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 PALGRAVE STUDIES IN GLOBAL CITIZENSHIP
EDUCATION AND DEMOCRACY

AFRICAN DEMOCRATIC
CITIZENSHIP EDUCATION
REVISITED
d
Edited by
Yusef Waghid and Nuraan Davids
Palgrave Studies in Global Citizenship Education
and Democracy

Series editor
Jason Laker
San Jose State University
San Jose, California, USA
Aim of the Series
This series will engage with the theoretical and practical debates regarding
citizenship, human rights education, social inclusion, and individual and
group identities as they relate to the role of higher and adult education on
an international scale. Books in the series will consider hopeful possibili-
ties for the capacity of higher and adult education to enable citizenship,
human rights, democracy and the common good, including emerging
research and interesting and effective practices. It will also participate in
and stimulate deliberation and debate about the constraints, barriers and
sources and forms of resistance to realizing the promise of egalitarian
Civil Societies. The series will facilitate continued conversation on policy
and politics, curriculum and pedagogy, review and reform, and provide a
comparative overview of the different conceptions and approaches to citi-
zenship education and democracy around the world.

More information about this series at

http://www.palgrave.com/series/14625
 Yusef Waghid • Nuraan Davids
Editors

African Democratic
Citizenship Education
Revisited
Editors
Yusef Waghid Nuraan Davids
Faculty of Education Faculty of Education
Stellenbosch University Stellenbosch University
Cape Town, South Africa Cape Town, South Africa

Palgrave Studies in Global Citizenship Education and Democracy

ISBN 978-3-319-67860-3    ISBN 978-3-319-67861-0 (eBook)
https://doi.org/10.1007/978-3-319-67861-0

Library of Congress Control Number: 2017956406

© The Editor(s) (if applicable) and The Author(s) 2018

This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and trans-
mission or information storage and retrieval, electronic adaptation, computer software, or by similar or
dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or
the editors give a warranty, express or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

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Printed on acid-free paper

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The registered company is Springer International Publishing AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
 Foreword

In the context of contemporary post-Westphalian nation-states, the ques-

tions of cross-border migration and settlements of various forms and
duration have intensified. Of particular significance is the policy implica-
tion pertaining specifically to citizenship, nationality, and political rights
fiercely debated, amidst the increasing neo-liberal globalization on a
world scale since the end of the twentieth century. Such rights are acquired
either through place of birth and/or labor. Education, as a social institu-
tion that continues to provide technical skills and values necessary for
economic and political participation, has a role to play in the provision
and acquisition of the tools required to exercise the relevant agency to
claim practically these rights. Additionally, in the context of ongoing
migrations, the vital grounds of active linkages to places of emigration
origin and destination, for instance, through African conceptualization
and lived experiences of family solidarity and obligations, calls for serious
examination of the assumed requirements of single spatial connection for
securing and exercising such rights. The claim for legitimate rights had
been put forth earlier by pan-African ideology and currently by some
aspects of the demand of contemporary Afropolitanism.
The topic of citizenship education has increasingly been addressed by
scholars and activists across the globe, highlighting broader trends and
similarities as well as local, national, and regional specificities. In African
Democratic Citizenship Education Revisited, co-editors Yusef Waghid and
v
vi Foreword

Nuraan Davids have raised thought-provoking questions such as “What

… does it mean to be African?” in conceptualizing and envisioning the
concrete context for citizenship education. This type of discourse and
concern for defining legitimate membership is not at all new, as it goes
back to centuries of the modern and contemporary eras during which
massive forced migration took place out of Africa due to the trans-­
Atlantic enslavement, which led to the emergence and claims of pan-­
Africanism. Similarly, during the same period, there was a reverse
migration to Africa that was partially voluntary (in the case of the colo-
nizers) and in part forced (in the case of the imported labor, for instance,
from Asia) and was linked to the same exigencies of empire, capitalist
accumulation, and colonization that led to the loss of humanity, and
subsequently, all rights of Africans and other populations subjected to the
policies of forced labor. The transition to independence and the gradual
consolidation of the externally drawn borders among current African
countries did not address fully the problematics of the initial rationale for
mapping the African continent based on external motives and the impli-
cations of separating and displacing different social groups while creating
artificial boundaries. All this led to the original pertinent question of
“What … does it mean to be African?” In essence, this question interro-
gates what it means to be a citizen of an African nation-state considering
the weight of history. What are the spatial component and implications
of “being African?”
The co-editors of this volume forcefully articulate the intricate rela-
tionship between “democratic citizenship” and the indispensable aware-
ness/consciousness by citizens of their rights. It is with this realization,
they contend, that “the ongoing dialogue calls for democratic citizenship
education.” It is worth recalling that the fierce battles waged by Africans
against colonization and in independence movements were triggered and
sustained by their quest for freedom, an essential part of the ability to
acquire and exercise citizens’ rights. In the non-colonized contexts, spe-
cific rights for members of different sociopolitical entities may have been
constructed on the lines of what has been labeled in some of the literature
in political science as “primordial ties.” Thus, the transition from coloni-
zation to independence, occurred relatively recently, considering what a
timeline entails when building political systems and nation-states. In the
 Foreword
   vii

transition, complete citizens’ rights were not fully and practically restored,
given the enduring neo-colonial framework of governance. Colonial rule
was essentially incompatible with the respect and teaching of the “sub-
jects” about their rights. Therefore, it is imperative that a relearning and
reclaiming of rights under post-colonial regimes transpire to function
effectively, considering the tendency of the persistence and reproduction
of some regimes that operate with African proxies of colonial systems
considering whose interests are being mainly served. Also, the continued/
resurgence of primordial ties may contribute to fragmentation of the citi-
zenry and pose a challenge in organizing processes of increased conscious-
ness about the rights of the citizens based on their objective conditions in
the contemporary nation-states without ambivalence in allegiance and
how to settle old grievances and clarify the new exigencies that can be
effectively addressed while empowering “democratic citizenship educa-
tion.” While doing so, legitimate questions need to be asked about what
type of democracy constitutes the reference in defining the type of citi-
zenship education.
Yusef Waghid and Nuraan Davids, as co-editors and contributors, and
the authors of the other chapters of the volume offer a timely and impor-
tant contribution to the critical examination of the persistent questions
of citizenship, political rights, and the prerequisites for acquiring compe-
tence in knowing and exercising such rights in the African context. They
provide theoretical frameworks and locate their respective case studies in
the broader global context and at the same time effectively elucidate the
specificities of national milieus and global-local dynamics. Historical fac-
tors related to the specific contexts of colonial, post-colonial, and national
experiences are authoritatively situated in these case studies amidst neo-­
liberal globalization and liberal democracy, together providing a powerful
analysis of the diverse and complex situations with expert insight point-
ing to the nuances.
The volume covers individual countries in different sub-regions of the
continent, specifically North Africa, Southern Africa, West, and East
Africa. While the authors do not claim to offer a template for action, they
convincingly provide arguments for deciphering the contradictions
between nationalism and democratic citizenship education, the hinder-
ing effects of neo-liberalism, and the role of education in general and
viii Foreword

especially higher education. They provide critical perspectives for forward-­

looking and action-oriented assessments of the imperatives for promot-
ing democratic citizenship education in Africa, which can enlighten both
the citizens and “those in power” to appreciate the potentially positive
effects of the capacity to exercise and respond to “accountability pres-
sures” which have salutary outcomes for all.
There is no doubt that this edited volume will be well received by
scholars, activists, policy makers, grassroots organizations, and the vari-
ous forms of civil society that are active in localities in specific countries,
at national and sub-regional levels to engage in rethinking democratic
citizenship education with renewed commitment for transformative
action.

Cornell University, Ithaca, NY, USA N’Dri T Assié-Lumumba

 Preface

‘Until the lion learns how to write, every story will glorify the hunter.’
—African proverb

Democratic citizenship education in Africa was heavily curtailed in

educational institutions during the period of colonisation, especially
between the 1950s and 1970s—not only because schools and universities
were subjected to the political control of colonised nation-states but also
as a corollary of ethnocultural allegiances among indigenous communi-
ties that tangibly showed an aversion to others and otherness. First, at a
political level, it did not behove colonised nation-states to act according
to values of democracy and citizenship primarily because of repression,
exploitation and exclusion. Of course, this does not mean that Africa’s
peoples did not resist their political exclusion and by implication
announced their democratic and citizenship aspirations. However, such
often-prohibited demands were easily quelled by the coercive powers of
the colonial authorities. Likewise, many indigenous communities by and
large succumbed to their own political dictatorships that mostly served as
political proxies to procure colonial rule. In addition, the post-colonial
period, mostly from the 1980s onwards, witnessed a deluge of political
resistance, in particular the demands of nation-states to be liberated from
foreign and colonial control and manipulation.

ix
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x Preface

As we might know, many African indigenous communities succeeded

in liberating the continent from unwarranted external political exploita-
tion. As we might also know, neoliberalism and globalisation have become
manifest in the majority of nation-states on the African continent. And,
as with any new and often exploitative form of political dispensation —
considering that more than a third of the continent in the 1990s aspired
to establish democratic states—democratic citizenship education evolved
as a new politico-societal means to ensure the free and open exercise of a
neoliberal market economy that would supposedly enhance the political
and economic liberties of African nation-states. Inasmuch as such events
corroborated the decline of the colonised continent and by implication
colonised nation-state, African communities, nevertheless, became more
acutely aware of their political rights to liberty and the exercise of the
pursuit of their own indigenous forms of cultural living. In a different
way, post-colonial Africans began to narrate their own stories more
authentically and authoritatively. Today, although more than half of the
continent has assumed the status of democratic nation-states, Africans
remain entangled in a web of political manoeuvring that privilege indig-
enous patriotism often at the expense of liberal democratic action. This in
itself might not necessarily be debilitating to Africa’s political liberation.
However, as our own understanding of the contributions in this volume
suggest, it might also be the springboard that would further enhance
Africa’s embrace of democratic citizenship education—a matter of
Africans narrating their autonomous stories.
As we write and read these words, we live and reveal our stories. Stories
allow us to make sense of who we are. As they slip off our tongues or flow
through our fingers, our stories give meaning to who we are and what we
might become. Africa has always been a kaleidoscope of stories and sto-
rytelling—echoing through the dark night sky, as rhythmic bodies sway
to the emotion of the land. Much has been written and recorded about
Africa—from Joseph Conrad’s unsettling Heart of Darkness (first pub-
lished in 1899) to Karen Blixen’s romanticised memoir, Out of Africa
(first published in 1937), the African has been caricatured into that which
others have desired him or her to be. In turn, history reveals that Africa
has often been debased to what she should never have been—as encoun-
tered in Chinua Achebe’s Things Fall Apart (1958), Ngugi wa Thiongo’s
 Preface
   xi

A Grain of Wheat (1967), or Alan Paton’s Cry, the Beloved Country

(1948). What, therefore, does it mean to be African? What does it mean
to live on the African continent? Is being born and living in Africa that
accords Africans their citizenship? Is stating that we are African the same
as stating that we are African citizens? In this collection of essays, we
endeavour to address some of these questions in relation to conceptions
of democratic citizenship education.
Conceptions of democratic citizenship are seemingly inextricably
embedded in particular sets of rights—meaning that, in order for citizens
to lay claim to citizenship, they have to have a sense of their social, politi-
cal and legal rights. This particular understanding begins to explain the
ongoing calls for democratic citizenship education. Conversely, therefore,
the argument could be made that if a citizen is unaware of his or her
rights, he or she, seemingly, would not be able to lay claim to his or her
citizenship. The latter is certainly the view of Logan and Bratton (2006: 1),
who argue that the problem with citizenship in Africa is not that Africans
are not actively involved in their respective dispensations but rather that
‘democracy remains unclaimed by them [Africans]’. In this sense, Logan
and Bratton (2006: 1) maintain,

People in African countries may have begun to transform themselves from

the ‘subjects’ of past authoritarian systems into active ‘voters’ under the
present dispensation. But at the same time, they do not appear to fully
grasp their political rights as ‘citizens’, notably to regularly demand
accountability from leaders. As such, most African political regimes have
yet to meet the minimum requirements of representative democracy.

We might concur with Logan and Bratton’s (2006) argument that per-
haps the greatest challenge facing democratic citizenship education in
Africa is not the absence of democracy but rather the absence of account-
ability pressures—not only in relation to voters but especially on the part
of those in power. When we reflect on our home country, we can cer-
tainly see tragic evidence of not only an unclaimed democracy by the
majority of South Africans, but unclaimed lives as the plight of the his-
torically dispossessed remains unrelieved. Seemingly, while South Africans
might have succeeded in transforming themselves into active voters, their
xii Preface

lives remain untransformed. However, we would question whether

understandings of democratic citizenship can only be couched in relation
to political and legalistic contours of what it means to be a citizen.
Part of what makes conceptions of democratic citizenship education so
multifarious and complex is that its dynamism or fluidity is manifested in
how citizenship education is interpreted and lived. In other words, while
notions of democratic citizenship might emanate from legalistic frame-
works and political manifestos, it is lived and made visible through
human interactions, deliberative engagement, regard for the other and
compassionate action. In taking into account the deep intricacy and con-
testations which infuse democratic citizenship education, this anthology
has adopted an at once attached-to and detached-from gaze at manifesta-
tions of citizenship on the African continent. In this sense, while the vari-
ous authors write from particular worldviews, which might signal levels
of attachment to this or that African identity (of which there are many),
they are nevertheless detached from the (im)possibilities of democratic
citizenship education in Africa. This detachment stems from a recogni-
tion that inasmuch as Africa has the potential for democratic enactments,
it equally has the (im)potentiality not to do so. And inasmuch as reasons
need to be sought and offered in relation to the (im)potentiality of Africa,
equal attention has to be afforded to the (im)potentiality of democratic
citizenship education.
This anthology of essays or chapters comprises ten chapters, and one
coda, which explore seven different geographical, social and citizenship
contexts and challenges. As such, the chapters offer a cross-spectrum of
engagement with very particular African contexts, from a diverse group
of scholars, who share a collective interest in the difficulties and hopes for
a citizenship of humanity flourishing on the African continent. The
inclusion of these particular contexts has been influenced by a number of
factors. These have included a focus on an emergent democratic land-
scape, as represented by South Africa, which offers a fertile space for the
reimagining of a democratic citizenship and education. The focus on
South Africa, as examined by Hungwe and Divala, also raises critical con-
cerns about particular enactments of democracy, citizenship and educa-
tion in relation to foreign African students. Like the focus on South
Africa, the inclusion of a chapter on Egypt is concerned with the
 Preface
   xiii

­ ossibility and plausibility of an emerging democracy. Of course, the two

p
countries have had very different, yet equally, complex histories, but the
interest remains—in the aftermath of an Arab Spring—whether it is at all
feasible to imagine an Egyptian citizenship underscored by democratic
principles and values. Similar concerns are raised in the chapters on
Zimbabwe, where the concern is not only on the viability of a form of
democratic citizenship, but indeed on the social and economic sustain-
ability of its citizens. These are real concerns, which present particular
challenges for human and humane existence, which, as in the cases of
Egypt, and Kenya, have implications for migration and displacement
across the African continent and especially in South Africa. The types of
instability and hopelessness encountered in Zimbabwe is not unlike that
experienced in Kenya, where tribal and ethnic violence continues to sub-
ject citizens into lifetimes of fear and degradation. The attention to coun-
tries such as Namibia, Malawi and Nigeria serves to offer a more subdued
reflection on what can be aspired towards—albeit that these aspirations
will remain in potentiality. Of course, these three countries have intricate
challenges of dire poverty, unemployment, and their associated trials and
confrontations but the focus is on democratic initiatives, which interests
this anthology. While we recognise the profound differences within and
across African countries, there is an equally profound collective desire,
which is for peaceful co-existence, mutual respect and regard for human
life. There are also intense religious, cultural and ethnic languages, arte-
facts, and lived experiences, which can neither be undermined, nor dis-
counted from conceptualisations of African democratic citizenship and
education.
Very aptly, the book commences with Yusef Waghid’s ‘On the rele-
vance of a theory of democratic citizenship education for Africa’, which
bravely questions the relevance of democratic citizenship education as a
theory to explain Africa’s post-colonial political and socio-economic aspi-
rations. He argues that a theory of democratic citizenship education can
only be relevant to humans living on the African continent, if such a
theory ‘would foreground the significance of people engaging with one
another through speech’. In this regard, it is Waghid’s argument that,
regardless of the challenges that beset African communities, democratic
citizenship education has to recognise the right of all people to engage
xiv Preface

with one another through the use of language. To this end, ‘a theory of
democratic citizenship education pronounces the importance of people
recognising one another with their commonalities and differences’, which
according to Waghid, implies the non-alienation of people from one
another, irrespective of their disagreements and differences. He main-
tains, ‘a democratic citizenship education theory that does not consider
people as equal speaking beings would itself become vulnerable to kinds
of prejudice that drive people apart rather than including them collec-
tively in communication’. Following on Waghid, Nuraan Davids, in her
chapter, ‘Democracy, citizenship and religion in Egypt: on the necessity
of disrupting a post-Arab spring’, questions whether conceptions of dem-
ocratic citizenship in Arab communities are at all possible and desirable.
She asserts:

the very language of dissensus and disruption that gave the Arab Spring its
definitive voice is the same one that is used to highlight the volatile and
violent nature of democracy. It is therefore not too difficult to point to the
instability and violence of democracy as a means of detracting attention
away from the violation and violence of authoritarian and repressive
regimes.

To this end, she posits that the emergence of a democratic citizenship

in Egypt is as tied up in its disruption of an authoritarian state as it is in
unequal and repressive religious interpretations and practices. By draw-
ing on a particular historical Islamic understanding of citizenship, as a
social contract between an individual and the state, the premise of the
chapter is that contemporary notions of citizenship are reconcilable with
Islam, and therefore (ought to be with) a Muslim state. Consequently,
Davids argues that a democratic citizenship education, as constructed
through a social contract, is ‘critical to meeting the needs of a society,
which might desire democracy, but are unfamiliar with its practices of
participation, inclusion, recognition, and engagement’.
In their chapter, ‘Rethinking democratic citizenship education in
Africa: Towards moderate deliberation’, Rachel Ndinelao Shanyanana
and Joseph Jinja Divala interrogate democratic citizenship in relation to
the post-colonial contexts of Malawi and Namibia. They contend that
 Preface
   xv

the challenges facing contemporary Malawi and Namibia are primarily

the result of a narrow conception of democratic citizenship, which is pre-
occupied with an emphasis on an electoral democracy, rather than on
deliberative participation. Following on this, Shanyanana and Divala
argue for a moderate, deliberative democratic education framework as
one that is consonant with an African democratic experience. They main-
tain that, unless the African democratic states promote moderate delib-
erative democratic education, citizens may possibly not be able to engage
in matters of mutual concern and will inevitably fail to have meaningful
deliberations that can start addressing unjust encounters confronting the
continent today, thereby potentially thwarting the many advantages of
developing democratic communities Africa requires to promote. In the
next chapter entitled ‘Afrophobia in the South African higher education
system: a threat to internalisation and global citizenship initiatives’,
Joseph Pardon Hungwe and Joseph Jinja Divala bring into disrepute the
objectives of higher education to prepare student graduates as global citi-
zens. In this regard, the authors examine the prevalence of Afrophobia, as
a distinct form of xenophobia, at South African universities. In exposing
Afrophobia as an exclusive discriminatory practice, which emphasises the
non-state citizenship of foreigners of African origin, the authors consider
Afrophobia to be ‘a denial of the concept of global citizenship on the
basis that it negates universalism and/or contradicts the inherent worthi-
ness of individuals, and this sharply contradicts what most universities
proclaim to be promoting in their visions and activities’. Hungwe and
Divala argue that if universities are to serve the public good of local and
international or foreign students, then global citizenship education ought
to be an indispensable part of any university environment.
In Chap. 5, ‘Nationalism and/or the annihilation of democratic citi-
zenship education: A critical analysis of Zimbabwe’s citizenship educa-
tion initiatives’, Agrippa Chingombe and Joseph Jinja Divala depart from
the premise that what is touted as ‘citizenship education’ in Zimbabwe is
far removed from citizenship education. The authors argue that although
concerns of human rights and democracy have been centralised in citi-
zenship education in Zimbabwe, what has emerged instead is ‘an extreme
nationalist citizenship education project, which continues to be radical,
exclusionary, discriminatory and very partisan thereby tearing apart the
xvi Preface

very fabric of society which it intends to build’. In foregrounding the

Nziramasanga Commission Report (1999), Chingombe and Divala
attempt to redefine and reposition citizenship education in Zimbabwe.
They do so by arguing that ‘the success for a deliberative active citizenship
education that appreciates participatory democracy is dependent upon
the attitude and behaviour of the custodians of institutions of learning
and politicians who have the power to influence the curriculum’. In her
chapter, ‘On the [im]possibility of democratic citizenship education in
Kenya: Spheres of change’, Jane Chiroma contends that it is ethnic vio-
lence which undermines democratic practices within Kenyan higher edu-
cation. Because Kenya has, as yet, not managed to address the prevalence
of ethnic violence in its society, she asserts, that this is perhaps indicative
of Kenya not having reached its full potentiality yet. In this regard,
Chiroma argues for a democratic citizenship education that is in becom-
ing—one that transcends the boundaries of possibilities and impossibili-
ties in order to enhance education as a process of becoming in relation to
human experience, interactions and/with ethnic relations. In her opin-
ion, a reconsidered understanding of democratic citizenship education in
becoming has the potential to enable Kenyan policymakers, educators
and students to think and speak differently and to suspend quick judge-
ment about how policies, power and decisions in education are made.
Taking a different turn, the chapter by Zayd Waghid and Faiq Waghid,
‘[Re]examining the role of technology in education through a delibera-
tive decision-making approach: In the quest towards democratic educa-
tion in South African schools’, looks at the use of educational technologies
as ‘maps’ or as ‘pedagogical practices’ in enhancing students’ learning
experiences. They contend that these ‘maps’ might assist students in
extracting deeper meanings from their learning experiences, which might
‘allow for more equal, deliberative and inclusive pedagogical relations by
promoting spontaneity pertaining to debates and discussions in the South
African classroom’. In turn, Waghid and Waghid argue for educators to
adopt a deliberative decision-making approach supported by educational
technologies in classroom settings—‘This is because deliberation pre-
mised on reasonableness and amplified by rationality is aimed at cultivat-
ing students’ voices as active participants in their own learning.’ Staying
in South Africa, Tracey Isaacs’ chapter, entitled, ‘The politics of
 Preface
   xvii

s­chooling—imagining critical democratic citizenship education in the

age of neoliberalism’, offers an in-depth critique of post-apartheid citi-
zenship education policy in relation to educational practice, specifically
the South African National Curriculum Statement (NCS). She follows
with an attempt to align critical conceptions of democratic citizenship
education to South African education to imagine how political literacy,
civic duty and tolerance may be signified in a state of advanced capital-
ism. It is imagined, states Isaacs, that the latter reflections

are necessary to appreciate the complex and sensitive area of citizenship

education, the vacuity of positive models of citizenship (in political leader-
ship and the capitalist classes especially), and how ideas of citizenship may
be converted into social levers that serve the common good.

In Chap. 9, ‘Continuing professional development of teachers and

democratic citizenship education in Nigeria: A hopeful pursuit?’ Ruth
Ayoola and Nuraan Davids explore the link between democratic citizen-
ship education and the continuing professional development (CPD) of
teachers. In this regard, the authors seek to understand whether the pro-
fessional development of teachers contributes towards their cultivation as
‘democratic’ teachers. The authors contend that while CPD programmes
in Lagos State, Nigeria, propagate democratic ideals, these programmes
fail to create the spaces in which these ideals might be deliberated upon.
As a result, teachers are often unclear about how to implement their own
understandings of particular concepts practically. The glaring gap between
conceptual understandings and practices among teachers, state Ayoola
and Davids, holds particular implications not only for the cultivation of
democratic citizenship education in schools but also for democratic citi-
zenship in Nigeria. In her chapter, ‘Democratic citizenship education
revisited in Zimbabwean higher education’, Monica Zembere raises con-
cerns about the silences of higher education policy documents in relation
to democratic citizenship education. She cautions that, unless issues of
equality, equity, human rights and social justice are addressed, the coun-
try’s political and social crises cannot be alleviated.
The anthology concludes with a coda by Nuraan Davids and Yusef
Waghid, in which they reflect upon a conception of democratic
xviii Preface

c­ itizenship, which connects to the human experience along the lines of

deliberative engagement, responsible action, co-belonging and equality
of speech and action. In this regard, the authors raise questions about
being too dependent on a view of democratic citizenship education which
favours and privileges individual rights and collective autonomy, and
which might not be sufficient in realising the type of democratic citizen-
ship education desirous for the African continent. To this end, by draw-
ing on Agamben’s (2002: 58) idea of ‘bare life’, Davids and Waghid argue
for a particular kind of democratic citizenship for Africa that remains
open to liberal and communitarian understandings of the concept, yet
blind to and captivated by what might still ensue as human interactions
and co-­belonging manifested in their practices.
What can be deduced from the main arguments in the volume is that
the recognition of rights and responsibilities, coupled with an emphasis
on deliberative engagement among citizens can be considered as apt ways
in which an African notion of democratic citizenship could manifest in
educational activities. Although the aforementioned understanding of
democratic citizenship education seems commensurate with say, liberal
communitarian understandings of the concept, what makes the afore-
mentioned notion of democratic citizenship significantly African is its
inextricable connection with an African situatedness. This means that
inasmuch as a recognition of rights and responsibilities, together with an
allegiance to deliberative engagement might not be uniquely African,
there is ample evidence (from the arguments proffered by authors in and
about various nation-states in particular) that the concept can most
appropriately be realised in relation to its connectedness with experiences
of people living on the continent. Of course, our potential critic might
correctly assert that nearly half (if not more) of the countries on the con-
tinent have been subjected to military dictatorship, which implies that
quite a substantive part of the continent seems to be out of congruence
with democratic aspirations. We are not misrecognising that the latter
seems to be the case. However, our reason for focusing on countries that
have an overwhelming allegiance to democratic citizenship education is
in part an acknowledgement on our part that the concept in a different
form—that is, one enveloped by an Africanness—has the potential to
manifest in practices on the continent. And, perhaps, as our collective
 Preface
   xix

optimism surfaces throughout this book, highlighting the successes of

African democratic citizenship education might just be the way to go in
addressing the malaise of its implementation in many countries where
autocratic rule prevails. Hence, our aim in and through this book is to
show that African democratic citizenship education can work and that
our confidence in an Africanised notion or notions of democratic citizen-
ship education can only advantage educational pursuits on the continent.
This in itself is not a denouncement of indigenous communal African
practices but rather an acknowledgement that acting democratically and
exercising an African citizenry might be an achievable ambition.
Stellenbosch University Yusef Waghid
Cape Town, South Africa Nuraan Davids

References
Achebe, C. (1958). Things Fall Apart. London: William Heinemann.
Agamben, G. (2002). In K. Attell (Ed.), The Open: Man and Animal. Stanford:
Stanford University Press.
Blixen, K. (2001). Out of Africa. London: Penguin Books.
Conrad, J. (1990). Heart of Darkness. London: Dover Thrift Editions.
Logan, C., & Bratton, M. (2006). Voters, but Not Yet Citizens: The Weak Demand
for Vertical Accountability in Africa’s Unclaimed Democracies (Afrobarometer
Working Papers). Cape Town: Afrobarometer.
Paton, A. (1948). Cry, the Beloved Country. London: Jonathan Cape.
Wa Thiongo, N. (1967). A Grain of Wheat. London: William Heinemann.
Visit https://textbookfull.com
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 Contents

1 On the Relevance of a Theory of Democratic Citizenship

Education for Africa   1
Yusef Waghid

2 Democracy, Citizenship and Religion in Egypt:

On the Necessity of Disrupting a Post-Arab Spring  13
Nuraan Davids

3 Rethinking Democratic Citizenship Education in Africa:

Towards Moderate Deliberation  31
Joseph Jinja Divala and Rachel Ndinelao Shanyanana

4 Afrophobia in the South African Higher Education

System: A Threat to Internalisation and Global
Citizenship Initiatives  53
Joseph Pardon Hungwe and Joseph Jinja Divala

xxi
xxii Contents

5 Nationalism and/or the Annihilation of Democratic

Citizenship Education: A Critical Analysis of
Zimbabwe’s Citizenship Education Initiatives  77
Agrippa Chingombe and Joseph Jinja Divala

6 On the [Im]possibility of Democratic Citizenship

Education in Kenya: Spheres of Change 103
Jane Adhiambo Chiroma

7 [Re]examining the Role of Technology in Education

Through a Deliberative Decision-Making Approach:
In the Quest Towards Democratic Education in South
African Schools 133
Zayd Waghid and Faiq Waghid

8 The Politics of Schooling: Imagining Critical Democratic

Citizenship Education in the Age of Neoliberalism 157
Tracey I. Isaacs

9 Continuing Professional Development of Teachers

and Democratic Citizenship Education in Nigeria:
A Hopeful Pursuit? 179
Ruth Ayoola and Nuraan Davids

10 Democratic Citizenship Education Revisited in

Zimbabwean Higher Education 199
Monica Zembere

11 Coda: Democratic Citizenship Education and the

Notion of ‘Bare Life’ 221
Nuraan Davids and Yusef Waghid

Index 231
 About the Editors

Yusef Waghid is Distinguished Professor of Philosophy of Education at

Stellenbosch University. He is the author of African Philosophy of Education
Reconsidered: On being Human, and co-editor (with Ian Davis and others) of
Global Citizenship Education (Palgrave Macmillan, 2018).
Nuraan Davids is Associate Professor of Philosophy of Education and
Chairperson of the Department of Education Policy Studies at Stellenbosch
University. Her interests include democratic citizenship education, Islamic educa-
tion, ethics in education, and educational leadership and management. Her recent
published works include Tolerance and Dissent Within Education (with Yusef
Waghid, Palgrave Macmillan, 2017); and African Democratic Citizenship Education
Revisited (co-editor with Yusef Waghid, Palgrave Macmillan, 2018).

xxiii
 List of Contributors

Ruth Ayoola Born and raised in Nigeria, Ayoola has developed a passion for
policy studies as a tool for solving educational challenges. She holds a master’s
degree in Education Policy Studies from the Stellenbosch University, South
Africa, and a B.Ed. (First class honours) in Education Management (Accounting)
from Ekiti State University, Nigeria.
Agrippa Chingombe is a Senior Lecturer in the Department of Educational
Foundations at the Great Zimbabwe University.
Jane Chiroma is Lecturer in Foundations of Education and Head of Education
Department at the Jos ECWA Theological Seminary, Nigeria.
Joseph Jinja Divala is Associate Professor of Philosophy of Education at the
University of Johannesburg. His research interests are aims and conceptions of
education; deliberative democratic citizenship theory; citizenship identities;
social justice; equity and governance in higher education systems; public policy
analysis. He has published in the areas of citizenship theory and education, aims
of education and higher education policy and practice. His recent works have
been published in The Sage Handbook of Education for Citizenship and Democracy
(2008), in Education Studies: History, Sociology, Philosophy (2016) and in
Knowledge and Change in African Universities. Volume 1: Current Debates.
African Higher Education: Development and Perspectives Series (2017).
Joseph Pardon Hungwe His research interests are internationalisation of
higher education, student international mobility, student body social diversity,
social cohesion in education and decolonisation of education.
xxv
xxvi List of Contributors

Tracey Isaacs Her dissertation Critical Student Agency in Educational Practice:

A South African Perspective opened up avenues for the researcher to explore the
dimensions of an ethical pedagogy. This position takes a serious look at issues of
culturally and economically marginalised students who navigate literacy and
numeracy development within a neoliberal school discourse. So the research
stance for this researcher is to better understand the complexities these students
face in order to help transform their social experience through schooling.
Rachel Shanyanana She is an assistant pro-vice chancellor at the University of
Namibia-Khomasdal Campus. Her research interests are higher education,
African ubuntu, deliberative democracy, citizenship education, education for
social justice, ethics of care, girls’ and women’s access to education in Africa and
transformative education in African university.
Faiq Waghid is a Lecturer of educational technology in the Centre for
Innovative Educational Technology (CIET) at Cape Peninsula University of
Technology. He is co-author of Educational Technology and Pedagogic
Encounters: Democratic Education in Potentiality (Sense Publishers, 2016).
Zayd Waghid is Lecturer in Economic and Management Sciences in the
Faculty of Education at the Cape Peninsula University of Technology, Cape
Town, South Africa. He holds a PhD from Stellenbosch University in 2014, and
his areas of research interest include educational technology, economics educa-
tion, social entrepreneurship education and social justice. He is the co-author of
Educational Technology and Pedagogic Encounters: Democratic education in
Potentiality (2017).
Monicah Zembere Her area of research interests includes education and social
issues emanating from policy and conflicts.
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the “sublimis anhelitus” of Horace, in his famous ode entitled
“Nireus.” I have often wondered that such a learned physician as
Julius Cæsar Scaliger, in his celebrated critique on Horace in his
Poetics, should have remarked on this expression: “Ex toto
Galeno non intelligo quid sit sublimis anhelitus.” Galen, in fact,
treats fully of the “sublimis anhelitus” in various parts of his works.
See in particular On Difficulty of Breathing.
[694] Galen has given us a lengthy Commentary on this case,
but a great part of it relates to the characters and to other matters
not of any very great importance in this place. As he remarks, it is
a striking example of an acute fever induced by immoderate
fatigue. It appears from his Commentary, moreover, that some of
the older authorities had added “drinking” to the excesses which
induced his affection; that is to say, they proposed to read πότων
instead of πόνων. The symptoms, upon reference to the
Prognostics, are all such as indicated a fatal result, namely, the
blackish and thin urine, “the fumbling with the bedclothes,” the
coldness and lividity of the extremities, the meteorism, and so
forth.
[695] In Galen’s Commentary on this case there is not much of
any great interest to the professional reader of the present day.
He animadverts again on the omission of all mention of the
treatment, although, as he states, venesection and the other
usual means had no doubt been tried; indeed the report implies
as much. Hippocrates, he repeats, never thinks of mentioning the
usual routine of practice, as he takes it for granted that the reader
will understand that it was not neglected. It is only on special
occasions, then, that he thinks of making any particular reference
to the treatment. Galen remarks, that ileus being an inflammation
of the upper intestines, is a particularly dangerous affection.
[696] As remarked by Galen in his Commentary, this was no
doubt a case of ardent fever or caucus, complicated with an
incidental miscarriage. There is no reason for looking upon it as
being a case of puerperal fever. Galen thinks that the last word
(caucus) is an addition made by the copyists, having been
transferred from the Glossarium to the text in the course of
transcription. Galen, as usual, directs attention to the characters
of the urine, which in this case are particularly unfavorable, being
defective both in quantity and quality.
[697] Galen’s remarks on the circumstances of this case are
sufficiently to the purpose, but there is nothing very striking in
them. He states that the abortion may have been occasioned
either by external causes—such as the application of pessaries
for this purpose, and the like—or internal, such as hemorrhage
from the neck of the uterus. and so forth. As in the former case,
he pronounces the last word (phrenitis) to be an addition to the
text, as Hippocrates never enters upon the diagnosis of diseases,
as is done in the work On Diseases. I suppose he means that our
author’s real works are all founded on Prognosis; whereas the
other, being derived from the Cnidian school, is founded on
Diagnosis. See our observations on this subject in the Preliminary
Discourse, and the Argument to the Prognostics.
[698] Galen remarks, that with such a combination of fatal
symptoms, namely, coldness of the extremities, fetid vomiting,
etc., it is wonderful that this patient stood out until the fourteenth
day. He thinks, however, that this is to be explained from her age
and constitution. He justly remarks that the occurrence of the
epistaxis could not be supposed sufficient to carry of such a
combination of unfavorable symptoms. He once more protests
against the last word of the report (causus) being admitted as
genuine. He confesses himself unable to determine whether “The
Liars’ Market” was in Athens or elsewhere.
[699] This is entitled the pestilential constitution by Galen. By
constitution, he explains, is meant not only the preternatural state
of the atmosphere, but also of everything else which influences
the state of the general health.
[700] Galen remarks, that in the First Book of the Epidemics
three constitutions of the year are described and also that others
are described in the Second Book; but that these are not carefully
drawn out for publication like those of the First and Third. He
further remarks on this head, that the constitution of the season
might prepare us for the putrid diseases, which are described
below, as heat is the active, and humidity the material, cause of
all putrefaction.
[701] Galen remarks that erysipelas is occasioned by a bilious
defluxion, but that it is not always of a malignant and putrid
nature; on the contrary, when the defluxion is mild, and the bile
which produces it is natural, it is not attended with any
considerable injury to the body, if properly managed; but that the
humor which produced the erysipelas about to be described was
not such, but of a malignant, corrosive, and septic nature, being
engendered by the humid and calm state of the weather in such
persons as were of a choleric constitution.
[702] According to Galen, aphthæ in general are superficial
ulcerations in the mouth, produced by the acrimony of the nurse’s
milk, and which are easily removed by an astringent application.
But in the present instance the aphthæ were of a malignant
nature.
[703] The carbuncle (anthrax), Galen says, is always
dangerous, and the product of bad humors. See Paulus
Ægineta, Vol. II., pp. 78, 79. Galen, in his excellent work On the
Difference of Fevers, writes thus: “In constitutions of the year,
similar to those which Hippocrates describes as taking place in
Cranon (See Ep. ii.). I have known cases of anthrax prevailing
epidemically in no few numbers, the formation and other
symptoms of which were exactly as described by him.” (Tom. vii.,
p. 293; ed. Kühn.)
[704] Galen explains under this head that the term epidemic is
not applied to any one disease, but that when many cases of any
disease occur at the same time in a place, the disease is called
an epidemic; and that when it is remarkably fatal it is called a
plague.
[705] The history of the epidemical erysipelas here described
cannot fail to prove interesting to the modern reader. I need
scarcely remark that epidemics of a similar nature are
occasionally met with in Great Britain at the present day. I myself
have encountered two such epidemics in the locality where I am
now writing, the one in 1823, and the other in 1846. As described
by Hippocrates, the disease sometimes supervened upon a slight
injury, and generally terminated in gangrene. On epidemical
erysipelas, see De Haen (Ratio Medendi), Bartholinus (Hist.
Anatom. Rat. Hist., 56), Wells (Transactions of a Society for the
Improvement of Medical and Chirurgical Knowledge), Cooper’s
Surgical Dictionary; and Cyclopædia of Practical Medicine, under
Erysipelas.
[706] Galen amply confirms this statement, that when
erysipelas fixes on a particular part of the body it is more
formidable in appearance than in reality, and that the disease is
attended with most danger when it leaves an external member,
and is determined inwardly.
 [707] The classical reader will here call to his recollection a
striking passage in the celebrated description of the Plague of
Athens, as given by Thucydides: “For the mischief, being at first
seated in the head, spread over the whole body, and if one
survived the most formidable symptoms, an attack on the
extremities manifested itself; for it was determined to the genital
organs and to the hands and feet, and many escaped with losing
them, and some with the loss of their eyes.” (ii., 49.) The passage
is thus rendered by Lucretius:

“tamen in nervos huic morbus et artus

Ibat et in partes genitales corporis ipsas;
Et graviter partim metuentes limina lethi
Vivebant ferro privati parte virili:
Et manibus sine nonnulli pedibusque manebant
In vita tamen et perdebant lumina partim.”
(vi., 1203.)

Lucretius, it will be remarked, understands the historian to

mean that the mortified parts were amputated; and this opinion,
although rejected by most of our non-professional editors of
Thucydides, is confirmed by what Galen says in his Commentary
on this passage, namely, that in erysipelas of the genital organs
“we (meaning the physicians of his own time) are often obliged to
excise the putrid parts, and apply the cautery to them.” I would
here further point out a singular mistake into which Dr. Bloomfield
falls in his note on this passage of Thucydides; he says that the
words of the original (ἄκρας χεῑρας καὶ πόδας) “can only signify
the ends of or lower joints of the fingers and toes.” No one who is
acquainted with the language of our author will require to be told
that this is an entire misconception. In the works of Hippocrates
χεῖρες is often put for the arms, and χεῖρες ἄκραι are always
applied to the hands.
[708] Upon reference to the Glossary of Erotian, the
Commentary of Galen, and the Annotations of Foës and Littré,
the reader will see that there is great difficulty in determining the
text in this place. After examining all that has been written on the
subject, one cannot come to any satisfactory conclusion as to the
true reading. I have adopted the meaning which seems to suit
best with the passage. The professional reader will scarcely
require to be reminded that in cases of phthisis there is often a
notable impairment of the voice.
 [709] Galen makes the important remark on this word, that, in
febrile diseases, epistaxis is always a bad symptom.
[710] This obliviousness is a feature of the plague, as
described by Thucydides: “And some, when they first left their
beds, were seized with an utter forgetfulness of all things, and
knew not themselves nor their relatives.” (l. c.)
[711] Our author alludes to the affection called coma vigil by
the later authorities. In this affection, as Galen remarks, the
patient lies with his eyes shut, but can get no sound sleep. This,
of course, is so much more the case provided pain be present, as
it necessarily will prevent the occurrence of sleep. See Galen’s
tract On Coma.
[712] The low muttering delirium of typhoid fevers is here
evidently alluded to. Galen, in his Commentary, guards the reader
against supposing that the fever passed into lethargus.
[713] This description apparently can refer to nothing but
pestilential buboes.
[714] It is impossible not to recognize this as a description of
purulent ophthalmia. Celsus thus describes the ficus: “Est etiam
ulcus quod a fici similitudine σύκωσις Græcis nominatur, ubi caro
excrescit; et id quidem generale est. Sub eo vero duæ species
aunt. Alterum ulcus durum et rotundum est: alterum humidum et
inæquale. Ex duro exiguum quoddam et glutinosum exit: ex
humido plus, et mali odoris.” See the Lexicons of Hesychius and
Phavorinus, and also Paulus Ægineta, Book III., 3. It will be
remarked that Hippocrates also makes mention of fungous
excrescences about the pudenda. Were they syphilitic? In other
words, did they derive their origin from elephantiasis? See the
Annotations on Paulus Ægineta, Book IV., 1, Sydenham
Society’s edition.
[715] The meaning of this term is not precisely determined.
Galen’s account of it may apply both to exanthemata, and
pustulæ. The description of the eruption in the Plague of Athens
is likewise vague and indeterminate. (Thucyd, ii., 49.)
[716] These intestinal complaints are all mentioned in the
description of the Plague at Athens. (l. c.) Upon reference to the
Commentary of Galen, the reader will remark that there is a
question here respecting the reading.
 [717] Galen, in his Commentary, makes the remark that he
observed the same symptom in the plague which raged in his
time.
[718] It will readily be understood that a colliquative diabetes
would prove a very unfavorable complication of these complaints.
[719] By nocturnal fevers, according to Galen, was meant
quotidians, which had their paroxysms during the night. Foës
inclines to think that diurnal should also be inserted in this place.
These nocturnal fevers are thus described by D. Monro: “The sick
were restless and uneasy at night; but commonly felt themselves
cooler and lighter in the daytime: and although they had no cold
fit, as the fever came on at nights, and many of them no breathing
sweat, as they became cooler and freer from the fever in the
morning; yet the fits were so remarkable, that many of the
patients used to say that they had a regular fit of an ague every
night, and some few that they had the fit every second night.”
(Army Diseases, etc., p. 158.)
[720] The account of the origin and progress of consumption
here given is, upon the whole, wonderfully correct. Common
experience seems to have decided that spring and autumn are
the most fatal seasons to phthisical patients. Avicenna makes the
remark, which is very important, and deserves to be kept in mind,
that by phthisis, in this place, Hippocrates most probably meant
hectic fever, connected with disease of the internal viscera, which
had been in an inflamed state during the acute attack of the fever.
(iii., 1, 3, 67.)
[721] I shall not enter into a discussion of the different
readings of this interesting passage. I may mention that our great
pathological authority on phthisis, Dr. Louis, agrees with
Hippocrates in deciding that the lymphatic temperament
constitutes a more or less marked predisposition to the
development of phthisis. (p. 483.) Galen describes the phlegmatic
temperament as being attended with a soft and slightly tumid
skin. He attributes the disease in their case to a cacochymy, that
is to say, to cachexia. I need scarcely remark that this opinion is
strongly advocated by one of the highest authorities of the day, I
mean Sir James Clark. See his treatise on Tubercular Phthisis.
Galen gives a discussion on the color of the eyes, about which
there is some difficulty, as the ancient terms which relate to colors
are not very well defined. The term here used (χαροπὸς) may
signify either blue or gray. Galen considers this color of the eyes
as a symptom of a cold and humid temperament.
[722] There is an ambiguity in the part of the sentence which
relates to women, as Galen states in his Commentary. Galen
does not hesitate to declare that women are more subject to
phthisis than men, an opinion upon which modern authorities are
not at all agreed. See the recent publications of Louis and Clark
on Phthisis.
[723] The last paragraph, and the latter clause of the
preceding one, were at first attached to the end of the subsequent
cases, and were transferred to their present position by
Dioscorides the commentator a short time before Galen. They
evidently embody a most distinct and admirable enumeration of
the general facts with which the practical physician ought to make
himself acquainted.
[724] We learn from the Commentary of Galen that some of
the older critics supposed that the sixteen cases about to be
related had been selected by Hippocrates in illustration of his
doctrines, as laid down in the preceding description of what is
generally entitled the Pestilential Season. Galen, however, does
not incline to this opinion.
[725] This is an example of one of those protracted fevers of
an intermittent type, which, as I have been informed by an
intelligent physician who practiced for several years in the Ionian
Islands, are so common in the climate of Greece. There is not
much of any particular value in Galen’s Commentary on this case.
He informs us that one of the older commentators absurdly
maintained the opinion that the country of this patient was given
because, according to Asclepiades, the inhabitants of Paros were
most especially benefited by bleeding. But, as Galen says, this
remark is particularly out of place here, since no mention of
venesection occurs in the report. Galen, and after him Foës, have
given very lengthy and elaborate disquisitions on the nature of
oily urine. The result is, that it is an unfavorable, but not
necessarily a fatal, character. It is minutely described by the later
authorities on urology, namely, Theophilus and Actuarius. See
also the Commentary on Paulus Ægineta, Book II., 14,
Sydenham Society’s edition.
[726] This appears clearly to be a case of fever, complicated
with, but not produced by parturition. Galen, however, seems to
ascribe the fever and its fatal results to the retention of the lochial
discharge. The characters of the urine, he properly remarks, are
unfavorable, being copious, thin, and black. He also calls
attention to the want of proper concoction in the sputa, to which
he attributes the fatal relapse.
[727] Galen’s Commentary on this case is written in his usual
light and diffuse style, but contains very little which is calculated to
throw light on the text, or on the nature of the disease which is
here described. If any one find difficulty in comprehending the
characters of the respiration, as given in this narrative, he can
turn to Galen’s work, On Difficulty of Breathing, where they are
explained very fully. I may just mention that by shortness of breath
(βραχύπνοος) was understood, by Hippocrates and Galen,
frequency of the act of respiration.
[728] This case, as Galen remarks, is an instance of the most
acute form of phrenitis. He states that he himself had met with
cases of phrenitis in which the patients had died on the fourth and
fifth day, but that he had never seen a case which proved so
suddenly fatal as the present one. He further makes some very
interesting reflections on the suddenness of the attack in such
cases, which is the more wonderful, as the exciting cause of them
must be gradually collecting in the system, and acquiring strength
and intensity, and it is singular that it should then be developed all
at once, and cut off the patient in a very short time, as if he had
swallowed poison, or had been stung by a venomous animal. He
compares the latency of the febrile humor in the system to that of
the mad dog, which will remain for a long time in the body of a
person who had been bitten, and then all at once will manifest its
effects, by inducing the rage. For the ancient views on the subject
of Hydrophobia, see Paulus Ægineta, Book V., 4, Sydenham
Society’s edition.
[729] Galen, in his Commentary on this case, enters into a
train of reflections how a physician ought to proceed when called
in to a patient so circumstanced. He ought, in the first place, as
the Commentator properly remarks, to make careful inquiry, in
order to find out whether the pain in the limb be occasioned by
any external cause, as persons often meet with local injuries by
sudden twisting and movements of their limbs, or even by laying a
limb uncomfortably in bed, without being aware of it. When no
such cause of the complaint can be discovered, Galen says the
physician should try to ascertain whether or not it be connected
with the regimen or temperament of the patient. If it shall turn out
that the body is in a plethoric state, general bleeding must be had
recourse to, before any local applications are made to the part. It
is then to be fomented, and liquid and heating medicines applied
to it. Whether or not this was the mode of treatment which
Hippocrates adopted in this case, Galen cannot take upon himself
to affirm, as no mention is made in the report of venesection, nor
of the particular remedies which were used. I am of opinion that
this is one of the most interesting cases in the whole Collection,
for I believe it to be a faithful report of a disease which on three
several occasions I have met with during an active professional
practice of thirty years, and which I have not seen described
elsewhere. In all my cases, indeed, the patients were from twelve
to sixteen years old, but in other respects the symptoms were the
same as here described by Hippocrates. In every one of the
cases the patient was seized with pain and swelling of the thigh,
attended with high fever, great jactitation, and partial delirium.
They all proved fatal in the course of three or four days. Whether
the disease be connected with diffuse inflammation of the areolar
substance, or with inflammation of the veins, or whether it be a
general fever complicated with a local affection of the limb, or
what may be the exact nature of the affection, I have not been
able to determine. From what is stated above, it will be clearly
seen how justly Hippocrates deserves the compliment paid to him
by Galen, of having been, of all medical authorities, the most
careful in observing the phenomena of disease. (Opera Galeni,
tom. vii., p. 829, ed. Kühn.)
[730] Galen remarks, that this is one of those cases which
appear formidable to the inexperienced, but which those who are
practiced in the art judge of as being likely to come to a speedy
crisis. He adverts to the slight swelling of the spleen and the
characters of the urine, which soon showed a proper sediment, as
being particularly favorable symptoms. The more that we study
Hippocratic medicine, we shall be the more convinced that too
little attention has been paid of late years to the physical
characters of the urine in all febrile complaints.
[731] Galen’s Commentary on this case is unusually brief. He
holds it to be a case connected with general plethora, as
indicated by the good color of the urine. He once more makes the
remark that a favorable issue of the case might have been
anticipated, from the characters of the urine.
 [732] Galen remarks in his Commentary, that of all the cases
related in the First and Third Books of the Epidemics, this is the
only one in which Hippocrates says that the patient was bled, not,
he adds, that this was the only case in which venesection was
adopted, but because, although the general rule was not to bleed
after the fourth day, the patient, in the present instance, was bled
on the eighth. Many others, he says, were no doubt bled on the
second, third, and fourth days, but of these bleedings, and the
other means used, Hippocrates in general takes no notice, except
that he sometimes states, in order to render the malignity of the
disease more apparent, that it was nowise benefited by the
remedies applied. In other cases he adds, he would appear, from
the words he uses (such as “as far as I am aware”), not to have
attended the patient at the commencement. Galen further directs
attention to the characters of the expectoration, the concoction of
which he looks upon as having proved the means of carrying off
this fever. Galen has reviewed the symptoms of this case very
fully, and in a most interesting manner, in the Second Book of his
work, On Difficulty of Breathing, see ed. Kühn, tom. vii., p. 854,
etc. That it was a case of fever complicated with pleurisy seems
clear, as Galen remarks. Galen further treats of the characters of
the sputa in this case, in the First Book of his work, On Crises.
Upon reference to the edition of Littré, it will be seen that
unfortunately there is considerable variation in the readings of this
passage.
[733] On this case Galen makes the remark that this patient
must have had a strong constitution, otherwise it could not have
withstood such an affection. He adds that, moreover, his pulse
must have possessed strength, but that, as formerly said by him,
this department of prognostics is altogether omitted by
Hippocrates, in his reports of febrile cases. He further remarks
that the respiration and appetite were not to complain of, and the
only bad symptom was the thinness and blackness of the urine,
which therefore required a long time for nature to overcome, by
occasioning hemorrhage, pain of the hip-joint, and determination
downwards. He adds, that great diseases require decided crises,
and that even with those now mentioned, the disease was not
entirely removed in this case, until concoction in the urine took
place.
[734] Galen passes over this case without any remark worth
mentioning. I cannot but think that the abundant sediment in the
urine, which preceded the favorable crisis, is a fact in the case
well deserving to be noticed. Galen, however, in the present
instance, omits all notice of it, and ascribes the recovery to the
profuse sweat.
[735] The only thing of importance in Galen’s Commentary on
this case is the remark that this woman’s melancholy was most
probably connected with suppression of the menses, and that to
this cause the dark color of the urine in the present instance is
most probably to be ascribed. To the critical evacuations by the
sweat and menstruation he attributes the recovery.
[736] There were several ancient cities of this name, but there
can be no doubt that the one here referred to is the celebrated
city of Thessaly. See Strabo, Geograph. ix.
[737] Galen considers it a remarkable feature in this case that
although the crisis occurred on the sixth day, there was no
relapse. The recovery he ascribes to the copious menstruation
which then took place for the first time. He also calls attention to
the characters of the urine, which, he says, are those which
usually accompany delirium, although this is omitted in the
Prognostics.
[738] Galen, in his Commentary, merely remarks that
Hippocrates, at the conclusion of the report, briefly enumerates
the more prominent symptoms from which a fatal result might
have been confidently prognosticated. By enlarged viscera, in this
case, we are informed by Galen in another place, that our author
meant inflammation and swelling (Comment. in Rat. Vict. in Acut.
c. iii.) There can be no doubt that by viscera Hippocrates meant
the liver and spleen (see the work just referred to). Galen briefly
remarks on this case towards the end of the Second Book of his
work, On Difficulty of Breathing.
[739] Cyzicus was a flourishing city on the Propontis. See
Strabo, Geogr. xii.; and Pliny, H. N. v. 32.
[740] Galen, in his Commentary, accounts for this fatal disease
upon the supposition that the uterus was inflamed, and affected
the brain by sympathy, hence maniacal delirium and convulsions
were the consequence. Galen, both in his Commentary, and in his
work On Crises, refers to this case, in confirmation of his doctrine
of critical days.
[741] I will venture to affirm, without much fear of contradiction,
that in all the works on medicine, both ancient and modern, there
is not to be found so vivid a delineation of the symptoms of fever,
complicated with effusion on the brain. Those who have added
new features to the picture, have thereby detracted from the
general effect. Galen, in his Commentary, insists more especially
on the character of the respiration, but there does not appear to
me to be any particular obscurity about it. He also touches on this
case towards the end of the Second Book, On Difficulty of
Breathing. After reading all his prolix disquisition on the subject,
one does not feel much better instructed on the subject. Galen, at
times, nay, very frequently, seems to forget a favorite saying of his
own, namely. that he who would wish to lay in a copious store of
knowledge during life, should trouble himself little about words,
and attend principally to things.
[742] There were two Thessalian cities of this name, the one
in Estiæotis, and the other in Magnesia. This would appear to be
the latter. See Pliny, H. N. iv., 9; and Livy, xliv., 13.
[743] Galen’s Commentary contains few observations of much
interest, and which are not sufficiently obvious. Excesses in
drinking and debauchery, he remarks, hurt the nerves and the
origin of them, that is to say, the brain. Thus he accounts for the
delirium with which this case of fever was attended. All the other
prominent symptoms, such as the palpitation in the epigastric
region, the swelling of the hypochondrium, and the like, were
noticed previously. Galen also reviews the symptoms of this case
in his work On Difficulty of Breathing, II.
[744] “Hippocrates qui tam fallere quam falli nescit.”
(Macrobius in Somn. Scipionis, i., 6.)
[745] Hippocratis Coi de Cap. Vuln., etc., a Francisco
Vertuniano. Ejusdem textus Græcus a J. Scalig. Castigatus, etc.
[746] Comment. de Ossibus.
[747] Hist. Animal., i., 7. In reference to this description, it is
stated by Vesalius, who in the course of his life had examined a
great number of crania, that it is very rare indeed to meet with a
skull in which the sutures are wanting. He accounts for the
statement made by Herodotus (Hist. ix.) and Aristotle (1. c.),
respecting skulls without sutures, upon the supposition that the
observations of these authors must have been made upon those
of old persons, in whom the sutures are often very indistinct.
(Chirurg. Magn., i., 17.)
[748] H. N., xi., 48; ed. Hardouin.
 [749] De Partib. Animal., p. 34; ed. Londin.
[750] Φοεός. The exact meaning of this term is well defined by
Eustathius in his Commentary on Homer (ad Iliad., ii., 219), ό ἐις
ὀξὺ λήγονσαν ἔχων τὴν κεφαλήν. It is excellently expressed by
Damm as follows: “One whose head diminishes towards the top
like a sugar-loaf.” (Lexicon Homericum in voce Φοεός.)
[751] De Usu Partium, ix., 17.
[752] Surgery, v., 4.
[753] Chirurg. Mag., i., 17.
[754] It is well known that in very advanced age the sutures
get nearly effaced. See the Cyclopædia of Anatomy, vol. i., p.
745.
[755] Comment. de Ossibus.
[756] Obs. Anatom.
[757] This letter was very varied in form. See Galen and Foës.
[758] The operation consisted in sawing the bone nearly
through, and leaving it in this state until it exfoliated, or until the
bone could be separated from the dura mater without violence.
See below.
[759] It is no doubt true that a simple cut in the outer table of
the bone, when accompanied with concussion or contusion, may
produce fatal effects within, and this, in fact, is stated by our
author; but, of itself, as he says, the simple incision or hedra
cannot be of a dangerous nature, nor require any recourse to
instruments. The cases related by M. Littré in the Argument were
all evidently complicated with contusion, and are thus referable to
the second class of these injuries. It is most worthy of remark,
that in the very interesting account of “slicing cuts,” given in Mr.
Guthrie’s excellent work, On Injuries of the Head, the result,
without any operation, by the most simple system of treatment,
was in general very favorable. (pp. 95, 96.) On these cuts and
superficial injuries of the skull, see further Hennen (pp. 283, 284),
Thomson (pp. 51, 52), and Chelius (vol. i., p. 388).
[760] London and Edinburgh Medical Journal, 1844.
[761] Although, as we have stated, Dr. Laurie’s rule of practice
now be to use the trephine on the preventive principle, it is
probable that most of his cases occurred at a period when the
practice of Mr. Abernethy was universally followed. His statistics
therefore are no test of the results of the operation, when
performed on the preventive principle.
[762] See Lawrence’s Clinical Lecture in the Medical Gazette,
vol. xxi., p. 345; and Guthrie’s work, On Injuries of the Head, p.
113.
[763] See De Articulis, § 50; and Mochlicus, § 36.
[764] On hypertrophy and swelling of the brain after injuries,
see the very interesting observations made by Mr. Guthrie, in his
work on Injuries of the Head, p. 125.
[765] It is proper to mention in this place that Quesnay, with
great good sense, discusses the question, whether or nor the
separation of the pericrunium in this case be a sure indication of
matter being collected within the cranium. He decides in the
negative. (p. 17, Syd. Soc. edition of Selected Mem. of the Acad.
of Surgery.)
[766] I ought to mention, however, in this place, that in simple
undepressed fractures, Pott allows of the operation as a
preventive; that, at least, is one of his objects in having recourse
to the operation. (p. 130.)
[767] Ambrose Paré expresses very strongly the difficulty of
forming a correct prognosis in injuries of the head: “Ex quo
intelligere licet, multos ab exiguis vulneribus mortem oppetere,
alios ex ingentibus et penitus magnis desperatisque
convalescere.” (Opera, ix., 9.)
[768] Injuries of the Head, p. 148.
[769] Aphor. v., 68.
[770] See the Argument to the treatise, On Regimen in Acute
Diseases.
[771] Opera, ix., 10.
[772] Sir Astley Cooper mentions an instance in which 208
ounces of blood were abstracted from a patient!! In Quesnay’s
Memoir there is nothing more common than to find it reported that
he had bled a patient three or four times in the course of a day. In
one case 160 ounces were taken in nine days; “but,” it is gravely
added, “two years elapsed before she was quite well again.”
[773] IV., 5, 3, 1.
 [774] The principles upon which depletion by bleeding and
purging should be regulated are fully stated and discussed by
Galen, in the Fourth Book of his great work on Therapeutics. The
rule is briefly given by Hippocrates in his Second Aphorism:
“respect being paid to place, season, age, and the disease in
which it is proper or not.”
[775] See Aphor. v., 18, 22; and § 12 of this treatise. The
professional authorities of the present day are not agreed as to
the expediency of using poultices or cold lotions in injuries of the
scalp. Guthrie and Hennen recommend the latter; but South, in
the edition of Chelius, prefers the former.
[776] This is related of Philagrius in a very interesting scholium
on the Aphorism just quoted. See Scholia in Hippocrat. et Galen.,
tom. ii., p. 457; ed. Dietz.
[777] Perhaps the meaning here is, that when the forehead is
much elevated, and the occiput much depressed, if one looks
down upon the skull from above, the sagittal and coronal sutures
will present the appearance of the letter Τ.
[778] The meaning, I suppose, may be, that when the
forehead is very low, and when the occiput is protuberant, if one
looks down upon the skull from above, the sagittal and lambdoidal
sutures will present the appearance of the letter Τ reversed.
[779] The meaning would appear to be, that in a square-built
head, that is to say, when it is prominent both before and behind,
the coronal and sagittal sutures run nearly parallel to one another,
and the sagittal connects them together in the middle. In this case
they would present the appearance of the letter Η reversed.
[780] Perhaps this alludes to the form of the head in which the
sagittal suture passes through the middle of the os frontis down to
the nose, in which case we may imagine that the coronal suture
intersects the lambdoidal in such a manner as to have some
resemblance to the letter χ. It is to be borne in mind, that the
character of this letter was very variable in ancient writing. Ruffus
Ephesius describes the sagittal suture as sometimes passing
down the middle of the frontal bone.
[781] This passage was considered by Scaliger as a gloss, but
as interpreted by M. Littré, whom I have followed, the meaning is
quite suitable. See his note, h. 1.
 [782] It is difficult to say what can be meant by caruncles in
this place, but still I agree with M. Littré that Scaliger was not
warranted in proposing to eject the passage from the text as an
interpolation. Unless the glandulæ Pacchioni are meant (and the
description must be admitted not to be quite applicable to them), I
cannot pretend to explain or account for the description.
[783] I need scarcely remark, that if by this is strictly meant
that wounds in the posterior part of the head are less dangerous
than those in the anterior, the statement is at variance with the
experience of certain modern authorities. See, in particular, Pott
and Liston, p. 46. At the same time, it is, no doubt, anatomically
correct, that the occipital bone can bear more violence, without
being seriously fractured, than the frontal or parietal bones, and it
is worthy of remark, that the views and experience of Mr. Guthrie
are very consonant with those of Hippocrates. He says: “The
result of my experience on this point is, that brain is more rarely
lost from the fore part of the head with impunity, than from the
middle part; and that a fracture of the skull, with even a lodgment
of a foreign body, and a portion of the bone in the brain, may be
sometimes borne without any great inconvenience in the back
part.... I have never seen a person live with a foreign body lodged
in the anterior lobe of the brain, although I have seen several
recover with the loss of a portion of the brain at this part. My
experience, then, leads me to believe, that an injury of apparently
equal extent is more dangerous on the forehead than on the side
or middle of the head, and much less so on the back part than on
the side. A fracture of the vertex is of infinitely less importance
than one of the base of the cranium, which, although not
necessarily fatal, is always attended with the utmost danger.” (On
Injuries of the Head, p. 3.) I feel difficulty in reconciling these
discordant results of modern experience. Perhaps the fact of the
matter is, that injuries on the upper part of the occipital region are
the least dangerous of any, whereas those in the lower part of it,
are particularly fatal.
[784] Vidus Vidius thus explains the hedra or sedes: “Inciditur
os ita ut teli vestigium remaneat, quod genus fracturæ appellatur
a Hippocrate ἒδρα, id est sedes, quum (ut ipse inquit) appareat in
osse qua telum insederit; fit autem ab acuto telo, quod et ipse in
sequentibus, et Galenus, in Commentario, in librum memoriæ
prodidit, quum sub telo acuto incidi os dixit. Requirit autem sedes
ut incisum os nullo modo ad cerebri membranam inclinatur.”
(Chirurg. Græc., p. 71.) Andreas à Cruce defines it thus:
“Potissimum vero sedes vocatur ubi osse in suo statu remanente
qua parte telum insederit apparet.” (De Vulneribus, 1. 2.) By
hedra would appear to have been understood a dint, or
impression, left in a bone by a blow which has not produced
fracture or depression. It was also applied to a cut or slash
affecting only the outer plate of the skull. Hippocrates, it will be
remarked, pronounces this sort of injury not to be dangerous of
itself, but M. Littré relates a case taken from the “Journal de
Médecine,” in which a sabre-cut, which only penetrated through
the external plate of the cranium, and did not touch the internal,
proved fatal. (Op. Hippocrat. iii., p. 170.) Our author, in the latter
part of this paragraph, mentions cursorily injury of the skull at a
suture, and more circumstantially in the twelfth paragraph. This
accident is very correctly described by the later writers, under the
name of diastasis. See Heliodorus (ap. Chirurg. Veteres, p. 100),
and Archigenes (ibid., p. 117). Pott declares that he did not
remember having ever seen a single instance of recovery when
there was separation of the bones at a suture. Morgagni, in like
manner, represents the case as being of a particularly serious
character. (De Caus. et Sed. Morb.) I once saw a strongly marked
case in which there was a considerable separation of the bones
at the upper part of the temporal suture, along with an extensive
wound, unguardedly inflicted by the scalpel of a juvenile surgeon,
in order to explore the nature of the accident. As might have been
expected, under these circumstances, the case had a fatal issue.
Mr. Guthrie writes thus of diastasis: “It is well known, that when a
violent shock has been received on the head, particularly by a fall
on the vertex, the sutures are often separated to a considerable
extent; these cases usually terminate fatally.” (p. 135.)
[785] The meaning here is somewhat obscure, but as Arantius
states in his commentary on this tract, our author probably means
that a fissure is necessarily complicated with a contusion, or, in
other words, that there can be no fissure without contusion.
[786] Arantius and Porralius, in their conjoined commentary on
this treatise, mention that in contusion sometimes only the outer
plate of the skull is contused, but the inner is depressed upon the
dura mater. This is a case of which we have examples in modern
surgery; but it does not appear clearly to be alluded to in this
place by our author. Mr. Guthrie, indeed, understands the
ἀπήχημα of the Greek authors, and resonitus of the Latin, to
apply to this variety of fracture; but he appears to me to be
mistaken, for these terms unquestionable refer to the contre-
coup, of which we will treat presently. Quesnay, indeed, uses the
term contre-coup in this double sense, but, as I think, very
injudiciously, as it tends to introduce confusion of ideas; for
assuredly the case of a fracture on a different part of the head
from that which received the blow, and a fracture on the inner
plate of the skull from an injury on the outer, are quite different
cases. See Quesnay, etc., p. 20, Syd. Soc. edit.
[787] The expressions in this place are somewhat confused,
but the meaning evidently is, that without fracture there can be no
depression.
[788] This third mode of fracture is thus defined by Celsus: “At
ubi medium desedit, eandem cerebri membranam os urget;
interdum etiam ex fractura quibusdam velut aculeis pungentibus,”
(viii., 4.) Hippocrates, it will be remarked, makes no mention of
spiculæ in his description of depression. Galen describes two
varieties of depression; in the one the depressed portion retains
its situation, and in the other it rises again to its former level. (De
Caus. Morb.) Hippocrates does not appear to have been
acquainted with the latter. Modern experience has shown that it
sometimes occurs in children.
[789] It is almost impossible to know what to make of this
passage, owing to the corrupt state of the text.
[790] The nature of this mode of injury is explained in the
annotations on the third paragraph. It does not appear clear why
our author has given two separate descriptions of this injury. He
describes, it will be remarked, several varieties of it, according as
it is complicated or not with contusion and fracture. Galen uses
hedra in one place. (Meth. Med. vi.) The term hedra is rendered
teli sedes by the Latin translators of the Greek medical authors.
(See Asellii Comment. in Hippocrat. de Vuln. Capit.) It is used
also by Ambrose Paré, Wiseman, and all our earlier writers on
surgery. Wiseman thinks the term most appropriate when applied
to wounds inflicted by a pole-axe, halberd, or the like. (v. 9.) Paré
applies it to a kind of injury, in which the bone is not broken
through, but the print of the weapon is left on the skull. (xx., 7.)
Fallopius gives an interesting discussion on it. (In librum
Hippocrat. de Vuln. Capit.) The term incision, borrowed from
Paulus Ægineta, has been since used in its stead. See Quesnay,
on the Use of the Trepan, p. 29, Syd. Soc. edition; and on simple
incisions or sabre-cuts, see, in particular, Mr. Guthrie, Injuries of
the Head, p. 86.
 [791] This, it will readily be perceived, is the fractura per
resonitum, that is to say, the fracture par contre-coup, or counter-
fissure of modern authorities. Except Paulus Ægineta, I am not
aware that any of the ancient authorities question the occurrence
of this species of the accident, and with the exception of Vidus
Vidius, Guido, Fallopius, and Dinus de Garbo, it is generally
recognized by the best modern authorities, from Bertaphalia and
Andreas à Cruce, down to Sir Astley Cooper and Mr. Liston. Mr.
Guthrie, indeed, remarks, that in recent times there has been no
well-authenticated instance of fracture on the one side of the
head from a blow on the other. Such cases, however, are not
wanting in the works of the earlier modern authorities. Quesnay
writes thus: “We find in authors, also, many cases of fracture by
contre-coup, from one part of the head to the part opposite: and in
honor of the ancients we may cite the case related by Amatus,
who applied the trepan to the part of the head opposite to the
wound, when he found that the symptoms were not relieved by
applying it on the side wounded, and that the patient suffered
from severe pain on the other side. This second trepan proved
very apropos, for it allowed the escape of pus, which had
collected under the skull.” (On the use of the Trepan.) All our
modern authorities, including Mr. Guthrie, admit the reality of the
case in which fracture of the base of the skull is produced by a
blow on the upper part of the head. In imitation of our author, this
case was denominated “infortunium” by the earlier authorities,
such as Asellius and Porralius, being accounted an irremediable
misfortune, because its seat could not be detected; and it is
noticed in the following terms by Sir Astley Cooper, who did not
trouble himself much about the writings of his predecessors, but
formed his opinions from actual observation: “When the basis of
the skull is fractured from a high fall, from the whole pressure of
the body resting upon that part, on opening the brain and tearing
up the dura mater, extravasated blood is commonly observed; this
kind of fracture must inevitably prove fatal, nor can it be
discovered till after death.” (Lectures, xiii.)
[792] Whatever opinion may now be formed of the rule of
practice here laid down, all must admit that it is clearly stated and
distinctly defined. We have seen above that our author describes
five modes of injury in the skull, namely, the incision or
indentation, confined to its outer table; the contusion; the direct
fracture; the fracture par contre-coup; and the depression. He
now states decidedly that it is only in the case of contusion and
simple fracture, that the trepan can be applied with advantage. I
have entered so fully into the rationale of this practice in the
Argument, that I do not think it necessary to say more on the
subject in this place.
[793] This passage indicates strongly our author’s partiality for
prognostics, or rather, I should say, for prorrhetics. It would
appear to have been a primary consideration with him, in all
cases, to secure the physician from blame, and to teach him how
to gain the confidence of the patient and his attendants. Few who
have practiced medicine for a great many years, will question the
propriety of these rules of conduct, or doubt the importance of
taking all honorable steps to ensure the confidence and good-will
of patients and their friends.
[794] There is a remark made by Arantius and Porralius on the
latter part of this paragraph, which, although it appears to be
scarcely warranted by anything in the text of our author, I quote
for its importance, as showing that the earlier authorities were
well aware of the danger and impropriety of treating injuries of the
head in children by instruments: “Sed præ ceteris illud notandum
quod dixerit (nudato osse) quasi dicat, eo non denudato quamvis
calliso aut fisso, quod raro accidit, non esse tamen sectione
denudandam calvariam: nam in pueris, ubi decidunt non raro
accidit ut eorum collidatur calvaria, frangaturque, cute integra,
quod etsi accidat, et tactu hoc probe precipiatur, sanguisque e
venis effusus sub cute fluctua, abstinendum tamen a sectione est,
neminem enim servatum vidi, cui sectio adhibita sit, propterea
quod eorum calor facile dissipetur, eoque magis, quum gemitu et
clamore caput valdè incelescat, et ad fluxiones suscipiendas
proclive reddatur,” (Comm. in Hip. de Vuln. Cap.) It will be seen at
§ 18, that our author allowed the application of a small trepan in
children when strongly indicated.
[795] This passage is rendered as follows by Celsus: “Igitur,
ubi ea percussa, protinus requirendum est, num bilem is homo
vomuerit; num oculi ejus obcæcati sint; num obmutuerit; num per
nores auresque sanguis ei effiuxerit: num conciderit, num sine
sensu quasi dormiens jacuerit. Hæc enim non nisi osse fracto
eveniunt; atque, ubi inciderunt, scire licet, necessariam, sed
difficilem curationem esse.” (viii., 4.) Now, although it is no doubt
true, as remarked by Pott (Injuries of the Head, § 4), that these
symptoms sometimes take place, without there being any fracture
of the skull, and that, on the other hand, as had been previously