[529] One mode of exercise, namely, gestation, is to be excepted, which had at least one distinguished advocate in ancient times. Celsus writing of it says, “Asclepiades etiam in recenti vehementique, præcipueque ardente febre, ad discutiendam eam, gestatione dixit utendum: sed id pericolose fit; meliusque quiete ejusmodi impetus sustinetur.” (ii., 15.) A great modern authority on fever, Dr. R. Jackson, speaks favorably of this practice, although, as we see, it is so pointedly condemned by Celsus. Celsus, however, admits of gestation in that species of remittent fever which was called lethargus. (iii., 20.)
[530] Observ. Med., vi., 3, 4.
[531] The Cnidian Sentences in all probability were the results of the observations and theories made in the Temple of Health at Cnidos. We may reasonably conclude from what we know of them, that, like the Coacæ Prænotiones at Cos, the Cnidian Sentences at Cnidos were looked up to in the time of Hippocrates as the great guides to medical practice. How much, then, it is to be regretted that they have not come down to us like the other! It is clear, however, from Galen’s Commentary, that the work was extant in his time, and from it, as will be seen, we are enabled to draw a few particulars respecting the theoretical and practical views of the Cnidians. Le Clerc considers it likely that Euryphon was the author of the Cnidian Sentences (Hist. Phys., i., 3, 30); but it is evident, from the terms in which Hippocrates refers to them, that they were not the work of a single author. He makes mention, it will be remarked, of more than one person being concerned in remodelling them.
[532] By this our author means that the Cnidians neglected Prorrhetics and Prognostics. This must be obvious to every person who had entered properly into the spirit of the Hippocratic system of medicine.
[533] The text of this sentence is in a very unsatisfactory state, and much difference of opinion has prevailed respecting the meaning. See the annotations of Littré, and the remarks of Galen, as quoted in the Argument.
[534] Galen, in his Commentary, mentions that the Cnidians described seven species of diseased bile, and twelve diseases of the bladder; and, again, four diseases of the kidneys; and, moreover, four species of strangury, four species of tetanus, and four of jaundice; and, again, three species of phthisis. Galen, having made this statement, remarks that they looked to the peculiarities of the body, instead of regarding the identity of the diatheses, as was done by Hippocrates. In other words, they split diseases into endless varieties, instead of attending to the essence or general nature of each. The system of Hippocrates, then, was founded on a rational prognosis, whereas that of the Cnidians was founded on mistaken principles of diagnosis. The principles of the Hippocratic system are admirably explained and developed in Galen’s great work On the Method of Cure, or Therapeutics.
[535] Galen, in his Commentary on this passage, states that when a disease of a mild character prevailed generally, it was called an epidemic; and when of a malignant nature, it was called the plague. (See further Paulus Ægineta, Book II., 36, Syd. Soc. edition.) It will be remarked that I have included the word (not) in brackets. This I have done because not only the reading, as given in the common editions of Galen, is in its favor, but because the sense appears to me to require it. Surely when diseases are of an epidemic character they are similar; but when they are sporadic, they are not similar. M. Littré, however, rejects it altogether.
[536] The question here mooted is certainly one of the most important that can well be entertained, namely, whether or not a certain portion of nutriment ought to be given to persons laboring under fever. It would appear, from what is stated by Galen upon the authority of Erasistratus, that the most diametrically opposite modes of practice had been followed by different individuals—that some had starved their patients altogether for a considerable time; whereas, on the other hand, a physician of the name of Petronas allowed his patients flesh and wine. Our author, it will be remarked, does not allude to these extreme modes of practice in this place, but enters at great length into the question whether or not unstrained ptisan (or barley gruel) should be administered in fevers, and, if so, under what circumstances.
[537] Galen, in his Commentary, has some very interesting remarks on the differences of opinion among the diviners. This, in fact, may well be supposed, since, as will now be pretty generally acknowledged, the whole art was founded upon conjecture and deception. The comparison of medicine to divination is therefore very discreditable to the former.
[538] Our author now enters upon the consideration of one of his principal objects in the present work, namely, to describe the modes of preparing ptisan (or the decoction of barley), and its uses in acute diseases. He is so full on this subject that the present treatise is quoted by Athenæus (Deipnos. ii., 16), by the name of the work On the Ptisan. Galen states that, on the principle that diseases are to be cured by their contraries, as the essence of a febrile disease is combined of heat and dryness, the indication of cure is to use means of a cooling and moistening nature, and that the ptisan fulfils both these objects. I may be allowed to remark in this place, that probably there is not a more important rule in the whole practice of medicine than this, that fevers are to be treated by things of a cooling and diluent nature. I may mention further regarding the ptisan of the ancients, that it would appear to have been very little different from the decoction of barley, as now in use; that is to say, it was prepared from pearl-barley roughly pounded and boiled for a time in water. As will be seen by the text, it was given to the sick either strained or entire, according to circumstances. A similar decoction was prepared from wheat, and was called πτιαάνη πυρίνη. See Galen (De Aliment., i.) The simple term ptisan, however, is always to be understood as applying to the decoction of barley.