第2章

Insomnolency,forthemostpart,especiallyinthesefevers,andagainadispositiontocoma。Thebowels,inalldiseases,weredisordered,andinabadstate,butworstofallinthese。Theurine,inmostofthem,waseitherthinandcrude,yellow,andafteratimewithslightsymptomsofconcoctioninacriticalform,orhavingtheproperthickness,butmuddy,andneithersettlingnorsubsiding;orhavingsmallandbad,andcrudesediments;thesebeingtheworstofall。

Coughsattendedthesefevers,butIcannotstatethatanyharmorgoodeverresultedfromthecough。

3。Themostofthesewereprotractedandtroublesome,wentoninaverydisorderlyandirregularform,and,forthemostpart,didinacrisis,eitherinthefatalcasesorintheothers;forifitleftsomeofthemforaseasonitsoonreturnedagain。Inafewinstancestheleverterminatedwithacrisis;intheearliestoftheseabouttheeightiethday,andsomeoftheserelapsed,sothatmostofthemwerenotfreefromthefeverduringthewinter;butthefeverleftmostofthemwithoutacrisis,andthesethingshappenedaliketothosewhorecoveredandtothosewhodidnot。Therebeingmuchwantofcrisisandmuchvarietyastothesediseases,thegreatestandworstsymptomattendedthemostofthem,namely,aloathingofallarticlesoffood,moreespeciallywiththosewhohadotherwisefatalsymptoms;buttheywerenotunseasonablythirstyinsuchfevers。Afteralengthoftime,withmuchsufferingandgreatwasting,abscesseswereformedinthesecases,eitherunusuallylarge,sothatthepatientscouldnotsupportthem,orunusuallysmall,sothattheydidnogood,butsoonrelapsedandspeedilygotworse。Thediseaseswhichattackedthemwereintheformofdysenteries,tenesmus,lientery,andfluxes;but,insomecases,thereweredropsies,withorwithoutthesecomplaints。Whateverattackedthemviolentlyspeedilycutthemoff,oragain,didthemnogood。Smallrashes,andnotcorrespondingtotheviolenceofthedisease,andquicklydisappearing,orswellingsoccurredabouttheears,whichwerenotresolved,andbroughtonnocrisis。Insometheyweredeterminedtothejoints,andespeciallytothehip—joint,terminatingcriticallywithafew,andquicklyagainincreasingtoitsoriginalhabit。

4。Peoplediedofallthesediseases,butmostlyofthesefevers,andnotablyinfantsjustweaned,andolderchildren,untileightortenyearsofage,andthosebeforepuberty。Thesethingsoccurredtothoseaffectedwiththecomplaintsdescribedabove,andtomanypersonsatfirstwithoutthem。Theonlyfavorablesymptom,andthegreatestofthosewhichoccurred,andwhatsavedmostofthosewhowereinthegreatestdangers,wastheconversionofittoastrangury,andwhen,inadditiontothis,abscesseswereformed。Thestranguryattacked,mostespecially,personsoftheagesIhavementioned,butitalsooccurredinmanyothers,bothofthosewhowerenotconfinedtobedandthosewhowere。Therewasaspeedyandgreatchangeinallthesecases。Forthebowels,iftheyhappenedpreviouslytohavewaterydischargesofabadcharacter,becameregular,theygotanappetiteforfood,andthefeversweremildafterwards。But,withregardtothestranguryitself,thesymptomswereprotractedandpainful。Theirurinewascopious,thick,ofvariouscharacters,red,mixedwithpus,andwaspassedwithpain。Theseallrecovered,andI

didnotseeasingleinstanceofdeathamongthem。

5。Withregardtothedangersofthesecases,onemustalwaysattendtotheseasonableconcoctionofalltheevacuations,andtothefavorableandcriticalabscesses。Theconcoctionsindicateaspeedycrisisandrecoveryofhealth;crudeandundigestedevacuations,andthosewhichareconvertedintobadabscesses,indicateeitherwantofcrisis,orpains,orprolongationofthedisease,ordeath,orrelapses;whichoftheseitistobemustbedeterminedfromothercircumstances。Thephysicianmustbeabletotelltheantecedents,knowthepresent,andforetellthefuture—mustmediatethesethings,andhavetwospecialobjectsinviewwithregardtodisease,namely,todogoodortodonoharm。Theartconsistsinthreethings—

thedisease,thepatient,andthephysician。Thephysicianistheservantoftheart,andthepatientmustcombatthediseasealongwiththephysician。

6。Painsabouttheheadandneck,andheavinessofthesamealongwithpain,occureitherwithoutfeversorinfevers。Convulsionsoccurringinpersonsattackedwithfrenzy,andhavingvomitingsofverdigris—greenbile,insomecasesquicklyprovefatal。Inardentfevers,andinthoseotherfeversinwhichthereispainoftheneck,heavinessofthetemples,mistinessabouttheeyes,anddistentionaboutthehypochondriacregion,notunattendedwithpain,hemorrhagefromthenosetakesplace,butthosewhohaveheavinessofthewholehead,cardialgiaandnausea,vomitbiliousandpituitousmatters;children,insuchaffections,aregenerallyattackedwithconvulsions,andwomenhavetheseandalsopainsoftheuterus;whereas,inelderpersons,andthoseinwhomtheheatisalreadymoresubdued,thesecasesendinparalysis,mania,andlossofsight。

ThirdConstitution7。InThasus,alittlebeforeandduringtheseasonofArcturus,therewerefrequentandgreatrains,withnortherlywinds。Abouttheequinox,andtillthesettingofthePleiades,therewereafewsoutherlyrains:thewinternortherlyandparched,cold,withgreatwindsandsnow。Greatstormsabouttheequinox,thespringnortherly,dryness,rainsfewandcold。Aboutthesummersolstice,scantyrains,andgreatcolduntilneartheseasonoftheDog—star。

AftertheDog—days,untiltheseasonofArcturus,thesummerhot,greatdroughts,notinintervals,butcontinuedandsevere:norain;

theEtesianwindsblew;abouttheseasonofArcturussoutherlyrainsuntiltheequinox。

8。Inthisstateofthings,duringwinter,paraplegiasetin,andattackedmany,andsomediedspeedily;andotherwisethediseaseprevailedmuchinanepidemicalform,butpersonsremainedfreefromallotherdiseases。Earlyinthespring,ardentfeverscommencedandcontinuedthroughthesummeruntiltheequinox。Thosethenthatwereattackedimmediatelyafterthecommencementofthespringandsummer,forthemostpartrecovered,andbutfewofthemdied。Butwhentheautumnandtherainshadsetin,theywereofafatalcharacter,andthegreaterpartthendied。Whenintheseattacksofardentfeverstherewasaproperandcopioushemorrhagefromthenose,theyweregenerallysavedbyit,andIdonotknowasinglepersonwhohadaproperhemorrhagewhodiedinthisconstitution。Philiscus,Epaminon,andSilenus,indeed,whohadatriflingepistaxisonthefourthandfifthday,died。Mostofthosetakenwithhadarigoraboutthetimeofthecrisis,andnotablythosewhohadnohemorrhage;thesehadalsorigorassociated。

9。Somewereattackedwithjaundiceonthesixthday,butthesewerebenefitedeitherbyanurinarypurgation,oradisorderofthebowels,oracopioushemorrhage,asinthecaseofHeraclides,whowaslodgedwithAristocydes:thisperson,thoughhehadthehemorrhagefromthenose,thepurgationbythebladder,anddisorderofthebowels,experiencedafavorablecrisisonthetwentiethday,notliketheservantofPhanagoras,whohadnoneofthesesymptoms,anddied。Thehemorrhagesattackedmostpersons,butespeciallyyoungpersonsandthoseintheprimeoflife,andthegreaterpartofthosewhohadnotthehemorrhagedied:elderlypersonshadjaundiceordisorderofthebowels,suchasBion,whowaslodgedwithSilenus。

Dysenterieswereepidemicalduringthesummer,andsomeofthosecasesinwhichthehemorrhageoccurred,terminatedindysentery,ashappenedtotheslaveofEraton,andtoMullus,whohadacopioushemorrhage,whichsettleddownintodysentery,andtheyrecovered。Thishumorwasredundantinmanycases,sinceinthosewhohadnotthehemorrhageaboutthecrisis,buttherisingsabouttheearsdisappeared,aftertheirdisappearancetherewasasenseofweightintheleftflankextendingtotheextremityofthehip,andpainsettinginafterthecrisis,withadischargeofthinurine;theybegantohavesmallhemorrhagesaboutthetwenty—fourthday,andtheswellingwasconvertedintothehemorrhage。InthecaseofAntiphon,thesonofCritobulus\'son,thefeverceasedandcametoacrisisaboutthefortiethday。

10。Manywomenwereseized,butfewerthanofthemen,andtherewerefewerdeathsamongthem。Butmostofthemhaddifficultparturition,andafterlabortheyweretakenill,andthesemostespeciallydied,as,forexample,thedaughterofTelebolusdiedonthesixthdayafterdelivery。Mostfemaleshadthemenstrualdischargeduringthefever,andmanygirlshaditthenforthefirsttime:incertainindividualsboththehemorrhagefromthenoseandthemensesappeared;thus,inthecaseofthevirgindaughterofDaetharses,themensesthentookplaceforthefirsttime,andshehadalsoacopinoushemorrhagefromthenose,andIknewnoinstanceofanyonedyingwhenoneorotherofthesetookplaceproperly。Butallthoseinthepregnantstatethatwereattackedhadabortions,asfarasI

observed。Theurineinmostcaseswasofthepropercolor,butthin,andhavingscantysediments:inmostthebowelsweredisorderedwiththinandbiliousdejections;andmany,afterpassingthroughtheothercrises,terminatedindysenteries,ashappenedtoXenophanesandCritias。Theurinewaswatery,copious,clear,andthin;andevenafterthecrises,whenthesedimentwasnatural,andalltheothercriticalsymptomswerefavorable,asIrecollecthavinghappenedtoBion,whowaslodgedinthehouseofSilenus,andCritias,wholivedwithXenophanes,theslaveofAreton,andthewifeofMnesistratus。