[675] Here again Galen calls attention principally to the characters of the urine, which is first described as being “of a good color, but thin.” Now, by a good color of the urine, Galen observes, was meant of a slightly yellow color. In this case, as usual, the crisis was marked by a sediment in the urine.
[676] Œuvres d’Hippocrate, tom. iii., Arg., pp. xxxvi.-xlii. tom. v., pp. 57–70.
[677] There is some doubt, however, even on this head; indeed Riolanus does not scruple to affirm, with a considerable degree of plausibility, that Ruffus must have lived after Galen, since he is nowhere mentioned by the latter. (Anthropographia, i., 5.)
[678] In illustration, consult Plutarch (Placit. Philosoph., v., 29).
[679] De Differ. Feb., i., 7; tom. vii., p. 296, ed. Kühn.
[680] Commentary on Paulus Ægineta, Book II., 16, 36; IV., 25, Syd. Soc. edition.
[681] Disquisitio Historico-Medica de Natura Morbi Atheniensium. Stuttgart, 1831.
[682] On this case Galen has left very lengthy and elaborate commentaries, containing much important and amusing matter, but not a little verbose trifling, to say the least. Our limits, as well as our tastes, dispose us to be very sparing in our extracts from them. Passing over his remarks on the solecism in syntax, with which the Report commences, and his observations on the absence of all mention of the exciting causes, as is the usual practice of our author, I shall proceed to state what Galen says on the apparent neglect of venesection in a case where it would certainly appear to have been clearly indicated. In this case, as Galen remarks, one or other of these suppositions may be made: either that bleeding was not practiced, or that the author did not think of mentioning the practice here, as supposing that it would be taken for granted that it was applied. Now, he adds, the former supposition is very improbable, considering how partial our author shows himself to this practice in his works which are unquestionably genuine, such as On the Regimen in Acute Diseases, the Aphorisms, the work On the Articulations, and even in this very book, where in one place he mentions that he abstracted blood copiously on the eighth day. If, then, he bled so late in febrile diseases, Galen contends that he was not likely to neglect the operation in an earlier stage, when so much more demanded. He argues further, that in many of the other reports of cases he neglects to mention that the usual routine of practice was followed: and therefore he inclines to the opinion that it is omitted to be mentioned here, because the author supposed there could be no question on this point, more especially as it was his universal rule to bleed in all great complaints, when not prevented by the age or powers of the patient. He afterwards insists strongly on venesection having been indicated in this case, in order to procure revulsion from the brain. As usual with the commentator, he calls attention to the characters of the urine, and explains the meaning of the term “cloudy,” as applied to the eneorema, or substances floating in the urine, by which he contends is to be understood a color intermediate between white and black. What follows in this very lengthy Commentary is very interesting in a general point of view as regards the views of some of the older commentators, but is not directly applicable to the present case. His observations on the characters affixed to this and many of the subsequent cases have been noticed in the Argument. The reader will further remark of this case that it is an instance of fever passing into a deposit (or abscess), and the latter into strangury, of which our author had made mention in the First Book of the Epidemics. I may further mention that the reader will find much interesting matter in Galen’s work On Trembling, in illustration of the nature of the attack under which the patient labored.
[683] Galen, in his Commentary, communicates a singular notion which one of the earlier commentators maintained respecting the name of the place where this patient was laid, that is to say, that this new wall, having been recently washed with quicklime, had been the cause of this patient’s illness. Galen, however, rejects this paltry conceit. He says on his own authority, that there being three distinct classes of fever, namely, the ephemeral, the hectic, and those connected with putrid humors, the present case belongs to the last of these.
[684] Galen compares the characters of the urine with their indications as given in the Prognostics. None of them are favorable, although not decidedly fatal.