2. The year being southerly, damp, and soft towards winter, all were healthy, except those affected3 with phthisis, of whom we shall write afterwards.
3. Early in spring, along with the prevailing4 cold, there were many cases of erysipelas, some from a manifest cause, and some not. They were of a malignant5 nature, and proved fatal to many; many had sore-throat and loss of speech. There were many cases of ardent6 fever, phrensy, aphthous affections of the mouth, tumors on the genital organs; of ophthalmia, anthrax, disorder7 of the bowels8, anorexia9, with thirst and without it; of disordered urine, large in quantity, and bad in quality; of persons affected with coma10 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 epidemic11. 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 putrefaction12, 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 concoction13 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 proceeding14 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 thereby15: 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, nausea16, and rigors17; fever acute, not much thirst, nor delirium18, 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 extremities19, 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 disorders20 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 stupor21.
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. Watery22 ophthalmies of a chronic23 character, with pains; fungous excrescences of the eyelids24, externally and internally, called fig25, which destroyed the sight of many persons. There were fungous growths, in many other instances, on ulcers26, 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 belly27. In the first place, tenesmus, accompanied with pain, attacked many, but more especially children, and all who had not attained28 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 bilious29, 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 guts30, 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 both in febrile complaints and in others no one drank unseasonably or disobeyed injunctions.
10. The urine in many cases was not in proportion to the drink administered, but greatly in excess; and the badness of the urine voided was great, for it had not the proper thickness, nor concoction, nor purged32 properly; for in many cases purgings by the bladder indicate favorably, but in the greatest number they indicated a melting of the body, disorder of the bowels, pains, and a want of crisis.
11. Persons laboring33 under phrenitis and causus were particularly disposed to coma; but also in all other great diseases which occurred along with fever. In the main, most cases were attended either by heavy coma, or by short and light sleep.
12. And many other forms of fevers were then epidemic, of tertian, of quartan, of nocturnal, of continual, of chronic, of erratic34, of fevers attended with nausea, and of irregular fevers. All these were attended with much disorder, for the bowels in most cases were disordered, accompanied with rigors, sweats not of a critical character, and with the state of the urine as described. In most instances the disease was protracted35, for neither did the deposits which took place prove critical as in other cases; for in all complaints and in all cases there was difficulty of crisis, want of crisis, and protraction of the disease, but most especially in these. A few had the crisis about the eightieth day, but in most instances it (the disease?) left them irregularly. A few of them died of dropsy without being confined to bed. And in many other diseases people were troubled with swelling36, but more especially in phthisical cases.
13. The greatest and most dangerous disease, and the one that proved fatal to the greatest number, was consumption. With many persons it commenced during the winter, and of these some were confined to bed, and others bore up on foot; the most of those died early in spring who were confined to bed; of the others, the cough left not a single person, but it became milder through the summer; during the autumn, all these were confined to bed, and many of them died, but in the greater number of cases the disease was long protracted. Most of these were suddenly attacked with these diseases, having frequent rigors, often continual and acute fevers; unseasonable, copious, and cold sweats throughout; great coldness, from which they had great difficulty in being restored to heat; the bowels variously constipated, and again immediately in a loose state, but towards the termination in all cases with violent looseness of the bowels; a determination downwards37 of all matters collected about the lungs; urine excessive, and not good; troublesome melting. The coughs throughout were frequent, and copious, digested, and liquid, but not brought up with much pain; and even when they had some slight pain, in all cases the purging31 of the matters about the lungs went on mildly. The fauces were not very irritable38, nor were they troubled with any saltish humors; but there were viscid, white, liquid, frothy, and copious defluxions from the head. But by far the greatest mischief39 attending these and the other complaints, was the aversion to food, as has been described. For neither been described. For neither had they any relish40 for drink along with their food, but continued without thirst. There was heaviness of the body, disposition41 to coma, in most cases swelling, which ended in dropsy; they had rigors, and were delirious42 towards death.
14. The form of body peculiarly subject to phthisical complaints was the smooth, the whitish, that resembling the lentil; the reddish, the blue-eyed, the leucophlegmatic, and that with the scapulae having the appearance of wings: and women in like manner, with regard to the melancholic44 and subsanguineous, phrenitic and dysenteric affections principally attacked them. Tenesmus troubled young persons of a phlegmatic43 temperament45. Chronic diarrhoea, acrid46 and viscid discharges from the bowels, attacked those who were troubled with bitter bile.
15. To all those which have been described, the season of spring was most inimical, and proved fatal to the greatest numbers: the summer was the most favorable to them, and the fewest died then; in autumn, and under the Pleiades, again there died great numbers. It appears to me, according to the reason of things, that the coming on of summer should have done good in these cases; for winter coming on cures the diseases of summer, and summer coming on removes the diseases of winter. And yet the summer in question was not of itself well constituted, for it became suddenly hot, southerly, and calm; but, not withstanding, it proved beneficial by producing a change on the other constitution.
16. I look upon it as being a great part of the art to be able to judge properly of that which has been written. For he that knows and makes a proper use of these things, would appear to me not likely to commit any great mistake in the art. He ought to learn accurately47 the constitution of every one of the seasons, and of the diseases; whatever that is common in each constitution and disease is good, and whatever is bad; whatever disease will be protracted and end in death, and whatever will be protracted and end in recovery; which disease of an acute nature will end in death, and which in recovery. From these it is easy to know the order of the critical days, and prognosticate from them accordingly. And to a person who is skilled in these things, it is easy to know to whom, when, and how aliment ought to be administered.
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1
copious
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| adj.丰富的，大量的 | |
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suffocating
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| a.使人窒息的 | |
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affected
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| adj.不自然的，假装的 | |
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prevailing
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| adj.盛行的；占优势的；主要的 | |
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malignant
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| adj.恶性的，致命的；恶意的，恶毒的 | |
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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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disorder
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| n.紊乱，混乱；骚动，骚乱；疾病，失调 | |
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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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anorexia
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| n.厌食症 | |
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coma
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| n.昏迷，昏迷状态 | |
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epidemic
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| n.流行病；盛行；adj.流行性的，流传极广的 | |
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putrefaction
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| n.腐坏，腐败 | |
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concoction
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| n.调配(物)；谎言 | |
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proceeding
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| n.行动，进行，(pl.)会议录，学报 | |
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thereby
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| adv.因此，从而 | |
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nausea
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| n.作呕，恶心；极端的憎恶(或厌恶) | |
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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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delirium
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| n. 神智昏迷,说胡话;极度兴奋 | |
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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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disorders
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| n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调 | |
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stupor
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| v.昏迷；不省人事 | |
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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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chronic
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| adj.(疾病)长期未愈的，慢性的；极坏的 | |
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eyelids
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| n.眼睑( eyelid的名词复数 )；眼睛也不眨一下；不露声色；面不改色 | |
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fig
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| n.无花果(树) | |
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ulcers
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| n.溃疡( ulcer的名词复数 )；腐烂物；道德败坏；腐败 | |
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belly
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| n.肚子，腹部；(像肚子一样)鼓起的部分，膛 | |
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attained
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| （通常经过努力）实现( attain的过去式和过去分词 )； 达到； 获得； 达到（某年龄、水平、状况） | |
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bilious
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| adj.胆汁过多的；易怒的 | |
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guts
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| v.狼吞虎咽，贪婪地吃，飞碟游戏（比赛双方每组5人，相距15码，互相掷接飞碟）；毁坏（建筑物等）的内部( gut的第三人称单数 )；取出…的内脏n.勇气( gut的名词复数 )；内脏；消化道的下段；肠 | |
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31
purging
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| 清洗； 清除； 净化； 洗炉 | |
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purged
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| 清除（政敌等）( purge的过去式和过去分词 )； 涤除（罪恶等）； 净化（心灵、风气等）； 消除（错事等）的不良影响 | |
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laboring
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| n.劳动，操劳v.努力争取(for)( labor的现在分词 )；苦干；详细分析；（指引擎）缓慢而困难地运转 | |
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erratic
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| adj.古怪的，反复无常的，不稳定的 | |
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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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36
swelling
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| n.肿胀 | |
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downwards
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| adj./adv.向下的（地），下行的（地） | |
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irritable
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| adj.急躁的；过敏的；易怒的 | |
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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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40
relish
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| n.滋味，享受，爱好，调味品；vt.加调味料，享受，品味；vi.有滋味 | |
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41
disposition
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| n.性情，性格；意向，倾向；排列，部署 | |
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delirious
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| adj.不省人事的，神智昏迷的 | |
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43
phlegmatic
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| adj.冷静的，冷淡的，冷漠的，无活力的 | |
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44
melancholic
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| 忧郁症患者 | |
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temperament
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| n.气质，性格，性情 | |
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acrid
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| adj.辛辣的，尖刻的，刻薄的 | |
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accurately
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| adv.准确地，精确地 | |
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