2. All these fevers described attacked great numbers. All these fevers attacked the smallest numbers, and the patients suffered the least from them, for there were no hemorrhages, except a few and to a small amount, nor was there delirium13; all the other complaints were slight; in these the crises were regular, in most instances, with the intermittents, in seventeen days; and I know no instance of a person dying of causus, nor becoming phrenitic. The tertians were more numerous than the ardent fevers, and attended with more pain; but these all had four periods in regular succession from the first attack, and they had a complete crisis in seven, without a relapse in any instance. The quartans attacked many at first, in the form of regular quartans, but in no few cases a transition from other fevers and diseases into quartans took place; they were protracted, as is wont14 with them, indeed, more so than usual. Quotidian15, 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 exacerbated16, and always turning worse, having small remissions, and after an abatement17 having more violent paroxysms, and growing worse, for the most part, on the critical days. Rigors18, 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 alleviation20, but, on the contrary, doing mischief21. Much cold of the extremities22 in them, and these were warmed with difficulty. Insomnolency, for the most part, especially in these fevers, and again a disposition23 to coma24. The bowels25, 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 concoction27 in a critical form, or having the proper thickness, but muddy, and neither settling nor subsiding28; or having small and bad, and crude sediments30; 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 loathing31 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 fluxes32; 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 determined34 to the joints35, and especially to the hip36-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 notably37 infants just weaned, and older children, until eight or ten years of age, and those before puberty. These things occurred to those affected38 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 conversion39 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 previously40 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 concoctions41 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 foretell42 the future — must mediate43 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 frenzy44, 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, mistiness45 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 nausea46, vomit10 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 subdued47, these cases end in paralysis48, mania49, 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 parched50, cold, with great winds and snow. Great storms about the equinox, the spring northerly, dryness, rains few and cold. About the summer solstice, scanty51 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 intervals52, 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 trifling54 epistaxis on the fourth and fifth day, died. Most of those taken with had a rigor19 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 disorder26 of the bowels, or a copious hemorrhage, as in the case of Heraclides, who was lodged55 with Aristocydes: this person, though he had the hemorrhage from the nose, the purgation by the bladder, and disorder of the bowels, experienced a favorable crisis on the twentieth day, not like the servant of Phanagoras, who had none of these symptoms, and died. The hemorrhages attacked most persons, but especially young persons and those in the prime of life, and the greater part of those who had not the hemorrhage died: elderly persons had jaundice or disorder of the bowels, such as Bion, who was lodged with Silenus. Dysenteries were epidemical during the summer, and some of those cases in which the hemorrhage occurred, terminated in dysentery, as happened to the slave of Eraton, and to Mullus, who had a copious hemorrhage, which settled down into dysentery, and they recovered. This humor was redundant56 in many cases, since in those who had not the hemorrhage about the crisis, but the risings about the ears disappeared, after their disappearance57 there was a sense of weight in the left flank extending to the extremity58 of the hip, and pain setting in after the crisis, with a discharge of thin urine; they began to have small hemorrhages about the twenty-fourth day, and the swelling33 was converted into the hemorrhage. In the case of Antiphon, the son of Critobulus’ son, the fever ceased and came to a crisis about the fortieth day.
10. Many women were seized, but fewer than of the men, and there were fewer deaths among them. But most of them had difficult parturition59, and after labor60 they were taken ill, and these most especially died, as, for example, the daughter of Telebolus died on the sixth day after delivery. Most females had the menstrual discharge during the fever, and many girls had it then for the first time: in certain individuals both the hemorrhage from the nose and the menses appeared; thus, in the case of the virgin61 daughter of Daetharses, the menses then took place for the first time, and she had also a copinous hemorrhage from the nose, and I knew no instance of any one dying when one or other of these took place properly. But all those in the pregnant state that were attacked had abortions62, as far as I observed. The urine in most cases was of the proper color, but thin, and having scanty sediments: in most the bowels were disordered with thin and bilious dejections; and many, after passing through the other crises, terminated in dysenteries, as happened to Xenophanes and Critias. The urine was watery, copious, clear, and thin; and even after the crises, when the sediment29 was natural, and all the other critical symptoms were favorable, as I recollect63 having happened to Bion, who was lodged in the house of Silenus, and Critias, who lived with Xenophanes, the slave of Areton, and the wife of Mnesistratus. But afterwards all these were attacked with dysentery. It would be worth while to inquire whether the watery urine was the cause of this. About the season of Arcturus many had the crisis on the eleventh day, and in them the regular relapses did not take place, but they became comatose64 about this time, especially children; but there were fewest deaths of all among them.
11. About the equinox, and until the season of the Pleiades, and at the approach of winter, many ardent fevers set in; but great numbers at that season were seized with phrenitis, and many died; a few cases also occurred during the summer. These then made their attack at the commencement of ardent fevers, which were attended with fatal symptoms; for immediately upon their setting in, there were acute fever and small rigors, insomnolency, aberration65, thirst, nausea, insignificant66 sweats about the forehead and clavicles, but no general perspiration67; they had much delirious68 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 luxuriously69; persons with shrill70, or rough voices, who stammered71 and were passionate72, 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 thereby73, 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 subsided74 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 interval53 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 frenzies75 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.
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1
torrents
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| n.倾注；奔流( torrent的名词复数 )；急流；爆发；连续不断 | |
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zephyr
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| n.和风，微风 | |
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copious
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| adj.丰富的，大量的 | |
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tempestuous
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| adj.狂暴的 | |
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protracted
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| adj.拖延的；延长的v.拖延“protract”的过去式和过去分词 | |
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remit
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| v.汇款，汇寄；豁免（债务），免除（处罚等） | |
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bilious
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| adj.胆汁过多的；易怒的 | |
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acrid
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| adj.辛辣的，尖刻的，刻薄的 | |
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watery
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| adj.有水的，水汪汪的；湿的，湿润的 | |
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vomit
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| v.呕吐，作呕；n.呕吐物，吐出物 | |
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ardent
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| adj.热情的，热烈的，强烈的，烈性的 | |
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diurnal
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| adj.白天的，每日的 | |
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delirium
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| n. 神智昏迷,说胡话;极度兴奋 | |
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wont
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| adj.习惯于；v.习惯；n.习惯 | |
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quotidian
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| adj.每日的，平凡的 | |
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exacerbated
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| v.使恶化，使加重( exacerbate的过去式和过去分词 ) | |
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abatement
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| n.减(免)税，打折扣，冲销 | |
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rigors
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| 严格( rigor的名词复数 )； 严酷； 严密； （由惊吓或中毒等导致的身体）僵直 | |
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rigor
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| n.严酷，严格，严厉 | |
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alleviation
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| n. 减轻，缓和，解痛物 | |
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mischief
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| n.损害，伤害，危害；恶作剧，捣蛋，胡闹 | |
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extremities
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| n.端点( extremity的名词复数 )；尽头；手和足；极窘迫的境地 | |
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disposition
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| n.性情，性格；意向，倾向；排列，部署 | |
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coma
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| n.昏迷，昏迷状态 | |
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bowels
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| n.肠，内脏，内部；肠( bowel的名词复数 )；内部，最深处 | |
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disorder
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| n.紊乱，混乱；骚动，骚乱；疾病，失调 | |
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concoction
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| n.调配(物)；谎言 | |
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subsiding
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| v.（土地）下陷（因在地下采矿）( subside的现在分词 )；减弱；下降至较低或正常水平；一下子坐在椅子等上 | |
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sediment
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| n.沉淀，沉渣，沉积(物) | |
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sediments
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| 沉淀物( sediment的名词复数 )； 沉积物 | |
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loathing
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| n.厌恶，憎恨v.憎恨，厌恶( loathe的现在分词)；极不喜欢 | |
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32
fluxes
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| 连续的改变( flux的名词复数 )； 不稳定的状态； 不停的变化； 通量 | |
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swelling
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| n.肿胀 | |
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determined
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| adj.坚定的；有决心的 | |
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joints
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| 接头( joint的名词复数 )； 关节； 公共场所（尤指价格低廉的饮食和娱乐场所） （非正式）； 一块烤肉 （英式英语） | |
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hip
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| n.臀部，髋；屋脊 | |
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notably
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| adv.值得注意地，显著地，尤其地，特别地 | |
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affected
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| adj.不自然的，假装的 | |
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conversion
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| n.转化，转换，转变 | |
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previously
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| adv.以前，先前（地） | |
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concoctions
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| n.编造，捏造，混合物( concoction的名词复数 ) | |
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foretell
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| v.预言，预告，预示 | |
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43
mediate
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| vi.调解，斡旋；vt.经调解解决；经斡旋促成 | |
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44
frenzy
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| n.疯狂，狂热，极度的激动 | |
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45
mistiness
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| n.雾，模糊，不清楚 | |
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46
nausea
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| n.作呕，恶心；极端的憎恶(或厌恶) | |
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subdued
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| adj. 屈服的，柔和的，减弱的 动词subdue的过去式和过去分词 | |
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paralysis
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| n.麻痹(症)；瘫痪(症) | |
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mania
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| n.疯狂；躁狂症，狂热，癖好 | |
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50
parched
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| adj.焦干的；极渴的；v.（使）焦干 | |
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51
scanty
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| adj.缺乏的，仅有的，节省的，狭小的，不够的 | |
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52
intervals
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| n.[军事]间隔( interval的名词复数 )；间隔时间；[数学]区间；（戏剧、电影或音乐会的）幕间休息 | |
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53
interval
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| n.间隔，间距；幕间休息，中场休息 | |
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54
trifling
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| adj.微不足道的；没什么价值的 | |
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55
lodged
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| v.存放( lodge的过去式和过去分词 )；暂住；埋入；（权利、权威等）归属 | |
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56
redundant
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| adj.多余的，过剩的；(食物)丰富的；被解雇的 | |
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disappearance
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| n.消失，消散，失踪 | |
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extremity
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| n.末端，尽头；尽力；终极；极度 | |
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parturition
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| n.生产，分娩 | |
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labor
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| n.劳动，努力，工作，劳工；分娩；vi.劳动，努力，苦干；vt.详细分析；麻烦 | |
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virgin
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| n.处女，未婚女子；adj.未经使用的；未经开发的 | |
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62
abortions
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| n.小产( abortion的名词复数 )；小产胎儿；（计划）等中止或夭折；败育 | |
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recollect
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| v.回忆，想起，记起，忆起，记得 | |
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comatose
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| adj.昏睡的，昏迷不醒的 | |
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aberration
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| n.离开正路，脱离常规，色差 | |
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insignificant
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| adj.无关紧要的，可忽略的，无意义的 | |
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67
perspiration
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| n.汗水；出汗 | |
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delirious
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| adj.不省人事的，神智昏迷的 | |
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luxuriously
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| adv.奢侈地，豪华地 | |
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shrill
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| adj.尖声的；刺耳的；v尖叫 | |
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stammered
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| v.结巴地说出( stammer的过去式和过去分词 ) | |
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passionate
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| adj.热情的，热烈的，激昂的，易动情的，易怒的，性情暴躁的 | |
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73
thereby
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| adv.因此，从而 | |
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74
subsided
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| v.（土地）下陷（因在地下采矿）( subside的过去式和过去分词 )；减弱；下降至较低或正常水平；一下子坐在椅子等上 | |
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frenzies
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| 狂乱( frenzy的名词复数 )； 极度的激动 | |
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