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
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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
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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
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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.
