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OF THE EMPLOYMENT OF LIQUIDS. - Hippocrates, The Writings of Hippocrates and Galen [1846]

Edition used:

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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OF THE EMPLOYMENT OF LIQUIDS.

DE LIQUIDORUM USU,FŒSIUS, Treat. vii. p. 424.
DE LIQUIDORUM USU,HALLER, iv. p. 230.
TRAITÉ DE L’USAGE DES LIQUIDES,GARDEIL, iii. p. 143.

Haller, in his preface to this treatise, tells us it contains ten aphorisms from the tenth book (No. xvi. to xxvi). Something is said of wines and vinegar. It was read by the ancients, who occasionally extracted from it, though without quoting the title. It is amongst the shortest of the tracts, and nearer than many to the original tracts of Hippocrates.

Subjects considered.—Of the effects and powers, &c., of warm and cold waters, wine, vinegar, &c. Of the effects produced by warm rather than cold water, and on what parts.

Chap. I. Of the powers and uses of warm and cold water employed as drinks.

Chap. II. Of the use of hot and cold water; what parts are benefited or injured by either of them; what affections they induce or cure.

Chap. III. Of sea-water, wine, vinegar; their powers; what parts they benefit, or what diseases they cure or induce, &c.

Chap. IV. Of the different powers of cold and hot waters; what parts are benefited or hurt by them; and what diseases cured or induced by them.

Gardeil says, that from the title of this treatise, it might be supposed that liquids in general were here considered. It, however, chiefly has respect to water, the liquid “par eminence.”

Sec. I. Of the advantages of water, and its different effects. Affusion of cold and hot water on the skin. Vapour-baths, general and local; highly extolled on many occasions; injurious, from inattention. Frozen feet, separated by immersion in hot water.

Sec. II. Bad effects of cold and hot water; what parts of the body each is best adapted to, and continued in Nos. iii., iv., v., vi. Skin, its connexion with every part of the body, by means of the nerves and blood-vessels that compose the fleshy pannicle; the effects of heat and cold on the vessels, and some remarks tending to strengthen a credence of the circulation.

Sec. VII. Sea-water as a bath; fumigations useful in phagedenic ulcers; salt, nitre, pickle, &c., their uses as stimulant applications.

Sec. VIII. Vinegar, lotions of, fumigations, &c., of great utility.

Sec. IX. Sea-salt, use of, in solution.

Sec. X. Wines, various, sweet, rough, white, &c.

Sec. XI. Cases wherein cold water is good; others in which hot water is preferable; both are good in diseases of the joints, gout, convulsions; greater care required in the use of cold than of warm water; constipation cured by;—warm in affections of the eye;—when cold water is preferable. Of cold water in tetanus; numerous other cases.

It would appear from this treatise, that water, cold and hot, sea and other waters, were among the most frequent medicamental resources of Hippocrates, by bathing, drinking, aspersion, sponging, &c.

SECTION V.

ON DISEASES.

DE MORBIS,FŒSIUS, Treat. i. p. 446.
DE MORBIS,HALLER, iii. p. 1.
TRAITÉ DES MALADIES,GARDEIL, iii. p. 153.

In his preface to this treatise, Haller says, “its author is uncertain; nor is it perfectly agreed, that these four books are those which, under the same title, the ancients largely quote from, for much of them is wanting here. Galen refers them to Thessalus, to the younger Hippocrates, or to Polybius.” But why (Haller adds) may they not be the production of some physician of the Gnidian school, as is conjectured by Fœsius? for the ancients found fault with the physicians of that school, that from the slightest difference, they established new species of diseases, so that they made seven or eight species of pleurisy; and this fault is to be found here. The remedies are repeated from the treatise “De victus ratione,” or they consist of the most powerful purgatives, very frequently prescribed in another place. The first book contains the theory that refers diseases to pituita and bile as their causes. We find also the pathology of diseases of the breast, of fevers, phrenitis, &c. There is much suspicion as to this book being known to the ancients. Saving the theory, it would appear to be not unworthy of Hippocrates.

Subjects treated of.—What is necessary to be inquired into by the physician, is here considered, and replied to. Of the internal and external causes of diseases. Of the appropriate and improper times for prescribing. Of proper and improper doings and sayings. Of good and evil, arising either spontaneously, by chance, or from error. What divided parts do not coalesce. Of the times for prescribing. Of manual dexterity. Of suppuration of the lungs, thorax, and stomach. Of erysipelas of the lungs, and tubercles of the lungs and side. Of fever, horror, rigor, sweat. Of pleurisy, peripneumony, ardent fever, phrenitis, melancholia. Of partially bloody and livid sputa.

BOOK I.

This book is divided by Haller into two sections, containing thirteen chapters, the contents of which are as follow.

Sec. I.—Chap. I. What is to be observed by the physician when about to prescribe, that he may correctly interrogate the patient and the attendants, and reply to them, or oppose their questions.

Chap. II. Of the causes of diseases, external and internal. Of fatal diseases, of doubtful, variable, chronic, or acute; of convertible diseases, and of such as necessarily supervene.

Chap. III. The opportunities of prescribing are numerous, varied, fleeting, and sometimes inappropriate; of what may be properly or improperly done or said, both in medicine and surgery.

Chap. IV. Of things beneficial or hurtful in disease, as well spontaneous as from the fortunate or unlucky lot of the physician; and of evils arising from the physician, and not necessarily imputable to the disease.

Chap. V. What parts, if divided, do not coalesce; no general principle of practice, either in theory or treatment, will apply to every case. In what manual dexterity consists.

Chap. VI. Of pulmonary suppuration from peripneumony; of a defluxion of pituita from the head; of rupture of the small vessels; of the contraction of varicose vessels; of the cure, and of death from suppuration of the lungs.

Chap. VII. Of empyema of the thorax arising from a defluxion of pituita from the head, from pleurisy, from pituita impacted in the side, from labour, and from rupture of the vessels; of suppuration in the lower belly, and its causes; of a collection of pituita and bile between the skin and muscles, and of convulsions.

Sec. II. Some preliminary remarks are here made, as to the influence of abdominal suppuration, and its effects on the system; and of defluxion from the head; the influence from age and other causes thereon, in hastening or checking the issue, &c.

Chap. VIII. Of the origin, causes, signs, and cure, of erysipelas of the lungs; of tubercle of the lungs and sides; of rupture and evulsion of the flesh and vessels.

Chap. IX. Of the cure, restoration, and death from suppuration, arising from wounded flesh or vessels; and in the cure, what is to be attended to, as respects sex, age, season, period, affection, and other circumstances.

Chap. X. Of the origin and causes of fever, rigor, horror, and cold and hot sweats.

Chap. XI. Of the origin, causes, parts affected, and cure, of pleurisy and peripneumony, with and without expectoration; which of the affected perish, which recover, or escape, if suppuration has taken place.

Chap. XII. Of those most obnoxious to ardent fever; its origin, attack, causes, symptoms; its passage into peripneumony, and its danger. Of phrenitis and melancholia; of the influence of the blood and bile in these cases.

Chap. XIII. Whence arise the half bloody and livid sputa in pleurisy and peripneumony; and who perish, and wherefore, from these diseases, as well as from ardent fever and phrenitis.

Gardeil, who makes thirty-one divisions of this book, says: Physicians who are desirous of knowing the mode of acting and of thinking, in the time of Hippocrates, of those who attended to external diseases, will have reason to be content, I think, with what they have already thus far seen. The present treatise, divided into four books, will satisfy them in many respects, as to what concerns internal affections. It will not always be easy to arrange what is said in them, as to the order, nomenclature, and classification of many internal diseases treated of by modern authors, either generally, or particularly. For the rest, I am persuaded in reading what has been thus far accomplished, much will have been found to be very abstruse; especially in the Prognostics, Humours, Predictions, on the Nature of Man, Aliments, the Parts of Man, &c. Yet I am persuaded, also, that they will give rise, some day, to excellent comments, by able men, who will develope them by explaining them in their schools. Many of the remainder, I am far from thinking deserving of such attention, but that, on the contrary, they would be improved by being compressed.

I. Preliminaries. As to the necessary previous knowledge of the origin of diseases, and why some are chronic, others rapid or acute in character, and mortal or otherwise; destructive to certain parts, or not so; their good or injurious tendency, their issue and other particulars; and as to the knowledge requisite properly to prescribe for them.

II. Of the causes of diseases, external and internal; their principal differences in respect to danger, duration, &c.

III. Of opportunity, or the proper occasion for action, the most important part of medicine.

IV. Of incorrect judgment as to the time of action.

V. Of errors in judgment as to the nature of the disease, or of the appropriate treatment. Continued in VI. and VII.

VIII., IX., X. Of spontaneous circumstances, either good or bad, dependent on nature, or on the physician.

XI. No general principle of treatment fitted for all cases; hopes to be excited at times, promptitude of action at others; cautions to be attended to in our manipulations.

XII. Of internal suppuration of different parts.

XIII. Three cases of pulmonary suppuration; from peripneumony, from pituita falling on the lungs, and from rupture of vessels, or their varicose state.

XIV. Of suppuration in the cavity of the pleura, from which the patient usually recovers, if a discharge by incision or cautery is not too long delayed. The causes of empyema are various. Of the influence of age, season, temperament, &c., on these cases.

XV. Abdominal suppurations, from bile, pituita, spasm, &c. Encysted tumours are difficult to know, when deep-seated.

XVI. Erysipelas of the lungs; its great danger, and metastasis of.

XVII. Of tubercles of the lungs; their suppuration; occasional cure; great danger of, and accompanying diarrhœa.

XVIII. Tubercles of the pleura. [Qu.? if not here connected with aneurism of vessels.—Ed.]

XIX. Pleurisy from inflammation of the intercostal muscles. Continued in XX. [This seems somewhat connected with hepatic inflammation.—Ed.]

XXI. Internal suppuration from external causes, as wounds, &c.

XXII. Conclusions on the preceding statements; on sex, age, strength, seasons, &c.

XXIII. Of fever: its formation, causes; coldness, chilliness, why they precede fever.

XXIV. Sweats, explanation of; hot and cold sweats, difference of, &c.

XXV., XXVI. In what manner pleurisy and peripneumony are formed, &c.

XXVII. Of pleurisy and peripneumony, unaccompanied by expectoration; treatment of.

XXVIII. Of ardent fever; who attacked by it; internal heat, and cold externally; danger frequently induces pleurisy and peripneumony.

XXIX. Of phrenitis, how produced. The blood by some persons supposed to be the principle of the understanding.a

XXX. Causes of the difference of expectoration, in pleurisy and peripneumony.

XXXI. Why death takes place in pleurisy, peripneumony, ardent fever, and phrenitis.

BOOK II.

DE MORBIS,FŒSIUS, Treat. i. p. 461.
DE MORBIS,HALLER, iii. p. 35.
TRAITÉ DES MALADIES,GARDEIL, iii. p. 189.

Haller, in his preface to this second book, says that “What was said of the first book, is applicable to the second and third, for they are full of the names of diseases, derived from some peculiar symptom; the remedies are almost every where the same: rest, vomits, purging, ptisans, and preparations with honey and vinegar, &c. In the second book, however, dietetic co-operation is more insisted on; whilst in the third book, medicines are predominant, and those of the most powerful description. The history of diseases is better, such as of pleurisy, peripneumony, empyema, whose description was given in the preceding book. It may be referred to the Gnidian physicians, from the praises of powerful remedies, as well as of the use of verdigris, arum, hellebore, thapsia, and peplium, to promote expectoration. Galen designates these books as the large and small.”

Contents.—Many species of diseases are here enumerated, both general and local; as of the head, brain, nose, ears, eyes, mouth, fauces, heart, lungs, trachea, breast, back, belly, liver, spleen, and limbs; with their causes, signs, and cure.

Sec. I.—Chap. I. Of an overheated temperature of the head, with pituita and bile; as such or such parts are inflamed by the fluxion to them, various symptoms follow; such as copious urine, strangury, loss of sight or hearing, &c. Several other affections of the head are enumerated, and their accompanying symptoms.

Chap. II. Of diseases of the head; sideratio; caries of the bones; sphacelus, &c.; their causes, symptoms, and prognosis.

Chap. III. Of angina; uva; inflammation, &c., of the tonsils, and surrounding parts.

Chap. IV. Of diseases arising from fulness of the head, attended with torpor; incontinence of urine, strangury; and of their dietetic, pharmaceutic, and surgical treatment.

Chap. V. Of ulcers of the head and legs, and swelled legs; of headache, with bilious vomiting and dysury, and of their cure.

Chap. VI. Of hydrocephalus;a of coldness, pain and fever in the head; excitement of vascular action in and about the brain; their causes, signs, and cure.

Chap. VII. Of the rise, causes, symptoms, signs, prognosis, and treatment of those affected with bile, &c., or from drunkenness.

Sec. II.—Chap. VIII. Of sideratio cerebri (qu.? σφαϰελος, ενϰεφαλȣ); caries of the bones, &c.; causes, symptoms, signs; dietetic, pharmaceutical, and surgical treatment.

Chap. IX. Of the causes and cure of three kinds of angina. Inhalation for, well described.

Chap. X. Of uva; in which the excision of the lower part of the uvula is ordered;b of tonsillitis; of tubercle of the tongue; of inflammation of the palate; and of the treatment.

Chap. XI. Of five kinds of polypus; the pendulous, oblong, soft, fleshy, and callous, which occupy the nostrils; and their treatment by excision, cautery, &c.

Chap. XII. Of jaundice, with, and without fever; and their treatment.

Chap. XIII. Of the treatment of three kinds of fever arising from bile.

Chap. XIV. Of the treatment of quartan fever.

Chap. XV. Of the signs and treatment of three kinds of pleurisy.

Chap. XVI. Of peripneumony; its origin, symptoms, and cure; of suppuration from peripneumony, and of incision therefor, and evacuation of the pus. Auscultationc is here clearly adverted to, and incision ordered for the removal of the pus.

Chap. XVII. Of consumption from pulmonary affections; signs of, and dangerous symptoms; falling off of the hair, with fetid expectoration, &c.; its treatment.

Sec. III.—Chap. XVIII. Of consumption of the lungs; of ulceration of the trachea; their diagnosis, prognosis, and treatment.

Chap. XIX. Of dorsal phthisis; its rise, causes, signs, and cure; of a disease of the lungs, somewhat differing from common phthisis.

Chap. XX. Of wounded trachea, and pulmonary lesion; convulsive twitching of the fibres of the lungs; their signs, prognosis, and remedies.

Chap. XXI. Of erysipelas of the lungs, its causes, signs, and treatment.

Chap. XXII. Of the signs and treatment of a dorsal affection, and tubercle of the lungs.

Chap. XXIII. Of engorgement of the lungs, and their lateral gravitation; their signs and cure.

Chap. XXIV. Of tubercle in the side; dropsy of the lungs; rupture of the breast or back; their signs and treatment. Incision between the ribs in dropsy of the lungs is here recommended.

Chap. XXV. Of ardent fever; of fever with singultus; their signs and cure.

Chap. XXVI. Of lethargy; marasmus; of a variety of fever, (called φονωδης, mortifera;) their signs and cure.

Chap. XXVII. Of the livid disease; and of one accompanied with eructation.

Chap. XXVIII. Of a pituitous disease affecting chiefly women; of leuco-phlegmasia; their signs and cure.

Chap. XXIX. Of melancholy; and of three varieties of (Μελαινα νȣσος) black disease; their signs and treatment.

Gardeil, in seventy-two paragraphs, gives the following outline of this second book.

I. From excessive heat of the head, the pituita is melted, and conveyed to all parts. This paragraph, and up to x. inclusive, is taken up with concise notices of some diseases of the head, the treatment of which follows, from xi. to xxxiv.a

XI. to XIII. Of diseases which arise from the head. Here, says Gardeil, (up to No. xix.,) the author appears to return to the diseases already mentioned, for the purpose of giving their treatment. At the same time, he adds, the order of the matters, in all the four books, is very difficult to attain, if, in fact, any order has been pursued. It may be remarked, that the use of the cautery is very frequent.

XIV. Refers to hydrocephalus, or water on the brain; the strabismus is noticed; and in the last resource an opening of the cranium is recommended, as in trepanning, in order to discharge the fluid.a

XV. Seems to refer to No. v. The pulsation of the vessels is here noticed. Some part omitted by Gardeil.

XVI. A singular treatment here recommended, for some vertiginous affection, by incision of the forehead near the hair, and sprinkling salt in it, and closing the wound, &c.

XVII. to XX. All referring to some of the previous numbers.

XXI., XXII. Refer to sphacelus and caries of the bones of the head, &c., in which scraping the bone to the diploe is recommended.b

XXIV. Quinsy, and its treatment, is here noticed, and continued in No. xxv. and xxvi. Inhalation is here recommended and described.

XXVII. Tumid uvula, (ϛταφυλη, uva.) Its excision recommended. Long prior to some assumed modern discoverers, passing down through the whole train of medical writers from Hippocrates to the present period; although apparently unknown to a late professor, or to some contemporaries, who ascribe the discovery of this operation to him.

XXVIII. Swelled tonsils; ranula; inflamed, swelled, and suppurated palate.

XXIX to XXXIII. Polypi of the nares, five species, and their treatment.

XXXIV. The chain is here broken. Icterus is treated of in this and the next paragraph.

XXXVI. Bilious fever.

XXXVII., XXXVIII. A variety of fever, approximating to yellow fever.

XXXIX. Quartan fever, treatment; sorbets, large doses of hellebore.

XL., XLI., XLII. Pleurisy, varieties of, and treatment.

XLIII. to XLVI. Peripneumony; empyema; something like auscultation noticed; fumigating; opening the cavity of the thorax to discharge the pus; the process described.

XLVII., XLVIII. Phthisis; affection of the trachea, leading to phthisis.

L. Tabes dorsalis, common to young married people, and libertines. This is rather a seminal weakness.

LI., LII. An affection of the lungs, in which fumigation is commended. Ulcerated trachea.

LIII. Twitchings or convulsion of the fibres of the lungs, commonly fatal.

LIV. Erysipelas of the lungs, chiefly excited by excess in eating and drinking. It seems to be of a chronic character, and requires a chronic treatment.

LV. A dorsal affection, with bloody urine, on the third or fourth day; mostly fatal.

LVI. Tumours or tubercles of the lungs, to be treated as empyema.

LVII. Engorged lungs [Qu.? peripneumonia notha.—Ed.] very fatal.

LVIII. The lungs falling on the pleura, [Qu.?] It arises sometimes from a wound, or from the operation for empyema; singular treatment for, by introducing air into the cavity.

LIX. Tumour of the pleura; incision recommended, or cautery, and introduce after the tenth day a mixture of warm wine and oil, retaining, and renewing it, &c.

LX. Of dropsy of the chest, hydrothorax, slower than empyema in progress.a Rupture of the breast or back.

LXI., LXII. Of burning fever (ϰαυσως), often ending in peripneumony; fever, with hiccup.

LXIII. Of lethargy. [Not that now so denominated. It seems to be rather coma, in the latter stage of some disease.—Ed.]

LXIV. A disease called αυαντη, Gr., resiccatorius, Fœs., of a chronic character. [I should think it connected with dyspepsia or marasmus.—Ed.]

LXV. Fever, (φονωδης, mortifera,) deadly.

LXVI. Morbus lividus. Qu.?

LXVII. Disease with much flatulence upwards.

LXVIII. Pituitous disease. Qu.? Asthma.

LXIX. Leuco-phlegmasia, or anasarca.

LXX. Melancholy.

LXXI., LXXII. The morbus niger. Qu.? Of two kinds (Μελαινα νȣσος). The gangrenous disease.

BOOK III.

DE MORBIS,FŒSIUS, Treat. i. p. 487.
DE MORBIS,HALLER, iii. p. 94.
TRAITÉ DES MALADIES,GARDEIL, iii. p. 257.

The following diseases, says Haller, are noticed in this book, viz.: tumour of the brain, and its painful repletion, apoplexy (Qu. βλητοι, Hipp.; sydere icti, Fœs.a ), lethargy, ardent fever, tumour of the lungs, headache, phrenitis, angina, jaundice, tetanus, opisthotonos, convolvulus, peripneumonia, pleurisy. Also of the drinks, &c., to be used in ardent fever.

Chap. I. Of tumour of the brain from infiammation; diagnosis, prognosis, and cure.

Chap. II. Of intense headache, from fulness of the brain; its symptoms and cure.

Chap. III. Of (Qu. apoplexy?) attoniti, Hal., vel sidere icti; its signs and cure. In the next chapter, the sideratio cerebri (ϛφαϰελισμος ενϰεφελȣ, Hipp.,) is considered.

Chap. V. Of the signs and cure of lethargy, and of suppuration from. It seems different from ours.

Chap. VI. Of ardent fever; diagnosis, prognosis, and cure.

Chap. VII. Of the lungs enlarging from heat; diagnosis, prognosis, and cure.

Chap. VIII. Acute headache, with aphonia; diagnosis, &c.

Chap. IX. Diagnosis and cure of phrenitis.

Chap. X. Angina, twofold, cynanche, and paracynanche; the signs and cure of each.

Chap. XI. Of icterus; its signs and treatment.

Chap. XII. Tetanus, opisthotonos; diagnosis, prognosis, and cure of each. In the latter, cold affusions recommended.

Chap. XIII. Volvulus; diagnosis and cure. Blowing up the intestines with a bellows is here recommended.a

Chap. XIV. Peripneumony; diagnosis, &c.

Chap. XV. Pleurisy; humid, bilious, bloody, dry; dorsal; their diagnostics, prognostics, pharmaceutic, dietetic, and chirurgical treatment, largely laid down. Something like auscultation alluded to; and paracentesis of the thorax to discharge the pus when formed.

Chap. XVI. Of a variety of cooling drinks in ardent fever.

Gardeil divides this book into forty-six paragraphs; from No. 26 of which, to the end, is a large variety of different kinds of drinks for sick people, especially in fevers, and which he calls “appropriate ptisans.”

1. Hippocrates tells us, that having heretofore treated of fevers, he now proceeds to other diseases.

2. Turgescence of the brain, with headache; here, in the treatment, after shaving the head, cooling applications, confined in a bladder, are recommended.

3. Headache from plenitude of the brain, accompanied with delirium.

4. Les Frappés, Gard.; sydere icti, Fœs.; βλητοι, Hipp.; [Qu. what is this? Gardeil refers us to sentence xxxi., chap. xvi., book ii., Coacæ, where it has connexion with peripneumony.]

5. Sphacelus of the brain—cerebri sideratio, Fœsius, p. 488.

6. Lethargy. [Certainly not that now so called, since it is closely connected with peripneumony. It seems to me merely a comatose symptom in peripneumonia notha.—Ed.]

7. Of ardent fever. This is said oftentimes to degenerate into peripneumony. Hot ablutions frequently employed, except to the head, are recommended.

8. Tumour of the lungs, from heat. This appears to be also peripneumonic.

9. Headache. Refers chiefly to that arising from drunkenness.

10. Phrenitis. Gardeil thinks this refers to inflammation of the diaphragm or paraphrenitis; and the symptoms warrant this opinion.—Ed.

11, 12. Of quinsy or angina, true and false. In the treatment of the latter it is recommended to introduce a tube, to assist respiration.

13. Of icterus (morbus regius, Fœs.) It is said to be an acute disease, which kills in a short time. Doubtful if our common jaundice.

14. Of tetanus.

15. Of opisthotonos. Cold water dashed on the patient is among the recommendations for this.

16. Of volvulus, or the iliac passion. Here, among other recommendations, is that of forcing up wind into the intestines by means of a bellows.

17. Of peripneumony. About the eighteenth day, if the expectoration is sweetish, the lungs are said to be in a state of suppuration, and may continue for a long time.

18, 19, 20. Of pleurisy. Of dry pleurisy. Of dorsal pleurisy.

21, 22. Of the examination of the tongue in pleurisy. Pain of pleurisy worse at night.

23. Treatment of pleurisy. [Bleeding seems but little attended to, and probably hence, apparently, the frequency of empyema; purging is more commended.—Ed.]

24. Suppuration being established, and having passed into the thorax, at a proper period, incision or cautery is recommended; and auscultation is obviously spoken of, to determine the presence and situation of the pus, which is slowly evacuated for several successive days.

25. The same treatment is recommended in suppuration from wounds.a

26. to the end, taken up with an enumeration of formulæ for ptisans and drinks.

BOOK IV.

DE MORBIS,FŒSIUS, Treat. i. p. 498.
DE MORBIS,HALLER, iii. p. 118.
TRAITÉ DES MALADIES,GARDEIL, iii. p. 285.

This book, says Haller, is very different from the preceding ones, and is replete with acute and ingenious reasoning. The origin of disease is deduced from four humours, bile, blood, pituita, and water, arising from the aliment taken in. If received beyond a just amount, on the third day, the body is disturbed, and if the excess is not removed, disease ensues. Of the judgment as to diseases. This should be made on the uneven days, in which the humour should pass out. Other matters are minutely treated of. Towards the close, something is said respecting worms, which are discovered even in the fœtus; of calculus, from hardened pituitous milk; of dropsy of the belly, uterus, and the whole body; its origin. Here too we find refuted, the descent of drink into the lungs, which in other books, Hippocrates maintains. The author cites the book he had written on female diseases. (De morbis muliebribus.)

The argument of this book, (divided into two sections and nineteen chapters, by Haller,) is, that there are four species of humours, bile, pituita, blood, and water; their origin, generation, causes, receptacles, sources, and effects; of food and drinks; of excretions, and their ducts. Fever is considered; the principles of diseases, and their causes; of pains, worms, calculi, and dropsy.

Sec. I. Chap. I. Of the origin of man. The seminal fluid of both parents is essential to generation, and is derived from every part. There are four humours in the body, bile, blood, pituita, and water, or atrabilis, which are formed from the food and drinks taken in. Their sources are fivefold, viz., the stomach, the head, the heart, spleen, and gall-bladder. Analogy of plants and births (partium). Every part attracts its congenerous humour to itself.

Chap. II. Excess or deficiency of assimilating humour, induces disease both in plants and in man. Plants spring up and grow, only where they can obtain an appropriate nourishment. All plants will not indiscriminately grow and flourish in all places. Cultivation has caused these difficulties to cease.

Chap. III. Pituita (φλεγμα), originating from pituitous food and drinks, is attracted to the head, and if in excess, it induces headache; and if conveyed away by the stomach and bladder, benefit ensues.

Chap. IV. Bile is more copiously produced from bilious food and drinks. It is drawn to the liver from the gall-bladder, and there retarded, proves the cause of pain. Food and drinks of different kinds often prove remedial.

Chap. V. Of the more copious flow of water, its causes, seats, affections; from whence pains of the spleen and of the lower parts of the body arise.

Chap. VI. Of blood, its origin, causes, affections. The heart is not affected with pain from its increased presence; although from it many diseases of the body arise.

Chap. VII. Four streams are continually supplying the body, as its parts are emptied by a mutual co-operation: numerous vessels exist in the body;—from whence arise the savour or disagreeableness of food and drinks; appetite and its cessation explained.

Chap. VIII. Bile is secreted from food and drinks, in the gallbladder; and there induces cardiogmus (cordis morsum), but does not produce disease of the heart. The head and spleen are more liable to disease. When, and how, humours noxious to man, become reduced. Four places from whence the system is purged, viz., the mouth, nose, rectum, and urethra.

Chap. IX. How man preserves his health, by proper attention to diet; this appropriately digested, distributed, and excreted; otherwise sickness ensues, followed by emaciation and weakness, together with repletion, heat, pain, and fever.

Chap. X. When discharges exceed what is received, men grow thin. Of the operation of indolence, and activity, on appetite and health; the importance of good habits; of fever from repletion, and of the termination of diseases on certain days.

Chap. XI. Why fever terminates; and why fevers and diseases remit, terminate, or diminish on uneven days; vitiated humours are disturbed and evacuated, horror ensues, and crises follow.

Chap. XII. Why death ensues on uneven days; the humours are disturbed, pains ensue; medicine improperly given, often injurious; ulcers become more inflamed; why swelling of the glands arises from ulcers; heat and pain of ulcers, and their influence in the subsequent uneven days, &c.

Sec. II. Chap. XIII. Why men sicken; necessity of purgation; fever from repletion; watery humour is most opposed to fever, but a bilious humour is its pabulum. Why water exhales more readily than oil; what, and how many, are the principles of disease,—and of their grade of violence.

Chap. XIV. Of the effects of violence, wounds, ulcers, contusion, tumour, pain, fever, disturbed humours. Comparison between milk and blood, and their parts. What effects arise from a disturbance, excess, and evacuation of humours; of the aliment of man, and the causes of putrefaction and death.

Chap. XV. How diseases arise from the air; by the solution, concretion, secretion, mixture, agitation, and situation of a single humour, various diseases may arise, such as disturbed bowels, griping, rigor, chill, inflammation, and fever.

Chap. XVI. Of worms; lumbricus latus, and teres; the latter procreate, the former do not, but break into pieces resembling gourd-seeds; of their origin, species, diagnosis, and prognosis. The existence of worms in children, even in utero, is here asserted.

Chap. XVII. Of calculus; its origin from milk; its causes; five signs of; its symptoms; its mode of increase and location.

Chap. XVIII. Drink is conveyed into the stomach, and not into the lungs; and from the stomach it is conveyed to every part, as shown by eight arguments.

Chap. XIX. Of three species of disease from dropsy or watery effusion; their origin, locality, causes, signs, symptoms, and prognostics.

Gardeil divides this book into twenty-five paragraphs, to the following effect.

1. Of the principles of the composition of the body, and the sources of diseases, from four humours,—pituita, blood, bile, and water.

2. Physiological explanation of the origin of the four humours, with a digression, in a parallel between the nutrition of vegetables and animals; and that from an improper soil, plants cannot always be naturalized; reference is even made to the difference of contiguous soils, in the culture of the vine.

3, 4, 5, 6. The above four humours considered; their sources, &c.; defect of, and superabundance.

7. The general theory of diseases, founded on the four humours, being in excess or defect. The intercommunication of vessels throughout the body. Four fountains in the body, supplied through the agency of the stomach. Importance and utility of the doctrine to dietetics.

8. Some principles as to the secretions and excretions. Four passages by which the above-mentioned humours are principally evacuated,—the mouth, nose, anus, and urethra.

9, 10. Wherein health consists; regularity, progress of the aliment, &c.; excess or defect in diet, &c.; humours evacuated the third day; fæcal matters on the second.

11. Theory of the diseased state arising from the excess or defect mentioned.

12. The cessation of fever explained; on the third, fifth, seventh, or ninth day.

13. Why fever finishes on uneven days, and of the disturbance of the humours on such days, by improper treatment. Ancient physicians are here adverted to.

14. Recapitulation.

15. Theory of diseases, from superabundance of humours, or from defect of excretions; seven signs of.

16. Two other sources of disease; external, and violence done to the body.

17. The effects of external things, acting violently; tumours, contusions, fatigues.

18. The effects of atmospheric agency; how the humours are affected; death from disorganization. Health, in what it consists. Engorgement of vessels, &c., illustrated.

19, 20. Coldness in disease, explained; brief recapitulation.

21. Of worms. Tænia; formed even in the fœtal state; their great length; curious account of their generation, &c.; symptoms; the cucurbitinæ illustrated.

22. Of calculus of the bladder; of its origin from impure milk sucked in early life (see treatise on Nature of Man), explained; five signs of calculus.

23. An article respecting the passage of drinks to the lungs, which is here denied, though elsewhere insisted on, and seven arguments against it. Of the voice and its formation, &c.; the epiglottis, its use.

24. Of the origin of dropsy. Varieties of ascites.

25. Of dropsies in general; of the womb, belly, legs, &c.; danger of, when acute disease attacks, &c.

[a ]“Sanguis, qui inest homini, plurimum ad prudentiam confert; quidam vero dicunt, totum.”—Haller.

[a ]In which, as an ultimate resort, the skull is perforated. “Demum inciso juxta sinciput capite; ad cerebrum usque perforato, et velut sectionem per terebram curato.”—Haller, iii. p. 48.

[b ]“Extrema parte præcidito.”—Haller, iii. 57.

[c ]“Tu vero agitato humero, quonam in latere (affectio) strepitum edat, auscultato,” &c.—Haller, iii. p. 69.

[a ]In No. vii., we have the caries of the bones of the cranium, which has some analogy with that arising from syphilis.—Ed.

[a ]“On ouvre le crâne à l’endroit de la fontenelle jusqu’au cerveau, et l’ou soigne comme dans l’operation du trepan,” iii. 202.

[b ]It is not clear to me, that this affection is not allied to some syphilitic taint.—Ed.

[a ]“Quod si infusum, aut fomentum, aut suffitum adhibeas, pus non sequitur, indeque cognoscas, non pus, sed aquam intus esse.”—Fœs. Qu.? If this implies a prior incision, and injection, as in empyema? Paracentesis is, at all events, recommended.

[a ]Ictus, attonitus, apoplecticus, Gr. Lex.

[a ]“Folle fabrili indito, in ventrem flatus immittendus, ut tum ventrem, tum intestinum contractum distendas.”—Hal. iii. p. 105.

[a ]The reader, remarks Gardeil, cannot fail of observing, when reading the works of Hippocrates, how frequently the operation for empyema was performed, doubtless with more facility and success than now, in the treatment of suppuration in the thorax from internal causes.—It appears to me (Ed.) that the principal cause of this arose from the dread of bleeding in the early stage of disease, lest concoction of the humours should be thereby prevented.