INTRODUCTORY ESSAYS

I

PROGNOSIS

Fevers, which we now call malarial. Further than this, at least as far as treatment is concerned, he did not think it necessary to go. ¹ In the clinical histories of Epidemics no attempt is made to diagnose the various cases, though of course the common names of various diseases are found to be useful in describing the “constitutions” of the same book. In the Cnidian treatises, on the contrary, diagnosis is carried to extremes.

Hippocrates held that it was impossible to decide with certainty when a variation in symptoms constituted a different disease, and he criticized the Cnidian physicians for multiplying types by assigning essential importance to accidental details. He attached far less value to diagnosis—the act of identifying a disease by its signs—than he did to what might be called the general pathology of morbid conditions, particularly of acute diseases. In all these diseases, according to Hippocrates, there are symptoms, or combinations of symptoms, that point to certain consequences in either the near or the remote future. In other words, there is a common element from which a common medical history can be written. Such a medical history for acute diseases is the work Prognostic.

Prognosis, as the knowledge of this general pathology was called, was valued by Hippocrates for three reasons:

(1) A physician might win the confidence of a patient by describing the symptoms that occurred before he was called in.

(2) He could foretell the final outcome with approximate certainty.

(3) A knowledge of dangers ahead might enable him to meet them, or even prevent them.

Besides these utilitarian reasons, we cannot doubt...