[559] I need scarcely mention that hydromel was a drink prepared by boiling honey in a large proportion of water. It was of different degrees of strength; sometimes there were only two parts of water to one of honey, and at other times from seven to eight parts were used See Paulus Ægineta, Book I., 96, Syd. Soc. edit.
[560] Galen, in explanation, mentions that hydromel is of a detergent nature; and hence it clears out the air-passages, and thus promotes expectoration. When the sputa are thick and viscid, it cuts and attenuates them. (Opera, tom. v., pp. 75, 76; ed. Basil.)
[561] Although, as we have shown in our analysis of the treatise on the Use of Liquids, Hippocrates and his followers were sufficiently liberal in the administration of water on proper occasions, it will be seen from the contents of this section that our author was by no means disposed to give water freely in febrile diseases, nor in affections of the chest. Whatever may now be thought of his observations on this point of practice, all must admit that they are deserving of high attention. Galen’s Commentary is also very interesting. It appears from it that he disapproved of giving water alone, but always added a small proportion of wine to it in order to give it a flavour. That the quantity of wine which was added to the water must have been small, is obvious from an anecdote which he relates in this place. He says that a certain physician, who saw the insignificant amount of the wine which was put into the water, said, bantering him, “Your patient will have the pleasure of seeing the wine indeed, but will not be able to taste it.” Galen, however, contends that, although the quantity thus added be small, it is sufficient to act as a stomachic, and to obviate the bad effects which the water would otherwise produce. (Opera, tom. v., p. 83; ed. Basil.) It will be perceived from the context, that Hippocrates intended to give a separate treatise on each particular disease, not considering the present work on general therapeutics sufficiently explicit, as Galen remarks.
[562] The smegma was an abstergent composition used by the ancients in bathing for the purpose of cleansing the skin. For a full account of the smegmata, see Paulus Ægineta, Vol. III., pp. 536–41.
[563] Galen, in his Commentary, remarks that the physicians usually did not put their patients into the baths, but made use of the douche, or affusion of hot water. He adds, that persons in good health may leave the hot bath and plunge into the cold, but that this practice is not safe in the case of invalids. He recommends, then, that there should be at hand a good supply of baths of various temperatures, so that the patient may gradually pass from one of a high to others of a low temperature. By the way, I have often wondered that Dr. Currie, who certainly had no inconsiderable pretensions to classical scholarship, should have been so profoundly ignorant as he appears to have been of the use of the warm affusion by Hippocrates and Galen in the treatment of febrile diseases. His rival, Dr. Jackson, had a much more respectable acquaintance with the ancient authorities on medicine; and I have often thought it was to be regretted that the profession at that period, in giving a trial to the affusion of cold and hot water in fever, put itself under the leadership of Currie instead of Jackson.
[564] Dr. Tweedie’s observations agree so well with those of Hippocrates, that I will give the reader an opportunity of comparing them together. “This organ (the stomach), in convalescence, partakes of the external or muscular debility, and the convalescent may as well expect to be able to carry a heavy load on his shoulders as to digest an undue quantity of food, even of a suitable kind.” (p. 215.)
[565] The directions given by that excellent authority Alexander Trallian, for the regulation of the regimen in phrenitis, are to the same effect. Wine is to be given when there is much insomnolency, when the strength is reduced, when the fever is no longer strong and ardent, and when concoction appears already in the urine. The author makes the acute remark, that the remedy is attended with certain evil consequences, but that it is the part of a prudent physician to balance the good and bad effects, and administer the article in question when the good preponderate. (i., 13.)
[566] This can scarcely be supposed anything else than a wilful misrepresentation of our author’s rule of practice in this case. See the fourth section of the preceding part.
[567] The causes of ardent fever of the ancients was decidedly the same as the bilious remittent fever of modern authors. See Paulus Ægineta, Vol. I., p. 262. We shall find many cases of it related in the Epidemics. In fact the causus is the ordinary fever of Greece and other countries bordering upon the Mediterranean. Galen, in his Commentary on this section, mentions that he had known it generally superinduced by drinking wine after great fatigue in summer. There can be no doubt that this was the fever of which Alexander the Great died. The description of the disease in his case, as given by Arrian from the Royal Journals (βασίλειοι ἑφημερίδες), has so much the air of truth, and withal appears to me so interesting, that I shall be excused introducing it in this place. “And the Royal Journals ran thus: that he drank at a jollification in the house of Medius; then rising up and being bathed, slept, and again supped with Medius, and again drank until the night was far advanced; that giving over drinking he bathed; and having bathed, ate a little, and slept there, because he was already feverish; that being carried on a little to the sacrifices, he performed them according to his daily practice; that the sacrifices being performed, he reclined in the dining-room (ἀνδρὼν) until the dusk of evening, and there gave orders to the commander respecting the march and voyage, that those who had to proceed on foot should be prepared for marching on the fourth day, and those who were to sail on the fifth; that he was carried hence upon a couch to the river, and being placed in a boat was taken across the river to the garden, and then being again bathed, that he rested. Next day, that he again was bathed and performed the appointed sacrifices; and going into a chamber, that he reclined and conversed with Medius, and gave orders to the commanders to meet him in the morning. That having done these things, he took a little supper; and having been carried back to the chamber, that he was in a continued state of fever during the whole night; that next day he bathed, and after the bath performed the sacrifices; that he gave orders to Nearchus and the other commanders respecting the voyage, that it should take place on the third day; that next day he bathed again, and performed the appointed sacrifices; that the religious rites being over, he did not cease to be feverish, but that calling the commanders he gave orders for having every thing in readiness for the voyage; that he was bathed next day, and being bathed was already in a bad state. That next day being carried to the house adjoining the bath, he performed the appointed sacrifices; that he was in a bad state, but yet that he called to him the chiefs of his commanders, and again gave orders respecting the voyage; that the following day he was carried with difficulty to the religious rites and sacrificed, and that notwithstanding he gave orders to the commanders respecting the voyage. That next day, although already in a bad state, he performed the appointed sacrifices; that he gave orders that the commanders should watch in the saloon, and the chiliarchs and pentacosiarchs before the doors; and that being altogether now in a bad state, he was carried from the garden to the palace. That when the commanders came in he recognized them, but did not speak, being now speechless; that he was in a bad state of fever during that night and day, and during another night and day. Thus it is written in the Royal Journals.” Thus far the report is no doubt to be strictly depended upon; the historical embellishments added to it from other sources can have no interest to the professional reader. (Appiani Exped. Alexandr., vii., 37.) It deserves to be remarked, as a remarkable feature in this case, that the mind appears to have been pretty entire during the whole course of the fever. Now, this is one of the characteristics of causus as described by Aretæus (Morb. Acut., ii., 4). It is further one of the most marked features of the yellow fever, which, from all I can learn of it, would appear decidedly to be an aggravated form of causus.
[568] Galen admits that he did not understand the exact import of this term.