Against Those Who Have Written on Disease Patterns

​GALEN’S BOOK TO THOSE WHO WROTE ON TYPES, OR, ON PERIODS. For the ancient physicians, it was sufficient merely to say that the paroxysms in some of the diseases occur according to a period, without further adding what the name ‘period’ signifies. For they knew they were writing books for Greek people who clearly understood that whenever something identical in kind occurs at equal intervals of time, all Greeks call this time a ‘period’. Thus, at any rate, they used to call certain Olympic and Pythian cycles ‘periods’. But the more recent physicians first introduced the designation of ‘type’ to periods. Then, some thought that the same thing was signified by the words ‘period’, ‘order’, and ‘type’; others, however, did not think so. And others attempt to define all these things in different ways, not only establishing their own definitions but also contradicting those of others. Now, those who have gone as far as vanity regarding definitions, yet concede that one and the same thing is signified by the three names—type, period, and order—talk less nonsense. But those who call ‘period’ the time through which something identical occurs, and ‘type’ not simply all such time, but when it is bounded by complete days and nights, bring down long and useless nonsense upon themselves, and having thereby wasted their own time and that of their disciples, when they come to the sick, they are worse than any layman. For a layman who has intelligence, when he sees someone suffering a paroxysm every day, whether the paroxysm is slightly delayed or occurs earlier, has some impression of the so-called quotidian period. And if someone should be both industrious and a lover of medicine, a certain conception of two tertians or three quartans enters his mind, and he demands that this be distinguished by the physicians. But those who are enslaved to the aforementioned hypotheses, if they meet a patient having the paroxysm anticipating by two hours each day, say that the period is twenty-two hours, and believe that the whole type is not simple, but some composite one; then, after investigating sufficiently and calculating among themselves, some on their fingers, others even on a diagram written in some book, say that such a type is twelve twelfth-day fevers. And when those who hear this laugh at them, they are indignant. And still more, whenever they see the paroxysm anticipating by one hour at some time, they then declare it to be twenty-four twenty-fourth-day fevers, and they themselves are laughed at, and they prepare a suspicion of ignorance among laymen against the other physicians. For when they see those men with a certain solemnity finding from a book, as if it were a matter of the greatest importance, twenty-four twenty-fourth-day fevers, it occurs to them to condemn all who read books, and they rather entrust themselves to those who practice the art with irrational experience. If, at any rate, anyone follows the hypotheses of the physicians who talk such nonsense, even when the tertian fever either anticipates or delays by one hour, he will call it anything rather than a tertian. For the one that anticipates, being twenty-four, he says is a complication of forty-eight-day fevers; and the one that delays, he will say is a fifty-day fever, and that this consists of twenty-five fevers. Who first began this mad wisdom, I do not know. But I will tell when I first heard it from the one who disclosed it. Antoninus, who became emperor after Hadrian, had recently departed from among men, and Severus was ruling then, having renamed himself Antoninus, and having taken Lucius into partnership of the rule, and renamed him Severus. At this time, having heard it for the first time, I was astonished at those who proposed questions in some such way: if someone, suffering a paroxysm for five hours, is relieved for two, so that the whole period is seven hours, and this occurs successively, what must we believe the type to be? So I replied to him immediately, that this was not even possible to happen. For such short paroxysms make the declines long, and for the most part indeed reach a state of no fever. ‘But you,’ I said, ‘describe a paroxysm of a disease that is most mild, yet by the continuity of the periods you declare it on the other hand to be most deadly.’ ‘Do not consider at all for now,’ he said, ‘whether the hypothesis is impossible or possible, but for the sake of exercise, concede that such things are investigated. For it will make us more resourceful toward the discovery of various types.’ To him, therefore, I attempted to show at that time that such an exercise makes us more perplexed rather than more resourceful; but now I shall demonstrate it to others, having first explained what indeed is the utility of such a theory.