首页 >出版文学> OF THE EPIDEMICS>第4章
  thediurnalisstillmoreprotracted,andinsomecasespassesintophthisis。Theseptanisprotracted,butnotfatal;thenonanmoreprotracted,andnotfatal。Thetruetertiancomesquicklytoacrisis,andisnotfatal;butthequintanistheworstofall,foritprovesfatalwhenitprecedesanattackofphthisis,andwhenitsupervenesonpersonswhoarealreadyconsumptive。Therearepeculiarmodes,andconstitutions,andparoxysms,ineveryoneofthesefevers;forexample,—thecontinual,insomecasesattheverycommencement,grows,asitwere,andattainsitsfullstrength,andrisestoitsmostdangerouspitch,butisdiminishedaboutandatthecrisis;inothersitbeginsgentleandsuppressed,butgainsgroundandisexacerbatedeveryday,andburstsforthwithallitsheataboutandatthecrisis;whileinothers,again,itcommencesmildly,increases,andisexacerbateduntilitreachesitsacme,andthenremitsuntilatandaboutthecrisis。Thesevarietiesoccurineveryfever,andineverydisease。Fromtheseobservationsonemustregulatetheregimenaccordingly。Therearemanyotherimportantsymptomsalliedtothese,partofwhichhavebeenalreadynoticed,andpartwillbedescribedafterwards,fromaconsiderationofwhichonemayjudge,anddecidedineachcase,whetherthediseasebeacute,acute,andwhetheritwillendindeathorrecovery;orwhetheritwillbeprotracted,andwillendindeathorrecovery;andinwhatcasesfoodistobegiven,andinwhatnot;andwhenandtowhatamount,andwhatparticularkindoffoodistobeadministered。
  3。Thosediseaseswhichhavetheirparoxysmsonevendayshavetheircrisesonevendays;andthosewhichhavetheirparoxysmsonunevendayshavetheircrisesonunevendays。Thefirstperiodofthosewhichhavethecrisisonevendays,isthe4th,6th,8th,10th,14th,20th,30th,40th,60th,80th,100th;andthefirstperiodofthosewhichhavetheircrisesonunevendays,isthe1st,3d,5th,7th,9th,11th,17th,21th,27th,31st。Itshouldbeknown,thatifthecrisistakeplaceonanyotherdaythanonthosedescribed,itindicatesthattherewillbearelapse,whichmayprovefatal。Butoneoughttopayattention,andknowintheseseasonswhatcriseswillleadtorecoveryandwhattodeath,ortochangesforthebetterortheworse。
  Irregularfevers,quartans,quintans,septans,andnonansshouldbestudied,inordertofindoutinwhatperiodstheircrisestakeplace。
  FourteenCasesofDiseaseCASEI。Philiscus,wholivedbytheWall,tooktobedonthefirstdayofacutefever;hesweated;towardsnightwasuneasy。Ontheseconddayallthesymptomswereexacerbated;lateintheeveninghadaproperstoolfromasmallclyster;thenightquiet。Onthethirdday,earlyinthemorninganduntilnoon,heappearedtobefreefromfever;towardsevening,acutefever,withsweating,thirst,tongueparched;passedblackurine;nightuncomfortable,nosleep;
  hewasdeliriousonallsubjects。Onthefourth,allthesymptomsexacerbated,urineblack;nightmorecomfortable,urineofabettercolor。Onthefifth,aboutmid—day,hadaslighttricklingofpurebloodfromthenose;urinevariedincharacter,havingfloatinginitroundbodies,resemblingsemen,andscattered,butwhichdidnotfalltothebottom;asuppositoryhavingbeenapplied,somescantyflatulentmatterswerepassed;nightuncomfortable,littlesleep,talkingincoherently;extremitiesaltogethercold,andcouldnotbewarmed;urine,black;sleptalittletowardsday;lossofspeech,coldsweats;extremitieslivid;aboutthemiddleofthesixthdayhedied。Therespirationthroughout,likethatofapersonrecollectinghimself,wasrare,andlarge,andspleenwasswelleduponinaroundtumor,thesweatscoldthroughout,theparoxysmsontheevendays。
  CASEII。SilenuslivedontheBroad—way,nearthehouseofEvalcidas。Fromfatigue,drinking,andunseasonableexercises,hewasseizedwithfever。Hebeganwithhavingpainintheloins;hehadheavinessofthehead,andtherewasstiffnessoftheneck。Onthefirstdaythealvinedischargeswerebilious,unmixed,frothy,highcolored,andcopious;urineblack,havingablacksediment;hewasthirsty,tonguedry;nosleepatnight。Onthesecond,acutefever,stoolsmorecopious,thinner,frothy;urineblack,anuncomfortablenight,slightdelirium。Onthethird,allthesymptomsexacerbated;anoblongdistention,ofasoftishnature,frombothsidesofthehypochondriumtothenavel;stoolsthin,anddarkish;urinemuddy,anddarkish;nosleepatnight;muchtalking,laughter,singing,hecouldnotrestrainhimself。Onthefourth,inthesamestate。Onthefifth,stoolsbilious,unmixed,smooth,greasy;urinethin,andtransparent;slightabsenceofdelirium。Onthesixth,slightperspirationaboutthehead;extremitiescoldandlivid;muchtossingabout;nopassagefromthebowels,urinesuppressed,acutefever。Ontheseventh,lossofspeech;extremitiescouldnolongerbekeptwarm;nodischargeofurine。Ontheeighth,acoldsweatallover;redrasheswithsweat,ofaroundfigure,small,likevari,persistent,notsubsiding;bymeansofaslightstimulus,acopiousdischargefromthebowels,ofathinandundigestedcharacter,withpain;urineacrid,andpassedwithpain;extremitiesslightlyheated;sleepslight,andcomatose;speechless;urinethin,andtransparent。Ontheninth,inthesamestate。Onthetenth,nodrinktaken;comatose,sleepslight;alvinedischargesthesame;urineabundant,andthickish;whenallowedtostand,thesedimentfarinaceousandwhite;extremitiesagaincold。Ontheeleventh,hedied。Atthecommencement,andthroughout,therespirationwasslowandlarge;therewasaconstantthrobbinginthehypochondrium;hisagewasabouttwenty。
  CASEIII。Herophonwasseizedwithanacutefever;alvinedischargesatfirstwerescanty,andattendedwithtenesmus;butafterwardstheywerepassedofathin,biliouscharacter,andfrequent;therewasnosleep;urineblack,andthin。Onthefifth,inthemorning,deafness;allthesymptomsexacerbated;spleenswollen;distentionofthehypochondrium;alvinedischargesscanty,andblack;hebecamedelirious。Onthesixth,delirious;atnight,sweating,coldness;
  thedeliriumcontinued。Ontheseventh,hebecamecold,thirsty,wasdisorderedinmind;atnightrecoveredhissenses;slept。Ontheeighth,wasfeverish;thespleendiminishedinsize;quitecollected;hadpainatfirstaboutthegroin,onthesamesideasthespleen;hadpainsinbothlegs;nightcomfortable;urinebettercolored,hadascantysediment。Ontheninth,sweated;thecrisistookplace;feverremitted。Onthefifthdayafterwards,feverrelapsed,spleenimmediatelybecameswollen;acutefever;deafnessagain。Onthethirddayaftertherelapse,thespleendiminished;deafnessless;
  legspainful;sweatedduringthenight;crisistookplaceontheseventeenthday;hadnodisorderofthesensesduringtherelapse。
  CASEIV。InThasus,thewifeofPhilinus,havingbeendeliveredofadaughter,thedischargebeingnatural,andothermattersgoingonmildly,onthefourteenthdayafterdeliverywasseizedwithfever,attendedwithrigor;waspainedatfirstinthecardiacregionofthestomachandrighthypochondrium;paininthegenitalorgans;
  lochialdischargeceased。Upontheapplicationofapessaryallthesesymptomswerealleviated;painsofthehead,neck,andloinsremained;nosleep;extremitiescold;thirst;bowelsinahotstate;
  stoolsscanty;urinethin,andcolorlessatfirst。Onthesixth,towardsnight,sensesmuchdisordered,butagainwererestored。Ontheseventh,thirsty;theevacuationsbilious,andhighcolored。Ontheeighth,hadarigor;acutefever;muchspasm,withpain;talkedmuch,incoherently;upontheapplicationofasuppository,rosetostool,andpassedcopiousdejections,withabiliousflux;nosleep。
  Ontheninth,spasms。Onthetenth,slightlyrecollected。Ontheeleventh,slept;hadperfectrecollection,butagainimmediatelywandered;passedalargequantityofurinewithspasms,(theattendantsseldomputtingherinmind),itwasthick,white,likeurinewhichhasbeenshakenafterithasstoodforaconsiderabletimeuntilithassubsided,butithadnosediment;incolorandconsistence,theurineresembledthatofcattle,asfarasIobserved。
  Aboutthefourteenthday,startingsoverthewholebody;talkedmuch;slightlycollected,butpresentlybecameagaindelirious。
  Abouttheseventeenthdaybecamespeechless,onthetwentiethdied。
  CASEV。ThewifeofEpicrates,whowaslodgedatthehouseofArchigetes,beingnearthetermofdelivery,wasseizedwithaviolentrigor,and,aswassaid,shedidnotbecomeheated;nextdaythesame。
  Onthethird,shewasdeliveredofadaughter,andeverythingwentonproperly。Onthedayfollowingherdelivery,shewasseizedwithacutefever,paininthecardiacregionofthestomach,andinthegenitalparts。Havinghadasuppository,wasinsofarrelieved;
  paininthehead,neck,andloins;nosleep;alvinedischargesscanty,bilious,thin,andunmixed;urinethin,andblackish。Towardsthenightofthesixthdayfromthetimeshewasseizedwiththefever,becamedelirious。Ontheseventh,allthesymptomsexacerbated;
  insomnolency,delirium,thirst;stoolsbilious,andhighcolored。Ontheeighth,hadarigor;sleptmore。Ontheninth,thesame。Onthetenth,herlimbspainfullyaffected;painagainofthecardiacregionofthestomach;heavinessofthehead;nodelirium;sleptmore;