                                     400 BC
                                OF THE EPIDEMICS
                                 by Hippocrates
                          translated by Francis Adams
                     OF THE EPIDEMICS
             BOOK I. Sect. I. First Constitution

  1. IN THASUS, about the autumn equinox, and under the Pleiades,
the rains were abundant, constant, and soft, with southerly winds; the
winter southerly, the northerly winds faint, droughts; on the whole,
the winter having the character of spring. The spring was southerly,
cool, rains small in quantity. Summer, for the most part, cloudy, no
rain, the Etesian winds, rare and small, blew in an irregular
manner. The whole constitution of the season being thus inclined to
the southerly, and with droughts early in the spring, from the
preceding opposite and northerly state, ardent fevers occurred in a
few instances, and these very mild, being rarely attended with
hemorrhage, and never proving fatal. Swellings appeared about the
ears, in many on either side, and in the greatest number on both
sides, being unaccompanied by fever so as not to confine the patient
to bed; in all cases they disappeared without giving trouble,
neither did any of them come to suppuration, as is common in swellings
from other causes. They were of a lax, large, diffused character,
without inflammation or pain, and they went away without any
critical sign. They seized children, adults, and mostly those who were
engaged in the exercises of the palestra and gymnasium, but seldom
attacked women. Many had dry coughs without expectoration, and
accompanied with hoarseness of voice. In some instances earlier, and
in others later, inflammations with pain seized sometimes one of the
testicles, and sometimes both; some of these cases were accompanied
with fever and some not; the greater part of these were attended
with much suffering. In other respects they were free of disease, so
as not to require medical assistance.
  2. Early in the beginning of spring, and through the summer, and
towards winter, many of those who had been long gradually declining,
took to bed with symptoms of phthisis; in many cases formerly of a
doubtful character the disease then became confirmed; in these the
constitution inclined to the phthisical. Many, and, in fact, the
most of them, died; and of those confined to bed, I do not know if a
single individual survived for any considerable time; they died more
suddenly than is common in such cases. But other diseases, of a
protracted character, and attended with fever, were well supported,
and did not prove fatal: of these we will give a description
afterwards. Consumption was the most considerable of the diseases
which then prevailed, and the only one which proved fatal to many
persons. Most of them were affected by these diseases in the following
manner: fevers accompanied with rigors, of the continual type,
acute, having no complete intermissions, but of the form of the
semi-tertians, being milder the one day, and the next having an
exacerbation, and increasing in violence; constant sweats, but not
diffused over the whole body; extremities very cold, and warmed with
difficulty; bowels disordered, with bilious, scanty, unmixed, thin,
pungent, and frequent dejections. The urine was thin, colorless,
unconcocted, or thick, with a deficient sediment, not settling
favorably, but casting down a crude and unseasonable sediment. Sputa
small, dense, concocted, but brought up rarely and with difficulty;
and in those who encountered the most violent symptoms there was no
concoction at all, but they continued throughout spitting crude
matters. Their fauces, in most of them, were painful from first to
last, having redness with inflammation; defluxions thin, small and
acrid; they were soon wasted and became worse, having no appetite
for any kind of food throughout; no thirst; most persons delirious
when near death. So much concerning the phthisical affections.
  3. In the course of the summer and autumn many fevers of the
continual type, but not violent; they attacked persons who had been
long indisposed, but who were otherwise not in an uncomfortable state.
In most cases the bowels were disordered in a very moderate degree,
and they did not suffer thereby in any manner worth mentioning; the
urine was generally well colored, clear, thin, and after a time
becoming concocted near the crisis. They had not much cough, nor it
troublesome; they were not in appetite, for it was necessary to give
them food (on the whole, persons laboring under phthisis were not
affected in the usual manner). They were affected with fevers, rigors,
and deficient sweats, with varied and irregular paroxysms, in
general not intermitting, but having exacerbations in the tertian
form. The earliest crisis which occurred was about the twentieth
day, in most about the fortieth, and in many about the eightieth.
But there were cases in which it did not leave them thus at all, but
in an irregular manner, and without any crisis; in most of these the
fevers, after a brief interval, relapsed again; and from these
relapses they came to a crisis in the same periods; but in many they
were prolonged so that the disease was not gone at the approach of
winter. Of all those which are described under this constitution,
the phthisical diseases alone were of a fatal character; for in all
the others the patients bore up well, and did not die of the other
fevers.
                  Sect. II. Second Constitution

  1. In Thasus, early in autumn, the winter suddenly set in rainy
before the usual time, with much northerly and southerly winds.
These things all continued so during the season of the Pleiades, and
until their setting. The winter was northerly, the rains frequent,
in torrents, and large, with snow, but with a frequent mixture of fair
weather. These things were all so, but the setting in of the cold
was not much out of season. After the winter solstice, and at the time
when the zephyr usually begins to blow, severe winterly storms out
of season, with much northerly wind, snow, continued and copious
rains; the sky tempestuous and clouded; these things were
protracted, and did not remit until the equinox. The spring was
cold, northerly, rainy, and clouded; the summer was not very sultry,
the Etesian winds blew constant, but quickly afterwards, about the
rising of Arcturus, there were again many rains with north winds.
The whole season being wet, cold, and northerly, people were, for
the most part, healthy during winter; but early in the spring very
many, indeed, the greater part, were valetudinary. At first
ophthalmies set in, with rheums, pains, unconcocted discharges,
small concretions, generally breaking with difficulty, in most
instances they relapsed, and they did not cease until late in
autumn. During summer and autumn there were dysenteric affections,
attacks of tenesmus and lientery, bilious diarrhoea, with thin,
copious, undigested, and acrid dejections, and sometimes with watery
stools; many had copious defluxions, with pain, of a bilious,
watery, slimy, purulent nature, attended with strangury, not connected
with disease of the kidneys, but one complaint succeeding the other;
vomitings of bile, phlegm, and undigested food, sweats, in all cases a
reduncance of humors. In many instances these complaints were
unattended with fever, and did not prevent the patients from walking
about, but some cases were febrile, as will be described. In some
all those described below occurred with pain. During autumn, and at
the commencement of winter, there were phthisical complaints,
continual fevers; and, in a few cases, ardent; some diurnal, others
nocturnal, semi-tertians, true tertians, quartans, irregular fevers.
  2. All these fevers described attacked great numbers. All these
fevers attacked the smallest numbers, and the patients suffered the
least from them, for there were no hemorrhages, except a few and to
a small amount, nor was there delirium; all the other complaints
were slight; in these the crises were regular, in most instances, with
the intermittents, in seventeen days; and I know no instance of a
person dying of causus, nor becoming phrenitic. The tertians were more
numerous than the ardent fevers, and attended with more pain; but
these all had four periods in regular succession from the first
attack, and they had a complete crisis in seven, without a relapse
in any instance. The quartans attacked many at first, in the form of
regular quartans, but in no few cases a transition from other fevers
and diseases into quartans took place; they were protracted, as is
wont with them, indeed, more so than usual. Quotidian, nocturnal,
and wandering fevers attacked many persons, some of whom continued
to keep up, and others were confined to bed. In most instances these
fevers were prolonged under the Pleiades and till winter. Many
persons, and more especially children, had convulsions from the
commencement; and they had fever, and the convulsions supervened
upon the fevers; in most cases they were protracted, but free from
danger, unless in those who were in a deadly state from other
complaints. Those fevers which were continual in the main, and with no
intermissions, but having exacerbations in the tertian form, there
being remissions the one day and exacerbations the next, were the most
violent of all those which occurred at that time, and the most
protracted, and occurring with the greatest pains, beginning mildly,
always on the whole increasing, and being exacerbated, and always
turning worse, having small remissions, and after an abatement
having more violent paroxysms, and growing worse, for the most part,
on the critical days. Rigors, in all cases, took place in an irregular
and uncertain manner, very rare and weak in them, but greater in all
other fevers; frequent sweats, but most seldom in them, bringing no
alleviation, but, on the contrary, doing mischief. Much cold of the
extremities in them, and these were warmed with difficulty.
Insomnolency, for the most part, especially in these fevers, and again
a disposition to coma. The bowels, in all diseases, were disordered,
and in a bad state, but worst of all in these. The urine, in most of
them, was either thin and crude, yellow, and after a time with
slight symptoms of concoction in a critical form, or having the proper
thickness, but muddy, and neither settling nor subsiding; or having
small and bad, and crude sediments; these being the worst of all.
Coughs attended these fevers, but I cannot state that any harm or good
ever resulted from the cough.
  3. The most of these were protracted and troublesome, went on in a
very disorderly and irregular form, and, for the most part, did in a
crisis, either in the fatal cases or in the others; for if it left
some of them for a season it soon returned again. In a few instances
the lever terminated with a crisis; in the earliest of these about the
eightieth day, and some of these relapsed, so that most of them were
not free from the fever during the winter; but the fever left most
of them without a crisis, and these things happened alike to those who
recovered and to those who did not. There being much want of crisis
and much variety as to these diseases, the greatest and worst
symptom attended the most of them, namely, a loathing of all
articles of food, more especially with those who had otherwise fatal
symptoms; but they were not unseasonably thirsty in such fevers. After
a length of time, with much suffering and great wasting, abscesses
were formed in these cases, either unusually large, so that the
patients could not support them, or unusually small, so that they
did no good, but soon relapsed and speedily got worse. The diseases
which attacked them were in the form of dysenteries, tenesmus,
lientery, and fluxes; but, in some cases, there were dropsies, with or
without these complaints. Whatever attacked them violently speedily
cut them off, or again, did them no good. Small rashes, and not
corresponding to the violence of the disease, and quickly
disappearing, or swellings occurred about the ears, which were not
resolved, and brought on no crisis. In some they were determined to
the joints, and especially to the hip-joint, terminating critically
with a few, and quickly again increasing to its original habit.
  4. People died of all these diseases, but mostly of these fevers,
and notably infants just weaned, and older children, until eight or
ten years of age, and those before puberty. These things occurred to
those affected with the complaints described above, and to many
persons at first without them. The only favorable symptom, and the
greatest of those which occurred, and what saved most of those who
were in the greatest dangers, was the conversion of it to a strangury,
and when, in addition to this, abscesses were formed. The strangury
attacked, most especially, persons of the ages I have mentioned, but
it also occurred in many others, both of those who were not confined
to bed and those who were. There was a speedy and great change in
all these cases. For the bowels, if they happened previously to have
watery discharges of a bad character, became regular, they got an
appetite for food, and the fevers were mild afterwards. But, with
regard to the strangury itself, the symptoms were protracted and
painful. Their urine was copious, thick, of various characters, red,
mixed with pus, and was passed with pain. These all recovered, and I
did not see a single instance of death among them.
  5. With regard to the dangers of these cases, one must always attend
to the seasonable concoction of all the evacuations, and to the
favorable and critical abscesses. The concoctions indicate a speedy
crisis and recovery of health; crude and undigested evacuations, and
those which are converted into bad abscesses, indicate either want
of crisis, or pains, or prolongation of the disease, or death, or
relapses; which of these it is to be must be determined from other
circumstances. The physician must be able to tell the antecedents,
know the present, and foretell the future- must mediate these
things, and have two special objects in view with regard to disease,
namely, to do good or to do no harm. The art consists in three things-
the disease, the patient, and the physician. The physician is the
servant of the art, and the patient must combat the disease along with
the physician.
  6. Pains about the head and neck, and heaviness of the same along
with pain, occur either without fevers or in fevers. Convulsions
occurring in persons attacked with frenzy, and having vomitings of
verdigris-green bile, in some cases quickly prove fatal. In ardent
fevers, and in those other fevers in which there is pain of the
neck, heaviness of the temples, mistiness about the eyes, and
distention about the hypochondriac region, not unattended with pain,
hemorrhage from the nose takes place, but those who have heaviness
of the whole head, cardialgia and nausea, vomit bilious and
pituitous matters; children, in such affections, are generally
attacked with convulsions, and women have these and also pains of
the uterus; whereas, in elder persons, and those in whom the heat is
already more subdued, these cases end in paralysis, mania, and loss of
sight.


                   Third Constitution

  7. In Thasus, a little before and during the season of Arcturus,
there were frequent and great rains, with northerly winds. About the
equinox, and till the setting of the Pleiades, there were a few
southerly rains: the winter northerly and parched, cold, with great
winds and snow. Great storms about the equinox, the spring
northerly, dryness, rains few and cold. About the summer solstice,
scanty rains, and great cold until near the season of the Dog-star.
After the Dog-days, until the season of Arcturus, the summer hot,
great droughts, not in intervals, but continued and severe: no rain;
the Etesian winds blew; about the season of Arcturus southerly rains
until the equinox.
  8. In this state of things, during winter, paraplegia set in, and
attacked many, and some died speedily; and otherwise the disease
prevailed much in an epidemical form, but persons remained free from
all other diseases. Early in the spring, ardent fevers commenced and
continued through the summer until the equinox. Those then that were
attacked immediately after the commencement of the spring and
summer, for the most part recovered, and but few of them died. But
when the autumn and the rains had set in, they were of a fatal
character, and the greater part then died. When in these attacks of
ardent fevers there was a proper and copious hemorrhage from the nose,
they were generally saved by it, and I do not know a single person who
had a proper hemorrhage who died in this constitution. Philiscus,
Epaminon, and Silenus, indeed, who had a trifling epistaxis on the
fourth and fifth day, died. Most of those taken with had a rigor about
the time of the crisis, and notably those who had no hemorrhage; these
had also rigor associated.
  9. Some were attacked with jaundice on the sixth day, but these were
benefited either by an urinary purgation, or a disorder of the bowels,
or a copious hemorrhage, as in the case of Heraclides, who was
lodged with Aristocydes: this person, though he had the hemorrhage
from the nose, the purgation by the bladder, and disorder of the
bowels, experienced a favorable crisis on the twentieth day, not
like the servant of Phanagoras, who had none of these symptoms, and
died. The hemorrhages attacked most persons, but especially young
persons and those in the prime of life, and the greater part of
those who had not the hemorrhage died: elderly persons had jaundice or
disorder of the bowels, such as Bion, who was lodged with Silenus.
Dysenteries were epidemical during the summer, and some of those cases
in which the hemorrhage occurred, terminated in dysentery, as happened
to the slave of Eraton, and to Mullus, who had a copious hemorrhage,
which settled down into dysentery, and they recovered. This humor
was redundant in many cases, since in those who had not the hemorrhage
about the crisis, but the risings about the ears disappeared, after
their disappearance there was a sense of weight in the left flank
extending to the extremity of the hip, and pain setting in after the
crisis, with a discharge of thin urine; they began to have small
hemorrhages about the twenty-fourth day, and the swelling was
converted into the hemorrhage. In the case of Antiphon, the son of
Critobulus' son, the fever ceased and came to a crisis about the
fortieth day.
  10. Many women were seized, but fewer than of the men, and there
were fewer deaths among them. But most of them had difficult
parturition, and after labor they were taken ill, and these most
especially died, as, for example, the daughter of Telebolus died on
the sixth day after delivery. Most females had the menstrual discharge
during the fever, and many girls had it then for the first time: in
certain individuals both the hemorrhage from the nose and the menses
appeared; thus, in the case of the virgin daughter of Daetharses,
the menses then took place for the first time, and she had also a
copinous hemorrhage from the nose, and I knew no instance of any one
dying when one or other of these took place properly. But all those in
the pregnant state that were attacked had abortions, as far as I
observed. The urine in most cases was of the proper color, but thin,
and having scanty sediments: in most the bowels were disordered with
thin and bilious dejections; and many, after passing through the other
crises, terminated in dysenteries, as happened to Xenophanes and
Critias. The urine was watery, copious, clear, and thin; and even
after the crises, when the sediment was natural, and all the other
critical symptoms were favorable, as I recollect having happened to
Bion, who was lodged in the house of Silenus, and Critias, who lived
with Xenophanes, the slave of Areton, and the wife of Mnesistratus.
But afterwards all these were attacked with dysentery. It would be
worth while to inquire whether the watery urine was the cause of this.
About the season of Arcturus many had the crisis on the eleventh
day, and in them the regular relapses did not take place, but they
became comatose about this time, especially children; but there were
fewest deaths of all among them.
  11. About the equinox, and until the season of the Pleiades, and
at the approach of winter, many ardent fevers set in; but great
numbers at that season were seized with phrenitis, and many died; a
few cases also occurred during the summer. These then made their
attack at the commencement of ardent fevers, which were attended
with fatal symptoms; for immediately upon their setting in, there were
acute fever and small rigors, insomnolency, aberration, thirst,
nausea, insignificant sweats about the forehead and clavicles, but
no general perspiration; they had much delirious talking, fears,
despondency, great coldness of the extremities, in the feet, but
more especially in their hands: the paroxysms were on the even days;
and in most cases, on the fourth day, the most violent pains set in,
with sweats, generally coldish, and the extremities could not be
warmed, but were livid and rather cold, and they had then no thirst;
in them the urine was black, scanty, thin, and the bowels were
constipated; there was an hemorrhage from the nose in no case in which
these symptoms occurred, but merely a trifling epistaxis; and none
of them had a relapse, but they died on the sixth day with sweats.
In the phrenitic cases, all the symptoms which have been described did
not occur, but in them the disease mostly came to a crisis on the
eleventh day, and in some on the twentieth. In those cases in which
the phrenitis did not begin immediately, but about the third or fourth
day, the disease was moderate at the commencement, but assumed a
violent character about the seventh day. There was a great number of
diseases, and of those affected, they who died were principally
infants, young persons, adults having smooth bodies, white skins,
straight and black hair, dark eyes, those living recklessly and
luxuriously; persons with shrill, or rough voices, who stammered and
were passionate, and women more especially died from this form. In
this constitution, four symptoms in particular proved salutary; either
a hemorrhage from the nose, or a copious discharge by the bladder of
urine, having an abundant and proper sediment, or a bilious disorder
of the bowels at the proper time, or an attack of dysentery. And in
many cases it happened, that the crisis did not take place by any
one of the symptoms which have been mentioned, but the patient
passed through most of them, and appeared to be in an uncomfortable
way, and yet all who were attacked with these symptoms recovered.
All the symptoms which I have described occurred also to women and
girls; and whoever of them had any of these symptoms in a favorable
manner, or the menses appeared abundantly, were saved thereby, and had
a crisis, so that I do not know a single female who had any of these
favorably that died. But the daughter of Philo, who had a copious
hemorrhage from the nose, and took supper unseasonably on the
seventh day, died. In those cases of acute, and more especially of
ardent fevers, in which there is an involuntary discharge of tears,
you may expect a nasal hemorrhage unless the other symptoms be of a
fatal type, for in those of a bad description, they do not indicate
a hemorrhage, but death.
  12. Swellings about the ears, with pain in fevers, sometimes when
the fever went off critically, neither subsided nor were converted
into pus; in these cases a bilious diarrhoea, or dysentery, or thick
urine having a sediment, carried off the disease, as happened to
Hermippus of Clazomenae. The circumstances relating to crises, as
far as we can recognize them, were so far similar and so far
dissimilar. Thus two brothers became ill at the same hour (they were
brothers of Epigenes, and lodged near the theatre), of these the elder
had a crisis on the sixth day, and the younger on the seventh, and
both had a relapse at the same hour; it then left them for five
days, and from the return of the fever both had a crisis together on
the seventeenth day. Most had a crisis on the sixth day; it then
left them for six days, and from the relapse there was a crisis on the
fifth day. But those who had a crisis on the seventh day, had an
intermission for seven days; and the crisis took place on the third
day after the relapse. Those who had a crisis on the sixth day,
after an interval of six days were seized again on the third, and
having left them for one day, the fever attacked them again on the
next and came to a crisis, as happened to Evagon the son of
Daetharses. Those in whom the crisis happened on the sixth day, had an
intermission of seven days, and from the relapse there was a crisis on
the fourth, as happened to the daughter of Aglaidas. The greater
part of those who were taken ill under this constitution of things,
were affected in this manner, and I did not know a single case of
recovery, in which there was not a relapse agreeably to the stated
order of relapses; and all those recovered in which the relapses
took place according to this form: nor did I know a single instance of
those who then passed through the disease in this manner who had
another relapse.
  13. In these diseases death generally happened on the sixth day,
as with Epaminondas, Silenus, and Philiscus the son of Antagoras.
Those who had parotid swellings experienced a crisis on the
twentieth day, but in all these cases the disease went off without
coming to a suppuration, and was turned upon the bladder. But in
Cratistonax, who lived by the temple of Hercules, and in the maid
servant of Scymnus the fuller, it turned to a suppuration, and they
died. Those who had a crisis on the seventh day, had an intermission
of nine days, and a relapse which came to a crisis on the fourth day
from the return of the fever, as was the case with Pantacles, who
resided close by the temple of Bacchus. Those who had a crisis on
the seventh day, after an interval of six days had a relapse, from
which they had a crisis on the seventh day, as happened to
Phanocritus, who was lodged with Gnathon the fuller. During the
winter, about the winter solstices, and until the equinox, the
ardent fevers and frenzies prevailed, and many died. The crisis,
however, changed, and happened to the greater number on the fifth
day from the commencement, left them for four days and relapsed; and
after the return, there was a crisis on the fifth day, making in all
fourteen days. The crisis took place thus in the case of most
children, also in elder persons. Some had a crisis on the eleventh
day, a relapse on the fourteenth, a complete crisis on the
twentieth; but certain persons, who had a rigor about the twentieth,
had a crisis on the fortieth. The greater part had a rigor along
with the original crisis, and these had also a rigor about the
crisis in the relapse. There were fewest cases of rigor in the spring,
more in summer, still more in autumn, but by far the most in winter;
then hemorrhages ceased.
                         Sect. III

  1. With regard to diseases, the circumstances from which we form a
judgment of them are,- by attending to the general nature of all,
and the peculiar nature of each individual,- to the disease, the
patient, and the applications,- to the person who applies them, as
that makes a difference for better or for worse,- to the whole
constitution of the season, and particularly to the state of the
heavens, and the nature of each country;- to the patient's habits,
regimen, and pursuits;- to his conversation, manners, taciturnity,
thoughts, sleep, or absence of sleep, and sometimes his dreams, what
and when they occur;- to his picking and scratching;- to his tears;-
to the alvine discharges, urine, sputa, and vomitings; and to the
changes of diseases from the one into the other;- to the deposits,
whether of a deadly or critical character;- to the sweat, coldness,
rigor, cough, sneezing, hiccup, respiration, eructation, flatulence,
whether passed silently or with a noise;- to hemorrhages and
hemorrhoids;- from these, and their consequences, we must form our
judgment.
  2. Fevers are,- the continual, some of which hold during the day and
have a remission at night, and others hold a remission during the day;
semi-tertians, tertians, quartans, quintans, septans, nonans. The most
acute, strongest, most dangerous, and fatal diseases, occur in the
continual fever. The least dangerous of all, and the mildest and
most protracted, is the quartan, for it is not only such from
itself, but it also carries off other great diseases. In what is
called the semi-tertian, other acute diseases are apt to occur, and it
is the most fatal of all others, and moreover phthisical persons,
and those laboring under other protracted diseases, are apt to be
attacked by it. The nocturnal fever is not very fatal, but protracted;
the diurnal is still more protracted, and in some cases passes into
phthisis. The septan is protracted, but not fatal; the nonan more
protracted, and not fatal. The true tertian comes quickly to a crisis,
and is not fatal; but the quintan is the worst of all, for it proves
fatal when it precedes an attack of phthisis, and when it supervenes
on persons who are already consumptive. There are peculiar modes,
and constitutions, and paroxysms, in every one of these fevers; for
example,- the continual, in some cases at the very commencement,
grows, as it were, and attains its full strength, and rises to its
most dangerous pitch, but is diminished about and at the crisis; in
others it begins gentle and suppressed, but gains ground and is
exacerbated every day, and bursts forth with all its heat about and at
the crisis; while in others, again, it commences mildly, increases,
and is exacerbated until it reaches its acme, and then remits until at
and about the crisis. These varieties occur in every fever, and in
every disease. From these observations one must regulate the regimen
accordingly. There are many other important symptoms allied to
these, part of which have been already noticed, and part will be
described afterwards, from a consideration of which one may judge, and
decided in each case, whether the disease be acute, acute, and whether
it will end in death or recovery; or whether it will be protracted,
and will end in death or recovery; and in what cases food is to be
given, and in what not; and when and to what amount, and what
particular kind of food is to be administered.
  3. Those diseases which have their paroxysms on even days have their
crises on even days; and those which have their paroxysms on uneven
days have their crises on uneven days. The first period of those which
have the crisis on even days, is the 4th, 6th, 8th, 10th, 14th,
20th, 30th, 40th, 60th, 80th, 100th; and the first period of those
which have their crises on uneven days, is the 1st, 3d, 5th, 7th, 9th,
11th, 17th, 21th, 27th, 31st. It should be known, that if the crisis
take place on any other day than on those described, it indicates that
there will be a relapse, which may prove fatal. But one ought to pay
attention, and know in these seasons what crises will lead to recovery
and what to death, or to changes for the better or the worse.
Irregular fevers, quartans, quintans, septans, and nonans should be
studied, in order to find out in what periods their crises take place.


                 Fourteen Cases of Disease

  CASE I. Philiscus, who lived by the Wall, took to bed on the first
day of acute fever; he sweated; towards night was uneasy. On the
second day all the symptoms were exacerbated; late in the evening
had a proper stool from a small clyster; the night quiet. On the third
day, early in the morning and until noon, he appeared to be free
from fever; towards evening, acute fever, with sweating, thirst,
tongue parched; passed black urine; night uncomfortable, no sleep;
he was delirious on all subjects. On the fourth, all the symptoms
exacerbated, urine black; night more comfortable, urine of a better
color. On the fifth, about mid-day, had a slight trickling of pure
blood from the nose; urine varied in character, having floating in
it round bodies, resembling semen, and scattered, but which did not
fall to the bottom; a suppository having been applied, some scanty
flatulent matters were passed; night uncomfortable, little sleep,
talking incoherently; extremities altogether cold, and could not be
warmed; urine, black; slept a little towards day; loss of speech, cold
sweats; extremities livid; about the middle of the sixth day he
died. The respiration throughout, like that of a person recollecting
himself, was rare, and large, and spleen was swelled upon in a round
tumor, the sweats cold throughout, the paroxysms on the even days.
  CASE II. Silenus lived on the Broad-way, near the house of
Evalcidas. From fatigue, drinking, and unseasonable exercises, he
was seized with fever. He began with having pain in the loins; he
had heaviness of the head, and there was stiffness of the neck. On the
first day the alvine discharges were bilious, unmixed, frothy, high
colored, and copious; urine black, having a black sediment; he was
thirsty, tongue dry; no sleep at night. On the second, acute fever,
stools more copious, thinner, frothy; urine black, an uncomfortable
night, slight delirium. On the third, all the symptoms exacerbated; an
oblong distention, of a softish nature, from both sides of the
hypochondrium to the navel; stools thin, and darkish; urine muddy, and
darkish; no sleep at night; much talking, laughter, singing, he
could not restrain himself. On the fourth, in the same state. On the
fifth, stools bilious, unmixed, smooth, greasy; urine thin, and
transparent; slight absence of delirium. On the sixth, slight
perspiration about the head; extremities cold and livid; much
tossing about; no passage from the bowels, urine suppressed, acute
fever. On the seventh, loss of speech; extremities could no longer
be kept warm; no discharge of urine. On the eighth, a cold sweat all
over; red rashes with sweat, of a round figure, small, like vari,
persistent, not subsiding; by means of a slight stimulus, a copious
discharge from the bowels, of a thin and undigested character, with
pain; urine acrid, and passed with pain; extremities slightly
heated; sleep slight, and comatose; speechless; urine thin, and
transparent. On the ninth, in the same state. On the tenth, no drink
taken; comatose, sleep slight; alvine discharges the same; urine
abundant, and thickish; when allowed to stand, the sediment
farinaceous and white; extremities again cold. On the eleventh, he
died. At the commencement, and throughout, the respiration was slow
and large; there was a constant throbbing in the hypochondrium; his
age was about twenty.
  CASE III. Herophon was seized with an acute fever; alvine discharges
at first were scanty, and attended with tenesmus; but afterwards
they were passed of a thin, bilious character, and frequent; there was
no sleep; urine black, and thin. On the fifth, in the morning,
deafness; all the symptoms exacerbated; spleen swollen; distention
of the hypochondrium; alvine discharges scanty, and black; he became
delirious. On the sixth, delirious; at night, sweating, coldness;
the delirium continued. On the seventh, he became cold, thirsty, was
disordered in mind; at night recovered his senses; slept. On the
eighth, was feverish; the spleen diminished in size; quite
collected; had pain at first about the groin, on the same side as
the spleen; had pains in both legs; night comfortable; urine better
colored, had a scanty sediment. On the ninth, sweated; the crisis took
place; fever remitted. On the fifth day afterwards, fever relapsed,
spleen immediately became swollen; acute fever; deafness again. On the
third day after the relapse, the spleen diminished; deafness less;
legs painful; sweated during the night; crisis took place on the
seventeenth day; had no disorder of the senses during the relapse.
  CASE IV. In Thasus, the wife of Philinus, having been delivered of a
daughter, the discharge being natural, and other matters going on
mildly, on the fourteenth day after delivery was seized with fever,
attended with rigor; was pained at first in the cardiac region of
the stomach and right hypochondrium; pain in the genital organs;
lochial discharge ceased. Upon the application of a pessary all
these symptoms were alleviated; pains of the head, neck, and loins
remained; no sleep; extremities cold; thirst; bowels in a hot state;
stools scanty; urine thin, and colorless at first. On the sixth,
towards night, senses much disordered, but again were restored. On the
seventh, thirsty; the evacuations bilious, and high colored. On the
eighth, had a rigor; acute fever; much spasm, with pain; talked
much, incoherently; upon the application of a suppository, rose to
stool, and passed copious dejections, with a bilious flux; no sleep.
On the ninth, spasms. On the tenth, slightly recollected. On the
eleventh, slept; had perfect recollection, but again immediately
wandered; passed a large quantity of urine with spasms, (the
attendants seldom putting her in mind), it was thick, white, like
urine which has been shaken after it has stood for a considerable time
until it has subsided, but it had no sediment; in color and
consistence, the urine resembled that of cattle, as far as I observed.
About the fourteenth day, startings over the whole body; talked
much; slightly collected, but presently became again delirious.
About the seventeenth day became speechless, on the twentieth died.
  CASE V. The wife of Epicrates, who was lodged at the house of
Archigetes, being near the term of delivery, was seized with a violent
rigor, and, as was said, she did not become heated; next day the same.
On the third, she was delivered of a daughter, and everything went
on properly. On the day following her delivery, she was seized with
acute fever, pain in the cardiac region of the stomach, and in the
genital parts. Having had a suppository, was in so far relieved;
pain in the head, neck, and loins; no sleep; alvine discharges scanty,
bilious, thin, and unmixed; urine thin, and blackish. Towards the
night of the sixth day from the time she was seized with the fever,
became delirious. On the seventh, all the symptoms exacerbated;
insomnolency, delirium, thirst; stools bilious, and high colored. On
the eighth, had a rigor; slept more. On the ninth, the same. On the
tenth, her limbs painfully affected; pain again of the cardiac
region of the stomach; heaviness of the head; no delirium; slept more;
bowels constipated. On the eleventh, passed urine of a better color,
and having an abundant sediment; felt lighter. On the fourteenth had a
rigor; acute fever. On the fifteenth, had a copious vomiting of
bilious and yellow matters; sweated; fever gone; at night acute fever;
urine thick, sediment white. On the seventeenth, an exacerbation;
night uncomfortable; no sleep; delirium. On the eighteenth, thirsty;
tongue parched; no sleep; much delirium; legs painfully affected.
About the twentieth, in the morning, had as light rigor; was comatose;
slept tranquilly; had slight vomiting of bilious and black matters;
towards night deafness. About the twenty-first, weight generally in
the left side, with pain; slight urine thick, muddy, and reddish; when
allowed to stand, had no sediment; in other respects felt lighter;
fever not gone; fauces painful from the commencement, and red; uvula
retracted; defluxion remained acrid, pungent, and saltish
throughout. About the twenty-seventh, free of fever; sediment in the
urine; pain in the side. About the thirty-first, was attacked with
fever, bilious diarrhea; slight bilious vomiting on the fortieth.
Had a complete crisis, and was freed from the fever on the eightieth
day.
  CASE VI. Cleonactides, who was lodged above the Temple of
Hercules, was seized with a fever in an irregular form; was pained
in the head and left side from the commencement, and had other pains
resembling those produced by fatigue; paroxysms of the fevers
inconstant and irregular; occasional sweats; the paroxysms generally
attacked on the critical days. About the twenty-fourth was cold in the
extremities of the hands, vomitings bilious, yellow, and frequent,
soon turning to a verdigris-green color; general relief. About the
thirtieth, began to have hemorrhage from both nostrils, and this
continued in an irregular manner until near the crisis; did not loathe
food, and had no thirst throughout, nor was troubled with
insomnolency; urine thin, and not devoid of color. When about the
thirtieth day, passed reddish urine, having a copious red sediment;
was relieved, but afterwards the characters of the urine varied,
sometimes having sediment, and sometimes not. On the sixtieth, the
sediment in the urine copious, white, and smooth; all the symptoms
ameliorated; intermission of the fever; urine thin, and well
colored. On the seventieth, fever gone for ten days. On the
eightieth had a rigor, was seized with acute fever, sweated much; a
red, smooth sediment in the urine; and a perfect crisis.
  CASE VII. Meton was seized with fever; there was a painful weight in
the loins. Next day, after drinking water pretty copiously, had proper
evacuations from the bowels. On the third, heaviness of the head,
stools thin, bilious, and reddish. On the fourth, all the symptoms
exacerbated; had twice a scanty trickling of blood from the right
nostril; passed an uncomfortable night; alvine discharges like those
on the third day; urine darkish, had a darkish cloud floating in it,
of a scattered form, which did not subside. On the fifth, a copious
hemorrhage of pure blood from the left he sweated, and had a crisis.
After the fever restless, and had some delirium; urine thin, and
darkish; had an affusion of warm water on the head; slept and
recovered his senses. In this case there was no relapse, but there
were frequent hemorrhages after the crisis.
  CASE VIII. Erasinus, who lived near the Canal of Bootes, was
seized with fever after supper; passed the night in an agitated state.
During the first day quiet, but in pain at night. On the second,
symptoms all exacerbated; at night delirious. On the third, was in a
painful condition; great incoherence. On the fourth, in a most
uncomfortable state; had no sound sleep at night, but dreaming and
talking; then all the appearances worse, of a formidable and
alarming character; fear, impatience. On the morning of the fifth, was
composed, and quite coherent, but long before noon was furiously
mad, so that he could not constrain himself; extremities cold, and
somewhat livid; urine without sediment; died about sunset. The fever
in this case was accompanied by sweats throughout; the sweats
throughout; the hypochondria were in a state of meteorism, with
distention and pain; the urine was black, has round substances
floating in it, which did not subside; the alvine evacuations were not
stopped; thirst throughout not great; much spasms with sweats about
the time of death.
  CASE IX. Criton, in Thasus, while still on foot, and going about,
was seized with a violent pain in the great toe; he took to bed the
same day, had rigors and nausea, recovered his heat slightly, at night
was delirious. On the second, swelling of the whole foot, and about
the ankle erythema, with distention, and small bullae (phlyctaenae);
acute fever; he became furiously deranged; alvine discharges
bilious, unmixed, and rather frequent. He died on the second day
from the commencement.
  CASE X. The Clazomenian who was lodged by the Well of Phrynichides
was seized with fever. He had pain in the head, neck, and loins from
the beginning, and immediately afterwards deafness; no sleep, acute
fever, hypochondria elevated with a swelling, but not much distention;
tongue dry. On the fourth, towards night, he became delirious. On
the fifth, in an uneasy state. On the sixth, all the symptoms
exacerbated. About the eleventh a slight remission; from the
commencement to the fourteenth day the alvine discharges thin,
copious, and of the color of water, but were well supported; the
bowels then became constipated. Urine throughout thin, and well
colored, and had many substances scattered through it, but no
sediment. About the sixteenth, urine somewhat thicker, which had a
slight sediment; somewhat better, and more collected. On the
seventeenth, urine again thin; swellings about both his ears, with
pain; no sleep, some incoherence; legs painfully affected. On the
twentieth, free of fever, had a crisis, no sweat, perfectly collected.
About the twenty-seventh, violent pain of the right hip; it speedily
went off. The swellings about the ears subsided, and did not
suppurate, but were painful. About the thirty-first, a diarrhea
attended with a copious discharge of watery matter, and symptoms of
dysentery; passed thick urine; swellings about the ears gone. About
the fortieth day, had pain in the right eye, sight dull. It went away.
  CASE XI. The wife of Dromeades having been delivered of a female
child, and all other matters going on properly, on the second day
after was seized with rigor and acute fever. Began to have pain
about the hypochondrium on the first day; had nausea and
incoherence, and for some hours afterwards had no sleep; respiration
rare, large, and suddenly interrupted. On the day following that on
which she had the rigor, alvine discharges proper; urine thick, white,
muddy, like urine which has been shaken after standing for some
time, until the sediment had fallen to the bottom; it had no sediment;
she did not sleep during the night. On the third day, about noon,
had a rigor, acute fever; urine the same; pain of the hypochondria,
nausea, an uncomfortable night, no sleep; a coldish sweat all over,
but heat quickly restored. On the fourth, slight alleviation of the
symptoms about the hypochondria; heaviness of the head, with pain;
somewhat comatose; slight epistaxis, tongue dry, thirst, urine thin
and oily; slept a little, upon awaking was somewhat comatose; slight
coldness, slept during the night, was delirious. On the morning of the
sixth had a rigor, but soon recovered her heat, sweated all over;
extremities cold, was delirious, respiration rare and large. Shortly
afterwards spasms from the head began, and she immediately expired.
  CASE XII. A man, in a heated state, took supper, and drank more than
enough; he vomited the whole during the night; acute fever, pain of
the right hypochondrium, a softish inflammation from the inner part;
passed an uncomfortable night; urine at the commencement thick, red,
but when allowed to stand, had no sediment, tongue dry, and not very
thirsty. On the fourth, acute fever, pains all over. On the fifth,
urine smooth, oily, and copious; acute fever. On the sixth, in the
evening, very incoherent, no sleep during the night. On the seventh,
all the symptoms exacerbated; urine of the same characters; much
talking, and he could not contain himself; the bowels being
stimulated, passed a watery discharge with lumbrici: night equally
painful. In the morning had a rigor; acute fever, hot sweat,
appeared to be free of fever; did not sleep long; after the sleep a
chill, ptyalism; in the evening, great incoherence; after a little,
vomited a small quantity of dark bilious matters. On the ninth,
coldness, much delirium, did not sleep. On the tenth, pains in the
limbs, all the symptoms exacerbated; he was delirious. On the
eleventh, he died.
  CASE XIII. A woman, who lodged on the Quay, being three months
gone with child, was seized with fever, and immediately began to
have pains in the loins. On the third day, pain of the head and
neck, extending to the clavicle, and right hand; she immediately
lost the power of speech; was paralyzed in the right hand, with
spasms, after the manner of paraplegia; was quite incoherent; passed
an uncomfortable night; did not sleep; disorder of the bowels,
attended with bilious, On the fourth, recovered the use of her tongue;
spasms of the same parts, and general pains remained; swelling in
the hypochondrium, accompanied with pain; did not sleep, was quite
incoherent; bowels disordered, urine thin, and not of a good color. On
the fifth, acute fever; pain of the hypochondrium, quite incoherent;
alvine evacuations bilious; towards night had a sweat, and was freed
from the fever. On the sixth, recovered her reason; was every way
relieved; the pain remained about the left clavicle; was thirsty,
urine thin, had no sleep. On the seventh trembling, slight coma,
some incoherence, pains about the clavicle and left arm remained; in
all other respects was alleviated; quite coherent. For three days
remained free from fever. On the eleventh, had a relapse, with rigor
and fever. About the fourteenth day, vomited pretty abundantly bilious
and yellow matters, had a sweat, the fever went off, by coming to a
crisis.
  CASE XIV. Melidia, who lodged near the Temple of Juno, began to feel
a violent pain of the head, neck, and chest. She was straightway
seized with acute fever; a slight appearance of the menses;
continued pains of all these parts. On the sixth, was affected with
coma, nausea, and rigor; redness about the cheeks; slight delirium. On
the seventh, had a sweat; the fever intermitted, the pains remained. A
relapse; little sleep; urine throughout of a good color, but thin; the
alvine evacuations were thin, bilious, acrid, very scanty, black,
and fetid; a white, smooth sediment in the urine; had a sweat, and
experienced a perfect crisis on the eleventh day.
                     BOOK II. Sect. I

  CASE I. Pythion, who lived by the Temple of the Earth, on the
first day, trembling commencing from his hands; acute fever, delirium.
On the second, all the symptoms were exacerbated. On the third, the
same. On the fourth alvine discharges scanty, unmixed, and bilious. On
the fifth, all the symptoms were exacerbated, the tremors remained;
little sleep, the bowels constipated. On the sixth sputa mixed,
reddish. On the seventh, mouth drawn aside. On the eighth, all the
symptoms were exacerbated; the tremblings were again constant;
urine, from the beginning to the eighth day, thin, and devoid of
color; substances floating in it, cloudy. On the tenth he sweated;
sputa somewhat digested, had a crisis; urine thinnish about the
crisis; but after the crisis, on the fortieth day, an abscess about
the anus, which passed off by a strangury.
  Explanation of the characters. It is probably that the great
discharge of urine brought about the resolution of the disease, and
the cure of the patient on the fortieth day.
  CASE II. Hermocrates, who lived by the New Wall, was seized with
fever. He began to have pain in the head and loins; an empty
distention of the hypochondrium; the tongue at first was parched;
deafness at the commencement; there was no sleep; not very thirsty;
urine thick and red, when allowed to stand it did not subside;
alvine discharge very dry, and not scanty. On the fifth, urine thin,
had substances floating in it which did not fall to the bottom; at
night he was delirious. On the sixth, had jaundice; all the symptoms
were exacerbated; had no recollection. On the seventh, in an
uncomfortable state; urine thin, as formerly; on the following days
the same. About the eleventh day, all the symptoms appeared to be
lightened. Coma set in; urine thicker, reddish, thin substances below,
had no sediment; by degrees he became collected. On the fourteenth,
fever gone; had no sweat; slept, quite collected; urine of the same
characters. About the seventeenth, had a relapse, became hot. On the
following days, acute fever, urine thin, was delirious. Again, on
the twentieth, had a crisis; free of fever; had no sweat; no
appetite through the whole time; was perfectly collected; could not
speak, tongue dry, without thirst; deep sleep. About the twenty-fourth
day he became heated; bowels loose, with a thin, watery discharge;
on the following days acute fever, tongue parched. On the
twenty-seventh he died. In this patient deafness continued throughout;
the urine either thick and red, without sediment, or thin, devoid of
color, and, having substances floating in it: he could taste nothing.
  Explanation of the characters. It is probably that it was the
suppression of the discharges from the bowels which occasioned death
on the twenty-seventh day.
  CASE III. The man who was lodged in the Garden of Dealces: had
heaviness of the head and pain in the right temple for a
considerable time, from some accidental cause, was seized with
fever, and took to bed. On the second, there was a trickling of pure
blood from the left nostril, but the alvine discharges were proper,
urine thin, mixed, having small substances floating in it, like coarse
barley meal, or semen. On the third, acute fever; stools black,
thin, frothy, a livid sediment in the dejections; slight coma;
uneasiness at the times he had to get up; sediment in the urine livid,
and somewhat viscid. On the fourth, slight vomiting of bilious, yellow
matters, and, after a short interval, of the color of verdigris; a few
drops of pure blood ran from the left nostril; stools the same;
urine the same; sweated about the head and clavicles; spleen enlarged,
pain of the thigh on the same side; loose swelling of the right
hypochondrium; at night had no sleep, slight delirium. On the sixth,
stools black, fatty, viscid, fetid; slept, more collected. On the
seventh, tongue dry, thirsty, did not sleep; was somewhat delirious;
urine thin, not of a good color. On the eighth, stools black,
scanty, and compact; slept, became collected; not very thirsty. On the
ninth had a rigor, acute fever, sweated, a chill, was delirious,
strabismus of the right eye, tongue dry, thirsty, without sleep. On
the tenth, much the same. On the eleventh, became quite collected;
free from fever, slept, urine thin about the crisis. The two following
days without fever; it returned on the fourteenth, then immediately
insomnolency and complete delirium. On the fifteenth, urine muddy,
like that which has been shaken after the sediment has fallen to the
bottom; acute fever, quite delirious, did not sleep; knees and legs
painful; after a suppository, had alvine dejections of a black
color. On the sixteenth, urine thin, had a cloudy eneorema, was
delirious. On the seventeenth, in the morning, extremities cold, was
covered up with the bedclothes, acute fever, general sweat, felt
relieved, more collected; not free of fever, thirsty, vomited yellow
bile, in small quantities; formed faeces passed from the bowels, but
soon afterwards black, scanty, and thin; urine thin, not well colored.
On the eighteenth, not collected, comatose. On the nineteenth, in
the same state. On the twentieth, slept; quite collected, sweated,
free from fever, not thirsty, but the urine thin. On the twenty-first,
slight delirium; somewhat thirsty, pain of the hypochondrium, and
throbbing about the navel throughout. On sediment in the urine,
quite collected. Twenty-seventh, pain of the right hip joint; urine
thin and bad, a sediment; all the other symptoms milder. About the
twenty-ninth, pain of the right eye; urine thin. Fortieth,
dejections pituitous, white, rather frequent; sweated abundantly all
over; had a complete crisis.
  Explanation of the characters. It is probable that, by means of
the stools, the urine, and the sweat, this patient was cured in
forty days.
                         Sect. II

  CASE I. In Thasus, Philistes had headache of long continuance, and
sometimes was confined to bed, with a tendency to deep sleep; having
been seized with continual fevers from drinking, the pain was
exacerbated; during the night he, at first, became hot. On the first
day, he vomited some bilious matters, at first yellow, but
afterwards of a verdigris-green color, and in greater quantity; formed
faeces passed from the bowels; passed the night uncomfortably. On
the second, deafness, acute fever; retraction of the right
hypochondrium; urine thin, transparent, had some small substances like
semen floating in it; delirium ferox about mid-day. On the third, in
an uncomfortable state. On the fourth, convulsions; all the symptoms
exacerbated. On the fifth, early in the morning, died.
  Explanation of the characters. It is probable that the death of
the patient on the fifth day is to be attributed to a phrenitis,
with unfavorable evacuations.
  CASE II. Charion, who was lodged at the house of Demaenetus,
contracted a fever from drinking. Immediately he had a painful
heaviness of the head; did not sleep; bowels disordered, with thin and
somewhat bilious discharges. On the third day, acute fever;
trembling of the head, but especially of the lower lip; after a little
time a rigor, convulsions; he was quite delirious; passed the night
uncomfortably. On the fourth, quiet, slept little, talked
incoherently. On the fifth, in pain; all the symptoms exacerbated;
delirium; passed the night uncomfortably; did not sleep. On the sixth,
in the same state. On the seventh had a rigor, acute fever, sweated
all over his body; had a crisis. Throughout the alvine discharges were
bilious, scanty, and unmixed; urine thin, well colored, having
cloudy substances floating in it. About the eighth day, passed urine
of a better color, having a white scanty sediment; was collected, free
from fever for a season. On the ninth it relapsed. About the
fourteenth, acute fever. On the sixteenth, vomited pretty frequently
yellow, bilious matters. On the seventeenth had a rigor, acute
fever, sweated, free of fever; had a crisis; urine, after the
relapse and the crisis, well colored, having a sediment; neither was
he delirious in the relapse. On the eighteenth, became a little
heated; some thirst, urine thin, with cloudy substances floating in
it; slight wandering in his mind. About the nineteenth, free of fever,
had a pain in his neck; a sediment in the urine. Had a complete crisis
on the twentieth.
  Explanation of the characters. It is probable that the patient was
cured in twenty days, by the abundance of bilious stools and urine.
  CASE III. The daughter of Euryanax, a maid, was taken ill of
fever. She was free of thirst throughout, but had no relish for
food. Alvine discharges small, urine thin, scanty, not well colored.
In the beginning of the fever, had a pain about the nates. On the
sixth day, was free of fever, did not sweat, had a crisis; the
complaint about the nates came to a small suppuration, and burst at
the crisis. After the crisis, on the seventh day, had a rigor,
became slightly heated, sweated. On the eighth day after the rigor,
had an inconsiderable rigor; the extremities cold ever after. About
the tenth day, after a sweat which came on, she became delirious,
and again immediately afterwards was collected; these symptoms were
said to have been brought on by eating grapes. After an intermission
of the twelfth day, she again talked much incoherently; her bowels
disordered with bilious, scanty, unmixed, thin, acrid discharges;
she required to get frequently up. She died on the seventh day after
the return of the delirium. At the commencement of the disease she had
pain in the throat, and it red throughout, uvula retracted, defluxions
abundant, thin, acrid; coughed, but had no concocted sputa; during the
whole time loathed all kinds of food, nor had the least desire of
anything; had no thirst, nor drank anything worth mentioning; was
silent, and never spoke a word; despondency; had no hopes of
herself. She had a congenital tendency to phthisis.
  CASE IV. The woman affected with quinsy, who lodged in the house
of Aristion: her complaint began in the tongue; speech inarticulate;
tongue red and parched. On the first day, felt chilly, and
afterwards became heated. On the third day, a rigor, acute fever; a
reddish and hard swelling on both sides of the neck and chest,
extremities cold and livid; and livid; respiration elevated; the drink
returned by the nose; she could not swallow; alvine and urinary
discharges suppressed. On the fourth, all of the symptoms were
exacerbated. On the fifth she died of the quinsy.
  Explanation of the characters. It is probable that the cause of
death on the sixth day was the suppression of the discharges.
  CASE V. The young man who was lodged by the Liars' Market was seized
with fever from fatigue, labor, and running out of season. On the
first day, the bowels disordered, with bilious, thin, and copious
dejections; urine thin and blackish; had no sleep; was thirsty. On the
second all the symptoms were exacerbated; dejections more copious
and unseasonable; he had no sleep; disorder of the intellect; slight
sweat. On the third day, restless, thirst, nausea, much tossing about,
bewilderment, delirium; extremities livid and cold; softish distention
of the hypochondrium on both sides. On the fourth, did not sleep;
still worse. On the seventh he died. He was about twenty years of age.
  Explanation of the characters. It is probable that the cause of
his death on the seventh day was the unseasonable practices
mentioned above. An acute affection.
  CASE VI. The woman who lodged at the house of Tisamenas had a
troublesome attack of iliac passion, much vomiting; could not keep her
drink; pains about the hypochondria, and pains also in the lower
part of the belly; constant tormina; not thirsty; became hot;
extremities cold throughout, with nausea and insomnolency; urine
scanty and thin; dejections undigested, thin, scanty. Nothing could do
her any good. She died.
  CASE VII. A woman of Pantimides, from a miscarriage, was taken ill
of fever. On the first day, tongue dry, thirst, nausea,
insomnolency, belly disordered, with thin, copious, undigested
dejections. On the second day, had a rigor, acute fever; alvine
discharges copious; had no sleep. On the third, pains greater. On
the fourth, delirious. On the seventh she died. Belly throughout
loose, with copious, thin, undigested evacuations; urine scanty, thin.
An ardent fever.
  CASE VIII. Another woman, after a miscarriage about the fifth month,
the wife of Ocetes, was seized with fever. At first had sometimes coma
and sometimes insomnolency; pain of the loins; heaviness of the
head. On the second, the bowels were disordered, with scanty, thin,
and at first unmixed dejections. On the third, more copious, and
worse; at night did not sleep. On the fourth was delirious; frights,
despondency; strabismus of the right eye; a faint cold sweat about the
head; extremities cold. On the fifth day, all the symptoms were
exacerbated; talked much incoherently, and again immediately became
collected; had no thirst; labored under insomnolency; alvine
dejections copious, and unseasonable throughout; urine scanty, thin,
darkish; extremities cold, somewhat livid. On the sixth day, in the
same state. On the seventh she died. Phrenitis.
  CASE IX. A woman who lodged near the Liars' Market, having then
brought forth a son in a first and difficult labor, was seized with
fever. Immediately on the commencement had thirst, nausea, and
cardialgia; tongue dry; bowels disordered, with thin and scanty
dejections; had no sleep. On the second, had slight rigor, acute
fever; a faint cold sweat about the head. On the third, painfully
affected; evacuations from the bowels undigested, thin, and copious.
On the fourth, had a rigor; all the symptoms exacerbated;
insomnolency. On the fifth, in a painful state. On the sixth, in the
same state; discharges from the bowels liquid and copious. On the
seventh, had a rigor, fever acute; much thirst; much tossing about;
towards evening a cold sweat over all; extremities cold, could no
longer be kept warm; and again at night had a rigor; extremities could
not be warmed; she did not sleep; was slightly delirious, and again
speedily collected. On the eighth, about mid-day, she became warm, was
thirsty, comatose, had nausea; vomited small quantities of yellowish
bile; restless at night, did not sleep; passed frequently large
quantities of urine without consciousness. On the ninth, all the
symptoms gave way; comatose, towards evening slight rigors; small
vomitings of bile. On the tenth, rigor; exacerbation of the fever, did
not sleep at all; in the morning passed much urine having a
sediment; extremities recovered their heat. On the eleventh, vomited
bile of a verdigris-green color; not long after had a rigor, and again
the extremities cold; towards evening a rigor, a cold sweat, much
vomiting; passed a painful night. On the twelfth, had copious black
and fetid vomitings; much hiccup, painful thirst. On the thirteenth,
vomitings black, fetid, and copious; rigor about mid-day, loss of
speech. On the fourteenth, some blood ran from her nose, she died.
In this case the bowels were loose throughout; with rigors: her age
about seventeen. An ardent fever.
                        Sect. III

  1. The year was southerly, rainy; no winds throughout. Droughts
having prevailed during the previous seasons of the year, the south
winds towards the rising of Arcturus were attended with much rain.
Autumn gloomy and cloudy, with copious rains. Winter southerly,
damp, and soft. But long after the solstice, and near the equinox,
much wintery weather out of season; and when now close to the equinox,
northerly, and winterly weather for no long time. The spring again
southerly, calm, much rain until the dog-days. Summer fine and hot;
great suffocating heats. The Etesian winds blew small and irregular;
again, about the season of Arcturus, much rains with north winds.
  2. The year being southerly, damp, and soft towards winter, all were
healthy, except those affected with phthisis, of whom we shall write
afterwards.
  3. Early in spring, along with the prevailing cold, there were
many cases of erysipelas, some from a manifest cause, and some not.
They were of a malignant nature, and proved fatal to many; many had
sore-throat and loss of speech. There were many cases of ardent fever,
phrensy, aphthous affections of the mouth, tumors on the genital
organs; of ophthalmia, anthrax, disorder of the bowels, anorexia, with
thirst and without it; of disordered urine, large in quantity, and bad
in quality; of persons affected with coma for a long time, and then
falling into a state of insomnolency. There were many cases of failure
of crisis, and many of unfavorable crisis; many of dropsy and of
phthisis. Such were the diseases then epidemic. There were patients
affected with every one of the species which have been mentioned,
and many died. The symptoms in each of these cases were as follows:
  4. In many cases erysipelas, from some obvious cause, such as an
accident, and sometimes from even a very small wound, broke out all
over the body, especially, in persons about sixty years of age,
about the head, if such an accident was neglected in the slightest
degree; and this happened in some who were under treatment; great
inflammation took place, and the erysipelas quickly spread all over.
in the most of them abscessed ended in suppurations, and there were
great fallings off (sloughing) of the flesh, tendons, and bones; and
the defluxion which seated in the part was not like pus, but a sort of
putrefaction, and the running was large and of various characters.
Those cases in which any of these things happened about the head
were accompanied with falling off of the hairs of the head and chin,
the bones were laid bare and separated, and there were excessive
runnings; and these symptoms happened in fevers and without fevers.
But these things were more formidable in appearance than dangerous;
for when the concoction in these cases turned to a these cases
turned to a suppuration, most of them recovered; but when the
inflammation and erysipelas disappeared, and when no abscess was
formed, a great number of these died. In like manner, the same
things happened to whatever part of the body the disease wandered, for
in many cases both forearm and arm dropped off; and in those cases
in which it fell upon the sides, the parts there, either before or
behind, got into a bad state; and in some cases the whole femur and
bones of the leg and whole foot were laid bare. But of all such cases,
the most formidable were those which took place about the pubes and
genital organs. Such was the nature of these cases when attended
with sores, and proceeding from an external cause; but the same things
occurred in fevers, before fevers, and after fevers. fevers. But those
cases in which an abscess was formed, and turned to a suppuration,
or a seasonable diarrhea or discharge of good urine took place, were
relieved thereby: but those cases in which none of these symptoms
occurred, but they disappeared without a crisis, proved fatal. The
greater number of these erysipelatous cases took place in the
spring, but were prolonged through the summer and during autumn.
  5. In certain cases there was much disorder, and tumors about the
fauces, and inflammations of the tongue, and abscesses about the
teeth. And many were attacked with impairment or loss of speech; at
first, those in the commencement of phthisis, but also persons in
ardent fever and in phrenitis.
  6. The cases of ardent fever and phrenitis occurred early in
spring after the cold set in, and great numbers were taken ill at that
time, and these cases were attended with acute and fatal symptoms. The
constitution of the ardent fevers which then occurred was as
follows: at the commencement they were affected with coma, nausea, and
rigors; fever acute, not much thirst, nor delirium, slight
epistaxis, the paroxysms for the most part on even days; and, about
the time of the paroxysms, forgetfulness, loss of strength and of
speech, the extremities, that is to say, the hands and feet, at all
times, but more especially about the time of the paroxysms, were
colder than natural; they slowly and imperfectly became warmed, and
again recovered their recollection and speech. They were constantly
affected either with coma, in which they got which they got no
sleep, or with insomnolency, attended with pains; most had disorders
of the bowels, attended with undigested, thin, and copious
evacuations; urine copious, thin, having nothing critical nor
favorable about it; neither was there any other critical appearance in
persons affected thus; for neither was there any proper hemorrhage,
nor any other of the accustomed evacuations, to prove a crisis. They
died, as it happened, in an irregular manner, mostly about the crisis,
but in some instances after having lost their speech for a long
time, and having had copious sweats. These were the symptoms which
marked the fatal cases of ardent fever; similar symptoms occurred in
the phrenitic cases; but these were particularly free from thirst, and
none of these had wild delirium as in other cases, but they died
oppressed by a bad tendency to sleep, and stupor.
  7. But there were also other fevers, as will be described. Many
had their mouths affected with aphthous ulcerations. There were also
many defluxions about the genital parts, and ulcerations, boils
(phymata), externally and internally, about the groins. Watery
ophthalmies of a chronic character, with pains; fungous excrescences
of the eyelids, externally and internally, called fig, which destroyed
the sight of many persons. There were fungous growths, in many other
instances, on ulcers, especially on those seated on the genital
organs. There were many attacks of carbuncle (anthrax) through the
summer, and other affections, which are called "the putrefaction"
(seps); also large ecthymata, and large tetters (herpetes) in many
instances.
  8. And many and serious complaints attacked many persons in the
region of the belly. In the first place, tenesmus, accompanied with
pain, attacked many, but more especially children, and all who had not
attained to puberty; and the most of these died. There were many cases
of lientery and of dysentery; but these were not attended with much
pain. The evacuations were bilious, and fatty, and thin, and watery;
in many instances the disease terminated in this way, with and without
fever; there were painful tormina and volvuli of a malignant kind;
copious evacuations of the contents of the guts, and yet much remained
behind; and the passages did not carry off the pains, but yielded with
difficulty to the means administered; for in most cases purgings
were hurtful to those affected in this manner; many died speedily, but
in many others they held out longer. In a word, all died, both those
who had acute attacks and those who had chronic, most especially
from affections of the belly, for it was the belly which carried
them all off.
  9. All persons had an aversion to food in all the afore-mentioned
complaints to a degree such as I never met with before, and persons in
these complaints most especially, and those recovering from them,
and in all other diseases of a mortal nature. Some were troubled
with thirst, and some not; and both in febrile complaints and in
others no one drank unseasonably or disobeyed injunctions.
  10. The urine in many cases was not in proportion to the drink
administered, but greatly in excess; and the badness of the urine
voided was great, for it had not the proper thickness, nor concoction,
nor purged properly; for in many cases purgings by the bladder
indicate favorably, but in the greatest number they indicated a
melting of the body, disorder of the bowels, pains, and a want of
crisis.
  11. Persons laboring under phrenitis and causus were particularly
disposed to coma; but also in all other great diseases which
occurred along with fever. In the main, most cases were attended
either by heavy coma, or by short and light sleep.
  12. And many other forms of fevers were then epidemic, of tertian,
of quartan, of nocturnal, of continual, of chronic, of erratic, of
fevers attended with nausea, and of irregular fevers. All these were
attended with much disorder, for the bowels in most cases were
disordered, accompanied with rigors, sweats not of a critical
character, and with the state of the urine as described. In most
instances the disease was protracted, for neither did the deposits
which took place prove critical as in other cases; for in all
complaints and in all cases there was difficulty of crisis, want of
crisis, and protraction of the disease, but most especially in
these. A few had the crisis about the eightieth day, but in most
instances it (the disease?) left them irregularly. A few of them
died of dropsy without being confined to bed. And in many other
diseases people were troubled with swelling, but more especially in
phthisical cases.
  13. The greatest and most dangerous disease, and the one that proved
fatal to the greatest number, was consumption. With many persons it
commenced during the winter, and of these some were confined to bed,
and others bore up on foot; the most of those died early in spring who
were confined to bed; of the others, the cough left not a single
person, but it became milder through the summer; during the autumn,
all these were confined to bed, and many of them died, but in the
greater number of cases the disease was long protracted. Most of these
were suddenly attacked with these diseases, having frequent rigors,
often continual and acute fevers; unseasonable, copious, and cold
sweats throughout; great coldness, from which they had great
difficulty in being restored to heat; the bowels variously
constipated, and again immediately in a loose state, but towards the
termination in all cases with violent looseness of the bowels; a
determination downwards of all matters collected about the lungs;
urine excessive, and not good; troublesome melting. The coughs
throughout were frequent, and copious, digested, and liquid, but not
brought up with much pain; and even when they had some slight pain, in
all cases the purging of the matters about the lungs went on mildly.
The fauces were not very irritable, nor were they troubled with any
saltish humors; but there were viscid, white, liquid, frothy, and
copious defluxions from the head. But by far the greatest mischief
attending these and the other complaints, was the aversion to food, as
has been described. For neither been described. For neither had they
any relish for drink along with their food, but continued without
thirst. There was heaviness of the body, disposition to coma, in
most cases swelling, which ended in dropsy; they had rigors, and
were delirious towards death.
  14. The form of body peculiarly subject to phthisical complaints was
the smooth, the whitish, that resembling the lentil; the reddish,
the blue-eyed, the leucophlegmatic, and that with the scapulae
having the appearance of wings: and women in like manner, with
regard to the melancholic and subsanguineous, phrenitic and dysenteric
affections principally attacked them. Tenesmus troubled young
persons of a phlegmatic temperament. Chronic diarrhoea, acrid and
viscid discharges from the bowels, attacked those who were troubled
with bitter bile.
  15. To all those which have been described, the season of spring was
most inimical, and proved fatal to the greatest numbers: the summer
was the most favorable to them, and the fewest died then; in autumn,
and under the Pleiades, again there died great numbers. It appears
to me, according to the reason of things, that the coming on of summer
should have done good in these cases; for winter coming on cures the
diseases of summer, and summer coming on removes the diseases of
winter. And yet the summer in question was not of itself well
constituted, for it became suddenly hot, southerly, and calm; but, not
withstanding, it proved beneficial by producing a change on the
other constitution.
  16. I look upon it as being a great part of the art to be able to
judge properly of that which has been written. For he that knows and
makes a proper use of these things, would appear to me not likely to
commit any great mistake in the art. He ought to learn accurately
the constitution of every one of the seasons, and of the diseases;
whatever that is common in each constitution and disease is good,
and whatever is bad; whatever disease will be protracted and end in
death, and whatever will be protracted and end in recovery; which
disease of an acute nature will end in death, and which in recovery.
From these it is easy to know the order of the critical days, and
prognosticate from them accordingly. And to a person who is skilled in
these things, it is easy to know to whom, when, and how aliment
ought to be administered.


                  Sixteen Cases of Disease

  CASE I. In Thasus, the Parian who lodged above the Temple of Diana
was seized with an acute fever, at first of a continual and ardent
type; thirsty, inclined to be comatose at first, and afterwards
troubled with insomnolency; bowels disordered at the beginning,
urine thin. On the sixth day, passed oily urine, was delirious. On the
seventh, all the symptoms were exacerbated; had no sleep, but the
urine of the same characters, and the understanding disordered; alvine
dejections bilious and fatty. On the eighth, a slight epistaxis; small
vomiting of verdigris-green matters; slept a little. On the ninth,
in the same state. On the tenth, all the symptoms gave way. On the
eleventh, he sweated, but not over the whole body; he became cold, but
immediately recovered his heat again. On the fourteenth, acute
fever; discharges bilious, thin, and copious; substances floating in
the urine; he became incoherent. On the seventeenth, in a painful
state, for he had no sleep, and the fever was more intense. On the
twentieth, sweated all over; apyrexia, dejections bilious; aversion to
food, comatose. On the twenty-fourth, had a relapse. On the
thirty-fourth, apyrexia; bowels not confined; and he again recovered
his heat. Fortieth, apyrexia, bowels confined for no long time,
aversion to food; had again slight symptoms of fever, and throughout
in an irregular form; apyrexia at times, and at others not; for if the
fever intermitted, and was alleviated for a little, it immediately
relapsed again; he used much and improper food; sleep bad; about the
time of the relapse he was delirious; passed thick urine at that time,
but troubled, and of bad characters; bowels at first confined, and
again loose; slight fevers of a continual type; discharges copious and
thin. On the hundred and twentieth day he died. In this patient the
bowels were constantly from the first either loose, with bilious,
liquid, and copious dejections, or constipated with hot and undigested
faeces; the urine throughout bad; for the most part coma, or
insomnolency with pain; continued aversion to food. Ardent fever.
  Explanation of the characters. It is probable that the weakness
produced by the fever, the phrenitis, and affection of the
hypochondrium caused death on the hundred and twentieth day.
  CASE II. In Thasus, the woman who lodged near the Cold Water, on the
third day after delivery of a daughter, the lochial discharge not
taking place, was seized with acute fever, accompanied with rigors.
But a considerable time before delivery she was feverish, confined
to bed, and loathed her food. After the rigor which took place,
continual and acute fevers, with rigors. On the eighth and following
days, was very incoherent, and immediately afterwards became
collected; bowels disordered, with copious, thin, watery, and
bilious stools; no thirst. On the eleventh was collected, but disposed
to coma; urine copious, thin, and black; no sleep. On the twentieth,
slight chills, and immediately afterwards was warm; slight
incoherence; no sleep; with regard to the bowels, in the same
condition; urine watery, and copious. On the twenty-seventh, free from
fever; bowels constipated; not long afterwards violent pain of the
right hip-joint for a considerable time; fevers afterwards supervened;
urine watery. On the fortieth, complaints about the hip-joint
better; continued coughs, with copious, watery sputa; bowels
constipated; aversion to food; urine the same; fever not leaving her
entirely, but having paroxysms in an irregular form, sometimes
present, sometimes not. On the sixtieth, the coughs left her without a
crisis, for no concoction of the sputa took place, nor any of the
usual abscesses; jaw on the right side convulsively retracted;
comatose, was again incoherent, and immediately became collected;
utter aversion to food; the jaw became relaxed; alvine discharges
small, and bilious; fever more acute, affected with rigors; on the
following days lost her speech, and again became collected, and
talked. On the eightieth she died. In this case the urine throughout
was black, thin, and watery; coma supervened; there was aversion to
food, aversion to food, despondency, and insomnolency; irritability,
restlessness; she was of a melancholic turn of mind.
  Explanation of the characters. It is probable that the suppression
of the lochial discharge caused death on the day.
  CASE III. In Thasus, Pythion, who was lodged above the Temple of
Hercules, from labor, fatigue, and neglected diet, was seized with
strong rigor and acute fever; tongue dry, thirsty, and bilious; had no
sleep; urine darkish, eneorema floating on the top of the urine, did
not subside. On the second day, about noon, coldness of the
extremities, especially about the hands and head; loss of speech and
of articulation; breathing short for a considerable time; recovered
his heat; thirst; passed the night quietly; slight sweats about the
head. On the third, passed the day in a composed state; in the
evening, about sunset, slight chills; nausea, agitation; passed the
night in a painful state; had no sleep; small stools of compact faeces
passed from the bowels. On the fourth, in the morning, composed; about
noon all the symptoms became exacerbated; coldness, loss of speech,
and of articulation; became worse; recovered his heat after a time;
passed black urine, having substances floating in it; the night quiet;
slept. On the fifth, seemed to be lightened, but a painful weight
about the belly; thirsty, passed the night in a painful state. On
the sixth, in the morning, in a quiet state; in the evening the
pains greater; had a paroxysm; in the evening the bowels properly
opened by a small clyster; slept at night. On the seventh, during
the day, in a state of nausea, somewhat disturbed; passed urine of the
appearance of oil; at night, much agitation, was incoherent, did not
sleep. On the eighth, in the morning, slept a little; but
immediately coldness, loss of speech, respiration small and weak;
but in the evening recovered his heat again; was delirious, but
towards day was somewhat lightened; stools small, bilious, and
unmixed. On the ninth, affected with coma, and with nausea when
roused; not very thirsty; about sunset he became restless and
incoherent; passed a bad night. On the tenth, in the morning, had
become speechless; great coldness; acute fever; much perspiration;
he died. His sufferings were on the even days.
  Explanation of the characters. It is probable that the excessive
sweats caused death on the tenth day.
  CASE IV. The patient affected with phrenitis, having taken to bed on
the first day, vomited largely of verdigris-green and thin matters;
fever, accompanied with rigors, copious and continued sweats all over;
heaviness of the head and neck, with pain; urine thin, substances
floating in the urine small, scattered, did not subside; had copious
dejections from the bowels; very delirious; no sleep. On the second,
in the morning, loss of speech; acute fever; he sweated, fever did not
leave him; palpitations over the whole body, at night, convulsions. On
the third, all the symptoms exacerbated; he died.
  Explanation of the characters. It is probable that the sweats and
convulsions caused death.
  CASE V. In Larissa, a man, who was bald, suddenly was seized with
pain in the right thigh; none of the things which were administered
did him any good. On the first day, fever acute, of the ardent type,
not agitated, but the pains persisted. On the second, the pains in the
thigh abated, but the fever increased; somewhat tossed about; did
not sleep; extremities cold; passed a large quantity of urine, not
of a good character. On the third, the pain of the thigh ceased;
derangement of the intellect, confusion, and much tossing about. On
the fourth, about noon, he died. An acute disease.
  CASE VI. In Abdera, Pericles was seized with a fever of the acute,
continual type, with pain; much thirst, nausea, could not retain his
drink; somewhat swelled about the spleen, with heaviness of the
head. On the first day, had hemorrhage from the left nostril, but
still the fever became more violent; passed much muddy, white urine,
which when allowed to stand did not subside. On the second day, all
the symptoms were exacerbated, yet the urine was thick, and more
inclined to have a sediment; the nausea less; he slept. On the
third, fever was milder; abundance of urine, which was concocted,
and had a copious sediment; passed a quiet night. On the fourth, had a
copious and warm sweat all over about noon; was free of fever, had a
crisis, no relapse. An acute affection.
  CASE VII. In Abdera, the young woman who was lodged in the Sacred
Walk was seized with an ardent fever. She was thirsty, and could not
sleep; had menstruation for the first time. On the sixth, much nausea,
flushing, was chilly, and tossed about. On the seventh, in the same
state; urine thin,but of a good color; no disturbance about the
bowels. On the eighth, deafness, acute fever, insomnolency, nausea,
rigors, became collected; urine the same. On the ninth, in the same
state, and also on the following days; thus the deafness persisted. On
the fourteenth, disorder of the intellect; the fever abated. On the
seventeenth, a copious hemorrhage from the nose; the deafness slightly
better; and on the following days, nausea, deafness, and
incoherence. On the twentieth, pain of the feet; deafness and delirium
left her; a small hemorrhage from the nose; sweat, apyrexia. On the
twenty-fourth, the fever returned, deafness again; pain of the feet
remained; incoherence. On the twenty-seventh, had a copious sweat,
apyrexia; the deafness left her; the pain of her feet partly remained;
in other respects had a complete crisis.
  Explanation of the characters. It is probable that the restoration
of health on the twentieth day was the result of the evacuation of
urine.
  CASE VIII. In Abdera, Anaxion, who was lodged near the with Thracian
Gates, was seized with an acute fever; pain of the right dry cough,
without expectoration during the first days, thirst, insomnolency;
urine well colored, copious, and thin. On the sixth, delirious; no
relief from the warm applications. On the seventh, in a painful state,
for the fever while the pains did not abate, and the cough was
troublesome, and attended with dyspnoea. On the eighth, I opened a
vein at the elbow, and much blood, of a proper character, flowed;
the pains were abated, but the dry coughs continued. On the
eleventh, the fever diminished; slight sweats about the head;
coughs, with more liquid sputa; he was relieved. On the twentieth,
sweat, apyrexia; but after the crisis he was thirsty, and the
expectorations were not good. On the twenty-seventh the fever
relapsed; he coughed, and brought up much concocted sputa: sediment in
the urine copious and white; he became free of thirst, and the
respiration was good. On the thirty-fourth, sweated all over, apyrexia
general crisis.
  Explanation of the characters. It is probable that the evacuation of
the sputa brought about the recovery on the thirty-fourth day.
  CASE IX. In Abdera, Heropythus, while still on foot, had pain in the
head, and not long afterwards he took to bed; he lived near the High
Street. Was seized with acute fever of the ardent type; vomitings at
first of much bilious matter; thirst; great restlessness; urine
thin, black, substances sometimes floating high in it, and sometimes
not; passed the night in a painful state; paroxysms of the fever
diversified, and for the most part irregular. About the fourteenth
day, deafness; the fever increased; urine the same. On the twentieth
and following days, much delirium. On the thirtieth, copious
hemorrhage from the nose, and became more collected; deafness
continued, but less; the fever diminished; on the following days,
frequent hemorrhages, at short intervals. About the sixtieth, the
hemorrhages ceased, but violent pain of the hip-joint, and increase of
fever. Not long afterwards, pains of all the inferior rule, that
either the fever and deafness increased, or, pains of the inferior
parts were increased. About the eightieth day, all the complaints gave
way, without leaving any behind; for the urine was of a good color,
and had a copious sediment, while the delirium became less. About
the hundredth day, disorder of the bowels, with copious and bilious
evacuations, and these continued for a considerable time, and again
assumed the dysenteric form with pain; but relief of all the other
complaints. On the whole, the fevers went off, and the deafness
ceased. On the hundred and twentieth day, had a complete crisis.
Ardent fever.
  Explanation of the characters. It is probable that the bilious
discharge brought about the recovery on the hundred and twentieth day.
  CASE X. In Abdera, Nicodemus was seized with fever from venery and
drinking. At the commencement he was troubled with nausea and
cardialgia; thirsty, tongue was parched; urine thin and dark. On the
second day, the fever exacerbated; he was troubled with rigors and
nausea; had no sleep; vomited yellow bile; urine the same; passed a
quiet night, and slept. On the third, a general remission;
amelioration; but about sunset felt again somewhat uncomfortable;
passed an uneasy night. On the fourth, rigor, much fever, general
pains; urine thin, with substances floating in it; again a quiet
night. On the fifth, all the symptoms remained, but there was an
amelioration. On the sixth, some general pains; substances floating in
the urine; very incoherent. On the seventh, better. On the eighth, all
the other symptoms abated. On the tenth, and following days, there
were pains, but all less; in this case throughout, the paroxysms and
pains were greater on the even days. On the twentieth, the urine white
and thick, but when allowed to stand had no sediment; much sweat;
seemed to be free from fever; but again in the evening he became
hot, with the same pains, rigor, thirst, slightly incoherent. On the
twenty-fourth, urine copious, white, with an abundant sediment; a
copious and warm sweat all over; apyrexia; the fever came to its
crisis.
  Explanation of the characters. It is probable that the cure was
owing to the bilious evacuations and the sweats.
  CASE XI. In Thasus, a woman, of a melancholic turn of mind, from
some accidental cause of sorrow, while still going about, became
affected with loss of sleep, aversion to food, and had thirst and
nausea. She lived near the Pylates, upon the Plain. On the first, at
the commencement of night, frights, much talking, despondency,
slight fever; in the morning, frequent spasms, and when they ceased,
she was incoherent and talked obscurely; pains frequent, great and
continued. On the second, in the same state; had no sleep; fever
more acute. On the third, the spasms left her; but coma, and
disposition to sleep, and again awaked, started up, and could not
contain herself; much incoherence; acute fever; on that night a
copious sweat all over; apyrexia, slept, quite collected; had a
crisis. About the third day, the urine black, thin, substances
floating in it generally round, did not fall to the bottom; about
the crisis a copious menstruation.
  CASE XII. In Larissa, a young unmarried woman was seized with a
fever of the acute and ardent type; insomnolency, thirst; tongue sooty
and dry; urine of a good color, but thin. On the second, in an
uneasy state, did not sleep. On the third, alvine discharges
copious, watery, and greenish, and on the following days passed such
with relief. On the fourth, passed a small quantity of thin urine,
having substances floating towards its surface, which did not subside;
was delirious towards night. On the sixth, a great hemorrhage from the
nose; a chill, with a copious and hot sweat all over; apyrexia, had
a crisis. In the fever, and when it had passed the crisis, the
menses took place for the first time, for she was a young woman.
Throughout she was oppressed with nausea, and rigors; redness of the
face; pain of the eyes; heaviness of the head; she had no relapse, but
the fever came to a crisis. The pains were on the even days.
  CASE XIII. Apollonius, in Abdera, bore up (under the fever?) for
some time, without betaking himself to bed. His viscera were enlarged,
and for a considerable time there was a constant pain about the liver,
and then he became affected with jaundice; he was flatulent, and of
a whitish complexion. Having eaten beef, and drunk unseasonably, he
became a little heated at first, and betook himself to bed, and having
used large quantities of milk, that of goats and sheep, and both
boiled and raw, with a bad diet otherwise, great mischief was
occasioned by all these things; for the fever was exacerbated, and
of the food taken scarcely any portion worth mentioning was passed
from the bowels; the urine was thin and scanty; no sleep;
troublesome meteorism; much thirst; disposition to coma; painful
swelling of the right hypochondrium; extremities altogether coldish;
slight incoherence, forgetfulness of everything he said; he was beside
himself. About the fourteenth day after he betook himself to bed,
had a rigor, became heated, and was seized with furious delirium; loud
cries, much talking, again composed, and then coma came on; afterwards
the bowels disordered, with copious, bilious, unmixed, and
undigested stools; urine black, scanty, and thin; much restlessness;
alvine evacuations of varied characters, either black, scanty, and
verdigrisgreen, or fatty, undigested, and acrid; and at times the
dejections resembled milk. About the twenty-fourth, enjoyed a calm;
other matters in the same state; became somewhat collected; remembered
nothing that had happened since he was confined to bed; immediately
afterwards became delirious; every symptom rapidly getting worn. About
the thirtieth, acute fever; stools copious and thin; was delirious;
extremities cold; loss of speech. On the thirty-fourth he died. In
this case, as far as I saw, the bowels were disordered; urine thin and
black; disposition to coma; insomnolency; extremities cold;
delirious throughout. Phrenitis.
  CASE XIV. In Cyzicus, a woman who had brought forth twin
daughters, after a difficult labor, and in whom the lochial
discharge was insufficient, at first was seized with an acute fever,
attended with chills; heaviness of the head and neck, with pain;
insomnolency from the commencement; she was silent, sullen, and
disobedient; urine thin, and devoid of color; thirst, nausea for the
most part; bowels irregularly disordered, and again constipated. On
the sixth, towards night, talked much incoherently; had no sleep.
About the eleventh day was seized with wild delirium, and again became
collected; urine black, thin, and again deficient, and of an oily
appearance; copious, thin, and disordered evacuations from the bowels.
On the fourteenth, frequent convulsions;extremities cold; not in
anywise collected; suppression of urine. On the sixteenth loss of
speech. On the seventeenth, she died. Phrenitis.
  Explanation of the characters. It is probable that death was caused,
on the seventeenth day, by the affection of the brain consequent
upon her accouchement.
  CASE XV. In Thasus, the wife of Dealces, who was lodged upon the
Plain, from sorrow was seized with an acute fever, attended with
chills. From first to last she wrapped herself up in her bedclothes;
still silent, she fumbled, picked, bored, and gathered hairs (from
them); tears, and again laughter; no sleep; bowels irritable, but
passed nothing; when directed, drank a little; urine thin and
scanty; to the touch of the hand the fever was slight; coldness of the
extremities. On the ninth, talked much incoherently, and again
became composed and silent. On the fourteenth, breathing rare,
large, at intervals; and again hurried respiration. On the
sixteenth, looseness of the bowels from a stimulant clyster;
afterwards she passed her drink, nor could retain anything, for she
was completely insensible; skin parched and tense. On the twentieth,
much talk, and again became composed; loss of speech; respiration
hurried. On the twenty-first she died. Her respiration throughout
was rare and large; she was totally insensible; always wrapped up in
her bedclothes; either much talk, or completely silent throughout.
Phrenitis.
  CASE XVI. In Meliboea, a young man having become heated by
drinking and much venery, was confined to bed; he was affected with
rigors and nausea; insomnolency and absence of thirst. On the first
day much faeces passed from the bowels along with a copious flux;
and on the following days he passed many watery stools of a green
color; urine thin, scanty, and deficient in color; respiration rare,
large, at long intervals; softish distention of the hypochondrium,
of an oblong form, on both sides; continued palpitation in the
epigastric region throughout; passed urine of an oily appearance. On
the tenth, he had calm delirium, for he was naturally of an orderly
and quiet disposition; skin parched and tense; dejections either
copious and thin, or bilious and fatty. On the fourteenth, all the
symptoms were exacerbated; he became delirious, and talked much
incoherently. On the twentieth, wild delirium, On the twentieth,
wild delirium, jactitation, passed no urine; small drinks were
retained. On the twenty-fourth he died. Phrenitis.


                           -THE END-
