Note 589 — ON REGIMEN IN ACUTE DISEASES. (continued 2)

Galen, in his Commentary on this section, finds many things imperfectly stated, and therefore unworthy of his great author. For example, he remarks, only two varieties of dropsy are mentioned, namely, anasarca and tympanites; whereas there are three at least, and some even describe four varieties. By the three kinds of dropsy, Galen and the other ancient authorities meant anasarca, ascites, and tympanitis. (See Paulus Ægineta, Book III., 48). That tympanites should have been ranked with dropsy need excite no wonder, when we consider the resemblance of this affection to ascites. In fact I have known cases of tympanites in which paracentesis was performed by inexperienced surgeons under the impression that they were cases of ascites. See some elaborate annotations on this head by Ermerins (Specimen Hist. Med., p. 125), and by Littré (Op. Hippocrat., tom. iv., p. 415). With regard to venesection in dropsy, Galen remarks that the rule of practice is not laid down here with sufficient precision; it is only when the dropsy is connected with the suppression of the hemorrhoidal or menstrual discharge, or when the patient is in a plethoric state, that blood can be abstracted with advantage. He also finds fault with the directions for the subsequent treatment, as not being accurately given. He justly remarks, that none but persons in the vigor of life and in good health would be able to digest dark-colored wine and pork after venesection. I may mention further that the text is faulty, that the words ἐγχειρέων γίνεσθαι ἄφυκτος should have been written ἀποκτέινει δ’ ἐυθὺς ὁ ὔδερος ἐφὴν γένηται. He attributes the mistake to the first amanuensis who wrote the words in question.