Galen's Commentaries on the Aphorisms of Hippocrates

it would be of no consequence to name those things which appear soon. Moreover, this must be understood concerning all occurrences or signs: that some of them signify the affection, some are attendant, some are decisive and critical, some show concoction, some crudity, some safety, and some destruction. Those indicative of the affection are those which attack along with the disease. But those which are attendant sometimes attack at the same time, sometimes supervene, and sometimes do not come at all. For they are neither inseparable from the disease, nor do they constitute its substance, as it were, but they produce its specific differences. Those, however, which are called decisive or critical by Hippocrates are not by nature suited to attack at the first strict beginning of diseases; but they are by nature suited to do so with the other two stages, of which we shall speak a little later. Sometimes, however, they appear neither in these, but when the diseases increase or are already at their height. Signs of concoction do indeed attack, and these never in the very first beginning of the disease; rather, they terminate that beginning which is a part of the whole disease. Signs of crudity attack immediately with the first beginning of the disease, and sometimes appear later, just as do the signs of death. For the production of these also follows upon the beginning of the disease. Now, we wish the "beginning of the disease" to be understood—as we have shown in the commentaries on Crises—as both its first onset, which is said to have no latitude, and that which is like a part of the whole disease when it is divided into the beginning, the increase, the status, and the decline; and another, which extends as far as the third day. But also in that same treatise we taught the powers of all occurrences, and at the same time we explained those words of Hippocrates pertaining to this which seemed to require exposition. But now we shall speak of them by way of a compendium; he who wishes to learn thoroughly the whole art of Hippocrates concerning these matters should go to that treatise.

From the things which soon appear, therefore, he commands that the whole constitution of the disease be conjectured; then, bringing forward a certain species of disease, he says: just as in a disease of the side, if the sputum should appear immediately near the beginning, it shortens the incipient disease; but if it appears later, it prolongs it. What he writes you may learn clearly if I set before you from the third book of the Epidemics what he himself writes concerning Anaxion, who suffered from a disease of the side—which patient I also revealed to be? in my exposition of the first book On Crises; the words of Hippocrates are these: "In Abdera, an acute fever seized Anaxion, who lived near the Thracian gates; there was continuous pain in the right side, a dry cough, nor did he spit up anything during the first days; he was thirsty, sleepless; the urine was well-colored, plentiful, and thin. On the sixth day he was delirious, nor did warming applications do any good. On the seventh day he suffered more because the fever was intensified, the pains were not diminished, the coughs persisted, and he breathed with difficulty. On the eighth day I opened a vein in the elbow; much blood flowed, and of the proper quality; the pains ceased in some measure, but dry coughs followed. On the eleventh day the fevers decreased, he sweated in the part about the head, and the coughs and the discharges from the lungs became more moist. On the seventeenth day he began to spit up a little that was concocted. On the twentieth day he sweated and the fever ceased. After the crisis he was relieved, though he was oppressed by thirst, and the purgings from the lungs were not altogether good. On the twenty-seventh day the fever returned, he coughed, he brought up much concocted matter; there was a great deal of white sediment in the urine, the thirst ceased, and he breathed well. On the thirty-fourth day he sweated all over, and after the crisis he recovered entirely from the fever."

This Anaxion, therefore, suffered from a disease of the side from the beginning, yet he did not spit up from the beginning; but even on the eighth day dry coughs still followed, as Hippocrates says. Wherefore the resolution of the whole disease was reasonably extended to the thirty-fourth day, although for the most part a disease of the side has the limit of its judgment on the fourteenth day, and even if not