[Philosophic-philologic element in the medical school. A contribution to medical history meant more for formation than information. II].
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Phrenitis has a history, from Hippocrates to Pinel. This study is owed to two scholars of different disciplines; the first is a classicist, the other a psychiatrist. It only concerns "phrenitis" in the Hippocratic Corpus. The authors have come to the conclusion that phrenitis has a pathology similar to the organic delirium.
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The author experienced anesthetic management of three chronic asthmatic patients for emergency or scheduled lower intraperitoneal operations. The patients were operated under high epidural anesthesia with upper level of T2, in the same way as non-asthmatic patients scheduled for the same lower abdominal operations. There were no worsening of the symptoms nor the signs of asthma, and vital signs were stable during and after the operations. There has not been any report that proved that epidural anesthesia worsens the pathology of asthma. Conversely, there were many asthmatic patients reported who had been relieved of attacks or whose symptoms and signs had not been changed by thoracic sympathetic blockade including epidural anesthesia. At the present time, neurohumoral innervation of the lungs remains to be elucidated, and it would be overhasty to conclude that epidural anesthesia is contraindicated in asthmatic patients.
In antiquity the 'higher' study of medicine shared with many other disciplines a pronounced philological character. Galen both exploited this 'philological paradigm' and underwent its influence. He exploited it in that it enabled him to invest the Corpus Hippocraticum with a dignity comparable to that of Homer only. But his philological instrumentarium, originally designed for the study of literary texts, also forced him to pose and answer certain questions that shed no light whatsoever on the informational content of Hippocrates' writings, questions about Hippocrates' language and style. Galen disentangles himself from the ensuing embarrassment by claiming that Hippocrates' style was ideal for the specific didactic genre he was involved in. This special style necessitates a reassessment of customary grammatical and rhetorical values: correctness recedes into the background, clarity and brevity become the predominant virtues of style.
Various approaches may be used in attempting to identify ancient medical instruments in cases where documentary or archaeological evidence fails to provide adequate information about their appearance or application, viz.: 1) the etymological approach, which is appropriate when only the instrument's name is known and when this indicates something about its form or function. 2) the philological approach, involving a Constitutio textus, the etymological analysis of the instrument's name and an examination of parallel references. This method is suitable in the case of instruments described in an ancient medical text whose meaning is not completely clear. 3) the philological-technical approach, which attempts an interpretation using the above philological approach supplemented by a consideration of the present-day function of a particular instrument or procedure. 4) the technical approach, which may be useful either when the existence of specific variants of an instrument has already been reliably established by means of appropriate technical terms or archaeological evidence and when the instrument is designated in the next in question only by some generic term, or alternatively when terminological specifications are lacking but the available archaeological evidence points to the existence of variants of an ancient instrument adapted for specific ends. For the purpose of illustration, the approaches described here will be applied to problem cases.