act by producing one of the above conditions. Thus, like the Empirics, they reduced medicine to a system of treatment, and Themison's boast that he had reversed the aphorism of Hippocrates, and that life was long and the art short, was not unjustified. The stricter Methodists held that even in cases of poisoning it was not necessary to consider the poison, but only the state of constriction or relaxation produced by it, but in others common-sense was not entirely absorbed by system, and to meet such cases they invented a fourth community, the "prophylactic," just as the Empirics had escaped from a similar difficulty by means of "epilogism".

He

The Methodic doctrines were brought to perfection by Thessalus of Tralles, who called himself "Conqueror of Physicians," claimed to be the inventor of the whole system, and offered to teach it anybody in six months. flourished under Nero, and dedicated one of his works to that emperor, in which he declares that he has founded a new sect, the only true one, "for no preceding physicians have left anything profitable either for the observation or cure of disease". His principal contribution to Methodism was the "metasyncritic" or alterative mode of treatment, by which he pretended that the state of the whole body, and especially of the pores, might be entirely changed. Though he claimed this, like everything else, as his own invention, he might have found it, and probably did find it, in the Hippocratic writings, whence we may take the simplest and most convenient example. In chronic disorders, says the author of the treatise, On Internal Diseases, it is often advantageous to try to make the patient fatter. For this purpose the amount of food should be gradually diminished and that of the exercise increased, till the patient finally eats one-tenth of the usual quantity and walks twelve miles or more daily. After maintaining this for a few days the conditions should be gradually reversed, the food increased, and the exercise diminished, till the normal state is regained. As appropriate diet for the first stage the writer recommends

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roast pork and sour wine, and for the second bread, porridge, fatty substances, and sweets. Here we have the alterative treatment of the Methodists, with its "resumptive" and recorporative" cycles in the simplest form, and Thessalus merely added complicated rules of diet and certain drugs to which he attributed special "alterative" properties. "This method," says Galen, "became a sheet-anchor for all who could not make a diagnosis, and was often successful, for many diseases are due to errors in diet."

The later Methodists, while departing considerably from the strict rules of the sect, still retained the title, and it is especially applied to Soranus of Ephesus, who flourished shortly before Galen (about A.D. 100). Many fragments of his works have survived, especially from the treatise On Diseases of Women, which was copied by another Methodist, Moschion, and it has been shown that the writings of Cælius Aurelianus are little more than Latin translations from Soranus. In them we find much attention paid to anatomy and diagnosis, matters despised by the orthodox Methodists, and the general rules of treatment, which always formed the strong point of the sect, are particularly well given. Thus, fresh air is said to be even more important than diet, for we are always breathing, but eat only at intervals, while charms and incantations, though they have no objective efficacy, are not to be entirely despised, for they may sustain the hopes and therefore the vitality of the patient.

We shall be able to trace a close analogy between Methodism and the Brunonian system, which flourished at the close of the last century, nor are there wanting resemblances and contrasts to a still existing "school" of medicine, and the system of Themison and Thessalus is in some respects the exact counterpart of that of Hahnemann. The term "allopathy" would indeed have puzzled Soranus, but if we take it as denoting a medical system of which the one therapeutic rule is Contraria contrariis curentur, it may fairly be applied to the Methodic and Brunonian doctrines, and to them only.

METHODISM AND HOMEOPATHY.

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The Methodic system originated during a period of transition, and was rejected by the chief adherents of the older schools. Thus Celsus, who holds the balance so fairly between the Empirics and Dogmatists, has no good word for the Methodists, whom he compares to cow-doctors and savages, declaring that the old physicians knew all about the "communities," but were not content with them, and that the method of treating diseases in bulk is permissible only in large slave infirmaries, where nothing better can be got. Galen was their mortal enemy, and called them "the asses of Thessalus," though, as usual in such cases, it is hard to say which side first employed abusive language. Thessalus, like Hahnemann, appealed from the profession to the public, and, like Hahnemann, he was successful; crowds followed him, including, if we may trust a prejudiced witness, all the ne'er-do-wells in Rome. Nor are the causes of this success far to seek. Here was a theory suited by its connection with the dominant Epicurean doctrines to the philosophic Greek. Here was a rule of thumb which attracted the practical and methodic mind of the Roman. Above all, here was a short and easy system by which a self-confident individual might, with least preliminary labour, put money in his purse, label himself with an attractive name, and become a fashionable practitioner.

The fact that so many Methodists were distinguished as "ladies' doctors" may indicate that that sex was particularly attracted by the new system. Celsus tells us that it was found useful in slave infirmaries, and we may, perhaps, picture the Lady Bountiful of the period walking through such an institution, armed with the last pamphlet by Thessalus, and followed by a slave bearing the typical Methodic remedies, a bottle of leeches for all the "stricti" on one side of the ward, and a jar full of decoction of poppy-heads and honey - the famous diacodion of Themison--for all the "laxati" on the other.

NOTE.

The fullest account of Methodism is to be found in Galen's works,, especially the treatises, De Optima Secta and De Methodo Medendi, i., and in the writings of Cælius Aurelianus; see also Constantin Tsintsiropoulos, La Médecine Grecque depuis Asclepiade jusqu'à Galien, Paris, 1892.

XVIII. CELSUS AND ANCIENT SURGERY.

AULUS CORNELIUS CELSUS, who has somewhat extravagantly been called the Cicero of physicians and the Latin Hippocrates, is the most important of Roman medical writers. But he does not seem to have been a member of the profession, and probably intended his treatises on agriculture, medicine, war and rhetoric to form a compendium of all the knowledge requisite for a wealthy citizen, who had a farm and slaves to superintend, and might hold a public office. He may himself have been in such a position, and may have acquired some practical knowledge in the "Valetudinaria" or slave infirmaries which were maintained by rich landowners, but, except that he lived in the Augustan age, we practically know nothing of him. The historical importance of his work, De Medicina, consists in the excellent but too brief sketch of medical history with which it commences, in its notices of more than seventy Greek physicians whose works have perished, and in the last two books which give us some idea of the progress of surgery, since the time of Hippocrates. It may, therefore, be conveniently taken as the text for a brief account of some of the more important aspects of ancient surgery, a subject which may be further simplified by connecting it with the names of the three greatest of Greek surgeons, Heliodorus, Archigenes, and Antyllus.

Celsus tells us that medicine was divided at Alexandria into three branches, one curing by diet, another by drugs, and a third by hand, which were called by the Greeks.

ANCIENT SURGERY.

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dietetic, pharmaceutic, and chirurgic respectively. This was, no doubt, mainly a theoretical division such as Celsus follows in his own work, but he repeats elsewhere that surgery began to have its special professors at Alexandria, and we have already noticed traces of such a division in yet earlier times. In the Roman period the physician and surgeon, the medicus clinicus and chirurgicus, were clearly distinguished, and Galen, writing on operative medicine, says he would probably have known more of the subject had he stayed in Asia, but on coming to Rome he found that such matters were left to "those called surgeons," and he had followed the general example.

The golden age of Greek surgery was the close of the first century, and it is marked by the names of Heliodorus and Archigenes, both of whom are mentioned by Juvenal; Antyllus probably flourished at least a century later, for, though largely quoted by Oribasius, he is not noticed by Galen.

Heliodorus seems to have been a pure surgeon, for all the surviving fragments of his writings deal with that art. He was specially famous for his knowledge and treatment of injuries of the head, and for the operation for hernia, and was, perhaps, the first to treat stricture by internal urethrotomy; but his name may most conveniently be connected with the history of the methods used by the ancients for checking hæmorrhage. The Hippocratic writers knew nothing of ligature, and treated hæmorrhage by cold, pressure, styptics, and sometimes by the actual cautery; but so obvious a method of closing a bleeding vessel could not long remain untried, and it was probably introduced by the Alexandrine anatomists. Celsus recommends that an injured vessel should be tied in two places, and divided between them, but it is Heliodorus who gives us the first account, not only of terminal ligature, but also of the supposed modern invention of torsion. Speaking of the operation for hernia, he says: "We ligature the larger vessels, but as for the smaller ones we catch them with hooks, and twist them