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Of the Epidemics

By Hippocrates
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Of the Epidemics

By Hippocrates

Written 400 B.C.E

Translated by Francis Adams

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Book II

Section 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 i. 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 ii. 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.

Section 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 i. 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 ii. 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 v. 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 i. 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 ii. 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 iii. 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 x. 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.

Section 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 i. 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 ii. 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 v. 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 i. 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 ii. 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 iii. 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 x. 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 i. 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 ii. 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 iii. 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 iv. 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 v. 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 vi. 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.


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