of the epidemics-第3章

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nausea；　insignificant　sweats　about　the　forehead　and　clavicles；　but



no　general　perspiration；　they　had　much　delirious　talking；　fears；



despondency；　great　coldness　of　the　extremities；　in　the　feet；　but



more　especially　in　their　hands：　the　paroxysms　were　on　the　even　days；



and　in　most　cases；　on　the　fourth　day；　the　most　violent　pains　set　in；



with　sweats；　generally　coldish；　and　the　extremities　could　not　be



warmed；　but　were　livid　and　rather　cold；　and　they　had　then　no　thirst；



in　them　the　urine　was　black；　scanty；　thin；　and　the　bowels　were



constipated；　there　was　an　hemorrhage　from　the　nose　in　no　case　in　which



these　symptoms　occurred；　but　merely　a　trifling　epistaxis；　and　none



of　them　had　a　relapse；　but　they　died　on　the　sixth　day　with　sweats。



In　the　phrenitic　cases；　all　the　symptoms　which　have　been　described　did



not　occur；　but　in　them　the　disease　mostly　came　to　a　crisis　on　the



eleventh　day；　and　in　some　on　the　twentieth。　In　those　cases　in　which



the　phrenitis　did　not　begin　immediately；　but　about　the　third　or　fourth



day；　the　disease　was　moderate　at　the　commencement；　but　assumed　a



violent　character　about　the　seventh　day。　There　was　a　great　number　of



diseases；　and　of　those　affected；　they　who　died　were　principally



infants；　young　persons；　adults　having　smooth　bodies；　white　skins；



straight　and　black　hair；　dark　eyes；　those　living　recklessly　and



luxuriously；　persons　with　shrill；　or　rough　voices；　who　stammered　and



were　passionate；　and　women　more　especially　died　from　this　form。　In



this　constitution；　four　symptoms　in　particular　proved　salutary；　either



a　hemorrhage　from　the　nose；　or　a　copious　discharge　by　the　bladder　of



urine；　having　an　abundant　and　proper　sediment；　or　a　bilious　disorder



of　the　bowels　at　the　proper　time；　or　an　attack　of　dysentery。　And　in



many　cases　it　happened；　that　the　crisis　did　not　take　place　by　any



one　of　the　symptoms　which　have　been　mentioned；　but　the　patient



passed　through　most　of　them；　and　appeared　to　be　in　an　uncomfortable



way；　and　yet　all　who　were　attacked　with　these　symptoms　recovered。



All　the　symptoms　which　I　have　described　occurred　also　to　women　and



girls；　and　whoever　of　them　had　any　of　these　symptoms　in　a　favorable



manner；　or　the　menses　appeared　abundantly；　were　saved　thereby；　and　had



a　crisis；　so　that　I　do　not　know　a　single　female　who　had　any　of　these



favorably　that　died。　But　the　daughter　of　Philo；　who　had　a　copious



hemorrhage　from　the　nose；　and　took　supper　unseasonably　on　the



seventh　day；　died。　In　those　cases　of　acute；　and　more　especially　of



ardent　fevers；　in　which　there　is　an　involuntary　discharge　of　tears；



you　may　expect　a　nasal　hemorrhage　unless　the　other　symptoms　be　of　a



fatal　type；　for　in　those　of　a　bad　description；　they　do　not　indicate



a　hemorrhage；　but　death。



　　12。　Swellings　about　the　ears；　with　pain　in　fevers；　sometimes　when



the　fever　went　off　critically；　neither　subsided　nor　were　converted



into　pus；　in　these　cases　a　bilious　diarrhoea；　or　dysentery；　or　thick



urine　having　a　sediment；　carried　off　the　disease；　as　happened　to



Hermippus　of　Clazomenae。　The　circumstances　relating　to　crises；　as



far　as　we　can　recognize　them；　were　so　far　similar　and　so　far



dissimilar。　Thus　two　brothers　became　ill　at　the　same　hour　（they　were



brothers　of　Epigenes；　and　lodged　near　the　theatre）；　of　these　the　elder



had　a　crisis　on　the　sixth　day；　and　the　younger　on　the　seventh；　and



both　had　a　relapse　at　the　same　hour；　it　then　left　them　for　five



days；　and　from　the　return　of　the　fever　both　had　a　crisis　together　on



the　seventeenth　day。　Most　had　a　crisis　on　the　sixth　day；　it　then



left　them　for　six　days；　and　from　the　relapse　there　was　a　crisis　on　the



fifth　day。　But　those　who　had　a　crisis　on　the　seventh　day；　had　an



intermission　for　seven　days；　and　the　crisis　took　place　on　the　third



day　after　the　relapse。　Those　who　had　a　crisis　on　the　sixth　day；



after　an　interval　of　six　days　were　seized　again　on　the　third；　and



having　left　them　for　one　day；　the　fever　attacked　them　again　on　the



next　and　came　to　a　crisis；　as　happened　to　Evagon　the　son　of



Daetharses。　Those　in　whom　the　crisis　happened　on　the　sixth　day；　had　an



intermission　of　seven　days；　and　from　the　relapse　there　was　a　crisis　on



the　fourth；　as　happened　to　the　daughter　of　Aglaidas。　The　greater



part　of　those　who　were　taken　ill　under　this　constitution　of　things；



were　affected　in　this　manner；　and　I　did　not　know　a　single　case　of



recovery；　in　which　there　was　not　a　relapse　agreeably　to　the　stated



order　of　relapses；　and　all　those　recovered　in　which　the　relapses



took　place　according　to　this　form：　nor　did　I　know　a　single　instance　of



those　who　then　passed　through　the　disease　in　this　manner　who　had



another　relapse。



　　13。　In　these　diseases　death　generally　happened　on　the　sixth　day；



as　with　Epaminondas；　Silenus；　and　Philiscus　the　son　of　Antagoras。



Those　who　had　parotid　swellings　experienced　a　crisis　on　the



twentieth　day；　but　in　all　these　cases　the　disease　went　off　without



coming　to　a　suppuration；　and　was　turned　upon　the　bladder。　But　in



Cratistonax；　who　lived　by　the　temple　of　Hercules；　and　in　the　maid



servant　of　Scymnus　the　fuller；　it　turned　to　a　suppuration；　and　they



died。　Those　who　had　a　crisis　on　the　seventh　day；　had　an　intermission



of　nine　days；　and　a　relapse　which　came　to　a　crisis　on　the　fourth　day



from　the　return　of　the　fever；　as　was　the　case　with　Pantacles；　who



resided　close　by　the　temple　of　Bacchus。　Those　who　had　a　crisis　on



the　seventh　day；　after　an　interval　of　six　days　had　a　relapse；　from



which　they　had　a　crisis　on　the　seventh　day；　as　happened　to



Phanocritus；　who　was　lodged　with　Gnathon　the　fuller。　During　the



winter；　about　the　winter　solstices；　and　until　the　equinox；　the



ardent　fevers　and　frenzies　prevailed；　and　many　died。　The　crisis；



however；　changed；　and　happened　to　the　greater　number　on　the　fifth



day　from　the　commencement；　left　them　for　four　days　and　relapsed；　and



after　the　return；　there　was　a　crisis　on　the　fifth　day；　making　in　all



fourteen　days。　The　crisis　took　place　thus　in　the　case　of　most



children；　also　in　elder　persons。　Some　had　a　crisis　on　the　eleventh



day；　a　relapse　on　the　fourteenth；　a　complete　crisis　on　the



twentieth；　but　certain　persons；　who　had　a　rigor　about　the　twentieth；



had　a　crisis　on　the　fortieth。　The　greater　part　had　a　rigor　along



with　the　original　crisis；　and　these　had　also　a　rigor　about　the



crisis　in　the　relapse。　There　were　fewest　cases　of　rigor　in　the　spring；



more　in　summer；　still　more　in　autumn；　but　by　far　the　most　in　winter；



then　hemorrhages　ceased。



　　　　　　　　　　　　　　　　　　　　　　　　　Sect。　III







　　1。　With　regard　to　diseases；　the　circumstances　from　which　we　form　a



judgment　of　them　are；…　by　attending　to　the　general　nature　of　all；



and　the　peculiar　nature　of　each　individual；…　to　the　disease；　the



patient；　and　the　applications；…　to　the　person　who　applies　them；　as



that　makes　a　difference　for　better　or　for　worse；…　to　the　whole



constitution　of　the　season；　and　particularly　to　the　state　of　the



heavens；　and　the　nature　of　each　country；…　to　the　patient's　habits；



regimen；　and　pursuits；…　to　his　conversation；　manners；　taciturnity；



thoughts；　sleep；　or　absence　of　sleep；　and　sometimes　his　dreams；　what



and　when　they　occur；…　to　his　picking　and　scratching；…　to　his　tears；…



to　the　alvine　discharges；　urine；　sputa；　and　vomitings；　and　to　the



changes　of　diseases　from　the　one　into　the　other；…　to　the　deposits；



whether　of　a　deadly　or　critical　character；…　to　the　sweat；　coldness；



rigor；　cough；　sneezing；　hiccup；　respiration；　eructation；　flatulence；



whether　passed　silently　or　with　a　noise；…　to　hemorrhages　and



hemorrhoids；…　from　these；　and　their　consequences；　we　must　form　our



judgment。



　　2。　Fevers　are；…　the　continual；　some　of　which　hold　during　the　day　and



have　a　remission　at　night；　and　others　hold　a　remission　during　the　day；



semi…tertians；　tertians；　quartans；　quintans；　septans；　nonans。　The　most



acute；　strongest；　most　dangerous；　and　fatal　diseases；　occur　in　the



continual　fever。　The　least　dangerous　of　all；　and　the　mildest　and



most　protracted；　is　the　quartan；　for　it　is　not　only　such　from



itself；　but　it　also　carries　off　other　great　diseases。　In　what　is



called　the　semi…tertian；　other　acute　diseases　are　apt　to　occur；　and　it



is　the　most　fatal　of　all　others；　and　moreover　phthisical　persons；



and　those　laboring　under　other　protracted　diseases；　are　apt　to　be



attacked　by　it。　The　nocturnal　fever　is　not　very　fatal；　but　protracted；



the　diurnal　is　still　more　protracted；　and　in　some　cases　passes　into



phthisis。　The　septan　is　protracted；　but　not　fatal；　the　nonan　more



protracted；　and　not　fatal。　The　true　tertian　comes　quickly　to　a　crisis；



and　is　not　fatal；　but　the　quintan　is　the　worst　of　all；　for　it　proves



fatal　when　it　precedes　an　attack　of　phthisis；　and　when　it　supervenes



on　persons　who　are　already　consumptive。　There　are　peculiar　modes；



and　constitutions；　and　paroxysms；　in　every　one　of　these　fevers；　for



example；…　the　continual；　in　some　cases　at　the　very　commencement；



grows；　as　it　were；　and　attains　its　full　strength；　and　rises　to　its



most　dangerous　pitch；　but　is　diminished　about　and　at　the　crisis；　in



others　it　begins　gentle　and　suppressed；　but　gains　ground　and　is



exacerbated　every　day；　and　bursts　forth　with　all　its　heat　about　and　at



the　crisis；　while　in　others；　again；　it　commences　mildly；　increases；



and　is　exacerbated　until　it　reaches　its　acme；　and　then　remits　until　at



and　about　the　crisis。　These　varieties　occur　in　every　fever；　and　in



every　disease。　From　these　observations　one　must　regulate　the　regimen



accordingly。　There　are　many　other　important　symptoms　allied　to



these；　part　of　which　have　been　already　noticed；　and　part　will　be



described　afterwards；　from　a　consideration　of　which　one　may　judge；　and



decided　in　each　case；　whether　the　disease　be　acute；　acute；　and　whether



it　will　end　in　death　or　recovery；　or　whether　it　will　be　protracted；



and　will　end　in　death　or　recovery；　and　in　what　cases　food　is　to　be



given；　and　in　what　not；　and　when　and　to　what　amount；　and　what



particular　kind　of　food　is　to　be　administered。



　　3。　Those　diseases　which　have　their　paroxysms　on　even　days　have　their



crises　on　even　days；　and　those　which　have　their　paroxysms　on　uneven



days　have　their　crises　on　uneven　days。　The　first　period　of　those　which



have　the　crisis　on　even　days；　is　the　4th；　6th；　8th；　10th；　14th；



20th；　30th；　40th；　60th；　80th；　100th；　and　the　first　period　of　those



which　have　their　crises　on　uneven　days；　is　the　1st；　3d；　5th；　7th；　9th；



11th；　17th；　21th；　27th；　31st。　It　should　be　known；　that　if　the　crisis



take　place　on　any　other　day　than　on　those　described；　it　indicates　that



there　will　be　a　relapse；　which　may　prove　fatal。　But　one　ought　to　pay



attention；　and　know　in　these　seasons　what　crises　will　lead　to　recovery