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Sunday, June 14, 2015

100 B.C.- 200 A.D. Ancient physicians recognize pneumonia

Plutarch (46-120 A.D.)
After Hippocrates introduced the medical world to pneumonia around 400 B.C., little was changed regarding how it was defined and treated.

Plutarch was a Greek author who wrote over 227 works, including 60 essays on ethical, religious, physical, political and literary topics.  (1)

He recognized that while pleurisy often accompanied pneumonia and may have been responsible for the pleuritic chest pain and fever, it sometimes occurred on its own. (2) (8)

He decided that the term peripneumonia was superfluous, and therefore referred to inflammation of the lungs as pneumnonia, and inflammation of the pleural sac as pleurisy. (2) (3, page 191)

Areteaus of Cappadocia, one of the ancient authors who helped us define asthma and how it was treated by the ancient world, concurred with Hippocrates regarding peripneumony, noting that death usually ensues on the sevenths day.

He wrote about the usefulness of the lungs, and explained that certain maladies can cause havoc: (2)
But if the lungs be affected, from a slight cause there is difficulty breathing, the patient lives miserably, and death is the issue, unless someone effects a cure. But in a general affection, such as inflammation, there is a sense of suffocation, loss of speech and breathing, and a speedy death. This is what we call peripneumonia, being an inflammation of the lungs, with acute fever, when they are attended with heaviness of the chest, freedom from pain, provided the lungs alone are inflamed."
The cure Areteaus wrote about for pneumonia was similar to that of Hippocrates, although he added the following to the list of options:  (2)
  • Wine
  • Hysopp
  • Rubafacients containing mustard applied to the chest
  • Diluent drinks
Claudius Galen of Pergamum, who was perhaps the most significant medical authority of the ancient world, also differentiated pneumonia from pleurisy, although he continued to refer to them as peripneumonia. (2, page 2)

His remedies for the malady were also similar to those of Hippocrates.  So the greatest medical mind of the 2nd century, and whose works were worshiped by physicians for the next two millennium, had no desire to add to the wisdom of the ancient Greeks, at least regarding pneumonia.

References:
  1. "Plutarch," britannica.com, http://www.britannica.com/EBchecked/topic/465201/Plutarch, accessed 7/20/14
  2. Marrie, Thomas J, "Community Acquired Pneumonia," 2001, New York, chapter one by Jock Murray, "The Captain of Men and Death: The History of Pneumonia."
  3. Allbutt, Clifford, ed, A System of Medicine, 1909, Toronto, chapter on "Lobar Pneumonia,"  by P.H. Pye-Smith, pages 191-205

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