Arguments against the treatment practices of Cnidus; Regimen in Acute Diseases, Hippocrates

 Why you might read Regimen in Acute Diseases?

This is Hippocrates' first work that systematically lays out how to treat disease. As such it gives us a better understanding of his cases studies.

It is in my  Self Education project because it informs how to understand other works in the corpus.

Content of Regimen in Acute Diseases

Hippocrates starts with how he does not agree with the Cnidus school of medicine. Especially about how to treat diseases. He states that their diagnosis is too simplistic. As well as their treatments being wrong. They are too simplistic because they miss things the physician could ascertain. These things cannot be gotten from asking the patient.

He spends the rest of the book giving his version of what to give as a treatment in what situation. He covers, barley meal or barley water and when to use each. As well as when to use fasting and when it only makes things worse. He covers drink as well when to give wine and what type. As well as when to use only water though he recommends this for very little.

At one point he recommends cutting a vein in the elbow and bleeding a patient. This is the only reference to that in this work. Hippocrates is more focused on food and drink as treatment.
Reflection on Regimen in Acute Diseases

Hippocrates was against taking just water in most cases. It is interesting that today water is the one thing we are told to consume when sick. Though Hippocrates is talking about Acute diseases i.e. those that might end in death. So maybe it isn't reasonable to compare those with a cold or flu. Also, he was not talking about treated water. Maybe that is also the reason for the difference.

The single reference to bleeding a patient is odd. It is offhand enough to think it was part of the common practice. And yet it is the only mention of it in the work. He also does not discuss its use but rather just adds it in as an afterthought.

It is also interesting that for gruel Hippocrates is focused on barley meal. Today when I think of gruel I would think of oats or wheat.

What others have to say about Regimen in Acute Diseases

"The main Hippocratic concepts on four still common acute and urgent respiratory diseases −pneumonia, pleurisy, thoracic empyema and upper airway obstruction− were identified and most of them were found to be in agreement with contemporary medical thinking and practice." From BMC Pulmonary Medicine

Comparisons with other texts

Like we see in Epidemics Hippocrates very rarely prescribes bloodletting. Though it is not common in his texts he is offhanded enough about it that it must have been common at the time.

Like Prognosis he deals with the acute diseases where there is a chance of death. But unlike prognosis where he is focused on survival this work is focused on treatments.

Conclusion
Hippocrates in refuting another school covers how to treat Acute Diseases. He is focused on food and drink. This includes how often to administer them. His philosophy of treatment could be summarised as; don't shock the body any more than you must. Hippocrates very rarely suggest bloodletting as a treatment. And this is the first book we have seen that is systematic about how to treat people rather than specific cases.

Have you read Regimen in Acute Diseases? If so what did you think of it? 
 
Want to read Regimen in Acute Diseases but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

Get a copy of Regimen in Acute Diseases.

How to tell if your patient is going to die; Prognosis, Hippocrates

 Why you might read Prognosis?

Prognosis is Hippocrates list of symptoms and their effects. As such it informs how he wrote his case studies. In doing so we gain a better understanding of his case studies.

It is in my Self Education project because it helps me understand his other works. On its own, it is a book of science about medical prognosis at the time. But as part of the corpus, it gives greater meaning and understanding to the books around it.

Content of Prognosis

Hippocrates systematically moves through different classes of symptoms. He uses this to categories if a patient will recover or die. He at times is very specific detailing in how many days death or recovery will happen.

He starts with classifications of the state of the face. Then continues on with phlegm, stool and urine descriptions. In each case, he classifies what are positive signs as well as what is negative. As well as what signs will lead to further illnesses or symptoms. He even spells out how some of these symptoms interact. These then tell us about the prognosis for the patient. 

Reflections on Prognosis

Hippocrates is systematic in his listing of classes of symptoms. Yet he gives us very little information as to how these symptoms mesh together. He does give us some but they are few and far between. This work does not contain enough synthesis for a Physician to make their own prognosis'. Unless of course, they had a wealth of experience to go with it. As such this is not a teaching text for beginners. Rather it is a complementary text for those already practising.

This is the first time I have struggled with Hippocrates' use of words. In this piece, he uses a lot of specific medical terminology. So if you're going to read it you might want to have your phone handy to look up some terms.

What others have to say about Prognosis

From STMU History Media "Hippocrates’s ability to give an accurate prognosis led to a greater amount of trust in physicians, ultimately increasing the demand for medical professionals across the Greek world."

Comparisons with other texts

Prognosis explains what we saw in Epidemics. There we saw lists of patients symptoms and whether they survived or not. This was given case by case. Here in prognosis, we see why these symptoms were important to Hippocrates. Possibly they were even more important to those reading his texts at the time. Prognosis lays out the overview and Epidemics shows those principles at work.

It takes the ideas of the Science of Medicine and puts them to work. It does this by classifying and quantifying how to make prognosis'.

Conclusion

Hippocrates in this work lays out symptoms and how to use those to make prognosis'. He does so systematically and completely. Though it is a little lacking of synthesis of those symptoms. It gives the structure for what we see in the way of listed symptoms in Epidemics. We have also seen this as the first time that Hippocrates has heavily relied on medical terminology.

Have you read Prognosis? If so what did you think of it? 

 
Want to read Prognosis but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

Get a copy of Prognosis.

Why location and weather matter in medicine; Airs, Waters and Places, Hippocrates

Why you might read Airs, Waters and Places?

Airs, Waters and Places is another foundational work of Hippocrates. It gives us a great overview of illness and Europe. As well as insight into the weather of the time. 

It has a place in my Self Education project both because of what it contains about health and location. But also because other works of Hippocrates stand on top of it. So it carries meaning through the rest of the corpus.

The content of Airs, Waters and Places

Hippocrates starts by describing how winds affect the population of a town. He covers all the compass points. When the town is exposed in that direction this is what health conditions will be prevalent. This includes what the population will look like. As well as what diseases they will be susceptible to and how deadly these illnesses will or will not be.

He then continues to do the same sort of analysis based on the water. He differentiates between lake water, spring water and brackish water. As well as rain and melted ice. He finds the ice to be the worst and the spring water from the mountains the best.

He spends the rest of the book detailing different places. This takes up most of the book. He first spends time on what he calls Asia and the Asian people but today we would call this the Middle East. He suggests that they are less prone to rashness because of their stable climate. That they get different diseases to Europe. And that their environment gives them a certain temperament. He then moves on the Scythian nomads and details why they are as they are. This includes that they have men who choose to be a woman. He suggests this is because of a practice of cutting behind the ear. They do it to fix one illness but Hippocrates says it causes impotence. He posits that after finding himself impotent many times a man of the Scythian gives up and chooses to be as a woman. He also suggests that this is more a problem for the wealthy. As the first illness, he recons is bought on by too much horse riding.

Reflections on Airs, Waters and Places

Hippocrates makes some interesting generalisation. He characterises people in ways we would never think of today. His focus on how the environment affects the people. He takes it to great lengths in classifying what that does to people is interesting. He goes into the realms of personality which we would now not connect with the environment of this type. Yet he must have been speaking from a place of some knowledge.

He takes us on a trip across Europe and we can learn much about the weather of parts of Europe and beyond. Almost more than we can learn about medicine and disease.

What others have to say about Airs, Waters and Places

"The presentation falls roughly into two halves, the first detailing various environmental factors that contribute to specific diseases, the second more ethnographic in its account of the differences between Asians and Europeans as a function of their environment and customs." From Faenum Publishing

From  Researchomatic "He advises the physician coming upon a city that is new to him to take note of the environmental factors that determine the kinds of diseases endemic to that location." 

Comparisons with other texts

Airs, Waters and Places is the explanation piece for what we see in Epidemics. In Epidemics the weather and conditions are listed. The Hippocrates moves on to the description of the diseases. Here in Airs, Waters and Places, we see why Hippocrates thinks that is of such importance. While in Airs, Waters and places we are given the overview in Epidemics we are given the specifics.

Conceptually it follows on from The science of Medicine. It follows because it is still overview type content and because it starts to detail some of that science.

Conclusion

Airs, Waters and Places cover how prevailing winds affect the health of a town. As well as their water supply. It also spends time discussing different people groups. Including how their environment affects them. We have discussed how this informs what we have seen in previous texts. As well as how much further Hippocrates is willing to take generalisations than we are today.

Have you read Airs, Waters and Places? If so what did you think of it? 

 
Want to read Airs, Waters and Places but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

Get a copy of Airs, Waters and Places.

Discussion on why Medicine is a science not an art; The Science of Medicine, Hippocrates

Why you might read the Science of Medicine?

The Science of Medicine gives us more insight. Especially into how Hippocrates separated the Charlatans and the actual practitioners. It follows on from his previous work to define good practice and good science.

In my Self Education project, it fills the role of completing a corpus. While it may have only a little to add by itself it is a part of a greater whole of what Hippocrates wrote.

The content of the Science of Medicine

The Science of Medicine covers Hippocrates arguments for medicine as a science. He argues against it being an art. He covers it both in the positive, that it is a science. He does this via arguments about a physician being able to learn from his patient's condition. That this learning lets him better help future patients. He also covers some of the objections. For example, the idea that even some untreated patients get well, while some who are treated die. He explains this by saying that the one that gets well has followed the advice a practitioner would give. Though he does so unknowingly and that is why he gets well. While the one who dies he says is likely not to have followed the advice given through lack of strength. 

Hippocrates also spends some time discussing the difficulties of treating internal diseases. Because they cannot be seen often they are given remedy far to late and the disease wins.

Reflection on the Science of Medicine

Hippocrates is almost a Philosopher with his arguments in this work. I am a little surprised in fact at how much of this he has done. How little, so far, has been written about the actual practice of Medicine.

We see again Hippocrates' passion for the role of Physician. How much he wants to protect the position from the falsehoods that are around. This is especially true as he works through objections to medicine being a science.

What others have to say about the Science of Medicine.

From Dr Axe "Still to this day medical doctors and historians consider Hippocrates to be the founder of medicine as a “rational science.”"

Comparisons to other texts

This text is really a continuation of The Oath and The Canon as it continues to expand upon the nature of medicine and what it is to be a good practitioner. It continues to expand upon the idea that medicine can be learned both from a teacher as well as through scientific methodology. So that a practitioner never stops learning from his patients' conditions and taking that to the next patient.

Conclusion

This text is Hippocrates proving that medicine is a science. He does this by first proving the positive and giving reasons why this is so. He then spends time dispelling the questions and ideas against his point. Finally, he distracts himself a little with a discussion on internal diseases.

Have you read The Science of Medicine? If so what did you think of it? 

 
Want to read The Science of Medicine but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

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Biblical Stories as plays; Everyman and Medieval Miracle Plays (1-5), Various Unknown

Why you might read the Miracle Plays?

The Miracle plays are a snapshot of how Medieval England saw the stories of the Bible. They were not produced by the church but rather were put on by the local guilds, for example, the shipwrights guild. They were common across England with slight variations. I am just reading a collection of them rather than each version. This makes them great to compare how Christianity was understood across time, even if they are not directly about doctrine.

For my Self Education project, they fill this role. They allow for a greater understanding of the way in which faith was a part of everyday life in medieval England. This will be important when I get to read more of the church fathers. As a narrative, it shows the development of the play in the English speaking world.

Stories of the Miracle Plays 1-5

The creation, and the fall of Lucifer

This play covers who God is and his creative power. It focuses on the creation of the angles. Specifically the creation of Lucifer as Gods second in charge. Lucifer becomes conceited with his beauty and greatness. He oversteps the line and asks to be worshipped alongside God. At this moment he is thrown out of heaven and into hell. We then see him lamenting his new position with another devil. The scene then moves back from heaven as the heavenly host work out how to work without Lucifer as a guide. They turn toward God and he is worshipped.

The creation of Adam and Eve

This play covers again God and his creative power. This time as God creates man. He commands the earth to make a form of a man. Then takes his rib and forms woman. Then finally tells breath to make them alive. This play ends with the man and woman, being named Adam and Eve. They then worship God.

The fall of Man

This play covers the deception of Eve by the serpent. The play does designate the serpent as Satan. The serpent uses the line of eating this will make you like God. First, though he spends some time running down what God had said. It is the make you like God that convinces Eve. She then goes on to convince Adam who eats as well. He instantly laments what he has done and states that he is naked. They resolve to sew together fig leaves for coverings. When God comes to the garden they hide. When God finds out what they have done, he curses them and has the angles throw them out of paradise.

Cain and Abel

This play covers the sacrifices made by Cain and Abel. As well as the Slaying of Abel by Cain. It starts by detailing how Adam asks the two brothers to make sacrifices. It has Abel explaining why he gave his best and can explaining why he gave his worst. This is missing in the Bible account. God accepts Abel offering but not Cains. Cain is angry at this and slays his brother. God asks Cain where his brother is and he complains he is not his brother's keeper. God knows what Cain has done and drives him away and curses him as punishment.

Noah's Flood

This play covers from Noah being told to build the ark, to Noah being told to go forth and multiply. Noah's family is present when he is told to build the ark. Together they build the Ark and house the animals. The ark has a mast in this account but does not in the Bible. Once everything is set his wife refuses to get on the ark but eventually is persuaded and just in time. They are on the ark 40 days and then Noah releases both a raven and a dove. He does this only once unlike the account in the Bible. The dove returns with an olive leaf and Noah and his family get out of the Ark. God then promises to never flood the world again. He also gives the rainbow as a sign.

Reflections on the Miracle Plays 1-5

The Creation, and the fall of Lucifer

This is a story that is only alluded to in the Christian bible. So the specific details while in line with what we know are fabrications. That being said it is all in line with the bible accounts.

The focus on the greatness of God is to be expected in this work. that being said it is interesting how much time is taken just to glorify him. 

The portrayal of Lucifer is interesting. You do not see any of the sinister action and working directly against God. Those actions are attributed to Lucifer later in the narrative in the bible.

The creation of Adam and Eve

This story mashes together the creation of Adam and Eve. In the Christian bible, there is some time between Mans creation and woman. Other than that it sticks to known facts and even contains the dominion given to man over the animals.

The fall of Man

Satans line to Eve that she will be like God is pretty standard for this narrative. But this play takes it a little further and he tells her they will be like gods and worshipped. It's the worshipped part that is an additive here. Here we start to see Satan or Lucifer being more deceitful and conniving.

Cain and Abel

This play again expands on the story as it is given in the Bible. It is interesting to see how people interpreted why Cains sacrifice was unacceptable. The version given is the most likely but it is not something the Bible is specific about.

The start of the play also adds Adam emploring his sons to give sacrifices. This is an interesting interpretation. It could have been at Adams prompting or it could have been at Gods promoting. Again the Bible does not say.

Noah's Flood

Having Noah's wife be rather cantankerous is quite a change. There is no mention of her behaviour in the Bible. It is interesting to see that at least in Medieval England there was this version of her.

It is almost off-putting to see Noah reference Christ and the Apostles. He could not know of them as their place is much later in the timeline.

What others have to say about the Miracle Plays

From Mr Donn "During Medieval times most plays were religious and were used to teach people about the Bible, the lives of saints, or how to live your life the right way."

From Brittanica "By the 13th century they had become vernacularized and filled with unecclesiastical elements. They had been divorced from church services and were performed at public festivals"

Comparisons with other texts

The Main comparison here is with the Bible. I have noted some of this in the discussion and summary of the stories.

Generally, the Plays take the story and embellish it. In most cases, these seem logical and are nice additions to the narrative. But the addition of an almost rebellious wife to the Noah story seems a bit out of place. Noah and his family are chosen because of their righteousness so it makes no sense that she would not obey her husband.

Conclusion

The stories so far have been from Genesis in the Bible. They tend to be embellishments of the stories. They have covered The fall of Lucifer, the creation and fall of man. As well as the first murder and the great flood. This is not the end of the collection. Rather it is the start and there will be two more posts on these miracle plays as well as the everyman play.

Have you read The Miracle Plays? If so what did you think of it? 

 
Want to read The Miracle Plays but haven't? Please leave me a comment and let me know why you want to read it.

Hopefully, this post inspires you to take the time to look into it on your own journey of Self Education.

Get a copy of The Miracle Plays.