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(Part 16)

Ancient Medicine After Galen

The Byzantine school of medicine, which closely corresponds to the Byzantine literary and historical schools, followed closely in Galen’s footsteps, and its writers were chiefly compilers and encyclopaedists. The earliest is Oribasius (326-403), whose date and position are fixed by his being the friend and court physician of Julian the Apostate. He was a Greek of Pergamum, educated in Alexandria, and long resident in Byzantium. His great work Synagogai iatrikai [Gk.], of which only about one-third has been preserved, was a medical encyclopaedia founded on extracts from Hippocrates, Galen, Dioscorides, and certain Greek writers who are otherwise very imperfectly known. The work is thus one of great historical value but of no originality. The next name which requires to be mentioned is that of Aetius (550 A.D.), a complier who closely followed Oribasius, but with inferior powers, and whose work also has an historical but no original value. A higher rank among medical writers is assigned to Alexander of Tralles (525-605), whose doctrine was that of an eclectic. His practical and therapeutical rules are evidently the fruit of his own experience, though it would be difficult to attribute to him and decided advance in medical knowledge. But the most prominent figure in Byzantine medicine is that of Paul of Aegina (Paulus Aegineta), who lived probably in the early part of the 7th century. His skill, especially in surgery, must have been considerable, and his Iatrika [Gk.] gives a very complete picture of the achievements of the Greeks in this department. Another work, on obstetrics, now lost, was equally famous, and procured for him, among the Arabs, the name of "the Obstetrician." His reputation lasted through the Middle Ages, and was not less in the Arabian schools than in the West. In this respect Paulus is a most important influence in the development of medicine. His great work on surgery was early translated into Arabic, and became the foundation of the surgery of Abulcasis, which in turn (to anticipate) was one of the chief sources of surgical knowledge to Europe in the Middle Ages. The succeeding period of Byzantine history was so little favourable to science that no name worthy of note occurs again (though many medical works of this period are still extant) till the 13th century, when we meet with a group of writers; -- Demetrius Pepagomenus, Nicolaus Myrepsus, and Johannes, called Actuarius, who flourished under the protectionof the Palaeologi. The work of the last has some independent merit; but all are interesting as showing a fusion of Greek and Arabian medicine, the latter having begun to exercise even in the 11th century a reflex influence on the schools of Byzantium. Something was borrowed even from the school of Salerno, and thus the close of Byzantine medicine is brought into connexion with the dawn of science in modern Europe.

In the West the period after Galen affords little evidence of anything but a gradual though unvarying decline in Roman medicine. Coelius Aurelianus, already referred to as the follower of Soranus, must be mentioned as showing the persistence of the methodic school. An abridgment of one of his writings, with the title of Aurelius, became the most popular of all Latin medical works. As a writer he was worthy of a better period of medical literature. Little else was produced in these times but compilations, of the most meager kind, chiefly of the nature of herbals, or domestic receipt-books; among the authors of which is may be sufficient to name Serenus Sammonicus (3rd century), Gargilius Martialis (3rd century), and Marcellus Empiricus (5th century). Certain complications still extant bear the falsely-assumed names of eminent writers, such as Pliny and Hippocrates. A writer with the (perhaps assumed) name of Apuleius Platonicus produced a herbal which held its ground till the 15th century at least, and was in the 9th translated into Anglo-Saxon. These poor compilations, together with Latin translations of certain works of Galen and Hippocrates, formed a medical literature, meager and unprogressive indeed, but of which a great part survived through the Middle Ages till the discovery of printing and revival of learning. It is important to remember that this obscure stream of tradition flowed on, only partially affected by the influx of Arabian, or even the early revival of purer classical learning.

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