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CASE I

Philiscus lived by the wall. He took to his bed with acute fever on the first day and sweating ; night uncomfortable.

Second day. General exacerbation, later a small clyster moved the bowels well. A restful night.

Third day. Early and until mid-day he appeared to have lost the fever ; but towards evening acute fever with sweating ; thirst ; dry tongue ; black urine. An uncomfortable night, without sleep ; completely out of his mind.

Fourth day. All symptoms exacerbated ; black urine ; a more comfortable night, and urine of a better colour.

Fifth day. About mid-day slight epistaxis of unmixed blood. Urine varied, with scattered, round particles suspended in it, resembling semen ; they did not settle. On the application of a suppository the patient passed, with flatulence, scanty excreta. A distressing night, snatches of sleep, irrational talk ; extremities everywhere cold, and would not get warm again ; black urine ; snatches of sleep towards dawn ; speechless ; cold sweat ; extremities livid. About mid-day on the sixth day the patient died. The breathing throughout, as though he were recollecting to do it,1 was rare and large. Spleen raised in a round swelling ; cold sweats all the time. The exacerbations on even days.

1 The patient seemed to forget the necessity of breathing, and then to remember it and to breathe consciously.

Hippocrates Collected Works I. Hippocrates. W. H. S. Jones. Cambridge. Harvard University Press. 1868.

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