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The History Of The Plague At Athens: Translated From Thucydides. With Remarks
Explanatory Of Its Pathology by Charles Collier
The British Medical Journal, Vol. 1, No. 56 (Jan. 23, 1858), p. 71
Published by: BMJ
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 Jan. 23,1858.]
PERISCOPE. Medical Joubnal.
_[British
cess of sensibility in the nerves of common or special sensa this we must refer to the work itself. It will afford
opinion,
tion, a propensity to spasmodic actions and to irregular organic instruction both to the epidemiologist and to the medical
phenomena, there is no essential distinction, they are simply historian, especially if they have the opportunity of perusing,
different facets of the same die. 16. That the essential dis
at the same time, in the original Greek, the graphic descrip
tinction between genuine hysterical and muscular affections is,
that a large amount of bodily rest is necessary cure tion of a man who wrote from personal observation?" avr?s
for the of
the latter, while it is not so for the former. T6 voofoas Kal avrbs iSui/ &\\ovs itdffxovras."
absolutely requisite
17. That, for the future, it will be necessary to discriminate
between pain arising from muscular fatigue, cramp, or fibrous
stretching and genuine neuralgia, and that there will be neither
precision in diction nor a clear idea of treatment until the dis
tinction is made." (pp. 160-1.)
In the treatment of the cases noticed by Dr. Inman, the in SURGERY.
dications "to husband the existing amount of con
are:?(a) THE PATHOLOGY OF ARTICULAR CARTILAGES.
stitutional strength, as far as possible: (b) to increase it."
The following is an abridgment of a paper published by
In the treatment of confirmed nervous affections, he lays
Mr. Bryant of Guy's Hospital in the Lancet for October 31
great stress on confidence and hope as holding the foremost
and November 7, 1857.
place. Purgatives and debilitating medicines are to be avoided,
Articular cartilages, standing as they do upon the confines
or, at most, very cautiously used. Tonics are his main medi
of the two anatomical divisions of tissues, hard and soft, offer
caments. to the anatomist an unusually of examining
" good opportunity
Here is Dr. Inman's description of the signs of the good the process of cell-development, and afford equally to the
time coming:"? pathologist the means of studying the changes which nucleated
" cells undergo in their degeneration or
When the profession shall have recognised the principles decay.
we have attempted to lay down?when The difference between what are called vascular and non
they begin to look with
at every dose of calomel, or that vascular tissues (to'which latter division articular cartilages
jealousy antimony, digitalis
is now known to be so slight, that the method by
they
*
order?when they take for * a starting-point the axiom that belong),
disease and that everything which weakens which this structure is nourished is no longer doubtful. The
implies debility,'
a patient must blood being conducted by its ordinary vessels to every tissue,
impede his restoration to health '?when bleed
each tissue extracts, or rather imbibes, the materials
ing shall have been dismissed to the limbo of scientific falla requisite
for its nourishment : the difference between the vascular
cies, to be recalled only by some medical judge of supreme only
blisters become the rifle-shot of the experi and non-vascular parts being determined by the spaces through
knowledge?when
enced hunter, who never fires without a definite aim, rather which this process of imbibition takes place (the vessels in
than the grape, canister, or the shrapnel-shot of the artillerist, the latter not perforating its substance). The nucleated cells,
who fires them comparatively at random?when are however, through which all structures are formed and grow,
purgatives
not considered and salivation is not a refuge for the still absorb from the vessels, however distant, their quantum
panaceas,
destitute of ideas?when of nourishment ; and in articular cartilages these cells are as
active treatment gives way to scien
active as in any other tissue. That the principal source of
tific, and the general health is considered superior to the appa
rent health of any one organ?when medicines are considered supply to the articular cartilages is derived through their bony
as means to an end, and not as so many doses of bottled com attachment, the investigations of Birkett, Toynbee, and others,
fort?when the doctor in recovery the result of a have well demonstrated. The vessels at their bony base form
recognises "
natural process rather than the imbibition of so many ounces loops, and yield the required nourishment
'
somewhat
'
in the
of physic?when there is a thorough same manner as the epidermis scales are nourished upon the
knowledge of what me
dicine can do, as well as what it cannot?when a discrimination vascular loops of the corium." The vessels ramifying in the
is made between the effects of a disease and the effect of pre synovial membrane, and at their circumference, furnish to their
sumed remedies?when the natural adjacent surfaces a sufficient It is clear, then, that
history of each complaint supply.
becomes more generally structures deriving nourishment through other, although adja
known,?not only will the science of
medicine be fixed upon a firm basis, but it will command a cent tissues, must depend much upon the integrity of these
confidence that it has never yet fully deserved." tissues ; and that if any disturbing cause should arise to pre
(pp. 199-200.) vent or arrest their powers of nutrition, the same, if not in
There arc in the profession,
probably, more men who think creased perversion of nutrition must ensue in the tissues thus
with Dr. Inman than he seems, from some passages of his secondarily supplied.
book, disposed to admit. To such, a man who speaks out so Articular cartilages, like other tissues, may hypertrophy, or
as our author is a welcome This book on atrophy, using the latter in its simplest sense. Inflame and
boldly ally. Spinal
Irritation is one which will, we think, promote the progress of
ulcerate they cannot, as the presence of vessels in the tissue is
generally considered necessary for such processes. But to
rational medicine ; and the author is entitled to the thanks of
granular, fatty, and fibrous degeneration they are peculiarly
the profession for its production. liable, and in these forms of degeneration may be included the
processes which have been so variously described by different
authors.
The History or the Plague at Athens : Translated from That hypertrophy
Hypertrophy of Articular Cartilage. may
Thucydides. With Remarks Explanatory of its Pa exist, under the same circumstances that generally induce
thology. By Charles Collier, M.D., F.R.S., Fellow of such a result in other tissues, cannot be denied : that is, in
the Royal College of Physicians, etc. pp. 80. London : cases where an unusual of blood, or liquor sanguinis,
quantity
David ?utt. 1857. is supplied to the tissue ; or when the functions of the part are
The classical in the profession called into unusual exercise. Whether such has occurred in
scholars are, or ought to be,
articular cartilage, Mr. Bryant is not to state; it has
familiar with the description of the plague at Athens prepared
by not fallen to his lot to witness a single instance, and he knows
Thucydides. The account he gives of the origin, symptoms, of no genuine case where was
such existence demonstrated.
and progress of the malady is, as the production of a non Cases are reported where the cartilage was found much thicker
medical writer, remarkable for its clearness and than natural, but, in all, some disease of the joint or neigh
accuracy.
Dr. Collier has taken in hand the investigation of the true bouring parts was present ; and it may be questioned whether
such thickening was not the result of softening and mere swell
nature of the so-called "plague"; and, examining the history
as given ing of the tissue, or other pathological change. That hyper
by Thucydides, he has arrived at the conclusion
" was trophy from simple excess of function should occur seems
that the Athenian plague that species of scarlatina which almost impossible, as the mind can hardly conceive a position
has been designated maligna; and that, if there was any devia in which such a demand should be required. That excess of
tion from this form, it must have belonged to the species vascular supply should induce this result, the same doubt
must naturally arise, as in cases where such supply is present,
anginosa, or that in which the morbid action is confined to the
the neighbouring synovial or bony structure must necessarily
fauces and throat." be involved ; and as congestion of these parts can hardly exist
For the full exposition of the author's reasons for adopting without some perversion of nutrition of the tissues themselves,
71

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