of the epidemics-第2节
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and diseases into quartans took place; they were protracted; as is
wont with them; indeed; more so than usual。 Quotidian; nocturnal;
and wandering fevers attacked many persons; some of whom continued
to keep up; and others were confined to bed。 In most instances these
fevers were prolonged under the Pleiades and till winter。 Many
persons; and more especially children; had convulsions from the
commencement; and they had fever; and the convulsions supervened
upon the fevers; in most cases they were protracted; but free from
danger; unless in those who were in a deadly state from other
complaints。 Those fevers which were continual in the main; and with no
intermissions; but having exacerbations in the tertian form; there
being remissions the one day and exacerbations the next; were the most
violent of all those which occurred at that time; and the most
protracted; and occurring with the greatest pains; beginning mildly;
always on the whole increasing; and being exacerbated; and always
turning worse; having small remissions; and after an abatement
having more violent paroxysms; and growing worse; for the most part;
on the critical days。 Rigors; in all cases; took place in an irregular
and uncertain manner; very rare and weak in them; but greater in all
other fevers; frequent sweats; but most seldom in them; bringing no
alleviation; but; on the contrary; doing mischief。 Much cold of the
extremities in them; and these were warmed with difficulty。
Insomnolency; for the most part; especially in these fevers; and again
a disposition to coma。 The bowels; in all diseases; were disordered;
and in a bad state; but worst of all in these。 The urine; in most of
them; was either thin and crude; yellow; and after a time with
slight symptoms of concoction in a critical form; or having the proper
thickness; but muddy; and neither settling nor subsiding; or having
small and bad; and crude sediments; these being the worst of all。
Coughs attended these fevers; but I cannot state that any harm or good
ever resulted from the cough。
3。 The most of these were protracted and troublesome; went on in a
very disorderly and irregular form; and; for the most part; did in a
crisis; either in the fatal cases or in the others; for if it left
some of them for a season it soon returned again。 In a few instances
the lever terminated with a crisis; in the earliest of these about the
eightieth day; and some of these relapsed; so that most of them were
not free from the fever during the winter; but the fever left most
of them without a crisis; and these things happened alike to those who
recovered and to those who did not。 There being much want of crisis
and much variety as to these diseases; the greatest and worst
symptom attended the most of them; namely; a loathing of all
articles of food; more especially with those who had otherwise fatal
symptoms; but they were not unseasonably thirsty in such fevers。 After
a length of time; with much suffering and great wasting; abscesses
were formed in these cases; either unusually large; so that the
patients could not support them; or unusually small; so that they
did no good; but soon relapsed and speedily got worse。 The diseases
which attacked them were in the form of dysenteries; tenesmus;
lientery; and fluxes; but; in some cases; there were dropsies; with or
without these complaints。 Whatever attacked them violently speedily
cut them off; or again; did them no good。 Small rashes; and not
corresponding to the violence of the disease; and quickly
disappearing; or swellings occurred about the ears; which were not
resolved; and brought on no crisis。 In some they were determined to
the joints; and especially to the hip…joint; terminating critically
with a few; and quickly again increasing to its original habit。
4。 People died of all these diseases; but mostly of these fevers;
and notably infants just weaned; and older children; until eight or
ten years of age; and those before puberty。 These things occurred to
those affected with the complaints described above; and to many
persons at first without them。 The only favorable symptom; and the
greatest of those which occurred; and what saved most of those who
were in the greatest dangers; was the conversion of it to a strangury;
and when; in addition to this; abscesses were formed。 The strangury
attacked; most especially; persons of the ages I have mentioned; but
it also occurred in many others; both of those who were not confined
to bed and those who were。 There was a speedy and great change in
all these cases。 For the bowels; if they happened previously to have
watery discharges of a bad character; became regular; they got an
appetite for food; and the fevers were mild afterwards。 But; with
regard to the strangury itself; the symptoms were protracted and
painful。 Their urine was copious; thick; of various characters; red;
mixed with pus; and was passed with pain。 These all recovered; and I
did not see a single instance of death among them。
5。 With regard to the dangers of these cases; one must always attend
to the seasonable concoction of all the evacuations; and to the
favorable and critical abscesses。 The concoctions indicate a speedy
crisis and recovery of health; crude and undigested evacuations; and
those which are converted into bad abscesses; indicate either want
of crisis; or pains; or prolongation of the disease; or death; or
relapses; which of these it is to be must be determined from other
circumstances。 The physician must be able to tell the antecedents;
know the present; and foretell the future… must mediate these
things; and have two special objects in view with regard to disease;
namely; to do good or to do no harm。 The art consists in three things…
the disease; the patient; and the physician。 The physician is the
servant of the art; and the patient must combat the disease along with
the physician。
6。 Pains about the head and neck; and heaviness of the same along
with pain; occur either without fevers or in fevers。 Convulsions
occurring in persons attacked with frenzy; and having vomitings of
verdigris…green bile; in some cases quickly prove fatal。 In ardent
fevers; and in those other fevers in which there is pain of the
neck; heaviness of the temples; mistiness about the eyes; and
distention about the hypochondriac region; not unattended with pain;
hemorrhage from the nose takes place; but those who have heaviness
of the whole head; cardialgia and nausea; vomit bilious and
pituitous matters; children; in such affections; are generally
attacked with convulsions; and women have these and also pains of
the uterus; whereas; in elder persons; and those in whom the heat is
already more subdued; these cases end in paralysis; mania; and loss of
sight。
Third Constitution
7。 In Thasus; a little before and during the season of Arcturus;
there were frequent and great rains; with northerly winds。 About the
equinox; and till the setting of the Pleiades; there were a few
southerly rains: the winter northerly and parched; cold; with great
winds and snow。 Great storms about the equinox; the spring
northerly; dryness; rains few and cold。 About the summer solstice;
scanty rains; and great cold until near the season of the Dog…star。
After the Dog…days; until the season of Arcturus; the summer hot;
great droughts; not in intervals; but continued and severe: no rain;
the Etesian winds blew; about the season of Arcturus southerly rains
until the equinox。
8。 In this state of things; during winter; paraplegia set in; and
attacked many; and some died speedily; and otherwise the disease
prevailed much in an epidemical form; but persons remained free from
all other diseases。 Early in the spring; ardent fevers commenced and
continued through the summer until the equinox。 Those then that were
attacked immediately after the commencement of the spring and
summer; for the most part recovered; and but few of them died。 But
when the autumn and the rains had set in; they were of a fatal
character; and the greater part then died。 When in these attacks of
ardent fevers there was a proper and copious hemorrhage from the nose;
they were generally saved by it; and I do not know a single person who
had a proper hemorrhage who died in this constitution。 Philiscus;
Epaminon; and Silenus; indeed; who had a trifling epistaxis on the
fourth and fifth day; died。 Most of those taken with had a rigor about
the time of the crisis; and notably those who had no hemorrhage; these
had also rigor associated。
9。 Some were attacked with jaundice on the sixth day; but these were
benefited either by an urinary purgation; or a disorder