MEDICAGO, Snail Trefoil, a genus of plants belonging to the diadelphia class, and in the natural method ranking under the 32d order, Papilionacea. See Botany Index. For the properties and culture of Lucern, a species of this genus, see Agriculture Index.

MEDICINAL, anything belonging to medicine.

MEDICINAL Springs, a general name for any fountain, the waters of which are of use for removing certain disorders. They are commonly either chalybeate or sulphureous. See Springs and Water.

MEDICINE. MEDICINE

Medicine is the art of preventing, curing, or alleviating those diseases to which the human species are subjected.

History of Medicine.

The fabulous history of the ancients derives this art immediately from their gods; and, even among the moderns, some are of opinion that it may justly be considered as of divine revelation. But without adopting any supposition of which no probable evidence can be given, we may conclude, that mankind were naturally led to it from casual observation on the diseases to which they found themselves subjected; and that therefore, to a certain degree at least, it is as ancient as the human race. But at what period it began to be practised as an art, by particular individuals following it as a profession, is not known. The most ancient physicians we read of were those who embalmed the patriarch Jacob by order of his son Joseph. The sacred writer styles these physicians servants to Joseph: whence we may be assured that they were not priests, as the first physicians are generally supposed to have been; for in that age we know the Egyptian priests were in such high favour, that they retained their liberty, when, through a public calamity, all the rest of the people were made slaves to the prince.

It is not probable, therefore, that among the Egyptians religion and medicine were originally conjoined; and if we suppose the Jews not to have invented the art, but received it from some other nation, it is as little probable that the priests of that nation were their physicians as those of Egypt.

That the Jewish physicians were absolutely distinct from their priests is very certain. Yet as the Jews resided for such a long time in Egypt, it is probable they would retain many of the Egyptian customs, from which it would be very difficult to free them. We read, however, that when King Asa was diseased in his feet, "he sought not to the Lord, but to the physicians." Hence we may conclude, that among the Jews the medical art was looked upon as a mere human invention; and it was thought that the Deity never cured diseases by making people acquainted with the virtues of this or that herb, but only by his miraculous power. That the same opinion prevailed among the nations who were neighbours to the Jews, is also probable from what we read of Ahaziah king of Judah, who having sent messengers to inquire of Baalzebub god of Ekron concerning his disease, he did not desire any remedy from him or his priests, but simply to know whether he should recover or not.

What seems most probable on this subject therefore is, that religion and medicine came to be mixed together only in consequence of that degeneracy into ignorance and superstition which took place among all nations. The Egyptians, we know, came at last to be sunk in the most ridiculous and absurd superstition; and then, indeed, it is not wonderful that we should find their priests commencing physicians, and mingling charms, incantations, &c. with their remedies. That this was the case, long after the days of Joseph, we are very certain; and indeed it seems as natural for ignorance and barbarism to combine religion with physic, as it is for a civilized and enlightened people to keep them separate. Hence we see, that among all modern barbarians their priests or conjurors are their only physicians.

We are so little acquainted with the state of physic among the Egyptians, that it is needless to say much concerning them. They attributed the invention of medicine, as they did also that of many other arts, to Thoth, the Hermes or Mercury of the Greeks. He is said to have written many things in hieroglyphic characters upon certain pillars, in order to perpetuate his knowledge, and render it useful to others. These were transcribed by Agathodemon, or the second Mercury, the father of Tat, who is said to have composed books of them, that were kept in the most sacred places of the Egyptian temples. The existence of such a person, however, is very doubtful, and many of the books ascribed to him were accounted forgeries as long ago as the days of Galen; there is also great reason to suspect that those books were written many ages after Hermes, and when physic had made considerable advances. Many of the books attributed to him are trifling and ridiculous; and though sometimes he is allowed to have all the honour of inventing the art, he is on other occasions obliged to share it with Osiris, Isis, and Apis or Serapis.

After all, the Egyptian physic appears to have been little else than a collection of absurd superstitions. Origin informs us, that they believed there were 36 demons, or gods of the air, who divided the human body among them; that they had names for each of them; and that by invoking them according to the part affected, the patient was cured. Of natural medicines we hear none recommended by the father of Egyptian physic; except the herb moly, which he gave to Ulysses in order to secure him from the enchantments of Circe; and the herb mercury, of which he first discovered the use. His successors made use of venesection, cathartics, emetics, and clysters. There is no proof, however, that this practice was established by Hermes; on the contrary, the Egyptians themselves pretended that the first hint of those remedies was taken from some observations on brute animals. Venesection was taught them by the hippopotamus, which is said to perform this operation upon itself. On certain occasions, he comes out of the river, and strikes his leg against a sharp-pointed reed. As he takes care to direct the stroke against a vein, the consequence must be a considerable effusion of blood; and this being suffered to run as long as the creature thinks proper, he at last stops up the orifice with mud. The hint of clysters was taken from the ibis, a bird which is said to give itself clysters with its bill, &c. They used venesection, however, but very little, probably on account of the warmth Origin of warmth of the climate; and the exhibition of the remedies above mentioned, joined with abstinence, formed the most of their practice.

Among the Greeks too had several persons to whom they attributed the invention of physic, particularly Prometheus, Apollo or Pæan, and Æsculapius; which last was the most celebrated of any. But here we must observe, that as the Greeks were a very warlike people, their physic seems to have been little else than what is now called surgery, or the cure of wounds, fractures, &c. Hence Æsculapius, and his pupils Chiron, Machaon, and Podalirius, are celebrated by Homer only for their skill in curing these, without any mention of their attempting the cures of internal diseases. We are not, however, to suppose that they confined themselves entirely to surgery. They no doubt would occasionally prescribe for internal disorders; but as they were most frequently conversant with wounds, we may naturally suppose the greatest part of their skill to have consisted in knowing how to cure these. If we may believe the poets, indeed, the knowledge of medicine seems to have been very generally diffused. Almost all the heroes of antiquity are reported to have been physicians as well as warriors. Most of them were taught physic by the centaur Chiron. From him Hercules received instructions in the medicinal art, in which he is said to have been no less expert than in feats of arms. Several plants were called by his name; from which some think it probable that he found out their virtues, though others are of opinion that they bore the name of this renowned hero on account of their great efficacy in removing diseases. Aristaeus king of Arcadia was also one of Chiron's scholars; and is supposed to have discovered the use of the drug called silphium, by some thought to be asafoetida. Theseus, Telamon, Jason, Peleus, and his son Achilles, were all renowned for their knowledge in the art of physic. The last is said to have discovered the use of verdigrise in cleansing foul ulcers. All of them, however, seem to have been inferior in knowledge to Palamedes, who hindered the plague from coming into the Grecian camp after it had ravaged most of the cities of the Hellespont, and even Troy itself. His method was to confine his soldiers to a spare diet, and to oblige them to use much exercise.

The practice of these ancient Greek physicians, notwithstanding the praises bestowed on them by their poets seems to have been very limited, and in some cases even pernicious. All the external remedies applied to Homer's wounded heroes were fomentations; while inwardly their physicians gave them wine, sometimes mingled with cheese scraped down. A great deal of their physic also consisted of charms, incantations, amulets, &c. of which, as they are common to all superstitious and ignorant nations, it is superfluous to take any farther notice.

In this way the art of medicine continued among the Greeks for many ages. As its first professors knew nothing of the animal economy, and as little of the theory of diseases, it is plain, that whatever they did must have been in consequence of mere random trials, or empiricism, in the strict and proper sense of the word. Indeed, it is evidently impossible that this or almost any other art could originate from another source than trials of this kind. Accordingly, we find, that some ancient nations were accustomed to expose their sick in temples, and by the sides of highways, that they might receive the advice of every one who passed. Among the Greeks, however, Æsculapius was reckoned the most eminent practitioner of his time, and his name continued to be revered after his death. He was ranked among the gods; and the principal knowledge of the medical art remained with his family to the time of Hippocrates, who reckoned himself the seventeenth in a lineal descent from Æsculapius, and who was truly the first who treated of medicine in a regular and rational manner.

Hippocrates, who is supposed to have lived 400 years before the birth of Christ, is the most ancient author whose writings expressly on the subject of the medical art are preserved; and he is therefore justly considered as the father of physic. All the accounts which we have prior to this time, if not evidently fabulous, are at the utmost highly conjectural. Even the medical knowledge of Pythagoras, so much celebrated as a philosopher, can hardly be considered as resting on any other foundation. But from the time of Hippocrates, medicine, separated from philosophy and religion, seems to have assumed the form of a science, and to have been practised as a profession. It may not, therefore, be improper, to give a particular account of the state of medical science, as transmitted to us in his writings. The writings of Hippocrates, however, it may be remarked, are even more than preserved. Many things have been represented as written by Hippocrates which are probably spurious. Nor is it wonderful that attempts should have been made to increase the value of manuscripts, by attributing them to a name of such eminence. But although what are transmitted to us under the title of his works may have been written by different hands, yet the presumption is, that most, if not all of them, are of nearly as early a date, and contain the prevailing opinions of those times.

According to the most authentic accounts, Hippocrates was a native of the island of Cos, and born in the beginning of the 88th Olympiad. In the writings transmitted to us as his, we find a general principle adopted, to which he gives the name of Nature. To this principle he ascribes a mighty power. "Nature (says he) is of itself sufficient to every animal. She performs every thing that is necessary to them, without needing the least instruction from any one how to do it." Upon this footing, as if Nature had been a principle endowed with knowledge, he gives her the title of just: and ascribes virtues or powers to her, which are her servants, and by means of which she performs all her operations in the bodies of animals; and distributes the blood, spirits, and heat, through all parts of the body, which by these means receive life and sensation. And in other places he tells us, that it is this faculty which gives nourishment, preservation, and growth, to all things.

The manner in which Nature acts, or commands her subservient power to act, is by attracting what is natural and agreeable to each species, and by retaining, preparing, and changing it; and on the other side in rejecting whatever is superfluous or hurtful, after she has separated it from the good. This is the foundation of the doctrine of depuration, conception, and crisis in fevers. fevers, so much insisted on by Hippocrates and many other physicians. He supposes also, that every thing has an inclination to be joined to what agrees with it, and to remove from every thing contrary to it; and likewise that there is an affinity between the several parts of the body, by which they mutually sympathize with each other. When he comes to explain what this principle called nature is, he is obliged to resolve it into heat, which, he says, appears to have something immortal in it.

As far as he attempts to explain the causes of disease, he refers much to the humours of the body, particularly to the blood and the bile. He treats also of the effects of sleep, watchings, exercise, and rest, and all the benefit or mischief we may receive from them. Of all the causes of diseases, however, mentioned by Hippocrates, the most general are diet and air. On the subject of diet he has composed several books, and in the choice of this he was exactly careful; and the more so, as his practice turned almost wholly upon it. He also considered the air very much; he examined what winds blew ordinarily or extraordinarily; he considered the irregularity of the seasons, the rising and setting of stars, or the time of certain constellations; also the time of the solstices, and of the equinoxes; those days, in his opinion, producing great alterations in certain distempers.

He does not, however, pretend to explain how, from these causes, that variety of distempers arises which is daily to be observed. All that can be gathered from him with regard to this is, that the different causes above mentioned, when applied to the different parts of the body, produce a great variety of distempers. Some of these distempers he accounted mortal, others dangerous, and the rest easily curable, according to the cause from whence they spring, and the parts on which they fall. In several places also he distinguishes diseases, from the time of their duration, into acute or short, and chronic or long. He likewise distinguishes diseases by the particular places where they prevail, whether ordinary or extraordinary. The first, that is, those that are frequent and familiar to certain places, he called endemic diseases; and the latter, which raged extraordinarily, sometimes in one place, sometimes in another, which seized great numbers at certain times, he called epidemic, that is, popular diseases: and of this kind the most terrible is the plague. He likewise mentions a third kind, the opposite of the former; and these he calls sporadic, or straggling diseases: these last include all the different sorts of distempers which invade at any one season, which are sometimes of one sort, and sometimes of another. He distinguished between those diseases which are hereditary, or born with us, and those which are contracted afterwards; and likewise between those of a kindly and those of a malignant nature, the former of which are easily and frequently cured, but the latter give the physicians a great deal of trouble, and are seldom overcome by all their care.

Hippocrates remarked four stages in distempers; viz. the beginning of the disease, its augmentation, its state or height, and its declination. In such diseases as terminate fatally, death comes in place of the declination. In the third stage, therefore, the change is most considerable, as it determines the fate of the sick person; and this is most commonly done by means of a crisis. By this word he understood any sudden change in sickness, whether for the better or for the worse, whether health or death succeed immediately. Such a change, he says, is made at that time by nature, either absolving or condemning the patient. Hence we may conclude, that Hippocrates imagined diseases to be only a disturbance of the animal economy, with which Nature was perpetually at variance, and using her utmost endeavours to expel the offending cause. Her manner of acting on these occasions is to reduce to their natural state those humours whose discord occasions the disturbance of the whole body, whether in relation to their quantity, quality, mixture, motion, or any other way in which they become offensive. The principal means employed by nature for this end is what Hippocrates calls concoction. By this he understood the bringing the morbid matter lodged in the humours to such a state, as to be easily fitted for expulsion by whatever means nature may think most proper. When matters are brought to this pass, whatever is superfluous or hurtful immediately empties itself, or nature points out to physicians the way by which such an evacuation is to be accomplished. The crisis takes place either by bleeding, stool, vomit, sweat, urine, tumors or abscesses, scabs, pimples, spots, &c. But these evacuations are not to be looked upon as the effects of a true crisis, unless they are in considerable quantity; small discharges not being sufficient to make a crisis. On the contrary, small discharges are a sign that nature is depressed by the load of humours, and that she lets them go through weakness and continual irritation. What comes forth in this manner is crude, because the distemper is yet too strong; and while matters remain in this state, nothing but a bad or imperfect crisis is to be expected. This shows that the distemper triumphs, or at least is equal in strength to nature, which prognosticates death, or a prolongation of the disease. In this last case, however, nature often has an opportunity of attempting a new crisis more happy than the former, after having made fresh efforts to advance the concoction of the humours.—It must here be observed, however, that, according to Hippocrates, concoction cannot be made but in a certain time, as every fruit has a limited time to ripen; for he compares the humours which nature has digested to fruits come to maturity.

The time required for concoction depends on the differences among distempers mentioned above. In those which Hippocrates calls very acute, the digestion or crisis happens by the fourth day; in those which are only acute, it happens on the 7th, 11th, or 14th day; which last is the longest period generally allowed by Hippocrates in distempers that are truly acute: though in some places he stretches it to the 20th or 21st, nay, sometimes to the 40th or 60th day. All diseases that exceed this last term are called chronic. And while in those diseases that exceed 14 days, he considers every fourth day as critical, or at least remarkable, by which we may judge whether the crisis on the following fourth day will be favourable or not; so in those which run from 20 to 40 he reckons only the sevenths, and in those that exceed 40 he begins to reckon by 20. Beyond the 120th he thinks that the number of days has no power over the crisis. They are then referred to the general changes of the seasons; some terminating about the equinoxes; others about the solstices; others about the rising or setting of the stars of certain constellations; or if numbers have yet any place, he reckons by months, or even whole years. Thus (he says), certain diseases in children have their crisis in the seventh month after their birth, and others in their seventh or even in their 14th year.

Though Hippocrates mentions the 21st as one of the critical days in acute distempers, as already noticed; yet, in other places of his works, he mentions also the 20th. The reason he gives for this in one of those places of his work is, that the days of sickness were not quite entire. In general, however, he is much attached to the odd days: insomuch that in one of his aphorisms he tells us, "The sweats that come out upon the 3d, 5th, 7th, 9th, 11th, 14th, 17th, 21st, 27th, 31st, or 34th days, are beneficial; but those that come out upon other days signify that the sick shall be brought low, that his disease shall be very tedious, and that he shall be subjected to relapses." He further says, "That the fever which leaves the sick upon any but an odd day is usually apt to relapse." Sometimes, however, he confesses that it is otherwise; and he gives an instance of a salutary crisis happening on the sixth day. But these are very rare instances, and therefore cannot, in his opinion, overthrow the general rule.

Besides the crisis, however, or the change which determines the fate of the patient, Hippocrates often speaks of another, which only changes the species of the distemper, without restoring the patient to health; as when a vertigo is turned to an epilepsy, a tertian fever to a quartan, or to a continued, &c.

But what has chiefly contributed to procure the great respect generally paid to Hippocrates, is his industry in observing the most minute circumstances of diseases, and his exactness in nicely describing every thing that happened before, and every accident that appeared at the same time with them; and likewise what appeared to give ease, and what to increase the malady: which is what we call writing the history of a disease.—Thus he not only distinguished one disease from another by the signs which properly belonged to each; but by comparing the same sort of distemper which happened to several persons, and the accidents which usually appeared before and after, he could often foretell a disease before it began, and afterwards give a right judgement of the event of it. By this way of prognosticating, he came to be exceedingly admired: and this he carried to such a height, that it may justly be said to be his master-piece; and Celsius, who lived after him, remarks, that succeeding physicians, though they found out several new things relating to the management of diseases, yet were obliged to the writings of Hippocrates for all that they knew of signs.

The first thing Hippocrates considered, when called to a patient, was his looks.—It was a good sign with him to have a visage resembling that of a person in health, and the same with what the sick man had before he was attacked by the disease. As it varied from this, so much the greater danger was apprehended. The following is the description which he gives of the looks of a dying man.—"When a patient (says he) has his nose sharp, his eyes sunk, his temples hollow, his ears cold and contracted, the skin of his forehead tense and dry, and the colour of his face tending to a pale green, or lead colour, one may pronounce for certain that death is very near at hand; unless the strength of the patient has been exhausted all at once by long watchings, or by a looseness, or being a long time without eating." This observation has been confirmed by succeeding physicians, who have, from him, denominated it the Hippocratic face. The lips hanging relaxed and cold, are likewise looked upon by Hippocrates as a confirmation of the foregoing prognostic. He also took his signs from the disposition of the eyes in particular. When a patient cannot bear the light; when he sheds tears involuntarily; when, in sleeping, some part of the white of the eye is seen, unless he usually sleeps after that manner, or has a looseness upon him: these signs, as well as the foregoing ones, prognosticate danger. The eyes deadened, as it were with a mist spread over them, or their brightness lost, likewise presage death, or great weakness. The eyes sparkling, fierce, and fixed, denote the patient to be delirious, or that he soon will be seized with a frenzy. When the patient sees anything red, and like sparks of fire and lightning pass before his eyes, you may expect a haemorrhagy; and this often happens before those crises which are to be attended by a loss of blood.

The condition of the patient is also shewn by his posture in bed. If you find him lying on one side, bed; his body, neck, legs, and arms, a little contracted, which is the posture of a man in health, it is a good sign: on the contrary, if he lies on his back, his arms stretched out, and his legs hanging down, it is a sign of great weakness; and particularly when the patient slides or lets himself fall down towards the feet, it denotes the approach of death. When a patient in a burning fever is continually feeling about with his hands and fingers, and moves them up before his face and eyes as if he was going to take away something that passed before them; or on his bed-covering, as if he was picking or searching for little straws, or taking away some filth, or drawing out little flocks of wool; all this is a sign that he is delirious, and that he will die. Amongst the other signs of a present or approaching delirium he also adds this: When a patient who naturally speaks little begins to talk more than he used to do, or when one that talks much becomes silent, this change is to be reckoned a sort of delirium, or is a sign that the patient will soon fall into one. The frequent trembling or starting of the tendons of the wrist, presage likewise a delirium. As to the different sorts of delirium, Hippocrates is much more afraid of those that run upon mournful subjects, than such as are accompanied with mirth.

When a patient breathes fast, and is oppressed, it is a sign that he is in pain, and that the parts above the diaphragm are inflamed. Breathing long, or when the patient is a great while in taking his breath, shows him to be delirious; but easy and natural respiration is always a good sign in acute diseases. Hippocrates depended much on respiration in making his prognostics; and therefore has taken care in several places to describe the different manner of a patient's breathing. Continual watchings in acute diseases, are signs of present pain, or a delirium near at hand. Hippocrates also drew signs from all excrements, whatever they are, that are separated from the body of man. His most remarkable prognostics, however, were from the urine. The patient's urine, in his opinion, is best when the sediment is white, soft to the touch, and of an equal consistence. If it continue so during the course of the distemper, and till the time of the crisis, the patient is in no danger, and will soon be well. This is what Hippocrates called concocted urine, or what denotes the concoction of the humours; and he observed, that this concoction of the urine seldom appeared thoroughly, but on the days of the crisis which happily put an end to the distemper. "We ought (said Hippocrates) to compare the urine with the purulent matter which runs from ulcers. As the pus, which is white, and of the same quality with the sediment of the urine we are now speaking of, is a sign that the ulcer is on the point of closing; so that which is clear, and of another colour than white, and of an ill smell, is a sign that the ulcer is virulent, and in the same manner difficult to be cured; the urines that are like this we have described are only those which may be named good; all the rest are ill, and differ from one another only in the degrees of more and less. The first never appear but when nature has overcome the disease; and are a sign of the concoction of humours, without which you cannot hope for a certain cure. On the contrary, the last are made as long as their crudity remains, and the humours continue unconcocted. Among the urines of this last sort, the best are reddish, with a sediment that is soft and of an equal consistence; which denotes, that the disease will be somewhat tedious, but without danger. The worst are those which are very red, and at the same time clear and without sediment; or that are muddy and troubled in the making. In urine there is often a sort of cloud hanging in the vessel in which it is received; the higher this rises, or the farther distant it is from the bottom, or the more different it is from the colour of the laudable sediment above mentioned, the more there is of crudity. That which is yellow, or of a sandy colour, denotes abundance of bile; that which is black is the worst, especially if it has an ill smell, and is either altogether muddy or altogether clear. That whose sediment is like large ground wheat, or little flakes or scales spread one upon another, or bran, presages ill, especially the last. The fat or oil that sometimes swims upon the top of the urine, and appears in a form something like a spider's web, is a sign of a consumption of the flesh and solid parts. The making of a great quantity of urine is the sign of a crisis, and sometimes the quality of it shows how the bladder is affected. We must also observe, that Hippocrates compared the state of the tongue with the urine; that is to say, when the tongue was yellow, and charged with bile, the urine he knew must of course be of the same colour; and when the tongue was red and moist, the urine was of its natural colour.

Among his prognostics from the excretions by stool are the following:—Those that are soft, yellowish, of some consistence, and not of an extraordinary ill smell, that answer to the quantity of what is taken inwardly, and that are voided at the usual hours, are the best of all. They ought also to be of a thicker consistence when the distemper is near the crisis; and it ought to be taken for a good prognostic, when some worms, particularly the round and long, are evacuated at the same time with them. The prognosis, however, may still be favourable, though the matter exerted be thin and liquid, provided it make not too much noise in coming out, and the evacuation be not in a small quantity nor too often; nor in so great abundance, nor so often, as to make the patient faint. All matter that is watery, white, of a pale green or red colour, or frothy and viscous, is bad. That which is blackish, or of a livid hue, is the most pernicious. That which is pure black, and nothing else but a discharge of black bile, always prognosticates very ill; this humour, from what part soever it comes, showing the ill disposition of the intestines. The matter that is of several different colours, denotes the length of the distemper; and, at the same time, that it may be of dangerous consequence. Hippocrates places in the same class the matter that is bilious or yellow, and mixed with blood, or green and black, or like the dregs or scrapings of the guts. The stools that consist of pure bile, or entirely of phlegm, he also looks upon to be very bad.

Matter ejected by vomiting ought to be mixed with bile and phlegm; where one of these humours only is observed, it is worse. That which is black, livid, green, or of the colour of a leek, indicates alarming consequences. The same is to be said of that which smells very ill; and if at the same time it be livid, death is not far off. The vomiting of blood is very often a mortal symptom.

The spittings which give ease in diseases of the lungs Expectorant and in pleurisies, are those that come up readily and without difficulty; and it is good if they be mixed at the beginning with much yellow; but if they appear of the same colour, or are red, a great while after the beginning of the distemper, if they are salt and acrimonious, and cause violent coughings, they are not good. Spittings purely yellow are bad; and those that are white, viscous, and frothy, give no ease. Whiteness is a good sign of concoction in regard to spittings; but they ought not at all to be viscous, nor too thick, nor too clear. We may make the same judgment of the excretions of the nose according to their concoction and crudity. Spittings that are black, green, and red, are of very bad consequence. In inflammations of the lungs, those that are mixed with bile and blood presage well if they appear at the beginning, but are bad if they arise not about the seventh day. But the worst sign in these distempers is, when there is no expectoration at all, and the too great quantity of matter that is ready to be discharged this way makes a rattling in the breast. After spitting of blood, the discharge of purulent matter then follows, which brings on a consumption, and at last death.

A kind good sweat is that which arises on the day Sweat of the crisis, and is discharged in abundance all over the body, and at the same time from all parts of the body, and thus carries off the fever: A cold sweat is alarming, especially in acute fevers, for in others it is only a sign of long continuance. When the patient sweats nowhere but on the head and neck, it is a sign that the disease will be long and dangerous. A gentle sweat in some particular part of the head and breast, for instance, gives no relief, but denotes the seat of the distemper, or the weakness of the part. This kind of sweat was called by Hippocrates *ephidrosis*.

The hypochondria, or the abdomen in general ought always to be soft and even, as well on the right side as on the left. When there is any hardness or unevenness in those parts, or heat and swellings, or when the patient cannot endure to have it touched, it is a sign the intestines are indisposed.

Hippocrates also inquired into the state of the pulse, or the beating of the arteries. The most ancient physicians, however, and even Hippocrates himself, for a long time, by this word understood the violent pulsation that is felt in an inflamed part, without putting the fingers to it. It is observed by Galen, and other physicians, that Hippocrates touches on the subject of the pulse more slightly than any other on which he treats. But that our celebrated physician understood something even on this subject, is easily gathered from several passages in his writings; as when he observes, that in acute fevers the pulse is very quick and very great; and when he makes mention, in the same place, of trembling pulses, and those that beat slowly. He likewise observes, that in some diseases incident to women, when the pulse strikes the finger faintly, and in a languishing manner, it is a sign of approaching death. He remarks also, in the *Coacce Pronotiones*, that he whose vein, that is to say, whose artery of the elbow, beats, is just going to run mad, or else that the person is at that time very much under the influence of anger.

From this account of Hippocrates, it will appear, that he was not near so much taken up with reasoning on the phenomena of diseases, as with reporting them. He was content to observe these phenomena accurately, to distinguish diseases by them, and judged of the event by comparing them exactly together. For his skill in prognostics he was indeed very remarkable, as we have already mentioned, insomuch that he and his pupils were looked upon by the vulgar as prophets. What adds very much to his reputation is, that he lived in an age when physic was altogether buried in superstition, and yet he did not suffer himself to be carried away by it; on the contrary, on many occasions, he expresses his abhorrence of it.

Having thus seen in what Hippocrates makes the difference between health and sickness to consist, and likewise the most remarkable signs from whence he drew his prognostics, we must now consider the means he prescribed for the preservation of health, and the cure of diseases. One of his principal maxims was this, That, to preserve health, we ought not to overcharge ourselves with too much eating, nor neglect the use of exercise and labour. In the next place, That we ought by no means to accustom ourselves to too nice and exact a method of living; because those who have once begun to act by this rule, if they vary in the least from it, find themselves very ill; which does not happen to those who take a little more liberty, and live somewhat more irregularly. Notwithstanding this, he does not neglect to inquire diligently into the articles which those who were in health used for food in his time. Here we cannot help taking notice of the prodigious disparity between the delicacy of the people in our days and in those of Hippocrates: for he takes great pains to tell the difference between the flesh of a dog, a fox, a horse, and an ass; which he would not have done if at that time they had not been used for victuals, at least by the common people. Besides these, however, Hippocrates speaks of all other kinds of provision that are now in use; for example, salads, milk, whey, cheese, flesh as well of birds as of four-footed beasts, fresh and salt fish, eggs, all kinds of pulse, and the different kinds of grain we feed on, as well as the different sorts of bread that are made of it. He also speaks very often of a sort of liquid food, or broth, made of barley-meal, or some other grain, which they steeped for some time, and then boiled in water. With regard to drink, he takes a great deal of pains to distinguish the good waters from the bad. The best, in his opinion, ought to be clear, light, without smell or taste, and taken out of the fountains that turn towards the east. The salt waters, those that he calls hard, and those that rise out of fenny ground, are the worst of all; he condemns also those that come from melted snow. But though Hippocrates makes all these distinctions, he advises those who are in health to drink of the first water that comes in their way. He speaks also of alum waters, and those that are hot; but does not enlarge upon their qualities. He advises to mix wine with an equal quantity of water: and this, (he says) is the just proportion; by using which the wine will expel what is hurtful to the body, and the water will serve to temper the acrimony of the humours.

For those that are in health, and likewise for such as are sick, Hippocrates advises exercise. The books, however, which treat on this subject, M. Le Clerc conjectures to have been written by Herodicus, who first introduced gymnastic exercise into medicine, and who is said by Hippocrates himself to have killed several people by forcing them to walk while they were afflicted with fevers and other inflammatory disorders. The advice given in them consist chiefly in directions for the times in which we ought to walk, and the condition we ought to be in before it; when we ought to walk slowly, and when to run, &c.; and all this with design to bring the body down, or dissipate the humours. Wrestling, although a violent exercise, is numbered with the rest. In the same place also mention is made of a play of the hands and fingers, which was thought good for health, and called *chronomie*; and of another diversion which was performed round a sort of ball hung up, which they called *corycus*, and which they struck forward with both their hands.

With regard to those things which ought to be separated from, or retained in the human body, Hippocrates observes, that people ought to take great care not to load themselves with excrements, or keep them in too long; and besides the exercise above mentioned, which carries off one part of them, and which he prescribes chiefly on this account, he advises people to excite and rouse up nature when she flagged, and did not endeavour to expel the rest, or take care of the impediments by which she was resisted. For this reason he prescribed meats proper for loosening the belly; and when these were not sufficient, he directed the use of clysters and suppositories. For thin and emaciated persons he directed clysters composed only of milk and oily unctuous substances, which they mixed with a decoction. they only made use of salt or sea-water.

As a preservative against distempers, Hippocrates also advised the use of vomits, which he directed to be taken once or twice a month during the time of winter and spring. The most simple of these were made of a decoction of hyssop, with an addition of a little vinegar and salt. He made those that were of a strong and vigorous constitution take this liquor in a morning fasting; but such as were thin and weakly took it after supper.—Venery, in his opinion, is wholesome, provided people consult their strength, and do not pursue it to excess; which he finds fault with on all occasions, and would have excess avoided also in relation to sleep and watching. In his writings are likewise to be found several remarks concerning good and bad air; and he makes it appear that the good or bad disposition of this element does not depend solely on the difference of the climate, but on the situation of every place in particular. He speaks also of the good and bad effects of the passions, and recommends moderation in regard to them.

From what we have already related concerning the opinions of Hippocrates, it may naturally be concluded, that for the most part he would be contented with observing what the strength of nature is able to accomplish without being assisted by the physician. That this was really the case, may be easily perceived from a perusal of his books entitled, "Of epidemical distempers;" which are, as it were, journals of the practice of Hippocrates: for there we find him often doing nothing more than describing the symptoms of a distemper, and informing us what has happened to the patient day after day, even to his death or recovery, without speaking a word of any kind of remedy. Sometimes, however, he did indeed make use of remedies; but these were exceedingly simple and few, in comparison of what have been given by succeeding practitioners. These remedies we shall presently consider, after we have given an abridgement of the principal maxims on which his practice was founded.

Hippocrates asserted in the first place, That contraries, or opposites, are the remedies for each other; and this maxim he explains by an aphorism; in which he says, that evacuations cure those distempers which come from repletion, and repletion those that are caused by evacuation. So heat is destroyed by cold, and cold by heat, &c. In the second place, he asserted that physic is an addition of what is wanting, and a subtraction or retrenchment of what is superfluous: an axiom which is thus explained, that there are some juices or humours, which in particular cases ought to be evacuated, or driven out of the body, or dried up; and some others which ought to be restored to the body, or caused to be produced there again. As to the method to be taken for this addition or retrenchment, he gives this general caution, That you ought to be careful how you fill up, or evacuate, all at once, or too quickly, or too much; and that it is equally dangerous to heat or cool again on a sudden; or rather, you ought not to do it: everything that runs to an excess being an enemy to nature.

In the fourth place, Hippocrates allowed that we ought sometimes to dilate, and sometimes to lock up: to dilate, or open the passages by which the humours are voided naturally, when they are not sufficiently opened, or when they are closed; and, on the contrary, to lock up or straiten the passages that are relaxed, when the juices that pass there ought not to pass, or when they pass in too great quantity. He adds, that we ought sometimes to smooth, and sometimes to make rough; sometimes to harden, and sometimes to soften again; sometimes to make more fine or supple; sometimes to thicken; sometimes to rouse up, and at other times to stupify or take away the sense; all in relation to the solid parts of the body, or to the humours. He gives also this farther lesson, That we ought to have regard to the course the humours take, from whence they come, and whether they go; and in consequence of that, when they go where they ought not, that we make them take a turn about, or carry them another way, almost like the turning the course of a river: or, upon other occasions, that we endeavour if possible to recall, or make the same humours return back again; drawing upward such as have a tendency downward, and drawing downward such as tend upward. We ought also to carry off, by convenient ways, that which is necessary to be carried off; and not let the humours once evacuated enter into the vessels again. Hippocrates gives also the following instruction, That when we do anything according to reason, though the success be not answerable, we ought not easily, or too hastily, to alter the manner of acting, as long as the reasons for it are yet good. But as this maxim might sometimes prove deceitful, he gives the following as a corrector to it: "We ought (says he) to mind with a great deal of attention what gives ease, and what creates pain; what is easily supported, and what cannot be endured." We ought not to do anything rashly; but ought often to pause, or wait, without doing anything: by this way, if you do the patient no good, you will at least do him no hurt.

These are the principal and most general maxims of the practice of Hippocrates, and which proceed upon the supposition laid down at the beginning, viz. that nature cures diseases. We next proceed to consider particularly the remedies employed by him, which will serve to give us further instructions concerning his practice.