[645] Modern observations have confirmed this account of the generally fatal issue of febrile diseases after parturition. In the Hippocratic work On Diseases, fever after delivery in a woman is reckoned among the cases which generally prove fatal.
[646] I would again request the attention of my contemporaries to the characters of the urine before a crisis, as given by Hippocrates; and, in confirmation of them I will venture to introduce here an extract from Donald Monro’s admirable account of the autumnal remittent fever: “The urine in the beginning was commonly of a high color, though sometimes it was pale and limpid; but when the fever came to remit, there was often a small sediment after each paroxysm; and as the fever was going off, it let fall a sediment in all.” (Army Diseases, etc., p. 159.) The absence of the sediment in the urine before the crisis is an important fact in the history of febrile diseases, which I have reason to think is not now sufficiently adverted to.
[647] Galen does not hesitate to give it as his opinion that the dysentery was owing to the bile not being properly purged off by the urine.
[648] The reader will find it interesting here to mark the alliance between the causus and phrenitis, to which we formerly adverted. Galen remarks that both arise from the same humour, that is to say, bile, which when it collects in the veins of the lower part of the body gives rise to causus; but from the beginning of autumn to the equinox, produces phrenitis by being determined to the brain.
[649] This is perhaps the most striking account of an aggravated form of causus which is anywhere to be found. Although less finished than the celebrated picture of the disease given by Aretæus, it is evidently more original. In fact, any human production which is very original cannot well be finished, and consequently a very finished work can scarcely be expected to be very original.
[650] It is impossible to overrate the importance of these observations on crises in fevers, provided they be correct and confirmed by general experience. Monro, without appearing to have our author in view, seems to give an ample confirmation of his doctrines on crises as here laid down.
[651] From Galen’s Commentary it appears that the text here is in a doubtful state. See also Littré.
[652] Allusion is here made to the symptoms of delirium as described in the fourth paragraph of the Prognostics. See Galen’s Commentary on this passage.
[653] What an admirable and comprehensive enumeration of all the circumstances upon which the prognosis and diagnosis of diseases are to be founded! Here we find nothing either wanting or redundant; and with what conciseness and precision the whole is stated! Galen gives an elaborate and, upon the whole, a very interesting Commentary on this section, but does not supply any new views, and there are few terms in it requiring explanation.
[654] Having already stated in this work, as well as in the Commentary on Paulus Ægineta, Book II., 27, my opinion respecting the nature of the continual fevers, I need not enlarge on the subject in this place. Whoever wishes for more information may find much to interest him in the Commentary of Galen. Respecting the septans and nonans, he remarks, that, although conversant with fevers from his youth, he had never met with any cases of these.