[628] Galen thus explains the origin of the ophthalmies. He says, the constitution of the air being not only cold and humid, but attended also with hurricanes. The eyes were thus injured, and consequently were the first part of the body to show symptoms of disease. The dysenteric and other alvine complaints which followed, he ascribes to the constriction of the skin induced by the cold, and to the humoursæ of the system aggravated and increased by the humid state of the season. These humours being thus shut up by the occlusion of the pores of the skin, part of them were determined to the intestines, occasioning diarrhœa, tenesmus, dysentery, etc.; some to the bladder, inducing strangury; and some to the mouth of the stomach, occasioning vomiting.
[629] Galen states in his Commentary that the phrenitis is connected with inflammation of the parts about the brain. We have mentioned before that the phrenitis of the ancients was a febrile affection, and not idiopathic inflammation of the brain, as is generally supposed.
[630] According to Galen, the causi or ardent fevers are occasioned by yellow bile collected about the vessels of the liver and stomach, and the tertians by the same diffused over the whole body.
[631] Galen states in his Commentary that children are peculiarly subject to convulsions owing to the weakness of their nervous system. He adds, that in their case convulsions are not attended with so much danger as in other cases. See the Hippocratic treatise On Dentition.
[632] The fever here described is evidently the semitertian. See Paulus Ægineta, Book II., 34. “The true semitertian,” says M. Bartels, as quoted by M. Littré, “is a real complication of an intermittent fever with another fever of a continual type. It does not show itself but rarely in our countries; but it is more frequent in the hotter countries of Europe, although the false semitertian has oftener than once been confounded with the true. In the true, the intermittent fever is tertian; the non-intermittent is quotidian.” See also Galen, Opera, tom. v., p. 362; ed. Basil.
[633] The text here is in an unsatisfactory state, and, as usual in such cases, no ingenuity nor pains can do much to mend it. See Foës and Littré. I have translated the disputed words “not resolved,” which seems to me to agree best with the sense. Every practical physician knows that swellings of the glands, which continue long and do not suppurate, are unfavorable in fevers.
[634] The modern physician will not fail to be struck with this observation as to the termination of certain cases of fever in determination to the kidneys. Galen remarks in his Commentary on this passage, that as the general system is often purged by the bowels, so is it also sometimes by the kidneys and bladder. This, he adds, is a protracted and painful mode of resolution in fevers. The reader will remark the characters of the urine as stated below by our author. One cannot help being struck with his statement, that all these cases recovered. I am not aware of any modern observations bearing on this point.
[635] There is considerable difficulty here in determining the reading. See Littré, whom I have followed.
[636] I need scarcely remark that this passage is of classical celebrity. Galen, in his Commentary, remarks that the first time he read it he thought it unworthy of Hippocrates to lay it down as a rule of practice, that “the physician should do good to his patient, or at least no harm;” but that, after having seen a good deal of the practice of other physicians, and observed how often they were justly exposed to censure for having bled, or applied the bath, or given medicines, or wine unseasonably, he came to recognize the propriety and importance of the rule laid down by Hippocrates. The practice of certain physicians, Galen remarks, is like playing at the dice, when what turns up may occasion the greatest mischief to their patients. The last clause of this passage is very forcibly put. Galen, however, informs us that in some of the MSS. instead of “art” he found “nature;” that is to say, that the physician is “the minister (or servant) of nature.” Either of the readings, he remarks, will agree very well with the meaning of the passage.
[637] The reader will find it interesting to refer here to the Prognostics. See also the Commentary of Galen. Let me here impress upon the reader the necessity of making frequent comparisons of the Prognostics with this work, if he would wish rightly to apprehend the bearing and meaning of the latter. That the Epidemics are entirely founded upon the principles of prognosis there can be no doubt.