previous next



CASE II

Silenus lived on Broadway near the place of Eualcidas. After over-exertion, drinking, and exercises

[p. 189] at the wrong time he was attacked by fever. He began by having pains in the loins, with heaviness in the head and tightness of the neck. From the bowels on the first day there passed copious discharges of bilious matter, unmixed, frothy, and highly coloured. Urine black, with a black sediment ; thirst ; tongue dry ; no sleep at night.

Second day. Acute fever, stools more copious, thinner, frothy ; urine black ; uncomfortable night ; slightly out of his mind.

Third day. General exacerbation ; oblong tightness1 of the hypochondrium, soft underneath, extending on both sides to the navel ; stools thin, blackish ; urine turbid, blackish ; no sleep at night ; much rambling, laughter, singing ; no power of restraining himself.

Fourth day. Same symptoms.

Fifth day. Stools unmixed, bilious, smooth, greasy ; urine thin, transparent ; lucid intervals.

Sixth day. Slight sweats about the head ; extremities cold and livid ; much tossing ; nothing passed from the bowels ; urine suppressed ; acute fever.

Seventh day. Speechless ; extremities would no longer get warm ; no urine.

Eighth day. Cold sweat all over ; red spots with sweat, round, small like acne, which persisted without subsiding. From the bowels with slight stimulus

[p. 191] there came a copious discharge of solid stools, thin,2 as it were unconcocted, painful. Urine painful and irritating. Extremities grow a little warmer ; fitful sleep ; coma ; speechlessness ; thin, transparent urine.

Ninth day. Same symptoms.

Tenth day. Took no drink ; coma ; fitful sleep. Discharges from the bowels similar ; had a copious discharge of thickish urine, which on standing left a farinaceous, white deposit ; extremities again cold.

Eleventh day. Death.

From the beginning the breath in this case was throughout rare and large. Continuous throbbing of the hypochondrium ; age about twenty years.

1 The word ὑπολάπαρος2 is often applied to ς1ύντας1ις2 or ἔντας1ις2 of the hypochondria. Galen (see Littré on Epidemics III, Case II, Vol. III, p. 34) says that it means "without bulk," or "without swelling." This is possible if the word is etymologically connected with λαπάζω. The translators are not very precise. Littré has "sans beaucoup de rénitence," "sans tumeur," "sans gonflement," "sans grand gonflement ;" Adams has "empty," "loose," "softish." In Epidemics I, Case XII, occurs the phrase φλεγμονὴ ὑπολάπαρος2 ἐκ τοῦ ἔς1ω μέρεος2, from which it seems that the prefix ὑπο- means "underneath," not "rather." "Empty underneath" seems the primary meaning, and suggests a tightness, or inflammation, with nothing hard and bulky immediately beneath the surface to cause the tightness or inflammation. Perhaps the word also suggests the tenderness often found in the hypochoudria of malaria patients.

2 I take λεπτός2 here to mean "thinner than usual, than might have been expected," a meaning it has once or twice in the Hippocratic Corpus. It might also mean "consisting of small pieoes." See on Epidemics III, Case II (first series).

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 3.0 United States License.

An XML version of this text is available for download, with the additional restriction that you offer Perseus any modifications you make. Perseus provides credit for all accepted changes, storing new additions in a versioning system.

load focus English (Charles Darwin Adams, 1868)
load focus Greek (W. H. S. Jones, 1868)
hide Display Preferences
Greek Display:
Arabic Display:
View by Default:
Browse Bar: