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WebAssembly: The Definitive
Guide
Safe, Fast, and Portable Code

Brian Sletten
WebAssembly: The Definitive Guide
by Brian Sletten
Copyright © 2022 Bosatsu Consulting, Inc. All rights reserved.
Printed in the United States of America.
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December 2021: First Edition

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2021-12-01: First Release

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WebAssembly: The Definitive Guide, the cover image, and related
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The views expressed in this work are those of the author, and do not
represent the publisher’s views. While the publisher and the author
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the author disclaim all responsibility for errors or omissions,
including without limitation responsibility for damages resulting from
the use of or reliance on this work. Use of the information and
instructions contained in this work is at your own risk. If any code
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subject to open source licenses or the intellectual property rights of
others, it is your responsibility to ensure that your use thereof
complies with such licenses and/or rights.
978-1-492-08984-1
[LSI]
Dedication
This book was born on a mountain of privilege during a period when
many people didn’t have the luxury of working from home. It is
therefore dedicated to the frontline and essential workers who kept
the lights on during a dark time.
Preface

I believe WebAssembly is an ascendant technology that has the

potential to transform the entire software development industry in
one form or another. I do not believe WebAssembly is going to be
transformative because I am writing a book on the topic. I’m writing
a book on it because I believe it will be transformative.
Presumably you are interested in the technology as well. The
problem is, I think I have less of an idea of who you are as a reader
than many authors do. If this were a book about a particular
programming language or a specific topic, there would be a self-
selecting aspect to the audience and I could proceed apace. But
WebAssembly is a much larger topic than most people realize, and I
am trying to paint a very large picture with this book. Most of the
other books that have been published have focused on a single
aspect of it, and I can understand why.
Some of you might think WebAssembly is a technology for killing
JavaScript. It isn’t. Some of you may think it is about bringing
applications to the browser. It is that, but it is also so much more. It
is useful on the server side, in the video game world, as a plug-in
mechanism, in support of serverless functions and edge computing,
in embedded systems, for the blockchain, and in many other topics
we will investigate together. This is the first attempt I know of to be
this comprehensive with the topic, and I felt it was important to tell
this more complete version.
In the lead-up to the publication of this book, I have mostly gotten
positive support and excitement from people I have spoken to about
the project. One limited form of pushback I have gotten is with
respect to the title. Some folks felt it was premature to have “The
Definitive Guide” for this new of a technology. That is a fair position
to take, but because I am trying to describe an extremely big and
encompassing technical landscape, I thought it was reasonable. I
hope by the end of the book you agree.
All I ask is that you have an open mind and a bit of patience.
WebAssembly touches a lot of languages, runtimes, and operational
environments. In addition to teaching you about the low-level
details, we will look at integrations with the dominant programming
languages in this space and several different use cases. I have tried
not to make too many assumptions about your background, so I
have heavily annotated the text with breadcrumbs for further
exploration and discovery via footnotes. If you are a more advanced
developer just seeking details about WebAssembly, feel free to
ignore these and don’t take offense. I expect a rather wide audience
will be at least perusing this book, and I want them to feel welcome,
too.
If you are on the junior side development-wise, this will be a
challenging book. But I have tried to make it possible for you to at
least see what is going on. Consider the various links and references
as a personal guide into a more sophisticated development reality.
Don’t get overwhelmed, just tackle things one at a time in whatever
order interests you or makes sense. There is no single way into this
industry, and however you get there is legitimate.
At the end of the day, WebAssembly is going to allow us to basically
choose our programming languages and run them securely in just
about any computational surface area. We have been promised this
before, but I think this time it is more likely to come to fruition.
Thank you for giving me the opportunity to explain why.

Conventions Used in This Book

The following typographical conventions are used in this book:
Italic
 Indicates new terms, URLs, email addresses, filenames, and file
extensions.

Constant width
Used for program listings, as well as within paragraphs to refer to
program elements such as variable or function names, databases,
data types, environment variables, statements, and keywords.

Constant width bold

Shows commands or other text that should be typed literally by
the user.

Constant width italic

Shows text that should be replaced with user-supplied values or
by values determined by context.

This element signifies a tip or suggestion.

This element signifies a general note.

Using Code Examples

Supplemental material (code examples, exercises, etc.) is available
for download at https://github.com/bsletten/wasm_tdg.
If you have a technical question or a problem using the code
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This book is here to help you get your job done. In general, if
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(O’Reilly). Copyright 2022 Bosatsu Consulting, Inc., 978-1-492-
08984-1.”
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Acknowledgments
At times, our own light goes out and is rekindled by a spark from
another person. Each of us has cause to think with deep gratitude
of those who have lighted the flame within us.
—Albert Schweitzer
The myth of the sole author is persistent. I have huge communities
of people to thank for the production of this book and their
assistance to me along the way. On the other hand, I alone am
responsible for any errors, inaccuracies, and problems.
I would like to start with the larger WebAssembly community. They
have done a remarkable job in designing this platform without
overdesigning it. It is a moving target, and they are busy juggling
and balancing a surplus of competing issues. Along the way, they
have left breadcrumbs to explain decisions and lay the foundations
for the future. I would like to call special attention to the
contributions of Lin Clark, who has emerged as one of my favorite
technical communicators. Not only is she generous with her time,
but her cartoon introductions to complex topics are also among the
most effective forms of technical communication I have
encountered.
The O’Reilly community is a top-notch organization. Everyone I have
encountered there, current and past, has been a solid representative
of the brand. I would like to thank Mike Loukides for his time in
discussing my much larger views and suggesting we start with
WebAssembly. My editors, Zan McQuade and Angela Rufino, have
been stalwart champions of the project with the absolute patience of
Job. Kate Galloway and her team helped me get it across the finish
line. I would like to issue a special thank you to Karen Montgomery
for the beautiful cover. My dogs’ groomer is especially fond of it, as
you caught the essence of this ridiculously lovable breed of Norwich
terriers. For those who have questioned the relevance, they are the
smallest working dog and—as I pitched it—small, fast, and portable,
just like WebAssembly.
For insight into the various WebAssembly use cases, I interviewed
several members of the projects and companies I mention
throughout. In no particular order, I would like to express my
gratitude to Tim McCallum, Aaron Turner, Connor Hicks, Liam
Randall, Kevin Hoffman, Sasha Krsmanovic, Jérôme Laban, and
Francois Tanguay.
The technical reviewers have honored me with the gift of their time
and feedback. I would like to thank Dr. Sam Bail, Taylor Poindexter,
Hannah Thoreson, Brooks Townsend, Jay Phelps, David Sletten, and
the incomparable Dr. Venkat Subramaniam.
I was given a venue to begin speaking professionally about
WebAssembly by Jay Zimmerman of the No Fluff Just Stuff
conference series back in 2017. He and I knew it was too soon, but
we wanted to start the conversation and I appreciate the
opportunity. The rest of the speakers and attendees of this
remarkable technical carnival have given me no end of inspiration
and feedback, for which I am so much the richer.
My friends and family have encouraged and supported me in all
things, a debt I will never be able to repay. No one has done more
than my wife and friend, Kristin. She and our dogs, Loki and Freyja,
have made this time at home during the pandemic not just bearable,
but richer than my life on the road.
Thank you, all.
Chapter 1. Introduction

Extraordinary claims require extraordinary evidence.

—Dr. Carl Sagan
This chapter will introduce WebAssembly and provide context for its
expansive reach. In some sense it is a culmination of the evolution
of the web over the last several decades. There is quite a bit of
history to cover to make sense of it all. If you are not a fan of
history and exposition, you can skip this chapter and go to directly to
Chapter 2, but I hope you don’t. I think it is important to understand
why this technology is so important and where it came from.

What WebAssembly Offers

One of the greatest skills an engineer can develop is the ability to
assess what a new technology brings to the table. As Dr. Fred
Brooks of the University of North Carolina reminds us, there are no
“silver bullets”; everything has trade-offs. Complexity is often not
eliminated with a new technology, but is simply moved somewhere
else. So when something does actually change what is possible or
how we do our work in a positive direction, it deserves our attention
and we should figure out why.
When trying to understand the implications of something new, I
usually start by trying to determine the motivation of those behind
it. Another good source of insight is where an alternative has fallen
short. What has come before, and how does it influence this new
technology we are trying to decipher? As in art and music, we are
constantly borrowing good ideas from multiple sources, so to truly
understand why WebAssembly deserves our attention and what it
provides, we must first look at what has preceded it and how it
makes a difference.
In the paper that formally introduced the world to WebAssembly, the
authors indicate that the motivation was about rising to meet the
needs of modern, web-delivered software in ways that JavaScript
alone could not.1 Ultimately, it was a quest to provide software that
is:

Safe
Fast
Portable
Compact
In this vision, WebAssembly is centered at the intersection of
software development, the web, its history, and how it delivers
functionality in a geographically distributed space. Over time, the
idea has expanded dramatically beyond this starting point to imagine
a ubiquitous, safe, performant computational platform that touches
just about every aspect of our professional lives as technologists.
WebAssembly will impact the worlds of client-side web development,
desktop and enterprise applications, server-side functionality, legacy
modernization, games, education, cloud computing, mobile
platforms, Internet of Things (IoT) ecosystems, serverless and
microservices initiatives, and more. I hope to convince you of this
over the course of this book.
Our deployment platforms are more varied than ever, so we need
portability at both the code and application levels. A common
instruction set or byte code target can make algorithms work across
various environments because we just need to map logical steps to
how they can be expressed on a particular machine architecture.
Programmers use application programming interfaces (APIs) such as
OpenGL,2 POSIX,3 or Win324 because they provide the functionality
to open files, spawn subprocesses, or draw things to the screen.
They are convenient and reduce the amount of code a developer
needs to write, but they create a dependency on the presence of
libraries to provide the functionality. If the API is not available in a
target environment, the application will not run. This was one of the
ways Microsoft was able to use its strength in the operating system
marketplace to dominate in the application suite space as well. On
the other hand, open standards can make it easier to port software
into different environments.
Another issue with the runtime side of the software we are building
is that different hosts have different hardware capabilities (number
of cores, presence of GPUs) or security restrictions (whether files
can be opened or network traffic can be sent or received). Software
often adapts to what is available by using features-testing
approaches to determine what resources an application can take
advantage of, but this often complicates the business functionality.
We simply cannot afford the time and money needed to rewrite
software for multiple platforms constantly. Instead, we need better
strategies for reuse. We also need this flexibility without the
complexity of modifying the code to support the platform on which it
will run. Making the code different for different host environments
increases its complexity and complicates testing and deployment
strategies.
After several decades, the value proposition of open source software
is clear. We gravitate toward valuable, reusable components written
by other developers as a means of satisficing our own needs.5
However, not all available code is trustworthy, and we open
ourselves up to software supply chain attacks when we execute
untrusted bits we have downloaded from the internet. We become
vulnerable to the risks, business impacts, and personal costs of
insecure software systems through phishing attacks, data breaches,
malware, and ransomware.
Until now, JavaScript has been the only way to solve some of these
problems. When it is run in a sandboxed environment, it gives us
some manner of security. It is ubiquitous and portable. The engines
have gotten faster. The ecosystem has exploded into an avalanche of
Another random document with
no related content on Scribd:
several of the older authorities, namely, Zeuxis, Heraclides, and
Glaucias, some of whom refer it to a younger Hippocrates, some to
Thessalus, others to Polybus, and others again to Democritus.[236]
Accordingly, the highest modern authorities, as Mercuriali, Gruner,
Ackerman, Kühn, and Littré, refuse to receive it into the list of
genuine works; and the last of these seems to make it out pretty
clearly that the treatise is composed of detached observations
extracted from the other Hippocratic works. After repeated perusals
of it, what strikes myself is, that it bears a close resemblance to the
treatise “On the Surgery,” that is to say, that it is a recapitulation of
the conclusions arrived at in certain of the other works of
Hippocrates. Perhaps, then, it must be admitted that there is some
inconsistency in allowing the one a place among the genuine works
of Hippocrates, and refusing the similar claims of the other. That the
work in question contains a most interesting summary of what were
regarded, in ancient times, as great medical truths, cannot be
doubted. From the condensed form in which the subject matters of it
are presented, it will readily be apprehended that they do not well
admit of being given in the form of an abstract, and that any
specimens of its contents will afford but a very imperfect idea of its
value as a whole. I would remark, at the outset, that the title of the
work, “On the Humors,” appears not very applicable, since very few
of the paragraphs relate to the humors; in fact, as already hinted,
the treatise may be said to be a recueil of various observations
gathered out of other works. I also feel at a loss to account for M.
Littré’s disposition to rank it as the eighth book of the Epidemics, as
it bears no resemblance either in form or matter to that work; the
one consisting of isolated observations and of particular facts, and
the other of general principles; and the style of the one being
comparatively full, whereas the other is remarkably succinct, so as to
be nearly unintelligible in many places. Take the following as a
specimen of it: “The earth is to trees what the stomach is to
animals; it nourishes, heats, and cools; cools when emptied, heats
when filled, as the earth when manured is hot in winter, so is it with
the stomach.” This important observation, that the earth, in
connection with the vegetable productions, is analogous to the
stomach in animals, is repeated by Aristotle and other of the ancient
philosophers.[237] The author makes the important remark, (§ 14,)
that we ought to study the condition of the body previous to the
season in which the disease broke out; in confirmation of which M.
Littré, in his arguments, gives some very interesting observations by
M. Forster.[238] In the paragraph on deposits, the author remarks,
that in fevers attended with a feeling of lassitude, the deposits
generally take place to the joints and jaws. It is afterwards stated—
and if confirmed by experience, as I think I have observed it to be in
many cases, it is an important remark—that “when the feet are hot,
the depositions point downwards, but when cold, upwards.” § 7. In §
12 diseases are thus classified: “with regard to the modes of
diseases, some are congenital, as may be learned upon inquiry;
some are connected with the nature of the locality, (for many are
affected, and therefore many are acquainted with them); some with
the condition of the body and the diet, the constitution of the
disease, and the seasons. The localities which are ill situated in
respect to the seasons engender diseases similar to the season; in
like manner, irregularities as to heat and cold in the same day when
it has such effects, produce autumnal diseases in the locality, and in
the other seasons likewise. The diseases which are engendered by
fetid and marshy waters are calculus and splenic diseases, and such
are influenced by good or bad winds.” Altogether, as will be readily
seen, it is a work of great ability, and will amply repay a diligent
perusal. Galen esteemed it very much, and did not hesitate to
declare that, not only Plato, Aristotle, and Theophrastus, but also
several of the most distinguished medical authors had copied freely
from it.[239]

XXXV. Περὶ χρήσιος ὑγρῶν—On the Use of Liquids.

This would seem to be the work which appears in Erotian’s list
under the title of “On Waters” (περὶ ὑδατῶν); and, contrary to what
is stated by Foës and Gruner, it is quoted by Galen in two places;
[240] and it is further referred to by Athenæus, under the same title
as that given to it by Erotian.[241] Foës pronounces it to be a
mutilated work, and one which is wanting in many of the MSS. of
the Hippocratic treatises; and all the modern critics, from Lemos and
Mercuriali down to Littré and Greenhill, regard it as spurious. Gruner
speaks of it as being a work of little importance, and Ackerman as
being a mere compilation from the Aphorisms.[242] Gruner further
remarks, that the title does not suit well with its contents, and this is
in so far correct, for undoubtedly the title given to it by Erotian is
more suitable, as it treats almost exclusively of the medicinal
properties of waters; and this it certainly does in a fuller and more
interesting manner than they are treated of in any other ancient,
and, I may almost venture to add, any modern work with which I
am acquainted. I look upon its contents, then, as being extremely
valuable, even as the work has come down to us, but it is to be
regretted that the text is in a very unsatisfactory state. Water the
author of the treatise recommends as a fomentation to the eyes,
when applied with a sponge; and further, as a general or local
fomentation, for producing relaxation of any part when contracted.
When poured over the head, and other parts, it is said to induce
sleep, is useful in convulsions, and relieves pains of the eyes and
ears. Cold water inflames ulcers, except such as have a tendency to
hemorrhage, and also fractures, luxations, etc. In applying water to
the body, the author recommends the feelings of the patient to be
consulted, unless he be in a state of paralysis or of stupor, or be
suffering from exposure to great cold, or be in great pain. In these
cases, he adds, the patient may be insensible, and instances have
occurred of persons having their feet congealed by cold, which have
dropped off upon the affusion of hot water. The immoderate use of
hot water induces relaxation of the fleshy parts (muscles?),
weakness of the nerves, torpor of the understanding, hemorrhage,
and deliquum animi, so as even to prove fatal; and much cold water
will occasion spasms, tetanus, lividity, and febrile rigors. The parts of
the body which are usually covered endure the cold water worst,
and are most refreshed by hot. Cold water disagrees with the brain
and its processes, the bones, the teeth, and the nerves; and hence,
it is added, convulsions, distentions, and febrile rigors, which are
induced by cold, are relieved by hot water. Hot water occasions
delight and determination (to the skin?); cold, on the other hand,
pain and determination inwardly: wherefore the loins, the breast, the
back, and the hypochondriac region, are injured by cold applications,
but delight in warm. Cold water, thrown on the extremities, relieves
lipothymia, the reason of which he states, but the text is so corrupt
that I dare not undertake to translate the passage. Ulcers,
excoriated parts of the body, and burns, bear cold ill. The
extremities, the bladder, and the organs of generation, delight in
warm water. Salt water is proper to itchy parts, and to parts affected
with pungent humors, but disagrees with burns, and abraded
surfaces. Vinegar is said to have much the same properties as salt
water in the cure of these complaints. Warm water, in which salt has
been melted, is beneficial in lichen, leprosy, alphos, and other
complaints of a like nature. The lees of vinegar (caustic potass?) also
answer in these cases. The astringency of cold water is increased by
having beet leaves, ivy, bramble, sumach, sage, etc. boiled in it. Red
pustules, like lentils, are benefited by cold things, but eruptions
arising from cold, and resembling millet, are improved by hot. There
are certain cases in which both hot and cold are applicable, such as
gouty affections, and most sprains: in these, cold applications
deaden the pain, and warm soothe it. Indurations and ankyloses of a
joint are to be removed by pouring warm water out of a vessel upon
it. Rheums of the eyes are relieved by rubbing them with some fatty
substance, to obtund the acrimony of the tears. In pains,
suppurations, pungent tears, and deep ulcers of the eyes, hot water
is most expedient; when the eyes are merely red, and free of pain,
cold is to be preferred. Cold does not agree with complaints of the
rectum and uterus, nor with cases of bloody urine. Cold raises pain
when it is applied to ulcers, hardens the skin, renders it painful,
suppresses suppuration, renders parts livid and black, is injurious in
febrile rigors, spasms, and tetanus. But he adds, sometimes in a
robust young man, in the middle of summer, when laboring under
tetanus not connected with a wound, the affusion of cold water
brings back the heat. (See Aphor. v., 21, and Paulus Ægineta, B. III.,
20). Hot water does the same. It promotes ulceration in all cases,
softens the skin, attenuates it, is anodyne, and soothes rigors,
spasms, and tetanus, and removes heaviness of the head. It is most
particularly applicable in fractures, when the bone is laid bare, and
especially in injuries of the head. Hot water agrees with all
ulcerations, whether innate or produced by artificial means, in
herpes exedens, in blackened parts, and in diseases of the ears,
anus, and womb. But cold water is inimical in all these cases, except
when hemorrhage is apprehended.
The above is a brief summary of the matters contained in this
little treatise. That they are highly important, and evince an
extraordinary talent for apprehending the true bearing of practical
points in medicine, will hardly be denied by any person who is a
competent judge. Many of the rules and observations contained in it
are, no doubt, the same as those found in the Aphorisms (see
Section v.), but there is also no lack of valuable matter in it, which is
not to be found elsewhere. Though I am disposed, then, to agree
with the authorities who exclude it from the list of genuine works, I
do not hesitate to declare it as my decided opinion, that it is not
unworthy of the reputation of the great Hippocrates, and that, if not
written by him, it must be the production of some person who
thoroughly apprehended his high principles and discriminating views.
How much, then, is it to be regretted, that this treatise should have
come down to us in so mutilated a state that the meaning, in many
places, can only be guessed at with considerable hesitation!

XXXVI. Περὶ γονῆς—On Semen.

XXXVII. Περὶ φύσιος παιδίου—On the Nature of the Infant.

That these two treatises originally constituted one work, has
been remarked by Foës, Gruner, Ackerman, Littré, and others.
Indeed, this will be made sufficiently obvious, upon comparing the
conclusion of the one with the beginning of the other. Galen, in one
place,[243] quotes the former of these as if he held it to be a
genuine work of Hippocrates, but elsewhere he mentions that it had
been referred to Polybus.[244] Erotian mentions, among the works of
Hippocrates, a treatise bearing the title of the latter, under which he
probably comprehended both treatises. It is also noticed as a
Hippocratic treatise by Palladius,[245] and by Macrobius.[246] Both
are rejected by Haller, Gruner, Ackerman, Kühn, Littré, and Greenhill.
Indeed the story of the female musician, whom the author gravely
admits that he taught the way how to get rid of a conception,[247] is
so alien to the morals of Hippocrates, as declared in “The Oath,” that
it is impossible for a moment to suppose him guilty of such an act of
flagitiousness. Moreover the treatise so abounds in little subtleties
and conceits, especially in reference to the Pythagorean doctrine of
numbers, that no competent judge will hesitate for a moment in
pronouncing it not to be the production of the Great Hippocrates.
[248] Without doubt, however, these treatises are of great antiquity,
and are valuable as containing the hypotheses with regard to the
origin of the fœtus which prevailed in the schools down to the days
of Harvey; that is to say, that the embryo is formed from the male
semen, into which the uterine vessels enter, and form the
cotyledones (or placenta). It contains, moreover, an hypothesis
adopted by Aristotle in several of his physiological works regarding
the semen, namely, that it is collected from all parts of the body;
and hence, if any part be mutilated in the parent, it is so likewise in
the fœtus.[249] The author moreover holds, that the fœtus breathes,
and is nourished by the umbilicus,[250] which may be looked upon as
an anticipation of the modern doctrine, that the placenta performs
the function both of a lung and of an intestine. It contains a
statement regarding the incubation of the egg, which has been often
repeated in modern times, but which, from personal observation, I
can affirm not to be true; namely, that the hen chips the shell to let
out the chick.[251] Presentations in delivery are divided into those by
the head, the feet, and crossways. I would mention, in conclusion,
that these works abound in repetitions, and are written in a diffuse
style, very unlike that of Hippocrates. Altogether, then, I can have no
hesitation in pronouncing both treatises to be spurious. From what
has been stated of them above, it must be obvious, however, that to
the student of ancient anatomy and physiology they are very
interesting, and will repay a careful perusal. Although, probably, later
productions than the age of Hippocrates, there can be no doubt that
they are anterior to the memorable epoch of Herophilus and
Erasistratus.

XXXVIII. Περὶ γυναικείων—On the Diseases of Women.

We have already stated in our critical remarks on the fourth
book, “On Diseases,” that it and the present treatise are evidently
the productions of the same author. Although Erotian and Galen[252]
make reference to it as if acknowledging it to be the production of
Hippocrates, its claim is rejected by Foës, Schulze, Gruner, and
Ackerman, and all the modern authorities of any note. Its connection
with the treatises “De Genitura” and “De Natura Pueri,” is pointed
out by Foës and Gruner; and Littré does not hesitate to refer to the
same author the whole of the following treatises, “De Genitum,” “De
Natura Pueri,” “De Morbis,” iv., “De Morbis Mulierum,” “De Morbis
Virginum,” “De Sterilibus.” Although not the composition of
Hippocrates, all these treatises are, without doubt, of high antiquity,
and were anterior to the age of Aristotle.
The work now under consideration contains much valuable
matter, and deserves a careful perusal. I feel rather at a loss what
selections to make from it, as a specimen of its contents, but shall
be brief on the present occasion, more especially as I have no
difficulty in establishing the point, that the treatise in question is not
one of the genuine works of Hippocrates.
The observations contained in the first part of it, on menstruation
and the causes of sterility, are ingenious. For the cure of sterility,
fumigation of the uterus is recommended, and a minute description
is given of the mode of performing this process, by means of a tube
introduced into the os uteri, and connected with a vessel which
emits aromatic fumes. When sterility is connected with the shutting
up of the os uteri, the author gives directions for expanding it by
means of a wooden or leaden pipe. We need scarcely remark, that
this practice has been revived of late years. A minute description is
given of a malformation of the vagina, in which the passage is nearly
obliterated by a membrane. Allusion is probably made here to a
preternatural rigidity of the hymen. The author directs the
membrane to be fairly torn, and the part dressed with wine and
myrrh. In transverse and footling presentations of the child it will be
best, he says, to bring it down by the head. Both cases are said to
be dangerous, so that either the mother or child is lost, and
sometimes both. Treating of retention of the placenta, the author
remarks, that if it is not cast off it becomes putrid, and thus comes
away on the sixth or seventh day, or later. To promote its expulsion,
he recommends southernwood, dittany, the flowers of the white
violet, and asafœtida. The process of abortion, and the unpleasant
circumstances connected with retention of the placenta in this case,
are given with much accuracy. Hydrops uteri is described at
considerable length. For an account of it, see Paulus Ægineta, Vol I.,
p. 573, Syd. Soc. edition, and the modern authorities there referred
to. For ulcers of the womb, he recommends applications consisting
of many stimulating ingredients, such as the flos argenti, etc. The
subject of difficult delivery is resumed; when the arm or leg of a
living child is protruding, it is directed to be pushed back, and the
child turned to the head; and if the fœtus be dead, either the same
thing may be done, or the projecting part may be cut off, and the
head opened with a sharp knife, and the bones thereof extracted,
and the body brought along. The chest also may be opened, if there
be any difficulty in extracting the body. The author expresses himself
strongly in regard to the danger of abortions. All abortions, he says,
are attended with more danger than deliveries at the full time.
Artificial abortion never takes place without violence, whether
produced by medicine, a draught, or food, or a suppository, or any
other means.
 The second book commences with a description of fluor albus, an
affection to which the old are stated to be more subject than the
young. It arises from suppression of the menses, from parturition, or
a fever. Among other means which he speaks of for the cure of it, he
mentions the application of cupping-instruments to the mammæ.
Astringents from the vegetable kingdom are to be administered,
such as sumach boiled in vinegar, mulberries, or the like. A full
account of the red fluor, or uterine hemorrhage, is also given. It is
said to be connected principally with parturition. The treatment
which is recommended can scarcely be improved upon, even after
the lapse of two thousand years: a sponge is to be wetted and
applied to the pudenda; soft garments are to be moistened with cold
water, and laid on the belly; and the foot of the bed is to be raised.
When the hemorrhage is connected with putridity many women thus
perish, indeed few recover. A long description is given of hysterical
convulsions which is said principally to attack antiquated maids and
widows. It is remarked that hysterical complaints bring on cough,
and other pectoral complaints. A very striking and accurate
description is given of procidentia uteri. Inflation of the womb is also
described. On it see Paulus Ægineta, Vol. I., p. 632, Syd. Soc. edition.
There is also a curious description of the mole. The clitoris is
described under the name of columna.[253]
From the extracts now given, it will be seen that these Books
contain a great variety of most important matter. Indeed, there are
few treatises in the Collection more deserving of an attentive
perusal. They furnish the most indubitable proofs that the obstetrical
art had been cultivated with most extraordinary ability at an early
period. Beyond all doubts the complaints of women, and the
accidents attending parturition, must at that time have come under
the jurisdiction of the male practitioner. But, considering the
wandering life which Hippocrates led, and that during the best part
of it he must have been what is now called a consulting physician, it
is not at all likely that he could have acquired that acquaintance with
the minutiæ of obstetrical practice which this work displays. It is not,
then, at all probable that he can be the author of it.
 XXXIX. Περὶ ἀφόρων—On Sterile Women.
This treatise is closely connected with the preceding one, both in
matter and style. It relates to a subject which, as we have shown, is
also treated of in the other work, I mean sterility, the most common
cause of which is held to be the state of the os uteri, when it is
oblique to the passages of the vagina, constricted from cicatrices, or
otherwise diseased. Distinct directions are given for opening the
mouth of the womb, after which a cleansing application, composed
of cantharides and myrrh, is to be made to it. The mole, and
procidentia uteri, are described in nearly the same terms as in the
preceding treatise. Though it bears a great resemblance, then, to
the work “On the Diseases of Women,” it is not likely, as suggested
by Albertus Fabricius,[254] that it is an appendix to it, for why should
an author treat twice of the same subject in the same work?

XL. Περὶ παρθενίων—On the Complaints of Young Women.

Foës looks upon this little tract as being the prelude to the
greater work “On the Diseases of Women.” It is destitute of all
claims to be held as genuine, and accordingly no critic, ancient or
modern, stands up for it. Gruner is inclined to ascribe it to the
author of the treatise “On the Sacred Disease,” but I see no grounds
for this opinion, except it be that, in the two treatises, there is a
certain similarity of views with regard to the nature of the hysterical
convulsion. This, however, is not a sufficient reason for deciding that
they both must have come from the same source, for all the ancient
authorities, from Hippocrates to Actuarius, held pretty much the
same ideas regarding the nature of “Uterine suffocation.” See Paulus
Ægineta, III., 71. The author of this little fragment gives very naïve
advice to virgins who are subject to hysterics; instead of making
costly oblations of garments and the like to Diana, as recommended
by the prophets, he gravely advises them ὡς ταχίστα συνοικῆσαι
ἀνδρασι.

XLI. Περὶ ἐπικυήσιος—On Superfœtation.

 This treatise, I believe, is not mentioned by any one of the
ancient authorities, and it is almost universally rejected by the
modern.
I need scarcely remark that it relates to a very curious subject,
and that great doubts are now entertained whether or not
superfœtation in women ever actually takes place. I can state,
however, that two trustworthy persons, the one a surgeon and the
other a sage femme, informed me, some years ago, that they once
attended together a case in which a woman was first delivered of a
fœtus about four months old, and, about thirty-six hours afterwards,
of a fully grown child. The ancient savants all believed in the
occurrence of superfœtation. See in particular Aristotle (Hist. Anim.
vii., 5); and Pliny, (H. N., vii., 11.)
The following are a few of the most interesting observations
which I have remarked in perusing this treatise. When the
secundines are evacuated before the child, they cause difficult
parturition, and the case is dangerous unless the head present.
Presentations of the hand and foot are directed to be replaced.
When the placenta is retained after the expulsion of the child, the
child is to be laid upon wool, or upon two bladders, filled with water,
either of which is to be pricked, so that the water may run off
gradually, and thus draw down the placenta. When there is a
copious discharge of blood before labor, there is a risk that the child
may be dead, or at least not viable. When women with child long for
coals, the appearance of these things is to be seen on the child’s
head. (For the opinions of the ancients on the effect of imagination
on the fœtus in utero, see the commentary on B. I., § 1, of Paulus
Ægineta, Syd. Soc. edition.) Some ridiculous things are contained in
this work, such as the following; when a man wishes to beget a
male child let his left testicle be tied, and when a female the right.
[255] The composition of suppositories for cleansing the uterus is
described at considerable length towards the end of the treatise.
Altogether, the work is by no means devoid of interest, but, as I
have already said, it is certainly not the composition of Hippocrates.
Littré, on the authority of the passage quoted from Aristotle on this
head, refers the treatise to Leophanes. From the account which we
have given of its contents, it will be remarked that the title and
contents of it do not well accord together. This remark, however,
applies to other of the Hippocratic treatises besides the one we are
now treating of.

XLII. Περὶ γυναικείης—On the Female Nature.

As Foës remarks, this work is mostly made up of excerpts from
the treatise “De Muliebribus.” I need not, therefore, occupy time in
discussing its claims to be regarded as genuine, nor in giving an
outline of its contents.

XLIII. Περὶ καρδίης—On the Heart.

Galen, in one place, appears to cite a passage in this treatise, but
without naming it.[256] It is not found in Erotian’s list, and all the
modern authorities, including even Foës, who is more disposed than
most of the others to deal leniently with the claims of the treatises
which bear the name of Hippocrates, concur in refusing to admit it
as genuine. Still, however, there can be no question as to its being a
work of very high antiquity. It is to be regretted, then, that the text
is in a very unsatisfactory state. It contains, upon the whole, a
wonderfully accurate description of all the parts about the heart—of
its substance, which is said to be a strong muscle; of its pericardium,
which is described as being a smooth tunic, containing a little fluid
resembling urine; of its ventricles (γαστέρες); of its auricles (ὄυατα);
of the origin of the veins from it; of its sigmoid valves; of its office,
to be, as it were, the fountain head, from which all parts of the body
are irrigated, and the seat of the understanding, which is said to be
in the left ventricle. The understanding, it is added, is not nourished
by the blood, but by a pure and luminous (φωτοειδὴς) superfluity
from it. Altogether, this little treatise bespeaks much practical
acquaintance with human anatomy, and, considering the age in
which it was written, must be the production of a very superior
mind. It contains an account of an experiment which has been much
animadverted upon, both by ancient and modern authorities. The
writer says, if a colored fluid be given to an animal, such as a sow,
to drink, and if its throat be cut while it is in the act of swallowing, it
will be found that part of the fluid has passed down by the gullet to
the lungs. See in particular Aulus Gellius (Noctes Atticæ, xvii., 11);
Macrobius (Saturnal. vii., 15); and Plutarch (Sympos. vii., 1.) Aulus
Gellius says decidedly that Plato had adopted this opinion from
Hippocrates. Aulus Gellius and Macrobius also quote Plutarch as
having stated, in his ‘Symposiacon,’ that Hippocrates is the author of
this opinion; but the text of Plutarch (l.c.) is in an unsatisfactory
state. See Schulze (Hist. Med. i., iii., vi., 12.)

XLIV. Περὶ τροφῆς—On Aliment.

It must be admitted that this treatise has very high authorities in
favor of its authenticity, such as Erotian, Galen,[257] Aulus Gellius,
[258] Palladius,[259] Stephanus;[260] and, in modern times,

Mercuriali, Foës, Haller, and Le Clerc.[261] It is rejected by Casper

Hoffman,[262] Gruner, Ackerman, Kühn, Littré, and Greenhill, though,
by the last two, not in decided terms. Considering the respectability
of the external evidence in its favor, I should certainly not have
hesitated in admitting it as genuine, had not a careful examination of
its contents led me to form the unbiassed decision that it must be
the production of some metaphysician, rather than of a medical
practitioner, such as we know Hippocrates to have been. The
physiological dogmata with which it abounds are announced in so
antithetical, not to say paradoxical, a manner, that I can conceive
nothing more foreign to the style and character of the true writings
of Hippocrates. I shall give a few specimens:—“The species of
aliment is one and many; all these (kinds of aliment?) are one
nature and not one. Purging is upwards and downwards, and neither
upwards nor downwards. Purging in aliment is excellent, purging in
aliment is bad. Aliment not aliment, unless it conveys nourishment;
it is aliment in name but not in deed; aliment in deed and no longer
in name only. Sweet and not sweet; sweet potentially, as water,
sweet to the taste, as honey. Things not animals are animated;
animals are animated, the parts of animals are animated. It (the
embryo) is and is not.” Now, I must say, that all this appears to me
to savour more of the taste of Democritus than of Hippocrates
himself. It may be said, indeed, that the very circumstance of
Galen’s having admitted the work as genuine, and having composed
an elaborate commentary on it, is a most presumptive proof of its
authenticity; for where shall we find so excellent a judge of the
doctrines of Hippocrates as his great commentator? But then it must
be taken into account that Galen himself had a great penchant
towards metaphysical subtleties, and this would lead him to believe
that what was in accordance with his own tastes must have been in
accordance with those of his great professional hero. But,
notwithstanding the doubts which hang over the question of its
authorship, it may be confidently affirmed regarding this treatise
that, illustrated as it is by Galen’s commentary (even although it has
come down to us in a mutilated state), few works in the Collection
are more suggestive than the present one. I shall merely give a few
more specimens of it:—“The root of the veins is the liver, and the
root of the arteries is the heart; and from them blood and spirits are
carried to all parts, and heat passes to the same.” This passage is
frequently quoted and commented upon by ancient authors; as by
Galen,[263] and Aretæus.[264] We have seen it stated in the
preceding treatise that the heart is the place from which both veins
and arteries originate. This seems a presumptive proof that these
two treatises must have had a distinct authorship. “The aliment
reaches to the hairs, the nails, and the outer surfaces from within;
and aliment from without passes from the most external to the most
internal parts, there is one conflux and one conspiration (ξύρροια
μία, ξύμπνοια μία). All parts sympathize throughout the whole frame,
but in so far every part has its own peculiar action.” This passage,
also, is very celebrated and frequently quoted.[265] I need scarcely
remark that it embraces a grand and most important view of the
animal economy. “Milk is food to some with whom it agrees, and to
others not. To some wine is food, and to others not; and so with
flesh and many other kinds of aliment. We must look to situation
and habit. Humidity is the vehicle of food. The natures (instincts?) of
all things are untaught. Persons who perspire freely are weak, more
healthy, and have easier recoveries than others. Those who perspire
ill are stronger than others before they become indisposed, but
being indisposed have more difficult recoveries. These remarks apply
to the whole and to the parts.”
From these specimens it will be readily seen that the work
abounds in curious matters, but of a very different stamp from those
which the true Hippocratic treatises contain. Contrary, then, to my
general rule, I certainly feel disposed in the present instance to
reject, upon internal evidence, a treatise which has the most
unexceptionable external evidence in its favor.

XLV. Περὶ σαρκῶν, ἤ ἀρχῶν—On Fleshes, or Principles.

This treatise does not appear in Erotian’s list of the Hippocratic
works, and it is rejected by all the modern authorities, from
Mercuriali downwards. Galen is inconsistent in his notice of it.[266]
Some of the philosophical dogmata which it contains are curious,
such as the following specimen: “It appears to me that what we call
heat is immortal, and that it knows all, sees, hears, and perceives all
things that are and will be.[267] When things, then, were thrown into
confusion the greater part of this passed off to the highest circle,
and this it is which the ancients called ether.” The following extract is
held by Gruner, but probably without any good reason, to evince a
degree of anatomical knowledge in advance of the age of
Hippocrates: “There are two hollow veins from the heart, the one
called the artery, and the other the vena cava. The artery has more
heat than the vein.” The other veins are also described with
considerable accuracy. It is stated that the fœtus in utero sucks in
fluid (liquor amnii?) by its lips, and in proof of this the author
remarks that the child voids fæces soon after delivery, which, it is
argued, must be derived from food. The opinion thus stated has
been often maintained in modern times, but does not appear to be
well founded. The author mentions correctly that persons in
attempting to commit suicide open the trachea, in which case, he
adds, the patient lives, but loses his voice until the opening be
closed. Conringius and Haller, with considerable plausibility, but yet
without any direct proof, attribute this treatise to Democritus.

XLVI. Περὶ ἑβδομάδων—On Hebdomads.

This treatise exists now only in the Latin translation, which M.
Littré has discovered in the Royal (National, it is now called!) Library
in Paris, and will be published in his edition of the works of
Hippocrates. M. Littré gives an elaborate and most interesting
disquisition on it, and seems to make out clearly that it is the
production of the same author as the treatise “On Fleshes,” which
we last noticed. It is cited by Philo Judæus,[268] and several other
writers of antiquity. Galen, however, held it not to be the production
of Hippocrates. A considerable extract from it is contained in the
tract “On Critical Days,” and the eighth section of the Aphorisms,
which has always been looked upon as spurious, is said by M. Littré
to be mostly taken from this treatise.

XLVII. Περὶ ἀδένων—On the Glands.

Erotian makes no mention of this treatise, and Galen pronounces
it to be the work of the recent Hippocratists.[269] M. Littré remarks,
and with great truth, that it is difficult to find out the grounds upon
which the ancient critics have rejected this work. Certain it is that it
contains a goodly store of interesting matters, none of which, as far
as I can discover, are inconsistent with the true doctrines of
Hippocrates. In it a pretty correct description is given of the glands,
including those of the mesentery. The brain itself is said to be of
glandular nature, and also the kidneys. An ingenious account is also
given of the origin of scrofula, which is said to be produced by the
lodgment of humors in the glands of the neck, which get into a state
of slow inflammation. Glands, the author says, are seated mostly in
parts of the body which most abound in humidities, such as the
armpits and groins, and hence such parts produce hairs. In the case
of the mesentery, however, no hairs are produced, because the
humidities here are excessive, and choke up, as it were, the seeds of
the hairs; in like manner as seeds sown in marshy grounds perish. A
very ingenious account is given of the origin of phthisis, which is said
to spring from tubercles in the lungs and matter (pus), which
corrodes the lungs when “the patients do not readily recover.” A
curious description is next given of the tabes dorsalis, “in which
disease the patient does not wish to live.” How expressive this
language is of the state of mind in the case of the unfortunates who
are subject to spermatorrhœa! The treatise concludes with some
striking remarks on the sympathy between the mammæ and uterus,
and on the influence which both exercise on the development of the
female character. Altogether the contents of this treatise are most
valuable, and may suggest important views to the medical
practitioner and physiologist, even at the present day. We need have
no hesitation in pronouncing, with regard to it, that it reflects infinite
credit on the school from which it emanated, and that it is not
unworthy of Hippocrates, although we have reason to believe that
he was not actually the author of it.

XLVIII. Περὶ φλεβῶν—On the Veins.

This is merely an excerpt from the treatise “On the Nature of the
Bones.”

XLIX. Περὶ ἰητροῦ—On the Physician.

I may mention in this place, generally, that the treatises which
follow have no ancient authority in support of them, and that, with
very few exceptions, they are also rejected by all the modern critics.
Their contents, moreover, are not of much practical importance, and
therefore I shall be very brief in my analysis of them.
The treatise in question is held to be genuine by no one critic, as
far as I know, with the exception of Foës, who appears, in part, to
sanction its claims. The object of the author is announced to be in
order to instruct the physician how to conduct matters connected
with the iatrium, that is to say, with his establishment or surgery.
Mercuriali, I may mention, is unjustly severe in his animadversions
on the exordium. (See Conringius, Introd. p. 120.) The physician
should have a healthy look himself, for the writer says, people fancy
that a person who does not keep himself in good health is not
qualified to take charge of the health of others. He should be of a
prudent disposition and a gentleman in morals.[270] Minute
directions are given respecting the site and other circumstances
connected with the iatrium: clean and soft towels are to be at hand,
linen is to be used for the eyes, and sponges for the sores. In
supplying bandages, attention is to be paid to utility rather than to
display. The surgeon should pay great attention to all matters
connected with this operation: for it is attended with much disgrace
when any manual operation does not succeed. Minute directions are
given about the performance of venesection at the arm, and
mention is made of several untoward accidents connected with it,
such as the blowing up of the vein, whereby the flow of blood is
stopped; and suppuration following as a consequence of the
operation. In order to acquire dexterity in the treatment of
accidents, the author recommends the young physician to attach
himself to some foreign army; and from this Gruner infers, that the
work cannot belong to Hippocrates, as domestic wars were but too
common in his time; and there could have been no necessity for the
surgeon’s seeking foreign service in order to gain experience. It does
not occur to me, however, that there is much force in this argument;
for intervals of peace were just as common during the long life of
Hippocrates, as during the interval between his death and the time
when the Collection was made. But, in fact, there is no necessity to
seek recondite reasons for rejecting a treatise which has no proper
authority in support of it.

L. Περὶ εὐσχημοσύνης—On Decorum.

 This work, like the last, has not the slightest claim to be looked
upon as genuine. Moreover, it has come down to us in a very
unsatisfactory state as regards the text, so that the meaning is often
very dark and uncertain; and I must confess that, as a general rule,
I have little inclination to spend much time in searching out a
meaning, in obscure writings, when, after it is discovered, it is not
likely to repay the exertions made in discovering it. I am always
disposed to remember the advice which Galen repeatedly gives to
the student of medicine, “to concern himself more about things than
about words.”[271] The object of the author seems to be to give
general directions with regard to decorum in the physician’s
communication with the sick. It is evidently the production of some
sophist, according to Bernard, of some one belonging to the Stoical
sect. I shall be brief in my abstract of it. A philosophical physician is
equal to a god. In the practice of medicine all the virtues relating to
wisdom are exercised; namely, contempt of money, decency,
modesty, simplicity in dress, character, judgment, quietness,
accessibility, purity of life, sententious maxims, knowledge of the
purifications which are proper and necessary in life, abstinence from
lucre, freedom from superstition, divine excellence. The physician
should keep himself aloof, and not hold much converse with the
common people, unless when necessary. The surgeon should be well
provided with all the means required in the practice of his
profession, such as dressings, medicines, instruments, and so forth,
as any deficiency in these might produce serious results. Minute
directions are given for the regulation of the physician’s address in
entering the chamber of the sick, and his conduct while there.

LI. Παραγγέλιαι—Precepts.
This little tract stands altogether in much the same circumstances
as the preceding one, that is to say, it is wholly destitute of all good
authority in its favor, and the nature of its contents is what might
rather be expected from a sophist than a practical physician. The
text, moreover, is in a most unsatisfactory state. I shall dismiss it
then with a very brief notice. It opens with an advice to the
physician not to trust to speculation but to rational experience. He
ought to learn remedies from all quarters, even from the vulgar, and
not be avaricious in his dealings with the sick, more especially if
strangers and needy. The author alludes, as Schulze thinks, to the
practice then followed by the physicians of migrating from one city
to another, and of making a public declaration of their pretensions at
their first entry into any place. These physicians were called
periodeutæ. The author of this tract advises the physician, in such a
case, not to make any vainglorious or inflated profession of his
abilities. He also enjoins the medical practitioner to look to the
health of those who are free from disease, as well as those who was
indisposed.

LII. Περὶ ἀνατομῆς—On Dissection.

This small fragment of ancient anatomical science has no claim to
be regarded as the work of Hippocrates. Neither Erotian nor Galen,
nor any other ancient critic, holds it as such, and the modern
authorities are unanimous in rejecting it. That it may have been the
composition of Democritus, as suggested by Gruner, seems not
unlikely. It abounds in harsh and obsolete terms, which have never
been satisfactorily explained. Some parts of the anatomical
description are difficult to determine, as for example, “the large
bronchia which extend from the heart to the liver;” “the vena
scalena, which extends from the liver to the kidneys.” The latter
passage, however, may be supposed to refer to the emulgent vein.

LIII. Περὶ ὀδοντοφυίης—On Dentition.

This little tract is destitute of any competent evidence of its
authenticity. Some of the observations contained in it bespeak a
familiar acquaintance with the diseases of infancy. Thus it is said,
that when the bowels are loose at the term of dentition, if the
digestion be good, the children thrive, and are not subject to
convulsions. When children at the breast vomit up their food, the
bowels are constipated. When there is fever accompanying dentition,
children are seldom attacked with convulsions. But when there is
heavy sleep along with dentition, there is danger of convulsions. All
the children that are seized with convulsions at the time of dentition
do not die. Children that take food during dentition bear vomiting
best. Ulcers on the tonsils are attended with danger.

LIV. Περὶ ἐγκατοτὸμης άμβρύου—On Excision of the Fœtus.

No one stands up for the genuineness of this treatise,[272] which,
however, is not wanting in interesting matter relative to the
extraction of the fœtus in cross-presentations. For an abstract of the
practice there recommended, see Paulus Ægineta, Vol. II., p. 389,
Syd. Soc. edition. A circumstantial description is also given of the
process of succussion, the dangerous effects of which, in certain
cases, are related in the Epidemics.

LV. Περὶ ὄψιος—On Vision.

This little fragment is admitted by all the authorities to be
spurious. It contains a description of glaucoma, for which purging of
the head and the application of the actual cautery are
recommended, and also in certain cases venesection. In epidemic
ophthalmy, purging both of the head and bowels is recommended.

LVI. Περὶ ὀστέων φύσιος—On the Nature of the Bones.

M. Littré has very ingeniously shown that this work is a
compilation made up of fragments of other works, and thus he has
announced his intention of excluding it altogether from the
Hippocratic Collection. Certain it is, beyond all dispute, that the
treatise is not the production of Hippocrates himself. The following
are a few of the most notable things which I have observed in it. “It
appears to me that what we call heat is immortal, and that it
understands, sees, hears, and perceives all things that are and will
be.” The heat, it is further said, is the origin of all movement in
animals. This will be recognized as the original of the doctrine of the
Calidum innatum, which figures in the works of our earlier
physiologists in modern times. See the works of Harvey and the
other physiologists of the seventeenth century; also what is said on
this subject in the next section. The aorta and vena cava are
correctly described, the one as an artery, the other as a vein; and
their origin from the ventricles of the heart is noticed. The author
states (p. 440, ed. Kühn), that he had known cases of attempted
suicide in which the windpipe had been opened, and yet death did
not ensue; only while the opening remained the person lost the
power of speaking. See No. XLV.

LVII. Περὶ κρισίων—On the Crises.

This tract has no ancient authority whatever in support of it, and
Foës, Gruner, and Littré concur in holding it to be a compilation from
other Hippocratic treatises, more especially the Aphorisms and
Prognostics. This, indeed, must be obvious to every person who
reads it with any attention.

LVIII. Περὶ κρισίμων—On Critical Days.

This treatise stands in the same predicament as the preceding
one, that is to say, it has no ancient authority in support of it; indeed
Galen declares against it when he says that Hippocrates had not
given any work on the Critical Days. (Tom. iii., p. 440; ed. Basil.) It is
manifestly a compilation from the other treatises, more especially
from those “On Internal Diseases” and “On Diseases.” Still it appears
to me to be an interesting and well-written compilation. For
example, it would be difficult to point out in any other work, ancient
or modern, a better description of pneumonia than is given towards
the conclusion of it. Tetanus also is accurately described. To be sure,
Gruner infers, from the circumstance that three varieties of this
disease are described, that the work in question must have
emanated from the Cnidian school. But Aretæus, and, indeed, all the
ancient authorities that treat of tetanus, describe three varieties of
this disease; and therefore this is no good reason for excluding it
from the Coan school.

LIX. Περὶ φαρμάκων—On Purgative Medicines.

Though it must be admitted that this little fragment can boast of
no competent authorities to establish its claim to be placed among
the genuine works of Hippocrates, it bears undoubted marks of
having been written by some person well acquainted with his
principles, and having no ordinary acquaintance with professional
matters. Thus the author states very correctly the effects of
idiosyncrasy in modifying the operation both of purgatives and
emetics, and advises the physician to make inquiry beforehand what
effects such medicines, if formerly taken, had produced on the
patient; for, he adds, it would be a disgraceful casualty to occasion a
man’s death by the administration of a purgative medicine. He also
interdicts the administration of purgatives during the heat of a fever,
and during the very hot seasons of the year. These practical rules
appear to me to be highly important, and yet how frequently do we
see them disregarded! At the time we have mentioned, the author
prudently remarks that it is safer to administer a clyster.

LX. Περὶ ἑλλεβορισμοῦ—On the Administration of Hellebore.

This little tract is usually published among the Epistolæ, and, as a
matter of course, it has no evidence in support of its genuineness
further than they have, which, as we shall presently see, is very
slender. It contains, however, very acute and important observations
on the administration of hellebore, to which it is well known that the
Hippocratists were very partial. But these are mostly extracted from
the Aphorisms, and need not be noticed in this place. The Book of
Prognostics also is quoted, but seemingly by mistake.

LXI. Ἐπιστολαι—The Epistles.

 No scholar can require to be informed that, since the memorable
controversy in this country between the Honorable C. Boyle and the
celebrated Dr. Bentley, respecting the authenticity of the Epistles
which bear the name of Phalaris, the whole of the “Epistolæ
Græcanicæ” have been generally condemned as spurious. Against
this judgment I have no intention to protest; but I may be allowed
to remark that many ancient works which are usually acknowledged
as genuine have not so much external evidence in their favor as
these Epistles possess. The Epistles ascribed to Plato, for example,
are quoted as genuine by Cicero,[273] and by Diogenes Laertius.[274]
Those of Hippocrates, too, are quoted and recognized by Erotian,
Soranus, and other ancient authorities. Still, however, as I have
stated, I have no intention to stand up against the general opinion of
scholars from the Scaligers down to the present time, by which they
have been condemned as supposititious; only I contend that, as it is
admitted on all hands that they are very ancient,[275] that is to say,
that they must have been composed within less than a hundred
years after the death of Hippocrates, it is utterly incredible that the
Sophists who wrote them, whether for a fraudulent purpose that
they might derive profit from them by passing them off for the
productions of the great name they bear, or whether for the purpose
of displaying their own skill in sustaining an assumed character,
should have made them turn upon alleged occurrences in the life of
Hippocrates which every person at that early period must have been
able to judge whether they were fictitious or not. I see no reason,
then, to doubt that the main facts to which these Epistles relate are
real, although the Epistles themselves be supposititious.[276]

Having thus stated my opinion of these Epistles in general terms,

I shall now dismiss them with a very brief notice.
They are differently arranged by modern authorities; I shall
follow M. Littré in the few remarks which I have to offer upon them.
 The first series of these Epistles relates to the services which
Hippocrates is said to have rendered to the people of Athens during
the time of the memorable plague. The spuriousness of these, it is
generally held, is proved beyond all doubt by the silence of
Thucydides with regard to any such professional services rendered
by Hippocrates on the occasion; and no doubt if it were maintained
that these took place at the outbreak of the disease in Greece, that
is to say, at the commencement of the Peloponnesian war, the
inference would be most legitimate. But if we be permitted to
suppose that, as the plague is known to have lurked about in
different parts of Greece for a considerable time, the services of
Hippocrates did not take place until several years afterwards, there
is nothing in the story which bears the slightest air of falsehood,
even if we adhere to the common chronology respecting the birth of
our author. Indeed, I repeat, if the Sophist who composed these
letters had founded them on tales which everybody knew to be
false, he could never have hoped to impose upon the learned men of
the next generation, and make his forgeries pass for genuine.
The second series relates to Democritus, and these must be
admitted to be the most interesting of the whole group. Now that
Hippocrates visited Abdera, and that he was familiarly acquainted
with Democritus, are facts which the most sceptical critic will hardly
venture to call in question.[277] But that the Epistles themselves
were not written by the physician and philosopher whose name they
bear, I readily admit to be probable. Most undoubtedly the letter of
Hippocrates, in which he is made to describe his visit to Democritus,
however full it may be of curious matters, is written in a style and
manner very unlike the well-known characters of the true writings of
Hippocrates.
Third. The short letter inscribed from Hippocrates to his son
Thessalus, contains nothing from which its authenticity or the
contrary could be legitimately inferred, only it is destitute of all
ancient authority in its favor. In it the father recommends to the son
the study of geometry and arithmetic, as a proper preparation to the
study of medicine.
Fourth. This series, consisting of “The Oration at the Altar,” “The
Decree of the Athenians,” and “The Oration of Thessalus, son of
Hippocrates,” although now generally regarded as spurious, possess
more direct evidence in their favor than any of the others. In fact,
they are decidedly recognized as genuine by Erotian. The documents
in question have all reference to the services of Hippocrates and his
disciples in the pestilence which pervaded Greece during the
Peloponnesian war. These services are alluded to by many ancient
authorities, as we have shown in the Commentary on Paulus Ægineta,
Book II., § 35. In conclusion, I repeat that, supported as the main
facts referred to in these documents are by the highest testimony
which antiquity can furnish, I cannot but regard the facts as true,
although the documents themselves be given up as supposititious.

I will now briefly recapitulate the general results of the

investigations on which I have been occupied in the present section:
1. That all the authorities, ancient and modern, who have
investigated the question regarding the genuineness of the works
which have come down to us under the name of Hippocrates, are
agreed that a considerable portion of them are not the productions
of the author himself.
2. That it is almost universally admitted that the following
treatises are genuine, viz.:
 The Prognostics.
On Airs, etc.
On Regimen in Acute Diseases.
Seven of the Books of Aphorisms.
Epidemics I. and III.
On the Articulations.
On Fractures.
On the Instruments of Reduction.
The Oath.

3. That the following treatises may be pretty confidently

acknowledged as genuine, although the evidence in their favor is not
so strong as it is with regard to the preceding list:—
On Ancient Medicine.
On the Surgery.
The Law.
On Ulcers.
On Fistulæ.
On Hemorrhoids.
On the Sacred Disease.

4. That as it certainly appears that the Book of Prognostics is

composed, in a great measure, from the contents of the First
“Prorrhetics” and the “Coacæ Prænotiones,” there can be little or no
doubt that these two treatises are more ancient than the time of
Hippocrates.
5. That although the exact time at which the Collection, as it now
stands, was made out has never been determined in a very
satisfactory manner, an examination of the contents of the different
treatises leads to the conclusion that most of them represent pretty
faithfully the opinions held by the family of Hippocrates and his
immediate successors in the Coan school of medicine.
6. That a few of them, and more especially the two important
works “On Internal Affections,” and “On Diseases,” would appear to
bear distinct traces of having emanated from the contemporary
school of Cnidos.
7. That although the Epistles and certain public documents
usually published at the end of the Collection may justly be
suspected of being spurious, there is undoubted evidence that they
are of very ancient date, and were composed, most probably, within
less than a hundred years after the death of Hippocrates, so that
there is every reason for believing that they relate to real events in
the life of our author, and not to fictitious as some have supposed.
 SECTION III.

ON THE PHYSICAL PHILOSOPHY OF THE ANCIENTS, AND MORE ESPECIALLY THEIR

DOCTRINES WITH REGARD TO THE ELEMENTS.

As it is impossible to understand properly the medical theories

which occur in the Hippocratic treatises without a competent
acquaintance with the Physical Philosophy of the ancients, I have
thought it necessary to devote an entire chapter to an exposition of
the tenets held by the philosophers regarding the elements of
things. I might have been able to dispense with this labor provided
there had been any modern publication to which I could refer the
reader for the necessary information on the subject in question; but,
unfortunately, there is no work in the English language, as far as I
am aware, in which the nature of the ancient doctrines is properly
described. To give an example in point: Dr. Watson, the bishop of
Llandaff, in his essay “On the Transmutability of Water into Earth,”
makes the following remarks on the ancient doctrine concerning the
elements: “If but one particle of water can, by any means, be
changed into a particle of earth, the whole doctrine of the Peripatetic
sect concerning the elements of things will be utterly subverted: the
diversities of bodies subsisting in the universe will no longer be
attributed to the different combinations of earth, air, fire, and water,
as distinct, immutable principles, but to the different magnitudes,
figures, and arrangements of particles of matter of the same
kind.”[278]
Now it will at once be perceived by any person who is at all
acquainted with modern science, that if the ancient dogmata be as
here represented, they are altogether destitute of any solid
foundation in truth and nature, and we may well wonder that such a
baseless structure should have endured for so long a period. But
before passing this severe judgment on the tenets of our great
forefathers in philosophy, it will be well to investigate their doctrines
more accurately than Dr. Watson appears to have done in this
instance.
 In pursuing the present investigation, I shall, in the first place,
give literal translations of extracts from the works of the most
celebrated sects of philosophers; namely, the Pythagoreans,
Platonists, Peripatetics, Stoics, and Epicureans. It will, of course, be
readily perceived, from what I have now stated, that I do not mean
to confine my inquiry to the period of ancient philosophy which
preceded Hippocrates, but that I am to bring it down to a pretty late
age. This course I find it indispensably necessary to follow, as I
could not derive sufficient illustration of the subject were I to restrict
myself to the works of the earlier philosophers, who either preceded
our author or were his contemporaries. I shall first give the extracts
by themselves, and then make some remarks in illustration of the
doctrines which they expound. I think it proper to mention further,
that I am answerable for the correctness of the translations in all
cases, unless where it is otherwise stated.
THE PYTHAGOREANS.

“Fire being compressed produces air, and air water, and water
earth: and from earth the same circuit of changes takes place till we
come to fire.”[279]
“In that part of the universe where Nature and Generation exert
their powers, it is necessary that there should be these three things:
In the first place, that thing which being tangible furnishes a body to
everything which comes into existence. This is the universal recipient
and substance of impression for things generated, bearing the same
relation to things which are generated from them that water does to
juice, and silence to sound, and darkness to light, and materials to
the things fabricated from them. For water is void of taste and
quality, bearing the same relation to sweet and bitter, and to sharp
and salt. The air is unformed as to sound, or speech, or melody. And
darkness is devoid of color and shape, and bears the same relation
towards bright, and yellow, and white. But white bears reference
also both to the statuary art and that which forms figures of wax.
But matter admits of another comparison with the art of statuary.