Points to Ponder:
-- In the following exerpt from Hippocrates, what can you detect as the primary causes of disease?
-- What kinds of things did Hippocrates consider important in the diagnosis of disease?
-- What kinds of symptoms was Hippocrates dealing with?
-- Did geography or climatology play a role in the medical theory of this period?
OF THE EPIDEMICS, Book I. Section I.
1. IN THASUS, about the autumn equinox,
and under the Pleiades, the rains were abundant, constant, and
soft, with southerly winds; the winter southerly, the northerly
winds faint, droughts; on the whole, the winter having the character
of spring. The spring was southerly, cool, rains small in quantity.
Summer, for the most part, cloudy, no rain, the Etesian winds,
rare and small, blew in an irregular manner. The whole constitution
of the season being thus inclined to the southerly, and with droughts
early in the spring, from the preceding opposite and northerly
state, ardent fevers occurred in a few instances, and these very
mild, being rarely attended with hemorrhage, and never proving
fatal. Swellings appeared about the ears, in many on either side,
and in the greatest number on both sides, being unaccompanied
by fever so as not to confine the patient to bed; in all cases
they disappeared without giving trouble, neither did any of them
come to suppuration, as is common in swellings from other causes.
They were of a lax, large, diffused character, without inflammation
or pain, and they went away without any critical sign. They seized
children, adults, and mostly those who were engaged in the exercises
of the palestra and gymnasium, but seldom attacked women. Many
had dry coughs without expectoration, and accompanied with hoarseness
of voice. In some instances earlier, and in others later, inflammations
with pain seized sometimes one of the testicles, and sometimes
both; some of these cases were accompanied with fever and some
not; the greater part of these were attended with much suffering.
In other respects they were free of disease, so as not to require
medical assistance.
2. Early in the beginning of spring, and through the summer, and
towards winter, many of those who had been long gradually declining,
took to bed with symptoms of phthisis; in many cases formerly
of a doubtful character the disease then became confirmed; in
these the constitution inclined to the phthisical. Many, and,
in fact, the most of them, died; and of those confined to bed,
I do not know if a single individual survived for any considerable
time; they died more suddenly than is common in such cases. But
other diseases, of a protracted character, and attended with fever,
were well supported, and did not prove fatal. . . . Consumption
was the most considerable of the diseases which then prevailed,
and the only one which proved fatal to many persons. Most of them
were affected by these diseases in the following manner: fevers
accompanied with rigors, of the continual type, acute, having
no complete intermissions, but of the form of the semi-tertians,
being milder the one day, and the next having an exacerbation,
and increasing in violence; constant sweats, but not diffused
over the whole body; extremities very cold, and warmed with difficulty;
bowels disordered, with bilious, scanty, unmixed, thin, pungent,
and frequent dejections. The
urine was thin, colorless, unconcocted, or thick, with a deficient
sediment, not settling favorably, but casting down a crude and
unseasonable sediment. Sputa small, dense, concocted, but brought
up rarely and with difficulty; and in those who encountered the
most violent symptoms there was no concoction at all, but they
continued throughout spitting crude matters. [T]hey were soon
wasted and became worse, having no appetite for any kind of food
throughout; no thirst; most persons delirious when near death.
. . .
3. In the course of the summer and autumn many fevers of the continual
type, but not violent; they attacked persons who had been long
indisposed, but who were otherwise not in an uncomfortable state.
In most cases the bowels were disordered in a very moderate degree,
and they did not suffer thereby in any manner worth mentioning;
the urine was generally well colored, clear, thin, and after a
time becoming concocted near the crisis. They had not much cough,
nor it troublesome; they were not in appetite, for it was necessary
to give them food (on the whole, persons laboring under phthisis
were not affected in the usual manner). They were affected with
fevers, rigors, and deficient sweats, with varied and irregular
[spasms]. . . . Of all those which are described under this constitution,
[these] diseases alone were of a fatal character. . . .