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OF INTERNAL AFFECTIONS. - Hippocrates, The Writings of Hippocrates and Galen [1846]

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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 INTERNAL AFFECTIONS.

DE INTERNIS AFFECTIONIBUS,FŒSIUS, Treat. iii. p. 531.
DE INTERNIS ADFECTIONIBUS,HALLER, ii. p. 401.
TRAITÉ DES AFFECTIONS INTERNES,GARDEIL, iii. p. 365.

This treatise, says Haller, is among the most confused, manifestly consisting of the Gnidian sentences; for diseases are here subdivided ad infinitum, and species constituted from a solitary case. Thus a nomenclature of diseases sprung up, distinguished by no connexion of characteristic symptoms; such as the great varieties of morbus crassus, of typhus, nephritis, hepatitis, and splenitis. In scarcely any of these, are the diseases to be distinguished by the accompanying symptoms; what credit can be given to one of the varieties of the morbus crassus (4th pachysmus, Hal.), in which the patients were injured by the smell arising from rain falling on the earth? The extreme violence of the Gnidian remedies is offensive, such as the grana gnidia, succus hypophæs, and lapis magnesiæ. The hellebore here mentioned, purges up and down. Many symptoms of diseases differ from those mentioned in other Hippocratic books, with the exception of tetanus, whose description and treatment agree with the third book, “De Morbis.” Drinks, moreover, are here stated to pass into the lungs.

The argument of this book is stated by Haller as pointing out the internal diseases of different parts, as of the windpipe, the vessels, heart, lungs, back, breast, side, spinal marrow, kidneys, of the vessels of the right and left side, of the abdomen, intestines, joints, skin, and of the whole body, together with their causes, signs, and cure.

Sec. I. Chap. I. Of ulcerated or wounded windpipe, or of any of the vessels of the lungs, their causes, signs, prediction, cure, and precautions in convalescence.

Chap. II. Of rupture of the pulmonary arteries or veins; symptoms, signs, and cure.

Chap. III. Of suppuration of the chest, and ruptured lungs.

Chap. IV. Of the causes, signs, and treatment, of pneumonic affection.

Chap. V. Of varix of the lungs, its causes, signs, and treatment.

Chap. VI. Of sanguineous or bilious repletion of the lungs.

Chap. VII. Of the causes, signs, and treatment, of inflammation of the lungs.

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

Chap. IX. Of rupture of the breast and back, its causes, signs, and treatment.

Chap. X. Of tubercle of the side, its signs, and cure.

Chap. XI., XII., XIII., XIV. Of four species of consumption; from a defluxion of pituita from the head, upon the lungs; from spitting of blood; from a ruptured vessel from labour; and from a defluxion on the spinal marrow; their signs and cure. The fourth, from dryness of the spinal marrow, owing to an obstruction of the vessels going to the spine, or of the passage from the brain to the spine, or from venery; its signs, and treatment.

Chap. XV., XVI., XVII., XVIII. Of four affections of the kidneys, viz.:—1. Calculus of those glands. 2. Of diseases arising from violent labour, inducing rupture of the vessels and suppuration, in which an incision at the lumbar region is recommended; which, if unsuccessful, the complaint terminates in tabes renalis. 3. Of ulcer of the kidneys. 4. Arises from obstruction, and from venery, ending in suppuration; some singular advice as to exercise in this complaint; origin, signs, cure, &c.

Chap. XIX. Of a violent disease of the venæ cavæ, succeeding nephritis; its causes, signs, and cure.

Chap. XX. Of another of a like nature.

Sec. II. Chap. XXI., XXII. Of several species of pituita, viz.: common or recent, of the white, chronic, or leucophlegmatic pituita.

Chap. XXIII. Of dropsy from cacochymia, or a thin pituita.

Chap. XXIV. Of dropsy of the lungs or thorax from drinking copiously of water, or from a rupture of tubercles; operation for; auscultation apparently adverted to.

Chap. XXV. Of dropsy, subsequent to an œdematous phlegmon of the liver; signs, &c.; surgical treatment.

Chap. XXVI. Of dropsy, arising from watery effusion from the liver into the belly; its treatment.

Chap. XXVII. Of inflammation of the spleen, and subsequent dropsy; its causes, signs, and treatment.

Chap. XXVIII. Of universal dropsy, arising from drinking stagnant water in long journeys, &c.

Chap. XXIX. Of hepatitis, and scirrhous inflammation of the liver; its causes, signs, and treatment.

Chap. XXX. Of hepatic erysipelas, or erysipelatous phlegmon; causes, &c.

Chap. XXXI. Of hepatic affection, with metastasis to the brain; causes, &c.

Chap. XXXII. to XXXVI., inclusive. Of various affections of the spleen,—phlegmonous, erysipelatous, scirrhous, plethoric, and pituitous; their symptoms, signs, and treatment.

Chap. XXXVII. to XL., inclusive. Of jaundice, from bile in summer; and in winter, from drink and cold, as well as bile; of epidemic jaundice, from obstruction induced by over-eating and drinking; and of jaundice from pituita; their origin, signs, and treatment.

Sec. III. Chap. XLI. to XLV., inclusive.—Of five different sorts of typhus; from bile; superfluous moisture; putrid bile mixed with the blood, and falling on the joints; from superfluous moisture from the use of fruit and cakes, and from a putrid moisture of the body generated from black bile; their causes, signs, and cure.

Chap. XLVI., XLVII., XLVIII. Of three varieties of ileus; their causes, various signs, distinction, and cure.

Chap. XLIX to LII., inclusive. (De pachysmo, Hal.; Morbi crassi, Fœs.; Grossissement, Gardeil.; παχυς, Hipp.) Of enlargements of the belly, legs, &c., from a defluxion or collection of pituita and bile. [Qu.? If these are not connected with rickets, &c., as mention is made of incurvation of the spine. It is in Chap. lii., that the influence of the odour of the earth from rain is mentioned. Some of the symptoms resemble those of chlorosis; it would be difficult to say what they are.—Ed.]

Chap. LIII. Of sciatica, four kinds of; ankylosis from, &c.

Chap. LIV., LV., LVI. Tetanus, opisthotonos, from wounds, cold, or other causes; wine copiously recommended in the first.

The preceding treatise (4th De Morbis), says Gardeil, is a choice piece of hygiene. The present one, which is similar in many things to the three last books of the treatise on diseases, gives us a pathology and therapeusis of various diseases, in which more precision is desirable. Many details of curative proceedings are to be found, which might be usefully employed at the present time.

Gardeil divides this treatise under the following paragraphs.—Ed.

I. Of affections of the breast caused by violence.

II. Of rupture or lesions in the chest; milk diet.

III. Of consumption (pulmonic), tubercles, suppuration.

IV. Varices of lungs.

V. Of black bile in the lungs.

VI. Of inflammation of the lungs, from excess in drink, &c.; vomiting in; its chronic state, &c.

VII. Of erysipelas of the lungs from congestion.

VIII. Of (déchirures, Gardeil; pectus et dorsum dirupta, Fœsius,) irritation of the back or breast from great fatigue; cure of, and danger of relapse.

IX. to XIII. Of tumours and suppuration of the pleura; of foura species of phthisis; the first, from pituita, its treatment and rare recovery from; the second, caused by great fatigue, is less hazardous, but very fatal. The third, from the spinal marrow becoming filled with blood; exercise in, at a certain period, from one to six leagues a-day; receipt for a drink of various roots and flowers; fumigations. The fourth, or dorsal phthisis, from a drying of the spinal marrow, chiefly caused by excess of venery. Immense quantity of asses’ milk employed in, mixed with honey, nine pounds; or fourteen pounds of cow or goat milk, (tres semicongios,) continued daily for forty-five days.

XIV. to XVII. Of four affections of the kidneys. In the first, sand sometimes is seen, leading the physician to imagine a stone in the bladder, when it is in the kidneys. A laxative of two gallons of weak broth; nephrotomy recommended in certain cases. In the second variety, from excessive fatigue, followed by rupture of the small veins going to the kidneys, causing blood to be passed with the urine, and subsequently pus, in which case nephrotomy is also recommended. Hippocrates remarks that many considered this last stage as nephritic phthisis. The third species, produced from black bile passing to the kidneys, and remaining, it lacerates the small vessels and substance of the gland; it is rarely cured, but becomes chronic. The fourth is the product of pituita and bile, and also arises from venery. Here again, if suppuration ensues, the pus is to be discharged by incision on the most prominent part; its treatment by regimen and exercise.

XVIII., XIX. Of a great disease of the venæ cavæ? Whatever may be intended by this, Gardeil is inclined to consider it a disease no longer known. In its treatment the actual cautery is freely advised, viz., three near the joint of the femur and pelvis; two below the trochanter; two at the middle of the thigh; one below the knee, and one above the ankle, besides four on the right shoulder. The same treatment is recommended, when the left vein is affected.

XX. Some speculations as to pituita and bile, with the treatment of the symptoms arising from those humours, and the mode of inducing vomiting in cases of an excess of recent pituita.

XXI. Of leucophlegmasia; cupping on the lumbar region; opening the scrotal veins.

XXII. Of anasarca following the above.

XXIII. Of hydrothorax, from drinking water profusely in summer; from tubercles. Tubercles very common in oxen, dogs, and sheep, as evinced by dissection; still more so in man; treatment by paracentesis above the third false rib, by incision, and trocar, draining off the water for twelve days.

XXIV., XXV. Of dropsy of the liver, and of the spleen; this last is ascribed to eating too freely of fresh figs or apples, &c.

XXVI. Dropsy (anasarca) from the use of bad water in long journeys; among other remedies, the same water is prescribed in the treatment. A very free use of nitre (Qu.?) as a glyster, is ordered, viz., Ʒx., with other articles.

XXVII., XXVIII., XXIX. Of hepatitis, three varieties noticed; in one, glysters of asses’ milk to four and a half pounds, or of mare’s milk; all these varieties said to be very dangerous, most of the patients dying on the fourth day.

XXX. to XXXIV. Of five species of affections of the spleen, all very similar, both in causes, symptoms, and treatment. Sawing wood for thirty days is one of the remedial means. One of these (second) varieties, Gardeil thinks very analogous to scurvy.

XXXV. to XXXVIII. Of four species of jaundice. Little variety is here found; cantharides used internally, infused in wine. One variety of jaundice is called epidemic (επιδημιος, quod omni tempore prehendat, Fœsius).

XXXIX. to XLIII. Of typhus; five kinds noticed, which Gardeil thinks we would rather call inflammatory fever. It is surprising what quantity of drink is ordered. In one of these, the prescription is ten pounds of goat’s milk whey with salt in one vessel, and ten with honey, in another, which is to be all drank by glassfuls, alternately, apparently in one day. A number of remarkable symptoms mentioned in a species of typhus; among them is that of a particular inclination to the odour of extinguished lamps, &c.

XLIV. to XLVI. Of three varieties of iliac passion.

XLVII. to L. Of enlargements; (Qu.? Grossissement, &c.) What these are is problematical; four kinds are mentioned; in one, the smell of the earth when it rains, is said to induce syncope.

LI. to LVI. Of sciatica; four varieties; frequent moving to prevent ankylosis.

LVII. to the end. Of three species of tetanus, in which epilepsy and hysteria seem implicated.

[a ]Hippocrates says three species.