Section III -- Constitution 2
Part 1
The year was southerly, rainy; no winds throughout. Droughts having
prevailed during the previous seasons of the year, the south winds
towards the rising of Arcturus were attended with much rain. Autumn
gloomy and cloudy, with copious rains. Winter southerly, damp, and
soft. But long after the solstice, and near the equinox, much wintery
weather out of season; and when now close to the equinox, northerly,
and winterly weather for no long time. The spring again southerly,
calm, much rain until the dog-days. Summer fine and hot; great suffocating
heats. The Etesian winds blew small and irregular; again, about the
season of Arcturus, much rains with north winds.
Part 2
The year being southerly, damp, and soft towards winter, all were
healthy, except those affected with phthisis, of whom we shall write
afterwards.
Part 3
Early in spring, along with the prevailing cold, there were many
cases of erysipelas, some from a manifest cause, and some not. They
were of a malignant nature, and proved fatal to many; many had sore-throat
and loss of speech. There were many cases of ardent fever, phrensy,
aphthous affections of the mouth, tumors on the genital organs; of
ophthalmia, anthrax, disorder of the bowels, anorexia, with thirst
and without it; of disordered urine, large in quantity, and bad in
quality; of persons affected with coma 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 epidemic. 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:
Part 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
[p. 130] 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 putrefaction,
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 concoction
in 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.
1 Such was the nature of these cases
when attended with sores, and proceeding from an external cause; but
the same things occurred in fevers, before fevers, and after 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 thereby: 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
[p. 131]took place
in the spring, but were prolonged through the summer and during autumn.
Part 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.
Part 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, nausea, and rigors; fever acute, not
much thirst, nor delirium, 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 extremities, 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 no sleep, or with insomnolency, attended with pains;
most had disorders 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 stupor.
Part 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
[p. 132] ulcerations, boils (phymata),
externally and internally, about the groins. Watery ophthalmies of
a chronic character, with pains; fungous excrescences of the eyelids,
externally and internally, called fig, which destroyed the sight of
many persons. There were fungous growths, in many other instances,
on ulcers, 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.
Part 8
And many and serious complaints attacked many persons in the region
of the belly. In the first place, tenesmus, accompanied with pain,
attacked many, but more especially children, and all who had not attained
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 bilious, 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 guts, 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.
Part 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.
Part 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 purged properly;
for in many cases purgings
[p. 133] 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.
2
Part 11
Persons laboring 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.
Part 12
And many other forms of fevers were then epidemic, of tertian,
of quartan, of nocturnal,
3 of continual, of chronic, of erratic, 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 protracted, 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 swelling,
but more especially in phthisical cases.
Part 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,
[p. 134] 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 downwards 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 purging of the matters
about the lungs went on mildly. The fauces were not very irritable,
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 mischief attending these and the other complaints,
was the aversion to food, as has been described. For neither been
described. For neither had they any relish for drink along with their
food, but continued without thirst. There was heaviness of the body,
disposition to coma, in most cases swelling, which ended in dropsy;
they had rigors, and were delirious towards death.
Part 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 melancholic and subsanguineous, phrenitic and dysenteric affections
principally attacked them. Tenesmus troubled young persons of a phlegmatic
temperament. Chronic diarrhoea, acrid and viscid discharges from the
bowels, attacked those who were troubled with bitter bile.
Part 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
[p. 135] it became suddenly hot, southerly, and calm; but, not withstanding,
it proved beneficial by producing a change on the other constitution.
Part 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 accurately
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.
