Front Page Titles (by Subject) SECTION III. a: ON THE NATURE OF MAN. - The Writings of Hippocrates and Galen
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SECTION III. a: ON THE NATURE OF MAN. - Hippocrates, The Writings of Hippocrates and Galen 
The Writings of Hippocrates and Galen. Epitomised from the Original Latin translations, by John Redman Coxe (Philadelphia: Lindsay and Blakiston, 1846).
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ON THE NATURE OF MAN.
The first portion of this book is, by Mercurialis, regarded as a genuine work of Hippocrates, and is frequently quoted by Galen and the ancients. Yet Galen, who comments upon it, has some doubts as to the latter part of it, which treats of the origin of the four great vessels,—and in this Haller seems to agree. It is, says Haller, a congeries of things the most diversified. It first notices the four humours, and their alternate predominance; and which by a species of affinity, are evacuated by medicines. It then adverts to the origin of epidemic diseases, which is attributed to the air, rather than to the mode of living. Correct as this may be in some respects, it is not wholly so, since by a similar diet of salted provisions, scurvy is found to arise in climates altogether different.
Among the various topics noticed is to be found the statement of four pair of vessels, which Haller says, smacks strongly of the Chinese writings. The account, moreover, erroneous as it is, differs greatly from the doctrine of Hippocrates, as it is laid down in his treatise “De locis in homine.” It is at this part that Galen stops; observing, however, that in what follows, excepting what relates to the four great vessels, the greater part is not unworthy of Hippocrates. In speaking of fevers and of various diseases, they are mostly 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 the head, refers to Galen, lib. 6, De Placitis; also to Hippocrates, περι οϛτεων φυϛιος, and to Aristotle, Hist. Animal. lib. 3, cap. 3.—The views of the blood-vessels are attributed to Polybius, although this is not the opinion of Galen. And Gardeil, in referring to the other treatises, in which the vessels are spoken of in nearly the same way as in the present one, remarks, that in the one entitled “De Natura Ossium,” although the title would indicate a principal attention to the bones, yet it is devoted almost entirely to the blood-vessels; and he adds, that although the whole is embarrassing, it appears to him infinitely more surprising to find so many angiological details, discovered without the aid of injections, than to meet with so many mistakes.—Ed.
Whoever is accustomed to hear the nature of man spoken of by persons who pretend to be acquainted with it, by any means distinct from medicine, will find nothing satisfactory to them in this treatise. I shall not tell them that man is altogether constituted of air, or of fire, or of water, or earth, nor of any other individual thing, 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 understand what they profess to teach. They all agree in one proposition, but differ entirely in the deductions they derive from it. They first advance the assertion that every thing existing is a unit, and that this unity is the universal whole; but then they disagree as to what this universal unit is. One affirms it to be air, another that it is fire, a third that it is water, and a fourth that it is earth; and each one grounds his assertion on reasoning and testimony of no value. Now, that they should agree at setting off, in one opinion, and then differ in what they say, is an evidence of their ignorance of the whole subject. This is soon discovered in their discourse. If they address the same audience, that audience will readily perceive that none of these philosophers is victorious thrice in succession. Now, it is one, then another, subsequently a third one; and he, the one that has the greatest volubility, and is best exercised in public speaking. If we profess to be fully masters of our subject, we ought undoubtedly to be always victorious in debate; and if we know it in fact, we can conclusively prove it. These philosophers appear to me to disagree, merely from a misapprehension of terms. They become, like Melissus,a inconsistent; and this is all I shall say upon the subject of these philosophical reveries as to the nature of man. In respect to the opinions of physicians on this particular, some maintain that man consists altogether of blood; some that he is only bile; and others constitute him of pituita. All reason in the same manner: they say that the individual is a unit by whatsoever name it may be termed, and that this unit changes its form and power, according as it is compelled thereto, by cold or heat; that it is capable of becoming sweet or bitter, white or black, or of assuming any other quality;—now none of this do I accredit. The greater number advocate other principles of a similar description. As to my own views, I affirm, that if man was constituted of only one species of matter, he could never feel pain; for how could pain be excited in him, if simple and uncompounded! Admit even that he did feel pain, the remedy applied is equally supposed to be one; but we know that remedies are various and distinct; and this because many 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 cure an equal difference in treatment. I therefore think, that whoever says man is constituted of blood and nothing else, should be able to prove 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, there ought to be at least one period, in which should be alone seen, that of which alone he is constituted. This reasoning applies equally to those who maintain that man consists only of bile, or of pituita. I shall however demonstrate, that the things which constitute the composition of man remain always the same, from their very nature, and the laws by which they are governed; and that this is the case in youth and age, and under every variety of temperature and season. I will likewise point out the signs by which these compounds are recognised, and the causes by which they are individually augmented or decreased in quantity.
The incipient formation or generation of man, cannot possibly arise from one thing only—for how can a single simple substance engender another without admixture with something else? Now, if what is mingled be not the product of different beings, of the same nature and of similar faculties, no generation can ensue of a being of a like character to them.a Moreover, if heat and cold, dry and humid, do not appropriately temper each other, or if either predominates unduly, generation cannot take place. How then can one thing alone engender, when a greater number cannot, unless their natural commixture is properly attempered? Since then such is the nature of generation, there must be, both in respect to man and of all other beings, more than a single thing, each of which is alike essential to the process, and gives to the body the power of accomplishing it. So also, when death takes place, each thing separates and passes off in conformity to its nature: the moist, joins itself to moisture; the dry returns to the dry; hot passes to heat, and the cold to cold. Such is the nature of animals, and of all other beings. All proceed from their like; all return to their like again, since they are compounded of the same things; and each, after serving in the composition, returns to those from which they were derived. Now the body of man contains 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 in due proportion of quantity and force, but especially when properly commingled. Disease takes place if either is in excess or deficient, or if not duly united. For when separate, not only the part in which there is a deficiency must be affected, but the part to which it goes being surcharged, will experience pain and uneasiness. When more than a mere superfluity is discharged from the system, the void occasioned thereby is productive of pain; but if 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 the repletion of that to which it is conveyed. I have stated that I would show, that those things of which man is composed remain always 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 those terms are at all equivocal, or liable to any obscurity; and moreover, the things themselves are in their nature entirely distinct—for pituita 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 there is 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 constituted alone of either fire, or water; and we at once distinguish that they are not, individually, one and the same, unless we can pronounce that fire and water are one and the same; but each one has its own peculiar nature and powers. If a medicine is administered that acts on the pituita, that alone is evacuated; if it acts upon the bile, bile is discharged; or black bile, if the remedy acts on the atrabilis. If the body is wounded in any part, blood flows from the wound. All this is the same, by day or night, in winter or summer, so long as man continues to respire; and this he can accomplish so long as he is not deprived of one of these, his constituent parts—for such they unequivocally must be; for they are found within him during the whole of his existence. Besides, the individual was generated by a being who possessed the same principles; and he was nourished by one who also had them. They in 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 who have 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 him discharge in death. They who say he consists of blood only, reason in like manner, from having seen persons whose throats were cut, discharging blood alone, and they employ proof of a like character. Yet no one ever died from super-purgation, by voiding bile alone. If a medicine is taken that acts upon the bile, that humour is first evacuated, and then pituita, which is followed by atrabilis; and if death ensues, blood is also discharged. Such is the case also, when remedies which act on the pituita are too largely taken. Pituita is first vomited, then yellow bile, next black bile, and lastly, before death, he vomits blood. The medicine taken, acts primarily on the humour to which it is most allied in its nature, and then attacks and evacuates the others. It is precisely as with plants, or seeds, which thrown upon the earth, attract or draw from thence, that which is most accordant to their nature. Now, there they find an acid, bitter, sweet, or saline. Each attracts at first that which is most congenial, and then takes a portion of the rest. So remedies act on the body; such as drive out bile, first purge off pure bile, and then a mixed congeries. If a man’s throat is cut, the blood first flows out very warm and red, then mixed with pituita, and lastly with much bile.
Pituita abounds in man more largely in the winter, since it is the humour that has naturally the greatest analogy with that reason; for of all the humours it is the coldest, of which we can easily satisfy ourselves. If you successively touch pituita, bile, and blood, the first will be found the coldest; it is more viscid, and combines with difficulty with atrabilis. It may be said, that every thing that is viscid and yields with difficulty, is, by the force employed for such a purpose, rendered hotter, although this is no argument against the actual frigidity of pituita. That it does augment in winter is very clear, for we cough up and discharge it largely at that season; besides which, it is during this season that œdemas and other pituitous swellings chiefly make their appearance. In spring, although pituita is still abundant, yet the blood increases, the cold recedes, and showers occur. The blood therefore ought to increase, both from the augmented humidity and from the increasing temperature, which are the natural concomitants of this season; and a proof of my position is, that men are more liable to dysenteries and epistaxis, and are hotter and higher coloured at those seasons. In the summer, the blood still abounds, but bile augments and extends into the autumn, the blood diminishing, since summer is contrary to its nature. The bile evinces its existence in the summer and in autumn, both by its spontaneous vomition, and by its copious discharge through the means of purgatives. It is equally shown; by the character of autumnal fevers, and by the colour of the skin. Pituita in summer is greatly weakened, for that season being hot and dry, it is naturally opposed to its presence. The blood is smallest in production in the autumn, for this is the dryest season, and already is the system becoming colder. And now the atrabilis predominates, both in power and in quantity. As winter approaches, the atrabilis is refrigerated, and is less abundant; whilst pituita resumes its station and extent, in consequence of abundant rains, 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 or otherwise 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 their presence; if one alone was wanting, universal destruction would be the result; for the same law that subserved the creation of all things, is equally required for their preservation. It is the same with 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. In man, it is the pituita, or blood, or bile, or atrabilis, that successively hold the sway, as is evident from the operation of the same remedy on the same individual in the four different seasons of the year. In winter the evacuations are most abundant in pituita; in spring they are more diluted; bile predominates in them in summer, and atrabilis in the autumn. Now, this being the case, the diseases which increase in winter, ought to end in summer, as those that arise in summer should be arrested by winter, unless checked by a certain determinate periodicity. This regularity in their termination is elsewhere discussed. In regard to vernal diseases, we must await their final termination in the autumn; as those of autumn may be expected to disappear in spring. Should they extend beyond the season of their usual termination, they will be continued through the year. The physician, therefore, in attending the sick, ought to observe 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 closes his commentary on it.—Ed.
The physician should likewise know what diseases are caused by repletion, and which are cured by evacuations; as also such as arise from evacuations, and are removed by re-integration. So those that spring from fatigue, yield to rest, and if originating in rest, they give way to exercise. In general, he should be acquainted with the means of fortifying the body against the diseases that threaten it, whether depending on temperament, season, or age. He should be able to strengthen what is relaxed, and to relax what is in a state of tension;a —this is the true means of removing the evil, and to this principle, in my opinion, the whole of medicine is reducible.
Some diseases arise from the diet or regimen employed; some from the air we breathe.b Whenever, in the same place, many persons are attacked with the same disease, at the same time, we must 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 drink water only, those who eat cakes alike with such as live on bread, labourers and the idle. Diet is therefore by no means the cause of the evil, since persons living in a way so opposite to each other are equally attacked by the same disease. But when, at the same time, diseases are altogether different, it is obvious that the diet of each must be the source of the disease of each individual. The cure must then be effected by opposing to each, the reverse of that which 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 to the temperament and age of the patient, as well as to the constitution and season of the year and the nature of the disease; then fix upon the plan of treatment, either by addition or subtraction, as I have elsewhere stated; always paying attention to age, season, constitution, and the nature of the disease, before prescribing either medicine or diet.
When an epidemic disease prevails, the cause of it assuredly is not in the food we take, but in the air respired, in which something noxious is to be found. In such a state of things it is useless to change the mode of living (diet), since it is not from thence the evil originates. Endeavour by all means to reduce the vigour and embonpoint of the body; retrench slowly in the usual amount of food and drink, for if suddenly changed it is hazardous. Your diet ought in general to be such as is altogether innoxious. Exposure to the air should be avoided as much as possible; or, if it can be done, remove from the place, or at least time live as separate as possible; for by such measures the least injury will be sustained from the noxious quality of the air respired. Diseases arising in the strongest parts of the body are much the most dangerous. If they continue in their original situation, the whole system must sympathize, inasmuch as it is the most vigorous part that is affected. If they leave that stronger part for one that is weaker, it will with difficulty be made to quit this latter situation; but if they quit a weak for a stronger part, the cure is much easier, the strength of the part enabling it to repel the fluxion.
I am now to advert to the vessels of the largest size.a Of these there are four pair in the body. The first pair, proceeding from the head, pass down behind the neck, along the spine on both sides exteriorly, and reach the ischium and thighs, proceeding to the legs and external malleoli, and thence to the feet. In diseases of the back and the ischia, venesection should be made at the ham and external ankle. The second pair of vessels arise also from the head, near the ears; they pass down the neck, and are called jugulars. They proceed internally, along each side of the spine, to the loins, the testes, and thighs, along the inner side of the ham, thence along the tibiæ to the internal malleoli and feet. In diseases of the loins and testes, we should bleed from the vessels of the inner ham and ankles. The third pair come from the temples, pass along the neck below the scapulæ, and thence to the lungs; that of the right side going to the left side of the lungs, that of the left to the right side. The right one passes out from the lungs under the breast, and proceeds to the spleen and kidneys; the left, leaving the right lobe, passes to the breast, to the liver, and the kidneys. The two vessels of this pair terminate in the rectum. The fourth pair parts from the forepart of the head and eyes, down the neck and under the clavicles, thence to the upper part of the arm, and down to its junction with the forearm, from whence it passes along the cubit to the junction of the carpus, and to the fingers; returning from the fingers along the upper part of the hand to the forearm, the elbow and axilla and the superior ribs, a branch proceeds to the spleen, and another to the liver; and both then, spreading over the belly, 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 arise from the large vessels, both external and internal, and pass to every part of the body, having mutual intercommunication with each other in every part. And this should be recollected in our choice of a part in which to bleed. We should remember also to bleed in a part the most distant from that in which pain occurs, or an accumulation of blood. By this means there will be less immediate and sudden change; and by thus diverting the blood from its accustomed course, we shall guard against its accumulation in the part to which its tendency is too great.
They who expectorate much pus without any fever, or whose urine deposits a large quantity of purulent sediment unaccompanied with pain; such as have bloody stools, as in dysentery, or long-continued diarrhœa, as young people of about thirty-five years of age; all such are in a diseased condition, dependent on the same cause. They must have laboured hard and worked much in early life; and then, suddenly ceasing from their active exertions, eating largely and of a quality different from what they have been used to, corpulence ensued, and a great change of their system must have resulted, so that no correspondence exists between their present and their former state. When any disease attacks them, as now 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. Should it occur in the intestines, a diarrhœa is induced, of a character, as to the discharges, nearly similar to the humour existing in the body. 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 its parts takes place, the lighter parts float above, and the thicker purulent parts fall to the bottom. It is on this account that in children we find the stone or calculus forming in the bladder, to the heat of which is superadded that of the whole body. In man its formation is less common, in consequence of their greater coldness. It is necessary that the heat of the body should be greatest in the growing state, and we find it coldest as an advance of life takes place, when 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 the body become.
Those affected as abovea generally recover spontaneously in forty-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 assails them. If the disease is not of long standing, and its cause is well known, a ready cure may be predicted. It must be commenced by prescribing what is the direct opposite to its exciting cause, by which means we destroy it, together with its cause. In cases where sand or gravel is deposited in the urine, there must have been originally some tumour of the great vein,b 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 urine is 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 such occur 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 with scabies. (ψωρια erosion.)
Fevers most commonly proceed from bile. There are four species, independently of such as have their origin in pain, and differ from them. These four species are denominated, synocha or continued, quotidian, tertian, and quartan. The first arises from a superabundance of unmixed bile, and its crisis is rapid; inasmuch as the body is not refreshed by intervals of calm, but on the contrary, is heated by an excessive warmth, it must necessarily soon come to an end. The quotidian also proceeds like the continued, from too much bile, though of less amount than in it: it ends in a shorter time than the two last, but continues longer than the first, because there is less bile, and also because during the intermission the body enjoys rest, which in the synocha it does not. The tertian is longer than the quotidian, being produced from a smaller amount of bile; and inasmuch as the intermission is longer than in the quotidian, so is the disease itself of longer duration. It is the same with the quartan, which is longer than the tertian, owing to its having less bile, which causes the heat; consequently the period of repose 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 the humours of the body, and that which is with the greatest difficulty evacuated. Now the proof that quartan fever proceeds from or partakes of atrabilis, is, that it is chiefly produced in autumn, and attacks principally those between twenty-five and forty-five years, the period of life in which atrabilis most abounds, and autumn is the season of the year best adapted for its production. If a quartan attacks at any other season and time of life, you may rest assured that it will be of short duration, unless some accidental circumstance should be conjoined with it.
Haller, in his preface to this treatise, states it as maintaining the intermixture of the seed of both parents; that this seed is derived from every part of them, principally from the head through the spinal marrow to the kidneys by the intermedium of the testes, and thence to the pudenda, by channels distinct from those that convey the urine. The semen is from both, both male and female, and whichever predominates, gives rise to a corresponding sex of the fœtus. 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 the uterus. Although the hypothesis is very coherent in all its parts, yet he esteems it too subtile for Hippocrates.a
As a general argument to the treatise, he tells us it consists of such particulars as have reference to venery and conception;—such as venereal pleasure, the appearance of the seed, nocturnal pollution, &c.; of the non-emission of semen, and the similitude or dissimilarity of children to their parents. These subjects are embraced in six chapters.a —Ed.
Chap. I. Of the semen; from what and whence derived. From whence arises the pleasure in venery. The cause of the spumescence or frothy appearance of the seed, and why secreted most abundantly in coition. Blood is occasionally discharged. Two passages for the seed and urine. Of the causes of nocturnal pollution.
Chap. II. Why eunuchs, boys, and young girls, do not feel the venereal 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 to generation, who have the veins behind the ears incised.
Chap. III. The female affords seed in the process of generation, but experiences less pleasure than the male. Celibacy is injurious to health, and in females is a source of many evils.
Chap. IV. By what means a woman may know whether she has conceived. The power of the seed in both sexes varies greatly. Each seed contains both male and female germs; and the stronger necessarily predominates in the formation of a boy; and of a girl if the weaker excels. A proof of both male and female germs existing in the seed of both sexes, is deduced from the circumstance that many women who had borne only girls, to one man, have, in union with another, given birth to boys; and so in the case of a man, who having only girls with one wife, has, with another, given origin to boys, or reversely.
Chap. V. The reasons assigned why children resemble, or differ in likeness from their parents; why some are small and weak, and others large and strong at birth. Among those reasons given, one is 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 its growth. Curious analogical illustration.
Chap. VI. Why and whence are constituted monsters, or mutilated offspring, even with healthy and sound parents; whilst sound and healthy children are often the offspring of mutilated parents.
Gardeil, in reference to this treatise, says, that although very concise, 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.
ON THE FŒTAL NATURE.
This treatise is by Gardeil regarded as merely a continuation of the preceding—and, in fact, whoever the author of that may be, at its conclusion he states his intention of recurring to the subject.
Haller says, that although this was by the ancients ascribed to Hippocrates, yet it is assuredly spurious, even in the opinion of Mercurialis. The system it sustains is very consistent, displays an acute acquaintance with nature, and was written posterior to Theophrastus and Herophilus. This is deducible from the great anatomical knowledge it demands, as well as from the anatomical experiments on generation, and the incubation of the egg. We find herein the account of a female musician, who, by the author’s direction, in violation of the oath, was made to abort by violent jumping, of what greatly resembled a human ovum! A mechanical explanation is afforded of sundry phenomena, through the means of breathing, and of attraction.
The male and female seed commingled, become heated, says the author, and breathing is excited, by which the cooler air is attracted, and that which was heated escapes, and thereby promotes the formation of an umbilicus. At length a pellicle is formed, and the articulations ensue in about six weeks, and aliment is received by means of the umbilicus. From the oozing of the blood a placenta is produced. At length, from want of adequate nourishment, the fœtus bestirs himself, breaks his membranes, and headforemost issues into daylight. All this is illustrated by the author from the generation of trees and fowls, who (remarks Haller) may be the same that wrote the preceding book,—for we find, in both, the two varieties of seed spoken of, from which, by different proportions and location in the uterus, a difference of sex ensues, or twins are produced. Indeed, Mercurialis considers it as a part of the former book. We find in it the book “De Morbis Muliebribus” quoted.
As the general argument or heading of the book, Haller states it to consist of an account of the procreation and principles of the fœtus, and of every thing having reference to the fœtal state of both sexes. Of the period of its formation; its various movements; of the generation of the menses and milk: all of which are illustrated by 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 point out the order of the above particulars.
Chap. I. The seed in the uterus attracts the air, and is nourished by this alternation of heat and cold. Becoming heated, it repels this air, and attracts that which is cold.
Chap. II. Of the seminal respiration, and formation and increase of 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 importance of it in the breathing and nutrition of the fœtus. When conception ensues; and what symptoms succeed the suppression of menstruation.
Chap. IV. Of the wonderful and primary formation of the fœtus and the secundines, and how accomplished.
Chap. V. Of the time required in the formation of a boy, and of a girl; of necessary lochial purgation in females, and danger from their suppression.
Chap. VI. Of the wonderful formation of the fœtal parts; how and when effected. Of the formation of bones, vessels, nerves, nails, hair, and cuticle.
Chap. VII. Of the motion of the fœtus, commencing in the male at 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, is compared 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.
Chap. IX. The health of the fœtus is greatly dependent on that of the mother. Of the situation of the fœtus in utero, and of its respiration by the umbilicus, with its similitude to the incubated egg. Of a ten-month birth and upwards, and of those below that term;—conception facilitated by menstrual purgation.
Chap. X. Of the generation of birds in the egg; air transmitted through it;a the chick excluded at twenty days. Analogy of birth in 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 a greater number.
A transient exposé of Gardeil’s division of this treatise, under twenty-two paragraphs or sections, will further illustrate its character.
Sec. I. Of the primary formation of the fœtus after coition; the importance of the breath (souffle, spiritus, πνευμα) is strongly insisted on, 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 entry of the air. Here the author recounts his examination of an abortion of six days, from a female musician, induced by powerful jumping or leaping, by his direction, in absolute contradiction to that part of the oath, by which every means of inducing abortion is prohibited. A particular detail is given of this examination.
Sec. III. The embryo is nourished by the maternal blood that goes to the uterus.
Sec. IV. Of the formation of other membranes, attached to each other, and all tending to the navel; then of the flesh. A digression on the purport and utility of the menses in females; the danger from their obstruction, and the symptoms following; all which the author will enlarge upon, in a treatise on the diseases of women.
Sec. V. Of the formation of the fœtal organs by the conjunction of similar parts, arising primarily from the parental organs; details of each.
Sec. VI. Of the period of the formation respectively of boys or girls.
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 continued increase 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 of the pubes, &c.; why it occurs only at puberty; and in females is altogether wanting on the chin, as likewise in the male, if castrated in infancy.
Sec. XI. Of the period of commencing motion of the fœtus, and the formation of milk.
Sec. XII. The nourishment and growth of the fœtus compared with the seed of plants, which develope themselves in order to give origin 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 on the fructification of trees.
Sec. XIV. Subject continued. The developements of plants by grafting explained.
Sec. XV. Fœtal nutrition resumed. Conclusion of all is, that the nature of vegetation, and that of the life of man, are perfectly analogous, 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 fœtal formation and the production of a bird from an egg. Experiments on eggs. An umbilicus in the egg.
Sec. XVIII. On parturition; causes leading thereto; time of, fixed at ten months.
Sec. XIX. Of the sources of deception which have led to the belief of pregnancy beyond ten months.
Sec. XX. Some parts recapitulated. A comparison drawn of the fœtus and the chick. Of the fixed limits of gestation in all animals.
Sec. XXI. Of labour and delivery; progress of, and results.
Sec. XXII. Of twin formations; causes of explained.
ON THE ORIGIN OF MAN.
Haller, in his preface to this treatise (which, by some, is considered as a treatise “De Principiis”), speaks of the author as a man of genius (acuti ingenii; perhaps the term of a perverted imagination would better suit); and that, so far as he could judge, the system advocated is a combination of that of Heraclitus, with that of the Peripatetics. It sets off with an exposé of first principles, of which innate heat is regarded as the chief, immortal, and omniscient. A portion of it escaping into the universal space, constituted the ether of the ancients; whilst the residue combined with the three other elements. That portion attached to the earth, by the process of putrefaction, formed small coverings, which served to invest the various organs as they were respectively produced, viz.: bones, nerves, brain, heart, vessels, &c., the formation of which are all particularly noticed. Anatomical observations, of some importance, lead Haller to suppose the treatise was composed in the period of Herophilus, when the knowledge of anatomy had greatly enlarged. The name of artery is here perhaps first given to the aorta; and reference is made to the loss of voice in those whose throats are cut.
As to the general argument of the treatise, it consists, says Haller, of an account of the principles, generation, and formation of each individual part. Of the organs of sight, smell, and hearing. Of the influence of the number seven in birth, in acute diseases, in ulcers and inflammations, and in the completion of dentition.
Gardeil merely remarks of this treatise, that in some manuscripts it is distinguished by the title of the Beginning or Principles, which is most appropriate, since it embraces the doctrine of the origin of man; a physical formation, he remarks in a note, which will unquestionably be considered as very extraordinary,—the same nearly as that which appears in the first book of the treatise on diet or regimen. It is unnecessary to give more than the mere outline of its contents. Gardeil, in a note, says, “Devois-je me dispenser d’en donner la traduction?”
Preliminary remarks as to the connexion of every thing in nature with man and animals, in relation to life, health, disease, and death. Of the creation of the universe. Of heat or fire; its immortality and universality;—the ether of the ancients. Other principles, cold or 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., and the different humours; external covering. Bone more fully elucidated. Brain, fat, spinal marrow, heart, lungs, liver, and other viscera. In what manner the air acts on the living system. Of the fœtal nutrition by suction; proofs of. Of the muscles. Some general propositions as to heat and cold, and on the nature of the blood, &c. Of the joints, the nails, the teeth, and of their nourishment, and that of all parts of the body. Of the dentes sapientiæ in the fourth septenary. Of the hair of the head, and other parts; late appearance of, on the chin, pubes, &c., explained. Of the organs of hearing, smell, sight; of voice and speech. Doctrine as to the number of months of pregnancy required to give vitality to the fœtus; how this knowledge was attained, from an examination of abortions induced by public women, and from information derived from them (some of which is confirmed to Gardeil, “par plusieurs mères d’un bon jugement;” and here Gardeil in a note remarks, that the mode of counting time by the author may greatly aid in lightening the difficulties that many have experienced, respecting the weeks of the celebrated prophecy of Daniel.) Some observations on seven, eight, nine, and ten month births. Of the numbers of critical days and periods of diseases. Remarks continued on the number seven.
ON THE SEVEN-MONTH BIRTH.
Haller appears to think that in the time of Galen, the two books, “De Septimestri et Octimestri Partu,” were regarded as one; in which he is supported by the authority of Fœsius. This production he contends, has given rise to the long prevalent opinion, that the fœtus is stronger and more capable of living when born at the seventh than at the eighth month. If not then brought forth, it languishes 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; those of ten and eleven months are better. The author divides gestation into periods of forty days, in the first of which abortion is most frequent. 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 of the number of days in which a seven-month birth is accomplished, and why vital. Of the power and pre-eminence of the septenary number in months and days. Some observations relating to an eight, nine, and ten-month birth, and of the period for perfecting a male or female fœtus. 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 perish at that period. Some of the facts noticed that are advanced by females respecting their pregnancy; and of the vitality of births at different periods. Observations to be made respecting certain days and months in pregnancy. Of the difficult gestation of an eight-month fœtus; of the time of conception, and of the sex; what credence 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 that coinciding with the eighth month, and intermediate periods; their powers respectively. Blind or mutilated at eight months, and if more difficult than those in health. Why children at nine and ten months live, and from whence the growth of body. Of critical days and months in conception, abortion, and delivery; and of forty days after parturition, &c.
In a note connected with the calculation of time, in the first paragraph, Gardeil remarks, that “it appears therefrom, that the author counted the year as being about three hundred and sixty-four days, the month of twenty-nine days nearly; and that he reckoned as months, during pregnancy, about one-half of the first and 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 twelve months of the year. Hence, in the time of Hippocrates, the Greeks were necessitated, every two years, to intercalate a month, making thereby a year of thirteen months. Their calendar, in consequence of lunar months, possessed many other imperfections.”
OF AN EIGHT-MONTH BIRTH.
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 of ten 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 the same with that of the preceding. The titles of this, and of the following treatise (on Superfœtation) scarcely correspond with their contents. They refer chiefly to parturition, and to the state of females in relation to pregnancy and conception; subjects more extensively treated of, and nearly in the same way, in the treatise on female diseases.
The general contents are the following.
Why all eight-month children die, whilst those of ten months mostly live. The most likely to survive are those born after the full complement of nine months. Of the numerous dangers of the fœtal state, at birth and subsequently. The superiority of a head presentation. Children often contract a disposition to disease in the 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 only medium of communication between the mother and child. Of the measures to be pursued to strengthen and invigorate children. Of births at ten and eleven months. Pregnancy may participate in eleven lunations, without exceeding two hundred and eighty days. Three days the shortest period of menstruation; but for the most part it continues longer. It is from the termination of this, that most females conceive; hence great variation in their statements, &c.
This treatise is considered by Haller as altogether spurious. It details several cases of difficult parturition, and speaks of the importance of the nail of the middle finger in aiding delivery. Of the death 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. Two cornua admitted to be in the uterus, by which superfœtation is explained. Many medical precepts are here repeated from the book “De Muliebribus.”
The general tenor of the book is that of superfœtation, the motion of the fœtus, the signs, the location and extraction of; and of the remedies aiding in conception; gestation, delivery, menstruation, the secundines, lochia, &c.
So far as mere conception is concerned, superfœtation may take place, but the chance of vitality is very trifling. The symptoms and causes of superfœtation. Of easy and difficult parturition, and of some circumstances that influence them. Of the signs of feeble life, or death of the infant. Of the difficult birth from the presentation of different parts of a vigorous child, and the measures to be adopted. Mode of delivery of the dead fœtus, and the importance of the nail in such cases. Of the tardy expulsion of the afterbirth, and of aiding it by means of gravitation, by the fœtal weight. Rupture of the cord, or its premature division. Signs of a dead fœtus; its putrid state, &c. Danger of hemorrhage before delivery and dilatation of the os uteri. Remarks on the state of pregnancy and difficult parturition. If conception occurs the same day, they are both enveloped in one membrane. Venery during pregnancy tends to promote difficulty of parturition. At what time to divide the cord in difficult labour. Of the signs of pregnancy, and of those of the dead or disordered fœtus, and of longing, and marking the infant; of vitiated 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 care to be taken at the cessation of child-bearing; bleeding for. Cure of the pains of pregnancy and of after-pains. Of the means to procure conception, and of the evidences of its occurrence. Causes and prevention of abortion, at two and more months. Tumefaction and ulceration of the uterus; cure of. Sterility, both in those who have and have not borne children, arising from the state or situation of the os uteri, &c.; how to treat. Spring best adapted for conception. Preparation to insure conception in the parties interested, and to attain either sex. Remedies applicable to different conditions of the os uteri. Pessaries, various; emollients, drastic purgatives; specifics, for fluor albus, &c., &c. Means of inducing menstruation, in the retention of, in virgins. Diet; ptisans; fumigations. Remedies at and after delivery, &c.
Though this is of a spurious origin, it is considered as a good practical 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 of the state of children before, and at the period of dentition, and of the crises and prognosis derived from such state, as shown by the character of nutrition, the excretions of stool and urine, vomiting up of the milk, &c., dentition, and its symptoms, and the various aphthæ and ulceration of the mouth and fauces. It occupies but a single chapter.—Ed.
OF THE HEART.
This book, says Haller, is altogether spurious, and this is admitted by Mercurialis. It appears not to have been acknowledged in the time of Galen. Haller says, Fœsius 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 their appropriate use. A portion of the fluids taken as drink, is asserted as passing by the trachea to the lungs. The maxims of Erasistratus appear to be sustained, for it teaches the non-existence of blood in the arteries. In the account of the ventilation of the blood, by means of the bellows-blowing power of the auricles, absurd as it may possibly be now regarded, we meet with no contradictions; but with a well-constructed edifice, not inferior for the period, than any that has more recently been erected, on a basis considered more firmly established, but which yet may well be doubted. The attentive reader will unquestionably wonder, at finding here so many anatomical details, especially as to the valves of the heart, with a precision not inferior to Harvey, who at least is not entitled to the discovery of this part of the vascular apparatus, nor to the pulmonary circuit of the blood!—Ed.
ON THE GLANDS.
According to Galen, says Haller, this treatise is wanting in Hippocratic simplicity, yet it is by no means inelegant, nor is it adverse to his doctrines on catarrh, as given in the treatise “De locis in homine.” Gardeil, in his translation of the book “De Articulis,” refers to this in a note, as presenting an interesting view on the subject of humoral diseases, and he concludes, from a passage therein, that this treatise 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 pretty correct. Mention is made of the mesenteric, renal, and those of joints, probably meaning the axillary and inguinal. The notice taken of the hoarseness and pectoral affections, following excision of the mammæ, is deserving of attention. The following outline will give sufficiently the character of the treatise.
Of the nature, uses, diversity, and diseases of the glands, their structure, &c. Tubercles; scrofula; inflammation, situation, &c., chiefly located in moist parts, and where hair is generated for the most part, if the moisture is not superabundant. Of particular glands, as of the neck, ear, axilla, groin, and intestines, and of their affections. Glands of the brain, which is considered as itself a gland, from whence those fluxions and affections proceed, of greater or less intensity, as apoplexy, mania, &c. Of the various passages for its abundant humours, producing externally, ophthalmia, itching, and discharges from the nostrils, purulent discharge from the ears, &c., catarrh, &c.; internally, phthisis, both pulmonary and dorsal, diarrhœa, &c. Of the mammæ or pectoral glands, affording milk in females; reasons why confined to them; diseases caused by this secreted fluid in the breasts; and of such as follow their excision, and which are frequently fatal.—Ed.
ON THE NATURE OF THE BONES.
In his preface to this treatise, Haller says that it is regarded by Galen as the work of Hippocrates, and that it was known to the ancients by the title of “Mochlicus.”a The first part agrees with its title; it is concise and not unworthy of its author, who, it may be perceived, examined the recent bones. He was acquainted, moreover, with the cubital nerve, which, when struck, produces stupor of the parts. The latter portion, which speaks of several of the vessels, appears to be an incomprehensible jumble (farrago ænigmatica). In some places a lucid description is given of four vessels, that does not tally with that in some other of his works. The epigastric and mammary vessels are noticed; likewise the vena cava, the vena sine pari, and the vessels of the extremities. Correct accounts of the par vagum and intercostal nerves, intermixed with errors. The distinction between arteries and veins is pointed out, and the name of vein, as applied to the vessel carrying blood, seems to indicate the more minute anatomy of an age posterior to that of Herophilus, the discoverer of the nerves. The version is abundantly vague. The cellular fabric of the spleen is described, and the pulsation of the vessels. Mercurialis, adds Haller, considered the account of the four pair of vessels as spurious, and as appertaining to the period of Aristotle; which caution is all that is necessary to the reader.
Gardeil, speaking of this book, says, that “its title might induce the belief, that it principally regarded the bones, but that, in fact, it more particularly is devoted to the blood-vessels.” We have here the detail of the doctrine on this subject, which is summarily given in the treatise “De locis in homine,” a work generally held to be legitimate; and also in that “De natura hominis,” the conclusion of which is thought to be spurious. He thinks, moreover, that the account 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 lost the connexion, in this embarrassing angiological detail. He is, however, more surprised to find so many facts, obtained without any aid from injections, than to meet with mistakes. I give the heads of his divisions.—Ed.
Brief enumeration of the bones. Vesiculæ seminales. The channels for drink; the liver; pericardium; intestines; vena cava, or aorta, its divisions. Nerves, their origin and division; division of the vessels to the right and left; secretion of urine; intercostal vessels; 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 of the body, and the origin of the four great vessels; first pair; second; with some physiological details concerning respiration, and on the formation of the seminal fluid, and cause of venereal gratification, &c.; third pair, distribution of; and of the changes of the colour of the skin and complexion, &c.
It will be seen from this outline, how truly Haller has applied to the treatise, the term mentioned above. Its strongly confused state is enough, assuredly, to demonstrate that Hippocrates had no hand in its production. It seems to be a bundle of shreds and patches, from different sources, and put together at random, by some person devoid of the organ of arrangement and order.—Ed.
ON AIRS, WATERS, AND LOCALITIES.
This book, says Haller, has always been esteemed as one of the genuine writings of Hippocrates. It has been commented on, and illustrated 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, and of their influence and effects. Next it treats of waters derived from different sources; incidentally adverting to calculus, as arising from their impurities, and as being less frequent in females, owing to the shortness of their urethra. It then proceeds to notice the diseases depending on different seasons of the year; and finally it treats of climates, as connected with the temperaments, customs, and diseases of their inhabitants.
Should however this book be critically examined, it will be found, continues Haller, to contain some things [many!—Ed.] that do not tally with present experience, such as the affirmed connexion between the diseases of a people and their habits and winds. Waters from earthy sources are preferred to those of rocky origin; and some subjects are singularly admitted, that are altogether undeserving of credit, yet which are apparently fully believed by the writer; particularly respecting the effeminacy and impotency of the Scythian nobles, together with the absurd treatment of the complaint, by section of the veins behind the ears! It treats cursorily also of the Amazons, and of the custom of burning off their right breast, in infancy, together with some other curious facts and speculations.
This book has been often translated, and it is incessantly quoted by medical men, when the qualities of the atmosphere are the subject of investigation. Dacier has translated it into French, but I have 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 no means neglect the subjects I am about to consider. The different seasons of the year, and what each is capable of effecting, will prove a source of reflection to him. They differ altogether from each other. Diversity exists in their respective constitutions, and even in their individual variations. We study the winds both as to heat and cold; those that are common to all countries, and such as are peculiar to certain regions. We ought also to examine the properties of the waters; since all are not alike in taste or gravity, so neither are they in virtues. Whoever, therefore, arrives at a town, of which he is not an inhabitant, should begin by regarding its position in relation to the winds and to the rising of the sun; he will not consider it as a matter of indifference whether its exposure is to the north, the south, the east, or the west; on the contrary, he must have a strict regard to its position, and to the nature of its waters; 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 for cooking vegetables. He should inspect the soil, and notice whether it be naked and arid, or covered and moist; if sunken and sultry, or high and airy. He should investigate the mode of living of the inhabitants, 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 with all of them fully acquainted, or at least of the greater part, will learn, when arriving at a town he has not frequented, the nature, both of the endemic diseases and of the general affections that should there be prevalent. He will not be unprepared for their treatment, nor will he commit those errors to which all are liable, who undertake to practise without these preliminaries. He can foretell what diseases ought to afflict the majority of the inhabitants in different seasons, in winter or in summer, and the danger to which they are exposed by a change of diet; for, if well acquainted with what such changes induce by the succession of the seasons, and the rising and setting of the stars, he will be enabled to foresee the constitution of the entire year. Acquiring thus a component knowledge of these different subjects, he will distinguish what is essential for the maintenance or re-establishment of health, and will prove highly successful in the practice of his profession. Should it be objected, that the information I thus require, appertains to meteorology, I reply, that a knowledge of the situation of the heavenly bodies is not one of the parts least essential to form the physician; on the contrary, it is highly useful. The succession of the seasons is accompanied with remarkable changes in all the cavities of the human body. I shall, therefore, state as clearly as I can, what regard we should have to all these circumstances, and what we may deduce therefrom.
A town exposed to the hot winds that blow between the rising and setting sun of winter, viz., from the south, and which are common to it, whilst it is protected from those of the north; such town has abundance of water, slightly saline, and arising necessarily in elevated places; hence they are warm in summer, and cold in winter.a If the summer is dry, diseases are of short duration; but if wet, they are of longer continuance. From the most trifling causes, wounds degenerate into eating ulcers. If the winter is cold, the head abounds with moisture and pituita, which fall upon the bowels, and often induce gastric affections. The constitution of the inhabitants is in general relaxed. They are neither great eaters nor hearty drinkers, for they who have weak heads can never make stout topers, since wine readily overpowers them. Now the following diseases are there the most common. Women are subject to catarrhs, and many are barren, rather from disease than from nature; abortions are frequent. Children are subject to convulsions and suffocations, that are often confounded with epilepsy. The men have dysenteries, diarrhœa, and epial fevers,b eruptions like flea-bites, chronic fevers of winter, and hemorrhoids. Few pleurisies are there seen, or peripneumonies, ardent fevers, and other 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 renders them epidemic. After fifty years of age, they are exposed to a kind of humour coming from the brain, which, if arrested, brings on palsy, or affections from the rays of the sun, or colds in the head. 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 winds are cold, and usually blow from between the east and west, that is, from the north; and which are free from both south and all hot winds, have this in common. The men there are strong and not very fat; with large breasts and small bellies; they abound with bile rather than with pituita; their head is sound and dry, and they are subject to hemorrhages. The following diseases are there common. Pleurisies, and all diseases called acute, as must necessarily be the case, the belly being hard and constipated: internal suppuration is not uncommon, depending on the distension of the body and dryness of the belly; this dryness co-operating with the coldness of the waters, occasions ruptures of the vessels. With such constitutions, they ought to be great eaters and moderate drinkers, for it is scarcely possible to combine both in one person. We also find there, dry and violent ophthalmias, which soon run to suppuration; 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 do not inflame nor take on a bad state: the manners are rather rude. Such is the state of things, independently of diseases induced by change 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, but abortions rare. After delivery, the mothers can rarely nourish their 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 disappears as they advance to maturity; puberty is, however, tardy.
Thus far I have stated what has reference to towns exposed to hot winds, between the beginning and ending of winter, and those of an opposite direction, blowing between the rise and termination of summer. We are now to speak of cities located towards the east. Such ought necessarily to be more healthy than those having a north or south exposure, although lying between both; for the heat and cold are there less felt, and the waters, whose springs are exposed to the east, are quite clear, soft, inodorous, and pleasant to drink: the morning sun, by its rays, purifies them as it does the air; hence the men have a good colour, and much vigour, unless affected by sickness; their voice is clear, and they are more lively and intelligent than the inhabitants of a northern exposure. The productions of the earth moreover are superior. In a town thus situated, in which the heat and cold preserve the temperature of spring, diseases should be mild and few in number. They are chiefly of the same character with those in cities looking towards the warm winds. The women are very fruitful, and have easy labours. Such are the circumstances in such exposures.
As to places looking to the west, and which feel no winds from the east, but are exposed to those from the north and south, their position beyond all others is most favourable to disease. The waters are not clear, because the morning air, usually surcharged with moisture, prevents their limpidity, the sun dissipating it only after it has advanced in its course. During summer, the early breezes cause an abundant dew, whilst during the remainder of the day, the heat scorches and oppresses the inhabitants. Hence their complexion is bad, and they have little vigour; they are liable to every disease I have mentioned, without an exception; their voice is hoarse, owing to the air, infected with the miasmata of disease, and from which it is not purified by northern winds. Those which blow, are charged with moisture, for the western winds place the atmosphere in a state resembling that of autumn; and a town thus situated, therefore, partakes of all the inconveniences which the evenings and mornings bring with them. Such are the remarks 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 state of our health. All waters that are stagnant, muddy, marshy, are necessarily heating. They are always thick, and smell badly in summer. As they have no current, and are maintained by the rain alone, they must naturally be of a bad colour, heavy, and bilious. Cold and frozen in winter, and disturbed, sometimes by snow or ice, they become a source of pituita and catarrh to those who employ them; they enlarge and indurate the spleen; they heat and constipate the belly; they cause a shrinking of the shoulders, the neck, and the face; the flesh seems to disappear in order to augment the spleen; hence men become thin although great eaters and drinkers; their belly is with difficulty discharged either upwards or downwards, so that they require powerful cathartics both in winter and summer. They are subject to dropsies, which are mostly fatal; and dysenteries, diarrhœas, and obstinate quartans are common in summer. These diseases naturally lead to dropsies terminating in death;—such then are the summer affections. In winter, young people are subject to peripneumonies and to diseases accompanied with delirium; and old people to ardent fevers arising from costiveness; women, to œdema and leucophlegmasia; they are not readily rendered pregnant, their labours are difficult, and their offspring gross and œdematous; they nourish them with difficulty, for suckling induces phthisis; their lochial discharges are imperfect; their children, especially the males, have hernia and varices of the legs. It is easily seen, that with such waters, long life 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 where there are warm springs, with metallic impregnations of iron, copper, silver, gold,—or of sulphur, alum, bitumen, or nitre; for all such are the products of a violent heat. In such situations the earth 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; such are soft and clear, and bear to be mixed with wine. They are warm in winter, and cool in summer, as is the like case with deep springs. Those are preferable that flow towards the east: they are always 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 which they are useful, as I shall presently notice. We ought to regard as the 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 the south: they are bad in proportion as they look to the south, between the 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 healthy man may dispense with a choice of waters, and be satisfied with such as he can procure; but when, from disease, the most appropriate drink is requisite, the following plan is to be pursued. If the patient 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 render them much better fitted to dry than to moisten the belly. All here mentioned is correct as to spring water. Let us now consider that of rain and melted snow.
Rain water is light, sweet, thin, and limpid; the sun carries off and raises the essence or lightest part of such waters, as we see demonstrated in making of salt; the dense and heavier parts remain and form salt, the lighter parts are raised by the sun, which deprives also, not only stagnant water, but also sea water of its lighter parts, as well as every thing that is usually moist. Now all bodies possess moisture; even from man himself, the sun carries off a slight dew, as we clearly perceive when he is walking or exposed to the sun; those parts of his body that are covered are moist with sweat, whilst the uncovered parts are dry, because the rays of the sun carry off the sweat as it forms, but suffer it to collect on the former, if protected by covering or in any other way: the heat of the sun forcibly abstracts the sweat, but the covering precludes evaporation. If he goes into the shade his whole body is covered with sweat, because the rays of the sun are prevented acting on it. Rain water readily corrupts and acquires a bad smell, owing to its being constituted of emanations from all sorts of bodies, whence a great disposition to putrefaction results; moreover, these vapours raised from bodies are carried to the highest parts of the atmosphere in all directions, and mix with the air; those that are thick and darkest, 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 thus collected together, they break when approximated by opposite winds; for it is highly probable that this happens whenever clouds, agitated and driven on by the wind, suddenly meet with others impelled in an opposite direction. They intermingle and become thicker by those succeeding; as they thicken they grow still darker, and at length break, precipitate by their weight, and fall down as rain. This rain water is very good, but requires boiling to divest it of its tendency to putrefaction and to a bad odour, and makes the voice of those who drink it thick and hoarse.
Snow and ice water are always bad. When water has been frozen, it never assumes its first nature. Its limpidity, mildness, and softness are separated and dispelled, its coarser and more fixed parts remain. To be convinced of this, place, if you choose, in winter, a certain measure of water to freeze; melt it again the next day in a sheltered situation, and measure it; it will be found to be greatly diminished, and hence it results that the lightest and most attenuated parts are dissipated, for it is impossible it should be the coarser and more ponderous. We may therefore conclude such waters to be injurious, and here we leave them.
Men are liable to the stone, to nephritis, colic, and strangury, to sciatic pains and hernia, when they employ as drink waters of different nature, as of large streams into which rivers empty, or of lakes which receive different rivulets; and generally from drinking water coming from a distance, for it is impossible that all waters can be alike. Some are soft, others saline, some aluminous, and some arise in places abounding in warm springs. When waters so various are mingled together, they necessarily act on each other; the strongest prevails, but it is not always the same one that is the strongest, sometimes the one, sometimes another. Besides, the winds then produce great changes; those from the north give a greater power to the one; from the south to another, and thus of the rest; they ought, consequently, from their intermixture, to deposit sand in the vessels of the bladder, and produce in those who drink of them the disease I have mentioned. Let us see why all are not thus affected. Those whose bowels are relaxed and moist, whose bladder is but little irritable, and have a large orifice, such persons pass their urine readily; but those whose belly is very hot, have the bladder necessarily in a like disposition, and when thus heated, its neck is equally so; hence the urine cannot so readily escape; 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. By motion in the bladder it attaches that which from time to time is deposited; thus it augments and forms a calculus. When the person makes water, the urine propels the stone to the orifice of the bladder, which arrests its flow, and causes severe pain. It is on this account that children with calculus pull forward the penis, striving thereby to displace the obstacle that prevents the urinary discharge. A proof that the stone is thus produced, is, that persons thus attacked, pass limpid urine like whey, nowise earthy nor gravelly; the thick and bilious parts remain in the bladder, and uniting, form at last a stone. It occurs also in infants, from their milk, when that is unwholesome, bilious, and heated; it induces heat of the bladder and intestines, and the urine becomes scalding. I affirm that it is better to give them wine well diluted, than such milk, for it dries the vessels less, and induces less heat. It is different in women; in them the urethra is shorter and larger, hence they make water more readily; nor do they thus violently rub the parts, as boys do, to enable it to pass, and consequently do not irritate the urethra opening in the vagina. Women having such a ready passage, generally void more urine than men; and these are probably very nearly the circumstances connected with the formation of calculus.
As to the constitution of the year, we may by attention discover which will be healthy or the reverse. Whenever the signs or phenomena correspond with the setting or rising of the stars, when the autumn is rainy and winter moderate, neither too dry nor too cold, when occasional showers fall in spring and summer, such a year ought naturally to be very healthy.
If the winter is dry and constantly chilled by the north wind, the spring 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 a spring, the body should not be overloaded with bad humours. Hence arise acute epidemic fevers, more common to those who abound in pituita. They will likewise have dysenteries, as well as those of a moist temperature. If at the risinga of the Dogstar rain should abound, and if the Etesian winds from the northeast fail not to come, it may be hoped that the diseases will terminate, and autumn prove healthy; if otherwise, there will be great mortality amongst women and children, but not amongst old people; fevers will degenerate into quartans, and terminate in dropsy.
When the winter is moderate, accompanied with showers and south winds; when spring is dry and cold, with north winds, pregnant women, who expected parturition in spring, miscarry, or else the offspring are weak and unhealthy, and soon die; or should they survive, 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, will have catarrhs, resulting from the pituita flowing from the brain. Bilious persons will have dry ophthalmias, owing to the heat and dryness of their flesh. Old people will have catarrhs, dependent on tumid and enlarged vessels, so that some will be carried off rapidly in a state of frenzy; others fall into palsies of the right side; for the winter being warm and rainy, neither the body nor the vessels 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 and hoarseness, becomes stuffed up and swells, so that when the summer heats arise, great and sudden changes ensue, with diseases ending in dysentery and dropsy, because the belly cannot readily become dry.
When the summer is rainy, accompanied with south winds, and autumn 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 pleurisies and peripneumonies. If summer is dry, with north winds, and autumn rainy, 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 rising of the Dogstar and Arcturus, at the close of summer and beginning of autumn, it is favourable for people of moist temperament and for women, but the reverse for such as are bilious. It dries them too much, and gives rise to ophthalmias and acute fevers, to chronic fevers and to atrabilious complaints; for the more watery parts of the 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; they lose their excess of humidity, and are thus in a good condition at the arrival of winter.
Whoever will consider all the above circumstances, and pay attention to them, may predict the greater part of the evils induced by the change of seasons. He must be guarded at the epoch of such great changes, not to give purgatives too freely, nor apply fire near any cavity, nor make incisions, until at least ten days after such changes. The two solstices are dangerous, especially that of summer;—the two equinoxes are likewise to be feared, particularly that of winter. The rising of the constellations should also be noted, particularly the Dogstar, then Bootes; and Pleiades at their setting; for on those days many diseases terminate, fatally in some, in others in health. Every thing assumes another aspect, and undergoes a change. Thus much on this subject.
PARALLEL BETWEEN THE ASIATICS AND EUROPEANS.
I wish at present to notice wherein Asia and Europe vary, and explain why their respective inhabitants so widely differ. I should be too prolix were I to speak of every particular diversity, and shall therefore mention only those principal points which appear most deserving of attention. I commence by observing, that Asia greatly exceeds Europe in respect both to its vegetation and its inhabitants. All is larger in Asia, and the country is milder,—the people are less active and more effeminate. The cause of this is to be found in the constitution of the seasons. Asia is located between the two extremes of winter and of summer, and therefore removed from the extremes of heat and cold. Every thing there increases greatly, and has a character of mildness, and of a just medium. It is not so, however, in every part of Asia; I speak only of that portion located intermediately between the two extremes above-mentioned. It is, moreover, abundant in fine fruit and beautiful trees; its sky is serene; there is abundance of water, both of rain and from springs, so that the country is neither scorched, dried up, nor affected by severe cold. It is sufficiently warm, and moistened by rain and snow; the seeds of fruit are there developed, and by means of culture and of grafting, man has ameliorated, and fitted them for both 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 country ought to have, naturally, a good soil, and an equable temperature in each season; but courage, patience, steady application, and firmness of mind, find no existence there, nor can the love of their own species 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 and to Lybia.
With respect to those who dwell on the right of the rising of the summer sun, to the Palus Mæotis, which separates Europe from Asia, they differ more from each other than those I have spoken of, both in regard to soil and climate. As elsewhere, whenever the seasons are more variable in degree or frequency, there the country is more wild and irregular. There we find mountains, forests, heaths, and meadows; and somewhat similar is seen in man, if closely observed. The nature of some resembles the mountains, forests, and rocks; others are like plains in fertility, and partake of the humid nature of meadows and marshes; in others again, we recognise the character of a dry and arid country. The various seasons of the year affording diversity of form, have, in their succession, many differences; and these variations are productive of as many peculiar and distinct constitutions. I say nothing of those countries that differ little from each other; I speak of such only in which nature and customs have established well-marked differences.
We commence with the Macro-cephali. No other people have such elongated heads. It is an ancient custom that gave rise to this, and nature concurred in the practice. A very long head is esteemed a mark of distinction: this opinion led them to compress their children’s heads with their hands, as soon as they were born, and whilst the bones were flexible; aiding this elongation by means of bandages and other measures adapted to destroy a spheroidal form. Such practice was at first the only measures pursued to produce this form, and time has insensibly rendered it natural; so that 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 send particles that are equally so; hence, bald fathers usually propagate bald children; those with blue eyes, get children with eyes of a similar colour; the lame beget lame children. Why then should not those who have long heads beget macro-cephali? Although at present, not perhaps for a like reason, because all customs become neglected and lose their power. This is my view as respects the Macro-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 about in boats formed of a single log (canoe), traversing the canals that every where abound. Their drink is the warm stagnant water of the falling rains that the sun has corrupted. The river Phasis itself is one of the slowest, its flow being scarcely perceptible; the fruits are unhealthy, soft, and imperfect, owing to the moisture, nor do they ever come to maturity. Thick clouds perpetually arise and fill the atmosphere; and these are the causes of the difference of the Phasians from other people. They are tall and very fat; no joint 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 mostly blow from the south, with one exception, appropriate to the country, called Cenchron, which is sometimes very violent, powerful, and hot: the north wind is rare, and when it blows, it is moderate and scarcely perceptible.
After what I have said as to the difference in the nature of the inhabitants of Asia and Europe, it follows that the former, possessing neither vigour nor courage, must be less fitted for war than the Europeans; whilst their manners are at the same time more amiable. We must attribute this to the seasons, as being less variable and less liable to great changes from cold to heat, and the reverse; 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 seasons is very variable, for all changes are the causes which most excite the 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 we are not our own masters, but receive laws from a despot instead of framing them ourselves, we cannot feel much disposed for war, but prefer peace, for the dangers are unequal. On the one hand, we must take the field, undergo fatigue, and die far from home, from wife, children, and friends, to satisfy the will of a master. On the other hand, any extraordinary action we perform is altogether for the advantage and aggrandizement of the sovereign. He alone receives the reward of danger and of death. If then amongst such people one should grow up courageous and brave, his courage would become enervated by the laws under which he would have to live; a proof of which is, that all the Greeks in Asia, as well as those barbarians who are not subjected to a master, who make their own laws, and labour for their own advantage solely, are warlike, inured to hardship, and are very brave. It is for their own profit that danger is encountered, for they know that they will enjoy the fruit of their courage, and that they will suffer from the effects of cowardice. In Asia we find the people of a character altogether different, though some are braver than others; and these differences depend chiefly on the seasons, as I have endeavoured to demonstrate.
Among the nations of Europe we find the Scythians, living near the Lacus Mœotis, 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 their virginity until they have killed three of them, nor cohabit with a husband before performing certain prescribed ceremonies. After this, 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 their mothers in infancy, by means of an appropriate heated copper instrument, by which the nourishment and strength of the shoulder and arm are greatly increased. Although the various Scythian tribes resemble one another, they differ greatly from all other nations. 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 in meadows, very bare, and considerably humid. It has large rivers, into which its waters are received. In this, those Scythians called Nomades, dwell, not in houses, but in chariots, covered with skins, the smaller of which have four, the larger six wheels. Some have but one apartment, others three, resembling in construction a house; and they are well secured against the rain, cold, and wind; and are drawn by two or three pair of oxen, without horns, which are hindered from growing by the cold. The women live in these cars; the men mount their horses and camels, and are followed by their flocks, oxen, and horses. So long as sufficient herbage is found for their cattle, they remain in the same place, and when this is exhausted they remove to another. They feed on baked flesh, and drink mare’s milk, of which they likewise make a sort of cheese called Hippace. Such is the mode of life of this wandering race, 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 the northern blasts; the region being but slightly under the solar influence, and that chiefly during the summer solstice. Southern gales are rare and faint, but those from the north are violent, with snow, ice, and rain. They rarely quit their mountains, which are habitable only to a south exposure. Dense clouds arise during the day, with great humidity, so that winter seems almost perpetual; the summer heat is moderate, and of short continuance. The plains are elevated and barren, and not protected by the 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; being open and flat, they cannot readily conceal themselves. The change of seasons is not considerable, being nearly alike,—and hence there is but little variety among the people; they employ the same food and clothing both in winter and summer; the air they breathe is damp and heavy; their drink is chiefly the water from ice or snow, and they exercise but little constancy in labour. It is hence impossible that either mind or body should be vigorous, and consequently the inhabitants of those countries are thick and heavy, their limbs flabby 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 greatly alike. There being so little change of seasons, there can be but a slight alteration or change in the semen of the parents, except induced by some accident or disease. I will state a manifest proof that moisture predominates, at least among the Nomadic Scythians. The greater number of them exhibit marks of burning on the shoulders, arms, wrists, breasts, thighs, and flanks; they burn those parts only to correct the humidity and softness of the flesh. They cannot, in their natural state, either draw the 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 the muscles; the body consequently is better, and the joints become stronger. In Scythia the men are fat and large, because, as in Egypt, they are not in infancy swaddled and bandaged; moreover, they are always on horseback or in cars, and until fit to ride, the boys live a nearly sedentary life, walking but little even in their journeys.
The women are astonishingly fat and large, generally ruddy from the cold, which gives that hue to their fair skin. Such a nation cannot be prolific. Men of a cold climate, delicate, and with relaxed bowels, can have but few desires for coition, independently of the enervation caused by constant equitation, which unfits them for the act of generation. So much for the male sex. As for the women, their fat and corpulency obstruct conception, their menses flow but rarely and in small amount, the mouth of the uterus, closed by fat, can neither attract nor retain the seed; want of exercise renders their bodies flabby and weak; the abdominal viscera are cold 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 become impotent, and that then they perform the duties of women; they acquire their tone of voice, and are called effeminate. The inhabitants ascribe this misfortune to the gods, and honour those thus affected, and fearing that the same may happen to them. For my own part, I believe that this affection, like every other, comes from God; none are properly the work of man, but all spring from Him. Every disease has its own particular mode of production, in which the above-mentioned participates, from natural causes: thus we find them always on horseback; their legs hanging down, fluxions to those parts necessarily ensue, which cause lameness, and a dragging of the limb as the disease advances. To cure this in the commencement, they open a vein behind each ear, suffering the blood to flow until much weakened, and sleep ensues. On awakening some are cured, others not. Now I apprehend, they lose their virility by this treatment, for we have veins near the ears whose section causes impotency, and I suspect they cut these. When, therefore, they desire to approach their wives, they find themselves incapable. At first this gives them little concern, but after three or four attempts, finding the evil to continue, they conclude that they have offended God, and to this they attribute it. Assuming now the female dress, they thereby proclaim distinctly their impotency; they live like the women, and perform their duties. This occurs among the rich and most considerable of the Scythians, such as are always on horseback, and possessed of large flocks, and not among the poorer classes, with whom it is uncommon, for they rarely ride. Now if this evil proceeded particularly from God, it ought 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 means to offer numerously; not so the poor, who even blame the gods for the misery they endure, so that on this score the evil should rather fall upon them. But it is with this as with all other diseases, which I have already remarked as beyond doubt coming from God, each one according to its peculiar nature. The cause productive of that of the Scythians, appears to me to be that I have stated; it operates equally on others. It may be observed that they who are perpetually on horseback, are subject to fluxions in the thighs, pains in the feet, and that generally they are little fitted for the battles of Venus. Such are the Scythians, and of all men, they are the least ardent 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 for lascivious feelings; besides which, the cold and fatigue prevent those 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 and form, owing to the great and frequent changes of the seasons, extremes of heat and cold, great rains and extreme droughts, with winds from every quarter. It is natural that men should feel this influence, and that the semen should differ in summer and winter, and in wet and dry weather. Hence we do not notice among Europeans 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 be the case if the seasons were uniform, or approaching thereto. It is the same as to manners. A rough unpolished state, with violent passions, ought to prevail where changes of seasons are great. Strong impressions induce somewhat of a savage character, and dispel mildness and tranquillity. It is on this account, I apprehend, that Europeans are more courageous than Asiatics. Uniformity of seasons induces indolence, the reverse strengthens both mind and body. Cowardice follows in the train of indolence, courage in that of exercise and labour. The Europeans ought therefore to be better calculated for war; their laws likewise co-operate, which do not, as in Asia, emanate from a king, for where kings have sway their courage is restricted. I have before said that minds enslaved will not naturally expose themselves to danger. Those on the contrary who are their own lawgivers, and encounter danger for their own advantage and not of others, do this with pleasure, and support labour readily, because they partake of the benefit. It is thus the nature of the government tends to promote courage, and we see in this respect a vast difference between Europe and Asia. I remark, in addition, that generally the European nations differ from each other in size and form for the same reasons, and equally so do they differ in respect to bravery. We notice, for example, that those who inhabit mountainous, barren, rough, and arid countries, with very variable seasons, are naturally tall, laborious, and brave; their character is wild and savage. In valleys and meadow countries, in close situations with warm exposure, man is neither so tall nor well proportioned. 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 large streams to convey away the rain and water of their lakes, and using stagnant water for drink, their complexions are inferior to those under opposite circumstances, and their spleen is affected. Those who live in open upland situations, exposed to the winds and moisture, are large and resemble each other; they are well proportioned and gentle in disposition. Such as reside in dry and open countries, with great changes in the seasons, have firm and robust bodies, with complexions fairer, manners free, unbridled passions, and strongly self-opinionated; for wherever seasons are very changeable, there we find great variety of figure, temperament, manners, and customs. The difference in the seasons may be set down as the principal cause of difference in the nature of men; next follows the situation and nature of the soil, and the quality of the waters. Wherever the earth is rich, loose, and moist, the waters high, in summer warm, and cold in winter, with equable temperature 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, the country is open, rough, and difficult of access, oppressed by cold in winter, 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 upon the 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.
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, (“bonique ordinis liber.”)—From one single principle, viz., flatus, the author with much skill has deduced doctrines of great consistency, and explains the origin of all diseases, from an error loci of this flatus. Some of the opinions of Hippocrates are advocated, but others are opposed, especially as to catarrh, as laid down in the book, “De locis.” The origin of the Pneumatic Sect is considered as here being first embodied.
The argument of the book is, that air penetrates and permeates all bodies, and that through its agency the causes of most disorders is explicable. Various modes of the generation of diseases are herein pointed out.
Whatever may have been the opinion of Haller as to the merits of this treatise, it has, however, been attributed to Hippocrates by Erotian, Galen, and other writers; some of whom have esteemed it as 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 whomsoever written, it is one of the most ingenious and well-arranged of all the treatises that have reached us, under the name of Hippocrates. It cannot 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 the blood was not, at that distant period, understood, precisely as it is now 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 men of those days; and that the pulse was sedulously attended to, and perhaps more correctly than at later periods. Gardeil terminates his translation of the treatise with a remark, that “after reading it, a person might be led to think he had been perusing some new thesis, composed and maintained by some systematic physician of the 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 a few words, the doctrine of the unity of disease, as more fully laid down and elaborated by the late Professor Rush, and even conveying, in the concise manner employed, the whole force of Dr. Rush’s more profound illustration of a doctrine he regarded as altogether his own, and as such, taught it in the University of Pennsylvania.
As in the preceding treatise, I propose to give merely an outline of the contents that may be looked for at large in the treatise itself.—Ed.
Preliminary remarks relating to the difficulties and disagreements in medicine. The art of medicine is one of the most laborious to the practitioner, although beneficial to the community. The influence of opinion on it. Attempt to reduce it to one general principle. Whatever is injurious is disease, and is to be removed or cured by contraries. Wherein medicine consists, and what constitutes the best physician. The essence of all diseases is one and the same.a Diseases differ merely in location, which alone causes the diversity of forms they assume.—Of the triple nutriment of animal life, viz., food, drink, and air. Distinctive appellation of this last, according to its relative situation, viz., spirit, air, flatus, wind; and of its absolute necessity, both as the cause of life and of disease. It is one of the principal agents of the animal economy, and of nature at large. It is essential to combustion, and to animal life, even to that of fish; in short, there is nothing that does not feel its influence. It is equally the cause of disease, as of life; food and drink may be 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 the production of fever, which is an accompaniment of most diseases, especially of such as are conjoined with inflammation. Fever, it is remarked, is twofold, common and particular. The first is general, attacking all indiscriminately, and is therefore denominated epidemic; the latter attacks such as are inattentive to their diet and mode of life. Remarks on each of these succeed, and an inquiry entered 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 is given, conformably to this doctrine of pneumatism, such as of the uneasiness and pains, chilliness, headache, and throbbing of the temples, &c., that precede or accompany fever. The same principles are applied to other diseases, as volvulus, colic, tormina,—all which arise from flatus; as well as catarrh in all its various forms of fluxion, viz., ophthalmia, cough, hoarseness, hemorrhage from the breast, dropsies, ruptures, apoplexy, epilepsy, and many more. The symptoms, causes, and cessation of epilepsy; and much stress is laid on the attention necessary in blood-letting; of its injurious influence when the blood is unduly perturbed, as seen in drunkenness, insomnia, &c.; its influence in the operations of reason is pointed out, and its state of purity or otherwise is noticed; whilst the inequality of its circulation is at times productive of every irregularity. All this is attributed to flatus, and is duly explained and illustrated. Ultimately it is added, that flatus appears, under numerous aspects or modes, to be the cause of diseases; other causes also 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.
Haller considers this treatise as differing greatly from the genius of Hippocrates, being chiefly speculative. The reader is fatigued by the attempt to demonstrate that epilepsy does not originate from the anger of the gods, but from humidity of the brain. It might, he thinks, be regarded of a later period, because in the comparison drawn between the human brain and that of animals, a less degree of anatomical information is conspicuous; whilst the nature of the disease is apparently deduced from experiments of incising the brains of sheep and goats. A tolerable description of the veins is given. That system seems to be adopted, which derives diseases from 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 some towering superstructure is erected, we may affirm, that admitting those of the present book, its superstructure is as admirably constructed as that of any theory of the present day, on this or any other subject. The irony of the author is highly amusing, and his respect for religion is not less exemplary.
Pursuing the plan of the preceding books, we give a concise outline of the various parts, premising that the treatise contains the description of the epilepsy, or morbus sacer—its name, nature, subjects, seat, causes, attack, symptoms, signs, treatment; and proposes sundry problems respecting it.—Ed.
Epilepsy is a natural disease, and has in it nothing more sacred or 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 other affections, are not less astonishing than epilepsy. Ignorance clothed itself in the mantle of religion, which was chosen as a mark of separation from the general community, and the people were deluded by a host of knaves, who endeavoured to persuade them that they held communion with heaven, and were better informed than mankind at large. Unable to prescribe usefully for this complaint, they asserted its sacred origin, and made its cure to depend on purifications and expiations, together with the interdiction of sundry kinds of food, both animal and vegetable. The patient was clothed in black, the colour of mourning; and strict regulations were given even 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, cannot be divine, nor does he imagine it was really so regarded by these quacks themselves, who seek only to deceive, by giving out for truth, what they had no knowledge of; and their pretended piety was the mere mask of religion, by which the power of divinity was made subordinate to the will of man! The deities to whom the disease was attributed, are stated as Cybele, Neptune, Proserpine, Apollo, Mars, and Hecate; and which of these was the source, 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 era of 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 at times, it is connected with pituita rather than bile, and is dependent on a peculiar constitution of the brain. A general outline of that organ is presented, its vascular distribution, and its torpor at times by the air or circulating flatus being impeded in its passage, and producing undue pressure on a part. The doctrine of the preceding treatise is consequently here advocated, and its influence in epilepsy is fully explained. Epilepsy, we are informed, attacks the fœtus (in utero, both healthy and unhealthy), if its brain be not properly emulged, and which thus becomes choked up by pituita, by which the regular play of air is precluded, followed by retardation of the blood, &c.,—of all which the symptoms are enumerated and explained, and also at a posterior period of infancy; in all which the air or flatus is seen to bear a principal and energetic part. Its effects 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 to attack after twenty years of age, unless in such as had it in infancy. Some animals, as goats, subject to the disease. Inveterate epilepsy absolutely incurable. An attack of epilepsy often foreseen by the patient. Influence of certain winds in producing it. The brain is the seat of all mental affections. The functions of that organ at times sound, at others depraved. Some remarks on mania. External effects produced by the operation of the mind in dreams. Of the vast empire of the brain in man; how it is operated on by the air. The diaphragm is not the seat of sentiment or intelligence—the name is therefore inappropriate;—nor is the heart the seat. The vessels of all the body go to the heart, and have a connexion with 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 any other disease, but is produced by similar causes; and that in its treatment, attention is to be paid to circumstances, without any reference to lustrations, purifications, or witchcraft. The following expression, towards the conclusion, may perhaps be deemed the prototype 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.
[a ]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 ætiology—or what has reference to natural causes.
[a ]Melissus, according to Galen, affirmed that only one element existed, which, nevertheless, he divided into four others.
[a ]The early credence of the necessity of an admixture of the seed of both sexes is here evinced—as also in the treatise on Generation,—without recurrence to the absurd doctrine of sympathy, &c.
[a ]This seems to be the origin of the doctrine of the “strictum et laxum,” about two centuries ago.
[b ]Πνευμα, spiritus, Hal.—Souffle, Gard.—Something contained in it, in order to sustain life.
[a ]Venæ crassissimæ, Fœs., Hal.;—φλεψ παχυς, Hipp.;—φλεψ, vena animalis, item aquarum et similium, Dict.
[a ]Query: if something is not here lost; can this apply to persons affected as detailed above?—Ed.
[b ]Query: the ureter, which is elsewhere so denominated, as likewise by Celsus.—Ed.
[a ]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 the propagation of the fœtus, or whether she acted only as a nidus, or location for the offspring of the male seed. To say nothing of the similarity of features in the child to the mother, which could scarcely ensue, unless in part derived from her, independently of mere nutrition subsequently to its procreation; Galen maintains that the female could have no venereal propensity, did she not possess the faculty of emitting seed; and we are expressly told in the Scriptures, that the seed (or issue) of the woman (Genesis) should bruise the head of the serpent. Now, as man had no part in the 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 production of hers could in no wise be appropriately called man, had man or woman no part in the mysterious propagation! It is in any other view, altogether of Divine origin; and the “Man Christ” (Tim. ii. 5) seems anomalous!—Ed.
[a ]Vide treatise de aquis, aeribus et locis.
[a ]In my inaugural Thesis on Inflammation, 1794, I had occasion to refer to some experiments I had made on the subject of the air which is always found in the larger end of the egg, and which I found to consist principally of oxygen in the early stage of incubation, and, gradually deteriorating, containing more or less of carbonic acid gas, as the incubation proceeded;—from which I was led to infer the analogy of this 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 of vital air to the chick in ovo, cut off from all maternal connexion, must be admitted, in order to perfect sanguification and circulation, whilst enclosed in its calcareous envelope, even if we cannot fully comprehend the process pursued by nature, to accomplish the wonderful end she proposed to effect.—Ed.
[a ]We have a treatise by this name in the sixth section, hereafter noticed. The term is derived from μοχλια, i. e. ossis, aut ossium a loco qui præter-naturam sit, ad naturalem reductio;—which word is itself derived from μοχλος, vectis, i. e. the apparatus by which the reduction of a luxation was accomplished.—Ed.
[a ]On 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 waters are 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.
[a ]Exortum, Hal., Fœsius; sitting, Clifton.
[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 unity of disease is here unquestionably sustained, or I am altogether mistaken as to the tenor of the entire passage, which is correctly rendered from the Greek text.—Ed.