Front Page Titles (by Subject) THE FIFTH BOOK OF EPIDEMICS. - The Writings of Hippocrates and Galen
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THE FIFTH BOOK OF EPIDEMICS. - 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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THE FIFTH BOOK OF EPIDEMICS.
Fœsius, p. 1141.
To me, says Haller, there seems nothing in this book unworthy of Hippocrates. The part which adverts to the manifest affinity of sutures and fissures, is pointed out by Celsus, and by Plutarch, in praise of this great man. It is in parts obscure, and difficult to comprehend; but it contains histories of various surgical cases, not always indeed coherent, but many of which are uncommon and useful. Peripneumony from metastasis of angina; tetanus from acrid applications to a wound; and death from a slight blow on the head. The distinction between arteries and veins might lead to the idea of the book being of a later period. Galen ascribes it to Draco, or to the second Hippocrates. He considers the seventh book as spurious, but ascribes the second, fourth, and fifth to Hippocrates, although probably not edited by him. To me, adds Haller, the fifth and seventh appear much superior to the others mentioned.—Ed.
The gardener’s wife, in Elis, had a continual fever, and received no benefit from purges. Below the navel the belly was hard, swelled, and in great pain. Upon its being handled, and pressed pretty much by the hand dipped in oil, a great deal of blood passed off downwards; after which she grew well, and continued so.
Timocrates, in Elis, after hard drinking, was seized with madness from black bile; and by the help of a purging potion brought away (though not without much uneasiness) a great deal of phlegm and black bile in the daytime, and had no more stools in the evening. After drinking some gruel he fell asleep, and did not awake till sunrise; but seemed all the while to the bystanders to be dead, neither fetching his breath, nor perceiving any thing that was said or done. His body was stretched out, and stiff; yet he was alive, and got up again.
Scomphus, in Oeniadæ, died of a pleurisy the seventh day, delirious, after having taken a purge the same day that wrought but little. The day before he was in his senses, but upon purging grew delirious.
Phœnix and Andreas, two brothers in Oeniadæ, had a swelling in one of their cheeks, and the lip that was opposite to the cheek and eye. Nothing appeared inwardly upon examination, nor was there any abscess outwardly, but it swelled, and putrefied, without discharging any thing. Both of them died; but Andreas died the seventh, after taking a purge to no purpose; whereas Phœnix had the putrefied part cut all round, and the ulcer discharged a great deal before he died. He died, however, though he held out long.
Pyridamus, in Oeniadæ, began to be delirious the tenth day in an inflammation of the lungs; but, being taken care of, came to himself again, and what he spit up was clearer than it had been. The disease grew better; a great deal of sleep followed upon it; but his eyes looked as in the jaundice, and about the twentieth he died.
A man in Oeniadæ had the following complaint. When he abstained from food, his belly rumbled mightily, and was in pain; and the very same complaints returned in a short time after he had eaten, and the food was ground small. His body also fell away and wasted; the food he took afforded no nourishment; and what passed downwards was of a bad sort and burnt. The rumbling and the pain were least perceived immediately after eating. He found no benefit from purges of every kind, both upwards and downwards; but being blooded at times in each hand, till he had hardly any blood left, he grew easier, and got rid of his complaint.
Eupolemus, in Oeniadæ, felt a pain in his right hip and groin, the nearest joining of the hip to the groin, and the forepart of the hip. Upon losing a vast deal of black thick blood from the ankle, and taking a smart purge downwards, he grew easier. The pains indeed did not cease, but the hip, the joining, and the part about the groin suppurated, though not without an increase of pain: for the pus laid deep, rather at the bone than in the flesh. He was neglected for some time in this condition, till he became extremely weak; and then a great many large eschars were made by the actual cautery, near one another, and a vast discharge of thick pus ensued. A few days after this he died, partly from the largeness and number of the ulcers, and partly from the weakness of his body. Whereas had one large incision been made, or even a second (if it had been necessary), and the pus discharged that way, and all this in time, he might have recovered it.
Lycon in Oeniadæ was in other respects in the same condition, but the pains extended to the leg, though not very much. Here indeed was no suppuration, and yet he did well after a long time; but then he took physic, was cupped, blooded, and seemed to be better of his complaints.
A man at Athens was seized with an itching all over, especially in his testicles and his forehead, which proved exceedingly troublesome. His skin was thick from head to foot, in appearance like that of a leper; and could not be taken up any where for the thickness of it. This man could receive no benefit from any body; but, upon using the hot-baths at Melus, got rid of his itching and his thick skin. He died, however, of a dropsy afterwards.
A man at Athens was taken with the cholera (or overflowing of the gall); purged upwards and downwards; was in pain; and could not be relieved of either vomiting or purging. His speech failed him, and he could not move out of his bed. His eyes were misty and hollow. Convulsions seized him in the stomach from the intestine, and a hiccough followed. He also purged much more than he vomited. But upon drinking hellebore after the juice of lentils, and upon this the other lentil juice, in as great a quantity as he could, a vomiting ensued, which put a stop to both his evacuations; but he grew cold. His lower parts were therefore bathed very much up to his private parts, till the upper grew warm again. He recovered upon it, and the next day drank some thin gruel.
Gorgias’s wife in Larissa, who had a suppression of her menses for four years, almost entirely, complained of a pulsation and weight in her womb, whichever side she lay on. She conceived afterwards, and conceived again upon the first. In nine months she was delivered of a live girl with an ulcer on her hip. The membranes came away, and with them a great flux of blood. The next day, the third, and the fourth, clotted blood came away; a fever attended for the first ten days; and the rest that came away was red. Her face, legs, feet, and one thigh swelled very much; her appetite failed her quite; and her thirst was very great. The coldest water was of service to her, but wine by no means. Her belly, after the first child came away, was somewhat softer, though it did not fall entirely, but was harder than it should be, and without pain. Forty days after the first, the second child came away, like a lump of flesh; the belly fell; all the swellings went off; the flux was small; the blood offensive; and she recovered.
A woman in Pheræ was troubled a long time with a violent pain of her head, and could get no relief from any body, nor even from purging the head; but was easiest when her menses came down freely. Fragrant pessaries applied to the womb were of service to her, when her pain was violent; and a little purging followed upon it. Her pains left her upon proving with child.
A woman with child in Larissa lost a great deal of blood in fourteen days in her tenth month, but most three days before her delivery. The fourteenth, a dead child fell out of the womb, with its right arm growing to the side. The third day, the same hour of the night the child was born in, the membranes came away, and the whites followed. After this, for three days and nights, a great deal came away, but not immoderately. This was succeeded by a fever that lasted two days and as many nights, attended with pains all over the belly and the hips, especially the lower part of the belly, by the pubes.
Hipposthenes in Larissa was supposed by his physicians to have an inflammation of the lungs, but the case was quite otherwise. The beginning of his illness was from a fall upon his back in a hard place, and another falling upon him, as he was wrestling. He was afterwards washed with cold water, got his supper, and seemed to be heavier. The next day, was feverish, coughed without spitting, and breathed quick. The fifth, hawked up bloody matter, but not much; began to be delirious; and upon coughing complained of a pain in his breast and back. The sixth, bled about a quart at the nose, upon sneezing; in the evening neither spoke, nor perceived what was done or said. The eleventh, died.
He was, for five days, sometimes perfectly in his senses, sometimes not, and without a fever. He spit nothing at all; nor had he any rattling; because there was no spittle to occasion it.
Scamandrus in Larissa had a mortification in his hip, and an abscess of long standing at the bone. A large incision being made, even to the bone, and ustion used afterwards, a convulsion began the twelfth day after the incision, and held him strong, reaching from the leg to the ribs, and affected also the other side. The leg was sometimes contracted, sometimes extended, and he had the use of his other limbs, but his jaws were set. The eighth day after the first convulsion he died in another. The cure was carried on by applying warm bottles and fomentations of tares to the whole body, not omitting a glyster; by which the fæces that had been long detained, came away in a small quantity. He also drank a bilious purge, and even a second; from which indeed there was a discharge, but to no advantage. After a little sleep he took another strong purge of the like kind, and in the evening died about sunset; but in all probability might have held out a long time, had not the physic been too strong for him.
A boy belonging to Palamedes’s stables of Larissa, about eleven years old, was struck by a horse upon the forehead above his right eye. The bone seemed to be hurt, and a little blood spurted out. A large incision was made by the trepan even to the marrow, and the bone thus affected was healed; the other lamina (viz. the anterior) growing again presently. Twenty days after this a swelling appeared about the ear, attended with a fever and shivering; and this swelling was greater in the day, and painful. The fever began with shivering; and his eyes, forehead, and whole body swelled, rather on the right side of his head than otherwise, though the left was not entirely free; but no bad consequences followed. At length a continual fever came on; and these complaints lasted eight days, but were less. However, by burning, evacuating downwards by a purging potion, and applying a cataplasm to the tumour, he recovered. As to his complaints, they were not at all occasioned by the wound.
Theophorbus’s son in Larissa had the scabies (or leprosy) of the bladder; made viscid urine; was in pain at the beginning and going off of his water; and rubbed his glans. After drinking a sharp diuretic nothing passed into the bladder, but he vomited a great deal of purulent matter and gall, part of which went also downwards. His belly was in pain, and as it were burnt within, while the rest of his body was cold, and entirely unbraced. Nor could he take any thing at all. His belly was grievously ulcerated, and that by the strength of the physic altogether; for the third day after it he died.
Antimachus’s wife, in Larissa, after having been with child about fifty days, loathed her victuals the rest of the time, and complained of pain in the womb and the pit of her stomach for seven days. A fever came on, and nothing passed downwards. Upon drinking a stronger dose of elaterium than was proper, she vomited burnt bile, occasioned by her abstinence and fever. For she had drank nothing at all. She vomited a little again with violence, and with it some grumous matter. After this she grew sick, lay down, and, finding herself weak, would drink no more water to encourage it. The intestines were upon this seized with a terrible pain, (for the medicine had ulcerated them,) and presently with the stools she voided something that was viscid, stringy, and a little bloody, as if the guts had been shaved. Her weakness and the sickness at her stomach increased continually, and the purging amounted to almost three pints. This indeed stopped, by pouring a great deal of water upon the belly, but still she could take nothing; and about midnight she died; though in all probability she might have lived, if she could have drank water, and vomited immediately before it passed downwards.
Onesidemus’s servant in Larissa had her stomach and bowels ulcerated by bile that was set afloat of itself; upon which bile and blood passed off upwards and downwards, not without a fever. She took, as she was a weak woman, a weak potion of elaterium, little in quantity and mixed with water. Upon this she vomited a great deal, and purged more; and in the evening it came upon her again. The next day she was feverish, but not much; the belly was ulcerated, and she had the same stools as before. The third she died about sunset, the fever raging vehemently.
The case appeared to be altogether desperate, but not at all from drinking cold water, while the vomiting lasted. But when the stomach, cleansed by the water, was become cold, she drank the cream of barley cold, and had some of the same injected.
Eudemus, in Larissa, who was troubled with the piles to a great degree and long, having but little blood left, was seized with the flowing of the gall. The body indeed was very little affected with it, but the belly was thrown into purgings, and what came away was bilious. The piles also came out. Upon drinking something to pass downwards he was purged well, and upon drinking the cream of barley after it he was purged more, not without a pain in the hypochondre. The belly not being in the best condition, the piles were taken in hand; for he wanted a farther cure, and vomited afterwards. Upon rubbing something upon the part swelled, a fever came on, and never left him till it killed him; for if at any time it intermitted, a shivering succeeded, and fever came on again, and bilious stools followed with wind that sometimes passed off, sometimes not; and the belly was also in pain. The piles were swelled without the anus, from the time the purgings were made use of; and the wind passed through them by the help of sneezing at the beginning.
A man at Larissa was wounded behind by a broad javelin, from one very near him, the point of which penetrated below the navel. The part was livid and swelled for a great way. Upon receiving the wound, a violent pain first seized him, and his belly swelled. The next day he took something to pass through him, discharged a little bloody matter, and died. His intestines seemed to be hurt, and his belly to be full of blood.
Apellæus, of Larissa, who was about thirty, or something less, was taken ill of a distemper that used to affect him by night in his sleep, rather than by day, and continued so two years before he died; attended with a vomiting of sometimes yellow, sometimes black bile, upon being waked. After purging the head smartly for a long time, and taking physic twice, it left him six months. He was a great eater, and of a bilious habit. A violent shivering seized him after much wrestling; a fever followed, and in the night his old distemper. The next day and the following he seemed to be well; but the next night it came upon him again, after he had supped, and taken his first sleep, and continued till supper-time the next day. Nor did he recover his senses before he died. A convulsion first seized his right side, then his face, and whole body, and after that his left side. When it seemed to be over, he grew comatose, snorted or rattled in his throat, and had a return of his distemper.
Eumelus of Larissa had such a stiffness in his legs, hands, and jaws, that he could neither extend nor bend them, without the help of another; nor could he open his jaws, without another did it for him. He was in no pain any where else, nor did he eat any thing but a sort of flummery, with mead for his drink. The twentieth day he fell from his seat backwards, and struck his head very hard against a stone. Upon this his sight grew dim; but he soon got up again, recovered himself, and was entirely free, except that, when he got up after sleeping, his joints seemed bound together. He was twelve or thirteen years old, and ill three or four months.
A maid in Larissa, after vomiting a little blood, had a collection of matter formed; upon which a fever coming, she could not get the better of it, till death freed her from all within three months. Before she died, her ears were so deaf that she could hear nothing at all, unless one bawled to her very loud: and before this vomiting of blood happened, she was but in a weak condition.
Dyseris’s servant, of Larissa, in her youthful days, complained of violent pain in the act of venery, and not at any other time. She never proved with child; but, when she was about sixty, was taken after noon with violent pains like labour-pains, having eat just before a good deal of garlic. She got up, when her pains were more violent than ever, and felt something rough in the mouth of the womb; but, fainting away afterwards, another woman put up her hand, and brought from her a rough stone as big as the whirl of a spindle. She grew well upon it immediately, and remained so.
A loaded wagon came upon the ribs of one who belonged to Malea, and broke them. Matter lodged for some time under the ribs, but upon being cauterized below the spleen, and the ulcer kept open with lints and the like, he held out ten months. After the skin was cut, a cavity appeared both ways, reaching to the omentum, not without putrefaction. It extended likewise to the kidney and the bones. The habit of this man’s body was not perceived to be bilious, and so the putrefaction became great and dry, affecting the omentum and other fleshy parts. A dry medicine was here immediately necessary, while the strength of the patient lasted; for the moist medicines were so far from abating, that they increased the putrefaction. The moisture being stopped by the lints that were applied, a shivering and a fever came on; the putrefaction increased; and a fetid, blackish, putrid matter ran out. But before we undertook the cure, a great deal of such stuff was discharged every day, though not freely. By this we knew the nature of the disease, and that it was deeper than the skin. So that if every thing had been done for him in a proper manner, yet his case would have been desperate; even though a purging had also happened.
Autonomus died in Omilus, the sixteenth day, in the middle of summer, of a wound of the head, occasioned by the throwing of a stone at a little distance upon the sutures in the middle of the os bregmatis, or parietal bone. I did not perceive that the trepan was wanting; for the injury was received upon the very sutures (as was extremely clear afterwards), and so deceived me. A violent pain seized the collar-bone first of all, and after that the side, together with a convulsion in both hands; for the wound was given in the middle of the head, and the parietal bone. The trepan was applied the fifteenth; a little pus came out; and the membrane appeared free from any corruption.
A young girl in Omilus, about twelve years old, died in the middle of summer, the fourteenth day, of a wound in her head, occasioned by somebody’s throwing a door upon her, that bruised and broke the bone. The wound was right upon the sutures, and it was plainly seen there was occasion for the trepan. It was accordingly applied, but not so far as it ought; however, what remained came to suppuration. The eighth day she shivered, and grew feverish; and though she was not as she should be, yet she was as she had been some time before, when she had no fever. The ninth, the remaining part was trepanned, and a very little pus, streaked with blood, appeared underneath. The membrane was clear, and sleep came on, but the fever never abated more. The left hand was convulsed, the wound being rather on the right side.
Cyrenius in Omilus was burnt upon the belly for a collection of pus there; and, though it was thirty days later than it ought to have been, yet he was pretty well after it, and the pus that was in the belly was dried up. But eating afterwards, in the hottest time of the year, the fruits of the season and other improper food, he fell into a fever and looseness, and went off.
Hecason in Omilus was cauterized later than he ought, just as the other was, and almost the whole belly was dried up too; but a dysentery came on; and, as soon as he got over it, he eat of every thing till he swelled all over. The pus afterwards broke its way downwards; a looseness attended it; and he died.
Hecason in Omilus had an acute pain fixed in his hip, from the foulness of his body, and injudicious purging. Upon its going off a fever ensued, that confined him to his bed a long while. He neither drank any thing, nor was thirsty, but was weak and chilly. His distemper went off in a proper manner, as it ought, and his body was the better for what was given him. At last the distemper broke downwards, and went all off with a great deal of bile. He grew delirious upon it, however, and died; but seemed to be able to get over it.
A man in Salamis, falling upon an anchor, was wounded in the belly, and in great pain. The physic he drank passed neither upwards nor downwards.
The woman that cut her own throat was strangled; but a purging potion, that was given her a good while after, passed through her.
The young man who came from Eubœa, and had been purged very much, grew feverish upon its intermitting and stopping. Concluding from this that a vomit was necessary, he drank a weak one, viz., the root, and elaterium, and died four days after, without any evacuation; but he was sleepy, and his thirst could not be quenched.
The maid-servant, that was a foreigner, vomited a little from what she drank, and was strangled; but purged very much downwards, and died in the night.
The man of Eubœa, upon drinking a purging potion, was purged three days, and died. His hand suppurated up to his elbow.
Symmachus’s boy was strangled with bile, as he was asleep in the night, and feverish. The physic he drank would not stay with him, nor was he purged in six days before he died.
He who lived by the race-house, and vomited blood in the night, died the next day, vomiting a great deal of blood, and strangled. The spleen and parts below it had a quantity of bloody matter pass that way.
The boy, that was struck by a mule upon the belly and the liver, died the fourth. His breath was quick, his senses confused, and a fever attended besides.
Hermophilus’s son, who was ill eleven days, was feverish, bound in his body, and delirious at first, but it went off in the night. The next day he lost his speech, rattled as he lay, had his eyes distorted, and was feverish. A feather being put down his throat, he brought up black bile, and by the help of a glyster had a very great discharge.
Aristion’s servant had a mortification about the middle of her foot from the inside obliquely, without any reason for it. The bones putrefied, separated, and came away in a fistulous manner by little and little. Upon a looseness succeeding, she died.
A woman in good health, and corpulent, complained of pain in her belly, a colic in her bowels, and with these a swelling, after drinking something upon account of conception. A difficulty of breathing attended, with great uneasiness of mind and pain. She also vomited blood, but not much, and fainted away five times so as to be thought dead. Neither the pain nor the breathing were relieved by vomiting with cold water; the only thing that relieved her was the pouring about thirty firkins of cold water upon her body. For after this a great deal of bile passed downward, and she recovered; whereas, when the pain was upon her, nothing could pass.
Antandrus, who was well in other respects after taking physic, seemed to have a pain about his bladder. A very great clearage and depuration was made there by what he had taken, and in the afternoon a violent pain seized him. The next day a suffocation, with great perplexity and restlessness. He vomited too, without any thing passing downwards, had a bad night, and no sleep. The third day a great deal went downwards, followed by blood, and so he died.
The cobbler of Pityus, as he was sewing a sole, ran the awl above his knee into his thigh about an inch, but no blood followed, and the wound closed up presently: however the whole thigh swelled upon it, and the swelling reached to the groin and flank. The third day he died.
A man received a wound in his groin by a dart, and recovered contrary to all expectation; for we saw the case. The head of the dart was neither taken out, because it lay very deep; nor was there any loss of blood to speak of, nor inflammation, or lameness; but six years after the accident we found the dart, and took it out. Our opinion is that it was buried between the nerves or tendons, without dividing either artery or vein.
Another received an insignificant wound to speak of (for it was not deep) a little below his neck behind from a sharp dart; which being taken out not long after, he was drawn and distorted backwards, as in the opisthotonus. His jaws were also fastened; and, if any thing moist was put into his mouth, and he attempted to swallow it, it returned again through the nose. In other respects he grew worse immediately. The second day he died.
A young man, running hastily over rough ground, felt a pain in his heel, especially the lower part. No moisture being collected, nor any abscess formed, the whole part turned black the fourth day, as far as the bone called astragalus, and the hollow part in the bottom of the foot. Before the mortification could break away or suppurate, he died, twenty days in all after the running.
He who was wounded by his eye, received it upon his eyelid, and the point of the dart went in deep, but the fang or beard of it appeared outwardly. Upon laying open the eyelid, every thing was taken out without any inconvenience: for the eye was saved and healed presently, and the blood flowed freely and sufficiently.
Nerius’s handsome girl, about twenty, was struck upon the parietal bone with the palm of the hand by another young woman in play; upon which a mist came on, and she could not breathe. As soon as she was brought home, a violent fever attacked her, with a pain in her head, and a redness about her face. The seventh day, above a spoonful of fetid reddish pus came out of her right ear; she seemed to be better, and was lighter and easier. The fever, however, increased again, and was attended with a dozing, a loss of speech, a contraction of the right side of the face, a difficulty of breathing, a convulsion, and a trembling. The tongue was also confined, the eye fixed, and the ninth she died.
A young man, after drinking a great deal of genuine wine, fell asleep in a certain shade, and the serpent called Arges crept into his mouth. As soon as he perceived it, not being able to speak, he grinded his teeth, bit the serpent through, was seized with great pain, threw out his hands as if strangled, tumbled and tossed about, fell into convulsions, and died.
Note.—At this place Clifton leaves out several pages as they appear in Haller; and what follows is from the sixth book, omitting nearly the two first of the sections as given in Haller,—the only explanation for which is in the following note, which to me is not satisfactory.—Ed.
“This is the first observationa in the sixth book (see section the 2d, aph. 22,) that I could insert here; the former being all aphorisms of such a nature, as cannot be brought, with any propriety, into a book of Epidemics. The other observations are not so good as I could wish them, but yet must not be omitted.”
[a ]This refers to the sixth book, beginning with “Broad eruptions,” in the next page.—Ed.