Some of the general principles of medical practice which Alexander lays
down are very significant even from our modern standpoint. He deprecated
drastic remedies of all kinds. He did not believe in severe purgation nor
in profuse or sudden blood-letting. His diagnosis was thorough and
careful. He insisted particularly on inspection and palpation of the whole
body; on careful examination of the urine, of the fæces, and the sputum;
on study of the pulse and the breathing. He dwelt on the fact that much
might be learned from the patient's history taken carefully. The general
constitution was the most important element, in his estimation. His
therapeutics is, above all, individual. Remedies must be administered with
careful reference to the constitution, the age, the sex, and the condition
of the patient's strength. Special attention must always be paid to
seconding nature's efforts to cure. Alexander had no sympathy at all with
the idea that nature was to be disturbed, much less that remedies must
work in opposition to natural tendencies to recovery.
Paul of Ægina, educated at the University at Alexandria, probably
flourished during the reign of the Emperor Heraclius, who died 641; his
works contain more of surgical than of medical interest.
The Arab writer, Abul Farag, to whose references we owe the definite
placing of the time when Paul lived, said that "he had special experience
in women's diseases, and had devoted himself to them with great industry
and success. The midwives of the time were accustomed to go to him and ask
his counsel with regard to accidents that happen during and after
parturition. He willingly imparted his information, and told them what
they should do. For this reason he came to be known as the Obstetrician."
Perhaps the term should be translated the man-midwife, for it was rather
unusual for men to have much knowledge of this subject. His knowledge of
the phenomena of menstruation was wide and definite. He knew a great deal
of how to treat its disturbances. He seems to have been the first one to
suggest that in metrorrhagia, with severe hæmorrhage from the uterus, the
bleeding might be stopped by putting ligatures around the limbs. This
same method has been suggested for severe hæmorrhage from the lungs as
well as from the uterus in our own time. In hysteria he also suggested
ligature of the limbs, and it is easy to understand that this might be a
very strongly suggestive treatment for the severer forms of hysteria. It
is possible, too, that the modification of the circulation to the nervous
system induced by the shutting off of the circulation in large areas of
the body might very well have a favourable physical effect in this
affection. Paul's description of the use of the speculum is as complete as
that in any modern textbook of gynæcology.
Public-domain text, read in full here on John Shaqi.
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