INTRODUCTION

THESE two books manifestly form one work, and that the most remarkable product of Greek science.

Pretensions to literary form it has none, yet no Greek writer, with the possible exception of Thucy-dides, has used language with better effect. Often ungrammatical, sometimes a series of disconnected words, the narrative is always to the point, and always conveys the impression that the writer's sole object is to express observed facts in the fittest and shortest way.

The composition shows violent dislocations. There come first two "constitutions,"1 then two short paragraphs on the duty of the physician and on certain symptoms respectively, then another constitution, then a few paragraphs on fevers, then fourteen clinical histories. The third book begins with twelve more histories, which are followed by a fourth constitution, at the end of which is another disconnected paragraph, and the book closes with sixteen histories.

Dislocations due to the ancient methods of copying manuscripts are common enough in classical authors, but startling changes like the above are not such as

[p. 142] can be ascribed to the vagaries or the carelessness of scribes. Combined with the broken grammar they seem to point to the work having never been prepared for publication. The writer probably jotted down his remarks as a series of notes in an order which happened to suggest itself, and never went on to edit them. Several of the shorter "interpolations" would have been in a modern book footnotes or appendices.

This theory is supported by the fact that a very great number of the histories have no connection at all with the constitutions. The first three constitutions refer to Thasos ; the place of the fourth is unnamed. The medical cases belong to Thasos, Larisa, Abdera, Cyzicus, and Meliboea, while many others have no locality attached to them. The nature, too, of the diseases bears no great likeness to those of the constitutions. They are all "acute," some exhibit abnormal symptoms and some are ordinary cases of remittent malaria. They illustrate Prognostic far better than they do the constitutions. "What do symptoms portend ?" is the subject of Prognostic, and the clinical histories give the data from which many of its generalizations may well have been framed. On the whole, it is probable that Epidemics was never published by its author.

The subject matter of the Epidemics, including the five books universally attributed to authors other than Hippocrates, namely, II and IV, V, VI, VII, present several interesting problems. For the present I will confine myself to I and III.

What are the diseases described in the Epidemics ? This question has interested physicians for centuries,

[p. 143] and each medical reader will enjoy the task of diagnosing them for himself. Several cases are difficult, but the section on Hippocratic diseases in the General Introduction should enable even a layman to identify many. Perhaps the most fascinating problem is whether the constitution in Book III refers to the plague year of Thucydides II.

Another interesting point is the clientéle of the writer and the scenes of his practice.2 The latter have already been referred to ; the names of the patients, and their position in life, are worth a moment's consideration.3 None of the clinical histories has a date, but most give the name and address of the sick person. Occasionally the name is given without the address, or the address is given without the name. In a few instances at the end of Book III the town is named but neither the patient nor his address is specified. In two cases (I, case 12, and III, case 4, of second series) name, address and locality are all omitted. The patients are sometimes householders, sometimes members of their families, sometimes slaves. Several seem to have been lodgers.4

The variety in the descriptions of patients seems to show that the writer attached no importance to them, but simply wrote in his note-book enough to

[p. 144] enable him to identify a patient for himself. In fact he rarely appears to be writing for a public ; in the clinical histories especially one feels that the only object is private information.

If the clinical histories are rough notes of this character it becomes plain why they vary in fulness of detail. The plan generally adopted is to give a daily bulletin, or at least to notice the critical days, but if the patient was not visited every day and the attendants did not report anything striking, gaps would occur such as we actually do find. An editor writing for a public would either have made these gaps less obvious or else have explained them.

But the most striking feature of this work is its devotion to truth. The constitutions are strictly limited to descriptions of the weather which preceded or accompanied certain epidemics ; the clinical histories are confined to the march of diseases to a favourable or a fatal issue. Nothing irrelevant is mentioned ; everything relevant is included.

Of the forty-two cases, twenty-five end in death, very nearly 60 per cent. The writer's aim is not to show how to cure--treatment is very rarely mentioned--but to discover the sequences of symptoms, to set down the successes and failures of Nature in her efforts to expel the disease. The physician is acting, not qua physician but qua scientist ; he has laid aside the part of healer to be for a time a spectator looking down on the arena, exercising that θεωρία which a Greek held to be the highest human activity.

MSS. AND EDITIONS

The chief MSS. for Epidemics I. are A and V, and for Epidemics III., V and D, supplemented for

[p. 145] both books by the interesting commentaries of Galen.

Editions were common in the sixteenth, seven-teenth, and eighteenth centuries,5 but none are of outstanding merit. There is an English translation of no merit by Samuel Farr (London, 1780), and the books are included in Adams' first volume.

ADDITIONAL NOTES

1. The word ὀξύς2, "acute," "sharp," is applied to fever, and to such diseases (pleurisy, pneumonia, remittent malaria, etc., Regimen in Acute Diseases, v) as are accompanied by high fever. The Hippocratic doctrines of crisis, coction, etc., apply chiefly to acute diseases, but not to them only, as the common cold (Ancient Medicine, xviii) shows coction.

2. The preposition παρά, meaning "at the house of," seems to be used indifferently with acc., gen., or dat. There are probably differences, but I cannot detect them.

1 "Constitution" is the traditional translation of κατάς1τας1ις2, climatic conditions of such a marked type as to give a distinguishing character to a period of time. The word is also used of diseases, and so on, to denote a fixed type prevalent at any particular time.

2 It is worth noticing that Greek physicians, like the Sophists, often passed from city to city, staying a longer or shorter period according to the demand for their services. It was for such περιοδευταί that Airs Waters Places was written, to enable them to know what diseases were likely to occur in a city they had never visited before.

3 See Littré, VIII. vii-xxix, where Meineke is considered.

4 See on these points Littré, X. pp. xxix-xxxii, where Rossignol's views are given and criticised. There seem to have been large boarding-houses in some places.

5 See Littré, II. 593-596.

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