OFTHEEPIDEMICS
BOOKI。Sect。I。FirstConstitution1。INTHASUS，abouttheautumnequinox，andunderthePleiades，therainswereabundant，constant，andsoft，withsoutherlywinds;thewintersoutherly，thenortherlywindsfaint，droughts;onthewhole，thewinterhavingthecharacterofspring。Thespringwassoutherly，cool，rainssmallinquantity。Summer，forthemostpart，cloudy，norain，theEtesianwinds，rareandsmall，blewinanirregularmanner。Thewholeconstitutionoftheseasonbeingthusinclinedtothesoutherly，andwithdroughtsearlyinthespring，fromtheprecedingoppositeandnortherlystate，ardentfeversoccurredinafewinstances，andtheseverymild，beingrarelyattendedwithhemorrhage，andneverprovingfatal。Swellingsappearedabouttheears，inmanyoneitherside，andinthegreatestnumberonbothsides，beingunaccompaniedbyfeversoasnottoconfinethepatienttobed;inallcasestheydisappearedwithoutgivingtrouble，neitherdidanyofthemcometosuppuration，asiscommoninswellingsfromothercauses。Theywereofalax，large，diffusedcharacter，withoutinflammationorpain，andtheywentawaywithoutanycriticalsign。Theyseizedchildren，adults，andmostlythosewhowereengagedintheexercisesofthepalestraandgymnasium，butseldomattackedwomen。Manyhaddrycoughswithoutexpectoration，andaccompaniedwithhoarsenessofvoice。Insomeinstancesearlier，andinotherslater，inflammationswithpainseizedsometimesoneofthetesticles，andsometimesboth;someofthesecaseswereaccompaniedwithfeverandsomenot;thegreaterpartofthesewereattendedwithmuchsuffering。Inotherrespectstheywerefreeofdisease，soasnottorequiremedicalassistance。
2。Earlyinthebeginningofspring，andthroughthesummer，andtowardswinter，manyofthosewhohadbeenlonggraduallydeclining，tooktobedwithsymptomsofphthisis;inmanycasesformerlyofadoubtfulcharacterthediseasethenbecameconfirmed;inthesetheconstitutioninclinedtothephthisical。Many，and，infact，themostofthem，died;andofthoseconfinedtobed，Idonotknowifasingleindividualsurvivedforanyconsiderabletime;theydiedmoresuddenlythaniscommoninsuchcases。Butotherdiseases，ofaprotractedcharacter，andattendedwithfever，werewellsupported，anddidnotprovefatal:ofthesewewillgiveadescriptionafterwards。Consumptionwasthemostconsiderableofthediseaseswhichthenprevailed，andtheonlyonewhichprovedfataltomanypersons。Mostofthemwereaffectedbythesediseasesinthefollowingmanner:feversaccompaniedwithrigors，ofthecontinualtype，acute，havingnocompleteintermissions，butoftheformofthesemi—tertians，beingmildertheoneday，andthenexthavinganexacerbation，andincreasinginviolence;constantsweats，butnotdiffusedoverthewholebody;extremitiesverycold，andwarmedwithdifficulty;bowelsdisordered，withbilious，scanty，unmixed，thin，pungent，andfrequentdejections。Theurinewasthin，colorless，unconcocted，orthick，withadeficientsediment，notsettlingfavorably，butcastingdownacrudeandunseasonablesediment。Sputasmall，dense，concocted，butbroughtuprarelyandwithdifficulty;
andinthosewhoencounteredthemostviolentsymptomstherewasnoconcoctionatall，buttheycontinuedthroughoutspittingcrudematters。Theirfauces，inmostofthem，werepainfulfromfirsttolast，havingrednesswithinflammation;defluxionsthin，smallandacrid;theyweresoonwastedandbecameworse，havingnoappetiteforanykindoffoodthroughout;nothirst;mostpersonsdeliriouswhenneardeath。Somuchconcerningthephthisicalaffections。
3。Inthecourseofthesummerandautumnmanyfeversofthecontinualtype，butnotviolent;theyattackedpersonswhohadbeenlongindisposed，butwhowereotherwisenotinanuncomfortablestate。
Inmostcasesthebowelsweredisorderedinaverymoderatedegree，andtheydidnotsuffertherebyinanymannerworthmentioning;theurinewasgenerallywellcolored，clear，thin，andafteratimebecomingconcoctednearthecrisis。Theyhadnotmuchcough，norittroublesome;theywerenotinappetite，foritwasnecessarytogivethemfood（onthewhole，personslaboringunderphthisiswerenotaffectedintheusualmanner）。Theywereaffectedwithfevers，rigors，anddeficientsweats，withvariedandirregularparoxysms，ingeneralnotintermitting，buthavingexacerbationsinthetertianform。Theearliestcrisiswhichoccurredwasaboutthetwentiethday，inmostaboutthefortieth，andinmanyabouttheeightieth。
Buttherewerecasesinwhichitdidnotleavethemthusatall，butinanirregularmanner，andwithoutanycrisis;inmostofthesethefevers，afterabriefinterval，relapsedagain;andfromtheserelapsestheycametoacrisisinthesameperiods;butinmanytheywereprolongedsothatthediseasewasnotgoneattheapproachofwinter。Ofallthosewhicharedescribedunderthisconstitution，thephthisicaldiseasesalonewereofafatalcharacter;forinalltheothersthepatientsboreupwell，anddidnotdieoftheotherfevers。
Sect。II。SecondConstitution1。InThasus，earlyinautumn，thewintersuddenlysetinrainybeforetheusualtime，withmuchnortherlyandsoutherlywinds。
ThesethingsallcontinuedsoduringtheseasonofthePleiades，anduntiltheirsetting。Thewinterwasnortherly，therainsfrequent，intorrents，andlarge，withsnow，butwithafrequentmixtureoffairweather。Thesethingswereallso，butthesettinginofthecoldwasnotmuchoutofseason。Afterthewintersolstice，andatthetimewhenthezephyrusuallybeginstoblow，severewinterlystormsoutofseason，withmuchnortherlywind，snow，continuedandcopiousrains;theskytempestuousandclouded;thesethingswereprotracted，anddidnotremituntiltheequinox。Thespringwascold，northerly，rainy，andclouded;thesummerwasnotverysultry，theEtesianwindsblewconstant，butquicklyafterwards，abouttherisingofArcturus，therewereagainmanyrainswithnorthwinds。
Thewholeseasonbeingwet，cold，andnortherly，peoplewere，forthemostpart，healthyduringwinter;butearlyinthespringverymany，indeed，thegreaterpart，werevaletudinary。Atfirstophthalmiessetin，withrheums，pains，unconcocteddischarges，smallconcretions，generallybreakingwithdifficulty，inmostinstancestheyrelapsed，andtheydidnotceaseuntillateinautumn。Duringsummerandautumnthereweredysentericaffections，attacksoftenesmusandlientery，biliousdiarrhoea，withthin，copious，undigested，andacriddejections，andsometimeswithwaterystools;manyhadcopiousdefluxions，withpain，ofabilious，watery，slimy，purulentnature，attendedwithstrangury，notconnectedwithdiseaseofthekidneys，butonecomplaintsucceedingtheother;
vomitingsofbile，phlegm，andundigestedfood，sweats，inallcasesareduncanceofhumors。Inmanyinstancesthesecomplaintswereunattendedwithfever，anddidnotpreventthepatientsfromwalkingabout，butsomecaseswerefebrile，aswillbedescribed。Insomeallthosedescribedbelowoccurredwithpain。Duringautumn，andatthecommencementofwinter，therewerephthisicalcomplaints，continualfevers;and，inafewcases，ardent;somediurnal，othersnocturnal，semi—tertians，truetertians，quartans，irregularfevers。
2。Allthesefeversdescribedattackedgreatnumbers。Allthesefeversattackedthesmallestnumbers，andthepatientssufferedtheleastfromthem，fortherewerenohemorrhages，exceptafewandtoasmallamount，norwastheredelirium;alltheothercomplaintswereslight;inthesethecriseswereregular，inmostinstances，withtheintermittents，inseventeendays;andIknownoinstanceofapersondyingofcausus，norbecomingphrenitic。Thetertiansweremorenumerousthantheardentfevers，andattendedwithmorepain;buttheseallhadfourperiodsinregularsuccessionfromthefirstattack，andtheyhadacompletecrisisinseven，withoutarelapseinanyinstance。Thequartansattackedmanyatfirst，intheformofregularquartans，butinnofewcasesatransitionfromotherfeversanddiseasesintoquartanstookplace;theywereprotracted，asiswontwiththem，indeed，moresothanusual。Quotidian，nocturnal，andwanderingfeversattackedmanypersons，someofwhomcontinuedtokeepup，andotherswereconfinedtobed。InmostinstancesthesefeverswereprolongedunderthePleiadesandtillwinter。Manypersons，andmoreespeciallychildren，hadconvulsionsfromthecommencement;andtheyhadfever，andtheconvulsionssuperveneduponthefevers;inmostcasestheywereprotracted，butfreefromdanger，unlessinthosewhowereinadeadlystatefromothercomplaints。Thosefeverswhichwerecontinualinthemain，andwithnointermissions，buthavingexacerbationsinthetertianform，therebeingremissionstheonedayandexacerbationsthenext，werethemostviolentofallthosewhichoccurredatthattime，andthemostprotracted，andoccurringwiththegreatestpains，beginningmildly，alwaysonthewholeincreasing，andbeingexacerbated，andalwaysturningworse，havingsmallremissions，andafteranabatementhavingmoreviolentparoxysms，andgrowingworse，forthemostpart，onthecriticaldays。Rigors，inallcases，tookplaceinanirregularanduncertainmanner，veryrareandweakinthem，butgreaterinallotherfevers;frequentsweats，butmostseldominthem，bringingnoalleviation，but，onthecontrary，doingmischief。Muchcoldoftheextremitiesinthem，andthesewerewarmedwithdifficulty。