of the epidemics-第7章

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despondency；　strabismus　of　the　right　eye；　a　faint　cold　sweat　about　the



head；　extremities　cold。　On　the　fifth　day；　all　the　symptoms　were



exacerbated；　talked　much　incoherently；　and　again　immediately　became



collected；　had　no　thirst；　labored　under　insomnolency；　alvine



dejections　copious；　and　unseasonable　throughout；　urine　scanty；　thin；



darkish；　extremities　cold；　somewhat　livid。　On　the　sixth　day；　in　the



same　state。　On　the　seventh　she　died。　Phrenitis。



　　CASE　IX。　A　woman　who　lodged　near　the　Liars'　Market；　having　then



brought　forth　a　son　in　a　first　and　difficult　labor；　was　seized　with



fever。　Immediately　on　the　commencement　had　thirst；　nausea；　and



cardialgia；　tongue　dry；　bowels　disordered；　with　thin　and　scanty



dejections；　had　no　sleep。　On　the　second；　had　slight　rigor；　acute



fever；　a　faint　cold　sweat　about　the　head。　On　the　third；　painfully



affected；　evacuations　from　the　bowels　undigested；　thin；　and　copious。



On　the　fourth；　had　a　rigor；　all　the　symptoms　exacerbated；



insomnolency。　On　the　fifth；　in　a　painful　state。　On　the　sixth；　in　the



same　state；　discharges　from　the　bowels　liquid　and　copious。　On　the



seventh；　had　a　rigor；　fever　acute；　much　thirst；　much　tossing　about；



towards　evening　a　cold　sweat　over　all；　extremities　cold；　could　no



longer　be　kept　warm；　and　again　at　night　had　a　rigor；　extremities　could



not　be　warmed；　she　did　not　sleep；　was　slightly　delirious；　and　again



speedily　collected。　On　the　eighth；　about　mid…day；　she　became　warm；　was



thirsty；　comatose；　had　nausea；　vomited　small　quantities　of　yellowish



bile；　restless　at　night；　did　not　sleep；　passed　frequently　large



quantities　of　urine　without　consciousness。　On　the　ninth；　all　the



symptoms　gave　way；　comatose；　towards　evening　slight　rigors；　small



vomitings　of　bile。　On　the　tenth；　rigor；　exacerbation　of　the　fever；　did



not　sleep　at　all；　in　the　morning　passed　much　urine　having　a



sediment；　extremities　recovered　their　heat。　On　the　eleventh；　vomited



bile　of　a　verdigris…green　color；　not　long　after　had　a　rigor；　and　again



the　extremities　cold；　towards　evening　a　rigor；　a　cold　sweat；　much



vomiting；　passed　a　painful　night。　On　the　twelfth；　had　copious　black



and　fetid　vomitings；　much　hiccup；　painful　thirst。　On　the　thirteenth；



vomitings　black；　fetid；　and　copious；　rigor　about　mid…day；　loss　of



speech。　On　the　fourteenth；　some　blood　ran　from　her　nose；　she　died。



In　this　case　the　bowels　were　loose　throughout；　with　rigors：　her　age



about　seventeen。　An　ardent　fever。



　　　　　　　　　　　　　　　　　　　　　　　　Sect。　III







　　1。　The　year　was　southerly；　rainy；　no　winds　throughout。　Droughts



having　prevailed　during　the　previous　seasons　of　the　year；　the　south



winds　towards　the　rising　of　Arcturus　were　attended　with　much　rain。



Autumn　gloomy　and　cloudy；　with　copious　rains。　Winter　southerly；



damp；　and　soft。　But　long　after　the　solstice；　and　near　the　equinox；



much　wintery　weather　out　of　season；　and　when　now　close　to　the　equinox；



northerly；　and　winterly　weather　for　no　long　time。　The　spring　again



southerly；　calm；　much　rain　until　the　dog…days。　Summer　fine　and　hot；



great　suffocating　heats。　The　Etesian　winds　blew　small　and　irregular；



again；　about　the　season　of　Arcturus；　much　rains　with　north　winds。



　　2。　The　year　being　southerly；　damp；　and　soft　towards　winter；　all　were



healthy；　except　those　affected　with　phthisis；　of　whom　we　shall　write



afterwards。



　　3。　Early　in　spring；　along　with　the　prevailing　cold；　there　were



many　cases　of　erysipelas；　some　from　a　manifest　cause；　and　some　not。



They　were　of　a　malignant　nature；　and　proved　fatal　to　many；　many　had



sore…throat　and　loss　of　speech。　There　were　many　cases　of　ardent　fever；



phrensy；　aphthous　affections　of　the　mouth；　tumors　on　the　genital



organs；　of　ophthalmia；　anthrax；　disorder　of　the　bowels；　anorexia；　with



thirst　and　without　it；　of　disordered　urine；　large　in　quantity；　and　bad



in　quality；　of　persons　affected　with　coma　for　a　long　time；　and　then



falling　into　a　state　of　insomnolency。　There　were　many　cases　of　failure



of　crisis；　and　many　of　unfavorable　crisis；　many　of　dropsy　and　of



phthisis。　Such　were　the　diseases　then　epidemic。　There　were　patients



affected　with　every　one　of　the　species　which　have　been　mentioned；



and　many　died。　The　symptoms　in　each　of　these　cases　were　as　follows：



　　4。　In　many　cases　erysipelas；　from　some　obvious　cause；　such　as　an



accident；　and　sometimes　from　even　a　very　small　wound；　broke　out　all



over　the　body；　especially；　in　persons　about　sixty　years　of　age；



about　the　head；　if　such　an　accident　was　neglected　in　the　slightest



degree；　and　this　happened　in　some　who　were　under　treatment；　great



inflammation　took　place；　and　the　erysipelas　quickly　spread　all　over。



in　the　most　of　them　abscessed　ended　in　suppurations；　and　there　were



great　fallings　off　（sloughing）　of　the　flesh；　tendons；　and　bones；　and



the　defluxion　which　seated　in　the　part　was　not　like　pus；　but　a　sort　of



putrefaction；　and　the　running　was　large　and　of　various　characters。



Those　cases　in　which　any　of　these　things　happened　about　the　head



were　accompanied　with　falling　off　of　the　hairs　of　the　head　and　chin；



the　bones　were　laid　bare　and　separated；　and　there　were　excessive



runnings；　and　these　symptoms　happened　in　fevers　and　without　fevers。



But　these　things　were　more　formidable　in　appearance　than　dangerous；



for　when　the　concoction　in　these　cases　turned　to　a　these　cases



turned　to　a　suppuration；　most　of　them　recovered；　but　when　the



inflammation　and　erysipelas　disappeared；　and　when　no　abscess　was



formed；　a　great　number　of　these　died。　In　like　manner；　the　same



things　happened　to　whatever　part　of　the　body　the　disease　wandered；　for



in　many　cases　both　forearm　and　arm　dropped　off；　and　in　those　cases



in　which　it　fell　upon　the　sides；　the　parts　there；　either　before　or



behind；　got　into　a　bad　state；　and　in　some　cases　the　whole　femur　and



bones　of　the　leg　and　whole　foot　were　laid　bare。　But　of　all　such　cases；



the　most　formidable　were　those　which　took　place　about　the　pubes　and



genital　organs。　Such　was　the　nature　of　these　cases　when　attended



with　sores；　and　proceeding　from　an　external　cause；　but　the　same　things



occurred　in　fevers；　before　fevers；　and　after　fevers。　fevers。　But　those



cases　in　which　an　abscess　was　formed；　and　turned　to　a　suppuration；



or　a　seasonable　diarrhea　or　discharge　of　good　urine　took　place；　were



relieved　thereby：　but　those　cases　in　which　none　of　these　symptoms



occurred；　but　they　disappeared　without　a　crisis；　proved　fatal。　The



greater　number　of　these　erysipelatous　cases　took　place　in　the



spring；　but　were　prolonged　through　the　summer　and　during　autumn。



　　5。　In　certain　cases　there　was　much　disorder；　and　tumors　about　the



fauces；　and　inflammations　of　the　tongue；　and　abscesses　about　the



teeth。　And　many　were　attacked　with　impairment　or　loss　of　speech；　at



first；　those　in　the　commencement　of　phthisis；　but　also　persons　in



ardent　fever　and　in　phrenitis。



　　6。　The　cases　of　ardent　fever　and　phrenitis　occurred　early　in



spring　after　the　cold　set　in；　and　great　numbers　were　taken　ill　at　that



time；　and　these　cases　were　attended　with　acute　and　fatal　symptoms。　The



constitution　of　the　ardent　fevers　which　then　occurred　was　as



follows：　at　the　commencement　they　were　affected　with　coma；　nausea；　and



rigors；　fever　acute；　not　much　thirst；　nor　delirium；　slight



epistaxis；　the　paroxysms　for　the　most　part　on　even　days；　and；　about



the　time　of　the　paroxysms；　forgetfulness；　loss　of　strength　and　of



speech；　the　extremities；　that　is　to　say；　the　hands　and　feet；　at　all



times；　but　more　especially　about　the　time　of　the　paroxysms；　were



colder　than　natural；　they　slowly　and　imperfectly　became　warmed；　and



again　recovered　their　recollection　and　speech。　They　were　constantly



affected　either　with　coma；　in　which　they　got　which　they　got　no



sleep；　or　with　insomnolency；　attended　with　pains；　most　had　disorders



of　the　bowels；　attended　with　undigested；　thin；　and　copious



evacuations；　urine　copious；　thin；　having　nothing　critical　nor



favorable　about　it；　neither　was　there　any　other　critical　appearance　in



persons　affected　thus；　for　neither　was　there　any　proper　hemorrhage；



nor　any　other　of　the　accustomed　evacuations；　to　prove　a　crisis。　They



died；　as　it　happened；　in　an　irregular　manner；　mostly　about　the　crisis；



but　in　some　instances　after　having　lost　their　speech　for　a　long



time；　and　having　had　copious　sweats。　These　were　the　symptoms　which



marked　the　fatal　cases　of　ardent　fever；　similar　symptoms　occurred　in



the　phrenitic　cases；　but　these　were　particularly　free　from　thirst；　and



none　of　these　had　wild　delirium　as　in　other　cases；　but　they　died



oppressed　by　a　bad　tendency　to　sleep；　and　stupor。



　　7。　But　there　were　also　other　fevers；　as　will　be　described。　Many



had　their　mouths　affected　with　aphthous　ulcerations。　There　were　also



many　defluxions　about　the　genital　parts；　and　ulcerations；　boils



（phymata）；　externally　and　internally；　about　the　groins。　Watery



ophthalmies　of　a　chronic　character；　with　pains；　fungous　excrescences



of　the　eyelids；　externally　and　internally；　called　fig；　which　destroyed



the　sight　of　many　persons。　There　were　fungous　growths；　in　many　other



instances；　on　ulcers；　especially　on　those　seated　on　the　genital



organs。　There　were　many　attacks　of　carbuncle　（anthrax）　through　the



summer；　and　other　affections；　which　are　called　〃the　putrefaction〃



（seps）；　also　large　ecthymata；　and　large　tetters　（herpetes）　in　many



instances。



　　8。　And　many　and　serious　complaints　attacked　many　persons　in　the



region　of　the　belly。　In　the　first　place；　tenesmus；　accompanied　with



pain；　attacked　many；　but　more　especially　children；　and　all　who　had　not



attained　to　puberty；　and　the　most　of　these　died。　There　were　many　cases



of　lientery　and　of　dysentery；　but　these　were　not　attended　with　much



pain。　The　evacuations　were　bilious；　and　fatty；　and　thin；　and　watery；



in　many　instances　the　disease　terminated　in　this　way；　with　and　without



fever；　there　were　painful　tormina　and　volvuli　of　a　malignant　kind；



copious　evacuations　of　the　contents　of　the　guts；　and　yet　much　remained



behind；　and　the　passages　did　not　carry　off　the　pains；　but　yielded　with



difficulty　to　the　means　administered；　for　in　most　cases　purgings



were　hurtful　to　those　affected　in　this　manner；　many　died　speedily；　but



in　many　others　they　held　out　longer。　In　a　word；　all　died；　both　those



who　had　acute　attacks　and　those　who　had　chronic；　most　especially



from　affections　of　the　belly；　for　it　was　the　belly　which　carried



them　all　off。



　　9。　All　persons　had　an　aversion　to　food　in　all　the　afore…mentioned



complaints　to　a　degree　such　as　I　never　met　with　before；　and　persons　in



these　complaints　most　especially；　and　those　recovering　from　them；



and　in　all　other　diseases　of　a　mortal　nature。　Some　were　troubled



with　thirst；　and　some　not；　and　bot