“Les fièvres décrites dans les Epidémies ont, dans leur apparence générale, une similitude très grande avec celles des pays chauds.
“La similitude n’est pas moins grande dans les détails que dans l’ensemble.
“Dans les unes comme dans les autres les hypochondres sont pour un tiers des cas, le siége d’une manifestation toute spéciale.
“Dans les unes comme dans les autres, il y a une forte tendence ou réfroidissement du corps, à la sueur froide et à la lividité des extrémités.”
On almost all the other diseases treated of in these books, M. Littré’s opinions, in like manner, exactly coincide with those delivered by me in the above-mentioned work. Thus he arrives at the conclusion, that the Phrenitis and Lethargus of Hippocrates were varieties of the Causus. Compare Paulus Ægineta, Book III., 6, 9. He refers them to les fièvres pernicieuses comateuses pseudo-continués et les fièvres pernicieuses dolorantes pseudo-continués of M. Maillot. It would appear from the extracts which he quotes from a work of M. Roux, on the Diseases of Morea, that a similar tendency to pass into phrenitis and lethargy is still observable in the land of Greece. The fevers of the East Indies also, as described by Dr. Twining,[614] appear to partake very much of the same character. In a word, the conclusions to which a patient study of modern authorities on the subject have brought me amount to this; that the fevers described by Hippocrates in his “Epidemics,” are exactly the same as those which are now described as still prevailing in the land of Greece: that they correspond very well with those described by Cleghorn as occurring in Majorca; differ but little from those described by Pringle, Monro, and Sylvius, as happening in the Low Countries, and differ from those described by Twining, as happening in Bengal, only in a few particulars.
From the analysis of their contents given above it will readily be understood that the subject-matters of these two books are not arranged methodically. Indeed it is quite obvious from the nature of the work that the matters which are treated of in it had never been methodized by the author. Certainly then, as proposed by Desmair,[615] it would be a much more natural arrangement to give the four Constitutions of the season first, and then to give the forty-two cases together. But the present arrangement being of old standing, no editor has thought himself warranted to depart from it.
There are two important professional subjects of which it may appear surprising that there is no mention in the “Books of the Epidemics,” I mean sphygmology and contagion. Galen repeatedly declares it as his opinion, that Hippocrates paid no attention to the characters of the arterial pulse, and that the subject was not at all studied until after his time; and as far as I can see there is no ground for calling in question this opinion of Galen. Herophilus, in fact, would appear to have been the first person that made any progress in this study. It is more remarkable that Hippocrates should omit all allusion to the other subject, more especially as the contagiousness of certain diseases would appear to have been the popular belief of his age. Thus his contemporary, Thucydides, in describing the plague, expresses himself in such terms as puts it beyond a doubt that he regarded the disease as being of a contagious nature. And another contemporary, Isocrates, makes such observations on a certain case of empyema, by which he evidently means phthisis pulmonalis, as to show that it also was regarded as being communicable.[616] How the omission is to be accounted for I do not know, but certain it is that not the least reference to contagion, in any shape, is to be found in any of the Hippocratic treatises.
BOOK I.—OF THE EPIDEMICS.
Sec. I.—Constitution First.
1. In Thasus,[617] about the autumnal equinox, and under the Pleiades,[618] the rains were abundant, constant, and soft, with southerly winds; the winter southerly, the northerly winds faint, droughts; on the whole, the winter having the character of spring. The spring was southerly, cool, rains small in quantity. Summer, for the most part, cloudy, no rain, the Etesian winds, rare and small, blew in an irregular manner. The whole constitution of the season being thus inclined to the southerly, and with droughts early in the spring, from the preceding opposite and northerly state, ardent fevers occurred in a few instances, and these very mild, being rarely attended with hemorrhage, and never proving fatal.[619] Swellings appeared about the ears, in many on either side, and in the greatest number on both sides, being unaccompanied by fever so as not to confine the patient to bed; in all cases they disappeared without giving trouble, neither did any of them come to suppuration, as is common in swellings from other causes. They were of a lax, large, diffused character, without inflammation or pain, and they went away without any critical sign. They seized children, adults, and mostly those who were engaged in the exercises of the palestra and gymnasium, but seldom attacked women. Many had dry coughs without expectoration, and accompanied with hoarseness of voice. In some instances earlier, and in others later, inflammations with pain seized sometimes one of the testicles, and sometimes both;[620] some of these cases were accompanied with fever and some not; the greater part of these were attended with much suffering. In other respects they were free of disease, so as not to require medical assistance.[621]