Section II. -- Second Constitution
PART 1
In Thasus, early in autumn, the winter suddenly set in rainy before
the usual time, with much northerly and southerly winds. These things
all continued so during the season of the Pleiades, and until their
setting. The winter was northerly, the rains frequent, in torrents,
and large, with snow, but with a frequent mixture of fair weather.
These things were all so, but the setting in of the cold was not much
out of season. After the winter solstice, and at the time when the
zephyr usually begins to blow, severe winterly storms out of season,
with much northerly wind, snow, continued and copious rains; the sky
tempestuous and clouded; these things were protracted, and did not
remit until the equinox. The spring was cold, northerly, rainy, and
clouded;
[p. 103] the summer was not very sultry, the Etesian winds blew constant,
but quickly afterwards, about the rising of Arcturus, there were again
many rains with north winds. The whole season being wet, cold, and
northerly, people were, for the most part, healthy during winter;
but early in the spring very many, indeed, the greater part, were
valetudinary. At first ophthalmies set in, with rheums, pains, unconcocted
discharges, small concretions, generally breaking with difficulty,
in most instances they relapsed, and they did not cease until late
in autumn. During summer and autumn there were dysenteric affections,
attacks of tenesmus and lientery, bilious diarrhoea, with thin, copious,
undigested, and acrid dejections, and sometimes with watery stools;
many had copious defluxions, with pain, of a bilious, watery, slimy,
purulent nature, attended with strangury, not connected with disease
of the kidneys, but one complaint succeeding the other; vomitings
of bile, phlegm, and undigested food, sweats, in all cases a redundance
of humors. In many instances these complaints were unattended with
fever, and did not prevent the patients from walking about, but some
cases were febrile, as will be described. In some all those described
below occurred with pain. During autumn, and at the commencement of
winter, there were phthisical complaints, continual fevers; and, in
a few cases, ardent; some diurnal, others nocturnal, semi-tertians,
true tertians, quartans, irregular fevers.
PART 2
All the fevers which are described attacked great numbers. The ardent fevers
attacked the smallest numbers, and the patients suffered the least
from them, for there were no hemorrhages, except a few and to a small
amount, nor was there delirium; all the other complaints were slight;
in these the crises were regular, in most instances, with the intermittents,
in seventeen days; and I know no instance of a person dying of causus,
nor becoming phrenitic. The tertians were more numerous than the ardent
fevers, and attended with more pain; but these all had four periods
in regular succession from the first attack, and they had a complete
crisis in seven, without a relapse in any instance. The quartans attacked
many at first, in the form of regular quartans, but in no few cases
a transition from other fevers and diseases into quartans took place;
they were
[p. 104] protracted, as is wont with them, indeed, more so than usual. Quotidian, nocturnal, and wandering fevers attacked many persons,
some of whom continued to keep up, and others were confined to bed.
In most instances these fevers were prolonged under the Pleiades and
till winter. Many persons, and more especially children, had convulsions
from the commencement; and they had fever, and the convulsions supervened
upon the fevers; in most cases they were protracted, but free from
danger, unless in those who were in a deadly state from other complaints.
Those fevers which were continual in the main, and with no intermissions,
but having exacerbations in the tertian form, there being remissions
the one day and exacerbations the next, were the most violent of all
those which occurred at that time, and the most protracted, and occurring
with the greatest pains, beginning mildly, always on the whole increasing,
and being exacerbated, and always turning worse, having small remissions,
and after an abatement having more violent paroxysms, and growing
worse, for the most part, on the critical days. Rigors, in all cases,
took place in an irregular and uncertain manner, very rare and weak
in them, but greater in all other fevers; frequent sweats, but most
seldom in them, bringing no alleviation, but, on the contrary, doing
mischief. Much cold of the extremities in them, and these were warmed
with difficulty. Insomnolency, for the most part, especially in these
fevers, and again a disposition to coma. The bowels, in all diseases,
were disordered, and in a bad state, but worst of all in these. The
urine, in most of them, was either thin and crude, yellow, and after
a time with slight symptoms of concoction in a critical form, or having
the proper thickness, but muddy, and neither settling nor subsiding;
or having small and bad, and crude sediments; these being the worst
of all. Coughs attended these fevers, but I cannot state that any
harm or good ever resulted from the cough.
PART 3
The most of these were protracted and troublesome, went on in a
very disorderly and irregular form, and, for the most part, did in
a crisis, either in the fatal cases or in the others; for if it left
some of them for a season it soon returned again. In a few instances
the lever terminated with a crisis;
[p. 105] in the earliest of these about
the eightieth day, and some of these relapsed, so that most of them
were not free from the fever during the winter; but the fever left
most of them without a crisis, and these things happened alike to
those who recovered and to those who did not. There being much want
of crisis and much variety as to these diseases, the greatest and
worst symptom attended the most of them, namely, a loathing of all
articles of food, more especially with those who had otherwise fatal
symptoms; but they were not unseasonably thirsty in such fevers. After
a length of time, with much suffering and great wasting, abscesses
were formed in these cases, either unusually large, so that the patients
could not support them, or unusually small, so that they did no good,
but soon relapsed and speedily got worse. The diseases which attacked
them were in the form of dysenteries, tenesmus, lientery, and fluxes;
but, in some cases, there were dropsies, with or without these complaints.
Whatever attacked them violently speedily cut them off, or again,
did them no good. Small rashes, and not corresponding to the violence
of the disease, and quickly disappearing, or swellings occurred about
the ears, which were not resolved, and brought on no crisis. In some
they were determined to the joints, and especially to the hip-joint,
terminating critically with a few, and quickly again increasing to
its original habit.
PART 4
Perons died of all these diseases, but mostly of these fevers,
and notably infants just weaned, and older children, until eight or
ten years of age, and those before puberty. These things occurred
to those affected with the complaints described above, and to many
persons at first without them. The only favorable symptom, and the
greatest of those which occurred, and what saved most of those who
were in the greatest dangers, was the conversion of it to a strangury,
and when, in addition to this, abscesses were formed. The strangury
attacked, most especially, persons of the ages I have mentioned, but
it also occurred in many others, both of those who were not confined
to bed and those who were. There was a speedy and great change in
all these cases. For the bowels, if they happened previously to have
watery discharges of a bad character, became regular, they got an
appetite for food, and the
[p. 106]fevers were mild afterwards. But, with
regard to the strangury itself, the symptoms were protracted and painful.
Their urine was copious, thick, of various characters, red, mixed
with pus, and was passed with pain. These all recovered, and I did
not see a single instance of death among them.
PART 5
With regard to the dangers of these cases, one must always attend
to the seasonable concoction of all the evacuations, and to the favorable
and critical abscesses. The concoctions indicate a speedy crisis and
recovery of health; crude and undigested evacuations, and those which
are converted into bad abscesses, indicate either want of crisis,
or pains, or prolongation of the disease, or death, or relapses; which
of these it is to be must be determined from other circumstances.
The physician must be able to tell the antecedents, know the present,
and foretell the future- must mediate these things, and have two special
objects in view with regard to disease, namely, to do good or to do
no harm. The art consists in three things- the disease, the patient,
and the physician. The physician is the servant of the art, and the
patient must combat the disease along with the physician.1
PART 6
Pains about the head and neck, and heaviness of the same along
with pain, occur either without fevers or in fevers. Convulsions occurring
in persons attacked with frenzy, and having vomitings of verdigris-green
bile, in some cases quickly prove fatal. In ardent fevers, and in
those other fevers in which there is pain of the neck, heaviness of
the temples, mistiness about the eyes, and distention about the hypochondriac
region, not unattended with pain, hemorrhage from the nose takes place,
but
[p. 107]those who have heaviness of the whole head, cardialgia and nausea,
vomit bilious and pituitous matters; children, in such affections,
are generally attacked with convulsions, and women have these and
also pains of the uterus; whereas, in elder persons, and those in
whom the heat is already more subdued, these cases end in paralysis,
mania, and loss of sight.
