and nothing can be clearer than the following statement
from the work “The Nature of Man”:
“The body of man contains in itself blood and
phlegm and yellow bile and black bile, which things
are in the natural constitution of his body, and the
cause of sickness and of health. He is healthy
when they are in proper proportion between one another
as regards mixture and force and quantity, and when
they are well mingled together; he becomes sick when
one of these is diminished or increased in amount,
or is separated in the body from its proper mixture,
and not properly mingled with all the others.”
No words could more clearly express the views of disease
which, as I mentioned, prevailed until quite recent
years. The black bile, melancholy, has given
us a great word in the language, and that we have
not yet escaped from the humoral pathology of Hippocrates
is witnessed by the common expression of biliousness—“too
much bile”—or “he has a touch
of the liver.” The humors, imperfectly mingled,
prove irritant in the body. They are kept in
due proportion by the innate heat which, by a sort
of internal coction gradually changes the humors to
their proper proportion. Whatever may be the
primary cause of the change in the humors manifesting
itself in disease, the innate heat, or as Hippocrates
terms it, the nature of the body itself, tends to restore
conditions to the norm; and this change occurring
suddenly, or abruptly, he calls the “crisis,”
which is accomplished on some special day of the disease,
and is often accompanied by a critical discharge,
or by a drop in the body temperature. The evil,
or superabundant, humors were discharged and this
view of a special materies morbi, to be got rid of
by a natural processor a crisis, dominated pathology
until quite recently. Hippocrates had a great
belief in the power of nature, the vis medicatrix
naturae, to restore the normal state. A keen observer
and an active practitioner, his views of disease,
thus hastily sketched, dominated the profession for
twenty-five centuries; indeed, echoes of his theories
are still heard in the schools, and his very words
are daily on our lips. If asked what was the
great contribution to medicine of Hippocrates and
his school we could answer—the art of careful
observation.
In the Hippocratic writings is summed up the experience
of Greece to the Golden Age of Pericles. Out
of philosophy, out of abstract speculation, had come
a way of looking at nature for which the physicians
were mainly responsible, and which has changed forever
men’s views on disease. Medicine broke
its leading strings to religion and philosophy—a
tottering, though lusty, child whose fortunes we are
to follow in these lectures. I have a feeling
that, could we know more of the medical history of
the older races of which I spoke in the first lecture,
we might find that this was not the first-born of
Asklepios, that there had been many premature births,
many still-born offspring, even live-births—the