Wikipedia:Reference desk/Archives/Science/2019 February 16

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February 16

Hippocrates: "A person who has an injury in the back of the hand or the back of the leg will die in 12 days"

In one of the lectures about the ancient times some months ago, we were told in the name of Hippocrates: "A person who has an injury in the back of the hand or the back of the leg will die in 12 days". I tried to find the source for that but I didn't find it. The lecturer answered me that he saw it but he doesn't remember now where exactly. I googled and found something almost the same in the Talmud saying that it's dangerous but without mentioning the death after 12 days or the name of Hippocrates. I'd like to know where the source of the quote. I tried to find them here as well, but I couldn't find something about the back of the hand or leg. 185.65.206.153 (talk) 00:10, 16 February 2019 (UTC)

It's difficult to say with any degree of certainty, but this seems very possibly an apocryphal attribution. Hippocrates (or rather the Hippocratic corpus, since we have an unclear understanding of how much of the body of work attributed to Hippocrates was his own and how much came from his students and immediate successors at the school he formed) actually identified rudimentary diagnoses and treatments of injuries to the extremities that, in many respects, continue to be those used in medicine to this day. As such, he (as either an actual historical individual or an amalgam of several thinkers from his school) had a fairly realistic understanding of the gross anatomy and physiology of such injuries and I doubt he/they would have included such a statement when they would have routinely seen much better outcomes and we're actively engaged in pursuing useful treatments.

Which is not to say that even for the relatively learned healer there not some peculiar axioms and beliefs at that time. But all things considered, I don't think you're going to find this attribution actually matches up with anything in the corpus. However, you can search various translations of the corpus here for yourself--my own quick searches turned up nothing of relevance, but you may have more luck with different queries. Lastly, one additional thought occurs to me as to what your lecturer may have been misremembering: Hippocrates is credited with first describing certain forms of swelling in the extremities, some of which are associated with late-stage pulmonary disease. I can't remember if Hippocrates himself made an association between these symptoms and a particular prognosis or just described the gross physiology, but, for example, the condition of nail clubbing is still sometimes called "Hippocratic fingers" to this day. Worth looking into as you investigate this. (Do let me know what you find, if anything--I'm curious myself now). Snow ^{let's rap} 02:46, 16 February 2019 (UTC)

Such a formulaic declaration sound to me more like certain documents from Ancient Egyptian medicine. I wonder if Hippocrates (who visited Egypt) might have quoted such a statement in order to refute it, and faulty memory has transferred its attribution? {The poster formerly known as 87.81.230.195} 2.122.1.40 (talk) 02:54, 16 February 2019 (UTC)

Well, I tend to doubt that, because the corpus tends to be written as a treatise from direct experience, rather than a collection of references to supposed insights from elsewhere in the world (that is, we're not talking about a Herodotus throwing out references like "It is said amongst the Thracians..."; rather it's more along the lines of "In cases of fracture in either of the bones of the forearm, treatment is easier if it is the upper bone that is broken, although it be the thicker one, both because the sound bone is situated below..." The works in the corpus tend be very clinical and directly authoritative for their relative dates of origin).

Actually though, something else did occur to me immediately after I hit the send button on my original post: Hippocrates did pioneer treatments for infection which urged the removal of necrotic flesh. I did a quick targeted search in this area, which turned up this: [1]. I think what the lecturer may have been referencing was some comment by Hippocrates that the amputation of an extremity may be preferable to letting tetanus or gangrene to run it's course and kill the patient. I can find no direct reference to this in the corpus (and indeed, a search for "twelve" turns up nothing which would fit the axiomatic rule being attributed to Hippocrates by the lecturer). But this still a probable source for a context in which Hippocrates may have spoken generally as to an injury of the extremity being a possible cause of death. Snow ^{let's rap} 03:19, 16 February 2019 (UTC)

Thank you for the comments, I read all of your comments and I noticed that one of the things that are the most weird in the mentioned quote and nobody referred to it is that quote from both alleged Hippocrates and Talmud say it about the "back of the hand" and the "back of the foot" (or leg). So based on that, the explanation about the extremities as extremities does not make sense, since for those quotes the same injury in the palm for example isn't dangerous as in the "back of the hand". Maybe it wasn't said by Hippocrates but by other physician in the ancient time.185.65.206.153 (talk) 14:40, 16 February 2019 (UTC)

You're very welcome. And I agree with your assessment: the specific detail of the placement on the hand is what makes this sound more like quasi-nonsense and therefore less likely to be a directly attributable to the Hippocrates corpus, which did include inaccuracies or incomplete understanding of physiology, but which was typically predicated on more reliable/well-vetted observations--indeed, this is one of the causes of the fame of the Hippocrates lineage, as he/it is seen as not just a milestone of well-reasoned medicine, but also of the empirical process more broadly. However, I suspect that what happened here (either with your lecturer or with someone else who related the quote to them, or even further along in a game of telephone) is that a genuine quote about the worries of an infected extremity (which may very well exist in the Hippocratic corpus somewhere) was conflated with the more shamanistic notion of a wound specifically on the back of the hand or leg dooming the victim. Snow ^{let's rap} 15:51, 16 February 2019 (UTC)

The already cited verse from the Talmud goes on to say at page 45 that it's not the injury but the swelling of the hand or foot that is dangerous. I'm no medical man, but it's obvious that in these two extremities of the body, circulation of the blood may not be as good as elsewhere in the body, and severe swelling could result in gangrene. It seems that the Talmud, which is discussing another matter entirely, namely the justification for transgressing Shabbat in order to save life, actually states that it is necessary to act pre-emptively in the case of injury to either of these two extremities to prevent swelling setting in. As for Hippocrates, it's possible that he has been half-quoted or only his response to a qualified question was recorded for posterity. Akld guy (talk) 02:09, 17 February 2019 (UTC)

I found a Talmudic reference at [2], not being able to access Google's "restricted page", but it is only perplexing. But I was thinking very much along the line of Akld guy above, though tetanus was the first thing in my mind. Wnt (talk) 15:31, 17 February 2019 (UTC)

Leeches

Does leech can survive or live in a stomach?

I always think about some creature that are not bacteria which can enter into the digestive system such as leech. Does it can survive or live in the stomach while it has an high level of acidity or it should be dissolved there? 2A03:F80:354:37:235:49:190:1 (talk) 15:06, 16 February 2019 (UTC)

Can leech survive in an high temperature?

It's said that leech can live in extreme cold temperature (-196 C) - see here and here. What about the highest temperature that the can survive in? 2A03:F80:354:37:235:49:190:1 (talk) 15:26, 16 February 2019 (UTC)

Your reference only says that Ozobranchus jantseanus leeches (parasites that live in the blood of fresh-water turtles; see Turtle leech) are able to survive being dipped into liquid nitrogen. You shouldn't conclude that the same is true of other leeches. In particular, Hirudinidae are quite different from Ozobranchus and are unlikely to be able to survive freezing. --Guy Macon (talk) 15:50, 16 February 2019 (UTC)

Leeches that survived by chemosynthesis rather than photosynthesis while isolated for millions of years in a low-oxygen environment with high concentrations of carbon dioxide CO₂, methane (CH₄), hydrogen sulfide (H₂S) and ammonia (NH₃) were discovered in the Movile Cave, Romania. DroneB (talk) 18:34, 16 February 2019 (UTC)

To sort of answer your actual question (since you seem to be interested not only in leeches), there are worms which can survive a substantial period of time in the stomach: [3]. They don't reproduce there though, so they eventually die off. Henry^Flower 18:49, 16 February 2019 (UTC)

Not to be confused with Diet of Worms. ←Baseball Bugs ^{What's up, Doc?} carrots→ 20:16, 16 February 2019 (UTC)

Nothing is impossible in biology, so leech survival in the stomach can really only be predicted by finding people who have swallowed leeches and seeing what happened. Provided they didn't get stuck in the throat, or even larynx, first! I didn't quickly find more than a surmise about the stomach, but there is doubtless more to find. There was a time when military men dunked their canteens in just about anything, and drained them when very thirsty indeed... But to take a guess, leeches are one of the groups most severely affected by acid rain [4]; solving pollution problems quickly restores lakes to their turbid, leech-infested natural state. [5] On the other hand, what is fast in ecological terms may be slow in medical terms. ;) Wnt (talk) 15:18, 17 February 2019 (UTC)

You may enjoy learning about the liver fluke. The larval parasites are ingested, pass through the stomach, and go interesting places. - Nunh-huh 22:55, 19 February 2019 (UTC)

Well, those are platyhelminthes which is something else. You have to go out to the level of Platytrochozoa to include both leeches and trematodes in a clade. They are somewhat more closely related to one another than to humans, perhaps excepting politicians and corporate lobbyists. Wnt (talk) 20:26, 20 February 2019 (UTC)