J. Antall szerk.: Medical history in Hungary. Presented to the XXII. International Congress for the History of Medicine / Orvostörténeti Közlemények – Supplementum 4. (Budapest, 1970)
ESSAYS-LECTURES - Gy. Regöly-Mérei: Paleopathological Examination of Skeletal Finds in the Roman Period and Description of Diseases in Greek and Roman Medical Texts (in English)
and 339—341 [5] says the disease appears either with sudden pain or begins latently, so he recognizes the diagnosis of rheumatic arthritis in the modern sense. According to Caelius Aurelianųs at the beginning of the disease the joints become red and swollen. These phenomenon are accompanied by indisposition and nausea. The skin often feels as though ants were crawling allover (De morbo chron . V. 12 [7]). Celsus [8] distinguishes between diseases of the knees (CXXX) as well as the small joints of the feet and hands. (CXXXI.) The latter he calls gout. Galenus gives a very exact diagnostic (Defin. med. [8]). "Ischias est morbus validum dolorem coxae per circuitum inferens qui dolor val usque ad poplitem et suram descended ' (CCXC). This appropiate definition could appear in any modern diagnostic books. He continues: "Arthritis est phlegmonestabilis circa articulos consistens dolorem ingerens vehemente nervis nimkrum affectis". (ibid. CCXCI). His third definition is equally ingenious: "Podagra est affectus qui circa pedes oritur et dolorem movet affectis nervis idque aliis cum ardore aliis cum algore." (ibid. CCXC II). Galenus separates in differential diagnostics temporary pains of the thigh naming them ischias and arthritis. The first is charcterized by pains flowing towards the knee and legs whereas in the latter cases the centre of the pain appears in the joints and their environment. Intensity of the pain also varies. Having become acquainted with these descriptions there is little wonder that Galenus—in spite of his many anatomic errors —influenced medical thinking during centuries. Hippocrates already dissociates chiragra apearing on the joints of the hand from podagra of the feet, he even emphasizes that the latter is more severe and lasts longer. Arataeus [5] is of the opinion arthritis is a general collective term. Caelius Aurelianųs summerizes this as follows: Igitur quidem medici arthriticam passionem genus vocant, podogricam vero species" (De chron. C.V. 2. [7]). Symptomatology of joint diseases were supplemented by Aetius (C. XII. 14 [1]), over the diseased oedematous joints the veins are widened ; urine is dense and cloudy, spontane settling abundant. It is possible that he really observed cases of gout or else these phenomena were in connection to a feverish condition. Rheumatic nodules are also well-known since long ago. Hippocrates had already evaluated them as unfavorable prognostic signs, such cases do not heal, just as those originating or spreading over into old age do not either. (Prorrheut . II 79 [13]) According to the opinion of Galenus the rheumatic modules are caused by thickenned fluids on effect of which these dry up ant become hard (ed. Kühn , XIII 993 [9]). Alexandros writes (Peri poron), such nodules occur very frequently on diseased joints. His explanation is that food is transformed into raw and indigestible fluid, but a permanent and excessive use of palliatives and sedatives can also induce it. This occurs on the effect of warm dyskrasia in case of "survival" (acrimonium) medicaments. In Papyrus Ebers columna 51 19—52, 1 and 25, 3—8 we can read about the st.t. disease caused by "mucous materia" which accumulated in the neck. The cervical vertebrae are painful, become rigid and when asked by the physician the patient can only look at his own abdomen with difficulty or not at all. 6o
