[589] Galen, in his Commentary on this section, finds many things imperfectly stated, and therefore unworthy of his great author. For example, he remarks, only two varieties of dropsy are mentioned, namely, anasarca and tympanites; whereas there are three at least, and some even describe four varieties. By the three kinds of dropsy, Galen and the other ancient authorities meant anasarca, ascites, and tympanitis. (See Paulus Ægineta, Book III., 48). That tympanites should have been ranked with dropsy need excite no wonder, when we consider the resemblance of this affection to ascites. In fact I have known cases of tympanites in which paracentesis was performed by inexperienced surgeons under the impression that they were cases of ascites. See some elaborate annotations on this head by Ermerins (Specimen Hist. Med., p. 125), and by Littré (Op. Hippocrat., tom. iv., p. 415). With regard to venesection in dropsy, Galen remarks that the rule of practice is not laid down here with sufficient precision; it is only when the dropsy is connected with the suppression of the hemorrhoidal or menstrual discharge, or when the patient is in a plethoric state, that blood can be abstracted with advantage. He also finds fault with the directions for the subsequent treatment, as not being accurately given. He justly remarks, that none but persons in the vigor of life and in good health would be able to digest dark-colored wine and pork after venesection. I may mention further that the text is faulty, that the words ἐγχειρέων γίνεσθαι ἄφυκτος should have been written ἀποκτέινει δ’ ἐυθὺς ὁ ὔδερος ἐφὴν γένηται. He attributes the mistake to the first amanuensis who wrote the words in question.
[590] In reference to this practice Horace says:
“Si noles sanus curres hydropicus.” (Serm. I., 1.)
[591] Galen finds many things in this section also carelessly and confusedly written, and therefore unworthy of Hippocrates. For example, the list of cases in which purging is inapplicable, Galen holds to be incomplete; and even in some of the cases specified by Hippocrates he demurs to admit his views to be correct; for example, in diseases of the spleen he contends that melanogogues are strongly indicated. Many more of the rules he considers to be vaguely and inaccurately stated. Altogether, then, he holds that it is a loss of time to devote much attention to writings of such a stamp; but, he shrewdly remarks, there is no persuading many people to study only such writings as are clear, and to leave such as are not so to the writers themselves; for it is just that, as they have paid no regard that we should understand what they have written, we should not be very anxious to find out and learn what they say.
[592] Galen correctly remarks that this rule is applicable in certain cases, but not in all.
[593] As Galen remarks in his Commentary, something appears to be wanting here in order to indicate the disease to which these directions apply. Perhaps, as he suggests afterwards, they are meant to apply to general pains.
[594] The Cantharis of the ancients was indisputably the Mylabris cichorii, or M. Fusselini. It continued to be used in ancient times as a diuretic, (see Paulus Ægineta, Vol. III., p. 153;) and is well known in the East at the present day.
[595] All the remaining part of this work evidently consists of fragments put together, without any method or arrangement. Though not devoid of interest, they decidedly have no connection with the treatise On Regimen in Acute Diseases. Indeed an impartial examination of the whole Appendix must satisfy any one that there are but too good grounds for holding with Galen, that the whole work is a disorderly compilation, which, although it may have been made up of notes written or dictated by Hippocrates, had certainly not been published by him.
[596] It most probably is the Reseda mediterranea. See Paulus Ægineta, Vol. III., p. 331.
[597] This description has always been regarded as very obscure. According to Galen it is the operation which was afterwards named anabrochismus. See Paulus Ægineta, Vol. III., pp. 262, 269. M. Littré gives the following interesting observations on this passage by M. Malgaigne: “Quoiqu’il semble que l’auteur emploie deux fils, cependant il n’est fait mention que d’une aiguille. Il paraît bien indiqué que l’aiguille traverse deux plis transverseaux en marchant de haut en bas. Voici comment je traduirais le passage en question: pour le trichiasis, avec une aiguille armée d’un fil, traversé de haut en bas le point le plus élevé (ou la base); de la paupière supérieure, après lui avoir fait former un pli, et repasser l’aiguille de la même manière un peu plus bas (ou près du bord libre); rapprochez les extrémités du fil, et fixez-les par un nœud: puis laissez-les tomber d’eux-mêmes. Si cela réussit, c’est bien: si non, it faudra recommencer.” (Op. Hippocrat., tom. iii., p. xliv). In my Commentary on Paulus Ægineta, (Vol. II., p. 163.) I have in so far fallen into the mistake of supposing this description to apply to the lower eyelid, and M. Ermerins would appear to have done the same. See Littré, l. c. The operation by the ligature on hemorrhoids will be found more circumstantially described in the treatise on that subject, of which a translation is given in this volume.