Hippocratic face

The facies hippocratica (Latin for Hippocratic face) describes a characteristic facial expression in dying ( moribund ) or severely ill patients. The facies hippocratica is in addition to the so-called cemetery roses in the early history of medicine, a known prognostic signs of imminent death if this was preceded by a prolonged agony.

Importance

The facies hippocratica results from a relaxation of the facial muscles and increasing restriction of blood flow in the peripheral parts of the body ( centralization ). A pale facial skin, sunken cheeks and eyes and a " pointy nose " are characteristics of this facial expression. Frequently one finds the facies hippocratica in severe peritonitis ( abdominal peritonitis ), which is why this particular form of facies abdominalis as facies or facies peritonealis is called.

Origin

Still in use today and introduced by early physicians such as Galen name goes back to Hippocrates of Kos, the very accurately describes this expression in the second chapter of his book prognostikon ( Προγνωστικόν, forecasts ) as the first. He shall in on various signs which suggest a near death and could be seen from the eyes, lips, ears and facial skin. However, Hippocrates refers in this forecast and the previous course of the disease and other conditions with a:

" First you watch the face of the patient, whether it is as in healthy individuals, especially if it otherwise looks like, because in this case it would be best; but it is quite the contrary way as usual, it is the worst. That would be the following case: tip nose, deep-set eyes, sunken temples, cold and shriveled ears, ear lobes reflexed, brittle, taut and dry facial skin, yellow or dark, bluish or leaden color of the whole face. Now, if the face looks at the onset of the disease and is not to expect it after the other signs so one must ask whether the patient was sleepless, or whether the bowel movements were very fluid, or whether he was suffering a little hungry. He affirmed anything of it, so you have to keep the state for less bad, because if the face looks as a result of these causes so it chooses within the day and night for the better. If he, however, denied all that and the illness does not stop even in the mentioned time, we must know that the patient is near death. "

The prognosis of the disease had a very high priority, especially the insight as to when medical action is meaningless and that the added solid doctor also recognize this in early medicine. In the prediction of imminent death, the healers spared the accusation obvious failure, where the patient soon dies. Knowledge of the exact signs of death or terminal illness was one of the foundations for the trusting position of the physician; it was connoted as " secular version of the prophecies ": " Prognostic sense made ​​a good impression and raised the gifted healer quacks and soothsayers ".

Evidence

• Ancient Medicine
• Pathology
• Death