PART 2
He should observe thus in acute diseases: first, the countenance of
the patient, if it be like those of persons in health, and more so,
if like itself, for this is the best of all; whereas the most opposite
to it is the worst, such as the following; a sharp nose, hollow eyes,
collapsed temples; the ears cold, contracted, and their lobes turned
out: the skin about the forehead being rough, distended, and parched;
the color of the whole face being green, black, livid, or lead-colored.
If the countenance be such at the commencement of the disease, and
if this cannot be accounted for from the other symptoms, inquiry must
be made whether the patient has long wanted sleep; whether his bowels
have been very loose; and whether he has suffered from want of food;
and if any of these causes be confessed to, the danger is to be reckoned
so far less; and it becomes obvious, in the course of a day and a
night, whether or not the appearance of the countenance proceeded
from these causes. But if none of these be said to exist, if the symptoms
do not subside in the aforesaid time, it is to be known for certain
that death is at hand. And, also, if the disease be in a more advanced
stage either on the third or fourth day, and the countenance be such,
the same inquiries as formerly directed are to be made, and the other
symptoms are to be noted, those in the whole countenance, those on
the body, and those in the eyes; for if they shun the light, or weep
involuntarily, or squint, or if the one be less than the other, or
if the white of them be red, livid, or has black veins in it; if there
be a gum upon the eyes, if they are restless, protruding, or are become
very hollow; and if the countenance be squalid and dark, or the color
of the whole face be changed- all these are to be reckoned bad and
fatal symptoms. The physician should also observe the appearance of
the eyes from below the eyelids in sleep; for when a portion of the
white appears, owing to the eyelids not being closed together, and
when this is not connected with diarrhea or purgation from medicine,
or when the patient does not sleep
[p. 45] thus from habit, it is to be reckoned
an unfavorable and very deadly symptom; but if the eyelid be contracted,
livid, or pale, or also the lip, or nose, along with some of the other
symptoms, one may know for certain that death is close at hand. It
is a mortal symptom, also, when the lips are relaxed, pendent, cold,
and blanched.
