Biology -- Greece -- History; Medicine, Greek and Roman
‘We must attend to the appearances of the eyes in sleep as presented
from below; for if a portion of the white be seen between the closing
eyelids, and if this be not connected with diarrhœa or severe purging,
it is a very bad and mortal symptom.’ In this, the last Aphorism which
we shall quote, we see the Hippocratic physician actually making his
observations. Now during sleep the eyeball is turned upward, so that
if the eye be then opened and examined only the white is seen. In the
later stages of all wasting and chronic diseases the eyelids tend not
to be closed during sleep. Such patients, as is well known, often die
with the eyes open and sometimes exhibiting only the whites.
But the Hippocratic physician was not content to make only passive
observation; he also took active measures to elicit the ‘physical
signs’. In modern times a large, perhaps the chief, task of the student
of medicine is to acquire a knowledge of these so-called physical
signs of disease, the tradition of which has been gradually rebuilt
during the last three centuries. Among the most important measures
in which he learns to acquire facility is that of auscultation. This
useful process has come specially into vogue since the invention of
the stethoscope in 1819 by Laennec, who derived valuable hints for it
from the Hippocratic writings. Auscultation is several times mentioned
and described by the Hippocratic physicians, who used the direct
method of listening and not the mediate method devised by Laennec.
There are, however, certain cases in which the modern physician still
finds the older non-instrumental Hippocratic method superior. In the
Hippocratic work περὶ νούσων, _On diseases_, we read of a case with
fluid in the pleura that ‘you will place the patient on a seat which
does not move, an assistant will hold him by the shoulders, and you
will shake him, applying the ear to the chest, so as to recognize on
which side the sign occurs’. This sign is still used by physicians and
is known as _Hippocratic succussion_. In another passage in the same
work the symptoms of pleurisy are described and ‘a creak like that of
leather may be heard’. This is the well known _pleuritic rub_ which the
physician is accustomed to seek in such cases, and of which the creak
of leather is an excellent representation.
Public-domain text, read in full here on John Shaqi.
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