History of medicine. "Prognostication and the doctrine of temperaments" (the most important)

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History of medicine. "Prognostication and the doctrine of temperaments" (the most important)

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7. "Prognostics and teaching about temperaments"

One of the works of the Hippocratic Collection, which became the basis for diagnosing diseases, is "Prognostics" (from the Greek prognosis - "initial knowledge"). This is the first work on ancient Greek therapy. The book provides detailed descriptions of the prognosis of various diseases, diagnosis, methods of examination, questioning the patient, monitoring him, as well as methods of "treatment at the patient's bedside." It was from this work that some diagnostic signs that have survived to this day have entered the centuries. For example, the "face of Hippocrates" (named not for external resemblance, but in honor of Hippocrates). This is a classic description of the face of a dying person, and now it is applied to people with certain certain diseases (metastatic cancer of the gastrointestinal tract, etc.).

"About air, waters, places" - an essay that has, rather, an ecological and geographical name, in fact, the first work devoted to the harmful effects of environmental factors on the human body. The work details various "types of people" depending on the locality in which they live. As a person who traveled to a large number of countries, he could draw some generalizing conclusions about the occurrence of certain diseases in people inhabiting, for example, sea coasts, high mountain regions, and desert territories. He was also able to link the frequency of occurrence of certain diseases with the time of year and even with biological and circadian rhythms. Thus, Hippocrates determined that "different types" of people had different susceptibility to diseases, and therefore looked for both treatments that could be applied to all people, and different types of approach to treating the same disease that arose in people of different types. He also for the first time made an assumption about four bodily juices, according to the predominance of one of them in the body - the division of people into different types. This theory formed the basis of the much later formed doctrine of the four temperaments. This was already in the Middle Ages. The teaching said that if mucus predominates in the body (from the Greek phlegma - "mucus"), then a person has a phlegmatic temperament; if blood predominates (from the Greek sanguis - "blood"), then the person is "sanguine"; if bile predominates (from the Greek chole - "bile"), then the character of the person is choleric; if there is a lot of black bile in the body (from the Greek melaine chole - "bile"), then the type of temperament will be melancholic. The basis of this system is erroneously attributed to the merits of Hippocrates, since even if he tried to divide people into types, it was not by temperament, but by predisposition to diseases. In addition, the names of temperaments in the work "On Air, Waters, Localities" are not contained, because some words (such as sanguis) are of Latin origin, and therefore they could not be used by Hippocrates. In the future, only the names of various "types of people" were preserved from the theory of temperaments. I. P. Pavlov connected them with the predominance of the processes of excitation and inhibition, as well as with possible body types.

Author: Bachilo E.V.

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