many experiments. Take a live dung beetle, put him in a red rag and hang him round the patient's neck" (xii. 8). A green lizard together with the patient's nail parings may be used instead of the beetle. "For epilepsy take a nail of a wrecked ship, make it into a bracelet and set therein the bone of a stag's heart taken from its body whilst alive; put it on the left arm; you will be astonished at the result" (i. 15). Alexander, indeed, apologises for these absurdities by saying that patients are like besieged cities and must be relieved by all possible means, that they undoubtedly do recover after using them, and that the most divine Galen, though he despised charms and amulets in his youth afterwards recognised their value (ix. 4).

Contemporary with Paul of Egina was Theophilus, physician to the Emperor Heraclius (603-41), who bore the honorary title of Protospatharius, or Captain of the Guard, and wrote several short works, on anatomy, fevers, pulses, and urines, condensing with considerable skill the Galenic doctrines on those subjects. The Anatomy, which has been edited by Dr. Greenhill (Oxon., 1842), perhaps contains some original work, e.g., the description of the palmaris brevis muscle, and olfactory nerve, while the two last named