The Writings of Hippocrates and Galen (2024)

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{{Template}}The Writings of Hippocrates and Galen is a book by John Redman Coxe.

THE WRITINGSOFHIPPOCRATES AND GALEN.EPITOMISED FROM THE ORIGINAL LATIN TRANSLATIONS,BYJOHN REDMAN COXE, M.Ď.,MEMBER OF THE BATAVIAN SOCIETY OF SCIENCES AT HAARLEM; OF THE ROYALMEDICAL SOCIETY, AND OF THE ROYAL SOCIETY OFSCIENCES OF COPENHAGEN, ETC.STORLABR.NEW-YORYMulta renascentur.PHILADELPHIA:LINDSAY AND BLAKISTON.1846.Entered, according to the Act of Congress, in the year 1846,By JOHN REDMAN COXE, M. D.,In the Clerk's office of the District Court for the Eastern District of Pennsylvania.C. SHERMAN, PRINTER,19 St. James Street.TO THE READER.THE writings that have reached us under the name of Hippocrates, the so-called " Father of Medicine, " occupy more thana thousand folio pages in the edition by Fosius. Those attributed to Galen are still more voluminous, embracing no less thansix or eight immense folios. It may, from this plain statement,be readily conjectured, how impossible must be the attempt toconvey even a tolerable idea of them, in the small compass of afew hundred octavo pages. A perfect comprehension of the fullvalue of both these literary and: scientific works can only beattained by referring to the original writings, or to a completetranslation.With the exception of a few of the Hippocratic treatises, anEnglish translation has never appeared. Of the writings ofGalen, not one has received that form, for the benefit of theEnglish reader. And yet the names of both these great menare familiar to our ears, as though they were the daily companions of our medical researches. Our teachers refer to themex cathedra; our books continually quote them; and yet, notiv TO THE READER.one in a hundred of the Profession, at least in America, have everseen them, and if interrogated, could not inform us of what theytreat.From what is thus said, it will appear evident to every reflecting mind, that the only object of the Editor, is that of affording aslight view of the subject-matter of the extensive treatises ofthese venerable writers; too slight indeed to constitute even animperfect idea of a tithe of their merits, yet enough, he hopes,to give an impulse to a further research of their interestingpages. It is not creditable to the Profession, either of GreatBritain or America, that a full translation of both these authorshas never yet been given to the English reader! and that, inAmerica at least, even in the original Greek, or Latin translation, so few copies are to be found, whilst hundreds of contemptible works are annually issuing from the press, to lumber up ourshelves, and to pass into oblivion. Few are the authors of thepresent day, who attend to the Roman poet's important precept,of " Nonum prematur in annum. " Scarcely has the studentescaped from his alma mater, when he deems himself qualifiedto become an author, and straightway gives to the world alearned work, purloined from the: "Dictionnaire des SciencesMédicales," or some analogous production, on some disease hehas never seen, but quoting authorities of ancient date, apparently familiar as his household gods!The gratification I have experienced in looking over thewritings of these pioneers of medicine, has led me to believethat even this imperfect exposition may be acceptable to many;and that more especially, since few are likely to possess them intheir complete and perfect form; yet it is necessary again torepeat, that to estimate the whole by this defective abstract,TO THE READER.would be like one who judged of the character of a building byexamining a brick which formed a fractional part of it. I havetherefore to request all due allowance for this attempt to introduce to my contemporaries, a few faint traces of their medicalprogenitors, who lived two thousand years before them.To enable the reader to judge of the difference of opinion thathas existed, with respect to the writings that have reached usunder the name of Hippocrates, amounting to nearly seventy innumber; I have given the arrangement by three editors, viz. ,Fosius and Haller, in their Latin translations, and of Gardeil,in a French one; by which it will be seen, that no entire agreement between them is to be found. One thing alone seems evident, viz. , that of these seventy treatises, about twelve or fourteenonly, are uniformly attributed to this illustrious man. The othersare variously ascribed to his son, his son-in-law, or to writersanterior or posterior to him. The arrangement I have myselfpursued, is that of Fœsius; not from any particular predilection,but from the accidental circumstance of his edition being thefirst that came into my possession, long before I even knew thatthe others had translated these writings. My copy of Fœsiusbears the date of 1624,-that of Haller, 1775,-and that of Gardeil, 1801. Since then, an edition has been given by Kühn, in1825, in which he chiefly follows Fosius, with few alterations.Fosius has abundant notes on nearly every treatise, besides fortyor fifty pages of " various readings," from numerous commentators, but which would apply solely to a full translation, andtherefore altogether unsuitable to the nature of this work.vi TO THE READER.As this abstract was originally formed for personal convenience, and without the remotest view of ever committing it topress, I have additional reason for requesting the indulgence ofmy readers for any errors they may find therein. I am now toofar advanced in life to again retrace the immense folios, which,thirty years ago, afforded me so much pleasure, but which atpresent I can merely recur to for occasional reference; and Iregard this outline but as a pioneer, to aid perhaps the labours ofa younger and more accomplished translator of the entire work.JOHN REDMAN COXE.Philadelphia, Sept. 16 , 1846.TABLE OF CONTENTSTO THE ABSTRACT OF HIPPOCRATES.PAGE.To the Reader,Table of Contents to this English edition,66 66 66 to Galen,379Arrangement of Fœsius, 13 66 of Haller,66 of Gardeil,·1415Introduction, consisting of a concise notice of the lives and writings ofHippocrates and Galen-from Le Clerc,The Oath of Hippocrates,1742The Law of Hippocrates,Of the Art of Medicine,4446Of the Art of Medicine in former times,Of the Physician, -Of Decency and Decorum,The Precepts of Hippocrates,The Book of Prognostics,Hippocrates on the Humours,66 on Crises,556975798599-109 66 on Critical Days,117Predictions of Hippocrates, Book 1 ,66 66 66The Coan Prognostics,Of the Nature of Man,Of Generation,Of the Fatal Nature,Of the Origin of Man,Of the Seven- Month Birth,Of the Eight-Month Birth,Of Superfætation,Of Dentition,122Book 2,124143147159162167169171172174Of the Heart,175Of the Glands,Of the Nature of the Bones,Of Airs, Waters, and Localities,Of Flatus,. 176177· 179198viii CONTENTS OF ABSTRACT OF HIPPOCRATES.Of Epilepsy,Of a Healthy Diet,Of Regimen, Books 1 , 2, 3,Of Dreams,Of Aliment,- Of Food in Acute Diseases,Of the Different Parts in Man,Of the Employment of Liquids,Of Diseases, Books 1, 2, 3, 4,Of Affections,·Of Internal Affections,Of the Diseases of Virgins,Of the Nature of Woman,Of Female Diseases, Books 1, 2,Of Barrenness,201204206, 210, 213215217219225252254, 259, 265, 268273278· 284286291, 303306Of Vision,Of the Shop or Office of the Physician,Of Fractures,Of the Joints ,Of Ulcers,- Of Fistulæ,Of Hæmorrhoids,Of Wounds of the Head,Of Dissections,308309311313Of the Reduction of Fractures and Luxations, 315316318319320Pestilential Constitution,·Of the Extraction of the dead Fœtus,The Epidemics of Hippocrates, Books 1, 3,Thucydides on the Plague at Athens,Clifton's proof of this not being that described by Hippocrates,Epidemics, Book 3, continued,Books 2, 4, 5, 6, 7,The Book of Aphorisms,Extraneous,Epistolæ Hippocratis,Notices of his Life,De Hominis Structura,321323324, 345351356· 360363371, 381, 399, 411, 414451454454455456De Natura Hominis,456Liber de Etate, 457De Septimestri Partu , 457De Significatione Vitæ et Mortis secundum Motum Lunæ, &c. , 457De Medicamentis Purgantibus,457De Veratri Usu, 458De Antidoto,458Antidotum,De Re Veterinaria,Conclusion of Hippocrates,458459459TABLE OF CONTENTSTO THE ABSTRACT OF GALEN.Introductory Remarks,Notice of Editions of his Works,·PROLEGOMENA, SEU LIBRI ISAGOGICI,Division of his Writings into Seven Classes, &c. ,Introductory Treatises, sixteen in number,Oration in favour of the Arts and Sciences,Agood Physician must be a Philosopher, -Of Verbal Sophistry, -If the Qualities of Bodies are incorporeal'Of the appropriate Books of Galen,Of the Order of his Books,Of the different Sects in Medicine,Of the best Sect, -Of the best mode of Education,An Exposition of the Empiric Sect,Essay in opposition to the Empiric Sect,Of the Constitution of the Art of Medicine,Of Medical Definitions,Introduction to Medicine, -Of the Detection of simulated Diseases,Of the Art of Medicine,·Class First. -OF PHYSIOLOGY,-28 Treatises,Of the Elements,Of Temperaments,·Commentary on the Book of Hippocrates entitled De NaturaHumana,Of the Atrabilis,Of the best bodily Constitution,Of a good Habit of Body,Of the Bones,Of Muscular Dissection,Of the Dissection of the Nerves,Of the Dissection of the Veins and Arteries,Is Blood naturally contained in the Arteries?Anatomical Investigations, -in 9 Books,PAGE.- 464473· 473474· 478479480480481481481482· 482483483484-484485· 486488· 488490491492493494496496497497499· 499500502X CONTENTS OF THE ABSTRACT OF GALEN.PAGE.Discovery of the six missing Books of Galen, (Note)519Of the Dissection of the Uterus,520Of the Organ of Smell,· 522Of the Uses of the different Parts of the Body-in 17 Books,523Of the Utility of Respiration,533Of the Causes of Respiration,535Of the Use of the Pulse,536Of the Subsistence of Natural Faculties, 537Of the Opinions of Hippocrates and Plato-in 9 Books,Of the Natural Faculties,538545Of Muscular Motion,548Of the Motion of the Thorax and Lungs, 549The Qualities of the Mind depend on the Corporeal Temperament,· 550Of the Fatal Formation,552Of the Semen,· 554If all parts ofthe Foetus are constituted simultaneously? 556If the Uterine Fœtus is an Animal? 557Of the Seventh-Month Birth, 558Class Second.- HYGIENE,559Three Commentaries on the Hippocratic Treatise ofAir, Water,and Localities,560Of the Powers of Aliment, 561Of the good and bad Juices of Food,· 562Commentary on the Hippocratic Book of a Healthy Diet,Of the Reasons for attention to Diet,564· 565Of the Ptisan, or Barley-Water, -Of the Game of Fives, or Tennis,565566Of the Knowledge and Cure of Mental Affections , 567A second Book on the same, 569Of Habit or Custom, 570Of the Preservation of Health, -in 6 Books, 571Whether the Preservation of Health depends on Medicine orExercise? 574Class Third. -ÆTIOLOGY, 576Of the Difference and Causes of Diseases and Symptoms, -in 6Books,· 577Ofthe Difference of Fevers, -in 2 Books, 582Of an unequal Intemperies, 583Of Atrophy or Marasmus, 584Of Coma, - 585Of Tremor, Palpitation, Rigor, and Convulsion, 585Of Difficult Respiration, -in 3 Books,586Of Plethora, · 587Of Præternatural Swellings,Of the Periods or Stages of Diseases,588588CONTENTS OF THE ABSTRACT OF GALEN. xiPAGE.Of the Periods of the entire Disease, 589Of the Form or Order of Diseases, 590Address to Writers on the Types of Diseases, 591Of Procatarctic Causes,5911st Commentary on the 1st Epidemics of Hippocrates,5922d 66 66 2d 66 66 5933 Commentaries 66 3d 66 66 593Commentary 66 6th 66Three Commentaries on the Book of Humours of Hippocrates,Class Fourth.-SEMEIOTICS, ·On the Parts affected by Disease, -in 6 Books,Treatise on the Pulse, for Students,66 594595596597600Of the Difference of Pulses, -in 4 Books,Of the Knowledge of the Pulse, -in 4 Books, -Of the Causes of the Pulse, -in 4 Books,Of Prediction from the Pulse, -in 4 Books,Synopsis of the 16 Books on the Pulse,· 602606· 607609610On Urines,614Of Crises,616Of Critical Days,618Three Commentaries on the 1st Prorrhetics of Hippocrates,Three Commentaries on the Prognostics of Hippocrates,619620Of Indication from Dreams, 620Of Prognosis,621·Of Medicinal Substitutes,Class Fifth. -PHARMACY,Of the Powers of Simple Remedies, -11 Books,Of the Powers of Purgative Remedies,622623· 625625Whom, with which, and at what time, Purgation is proper,626Of the Theriaca,626Ofits use,627Of Antidotes, -in 2 Books, 627Of the Composition of Local Remedies, -in 10 Books, -Of the Composition of Remedies, per Genera, -7 Books,Of Weights and Measures,Class Sixth. -INSTRUMENTS OF CLINICAL PRACTICE,Of Leeches, Revulsion, Cups, and Scarification,Of Venæsection in opposition to Erasistratus,628631· 633634635636Of 66 in opposition to the Erasistratians of Rome, 638Of the Rationale of Bloodletting, 638Class Seventh.-THERAPEUTICS, 642Of the Mode of Cure, -in 14 Books, 643Of the Method of Cure, -in 2 Books, · 646Four Commentaries on Hippocrates' Book, on Food in AcuteDiseases, 648Of the Hippocratic Diet in Acute Diseases, 649xii CONTENTS OF THE ABSTRACT OF GALEN.PAGE.Of Remedies readily prepared, -2 Books, 649, 650Advice for an Epileptic Boy,651Of Incantation, Adjuration, and Charms,651Second Commentary on the Book De Natura Humana, 652Treatment of Ophthalmic Affections, 652Of Disease of the Kidneys and its Cure, 653Three Commentaries on the Hippocratic Treatise of the Officeof a Physician, -653Three Commentaries on Hippocrates' Book of Fractures, 654Four Commentaries on Hippocrates' Book on Luxations, 654Of Bandages,Of Ligatures,655656Of Surgical Apparatus,656Additional Class-Having reference to Galen's seven Commentariesof the Aphorisms of Hippocrates, &c. ,657Spurious Writings that have been attributed to Galen, -in thirty-threetreatises, 659-668works, & c. ,·Fragments discovered, having some relation to various parts of Galen'sDifficulties in perusing the old editions of Galen enumerated,Chartier's List of the Books of Galen, from Le Clerc,669670671ARRANGEMENT OF THE WRITINGS OF HIPPOCRATES.By Fasius.- Under Eight Sections.SECTIO 1. De Alimento.De Victus Ratione in Morbis Acutis.De Locis in Homine.De Liquidorum Usu.Hippocratis Jusjurandum.Hippocratis Lex.De Arte.De Prisca Medicina.De Medico.De decenti Habitu, aut decoro.Præceptiones.SECTIO 2.Prænotionum Liber.De Humoribus.De Judicationibus.De Diebus Judicatoriis.Prædictorum,-Libri 2.Coacæ Prænotiones.SECTIO 5.De Morbis,-Libri 4.De Affectionibus.De Internis Affectionibus.De his quæ ad Virgines spectant.De Natura Muliebri.De Mulierum Morbis, -Libri 2.De his quæ Uterum non gerunt.De Videndi Acie.SECTIO 3.De Fracturis,De Articulis.SECTIO 6.De Natura Hominis.De Genitura.De Natura Pueri.De Carnibus.De Septimestri Partu.De Octimestri Partu.De Superfœtatione.De Dentitione.Vectiarium.De Ulceribus.De Fistulis.De Hæmorrhoidibus.De Capitis Vulneribus.De Fœtus mortui exsectione.De Corporum resectione.De Corde.De Glandulis.De Ossium Natura.De Aëre, Locis, et Aquis.De Flatibus.De Morbo Sacro.SECTIO 7.De Morbis Popularibus, -Libri 7.Aphorismorum, Liber.SECTIO 4.De Salubri Victus Ratione.De Victus Ratione, -Libri tres.De Insomniis.SECTIO 8.Epistolæ aliquot.Athenensium Senatus-Consultum.Oratio ad Aram .Thessali Legati Oratio.Genus et Vita Hippocratis, Sorani.ARRANGEMENT OF THE WRITINGS OF HIPPOCRATES,By Haller.-In 4 vols. 8vo. -Lausanne, 1775.Tomus primus continet1. Hippocratis librum de Aeribus,Aquis, et Locis.2. De Natura Hominis.3. De Locis in Homine.4. De Humoribus.5. De Alimento.6. De Morbis Popularibus, lib. 1.7. De Morbis Popularibus, lib. 3.8. Prognosticon.9. Prædictionum , libri duo.10. De Victus Ratione in Morbis Acutis,-Libros 4.11. De Fracturis.12. De Articulis.13. Mochlicus.14. De Capitis Vulneribus.15. De Officina Chirurgi.16. Aphorismorum, -Sectiones septem .Tomus secundus continet1. Hippocratis librum de Corporumresectione.2. De Carnibus seu Principiis.3. De Ossium Natura.4. De Corde.5. De Glandulis.6. De Genitura.7. De Natura Pueri.8. De Septimestri Partu.9. De Octimestri Partu.10. De Superfœtatione.11. De Dentitione.12. De Prædictionibus.13. Coacæ Prænotiones, sectiones tres.14. De Judicationibus.15. De Diebus Judicatoriis.16. De Morbis Popularibus, lib. 2.17.66 แ lib. 4.18. 66 66 lib. 6.19. 66 66 แ lib. 5.20.66 66 66 lib. 7.21. De Adfectionibus, -Sect. 3.Tomus tertius continet1. Hippocratis librum 1 , De Morbis.2. 66 ejusdem librum 2.3.แ ejusdem librum 3.4.66 ejusdem librum 4.5. Muliebrium, lib. 1.6. Muliebrium, lib. 2.7. De Natura Muliebri.8. De Sterilibus.9. De Morbis Virginum.10. De Morbo Sacro.11. De Insania.12. De Flatibus.13. De Visu.Tomus quartus continet1. Hippocratis de Sanorum Victus Ratione, librum 1mum.2. " ejusdem, librum 2dum .3. " ejusdem, librum 3tium.4. De Victus Ratione Salubri.5. De Insomniis.6. De Ulceribus.7. De Fistulis.8. De Hæmorrhoidibus.9. De Veteri Medicina.10. De Arte.11. De Medico.12. De Decenti Habitu.13. Præceptiones.14. De Lege.15. De Jurejurando.16. De Hominis Structura.17. De Natura Hominis.18. De Etate.19. De Ætate, Fragmentum .20. De Septimestri Partu.21. De Significatione Vita et Mortissecundum motum Lunæ et adspectus Planetarum.22. De Liquidorum usu.23. De Medicamentis Purgantibus.22. De Internis Adfectionibus, -Sect. 3. 24. De Veratri usu.ARRANGEMENT OF THE WRITINGS OF HIPPOCRATES. XV25. Antidotos.26. De exsectione Fœtus.27. De Re Veterinaria.28. Epistolas.29. Vitam ex Sorano.30. De Vita et Familia Scriptisque Hip.pocratis testimonia.31. Fragmenta et Elogia.32. Consentientia.33. Contradicta et Defensa.ARRANGEMENT OF THE WRITINGS OF HIPPOCRATES ,By Gardeil. -4 vols. 8vo. -Toulouse, 1801.Gardeil divides his translation into two parts. The first comprises only thosetreatises that are uniformly attributed to Hippocrates; the second part contains suchas are ascribed to either his son, Thessalus, or to Polybius, his son-in-law.Des Prognostics.Des Humeurs.Des Prédictions.De la Nature de l'Homme.Partie première, savoir,Des Airs, des Lieux, et des Eaux.Des Alimens.Du Regime dans les Maladies Aiguës.Des Lieux dans l'Homme.Du Laboratoire du Chirurgien.Des Fractures.Des Articles.Le Mochlique.Des Plaies de la Tête.Des Épidémies, liv. ler.66 66 liv. 3me.Aphorismes.Partie seconde.Le Serment.La Règle.De l'Art.De l'Ancienne Médecine.Du Médecin.De la Décence.Les Avis.Des Crises.Des Jours Critiques.Prédictions.Coaques.De la Génération.De la Nature de l'Enfant.Des Chairs.De la Grossesse de sept mois.De la Grossesse de huit mois.De la Superfétation.De la Dentition.Du Cœur.De la Diète salubre.Du Régime.Des Songes.De l'Usage des Liquides.Des Maladies.Des Affections.Des Affections Internes.Des Affections des Filles.De la Nature de la Femme.Des Maladies des Femmes, liv . ler.66 66 66 66 liv. 2de.Des Femmes Stériles.De la Vue.Des Plaies.Des Fistules.Des Hémorroïdes.De l'Extraction du Fœtus.De la Dissection des Corps.Des Epidemies, liv. 2.Des Glandes.66 66 liv. 4.De la Nature des Os.Des Vents.66 liv. 5.66 66 liv. 6.De l'Epilepsie, ou Maladie sacrée.66 46 liv. 7.

AN ABSTRACTOF THEWRITINGS OF HIPPOCRATES.

INTRODUCTION.COULD man, as well as animals in general, invariably subsist intheir natural state; in other words, if their functions always continued perfect in consequence of the perfect state of their organs,they would enjoy perpetual health, and disease being unknown,the objects of the physician could never have come into existence.This, however, not being the case, and disease from varioussources springing up in his path, man necessarily was led to investigate the causes tending to such a change, and equally impelledto attempt the discovery of the means of relief. As experiencecould alone enlighten him on a subject so interesting to his temporal concerns, and as such experience could be elicited solely byobservations, such observations long continued must have givenrise to that science which is designated by the name of Medicine.We stop not to inquire whether such knowledge proceeded fromheaven, as was formerly imagined. However this might have beenmaintained in the early ages of the world, we must now be satisfiedthat reason and reflection gave the first impulse to those inquiriesand researches, by which Medicine sprang into existence, andthrough which it has reached us in the state we find it. TheBabylonians are even affirmed by Herodotus to have exposedtheir sick in public places, for the benefit of the advice of passersby, who might have previously witnessed similar cases of disease,and hence be enabled to apply their experience for their cure.Strabo relates the same, not of the Babylonians alone, but likewiseof the Egyptians and others; hence it appears, that although in theearly periods of the world there might not be physicians strictly socalled, yet that medicine, practically, was pursued even by themost barbarous nations; and although we read in fable, or history(then, and perhaps even now, not much more real) , that the invention of medicine is attributed to some particular individuals, we arenot to suppose that such persons were actually the first who pre218 INTRODUCTION.scribed remedies, but rather that this honour was given to them,from their being among the first who particularly devoted themselves to medicine, and thereby excelled the common mass, by thesuperiority attained through experience more amply afforded.race.If Adam and his immediate descendants were subject to the common laws of nature, disease from various causes must necessarilyhave produced its usual effects on their frame, and it cannot besupposed that attempts would not even then be made, and that mostsedulously, from parental affection, to mitigate the sufferings thatwere conspicuous. Unquestionably then, in a limited view of thesubject, medicine may be presumed to be coeval with the humanAges however probably elapsed before any individualcould directly claim to be acknowledged as a physician; and,accordingly, we find but few recorded even remotely as such, orwhose acquirements in this science have descended to us. Weread of Bacchus, Zoroaster, Hermes, and others, who are supposedto be the same with some of the early noticed personages of HolyWrit: but speculation has been as endless as it is useless, inattempting to reconcile all the absurdities of remote antiquity, inwhich oral tradition was the sole intermedium of the preservationof knowledge.In proceeding down the vista of nearly thirty centuries, or halfthe period since creation, little else than fable meets our researchon topics connected with our professional history. Each nationclaims for itself the origin of our science, and with equal justicemight our aborigines do the same. The knowledge of all barbarous nations must necessarily be limited, and little else than blindempiricism must direct the progress of our science, under circumstances so unpropitious to its extension and permanent utility. Wetherefore pass them by, without even pausing upon Esculapius,who was regarded by the Egyptians as the pupil of Hermes, (towhom they attributed the invention of medicine, ) but who was notthe same with the celebrated Esculapius of the Greeks.Among the earlier pretenders to this science, we find Melampusof Argos, who, from a shepherd, became celebrated for the cure ofthe daughters of Prætus, by the use of hellebore, baths, and charms;and received for his recompense the hand of one of the princesses,together with one-third of King Prætus's dominions. Nor is thecentaur Chiron, the tutor of Achilles, less celebrated as a founderof our science, with equal probability to back his pretensions. HisINTRODUCTION. 19pupils are among the most illustrious heroes of the fabulous age, asHercules, Theseus, Telamon, Teucer, Jason, Peleus, and Achilles,all of whom were more or less acquainted with the healing art.The Grecian Esculapius was however the first, or at least themost famous of all the presumed inventors of medicine. Galen hasunfolded his history in the introduction to his writings, entitled"Medicus," and in other parts. Charms, enchantments, amulets,magic incantations, and such like means, appear to have constituted the basis of the therapeia of most of those early aspirants tomedical celebrity. It is nevertheless presumable, that, althoughthe birth of Esculapius is ascribed to Apollo, yet such an individualreally had existence , and probably possessed uncommon attainments for his time. Enveloped in the mystifications of those darkages, it is impossible to ascertain his real merits. He was regardedas a god, and as such worshipped by the Greeks, and subsequentlyat Rome; temples in abundance were erected to his worship; andhis sons Machaon and Podalirius are immortalized by Homer, asbeing actively engaged at the siege of Troy. The latter is said tohave first employed blood- letting, and among his children to havehad one named Hippolochus, the reputed ancestor of Hippocrates.My object in these few details of what had preceded Hippocratesin the way of his profession, and to which he unquestionably musthave had access, is to evince that we are unwittingly led, unduly toestimate his pretensions, as though he were the actual father andgreat head of our exalted science. Now what is already stated isamply sufficient to show, that facts known and enumerated forcenturies before him, were merely embodied into writing by him,in place, as previously, of being sustained chiefly through themedium of oral tradition.-What actual portion of those writingsthat have reached us under his name, belonged exclusively to him,it is impossible to say. I should myself judge but few, and thatone of his chief merits consists in having afforded them, through hiswritings, a "local habitation and a name."The fanciful and imaginative powers of the ancients are probably as well illustrated by the various names afforded to their medical divinities as by any other means, as evinced by the etymologyof several of them. Thus, the sun, under the name of Apollo, isthe presumed author of medicine; Esculapius, the asserted son ofApollo, is taken for the air; Hygeia, or health, is called his wife ordaughter, because our health depends on the air we respire above20 INTRODUCTION.all things; Æglè, or light, denotes that air, illumined and purifiedby the sun, is the best of all; Panacea, and läso, or cure and universal medicine, signified that a good air cured all diseases; andso of the rest. But imagination is a poor guide in the mysteriousapproaches to the temple of medical science, and it is useless tooccupy time in elucidating the views detailed under the histories ofMedea, Circe, Cybele, Latona, and a host of other female divinitiesor enchantresses, with which our ancient medical legends abound:and I proceed, therefore, to afford an outline of our science fromthe period of the siege of Troy, in about the twenty-eighth century,to that of the war of Peloponnesus, near eight hundred years subsequently, that is, in the thirty- sixth century of the world.During this prolonged period, according to Pliny, medicine remained concealed in thickest darkness, until Hippocrates brought itinto view. Strictly speaking, this, however, was not the fact; for,during that interval, some of the most illustrious of the ancient philosophers existed, who first began seriously to attempt an explanation of the laws of physiology and of natural science. Such werePythagoras, Empedocles, Democritus, and, generally speaking, thedescendants of Esculapius, or the Asclepiades, from whom Hippocrates traces his descent.These descendants of Esculapius have been reputed to have preserved in their family, uninterruptedly, the knowledge of medicine,and which, but for the loss of the writings of Eratosthenes, of Pherecydes, of Apollodorus, of Arius of Tarsus, of Polyanthus of Cyrene, and of others who had carefully written their history, wemight have better known. From his own account, Hippocrateswas the eighteenth in descent from Esculapius, which, fabulous asit may be, we must be content to receive. By some or otherbranches of this family, the schools of Rhodes, of Cnidus, and ofCos, were established; and from them sprung most of the philosophers who added so greatly to the reputation of Greece.The first scientific labours in medicine, and the first traces ofmedical history are probably to be alone found in the philosophicschools of Greece; for although up to the period of the siege ofTroy, as we have seen, little but fable is known as to medicine, andof that little nothing of importance; and although, from that periodto the thirty-sixth century, that is for a period of about seven oreight hundred years, nothing has formally reached us as a medicaltreatise, until Hippocrates truly brought to light what was knownINTRODUCTION. 21up to his time, yet the evidence of physiological research, of muchanatomical and other knowledge, of the materia medica, of dietetics, of exercise and gymnastics, &c. , as applied to medicine, issufficiently extensive to point out the vast resources to which Hippocrates could have, and must have had recourse, to permit us to dignify him exclusively with those honourable, though specious appellations, by which his predecessors and contemporaries are entirelyrejected, and himself unduly elevated. Nor can we believe thatHippocrates for an instant dreamed of assuming such a character,to the degradation of his predecessors, inasmuch as he has givenus an express treatise " De prisca Medicina," in which the preceding views of medicine are unfolded, and reference is frequentlymade to it in other of the treatises which under his name havecome down to us. We may cursorily indicate some of the individuals who preceded him, and notice some writings that have beenascribed to them.-Democedes, a contemporary of Pythagoras,Thales, Epimenides, who has been by some regarded as theauthor of the Cnidian Sentences ascribed to Hippocrates, as theCoac Prænotions have been ascribed to the physicians generally ofthe Coan school, anterior to Hippocrates, and of which school hewas a member. Anatomy has been thought to have been knownto many of them, and that in no inconsiderable a degree, since theypractised surgery successfully. If we may judge from the writingsof Hippocrates, they must have had a competent knowledge ofosteology, of angiology, of many of the viscera, as the stomach andintestines, the liver, spleen, kidneys, bladder, uterus, diaphragm,heart, lungs, brain, &c. , as well as of many of the more importanthumours of the body, and of the various excretions from its different parts.Thales, the Milesian, who lived about A. M. 3330, has beenregarded as the first who wrote on natural philosophy, whichwould seem to imply some acquaintance with medicine, and toPherecydes of Scyros, his contemporary, has been attributed oneof the books on Diet, to be found among the writings of Hippocrates.Pythagoras, by far the most celebrated of the ancient philosophers,according to Celsus, was the oldest of those who joined the studyof medicine to that of physics. He lived about the sixtieth Olympiad, or nearly A. M. 3420. His science was universal to its thenextent, and his disciples were scarcely inferior in their attainments.All, more or less, appear to have pursued physiology, and to have22 INTRODUCTION.been more or less proficient in medical attainments. Empedocles,one of them, is said to have written on medicine not less than sixthousand verses, and he was nearly contemporary with Hippocrates. Democritus, whose merits in comparative anatomy areattested by Hippocrates himself, was also his contemporary, andhe wrote on the Nature of Man, which is the same title with one ofthe books ascribed to Hippocrates. He wrote also another on pestilential diseases, a third treatise on prognostics, a fourth on diet,a fifth on the causes of diseases, &c. , -and others on seeds, trees,fruits, and animals, and even one on the Stone. In short, thegalaxy of science scarcely ever shone so resplendent by its cultivators than at this very point of time, when the illustrious Hippocrates began his career. Whatever then may have been the realvalue of the writings of Democritus, it is obvious they must havebeen a source of great advantage to the opening and observantgenius of Hippocrates. We may incidentally remark, that Columella quotes two books of Democritus, one on Agriculture, theother on Antipathies, in the latter of which he seems to have beenthe first to attach the powers of death and destruction to caterpillars and insects generally in our gardens, if a female in the menstrual period walks thrice around the borders, barefooted and dishevelled;-a ridiculous assertion, void of truth, but which is, perhaps, not even now altogether discredited. -Besides the above,Cælius Aurelianus speaks of two other books (Acut. , lib. cap. 14-16, &c. ) that passed under his name, but which he expresses doubtsof;-one treated of convulsive diseases, the other of elephantiasis,in which bleeding is especially commended.That Hippocrates had the highest esteem for this great man,cannot be questioned, from the facts that have reached us. Elianeven remarks (Var. Hist. lib. 4, cap. 20) that on his account, Hippocrates wrote all his books in the Ionic dialect, although the Doricwas his native idiom; and this fact, unquestioned I believe, hasstrongly led me to infer, that many of the books, even of those thathave been absolutely ascribed to Hippocrates, are the writings ofothers given under the sanction of his name. I would not for aninstant throw this aspersion on the character of this great man, wereit not allowed by Galen himself, and by writers anterior to him,that very many of the books that have reached us under his name,are the absolute production of others; and that even of those ascribed to him, doubts have not been wanting as to which are reallyINTRODUCTION.23such. Now, since certainty cannot here be attained, whilst at thesame time conclusive evidence is produced that some called his arenot so, I do not perceive that my veneration for Hippocrates shouldbe questioned, because in a matter of uncertainty I hold the possibility of his having employed, or rather collected (for which weowe him thanks) into one work, the writings and opinions of thosewho preceded him. I shall not pretend to affirm, that, as literaturethen existed chiefly orally and traditionally, as we have seen, hewas bound absolutely to point out his respective authorities, whichmight have been of extreme difficulty, if not altogether impossible;but that being of that vague description which forbid him to ascribe them positively to any particular individual, he might consider them as public property, and therefore made them his byembodying them into one general mass, for which accident alonehas given him the sole credit. It is very certain that many of theremedies employed by Hippocrates had been in common use longbefore him, such as elaterium, colocynth, hellebore, and others;and the employment of such active articles certainly implies a considerable acquaintance with the Methodus Medendi, which onlywanted the facilities of printing to have established a character forthe Materia Medica of the age, but the want of which, necessarilydevolved it on him to rescue it from oblivion, by embodying in hiswritings all the medical information that had reached him.To condense what has been said above, it would appear, that atleast during the first three thousand years of the world, all that hasreached us, as to medicine, is chiefly fabulous, uncertain, and oflittle importance; that the discoveries made were few and superficial. Notwithstanding this, if medicine consists rather in effectsthan in words, and if the invention or discoveries of remedial meansis more important than all our reasonings on disease, then it will beperceived, that the first physicians actually were intimate with whatis even now considered most essential in our science, and thatprior to Hippocrates they knew and employed almost all theimportant and fundamental means of cure which have reached ourtimes. Thus all those ancient physicians esteemed bleeding andpurgation as universal remedies, and employed them accordingly,even in those fabulous times, quite as familiarly as Hippocrateshimself. They sedulously attended to diet, to bathing, and to exercise, which are not less deserving of attention at the present day,although far too much neglected. They were acquainted with the24 INTRODUCTION.effects of opium, if Homer is to be accredited, and apparently withspecifics for many diseases.All this, indeed, may be considered as being acknowledged byHippocrates himself, for he expressly tells us " that medicine in allits branches had been long established; that they had found out theprinciple, and the route of discovery as already had been done, ofmany excellent things which would serve for the further discoveryof more, provided those that undertook the task were fitted for it,and, possessing a knowledge of what had already been done, shouldpursue a similar route. He, that rejecting all (he adds) that is already known, should pursue another plan for his researches, andboasts of having found out something new, deceives alike himselfand others also. " Now this ancient route of which he speaks, isthat of observation and experience; and his remarks may be considered as a full acknowledgment of the important advantage hispredecessors had been to him; and had he been equally generousin specifying them individually, by naming his authorities, the remarks I have made would have been altogether inappropriate.Whatever merit then we may think fit to award Hippocrates, assuredly we ought not so far to forget the other great men by whosemeans he was enabled to reach the pinnacle of fame, as not evento grant them a niche in that temple, of which he was indeed thebrightest ornament; but in admitting his claims, which have thusrolled down the stream of twenty-three centuries, I think it must beconceded, that with the overshadowing I have thus presented, wecannot in the full force of the term admit, that the title of Father ofMedicine is justly his due!-nor, indeed, of several other equallyhighsounding appellations, without encroaching on the rights ofothers; especially since it is incontestably proved that many ofthosetreatises we admire as his, have really emanated from other sources.We follow the routine of our forefathers in this respect, and yetscarcely with any of the well- grounded reasons they possessed.They actually read, and studied thoroughly his writings, whilstnow, should he happily possess a nook in our libraries, it is almostthe sole communication we have with this " divine old man."We treat him as a deity by enshrining him where no mortal eyecan reach him, and are satisfied to afford him at second- hand, thetribute which we suppose to be his due.Galen has done ample justice to the merits of Hippocrates, bystating that he held the first rank among philosophers as well asINTRODUCTION. 25among physicians: assuring us that Plato rejected none of his opinions, and that the writings of Aristotle are chiefly commentarieson his philosophy, and that he himself had done nothing more thaninterpret Hippocrates and Plato. If this be true (exclusively of thevast merits of Aristotle on other points) assuredly his writingsought not to be neglected. Galen further remarks, that it is fromHippocrates and Plato that Aristotle has derived his doctrine offour primary qualities, viz.: hot, cold, dry, and humid. Hippocratesdoes not indeed speak in direct terms of these qualities; but headmits of four elements, air, water, fire, and earth, which he afterwards reduces to two, viz.: fire and water. Now these contradictions are presumed to be reconciled by the statement above detailed,that the various writings are mixed up with those of Hippocratesthat are not his, for the book in which this appears, is one of thosethat very anciently was set down as supposititious. Hippocrates,however, recognised a general principle, by him called Nature, *and which is used in various senses by him; yet in all possessinggreat power, and superior to all others; acting through the mediumof the faculties, its aids or servants: on the one side attracting whatis good or expedient, on the other rejecting what maybe superfluousor hurtful, and on these propositions turn nearly all the physiology ofHippocrates, which is meagre and threadbare, when comparedwith the extension it received from the expanded mind of Galen.To use the expression of Hippocrates himself, in his own hands, histheory is crude and unconcocted;-in those of Galen, it becomes abeautiful and imposing structure, almost the work of his ownlabour, based onthe rude materials already existing, which, althoughascribed in general to Hippocrates, are, as has been shown, whenindividually considered, almost without a parent, seeing that manyof the books, which chiefly develope his system, are suspected notto be his (especially those entitled " De Flatibus,” “ De Carnibus,”"De Natura Hominum," " De Natura Pueri," and " De Dieta, ")-itis consequently scarcely necessary to dwell on such apocryphalproductions in order to swell the praise of Hippocrates, or to singpæans, to what is, as it respects him, almost intangible.We must not however omit to mention, to the credit of this illustrious man, that he was the first founder, if we may so say, of the

• See Le Clerc, Hist. de la Med. p. 107. Auvauss, faculté, pouvoir, force, vertu, proprieté.

26 INTRODUCTION.humoral pathology. Not that he troubled his head with the absurd distinctions since made as to solidism and humoralism; for he possessedtoo much good sense not to perceive that a mass of matters, constituting by far the largest part of the system, and in fact , the verypart from which the identical lesser proportion itself had been derived, could not be independent of the causes of disease; that ifexcessive or defective in amount, or modified by any circumstances,or change of place, productive of an error loci, they could not failof inducing disease proportionate to such modifications; and in thechanges induced in these respects in the blood, pituita or phlegm,yellow bile and black bile, his four cardinal humours, Hippocratesfounds a large proportion of morbid actions or diseases.According to him, the body of man is composed of the abovefour substances, and it is by them that disease and health ensue.We continue in a state of health so long as they continue in anatural state, and in due proportion as to quantity, quality, andmixture. On the contrary, disease ensues when either of them isdeficient or excessive in amount, when either separates from theother in any part of the body, or when all of them are wanting intheir requisite qualities, or are not united together as they ought to be. If these positions assumed by Hippocrates do not constitutehim a humoral pathologist, we are altogether ignorant of, or mistaken in, the real nature of the term; yet, with these forcible illustrations of his doctrines before our eyes, he is absolutely set downby many, as a supporter of the dogmas of solidism! If necessary,this might be entered upon in extenso, and more largely demonstrated, but it would be only a work of supererogation, which, perhaps, after all, would not satisfy the tenacious maintainers ofsympathetic solidism and ventricular centralization! I will merelyadd, that passages in his writings would appear to indicate that heconsidered the bile and pituita to be the chief causes of disease bymixing with the blood, or from defect of quantity or quality, orrelatively to the part in which they ought or ought not to mix ormeet. The solid parts or the containing, are the subjects of diseaseand health, inasmuch as they are so, only according to the good orbad disposition caused in them by the humours and spirits, or theadvantageous or unfortunate impressions made on them by foreign orexternal bodies. It is on these principles that Hippocrates layssuch stress on the coction or crudity of the humours, —a matter ofINTRODUCTION. 27no importance in the doctrines of solidism, or at least in only asecondary degree.This coction of the humours requiring, according to his views, acertain definite period for perfection, led to the doctrine of crises orcritical days, in which more particularly, certain changes were anticipated in disease; and these anticipated changes give rise to andcontinue to afford the chief means of forming our prognostics as tothe event. Now these prognostics of course can only be formedon the presence of symptoms; and the attention of Hippocrates tosymptomatology, is that which has chiefly gained him his title toimmortality on the records of medicine. It is true much is absolutely false as to the prognostics he has left us; or rather it shouldbe said that we know not precisely his own, from the admixture ofhis successors and predecessors. Long as was his life, however,it is impossible but that much must have been derived from theprevious experience of his Asclepiadean ancestors, rejecting whathe found to be erroneous, and combining together only what conformed to his own practical knowledge.His symptoms were derived from every source; from the countenance, the eyes, the mode of decubitus, the motion of the hands,the loquacity or taciturnity of the individual, his respiration, watchfulness or somnolency, his excretions of all kinds, such as fæces,urine, sweat, crepitus, saliva , sputa, tears, &c . , all considered inrelation to quantity, quality, and the like. It has even been assertedby some writers that he employed the sense of taste to discriminatemany; this has, however, been denied by others, who affirm that ifdone at all, it was effectuated by the organs of the patient and notby his own.One thing bespeaks greatly the independence of mind of thisgreat man, viz.: that, although living in an age in which superstition constituted a large portion of the practice of the physicians,he did not yield to its influence; his reasoning, his observations,and his remedies in no respect seem tinctured with this failing. Hebled freely, and used purgatives of the most active nature; diuretics and sudorifics were also employed by him; but after all, hisprincipal reliance was on dietetics, in which none have ever excelled him. Fomentations and other external measures were notomitted, both topical and general, and for the period in which heflourished, he may be considered as a bold practitioner. In surgeryhe appears to have been very proficient, and to have practised28 INTRODUCTION.many important operations. Even now, his sentiments and maximsrelative to medicine and physicians in general, are not unworthyof deep regard.Let us now proceed to a brief consideration of the illustriousGalen, whose works may be said with truth to have bound themedical world for many successive ages in a chain of adamantinestrength, superior even to Hippocrates himself. Nor will any onebe surprised at this who will even cursorily glance them over.Here, we see our way, and mark with astonishment the eagle- flightof this extraordinary man. His writings are confessedly his own;few adventitious books of others swell his pages, further, than as acommentator on his predecessors this was requisite, but for whichhe was fully qualified, from his persevering attachment to the studyand pursuit of his profession.He was born at Pergamos, in Asia Minor, a city celebrated fora temple dedicated to Esculapius, about A. D. 130—in the fifteenthyear of the reign of Adrian. He lived to the age of one hundred,under Antoninus, Marcus Aurelius, Lucius Verus, Commodus, andSeverus. His father Nicon was a rich and learned man, skilled inthe belles-lettres, the philosophy, astronomy, geometry, and architecture of the times; and who spared no pains nor expense in hiseducation, attending to it himself in the first instance, and then supplying him with the best preceptors. He studied first in the schoolofthe Stoics, next in that of the Academicians, then of the Peripatetics and Epicureans, so that he was fully qualified to judge oftheir respective merits. With this preliminary knowledge he commenced the study of medicine at the age of seventeen, and had inits pursuit several masters. In his youth he travelled much, aswell to profit by the conversation of the best physicians, as to instruct himself respecting various medicines derived from differentcountries. He dwelt some years in Alexandria amidst the cultivators of science; then proceeded to Cilicia, Palestine, Crete, Cyprus,and elsewhere, passing to the Isle of Lemnos to investigate the properties of the Lemnian earth, at that period in high esteem: fromthence he went to Syria to examine the opobalsamum, and attwenty-eight years returned to Pergamos, having acquired greatskill in the treatment of wounded nerves, which he successfullypursued with the wounded gladiators of that place.At the expiration of four years he went to Rome with the intent ofthere fixing himself, but the jealousy of the physicians droveINTRODUCTION. 29him thence in a few years: however, during his residence atRome, he became intimate with different persons of considerationin rank or knowledge, which was apparently the principal sourceof the ill will of rivals for public favour. Leaving Rome at aboutthe age ofthirty- seven, he returned to Pergamos; but was soon recalled by Marcus Aurelius, and thenceforth continued to reside ator near the metropolis. It is unnecessary to pursue further theparticulars of his life. His facility in writing is well established bythe numerous works that have come down to us, independently ofmany that are lost. More than five hundred books are stated bySuidas to have been written by him on medicine and philosophy,and nearly half that number on other branches of science. Twobooks were written by him merely enumerating his works, and torecord, as to some of them, the place and time in which he composed them, the occasion leading to it , and the order in which theywere to be read; and we learn from him, that a part of his literarylabours was lost by a fire that destroyed the Temple of Peace atRome, in which they had been deposited.His works were greatly esteemed, even by his contemporaries;and we need scarcely remark, that they were the dominant sourceof all medical acquirement for more than twelve centuries! Eusebius, who lived five hundred years after him, says that the veneration in which he was held was such, that he was by many regardedas a god, and that religious worship was paid him. Trallian entitles him most divine; and Oribasius, by his extracts, as well asby his praises, evinces the high estimation in which he held him.Aëtius and Paul of Ægina, as well as Avicenna and other Arabianphysicians, equally copied from him. He had, however, opponents,especially of those sects whose opinions he combated; but still, thefar greater part of the medical world adhered to him closely astheir principal authority on every question of importance.To enter on his various opinions in this brief outline of his lifewould be useless and imperfect. It is principally from the vastcollection of facts embodied in his writings by which his worth isto be estimated and his actual acquirements judged of. It is thisthat leads me to press him on the profession as deserving of regard,and thereby appreciate fully the high extent of medical informationof a period so remote, but which pride and self-sufficiency forbidsus to acknowledge. Perhaps I should rather attribute it to anabsolute ignorance of the subjects he treats, for to me, it seems30 INTRODUCTION.impossible to imagine that any medical man can actually perusehis writings, without finding in them a complete encyclopedia ofancient medicine, both practical and theoretical, amply sufficientto repay him for what may at first be considered as a task, butwhich in its progress will be found to be in the highest degree engaging and instructive. If indeed any one can read him withoutadmiration at his wonderful attainments, I can only say I thinkhim greatly to be pitied. -It must not from this be supposed that Iam insensible to his defects! They are unquestionably considerable;yet they ought to be rather esteemed the defects of the age than ofhis own immediately. It must be borne in mind, that he wroteunder disadvantages that are not now experienced. The lights ofscience then, compared with ours, were dim and obscure; and imperfect as they were, we have the greater cause for admirationthat he wrote so well. Had he lived in our time, with all our aidsfor his co- operation, he would have been a bright and shining lightthat would have dimmed the minor luminaries of our numerousaspirants for medical celebrity! Consider that we are elevated ona pinnacle of sixteen centuries, of which he constitutes the base;yet, elevated thus above him, where is the man who will now venture to dispute his superior title to the palm of medical glory, orwho will venture to take a more extended view of our science inall its bearings by his own contracted vision, than Galen hasaccomplished so many ages in advance? We want his energy,his perseverance in preliminary attainments. The very facilities wepossess, are among the chief causes of our imperfection. Like thehare in the fable, we lie down to repose, in full persuasion that thehours of indolence may be easily regained; or, trusting to the exertions of more active members, whose improvements are at oncediffused over the habitable globe by means of printing, we makethem ours, with no exertions, and no acknowledgments on ourpart.It has been said that Galen has evinced great vanity throughouthis writings! He has so; and if any man, legitimately, was entitled to show it, that man was Galen! But shall a weakness, commonto every one in riding his respective hobby, be pardonable in themajority, yet reprehensible in him? I apprehend, indeed, that noone, who cannot claim to be his equal, is entitled to say what shouldbe considered as vanity in Galen. He is undoubtedly reprehensiblewhen he allows his contempt for his contemporaries to permit himINTRODUCTION. 31to call them the " Asses of Thessalus." Yet some extenuation maybe made for him when we recollect that friendless and a strangerat first settling at Rome, the persecutions he met with drove himthence. The associations of early lacerated feelings must no doubthave had an important influence on his mind, more especially astime had placed him in the foremost rank in medicine: he mightindeed have employed the pens of others, and probably would havedone so, had parasites been in such abundance as at present! Writers were, however, few, and the requisite apparatus for writingrare and costly. I do not think this fault of Galen is exclusive;few writers of ancient times neglected the opportunity of noticing,without a blush, their own pretensions, and certainly Galen's wereat least of equal weight.It is scarcely necessary to attempt to excuse or apologize for hissuperstition as to dreams, incantations, and other characteristicfooleries of the age; when, at this enlightened period, we accreditsnakestones, panaceas, Perkinism, Mesmerism, clairvoyance, &c. ,surely we have no right to reproach him.We have already stated that a succession of great and learnedmen had for ages collected together, and preserved in one family avast assemblage of facts relating to the healing art. The observingcharacter of Hippocrates, and his peculiar disposition to order andarrangement, led him to place them on a basis more secure; andwhat had previously depended on oral tradition chiefly, throughtwenty generations of the family of the Asclepiades, became by hiscare embodied into one. No contending doctrines marred theirprogress, nor did he deem it essential to his practical views to deface this fair autograph of medical knowledge with the fantasticgarb of hypothetic observations, which soon began to shed a baneful influence. Whatever might, indeed, be his private reasons foravoiding speculation, certainly we may gather from the extravagance of his followers, down to the present era, how little the boundsof truth are thereby enlarged. Successively changing, we findpresented to us even in the time of Galen, no less than six prominentsects in medicine, each one combating the others, and all equallyliable to objection. These sects were, the Dogmatic, the Empiric,the Methodic, the Episyinthetic, the Pneumatic, and the Eclectic .From these, Galen was to make his choice; and although he protests he will not be called a follower of either of them , yet, so faras he can be said to choose among so many, it may be esteemed32 INTRODUCTION.the last, or the Eclectic, for he seems to have selected from all, ashis judgment indicated. It is true, the doctrines of Galen are basedin great measure on those of Hippocrates; and if it could be shownclearly that Hippocrates was the sole framer of the opinions maintained in his writings, and that all the writings under his name arereally his, and from which, by piecemeal as it were, the doctrinesmust be picked out; and further, that they were not the generalsentiments of all the Asclepiadean family throughout a series ofseveral centuries; then, indeed, we might award its merit, if any,to him, but it is clear that the doctrines of four elements, &c. , hadbeen long previously maintained.Galen, adopting this system, has embodied it in a more compactand beautiful manner than had previously been known, and maytherefore be considered as its true founder;-but since the doctrine.is fundamentally false in itself, inasmuch as the four bodies, fire,air, earth, and water, are no longer regarded as elements, it maybe properly asked why the subject is dwelt upon? Now, althoughit is true that the above four bodies are rejected as elementary inthe present day, yet it is equally true that a very large number ofelementary bodies have, through the agency of chemistry, beenbrought to our knowledge, of which many enter into the composition of the animal machine, and by their union constitute theorganization of the animal kingdom in all its diversified forms; andby the changes ensuing in the forms, sizes, and proportion of theseprinciples, so will there be a proportionate departure from a stateof health. Hence, whatever would in former times afford evidenceof truth as to the doctrines founded on the former affirmed fourelements, by Hippocrates or Galen, it is obvious that the same willhold with respect to the present elements assumed by us, andstrengthened through the aid of chemical analysis, an engine of research unknown to the ancients; and hence, their forcible explanations and illustrations are the more surprising. In order todemonstrate this, a concise outline of the system Galen adopted willnot be misplaced, as exhibiting a display of talent and power ofcombination in its construction, never excelled, if indeed everequalled! Certainly, other theories, ancient or modern, comparedwith his, have been ephemeral; all have sunk into the common.tomb of wire-drawn hypotheses; few have survived even the architect of their existence, and some have died before their authors,without a sympathetic feeling for their wounded pride by contempoJINTRODUCTION. 33rary practitioners! Now, it is true, that the same fate has attended Galen; but it must be remembered to his superior merit, that hisdoctrines maintained a proud and universal ascendency for morethan twelve centuries;-will those of present notoriety reach evento the end of the present? we are constrained to doubt it. In truth,it may be affirmed, that nearly all, if not the whole, of past andpresent theories, are really to be found, at least in embryo, in thewritings of the two great men whose views in medicine are thussuccinctly noticed.In orderto comprehend the state of medicine in the time of Galen,it is necessary to recall to mind the diversity of sects then prevalentin Rome. How many offsets of inferior interest might have mergedin the six above mentioned, we cannot now determine; of these,the Methodists were chiefly in vogue, and next to them the Dogmatists, who split under the respective leaders, Hippocrates, Erasistratus, Asclepiades, and others. The Empirics were less esteemed,nor were the Eclectics much more regarded. The others wererather scintillations from the Methodists.Though Galen protests that he will not avow himself a followerof any preceding physicians, and considers all those as slaves whoin his time called themselves Hippocratists, Praxagoreans, or byother names; and therefore apparently ranks among the Eclecticdivision, choosing the best, from all former writers indifferently;yet, with all this, he was an undoubted Dogmatist, or Hippocratist,for he followed him alone, although differing from him in manyparticulars. He was his favourite author; and although not sparing him in his commentaries on his writings, he neverthelessevinces the highest esteem for him, and avows that he had laid thefoundation of true medicine. Thus prepossessed, he wrote variousbooks against the other sects, to overturn their doctrines, and reestablish the Hippocratic principles. He even affirms that all previous commentators to himself, had failed , and that he alone hadpenetrated the true meaning of his favourite predecessor. Had he,indeed, done nothing more than illustrate the medicine of Hippocrates, his labours would have been of high importance; for, ifHippocrates had taught the only true medicine, certainly his successors had strangely deviated from the route he pointed out. Itis not this, however, from which he assumes most honour; it is thathe first pointed out a just and rational method of treating medicine,and which is omitted by Hippocrates; and to fully inquire into334 INTRODUCTION.which, would be to establish a complete essay on the institutes andpractice of physic in conformity to his principles; but of which ashort and general idea can here alone be given, yet sufficient to establish the relation and difference in the medicine of these two celebrated men. Attention to it will, I think, demonstrate that eventhus contrasted, its merits are pre-eminent; and that a man whocould write so well as often to persuade, if not always to convince,is not lightly to be rejected or forgotten, merely from being clothedin a garment not at present fashionable.Galen sets off with the judicious remark, that in order to becomeacquainted with any art, we must knowthe end which that art proposes to attain; and that the same mode that should be followed todistinguish other arts, will equally apply to make known the art ofmedicine. Some arts are merely contemplative, as arithmetic, astronomy, &c. , others, wherein a certain effect is obvious, but sosoon as that effect ceases, the operation of the art is no longerconspicuous, as in dancing. In others, the effect is permanentlyconspicuous, as in architecture. There are others again, whosewhole design consists in acquisition, as in venation and fishing, &c.,but which may be considered as producing nothing. Medicine isof the number of those arts which produce something, and whosework is evident, although its action ceases. Hence it appears, thatin arts whose effects continue, a distinction may be drawn, the oneproducing something that did not exist previously, the other reestablishes that which had a previous existence, as in the case ofmedicine, which maintains or preserves the health of the humanframe, or restores it when it is lost.This being admitted, Galen proceeds to say, that as an architectought necessarily to know all the parts of a house, whether undertaking to build a new one, or to repair one that is old, so he whowould desire to establish an art, the subject of which is the humanbody (viz. medicine) , ought to be acquainted with all the parts composing that body, their substance, magnitude, figure, situation, number and inter- connexion; all which is attainable only by anatomicalexamination. But the physician is distinguished from the architectin this, that he should not only know the parts of the human body,but also the action of each part, since there is no one part that hasnot its own particular action or function.The duty of the physician thus instructed, is in the first place topreserve the parts in their natural healthy state, so as to subserveINTRODUCTION, 35their destined use, and freely perform their functions. 2d. To reestablish them in their former state, when those functions are obstructed, or even to endeavour to reproduce when possible, partsthat are defective. Now, without stating further what is advancedon these points, I think it must be admitted that this foundation ofthe Galenic system is good, and perfectly true. It is from this pointthat speculation begins, but it will not yield in ingenuity to any ofthe systems of the present day, either in lucidness or in a firmadaptation of all its parts. Archimedes exclaimed, " Give me aplace to stand on, and I will move the earth;" with equal justicemight Galen say, " Admit my premises, and my superstructure isperfect. "The first elements of all the parts above adverted to, as of allother bodies, according to Galen, are fire, air, earth, and water.The qualities of these elements are heat, cold, moisture, and dryness. So long as none ofthe elements or qualities are predominant,or while there is an exact proportion between them, conformableto the natural disposition of similar parts, such parts have a justtemperament, and perform their ordinary functions correctly; butif any one of them is defective or excessive, an intemperies follows,which, reaching a certain point, either destroys the function, orchanges it from what it should be. This temperament and intemperies has relation also to organic parts, inasmuch as they arecompounds of similar parts; and it is to be remarked also with regard to organic parts, that they are, or are not in a natural state,accordingly as they do, or do not, possess their ordinary figure ormagnitude, or as they are, or are not, in their accustomed place ornumber. Add to this, moreover, their union or defect of union,and a knowledge will be thus acquired of the good or bad disposition of the body, in which health and disease may be affirmed toconsist.In relation to the possibility or impossibility of curing disease,this has a bearing both on nature and on the physician. There arecertain things which nature can accomplish, and others which shecannot. She can reproduce flesh removed by a wound or consumed by an abscess, because flesh is a part that owes its origin tothe blood; but she cannot regenerate a nerve or an entire bone.Now that which nature cannot effect, neither can the physicianwho is only her assistant; but he aids nature by seconding herefforts, or by following her intentions in all that can at times be36 INTRODUCTION.accomplished by herself. If nature can fill up a deep ulcer withflesh, the physician labours on his part to make the flesh grow, byremoving every obstacle that can oppose it, so far as it is in hispower.Medicine, says Galen, is an art that teaches how to preserve andto restore health, or cure disease: and elsewhere, that it is a sciencethat teaches the knowledge of what is healthy, unhealthy, or intermediate between both; which, although ascribed to Herophilus,has yet been explained or commented on very differently by Galen,and in a manner replete with ingenuity and good sense. Thussays he, there are three kinds of things that are objects of medicine,and which the physician regards as healthy, unhealthy, and neutral.These three things are, the human body, the symptoms of disease,and the causes of disease, on all which he largely reasons and explains. It is necessary here merely to notice, that the body mayexist under three dispositions, viz. , of health, of disease, and neutralor intermediate between both, and these comprehend all the extentor distance from extreme health to extreme disease, each disposition having its peculiar range, depending on the due or undue apportionment of the principles of heat, cold, moisture, and dryness,and the due or undue disposition, size, figure, connexion, &c. , ofthe various parts; and these are subdivided by the greater or lesspredominance of the one over the other; superadded to which is acertain inexplicable peculiarity or property of the bodies of someindividuals, having no connexion with the qualities stated, but depending on occult or hidden causes. This peculiarity of temperament is called idiosyncrasy; by which one person has an aversionto some peculiar food, another, to another kind; some are affectedby a peculiar odour, &c. The different temperaments may deviateindefinitely from their relative existence in health, yet this does notproduce actual disease, so long as the intemperies that causes themto diverge from perfection, does not hinder the action of the parts;but as soon as this ensues, the body is in a morbid state. Hence itis, properly speaking, the impediment to the proper action of partsthat constitutes disease. All that space between the two is neutral,that is, a state neither of disease nor health; the individual is not yetsick, because the action of parts is not yet sensibly impeded; he isnot well, because the disposition exists in those actions, not to follow their accustomed train. He then describes at large the signsof a good and bad constitution of the body, as well as of the neutralINTRODUCTION. 37state: they are derived from his first named qualities, hot, cold, &c. ,when similar parts are in question, and when compound or organicparts are the subject, from the due or undue proportion of theirsize, figure, situation, &c. , and he derives the causes of these threedifferent constitutions from the same source.It may be remarked, that Galen, like Hippocrates, establishesthree principles of animated bodies, viz. , the solid parts, the humours,and the spirits. The solids he divides into similar and organic.He also recognises the four humours of Hippocrates, viz. , blood ,pituita, bile, and melancholy; and his opinions relative to hot, cold ,dry, and moist, are nearly the same as those of his illustrious predecessor. As to the spirits, he divided them into natural, vital, andanimal, which he supposed answered to, and were instrumental tothree sorts of faculties residing in those parts in which each kind ofspirit was produced. Without entering further into his views, Ishall merely mention that phrenological ideas were assuredly familiar to him, for in one part of his writings, according to Heurnius'quotation, he is made to say, that when the brain is affected " apudanticos ventres suos lædi imaginationem; sin illi medios secum ventriculos trahant, perverti et cogitationem. " Now although Galen'sopinions on this point are really of no moment in deciding its truth,it is nevertheless worthy of consideration, whether the reasonableness of its investigation is not supported, by perceiving it to be thenatural emanation of a strong and vigorous mind, even sixteen centuries before it was recognised as a science.The preceding, together with some minor distinctions and terms,may be considered as the foundation of all Galen's reasonings ortheories on the causes and nature of health and disease. He presumed that health was maintained so long as the faculties are fit toproduce their ordinary actions, or while those actions are entireand perfect; whilst the reverse of this induces disease. Now, asthe actions cannot be free or entire unless the solids as well as thefluids are well disposed, it may be said that health depends in thefirst place on the symmetry of the organic parts, and in the unionor connexion of them all. So long as the humours and solidscontinue thus, the spirits which follow the nature of the humourscannot be otherwise than well- conditioned, and consequently theactions (the result of the organs of the spirits, which are themselvesdirected by the faculties mentioned), cannot but be perfect. Onthe contrary, let the humours and solids become altered , deranged ,38 INTRODUCTION.or disunited, the spirits must become disordered, and their actionsinterrupted. And here I must be permitted to remark, that, atleast in my opinion, this theory of Galen, embracing as it does boththe solids and the fluids, is infinitely superior to the dogmas of ourtimes, by which the doctrines of Solidism or of Humoralism areseparately maintained; for it is utterly impossible that those parts,so essentially united by the Deity, can be separate and independentmedia of disease, individually considered. If we might be permitted to apply to these respective and equally essential parts ofthe animal economy, the anathema of the marriage ceremony, wemight emphatically repeat on this point: " What God hath joined,let no man put asunder!"On the principles above unfolded, Galen defined disease, to be anunnatural disposition or affection of the parts of the body, whichprimarily, and per se, prevents their action; and he establishedthereon three principal genera of disease. The first regards similarparts; the second, organic or compound parts; and the third, wascommon to both. It is unnecessary to enter into particulars as toeach of these; I will merely say, that, admitting the premises tobe correct, the superstructure is not unworthy of his expandedmind; neither can I enter into a detail as to wherein he agrees ordiffers from the fundamental views of Hippocrates. He has, asoccasion required, added to, or retrenched from them; and hasthereby constituted a whole, far superior to that of Hippocrates,more consolidated and perfect. Whoever desires more fully toinvestigate the respective views of these great and illustrious men,will do well closely to read their works; or if they are not attainable, at least to study them, as given in the excellent histories ofmedicine by Le Clerc, Friend, and Sprengel, especially the former,-who, after giving pretty fully in detail the system of Galen, says,that its faults, if examined in connexion with the Cartesian philosophy, or that of Democritus, of Epicurus, or of Asclepiades, will notpermit us to disavow that it is very ingenious, and perfectly wellcarried out; that if we find some scholastic questions that if useless may be passed over, many things are to be discovered in itwhich greatly assist in forming the physician, and pointing out tohim the road to practice; and that this would be especially discovered, if in place of giving a mere idea of his medicine, anabstract had been given of all his writings; which, we may add,whether referring to his particular knowledge of the individualINTRODUCTION. 39branches of the science, or to his more extended and general viewsof the whole, bespeak such a profound degree of knowledge, as tocall forth our warmest veneration and respect. Engaged as hewas most fully in the practice of his profession, the mind is overwhelmed by the consideration of his extensive literary and scientific productions; six immense folios on medicine have reached us,besides a vast number of his writings, nearly equal in amount, thathave perished by the chance of time, bespeak his indefatigableexertions, proving that not a moment passed him unattended to!Can such a man be cast into oblivion, or suffered to remain unknown to us, except by name, in these days of inquiry and research?If nothing more, curiosity alone should urge to a more full inquiryas to what a writer, of nearly the period of our Saviour, has leftbehind him: and should that powerful engine provoke to the research, it will soften down to the calmer desire of really becomingacquainted with him; for we shall soon discover that his pages arereplete with facts and observations not less important to our sciencenow, than at the distant period at which he flourished; and I mostsincerely hope and trust that the day is not far distant when we shallbe enabled to view him fully in an English translation, and therebyprove, that hundreds of the profession have derived their celebrity,from our general ignorance of the learning and attainments ofGalen, by stripping the laurels from his honoured brow, with whichthey have unduly weaved a wreath to place around their own,altogether undeserving of it.

1THE WORKS OF HIPPOCRATES.THE OATH OF HIPPOCRATES.SECTION I -TREATISE I.JUSJURANDUM HIPPOCRATIS,DE JUREJURANDO,LE SERMENT,FESIUS, p. 1 .HALLER, iv. p. 197.GARDEIL, ii. p. 179.THIS treatise, constituting the celebrated Oath of Hippocrates, weare told by Haller, contains the rules or statutes of medicine, whichthe student was required to receive, and confirm by taking it. Itpoints out the gratitude due to the preceptor; adverts to the treatment of the sick, and abjures the use of all dangerous remedies ormeasures. It leaves certain operations to the professed artists inthat line; and he adds, that it might be supposed to be writtenafter the subdivision of medicine into distinct branches. Some ofthe ancients acknowledged this treatise, but Mercurialis considersit as spurious. It has been largely and learnedly commented on,by various writers, more particularly by Meibomius, who haspressed into his service the aid of not less than four hundred authors, in law, physic, and divinity."It is scarcely to be credited that Hippocrates was the author ofthis oath- many, besides Mercurialis, have ascribed it to other

• Z. Zwingerus, J. Gorreus, B. Hollerius, Rauchinus, &c. , are among the most celebrated.

42 THE WORKS OF HIPPOCRATES.persons. A strong presumption of its not being his, may be derivedfrom the oath itself, in which every means of inducing abortion issedulously prohibited; and yet, in the treatise " De natura pueri,"we find a female made to abort under the author's exclusive direction and prescription. Now, if Hippocrates was the author of this.last named treatise, and was the pious character which his writings pretty generally indicate, it is inconceivable that he shouldthus have perjured himself. If not his, it has never been shownsatisfactorily, whether it is anterior, or posterior to his time, thoughprobably posterior. -ED.The first part of the oath is taken up by an adjuration to Apollo,Esculapius, Hygeia, Panacea, and all the deities , faithfully tofulfil all its requirements, to the best of his knowledge and power.Next follows the avowal of gratitude, and its scrupulous performance in the highest degree, towards his preceptor and all his family:regarding him as a parent, and his children as relations; engagingto teach the science to them without a fee, in its full extent, as hewould do to his own, and that without a previous assumption ofthis oath, he would teach the science to no one. In the next clauseof the oath, he promises to act faithfully towards the sick, prohibiting all that could harm them, and never prescribing (medicamentum lethale, Fœs.; pappaxov, Hip. ) poisons, or remedies for procuring abortion. Neither will he operate for the stone, but leaveit to those who are devoted to it. He professes to live a chasteand pious life-to observe profound secrecy in his profession as tofamily transactions; will avoid all corrupt influence with eithersex in the employment of aphrodisiacs, whether bond or free, andin case he should act in opposition to the above, he prays that hemay neither live long, be successful in his pursuits, or become celebrated in his profession; but that if he scrupulously observes theserules, the reverse may be his destiny.That part ofthe oath which has a reference to venery (appodisiwv),might, without much difficulty, perhaps, be made to refer to a dePessum subdititium ad fœtum corrumpendum, Fosius; Pessum abortivum, Haller; Пessor Oopsov, Hippocrates.-A dangerous pessary.THE OATH OF HIPPOCRATES. 43termination to give no attention to syphilis and its various complications; [" ab omni scelere voluntario et corruptila, tum alia, tumoperum venereorum in corporibus mulierum ac virorum, liberorum ,ac servorum procul remotus," Haller. ] Fosius differs but little.Such were the libidinous and sodomitic propensities at that periodin Greece, that it surely cannot be supposed that all venereal diseases were then unknown! -or, that, being known, their cure mightnot have been left to particular individuals. It is probable, however, that it is not the intrinsic intent of the text.-ED.NOTE. " Opus, item Jusjurandum. Medicis peculiare conscripsit Hippocrates nonadeo ineptum. Præstatio Juramenti non solum lingua, sed et corde, vel animo puro fieri debet."-Castelli Lexicon Medicum.THE LAW OF HIPPOCRATES.SECTION I.-TREATISE II.OF THE REQUISITES TO CONSTITUTE THE ACCOMPLISHED PHYSICIAN.HIPPOCRATIS LEX,DE LEGE,LA RÉGLE,· FOSIUS, p. 1 .HALLER, vol. ii . p. 195.GARDEIL, vol. ii. p. 181.HALLER tells us, that this treatise was every where accreditedby the ancients, but was rejected by Mercurialis; and that it refersto the education, &c. , of the physician. That medicine, althoughof the highest rank, had yet been extremely degraded, and pointsout the causes. The rules for its attainment are stated particularly, under six requisites, in order to become fully masters of thescience.As this treatise is short, I have judged it to be sufficientlyinteresting to give it nearly in detail. It has been, I believe, translated by M. Dacier-but I have never met with it. It has beenillustrated by Zwingerus, Heurnius, Fonseca, and others. —ED.Of all the arts, medicine is the most illustrious; but the ignorance of its professors, and that of those who judge of their qualifications, is the cause of its having been considered as among themost contemptible. This, in my opinion, arises chiefly, from thecircumstance, that medicine is the only profession, for which, inour cities, there is no penalty attached to such as ignorantly pursueit, beyond that of contempt. But ignominy scarcely wounds theignorant. It is with them, as with the dumb performers of thetheatre they have the form, the dress, and mask of the realactors, but in nothing else do they resemble them. So we findmany who are physicians in name and appearance, but few whoare such in reality. Six things are required to constitute a physician -Natural talents-a good education-a competent instructer-early study-industry, and adequate time. The chief of these,THE LAW OF HIPPOCRATES. 45is natural talent. In want of this, all is useless. But if this ispossessed, the art may be acquired, by due attainments previously;-and by beginning to study it at an early age, and in a properplace. We must, moreover, be industrious, and continue long instudy, by which means the science becomes, as it were, natural,—rapidly increases, -extends its researches, and brings forth maturefruit.The study of medicine may be compared to the culture ofplants. Our nature or disposition is the ground; the precepts ofthe teacher are the seed; commencing our studies early, resemblesthe sowing of the seed in a proper season; an appropriate locationfor the pursuits of study, resembles the surrounding atmospherewhich affords nourishment and growth to the plant; diligence instudy, is like the various means pursued to render the groundfertile; finally, the long continuance of our studies, resembles theperiod essential to full and perfect fructification.Those who fully attend to the above precepts, will attain to atrue knowledge of medicine, and should every where be considered as masters of their profession, and not merely nominalphysicians. They may come forward with confidence; whilstignorance proves but a poor foundation, and an empty treasury atall times; the enemy of all confidence and trust; a source ofaudacity as well as of timidity-since timidity is the offspring ofweakness, as audacity is of ignorance. Science and opiniongovern the world: the one points out our knowledge-the latterour deficiency. Things of a sacred character should be unveiledto the pure alone; for it is sacrilegious to communicate them tothe profane, before they have been initiated into the mysteries ofscience.NOTE.-" Lex, vouos, licet proprie non sit terminus medicus, Hippocrates tamentranssumsit e foro politico in medicum, &c. " De necessitate legum adversus pseudomedicos, vide C. Regies, Camp. Elys. Q. 21. n. 16.- Castelli Lexicon Medicum.ON THE ART OF MEDICINE. *SECTION 1.-TREATISE III.DE ARTE,DE ARTE,DE L'ART,FOSIUS, p. 2.HALLER, Vol. iv. p. 155.GARDIEL, vol. ii. p. 183.In his prefatory remarks, Haller says that Mercurialis regardedit as spurious, and unnoticed by any of the ancients except theauthor of the Definitions. He says it is altogether a tissue of reasoning; it enters into a defence of physicians, and regards them asfree from blame when death takes place, which he considers asrather dependent on the fault of the patient, or the impotence ofmedicine from the insufficiency of its means, when no suspicion ofthe intelligence or attention of the physician can be apparent. Neither is it considered as correct, that any one is restored to healthwithout the employment of medicine, although unattended by aphysician, since every thing that is beneficial or injurious, pertainsto medicine. Nor is the physician blamable who refuses attention to desperate diseases. It proceeds then to the consideration ofseveral particulars of an obscure nature in the human body, whichare to be comprehended through a process of reasoning, dependingon the manifest qualities of the excretions, &c. Some notice istaken of several of the cavities, the cellular tissue, &c.The order of the treatise is a dissertation against the calumniators of medicine, whether sophists or the common people. It refersprimarily to the arts in general, and then to medicine in particular,the certainty of which, as an art, it professes to demonstrate; thisis followed by a variety of topics, appertaining to the physician, tothe patient, and to the disease. We give a free translation of thewhole.-ED.NOTE. " Ars, Txv , verum est genus medicinæ, quicquid nonnulli Arabum secutiplacita regerant. Denominatio a fine petenda est ultimo. Quæcunque igitur terminantur operatione, sunt artes: quorum terminus est sola cognitio, scientiarum nominevenire debent. Imo xar xr vocab. hoc Medicinam significat., 1. aph. 1," &c.—Castelli Lexicon Medicum .ON THE ART OF MEDICINE. 47Many undertake to decry the arts, not from any expectation ofdestroying them, but merely to evince their genius. The real intention of an enlightened mind, however, is that of attempting todiscover something new that may be useful, or to perfect thatwhich is already known. To pretend to tarnish the labours ofothers by idle remarks without improving them, for the sole purposeof lessening their merit in the eyes of ignorance, is a proof ratherof malevolence than of a good disposition. As ignorant and wickedpeople are naturally envious, it is of course to be expected that theywill attempt to overturn what is good, or to ridicule its deficiencies:but they cannot attain their end. It is incumbent on all to upholdtheir profession to the best of their abilities, against insolence andtemerity; and here it is my intention to defend medicine againstinjustice and calumny. If, in this intention, there is any presumption, considering whom I am to attack, the art I profess to defend,will render my attempt easy,-the principles on which it is basedwill afford ample means.It will be admitted at once, that there can be no art, in respectto things that have no existence; it would be absurd to treat of anon-entity in any way; for how can any conceive the mode of existence of what has no existence? and if it is impossible to see whatdoes not exist, as we see that which does, by what means shall weknow it, or whether it be good or bad! Were this possible, I cannot perceive how we could discriminate between non- entities andthose things that are cognizable to our senses. Existing things mayalways be perceived-and by this alone that existence is appreciated. Those arts which exist, are known by our seeing them ,for not one exists that is not manifest in some way. Now it is theparticular species of art, that has given to each its especial title. Itwould be absurd to suppose the particular species is owing to itsname, that is impossible. Names are merely conventional terms,whereas species are the real products. If the reader does not comprehend this sufficiently, he must have recourse to other works.As to medicine, our present subject, I undertake to demonstrateits existence, and what it actually is, -I commence therefore withits definition, according to my apprehension.Medicine is an art that cures the sick, or lessens their pains, andwhich has nothing to do with incurable diseases: for that which isa Ostentationem scientiæ.48 THE WORKS OF HIPPOCRATES.irremediable, medicine knows not how to attempt its cure. And Inow proceed to prove, that it performs what it promises, and thatit is always capable of doing so; and I will at the same time refutethe reasons of those who attack it in those parts, wherein to themit seems most weak.My first proposition no one can deny. It will be admitted thatsome of those who apply for medical assistance have been cured,but not all and it is this which has given rise to the oppositionagainst medicine. Its enemies assert, that the larger part of thoseattacked by the same disease, and who are restored to health, oweit to good luck, and not to the rules of art. Now, I have no desireto rob Fortune of her just rights, and therefore I must acknowledgethat all who are well attended to, are very fortunate, whilst thosewho are neglected or illy treated, are extremely unlucky. But howhappens it that those who are cured, should prefer ascribing it toany thing rather than to art, when their cure has been actually accomplished solely by their having employed and attended to itsrules? They did not commit themselves to fortune, but called inthe assistance of art. Hence, they are in this respect altogetherabsolved from all acknowledgment to the former, but not so withrespect to art. They recognise art, insomuch as they pursued itsrules, and cannot deny its existence, when evinced in the effects ithas produced.But it will be said, that many sick persons have been curedwithout the aid of a physician. Who doubts this? It is verypossible, that without having called in a physician, they, nevertheless, have fallen into the arms of medicine. Not that they knewwhat medicine approved of, or disapproved; but they happilyemployed the very means which a good physician would havehimself made use of, had he been called to their assistance; and,it is a strong evidence of art and its powers, when those, who haveno belief in it, yet owe their safety to its rules: for it is certain,that those who have recovered, without the aid of a physician,must have been cured, either by doing certain things, or by doingnothing. In fact, they have been saved, by food or by abstinence;by drinking or abstaining from drinks; by bathing or not bathing;by labour or rest; by watching or sleeping; or by an alternation ofall these. Now, since benefit was obtained, they must of necessityadmit, that there was something done, by which that benefit wasobtained. On the contrary, if injury was sustained, it must equallyON THE ART OF MEDICINE. 49have arisen from something. It is indeed true, that few are qualified to distinguish between what was beneficial or hurtful to them.He, however, who is capable of such a discrimination, and ofjustly appreciating the measures he may have adopted, will equallydiscover, that what has saved him, is, in fact, a part of medicine.Even the faults he may have committed, are not less strikingevidences of the existence of medicine: for, that which benefited,did so , only on account of its timely employment; as, on the contrary, what was injurious, was so, only on an opposite reason.Now, wherever the good, or the bad, has its own peculiar termination, how can it appear that art has no existence? For myself, Ithink, that art can alone be absent, when what was done, producedneither a good nor a bad effect; and that, when either appears, theexistence of art, is fully substantiated.I admit, that if medicine and physicians effected cures by purgatives or astringents alone, our arguments would be weak; -but wesee the ablest physicians cure diseases by regimen, as well as byevery other kind of remedies. Now, we must admit, unless weare ignorant, or deficient in understanding, that the employment ofregimen, is a dependent on art. Nothing is useless in medicine inthe hands of good physicians-we see various remedies, and curesin many instances, under the operation of nature, as well as throughthat of human industry; and such as have been restored withoutthe aid of a physician, can in no respect attribute their recovery tochance, with any just foundation.Chance, when we come to examine the phrase, means absolutelynothing. Every event has a certain cause, which is, itself, theeffect of some preceding one. Chance, therefore, cannot be saidto have existence. It is a term employed by ignorance for what itdoes not comprehend. But medicine is, and always will be, seenand demonstrated in its effects, induced by causes, which necessarily are incapable of producing any others, and this is ouranswer to those who attribute their recovery to chance, ratherthan to the art of medicine.As to those who allege the number of deaths under the employment of medicine, I wonder what reason so evident can be given,that complaint should be made of the ignorance of the physician,rather than of the irregularity of the patient; as if it was possiblefor the former, alone, to practice incorrectly, and impossible forthe latter, to counteract his directions! It is much more credible,450 THE WORKS OF HIPPOCRATES.that the latter is the case. In fact, when an able physician undertakes a patient, and is sound in mind and body-is he not qualifiedto reason on the present state of the patient, and to compare hisdisease with such as he had previously seen, either the same, orapproaching thereto, and which he has cured by the admission ofthe patient himself? Whilst the patient knows neither his disease,nor its causes, he knows not its termination, or what has takenplace under similar circumstances. He receives his directionsunder present pain, and future dread. He thinks only of his disorder, and is weakened by want of food. He desires what isagreeable, rather than what may cure him;-not that he is desirous of dying, but that he detests physic. In such a case, whichis most probable? That the patient duly obeys his physician, inall his directions, or, that the latter, with the qualities above stated,should practice erroneously? Is it not more likely that the physician performs his duty correctly, and that the patient (incapablesometimes of paying obedience) does disobey, and falls a victimto his own folly? Those who incorrectly judge of events, accusethe innocent, and exculpate the guilty.Others there are who condemn medicine, under the pretext thatphysicians never undertake the care of those, who are alreadyoverpowered by disease. They say, that he cheerfully attends onsuch as would recover without him—but not a step will he take inbehalf of those who are most in need of his assistance. If therewas an art of medicine, they moreover say, it ought to cure theseas well as the former. Those who speak thus, would have morereason to complain of a physician who would not treat them asfools, than they have, to accuse medicine in such manner. Hewho requires of an artist, what belongs not to his art, or what isbeyond its power, is more knave than fool. We can effect everything that is capable of being accomplished through the means ofNature, or of the instruments of our profession; but we possess nomore. When the disease is more powerful than any of thesemeans, it cannot be expected that medicine can overcome it.Thus, we have many caustics in medicine, of various powers, ofwhich fire is the most so. We may reasonably doubt, in suchcases as require the use of caustics, whether the highest degree ofevil in such case, would not resist the fire, whilst we have nodoubt of its utility in an inferior grade. Now, in such cases whichfire cannot reach, nothing can be expected of an art that has noON THE ART OF MEDICINE. 51power stronger than fire. It is the same with all the instrumentsof medicine, and I apprehend, therefore, that when employed inextreme cases without advantage, the fault is in the violence of thedisease and not in the art.ofSome there are who reproach us for avoiding such as arealready worn down by disease: this is like requiring of any art, todo that which does not belong to it. Nominal physicians will, it istrue, undertake this from a desire admiration; but they arelooked on as ridiculous by real ones. Those who are masters oftheir profession, care neither for the praise nor reproof of suchpeople they esteem those only who know how to discriminate,and discern when and wherein the operations of art are perfector imperfect, and whether the imperfection arises from the workman or his subject.-We may, perhaps, in a future treatise, takenotice of what belongs to other arts. As to medicine, we havealready shown what it is, and now proceed to point out how it isto be judged of.All who are acquainted with it, will admit that there are twoclasses of diseases: one, affecting the external parts, and few innumber; the other is in vast amount and attacks the parts thatare internal and concealed, wherein they manifestly differ from theformer. They are apparent both to sight and to the touch, bytumours, redness, &c .; and evince themselves by hardness, coldness, moisture, heat, &c. , -and thus enable us to recognise thepresence or absence of such or such qualities as may or may notbelong to them. There ought to be no mistake as to these,-notthat they are easy to be comprehended, but because they arereadily discovered, at least by those who are qualified to seek forthem, by industry and natural attainments. Our art abounds inresources for visible diseases, -nor are they less abundant forthose of a hidden character, or which attack the cavities or bones.The human body has many cavities: thus, two exist for the reception and discharge of food, with many others, known to those whohave studied the subject. All those fleshy, rounded parts, calledmuscles, are cavernous; all parts, in fact, in which there is defectof continuity, are cavities, whether covered by flesh or skin, -andthey are filled with air (spiritus) in health, but in disease with unhealthy humours. Such fleshy parts are seen in the arms, thethighs, and legs. Even those parts that are not fleshy, have asimilar structure. For instance, the liver concealed in the abdo-52 THE WORKS OF HIPPOCRATES.men, the brain in the skull, the lungs in the thorax, &c . , all havecavities with subordinate divisions, or vessels, filled with humoursof a healthy or injurious tendency. There are, moreover, nervesand vessels innumerable, passing to the bones; -and ligaments andcartilages belonging to the joints, wherein the bones move, andwhich are moistened by a glairy fluid (synovial) emitted fromsmall cavities, which sometimes discharge much sanious matterwhen they are opened, accompanied with extreme pain. Now,none of all these parts are apparent to our sight , and hence theabove division of diseases into concealed and apparent. It mustnot, however, be supposed, that those thus latent are beyond thereach of medicine. The possibility of this depends very much,nevertheless, on the accuracy of the report by the patient of hiscomplaint, and the tact of the physician in his interrogatories.Sometimes this seems to be attained as by intuition, although moretime and labour are required than in the case of external diseases.The evil experienced by the sick from the delay of making knowntheir disease, ought not to be attributed to medicine, but to thepatient, or to the actual violence of the complaint. The physicianwho cannot by sight detect it, nor by the imperfect statement ofthe patient, is obliged to recur to reasoning; for it is certain, thatwhen describing their internal complaints, they speak more fromopinion than from any certain knowledge. Were they possessedof this, they would not require the aid of the physician, since thesame science which enabled them to know their disease, wouldequally teach them the appropriate means of cure. Hence, sincethe physician cannot derive from the patient's report a certain andabsolute knowledge of his complaint, he is obliged to attain it insome other mode-which necessary delay, is not the fault of art,but arises from the nature of the case itself. Medicine requiresonly to know the disease, in order to proceed to its cure; yet, withprudence devoid of temerity, and depending more on patient attention than on violent efforts. It is requisite also, that the diseasebe curable, and that time be allowed for the purpose. If then thedisease is known, and is found to be too powerful, either from itsnature or from delay of calling in medical aid, the patient willdie; for it rarely happens that it is too powerful, if soon attendedto. Disease is rarely victorious, except from being permitted togain too great advance, which arises from its concealed character, or from delayed assistance. It is, therefore, in my opinion,ON THE ART OF MEDICINE. 53more correct to praise the art of medicine for the cure of suchconcealed diseases, than for undertaking, what it is impossible itcan perform . Is there no parallel to be found in the other hithertoknown arts? Those who employ fire in their operations, mustremain inactive when their fire is extinguished, and must postponetheir labour until it is again relighted. Most of the arts are exercised on subjects, where the work can be corrected; such as wood,leather, brass, iron, and similar materials. Here, nevertheless, farfrom precipitancy in working them, all necessary time is affordedin order to perfection. Should any requisite instrument be wanting, the work is suspended, and remains imperfect. In all thesecases, in which slowness is more inconvenient than useful, suchdelay is nevertheless approbated. Medicine is the only art, inwhich, although error is almost invariably irreparable, haste isrequired to satisfy the impatience of the sick, without due attentionto its rules, although, as we have stated, it is incapable of attaininga knowledge of many diseases, by the sense of feeling or of sight.It neither perceives the diseases of the liver or of the kidneys, northe abscess that may exist in the chest or other cavity. Here, andin like cases, it has adopted other means of conduct. Thus, itconsiders the voice, as to its clearness or hoarseness. It examinesthe discharges from certain regular channels; and drawing consequences from their odour, colour, consistence or fluidity,-hejudges of the character of the disorders, and the existing state ofthe patient; and by the same means, medicine is even enabled,not only to ascertain the past, but likewise his future state. Afterhaving thus become acquainted with diseases, by their symptoms,if nature is unable to effect a cure, art then teaches how to excitethose salutary movements, by which, without danger, the systemmay discharge itself of what is injurious to it.It is in the efforts of nature that an attentive and skilful physicianperceives the measures he ought to adopt. If pituita predominates,by diet and acrid drinks, he excites the natural heat, and thus discharges it. By exercise, he causes respiration to testify still furtherto his senses. Sometimes, he has recourse to sweating, throughthe agency of warm baths. In some cases, he prefers to examinethe urinary evacuation; and by appropriate food and drinks, thehumours are aided in their discharge, which would not otherwisebe accomplished. But as the vitiations differ, so also are there different symptoms, and different remedial means, through which the54 THE WORKS OF HIPPOCRATES.physician becomes enabled to estimate the treatment he ought topursue.It is then by no means surprising, that the physician should beslow in forming his judgment of diseases, before he undertakes theircure; since he has, as it were, to negotiate with them, by theagency of an interpreter. It appears, then, from all I have said,that medicine has an appropriate means of discovering the mode ofcure, or at least of assuaging the sufferings of disease; and that itis not deficient in substantial reasons, for declining those that areincurable, or at any rate, of overthrowing the unjust reproachesmade against physicians when unsuccessful in such cases. Muchmore might be said in these particulars, as derived from the manifest and daily proofs afforded by skill and attention . Facts are farsuperior to reasoning; and instead of calling for admiration of theireloquence, such practitioners will refer you to the visible effects oftheir care and attention.THE ART OF MEDICINE IN FORMER TIMES.SECTION I.-TREATISE IV.DE PRISCA MEDICINA,DE VETERI MEDICINA,DE L'ANCIENNE MÉDECINE,FOSIUS, p. 8.HALLER, iv. p. 129.GARDEIL, ii. p. 197.THIS treatise, says Haller, is correctly considered as spurious, byMercurialis. It is manifestly posterior to the time of Aristotle,whose principles it altogether repudiates. It is entirely devoted toreasoning, but learnedly and acutely written. The origin ascribedto medicine is very probable, in a due attention to what provedhurtful or useful in diet, and in conforming its employment to thestate of disease. It was undoubtedly imperfect at first, but is notundeserving of praise. It confutes the hypothesis of four primaryqualities, viz. , hot, moist, cold, and dry. Asserts diseases to ariseindependently of these, and attributes them to an acid, saline, acerbor bitter humour, secreted, and acting alone, or conjointly, by whichchanges occur in them; or to a change of form in various ways,productive of fluxions, wind, &c.The treatise is stated as pointing out the antiquity, invention, certainty, and importance of medicine. Of food, generally and particularly, as of broths, drinks, bread, wine-by the first of which,seems to be chiefly meant barley water of varied strength, and constituting a chief part of dietetic practice; it then proceeds to consider primary and secondary qualities, and is followed by that offluxions, humours, and flatus.-Ed.Those who have undertaken to treat of medicine, have manifestly been deceived in most particulars, by attempting to found thisdoctrine on the hypothetical notions of cold and hot, of dry andmoist, thus reducing to one or two principles the causes of deathand of disease. Of this our art may reasonably complain, since itsreality is acknowledged by its daily employment, and its cultivationin the hands of the most able practitioners. Doubtless there are56 THE WORKS OF HIPPOCRATES.among physicians both good and bad; and this is another proof ofits existence, since, if it did not exist, this could not be the case,for all would be alike ignorant, and chance alone would decide asto the mode of treatment. We see, however, in medicine, as inother arts, workmen of infinite difference, as it respects the practice, both manual and mental.Recourse to hypothesis should therefore be avoided in medicine,and left to subjects obscure and doubtful, which afford nothingbetter to their advocates. Thus in astronomy, &c. , however persuaded we may be of the truth of our opinions, yet we cannot establish them fully, so as to destroy completely the doubts of others,since there is no established rule of truth, to which we can at alltimes refer. Such a rule, however, exists in medicine; it is an artof long existence, of sure principles, and certain regulations, throughwhich, for a long period, numerous discoveries have been made,and which are confirmed by experience, unmixed with hypothesis.Much is, however, still required to render it perfect, by the researches ofthe learned; and by the aid of what is already known,endeavour to obtain the knowledge of that we know not. All thosewhodepart from well-established rules, to riot in the path of novelty,and boast of having discovered something in our art, deceive themselves as well as others. I shall endeavour to prove this, by pointing out what medicine really is; from which it will appear, thatall deviation from its present route is to be avoided.And first it seems to me, that in treating of this art, we oughtchiefly to notice such things as all mankind will agree in, for theresearches of the physician should be confined to diseases to whichevery one is liable. It is true, that as the majority are uninformed,they cannot of themselves know how their disorders commence,nor how they will end; what increases, nor what moderates theirforce. This is, however, readily acquired through the informationderived from those acquainted with the subject, and this more easily,since nothing is remembered with more facility than that which isthe result of self- experience. A physician who is unable to makehimself understood by the most ignorant, or convince them as to thenature of their complaints, would be ignorant himself, and wouldnot mend the matter by mere speculation. Medicine would neverhave been discovered , had not speculation come to its assistance.No one, indeed, would have troubled himself respecting it. Whatneed could the sick have had of medicine, who lived exactly asTHE ART OF MEDICINE IN FORMER TIMES. 57those in health, had they never drawn a comparison between theirown state, and of those who pursued a different regimen, and observed the superiority of the one to the other? It was by noticingan apparent injury or benefit, which led them to a discovery of ourart. This arose from the sick discovering that they were injuredby the use of food that was beneficial in health, just as we now findto be the case. We may even go further, and say, that the dietand food in health that is now employed, would not have beenfound out, if men had been content with that of animals, such asgrass, hay, and the fruits and productions ofthe earth. All animalswell fed, are healthy, without any other kind of nourishment. Atfirst, mankind lived like the beasts; and food , as at present prepared, has only been introduced, because that which was first employed was too simple and indigestible, and was, as at present, thesource of indisposition, violent pains, severe disease, and even ofdeath. It is true, habit, then, rendered it less dangerous and moresupportable, yet still it proved injurious. They whose stomach wasenfeebled, soon perished, whilst such as were of a stronger constitution, resisted for a longer time. Just so we find it at present; somereadily digest the strongest food, which to others is difficult in theextreme. Hence arose the necessity for seeking a diet adaptedto their nature, and by degrees they were led to that we now employ. After having thrashed out and washed the grain, ground andsifted it, it was kneaded and made into bread and cakes, or boiledand roasted with other things. A mixture was formed by food ofdifferent strength, in order to accommodate it to the constitution,from the belief, that eating any thing too strong and indigestiblewould induce pain, disease, and even death, whilst that which wasappropriate and readily digested, became the source of health andstrength.Now, what more fitting name could be given to this discoverythan that of medicine, which means the method of remedying evil,since this invention was intended to produce a healthy nourishment,and to preserve health, by securing them from an irregular diet,productive of pain and disease? It may indeed be said, that thisprimary invention is not an art, since, in what is now well known,and uniformly employed, it would perhaps be unusual, to qualifythe practice by the name of an art. It at least is the fact, that suchpractice and invention is highly important, and is the fruit of greatart and much consideration. We see in the present day, indivi-58 THE WORKS OF HIPPOCRATES.duals appointed in our gymnasia to superintend the Athletæ, continually making discoveries in the same way, as to the most appropriate diet for those persons.Let us examine now, how medicine, properly so called, and invented for the benefit of the sick, deserves the name; how it gaverise to artists, and why there is so much difference between them.I believe firmly, as I said before, that no one would have been ledto seek for it , had the same food and regimen been equally properboth in health and sickness. We still observe among nations wheremedicine is unknown, that both in health and sickness, the samediet is employed. Every thing gives way to the wish of themoment, nor do they abstain from any thing that gratifies them.But, where the art is known and its dictates pursued, it is reasonable to presume that similar impressions led to the same results, asin the case above mentioned. They began by lessening the amountof food in case of sickness. This proving beneficial in some instances, but insufficient in others of greater intensity, a still weakerdiet was deemed requisite. Thus they were led to employ dilutedfood or broths, by mixing small quantities of stronger food withwater, and thereby weakening them, as well as by their mode ofpreparation. If even this nourishment proved too powerful in somediseases, it was discontinued, and liquids of a simple nature, regulated both as to quantity and quality, came into use. Even suchslops (Sorbitiones) are occasionally injurious, increasing the complaint without strengthening the patient-all which proves, that foodover-proportioned to the state of the patient, is equally injurious asin health. What difference then is there between the discovery ofan appropriate regimen in disease, by a physician, and that originally contrived, in the change of the primary savage diet, to thatwhich is now universally adopted? I think it is the result, in bothinstances, of one and the same invention. There is only this difference, that the last is more varied and extensive, requiring greaterreflection and experience, although it is plainly deducible from theformer.If we compare the regimen of health and that required in disease,it will be perceived that ordinary food would be much more injurious in sickness than the first rude and savage nourishment wouldbe in health. Thus, a person attacked with a disease, not of extraordinary violence, and yet somewhat dangerous, unacquaintedwith the risk he runs, eats bread, flesh, or other food appropriate toTHE ART OF MEDICINE IN FORMER TIMES. 59health, whilst another, in health, employs that which is used foranimals, such as peas, barley, &c. It is certain that the latter willnot be equally incommoded as the former, and this is an additionalproof of the art of medicine having been discovered in the mannerI have stated.If it was the fact, as some imagine, that too strong food alone ishurtful, and that a weaker kind was equally useful in health and indisease, nothing would be easier than to fix upon a good regimen;for all that would be required, would be the mere reduction of allto a proper medium. Unhappily this is not the case. The fault isnot lessened, yet the evil is as great, from the excess or defect ofnourishment. -Hunger has an amazing power over man, either tocure, to weaken, or even to destroy life. Repletion causes manydifferent disorders; inanition is productive of others not less hazardous. Hence this last, as a remedial means, is more extensivethan the former, and demands more care and attention. A happymedium is a desideratum; but for this we have neither weight normeasure to assist us. The personal feeling of the individual seemsthe best resource; but how we are to avoid all error in the case, isthe difficulty; and I will cheerfully praise the physician, who, insuch circumstances, is guilty of but trifling mistakes; to avoid thementirely is almost impossible.Most physicians resemble unskilful pilots, whose faults are unperceived in calm weather, but should a storm arise their ignoranceis manifest, and destruction follows. So with the ignorant physician, in his treatment of trifling diseases, wherein he may make thegrossest mistakes with impunity and escape detection; but if bymisfortune they meet with a violent and dangerous disease, theyare at fault; their ignorance and presumption are apparent to all,and their punishment promptly follows.That improper fasting is as dangerous as over- eating may beproved by the example of those in health. Some have made it arule to eat but once a day. Others, to preserve their health, maketwo meals daily. I do not refer to those who occasionally, or fromrevelry, do the same, for there are constitutions which are enabledto bear such changes with impunity, and make one or two repasts,although not accustomed thereto. There are many, however, whocannot deviate from their customary habits, without immediatelyfeeling its influence. If, used to one meal only, they take another,they feel tired and stupid; they yawn, are drowsy, and very thirsty.60 THE WORKS OF HIPPOCRATES.Flatulence and colics assail them, and not unfrequently some severedisease attacks them; and all this arises from deviation from theirsingle meal. On the other hand, when the first accustomed repastis neglected, the usual period for it has scarcely past, when theyfeel weak and tremulous; their eyes are languid, their urine becomes hot and turbid, and a bitter taste is felt in the mouth. Bellyache succeeds, with vertigo, irritability, moroseness, and dulness.At the arrival of the period for their second meal, they are incapable of digesting it. It is attended with flatulence and colic, andcostiveness ensues. Their sleep is disturbed, uneasy, and troubledby dreams. And in like manner, these symptoms are the precursors of severe sickness.From whence do these symptoms originate? In my opinion, hewho is accustomed to one meal alone, is incommoded only fromnot allowing his digestive organ full time for disposing of his previous meal of the preceding day-but he fills it afresh, before theformer food is properly concocted. Such stomachs digest muchmore slowly than others; they require more relaxation and repose.He, on the other hand, who has been accustomed to two meals,and omits the first, suffers from not affording his system the nourishment it required at a fixed period; that which had been previously taken having been completely exhausted. It is hunger thatundermines and consumes him, and his situation I ascribe altogetherto it; and any one who should pass two or three days without foodwould experience similar symptoms. Those constitutions that feelviolently and speedily the slightest errors, may be considered asbeing weaker than others. Disease is the near neighbour of suchdebility of constitution. The difference is, that the debility in thiscase being greater, the slightest error in diet must be felt in agreater degree. Medicine requires, therefore, in such cases, verygreat strictness. It is undoubtedly difficult to attain a certainty;but art has discovered various modes of approximation, whichought to be well known, and will be duly treated of. There is nojustice in opposing the ancient medicine as being founded on badprinciples, from the pretext that it is not yet perfect. On the contrary, it is deserving of admiration from its advancing so far'towards it, and from its having, in a period so unenlightened, discovered the route pointed out by reason, as the sure way to reachperfection.As to those who have endeavoured to attain the art by a planTHE ART OF MEDICINE IN FORMER TIMES. 61altogether new, and strive to establish its foundation on hypothesis,I would ask them which it is that is prejudicial, hot or cold, dry ormoist; and if a skilful physician ought to correct each of these qualities by their opposites? Give me an individual of a weak constitution, and let him feed on wheat just thrashed, or raw flesh, anddrink only water; they must admit that such fare will produce.much evil, such as violent pains, deranged stomach, debility; hewould not long survive. What assistance does he require? Cold,hot, dry, or moist? Which shall we select? If it is one of thesefour that has caused the disorder, we must choose its opposite, according to them. But the most direct and certain remedy is a change.of food, giving bread instead of grain, cooked meat in place of raw,and add wine to his water. Such a change would speedily restorehim to health, unless the injurious regimen had been too long persisted in. Will they persist in saying that his disease had beencaused by cold, and that they had dissipated it by heat, or reversely?It would be difficult to prove the truth of such responses.In making bread, the above four qualities are removed from thewheat. Besides this, water, fire, and many other things, each possessing its own peculiar powers and qualities, are employed. It losespart of what it had, and what remains is a compound mixture. Iam convinced, that the action of bread on man is very different,according as it is made from well-washed grain or from that whichhas not been washed; or from white or brown bread; betweenthat which has been kneaded with much or little water, and betweenill and well- baked bread. Many other circumstances producegreat difference. The same may be said of barley cakes, wherewe find numerous and different qualities. How can one, who hasnever examined this, nor thought about it, become acquainted withdiseases, when each of the particulars above mentioned is productive of different sensible effects, on which depend the lives of healthypersons, of convalescents, and of the sick? Nothing is more important than a full acquaintance with all these different qualities.They who have rightly pursued the art of medicine, have thereinfound the variation in the nature of man: a subject so extraordinary, as to have ascribed it to a Deity. They have not consideredwhether it was the cold, hot, dry, or moist, that benefited or injuredman; but believed that injury was the result of an excess of power,which human nature could not overcome, and which they thereforestrove to weaken, by opposing mild things to stronger of the same62 THE WORKS OF HIPPOCRATES.nature, weak bitters to the more powerful, &c. , and thus of everything carried to its highest grade. They observed that all thesequalities were found in man, and all at times became prejudicial.In fact, there is in him, both bitter, saline, mild, acid , acrid, insipid ,and many other qualities, possessed of different powers, in proportion to their quantity and degree of strength. All of these, whenwell united, and tempered by each other, are insensible to us, anddo no injury; but if one should separate, and exist alone, it thenbecomes sensible, and ravages the system. It is the same with aliment. That which is improper for us, is either bitter, saline, acid,or too strong. Hence it is productive of the same inconvenienceas the humours I have mentioned, whilst that which is appropriatepossesses none of those injurious qualities, nor is it too powerful.Such is the case with bread, barley cakes, and other similar articles,employed in profusion by mankind. I do not speak of dishes andpreparations, intended solely to gratify the taste or irritate the appetite. Such are highly pernicious. I refer to common nourishment,which causes no uneasiness, or any separation of the particles ofthe humours of the body, and serving only to strengthen, nourish,and promote its growth. All these benefits arise from its well-attempered state, in which nothing predominates, nothing is irritating,nothing too strong. Every thing is reduced to a point, so as to beesteemed simple, homogeneous, and at the same time, of adequatestrength.I cannot imagine how the partisans of this doctrine, which is sodistant from the true route of medical science, and so beset withconjectures, could contrive to practise on their system, for I do notthink they have ever discovered any thing, that is, per se, hot, cold,dry, or moist, and unparticipating in any other quality; nor thatthey have other varieties of food and drinks than those familiar tous; but it has pleased them to call such a thing hot, that one cold,this dry, and another moist! Now they must be embarrassedshould they order something hot, and the patient should ask themwhich; they must therefore either trifle with him, or change theirnotions; for if the hot is always conjoined with the bitter in onething, with the insipid in another, and with the nauseous in a third ,and if many other qualities are also united with the hot, even suchas are of a contrary nature, which of all these hot things will hedirect? the hot and bitter, or hot and insipid , or perhaps, somethingthat is cold and bitter, for such there are as well as cold and tasteless. But we well know that each of these four varieties producesTHE ART OF MEDICINE IN FORMER TIMES. 63contrary effects, not on man alone, but likewise on leather, wood,and many other bodies, far less sensible than that of man.It is not the hot that exercises such power, but the bitter, thetasteless, and the other qualities I have mentioned, that produce apowerful effect both externally and internally on man, whether ineating or drinking, or in employment of external applications. Ina word, heat and cold, of all qualities, I conceive to be those thathave the least power over our bodies, and for the following reasons.Whilst the hot and cold are well united together, they do no harm,since they mutually neutralize each other; but if disunited, or eitherpredominates, then they prove injurious. Even here, however, ifit is cold that affects us, the injury is not of long duration; for ourinternal heat immediately opposes it with all its power, without theneed of other assistance, and this both in health and disease; hencewe see that if in health we are made extremely cold, by winter orcold bathing, or other cause, the greater the degree of cold, notamounting to an actual freezing of the body, in the same proportion will he be warmed by clothing. himself, or getting under cover.So likewise, if much heated by the warm bath, or a large fire, hecontinues with the same clothing, in a place but little cooler, it willappear much colder to him; and should he expose himself to adraft of air, or fan himself, the sense of cold will be greatly augmented. This is still more evident from walking upon ice or snow.The feet, the hands and face, suffer much from the cold, and whencovered up in bed, they suffer from heat and irritation, and sometimes small vesicles appear on the skin, as if it had been burnt byfire. So long as the cold continued, this was not felt, so true it is,that these two opposing powers succeed each other quickly. Manyother instances might be adduced, but we will now examine whatensues in case of sickness. In the instance of fevers, in proportionto the violence of the chill, will be that of the subsequent hot stage.If the chill was not of long continuance, the fever is commonly ofshort duration, and rarely dangerous. In terminating, the heat retires last from the feet, as being the part of the body in which thecold had been most severe, or of longer continuance. At length,when the sweating stage has carried off the fever, the patient's sensations are much more cool and refreshed, than if he had not hadthe preceding febrile state. Since, then, these two opposites soquickly succeed each other, and thereby temper their respective64 THE WORKS OF HIPPOCRATES.excess, what great harm can result, or what need of much foreign' assistance?It is asserted that those who have ardent fevers, or inflammationof the lungs or other parts, are not so speedily liberated from theheat, nor do they feel this beneficial influence of the cold. I replyto this, that I consider it a certain proof, that fever does not arisefrom heat alone, but requires the co- operation of other causes. Wehave a hot bitter, a hot acid, a hot salt, and many more of differentcharacter; and the same may be said of cold. Now these are thecauses of the disease. Heat is present undoubtedly, but it exertsno injurious effects, unless conjoined with some other quality, whichirritates, and augments its influence, without which it possessesalone its own appropriate power of warming.We have one fact, among many others, of the most conclusivecharacter, that is, when attacked with a cold in the head, and adischarge from the nose takes place, the humour is more acrid atthe beginning than that which is natural to the parts. The nose isswelled and inflamed, and the increased heat is manifest to thetouch. If long continued, the humour produces excoriation; atlength the symptoms become moderated, but not until the humoursbecome thicker, less acrimonious, more concocted and commingled,than at first. It is true we have such fluxions, manifestly inducedby cold alone; such are cured by warmth, just as affections resulting from heat alone are removed by cold, and in both cases,promptly and without coction . All other fluxions arising fromacrimony and an ill state of the humours, are only cured by theconcoction and bland state that is brought about in them. So alsowe see fluxions on the eyes, owing to various acrimonies that ulcerate the lids, excoriate the cheeks, and even destroy the cornea.These violent effects are only terminated by the concoction of thehumours, becoming thereby more consistent, and of a purulent nature. Now this concoction is accomplished through the mixtureand modified temperature of the humours. We observe in likemanner fluxions on the fauces, throat, &c., inducing hoarseness,quinsy, erysipelas, peripneumony;—all such humours are at firstsalt and irritating, and thus produce and maintain these complaints;but when they become thicker, and by concoction lose their acrimony, then the fever declines, and the evil passes away. Now ifhot or cold, without the addition of any other quality , should inducediscase, and such is sometimes the case, then it ought to terminateTHE ART OF MEDICINE IN FORMER TIMES. 65so soon as they are respectively changed for each other; in allother cases, the evil ensuing arises from the agency of other powers.Thus, when a humour, called yellow bile, is diffused through thesystem, what anxiety, heat, and debility immediately ensue! Aspontaneous discharge from the bowels, or produced by medicine.duly and appropriately, almost as rapidly put them to flight. Butif this humour is allowed to remain, crude and unconcocted, thefever and pains will continue unabated. But if the humour be thatcalled green bile (æruginosi humores), how raging are the symptoms, and the pains in the intestines and chest! Nor do they cease,until this bile, mixed and weakened by other humours, is discharged .There are several ways of concocting, weakening, and inducingthe natural consistence of such humours; and to these we are wonderfully assisted, by a knowledge of crises, and of critical days. Itis neither on the hot nor the cold that we are to operate, for theycan neither concoct, nor render consistent. What then is accomplished? We reply, that they are capable of admixture, and thatby this they destroy each other's influence. Mixed with any thingelse, they still are hot and cold, and cease not to act, unless commingled together. The other qualities in man, the more they aremixed together, so much the milder and better they become; andman is never in better health, than when these humours are thoroughly concocted and at rest, without any one predominating; andthis, I trust, is sufficient, so far as respects the hypothesis of thesefour qualities!I will now say a few words relative to sundry philosophers andphysicians, who affirm, that it is impossible to become acquaintedwith medicine without previously knowing the nature of man, andhow he was first formed and created. I think myself, that all thatthey have written or said about nature, is infinitely less useful to thephysician than to the book-maker; and that, whatever can be bestattained respecting the nature of man, is through the means of medicine itself; nor can it be attained, without a full acquaintancewith this art in all its vast extent. I have known many personsthoroughly acquainted with all that has been said by those writersrespecting the nature of man, &c. But all that is requisite for thephysician, on this head, in order to practise successfully, is thatwhich is connected with his food and drink, and the changes whichdifferent articles are capable of producing in him. It is not sufficient to say that cheese is injurious, because it induces pain from566 THE WORKS OF HIPPOCRATES.eating it in excess. We must know also, what kind of pain, andwhich, and why, such or such parts of the body suffer from it.Amidst our food and drinks, there are many that are bad, whichdo not affect the system in the same way. Pure wine, taken inexcess, weakens as those acquainted with its powers well know,as well as the parts of the body on which it acts. Now I wish thesame information, as to other things. Cheese, since we have mentioned this, is not injurious to every one. Many employ it largely,without any bad effect. Nay, it is beneficial to thin persons; although, it is true, that some are much incommoded by its employment. This depends on a difference of constitution, and this isowing to something in the system that is inimical to cheese, and byits presence it becomes excited; and the more abundant the humourand powerful, the greater will be the opposition it occasions. If,however, cheese was contrary to the nature of man, all shouldequally suffer from it, and those who are fully sensible of all this,will not be led into mistake. In convalescence, as well as inchronic diseases, many troublesome symptoms ensue, some arisingspontaneously, others from the rash or imprudent use of differentthings. I have known many physicians, as well as common people,attribute such symptoms to something out of the way done by thepatient, as bathing, walking, or eating what they were not accustomed to; and limiting their views to this alone, although, inmany instances, it might be the most appropriate step they couldhave taken. Ignorant of the cause, they blame at hazard, and prohibit that which is most proper. This is an evil of no trifling import. In order to avoid it, the physician should be acquainted withthe different effects of bathing at a fit or improper time, and so ofother things, for all act diversely according to circumstances.Now, a physician unacquainted with the comparison of action ofdifferent things, on man, under different circumstances, can neitherknow their effects nor employ them properly.He ought, moreover, to know how to distinguish between thoseaffections that arise from the functions, and those of his organization. I mean by the functions or faculties, the highest grade andpower of the humours; by organization, the conformation of theparts that compose the body. Some of these are hollow and contractile, some expanded, others solid and round, or broad andpendent; some are broad, long, dense, thin, florid, spongy, and soft.Of all these, which are best adapted to attract moisture from theTHE ART OF MEDICINE IN FORMER TIMES. 67rest? The hollow and equally expanded, or the solid and round,or the hollow, gradually diminishing? Doubtless, the last, as exemplified externally. A man, for instance, cannot drink with hismouth open; but he closes his lips, so as to leave only a small opening, or by employing a tube, when the liquid is readily attracted.Cups, have been made on this principle, with a large belly and smallorifice, to attract the humours from the flesh. There are in naturemany things analogous. In the human body, the head and bladder,and uterus, for they all manifestly attract, and hence are alwaysfull of moisture. Those that are hollow, but expanded, althoughretaining fluids that are poured into them, yet they cannot attractthem. Such parts as are solid and round, neither attract nor contain, for the liquids finding no place, will run over them. Thespongy and soft parts, as the spleen, the lungs, the breasts, suck upthe moisture presented to them, by which they swell and becomehard. It is so likewise, with the cavities containing humours, asthe stomach, or any into which a daily flow is made, with no powerto distribute from its structure. These imbibe the humour, and byits incorporation, although small and empty, they become dense,firm , and hard, if concoction does not ensue, and the humour is notdischarged. All this promotes flatus and pain, causing the soundthat is heard in the large and hollow cavities of the chest and belly;for as this wind is not confined to one spot, its motion is accordingly accompanied by noise and uneasiness. Should it press upon thesoft and fleshy parts, these will feel a sense of fulness and of numbness. Or should it be opposed by some large part, which is notstrong enough to resist it without suffering, nor yet so weak as toyield, and give way to it; if, like the liver, the part is tender, florid,sanguineous, &c. , its size and firmness prevents it giving way; thewind, from this resistance becomes more powerful, and greatlyaugments the evil. Hence so frequently arise such severe pain inthe liver, terminating often in tumours and abscess. So also with thediaphragm, though in a less degree. It is a firm and resisting part,but being more tendinous and stronger, it is less sensible to pain;yet this occurs at times, and even abscesses are formed.Many other varieties of form exist, both in and externally, verydifferent from each other, and modifying the occurrences both ofhealth and of disease. A large or small head, -a large, long, orshort neck, a round or flaccid abdomen, narrow or broad chest andribs, and many more, whose variations all require to be known, in68 THE WORKS OF HIPPOCRATES.order to be enabled to discover correctly, the true cause of thesymptoms we perceive.As to the powers of the humours, or what they effect on the system, we should be acquainted with their respective affinities. Forinstance, we should know, if a mild humour is changed into anotherkind, not by any mixture, but by degenerating from its pristinestate, what is the first alteration it undergoes; whether it becomesbitter, saline, austere, or acid. The last of these is certainly themost injurious of all these changes which it could pass through; andwhoever can, by his research on external circumstances, extend itto those of internal character, will be the best qualified to estimatetheir proper treatment, which consists in the removal, as far as possible, of every thing hurtful to the body.OF THE PHYSICIAN.SECTION I -TREATISE V.De Medico,DE MEDICO,DU MÉDECIN,FœSIUS, p. 19.HALLER, V. iv . , p. 169.GARDEIL, ii., 225.HALLER, in his preface to this treatise, says, a more appropriatetitle for it would have been, " Of the Shop or Office of the Physicianor Surgeon," which is minutely described; -nothing is stated as toplants or medicines. It might be supposed to be written after thesubdivision of the art, and during a period of peace, since the authorrecommends attendance on foreign campaigns, in order to attain aknowledge of the treatment of wounds. The treatise is intended topoint out what a physician ought to be, both in respect to body andmind. It then describes the plan of his office or shop, in regard tosituation, light, the various instruments and appurtenances required,and speaks of several operations, as cupping, scarification, bleeding,&c. , ofthe extraction of darts, &c. , of ulcers, and of tubercles.-ED.This treatise is intended to point out some short precepts andadvice, as to what is essential to the physician; and first, as to hisexterior; he ought to have a healthy appearance, and be of proportionate size to his particular constitution: for should he be otherwise, the public will believe him unqualified to attend to the healthof others. His dress should be neat, and his person clean and unperfumed, lest it might be supposed he employed perfumes to conceal some disagreeable emanation, that might be unpleasant to thesick.As to internal qualifications, he should possess much prudence;not that merely which prevents indiscreet or untimely conversation,but in all his concerns. His mode of life should be perfectly correct; for good manners and modesty contribute greatly to his reputation. He ought to possess circumspection and humanity:haste and assurance will be followed by contempt, although they70 THE WORKS OF HIPPOCRATES.may occasionally benefit him, for it is not always possible to avoidhis services. They are at times useful, but rarely to be employedby the physician who desires to secure esteem .In regard to manners, he should be grave, without austerity, lesthe should be considered proud or misanthropical; and he shouldavoid perpetual laughter and hilarity, for they are not at all timesacceptable. In his moral character, justice should predominate.It is at all times of infinite importance, and especially in that intercourse that exists between the physician and his patients. Theseplace themselves entirely in his hands; at all times, wives, daughters, and goods are placed at his discretion . Well then does itbehoove the physician to be continually on his guard. And thusmuch in regard to his mind and body.We will now take notice of what is requisite in the study andpractice of his profession. In order to excel, it is essential to becareful in the choice of a teacher. Those who give instruction,usually have every thing requisite about them. They ought to becareful in the location of their dwelling, that it should not be incommoded by the wind or sun, to the injury of the sick. Toostrong a light, though not felt by the physician, is painful to thesick, and detrimental to the sight; the meridian sun ought to becarefully guarded against, and the light should rather be admittedfrom the opposite side. * The seats of the patients should be ofproper dimensions. No ornaments of brass about them; such areonly adapted for the instruments; in any other respect they shouldbe considered inappropriate. Good and pure water for drink shouldbe provided for the sick, and the towels should be clean and soft.For the eyes, soft linen is employed, and sponges for wounds; theproperty they possess of swelling up, renders them very useful.All the instruments ought to be well made for use, as respects size,weight, and finish. In regard to external applications, such ascompresses, bandages, plasters, and cataplasms, the greatest attention should be paid to their accurate adjustment, especially whenthey are to be of long continuance. The removal of dressings, andtheir renewal after washing and cleansing wounds, is soon done;the thing to be chiefly attended to, is as to the frequency of this,for much depends on acting correctly herein. As to bandaging,

• It would appear as if a dispensary or hospital is here described. It seems scarcely

allied to the private domicile of the practitioner.OF THE PHYSICIAN. 71two things are essential, that the pressure should be on the appropriate part, and not be unduly tight. Attend also to the temperature,for the impression of the air is at times to be guarded against. Hemust also be acquainted with those weak parts, that will not beartoo strong a pressure. Pay no regard to those intricate bandages.that are more ostentatious than useful; they are superfluous, andoften injurious. It is not ornament, but utility that is required.With respect to operations, either by the knife or by cautery, theydemand both promptitude and caution, for both at times are proper.When a single incision is required, do it quickly; for, as cutting isattended with great pain, we must make it as short as possible;but when accurate dissection is necessary, it must be slowly accomplished, since, if too hastily effected , the pain is continual andsevere, whilst some intermission of it is experienced by the formerproceeding. Of instruments, it may be stated, that large or smallknives are not to be indiscriminately employed. In the body areparts from whence the blood flows largely, and is not readilyarrested, as from varices, &c. Small incisions here are proper,and give us the means of more ready restraint, whenever it maybe necessary to allow its discharge, but in parts not dangerous,nor attended with hæmorrhage, large knives may be made use of,and the blood will be evacuated, which would not otherwise be thecase. It is disgraceful in the surgeon not to effect properly theintention he had in view.Cups are employed in two ways. If the fluxion is deep- seated,the neck and belly should be narrow, and the handle long, but light.Cups of this description draw in a direct line, and attract towardsthe surface the deep- seated humours. But if the affection is moreexternal and diffused, the cups, in other respects similar to theabove, should have a wide orifice, which adapts it to draw from amore extensive surface what is to be evacuated. If they are atthe same time heavy, by their greater pressure, they act moredeeply, and less superficially, thus perhaps leaving behind a partof the external humours. So likewise, if the fluxion is profound,should the orifice of the cups be large; they then act upon the surface, which thereby, from the moisture thus attracted, prevents thatof the deeper-seated humours, thus leaving behind what was injurious, and drawing off that which did no harm. The size of thecups must depend on the parts to which they are applied.scarification is necessary, make the incisions perpendicular to theIf72 THE WORKS OF HIPPOCRATES.surface, which affords a greater discharge from the tumid part, inwhich the blood has accumulated. The bistouries for this purposeshould be rounded, and of a moderate size, for sometimes the serous.and bloody fluid evacuated, is thick and tenacious, and would beleft, should the incisions be too small.The vessels in bleeding must be sustained by ligatures, for in somecases, they readily move under the skin, from not being sufficientlyadherent to the parts beneath, and hence the skin is pierced without touching the vessel. If only slightly penetrated, the partsswell, the discharge of blood is impeded, and suppuration mayensue. Two evils hence follow, pain for the patient, and disgrace for the operator. And this remark holds good in all similarcases.Besides the instruments mentioned as essential, others are alsorequired, such as forceps for drawing the teeth, and for taking holdof the uvula; these are in common use and extremely simple.Tumours and ulcers are diseases of more importance, and deserve attention. The principal point as to the former, is to dispersethem, and prevent their enlargement. Should this take place, wemust endeavour to reduce them as much as possible, and equably;otherwise they may chance to become excoriated , and form ulcersof difficult cure. They are not to be rashly removed, nor shouldthey be opened, until their contents are fully concocted. The meansfor promoting this are elsewhere described. As to wounds andulcers, four kinds are observed. 1. Characterized from depth:these are fistulous, cicatrizing above, but hollow and filled withsanies. 2d. Characterized by elevated carnosities. 3d. By theirbreadth or extent of surface, and denominated creeping. 4th, andmost natural, is attended with suppuration;—all these are seated infleshy parts, and have a common relationship. We have elsewheredetailed their respective symptoms and method of treatment; viz. ,to resolve congestions, to fill up cavities, destroy excrescences, andrestrain their enlargement. We must particularly attend to thedue adaptation of poultices, dressings, and bandages. The first,correctly placed, are of immense utility, and help to sustain thedressings. Their composition assists in the cure, by their action onthe surrounding parts. Time and circumstances must determinetheir composition; this cannot be noticed at present, but it requiresboth knowledge and experience.OF THE PHYSICIAN. 73We have only further to take notice of battle wounds from javelins, &c. , of which few examples occur in towns, though frequent inhostile encounters. Whoever wishes to excel in such cases, mustfollow the camp, and quit his home, as the only means of pursuingthis the most laborious and yet useful branch of his profession. Aknowledge of the symptoms of a concealed weapon in the body, bywhich its presence is denoted, is a high degree of surgery; itscontinuance detects the ignorant, for science only is capable of undertaking those cases. Of this we have elsewhere treated.ON DECENCY IN MANNERS AND IN DRESS.SECTION I.-TREATISE VI.DE DECORO, AUT DECENTI HABITU,DE DECENTI HABITU,DE LA DÉCENCE,FESIUS, p. 22.HALLER, iv. 178.GARDEIL, ii. p. 232.HALLER says this treatise has been always considered spurious,and is unnoticed by the ancients. The writer, whoever he mayhave been, is nevertheless a philosophic physician, and the work isreplete with sound morality. It instructs the practitioner as to whatis essential in his attendance on the sick, so that he may be esteemeda learned, prudent, careful, and attentive man.It is with justice that philosophers commend wisdom in the common concerns of life. There are, however, many kinds of wisdomor philosophy which tend in my opinion to no useful purpose. Imean such as consist of mere verbiage on points of no importance.Yet of these something may be learned, provided it is unmixed withdepravity-I say depravity, for ignorance and inutility are nearlyallied to mischief, and often lead to it. Every thing that awakensattention and accustoms the mind to think, leads to good habits;even discussions on subjects not in themselves of much utility.Such things as are connected with the improvement of science,and subservient to the welfare and honour of mankind, are withreason to be preferred; whatever is not base in itself, or merelyconnected with worldly advantage, is deserving of attention, but itmust at the same time be perfectly innocent. Youth often fallinto the hands of persons who are continually arguing; but whenarrived at maturity, they regard them with contempt, and at alater period, from indignation perhaps, obtain the passage of somelaw, to banish them. Such persons are well adapted to hold forthin public assemblies, where they industriously propagate their deceptions, and thus extend them through a community. They maybe known by their dress and their manners. The more extrava-ON DECENCY IN MANNERS AND IN DRESS. 75gant their attire, the more carefully should they be shunned. Howdifferent are those who are neat and simple in their dress; you seeat a glance that they are deserving of esteem, and their prudenceand moderation are readily appreciated; always uniform , there isneither pride nor ostentation in their demeanour. Serious in conversation and mild in reply, they are nevertheless acute in argument,and not readily discomposed in pursuing it. They are amiableamongst friends and moderate towards all; silent to the clamours ofothers, and deliberating before they speak, they await patiently forthe proper occasion. Temperate in their mode of living, a littlecontents them, and when necessary, can submit to abstinence.Lucid in their discourses, they conceal nothing that they are acquainted with; and from their graceful delivery, are respected byall who hear them, for they assert nothing which they cannot demonstrate. To nature they are principally indebted for all thesequalifications, which, when attained , enable them rapidly to advance in science, for in the acquirement of knowledge, some preparatory attainments are absolutely requisite. Nature and art thenhappily combine in their improvement. We see many who, fromthe deficiency both from nature and from teaching, attract nonotice; hence if required by any one to demonstrate what theyhave asserted, neither nature nor art can aid them. Yet they havepursued the method of the Sophists we have animadverted on, butbeing deficient in essentials, they are exposed, and finally becomecontemptible.Instruction, to be beneficial, should be founded on facts. Artsare deduced from reflection; but any reflections or reasoning, notaccompanied by facts, evince that fault somewhere exists. Tothink merely, and produce nothing, is a proof of error, or of ignorance especially in medicine. Here, opinion alone is criminal,and becomes injurious to the sick. Confidence in self- opinion isdelusive, since fact too often proves its falsehood, as impure goldis tried in the furnace. The common remark, that " finis coronatopus," is lost on such persons as I have pointed out, although thetrue method of attaining the science is daily manifested to all whodesire its acquirement.It may be concluded then, admitting the truth of the precedingremarks, that knowledge and medicine must go hand in hand.The physician who is truly a philosopher is a demigod. Medicineand philosophy are closely allied. That which is taught by the76 THE WORKS OF HIPPOCRATES.latter, is practised by the former, -contempt of riches, moderation,decency, modesty, honour, justice, affability, cleanliness, gravity, ajust appreciation of all the wants of life , courage in adversity—opposition to fraud and superstition , and due consideration of theDivine power. The physician is perpetually exposed to the hazardsof incontinence, turpitude, avarice, intemperance, detraction, andinsolence. How far these may influence his character, may beestimated by his conduct towards his patients, his friends, andfamilies. In all these particulars, the appropriate connexion ofwisdom and of medicine is conspicuous; but particularly so inrespect to the Deity, towards whom the thoughts of the physicianmust be perpetually directed; for the various accidents of lifewhich come under his notice must compel him to acknowledgeHis omnipotence. He dare not ascribe to his art unqualifiedpower, when he reflects on its frequent failure; even when successattends, it is to Heaven alone he owes it. We perceive now, howmedicine leads to wisdom. They, even, who disbelieve in Providence, are compelled to recognise it in their examination of whattakes place in the system, in the change of forms produced, and ofthe cures, both surgical and medical, from operations, or frominternal remedies, and good regimen. These are considerations ofextreme importance.Besides what is said above, something more is wanting to thephysician. This is urbanity. Austerity, repulsive to those inhealth, is much more so to the sick. He must carefully avoidexposing his body too much, or discoursing with the bystandersbeyond what is absolutely necessary. A good physician avoidsall measures that are not conducive to the welfare of the patient;he adopts nothing that is singular or inefficient.A physician should always be prepared for whatever mayoccur, by having every thing essential to his practice duly athand, or it may chance that some article may be wanting whenhe is most in need of it. He ought to accustom himself at alltimes to prepare his remedies, &c. , such as lotions , liniments,pledgets, compresses, and bandages of different kinds, —collyria,&c.; and he should have in readiness all sorts of instruments,machines, and apparatus. Deficiency in these, implies a want offoresight that may prove injurious. A smaller collection shouldbe kept ready in case of a distant call. All should be properlyarranged, so that what is necessary may be immediately found,ON DECENCY IN MANNERS AND IN DRESS. 77for it is impossible to carry every thing with him. His mindshould fully retain the recollection of his medicines and theirvirtues, that also of diseases, their various forms and accompanying symptoms. This may be esteemed the A, B, C, of medicine.He is also to acquaint himself with the compounding of his drugsfor the various intentions he has in contemplation; such as different drinks, purgative potions, &c., having due regard to thearticles he employs, not only as respects their source and species,but likewise the bulk, and age, &c. , all in reference to what isrequired in visiting his patients, so as to be certain of having themat the time they are essential.Previous to seeing the sick, he should consider what he may find.it necessary to do,-for it is assistance that is needed, and notspeculation. Experience will enable him to foresee what may takeplace; this gives him credit, and is not always very difficult. Onentering a sick chamber, he should pay attention to his mode ofseating himself, and arranging his dress (mantle); he should talkbut little, and neither be disturbed himself, nor trouble others. Address the patient cautiously, and let his own remarks be calm, evenif agitation and apprehension exist around him. By this he willshow that he knows what is to be done on the existing occasion.He then may give his directions, and mention his opinion as towhat further may ensue.Frequent visits are required to regulate the changes that maytake place from error or inattention. The disease will thus bebetter understood, and mistakes less liable. The humours areperpetually varying, either from their peculiar nature or from accident. If the proper moment is neglected for timely assistance, thedisease soon increases, and the patient may be carried off from theconcurrence of numerous unsurmountable symptoms, that wouldhave readily subsided had they been foreseen and promptly attended to, by the experience acquired from similar cases. Noticeshould be taken of the faults committed by the sick, who oftendeceive with respect to their remedies. Many fall victims to thisduplicity, arising from their aversion to them. So far from avowing this neglect, they blame the physician. -Care is requisite respecting the sleeping apartments, which should be accommodatedto the season, and to the nature of the disease. Some require bedsin an elevated situation; others, low, and in dark rooms. All noiseand odours should be guarded against, especially that of wine,78 THE WORKS OF HIPPOCRATES.which is very hurtful. If changes of situation are requisite, let allbe done with perfect silence, and as quickly as convenient, so asnot to disturb the patient, for tranquillity is highly essential to hiswelfare. The physician should possess the tact of directing hispatient's longings, by a proper intermixture of mildness and determination, and afford them every consolation , without letting themknow the nature of their disease, or its probable event.-Inattentionin these particulars has tended to augment the present danger, andhasten on the future.It is requisite to have the co- operation of a pupil or assistant, toreceive and execute the orders of the physician. He should beselected from amongst the more advanced in their studies, capableof acting, in any sudden emergency, without injury and of detailing with accuracy all that has taken place during his absence. Byno means should the patient be committed to the ignorant and unskilful; their ill conduct will be ascribed to the physician. Nothingshould be equivocal; by which all blame will be avoided, and hismerit acknowledged. -Let the physician therefore announce to theattendants all that may be anticipated .Since what we have said respecting decorum and wisdom isequally applicable to philosophy and to medicine, and to all otherarts, the physician will attend to them in their particular connexionwith himself, without neglecting what is common to him withsociety at large; for what is favourable to a good name should begenerally pursued by all mankind . Such is the method by whichcelebrity may be attained, both present and future.-If intelligenceis, however, unhappily wanting, at any rate, let prudence, as far aspossible, supply its place.PRECEPTS OF HIPPOCRATES.SECTION I.-TREATISE VII.HIPPOCRATIS PRÆCEPTIONES,*HIPPOCRATIS PRÆCEPTIONES,Avis,FESIUS, p. 25.HALLER, iv. p. 186.GARDEIL, ii. p. 240.WITH respect to this treatise, Haller says, that although spurious,it is by no means unimportant. Its commencement and conclusionappear to be derived from Hippocrates, to whose brevity and gravity it approximates. It gives advice to the physician concerninghis fees, his remedies, and food. Treats of consultations, and denounces the impudence of quackery. In short, like the precedingtreatise, it contains many general precepts that are well calculatedto excite reflection in a philosophic physician, and to prove usefulto him.Opportunity is the work of a moment; itself, of short duration.Aid from medicine is sometimes the work of time, but not unfrequently, it is immediately called for. This is to be well consideredin our intercourse with the sick, who require to be treated, not frommere probabilities, but by observation in connexion with reason.Reflection is a well- regulated remembrance of events perceptible tothe senses. Events are evident facts, which are transmitted to themind through the medium of the senses. Impressions thus frequently produced, the regular train of such events, antecedently and subsequent, is preserved by memory. Reasoning becomes allowable,provided it is based on the complete train of events which are retraced by memory in their proper order and succession. It wouldseem that nature is impelled to its various changes and movementsby many different causes, which serve to illustrate it; because the"Præceptiones- pag -significat præceptum, sive comprehensionem aphoristicam et brevem, quæ facit vel instruendum Medicum, vel etiam ægrum, aut adstantes.Ita Hippocrates libellum præceptionum ad medicum pertinentium conscripsit, &c. "—Castelli, Lexicon Med.80 THE WORKS OF HIPPOCRATES.event that ensues is fixed and certain, and the mind can only become acquainted with it in the way I have pointed out, the onlyway in which it can arrive at certainty. If, on the contrary, ourreasoning is not founded on an evident chain of certain facts, butmerely of probable events, the most fatal consequences may resultfrom the opinions that may be formed; resembling the case of atraveller in an unknown and trackless country. Such persons,therefore, who practise medicine on such doubtful principles, deserve to suffer for their bad success. Is it not sufficient that theunhappy patient is prostrated by sickness, without having it augmented through the unskilfulness of his physician? I repeat therefore, that success cannot be anticipated from reasoning alone, butthrough the agency of the means above referred to. The merebabbler is certain of nothing, and is replete with error and deceit.An accurate attention to events, without neglecting attending circumstances, can alone promote that sure and certain practicewhich is called medicine. It is this only that can render the physician useful to those around him.No difficulty should be made at receiving information from themost illiterate, provided it appears that they have some knowledgeof the subject under consideration. It was thus, I think, that ourart had its origin; collecting together, from all quarters, a body offacts. We ought not to neglect what chance may present, especially if it be reiterated; listening with attention in order to profit,and not repulsing our informant, by boasting of our cures, anddeeming his experience void of utility. Doubts as to remediesspoken of as if alone appropriate, are highly proper. This doesnot imply obstinacy; all diseases, from a variety of circumstances,require at times a difference of treatment.A point deserving of attention in medicine, is respecting the feeof the physician. If he commences by speaking of payment, thepatient will presume that he will not be neglected. By not attendingto this, he will be led to imagine that your attendance will be irregular. I apprehend therefore that a stipulation as to this particularis perfectly correct, except in cases of an acute nature. Here, therapidity of the disease admits of no delay; and humanity will leadthe physician to think more of the esteem he may acquire, than ofmere profit. It is far preferable in such cases to bear the ingratitude of those you preserve, than to stipulate for payment whilst thepatient is in danger. It is true, some persons who under the pre-PRECEPTS OF HIPPOCRATES. 81tence of the hospitality afforded, or the facility of cure, object topayment. Such are worthy of contempt alone. The sick shouldbe considered in the light of the shipwrecked mariner. And whereis the real physician who will not rather faithfully afford his services, than act with inhumanity and rigour? Wherefore, whenyou have made yourself acquainted with the disease, pursue aregular mode of treatment, and neglect nothing that may proveconducive to a cure. Your views as to payment should be moderate, yet sufficient to recompense your labour, without howeverdespising wealth. And with respect to the poor, to visit them gratuitously; preferring thus the pleasure of a grateful mind, to the increase of pomp and parade. Strangers and the poor demandpeculiar attention from the physician, for no one can have a properregard for medicine, who forgets his duty to his fellow- creatures.Some, on their recovery from sickness, appreciating the dangerthey have gone through, extol the benevolence of their physician,repaying thus a debt of gratitude. It is highly praiseworthy to giveadvice, preservative of health, and even of bodily appearance.The ignorant physician cannot comprehend such wholesome preventive admonitions; but being carried away by self- sufficiency,he evinces by his conduct that his standing is misplaced, and hissole desire is that of gain; hence he demands payment both fromthe rich and poor. Proud in prosperity, he spares no expense inhis luxurious habits, and cares not for the faults he commits, undera conviction of impunity; but if adversity overtakes him, he issubmissive and base in the extreme. The true physician earnestlystrives to avoid mistakes, and by this, deservedly merits the nameof master of his art. In the pursuit of his duty, he neglects nothing,not even to those in the most abject poverty, for good faith andjustice accompany him in all his actions. The reverse of this, isevident in those of an opposite character. Dangerous diseasesthey sedulously avoid, and undertake those only that can give theméclat. Consultation with other physicians they carefully shun, bydeclaring their want of confidence in their opinion and judgment.Their patients consequently experience all the unhappy effects, resulting from their imprudent choice. A better selection might atleast have proved beneficial, a circumstance of no trifling importance at times, even if inadequate to a perfect cure.The samereasons that led them to have recourse to quacks, the hope of a682 THE WORKS OF HIPPOCRATES.speedy and perfect restoration to health, frequently induce greatimpatience and neglect in the due continuance of remedies, or inperpetually changing them.If, now, you would institute a comparison as to the ingratitudeof patients, it will be seen that for the most part all are deficient ina due recognition of the services of the physician. The poor, atfirst, are mild and obedient, but ingratitude and ill behaviour toooften succeed. The affluent, in sickness, are exuberant in theirprofessions and promises; but in health, when reminded of payment, they excuse their neglect by their rents not being received,and then think no more on the subject. Enough, however, on thishead. The physician must act according to circumstances.A physician, if embarrassed by the state of the patient, or by thenovelty of the disease, ought to feel no repugnance in calling foraid in consultation, for it often happens that in a dangerous andunyielding disease, anxiety leads to the omission of much thatmight be useful, by destroying that presence of mind which is sohighly necessary to the medical man. Many regard it as a right,that in consultation, their opinion should be acquiesced in; or perhaps they sustain it by calling in question that of others. Now Iam persuaded, that a physician who is prompt to blame others,must render himself contemptible: it is the common practice ofquacks. Consultations, however, are not constituted on such illiberalprinciples, for it is fully admitted, that with even the highest attainment of medicine, still, much is wanting to be known.These particulars being thus disposed of, one still remains to benoticed, as marking the accomplished practitioner, viz. , the due encouragement of the sick, and checking that anxiety with regard tothe progress of disease, which so usually is present. Such anxietyis extremely prejudicial, and he who knows how to prevent or allayit, is of infinite service. How many fall victims to this despair thatinvades them! When, therefore, any one is charged with the careof the sick, their confidence will be gained by stating that our artconsists in following nature, and not striving to oppose her. Anyother plan will prove unsuccessful. In truth, health is that naturalstate, in which foreign agencies are not employed, but a certain harmony of action existing between the air and heat and the concoctionof the humours. Nature exerts herself in the promotion of health, bymeans of our food , and the appropriate functions of the body, unless,PRECEPTS OF HIPPOCRATES. 83indeed, some malformation exists from birth, in which case attemptsto remedy it should be made; for all derangement is unnatural, evenalthough it may progress but slowly.The physician should carefully avoid all affectation, such as theuse of perfumes and similar superfluities. His dress should be neatand decent, without an admixture of finery or ostentation. Anexcess of attention, even to this, is sometimes morbid; of little importance, if duly confined, but when carried to an extreme, it isinjurious to him. I would on no account depreciate gentility. Itis essential to him in his pursuits; but it is important that he shouldknow its boundaries, and its true intent. In a public discourse, heshould not be too flowery or poetical in his remarks; they ratherproceed from idleness or ignorance, than from real knowledge.All information, if even the offspring of deep research, is to becarefully avoided, if it has no bearing on the subject before us.This is particularly the case in medicine, which is sufficientlyattractive in itself, and requires not the foreign aid of ornament.They who begin the study of medicine late in life are much toblame. Self- experience is insufficient; that of others is often ofgreat importance; but their memory of what has been handeddown, is so confused as to confound and render useless all theysay. They talk of their superior knowledge, as if desirous toinstruct the friends around their patients, who have attended to receive their orders. For my part, when called in consultation withsuch boasters, I do not stop to argue with them about the disease,but come at once to the point, by asking what plan they proposefor adoption. As they may chance to know something of whatshould be done, although otherwise deficient, I desire only theirpractical information, and pay no attention to their assumed knowledge in the principles of the art. -Experience, constant, and of longcontinuance, can alone lead to a full and thorough acquaintancewith them. Those who profess to understand them, may be allowedthe privilege of talking; but their practice must be deemed the testof their knowledge.A severe regimen, if not too long continued , increases the desirefor food, but if not cautiously administered, it will augment disease.Should all the wishes of a blind man be indulged, how much injurywould it not be productive of, even in those which he might most.particularly desire.84 THE WORKS OF HIPPOCRATES.Some few remarks of an aphoristic character here follow. -ED.Sudden changes of the air are to be carefully avoided.In youth every thing seems pleasing;-such is not the case in age.Difficulty in speaking may arise from some disease, or from imperfection in the organs of hearing;-from too rapid pronunciation,or extreme rapidity in the evolution of ideas. -Such is by no meansuncommon in those who pursue the different paths of science.Youth is sometimes the best remedy in slight affections.The continuance of disease, with no alteration, indicates that itwill prove of long duration.Diseases are terminated by crises.Little is required to cure, unless the part affected is of great importance.As we suffer by sympathy from the affections of others, so alsowill pain in one part of the system sympathetically call into actionother parts.We should bear with patience the complaints of those in pain.Extreme labour is deserving of some indulgence.A healthy locality is very desirable.SECTION II."THE BOOK OF PROGNOSTICS.HIPPOCRATIS PRÆNOTIONUM LIBER, FOSIUS, Treat. i . p. 36.HALLER, i . p. 166.GARDEIL, i . p. 29.HIPPOCRATIS PROGNOSTICON,TRAITÉ DES PRONOSTICS, .THIS book is uniformly considered as one of the genuine writingsof Hippocrates. In the preface to it , Haller speaks of it as " containing all the symptoms, good or bad, of diseases, as derived fromevery source, and arranged in a natural order, which is unusualfor him. The first symptoms are drawn from the countenance,the mouth, the lips, and eyes: next, from the decubitus; then fromthe appearance of wounds or ulcers; from tossing about of thehands, or picking the bedclothes; from respiration, sweat, the stateof the hypochondria, swelling of them , or of the belly. It nexttreats of suppuration; of dropsical symptoms in acute diseases; ofthe power of the patient in sustaining his disease; his limbs, &c. ,as to colour, temperature, and sense of feeling. Of sleep, alvinedischarges, urine, vomiting, sputation, and of empyema from anacute disease; of auricular abscess-paraphrenitis-inflammationof the bladder; general termination of fever, acute pain of thehead, and ears; ulcers of the throat, and angina; tumour of theuvula; termination of fever in abscess; prognostics of vomiting,and of nasal hemorrhage, and convulsions. Towards the conclusion, Hippocrates demonstrates the absolute necessity of the varioussymptoms enumerated, as the basis of a faithful prognosis. AddingThis section, under the head of Semeiotica, vel " Ea de quæ Signis agunt," contains six treatises. -Enμtrix ,-pars medicinæ quæ signa morborum dijudicat.-Lexicon Hederici.—“ Semeiosis, significatio, notatio, aut designatio dicitur. Comprehendit sub se Dignotionem et Prænotionem: et pars medicinæ doctrinam signorumdiagnosticorum et prognosticorum comprehendens, vocatur Semeiotica, rectius Semiologia, estque pars medicinæ, signorum omnium differentias et vires expendens. "-Castelli Lex. Med.86 THE WORKS OF HIPPOCRATES.that those symptoms, which in Greece are good or bad, are equallythe same in every other country: that even in Scythia, whoever isacquainted with them, is capable of prognosticating. The sameprognosis holds good in relation to diseases not mentioned, butwhich terminate on the same days. The careful observation ofepidemics and of the atmospheric constitution, is enforced. Thepulse alone seems to be here overlooked. "In addition to the above from Haller, I shall introduce a fewpreliminary remarks from Gardeil, who, among other particulars,states that it has been well translated by M. le Febre- Villebrune—a work I have not seen. After saying that the first section ofFosius contains none of the writings ascribed to Hippocrates, hethus proceeds: " It is unquestionably one of the most precious ofthe writings of the father of medicine. In it, the physician willfind the foundation of the whole doctrine of crises, of urines, expectoration, hemorrhages, abscesses, &c. , and every where a master'shand is apparent, so that it appears perfect and complete. Such isnot the case with the aphorisms, and I think every physicianwould find it useful to commit it to memory. Its brevity is its principal defect. It is nevertheless highly probable, that many of ourpresent race of doctors will ridicule many things that are to befound therein, more especially the statement relating to urines; forit is now beneath their dignity to examine the urine of the sick,or even their expectoration for the most part! My own constantobservation of the urine, preserved in glasses for inspection, hasconfirmed me in my opinion of the correctness of the Hippocraticdoctrines. In respect to the pulse, which Hippocrates attended tobut in a very slight degree, I think we err in depending so muchupon it to the exclusion of those particulars almost entirely, inwhich he had the greatest confidence. ” —ED.A physician should endeavour to become acquainted with thephenomena of diseases. He who can inform the sick, not only oftheir present state, but of what preceded and of what may beexpected, and point out what they have omitted to mention, willreadily be esteemed as being perfectly acquainted with theirdisease, and they will therefore with confidence commit themselvesto his care. A foresight of what is to be expected, enables him.the better to fix upon his plan of treatment: a certain cure at allTHE BOOK OF PROGNOSTICS. 87times is impossible, although of more importance than a foreknowledge of events. Some are carried off by the violence of diseasebefore a physician is called on; others, immediately after; somesurvive for a day, others longer; time is not always afforded toemploy fully the resources of our art. It is of consequence however in all cases, to know if the nature of the disorder transcendsthe power of the constitution; or if there is not in it somethingsupernatural; ( IV I. Hipp.; divinum, Hall. , Foes. ) In all caseswe ought to be acquainted with what may take place, as a meansof acquiring a just celebrity, and of meriting the character of anexperienced practitioner; for if a disease is capable of cure, he isthe best qualified to effect it who can best guard against the evilsanticipated moreover, by being capable of prognosticating theevent either of death or recovery, all blame is avoided.In acute diseases, the first thing to be noticed is the countenance.Does it look like that of health? especially is it perfectly natural?The more it differs therefrom the worse. A sharp nose, holloweyes, temples collapsed, the brows knit, ears cold and contracted,and their lobes inverted, the forehead hard, dry, and tense, the wholecountenance pallid , greenish , black, livid or of a leaden hue. If atthe commencement of disease such is the aspect, without other accompanying symptoms, in order to form a right judgment, it willbe proper to inquire whether it may not depend on excessive wantof rest, on violent purgation, or even on want of food. In eithercase, the state of the countenance is of less consequence, and thedisordered system may be restored in twenty- four hours; but if itarises from other causes, and does not change in that space of time,we may safely affirm that death is not far distant. If the disease.is of more than three or four days' standing, and the countenancehas assumed the above-described appearance, we must examineinto the causes that could especially lead to it; at the same timeattending to the signs that may exist in other parts of the body.In examining the eyes, we should ascertain if the light affectsthem, or involuntary tears flow; if squinting attends, or one eyeseems smaller than the other; if the white is of a reddish hue, orthe lids of a livid tint, with the small vessels turgid with dark blood,the cornea coated with sordes, the globe of the eye turned upwardsor pressed forward, or deeply ensconced in the orbit, with diminished transparency, and the whole countenance changed in colour;such symptoms should be considered of the worst character, and88 THE WORKS OF HIPPOCRATES.even mortal. The eyes sometimes are seen in sleep, from the lidsnot closing; if this is customary to the individual, it is less important, or when it arises from a diarrhoea, or from a purgative;otherwise it is a bad symptom, and usually portends death.If the eyelids, the nares, or lips are convulsed, or cold, pale, orlivid, accompanied by any other bad symptom, death is not fardistant. So also may it be said when the lips remain flaccid, cold ,and pallid.With respect to the decubitus of the patient, that situation isbest, that approaches nearest to that of health-as lying on theside, with the arms, neck, and legs slightly bended, with a gentlemoisture over the surface? To lie on the back, with rigid neckand limbs, is bad; but if the patient slides from the pillow towardsthe foot of the bed, it is infinitely worse. The feet uncovered andcold, the legs, and arms, and neck the same, and in continual jactitation, are symptoms indicating great anxiety. Sleeping on the back,with the mouth constantly open, and the legs strongly interlocked,is fatal. Lying on the belly, if unusual in health, is symptomatic ofdelirium or severe pain. Sitting upright at the acme of the disease,is bad in all acute cases, but in pulmonic affections, indicates thegreatest danger. Gritting of the teeth in fever, unless it be a longexisting habit, is a sign of approaching delirium and death: if occurring in the state of delirium , it is fatal.Sores, both old and recent, should be noticed. If the disease ismortal, they become livid, dry, or pallid , and quite dry shortly before death.My remarks as to the motions ofthe hands are the following. Inacute fevers, pulmonary inflammation, phrenitis or headache, if thepatient moves them before his face, to and fro, as if catching atflies or motes, or picks the bedclothes or the walls, his state isdesperate.Frequent respiration denotes pain or inflammation above the diaphragm; deep and very slow respiration announces delirium; coldexspiration from the nose and mouth is mostly a fatal sign. Aneasy breathing in acute diseases, with fever which terminateswithin forty days, is very salutary.Sweats are beneficial in all acute diseases, if they occur oncritical days, and remove the fever. Likewise when they are universal, and do not weaken the patient; otherwise they are injurious.Cold sweats, or, if limited to the head, the face, or neck, are bad,THE BOOK OF PROGNOSTICS. • 89and if associated with violent fever, indicate death. If the fever ismoderate, they indicate a long disease. If they form in drops, likemillet seed, about the neck only, it is bad; but if universal over thebody, it is a favourable symptom. Sweats arising from debility, orfrom violent inflammation, are never salutary.The state of the hypochondria is best when no pain is felt there,and when they are equably soft. If inflammation and pain attend,with tension and inequality, danger is to be suspected. If pulsationis felt in them, it indicates great disturbance, or delirium. Theeyes should be inspected, for if much agitated, madness is to befeared. Hard and painful tumours in the hypochondria, if extensive, are very bad; but if on one side only, the danger is less, particularly if in the left side. Death may be soon expected, if thisstate continues; or, if the fever and swelling extend beyond twentydays, suppuration ensues. A bleeding from the nose, of a salutarytendency, sometimes takes place within a week, which may be expected if the patient complains of headache and disturbed vision,and is under thirty- five years of age. Tumours, soft, and unaccompanied by pain, and yielding to the touch, are longer in duration, but less dangerous. If fever attends, and they do not recedewithin sixty days, an abscess may be expected . Such is the casein whatever part of the belly the tumour exists;—and all such asare large, hard, and very painful, announce the danger of speedydeath. If soft and less painful, death is more remote. Abdominaltumours are less liable to form abscesses, if seated in the epigastrium, than if in the hypochondria. If below the umbilicus, suppuration seldom occurs. Hæmorrhage is more common from tumoursabove the umbilicus. Suppuration, however, is to be apprehendedunder all these circumstances, -and in considering this chance, wemay conclude that tumours pointing outwards are least dangerous,even if extensive, whilst smaller ones, deeply seated, if free of pain,and the surface retains its natural appearance, are not often hazardous. When suppuration ensues, that pus is best that is white, smooth,and soft to the touch, without any offensive odour. It is bad in proportion as it varies from this standard.Dropsies, supervening acute diseases, are all dangerous. Theydo not dispel the fever, but are accompanied with much pain, andare usually fatal. Some have their origin in the iliac regions, somein the lumbar, and others proceed from the liver. In the former,the feet swell, and obstinate diarrhoea attends, without diminution90 THE WORKS OF HIPPOCRATES.of the pain, or of the aqueous depositions. In the latter case, continual disposition to cough exists, which is harsh and dry; the legsswell, and costiveness ensues, with much pain and little evacuation.Swellings of the belly are occasionally seen, sometimes on one,sometimes on the other side; sometimes they are persistent, and attimes disappear.Coldness of the head, feet, and hands, conjoined with heat in thebreast and belly, is a bad symptom. The best state consists in anequable and mild temperature over the whole body. An easychange of position is favourable; but a feeling of heaviness andweight in so doing is dangerous. If to this is added a lividity ofthe nails and fingers, death is close at hand; a dark or black appearance of those parts is less to be dreaded. All conjoined symptoms are to be noticed; for if the patient appears to bear his illnesspretty well, and others equally favourable ensue, the formation ofan abscess may be hoped for, that will prove beneficial, and themortified parts may happily separate. A retraction of the testesand scrotum and penis are significative of severe pain and dangerof death.With respect to sleep, it ought to approximate to that of health,resting at night, and awake during the day. The reverse of this isbad. It is true that sleep from six to ten in the morning is less injurious than after that period; but it is far worse not to be able tosleep at all; whether arising from pain, or fatigue, it may portenddelirium.Those alvine discharges are the best, which have a due consistence, without being hard, and which take place at the accustomedtime of health, and in quantity proportioned to the food taken in.Such are indicative of a healthy state of the bowels. If the stoolsare liquid, it is better that they should not be frequent and large, oraccompanied with flatus. They disturb the patient-prevent sleep-and often, if too copious and frequent, induce fainting. Accordingto the nature of the food, and its amount, two or three dischargesby day, and one during the night may be considered as right, thelargest in the morning, as usual in health. This, however, dependson habit. As a crisis approaches, the discharges ought to becomemore consistent, and of a yellowish tinge, without any very badodour;-round worms discharged at the same time are deemed tobe favourable.In all diseases, a soft and un- enlarged belly, is a good sign. If theTHE BOOK OF PROGNOSTICS. 91discharges are very liquid, white, green, or very red and frothy, allsuch are bad; so are also such as are small, tenacious, whitish, orgreenish. The worst discharges are black, oily, livid, eruginous,and extremely fetid. Those of a mixed character may continue fora longer time, but are equally dangerous; also such as resemble thewashings of flesh , bilious, porraceous, black; sometimes separately,at times commingled . Wind discharged with little or no noise isfavourable; but it is better to be so discharged than to be retained.When passed with crepitus, it often indicates pain or delirium,unless indeed this is done at the caprice of the sick.Swelling and pain in the præcordia, if recent, and not attendedwith inflammation , pass off by rumbling in those parts, especially ifsuperadded to this, there is a fæcal discharge, with wind and urine;the gradual descent of the rumbling to the lower bowels is of itselfa source of relief.Urine, which, up to the crisis, deposits a white,light, and equablesediment, is the best, and denotes a short and not dangerous disease. If it be irregular, sometimes without, sometimes with a sediment, the disease will be longer in duration, and more uncertain.When it is red, and the sediment likewise, it will be longer, butsafer. The sediment resembling coarse meal is bad; yet worse ifit has the appearance of small scales. White and very tender sediment is pernicious; the worst of all is the branlike sediment. Whiteclouds in the urine are good; black clouds are bad. As long asthe urine continues red and limpid, no coction ensues in the disease;if this symptom is prolonged there is much danger lest the diseaseshould be fatal before concoction can take place. The worst urineis that whose odour is fetid, and clear as water, or black and thick;of these the black is the most dangerous, both in man and woman,but the aqueous in children. If the urine continues thin and crude,whilst the other symptoms are more favourable, an abscess belowthe diaphragm may be apprehended. A greasy, web- like appearance on the surface of the urine, denotes a colliquation, and thedanger of consumption. The clouds in the urine should be examined, whether they are high in it, or fall to the bottom; the latter,if of the good colours stated above, is favourable: but the reverse,if the colour is of the bad ones enumerated. In order to avoid deception in prognosis from urine, careful examination should bemade whether any particular disease of the bladder exists; in such92 THE WORKS OF HIPPOCRATES.a case, the symptoms are declaratory only of the bladder, and notof the system .Ofvomiting. The vomiting of bile and phlegm, if not too excessive, is very beneficial. Either of them, singly discharged, is lessfavourable. If the discharge is green, livid, or black, it is a badsign; but dangerous in the extreme, should all of them combine. Alivid- coloured discharge, of an extreme fetor, denotes death. Fetorof any kind in the discharges from vomiting is always bad.Ofsputation. The expectoration in all diseases of the lungs andbreast ought to be prompt and easy, and of a yellow uniform tinge.If after some continuance of pain, it is yellow or red, with muchcoughing, and not well mixed , it is a bad sign. A yellow unmixedsputation is bad. If white, viscid, and globular, this is also unfavourable, as is also that which is grayish and frothy. If not wellmixed, and if black, it is highly dangerous. If nothing is dischargedby coughing, but the rattling in the throat evinces the surcharge ofthe lungs, it is very bad. In all diseases of the lungs, coryza andsneezing, whether preceding or succeeding the attack, are dangerous; but in other, and even dangerous diseases, sneezing is a goodsymptom. Yellow expectoration, with a slight intermixture ofblood, in the onset of peripneumonia, is salutary; but if this extendsto the seventh day and more, less so. All sputation, unaccompanied by relief, is bad, especially if black. All are beneficial whenthey afford relief. Whenever, in these cases, relief is unobtainedby expectoration, purging, bleeding, or by other remedies, or bydiet, suppuration may be expected. If suppuration ensues whilstthe expectoration continues bilious, whether alone or mingled withpus, it is very pernicious, especially if the pus is thus apparentwith the bilious expectoration on the seventh day of the disease;for the danger of death on the fourteenth day is great, unless somefavourable symptom should occur in the interval. Thus, if thepatient sustains his disease with ease, breathes and expectorateswith facility and with less pain, has his body of an equable temperature and softness, and is not very thirsty; if, also, the urine,stools, sleep, sweat, and other signs are favourable, as previouslymentioned, every hope may be entertained of a happy termination;but if several of these good symptoms are wanting, he will not survive the fourteenth day. If, on the contrary, the disease is badlysupported, the breathing quick and frequent, pain unmitigated, ex-THE BOOK OF PROGNOSTICS. 93pectoration difficult, thirst extreme, unequal heat of the body, thebelly and breast very hot, forehead, hands, and feet, cold, -sweat,sleep, urine, stools, of a bad character; all these are dangeroussymptoms; for if any ofthem are conjoined with bilious and purulent expectoration, the patient will die on the ninth or eleventh day.In these conjunctures, such sputation must be deemed fatal , and asannouncing death before the fourteenth day. By a comparativeestimate of these good and bad signs, we deduce the prognosis, andthereby look into futurity.Some ofthese abscesses break on the twentieth day, some on thethirtieth and fortieth, whilst a few extend to sixty days. We maypresume that suppuration has commenced from the day that feverhas shown itself, or previous chills, particularly if the patient complains of a great weight, instead of pain of the affected part, forsuch is the usual mode of an incipient suppuration. The time ofthe abscess breaking will be as above stated, reckoning from thebeginning of the disease. In order to know on which side, or ifonly on one, the abscess exists, the patient should be turned oneach alternately, and thereby ascertain if he suffers pain in onealone, and feels a greater heat in either; if lying on the sound side.he feels as it were a weight pressing above it, the abscess exists inthe side in which the weight is felt. The general diagnosis of anempyema is as follows. The fever is permanent, slightly remittingduring the day, but augmenting at night, with copious sweat, cough,and tracheal irritation, with but trifling expectoration. The eyesbecome hollow, the cheeks red, the nails curved , the fingers become hot at their extremities; the feet swell, and the appetite islost; pustules arise over all the body. In all chronic abscesses ofthe thorax, these symptoms appear, and may be depended uponunhesitatingly. But in recent empyema, the symptoms previouslymentioned as occurring at the beginning of a suppuration, arepresent, to which may be added great difficulty of respiration.As to the prognosis in empyema, the following symptoms willguide us, as to the period of their rupture. If at the commencement there is severe pain and oppression, with cough unaccompanied by expectoration, it may be expected on the twentieth dayor sooner; if the pain is moderate, the other symptoms existing asabove, it will rupture later, but previous to this event, the pain,a Vomica, suжNμA.94 THE WORKS OF HIPPOCRATES.oppression, and cough, will greatly augment. After the rupture ofthe abscess, those escape, in whom the fever terminates the sameday, with a return of appetite and cessation of thirst. The fæcesare small in amount and solid; expectoration is easy and withoutsevere coughing, of well-concocted pus, of a uniform colour, andunmixed with phlegm: a cure soon follows. In proportion as theexisting symptoms differ, in the same degree will health be postponed. Ifthe fever does not cease, or if afterwards it returns withviolence, attended with nausea, thirst, diarrhoea; if the matter expectorated is greenish, livid, and frothy, and pituitous, death willassuredly follow; but if only a part of these symptoms take place,some will die, whilst others recover after a long time. All theseand every other symptom are to be attended to, in forming a prognosis. In pulmonic diseases, if abscesses about the ears ensue, orabout the lower limbs, these depositions are favourable, and curewill follow. It is to be noticed in these cases, that when fever continues, with unmitigated pain, and expectoration is unduly small inamount; the stools neither bilious nor well mingled; the urine trifling, with little sediment, whilst other symptoms are favourable,such metastases may be looked for. Abscesses form in the lowerextremities, when pain and inflammation about the hypochondriahave existed; but in the upper extremities, when they have beenfree from those attendants, and the difficult breathing has subsidedwithout any evident cause. Abscesses in the legs in dangerousperipneumonies, are always favourable; the most so, are those thattake place at the time of a change in the expectoration. If swelling and pain take place, when the expectoration becomes purulent,and easily discharged, the patient will certainly recover, and theabscess will soon heal without pain. But if the sputation is bad,and the urine affords a bad sediment, there is danger of the abscesscausing lameness, or great trouble. And should such abscessesdisappear, and expectoration not follow, but the fever continuing,delirium and death are to be looked for. Internal abscesses fromperipneumonies are usually fatal to old people. Young people aremore in danger from abscesses elsewhere.lower limbs, beOther attendantFever, accompanied with pain in the loins orcomes dangerous by metastasis to the diaphragm.signs are to be attended to, for if they are bad, the state of thepatient is hopeless. If, on the contrary, they are favourable, aninternal abscess may be anticipated. In all abscesses, openedTHE BOOK OF PROGNOSTICS. 95either by cautery or incision, if the pus is white, and not offensive,health will follow; but if it be sanious and muddy, death is to belooked for.Of Symptoms derived from the Bladder. -A hard and painfulbladder is altogether dangerous and fatal, especially if accompanied with continued fever. The pains of the bladder are of themselves adequate to produce death. They induce such obstinateconstipation, that the hardened mass can only be removed byforce. If the urine becomes purulent, with a white and light sediment, the danger is removed; but if, notwithstanding, the pain continues, the tension of the bladder also , and the fever, there is everyreason to expect a speedy death. This state is most usual in youth,between seven and fifteen years.OfFevers and their Crises. -The day on which fevers terminate,is ascertained, from observation, long continued, of the day of therecovery or death of the sick.The mildest fevers, accompanied by the most favourable symptoms, usually terminate on the fourth day or sooner. Those of aworse character, and most unfavourable symptoms, end in deathon or before the fourth day. Such is the shortest course they run.The second series terminate on the seventh day; the third on theeleventh; the fourth extends to fourteen days; the fifth to seventeendays; the sixth to twenty. Thus all acute diseases terminate infrom four to twenty days, with intervals of about four days. Anabsolute accuracy cannot be attained; for neither are the years ormonths determined by a precision in days. Another series thenoccurs, in which the first circuit extends to thirty-four days, thesecond to forty, the third to sixty days. To ascertain at first thecrisis of diseases of long duration, is very difficult; it is equally soas to their absolute commencement. Strict observation is necessary from the first, and thenceforward by quaternary periods, inorder to discover how the disease will end. The same order isobserved in our judgment as to quartan fevers. It is easy to predict the event in diseases of a short course, for their character isdifferent from the beginning. Such as tend to recovery, areaccompanied with easy respiration, without pain; the patientsleeps well, and other good symptoms attend. Those tending todeath are in all respects the reverse, and have delirium, with allaOwing to the frequent intercalation of the Greek calendar.96 THE WORKS OF HIPPOCRATES.the train of dangerous symptoms. Such being the case, we formour prognosis, near the period of their crisis, from their duration,and from every existing circumstance. In predicting the eventswhich follow delivery in females, we are to reckon from thatperiod.In fever with violent and continual headache, with other dangerous symptoms, death generally ensues; but should it extend totwenty days, without other bad symptoms, a bleeding from thenose, or an abscess in the lower parts, may be expected. Thesemay also be looked for at the commencement, if the pain is felt inthe temples and forehead. Hemorrhage is more common underthirty-five years, and abscess after that age.Acute ear-ache, with continued fever of extreme violence, is amost dangerous, symptom; it indicates delirium and death, andtherefore demands particular attention to every other symptom' from the very beginning. Death takes place, in youth, within sevendays, but in adults at a much later period: the fever and deliriumin these are much less intense, and the suppuration of the ears isenabled to take place. Relapses are more likely to carry them off.The former perish before suppuration is established, unless a flowof whitish pus ensues, when there is some hope, more especially ifsome favourable symptom should show itself.Ulcers of the fauces, with fever, are very dangerous, particularlyif any ofthe bad symptoms enumerated appear. Quinsies are mostdangerous, and speedily prove fatal, whenever they are unattended by any sensible appearance in the neck or fauces, but are accompanied by violent pain and orthopnoea. Death in such casesoften happens in twenty-four hours, although it may be deferred tothe second, third, or even the fourth day. If a tumour and rednessattends, the danger is imminent, and in proportion to the inflammation; but the termination is more distant. When the inflammationoccupies both the throat and fauces, the period may be of yet further extension. Some under these circumstances escape; especially if the redness of the neck extends to the breast, and shouldnot strike in. But if this erysipelas does not recede on the criticaldays, and no external tumefaction appears, if no pus is coughed.up, the patient free from pain, and seeming well, death is indicated,or a retrocession of the erysipelas. It is less dangerous when theswelling and redness soon appear externally; but should the diseaseTHE BOOK OF PROGNOSTICS. 97extend to the lungs, delirium follows, and it not unfrequently terminates in empyema.When the uvula is red and tumid, there is danger in burning,scarifying, or cutting it, for it is followed by inflammation andhemorrhage. Other measures must therefore be duly employed torelieve it. But if it becomes paler, and the relaxation gives theround appearance at its extremity of a grape, whilst its upper partappears thin, it may then be safely removed. It is proper to purgegently before the operation, if the hazard of immediate suffocation.will admit of the delay.IfWhen fevers disappear without the accompanying favourablesigns at the critical periods, a relapse may be apprehended.they continue for a long period without any inflammation or othermanifest cause of pain, an abscess with tumour and pain in someof the joints, especially of the lower extremities, may be looked for;-such occur more speedily, and more frequently in persons underthirty years of age, and rarely until the fever has continued morethan twenty days. Old people seldom suffer in this way, even infevers of the longest duration. Such abscesses occur in continuedfever; but if it is erratic in its type, and comes and goes, it will, asautumn advances, be likely to assume the quartan form . And, asabove stated, abscesses are more common before the age of thirty,so after that period and in old age, quartan fevers are predominant.Abscesses are more common in the winter; they are longer inhealing, but are less liable to recur.Of vomiting.-Whoever labouring under a fever that is notdangerous, complains of violent headache, with cardialgia, andnubicula floating before his eyes, will vomit up bile. If rigoraccompanies those symptoms, and the inferior parts of the præcordia are cold, the vomiting is at hand and will be hastened byeating or drinking. Those who suffer from headache at the time.of attack will have it augmented on the fourth and fifth days, andon the seventh it will terminate. It is more usual for the headacheto begin on the third day; the fifth is then the worst, and the ninthor eleventh it ceases. Should it begin on the fifth day, and be inother respects as above mentioned , the disease ends on the fourteenth. Such is the case with adults, both males and females, intertians especially. In young people also, but more so in continuedfever, and those of a true tertian type. When in these sorts offever headache occurs, and weakness of vision, or sparks appear,798 THE WORKS OF HIPPOCRATES.with tension of one or the other hypochondria, without pain orinflammation, epistaxis and not vomiting may be expected. This,especially in young people; it is not so common beyond thirty, andin advanced life: in these, vomiting may be expected.Of convulsions.-When children have an acute fever, withcostiveness, insomnia, and are readily terrified and cry, withfrequent change of colour from florid to pale or yellowish, convulsions may be anticipated. These readily take place from theslightest causes in infancy to seven years; beyond that period,convulsions in fever are more uncommon, without the attendanceof such dangerous symptoms as are seen in phrenitis. Our prognosis in the diseases of children, both of health and death is, as inother cases, to be deduced from all those symptoms that have beenmentioned: we mean in acute diseases, and those which resultfrom them. Now, whoever wishes to foretell whether health ordeath will take place, or whether the disease will be long or short,ought to make himself fully acquainted with all the symptoms andtheir respective strength, especially as to those derived from urine,and from expectoration in which there is a mixture of pus andbile. He must also be able to determine promptly, the nature ofexisting epidemics, and the constitution of the atmosphere-neverforgetting, that in every year and season bad symptoms are theevidences of ensuing evil, and good ones of a fortunate issue. Suchas I have described, are equally true as to Lybia, Delos, or Scythia.The verification of our prognosis in those regions will not surprise.if given with deliberate judgment, and an accurate estimate of allthe symptoms. Those diseases that have not here been spoken ofby name, are all to be judged of by the same indications whentheir crises occur in the same periods.HIPPOCRATES ON THE HUMOURS."DE HUMORIBUS,DE HUMORIBUS,DES HUMEURS,FESIUS, Treat. ii. p. 47.HALLER, i. p. 89.GARDEIL, i. p. 57.In his preface to this treatise, Haller tells us that Galen appearsto have thought it genuine, since he wrote a commentary upon it,or else upon another that has been lost. Mercurialis consideredit doubtful, since ancient critics mostly repudiated it. To me, saysHaller, it seems genuine, and the production of the writer of thetreatise, " De Locis, " for we find in it the same alternating superiority of bile and pituita, that is there depicted. It also containssome things that are to be found in the first Epidemics, a book thatis undoubtedly genuine; as well as some aphorisms, the same to aword, as in the book under that title. It possesses, moreover, thebrevity of Hippocrates; for we find the names of things alone, without the slightest comment. It commences with a theory of the humours, and of their various tendencies. It briefly rehearses thesigns of diseases, and the common rules of practice; notices thecritical days, and the power of different ages, years, and winds, andaffords examples of metastases from the Epidemics.In its general character it consists, according to Haller, of medical precepts, relating both to the sick, and to the diseasesthemselves, their different sources in atmospheric changes andconstitution; how to foretell those different constitutions from theexisting diseases, and of the preventive powers of hemorrhoidalaffections.According to Gardeil, if this treatise is compared with a commentary on it, by Galen, it will be found to be mutilated inseveral places. Haller has conveniently divided this treatise underaXvμos, succus, humor, —in a general way, may be considered as embracing all thevarious fluids of the body, chyle, blood, bile, &c.100 THE WORKS OF HIPPOCRATES.eight short chapters, in which I follow him, with the heading toeach one.-ED.CHAPTER I.The collection of humours is to be conveyed away by appropriate channels at propertimes, or must be resolved by derivation, revulsion, and other means.The colour of the humours, unless deep- seated , is perceived, likean efflorescence on the skin. When they tend at any time to breakforth, they should be directed through their appropriate excretories,with the exception of such as require time for maturation, observing carefully, whether their tendency is outwards or internally, andtaking every due precaution, by attention to the rise of symptoms,and to any difficulty they may present. The state of the hair, ofthe viscera, the fulness of the lower parts, and the good state of thesuperior; what has a tendency of its own accord, either upwards ordownwards, and what appears injurious or beneficial; what is inconformity with custom, region, age; the state of the season, andnature of the disease; what is deficient, or in excess, or altogetherwanting. The discharges, remedies, variation or decline of disease, or its tendency to the head or sides, or downward by revulsionfrom the upper parts, or upwards, from the inferior. All theseparticulars require attention; so also as to what parts require desiccation, or moistening, or other means of relief. Effused fluidsare to be prevented returning, and their passages are to be driedup. Disturbance in the bowels, how to cleanse them; if abscessthreatens in the fundament, and if to be remedied by medicine orby suppuration; if there is a congestion, or appearance of pustules,a discharge of flatus, or food, or worms, or great heat, or any otherdisease.a " Ducere oportet quam in partem momento feruntur, per loca accommodata, nisiquorum maturationes progressu temporis contingunt, quæ vel foras, vel intro, vel alioquo expedit tendunt. ” —Fœs. , p . 47. It might be supposed without difficulty, that what is marked above in italics has reference to some of the exanthematous eruptions, as measles or small pox.b Bλaσтnμa; pullulatio, Fœs.; pustulosa eruptio, Hal.ON THE HUMOURS. 101CHAPTER II.What is to be regarded by the physician-Activity essential in the art of medicineConsiderations respecting irregularity of humours—Of infra- umbilical pains.Notice is to be taken of what terminates spontaneously; if thepustular eruptions arise from heat, and if they are injurious or beneficial. So too, we are to observe the form, mobility, elevation,and depression of tumours, sleep, insomnia, anxiety, jactitation; andthus foresee what we are to do, and what to avoid. Attention isrequired as to vomiting, purging, expectoration , nasal mucus, cough,flatulence both up and down, singultus, sneezing, urine, tears,itching, excoriation, palpitation, thirst, hunger, repletion, dreams,facility or inaptitude to work. We are to attend to the state ofthe mind, as developed by its ideas, by memory, speech, and taciturnity.In female affections, regard is to be paid to the uterine discharges; if upwards, inducing tormina; if sebaceous, uniform, unmixed, frothy, hot, acrimonious, eruginous, of different colours,feculent, bloody, not flatulent, crude, concocted, dry, and also thedischarges of the parts adjoining. How all these are sustained, andwhen and how they are to be checked; which tend to maturation,and to be evacuated downwards; the fluctuation of such as areseated above, or are discharged from the uterus; the sordes fromthe ears; the maturation, rupture, discharge, heat or coldness, bothinternally and externally. Intestinal tormina below the umbilicusare less intense and frequent than when above.CHAPTER III.Alvine evacuations considered.We are to notice the character and appearance of the alvine discharges, if, or not frothy,-whether crude or concocted, cold, fetid,dry, moist, or very offensive. Does thirst arise without great heat,or other apparent cause? Examine the urine, and nasal moisture;102 THE WORKS OF HIPPOCRATES.is there great jactitation and heat of the body, and difficulty in respiration? How are the præcordia and extremities, the eyes, the countenance, the pulse? Is there palpitation, rough cuticle? Howis thestate ofthe tendons and joints, of the voice, mind, person, hair, andnails? and how does the patient bear his sickness? All these areso many symptoms for our attention.Other symptoms are derived from the odour of the body, or ofthemouth, the stools, the ears, flatus, urine, ulcers, sweat, sputum, tears,&c. Are any of these humours saline? All these signs may beunder particular circumstances good, or bad. Insomnia also affordsus information, as likewise what occurs in sleep. We must ascertain if the patient hears well, and is obedient to directions, and ifthe majority of symptoms, and the strongest, are favourable. If thepatient is perfect in his senses, and readily accommodates himselfto every thing around, as odours, conversation, clothes, figures, andif he seems benefited by any of them. All these, if natural, areadvantageous, especially towards a crisis. Eructations, and theurine deserve attention also, the last especially, if it is at propertimes and in due amount; if the signs are adverse, we must directour care to restrain the evil.Those parts that are nearest to the organ affected , or which arealike in function, are the first to become influenced by it, and in ahigher degree. Its nature is judged of by the primary symptoms;the crisis is estimated by the urine and all other concurrent signs,such as the change of colour of the skin, difficulty of breathing,and others associated. We must examine whether or no the excretions are natural, whether of the urine, from the uterus, thesputa, by the nostrils. Examine the eyes, and if any exudationoccurs from tubercles, wounds, or pustules, compare what may benatural, and what the effect of art; what connexion exists betweenall these about the crisis, whether for good or evil, that you mayas much as possible avert the bad, and aid those that are of afavourable nature.We must also attend to the skin, the extremities, and joints, thepræcordia, the eyes, mouth, tongue, manner of decubitus, andsleep; from all which indications are derived as to the crisis,and the measures to pursue; they aid in estimating the formationof abscesses; we must not omit to judge of the effects producedfrom the different foods and drinks, and odours; from seeing, hear-" ON THE HUMOURS.103ing, ideas, thinking; from heat and cold, moisture and aridity;and with respect to remedies, we must attend to their effects,whether they be unctions, liniments, cataplasms, plasters, or aspersions, singly or conjointly.We must consider if the patient be accustomed to work, orinactivity; notice his sleep and watchfulness; if easily excited ordepressed, and if such influence is partial or universal, or the resultof the measures adopted. Also, if at or near the increase of thedisease, or at its decline, and if the feet are cold. In periodic complaints, during the access, we must not give food or force it uponhim. At the crisis, and even a short time before, nothing shouldbe done, but leave all to nature. After concoction has taken place,then we may act; never whilst the humours are crude, or at thebeginning, unless by their force they tend to discharge themselves,which is rarely the case. When necessary to evacuate, effect thisthrough those channels to which a tendency is evident. The utilityof evacuations is not to be estimated by their quantity, but by theirfitness, and by the relief they afford. When it is necessary to induce debility and faintness, this may be effected by derivation, orby drying up, or moistening, as the case may be, that is, if the patient can bear it. This is known by parts naturally dry, becominghot, and those that are moist, becoming cold. Alvine dischargesare here generally to be restrained. If the disease is periodic, andwell marked by exacerbation on uneven days, emetics are given,—and purgatives on even days; for we find spontaneous evacuationsuseful, unless the exacerbation occurs on even days, -in which casethe treatment is to be reversed. Such, however, seldom occur, andwith difficulty is a crisis produced. If such a type continues forany time, as for instance if the increase is well marked on the thirteenth or fourteenth day, then we should purge on the thirteenth,and vomit on the fourteenth, by which a crisis is assisted. In suchas extend to twenty days, besides the regular stools, copious purgation should be employed before the crisis.In acute diseases, much purgation is unnecessary in those whoare worn down by them. In fevers, abscesses of the joints or parotid tumours take place near where pain has been felt, which iscommonly in the superior parts. If the disease be slow, and tendsdownwards, the abscess will be in the inferior parts. Hot feetgenerally indicate its location below; and cold feet, in the upperparts. In convalescence, if the patient experiences sudden pains in104 THE WORKS OF HIPPOCRATES.his hands and feet, there the abscess will form; or if, previous tofalling sick, he had pains in any part, there will the deposit takeplace. Such was the case in those with coughs and anginas atPerinthus, for they as well as the fevers ended in abscess. Such,too, occurs in those surcharged with humours, or by a wastingaway ofthe body or mind. Hence it is necessary to know at whatseason the humours are most turgid, and to what diseases they giverise, with their appropriate symptoms. We should be acquaintedlikewise with the disease to which a patient may be most liable inany part, as to an indurated spleen. And as regards other parts,what is it that produces an unhealthy colour of the skin, or shrivelsup the body?—and so of the rest.CHAPTER IV.Of the uneasiness of the mind and body—The sudden sight of a serpent induces apallid countenance-The earth assimilated to the stomach.We are also to consider what are the effects of intemperancein food or drink; of too much or too little sleep; or of thepassions, as of gaming; of great fatigue, whether of body ormind, and if or not of an accustomed character. The changeswhich take place are to be investigated, together with their causesand effects. Thus, as to what are the effects of mental labour, indeep research, thought, seeing, converse; or from sorrow, anger,avarice, and all that can exert an influence on the mind andbody, through vision or hearing. The noise of a grindstone setsthe teeth on edge; the sight of a precipice near to which we pass,makes the legs tremble; as do our hands, when any thing is suddenly snatched from them that we wish to retain; the unexpectedsight of a snake induces paleness. Fear, modesty, pain, pleasure,anger, &c. , all produce some change in some part of the body, assweat, palpitation, and similar effects.External agents are beneficial or hurtful, according to circumstances; as anointing, shower baths, liniments, plasters, cataplasms,bandages, and such like. They produce effects internally, just asinternal remedies produce external effects; sleeping on uncleanwoollen fleeces, smelling the cumin called royal. We observethe effects of catarrh on the voice and speech,-the influence ofON THE HUMOURS. 105age on the mammæ, the uterus, the testicles, and their secretion,inducing hysteria, cough, and difficulty of breathing. As the earthis to vegetables, so is the stomach to animals, in the production ofnutrition, warmth, and cold; warmth when it is full, and cold whenempty. As the ground well manured is warm in winter, so is thestomach. Trees have a dry and thin bark, but if their interior isdry and pulpy, they are healthy, lively, and not apt to decay. It isthe same with animals, such as tortoises and the like, under similarages, seasons, and years. The actions of life are all benefited bymoderation. As a new cask leaks, and an old one retains its contents, so the stomach transmits its nourishment, but retains therecrements.CHAPTER V.Of the modes of diseases-Diseases dependent on the seasons--Seasons judged of by diseases.The forms of disease are various. Some are congenital, and aredetected by inquiry. Some are endemic, peculiar to certainregions, and attacking numbers. Others originate from a peculiarconstitution, regimen, locality, or season. Unhealthy situationsproduce diseases corresponding to the constitution of the atmosphere that is dependent on their locality. Sudden changes oftemperature bring on complaints analogous to those of autumn, andso of other changes. Some diseases arise from marsh and otherexhalations; or from the nature of the water, producing calculusor affections of the spleen. The winds are also of a beneficial orhurtful character. As are the constitutions of the year, so are thediseases. If mild and not tempestuous, the diseases are not difficultto manage. Diseases peculiar to certain seasons, indicate by theirappearance the approach of those seasons. According to thevariation of the seasons in their constitution, diseases of a regularor irregular type appear. If the season is natural, they are of acommon kind; in autumn, repeated variation in heat and cold induces jaundice. If heat predominates, the diseases are bilious, andshould it be extreme, the spleen becomes affected. If similar variations take place in spring, jaundice is likewise seen. If summer .has the character of spring, the fevers are accompanied by sweats;they are mild, and not very acute, and the tongue is moist; but if106 THE WORKS OF HIPPOCRATES.spring resembles winter, and the cold is long continued, the diseasesresemble those of winter, and coughs, pleurisies, and sore throatare common. Again, in autumn, if the cold is tardy in appearance, the usual seasonable complaints are wanting; and whenthey appear, they are of anomalous character; for seasons, likediseases, have their irregularities, whether of too early, late, orsudden approach. Generally, however, the seasons and theirdiseases are sufficiently uniform, and it is proper to pay someattention to the state of the system at these different seasons ofthe year.CHAPTER VI.Irregularity of the seasons are productive of difficulty in crises; and also inducerelapses.A south wind affects the sight and hearing, induces headacheand lassitude; if of long continuance, the discharge from woundsand ulcers is augmented, particularly those of the mouth, pudenda,&c. If the north wind prevails-coughs and sore throats ensue,with costiveness and paucity of urine, and pains in the side andbreast. These are all more likely to appear as the wind predominates-and should it still continue, accompanied by drought,fevers will follow, equally as after rains, or other extremes of theatmospheric constitution, according to the state of the body duringsuch successive constitutions, and the humour that predominatesin it. The aridity of the north and south winds differs in manyrespects, as to the degree of dryness at different seasons of theyear, and in different countries. In summer, bile is produced, andblood in spring-and thus of the other humours. All vicissitudesinduce disease, and those, proportioned to such changes whichoccur in different seasons. The change is sometimes insensible,and the seasons are then less sickly. So with food, cold, and heat;they ought to be slowly diversified as the ages of life pass into- each other. The constitution differs in relation to the season;some are improved by winter, others by the summer. They varylikewise in respect to climate, age, food, and even to diseasesome constitutions are less influenced by these than others. Somereadily adapt themselves to seasons, climate, diet, and disease.There are food and drinks, and regimen peculiarly adapted to theON THE HUMOURS. 107different seasons. Winter is a season of relaxation , and requireslight nourishment and of easy digestion; this is of importance.The autumn is that of labour and exposure, and demands muchdrink, different sorts of aliment, wine, and fruit.CHAPTER VII.The character of diseases may be conjectured from that of the seasons; and fromthe character of diseases we may predict the nature of the subsequent season-Foretelling of dropsical complaints—Variation of complexion according to the seasons.As we are capable of conjecturing the various complaints of thedifferent seasons, so also, by the diseases that ensue, are weenabled to foretell the occurrence of drought, of rain, and thedirection of the winds. Attention will confirm this remark. Weobserve, for example, some cutaneous affections and pains in thejoints, that are affected with much itching on the approach of rain-and so in other cases. Rain occurs at times periodically, viz.:daily, every third day, or continued, or at other intervals. Certainwinds likewise blow for successive days, others in opposition tothem; some continue for a brief period-others, at fixed andsettled times, having an apparent connexion with the constitution ofthe seasons, but of less duration. If a peculiar constitution of theair continues throughout a great portion of the year, the diseasesto which it gives rise will also continue; and the more violentthey are, so will they be more extended, and of longer duration.Humidity after extreme drought is promotive of dropsies on thecoming on of rain, or when slight changes of the wind are apparent. We may hence form an idea of what diseases may beexpected from the state of the winds and moisture; and endeavourto ascertain what kind of spring or summer will succeed to suchor such a winter.The complexion is not uniform, either in the seasons, or in theconstitutions of the air, induced by the north or south winds; norat the different periods of life, whether by comparison of individuals with themselves, or with others. This must be referred tocauses which we know to be productive of such irregularity; ageitself acting in a measure like the seasons, both as to complexionand existence.108 THE WORKS OF HIPPOCRATES.CHAPTER VIII.To what diseases those affected with hemorrhoids are not subjected.Those who have hemorrhoids are not subject to pleurisy, inflammation of the lungs, to phagedenic ulcers, furunculi or tubercles; perhaps not to lepra, nor to vitiligo: but if the hemorrhoidsare unseasonably healed up, they are not unfrequently attackedby some of those complaints, and sink under them. Besideshemorrhoids, other abscesses are occasionally preventive of diseases, and sometimes cure them when supervening during theiractual existence; but where they are concomitants of the disease,they cannot be regarded in this salutary point of view. Parts, ofwhich we have apprehension of danger, are at times preserved bythe accession of pain and uneasiness in the parts already diseased,or elsewhere, or by some sympathetic connexion: blood, if notthen any longer discharged, may be expected as near at handfrom the lungs. And here, in some cases, bleeding is foundproper; in others, its omission is most correct: the season , painof side, bile, &c. , will help to determine its propriety. If swellingsabout the ears do not suppurate at the crisis, the disease will returnon the subsidence of those tumours; and if at the crisis of thisrelapse they are again elevated, and continue so to imitate theperiodic type of the fever, it may be expected that the disease willbe transferred to the joints. The urine sometimes becomes thickand white (as in the case of Archigenes) , in fevers attended withgreat lassitude, on the fourth day, with advantage, especially ifaided by copious bleeding from the nose, by which means suppuration is prevented. A person who was afflicted with the gout,was attacked with pain of the bowels, which assuaged that of thejoints; but when the pain of the bowels ceased, that of the goutreturned with redoubled force.HIPPOCRATES ON CRISES.DE JUDICATIONIBUS,DE JUDICATIONIBUS,• FESIUS, Treat. iii. p. 52.HALLER, ii . 205.DES CRISES, C'EST- A- DIRE, DES JUGEMENS DES MALADIES, . GARDEIL, ii. 250.THIS treatise is in an aphoristical form, and of great brevity, as ifwritten, says Haller, by some pupil of Hippocrates, who had collected together the maxims of his master. Many of the presagesappear in various other of the books, as in the Aphorisms, Prænotions, and De Locis. This contains a statement of the crises ofdiseases, both good and bad, as derived from the alvine discharges,the urine, sweat, abscesses, symptoms, and other circumstances;and of which are good or bad in fevers and other diseases.In order the better to comprehend this treatise, it may not beimproper to precede it by a short exposition of the subject of crises,as laid down by the ancients. By them a crisis was considered tobe a sudden and unlooked-for change in a disease, pointing to recovery or death, occasioned by the contest between nature and thedisease; wherein, if she was superior, the patient was preserved,otherwise death was the result. In a more limited sense, the termsometimes was applied to the secretion of some humour; butusually it was intended to convey the idea of a judgment formedon the existing disease. In this view, crises were considered aseither perfect, or imperfect. The first implying a perfect and absolute liberation of the sick person from his disease, either by a restoration to health, or a termination in death. Hence it was termedsalutary, or fatal. A salutary crisis required the following circumstances. 1. That it should be attended by a train of the most favourable signs or symptoms. 2. That it should be manifest andclear. 3. That it should occur on a critical day. 4. That itshould be trustworthy. 5. Absolutely certain and secure; and 6.110 THE WORKS OF HIPPOCRATES.Of a character befitting both the disease and the patient. The imperfect crisis consisted in its not producing a perfect terminationof the complaint, but in part only, leaving this for a future recurrence, which might be for the better or worse. If for the better,although not entirely removing the disease, yet the patient was evidently benefited by it; whilst, in the opposite case, every thingbecame exasperated and more dangerous. Many considered acrisis as depending upon the motions and influence of the moon andstars. Others supposed it owing to the greater or less degree ofmaturation of the humours, &c.; whilst others ascribed it to a difference in the constitution of patients, and to the plan of treatmentthat was pursued. The term crisis is derived from xp , judico.I follow Haller's division into chapters, as in the preceding treatise.-ED.CHAPTER I.What sweats, alvine discharges, urines, and other important symptoms, portenda favourable change and crisis.The symptoms which portend a speedy recovery are the sameas those which, for the most part, are indicative of health.The best sweats are such as most speedily diminish fever, whichtake place on critical days, and finally subdue the fever. Thoseare also beneficial which are universal, and relieve the patient.When they do not produce this effect, they are of no advantage.When disease is tending to a crisis, the alvine discharges shouldbe more consistent, slightly yellow, and not very offensive. Thedischarge of worms at this period is beneficial.The best urine is that which deposits a white, light, and uniformsediment, during the progress of the disease. It indicates safety,and a short attack. If the disease ceases at the coming on ofsweat, and a white sediment appears in a reddish urine, it willrecur on the same day, but terminate happily on the fifth day. Inthose whose recovery is at hand, we find them free from pain,tranquil, with sound sleep at night, and other favourable appearances.ON CRISES. 111CHAPTER II.Of the causes and solution of headache in fevers not of a dangerous character-Ofcritical days, and by what channel a crisis occurs-What a jaundice indicates in such cases.In slight fever, accompanied with headache, with other attendantsymptoms, bile predominates. When those attacked suffer much inthe commencement, and the pain augments on the fourth and fifthdays, the fever will subside on the seventh day.Fevers terminate in a crisis in the same number of days in whichthe sick die or escape. When of the mildest character, accompanied with favourable symptoms, they finish on the fourth or sooner;but if dangerous in their nature and in their accompanying symptoms, death ensues on the fourth or before. This is the first period;the second extends to the seventh day, the third to the eleventh, thefourth to the fourteenth, the fifth to the seventeenth, the sixth to thetwentieth. This order of diseases then, (acute,) extends to twentydays, by intervals of four, which however are not to be strictlyand rigorously enumerated. The months and years do not exactlycoincide in their subdivisions.In ardent fevers, the best symptoms are such as approximate tothose of health; those are less so that indicate a remission on thethird day, &c. If after the seventh day a jaundice occurs, sweating may be expected. Usually they do not tend, per se, to sweat,or to suppuration . The heat subsiding, sweating follows, and acrisis consequently ensues, accompanied by a copious urinary oralvine discharge, or a bleeding from the nose, or copious sweat orvomiting. In females the menses sometimes appear. All theseunited will constitute a crisis, or a near approach to it; sometimesit is less marked and different from the above. When jaundiceoccurs in ardent fever, on or after the seventh day, with difficultyet abundant expectoration (and this happens in other fevers also) ,and the fever does not decline, it denotes that instead of terminatingas above, an abscess will form in some great tumour, with severepains, or a colliquation from the febrile heat of the humours.112 THE WORKS OF HIPPOCRATES.CHAPTER III.Judgment as to health, death, or long continuance, of ardent fever -Its change intoa lyperia or epialis; jaundice succeeding-Good, bad, and doubtful signs-Judg.ment of tertian and acute fevers.Exacerbations and remissions in ardent fever indicate its prolongation, and if of great violence, the probability of death. Otherardent fevers without remissions are less dangerous, and terminateon the seventh or fourteenth day. They sometimes change into alyperia, continuing for forty days, and ending in an epialis. Lyperia exhibits symptoms which appear and disappear the same day,with considerable headache. When lyperia does not terminate inforty days, but headache and delirium attend it, purge freely. Butin whatever manner ardent fever ends, if jaundice succeeds , sweatsand abscesses rarely follow, but recovery ensues. Tertian feverusually terminates on the seventh accession. If, in violent fevers,jaundice appears on the seventh, ninth, or fourteenth day, it is favourable, provided a hardness does not occur in the right hypochondrium; if so, it is of a doubtful character. Acute diseasescommonly terminate in fourteen days. Fevers are terminated bysweats, if they occur on the third, fifth, seventh, ninth, eleventh,fourteenth, twenty- first, or thirtieth day; if they do not on one ofthose days, much trouble may be expected. The coction of theurine by gradual maturation, if occurring on a critical day, puts anend to the disease. What respects the urine, may be comparedwith what we see in ulcers. If they are covered with a white pus,a speedy cure may be looked for; but if the discharge is sanious,they assume a bad character. A similar presage may be derivedfrom the urine. If after pain it becomes clear, we should investigate the cause; and if the disease increases and it still continuesclear, we must not expect the disease soon to terminate.If in headache fever should succeed, and the pain should still continue when it ceases, it is not critical. Many symptoms, even iffavourable, may yet be associated with a tardy crisis.Small and soft tumours in the præcordia, without pain, and readily yielding to pressure, indicate a continuance of disease, but ofless danger than when the tumours are opposite in character. Thesame may be said of other ventral swellings.ON CRISES. 113CHAPTER IV.Judgment derived from the urine as to gouty diseases-From sweats and alvine discharges, as tending to health, to death, or to a continuance.If the urine when evacuated is turbid, it indicates, though the sediment be white and uniform, that the crisis is distant, and not ascertain as when the urine is of a more healthful character. If it isred, and the sediment also red and light, the crisis will be still moreremote, but at the same time salutary. All gouty affections, unaccompanied by inflammation, terminate in forty days, the symptomsmostly improving in this slow tendency to a crisis. When deaththreatens, the crisis occurs in twenty-four hours; the symptoms arethose of great debility, as after taking a powerful medicine thatoperates both up and down, with anxiety and symptoms of a similar kind. If they do not cease in twenty-four hours, the case maybe esteemed fatal. Of all sweats the worst are those that are coldand arise about the neck; they announce a prolonged disease, anddeath. Alvine discharges of different colours continue indeed for alonger period than black ones, but are not of a less pernicious character, and they are ultimately fatal. Some ofthese stools have theappearance of the washings of raw flesh, some are bilious, bloody,porraceous, black, sometimes all combined, sometimes separate anddistinct. Urine that is sometimes clear, and at times deposits awhite and smooth sediment, indicates a longer persistence thanwhen it is of a healthy appearance. If it continues for a longtime red and clear, there is a great chance that the patient cannotbear up to the period of its maturation; but if some other favourable symptoms combine, an abscess in some part below the dia- /phragm may be looked for. In fevers, changes in the urine indicatea prolonged disease, and the patient will vary for better and worse.If it is irregular, from thin, becoming thick, then clear and persistent, a crisis is difficult and uncertain.8114 THE WORKS OF HIPPOCRATES.CHAPTER V.Judgments derived from cold and copious sweats-From the heat and coldness of thebody, from evacuations, from the pulsation of vessels, from the face, hypochondria,tremors of the hands, dyspnoea, watchfulness-From tetanus, jaundice, singultus,and critical days.Cold sweats in acute fever are a fatal symptom, but if the feveris of a milder kind, they indicate a continuance of the disease.That part may be considered as the seat of disease, wherein coldand heat alternate, and when such changes are frequent. If thosemutations are universal in the system, with frequent change ofcolour, they indicate a long disease. It is a bad sign when feverdoes not diminish on the coming on of sweat, -the disease willbe of long continuance, accompanied with a superabundance ofhumours. Cold sweats occurring in fevers announce their longcontinuance. In health, a copious and incessant sweat denotes anapproaching indisposition; milder, if in summer, more severe, if inwinter. If the discharges have a deposit resembling scrapings,but in small amount, the disease is trifling; if large, then it will bemore considerable, and the bowels require to be cleansed. If blackbile is voided in small amount, the disease is moderate, but of moreviolence, if it is abundant. If the vessels pulsate, the foreheadtense, the hypochondria hard and prominent, a prolonged disease isto be looked for, terminating in convulsions, epistaxis, or violentpains. Subsultus tendinum indicate a long continued fever, or anapproaching crisis, followed by increased disease, and the probability of death. Such as are soon to die, have extremely violentsymptoms from the very onset, such as difficult respiration, sleeplessness, and others of equal danger. If continued fever exacerbateson the fourth and seventh days, and does not finish on the eleventh,it is mostly fatal. Tetanus is commonly fatal in four days, but ifthat is surmounted, health is restored. If jaundice and singultusoccur on the fifth day, it is fatal. . Relapses happen in fevers, whenobstinate insomnia or disturbed rest occur, with great debility ofthe body, or pain of the limbs, and when the fever has ceased ona non-critical day without any signs of crisis. Even if sweat succeeds the fever, and the urine deposits a white sediment, itself beingON CRISES. 115red, a return of fever may be expected the same day. Such relapsesare, however, not dangerous, and terminate on the fifth day; butif, after the crisis, a red urine deposits a red sediment, and a return.of fever occurs the same day, very few of such escape. Mostly, arelapse of ardent fever is accompanied with sweat, especially if itcontinues as long as at first. The fever even returns a third time,unless the relapse terminates on an uneven day. If the urine isunconcocted, and no reasonable symptoms have preceded, the relapse happens on a critical day, and sometimes even when it is notthe case.1CHAPTER VI.Judgment as to relapses, abscesses-Of tetanus, melancholy, phrenitis, mania, suppuration Of pains in the inferior parts-Of ardent fevers.When, at the period of a crisis, tumours about the ears do notsuppurate, the disease, as the tumours disappear, returns as it were,in the nature of a relapse, with a chance of an abscess forming insome other place. If the urine is thick, resembling the white appearance in the urine of those labouring under a quartan, theabscess is prevented. In some of these cases a bleeding from thenose takes place, which does not put an end to the disease; this isaccomplished by an abscess forming. Hemorrhoids occurring inmelancholic and phrenitic cases are beneficial. Those who at thespontaneous termination of disease become insane, are cured ofthis, if a pain of the feet or breast supervenes, or if a severe coughattacks them; if this should not be the case, blindness follows thecessation of the insanity. Stuttering and repetition of words, without a proper control of the lips, in disease, are followed by an imposthume, when those impediments cease. A severe pain in thelower extremities, or copious bleeding from the nose, are removedby deafness. Insanity sometimes removes violent constitutionaldiseases. Ardent fever is cured by ischiatic pains, or by distortionof the eyes and blindness, or swelling of the testicles or breasts,and at times by epistaxis. In such fevers, the occurrence of chilliness indicates sweating. Shiverings in such fevers end in delirium.If such fevers are not removed by deafness coming on, manianecessarily occurs, which is cured by epistaxis, by bilious stools ,116 THE WORKS OF HIPPOCRATES.by dysentery, or by pains in the knees or ischium. Fever succeededby cold, is removed thereby.CHAPTER VII.Judgments of unexpected pains-Of dropsy- Of leucophlegmatia-Diarrhoea-Volvulus-Cephalalgia-Ophthalmia-Convulsions- Tetanus.In sudden pains, with swelling of the hypochondria, if the painsextend to the false ribs, bleeding and purging remove them; forfever will not attack with violence a weakened part. In dropsy, ifthe water finds a passage by the vessels to the intestines or bladder,a cure will result. A copious diarrhoea cures a leucophlegmasia.Such as are affected with a chronic diarrhoea , accompanied withcough, are not cured, except a severe pain in the feet attacksthem. If any change in the nature of a disease is likely to happen,no diarrhoea attending, and merely flatus discharged, showing theabsence of humours, you may safely administer what is properfor the patient. In iliac passion, give plenty of pure, cold wine, bysmall doses, until sleep, or pain of the legs ensue: fever or dysentery stops its progress. A discharge of pus from the ears ornostrils, checks headache in diseases. Whoever in health is suddenly attacked with headache, loss of speech, and snoring, will diewithin seven days, if fever does not come on. In severe andgeneral headaches, apply cups to the upper parts. Should painsofthe ischium or knees, or asthma take place, the headache ceases.In ophthalmia, a diarrhoea is useful. In spasm or tetanus, a fevercoming on removes it. In fever, if spasm occurs, the fever isarrested within three days. In spasm of the hands and feet, ifmania occurs, if the vessels of the hands beat, the face full, thehypochondria hard and swelled, the disease will be tedious, butwithout convulsions.OF CRITICAL DAYS, OR OF WHAT HAS A RELATIONTO CRISES.HIPPOCRATIS DE DIEBUS JUDICATORIIS LIBER,HIPPOCRATIS DE DIEBUS JUDICATORIIS LIBER,DES JOURS CRITIQUES,FESIUS, Treat. iv. p. 56.HALLER, ii . p. 215.GARDEIL, ii. 261.ACCORDING to Haller, this treatise was not by the ancients attributed to Hippocrates, although Mercurialis considers it as containing his opinions. Haller regards it as an abbreviated transcriptfrom the book " De Internis Adfectionibus, " in which are contained the Gnidian sentences;-referring sundry diseases herementioned to similar ones in that treatise. All, however, are notfrom that source. Diseases are by the author derived, some frombile, or from bile and pituita, or blood. The book in general treatsof the judgments to be formed by the art of medicine; and of therequisites by which the physician can form a just estimate ofdiseases; and of the various symptoms and circumstances bywhich his judgments may be formed.— (ED.)CHAPTER I.What is essential to be known by the physician is here pointed out, to prevent hisbeing deceived.I esteem it an important part of our art, to be well acquaintedwith the best writings that have reached us on the subject; for hewho is thus informed and properly employs his knowledge, cannot,in my opinion, make many mistakes. Now, he should know theconstitution of the different seasons of the year and of diseases /accurately; and of diseases individually-the good or bad of each,either as depending on their own peculiar character, or on the existing state of things; the signs that announce their duration anddanger; of chronic diseases, which are salutary; and if acute-118 THE WORKS OF HIPPOCRATES.which are dangerous, which safe. He should know from these howto judge of the order of critical days, and to predict from themthe event; and deduce his rules as to the proper regulation of diet,as to time, amount, and quality. It is of the highest import to thewelfare of a patient in ardent fever, that the disease and everything connected with it, should be consistent with its nature; forwhat depends on natural laws, is salutary. A second and not lessimportant circumstance is, the concurrence of the season with thedisease; for the nature of man is not superior to the power of theuniverse. After this, we are to notice the general appearance ofthe patient; if the face is extenuated; if the vessels of the handsand in the angles of the eyes, and the eyebrows are quiescent,after having been previously active; if the voice is weaker andsofter; the respiration less frequent and laborious than before; -insuch a case, a remission will occur the following day; and hencethe importance of attending to every circumstance connected withcrises. Examine the tongue, whether its body or tip is furred ormoist, and in what degree. If all these signs are but slight, achange for the better will occur probably on the third day; but ifmore strongly marked, the succeeding day, or even the same day,when they are of the highest grade. The white of the eye, moreover, is necessarily rendered dull when the disease is violent; whenbrilliant, it is a sign of health, and indicates its approach in proportion as its brilliancy is restored.CHAPTER II.Description, causes, signs, and symptoms of acute affections of the liver -Fanciful influences in such affections.Acute diseases originating in an afflux of bile to the liver, andtending to the head, proceed as follows: the liver tumefies, and ispressed towards the diaphragm; immediately headache ensues,especially at the temples; hearing and sight are diminished; andchills and fever come on. These symptoms are the first observed,and vary in intensity in different cases. As the disease progressesthe pains increase; the eyes wander and become obscured; if thefinger is presented to them it is not perceived, as may be concludedfrom their not winking at its approach; yet the patient appears toOF CRITICAL DAYS. 119see something, for he picks the bedclothes as if catching bugs; andin proportion as the liver presses against the diaphragm, he becomes delirious, thinking he sees snakes and wild beasts aroundhim, or soldiers fighting with him,-talking at the same time interms, as if this was truly the case. He strives to escape, andthreatens those who oppose him. If raised up, his legs fail him,and he falls down; his feet are constantly cold; and when sleepinghe starts, and has horrid dreams, as may be presumed from hiswaking suddenly in a fright; and when recovering his recollectionhe details his dreams, which correspond with his actions andtalking during sleep. Such are his sufferings; at times he isspeechless for twenty-four hours; his respiration rapid, and elevated; his reason returns at the ceasing of his flightiness, and hereplies consistently to any question, and understands every thingthat is said, but almost immediately relapsing into his precedingcondition. Such affections are more common in long journeysacross deserts, but are not confined to these.CHAPTER III.Three varieties of tetanus described, and the judgment respecting them.There are two or three kinds of tetanus: when it arises from awound, the jaws are rigid like a piece of wood, and the mouth cannot be opened. Tears flow abundantly at times, and the eyes sink.The back is stiff, and neither the legs, arms, nor spine, can bebended. Food and liquors taken previously, are frequently discharged through the nostrils. In opisthotonos, the symptoms aresimilar. It arises from the tendons of the back of the neck beingaffected from angina, or from an affection of the uvula, or otherparts of the throat or tonsils. Sometimes it occurs from feversattacking the head. That arising from wounds, affects the posteriorparts; the pain renders the spine rigid, and the breast suffers; thespasms are so severe, that the patient can scarcely be preventedfrom being thrown from the bed. There is another variety, lessfatal than the former, arising from the same causes, and affectingin like manner the whole body.Ardent fever does not originate as tetanus. It at once shows itsnature to resemble that of a great fire. It commences with a vio-120 THE WORKS OF HIPPOCRATES.lent thirst and high fever; the tongue cracks, becomes rough anddry, and from its natural colour, turns black. If this change ofcolour is early in the disease, the crisis will be hastened; if later,so will be the crisis.CHAPTER IV.Ofthe distinction and judgment of sciatica and jaundice.Sciatica commonly arises from long exposure to the sun, bywhich the hip joint becomes heated, and its humours are dried up;that this is the case, is apparent from the patient's inability to turnor move his limbs, owing to the pain of the joints, and to a constriction of the spine. The pain is most severe in the loins andvertebræ adjoining the ischium, and in the knees; but it is oftenfelt in the groin. If the patient is raised up he cannot move himself, the severity of the pain causes him to groan aloud, and notunfrequently convulsions attack him, followed by rigor and fever.Bile is the origin of sciatica , and sometimes blood, and pituita. Thepains in all these diseases are pretty similar, and chills and slightfever sometimes attend. There is a species of acute jaundice thatspeedily terminates in death; the skin is every where of the colourof the rind of a pomegranate, verging on a green, similar to thatof some lizards; the sediment of the urine is nearly of the samehue, red like orobes; the fever and chill are inconsiderable. Attimes the patient cannot bear any covering; he feels in the morning internal twitchings, as if from a grater, and although the intestines are empty, there is great rumbling. If spoken to, or raisedup, he complains. Death takes place usually within fourteen days;if that period is surmounted, he recovers.CHAPTER V.Diagnosis and critical days of peripneumony and of fevers.Peripneumony occurs as follows: violent fever, respiration hotand impeded; anxiety, debility, and restlessness; pains about thea A leguminous plant.OF CRITICAL DAYS. 121scapula, clavicle, and breast; a sense of weight in the chest, withdelirium. Sometimes there is an absence of pain, although coughhas commenced; such cases are of longer duration and more dangerous. At first the cough yields only a white and frothy sputum;the tongue is yellow, but ultimately assumes a dark colour. Ifdark- coloured at the beginning, the changes are more rapid thanwhen this colour ensues at a later period: the tongue finally cracks,and if the finger is applied, it adheres to it. The change in thisdisease and in pleurisy is announced by the state of the tongue. Itcontinues at least fourteen and may reach to twenty- one days,during which period the cough is vehement, and the expectorationtinged with blood; at first , indeed, it is copious and frothy. On theseventh or eighth day, when the fever is at its height, the inflammation softens down, and the sputum thickens, though not invariably; on the ninth and tenth days, it changes to a palish green,intermixed with a little blood; from the twelfth to the fourteenth, itis profuse and purulent. In those of a moist temperament, the disease is very violent, but much less so in those of an opposite character.As to critical days, I have elsewhere mentioned them. Fevers,however, have their crises on the fourth, seventh, eleventh, fourteenth, seventeenth, and twenty-first days. Some of an acute nature even, terminate on the thirtieth, fortieth, and sixtieth day,beyond which the diurnal characters are entirely lost.PREDICTIONS OR PROGNOSTICS.BOOK I.HIPPOCRATIS PREDICTORUM, LIBER PRIMUS,HIPPOCRATIS LIBER PRIMUS DE PRÆDICTIONIBUS,TRAITÉ DES PREDICTIONS, LIVRE PREMIER,FESIUS, Treat. v. p. 67.HALLER, ii . p. 125.GARDEIL, ii. p. 268.FESIUS has a preface to this treatise and its immediate successor, (the second book of Predictions, ) explanatory of the two,but too long to be here inserted, and indeed not forming a part ofmy plan, viz. , that of giving a brief view of the different treatises ,without troubling either myself or reader with any extensive research as to the real author of each. It is perhaps sufficient, as inthe preceding treatises, to give the short exposition of Haller, serving as a preface or head-piece, and which is to the followingeffect, viz. that Galen considered this treatise as the production of one of Hippocrates' children , but that although initiated inthe art of prediction, yet it was in a degree vastly inferior to Hippocrates himself. He knew not how to deduce general axiomsfrom particular events, and not unfrequently has given particularobservations for axioms. He has not sufficiently discriminated thesymptoms depending on the cause of disease, and too often exhibits.as symptoms different and incoherent events. He oftentimes mentions the names of the sick, from whose diseases he derives hisaxioms; among them some of Cos, from which island Hippocratesis supposed to have removed at an early period. He likewisemakes use of obsolete words, or else employs them in an unaccustomed sense. Nearly half the treatise is taken up with deliriumand the symptoms of soporose diseases. A third part is taken upwith convulsions, and the remainder with hemorrhages and abscesses, especially of those occurring behind the ears. On thistreatise Galen has written a commentary. As the general argu-> ment of the treatise, Haller adds, that it consists of the enunciationof what is salutary or injurious in diseases, and of what portendsPREDICTIONS OR PROGNOSTICS. 123good or evil; as also, what the peculiar occurrences are, which inalmost all diseases happen to the sick.It is divided into eleven chapters by Haller, and under one hundred and seventy short sentences by Fosius. This treatise, togetherwith Fœsius's comments, has been very ably translated by Dr.Moffat, under the title of Prorrhetics, ( goggnxov, Hipp.; implyingvaticinium, prædictio, ) Lond. 1788, together with the Prognostics,and will compensate the reader for its full perusal. As this can bereadily obtained, I have deemed it less necessary to give more thana very brief outline of the contents, although I have translated thewhole. -ED.Presages respecting those who are attacked with coma, prenitis, madness, melancholia, their various signs, and symptoms;-of what throbbing pains about the navel, leg, and thigh, portend;presages from pains of the loins; from the voice, thirst, mode ofreply, the eyes, teeth, respiration, countenance, alvine and urinarydischarges, in acute and bilious diseases; vomiting, forgetfulness,imperception, rigors and heat in the side, redness of the face, distortion of the eyes, all of which are bad. In what circumstancespurging is improper; pains in the cardia, neck, and with tumidpræcordia, &c.; soporose fevers, and their concomitants; vomiting,variety of; non-discharge of puerperal lochia; apoplexy; lumbarpains, and translation of, to the stomach; pains of the fauces withoutswellings, but with difficult breathing, extreme danger of; varioussoporose and spasmodic affections, their danger; singultus; pains ofthe neck with sopor, sweat, tension of the abdomen; ulceratedmouth, &c.; lumbar pains, their fatal metastasis to the præcordiaand head; rigors; pervigilium, involuntary discharge of urine insleep; headache, with sopor, &c. , in pregnancy; fatal signs of someanginose and other affections of the fauces; signs of convulsions;variety of alvine discharges; good, bad, indicative of convulsions,&c.; what convulsions indicate in fever and mental affections;of various convulsive states and mental emotions, especially in females; their causes and symptoms; of hemorrhages, &c. , how toestimate them; presages from epistaxis; nasal stillicidium; of tumours and abscesses about the ears, &c.; suppression of urine;alvine discharges; various pains, &c. , deafness, &c. , all connectedwith parotid swellings; danger from, in various diseases; convulsions from hemorrhages from different parts, and their associationand connexion with abscesses of and about the ears.PREDICTIONS OR PROGNOSTICS.BOOK II.HIPPOCRATIS PREDICTORUM, LIBER SECUNDUS,HIPPOCRATIS LIBER SECUNDUS DE PRÆDICTIONIBUS,TRAITÉ DES PREDICTIONS,FŒSIUS, p. 83.HALLER, i . p. 193.GARDEIL, i. p. 75.THIS book, (says Haller, ) the genuine production of a great manas we may readily perceive, from the weight, modesty, method,and continued succession of observations it evinces, is far superiorto the first book. It commences with a notice of the ostentatious predictions of some of the physicians of his time. It thenspeaks of the predictions in a healthy state, derived from the discharges, and from the respiration. This is followed by a noticeof several diseases; dropsy, phthisis, empyema, gout, epilepsy,ulcers, wounds in general, and particularly of those of the head, thecubit, and spinal marrow; of sanguineous angina , diseases of theeyes, dysentery, diarrhoea, lientery; of easy or difficult conception,of headache, of chlorosis, nyctalopia, epistaxis, enlarged spleen, adisease closely allied to scurvy; of sciatica, leprosy, lichen, andmorphew. It points out the principal events and symptoms ofeach, and I cannot think the first book of Predictions can possiblybe referred to the same class of genuine writings. The book maybe considered as adverting to the ancient modes of prediction; tothe predictions of most importance in the art, together with thegood and bad symptoms, from which such predictions are derived.Hippocrates in this treatise, (says Gardeil, ) seems to have principally had in view the exposure of the vanity of the diagnostics andprognostics of the gymnastic physicians, and to establish firmly thefoundation of a true science of prognostics, by a copious detail inmany instances. -ED.

• Clifton has given a translation of this treatise under the head of " Hippocrates on

Prognostics." Haller has divided it under nineteen chapters, but I have followedClifton in making no distinct parts.-ED.PREDICTIONS OR PROGNOSTICS. 125We hear much of numerous surprising and wonderful predictionsmade by physicians, such as I must confess I have never made myself, nor seen made by others. Some of them I will here relate.A man in the last extremity, was so considered by all aroundhim; another physician being called in, exclaims, " This man willnot die, but he will lose his sight." In another case of equaldanger he predicted that the patient would survive, but that hewould lose the use of his hand. In a third, not expected to live, hedeclared that he would recover, but that his toe-nails would becomeblack, and fall off from putrefaction. Many others are related of asimilar nature.Another method, in predicting to such as are engaged in business,is to announce death to some, or mania, or other disease; which theypretend to know from past events, and declare they have never beendeceived. In the gymnasia, among the athlete and others who gothere for exercise and to strengthen their system, they profess todetermine accurately whether any deviation has been made in theiraccustomary and prescribed regimen or drinks, or in their statedexercise, or if venery has been indulged in. Nothing of all thiscan be hidden from us, say they, however slight the fault, so perfectis our art. And all this foolery is dignified by the name of prediction.For my part, I pretend not to such predictions; I describemerely the symptoms by which we may judge if health or deathwill follow; of the continuance of the disease, and whether futurehealth or death may be expected. Elsewhere I have treated ofabscesses that occur, and how to judge of each by their respectiveappearance. I think that those persons who have predicted lame.ness and such events, have made the assertion after the disease wasconfirmed, and when it was evident that the abscess could not berestrained; for I cannot persuade myself that their prediction couldhave preceded its formation; and I think the same as to their otherasserted predictions. Their proceedings are by no means difficultto such as choose to follow them. Thus, who is so ignorant as notto know a dropsy, or phthisis? and as for insanity, it is easilyknown if a predisposition to it exists, or if they have previouslysuffered from it. Such persons, by excess in drinking or in eating,or privation of rest, or by imprudent exposure to the vicissitudes oftemperature, are assuredly very likely to be thus attacked. So inthose affected with hemorrhoids; if in winter we notice them with126 THE WORKS OF HIPPOCRATES.a high colour, and drinking freely, is it not easy to predict what sooften is observed to follow, viz. , that in the spring a copious hemorrhage will take place, followed by pallid countenance and dropsicaleffusions in the summer? He, however, who desires to excel inthis kind of quackery, will do well to attend to these particulars,and also consider if he will gather laurels from it. From worksalready in our hands, we are enabled oftentimes to foretell bothdeath, delirium, and recovery. Much more might be added, but Ihave determined to write only what is most easily to be attained;at the same time advising every one to be very prudent and reserved, not only as to their predictions, but also in every part oftheir profession; being well assured that, by just predictions, theywill be esteemed and regarded by every intelligent person, whilstdeception or failure in prediction, will cause their discredit, andvery soon lead others to consider them fools. I recommend, therefore, the utmost prudence in advancing predictions or other assertions, for I daily see and hear persons of but little judgment, whoerroneously relate every thing that is done, said, or written, in relation to medicine.With respect to the predictions affirmed to have been made tothose who frequent the gymnasium as a means of improvement ofhealth, I have no faith in the statements as they have been related;yet if any one thinks fit to believe them, he has my full consent.Opinion will scarcely be set aside by probability, good or bad, orbe deemed sufficient by an individual who has pinned his faith onthe subject asserted; for such faith has not been the result of astrict examination. I leave every one therefore to believe as hechooses. If nevertheless there is any truth in the assertions made,or in those things which the physicians of the gymnasium professto affirm , relative to the omissions in the regimen they may havedirected; still , he who has made such divination, must have foundedit on some symptom, and have spoken of it doubtfully at first,though by subsequent extension it assumes a marvellous character.It is not easily ascertained in diseases, when errors are committedin regimen; although here, the patient is confined to his bed, andhis treatment is simple, so that inquiries are necessarily very limited.Many are restricted to mere liquids, others in addition employbroths, or solid food of a stronger nature. Now, in such cases, ifthe simple drinks are too largely taken, respiration will be impeded,and the discharge of urine increased. If broths are taken beyond1PREDICTIONS OR PROGNOSTICS. 1271due amount, or a stronger nourishment, thirst and fever are superadded, and the belly becomes distended and hard. The physiciancan readily by examination convince himself of these changes andof any others, by means of daily observation. By the use of hisreason and of sight, when visiting a person who ought to have remained quietly at home, under a particular regimen, it is easily ascertained if any deviation has taken place; as for instance if he hadbeen moving about, or had eaten different articles; and by the aidof his own hands, he can discover the state of the belly or of thepulse. The sense of smell, in fevers, affords him much assistance,for the odour varies greatly in them, which is not the case inhealth if accompanied with an appropriate diet. Even our earsenable us to judge of the voice and of respiration in diseases, differing as they do from what is perceived in health. Suppose a physician to be acquainted with the nature of diseases and the habits ofthe sick, yet he is not thereby qualified to form a prediction; for ifthe disease is as yet unsettled, the above symptoms do not authorizeit, and we must await its further progress before we can safelyjudge of what is to follow. If the symptoms above mentioned arethe mere results of some error in regimen, they will probably disappear in twenty-four hours, and if such an event is announced, itwill no doubt prove true. So far I cheerfully acknowledge that we .may determine wherein a patient thus confined at home, may haveproved disobedient; but as to those persons who frequent the gymnasia, and commit errors in diet, &c., I listen to the reports respecting them, and laugh at the narration. When only triflingerrors are committed , I know no means of assuring myself aboutthem; but if they are considerable, I will state how we may beled to their detection.We must, in the first place, carefully observe the individual forat least a day, in the same place and at the same hour, especiallyat sunrise; at that time, fasting, and empty from his evacuations,he has had nothing to tire him, save perhaps a short walk, of no, injurious tendency. He who follows a good regimen, will necessarily, at this time, be of his natural standard, both as to his complexion and his whole system; whilst the observer is also thenmore acute in mind and in vision. He ought to consider the character, habits, and powers of the person; for some more readilythan others conform to directions. If one on a restricted diet shouldgo considerably beyond it, it will be evident from an increase of128 THE WORKS OF HIPPOCRATES.•fulness of the body and of its colour, except indeed the excretionsare increased in due proportion. Labour is moreover better supported; we may inquire also if wind is discharged up or down, asis usually the case from such excess in eating and drinking. If theregimen requires frequent meals, and hard work, and the properquantity is not taken, or drunkenness is indulged in; or if, after ahearty supper, exercise is pretermitted, this state of disobediencemay be thus discovered. If, after omission of his supper, his usualexercise renders him more active, agile, and fit for work. If theexercise after supper is omitted, eructations, and flatulence ab anotake place, with little or no relief of a sense of fulness. Sweating,from work is more easily induced, respiration is difficult and oppressed, and the alvine discharges are more copious and less consistent. If both supper and exercise are omitted, languor and flatulent extension are increased. Should he have been inebriated,sweating is more profuse, with a difficulty of respiration, a sense ofweight, abundant urine, and, unless headache exists, an augmentedgayety. If venereal desire attends, and be moderately indulged in,it is useful; but if in excess, lassitude follows, the skin becomesrigid, and of an unhealthy colour.As to the predictions from the alvine discharges, it may be remarked, that people who work hard, with little sustenance, havesuch evacuations, small and hard, daily, or every three or fourdays, or even at longer intervals, when there is danger of an attackof fever or diarrhea; but liquid dejections, not moulded in passing,are of a worse character. Those who work hard and eat copiously should have easy discharges, the amount of food being proportioned to their labour; hence, with equal quantity of food, in health,if the work is great, the discharge will be small; whilst if the workis inconsiderable the discharges will be greater, and this is a rule ofgeneral standing. Liquid dejections or diarrhea without fever, andending on the seventh day or sooner, are advantageous, providedthe discharge is made at once and not repeated; but if fever attends, or the diarrhoea is frequently renewed and obstinate, they arealtogether bad, whether bilious, watery, or crude. Each of thesevarieties requires its own particular regimen and remedies.The urine ought to be proportioned to the fluids taken in, passoff in an equable stream and with ease emptying the bladder,having a rather greater density than the drink taken. If less so inthis particular, and at the same time more abundant than the pre-PREDICTIONS OR PROGNOSTICS. 129scribed drink, it indicates that more was taken, or that the nutriment was carried off by this channel. If discharged with a slighthissing sound, purgation is indicated, or may denote the existenceof some affection of the bladder. A slight discharge of blood ,without pain or fever, is of little importance, and may arise fromfatigue; but if it is of frequent occurrence, and is accompanied bypain and fever, it is unfavourable, and we may predict a subsequentdischarge of pus with relief to the pain. Athick urine, depositinga lightish sediment, denotes tumour or pain in some of the joints.All the other sediments in the urine of those who labour, arise fromvesical affections, as manifested by pains not readily removed. Allthis, and similar, I have noticed , and have judged it proper to detail.I have associated with those who have talked of the exact predictions elsewhere made, I have conversed with their children, andwith their disciples, and have read their writings, and having thusmade myself fully master of their opinions, but finding no solidgrounds for them, I was thence determined to commit my own towriting.With respect to dropsy, phthisis, gout, and epilepsy, I shall remark that this is common to them all, viz., their extreme difficultyof cure when congenital. And now of each in particular.For the cure of dropsy, sound viscera and adequate strength,with good digestion, are very essential; good breathing, freedomfrom pain, equable temperature of the whole body, no emaciation ofthe limbs, but rather a fulness, although the absence of both is best,with natural softness and size, and the belly soft to the touch.There should be neither cough, thirst, nor dry tongue, whetherafter sleep, or at other times, as often is the case. The appetiteshould be good, and after eating no uneasiness. Purgatives shouldoperate promptly, and at other times the stools should be soft andfigured. The urine should correspond with the regimen, and withthe changes of wines. Labour should be readily supported withoutfeeling fatigued. Such is the best state for an hydropic person, togive the expectation of recovery. In proportion as it deviatestherefrom are our hopes to be less sanguine; but they must entirely cease when the reverse of what is above stated is the actualcondition; or only be maintained according to the existing state ofthings.It is much to be feared that dropsy will succeed large dischargesof blood from the stomach and bowels; when connected with fever9130 THE WORKS OF HIPPOCRATES.it will be of a brief character, and few recover. A prediction tothis effect may be safely made to the friends of the patient. Largeœdematous swellings, disappearing, and recurring again, are morereadily cured than in the preceding case. They are, however,very deceptive, inducing the patient to dismiss his physician, andthus dying without assistance.Of phthisis, advanced to the state of cough and suppuration , Ishall refer to what I have already said of empyema. If likely torecover, the expectoration is easy, and should appear white, uniform in colour and in consistence, and free from pituita . Humoursfrom the head should flow freely by the nose; fever should beabsent, so that nourishment need not be interdicted, and no thirstshould attend. A daily evacuation of healthy fæces, in amountproportioned to the food taken , should take place; emaciationought not to occur; the chest should be square and hairy; andthe sternum, small and well covered with flesh , should not project.With such accompaniments, there is little danger; without them,death is not remote. In youth, when suppuration forms from congestion, or from previous ulceration, or any similar cause, or froma repetition of an abscess, a recovery is not to be looked for, unlessthere is a combination of nearly all the above favourable signs.Such persons commonly die in the autumn, as is usually the casein all other chronic affections. Women and girls, in whom phthisisoccurs from suppressed menstruation, rarely escape. If it occasionally happens, besides the presence of the above symptoms, aperfect and regular return of the catamenia must follow, or thereis no hope to be entertained. No less fatal in man, woman, andgirls, is the suppuration succeeding to a profuse hæmoptysis. It isby duly attending to all the symptoms mentioned, that a predictioncan be given of health or death in phthisis accompanied with suppuration. Those who after hæmoptysis experience less pain intheir back and breast, are most likely to recover; for their coughis less frequent, and though fever attends, it is accompanied withbut trifling, thirst. Nevertheless, the hemorrhage is often renewed,or an abscess is induced with a discharge of blood. When, withpains of the breast, emaciation slowly advances, with cough, anddifficult breathing, but unaccompanied by fever or discharge ofpus, we must inquire if something of a compact nature and of anoffensive odour is not discharged by coughing.As to gout, my sentiments are as follow:-Old people who havePREDICTIONS OR PROGNOSTICS. 131tophaceous concretions of the joints, with continual suffering, andhabitual costiveness, are incurable, at least by any measuresknown to me. They are relieved by pain in the intestines (dysentery, Hal.) , and by the humours tending to the inferior parts.When the patient is young, and not affected with articular nodosities, if he leads an active life, and is very regular in his evacuations, and in a duly adapted regimen, he may hope for a cure.Epilepsy is very difficult to cure, when arising in childhood;and it strengthens by age. Next to this, when it arises in manhood from twenty-five to forty- five years. Then those, who havea sudden attack without any previous symptoms in any part.Such as have it springing from the head, or sides, or hands, orfeet, are more readily cured. Even here there is much diversity;for if arising from the head, it is most difficult, and next from thesides it is much more easy to cure, when its origin is in the feet,or hands. The cure is to be attempted by the same means whichare useful in young, vigorous, and laborious people, unless themind is affected, or an apoplectic tendency exists; for all vehement emotions of the mind are very bad: other emotions tendingdownwards are useful on whatever organ they may fix, especiallyif a sanguineous discharge is promoted. As to epilepsy occurringin old age, it is mostly fatal; if not soon destructive, they recoverspontaneously, and without any medical assistance. When children suddenly squint, or are still more changed as to their vision;if tubercles of the neck occur, or stammering in speech, or longcontinued dry cough;-or, if rather older, tormina take place without discharge, and contortions in the sides, with varicose vesselson the belly, or a hernia of the omentum, swelled testicles, wastingof the hands or feet, or their complete impotency, without anyapparent cause-be assured that in all such cases, there has beenan attack of epilepsy. This will often be admitted by those whohave the care of them. Some however have not observed it , andtherefore deny that such an event has taken place.In order to predict the termination of ulcers, it is essential previously to study carefully the constitution of the individual; for insome they readily heal up, in others they do not. Age likewise isto be had in view, for each advance of life has its peculiar ulcers,of more or less easy removal. The parts of the body are equallydifferent in this respect. Especially is it necessary to be well informed as to the good or bad in all these cases; -and he who has132 THE WORKS OF HIPPOCRATES.made himself fully master of them, is alone qualified to predict theirevents; for how is it possible, if this is not the case? Now a goodstate of the body consists in its agility, good proportion, a healthystate of the viscera, and being neither too fat nor too meagre.The skin should be fair, brown, or of a light fleshy tint. All ofthese separately are good; but if intermixed with a greenish hue,or if pale or livid, this is unhealthy in fine, every deviation fromthe three colours above mentioned, may be reckoned to be bad.As to the connexion of age with ulcers, children are liable totumours, which suppurate, and to struma, which for the most partreadily heal. If older, such also occur, and are less easily cured.Men are not so liable to them, but they are to tumours of an encysted, or cancerous nature, often concealed, and of a high degree ofdanger; sometimes to pustular eruptions and creeping ulcers, up tosixty years of age. A still more advanced period brings with it adisposition to cancers of the internal organs, or of the extremities,scarcely ceasing but by death. The most difficult of these to cure,are seated in the axilla, in the loins, and thighs, to which partsthe humours are most abundantly directed, and a return of them isvery usual. In affections of the joints, the thumb and great toeare the parts most liable to be attacked, especially the latter. Thetongue is not unfrequently ulcerated by some adjoining decayedtooth.Wounds are mostly fatal that are made in the large vessels; likewise in those of the neck and groins, or in the brain and liver,intestines and bladder; the danger is proportioned in a measure tothe extent of the wound, as well as to its direction: the constitutionis also to be considered; -in some persons, little or no fever or inflammation take place after wounds, whilst others are promptlyaffected thereby. Ifthe patient becomes delirious, whilst the woundappears otherwise trifling, every attention must be paid to it thatart can bestow, seeing that death occurs from all description ofwounds. There are an immense number of vessels, both great andsmall, from which a spontaneous hemorrhage might prove fatal,but which on other occasions might be opened with advantage.Many wounds occur in parts of little importance, and which apparently have nothing formidable in them, which are, however, attended with such severe pain as to impede respiration. At times,instead of this, the pain induces delirium and fever, with death. Ifsubject to these symptoms, it is less alarming when they occur.PREDICTIONS OR PROGNOSTICS. 133Nor is this surprising, considering the difference between men, bothas to mind and body, and of what resistance they are capable.Should wounds happen under these circumstances of mind andbody, whilst there seems from the irritation and violence of theinjury, but little hope of restoration to his senses and to health, everything must be abstained from, save only what is absolutely required torestrain the frequent faintings. As to all other wounds, especiallyif recent, their cure should be undertaken and persevered in , untilall fever subsides, or danger of hemorrhage, or of a degenerationinto eating ulcers. Always be watchful to guard against accidents,for it is of much importance. Eating ulcers, with great depth,blackness, and dryness, are fatal. The state of such as afford ablackish sanies is very dangerous. When the discharge is whiteand mucous, they are less fatal, but more frequent, and of longercontinuance. Tetters, of all the eating ulcers, are the least fatal,but they are, like occult cancers, difficult of cure. In all thesecases a fever for twenty-four hours affords relief, especially if thesuppuration is white and thick. The exfoliation of a tendon or ofa bone, or of both, is useful in deep and black suppurations, for itthen happens that the pus improves and the putrefaction ceases.As to wounds of the head, such are the most to be dreaded thatreach the brain. All are dangerous, if accompanied by denudationof the bone, by compression, or by fracture. Ifthe wound is small,but with extensive fissure of the bone, the danger is greater; andyet more so, if it be near the sutures and the upper part of thehead. In all cases of wounds of the head deserving attention, ifrecent and fresh, we should inquire if the person fell from the blowat once, and became drowsy. If so, greater care is requisite, asthere is reason to presume the brain is interested. Should theinjury be of longer standing, other symptoms must be regarded andcarefully considered. Now, it is very favourable if there be anabsence of fever, hemorrhage, and inflammation, and no pain hassucceeded. If any of these attend, it is better that it should havetaken place immediately, and been of short duration. If painattends, an inflammation of the edges of the wound is favourable,and after the hemorrhage, that pus should make its appearance; iffever, that the favourable signs elsewhere described in treating ofacute fevers should attend; the reverse of which is unpropitious.But when the fever begins on the fourth, seventh, or eleventh day,it is a fatal symptom. It commonly has a crisis on the eleventh134 THE WORKS OF HIPPOCRATES.day, if its commencement was on the fourth; on the fourteenth orseventeenth, if it began the seventh; and on the twentieth, if itbegan on the eleventh, conformably to what is written on feversarising without any manifest cause. If, at the commencement ofthe fever, delirium takes place, or paralysis of any part, the personwill die, unless some very favourable symptom is present, or hisconstitution is very strong. This must be particularly attended to,for in some cases there is a hope of recovery, yet with the continuedloss ofthe limb that had been affected, if he should survive.In wounds of the limbs, if large, and the tendons are divided thatare connected with the joints, it is evident that the use of them willbe destroyed. If any doubt as to this exists, that is, of the woundof the tendons, when pierced by a dart, a direct wound is morefavourable than if oblique. If the weapon inflicting the injury beheavy and blunt, the danger is equally great, and is to be estimatedby the depth of the wound and other symptoms. Among these are,whether suppuration extends to the joint, which is very dangerous;whether obstinate tumours continue, producing induration of theparts, of long duration, even after the wound is healed; in whichcase the motion of the joint will be long in restoration, especially ifthe limb has been suffered to remain in a state of extension duringthe cure. When the probability is that the tendon will exfoliate, itis correct to predict lameness of the part, especially if in the lowerextremities. The destruction of the tendon may be known by thelong- continued discharge of a white, thick, purulent matter, withpain and inflammation of the joint from the onset. The same is thecase when the bone separates. In fractures of the elbow, with inflammation, and ending in suppuration, incisions and cautery arerequired. In affections of the spinal marrow from falls or othercause, or if spontaneous, the use of the legs is lost; if the hand isplaced on the belly or bladder, no sensation is felt. At the commencement, neither fæces nor urine are discharged except by medicine; but if of longer standing, they pass off involuntarily, and deathsoon follows.When the fauces are filled with blood, by day and by night, unaccompanied by headache or cough, or vomiting, fever, or pain inthe breast or back; the fauces and nostrils should be examined, toascertain whether it may not arise from ulceration or from a leech.Watery eyes are easily cured, when the swelling, tears, andsordes all commence at once; if the tears and sordes are inter-PREDICTIONS OR PROGNOSTICS. 135mixed, without much heat, if the sordes be white and soft, and theswelling light and extended, and the lids agglutinated, but withoutpain, little danger is to be dreaded, and the disease will be of shortduration. But if the tears are abundant, hot, with a small discharge, and swelling in one eye only, it is of longer continuance,although not dangerous, and without pain. Here, it is highly necessary to attend to the crisis, which may be expected on the twentiethday; if it extends beyond this period, it occurs on the fortieth, oreven proceeds to the sixtieth. During all which time the dischargeshould be examined, whether it is mixed with the tears, if whiteand soft, and this especially at the time of the crisis, as such willbe the case if the disease is about to terminate. If both eyes areaffected equally, there is more hazard of ulceration, and the crisiswill be less prolonged. Ophthalmia, if dry, is very painful; it isnot of long continuance unless ulceration ensues.If the swellingis large, dry, and without pain, it is not dangerous; but if it ispainful and dry, an ulceration of the eye may be feared, and accretion of the lids. There is danger when the pain is accompaniedwith tears, for from such hot and salt humours ulceration of thepupil or lids may be apprehended. If the swelling continues, withdischarge of tears and sordes for a long time, an eversion of thelids is to be expected in men; and the same, together with ulceration, in women and children. Should the sordes be of a greenishor livid tinge, the tears abundant and scalding, with heat of thehead, and pain extending from the temples and fixed in the eye,preventing sleep, ulceration will ensue in the eye, with danger ofits bursting. A fever supervening is favourable, as is also a painabout the loins. To predict in such a case, the time of the complaint must be kept in view, as well as the nature of the dischargefrom the eye, the pains, and the insomnia. When enabled to examine the eye, if any part is found ruptured, and through the opening any part should project, this is very unfavourable, for it isdifficult to replace it. Should it be in a state of putrefaction, thereis no hope of its recovery; the sight is entirely lost. The results ofother ulcerations may be predicted from a consideration of their locality, and the extent and depth of the ulcer, for the cicatrix that ensueswill be in proportion thereto. When the eye is ruptured and thepupil is thereby displaced, there is no further hope of the recovery ofsight, either from time or from remedial means. Slight displacements may indeed be relieved in young subjects, provided nothing136 THE WORKS OF HIPPOCRATES.bad supervenes. We may anticipate in youth, if no further evilensues, that the cicatrices, if recent, may be removed by time or byart. As to the part wounded, the most dangerous is that in whichthe pupil is interested ,-next, when it is above the supercilia, andthen according to the proximity to them. Whenthe pupil assumesa grayish, argentine, or bluish tint, it is a bad sign. If it contracts,it is more favourable; or if it enlarges and contracts, or even assumes an angular appearance, whether spontaneously, or fromsome obvious cause. Obscurity of vision, clouds, and white spots,diminish and disappear, unless an ulcer should attack the part, or aprevious cicatrix or pterygion had existed. If a cicatrix of theblack of the eye should occur, giving to the part a whitish appearance, and in time becoming thick and rough, it will leave behind it.evidence of its existence not easily eradicated.The crises as described in fevers, are similar in these cases. Inorder to predict them, we must be master of the symptoms, knowwell the diseases of the eyes, and their differences. The greaterthe number of the unfavourable signs, the disease will be in thesame ratio prolonged, as is explained in writings on the subject. Ifthe symptoms are good, in the like ratio will be the period of thedisease, and a crisis may be looked for on the seventh day, orshortly after, and all danger considered as past. Relapses are tobe guarded against, when such changes for the better occur onnon-critical days, and without the accompaniment of good symptoms. In all affections of the eyes, the urine should be inspected,and the fleeting nature of opportunity should be kept in constantremembrance.Pains in the bowels, attended with fever, and a variety of alvinedejections, with inflammation of the liver, of the præcordia or belly,with nausea and thirst, are always bad; and the more of these thereare, in the same degree are they dangerous. If few in number,the hope is the greater. The greatest danger is at about five yearsof age, and thus up to that of ten, after which it is much lessened.Such pains as are beneficial are unattended by the above sympWhen accompanied with bloody stools, and such as resemble the washings of flesh, they terminate on the seventh or fourteenth, the twentieth or fortieth day, or at some intermediate period.Such discharges often give relief to other diseases. If of a chronicnature, that relief is more slow, but quicker if they are recent.Women, during pregnancy, are subject to them up to, and eventoms.PREDICTIONS OR PROGNOSTICS. 137after delivery. The discharges of blood and matters resemblingthe scraping ofthe bowels, and that for months, are not always thesource of abortion, unless conjoined with pain and other of theenumerated symptoms of dysentery. If so, they prove fatal to thefœtus, and of great danger to the mother, until parturition and thedischarge of the secundines; and afterwards, if then the dysenterydoes not at once cease, or soon after.Frequent and long- continued lientery, coming on at all hours,both by day and night, with or without strepitus, with a dischargeof crude and undigested or dark- coloured matters, and unformed,of offensive smell, are uniformly bad. They excite thirst, but thefluid is not conveyed away by urine. The mouth becomes ulcerated, blotches and spots of different colours appear in the face,similar to what are called freckles, and the skin of the belly becomes rough, like dough in fermentation. The appetite entirelyfails, and all exercise or work is out of the question. This diseaseis most severe in old age; in middle life, less so; but much less soin early life. In all cases, except the two first mentioned, whenthe above formidable symptoms are not in great amount, it is lessto be dreaded. It requires to be carefully attended to, until theurine is discharged in due amount to the drink taken in, and thesystem appears to derive nourishment from the food, and the skinto be liberated from its mottled appearance. The other profluvia,unaccompanied with fever, are of short duration, and generally ofa mild character; they commonly cease spontaneously, or yield tolotions. We may announce the evacuations about to cease, whenon applying the hand to the belly, no motion is felt, and when flatusis discharged at the close of an evacuation. Diarrhoea, in menafflicted with the hemorrhoids, occasions a prolapsus ani; anddysentery induces the same in children with calculus, and in oldpeople who with difficulty evacuate their mucous accretions.We may estimate the facility or difficulty of conception in themanner following. First, as to the exterior. Small women aremore apt to conceive than large ones; thin women than fat; brownthan pallid; white than florid; such as have prominent veins, thanthose in whom they are deep-seated . Excessive fleshiness is unfavourable to conception at an advanced age. Large and turgidbreasts are favourable; all of which signs are apparent to view.With respect to the interior, it is necessary to know the state of theuterus, as to its health, its dryness, and softness; neither retracted138 THE WORKS OF HIPPOCRATES.nor too low down; its orifice should not be awry, nor compressed,nor too extended; for in all such cases pregnancy is impossible.So likewise we must ascertain the state of menstruation; if it dulytakes place every month, in adequate quantity, and of a propercolour; at regular and equal times in a month. If so, the circumstances are favourable. When therefore conception does not occur,if the womanis pallid, free from fever, and no apparent fault of thebowels; if she complains of headache, of painful and ill - conditionedcatamenia, in small amount, and at distant and irregular periods,the uterus requires to be evacuated. If the woman has a goodcomplexion, with much flesh and fat, so that the vessels are unseen;iffree from pain, and menstruation is entirely absent, or trifling andill- conditioned, it is very difficult to promote conception. On thecontrary, if the body is vigorous, the menses superabundant, andpregnancy does not occur, there is some fault of the womb; it isretracted, or too open. Other affections of that organ are connected with pain, and a bad complexion, together with emaciation.Should there be an ulcer in the womb, the result of parturition, orof some tumour or other cause, fever is the consequence, withswellings and pains in the groins and if to this an interruption ofthe lochia be added , the evil is rendered worse and more obstinate;and there are, moreover, superadded, headache and pains of thepræcordia. When the ulcer heals, the part is left in an induratedstate, and the aptitude to conceive is diminished. When the ulceris in the left side only, and whilst continuing, conception takes place;or if it has healed, and the state of health is otherwise good, it ismost probable that the child is a male; but if it is the right sidethat has been affected, the probability is greater of its being afemale. If pregnancy cannot take place, and fever and a coughoppress her, it is necessary to ascertain whether an ulcer of thewomb exists, or any of the affections I have mentioned; and ifthere is not, a vomiting of blood may be anticipated, presumingthat the menses have necessarily disappeared: but if they return ,and the fever leaves her after the hemorrhage, pregnancy mayensue. If the bowels are greatly disordered previous to the hemorrhage, there is danger of dying before the vomiting up of the blood.Some persons imagine themselves pregnant when it is not the case,and persevere in the mistake for many months. The menses disappear, the belly enlarges, motions are felt, headache and painsof the neck and hypochondria attend; but little or no milk in thePREDICTIONS OR PROGNOSTICS. 139breasts, or if any, of an aqueous nature. When the belly subsidesand becomes soft, if nothing else prevents, conception may occur;for such a state is calculated to promote a change in the uterusfavourable thereto. All the above-mentioned pains are not felt intrue pregnancy, unless from being previously accustomed to them.Headache exists and milk is secreted. In long-continued uterinefluxes, we should inquire if headache, and pains of the loins andpelvis are present; and also if there are toothache, dimness of sight,and humming of the ears. Whenever, fasting, bilious matters arevomited for many successive days, without being in a pregnantstate, or having fever, ascertain whether lumbrici are not alsovoided at the same time. Ifthe answer is in the negative, we mayannounce their probable occurrence; for it is by no means uncommon with women and virgins, but less the case with men.They who suffer pains without fever are not in danger of death,but of a long continuance, together with metastases and relapses.Of these pains are headache, sometimes trifling, at others severe.We must notice if there is dizziness, with redness of the eyes anditching of the forehead, in which case bleeding, or a spontaneousdischarge of blood, will afford relief; it is a simple case. But whenheadache and pain in the forehead arise from exposure to windsand cold, whilst much heated, a catarrh sometimes dissipates it.Sternutatories are useful, producing a copious discharge of mucouspituita from the nose. Catarrhs very naturally are followed bycough, and if the accompanying sneezing does not give relief,swellings and changes of complexion succeed. Where obstinateand universal headache occur, with apparent cause, if the patientis thin and exhausted, a more severe disease is to be feared. Ifthe pains fly from the head to the neck or back, and then return, itis worse; and still more so, if at the same time all the three partsmentioned are suffering from it. An abscess occurring any whereaffords relief, so does a purulent expectoration, a hemorrhoidaldischarge, or a crop of pustular eruptions over the body. A scaldhead sometimes cures it.In case of drowsiness, with intolerable itching of the whole head,or some particular part, with a sense of coldness over the head attimes, we should inquire if the itching extends to the end of thetongue. If so, some disease of difficult cure is forming; otherwisethe cure is easy. Its mode of termination may be deduced fromwhat has heretofore been said respecting abscesses, which howeverare less frequent in these cases. Should vertigo be conjoined with140 THE WORKS OF HIPPOCRATES.the pains, the disease will prove obstinate and threatens mania.Other affections of the head,women, are less dangerous,Old people are more subject to this.which often attack both men andthough violent and of long duration. Boys and girls often sufferfrom them, particularly the latter, at the approach of menstruation.The headache of women in most particulars is similar to that ofmen, but with less itching and bilious affections, unless after thecessation of the menses.All those who in early life have a bad complexion for a longcontinuance, not however icteritious, whether men or women, aresubject to headache; they devour earth and gravel, and are affected with hemorrhoids. A bilious complexion, of an obstinatecharacter, but not of a strongly marked icteritious nature, is accompanied with similar complaints; but in place of the unnaturalappetite mentioned, they have much more pain in the præcordia.Long-continued paleness with tumid face, is accompanied withheadache or pain in the bowels, or they have some disease of therectum. In other respects the disorders mentioned are seldomsingle, but often remain latent and subsequently appear.Nyctalopia is an affection indicated by seeing in the dark. Itoccurs in youth, both in childhood and adults; it disappears spontaneously, sometimes in forty days, at times in seven months, oreven continues a year. The period of its cessation may be judgedof from the degree of the affection and the age of the patient. Acure follows a formation of abscesses on the lower extremities,which is not however common in early life. Women are exemptfrom it, and girls also when menstruation appears. If the diseasefollows a long- continued flow of the tears, inquiry should be madeif previously headache was common.If without fever or an unhealthy complexion, headache and painsin the temples are customary, when no tendency to eruption in theface exists, nor hoarseness of the voice, nor toothache, we may anticipate a hemorrhage from the nose. In such cases, althoughapparently enjoying good health, we shall find the spleen enlarged,and headache, or sparks flying before the eyes. In most cases,affections of the spleen are accompanied with headache.Ulceration of the gums and fetid breath are frequent attendantson enlarged spleen. When with enlarged spleen there is neitherhemorrhage nor offensive breath, it will be found that there existill-conditioned ulcerations of the legs and livid scars. If, moreover, eruptions of the face attend, hoarse voice, and toothache,PREDICTIONS OR PROGNOSTICS. 141epistaxis may be looked for. The spleen is enlarged also in suchas have the lower lids tumefied. If the feet swell, and appear tobe anasarcous, the belly and the loins should be carefully examined.Twitchings of the face, without the rest of the body suffering,soon disappear, either alone or by some slight remedy; otherwisethere is a chance of apoplexy. And if to the loss of motion, atrophy of the limb is united, its restoration to health is not to be expected; but if it still continues to receive its nutrition, motion willbe restored. In order to estimate the period of its restoration,regard must be had to the extent of the complaint, its period ofcommencement, the age ofthe patient, and the season of the year;always bearing in mind that the older the disease the more obstinate and dangerous it is, as well as more frequent in recurrence,and more particularly in old age. Autumn and winter are lessfavourable for its removal than spring or summer. Pains in theshoulders descending to the hands, and there inducing numbness,are not followed by abscesses, but are relieved by vomiting upblack bilious matters. When the pains remain fixed in the shoulders, or extend to the back, a discharge of pus or of black bilerestores health. The issue of each of the above may be conjectured by the respiration being free or difficult; if free, and thepatient is thin, the presumption is in favour of the bilious vomiting;if difficult, and the countenance is florid beyond what is usual, anddiffering from its common hue, the probability is that pus will bedischarged. We should ascertain if the feet are swelled, as this isa confirmatory symptom. This disease is more usual and violentfrom forty to sixty years of age, which is likewise the period atwhich sciatica is most prevalent.With respect to sciatica, the following observations demandattention. In age, if subject to cramps, with coldness of the loinsand legs, the penis torpid, the intestines moved only by medicine,and then principally of mucosities, the disease will be very obstinate. It may be predicted to continue for a year at least, unlessrelieved by spring and summer. In young people, the disease is tothe full as painful, but it is of less duration; forty days will usuallybring it to a termination. The cramps are less severe with them,as is likewise the coldness of the loins and legs. Whenthe pains ofthe loins and thighs are not sufficiently great to keep them lyingdown, we must examine if in the sciatic region there is any swelling, and if the pain extends to the groin; for if either of these be•142 THE WORKS OF HIPPOCRATES.the case, the disease will be of long continuance. Inquire also ifthere be numbness of the thigh and of the ham. If the answer isaffirmative, ask if it extends to the leg and tarsus. When this isthe case, it may be foretold that the thigh will have alternate accessions of heat and cold. Should the disease quit the loins for theinferior parts, we may give encouragement to the patient; but if itcontinues in the loins and sciatic region , and extends upwards, itmay be considered as very serious.In all intermitting pains and swellings of the joints, not having agouty character, the viscera will be found enlarged, and a white deposit takes place in the urine. If in such cases there is tumefactionof the temples, there will likewise be much pain and night sweats.But if a white deposit does not take place in the urine, and there areno sweats, there is danger of lameness of some joint, or a formation of the kind of tumour denominated meliceris. Such occur inthose persons who in childhood and youth were subject to bleedingfrom the nose, which had been arrested . Inquire , therefore, if suchhad been the case, and whether sharp itching and heat of the backand breast are present, and if also there is a sharp and constantpain of the bowels, or hemorrhoidal tumours; for these are commonly the source of the complaint. If the complexion alters ,inquire if headache exists, and such will be found to be the case.When the pain of the belly is confined to the right side, it ismore severe than if on the left, particularly in those in whom thepain extends from the hypochondrium to the liver. Such pains aresometimes relieved by the discharge of wind, which is followedsoon after with that of much pale urine. This disease is not fatal,but of long duration; and if very inveterate, is apt to affect thesight. We should make inquiry respecting any hemorrhages inyouth, or defect of vision, respecting the colour of the urine, andof the discharge of flatus, and whether benefited thereby.Impetigines, and vitiligo, and morphew, occurring in infancy orin youth, apparently trifling at first, ultimately augment; the abscesses and eruptions attending are not the consequence of, butconstitute a part of the disease itself. In fact, when a tumour formshere suddenly, and is large, it becomes a real abscess. A speciesof white leprosy, called elephantiasis, is one of the most fatal disAll these affections arise from atrabilis. The more recentthey are, the more readily are they cured in early life, and whenconfined to the most soft and fleshy parts.eases.THE COAN PROGNOSTICS.HIPPOCRATIS COI COACARUM PRÆNOTIONES,HIPPOCRATIS COACE PRENOTIONES,PRÉNOTIONS COAQUES,FESIUS, Treat. ii. p. 115.HALLER, ii . 142.GARDEIL, ii. p. 289.DURETUS (says Haller in his preface to this treatise), like most ofits commentators, divides it into several parts. Haller himself, constituting it as a single book, divides it into three sections, consistingof twenty-seven chapters. Gardeil divides it into three books, asDuretus has done; the first of which is simply subdivided into onehundred and sixty- six sentences. The second book contains twentysix chapters, subdivided into three hundred and fifty- nine sentences;as is the case also with the third book, containing four chapters,and two hundred and forty- six sentences. The whole number ofsentences is seven hundred and seventy- one. Fosius makes sixhundred and forty-nine sentences, accompanied by copious notes,and preceded by a long prefatory dissertation, of considerable interest, but scarcely embraced by my present intentions. Haller tellsus that Galen considered this treatise as spurious, and that Fœsiusdid not much esteem it . It is admitted by all to be very obscure.Questions are propounded, to which no one can reply, and manyfallacious aphorisms are given with too great precision. Many, arethe same with those that are given in the preceding book ( De Predictionibus, Lib. i.) The first part of the treatise is devoted to suchparticulars as belong to fever. The second treats of those thatare connected with the various parts of the human body, as thehead, neck, chest, abdomen, &c.; and the prognostics are stated inconnexion with the parts from which the symptoms are derived.The third division derives the first part of its presages almostentirely from the Prognostics; a second portion is assigned towounds of the head and other parts; and the third portion is devoted to female diseases. An addition is made of the presagesderived from the various excretions, & c.144 THE WORKS OF HIPPOCRATES.The book may be generally considered as delivering the existingand supervening symptoms of fevers, and other diseases, bothfebrile and non-febrile, affecting the whole system or its parts, andexplained by theorems, with the predictions to be derived fromthem, both benefical or injurious.In a note at the commencement of this treatise, Gardeil states,"that it is usually designated by name of the Coacæ simply, andthat it is constantly referred to in medical writings. It is not considered by the learned as the work of Hippocrates, in which opinion (says he) I acquiesce." Nevertheless it is much esteemed, for,notwithstanding its imperfections, its authority in medicine is of thehighest grade. It is supposed to be the composition of some physicianof the celebrated school of Cos, of which Hippocrates was the mostillustrious member; but it is uncertain whether this collection ofsentences was anterior or posterior to him . I have pursued, saysGardeil, the order adopted by Duretus, as being very commodious,although not always adapted to the discovery of what we are seeking, in consequence of its division in the distributed matter. Itwould indeed be impossible to effect this, without continued repetition of those sentences that have reference to more than oneparticular.M. De Mercy, in 1815 , printed at Paris a French translation ofthis treatise, entitled " Prognostics de Cos, D'Hippocrate, traduitssur le texte grec, d'après la collation des manuscrits de la Bibliothèque Impériale, avec une dissertation sur ces manuscrits, desyariantes, des notes explicatives, et une table analytique. ”This analytical table is so excellent, that I have deemed it betterto give it here, than to attempt a more full and complete translationof the whole, omitting at the same time his references, whichcould only be applicable to the entire translation. As it is, thisanalysis extends to nearly fifty pages.It may be further remarked, that the latter part, commencingwith chap. xxviii . , entitled " Prognostics common to all parts of thebody," and constituting the third book of Duretus, contains generally what is to be found with more minuteness in the Predictions,Prognostics, Aphorisms, &c. Sometimes the precision is remarkable.THE COAN PROGNOSTICS. 145It may be concisely stated, that M. De Mercy, in his prefatory observations on this treatise, divides it under five principal heads. Thefirst, up to the one hundred and sixtieth sentence, relates to acuteand epidemic fevers, and their varied and complicated symptoms,such as rigor, chills, hemorrhages, menstrual discharges, hemorrhoids, bilious vomitings, and purgings, -urine, sweat, parotids,abscesses, crises, good and bad, as announced by various symptoms, such as insomnia, subsultus tendinum, sputation, alterationand loss of the voice, delirium, convulsions, and all that characterizes the highest grade of fever. The second part consists ofinflammation of the organs and different viscera, with continualfever, such as acute headache, phrenitis, convulsions, suppuration,and sphacelus of the brain, &c. , otitis and deafness, &c. , as noticedin the headings of the succeeding chapters. The third part hasreference to external lesions and wounds, &c. The fourth to thediseases of females; and the fifth to the different excretions, asvomiting, sweat, urine, and the dejections.Most of the sentences here enumerated are to be found in someone or other of the Hippocratic writings, and are pointed out byM. De Mercy; such are the parts relating to the face, which he tellsus are the same as in the Prognostics, and in the Prenotions also,but less correct;-the same of the eyes. Some Aphorisms are herefound, and a few passages from the book, " De Morbis." Some arealike with parts of the Predictions, &c. , and his observations terminate as follows: " The intentions of the different sentences cannotbe misapprehended. Many passages are extracted from otherworks, especially De Morbis,' which certainly is not one of Hippocrates' . We can discover no other object than that of forminga general collection of the prognosis of disease. It is easy to assureourselves of this, even from the conclusion of the book, which is arecapitulation of all the varieties of the different excretions, ofwhich mention is made throughout the treatise. No doubt theCoan Prognostics are a very estimable and essential part in thepractice of medicine; a kind of vade mecum, but difficult from theirnumber, to be recollected. The analysis of the chapters is intendedto render the connexion of the different sentences more clear anddistinct, and will in a degree subserve the purpose of an index. ”It would too much prolong this, if continued; I give, thereforeonly the heads of the chapters. -Ed.10146 THE WORKS OF HIPPOCRATES.COAN PROGNOSTICS.CHAP. I. a. OfFevers.b. OfParoxysms.c. Of Ardent Fevers.BOOK I.CHAP. I. d. Of Phrenitis.BOOK II.e. OfCompound Fevers.f. Of different kinds of Crises.CHAP. I. Of Headache.II. OfCarus, and Coma.III. Of Diseases ofthe Ear.IV. Of Parotids.V. Of Diseases of the Face.VI. Of Diseases of the Eyes.VII. Ofthe Tongue and Fauces.VIII. Ofthe Voice.IX. Of Respiration.X. Ofthe Neck and Throat.XI. Of the Hypochondria.XII. Ofthe Back and Loins.XIII. Of Hemorrhages.XIV. Of Palpitations, Shakings, Convulsions.XV. Of Angina.aXVI. Of Pleurisy and Peripneumony.CHAP. XVII. Of Phthisis.XVIII. Of Hepatic Affections.XIX. Of Dropsy.XX. Of Dysentery.XXI. Of Lientery,XXII. Of Diseases of the Bladder.XXIII. Of Apoplexy, Palsy, and Pa.raplegia.XXIV. OfMelancholy and Madness.XXV. OfColdness ofthe Loins.XXVI. Of Tumours, and on Bleeding.XXVII. A chapter of Cautions.XXVIII. Prognostics common to allparts of the Body.XXIX. Of Dangerous Wounds.XXX. OfWounds, and Fistulæ.APPENDIX.OF THE DISEASES INCIDENT TO DIFFERENT AGES.CHAP. XXXI. Ofthe Diseases incident to Females.XXXII. Ofthe various Excretions.a. Vomiting. b. Sweats. c. Urine. d. Stools.• In this and some other parts of the Hippocratic books, various expressions wouldseem to indicate, that percussion of the Thorax of some character was occasionallyemployed. -ED.SECTION III.ªON THE NATURE OF MAN.DE NATURA HOMINIS,DE NATURA HOMINIS,DE LA NATURE DE L'HOMME,FOSIUS, Treat. i. p. 224.HALLER, i . p. 33.GARDEIL, i. p. 113.THE first portion of this book is, by Mercurialis, regarded as agenuine work of Hippocrates, and is frequently quoted by Galen and the ancients. Yet Galen, who comments upon it, has somedoubts as to the latter part of it, which treats of the origin of thefour great vessels, and in this Haller seems to agree. It is, saysHaller, a congeries of things the most diversified. It first noticesthe four humours, and their alternate predominance; and whichby a species of affinity, are evacuated by medicines. It thenadverts to the origin of epidemic diseases, which is attributed tothe air, rather than to the mode of living. Correct as this maybe in some respects, it is not wholly so, since by a similar diet ofsalted provisions, scurvy is found to arise in climates altogether different.Among the various topics noticed is to be found the statement offour pair of vessels, which Haller says, smacks strongly of the Chinese writings. The account, moreover, erroneous as it is, differsgreatly from the doctrine of Hippocrates, as it is laid down in histreatise "De locis in homine." It is at this part that Galen stops;observing, however, that in what follows, excepting what relates tothe four great vessels, the greater part is not unworthy of Hippocrates. In speaking of fevers and of various diseases, they aremostly ascribed to a diversity of the bile, either in quantity or quality; thus a quartan is attributed to atra bilis, &c.Fœsius, at p. 312, note 69, on the origin of the vessels from thea This section consists of fourteen treatises in the order of arrangement by Fœsius,under the general head of τα φισικα και αιτιολογικα—i. e. physics and etiology-or what has reference to natural causes.148 THE WORKS OF HIPPOCRATES.head, refers to Galen, lib. 6, De Placitis; also to Hippocrates, TepOSTεWV pusios, and to Aristotle, Hist. Animal. lib. 3, cap. 3.-The viewsof the blood- vessels are attributed to Polybius, although this is notthe opinion of Galen. And Gardeil, in referring to the other treatises, in which the vessels are spoken of in nearly the same way asin the present one, remarks, that in the one entitled " De NaturaOssium," although the title would indicate a principal attention tothe bones, yet it is devoted almost entirely to the blood- vessels; andhe adds, that although the whole is embarrassing, it appears to himinfinitely more surprising to find so many angiological details, discovered without the aid of injections, than to meet with so manymistakes.-ED.Whoever is accustomed to hear the nature of man spoken of bypersons who pretend to be acquainted with it, by any means distinct from medicine, will find nothing satisfactory to them in thistreatise. I shall not tell them that man is altogether constituted ofair, or of fire, or of water, or earth, nor of any other individualthing, since I am persuaded man is not formed of one single element; nevertheless , I leave such opinions willingly to those who maintain them, although they appear to me not clearly to understandwhat they profess to teach. They all agree in one proposition, butdiffer entirely in the deductions they derive from it. They firstadvance the assertion that every thing existing is a unit, and thatthis unity is the universal whole; but then they disagree as to whatthis universal unit is. One affirms it to be air, another that it isfire, a third that it is water, and a fourth that it is earth; and eachone grounds his assertion on reasoning and testimony of no value.Now, that they should agree at setting off, in one opinion, and thendiffer in what they say, is an evidence of their ignorance of thewhole subject. This is soon discovered in their discourse. Iftheyaddress the same audience, that audience will readily perceive thatnone ofthese philosophers is victorious thrice in succession. Now,it is one, then another, subsequently a third one; and he, the onethat has the greatest volubility, and is best exercised in publicspeaking. If we profess to be fully masters of our subject, weought undoubtedly to be always victorious in debate; and if weknow it in fact, we can conclusively prove it. These philosophersappear to me to disagree, merely from a misapprehension of terms.ON THE NATURE OF MAN. 149aThey become, like Melissus, inconsistent; and this is all I shall sayupon the subject of these philosophical reveries as to the nature ofman. In respect to the opinions of physicians on this particular,some maintain that man consists altogether of blood; some that heis only bile; and others constitute him of pituita. All reason in thesame manner: they say that the individual is a unit by whatsoever name it may be termed, and that this unit changes its formand power, according as it is compelled thereto, by cold or heat;that it is capable of becoming sweet or bitter, white or black, or ofassuming any other quality; -now none of this do I accredit. Thegreater number advocate other principles of a similar description.As to my own views, I affirm, that if man was constituted of onlyone species of matter, he could never feel pain; for how could pain.be excited in him, if simple and uncompounded! Admit even that hedid feel pain, the remedy applied is equally supposed to be one; butwe know that remedies are various and distinct; and this becausemany things are combined in the body, from which, when becoming, inter se , preternaturally heated or cooled, or dry or humid, different diseases ensue, and under different forms, requiring for their curean equal difference in treatment. I therefore think, that whoeversays man is constituted of blood and nothing else, should be able toprove that he is at all times the same, and incapable of changing!-or at least he should be able to assign some period of the year,or of his life, in which blood only was to be found in him; since,in order to be assured of the real foundation of his opinion, thereought to be at least one period , in which should be alone seen, thatof which alone he is constituted. This reasoning applies equallyto those who maintain that man consists only of bile, or of pituita.I shall however demonstrate, that the things which constitute thecomposition of man remain always the same, from their very nature, and the laws by which they are governed; and that this isthe case in youth and age, and under every variety of temperatureand season. I will likewise point out the signs by which thesecompounds are recognised, and the causes by which they are individually augmented or decreased in quantity.The incipient formation or generation of man, cannot possiblyarise from one thing only-for how can a single simple substance

• Melissus, according to Galen, affirmed that only one element existed, which,

nevertheless, he divided into four others.150 THE WORKS OF HIPPOCRATES.engender another without admixture with something else? Now,if what is mingled be not the product of different beings, of thesame nature and of similar faculties, no generation can ensue of abeing of a like character to them. Moreover, if heat and cold,dry and humid, do not appropriately temper each other, or ifeither predominates unduly, generation cannot take place. Howthen can one thing alone engender, when a greater number cannot,unless their natural commixture is properly attempered? Sincethen such is the nature of generation, there must be, both inrespect to man and of all other beings, more than a single thing,each of which is alike essential to the process, and gives to thebody the power of accomplishing it. So also, when death takesplace, each thing separates and passes off in conformity to itsnature: the moist, joins itself to moisture; the dry returns to thedry; hot passes to heat, and the cold to cold. Such is the natureof animals, and of all other beings. All proceed from their like;all return to their like again, since they are compounded of thesame things; and each, after serving in the composition, returnsto those from which they were derived. Now the body of mancontains blood, pituita , and two kinds of bile-yellow and black;and his nature is such that it is through them that he enjoys health,or suffers from disease. He enjoys the former when each is indue proportion of quantity and force, but especially when properlycommingled. Disease takes place if either is in excess or deficient, or if not duly united. For when separate, not only the partin which there is a deficiency must be affected, but the part towhich it goes being surcharged, will experience pain and uneasiness. When more than a mere superfluity is discharged fromthe system, the void occasioned thereby is productive of pain; butif this void is caused by the separation of the humours in one part,and being carried by metastasis to another, the pain is twofold ,viz. that induced by the vacuity of the part it leaves, and therepletion of that to which it is conveyed. I have stated that Iwould show, that those things of which man is composed remainalways the same, both from their nature, and their true intent.Now I say that blood, pituita, and yellow and black bile are invariably the same and at all times so considered, since none of thoseThe early credence of the necessity of an admixture of the seed of both sexes ishere evinced-as also in the treatise on Generation,-without recurrence to the absurddoctrine ofsympathy, &c.ON THE NATURE OF MAN. 151terms are at all equivocal, or liable to any obscurity; and moreover, the things themselves are in their nature entirely distinct-forpituita in no respect resembles blood, nor does blood resemble bile,nor bile pituita. How then can they possibly be confounded,whilst to the eye their colour is different, and also to the touch thereis no similarity? In warmth and coldness, in tenuity and consistence, they alike differ. Distinct therefore they must needs be,for they are not one and the same thing; they are not constitutedalone of either fire, or water; and we at once distinguish thatthey are not, individually, one and the same, unless we can pronounce that fire and water are one and the same; but each one hasits own peculiar nature and powers. If a medicine is administeredthat acts on the pituita , that alone is evacuated; if it acts upon thebile, bile is discharged; or black bile, if the remedy acts on theatrabilis. If the body is wounded in any part, blood flows fromthe wound. All this is the same, by day or night, in winter orsummer, so long as man continues to respire; and this he canaccomplish so long as he is not deprived of one of these, his constituent parts -for such they unequivocally must be; for they arefound within him during the whole of his existence. Besides, theindividual was generated by a being who possessed the same principles; and he was nourished by one who also had them. Theyin fact evince their presence, without the necessity of any reasoning on the subject.They who affirm that man is constituted of only one principle,seem to found their opinion on reasons to this effect. Persons whohave taken purgatives, have been known to die of super-purgation;some of whom have vomited bile, others pituita. Hence they supposed that man consisted of that humour which they saw himdischarge in death. They who say he consists of blood only,reason in like manner, from having seen persons whose throatswere cut, discharging blood alone, and they employ proof of a likecharacter. Yet no one ever died from super- purgation, by voidingbile alone. If a medicine is taken that acts upon the bile, thathumour is first evacuated, and then pituita, which is followed byatrabilis; and if death ensues, blood is also discharged. Such isthe case also, when remedies which act on the pituita are toolargely taken. Pituita is first vomited, then yellow bile, next blackbile, and lastly, before death, he vomits blood. The medicine taken,acts primarily on the humour to which it is most allied in its nature,152 THE WORKS OF HIPPOCRATES.and then attacks and evacuates the others. It is precisely as withplants, or seeds, which thrown upon the earth, attract or drawfrom thence, that which is most accordant to their nature. Now,there they find an acid, bitter, sweet, or saline. Each attracts atfirst that which is most congenial, and then takes a portion of therest. So remedies act on the body; such as drive out - bile, firstpurge off pure bile, and then a mixed congeries. If a man's throatis cut, the blood first flows out very warm and red, then mixedwith pituita, and lastly with much bile.Pituita abounds in man more largely in the winter, since it is thehumour that has naturally the greatest analogy with that season;for of all the humours it is the coldest, of which we can easilysatisfy ourselves. If you successively touch pituita , bile, and blood,the first will be found the coldest; it is more viscid, and combineswith difficulty with atrabilis. It may be said, that every thing thatis viscid and yields with difficulty, is, by the force employed forsuch a purpose, rendered hotter, although this is no argumentagainst the actual frigidity of pituita. That it does augment inwinter is very clear, for we cough up and discharge it largely atthat season; besides which, it is during this season that oedemasand other pituitous swellings chiefly make their appearance. Inspring, although pituita is still abundant, yet the blood increases,the cold recedes, and showers occur. The blood therefore ought toincrease, both from the augmented humidity and from the increasingtemperature, which are the natural concomitants of this season; anda proof of my position is, that men are more liable to dysenteriesand epistaxis, and are hotter and higher coloured at those seasons.In the summer, the blood still abounds, but bile augments andextends into the autumn, the blood diminishing, since summer iscontrary to its nature. The bile evinces its existence in the summer and in autumn, both by its spontaneous vomition, and by itscopious discharge through the means of purgatives. It is equallyshown, by the character of autumnal fevers, and by the colour ofthe skin. Pituita in summer is greatly weakened, for that seasonbeing hot and dry, it is naturally opposed to its presence. Theblood is smallest in production in the autumn, for this is the dryestseason, and already is the system becoming colder. And now theatrabilis predominates, both in power and in quantity. As winterapproaches, the atrabilis is refrigerated, and is less abundant; whilstpituita resumes its station and extent, in consequence of abundantON THE NATURE OF MAN. 153rains, and the greater length of night. The human body has, therefore, constantly, all the above humours; but they increase or diminish, each according to the season, as it may be conformable orotherwise to their nature respectively. As, throughout the year,there is always present both heat and cold, dryness and moisture,and as nothing in nature could for an instant subsist without theirpresence; if one alone was wanting, universal destruction would bethe result; for the same law that subserved the creation of allthings, is equally required for their preservation. It is the samewith man; if one of those things that are essential to his constitution, were destroyed, he could not possibly exist. During the year,winter, spring, summer, and autumn, alternately predominate. Inman, it is the pituita , or blood, or bile , or atrabilis, that successivelyhold the sway, as is evident from the operation of the same remedyon the same individual in the four different seasons of the year. Inwinter the evacuations are most abundant in pituita; in spring theyare more diluted; bile predominates in them in summer, and atrabilis in the autumn. Now, this being the case, the diseases whichincrease in winter, ought to end in summer, as those that arise insummer should be arrested by winter, unless checked by a certaindeterminate periodicity. This regularity in their termination iselsewhere discussed. In regard to vernal diseases, we must awaittheir final termination in the autumn; as those of autumn may beexpected to disappear in spring. Should they extend beyond theseason of their usual termination, they will be continued throughthe year. The physician, therefore, in attending the sick , ought toobserve what is predominant in the system, as it regards the body,and also the season of the year.Here, Galen thinks the genuine character of the treatise ceases,and that what follows is incorrectly added to it; and he here closeshis commentary on it.-ED.The physician should likewise know what diseases are causedby repletion, and which are cured by evacuations; as also such asarise from evacuations, and are removed by re-integration. Sothose that spring from fatigue, yield to rest, and if originating inrest, they give way to exercise. In general, he should be acquainted154 THE WORKS OF HIPPOCRATES.with the means of fortifying the body against the diseases thatthreaten it, whether depending on temperament, season, or age.He should be able to strengthen what is relaxed, and to relax whatis in a state of tension; -this is the true means of removing theevil, and to this principle, in my opinion, the whole of medicine isreducible.Some diseases arise from the diet or regimen employed; somefrom the air we breathe. Whenever, in the same place, manypersons are attacked with the same disease, at the same time, wemust attribute this to some common cause. Now this is the air.It is evident it cannot be the diet, because the disease attacks all,indiscriminately, men and women, great drinkers and such as drinkwater only, those who eat cakes alike with such as live on bread,labourers and the idle. Diet is therefore by no means the cause ofthe evil, since persons living in a way so opposite to each otherare equally attacked by the same disease. But when, at the sametime, diseases are altogether different, it is obvious that the diet ofeach must be the source of the disease of each individual. Thecure must then be effected by opposing to each, the reverse of thatwhich tended to excite his disease, as I have elsewhere explained.The mode of living must be changed. It is clear that the one pursued is bad, either wholly or in a great degree, in some particular.In order to know what change to make, we must have regard tothe temperament and age of the patient, as well as to the constitution and season of the year and the nature of the disease; then fixupon the plan of treatment, either by addition or subtraction, as Ihave elsewhere stated; always paying attention to age, season, constitution, and the nature of the disease, before prescribing eithermedicine or diet.When an epidemic disease prevails, the cause of it assuredly isnot in the food we take, but in the air respired, in which somethingnoxious is to be found. In such a state of things it is useless tochange the mode of living (diet) , since it is not from thence theevil originates. Endeavour by all means to reduce the vigour andembonpoint of the body; retrench slowly in the usual amount offood and drink, for if suddenly changed it is hazardous. Your dietought in general to be such as is altogether innoxious. ExposureThis seems to be the origin of the doctrine of the " strictum et laxum," about two centuries ago.b Пvuua, spiritus, Hal. -Souffle, Gard.-Something contained in it, in order tosustain life.ON THE NATURE OF MAN. 155to the air should be avoided as much as possible; or, if it can bedone, remove from the place, or at least time live as separate aspossible; for by such measures the least injury will be sustained.from the noxious quality of the air respired. Diseases arising inthe strongest parts of the body are much the most dangerous. Ifthey continue in their original situation , the whole system mustsympathize, inasmuch as it is the most vigorous part that isaffected. If they leave that stronger part for one that is weaker,it will with difficulty be made to quit this latter situation; but ifthey quit a weak for a stronger part, the cure is much easier, thestrength of the part enabling it to repel the fluxion.1 am now to advert to the vessels of the largest size . Of thesethere are four pair in the body. The first pair, proceeding fromthe head, pass down behind the neck, along the spine on both sidesexteriorly, and reach the ischium and thighs, proceeding to the legsand external malleoli, and thence to the feet. In diseases of theback and the ischia, venesection should be made at the ham andexternal ankle. The second pair of vessels arise also from thehead, near the ears; they pass down the neck, and are called jugulars. They proceed internally along each side of the spine, to theloins, the testes, and thighs, along the inner side of the ham , thencealong the tibiæ to the internal malleoli and feet. In diseases of theloins and testes, we should bleed from the vessels of the inner hamand ankles. The third pair come from the temples, pass along theneck below the scapula, and thence to the lungs; that of the rightside going to the left side of the lungs, that of the left to the rightside. The right one passes out from the lungs under the breast,and proceeds to the spleen and kidneys; the left, leaving the rightlobe, passes to the breast, to the liver, and the kidneys. The twovessels of this pair terminate in the rectum. The fourth pair partsfrom the forepart of the head and eyes, down the neck and underthe clavicles, thence to the upper part of the arm, and down to itsjunction with the forearm, from whence it passes along the cubit tothe junction of the carpus, and to the fingers; returning from thefingers along the upper part of the hand to the forearm, the elbowand axilla and the superior ribs, a branch proceeds to the spleen,and another to the liver; and both then, spreading over the belly,a Venæ crassissimæ, Fœs. , Hal.;—qλe↓ raxus, Hipp.; —qas↓, vena animalis, itemaquarum et similium, Dict.156 THE WORKS OF HIPPOCRATES.terminate in the pudenda. Such is the route of the largest vessels.Besides these, a great many different vessels arise from the stomach,by which nourishment is conveyed to the body; and others arisefrom the large vessels, both external and internal, and pass to everypart of the body, having mutual intercommunication with each otherin every part. And this should be recollected in our choice of apart in which to bleed. We should remember also to bleed in apart the most distant from that in which pain occurs, or an accumulation of blood. By this means there will be less immediateand sudden change; and by thus diverting the blood from itsaccustomed course, we shall guard against its accumulation in thepart to which its tendency is too great.They who expectorate much pus without any fever, or whoseurine deposits a large quantity of purulent sediment unaccompaniedwith pain; such as have bloody stools, as in dysentery, or longcontinued diarrhoea, as young people of about thirty-five years ofage; all such are in a diseased condition , dependent on the samecause. They must have laboured hard and worked much in earlylife; and then, suddenly ceasing from their active exertions, eatinglargely and of a quality different from what they have been usedto, corpulence ensued, and a great change of their system musthave resulted, so that no correspondence exists between their present and their former state. When any disease attacks them, asnow constituted, they at first resist it, but they are slowly undermined. The evil penetrates the vessels, and a sanious and unhealthy fluid is discharged wherever opportunity presents. Shouldit occur in the intestines, a diarrhoea is induced, of a character, asto the discharges, nearly similar to the humour existing in thebody. Finding a ready passage, it is not long confined to the intestines. Should the collection tend to the thorax, suppuration`ensues, and if the purgation is impeded, the matter in the chest putrefies, and is discharged as pus. When thrown upon the bladder,the heat of the part warms and blanches it, a separation of itsparts takes place, the lighter parts float above, and the thicker purulent parts fall to the bottom. It is on this account that in childrenwe find the stone or calculus forming in the bladder, to the heat ofwhich is superadded that of the whole body. In man its formationis less common, in consequence of their greater coldness. It is necessary that the heat of the body should be greatest in the growingstate, and we find it coldest as an advance of life takes place,ON THE NATURE OF MAN. 157when the body shrinks, and it is about to fall into ruin. The heat,during our life, is in exact correspondence with this progression;the faster the growth, in early life, so in proportion is this heat increased; the more we diminish, as life declines, the colder does thebody become.Those affected as above generally recover spontaneously inforty-five days of the same season in which they began to decline;as to those who survive that period, they are usually restored spontaneously in the course of the year, unless some new disease assailsthem. If the disease is not of long standing, and its cause is wellknown, a ready cure may be predicted. It must be commencedby prescribing what is the direct opposite to its exciting cause, bywhich means we destroy it, together with its cause. In cases wheresand or gravel is deposited in the urine, there must have been originally some tumour of the great vein, which has ended in suppuration. Subsequently, since an abscess is not so immediately broken,portions of the pus coalesce, and are discharged through the vein,and pass off with the urine from the bladder. Whenever the urineis bloody, there is some affection of the vein [Query: ureter.-ED].When we see in a turbid urine small fleshy filaments resembling hair,we must presume that they are produced in the kidneys, and suchoccur in gouty cases. If in urine that is perfectly clear, we perceive from time to time something on its surface resembling bran,we may conclude that the inner coat of the bladder is affected withscabies. wpia erosion. )Fevers most commonly proceed from bile. There are four species, independently of such as have their origin in pain, and differfrom them. These four species are denominated, synocha or continued, quotidian, tertian, and quartan. The first arises from asuperabundance of unmixed bile, and its crisis is rapid; inasmuchas the body is not refreshed by intervals of calm, but on the contrary, is heated by an excessive warmth, it must necessarily sooncome to an end. The quotidian also proceeds like the continued,from too much bile , though of less amount than in it: it ends in ashorter time than the two last, but continues longer than the first,because there is less bile, and also because during the intermissionthe body enjoys rest, which in the synocha it does not. The tertianQuery: ifsomething is not here lost; can this apply to persons affected as detailed above?-ED.bQuery: the ureter, which is elsewhere so denominated, as likewise by Celsus. - ED158 THE WORKS OF HIPPOCRATES.is longer than the quotidian, being produced from a smaller amountof bile; and inasmuch as the intermission is longer than in the quotidian, so is the disease itself of longer duration. It is the samewith the quartan, which is longer than the tertian, owing to itshaving less bile, which causes the heat; consequently the period ofrepose is longer, during which the body is cooled. The quartan,however, is peculiar, in having an excess of atrabilis , which renders its cure difficult; for atrabilis is the most tenacious of all thehumours of the body, and that which is with the greatest difficultyevacuated. Now the proof that quartan fever proceeds from orpartakes of atrabilis, is, that it is chiefly produced in autumn, andattacks principally those between twenty-five and forty- five years,the period of life in which atrabilis most abounds, and autumn isthe season of the year best adapted for its production. If a quartanattacks at any other season and time of life, you may rest assuredthat it will be of short duration, unless some accidental circumstance should be conjoined with it.ON GENERATION.DE GENITURA,DE GENITURA,TRAITÉ DE LA GÉNÉRATION,FESIUS, Treat. ii. p. 231.HALLER, ii. p. 50.GARDEIL, ii. p. 386.HALLER, in his preface to this treatise, states it as maintaining theintermixture of the seed of both parents; that this seed is derivedfrom every part of them, principally from the head through thespinal marrow to the kidneys by the intermedium of the testes, andthence to the pudenda, by channels distinct from those that conveythe urine. The semen is from both, both male and female, andwhichever predominates, gives rise to a corresponding sex of thefœtus. The parts of the child are like father or mother, proportionately to the amount of semen derived from such parts in either.Defective children are explained from pressure experienced in theuterus. Although the hypothesis is very coherent in all its parts,yet he esteems it too subtile for Hippocrates. "As a general argument to the treatise, he, tells us it consists ofsuch particulars as have reference to venery and conception; -suchas venereal pleasure, the appearance of the seed, nocturnal pollu-

• It has been, from time immemorial, a subject of dispute among medical men and

others, whether the female possessed or emitted a seminal fluid, as essential to thepropagation of the fœtus, or whether she acted only as a nidus, or location for theoffspring of the male seed. To say nothing of the similarity of features in the childto the mother, which could scarcely ensue, unless in part derived from her, indepen.dently of mere nutrition subsequently to its procreation; Galen maintains that thefemale could have no venereal propensity, did she not possess the faculty of emittingseed; and we are expressly told in the Scriptures, that the seed (or issue) of thewoman (Genesis) should bruise the head ofthe serpent. Now, as man had no part inthe procreation of Jesus Christ, the expression seems incorrect, if she, ( the female,Mary, ) had no further concern than as a nidus for the purpose, and which produc.tion of hers could in no wise be appropriately called man, had man or woman no partin the mysterious propagation! It is in any other view, altogether of Divine origin;and the " Man Christ" (Tim. ii. 5) seems anomalous! -ED.160 THE WORKS OF HIPPOCRATES.tion, &c.; of the non-emission of semen, and the similitude or dissimilarity of children to their parents. These subjects are embracedin six chapters.'- ED.CHAP. I. Of the semen; from what and whence derived. Fromwhence arises the pleasure in venery. The cause of the spumescence or frothy appearance of the seed, and why secreted mostabundantly in coition. Blood is occasionally discharged. Twopassages for the seed and urine. Of the causes of nocturnal pollution.CHAP. II. Why eunuchs, boys, and young girls, do not feel thevenereal pruritus. It would seem that eunuchs were constituted,either by total excision in castration, or by compressing and twisting the parts. Those persons are affirmed to become inapt togeneration, who have the veins behind the ears incised.many evils.CHAP. III. The female affords seed in the process of generation,but experiences less pleasure than the male. Celibacy is injuriousto health, and in females is a source ofCHAP. IV. By what means a woman may know whether shehas conceived. The power of the seed in both sexes varies greatly.Each seed contains both male and female germs; and the strongernecessarily predominates in the formation of a boy; and of a girl ifthe weaker excels. A proof of both male and female germs existing in the seed of both sexes, is deduced from the circumstance thatmany women who had borne only girls, to one man, have, in unionwith another, given birth to boys; and so in the case of a man,who having only girls with one wife, has, with another, given originto boys, or reversely.CHAP. V. The reasons assigned why children resemble, or differin likeness from their parents; why some are small and weak, andothers large and strong at birth. Among those reasons given, oneis that the child may have had some disease whilst in the womb;another is dependent on the size of the womb, which, if too contracted, may unduly press on its tender burden, and prevent itsgrowth. Curious analogical illustration .a Vide treatise de aquis, aeribus et locis.ON GENERATION. 161CHAP. VI. Why and whence are constituted monsters, or mutilated offspring, even with healthy and sound parents; whilst soundand healthy children are often the offspring of mutilated parents.Gardeil, in reference to this treatise, says, that although veryconcise, it yet affords many of the physiological ideas on the subject of generation, that are generally prevalent in our time, renewed,and modified by different writers. -ED.11ON THE FETAL NATURE.DE NATURA PUERI,DE NATURA PUERI,TRAITÉ DE LA NATURE DE L'ENFANT,.FESIUS, Treat. iii. p. 235.HALLER, ii. p. 60.GARDEIL, ii. p. 396.THIS treatise is by Gardeil regarded as merely a continuation ofthe preceding and, in fact, whoever the author of that may be, atits conclusion he states his intention of recurring to the subject.Haller says, that although this was by the ancients ascribed toHippocrates, yet it is assuredly spurious, even in the opinion ofMercurialis. The system it sustains is very consistent, displays anacute acquaintance with nature, and was written posterior toTheophrastus and Herophilus. This is deducible from the greatanatomical knowledge it demands, as well as from the anatomicalexperiments on generation, and the incubation of the egg. Wefind herein the account of a female musician, who, by the author'sdirection, in violation of the oath, was made to abort by violentjumping, of what greatly resembled a human ovum! A mechanicalexplanation is afforded of sundry phenomena, through the means ofbreathing, and of attraction.The male and female seed commingled, become heated, says theauthor, and breathing is excited, by which the cooler air isattracted, and that which was heated escapes, and thereby promotes the formation of an umbilicus. At length a pellicle isformed, and the articulations ensue in about six weeks, and alimentis received by means of the umbilicus. From the oozing of theblood a placenta is produced. At length, from want of adequatenourishment, the foetus bestirs himself, breaks his membranes, andheadforemost issues into daylight. All this is illustrated by theauthor from the generation of trees and fowls, who (remarksHaller) may be the same that wrote the preceding book, -for wefind, in both, the two varieties of seed spoken of, from which, bydifferent proportions and location in the uterus, a difference of sexON THE FETAL NATURE. 163ensues, or twins are produced. Indeed, Mercurialis considers it asa part of the former book. We find in it the book " De MorbisMuliebribus" quoted.As the general argument or heading of the book, Haller states itto consist of an account of the procreation and principles of thefœtus, and of every thing having reference to the fœtal state of bothsexes. Of the period of its formation; its various movements; ofthe generation of the menses and milk: all of which are illustratedby references to plants and to eggs. It treats, moreover, of twins,and of the difference of sex.The heading of each chapter, from Haller, will sufficiently pointout the order of the above particulars.CHAP. I. The seed in the uterus attracts the air, and is nourishedby this alternation of heat and cold. Becoming heated , it repels thisair, and attracts that which is cold.CHAP. II. Of the seminal respiration, and formation and increaseof the fœtal covering. Menstruation is absent in healthy pregnancy.CHAP. III. Why the menses, retained in the state of pregnancy,are not so injurious as in the unimpregnated, from the importanceof it in the breathing and nutrition of the foetus. When conception ensues; and what symptoms succeed the suppression of menstruation.CHAP. IV. Of the wonderful and primary formation of the fœtusand the secundines, and how accomplished.CHAP. V. Of the time required in the formation of a boy, and ofa girl; of necessary lochial purgation in females, and danger fromtheir suppression.CHAP. VI. Of the wonderful formation of the foetal parts; howand when effected. Of the formation of bones, vessels, nerves,nails, hair, and cuticle.CHAP. VII. Of the motion of the foetus, commencing in the maleat three, and in the female at four months; of the formation of milk,and its conveyance to the uterus and to the breasts.CHAP. VIII. The fœtus in its origin, nutrition, and growth, iscompared to the germination of plants, in their roots, branches,leaves, fruit, seed, as effectuated by external causes, such as water,air, season, temperature, and vicissitudes of weather, & c. •164 THE WORKS OF HIPPOCRATES.CHAP. IX. The health of the foetus is greatly dependent on thatof the mother. Of the situation of the foetus in utero, and of itsrespiration by the umbilicus, with its similitude to the incubatedegg. Of a ten-month birth and upwards, and of those below thatterm;-conception facilitated by menstrual purgation.CHAP. X. Of the generation of birds in the egg; air transmittedthrough it; the chick excluded at twenty days. Analogy of birthin birds, to that of man. Of easy, difficult, and laborious births;the umbilicus and secundines discharged last.CHAP. XI. Of the generation of twins, male and female, or of agreater number.A transient exposé of Gardeil's division of this treatise, undertwenty-two paragraphs or sections, will further illustrate its character.SEC. I. Of the primary formation of the fœtus after coition; theimportance of the breath (souffle, spiritus, vεvμa) is strongly insistedon, and explained.SEC. II. A ventilation or fixation or breathing of air is established in the heated seed, and is followed by the formation of a membrane around it, having passages left in it for the issue and entryof the air. Here the author recounts his examination of an abortion of six days, from a female musician, induced by powerfuljumping or leaping, by his direction, in absolute contradiction tothat part of the oath, by which every means of inducing abortionis prohibited. A particular detail is given of this examination.SEC. III. The embryo is nourished by the maternal blood thatgoes to the uterus.SEC. IV. Of the formation of other membranes, attached to eachother, and all tending to the navel; then of the flesh. A digressionIn my inaugural Thesis on Inflammation, 1794, I had occasion to refer to someexperiments I had made on the subject of the air which is always found in the largerend of the egg, and which I found to consist principally of oxygen in the early stageof incubation, and, gradually deteriorating, containing more or less of carbonic acidgas, as the incubation proceeded; -from which I was led to infer the analogy ofthis process to respiration in the living subject. If I do not mistake, views of a like.nature had presented themselves to the writer of this treatise; but the importance ofvital air to the chick in ovo, cut off from all maternal connexion, must be admitted, inorder to perfect sanguification and circulation , whilst enclosed in its calcareous envelope, even if we cannot fully comprehend the process pursued by nature, to accomplishthe wonderful end she proposed to effect.-ED.ON THE FETAL NATURE. 165on the purport and utility of the menses in females; the dangerfrom their obstruction, and the symptoms following; all whichthe author will enlarge upon, in a treatise on the diseases ofwomen.SEC. V. Ofthe formation of the foetal organs by the conjunctionof similar parts, arising primarily from the parental organs; detailsof each.SEC. VI. Of the period of the formation respectively of boys orgirls.SEC. VII. Of the discharges after parturition; their continuance;variable in time and amount. Their character and appearance;correspondence in various points with the male or female respectively.SEC. VIII. This subject is still continued; and the continuedincrease of the fœtus.SEC. IX. Of the formation of the bones, epiphyses, fingers, nails,vessels, &c.SEC. X. The hair of the head, and of the body; beard; that ofthe pubes, &c.; why it occurs only at puberty; and in females isaltogether wanting on the chin, as likewise in the male, if castratedin infancy.SEC. XI. Of the period of commencing motion of the fœtus, andthe formation of milk.SEC. XII. The nourishment and growth of the fœtus comparedwith the seed of plants, which develope themselves in order to giveorigin to a new one.SEC. XIII. A digression relative to the nutrition of vegetables.On the interior state of the earth in winter and summer; and onthe fructification of trees.SEC. XIV. Subject continued. The developements of plants bygrafting explained.SEC. XV. Fotal nutrition resumed. Conclusion of all is, thatthe nature of vegetation, and that of the life of man, are perfectlyanalogous, from first to last.SEC. XVI. Of the situation of the fœtus in utero, and its membranes arising from its navel.SEC. XVII. Analogy between the foetal formation and the production of a bird from an egg. Experiments on eggs. An umbilicus in the egg.166 THE WORKS OF HIPPOCRATES.SEC. XVIII. On parturition; causes leading thereto; time of,fixed at ten months.SEC. XIX. Of the sources of deception which have led to thebelief of pregnancy beyond ten months.SEC. XX. Some parts recapitulated. A comparison drawn ofthe fœtus and the chick. Of the fixed limits of gestation in allanimals.SEC. XXI. Of labour and delivery; progress of, and results .SEC. XXII. Of twin formations; causes of explained.ON THE ORIGIN OF MA N.HIPPOCRATIS DE CARNIBUS, LIBER,.HIPPOCRATIS DE CARNIBUS, SEU PRINCIPIIS,TRAITÉ DES CHAIRS, ou du COMMENCEMENT DE L'HOMME,FESIUS, Treat. iv. p. 248.HALLER, ii. p. 3.GARDEIL, ii. p. 427.HALLER, in his preface to this treatise (which, by some, is considered as a treatise " De Principiis") , speaks of the author as a manof genius (acuti ingenii; perhaps the term of a perverted imagination would better suit); and that, so far as he could judge, thesystem advocated is a combination of that of Heraclitus, with thatofthe Peripatetics. It sets off with an exposé of first principles, ofwhich innate heat is regarded as the chief, immortal, and omniscient. A portion of it escaping into the universal space, constitutedthe ether of the ancients; whilst the residue combined with thethree other elements. That portion attached to the earth, by theprocess of putrefaction, formed small coverings, which served toinvest the various organs as they were respectively produced, viz.:bones, nerves, brain, heart, vessels, &c. , the formation of whichare all particularly noticed. Anatomical observations, of some importance, lead Haller to suppose the treatise was composed in theperiod of Herophilus, when the knowledge of anatomy had greatlyenlarged. The name of artery is here perhaps first given to theaorta; and reference is made to the loss of voice in those whosethroats are cut.As to the general argument of the treatise, it consists, saysHaller, of an account of the principles, generation, and formationof each individual part. Of the organs of sight, smell, and hearing.Of the influence of the number seven in birth, in acute diseases, inulcers and inflammations, and in the completion of dentition.Gardeil merely remarks of this treatise, that in some manuscriptsit is distinguished by the title of the Beginning or Principles, whichis most appropriate, since it embraces the doctrine of the origin ofman; a physical formation, he remarks in a note, which will un-168 THE WORKS OF HIPPOCRATES.questionably be considered as very extraordinary, the same nearlyas that which appears in the first book of the treatise on diet orregimen. It is unnecessary to give more than the mere outline ofits contents. Gardeil, in a note, says, " Devois-je me dispenser d'endonner la traduction?"Preliminary remarks as to the connexion of every thing in naturewith man and animals, in relation to life , health, disease, and death.Of the creation of the universe. Of heat or fire; its immortalityand universality;—the ether of the ancients. Other principles, coldor earth, moisture or water, and dry or air , are merely secondary.How, by a circular movement, creation from these promoted.Formation of bone, ligaments, cartilage, nerve, membrane, vessels,fluids, the various hollow organs, as intestines, bladder, &c . , andthe different humours; external covering. Bone more fully elucidated. Brain, fat, spinal marrow, heart, lungs, liver, and otherviscera. In what manner the air acts on the living system. Ofthe fœtal nutrition by suction; proofs of. Of the muscles. Somegeneral propositions as to heat and cold, and on the nature of theblood, &c. Of the joints, the nails, the teeth, and of their nourishment, and that of all parts of the body. Of the dentes sapientiæ inthe fourth septenary. Of the hair of the head, and other parts;late appearance of, on the chin, pubes, &c. , explained . Of theorgans of hearing, smell, sight; of voice and speech. Doctrine asto the number of months of pregnancy required to give vitality tothe foetus; how this knowledge was attained, from an examinationof abortions induced by public women, and from information derived from them (some of which is confirmed to Gardeil, " parplusieurs mères d'un bon jugement;" and here Gardeil in a noteremarks, that the mode of counting time bythe author may greatlyaid in lightening the difficulties that many have experienced, respecting the weeks of the celebrated prophecy of Daniel. ) Someobservations on seven, eight, nine, and ten month births. Of thenumbers of critical days and periods of diseases. Remarks continued on the number seven.ON THE SEVEN- MONTH BIRTH.DE SEPTIMESTRI PARTU,DE SEPTIMESTRI PARTU,DE LA GROSSESSE DE SEPT Mois, .FESIUS, Treat. v. p. 255.HALLER, ii . , p. 90.GARDEIL, ii., 443.HALLER appears to think that in the time of Galen, the two books,"De Septimestri et Octimestri Partu," were regarded as one; inwhich he is supported by the authority of Fasius. This productionhe contends, has given rise to the long prevalent opinion, that thefœtus is stronger and more capable of living when born at theseventh than at the eighth month. If not then brought forth, itlanguishes for forty days, and is born after the ninth month. If,however, it is born during that interval, it is weak and cannot survive. Even nine-month children are scarcely superior; thoseof ten and eleven months are better. The author divides gestationinto periods of forty days, in the first of which abortion is mostfrequent. A head presentation is the best, and the fœtus before birth.turns to that position. Some have regarded this as a spurious production.The argument of the whole book consists in the consideration ofthe number of days in which a seven-month birth is.accomplished,and why vital . Of the power and pre-eminence of the septenarynumber in months and days. Some observations relating to aneight, nine, and ten- month birth, and of the period for perfecting amale or female foetus. The outline is as follows.Of the duration of pregnancy, especially that of seven months;consideration of, in months and days, and reasons why many perishat that period. Some of the facts noticed that are advanced byfemales respecting their pregnancy; and of the vitality of birthsat different periods. Observations to be made respecting certaindays and months in pregnancy. Of the difficult gestation of an170 THE WORKS OF HIPPOCRATES.eight-month fœtus; of the time of conception, and of the sex; whatcredence to be given to female statements on the subject. Of certain divisions or periods of forty days to be noticed in pregnancy.Of the first of these, in which abortion is most prevalent. Of thatcoinciding with the eighth month, and intermediate periods; theirpowers respectively. Blind or mutilated at eight months, and ifmore difficult than those in health. Why children at nine and tenmonths live, and from whence the growth of body. Of criticaldays and months in conception, abortion , and delivery; and offortydays after parturition, &c.In a note connected with the calculation of time, in the firstparagraph, Gardeil remarks, that " it appears therefrom, that theauthor counted the year as being about three hundred and sixtyfour days, the month of twenty- nine days nearly; and that hereckoned as months, during pregnancy, about one-half of the firstand one- half of the last month. It is readily seen by this, ( adds he,)that we should often be obliged to add a thirteenth to the twelvemonths of the year. Hence, in the time of Hippocrates, the Greekswere necessitated, every two years, to intercalate a month, makingthereby a year of thirteen months. Their calendar, in consequenceof lunar months, possessed many other imperfections."OF AN EIGHT- MONTH BIRTH.DE OCTIMESTRI Partu,DE OCTIMESTRI PARTU,FESIUS, Treat. vi. p. 258.HALLER, ii . p. 99.TRAITÉ DE LA GROSSESSE DE HUIT MOIS, • GARDEIL, ii. p. 452.HALLER has no specific preface to this treatise, that of the preceding being apparently intended to answer for both. The argument of its contents is as follows.Why an eight-month birth is less likely to survive than one often months. In what manner the fœtus is more safely nourished.Some observations respecting the umbilicus and the menstrual discharge; also concerning an eleven- month birth.It is evident, says Gardeil, that the author of this treatise is thesame with that of the preceding. The titles of this, and of the following treatise (on Superfœtation) scarcely correspond with theircontents. They refer chiefly to parturition, and to the state offemales in relation to pregnancy and conception; subjects moreextensively treated of, and nearly in the same way, in the treatiseon female diseases.The general contents are the following.Why all eight- month children die, whilst those of ten monthsmostly live. The most likely to survive are those born after thefull complement of nine months. Of the numerous dangers of thefœtal state, at birth and subsequently. The superiority of a headpresentation. Children often contract a disposition to disease inthe uterus, from the navel- string being twisted around the neck,and from other causes. Dangers arising from changes in food,situation, clothing, &c. , so different after birth. The navel the onlymedium of communication between the mother and child. Of themeasures to be pursued to strengthen and invigorate children. Ofbirths at ten and eleven months. Pregnancy may participate ineleven lunations, without exceeding two hundred and eighty days.Three days the shortest period of menstruation; but for the mostpart it continues longer. It is from the termination of this, thatmost females conceive; hence great variation in their statements, &c.ON SUPERFETATION.DE SUPERFITATIONE,DE SUPERFITATIONE,TRAITÉ DE LA SUPERFÉTATION,FESIUS, Treat. vii. p. 260.HALLER, ii. p. 103.GARDEIL, ii. p. 456.THIS treatise is considered by Haller as altogether spurious. Itdetails several cases of difficult parturition, and speaks of the importance of the nail of the middle finger in aiding delivery. Of thedeath of the fœtus in utero, its signs, and ultimate putrefaction.Some remarks relative to the signs of pregnancy, and of the situation of the child, as pointed out by an enlarged breast. Twocornua admitted to be in the uterus, by which superfotation is explained. Many medical precepts are here repeated from the book"De Muliebribus."The general tenor of the book is that of superfotation, the motionof the fœtus, the signs, the location and extraction of; and of theremedies aiding in conception, gestation, delivery, menstruation, thesecundines, lochia, &c.So far as mere conception is concerned, superfotation may takeplace, but the chance of vitality is very trifling. The symptomsand causes of superfœtation. Of easy and difficult parturition, andof some circumstances that influence them. Of the signs of feeblelife, or death of the infant. Of the difficult birth from the presentation of different parts of a vigorous child, and the measures to beadopted. Mode of delivery of the dead foetus, and the importanceof the nail in such cases. Of the tardy expulsion of the afterbirth,and of aiding it by means of gravitation, by the foetal weight.Rupture of the cord, or its premature division. Signs of a deadfœtus; its putrid state, &c. Danger of hemorrhage before deliveryand dilatation of the os uteri. Remarks on the state of pregnancyand difficult parturition. If conception occurs the same day, theyare both enveloped in one membrane. Venery during pregnancytends to promote difficulty of parturition. At what time to dividethe cord in difficult labour. Of the signs of pregnancy, and of thoseON SUPERFŒTATION. 173of the dead or disordered fœtus, and of longing, and marking theinfant; ofvitiated appetite; enlarged breasts, &c. , leading to a knowledge of the situation of the child. Signs of conception; causes preventing it in great obesity, and state of the os uteri. Of the careto be taken at the cessation of child-bearing; bleeding for. Cureof the pains of pregnancy and of after-pains. Of the means to procure conception, and of the evidences of its occurrence. Causesand prevention of abortion, at two and more months. Tumefactionand ulceration of the uterus; cure of. Sterility, both in those whohave and have not borne children, arising from the state or situation of the os uteri, &c.; how to treat. Spring best adapted forconception. Preparation to insure conception in the parties interested, and to attain either sex. Remedies applicable to differentconditions of the os uteri. Pessaries, various; emollients, drasticpurgatives; specifics, for fluor albus, &c. , &c. Means of inducingmenstruation, in the retention of, in virgins. Diet; ptisans; fumigations. Remedies at and after delivery, &c.ON DENTITION.DE DENTITIONE,DE DENTITIONE,TRAITÉ DE LA DENTITION,FESIUS, Treat. viii . p. 267.HALLER, ii . p. 123.GARDEIL, ii. P. 476.THOUGH this is of a spurious origin, it is considered as a goodpractical treatise, and much in character of the Hippocratic writings. It speaks of numerous aphthous ulcerations, the accompaniments of infancy. It may be stated concisely, to give a detail ofthe state of children before, and at the period of dentition, and ofthe crises and prognosis derived from such state, as shown by thecharacter of nutrition, the excretions of stool and urine, vomitingup of the milk, &c . , dentition, and its symptoms, and the variousaphthæ and ulceration of the mouth and fauces. It occupies but asingle chapter. -Ed.OF THE HEART.DE CORDE,DE CORDE,TRAITÉ DU CŒUR,FESIUS, Treat. ix. p. 268.HALLER, ii. p. 35.GARDEIL, ii . p. 479.THIS book, says Haller, is altogether spurious, and this is admitted by Mercurialis. It appears not to have been acknowledgedin the time of Galen. Haller says, Fosius conjoins it with the book"De Carnibus;"-this is not the case. He thinks it ought to be so,and assigns his reasons; but although placed in the same section,no less than four treatises intervene. Haller considers this book,of all the Hippocratic collection, as presenting the greatest anatomical knowledge. It describes the heart, its figure, pericardium,ventricles, their situation and difference of size, its valves, and theirappropriate use. A portion of the fluids taken as drink, is assertedas passing bythe trachea to the lungs. The maxims of Erasistratusappear to be sustained, for it teaches the non-existence of blood inthe arteries. In the account of the ventilation of the blood, bymeans of the bellows- blowing power of the auricles, absurd as itmay possibly be now regarded, we meet with no contradictions;but with a well- constructed edifice, not inferior for the period, thanany that has more recently been erected, on a basis consideredmore firmly established, but which yet may well be doubted. Theattentive reader will unquestionably wonder, at finding here somany anatomical details, especially as to the valves of the heart,with a precision not inferior to Harvey, who at least is not entitledto the discovery of this part of the vascular apparatus, nor to thepulmonary circuit of the blood! —ED.ON THE GLANDS.DE GLANDULIS LIBER,DE GLANDULIS LIBER,FESIUS, Treat. x. p. 270.HALLER, ii . p. 40.TRAITÉ DES GLANDES, GARDEIL, ii. p. 485.ACCORDING TO Galen, says Haller, this treatise is wanting in Hippocratic simplicity, yet it is by no means inelegant, nor is it adverseto his doctrines on catarrh, as given in the treatise " De locis in homine. " Gardeil, in his translation of the book " De Articulis," refersto this in a note, as presenting an interesting view on the subject ofhumoral diseases, and he concludes, from a passage therein, that thistreatise on glands is in fact the work of Hippocrates, notwithstanding Galen's dissent therefrom.Not much is said about the glands, but what there is , is prettycorrect. Mention is made of the mesenteric, renal, and those ofjoints, probably meaning the axillary and inguinal. The noticetaken of the hoarseness and pectoral affections, following excisionof the mamma, is deserving of attention. The following outlinewill give sufficiently the character of the treatise.Of the nature, uses, diversity, and diseases of the glands, theirstructure, &c. Tubercles; scrofula; inflammation, situation, &c . ,chiefly located in moist parts, and where hair is generated for themost part, if the moisture is not superabundant. Of particularglands, as of the neck, ear, axilla, groin, and intestines, and of theiraffections. Glands of the brain, which is considered as itself agland, from whence those fluxions and affections proceed, of greateror less intensity, as apoplexy, mania, &c. Ofthe various passagesfor its abundant humours, producing externally, ophthalmia, itching, and discharges from the nostrils, purulent discharge from theears, &c. , catarrh, &c.; internally, phthisis, both pulmonary anddorsal, diarrhoea, &c. Ofthe mammæ or pectoral glands, affordingmilk in females; reasons why confined to them; diseases caused bythis secreted fluid in the breasts; and of such as follow their excision, and which are frequently fatal .-ED.ON THE NATURE OF THE BONES.DE OSSIUM NATURA,DE OSSIUM NATURA,TRAITÉ DE LA NATURE DES OS,FESIUS, Treat. xi. p. 274.HALLER, ii. p. 19.GARDEIL, ii. p. 494.In his preface to this treatise, Haller says that it is regarded byGalen as the work of Hippocrates, and that it was known to theancients by the title of " Mochlicus." The first part agrees withits title; it is concise and not unworthy of its author, who, it maybe perceived, examined the recent bones. He was acquainted,moreover, with the cubital nerve, which, when struck, producesstupor of the parts. The latter portion, which speaks of several ofthe vessels, appears to be an incomprehensible jumble (farragoænigmatica). In some places a lucid description is given of fourvessels, that does not tally with that in some other of his works.The epigastric and mammary vessels are noticed; likewise thevena cava, the vena sine pari, and the vessels of the extremities.Correct accounts of the par vaguin and intercostal nerves, intermixed with errors. The distinction between arteries and veins ispointed out, and the name of vein, as applied to the vessel carryingblood, seems to indicate the more minute anatomy of an age posteThe ver- rior to that of Herophilus, the discoverer of the nerves.sion is abundantly vague. The cellular fabric of the spleen isdescribed, and the pulsation of the vessels. Mercurialis, addsHaller, considered the account of the four pair of vessels as spurious, and as appertaining to the period of Aristotle; which cautionis all that is necessary to the reader.Gardeil, speaking of this book, says, that " its title might inducethe belief, that it principally regarded the bones, but that, in fact, itmore particularly is devoted to the blood- vessels." We have hereWe have a treatise by this name in the sixth section, hereafter noticed. The termis derived from μox , i. e. ossis, aut ossium a loco qui præter- naturam sit, ad natu.ralem reductio;-which word is itself derived from μoxos, vectis, i . e. the apparatusby which the reduction of a luxation was accomplished. - ED.12178 THE WORKS OF HIPPOCRATES.the detail of the doctrine on this subject, which is summarily givenin the treatise " De locis in homine," a work generally held to belegitimate; and also in that " De natura hominis," the conclusion ofwhich is thought to be spurious. He thinks, moreover, that theaccount given of the vessels, is of three pair only; and that the description of the fourth pair has either been lost, or was never completed; though, he ingenuously adds, that possibly he may have lostthe connexion, in this embarrassing angiological detail . He is,however, more surprised to find so many facts, obtained withoutany aid from injections, than to meet with mistakes. I give theheads of his divisions.- ED.Brief enumeration ofthe bones. Vesiculæ seminales. The channels for drink; the liver; pericardium; intestines; vena cava, oraorta, its divisions. Nerves, their origin and division; division ofthe vessels to the right and left; secretion of urine; intercostalvessels; aorta; vena cava; decussation of vessels; their distribution; four great pair. Hepatic vein. Intercostal and splenic nerves,and their distribution . Of the general use of the different parts ofthe body, and the origin of the four great vessels; first pair; second; with some physiological details concerning respiration, andon the formation of the seminal fluid, and cause of venereal gratification, &c.; third pair, distribution of; and of the changes of thecolour of the skin and complexion, &c.It will be seen from this outline, how truly Haller has applied tothe treatise, the term mentioned above. Its strongly confused stateis enough, assuredly, to demonstrate that Hippocrates had no handin its production. It seems to be a bundle of shreds and patches,from different sources, and put together at random, by some persondevoid ofthe organ of arrangement and order.-ED.ON AIRS, WATERS, AND LOCALITIES.DE AERE, LOCIS ET AQUIS,.DE AERIBUS, AQUIS ET LOCIS,TRAITÉ DES AIRS, DES EAUX ET DES LIEUX,FESIUS, Treat. xii. p. 280.HALLER, i. թ. 1.GARDEIL, i. p. 133.THIS book, says Haller, has always been esteemed as one of thegenuine writings of Hippocrates. It has been commented on, andillustrated by Galen, and various writers since his time. Its language becomes the Father of Medicine, and its reasoning is sound.The book chiefly treats of as to what the body suffers from winds,waters, seasons, climates, and localities. It begins with a consideration of the exposure of the Grecian cities to various winds, andof their influence and effects. Next it treats of waters derived fromdifferent sources; incidentally adverting to calculus, as arising fromtheir impurities, and as being less frequent in females, owing to theshortness of their urethra. It then proceeds to notice the diseasesdepending on different seasons of the year; and finally it treats ofclimates, as connected with the temperaments, customs, and diseases oftheir inhabitants.Should however this book be critically examined, it will be found,continues Haller, to contain some things [many! -ED. ] that do nottally with present experience, such as the affirmed connexion between the diseases of a people and their habits and winds. Watersfrom earthy sources are preferred to those of rocky origin; andsome subjects are singularly admitted, that are altogether undeserving of credit, yet which are apparently fully believed by thewriter; particularly respecting the effeminacy and impotency ofthe Scythian nobles, together with the absurd treatment of the complaint, by section of the veins behind the ears! It treats cursorilyalso of the Amazons, and of the custom of burning off their rightbreast, in infancy, together with some other curious facts and speculations.This book has been often translated , and it is incessantly quotedby medical men, when the qualities of the atmosphere are the sub-180 THE WORKS OF HIPPOCRATES.ject of investigation. Dacier has translated it into French, but Ihave never seen it. Clifton has given a version of it in English,about a century ago.-ED.Whoever desires to understand medicine thoroughly, can by nomeans neglect the subjects I am about to consider. The differentseasons of the year, and what each is capable of effecting, willprove a source of reflection to him. They differ altogether fromeach other. Diversity exists in their respective constitutions , andeven in their individual variations. We study the winds both as toheat and cold; those that are common to all countries, and suchas are peculiar to certain regions. We ought also to examine theproperties of the waters; since all are not alike in taste or gravity,so neither are they in virtues. Whoever, therefore, arrives at atown, of which he is not an inhabitant, should begin by regardingits position in relation to the winds and to the rising of the sun; hewill not consider it as a matter of indifference whether its exposureis to the north, the south, the east , or the west; on the contrary, hemust have a strict regard to its position, and to the nature of itswaters; he must examine whether they are muddy, hard, or soft;if they pass through high and stony places; if of a saline nature,and if they set light on the stomach, and are well adapted forcooking vegetables. He should inspect the soil, and notice whetherit be naked and arid, or covered and moist; if sunken and sultry,or high and airy. He should investigate the mode of living of theinhabitants, whether they are sots and gluttons , if idle or laborious,fond of exercise, moderate in eating and drinking; all these particulars are deserving of attention, and whoever makes himself withall of them fully acquainted, or at least of the greater part, willlearn, when arriving at a town he has not frequented, the nature,both of the endemic diseases and of the general affections thatshould there be prevalent. He will not be unprepared for theirtreatment, nor will he commit those errors to which all are liable,who undertake to practise without these preliminaries. He canforetell what diseases ought to afflict the majority of the inhabitantsin different seasons, in winter or in summer, and the danger towhich they are exposed by a change of diet; for, if well acquaintedwith what such changes induce by the succession of the seasons,and the rising and setting of the stars, he will be enabled to foreseethe constitution of the entire year. Acquiring thus a componentON AIRS, WATERS, AND LOCALITIES. 181knowledge of these different subjects, he will distinguish what isessential for the maintenance or re- establishment of health, and willprove highly successful in the practice of his profession . Should itbe objected, that the information I thus require, appertains to meteorology, I reply, that a knowledge of the situation of the heavenlybodies is not one of the parts least essential to form the physician;on the contrary, it is highly useful. The succession of the seasonsis accompanied with remarkable changes in all the cavities of thehuman body. I shall, therefore, state as clearly as I can, what regard we should have to all these circumstances, and what we maydeduce therefrom.A town exposed to the hot winds that blow between the risingand setting sun of winter, viz. , from the south, and which are commonto it, whilst it is protected from those of the north; such townhas abundance of water, slightly saline, and arising necessarily inelevated places; hence they are warm in summer, and cold inwinter. If the summer is dry, diseases are of short duration; butif wet, they are of longer continuance. From the most triflingcauses, wounds degenerate into eating ulcers. If the winter iscold, the head abounds with moisture and pituita, which fall uponthe bowels, and often induce gastric affections. The constitutionof the inhabitants is in general relaxed. They are neither greateaters nor hearty drinkers, for they who have weak heads cannever make stout topers, since wine readily overpowers them . Nowthe following diseases are there the most common.Women aresubject to catarrhs, and many are barren, rather from disease thanfrom nature; abortions are frequent. Children are subject to convulsions and suffocations, that are often confounded with epilepsy.The men have dysenteries, diarrhoea, and epial fevers, eruptionslike flea- bites, chronic fevers of winter, and hemorrhoids. Fewpleurisies are there seen, or peripneumonies, ardent fevers, andother acute diseases; such cannot be frequent where the bowels.are relaxed. There are moist ophthalmias, that are neither dangerous nor of long duration, unless a change of season rendersthem epidemic. After fifty years of age, they are exposed to akind of humour coming from the brain, which, if arrested, bringsOn the contrary, a town that has a good exposure to the sun and winds, has excellent water that is less influenced by the seasons. Where marshy and muddy watersare employed, and the exposure to the sun and winds is bad, then the change of seasons is severely felt. -GARDEIL.b A species of continual fever.182 THE WORKS OF HIPPOCRATES.on palsy, or affections from the rays of the sun, or colds in thehead. Such are the usual diseases in the places I have described,independent of epidemics caused by a change of season.Places situated in an exposure directly opposite, where the windsare cold, and usually blow from between the east and west, that is,from the north; and which are free from both south and all hotwinds, have this in common. The men there are strong and notvery fat; with large breasts and small bellies; they abound withbile rather than with pituita; their head is sound and dry, and theyare subject to hemorrhages. The following diseases are therecommon. Pleurisies, and all diseases called acute, as must necessarily be the case, the belly being hard and constipated: internalsuppuration is not uncommon, depending on the distension of thebody and dryness of the belly; this dryness co- operating with thecoldness of the waters, occasions ruptures of the vessels. Withsuch constitutions, they ought to be great eaters and moderatedrinkers, for it is scarcely possible to combine both in one person.We also find there, dry and violent ophthalmias, which soon run tosuppuration; hemorrhages from the nose in young people, especially in summer; a few epilepsies, but of a violent character.The term of life is in general longer than elsewhere; wounds donot inflame nor take on a bad state: the manners are rather rude.Such is the state of things, independently of diseases induced bychange of seasons. Women are there subject to hard tumours,owing to the cold and crude waters. Their catamenia are irregular, small in quantity, and painful. Parturition is laborious, butabortions rare. After delivery, the mothers can rarely nourishtheir children; their milk fails, owing to the crudeness and hardness of the waters; and many, after delivery fall into phthisis,caused by convulsions, and rupture of vessels, the result of violence.Children whilst young, are subject to hydrocele, which disappearsas they advance to maturity; puberty is, however, tardy.Thus far I have stated what has reference to towns exposed tohot winds, between the beginning and ending of winter, and thoseof an opposite direction, blowing between the rise and terminationof summer. We are now to speak of cities located towards theeast. Such ought necessarily to be more healthy than those having a north or south exposure, although lying between both; forthe heat and cold are there less felt, and the waters, whose springsare exposed to the east, are quite clear, soft, inodorous, and plea-ON AIRS, WATERS, AND LOCALITIES. 183sant to drink: the morning sun, by its rays, purifies them as it doesthe air; hence the men have a good colour, and much vigour, unless affected by sickness; their voice is clear, and they are morelively and intelligent than the inhabitants of a northern exposure.The productions of the earth moreover are superior. In a townthus situated, in which the heat and cold preserve the temperatureof spring, diseases should be mild and few in number. They arechiefly of the same character with those in cities looking towardsthe warm winds. The women are very fruitful, and have easylabours. Such are the circumstances in such exposures.As to places looking to the west, and which feel no winds fromthe east, but are exposed to those from the north and south, theirposition beyond all others is most favourable to disease. Thewaters are not clear, because the morning air, usually surchargedwith moisture, prevents their limpidity, the sun dissipating it onlyafter it has advanced in its course. During summer, the earlybreezes cause an abundant dew, whilst during the remainder ofthe day, the heat scorches and oppresses the inhabitants. Hencetheir complexion is bad, and they have little vigour; they are liableto every disease I have mentioned , without an exception; theirvoice is hoarse, owing to the air, infected with the miasmata ofdisease, and from which it is not purified by northern winds. Thosewhich blow, are charged with moisture, for the western windsplace the atmosphere in a state resembling that of autumn; and atown thus situated, therefore, partakes of all the inconvenienceswhich the evenings and mornings bring with them . Such are theremarks I have to make as to good or bad exposures, so far as relates to the winds.We pass to the consideration of the waters; and to the examination of such as are good or bad, as on this chiefly depends the stateof our health. All waters that are stagnant, muddy, marshy, arenecessarily heating. They are always thick, and smell badly insummer. As they have no current, and are maintained by the rainalone, they must naturally be of a bad colour, heavy, and bilious.Cold and frozen in winter, and disturbed, sometimes by snow orice, they become a source of pituita and catarrh to those who employ them; they enlarge and indurate the spleen; they heat andconstipate the belly; they cause a shrinking of the shoulders, theneck, and the face; the flesh seems to disappear in order to aug.ment the spleen; hence men become thin although great eaters and185 THE WORKS OF HIPPOCRATES.drinkers; their belly is with difficulty discharged either upwardsor downwards, so that they require powerful cathartics both inwinter and summer. They are subject to dropsies, which aremostly fatal; and dysenteries, diarrhoeas, and obstinate quartansare common in summer. These diseases naturally lead to dropsiesterminating in death;-such then are the summer affections. Inwinter, young people are subject to peripneumonies and to diseasesaccompanied with delirium; and old people to ardent fevers arisingfrom costiveness; women , to œdema and leucophlegmasia; theyare not readily rendered pregnant, their labours are difficult, andtheir offspring gross and œdematous; they nourish them with difficulty, for suckling induces phthisis; their lochial discharges areimperfect; their children, especially the males, have hernia andvarices of the legs. It is easily seen, that with such waters, longlife is not to be expected , but a premature old age. I add, moreover, that females often think themselves pregnant when not so;their bellies after parturition become flabby. I esteem these waters,then, as altogether bad.Let us now advert to waters proceeding from rocky mountains:such are necessarily hard, especially if arising in places wherethere are warm springs, with metallic impregnations of iron, copper, silver, gold,-or of sulphur, alum, bitumen, or nitre; for allsuch are the products of a violent heat. In such situations theearth cannot yield pure water, but such only as are hard and sharp,passing off by urine with difficulty, and producing costiveness.They are better if they flow from high and earthy elevations; suchare soft and clear, and bear to be mixed with wine. They arewarm in winter, and cool in summer, as is the like case with deepsprings. Those are preferable that flow towards the east they arealways clear, light, and of a pleasant odour.Saline, hard, and refractory waters, are absolutely bad for common drinking; yet there are temperaments and diseases in whichthey are useful, as I shall presently notice. We ought to regard asthe best of these waters, those whose springs have an eastern exposure; and next to these, such as being between the east and west,are nearer to the east; and in the third set, such as rise in thesouth they are bad in proportion as they look to the south, betweenthe setting and rising sun of winter; those to the south are bad,but less so than those to the north.The mode of using them is as follows: every strong and healthyON AIRS, WATERS, AND LOCALITIES. 185man may dispense with a choice of waters, and be satisfied withsuch as he can procure; but when, from disease, the most appropriate drink is requisite, the following plan is to be pursued. If thepatient is easily heated, and is costive, he must employ the mildest,the lightest, and most limpid water. If the bowels are relaxed,moist, and mucose, then saline, hard, and refractory ones are useful. It is natural that waters that readily boil, should evacuate,and, as it were, melt down the belly; whilst such as boil with difficulty, and are hard and refractory, ought to bind and dry it up.Many deceive themselves as to the influence of salt waters, considering them as being laxative, whilst they possess a directly opposite power; their refractory nature and difficult coction renderthem much better fitted to dry than to moisten the belly. All herementioned is correct as to spring water. Let us now consider thatof rain and melted snow.Rain water is light, sweet, thin, and limpid; the sun carries offand raises the essence or lightest part of such waters, as we seedemonstrated in making of salt; the dense and heavier parts remain and form salt, the lighter parts are raised by the sun, whichdeprives also, not only stagnant water, but also sea water of itslighter parts, as well as every thing that is usually moist. Now allbodies possess moisture; even from man himself, the sun carries offa slight dew, as we clearly perceive when he is walking or exposedto the sun; those parts of his body that are covered are moist withsweat, whilst the uncovered parts are dry, because the rays of thesun carry off the sweat as it forms, but suffer it to collect on theformer, if protected by covering or in any other way: the heat ofthe sun forcibly abstracts the sweat, but the covering precludesevaporation. If he goes into the shade his whole body is coveredwith sweat, because the rays of the sun are prevented acting on it.Rain water readily corrupts and acquires a bad smell, owing to itsbeing constituted of emanations from all sorts of bodies, whence agreat disposition to putrefaction results; moreover, these vapoursraised from bodies are carried to the highest parts of the atmospherein all directions, and mix with the air; those that are thick anddarkest, separate as dense clouds, the lighter parts remain suspended, and become attenuated and heated by the sun, and thereby ameliorated, diffused, and carried into the atmosphere. When thuscollected together, they break when approximated by oppositewinds; for it is highly probable that this happens whenever clouds,186 THE WORKS OF HIPPOCRATES.agitated and driven on by the wind, suddenly meet with others impelled in an opposite direction. They intermingle and becomethicker bythose succeeding; as they thicken they grow still darker,and at length break, precipitate by their weight, and fall down asrain. This rain water is very good, but requires boiling to divestit of its tendency to putrefaction and to a bad odour, and makesthe voice of those who drink it thick and hoarse.Snow and ice water are always bad. When water has beenfrozen, it never assumes its first nature. Its limpidity, mildness,and softness are separated and dispelled, its coarser and more fixedparts remain. To be convinced of this, place, if you choose, inwinter, a certain measure of water to freeze; melt it again thenext day in a sheltered situation , and measure it; it will be foundto be greatly diminished, and hence it results that the lightest andmost attenuated parts are dissipated, for it is impossible it shouldbe the coarser and more ponderous. We may therefore concludesuch waters to be injurious, and here we leave them .Men are liable to the stone, to nephritis, colic, and strangury, tosciatic pains and hernia, when they employ as drink waters ofdifferent nature, as of large streams into which rivers empty, or oflakes which receive different rivulets; and generally from drinkingwater coming from a distance, for it is impossible that all waterscanbe alike. Some are soft, others saline, some aluminous, and somearise in places abounding in warm springs. When waters sovarious are mingled together, they necessarily act on each other;the strongest prevails, but it is not always the same one that is thestrongest, sometimes the one, sometimes another. Besides, thewinds then produce great changes; those from the north givegreater power to the one; from the south to another, and thus ofthe rest; they ought, consequently, from their intermixture, to deposit sand in the vessels of the bladder, and produce in those whodrink of them the disease I have mentioned. Let us see why allare not thus affected. Those whose bowels are relaxed and moist,whose bladder is but little irritable, and have a large orifice, suchpersons pass their urine readily; but those whose belly is very hot,have the bladder necessarily in a like disposition, and when thusheated, its neck is equally so; hence the urine cannot so readilyescape; it is , as it were, parboiled; the lighter and purer parts escape, the gross and thicker parts remain, consolidate, and harden.At first this is merely a small nucleus, and slowly increases. ByON AIRS, WATERS, AND LOCALITIES. 187motion in the bladder it attaches that which from time to time isdeposited; thus it augments and forms a calculus. When the person makes water, the urine propels the stone to the orifice of thebladder, which arrests its flow, and causes severe pain. It is onthis account that children with calculus pull forward the penis,striving thereby to displace the obstacle that prevents the urinarydischarge. A proof that the stone is thus produced, is , that personsthus attacked, pass limpid urine like whey, nowise earthy norgravelly; the thick and bilious parts remain in the bladder, anduniting, form at last a stone. It occurs also in infants, from theirmilk, when that is unwholesome, bilious, and heated; it inducesheat of the bladder and intestines, and the urine becomes scalding.I affirm that it is better to give them wine well diluted, than suchmilk, for it dries the vessels less, and induces less heat. It is different in women; in them the urethra is shorter and larger, hencethey make water more readily; nor do they thus violently rub theparts, as boys do, to enable it to pass, and consequently do not irritate the urethra opening in the vagina. Women having such aready passage, generally void more urine than men; and these areprobably very nearly the circumstances connected with the formation of calculus.As to the constitution of the year, we may by attention discoverwhich will be healthy or the reverse. Whenever the signs or phenomena correspond with the setting or rising of the stars, when theautumn is rainy and winter moderate, neither too dry nor too cold,when occasional showers fall in spring and summer, such a yearought naturally to be very healthy.If the winter is dry and constantly chilled by the north wind, thespring rainy, and heated by the south winds, the summer will necessarily bring with it numerous fevers and ophthalmias. The earth,moistened by the rains of spring, and heated by the south winds;the summer heat and the moisture from the heated soil, induce humidity of the belly and brain. It is impossible that with such aspring, the body should not be overloaded with bad humours.Hence arise acute epidemic fevers, more common to those whoabound in pituita. They will likewise have dysenterics, as well asthose of a moist temperature. If at the rising of the Dogstar rainshould abound, and if the Etesian winds from the northeast fail not2Exortum, Hal., Fosius; sitting, Clifton .188 THE WORKS OF HIPPOCRATES.to come, it may be hoped that the diseases will terminate, and autumn prove healthy; if otherwise, there will be great mortalityamongst women and children, but not amongst old people; feverswill degenerate into quartans, and terminate in dropsy.When the winter is moderate, accompanied with showers andsouth winds; when spring is dry and cold, with north winds, pregnant women, who expected parturition in spring, miscarry, or elsethe offspring are weak and unhealthy, and soon die; or should theysurvive, they will be small, languishing, and unhealthy. Dysenteries and dry ophthalmias will occur, and catarrhs in the head, falling upon the lungs. Men of humid temperaments and females, willhave catarrhs, resulting from the pituita flowing from the brain.Bilious persons will have dry ophthalmias, owing to the heat anddryness of their flesh. Old people will have catarrhs, dependenton tumid and enlarged vessels, so that some will be carried offrapidly in a state of frenzy; others fall into palsies of the rightside; for the winter being warm and rainy, neither the body nor thevessels are strengthened. The spring succeeding, with north winds,drought and cold , the brain, which at this season ought to be cleared of those gross humours producing stoppages in the head andhoarseness, becomes stuffed up and swells, so that when the summerheats arise, great and sudden changes ensue, with diseases endingin dysentery and dropsy, because the belly cannot readily becomedry.When the summer is rainy, accompanied with south winds, andautumn is the same, the winter of necessity must prove sickly; especially in pituitous persons, and those above forty years of age.Ardent fevers will prevail, and the bilious will suffer from pleurisiesand peripneumonies. Ifsummer is dry , with north winds, and autumnrainy, with south winds, we shall have in winter affections of the head,paralysis, hoarsenesses, oppressive coughs, and some consumptions.When summer is dry, with north winds, without rain at the risingof the Dogstar and Arcturus, at the close of summer and beginningof autumn, it is favourable for people of moist temperament and forwomen, but the reverse for such as are bilious. It dries them toomuch, and gives rise to ophthalmias and acute fevers, to chronicfevers and to atrabilious complaints; for the more watery parts ofthe bile are dissipated, leaving only the thicker and more acrid parts.It is the same with the blood, and hence the source of these diseases. Such a season is however favourable to pituitous persons;ON AIRS, WATERS, AND LOCALITIES. 189they lose their excess of humidity, and are thus in a good conditionat the arrival of winter.Whoever will consider all the above circumstances, and pay attention to them, may predict the greater part of the evils inducedby the change of seasons. He must be guarded at the epoch ofsuch great changes, not to give purgatives too freely, nor applyfire near any cavity, nor make incisions, until at least ten days.after such changes. The two solstices are dangerous, especiallythat of summer;-the two equinoxes are likewise to be feared, particularly that of winter. The rising of the constellations should alsobe noted, particularly the Dogstar, then Bootes; and Pleiades attheir setting; for on those days many diseases terminate, fatally insome, in others in health. Every thing assumes another aspect, andundergoes a change. Thus much on this subject.PARALLEL BETWEEN THE ASIATICS AND EUROPEANS.I wish at present to notice wherein Asia and Europe vary, andexplain why their respective inhabitants so widely differ. I shouldbe too prolix were I to speak of every particular diversity, and shalltherefore mention only those principal points which appear mostdeserving of attention. I commence by observing, that Asia greatlyexceeds Europe in respect both to its vegetation and its inhabitants.All is larger in Asia, and the country is milder, the people areless active and more effeminate. The cause of this is to be foundAsia is located between the two-in the constitution of the seasons.extremes of winter and of summer, and therefore removed fromthe extremes of heat and cold. Every thing there increases greatly,and has a character of mildness, and of a just medium. It is notso, however, in every part of Asia; I speak only of that portionlocated intermediately between the two extremes above- mentioned.It is, moreover, abundant in fine fruit and beautiful trees; its skyis serene; there is abundance of water, both of rain and fromsprings, so that the country is neither scorched, dried up, nor affected by severe cold. It is sufficiently warm, and moistened byrain and snow; the seeds of fruit are there developed, and by meansof culture and of grafting, man has ameliorated, and fitted them forboth his gratification and his wants. The cattle are numerous,fruitful, and well fed; -the men are large and of good proportions,and scarcely differ in height or in appearance. Such a country190 THE WORKS OF HIPPOCRATES.ought to have, naturally, a good soil, and an equable temperaturein each season; but courage, patience, steady application, and firmness of mind, find no existence there, nor can the love of their ownspecies predominate. Pleasure alone exerts an absolute control,and gives origin to the many monsters observable among brutes.What I thus affirm of a part of Asia, applies equally to Egypt andto Lybia.With respect to those who dwell on the right of the rising ofthesummer sun, to the Palus Mæotis, which separates Europe fromAsia, they differ more from each other than those I have spoken of,both in regard to soil and climate. As elsewhere, whenever theseasons are more variable in degree or frequency, there the countryis more wild and irregular. There we find mountains, forests,heaths, and meadows; and somewhat similar is seen in man, ifclosely observed. The nature of some resembles the mountains,forests, and rocks; others are like plains in fertility, and partake ofthe humid nature of meadows and marshes; in others again, werecognise the character of a dry and arid country. The variousseasons of the year affording diversity of form, have, in their succession, many differences; and these variations are productive of asmany peculiar and distinct constitutions. I say nothing of thosecountries that differ little from each other; I speak of such only inwhich nature and customs have established well- marked differences.We commence with the Macro- cephali. No other people havesuch elongated heads. It is an ancient custom that gave rise tothis, and nature concurred in the practice. A very long head isesteemed a mark of distinction: this opinion led them to compresstheir children's heads with their hands, as soon as they were born,and whilst the bones were flexible; aiding this elongation by meansof bandages and other measures adapted to destroy a spheroidalform. Such practice was at first the only measures pursued toproduce this form, and time has insensibly rendered it natural; sothat it is no longer requisite to use violence. In the act of generation, portions of the seed come from every member of the body;the humid members transmit moisture, those that are diseased sendparticles that are equally so; hence, bald fathers usually propagatebald children; those with blue eyes, get children with eyes of asimilar colour; the lame beget lame children. Why then shouldnot those who have long heads beget macro- cephali? Although atpresent, not perhaps for a like reason, because all customs becomeON AIRS, WATERS, AND LOCALITIES. 191neglected and lose their power. This is my view as respects theMacro-cephali.As to those who inhabit Phasis, -this country is marshy, hot,humid, and woody; the rains are frequent and heavy at all seasons;the men live in marshes, in dwellings formed of reeds on the water:they are rarely seen in towns and public places, but wander aboutin boats formed of a single log (canoe) , traversing the canals thatevery where abound. Their drink is the warm stagnant waterof the falling rains that the sun has corrupted. The river Phasisitself is one of the slowest, its flow being scarcely perceptible; thefruits are unhealthy, soft, and imperfect, owing to the moisture, nordo they ever come to maturity. Thick clouds perpetually ariseand fill the atmosphere; and these are the causes of the differenceof the Phasians from other people. They are tall and very fat; nojoint or vein is well distinguished; their complexion is sallow,allied to jaundice; their voice is hoarse from living in an impure,humid, and thick atmosphere; and they are unable to bear fatigue.The seasons differ but little as to heat or cold; the winds mostlyblow from the south, with one exception, appropriate to the country,called Cenchron, which is sometimes very violent, powerful, andhot: the north wind is rare, and when it blows, it is moderate andscarcely perceptible.After what I have said as to the difference in the nature of theinhabitants of Asia and Europe, it follows that the former, possessing neither vigour nor courage, must be less fitted for war than theEuropeans; whilst their manners are at the same time moreamiable. We must attribute this to the seasons, as being lessvariable and less liable to great changes from cold to heat, and thereverse; the senses are less powerfully affected, and the constitution of their bodies is more enervated; hence anger and other passions are less vehement than where the temperature of the seasonsis very variable, for all changes are the causes which most excitethe mind and prevent the tranquillity of man. I think, therefore,the defect of courage in the Asiatics arises from these causes;though another powerful one is to be found in their form of government. They are almost entirely under regal authority. When weare not our own masters, but receive laws from a despot instead offraming them ourselves, we cannot feel much disposed for war, butprefer peace, for the dangers are unequal. On the one hand, wemust take the field, undergo fatigue, and die far from home, from192 THE WORKS OF HIPPOCRATES.wife, children, and friends, to satisfy the will of a master. On theother hand, any extraordinary action we perform is altogether forthe advantage and aggrandizement of the sovereign. He alonereceives the reward of danger and of death. If then amongst suchpeople one should grow up courageous and brave, his couragewould become enervated by the laws under which he would haveto live; a proof of which is, that all the Greeks in Asia, as well asthose barbarians who are not subjected to a master, who make theirown laws, and labour for their own advantage solely, are warlike,inured to hardship, and are very brave. It is for their own profitthat danger is encountered, for they know that they will enjoy thefruit of their courage, and that they will suffer from the effects ofcowardice. In Asia we find the people of a character altogetherdifferent, though some are braver than others; and these differencesdepend chiefly on the seasons, as I have endeavoured to demonstrate.Among the nations of Europe we find the Scythians, living nearthe Lacus Mootis, and differing entirely from all the others.Amongst them are the Sarmatians, whose females ride on horseback, draw the bow and shoot their arrows from that situation;and fighting their enemies whilst yet virgins; nor do they lose theirvirginity until they have killed three of them, nor cohabit with ahusband before performing certain prescribed ceremonies. Afterthis, they dwell with their husbands, and are dispensed from riding,except when necessity requires the whole nation to join in battle.They are deficient in the right breast, which is burned by theirmothers in infancy, by means of an appropriate heated copperinstrument, by which the nourishment and strength of the shoulderand arm are greatly increased. Although the various Scythiantribes resemble one another, they differ greatly from all othernations. It is the same with the Egyptians, who are, however,oppressed by heat, but the Sarmatians by cold.What is called the Scythian desert is a vast plain, abounding inmeadows, very bare, and considerably humid. It has large rivers,into which its waters are received. In this, those Scythians calledNomades, dwell, not in houses, but in chariots, covered with skins,the smaller of which have four, the larger six wheels. Some havebut one apartment, others three, resembling in construction a house;and they are well secured against the rain, cold, and wind; andare drawn by two or three pair of oxen, without horns, which areON AIRS, WATERS, AND LOCALITIES. 193hindered from growing by the cold. The women live in thesecars; the men mount their horses and camels, and are followedby their flocks, oxen, and horses. So long as sufficient herbage isfound for their cattle, they remain in the same place, and when thisis exhausted they remove to another. They feed on baked flesh,and drink mare's milk, of which they likewise make a sort ofcheese called Hippace. Such is the mode of life ofthis wanderingrace, and it is greatly allied with the nature of their seasons.The Scythians have customs and a character peculiar to themselves, by which they are distinguished from all other people,in the same way as the Egyptians. Their women are not fruitful; their wild animals are small and few in number; their location is under the Riphean Mountains, from whence proceed thenorthern blasts; the region being but slightly under the solar influence, and that chiefly during the summer solstice. Southern galesare rare and faint, but those from the north are violent, withsnow, ice, and rain. They rarely quit their mountains, which arehabitable only to a south exposure. Dense clouds arise during theday, with great humidity, so that winter seems almost perpetual;the summer heat is moderate, and of short continuance. Theplains are elevated and barren, and not protected bythe mountains,having all a northern inclination. The wild animals are all small,and easily protect themselves from the cold in holes in the earth;the frosts and sterility of the country checking their increase; beingopen and flat, they cannot readily conceal themselves. The changeof seasons is not considerable, being nearly alike, and hence thereis but little variety among the people; they employ the same foodand clothing both in winter and summer; the air they breathe is dampand heavy; their drink is chiefly the water from ice or snow, andthey exercise but little constancy in labour. It is hence impossiblethat either mind or body should be vigorous, and consequently theinhabitants of those countries are thick and heavy, their limbsflabby and relaxed, their belly loose; how indeed could it be otherwise in such a country and with such seasons? With such uniformity of surface, &c . , the men and women also must be greatlyalike. There being so little change of seasons, there can be but aslight alteration or change in the semen of the parents, except induced by some accident or disease. I will state a manifest proofthat moisture predominates, at least among the Nomadic Scythians.The greater number of them exhibit marks of burning on the13194 THE WORKS OF HIPPOCRATES.shoulders, arms, wrists, breasts, thighs, and flanks; they burn thoseparts only to correct the humidity and softness of the flesh . Theycannot, in their natural state, either drawthe bow, or throw a dart,on account of the weakness and atony of their limbs; the application of fire dries up the excess of moisture, and strengthens themuscles; the body consequently is better, and the joints becomestronger. In Scythia the men are fat and large, because, as inEgypt, they are not in infancy swaddled and bandaged; moreover,they are always on horseback or in cars, and until fit to ride, theboys live a nearly sedentary life, walking but little even in theirjourneys.The women are astonishingly fat and large, generally ruddy fromthe cold, which gives that hue to their fair skin. Such a nationcannot be prolific. Men of a cold climate, delicate, and with relaxed bowels, can have but few desires for coition, independentlyof the enervation caused by constant equitation, which unfits themfor the act of generation. So much for the male sex. As for thewomen, their fat and corpulency obstruct conception, their mensesflow but rarely and in small amount, the mouth of the uterus, closedby fat, can neither attract nor retain the seed; want of exerciserenders their bodies flabby and weak; the abdominal viscera arecold and deficient in tone; -all which causes insure a defect of fecundity, as is manifest from the opposite result in their servants,who, from their active life and want of corpulency, are readily impregnated. I shall here remark that many of the Scythians becomeimpotent, and that then they perform the duties of women; theyacquire their tone of voice, and are called effeminate. The inhabitants ascribe this misfortune to the gods, and honour those thusaffected, and fearing that the same may happen to them. For myown part, I believe that this affection, like every other, comes fromGod; none are properly the work of man, but all spring from Him.Every disease has its own particular mode of production, in whichthe above- mentioned participates, from natural causes: thus we findthem always on horseback; their legs hanging down, fluxions tothose parts necessarily ensue, which cause lameness, and a dragging of the limb as the disease advances. To cure this in thecommencement, they open a vein behind each ear, suffering theblood to flow until much weakened, and sleep ensues. On awakening some are cured, others not. Now I apprehend, they lose theirvirility by this treatment, for we have veins near the ears whoseON AIRS, WATERS, AND LOCALITIES. 195section causes impotency, and I suspect they cut these. When,therefore, they desire to approach their wives, they find themselvesincapable. At first this gives them little concern, but after three orfour attempts, finding the evil to continue, they conclude that theyhave offended God, and to this they attribute it. Assuming nowthe female dress, they thereby proclaim distinctly their impotency;they live like the women, and perform their duties. This occursamong the rich and most considerable of the Scythians, such asare always on horseback, and possessed of large flocks, and notamong the poorer classes, with whom it is uncommon, for theyrarely ride. Now if this evil proceeded particularly from God, itought to be common to both classes, and especially to the poor,who are unable to sacrifice to the gods, if indeed they delight in sacrifices, and count the number of victims. The rich have the meansto offer numerously; not so the poor, who even blame the gods forthe misery they endure, so that on this score the evil should ratherfall upon them. But it is with this as with all other diseases, whichI have already remarked as beyond doubt coming from God, eachone according to its peculiar nature. The cause productive of thatof the Scythians, appears to me to be that I have stated; it operatesequally on others. It may be observed that they who are perpetually on horseback , are subject to fluxions in the thighs, pains inthe feet, and that generally they are little fitted for the battles ofVenus. Such are the Scythians, and of all men, they are the leastardent and apt for the rites of marriage, for the reasons thus assigned. It may be added, that passing their lives thus on horseback,and wearing drawers, they have less leisure and opportunity forlascivious feelings; besides which, the cold and fatigue preventthose desires for women, so that at length this loss of virility becomes almost a matter of indifference. So much for the Scythians.In other European nations men differ greatly both in size andform, owing to the great and frequent changes of the seasons, extremes of heat and cold, great rains and extreme droughts, withwinds from every quarter. It is natural that men should feel thisinfluence, and that the semen should differ in summer and winter,and in wet and dry weather. Hence we do not notice amongEuropeans the same similarity that is observed among the Asiatics.A difference of size is frequently noticed even in adjoining towns;the seed is modified in a variety of ways beyond what would bethe case if the seasons were uniform, or approaching thereto. It196 THE WORKS OF HIPPOCRATES.is the same as to manners. A rough unpolished state, with violentpassions, ought to prevail where changes of seasons are great.Strong impressions induce somewhat of a savage character, anddispel mildness and tranquillity. It is on this account, I apprehend,that Europeans are more courageous than Asiatics. Uniformity ofseasons induces indolence, the reverse strengthens both mind andbody. Cowardice follows in the train of indolence, courage in thatof exercise and labour. The Europeans ought therefore to be bettercalculated for war; their laws likewise co- operate, which do not,as in Asia, emanate from a king, for where kings have sway theircourage is restricted. I have before said that minds enslaved willnot naturally expose themselves to danger. Those on the contrarywho are their own lawgivers, and encounter danger for their ownadvantage and not of others, do this with pleasure, and supportlabour readily, because they partake of the benefit. It is thus thenature of the government tends to promote courage, and we see inthis respect a vast difference between Europe and Asia. I remark,in addition, that generally the European nations differ from eachother in size and form for the same reasons, and equally so do theydiffer in respect to bravery. We notice, for example, that thosewho inhabit mountainous, barren, rough, and arid countries, withvery variable seasons, are naturally tall, laborious, and brave; theircharacter is wild and savage. In valleys and meadow countries, inclose situations with warm exposure, man is neither so tall nor wellproportioned. They grow plump, and have a darker complexion,are less pituitous than bilious, and are less; but they are not deficient in strength or courage. Their nature is unequal, being modified by circumstances of laws and customs. Being deficient in largestreams to convey away the rain and water of their lakes, andusing stagnant water for drink, their complexions are inferior tothose under opposite circumstances, and their spleen is affected.Those who live in open upland situations, exposed to the winds andmoisture, are large and resemble each other; they are well proportioned and gentle in disposition. Such as reside in dry and opencountries, with great changes in the seasons, have firm and robustbodies, with complexions fairer, manners free, unbridled passions,and strongly self- opinionated; for wherever seasons are verychangeable, there we find great variety of figure, temperament,manners, and customs. The difference in the seasons may be setdown as the principal cause of difference in the nature of men;ON AIRS, WATERS, AND LOCALITIES. 197next follows the situation and nature of the soil, and the quality ofthe waters. Wherever the earth is rich, loose, and moist, thewaters high, in summer warm, and cold in winter, with equabletemperature of the seasons, you may be assured that the inhabitants are lazy, weak, and commonly mischievous, unskilled in arts,and not bright of understanding. Where, on the contrary, thecountry is open, rough, and difficult of access, oppressed by cold inwinter, and by the heats of summer, there the men are vigorous,lusty, hairy, laborious, hardy, watchful, violent, obstinate, harsh,and well adapted for war. In general every thing that grows uponthe earth partakes of its quality;-and here I terminate what I desire to say on the subject of the principal differences in the forms.and characters of men. It might be greatly extended , without falling into error, keeping in view the same principles .DE FLATIBUS,DE FLATIBUS,TRAITÉ DES VENTS,OF FLATUS.FESIUS, Treat. xiii. p. 295.HALLER, iii. p. 433.GARDEIL, ii. p. 512.HALLER considers this treatise to be spurious, and as vastly below the standard of Hippocratic genius. He admits it, nevertheless, to be admirably written and well arranged, (" boniqueordinis liber. " )—From one single principle, viz. , flatus, the authorwith much skill has deduced doctrines of great consistency, andexplains the origin of all diseases, from an error loci of this flatus.Some of the opinions of Hippocrates are advocated, but others areopposed, especially as to catarrh, as laid down in the book, " Delocis. " The origin of the Pneumatic Sect is considered as herebeing first embodied.The argument of the book is, that air penetrates and permeatesall bodies, and that through its agency the causes of most disordersis explicable. Various modes of the generation of diseases areherein pointed out.Whatever may have been the opinion of Haller as to the meritsof this treatise, it has, however, been attributed to Hippocrates byErotian, Galen, and other writers; some of whom have esteemed itas one of the most interesting in the history of medical systems,and one that will be read with much pleasure. If permitted to express an opinion respecting it, I would say, that, by whomsoeverwritten, it is one of the most ingenious and well-arranged of all thetreatises that have reached us , under the name of Hippocrates. Itcannot be his, I think, since it ascribes to a single principle, air,(flatus, wind, ) almost every disease; whilst pituita , bile, &c . , constitute a more complex set of causes in the real Hippocratic writings.Many remarks in this treatise, in connexion with those to be elsewhere found, concur in satisfying me, that, if the circulation of theblood was not, at that distant period , understood , precisely as it isOF FLATUS. 199now sustained and taught, yet, that such a function was nevertheless admitted as a well-known and general proposition in medicine;as an anatomical and physiological fact, which was fully appreciated, both pathologically and therapeutically, by the medical menof those days; and that the pulse was sedulously attended to , andperhaps more correctly than at later periods. Gardeil terminateshis translation of the treatise with a remark, that " after reading it,a person might be led to think he had been perusing some newthesis, composed and maintained by some systematic physician ofthe present day." This remark seems to me to be perfectly correct;for it is obvious that if terms have any meaning, we here find, in afew words, the doctrine of the unity of disease, as more fully laiddown and elaborated by the late Professor Rush, and even conveying, in the concise manner employed, the whole force of Dr. Rush'smore profound illustration of a doctrine he regarded as altogetherhis own, and as such, taught it in the University of Pennsylvania.As in the preceding treatise, I propose to give merely an outlineof the contents that may be looked for at large in the treatise itself.-ED.Preliminary remarks relating to the difficulties and disagreementsin medicine. The art of medicine is one of the most laborious tothe practitioner, although beneficial to the community. The influenceof opinion on it. Attempt to reduce it to one general principle.Whatever is injurious is disease, and is to be removed or cured bycontraries. Wherein medicine consists, and what constitutes thebest physician. The essence of all diseases is one and the same.ªDiseases differ merely in location, which alone causes the diversityof forms they assume. Of the triple nutriment of animal life , viz. ,food, drink, and air. Distinctive appellation of this last, accordingto its relative situation , viz. , spirit, air, flatus, wind; and of itsabsolute necessity, both as the cause of life and of disease. It isone of the principal agents of the animal economy, and of natureat large. It is essential to combustion, and to animal life, even tothat of fish; in short, there is nothing that does not feel its influence.a That is, all disease is a unit. "Morborum autem omnium cum idem modus sit ,locus tamen diversus est. Morbi igitur ob locorum varietatem et dissimilitudinem,nihil inter se habere simile videntur. " -Fœsius, p. 296; Haller, iii. p. 435. The unityof disease is here unquestionably sustained, or I am altogether mistaken as to thetenor of the entire passage, which is correctly rendered from the Greek text.-ED.200 THE WORKS OF HIPPOCRATES.It is equally the cause of disease, as of life; food and drink maybe deficient for days without injury, but death is the almost immediate result of the absence of air. It is the vehicle of miasmata;and here the author applies his principle thus laid down, to theproduction of fever, which is an accompaniment of most diseases,especially of such as are conjoined with inflammation. Fever, itis remarked, is twofold, common and particular. The first isgeneral, attacking all indiscriminately, and is therefore denominatedepidemic; the latter attacks such as are inattentive to their diet andmode of life. Remarks on each of these succeed, and an inquiryentered into, why all animals are not equally attacked. Particular fevers, originating from faults in diet, are then attended to;and we are informed that from air, or flatus, originate eructations,chilliness, and rigors; and an explanation of many symptoms isgiven, conformably to this doctrine of pneumatism, such as of theuneasiness and pains, chilliness, headache, and throbbing of thetemples, &c. , that precede or accompany fever. The same principles are applied to other diseases, as volvulus, colic , tormina,-allwhich arise from flatus; as well as catarrh in all its various formsof fluxion, viz. , ophthalmia, cough, hoarseness, hemorrhage from thebreast, dropsies, ruptures, apoplexy, epilepsy, and many more.The symptoms, causes, and cessation of epilepsy; and much stressis laid on the attention necessary in blood- letting; of its injuriousinfluence when the blood is unduly perturbed, as seen in drunkenness, insomnia, &c.; its influence in the operations of reason ispointed out, and its state of purity or otherwise is noticed; whilstthe inequality of its circulation is at times productive of every irregularity. All this is attributed to flatus, and is duly explained andillustrated. Ultimately it is added, that flatus appears, under numerous aspects or modes, to be the cause of diseases; other causesalso may co- operate, or may act an intermediate part.If I should extend these remarks to every case of disease mentioned, it would greatly enlarge, but would not more fully demonstrate the truths advanced. -Ed.OF EPILEPSY.DE MORBO SACRO,DE MORBO SACRO,TRAITÉ DE L'Epilepsie ou MALADIE SACRÉE,FESIUS, Treat. xiv. p. 301.HALLER, iii. p. 411.GARDEIL, iii. p. 5.HALLER considers this treatise as differing greatly from the geniusof Hippocrates, being chiefly speculative. The reader is fatiguedby the attempt to demonstrate that epilepsy does not originate fromthe anger of the gods, but from humidity of the brain. It might,he thinks, be regarded of a later period, because in the comparisondrawn between the human brain and that of animals, a less degreeof anatomical information is conspicuous; whilst the nature of thedisease is apparently deduced from experiments of incising thebrains of sheep and goats. A tolerable description of the veins isgiven. That system seems to be adopted, which derives diseasesfrom pituita and bile. The position is assumed, that air finds a passage to the brain. The diction is diffuse, and Asiatic . The treatise is incidentally noticed by Cœlius and other ancient authors.This is an admirable treatise, the remarks of Haller, to the contrary, notwithstanding. If, in every theory advanced, it be absolutely requisite that the premises be admitted on which sometowering superstructure is erected , we may affirm, that admittingthose of the present book, its superstructure is as admirably constructed as that of any theory of the present day, on this or anyother subject. The irony of the author is highly amusing, and hisrespect for religion is not less exemplary.Pursuing the plan of the preceding books, we give a conciseoutline of the various parts, premising that the treatise contains thedescription of the epilepsy, or morbus sacer-its name, nature, subjects, seat, causes, attack, symptoms, signs, treatment; and proposessundry problems respecting it.-ED.202 THE WORKS OF HIPPOCRATES.Epilepsy is a natural disease, and has in it nothing more sacredor divine than any other. Its name originated as much from ignorance and astonishment, as from the fictitious piety of philosophers,priests, quacks, and jugglers. Here follow some sharp and sarcastic remarks, on the accredited superstition of the times in relation to the disease. Somnambulism, the nightmare, and otheraffections, are not less astonishing than epilepsy. Ignorance clotheditself in the mantle of religion , which was chosen as a mark ofseparation from the general community, and the people were deluded by a host of knaves, who endeavoured to persuade them thatthey held communion with heaven, and were better informed thanmankind at large. Unable to prescribe usefully for this complaint,they asserted its sacred origin, and made its cure to depend onpurifications and expiations, together with the interdiction of sundrykinds of food, both animal and vegetable. The patient was clothedin black, the colour of mourning; and strict regulations were giveneven for the manner and position in sleeping. If the sick recovered,they claimed the credit, and lost none if he died. If the cure depends on such observances, the disease, says Hippocrates, cannotbe divine, nor does he imagine it was really so regarded by thesequacks themselves, who seek only to deceive, by giving out fortruth, what they had no knowledge of; and their pretended pietywas the mere mask of religion, by which the power of divinitywas made subordinate to the will of man! The deities to whomthe disease was attributed, are stated as Cybele, Neptune, Proserpine, Apollo, Mars, and Hecate; and which of these was thesource, is pointed out by certain accompanying signs,—all which,and the treatment for , are duly reprehended. Quackery seems indeed to have been equally successful in Greece, at the distant eraof Hippocrates, as at any since he flourished!The origin or rise of epilepsy is next considered, its natural explanation and its causes assigned, without referring it to heaven.Its causes are similar to those of other diseases. Hereditary attimes, it is connected with pituita rather than bile, and is dependenton a peculiar constitution of the brain. A general outline of thatorgan is presented, its vascular distribution, and its torpor at timesby the air or circulating flatus being impeded in its passage, andproducing undue pressure on a part. The doctrine of the precedingtreatise is consequently here advocated, and its influence in epilepsyis fully explained . Epilepsy, we are informed, attacks the fœtus1OF EPILEPSY. 203(in utero, both healthy and unhealthy) , if its brain be not properlyemulged, and which thus becomes choked up by pituita, by whichthe regular play of air is precluded, followed by retardation of theblood, &c . , —of all which the symptoms are enumerated and explained, and also at a posterior period of infancy; in all which theair or flatus is seen to bear a principal and energetic part. Itseffects in infancy; and why more common and fatal at that period.If they survive, the effects it leaves. Its effects in adolescence,manhood, old age, &c. , severally explained. It is said not toattack after twenty years of age, unless in such as had it in infancy.Some animals, as goats, subject to the disease. Inveterate epilepsyabsolutely incurable. An attack of epilepsy often foreseen by thepatient. Influence of certain winds in producing it. The brain isthe seat of all mental affections. The functions of that organ attimes sound, at others depraved. Some remarks on mania. External effects produced by the operation of the mind in dreams. Ofthe vast empire of the brain in man; how it is operated on by theair. The diaphragm is not the seat of sentiment or intelligencethe name is therefore inappropriate; -nor is the heart the seat.The vessels of all the body go to the heart, and have a connexionwith it so remarkable, that if any part suffers, that organ feels it.Some general remarks follow in conclusion, on the nature of epilepsy, and as showing that it has no more a divine origin , than anyother disease, but is produced by similar causes; and that in itstreatment, attention is to be paid to circumstances, without any reference to lustrations, purifications, or witchcraft. The followingexpression, towards the conclusion, may perhaps be deemed theprototype of Homœopathic views, " Et plærique ab iisdem, à quibus.oriuntur, sanantur," and is respectfully recommended to the consideration of that sect, and of Hahnemann in particular.SECTION IV.ON A HEALTHY DIET.DE SALUBRI VICTUS RATIONE,DE SALUBRI VICTUS RATIONE,FESIUS, Treat. i. p. 377.HALLER, iv. p. 81.TRAITÉ DE LA DIÈTE SALUBRE, GARDEIL, iii. p. 27.THE ancients, says Haller, united this with the treatise " DeNatura Hominis." To me, it appears more connected with thethird book of the treatise on diet, from which much is transcribedhere and there, and other matter more extensively treated of; as,for example, the reasons for dietetic vomition.The argument of the book is the pointing out the proper use offood, as instituted from the various circumstances of time, habitof body, age, affections, sex, and custom. It is divided into threechapters by Haller.CHAP. I. Of the rules of diet in respect to different seasons of theyear and age of life. Of exercise, and bathing, &c.CHAP. II. Of the measures to induce corpulency or leanness.How and when to administer vomits.CHAP. III. Of various exercises; which, when, and for what reasons, best.Gardeil considers the next treatise on regimen as a continuationof the present, although it is probable they are the production oftwo different authors. He divides this under fourteen paragraphs.SEC. I. to IV. Of the diet or regimen for winter, spring, summer,and autumn.SEC. V. Of diet in respect to age and temperament.SEC. VI. General principles respecting diet.ON A HEALTHY DIET. 205SEC. VII. On the use of emetics, glysters, &c.; when to be employed.SEC. VIII. , IX. General principles of regimen for children; forwomen.SEC. X. Of gymnastic exercises, and of a fit regimen therefor.SEC. XI. , XII., XIII. Regimen required in some particular cases.SEC. XIV. General maxim concerning dietetics.ON REGIMEN.IN THREE BOOKS.BOOK I.DE VICTUS RATIONE,DE SANORUM VICTUS RATIONE,TRAITÉ DU RÉGIME,FESIUS, Treat. ii. p. 340.HALLER, iv. p. 1 .GARDEIL, iii . p. 34.HALLER says, that Galen and Mercurialis considered this treatise as unworthy of Hippocrates. It is, adds he, certainly of greatantiquity, for it contains the precepts of Heraclitus. It is wonderfully concise, obscure, and so far Hippocratic. All things aremade to consist of fire and water, and these are deemed adequatefor every purpose. The first giving motion, the latter nourishment;the life or soul (anima) is even produced bythem. Eight temperaments are produced by the varied proportions and powers of each;and the difference of disposition is ascribed to the different temperies of these elements, to each of which appropriate remedialplans are adopted. Thus in the choleric, cold and humid nourishment and baths are prescribed. No mention is made of bleeding.A theory of temperaments is presented, very different from thatgiven in the treatise " De Carnibus. ” A twofold semen is here advocated, as in the tract " De Genitura, " and the dispositions are attributed to the predominance of the one or the other. The uterusis stated as being double. Exercise and emetics are important aidsin practice. Between this and the third book there is not much.difference.In the subsequent portions much obscurity exists, which the greatsagacity of Gesner has elucidated in the germs of animals andplants; which, if unputrefied, alternately become apparent, vegetate,and grow, and then return to an inconspicuous state. Much is interspersed, the sense and scope of which are not very readily perceived.• " Idem mire brevis, obscurus, et hactenus Hippocraticus. "ON REGIMEN. 207The argument of this first book is, that it points out the pre-requisites for instituting a healthy regimen; treats of the constituents ofthe animal body; of the connexion of art and nature; the union ofthe sexes in establishing the strength, increase, and nutrition of thebody; of the temperaments as influenced by sex and age; and ofvarious affections of the mind.-ED.CHAP. I. The proëmium of the whole, as founded on attention, docility, and kindness. What previous information is necessary to thedietetic physician. Of the power or property of food and drink.CHAP. II. Propositions as to diet , both general and particular.As to the knowledge of the powers of food, drink, labour, theheavens, and climates, &c. in its employment.CHAP. III. Continued; discusses the principles of nature; assertsthem to be two, viz. , fire and water, which are endowed with fourqualities, viz. , hot, and dry, and cold, and moist, &c.CHAP. IV. Of the resulting compounds of the principles; nothingperishes; but, by their modification, alteration, increase and decrease ensue.CHAP. V. Further progress in the view of natural objects; andits basis laid down; treats generally of life and death, and of adivine necessity in the various changes.CHAP. VI. Of the origin, growth, and food of man; and of thewonderful harmony in the intermixture produced, &c.CHAP. VII. Of the origin and increase ofthe fœtus; demonstratedand explained.CHAP. VIII. A comparison of some of the actions and affectionsof human beings, whether derived from nature or art; confirmingand illustrating the doctrine of birth and of growth.CHAP. IX. The preceding theory of the general origin and growthof man, illustrated and confirmed by induction.CHAP. X. The difference of origin and of growth in the male andfemale, pointed out.CHAP. XI. The difference shown further, in the diversity of numbers of fœtuses, twins, sex, &c.CHAP. XII. Further shown in the different constitutions of thehuman body, and the different diet necessary for different periodsof life.208 THE WORKS OF HIPPOCRATES.CHAP. XIII. The same further demonstrated in the powers of themind; its difference in strength, intellectual and sensitive.CHAP. XIV. The subject continued; the passions, & c.-HALLER.This treatise, says Gardeil, " consists of three books, in whichwe find prescribed , that mode of living which is best calculated toavoid disease. Although not unanimously regarded as the work ofHippocrates, and although Haller has removed it from that class, itappears to me in many respects worthy of the Father of Medicine,and I believe it is really his work. This opinion will perhaps bethought to be well-founded, by attending to what is said at No.iii. of this book, and No. viii. of the third book. We are occasionally dissatisfied by finding the author strangely deviatingfrom his subject in the first book, and in a large part of the second.At the same time we are gratified extremely, after perusing thethird. And we find, if I am not mistaken, that the subject of regimen is admirably treated in all the books united. "SEC. I. Preamble, in regard to preceding writers on regimen;praise and blame awarded; the writer's own views on the subject.SEC. II. Of the preliminary information essential to the writer onregimen; the subject of gymnastics and astronomy touched upon.SEC. III. Further necessary considerations on the subject.SEC. IV. Of the nature of man, as constituted of two oppositeprinciples, viz. , water and fire; neither of which predominate absolutely, but differ only as to the greater or less amount.SEC. V. The preceding principle applicable to all things, animalor others; none of which are ever entirely destroyed; nothing newis created, nor is any thing lost; life and death are merely mixturesand separations.SEC. VI. Death, diminution, and separation are synonymous; allare under the operation of laws provided by nature; and the control of a divine necessity, involving the doctrine of a metempsychosis, or change of matter as to form, &c. The animal soul isunder the same influence; that of man is a mixture of fire andwater, constituting a part of himself; sundry speculations and analogies on this subject.ON REGIMEN. 209SEC. VII. Of what takes place in the early period of fœtation;the motions induced are owing to fire; in what manner bones, ligaments, vessels, &c. , are produced; of the mixture of the male andfemale seed; three great hollow vessels, the vena cava, vena porta,and aorta, with their ramifications, & c .SEC. VIII. Medicine is but an imitation of nature, as are likewiseall other arts. (Here follows a long and curious digression, respecting the greater part of the arts cultivated by man, in order to demonstrate that all are reducible to the principle of plus and minus,and continued in sections ix. , x . , xi. , &c . , to xxii. , embracing divination, workers in iron, medical gymnastics, fulling, shoemaking,carpentry, architecture, cookery, tanning, sculpture, music, goldsmiths, potters, writing, public schools, merchants, and actors. )SEC. XXIII. The author returns to the formation of man, (inwhose nature all the arts participate,) in being a mixture of fire andwater. The soul is expanded throughout whilst life exists, andaugments with the growth of the body. Organization of the fœtus;perfect in some at forty-three days, in others in three months;the former are born at seven, the latter at nine months, bringingwith them the temperament which continues through life.SEC. XXIV. Of the formation of males and females. Twins.Superfœtation. The subject continued to sec. xxviii.SEC. XXVIII. Oftemperaments. What constitutes them. General views on regimen. The first species of temperament. The2d, 3d, 4th, 5th, and 6th species, extending to sec. xxxiii.SEC. XXXIV. Of the phenomena proper to the temperaments;derived from-first, the age, second , sex.SEC. XXXV. Of different constitutions in regard to the soul;with views as to the regimen best adapted as the medicina mentis.Continued to the end, and embracing the diseases to which the mindis subjected.14DE VICTUS RATIONE,DE SANORUM RATIONE,TRAITÉ DU RÉGIME,ON REGIMEN.BOOK II.FESIUS, Treat. ii. p. 353.HALLER, iv. p. 31.GARDEIL, iii. p. 68.THIS book, says Haller, is not unworthy of the Hippocraticname by its good construction; in which those things, called nonnaturals by the schools, are considered , together with their powersin relation to the human body. The author derives those powersfrom simple qualities, viz. , sweet, acrid, watery, fat; from whicharise those called attenuants, calefaciants, refrigerants, purgatives,siccatives, astringents, emollients. At the commencement he treatsof airs, waters, and situations, pretty much as Hipprocrates does,in his treatise under that title. He discourses largely of the foodemployed in Greece, the various kinds of bread and grain; then ofanimal food, amongst which we find that of dogs and horses.Next he mentions birds, and numerous fish which is there largelyemployed. To these succeed the drinks, pot- herbs, legumes, vegetables, apples, &c . , which are nearly all in use at present. Of culinary preparations, and their respective value; and he terminateswith gymnastics, funerals, races, baths. He adverts to the properemployment of food in removing the lassitude of unaccustomed orover-fatigue. Extols the use of vomits, and, as in the formerbook, he teaches that all things are constituted of fire and water.The consideration of diet follows the relation of the principlesand differences of the human body, whereby it is preserved in thesame condition, or changed and modified by their quality andquantity. Hence it treats of the nature and situation of the windsand climates; of the faculties and difference of food , derived fromanimals and vegetables; of baths and external operations; and ofdifferent kinds of exercise.ON REGIMEN. 211CHAP. I. Of the location and temperature of places.CHAP. II. Of the air, and of the nature and properties of thewinds, as to heat, cold, moisture, & c.CHAP. III. Of food-in general, in special-cerealia-bread,variety of, and properties.CHAP. IV. Of leguminous vegetables; of flesh and its juices.CHAP. V. Of animal food; quadrupeds, birds, fish.CHAP. VI. Of drinks-water, wine, vinegar, new wine, thinwine.CHAPS. VII. , VIII. Of plants-potherbs. Fruits, various- mulberry, pear, apple, &c.CHAP. IX. Of certain kinds of flesh-preservation of, effects of,age of, and preparation, &c .CHAP. X. Of baths-anointing, sweat, venery, vomition, sleep,labour, rest, eating, and, in fine, of all such things that in anyway are admitted to the body.CHAP. XI. Of exercise, both general and particular.CHAP. XII. Of some inconveniences from exercise, and fromover-fatigue, &c.Gardeil has no prefatory remarks; his paragraphs are to thiseffect:SEC. I. to XI. General remarks relating to the soil and habitations,the winds, of food and drinks, viz. , the cerealia and their preparations, wheat, rye, barley, &c. Some observations on fresh meal,hot bread, &c.SEC. XII. Legumes, and other vegetables, their juices, &c. , tosec. xxvi.SEC. XXVI. to XXXV. Animal food-beef, pork, &c.; dog,horse, fox, &c.SEC. XXXV. , XXXVI. Of birds-they are drier in quality thanquadrupeds, owing to their having no bladder, nor urine, nor saliva ,and why.*SEC. XXXVII. to XLVI. Fish-sea, river, lake, &c.; shell- fish ,dried, salted, &c.SEC. XLVI. to XLIX. General remarks on the difference ofApparently these deficiencies should render them moister; however, Hippocratesfinds no difficulty in explaining this.—ED.212 THE WORKS OF HIPPOCRATES.animals as to nourishment, owing to their modes of life, their peculiar qualities , the parts used for food, &c.SEC. XLIX. to LVII. Drinks-wines, new, old, sweet, white,&c.; vinegar, &c.; honey, &c.SEC. LVII. to XCI. Of vegetables-pot- herbs, garden plants,wild, and cultivated, & c.SEC. XCI. to CIX. Of fruits-summer and autumnal, pulpyfruits, &c.SEC. CIX. to CXVII. Influence of food variously prepared;general remarks on the effects of sweet, acid, acrid, and otherarticles, and of condiments.SEC. CXVII. to CXXI. Of baths-fresh, saline, hot, cold, &c.Exercise-venery. Emetics, &c.; and of their utility in constipation, and also in the opposite state.SEC. CXXI. , CXXII. Of sleep and waking. Inactivity and repose.SEC. CXXIII. , CXXIV. Influence of a single meal daily. Drinks,cold or warm, &c.SEC. CXXV to CXLV. Exercise; gymnastics. Exercise, naturaland ill-timed. Of the exercise of sight, hearing, thought, and voice,in talking, reading, &c. Walking at different periods; before orafter eating, &c. Running, riding, racing, leaping, wrestling, frictions, &c. Playing at ball, holding the breath, &c.SEC. CXLV. On the use of frictions, with sand, oil, &c. , beforeand after gymnastics.SEC. CXLVI. Fatigue, from want of exercise; from unaccustomed or excessive exercise. Its effects explained as arising therefrom-including remarks indicating ideas of a circulation, &c. ,to end.ON REGIMEN.BOOK III.DE VICTUS RATIONE,DE SANORUM VICTUS RATIONE,TRAITÉ DU RÉGIME,FESIUS, Treat. ii . p. 366.HALLER, iv. p. 60.GARDEIL, iii. p. 104.THIS book, says Haller, has nothing in common with the twopreceding, nor is it from Hippocrates. Clerke supposes it the workof Herodicus the Gymnast. It treats of the commencement of diseases, from too much or too little exercise in early life, and oftheir appropriate remedies. This chiefly depends on regimen, abstinence, vomition, and a due regulation of exercise. A weakstomach is benefited by vomiting, excited by the flesh of whelps.*In every respect the ratio medendi differs from ours. The appropriate change of diet for the different seasons is pointed out. Theconstant exercise of the Greeks, both in summer and winter, isremarkable. No mention is made of their use of fire. Cold bathing recommended.Argument. The author considers himself as first properly instituting the method of dietetics. The difficulty of this attemptadverted to. Of the appropriate regimen both of rich and poor atdifferent seasons of the year. Of the symptoms and cure of repletion and of lassitude. Of diarrhoea , crudities, bad complexion,eructations, stercoraceous vomiting, and other affections.CHAP. I. The consideration of human diet proposed. Diversityoffood.CHAP. II. A healthy regimen pointed out generally for everyseason ofthe year.CHAP. III. How to discover the errors of diet in health froma Catulorum carnibus.214 THE WORKS OF HIPPOCRATES.various kinds of repletion. Of the symptoms and cure of the firstspecies of repletion.CHAP. IV. Signs of the second, third, and fourth species of repletion.CHAP. V. Signs of the fifth, sixth, and seventh species.CHAP. VI. Signs of the eighth, ninth, and tenth species.CHAP. VII. Signs of the eleventh, twelfth, and thirteenth species.CHAP. VIII. Of the signs and cure of two species of inanition.Gardeil has no preliminary remarks. He divides it intotwentythree paragraphs, which are headed to the following effect.SEC. I. Some previous and general observations on the impossibility of prescribing generally the exercise and diet fitted forall men.SEC. II. General rules of regimen for labouring people in thefour different seasons of the year. Emetics thrice a month; when.SEC. VIII. Ofthe regimen for people in easy circumstances. Heexults in having first discovered the rules for this, and having thuslaid down a body of doctrine.SEC. IX. Observations pointing out whereon the peculiar regimenfor each individual ought to be established; 1st. On account ofrepletion, in a state of health; symptoms indicating such a state.2d. Excess of exercise; the means of obviating, &c.SEC. XI. to XIV. 3d. Of repletion, threatening peripneumony,and how to obviate. 4th. Of repletion, the symptoms of whichaffect the head chiefly. 5th. Of that which principally determinesto the primæ viæ. 6th. Of that arising from a coldness of the stomach, causing crudities.SEC. XV. Of that induced by excess of exercise, manifestingitself by its influence on digestion, as indicated by acid vomitings,&c., heat of stomach, &c.SEC. XVII. Of that repletion which manifests itself in lientery.Another with crude and hardened stools; and again with putridstools, following great fatigue; and another accompanied with dryand burnt-up stools, with vomiting. These are all described as totheir respective symptoms, and the means of cure pointed out.SEC. XXII. Of excess in walking; its symptoms and effects; andin gymnastic exercises; the symptoms, cure, &c.ON DREAMS.DE INSOMNIIS ,DE INSOMNIIS,TRAITÉ DES SONGES,· FESIUS, Treat. iii. p. 375.HALLER, iv. p. 89.GARDEIL, iii. p. 129.•HALLER, in his preface to this treatise, says, one would supposethis to be written by the author of the third book on diet. Such,he adds, is the opinion of Fœsius. Similar precepts are here delivered as to the increase or diminution of food, of exercise, and ofmedicine. It is in other respects an elegant and connected work,wherein dreams are referred to their physical causes, heat, cold,secretions, repletions. Indications are derived from dreams ofthose measures by which those diseases may be relieved whichgive origin to the dreams. Although occasionally recommendingpropitiations to the deity, it is obvious he regarded it as of littleimportance. In this book we find a manifest expression of theincreased and diminished circulation.Subject-matter.- Dreams are here explained, from which, ineight chapters, may be obtained some certain signs of good or illhealth; and some things which the mind imagines in the state ofsleep.CHAP. I. Prefatory remarks of the importance and utility of indications from dreams. Ofthe soul in wakefulness and sleep. Sleepis either natural or preternatural.CHAP. II. Of dreams depending on daily occurrences, of a healthyor morbid character; curative measures.CHAP. III. Of dreams connected with the heavenly bodies, significative of health or disease; and of the cure of disturbed repose.CHAP. IV. Variations of the heavens and its luminaries indreams, indicative of different affections; and variety in the methodus medendi.CHAP. V. Of dreams connected with corporeal and civil func-216 THE WORKS OF HIPPOCRATES.tions; and of those relating to the earth; trees, rivers, fountains,and seas.CHAP. VI. Of dreams relating to earthquakes, inundations, darkness, fires, swimming, &c.CHAP. VII. Of dreams of various forms of bodies, or their parts,and of the dead, clothing, & c.CHAP. VIII. Of dreams from eating, drinking, seeing, fighting,crossing rivers; enemies and monsters.It is plain, says Gardeil, from the termination of this treatise, thatit is a continuation of the third book on regimen. Yet it is so fullof superstition, that we are not disposed to regard it as a production of the same writer to whom we are indebted for the excellenttreatises that precede it; without, at least, rejecting a number ofthings that appear as unfortunate attendants on the weakness inseparable from the nature of the human mind, and of the age inwhich Hippocrates lived.SEC. I. Preliminary remarks on dreams.SEC. II. Inductions to be derived from natural dreams, fromwhich to attain a knowledge of the good or bad state of the body.SEC. III . to XII. Of dreams of the heavenly bodies. 1. Whenserene, or troubled . 2. When changes of the moon are observed.3. Or in the sun. 4. When they represent the firmament in a stateof drought. 5. Or fires in the heavens. 6. Or falling stars. 7.Or dews and vapours. 8. Or when good gifts appear to be sentfrom heaven. 9. Or when the dreams are of rains and storms.SEC. XII. Of prayers to the deity under these circumstances toavert misfortunes.SEC. XIII. Considerations from dreams relating to different statesof the earth and of travelling, trees, rivers, &c. , indicating the stateof the blood, &c. , and of the regimen and prayers required undersuch circumstances.SEC. XIV. Indications from dreams relative to the particularconstitution of the body; and such as represent strange objects,the dead, monsters, &c.SEC. XV. Of dreams of eating, drinking, &c.SEC. XVI. Of dreams of massacres, battles, sieges, &c. Theauthor terminates by assuring good health to all who will attendto his advice; and says, he thinks, by the aid of the gods, he hasdiscovered dietetic rules, as good as it is possible for any one to give.OF ALIMENT.DE ALIMENTO,DE ALIMENTO,TRAITÉ DE L'ALIMENT,FESIUS, Treat, iv. p. 380. HALLER, i. p. 102.GARDEIL, i. p. 169.THIS book, says Haller, contains much of the brevity and antithesis of the treatise " De Humoribus. " It imitates the Hippocraticbrevity. Mercurialis considers it as a genuine production of thedivine old man, although he places it in his second class. Galendeems it genuine, and wrote four commentaries to illustrate it , andfrequently quotes passages from it as such. Others have equallydeemed it genuine. In this is to be found a passage, which, by toofree an interpretation, has been applied to the circulation of theblood. The clearest parts are those that refer to the perspiration,and its importance to health. Here also we find the liver regardedas the root or source of the veins, and the heart of the arteries, bywhich the blood and spirit flow to every part, -from which wemight imagine the work not to be more ancient than Erasistratus,since it contains his views. It treats of the time in which the fœtus .is formed, and gives a short and incorrect osteology. Advertsagain to the pulsation of the vessels, and of the spirit which is itsaliment. It contains nothing of a dietetic character.-Subject. Of food, its varieties and powers; to what parts conveyed; which most easily, or with greater difficulty, changed;what are the principles of which it is formed; which are, and arenot, nutritive.- ED.CHAP. I. Of the varieties and forms of food . Effect and influence of. Of the variety of juices, hurtful, or innoxious. Of thedifference of diseases, and their signs;-remarks, &c., cognizantof a circulation here, and in the next chapter.CHAP. II. Of perspiration and its importance;-aliment, —various,-not equally fitted in all cases,-differing in different periods oflife. Foetal formation, & c.218 THE WORKS OF HIPPOCRATES.CHAP. III. Of the nutrition of bones-length of time in healingwhen fractured, &c. Of the change of food and its conversion intodifferent parts."This treatise," says Gardeil, " would be more correctly entitled'On Nutrition'-both from its Greek derivation, and from the subjects it treats of. It ought rather to rank in Fœsius' third section,since it is more of a physiological than of a dietetic character. Itis pretty abstract, and somewhat tiresome, not only in my owntranslation, but in the original, and other translations, arising eitherfrom the generality of ideas, or from the extreme brevity in whicha number of objects are presented at the same time, in order tosubject them to one single principle, which in the present period isdenominated the vital principle. Several of its parts appear to besusceptible of different construction or explanation by differentreaders. Galen wrote four commentaries on this treatise, a considerable portion of which has reached us; but I have not derivedmuch benefit from them."SEC. I. Aliment; what is to be understood by it; general principles on.SEC. II. Physiological principles as to nutrition.SEC. III. Of the natural excretions, and of unnatural growth,&c. , of parts.SEC. IV. Continuation of the principles respecting aliment.SEC. V. Numerous sources of derangement which induce symptoms that accompany different diseases.SEC. VI. Every thing is but relative in the animal economynothing absolute.SEC. VII. Of the various channels for aliment-immense varietyobserved, as well relatively to good and evil, as to many other circumstances amongst others, the variation as to the period ofpregnancy.SEC. VIII. Of the variation as to the period of the callus produced after the fracture of different bones;-other differences andtheir causes.SEC. VIII. (bis.) Of the benefit of liquids in alimentation- andalso of motion.SEC. IX. Of pus, and of the marrow.THE RATIONALE OF FOOD IN ACUTE DISEASES.DE RATIONE VICTUS IN MORBIS ACUTIS,DE VICTUS RATIONE IN MORBIS ACUTIS,TRAITÉ DU RÉGIME DANS LES MALADIES AIGUES,FESIUS, Treat. v. p. 383.HALLER, i . p. 228.GARDEIL, i. p. 178.ALTHOUGH Fœsius constitutes but a single book alone of thistreatise, Haller (why, is not adequately explained) has divided itinto four, the heads of which are here successively given, together with the preface and argument of each.BOOK I.Preface. The first three parts of this work seem to be genuine;the fourth, although very ancient, even anterior to Erasistratus,appears to Galen to be spurious. In the first book, Hippocrateswrites upon his Ptisan, in opposition to the Gnidians, who had entirely neglected the rules of diet. He next attacks the physiciansof his own period, who, in the commencement of an acute disease,exhausted the patient by starvation, but allowed food at a periodmore advanced. In opposition to which, he contends, that in thebeginning of acute diseases, the diet should be of the lightest kind,such as mulsa, or barley water; and that the physician mightgradually advance to more substantial food, as ptisan, &c.CHAP. I. The ancients wrote nothing worthy of record on thesubject of diet, so far as we can judge from the Gnidian sentences.The physician is best appreciated in acute diseases. Great discrepancy of opinion among them in these.⚫ Hydromel-sive potus ex aqua et melle fermentando paratus. -Blanchard Med.Lex.A decoction of pearl barley, with mashed raisins, liquorice, &c.220 THE WORKS OF HIPPOCRATES.CHAP. II. The ptisan is preferable in acute diseases. It shouldbe prepared from the best barley, and thoroughly boiled. It shouldbe very slippery (lubricissima)-and is an excellent corrector ofthirst. It is sometimes useful, at times injurious. What the ancients meant by siderati. Of the proper or improper time of givingslops, or broths (sorbitiones).BOOK II.Preface. In this book is contained Hippocrates' treatment ofpleurisy, by venesection, fomentations, mulsa, oxymel; -in lowseated pain of the side , he prescribes venesection.Subject. In case of pleurisy, the treatment is stated, as consisting of fomentations, venesection, glysters, purging, and other evacuations. It then treats of barley water, ptisan, maza, and bread;of water, wine, aqua mulsa-vinegar and mulsa; finally, an ampledetail is afforded of the varied and frequent changes of appropriatemeasures in five chapters.CHAP. I. Of attempts to be made for removing the pain of pleurisy, by means of warm fomentations, or venesection, or looseningthe bowels by black hellebore, peplium , or such like articles, and ofthe proper occasion of using them.CHAP. II. Accustomed food and drinks to be preferred; a suddenchange of diet is injurious in health, but not in disease.CHAP. III. Hints as to the safe prescribing of diet to the sick. Inthe commencement of disease, the patient should be fed with slopsand barley water; and during its violence the lightest possible dietmust be employed.CHAP. IV. Symptoms of depraved diet, and indicating a fatalissue, &c. Of rest and exercise under like circumstances, &c. Ofwhat concerns the bowels.CHAP. V. A change from spare to copious diet, or from continual rest to excessive labour, is very injurious: it is useful to beaware of this. Of the use of barley water; and of the symptomsof watchfulness and of somnolency.a Aspecies ofspurge.THE RATIONALE OF FOOD IN ACUTE DISEASES. 221BOOK III.Preface. Here Hippocrates states the efficacy of drinks in acutediseases. Of water alone he speaks unfavourably; of mulsa; ofoxymel; of wine, in the use of which he is liberal. Of baths, inwhat cases most useful.CHAP. I. Of wines, and their effects.CHAP. II. Of aqua mulsa (hydromel), when useful or the reverse.CHAP. III. Of oxymel ( acetum mulsum) , when useful or otherwise.CHAP. IV. Water alone of little benefit in acute diseases, andwhy so?CHAP. V. Bathing, not proper for all persons, nor at all times.BOOK IV.Preface. To me, says Haller, this book appears undoubtedlyspurious, both from its numerous prescriptions, and various remedies not mentioned in the legitimate writings of Hippocrates. Comments are interspersed on subjects totally different from his. Prettygood histories are given of various diseases, as pleurisy, angina,cholera, dropsy, for which last are recommended cantharides andother acrids. Then follow dietetic precepts respecting flesh andvegetables, aphorisms on condiments, and conclusions of too generala character, deduced from individual events: vomits are ordereddietetically three or four times a month, as in the books on diet.Some chirurgical observations also are given.Subjects treated of.-Treats of many acute and other diseases.Of causos, angina, aphonia, inflamed præcordia, catarrh, ulceratedtrachea, [arteriæ ulceratione, ] heat of the lungs, different fevers,pleurisy, peripneumony, dysentery, jaundice, tetanus, dropsy, hemorrhoids; abscesses; their symptoms; pains of the side, eyes, loins,and other parts; of all which the diagnostics, prognostics, andtherapeutics are given.Gardeil has but few remarks on this treatise; he includes thefour books, as given by Haller, in one, as Fœsius does. He merely222 THE WORKS OF HIPPOCRATES.remarks that this is the fifth treatise in the fourth section of Fasius,and that we find in it the same attention in observation, and thesame excellence of judgment, which have rendered Hippocratesso admirable in all that has reached us of his writings in more than2000 years.The headings to 64 paragraphs are to the following effect:SEC. I. The insufficiency of the doctrines contained in the GnidianSentences.SEC. II. Justice rendered to physicians as to certain remedies insundry diseases; observations as to their bad classification.SEC. III. Of the objects of medicine, and difference in their usefrom the judgment of practitioners.SEC. IV. Regimen, its previous and complete neglect. The appropriate use of the ptisan as nourishment is of the greatest importance.SEC. V. , VI. Chief regulations for the administration of ptisan.SEC. VII. The ptisan, how to be made, and its effects accordingas it is employed. The inconvenience of insufficient nourishment,or of one too strong, after great abstinence.SEC. VIII. General rule respecting the administration of theptisan, and as regards regimen.SEC. IX. Rule as to the proper time of giving food.SEC. X. Utility of different fomentations; of blood - letting andpurging in a stitch of the side , as it may differ in situation; and ofthe subsequent administration of the purée. *SEC. XI. The question examined, if it is best to keep the patientat the beginning on a strict abstinence, or to use the ptisan.SEC. XII. Bad effects of eating more than usual; how to remedythis. The reverse of this considered, and its remedy. Greatchanges hurtful.SEC. XIII. XIV. Some general remarks on regimen, on differentkinds of bread, &c. , and on the different species of wine. Exceptions.SEC. XV. General rule-It is better to err at the commencement, by defect rather than by excess. Faults from excess aremore readily repaired than those from defect. Cases stated, inwhich an almost absolute abstinence may be pursued.SEC. XV. (bis. ) Diversity of cases from which death may ensue.

• Porridge, Fr. Dict.

THE RATIONALE OF FOOD IN ACUTE DISEASES. 223SEC. XVI. All sudden changes are injurious.SEC. XVII. Application of what has preceded, to nutrition.SEC. XVIII. Brief conclusion concerning the changes of nourishment in acute diseases.SEC. XIX. to XXIII. Examination as to drinks. Different kindsof wine.SEC. XXIII. Of hydromel. It is more nourishing and morestrengthening than the small white wines, and should be givenbefore, and not after the purée.SEC. XXIV. Of oxymel-its variety, crude and prepared. It isan excellent drink in acute diseases, as well as hydromel, but ismore purgative.SEC. XXVI. Of water. The author no friend to it in acute diseases.SEC. XXVII. Of medicinal ptisans.SEC. XXVIII. Of baths; remarks on their employment; hurtfulor beneficial according as they are employed. In whom useful,&c. In whom hurtful.SEC. XXIX. Of different species of diseases. Ardent fever andits cure, &c. Rules for bleeding in acute diseases.SEC. XXX. Of orthopnoea, (probably what we call dry asthma.)The inconveniences of purgatives given at its commencement, andgenerally in the beginning of every inflammatory state. Importantrule in their administration.SEC. XXXI. This paragraph seems to relate to apoplexy, and itstreatment.SEC. XXXII. Of quinsy-its course, symptoms, and cure. [Qu.croup?]SEC. XXXIII. Fevers from intestinal plenitude, called improperlyin our days, putrid.SEC. XXXIV. Ardent fever with inanition; not to purge beforethe fourth day; its treatment. Coldness of the extremities in the increase explained.SEC. XXXV. Of diarrhoea and some other dangerous symptomsin ardent fevers.SEC. XXXVI. Of fevers in general, & c.SEC. XXXVII. Of the fever called asodes.SEC. XXXIX. Of fever with hiccup. Probably a symptomonly, not a particular species.SEC. XL. Of pleurisy and peripneumony, and their modes of cure.224 THE WORKS OF HIPPOCRATES.SEC. XLI. Of dysentery.SEC. XLII. Of bilious fever and bilious colic. General rule asto the termination of diseases.SEC. XLIII. Rules for administering hellebore.SEC. XLIV. Distinction between symptoms arising from fatigueand other causes.SEC. XLV. Inconvenience of aqueous drinks; and those too strong.SEC. XLVI. Conduct necessary when one repast only is made,if accustomed to two.SEC. XLVII. , &c. Effects of garlic, of cheese, of legumes, ofbeef, goats' flesh, pork.SEC. LII. How to treat cases of fulness of the bowels, but notof the stomach.SEC. LIII. Two kinds of dropsy, aqueous and flatulent.SEC. LIV. Of discharges from the bowels, with great heat andirritation.SEC. LV. General remarks for all diseases.SEC. LVI. to end. Some recipes and treatment of sundry diseases.About fifteen or twenty lines in Fosius and Haller are hereomitted, as consisting of a number of recipes, and which Gardeilcould not make out.ON THE DIFFERENT PARTS OF MAN.DE LOCIS IN HOMINE,DE LOCIS IN HOMINE,TRAITÉ DES LIEUX DANS L'HOMME,FESIUS, Treat. vi . p. 407.HALLER, i . 51.GARDEIL, i. p. 241.THIS is one of those books admitted generally to be genuine, butnot perfected by Hippocrates: so that Haller concludes the analysisof it, in his preface, by saying, —It may be the work of Hippocrates, for the methodus medendi differs not from that of hisgenuine writings. Many choice things are, however, mixed upwith foreign matters difficult of explanation.There is, adds he, in this book a mixture of argument, somewhatof anatomy, as of the membranes of the eye and brain, of thenares, a part of the angiology of the head, of the temporal arteries;which he denies to carry blood, yet in the same place admits oftwo opposing streams of blood. Here we find an account, (altogether different from that given in the treatise, De ossium natura) ,of those vessels from the tendons of the neck which go to thetestes, also of others, and of the vena cava; of those going to themalleoli, which , if divided, cause impotency; of the vein of thearm, which is incised for affections of the spleen; and notice istaken of the anastomosis of the vessels. Something is said of thenerves, with which he appears to confound the tendons. Something, also, as to a history of the bones, the sutures , and a completeskeleton. The author seems acquainted with the articular synovia.He admits of fibres from the stomach to the bladder; of metastasisof humours from one part to another, and the channels of suchconveyance; of diseases arising from fluxion, and their remedies;of diseases of the eyes, wherein no remedy is to be employedimmediately to them, but an incision to the bone is recommendedon the head, and the pulsating veins [qu.? temporal arteries] between the ear and the temples, are to be cauterized. He thenpasses to the consideration of different species of bile, to which heimputes diseases of the breast, which he cauterizes, when suppu15226 THE WORKS OF HIPPOCRATES.rated. His cure for pleurisy, of mulsum and vinegar (hydromel) .In dropsy he cauterizes the neck in three places, and in sciaticaemploys cups. He uses fire also in enlarged spleen. The booknext considers the cause of fever, as originating in a stagnatinghumour falling on a weakened part, and of the cure by mulsumand posca (oxycrat) . Also of refrigerants, as cucumbers, infever; of jaundice, and the use of elaterium in it as a purgative;after which he gave wine. In true angina, he bled and purged.He then proceeds to fractures of the head. Diarrhoea removed byvomiting. His prudent counsel to abstain from violent remedies inunknown diseases. He gave mandragore in melancholy and convulsions. Of cauterizing the veins in disease, and which. Of thedifficulties and opposite indications in medicine, which cannot bereduced strictly to a certain art. Something is said on the classesof medicine. He recommends the physician never to be cast downby fortune. -ED.Subject ofthe treatise in general. -Something is here stated as toparts of the human body, generally. Of the external senses. Ofthe veins, nerves, sutures, joints, and other parts. Of fluxions,fevers, ulcers, and other diseases; together with the appropriate useof several remedies.SEC. I. - CHAP. I. The human body is a circle, of which each partmay be esteemed as both the beginning and the end. Bodies areobnoxious to disease, in proportion to their aridity. A primaryaffection of any part, induces sympathetic and secondary diseases.A stoppage of humours is a cause of fluxion and of disease. Theprinciple of cure is deducible from the primary disease. Of theknowledge of parts, their sympathy and communication. Bytheaffection of one part, the whole body may become affected.CHAP. II. Of hearing, smell, and sight; their organs and vessels.Of the three membranes of the eye, and the two of the brain. Ofthe distribution of veins from the brain, and their inter-communication. Of the distribution of the vena cava. Of the causes ofimpotence, loss, and disturbance of vision; and of bloody urine.CHAP. III. Of the nature of the nerves, their nutrition, substance,situation, colour, strength, and diseases. Of several sutures of thehead. Of the bones of the whole, and of parts, of the body. Oftheir articulations; and of the diseases, pains, mucus, and lamenessof the joints.ON THE DIFFERENT PARTS OF MAN. 227CHAP. IV. The stomach a receptacle for food and drinks; thebladder for serous fluids. Fluxions are caused by cold applied to,and contracting the body; by heat, rarefying the flesh, and attenuating the fluids; by repletion which obstructs, and evacuation whichenlarges the passages. The inferior parts are drier than the upper,owing to their less vascularity.CHAP. V. Seven different fluxions from the head. Three of themconspicuous from the ears, nose, and eyes. Four are latent; in thebreast, producing bile, lassitude, empyema, tabes; in the spinalmarrow, productive of dorsal phthisis; in the vertebræ and muscles, inducing dropsy; in the joints, causing gout, sciatica, andœdema.CHAP. VI. Of the cure of those fluxions, as manifested in coryza.Otalgia and fistula of the ears. Ophthalmia, prurigo palpebrarum ,epiphora, and albugo, &c. , cure by chirurgical means, as incisionand cautery; or pharmaceutic, by topics and cathartics.CHAP. VII. Of a bilious fluxion from the head upon the thorax,inducing peripneumony, pleurisy, suppuration, tabes, and cough;also inducing, when flowing on the spine, icterus, and tabes dorsalis.Of the rise, causes, signs, both diagnostic and prognostic, of thesame.SEC. II . CHAP. VIII . Of the cure of pleurisy, peripneumonia,empyema, consumption; and of an eighth fluxion ofthe fauces, falling on the belly.CHAP. IX. Ofthe cure of dropsy, sciatica, and tabes from fluxionfrom the head to the hinder parts; and of the enlarged spleen anddropsy of boys.CHAP. X. Of a dry pleurisy, unaccompanied by catarrh, and ofits cure. Ofthe origin and cure of fever.CHAP. XI. Of the cure of icterus, malignant ulcers, and angina.CHAP. XII. Of fractures and fissures of the skull, and their cureby the saw or terebra. Of fatal purgations, wounds and ulcers.Of the cure of a person labouring under purgation. Eruption ofbile is with difficulty allayed; vomiting assuages the evacuation.CHAP. XIII. Of the cure of unknown disease, of strong and weakpersons, of ulcers, fluxions, melancholies, and convulsions.CHAP. XIV. Of cauterizing the veins, and mode of, and use.Whatever stops the blood arrests a fluxion and cures headache.CHAP. XV. Medicine is an art of long and difficult attainment,228 THE WORKS OF HIPPOCRATES.on account of the variety of subjects, the different complaints, andfrequently contradictory effects of remedies.CHAP. XVI. What a remedy is. Of mild and powerful remediesin purging and binding, and of their employment.CHAP. XVII. The art of medicine is certain and constant to himwho is acquainted with it, and depends not on chance. With orwithout chance he will act correctly, and may expect success.Gardeil, without affording a reason for the omission, has left outwhat constitutes nearly a column in Fœsius, and the first chapterin Haller. A reference to the foregoing will be sufficient howeverto establish the connexion, and to show the views of sympathy heldby Hippocrates. In proceeding from that point, Gardeil gives abriefenumeration of the parts of the body, thus-Ed.1. Ofthe organ of hearing. 2. Ofthat of smell. 3. Of that ofvision. 4. Of the brain, and of the origin and distribution of theblood-vessels; continued in 5 and 6; in which last, the communication or inosculation of the vessels is particularly stated. In 7 thediseases of the fleshy parts, the nerves, membranes, and tendonsare treated of, and are regarded as being more difficult to curethan of the fluids. 8. Of the sutures of the cranium. 9. Of thebones of the trunk. 10. The superior extremities. 11. The hand.12. The pelvis and lower extremities. 14. Of the synovia and articulations. 15. The stomach receives the food and drink taken;and certain vessels convey liquids to the bladder. 16. Hippocrateshere commences to treat of diseases, and first, of fluxions, or catarrhs. 17. Explanation of the causes of fluxions, of which thereare seven, proceeding from the head; one to the nose, one to theears, and one to the eyes, all which are conspicuous to every one;a fourth goes to the breast, and causes suppurations and phthisis.20. When the fluxion is to the spinal medulla, dorsal phthisis is theresult. 21. If it goes to the vertebræ and to the flesh , a peculiarkind of dropsy follows. 22. Ifthe fluxion proceeds slowly, sciaticaand rheumatism ensue. 23. The treatment of these seven speciesis given in this and the succeeding numbers. In 32 is a detaileddescription of the fourth species, viz. , that on the breast and trachea, producing suppuration and phthisis, and accompanied withthe views of Hippocrates, as to peripneumony and pleurisy. 33. Ofdorsal phthisis, from fluxion on the spine. 34. Treatment of pleu-ON THE DIFFERENT PARTS OF MAN. 229eases.risy. 35. Of the cure of empyema. 36. Of fluxion on the bellythrough the œsophagus. 37. Treatment of fluxions on the soft partsnear the vertebræ, inducing dropsy. 38. And of fluxions inducingsciatica. 39. Treatment of enlarged spleen, with wasting away ofthe omentum. 40. Of that of dropsy in children. 41. Of a drypleurisy without catarrh. 42. Of fever from repletion, and its opposite. 43. Of jaundice. 44. Of malignant ulcers. 45. Of quinsy.46. Of ulceration of the tongue. 47. General rules for treating dis48. Wounds of the head. 49 to 57. Sundry aphorisms relating to treatment. 58. Of treatment of unknown diseases. 59.Of tumours and ulcers. 60. Of the use of mandragore in some diseases. 63, 64. Aphorisms. 65. On cauterizing the vessels, andprecautions in, as to hemorrhage. 67. Of the difficulties attendingthe learning of medicine. 68. Apparent contradictions in medicine,and reasons assigned in 69 and 70. 71. Importance of seizing onopportunity, or acting apropos. Whatever induces a change inthe actual state of the system, is to be viewed as remedial. Thesubject continued in 72 and 73. Repudiation of chance in medicine,for medicine is founded on solid grounds, unmixed with chance;and chance is, in all things, to be denied. If a proper treatment ispursued, the result is beneficial; the reverse is the result of ignorance. (This seems to be omitted by Haller, but is found inFœsius. ) 74. Of female diseases; all which are ascribed to theuterus, and its asserted movements. The menses in young personsare affirmed to be good blood; but in old, mixed with mucosities.I have given the outline of this treatise, as afforded both by Hallerand Gardeil; but inasmuch as it is considered as an important Hippocratic work, I have added the following full translation. Towardsthe close many aphoristic sentences seem intermingled with thetext.-ED.It appears to me that no particular part of the body can beregarded as its beginning; each individual part may, in fact, be soconsidered, and equally so as to its termination. In describing acircle, no beginning is found, and so it would seem to be in respectto the members of the body. The drier it is, so is it the more calculated to originate and labour under disease; less so if moist, fordisease in the dry body is fixed, and does not yield; but if in thea Nocovμatav, Hipp.; -Membrorum, Fos.; -Morborum, Hal.230 THE WORKS OF HIPPOCRATES.moist, it circulates and occupies different parts, and by this changeinduces rest, and is more readily tranquillized, from not beingattached to any particular spot. Changing thus from one part toanother, disease shows itself accordingly; as in a metastasis fromthe belly to the head, from the head to the muscles and abdomen,and so of the rest for a similar reason; for when the belly does notmoderately discharge itself, and food is taken in , the body is moistened by the humours of the food; but that humour interrupted bythe belly, the passage to the head is excited, but not being therereadily received by its vessels, it flows where chance may direct,and is carried into the circuit of the head and brain; but should itagain be conveyed towards the belly, it there induces disease, orin any other part on which it may fall. Hence it is best to undertake the cure of diseased parts through those which cause the disease, and therefore it is more readily cured by taking it at its onset.But the body itself is similarly constituted, although all its parts,large and small, are not exactly alike, neither are the superior andinferior parts; yet, if the smallest part be intercepted, it becomesaffected, and that affection, whatever be its nature, is soon felt bythe whole body, because its smallest part is constituted alike withthe largest, and that smallest part, whatever may affect it, affectsits congeners, each conformably to its nature, whether that be goodor bad; and since the body, from the intimate connexion of itssmallest part, feels pain or the reverse, from whatever reaches thatsmallest part, such is then carried to, and felt by all that resembleit, and thence it is, that every part is threatened thereby.The nature of the body claims the first rank in teaching the artof medicine. I begin then by observing that the body has severalopenings, and first of that which serves for hearing. The externalparts of the ear serve merely to increase and strengthen the sound;that which reaches the brain through the membrane of the tympanum, is clearly what causes hearing; there is a passage bymeans of a foramen that conveys it to the brain, which is surrounded by meninges.As for the nostrils, properly speaking, there is no foramen; butthere is an apparatus pierced somewhat like a sponge; hencesounds are heard at a greater distance than we perceive odours;the odorant particles separate and divide in passing through theorgan of smell. In respect to the eyes, there go to the brain, inorder to induce vision, two small vessels, which traverse the me-ON THE DIFFERENT PARTS OF MAN. 231ninges that envelope it; they produce vision by means of a verypure humour furnished by the brain, on which we see in the eyesa representation of objects. If these vessels' dry up, vision is lost.The eyes are enveloped in three membranes for their security;the external one is very thick, the middle much less so, and thethird, containing the vitreous humour, is extremely delicate. Whenthe external one is wounded, it produces disease; laceration of themiddle one is replete with danger, and when torn, we see a kind ofbladder protrude; the third presents still greater danger, because itis that which contains the humour on which vision depends.The brain has two membranes; an external one, very strong;the other, immediately investing the brain, is very delicate, and doesnot reunite if it is wounded. 'There are vessels that adhere to thebones after traversing the muscles. Two descend from the vertexand go towards the eyebrows and terminate in the angles of theeyes. One other is carried to the nostrils; whilst two others passalong the temples behind the ears, and go to supply the eyes, andhave a constant pulsation. These are the only vessels that divertaway the blood, instead of moistening the parts; that part that isthus turned back does not harmonize with the progressing portion.The former in its route meets the descending portion, and rebounding against each other, a shock is produced that gives rise to thepulsation of the vessels. I have stated that vision is maintained bya very pure humour coming from the brain; now if any thingfrom these vessels mixes with it, the humour becomes turbid, andis no longer fitted to represent objects. We sometimes, then, seeas it were flies, nubiculæ, or dark moving spots, at others, nothingclearly marked. There are two other vessels located betweenthose above- mentioned and the ears; they go towards the ears, andthere dip down; two others, arising near the junction of the temporal bone, go to the ears; two pass near the tendons of the neck,towards the vertebræ, and terminate in the kidneys and testicles;when these are affected, bloody urine is discharged. Two morego from the head to the shoulders, and are properly called humoral. Two more from the vertex, passing near the ears on the forepart of the neck, go to the vena cava. The vena cava, elongatedlike the œsophagus, is located between it and the trachea, and goingtowards the diaphragm, enters the heart; passing through the• Doubtless the optic nerves are here intended.-ED.232 THE WORKS OF HIPPOCRATES.diaphragm downwards, it divides and goes to the groins andthighs, branching off, and proceeding to the legs and ankles insideof the tibia. If this last is divided, impotency is induced. It thenproceeds, and is lost in the toes. A ramification of the vena cavagoes to the left hand; another passes under the spleen to the leftflank, at the place where the spleen lies under the epiploon, andwhich terminates at the lower part of the thorax: it arises nearthe diaphragm, and communicates as it mounts up, with thehumoral, and goes under the elbow-joint, after having divided intotwo branches, one of which is divided in affections of the spleen.There is another in the belly, which takes a similar course. Inother respects we find all the veins communicate and empty intoone another; some unite amongst themselves; others, by the meansof small vessels that emanate from them, give nourishment to themuscles at the place where their extremities communicate together.Now it is more easy to cure diseases of the vessels than those ofthe nerves. In the first case, the disease is in perpetnal motion;it is carried by the fluid contained in the vessels, which is never atrest. The nature of the veins is to contain the humours in theflesh; the nerves, on the contrary, are dry, solid , and attached tobones; from whence they derive their ordinary support. Theyare also nourished by the flesh; they are moister and softer thanthe bones, but firmer than the flesh. When disease attacks them ,it becomes fixed there, and stronger, and it is difficult to remove it.Tetanus then ensues, with spasms of the limbs and body. Thenerves (tendons) serve to strengthen the articulations; they arespread throughout the body, and give strength to the parts, and weobserve that they are always very strong in those parts of the bodywhere the flesh is in smallest amount. The body is filled withnerves (tendons); there are none in the face or head, but we therefind vessels similar to nerves, between the flesh and bone, verystrong and small; they are, as it were, nerves with a cavity.We see in the head, sometimes three, sometimes four sutures.When there are four, one is seen on each side, going towards theear, another before, and another behind. Such is the case withfour sutures. When there are three, one is in front, and the twoothers on each side going to the ear, as in the case of four, but thehinder one is wanting. Those who have more, enjoy better health.

• Apparently, the term nerves here implies tendons, aponeuroses, &c.- ED.

ON THE DIFFERENT PARTS OF MAN. 233At the eyebrows there is a bone that connects them; two othersare connected at the chin: those of the upper jaw are united withthose of the head.The vertebræ are more numerous in some subjects than in others:their smallest number is twenty-two; the upper are near the head, thelower lead toward the anus. The ribs are seven in number; theyare articulated behind with the vertebræ; in front of the chest theyunite together. The clavicles unite together in front of the breastnear the trachea, where they join the sternum; they are coveredbehind by the shoulder-blade, which bends forward, and is alwaysfixed at the upper part of the back. The shoulder-blade is attachedto the bone of the arm by a projection that joins to the humerus.This bone has, at its upper part, two eminences, one internal, thecoronoid, the other external, the acromion, besides the lower onethat articulates with the humerus, that is, the head of the shoulderblade, in which is the glenoid cavity. The prominences at theelbow on the lower part of the humerus, serve for the articulationof the radius; and a little lower on the inner side with the cubit.It is this, which with the radius forms the elbow-joint. Four smallprominences are there noticed, two superior and two inferior. Thecubit presents two superior, that assist in the articulation, and forma projection at the part where the humerus terminates; the twolower, which are also a little internal and very near each other,inside the elbow, belong to the articulation of the radius with theother bone of the forearm. At the lower part of these two bones,the carpus is articulated with the radius: the tuberosities of thebone at this part being movable in every direction, do not formseparate and distinct articulations, except at the upper and lowerparts.The hands have numerous joints, for all the bones articulate withthose adjoining: the fingers likewise present many joints, each onehaving three, one of which is below the nail, between it and thetuberosity; the second between the first and second tuberosity,where one of the flexions of the finger takes place; the third articulation ofthe fingers is at the part where they are connected withthe hand.We observe two cavities in the os ischium called cotyloid, withwhich the thigh-bones articulate. At the upper part of the thighbone two eminences are noticed , one tending outwards , the otherinwards, neither of which forms the joint, but constitute a part of234 THE WORKS OF HIPPOCRATES.the bone itself. The femur at one of its upper portions enters thecotyloid cavity; for its upper extremity has two terminations, oneof which, internal, is round and smooth, and forms the joint; theother is exterior and smaller, and projecting. Towards the bottomof the buttocks we see a projection that belongs to the ischium . Atits lower end, the thigh- bone has two condyles that have a hingelike articulation or ginglymus with the tibia, above which the rotulaadapts itself, and prevents the fluids from the soft parts entering thejoint when the leg is bent. We see at the upper part of the legtwo eminences, one internal; the external one does not form a partof the knee-joint. Another eminence at the inferior part assists inits articulation with the foot. In the foot are numerous articulations as in the hands; for as many bones, so many articulations.We reckon as many bones in the foot as in the hand.We find likewise in the body many small articulations, not all ofequal size, but resembling those I have described: there are alsomany small vessels besides those already mentioned , but they areof not much importance.The synovia (múğa, mucus) is natural to all the articulations;when it is pure, the bones are moistened by it, and by this lubrication their motion is easy. Onthe contrary, it is difficult and painful, when the soft parts pour out a vitiated humour. The jointstiffens whenever the humour supplied by the soft parts is not unctuous. As the synovia is exhausted by motion, if the soft parts arenot continually moistened, the joints become dry; if it is in toogreat quantity, the joints being unable to contain the humour, itspreads around, and infarctions are the consequence. The nerves,which serve to connect the bones, swell and relax. We often seelameness produced by one or other of these causes. When theyare powerful, the lameness is more considerable, but less so whenweak.What we eat and drink goes to the stomach, from whence vessels convey a part of the liquids to the bladder.Fluxions ensue from refrigeration and tumefaction of the flesh.Sometimes, when the cold acts upon the distended flesh and vesselsof the head, they are contracted, and the humours contained inthem are expressed: the soft parts are compelled to pour them outfrom their diminished bulk; the contraction of the skin by pressingon the roots of the hair causes its erection; the fluids thus pressedupon spread wherever a passage can be found. Fluxions areON THE DIFFERENT PARTS OF MAN. 235tracts.caused by heat, because the soft parts are rarefied when heated;the pores are thus enlarged, and the humours they contain are attenuated, and yield readily to every pressure. The greater therarefaction the greater is the flow, particularly when the soft partsare replete with humour; that portion which they cannot anylonger retain, is poured out from every part, and a passage oncemade, they issue through it, until the body drying, the passage conAs every part communicates, the moisture taken up is attracted to the dry parts. The body of man being permeable, it iseasy for those parts that have not augmented in volume or imbibedany thing, to attract humours, especially if it is the lower parts thatare dry, and the upper that are moist, as in fact is the case; for inthe superior parts there are more vessels, and the thinner soft parts.of the head require less moisture; the passage is thus very easyfrom the over-moistened to the dry parts, especially as every drypart absorbs moisture; nor can it be denied that the humours tendnaturally downwards, however light they may be, and by whatsoever power they are moved.There are seven fluxions from the head, viz. , one to the nose, oneto the ears, and one to the eyes; all which are visible to every one.When the fluxion is to the breast, in consequence of cold, bile exists.Catarrh caused by cold readily falls upon the breast, because thepassage by the trachea is very easy, and because the trachea isexposed to the air, and is in constant motion. When then the softparts are charged with moisture and with bile, as they never are atrest, but always agitated, they find themselves in pain and fatigued,resembling that felt in the limbs by the agitations of a journey;from hence result suppuration and phthisis, when the fluxion is tothe breast. Ifthe fluxion is to the spinal marrow, a dorsal, or blindphthisis ensues. Should the catarrh go to the vertebræ and softparts, a peculiar species of dropsy is the result; the forepart of thehead, the nose and eyes are not oedematous, but the sight is affected, the eyes are dry, and assume a greenish hue like the rest of thebody; the humours do not flow out, although falling down largelyfrom the head, through the soft parts, posteriorly, leaving the foreparts dry, whilst those behind are inundated; the humours tend internally, and find little or no passage externally by the nose. Thebody becomes firmer externally than within, the pores of the formercontract, mutually approximate, and oppose a resistance to anyfluxion: internally, on the contrary, all expands; the solid parts236 THE WORKS OF HIPPOCRATES.become attenuated, and the fluxion from above finds little oppositionfrom them, and fills the soft parts with fluids. That which is derived from food is corrupted by mixture with the impure humoursfrom the head, so that the body is imperfectly nourished; the softparts therefore surcharged with humours, and receiving only aqueous matters, become engorged and tumid.If the fluxion is slowly effected, it produces sciatica and rheumatism, after which it stops flowing; the humour coming insensibly,is repelled by the stronger parts, by which it is compelled to fallupon the joints. Sciatica and rheumatism are also produced at theconclusion of some diseases, whenever that which has given rise tothem, having lost its noxious quality, still remains to be expelled.The humour, unable to escape externally, or to be internally retained, causes swellings beneath the skin; or else, if it leaves the part,it is transported towards the joints, which yield to it, and it thereexcites either sciatica or rheumatism. Ifthe fluxion is on the nose,it fills it with thick and pituitous humours, and requires to be attenuated by fomentations or other means, so as not to be driven tosome other part; for should this be the case, it will induce diseaseof a more dangerous nature. Should the fluxion be upon the ears,it there first induces acute pain and suffering, which continues untila discharge ensues, from which time the pain decreases. Whilstthe pain is severe we must employ warm applications, and dropinto the ear some balsam, apply cups behind the right ear if the leftis affected, or reversely;—it is unnecessary to scarify, it being sufficient that the cup should merely draw. If after this the pain continues, we give cooling drinks and a purgative, but by no meansan emetic, for it will do no good; the refrigerants must be continued, and those remedies changed that are productive of no good.Should any produce a bad effect, their direct opposites must be employed; and if any benefit is perceived, the measures must be pursued without alteration. So soon as the humour finds an issue, anda bloody fetid pus is discharged, we must pursue the followingplan: fill a sponge with some desiccative remedy, and thrust it aslow as possible into the ear; let the patient snuff up some errhine,in order to draw off by the nares the humour falling on the ears,and thereby prevent its return to the head.When the fluxion attacks the eyes, they inflame and swell. Wemust first apply drying remedies, and employ errhines, which evacuate the head through the nose, thereby determining the humoursON THE DIFFERENT PARTS OF MAN. 237from the affected part. If a sensation is felt like that of fine sandrolling over the eye, we use applications that largely provoke aflow of tears; at the same time moistening and relaxing the bodyin order to relieve the eyes, by dissolving and carrying off thosesmall concretions. Should the fluxion only slowly attack the eyes,exciting itching, mild liniments should be employed, calculated todry up and diminish the discharge of tears, and errhines to promotethe discharge from the nose of about two ounces in twenty-fourhours, and repeated every third day. We should attract the humours by mild remedies from the eyes, and thus dry them. Errhinesthat purge the head powerfully, attract the humours from all parts,but if mild and weak, from the eyes only and adjoining parts. Ifthe fluxion attacks the soft parts and cellular tissue between thebones and the muscles of the eye, we know it by the flow of humours which ooze out on pressure. Ulcers ensue there, with headache; the eyes weep much without the eyelids ulcerating; noitching is felt, and the sight, far from being obscured, is renderedmore acute. The humour not coming from the brain, is not salinebut mucose. The proper treatment is as follows. The head ispurged by mild errhines; the amount of humours lessened bymeans of food and remedies of a laxative nature in order to drythe whole body slowly, and thus turn aside the moisture, in conjunction with the errhines. If the headache is not dissipated, wemust make transverse incisions on the head, even to the bone, thatthe catarrh may flow promptly by the various openings thus madein the soft parts. Such is the treatment by which we may hopefor success; should it prove abortive, and the humours not bethereby evacuated, and the sight improved, the eyes become moresparkling, and at length vision is destroyed. When bloody humoursapear in the eye, by which the purity of its natural fluids is soiled,the pupil appears bloodshot, and has an irregular appearance; thepart in which the bloody humour is seen, is not transparent, whichis also another reason for the irregularity of the pupil; for thishumour like a moving opaque body flits before it, and hence no object is seen correctly. In this case cauteries should be applied tothe vessels which constantly pulsate between the ears and the temples. After which, moistening and relaxing remedies are appliedto the eyes; the tears should be, abundantly excited, in order todivert the humour carried to them, in which the disease consists.When any rupture of the eye takes place, emollient and astringent238 THE WORKS OF HIPPOCRATES.applications are to be employed, in order to contract the wound,and form a cicatrix as small as possible. If albugo appears in theeyes, the tears must be excited.When the catarrh falls on the breast, and is accompanied withbile, it is known by the pains felt, extending from the flancs to theclavicle of that side; there is fever, the tongue is of a palish green,and viscid sputa are discharged. The danger of this disease is onthe seventh or ninth day. If both sides are affected, it is of thesame character. Sometimes it is an inflammation of the lungs,sometimes a pleurisy. These diseases are induced, because thecatarrh flowing from the head by the throat and trachea, the lungs,whose substance is soft and dry, attracts all the moisture it can,and to whatever part it goes, the bulk is augmented: if both sidesare filled, it produces peripneumony; if one side only, a lateralaffection, or pleurisy, ensues. The former is by far the most dangerous, the pains are greater in the flancs and sides, the tongue ismuch paler, the throat suffers from the fluxion; the labour andoppression in respiration are extreme on the seventh or eighth day.If the fever does not diminish on the seventh day, death ensuesfrom suffocation or weakness, or from both. If the fever, afterdiminishing for two days, returns on the ninth, death usually ensues,or else an internal suppuration takes place. If the fever returns onthe twelfth day, suppuration has ensued; but if the fever is delayed.to the fourteenth day, the patient is safe. All those in whom suppuration takes place in the termination of peripneumony or pleurisydo not perish; some escape. Suppuration happens when the fluxiongoes to the same place to which the flow of bile has been conveyed;which last being movable, it finds a passage, and checks the flow;but if excretion is diminished, and the fluxion has accumulated,suppuration follows, because more humours flow to the lungs thanthose organs discharge, and this excess then is converted into pus;this remaining in the lungs and in the chest, ulceration and putrefaction follow, and when the ulcer is fully established, the lungsmelt down, and are coughed up with the sputa; the cough, by itssuccussion, invites still more humours from the head; the ulcers inthe lungs open in every part in consequence of this motion, so that,if even the head could not furnish any more humours, the ulcers ofthe lungs would alone suffice to continue the disease. The ulcerssometimes induce empyema, which is more easily cured, especiallyif exterior to the lungs, when it points outwardly, and occasionallyON THE DIFFERENT PARTS OF MAN. 239forms an opening where the flesh has been softened by it, and frequently, on shaking the body, we can perceive a fluctuation, andhear a sound. Such cases are cured by fire. If the fluxion, instead of this general character, is carried to a single spot, andenters into the structure of the lungs, phthisis ensues; for whenthe humour reaches there slowly, bringing consequently but littlemoisture into them, it thickens, concretes, and dries in the bronchi;it excites cough by adhering to and filling the narrow cavities,rendering thereby an entrance to the air more difficult; from adefect of respiration, oppression of the breast ensues; a prickingsensation is felt in the lungs, which is not experienced when theflow from the head to that part is more copious. If the fluxion becomes great, the whole body is surcharged, and the phthisis ischanged to an empyema; and reversely, when the body becomesdry, the empyema passes from that state to phthisis. We know anempyema by these indications. The patient at first feels a pain inthe side, pus collects, and the pain continues, with cough and expectoration of pus, and difficult respiration. If, however, the pushas not yet found an exit, concussion of the body renders it perceptible in its fluctuation, by a sound similar to that of a fluid shakenin a bottle. When these signs are absent, and yet empyema exists,it may be suspected from the great oppression and the hoarsevoice; the feet and knees swell, principally on the affected side,the thorax curves, lassitude is extreme, universal sweats, alternately cold and hot, the nails becomes crooked, a sense of heat inthe abdomen, all of which are so many indications of an empyema.Should catarrh fall upon the spine, a phthisis ensues, of whichthe following are the signs. Pain in the loins, a sense of vacuityin the forehead; the bile that shows itself is of the worst characterif it gives a yellow tinge to the eyes. The nails turn livid; if anyulcers exist, their edges also assume a livid hue. The sweats arepartial, and confined to some local spot; fever follows, with livid.sputa, or if not discharged, what continues in the lungs is equallyWhat thus remains, causes the respiration to be sonorous, witha croaking noise; breathing is difficult, hiccup and fever diminish,whilst the sputa are retained; and as the debility increases diarrhoeacomes on. When such symptoms occur in peripneumony or pleurisy, the greatest degree of danger exists.Pectoriloquism! -ED.240 THE WORKS OF HIPPOCRATES.The cure of pleurisy is as follows. Do not endeavour to checkthe fever before the seventh day; prescribe either oxymel or oxycratfor drink, and give it copiously, in order to facilitate expectorationby dilution; heating remedies are to be used to calm the pains, andto favour a discharge from the lungs. On the fourth day the patientmust be placed in the bath; on the fifth and sixth he is to beanointed with oil, and on the seventh the bath is to be renewed,unless the fever is diminished, and thereby excite perspiration.From the fifth to the eighth day the most active expectorants areto be employed, if the disease progresses favourably. Should thefever not decline on the seventh, it ought to do so on the ninth,unless some dangerous symptoms supervene. When the feverterminates, we employ the weakest broths; if diarrhoea ensues,the system being still vigorous, we omit the drink, and give barleywater if the fever has ceased. Peripneumony is to be treated inthe same manner. In case of empyema, mild errhines, to excite adischarge from the nose, and thereby relieving the head, are to beemployed, and such food as will loosen the bowels; if the diseaseis thereby arrested, and the humours diminish, we are then to promote expectoration, both by medicine and by appropriate food, bymeans of which coughing is excited. In order to effect this , thefood should be of a fatty and saline quality, with wine of a roughcharacter. Phthisical patients are treated in the same way, withthe exception of giving less food at a time, and wine more diluted,so that the debilitated system may not be too greatly heated, andan afflux of humours thereby induced.When the fluxion falls down upon the bowels by the oesophagus,an accumulation takes place below, and sometimes in the superiorparts. From the commencement, if pain of the belly exists, wemust purge by means of laxatives, either of food, or mixed withthe drink, and employ stronger purgatives as the pain declines,together with more substantial food. This treatment is pursued forsome days after the disease has terminated. If the patient is weakand cannot support it, he is to use the ptisans, and after beingthereby evacuated, astringents are to be given. If the fluxion tendsto the soft parts near the vertebræ, inducing anasarcous swelling,the following plan must be adopted. Fire is applied to the fleshnear the neck in three places, and when the eschars fall off, approximate the edges, so as to make the cicatrices as small as possible.After opposing this barrier to the fluxion , we use errhines to causeON THE DIFFERENT PARTS OF MAN. 241a determination to the nose, at the same time keeping the foreheadwarm and the occiput cool. The front being thus heated, warmfood is given that does not relax, the belly, in order that the fluxionshould direct itself to the front openings for its exit. If, when thusrestrained, any portion of the fluxion shall have found a passageinternally before taking the above direction, we proceed as follows.If it is intercutaneous, fumigations are employed; if abdominal,and not anasarcous, we purge; if both anasarca and ascites exist,purging and fomentations are appropriate, being careful always toevacuate by the channel nearest the collection, whether up or down.When catarrh produces sciatica , cups should be applied to drawoutwards, but without scarification; and internally, heating remedies and purgatives, so as to clear the passages, externally by theformer, internally by the latter. It happens that when a fluxion hasbeen confined, not knowing by what channel to escape, it fixes uponthe joints which yield to it, and thus produces sciatica or a dorsalphthisis. In this case we must purge the head by mild errhinesuntil the humours are diverted, and employ the same regimen as inthe former case. Elaterium is used to purge, and the belly is keptopen by means of whey; and fomentations must not be neglected.When the spleen becomes enlarged, and the body wastes away,the fat of the omentum melting down leaves the vessels empty,towards which a flux of humours takes place; they swell up thespleen which is near the omentum, and when any disease attacksthe body, these parts become one of the places of attack, in whichif not remedied it fixes obstinately. Even if well attended to, thisstate is highly dangerous. We administer hydragogue purgatives,and very nourishing food. If this proves inefficient, we burnlightly and superficially around the navel, to allow an issue to thehumours. We likewise burn the navel itself, and abstract thehumour daily. This is one of the most dangerous states, and it istherefore expedient to risk something: if successful, the patient iscured; should you not succeed after the burning, the danger ofdeath, which must have ensued without them, is not thereby augmented.Anasarca in children is cured thus. We open with a lancet thetumid part by several punctures. This plan is adapted to everypart; and to the part thus scarified fomentations are applied, andthe punctures anointed with some warm balsam.There is a dry pleurisy without catarrh, occurring when the16242 THE WORKS OF HIPPOCRATES.1lungs, naturally dry, become preternaturally so from excessivethirst; the lung becomes thin and weak, and inclines to the side, soas to come in contact with the pleura; the pleura being moist,attaches it, and a pleurisy ensues, with pain in the side extendingto the clavicle; fever follows, and whitish sputa are expectorated.This disease is cured by copious drinking and using the bath; expectorants are employed, and remedies to relieve the pain. It iscured in seven days, and is not dangerous, nor is diet necessary.Fever takes place when the body, being replete with humours, thesoft parts swell; the bile and pituita continue stagnated, and fromwant of movement are unrefreshed; nothing passes out, nothingenters to renew them. As soon as this repletion, fever, and consequent lassitude appear, we should at once dilute largely, employembrocations, and excite warmth, in order to open the passages,and removethe fever by sweating; this is continued for three orfour days, when, if the disease is not abated, we purge with chologogues, and endeavour to arrest the fever before it changes to aquartan. Whilst the swelling is considerable, purging is to beavoided, for the disease will not terminate whilst the system is replete with humours; in order to cure the fever, we omit purgativesuntil the body begins to discharge those humours; we enjoin abstinence, even from slops that are laxative, but give abundantly ofwater, hydromel, and oxycrat. Warm drinks thus taken in, sooncarry off a part of the disease, either by urine or sweat; and everyevacuation thus produced is beneficial to the patient by exciting aninternal movement. When fever attacks an emaciated body, itassuredly cannot be from repletion; and if not quickly checked, wemust give nourishment to the system, which, if not speedily beneficial, will aggravate the fever, and render purgation necessary, thusattacking it in its stronghold, by emetics or cathartics, according toits upper or inferior location . Without reference to debility, strongremedies are required, though not of equal force to all alike, butproportioned to their vigour or weakness. Scalding in passing theurine is moderated by dilution and broths, as in fever by refrigerantsand the like. If these cooling remedies produce nausea, calefacientsare employed, and we recur to the former if the ardor urinæ continues.Jaundice is treated in the following manner. Commence withnourishing and fat substances, and drinks, and baths, for three orfour days. After adequate moistening, purging is pursued, and theON THE DIFFERENT PARTS OF MAN. 243body is then dried by promptly suppressing all substantial food , andstriving at the same time to discharge the humours by every emunctory. To evacuate the head, errhines of a medium force shouldbe used. Diuretics are likewise proper, administered with the viewof evacuating humours thus set in motion, and checking in somedegree the nourishment afforded by food. When the body ismoderately reduced, baths are employed, in which slices of theroots of the wild cucumber are infused. Chologogues are abstainedfrom, lest the body should be too much irritated; and after it isadequately dried, and the disease is lessened, good food and redwine are directed, together with every other measure adapted torestore a healthy aspect. If, in spite of all these measures, ayellow colour still continues, we again reduce the system withoutdrying it, lest that colour should become permanent.Malignant ulcers take place on the body when the surroundingsoft parts inflame, and the lips become thickened; a sanious discharge of abundant serosities , and ichorous matters that dry up,and appear to close the ulcer; this putrid matter cannot then escape; the flesh surcharged thereby inflames and swells. Whereverthis ichor reaches, swelling and putrefaction are excited. Theseulcers should be treated by humectants and balsamics, to permitthe escape of the humour, and prevent its spreading among the softparts; refrigerants are likewise employed to obviate the passage ofthe humours to the ulcer. We must endeavour to strengthen theflesh, and enable it to resist the afflux when not already injured.Generally speaking, humectants and refrigerants are employed inthe treatment of all ulcers.Angina arises from blood arrested in the vessels of the neck.We must bleed in the arm and purge, to divert downward thehumours that cause the disease; and the same treatment is pursuedin extensive ulcerations of the tongue.We should attend to all diseases at their commencement; andwherever there is a tendency to a flow of humours, it should be atonce arrested, and any other cause that may give rise to disease,must be obviated at its onset by appropriate treatment. Thuswhen the fluxion is abundant, it should be diverted; if moderate, bya fitting regimen.In fractures of the skull, if the bone is comminuted, there is lessdanger than when it is a fissure, and that internal; in the first case,humectants only are required; but in the last, we must use the244 THE WORKS OF HIPPOCRATES.trepan to prevent the extravasated blood from corrupting themeninges; the blood thus extravasated, and having no exit, inducesgreat disorder and delirium. By means of the trepan, such a passage is procured to the sanious matters, and appropriate remediesare topically applied to abstract them, and deterge the wound.APHORISTICAL SENTENCES.Errhines should not be administered in fever for fear of inducingdelirium; for such remedies heat the head, and that, in addition tothe febrile heat. Wounds are mortal in those, who already, inconsequence, vomit atrabilis; so also, if the discharge is great, andgreat debility follows, if the wound contracts and dries up rapidly.In fever, if the patient is greatly debilitated , it is a mortal symptomif small livid ulcerations occur. If a disease augments after administering a remedy, and the patient is evacuated both upwards anddownwards, diluted wine should first be given, then stronger; thisallays the discharge; give neither purgatives nor emetics. Biledischarged up or down of its own accord, is restrained with difficulty, for it arises from its internal acrimony; but when it resultsfrom a remedy given, such acrimony may not exist. The vomitingof a drunken man should not be checked. Excessive purgation ischecked by emetics, which last, may then be easily stopped; andif, after vomiting, much debility is exhibited, anodynes should berecommended. If blood is the source of disease, pains are anaccompaniment, but a sense of weight, if it be pituita; at least suchcommonly is the case. When unacquainted with the disease, weshould give weak remedies, if any. If the patient is relieved, wepursue the treatment, for the road is clear; reversely, if he feelsworse. When great abstinence is the cause, employ food of morenutritive character, frequently changing it from one to another. Ifthe patient is strong, and the disease of feeble description, shouldwe be obliged to change our plan in order to discover the propertreatment, we may with safety resort to more powerful remediesthan the disease, because, operating on healthy as well as diseasedparts, no great danger can be apprehended; but when the diseaseis strong, and the patient weak, milder remedies should be chosen,such as are fitted to cure, without further debilitating the patient.Gymnastics differ greatly from medicine; the former do not induceON THE DIFFERENT PARTS OF MAN. 245changes in the system; which, though required in disease, is by nomeans necessary in the healthy state.Diseases productive of ulcers, or tumours externally, should betreated by abstinence and appropriate remedies. When humoursflow from the head, vomits must be used. Chronic diseases aremore difficult to cure than recent ones. Callous ulcers require arenewal of their surface by means of suppurating remedies, andthen to be cicatrized. If the applications produce tumefaction,the body should be extenuated by purgatives. To create cicatrization too early, is to afford nutriment to the morbific matter, andincrease the ulcer. When the proper time has arrived for this, andto fill it fromthe bottom, the tumefaction is beneficial, even in ulcers.of the head; the proud-flesh pushes up from the bottom the decayedparts, notwithstanding their resistance. When it is elevated to thesurface, the food is to be diminished. In case grief induces disease and a disposition to suicide, we give mandragore root in themorning, but in amount not calculated to produce madness. Tocure convulsions, we use the same remedy in small doses; a smallchaffing- dish of coals on each side of the bed serves to heat thoseapplications that should be applied to the tendons on the nape ofthe neck. If fever occurs after convulsions, it ceases either atonce, or in two or three days. When fever caused by a rupturetakes place, it ensues in three or four days. Care must be taken,however, for if it arises from some other cause, the treatment isdifferent. A person suffering from a violent strain of the hands orfeet, will be apt to fall into convulsions. To cauterize the vessels,the disease and the state of the patient should be considered: incase of hemorrhage, two precautions are required for safety beforeapplying the cautery; 1st. Whether it may not be proper to prevent reunion, and whether the discharge is not itself useful; for,after cauterization, the discharge will cease, the two extremities ofthe vessel contract, and they dry up.terized, the bleeding will continue.the vessel should be burned across.we make incisions on either side above and below, by way of derivation; the applications will then be more effective, from the forceof the blood being diminished.If any vessels are left uncau2d. To arrest the hemorrhage,When the burn is inadequate,In pains of the head, bleeding must be resorted to; should thisnot succeed, then we must cauterize the vessels, and the pain willcease; errhines tend to increase the complaint.246 THE WORKS OF HIPPOCRATES.It is impossible to acquire a knowledge of medicine quickly, forinvariable principles cannot be established. A person acquiring aknowledge of painting, by learning all that is taught him, soonattains all that others know, because the practice is the same withall, both now and to- morrow; it does not vary; nor is it necessaryfor him to seize on an especial occasion that will never again.recur; but medicine requires that some one thing be done at onemoment, and its opposite at another, for it has to reconcile contradictory points frequently. Thus it is with purgatives; they do notfulfil that indication always, but sometimes are even promotive ofa contrary effect. In great constipation, the body becomes chargedwith pituita, which, falling on the bowels, produces a purgativeeffect; for the collected pituita acquires thereby a purgative influence. In like manner purgatives, by drying up the belly,induce costiveness. If you do not give purgatives, that whichproduces the disease will moisten, and thus purifying, health willbe restored when the body has thus been washed out. Remedies binding the body, prepare the way for the evacuants, as theseprepare the way for the former. It is precisely the same inregard to the complexion: watery humours dispel a good complexion, and render it pale; tonics on the contrary restore it.Every remedy has its opposite. If any one becomes tumid andpallid, he wastes away if remedies are not employed, which, bydispelling that tumid state, restore a healthy complexion. In thiscase, attenuants are useful and dissipate the pallor; but if it proceeds from inanition , analeptics are to be resorted to. Pains arealso the result of cold or heat, either in excess or reversely; thosewhose surface is rendered cold, experience pain when exposed toheat, and those greatly heated suffer by exposure to cold. Suchas have naturally a dry surface suffer from moisture, whilst thosenaturally moist suffer from dryness. All unnatural changes arefollowed by pain, and pains are dispersed by what is opposite totheir productive causes, independently of what may be a peculiarity in the disease. Persons of a warm constitution, who aremade ill by cold, are relieved by warmth, and thus it is in other cases.There is another mode in the production of disease, viz.: from theircongeners [Homœopathy! twothousand years before Hahnemann! ];for the same things that cause, also cure the complaint; (" aliomodo per similia morbus oritur et per similia oblata ex morbissanantur!") Thus we find strangury cured by the very meansON THE DIFFERENT PARTS OF MAN. 247that otherwise induces it; and a cough, like dysury, is caused andcured by the same things, although also by contraries.There also exists another mode, as in the fever of inflammation;here the fever excited by inflammation is sometimes cured by theinflammation itself, and also by its opposites. Sometimes water,warm, and copiously drank and used as a bath, will restore health,by dissipating a fever by such means as are capable of promotinginflammation.The effect of a purgative or emetic may be arrested by irritants,and augmented by calments. In making a person who is vomiting,drink water copiously, he often with the water discharges in vomiting that which occasioned it; thus vomiting is cured by vomiting.On other occasions we cure by calming it, and causing what produced it to pass downwards by stool; thus it is, that health is recovered in similar cases by opposite means: were this the case inevery instance, we should at least have this rule, that we must cureeither by contraries or by the same, whatever be the disease or itscause, in such and such cases. But the debility of the body is areason of the infinite diversity that is seen. The body is everywhere equally nourished by food that is appropriate to all its parts;but when more or less than is required is taken, or when changesare made, the body is incommoded, and the digestion becomes imperfect. If it is overpowered by nourishment, it induces repletion,and from thence an opposite tendency ensues. Warm bathing invigorates the system whilst in a vigorous state, but otherwise ittends to weaken it: the same results from good living. So long asthe body is strong, health is afforded by food; but the same food ina debilitated system is productive of diarrhoea and other evils.When the recipient is altered, that which is introduced into it mustof necessity be likewise modified; the body then, altered and overpowered by the food, wastes away, having many enemies tostruggle with. It is the same with evacuants or tonics; all maybring destruction to the body; and the same is equally true withevery thing, even the most opposite.Opportunity, in the practice of medicine is very brief, and he thatcomprehends this will duly expect it. He distinguishes essentialfrom merely accidental symptoms, such as are not necessarily con-

• “ Ac siquidem in omnibus hoc modo sehabeat, constitutum quidem sic fuerit, hæc

quidem contrariis curari quæcunque sint et quacunque ex causa fiant, illa vero simi.libus, quæcunque tandem sint et a quacunque causa fiant."248 THE WORKS OF HIPPOCRATES.nected with the existing state; he knows that purgation is not anecessary result of purgatives, and that what are contrary to oneanother are not so invariably. In giving nourishment, the fittingtime is when the system can master it; if seasonably given, suchfood as is laxative will loosen the bowels, and that which is substantial will tend to invigorate it. Whenever the state of the system is superior to the food, its state being natural, the food producesno unexpected effects; and such is the opportune occasion withwhich the physician should be acquainted, for if he does not takeadvantage of it, the patient, so far from an easy digestion, will feelit as a load on the stomach, with heat and oppression. The bodyis nourished by that only which it is enabled to overpower. If aliment is taken inopportunely, its effects differ from what had been.anticipated; the person falls away. It is the same with every thingthat might tend to improve it; its action being relative to the powersof the system, to its intrinsic nature and existing circumstances. Ifthose circumstances are unattended to, contrary effects will ensue.Every thing that effects an alteration in the actual state of the system may be regarded as remedial; the strongest overthrow it, andhence we can destroy the body by remedies; we can inducechanges in it by means of aliment, and change is favourable in disease. Should no change take place, the disease must augment.In diseases of an intermediate strength, powerful remedies are improper, their action is to be feared; powerful remedies should bereserved for such diseases as are powerful; weak ones for those ofinferior force. Neither ought we to denaturalize remedies by admixture, but as much as possible administer them in their naturalstate, employing the most powerful in robust constitutions, and theweaker in cases of an opposite tendency. Evacuations should bemade by those emunctories that are nearest to the part affected, forit is there an exit will be found for them. Such articles as loosenthe belly are lubricating, and are attended by heat; the belly beinghot, saline matters are not readily discharged, but give rise to flatulence. What causes flatulence is for the most part fixed, and givesit off in drying, as all humours do. Astringents are of this nature,and every thing that by heat is rendered consistent, dries and becomes friable. Every thing that, internally applied, induces a flowof humours, causes dryness on the surface; such are tonics andstimulants. Purgatives weaken and heat the body; acids also provoke humours. Refrigerants induce evacuation, and equally so ifON THE DIFFERENT PARTS OF MAN. 249they are of a humid nature; but if they should not purge, they induce heat. Such remedies as are heating, become refrigerant ifthey induce evacuation; otherwise they heat the system . Thoseare most heating that induce a large flow of humours; and such asin large doses do not excite so great an afflux, are simply laxative.It appears to me that medicine, at the present day, has made asgreat a progress as could reasonably be anticipated. It teaches usto compare those circumstances that spring up from time and opportunity; and whoever attains to this knowledge, will ascribe nothing to chance. Let chance favour him or not, he will pursue themost appropriate measures in his treatment of disease; for medicineis established on a firm foundation, that does not require the co-operation of chance. Science effects the benefit, if we know appropriately how to employ it. What need have we of chance? Ifremedies in their very nature have a faculty fitted to cure disease,as to me seems the fact, chance can have nothing to do in the business. If chance is essential, it should follow, that that which is nota remedy, would be fully as efficacious as the best remedies, curingthus diseases by mere good luck. If we were altogether to excludechance, not only in medicine, but in every case whatever, weshould, in my opinion, act correctly. Let us avow then, that fortune, good luck, or chance, is for those only who always act correctly. It appears to me, that we succeed or fail exactly in theproportion of our acting properly or the reverse. To act properlyis to succeed, and this is the lot of the skilful practitioner; to actbadly is to fail, and such is the lot of ignorance or presumption.How can we possibly assert that ignorance is successful? Wecannot make account of such success; nothing is certain from onewho does not conduct himself with certainty, but is determined toact, without knowing whether what he does will or will not effecthis intentions.[The following is omitted by Haller.-ED. ]Those affections denominated female diseases, all arise from theuterus; whenever it agitates itself, it occasions disease, whether itadvances or retreats by change of situation. When its mouth doesnot approach the labia pudendi so as to be readily felt, the evil isnot very considerable; but when it advances considerably, it ispainful when it is touched, and the womb finding itself restrainedand closed, does not readily allow of the menstrual discharge, andconsequently becomes tumid and painful. If in descending still250 THE WORKS OF HIPPOCRATES.lower it turns upwards towards the groin, it produces a tumourthat is extremely painful. When it mounts upwards beyond its' limits, its body becomes rarefied, causing afflicting complaints,with headache and ischiatic pains; the womb continuing to swell,the menses are arrested, and its bulk thereby is augmented; thepains extend to the thighs; the female often feels the motion of theuterus to and fro, like a globe, sometimes to the right, sometimes tothe left, and sometimes over the whole abdomen. This is accompanied by headache, and such being the state of things, the following treatment is to be pursued.If it is merely a descent of the womb, we should if possibleanoint it with some fetid substance of any kind, such as oil of cedar,or the pulp of garlic or onions, or even something more unpleasant.We also employ fumigations, taking care not to burn the parts.During this time we avoid drinks and diuretics, as also washingwith warm water. When the womb ascends and there is no longerany obstruction, we use aromatic fumigations of an agreeable odour,such as myrrh, balsam, or any other heating article of the samenature; we bathe with hot wine and employ diuretics. We knowwhen the womb ascends that there is no obstruction, from the flowof the menses; if it is obstructed they are suppressed. We mustthen begin with fumigations as follows. After boiling figs in wine,we put the decoction into the half of a gourd, divided in two parts,one-half of which serves as a cover, in which is a hole to directthe steam towards the womb, by means of this small aperture.Hot water is added, as necessary; after which, the hot remediesmentioned are to be employed, together with the dung and gall ofan ox, alum, galbanum, and such like. We purge frequently withelaterium, which also vomits in delicate temperaments, by whichsuperpurgation is prevented. If strong pessaries are required, takehoney boiled one-half away, and incorporate it with the heatingremedies above mentioned: after the mixture is made, pessaries areformed from it, long and slender like suppositories. Place thewoman on her back, her feet elevated and separated, in order tointroduce the pessary, and maintain it in its place by cloths or othermaterial, warmed, so as to promote relaxation, and gradual melting of the pessary. If less active ones are required, they may beenveloped in fine linen. When the womb is over-moistened byhumours, which swell its mouth, and prevent the menstrual flow,we must apply to it perfumes, &c. , similar to those mentioned in aON THE DIFFERENT PARTS OF MAN. 251previous case, when speaking of the descent of the womb as obstructing the expected catamenial discharge. When this dischargeis too abundant, we must avoid heating by means of warmth orother calefacients, nor must we use diuretic drinks or laxative diet;the patient should sleep in a bed elevated at the feet, to obviate theflow ofblood towards the womb, and astringents should at the sametime be prescribed. Menstruation, when regular, shows its appropriate sanguine character; but when it is irregular, it becomessomewhat purulent. Young persons discharge good blood, but inaged persons, it is mixed with much mucosity.18OF THE EMPLOYMENT OF LIQUIDS.DE LIQUIDORUM USU,DE LIQUIDORUM USU,TRAITÉ DE L'USAGE DES LIQuides,FESIUS, Treat. vii. p. 424.HALLER, iv. p. 230.GARDEIL, iii. p. 143.HALLER, in his preface to this treatise, tells us it contains tenaphorisms from the tenth book (No. xvi. to xxvi) . Something is saidof wines and vinegar. It was read by the ancients, who occasionally extracted from it, though without quoting the title. It isamongst the shortest of the tracts, and nearer than many to theoriginal tracts of Hippocrates.Subjects considered. Of the effects and powers, &c. , of warmand cold waters, wine, vinegar, &c. Of the effects produced bywarm rather than cold water, and on what parts.CHAP. I. Of the powers and uses of warm and cold water employed as drinks.CHAP. II. Of the use of hot and cold water; what parts are benefited or injured by either of them; what affections they induce orcure.CHAP. III. Of sea- water, wine, vinegar; their powers; what partsthey benefit, or what diseases they cure or induce, &c.CHAP. IV. Of the different powers of cold and hot waters; whatparts are benefited or hurt by them; and what diseases cured orinduced by them.Gardeil says, that from the title of this treatise, it might be supposed that liquids in general were here considered. It, however,chiefly has respect to water, the liquid " par eminence. "SEC. I. Of the advantages of water, and its different effects. Affusion of cold and hot water on the skin. Vapour-baths, generaland local; highly extolled on many occasions; injurious, from inattention. Frozen feet, separated by immersion in hot water.SEC. II. Bad effects of cold and hot water; what parts of theON THE EMPLOYMENT OF LIQUIDS. 253body each is best adapted to, and continued in Nos. iii. , iv. , v. , vi.Skin, its connexion with every part of the body, by means of thenerves and blood- vessels that compose the fleshy pannicle; theeffects of heat and cold on the vessels, and some remarks tendingto strengthen a credence of the circulation.SEC. VII. Sea-water as a bath; fumigations useful in phagedeniculcers; salt, nitre, pickle, &c . , their uses as stimulant applications.SEC. VIII. Vinegar, lotions of, fumigations, &c. , of great utility.SEC. IX. Sea-salt, use of, in solution.SEC. X. Wines, various, sweet, rough, white, &c.SEC. XI. Cases wherein cold water is good; others in which hotwater is preferable; both are good in diseases of the joints, gout,convulsions; greater care required in the use of cold than of warmwater; constipation cured by; -warm in affections of the eye;-when cold water is preferable. Of cold water in tetanus; numerous other cases.It would appear from this treatise, that water, cold and hot, seaand other waters, were among the most frequent medicamental resources of Hippocrates, by bathing, drinking, aspersion, sponging, &c.DE MORBIS,SECTION V.ON DISEASES.DE MORBIS,TRAITÉ DES MALADIES,FESIUS, Treat. i . p. 446.HALLER, iii. p. 1 .GARDEIL, iii. p. 153.In his preface to this treatise, Haller says, " its author is uncertain; nor is it perfectly agreed, that these four books are thosewhich, under the same title, the ancients largely quote from, formuch of them is wanting here. Galen refers them to Thessalus,to the younger Hippocrates, or to Polybius." But why ( Halleradds) may they not be the production of some physician of theGnidian school, as is conjectured by Fasius? for the ancientsfound fault with the physicians of that school, that from the slightestdifference, they established new species of diseases, so that theymade seven or eight species of pleurisy; and this fault is to befound here. The remedies are repeated from the treatise " Devictus ratione," or they consist of the most powerful purgatives,very frequently prescribed in another place. The first book contains the theory that refers diseases to pituita and bile as their causes.We find also the pathology of diseases of the breast, of fevers,phrenitis, &c. There is much suspicion as to this book being knownto the ancients. Saving the theory, it would appear to be not unworthy of Hippocrates.Subjects treated of. -What is necessary to be inquired into bythe physician, is here considered, and replied to. Of the internaland external causes of diseases. Of the appropriate and impropertimes for prescribing. Of proper and improper doings and sayings.Of good and evil, arising either spontaneously, by chance, or fromerror. What divided parts do not coalesce. Of the times forprescribing. Of manual dexterity. Of suppuration of the lungs,thorax, and stomach. Of erysipelas of the lungs, and tubercles ofON DISEASES. 255the lungs and side. Of fever, horror, rigor, sweat. Of pleurisy,peripneumony, ardent fever, phrenitis, melancholia. Of partiallybloody and livid sputa.BOOK I.This book is divided by Haller into two sections, containingthirteen chapters, the contents of which are as follow.SEC. I.- CHAP. I. What is to be observed by the physician whenabout to prescribe, that he may correctly interrogate the patientand the attendants, and reply to them, or oppose their questions.CHAP. II. Of the causes of diseases, external and internal. Offatal diseases, of doubtful, variable, chronic , or acute; of convertible diseases, and of such as necessarily supervene.CHAP. III. Theopportunities of prescribing are numerous, varied,fleeting, and sometimes inappropriate; of what may be properlyor improperly done or said, both in medicine and surgery.CHAP. IV. Of things beneficial or hurtful in disease, as wellspontaneous as from the fortunate or unlucky lot of the physician;and of evils arising from the physician, and not necessarily imputable to the disease.CHAP. V. What parts, if divided, do not coalesce; no generalprinciple of practice, either in theory or treatment, will apply toevery case. In what manual dexterity consists.CHAP. VI. Of pulmonary suppuration from peripneumony; of adefluxion of pituita from the head; of rupture of the small vessels;of the contraction of varicose vessels; of the cure, and of deathfrom suppuration of the lungs.CHAP. VII. Of empyema of the thorax arising from a defluxionof pituita from the head, from pleurisy, from pituita impacted inthe side, from labour, and from rupture of the vessels; of suppuration in the lower belly, and its causes; of a collection of pituitaand bile between the skin and muscles, and of convulsions.SEC. II. Some preliminary remarks are here made, as to theinfluence of abdominal suppuration, and its effects on the system;and of defluxion from the head; the influence from age and othercauses thereon, in hastening or checking the issue, &c.256 THE WORKS OF HIPPOCRATES.CHAP. VIII. Of the origin, causes, signs, and cure, of erysipelasof the lungs; of tubercle of the lungs and sides; of rupture andevulsion of the flesh and vessels.CHAP. IX. Of the cure, restoration, and death from suppuration,arising from wounded flesh or vessels; and in the cure, what is tobe attended to, as respects sex, age, season, period , affection , andother circumstances.CHAP. X. Of the origin and causes of fever, rigor, horror, andcold and hot sweats.CHAP. XI. Of the origin, causes, parts affected, and cure, ofpleurisy and peripneumony, with and without expectoration; whichof the affected perish, which recover, or escape, if suppuration hastaken place.CHAP. XII. Of those most obnoxious to ardent fever; its origin,attack, causes, symptoms; its passage into peripneumony, and itsdanger. Of phrenitis and melancholia; of the influence of theblood and bile in these cases.CHAP. XIII. Whence arise the half bloody and livid sputa inpleurisy and peripneumony; and who perish, and wherefore, fromthese diseases, as well as from ardent fever and phrenitis.Gardeil, who makes thirty-one divisions of this book, says: Physicians who are desirous of knowing the mode of acting and of thinking, in the time of Hippocrates, of those who attended to external diseases, will have reason to be content, I think, with what they havealready thus far seen. The present treatise, divided into four books,will satisfy them in many respects, as to what concerns internalaffections. It will not always be easy to arrange what is said inthem, as to the order, nomenclature, and classification of many internal diseases treated of by modern authors, either generally, orparticularly. For the rest, I am persuaded in reading what hasbeen thus far accomplished, much will have been found to be veryabstruse; especially in the Prognostics, Humours, Predictions, onthe Nature of Man, Aliments, the Parts of Man, &c. Yet I ampersuaded, also, that they will give rise, some day, to excellentcomments, by able men, who will develope them by explainingthem in their schools. Many of the remainder, I am far fromthinking deserving of such attention, but that, on the contrary, theywould be improved by being compressed.+ON DISEASES. 257I. Preliminaries. As to the necessary previous knowledge of theorigin of diseases, and why some are chronic, others rapid or acutein character, and mortal or otherwise; destructive to certain parts,or not so; their good or injurious tendency, their issue and otherparticulars; and as to the knowledge requisite properly to prescribefor them.II. Of the causes of diseases, external and internal; their principal differences in respect to danger, duration, &c.III. Of opportunity, or the proper occasion for action, the mostimportant part of medicine.IV. Of incorrect judgment as to the time of action.V. Of errors in judgment as to the nature of the disease, or ofthe appropriate treatment. Continued in VI. and VII.VIII , IX. , X. Of spontaneous circumstances, either good or bad,dependent on nature, or on the physician.XI. No general principle of treatment fitted for all cases; hopesto be excited at times, promptitude of action at others; cautions tobe attended to in our manipulations.XII. Ofinternal suppuration of different parts.XIII. Three cases of pulmonary suppuration; from peripneumony, from pituita falling on the lungs, and from rupture of vessels, or their varicose state.XIV. Of suppuration in the cavity of the pleura, from which thepatient usually recovers, if a discharge by incision or cautery is nottoo long delayed. The causes of empyema are various. Of theinfluence of age, season, temperament, &c. , on these cases.XV. Abdominal suppurations, from bile, pituita , spasm, &c.Encysted tumours are difficult to know, when deep- seated.XVI. Erysipelas of the lungs; its great danger, and metastasis of.XVII. Of tubercles of the lungs; their suppuration; occasionalcure; great danger of, and accompanying diarrhœa.XVIII. Tubercles of the pleura. [Qu.? if not here connectedwith aneurism of vessels.-ED. ]XIX. Pleurisy from inflammation of the intercostal muscles.Continued in XX. [ This seems somewhat connected with hepaticinflammation.-ED. ]XXI. Internal suppuration from external causes, as wounds, &c.XXII. Conclusions on the preceding statements; on sex, age,strength, seasons, &c.17258 THE WORKS OF HIPPOCRATES.XXIII. Of fever: its formation, causes; coldness, chilliness, whythey precede fever.XXIV. Sweats, explanation of; hot and cold sweats, differenceof, & c.XXV. , XXVI. In what manner pleurisy and peripneumonyare formed, &c.XXVII. Of pleurisy and peripneumony, unaccompanied by expectoration; treatment of.XXVIII. Of ardent fever; who attacked by it; internal heat,and cold externally; danger frequently induces pleurisy and peripneumony.XXIX. Of phrenitis, how produced. The blood by some personssupposed to be the principle of the understanding."XXX. Causes of the difference of expectoration , in pleurisy andperipneumony.XXXI. Why death takes place in pleurisy, peripneumony, ardentfever, and phrenitis.2 66 Sanguis, qui inest homini, plurimum ad prudentiam confert; quidam verodicunt, totum."-Haller.ON DISEASES.BOOK II.DE MORBIS,DE MORBIS,TRAITÉ DES MALADIES,FESIUS, Treat. i . p. 461.HALLER, iii. p. 35.GARDEIL, iii. p. 189.HALLER, in his preface to this second book, says that " Whatwas said ofthe first book, is applicable to the second and third, forthey are full of the names of diseases, derived from some peculiarsymptom; the remedies are almost every where the same: rest,vomits, purging, ptisans, and preparations with honey and vinegar,&c. In the second book, however, dietetic co-operation is moreinsisted on; whilst in the third book, medicines are predominant,and those of the most powerful description. The history of diseasesis better, such as of pleurisy, peripneumony, empyema, whosedescription was given in the preceding book. It may be referredto the Gnidian physicians, from the praises of powerful remedies,as well as of the use of verdigris, arum, hellebore, thapsia, andpeplium, to promote expectoration. Galen designates these booksas the large and small."Contents. Many species of diseases are here enumerated, bothgeneral and local; as of the head, brain, nose, ears, eyes, mouth,fauces, heart, lungs, trachea, breast, back, belly, liver, spleen, andlimbs; with their causes, signs, and cure.SEC. I. CHAP. I. Of an overheated temperature of the head,with pituita and bile; as such or such parts are inflamed by thefluxion to them, various symptoms follow; such as copious urine,strangury, loss of sight or hearing, &c. Several other affectionsof the head are enumerated, and their accompanying symptoms.260 THE WORKS OF HIPPOCRATES.CHAP. II. Of diseases of the head; sideratio; caries of the bones;sphacelus, &c.; their causes, symptoms, and prognosis.CHAP. III. Of angina; uva; inflammation, &c. , of the tonsils,and surrounding parts.CHAP. IV. Of diseases arising from fulness of the head, attendedwith torpor; incontinence of urine, strangury; and of their dietetic,pharmaceutic, and surgical treatment.CHAP. V. Of ulcers of the head and legs, and swelled legs; ofheadache, with bilious vomiting and dysury, and of their cure.CHAP. VI. Of hydrocephalus; of coldness, pain and fever inthe head; excitement of vascular action in and about the brain;their causes, signs, and cure.CHAP. VII. Of the rise, causes, symptoms, signs, prognosis, andtreatment of those affected with bile, &c. , or from drunkenness.SEC. II.-CHAP. VIII. Of sideratio cerebri (qu.? oqaxeλos, ev×ɛpaλs); caries of the bones, &c.; causes, symptoms, signs; dietetic ,pharmaceutical, and surgical treatment.CHAP. IX. Of the causes and cure of three kinds of angina.Inhalation for, well described .CHAP. X. Of uva; in which the excision of the lower part of theuvula is ordered; of tonsillitis; of tubercle of the tongue; of inflammation of the palate; and of the treatment.CHAP. XI. Of five kinds of polypus; the pendulous, oblong, soft,fleshy, and callous, which occupy the nostrils; and their treatmentby excision, cautery, & c.CHAP. XII. Of jaundice, with, and without fever; and their treatment.CHAP. XIII. Of the treatment of three kinds of fever arisingfrom bile.CHAP. XIV. Of the treatment of quartan fever.CHAP. XV. Of the signs and treatment of three kinds of pleurisy.CHAP. XVI. Of peripneumony; its origin, symptoms, and cure;of suppuration from peripneumony, and of incision therefor, andevacuation of the pus. Auscultation is here clearly adverted to,and incision ordered for the removal of the pus.a

• In which, as an ultimate resort, the skull is perforated. " Demum inciso juxta

sinciput capite; ad cerebrum usque perforato, et velut sectionem per terebram curato. "-Haller, iii. p. 48.b " Extrema parte præcidito." -Haller, iii . 57.c "Tu vero agitato humero, quonam in latere (affectio) strepitum edat, auscultato,"&c.-Haller, iii . p. 69.ON DISEASES. 261CHAP. XVII. Of consumption from pulmonary affections; signsof, and dangerous symptoms; falling off of the hair, with fetidexpectoration, &c.; its treatment.SEC. III. -CHAP. XVIII. Of consumption ofthe lungs; of ulceration of the trachea; their diagnosis, prognosis, and treatment.CHAP. XIX. Of dorsal phthisis; its rise, causes, signs, and cure;of a disease of the lungs, somewhat differing from common phthisis.CHAP. XX. Of wounded trachea, and pulmonary lesion; convulsive twitching of the fibres of the lungs; their signs, prognosis,and remedies.CHAP. XXI. Of erysipelas of the lungs, its causes, signs, andtreatment.CHAP. XXII. Of the signs and treatment of a dorsal affection,and tubercle of the lungs.CHAP. XXIII. Of engorgement of the lungs, and their lateralgravitation; their signs and cure.CHAP. XXIV. Of tubercle in the side; dropsy of the lungs; rupture of the breast or back; their signs and treatment. Incision between the ribs in dropsy of the lungs is here recommended.CHAP. XXV. Of ardent fever; of fever with singultus; their signsand cure.CHAP. XXVI. Of lethargy; marasmus; of a variety of fever,(called povwons, mortifera; ) their signs and cure.CHAP. XXVII. Of the livid disease; and of one accompaniedwith eructation.CHAP. XXVIII. Of a pituitous disease affecting chiefly women;of leuco-phlegmasia; their signs and cure.CHAP. XXIX. Of melancholy; and of three varieties of (Meλawavoog) black disease; their signs and treatment.Gardeil, in seventy-two paragraphs, gives the following outlineof this second book.I. From excessive heat of the head, the pituita is melted, andconveyed to all parts. This paragraph, and up to x. inclusive, istaken up with concise notices of some diseases of the head, thetreatment of which follows, from xi. to xxxiv.XI. to XIII . Of diseases which arise from the head. Here, saysIn No. vii., we have the caries of the bones of the cranium, which has some analogy with that arising from syphilis. —ED.262 THE WORKS OF HIPPOCRATES.Gardeil, (up to No. xix. , ) the author appears to return to the diseases already mentioned, for the purpose of giving their treatment.At the same time, he adds, the order of the matters, in all the fourbooks, is very difficult to attain, if, in fact, any order has been pursued. It may be remarked, that the use of the cautery is very frequent.XIV. Refers to hydrocephalus, or water on the brain; the strabismus is noticed; and in the last resource an opening of the cranium is recommended, as in trepanning, in order to discharge thefluid.XV. Seems to refer to No. v. The pulsation of the vessels ishere noticed. Some part omitted by Gardeil.XVI. A singular treatment here recommended, for some vertiginous affection, by incision of the forehead near the hair, and sprinkling salt in it, and closing the wound, &c.XVII. to XX. All referring to some of the previous numbers.XXI. , XXII. Refer to sphacelus and caries of the bones of thehead, &c. , in which scraping the bone to the diploe is recommended.XXIV. Quinsy, and its treatment, is here noticed, and continuedin No. xxv. and xxvi. Inhalation is here recommended and described.XXVII. Tumid uvula, (sraquλn, uva. ) Its excision recommended.Long prior to some assumed modern discoverers, passing downthrough the whole train of medical writers from Hippocrates to thepresent period; although apparently unknown to a late professor,or to some contemporaries, who ascribe the discovery of this operation to him.XXVIII. Swelled tonsils; ranula; inflamed, swelled, and suppurated palate.XXIX to XXXIII. Polypi of the nares, five species, and theirtreatment.XXXIV. The chain is here broken. Icterus is treated of in thisand the next paragraph.XXXVI. Bilious fever.XXXVII. , XXXVIII. A variety of fever, approximating to yellow fever."On ouvre le crâne à l'endroit de la fontenelle jusqu'au cerveau, et l'ou soignecomme dans l'operation du trepan," iii. 202.It is not clear to me, that this affection is not allied to some syphilitic taint.—ED.ON DISEASES. 263XXXIX. Quartan fever, treatment; sorbets, large doses of hellebore.XL., XLI., XLII. Pleurisy, varieties of, and treatment.XLIII. to XLVI. Peripneumony; empyema; something like auscultation noticed; fumigating; opening the cavity of the thorax todischarge the pus; the process described.XLVII. , XLVIII. Phthisis; affection of the trachea, leading tophthisis.L. Tabes dorsalis, common to young married people, and libertines. This is rather a seminal weakness.LI., LII. An affection of the lungs, in which fumigation is commended. Ulcerated trachea.LIII. Twitchings or convulsion of the fibres of the lungs, commonly fatal.LIV. Erysipelas of the lungs, chiefly excited by excess in eatingand drinking. It seems to be of a chronic character, and requires achronic treatment.LV. A dorsal affection, with bloody urine, on the third orfourth day; mostly fatal.LVI. Tumours or tubercles of the lungs, to be treated as empyema.LVII. Engorged lungs [ Qu.? peripneumonia notha. —ED.] veryfatal.LVIII. The lungs falling on the pleura, [ Qu.?] It arises sometimes from a wound, or from the operation for empyema; singulartreatment for, by introducing air into the cavity.LIX. Tumour of the pleura; incision recommended, or cautery,and introduce after the tenth day a mixture of warm wine and oil,retaining, and renewing it, &c.LX. Of dropsy of the chest, hydrothorax, slower than empyemain progress. Rupture of the breast or back.LXI. , LXII. Of burning fever (xavows), often ending in peripneumony; fever, with hiccup.LXIII. Of lethargy. [ Not that now so denominated. It seems tobe rather coma, in the latter stage of some disease. -ED. ]LXIV. A disease called avavrn, Gr. , resiccatorius, Fos., of a"Quod si infusum, aut fomentum, aut suffitum adhibeas, pus non sequitur, indequecognoscas, non pus, sed aquam intus esse."-Fœs. Qu.? If this implies a prior incision, and injection, as in empyema? Paracentesis is, at all events, recommended.264 THE WORKS OF HIPPOCRATES.chronic character. [I should think it connected with dyspepsia ormarasmus. -ED. ]LXV. Fever, (povwdns, mortifera,) deadly.LXVI. Morbus lividus. Qu.?LXVII. Disease with much flatulence upwards.LXVIII. Pituitous disease. Qu.? Asthma.LXIX. Leuco-phlegmasia, or anasarca.LXX. Melancholy.LXXI. , LXXII. The morbus niger. Qu.? Of two kinds (Mɛλavavados). The gangrenous disease.ON DISEASES.BOOK III.DE MORBIS,DE MORBIS,TRAITÉ DES MALADIES,• FESIUS, Treat. i. p. 487.HALLER, iii. p. 94.GARDEIL, iii. p. 257.THE following diseases, says Haller, are noticed in this book,viz. tumour of the brain, and its painful repletion, apoplexy (Qu.Banro , Hipp.; sydere icti, Foes. ) , lethargy, ardent fever, tumourof the lungs, headache, phrenitis, angina, jaundice, tetanus, opisthotonos, convolvulus, peripneumonia , pleurisy. Also of the drinks,&c., to be used in ardent fever.CHAP. I. Of tumour of the brain from inflammation; diagnosis,prognosis, and cure.CHAP. II. Of intense headache, from fulness of the brain; itssymptoms and cure.CHAP. III. Of (Qu. apoplexy?) attoniti, Hal. , vel sidere icti; itssigns and cure. In the next chapter, the sideratio cerebri (spaxsλioμosεvxεдeλx, Hipp.,) is considered.CHAP. V. Of the signs and cure of lethargy, and of suppurationfrom . It seems different from ours.CHAP. VI. Of ardent fever; diagnosis, prognosis, and cure.CHAP. VII. Of the lungs enlarging from heat; diagnosis, prognosis, and cure.CHAP. VIII. Acute headache, with aphonia; diagnosis, &c.CHAP. IX. Diagnosis and cure of phrenitis.CHAP. X. Angina, twofold, cynanche, and paracynanche; thesigns and cure of each.CHAP. XI. Of icterus; its signs and treatment.CHAP. XII. Tetanus, opisthotonos; diagnosis, prognosis, and cureof each. In the latter, cold affusions recommended.aIctus, attonitus, apoplecticus, Gr. Lex.266 THE WORKS OF HIPPOCRATES.CHAP. XIII . Volvulus; diagnosis and cure.intestines with a bellows is here recommended.*CHAP. XIV. Peripneumony; diagnosis, &c.Blowing up theCHAP. XV. Pleurisy; humid, bilious, bloody, dry, dorsal; theirdiagnostics, prognostics, pharmaceutic, dietetic, and chirurgicaltreatment, largely laid down. Something like auscultation alludedto; and paracentesis ofthe thorax to discharge the pus when formed.CHAP. XVI. Of a variety of cooling drinks in ardent fever.Gardeil divides this book into forty- six paragraphs; from No. 26of which, to the end, is a large variety of different kinds of drinksfor sick people, especially in fevers, and which he calls " appropriate ptisans."1. Hippocrates tells us, that having heretofore treated of fevers,he now proceeds to other diseases.2. Turgescence of the brain, with headache; here, in the treatment, after shaving the head, cooling applications, confined in abladder, are recommended.3. Headache from plenitude of the brain, accompanied withdelirium.4. Les Frappés, Gard.; sydere icti , Foes.; Bro, Hipp.; [Qu.what is this? Gardeil refers us to sentence xxxi. , chap. xvi. , bookii., Coacæ, where it has connexion with peripneumony. ]5. Sphacelus of the brain-cerebri sideratio, Fosius, p. 488.6. Lethargy. [ Certainly not that now so called, since it isclosely connected with peripneumony. It seems to me merely acomatose symptom in peripneumonia notha. -ED.]7. Of ardent fever. This is said oftentimes to degenerate intoperipneumony. Hot ablutions frequently employed, except to thehead, are recommended.8. Tumour of the lungs, from heat. This appears to be alsoperipneumonic.9. Headache. Refers chiefly to that arising from drunkenness.10. Phrenitis. Gardeil thinks this refers to inflammation of thediaphragm or paraphrenitis; and the symptoms warrant this opinion.—ED.11, 12. Of quinsy or angina, true and false. In the treatment"Folle fabrili indito, in ventrem flatus immittendus, ut tum ventrem , tum intes.tinum contractum distendas. "-Hal. iii. p. 105.ON DISEASES. 267of the latter it is recommended to introduce a tube, to assist respiration.13. Of icterus (morbus regius, Foes. ) It is said to be an acutedisease, which kills in a short time. Doubtful if our commonjaundice.14. Of tetanus.15. Of opisthotonos. Cold water dashed on the patient is amongthe recommendations for this.16. Of volvulus, or the iliac passion. Here, among other recommendations, is that of forcing up wind into the intestines by meansof a bellows.17. Of peripneumony. About the eighteenth day, if the expectoration is sweetish, the lungs are said to be in a state of suppuration,and may continue for a long time.18, 19, 20. Of pleurisy. Of dry pleurisy. Of dorsal pleurisy.21 , 22. Of the examination of the tongue in pleurisy. Pain ofpleurisy worse at night.23. Treatment of pleurisy. [ Bleeding seems but little attendedto, and probably hence, apparently, the frequency of empyema;purging is more commended. -ED. ]24. Suppuration being established, and having passed into thethorax, at a proper period, incision or cautery is recommended;and auscultation is obviously spoken of, to determine the presenceand situation of the pus, which is slowly evacuated for severalsuccessive days.25. The same treatment is recommended in suppuration fromwounds."26 to the end, taken up with an enumeration of formulæ forptisans and drinks.The reader, remarks Gardeil, cannot fail of observing, when reading the works ofHippocrates, how frequently the operation for empyema was performed, doubtless withmore facility and success than now, in the treatment of suppuration in the thorax frominternal causes .-It appears to me ( Ed. ) that the principal cause of this arose from thedread of bleeding in the early stage of disease, lest concoction of the humours shouldbe thereby prevented.ON DISEASES.BOOK IV.DE MORBIS,DE MORBIS,TRAITÉ DES MALADIES,FESIUS, Treat. i. p. 498.HALLER, iii. p. 118.GARDEIL, iii. p. 285.THIS book, says Haller, is very different from the preceding ones,and is replete with acute and ingenious reasoning. The origin ofdisease is deduced from four humours, bile, blood, pituita , andwater, arising from the aliment taken in. If received beyond ajust amount, on the third day, the body is disturbed, and if the excess is not removed, disease ensues. Of the judgment as to diseases.This should be made on the uneven days, in which the humourshould pass out. Other matters are minutely treated of. Towardsthe close, something is said respecting worms, which are discoveredeven in the fœtus; of calculus, from hardened pituitous milk; ofdropsy of the belly, uterus, and the whole body; its origin. Heretoo we find refuted, the descent of drink into the lungs, which inother books, Hippocrates maintains. The author cites the book hehad written on female diseases. (De morbis muliebribus. )1The argument of this book, (divided into two sections and nineteen chapters, by Haller, ) is, that there are four species of humours,bile, pituita, blood, and water; their origin, generation, causes, receptacles, sources, and effects; of food and drinks; of excretions,and their ducts. Fever is considered; the principles of diseases,and their causes; of pains, worms, calculi , and dropsy.SEC. I. CHAP. I. Of the origin of man. The seminal fluid of bothparents is essential to generation, and is derived from every part.ON DISEASES. 269There are four humours in the body, bile, blood, pituita, and water,or atrabilis, which are formed from the food and drinks taken in.Their sources are fivefold , viz., the stomach, the head, the heart,spleen, and gall- bladder. Analogy of plants and births (partium ) .Every part attracts its congenerous humour to itself.CHAP. II. Excess or deficiency of assimilating humour, inducesdisease both in plants and in man. Plants spring up ' and grow,only where they can obtain an appropriate nourishment. All plantswill not indiscriminately grow and flourish in all places. Cultivation has caused these difficulties to cease.CHAP. III. Pituita (pλsyµa), originating from pituitous food anddrinks, is attracted to the head , and if in excess, it induces headache; and if conveyed away by the stomach and bladder, benefitensues.CHAP. IV. Bile is more copiously produced from bilious food anddrinks. It is drawn to the liver from the gall-bladder, and thereretarded, proves the cause of pain. Food and drinks of differentkinds often prove remedial.CHAP. V. Of the more copious flow of water, its causes, seats,affections; from whence pains of the spleen and of the lower partsof the body arise.CHAP. VI. Of blood, its origin, causes, affections. The heart isnot affected with pain from its increased presence; although fromit many diseases of the body arise.CHAP. VII. Four streams are continually supplying the body, asits parts are emptied by a mutual co-operation: numerous vesselsexist in the body;-from whence arise the savour or disagreeableness of food and drinks; appetite and its cessation explained.CHAP. VIII. Bile is secreted from food and drinks, in the gallbladder; and there induces cardiogmus (cordis morsum) , but doesnot produce disease of the heart. The head and spleen are moreliable to disease. When, and how, humours noxious to man, become reduced. Four places from whence the system is purged,viz., the mouth, nose, rectum , and urethra.CHAP. IX. How man preserves his health, by proper attention todiet; this appropriately digested, distributed, and excreted; otherwise sickness ensues, followed by emaciation and weakness, togetherwith repletion, heat, pain, and fever.CHAP. X. When discharges exceed what is received, men growthin. Of the operation of indolence, and activity, on appetite and270 THE WORKS OF HIPPOCRATES.health; the importance of good habits; of fever from repletion, andof the termination of diseases on certain days.CHAP. XI. Why fever terminates; and why fevers and diseases.remit, terminate, or diminish on uneven days; vitiated humours aredisturbed and evacuated, horror ensues, and crises follow.CHAP. XII. Why death ensues on uneven days; the humours aredisturbed, pains ensue; medicine improperly given, often injurious;ulcers become more inflamed; why swelling of the glands arisesfrom ulcers; heat and pain of ulcers, and their influence in the subsequent uneven days, &c.SEC. II. CHAP. XIII. Why men sicken; necessity of purgation;fever from repletion; watery humour is most opposed to fever, buta bilious humour is its pabulum. Why water exhales more readilythan oil; what, and how many, are the principles of disease,-andof their grade of violence.CHAP. XIV. Of the effects of violence, wounds, ulcers, contusion,tumour, pain, fever, disturbed humours. Comparison between milkand blood, and their parts. What effects arise from a disturbance,excess, and evacuation of humours; ofthe aliment of man, and thecauses of putrefaction and death.CHAP. XV. How diseases arise from the air; by the solution,concretion, secretion, mixture, agitation, and situation of a singlehumour, various diseases may arise, such as disturbed bowels,griping, rigor, chill, inflammation, and fever.CHAP. XVI. Of worms; lumbricus latus, and teres; the latterprocreate, the former do not, but break into pieces resemblinggourd-seeds; of their origin, species, diagnosis, and prognosis. Theexistence of worms in children, even in utero, is here asserted.CHAP. XVII. Of calculus; its origin from milk; its causes; fivesigns of; its symptoms; its mode of increase and location.CHAP. XVIII. Drink is conveyed into the stomach, and not intothe lungs; and from the stomach it is conveyed to every part, asshown by eight arguments.CHAP. XIX. Of three species of disease from dropsy or wateryeffusion; their origin, locality, causes, signs, symptoms, and prognostics.Gardeil divides this book into twenty-five paragraphs, to the following effect.1. Of the principles of the composition of the body, and theON DISEASES.271sources of diseases, from four humours,-pituita, blood, bile, andwater.2. Physiological explanation of the origin of the four humours,with a digression, in a parallel between the nutrition of vegetablesand animals; and that from an improper soil, plants cannot alwaysbe naturalized; reference is even made to the difference of contiguous soils, in the culture of the vine.3, 4, 5, 6. The above four humours considered; their sources,&c.; defect of, and superabundance.7. The general theory of diseases, founded on the four humours,being in excess or defect. The intercommunication of vesselsthroughout the body. Four fountains in the body, supplied throughthe agency of the stomach. Importance and utility of the doctrineto dietetics.8. Some principles as to the secretions and excretions. Fourpassages by which the above- mentioned humours are principallyevacuated,-the mouth, nose, anus, and urethra.9, 10. Wherein health consists; regularity, progress of the aliment, &c.; excess or defect in diet, &c.; humours evacuated thethird day; fæcal matters on the second.11. Theory of the diseased state arising from the excess ordefect mentioned.12. The cessation of fever explained; on the third, fifth , seventh ,or ninth day.13. Why fever finishes on uneven days, and of the disturbanceof the humours on such days, by improper treatment. Ancientphysicians are here adverted to.14. Recapitulation.15. Theory of diseases, from superabundance of humours, orfrom defect of excretions; seven signs of.16. Two other sources of disease; external, and violence doneto the body.17. The effects of external things, acting violently; tumours,contusions, fatigues.18. The effects of atmospheric agency; how the humours areaffected; death from disorganization. Health, in what it consists.Engorgement of vessels, &c. , illustrated.19, 20. Coldness in disease, explained; brief recapitulation.21. Of worms. Tænia; formed even in the foetal state; theirgreat length; curious account of their generation, &c.; symptoms;the cucurbitinæ illustrated.272 THE WORKS OF HIPPOCRATES.22. Of calculus of the bladder; of its origin from impure milksucked in early life (see treatise on Nature of Man) , explained; fivesigns of calculus.23. An article respecting the passage of drinks to the lungs,which is here denied, though elsewhere insisted on, and sevenarguments against it. Of the voice and its formation, &c.; theepiglottis, its use.24. Ofthe origin of dropsy. Varieties of ascites.25. Of dropsies in general; of the womb, belly, legs, &c.; dangerof, when acute disease attacks, &c.ON AFFECTIONS."DE AFFECTIONIBUS,DE AFFECTIONIBUS,FESIUS, Treat. ii. p. 516.HALLER, ii. p. 366.TRAITÉ DES AFFECTIONS, GARDEIL, iii. p. 328.In his preface to this treatise, Haller speaks favourably of it, ashaving in it little reasoning, but much good observation. It is, headds, commonly ascribed to Polybius, but this is mere conjecture.The arguments are of a mixed character, a fault, by the by, common to the Hippocratic authors. It begins with some histories ofdiseases, which differ from those in the books " De Morbis."Scarcely does the author notice any remedies, but he refers to abook now lost, wεps papμaxwv. The conclusion relates to things appertaining to diet; and what is here given differs from that whichappears in the books " De Dieta, " and seems to me very useful,especially in what relates to the qualities and powers of aliment.Some short and by no means absurd things are stated as to thereason of causes. Man is stated to consist of four humours, -blood,pituita, bile, and melancholy or black bile.The argument of this book, divided into two sections and sixteenchapters, is, that it consists of many diseases of different parts;fevers, ulcers; their causes, signs, and treatment; of food, both forthe sick and convalescent; and an explanation of the powers anddifferences of several kinds of aliment.SEC. I. CHAP. I. Of what is requisite to be known in consultingThis treatise seems a kind of brief ofthe preceding, and of the nature ofa treatiseon Domestic Medicine for general use.-ED.18274 THE WORKS OF HIPPOCRATES.for the treatment of diseases. The beginning and source of alldiseases are bile and pituita; elucidation of.CHAP. II . Of diseases arising from pituita of the head; pains ofhead and ears; inflammation of the fauces and uvula; toothache,polypus, and the cure of these.CHAP. III . Of acute diseases of the belly; most violent in winter.Of pleurisy, peripneumony, ardent fever, phrenitis, with others of alighter description, but becoming acute in winter; their changes,causes, signs, and cure.CHAP. IV. Of summer complaints; pains, fevers, ardent fevers,tertian, quartan; their symptoms, causes, signs, crises, and cure.CHAP. V. Of white pituita, with large, hard, and suppuratedspleen; their causes, conversion to dropsy, symptoms, and cure.CHAP. VI. Of volvulus, dropsy; their causes, prognosis, and cure;surgical treatment of dropsy; inflating the intestines in volvulus. *CHAP. VII. Of dysentery, lientery, diarrhoea, tenesmus, cholera;their causes, signs, and treatment.SEC. II. CHAP. VIII. Of strangury, sciatica, arthritis, podagra;causes, signs, and cure; flax.CHAP. IX. Of icterus and tubercles (puuara); their causes andcure; of some unsightly affections; lepra, prurigo, itch, impetigo,vitiligo, alopecia, favo, panis, furunculus, and carbuncle.CHAP. X. Of what the physician must inquire, when visiting hispatient; and of the proper remedies in wounds, both dietetic andpharmaceutic .CHAP. XI. The food proper in health, is to be changed in sickness; drinks are chiefly to be employed, (sorbitiones, ptisana, &c.)What food and drinks loosen or bind the belly, and renew thestrength; what kinds are proper when purgatives are given; infever, which foods moisten, or dry the body.CHAP. XII. Treatment of convalescents. In disease, attentionrequisite as to what dries or moistens. Articles desired by the sickto be allowed if not injurious; food is to be slowly added or abstracted; more solid food to be given as convalescence advances,and liquids to be diminished. Aliments and medicines, that area “ Quod si clysterem non admittat, fistula propendulo utriculi petiolo alligata et inflata, multus flatus immittendus; quumque intestinum et venter a flatu elevata fuerint,exempta fistula, statim clyster injiciendus. " —Haller, ii . p. 379.b Used as moxa. "Ustio autem per linum crudum fiat. "-Haller, ii. 385.ON AFFECTIONS. 275employed in practice, should be well understood; and which areappropriate in debility.CHAP. XIII. How to appreciate the powers of different food;which are light, which heavy. What food and drinks most conducive to health, and strength of body; which cause acid eructations, tormina, and flatulence; which promote evacuation by stoolor urine.CHAP. XIV. Of the proper and improper use of food and drinks;of such as are drying, moistening, strengthening, &c .; of weakand strong, light and heavy food; and of the diversity of bread,flesh, and fish.CHAP. XV. Of baths; of some pot-herbs, as to their hot, cold,moist, and dry powers; and exciting the urine, stools, and menses;of astringent, stomachic, drying, and attenuating herbs.CHAP. XVI. Of the various grains and wines; of strong andweak food; the bread most proper in disease; vomition from foodor drink; apples and nuts after food; what wine is useful in obviating the ill effects of food and drinks; why the belly is disordered ,bound, or loosened; what food is weakening; when food is to begiven to febrile patients; when wine and honey are most appropriate; food adapted to health is more powerful in sickness.This treatise, says Gardeil, is merely an abridged domesticmedicine, the conclusion of which is particularly devoted to regimen, both in health and sickness. As it treats only of diseasesgenerally known, practitioners will there find the means of recognising those that are elsewhere spoken of under numerous differentdenominations. He divides it into sixty-four paragraphs.I. Of the importance of domestic medicine, and the means ofattaining a knowledge of it.II. to XIII. Of diseases of the head, ear, throat, gums, palate,teeth; of nasal polypi; of diseases of the trunk of the body;pleurisy, peripneumony, phrenitis, ardent fever; ( in x. is defined themeaning ofjudicatus, as applied to diseases, and in xi. a treatise onpharmacy is referred to , which seems to be lost;) change of thetwo last to peripneumony..276 THE WORKS OF HIPPOCRATES.XIV. These four diseases are called acute; great care requiredin acute diseases; the slightest fault is hazardous; febrile diseasesof winter, their treatment.XV. Of fevers in the summer.XVI. General remarks on fever and their treatment.XVII. , XVIII. Evidence of presence of bile. Of pains in thebelly, and erratic throughout.XIX. General remarks on summer diseases.XX. , XXI. Of tertians and quartans.XXI. bis. Leucophlegmasia.XXII. Enlarged spleen.XXIII. Iliac passion.XXIV. Edematous affections.XXV. Dysentery.XXVI. Lientery.XXVII. Chronic diarrhoea.XXVIII. Tenesmus.XXIX. Cholera morbus.XXX. Strangury.XXXI. Sciatica. Flax used as moxa.XXXII. Gout.XXXIII. Icterus.1XXXIV. Of regimen in the preceding diseases. Cautions as toremedies.XXXV. Of tumours.XXXVI. Cutaneous affections, &c.XXXVII. Purgatives, not indifferent remedies; opiates.XXXVIII. Precepts for conduct, previous to prescribing for thesick.XXXIX. How to act in case of wounds.XL. Of the nourishment of the sick.XLI. Substitution of oil and wine as frictions, for baths.XLII. Regimen in certain cases.XLII. bis. Of the means of attaining a knowledge of the mostexpedient remedies.XLIII. Of the preparation and quality of food. Of good andbad digestion.XLIV. Of drinks, & c .XLV. Of a drying regimen.XLVI. Effects of bread and cakes.QN AFFECTIONS. 277XLVII. to LV. Of wines and various foods, & c.LVI. Influence of soils on, & c.LVII. General observations on regimen continued, and use ofvomits in its improper employment.LXII. Rules for diet in intermittents.LXIII. Of wine and honey.LXIV. Of the necessary modification of regimen on account ofthe state of disease.OF INTERNAL AFFECTION S.DE INTERNIS AFFECTIONIBUS,DE INTERNIS ADFECTIONIBUS,TRAITÉ DES AFFECTIONS INTERNES,FOSIUS, Treat. iii. p. 531.HALLER, ii . p. 401.GARDEIL, iii. p. 365.THIS treatise, says Haller, is among the most confused, manifestly consisting of the Gnidian sentences; for diseases are heresubdivided ad infinitum, and species constituted from a solitarycase. Thus a nomenclature of diseases sprung up, distinguishedby no connexion of characteristic symptoms; such as the greatvarieties of morbus crassus, of typhus, nephritis, hepatitis, and splenitis. In scarcely any of these, are the diseases to be distinguishedby the accompanying symptoms; what credit can be given to oneof the varieties of the morbus crassus (4th pachysmus, Hal. ) , inwhich the patients were injured by the smell arising from rain falling on the earth? The extreme violence of the Gnidian remediesis offensive, such as the grana gnidia, succus hypophæs, and lapismagnesiæ. The hellebore here mentioned, purges up and down.Many symptoms of diseases differ from those mentioned in otherHippocratic books, with the exception of tetanus, whose description and treatment agree with the third book, " De Morbis.”Drinks, moreover, are here stated to pass into the lungs.The argument of this book is stated by Haller as pointing outthe internal diseases of different parts, as of the windpipe, the vessels, heart, lungs, back, breast, side, spinal marrow, kidneys, of thevessels of the right and left side, of the abdomen, intestines, joints,skin, and of the whole body, together with their causes, signs, andcure.SEC. I. CHAP. I. Of ulcerated or wounded windpipe, or of anyof the vessels of the lungs, their causes, signs, prediction, cure, andprecautions in convalescence.OF INTERNAL AFFECTIONS. 279CHAP. II. Of rupture of the pulmonary arteries or veins; symptoms, signs, and cure.CHAP. III. Of suppuration of the chest, and ruptured lungs.CHAP. IV. Of the causes, signs, and treatment, of pneumonicaffection.CHAP. V. Of varix of the lungs, its causes, signs, and treatment.CHAP. VI. Of sanguineous or bilious repletion of the lungs.CHAP. VII. Of the causes, signs, and treatment, of inflammationofthe lungs.CHAP. VIII. Of erysipelas of the lungs, its signs, and treatment.CHAP. IX. Of rupture of the breast and back, its causes, signs,and treatment.CHAP. X. Of tubercle of the side, its signs, and cure.CHAP. XI., XII. , XIII. , XIV. Of four species of consumption;from a defluxion of pituita from the head, upon the lungs; fromspitting of blood; from a ruptured vessel from labour; and from adefluxion on the spinal marrow; their signs and cure. The fourth,from dryness of the spinal marrow, owing to an obstruction of thevessels going to the spine, or of the passage from the brain to thespine, or from venery; its signs, and treatment.CHAP. XV. , XVI. , XVII. , XVIII. Of four affections of the kidneys, viz.:-1 . Calculus of those glands. 2. Of diseases arisingfrom violent labour, inducing rupture of the vessels and suppuration, in which an incision at the lumbar region is recommended;which, if unsuccessful, the complaint terminates in tabes renalis. 3.Of ulcer of the kidneys. 4. Arises from obstruction, and fromvenery, ending in suppuration; some singular advice as to exercisein this complaint; origin, signs, cure, &c.CHAP. XIX. Of a violent disease of the venæ cavæ, succeedingnephritis; its causes, signs, and cure.CHAP. XX. Of another of a like nature.SEC. II. CHAP. XXI. , XXII. Of several species of pituita , viz.:common or recent, of the white, chronic, or leucophlegmaticpituita.CHAP. XXIII. Of dropsy from cacochymia, or a thin pituita.CHAP. XXIV. Of dropsy of the lungs or thorax from drinkingcopiously of water, or from a rupture of tubercles; operation for;auscultation apparently adverted to.280 THE WORKS OF HIPPOCRATES.CHAP. XXV. Of dropsy, subsequent to an oedematous phlegmonof the liver; signs, &c.; surgical treatment.CHAP. XXVI. Of dropsy, arising from watery effusion from theliver into the belly; its treatment.CHAP. XXVII. Of inflammation of the spleen, and subsequentdropsy; its causes, signs, and treatment.CHAP. XXVIII. Of universal dropsy, arising from drinking stagnant water in long journeys, &c.CHAP. XXIX. Of hepatitis, and scirrhous inflammation of theliver; its causes, signs, and treatment.CHAP. XXX. Of hepatic erysipelas, or erysipelatous phlegmon;causes, &c.CHAP. XXXI. Of hepatic affection, with metastasis to the brain;causes, &c.CHAP. XXXII. to XXXVI. , inclusive. Of various affections ofthe spleen, phlegmonous, erysipelatous, scirrhous, plethoric, andpituitous; their symptoms, signs, and treatment.CHAP. XXXVII. to XL., inclusive. Of jaundice, from bile in summer; and in winter, from drink and cold, as well as bile; of epidemicjaundice, from obstruction induced by over- eating and drinking; andof jaundice from pituita; their origin, signs, and treatment.SEC. III. CHAP. XLI. to XLV. , inclusive. -Of five different sortsof typhus; from bile; superfluous moisture; putrid bile mixed withthe blood, and falling on the joints; from superfluous moisture fromthe use of fruit and cakes, and from a putrid moisture of the bodygenerated from black bile; their causes, signs, and cure.CHAP. XLVI. , XLVII. , XLVIII. Of three varieties of ileus; theircauses, various signs, distinction, and cure.CHAP. XLIX to LII. , inclusive. (De pachysmo, Hal.; Morbicrassi, Foes.; Grossissement, Gardeil.; Taxus, Hipp.) Of enlargements of the belly, legs, &c. , from a defluxion or collection ofpituita and bile. [Qu.? If these are not connected with rickets, &c . ,as mention is made of incurvation of the spine. It is in Chap. lii . ,that the influence of the odour of the earth from rain is mentioned.Some ofthe symptoms resemble those of chlorosis; it would be difficult to say what they are.-ED.]CHAP. LIII. Of sciatica, four kinds of; ankylosis from, & c.CHAP. LIV., LV., LVI. Tetanus, opisthotonos, from wounds,cold, or other causes; wine copiously recommended in the first.OF INTERNAL AFFECTIONS. 281The preceding treatise (4th De Morbis), says Gardeil, is a choicepiece of hygiene. The present one, which is similar in manythings to the three last books of the treatise on diseases, gives us apathology and therapeusis of various diseases, in which more precision is desirable. Many details of curative proceedings are to befound, which might be usefully employed at the present time.Gardeil divides this treatise under the following paragraphs.-ED.I. Of affections of the breast caused by violence.II. Of rupture or lesions in the chest; milk diet.III. Of consumption (pulmonic) , tubercles, suppuration.IV. Varices of lungs.V. Ofblack bile in the lungs.VI. Of inflammation of the lungs, from excess in drink, &c.;vomiting in; its chronic state, &c .VII. Of erysipelas of the lungs from congestion.VIII. Of (déchirures, Gardeil; pectus et dorsum dirupta, Fœsius,)irritation of the back or breast from great fatigue; cure of, anddanger of relapse.IX. to XIII. Of tumours and suppuration of the pleura; of four²species of phthisis; the first, from pituita, its treatment and rarerecovery from; the second, caused by great fatigue, is less hazardous, but very fatal. The third , from the spinal marrow becomingfilled with blood; exercise in, at a certain period, from one to sixleagues a- day; receipt for a drink of various roots and flowers;fumigations. The fourth, or dorsal phthisis, from a drying of thespinal marrow, chiefly caused by excess of venery. Immensequantity of asses' milk employed in, mixed with honey, nine pounds;or fourteen pounds of cow or goat milk, (tres semicongios,) continued daily for forty-five days.InXIV. to XVII. Of four affections of the kidneys. In the first,sand sometimes is seen, leading the physician to imagine a stone inthe bladder, when it is in the kidneys. A laxative of two gallonsof weak broth; nephrotomy recommended in certain cases.the second variety, from excessive fatigue, followed by rupture ofthe small veins going to the kidneys, causing blood to be passedwith the urine, and subsequently pus, in which case nephrotomy isalso recommended. Hippocrates remarks that many considered• Hippocrates says three species.282 THE WORKS OF HIPPOCRATES.this last stage as nephritic phthisis. The third species, producedfrom black bile passing to the kidneys, and remaining, it laceratesthe small vessels and substance of the gland; it is rarely cured,but becomes chronic. The fourth is the product of pituita and bile,and also arises from venery. Here again, if suppuration ensues,the pus is to be discharged by incision on the most prominent part;its treatment by regimen and exercise.XVIII. , XIX. Of a great disease of the vena cavæ? Whatevermay be intended by this, Gardeil is inclined to consider it a diseaseno longer known. In its treatment the actual cautery is freely advised, viz. , three near the joint of the femur and pelvis; two belowthe trochanter; two at the middle of the thigh; one below the knee,and one above the ankle, besides four on the right shoulder. Thesame treatment is recommended, when the left vein is affected.XX. Some speculations as to pituita and bile, with the treatmentof the symptoms arising from those humours, and the mode of inducing vomiting in cases of an excess of recent pituita.XXI. Of leucophlegmasia; cupping on the lumbar region; opening the scrotal veins.XXII. Of anasarca following the above.XXIII. Of hydrothorax, from drinking water profusely in sumfrom tubercles. Tubercles very common in oxen, dogs, andsheep, as evinced by dissection; still more so in man; treatmentby paracentesis above the third false rib, by incision, and trocar,draining off the water for twelve days.XXIV. , XXV. Of dropsy of the liver, and of the spleen; this lastis ascribed to eating too freely of fresh figs or apples, &c.XXVI. Dropsy (anasarca) from the use of bad water in longjourneys; among other remedies, the same water is prescribed inthe treatment. A very free use of nitre (Qu.? ) as a glyster, isordered, viz. , 3x., with other articles.XXVII. , XXVIII. , XXIX. Of hepatitis, three varieties noticed;in one, glysters of asses' milk to four and a half pounds, or of mare'smilk; all these varieties said to be very dangerous, most of thepatients dying on the fourth day.XXX. to XXXIV. Of five species of affections of the spleen, allvery similar, both in causes, symptoms, and treatment. Sawingwood for thirty days is one of the remedial means. One of these(second) varieties, Gardeil thinks very analogous to scurvy.XXXV. to XXXVIII. Of four species of jaundice. Little varietyOF INTERNAL AFFECTIONS. 283is here found; cantharides used internally, infused in wine. Onevariety of jaundice is called epidemic (siduos, quod omni temporeprehendat, Faesius).XXXIX. to XLIII. Of typhus; five kinds noticed, which Gardeilthinks we would rather call inflammatory fever. It is surprising whatquantity of drink is ordered. In one of these, the prescription is tenpounds of goat's milk whey with salt in one vessel, and ten withhoney, in another, which is to be all drank by glassfuls, alternately,apparently in one day. A number of remarkable symptoms mentioned in a species of typhus; among them is that of a particularinclination to the odour of extinguished lamps, &c.XLIV. to XLVI. Of three varieties of iliac passion.XLVII. to L. Of enlargements; (Qu.? Grossissement, &c.)What these are is problematical; four kinds are mentioned; in one,the smell of the earth when it rains, is said to induce syncope.LI. to LVI. Of sciatica; four varieties; frequent moving to prevent ankylosis.LVII. to the end. Of three species of tetanus, in which epilepsyand hysteria seem implicated.OF DISEASES OF VIRGINS.DE HIS QUE AD VIRGINES SPECTANT,DE VIRGINUM MORBIS,DES AFFECTIONS DES FILLES,FESIUS, Treat. iv. p. 462,HALLER, iii. p. 409.GARDEIL, iv. p. 5.It ascribes menstrua- THIS treatise, says Haller, is a short one.tion to plethora, which is to be treated by venesection, or bycoition. This book is quoted by the author of the books on femalediseases, and he would seem to be the author of this also.After contending for the difficulty of knowing the nature of diseases, without certain preliminary attainments, and mentioningseveral, as epilepsy, apoplexy, &c . , and their not unfrequent ascription to demons, the author proceeds to state the sufferings offemales approximating to maturity, and who had not previouslybeen affected, as arising from the arrestation of the menstrual flow.The symptoms attending this state of things are detailed, and thehysteric feelings thence arising, together with the inadequate anddeceptive recommendations of the priests. It is added, that venesection is to be employed, if not contra-indicated, and that marriage as early as possible is to be adopted, for if pregnancy ensues,health follows. Barren women are most afflicted with these complaints.Gardeil thinks it probable, that what we possess of this shorttreatise, is merely a fragment, for the author of the treatise onfemale complaints quotes this, as having therein already mentionedthings, which we do not here find. The doctrine of this treatise,and of those of the nature of woman, and of the diseases of women,OF DISEASES OF VIRGINS. 2853he adds, is found abridged in the Predictions, and in the treatise,66 Des Lieux dans l'Homme."I. General remarks on the difficulty of knowing diseases, especially of some that are more peculiar to women than men.II. An explanation of the derangements of health which femalesexperience at the age of puberty; hysteria, melancholia, mania,&c.; the cure consists principally in sexual intercourse.OF THE NATURE OF WOMAN.DE NATURA MULIEBRI,DE NATURA MULIEBRI,DE LA NATURE DE LA FEMME,FESIUS, Treat. v. p. 563.HALLER, iii . p. 331.GARDEIL, iv. p. 9.HALLER says this treatise is nearly the same with the booksentitled " De Morbis Muliebribus." Numerous diseases are statedin the Gnidian manner. A detail of an infinite number of cases ofchange of situation of the os uteri, its obliquity and induration ,&c.; as in the second of the books referred to. The farrago ofremedies, from the three kingdoms of nature, is not at all diminished.It is divided into three sections by Haller, but not into chapters.In reading this treatise, it will be seen, says Gardeil, that itmight be remodelled with great advantage, and reduced at leastone-third. Had its author revised it, undoubtedly he would haveerased the many repetitions of the same cases, that are spreadthroughout. He would likewise have located it after the treatiseof the diseases of females, of which it is a mere abridgment, augmented with some formula of remedies, of little importance. Gardeil makes no less than one hundred and seventy- five paragraphs.I. Some general remarks as to what constitutes that dispositionin females which renders them liable to certain complaints that arepeculiarly their own.Here the author commences, by stating, that, as to what appertains to the nature of women and their diseases, he thinks, in thefirst place, that all human affairs are in the hands of the Deity;and, secondly, that such and such circumstances contribute to theirparticular ills; and, therefore, that in discussing this subject, it isessential, primarily, to look up to heaven, and then to study theOF THE NATURE OF WOMAN. 287subordinate causes, such as the temperaments and the ages ofwomen, the seasons, and the places in which they reside.II. Treats of the moisture of females, and of its influence onmenstruation, in diminishing or suppressing the discharge. Thesymptoms ensuing are noticed, and the treatment pointed out;among the remedies is a pessary of cantharides, or into which itenters.III. Here, and in several following paragraphs, are noticed thecases in which the uterus is presumed to move its situation.1. Where it rises towards the liver; a state said to be morecommon in virgins in advanced life, or in young widows. Thetreatment is given, and a recommendation of marriage for virgins.2. When the uterus descends, and appears externally, which is notuncommon after delivery, if the sexual intercourse is too muchpermitted. In the cure, this, therefore, as well as bathing, is strictlyprohibited. 3. In case of complete external descent or prolapsus,which is said to occur from coition after lying- in, and during thedischarge of the lochiæ; various measures are mentioned for itsreduction and retention. If unsuccessful in replacing it, it is recommended to employ " la sacade de l'échelle la téte en bas,” p.14. A large (dry) cupping-glass (dxuny) to the upper part of thethigh is also commended.VI. In case of adhesions between the uterus and other parts, indurations, suppuration of the womb, and ulcers, sometimes arise,or discharges which prove fatal if not attended to; fomentations ofurine are among the measures recommended. The usual effect ofthis state is said to be sterility.VII. In case of the mouth of the uterus doubling or being inverted on itself, the menses are impeded; here, we find fomentations of the urine of a man commended. This is also stated as acause of sterility.VIII. When the uterus falls upon the ischium, menstruation isimpeded; here we have a drink recommended, formed with dif"Et si quidem sic intro redierint, satis est, sin minus, summis uteris derasis etcalefactis, ablutis et illitis, alligataque ad scalam muliere, scalam ad caput concutito,et manu uteros intro trudito, postea ejus cruribus alternatim simul colligatis, sic per diem et noctem sinito, et paucum ptisana succum frigidum, nihilque aliud exhibeto."See, also, treatises " De Articulis, " " De Morbis Mulierum, " and " De l'Extrait duFetus Mort. "288 THE WORKS OF HIPPOCRATES.ferent articles, among them are four cantharides, from which thefeet, the wings, and the head are removed.IX. Ifthe lochia do not flow after delivery, after other measures,tar-water is ordered as a drink, (forestalling Bishop Berkeley , )and copious unction of the mouth of the uterus.X. When fluor albus occurs (menses albi pituitosi) , the treatmentvaries, as there is, or is not, accompanying sharpness and excoriation; in the latter case the fluxion is from the head, in the formerfrom the stomach.XI. Inflammation of the womb; its symptoms, sometimes similating pregnancy, and followed by dropsy.XII. Erysipelas of the uterus, its symptoms, &c.; these resemblein a great degree those accompanying the milk-leg. When occurring in pregnancy, it is said to be fatal, and at all times difficult ofcure.XIII. Too great dilatation of the os uteri, its symptoms, &c.; itis said to be fatal.XIV. The womb retiring towards the middle of the loins; here,syncope is mentioned among the symptoms, in which state it isdirected to introduce into the uterus a tube, through which to inflateit. Sterility and lameness are said to result.XV. Fluor albus; resembling the urine of an ass; among othermeans, the use of asses' milk for forty days is ordered, with somesingular directions in its employment.XVI. , XVII . Of cases in which the female is subject to abortion;means of obviating.XVIII. Of difficult menstruation, symptoms and treatment;among which the pessary containing cantharides is employed, andalso the drink with cantharides.XIX. Of abortion at the end of the first or second month; onecase of which is said to depend on the pressure of an enlargedomentum on the womb.XX. Induration of the orifice of the uterus, and its displacement.XXI. Incapacity to conception; singular process previous topurging, in order to ascertain whether the patient is bilious orpituitous.XXII. Total suppression; a too humid state of the os uteri, andtreatment of.XXIII. Falling of the uterus on the ischium (see viii. ); a different treatment.OF THE NATURE OF WOMAN. 289XXIV. Pressure or suffocation ( vywo ) of the womb; probablyhysteria, as fetids are profusely ordered.XXV. to XXX. inclusive. Of apprehended inflammation of thewomb at delivery; of debility of the uterus; of apprehended cancer,&c. In one of the cases (resembling viii. and xxiii. ) , we aredirected to employ a large suppository of sulphur, bitumen, andhoney; a pessary of the same is also ordered.Here follow, from XXXI. to LXXIII. , a vast assortment of pessaries and other remedies, appropriate to female complaints. Adrink, having in its composition five cantharides; a pessary of cantharides and elder juice; an infusion of the root of the croton;pessaries to excite a discharge of blood , formed of five cantharidesand other articles; others with large amount of elaterium; sectionsof the squill, &c. In short, pessaries of every presumed character,emollient, astringent, &c.LXXIV. to LXXXV. are taken up with the statement of lotions,fumigations, and fomentations of various kinds, including someointments for various intentions.LXXXVI. to CI. Here the author returns to the consideration ofcases already noticed, and gives others of analogous character.Dropsy of the uterus, its causes and treatment, in which the introduction of a tin sound (specillum stanneum, speculum uteri? ) ismentioned. Induration of the womb, its neck and orifice; displacement of the uterus; -a milk diet largely used for forty days.Entire closure of the os uteri, in which again the sound is recommended; obliquity of the os uteri; inflated uterus; grumous andclotted blood in the womb, for which, among other means, something to scrape out the clots is recommended; frequent change ofits situation;-a pomegranate filled with pitch softened with wine,is here employed as a pessary; a too great enlargement of theos uteri; a softened state of the womb; its tending towards thebelly, or the head, or when it acts upon the legs and feet, or frompain, induces loss of appetite, &c.: in all these cases irregular menstruation exists, and inability to conception.CII. , CIII. The author here adverts to several evils subsequentto delivery, as diarrhoea, vomiting of blood; in this last, asses'milk for five days, and to be succeeded by that of a black cow,fasting, for forty days.CIV. Retardation of the menses; -of purgation of the uterus.CVI. Constipation from the uterus tending towards the anus;19290 THE WORKS OF HIPPOCRATES.inflammation or ulceration of its mouth; retention of the afterbirth; inflamed uterus, &c.; the catamenia not appearing at theirregular period; excoriation of the pudenda; difficulty of makingwater; choking or difficulty of breathing; chills subsequent to delivery or abortion; flatulence; fetor, and carnosities of the pudenda, ulcers and pruritus;-all these, and more, are noticed, andremedies pointed out for them.CXIX. Inaptitude to conception, from not menstruating naturally; either from the obstruction of a membrane, [ supposed to be amodern discovery! ] or other cause, discoverable by the finger.CXX. to CXLV. Abridgment in a great measure of the preceding numbers, at least as to the measures prescribed.CXLVI. Various recommendations when the woman loses hermilk.CXLVII. Directions as to the measures to promote conception.CXLIX. A medicine employed as a pessary, to ascertain if conception will ensue. Various other means are scattered through thisbook, as to this and other particulars relating to conception, andperhaps equal to those now in vogue among nurses and other oldwomen of both sexes. Fomentations, cataplasms, fumigations, &c. ,all connected with the female and her uterine affections, follow inrapid succession, -some of a character of great violence, and requiring much courage or hardihood in their prescription; thus, thirtygrains of the cucumis agrestis, with other active ingredients, madeup and applied to the os uteri five times daily, as a pessary; thatformed with cantharides, is repeatedly mentioned as an emmenagogue pessary;-some are singular enough, such as fumigationswith two pounds of bull's urine, with other articles. It would seemthat almost every substance employed as a medicine, internally, isalso here to be found in some or other form of pessary.OF FEMALE DISEASES.DE MULIERUM MORBIS,DE MULIERUM MORBIS,DES MALADIES DES FEMMES,BOOK I.FOSIUS, Treat. vi. p. 588.HALLER, iii. p. 161.GARDEIL, iv. p. 79.THIS book, says Haller, is the production of an unknown author,not of Hippocrates, although he transiently quotes from the treatise"De Natura Pueri," in which this book is in like manner referredto. It contains an infinitely too great a farrago of remedies, andthey of too compound a character. The very face of the book seemsto stamp it as of a date less ancient. It is plentifully stocked withfemale diseases, even more so than any of later date. They areon the subject of suppressed, diminished, or vitiated catamenia; ofmoles, abortion, difficult parturition, suppressed lochia, inflammation of the womb, and barrenness. The most acrid remedies areusually prescribed, such as drastic purges, suppositories and pessaries; and numerous vegetable and fossil remedies mentioned inthe other writings of Hippocrates, to which virtues are ascribed,often differing from those that are commonly attributed to them.He mentions the rapdevia, or matricaria. Some things are added,which appear to be of the same author, referring chiefly to the diseases of infants, and of the eyes, and enemata. This is one of themost extensive of the Hippocratic books. Haller divides it intofour sections."The author of this book, (says Gardeil, ) is certainly the samewith that of the treatise we possess, under the title of ' The Natureof the Child,' to which it refers more than once. Besides otherfaults to be found herein, and which are similar in doctrine to thosein the treatise ' Of the Nature of Woman,' we find here many tiresome repetitions and endless distinctions of the different diseasedstates of the uterus and its neck. This multiplication of diseasesfundamentally the same, has led to the opinion that this work, as292 THE WORKS OF HIPPOCRATES.well as that On the Nature of Woman, were productions of theGnidian school. I think, nevertheless, that we here find many veryinteresting passages; and that both this and the preceding treatisemay be advantageously read, by noticing that the ancient physicians, in the cure of most of those diseases here referred to , depended on the use of external remedies, which are now no longerdistinguished. I can, however, affirm , that I have seen effects fromthem that appeared almost miraculous. " He divides it under twohundred and three numbers, the outline of which is here given.I. The author set soff with his opinion , that with respect tofemale diseases, if they have never been pregnant, the derangedstate of menstruation is more common and more dangerous thanwhen they have borne children. His reasons for this, if not satisfactory, are at least as much so as any of present notoriety. Here,he adds, that he had explained all this, in the treatise ' De NaturaPueri," ( Epi Quois Tadio ) . It consists chiefly in the general enlargement of the vessels of all the body, but especially of those of theuterus, during gestation, &c., which renders the menstrual discharge a more ready exit, after delivery, and which is not the casewith those who have never borne children. The catamenia consequently are more readily intercepted. This is illustrated by somecurious analogies, and an explanation is given, why the same plenitude of the vessels is not found in the male sex , although a monthlypurgation does not occur.II. The author next proceeds to mention the inconveniences anddiseases most common to females, who not being pregnant are deprived of menstruation, from the closure of the os uteri, or its beingin any way displaced from its natural position, or from any displacement of the parts of generation; which state of things he attempts to elucidate. If after three months the menses appear, andthus relieve the plethora, the symptoms are mitigated; but if not,very soon ensue fever, shivering, lumbar pains, &c. , all which augment, if they do not still appear, and especially at the period atwhich they might be expected; although, after that period, they(the symptoms) sometimes diminish. Other symptoms follow afterthe fourth month of non-appearance. If properly treated, healthfollows. If the menses still are absent, the evil augments, and afterthe sixth month the cure is very difficult. All the symptoms increase, and others supervene.III. From these more general symptoms, the author passes toOF FEMALE DISEASES-BOOK I. 293the different affections of the uterus, arising from defective menstruation. The elevation of the womb towards the stomach, andits agitation in the abdomen, is accompanied by numerous distressing symptoms, and death sometimes ensues. A suppression of eventwo months causes sometimes a determination to the lungs, andinduces a fatal phthisis. Suppurations are sometimes the result oftwo or three months' retention of the menses, which, if care benot taken, may terminate in ulceration of a bad character and ofdifficult removal, and discharging by the groin a fetid pus; deathgenerally follows; at all events perpetual barrenness. Sometimesthe catamenia flow by such an inguinal suppuration but thedanger is not diminished.VI. Sometimes the menses are vicariously discharged by vomitingor stool; more commonly is this the case with virgins than withmarried women, as he had stated in the treatise " De Morbis Virginum."VII. Ofthe suppression of the menses in general and of its treatment, by vomiting and purging, and by remedies at intervals to evacuate the uterus. Should these not succeed , there may be reason tosuspect pregnancy, from the symptoms if present, which are enumerated. The menses sometimes suddenly appear abundantly at the endof three months, in clots of black blood, resembling flesh; sometimesulcers of the uterus ensue, requiring much attention. Other circumstances are mentioned also; should the menses be suspended forsix months, the symptoms are in due degree; and if neglected tothe eighth month, death is often the result. Sometimes the mensesare for a long time pituitous, and small in amount; but if wellattended to, the patient may recover perfect health. The diminution of the discharge is next considered, arising from a deflexion ofthe os uteri from its proper position, or from its bending on itself,preventing the full discharge; the symptoms are narrated, and itsdangers stated; being less in those who have borne children.X. Of menstruation, when too abundant or too frequent, andwhy? relaxation of uterus; too frequent coitus; high living; -theinfluence of these on the female. If disease attacks under thesecircumstances, it readily falls on the weakened part; the symptomssucceeding thereto, and ultimate danger.XI. The menstrual blood is thicker, redder, and flows morecopiously about the middle period of the discharge than either atits commencement or termination. Its amount in health, about294 THE WORKS OF HIPPOCRATES.twenty ounces in two or three days (duarum atticarum heminarummensuram, Fœs. ) , the usual period; although great diversity existsin this respect, depending on the constitution of the individual. Theblood which is discharged, is red like that of victims ( pe ), and itcoagulates promptly, ifthe woman is in health, &c.XII. When sudden suffocations affect the female, which moreespecially occur from non- cohabitation, and at a more advancedage, (Qu. hysteric paroxysms?) from the uterine vessels being deficient in their contents; and after uncommon fatigue, the uterusbeing too dry, tends towards the liver, the consequences of whichare detailed by the author.XIII. When in a diseased state, the menses are of a bilious character; they have a black and shining appearance, in small amount,and coagulate freely; and are accompanied with an erratic fever,with chills, nausea, and heartburn. These symptoms are readilyremoved by proper attention; otherwise they are much augmented,and others supervene, which are benefited by bilious vomiting orstool, or by the discharge of bilious catamenia, provided none ofthese are too abundant, which would be dangerous.XV. If the menses are pituitous, they are of a whitish appearance, and exhibit a membranous or web- like character. This stateof things is enlarged upon by the author, and their perniciouseffects, if not attended to. The discharge is said to become atlength of so acrid a nature as to act on the earth like vinegar.XVI. The author here treats of the different causes of a defectof conception, and of the mode of distinguishing the species ofvitiation of the menstrual discharge, some of which are very singular. He then mentions the mode of cure of pituitous menstruation, by which sterility is removed; viz., by means of generalfumigations, frequent vomits, and other measures, such as pessaries,as preparatory to coition. A hollow leaden tube introduced into.the os uteri, is a means recommended to convey the fumigation tothe uterus, just anterior to receiving the embraces of her husband;and much detail is given of the subsequent attention of the female.to insure success. The measures for a like intent, when sterilityarises from a dryness of the womb, is next adverted to, such asemollient injections, both per anum et vaginam. In both the cases,coitus, pendente menstruatione is advised.a These uterine discharges appear to have been closely examined by the physician,equally as those by the other emunctories! and why should this not be the case?-ED.OF FEMALE DISEASES BOOK I. 295XIX. The author next considers sterility, as arising from debility of the female, either from deficient nutriment, or from an abuseof the numerous remedies and fumigations employed, or from a badsituation of the orifice or neck of the uterus, &c. , all which areparticularly treated of. In the case of the os uteri being stronglyclosed, bougies and leaden sounds are recommended to open it;and when the direction of the uterus is wrong, after redressing it bythe finger, and using aromatic fumigations, it is to be maintained inits place by the bougies and sound above-mentioned. Pessaries ofvarious kinds are recommended in those cases of inaptitude to conceive, which arise from the orifice of the uterus being very fat andthick. And the case of sterility arising from the semen remainingand putrefying in the uterus, with the means of obviating it, arethen considered, together with the causes productive of this state.In this place, the author states conception to be more certain, whenthe semen of both the man and woman reach the womb at the sametime, the non-occurrence of which he considers as a frequent causeof failure.XXI. He here treats of non- conception, although still at a properage and having previously borne children. The menses being suppressed, a pessary is ordered every three or four days, of alum inpowder, mixed with ointment, which is incorporated with wool,and is to be retained for three days, when it is replaced by one ofox-gall and oil, on wool as above, and also retained for three days,previous to coition. Sometimes, when conception does not occur,although menstruation is regular, the author states it as arisingfrom a membrane, whose extension from the uterus may be discovered by the finger; when a pessary of flores cupri (avdos xaλxx)incorporated with honey, is ordered to be introduced as far as possible, or, if possible, to remove the whole by incision. He indicatescertain cases of abortion, either from the inner coat of the uterusbeing too smooth, either naturally or from ulceration, causing theplacenta to adhere less strongly. In this case an examination isrecommended, which, he adds, should be done by a woman, asbeing more decent than by the physician. Other cases of abortionare also adverted to, from too much eating or drinking, &c.XXV. The author now adverts to the diseases accompanyingpregnancy and delivery: the sudden occurrence of menstruation atthe period of two or three months, and recurring every month; itsdanger to the mother and child; and he adds, that in certain cases,296 THE WORKS OF HIPPOCRATES.much care and precaution are required to conduct pregnancy to ahappy termination.XXVI. The author, then, in reference to the fœtus, considers itas unquestionable, that it participates in the ill or good state ofhealth of the mother, and that its constitution is in conformitythereto. The state also of the lochial discharges depends thereon,and are less abundant and unhealthy. When they are suppressed,he says death commonly ensues on the thirty-first day. When thebreasts and belly of the pregnant female, about the seventh oreighth month, suddenly subside; the former shrinking and the milknot appearing, the embryo is either dead, or in a state of great debility. The appearance of the menses during pregnancy, is asource of apprehension of abortion; should they be abundant, andof an ill odour, the child is certainly sick. This is followed by observations on pituitous and aqueous lochia; the characteristic symptoms are detailed, and their results, together with the treatment;and further remarks are made respecting the hysteric paroxysmsat times occurring during pregnancy.XXXVI. At the time of parturition, and labour pains come on,continuing long, without delivery; this arises, we are told, from anunnatural position, in which the feet presentation is included, andits explanation is a most singular one. It is, says our author, asif an olive had fallen into a narrow-necked bottle, &c. The caseis dangerous, and both mother and child have frequently lost theirlives . In speaking of the various inconveniences of pregnancy, anexplanation is attempted of the extraordinary diseased appetitesthat often occur in it, and of the frequent respiration, especially atthe latter period of gestation; notice is taken of the ailments afterdelivery, as flatus (which is stated as filling the wornb), lumbarpain, and oppression, &c. Some of the dangerous results of delivery are also mentioned, such as excessive flooding, injury done tothe uterus, bladder, or rectum, so that the urine and fæces cannotbe retained; and some trivial recommendations follow for the same,and also for aiding delivery. A reference is next made to tumours,during or after delivery, of the uterus or the pudenda, in which,says the author, we must not employ astringents, like many medicalmen, but rather use internal remedies, a host of which are mentioned. In excoriation of the pudenda, a very good ointment ofwell-triturated almonds and marrow is recommended.XLVI. He goes on now to consider the discharges and resultsOF FEMALE DISEASES-BOOK I. 297from delivery; the causes, symptoms, and treatment, under theirtotal arrestation; or if too small, or too abundant in amount; andof their character and the danger respectively. Some ofthe symptoms enumerated seem to be in a degree allied to the milk- leg,and puerperal fever, arising from an insufficient lochial discharge.The treatment consists at first of light nutriment and of purgativedrinks, under some circumstances of irritation; of chologogues ifbile predominates, or phlegmagogues should pituita prevail. Thisis all well enough; but we are then told to fumigate the uterus witharomatics, and employ fomentations, and if the uterus continueshard, then to use, in addition, lotions, and introduce a sound ( fistulaplumbea) of lead, and afterwards a pessary of salt and myrrh withpitch, on wool, of the size of a gall-nut! to be left for twenty- fourhours; after three days, other varieties of pessary are employed, ofa powerful nature , such as grains of Gnidos and pepper, of cucumissylvestris, &c. A digression then follows as to cases of difficultmenstruation, in which pessaries are abundantly used, and tarwater is to be largely drank. Ulceration and inflammation of thewomb succeed, and their danger is pointed out; and if by themeasures adopted , the lochia do not flow, death soon follows, unlessbleeding is promptly recurred to. The treatment of suppressedlochia from a union of the parts by injury sustained in delivery,is next considered; and in a case which the author himself saw;by an appropriate attention, health was restored, and the woman.subsequently bore children. Unless great care is bestowed, thereis danger ofthe ulceration becoming cancerous.LVII. Ametastasis of the lochia to the head, the breast, and lungsis noticed, and its danger, should a diversion not take place, by adischarge from the mouth or nose;-a long duration of the diseasesometimes produces delirium, passing even to mania. Some othercases are adverted to,-as vomiting of blood, &c . , ascribed to arupture of an hepatic vessel, and regarded as dangerous. Asses'milk is ordered for five or seven days, succeeded by that of a blackcow, and the interdiction of solid food for forty days.LX. In case of losing the milk, in order to restore it, variousmeasures are directed; —and the author proceeds to state the measures to be adopted for discharging the afterbirth, if retained;which, if successful, the woman is saved. It frequently putrefiesand is discharged on the seventh or eighth day, or later; a varietyof articles is enumerated to promote it, -and an attempt is made to298 THE WORKS OF HIPPOCRATES.explain the cause of its retention; -a slight notice is also given ofthe fœtus dying in utero, at an early period of gestation.LXV. The repeated recurrence to circumstances already noticed, renders the whole of this treatise extremely tiresome, although something of interest is to be found in the mass of rubbish.Again, he refers to injury sustained in delivery, by the womb or itsorifice; of its inflammation subsequently, and of afterpains; of pituita oppressing the uterus, and giving rise to fluor albus, and derangement of menstruation, sometimes recurring three times in amonth. Under circumstances of excoriation of the parts, amongother prescriptions, we find an ointment made with flores argenti[Qu.? αργυρω ανθος] .LXXII. When the cotyledons (xoruλndovss, Hipp.; acetabula uteri ,Fos. , Hal.; les cornes de la matrice, Gard. ), are surcharged withpituita, the menses are diminished, and if pregnancy should ensue,the foetus will not live, even if vigorous at first. The signs andtreatment of this are then stated; as are likewise those of dropsyof the uterus. This disease is sometimes of long continuance, andif pregnancy take place, abortion will ensue, with a discharge ofwater. Various baths, fomentations, and pessaries, are here directed; cantharides among them, and the metallic sound, &c . Dropsy,from a moist and enlarged spleen, is next considered and an explanation attempted; the fluids are carried to that viscus, and fromthence by the vessels to the omentum and other viscera, &c. Themenses are at times copious, at others in small amount, and irregular, resembling the washings of flesh, sometimes thicker, and notcoagulating. A suspicion of pregnancy, and even a presumed motion ofthe fœtus, is at times credited. It is troublesome, dangerous,and of long duration , and more common with those who have notborne children, and at an advanced life, when menstruation is about.to terminate. The misapprehension of the female is highly injurious, since the physician is not informed in time of the state ofthings. Modesty sometimes, or a want of confidence, prevents hisbeing informed, even when known to the female. The physician issometimes deceived also, from not being fully informed of the stateof affairs, in consequence of the female being herself ignorantof the cause, but ascribing it to other sources; and he, not fully investigating the disease, frequently loses the patient, as the authorsays he had often seen. It is absolutely necessary, therefore,OF FEMALE DISEASES-BOOK I. 299promptly and fully to question the patient, in order to attain thenecessary information.LXXV. The author renews the subject of suppuration of thewomb; states the symptoms and treatment; its occurrence fromabortion, and from acrid and bilious menstruation; fumigations,purging, milk diet, followed by a tonic regimen of animal food,&c., with particular restrictions. Some physicians, it is stated ,order milk when the headache is severe, with a view to its removal; but he thinks water is better in this case, and milk in thatof acrimony. Lotions to the womb are now directed, of differentkinds, and ointments; among which is again mentioned that formed of flowers of silver ( argenti flores) , and a variety of other ingredients. A vast number of remedies follow; but it is a fatal andslow disease, from which few escape. Wounds of the uterus, andulcers from any cause, are then adverted to, and with much particularity and repetition of what had been previously given. Woundsarising from abortion, or from acrid pessaries, or from a bad presentation, are specified; and the management to be pursued, whendelivery is prevented by the enlarged state of the fœtus, or from across presentation , the treatment is very minutely laid down. Sternutatories are ordered; and in order to render their effects morepowerful, the nostrils and mouth are closed,-the woman is to bewell shaken, and the very extraordinary process is detailed, resembling greatly that described in the treatise on the joints andelsewhere:-The woman is to be fixed on a solid firm bed, on herback, by a bandage across the breast, under the arms, and attachedto the bed; the arms are also secured; and the legs, separated,are tied at the ankles. The bed is then to be raised vertically, andapparently to be shaken against the floor, or rather, against twolarge pieces of wood that are placed below the legs of the bedstead,and thus support it in its upright position. The bedstead, with thewoman attached, is then raised from these pieces by two men, oneon each side, and allowed to fall upon them equably when the painscome on; this is done at intervals, until the child is born. Suchis the mode, says the author, of inducing the birth of the child, in anatural presentation, the parts being previously well anointed, andbathed with decoction of mallows or foenugrec, and frequently renewing them during labour. Nothing more is to be done, exceptthat it seems the accoucheur was busy in gently enlarging the passages with emollients, and attending to the navel-string. When the300 THE WORKS OF HIPPOCRATES.presentation is crosswise, whether alive or dead, the infant is to bepushed back, to endeavour to turn it, and give it a natural headpresentation. In order to accomplish this, the woman is placed soas to raise her thighs above the head, by which the intention is facilitated, when the woman is replaced as before, and delivery is pursued in the usual way. It would appear that a foot presentationwas regarded as very unfavourable, and placed on a footing withthat of the arm . When, says the author, the feet or arms present,they should be immediately returned, and the presentation of thehead should be facilitated by turning the fœtus;-so likewise inother cases of unnatural presentation, previously placing the woman over a bath of hot water, in order to relax the parts. If thefœtus be already dead, and a foot or arm presents, a similar turningshould be adopted. If this is not to be effected , and the female partsbecome tumefied, the head is to be opened by a bistoury, and crushed, the bones brought away, and the delivery completed by the forceps or hook; the application of all which is described. When thedelivery has advanced to the shoulders and there arrested, the armsare to be detached at the shoulder joints. If the trunk is impeded,the thorax is opened and the ribs crushed, carefully avoiding thebelly, to prevent the intestines and their contents from escaping;which yet, if however too enlarged , may be slightly opened, allowing any flatus to escape, and no further difficulty will ensue. -Theauthor now proceeds to consider the cause of the formation ofmoles, and their signs. In this state the woman will continue sometimes for two or three years, and it occasionally induces deathfrom its magnitude, or from an excessive hemorrhage. The magnitude of the belly and want of motion are means of recognition,for a male fœtus moves at three months, and a female at four; afterwhich period, should the woman feel no motion, and the milk notappear, the case is plain, and it requires great care and attention;this consists in fumigations, glysters, lotions to the uterus, pessariesofthe most powerful character, various vinous drinks, cups appliedto the loins, and letting them bleed copiously. In fine, says our author, we must act carefully according to circumstances.LXXXV. A brief recapitulation respecting the state of pregnancy, and its accompanying diseases, not devoid of interest,ensues, and may be said to terminate the treatise; for the residueconsists almost entirely of a long enumeration of the remediesemployed in the treatment of female diseases, and the formula oftOF FEMALE DISEASES-BOOK I. 301the prescriptions, &c.; thus they are such as are intended to induceor restrain menstruation, as pessaries, purgatives, &c. , and arechiefly repetitions of those before given. Among the articles arecantharides and the rubigo or rust of wheat. Others for promotingconception. Among these are fumigation, with at least ten pints ofstale urine, into which, when heated, scoria of iron heated red hotare thrown, and after the fumigation, the head is to be bathed withit, and then washed; this is repeated for seven days;-fumigationslikewise of the hair of a white ass, and the dung of a wolf. Uterineinjections of the milk of a female the nurse of a boy, mixed withthe juice of pomegranate, and the calcined powder of the perineumof the sea-tortoise. A pessary formed of the chorion, and of theheads of worms that breed in flesh, with Egyptian alum, all bruisedtogether with goose-grease. Others, as drinks, to accelerate delivery; to prevent conception; and pessaries to enlarge the os uteri.Among the means to promote the lochia, we find the recent liverof the sea-tortoise , triturated with the milk of a woman, and oil ofiris and wine, to be injected into the uterus. Remedies to expelthe afterbirth, containing cantharides. To ascertain if pregnancyhas taken place, a boiled clove of garlic is placed in the vagina foran hour, and the breath is then examined to ascertain if the odouris perceived in the mouth. Erugo or verdigris is also recommended, with honey and liquor of Smyrna [qu.?] as a drink to discharge the fœtus and the uterine immundities. For a similar purpose a pessary of fine flax is employed, sprinkled with copperdust (æris limatum scobem). Among the injections ordered, it ismentioned that they should be eighteen ounces at most, and that isthe extent of quantity in all injections. Many other singular prescriptions and directions are given, which it would be loss of timeto repeat. The above samples may suffice; but it must bementioned, that at the close of this first book, are given an additional variety of prescriptions (called by Fosius notha quædam), ofabout an equal description, and of which I shall notice only two orthree. They are supposed by some to be of great antiquity, andevince the use of emetics in the coughs of children. The innerpart of an onion triturated with honey is recommended as a gooda Qu . Ifthis can have any reference to our secale cornutum?b Syrmæa, Hal. et Fœs.302 THE WORKS OF HIPPOCRATES.suppository to open the bowels of children. Others are noticed fora like intention, in one of which cinnabar forms a part. Variousescharotics are given, containing scoriæ of copper or brass calcined, of different strength; remedies for burns and for ophthalmia; various plasters; depilatories, &c. When it is wished merelyto promote the discharge of fæces, it is useless to take internal purgatives; other means should be pursued; different forms of glystersare given for dysentery.OF FEMALE DISEASES.BOOK II.DE MULIERUM MORBIS,DE MULIERUM MORBIS,• FESIUS, Treat. vi . p. 637.HALLER, iii. p. 252.DES MALADIES DES FEMMES, GARDEIL, iv. p. 201 .THIS treatise, according to Haller, may be ascribed to the writerof the preceding, for it is of the same character throughout, withmuch repetition, and in many places with scarcely any alteration.In conformity with the Gnidian doctrines, we find a great varietyof fluor albus, of white and ropy discharges, uterine flatus, ulcers,callosities, cancer, hysteric affections, prolapsus uteri, and a closureof its orifice, inducing sterility. It treats of the diseases of thebreasts and of the vagina, of freckles, toothache, and of several notpeculiar to females. Many extraordinary cures are here mentioned, very different from our present views. The uterus is regarded as connected with almost every viscus; and a bridle orcolumella is described as growing in the uterus, which is orderedto be cut off.Persons of advanced life are more subject than the young, to thefluor albus; in both, the discharge is usually yellowish, but redderwith the last. The causes and symptoms are enumerated, someof which are singular, and some cases are said to terminate indeath. In the treatment, among a variety of means, both pharmaceutic and dietetic , it is directed to bandage the hands and forearm to above the elbows, and the legs to above the knees; cupsare then applied to the elevated breasts alternately, but not to drawExuns, Hipp,; cucurbitula, Fos., Hal.—It is remarkable that Gardeil, here, p. 203,translates this word, by sangsues, leeches, which were not employed in the days ofHippocrates; yet every where else, where the word is used, he properly has translatedit Ventouses or cups. Aliquando dormitat.304 THE WORKS OF HIPPOCRATES.blood. Emetics in some cases are directed; and in all, it is directedto attend carefully to the temperament of the female, her complexion and age, to the season of the year, the situation in which.she lives, and the direction of the wind, on which much depends inthe cure.In floodings, grumous clots usually accompany. The symptomsof pain in the back and hips, fever, and tenderness of hypogastricregion, &c . , are noticed, and the vessels are said to beat strongly.Pessaries are almost invariably ordered, differing according to circumstances; and cold applications to the belly, guarding against chills.In the copious flooding after delivery, from something retained, whichirritates and putrefies, the continual application of cloths with coldwater is directed, the elevation of the feet above the head, and suchmedicines as are appropriate to female diseases, are given, in formof drink; other means are pursued , as milk diet, &c. The dangerof death is great, however, and few recover.A species of flooding is ascribed to the efforts in delivery, or toany severe work, by which injury is sustained in the uterine attachments; and is distinguished from a menstrual discharge or rathermenorrhage, as so considered by some physicians, and the difference pointed out. To notice the variety of the discharges mentioned, so far exceeding what are now looked for, would be superfluous, particularly since the whole book appears to consist chieflyof the same materials as are to be found in the preceding, and differing therefrom only as we might expect from two individualsepitomising one common treatise. All these variously describeddischarges are, however, noticed as different diseases, and asrequiring different treatment. We have a yellow discharge, offetid odour, abundant, and resembling rotten eggs; another, whichresembles the urine of a female ass, or sheep, &c. , wherein cows'milk is given warm fromthe animal for forty days, to aid convalescence, in amount of nearly two quarts per day. In one of thedischarges, reference is made to feeling the pulse at the wrist. Thecausticity of some of them is assimilated to brine, explainingthereby the erosion of the soft parts adjoining. The varied attacks.of hysteric paroxysms are described as different affections, andattributed to the displacement of the uterus. Fumigations, baths,and pessaries, seem the chief means of cure; and the best pessaryin some cases, is said to be that made with cantharides. A soundor bougie of lead is employed to enlarge the os uteri , sometimes asOF FEMALE DISEASES-BOOK II. 305•preparing the female for more ready conception; for pregnancy isconsidered in many cases as advantageous, and hence virgins areto be recommended to marry.The peripatetic character of theuterus is constantly insisted on. It seems, like the owners of thatorgan, to have been always gadding! No wonder it was continually out of sorts! Its diseases are, however, ascribed at timesto affections of the general system, and remedies to purify the bloodare recommended; among these the long-continued use of cows'milk is greatly urged. This displacement of the uterus or its orifice, is stated as an obstacle to menstruation, followed by sterility;the appropriate treatment in each case respectively, is laid downwith precision, especially that of the manipulations, by pessaries,sounds, and fumigations. Tar- water, fasting, and again on comingout of the bath, with many particulars directed as to eating anddrinking. The chief remedy for all these diseases, seems to be,however, considered that of pregnancy. Cantharides infused inwine, as a drink, or used in pessaries, &c. , are frequent prescriptions. Dry cupping, long continued, to different parts, the thighs,below the breasts, in the groin, &c. Falling down of the womb,and its full procidentia, are noticed, and their treatment detailed .Its inflammation, scirrhosity, induration, and vitiated orifice arealso mentioned, and how to meet the different symptoms. Erysipelas, dropsy, and some other complaints of the organ, are finallynoticed, and a profusion of prescriptions for pessaries, &c. , closethe treatise.Tar-water, or some infusion of the pine, seems to have been no uncommon drink,thus forestalling the Bishop of Cloyne.20DE STERILIBUS,DE STERILIBUS,ON BARRENNESS.FESIUS, Treat. vii. p. 675HALLER, iii. p. 383.TRAITÉ DES FEMMES STÉRILES, GARDEIL, iv. p. 295.MUCH of this treatise on sterility seems to be transcribed verbatimfrom the books " De Morbis Muliebribus." Some few noveltiesand singularities are introduced, and some unimportant experimentsrelating to the certainty of conception.The treatise consists of an attempt to explain why sterility issometimes absolute; and occasionally is removed by the power ofmedicine. Five different causes are assigned. The os uteriwrongly situated, and firmly closed; the lubricity of the uteruspreventing the retention of the seed; ulceration of the body of theuterus, consequent to some of the diseases that have been mentioned; retention of the menses partially, productive of effects opposed to conception; and too great laxity of the orifice of theuterus, precluding the retention of the seed . All these causes areconsidered and explained; and the writer then proceeds to state,that when menstruation is altogether defective, or not sufficientlyabundant, conception cannot ensue. That superabundant menstruation is equally unpropitious; as is a prolapsus of the uterus;and a metastasis of the menses to the hemorrhoidal vessels. Untilthe causes producing these effects are remedied, conception is impossible, and as they are so numerous, the sterile state of so manyfemales is by no means surprising.To these succeed an account of the means by which may beascertained, whether a female will become pregnant. Means ofascertaining the state of actual pregnancy, and of what sex is theembryo. Approved means for procuring conception, and of theremedies to be used in the cases of sterility noticed in the beginning. Circumstances favourable to conception and the preservationofthe germ. Among the means prescribed for remedying sterility,one consists of fumigating (after some previous measures) theON BARRENNESS. 307uterus for two days, with putrid female urine mixed with nitre , andsubstituting that of the cow on the third day; after some furthermeasures, the os uteri is to be opened by means of five leadensounds, of eight fingers' breadth long, and each successively largerthan the preceding, to be introduced after bathing, beginning withthe smallest, each being retained one day. After the mouth ofthe uterus is hereby enlarged, a pessary is passed up to cleanse it,made of five cantharides, powdered, and mixed with other ingredients, and incorporated by means of honey, with wool! In onecase the cause is affirmed to be a membrane that occasionally formsat the mouth of the uterus. Its treatment by a pessary containingrust of copper is mentioned. In a form of the disease stated, weare told that if we think proper, we can use in fumigation , the rustof wheat, and the tar-water daily; and towards the conclusion,when speaking of the complete protrusion of the uterus, when othermentioned means have failed, the bottom of the uterus is to beincised, to disgorge its vessels; and after bathing it with decoctionof the pine, the woman is to be suspended, head downwards, and tobe shaken, whilst the uterus is pushed back!DE VISU,ON VISION.FESIUS, Treat. ii . p. 688.DE VISU,TRAITÉ DE LA VUE,HALLER, iii. p. 447.GARDEIL, iv. p. 327.HALLER tells us that this treatise has been altogether rejected byMercurialis, and thrown into his fourth class or division. It is,however, considered as by no means an ill- written one. Gardeileven affirms that it ought to be attentively read by every oculistwho feels an attachment to his profession. It is very concise, andrecommends many acrid and severe applications in diseases of theeyes. Ofthese, cauterization constitutes the chief means.Cataract is first noticed; -neither extraction, nor depression ofthe lens, seem to have been then practised. Early attention to evacuate the head, and cauterize the vessels, is said to arrest and checkthe progress ofthe disease. Near- sighted people are mentioned;-this state would appear to have been considered as morbid, andcauterization, &c . , are recommended; bleeding is said to be injurious in it, and in some other affections. The treatment seems tohave been deferred until full growth was attained, when cauterizingin different places was freely pursued, and scarification of the lids.The principal object, in most cases, seems to have been to evacuateor purge the head; and, in some instances, some of the flesh of thelids appears to have been cut away, and then slightly cauterizing, —carefully guarding the cartilage and the roots of the eyelashes.Itching of the lids, nyctalopia , gutta serena, and ophthalmia, areall mentioned, and some singular treatment recommended, thatmay possibly have been found beneficial. Thus in gutta serena,we are told to trepan near the fontanelle, to remove water that isbelow it, &c. Some useful remarks in ophthalmic cases are given.SECTION VI."ON THE SHOP OR OFFICE OF THE PHYSICIAN.DE OFFICINA MEDICI, SEU DE OFFICIO MEDICI,DE OFFICINA CHIRURGI,TRAITÉ DU LABORATOIRE DU CHIRURGIEN,FESIUS, Treat. i . p. 740.HALLER, i. p. 449.GARDEIL, i. p. 284.FESIUS has a sufficiently interesting preface to the section nowto be considered; but it is not adapted to my plan, independently ofits extent. Of the ten treatises here noticed in the arrangement ofFœsius, five are esteemed to be genuine by Haller. Other commentators and translators have thought differently, and have separated them in conformity to their views, and arranged them elsewhere. The subject is briefly adverted to, in a preliminary addressto the reader, by a friend of Haller, in the first volume of his translation. Be they or not the offspring of Hippocrates, there is not onefrom which we cannot gain information, and at the same time enjoy both the " utile and the dulce. ” —ED.Although, says Haller, Galen doubted if this were of the genuinewritings of Hippocrates; yet that it is so, is easily detected by itsraciness (ex ipso sapore). Brief, profound, and even in the less.important parts, not less informed attention is bestowed on theminutest concerns, and precepts given as to the best situation forthe surgeon or physician, and mode of standing or sitting in hisoperations, &c. The subject of bandages is by no means uninteresting, and is pretty copiously treated of. Gardeil, speaking ofthe title ofthis treatise, says it has undergone alterations among theancients, and been the object of dispute to the learned. I have,aThis section, entitled by Fasius espoupgovμeva, or that part of medicine calledChirurgia or Surgery, consists of ten treatises.310 THE WORKS OF HIPPOCRATES.adds he, given in French, the name that seemed to me to be bestadapted to the matters treated of, as well as to the Latin transla- 'tions, by which it is quoted, de Officina Chirurgi. His title is " DuLaboratoire du Chirurgien." Le Clerc thinks that the term is inappropriate, inasmuch as surgery did not then constitute a distinctbranch of medicine, and that the term Inrgov implies " La Boutiquedu Médecin," and not " du Chirurgien;" the title of surgery appearing no where in the writings of Hippocrates, although the artconstituted a large part of his medical practice.The treatise sets off by stating that the means of instruction inevery case, are dependent on the senses, by which we are enabledto form comparisons, and from them deduce our judgments. Inrelation to the objects of the physician in his shop, they are enunciated under the heads of the patient, the operator, assistants, situation for the operation, instruments, light, as best adapted to performit, and other necessary appurtenances; all which are briefly considered, as well as some particulars respecting the hands, nails, andthe regular placing of the instruments as they may be called for,the silence and attention requisite, and other circumstances. Thisis followed by the subject of bandages, the making, form , and application; compresses, &c. , and their various intentions explained;the natural situation of injured parts by extension, flexion, &c.; theattention constantly required to keep up the full advantages thatproper bandaging affords, and obviate the injury that negligencebrings with it; with many hints and suggestions of a useful nature,not irrelevant even at the present time.ON FRACTURES.HIPPOCRATIS DE FRACTIS LIBER,HIPPOCRATIS LIBER DE FRACTURIS,TRAITÉ DES FRACTURES, ·FESIUS, Treat. ii.HALLER, i . 282.GARDEIL, i. p. 298.p. 750.AN admirable production of a wise and experienced man, (saysHaller,) and worthy of Hippocrates. He correctly explains thefractures of the humerus, femur, tibia, and forearm, and the luxations of the tibia, and forearm . He teaches lucidly their chirurgical administration, together with the statement of the dueprecautions, apparatus, and precepts. He properly directs the extension of fractured and luxated bones, to be performed on the firstor second day, and not to be delayed to the third. Throughout heappeals to his own experience.This book, although entitled " De Fracturis, " is at least equallytaken up with the subject of luxations, as the succeeding one onluxations embraces much on the subject of fractures. So much isthis the case, that Haller considers it as merely a continuation ofthe present. The author begins this with some general preceptson the subject of both these accidents, and then follows more indetail, on the fracture of the bones of the hand, in which heseverely animadverts on the ignorance of some reputed able practitioners;-on that of the forearm, wherein much stress is laid onthe proper application of bandages, &c. , and which is highly deserving of attention. Fracture of the humerus succeeds, then luxation of the bones of the feet; of the leg at the ankle joint; fracturesof the bones of the leg, and the difference of treatment in these,from the fractures of the upper extremities; of fractured femur.Fracture with wounds, considered, as well as luxations; spicule offractured bones;-all these minutely described, and the treatment,312 THE WORKS OF HIPPOCRATES.both by others and himself. Extension, if not previously made, isto be sedulously avoided the third and fourth day; and reasonsassigned. Luxation of the knee and elbow; reduction of; fractureof radius, of cubitus, & c.This treatise could scarcely be read without benefit, even bysurgeons of the present day. It would at least convince them,that their science was, practically, not less perfectly comprehendedthan it now is!-ED.ON THE JOINTS.DE ARTICULIS LIBER,DE ARTICULIS LIBER,TRAITÉ DES ARTICLES,FESIUS, Treat. iii. p. 780.HALLER, i. 326.GARDEIL, i . p. 353.THIS treatise, considered by most commentators and translators,as being a manifest continuation of the preceding one, " De Fracturis," embraces those fractures and luxations that are not thereinmentioned, such as fracture of the ribs, scapula, clavicle, nose, ear,&c. , and luxation of the vertebræ, maxilla, femur, &c. It is of equalvalue as the preceding, and equally deserves attention.Fourvarious luxations of the femur are accurately detailed by Hippocrates, together with the appropriate manipulation and treatmentof each in the reduction; and which can scarcely fail, in the perusal,to throw light upon the subject, even at this more advanced period.Luxation ofthe head ofthe humerus begins the treatise, of whichthe author says, he had seen but one mode, and that downwards,in the axilla; and he gives his reasons for believing that some ofthe varieties mentioned by physicians, were not as stated, but thaterror existed on their part. He points out and explains no less thansix modes of reducing this luxation, and affords some reflections onthe causes of the facility or difficulty in the operation; mentionsthe diagnostics of the injury, and states the mode of applying theactual cautery in some cases, and to what parts, together with theresults of such luxations. Luxation of the humeral extremity ofthe clavicle, fracture of the clavicle, and treatment of each. Luxation of the elbow, complete and imperfect, and their respectivetreatment. Ofthe fingers, hand, the lower jaw, and fracture of thelatter. Fracture of the nose, crash, or fracture of the external ear;treatment of all these, with some general maxims of importance inmany diseases, tending to illustrate the propriety of not doing toomuch. Luxation of the spine or its processes; deformity from; observation on, relative to situation , causes, and treatment. Of thestructure of the spine and luxation of the vertebræ; curvature of314 THE WORKS OF HIPPOCRATES.the spine and treatment; danger from; incurable if it is inward.Fracture of the ribs, and treatment; luxation of the head of thefemur in four ways, each particularly considered in their symptomsand treatment, accompanied with many judicious remarks as to theatrophy and deformity of parts caused thereby. Luxation of thefemur at the knee joint, with accompanying observations on thesymptoms, &c. General remarks on luxations, and on bandy legs;treatment of, in children, and of club- foot. Luxations with laceration, and projection of the bone; danger from, and treatment ofvarious cases of; gangrene from. Of the reduction of the differentkinds of luxation of the femur, and the machinery described forextension, & c. , and for that of other luxations.ON THE REDUCTION OF FRACTURES ANDLUXATIONS.MOCHLICUS, SEU VECTIARIUS,MOCHLICUS, ·FESIUS, Treat. iv. p. 841HALLER, i . p. 408.LE MOCHLIQUE, GARDEIL, ii . p. 5.HALLER calls this a brief, yet not inelegant compound of the twopreceding books; or, as Gardeil states it, a recapitulation of thosetreatises, of a summary character, for such as would not chargetheir memory with all that they contain. Such being the case, afew outlines will suffice.Moxa, is defined to be " ossis aut ossium a loco qui præter-naturam sit, ad naturalem reductio. " It is derived from μoxλos, vectis;or the apparatus, &c. , by which the reduction was effected.It begins with a brief description of most of the bones. This isfollowed by the statement of the fractures and luxations of the different bones, nearly in the order as we find them in the precedingbooks; terminating with some general remarks on reduction, onsome of the machinery employed, and on some incidental particulars, in a greater or less degree connected with the subject.ON ULCERS.LIBER DE ULCERIBUS,DE ULCERIBUS LIBER,TRAITÉ DES PLAIES,FESIUS, Treat. iv. p. 869.HALLER, iv. p. 101.GARDEIL, iv. p. 332.FROM the number and variety of remedies herein mentioned, thiswould appear not to be one of the genuine productions of Hippocrates. It does not add the doses, as in the books De Muliebribus.Sundry admonitions are given against the abuse of oleaginous andrelaxing applications about the ulcerated parts. The remediesthemselves are sufficiently adapted to the nature of things. Arsenic,black hellebore, and cantharides are amongst them. Some plantsare briefly described. This book, according to Gardeil, is oftenquoted in surgical books.Some general remarks commence this book, which are of muchimportance as to certain applications, rest, &c. A principalintention is to prevent inflammation, and promote suppuration;to permit fresh wounds to bleed freely, and avoid greasy applications, except in certain particular cases. Purging; bandaging,when proper; seasons, which are best for ulcers; of measures forpromoting cicatrization; treatment of round and deep ulcers, andof ulcers accompanied by erysipelas. Signs of suppuration, andof difficult cicatrization. Some recommendations to accelerate it.A variety of formulæ, simple and compound, follows, for remedial applications, as cataplasms, &c. In one of these, we find thejuice of the stramonium, or solanum, where erysipelas is apprehended. Ærugo, mixed with various ingredients, as sweet wine,honey, resin, myrrh, and nitre (virpov) , made into a kind of ointment,for dressing ulcers when they do not discharge adequately,—andspoken of as especially useful in those of the prepuce, head, andears; if correctly made, I think it must be an excellent ointment,

ON ULCERS. 317and well adapted for cleansing or deterging wounds and ulcers: itis stated as equally good in recent and in inveterate ulcers. Manyother active ointments are mentioned, in some of which are to befound lead, tutty, alum, copper, arsenic, cantharides, &c.; someused in form of a lotion. Some observations are made on swellings of the feet, on varicose veins, &c.; their treatment, and a fewremarks on the use of cups.ON FISTULE.DE FISTULIS,DE FISTULIS,TRAITÉ DES FISTULES,FESIUS, Treat. vi. p. 883.HALLER, iv. p. 115.GARDEIL, iv. p. 350.FESIUS regards this as a genuine work of Hippocrates, to whichHaller does not subscribe.-Description of fistula in ano, and itscure;-one mode consists of a twisted ligature, composed of fineflax entwined around horse hairª (certainly an animal ligature) , andemployed as at present. Another mode is that of incision. Astringents are praised in cases of prolapsus ani. It is remarked,that in going to stool, the prolapsus is infinitely less, if the legs areextended. Its cause is referred to pituita and bile, as stated also inthe book " De Mulierum Morbis. " An abundant display of remedies follows. The book on Hemorrhoids seems closely connected with this.-HALLER.How fistula in ano is produced; of its treatment by variouspharmaceutic preparations according to the nature of the case;ligature of flax, twisted around horse hair! incising the fistula;injections; attentions requisite; prolapsus, how to be treated; precautions in going to stool; various remedies noticed. -GARDEIL.• Pilum equinum.b "Dum autem ventrem exonerat, crura extendat: sic enim minime sedes exci.derit.-HAL. iv. 120.ON THE HEMORRHOIDS OR PILES.DE HEMORRHOIDIBUS,DE HEMORRHOIDIBUS,TRAITÉ DES HEMORROÏDES,FESIUS, Treat. vii. p. 891.HALLER, IV. p. 122.GARDEIL, iv. p. 358.ALTHOUGH, зays Haller, this is a spurious book, it is by no meansa bad one. It cannot be a writing from the author of the Aphorisms, since there, one of the tumours is directed to be kept open;whilst here, the whole are cured. Pituita and bile are the foundation of the author's theory. Various means of cure recommended;acrid applications, and even the cautery.Of the formation of hemorrhoids, and of their treatment byincision, ligature, cautery; how to distinguish hemorrhoidal tumours. A styptic composed of urine, mixed with calcined copperfilings in a copper vessel, and exposed to the sun, frequently stirringit, until dry, then powder it finely, and sprinkle slightly on each incision. Mulberry tubercles, external and internal; treatment; speculum ani (xapos); —here, reference is made (in order to explainwhy so little discharge of blood follows the falling off of the tumours) to amputation of the legs or arms at the joints, when compared with the operation either above or below; the particularanalogy would be difficult to apprehend, even with the accompanying explanation! Cauterization seems to have been employedinternally, through the medium of a canula of some kind introduced. The tumours, when burning or cutting were deemed improper, were sometimes made to extrude, and were then sprinkledwith a mixture of myrrh, galls, and alum, calcined. Some otheranalogous preparations are given."Hoc est, de Venis in ano sanguinem fundere solitis. "-Fasius.b See different meanings among the ancients, of this term; it was used often toimply hemorrhagies of different kinds.ON WOUNDS OF THE HEAD.DE CAPITIS VULNERIBUS,DE CAPITIS VULNERIBUS,TRAITÉ DES PLAIES DE LA TÊTE,FESIUS, Treat. viii. p. 895.HALLER, i . p. 430.GARDEIL, ii. p. 38.THIS, says Haller, is one of the genuine writings of Hippocrates,and, with his other surgical works, amongst his best. His treatiseson practice and on semeiotics, have many parts that require explanation and restriction. Here, all are clear and true; you perceive at once that the author is conscious of this being the case.Some anatomical observations precede, and also somewhat paradoxical in relation to the sutures. In one part we find him noticinghis having been deceived by them, and taking them for fissures;thus having a manifest connexion with the case of Autonomus inthe fifth Epidemics.-Affections of the head induce bad symptomson the opposite side. The trepan noticed, and directions for.This treatise commences with general remarks on the suturesand on the bones of the cranium. The danger of wounds of thehead depends very greatly on the bones concerned therein. Ofthe various ways in which the bones of the head are affected bywounds. Contusion with fissure. Simple contusion. Depression,&c. Contre-coup. Cases in which perforation is required. Regard to be had in the treatment to the mode in which the blow hasbeen given, as also to the nature of the body inflicting it. Difficulties arising from the sutures, in the diagnostics of the real stateof the wound, and of its treatment. Lotions and bandages prohibited in wounds of the head. Advantages of incising the scalp,especially when the bone is denuded. Certain reservations as tothis, and remarks. Of the time for perforating the bone, and cautions thereon. Indications to be derived from the state of the surrounding flesh. Requisites for a good exfoliation in certain cases.Cautions as to the diagnosis and prognosis. Prognosis in desperatecases. Necessity of hastening the operation in certain cases.Mode of trepanning; hazard of wounding the meninges; precautions in and during the operation.ON THE EXTRACTION OF THE DEAD FETUS.DE FETUS IN UTERO MORTUI EXSECTIONE,LIBER DE EXSECTIONE FŒTUS, •TRAITÉ DE L'EXTRACTION DU FETUS MORT,· FESIUS, Treat. ix. p. 914.HALLER, iv. p. 245.GARDEIL, iv. p. 363.THIS short treatise, says Haller, instructs us how to bring awaythe fœtus by piecemeal, and how to crush the head. It detailsmoreover, a most extraordinary concussion of the parturient female, in order that the fœtus may obtain more room for its exit.Some directions are given in relation to the replacing of the prolapsed uterus.Gardeil properly warns us against attributing to Hippocrates allof the doctrine in this short tract; which will, says he, shock theaccoucheurs of our time in more parts than one, —and which wecannot accredit to him, after having perused the treatises alreadygiven.I am about to notice the case, ( says the author, whoever he maybe,) in which the woman cannot be delivered naturally, and whichrequires the fœtus to be extracted by piecemeal;-beginning byveiling from her the sight of such a frightful operation, &c. Theoperation is then pretty amply detailed; and other cases of difficultdelivery are mentioned. Then succeeds the plan adverted to, ofshaking the female, at least ten times, and if not successful, she isto be turned head downwards, her feet in the air, and to be wellshaken by the shoulders, so as to afford the chance of the fœtusobtaining a more favourable position for his exit!"—Of side preAs this is a singular obstetrical operation of the olden times, we give it in detailfrom Gardeil, vol. iv. p. 365. It will be a bonne bouche for the accoucheurs of the pre- sent age."Voici comment on donne les secousses. On met un drap de lit sous la femme, quis'y étend dessus. On on met un autre sur les cuisses, pour couvrir ses parties. Onroule ces draps autour des cuisses et des bras. Puis deux femmes vigoureuses prendrontcelle qui est en travail, une de chaque côté par les bras, et deux autres par les cuisses.Elles la saccadent ainsi, ( to jerk or shake, ) dix fois au moins, en la tenant fortement.21322 THE WORKS OF HIPPOCRATES.sentation; of the cord around the neck; the head locked , and handprojecting, are adverted to; and the subject of prolapsed uterus isthen noticed. If the subject is old, it is best to do nothing; if young,the skin of the orifice and neck of the uterus is to be slightly incised, and that in both directions, rubbing it with a soft towel toexcite inflammation and empty the vessels. Some unctions arenext applied, or astringent lotions; after its reduction, tents ofsponge with wine are introduced into the vagina, and a recumbentposition, with the legs crossed, is maintained.Ensuite, si cela n'a pas suffi, elles la mettent la tête en bas et les jambes en haut, latenant par les cuisses, et la secouant vers les épaules, cherchant à faire passer ainsi lefœtus dans une place vide, pour qu'il prenne une situation plus favorable à sa sortie.Quand on ne voudra point avoir recours à ce moyen, on donnera du castor cuit dansdu vin de Chio."ON DISSECTION S.LIBER DE CORporum ResectiONE,LIBER DE CORPORUM RESECTIONE,TRAITÉ DE LA DISSECTION DES CORPS, .. FESIUS, Treat. x. p. 915.HALLER, ii . p. 1.GARDEIL, iv. p. 366.A CONCISE treatise, says Haller, giving some account of the lungs,heart, liver, and other abdominal viscera; correct, and derived fromhuman dissection; [which I much doubt.-ED. ] It can be lookedupon, says Gardeil, merely as a slight sketch of the anatomicalknowledge of the period; and it speaks only of the most essentialorgans of the trunk of the body. Somewhat is said as to the namesand etymology of the oesophagus, &c. This terminates the sixthsection.SECTION VII."THE EPIDEMICS OF HIPPOCRATES.DE MORBIS VULGARIBUS,DE MORBIS POPULARIBUS,DES ÉPIDÉMIES,FESIUS, p. 938.HALLER, i. p. 110.GARDEIL, ii. p. 57.THE prefatory remarks of Fœsius to the seven books of Epidemics are deserving of attention, as explanatory of the genuine andother books under this general title."There are," says he, " seven books of Epidemics, in the collection we possess under the name of the Works of Hippocrates; butthey are not generally believed to be all derived from the samesource. Thefirst and third books are alone regarded as incontestably his. The remainder are greatly inferior to them, even thefifth and the seventh, though all are valuable. The order that characterizes the first and third, (which last is manifestly a continuationofthe first,) is not apparent in any of the other five, yet each contains much excellent matter. In the fifth and seventh are numeroussurgical observations."I had prepared an outline of the whole of these books, but as theyare considered among the principal of the writings of Hippocrates,I judged that the medical public would be better pleased to see themin extenso; and as Clifton has given a translation of the whole, Ihave concluded to make use of it. That gentleman published thefirst edition of the work in 1734. A second edition appeared in1752, which is the one here chosen; whether improved, or modifiedfrom the former, I know not. I cannot say his translation conformsin every part to the ideas I formed, from perusing the Latin translations of Fœsius and Haller, although it affords generally a sufficienta This Section consists of the seven books of Epidemics, and the Book of Aphorisms,and is entitled by Fœsius тa μтa-hoc est, permixtam omnium medicinæ partiumtractationem .THE FIRST BOOK OF EPIDEMICS. 325ly accurate view of the work. He has not divided his translation intoregular books, but gives it as one continuous text, under the general head of " Hippocrates on Epidemical Diseases." In order toenable the reader to refer to each respective book, either in Fosiusor Haller, I have therefore kept up that division, though otherwiseofno importance; and have also to each book given the short prefatory remarks of Haller, and sometimes of Gardeil, as they generally afford a concise view of the purport of the treatise. I may addthat I have omitted a number of notes that are added by Clifton,which would too much swell these pages, although many are instructive, and aid in understanding the text itself.-ED.THE FIRST BOOK OF EPIDEMICS.THIS book, says Haller, is one of the principal works of Hippocrates, and is by all, attributed to him. It is a production worthyof him , although consisting chiefly of a history of diseases, unmixed with medicine. Its value consists in his description of them,and his notice of crises . It contains, under three sections, the statement of the seasons for three years, as occurring at Thasus, followed by the rise of an epidemic state of disease of two years'continuance; in one of these recurrent fevers predominated, andardent fevers in the other. To these last belong a large proportionof fourteen patients here recorded, and with mostly a fatal termination. One case is particularly interesting, of a parturient femalewho recovered after a very prolonged disease.-HALLER.SECTION I. YEAR I.In Thasus in the autumn, about the equinox, and under thePleiades, the rains were great, continual, and soft, as when thewind is southerly. The winter mild, with southerly winds, andvery little northerly. With these were greater droughts than ordinary, so that the whole winter was, in effect, like the spring. Thespring was also affected with southerly winds, but yet was cold,and a little wet. The summer was for the most part cloudy anddry. The Etesiæ blew but little, faintly, and irregularly.326 THE WORKS OF HIPPOCRATES.The whole year being thus affected with southerly winds, andgreater droughts than ordinary, early in the spring (from the formeryear's being different, and affected with northerly winds) some fewwere attacked with burning fevers of a kind good sort, and a fewothers with hemorrhages, neither of which proved mortal. Swellings appeared behind the ears, in many on one side, in most onboth, without a fever or any confinement, but in some with a littlefever. In all they disappeared without either inconvenience orsuppuration, contrary to the custom of such tumours from othercauses. At this particular time they were naturally soft, large,diffused, without inflammation or pain, and went off universallywithout any visible signs. Children, young persons, adults, especially those who frequented the public places of exercise, weremost subject to them. A few women were also affected. Thegreatest part had dry coughs, which were soon succeeded byhoarsenesses. Some again after a while had painful phlegmonsupon the testicles, sometimes upon one, sometimes upon both. Somehad fevers, others none; most of them trouble and fatigue enough:but with respect to the chirurgical part they did very well.Early in the summer, and from that time till the winter, manyof those who had been for a long while somewhat consumptive,were laid up with consumptions; and others, who were doubtful,were then fatally convinced. Others again, where nature tendedthat way, dated the beginning of it from that time. A great number of such patients dropped off; and I do not remember that anyof those who were laid up held out even a moderate time, but diedmuch sooner than is usual in such cases, after having suffered othercomplaints, and those for a long time, in their fevers, without eitherfatigue or dying. Of these we shall now treat: for the only, andthe greatest of the diseases then reigning, and that proved fatal tomany, was the consumption.The manner in which most of them were affected is as follows.They were seized with continual, acute fevers, attended with achilliness, but no intermission; of the semitertian kind; the fit beingone day moderate, the next vehement, and so increasing to greatvehemence. They sweated continually, but not all over. The extremities were very cold, and grew warm again with difficulty.The belly was disturbed with bilious, small, simple, thin, gripingstools, and that frequently. The urine thin, without colour, crude,and little in quantity; or else thick, with a small sediment, that didTHE FIRST BOOK OF EPIDEMICS. 327not subside well, but appeared crude and unseasonable. Theycoughed a little and often, and the matter expectorated was indeeddigested, but brought away by little and little, and with difficulty.Where the case was very violent, no digestion happened, but whatthey spit was continually crude. The throats of most of them werefrom the beginning and all along painful, red, and inflamed. Therheum that came from them little, thin, and sharp. A consumptionand general disorder soon followed. An aversion to all kind offood was continually upon them, but without thirst; and many,before they died, became delirious. Thus the case stood amongthe consumptive.In the summer and the autumn many fevers came on, of thecontinual kind, though not , violent; and that to such as had beenlong ill , but in other respects not worn out. Disorders of the bellylikewise happened to many, but such as were very tolerable, andwithout any remarkable injury. The urine was generally wellcoloured and clear, but thin, and after a while, about the crisis,digested. Coughs were moderate, and expectoration easy; norwere they so averse to food, but very willing to take what wasgiven them. In a word, these consumptive patients were affectedin a manner different from such a state, sweating a little in theirchilly fevers; while others were seized with paroxysms in a vagueand uncertain manner, never leaving them entirely, but returningas a semitertian. The crisis happened upon the twentieth day atthe shortest, in most upon the fortieth, and in many upon the eightieth. In some again it never happened, but the fever went off inan erratic or wandering manner. Here indeed it returned again forthe most part, after a short intermission; and after the return cameto its crisis in the same periods as before. Many of them held outso long, as to be ill in the winter; but of all here described nonebut the consumptive died. The rest bore their fevers and othercomplaints very well and escaped.SECTION II. YEAR II.In Thasus, early in the autumn, the weather was unseasonable,and on a sudden grew wet with much northerly and southerlywind, that lasted the whole time of the Pleiades, and even to theirsetting. The winter was affected with northerly winds; the rains328 THE WORKS OF HIPPOCRATES.were great and heavy, attended with snow, and for the most parta mixture of fair weather. Thus the whole affair stood; and, withrespect to the cold, what happened was not very unseasonable.But after the winter solstice, and when the west wind begins toblow, there was very severe winter weather, with much northerlywind and snow, and abundance of rain without ceasing. Overhead it looked stormy and cloudy. This state lasted without remission to the equinox. The spring was cold, northerly, watery,and cloudy; the summer not very scorching. The Etesia blewcontinually; and, about the rising of Arcturus, a great deal of rainfell again on a sudden, with northerly winds. The whole yearbeing thus damp and cold, affected with northerly winds, theypassed the winter well for the most part, but in the beginning ofthe spring many persons (not to say a great many) were taken ill .First of all appeared humid ophthalmies (or inflammations of theeyes), with weepings, pain, and indigestion. Little concretedmatter broke out with difficulty on the eyes of many persons, returned again in most, and went away at last about autumn. Inthe summer and the autumn, dysenteries, tenesmuses, and lienteries,were complained of; so were bilious purgings, of a thin, crude,griping nature, and much in quantity. Others again were watery;and many complained of painful fluxes that were also bilious,watery, ragged, purulent, and strangurious; not from any fault inthe kidneys, but from one humour or complaint coming uponanother. They likewise vomited bile, and phlegm, and indigestedfood. They sweated too in general, the humidity being greatevery where. To many these things happened without a fever orconfinement, to others with a fever, as we shall see hereafter.Where all that is here mentioned happened, they became consumptive, not without pain.In the autumn and the winter, continual fevers turned out, besidesa few that were ardent, diurnal, nocturnal, semitertians, perfecttertians, quartans, and erratics; every one of which happened tomany, but ardent fevers to very few, and were the least troublesome: for they were neither taken with bleedings, unless in a verysmall quantity, and that but seldom, nor with deliriums. In allother respects they bore it well. The crisis happened to most in avery regular manner (intermissions included) in seventeen daysgenerally, without any body's dying or becoming phrenitic. Ter-THE FIRST BOOK OF EPIDEMICS. 329tians were more frequent than ardents, and more troublesome. Inall the progress was very regular from the first paroxysm to thefourth, and the seventh proved a perfect crisis, without any relapse.Quartans attacked many at first as a quartan should, and manywere seized with it as the crisis of other fevers and diseases.These were of long standing, and indeed longer than usual. Quotidians, nocturnals, and erratics were likewise frequent, and lastedlong, both among those who were confined at home, and those whowalked about. The major part could not get rid of their feversduring the Pleiades, nor even till winter. Convulsions were alsofrequent, especially among children, from the beginning, but notwithout a fever. They came upon fevers likewise, and lasted along time in general, but without any harm, except where othercircumstances had made the case desperate. The other feverswere altogether of the continual kind, without any intermission,and the paroxysms in all like the semitertians, one day better,another day worse; and, of all the fevers that then reigned, thesewere the most vehement, the most tedious, and the most painful;beginning very mildly, but increasing always, and growing worseand worse upon the critical days. After a little abatement theysoon grew bad again, had stronger fits upon the critical days, andwere for the most part worse. Shiverings were universally irregular and uncertain, seldom and very little in these, but in otherfevers more. Sweats were common, but here least of all, and sofar from easing the patient, that on the contrary they did him harm.The extremities were very cold, and could scarce grow warmagain. Nor were they altogether watchful, especially in this case,but fell again into comas. The belly in all was disturbed, and in abad manner, but worst of all by much in these. The urine wasfor the most part thin, crude, without colour, and after a while appeared a little digested as though critical; or had some consistencein it, but yet was turbid without any sediment or concoction; atleast the sediment was but little, and that bad and crude. In fineall these things were bad. The fevers were likewise attended withcoughs, but I cannot say that I perceived either good or harm fromthem . Most of these complaints were tedious and difficult, veryirregular and inconstant, and that without coming to a crisis, eitherin those whose case was desperate, or in those whose case wasnot so. For, if it intermitted a little at any time, it soon returnedagain; and in the few that had the benefit of a crisis, it happened330 THE WORKS OF HIPPOCRATES.not at the soonest before the eightieth day, and to some of these itreturned, so that many of them were ill in the winter. In thegreatest part it went off without a crisis; and these things happened alike to those who did well, and to those who did not.As there was a great want of the critical variety that is usual indiseases, the greatest and worst symptom attended many of themto the last, viz.: a general dislike to food, especially where otherfatal circumstances appeared. They were not indeed very thirstyout of season, but after a long time, a great deal of pain, and a baddecay, abscesses formed themselves, sometimes too great for thepatient's strength to bear, at other times too little to be of any service; so that a relapse presently followed, and the patient grewworse and worse. Dysenteries, tenesmuses, lienteries, and fluxeswere likewise added; and some fell into dropsies. Nauseas andgreat uneasiness happened with and without these. Whatever wasvery vehement, either despatched the patient soon, or was of nobenefit to him at all. Little eruptions appeared, not equal to thevehemence of the disease, and soon after disappeared again; orswellings behind the ears, that were by no means critical, and sosignified nothing. Others were affected in their joints, especiallythe hip, where it proved critical to a few, but it soon after got thebetter and returned to its former state.It proved fatal to persons of every age, but chiefly to childrenjust weaned, and to those of eight or ten years old, and those underthe age of puberty. These were thus affected, not without the firstcircumstances here mentioned, but the first happened to many without these. The only beneficial thing, and the greatest of the signs.then existing, and what saved many in the greatest extremity, wasthe strangury. For this way the disease spent itself; and it was afrequent complaint, especially among those tender patients, as wellas among those who were not obliged to lie by their illness, andthose who were. This proved a speedy and great change throughout. For, if the belly was affected with ill- conditioned fluxes, theystopped; food in general became agreeable to them; and the fevergrew mild after this crisis. But the strangury complaints werelasting and painful; and the urine copious, thick, various, red , andpartly purulent, not without pain. All these recovered to a man,as far as I know.Where no danger is suspected, we are to consider the digestionsof what passes off, whether they are all every where considerableTHE FIRST BOOK OF EPIDEMICS. 331or seasonable, good and critical. Digestions imply a quick crisis,and a sure recovery; but crudities, indigestions, and bad abscesses,imply no crisis at all, or else pains, or duration, or death, or returnsof the same complaints. But which of these is most likely to happen, must be considered from other things; the duty of a physicianbeing to relate what is past, to understand what is present, and toforetell what is to come. He is also to take special care of twothings, viz. , to do good in his office, or at least no harm.The art consists in three particulars, viz. , the disease, the patient,and the physician, who is the servant or assistant of the art, andthe patient is to concur with the physician in opposing the powerof the disease.Pains and heavinesses about the head and neck, with or withouta fever, in phrenitic cases denote convulsions; and æruginous vomitings succeed. Some of these die presently. But in burning feversand others, a pain of the neck, a heaviness of the temples, a dimness of the sight, or a painful distension of the hypochondre, denotea hemorrhage from the nose. Where the whole head is heavy, attended with heartburns and nauseas, bilious and phlegmatic vomitings succeed. Children are generally attacked thus, and mostlyaffected with convulsions in these cases. Women are also attacked, and with pains in their private parts. But old persons, and thosewhose heat is got the better of, are attacked with palsies, madnesses,or blindness.SECTION III. YEAR III.In Thasus, a little before the rising of Arcturus, and during itscontinuance, there fell many great showers with northerly winds;but about the equinox, and to the rising of the Pleiades, little southerly showers. The winter was northerly, and drier than ordinary.The winds cold, and the snows deep. About the equinox the coldwas sharpest. The spring was northerly and drier than ordinary;but yet the weather was a little wet and cold. About the summersolstice a little rain with a great deal of cold, to the rising of theDog-star; from which time to the rising of Arcturus the summerwas hot, and the heats were great and scorching, not gradually orat intervals, but continually. The droughts were also great, andthe Etesia blew. About the rising of Arcturus southerly gentleshowers fell to the equinox.332 THE WORKS OF HIPPOCRATES.During this state of the weather, in the winter, paraplegias beganand attacked many, some of whom died in a short time: for thedisease was very epidemical. In other respects they were well.But in the very beginning of the spring burning fevers came on,and continued to the equinox, and even to the summer. Most ofthose escaped who were seized presently after the beginning of thespring and summer, and some few died: but when the autumn andwet weather set in, they proved mortal to many. These fevers wereof such a nature, that where any one bled freely and plentifully atthe nose, he was saved by it more than by any thing else; and notone of those who were taken thus died this season, so far as I know.For Philiscus, and Epaminon, and Silenus, bled but a few drops atthe nose the fourth and fifth day, and died. Most of them wereseized with shiverings about the crisis, especially where there hadbeen no hemorrhage, and with the shivering came on a sweat aboutthe head and shoulders. Others again were attacked with a jaundice the sixth day, and these were relieved either by a dischargeby urine or stool, or a plentiful hemorrhage, as Heraclides was,who lived with Aristocydes. Not but he bled at the nose, and hadthe benefit of the other evacuations too; and so was freed thetwentieth. It fared otherwise with the servant of Phanagoras; for,as none of these things happened to him, he died. Hemorrhageswere very frequent, especially among young persons and adults;and, where nothing of this kind happened, it very often provedfatal. Those who were more advanced in years had the jaundice,or a disorder in their belly, or a dysentery, as Bion, who lived withSilenus. In the summer, dysenteries were epidemical; and, evenwhere hemorrhages had happened, some were at last seized withdysenteries, as Eraton's boy, for instance, and Myllus; for they,after a great hemorrhage, fell into a dysentery, and recovered.This humour was particularly redundant in many. For, wherethere was no hemorrhage at the crisis, the tumours behind the earsdisappeared, and upon this a weight was felt in the left side of thebelly, and at the extremity of the hip. Pain coming on after thecrisis, and thin urine passing off, they began to bleed a little . ThusAntiphon, the son of Critobulus, had the twenty-fourth day a separation of humours by bleeding; his disorder ceased, and about thefortieth he got quite rid of it. Many women were taken ill , but lessthan the men, and died less. Many of them had hard labours, andafter the birth were taken ill again, and for the most part died, asTHE FIRST BOOK OF EPIDEMICS. 333Telebolus's daughter, who died the sixth day after her delivery.A great many had their menses come down in their fevers; othersbled at the nose, and many young girls had the first appearance oftheir menses then. Others again bled at the nose, and had theirmenses too, as Datharsis's daughter, for instance, a maid, who hadthem then for the first time, and also bled plentifully at the nose.Nor do I remember any died, where any one of these happenedwell. All of my acquaintance miscarried that chanced to be withchild. The urine was in general well coloured but thin, and witha small sediment. The stools were thin and bilious. And in many,where there was a crisis in other respects, it terminated in a dysentery, as in Xenophanes and Critias. The urine was watery, much,clear, and thin; and even after the crisis, where there was a goodsediment, and in other respects a laudable crisis, a dysentery cameupon some, as particularly upon Bion who lived with Silenus, Critias with Xenophanes, Areton's boy, and Mnesistratus's wife, whowere all afterwards seized with a dysentery. Query? Whetherit was owing to the watery urine?About the rising of Arcturus a crisis happened to many theeleventh day, nor did the fever return again in the natural and usualway of returns; but they were comatose at this time, especiallychildren, of whom fewer died than any. But about the equinox , tothe rising of the Pleiades, and even in the winter, burning feverscontinued. About the same time too a great many became phrenitic, and went off; and a few in the summer. These burningfevers pointed out the prognostics from the beginning, where thecase was desperate. For immediately an acute fever came onfrom the first, with gentle shiverings, watchings, ramblings, thirst,nauseas, and anxiety. They sweated a little about the foreheadand collar-bone, but nobody all over. Great deliriums attended ,with fears and dejectedness; the extremities were coldish, the toesand fingers especially. The paroxysms were upon equal days, andin many the greatest pains upon the fourth. The sweats weregenerally somewhat cold. The extremities did not recover theirwarmth, but were livid and cold; nor did they then complain ofthirst. The urine was black, little, and thin; the body bound. Nohemorrhage from the nose, where this was the case, but only a fewdrops; nor did any of these relapse, but died the sixth day in asweat. As to the phrenitics, all the circumstances here mentioneddid not happen to them, but the crisis came on generally the eleventh334 THE WORKS OF HIPPOCRATES.day, and in some the twentieth. Where the frenzy did not immediately appear from the beginning about the third or fourth day,but things went on moderately at first, there the fever raged mostupon the seventh.The number of diseases was now very great, and those whodied of them were chiefly children, young persons, adults, and suchas had smooth bodies, white skins, straight hair, black hair, andblack eyes. The lazy and indolent died likewise, and so did thosewhose voice was either high, small, or rough, and where there wasany impediment in the speech, or a choleric temper. Many womenof this kind died too. But, during this situation, some were preserved by the four following particulars, viz. , by bleeding plentifully at the nose; by making a great deal of water with a largeand good sediment; by considerable bilious stools; or by fallinginto a dysentery. These proved critical to a great many, notsingly indeed, but jointly, though not without much trouble. However all such escaped whose case was thus. Women, too, andmaids were subject to every one of these symptoms; and whereany of them happened well, or where the menses came down plentifully, it proved a salutary crisis , and none of them died. For, asto Philon's daughter, who bled freely at the nose, she died theseventh day, after having eat a very improper and unseasonablesupper.

• In acute fevers, and especially burning fevers, involuntary tears

are a sign of a hemorrhage from the nose, if other circumstancesdenote not death. In this case, they are a sign of death and not ahemorrhage.In a fever painful swellings behind the ears sometimes neitherfall nor suppurate, though the fever goes off entirely. In this casea bilious looseness, or a dysentery, or thick urine with a sediment,is salutary, as in the case of Hermippus of Clazomenæ.Critical circumstances, by which we distinguish, are either alikeor unlike, as in the case of the two brothers, who lived by Epigenes's Theatre, and were taken ill the same hour. The eldest hadhis crisis the sixth day; the youngest, the seventh; both of themrelapsed the same hour. It intermitted five days, and after the return both were entirely freed the seventeenth. Many had a crisisthe fifth, an intermission seven days, and another crisis the fifth.Others again had their crisis upon the seventh, an intermissionseven days, and the last crisis the third day after the return. SomeTHE FIRST BOOK OF EPIDEMICS. 335had a crisis the seventh, an intermission three days, and anothercrisis the seventh. Others again had a crisis the sixth, and an intermission six days: after this an attack for three days; then, anintermission one day, and the next a return and crisis the sameday; as Euagon the son of Daitharsus. To some it came to acrisis the sixth, intermitted seven, and was determined the fourthday after the return, as in Aglaidas's daughter. The greatest number of those who were taken ill this season were thus affected; andI know of none that escaped without a relapse, according to thenatural course of relapses. Neither do I know of any that miscarried, where the relapses happened in this manner; nor of any,thus affected, who had returns again. But many died the sixthday, among whom were Epaminondas, Silenus, and Philiscus, theson of Antagoras.Where any tumours happened behind the ears, the crisis cameon the twentieth; the tumours subsided universally where no suppuration followed, and were turned upon the bladder. But in Cratistonax's case, who lived by Hercules' Temple, and in that ofScymnus, the fuller's maid- servant, where a suppuration happened,they died. In some the crisis happened the seventh, the intermission nine days, and another crisis the fourth day after the return.In others the crisis happened the seventh, the intermission six days,and the other crisis seven days after the return; as it did to Phanocritus, who lived by Gnathon, the painter. But in the winter,about the winter solstice, and even to the equinox, the burningfevers and phrensies remained, and were very mortal. The crisishappened to many the fifth day from the beginning, and after anintermission of four days the fever returned again, and five daysafter this the other crisis came on, in all fourteen days. Thus ithappened to most children, and to those of a more advanced age.Sometimes the crisis came on the eleventh, the return the fourteenth, and the perfect crisis the twentieth. But, if any wereseized with shiverings upon the twentieth, it was then protractedto the fortieth. The greatest part shivered upon the first crisis;and those who shivered at the beginning shivered again at thecrisis, and the relapses after the crisis. But shiverings happenleast in the spring, more in the summer, more still in the autumn,and most of all in the winter. The hemorrhages also ceased.The knowledge of diseases is to be learnt from the commonnature of all things, and from the nature of every individual; from336 THE WORKS OF HIPPOCRATES.the disease, the patient, the things that are administered, and theperson that administers them; for the case becomes easier or moredifficult accordingly. We are to consider likewise the wholeseason in general, and the particular state of the weather, and ofevery country; the customs, the diet, the employments, the agesof every one, the conversations, the manners, the taciturnity, theimaginations, the sleeps, the. watchings, and the dreams; and howfar vellications, itchings, and tears are concerned; and what theparoxysms are; and what the evacuations by stool, or urine, orspitting, or vomiting may be; and what changes may happen fromone disease to another, and the separations that end in death orlife. Sweat, cold, shiverings, coughs, sneezings, sighings, breathings, belchings, flatuses (secret and audible), hemorrhages, andhemorrhoids, are also to be considered, together with their respective consequences.Of fevers, some are continual, others affect us in the day, andintermit at night; or continue in the night, and leave us in theday. There are likewise semitertians, tertians, quartans, quintans,septans, and nonans; but the acutest, the strongest, the most dangerous, and the most fatal, are the continual. The safest, theeasiest, and the longest of any is the quartan; for it is thus notonly in its own nature, but also frees us from other great diseases.The semitertian is attended with acute disorders, and is more fatalthan any of the rest. Add to this, that consumptive persons, andthose who have been long ill of other distempers, are most subjectto it. The nocturnal is not very dangerous, but tedious. Thediurnal longer, and sometimes tends to a consumption. The septanis long, but not dangerous; the nonan longer, but not dangerous.A true tertian comes to its crisis soon without danger; but aquintan is the worst of all; for coming before or upon a consumption, it is death. In every one of these fevers, as well continual asintermitting, there are forms, conditions, and paroxysms to beconsidered. For instance, a continual, sometimes flowers as itwere, at the beginning, becomes very vehement, and grows worseand worse; but about the crisis, and at the time of the crisis,becomes weaker. Sometimes again it begins mildly and secretly,increases and grows worse every day, but about the crisis, andduring that time, breaks out vehemently. At another time itbegins mildly, increases more and more, and, coming to its fullstrength by a certain time, remits again at the crisis, and duringTHE FIRST BOOK OF EPIDEMICS. 337all that time. These things happen in every fever and everydisease.The diet should likewise be regulated by these considerations.And there are many other considerable signs of the like nature withthese, some of which we have treated of already, and the rest shallbe considered hereafter. But whoever undertakes this provincein good earnest should try and inquire which of them is acute andmortal, and which recoverable; where food is proper, and whereit is not; without omitting the time, the quantity, and the quality.Where the paroxysms are upon equal days, there the crisis isupon equal days; and where they are upon unequal, there the crisisis so too.The first critical day of the periods that terminate upon equaldays is the fourth, then the sixth, the eighth, the tenth, the fourteenth, the twenty- eighth, the thirtieth, the forty- eighth, the sixtieth,the eightieth, and the hundredth. The first of those that terminateupon unequal days is the third, then the fifth, the seventh, the ninth,the eleventh, the seventeenth, the twenty- first, the twenty- seventh,and the thirty- first. And if a crisis happens otherwise, or out ofthese mentioned days, a relapse is to be feared, and even death. Itis also to be considered, that the crises that shall happen at thesetimes will be salutary or fatal, or there will be a turn for the betteror the worse. As to erratic fevers, quartans, quintans, septans, andnonans, their critical periods are also to be considered.Philiscus, who dwelt by the wall, took to his bed the first day.An acute fever, a sweat, and an uneasy night followed. The nextday he was worse in all respects; but in the evening had a gooddischarge from a glyster, and afterwards a quiet night. The thirdday betimes, and till noon, his fever seemed to have left him , but inthe evening it returned with vehemence, attended with a sweat, athirst, a dry tongue, black urine, an uneasy night, no sleep, andmuch delirium. The fourth day, worse in all respects. Blackurine; but an easier night, and the urine well- coloured. The fifth,about noon, a few drops of pure blood from the nose. The urinevery various, with round seed-like particles floating up and down,without any sediment. A suppository brought away a little wind.A restless night. Little sleeps, with rambling discourse. The extremites cold all over, without any return of warmth. Black urine.A little sleep. In the day loss of speech, a cold sweat, and theextremities livid. Died about the middle of the sixth day.22338 THE WORKS OF HIPPOCRATES.His breath was all along drawn back, as it were, deep, andseldom. Upon the spleen was a round swelling. Cold sweatscontinually. The paroxysms upon equal days.Silenus, who lived upon the sea- shore, near to Eualcides's, wasseized with a violent fever after labour, and drinking, and unseasonable exercise. It began with pain in the loins, a heaviness inthe head, and a stiffness in the neck. His stools the first day werebilious, simple, frothy, deep- coloured, and many. His urine black,with a black sediment. A thirst came on, with a dry tongue, andno sleep in the night. The second day, an acute fever. Morestools, thinner, and frothy. Black urine. An uneasy night. Rambled a little. The third , worse in all respects. A distension ofboth the flanks, reaching to the navel, but softish withal. His stoolsthin and blackish. The urine turbid and blackish. No sleep in thenight. He talked much, laughed , sung, and could not containhimself. The fourth, no alteration. The fifth, his stools weresimple, bilious, smooth, and greasy. His urine thin and transparent. His understanding recovered itself a little. The sixth, alittle sweat about the head, the extreme parts cold and livid. Muchtumbling and tossing. No evacuation by stool or urine. The feveracute. The seventh, loss of speech. No warmth in the extremities. No urine. The eighth, a cold sweat all over, with little,red, round eruptions, like pimples in the face, that remained withoutcoming to suppuration. From a gentle stimulus of the belly agreat discharge of thin, and as it were undigested fæces, with pain;and what came away by urine was acrid and painful. The extremities a little warmer. Light sleeps, with a comatose disorder.Loss of speech. Thin transparent urine. The ninth, no alteration.The tenth, drank nothing. A coma, with light sleeps. From thebelly, the same discharge as before. A great deal of thick urine,that came away gushing, and afterwards let fall a white sediment,like ground barley; the extremities cold again. The eleventh, hedied.His breath was all along, from the beginning, deep and seldom;his flanks continually palpitating; and his age about twenty.Herophon was seized with an acute fever, and had a small discharge downwards, with a tenesmus at the beginning, but afterwards his stools were thin, bilious, and frequent. No sleep. Black,thin urine. The fifth, betimes in the morning, he grew deaf, andwas worse in all respects. His spleen swelled, and his flanks wereTHE FIRST BOOK OF EPIDEMICS. 339distended. His stools were small and black; and his head rambled .The sixth, he was delirious, sweated at night, was cold, and delirious still. The seventh, was cold outwardly, thirsty, and delirious;at night came to himself, and slept. The eighth, was feverish, butnot so swelled in his spleen; and came perfectly to himself. Aswelling appeared in the groin for the first time, on the same sidewith the spleen; after which a pain seized him in both his legs.He rested pretty well; his urine was well- coloured, and had asmall sediment. The ninth, he sweated, and was cured. The fifth,it returned again, and immediately his spleen swelled. The feverwas acute, and his deafness returned. Three days after this, thespleen and deafness grew better; his legs were uneasy, and a sweatcame on in the night. The crisis happened the seventeenth, without his being delirious after the return.In Thasus, Philinus's wife was seized with a fever and shivering,the fourteenth day after her delivery of a daughter, her affairs goingon very well, without any reason for complaint in other respects.The upper part ofthe stomach, the right hypochondre, and her private parts grew painful from the first. Her cleansings stopped.However, by help of a pessary she grew easier; but the pain inher head, neck, and loins remained . She could get no sleep; wascold in her extremes; and a thirst succeeded. Her belly was in amanner burnt up, and discharged very little. Her urine was thin,and without colour at first . The sixth, she was very delirious atnight, and then came to herself again. The seventh, was thirsty;and her stools were bilious and deep- coloured. The eighth, ashivering came on, with an acute fever, and many convulsions followed, with pain. She also talked much out of the way; got up toreceive a suppository; had a great discharge downwards of biliousmatter; but no sleep. The ninth, was convulsed. The tenth, camea little to herself. The eleventh, slept, remembered every thing,but in a little time grew lightheaded. After the convulsions madea great deal of water in a little while (the servants, or those abouther, seldom reminding her), of a thick and white kind, like whatappears upon shaking water that has subsided after standing a longtime, but had no sediment; in colour and consistence like thatwhich is made by a beast of burden, so far as I saw. About thefourteenth she trembled all over, talked much, and came a little toherself; but soon became lightheaded again. About the seventeenth, lost her speech; and the twentieth, died.340 THE WORKS OF HIPPOCRATES.Epicrates's wife, who lived by Archigetes's, just before her labour, was taken with a violent shivering, and could not grow warmagain, as I was informed. The next day, she was much the same.The third, she was delivered of a daughter, and every thing wenton well. The second day after the birth an acute fever seized her,with pains in the pit of her stomach and private parts, which weremitigated by a pessary; but a pain in the head, neck, and loinscontinued, without any sleep. Her stools were small, bilious, thin,and simple. Her urine thin and blackish. The sixth day after shehad been taken, at night she grew delirious. The seventh , wasworse in all respects; watchful , delirious, thirsty; and had bilious ,deep-coloured stools. The eighth, shivered, and slept much. Theninth, no alteration. The tenth, a pain in her legs and the pit ofher stomach again, with a heaviness in her head, but without adelirium . She slept more, but had no stool. The eleventh, theurine was better coloured, and the sediment large. She felt herselflighter. The fourteenth shivered again, and was very feverish.The fifteenth, vomited bilious yellow matter, pretty often; sweated,and missed her fever; but at night it returned violently. Her waterwas thick, and with a white sediment. The sixteenth, worse again,rested badly, got no sleep, and was lightheaded. The eighteenth,was thirsty, and the tongue burnt up. No sleep; much lightheadedness; pain in the legs. About the twentieth, betimes in the morning, shivered a little, and was comatose or stupified; slept quietly;vomited a little bilious black matter; and grew deaf in the night.About the twenty-first, a pleuritic pain came on quite through theleft side, with a gentle cough. The urine was thick, turbid, reddish,and did not subside after standing. In other respects she was easier,but not without her fever. Her throat was inflamed and painfulimmediately from the first; the uvula was contracted; and therheum remained sharp, biting, and salt continually. About thetwenty-seventh, the fever left her; the urine broke, but the sidewas painful. About the thirty-first, the fever came on again; herstools were bilious and stimulating. The fortieth, she vomited alittle bile, and was entirely freed from her fever the eightieth.Cleonactis, who lived above the Temple of Hercules, was takenill with a violent fever of the erratic kind. He had a pain of thehead and the left side from the beginning, and in the other partsof his body pains like those that proceed from weariness. Theparoxysms ofthe fever were very irregular, sometimes with, some-THE FIRST BOOK OF EPIDEMICS. 341times without, a sweat; but for the most part they appeared uponthe critical days more than upon others. About the twenty-fourth,he was cold at his fingers' ends; vomited bilious yellow stuff prettyoften, and soon after æruginous; and was better in every respect.About the thirtieth , he bled from both nostrils, irregularly, a little ata time, to the crisis. He had neither an aversion to food, nor athirst all the time, nor want of sleep; and his urine was thin, thoughnot without colour. About the fortieth, it appeared reddish, and hada large sediment, very red, that relieved him. After this it changedseveral ways, and sometimes had a sediment, at other times none.The sixtieth, there was a great, white, smooth sediment; all thecomplaints abated; his fever intermitted; and his urine was thinagain, but well- coloured. The seventieth, he had no fever, and itintermitted ten days. The eightieth, a shivering came on, and anacute fever. A great sweat followed; the sediment in his urinewas red and smooth; and he obtained a perfect crisis.Meton was taken ill of very acute fever, with a heaviness andpain in his loins. The second day, he had a good discharge downwards, from drinking a pretty large quantity of water. The third ,a heaviness in his head, with thin, bilious, reddish stools. Thefourth, worse in all respects. A little blood from the left nostriltwice. A restless night. Stools, as before. Blackish urine, with ablackish cloud floating up and down, without any sediment. Thefifth, a great deal of pure blood from the left nostril; a sweat, anda crisis; but after the crisis, want of sleep, lightheadedness, andthin blackish urine. After bathing the head he slept, and came tohimself; had no relapse afterwards, but frequent hemorrhages, evenafter the crisis.Erasinus, who lived by the Torrent of Bootes, grew very feverish after supper, and had a very bad night. The first day he waseasy, but in pain in the night. The second, worse in all respects,and at night lightheaded. The third , uneasy , and very delirious.The fourth, exceeding ill, and had no sleep at night, but dreamedand talked, and was afterwards remarkably worse, frightened , andimpatient. The fifth, betimes in the morning, was composed andcame perfectly to himself, but before noon was so raving mad, thathe could not contain himself. His extreme parts were cold, andsomewhat livid; his urine stopped; and about sunset he died.This patient's fever was continually upon him, with sweats; hisflanks were tumefied, distended , and painful; his urine black, with342 THE WORKS OF HIPPOCRATES.round clouds that subsided not; his belly not bound; his thirst perpetual, but not great; and before he died, he was convulsed muchand sweated.Criton, in Thasus, was seized, as he was walking, with a violentpain of his foot from the great toe, and obliged to go to bed the'same day. A chilliness ensued, with nauseas, a gentle heat, andat night a delirium. The second day, the whole foot was swelled,and a redness appeared about the ankle with the skin stretched.Little black spots (or pimples) appeared likewise. An acute fevercame on, with violent ravings. His stools were unmixed, bilious,and very frequent. The second day of his illness he died.The Clazomenian, who lived by Phrynichides's well, was seizedwith a violent fever, attended from the beginning with a pain of thehead, neck, and loins; and immediately after with a deafness. Nosleep; the fever acute; the flanks tumefied, but without any greatdistension; and the tongue dry. The fourth day, he was deliriousat night. The fifth, was uneasy, and worse in every respect.About the eleventh, a little remission. His stools from the beginning to the fourteenth, were thin, large, and watery, withoutfatiguing him. After this they stopped. The urine all along wasthin indeed, but of a good colour, and had many clouds here andthere, without subsiding. But about the sixteenth day, his urinewas a little thicker, with a small sediment. He was somewhatrelieved, and came more to himself. The seventeenth it was thinagain. Swellings arise behind both the ears, attended with pain.He got no sleep, but was delirious, and had a pain in his legs. Thetwentieth, the fever left him. The crisis came on without a sweat,and he recovered himself perfectly. About the twenty- seventh, aviolent, but short, pain of his right hip seized him. The swellingsbehind the ears neither subsided nor suppurated , but were painful.The thirty- first, many watery stools, with pain and difficulty, as ina dysentery. The urine thick; the swellings went away. But,about the fortieth, a pain of the right eye came on with a dulnessof sight, that went off again.Dromeadas's wife, the second day after she had been brought tobed of a daughter, and had no reason to complain of her otheraffairs, was seized with a shivering and an acute fever. The hypochondres began to be painful the first day. A nausea came on,with horrors and tossings, nor could she afterwards sleep. Shefetched her breath deep and seldom , and immediately drew it backTHE FIRST BOOK OF EPIDEMICS. 343again. The second day after the shivering she had a very goodstool; her urine was thick, white, and turbid, as when it is shookafter standing a long time, but had no sediment. No sleep in thenight. The third day about noon she shivered again, and was veryfeverish. The urine, as before; the flanks painful, with nauseas;an uneasy night, and no sleep. She was also in a coldish sweat allover, but presently grew warm again. The fourth, the hypochondres were a little easier, but the head heavy and painful, withsomewhat of a stupidness. A few drops from the nose; a drytongue, and thirsty; the urine thin and oily; and with these a littlesleep. The fifth, she was thirsty and qualmish. The urine as before, and the body bound. About noon was very lightheaded, andpresently after came to herself again. Upon getting up was somewhat stupid, and a little cold; slept in the night, and was lightheaded. The sixth day betimes in the morning she shivered again,and presently grew warm; sweated all over, but the extremitieswere cold; grew lightheaded, and breathed deep and seldom.Soon after convulsions came on from the head, and she went offpresently.A man who was a little feverish got his supper and drank plentifully, but in the night brought up all again. An acute fever followed, with a pain of the right hypochondre, and a gentle softishinflammation tending outwards. He rested badly; his urine at firstwas thick, red, and had no sediment after standing; his tongue dry,but not very thirsty. The fourth, an acute fever, with pain all over.The fifth, smooth, oily urine in great quantity. A raging fever.The sixth, in the evening, he was very lightheaded, and had nosleep in the night. The seventh, was worse in all respects. Theurine, as before. He talked much, and could not contain himself.The belly, being stimulated, discharged watery ' turbid stuff withworms. An uneasy night. Betimes in the morning a shivering,and acute fever; a hot sweat followed, and the fever seemed to gooff. He slept but little, and upon waking was cold, spit much, andin the evening was very delirious. Soon after he vomited blackstuff, a little bilious. The ninth, was cold again, very delirious,and got no sleep. The tenth, had a pain in his legs, and was in allrespects worse and delirious. The eleventh, died.A woman that lived upon the shore, three months gone withchild, was taken with a violent fever, and immediately complainedof pain in her loins. The third day she had a pain in her neck,344 THE WORKS OF HIPPOCRATES.head, collar-bone, and right hand; and in a short time lost herspeech. Her right hand was convulsed, and became paralytic.She grew very delirious, had an uneasy night, and got no sleep,but discharged a little bilious unmixed matter downwards. Thefourth, she recovered her speech, but the convulsions remained asbefore, with pains all over. About the hypochondre a painful swelling appeared. She could get no sleep; grew lightheaded; discharged downwards; and her urine was thin, but not well-coloured.The fifth, a violent fever; a pain in the hypochondre; great lightheadedness; bilious stools; a sweat at night, and no fever. Thesixth, she came to herself, and was better every way; but aboutthe left collar-bone the pain remained . A thirst came on; theurine was thin, and she got no sleep. The seventh, tremblings followed, with something of stupidness. She was also a little delirious,and the pain about the collar- bone and left arm remained. In otherrespects she was better, and came to herself perfectly. The intermission lasted three days without any fever. The eleventh, it returned, with shivering and great vehemence. About the fourteenth,she vomited bilious yellow matter pretty often; fell into a sweat,and was cured.Melidia, who lived by the Temple of Juno, complained of a violent pain in her head, neck, and breast; and presently after an acutefever came on. Her menses came down a little, with a continualpain in all those parts. The sixth she was comatose, qualmish,chilly, and red about the cheek, with something of a delirium. Theseventh, sweated; the fever intermitted; the pains remained; thefever returned again; and she slept a little. Her urine was constantly thin, but well- coloured; her stools thin, bilious, acrid, verysmall, black and fetid; the sediment in the urine white and smooth.She fell into a sweat, and had a perfect crisis the eleventh.THE THIRD BOOK OF EPIDEMICS.FESIUS, p. 1059. HALLER, i . p. 138. GARDEIL, ii. p. 92.THIS book, says Haller, is alike in value and in manner with thepreceding, of which it appears to be a continuation; the firsttwelve cases manifestly belong to it. The latter portion has reference to a pestilential constitution: not that a true plague accompanied with carbuncles and buboes is here described; but because alldiseases then occurring were of the highest malignity. Not one ofthe sixteen cases mentioned in this part had symptoms of the trueplague, although gangrene was not unfrequent in conjunction withthe fever, so that entire limbs fell off.Gardeil, in a short note, says, " that the lovers of ancient lorewill find at the end of each case (the first twelve) , certain hieroglyphics constituted of five or six letters each, that may be regardedas algebraic signs, to designate briefly the practical result of eachobservation, and relating more particularly to prognostic."These characters, Fasius informs us, are found in several manuscripts, but are wanting in others; and that we are ignorant whether they are from Hippocrates, or from his school; or if they arenot of a later origin. They are anterior to Galen, for he mentionsthem. Fœsius introduces them. As a mere matter of curiosity, Ithought of giving them a place here; but their want of utility ledmeto forego my first intention. -ED.This leads Clifton in his preface, to complain of the miserable arrangement of thewritings of Hippocrates, by which many books that should precede others, are madeto follow them, whilst a knowledge of these last is essential to the comprehension ofthe others. Such he asserts is the case in the editions of Mercurialis and of Fœsius.Again, he affirms, " other parts have been divided to the ruin of the main design,"&c., and mentions the first and third books of Epidemics to have been thus " very injudiciously split into two," &c., in all which remarks I think him correct; but havingto select an arrangement from among the various editions, I fixed upon that of Fœsius,and that principally from his coming first into my possession. -ED.346 THE WORKS OF HIPPOCRATES.Pythion, who lived by the Temple of the Earth, was taken witha trembling in his hands, which was succeeded the same day byan acute fever and delirium. The second, worse in all respects.The third, no alteration. The fourth, a little, simple, bilious discharge downwards. The fifth , worse in all respects. Little sleeps;no stool. The sixth, a variety of spitting, with something upon thered. The seventh, his mouth was drawn aside. The eighth, worsein all respects. The tremblings remained. The urine from thebeginning to the eighth day thin and without colour, with a littlesuspended cloud in it. The tenth, he sweated, spit matter a littledigested, and had a crisis. The urine was whitish about this time,and, forty days after, an abscess appeared by the anus, which wassucceeded by the strangury.Hermocrates, who lived by the new wall, was seized with avery acute fever, and began to have a pain in his head and loins,with a moderate distension of the hypochondre. The tongue wasburnt up from the beginning. Presently after, he grew deaf; andcould get no sleep. His thirst was moderate, and his urine thickand red, without a sediment after standing. His stools were largeand burnt. The fifth, thin urine, with a cloud that did not fall. Atnight he was lightheaded. The sixth, a jaundice; worse in allrespects, and lightheaded still. The seventh, great restlessness.The urine thin, and like the former. The succeeding days, verylittle alteration. About the eleventh every thing seemed to abate.A coma began. The urine was thick, reddish, thin towards thebottom, and subsided not. He came to himself by little and little.The fourteenth, he was neither feverish, nor sweated, but slept, andcame perfectly to himself. The urine much the same. About theseventeenth, he relapsed, grew hot, and the days following had anacute fever, with thin urine. About the twentieth another crisis.The fever went off, but without sweating. An aversion to foodlasted all the time. He came to himself, but could not speak. Histongue was dry, but without thirst. He laid comatose. About thetwenty-fourth grew hot again, and discharged much thin matterdownwards. The days following an acute fever, with a burnttongue. The twenty- seventh, he died.This patient was deaf all along; his urine thick and red withouta sediment, or thin and colourless, with a little cloud; and he couldtaste nothing.He that lived in Dealces's Garden, felt a heaviness in his head,THE THIRD BOOK OF EPIDEMICS. 347and a pain of the right temple a long time; and, upon an occasiongiven, was seized with a violent fever, and carried to bed. Thesecond day a little pure blood from the left nostril, and a good stool.The urine thin and various, with a cloud suspended, almost likeground barley and seed. The third, an acute fever. Black , thin,frothy stools, with a livid sediment in them. He was also a littlesoporose, and bore rising up with difficulty. The sediment of theurine turned livid, and somewhat glutinous. The fourth, biliousyellow vomitings in a small quantity, and after a little resting æruginous or violet. A little pure blood from the left nostril. The.stools and urine as before. A sweat about the head and collarbone. The spleen tumefied. A pain of the same thigh. A softishdistension of the right hypochondre. No sleep in the night. Alittle rambling. The fifth, more stools, black and frothy, with ablack sediment. No sleep in the night; ramblings. The sixth,black, fat, glutinous, fetid stools. Slept, and came more to himself. The seventh, a dry tongue, and thirsty. No sleep, but ramblings. The urine thin , and not well- coloured. The eighth, black,small, compacted stools; slept, and came to himself; and was notvery thirsty. The ninth, shivered, burned, sweated, was cold,delirious, and convulsed (or distorted) in his right eye; with a drytongue, thirst, and watching. The tenth, very little alteration. Theeleventh, came to himself perfectly, lost his fever, and slept. Theurine was thin about the crisis. The fever intermitted two days,and returned again the fourteenth. No sleep that night, but strongdeliriums. The fifteenth, turbid urine, as when it is shook afterstanding. A raging fever, with strong deliriums, and no sleep. Apain in the knees and legs. Black stools, by means of a suppository. The sixteenth, thin urine, with a suspended cloud. Waslightheaded. The seventeenth, early in the morning, was cold inthe extreme parts, and covered up. The fever raged; a sweatcame on all over, that relieved him; he came more to himself uponit, but was not free from his fever or his thirst. He also vomitedbilious yellow stuff in a small quantity, and had a stool; soon afterwhich, black thin stuff came away in a small quantity. The urinewas thin and not well- coloured. The eighteenth, he did not cometo himself, but was comatose. The nineteenth, no alteration. Theurine thin. The twentieth, slept, came to himself perfectly, sweated,lost his fever and thirst; but the urine was thin. The twenty- first,rambled a little , and was a little dry. A pain attacked him in the348 THE WORKS OF HIPPOCRATES.The twenty- flanks, and a continual palpitation about the navel.fourth, a sediment in the urine; and he came perfectly to himself.The twenty- seventh, a pain in the right hip. Thin urine, with asediment; and in other respects very easy. About the twentyninth, a pain in the right eye. The urine thin. The fortieth, stoolsof a phlegmy white nature, and pretty often. A great sweat allover, and a perfect crisis.Philistes, in Thasus, had a pain of his head a long time, and atlast, being somewhat stupid, was forced to lie down; but continualfevers coming on from drinking-bouts, the pain grew worse, andin the night his last fever first seized him. The next day he vomitedbilious yellow matter, at first in a small quantity, and afterwardsæruginous in a larger. His body was open, but he could get norest in the night. The second, he grew deaf, his fever raged; hisright flank was distended and turned inwards. The urine thin andtransparent, with a seed- like cloud suspended. About noon he wasa little mad. The third very uneasy. The fourth convulsed, andin all respects worse. The fifth betimes in the morning he died.Charion, who lived near Demænetus, was seized with a violentfever from a drinking- bout, and immediately complained of a heaviness and pain in his head. No sleep. Thin stools, somewhatbilious. The third day, a violent fever. The head trembled, especially the lower lip, and soon after he shivered, was convulsed, andvery lightheaded . An uneasy night. The fourth, was easy, andslept a little, but rambled. The fifth , was in pain, worse in all respects, and delirious. A bad night again, and no sleep. Thesixth, no alteration. The seventh, shivered , burned, sweated allover, and had a crisis.This patient had all along bilious, small, unmixed stools; andthin well- coloured urine, with a cloud suspended. About theeighth, the colour was better, and it had a white but little sediment. He came to himself. The fever intermitted , and returnedthe ninth. About the fourteenth, he was very feverish again,and sweated. The sixteenth, vomited a pretty deal of biliousyellow matter. The seventeenth, shivered again, was very hot,sweated, lost his fever, and had another crisis. The urine wasbetter- coloured after the relapse and the crisis, and had a sediment;nor was he delirious in his relapse. The eighteenth, he was a littlehot, and a little dry. His urine thin, with a suspended cloud; andhe rambled a little. The nineteenth, was free from the fever, butTHE THIRD BOOK OF EPIDEMICS. 349had a pain in his neck. A sediment in the urine, and a perfectcrisis the twentieth.Euryanax's daughter, a maid, was seized with a violent fever.She had no thirst all along, nor eat any thing; but had a littledischarge downwards. The urine was thin, small, and not wellcoloured. At the beginning of the fever a pain came about theanus. The sixth day, neither fever, nor sweat, and yet a crisis;the complaint about the anus suppurating a little, and breaking atthis time. The seventh, after the crisis she shivered, was a littlehot, and sweated. The eighth day after the crisis she shiveredagain, but not much; and afterwards her extremities were alwayscold. About the tenth, after the sweat that then was upon her, shegrew lightheaded, but recovered herself again presently; occasioned, as they said, by her tasting a bunch of grapes. It intermitted the twelfth day, and again she was very delirious. Herstools were bilious, small, unmixed, thin, and acrid. She got upoften: The seventh day after the last delirium she died.This patient complained at the beginning of a pain in her throat,which was inflamed all along, with the uvula drawn up; and of agreat rheum, that was withal a little sharp. She coughed too, butbrought nothing away digested. She had an aversion to everything, and not the least desire to any thing, all along; had no thirst,and drank nothing worth speaking of; was silent, and said nothing.Her mind was much dejected, and in a despairing way, and herconstitution seemed inclinable to a consumption.The woman with the quinsy, that was by Aristion's, who firstcomplained of her tongue, lost her speech, and her tongue was both.red and dry. The first day a chilliness came on, with heat afterwards. The third, a shivering, a burning, and a reddish hard swelling upon the neck and breast on both sides. Her extremities coldand livid. Her breathing difficult, with great elevation of thebreast. The drink came through her nose, and she could not swallow. Her evacuations by stool and urine were stopped. The fourth,was worse in every respect. The fifth, she died of her quinsy.The young man, who lived upon the Lyars Market, was takenwith a violent fever, after weariness, labour, and running more thanusual. The first day he had many thin, bilious stools. His urinewas thin and blackish. No sleep, and considerable thirst. Thesecond, worse in all respects. More stools, unseasonably. Nosleep. Rambled a little, and sweated a little. The third, was un-350 THE WORKS OF HIPPOCRATES.easy, dry, qualmish, with great anxiety, tossings, and ramblings.The extremities livid and cold. The soft part of his belly gentlydistended on both sides. The fourth, no sleep; was worse. Theseventh, he died, in about the twentieth year of his age.The woman by Tisamenus, who was seized with the iliac passion, was extremely uneasy, vomited much, could not contain whatshe drank, was in pain about the flanks, and the lower parts of herbelly, and in continual torment. She had no thirst, but yet grewhot. Her extremities were continually cold. A loathing, andwatchfulness came on; her urine was thin and little; and herstools crude, thin, and small. Nothing being able to relieve her,she died.A woman, who miscarried of a child, among those that wereabout Pantimis, was seized the same day with a violent fever.Her tongue was dry and thirsty , nor could she get any sleep. Herstools were thin, many, and crude. The second, she shivered, wasvery feverish, had many stools, and no sleep. The third, her painsincreased. The fourth, she was lightheaded. The seventh, shedied.Her belly was all along lax; her stools many, thin, and crude;and her urine but little and thin.Another, that miscarried about the fifth month, had a violentfever too, which at the beginning was attended with a coma, andagain a watchfulness; together with a pain of the loins, and aheaviness of the head. The second day, a few, thin, and at firstunmixed, stools . The third, more and worse. No sleep in thenight. The fourth, was lightheaded , frightened, dejected , had theright eye drawn on one side, and a little cold sweat about the head.The extremities were also cold; the fever exasperated, and a violent delirium succeeded, but went off again presently. She had nothirst, but was watchful, and had many unseasonable stools allalong. Her urine was little, thin, and blackish; her extremitiescold, and somewhat livid. The sixth, no alteration. The seventh,she died in a frenzy.The woman that lived upon the Lyars Market, after she hadbeen delivered, with a great deal of pain, of her first child (a son),was seized with a violent fever, and immediately from the beginning was thirsty, qualmish, and in great pain about the pit of herstomach. Her tongue was dry; her stools thin and few; and noTHE THIRD BOOK OF EPIDEMICS. 351sleep. The second day she shivered a little, burned, and had alittle cold sweat about the head. The third, was uneasy. Herstools crude, thin, and many. The fourth, shivered again; wasworse in all respects; and could get no sleep. The fifth, uneasy.The sixth, no alteration, but many liquid stools. The seventh,shivered again, burned, was very thirsty, and extremely restless.About the evening sweated all over, but it was cold. The extremities were cold too, and could not get warm again. Shiveredonce more at night. The extremities remained cold. No sleep. Alittle delirious, but came to herself again presently. The eighthabout noon, grew hot, dry, comatose, quamish, and vomited biliousmatter with a little yellow in it. A restless night, and no sleep. Agreat deal of urine in a gushing manner, and without her knowledge. The ninth, every thing remitted, but the coma did not gooff. In the evening she shivered a little again, and vomited a littlebilious matter. The tenth, another shivering, an acute fever, andno sleep. In the morning early made a deal of water, that subsided. The extremities were warm again. The eleventh, vomitedæruginous bilious matter, and not long after shivered again. Theextremities grew cold again. In the evening sweated, shivered,vomited much, and had an uneasy night. The twelfth, vomitedmuch black, fetid matter; hiccuped often; was dry, and uneasy.The thirteenth, vomited much black, fetid matter again; shivered,and about noon lost her speech. The fourteenth, bled at the nose,and died.This patient was all along loose in her body, and chilly. Herage, about seventeen.At this part, Fosius begins with the account of the " Status Pestilens," the xarasadis λouwons, of Hippocrates. Haller calls it " Constitutio Temporis Pestilens," and Clifton, " The Malignant State."As this pestilential constitution has by many been considered as adescription of the plague at Athens, as given by Thucydides, Clifton has shown, I think conclusively, that Hippocrates has no reference to it , in this detail. It may be interesting to many to readThucydides' account, with the objections of Clifton, in connexionwith this part of the Third Epidemics. -ED.352 THE WORKS OF HIPPOCRATES..The year was southerly, showery, and perpetually calm: but,greater droughts than ordinary happening some time before, muchrain fell about the rising of Arcturus with the southerly winds.The autumn was gloomy, cloudy, and very wet. The wintersoutherly, wet, and mild; but a considerable while after the solstice, near the equinox, the weather was very severe; and, evenabout the equinox, northerly winds set in, and snow that lasted notlong. The spring was again southerly and calm. A great dealof rain fell continually to the rising of the Dog- star. The summerwas serene and hot, attended with great suffocating heats. TheEtesia blew faintly and by intervals. About the rising of Arcturusmuch rain fell again, with the wind northerly. The year being thussoutherly, damp, and mild , the winter proved healthy to all but consumptive people, as we shall see by and by.Early in the spring, with the cold weather that then set in, camea great many erysipelases, some from evident causes, others unaccountably; of a bad sort, and fatal to many. Many complained ofpain in their throats, and impediments in their speech; of burningfevers, with frenzies, aphthas in the mouth, tubercles upon the private parts, inflammations of the eyes, carbuncles, disorders of thebelly, aversions to food, with thirst in some, in others not; turbidurine, in abundance, and of a bad sort; comas for the most part,and again watchings; crises not at all in many, or with difficulty;dropsies, and consumptions not a few. These were the epidemicaldiseases, of which there were some ill of every kind, and manynever recovered it. The manner of their illness was as follows.Many had erysipelases (that came from evident causes), uponvery slight and trifling wounds, all over the body, especially aboutthe head in those who were near sixty, if they were but a littleneglected. Many again, while under cure, had great phlegmonsformed, round which the erysipelas spread considerably, and in ashort time. In most of them the matter that was separated turnedto suppuration, and great fallings off of flesh, tendons, and bonesensued. The humour that was collected there was not like pus,but a certain kind of putrefaction, with a copious running of greatvariety. Now, wherever any of these happened about the head,the hair of the whole head and chin came off, and the bones werelaid bare, and fell off, attended with great discharges. Thesethings happened sometimes with, sometimes without, a fever, andwere more terrible than dangerous. For, wherever any of thesedisorders were digested and turned to suppuration, there most ofTHE THIRD BOOK OF EPIDEMICS. 353them did well; but where the phlegmon and erysipelas went offwithout any such abscess, there many of them died. The like circumstances happened, whatever part of the body it fell upon in itsway. In many a flux happened upon the arm and whole elbow.Where it fell upon the ribs, it affected them either before or behind.Some had the whole thigh, or the leg, or the foot, laid bare: butthe most dangerous of these was, when they fell upon the pubes orprivate parts. This was the nature of their attack, when eitherulcers, or any other cause, occasioned the erysipelas. Many ofthem had it in fevers, before fevers, and upon fevers. To these,where any of them went off by suppuration, or by a considerablepurging, or a discharge of laudable urine, it proved critical; butwhere none of these happened, and they disappeared without anysigns, it proved fatal. Thus the case stood among many with respect to the erysipelas in the spring, which continued also throughthe summer, and during the autumn. The tubercles in the throatwere very troublesome too to some persons, and so were the inflammations of the tongue, and the abscesses of the teeth. Thevoice, when it was vitiated and obstructed, was likewise anothersign to many, especially to those who began to be consumptive,and to those who had burning fevers and phrensies.These fevers and phrensies began early in the spring after the coldweather that then happened, and a great number were laid up withthem at that time. They also proved very acute and mortal. Thestate of the fevers was thus. At the beginning they were troubledwith comas, nauseas, horrors, acute fevers, but little thirst, and nodelirium. They also bled a little at the nose, and the paroxysmsfor the most part were upon equal days. About the time of theparoxysins came on loss of memory, great languidness, and loss ofspeech. The fingers and toes were always cold, but much more soabout the paroxysms, and the warmth returned again slowly andimperfectly. They came to themselves again , and spoke; buteither a continual coma, without sleep, was upon them, or painfulwatchings. A great many were troubled with crude thin stools inabundance. The urine was plentiful and thin, without any thingcritical or beneficial in it; nor did any thing else of a critical kindhappen to those who were thus affected; for they had neither agood hemorrhage, nor any critical separation of what is usual topass off; but every one died, ( as fate would have it, ) in a vagueand uncertain manner, about the time of the crisis for the most.23354 THE WORKS OF HIPPOCRATES.part; some held out a longer time, but died at last , without speaking, and many sweating. Thus the case was among those whowere mortally ill; and there was but little difference in the phrensies.For they were entirely without thirst or madness, as in otherphrenŝies, but were taken with a kind of stupid delirium, and diedwith the heaviness upon them. There were also other fevers, ofwhich we shall take notice. Aphthas, and ulcers in the mouth,were frequent; and great fluxes upon the private parts, with ulcerations, tubercles, outwardly and inwardly; swellings in the groin;inflammations of the eyes that were humid, of long duration, andpainful; besides little tumours upon the eyelids, outwardly and inwardly, called Luxa, that destroyed the sight in many persons. Thelike happened upon other ulcers, and upon the private parts. Therewere also many carbuncles in the summer, and other large pustulesof the putrid kind, called En; many large herpes's or tetters, andmany complaints in the belly too, that did a great deal of harm.In the first place many were seized with painful tenesmus's, especially children, and those who were under the age of puberty, mostof whom died. Many also had lienteries, and dysenteries, but thesewithout much pain. The discharges were of the bilious, fat, thin,and watery kind; and in many the distemper took this turn, sometimes with, sometimes without, a fever. There were likewise cruelgripings and twistings of the guts, with intolerable pain. Manythings that were in the body and suppressed were let out, but thesedischarges did not carry off the pains. What was administeredmet with great difficulty; for purges were very injurious to most.Of these that were thus affected many died in a short time, andmany again held out longer. In a word, all that were ill , whetherof acute or chronical complaints, died chiefly of disorders of thebelly; for the belly was the general receiver of all. There was, asfar as I could observe, an aversion to food in every body, in all theforementioned diseases. In many, especially of this sort, and thelike; and among others of those who were mortally ill , some werethirsty, others not. Of those who had fevers and other disordersno one drank intemperately, but with respect to this regulated.themselves as the physician would have them. The urine wasmuch, and that not in proportion to the drink taken in, but vastlymore; and that which came away was very bad in its quality;having neither thickness, nor digestion, nor was the body wellcleansed by it. Whereas in many cases cleansings by the urineTHE THIRD BOOK OF EPIDEMICS. 355that are good are very beneficial. To the greatest part they nowimplied corruption or colliquation, disorder, pains, and the want ofa crisis. Comas likewise happened, particularly in the phrensies andthe burning fevers; not but they happened too in all the other capital diseases, where a fever attended; but in many, a heavy comafollowed, or little and gentle sleeps, all the time.Many other kind of fevers were also epidemical, such as tertians,quartans, nocturnals, continuals, chronicals, erratics, inconstants,and such as were attended with nauseas and inquietude. All thesebrought with them great uneasiness: for the belly was in mostcases much disturbed, horrors came on, and sweats that were notcritical. As to the urine, that was as we have already describedit . A great many of them were likewise tedious; the abscesses,that happened here, not proving critical as at other times. Addto this, the crises were universally very difficult, and sometimesnot at all; or proved very tedious, especially to these. A few ofthem were determined in about eighty days; but to the greatestpart they went off at random. A few of these died of a dropsy,without being confined to their beds. Many were afflicted withtumours that came upon other diseases, and above all those whowere consumptive. For the greatest, most difficult, and most fatalwas the consumption. Many of these, beginning in the winter,obliged a great number to keep their beds, while some of thembore it standing. Early in the spring most of those who were laidup died, and none of the rest got rid of their coughs. They abatedindeed in the summer, but in the autumn they were all laid up,many died, and most of them were ill a long time. The greatestnumber of these began to be extremely ill presently after thesecomplaints, and had frequent horrors, continual acute fevers veryoften, and unseasonable sweats. Many were cold continually thecold was great too, and they could hardly get warm again. Thebelly was bound many ways, and presently again became humid;all that oppressed the lungs passing downwards. A great deal ofurine was made, but not good; bad colliquations appeared; coughswere frequent all along, and much came away digested and moist,and with tolerable ease. But if they were a little in pain, the discharge from the lungs was then very gentle in all. The throat wasnot much affected with acrid, nor did salt humours do any harm.What came from the head was viscid, white, moist, and frothy.But the greatest evil of all, in these and other cases, was, what we356 THE WORKS OF HIPPOCRATES.have taken notice of before, a dislike to food: for they had no pleasure in eating and drinking, but passed the time very free fromthirst. There was also a heaviness in the body, and a coma.A great many swelled, and fell into dropsies, were troubled withhorrors, and before they died grew delirious.Those who fell into consumptions were the smooth, 'the whitish,the lentil- coloured, the reddish, the gray- eyed, the leucophlegmatic ,and those whose shoulders stuck up behind. Nor did women ofthese kinds escape. The melancholic, and the sanguine sufferedtoo. These were affected with burning fevers, phrensies, and dysenteries; the young men, with tenesmuses; the phlegmatic, with longdiarrhoeas; and the bilious, with sharp and fat purgings. To allthe above-mentioned the most troublesome time was the spring,which proved fatal to great numbers; the summer was the easiest,and fewest died; but in the autumn, and during the Pleiades, agreat many died of quartans.The summer happening as it ought, is, in my opinion, of greatservice for summer diseases cease upon the coming in of winter,and winter diseases upon the coming in of summer. Though thesummer that then was, was not well- conditioned, but on a suddenhot and southerly and calm; yet changing to another constitutionor season was of service. And indeed I look upon it to be a greatpart of the art to be able to consider properly what has been already wrote. For he who knows, and makes use of, these things,does not seem to me capable of any great mistakes in his profession.But then he ought to be well acquainted with the condition of everyseason, and also with the disease; the good that is common to theseason or the disease, and which disease will be long and fatal,long and safe, acute and fatal, acute and safe; and likewise theorder of the critical days. These things he ought to consider andpredict from; because they are able to supply him. And he whois acquainted with these things will know whom, when, and howto diet, or manage the rest.THUCYDIDES UPON THE PLAGUE AT ATHENS.In the very beginning of summer, the Peloponnesians, with twothirds of their allies, invaded Attica, as they had done the first yearTHE THIRD BOOK OF EPIDEMICS. 357of the war, under the conduct of Archidamus the son of Zeuxidamus king of Sparta; and, after encamping, wasted the countryabout them. They had not been many days in Attica, before theplague first broke out among the Athenians, after having beforethat visited, as the report went, Lemnos and many other places:but so great a plague and mortality was never yet known, in thememory of man. The physicians were so far from being able tocure it at first, for want of knowing the nature of it, that they themselves died faster than others, as being most familiar with the sick;nor could any other art of man make head against it. All supplications to the gods, and inquiries of oracles, and the like, signifiednothing; so that, at last, overcome with the distemper, they leftthem all off. It began, by report, first in that part of Ethiopia thatlies above Egypt, and so came down into Egypt and Lybia, and agreat part of the King of Persia's dominions. Athens was seizedwith it on a sudden, but first in Piraeus; which occasioned a reportthat the Peloponnesians had thrown poison into the wells; for atthat time they had no springs or fountains there. Afterwards itcame up into the high city, and proved much more mortal thanbefore. Now let every man, physician or private person, say, according to his knowledge, what the origin of this distemper mightbe, or what causes might be sufficient to produce so great analteration. For my own part, having been ill of it myself, and seenothers that were so too, I shall now declare what the manner of itwas, that, if ever it should happen again, nobody who reflects uponit, may be at a loss through ignorance.The year was universally allowed to be the healthiest and freestfrom other diseases of any; and, if any one was sick before, all hisillness was converted to this. Others, who were in perfect health,were taken suddenly, without any apparent cause, with violentheats in their heads, and with redness and inflammations in theireyes. Their tongues and throats within became immediatelybloody; their breath in great disorder and offensive. A sneezingand a hoarseness ensued; and, in a short time, the pain descendedinto the breast, attended with a violent cough. When it was oncesettled about the mouth ofthe stomach, a retching, and vomiting ofbilious stuff, in as great a variety as ever was known among physicians, succeeded, but not without the greatest anxiety imaginable.Many were seized with a hiccup, that brought up nothing, butoccasioned a violent convulsion, which in some went off presently,358 THE WORKS OF HIPPOCRATES.but in others continued much longer. The body outwardly wasneither very hot to the touch , nor pale, but reddish, livid, and flowered (as it were) all over with little pimply eruptions, and ulcers;but inwardly the heat was so exceedingly great, that they couldnot endure the slightest covering, or the finest linen, or any thingshort of absolute nakedness. It was also an infinite pleasure tothem to plunge into cold water; and many of those who were notwell attended did so, running to the wells, to quench their insatiablethirst not that it signified whether they drank much or little; agreat uneasiness and restlessness attending them, together with acontinual watching. While the distemper was advancing to theheight, the body did not fall away, but resisted the vehemence of itbeyond expectation; so that many of them died the ninth and theseventh day of the inward burning, some strength yet remaining;or, if they held out longer, many of them afterwards died of weakness; the distemper descending into the belly, and there producingviolent ulcerations, and fluxes of the simple or unmixed kind. Forthe disease went through the whole body, beginning first in thehead; and, if any escaped, where the case was very desperate, thiswas denoted by the extremities being affected: for it broke outupon the private parts, the fingers and toes; and many came offwith the loss of those parts. Some, again, lost their eyes; otherswere seized, immediately upon their getting up, with an absoluteforgetfulness of every thing, not knowing themselves, or those thatwere most familiar; the appearance, or the nature, of the distemperbeing greater than words can possibly express, and harder to beborne than human nature is accustomed to. Nor indeed was it anyof those diseases that are bred among us, as appeared very plainfrom this circumstance. For the birds and beasts that feed onhuman flesh, though many carcasses laid abroad unburied, eithercame not to them, or tasting died. The manifest defect or scarcityof such fowl was a proof of this; for they were neither seen anywhere else, nor about any of the carcasses: but the dogs, beingbrought up among us, made the case yet more evident. The disease therefore (to pass over many strange particulars that happeneddifferently in different persons) was in general such as I have described it; and as to other usual distempers, none of them werethen troublesome; or, if any appeared, they all centered in this.Some of them died for want of attendance, and some again withall the care imaginable. Nor was there any (to say) certainTHE THIRD BOOK OF EPIDEMICS. 359remedy, which, upon application, must have helped them: for, if itdid good to one, it did harm to another. Nor was there any difference in bodies, as to strength or weakness, to enable them toresist it; but it swept all away, what care or method soever wastaken. The terriblest circumstance of all was the dejection of mindin those that found themselves beginning to be ill (for, growing immediately desperate, they gave themselves over much more, without making any resistance); and their dying like sheep, infectedby their care and concern for others, increased their despair; thegreatest mortality proceeding this way. For, if they were unwilling to visit others through fear, they died by themselves withoutassistance (by which means many families became desolate, forwant of somebody to take care of them); or, if they visited, theylikewise died, especially those who had virtue or humanity enoughto do any friendly offices: for such out of shame would not sparethemselves, but went in to their friends, especially after it came tothat pass that even the domestics, wearied with the lamentations ofthose that died, fell ill themselves, overcome with the greatness ofthe calamity. But those that were recovered had much compassion on those that were dying, and on those that lay sick, as havingknown the misery themselves, and now were in a secure and safesituation: for it never seized the same person twice, so as to bemortal. Others, therefore, esteemed them happy, and they themselves, through excess of present joy, conceived a kind of smallhope never to die of any future sickness.The bringing provisions from the country to the city was an additional grievance, and equally affected those who came with theminto the city. For, having no houses, but dwelling, at that time ofthe year, in stifling booths or huts, the mortality was now withoutany form or order; dead men, and those that were just expiring,lying upon one another in the streets, while men half dead layabout every well, desiring a little water. The temples, also, wherethey dwelt in tents, were also full of the dead that died there: for,oppressed to the last degree by the violence of the distemper, andnot knowing what course to take, men grew equally careless bothof holy and profane things. All the laws relating to funerals, thathad been observed before, were now violated and confounded;every one burying where he could find room. Many, for want ofnecessaries, after so many deaths before, were become even impudent in the article of funerals. For, when one had made a funeral-360 THE WORKS OF HIPPOCRATES.pile, another, getting before him, would throw on his dead, and setfire to it and, while one was burning, another would come, andthrowing him upon it that he had brought along with him, wouldgo away again.The great licentiousness, which was also used here in other respects, began at first from this disease. For what a man wouldbefore dissemble, and not acknowledge to be done for the sake ofpleasure, he now durst freely own, seeing before his eyes suchquick revolutions of things, rich men dying suddenly, and succeededby others not worth a groat; so that they thought it better to havea speedy enjoyment of their estates and pleasures, as men that heldtheir lives and fortunes alike by the day. As to laborious works,no man was forward to undertake any thing noble or laudable;not knowing whether he should live to finish it; but what any manknew to be delightful, and every way conducing to pleasure, thatwas made both profitable and honourable; neither the fear of theGods, nor the laws of men, restraining any. For, with respect tothe one, they concluded, from what they saw, that it was all thesame whether they worshipped, or not worshipped; all men dyingwithout distinction; and, with respect to the other, no man expectedhis life would last until the law could punish him for his misbehaviour. But they thought there was now, over their heads, somegreater judgment decreed against them, before which fell, it wasbut fit they should enjoy some little part of life. Such was thecalamity that came upon the Athenians, and oppressed themgreatly; their men dying of the disease within, and the enemywasting the country without.CONCLUSION OF THE HISTORY OF THE PLAGUE AT ATHENS.Clifton having in his preface attempted to overthrow the opinionof this Plague, being the same as Hippocrates has described underhis Pestilential Constitution, his reasons are placed here, for theconsideration of the reader. -ED."To correct a mistake that several learned men have run into, Ihave added (by way of comparison) , at the end of the malignantor pestilential year, the account of the plague of Athens by Thucy-THE THIRD BOOK OF EPIDEMICS. 361dides, by which the reader will plainly see, that Hippocrates neverintended a description of that plague, or of any other properly socalled, but only of the raging ill- conditioned fevers, and other severecomplaints, that then went about. There are indeed some circumstances concurring with Thucydides, such as the inflammations ofthe eyes, with sometimes a total loss of the sight; the disorders ofthe belly, and the private parts, &c.; but then no notice is takenof the violent heats in the head, the bloodiness of the throat, thesneezings and the hoarseness, the vomitings and the hiccups, theplungings into cold water and despondencies, (to pass by manyother particulars, ) mentioned by Thucydides; circumstances, thatit was not possible for so curious an observer as Hippocrates toforget or overlook. Add to this, that the description here givencontains nothing uncommon for such a country, or inconsistentwith such a sultry wet season, and is supported by cases not atall from Athens, but from places far remote, and more upon theThracian coast than any where else, such as Thasus and Abdera;places that Hippocrates chiefly resided at. Whereas, if the plagueof Athens had been here intended, the cases would have been allrelated from the very place itself, and in a manner quite differentfrom the present. I therefore conclude, that our learned countryman, Prideaux, and all others of his opinion , are very much mistaken, when they look upon this section in Hippocrates, as a description of that terrible plague. But to consider the point a littlefarther. Thucydides observes, that the distemper broke out firstin Lemnos, and many other places, before it came to Athens, beginning (by report) in that part of Ethiopia that lies above Egypt,and so came down into Egypt and Libya, and a great part of theKing of Persia's dominions. Nor did it leave the Greek islandstill some considerable time after. Accordingly we find a letterfrom Artaxerxes to Hystanes, the Persian governor of the Hellespont, complaining of the plague being got among his army, anddesiring at any rate the assistance of Hippocrates. Now thisseems to be the same plague described by Thucydides; and yet,

• See his Connexion, vol. ii. p. 569, the ninth edition , in 1725, where are these express words, viz.: " Lucretius has also given us a poetical description of it (meaning

the plague) , and Hippocrates has written of it as a physician. For that great masterofthe art ofphysic lived in those times, and was at Athens all the while this distemperraged there. "362 THE WORKS OF HIPPOCRATES.in the life of Hippocrates wrote by Soranus, we find anotheraccount very different: for the plague there mentioned, that gainedhim so much honour, is said to have begun among the Illyrians andPoonians, and so came down into several parts of Greece. Nowthe Illyrians were a people that inhabited that part of the countrywhich we call Servia, and Albania, bordering upon Dalmatia,Dardania (or Bosnia) , Macedonia, and Pœonia; and the Pœoniansbordered upon Macedonia to the south, Illyris to the north, Dardania to the west, and Thracia to the east; so that this plague (ifany such there was) seems to have travelled from the north to thesouth; whereas the other travelled directly contrary, or at leastfrom the southeast to the northwest. I conclude, therefore, that , ifthe Illyrian story is true, the description here given answers betterto the state of diseases then; but that the whole story is false I ammore inclined to believe, because the plague of Athens was theonly one in those days recorded by men of credit. It is true, theIllyrians might have reason enough to complain of a very sicklyseason, and other countries might be attacked with the same, oreven worse, disorders; all which might proceed from the plagueoriginally, for any thing I can say to the contrary. For, as Thucydides observes, Lemnos and many other places were infected aswell as Athens, the skill of the physicians availing nothing; and, ifhis account be true, the same winds that brought it there (supposingthe wind to have had a share in the affair) might easily have carried it farther, Lemnos being but a little step from the Thracianshore one way, and the south parts of Macedonia another; though,in travelling there, the force and virulence of it might be so farbroke as to produce no more than a very sickly season. Butwhether the malignant time here mentioned was actually at thetime of the plague, or very near it, this at least is certain, that wetseasons, sultry heats, and calm weather, are always attended withbad diseases; and such was the year now in question; but, forwant of a date (a great omission in Hippocrates) the precise timecannot certainly be known, though there is a great deal of room tobelieve, both from the title itself, xarastacıs 201µwdns, (which, however,Galen suspects as spurious) and the nature of the diseases therementioned (which certainly were of a very bad, or, if you please,malignant sort), that it was drawn up much about that terribletime, and perhaps the very year of the plague; yet not as a description of the plague itself ( for then it would have been weg oo ),THE THIRD BOOK OF EPIDEMICS. 363but only of a malignant year, not many degrees removed from theother."We now return to Hippocrates. -ED.In Thasus, the son of Parion, who lived above the Temple ofDiana, was seized with an acute fever, which at first was continual,burning, and attended with thirst. He was from the beginningcomatose, and again watchful. His belly loose. His urine thin.The sixth day oily urine, with ramblings. The seventh, worse in allrespects; no sleep; the urine as before; lightheadedness, together withbilious, fat, stools. The eighth, he bled a little at the nose; vomitedæruginous stuff in a small quantity; and slept a little. The ninth,no alteration. The tenth, a remission of all the symptoms. The eleventh, a sweat, but not all over. He grew cold all over, and in ashort time warm again. The twelfth, an acute fever; manybilious, thin stools; a thin cloud in the urine; and a ramblinghead. The seventeenth, great uneasiness, having had no sleep, buthis fever did not increase. The twentieth, a sweat all over; nosleep; bilious stools; an aversion to food; and a coma. Thetwenty-fourth, a relapse. The thirty-fourth, no fever; the bodynot bound; but he grew hot again. The fortieth, no fever; the bodybound, but not long; an aversion to food; a gentle fever again,but in the erratic way continually, sometimes present, sometimesnot; for, if it left him or if he was easier, it returned again. Whathe eat was of the worst kind, and in a great quantity. After thereturn he slept badly, and was lightheaded. The urine was thenthick, but turbid and bad. The body sometimes bound, sometimeslax. He was also continually feverish, had many thin stools, andthe hundred and twentieth day he died.This patient's belly was constantly, from the first day, either laxwith many bilious liquid stools, or bound with hot and undigestedmatter. The urine bad all along; and a coma for the most part,with pains, watchings, loathing of food, and a burning fever continually.In Thasus, the woman that lived by the cold Spring, after beingdelivered of a daughter, and not cleansed, was taken with an acutefever the third day, and a chilliness. But, long before she wasbrought to bed, she had been laid up with a fever, and aversion tofood. After the shivering, the fever became continual, and acute,attended with a sense of horror or chilliness. The eighth day and364 THE WORKS OF HIPPOCRATES.the following she was lightheaded, but came to herself again presently, and had many thin, watery, bilious stools, without thirst.The eleventh, she came to herself again, but was inclined to astupidness; made a great deal of thin and black urine; and keptawake. The twentieth, was a little cold outwardly, and warmagain presently; rambled a little, and kept awake. Her stools asbefore; and her urine watery, and plentiful. The twenty- seventh,neither fever, nor stool, but not long after a violent pain of the righthip that lasted long. She grew feverish again, and made wateryurine. The fortieth, the hip was a little easier; but she had a continual cough, and very humid; no stool; a dislike to food; and theurine as before. The fever not entirely off, and the paroxysms inthe erratic way, sometimes present, sometimes not. The sixtieth,the cough ceased without any sign; no concoction appearing inwhat was spit, nor any separation of what is usual, but the rightjaw was convulsed . She was also comatose, and lightheadedagain, but came to herself presently. Her aversion to food stillcontinued; the jaw came to itself; the stools were a little bilious;the fever increased, not without chilliness; and the days followingshe lost her speech, recovered herself again, spoke, and died theeightieth.This patient's urine was all along black, thin, and watery. Acoma came on, with fasting, despondency, watchings, anger, impatience, and melancholy.In Thasus, Pythion, who lived above the Temple of Hercules,after labour, and weariness, and careless eating, was taken with agreat shivering, and an acute fever. His tongue was dry, thirsty,bilious. No sleep. His urine blackish, with a thin cloud above,and no sediment. The second day about noon his extremities werecold, especially his hands and head. He lost his voice, and couldnot speak; was short-breathed; in a little time grew warm; wasthirsty; had a quiet night; and sweated a little about the head.The third, a quiet day. In the evening, about sunset, he grew alittle cold; had a very restless night and no sleep; and voided littlehard pellets. The fourth, in the morning early, he grew easy again,but about noon worse in all respects. He was also cold; lost hisvoice and speech too; was worse and worse; in time grew warmagain; made black urine, with a little floating cloud; had a quietnight, and slept. The fifth, he seemed to be easier, but complainedof a weight in the belly with pain; was thirsty; and had an uneasyTHE THIRD BOOK OF EPIDEMICS. 365night. The sixth, in the morning early, he was quiet, but aboutsunset his pains increased, and he was worse; but, after a gooddischarge in the evening from a glyster, slept in the night. Theseventh, he was qualmish in the day, and a little impatient; madeoily urine; at night was much out of order, rambled, and got nosleep. The eighth, slept a little betimes in the morning, but presently grew cold, lost his speech, and breathed but faintly and lessand less. In the evening was hot again, and delirious; but, as theday advanced, was a little easier. His stools simple, small, andbilious. The ninth, was comatose, and qualmish, when he wasraised, but not very thirsty. About sunset was very restless, rambled, and had a bad night. The tenth in the morning early wasspeechless, very cold, very feverish, sweated much, and died.His pains were upon equal days.He that had a phrensy and was laid up the fifth day, vomitedmuch green thin matter; was feverish and chilly; sweated muchand continually all over; and had a weight and pain in the headand neck. He had also thin urine, with little clouds scattered upand down, that subsided not; thundering stools; rambled much; andgot no sleep. The second day betimes in the morning he lost hisspeech; was very feverish; sweated, but did not lose his fever;trembled all over; and at night was convulsed. The third, wasworse in all respects. The fourth, died.In Larissa, one who was bald was taken suddenly with a pain inhis right thigh, and nothing that was applied to it did him any good.The first day an acute and burning fever, which abated a little, butthe pain still continued. The second, the pain of the thigh abated,but the fever increased. He was also somewhat impatient, without sleep, cold in his extreme parts, and made a great deal of water,but not good. The third, the pain of the thigh ceased, but he grewlightheaded upon it, greatly disordered, and full of tossing. Thefourth, about noon, he died in a very acute manner.In Abdera, Pericles was taken with an acute, continual, feverand pain. A great thirst succeeded, and a qualmishness; nor couldhe contain what he drank. He was also somewhat large- spleened ,and heavy-headed. The first day, blood came from the left nostril;the fever raged much; and his urine was turbid, thin, copious, without a sediment after standing. The second, worse in all respects,but the urine was thick indeed, and rather subsided; and with respect to his oualmishness he was easier, and slept. The third, the366 THE WORKS OF HIPPOCRATES.fever abated. The urine was increased, digested, and had a greatsediment. The night was pleasant. The fourth day about noon,a great hot sweat all over. The fever was carried off by it, andreturned not again.In Abdera, a virgin, who lived upon the Holy Way, was seizedwith a burning fever, thirst, and watchfulness. Her menses camedown then for the first time. The sixth day she was very sick ather stomach, high- coloured, shivering a little, and restless . Theseventh, no alteration. The urine thin indeed, but well- coloured;the belly quite easy. The eighth, she was deaf, very feverish,watchful, qualmish , shivering a little, but yet in her senses, andmade the same urine. The ninth, and the following days, no alteration. The deafness remained. The fourteenth, the mind wasdisordered, and the fever abated. The seventeenth , she bled muchat the nose; the deafness abated a little; but the following daysshe was qualmish, deaf, and lightheaded. The twentieth a pain inher feet came on; her deafness and delirium went off; she bled alittle at the nose, sweated, and lost her fever. The twenty-fourth,she relapsed, and was deaf again; the pain in her feet remained,and she grew delirious. The twenty- seventh, sweated much, andlost her fever and deafness; the pain in her feet remained a little,but in other respects the crisis was perfect.In Abdera, Anaxion, who lived by the Thracian Gates, wasseized with an acute fever. His right side was continually in pain,attended with a dry cough, that brought nothing up the first days.A thirst came on, with a want of sleep, and urine that was wellcoloured, much, and thin. The sixth day he was lightheaded, andreceived no benefit from warm applications. The seventh, wasvery uneasy. The fever increased, and the pains abated not. Thecough was very troublesome, and a difficulty of breathing came on.The eighth, he was blooded in the arm, and that plentifully, as heought. The pains abated, but the dry cough still continued. Theeleventh, the fever abated; he sweated a little about the head;coughed still; and brought away from the lungs something morehumid. The seventeenth, he began to spit a little concocted matter,and was relieved; but was thirsty, and the lungs were not wellcleansed. The twentieth, he sweated, lost his fever, and after thecrisis was easier. The twenty- seventh, the fever returned; andmuch digested matter came away by coughing. The urine had alarge white sediment; the thirst went off, and sleep came on. TheTHE THIRD BOOK OF EPIDEMICS. 367thirty-fourth, he sweated all over, had no fever, and was perfectlyfreed.In Abdera, Heropythus was taken with a pain in his head as hewas upon his legs, and not long after was forced to lie down. Hishouse was by the upper path. An acute burning fever came on,with a vomiting of much bile at the beginning; a thirst; great uneasiness; and thin black urine, sometimes with, sometimes without,a cloud atop. The night was uneasy; the paroxysms of the feveruncertain; and for the most part out of the common course. Aboutthe fourteenth day he grew deaf; the fever increased; the urine, asbefore. The twentieth, and the following days, he was very lightheaded. The fortieth , bled much at the nose, and came more tohimself. The deafness remained still, but was less. The feverabated. The following days he bled again often, and a little at atime. About the sixtieth his bleedings stopped; but in the right hipwas a violent pain; the fever increased; and not long after painsattacked all the lower parts. It happened too, that the fever waseither greater, and the deafness considerable, or that, upon anabatement of these, the pains in the lower parts, about the hip, werestronger. About the eightieth, there was a general remission, butit did not go quite off. The urine was well- coloured, and had agood sediment; and the deliriums were abated. About the hundredth, a great discharge of bilious matter downwards, that did notcease presently. These were succeeded by dysenteric complaintsand pain; though in other respects he was very easy. In fine, thefever went off, the deafness ceased, and upon the hundredth day aperfect crisis happened in this burning fever.Nicodemus, in Abdera, after venery and drinking, was seizedwith a violent fever. In the beginning he was qualmish, heartburnt, thirsty, with a burnt tongue, and thin black urine. Thesecond day the fever increased. He was also chilly; qualmish;got no sleep; vomited bilious yellow stuff; made the same urine asbefore; had a quiet night, and slept. The third, every thing abated,and he was easy; but about sunset he was taken with an uneasinessagain, and had a bad night. The fourth he shivered; was veryfeverish; in pain all over; made thin urine, with a cloud in it; andwas very delirious. The seventh, easy again. The eighth, all theother complaints abated. The tenth, and the following days, hecomplained of pains, but not so much as before; and both painsand paroxysms were all along rather upon equal days. The twen-368 THE WORKS OF HIPPOCRATES.tieth, white thick urine, that subsided not upon standing; a greatsweat; the fever seemingly spent: but about sunset he grew hotagain, and had the same pains, with chilliness, thirst, and a littlerambling. The twenty- fourth, much white urine, with a good sediment; and a great hot sweat all over, that put an end to the fever,and produced a good crisis.A peevish, melancholy woman, in Thasus, was taken, after grieving upon some occasion, with watchings, dislike to food, thirst, andgreat uneasiness, while standing and walking about. She livednear Pylades's, upon the Plain. The first day, as the night cameon, she grew fearful, talked much, desponded, and had a little fever.The next morning early was much convulsed, and, upon the convulsions intermitting, was lightheaded, and talked obscenely. Herpains were many, great, and constant. The second day, no alteration; no sleep; the fever higher. The third, the convulsionsceased, but the coma and delirium remained. She waked again,got up, and could not contain herself; was very lightheaded, andvery feverish. The same night she had a plentiful sweat, but notall over; the fever however left her; she slept, came to herself perfectly, and had a crisis. About the third day the urine was blackand thin, and the cloud in it for the most part round and floating.At the crisis her menses came down plentifully.In Lariffa, a maid was seized with an acute burning fever, attended with want of sleep, thirst, a fuliginous (or sooty) dry tongue,and urine that was well- coloured, but thin. The second day shewas uneasy, and got no sleep. The third, had several waterystools, and the following days the like, without fatigue. The fourth,the urine was thin, a little in quantity, with an elevated cloud thatsubsided not. A delirium at night. The sixth, she bled very freelyat the nose; shivered a little; sweated plentifully and hot all over;and the fever came to its crisis. But in the course of the fever, andupon the crisis happening, her menses came down then for thefirst time, she being a young virgin.She was all along qualmish, subject to horrors, red in the face,and had a pain in her eyes, with a heaviness in her head. Thecrisis happened without a relapse, and her pains upon equal days.Apollonius, in Abdera, was ill a long time, but not so as to be confined. He was a large-bowelled man, had an old pain about theliver a long while, and was at that time troubled with a jaundice,bloated, and of a whitish complexion. Upon eating beef and drink-THE THIRD BOOK OF EPIDEMICS. 369ing intemperately, he was at first seized with a little warmth, andwent to bed. But upon using milk plentifully, both goat's andsheep's, boiled and raw, and a bad diet withal, all his complaintswere made considerably worse. For his fever was exasperated,and ofwhat he took in , very little to speak of passed through him.His urine was thin and little; his sleep, nothing at all; but a badkind of inflation, a violent thirst, a coma, a painful elevation of theright flank, a coldishness all about the extremities, a little rambling,with a forgetfulness of what he had said, and at last a strong delirium laid hold of him. About the fourteenth day from the timethat he shivered, grew hot, took to his bed, and was mad; he bawled out, was greatly disordered, talked much, and then was silent.After this he grew comatose, and had many bilious, unmixed, crudestools. His urine was black, little, and thin; his uneasiness great;his stools various, sometimes black, little, and thin; at other timesfat, crude, and acid; and at last milky to appearance. About thetwenty-fourth he was easier; in other respects no alteration, butcame a little to himself, (whereas, from the time he laid down, heremembered nothing) and presently after lost himself again. Everything hurried on for the worse. About the thirtieth, he was veryfeverish; had many small stools; was delirious; cold in his extremities; and dumb. The thirty - fourth, he died.This patient, during my attendance, was all along disordered inhis belly; his urine thin and black; and he was comatose, watch.ful, cold in his extremities, and perpetually delirious.A woman in Cyzicus, who was delivered with much difficultyof two daughters, and not well cleansed afterwards, was taken atfirst with a chilliness and acute fever, attended with a weight andpain of the head and neck. She could get no sleep from the beginning; was silent, sullen, and inflexible. The urine was thin,and without colour. She was also thirsty, and for the most partqualmish and uneasy. The belly irregular, sometimes loose, andsometimes bound. The sixth day at night she was very delirious,and got no sleep. About the eleventh, was mad, and came to herself again. The urine black, thin, and, after a while, oily. Thestools many, thin, and turbid. The fourteenth, she was much convulsed; cold in her extreme parts; lost her senses; and had a suppression of urine. The sixteenth, was dumb; and the seventeenth,died.In Thasus, Dealces's wife, who lived upon the plain, was taken24370 THE WORKS OF HIPPOCRATES.with a chilliness and acute fever, occasioned by sorrow.She wascovered up from the beginning, and, without ever speaking to thelast, felt about with her hands, plucked off, scratched, and gatheredthe nap of the clothes; cried, and presently after laughed; got nosleep; had no stool, though the belly was stimulated with something; drank a little at the request of others; made a little thinwater; was but moderately feverish to the touch; and cold in herextremities. The ninth, was very delirious, and soon after recovered herself, but was silent. The fourteenth, her breathing wasdeep and seldom, long and short. The seventeenth, another stimulus was used to the belly; after which what was drank passedthrough, without any gathering together, or stoppage. She wasinsensible of every thing; and her skin was distended and dry.The twentieth, she talked much, and again recovered herself, butwas afterwards dumb, and breathed short. The twenty-first shedied.This patient's breathing was all along deep and slow. She wasinsensible of every thing; was always covered up; and eithertalked much, or was silent to the last.In Melibea, a young man, heating himself a long time with drinkand venery to excess, was taken with a chilliness, a nauseousness,and want of sleep, but without a thirst. The first day, he hadmany stools, with a great flux of humours, and the following daysmany watery ones. The urine was thin , little, and without colour.The breathing seldom, deep, and long. The hypochondres distended, but somewhat soft, and that for a considerable length onboth sides. He had also a continual palpitation of the heart to thelast; made oily urine; rambled moderately; was composed againand quiet. His skin was dry and distended; his stools many, thin,bilious, and fat. The fourteenth, was worse in all respects; rambled, and raved much. The twentieth, was mad; threw his limbs.about; made no water, and scarce kept his drink. The twentyfourth, died.THE SECOND BOOK OF EPIDEMICS.FOSIUS, p. 944.It would seem from Haller's prefatory remarks, that Galen refersto certain books, which he insists must have been formed by Thessalus, from the common-place book of Hippocrates. Thefirst section of the present one, pays attention to the subject of crises , morecarefully and better arranged than any of the Hippocratic books.The other sections are entirely promiscuous. In the second section are some imperfect histories of patients, and of diseases, suchas angina, &c. Section third contains the Perinthian epidemic;and predictions are intermingled with the history of diseases. Inthe fourth section, we have an account of the vessels, pretty muchlike that in the book " De Ossibus." The histories of diseases areintroduced; among which is to be found a paralytic affectionarising from the use of vitiated grain. The two last sections contain predictions, and a mingled mass of other matters.There appears to be here, as well as elsewhere, much uselessvariation in the divisions of these books, as given by Fasius, Haller, Gardeil, and others, dependent, it may be presumed, on the individual fancy of each. Such diversity, however, renders referencemore difficult, and appears to be called for by no solid reason.-Ed.Gardeil, in some preliminary remarks on this book, says, that itis generally believed that the second, fourth, fifth, sixth, and seventhbooks on Epidemics, are not productions of Hippocrates; at leastthe same order that exists in the first and third , is here defective.We have, however, a commentary by Galen on the sixth book,which he looks upon as being the work of the Father of Medicine.In my opinion, continues Gardeil, the fifth and seventh books arequite as interesting as the sixth, in consequence of a considerablenumber of surgical observations. We might even be authorized,aAnalogous to what has been ascribed in later times to the use of ergotedrye.-ED.372 THE WORKS OF HIPPOCRATES.he adds, to consider all the five books above- mentioned, as the realworks of Hippocrates, since we find in them the principles andfacts precisely as we read them in the other treatises that are usually acknowledged to be his, such as the one " De Humoribus," &c.This, however, by no means proves that all the seven books onEpidemics, wherein so little order is preserved, have emanatedfrom the same author to whom we are indebted for several of thosewe have given, yet all are generally regarded as being nearly ofthe same period, and as emanating from the same school. Manygeneral propositions are given in an aphoristic form, accompaniedwith numerous observations.Clifton, in the beginning of this book, leaves out several pages,amounting to nearly the whole of the first section of Fœesius, statingin a note, that it consists of " aphorisms of various kinds that noways agree with the title of the book, and so are placed under theirproper heads in other parts of this work," &c. , to which he makesreference.I cannot commend his translation on many occasions; a betterone, and more accurate to the text, is a desideratum . - ED.In Cranon, in the summer, were carbuncles. It rained , duringthe excessive heats, very much, and continually, but more with thesoutherly winds. Under the skin were thin sharp humours, which,being confined, grew hot, and caused an itching; after which pustules broke out, like what comes upon a burnt part, and occasioneda sense of burning underneath.In this city inveterate pains are attended with cold; fresh ones,with heat; and most of them from the blood. Those from the hipare likewise cold.A woman had the heartburn, and could not be easy; but uponsteeping the finest flour of barley in the juice of quince, and eatingbut once a day, she vomited no more; as was the case of Charion.Changes, where the change is not for the worse, are of service;as in fevers to vomit after taking a medicine. But where a vomitterminates in something simple and unmixed, there corruption isdenoted, as in the case of Dexippus.Serapis swelled after a looseness, but the exact time of the itchingI know not, though it was not long. An abscess in the flank, thatmortified, was her death.THE SECOND BOOK OF EPIDEMICS. 373Stymargus's wife swelled too, after recovering from a shortlooseness designedly stopped, and a miscarriage of a female childfour months old.Moschus, who was much troubled with the stone, had a littletumour like a barley- corn upon his upper eyelid in the part nextthe ear, which ulcerated inwardly. The fifth and sixth day thematter that was pent in broke out, and the complaints below weretaken away. He had also a swelling of the gland by the car, andanother in the neck, right against the upper swelling.Aristaus's wife's brother fatigued himself upon the road when hewas hot, and so brought little black swellings, or tubercles, uponhis leg, with a continual fever. The next day he sweated, andafter that upon the other equal days, without being quit of his fever.His spleen was a little suspected; he bled often from his left nostril, though but little at a time; and was freed. The next day atumour appeared behind the left ear, and the day after anotherbehind the right, but this was less and grew warm. Both of themsubsided gradually, without coming to suppuration.He that came from Alcibiades had, a little before the crisis, aswelling in his left testicle from a fever. His spleen was largetoo, and his crisis happened upon the twentieth day. After this hegrew a little warm now and then, and his spitting was somewhatflorid.She, who brought up little or nothing to speak of with her cough,was seized with a palsy in her right arm and left leg, without anyalteration in her countenance, or understanding, or any other part;and even here it was not vehement. About the twentieth she beganto go better, perhaps from the breaking out of her menses, whichwas then the first time; for she was a young virgin.Apemantus, and the builder's father that broke the head, andNicostratus, did not cough at all, but on the contrary were in painabout the kidneys. Being asked, they confessed they were alwayseating or drinking.Hercules swelled the eighth day of his illness.To one that suckled , pustules broke out all over the body, which,upon leaving off, were dispersed in the summer.The currier's wife, that made the leathers, after she had beenbrought to bed, and to appearance perfectly well delivered, had apart of the membrane, chorion, left behind, which came away thefourth day with great difficulty; a strangury being upon her.374 THE WORKS OF HIPPOCRATES.Soon after she proved with child again, and had a son. Thiscourse lasted many years, and at length her menses stopped. Whenshe was brought to bed, her strangury gradually left her.Another woman had a pain in her hip before conception, whichwas cured by conception. The twentieth day after the birth shewas in pain again, and delivered of a son.Another woman with child had little pustules upon the lowerpart of the right leg, and the thumb of the right hand, in the thirdor fourth month of her pregnancy; to which the chips of frankincense were applied. But whether she was brought to bed or not,I cannot say; for I left her in her sixth month. She lived, as Iremember, at the house of Archelaus, by the precipice.Antigenes's wife, who lived with Nicomachus, was delivered ofa child all over fleshy, but distinct in the principal parts, and aboutthe bigness of four fingers. It had no bones, and was afterwardsthick and round. The mother was asthmatic before her lying-in,and in her delivery vomited a little matter like that which comesfrom the boil called a felon.She that was delivered of two daughters after a hard labour,and was not well cleansed afterwards, swelled all over, and becamevery big in her belly, but fell away in her other parts. The redscontinued for six months, and then the whites the rest of the time,in great quantities. These evacuations hindered her conception;but her menses came again pure, unmixed, and in a proper manner.In lienteries of long standing, an acid belching, where nothing ofthis kind has happened before, is a good sign; as in the case ofDemænetas. Art at this time should try to imitate nature; forsuch disturbances make a great alteration, and perhaps acid belchings will carry off a lientery.Lycias, who was cured by drinking hellebore, was at lastattacked with a painful swelling of the spleen, and a fever; andthe pain reached up to her arm. The splenic vein in the elbowwas opened, and beat often. Sometimes again it was not opened,and the pain went off spontaneously, or with a sweat. Upon thisgoing off the spleen reached to the right side; her breathing wasdoubled within, and not great; she grew lightheaded; was coveredup; troubled with wind, but nothing passed downwards, nor byurine; and, before she was delivered, she died.The swellings, that were produced by a great flux of humours onTHE SECOND BOOK OF EPIDEMICS. 375each side the throat, did not ulcerate, but passed off to the left; thespleen was affected with pain, and there was no crisis.Hieron's crisis was the fifteenth day.Cous's sister had a swelling upon her liver like the spleen, anddied the second day.Bion bled at the left nostril, after making a very great quantityof urine without a sediment; his spleen being hard, and gibbous.He got over it, but had a relapse.Those who had the quinsy were thus affected. The vertebræ ofthe neck turned inwards, in some more, in others less, leaving amanifest cavity outwards; and here the neck upon touching waspainful. It was also somewhat lower than the process called thetooth, and not altogether so acute. In some it was very evidentby the greatness of the circumference; but the throat was notinflamed, except by the tooth above-mentioned, but subsided. Theparts under the jaws swelled, but not as when inflamed; nor werethe glands at all inflamed, but in their natural state. The tongueindeed could not easily be stirred, but seemed larger and more prominent; and the veins under it were very evident. They couldnot swallow, or but with great difficulty; and, if violence wasused, the liquor returned by the nose; through which part thevoice came likewise. The breathing was not attended with greatelevation of the shoulders. In some the veins in the temples, head,and neck were tumefied; and in these, where the pains were renewed and augmented, the temples grew a little hot, though inother respects they were not feverish. The greatest part keptclear of suffocation, unless they desired to swallow their spittle orsomething else; nor did the eyes sink at all.Where the tumour affected not any one side, but came directlyforward, none of these, so far as I remember, became paralytic,but all recovered. Some grew easy in a very short time, but thegreatest part continued forty days, and that without a fever. Manyhad some remains of the tumour a very long time, as appearedfrom their swallowing and their voice. The wasting of the uvulawas a proof that the distemper was not quite gone off, though theyseemed to have nothing bad about them. Where the tumour appeared sideways, there a palsy followed in the part from whencethe vertebræ inclined , and they were drawn on one side. Thesewere most evident in the face, the mouth, and the septum of theuvula. Add to this, that the lower jaws were changed in propor376 THE WORKS OF HIPPOCRATES.tion. The palsies did not affect the whole body, as in other cases,but stopped at the hand of the quinsy- side. What they spit wasdigested, and a hoarseness followed. Where the tumour was direct,they also spit. But where a fever attended, there the difficulty ofbreathing was much greater, the spittle could not be contained inspeaking, and the veins were more tumefied. The feet, which arecoldest of all, were remarkably so at this time; and those, whodied not immediately, were unable to stand upright: but those,that I was acquainted with, all died.Coughs began the fifteenth or twentieth day about the wintersolstice, from the frequent changing of the southerly and northerlywinds, and snowy weather; some of which lasted but a little time,others longer; and were succeeded by peripneumonies in abundance. Many had a return again before the equinox, forty daysfor the most part from the beginning. In some indeed they werevery short, and went off well; in others, inflammations of thethroat, quinsies, palsies, and that disorder of the eyes called nyctalopia, happened, especially among children. The peripneumonieswere very short; but inflammations of the throat came at last aftercoughing, or else held them a little while in the room of the cough.These were of short duration , especially the disorder of the eyesnow mentioned; but the quinsies and palsies were either hard anddry, or little, and seldom attended with digested spittings. Someindeed brought away a great deal. Where any took more thanordinary pains in speaking, or fell into a shivering, there a quinsywas generally the consequence. Where any used their hands much,their hands only were paralytic: but where they rode, or walkedmuch, or exercised their legs any other way, there paralytic weaknesses fell upon the loins or legs, with a weakness and pain in thethighs and shins. The hardest and most vehement coughs weresuch as ended in palsies. All these things happened in the relapses,but not very much in the beginning. In many they remitted aboutthe middle, but did not leave them entirely, and appeared again atthe return. Where the voice was broke with coughing, there thea "This is the seventh section of the sixth book of Epidemics; a section entirelyindependent ofthe rest of the book, and of a piece, in some measure, with the observa.tions we have been just now seeing. Whether he means fifteen or twenty days beforeor after the winter solstice, does not appear from the text. " -CLIFTON.Clifton employs too great a license on many occasions-as here, and in not unfrequently leaving out portions of the text.-ED.THE SECOND BOOK OF EPIDEMICS.3771greatest part escaped a fever, and some had it but a little. Add tothis, that neither peripneumonies, nor palsies, nor any thing else appeared in this case, but the crisis was determined by the voicealone. The disorder of the eyes above-mentioned was as when itcomes from other causes, and affected children most. The blackof the eye had a great variety, where the pupils were small; but inshort it was generally black. The eyes were rather large thansmall, and the hair straight and black. Women were not equallyfatigued with coughing, but a few had fevers. Of these very fewcame to peripneumonies, and such as did were among the elderlysort; all of whom recovered. The reason of this was, in myopinion, their not going abroad so much, and their not being at allso liable to be seized as men. Quinsies, and those of a very mildkind, happened to two free women, but among the slaves frequently,and, where they were violent, they proved fatal very soon. Manymen were also seized, some of whom recovered, others died. In aword, those who were able but to drink had a very mild and easytime; those, who could not speak distinctly besides, had a moretroublesome and tedious one. Those, whose veins in the templesand neck were swelled, were somewhat bad; and those, whobreathed with great elevation of the shoulders, were very bad: forthese grew hot also. The disorders were thus ally'd, or determined,as here described. The first happened without the last, but the lastnot without the first. They died very soon, after shivering nowand then as in a fever. As they were not oppressed with frequentmotions or risings to stool, I tried what stimulating the belly, andwhat bleeding would do, but nothing was of service to speak of.I also bled them under the tongue, and some I gave a vomit to.These things happened always in the summer, as many other thingsdid of the eruptive kind. So painful ophthalmies, when the droughtwas greater than ordinary, were very common.Swellings of the glands were likewise common, because the liverwas inflamed and out of order; and where they proceeded froman artery ill-disposed, as in the case of Posidonius, it was a badsign.We came to Perinthus much about the summer solstice. Thewinter had been serene and southerly; the spring and summer verydry, to the setting of the Pleiades; or, if any rain fell, it was insmall drops. The Etesia blew but little, and that not constantly.In the summer many burning fevers raged among the people;378 THE WORKS OF HIPPOCRATES.during which they were free from vomitings, but subject to thin,watery, frothy stools in abundance, without bile, but not without asediment now and then in that that was set by, and in that part ofit which was exposed to the air. Now, where no alteration happens at any time, as to the appearance ofthe excrement, it is a badsign. Many were comatose and lightheaded in their fevers, andsome became so after sleeping, but recovered themselves entirelyupon getting up. They elevated their shoulders in breathing, butnot much. The urine was thin in most, and little in quantity, butin other respects not without colour. Bleedings at the nose werevery rare; and so were swellings behind the ears; of which morenotice will be taken afterwards. There was no swelling upon thespleen, nor upon the right hypochondre; neither did any great pain,or vehement distension attend it, but yet there was something of anindication, and the crisis happened for the most part upon the fourteenth day, partly by sweat, partly by shivering, with very few relapses. During the drops that fell in the summer, they began tosweat in their fevers, and some fell into them from the beginningwithout any injury; others about this time, and the crisis went offthis way. In the summer fevers, about the seventh, the eighth, andthe ninth day, little miliary roughnesses, very like the bites of gnats,appeared upon the body, without any great itching. These lastedto the crisis; but none of the men had them that I saw; nor didany of the women, that had them, die. Their appearance wasforetold by a thickness of hearing, and a coma, where they werenot very comatose before. These complaints did not last the wholeyear, but in the summer and to the setting of the Pleiades theywere comatose and sleepy, but afterwards more watchful. Nor infine did they die during this constitution or season. The purgingcould not be checked even by diet; but one might imagine that anirrational method of cure might be serviceable, though the discharges in some were very great, occasioned by lying on a bed inthe cold; for cold ulcerates. The warming such bodies ought tobe gradual, without offering any violence to nature; and as tothose who are troubled with signs or complaints of this kind, whether more or less, viz., gaping, coughing, sneezing, yawning,stretching, belching, and flatus, all such tend to destruction.Zoilus, who lived by the wall, was seized with an acute feverfrom a digested cough. His face was red, and his body bound,unless when loosened by art. His left side was painful, and the leftTHE SECOND BOOK OF EPIDEMICS. 379ear very painful; the head not so much. Spitting continually asomewhat purulent matter, he could not get well, but in other respects had a crisis, and discharged much matter by the ear, aboutthe eighth or ninth day. The beginning of the ninth the pain of hisear ceased; but how the crisis could be without a shivering I knownot. About his head was a great sweat, and about his ear and leftside a fixed burning heat. With the pain of the ear above, theother pain ceased, especially about the shoulder-blade; but firstcame on a great spitting, which at the beginning was florid, and soon to the seventh or eighth day, and after that difficult and painful.The belly was bound till about the ninth or tenth day; the painwas quite removed, the swelling abated, and little sweats came on,but not critical, as appeared from other circumstances, and thegoing off. For, when the pain of the ear began, the belly wasloose; the abscess from the ear was the ninth, and the crisis thefourteenth, without any shivering the same day. Add to this, thatwhen the ear broke, the spitting became more copious and moredigested; but sweats and tetters about the head lasted long, thoughthey dried up (in a manner) the third day.Whatever disappears without the proper signs makes the crisisdifficult, as in the erysipelas that happened to Polemarchus's maid.Scopus, upon an acrid, saline, bilious, distillation from the head,an inflammation of the chops, and a bad regimen, was bound in hisbody, and seized with a continual fever. His tongue was dry; hissleep gone from him; the rim of his belly violently, but equally,distended, the distension proceeding gradually to the bottom oftheright side; his breathing, pretty frequent; his hypochondres in pain,both in breathing and turning; and he brought away, withoutcoughing, a thickish matter. Upon taking peplium, the pain wentoff from the hypochondre, but nothing passed through. The nextday two suppositories put up appeared no more; but the urine wasthick and turbid, with a smooth and even sediment. The turbidness occasioned no stool; the belly grew softer; the spleen wasswelled, pointing downwards; and his drink was mead with vinegar. The tenth, a little watery blood came from the left nostril,which gave him very little relief. In the sediment ofthe urine wassomething whitish and thin, sticking to the vessel, that was neitherlike, nor very unlike, seed, and continued so some little time. Thenext day (the eleventh) , the crisis came on, and he lost his fever.His stools were somewhat viscid, and mixed with bile as they380 THE WORKS OF HIPPOCRATES.came away. His urine was a great relief to him, both as to quantity and sediment, which, before he began to drink wine, was alittle like thin phlegm. Though his stools were little upon theeleventh, they were at the same time viscid, stercoraceous, andturbid.Query? Whether such a discharge is critical, as in the case ofAntigenes in Perinthus?Hippostratus's wife, after a quartan of a year's standing, wastaken with a swelling, and was manifestly coldish with it. It wentall over her body; a sweat followed upon it, and a crisis. Hermenses afterwards came down in great abundance, continuedlonger than usual (having been stopped before) , and seemed unwilling to give over.In hemorrhages, attended with pulsations, the figure or positionof the part is to be studied; and, if they happen in very dependingparts, they are always to be elevated. So moderate ligatures inblood-letting promote the evacuation , but violent ones suppress it.Those who are of a sanguine and somewhat bilious nature aresubject to sour belchings, and perhaps at last fall into the blackjaundice.In Enus, those who lived continually upon leguminous food,whether men or women, became infirm in their legs, and remainedso. And those who lived upon vetches, or tares, complained of painin their knees.In order to recover the colour and fuse the humours, we shouldstudy to put a man in a violent passion; and, upon other occasions,to bring on cheerfulness or timorousness, and the like.If the whole body is out of order, the cure should be general; ifotherwise, particular.Stymargus's servant, the Idumæan, upon a distortion of themouth of the uterus, in her being delivered of a daughter, wasseized with a pain in her hip and leg, which grew better by bleeding in the foot; but her body trembled all over. We are thereforeto consider the occasion, and the beginning of that occasion, in diseases.In the fourth section of this second book, we find that from theconstant use of some kind of grain, [" ex assiduo leguminum usu,feminæ et masculi, crurum impotentes facti sunt, ac vitam degerunt. "-Fœs. , Hal. ] several symptoms were induced, not dissimilarto those produced from ergoted rye.-ED.THE FOURTH BOOK OF EPIDEMICS.FESIUS, p. 1120.Or all the books on Epidemics, says Haller, this one to me appears of the least importance. All is intermingled and confused;imperfect histories of diseases, and aphorisms inadequately confirmed. Some few things appear, which possibly were written byHippocrates, or were transcribed from him. Galen refers it to theCollectanea of Hippocrates, edited without the corrections of Thessalus, nor is it unlikely. Much is interspersed respecting the sea-.sons, and the atmospheric changes. Mention is made of the Cynic,who called the author to a patient. Now, as Diogenes was posterior to Hippocrates, and was also the founder of that sect, it is bymany supposed, that the author of this book must be some physician posterior to Hippocrates.Gardeil, in a note to this book, says, it is difficult to determinethe country in which the patients herein mentioned are to be assigned, since this is not expressly mentioned. The same may besaid of the books that follow. Nor must we, from the title of Epidemics, believe that they are confined to such diseases. They arerather to be viewed as a choice collection of observations.Outline of contents.-Metastasis of certain humours after thevernal equinox; notice of various patients, some of them of interest; relapses frequent after the autumnal equinox; the state of theatmosphere, and the diseases in winter; frequent abortions; othercases. State of the urine in different persons; notice of the stateof the sick towards the end of autumn; interesting case of a youngman attacked with copious epistaxis on the third day of his illness,continuing till the sixth, with delirium and coma on the seventh.He seems to have surmounted this, and had a relapse, and thatmore than once. A discharge from the left ear of a viscous, thick,and ichorous matter, fell upon the teeth, inducing great destructionof the parts adjoining, viz. , the palate bones, and upper jaw, and382 THE WORKS OF HIPPOCRATES.•septum nasi, with other effects; the result is not mentioned. -Crises,&c. , with detached remarks and cases. A cursory notice of alarge star or meteor, followed by an earthquake. Menstruationduring pregnancy not uncommon; case of delivery on the seventhday of seventh month; the woman goes out in four days; injuryfrom, &c. Another case of injury to the jaws and teeth; variouscases; a curious one stated of a woman, whose mouth was twistedto the right side, but which was turned to the left in the fifth monthof pregnancy. A slave relieved from a swelling and tension ofthebelly by the return of menstruation, after a suspension of sevenyears. Observations on errhines, on tumours, on sciatica, &c.; peculiarities or diversity in the onset of diseases; observations on theintestinal evacuations, &c. Diseases occurring at Eno and elsewhere; various results of cough in this state of the air; nyctalopia;decay of the teeth; expectoration; some few aphoristic remarkstowards the conclusion.After the equinox and the setting of the Pleiades, a sort of corroding mucus, that opened the head, broke out above the ear; but inhim who was with Leocydes, upon the foot; and in Phanodicus,upon the toes by the sole.He, whose tibia was cut, had a blackness come upon the part.The ulcer was large on the outside, and the discharge from thehinder part. When it was cleansed, he was seized with a pain ofthe side and left breast opposite to it, grew feverish, and died of hisfever.The ropemaker complained of a very bilious disorder; and, uponapplying caustical (or burning) remedies, he lost a great deal ofblood downwards about the equinox.A very old man, who had a great abscess, held out not abovefourteen days.He, who was marked and burned by Antiphilus, was freed froma bilious ardent fever (of that kind which is called rupos) the seventhday. Three days after the crisis or thereabouts he spit blood, recovered, and had a relapse afterwards. His first crisis after thiswas, as it ought to be, about the setting of the Pleiades; and afteraSydus insigne visum est, quinto autem post sextoque die terræ motus extetit, Hal.ii. 255; Foes., 1128.THE FOURTH BOOK OF EPIDEMICS. 383their setting his biliousness extended to madness. Another crisishappened the ninth day without a sweat, and he got over it.The Chalcidonian, who was brought from the gates to themarket-place, about the equinox, being in pain from a ruptureabout the right breast, spit up now and then a pale greenish matter.The belly was in good order. A sweat began the seventh, whichlasted for the most part to the eighth, and the crisis happened thefourteenth. About the fortieth, swellings appeared behind both cars;nor was it unlikely that a suppuration should follow, though itdid not.Aristodemus was burnt upon his breast; and so was the son ofPhilis, for an abscess that came after a fall; but he had had a painhigher before this.After the autumnal equinox relapses happen, and at other timesto the winter solstice.After the summer solstice, the wife of Achelous miscarried thesixth day, being full of blood and chilly. She sweated afterwards,and had a crisis the fourteenth. How many months gone withchild I know not. Twenty days after this she said she miscarriedof another male child; but, whether she said true or no, I cannottell.About the winter solstice the wind was northerly. Jaundices ofvery deep colours appeared, sometimes with a chilliness, sometimeswithout. The tongue was burnt up the third day. About the sixthand seventh, great disorders that lasted long. The fourteenth, anastringency in the belly that could not be removed by physic; andno sweats, as is usual in fevers. In some the spleens were small,extended to the right hypochondre, and rumbled upon being touched. Hemorrhages succeeded, and such depurations by urine, butmore especially by stool (for the belly had been long bound) , asproduced a crisis. Where these things did not happen, but thespleens were tumefied, they bled at the left nostril.After the solstice, rough winter weather, with northerly winds,and in a short time southerly, for fifteen days; and then abundanceof snow for fourteen days more. About this season deep- colouredjaundices came on, that terminated not in a clear and evident manner, but returned again. After the snow came southerly winds andgentle showers. Runnings at the nose ensued, with and without afever. In one person, who had been in moderate pain before, it fellupon the teeth on the right side, the eyebrows, and the eye. They384 THE WORKS OF HIPPOCRATES.were hoarse too; the throat was inflamed, and the glands calleddroyyo (amygdala) swelled, attended with soft swellings about theears and jaws, that subsided with the fever. Many of these happenedabove and on each side, at the beginning of the fever; and some hadthe tonsils swelled in the autumn and the winter. Add to this, brannyfoulnesses of the skin came on; and many women miscarried allkind of ways, and had hard labours.A maid, who had a crisis the sixth day, had a relapse the sixth,and another crisis in six days. And in six or eight days all thecrises happened at that time.About the setting of the Pleiades, the wife of Meander, the blindman, spit from the first a pale greenish matter, and soon after,about the sixth day, purulent. The liver swelled, and she had alittle purging. What she spit was in a small quantity, white, broad,and like purulent flesh. She had an aversion to food, and diedabout the twentieth.Thestor's servant, in the neighbourhood, was taken with a bilioussevere purging, and a distension of the hypochondres, occasionedby something that was caustical. The sixth day after the purgingwas stopped, she had one large thin stool, fell into a sweat immediately, and had a crisis, without any more purging. The same hourshe shivered and grew feverish, but it went off again the same hour.The wife of Thersander, who was not very leucophlegmatic, fellinto an acute fever upon suckling. Her tongue, as other parts wereburnt up, was likewise burnt at the same time, and became roughlike thick hail. Worms also came out of her mouth. About thetwentieth she had not a perfect crisis .About the setting of the Pleiades, Metrophantus's son, who waswounded on the head with a brickbat by another boy, was takenwith a fever twelve days after; occasioned by rubbing the partsabout the wound in cleansing it. A coldness succeeded, and thelips swelled immediately, but the skin beyond the ulcer was inmany places very thin. Upon trepanning without delay, neitherpus came out, nor was the patient relieved; but upon the left jaw,by the ear, (for here the wound was,) there seemed to be a collection of matter. This, however, went off too without suppuration,and there was immediately a collection in the right arm. Thepatient died the twenty-fourth.After the setting of the Pleiades, he who had a pain in his earlost his speech twenty days after, and became paralytic on theTHE FOURTH BOOK OF EPIDEMICS. 385right side, without a fever, but not without sweating. The rightear and the right eye gave way a little, and ' drew something fromthe lower part. The eye was distorted to the left with a great dealof pain; the neck became hard, and within three hours was equallypainful.After the setting of the Pleiades, the servant of the Attican, whohad been ill with a quartan, had a stupid foolishness fixed upon him.Another at the same time was taken with a true typhomania;which, upon the hips and legs becoming painful, went off; but whatday I know not.About the same time chillinesses; vomitings; and, after the crisis,aversions to food; bilious discharges; great, hard, painful spleens,and likewise hemorrhages were the complaints of some; and ofothers, at the same time, hemorrhages from the nose of a palegreenish colour, occasioned by the spleens.In Cranon, the wife of Nicostratus, who was seized with a fever,complained at once upon the fourteenth day of a paralytic disorder(or imbecility) in her neck and other parts. She had had no stoolto the tenth; breathed often and little; could not contain herself,but felt about with her fingers; was delirious, sweated, and had herneck, mouth, eye, and nose drawn to the right side. The sedimentin her urine was white, like pulse, at one time; at another, white,stringy, and membranous; and at another, somewhat pale with agreenish cast, like the meal of lentils. Sometimes again the surfacewould be fat and greasy, and that in a heap, resembling sheep'swool; and not much dispersed, as a scattered cloud appears inurine. After this her urine would have no sediment at all, butsomething of this kind. Again, it would have some such sediment,at one time broad and scattered up and down; at another, turbid.Sometimes the cloud would resemble a blackish cloud of some consistence; at another time it would be soft and thin. Again, it wouldbe thin, and of this kind; at another time, like horses' urine; andat another, dark and shady.The lad, that was first taken delirious, made thin clear urine;and his evacuations the other way were thin and plentiful, withoutbile. His tongue was very rough; his fever burning; his bellytumefied; and he could get no sleep. In his ravings upon theeighth day (if I mistake not) he behaved very wantonly, getting up,fighting, and talking very obscenely, contrary to his usual manner.Upon making a great deal of thin water in a gushing manner (for 25386 THE WORKS OF HIPPOCRATES.it had been suppressed) , sleep came on, together with a continualsweat, that seemed from the circumstances to be critical, muchabout the tenth day. After this his madness returned , and he diedsuddenly the eleventh; occasioned (I imagine) by his drinkingmuch neat wine a little before his madness. His age was abouttwenty.In the autumn, Eumenes's wife vomited black bile, as was alsoevident from the smell. A fever ensued with chilliness, heartburn,and little bilious vomitings, in which came away a worm. Herstools were thin all along before the setting of the Pleiades, andstopped about that time.Hemorrhages; short fevers, that returned immediately for a littlewhile; aversions to food; extreme languors and lassitudes; nauseasand heartburns happened about the same time, together with a discharge of worms about the crisis , shiverings, and bilious complaints.The young man that was a stranger bled much at the nose thethird, the fourth, and the fifth day; the sixth it stopped, and a moderate delirium followed. The seventh, no stool; a comatose disorder. The third day a relapse; the belly loosened; the urine Isaw not. About the crisis things were as they ought. But aboutthe setting of the Pleiades southerly winds set in, with gentleshowers. The young man had then a great many mucous, bilious,digested, viscid stools; and a violent fever continually, with a drytongue. The sixth day it came to its crisis. The seventh it returned again, and went off the same day with a trembling. Thesixth day there was a glutinous thick discharge from the left ear..The boy, that had the phagedænic ulcer, had his lower teeth,and the fore-teeth of the upper and lower jaw fall out by suppuration, and a cavity was left there. Now, where the bone of thepalate comes away, the nose sinks in the middle: and where theupper teeth before, the end of the nose becomes broad. The fifthfrom the fore-teeth has four roots, two of which are united to boththe next teeth, and all the extremities turned inwards. The thirdtooth is more liable to suppuration than all the other, and to occasion thick rheums from the nose, as well as pain in the temples.This was eaten away, especially the fifth, and in the middle wasa tubercle of the two fore-teeth; the less was first eaten away in theinside by the two next. The seventh had athick sharp root.The Athenian boy had a pain of his tooth, the left side below,the right above, that was carried off by an abscess in the right ear.THE FOURTH BOOK OF EPIDEMICS. 387After the Pleiades the weather was mild, cloudy, and misty. Thecrises happened upon the fifth, sixth, seventh day, and even later.The fevers were subject to return, to be erratic, to be bilious, andattended with aversions to food. Dysenteries also, with aversionsto food, and vehement fevers, were complained of. About the setting of the Pleiades the southerly winds came strong, attended withhemorrhages, and fevers nearly resembling tertians, besides othersof another kind, in which the patient is cold and shivering perpetually. They call them Haλa,He that belonged to the shoemaker bled plentifully, purged alittle, and had his crisis upon the seventh, with a shivering.He that lived at the last public house bled plentifully the fourth,and immediately was lightheaded, bound in his body, and his hypochondres hard and painful. By means of a suppository the sixthday he had a yellow bad stool. The seventh in the morning early,was exceedingly restless, bawled out greatly, and had a pulsation ofthe vessels about the navel.In the acutest fevers the pulsations are oftenest and strongest, asthe paroxysms are in every disease, towards the evening.With respect to the beginnings, the paroxysms, the first of themorning, the continuation of the distemper, and the season of theyear, are to be taken into consideration.The wind was southerly after the setting of the Pleiades. Crisescame the fifth, then an intermission for one day, and a return thenext. Eruptions of a soft and lax kind , like bladders, or like theeffects of the prickly acanthus, also appeared. About the sametime a great roughness came upon the skin, but without itchings orweepings, especially now. There were also tetters above the skin,like what happened to Pythodorus's wife, and him who kept thepublic house; not without a fever. But as to Pythodorus's wife,she was seized, pretty near the beginning of her fever, with a greatweakness in the hips.After the setting of the Pleiades came chilliness and hemorrhagesfrom the nose.The shoemaker had his crisis the seventh, an intermission oneday, the next a return, and another crisis the fourth.One who belonged to Leocydes, had his crisis the seventh; andanother the fourth.Moschus bled plentifully from the left nostril the ninth, and alittle from the right; had his crisis the fourteenth, as he ought; but388 THE WORKS OF HIPPOCRATES.at the beginning was much disturbed. The seventeenth, was guiltyof mismanagements in diet. The nineteenth at night arose a smalltumour on the right ear, hard within, but a little soft without, andpainful without remission.In those who are very bilious, especially where a suppuration is,what comes away by purging is like the ink of the cuttle-fish.Such was the purging of him who had the cupping- glass applied,when his hip was in pain. It removed downwards into his leg, andhe was easy.He who fell from the horse of clay, and had a cupping-glass applied immediately, complained of an inward burning. The twentieth, upon its breaking out again afresh, a hemorrhage ensued,with a discharge of feculent corroding matter.The Tenedian woman miscarried the fourth day of a child, that,as she said, was thirty days old, She had also a loose small stool,a burnt tongue, and a crisis the fourth.After the setting of the Pleiades disorders of the spleen came on,and to the fifth day hemorrhages with a crisis. Upon the seventh,the urine was like the water in which tares have been washed, allof a piece, and after that clear. A relapse followed. Megaris'sson had also an intermission, and that without a hemorrhage, butthe urine was white, thick, and all alike, as in Artigenes's case.About the winter solstice a great star appeared, and the fifth andsixth day after, an earthquake.2 "As to the great star that is said, in the fourth book of Epidemics, to have appearedabout the winter solstice, attended with an earthquake, all the information I havebeen able to get (and for which I am very much obliged to that most ingenious andlearned gentleman , Mr. Machin, Astronomy Professor at Gresham College, and Secretary to the Royal Society) amounts to this, viz., that there were two comets in thedays of Hippocrates, and both of them attended with an earthquake. The first appeared about the time of the winter solstice, in the month Gamelion, in the secondyear of the 88th Olympiad, i . e. in the 427th year before Christ, the 5th year of thePeloponnesian war, and the 33d year of Hippocrates's age (according to Soranus's ac.count ofhis birth); Eucleis ( or Euclides, the son of Molon) , the successor of Diotimus,/ being then Archon of Athens. See Arist. Meteorolog. , cap. 6, lib. i . and Joh. Philopon.Meteorol. Arist. , f. 96, p . 2 , edit . Ven. 1551 ."The other was a great comet, called by Aristotle μgas xoμnTns, i . e. the greatcomet, to distinguish it from all others. This appeared also in the winter in a clearfrost, about sunset, and was attended with the earthquake and inundation ofAchaia,that destroyed so many places and cities mentioned by Seneca (nat. quæst. lib. 7, )and others; Aristaus (or Asteus, as he is called by some) being then Archon ofAthens, viz. , in the fourth year of the 101st Olympiad, i , e. in the 373d year beforeTHE FOURTH BOOK OF EPIDEMICS. 389Antigenes's wife, who was in Perinthus, remained asthmatical,and had her menses come down at a time when she did not knowwhether she was with child or not. Her belly was sometimessmall, sometimes large; for she was always coughing, as if she hadbeen walking faster than ordinary. She was eight months gonewhen it stopped, and had been feverish before.The wife of Apemantus's brother miscarried the seventh day ofa girl, that, as she said, was sixty days old; and about the ninthwas in great disorder. After the crisis she had a pain in the rightside, as if from a distortion of the womb. She conceived againsoon, and miscarried.Another was delivered of a daughter with the whites upon her,another with the reds, as it should be.Chillinesses, nauseas, aversions to food, relapses, bilious complaints, hemorrhages, and disorders of the spleen were to be metwith, and most of them attended with pain from the left side.Apemantus's wife, when she was turned on this side, was affected.in her right eye; when on the contrary, in her flank.Aristophon's daughter was feverish the third and fifth day, andremained dry for the most part; but her belly was lax and discomposed, the crisis difficult, and about the thirtieth day she losther fever.Pustules, that come upon no violent exercise, reach the seventhday, and are somewhat livid (the maid that lived behind Herouswas taken with a shivering); the white and large are not of anygreat service in those who are seized with a deep stupidness, ordozing, or in diseases that are not of the falling kind, or where thebile stops; neither are those serviceable that subside not, whetherthe body be loose or bound.Christ, and the 87th year of Hippocrates's age. But the appearance of this comet,though it is said to be in the winter, is not so particularly described as that of theother; Aristotle mentioning the appearance of the first to be about the winter solstice,agreeable to the Hippocratic memorandum; but of the second to have been in thewinter only, without mentioning what time in the winter. Thucydides likewise observes, that in the fifth and sixth years of the Peloponnesian war there were manytremblings or shakings of the earth, and the plague, that had not been quite extinguished, broke out again at that time, and continued above a year after; so that it isvery probable, if the malignant year already mentioned did not happen about the timeof the plague in the beginning of the war, it was about the time of this comet's appearance, viz. , in the fifth year of the same war; such appearances, and such tremblings, generally producing very sickly seasons."-CLIFTON, Preface.390 THE WORKS OF HIPPOCRATES.Zoilus, the carpenter, had a trembling slow pulse; the dischargesby stool and urine moderate, but without colour; the bottom of thebelly distended on both sides directly to the navel, with an acutefever, an aversion to food, and no thirst.The clerk of the market's daughter at Tecomaius's, when herpregnancy was uncertain, vomited for two months, sometimesphlegm, sometimes bile. After this she had a hard labour, wasperfectly well cleansed, and vomited as before to the thirtieth.Then a purging came on, and her vomiting stopped. A lienteryfollowed, and her menses kept up, but for two years she had thepiles in the winter.The two brothers, that lived by Cecrops's, were at the beginningseized with black stools; had afterwards feculent bloody stools,and, from very frothy ones, bilious.He, who by agreement lift up the ass, immediately grew feverish,and bled the third, the fourth, the fifth, and the seventh. A crisiscame the eighth by stool.He, who was concerned in the mines, and had his right hypochondre stretched; his spleen large; his belly distended, hardish,and flatulent, without colour; was taken with a pain in hisleft knee,but had a relapse again, and after that a perfect crisis.Temeneus's son had a little difficulty of breathing, so as to makehim pale with a greenish cast, which colour reached to his handstoo.The husband of the woman that lyed- in near Sitodocus's, whohad a jaundice upon him, and sent for me the seventh day, died theeighth without any evacuation by stool or urine. His flanks werelarge and hard, and his breathing quick; nor was his foreheadmoist with the pain, before he died.The wife of this person miscarried of a girl the seventh day inher seventh month, the signs of which appeared the fourth. A painseized her in her feet at the beginning, and, upon the fever ceasing,her difficulty of breathing was not carried off, but remained still.The pain likewise affected her hands and arms.Where the urine stopped before the crisis, relapses were of longcontinuance.Temeneus's sister's crisis was with a shivering. A pain seizedher hands and shoulders upon the sudden going off of her palegreenish colour. These pains ceasing, her head was affected; theTHE FOURTH BOOK OF EPIDEMICS. 391upper eyelids were tumefied, and the tears ran out. The rest I ama stranger to. Her first crisis was the seventh day.The case of him who kept Menander's vineyard was the same,except that at the beginning he had thin stools, which stopped afterwards, as well as the urine; but a crisis followed, without anyshivering the seventh day, because of the purging that had happened before.Potamon's son had no purging the seventh day, nor a shiveringtwo days before the crisis, nor, for the same reason, a suppressionof urine.Hegesistratius, who had had an abscess near his eye, had a collection of matter about his last tooth. The eye was healed, and thenose discharged thick matter; but about the gums little round caruncles broke out, which about the third day seemed to suppurate,but it went off afterwards, and immediately his jaws and eyesswelled. Now, wherever abscesses form themselves about the eyesin burning fevers, a redness appears upon the cheeks, and a hemorrhage follows. The like happens in abscesses behind the ears; andperhaps abscesses in the joints are more likely to follow; but this Iam not perfectly satisfied in.Shiverings, with tremblings, distensions of the hypochondres, anda breaking out of the menses, happened the seventeenth day. If thesethings continued thus, in some the crisis was the third, in others thefifth, and in others the seventh.Hegesistratius's two last teeth were in their turns eaten away.The last had two tubercles above the gums, one near the erosion,the other opposite. Where they both touched, there the roots werebroad, alike, and answered to one another. On either side half remained that was almost round.The woman, that had a hemorrhage the fourth and sixth day,had a crisis the seventh, with great redness.The other, that had a violent pain in her head, had her crisisabout the twentieth; at which time her hypochondres were hot andburning. The seventh day she did not bleed much; her stools werethin; and about the eighth an abscess appeared by the right eye.A man was affected in the same manner, except that his crisishappened the seventh day, with a moderate swelling of the spleenon the left side. The eightieth day the eye was affected in thisperson, and longer too; perhaps, because it came after the crisis,and because there was much to come away.392 THE WORKS OF HIPPOCRATES.Temeneus's sister had a difficulty of breathing, and a distensionof the flanks a long time. Whether she was with child or no, Iknow not. Her body was bound at first, and then it was shevomited; afterwards the vomiting stopped, upon a great deal ofviscid bilious matter passing downwards, without any hindrancefrom the hypochondres. The eleventh, the phlegmon attacked theright thumb: it broke, and the vomiting returned. Upon this shegrew better, her dozing and fever abating. Her breath was alsofreer; because she brought up foul nasty stuff. The sixteenth herbreath was little and quick, her fever came on, and she died.She had a fever before the abscess, and died the seventh dayafter the abscess. She was also something florid.Apemantus's sister's son had a swelling upon his hypochondresand spleen; a difficulty of breathing; a discharge of viscid, bilious,and somewhat stercoraceous matter downwards; and a wearinessafter working. The twentieth, his feet were affected. Query?Whether the crisis after such weariness does not happen upon thejoints, rather than on the eyes? His hypochondres were distendedtoo, and he had a dry gentle little cough.What is left after a crisis is apt to cause relapses, and what isseparated in the course of the disease. So will a spitting digestedbefore its time; so will the belly, as it happens to be affected; sowill intemperance, and the like.Apemantus, who complained of pains in his fundament, his rightflank, and a little below his navel, made bloody urine before thepain in his right side, which gave over the third day. The carpenter too made bloody urine from a pain of the contrary side inthe same direction, and upon its stopping, both of them had a sediment the third day. Apemantus was very much heated; the otherfelt nothing but on the left side.Nicostratus had also something at the extremity of the right side,lower than where it happened on the left. It reached too in bothabove the flank even to the navel.The old woman at Sosileus's, who was of a leucophlegmatichabit, had hard, white, rough and scaly swellings upon her legs,and upon her feet too, but less. The parts below the thighs werealso affected, and in many this complaint passes off with difficulty.Add to this, that the loins were also affected, the belly slender, theflanks softish, and the breath not very short. Most of these ceasing,our next care was about the eyes becoming grayish; a disorderTHE FOURTH BOOK OF EPIDEMICS. 393that was somewhat milder than the other. The pains of the hipand leg seemed to depend upon the womb: for a sweet- smellingsuppository of meal and ointment dispersed and put an end to themquickly. The time of the abscess (or disorder) about the eye wasa year.One had a pain about the navel, where the pustules were notperfectly suppurated. The like happens too from dysenteric complaints.In the village of Hippolochus there was a boy, who had something in both his hypochondres, that was in the lower part like thebrasier's wife, who had a dropsy, which upon watery stools passing off was softened a little. This was upon the right side, all alike,but raised above the rest, and in some measure round. His navelwas black from the birth, and deeply ulcerated; nor was any scarbrought upon it. The glans of the penis was naked too, but not ona sudden, or from the birth; and became more so afterwards. Hevomited for the most part, was feverish, and averse to food, but recovered. About the seventh day of his confinement to the bed (forhe had been ill before) , upon drinking much water, and perhapscommitting other irregularities, he grew very restless and uneasy,and was somewhat convulsed. The convulsion ceasing, he diedbefore we were aware of it; but first made water plentifully, andwind passed off audibly. The parts above were not at all softened;but, immediately upon his dying, a great relaxation followed; andthe whole body appeared red as if beaten with rods, except wherethe tumour and the heat remained long.One of Abdera had an evacuation downwards. Another had aswelling forwards, without a fever; and the swelling was to thetouch like an abscess.A servant maid that was asthmatical, and subject to hemorrhages, at the time of her menses was taken with an asthma.These stopping, a fever came on; her left breast suppurated above,and her ear from the beginning.Olympiodorus's servant bled at the right nostril, and had a crisisthe twentieth in the way that fevers generally terminate; and hisstools were such as were commonly in the summer, like those ofHipponax.Hyle, the servant of Aristides, upon taking a purge the eighthday, had the appearance of those who bear purging well, if theirstrength is not unreasonably pulled down by it; and voided neither394 THE WORKS OF HIPPOCRATES.frothy nor bloody stools, but like eggs, as the wife of Heraclidesdid, who was purged briskly, and bore it with ease.One, in the village of Bulagoras, upon purging began to be feverish from the spleen. Now those who have a rising on the rightside, but no distension, are red. She was rather red than otherwise, and had a purging from the beginning; and it was expectedit would have fixed upon the eye. The seventh day a salt humourran down from the eyes like tears. It ran likewise through thenose, and into the throat, and upon the left ear. The fifteenth, shesweated, and shivered, but had no crisis. Before the shivering shegrew very pale with a greenish cast; the countenance was distended, and fell. The opposite ear to the spleen, and the side, grewpainful.Children were subject to purgings, and dry coughs; and sometimes, towards the conclusion of the coughs, an abscess was formedin the shoulder.The fuller was in pain about his neck and head. The seventhday his hand was numb. The ninth, his leg was numb too, and hiscough ceased.She, whose jaw was drawn aside, felt a contraction in her wombto the left side five months after.In Cranon, Lycinus the grammarian, who was ill of a biliousfever that came upon a swelling of the spleen, was taken with aheaviness of the head, and some little hard tubercles or roughnessesabout the spleen. Both his lips had ulcers on them, round withinand small, and afterwards a little blood came out of the oppositepart.The bought servant, that I saw, who had a great hardness onthe right side, not very painful, with a belly large and distended,but not like a dropsy; and who in other respects was fat, and notvery short-breathed, but without colour, missed her menses forseven years. A dysentery attended her without a tenesmus, andafter this the hardness became painful. A slow fever came on, butnot above seven days, and her stools were like amber, somewhatglutinous, and large. She was well some days, and after that hermenses came down; the hardness grew soft; her colour laudable;and her body thick.Minois's wife, who fell into a mortification from too great a pressure upon an incision, presently gave notice, (upon the mattersTHE FOURTH BOOK OF EPIDEMICS. 395fixing on the lungs, ) how many days she was to live, and thatsomething else was concealed within.Upon putting any thing up the nose, if a fever ensues, or if thepain is removed, a flux is produced of thick matter from the nostril.But if neither the pain is removed, nor a fever excited , the matteris thin, and perhaps burning; as the thin matter in Hegesippus, whohad something put up over night; but it was thick in Celeuris's son,of Corinth, who was like an eunuch.Digested abscesses in diseases are known to be critical by thesemarks, viz. , if, being of a hot burning nature, a fever follows not;or if, hard to be borne, they are nevertheless easily borne: as wasthe case of Charon, in what settled upon his fundament. But inLeambius, whose intestine was thought to be ulcerated, his armand seat on the left side, upon taking medicines for a dysentery,were ulcerated, and a fever followed.He, who was distended with wind, had his flank tumefied andpainful. Upon drinking much milk and pure wine, and sleepingafterwards, he was taken presently with a sickness at his stomachand heat. Afterwards, making a fire, and, instead of meat, eatingmeal baked over the coals, his body was tied up, and somethinglike pus came away. But, though the anus was inflamed, I affirmhe had neither fever nor pain.The old man, who lived in the stone-porch, had a pain in hisloins and both his legs, which also affected both his thighs, andsometimes his shins; sometimes also his knees. This continuedlong, and returned often. His feet, legs, and loins swelled; theglands in his groin swelled a little too; the belly was hard; and allthe lower part of his belly distended and painful. For the mostpart his bladder was hard and painful, attended with eruptions andheats.Aristmas, of Amphilochus's village, was lightheaded the fourthday. His stools were pale and greenish; his sleeps sound; and hiscolour white.Some at the beginning had a sort of trembling in the fingers, andlips, when they spoke; but in other respects were nimble-tonguedenough, though not with the best manners. Such had a redness intheir faces for the most part; were lovers of wine to excess; or,after vomiting advantageously, swelled.He that lived at Medosadas's, who had many thin watery stoolsthat were not bilious, had his hypochondres yielding and tumid.396 THE WORKS OF HIPPOCRATES.He was also comatose. About the fourteenth, while the crisis wasgoing forward, a shivering seized him without trembling, attendedwith a relaxation, a languidness, and a falling down of his limbs;his belly was loose; the coma continued; and he was lightheadedafter sleeping, but not mad. The fourteenth, had a crisis , none ofthe critical signs opposing it.Just so it was with the other person, who at the beginning hadstools that were glutinous, of which the thick part proved critical.He was watchful too; and afterwards had stools that were somewhat glutinous, somewhat bilious, digested, more bilious, and notthin: but, when they began to have a consistence, the crisis sooncame on. The hypochondre appeared distended about the sixth,with heat and pain, as when the veins are distended and agitated.After that he slept the seventh, and had a crisis the ninth. Both ofthem were white- coloured, not yellow. The watery stools, exposedto the air, were smooth and thin upon the surface, very like woador yellow amber, and had a sediment at the bottom .A softish distension of the right side denotes a phrensy, if it doesnot go off upon the fever's going off.If, upon the softness of the belly, something happens to be collected there, hard, and painful, and of such a bad quality as notto be dispersed, perhaps a suppuration will follow from such aswelling.Swellings on the right side, as many as are in a great measuresoft, especially upon pressing, if a murmuring follows, are not to bedeemed of a bad quality; as in the Amphilochian, and the Medosadean, who were both of them comatose and delirious in theirsleep.He who had an ulcer upon his shin had red large pustules breakout, upon using the Attick ointment: and this, instead of a coughthat was afterwards troublesome, for he had no cough before.In Enus, as many as were chilly, and wounded in the head,were in a bad way, and came to suppuration. They had also apain in their feet upon travelling, from a tenesmus; and, in oftenattempting to discharge, a weariness. Such was the case of Clinias, who was averse to food, fell away, and discharged a matterthat was sometimes a little bloody, at other times pure pus.Hippeus's wife, who was dropsical, coughed for three years inthe beginning of the spring, collected a great quantity of matter,THE FOURTH BOOK OF EPIDEMICS. 397and in the winter became dropsical, but was relieved by purges forthat purpose. The maid-servant died.Those among the coughers, who laboured with their hands, asthe boy that twisted osiers, and Amyntas's son, were both of themparalytic in the right hand only, and the cough ceased; afterwhich they had it with the cough. Those who rid on horseback,or travelled, had it in their loins and thighs. But the coughs werefor the most part dry; or, if not, very violent.Enmyris's wife, who was taken ill (but not in the usual manner)seemed to be without a fever, and yet had something of a typhus.After this a trembling came on all over, a wasting, an aversion tofood, a thirst, and a coldness.Those who had the disease of the eyes called nyctalopia, andmade a great deal of water, afterwards made but little; but uponcoughing and growing feverish had abscesses broke behind the earsabout the seventh or eighth day.Enmyris's daughter was feverish, and pus came out of her earabout the eighth day; but I am not certain. Some had a tootheaten away, especially the third of the upper jaw. In some it waspainful, and suppurated; in others the suppuration was in the ears;and these coughed much more vehemently than those. Othersagain had a collection of matter with a fever, and were freed theseventh. Upon the hypochondres being irritated no solution happened; and, upon the belly's being softened, there were little glutinous concretions, not of any service; the urine like blood; thespittle frothy.He the Cynick brought me to, was much disordered the seventhday, and had a crisis the fourteenth. The bad symptoms dwindledaway by degrees. His throat was clear; and what he spit waslittle, broad, and digested. A few drops fell from his nose; hishead was heavy; his hands and legs somewhat paralytic; his bellyloose, and to good purpose; and his feet always warm. He alsoslept, and had nothing behind his ears, because of his digestedspittings.Demaratus's wife was warm in her feet, even when chilly; but,whether it tended to suppuration or not, she died.The old man who died was taken ill with his wife, who hadsomething concealed in her very furious; but upon a thickishworm coming away, and the refreshment of a little food, her complaints immediately ceased; she slept, and was quite well. The398 THE WORKS OF HIPPOCRATES.old man had the skin of his body stretched, and his extremitiescold. He was also soft, and trembled from the beginning in hislips, hands, and speech; was moderately lightheaded; and laidwith his mouth open, not much oppressed in his breathing. Hedied at last, but how many days beyond twenty I know not.Where the hypochondres and the belly discharge compressedmatter in abundance, without any rumbling, as in Abdera, the excrement is variegated.What is spit up in peripneumonies is in some bilious, when thedisease will go off; in others very yellow, when the crisis will beshort.If such, as appear at the beginning, appear the same afterwards,this is an argument of very little concoction; and the crisis is as inhim who lived with the master, or as I have seen it at other times.Nicippus in his fever had frequent emissions, without any inconvenience; and was foretold that they would cease, when the feverwas come to its crisis; and so it happened.Critias was pestered with dreams in his fever, from which I knowhe was freed after the crisis.Alcippus, who was subject to the piles, was forbid to be cured,and upon being cured went mad. An acute fever coming on, carried the other off.In acute fevers, those who are thirsty, and deprived of drink byheir physicians or themselves (though they could drink a greatdeal) , are the better for cold water given to vomit them; for muchbilious matter will come away.That the nerves (or tendons) attract one another, is plain fromthis: for, if the upper tendons of the hand are wounded, the handwill incline downwards, drawn by the lower; and so vice versa.A dry cough produces à swelling of the testicle; and whatcomes from a cough upon the testicle must be cured by bleeding.Inflammations cause coughs. They also come upon fevers thatarise from swelled glands.THE FIFTH BOOK OF EPIDEMICS.FESIUS, p. 1141.To me, says Haller, there seems nothing in this book unworthyof Hippocrates. The part which adverts to the manifest affinityof sutures and fissures, is pointed out by Celsus, and by Plutarch,in praise of this great man. It is in parts obscure, and difficult tocomprehend; but it contains histories of various surgical cases, notalways indeed coherent, but many of which are uncommon anduseful. Peripneumony from metastasis of angina; tetanus fromacrid applications to a wound; and death from a slight blow onthe head. The distinction between arteries and veins might leadto the idea of the book being of a later period. Galen ascribes itto Draco, or to the second Hippocrates. He considers the seventhbook as spurious, but ascribes the second, fourth, and fifth to Hippocrates, although probably not edited by him. To me, addsHaller, the fifth and seventh appear much superior to the othersmentioned. -Ed.The gardener's wife, in Elis, had a continual fever, and receivedno benefit from purges. Below the navel the belly was hard, swelled, and in great pain. Upon its being handled, and pressed prettymuch by the hand dipped in oil , a great deal of blood passed offdownwards; after which she grew well, and continued so.Timocrates, in Elis, after hard drinking, was seized with madness from black bile; and by the help of a purging potion broughtaway (though not without much uneasiness) a great deal of phlegmand black bile in the daytime, and had no more stools in the evening. After drinking some gruel he fell asleep, and did not awaketill sunrise; but seemed all the while to the bystanders to be dead,neither fetching his breath, nor perceiving any thing that was said.or done. His body was stretched out, and stiff; yet he was alive,and got up again.400 THE WORKS OF HIPPOCRATES.Scomphus, in Oeniadæ, died of a pleurisy the seventh day, delirious, after having taken a purge the same day that wrought butlittle. The day before he was in his senses, but upon purging grewdelirious.Phoenix and Andreas, two brothers in Oeniadæ, had a swellingin one of their cheeks, and the lip that was opposite to the cheekand eye. Nothing appeared inwardly upon examination, nor wasthere any abscess outwardly, but it swelled, and putrefied , withoutdischarging any thing. Both of them died; but Andreas died theseventh, after taking a purge to no purpose; whereas Phoenix hadthe putrefied part cut all round, and the ulcer discharged a greatdeal before he died. He died, however, though he held out long.Pyridamus, in Oeniadæ, began to be delirious the tenth day in aninflammation of the lungs; but, being taken care of, came to himself again, and what he spit up was clearer than it had been. Thedisease grew better; a great deal of sleep followed upon it; but hiseyes looked as in the jaundice, and about the twentieth he died.A man in Ocniada had the following complaint. When he abstained from food, his belly rumbled mightily, and was in pain; andthe very same complaints returned in a short time after he hadeaten, and the food was ground small. His body also fell awayand wasted; the food he took afforded no nourishment; and whatpassed downwards was of a bad sort and burnt. The rumblingand the pain were least perceived immediately after eating. Hefound no benefit from purges of every kind, both upwards anddownwards; but being blooded at times in each hand, till he hadhardly any blood left, he grew easier, and got rid of his complaint.Eupolemus, in Oeniadæ, felt a pain in his right hip and groin,the nearest joining of the hip to the groin, and the forepart of thehip. Upon losing a vast deal of black thick blood from the ankle,and taking a smart purge downwards, he grew easier. The painsindeed did not cease, but the hip, the joining, and the part aboutthe groin suppurated, though not without an increase of pain: forthe pus laid deep, rather at the bone than in the flesh. He wasneglected for some time in this condition, till he became extremelyweak; and then a great many large eschars were made by theactual cautery, near one another, and a vast discharge of thick pusensued. A few days after this he died, partly from the largenessand number of the ulcers, and partly from the weakness of his body.Whereas had one large incision been made, or even a second (if itTHE FIFTH BOOK OF EPIDEMICS. 401had been necessary) , and the pus discharged that way, and all thisin time, he might have recovered it.Lycon in Oeniada was in other respects in the same condition,but the pains extended to the leg, though not very much. Hereindeed was no suppuration, and yet he did well after a long time;but then he took physic, was cupped, blooded, and seemed to bebetter of his complaints.A man at Athens was seized with an itching all over, especiallyin his testicles and his forehead, which proved exceedingly troublesome. His skin was thick from head to foot, in appearance likethat of a leper; and could not be taken up any where for the thickness of it. This man could receive no benefit from any body; but,upon using the hot- baths at Melus, got rid of his itching and histhick skin. He died, however, of a dropsy afterwards.A man at Athens was taken with the cholera (or overflowing ofthe gall); purged upwards and downwards; was in pain; and couldnot be relieved of either vomiting or purging. His speech failedhim, and he could not move out of his bed. His eyes were mistyand hollow. Convulsions seized him in the stomach from the intestine, and a hiccough followed. He also purged much more thanhe vomited. But upon drinking hellebore after the juice of lentils,and upon this the other lentil juice, in as great a quantity as hecould, a vomiting ensued, which put a stop to both his evacuations;but he grew cold. His lower parts were therefore bathed verymuch up to his private parts, till the upper grew warm again. Herecovered upon it, and the next day drank some thin gruel.Gorgias's wife in Larissa, who had a suppression of her mensesfor four years, almost entirely, complained of a pulsation andweight in her womb, whichever side she lay on. She conceivedafterwards, and conceived again upon the first. In nine monthsshe was delivered of a live girl with an ulcer on her hip. Themembranes came away, and with them a great flux of blood. Thenext day, the third, and the fourth, clotted blood came away; afever attended for the first ten days; and the rest that came awaywas red. Her face, legs, feet, and one thigh swelled very much;her appetite failed her quite; and her thirst was very great. Thecoldest water was of service to her, but wine by no means. Herbelly, after the first child came away, was somewhat softer, thoughit did not fall entirely, but was harder than it should be, and without pain. Forty days after the first, the second child came away,26402 THE WORKS OF HIPPOCRATES.like a lump of flesh; the belly fell; all the swellings went off; theflux was small; the blood offensive; and she recovered.A woman in Phere was troubled a long time with a violent painof her head, and could get no relief from any body, nor even frompurging the head; but was easiest when her menses came downfreely. Fragrant pessaries applied to the womb were of service toher, when her pain was violent; and a little purging followed uponit. Her pains left her upon proving with child.A woman with child in Larissa lost a great deal of blood in fourteen days in her tenth month, but most three days before her ' delivery. The fourteenth, a dead child fell out of the womb, with itsright arm growing to the side. The third day, the same hour ofthe night the child was born in, the membranes came away, andthe whites followed. After this, for three days and nights, a greatdeal came away, but not immoderately. This was succeeded byfever that lasted two days and as many nights, attended with painsall over the belly and the hips, especially the lower part of the belly,by the pubes.Hipposthenes in Larissa was supposed by his physicians to havean inflammation of the lungs, but the case was quite otherwise.The beginning of his illness was from a fall upon his back in a hardplace, and another falling upon him, as he was wrestling. He wasafterwards washed with cold water, got his supper, and seemed tobe heavier. The next day, was feverish, coughed without spitting,and breathed quick. The fifth, hawked up bloody matter, but notmuch; began to be delirious; and upon coughing complained of apain in his breast and back. The sixth, bled about a quart at thenose, upon sneezing; in the evening neither spoke, nor perceivedwhat was done or said. The eleventh, died.He was, for five days, sometimes perfectly in his senses, sometimes not, and without a fever. He spit nothing at all; nor had heany rattling; because there was no spittle to occasion it.Scamandrus in Larissa had a mortification in his hip, and anabscess of long standing at the bone. A large incision being made,even to the bone, and ustion used afterwards, a convulsion beganthe twelfth day after the incision, and held him strong, reachingfrom the leg to the ribs, and affected also the other side. Thelegwas sometimes contracted, sometimes extended, and he had the useof his other limbs, but his jaws were set. The eighth day afterthe first convulsion he died in another. The cure was carried onTHE FIFTH BOOK OF EPIDEMICS. 403by applying warm bottles and fomentations of tares to the wholebody, not omitting a glyster; by which the fæces that had beenlong detained, came away in a small quantity. He also drank abilious purge, and even a second; from which indeed there was adischarge, but to no advantage. After a little sleep he took anotherstrong purge ofthe like kind, and in the evening died about sunset;but in all probability might have held out a long time, had not thephysic been too strong for him.A boy belonging to Palamedes's stables of Larissa, about elevenyears old, was struck by a horse upon the forehead above his right.eye. The bone seemed to be hurt, and a little blood spurted out.A large incision was made by the trepan even to the marrow, andthe bone thus affected was healed; the other lamina (viz. the anterior) growing again presently. Twenty days after this a swellingappeared about the ear, attended with a fever and shivering; andthis swelling was greater in the day, and painful. The fever beganwith shivering; and his eyes, forehead, and whole body swelled ,rather on the right side of his head than otherwise, though the leftwas not entirely free; but no bad consequences followed. At lengtha continual fever came on; and these complaints lasted eight days,but were less. However, by burning, evacuating downwards by apurging potion, and applying a cataplasm to the tumour, he recovered. As to his complaints, they were not at all occasioned bythe wound.Theophorbus's son in Larissa had the scabies (or leprosy) of thebladder; made viscid urine; was in pain at the beginning andgoing off of his water; and rubbed his glans. After drinking asharp diuretic nothing passed into the bladder, but he vomited agreat deal of purulent matter and gall, part of which went alsodownwards. His belly was in pain, and as it were burnt within,while the rest of his body was cold, and entirely unbraced. Norcould he take any thing at all. His belly was grievously ulcerated,and that by the strength of the physic altogether; for the third dayafter it he died.Antimachus's wife, in Larissa , after having been with child aboutfifty days, loathed her victuals the rest of the time, and complainedof pain in the womb and the pit of her stomach for seven days. Afever came on, and nothing passed downwards. Upon drinking astronger dose of elaterium than was proper, she vomited burnt bile,occasioned by her abstinence and fever. For she had drank no,404 THE WORKS OF HIPPOCRATES.thing at all. She vomited a little again with violence, and with itsome grumous matter. After this she grew sick, lay down, and,finding herself weak, would drink no more water to encourage it.The intestines were upon this seized with a terrible pain, (for themedicine had ulcerated them, ) and presently with the stools shevoided something that was viscid, stringy, and a little bloody, as ifthe guts had been shaved. Her weakness and the sickness at herstomach increased continually, and the purging amounted to almostthree pints. This indeed stopped, by pouring a great deal of waterupon the belly, but still she could take nothing; and about midnightshe died; though in all probability she might have lived, if shecould have drank water, and vomited immediately before it passeddownwards.Onesidemus's servant in Larissa had her stomach and bowelsulcerated by bile that was set afloat of itself; upon which bile andblood passed off upwards and downwards, not without a fever.She took, as she was a weak woman, a weak potion of elaterium,little in quantity and mixed with water. Upon this she vomited agreat deal, and purged more; and in the evening it came upon heragain. The next day she was feverish, but not much; the bellywas ulcerated, and she had the same stools as before. The thirdshe died about sunset, the fever raging vehemently.The case appeared to be altogether desperate, but not at allfrom drinking cold water, while the vomiting lasted. But whenthe stomach, cleansed by the water, was become cold, she drankthe cream of barley cold, and had some of the same injected.Eudemus, in Larissa, who was troubled with the piles to a greatdegree and long, having but little blood left, was seized with theflowing of the gall. The body indeed was very little affected withit , but the belly was thrown into purgings, and what came awaywas bilious. The piles also came out. Upon drinking somethingto pass downwards he was purged well, and upon drinking thecream of barley after it he was purged more, not without a pain inthe hypochondre. The belly not being in the best condition, thepiles were taken in hand; for he wanted a farther cure, andvomited afterwards. Upon rubbing something upon the partswelled, a fever came on, and never left him till it killed him; forif at any time it intermitted, a shivering succeeded, and fever cameon again, and bilious stools followed with wind that sometimespassed off, sometimes not; and the belly was also in pain. TheTHE FIFTH BOOK OF EPIDEMICS. 405piles were swelled without the anus, from the time the purgingswere made use of; and the wind passed through them by the helpof sneezing at the beginning.A man at Larissa was wounded behind by a broad javelin, fromone very near him, the point of which penetrated below the navel.The part was livid and swelled for a great way. Upon receivingthe wound, a violent pain first seized him, and his belly swelled.The next day he took something to pass through him, discharged alittle bloody matter, and died. His intestines seemed to be hurt,and his belly to be full of blood.Apellæus, of Larissa, who was about thirty, or something less,was taken ill of a distemper that used to affect him by night in hissleep, rather than by day, and continued so two years before hedied; attended with a vomiting of sometimes yellow, sometimesblack bile, upon being waked. After purging the head smartly fora long time, and taking physic twice, it left him six months. Hewas a great eater, and of a bilious habit. A violent shiveringseized him after much wrestling; a fever followed, and in the nighthis old distemper. The next day and the following he seemed tobe well; but the next night it came upon him again, after he hadsupped, and taken his first sleep, and continued till supper-time thenext day. Nor did he recover his senses before he died. A convulsion first seized his right side, then his face, and whole body,and after that his left side. When it seemed to be over, he grewcomatose, snorted or rattled in his throat, and had a return of hisdistemper.Eumelus of Larissa had such a stiffness in his legs, hands, andjaws, that he could neither extend nor bend them, without the helpof another; nor could he open his jaws, without another did it forhim. He was in no pain any where else , nor did he eat any thingbut a sort of flummery, with mead for his drink. The twentiethday he fell from his seat backwards, and struck his head very hardagainst a stone. Upon this his sight grew dim; but he soon got upagain, recovered himself, and was entirely free, except that, whenhe got up after sleeping, his joints seemed bound together. He wastwelve or thirteen years old, and ill three or four months.A maid in Larissa, after vomiting a little blood, had a collectionof matter formed; upon which a fever coming, she could not getthe better of it, till death freed her from all within three months.Before she died, her ears were so deaf that she could hear nothing406 THE WORKS OF HIPPOCRATES.at all, unless one bawled to her very loud: and before this vomiting of blood happened, she was but in a weak condition. -Dyseris's servant , of Larissa, in her youthful days, complainedof violent pain in the act of venery, and not at any other time.She never proved with child; but, when she was about sixty, wastaken after noon with violent pains like labour- pains, having eat justbefore a good deal of garlic. She got up, when her pains weremore violent than ever, and felt something rough in the mouth ofthe womb; but, fainting away afterwards, another woman put upher hand, and brought from her a rough stone as big as the whirl ofa spindle. She grew well upon it immediately, and remained so.A loaded wagon came upon the ribs of one who belonged toMalea, and broke them. Matter lodged for some time under theribs, but upon being cauterized below the spleen, and the ulcer keptopen with lints and the like, he held out ten months. After theskin was cut, a cavity appeared both ways, reaching to the omentum, not without putrefaction. It extended likewise to the kidneyand the bones. The habit of this man's body was not perceivedto be bilious, and so the putrefaction became great and dry, affecting the omentum and other fleshy parts. A dry medicine was hereimmediately necessary, while the strength of the patient lasted;for the moist medicines were so far from abating, that they increased the putrefaction. The moisture being stopped by the lintsthat were applied, a shivering and a fever came on; the putrefaction increased; and a fetid , blackish, putrid matter ran out. Butbefore we undertook the cure, a great deal of such stuff was discharged every day, though not freely. Bythis we knewthe natureof the disease, and that it was deeper than the skin. So that ifevery thing had been done for him in a proper manner, yet his casewould have been desperate; even though a purging had also happened.Autonomus died in Omilus, the sixteenth day, in the middle ofsummer, of a wound of the head, occasioned by the throwing of astone at a little distance upon the sutures in the middle of the osbregmatis, or parietal bone. I did not perceive that the trepan waswanting; for the injury was received upon the very sutures (aswas extremely clear afterwards), and so deceived me. A violentpain seized the collar-bone first of all, and after that the side, together with a convulsion in both hands; for the wound was givenin the middle of the head, and the parietal bone. The trepan wasTHE FIFTH BOOK OF EPIDEMICS. 407applied the fifteenth; a little pus came out; and the membraneappeared free from any corruption.Ayoung girl in Omilus, about twelve years old, died in the middle of summer, the fourteenth day, of a wound in her head, occasioned by somebody's throwing a door upon her, that bruised andbroke the bone. The wound was right upon the sutures, and itwas plainly seen there was occasion for the trepan. It was accordingly applied, but not so far as it ought; however, what remained came to suppuration. The eighth day she shivered, andgrew feverish; and though she was not as she should be, yet shewas as she had been some time before, when she had no fever.The ninth, the remaining part was trepanned, and a very little pus,streaked with blood, appeared underneath. The membrane wasclear, and sleep came on, but the fever never abated more. Theleft hand was convulsed, the wound being rather on the right side.Cyrenius in Omilus was burnt upon the belly for a collection ofpus there; and, though it was thirty days later than it ought tohave been, yet he was pretty well after it , and the pus that was inthe belly was dried up. But eating afterwards, in the hottest timeof the year, the fruits of the season and other improper food, hefell into a fever and looseness, and went off.Hecason in Omilus was cauterized later than he ought, just asthe other was, and almost the whole belly was dried up too; but adysentery came on; and, as soon as he got over it, he eat of everything till he swelled all over. The pus afterwards broke its waydownwards; a looseness attended it; and he died.Hecason in Omilus had an acute pain fixed in his hip, from thefoulness of his body, and injudicious purging. Upon its going offa fever ensued, that confined him to his bed a long while. He neither drank any thing, nor was thirsty, but was weak and chilly.His distemper went off in a proper manner, as it ought, and hisbody was the better for what was given him. At last the distemperbroke downwards, and went all off with a great deal of bile. Hegrew delirious upon it, however, and died; but seemed to be ableto get over it.A man in Salamis, falling upon an anchor, was wounded in thebelly, and in great pain. The physic he drank passed neither upwards nor downwards.The woman that cut her own throat was strangled; but a purging potion, that was given her a good while after, passed throughher.408 THE WORKS OF HIPPOCRATES.The young man who came from Euboea, and had been purgedvery much, grew feverish upon its intermitting and stopping. Concluding from this that a vomit was necessary, he drank a weak one,viz., the root, and elaterium, and died four days after, withoutany evacuation; but he was sleepy, and his thirst could not bequenched.The maid- servant, that was a foreigner, vomited a little fromwhat she drank, and was strangled; but purged very much downwards, and died in the night.The man of Eubœa, upon drinking a purging potion, was purgedthree days, and died. His hand suppurated up to his elbow.Symmachus's boy was strangled with bile, as he was asleep inthe night, and feverish. The physic he drank would not stay withhim, nor was he purged in six days before he died.He who lived by the race-house, and vomited blood in the night,died the next day, vomiting a great deal of blood, and strangled.The spleen and parts below it had a quantity of bloody matter passthat way.The boy, that was struck by a mule upon the belly and the liver,died the fourth. His breath was quick, his senses confused, and afever attended besides.Hermophilus's son, who was ill eleven days, was feverish, boundin his body, and delirious at first, but it went off in the night. Thenext day he lost his speech, rattled as he lay, had his eyes distorted,and was feverish. A feather being put down his throat, he broughtup black bile, and by the help of a glyster had a very great discharge.Aristion's servant had a mortification about the middle of herfoot from the inside obliquely, without any reason for it. The bonesputrefied, separated, and came away in a fistulous manner by littleand little. Upon a looseness succeeding, she died.A woman in good health, and corpulent, complained of pain inher belly, a colic in her bowels, and with these a swelling, afterdrinking something upon account of conception. A difficulty ofbreathing attended, with great uneasiness of mind and pain. Shealso vomited blood, but not much, and fainted away five times soas to be thought dead. Neither the pain nor the breathing wererelieved by vomiting with cold water; the only thing that relievedher was the pouring about thirty firkins of cold water upon herbody. For after this a great deal of bile passed downward, andTHE FIFTH BOOK OF EPIDEMICS. 409she recovered; whereas, when the pain was upon her, nothingcould pass.Antandrus, who was well in other respects after taking physic,seemed to have a pain about his bladder. A very great clearageand depuration was made there by what he had taken, and in theafternoon a violent pain seized him. The next day a suffocation,with great perplexity and restlessness. He vomited too, withoutany thing passing downwards, had a bad night, and no sleep. Thethird day a great deal went downwards, followed by blood, and sohe died.The cobbler of Pityus, as he was sewing a sole, ran the awl abovehis knee into his thigh about an inch, but no blood followed, andthe wound closed up presently: however the whole thigh swelledupon it, and the swelling reached to the groin and flank. The thirdday he died.A man received a wound in his groin by a dart, and recoveredcontrary to all expectation; for we saw the case. The head of thedart was neither taken out, because it lay very deep; nor was thereany loss of blood to speak of, nor inflammation, or lameness; butsix years after the accident we found the dart, and took it out. Ouropinion is that it was buried between the nerves or tendons, without dividing either artery or vein.Another received an insignificant wound to speak of (for it wasnot deep) a little below his neck behind from a sharp dart; whichbeing taken out not long after, he was drawn and distorted backwards, as in the opisthotonus. His jaws were also fastened; and,if any thing moist was put into his mouth, and he attempted toswallow it, it returned again through the nose.In other respectshe grew worse immediately. The second day he died.A young man, running hastily over rough ground, felt a pain inhis heel, especially the lower part. No moisture being collected,nor any abscess formed, the whole part turned black the fourthday, as far as the bone called astragalus, and the hollow part in thebottom of the foot. Before the mortification could break away orsuppurate, he died, twenty days in all after the running.He who was wounded by his eye, received it upon his eyelid,and the point of the dart went in deep, but the fang or beard of itappeared outwardly. Upon laying open the eyelid, every thingwas taken out without any inconvenience: for the eye was savedand healed presently, and the blood flowed freely and sufficiently.410 THE WORKS OF HIPPOCRATES.Nerius's handsome girl, about twenty, was struck upon the parietal bone with the palm of the hand by another young woman inplay; upon which a mist came on, and she could not breathe. Assoon as she was brought home, a violent fever attacked her, with apain in her head, and a redness about her face. The seventh day,above a spoonful of fetid reddish pus came out of her right ear; sheseemed to be better, and was lighter and easier. The fever, however, increased again, and was attended with a dozing, a loss ofspeech, a contraction of the right side of the face, a difficulty ofbreathing, a convulsion, and a trembling. The tongue was alsoconfined, the eye fixed, and the ninth she died.Ayoung man, after drinking a great deal of genuine wine, fellasleep in a certain shade, and the serpent called Arges crept intohis mouth. As soon as he perceived it, not being able to speak, hegrinded his teeth, bit the serpent through, was seized with greatpain, threw out his hands as if strangled, tumbled and tossed about.fell into convulsions, and died.NOTE.-At this place Clifton leaves out several pages as they appear in Haller; andwhat follows is from the sixth book, omitting nearly the two first of the sections asgiven in Haller, the only explanation for which is in the following note, which tome is not satisfactory.—ED."This is the first observation in the sixth book (see section the 2d, aph. 22, ) that Icould insert here; the former being all aphorisms of such a naturc, as cannot bebrought, with any propriety, into a book of Epidemics. The other observations arenot so good as I could wish them, but yet must not be omitted. "This refers to the sixth book, beginning with " Broad cruptions," in the nextpage.-ED.THE SIXTH BOOK OF EPIDEMICS.FOSIUS, p. 1164.THIS, says Haller, is much of the same character with the preceding; and is said to have been transcribed from the note- book ofHippocrates, by Thessalus. Galen has commented upon it. It isa medley of histories of diseases, aphorisms, and predictions, frequently taken from the other writings of Hippocrates, often deficient in limitation, and half true. Herodicus ridicules his ratiomedendi. Some physiological remarks are interspersed; -and astory is given of an Abderite woman, who was changed into a man,and whom the author in vain attempted to cure!Gardeil, speaking of this book, says, that Galen had written acommentary on it, for the use of his disciples, a part only of whichhas reached us, from which we may however perceive how muchhe was frequently embarrassed to discover the real meaning of theauthor. This difficulty must now be much augmented; and heclaims on this score the indulgence of the readers of his translation,stating that he had submitted its revision to several friends beforecommitting it to press. These he gratefully names,-and asks forfurther favours from distant members of the profession, in caseanother edition should be required. He states this book as containing numerous sentences, mostly deserving attention, both in respectto hygiene and to therapeutics. -Ed.Broad eruptions, without any great itchings (such as Simon'swere in the winter), were not relieved by vomitings; but perhapswarm fomentations applied might have been of service; for he,upon being either anointed by the fire, or bathed with warm water,was relieved.The woman that lived bythe great theatre, behind the Heroesmonument, was taken with a jaundice that remained with her; and412 THE WORKS OF HIPPOCRATES.the man that lived by Timenes's niece was taken with a blacknessall over.In Perinthus, the urine was like seed. Such was also critical.Complaints about the pubes are relieved this way, when the case iscurable by urine: for, without much flatus, or much (but viscid)excrement passing off, it grew soft; the hypochondre not beinglarge. The seventh day he ate some cabbage, while a difficultyof breathing was upon him, grew softer about the pubes, breathedwell, and his belly was loosened by it.The woman, that I first cured in Cranon, had naturally a largespleen. Her fever was of the burning kind, attended with greatredness and difficulty of breathing. The tenth day she sweatedupwards for the most part; but, the fourteenth, a little downwards.Agasius's daughter, when she was a girl, was short-breathed;and, when a woman, was taken with a little pain not long after herdelivery; and, upon lifting up a great weight, something seemed tocrack in her breast. The next day she was asthmatic , and had apain in her right hip. When this was troublesome, her asthma wasso too, but ceased with the other's ceasing. What she spit wasfrothy, but florid at the beginning; and, after standing, resembleda bilious thin vomiting. Her pains were greatest, when she worked with her hands. She was forbid meddling with garlic, pork,mutton, and beef; or to bawl, or put herself in a passion, whenevershe had occasion to speak.Where a tumour in the head spread itself, there burnt alum wasat first serviceable. Another abscess followed, perhaps because thebone was to come away. This happened sixty days after, abovethe ear, whereas the wound was higher, upon the crown of thehead.A man after a fatiguing journey, was quite spent, heavy, and fella spitting; a cough coming from the top of his head. A smartfever ensued, that was very uneasy to the touch. The next day aheaviness in his head, with a burnt tongue. No blood from the leftnostril, though picked with his nails. The spleen was large, hard,and painful.The autumn is bad for consumptive persons; and so is the spring,when the fig-leaves are like a crow's foot.In Perinthus, a great many were consumptive in the spring, occasioned in some by an epidemic cough, in the winter; and in othersby the long continuance of disorders: for thus what was doubtfulTHE SIXTH BOOK OF EPIDEMICS. 413before was now confirmed. Some indeed, who had been long ill,escaped a consumption, as those did who were troubled with nephritic pains; and so did some others, as the man, for instance, theCynic brought me to.Satyrus, in Thasus, surnamed Grypalopex, when he was aboutfive-and-twenty, often spent in his sleep, and indeed often in thedaytime. A consumption seized him about thirty, and he died.The keeper of the wrestling-place in Abdera, whose name wasStheneus (or the strong man) , after wrestling much with a stronger,and falling upon his head, went away and drank a great deal ofcold water. He could get no sleep that night, was very restless ,and cold in his extremes. The next day he went home; had nostool, though a suppository was put up; made water a little, whereas before he had made none; was bathed at night, but yet couldget no sleep, or lie still, and was lightheaded. The third day, wascold in his extremes; grew hot, and sweated; but died this veryday, after drinking mead.Phaethusa, in Abdera, the wife of Pytheus, who had had a childformerly when she was very young, upon her husband's being banished , missed her menses a long time; and her joints grew afterwards painful and red. Upon this her body became manly, andhairy all over; a beard thrust out, and her voice became rough.Every thing was tried by us that was likely to bring down hermenses, but all to no purpose; and not long after she died.The same thing happened in Thasus, to Namusias, the wife ofGorgippus. All the physicians that I talked with were of opinion,that the only hope left was in her menses coming down again asthey ought. But this could never be brought about, though we triedevery thing; and she died not long after.NOTE. Here, throughout, large portions of the text are omitted by Clifton; givinghis reasons therefor in the preceding note.-ED.THE SEVENTH BOOK OF EPIDEMICS.Fasius, p. 1206.THIS book, says Haller, is the production of the author of thefifth book, in both of which we find much repetition, and with littleorder, from his note-book, on the subjects of phrenitis, continuedfever, dropsy, the diseases of pregnancy, and some surgical cases.A fœtus remaining in utero nine years, is mentioned. The bookcontains a larger number of histories of epidemic diseases than theothers, the best of which are at the commencement.In his notes, Gardeil has taken the pains to point out some of theparts of this book with which Book V. corresponds. -ED.After the dog-days the fevers were attended with sweats, norwere they thoroughly cold after sweating, but grew warm again,and were feverish a long time, had commonly a difficult crisis, andwere not very thirsty. In some they ceased upon the seventh andthe ninth day; in others upon the eleventh, the fourteenth, theseventeenth, and the twenty-second.Polycrates had a fever, and sweated in the manner now mentioned. After taking a smart purge, his fever was so mild, that onecould hardly perceive it, except in his temples. In the eveninglittle sweats came on again about his head, neck, and breast, andafterwards all over; upon which he grew warm again. About thetwelfth and the fourteenth the fever increased, his stools were few,and after purging he supped either broth or gruel. About thefifteenth, had a pain in his belly by the spleen and the left hypochondre, which was relieved by applying cold things rather thanwarm, and upon taking a soft glyster ceased entirely.The same method relieved Cleocydes of a like pain and fever.About the sixteenth the heats seemed to abate; pure bile passeddownwards; he grew fierce and audacious; breathed moderately,THE SEVENTH BOOK OF EPIDEMICS. 415and sometimes, when he drew it in plentifully, discharged it againtumultuously, as if he was swooning, or as a man breathes whenhe sits in the shade after travelling in the heat. The seventeenth,as he was sitting on his bench in the evening, he fainted away, losthis speech a long time, and was senseless. He drank some meadwith great difficulty, the fibres of his neck being stretched, as whenthe throat is dried, and a general impotency upon one. At last herecovered himself with great difficulty, and the heats abated. Afterthis his disorder left him the twenty- second.About the same time Pythodorus was taken with a continualfever. The eighth day he sweated, and again grew hot. Thetenth, another sweat. The twelfth, supped some ptisan, and to thefourteenth had no sensible fever, except in his temples; nor anythirst; and thought himself well. Sweats came on every day; andthe fifteenth, after supping chicken broth he vomited bile, purged,and had his fever more than ever, but it stopped again. He sweated much, but the whole body, except the temples, was very cold,and the pulsation did not cease; it seemed however to cease for alittle while, so that he thought he was going to be hot again. Thetwenty- fourth, after eating meat for many days, and dining, he wasvery feverish, and in the evening delirious as he slept. The feverwas continual and strong, without any sleep for sometimes one,sometimes two nights; and all the rest of the time he was so heavyto sleep, that it was not the easiest matter to wake him. He wasdelirious too in his sleep; and, if at any time he was waked, hewas hardly himself, had no thirst, breathed moderately, sometimesas Polycrates, and his tongue had some colour. Seven days afterthe relapse, ptisans were offered him; and, after the fourteenth,meat. The first seven days he broke wind and vomited, and sometimes matter a little bilious came away with his drink without anysickness, till a passage was opened downwards. The sweats lefthim after the relapse, except upon the forehead, where they weretoo small to signify any thing. His tongue, if he did not wash it.after sleeping, faltered from the dryness of it, and ulcers broke outupon it, and also upon the lower lip, and about the teeth. Hisstools were few; but, about the fifteenth day after the relapse, morefrequent and glutinous; which were stopped by a decoction of pomegranates. The urine, such as in long cases. Towards the conclusion a pain took him so in his breast, as he was swallowing hisdrink, that he put his hand upon it. This was removed by supping416 THE WORKS OF HIPPOCRATES.cummin and egg. The tongue was relieved by a medicine madewith the chips of frankincense. The fiftieth day from the beginning, about the rising of Arcturus, little short sweats came on aboutthe loins and breast, with a coldness all over (except the temples),that lasted but a little while. The fifty-first, a remission, without areturn the next day.•Eratolaus's boy was taken with a dysentery and a fever aboutthe autumnal equinox. His stools were bilious, thin, frequent, andmoderately bloody; but the pain of his belly vehement. Upondrinking whey and burnt milk his pains abated; his stools weresomewhat bloody, and afterwards bilious; but he was forced torise often, though without pain. Some part of the time, after thefirst six days, the fever seemed to the patient and to many othersto be off, it was so imperceptible; but yet there was a pulsation inthe temples, and the tongue faltered from its dryness. His thirst,however, was but moderate; and as to sleep, he could never obtainit. What he lived upon was soups and wines. About the fourteenth, hard, crude tumours appeared behind the ears, first one,then the other, which disappeared afterwards entirely, and weremoderately painful; but his stools continuing, and all along bilious,the bile and the pain abated for some time, upon his supping theplant that was boiled with the meal; however, his discharges werestill frequent and liquid; and his aversion to food so great, that henever took it but upon the utmost necessity. His fever, his tongue,and his thirst, were as I have related them, without any sweat atall. His memory failed him in such a manner, that, if he askedabout any thing he had heard but a little before, after pausing alittle he would ask again, just as if he had said nothing before; andupon sitting down would forget himself, if nobody put him in mind.This disorder he was sensible of himself; and yet fetched hisbreath like a man in health. From the thirtieth to the fortieth daythe pain of his belly increased much; he lay down upon his back,and could not turn himself in the least. His pain was so violentthat others were forced to feed him. His stools were large, separated, and thin, resembling sometimes the colour of the wine hehad drank, and sometimes blood . The firmness of his body waswasted to the last degree; and so great a weakness came on, thathe could not rise even with the assistance of another. If any onelaid his hand between the navel and the cartilage (or pit of thestomach), there was a greater palpitation than is ever felt about theTHE SEVENTH BOOK OF EPIDEMICS. 417heart after running or a fright. Upon drinking for two days together nine Attick cotylas" of ass's milk boiled, a very great discharge of bile followed, his pains ceased, and his appetite returned.After this he drank about four Attick cotylas of cows' milk raw,at the rate of a quarter of a pint at a time, in a day, first mixing asixth part water, and a little black, rough wine. He eat but oncea day, in the evening, about half a choenix of bread baked underashes, or a little rock-fish, dressed plain, or a bit of goat or mutton.The milk was drank forty days without water, after the first tendays, with a small quantity of black wine. Seventy days from thefirst he sweated a little in the night after bathing; drank but little;and, after eating, drank his usual drink, or rougher than he used totake it.Ctesicrates was relieved more by that preparation with the mealthan by goats' whey, when the pain was all over his belly, attendedwith fatigue, rising often, stools a little bloody, and a swelling inhis feet. So was Adrianus for about twenty- five days; but Cæneus had most benefit from ass's milk boiled.Cydis's son was taken, about the winter solstice, with a shivering, a fever, a pain of his right ear, and a pain of his head. Hehad been subject to this sort of pain from his infancy, with a running, and a fistula of a bad smell. While it was thus, he was generally without pain; but now his pain was acute, attended with apain in his head. The second or third day he vomited bile, and, ashe sat, had a bilious viscid stool, of a pale yellow like an egg. Thefourth and fifth, was a little lightheaded; and the pain of his headand ear violent, with a fever besides. The sixth, was purged withthe herb mercury, upon which the heat and pain seemed to be carried off. The seventh, was in a manner well, but the beating in histemples did not leave him, nor did any sweat follow. The eighth,supped the cream of barley, and in the evening the juice of bete;slept in the night, and had no manner of pain. The ninth, was inhigh spirits till sunset; but at night the pain of his head and earreturned with vehemence; and immediately, upon the pain's becoming vehement, pus ran out of the ear; but all that night, andthe next day, and the greatest part of the night, he knew nobody,and groaned continually. The next day he came to himself; thepain ceased; the heat was milder; and, upon taking another soup• An Attick cotyla is something more than our half-pint. See Arbuthnot's Tables.27418 釁 THE WORKS OF HIPPOCRATES.or drink made of mercury, had, the eleventh day, phlegmy, slimy,fetid stools. The twelfth and the thirteenth, was pretty well. Thefourteenth, began to sweat all over from daybreak till noon, sleeping and being so comatose that it was not the easiest matter towake him. In the evening his sleep left him, and his body wasmoderately cool, but the beating in his temples remained. Thefifteenth and sixteenth, supped some juices or creams. The seventeenth, his pains returned again at night, with lightheadedness, anda discharge of pus. The eighteenth, nineteenth, and twentieth, hewas mad, bawled out, and attempted to raise himself up, but couldnot keep his head still; and, stretching out his hands, was alwayscatching at something in vain. The twenty-first, sweated a littleabout his right side, breast, and head. The twenty- second, sweatedmost about his face; and, as to his speech at that time, if he tookvery great pains, he could say whatever he had a mind to, distinctly; but, if he did not take such great pains, imperfectly, andby halves. His mouth became paralytic, and his jaws and lips.were always in motion, as if he had a mind to speak. His eyesmoved quick, looked earnestly, and the colour of the right one wasas if it had been blood-shotten. The upper eyelid swelled; hischeek was red before he died; all the veins in the face appeared;his ears were contracted; his eyes no longer winked, but werefixed, and the upper eyelid was elevated, as when something fallsupon the eye. When he drank, a sound followed it, as it fell intothe thorax and stomach, just as in Chartades's case. His breathingwas generally moderate all along; his tongue of a pale white colourfrom the beginning, as in an inflammation of the lungs; his head incontinual pain; his neck so stiff that it could not be moved withthe head; and the spine from the neck downwards strong and inflexible . His posture in lying was as we have said already, andnot always with his face upwards. The pus was serous, white,very troublesome to be dried up with sponges, and besides veryfetid . As he drew near his end, he was insensible when his feetwere touched.Harpalidas's sister, in the fourth or fifth month of her pregnancy,had watery swellings in her legs, a swelling in the hollow part ofher eyes, and her whole body puffed up as in a phlegmatic habit.Besides these she had a dry cough, a difficulty of breathing of theerect kind, and an asthma of the same. Sometimes she was sonear suffocation in her breath, that she was obliged to sit up in herTHE SEVENTH BOOK OF EPIDEMICS. 419bed continually, without being able to lie down; and, if she hadany inclination or thought of sleeping, it was in a sitting posture;but yet she was seldom feverish. The child within her was thegreatest part of the time without motion, and fell down as thoughcorrupted or dead. Her asthma followed upon it near two months,but upon using beans mixed with honey, licking honey itself, anddrinking Ethiopian cummin in wine, she grew easier. After thisshe coughed up a great deal of digested , phlegmatic, white matter;her difficulty of breathing went off, and she was brought to bed ofa girl.Polycrates's wife, in the summer, about the time of the dog-days,was taken with a fever. Her difficulty of breathing was less in amorning, and greater after the middle of the day, and a littlequicker. She coughed and hawked up, immediately from the first,as those do who have pus within them. In the inside, about thewindpipe and upper part of the gullet, there was a roughness andhissing. The countenance was of a good colour; the cheeks red,not indeed extremely, but moderately florid. In process of timethe voice grew hoarse, and the body wasted. About the loins werebreakings- out; and the belly at last became loose. The seventiethday she was feverish, but very cold outwardly, without any beatingin her temples; and her breathing was quicker. After the beatingceased, her breath was so quick that she was forced to keep sittingtill she died.In the windpipe there was a great noise; her sweats were bad;but she was very composed to the last. The coldness continuedabove five days; and after the first she continually hawked uppurulent matter.The woman, that lived above the gates, had a little fever in herold age, which, upon ceasing, was followed with a pain of her neckdown to her back-bone and loins; parts that she was not verystrong in. Her jaws and teeth were so set, that a probe could notbe introduced; her speech faltered, from the body's being paralytic,immovable, and weak; but still she kept in her senses. By warmapplications and warm mead there was something of a relaxationthe third day; and after this, by the help of soups and broths, sherecovered perfectly. This happened about the end of autumn.The anointer by Harpalis, growing impotent in his hands andlegs about autumn, drank a medicine rashly that purged him upwards and downwards, after which he grew feverish. Something420 THE WORKS OF HIPPOCRATES.fell upon his windpipe that hindered his speaking; and wheneverhe spoke he was asthmatic, as one in a quinsy with a hoarseness.He had also the suffocation and other symptoms that attend aquinsy, but no swelling. The fever and the cough increased, anda great deal of moist phlegm was hawked up. In the course of hisillness a pain seized him in his chest and left breast; and, when hewould rise or be moved, he was very asthmatical, and sweatedupon his forehead and head. The complaints about his throat continued, but in a less degree, the pain removing to the chest. Uponthese considerations he used beans with honey from the beginning;but, when the fever was upon him, rather warm oxymel, and alambative of honey plentifully. After fourteen days all his complaints ceased; and, before it was long, he had very good commandof his hands and legs.Chartades had a burning fever, discharged much bile upwards.and downwards, could get no sleep, and had a round swelling uponhis spleen. The third day he rose early, upon a rumbling in hisbelly without pain; and, as he was discharging, above a gallon offresh blood came away. After stopping a little, concreted lumpsof blood came away the third time. His heart was sick, andgreatly disordered; and a little sweat broke out almost all over,with a gentle fever. At first he seemed to be perfectly in his senses;but, as the day advanced, his sickness and restlessness increased;his breathing was a little quicker; his speech and reception bolder,and again more humane, than occasion required; and he seemedinclinable to faintings. Nor did the soups or the barley- water thatwere offered him take them off; but his breathing towards eveningwas exceedingly difficult; his tossing, first on one side, then on theother, very great, without being able to rest one moment. His feetwere cold, his temples and head rather hot, with many little sweatsabout them, as death approached. His drink occasioned, as itpassed, a sound about the breast and stomach; which was as bada sign as could be: and, while he was saying that somethingwanted to pass downwards, he fixed his eyes, and in a short timeexpired.Hermoptolemus's wife was taken in the winter time with a feverand pains in her head. Whenever she drank, it was with so muchdifficulty that she got up and said she had a great uneasiness at herheart, or at least the mouth of her stomach. Her tongue was lividfrom the beginning; and the occasion of all seemed to be a chilli-THE SEVENTH BOOK OF EPIDEMICS. 421ness after bathing. She got no sleep night nor day. After the firstdays she complained no more (upon our asking) of the pain of herhead, but of pain all over her body. Her thirst was sometimesvehement, at other times moderate. The fifth and sixth, and almostto the ninth, she was delirious, but came in some measure to herself again, and spoke her words by halves, being comatose. Sometimes she reached out her hand to the wall, and clapped a littlecold pillow that was under her head to her breast. At other timesshe threw off the clothes. Her right eye was a little bloody, andwept. Her urine such as we always count bad in children. Herstools from the first yellowish, and afterwards very watery, but ofthe same colour. The eleventh day the heat seemed to be moremoderate. The thirst left her sometimes so far, that, if they didnot give her any thing, she never asked. After the first time shecommonly slept in the day, and kept awake in the night, complaining of more pain at that time. The ninth, her stools were watery,and so they were the eleventh. The following days she commonlygot up often, and had the same sort of stools. The first days ofher illness she was violently passionate, grieved like a child, criedout aloud, was frightened, and looked about her, when she cameout of her coma. The fourteenth, it was a hard matter to hold her,she jumped and bawled so, on a sudden, and with as much vehemence, as if she had been struck, or was in great pain, or in a greatsurprise from somebody's seizing and detaining her a little. Afterthis she was quiet again, comatose, and slept perpetually, withoutseeing at all, and sometimes without hearing, but not without frequent changes (almost the whole day) from one to another, first ofruffle, then of quiet. The next night she voided something a littlebloody like slime, and again like muddy slimy stuff, and after thisvery leeky and black. The fifteenth , violent agitations of the bodywith frights, but the bawling moderate. Upon this followed fierceness, rage, and crying, if what she had a mind to was not reachedher presently. She knew every body and every thing immediatelyfrom the first days. That about her eye went no further; but herunreasonable madness, and bawling, together with the change before-mentioned, followed to the coma. She heard unequally; sometimes very well, even though one spoke but low; at other times alouder voice was necessary. Her feet were always of an equalwarmth to the last with the rest of her body, but the sixteenth less.The seventeenth, greater moderation than the other days; but at1422 THE WORKS OF HIPPOCRATES.night, contracting herself as if a chilliness had come upon her, shegrew more feverish and very dry, other complaints of the like kindfollowing. Her hands trembled; her head shook; her eyes lookedbad; her thirst so vehement, that, after she had drank, she askedagain, snatched the mug, and drank plentifully; nor could they pullit away from her. Her tongue was dry and very red; her wholemouth and lips ulcerated and dry. She carried both her hands toher mouth trembling, and fell a chewing; and, if any one offeredher something to chew or sup, she drank and supped plentifullyand like a mad woman, looking all the time badly. Three or fourdays before she died, such a chilliness came upon her that her bodywas contracted and covered up, and her breathing rendered verydifficult. Her legs were stiff, her feet cold, her thirst and understanding, as before. Her gettings up to stool were either to nopurpose, or what came away was little and thin, with some smalltension. The last day of all, viz. , the twenty-third, the eye waslarge in the morning, and she looked about but little, and was easy,sometimes without being covered, or without being comatose; butin the evening the right eye moved about, from the external angleto the nose, as if she was looking at, or wanted, something. Sheknew every body, and answered to what was asked her. A littleafter this, her speech, broke with bawling and hoarse withal, faltered.Amphiphrades's son was taken in the summer with a pain of hisleft side, a cough, and many watery bilious stools. The fever seemed to go off about the seventh, but the cough continued. His spitting was whitish and palish; but about the fourteenth, of a paleyellow colour. As the disease advanced, his breathing was alwaysthicker and asthmatical, attended with a kind of wheezing abouthis breast and windpipe. He made use of soups, and kept his sensesall along. About the twenty-eighth he died. Sweats sometimes broke out.The cook, that had an inflammation of his lungs, had also a discharge downwards immediately. About the fourth he sweatedmuch; the fever seemed to go off; and his cough was nothing tospeak of. The fifth, sixth, and seventh, was feverish again, andsweated again the eighth. The ninth, hawked up pale yellow matter. The tenth, purged very much, but not often. The eleventh,was easier; and the fourteenth, quite well.Hermoptolemus, after the setting of the Pleiades, grew feverish,THE SEVENTH BOOK OF EPIDEMICS. 423coughed a little, and his tongue was as in an inflammation of thelungs. The ninth, he sweated, and was cold all over, to appearance. About noon they gave him the cream of barley, and he grewhot. The eleventh, he sweated again; and, upon his belly's beingdisturbed, had bilious stools that were followed by a small cough.The fourteenth, what he hawked up was pale, and he rattled in histhroat. The fifteenth, after having been sensible all the time, hedied.Another person had the like noise upon the roof of his mouth;his tongue was dry, as in an inflammation of the lungs; his sensesremained, and he died.Posidonius was also taken, in the summer, with a pain in hisbreast, hypochondres, and side, that lasted a long time, but withouta fever. Many years before he had had a collection of matter inhis breast; and, being chilly in the winter, the pain increased , anda little fever came on. What he hawked up was purulent. Hiscough was attended with a wheezing in his throat and a rattling.He also kept his senses to the last moment.Bales's son, having been guilty of all kind of irregularities in thesummer, had upon the sixth day a very red bad tongue; a faltering voice; discoloured eyes, that moved up and down as in winking, for want of sleep; and the colour of the rest of his body notvery much upon the jaundice, but palish and livid. His voice wasbad, and not distinct; his tongue, as in an inflammation of thelungs; his senses, not perfect; his breathing, manifestly bad, andyet neither thick, nor deep; his feet, cold as stones. About theninth he died.The woman with the quinsy, who lived at or by Metron's, had apain of her right hand and leg, with a little fever, a gentle cough,and a suffocation. The third day, a remission. The fourth, wasconvulsed and dumb, rattled in the throat, grated her teeth, andhad a redness in her cheeks. Not being able to hold out any longer,she died the fifth or sixth; and of this the lividness that was in herhand was a sign.Bion, after having been long ill of a dropsy, had an aversion toeating many days, and was taken with a strangury. An abscesscame upon the left knee, that suppurated; and he died.Ctesiphon fell into a dropsy after a violent burning fever; and,being dropsical and splenetic before, the scrotum, legs, and bellywere filled prodigiously. Towards the conclusion a cough came424 THE WORKS OF HIPPOCRATES. *on, with stranglings in the night, more from the lungs (as thosehave whose lungs are vitiated) than elsewhere. Three or four daysbefore he died, he shivered, was feverish, and, in the inner part ofthe right thigh by the middle vein that comes from the groin, a sortof lividish erysipelas gathered, that had withal a redness. At nighta pain seized him about the heart, which was soon followed by lossof speech, strangling, rattling, and death.One in Olynthus, who had also the dropsy, presently lost hisspeech, was lightheaded day and night, and died.Prodromus's son could not speak plain in the summer; had aburning fever; a tongue so dry that his words could hardly beheard; a violent purging; and recovered.Leophorbidas had an acute fever, after the winter solstice, attended with a pain of the flanks and belly; many liquid , biliousstools; a stupid heaviness in the daytime; a peripneumonic tongue,and no cough. The twelfth, his stools were black, little, and leeky.The fourteenth, the fever seemed to go off; after which he madeuse of soups. The sixteenth, the mouth was very salt and dry. Thebeginning of the evening a shivering came on, and a fever. Thetwenty-first, about the middle of the day, he shivered and sweated.The fever went off, but yet a little heat remained. At night hesweated again. The twenty-second at night another sweat, andthe heat abated. All the former days he was without a sweat, butthe belly was humid, even in the relapse that afterwards seemed tohappen. JTheocles's relation, who lived above, was taken with an acutefever, during the Pleiades. The sixth day it seemed to go off, andshe bathed herself as if it was gone. The seventh, in the morningher cheek was very red, but which I don't remember. In the evening she was very feverish again, fainted , and lost her speech. Soonafter this she sweated, and recovered perfectly the seventh.Theodorus's wife lost a great deal of blood in a fever in thewinter time; and, upon the fever's going off the second day, aweight first attacked her in her right side as if from the womb, andafterwards an acute pain of the breast. The pain in the side, uponfomenting the part, abated. The fourth, her pains returned. Herbreathing was quicker; the windpipe wheezed a little, as she wasscarce able to fetch her breath; and, lying with her face upwards,she could not easily be turned. At night the fever was more acute,attended with a short delirium. The fifth in the morning she seemedTHE SEVENTH BOOK OF EPIDEMICS. 425to be easier. A little sweat broke out first upon the forehead fora short time, and then was diffused for a long time over all thebody down to the feet. After this the violence of the heat abated,and the body was colder to the touch than it seemed to be bythearteries, the beating of which was greater in the temples than anywhere else. Her breathing was quicker; now and then she wasdelirious; and worse in all respects. Her tongue was all alongvery white; and she had no cough, except a little while the thirdand the fifth day. She had no thirst, but spit . Her right hypochondre was very much tumefied about the fifth, but after thatsofter. The third, she had a little stool from a suppository. Thefifth, another that was liquid. The belly was soft. The urine viscidand like seed. The eyes like one fatigued, looking up and movingabout with difficulty. The fifth, at night, she was very much outof order, and after that delirious. The sixth, she sweated much,about the same hour that the forum used to be full, first in the forehead, and afterwards all over a long time. She came to herself,and put her affairs in order; but about the middle of the day wasvery delirious. As to the cold, that was as before; but every thingabout the body was heavier. In the evening her leg fell out of bed;she threatened her little boy unreasonably; then held her tongue,and was quiet again. About the first sleep she was very thirstyand mad; sat down and abused the company; then held hertongue, and was quiet again, and seemed to doze away the rest ofthe night, but her eyes were not closed. The next day she answered for the most part with nods; was quiet in her body, and tolerably sensible in her mind; and sweated again the same day.Her eyes were dejected as before, rather lying upon the lower eyelid, and looking fixed and stupidly. The whites were pale anddeadish, and the whole colour pale and black. Her hands weregenerally employed about the wall, or the clothes. A great noiseattended drinking, and it was returned upwards by the nose. Shespread out her hands, picked up the nap of the bedclothes, and hidher face. After sweating, her hands were like crystals; a coldsweat followed, and the body was cold to the touch. She jumpedup, bawled out, grew mad, breathed hard, trembled in her hands,and, as she drew near her end, was convulsed. The seventh dayshe died. The sixth, made but little water in the night, and that,upon drawing it out with a twig, appeared viscid and seedy; got426 THE WORKS OF HIPPOCRATES.no sleep all the time; and after the sixth day made water a littlebloody.Antiphanes's son had a pain of his right side in the winter, witha cough and fever; but yet he eat, went about, was a little feverish,and seemed to have something broke within him. The ninth, thefever remitted, but did not leave him; his cough was much, thick,and frothy; his side was painful. About the fourteenth, and againabout the twentieth, his fever seemed to leave him, but returnedagain. The heat indeed was but small, and in a little time left him.The cough was sometimes gone, sometimes vehement, with muchstrangling; then it abated, and he hawked up afterwards a greatdeal, coughing as if he should be choked. The purulent matter,that fell upon the vessel, boiled and frothed; and in the throat wasgenerally a hoarse roughness and a kind of wheezing. He wasalways asthmatical , and breathed quick; seldom well. After fortydays, and near sixty (as I remember) , the left eye was blinded by atumour without pain; and, not long after, the right. The pupilswere very white and dry; and in a short time after this blindness(not above seven days) he died, rattling in the throat, and talkedmuch out ofthe way.The like symptoms happened from the like causes about the sametime to Thessalion , as to the boiling, the frothing, the pus, the cough,and the hoarse roughness in the throat.Polemarchus's wife had a swelling about the windpipe in a quinsyin the winter, and was very feverish. Upon being let blood thestrangling in the throat went off, but the fever continued. Aboutthe fifth her left knee was painful and swelled; something seemedto be gathered about her heart; and she breathed as a man doesafter being dipped over head and ears. Such a sound came from thebreast, as those impostors make, who, in prophesying events, speakfrom their belly, and are therefore called sfyaspivo . About theeighth or ninth at night a purging came on, and her stools weremany, liquid, tumultuous, bad, and fetid. Her speech failed her,and she died.Aristippus, after receiving a wound in his belly from a javelin,had a great deal of difficulty to survive it. A violent pain of thebelly came on, which heated it presently to such a degree that nothing passed downwards. He was sick at his stomach, and vomited bile of a very deep colour, after which he seemed to be easier,but in a little while his pains returned again with vehemence; theTHE SEVENTH BOOK OF EPIDEMICS. 427belly was burnt up as in ' an ileus; he grew hot and dry, and inseven days expired.Neopolis, from the like wound had the same complaints; but bythe use of a sharp glyster had a great discharge downwards. Thecolour diffused over him was thin, pale, black. His eyes weresqualid, heavy, turned inwards, and fixed.He, who was wounded upon the liver by a dart near hand, hadhis colour changed presently to deadish. His eyes were hollow;and, after tumbling and tossing about with great anxiety, he diedbefore the assembly was dismissed, the very day that he waswounded.He who was wounded upon the head with a stone by the Macedonian, though the wound was little more than skin deep upon theleft temple, was seized with a dizziness, and fell down. The thirdday he lost his speech, was exceedingly restless, feverish but notmuch, and had a small beating in his temples, as when the heat ismild. Add to this, that he lost his hearing and his senses, andcould take no rest. The fourth day a dew broke out about hisforehead, and under the nose down to the chin. The fifth , he died.Eniates was wounded in Delus with a javelin upon the backpart of his left side, but the wound was not painful. The third dayhis belly was in a little pain, and voided nothing; but, upon havinga glyster at night, a stool followed, and the pain went off. Theanus came out to the scrotum . The fourth, such a violent painseized the pubes and the whole belly, that he could not rest. Biliousvomitings of a deep colour came on; his eyes were pale with agreenish cast, and like the appearance they make in a swoon.After five days he died. Add to this, he was a little hot.Audellus being wounded in the back, a great deal of wind camethrough the wound with a noise, and blood followed it; but, uponapplying, with a bandage, the medicine for green wounds, he recovered.Philias's most unfortunate boy, upon thebare, was taken with a fever the ninth day.and he died.forehead's being laidThe bone turned livid,Phanius's son, and Euergus's, upon the bone's being livid, attended with a fever, had a separation of the skin from the bone,but the pus made its way inwards. Upon applying the trepan, athin, serous, palish, fetid, deadly sanies came up from the verybone.428 THE WORKS OF HIPPOCRATES.Vomitings came on in these patients, and towards the conclusionconvulsions. Some in this case make a shrill noise, and others arequite impotent. Again, if the wound happens on the right side, theleft is affected; if on the left, the right.Theodorus's son, basking himself in the sun, the ninth day, wastaken with a fever the tenth from the bone's being bare, though nothing at all to speak of. A lividness came on with the fever; theskin separated; and his voice was very shrill. The twenty- secondhis belly swelled , especially about the flanks. The twenty-third hedied.Those, whose bones are broke, are feverish upon the seventhday; sooner, if the weather be hot; and immediately, if they arevery much broke.Exarmodus's little boy was affected pretty much in this manner,and had a pain of his thigh, but not opposite to the wound. Hisvoice was also shrill, and his neck painful.Posidocreon was convulsed the third day, continually hot, anddied the eighteenth.Isagoras's son, who was wounded in the back part of his head,recovered the fifth, though the bone was shivered and turned black,but did not separate.The master of a great ship had the forefinger and the lower boneof his right hand broke to pieces. An inflammation came on, amortification, and a fever. The fifth day he was purged moderately; the heat and pain abated; and part of the finger fell off. Afterthe seventh, a little gleet came away; and after this he said hecould not pronounce his words plain. A prediction was made, thatthat kind of convulsion which draws one backward would happen;to which contributed the jaws being set, and drawn down to theneck. The third day the above- mentioned convulsion seized himall over, and he sweated. The sixth day after the prediction hedied.Telephanes's son, by Harpalus' freed woman, received a woundor bruise of his great toe. An inflammation came on, with a vastdeal of pain. Upon its abating he went into the field, and, as hewas going, a pain took him in his loins, for which he used bathing.At night his jaws were set, and the convulsion that draws onebackward seized him. What he spit was frothy, and came fromhim through his teeth with difficulty. The third day he died.Zeno, the son of Damon, had an ulcer about the bone of the leg1THE SEVENTH BOOK OF EPIDEMICS. 429or the ankle by the tendon, that was now grown clean. Upon theapplication of a corroding medicine he fell into convulsions of theopisthotonic kind, and died.Menon, who was but in a weak condition (about the rising ofArcturus and before) from a fever in the summer and a looseness,upon being fatigued with a journey was taken with a pain of hisleft side; and the cough, that he had had before from a catarrh,was now become vehement. He could get no sleep, and bore hisfever from the very first with great uneasiness. The third day hesat down, and spit pale matter with a gentle wheezing and rattlingin his windpipe. About the fifth day his breathing was commonlythick; his feet, shins, and extremities for the most part cold anduncovered. A bilious looseness came on from the first, and wasmoderate enough. The seventh, eighth, and ninth he seemed tobear his illness easier, got some sleep, and what he hawked up wasmore digested. The tenth, and even to the fourteenth, it was verywhite and clear. The right hypochondre was softer, and made thebreathing easier; but the left was distended . However, upon usinga suppository, a moderate discharge followed. The thirteenth, thespitting was pale again, and more so the fourteenth. The fifteenth ,it was of a leek- colour; and a fetid , bilious, liquid stool followedfrequently. The left hypochondre was swelled. The sixteenth, theswelling was very great; he rattled in his breathing; sweated aboutthe forehead and neck, seldom about the breast. The extremities,and the forehead, were generally cold; the vessels in the templeskept beating; his sleeps were comatose day and night towards theconclusion; and his urine crude from the first, and of the colour ofashes. About the tenth, and to the thirteenth, it was thin, and notcoloured at all; but from the thirteenth, just as at the beginning.Cleochus had a pain of his side and a fever. The fever afterwards remitted, a sweat came on all over, a great deal went off byurine; after which it grew very turbid.About the setting of the Pleiades, Olympiades's wife, who waseight months gone with child, was taken with an acute fever upona fall. Her tongue was dry, reddish, and of a pale yellow, as in aburning fever. Her eyes were of a pale yellow, and the colourdeadish. The fifth day she miscarried without any difficulty, andher sleep seemed to be of the comatose kind. In the evening, whenthey took her up, she was not sensible, but recovered her hearing430 THE WORKS OF HIPPOCRATES.a little by the help of a sternutatory. She also drank some ptisan,and coughed a little in the drinking, but did not recover her voiceby it, or bring any thing up. Her eyes looked dejected; her breathwas fetched with much heaving, and drawn through her nose; hercolour was bad; and a little before she died, a sweat appeared uponher feet and legs.Nicolaus's wife had large swellings behind both her ears from aburning fever; one of which a short time after (the fever nowseeming to abate upon the swelling's appearing) subsided about thefourteenth day, without any signs of solution; and so the fever returned again. The colour was deadish; the tongue rough, verythick, whitish, and dry; the discharge downwards much, liquid ,and fetid all the time; and, before she died , (which happened aboutthe twentieth) her body was consumed by the quantity.Before the setting of the Pleiades, Andreas was taken with achilliness, a fever, and vomiting. It appeared to be a semitertianfrom the first. The third day, while he was attending the forumagain, he grew chilly and feverish; vomited pure bile; was lightheaded, and at night easier again. The fifth, was very much outof order. The sixth, had some good stools from an infusion of mercury. The seventh was worse, and after this the fever was morecontinual. He had no sweats from the beginning, and was thirsty.His mouth in particular was dried up a little, and he could drinknothing with pleasure, there was so much disagreeableness abouthis mouth. His tongue was dry, inarticulate, rough, and of a palewhite colour. He was also watchful, sick at his stomach, relaxedall over, and as it were broke to pieces. His tongue was sometimes so dry that he could not speak, without stammering, till hehad washed his mouth. What he lived most upon was ptisan.The ninth or tenth day, the little swellings that were behind hisears disappeared without any sign. The urine all along had acolour, but no sediment. The fourteenth, he sweated upwards, notmuch indeed, but moderately. The seventeenth, the heat went off.After the tenth, his body was so bound as to discharge nothingwithout suppositories. About the twenty-fifth, small pustules thatitched a little, and were hot, as if burnt with fire, broke out. A painwas also felt about the armpits and the sides, which afterwardsremoved to the legs, without any signs that were critical, and thereceased. Bathing was of service, and anointing with the ointmentTHE SEVENTH BOOK OF EPIDEMICS. 431made with vinegar. Two, or perhaps three, months after, the painthat he had complained of at times fixed upon his kidneys.Aristocrates was taken, about the winter solstice, with a lassitude, a chilliness, and heat. The third day a pain of his side andloins came on, together with a hard swelling, that, arising from thearmpit, reached all over the right side, and was red the whole wayat first, but afterwards livid , as if heated and burnt with fire. Hewas also sick at his stomach; bore his illness badly; was verythirsty; had a whitish tongue; made no water; and was coldishin his feet. After an infusion of mercury he had a small, liquid,whitish, frothy discharge downwards. At night he heaved verymuch in his breathing; sweated a little about the forehead, wascold in his extreme parts; sick at his stomach and restless; bloatedin his neck, but without a cough; and died very sensible.Onesianax had an inflammation of his eyes about the autumn,and afterwards a quartan; in the beginning of which he was veryaverse to food, but in the progress of it very well pleased with it.Polychares was also affected in a quartan after the same manneras to eating; but Onesianax had a looseness before and for a longtime after his fever, attended with a discharge of much white mucous matter; sometimes a little blood came away, without eithertrouble or pain; and, besides these, he had a rumbling noise in hisbelly. After the fever a hard tumour was formed about the anus,which remained undigested a long time, but at last broke into thegut, and became fistulous outwardly. As he was walking in theforum, flashes appeared before his eyes, that hindered him fromseeing the sun very well. Upon quitting his place he was a littlelightheaded and convulsed in his neck; and, when he was broughthome, he scarce saw any thing, and was hardly himself. First ofall he looked about upon those that stood around him; and his bodywas so cold that it could scarce be warmed by the application ofwarm things, and fomentations applied under him. Whenhe cameto himself, and got up, he was not for going out, but said he wasafraid; and, if any body spoke of dangerous diseases, he withdrewhimself for fear. Sometimes he said he was hot in his hypochondres, and the flashing of his eyes followed upon it . His evacuations downwards were copious, frequent, and like what he had hadin the winter. He was blooded , took hellebore, drank cow's milk,and before that, ass's, which agreed well with him, and stopped his432 THE WORKS OF HIPPOCRATES.looseness. He likewise drank water from the beginning, walkedabout, and was purged in his head.Anechetus's son was thus affected in the winter. Upon beinganointed by the fire after bathing he grew hot, and immediatelyfell into convulsions like epileptic fits; and, when many of thesehad attacked him, he looked about, and was not quite in his senses.After coming to himself he was convulsed again the next morning,but did not foam much. The third day he could not speak distinctly. The fourth, made signs with his tongue. The fifth, couldnot speak at all, but was stopped at the beginning of the words;and the very same day his tongue was very much affected; a convulsion came on, and he grew lightheaded again. Upon a remission of these, his tongue recovered, with difficulty, its former state.The sixth, he abstained from every thing, not excepting his soupsand drink, and took nothing more.Cleochus, after weariness and exercise, was seized with a swelling in his right knee upon the use of honey for some days, especially towards the lower part about the tendons that are under theknee. He went about, however, though a little lame. The calf ofthe leg swelled, and was hard even to the foot and the right ankle.His gums about his teeth were large, like grape- stones, livid, black,and without pain, when he did not eat. His legs were free frompain too, but when he got up: for the swelling came upon the leftside, and was not so livid . In the swellings that were about theknees and feet, something like pus seemed to be contained; and atlast he could neither stand nor go upon his heels, but was forced tokeep his bed. Sometimes he was manifestly hot; loathed hisvictuals; and yet was not very thirsty, nor got up to his seat. Asickness and uneasiness attended him, and sometimes he was pusillanimous. Hellebore was prescribed him, and his head was purged.His mouth was also relieved with the medicine made of the chipsof frankincense, mixed with other things. Lentil broth was also ofservice to the ulcers in his mouth. The sixtieth, the swellings subsided upon the second dose of hellebore, and only a pain affectedthe knees as he was laid. A humour mixed with bile fell upon hisknees, and that many days before he took the hellebore.Pisistratus had a pain and weight in his shoulder a long time,while he was walking about, and in other respects well. But inthe winter a great pain of the side attacked him with heat, a cough,and a hawking up of frothy blood, which brought on a rattling inTHE SEVENTH BOOK OF EPIDEMICS. 433the throat. He bore all this well, and was perfectly in his senses.The heat, the hawking, and the rattling abated; and about thefourth or fifth day he got well.Simus's wife, who was shook in her delivery, had a pain abouther breast and side, accompanied with a cough, a fever, purulenthawkings, and a consumption. The fever lasted six months, witha continual looseness. At last the fever stopped , and after that thelooseness; but in seven days' time she died.Euxenus's wife, too, seemed to derive her illness from fomenting.The heat never left her, but was rather greater towards the evening, and she sweated all over. When the fever was about to increase, her feet, and sometimes her legs and knees, were cold; alittle dry cough came on, when the fever began to grow worse,and then ceased; but a rigor all over continued a long time; andshe was all along free from thirst. Upon taking a purge, and wheyafterwards, she grew rather worse. From the beginning she wasentirely free from pain, and breathed well; but about the middle ofthe time a pain took her in her right side, attended with a cough,an asthma, and a hawking up of little, white, thinnish matter. Thechilliness was no longer from the feet, but from the neck and back;the belly was more liquid; the fever abated with a great sweat;and the coldness returned again. Her asthma had great variety,and she died in her senses the seventh day after the remission.Polemarchus's wife began to be feverish in the summer, but itleft her the sixth day. After this she crept about, was hot at night,and, after another intermission, the fever seized her again, and heldher near three months, with a violent cough, and a hawking ofphlegm. From the twentieth day her breathing was always quick;noises were heard in the breast; and a sweat was commonly uponher. In a morning the fever was milder; a chilliness sometimescame on; and sleep ensued. She was also sometimes loose in herbody, sometimes bound; and tasted her victuals tolerably. Aboutthe middle of the time a pain took her in her knees and legs, so thatshe could neither bend nor stretch them out without assistance;and this complaint of the legs continued to the last. As she drewnear her end, her feet swelled up to the legs, and upon beingtouched were painful. The sweats and the shivering went off,and the fever was always increasing. Before she died, a loosenesscame on, but her senses still continued. Three days before she28434 THE WORKS OF HIPPOCRATES.went off, a rattling in the throat came on, and upon the return of itshe expired.Hegesipolis's little boy had a gnawing pain about his navel nearfour months, which in time increased. He beat and twitched hisbelly; was troubled with heats; and wasted away, except in hisbones. His feet and testicles swelled. That part of his belly waspuffed up, as when a disturbance or looseness of the belly is comingon. He was also averse to food, and lived upon nothing but milk.As he drew near his end a looseness came on, with a discharge ofbloody, fetid sanies; the belly was exceeding hot with it, and hedied vomiting a little phlegmy substance, that one would havealmost taken for seed.Plateas's boy had the suture of his head very much hollowed inhis last moments, and in time of health was always beating theforepart of his head with his hand, but especially as he drew nearhis end, and yet the head was not in pain. In the left thigh theparts below the groin were livid (perhaps the day before) , and histesticles were grown slender.Hegetoridas's son was affected in the same manner, and died;but with this difference, that he had more vomitings towards theconclusion.Hippias's sister, who was ill of a phrensy in the winter, tore herself the fifth day (not knowing what she did) , as she was doingsomething with her hands. The sixth, at night she lost her speech,was comatose, bloated in her cheeks and lips as a person in hissleep, and died the seventh.Asandrus was chilly, had a pain of his side, and in his knees andthigh; after eating grew delirious, and in a short time died.Cleotimus, the cobbler, after a long illness, and a feverish disorder, had a rising like a tubercle about the liver, which fell uponthe intestines, and occasioned a looseness. Another such tuberclecame about the liver above, near the hypochondre, and he died.Some were troubled with a violent pain of their head, and heatat the same time. Now where it affects half the head, and something of a thin or digested humour discharges itself downwards bythe nose, or ears, or throat, there is the greatest security; butwhere these parts are dry, and the corruption of the brain verygreat, there danger is to be feared. If, besides all this, there is aruffling, or bilious vomiting, a stupidness of the eyes, a loss ofspeech, or but a word now and then, or any delirium, death andTHE SEVENTH BOOK OF EPIDEMICS. 435convulsions are then to be feared. Again, where a pain seizes halfthe head from a catarrh, and, the humour discharging itself by thenose, a gentle fever succeeds, in five or six days they grow coldagain.Echecrates, the blind man, had a violent pain of his head (ratherbehind, where the neck and head join), which proceeded to thecrown, and in time to the left ear, affecting half his head verymuch. A mucous matter came away constantly, but commonlyburnt a little; a little heat followed it, with a loathing of his food.In the day he was easy, but in the night in pain; and, when thepus made its way out at the ear, every thing ceased. This eruption happened about winter.Query, Whether, in all collections of matter, and in disordersof the eyes, the pains are at night?Those who have coughs in the winter, and especially with thesoutherly winds, are subject to fevers during their hawking up muchthick matter; but then they commonly cease in five days. Butcoughs will extend to forty, as in the case of Hegesipolis.Those who have sometimes a cessation of great heats, are curedof them by sweating , not indeed all over the body, but either aboutthe neck, the armpits, or the head.Charites was taken in the winter with an acute fever upon acough that was epidemical. He threw off the bed- clothes; wascomatose, and uneasy; his urine was red, like the washing ofvetches, with a large white sediment immediately from the first,and afterwards a reddish. The seventh, he had a little stool from asuppository. The coma continued, but without uneasiness. A dewappeared upon his forehead. He slept at night, and the heat wasmilder. The eighth , supped some ptisan, and remained comatosetill the eleventh, the heat in a great measure then ceasing. Uponcoughing he always hawked up a great deal with ease, first viscid,white, thick, and after that digested like pus. The urine after theeleventh was clearer, the sediment rough. The thirteenth, a painon the right side to the flank and lower part of the belly. Theurine stopped, but was relieved by an infusion or decoction of theCalliphyllum. The fifteenth, the pain returned again. The sixteenth, at night, the pain of the flank came more upon the belly, butwas carried down by an infusion or decoction of mercury. Theheat was spent within twenty days; but the hawking up of thickmatter with ease continued forty.436 THE WORKS OF HIPPOCRATES.The bellies of people should be gently purged in diseases, whenthe humours are digested; the lower, when you are satisfied thatthey are settled downwards: (this may be known by the patient'snot being sick at his stomach or uneasy, or heavy in his head) andwhen the heat is mildest, or when it ceases after the fits; theupper (or the stomach) in the fits themselves; for, when the upperparts are sick, or uneasy and heavy, the humours are then raisedupwards spontaneously. For this reason no purge should be givenat the beginning, because at such a time they are purged spontaneously, or delays are dangerous.The great process of the elbow being wounded by a fall, a mortification came on, and upon that a suppuration. When the matterwas digested, a thick glutinous sanies was pressed out, and soonstopped, as in the cases of Cleogeniscus and Demarchus, the son ofAglaoteles. So again from the very same causes no pus cameout, as in the case of Eschylus's son; but in most cases, wherepus is gathering, a chilliness and fever attend.Alcmanes, recovering from nephritic complaints, and beingblooded downwards, the disease was translated to the liver. Theheart was in such violent pain that the breath was suspended by it;the belly discharged with difficulty little pellets like goats' dụng;there was no sickness or anxiety at the stomach, but sometimes heshivered, and was a little feverish. He sweated, too, and vomited.While the pain was upon him, he received no benefit from a glysterof sea-water, but from a decoction of brans he did. He had anaversion to food seven days; drank a simple kind of mead, lentilbroth, and thin panada, with water after it. He then drank water,and eat a little of a boiled puppy, with a small quantity of maizeas old as possible. As the time advanced, his diet was neat's feet,or pigs' petty-toes boiled. The next day he drank water again,rested, and covered himself up. For the nephritic complaint aglyster of wild cucumber was given.Parmeniscus's boy was deaf, and received benefit from his earsbeing cleansed with wool, and then oil or netopum poured in, without any syringing. He was also ordered (and to advantage too)to walk, rise early, and drink white wine; to abstain from herbs,and to live upon bread and rock- fish.Aspasius's wife had a violent pain of the tooth, with a swellingof her jaws. Upon washing with castor and pepper, and holdingthe same in her mouth, it abated. Her strangury complaints abatedTHE SEVENTH BOOK OF EPIDEMICS. 437too. The flour or meal that is mixed with ointment of roses is alsohealing.Headaches from the womb are taken off by castor.The greatest part of hysterics are caused by winds, as is plainfrom belchings, noises about the belly, swelling of the loins, andpains about the kidneys and hips. Black wine that has been keptso long under ground as to have nothing of the must left; or onethird spices, and two of flour, boiled in sweet- scented white wine,and poured upon a cloth, apply, when it is daubed with the ointment, as a cataplasm, where the hysteric pains affect the belly.Callimedon's son, who had a hard, large, crude, painful tuberclein his neck, was relieved by bleeding in the arm, and a cataplasmoftorrefied linseed moistened with oil and white wine, not hot, normuch boiled, or else boiled in mead with the flour of fænugreek, orbarley, or wheat.Melisander was relieved by bleeding in the arm, in a great swelling of the gums, attended with much pain. Egyptian alum at thebeginning is also of service as a represser.Eutychides was seized at last with cramps in his legs, and apurging, from a cholera morbus. He vomited a great deal of bileof a deep colour, and very red, for three days and nights; dranksomething upon his vomiting; was mighty restless, and sick at hisstomach; nor could he contain any thing that he either drank oreat. His evacuations by urine and stool were much suppressed;soft fæces came up with the vomitings, and also made their waydownwards.The Cholera Morbus, " witness the case of Bias, the champion,who was naturally voracious," proceeds from eating of flesh, especially swine's, with the blood in it; vetches; drinking to excess ofold sweet- scented wine; insolation, or being exposed to the sun;from cuttle- fish , lobsters or cray- fish, and crabs; and from eatingof herbs, especially leeks and onions. It also comes from boiledlettuce, cabbage, and the cruder docks; from desserts, sweetmeats,summer fruits, as apples, and ripe cucumbers; from milk and winemixed; from tares, and new barley meal.The summer is most productive of choleras, and intermittingfevers, and such as are attended with chillinesses. These are sometimes of a bad sort, and pass into acute diseases; but care must betaken. The fifth , the seventh, and the ninth days are the principal438 THE WORKS OF HIPPOCRATES.indicants in these diseases; but it is better to be upon our guard tothe fourteenth.Calligenes, when he was about twenty- five, had a catarrh and agreat cough, attended with much difficulty in bringing the matterup, but without any discharge downwards. This continued forfour years, with gentle heats at the beginning. Hellebore was ofno service at all, but a spare diet was, in conjunction with exercisesof several kinds, eating of bread, drinking of black wine, eatingwith bread whatever he would, whether flesh or fish; and abstaining from every thing sharp, salt, or fat; the juice of silphium, andcrude herbs; and with walking much. Drinking of milk was of noservice, but drinking something more than three spoonfuls of sesamum with soft wine was.Timocharis, in the winter, had a defluxion upon his nose, thatwas stopped entirely by venereal recreations. A lassitude and heatcame on, with a heaviness in the head, and a great sweat, firstabout the head, and then all over. Sweats were familiar to him intime of health. The third day he recovered.Cleomenes's boy began, in the winter, to loathe his food; fellaway upon it, but had no fever; vomited his victuals and phlegm;and seemed thus disgusted two months.The cook, that had the bunch upon his backbone after a phrensy,received no benefit from any kind of purging potions; but blackwine, eating of bread, abstinence from bathing, anointing the part,and gentle friction after unction, with warming the part gently, andnot by much fomenting, were of service to him.Tesimus's daughter, upon drinking something for that purpose ofher own head, miscarried of a fœtus thirty days old. Pain followedupon it; and, whenever she drank, she vomited much bilious, pale,leeky, black stuff. The third day was convulsed, and bit hertongue. The fourth I came to her, and found her tongue blackand large; the whites of her eyes red. She got no sleep, and diedthe same day at night.The girl that fell from the precipice lost her speech, was exceedingly restless, vomited at night, bled a great deal from the left earthat she fell upon, drank mead with difficulty, rattled in her throatand breathed quick like a dying person. The veins about her facewere distended; her position was supine, her feet warm, her fevernot much, but yet sometimes acute, with great stupidness in herunderstanding. The seventh, she recovered her speech; the heatswere milder; and she got over it.THE SEVENTH BOOK OF EPIDEMICS. 439Onisantides was relieved, in a pain of his arm in the summertime from an abscess, by bathing or moistening his body and hisarm for a long time in the sea. For three days together he dranka white watery wine lying in the sea, and made water there beforehe came out of it. 1The fuller in Syrus, who was ill of a phrensy, and had a trembling in his legs after burning, was marked upon the skin like thebites of gnats. His eye was large, and the motion quick. Hisvoice broken or interrupted, but yet distinct or intelligible. Hisurine clear, without a sediment. Query-Whether from his purging with thapsia? The eighteenth it remitted, and went off without a sweat.Nicoxenus, in Olynthus, seemed to have the like remission theseventh day with a sweat. He afterwards took soups, wine, andgrapes dried in the sun. The seventeenth day I came to him, andfound his tongue burnt up, with a heat upon him, but not veryvehement, outwardly; his body was terribly loose and flabby; hisvoice so broke that it was a trouble to hear him, though it was atthe same time distinct; his temples fallen; his eyes hollow; hisfeet soft and warm; and a distension about his spleen. He couldnot keep the glyster, but returned it. At night a stool came awaya little solid, and a small quantity of blood; I suppose from theglyster. The urine was clear and bright; his position in bed supine; his legs parted as through excessive weariness; but he couldget no sleep all the time. The heat went off within twenty days.His drink was bran-water, with the juice of apples and pomegranates, the juice of torrefied lentils cold, and the washings of mealboiled into a thin soup. He got over it.The fullers had large and hard swellings of the glands, withoutpain, about the pubes, and the like about the neck. A fever attended at first for ten days, and a cough succeeded upon their breaking.The third or the fourth month the belly wasted; heats came on;the tongue was dry and thirsty; the evacuations downwards difficult; and death put an end to all.Pherecydas, after the winter solstice, lost a pain of his right sideat night that he had been used to before. He got his dinner, wentout, was chilly, and at night feverish, but without pain. A drycough came on. A great deal of urine, with much sediment, thatappeared from the first like shavings, smooth, and dispersed, butafter four days was turbid. The urine was not without colour,440 THE WORKS OF HIPPOCRATES.and had a sediment, but no collection appeared in the chamber- pot,when it was cold. The third day, a natural stool. The fourth, bythe help of a suppository, stercoraceous and bilious stools, with agreat flux of humours. He slept a little in the night, and a littlemore in the day; and was not very thirsty. The same day, especially at night, the skin about his forehead and other parts was continually soft. The fever seemed to the touch to be brought under,and a dewy moisture broke out. The pulsation of the vessels inthe forehead (or temples) was very obscure. Whenever he turned,or went to stool, a heaviness came upon him for a little while, buthe was free from pain all along from the first, and after being sickat his stomach a little while vomited. The seventh, by means of asuppository had three stools, bilious, stercoraceous, very liquid, andpale; rambled a little; and soon had a dew upon his foreheadagain. He covered his face with the clothes, looked about againto no purpose, as if he saw something; winked again, and threwhis clothes off. The ninth, a sweat began in the morning about hisbreast, and continued till he died. The fever raged; the deliriumcontinued; he sweated much about his forehead, but with a terribleor whitish appearance; the skin under his hair was marked; hisright hypochondre tumefied; and his discharges downwards bilious.The eighth, he was marked, as if bit by gnats. Before he died, hecoughed up things like mushrooms, made of slime and surroundedwith white phlegm; a little before which he hawked up white,milky, concretions.A certain person was taken with a chilliness in his sleep aftersupper. The next morning he got up, and complained of a heaviness in his head, was chilly, vomited, and had the same heavinessstill. At night it abated, and remained so till about the middle ofnext day. Then he grew chilly again, and passed the night butbadly. The next day he was very feverish, had a stupidness in hishead, vomited much bile, the greatest part of it porraceous; wasbetter in all respects after it; slept at night; was cold all over nextmorning; sweated a little, and had a dew upon the greatest part ofhis body. His spleen (for he pointed to the place with his hand)had a collection of something without pain, that went off again presently. At night he got no sleep. About the hour of the assembly'smeeting, the fever was exasperated; a sickness at the stomach cameon; a dizziness; a pain of the intestines and head; and a vomitingof porraceous, smooth, viscid matter like phlegm. About sunsetTHE SEVENTH BOOK OF EPIDEMICS. 441every thing ceased. He sweated about the head and neck; andafter vomiting had a stercoraceous, liquid, bilious discharge, neitherblack, nor convenient. The night and next day were tolerable.At night again he got no sleep; vomited in the morning as before,and also the next day, without any sickness. The pain of the headwent off after sweating. In the evening every thing abated. Theninth, no vomiting, but he was rather hot. In other respects heseemed to have no fever, but yet had a pulsation in the temples.No pain any where, but a continual thirst. The same day, as hegot up upon the stool, he fainted very much; by means of a suppository he voided black bilious shavings, and what dropped away wasof a stercoraceous colour. The voice was broke; a heaviness attended turning; the eyes were hollow; the skin of the foreheadstretched. As to the rest, he breathed well, and was composed;generally turned to the wall; and was moist, curved, and at restin his bed. His tongue was also smooth and white. About thetenth day and after, the urine looked red about the edges, and alittle white in the middle. The twelfth, the same bilious andabraded droppings from the suppository, and afterwards faintings.After that the mouth was dried, and always washed; and, if thewater was not very cold, like snow itself, he would say it waswarm. There was no thirst complained of. He always put theclothes off from his breast, nor would he suffer his gown to bewarmed. The fire was at a distance, and but little. Both hischeeks were red. After this his speech was inarticulate, and hegrew hot again a day or two, and then it terminated.Androthales lost his speech, was ignorant of what passed, andwithal delirious. But, these going off, he went about many years,and then relapsed. His tongue remained all the time so dry, that,unless he washed his mouth, he could not speak. There was alsoa great bitterness for the most part. The mouth of the stomachwas sometimes in pain, but this was taken off by bleeding. Drinking of water and mead was of service to him. He also drankblack hellebore, but nothing bilious passed off, or but very little. Atlast, being taken ill in the winter, a lightheadedness came on; thetongue was affected in the same manner as it had been; the heatwas small, and without pain; the colour of the tongue nothing atall; and the voice, as in a peripneumony. He threw the clothes.off of his breast, and ordered them to carry him out, as though hewanted to make water, not being able to speak any thing plain, nor442 THE WORKS OF HIPPOCRATES.to keep his senses. He was accordingly led out, and died at night,after having lain two or three days.Nicanor's disorder was of such a kind, that, when he was obligedto go to a drinking- bout, he was always afraid of a flute; and, whenthe piper began to play, the music immediately threw him into sucha great fright, that he was not able to bear the disorder of it, if itwas night; but if he heard it in the day, it gave him no uneasinessat all. This continued with him a long time.Timocles, who was with him, seemed to be dim- sighted, and of abroken texture of body; and said he could not pass by a precipice,or over a bridge, or cross a ditch, though never so shallow, and thatthrough fear of falling; but at the same time could go through thatvery ditch. This lasted some time too.Phænix's complaint was of such a nature, that flashes like lightning seemed to dart from his eye, and generally his right eye. Notlong after, a violent pain seized his right temple, and then his wholehead and neck. The back part of his head at the vertebræ swelled;and the tendons were upon the stretch and hard. Now if he attempted to move his head, or to open his teeth, a pain seized himfrom the violence of the stretch. Vomitings, whenever they happened, removed the pains now mentioned, or made them easier.Bleeding was also of service; and hellebore draughts brought awayall sorts of humours, especially porraceous.Parmeniscus, who was formerly in a despairing way, and desirous of death, would sometimes be in his right senses, and well disposed. In Olynthus, he was taken one autumn with a loss ofspeech, but lay quiet, attempting to speak as little as possible; and,when he did speak any thing, he lost his speech again. Sometimeshe slept, sometimes kept awake; tossed about without saying aword; was under great anxiety, and clapped his hand to his hypochondre, as if he was in pain there. Sometimes he turned awayhis face, and lay quiet; was feverish continually, but breathed well.At last he said he knew those that came in. Sometimes he wouldnot drink for a whole day and night, though it was offered him; atanother time he would snatch up the pitcher, and drink all theHis urine was thick like that of beasts of burden. Aboutthe fourteenth it abated.water.Conon's maid-servant, from a pain that began in her head, grewlightheaded, bawled and lamented mightily, and was seldom quiet.THE SEVENTH BOOK OF EPIDEMICS. 443About the fortieth day she died, but lost her speech, and was convulsed, ten days before she died.Timochares's servant died in the same manner, and about thesame time, affected (to appearance) with the same melancholy disorders.Nicolaus's son was taken about the winter solstice with a chilliness after a drinking-bout, and was feverish at night. The nextday he vomited a little pure bile. The third, while the assemblywas full, sweated all over; lost his fever, but soon grew hot again.About the middle of the night shivered, was very feverish, and thenext day shivered again at the same hour, but soon grew hot again,and vomited as before. The fourth, from an infusion of mercuryhad a very good stercoraceous liquid stool, but somewhat fetid.The urine was of the colour of ashes, not unlike the mercury infusion, but without any sediment; nor was there much urine, andbut little cloud. The left flank and loins were in pain. He thoughtto fetch his breath well after vomiting, but fetched it sometimesdouble. His tongue was white, and had a small concretion sprouting out like a lupine, on the right side. He was withal a littlethirsty, watchful, and lightheaded. The sixth, his right eye seemedlarger than ordinary. The seventh, he died; but before his death.his belly swelled, and his back parts were red after death.·Meton, after the setting of the Pleiades, had a fever, and a painof the left side to the collar- bone, so acute that he could not possiblyrest. The inflammation continued , and his stools were many andbilious. In about three days the pain went off, and the heat aboutthe seventh or ninth. A cough attended, but what he hawked upwas neither somewhat bilious, nor large in quantity, but a coughingup of phlegm succeeded. He tasted what he eat, and sometimeswent out as if he was well; but was sometimes taken with littleheats, that lasted not long. Gentle sweats came on at night. Hisbreath, while the heat was upon him, was thicker; his cheek red;and about his side, under his armpits, and even to his shoulder, hefelt a weight. The cough continued; and the medicine he tookbrought away bilious stuff upwards. The third day after the physic,pus broke out, forty days from the first of his illness. About fiveand-thirty days after, he was purged again, and grew well.Theotimus's wife, in a semitertian, was sick at her stomach,vomited, was chilly at the beginning, and dry. As it advanced,the heat was very great at the beginning of a fit; but upon drink-444 THE WORKS OF HIPPOCRATES.ing mead, and returning it again, the chilliness and the sicknesswent off; after which she drank the juice of quinces.Diopethes's sister, in a semitertian, had a violent pain at themouth of her stomach, when the fit came on, and it lasted the wholeday. Other women had nearly the same complaint; but, about thesetting of the Pleiades, men were more rarely affected in thismanner.Apomotus's wife, about the time of Arcturus, had a violent painat the mouth of her stomach upon a fit , in a semitertian, coming on.She vomited too, and had hysterical chokings at the same time, besides pains in the back near the spine. These, when they got there,put an end to her stomach-pains.Terpidas's mother, who came from Doriscus, after miscarryingof twins by a fall in the fifth month (one coming away immediately,enclosed in a certain membrane, and the other in about fortydays) , conceived again. But in the ninth year she complained ofviolent pains in the stomach a long time, beginning sometimes fromthe neck and spine, and ending in the lower part of the stomachand groins; at other times from the right knee, and ending in thesame place. When the pains were about the stomach, the bellywas swelled; and when it went off, the heartburn came on , withoutany stranglings indeed, but the body was as cold as if it laid inwater. At the time the pain was upon her, the other pains returned all over, but with more mildness than at first. Garlic, silphium, and all acrid things signified nothing; nor sweet, nor acidthings, nor white wines, but black wines, and bathing now and thenwere of service. Terrible vomitings came on from the beginning,and no food could be taken; nor did her menses come down withthe pains.Cleomenes's wife, about the time of the west wind's blowing,was taken, after a sickness at her stomach and a weariness, with apain of her left side, that began from the neck and shoulder. Shegrew feverish, was chilly, and sweated. After the fever began, itabated not, but increased. The pain was vehement; a cough cameon, and what she brought up was a little bloody, pale, and in greatquantity. Her tongue was white; her stools moderate and liquid;her urine bilious. The fourth at night her menses came down plentifully. The cough, and the hawking, abated. The pain abatedalso, and the heat was very moderate.Epicharmus's wife, before she was brought to bed, had a dysen-THE SEVENTH BOOK OF EPIDEMICS. 445tery with a great deal of pain, and stools that were somewhatbloody and slimy. Upon her delivery she grew well immediately.Polemarchus's wife, who had been troubled with pains in herjoints, was taken on a sudden with a violent pain in her hip fromher menses not flowing. Upon drinking an infusion of bete, shelost her voice a whole night, and to the middle of the next day.However, her hearing and her understanding were good, and shemade signs with her hand that the pain was in her hip.Licinius's sister, who was a little past her bloom, vomited whatever she took for fourteen days, without a fever; brought awayblood in her vomitings; and complained of belchings. A contraction and strangling was also about the heart. Upon taking castor,seseli , and the juice of pomegranate, all was stopped; but a moderatepain went offto the flank. The juice of a bulb, austere wine milkwarm, and loaves as small as possible dipped in oil, were madeuse of.Pausanias's daughter, upon eating a raw mushroom, was takenwith a sickness at her stomach, a strangling, and a pain of herbelly. Drinking warm mead, and vomiting, were of service to her,and so was warm bathing: for in the bath she brought up themushroom; and, when every thing was going off, she fell into asweat.Epicharmus, about the setting of the Pleiades, was taken with apain of his shoulder, and a very great weight upon the arm. Hewas also sick at his stomach, vomited frequently, and drank water.Euphranor's son had eruptions like the bites of gnats for a littlewhile, and the next day he grew feverish.After the west wind, great droughts set in to the autumnal equinox. In the dog-days were excessive heats, hot winds, sweatingfevers, that immediately grew hot again. Tubercles behind theears appeared in many; particularly in the old woman with thecough, about the ninth day; in the young man whose spleen wasout of order (the maid- servant's son) with a purging at the sametime; in Ctesiphon, about Arcturus, and pretty near the seventhday; in the boy (the only case that came to suppuration); in Eratolaus's boy, where they went off again on both sides. No sweatsfollowed; but a stuttering or lisping, from the dryness of the tongue.The Ornithiæ blew much and cold; snows fell sometimes afterclear weather; and after the equinox came southerly winds mixedwith northerly, and frequent showers. Many coughs went about446 THE WORKS OF HIPPOCRATES.epidemically, especially among children; and in many behind theears were appearances as in the satyrs. Sometimes the winter,even before this part of it, was rough and turbulent, attended withsnow and northerly showers.Timonax's little boy, about two months old, had small eruptionson his legs, hips, loins, and lower part of his belly. The swellingswere very red, and upon their subsiding, or going in again, convulsions and epileptic fits attacked him, without a fever, for many daysbefore his death.Polemarchus's son, who had been troubled with a collection ofmatter and hawking some time before, grew hot afterwards, anddropsical, attended with a swelling of the spleen, and an asthma.If he went at any time up of high ground, he grew faint and thirsty;and sometimes he had a little aversion to eating. A dry coughcontinued with him a long time. However he crept about, and, ifhe had no more than one stool a day, with ease, he seemed full,and his asthma and suffocation increased. At last a catarrh andhawking came upon him with a cough; and what he brought upwas thick and pale, but purulent. The fever was smart, but seemedto go off; the cough was milder; and what he hawked up wasclear. The fever returned again with vehemence; he breathedthick, and died, but shivered first in his feet, and afterwards grewcold. His breath was more intercepted; his urine stopped; hisextremities cold; and he died sensible, three days after the return.Thynus's son was oppressed almost to death with hunger in aburning fever; had a great many stools, with bile, faintings, andmuch sweating; grew very cold, and lost his speech a whole dayand night. The cream of barley, that was poured down, stayedwith him. His understanding was clear, and his breath good.Epicharmus's son, from walking and drinking, fell into a crudityof digestion; and the next day, upon drinking water, vinegar, andsalt, in the morning, vomited phlegm. After this he shivered,bathed with a fever upon him, and felt a pain in his breast. Thethird day, about daybreak, a coma seized him for a little while, 'and he became delirious, very feverish, and restless under his disorder. The fourth, he could get no sleep, and died.Ariston's toe was ulcerated. A fever came on, and he couldspeak distinctly. The mortification spread up to the knee, andkilled him. The ulcer was black, dryish, and fetid.He, that had the cancer in his throat burnt, was cured by us.THE SEVENTH BOOK OF EPIDEMICS. 447Polyphantus, in Abdera, had a pain of his head in a violent fever.His urine was thick and much, and the sediment thick and turbid.The pain of his head not ceasing, medicines were ordered the tenthday to sneeze with; after which a violent pain of his neck attackedhim. The urine was red and turbid , like that of a beast of burden.He rambled like a man in a phrensy, and died in strong convulsions.The domestic of Eualcides was affected in much the same manner. After the urine had come away thick a long time, and thehead had been in pain, she became phrenitic, and died in strongconvulsions as the former. For urine, that is very thick and turbid,is a certain sign of pain of the head, convulsions, and death.The Halicarnassean, who lodged in Xantippus's house, wastroubled in the winter with a pain in his ear, and a violent one inhis head. He was then about fifty. A vein was opened by Mnesimarchus, from which the head, being emptied and cooled, was injured; for no suppuration followed. A phrensy took him, and hedied . His urine was also thick.Metrodorus's son, in Cardia, had a mortification of the jaw froma pain of the teeth, and a terrible excrescence of the gums. Amoderate suppuration came on, and both the grinders and the jawfell out.Anaxenor, in Abdera, who was splenetic and ill - coloured, happened to have a swelling about the left thigh that disappeared on asudden. Not many days after, that which they call epinyctis (fromits beginning in the night) appeared upon the spleen, attended witha hard, red swelling. Four days after this a burning fever cameon, and the parts all round looked livid and putrefied. Death ensued, but he was purged a little before that, and came to himself.Clonigus, in Abdera, who had nephritic complaints about him,pissed blood by little and little, and generally with difficulty. Adysentery was added to his other misfortune. He was ordered todrink goat's milk in a morning, with a fifth part water, so that thewhole quantity should amount to a pint and half; to eat in an evening bread thoroughly baked, and with his bread beet or cucumber.His urine was black and thin. He also eat ripe cucumbers. Bythis diet his dysentery stopped, his urine came away clear, and hecontinued the milk till the urine was come to its proper state.A woman, in Abdera, had a cancer upon her breast of such a448 THE WORKS OF HIPPOCRATES.nature, that a sanies somewhat bloody discharged itself through thenipple, which discharge, being stopped, killed her.Dinius's little boy, in Abdera, had a slight wound upon the navel,that ended in a fistula; through which a thick worm sometimespassed, and sometimes bilious matter, (as he himself said , ) when hewas feverish. The gut being near, fell upon the fistula, and wascorroded as that was. Another rupture succeeded, and would letnothing stay.Python's son, in Pela, began to be very feverish immediately,and very heavy to sleep. His voice was lost, his sleeps came tohim, and his belly was hard all the time. A suppository of gallbeing applied, a great discharge followed, and immediately uponthat a remission. But the belly was soon swelled again, the feverraged, and the same heaviness to sleep came on. While he wasin this condition, he took a little of those medicines that are madewith wild saffron, wild cucumber, and meconium; upon which hefell into a bilious purging, and immediately the stupidness went off,the fever grew mild, every thing was easier, and the crisis happened the fourteenth.Eudemus had a violent pain in his spleen, and was ordered byhis physicians not to eat much, to drink a little thin wine, to walkoften, and to keep strictly to this method. He was also blooded;lived but sparingly in his eating and drinking; walked by degrees;drank black thin wine; and recovered.Philistides , the wife of Heraclidas, was taken with an acute fever.Her face was red, without any evident occasion; and a little after,in the day, a shivering came on, and was succeeded, as she did notgrow hot, by a convulsion in her fingers and toes; a little afterwhich she grew hot. Her urine had something in it compact,cloudy, and as it were torn off. She slept at night. The secondday shivered again; grew a little hotter in the day; the rednessabated; the convulsions became more moderate; and the urine theShe slept again at night, but laid awake a little, withoutany manner of uneasiness. The third, her urine was better coloured, and had a little sediment. The same hour she shivered again,grew very hot, sweated at night all over; but in the evening hercolour was changed to a jaundice, and she slept the whole night.The fourth she bled very much from the left nostril, and her mensesappeared a little in their natural course. But the same hour shegrew very feverish again; her urine had the like compacted parsame.THE SEVENTH BOOK OF EPIDEMICS. 449ticles in it, and was in small quantity. Her belly, which wasnaturally bound, was now much more so, and nothing passeddownwards without a suppository. She slept at night. The fifththe fever was milder; at night she sweated all over; her menseswent on; and she slept in the night. The sixth, she made a greatdeal of water in a gushing manner, and with the same particles asbefore. It had also a little sediment of the same colour. Aboutthe middle of the day she shivered again, grew a little hot, andsweated all over. Her water was of a good colour, and she had aperfect crisis.Tychon, at the siege of Datus, was wounded upon the breast bythe engine they used to throw darts or stones with, and in a shorttime fell into a fit of tumultuous noisy laughter. The physician,who took out the woody part, seemed to me to leave the iron of thedart within, by the diaphragm. In the evening he had a glyster anda purge, being in pain. The first night was very troublesome tohim; but in the morning early his physician and others thoughthim better; because he was quiet. A prediction was made, that aconvulsion would come and carry him off. The next night he wasvery restless, got no sleep, and lay upon his belly for the most part.The third day betimes in the morning a convulsion came, and hedied about the middle of the day.The eunuch, that lived by Elealces's spring, fell into a dropsyfrom hunting and running about. He had had for near six yearsthe complaints that proceed from such riding, together with a swelling in his groin, a sciatica , and defluxions upon his joints.A person in a dropsy should use exercise, sweat, eat hot breaddipped in oil , drink but little, bathe his head much with hot orrather warm water, drink white thin wine, and take but little sleep.He who had the tabes dorsalis died the seventh.In those who at first bring up undigested pus, salt things mixedwith honey are good.Venery is a cure for a long dysentery.Leonidas's daughter's menses were coming down powerfully, butdiverted another way. Bleeding at the nose ensued, and a greatchange. The physician did not perceive it, and the girl died.Philotimus's boy, a stripling about fifteen, came to me with thebone of his skull as incurable. The wound was above, upon thecrown of his head, and he was cured by a discharge of pus fromthe ears.29450 THE WORKS OF HIPPOCRATES.Pythocles used to prescribe his patients water, and milk mixedwith a great deal of water, by way of nourishment.Kibes are to be cured by scarification, calefaction, and heatingthe feet as much as possible by fire and water.Lentils, sweet apples, and herbs are bad for the eyes. But forpains about the loins, or hips, or legs, from hard working, bathingthe part with salt water and vinegar, fomenting with sponges dipped in the same, and binding up with unwashed wool and lambskin, are good.Drinking origanum is bad for inflamed eyes and the teeth.THE BOOK OF APHORISMS.APHORISMORUM LIBER,LIBER APHORISMORUM,FESIUS, Treat. ii . p. 1242.HALLER, i . p. 460.DES APHORISMES, . • GARDEIL, ii. p. 128.THIS book of Aphorisms, the most extensively known perhaps,and that which has probably been more frequently given to theworld in an isolated form than any of the other writings that havereached us under the imposing title of Hippocrates, is divided undeseven sections, by Fosius, Haller, and others. C. J. Sprengel, inthe English dress he has given to it, more than a century ago,(London, 1708,) has given it in eight sections, and has apparentlyadded several aphorisms from other of the books that have heretofore been noticed. De Gorter has done the same, (Amsterdam,1742, ) and both accompanied with copious explanations and references. I have made a concise table of these different divisions, asin some respects they may be useful in reference.Sect. 1. Sect. 2. Sect. 3. Sect. 4. Sect. 5. Sect. 6. Sect. 7. Sect. 8. Total.Fœsius,Sprengel,2525De Gorter, • 25Haller, 25Gardeil,b 25NO5454545433333313131 54 31 83 72 3182*****838382222228888872 6060 7960 85608226841218 79 8842214 418 420 412At the beginning of the eighth section, Sprengel remarks, that"A great many have omitted this eighth section; some have onlyadded six aphorisms of it to the foregoing; but others have addedthe whole section as we have done here. For there are severalof them that ought not to be despised. ""APHORISMUS.- popioμos, est oratio, quæ omnes rei proprietates brevissimis verbiscircumscribit."-Castelli Lexicon,b Gardeil's division is into seven books."452 THE WORKS OF HIPPOCRATES.De Gorter, at page 886, gives the residuary aphorisms (405 to418) under the title of Aphorismi interjecti;-with some slight explanation, not very dissimilar from Sprengel, of the circumstancesleading to the diversity of different editors."We might, (says Gardeil in concluding the book, and arrangingthe sections after Fosius,) here remark, that in some editions, otheraphorisms have been added that are not to be found in Fosius; andwe might augment the number of them, exclusively of those tracts .that are written aphoristically, such as the Prognostics, Humours,Predictions, &c. , by a variety of aphoristic sentences, especiallyfrom the books on Epidemics, and De Locis in Homine; but confining myself strictly to the Aphorisms really of Hippocrates. Thoseunder the name of Coaca, can scarcely be so regarded, althoughhighly esteemed by ancient physicians, and which are truly a collection of Aphorisms, unaccompanied either by discussions or reasoning,-appearing to constitute a part of those writings that havebeen ascribed to Thessalus or Polybius, or perhaps to some physicians of the celebrated school of Cos; though whether prior to, orafter Hippocrates, is not fully settled ."-In what may be deemed a preface to this book, Gardeil says,"The Aphorisms of Hippocrates are to be esteemed as generalmaxims, which he attempted to constitute from his practice, in proportion as the observation of the progress and issue of diseases presented various results. Certainly he could not consider all hisAphorisms as rules with no exceptions; but merely as facts ofsufficient extent to deserve to be collected together; and every manendowed with a portion of genius and sagacity, in any profession,will be led by many circumstances to act like him. We all canjudge that such a collection could never end, for it would be unceasingly augmented and corrected to the close of life . All admit,that in publishing this work in advanced life, he thought that itneeded to be reviewed and corrected; and we find scatteredthroughout the writings that appear under his name, many of suchmedical sentences, that could without difficulty be transferred tothe close of this one."Haller, in noticing this treatise, says, " That from time immemorial, it has been considered genuine, and as having been writtenby Hippocrates in advanced life and maturity of judgment. Yet itmust be admitted by the lover of truth, that it was loosely performed, and handed to posterity; since many aphorisms are twiceTHE BOOK OF APHORISMS. 453-repeated, and some are contradictory to each other, (which are allcasually noticed by Gardeil.) The best parts are those that referto the symptoms and termination of acute diseases; the worst arethe physiological; some being false, respecting the fœtus, the signsof conception and of fruitfulness, as likewise of abortion from venesection." He here makes reference to the eighteen spurious aphorisms of some editions, and then indicates the character of those ineach section.The first and second sections consist chiefly of aphorisms thathave reference to regimen and evacuations both in sickness and inhealth. The third, to the influence of different seasons, and thediseases incident to the various ages of life. The fourth, considersthe subject of purgatives and the nature of the stools; though afterthe twenty-eighth, a variety of different ones are introduced, andfrom forty-one to sixty- seven, a succession of aphorisms in respectto fever; and on urines, from thence to the end of the section.The fifth, relates to the female sex, at least after the twenty-ninthaphorism to the sixty-third. The others are various, and appertainto convulsions, phthisis, heat, cold, &c. There is but little order inthe distribution of the various aphorisms of the sixth and seventhbooks. They refer chiefly to the signs and presages of disease andhealth, & c . , as deduced from different circumstances; and much issuspicious as to the authority from whence derived. Some are oftrifling importance, others but repetitions or coincidences of some ofthe other sections, or even of the same one.With this we terminate the seventh section, venturing the remark, that, although so often quoted and spoken of, as a whole, theAphorisms, collectively taken, add nothing to the celebrity of Hippocrates. -ED.SECTION VIII.EXTRANEOUS.BESIDES the articles here mentioned, as found in the eighth sectionof Fœesius, accompanied with the Greek version; we find in Haller'sedition (8vo. Laus. , vol. iv. p. 199, et seq. ) sundry other smalltracts, and which, after those from Fœsius, I shall introduce amongthe wrixa, as probably their most appropriate location. HowHaller comes by them, I do not altogether comprehend; nor howit is that Fœsius makes no mention of them, or at least of only twoor three which are intermingled with the letters. I enumerate theletters as I find them in Fosius, without reference to their contents. -ED.EPISTOLE HIPPOCRATIS.Haller, as a preface to these letters, says, they are very ancient,since Cato alludes to the one in which Hippocrates refuses his assistance to Artaxerxes. Many of them, however, are deemedproblematical. The honorarium of ten talents from the Abderitesto Hippocrates, was far beyond their means. The dream is unworthy of the gravity of Hippocrates, and the collection of lettersappears to be rather the production of some sophist, than of thateminent man. Cratevas is manifestly of a different era; and theaccount of the plague cured by Hippocrates, can scarcely be reconciled with the narration of Thucydides; neither is it any wherecited by Galen.

• This section contains in the arrangement of Fasius (p. 1271 ) , under the title of raτα

TIXz, hoc est externa, the following articles: Epistolæ aliquot; -AtheniensiumSenatus- consultum;-Oratio ad Aram;-Thessali Legati oratio;-Genus et Vita Hippocratis secundum Soranum.EXTRANEOUS. 4551. Artaxerxes to Pætus, respecting the plague in his army.2. Pætus to Artaxerxes, recommending Hippocrates to him.3. Artaxerxes to Hystanides, præfect, offering high rewards forthe services of Hippocrates.4. Hystanides to Hippocrates, announcing this to him.5. Hippocrates to Hystanides, refusing his services to an enemy.6. Hippocrates to Demetrius.7. Hystanides to Artaxerxes.8. Artaxerxes to the Coans, threatening them if Hippocrates isnot sent.9. The Coans, in reply, refusing his demand.10. The Abderite senate and people, to Hippocrates, in behalf ofDemocritus.11. Hippocrates, in reply.12. Hippocrates to Philopæmon.13. Hippocrates to Dyonisius.14. Hippocrates to Damagetus.15. Hippocrates to Philopæmon.16. Hippocrates to Cratevas.17. Hippocrates to Damagetes, a long letter in relation to Democritus.18. Democritus to Hippocrates.19. Hippocratis de Insania scriptum .20. Hippocrates to Democritus.21. Hippocratis de Veratri usu libellus.22. Hippocrates to his son Thessalus.23. Democritus to Hippocrates, de natura humana.24. Hippocrates to King Demetrius.25. Decree of the Athenians in favour of Hippocrates and theCoans.26. Oration of Hippocrates before the altar of Minerva.27. Oration of Thessalus, his son, to the Athenians.These letters are followed by an account of the life, family, andwritings of Hippocrates, from Soranus, and Vander Linden, withnumerous testimonials from various sources; the last of which istaken from the " Itinerary of John Mandevyle, " chap. 6, and is entitled, " De filia Hippocratis mirabile." A curious relation, from acurious traveller!456 THE WORKS OF HIPPOCRATES.Subsequent to these testimonials, we find in Haller, vol. iv. p.345 to 367, a collection of what he denominates, " Fragmenta etElogia" ex eodem Lindenio, from numerous ancient writers,-Plato,Aristotle, &c. , down to Ulpian and Bartolus. Following which,appear the " Consentientia ex Galeno," from various authors, p.367 to 398; and lastly, a division entitled " Contradicta et Defensa,"p. 399 to 414, with which the edition of Haller terminates.A few short treatises, introduced by Haller under his division of"6 Hippocrati adscripta opera spuria, " vol. iv. p. 127 , require to behere noticed, as some of them do not appear in Fosius; and theyare therefore here added to complete the object of the editor.I. LIBER DE HOMINIS STRUCTURA, AD PERDICCAMREGEM.HALLER, iv. p. 199.Haller tells us this exists only in the Latin. It treats of the fourelements; of nature; and the four humours of the human body,their constitution, and location, &c.; of arteries; veins; the causesof mirth or sorrow, pusillanimity, &c.; of lethargy, phrenitis,palsy. Some affections of the head depend on the stomach;sutures of the head occasionally wanting; colour of the hair, baldness, &c., explained. Three gradations of voice: grave, acute,and intermediate. Liver, its influence in digestion. Five senses.Fourteen constituents of man stated (qu. tissues? -ED. ) , viz.:nerve, vein, artery, blood, spirit , flesh, fat, cartilage, nails, bones,marrow, hair, membrane, and humours. To these are added, inthe female, milk and catamenia . Spine consists of twenty-fourvertebrææ, and as many ribs. Teeth more than thirty. Stomachin length five palms; intestines thirteen cubits. Names of the different fingers. The four seasons; their properties, &c. Someobservations as to the non-naturals, &c .II. DE NATURA HOMINIS.HALLER, iv. p. 205.This constitutes the twenty-third letter, of Democritus to Hippocrates, in the preceding list. It is, says Haller, a rhetorical description of parts of the body, in which much appears of a later periodthan that of Hippocrates. It is a piece of little or no importance.EXTRANEOUS. 457III. LIBER DE ETATE.HALLER, iv. p. 208.Asmall treatise of two pages, which Haller says is a fragment;in which the signs are pointed out of fœtal death at seven and eightmonths, in a better way than in the legitimate treatises under thosetitles . A description is given of certain human ova, of seven days'formation, discharged by whores, through the agency of abortives;in which the outline of every part was conspicuous. Septenaryperiods of life, & c.A small fragment on the same subject, by Philo, follows. It isentitled, " De Etate Fragmentum, ex Philonis Judæi, de Opif.Mundi," p. 24. It seems a mere abstract of the above, and of aboutthe same estimate.IV. DE SEPTIMESTRI PARTU, LIBER SPURIUS.HALLER, iv. p. 211.Undeserving of notice, says Haller.-It is, however, well to lookinto it, if only to become acquainted with some former opinions.V. DE SIGNIFICATIONE VITÆ ET MORTIS, SECUNDUMMOTUM LUNE, ET ADSPECTUS PLANETARUM.HALLER, iv. p. 214.Altogether astrological, says Haller, and very remote from thewisdom of Hippocrates. It does not exist in the Greek, and is theproduction of some later writer. It runs over (in fourteen paragraphs, and sixteen pages) the whole signs of the zodiac, and ofthe moon's locality in relation to them. Its perusal will afford someinsight into the absurdities of astrology; a science still pointed to,in the figure as a frontispiece to many of our annual almanacs!VI. LIBER DE MEDICAMENTIS PURGANTIBUS.HALLER, iv. p 238.Some things herein, says Haller, are taken from the Aphorisms.A bold defence is set up for the doctrine of elective purgation,founded on the difference of the four humours.The great variety in the operation of purgatives noticed. The458 THE WORKS OF HIPPOCRATES.same one at times operating powerfully, at other times, not at all.Sometimes what is not expected is discharged, or in smaller amount,&c. All which is explained, and leads to the division of purgativesinto chologogues, &c. , according as they act on the humours; anddirections are laid down for the success of this: for, adds theauthor, it is a shameful misfortune to kill a man by super-purgation.VII. DE VERATRI USU.FESIUS, EPIST. xxi. p. 1287.-HALLER, iv. p. 241.Haller here states, that much is taken from the Aphorisms, Prognostics, and Prænotions, relating to the ptisan, and menstruation,which are quoted as if the productions of the author of this treatise.Towards the close, some extension is given to the subject of purgation by means of sesamoid; and cases are stated wherein veratrumis appropriate, and cautions given as to its employment. Purgation,in this treatise, seems more intended for vomition, or purging upward (sursum).VIII. DE ANTIDOTO.EX ACTUARII Methodi Medendi, vi.—Haller, iv. p. 243.This is called by Haller, a " farrago aromatum," and is said tobe from Myrepsus. It is in the text called an antidote of Hippocrates, “ quo usus corona Athenis est donatus. " Many virtues areattributed to its employment; its doses are stated, and mode ofadministration; its preparation is finally given, constituted of abouttwenty-five ingredients, and no doubt was equally a panacea withthe confectio Damocritis, and Theriaca so celebrated by Galen!IX. ANTIDOTUM.EX NICOLAI ALEXANDRINI, DE COMP. MEDIC. i . 365.-HALLER, iv. 244.Pretty much of the same character with the preceding, but consisting of only eleven ingredients, one of which is opium. This isalso called an antidote of Hippocrates, and was used as a panacea!Hundreds might be formed of equal importance, by drawing outthe names of medicines from a wheel, and manipulating the ingredients secundum artem!EXTRANEOUS. 459X. DE RE VETERINARIA.HALLER, iv. p. 247.Much posterior (says Haller) to the period of Hippocrates. Afarrago of remedies, many of a superstitious character. It is notaltogether devoid of interest, as being of so remote antiquity, andnot deficient in treatment of sundry affections of importance.Venesection described, &c.I have now brought to a conclusion the immediate object inview, that of affording a general outline of all the writings thathave reached us under the name of Hippocrates, rather than acomplete translation of the whole. I trust such a work may yetappear in the English language; and, although it will be perceivedthat of nearly eighty treatises, scarcely a dozen are attributed undisputedly to him, -yet their antiquity alone would be a sufficientplea for the medical profession, to desire to know the state of thatprofession nearly three hundred years before the birth of ourSaviour; and that, even if it did not contain much really usefulmatter. Were I now half a century younger, with my presentfeelings towards the memory of that great man, and of his stillgreater successor, Galen, I should take pleasure in assuming thetask; but at the age of more than "threescore years and ten," Ifeel that the hour- glass of life must soon have its sand expended;and that other cares should now engross my mind. I will add,that imperfect as this present attempt is, by myself considered ,I look forward with a fervent hope, that it may prove a pioneer fora more efficient labourer in the schools of Hippocrates and ofGalen, when the present writer may perhaps, be holding an interesting communionship with those individuals themselves in a higherstate of existence. -EDITOR.END OF THE WORKS OF HIPPOCRATES.12$AN ABSTRACTOF THEWRITINGS OF GALEN.

INTRODUCTORY REMARKS.DURING several years, whilst holding successively the Professorships of Chemistry, and of Materia Medica and Pharmacy, in theUniversity of Pennsylvania, I endeavoured in my IntroductoryLectures to afford some slight information to my class, as to thecharacter and writings of Hippocrates; and to vindicate him fromthe unwarrantable aspersions that have been cast upon him, evenby those who considered themselves as being among his warmestadmirers. That they derived their impressions of that great manfrom second-hand observations, whether favourable or unfavourableto him, I have no doubt; for I consider such an imperfect and partial acquaintance with his writings, as being the only means bywhich we can explain the singular circumstance, that fault hasbeen found with him, and ignorance ascribed to him on subjects,which a due and personal acquaintance with his works, would haveassuredly prevented. I pursued a similar plan with respect toGalen in two or three successive Introductories, but the continuance of which was precluded by my separation from that institution.Being thereby prevented from pursuing the object I contemplated,I have long been led to think that it might not be unacceptable to theProfession, if I should, by slightly modifying the lectures, present abrief outline of the works of both those wonderful and accomplishedphysicians. In the preceding pages, my readers will have attainedsome slight view as to Hippocrates and his writings; and in those thatfollow, will be found an epitome of Galen-his illustrious successor,his warmest advocate moreover, and vindicator, as well as commentator; hoping that it might lead to an eventual consideration of a461 INTRODUCTORY REMARKS.debt of gratitude to him, of long standing, that of giving him acomplete and perfect English dress; by which thousands, unacquainted with the Greek original, or the Latin translation , mightbe enabled to peruse with pleasure and with benefit, his learnedlucubrations. "Not inferior, probably superior to Hippocrates, from possessingthe advantage of four centuries of additional information, accumulated in the vast libraries of Alexandria, Greece, and Rome; improved moreover by the extension of that information, or rather itscollection and concentration as it were into a focus, constituted ofthe Greek and Alexandrine schools, we cannot doubt that Medicinereceived its full proportion of attention; since, even prior to thetime of Galen , it had obtained the fostering care of kings andprinces. Mithridate, so called from the great King of Pontus, hasreached the present day, though greatly modified; together withthe Theriaca, prepared for use by the chief physician alone; andwhich last has been illustrated and described by Galen, in a curiousand learned commentary, whilst it was held in the highest estimationfor nearly fourteen hundred years.That Galen and his doctrines should have so long maintainedthe highest rank in medicine, and been the arbiter of our sciencefor upwards of a thousand years, will appear surprising to thosealone, who are ignorant of him and of his imperishable writings!It is true, his works, originally in Greek, are from that cause asealed book to a majority of the Profession; but numerous editionsfrom the Juntas of Venice, and Frobinius of Basil, of the Latintranslation exist, and might be obtained by all who really desire toconsult them; or at least if their high price should prove an obstacleto this, all will admit, that no public library, especially a medicalone, can possibly be complete without them. Imagine them nowpresented in an English dress! how many embryos of the hundredsof our since discovered facts and theories, should we not behold?I appeal to those who may honour these pages with a perusal, whether they haveever known fully, what were the subjects of the voluminous writings of Galen, evenby name?—And I might make the same appeal with respect to a large portion ofthe writings of Hippocrates!-By a majority of the medical profession, if this appealwere truly replied to, I doubt not the answer would be in the negative!—And yet the names of both those illustrious authors are familiar to all the Profession as theirhousehold gods!!INTRODUCTORY REMARKS. 465The plagiarists of past and present times would stand forth in boldrelief, and credit would be awarded to the great original! Hincille lachrymæ!-Our authors wish not to withdraw the veil, or elseit might with ease be accomplished. Galen has never yet been permitted to assume the British toga, although the Roman fitted himso well.I cannot but admire the apathy with which those extraordinaryproductions are regarded by many of the learned professors of ourscience! who, whilst they employ the lighter works of fancy to formthe chief intermedia between the present and by-gone times; theylook through a glass, darkly, along a vista of more than fifteen hundred years, when Galen constitutes the object of their contemplation! Fain would I hope, that his works may yet be given to theworld, in such a dress, as readily to introduce them, not to ourlibraries only, but to our minds. May it devolve on America to discharge this debt;-but little hope can be anticipated from England,in this particular. It would present a mirror that would reflectback the images of facts and theories, long assumed and regardedas of domestic origin, with no acknowledgment of their Greciansource. Here, in the pages of Galen, would be discovered many ofthose great principles, both in theory and practice, which have, atdifferent periods, been advanced as novelties; for Galen has remained a fixture only, on the shelves of medical libraries. As inthe pages of Burton, the plagiarisms of Sterne have been demonstrated by Ferriar; so in those of Galen, an equally egregiousmemento of medical effrontery might be readily shown to exist.But who now, we may be permitted to inquire, -who reads hisworks? Where indeed, with few exceptions, are they to be found,even in our public institutions for private reference? It is time thatjustice, so long delayed, should at length be exercised towards oneof the most brilliant stars of the medical world. It is time to dispelthose fanciful dreams, that in the mighty march of intellect, " allthe talents" are concentrated in our present period, and that retrospection is unnecessary. The flippant usage of too many ofour publicwriters and teachers, of denying to the ancients any merit, as iftheir intellects were barren as their own, cannot be too severelyreprehended. Those ages which produced the poets and philosophers, whose works have reached us, and which have ever beenconsidered as the standards of merit in their respective spheres;could never have been deficient in the yet more important and per- 30466 INTRODUCTORY REMARKS.sonally interesting science of medicine! Test this, by the writingsof Galen alone, and its truth will conspicuously appear, in opposition to the dicta of our would-be master spirits, who fondly pleasethemselves that they alone are the shining lights of the Profession;and which their vanity, and ignorance of those bygone writerswhom they profess to contemn, yet, as opportunity serves, mostostentatiously quote, can alone explain. When we hear the ancients most unblushingly undervalued, let us set it down as a fact,that such persons have never examined the authors they contemn,and are therefore desirous of retaining others on a level with themselves, either of ignorance or indifference.In following up the plan I have marked out, it is my intentionbriefly to glance at the contents of the several writings of the extraordinary person in question, that my readers may know whata “ས O vous qui jugez avec autant d'injustice que de légéreté la physique de Séneque, etqui payez d'un souris dédaigneux et malin les fruits utiles de ses veilles; oubliez le moment où vous existez, et ce que vous devez aux découvertes de votre siecle sur cettescience: transportez-vous au temps où il a écrit; proposez- vous les mêmes questions,et voyez si vous les résoudriez mieux que lui. Vous seriez peut-être très vains alors derencontrer son erreur. " -Avertisement de L'Editeur des Œuvres de Séneque, sur lesQuestions Naturelles. Vol. 6th, Paris edition, an 3.In the above, the reader must be pleased to read " la médecine de Galen." Mutatismutandis, the application is fully as correct.bDid time and space permit, I could furnish from Fabricius a copious and extraordinary catalogue of " Opera deperdita," which would probably astonish the reader, andlead him to regret the loss the world has sustained from the non-discovery of printingin those bygone times. We may, however, like the old woman and the empty cask,in Æsop's Fables, form some judgment of our loss, by the comparatively few that havefortunately been spared from the ravages of time, under the controlling influence ofdespotism, barbarism, and superstition.These gentlemen might learn a lesson from Shakspeare's favourite knight, SirJohn, at least, in relation to Galen, that would be useful to them. -Vide Henry IV.Part II. Sc. 2."Lord ChiefJustice.-You would not come when I sent for you.Falstaff. I hear, moreover, his highness is fallen into this same whoreson apoplexy.Ch. J.-Well, Heaven mend him! I pray let me speak with you.Fal. This apoplexy is, as I take it, a kind of lethargy, an't please your lordship;a kind of sleeping in the blood, a whoreson tingling.Ch. J.-What tell you me of it? be it as it is.Fal. It hath its original from much grief; from study and perturbation of the brain:Ihave read the cause of his effects in Galen: it is a kind of deafness.Ch. J.-I think you have fallen into the disease; for you hear not what I say to you.Fal. Very well, my lord, very well! -Rather, an't please you, it is the disease of notlistening, the malady of not marking, that I am troubled with," &c.INTRODUCTORY REMARKS. 467they may expect to find in full, should they think fit to look into thevenerable and nearly obsolete folios of their most illustrious predecessor; and if unable or unwilling so to do, that at least they maybe checked in any attempt to decry them, bythis slight epitome.It will consist, for the most part, of the simple outline (with a fewexceptions more fully given) , of those writings, as they have appeared to the editor; and which can scarcely be considered as evena skeleton, as it were, of the proudest work of which the science ofmedicine can boast, either in ancient or modern times, if estimatedby its individual merits alone! No slavish and ignoble plagiaristwas Galen. In thought, as in action, he appears to have been free:and those thoughts are evincive of superior genius, improved byall the arts and science of his own, and of preceding ages. Inevery page, his character stands forth in bold relief. His works area library of past events, an encyclopedia of facts from every branchof medical literature; and forestalling many of the most extraordinary events of our own times; whilst even in experiments and inoperations, considered as novelties in the present day, he has preceded them.In order to comprehend the writings of Galen, he must, I think ,be permitted to explain himself, through the context of other parts.That he was wrong on many points of physiology, when comparedwith those deemed perfect in our day, cannot be denied; but arewe absolutely certain of the truth of all those we now maintain?Will not the fluctuation of the physiology of the last fifty years beadequate to set aside such flattering pretensions? The stamp ofmutability is affixed to the science, now, at least as much so, as inthe days of Galen; for, with all our boasted attainments, it canscarcely with justice be affirmed, that the superstructures we haveerected, are more beautifully, or more securely and symmetricallyarranged, than was that of Galen; or that we have, in truth, a system of physiology that is more settled or superior to his. Let us

• I would earnestly request the older members of the Profession, ( I mean those of

thirty or forty years' standing), to cast a retrospective glance at the numerous changesin physiology, and pathology, and therapeutics, that have been given to the medical worldsince their first connexion with it. Nearly a century ago, a Doctor Lizarri of Venice,published a defence of oleaginous remedies in bilious diseases, in opposition to thecelebrated Tissot, who condemned their use. Lizzari affirms, that in order to favourhis opinions, Tissot had even frequently mutilated the text of Hippocrates. A journalist of Venice, reviewing the work, exclaims, “ Malheureux sort de l'humanité; il n'est468 INTRODUCTORY REMARKS.inquire how stands the fact, in two or three particulars. WhilstGalen regarded respiration as intended to cool and ventilate theblood, we have, at one time, been led to consider it as productive ofanimal heat, and at another, as being required to oxygenate, or, todecarbonize the blood. Now, of all these, which is true?-If somehave supposed the air to be absorbed, in whole, or in part, in thedifferent views of respiration, Galen had, before them, thought thesame; and surely the ventilation of the blood, and conveying to itan aeriform fluid or spirit, as taught by the ancients, is an hypothesisat least as beautiful; and is by Galen as well maintained, as any ofthe present day; even if we cannot perceive in it a complete forerunner of those systems, which as now vamped up, are proclaimedas new, though based on a groundwork of nearly 2000 years.All this has been accomplished by the magic influence of a fewnew-fangled, and fresh- coined terms, derived from the fluctuatingvocabularies of our changing systems of medical philosophy.With respect to the various opinions as to the power and agency,by which the circulation is enforced and continued; whether by thatof the heart alone, or by that of the arteries, or of both combined;it may be allowed us to inquire whether, with all our greater andmore ample anatomical researches, aided by the microscope, andby injections, and by the most powerful physiological acumen, thisinteresting fact is better ascertained, or more conclusively substantiated than it was by Galen, who ascribes it to the heart alone; andfounds his reasons, in part, on the synchronous character of itsbeat, with that of all the arteries of the body.In regarding the veins, as the channel by which nourishment wasconveyed to every part, according to our present views, Galen wasin error. That he perceived the absolute necessity of a circulation, from the very facts themselves, of nourishment and growthin every part, seems to follow, as an almost necessary result;and one that can scarcely be supposed to have been beyond thespeculations of his penetrating and inquiring mind. Now this ispas encore décidé si l'huile est salutaire ou nuisible dans telles maladies, et les malades,meurent pendant la dispute!" Will not this equally apply at present, to much of medicine in its different branches?It must be remembered that by the ancients, the term pa , was a generic onefor tubes of every kind capable of conveying fluids. It was not limited to the vesselsalone in the human body; but in order to discriminate between an artery and a vein,the former was called a pulsating, the latter a non-pulsating vein.INTRODUCTORY REMARKS. 469infinitely strengthened by comparing and connecting those disjointedor independent portions of his multifarious pen; in which a circulation is more than merely obscurely hinted at, as we shall endeavourto demonstrate in the progress ofthese pages. The assumption, (forit is nothing more, ) that his idea of a circulation was simply that ofa flux and reflux of the blood in the same vessel, like the rise or fallof the tide, will not coincide with the circumstances of the text innumerous parts of his works; and can only be maintained by those,who, at all hazards, uphold the sole right ofHarvey to the discoveryof the circulation in all, its most unlimited extent. We can at present merely surmise, that Galen could not have looked, either for ageneral, or partial nutrition, without some definite views as to achannel of communication, for the especial purpose of transferringto every part, an ever- moving fluid , which he undoubtedly regardedas containing the nourishment of the system at large, and that nourishment taken in, ab extra, daily, at his meals. Howhe supposednutrition to be actually accomplished from the blood, as freightedwith its important addition, we may partly comprehend from hisingenious doctrines of attraction and repulsion; together with otherpowers, which he ascribes to every organ of the body; doctrinesprobably not surpassed by any since promulgated; and quite as ingeniously built up and sustained. We ascribe the deposit of variousmatters, either of nutrition or secretion, to arterial branches of thecirculating system; yet, at the same time we admit the anomaly ofthe secretion of bile from venous branches. It is not then, perhaps, incorrect to admit that Galen was partially right on points, inwhich, even now, from our absolute uncertainty as to the exactcharacter of the capillary link of circulation, we have no positiveor fixed conviction.It may excite surprise, but it is not the less true, that by changingour present nomenclature for that of Galen, we find the doctrine ofTissues very distinctly taught by him;-a doctrine so ably andbeautifully, and let us cheerfully add, more fully and satisfactorilyenlarged upon by the celebrated Bichat. That a doctrine so luminous and harmonious, should have occurred to both these illustrious men, may be regarded as a strong presumption of its beingfounded in truth; and identifies in a powerful manner, the congeniality of their minds and pursuits. It is possible that Bichatderived his views on this subject from Galen; yet it is not improbable, considering the neglect into which the writings of Galen had470 INTRODUCTORY REMARKS.fallen, that Bichat owed it to himself. Their mutual and strongattachment to anatomical research, qualified them certainly, for farmore extended views of physiology and pathology, than falls to thelot of the major part of the Profession. At an interval then, ofnearly sixteen hundred years, during which the doctrine had slumbered, it may be said to have again been discovered, or resuscitatedand embellished, by those improvements which may be concededto have sprung up.Nor is the division of diseases into Functional and Organic, byany means obscurely taught by Galen. By merely a change ofterms, we find the same ideas, that are now enunciated. And if,as Shakspeare says, " a rose, by any other name would smell assweet," it would be difficult to say, why the doctrines of Galenshould be less acceptable to us, under his primitive nomenclature,than as now set forth to the public, as novel, under a mask of newfangled names and explanatory elucidations.I cannot forbear to repeat, what Galen himself perpetually enforces, that the fluctuation of names, has always retarded thepursuit of knowledge; and that it has been, is now, and ever willbe, the principal means adopted by every dexterous plagiarist, tomystify an otherwise well- known subject; and by giving it to theworld in a new dress, an aspect of novelty, it is palmed upon ignorance or apathy, as the production of genius and research, such aspreviously had no existence. This nomenclatural fluctuation waswell known to Galen; and whilst it is wofully deplored by him as asource of infinite evil, he fails not to castigate it by those sarcasticremarks he often indulges in.*Although in several places, Galen seems to incline to the doctrine ofthe unity of disease, yet the prior claim to it by Hippocratesmust be admitted, if there is any force in words.-" Morborumomnium unum et idem modus est, locus autem differentiam facit. "-Lib. de Flatibus.-Or, as an annotator (Fracassini, opusc: Pathol.Leipsic, 1758, ch. 18, p. 92, ) on this part has it: " Cum humanumcorpus liquidis ac solidis, nempe vasis ipsa liquida continentibus,constet, et utraque in statu sano æquabili ac proportionato motuIt might well be demanded of these incessant coiners of new terms, " by whatauthority" they do this? by which almost every science is kept in a constant fluctuation, ifnot absolutely retarded. -Let any one compare the changes of nomenclaturefor the last fifty years, in Medicine , in Botany, in Mineralogy, in Chemistry! —andthen ask, "Cui bono?"INTRODUCTORY REMARKS. 471moveantur, vasa scilicet oscillatio quo dilatantur ac contrahuntur;liquida vero progressivo ac circulari, quotiescunque horum motuuminterruptionis, vel perturbationis causa, in qua morbus consistit, exuno in alium locum transferatur, essentia morbi commutatur, acaltero exsurgente, alter sæpe recedit; si vero per quodcunque organorum secretiorum materiæ trajiciundæ aptorum eliminetur, omnino extinguitur morbus. "-Whatever may be thought of the explanation here given, there seems no room to doubt, that here is tobe found a complete exposition of the " Unity of Disease. "These preliminary remarks are, however, sufficiently extended.In confining myself to the simplest outline, I shall take the libertyof making occasional observations, in order to direct attention tosome particular point, in a more especial manner; and shall introduce but rarely, the appropriate quotations, on which those observations may be founded, as well as those on which I should rest myclaims to the attention of the Profession, for Galen and his works.EDITOR.гTHE WORKS OF GALEN.THE writings of Galen consist of nearly seven hundred booksor treatises, of which several are lost, and they constitute a massof materials that ean scarcely be appreciated, except by directreference to them. Originally written in the language of Greece,they have been translated into Latin by different persons; andthese have passed through numerous editions, the principal and bestof which may be considered to be those that have been publishedby the Juntas at Venice, and by Frobinius at Basil. Besides twodifferent Greek editions, I possess in the Latin, the third of 1556;the sixth of 1586, and the ninth of 1609, all Venice copies; andthe Basil edition of 1549, -from which last I have chiefly formedthe following epitome. The editors of the Latin copies stated,have divided the writings differently from the Grecian. They have,however, carefully collected, not only those admitted to be fromGalen, and complete, but likewise such as are spurious and imperfect.*The writings of Galen in the Latin editions, have been principallydivided into seven classes, embracing all the range of medicalscience, as will be comprehended by a concise exposition of theplan pursued. These classes are preceded by the PROLEGOMENA,or introductory books, denominated LIBRI ISAGOGICI . They willbe found in some measure to form an epitome of the whole, givingsome general ideas to the reader of what may be expected in thosethat follow.

• I have lately added to my collection the edition by Kühn, in 20 vols. 8vo. , containing both the Greek and Latin texts, and which is infinitely more convenient for

reference than the ponderous folio.bElayan.—Introductio, Lexicon. Hence students, as beginners, are called byGalen, vaqueros, i. e. Tyrones.- Lib. de Pulsibus ad Tyrones.474 THE WORKS OF GALEN.CLASS I.This class embraces Physiology. -Its different books are consequently devoted to the consideration of the nature of the human.body, its elements, temperaments, humours, various structure andhabits, the anatomy and use or functions of the various parts,together with their respective faculties or powers; observationsrespecting the seminal fluid and the foetus, as necessarily connectedwith the subject of generation. In this class some of the mostinteresting works of Galen are introduced.CLASS II.This class embraces Hygiene -or the means of preservinghealth, chiefly constituted of the various so- called non- naturals;viz. air, food, drink, sleep, wakefulness, rest and motion, repletionand abstinence; and the affections and emotions of the mind.Herein too, we find several commentaries of much value, on someof the books of Hippocrates, as for example, three, on the celebratedtreatise " De Aere, Aquis, et Locis; " and on that " De SalubriDiæta." Much is said of the powers of food; of the healthy orunhealthy state of the fluids; of the ptisan, so celebrated by theGrecian practitioners. Some mental affections are also considered;some gymnastic exercises; the influence of habits and customs,&c.; and it will be found, on the whole, a class of considerableinterest.CLASS III.Is Aëtiological —that is, explanatory of diseases, and of their

• Quoteλogia. —Idem est, quod Physica, vel specialiter in medicina ea dicitur pars

ministra, quæ explicat tres res secundum naturam, puta sanitatem, causas ejus, etaccidentia, in rebus naturalibus corporis humani fundatas. -Castelli Lexicon Medicum.bryn.—Vocatur methodi medicinalis pars prior , quæ tractat modum sanitatemconservandi in sanis per certas indicationes et congrua media.-Castellus.CAT . -Vocatur quibusdam medicinæ pars pathologica, in qua non solùmcaussa morborum, sed et morbi ipsi et symptomata pertractantur. - Castellus.PROLEGOMENA. 475different symptoms and causes, &c . , all which are taken up in succession, and are duly considered. Some of the books of this classare commentaries on various Hippocratic writings, especially onthe Epidemics, and are a valuable addition to the reader, in enablinghim to comprehend them more readily.CLASS IV.SEMEIOTICS is the division of medicine that is connected with thesymptoms which distinguish diseases and the parts affected, and bywhich, likewise, we are enabled to predict what is subsequentlyto happen; that is, the prognosis, derived from the attendantsymptoms, as evinced by the pulse, by respiration, excretions, &c.In this class are several commentaries on Hippocrates, viz. , hisPrognostics and Prorrhetics. The subjects of crises and of criticaldays are also duly noticed; together with much interesting matterof a highly practical character, and which will amply repay theattentive perusal of these books.CLASS V.PHARMACY OR PREPARATION, ETC. , OF REMEDIES.This class embraces all that is connected with simple remediesand their preparations and substitutes; purgatives, antidotes, compounding of medicines, weights, and measures. The class is of considerable interest, as giving probably the best history we possess ofthe various articles at that period employed in practice. We findmany that have reached our own times, and which, consequently,may be deemed to have received the sanction of all the intermediateages. Here too, we find the most particular details of the long- esteemed Theriaca, and of some other then-deemed Panaceas.Enurin.-Est pars medicinæ signorum omnium differentias et vires expendens.-Castellus.b Dapμansuτinn. —Vocatur pars ministra artis medicæ, tradens descriptionem medi.camentorum et rite adhibendi modum.- Castellus.476 THE WORKS OF GALEN.CLASS VI.This, although by far the shortest of all the different classes, isyet one of the most interesting, embracing, as it does, under thetitle of " de cucurbitulis, scarificationibus, hirudinibus, et phlebotomia," every thing connected with the evacuation of blood throughtheir means. The importance of blood- letting is maintained in opposition to Erasistratus, who seems to have been nearly as violentan opponent to it as old Van Helmont in times nearer to our own.Galen likewise attacks , with equal severity, the followers of Erasistratus, and shows, that, whatever they might say, they either didnot comprehend their master, or if they did, that they made noscruple to deceive on the subject.CLASS VII.THERAPEUTICS. "This class, which in its different books, is more or less diffuselyconsidered, contains, as may be understood from the title, everything appertaining to the practice of the profession , such as diet inacute and other diseases; remedies for each disease , &c.; the principles and practice of surgery, embracing the treatment of fracturesand luxations, the description of bandages, &c. , (fasciarum et laqueorum, ) and of the different apparatus. We find also severalcommentaries on different books of Hippocrates, which servegreatly in their elucidation.CLASS EXTRAORDINARY.The above class closes the regular writings attributed chiefly toGalen. The present one is formed of those that are probably hisalso; but which are more of an aphoristic character. They are,however, of great interest, containing, as they do, commentaries onthe Hippocratic aphorisms, as also an explanation of many obsoletewords that are found in that author.Ospariurinn .-Pars medicinæ curatoria; -methodus medendi.-Castellus.PROLEGOMENA. 477Superadded to this extra- class we have a variety of those spuriouswritings that have been attributed to Galen. Whether spurious ornot, many of them abound in interest, and deserve to be known.They amount to nearly forty distinct essays or tracts, and they arefollowed by numerous FRAGMENTS, appertaining to different parts ofmedicine, which have been considered as derived from Galen; andwhich, although mere fragments, possess considerable interest.In estimating the above as a mere table of contents, we mayventure to state, that the writings of this great man will, withoutdifficulty, arrange themselves under the following heads, -andamongst them, scarcely will there be found wanting a single subject, that in any way appertains to medicine.1. General or introductory.2. Such as appertain to Anatomy.3.66 664.3466 665.66 666.66 667.66 66Physiology.Hygiene including the practice ofPhysic and Surgery.Materia Medica et Alimentaria.Philosophy and Metaphysics.Miscellaneous subjects.Can it be possible that such a writer can be devoid of merit, andhis works undeserving of examination in the present day, when itis remembered, that for more than one thousand years they maintained a supremacy, that has never been exceeded , perhaps not evenequalled!I now proceed to present a concise notice of all the differentworks that are to be found in the above- mentioned classes.PROLEGOMENA,VEL GALENI LIBRI ISAGOGICI.THE INTRODUCTORY TREATISES OF GALEN.UNDER the above distinctive title, we have sixteen books or treatises of an introductory character; but, which, in interest, arescarcely surpassed by any of those that are to be found in the succeeding divisions. We give, in a connected view, the respectivetitle of each one.1. Galeni, Oratio suasoria ad Artes.2. Si quis optimus Medicus est, eundem esse Philosophus.De Sophismatis in Verbo contingentibus.Quod Qualitates incorporeæ sint.De libris propriis Galeni.De ordine librorum suorum.De optima Secta.De optimo docendi genere.3.4.5.6.7. De Sectis.8.9.10.11.12 .13.14.15.16.De Subfiguratione Empirica.Sermo adversus Empiricos Medicos.De Constitutione Artis Medicæ.Finitiones Medicæ.Introductio, vel Medicus.Quomodo morbum simulantes sint deprehendendi.Ars Medicinalis.INTRODUCTORY TREATISES. 4791. ORATIO SUASORIA AD ARTES.AN ORATION IN FAVOUR OF THE ARTS AND SCIENCES.(EIGHT CHAPTERS.)In this first book of the introductory division of the works ofGalen, we have a topic of much interest presented for consideration.Galen sets off by showing that man alone, of all the animal creation,is endowed with reason, by which he is qualified for the pursuit ofevery art and science; that consequently, the improvement of themind is of infinitely more importance than that of the body, or thanan increase of wealth; and therefore that it is disgraceful to neglectthose sciences for the mere pursuit of gain. This leads him naturally to a description of Fortune, whose inconstancy is pointed out,and exemplified by several conspicuous and familiar instances; suchas Croesus, Priam, Dionysius, Cæsar, and others; and he deducesfrom various circumstances, the superiority of striving to improvein the beneficial arts, to that of toiling in the mere pursuit of riches;strengthening his remarks by quoting the opinions of Diogenes andDemosthenes and others on the subject. He furthermore points outthe folly of those who lay great stress on their nobility, aiding hisown, by the remarks of Themistocles and Anacharsis. -Even theelegance of the body, and of furniture and dress , &c . , is consideredby him of little importance, unless it be at the same time unitedwith a well- adorned mind. He cautions all to whom his remarksa Brutes, however, he concedes that they possess somewhat of the like in commonwith us, some in a greater, others in a less degree-but all, with few exceptions, aredeficient in art; and what these enact, man imitates-as spiders, bees, &c. From theseand other enumerated causes, although reason is not wanting to other animals, yetman alone, as superior to them, is said to be endowed with it.Here he inserts a story of Diogenes, who received an invitation to dine with onewhose house was splendidly furnished, in the highest order and taste, and nothingtherein wanting. Diogenes, hawking, and as if about to spit, looked in all directions, and finding nothing adapted thereto, spat right in the face of the master. He,indignant, asked why he did so? Because ( said D. ) I saw nothing so dirty and filthy inall your house. For the walls were covered with pictures, the floors of the most precious tessellated character; -and ranged with the various images of gods, and otherornamental figures. ( Now (adds Galen ) , since we are connected with the gods by theuse of reason, so are we with brutes, inasmuch as we are mortal; it is therefore moreexpedient to attend to the mind and its improvement, than to the body and its appen- dages, &c., by which we are on a par with the brutes alone.480 'THE WORKS OF GALEN.apply, by no means to misapprehend him when he speaks of studyor of the arts; none of which are of importance, unless they benefitsociety; and he supports his views, by giving some details and particulars relative to the care bestowed in the gymnastic trainings ofthe athletæ, in preparing for their duties of merely a corporealcharacter. He considers the nature of the arts as being twofold;the one is noble, from its connexion with the gifts of the mind; theother is ignoble or inferior, being dependent on corporeal labouralone; the first receives the name of liberal; the other is calledmechanical. Then, as might be anticipated, he places medicine atthe head of the first division, from its being superior to everyother mental pursuit that classes such among the liberal arts.II. SI QUIS OPTIMUS MEDICUS EST, EUNDEM ESSEPHILOSOPHUS.A GOOD PHYSICIAN MUST ALSO BE A PHILOSOPHER.In this book Galen endeavours to prove that, which the title amplyimplies, viz. , how greatly the medical man is improved by an intercommunion with learned men, and by a knowledge of philosophy;and it is of further interest, by the insight it affords of much of thephilosophy of that period.III. DE SOPHISMATIS IN VERBO CONTINGENTIBUS.OF VERBAL SOPHISTRY.(FOUR CHAPTERS. )Here, he takes notice of the sophisms in conversation, givingvarious examples of them. It is an ingenious and amusing treatise,but is not very particularly connected with medicine. It serves todemonstrate, nevertheless, the magnitude of a mind, which seemsto have embraced the whole circle of science as then pursued, bothat Rome, and elsewhere.INTRODUCTORY TREATISES. 481IV. QUOD QUALITATES INCORPORE SINT.WHETHER THE QUALITIES OF BODIES ARE INCORPOREAL.(NINE CHAPTERS. )In this metaphysical tract, the question is considered as to thepropriety of the Stoics, in denominating the qualities and otheraccidents of bodies corporeal. Galen denies it, and gives a definitionof a body.V. DE LIBRIS PROPRIIS GALENI.OF THE APPROPRIATE WRITINGS OF GALEN.(EIGHTEEN CHAPTERS. )This book is of importance, inasmuch as it enables us, ( at leastto a certain extent, ) to establish the writings that are his, and topoint out those that are erroneously ascribed to him. A prefaceexplains the circumstance leading to his writing it. He then proceeds to mention the works he had written on his first arrival atRome;-next, those that were written by him and given afterwardsto his friends, when he left that city. He then speaks of hisanatomical writings, and adverts to twenty books on anatomy byMarinus, which he had epitomized. After this, he mentions hisbooks on Diagnostics, Therapeutics, and Prognostics; his commentaries on Hippocrates, on Erasistratus, Asclepiades, the Empirics,and the Methodists; and of those that pertain to demonstration, orwhich are proper and common in the arts. Lastly, he notices suchof his works as belong to Moral Philosophy, to the Platonic, Aristotelian, Stoic, and Epicurean systems; and of those that werecommon to grammar and rhetoric.VI. DE ORDINE LIBRORUM SUORUM.OF THE ORDER IN WHICH HIS WRITINGS ARE TO BE PLACED.The title sufficiently explains the purport of this book.31482 THE WORKS OF GALEN.VII. DE SECTIS.OF DIFFERENT SECTS IN MEDICINE.This book gives an interesting account, and one, probably, moreaccurate than is elsewhere to be found, of the different sects inmedicine. From this, every writer on the subject, from the daysofGalen to the present period, seems deeply to have quaffed, eitherdirectly, or as copyists, without any, or but trifling acknowledgment.No one, whilst reading the lofty pretensions and explanations ofhypotheses assumed to be of modern origin; or in hearing thesame detailed in learned lucubrations, ex cathedra, would supposethat the subject had ever, previously, received the slightest elucidation! Happily for these conceited and oracular exponents, Galenpreceded them by ten or more centuries; and from his extensivehives, those drones have stolen the honey, if any is to be found intheir asserted claims. It is but just to pay our homage in return ,and rendering to Cæsar the things that are his, confess his superiority with a " detur dignissimo."This book embodies much matter that is of a character peculiarlyinteresting to those who may desire to explore the discrepancies offormer sectarians, and to investigate by what means the sameremedies were alike employed in the practice of them all , althoughit was founded on principles so different! Notice has also beentaken as to what has, by turns, received the opposition of them all.The Methodists receive a due share of attention, both as to theirdefence, and to the attacks made upon them by the Empirics andRationalists.VIII. GALENI, DE OPTIMA SECTA.OF THE BEST SECT.This is an important and interesting book, consisting of no lessthan fifty-one chapters, in which the pretensions of the differentsects in medicine are duly canvassed. Galen sets off with the proposition that every medical precept, and every general precep' ,should be founded in truth as its primary recommendation; then,INTRODUCTORY TREATISES. 483that it should be useful, and lastly, conformable to established principles. By these alone can a sound precept be properly judged of,and that, if deficient in either, it should not be tolerated. Thewhole of this book seems to base its remarks on these propositions,and an infinite variety of highly valuable matter is spread over thewhole treatise. He adverts to the difficulties that spring up in considering and judging of precepts assumed from mere appearances,or which are assumed from the authority of others as having beenpreviously demonstrated. He points to the cautions essential insuch investigations, and strengthens his views by numerous cases,either actual or supposititious. By these propositions he enters intohis inquiry as to the character, &c. , of the three principal sects, viz. ,the Rationalist, the Empiric, and the Methodic; by which his judgment may be enlightened as to his selection of the best. This hefully does, and points out their respective advantages or defects ,their discrepancies, and the imperfection of many of their remarks.In short, it is a valuable criticism, which may be very advantageously consulted by every medical man, who desires sincerely toarrive at truth in his researches, and not be led away bythe emptyand frivolous hypotheses that swell the publications and lectures ofthe last fifty years.IX. DE OPTIMO DOCENDI GENERE.OF THE BEST MODE OF EDUCATION.This book is of a general character in respect to education, andis deserving attention , if merely as affording the views of a manmost deeply impressed with, and who appears to have thoughtmuch, upon the subject.X. DE SUBFIGURATIONE EMPIRICA.AN EXPOSITION OF THE EMPIRIC SECT.This may be regarded as a compendious history of the sect ofthe Empirics. As to their origin, they themselves derive it fromHippocrates; but Galen considers them as springing from the484 THE WORKS OF GALEN.Sceptics of the more ancient philosophers. The foundation oftheir art is said to be that of experience. What that consists of isconsidered, and an explanation given of some terms connectedwith it such as autofia, sμreipia , &c. Galen adverts to the divisionmade of the art by some of them, into two parts; by others intothree, and four, and even five parts. Herophilus's definition ofmedicine is stated, and the difference is pointed out betweenEmpiricism and Dogmatism. The whole book is replete withinterest, at least to those who desire to investigate the origin anddiversity of the various doctrines of those distant times.XI. SERMO ADVERSUS EMPIRICOS MEDICOS.In the Venice edition of Galen's works is a short essay whichdoes not appear in the Basil edition of Frobinius, entitled " ADiscourse delivered in opposition to the Empiric Physicians. " Itis of little or no importance, and why introduced at all would bedifficult to say, especially in this part of Galen's works; -for, evenin the Venice edition , it is called " Fragmentum quoddam exiguumet mendosum." Its title gives its intent.XII. DE CONSTITUTIONE ARTIS MEDICÆ.OF THE ART OF MEDICINE.A considerable number of Galen's writings appear as letters, ifwe may so express it, addressed to different individuals, probablyhis disciples; and, at times, apparently under fictitious names: thusthe present book is addressed in its prefatory remarks, to Patrophilus, which may, or may not be a real one. By some, the bookhas been divided into two parts, the first, consisting of remarks onsuch particulars as lead to a knowledge of bodies, either simple orcompound. The second, of a notice of remedies, or those instruments of pharmacy and of aliment, in any way employed by thephysician.Galen commences by assigning his reasons for writing the book,and strongly exhorts to the pursuit of useful arts, declaiming at thesame time against the ignorance of the age and of its increase.INTRODUCTORY TREATISES. 485He points out the arts as being of a fourfold character: 1. Contemplative; 2. Practical, or Active; 3. Effective, poetically; thatis, in creating that which had no previous existence, or in correcting that which did exist. Of this description he affirms medicine to be. Lastly; 4. Acquisitive, or Accumulative, as in thevarious arts of hunting, fishing, &c. He then proceeds to a moreparticular consideration of medicine as a factitious art, and explainshow it is so; its parts, and actions;-states the essence of each partto consist in its conformation, magnitude, number, sympathy, anduse, with much other speculative, yet interesting matter, diversifiedwith that of a medical character. He then remarks on the natureof remedies, their discovery; the mode of attainment of the natureof diseases, and of the part affected, especially if internal; speaksof their causes, symptoms, variety, prognosis, and divination, &c;of the selection of remedies, prevention of disease, and of convalescence.XIII. FINITIONES MEDICE.MEDICAL DEFINITIONS.This is useful by directing attention to the importance of definitions. It adverts to physicians, anterior to the time of Hippocrates,as having written but little, and defined nothing. Hippocrates wasthe first to collect these scattered fragments, and add to them hisown. Many after him pursued the same plan , though without anykind of order, but merely spread at random through their works,such as Herophilus, Apollonius, and others. We are now presented with a definition, of what a definition is; -then follow,def