Palla Ákos szerk.: Az Országos Orvostörténeti Könyvtár közleményei 15-16. (Budapest, 1959)

Dr. Mihóczy László: A hippokratészi corpus phthisiologiája

and pyopneumothorax are connected with tuberculosis. He attached an utmost importance to the effect of the milieu, the geographical and meteorological peristasis. Very specified are those conclusions of his, which he makes of the point of view of establishing the diagnosis and fixing the probable course of the disease. The cyclic progress of tuberculosis is well known to him, which one thinks as the work of Fernel, who liwed 2000 years later. Hippokrates bestows significant chapters upon the description of pleurisy and pyopneumothorax. A part of these, thus the „Hippocratic splash" are wellknown. He knows very much about the pathogenesis of pleurisy and pyopneumothorax. He realizes the significance of age, weather and constitution. Above the already mentioned connection of pleurisy and pyopneumothorax with tuberculosis, he knows very well, that these are also in connection with one another, in genesis of the pyopneumothorax very often the sous pleurisy, respectively the suppuration of the haemothorax take part. He points out here also, that the disease itself latent in the organism - we would call it nowdays as a certain infection - is not enough, for the development of the disease, a lasting or momentary debilitation of the resistance of the organism is also necessary. Above the „splash" he also describes the rubbing, which charaterizes the dry pleurisy. He also went in for auscultation, which was discovered again by Laenec and describes it very vividly. One can consider the Hippocratical method of „sergical" treatment of pleurisy, respectively that of pyopneumothorax as for astonishingly up to date. The fact, that a very recurrent consequence of the purulent pleurisy is the ,,empyema necessitatis", the bursting, is well known to him. Neverthaless he did not observe the process with folded arms, but tried to influence the same in a favourable direction through opening the chest by tapping. He also taps for the purpose of establishing the exact diagnosis, he makes howewer his point of view unmistakably clear about the necessity of the therapical tapping, the withdrawel of the fluid. He describes with full particulars the method of carrying out of the puncture. He knows that the fluid must be drawn gradually, in small quantities, because otherwise the procedure involves risks. He tapped frequently, through days, taking care, that he should not burden the organism much too much. Besides he bathed the pleural cavity systematically, similarly as it is customary nowdays in the treatment of pyopneumothorax. Above all these he adopted even drainage and removed the canule after the wound has been healed with the greatest skill.