OF THE EPIDEMICS.txt

                                     400 BC



                                OF THE EPIDEMICS



                                 by Hippocrates



                          translated by Francis Adams











                     OF THE EPIDEMICS



             BOOK I. Sect. I. First Constitution







  1. IN THASUS, about the autumn equinox, and under the Pleiades,



the rains were abundant, constant, and soft, with southerly winds; the



winter southerly, the northerly winds faint, droughts; on the whole,



the winter having the character of spring. The spring was southerly,



cool, rains small in quantity. Summer, for the most part, cloudy, no



rain, the Etesian winds, rare and small, blew in an irregular



manner. The whole constitution of the season being thus inclined to



the southerly, and with droughts early in the spring, from the



preceding opposite and northerly state, ardent fevers occurred in a



few instances, and these very mild, being rarely attended with



hemorrhage, and never proving fatal. Swellings appeared about the



ears, in many on either side, and in the greatest number on both



sides, being unaccompanied by fever so as not to confine the patient



to bed; in all cases they disappeared without giving trouble,



neither did any of them come to suppuration, as is common in swellings



from other causes. They were of a lax, large, diffused character,



without inflammation or pain, and they went away without any



critical sign. They seized children, adults, and mostly those who were



engaged in the exercises of the palestra and gymnasium, but seldom



attacked women. Many had dry coughs without expectoration, and



accompanied with hoarseness of voice. In some instances earlier, and



in others later, inflammations with pain seized sometimes one of the



testicles, and sometimes both; some of these cases were accompanied



with fever and some not; the greater part of these were attended



with much suffering. In other respects they were free of disease, so



as not to require medical assistance.



  2. Early in the beginning of spring, and through the summer, and



towards winter, many of those who had been long gradually declining,



took to bed with symptoms of phthisis; in many cases formerly of a



doubtful character the disease then became confirmed; in these the



constitution inclined to the phthisical. Many, and, in fact, the



most of them, died; and of those confined to bed, I do not know if a



single individual survived for any considerable time; they died more



suddenly than is common in such cases. But other diseases, of a



protracted character, and attended with fever, were well supported,



and did not prove fatal: of these we will give a description



afterwards. Consumption was the most considerable of the diseases



which then prevailed, and the only one which proved fatal to many



persons. Most of them were affected by these diseases in the following



manner: fevers accompanied with rigors, of the continual type,



acute, having no complete intermissions, but of the form of the



semi-tertians, being milder the one day, and the next having an



exacerbation, and increasing in violence; constant sweats, but not



diffused over the whole body; extremities very cold, and warmed with



difficulty; bowels disordered, with bilious, scanty, unmixed, thin,



pungent, and frequent dejections. The urine was thin, colorless,



unconcocted, or thick, with a deficient sediment, not settling



favorably, but casting down a crude and unseasonable sediment. Sputa



small, dense, concocted, but brought up rarely and with difficulty;



and in those who encountered the most violent symptoms there was no



concoction at all, but they continued throughout spitting crude



matters. Their fauces, in most of them, were painful from first to



last, having redness with inflammation; defluxions thin, small and



acrid; they were soon wasted and became worse, having no appetite



for any kind of food throughout; no thirst; most persons delirious



when near death. So much concerning the phthisical affections.



  3. In the course of the summer and autumn many fevers of the



continual type, but not violent; they attacked persons who had been



long indisposed, but who were otherwise not in an uncomfortable state.



In most cases the bowels were disordered in a very moderate degree,



and they did not suffer thereby in any manner worth mentioning; the



urine was generally well colored, clear, thin, and after a time



becoming concocted near the crisis. They had not much cough, nor it



troublesome; they were not in appetite, for it was necessary to give



them food (on the whole, persons laboring under phthisis were not



affected in the usual manner). They were affected with fevers, rigors,



and deficient sweats, with varied and irregular paroxysms, in



general not intermitting, but having exacerbations in the tertian



form. The earliest crisis which occurred was about the twentieth



day, in most about the fortieth, and in many about the eightieth.



But there were cases in which it did not leave them thus at all, but



in an irregular manner, and without any crisis; in most of these the



fevers, after a brief interval, relapsed again; and from these



relapses they came to a crisis in the same periods; but in many they



were prolonged so that the disease was not gone at the approach of



winter. Of all those which are described under this constitution,



the phthisical diseases alone were of a fatal character; for in all



the others the patients bore up well, and did not die of the other



fevers.



                  Sect. II. Second Constitution







  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; 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



reduncance 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.



  2. All these fevers described attacked great numbers. All these



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 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



intermi...