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THE FIRST BOOK OF EPIDEMICS. - Hippocrates, The Writings of Hippocrates and Galen 
The Writings of Hippocrates and Galen. Epitomised from the Original Latin translations, by John Redman Coxe (Philadelphia: Lindsay and Blakiston, 1846).
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THE FIRST BOOK OF EPIDEMICS.
This book, says Haller, is one of the principal works of Hippocrates, and is by all, attributed to him. It is a production worthy of him, although consisting chiefly of a history of diseases, unmixed with medicine. Its value consists in his description of them, and his notice of crises. It contains, under three sections, the statement of the seasons for three years, as occurring at Thasus, followed by the rise of an epidemic state of disease of two years’ continuance; in one of these recurrent fevers predominated, and ardent fevers in the other. To these last belong a large proportion of fourteen patients here recorded, and with mostly a fatal termination. One case is particularly interesting, of a parturient female who recovered after a very prolonged disease.—Haller.
SECTION I. YEAR I.
In Thasus in the autumn, about the equinox, and under the Pleiades, the rains were great, continual, and soft, as when the wind is southerly. The winter mild, with southerly winds, and very little northerly. With these were greater droughts than ordinary, so that the whole winter was, in effect, like the spring. The spring was also affected with southerly winds, but yet was cold, and a little wet. The summer was for the most part cloudy and dry. The Etesiæ blew but little, faintly, and irregularly.
The whole year being thus affected with southerly winds, and greater droughts than ordinary, early in the spring (from the former year’s being different, and affected with northerly winds) some few were attacked with burning fevers of a kind good sort, and a few others with hemorrhages, neither of which proved mortal. Swellings appeared behind the ears, in many on one side, in most on both, without a fever or any confinement, but in some with a little fever. In all they disappeared without either inconvenience or suppuration, contrary to the custom of such tumours from other causes. At this particular time they were naturally soft, large, diffused, without inflammation or pain, and went off universally without any visible signs. Children, young persons, adults, especially those who frequented the public places of exercise, were most subject to them. A few women were also affected. The greatest part had dry coughs, which were soon succeeded by hoarsenesses. Some again after a while had painful phlegmons upon the testicles, sometimes upon one, sometimes upon both. Some had fevers, others none; most of them trouble and fatigue enough: but with respect to the chirurgical part they did very well.
Early in the summer, and from that time till the winter, many of those who had been for a long while somewhat consumptive, were laid up with consumptions; and others, who were doubtful, were then fatally convinced. Others again, where nature tended that way, dated the beginning of it from that time. A great number of such patients dropped off; and I do not remember that any of those who were laid up held out even a moderate time, but died much sooner than is usual in such cases, after having suffered other complaints, and those for a long time, in their fevers, without either fatigue or dying. Of these we shall now treat: for the only, and the greatest of the diseases then reigning, and that proved fatal to many, was the consumption.
The manner in which most of them were affected is as follows. They were seized with continual, acute fevers, attended with a chilliness, but no intermission; of the semitertian kind; the fit being one day moderate, the next vehement, and so increasing to great vehemence. They sweated continually, but not all over. The extremities were very cold, and grew warm again with difficulty. The belly was disturbed with bilious, small, simple, thin, griping stools, and that frequently. The urine thin, without colour, crude, and little in quantity; or else thick, with a small sediment, that did not subside well, but appeared crude and unseasonable. They coughed a little and often, and the matter expectorated was indeed digested, but brought away by little and little, and with difficulty. Where the case was very violent, no digestion happened, but what they spit was continually crude. The throats of most of them were from the beginning and all along painful, red, and inflamed. The rheum that came from them little, thin, and sharp. A consumption and general disorder soon followed. An aversion to all kind of food was continually upon them, but without thirst; and many, before they died, became delirious. Thus the case stood among the consumptive.
In the summer and the autumn many fevers came on, of the continual kind, though not violent; and that to such as had been long ill, but in other respects not worn out. Disorders of the belly likewise happened to many, but such as were very tolerable, and without any remarkable injury. The urine was generally well coloured and clear, but thin, and after a while, about the crisis, digested. Coughs were moderate, and expectoration easy; nor were they so averse to food, but very willing to take what was given them. In a word, these consumptive patients were affected in a manner different from such a state, sweating a little in their chilly fevers; while others were seized with paroxysms in a vague and uncertain manner, never leaving them entirely, but returning as a semitertian. The crisis happened upon the twentieth day at the shortest, in most upon the fortieth, and in many upon the eightieth. In some again it never happened, but the fever went off in an erratic or wandering manner. Here indeed it returned again for the most part, after a short intermission; and after the return came to its crisis in the same periods as before. Many of them held out so long, as to be ill in the winter; but of all here described none but the consumptive died. The rest bore their fevers and other complaints very well and escaped.
SECTION II. YEAR II.
In Thasus, early in the autumn, the weather was unseasonable, and on a sudden grew wet with much northerly and southerly wind, that lasted the whole time of the Pleiades, and even to their setting. The winter was affected with northerly winds; the rains were great and heavy, attended with snow, and for the most part a mixture of fair weather. Thus the whole affair stood; and, with respect to the cold, what happened was not very unseasonable. But after the winter solstice, and when the west wind begins to blow, there was very severe winter weather, with much northerly wind and snow, and abundance of rain without ceasing. Over head it looked stormy and cloudy. This state lasted without remission to the equinox. The spring was cold, northerly, watery, and cloudy; the summer not very scorching. The Etesiæ blew continually; and, about the rising of Arcturus, a great deal of rain fell again on a sudden, with northerly winds. The whole year being thus damp and cold, affected with northerly winds, they passed the winter well for the most part, but in the beginning of the spring many persons (not to say a great many) were taken ill.
First of all appeared humid ophthalmies (or inflammations of the eyes), with weepings, pain, and indigestion. Little concreted matter broke out with difficulty on the eyes of many persons, returned again in most, and went away at last about autumn. In the summer and the autumn, dysenteries, tenesmuses, and lienteries, were complained of; so were bilious purgings, of a thin, crude, griping nature, and much in quantity. Others again were watery; and many complained of painful fluxes that were also bilious, watery, ragged, purulent, and strangurious; not from any fault in the kidneys, but from one humour or complaint coming upon another. They likewise vomited bile, and phlegm, and indigested food. They sweated too in general, the humidity being great every where. To many these things happened without a fever or confinement, to others with a fever, as we shall see hereafter. Where all that is here mentioned happened, they became consumptive, not without pain.
In the autumn and the winter, continual fevers turned out, besides a few that were ardent, diurnal, nocturnal, semitertians, perfect tertians, quartans, and erratics; every one of which happened to many, but ardent fevers to very few, and were the least troublesome: for they were neither taken with bleedings, unless in a very small quantity, and that but seldom, nor with deliriums. In all other respects they bore it well. The crisis happened to most in a very regular manner (intermissions included) in seventeen days generally, without any body’s dying or becoming phrenitic. Tertians were more frequent than ardents, and more troublesome. In all the progress was very regular from the first paroxysm to the fourth, and the seventh proved a perfect crisis, without any relapse. Quartans attacked many at first as a quartan should, and many were seized with it as the crisis of other fevers and diseases. These were of long standing, and indeed longer than usual. Quotidians, nocturnals, and erratics were likewise frequent, and lasted long, both among those who were confined at home, and those who walked about. The major part could not get rid of their fevers during the Pleiades, nor even till winter. Convulsions were also frequent, especially among children, from the beginning, but not without a fever. They came upon fevers likewise, and lasted a long time in general, but without any harm, except where other circumstances had made the case desperate. The other fevers were altogether of the continual kind, without any intermission, and the paroxysms in all like the semitertians, one day better, another day worse; and, of all the fevers that then reigned, these were the most vehement, the most tedious, and the most painful; beginning very mildly, but increasing always, and growing worse and worse upon the critical days. After a little abatement they soon grew bad again, had stronger fits upon the critical days, and were for the most part worse. Shiverings were universally irregular and uncertain, seldom and very little in these, but in other fevers more. Sweats were common, but here least of all, and so far from easing the patient, that on the contrary they did him harm. The extremities were very cold, and could scarce grow warm again. Nor were they altogether watchful, especially in this case, but fell again into comas. The belly in all was disturbed, and in a bad manner, but worst of all by much in these. The urine was for the most part thin, crude, without colour, and after a while appeared a little digested as though critical; or had some consistence in it, but yet was turbid without any sediment or concoction; at least the sediment was but little, and that bad and crude. In fine all these things were bad. The fevers were likewise attended with coughs, but I cannot say that I perceived either good or harm from them. Most of these complaints were tedious and difficult, very irregular and inconstant, and that without coming to a crisis, either in those whose case was desperate, or in those whose case was not so. For, if it intermitted a little at any time, it soon returned again; and in the few that had the benefit of a crisis, it happened not at the soonest before the eightieth day, and to some of these it returned, so that many of them were ill in the winter. In the greatest part it went off without a crisis; and these things happened alike to those who did well, and to those who did not.
As there was a great want of the critical variety that is usual in diseases, the greatest and worst symptom attended many of them to the last, viz.: a general dislike to food, especially where other fatal circumstances appeared. They were not indeed very thirsty out of season, but after a long time, a great deal of pain, and a bad decay, abscesses formed themselves, sometimes too great for the patient’s strength to bear, at other times too little to be of any service; so that a relapse presently followed, and the patient grew worse and worse. Dysenteries, tenesmuses, lienteries, and fluxes were likewise added; and some fell into dropsies. Nauseas and great uneasiness happened with and without these. Whatever was very vehement, either despatched the patient soon, or was of no benefit to him at all. Little eruptions appeared, not equal to the vehemence of the disease, and soon after disappeared again; or swellings behind the ears, that were by no means critical, and so signified nothing. Others were affected in their joints, especially the hip, where it proved critical to a few, but it soon after got the better and returned to its former state.
It proved fatal to persons of every age, but chiefly to children just weaned, and to those of eight or ten years old, and those under the age of puberty. These were thus affected, not without the first circumstances here mentioned, but the first happened to many without these. The only beneficial thing, and the greatest of the signs then existing, and what saved many in the greatest extremity, was the strangury. For this way the disease spent itself; and it was a frequent complaint, especially among those tender patients, as well as among those who were not obliged to lie by their illness, and those who were. This proved a speedy and great change throughout. For, if the belly was affected with ill-conditioned fluxes, they stopped; food in general became agreeable to them; and the fever grew mild after this crisis. But the strangury complaints were lasting and painful; and the urine copious, thick, various, red, and partly purulent, not without pain. All these recovered to a man, as far as I know.
Where no danger is suspected, we are to consider the digestions of what passes off, whether they are all every where considerable or seasonable, good and critical. Digestions imply a quick crisis, and a sure recovery; but crudities, indigestions, and bad abscesses, imply no crisis at all, or else pains, or duration, or death, or returns of the same complaints. But which of these is most likely to happen, must be considered from other things; the duty of a physician being to relate what is past, to understand what is present, and to foretell what is to come. He is also to take special care of two things, viz., to do good in his office, or at least no harm.
The art consists in three particulars, viz., the disease, the patient, and the physician, who is the servant or assistant of the art, and the patient is to concur with the physician in opposing the power of the disease.
Pains and heavinesses about the head and neck, with or without a fever, in phrenitic cases denote convulsions; and æruginous vomitings succeed. Some of these die presently. But in burning fevers and others, a pain of the neck, a heaviness of the temples, a dimness of the sight, or a painful distension of the hypochondre, denote a hemorrhage from the nose. Where the whole head is heavy, attended with heartburns and nauseas, bilious and phlegmatic vomitings succeed. Children are generally attacked thus, and mostly affected with convulsions in these cases. Women are also attacked, and with pains in their private parts. But old persons, and those whose heat is got the better of, are attacked with palsies, madnesses, or blindness.
SECTION III. YEAR III.
In Thasus, a little before the rising of Arcturus, and during its continuance, there fell many great showers with northerly winds; but about the equinox, and to the rising of the Pleiades, little southerly showers. The winter was northerly, and drier than ordinary. The winds cold, and the snows deep. About the equinox the cold was sharpest. The spring was northerly and drier than ordinary; but yet the weather was a little wet and cold. About the summer solstice a little rain with a great deal of cold, to the rising of the Dog-star; from which time to the rising of Arcturus the summer was hot, and the heats were great and scorching, not gradually or at intervals, but continually. The droughts were also great, and the Etesiæ blew. About the rising of Arcturus southerly gentle showers fell to the equinox.
During this state of the weather, in the winter, paraplegias began and attacked many, some of whom died in a short time: for the disease was very epidemical. In other respects they were well. But in the very beginning of the spring burning fevers came on, and continued to the equinox, and even to the summer. Most of those escaped who were seized presently after the beginning of the spring and summer, and some few died: but when the autumn and wet weather set in, they proved mortal to many. These fevers were of such a nature, that where any one bled freely and plentifully at the nose, he was saved by it more than by any thing else; and not one of those who were taken thus died this season, so far as I know. For Philiscus, and Epaminon, and Silenus, bled but a few drops at the nose the fourth and fifth day, and died. Most of them were seized with shiverings about the crisis, especially where there had been no hemorrhage, and with the shivering came on a sweat about the head and shoulders. Others again were attacked with a jaundice the sixth day, and these were relieved either by a discharge by urine or stool, or a plentiful hemorrhage, as Heraclides was, who lived with Aristocydes. Not but he bled at the nose, and had the benefit of the other evacuations too; and so was freed the twentieth. It fared otherwise with the servant of Phanagoras; for, as none of these things happened to him, he died. Hemorrhages were very frequent, especially among young persons and adults; and, where nothing of this kind happened, it very often proved fatal. Those who were more advanced in years had the jaundice, or a disorder in their belly, or a dysentery, as Bion, who lived with Silenus. In the summer, dysenteries were epidemical; and, even where hemorrhages had happened, some were at last seized with dysenteries, as Eraton’s boy, for instance, and Myllus; for they, after a great hemorrhage, fell into a dysentery, and recovered. This humour was particularly redundant in many. For, where there was no hemorrhage at the crisis, the tumours behind the ears disappeared, and upon this a weight was felt in the left side of the belly, and at the extremity of the hip. Pain coming on after the crisis, and thin urine passing off, they began to bleed a little. Thus Antiphon, the son of Critobulus, had the twenty-fourth day a separation of humours by bleeding; his disorder ceased, and about the fortieth he got quite rid of it. Many women were taken ill, but less than the men, and died less. Many of them had hard labours, and after the birth were taken ill again, and for the most part died, as Telebolus’s daughter, who died the sixth day after her delivery. A great many had their menses come down in their fevers; others bled at the nose, and many young girls had the first appearance of their menses then. Others again bled at the nose, and had their menses too, as Dætharsis’s daughter, for instance, a maid, who had them then for the first time, and also bled plentifully at the nose. Nor do I remember any died, where any one of these happened well. All of my acquaintance miscarried that chanced to be with child. The urine was in general well coloured but thin, and with a small sediment. The stools were thin and bilious. And in many, where there was a crisis in other respects, it terminated in a dysentery, as in Xenophanes and Critias. The urine was watery, much, clear, and thin; and even after the crisis, where there was a good sediment, and in other respects a laudable crisis, a dysentery came upon some, as particularly upon Bion who lived with Silenus, Critias with Xenophanes, Areton’s boy, and Mnesistratus’s wife, who were all afterwards seized with a dysentery. Query? Whether it was owing to the watery urine?
About the rising of Arcturus a crisis happened to many the eleventh day, nor did the fever return again in the natural and usual way of returns; but they were comatose at this time, especially children, of whom fewer died than any. But about the equinox, to the rising of the Pleiades, and even in the winter, burning fevers continued. About the same time too a great many became phrenitic, and went off; and a few in the summer. These burning fevers pointed out the prognostics from the beginning, where the case was desperate. For immediately an acute fever came on from the first, with gentle shiverings, watchings, ramblings, thirst, nauseas, and anxiety. They sweated a little about the forehead and collar-bone, but nobody all over. Great deliriums attended, with fears and dejectedness; the extremities were coldish, the toes and fingers especially. The paroxysms were upon equal days, and in many the greatest pains upon the fourth. The sweats were generally somewhat cold. The extremities did not recover their warmth, but were livid and cold; nor did they then complain of thirst. The urine was black, little, and thin; the body bound. No hemorrhage from the nose, where this was the case, but only a few drops; nor did any of these relapse, but died the sixth day in a sweat. As to the phrenitics, all the circumstances here mentioned did not happen to them, but the crisis came on generally the eleventh day, and in some the twentieth. Where the frenzy did not immediately appear from the beginning about the third or fourth day, but things went on moderately at first, there the fever raged most upon the seventh.
The number of diseases was now very great, and those who died of them were chiefly children, young persons, adults, and such as had smooth bodies, white skins, straight hair, black hair, and black eyes. The lazy and indolent died likewise, and so did those whose voice was either high, small, or rough, and where there was any impediment in the speech, or a choleric temper. Many women of this kind died too. But, during this situation, some were preserved by the four following particulars, viz., by bleeding plentifully at the nose; by making a great deal of water with a large and good sediment; by considerable bilious stools; or by falling into a dysentery. These proved critical to a great many, not singly indeed, but jointly, though not without much trouble. However all such escaped whose case was thus. Women, too, and maids were subject to every one of these symptoms; and where any of them happened well, or where the menses came down plentifully, it proved a salutary crisis, and none of them died. For, as to Philon’s daughter, who bled freely at the nose, she died the seventh day, after having eat a very improper and unseasonable supper.
In acute fevers, and especially burning fevers, involuntary tears are a sign of a hemorrhage from the nose, if other circumstances denote not death. In this case, they are a sign of death and not a hemorrhage.
In a fever painful swellings behind the ears sometimes neither fall nor suppurate, though the fever goes off entirely. In this case a bilious looseness, or a dysentery, or thick urine with a sediment, is salutary, as in the case of Hermippus of Clazomenæ.
Critical circumstances, by which we distinguish, are either alike or unlike, as in the case of the two brothers, who lived by Epigenes’s Theatre, and were taken ill the same hour. The eldest had his crisis the sixth day; the youngest, the seventh; both of them relapsed the same hour. It intermitted five days, and after the return both were entirely freed the seventeenth. Many had a crisis the fifth, an intermission seven days, and another crisis the fifth. Others again had their crisis upon the seventh, an intermission seven days, and the last crisis the third day after the return. Some had a crisis the seventh, an intermission three days, and another crisis the seventh. Others again had a crisis the sixth, and an intermission six days: after this an attack for three days; then, an intermission one day, and the next a return and crisis the same day; as Euagon the son of Daitharsus. To some it came to a crisis the sixth, intermitted seven, and was determined the fourth day after the return, as in Aglaidas’s daughter. The greatest number of those who were taken ill this season were thus affected; and I know of none that escaped without a relapse, according to the natural course of relapses. Neither do I know of any that miscarried, where the relapses happened in this manner; nor of any, thus affected, who had returns again. But many died the sixth day, among whom were Epaminondas, Silenus, and Philiscus, the son of Antagoras.
Where any tumours happened behind the ears, the crisis came on the twentieth; the tumours subsided universally where no suppuration followed, and were turned upon the bladder. But in Cratistonax’s case, who lived by Hercules’ Temple, and in that of Scymnus, the fuller’s maid-servant, where a suppuration happened, they died. In some the crisis happened the seventh, the intermission nine days, and another crisis the fourth day after the return. In others the crisis happened the seventh, the intermission six days, and the other crisis seven days after the return; as it did to Phanocritus, who lived by Gnathon, the painter. But in the winter, about the winter solstice, and even to the equinox, the burning fevers and phrensies remained, and were very mortal. The crisis happened to many the fifth day from the beginning, and after an intermission of four days the fever returned again, and five days after this the other crisis came on, in all fourteen days. Thus it happened to most children, and to those of a more advanced age. Sometimes the crisis came on the eleventh, the return the fourteenth, and the perfect crisis the twentieth. But, if any were seized with shiverings upon the twentieth, it was then protracted to the fortieth. The greatest part shivered upon the first crisis; and those who shivered at the beginning shivered again at the crisis, and the relapses after the crisis. But shiverings happen least in the spring, more in the summer, more still in the autumn, and most of all in the winter. The hemorrhages also ceased.
The knowledge of diseases is to be learnt from the common nature of all things, and from the nature of every individual; from the disease, the patient, the things that are administered, and the person that administers them; for the case becomes easier or more difficult accordingly. We are to consider likewise the whole season in general, and the particular state of the weather, and of every country; the customs, the diet, the employments, the ages of every one, the conversations, the manners, the taciturnity, the imaginations, the sleeps, the watchings, and the dreams; and how far vellications, itchings, and tears are concerned; and what the paroxysms are; and what the evacuations by stool, or urine, or spitting, or vomiting may be; and what changes may happen from one disease to another, and the separations that end in death or life. Sweat, cold, shiverings, coughs, sneezings, sighings, breathings, belchings, flatuses (secret and audible), hemorrhages, and hemorrhoids, are also to be considered, together with their respective consequences.
Of fevers, some are continual, others affect us in the day, and intermit at night; or continue in the night, and leave us in the day. There are likewise semitertians, tertians, quartans, quintans, septans, and nonans; but the acutest, the strongest, the most dangerous, and the most fatal, are the continual. The safest, the easiest, and the longest of any is the quartan; for it is thus not only in its own nature, but also frees us from other great diseases. The semitertian is attended with acute disorders, and is more fatal than any of the rest. Add to this, that consumptive persons, and those who have been long ill of other distempers, are most subject to it. The nocturnal is not very dangerous, but tedious. The diurnal longer, and sometimes tends to a consumption. The septan is long, but not dangerous; the nonan longer, but not dangerous. A true tertian comes to its crisis soon without danger; but a quintan is the worst of all; for coming before or upon a consumption, it is death. In every one of these fevers, as well continual as intermitting, there are forms, conditions, and paroxysms to be considered. For instance, a continual, sometimes flowers as it were, at the beginning, becomes very vehement, and grows worse and worse; but about the crisis, and at the time of the crisis, becomes weaker. Sometimes again it begins mildly and secretly, increases and grows worse every day, but about the crisis, and during that time, breaks out vehemently. At another time it begins mildly, increases more and more, and, coming to its full strength by a certain time, remits again at the crisis, and during all that time. These things happen in every fever and every disease.
The diet should likewise be regulated by these considerations. And there are many other considerable signs of the like nature with these, some of which we have treated of already, and the rest shall be considered hereafter. But whoever undertakes this province in good earnest should try and inquire which of them is acute and mortal, and which recoverable; where food is proper, and where it is not; without omitting the time, the quantity, and the quality.
Where the paroxysms are upon equal days, there the crisis is upon equal days; and where they are upon unequal, there the crisis is so too.
The first critical day of the periods that terminate upon equal days is the fourth, then the sixth, the eighth, the tenth, the fourteenth, the twenty-eighth, the thirtieth, the forty-eighth, the sixtieth, the eightieth, and the hundredth. The first of those that terminate upon unequal days is the third, then the fifth, the seventh, the ninth, the eleventh, the seventeenth, the twenty-first, the twenty-seventh, and the thirty-first. And if a crisis happens otherwise, or out of these mentioned days, a relapse is to be feared, and even death. It is also to be considered, that the crises that shall happen at these times will be salutary or fatal, or there will be a turn for the better or the worse. As to erratic fevers, quartans, quintans, septans, and nonans, their critical periods are also to be considered.
Philiscus, who dwelt by the wall, took to his bed the first day. An acute fever, a sweat, and an uneasy night followed. The next day he was worse in all respects; but in the evening had a good discharge from a glyster, and afterwards a quiet night. The third day betimes, and till noon, his fever seemed to have left him, but in the evening it returned with vehemence, attended with a sweat, a thirst, a dry tongue, black urine, an uneasy night, no sleep, and much delirium. The fourth day, worse in all respects. Black urine; but an easier night, and the urine well-coloured. The fifth, about noon, a few drops of pure blood from the nose. The urine very various, with round seed-like particles floating up and down, without any sediment. A suppository brought away a little wind. A restless night. Little sleeps, with rambling discourse. The extremites cold all over, without any return of warmth. Black urine. A little sleep. In the day loss of speech, a cold sweat, and the extremities livid. Died about the middle of the sixth day.
His breath was all along drawn back, as it were, deep, and seldom. Upon the spleen was a round swelling. Cold sweats continually. The paroxysms upon equal days.
Silenus, who lived upon the sea-shore, near to Eualcides’s, was seized with a violent fever after labour, and drinking, and unseasonable exercise. It began with pain in the loins, a heaviness in the head, and a stiffness in the neck. His stools the first day were bilious, simple, frothy, deep-coloured, and many. His urine black, with a black sediment. A thirst came on, with a dry tongue, and no sleep in the night. The second day, an acute fever. More stools, thinner, and frothy. Black urine. An uneasy night. Rambled a little. The third, worse in all respects. A distension of both the flanks, reaching to the navel, but softish withal. His stools thin and blackish. The urine turbid and blackish. No sleep in the night. He talked much, laughed, sung, and could not contain himself. The fourth, no alteration. The fifth, his stools were simple, bilious, smooth, and greasy. His urine thin and transparent. His understanding recovered itself a little. The sixth, a little sweat about the head, the extreme parts cold and livid. Much tumbling and tossing. No evacuation by stool or urine. The fever acute. The seventh, loss of speech. No warmth in the extremities. No urine. The eighth, a cold sweat all over, with little, red, round eruptions, like pimples in the face, that remained without coming to suppuration. From a gentle stimulus of the belly a great discharge of thin, and as it were undigested fæces, with pain; and what came away by urine was acrid and painful. The extremities a little warmer. Light sleeps, with a comatose disorder. Loss of speech. Thin transparent urine. The ninth, no alteration. The tenth, drank nothing. A coma, with light sleeps. From the belly, the same discharge as before. A great deal of thick urine, that came away gushing, and afterwards let fall a white sediment, like ground barley; the extremities cold again. The eleventh, he died.
His breath was all along, from the beginning, deep and seldom; his flanks continually palpitating; and his age about twenty.
Herophon was seized with an acute fever, and had a small discharge downwards, with a tenesmus at the beginning, but afterwards his stools were thin, bilious, and frequent. No sleep. Black, thin urine. The fifth, betimes in the morning, he grew deaf, and was worse in all respects. His spleen swelled, and his flanks were distended. His stools were small and black; and his head rambled. The sixth, he was delirious, sweated at night, was cold, and delirious still. The seventh, was cold outwardly, thirsty, and delirious; at night came to himself, and slept. The eighth, was feverish, but not so swelled in his spleen; and came perfectly to himself. A swelling appeared in the groin for the first time, on the same side with the spleen; after which a pain seized him in both his legs. He rested pretty well; his urine was well-coloured, and had a small sediment. The ninth, he sweated, and was cured. The fifth, it returned again, and immediately his spleen swelled. The fever was acute, and his deafness returned. Three days after this, the spleen and deafness grew better; his legs were uneasy, and a sweat came on in the night. The crisis happened the seventeenth, without his being delirious after the return.
In Thasus, Philinus’s wife was seized with a fever and shivering, the fourteenth day after her delivery of a daughter, her affairs going on very well, without any reason for complaint in other respects. The upper part of the stomach, the right hypochondre, and her private parts grew painful from the first. Her cleansings stopped. However, by help of a pessary she grew easier; but the pain in her head, neck, and loins remained. She could get no sleep; was cold in her extremes; and a thirst succeeded. Her belly was in a manner burnt up, and discharged very little. Her urine was thin, and without colour at first. The sixth, she was very delirious at night, and then came to herself again. The seventh, was thirsty; and her stools were bilious and deep-coloured. The eighth, a shivering came on, with an acute fever, and many convulsions followed, with pain. She also talked much out of the way; got up to receive a suppository; had a great discharge downwards of bilious matter; but no sleep. The ninth, was convulsed. The tenth, came a little to herself. The eleventh, slept, remembered every thing, but in a little time grew lightheaded. After the convulsions made a great deal of water in a little while (the servants, or those about her, seldom reminding her), of a thick and white kind, like what appears upon shaking water that has subsided after standing a long time, but had no sediment; in colour and consistence like that which is made by a beast of burden, so far as I saw. About the fourteenth she trembled all over, talked much, and came a little to herself; but soon became lightheaded again. About the seventeenth, lost her speech; and the twentieth, died.
Epicrates’s wife, who lived by Archigetes’s, just before her labour, was taken with a violent shivering, and could not grow warm again, as I was informed. The next day, she was much the same. The third, she was delivered of a daughter, and every thing went on well. The second day after the birth an acute fever seized her, with pains in the pit of her stomach and private parts, which were mitigated by a pessary; but a pain in the head, neck, and loins continued, without any sleep. Her stools were small, bilious, thin, and simple. Her urine thin and blackish. The sixth day after she had been taken, at night she grew delirious. The seventh, was worse in all respects; watchful, delirious, thirsty; and had bilious, deep-coloured stools. The eighth, shivered, and slept much. The ninth, no alteration. The tenth, a pain in her legs and the pit of her stomach again, with a heaviness in her head, but without a delirium. She slept more, but had no stool. The eleventh, the urine was better coloured, and the sediment large. She felt herself lighter. The fourteenth shivered again, and was very feverish. The fifteenth, vomited bilious yellow matter, pretty often; sweated, and missed her fever; but at night it returned violently. Her water was thick, and with a white sediment. The sixteenth, worse again, rested badly, got no sleep, and was lightheaded. The eighteenth, was thirsty, and the tongue burnt up. No sleep; much lightheadedness; pain in the legs. About the twentieth, betimes in the morning, shivered a little, and was comatose or stupified; slept quietly; vomited a little bilious black matter; and grew deaf in the night. About the twenty-first, a pleuritic pain came on quite through the left side, with a gentle cough. The urine was thick, turbid, reddish, and did not subside after standing. In other respects she was easier, but not without her fever. Her throat was inflamed and painful immediately from the first; the uvula was contracted; and the rheum remained sharp, biting, and salt continually. About the twenty-seventh, the fever left her; the urine broke, but the side was painful. About the thirty-first, the fever came on again; her stools were bilious and stimulating. The fortieth, she vomited a little bile, and was entirely freed from her fever the eightieth.
Cleonactis, who lived above the Temple of Hercules, was taken ill with a violent fever of the erratic kind. He had a pain of the head and the left side from the beginning, and in the other parts of his body pains like those that proceed from weariness. The paroxysms of the fever were very irregular, sometimes with, sometimes without, a sweat; but for the most part they appeared upon the critical days more than upon others. About the twenty-fourth, he was cold at his fingers’ ends; vomited bilious yellow stuff pretty often, and soon after æruginous; and was better in every respect. About the thirtieth, he bled from both nostrils, irregularly, a little at a time, to the crisis. He had neither an aversion to food, nor a thirst all the time, nor want of sleep; and his urine was thin, though not without colour. About the fortieth, it appeared reddish, and had a large sediment, very red, that relieved him. After this it changed several ways, and sometimes had a sediment, at other times none. The sixtieth, there was a great, white, smooth sediment; all the complaints abated; his fever intermitted; and his urine was thin again, but well-coloured. The seventieth, he had no fever, and it intermitted ten days. The eightieth, a shivering came on, and an acute fever. A great sweat followed; the sediment in his urine was red and smooth; and he obtained a perfect crisis.
Meton was taken ill of a very acute fever, with a heaviness and pain in his loins. The second day, he had a good discharge downwards, from drinking a pretty large quantity of water. The third, a heaviness in his head, with thin, bilious, reddish stools. The fourth, worse in all respects. A little blood from the left nostril twice. A restless night. Stools, as before. Blackish urine, with a blackish cloud floating up and down, without any sediment. The fifth, a great deal of pure blood from the left nostril; a sweat, and a crisis; but after the crisis, want of sleep, lightheadedness, and thin blackish urine. After bathing the head he slept, and came to himself; had no relapse afterwards, but frequent hemorrhages, even after the crisis.
Erasinus, who lived by the Torrent of Bootes, grew very feverish after supper, and had a very bad night. The first day he was easy, but in pain in the night. The second, worse in all respects, and at night lightheaded. The third, uneasy, and very delirious. The fourth, exceeding ill, and had no sleep at night, but dreamed and talked, and was afterwards remarkably worse, frightened, and impatient. The fifth, betimes in the morning, was composed and came perfectly to himself, but before noon was so raving mad, that he could not contain himself. His extreme parts were cold, and somewhat livid; his urine stopped; and about sunset he died.
This patient’s fever was continually upon him, with sweats; his flanks were tumefied, distended, and painful; his urine black, with round clouds that subsided not; his belly not bound; his thirst perpetual, but not great; and before he died, he was convulsed much and sweated.
Criton, in Thasus, was seized, as he was walking, with a violent pain of his foot from the great toe, and obliged to go to bed the same day. A chilliness ensued, with nauseas, a gentle heat, and at night a delirium. The second day, the whole foot was swelled, and a redness appeared about the ankle with the skin stretched. Little black spots (or pimples) appeared likewise. An acute fever came on, with violent ravings. His stools were unmixed, bilious, and very frequent. The second day of his illness he died.
The Clazomenian, who lived by Phrynichides’s well, was seized with a violent fever, attended from the beginning with a pain of the head, neck, and loins; and immediately after with a deafness. No sleep; the fever acute; the flanks tumefied, but without any great distension; and the tongue dry. The fourth day, he was delirious at night. The fifth, was uneasy, and worse in every respect. About the eleventh, a little remission. His stools from the beginning to the fourteenth, were thin, large, and watery, without fatiguing him. After this they stopped. The urine all along was thin indeed, but of a good colour, and had many clouds here and there, without subsiding. But about the sixteenth day, his urine was a little thicker, with a small sediment. He was somewhat relieved, and came more to himself. The seventeenth it was thin again. Swellings arise behind both the ears, attended with pain. He got no sleep, but was delirious, and had a pain in his legs. The twentieth, the fever left him. The crisis came on without a sweat, and he recovered himself perfectly. About the twenty-seventh, a violent, but short, pain of his right hip seized him. The swellings behind the ears neither subsided nor suppurated, but were painful. The thirty-first, many watery stools, with pain and difficulty, as in a dysentery. The urine thick; the swellings went away. But, about the fortieth, a pain of the right eye came on with a dulness of sight, that went off again.
Dromeadas’s wife, the second day after she had been brought to bed of a daughter, and had no reason to complain of her other affairs, was seized with a shivering and an acute fever. The hypochondres began to be painful the first day. A nausea came on, with horrors and tossings, nor could she afterwards sleep. She fetched her breath deep and seldom, and immediately drew it back again. The second day after the shivering she had a very good stool; her urine was thick, white, and turbid, as when it is shook after standing a long time, but had no sediment. No sleep in the night. The third day about noon she shivered again, and was very feverish. The urine, as before; the flanks painful, with nauseas; an uneasy night, and no sleep. She was also in a coldish sweat all over, but presently grew warm again. The fourth, the hypochondres were a little easier, but the head heavy and painful, with somewhat of a stupidness. A few drops from the nose; a dry tongue, and thirsty; the urine thin and oily; and with these a little sleep. The fifth, she was thirsty and qualmish. The urine as before, and the body bound. About noon was very lightheaded, and presently after came to herself again. Upon getting up was somewhat stupid, and a little cold; slept in the night, and was lightheaded. The sixth day betimes in the morning she shivered again, and presently grew warm; sweated all over, but the extremities were cold; grew lightheaded, and breathed deep and seldom. Soon after convulsions came on from the head, and she went off presently.
A man who was a little feverish got his supper and drank plentifully, but in the night brought up all again. An acute fever followed, with a pain of the right hypochondre, and a gentle softish inflammation tending outwards. He rested badly; his urine at first was thick, red, and had no sediment after standing; his tongue dry, but not very thirsty. The fourth, an acute fever, with pain all over. The fifth, smooth, oily urine in great quantity. A raging fever. The sixth, in the evening, he was very lightheaded, and had no sleep in the night. The seventh, was worse in all respects. The urine, as before. He talked much, and could not contain himself. The belly, being stimulated, discharged watery turbid stuff with worms. An uneasy night. Betimes in the morning a shivering, and acute fever; a hot sweat followed, and the fever seemed to go off. He slept but little, and upon waking was cold, spit much, and in the evening was very delirious. Soon after he vomited black stuff, a little bilious. The ninth, was cold again, very delirious, and got no sleep. The tenth, had a pain in his legs, and was in all respects worse and delirious. The eleventh, died.
A woman that lived upon the shore, three months gone with child, was taken with a violent fever, and immediately complained of pain in her loins. The third day she had a pain in her neck, head, collar-bone, and right hand; and in a short time lost her speech. Her right hand was convulsed, and became paralytic. She grew very delirious, had an uneasy night, and got no sleep, but discharged a little bilious unmixed matter downwards. The fourth, she recovered her speech, but the convulsions remained as before, with pains all over. About the hypochondre a painful swelling appeared. She could get no sleep; grew lightheaded; discharged downwards; and her urine was thin, but not well-coloured. The fifth, a violent fever; a pain in the hypochondre; great lightheadedness; bilious stools; a sweat at night, and no fever. The sixth, she came to herself, and was better every way; but about the left collar-bone the pain remained. A thirst came on; the urine was thin, and she got no sleep. The seventh, tremblings followed, with something of stupidness. She was also a little delirious, and the pain about the collar-bone and left arm remained. In other respects she was better, and came to herself perfectly. The intermission lasted three days without any fever. The eleventh, it returned, with shivering and great vehemence. About the fourteenth, she vomited bilious yellow matter pretty often; fell into a sweat, and was cured.
Melidia, who lived by the Temple of Juno, complained of a violent pain in her head, neck, and breast; and presently after an acute fever came on. Her menses came down a little, with a continual pain in all those parts. The sixth she was comatose, qualmish, chilly, and red about the cheek, with something of a delirium. The seventh, sweated; the fever intermitted; the pains remained; the fever returned again; and she slept a little. Her urine was constantly thin, but well-coloured; her stools thin, bilious, acrid, very small, black and fetid; the sediment in the urine white and smooth. She fell into a sweat, and had a perfect crisis the eleventh.