Cnidian school is the mode of treating pneumonia here laid down, which
certainly in so far agrees with what Galen says of Cnidian practice
in such cases, namely, that those authorities omitted bleeding and
purging. See Opera, tom. v., p. 87.
[198] See under Ἱππωκράτης. The meaning of the passage, however, is
somewhat doubtful.
[199] Comment, in Lib. Vict. Acut., i., p. 43; ed. Basil.
[200] Zuinger, however, stands up for its genuineness. Hippocratis
Vigenti duo Comment., etc., p. 386. He gives a most elaborate analysis
of it.
[201] These dreamy views of human life look very much like an
anticipation of the Fourierism of the present day. So true is the
hackneyed saying, “there is nothing new under the sun!”
[202] Hist. de la Méd., i., iii., 13.
[203] Hippocrates, in his treatise ‘On Diet in Acute Diseases,’ says
decidedly that the ancients--that is to say, his predecessors--had
written nothing of any value on the subject of Dietetics (§ 1). From
this we may infer that the present work was not known in his days; for
it can scarcely be supposed that he would have spoken so disparagingly
of it.
[204] Galen quotes it as a portion of the work on Diet. See Opera, tom.
v., p. 377; ed. Basil.
[205] This idea is well explained and enlarged upon by Alexander
Aphrodisiensis.--Probl. i., 118. This writer must not be confounded
with the commentator on Aristotle.
[206] Zuinger points out a striking mark of the connection between it
and the work ‘On Diet:’ op. sup. laud. p. 549.
[207] Amstel., 1658.
[208] Oneirocritica, etc. Lutetiæ, 1603.
[209] Σκιᾱς ὄναρ ἄνθρωποι. Pind. Pyth., viii.
[210] Comment. in Libr. de Diæt. Acut., i.
[211] Tom. v., pp. 306, 614, etc.; ed. Basil.
[212] See the Syd. Soc. edition of PAULUS ÆGINETA, Vol. I., p.
264.
[213] Galen, by the way, mentions that Euryphon, the celebrated Cnidian
physician in the days of Hippocrates, was in the practice of treating
empyema with the actual cautery.--Comment. in Aphor., vii., 44. This
is a strong confirmation of the opinion that this treatise must have
emanated from the Cnidian school.
[214] See the Syd. Soc. edition of PAULUS ÆGINETA, Vol. I., p.
354.
[215] I presume it was the rib itself that was perforated, and not
the intercostal space. The term τρύπανον was generally applied to the
trepan. The epithet τρυγλητήριον, or, as Foës proposes to read it,
τρωλοδυτήριων, is probably derived from τρώγλη, a hole, and δύω, to
penetrate; joined together, they would signify a trepan for boring
holes.
[216] Morb. Acut., iii., 17.
[217] De Humor., Comment. in VI. Epidem.
[218] Opera, tom. v., p. 456; ed. Basil.
[219] The silphium, indeed, is mentioned among the remedies for this
case in the treatise “On Regimen in Acute Diseases” (7), but not the
other articles.
[220] Ad Epidem., vi., 6, 27.
[221] Hippocrat. Opera, i., p. 318.
[222] The opinions on this subject are given very fully by Aulus
Gellius. Noctes Atticæ, iii., 10.
[223] I should mention that Zuinger pronounces, without the slightest
hesitation, in favor of their genuineness: op. sup. laud. pp. 188, 199.
[224] De Difficult. Respir., ii., 8; ibid., iii., 1.
[225] Comm. Epid., vi., 2, 15.
[226] Opera, tom. v., p. 24; ed. Basil.
[227] See series of papers in illustration of it, published in the
Medical Gazette for the year 1847, by Dr. Wardel. On one point I
cannot agree with this writer; he says, the fever was of a continued
character, whereas in all the cases which I met with it was decidedly
remittent.
[228] VIII., 4.
[229] Institut., Orat. iii.
[230] De Perfect. in Virt.
[231] § 27.
[232] It cannot but appear singular that so distinguished a person as
Robert Boyle should have found fault with Hippocrates for relating
so many cases of which the issue was fatal. He says, “Revera penes
me non parum Hippocratis auctoritate decedit, quod in scriptis suis
tot ægrotorum epiphonema _ipsos mortuos esse_ legerem.”--Exer.
v., de Utilitate Philosoph. Exper., p. 192. On the other hand, Mart.
Lister justly defends Hippocrates: “A me sane absit illa quorundam
nuperorum scriptorum jactantia, qui nihil exhibent, nisi quod bonum
eventum habuit; errores et infortunia caute abscondunt, aliter autem
nobis profuit magnus Hippocrates, apud quem fere non nisi casus funesti
occurrunt, ac si iidem potioris doctrinæ essent.”--Exercit. de Hydrope.
[233] Acut. Morb., iii., 17.
[234] Perspiratio dicta Hippocrati.
[235] By Nature, the ancient philosophers understood an immaterial
principle diffused through all the works of creation, that is to say,
an internal principle of motion and of rest, which presides over
the growth and nourishment of all substances. It is well defined by
Aristotle in different parts of his works. See De Anima, ii., 4; and
Auscultationes Naturales, pluries. That truly learned and ingenious
author Bishop Berkeley, in his “Siris,” describes nature as being mind
so fuddled with matter as to have lost its consciousness. Probably, the
distinction between a material and immaterial principle as the cause
of the vital phenomena was not so well understood until after Plato
and Aristotle had cultivated mental philosophy with so great success;
for, as we shall see in the next section, Hippocrates seems to identify
mind with heat, that is to say, he confounds the cause of motion and of
change with its first instrument, _or_ co-cause (συνάιτιον).
[236] See the references given by Gruner, Ackerman, and Littré.
[237] See Musonius, Ap. Stobæi Sentent., xviii. It occurs frequently in
Galen.
[238] Des Maladies de la France dans leurs Rapports avec les Saisons,
p. 193. Paris, 1840.
[239] Natural. Facult., ii., 8; de Placit. Plat. et Hippocrat., viii.,
5.
[240] Opera, tom. v., pp. 257, 479; ed. Basil.
[241] Deipnos, ii., 46.
[242] Zuinger considers it in the light of extracts from the Note-book
of Hippocrates (or Hippocratea Adversaria).
[243] Ad Aphor. v., 37.
[244] De Fœtus fabricat.
[245] Comment. in Libr. de Fract. ap. Foës, p. 147.
[246] Somnium Scipionis, i., 6.
[247] Vol. i., p. 386; ed. Kühn.
[248] Even Zuinger admits that, both in style and matter, these
treatises are unlike the genuine works of Hippocrates.
[249] Vol. i., p. 371; ed. Kühn.
[250] Ibid., p. 387.
[251] Ibid., p. 420.
[252] In Gloss. in voce ἄλφιτα, etc.
[253] See Foës, Œconom. Hippocrat. in voce κιών.
[254] Bibl. Græc., ii., 24, p. 801.
[255] Aristotle refers this opinion to Leophanes, De Generatione
Animalium, v., 1.
[256] De Placit. Hippocrat. et Plat., ix.
[257] Comment., tom. xv., p. 224; ed. Kühn.
[258] Noct. Attic., iii., 16.
[259] Ap. Foës; ed. Hippocrat.
[260] Comment. in Galen; ed. Dietz.
[261] Hist. Med., P. i., iii., 2, 257.
[262] In Boerhaav. Meth. Stud. Med., i., 3, p. 594.
[263] De Placit. Hippocrat. et Platon.
[264] De Acut., i., 7; de Chron., i., 13.
[265] See Galen, de Facult. Natural., i.; de Diff. Febr., ii.; de Usu
Pulsuum, i.; and Alexander Trallian, i.
[266] In Epidem. Comm., iii., 29, etc.
[267] See the remarks on this passage in the next section.
[268] De Cosmopœa.
[269] Opera, tom. v., p. 594; ed. Basil.
[270] Καλὸν καὶ αγαθὸν. See the Annotations on Mitchell’s Aristophanes
as to the import of this expression. I quote from memory.
[271] I quote here from memory, not having leisure to search the
passages in Galen’s works where this saying occurs. It is a maxim,
however, which he frequently repeats.
[272] One word (ἰχθύη) which occurs in this work is in the Glossaries
of Galen and Erotian. This is likely to be an interpolation.
[273] Tuscul. Disputat., v., 35.
[274] In vita Platonis.
[275] I have always looked upon the “Epistolæ Græcanicæ” as being a
species of literary composition allied to the _Declamationes_
of the Romans, that is to say, that they were mere exercises in
composition. On the latter, see Quintilian, Instit. Orator., iv.,
2. We possess a volume of these Declamations under the name of
Quintilian, but they are not generally admitted to be genuine. They
are exercises on themes prescribed in the schools of rhetoric. The
subjects were sometimes historical events, connected with the lives of
distinguished personages. The poet Juvenal alludes to Declamations in
several places, as in Satir. i., 16; x., 167; vi., 169; vii., 161. The
Satyricon of Petronius Arbiter opens with a powerful invective against
the declaimers of the day, whom the author holds to have been the
corrupters of all true eloquence.
[276] Scaliger, Menage, Gruner, and Littré, although they regard the
Epistles as spurious, admit that they are “very ancient.”
[277] See Diog. Lært. ix. Ælian. Var. Hist. iv., 20.
[278] Chemical Essays, vol. iv., Essay 7.
[279] Ocellus Lucanus, On the Universe.
[280] Αόγοι γὰρ ἀσώματοι τυγχάνουσι τούτων.
[281] Ocellus Lucanus, On the Universe.
[282] Ibid.
[283] Timæus Locrus, On the Soul of the Universe.
[284] Diogenes Laertius, Life of Pythagoras. That Monad and Duad, in
the symbolical language of Pythagoras, signified Mind and Matter, is
positively stated by Philo Judæus. Ἑπόμενος δ' ἀκολουθίᾳ ύσεως κἀκεῖνο
λέξω ὅτι μουὰς εἴκων αἰτίου πρώτου, δυὰς δε παθητῆς καὶ διαιρετῆς
ὕλης.--De Specialibus Legibus. It may be proper to mention here that it
is not true, as has been often stated in modern works, that Pythagoras
himself taught the same system of the world as Copernicus; the first
person who did so was Philolaus the Pythagorean philosopher. See
Diogenes Laertius.
[285] Jamblichus, Life of Pythagoras, § 27. I have adopted the
emendation of the text proposed by Obrechtus.
[286] Ovid’s Metamorph., translated by Dryden, Book XV.
[287] Plato, in his Timæus.
[288] Ἐκμαγεῖον. Harris, in his Philosophical Arrangements, translates
this word by “impression”; but it does not, strictly speaking, signify
impression, but the substance which receives the impression. Wax, for
example, is not the impression of the seal, but the substance which
receives the impression. Matter, in like manner, is not the impression
of forms, but the substance which receives the impression.
[289] Plato, in his Timæus.
[290] Ibid. These opinions regarding the elements and the first matter
are expressed with much precision and clearness; but, in other parts of
his Timæus, it must be admitted that he betrays some confusion of ideas
on this subject, as is remarked by his illustrious pupil Aristotle (De
Ortu et Interitu, ii., 1). A translation of part of Plato’s Timæus
regarding the elements, may be seen in the Somnium Scipionis of
Macrobius, lib. i.
[291] Apuleius the Platonic Philosopher, On Natural Philosophy.
[292] Idem, On the Universe.
[293] Cicero, On the Nature of the Gods, ii., 33.
[294] Plotinus, Ennead ii., 4.
[295] Plotinus, Ennead ii., 6.
[296] Proclus, Inst. Theol., 72.
[297] Plutarch, On the Opinions of the Philosophers.
[298] Galen, On the Elements, etc., ii.
[299] Galen, Commentary on the Nature of Man.
[300] Idem, On the Elements, etc.
[301] Philo, on the Creation of the World.
[302] On the Indestructibility of the Universe.
[303] On the Creation.
[304] On a Contemplative Life.
[305] Haly Abbas, Theor., i., 5.
[306] Auscult. Natur., i., near the end.
[307] Categor.
[308] On Birth and Death, ii., 1.
[309] Auscult. Phys., iv.
[310] Simplicius, Comment. in Auscult. Nat., iv.
[311] Ammonius, Comment. in Porphyr. Introd.
[312] Ibid.
[313] Theophrastus, On Fire.
[314] Ibid.
[315] Cicero, Quæd. Acad., i., 6.
[316] Cicero, Quæd. Acad., i., 7.
[317] Diogenes Laertius, in the Life of Zeno the Stoic. The reader must
take care not to confound him with Zeno the Eclectic.
[318] Seneca, Ep. 65.
[319] Seneca, Nat. Quæst., ii., 15.
[320] Seneca, Nat. Quæst., iii., 10.
[321] Lactantius, Div. Inst., iii., 3.
[322] See under ἀρχαι.
[323] Plutarch, Concerning the Opinions of the Philosophers.
[324] Simplicius, Comm. in Aristot. Auscult. Nat., p. 7; ed. Ald.
[325] Marcus Antoninus, iv., 46.
[326] Ibid.
[327] Ibid.
[328] Manilius, Astron., iii., 53:--
“Principium rerum et custos natures latentûm
Cum tantas strueret moles per inania mundi:
* * * * *
Aëraque et terras flammamque undamque natantem
Mutua in alternum præbere alimenta juberet.”
[329] Lucretius, Of the Nature of Things, Book i., translated by Creech.
[330] Cicero, Acad. Quæst., i., 2; Galen, de Elementis.
[331] Diogenes Laertius, Life of Democritus.
[332] Ἡ ὔλη ἄποιος. Galen, de Element. ex Hippocrat.
[333] The eternity of matter is a doctrine which was maintained by all
the ancient philosophers and by several of the Christian fathers of
the church, but is generally rejected by our modern divines as being,
in their opinion, contradictory to Revelation. But were it really
so, it would hardly have found an advocate in the learned and pious
author of “Paradise Lost.” That such was truly his opinion can now
admit of no doubt, from what he states on the subject in his treatise
on Christianity, published some years ago by the present Archbishop
of Canterbury; and the same might have been inferred from more than
one passage in his great poem. The Jewish philosopher, Philo, seems to
admit the eternity of matter, although he denies the eternity of the
world. (On the Creation.)
[334] “There are varieties,” says Strabo, “of the watery element; for
this kind is saltish, and that sweet, and fit for drink; and others
again poisonous, salutary, deadly, cold, and hot.”--Geograph., xvii.,
1. See also Aristot., Meteorol.
[335] Aristotle inquires whether the atmosphere be a single substance
or many, and if many, of how many it consists. (Meteorol., i., 3.) I
may be allowed to remark in this place, that Galen’s ideas regarding
respiration are wonderfully accurate, and not very different from
those now entertained by the profession. Thus he compares the process
of respiration to combustion, and says it produces the same change
upon atmospheric air. He further agrees with modern physiologists in
considering it as the vital operation by which the innate (or animal)
heat is preserved. (De Respiratione.) Compare this treatise with Baron
Cuvier’s admirable section on Respiration and observe on how many
points these two great physiologists agree. (Leçons d’Anatom. Compar.,
26.)
[336] Timæus.
[337] De Igne.
[338] De Partibus Animalium, ii., 2. His great commentator, Averrhoes
the Arabian, states this distinction very correctly. See Cantic.
Avicennæ, tr. v.
[339] Lucan’s Pharsalia, i., 157, 606.
[340] De Carnibus. (See the preceding section.) In like manner
Phornutus says, “our souls are fire.” (De Nature Deorum, ap. Gale’s
Opuscula Mythologica, p. 142.) Such is also said to have been the
doctrine of Hippocrates and Democritus. See Macrobius (Somnium
Scipionis, i., 14); and Nemesius (de Nat. Hominis). In the Hippocratic
treatise De Septimadibus, which M. Littré has discovered in Latin, the
essence of the soul is held to be heat. (Ed. Littré, i., p. 391.)
[341] De Partibus Animalium, ii., 7.
[342] De Anima, ii., 4.
[343] Ὄτι πᾶν ἐκ πάντος γινέσθαι πέφυκε.--Aristot. de Ortu et Interitu.
et Auscultationes Naturales, i.
[344] See Simon’s Chemistry, vol. i., p. 118, and the authorities there
referred to.
[345] Baron Cuvier says: “En un mot, toutes les fonctions animales
paroissent en reduire à des transformations de fluides; et c’est dans
la manière dont ces transformations s’opérent, que gît le véritable
secret de cette admirable économie.”--Leçons d’Anatom. Comp. lib. i.
[346] It will be readily understood that allusion is here made to the
diseases ossification and osteosarcoma.
[347] The same application of this myth is made by Eustatheus, the
commentator on Homer (ad Odyss., iv., 417), and by Heraclides Ponticus
(Gale’s Opuscula Mytholog., p. 490). The words of Heraclides are very
striking: “That hence it was with good reason that the formless matter
was called Proteus; and that Providence which modified each being with
its peculiar form and character was called Eidothia.”
[348] De Sapient. Vet., cap. xiii.
[349] Op. cit., iv.
[350] These opinions of Newton bear a strong resemblance to those of
Strabo, as expressed in the following passage: “Since all things are in
motion and undergoing great changes, it is to be supposed that neither
does the earth always remain the same, so as neither to be augmented
nor diminished; nor yet water; nor that either always possesses the
same seat, for that a change of one thing into another seems very much
according to nature. For that much earth is converted into water, and
much water into earth.”--Geograph., xvii., 1.
[351] See p. 120, Ray Society’s edition.
[352] See Simon’s Chemistry, vol. i., p. 5; Sydenham Society’s edition.
The etymology of the term _protein_ is there given from πρωτέυω,
_I am first_; but it may more properly be derived from Proteus, to
which, as we have mentioned above, the first matter was likened.
[353] Lucretius, de R. N., i., 48.
[354] I have always looked upon the story of the Sirens as being one
of the most beautiful fictions in the Homeric poems. By the two Sirens
I cannot but think that the poet meant to represent Philosophy and
Melody, these being, as it were, the handmaids of Poetry. They assail
the virtue of Ulysses with no vulgar temptations, by assuring him that
they were well acquainted with all the martial exploits in which he had
been engaged, and that he would leave them “much delighted, and with an
increase of knowledge.”
Ἀλλ’ ὄγε τερψάμενος νεἰται καὶ πλέιονα ἐιδώς.
Odyss, xii., 188.
[355] Diogenes Laertius, in fact, states that Xenophanes, the founder
of the school, held the doctrine of the four elements. On the Eleatic
philosophy, see further, Aristotle (de Xenophane; and Metaphys.,
i., 5); and, of the modern authorities Ritter (History of Ancient
Philosophy, vol. i.,) and Grote (Hist. of Greece, tom. iv., p. 518,
etc.) Whether or not these modern authors, however, have rightly
apprehended the doctrine of Xenophanes and Anaximander with regard to
the elements, may, I think, be justly doubted. Dr. Thirlwall gives
a very judicious exposition of the ethical opinions of the Eleatic
philosophers, but does not touch on their physical. (Hist. of Greece, §
12.)
[356] M. Littré is inclined to give the Pythagorean philosopher,
Alcmæon, the credit of priority in broaching the philosophical theory
which runs through this treatise. His only authority, however, on this
point is Plutarch (De Placit. Philos., v., 30); whereas Galen, as he
admits, says expressly that Hippocrates himself is the author of this
theory. Now, I must say that, of the two, Galen appears to me to be
the better authority, being profoundly skilled both in medical and
philosophical literature. But further, neither Diogenes Laertius in his
life, nor any other writer who has noticed Alcmæon, says anything of
his having promulgated the theory of the Crasis.
[357] Tom. i., p. 567.
[358] See Note, p. 191.
[359] The invention of bread must have been very ancient, as is obvious
from the circumstance of its being referred to a mythological name,
that is to say, Demeter _or_ Ceres. The ancients would appear to
have paid great attention to the manufacture of bread. See Athenæus
Deipnos, iii., 26; and PAULUS ÆGINETA, B. I., 78, Syd. Soc.
edition.
[360] The maza was a sort of pudding _or_ cake made from
barley-meal mixed up with water, oil, milk, oxymel, hydromel, or the
like. It also was a very ancient invention, for it is mentioned in one
of the works of Hesiod, which is universally allowed to be genuine, I
mean the Opera et Dies, 1., 588.
[361] We have stated in our brief sketch of the Life of Hippocrates,
that he studied the application of gymnastics to medicine under the
great master of the art, Herodicus. He was a native of Selymbra in
Thrace, and is generally represented as the father of medicinal
gymnastics; but, as we have mentioned above, this statement must be
received with considerable allowance, since there is every reason to
believe that the Asclepiadæ applied exercises to the cure of diseases.
[362] He means both the pilot and physician.
[363] Καθαρὸς ἄρτος ἢ συγκομιστός. There has been some difference
of opinion regarding these two kinds of bread; but it appears to me
probable that the former was made of flour from which the bran had been
entirely excluded, and the other from flour containing the whole of the
bran. Later authorities called the one _siligo_, and the other
_autopyrus_. See PAULUS ÆGINETA, Vol. I., p. 121.
[364] He alludes here to the secretions and humors in the body. See the
Commentary of Heurnius.
[365] See Littré, h. 1.
[366] Meaning probably the diaphragm, with its membranes. See the
Commentary of Heurnius, p. 92.
[367] Meaning the mammæ, according to Heurnius.
[368] Such as the spleen and lungs.
[369] Although I shall touch cursorily on this subject in my
annotations, I cannot deny myself the pleasure of setting down here the
following passage from the treatise of Longinus “On the Sublime.” It is
to be borne in mind that it was written by a noble-minded Greek, who
lived at the court of an Oriental despot, and must have been a daily
observer of the effects which he so feelingly depicts. Who does not
lament to think of a generous mind placed under circumstances where
cowardice is honored and courage debased? And what more melancholy
picture of human misery can be imagined than that which is here
exhibited of the bodily and mental powers in a state of arrested
development from the effects of confinement?
Ἥμισυ γάρ τ' ἀρετῆς (κατὰ τὸν Ὅμηρον) ἀποαίνυται δύλιον ἦμαρ· ὥσπερ οὖν
(εἴγε γησὶ, τοῦτο πιστόν ἐστι) ἀκούω τὰ γλωττόκομα, ἐν οἱς οἱ Πυγμαῖοι
καλούμενοι νάνοι τρέφονται, οὐ μόνον κωγύει τῶν εγκεκλεισμένων τὰς
αὐξήσεις, ἀλλὰ καὶ συνάγει διὰ τὸν περικείμενον τοῖς σώμασι δεσμόν· οὒ
τως ἅπασαν δουλείαν, καὶ ἦ δικαιοτάτη, ψυχῆς γλωττόκομον, καὶ κοιόν δή
τις ἀποφήναιτο δεσωπτήριον.--§ 39.
[370] M. Littré thus states the four principal points to which
Hippocrates here directs attention:
“1st. Il cherche quelle est, sur le maintein de la santé et la
production des maladies, l’influence de l’exposition des villes par
rapport au soleil et aux vents.
“2d. Il examine quelles sont les propriétés des eaux, bonnes ou
mauvaises.
“3d. Il s’efforce de signaler les maladies qui prédominent suivant les
saisons, et suivant les alternatives que chacune d’elles épreuve.
“4th. Enfin, il compare l’Europe et l’Asie, et it rattache les
différences physiques et morales qui en séparent les habitants, aux
différences du sol et du climat.”
He goes on, however, to state, that these four questions, although
neatly put, are merely sketched, and half insinuates that it is a
defect in the work, that it merely contains our author’s assertions,
without the corresponding proofs. In a modern work, he remarks, the
mode of procedure would be different; for it would be expected that the
general truths should be supported by detailed and prolonged statistics
on particular facts. It is to be borne in mind, however, that the work
of Hippocrates was probably meant merely as a text-book, on which were
grounded his public prelections, wherein would, no doubt, be given all
the necessary proofs and illustrations. In this respect, it resembles
the esoteric works of Aristotle, of which the author of them said that
when they were published the contents of them, in one sense, were not
communicated to the public, as they would be unintelligible without
the illustrations by which they were accompanied when delivered in his
school. In conclusion, I would beg leave to remark that, if the work
of Hippocrates, in its present form, appear defective when compared
with what a modern work on the same subject would be expected to be,
it has also peculiar traits which would hardly be matched in a modern
composition. In a modern work we might have a greater abundance of
particular facts, and a more copious detail of individual observations,
but would there be such an exuberance of general truths, of grand
results, and of original reflections?
[371] The classical reader is referred to Theophrastus’ treatise De
Signis Aquarum et Ventorum, for much interesting information on this
subject.--See also Galen, Op. tom. v., p. 346, 347, ed. Basil.
[372] I. 105.
[373] It appears to me, however, that the meaning of Longinus in this
place is rather overstrained.
[374] Coster, Défense des (Œvres de Voiture, etc., p. 194.
[375] Réponse à l’Apologie de Voiture, par Coster, p. 54.
[376] Memoria Scythica, in Comm. Petropol. p. 377–78.
[377] P. vi., p. 35.
[378] Notæ in Longinum.
[379] Comment, in vetus Monument, p. 415.
[380] Nosol. Meth. p. 365.
[381] De maribus inter Scythas morbo effeminatis, etc., p. 28.
[382] Hipp. de Aere, etc., t. ii., p. 326.
[383] Morb. Târd. iv., 9.
[384] Hist. of Greece, pluries.
[385] The part in parenthesis is rather obscure. In the old French
translation it is rendered thus: “Elles sont très différentes entre
elles par leur nature, et il arrive d’ailleurs une infinité de
changemens qui sont tous divers.” On these changes, see Aphor. iii.,
2–15.
[386] I have translated this passage agreeably to the reading suggested
by Coray, that is to say, ὀυκ ἐδωδὸς, which appears to be a great
improvement, although it is not adopted by Littré. Without the negation
(ὀυκ) the contrast between the first and the last clause of the
sentence is entirely lost. It will be remarked that I have translated
ἀριστητάι, eating to excess. The ἄριστον, or dinner, was a meal which
persons of regular habits seldom partook of, and hence Suetonius
mentions it as an instance of Domitian’s gormandising propensities,
that he was in the habit of taking dinner.--See Vita Domitiani; also
PAULUS ÆGINETA, B. I., 109.
[387] It will be remarked that our author uses meteorology and
astronomy almost as synonymous terms. In his time meteorology was
looked upon by practical men as a visionary subject of investigation,
which had a tendency to make those who engaged in it atheists, and the
enemies of Socrates took advantage of the prejudices then prevailing
against it to represent him as a meteorologist. See Aristophanes
(Nub. 225.) Aristophanes, who would appear to have been always too
ready to pander to the popular prejudices of the day, also represents
the physicians as being “meteorological impostors,”--μετεωροφένακας.
(Ibid. 330.) The enlightened mind of Aristotle, however, regarded
meteorology in a very different light, and accordingly he wrote a
work on the subject replete with all the astronomical and geological
knowledge of his time. In it he professes to treat of the heavenly
bodies and atmospherical phenomena, including winds, earthquakes and
the like; also of minerals, fossils, etc. See the introduction to his
_Meteorologica_.
[388] Upon reference to the editions of Coray, Clifton, and Littré, it
will be seen that the text here is in a doubtful state. I shall not
weary the reader by stating my reasons for adhering to the meaning
which I have adopted.
[389] In place of the common reading, παιδίον, Coray adopts θεῖον which
certainly, at first sight, appears to be an improvement. But I admit,
with Littré, that the authority of Galen (tom. v., p. 447, ed. Basil),
is quite decisive in favour of παιδίον. It is also to be taken into
account in this place that the author of the treatise on Dentition
brings prominently into view the connection between infancy and
convulsions, which adds probability to the supposition that in those
days convulsions may have been called “the disease of infancy.”
[390] The Hepialus is a species of intermittent fever, very common in
warm climates. It would appear to be a variety of the quotidian. See
PAULUS ÆGINETA, Vol. I., 252, Syd. Soc. edition.
[391] Frequent mention of this disease of the skin occurs in the works
of the ancient writers on medicine. See PAULUS ÆGINETA, Vol.
II., 40. We have there stated that it would appear to have been some
species of Eczema, with which we are now unacquainted. Coray has a
very lengthy note on it, but arrives at no satisfactory conclusions on
the subject. He brings into review three cutaneous diseases, namely,
the _bouton d’Alep._. (described, Mémoir. de la Société Royale
de Médic., année 1777, 1778, t. i., p. 313;) the _pelagre_,
(described, Toaldo, Essai Méteorolog., pp. 19, 20; Comment. de Rebus
in Scient. Nat. et Médec. Gestis., tom. xxxi., p. 553; and Journ. de
Médec. tom. lxxx., p. 272;) and the _lepre des Asturies_ or _mal
de la rosa_, (described by Thieri, Journ. de Médec., tom. ii., p.
337.)
[392] _Coups de soleil_, or strokes of the sun, are often
mentioned incidentally in the works of the ancient authors, but no
one has treated of them in any very systematic manner, as far as I
recollect. On the effects of exposure to cold and heat, see, however,
PAULUS ÆGINETA, Vol. I., 49–51, Syd. Soc. edition.
[393] Ῥηγματα καὶ σπάσματα. There has been much difference of opinion
as to the exact import of these two terms. It would appear to me that
they were intended to apply to a rupture or straining of the fibres,
occasioned by external violence. M. Littré has a very interesting note
on this subject, tom. v., p. 579. On these strainings see further Coacæ
Prænotiones, 376, 418. M. Littré, l. c., relates a case of empyema
brought on by lifting a heavy piece of wood. On these terms see further
the Annotations on Demosthenes, Olynth. ii., 8, ed. Dobson; and Foës,
Œc. Hippocr.
[394] Clifton translates this clause of the sentence thus: “Even if
there be but a small distance between them,” and, I think, correctly,
although Coray is not quite satisfied with this interpretation. The
stadium was _nearly_ the eighth part of a Roman mile, that is to
say, it consisted of 94½ French toises, or 625 English feet.
[395] In another place, I have given a summary of the information
supplied by the ancient authors on this subject, (PAULUS
ÆGINATA, Vol. I., 66.) Upon the whole, none of them gives so
much valuable matter on it as our author. Coray has some elaborate
annotations on this passage.
[396] It can scarcely admit of a doubt that our author here alludes to
scurvy. (See Coray at this place, and Lind on Scurvy, iii., 1.) He also
describes the disease distinctly in the second book of Prorrhetics,
that is to say, if Hippocrates be actually the author of that book.
See also Epidem. ii., 1; de Affection., de inter. affect.; Cælius
Aurelianus, Tard. Pass. iii., 4; Celsus, iv., 9; Aëtius, x., 11; Pliny,
H. N., xxv., 3; Aretæus, Morb. Diuturn, i., 14; and Paulus Ægineta,
iii., 49; Marcellus, de Medic. ii.
[397] The leucophlegmasia is treated of in different parts of the
Hippocratic treatises, as Aphor. vii., 29; de Morb. ii. By it he
evidently meant a species of dropsy, as Galen remarks in his commentary
on the Aphorisms (l. c.). It occurs in Aretæus’s chapter on dropsy.
Morb. Diuturn. ii., 1; Octavius Horatianus, v. Celsus makes it to be
synonymous with anasarca, iii., 21. Our author would seem to notice
these varieties of dropsy as being affections to which pregnant women
are subject.
[398] On hydrops uteri see the authorities quoted in the Commentary on
PAULUS ÆGINATA, B. III., 48, Syd. Soc. edition. It may appear
singular that hydatids of the womb should be particularly prevalent
in the case of women that drink unwholesome water from marshes, and
yet our author’s observation is confirmed by a modern authority as
quoted by Coray: “Il a été également prouvé par les observations des
Modernes, que les fausses grossesses produites par les hydatides; sont
très-communes dans les pays marécageux, ou la plupart des habitans
ont une constitution lâche, propre à l’affection scorbutique, qui
y est presque endémique, qu’elles terminent plus ou moins tard par
l’excrétion de ces hydatides.”--(Notes sur le Traité des Airs, &c., p.
106.) Sydenham, moreover, describes the symptoms of false pregnancy in
much the same terms as our author. (Tract de Hydrop.)
[399] On the Thermal waters of the ancients, see PAULUS ÆGINATA, Vol.
I., 72. I have treated fully of the ancient _alum_ and _nitre_ under
στυπτηρία and λίτρον, in the Third Volume. Coray, in his notes on this
passage, does not throw much light on this subject. The opinion here
delivered by our author, that these metallic substances are produced by
the operation of heat, is adopted and followed out by Aristotle towards
the end of the third book on Meteorologia.
[400] Corny appears to me to be unnecessarily puzzled to account for
our author’s statement, that saltish waters, although held to be
purgative, are, in fact, astringent of the bowels. But, although their
primary effect certainly be cathartic, is it not undeniable that their
secondary effect is to induce or aggravate constipation of the bowels?
Certain it is, moreover, that all the ancient authorities held salts
to be possessed of desiccant and astringent powers. See PAULUS
ÆGINETA, Vol. III., under ἂλες.
[401] Aristotle discusses the subject in his Problems, ii., 9, 36, 37;
ii., 15; i., 53; v., 34, and arrives at nearly the same conclusions as
Hippocrates. See also Theophrastus de Sudoribus.
[402] I cannot hesitate in adopting the emendation suggested by Coray
(ἀποσήθεσθαι) in place of the common reading (ἀποσήπεσθαι), which
evidently has no proper meaning in this place. I am surprised that M.
Littré should have hesitated in admitting it into the text.
[403] Athenæus, in like manner, praises rain water. Deipnos ii., 5.
[404] It appears singular that Athenæus, who is undoubtedly a most
learned and judicious authority on all matters relating to Dietetics,
speaks as favorably of water from ice as he does of rain water. Both
he praises for their lightness, (l. c.) Celsus gives the character
of the different kinds of water with his characteristic terseness
and accuracy: “Aqua levissima pluvialis est; deinde fontana; tum ex
flumine; tum ex puteo: post hæc ex nive, aut glacie; gravior his ex
lacu; gravissima ex palude,” (ii., 19.) Galen treats of the medicinal
and dietetical properties of water in several of his works, and
uniformly agrees with Hippocrates in the judgment he pronounces on
them. See in particular, De Ptisana; De Sanit. tuend. ii.; Comment. ii.
in Libr. de Ratione victus in Morb. acut.
[405] Athenæus, on the other hand, argues from the fact that ice is
lighter than water, that water formed from ice must be light. Pliny
gives a lucid statement of the opinions of those who held that water
from ice is light and wholesome, and those who, like Hippocrates,
held it to be just the reverse. He says in the words of Hippocrates,
literally translated, “nec vero pauci inter ipsos e contrario ex
gelu ac nivibus insaluberrimos potius prædicant, quoniam exactum sit
inde, quod tenuissimum fuerit.” (H.N. xxxi., 21.) See also Seneca,
Quæst. Natural. iv. It would appear that iced _liqueurs_ were
greatly relished at the tables of _gourmands_ in those days. I
need scarcely remark that there has been great difference of opinion
in modern times regarding the qualities of water from melted snow and
ice. It was at one time generally believed that it is the cause of the
goîtres to which the inhabitants of the valleys bordering on the Alps
are subject. This opinion, however, is by no means generally held at
the present time.
[406] This is a most interesting chapter, as containing the most
ancient observations which we possess on the important subject of
urinary calculi. The ancients never improved the theory, nor added much
to the facts which are here stated by our author. We have given the
summary of their opinions in the Commentary on PAULUS ÆGINETA,
B. III., 45. I would beg leave to remark that, notwithstanding the
number of curious facts which modern chemistry has evolved regarding
the composition of urinary calculi, the etiology of the disease is
nearly as obscure now as it was in the days of Hippocrates.
[407] Coray remarks that Prosper Martian, in his commentary on this
passage, confirms the truth of the observation here made, that persons
affected with calculus have the bowels constipated.
[408] Theophilus, in his treatise De Urinis, would seem to contradict
this observation of Hippocrates, when he states that the urine of
calculous persons is thick and milky (8.) But, according to Prosper
Martian, when the calculus is in the state of formation, its characters
are as described by the latter, whereas, when the calculus is already
formed, the urine is limpid, as described by Hippocrates.
[409] It is worthy of remark that Celsus states just the reverse with
regard to the practice of women laboring under the stone; he says:
“Feminæ vero oras naturalium suorum manibus admotis scabere crebro
coguntur.” (ii., 7.) Are we to suppose that he followed a different
reading? Considering how well he shows himself acquainted with the
works of Hippocrates, it cannot be thought that he had overlooked this
passage.
[410] Our author, it will be remarked, ascribes the comparative
immunity from calculus which females enjoy to their freer use of
liquids. Celsus, in laying down directions for the regimen of a
calculous person, as preparatory for the operation, among other things,
directs, “ut aquam bibat,” (vii., 26–2.) Coray collects the opinions of
several modern authorities in favor of drinking water as a preventive
of calculus. Thus Tissot states that the Chinese, who drink so much
water with their tea, enjoy almost an immunity from the disease. (De la
Santé des Gens de Lettres, p. 196,) Campfer, in like manner, affirms
that calculus has become less common in Europe since the introduction
of tea, which he justly attributes to the amount of water drunk with
it, rather than to any virtues of the plant itself. (Comment de Reb. in
scient. nat. et medic. gestis, vol. xvi., p. 594.) Metzger attributes
the diminution of the number of calculous cases in Königsberg to the
use of draughts of tepid water. (Journal de Médec., vol. lxvii., 348.)
The Turks, according to Thevenot, owing to their free use of water, are
almost exempt from the disease. (Voyage au Lévant, c. xxvii., p. 70.)
[411] Coray makes the following remarks on the natural characters of
the seasons in Greece. The natural temperature of the winter in Greece
was cold and humid; thus a dry and northerly winter was reckoned an
unnatural season. Spring was reckoned unnatural when the heat and rain
were excessive. See further Theophrast. de Caus. Plant. ii., 1.
[412] See Aphorism iii., 11.
[413] The celebrated Haller charges Hippocrates with inaccurate
observation in stating that dysenteries are epidemic in spring, which,
he contends, is contrary to modern experience. (Bibl. Med. Pract., vol.
i., p. 61.) Hippocrates, however, is defended by Gruner (Cens. libr.
Hippocrat. ii., 5, p. 51), and by Coray. (Notes, etc., p. 159.) The
latter justly argues, that although dysentery may not prevail at that
season in Germany, that is no reason for holding why it may not be
so in Greece. He also refers to the works of Birnstiel and Stoll for
descriptions of epidemical dysentery, occurring in the season of spring.
[414] See Aphorism iii., 12; also Aristot. Probl. i., 9; Celsus, ii., 1.
[415] Coray, in this place, refers to an epidemic of the same
description related by Caillar, which prevailed in the winter of 1751,
and was treated by emetics more successfully than by bleeding.
[416] By sphacelus of the brain Clifton understands “paralytic
diseases,” which is not far removed from the conclusion which we have
arrived at respecting it in the Commentary on PAULUS ÆGINETA,
Vol. I., p. 365. See Coray’s lengthened note on this passage.
[417] Aphorism, iii., 13.
[418] Aphorism, iii., 14.
[419] I have stated in my analysis of the short treatise “On Purgative
Medicines,” that the author of it forbids the administration of these
medicines, that is to say, of drastic purgatives, during excessive heat
or cold.
[420] One may see, upon consulting the editions of Clifton, Coray, and
Littré, that there are great varieties of readings in regard to the
word which I have translated “affectionate.” It will be remarked that I
have followed Coray and Littré in reading εύοργητότερα. Clifton adopts
ἀεργότερα, and translates it “unactive.”
[421] This expression of our author is ambiguous. Coray explains it
thus: “il entend le lever d’été, qu’il place à 45 degrés de l’Est au
Nord, dans l’horizon de la Grece, et particulièrement celui de l’île de
Cos; et le lever d’hiver qu’il place à 45 degrés de l’Est au Sud.”
[422] The sense undoubtedly requires this addition, and therefore I
have not scrupled to follow the reading of Cornarius, καὶ τοῡ θερμοῡ.
[423] The term here used meant particularly the fructus horæi, or
summer fruits; namely, cucumbers, gourds, and the like. (See PAULUS
ÆGINETA, B. I., § 80.) Surely Coray forgot himself, when he wrote
thus regarding the distinction between the summer and autumnal fruits
of his country: “les Grecs entendoient particulièrement par ὡρᾱια les
fruits de la fin de l’été, c’est-à-dire, de cette partie de l’année
qu’ils appelloient ὀπώραν, etc.”
[424] It is but too apparent that there is a lacuna in the text here. A
chapter devoted to an examination of the peculiarities of the Egyptians
and Libyans is evidently lost. As M. Littré has remarked, Galen appears
to refer to the contents of the lost chapter. (Opera, tom. xvi., p.
392; ed. Kühn.)
[425] That is to say, the Sea of Azoff. See Herodotus, iv., 86, who
calls it Μαιῆτις. This was generally held to be the division between
Europe and Asia, as stated by our author. As Coray remarks, its borders
on the north-west are occupied by the inhabitants of Little Tartary:
it has the Crimea on the south-west; the Tartars of Cuban and the
Circassians on the south-east.
[426] That the inhabitants of a country bear a resemblance to the
country itself, is no doubt a profound and most philosophical remark,
although it must be admitted that the comparisons which our author
makes are somewhat quaintly expressed, and hence a German physician
wished the passage expunged, as being unworthy of Hippocrates. (Comment
de Reb. in Scient. Natur. et Med. gestis, vol. xx., p. 131.) There
can be no question, however, that it embodies a grand general truth,
although the particular application of it may not always be apparent.
[427] On the Macrocephali, see Pliny, H. N. vi., 4; Stephanus, de
Urbibus; Suidas and Harpocration in Μακροκέφαλοι; Pomponius Mela, i.,
19; Strabo, xii.; Scholiast Apollon. Rhod., i.; Dionysius Periegetes.
The exact situation of the savage nation of the Macrocephali cannot
be precisely determined, but it was evidently not far from the Palus
Mæotis, and most probably in the vicinity of the Caucasus. Little is
known of them, except what our author says respecting the practice
which they had of disfiguring their heads by squeezing them, in early
infancy, into an elongated shape. It is well known that the same absurd
usage prevailed among the early inhabitants of MEXICO. I need
scarcely say that much important information respecting them has been
obtained of late years. M. Littré, in the fourth vol. of his edition of
Hippocrates, supplies some very important information in illustration
of this subject, from a recent publication of Dr. H. Rathke. Certain
tumuli having been excavated at Kertch, in the Crimea, there were found
in them, besides different utensils and statues, several skeletons,
and it was most remarkable that the form of the head was greatly
elongated, in the manner described by Hippocrates with regard to the
Macrocephali. The author’s words are: “On y remarquait, en effet, un
hauteur extraordinaire par rapport au diamètre de la base, et par là
ils frappaient même les personnes qui n’avaient aucune connaissance de
la structure du corps humain.”
[428] The same theory respecting the secretion of the semen is given
in the treatises “De Genitura” and “De Morbo Sacro.” It is espoused by
Galen, in his little work. “Quod animal sit quod utero continetur.”
Coray remarks that Hippocrates’s theory on the origin of the fœtus does
not differ much from that of Buffon.
[429] I need scarcely remark that both the river and city of this name
are very celebrated in ancient mythology and history. See in particular
Apollonius Rhodius, with his learned Scholiast, Arg. II.; Strabo, xi.;
Pliny, H. N., vi., 4; Procopius, Pers., ii., 29; Mela, i., 85; Arrian,
periplus. The river takes its rise in the Caucasus, and terminates in
the Black Sea. It is called _Rion_ by the inhabitants, and the
river and a city situated upon it are called _Fache_ by the Turks.
See Coray at this place, and Mannert., Geograph., iv., 394.
[430] Coray quotes from Lamberti, a modern traveller, a description
of the Colchide and its inhabitants, which agrees wonderfully with
the account of both given by our author. The following is part of his
description: “Il sito della Colchide porta seco un’ aria tanto humida
che forse in altro luogo non si è veduta la simile. E la ragione si è
perchè venendo dall’ occidente bagnata, dall’ Eusino, et dall’ oriente
cinta dal Caucaso, dal quale sorgano gran quantità di fiumi rende
da per tutto l’aria humidissima affatto. A questo s’ aggiungono la
frequenza de’ boschi, fra quali non viene agitata l’aria da’ venti, et
li spessi venti marini apportatoi di pioggie et de’ vapori del mare.
Questa humidità si grande genera poi gran quantità de’ vapori, che
sollevati in alto si dissolvono in frequentissime pioggie.”--Relatione
della Colchide, c. 27. He goes on to state that a great part of the
inhabitants are fishers.
[431] It is singular that Procopius, on the other hand, states that
the Phasis is a very rapid river, and Chardin confirms his statement.
(Voyage en Perse, vol. i., p. 105.) Lamberti reconciles these
discrepant accounts by explaining that the river is rapid in its course
near where it rises among the mountains, but quite smooth and stagnant
when it arrives at the plain.--Relat. dell Colchid., 29.
[432] The best practical proof of the justness of our author’s
reflections in this place is the result of the battle of Salamis; and
the noblest intellectual monument which ever the wit of man has raised
to the triumph of freedom is the Persæ of Æschylus, in celebration of
that event. A single line, descriptive of the Greeks, is sufficient to
account for their superiority to the Asiatics:
Οὔ τινος δοῦλοι κέκληνται φωτὸς, οὐδ' ὑπήκοοι.--1., 240.
None seem to have felt the force of this great truth so much as the
Persian despots themselves, or to have estimated the effects of
civil liberty higher than they did. The younger Cyrus, before the
battle of Cynaxa, addresses his Grecian soldiers in the following
memorable words: Ὦ ἄνδρες Ἕλληνες, οὐκ ἀνθρώπων ἀπορῶν βαρβάρων
συμμάχους ἡμᾶς ἄγω, ἀλλὰ νομίζων ἀμείνονας καὶ κρείττους πολλπῶν
βαρβάρων ὑμᾶς εἶναι διὰ τοῦτο προσέλαβον ὅπως οὖν ἔσεσθε ἄνδρες ἄξιοι
τῆς ἐλευθερίας, ἧς κέκτησθε, καὶ ὑπὲρ ἧς ὑμᾶς ἐγὼ εὐδαιμονίζω· εὖ
γὰρ ἴστε, ὅτι τὴν ἐλευθερίαν ἑλοίμην ἂν ἀντὶ ὧν ἔχω πάντων καὶ ἄλλων
πολλαπλασίων.--Anab., i., 7. Such being the established opinions of
the intelligent portion of mankind in the days of Hippocrates, the
sentiment here expressed would then be regarded as a self-evident
truth. Plato, indeed, modifies this opinion in so far when he holds
despotism to be the consequence and not the cause of servility.--De
Repub., viii.
[433] The name Sauromatæ or Sarmatæ was applied by the ancient
geographers to certain inhabitants of that vast and, to them, nearly
unexplored country, extending from the Sinus Codanus _or_ Baltic
Sea, to the Euxine _or_ Black Sea. It comprehends, then, a large
portion of Russia, Poland, and perhaps Prussia. (See Pomponius Mela,
iii., 4; Ptolemy, Geograph.; and Maltebrun, Geograph., vol. i., p.
126.) That the Sarmatians and Scythians were the same race of men,
although some of the authorities make a distinction between them, can
scarcely admit of a doubt. Our author, it will be remarked, seems to
restrict the name to a peculiar race of Scythians, who lived near the
Palus Mæotis (_or_ Sea of Asaph). From the account which he gives
of them it is impossible to doubt that he alludes to the Amazonians, so
celebrated in ancient legends. The opinion which I entertain of them is
pretty fully stated in the Argument to this treatise. That our author
should not have doubted the real existence of the Amazonians need
excite no wonder, considering the very positive and very circumstantial
account of them given by his contemporary Herodotus (iv., 110–18).
[434] It may at first sight appear singular that our author should have
mixed up his account of the Scythians with allusions to the Egyptians;
but he probably had in view Herodotus (ii., 103–6), who connects the
Egyptians with the Scythians, and more especially with the tribe of
them called Colchians. He states in particular that the Colchians and
Egyptians resembled one another in the fashion of their linen, their
whole course of life, and in their language.
[435] Herodotus (iv., 28, 29) and Strabo (Geogr., vii.), assign the
same reason for the Scythian cattle not having horns.
[436] This description evidently applies to the wandering tribes
which roam over the steppes of Tartary. The passage is of classical
celebrity, for I cannot but fancy that certainly Virgil (Georg.,
iii., 349–83), and perhaps Horace (Od. iii., 24), had it in view
when they drew their pictures of the nomadic life of the Scythians.
The extraordinary cold of that region, notwithstanding its southern
latitude, has not been exaggerated by ancient authors; but to account
for it, as the modern traveller, Clark, remarks, is still a problem
which no one has solved. Strabo mentions that carts were driven
across the Palus Mæotis (Geogr., vii., 3). The chariots covered in
from the inclemency of the weather with a roof of felt, are described
also by Strabo (Geogr., l. c.); and, according to Dr. Coray, similar
contrivances are still to be found among the Kalmucs and other savage
nations. (Notes sur le Traité des Airs, etc., h. 1.) A preparation from
milk resembling the hippace is still used by the inhabitants of that
region. On the people who lived upon this composition from milk, see in
particular Strabo, vii., 3.
[437] The following lines of Virgil, referred to above, may be almost
said to be a translation of this passage:
“Semper hiems, semper spirantes frigora Cauri.
Tum sol pallentes haud unquam discutit umbras;
* * * * *
Talis Hyperboreo septem subjecta trioni
Gens effrena virûm Rhiphæo tunditur Euro.”
It was in this region of mist and cold that the celebrated race of the
Cimmerians resided. See Herodot., i., 6, etc.; Homer, Odyss. x., 14.
The montes Rhiphæi would appear to have been the Ural mountains which
separate Russia from Siberia.
[438] It is well known now that excessive cold has a tendency to retard
the growth of animals. This opinion is confirmed in several instances
by Pallas (Voy. en Russie, i., 197; iii., 431.) Strabo mentions, as the
consequences of the cold which prevails in the country of the Getæ,
that there are no asses in it, the cattle want horns, and the horses
are small. (Geogr., vii., 3.)
[439] Buffon, on the other hand, maintains that the Nomadic race
are men of active habits. (Hist., Nat., tom. iii., p. 384.) Pallas,
however, confirms the judgment of Hippocrates. (Voyag. en Russie, tom.
i., p. 499.) See also Coray, ad. h. l.
[440] It is to be borne in mind that Hippocrates, and after him most of
the ancient authorities, held that the fœtus is formed from the male
semen. This doctrine prevailed generally down to the days of Harvey.
Some of the ancient physiologists, however, maintained that “omne
animal est ab ovo.” See Plutarch, de Placit. Philos.
[441] Ὑγρότης, when applied to the body, may signify both humidity and
relaxation, in like manner as the adjective (ὑγρὸς) signifies humid and
relaxed. We shall see an example of the latter signification in the
Prognostics.
[442] This practice came to be one of the regular operations of
surgery, being performed with the view of correcting the tendency of
a joint to dislocation. It is minutely described by Hippocrates (De
Artic., xi.), Paulus Ægineta, (VI., 42), Albucasis (Chirurg., i., 27),
Haly Abbas (Pract., ix., 78). See the Sydenham Society’s edition of
PAULUS ÆGINETA, 1. c.
[443] The meaning of this passage is ambiguous. I have followed Coray,
who gives some very interesting annotations on it. He translates these
words, “Ils sont naturellement d’une complexion lâche et trapus;
premièrement, parceque dans leur enfance ils ne sont point emmaillotés,
non plus que les Ægyptiens.” Clifton has given nearly the same meaning
of the passage: “Their fluidness and breadth proceed first from their
neglect of bandages, as in Egypt.” Littré, on the other hand, appears
to give a different interpretation of the passage: “D’abord parceque on
ne les emmaillotte pas, comme en Egypte.”
[444] A fat condition of the body was also supposed adverse to
conception in the case of cattle. Virgil alludes to this opinion, and
the means used to counteract the effects of an excessively fat state
of the body in the following verses, which have been always admired as
an example how delicately a great genius can touch upon an indelicate
subject:
“Ispa autem macie tenuant armenta volentes,
Atque, ubi concubitus primos jam nota voluptas
Sollicitat, frondesque negant, et fontibus arcent.
Sæpe etiam cursu quatiunt et sole fatigunt;
Hoc faciunt nimio ne luxu obtusior usus
Sit genitali arvo, et sulcos oblimet inertes;
Sed rapiat sitiens venerem, interiusque recondat.”
Georg., iii., 136.
[445] On the nature of this affection see the Argument. There is a
variety in the reading, most of the MSS. having ἀνανδριείς, but the one
usually marked 2146, which is followed in the Aldine edition, reading
ἀνδριεῖς. See a long discussion in Coray’s edition on this point. There
seems to be no good reason for at all interfering with the text as it
now stands.
[446] Our author in this place, as in the treatise on the Sacred
Disease, holds the philosophical opinion in opposition to the
superstitious, that all diseases have natural causes, and that no one
more than another is to be ascribed to the extraordinary interference
of supernatural beings. Plato, his contemporary, would appear to have
endeavored to steer a sort of middle course between the scientific and
the popular belief. Thus he ascribes epilepsy, like all other diseases,
to a natural cause, namely, in this instance, to a redundancy of black
bile; but he qualifies this opinion by calling the passages of the
brain (the ventricles?) most divine, and adds that the disease had been
most appropriately denominated sacred. (Timæus, § 66.)
[447] The origin and signification of this term are by no means well
defined. See Galen (Exeges, etc.), Foës (Œcon. Hippocr.), and Coray
(ad h. l.). It has been applied first, to certain varieties of morbus
coxarius; secondly, to chronic buboes, superinduced by disease of the
hip-joint; thirdly, to paralysis of the muscles about the genital
organs; fourthly, aneurismal varix. (See Aretæus, Morb. Acut., ii.,
8; and the note in Boerhaave’s edition.) I must own that I find some
difficulty in deciding to which of these significations I should give
the preference; I rather incline, however, to the first, from what our
author says towards the end of this section, namely, that all men who
ride much “are afflicted with rheums in the joints, sciatica and gout,
and are inept at venery.”
[448] This opinion of our author was no doubt founded on the erroneous
notion regarding the distribution of the veins which prevailed in his
time, and which we find advocated in the tract “on the Nature of Man,”
and elsewhere. (See Aristot., H. N., iii., 3.) Coray strives hard, in
his annotations on this passage, to make out that the fact may be as
stated by his ancient countryman, although the hypothesis by which
he explained it be false. It is singular, however, that, after the
lapse of more than two thousand years, Phrenology should have come to
the assistance of Hippocrates in this case. I need scarcely remark
that Gall and his followers hold that the cerebellum is the seat of
the animal appetites, so that, if this be really the fact, a close
sympathy between the back of the head and the genital organs may be
very legitimately inferred. At all events, this coincidence between
ancient observation and modern hypothesis must be admitted to be very
remarkable.
[449] Aristotle, on the other hand, holds that the effects of
equitation are aphrodisiac. (Probl. iv., 12.) Coray attempts to
reconcile the discordant opinions of the physician and philosopher, by
supposing that moderate exercises may excite the venereal appetite,
whereas excessive extinguish them. Van Swieten agrees with Hippocrates
that inordinate exercise in riding may induce impotence. (Comment. in
Boerh. Aphor., § 1063.)
[450] It is a singular idea of our author that the wearing of breeches
by confining the development of the genital organs impairs the sexual
desires. It is curious, as remarked by Coray, that the same opinion is
advocated by Hunter in his treatise on the Venereal Disease. Coray also
quotes the following passage from Lalement: “Sæpe audivimus pistores et
cæteros quorum partes pudendæ subligaculis non obteguntur sed liberius
pendent crassos et bene nutritos habere testiculos.”--Comment. in
Hippocrat. de Aer., etc.
[451] I trust I shall be excused in quoting entire Dr. Coray’s note
on this section: “Trente mille Macédoniens (dit Pauw) ont conquis la
Perse; quarante mille Mogols ont conquis les Indes; cinquante mille
Tartares ont conquis la Chine, où l’on comptait alors plus de quarante
millions d’habitans, qui abandonnèrent leurs souverains. On a vu de nos
jours l’armée du grand Visir déserter presque complètement dans les
environs de Varna; et jamais les Turcs n’eurent plus de bon sens qu’en
cette occasion là; car leurs tyrans ne méritent pas qu’on verse une
seule goutte de sang pour les maintenir sur le trône de ces contrées
qu’ils ont dévastées en voleurs et en brigands. (Recherch. philosoph.
sur les Grecs.)--Par ce dernier exemple on voit encore combien les
causes politiques ou morales, et les causes naturelles, peuvent se
modifier réciproquement. Les Russes, quoique soumis à un gouvernement
despotique, ont cependant été la terreur des Turcs, à cause, sans doute
de la différence du climat, de la discipline militaire, et des progrès
dans la civilisation. Ces circonstances ont concouru à mitiger le
despotisme Russe, et à le rendre si différent du despotisme brutal des
Turcs. Il en est de même des autres peuples Septentrionaux de l’Europe.
Quoique gouvernés par des loix qui ne sont point leur ouvrage, ils sont
très belliqueux, et par la nature de leur climat, et par les lumières
que les sciences et les arts ont répandues parmi eux.”
[452] Aristotle, in drawing the traits of the European and Asiatic
character, would appear to have borrowed freely from our author. He
says the inhabitants of cold countries and of Europe are full of
spirit, but deficient in intellect and skill; they therefore remain
in a state of freedom, but without regular government, and they are
incapable of governing their neighbors. The inhabitants of Asia are
described by him as being intellectual and skilled in the arts, but
deficient in courage, and therefore they are in constant subjection and
slavery. The Greeks, he maintains, held an intermediate place between
these two, have both courage and intellect, and therefore enjoy freedom
and good government. (Polit., iii., 7.)
[453] We have lately had a notable example of the warlike and
independent spirit of mountaineers in the determined resistance which
the Circassians have made to the colossal power of Russia. Great
Britain, too, I may be permitted to remark, experienced disasters in
contending with the mountaineers of Affganistan, such as she had never
met with in the rich plains of India. And, by the way, the conqueror of
Greece and of Persia was very nearly cut off by the same people. See
Arrian, Exped. Alexandr., iv., 22, etc.
[454] Ἄναρθροι. The meaning of this term seems to be, persons whose
joints are indistinct owing to fatness.
[455] Coray supposes, and apparently with justice, that our author
in this passage tacitly refers to the inhabitants of Attica. It is
worthy of remark that Thucydides ascribes the early civilization of the
Athenians to the infertility of the soil. (Ἀττίκην λεπτόγεων, i., 2.)
See Arnold’s Note, h., 1.; also the quotation from Aristotle at § 23;
and Plato’s Timæus, tom. iii., p. 247; ed. Bekker. According to Coray
(but perhaps he was partially disposed towards his adopted country),
the characters of Provence and Marseilles are analogous to those of
Attica and Athens, and the effects on the inhabitants similar. That
Marseilles was at one time a flourishing seat of learning is undoubted;
see Tacitus (Agricola) and Strabo (Geogr., iii.); but in literary
celebrity it cannot surely aspire to be put on a level with the region
which produced an Æschylus, a Thucydides, a Plato, and a Demosthenes!
And it may be doubted whether even the Marseillais Hymn equals in
masculine energy the war songs of Tyrtæus!
[456] Its title is, Specimen Historico-Medicum Inaugurale de
Hippocratis Doctrina a Prognostice Oriunda. Lugduni Batavorum, 1832.
[457] Cap. v.
[458] Comment. in Prognos. ap. Dietz.
[459] The opinion here advanced is expressed with great precision
by a French writer who has been making some figure in the political
world of late. “Great men,” says Louis Blanc, “only govern society
by means of a force which they themselves borrow. They enlighten the
world only by a burning focus of all the scattered rays emanating from
itself.”--Organization of Labor, p. 98, English edition.
[460] Ascarus, a Theban statuary for one. See Pausanias, v., 24, 1.
[461] See the Commentary of Simplicius. As I quote from memory I cannot
refer to the page.
[462] Galen, in his Commentary on this clause of the sentence, acutely
remarks that patients are justly disposed to form a high opinion of a
physician who points out to them symptoms of their complaint which they
themselves had omitted to mention to him. And Stephanus further remarks
that the patient naturally estimates highly the acumen of the physician
who detects any errors in regimen which he has been guilty of, such as
drinking water, or eating fruit when forbidden; (Ed. Dietz, p. 54;) or
when he has some disease about him, such as bubo or inflammation, which
he wishes to conceal. (Ibid., p. 63.)
[463] It has puzzled all the commentators, ancient and modern, to
explain satisfactorily why Hippocrates, in this place, seems to adopt
the popular creed, and acknowledge that a certain class of diseases are
of divine origin; whilst in his treatises “On Airs,” etc., and “On the
Sacred Disease” he combats this doctrine as being utterly unfounded.
Galen attempts to get over the difficulty by supposing that, in this
place, by divine our author means diseases connected with the state of
the atmosphere; this, however, would merely imply that, on the present
occasion, he expressed himself in accordance with the popular belief.
And, by the way, I would beg leave to remark that the plague which is
described by Homer in the exordium to the Iliad, and is referred to the
wrath of a god, that is to say, of Apollo, was at the same time held
by Eustathius and other commentators to be connected with the state
of the atmosphere; that is to say, agreeably to the vulgar belief,
epidemical diseases were looked upon as divine. See also Stephanus,
the commentator, t. i., p. 77; ed. Dietz. M. Littré has given, from a
MS. in the Royal (National?) Library at Paris, a gloss never before
published, which contains an interesting extract from one of the
early Hippocratic commentators, Xenophon of Cos, bearing upon this
passage. It is to this effect, that Bacchius, Callimachus, Philinus,
and Heraclides Terentinus, supposed that by divine, in this place, was
meant pestilential, because the pestilence was held to be from god; but
that Xenophon, the acquaintance of Praxagoras, reckoned the nature of
the critical days divine; for, as to persons in a storm, the appearance
of the gods Dioscuri brings safety, so do the critical days bring life
to men in disease. (Opera, tom. i., p. 76.) See some remarks on this
scholium by Grote, Hist. of Greece, vol. i., p. 488. On the θεῖον of
Hippocrates see further Berends, Lect. in Aphor., p. 349.
[464] It will be remarked that, in his sketch of Prognosis (πρόνοια),
in this place our author uses the term with considerable latitude; in
fact, it comprehends the past, the present, and the future condition
of the patient. Hippocrates, in a word, appears to have desired
that the physician should be in his line what his contemporary,
Thucydides, describes Themistocles to have been as a statesman: “Quod
de instantibus (ut ait Thucydides), verissime judicabat, et de futuris
callidissime conjiciebat.”--Cornelius Nepos, in vita Themistocles. See
also Thucydides, i., 138. Probably both these writers had in his mind
the character of the prophet as drawn by Homer: Ὃς ᾔδη τά τ' ἕοντα τά
τ' ἐσσόμενα πρό τ' ἔοντα.. (Iliad i.)
[465] The groundwork of the matters contained in this section is to be
found in the Coacæ Prænotiones, 212; but it is greatly expanded and
improved by our author. I need scarcely remark that the description of
the features of a dying man is of classical celebrity. It is given in
elegant prose by Celsus, ii., 6; and by Lucretius it is thus put into a
poetical form:
“Item ad supremum denique tempus
Compressæ nares, nasi primoris acumen
Tenue, cavati oculi, cava tempora, frigida pellis
Duraque, inhorrebat rictum, frons tenta minebat.”
De Rerum Natura, vi., 1190.
Shakespeare’s description of the death of Falstaff, by the way,
contains images which have always appeared to me to be borrowed (at
second-hand, no doubt) from this and other passages of the present
work: “For after I saw him fumble with the sheets, and play with
flowers, and smile upon his fingers’-ends, I knew there was but one
way: for his nose was as sharp as a pin, and he babbled of green
fields.--So he bade me lay more clothes on his feet: I put my hand into
the bed and felt them, and they were as cold as any stone,” etc.--Henry
V., ii., 3. Although perhaps it may be thought rather hypercritical,
I cannot omit the present opportunity of making the remark, that it
appears to me rather out of character to make the wandering mind of a
London debauchee dwell upon images “of green fields.” One would have
thought that “the ruling passion strong in death” would have rather
suggested stews and pot-houses to the imagination of such a person.
[466] It will be remarked that our author modifies his judgment on
the result of the _ensemble_ of dangerous symptoms which he has
just described, provided they be connected with want of food and of
rest, or with looseness of the bowels. See Galen’s Commentary on this
passage. Celsus renders this clause of the sentence as follows: “Si ita
hæc sunt, ut neque vigilia præcesserit, neque ventris resolutio, neque
inedia.”--ii., 6. I may briefly mention that both Galen and Stephanus
seem to have understood this passage as I have translated it. Littré it
will be seen has rendered it somewhat differently.
[467] The prognostics, drawn from the position in which the patient is
found reclining, are mostly taken from the Coacæ Prænotiones, 497. As
usual, however, Hippocrates has improved very much the materials which
he avails himself of.
I would here point out a mistake which most of the modern translators
have committed respecting the meaning of an expression contained in
this paragraph. It is καὶ τὸ ξύμπαν σῶμα ὑγρον κείμενον, which Clifton,
Moffat, and even Littré understand as descriptive of the body’s being
in a moist state with sweat. Littré’s translation is, “Le corps entier
en moiteur.” The translators forget that the word ὑγρὸν is used by the
best classical authors to signify “relaxed” or “soft.” Thus Pindar,
in his celebrated description of the eagle perched upon the sceptre
of Jupiter, and lulled asleep by the power of music (every English
scholar will remember Gray’s version of it in his Ode on the Progress
of Poesy), has the expression ὑγρὸν νῶτον, which Heyne interprets
by _flexile_ and _lubricum_. (Ad Pyth., 1.) See also the
Scholiast, in h. 1. Galen apprehends the meaning of the term as I have
stated it: thus he defines it as applying to the position intermediate
between complete extension and complete flexion, that is to say,
half-bent or relaxed. Foës also renders the expression correctly by
“corpus molliter positum.” (Œconom. Hippocrat.) See also Stephanus
(p. 96, ed. Dietz), who decidedly states that the epithet (ὑγρὸς), in
this place, means slightly bent or relaxed. Heurnius explains ὑγρὸν as
signifying “molliter decumbens,” p. 189. Celsus renders the words in
question by “cruribus paulum reductis,” ii., 3.
[468] This is taken pretty closely from the Coacæ Prænotiones, 235.
[469] This sentence is thus translated by Celsus: “Ubi ulcus, quod aut
ante, aut in ipso morbo natum est, aridum, et aut pallidum, aut lividum
factum est.” (ii., 6.) It is imitated from the Coacæ Prænotiones, 496.
[470] This graphic description of the movement of the hands in delirium
is nearly original, being but slightly touched upon in the Coacæ
Prænotiones, 76. The terms are copied by most of the ancient authors
subsequent to Hippocrates, in their descriptions of phrenitis and
febrile delirium. See in particular PAULUS ÆGINETA, Book III.,
6. Stephanus, in his Commentary, has several very philosophical remarks
on this passage, namely, upon the rationale of the ocular deception
which leads to these extraordinary movements of the hands. (Ed. Dietz,
t. i., pp. 103, 104.)
[471] This is imitated pretty closely from the Coacæ Prænotiones, 260.
Dr. Ermerins remarks that there is a greater number of symptoms in the
Prænotiones than in the Prognostics. He therefore suggests the question
whether there may not be a lacuna in the text. The description of the
respiration preceding dissolution in the Prænotiones is certainly
most graphic, and it appears wonderful that it should be omitted by
Hippocrates in the Prognostics.
[472] The paragraph on sweats is founded on the Coacæ Prænotiones, 572,
573; but the Prognostics is much fuller than the other. The cold sweats
described in this paragraph were called syncoptic by the ancients, and
were supposed to be connected with atony of the pores of the skin. See
Galen, h. 1., and De Causis Sympt. iii., 9. Stephanus, with rather too
much logical parade, gives a good many acute and interesting remarks on
this passage. He says that cold sweats are connected with a complete
prostration of the innate heat (calidum innatum). (p. 114.)
[473] The characters of the hypochondriac region are copied in part
from the Coacæ Prænotiones, 279, 280, 282; but they are much improved
in the Prognostics. It will be remarked that in the Epidemics great
attention is paid to the state of the hypochondria. Stephanus remarks
that pulsation _or_ palpitation in the hypochondria is caused by
violent throbbing of the aorta as it passes through this region, which
is occasioned by the effervescence and inflammation of the important
parts which are situated in it, and with which the brain is apt to
sympathize. (p. 118.) Meteorism of the hypochondriac region is often
mentioned in the reports of the cases described in the Epidemics.
[474] The author evidently alluded to hepatitis ending in abscess. This
would seem to have been a very common termination of inflammation of
the liver in Greece, as it is often described in the ancient medical
works. See PAULUS ÆGINETA, B. III., 46, and the authorities
quoted there in the Sydenham Society’s edition.
[475] The paragraph on the prognostics relating to dropsies is founded
in a great measure on the Coacæ Prænotiones, 454. The ancient writers
who treat systematically of dropsy generally describe four varieties
of it, namely, dropsy from disease of the liver, from disease of the
spleen, from fever, and from a sudden draught of cold water. See De
Morbis, and PAULUS ÆGINETA, B. III., 48, Sydenham Society’s
edition.
[476] On this variety I have remarked in the Comment. on Paulus
Ægineta: “Hippocrates refers one species of dropsy to disease of the
parts situated in the loins, by which Galen and Stephanus agree that
he means the jejunum, mesaraic veins, and kidneys.” (Paulus Ægineta,
l. c.) M. Littré accordingly holds it probable that allusion is made
to granular degeneration of the kidneys, that is to say, to Bright’s
disease. (Opera, etc., tom. ii., 388.)
[477] Dr. Ermerins remarks that the species of dropsy here described
was most probably connected with organic disease of the parts situated
in the abdominal region, arising from inflammation with which they had
been previously attacked.
[478] This paragraph is pretty closely taken from the Coacæ
Prænotiones, 492. A good deal of stress is laid upon the state of the
temperature of the extremities in the reports of the febrile cases
contained in the Epidemics. He announces it as a general truth that
coldness of the extremities in acute diseases is bad. (Aphor. vii., 1.)
Sprengel considers that he has stated this fact in too general terms,
as there are many exceptions to it. (Hist. de la Méd., tom. i., 317.)
[479] This is taken in part from the Coacæ Prænotiones, 493. Sprengel
finds great fault with Hippocrates for laying it down as a rule, that
in cases of gangrene a black color of the part is less dangerous than
a livid. Dr. Ermerins, however, espouses the side of Hippocrates,
and maintains that our author has acutely pointed out the difference
between gangrene proving critical, and gangrene connected with weakness
of the vital actions in the part. In the former case the part becomes
perfectly black, whereas in the other it is livid. He mentions that
he observed in an hospital at the same time a case of mortification
from cold, and another of the same from want and congelation; that in
the former the part was black, and the patient recovered; whilst in
the other the arms were livid, and the patient soon died. (Specimen
Hist. Med., p. 68.) Stephanus, by the way, gives nearly the same
explanation of this remark. (p. 142.) Perhaps our author had in view
the plague of Athens, in which the disease often terminated favorably
in mortification of the fingers or toes. (Thucyd., ii., 49.)
[480] A considerable portion of the Prognostics from Sleep are taken
from the Coacæ Prænotiones, 497. This part is elegantly rendered
by Celsus: “Ubi nocturna vigilia premitur, etiamsi interdiu somnus
accedit; ex quo tamen pejor est, qui inter quartam horum et noctem
est, quam qui matutino tempore ad quartam. Pessimum tamen est, si
somnus neque noctu, neque interdiu accedit; id enim fere sine continuo
dolore esse non potest.” (ii., 4.) Stephanus gives a philosophical
disquisition on the nature and causes of sleep. (pp. 142–8.)
[481] This is pretty closely taken from the Coacæ Prænotiones, 601.
[482] A small part of this is to be found in the Coacæ Prænotiones, 609.
[483] Part of this is borrowed from the Coacæ Prænotiones, 601.
[484] Strigmentosa: that is to say, resembling the scrapings _or_
strippings of the bowels.
[485] This in part is borrowed from the Coacæ Prænotiones, 604, 631.
[486] This is pretty closely copied from the Coacæ Prænotiones, 495.
[487] This is taken from the Coacæ Prænotiones, 281. Several of the
other ancient writers on medicine, both Greek and Arabian, have
treated fully on the characters of the alvine discharges; but, upon
the whole, have not added much to the information contained in the
Coacæ Prænotiones and Prognostics. See the Commentary on PAULUS
ÆGINETA, B. II., 13. Stephanus has many interesting observations
on the prognostics from the urine. He remarks that the urine is a good
index of the condition which the digestive process is in, and more
especially the process of sanguification. (p. 162.)
[488] This is closely copied from the Coacæ Prænotiones, 575.
[489] According to Stephanus, both the farinaceous and leafy sediments
are the products of a melting of the solid parts, as a consequence of
inflammatory heat. (p. 165.)
[490] A small portion of the above occurs in the Coacæ Prænotiones, 578.
[491] For part of this our author is indebted to the Coacæ Prænotiones,
580.
[492] See Coacæ Prænotiones, 582.
[493] This is partly taken from the Coacæ Prænotiones, 577.
[494] Galen, in his Commentary, justly praises Hippocrates for the
acuteness of the remark contained in this sentence, since both with
regard to the urinary and fecal discharges, it must be highly important
to determine whether their characters be indicative of the condition
of the general system, or of the viscus by which they are secreted.
(Opera, v., p. 142; ed. Basil.) The ancients paid great attention
to the characters of the urine in disease, and their knowledge of
the subject will be admitted, even at the present day, to have been
remarkable. The works of some of the later authorities, particularly of
Theophilus and Actuarius, are well deserving of an attentive perusal.
See PAULUS ÆGINETA, Vol. I., p. 225.
[495] This is partly taken from the Coacæ Prænotiones, 556.
[496] These characters of the sputa are partly borrowed from the Coacæ
Prænotiones, 390, 399.
[497] They are founded on the Coacæ Prænotiones, 390, 391.
[498] This is taken in part from the Coacæ Prænotiones, 302, 304.
The succeeding paragraphs on empyema are also partly derived from
the Coacæ Prænotiones, 393, 402, 428. I may be allowed to remark
in this place that modern pathologists are agreed that abscesses
after pneumonia are of rare occurrence; at the same time, however,
purulent infiltration and its natural consequence, expectoration of
pus, are not so very uncommon results of the disease. True pulmonary
abscess or empyema is commonly occasioned by chronic inflammation. I
am inclined to think that the ancients applied the term also to the
cavities in the lungs produced by the softening of tubercles. It is
difficult otherwise to account for the frequent mention of empyemata
in the works of the ancient authorities on medicine, especially
in the Hippocratic treatises. See De Locis in Homine, p. 415, ed.
Foës; and tom. i., p. 306, ed. Kühn, et alibi. M. Littré makes the
following remarks on the descriptions of empyema which occur in the
Hippocratic treatises: “On remarquera dans le _Pronostic_, et
cette remarque s’étend à plusieurs autres des écrits Hippocratiques,
qu’une très-large place est faite aux affections de la poitrine,
péripneumonies et pleurésies. Il paraîtrait que, sous le climat de
la Grèce, ces affections ont une grande fréquence, plus peut-être
qu’elles n’en ont même dans notre climat. La description, fort abrégée
il est vraie, qu’en donne Hippocrate, me porte à penser que, si cette
description est exacte, elles ne suivent pas la même marche que parmi
nous. En effet, que sont ces empyèmes que, suivant Hippocrate, se font
jour an dehors sous forme d’expectoration purulente? On peut croire,
que dans les dénominations d’empyèmes sont compris les épanchements
pleurétiques; mais les épanchements pleurétiques ne se font pas jour au
dehors, ils se guérissent par résorption; alors, que sont ces empyèmes
signalés par Hippocrate, comme terminaison des péripneumonies, et ces
expectorations qui en procurent l’evacuation? Il m’est impossible de
répondre à ces questions: peut-être des observations faites dans la
Grèce même, permettraient de résoudre la difficulté.” (Œuvres Complets
d’Hippocrate, tom. ii., p. 97.) Perhaps, as I have hinted above, the
most probable answer that could be returned to the questions put by M.
Littré would be, that many of the cases of pneumonia terminating in
empyema, which occur in the Hippocratic treatises, were what are now
described as cases of acute phthisis. See Louis on Phthisis, ii., 2.
In confirmation of my supposition that many of the cases of empyema
described by the ancients were, in fact, cases of phthisis, I would
refer to PAULUS ÆGINETA, B. III., 32, where it will be seen
that the two diseases, phthisis and empyema, are treated of under the
same head. See also the second book of the Prorrhetics, tom. i., pp.
198–201; ed. Kühn.
M. Littré reverts to this subject in the Argument to the Coacæ
Prænotiones, tom. v., p. 576, where he relates, from two recent
authorities, a case of empyema after pleurisy, and another after
pneumonia, in both of which the pus was evacuated by the mouth. He also
quotes the remark of an English writer, Dr. Twining, that, in and about
Bengal, abscess of the lungs after pneumonia is by no means very rare.
Still M. Littré admits that the paucity of such cases in modern works
must lead to the conclusion either that Hippocrates had not observed
correctly, or that this termination is more rare now than formerly. I
leave the reader to judge whether my suggestion stated above does not
remove this difficulty.
[499] The observations of Andral have in some measure confirmed the
opinion of Hippocrates and other authors, ancient and modern, that
there are certain days in the duration of the disease in which there
is a greater tendency to amelioration. Of ninety-three cases, he found
twenty-three give way on the seventh, thirteen on the eleventh, eleven
on the fourteenth, and nine on the twentieth days. The recoveries in
the remaining cases commenced on twelve out of forty-two non-critical
days, as many as eleven being ascribed to the tenth day. Thus the
recoveries on critical days averaged as high as fourteen, while those
on non-critical scarcely exceeded three. (Dr. C. J. B. Williams on
Pneumonia, Cyclop. of Pract. Med., vol. iii., p. 405.) See also Andral,
Clin. Med., c. ii., p. 365.
[500] Stephanus has a lengthened and most important commentary on this
passage, containing an elaborate disquisition on empyema. (pp. 184–91.)
[501] This is taken pretty closely from the Coacæ Prænotiones, 395.
[502] A part of this is copied from the Coacæ Prænotiones, 396.
[503] It will be seen in our analysis of several of the Hippocratic
treatises, such as De Affect. Intern., De Morbis, etc., that it was
the common practice in such cases to evacuate the matter either by the
cautery or the knife. See also Aphorism, vii., 44.
[504] Part of this is borrowed from the Coacæ Prænotiones, 108.
[505] This is in part derived from the Coacæ Prænotiones, 471. Galen,
in his commentary, is at pains to explain that by a hard bladder
Hippocrates means a bladder in a state of inflammation.
[506] The subject of the critical days is not touched upon in the Coacæ
Prænotiones, so that the contents of this section are either original
or taken from some source with which we are totally unacquainted.
Galen, indeed, does not hesitate to declare that Hippocrates himself
was the first who treated of the critical days; but whether he had
any competent authority for pronouncing this opinion cannot be
satisfactorily determined. The critical days are incidentally treated
of in the Epidemics and Aphorisms; but, as we have stated in our
critique on the Hippocratic treatises in the Preliminary Discourse,
the work “On Critical Days” is in all probability spurious. The system
of the critical days taught by Hippocrates was adopted by almost all
the ancient authorities, with the exception of Archigenes and his
followers, who, however, were not numerous nor of any great name, with
the exception of Celsus. See the Commentary on PAULUS ÆGINETA,
B. II., 7, Syd. Soc. edition.
[507] The contents of this section are borrowed in a great measure from
the Coacæ Prænotiones, 160. Dr. Ermerins remarks that the headache here
described is probably of a catarrhal or rheumatic nature. (Specimen
Hist. Med. Inaug., etc., p. 84.)
[508] This is taken in great measure from the Coacæ Prænotiones, 189.
Galen in his commentary, remarks that patients die of violent pains of
the ear, owing to the brain sympathizing, which brings on delirium, and
sometimes occasions sudden death. I may be allowed to remark that every
experienced physician must have met with such cases.
[509] A considerable part of this section on ulcerated sore-throat is
extracted from the Coacæ Prænotiones. The present sentence is from
§ 276. The medical reader will not fail to remark that Hippocrates
displays a wonderfully accurate acquaintance with these affections.
[510] This is founded on the contents of the Coacæ Prænotiones, 363.
The disease here described is evidently angina laryngæa.
[511] This is taken in part from the Coacæ Prænotiones, 364. As Dr.
Ermerins remarks in his note on it, the disease here described is
evidently angina pharyngæa.
[512] This is closely copied from the Coacæ Prænotiones, 365. The
danger of erythematous swelling being determined inwards, is well
understood nowadays.
[513] This is taken, with slight alterations, from the Coacæ
Prænotiones, 365, 367. The latter clause is more fully expressed in
the Coacæ Prænotiones than in the Prognostics. “In those cases in
which cynanche is determined to the lungs, some die in seven days, and
some escaping these get into a state of empyema, unless they have a
pituitous expectoration.” This is evidently a correct description of
the disease spreading to the lungs.
[514] No part of this last clause is to be found in the Coacæ
Prænotiones. The operations of excising and burning the diseased uvula
are minutely described by Paulus Ægineta and other of the ancient
authorities. See PAULUS ÆGINETA, B. VI., 31. I need scarcely
remark that both these operations have been revived of late years.
[515] This is taken with little variation from the Coacæ Prænotiones,
146.
[516] A part of what precedes is taken from the Coacæ Prænotiones, 143;
all that follows, with the exception of a short sentence, is original.
[517] Our author here and elsewhere impresses it upon his readers that
it is from the _tout ensemble_ of the symptoms that a judgment
is to be formed in every case. This is evidently a remark of the most
vital importance in forming a prognosis. Galen’s observations in the
succeeding commentary are very interesting, and deserve an attentive
perusal.
[518] That is to say, the physician ought to get speedily acquainted
with the nature of the epidemics which prevail at every particular
season. I need scarcely remark that this is a subject which is
largely treated of in the works of our English Hippocrates, Sydenham.
Hippocrates himself is very full on this head, more especially in his
Epidemics and Aphorisms, as we shall see below.
[519] It has excited a great deal of discussion and difference of
opinion to determine what our author means by specifying these three
places; but the explanation given by Galen in his Commentary seems to
me quite satisfactory. According to him, the meaning of our author is
that good and bad symptoms tell the same in all places, in the hot
regions of Libya, the cold of Scythia, and the temperate of Delos. It
is further to be borne in mind that Odessus in Scythia, and Cyrene in
Libya, were the extremities of the Grecian world, whilst Delos may be
regarded as its centre. It is proper to remark, however, that by the
three places mentioned, Erotian understands the three quarters of the
earth--Africa, Asia, and Europe. See under Λιβύη.
[520] The meaning of this last sentence has been supposed to be
somewhat ambiguous; but to me it appears evidently to be this, that
the rules of prognosis, as laid down above, apply to all diseases of
an acute character, whether their names happen to be mentioned in the
course of this work or not, so that it should not be considered a
defect in the work that any one is omitted.
[521] See Epidem., i., and iii.
[522] Empyema is treated of in the Prognostics, the first book of
Prorrhetics, the Coacæ Prænotiones, and the work De Morbis. Which of
these is here alluded to cannot be determined for certain; it seems
probable, however, that it is to the preceding book of Prorrhetics.
[523] This important observation is thus rendered by Celsus: “Quæ in
latere linguæ ulcera nascuntur diutissimè durant. Videndumque est, num
contra dens aliquis acutior sit, qui sanescere sæpe ulcus eo loco non
sinit, ideoque limandus est.” (vi., 12.)
[524] Allusion seems to be made to herpes exedens.
[525] See PAULUS ÆGINETA, B. III., 25.
[526] Foës inclines to think that the proper reading in this place
is νοὔσος φοινικίη, and not φθινικὴ, and that Galen alludes to this
passage in his Exegesis under the former of these terms, where he
says that by φοινικίη νοῡσος was probably meant elephantiasis. The
other reading, however, would seem quite applicable, for I have known
phthisis and leprosy combined in the same case.
[527] The phrenitis of Sydenham in like manner was an epidemical fever,
and not an idiopathic inflammation of the brain. See Opera, p. 56; ed.
Syd. Soc. That Hippocrates regarded phrenitis as a variety of causus,
attended with determination to the brain, is obvious from Epidem. i.
See Op. Galen., tom. v., p. 371; ed. Basil.
[528] Horace, Serm. i., 2.
[529] One mode of exercise, namely, gestation, is to be excepted,
which had at least one distinguished advocate in ancient times. Celsus
writing of it says, “Asclepiades etiam in recenti vehementique,
præcipueque ardente febre, ad discutiendam eam, gestatione dixit
utendum: sed id pericolose fit; meliusque quiete ejusmodi impetus
sustinetur.” (ii., 15.) A great modern authority on fever, Dr. R.
Jackson, speaks favorably of this practice, although, as we see, it is
so pointedly condemned by Celsus. Celsus, however, admits of gestation
in that species of remittent fever which was called lethargus. (iii.,
20.)
[530] Observ. Med., vi., 3, 4.
[531] The Cnidian Sentences in all probability were the results of the
observations and theories made in the Temple of Health at Cnidos. We
may reasonably conclude from what we know of them, that, like the Coacæ
Prænotiones at Cos, the Cnidian Sentences at Cnidos were looked up to
in the time of Hippocrates as the great guides to medical practice.
How much, then, it is to be regretted that they have not come down
to us like the other! It is clear, however, from Galen’s Commentary,
that the work was extant in his time, and from it, as will be seen,
we are enabled to draw a few particulars respecting the theoretical
and practical views of the Cnidians. Le Clerc considers it likely that
Euryphon was the author of the Cnidian Sentences (Hist. Phys., i., 3,
30); but it is evident, from the terms in which Hippocrates refers
to them, that they were not the work of a single author. He makes
mention, it will be remarked, of more than one person being concerned
in remodelling them.
[532] By this our author means that the Cnidians neglected Prorrhetics
and Prognostics. This must be obvious to every person who had entered
properly into the spirit of the Hippocratic system of medicine.
[533] The text of this sentence is in a very unsatisfactory state, and
much difference of opinion has prevailed respecting the meaning. See
the annotations of Littré, and the remarks of Galen, as quoted in the
Argument.
[534] Galen, in his Commentary, mentions that the Cnidians described
seven species of diseased bile, and twelve diseases of the bladder;
and, again, four diseases of the kidneys; and, moreover, four species
of strangury, four species of tetanus, and four of jaundice; and,
again, three species of phthisis. Galen, having made this statement,
remarks that they looked to the peculiarities of the body, instead of
regarding the identity of the diatheses, as was done by Hippocrates.
In other words, they split diseases into endless varieties, instead
of attending to the essence or general nature of each. The system
of Hippocrates, then, was founded on a rational prognosis, whereas
that of the Cnidians was founded on mistaken principles of diagnosis.
The principles of the Hippocratic system are admirably explained and
developed in Galen’s great work On the Method of Cure, _or_
Therapeutics.
[535] Galen, in his Commentary on this passage, states that when a
disease of a mild character prevailed generally, it was called an
epidemic; and when of a malignant nature, it was called the plague.
(See further PAULUS ÆGINETA, Book II., 36, Syd. Soc. edition.)
It will be remarked that I have included the word (_not_) in
brackets. This I have done because not only the reading, as given in
the common editions of Galen, is in its favor, but because the sense
appears to me to require it. Surely when diseases are of an epidemic
character they are similar; but when they are sporadic, they are not
similar. M. Littré, however, rejects it altogether.
[536] The question here mooted is certainly one of the most important
that can well be entertained, namely, whether or not a certain portion
of nutriment ought to be given to persons laboring under fever. It
would appear, from what is stated by Galen upon the authority of
Erasistratus, that the most diametrically opposite modes of practice
had been followed by different individuals--that some had starved
their patients altogether for a considerable time; whereas, on the
other hand, a physician of the name of Petronas allowed his patients
flesh and wine. Our author, it will be remarked, does not allude to
these extreme modes of practice in this place, but enters at great
length into the question whether or not unstrained ptisan (_or_
barley gruel) should be administered in fevers, and, if so, under what
circumstances.
[537] Galen, in his Commentary, has some very interesting remarks on
the differences of opinion among the diviners. This, in fact, may well
be supposed, since, as will now be pretty generally acknowledged, the
whole art was founded upon conjecture and deception. The comparison of
medicine to divination is therefore very discreditable to the former.
[538] Our author now enters upon the consideration of one of his
principal objects in the present work, namely, to describe the modes of
preparing ptisan (_or_ the decoction of barley), and its uses in
acute diseases. He is so full on this subject that the present treatise
is quoted by Athenæus (Deipnos. ii., 16), by the name of the work On
the Ptisan. Galen states that, on the principle that diseases are to
be cured by their contraries, as the essence of a febrile disease is
combined of heat and dryness, the indication of cure is to use means
of a cooling and moistening nature, and that the ptisan fulfils both
these objects. I may be allowed to remark in this place, that probably
there is not a more important rule in the whole practice of medicine
than this, that fevers are to be treated by things of a cooling and
diluent nature. I may mention further regarding the ptisan of the
ancients, that it would appear to have been very little different from
the decoction of barley, as now in use; that is to say, it was prepared
from pearl-barley roughly pounded and boiled for a time in water. As
will be seen by the text, it was given to the sick either strained or
entire, according to circumstances. A similar decoction was prepared
from wheat, and was called πτιαάνη πυρίνη. See Galen (De Aliment., i.)
The simple term ptisan, however, is always to be understood as applying
to the decoction of barley.
[539] Galen gives the following illustration of what is meant by a
disease of a peculiarly dry nature. In pneumonia, pleurisy, and in all
the affections about the lungs and trachea, the disease is held to be
of a dry nature when there is no expectoration from the parts affected;
and in any complaints about the liver, the mesentery, the stomach, the
small or great intestines, or spleen, when the belly is either entirely
constipated, or when the discharges brought away by artificial means
are dry and scybalous; and diseases of the arteries and veins are known
to be dry by the dryness of the tongue, and the parched appearance of
the whole body. In the same manner external ulcers are accounted dry
when there is no discharge from them. And ophthalmies are held to be
dry when there is no discharge from the eyes or nose. And, in short,
all diseases are recognized as being dry which are not attended with
any discharge.
[540] It is curious to remark that a double charge was founded against
our author on the ground of his treatment of febrile cases, as here
laid down. The followers of Thessalus held that he gorged his patients
with too much food, whereas Erasistratus and his followers held that
he starved them. Galen, on the other hand, contends that the practice
of Hippocrates is the _juste milieu_ between these two extremes.
(Opera, tom. v., p. 47; ed. Basil.)
[541] This sentence shows that Hippocrates understood thoroughly
the proper treatment of pleurisy. When the disease did not yield to
fomentations, but the pain continued, either a vein was opened or the
bowels moved; for without first using these means, it was reckoned
fatal practice to administer ptisan. Galen relates that it was also
considered an unsafe practice to give opium, mandragora, or hyoscyamus
for the purpose of alleviating the pain, instead of having recourse
to venesection or purging for the removal of it. This is a practical
remark well deserving of the most serious consideration.
[542] How briefly, and yet how graphically, our author has described
the termination of pleurisy! It is singular that no succeeding author
has written so learnedly of _râles_ in affections of the breast
as Hippocrates, down at least to the time of Laennec, who repeatedly
acknowledges his obligations to our author.
[543] I need scarcely remark that the seasonable administration of
drink, and especially of water, is one of the most important points
connected with the treatment of febrile diseases. This is so much the
case that, as Galen remarks in his Commentary on this passage, fevers
may often be extinguished at once by a large quantity of water given
in due season. This subject is fully treated of by him in his Methodus
Medendi.
[544] The professional reader will not fail to remark, what is pointed
out in strong language by Galen, how judiciously our author commences
with the most gentle means, and gradually rises to the most powerful
and dangerous; namely, bleeding and the administration of drastic
purgatives. One cannot help being further struck with the rich supply
of information which he has on the simple subject of fomentations.
[545] By livid (πέλιον) is here meant the colour intermediate between
red and black. See Galen, h. 1.
[546] Probably the _Helleborus niger_. See PAULUS ÆGINETA, Vol. III.,
p. 108.
[547] The _Euphorbia peplus_. See Ibid., Vol. III., p. 294.
[548] Probably the _Seseli tortuosum_. See Ibid., Vol. III., p. 330;
and Dierbach, Arzn. der Hipp. p. 186.
[549] A species of asafœtida, probably the _Laserpetium derias_. PAULUS
ÆGINETA, Vol. III., p. 339.
[550] It is worthy of remark, that our author directs aromatics to be
mixed with the purgatives. The reason for prescribing them, as Galen
states, was to counteract the bad effects of the purgatives upon the
stomach. The ancients, in my opinion, acted much more wisely in this
respect than the moderns generally do, for the latter are constantly
administering the most nauseous cathartics to their patients without
taking any pains to obviate their bad effects upon the stomach. On the
ancient modes of administering purgatives, see PAULUS ÆGINETA,
B. VII., 4.
[551] Galen, in his Commentary, remarks that the common herd of
physicians followed the very opposite rule to that here laid down
by Hippocrates, that is to say, they administered food copiously
after evacuations. According to Galen, the object of Hippocrates in
proscribing food of all descriptions at that season is, because the
powers of the system, being then weakened, are unable either to bear
food or to digest it.
[552] See Celsus, I., 3.
[553] The _cyceon_ was a mixture of various articles of food, but
generally contained cheese, honey, and wine. See Athenæus (Deipnos,
ii.). It is described by Homer as the potion which Circe administered
to the followers of Ulysses. (Odyss. x., 235). There is frequent
mention of it in the Hippocratic treatises, as at De Diæta, ii.; de
Muliebribus, ii.; and in the works of the other medical authors.
[554] The meaning here is somewhat obscure, but appears to be this:
that if a patient fast for the first two or three days, and take food
of a heavy nature on the fourth or fifth, he will be much injured, but
that the mistake will be still more fatal if the fast be continued for
the first four or five days, and if he then indulge freely in food at
the end of these.
[555] There is considerable difficulty as to the text at this place.
See Foës in his Annotations and Œconomica, and a very lengthy note by
Littré.
[556] The preternatural mode of respiration here described is several
times adverted to by Galen, as at De Dyspnœa, iii.; Comment. in Aphor.,
iv., 68; and Comment. in h. 1. Galen seems to understand the meaning to
be, that the breathing is intercepted in the inspiration. I should have
rather been disposed to think that it is the expiration which is said
to be interrupted. But I suppose we must bow to so great an authority
as Galen! I may mention, by the way, that his Commentary on this and
the collateral passages of our author is most interesting; but, as
usual, too diffuse for my narrow limits. It relates to a most important
point in medical practice, on which great ignorance and uncertainty
prevail among us, even at the present day.
[557] Galen finds the language in this last sentence so confused, that
he does not hesitate to declare that he is convinced the work must have
been left by Hippocrates in an unfinished state, and not published
until after his death. He decides that ἐφθότης signifies a heated
state connected with humors, and not with dryness; that is to say, a
condition analogous to boiling, and not to roasting.
[558] Galen, in his elaborate Commentary on this section, complains
that our author’s account of wines is imperfect, inasmuch as several
varieties are omitted; at the same time it must be admitted that his
observations on this head are very much to the purpose, and highly
judicious. For the other ancient authorities on this subject, see
PAULUS ÆGINETA, Book I., 95, Syd. Soc. edit.
[559] I need scarcely mention that hydromel was a drink prepared by
boiling honey in a large proportion of water. It was of different
degrees of strength; sometimes there were only two parts of water to
one of honey, and at other times from seven to eight parts were used
See PAULUS ÆGINETA, Book I., 96, Syd. Soc. edit.
[560] Galen, in explanation, mentions that hydromel is of a detergent
nature; and hence it clears out the air-passages, and thus promotes
expectoration. When the sputa are thick and viscid, it cuts and
attenuates them. (Opera, tom. v., pp. 75, 76; ed. Basil.)
[561] Although, as we have shown in our analysis of the treatise on
the Use of Liquids, Hippocrates and his followers were sufficiently
liberal in the administration of water on proper occasions, it will be
seen from the contents of this section that our author was by no means
disposed to give water freely in febrile diseases, nor in affections
of the chest. Whatever may now be thought of his observations on this
point of practice, all must admit that they are deserving of high
attention. Galen’s Commentary is also very interesting. It appears
from it that he disapproved of giving water alone, but always added a
small proportion of wine to it in order to give it a flavour. That the
quantity of wine which was added to the water must have been small, is
obvious from an anecdote which he relates in this place. He says that a
certain physician, who saw the insignificant amount of the wine which
was put into the water, said, bantering him, “Your patient will have
the pleasure of seeing the wine indeed, but will not be able to taste
it.” Galen, however, contends that, although the quantity thus added be
small, it is sufficient to act as a stomachic, and to obviate the bad
effects which the water would otherwise produce. (Opera, tom. v., p.
83; ed. Basil.) It will be perceived from the context, that Hippocrates
intended to give a separate treatise on each particular disease, not
considering the present work on general therapeutics sufficiently
explicit, as Galen remarks.
[562] The smegma was an abstergent composition used by the ancients in
bathing for the purpose of cleansing the skin. For a full account of
the smegmata, see PAULUS ÆGINETA, Vol. III., pp. 536–41.
[563] Galen, in his Commentary, remarks that the physicians usually
did not put their patients into the baths, but made use of the
_douche_, or affusion of hot water. He adds, that persons in good
health may leave the hot bath and plunge into the cold, but that this
practice is not safe in the case of invalids. He recommends, then, that
there should be at hand a good supply of baths of various temperatures,
so that the patient may gradually pass from one of a high to others
of a low temperature. By the way, I have often wondered that Dr.
Currie, who certainly had no inconsiderable pretensions to classical
scholarship, should have been so profoundly ignorant as he appears to
have been of the use of the warm affusion by Hippocrates and Galen in
the treatment of febrile diseases. His rival, Dr. Jackson, had a much
more respectable acquaintance with the ancient authorities on medicine;
and I have often thought it was to be regretted that the profession at
that period, in giving a trial to the affusion of cold and hot water in
fever, put itself under the leadership of Currie instead of Jackson.
[564] Dr. Tweedie’s observations agree so well with those of
Hippocrates, that I will give the reader an opportunity of comparing
them together. “This organ (the stomach), in convalescence, partakes
of the external or muscular debility, and the convalescent may as well
expect to be able to carry a heavy load on his shoulders as to digest
an undue quantity of food, even of a suitable kind.” (p. 215.)
[565] The directions given by that excellent authority Alexander
Trallian, for the regulation of the regimen in phrenitis, are to the
same effect. Wine is to be given when there is much insomnolency, when
the strength is reduced, when the fever is no longer strong and ardent,
and _when concoction appears already in the urine_. The author
makes the acute remark, that the remedy is attended with certain evil
consequences, but that it is the part of a prudent physician to balance
the good and bad effects, and administer the article in question when
the good preponderate. (i., 13.)