the book of prognostics-第4节

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The　first　class　of　them　as　to　violence　ends　thus：　the　second　is

protracted　to　the　seventh　day；　the　third　to　the　eleventh；　the　fourth

to　the　fourteenth；　the　fifth　to　the　seventeenth；　and　the　sixth　to

the　twentieth。　Thus　these　periods　from　the　most　acute　disease　ascend

by　fours　up　to　twenty。　But　none　of　these　can　be　truly　calculated　by

whole　days；　for　neither　the　year　nor　the　months　can　be　numbered　by

entire　days。　After　these　in　the　same　manner；　according　to　the　same

progression；　the　first　period　is　of　thirty…four　days；　the　second　of

forty　days；　and　the　third　of　sixty　days。　In　the　commencement　of

these　it　is　very　difficult　to　determine　those　which　will　come　to　a

crisis　after　a　long　interval；　for　these　beginnings　are　very　similar；

but　one　should　pay　attention　from　the　first　day；　and　observe　further

at　every　additional　tetrad；　and　then　one　cannot　miss　seeing　how　the

disease　will　terminate。　The　constitution　of　quartans　is　agreeable　to

the　same　order。　Those　which　will　come　to　a　crisis　in　the　shortest

space　of　time；　are　the　easiest　to　be　judged　of；　for　the　differences　of

them　are　greatest　from　the　commencement；　thus　those　who　are　going　to

recover　breathe　freely；　and　do　not　suffer　pain；　they　sleep　during

the　night；　and　have　the　other　salutary　symptoms；　whereas　those　that

are　to　die　have　difficult　respiration；　are　delirious；　troubled　with

insomnolency；　and　have　other　bad　symptoms。　Matters　being　thus；　one　may

conjecture；　according　to　the　time；　and　each　additional　period　of　the

diseases；　as　they　proceed　to　a　crisis。　And　in　women；　after

parturition；　the　crises　proceed　agreeably　to　the　same　ratio。

　　21。　Strong　and　continued　headaches　with　fever；　if　any　of　the

deadly　symptoms　be　joined　to　them；　are　very　fatal。　But　if　without　such

symptoms　the　pain　be　prolonged　beyond　twenty　days；　a　discharge　of

blood　from　the　nose　or　some　abscess　in　the　inferior　parts　may　be

anticipated；　but　while　the　pain　is　recent；　we　may　expect　in　like

manner　a　discharge　of　blood　from　the　nose；　or　a　suppuration；

especially　if　the　pain　be　seated　above　the　temples　and　forehead；　but

the　hemorrhage　is　rather　to　be　looked　for　in　persons　younger　than

thirty　years；　and　the　suppuration　in　more　elderly　persons。

　　22。　Acute　pain　of　the　ear；　with　continual　and　strong　fever；　is　to　be

dreaded；　for　there　is　danger　that　the　man　may　become　delirious　and

die。　Since；　then；　this　is　a　hazardous　spot；　one　ought　to　pay

particular　attention　to　all　these　symptoms　from　the　commencement。

Younger　persons　die　of　this　disease　on　the　seventh　day；　or　still

earlier；　but　old　persons　much　later；　for　the　fevers　and　delirium

less　frequently　supervene　upon　them；　and　on　that　account　the　ears

previously　come　to　a　suppuration；　but　at　these　periods　of　life；

relapses　of　the　disease　coming　on　generally　prove　fatal。　Younger

persons　die　before　the　ear　suppurates；　only　if　white　matter　run　from

the　ear；　there　may　be　hope　that　a　younger　person　will　recover；

provided　any　other　favorable　symptom　be　combined。

　　23。　Ulceration　of　the　throat　with　fever；　is　a　serious　affection；　and

if　any　other　of　the　symptoms　formerly　described　as　being　bad；　be

present；　the　physician　ought　to　announce　that　his　patient　is　in

danger。　Those　quinsies　are　most　dangerous；　and　most　quickly　prove

fatal；　which　make　no　appearance　in　the　fauces；　nor　in　the　neck；　but

occasion　very　great　pain　and　difficulty　of　breathing；　these　induce

suffocation　on　the　first　day；　or　on　the　second；　the　third；　or　the

fourth。　Such　as；　in　like　manner；　are　attended　with　pain；　are　swelled

up；　and　have　redness　（erythema）　in　the　throat；　are　indeed　very

fatal；　but　more　protracted　than　the　former；　provided　the　redness　be

great。　Those　cases　in　which　both　the　throat　and　the　neck　are　red；

are　more　protracted；　and　certain　persons　recover　from　them；　especially

if　the　neck　and　breast　be　affected　with　erythema；　and　the　erysipelas

be　not　determined　inwardly。　If　neither　the　erysipelas　disappear　on　the

critical　day；　nor　any　abscess　form　outwardly；　nor　any　pus　be　spit

up；　and　if　the　patient　fancy　himself　well；　and　be　free　from　pain；

death；　or　a　relapse　of　the　erythema　is　to　be　apprehended。　It　is　much

less　hazardous　when　the　swelling　and　redness　are　determined　outwardly；

but　if　determined　to　the　lungs；　they　superinduce　delirium；　and

frequently　some　of　these　cases　terminate　in　empyema。　It　is　very

dangerous　to　cut　off　or　scarify　enlarged　uvulae　while　they　and　red　and

large；　for　inflammations　and　hemorrhages　supervene；　but　one　should　try

to　reduce　such　swellings　by　some　other　means　at　this　season。　When

the　whole　of　it　is　converted　into　an　abscess；　which　is　called　Uva；

or　when　the　extremity　of　the　variety　called　Columella　is　larger　and

round；　but　the　upper　part　thinner；　at　this　time　it　will　be　safe　to

operate。　But　it　will　be　better　to　open　the　bowels　gently　before

proceeding　to　the　operation；　if　time　will　permit；　and　the　patient　be

not　in　danger　of　being　suffocated。

　　24。　When　the　fevers　cease　without　any　symptoms　of　resolution

occurring；　and　not　on　the　critical　days；　in　such　cases　a　relapse　may

be　anticipated。　When　any　of　the　fevers　is　protracted；　although　the　man

exhibits　symptoms　of　recovery；　and　there　is　no　longer　pain　from　any

inflammation；　nor　from　any　other　visible　cause；　in　such　a　case　a

deposit；　with　swelling　and　pain；　may　be　expected　in　some　one　of　the

joints；　and　not　improbably　in　those　below。　Such　deposits　occur　more

readily　and　in　less　time　to　persons　under　thirty　years　of　age；　and　one

should　immediately　suspect　the　formation　of　such　a　deposit；　if　the

fever　be　protracted　beyond　twenty　days；　but　to　aged　persons　these　less

seldom　happen；　and　not　until　the　fever　be　much　longer　protracted。　Such

a　deposit　may　be　expected；　when　the　fever　is　of　a　continual　type；

and　that　it　will　pass　into　a　quartan；　if　it　become　intermittent；　and

its　paroxysms　come　on　in　an　irregular　manner；　and　if　in　this　form　it

approach　autumn。　As　deposits　form　most　readily　in　persons　below　thirty

years　of　age；　so　quartans　most　commonly　occur　to　persons　beyond　that

age。　It　is　proper　to　know　that　deposits　occur　most　readily　in

winter；　that　then　they　are　most　protracted；　but　are　less　given　to

return。　Whoever；　in　a　fever　that　is　not　of　a　fatal　character；　says

that　he　has　pain　in　his　head；　and　that　something　dark　appears　to　be

before　his　eyes；　and　that　he　has　pain　at　the　stomach；　will　be　seized

with　vomiting　of　bile；　but　if　rigor　also　attack　him；　and　the

inferior　parts　of　the　hypochondrium　are　cold；　vomiting　is　still　nearer

at　hand；　and　if　he　eat　or　drink　anything　at　such　a　season；　it　will

be　quickly　vomited。　In　these　cases；　when　the　pain　commences　on　the

first　day；　they　are　particularly　oppressed　on　the　fourth　and　the

fifth；　and　they　are　relieved　on　the　seventh；　but　the　greater　part　of

them　begin　to　have　pain　on　the　third　day；　and　are　most　especially

tossed　on　the　fifth；　but　are　relieved　on　the　ninth　or　eleventh；　but　in

those　who　begin　to　have　pains　on　the　fifth　day；　and　other　matters

proceed　properly　with　them；　the　disease　comes　to　a　crisis　on　the

fourteenth　day。　But　when　in　such　a　fever　persons　affected　with

headache；　instead　of　having　a　dark　appearance　before　their　eyes；

have　dimness　of　vision；　or　flashes　of　light　appear　before　their

eyes；　and　instead　of　pain　at　the　pit　of　the　stomach；　they　have　in

their　hypochondrium　a　fullness　stretching　either　to　the　right　or

left　side；　without　either　pain　or　inflammation；　a　hemorrhage　from

the　nose　is　to　be　expected　in　such　a　case；　rather　than　a　vomiting。　But

it　is　in　young　persons　particularly　that　the　hemorrhage　is　to　be

expected；　for　in　persons　beyond　the　age　of　thirty…five；　vomitings

are　rather　to　be　anticipated。　Convulsions　occur　to　children　if　acute

fever　be　present；　and　the　belly　be　they　cannot　sleep；　are　agitated；

and　moan；　and　change　color；　and　become　green；　livid；　or　ruddy。　These

complaints　occur　most　readily　to　children　which　are　very　young　up　to

their　seventh　year；　older　children　and　adults　are　not　equally　liable

to　be　seized　with　convulsions　in　fevers；　unless　some　of　the

strongest　and　worst　symptoms　precede；　such　as　those　which　occur　in

frenzy。　One　must　judge　of　children　as　of　others；　which　will　die　and

which　recover；　from　the　whole　of　the　symptoms；　as　they　have　been

specially　described。　These　things　I　say　respecting　acute　diseases；　and

the　affections　which　spring　from　them。

　　25。　He　who　would　correctly　beforehand　those　that　will　recover；　and

those　that　will　die；　and　in　what　cases　the　disease　will　be

protracted　for　many　days；　and　in　what　cases　for　a　shorter　time；　must

be　able　to　form　a　judgment　from　having　made　himself　acquainted　with

all　the　symptoms；　and　estimating　their　powers　in　comparison　with　one

another；　as　has　been　described；　with　regard　to　the　others；　and　the

urine　and　sputa；　as　when　the　patient　coughs　up　pus　and　pus　and　bile

together。　One　ought　also　to　consider　promptly　the　influx　of　epidemical

diseases　and　the　constitution　of　the　season。　One　should　likewise　be

well　acquainted　with　the　particular　signs　and　the　other　symptoms；

and　not　be　ignorant　how　that；　in　every　year；　and　at　every　season；

bad　symptoms