The pustules were black and their passage to ulceration was the most common

The master has decided otherwise, or perhaps it should not be him who should bear the responsibility such an unexpected omission. No one is unaware that contemporary literature laments huge voids. Chance or some resolute will has saved certain privileged works from sinking. But how many others died without leaving a trace! Manuscripts could only be propagated and perpetuated by means of copies, the slow and expensive reproduction of which was necessarily very limited, and all too often suffered from the ineptitude or negligence of the scribes. Many of these copies disappeared before they were sufficiently multiplied, or without having crossed the radius of a very limited advertisement. Others have reached their distant destination, mutilated and unrecognizable. On the strength of the title, the homogeneity of the Hippocratic collection has long been admitted; modern scholarship has restored the truth. Everyone agrees today to discover works of very different origins. For the same reason, many of the works decorated, rightly, with the signature of Hippocrates, have been detached from his books, and have not resumed their place there. Let’s share, history by hand, accidental fires, deliberate destruction, political vicissitudes, etc., and we will have no trouble explaining the annihilation of so many treasures, predestined also to a short life by the weakness of their material constitution.

If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. Everyone agrees today to discover works of very different origins. For the same reason, many of the works decorated, rightly, with the signature of Hippocrates, have been detached from his books, and have not resumed their place there. Let’s share, history by hand, accidental fires, deliberate destruction, political vicissitudes, etc., and we will have no trouble explaining the annihilation of so many treasures, predestined also to a short life by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. Everyone agrees today to discover works of very different origins. For the same reason, many of the works decorated, rightly, with the signature of Hippocrates, have been detached from his books, and have not resumed their place there. Let’s share, history by hand, accidental fires, deliberate destruction, political vicissitudes, etc., and we will have no trouble explaining the annihilation of so many treasures, predestined also to a short life by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. many of the works, properly decorated, with the signature of Hippocrates, have been detached from his books, and have not resumed their place there. Let’s share, history by hand, accidental fires, deliberate destruction, political vicissitudes, etc., and we will have no trouble explaining the annihilation of so many treasures, predestined also to a short life by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. many of the works, properly decorated, with the signature of Hippocrates, have been detached from his books, and have not resumed their place there. Let’s share, history by hand, accidental fires, deliberate destruction, political vicissitudes, etc., and we will have no trouble explaining the annihilation of so many treasures, predestined also to a short life by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. accidental fires, voluntary destruction, political vicissitudes, etc., and we shall have no difficulty in explaining the annihilation of so many treasures, predestined also to a short life, by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable. accidental fires, voluntary destruction, political vicissitudes, etc., and we shall have no difficulty in explaining the annihilation of so many treasures, predestined also to a short life, by the weakness of their material constitution. If I make these remarks, it is because I would like to persuade myself that Hippocrates’ writing, which shines through its absence in its authentic collection, may well have had the fate of many others whose loss is irreparable.

This assumption, which is entirely personal, is replaced by legends whose criticism has done justice, and which I must nevertheless recall, in a few words, if only to preserve the historical truth.

Most of Hippocrates’ biographers and subsequent writers repeat with confidence that he went to Athens, in the middle of an epidemic, and that he ordered to light large fires in the streets and squares to disinfect the air. The author of the book of Theriac, at Pison , adds that he recommended the mixing of odorous flowers and perfumed oils with the fuel . This measure would have had, it is said, the best effects.

Actuarius goes so far as to say that he employed with marvelous success an antidote of which he even gives the formula. Public recognition would have awarded to the author of a great blessing of great rewards .

It is for me an unanswerable proof that Hippocrates did not go to Athens during the reign of the plague. It is because Thucydides does not even pronounce his name and does not make the slightest allusion to an event which should have left, in the memories of that time, an indelible trace. The illustrious writer bitterly deplores the uselessness of the remedies tried by turns, and the absolute impotence of art struggling with an unknown disease. He declares that he has written this account, which is foreign to his ordinary studies, only to give some useful indications to those who were threatened with the same ordeals. How to believe that he would not have welcomed the arrival of the most famous doctor of the time bringing to a population decimated and prey to despair a sovereign antidote? For what purpose would the loyal and truthful chronicler have concealed a fact from which he ought to have foreseen the inevitable repercussion? The silence he has kept is an argument that dispenses with everything else.

But if we look at the purely medical point of view, we can boldly say that any narrative proclaiming the triumph of human art, in struggle with a great epidemic, is ipso facto convinced of imposture. The physician who has followed the history of these exterminating scourges, and who has seen the cholera of this century, does not allow himself to be taken by so-called prodigies, so cruelly denied by the realities of the practice.

Thucydides informs us that the plague, which had not completely disappeared, appeared the following winter in Athens. This recrudescence lasted for one year, bringing to three the total duration of the epidemic since its invasion. What becomes of the effectiveness of the advice of Hippocrates and his heroic antidote? To what benefit would the expansive recognition of the Athenian population have been directed?

Should we recall here the following anecdote already so known? Artaxerce Longue-Hand, touched by the misery of his people, sent ambassadors to Hippocrates, it is said, to implore his assistance. The latter proudly repulsed the entreaties of the great king, and the rich presents that were offered him in his name, “not wishing,” he said, “to help the barbarians who are the enemies of Greece .”
This scene, which inspired modern painting, was adopted by doctors as a symbol of professional dignity.

Some biographers have alleged against the authenticity of this fact, the youth of Hippocrates. The objection is not serious. Hippocrates was then about thirty-two years old, and the genius is ahead of the age. It is well to believe that the man who was to have one day the glorious title of Father of Medicine , had gained from a rapid flight the summits of fame. But it is certain that he could not have at that time, as we have said, son and son-in-law to answer the call of the cities of Greece invaded by the plague.

In summary, it can be affirmed today that all these stories handed down from hand to hand are pure fables that have no guarantee other than notoriously apocryphal correspondences. A rather attentive reading of the pieces annexed to the works of Hippocrates, peremptorily proves the falseness .

Some doctors can not bring themselves to admit that Hippocrates refrained from speaking on a pathological event so closely related to his favorite studies,confidentthe disease of Athens was designated in the following passage of Book III Outbreak (4 e constitution):

“In the summer a great number of coals and other putrid diseases, extensive pustular eruptions, were seen ; in many, large eruptions of herpes. ”

Dr. Auguste Krauss claims that these various cutaneous determinations can only be those described by Thucydide .

It is impossible for me to share this feeling and to base a plausible conjecture on such insufficient semeiotic elements. If Hippocrates had wished to represent this striking type, this original physiognomy of the great epidemic, he would certainly not have reduced his comment to this rapid and vague allusion. He would not have simply indicated, as in passing, a subject so fertile in medical considerations of the first order. The hand that sketched the picture of the epidemic of Perinth would have reproduced the image of the disease of Athens, with all the features of the model, and there would not have remained the least uncertainty about its identity.

But let us leave these questions of erudition, which have only a secondary interest in this place, and return to the nosological interpretation of Thucydides’s account.

I must, first of all, warn that one would have a false idea of ​​the illness which he depicts, if one imagined, on the strength of his vulgar designation, that he had not crossed the road. enclosure of the capital of Attica. Thus history often mentions, under the name of the plague of Florence , the famous epidemic that went around the world XIV th century.

The generally accredited etiology which attributes it to the clutter provoked by the approach of the Lacedaemonian army seems to justify this error. In this hypothesis, it would only represent a special form of this malignant fever which its infectional origin has caused to be named, according to the case, fever of the prisons , the hospitals , the camps , the vessels .

The truth is that the disease, part of the East, had just embarked on a long journey of which Athens was only one stage. Thucydides reports, as a public rumor, that she was born in Ethiopia, and that she had devastated Egypt and especially Persia, before melting on the unhappy city where he witnessed it. It soon spread to the rest of Greece, and attacked troops who besieged, at the same time, some cities of Thrace.

M. Littré judiciously observes that, if we can not follow it in Italy and in Gaul, it is because at this remote period writers are missing everywhere else than in Greece .

Thucydides tells us nothing about the antecedent atmospheric constitution, and we can not, therefore, appreciate how much influence it might have had on the invasion of the epidemic. He only notes that the year was remarkable for its wholesomeness, which suggests that during the previous winter there had been no marked bad weather. In the passage in which he enumerates the disasters of every kind occasioned by the Peloponnesian War, and which extended, later on, to the whole Greece, he mentions earthquakes, eclipses of the sun, great droughts, followed by famines. But he points out these events only as a fatal coincidence, without relating them to the state of public health. Epidemics, especially at certain times, have been much concerned with these various meteors to which they have vaguely assigned an etiological role, on which science still retains many doubts. But it is good to take note of a fact which is often the forerunner of popular diseases, so that we may be authorized to look for the secret relation which perhaps connects the two phenomena.

Moreover, the state of the atmosphere indicated by Hippocrates, during the same period, agrees perfectly with the data provided by Thucydide.

“The year having been southern, wet and mild, health was good during the winter .”

Lucretius is satisfied with some general considerations on the origin of epidemic diseases. According to his theory, the morbid germs engendered in the atmosphere are spread far and wide across the various countries they infect in passing. They mingle with the drinks or foods that man uses or they enter the economy with the air inspired . If the poet did not think it his duty to apply these principles to the disease of Athens, it is because he naturally wished to avoid the most difficult part of his task.

Diodorus of Sicily was more precise in the detailed enumeration of the influences which contributed, according to him, to the production of the memorable epidemic.

He says that the heavy rains that had fallen during the winter had left stagnant water in many places. The excessive heat of the following summer had provoked in these waters a putrid fermentation, the deleterious emanations of which had permeated the ambient air. The products of the soil, altered by these unusual rains, contained only materials unfit for food. On the other hand, the winds that had not blown at this time, as usual, could not temper the devouring heat of the season. Thus Diodorus attributes the intolerable heat of the sick to the heat of the outside air. This does not imply, in his thought, that the organisms were in equilibrium of temperature with the atmosphere, in accordance with the laws of ordinary physics. .

I only recalled these etiological conjectures because they fit historically into my plan. We know very well that atmospheric constitutions have but a very obscure part to claim in the production of great epidemics, and that their pathogeny must be sought in another order of conditions.

I will have in the course of this book many opportunities to renew this remark, and I ask in advance for recitations difficult to avoid in a long-term work. It is not one of the least curious characters of the epidemics which run the world that this kind of indifference for the external modifiers whose ascendancy is so powerful on the generation and the development of vulgar diseases. By all their sides, the great popular diseases seem to emancipate themselves from the common laws of pathology.

In the days of polytheism any phenomenon whose natural cause could not be discovered was attributed to the direct intervention of the gods. This simplified the etiology of extraordinary epidemics. It was Apollo who passed to the Greeks, to be invested, by special delegation, the power to arouse these great scourges, to extend the course at its discretion and to fix the term, when his revenge was satiated. It was he, above all, who endeavored to bend with supplications and expiatory ceremonies.

The religious prescriptions were not neglected in Athens during these days of mourning. All the games were suspended, the temples were incessantly filled with a desperate crowd imploring the end of its evils. Bacchantes with scattered hair celebrated Dionysiacs, unexplained mysteries that had the virtue of appeasing celestial wrath. Long processions crisscrossed the road to Eleusis. But the gods were pitiless, and the unhappy Athenians, seeing themselves abandoned, resigned themselves to their fate, as Thucydides says, without attempting to escape it.

When, unexpectedly, the epidemic struck its first blows, the population, mad with terror, did not at first think of seeking in the superhuman spheres the origin of this disaster. The Peloponnesians were accused of having poisoned the wells of the district which had been the first to be invaded, and it was thought to explain thus the strange form and the rapidly mortal march of this unknown evil.

The belief in the poisoning of drinking water in a city or country was then very widespread, and cited examples. It was by this artifice, it was asserted, that Cyrha, city of Phocis, was taken little distance from Delphi. Pausanias relates that the general who commanded the siege had given the order to throw hellebore roots into the river which watered the inhabitants. Violent stomach flows declared soon, and the besieged renouncing defend surrendered at discretion .

This prejudice does not belong only to antiquity, and is found in the Middle Ages. When the plague broke out in the XIV th century, Jews were also accused of poisoning the fountains and wells, and became, under the absurd pretext of the most cruel persecutions object .

The centuries are replacing without changing anything to human passions. Did we not see, in 1832, during the first invasion of the cholera epidemic, the people of Paris believe in the poisoning of water and meat debit by the butchers, and persecute against alleged authors of these evil spells?

Let us say, however, after having cursed these sad errors, that this suspicion so eagerly greeted by the ignorant mass, at the beginning of the great mortalities, can be explained by the fixed and identical form of the morbid cases which recall too faithfully the ordinary effects of specific poisons.

China Rifampicin