diff --git a/data/tlg0627/tlg001/tlg0627.tlg001.perseus-eng3.xml b/data/tlg0627/tlg001/tlg0627.tlg001.perseus-eng3.xml index 21ff6c0f7..79f8c7d6e 100644 --- a/data/tlg0627/tlg001/tlg0627.tlg001.perseus-eng3.xml +++ b/data/tlg0627/tlg001/tlg0627.tlg001.perseus-eng3.xml @@ -100,13 +100,13 @@

And if it were simply, as is laid down, that such things as are stronger prove injurious, but such as are weaker prove beneficial and nourishing, both to sick and healthy persons, it were an easy matter, for then the safest rule would be to circumscribe the diet to the lowest point. But then it is no less mistake, nor one that injuries a man less, provided a deficient diet, or one consisting of weaker things than what are proper, be administered. For, in the constitution of man, abstinence may enervate, weaken, and kill. And there are many other ills, different from those of repletion, but no less dreadful, arising from deficiency of food; wherefore the practice in those cases is more varied, and requires greater accuracy. For one must aim at attaining a certain measure, and yet this measure admits neither weight nor calculation of any kind, by which it may be accurately determined, unless it be the sensation of the body; wherefore it is a task to learn this accurately, so as not to commit small blunders either on the one side or the other, and in fact I would give great praise to the physician whose mistakes are small, for perfect accuracy is seldom to be seen, since many physicians seem to me to be in the same plight as bad pilots, who, if they commit mistakes while conducting the ship in a calm do not expose themselves, but when a storm and violent hurricane overtake them, they then, from their ignorance and mistakes, are discovered to be what they are, by all men, namely, in losing their ship. And thus bad and commonplace physicians, when they treat men who have no serious illness, in which case one may commit great mistakes without producing any formidable mischief (and such complaints occur much more frequently to men than dangerous ones): under these circumstances, when they commit mistakes, they do not expose themselves to ordinary men; but when they fall in with a great, a strong, and a dangerous disease, then their mistakes and want of skill are made apparent to all. Their punishment is not far off, but is swift in overtaking both the one and the other.He means both the pilot and physician.

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And that no less mischief happens to a man from unseasonable depletion than from repletion, may be clearly seen upon reverting to the consideration of persons in health. For, to some, with whom it agrees to take only one meal in the day, and they have arranged it so accordingly; whilst others, for the same reason, also take dinner, and this they do because they find it good for them, and not like those persons who, for pleasure or from any casual circumstance, adopt the one or the other custom and to the bulk of mankind it is of little consequence which of these rules they observe, that is to say, whether they make it a practice to take one or two meals. But there are certain persons who cannot readily change their diet with impunity; and if they make any alteration in it for one day, or even for a part of a day, are greatly injured thereby. Such persons, provided they take dinner when it is not their wont, immediately become heavy and inactive, both in body and mind, and are weighed down with yawning, slumbering, and thirst; and if they take supper in addition, they are seized with flatulence, tormina, and diarrhea, and to many this has been the commencement of a serious disease, when they have merely taken twice in a day the same food which they have been in the custom of taking once. And thus, also, if one who has been accustomed to dine, and this rule agrees with him, should not dine at the accustomed hour, he will straightway feel great loss of strength, trembling, and want of spirits, the eyes of such a person will become more pallid, his urine thick and hot, his mouth bitter; his bowels will seem, as it were, to hang loose; he will suffer from vertigo, lowness of spirit, and inactivity,- such are the effects; and if he should attempt to take at supper the same food which he was wont to partake of at dinner, it will appear insipid, and he will not be able to take it off; and these things, passing downwards with tormina and rumbling, burn up his bowels; he experiences insomnolency or troubled and disturbed dreams; and to many of them these symptoms are the commencement of some disease.

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And that no less mischief happens to a man from unseasonable depletion than from repletion, may be clearly seen upon reverting to the consideration of persons in health. For, to some, with whom it agrees to take only one meal in the day, and they have arranged it so accordingly; whilst others, for the same reason, also take dinner, and this they do because they find it good for them, and not like those persons who, for pleasure or from any casual circumstance, adopt the one or the other custom and to the bulk of mankind it is of little consequence which of these rules they observe, that is to say, whether they make it a practice to take one or two meals. But there are certain persons who cannot readily change their diet with impunity; and if they make any alteration in it for one day, or even for a part of a day, are greatly injured thereby. Such persons, provided they take dinner when it is not their wont, immediately become heavy and inactive, both in body and mind, and are weighed down with yawning, slumbering, and thirst; and if they take supper in addition, they are seized with flatulence, tormina, and diarrhea, and to many this has been the commencement of a serious disease, when they have merely taken twice in a day the same food which they have been in the custom of taking once. And thus, also, if one who has been accustomed to dine, and this rule agrees with him, should not dine at the accustomed hour, he will straightway feel great loss of strength, trembling, and want of spirits, the eyes of such a person will become more pallid, his urine thick and hot, his mouth bitter; his bowels will seem, as it were, to hang loose; he will suffer from vertigo, lowness of spirit, and inactivity,—such are the effects; and if he should attempt to take at supper the same food which he was wont to partake of at dinner, it will appear insipid, and he will not be able to take it off; and these things, passing downwards with tormina and rumbling, burn up his bowels; he experiences insomnolency or troubled and disturbed dreams; and to many of them these symptoms are the commencement of some disease.

But let us inquire what are the causes of these things which happened to them. To him, then, who was accustomed to take only one meal in the day, they happened because he did not wait the proper time, until his bowels had completely derived benefit from and had digested the articles taken at the preceding meal, and until his belly had become soft, and got into a state of rest, but he gave it a new supply while in a state of heat and fermentation, for such bellies digest much more slowly, and require more rest and ease. And as to him who had been accustomed to dinner, since, as soon as the body required food, and when the former meal was consumed, and he wanted refreshment, no new supply was furnished to it, he wastes and is consumed from want of food. For all the symptoms which I describe as befalling to this man I refer to want of food. And I also say that all men who, when in a state of health, remain for two or three days without food, experience the same unpleasant symptoms as those which I described in the case of him who had omitted to take dinner.

Wherefore, I say, that such constitutions as suffer quickly and strongly from errors in diet, are weaker than others that do not; and that a weak person is in a state very nearly approaching to one in disease; but a person in disease is the weaker, and it is, therefore, more likely that he should suffer if he encounters anything that is unseasonable. It is difficult, seeing that there is no such accuracy in the Art, to hit always upon what is most expedient, and yet many cases occur in medicine which would require this accuracy, as we shall explain. But on that account, I say, we ought not to reject the ancient Art, as if it were not, and had not been properly founded, because it did not attain accuracy in all things, but rather, since it is capable of reaching to the greatest exactitude by reasoning, to receive it and admire its discoveries, made from a state of great ignorance, and as having been well and properly made, and not from chance.

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But I wish the discourse to revert to the new method of those who prosecute their inquiries in the Art by hypothesis. For if hot, or cold, or moist, or dry, be that which proves injurious to man, and if the person who would treat him properly must apply cold to the hot, hot to the cold, moist to the dry, and dry to the moist- let me be presented with a man, not indeed one of a strong constitution, but one of the weaker, and let him eat wheat, such as it is supplied from the thrashing-floor, raw and unprepared, with raw meat, and let him drink water. By using such a diet I know that he will suffer much and severely, for he will experience pains, his body will become weak, and his bowels deranged, and he will not subsist long. What remedy, then, is to be provided for one so situated? Hot? or cold? or moist? or dry? For it is clear that it must be one or other of these. For, according to this principle, if it is one of the which is injuring the patient, it is to be removed by its contrary. But the surest and most obvious remedy is to change the diet which the person used, and instead of wheat to give bread, and instead of raw flesh, boiled, and to drink wine in addition to these; for by making these changes it is impossible but that he must get better, unless completely disorganized by time and diet. What, then, shall we say? whether that, as he suffered from cold, these hot things being applied were of use to him, or the contrary? I should think this question must prove a puzzler to whomsoever it is put. For whether did he who prepared bread out of wheat remove the hot, the cold, the moist, or the dry principle in it?—for the bread is consigned both to fire and to water, and is wrought with many things, each of which has its peculiar property and nature, some of which it loses, and with others it is diluted and mixed.

+

But I wish the discourse to revert to the new method of those who prosecute their inquiries in the Art by hypothesis. For if hot, or cold, or moist, or dry, be that which proves injurious to man, and if the person who would treat him properly must apply cold to the hot, hot to the cold, moist to the dry, and dry to the moist—let me be presented with a man, not indeed one of a strong constitution, but one of the weaker, and let him eat wheat, such as it is supplied from the thrashing-floor, raw and unprepared, with raw meat, and let him drink water. By using such a diet I know that he will suffer much and severely, for he will experience pains, his body will become weak, and his bowels deranged, and he will not subsist long. What remedy, then, is to be provided for one so situated? Hot? or cold? or moist? or dry? For it is clear that it must be one or other of these. For, according to this principle, if it is one of the which is injuring the patient, it is to be removed by its contrary. But the surest and most obvious remedy is to change the diet which the person used, and instead of wheat to give bread, and instead of raw flesh, boiled, and to drink wine in addition to these; for by making these changes it is impossible but that he must get better, unless completely disorganized by time and diet. What, then, shall we say? whether that, as he suffered from cold, these hot things being applied were of use to him, or the contrary? I should think this question must prove a puzzler to whomsoever it is put. For whether did he who prepared bread out of wheat remove the hot, the cold, the moist, or the dry principle in it?—for the bread is consigned both to fire and to water, and is wrought with many things, each of which has its peculiar property and nature, some of which it loses, and with others it is diluted and mixed.

And this I know, moreover, that to the human body it makes a great difference whether the bread be fine or coarse; of wheat with or without the hull, whether mixed with much or little water, strongly wrought or scarcely at all, baked or raw—and a multitude of similar differences; and so, in like manner, with the cake (maza); the powers of each, too, are great, and the one nowise like the other. Whoever pays no attention to these things, or, paying attention, does not comprehend them, how can he understand the diseases which befall a man? For, by every one of these things, a man is affected and changed this way or that, and the whole of his life is subjected to them, whether in health, convalescence, or disease. Nothing else, then, can be more important or more necessary to know than these things. So that the first inventors, pursuing their investigations properly, and by a suitable train of reasoning, according to the nature of man, made their discoveries, and thought the Art worthy of being ascribed to a god, as is the established belief. For they did not suppose that the dry or the moist, the hot or the cold, or any of these are either injurious to man, or that man stands in need of them, but whatever in each was strong, and more than a match for a man’s constitution, whatever he could not manage, that they held to be hurtful, and sought to remove. Now, of the sweet, the strongest is that which is intensely sweet; of the bitter, that which is intensely bitter; of the acid, that which is intensely acid; and of all things that which is extreme, for these things they saw both existing in man, and proving injurious to him. For there is in man the bitter and the salt, the sweet and the acid, the sour and the insipid, and a multitude of other things having all sorts of powers both as regards quantity and strength. These, when all mixed and mingled up with one another, are not apparent, neither do they hurt a man; but when any of them is separate, and stands by itself, then it becomes perceptible, and hurts a man. And thus, of articles of food, those which are unsuitable and hurtful to man when administered, every one is either bitter, or intensely so, or saltish or acid, or something else intense and strong, and therefore we are disordered by them in like manner as we are by the secretions in the body. But all those things which a man eats and drinks are devoid of any such intense and well-marked quality, such as bread, cake, and many other things of a similar nature which man is accustomed to use for food, with the exception of condiments and confectioneries, which are made to gratify the palate and for luxury. And from those things, when received into the body abundantly, there is no disorder nor dissolution of the powers belonging to the body; but strength, growth, and nourishment result from them, and this for no other reason than because they are well mixed, have nothing in them of an immoderate character, nor anything strong, but the whole forms one simple and not strong substance.

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But I think that of all the qualities heat and cold exercise the least operation in the body, for these reasons: as long time as hot and cold are mixed up with one another they do not give trouble, for the cold is attempered and rendered more moderate by the hot, and the hot by the cold; but when the one is wholly separate from the other, then it gives pain; and at that season when cold is applied it creates some pain to a man, but quickly, for that very reason, heat spontaneously arises in him without requiring any aid or preparation. And these things operate thus both upon men in health and in disease. For example, if a person in health wishes to cool his body during winter, and bathes either in cold water or in any other way, the more he does this, unless his body be fairly congealed, when he resumes his clothes and comes into a place of shelter, his body becomes more heated than before. And thus, too, if a person wish to be warmed thoroughly either by means of a hot bath or strong fire, and straight-way having the same clothing on, takes up his abode again in the place he was in when he became congealed, he will appear much colder, and more disposed to chills than before. And if a person fan himself on account of a suffocating heat, and having procured refrigeration for himself in this manner, cease doing so, the heat and suffocation will be ten times greater in his case than in that of a person who does nothing of the kind. And, to give a more striking example, persons travelling in the snow, or otherwise in rigorous weather, and contracting great cold in their feet, their hands, or their head, what do they not suffer from inflammation and tingling when they put on warm clothing and get into a hot place? In some instances, blisters arise as if from burning with fire, and they do not suffer from any of those unpleasant symptoms until they become heated. So readily does either of these pass into the other; and I could mention many other examples. And with regard to the sick, is it not in those who experience a rigor that the most acute fever is apt to break out? And yet not so strongly neither, but that it ceases in a short time, and, for the most part, without having occasioned much mischief; and while it remains, it is hot, and passing over the whole body, ends for the most part in the feet, where the chills and cold were most intense and lasted longest; and, when sweat supervenes, and the fever passes off, the patient is much colder than if he had not taken the fever at all. Why then should that which so quickly passes into the opposite extreme, and loses its own powers spontaneously, be reckoned a mighty and serious affair? And what necessity is there for any great remedy for it?

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One might here say- but persons in ardent fevers, pneumonia, and other formidable diseases, do not quickly get rid of the heat, nor experience these rapid alterations of heat and cold. And I reckon this very circumstance the strongest proof that it is not from heat simply that men get into the febrile state, neither is it the sole cause of the mischief, but that this species of heat is bitter, and that acid, and the other saltish, and many other varieties; and again there is cold combined with other qualities. These are what proves injurious; heat, it is true, is present also, possessed of strength as being that which conducts, is exacerbated and increased along with the other, but has no power greater than what is peculiar to itself.

+

One might here say—but persons in ardent fevers, pneumonia, and other formidable diseases, do not quickly get rid of the heat, nor experience these rapid alterations of heat and cold. And I reckon this very circumstance the strongest proof that it is not from heat simply that men get into the febrile state, neither is it the sole cause of the mischief, but that this species of heat is bitter, and that acid, and the other saltish, and many other varieties; and again there is cold combined with other qualities. These are what proves injurious; heat, it is true, is present also, possessed of strength as being that which conducts, is exacerbated and increased along with the other, but has no power greater than what is peculiar to itself.

With regard to these symptoms, in the first place those are most obvious of which we have all often had experience. Thus, then, in such of us as have a coryza and defluxion from the nostrils, this discharge is much more acrid than that which formerly was formed in and ran from them daily; and it occasions swelling of the nose, and it inflames, being of a hot and extremely ardent nature, as you may know, if you apply your hand to the place; and, if the disease remains long, the part becomes ulcerated although destitute of flesh and hard; and the heat in the nose ceases, not when the defluxion takes place and the inflammation is present, but when the running becomes thicker and less acrid, and more mixed with the former secretion, then it is that the heat ceases. But in all those cases in which this decidedly proceeds from cold alone, without the concourse of any other quality, there is a change from cold to hot, and from hot to cold, and these quickly supervene, and require no coction. But all the others being connected, as I have said, with acrimony and intemperance of humors, pass off in this way by being mixed and concocted.

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There are both within and without the body many other kinds of structure, which differ much from one another as to sufferings both in health and disease; such as whether the head be small or large; the neck slender or thick, long or short; the belly long or round; the chest and ribs broad or narrow; and many others besides, all which you ought to be acquainted with, and their differences; so that knowing the causes of each, you may make the more accurate observations.

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And, as has been formerly stated, one ought to be acquainted with the powers of juices, and what action each of them has upon man, and their alliances towards one another. What I say is this: if a sweet juice change to another kind, not from any admixture, but because it has undergone a mutation within itself; what does it first become?- bitter? salt? austere? or acid? I think acid. And hence, an acid juice is the most improper of all things that can be administered in cases in which a sweet juice is the most proper. Thus, if one should succeed in his investigations of external things, he would be the better able always to select the best; for that is best which is farthest removed from that which is unwholesome.

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And, as has been formerly stated, one ought to be acquainted with the powers of juices, and what action each of them has upon man, and their alliances towards one another. What I say is this: if a sweet juice change to another kind, not from any admixture, but because it has undergone a mutation within itself; what does it first become?—bitter? salt? austere? or acid? I think acid. And hence, an acid juice is the most improper of all things that can be administered in cases in which a sweet juice is the most proper. Thus, if one should succeed in his investigations of external things, he would be the better able always to select the best; for that is best which is farthest removed from that which is unwholesome.

diff --git a/data/tlg0627/tlg002/__cts__.xml b/data/tlg0627/tlg002/__cts__.xml index 1f4d9a7ff..c6ecb3b0b 100644 --- a/data/tlg0627/tlg002/__cts__.xml +++ b/data/tlg0627/tlg002/__cts__.xml @@ -3,7 +3,7 @@ Περὶ ἀέρων, ὑδάτων, τόπων - Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). diff --git a/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng3.xml b/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng3.xml index 368f6971d..8aa84740a 100644 --- a/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng3.xml +++ b/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng3.xml @@ -89,13 +89,13 @@

From these things he must proceed to investigate everything else. For if one knows all these things well, or at least the greater part of them, he cannot miss knowing, when he comes into a strange city, either the diseases peculiar to the place, or the particular nature of common diseases, so that he will not be in doubt as to the treatment of the diseases, or commit mistakes, as is likely to be the case provided one had not previously considered these matters. And in particular, as the season and the year advances, he can tell what epidemic diseases will attack the city, either in summer or in winter, and what each individual will be in danger of experiencing from the change of regimen. For knowing the changes of the seasons, the risings and settings of the stars, how each of them takes place, he will be able to know beforehand what sort of a year is going to ensue. Having made these investigations, and knowing beforehand the seasons, such a one must be acquainted with each particular, and must succeed in the preservation of health, and be by no means unsuccessful in the practice of his art. And if it shall be thought that these things belong rather to meteorology, it will be admitted, on second thoughts, that astronomy contributes not a little, but a very great deal, indeed, to medicine. For with the seasons the digestive organs of men undergo a change.

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But how of the aforementioned things should be investigated and explained, I will now declare in a clear manner. A city that is exposed to hot winds (these are between the wintry rising, and the wintry setting of the sun), and to which these are peculiar, but which is sheltered from the north winds; in such a city the waters will be plenteous and saltish, and as they run from an elevated source, they are necessarily hot in summer, and cold in winter; the heads of the inhabitants are of a humid and pituitous constitution, and their bellies subject to frequent disorders, owing to the phlegm running down from the head; the forms of their bodies, for the most part, are rather flabby; they do not eat nor drink much; drinking wine in particular, and more especially if carried to intoxication, is oppressive to them; and the following diseases are peculiar to the district: in the first place, the women are sickly and subject to excessive menstrua- tion; then many are unfruitful from disease, and not from nature, and they have frequent miscarriages; infants are subject to attacks of convulsions and asthma, which they consider to be connected with infancy, and hold to be a sacred disease (epilepsy). The men are subject to attacks of dysentery, diarrhea, hepialus,The Hepialus is a species of intermittent fever, very common in warm climates. It would appear to be a variety of the quotidian. See PAULUS AEGINETA, Vol. I., 252, Syd. Soc. edition. chronic fevers in winter, of epinyctis,Frequent mention of this disease of the skin occurs in the works of the ancient writers on medicine. frequently, and of hemorrhoids about the anus. Pleurisies, peripneumonies, ardent fevers, and whatever diseases are reckoned acute, do not often occur, for such diseases are not apt to prevail where the bowels are loose. Ophthalmies occur of a humid character, but not of a serious nature, and of short duration, unless they attack epidemically from the change of the seasons. And when they pass their fiftieth year, defluxions supervening from the brain, render them paralytic when exposed suddenly to strokes of the sun, or to cold. These diseases are endemic to them, and, moreover, if any epidemic disease connected with the change of the seasons, prevail, they are also liable to it.

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But how of the aforementioned things should be investigated and explained, I will now declare in a clear manner. A city that is exposed to hot winds (these are between the wintry rising, and the wintry setting of the sun), and to which these are peculiar, but which is sheltered from the north winds; in such a city the waters will be plenteous and saltish, and as they run from an elevated source, they are necessarily hot in summer, and cold in winter; the heads of the inhabitants are of a humid and pituitous constitution, and their bellies subject to frequent disorders, owing to the phlegm running down from the head; the forms of their bodies, for the most part, are rather flabby; they do not eat nor drink much; drinking wine in particular, and more especially if carried to intoxication, is oppressive to them; and the following diseases are peculiar to the district: in the first place, the women are sickly and subject to excessive menstruation; then many are unfruitful from disease, and not from nature, and they have frequent miscarriages; infants are subject to attacks of convulsions and asthma, which they consider to be connected with infancy, and hold to be a sacred disease (epilepsy). The men are subject to attacks of dysentery, diarrhea, hepialus,The Hepialus is a species of intermittent fever, very common in warm climates. It would appear to be a variety of the quotidian. See PAULUS AEGINETA, Vol. I., 252, Syd. Soc. edition. chronic fevers in winter, of epinyctis,Frequent mention of this disease of the skin occurs in the works of the ancient writers on medicine. frequently, and of hemorrhoids about the anus. Pleurisies, peripneumonies, ardent fevers, and whatever diseases are reckoned acute, do not often occur, for such diseases are not apt to prevail where the bowels are loose. Ophthalmies occur of a humid character, but not of a serious nature, and of short duration, unless they attack epidemically from the change of the seasons. And when they pass their fiftieth year, defluxions supervening from the brain, render them paralytic when exposed suddenly to strokes of the sun, or to cold. These diseases are endemic to them, and, moreover, if any epidemic disease connected with the change of the seasons, prevail, they are also liable to it.

But the following is the condition of cities which have the opposite exposure, namely, to cold winds, between the summer settings and the summer risings of the sun, and to which these winds are peculiar, and which are sheltered from the south and the hot breezes. In the first place the waters are, for the most part, hard cold. The men must necessarily be well braced and slender, and they must have the discharges downwards of the alimentary canal hard, and of difficult evacuation, while those upwards are more fluid, and rather bilious than pituitous. Their heads are sound and hard, and they are liable to burstings (of vessels?) for the most part. The diseases which prevail epidemically with them, are pleurisies, and those which are called acute diseases. This must be the case when the bowels are bound; and from any causes, many become affected with suppurations in the lungs, the cause of which is the tension of the body, and hardness of the bowels; for their dryness and the coldness of the water dispose them to ruptures (of vessels?). Such constitutions must be given to excess of eating, but not of drinking; for it is not possible to be gourmands and drunkards at the same time. Ophthalmies, too, at length supervene; these being of a hard and violent nature, and soon ending in rupture of the eyes; persons under thirty years of age are liable to severe bleedings at the nose in summer; attacks of epilepsy are rare but severe. Such people are likely to be rather long-lived; their ulcers are not attended with serious discharges, nor of a malignant character; in disposition they are rather ferocious than gentle. The diseases I have mentioned are peculiar to the men, and besides they are liable to any common complaint which may be prevailing from the changes of the seasons. But the women, in the first place, are of a hard constitution, from the waters being hard, indigestible, and cold; and their menstrual discharges are not regular, but in small quantity, and painful. Then they have difficult parturition, but are not very subject to abortions. And when they do bring forth children, they are unable to nurse them; for the hardness and indigestable nature of the water puts away their milk. Phthisis frequently supervenes after childbirth, for the efforts of it frequently bring on ruptures and strains. Children while still little are subject to dropsies in the testicle, which disappear as they grow older; in such a town they are late in attaining manhood. It is, as I have now stated, with regard to hot and cold winds and cities thus exposed.

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Cities that are exposed to winds between the summer and the winter risings of the sun, and those the opposite to them, have the following characters:- Those which lie to the rising of the sun are all likely to be more healthy than such as are turned to the North, or those exposed to the hot winds, even if there should not be a furlong between them. In the first place, both the heat and cold are more moderate. Then such waters as flow to the rising sun, must necessarily be clear, fragrant, soft, and delightful to drink, in such a city. For the sun in rising and shining upon them purifies them, by dispelling the vapors which generally prevail in the morning. The persons of the inhabitants are, for the most part, well colored and blooming, unless some disease counteract. The inhabitants have clear voices, and in temper and intellect are superior to those which are exposed to the north, and all the productions of the country in like manner are better. A city so situated resembles the spring as to moderation between heat and cold, and the diseases are few in number, and of a feeble kind, and bear a resemblance to the diseases which prevail in regions exposed to hot winds. The women there are very prolific, and have easy deliveries. Thus it is with regard to them.

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Cities that are exposed to winds between the summer and the winter risings of the sun, and those the opposite to them, have the following characters:— Those which lie to the rising of the sun are all likely to be more healthy than such as are turned to the North, or those exposed to the hot winds, even if there should not be a furlong between them. In the first place, both the heat and cold are more moderate. Then such waters as flow to the rising sun, must necessarily be clear, fragrant, soft, and delightful to drink, in such a city. For the sun in rising and shining upon them purifies them, by dispelling the vapors which generally prevail in the morning. The persons of the inhabitants are, for the most part, well colored and blooming, unless some disease counteract. The inhabitants have clear voices, and in temper and intellect are superior to those which are exposed to the north, and all the productions of the country in like manner are better. A city so situated resembles the spring as to moderation between heat and cold, and the diseases are few in number, and of a feeble kind, and bear a resemblance to the diseases which prevail in regions exposed to hot winds. The women there are very prolific, and have easy deliveries. Thus it is with regard to them.

But such cities as lie to the west, and which are sheltered from winds blowing from the east, and which the hot winds and the cold winds of the north scarcely touch, must necessarily be in a very unhealthy situation: in the first place the waters are not clear, the cause of which is, because the mist prevails commonly in the morning, and it is mixed up with the water and destroys its clearness, for the sun does not shine upon the water until he be considerably raised above the horizon. And in summer, cold breezes from the east blow and dews fall; and in the latter part of the day the setting sun particularly scorches the inhabitants, and therefore they are pale and enfeebled, and are partly subject to all the aforesaid diseases, but no one is peculiar to them. Their voices are rough and hoarse owing to the state of the air, which in such a situation is generally impure and unwholesome, for they have not the northern winds to purify it; and these winds they have are of a very humid character, such being the nature of the evening breezes. Such a situation of a city bears a great resemblance to autumn as regards the changes of the day, inasmuch as the difference between morning and evening is great. So it is with regard to the winds that are conducive to health, or the contrary.

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MenThis is a most interesting chapter, as containing the most ancient observations which we possess on the important subject of urinary calculi. The ancients never improved the theory, nor added much to the facts which are here stated by our author. We have given the summary of their opinions in the Commentary on PAULUS AEGINETA, B. III., 45. I would beg leave to remark that, notwithstanding the number of curious facts which modern chemistry has evolved regarding the composition of urinary calculi, the etiology of the disease is nearly as obscure now as it was in the days of Hippocrates. become affected with the stone, and are seized with diseases of the kidneys, strangury, sciatica, and become ruptured, when they drink all sorts of waters, and those from great rivers into which other rivulets run, or from a lake into which many streams of all sorts flow, and such as are brought from a considerable distance. For it is impossible that such waters can resemble one another, but one kind is sweet, another saltish and aluminous, and some flow from thermal springs; and these being all mixed up together disagree, and the strongest part always prevails; but the same kind is not always the strongest, but sometimes one and sometimes another, according to the winds, for the north wind imparts strength to this water, and the south to that, and so also with regard to the others. There must be deposits of mud and sand in the vessels from such waters, and the aforesaid diseases must be engendered by them when drunk, but why not to all I will now explain. When the bowels are loose and in a healthy state,Coray remarks that Prosper Martian, in his commentary on this passage, confirms the truth of the observation here made, that persons affected with calculus have the bowels consipated. and when the bladder is not hot, nor the neck of the bladder very contracted, all such persons pass water freely, and no concretion forms in the bladder; but those in whom the belly is hot, the bladder must be in the same condition; and when preternaturally heated, its neck becomes inflamed; and when these things happen, the bladder does not expel the urine, but raises its heat excessively. And the thinnest part of it is secreted, and the purest part is passed off in the form of urine, but the thickest and most turbid part is condensed and concreted, at first in small quantity, but afterwards in greater; for being rolled about in the urine, whatever is of a thick consistence it assimilates to itself, and thus it increases and becomes indurated. And when such persons make water, the stone forced down by the urine falls into the neck of the bladder and stops the urine, and occasions intense pain; so that calculous children rub their privy parts and tear at them, as supposing that the obstruction to the urine is situated there. As a proof that it is as I say, persons affected with calculus have very limpid urine, because the thickest and foulest part remains and is concreted. Thus it generally is in cases of calculus. It forms also in children from milk, when it is not wholesome, but very hot and bilious, for it heats the bowels and bladder, so that the urine being also heated undergoes the same change. And I hold that it is better to give children only the most diluted wine, for such will least burn up and dry the veins. Calculi do not form so readily in women, for in them the urethra is short and wide, so that in them the urine is easily expelled; neither do they rub the pudendum with their hands, nor handle the passage like males; for the urethra in women opens direct into the pudendum, which is not the case with men, neither in them is the urethra so wide, and they drink more than children do. Thus, or nearly so, is it with regard to them.

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And respecting the seasons, one may judge whether the year will prove sickly or healthy from the following observations:Coray makes the following remarks on the natural characters of the seasons in Greece. The natural temperature of the winter in Greece was cold and humid; thus a dry and northerly winter was reckoned an unnatural season. Spring was reckoned unnatural when the heat and rain were excessive.- If the appearances connected with the rising and setting stars be as they should be; if there be rains in autumn; if the winter be mild, neither very tepid nor unseasonably cold, and if in spring the rains be seasonable, and so also in summer, the year is likely to prove healthy. But if the winter be dry and northerly, and the spring showery and southerly, the summer will necessarily be of a febrile character, and give rise to ophthalmies and dysenteries. For when suffocating heat sets in all of a sudden, while the earth is moistened by the vernal showers, and by the south wind, the heat is necessarily doubled from the earth, which is thus soaked by rain and heated by a burning sun, while, at the same time, men’s bellies are not in an orderly state, nor the brain properly dried; for it is impossible, after such a spring, but that the body and its flesh must be loaded with humors, so that very acute fevers will attack all, but especially those of a phlegmatic constitution. Dysenteries are also likely to occur to women and those of a very humid temperament. And if at the rising of the Dogstar rain and wintery storms supervene, and if the etesian winds blow, there is reason to hope that these diseases will cease, and that the autumn will be healthy; but if not, it is likely to be a fatal season to children and women, but least of all to old men; and that convalescents will pass into quartans, and from quartans into dropsies; but if the winter be southerly, showery and mild, but the spring northerly, dry, and of a wintry character, in the first place women who happen to be with child, and whose accouchement should take place in spring, are apt to miscarry; and such as bring forth, have feeble and sickly children, so that they either die presently or are tender, feeble, and sickly, if they live. Such is the case with the women. The others are subject to dysenteries and dry ophthalmies, and some have catarrhs beginning in the head and descending to the lungs. Men of a phlegmatic temperament are likely to have dysenteries; and women, also, from the humidity of their nature, the phlegm descending downwards from the brain; those who are bilious, too, have dry ophthalmies from the heat and dryness of their flesh; the aged, too, have catarrhs from their flabbiness and melting of the veins, so that some of them die suddenly and some become paralytic on the right side or the left. For when, the winter being southerly and the body hot, the blood and veins are not properly constringed; a spring that is northerly, dry, and cold, having come on, the brain when it should have been expanded and purged, by the coryza and hoarseness is then constringed and contracted, so that the summer and the heat occurring suddenly, and a change supervening, these diseases fall out. And such cities as lie well to the sun and winds, and use good waters, feel these changes less, but such as use marshy and pooly waters, and lie well both as regards the winds and the sun, these all feel it more. And if the summer be dry, those diseases soon cease, but if rainy, they are protracted; and there is danger of any sore that there is becoming phagedenic from any cause; and lienteries and dropsies supervene at the conclusion of diseases; for the bowels are not readily dried up. And if the summer be rainy and southerly, and next the autumn, the winter must, of necessity, be sickly, and ardent fevers are likely to attack those that are phlegmatic, and more elderly than forty years, and pleurisies and peripneumonies those that are bilious. But if the summer is parched and northerly, but the autumn rainy and southerly, headache and sphacelus of the brain are likely to occur; and in addition hoarseness, coryza, coughs, and in some cases, consumption. But if the season is northerly and without water, there being no rain, neither after the Dogstar nor Arcturus; this state agrees best with those who are naturally phlegmatic, with those who are of a humid temperament, and with women; but it is most inimical to the bilious; for they become much parched up, and ophthalmies of a dry nature supervene, fevers both acute and chronic, and in some cases melancholy; for the most humid and watery part of the bile being consumed, the thickest and most acrid portion is left, and of the blood likewise, when these diseases came upon them. But all these are beneficial to the phlegmatic, for they are thereby dried up, and reach winter not oppressed with humors, but with them dried up.

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And respecting the seasons, one may judge whether the year will prove sickly or healthy from the following observations:Coray makes the following remarks on the natural characters of the seasons in Greece. The natural temperature of the winter in Greece was cold and humid; thus a dry and northerly winter was reckoned an unnatural season. Spring was reckoned unnatural when the heat and rain were excessive.—If the appearances connected with the rising and setting stars be as they should be; if there be rains in autumn; if the winter be mild, neither very tepid nor unseasonably cold, and if in spring the rains be seasonable, and so also in summer, the year is likely to prove healthy. But if the winter be dry and northerly, and the spring showery and southerly, the summer will necessarily be of a febrile character, and give rise to ophthalmies and dysenteries. For when suffocating heat sets in all of a sudden, while the earth is moistened by the vernal showers, and by the south wind, the heat is necessarily doubled from the earth, which is thus soaked by rain and heated by a burning sun, while, at the same time, men’s bellies are not in an orderly state, nor the brain properly dried; for it is impossible, after such a spring, but that the body and its flesh must be loaded with humors, so that very acute fevers will attack all, but especially those of a phlegmatic constitution. Dysenteries are also likely to occur to women and those of a very humid temperament. And if at the rising of the Dogstar rain and wintery storms supervene, and if the etesian winds blow, there is reason to hope that these diseases will cease, and that the autumn will be healthy; but if not, it is likely to be a fatal season to children and women, but least of all to old men; and that convalescents will pass into quartans, and from quartans into dropsies; but if the winter be southerly, showery and mild, but the spring northerly, dry, and of a wintry character, in the first place women who happen to be with child, and whose accouchement should take place in spring, are apt to miscarry; and such as bring forth, have feeble and sickly children, so that they either die presently or are tender, feeble, and sickly, if they live. Such is the case with the women. The others are subject to dysenteries and dry ophthalmies, and some have catarrhs beginning in the head and descending to the lungs. Men of a phlegmatic temperament are likely to have dysenteries; and women, also, from the humidity of their nature, the phlegm descending downwards from the brain; those who are bilious, too, have dry ophthalmies from the heat and dryness of their flesh; the aged, too, have catarrhs from their flabbiness and melting of the veins, so that some of them die suddenly and some become paralytic on the right side or the left. For when, the winter being southerly and the body hot, the blood and veins are not properly constringed; a spring that is northerly, dry, and cold, having come on, the brain when it should have been expanded and purged, by the coryza and hoarseness is then constringed and contracted, so that the summer and the heat occurring suddenly, and a change supervening, these diseases fall out. And such cities as lie well to the sun and winds, and use good waters, feel these changes less, but such as use marshy and pooly waters, and lie well both as regards the winds and the sun, these all feel it more. And if the summer be dry, those diseases soon cease, but if rainy, they are protracted; and there is danger of any sore that there is becoming phagedenic from any cause; and lienteries and dropsies supervene at the conclusion of diseases; for the bowels are not readily dried up. And if the summer be rainy and southerly, and next the autumn, the winter must, of necessity, be sickly, and ardent fevers are likely to attack those that are phlegmatic, and more elderly than forty years, and pleurisies and peripneumonies those that are bilious. But if the summer is parched and northerly, but the autumn rainy and southerly, headache and sphacelus of the brain are likely to occur; and in addition hoarseness, coryza, coughs, and in some cases, consumption. But if the season is northerly and without water, there being no rain, neither after the Dogstar nor Arcturus; this state agrees best with those who are naturally phlegmatic, with those who are of a humid temperament, and with women; but it is most inimical to the bilious; for they become much parched up, and ophthalmies of a dry nature supervene, fevers both acute and chronic, and in some cases melancholy; for the most humid and watery part of the bile being consumed, the thickest and most acrid portion is left, and of the blood likewise, when these diseases came upon them. But all these are beneficial to the phlegmatic, for they are thereby dried up, and reach winter not oppressed with humors, but with them dried up.

Whoever studies and observes these things may be able to foresee most of the effects which will result from the changes of the seasons; and one ought to be particularly guarded during the greatest changes of the seasons, and neither willingly give medicines, nor apply the cautery to the belly, nor make incisions there until ten or more days be past. Now, the greatest and most dangerous are the two solstices, and especially the summer, and also the two equinoxes, but especially the autumnal. One ought also to be guarded about the rising of the stars, especially of the Dogstar, then of Arcturus, and then the setting of the Pleiades; for diseases are especially apt to prove critical in those days, and some prove fatal, some pass off, and all others change to another form and another constitution. So it is with regard to them.

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Such is the general character of Europe and Asia.

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And there are in Europe other tribes, differing from one another in stature, shape, and courage: the differences are those I formerly mentioned, and will now explain more clearly. Such as inhabit a country which is mountainous, rugged, elevated, and well watered, and where the changes of the seasons are very great, are likely to have great variety of shapes among them, and to be naturally of an enterprising and warlike disposition; and such persons are apt to have no little of the savage and ferocious in their nature; but such as dwell in places which are low-lying, abounding in meadows and ill ventilated, and who have a larger proportion of hot than of cold winds, and who make use of warm waters- these are not likely to be of large stature nor well proportioned, but are of a broad make, fleshy, and have black hair; and they are rather of a dark than of a light complexion, and are less likely to be phlegmatic than bilious; courage and laborious enterprise are not naturally in them, but may be engendered in them by means of their institutions. And if there be rivers in the country which carry off the stagnant and rain water from it, these may be wholesome and clear; but if there be no rivers, but the inhabitants drink the waters of fountains, and such as are stagnant and marshy, they must necessarily have prominent bellies and enlarged spleens. But such as inhabit a high country, and one that is level, windy, and well-watered, will be large of stature, and like to one another; but their minds will be rather unmanly and gentle. Those who live on thin, ill-watered, and bare soils, and not well attempered in the changes of the seasons, in such a country they are likely to be in their persons rather hard and well braced, rather of a blond than a dark complexion, and in disposition and passions haughty and self-willed. For, where the changes of the seasons are most frequent, and where they differ most from one another, there you will find their forms, dispositions, and nature the most varied. These are the strongest of the natural causes of difference, and next the country in which one lives, and the waters; for, in general, you will find the forms and dispositions of mankind to correspond with the nature of the country; for where the land is fertile, soft, and well-watered, and supplied with waters from very elevated situations, so as to be hot in summer and cold in winter, and where the seasons are fine, there the men are fleshy, have ill-formed joints, and are of a humid temperament; they are not disposed to endure labor, and, for the most part, are base in spirit; indolence and sluggishness are visible in them, and to the arts they are dull, and not clever nor acute. When the country is bare, not fenced, and rugged, blasted by the winter and scorched by the sun, there you may see the men hardy, slender, with well-shaped joints, well-braced, and shaggy; sharp industry and vigilance accompany such a constitution; in morals and passions they are haughty and opinionative, inclining rather to the fierce than to the mild; and you will find them acute and ingenious as regards the arts, and excelling in military affairs; and likewise all the other productions of the earth corresponding to the earth itself. Thus it is with regard to the most opposite natures and shapes; drawing conclusions from them, you may judge of the rest without any risk of error.

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And there are in Europe other tribes, differing from one another in stature, shape, and courage: the differences are those I formerly mentioned, and will now explain more clearly. Such as inhabit a country which is mountainous, rugged, elevated, and well watered, and where the changes of the seasons are very great, are likely to have great variety of shapes among them, and to be naturally of an enterprising and warlike disposition; and such persons are apt to have no little of the savage and ferocious in their nature; but such as dwell in places which are low-lying, abounding in meadows and ill ventilated, and who have a larger proportion of hot than of cold winds, and who make use of warm waters—these are not likely to be of large stature nor well proportioned, but are of a broad make, fleshy, and have black hair; and they are rather of a dark than of a light complexion, and are less likely to be phlegmatic than bilious; courage and laborious enterprise are not naturally in them, but may be engendered in them by means of their institutions. And if there be rivers in the country which carry off the stagnant and rain water from it, these may be wholesome and clear; but if there be no rivers, but the inhabitants drink the waters of fountains, and such as are stagnant and marshy, they must necessarily have prominent bellies and enlarged spleens. But such as inhabit a high country, and one that is level, windy, and well-watered, will be large of stature, and like to one another; but their minds will be rather unmanly and gentle. Those who live on thin, ill-watered, and bare soils, and not well attempered in the changes of the seasons, in such a country they are likely to be in their persons rather hard and well braced, rather of a blond than a dark complexion, and in disposition and passions haughty and self-willed. For, where the changes of the seasons are most frequent, and where they differ most from one another, there you will find their forms, dispositions, and nature the most varied. These are the strongest of the natural causes of difference, and next the country in which one lives, and the waters; for, in general, you will find the forms and dispositions of mankind to correspond with the nature of the country; for where the land is fertile, soft, and well-watered, and supplied with waters from very elevated situations, so as to be hot in summer and cold in winter, and where the seasons are fine, there the men are fleshy, have ill-formed joints, and are of a humid temperament; they are not disposed to endure labor, and, for the most part, are base in spirit; indolence and sluggishness are visible in them, and to the arts they are dull, and not clever nor acute. When the country is bare, not fenced, and rugged, blasted by the winter and scorched by the sun, there you may see the men hardy, slender, with well-shaped joints, well-braced, and shaggy; sharp industry and vigilance accompany such a constitution; in morals and passions they are haughty and opinionative, inclining rather to the fierce than to the mild; and you will find them acute and ingenious as regards the arts, and excelling in military affairs; and likewise all the other productions of the earth corresponding to the earth itself. Thus it is with regard to the most opposite natures and shapes; drawing conclusions from them, you may judge of the rest without any risk of error.

diff --git a/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng4.xml b/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng4.xml index 010267fdf..76e4ef863 100644 --- a/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng4.xml +++ b/data/tlg0627/tlg002/tlg0627.tlg002.perseus-eng4.xml @@ -111,7 +111,7 @@

This, or something very like this, is the truth concerning these matters. As to the seasons, a consideration of the following points will make it possible to decide whether the year will prove unhealthy or healthy. If the signs prove normal when the stars set and rise; if there be rains in autumn, if the winter be moderate, neither too mild nor unseasonably cold, and if the rains be seasonable in spring and in summer, the year is likely to be very healthy. If, on the other hand, the winter prove dry and northerly, the spring rainy and southerly, the summer cannot fail to be feverladen, causing ophthalmia and dysenteries. For whenever the great heat comes on suddenly while the earth is soaked by reason of the spring rains and the south wind, the heat cannot fail to be doubled, coming from the hot, sodden earth and the burning sun; men’s bowels not being braced nor their brain dried—for when spring is such the body and its flesh must necessarily be flabby—the fevers that attack are of the acutest type in all cases, especially among the phlegmatic. Dysenteries are also likely to come upon women and the most humid constitutions. If at the rising of the Dog Star stormy rain occurs and the Etesian winds blow, there is hope that the distempers will cease and that the autumn will be healthy. Otherwise there is danger lest deaths occur among the women and children, and least of all among the old men; and lest those that get better lapse into quartans, and from quartans into dropsies. But if the winter be southerly, rainy and mild, and the spring be northerly, dry and wintry, in the first place women with child whose delivery is due by spring suffer abortion; and if they do bring forth, their children are weak and sickly, so that either they die at once, or live puny, weak and sickly. Such is the fate of the women. The others have dysenteries and dry ophthalmia, and in some cases catarrhs descend from the head to the lungs. Phlegmatics are liable to dysenteries, and women also, phlegm running down from the brain because of the humidity of their constitution. The bilious have dry ophthalmia because of the warm dryness of their flesh. Old men have catarrhs because of their flabbiness and the wasting of their veins, so that some die suddenly, while others become paralyzed on the right side or the left. For whenever, owing to the winter being southerly and the body warm, neither brain nor veins are hardened, a northerly, dry, cold spring supervening, the brain, just at the time when it ought to have been relaxed along with spring and purged by cold in the head and hoarseness, congeals and hardens, so that the heat of summer having suddenly supervened and the change supervening, these diseases befall. Such cities as are well situated with regard to sun and winds, and use good waters, are less affected by such changes; but if they use marshy or standing waters, and are not well situated with regard to winds and sun, they are more affected. If the summer prove dry, the diseases cease more quickly; if it be rainy, they are protracted. Sores are apt to fester from the slightest cause. Lienteries and dropsies supervene on the conclusion of the diseases, as the bowels do not readily dry up. If the summer and the autumn be rainy and southerly, the winter must be unhealthy; phlegmatics and men over forty are likely to suffer from ardent fevers, bilious people from pleurisy and pneumonia. If the summer prove dry and northerly, and the autumn rainy and southerly, it is likely that in winter headaches occur and mortifications of the brain,See Littré V. 581 foll. and in addition hoarseness, colds in the head, coughs, and in some cases consumption as well. But if the weather be northerly and dry, with no rain either during the Dog Star or at Arcturus, it is very beneficial to those who have a phlegmatic or humid constitution, and to women, but it is very harmful to the bilious. For these dry up overmuch, and are attacked by dry ophthalmia and by acute, protracted fevers, in some cases too by melancholies. For the most humid and watery part of the bile is dried up and is spent, while the thickest and most acrid part is left, and similarly with the blood. Consequently these diseases come upon them. But all these conditions are helpful to the phlegmatic, for they dry up and reach winter dried up and not flabby.

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By studying and observing after this fashion one may foresee most of the consequences of the changes. One should be especially on one’s guard against the most violent changes of the seasons, and unless compelled one should neither purge, nor apply cautery or knife to the bowels, before at least ten days are past. The following are the four most violent changes and the most dangerous :—both solstices, especially the summer solstice, both the equinoxes, so reckoned, especially the autumnal. One must also guard against the risings of the stars, especially of the Dog Star, then of Arcturus, and also of the setting of the Pleiades. For it is especially at these times that diseases come to a crisis. Some prove fatal, some come to an end, all others change to another form and another constitution.

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By studying and observing after this fashion one may foresee most of the consequences of the changes. One should be especially on one’s guard against the most violent changes of the seasons, and unless compelled one should neither purge, nor apply cautery or knife to the bowels, before at least ten days are past. The following are the four most violent changes and the most dangerous:—both solstices, especially the summer solstice, both the equinoxes, so reckoned, especially the autumnal. One must also guard against the risings of the stars, especially of the Dog Star, then of Arcturus, and also of the setting of the Pleiades. For it is especially at these times that diseases come to a crisis. Some prove fatal, some come to an end, all others change to another form and another constitution.

So much for the changes of the seasons. Now I intend to compare AsiaThat is, Asia Minor. and Europe, and to show how they differ in every respect, and how the nations of the one differ entirely in physique from those of the other. It would take too long to describe them all, so I will set forth my views about the most important and the greatest differences. I hold that Asia differs very widely from Europe in the nature of all its inhabitants and of all its vegetation. For everything in Asia grows to far greater beauty and size; the one region is less wild than the other, the character of the inhabitants is milder and more gentle. The cause of this is the temperate climate, because it lies towards the east midway between the risingsThat is, the winter rising and the summer rising. of the sun, and farther away than is Europe from the cold. Growth and freedom from wildness are most fostered when nothing is forcibly predominant, but equality in every respect prevails. Asia, however, is not everywhere uniform; the region, however, situated midway between the heat and the cold is very fruitful, very wooded and very mild; it has splendid water, whether from rain or from springs. While it is not burnt up with the heat nor dried up by drought and want of water, it is not oppressed with cold, nor yet damp and wet with excessive rains and snow. Here the harvests are likely to be plentiful, both those from seed and those which the earth bestows of her own accord, the fruit of which men use, turning wild to cultivated and transplanting them to a suitable soil. The cattle too reared there are likely to flourish, and especially to bring forth the sturdiest young and rear them to be very fine creatures.Or, if πυκνότατα and κάλλιδτα be adverbs, they are very prolific and the best of mothers. The men will be well nourished, of very fine physique and very tall, differing from one another but little either in physique or stature. This region, both in character and in the mildness of its seasons, might fairly be said to bear a close resemblance to spring Courage, endurance, industry and high spirit could not arise in such conditions either among the natives or among immigrants,The writer is thinking of Asiatic natives and the Greek colonists on the coast of Asia Minor. but pleasure must be supreme . . .There is a gap in the text here dealing with the Egyptians and Libyans. wherefore in the beasts they are of many shapes.

diff --git a/data/tlg0627/tlg003/__cts__.xml b/data/tlg0627/tlg003/__cts__.xml index dddab0b46..b0924959e 100644 --- a/data/tlg0627/tlg003/__cts__.xml +++ b/data/tlg0627/tlg003/__cts__.xml @@ -3,7 +3,7 @@ Προγνωστικόν - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). Of the Prognostics diff --git a/data/tlg0627/tlg003/tlg0627.tlg003.perseus-grc2.xml b/data/tlg0627/tlg003/tlg0627.tlg003.perseus-grc2.xml index 02a6174b4..b71fd0d59 100644 --- a/data/tlg0627/tlg003/tlg0627.tlg003.perseus-grc2.xml +++ b/data/tlg0627/tlg003/tlg0627.tlg003.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg004/__cts__.xml b/data/tlg0627/tlg004/__cts__.xml index a60774b3e..20f28a61f 100644 --- a/data/tlg0627/tlg004/__cts__.xml +++ b/data/tlg0627/tlg004/__cts__.xml @@ -3,7 +3,7 @@ Περὶ διαίτης ὀξέων - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg004/tlg0627.tlg004.perseus-eng2.xml b/data/tlg0627/tlg004/tlg0627.tlg004.perseus-eng2.xml index 28232b9f3..5590a18c4 100644 --- a/data/tlg0627/tlg004/tlg0627.tlg004.perseus-eng2.xml +++ b/data/tlg0627/tlg004/tlg0627.tlg004.perseus-eng2.xml @@ -83,7 +83,7 @@

Ptisan, then, appears to me to be justly preferred before all the other preparations from grain in these diseases, and I commend those who made this choice,Our author now enters upon the consideration of one of his principal objects in the preent work, namely, to describe the modes of preparing ptisan (orthe decoction of barley), and its uses in acute diseases. He is so full on this subject that the present treatise is quoted by Athenaeus (Deipnos. ii., 16), by the name of the work On the Ptisan. Galen states that, on the principle that diseases are to be cured by their contraries, as the essence of a febrile disease is combined of heat and dryness, the indication of a cure is to use means of a cooling and moistening nature, and that the ptisan fulfils both these objects. for the mucilage of it is smooth, consistent, pleasant, lubricant, moderately diluent, quenches thirst if this be required, and has no astringency; gives no trouble nor swells up in the bowels, for in the boiling it swells up as much as it naturally can. Those, then, who make use of ptisan in such diseases, should never for a day allow their vessels to be empty of it, if I may say so, but should use it and not intermit, unless it be necessary to stop for a time, in order to administer medicine or a clyster. And to those who are accustomed to take two meals in the day it is to be given twice, and to those accustomed to live upon a single meal it is to be given once at first, and then, if the case permit, it is to be increased and given twice to them, if they appear to stand in need of it. At first it will be proper not to give a large quantity nor very thick, but in proportion to the quantity of food which one has been accustomed to take, and so as that the veins may not be much emptied. And, with regard to the augmentation of the dose, if the disease be of a drier nature than one had supposed, one must not give more of it, but should give before the draught of ptisan, either hydromel or wine, in as great quantity as may be proper; and what is proper in each case will be afterward stated by us. But if the mouth and the passages from the lungs be in a proper state as to moisture, the quantity of the draught is to be increased, as a general rule, for an early and abundant state of moisture indicates an early crisis, but a late and deficient moisture indicates a slower crisis. And these things are as I have stated for the most part; but many other things are omitted which are important to the prognosis, as will be explained afterwards. And the more that the patient is troubled with purging, in so much greater quantity is it to be given until the crisis, and moreover until two days beyond the crisis, in such cases as it appears to take place on the fifth, seventh, or ninth day, so as to have respect both for the odd and even day: after this the draught is to be given early in the day, and the other food in place is to be given in the evening. These things are proper, for the most part, to be given to those who, from the first, have used ptisan containing its whole substance; for the pains in pleuritic affections immediately cease of their own accord whenever the patients begin to expectorate anything worth mentioning, and the purgings become much better, and empyema much more seldom takes place, than if the patients used a different regimen, and the crises are more simple, occur earlier, and the cases are less subject to relapses.

-

Ptisans are to be made of the very best barley, and are to be well boiled, more especially if you do not intend to use them strained. For, besides the other virtues of ptisan, its lubricant quality prevents the barley that is swallowed from proving injurious, for it does not stick nor remain in the region of the breast; for that which is well boiled is very lubricant, excellent for quenching thirst, of very easy digestion, and very weak, all which qualities are wanted. If, then, one do not pay proper attention to the mode of administering the ptisan, much harm may be done; for when the food is shut up in the bowels, unless one procure some evacuation speedily, before administering the draught, the pain, if present, will be exasperated; and, if not present, it will be immediately created, and the respiration will become more frequent, which does mischief, for it dries the lungs, fatigues the hypochondria, the hypogastrium, and diaphragm. And moreover if, while the pain of the side persists, and does not yield to warm fomentations, and the sputa are not brought up, but are viscid and unconcocted, unless one get the pain resolved, either by loosening the bowels, or opening a vein, whichever of these may be proper;- if to persons so circumstanced ptisan be administered, their speedy death will be the result. For these reasons, and for others of a similar kind still more, those who use unstrained ptisan die on the seventh day, or still earlier, some being seized with delirium, and others dying suffocated with orthopnoee and riles. Such persons the ancients thought struck, for this reason more especially, that when dead the affected side was livid, like that of a person who had been struck. The cause of this is that they die before the pain is resolved, being seized with difficulty of respiration, and by large and rapid breathing, as has been already explained, the spittle becoming thick, acid, and unconcocted, cannot be brought up, but, being retained in the bronchi of the lungs, produces riles; and, when it has come to this, death, for the most part, is inevitable; for the sputa being retained prevent the breath from being drawn in, and force it speedily out, and thus the two conspire together to aggravate the sputa being retained renders the respiration frequent, while the respiration being frequent thickens the sputa, and prevents them from being evacuated. These symptoms supervene, not only if ptisan be administered unseasonably, but still more if any other food or drink worse than ptisan be given.

+

Ptisans are to be made of the very best barley, and are to be well boiled, more especially if you do not intend to use them strained. For, besides the other virtues of ptisan, its lubricant quality prevents the barley that is swallowed from proving injurious, for it does not stick nor remain in the region of the breast; for that which is well boiled is very lubricant, excellent for quenching thirst, of very easy digestion, and very weak, all which qualities are wanted. If, then, one do not pay proper attention to the mode of administering the ptisan, much harm may be done; for when the food is shut up in the bowels, unless one procure some evacuation speedily, before administering the draught, the pain, if present, will be exasperated; and, if not present, it will be immediately created, and the respiration will become more frequent, which does mischief, for it dries the lungs, fatigues the hypochondria, the hypogastrium, and diaphragm. And moreover if, while the pain of the side persists, and does not yield to warm fomentations, and the sputa are not brought up, but are viscid and unconcocted, unless one get the pain resolved, either by loosening the bowels, or opening a vein, whichever of these may be proper;—if to persons so circumstanced ptisan be administered, their speedy death will be the result. For these reasons, and for others of a similar kind still more, those who use unstrained ptisan die on the seventh day, or still earlier, some being seized with delirium, and others dying suffocated with orthopnoee and riles. Such persons the ancients thought struck, for this reason more especially, that when dead the affected side was livid, like that of a person who had been struck. The cause of this is that they die before the pain is resolved, being seized with difficulty of respiration, and by large and rapid breathing, as has been already explained, the spittle becoming thick, acid, and unconcocted, cannot be brought up, but, being retained in the bronchi of the lungs, produces riles; and, when it has come to this, death, for the most part, is inevitable; for the sputa being retained prevent the breath from being drawn in, and force it speedily out, and thus the two conspire together to aggravate the sputa being retained renders the respiration frequent, while the respiration being frequent thickens the sputa, and prevents them from being evacuated. These symptoms supervene, not only if ptisan be administered unseasonably, but still more if any other food or drink worse than ptisan be given.

For the most part, then, the results are the same, whether the patient have used the unstrained ptisan or have used the juice alone; or even only drink; and sometimes it is necessary to proceed quite differently. In general, one should do thus: if fever commences shortly after taking food, and before the bowels have been evacuated, whether with or without pain, the physician ought to withhold the draught until he thinks that the food has descended to the lower part of the belly; and if any pain be present, the patient should use oxymel, hot if it is winter, and cold if it is summer; and, if there be much thirst, he should take hydromel and water. Then, if any pain be present, or any dangerous symptoms make their appearance, it will be proper to give the draught neither in large quantity nor thick, but after the seventh day, if the patient be strong. But if the earlier-taken food has not descended, in the case of a person who has recently swallowed food, and if he be strong and in the vigor of life, a clyster should be given, or if he be weaker, a suppository is to be administered, unless the bowels open properly of themselves. The time for administering the draught is to be particularly observed at the commencement and during the whole illness; when, then, the feet are cold, one should refrain from giving the ptisan, and more especially abstain from drink; but when the heat has descended to the feet, one may then give it; and one should look upon this season as of great consequence in all diseases, and not least in acute diseases, especially those of a febrile character, and those of a very dangerous nature. One may first use the juice, and then the ptisan, attending accurately to the rules formerly laid down.

@@ -99,11 +99,11 @@

And the following observations are similar to those now made respecting the bowels. If the whole body rest long, contrary to usage, it does not immediately recover its strength; but if, after a protracted repose, it proceed to labor, it will clearly expose its weakness. So it is with every one part of the body, for the feet will make a similar display, and any other of the joints, if, being unaccustomed to labor, they be suddenly brought into action, after a time. The teeth and the eyes will suffer in like manner, and also every other part whatever. A couch, also, that is either softer or harder than one has been accustomed to will create uneasiness, and sleeping in the open air, contrary to usage, hardens the body. But it is sufficient merely to state examples of all these cases. If a person having received a wound in the leg, neither very serious nor very trifling, and he being neither in a condition very favorable to its healing nor the contrary, at first betakes himself to bed, in order to promote the cure, and never raises his leg, it will thus be much less disposed to inflammation, and be much sooner well, than it would have been if he had strolled about during the process of healing; but if upon the fifth or sixth day, or even earlier, he should get up and attempt to walk, he will suffer much more then than if he had walked about from the commencement of the cure, and if he should suddenly make many laborious exertions, he will suffer much more than if, when the treatment was conducted otherwise, he had made the same exertions on the same days. In fine, all these things concur in proving that all great changes, either one way or another, are hurtful. Wherefore much mischief takes place in the bowels, if from a state of great inanition more food than is moderate be administered (and also in the rest of the body, if from a state of great rest it be hastily brought to greater exertion, it will be much more injured), or if from the use of much food it be changed to complete abstinence, and therefore the body in such cases requires protracted repose, and if, from a state of laborious exertion, the body suddenly falls into a state of ease and indolence, in these cases also the bowels would require continued repose from abundance of food, for otherwise it will induce pain and heaviness in the whole body.

-

The greater part of my discourse has related to changes, this way or that. For all purposes it is profitable to know these things, and more especially respecting the subject under consideration,- that in acute diseases, in which a change is made to ptisans from a state of inanition, it should be made as I direct; and then that ptisans should not be used until the disease be concocted, or some other symptom, whether of evacuation or of irritation, appear in the intestines, or in the hypochondria, such as will be described. Obstinate insomnolency impairs the digestion of the food and drink, and in other respects changes and relaxes the body, and occasions a heated state, and heaviness of the head.Galen finds the language in this last sentence so confused, that he does not hesitate to declare that he is convinced the work must have been left by Hippocrates in an unfinished state, and not published until after his death.

+

The greater part of my discourse has related to changes, this way or that. For all purposes it is profitable to know these things, and more especially respecting the subject under consideration,—that in acute diseases, in which a change is made to ptisans from a state of inanition, it should be made as I direct; and then that ptisans should not be used until the disease be concocted, or some other symptom, whether of evacuation or of irritation, appear in the intestines, or in the hypochondria, such as will be described. Obstinate insomnolency impairs the digestion of the food and drink, and in other respects changes and relaxes the body, and occasions a heated state, and heaviness of the head.Galen finds the language in this last sentence so confused, that he does not hesitate to declare that he is convinced the work must have been left by Hippocrates in an unfinished state, and not published until after his death.

One must determine by such marks as these, when sweet, strong, and dark wine, hydromel, water and oxymel, should be given in acute diseases. Wherefore the sweet affects the head less than the strong, attacks the brain less, evacuates the bowels more than the other, but induces swelling of the spleen and liver; it does not agree with bilious persons, for it causes them to thirst; it creates flatulence in the upper part of the intestinal canal, but does not disagree with the lower part, as far as regards flatulence; and yet flatulence engendered by sweet wine is not of a transient nature, but rests for a long time in the hypochondria. And therefore it in general is less diuretic than wine which is strong and thin; but sweet wine is more expectorant than the other. But when it creates thirst, it is less expectorant in such cases than the other wine, but if it do not create thirst, it promotes expectoration better than the other. The good and bad effects of a white, strong wine, have been already frequently and fully stated in the disquisition on sweet wine; it is determined to the bladder more than the other, is diuretic and laxative, and should be very useful in such complaints; for if in other respects it be less suitable than the other, the clearing out of the bladder effected by it is beneficial to the patient, if properly administered. There are excellent examples of the beneficial and injurious effects of wine, all which were left undetermined by my predecessors. In these diseases you may use a yellow wine, and a dark austere wine for the following purposes: if there be no heaviness of the head, nor delirium, nor stoppage of the expectoration, nor retention of the urine, and if the alvine discharges be more loose and like scrapings than usual, in such cases a change from a white wine to such as I have mentioned, might be very proper. It deserves further to be known, that it will prove less injurious to all the parts above, and to the bladder, if it be of a more watery nature, but that the stronger it is, it will be the more beneficial to the bowels.

-

Hydromel, when drunk in any stage of acute disease, is less suitable to persons of a bilious temperament, and to those who have enlarged viscera, than to those of a different character; it increases thirst less than sweet wine; it softens the lungs, is moderately expectorant, and alleviates a cough; for it has some detergent quality in it, whence it lubricates the sputum. Hydromel is also moderately diuretic, unless prevented by the state of any of the viscera. And it also occasions bilious discharges downwards, sometimes of a proper character, and sometimes more intense and frothy than is suitable; but such rather occurs in persons who are bilious, and have enlarged viscera. Hydromel rather produces expectoration, and softening of the lungs, when given diluted with water. But unmixed hydromel, rather than the diluted, produces frothy evacuations, such as are unseasonably and intensely bilious, and too hot; but such an evacuation occasions other great mischiefs, for it neither extinguishes the heat in the hypochondria, but rouses it, induces inquietude, and jactitation of the limbs, and ulcerates the intestines and anus. The remedies for all these will be described afterwards. By using hydromel without ptisans, instead of any other drink, you will generally succeed in the treatment of such diseases, and fail in few cases; but in what instances it is to be given, and in what it is not to be given, and wherefore it is not to be given,- all this has been explained already, for the most part. Hydromel is generally condemned, as if it weakened the powers of those who drink it, and on that account it is supposed to accelerate death; and this opinion arose from persons who starve themselves to death, some of whom use hydromel alone for drink, as fancying that it really has this effect. But this is by no means always the case. For hydromel, if drunk alone, is much stronger than water, if it do not disorder the bowels; but in some respects it is stronger, and in some weaker, than wine that is thin, weak, and devoid of bouquet. There is a great difference between unmixed wine and unmixed honey, as to their nutritive powers, for if a man will drink double the quantity of pure wine, to a certain quantity of honey which is swallowed, he will find himself much stronger from the honey, provided it do not disagree with his bowels, and that his alvine evacuations from it will be much more copious. But if he shall use ptisan for a draught, and drink afterward hydromel, he will feel full, flatulent, and uncomfortable in the viscera of the hypochondrium; but if the hydromel be taken before the draught, it will not have the same injurious effects as if taken after it, but will be rather beneficial. And boiled hydromel has a much more elegant appearance than the unboiled, being clear, thin, white, and transparent, but I am unable to mention any good quality which it possesses that the other wants. For it is not sweeter than the unboiled, provided the honey be fine, and it is weaker, and occasions less copious evacuations of the bowels, neither of which effects is required from the hydromel. But one should by all means use it boiled, provided the honey be bad, impure, black, and not fragrant, for the boiling will remove the most of its bad qualities and appearances.

+

Hydromel, when drunk in any stage of acute disease, is less suitable to persons of a bilious temperament, and to those who have enlarged viscera, than to those of a different character; it increases thirst less than sweet wine; it softens the lungs, is moderately expectorant, and alleviates a cough; for it has some detergent quality in it, whence it lubricates the sputum. Hydromel is also moderately diuretic, unless prevented by the state of any of the viscera. And it also occasions bilious discharges downwards, sometimes of a proper character, and sometimes more intense and frothy than is suitable; but such rather occurs in persons who are bilious, and have enlarged viscera. Hydromel rather produces expectoration, and softening of the lungs, when given diluted with water. But unmixed hydromel, rather than the diluted, produces frothy evacuations, such as are unseasonably and intensely bilious, and too hot; but such an evacuation occasions other great mischiefs, for it neither extinguishes the heat in the hypochondria, but rouses it, induces inquietude, and jactitation of the limbs, and ulcerates the intestines and anus. The remedies for all these will be described afterwards. By using hydromel without ptisans, instead of any other drink, you will generally succeed in the treatment of such diseases, and fail in few cases; but in what instances it is to be given, and in what it is not to be given, and wherefore it is not to be given,—all this has been explained already, for the most part. Hydromel is generally condemned, as if it weakened the powers of those who drink it, and on that account it is supposed to accelerate death; and this opinion arose from persons who starve themselves to death, some of whom use hydromel alone for drink, as fancying that it really has this effect. But this is by no means always the case. For hydromel, if drunk alone, is much stronger than water, if it do not disorder the bowels; but in some respects it is stronger, and in some weaker, than wine that is thin, weak, and devoid of bouquet. There is a great difference between unmixed wine and unmixed honey, as to their nutritive powers, for if a man will drink double the quantity of pure wine, to a certain quantity of honey which is swallowed, he will find himself much stronger from the honey, provided it do not disagree with his bowels, and that his alvine evacuations from it will be much more copious. But if he shall use ptisan for a draught, and drink afterward hydromel, he will feel full, flatulent, and uncomfortable in the viscera of the hypochondrium; but if the hydromel be taken before the draught, it will not have the same injurious effects as if taken after it, but will be rather beneficial. And boiled hydromel has a much more elegant appearance than the unboiled, being clear, thin, white, and transparent, but I am unable to mention any good quality which it possesses that the other wants. For it is not sweeter than the unboiled, provided the honey be fine, and it is weaker, and occasions less copious evacuations of the bowels, neither of which effects is required from the hydromel. But one should by all means use it boiled, provided the honey be bad, impure, black, and not fragrant, for the boiling will remove the most of its bad qualities and appearances.

You will find the drink, called oxymel, often very useful in these complaints, for it promotes expectoration and freedom of breathing. the following are the proper occasions for administering it. When strongly acid it has no mean operation in rendering the expectoration more easy, for by bringing up the sputa, which occasion troublesome hawking, and rendering them more slippery, and, as it were, clearing the windpipe with a feather, it relieves the lungs and proves emollient to them; and when it succeeds in producing these effects it must do much good. But there are cases in which hydromel, strongly acid, does not promote expectoration, but renders it more viscid and thus does harm, and it is most apt to produce these bad effects in cases which are otherwise of a fatal character, when the patient is unable to cough or bring up the sputa. On this account, then, one ought to consider beforehand the strength of the patient, and if there be any hope, then one may give it, but if given at all in such cases it should be quite tepid, and in by no means large doses. But if slightly acrid it moistens the mouth and throat, promotes expectoration, and quenches thirst; agrees with the viscera seated in the hypochondrium, and obviates the bad effects of the honey; for the bilious quality of the honey is thereby corrected. It also promotes flatulent discharges from the bowels, and is diuretic, but it occasions watery discharges and those resembling scrapings, from the lower part of the intestine, which is sometimes a bad thing in acute diseases, more especially when the flatulence cannot be passed, but rolls backwards; and otherwise it diminishes the strength and makes the extremities cold, this is the only bad effect worth mentioning which I have known to arise from the oxymel. It may suit well to drink a little of this at night before the draught of ptisan, and when a considerable interval of time has passed after the draught there will be nothing to prevent its being taken. But to those who are restricted entirely to drinks without draughts of ptisan, it will therefore not be proper at all times to give it, more especially from the fretting and irritation of the intestine which it occasions, (and these bad effects it will be the more apt to produce provided there be no faeces in the intestines and the patient is laboring under inanition,) and then it will weaken the powers of the hydromel. But if it appears advantageous to use a great deal of this drink during the whole course of the disease, one should add to it merely as much vinegar as can just be perceived by the taste, for thus what is prejudicial in it will do the least possible harm, and what is beneficial will do the more good. In a word, the acidity of vinegar agrees rather with those who are troubled with bitter bile, than with those patients whose bile is black; for the bitter principle is dissolved in it and turned to phlegm, by being suspended in it; whereas black bile is fermented, swells up, and is multiplied thereby: for vinegar is a melanogogue. Vinegar is more prejudicial to women than to men, for it creates pains in the uterus.

@@ -118,10 +118,10 @@

Bleed in the acute affections, if the disease appear strong, and the patients be in the vigor of life, and if they have strength. If it be quinsy or any other of the pleuritic affections, purge with electuaries; but if the patient be weaker, or if you abstract more blood, you may administer a clyster every third day, until he be out of danger, and enjoin total abstinence if necessary.

Appendix 3 -

Hypochondria inflamed not from retention of flatus, tension of the diaphragm, checked respiration, with dry orthopnoea, when no pus is formed, but when these complaints are connected with obstructed respiration; but more especially strong pains of the liver, heaviness of the spleen, and other phlegmasiae and intense pains above the diaphragm, diseases connected with collections of humors,- all these diseases do not admit of resolution, if treated at first by medicine, but venesection holds the first place in conducting the treatment; then we may have recourse to a clyster, unless the disease be great and strong; but if so, purging also may be necessary; but bleeding and purging together require caution and moderation. Those who attempt to resolve inflammatory diseases at the commencement by the administration of purgative medicines, remove none of the morbific humors which produce the inflammation and tension; for the diseases while unconcocted could not yield, but they melt down those parts which are healthy and resist the disease; so when the body is debilitated the malady obtains the mastery; and when the disease has the upper hand of the body, it does not admit of a cure.

+

Hypochondria inflamed not from retention of flatus, tension of the diaphragm, checked respiration, with dry orthopnoea, when no pus is formed, but when these complaints are connected with obstructed respiration; but more especially strong pains of the liver, heaviness of the spleen, and other phlegmasiae and intense pains above the diaphragm, diseases connected with collections of humors,—all these diseases do not admit of resolution, if treated at first by medicine, but venesection holds the first place in conducting the treatment; then we may have recourse to a clyster, unless the disease be great and strong; but if so, purging also may be necessary; but bleeding and purging together require caution and moderation. Those who attempt to resolve inflammatory diseases at the commencement by the administration of purgative medicines, remove none of the morbific humors which produce the inflammation and tension; for the diseases while unconcocted could not yield, but they melt down those parts which are healthy and resist the disease; so when the body is debilitated the malady obtains the mastery; and when the disease has the upper hand of the body, it does not admit of a cure.

Appendix 4 -

When a person suddenly loses his speech, in connection with obstruction of the veins,- if this happen without warning or any other strong cause, one ought to open the internal vein of the right arm, and abstract blood more or less according to the habit and age of the patient. Such cases are mostly attended with the following symptoms: redness of the face, eyes fixed, hands distended, grinding of the teeth, palpitations, jaws fixed, coldness of the extremities, retention of airs in the veins.

+

When a person suddenly loses his speech, in connection with obstruction of the veins,—if this happen without warning or any other strong cause, one ought to open the internal vein of the right arm, and abstract blood more or less according to the habit and age of the patient. Such cases are mostly attended with the following symptoms: redness of the face, eyes fixed, hands distended, grinding of the teeth, palpitations, jaws fixed, coldness of the extremities, retention of airs in the veins.

Appendix 5

When pains precede, and there are influxes of black bile and of acrid humors, and when by their pungency the internal parts are pained, and the veins being pinched and dried become distended, and getting inflamed attract the humors running into the parts, whence the blood being vitiated, and the airs collected there not being able to find their natural passages, coldness comes on in consequence of this stasis, with vertigo, loss of speech, heaviness of the head, and convulsion, if the disease fix on the liver, the heart, or the great vein (vena cava?); whence they are seized with epilepsy or apoplexy, if the defluxions fall upon the containing parts, and if they are dried up by airs which cannot make their escape; such persons having been first tormented are to be immediately bled at the commencement, while all the peccant vapors and humors are buoyant, for then the cases more easily admit of a cure; and then supporting the strength and attending to the crisis, we may give emetics, unless the disease be alleviated; or if the bowels be not moved, we may administer a clyster and give the boiled milk of asses, to the amount of not less than twelve heminae, or if the strength permit, to more than sixteen.

@@ -172,7 +172,7 @@

There are two kinds of dropsy, the one anasarca, which, when formed, is incurable; the other is accompanied with emphysema (tympanites?) and requires much good fortune to enable one to triumph over it. Laborious exertion, fomentation, and abstinence (are to be enjoined). The patient should eat dry and acrid things, for thus will he pass the more water, and his strength be kept up. If he labors under difficulty of breathing, if it is the summer season, and if he is in the prime of life, and is strong, blood should be abstracted from the arm, and then he should eat hot pieces of bread, dipped in dark wine and oil, drink very little, and labor much, and live on well-fed pork, boiled with vinegar, so that he may be able to endure hard exercises.

Appendix 21 -

Those who have the inferior intestines hot, and who pass acrid and irregular stools of a colliquative nature, if they can bear it, should procure revulsion by vomiting with hellebore; but if not, should get a thick decoction of summer wheat in a cold state, lentil soup, bread cooked with cinders, and fish, which should be taken boiled if they have fever, but roasted if not feverish; and also dark-colored wine if free of fever; but otherwise they should take the water from medlars, myrtles, apples, services, dates, or wild vine. If there be no fever, and if there be tormina, the patient should drink hot asses’ milk in small quantity at first, and gradually increase it, and linseed, and wheaten flour, and having removed the bitter part of Egyptian beans, and ground them, sprinkle on the milk and drink; and let him eat eggs half-roasted, and fine flour, and millet, and perl-spelt (chondrus) boiled in milk;- all these things should be eaten cold, and similar articles of food and drink should be administered.

+

Those who have the inferior intestines hot, and who pass acrid and irregular stools of a colliquative nature, if they can bear it, should procure revulsion by vomiting with hellebore; but if not, should get a thick decoction of summer wheat in a cold state, lentil soup, bread cooked with cinders, and fish, which should be taken boiled if they have fever, but roasted if not feverish; and also dark-colored wine if free of fever; but otherwise they should take the water from medlars, myrtles, apples, services, dates, or wild vine. If there be no fever, and if there be tormina, the patient should drink hot asses’ milk in small quantity at first, and gradually increase it, and linseed, and wheaten flour, and having removed the bitter part of Egyptian beans, and ground them, sprinkle on the milk and drink; and let him eat eggs half-roasted, and fine flour, and millet, and perl-spelt (chondrus) boiled in milk;—all these things should be eaten cold, and similar articles of food and drink should be administered.

Appendix 22

The most important point of regimen to observe and be guarded about in protracted diseases, is to pay attention to the exacerbations and remissions of fevers, so as to avoid the times when food should not be given, and to know when it may be administered without danger; this last season is at the greatest possible distance from the exacerbation.

diff --git a/data/tlg0627/tlg005/__cts__.xml b/data/tlg0627/tlg005/__cts__.xml index d3ac8f222..73e59b31b 100644 --- a/data/tlg0627/tlg005/__cts__.xml +++ b/data/tlg0627/tlg005/__cts__.xml @@ -3,6 +3,6 @@ Περὶ διαίτης ὀξέων. Νόθα - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 2. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg005/tlg0627.tlg005.perseus-grc2.xml b/data/tlg0627/tlg005/tlg0627.tlg005.perseus-grc2.xml index 73b95ebc2..43f797ebc 100644 --- a/data/tlg0627/tlg005/tlg0627.tlg005.perseus-grc2.xml +++ b/data/tlg0627/tlg005/tlg0627.tlg005.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg006/__cts__.xml b/data/tlg0627/tlg006/__cts__.xml index 80a9558f8..4169fb276 100644 --- a/data/tlg0627/tlg006/__cts__.xml +++ b/data/tlg0627/tlg006/__cts__.xml @@ -3,11 +3,16 @@ Ἐπιδημίων - Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923. + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). The Epidemics Hippocrates, The Genuine Works of Hippocrates, Vol. 1. Adams, Francis, translator. New York: William Wood and Company, 1886. + + + Epidemics + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + diff --git a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.tracking.json b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.tracking.json deleted file mode 100644 index cae83469a..000000000 --- a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0251", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.jones_eng.xml---subdoc---text=Epid.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.xml b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.xml deleted file mode 100644 index 47ad73d7f..000000000 --- a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng2.xml +++ /dev/null @@ -1,2442 +0,0 @@ - - - - - - EPIDEMICS I AND III - Hippocrates - W. H. S. Jones - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 1, 2005 - - - - - Hippocrates Collected Works I - Hippocrates - W. H. S. Jones - - Cambridge - Harvard University Press - 1923 - - - - - - - - - -

Data Entry

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - English - Greek - - - - - - -
- EPIDEMICS I -
- FIRST CONSTITUTION -
- PART 1 -

I. IN Thasos during autumn, about the time of the - equinox to near the setting of the Pleiades,U(PD in expressions denoting time seems - in Hippocrates to mean "about" or "during." The period is roughly - from September 21 to November 8. there were many rains, - gently continuous, with southerly winds. Winter southerly,That is, - the winds were generally from the south, and such north winds as - blew were light. north winds light, droughts; on the whole, - the winter was like a spring. Spring southerly and chilly; slight - showers. Summer in general cloudy. No rain. Etesian winds few, light and - irregular.

-

The whole weather proved southerly, with droughts, but early in the - spring, as the previous constitution had proved the opposite and - northerly, a few patients suffered from ardent fevers, and these very - mild, causing hemorrhage in few cases and no deaths. Many had swellings - beside one ear, or both ears, in most cases unattended with - fever,Or, punctuating after =(WTA and PLEI/S1TOIS1IN, "There were swellings beside the - ears, in many cases on one side, but in most on both." The epidemio - was obviously mumps. so that confinement to bed was - unnecessary. In some cases there was slight heat, but in all the - swellings subsided without causing harm; in no case was there - suppuration such as attends swellings of other origin. This was the - character of them :--flabby, big, spreading, with neither inflammation - nor pain; in every case they

- -

disappeared without a sign.That is, with no symptoms indicative of - a crisis. The sufferers were youths, young men, and men in - their prime, usually those who frequented the wrestling school and - gymnasia. Few women were attacked. Many had dry coughs which brought up - nothing when they coughed, but their voices were hoarse. Soon after, - though in some cases after some time, painful inflammations occurred - either in one testicle or in both, sometimes accompanied with fever, in - other cases not. Usually they caused much suffering. In other respects - the people had no ailments requiring medical assistance.That is, - nobody was ill enough to make a visit to the physician's surgery - (I(HTREI=ON) - necessary.

-
-
- PART 2 -

II. Beginning early in the summer, throughout the summer and in winter - many of those who had been ailing a long time took to their beds in a - state of consumption, while many also who had hitherto been doubtful - sufferers at this time showed undoubted symptoms. Some showed the - symptoms now for the first time; these were those whose constitution - inclined to be consumptive. Many, in fact most of these, died; of those - who took to their beds I do not know one who survived even for a short - time. Death came more promptly than is usual in consumption, and yet the - other complaints, which will be described presently, though longer and - attended with fever, were easily supported and did not prove fatal. For - consumption was the worst of the diseases that occurred, and alone was - responsible for the great mortality.

-

In the majority of cases the symptoms were these. Fever with shivering, - continuous, acute, not completely intermitting, but of the semitertian - type; remitting during one day they were exacerbated on the next, - becoming on the whole more acute. Sweats

- -

were continual, but not all over the body. Severe chill in the - extremities, which with difficulty recovered their warmth. Bowels - disordered, with bilious, scanty, unmixed, thin, smarting stools, - causing the patient to get up often. Urine either thin, - colourless,Throughout Epidemics - A\)XRWS2 may mean, not merely - "without colour," but "of bad colour." It certainly has this meaning - in Airs Waters Places, VII, l. ii. See p. - 85. unconcocted and scanty, or thick and with a slight - deposit, not settling favourably, but with a crude and unfavourable - deposit. The patients frequently coughed up small, concocted sputa, - brought up little by little with difficulty. Those exhibiting the - symptoms in their most violent form showed no concoction at all, but - continued spitting crude sputa. In the majority of these cases the - throat was throughout painful from the beginning, being red and - inflamed. Fluxes slight, thin, pungent. Patients quickly wasted away and - grew worse, being throughout averse to all food and experiencing no - thirst. Delirium in many cases as death approached. Such were the - symptoms of the consumption.

-
-
- PART 3 -

III. But when summer came, and during autumn occurred many continuous but - not violent fevers, which attacked persons who were long ailing without - suffering distress in any other particular manner; for the bowels were - in most cases quite easy, and hurt to no appreciable extent. Urine in - most cases of good colour and clear, but thin, and after a time near the - crisis it grew concocted. Coughing was slight, and caused no distress. - No lack of appetite; in fact it was quite possible even to give food. - In general the patients did not sicken, as did the consumptives,

- -

with shivering fevers, but with slight sweats, the paroxysms being - variable and irregular.The words omitted by Kéhlewein mean "not - intermitting altogether, but with exacerbations after the manner of - tertians." The earliest crisis was about the twentieth day; - in most cases the crisis was about the fortieth day, though in many it - was about the eightieth. In some cases the illness did not end in this - way, but in an irregular manner without a crisis. In the majority of - these cases the fevers relapsed after a brief interval, and after the - relapse a crisis occurred at the end of the same periods as before. The - disease in many of these instances was so protracted that it even lasted - during the winter.

-

Out of all those described in this constitution only the consumptives - showed a high mortality-rate; for all the other patients bore up well, - and the other fevers did not prove fatal.

-
-
-
- SECOND - CONSTITUTION -
- PART 4 -

IV. In Thasos early in autumn occurred unseasonable wintry storms, - suddenly with many north and south winds bursting out into rains. These - conditions continued until the setting of the Pleiades and during their - season. Winter was northerly; many violent and abundant rains; snows; - generally there were fine intervals. With all this, however, the cold - weather was not exceptionally unseasonable. But immediately after the - winter solstice, when the west wind usually begins to blow, there was a - return of severe wintry weather, much north wind, snow and

- -

copious rains continuously, sky stormy and clouded. These conditions - lasted on, and did not remit before the equinox. Spring cold, northerly, - wet, cloudy. Summer did not turn out excessively hot, the Etesian winds - blowing continuously. But soon after, near the rising of Arcturus, there - was much rain again, with northerly winds.

-
-
- PART 5 -

V. The whole year having been wet, cold and northerly, in the winter the - public health in most respects was good, but in early spring many, in - fact most, suffered illnesses. Now there began at first inflammations of - the eyes, marked by rheum, pain, and unconcocted discharges. Small gummy - sores, in many cases causing distress when they broke out; the great - majority relapsed, and ceased late on the approach of autumn. In summer - and autumn dysenteric diseases, tenesmus and lientery; bilious - diarrhœa, with copious, thin, crude, smarting stools; in some cases it - was also watery. In many cases there were also painful, bilious - defluxions, watery, full of thin particles, purulent and causing - strangury. No kidney trouble, but their various symptoms succeeded in - various orders. Vomitings of phlegm, bile, and undigested food. Sweats; - in all cases much moisture over all the body. These complaints in many - cases were unattended with fever, and the sufferers were not confined to - bed; but in many others there was fever, as I am going to describe. - Those who showed all the symptoms mentioned above were consumptives who - suffered pain. When autumn came, and during winter, continuous - fevers--in some few cases ardent--day fevers, night fevers, - semitertians, exact tertians, quartans, irregular fevers. Each of the - fevers mentioned found many victims.

- -
-
- PART 6 -

VI. Now the ardent fevers attacked the fewest persons, and these were - less distressed than any of the other sick. There was no bleeding from - the nose, except very slight discharges in a few cases, and no delirium. - All the other symptoms were slight. The crises of these diseases were - quite regular, generally in seventeen days, counting the days of - intermission, and I know of no ardent fever proving fatal at this time, - nor of any phrenitis. The tertians were more numerous than the ardent - fevers and more painful. But all these had four regular periods from the - first onset, had complete crises in seven, and in no case relapsed. But - the quartans, while in many instances they began at first with quartan - periodicity, yet in not a few they became quartan by an abscession from - other fevers or illnesses.There are often mixed infections in - malaria. If the quartan be one of these, being the longest it - outlasts the others. So the disease appears to have turned into a - quartan. They were protracted, as quartans usually are, or - even more protracted than usual. Many fell victims to quotidians, night - fevers, or irregular fevers, and were ill for a long time, either in bed - or walking about. In most of these cases the fevers continued during the - season of the Pleiades or even until winter. In many patients, - especially children, there were convulsions and slight feverishness from - the beginning; sometimes, too, convulsions supervened upon fevers. - Mostly these illnesses were protracted, but not dangerous, except for - those who from all other causes were predisposed to die.

-
-
- PART 7 -

VII. But those fevers which were altogether continuous and never - intermitted at all, but in all cases

- -

grew worse after the manner of semitertians, with remission during one - day followed by exacerbation during the next, were the most severe of - all the fevers which occurred at this time, the longest and the most - painful. Beginning mildly, and on the whole increasing always, with - exacerbation, and growing worse, they had slight remissions followed - quickly after an abatement by more violent exacerbations, generally - becoming worse on the critical days. All patients had irregular rigors - that followed no fixed law, most rarely and least in the - semitertians,I take the pronoun AU)=TOS2 throughout this chapter to refer to the - remittent semitertian, or to sufferers from it. but more - violent in the other fevers. Copious sweats, least copious in the - semitertians; they brought no relief, but on the contrary caused harm. - These patients suffered great chill in the extremities, which grew warm - again with difficulty. Generally there was sleeplessness, especially - with the semitertians, followed afterwards by coma. In all the bowels - were disordered and in a bad state, but in the semitertians they were - far the worst. In most of them urine either (a) - thin, crude, colourless, after a time becoming slightly concocted with - signs of crisis, or (b) thick enough but turbid, in - no way settling or forming sediment, or (c) with - small, bad, crude sediments, these being the worst of all. Coughs - attended the fevers, but I cannot say that either harm or good resulted - from the coughing on this occasion.

-
-
- PART 8 -

VIII. Now the greatest number of these symptoms continued to be - protracted, troublesome, very disordered, very irregular, and without - any critical signs, both in the case of those who came very near - death

- -

and in the case of those who did not. For even if some patients enjoyed - slight intermissions, there followed a quick relapse. A few of them - experienced a crisis, the earliest being about the eightieth day, some - of the latter having a relapse, so that most of them were still ill in - the winter. The greatest number had no crisis before the disease - terminated. These symptoms occurred in those who recovered just as much - as in those who did not. The illnesses showed a marked absence of crisis - and a great variety; the most striking and the worst symptom, which - throughout attended the great majority, was a complete loss of appetite, - especially in those whose general condition exhibited fatal signs, but - in these fevers they did not suffer much from unseasonable thirst. After - long intervals, with many pains and with pernicious wasting, there - supervened abscessions either too severe to be endured, or too slight to - be beneficial, so that there was a speedy return of the original - symptoms, and an aggravation of the mischief.That is, the - abscessions did not carry off the morbid humours, which spread again - throughout the system.

-
-
- PART 9 -

IX. The symptoms from which these patients suffered were dysenteries and - tenesmus, lienteries also and fluxes. Some had dropsies also, either - with or without these. Whenever any of these attacked violently they - were quickly fatal, or, if mild, they did no good. Slight eruptions, - which did not match the extent of the diseases and quickly disappeared - again, or swellings by the ears that grew smallerMWLUO/MENA would mean "remained - crude." and

- -

signified nothing, in some cases appearing at the joints, especially the - hip-joint, in few instances leaving with signs of crisis, when they - quickly re-established themselves in their original state.

-
-
- PART 10 -

X. From all the diseases some died, but the greatest number from these - fevers,It is not clear to what PA/NTWN and TOU/TWN - refer. Probably PA/NTWN refers to - all the semitertians, and TOU/TWN - to the special type of them described in Chapter IX. - especially children--those just weaned, older children of eight or ten - years, and those approaching puberty. These victims never suffered from - the latter symptoms without the first I have described above, but often - the first without the latter. The only good sign, the most striking that - occurred, which saved very many of those who were in the greatest - danger, was when there was a change to strangury, into which abscessions - took place. The strangury, too, came mostly to patients of the ages - mentioned, though it did happen to many of the others, either without - their taking to bed or when they were ill. Rapid and great was the - complete change that occurred in their case. For the bowels, even if - they were perniciously loose, quickly recovered; their appetite for - everything returned, and hereafter the fever abated. But the strangury, - even in these cases, was long and painful. Their urine was copious, - thick, varied, red, mixed with pus, and passed with pain. But they all - survived, and I know of none of these that died.

-
-
- PART 11 -

XI. In all dangerous cases you should be on the watch for all favourable - coctions of the evacuations from all parts, or for fair and critical - abscessions. Coctions signify nearness of crisis and sure recovery

- -

of health, but crude and unconcocted evacuations, which change into bad - abscessions, denote absence of crisis, pain, prolonged illness, death, - or a return of the same symptoms. But it is by a consideration of other - signs that one must decide which of these results will be most likely. - Declare the past, diagnose the present, foretell the future; practise - these acts. As to diseases, make a habit of two things--to help, or at - least to do no harm. The art has three factors, the disease, the - patient, the physician. The physician is the servant of the art. The - patient must co-operate with the physician in combating the disease.

-
-
- PART 12 -

XII. Pains about the head and neck, and heaviness combined with pain, - occur both without and with fever. Sufferers from phrenitis have - convulsions, and eject verdigris-coloured vomit; some die very quickly. - But in ardent and the other fevers, those with pain in the neck, - heaviness of the temples, dimness of sight, and painless tension of the - hypochondrium, bleed from the nose; those with a general heaviness of - the head, cardialgia, and nausea, vomit afterwards bile and phlegm. - Children for the most part in such cases suffer chiefly from the - convulsions. Women have both these symptoms and pains in the womb. Older - people, and those whose natural heat is failing, have paralysis or - raving or blindness.

-
-
-
- THIRD CONSTITUTION -
- PART 13 -

XIII. In Thasos a little before and at the season of Arcturus many - violent rains with northerly winds. About the equinox until the setting - of the Pleiades

- -

slight, southerly rains. Winter northerly, droughts, cold periods, - violent winds, snow. About the equinox very severe storms. Spring - northerly, droughts, slight rains, periods of cold. About the summer - solstice slight showers, periods of great cold until near the Dog Star. - After the Dog Star, until Arcturus, hot summer. Great heat, not - intermittent but continuous and severe. No rain fell. The Etesian winds - blew. About Arcturus southerly rains until the equinox.

-
-
- PART 14 -

XIV. In this constitution during winter began paralyses which attacked - many, a few of whom quickly died. In fact, the disease was generally - epidemic. In other respects the public health continued good. Early in - spring began ardent fevers which continued until the equinox and on to - summer. Now those who began to be ill at once, in spring or the - beginning of summer, in most cases got well, though a few died; but - when autumn and the rains came the cases were dangerous, and more - died.

-

As to the peculiarities of the ardent fevers, the most likely patients to - survive were those who had a proper and copious bleeding from the nose, - in fact I do not know of a single case in this constitution that proved - fatal when a proper bleeding occurred, For Philiscus and Epaminon and - Silenus, who died, had only a slight epistaxis on the fourth and fifth - days. Now the majority of the patients had rigors near the

- -

crisis, especially such as had no epistaxis, but these had sweats also as - well as rigors.

-
-
- PART 15 -

XV. Some had jaundice on the sixth day, but these were benefited by - either a purging through the bladder or a disturbance of the bowels or a - copious hemorrhage, as was the case with Heraclides, who lay sick at the - house of Aristocydes. This patient, however, who had a crisis on the - twentieth day, not only bled from the nose, but also experienced - disturbance of the bowels and a purging through the bladder. Far - otherwise was it with the servant of Phanagoras, who had none of these - symptoms, and died. But the great majority had hemorrhage, especially - youths and those in the prime of life, and of these the great majority - who had no hemorrhage died. Older people had jaundice or disordered - bowels, for example Bion, who lay sick at the house of Silenus. - Dysenteries also were general in summer, and some too of those who had - fallen ill, and also suffered from hemorrhage, finally had dysentery; - for example, the slave of Erato and Myllus, after copious hemorrhage, - lapsed into dysentery. They recovered.

-

This humour,That is, blood. then, especially was in great - abundance, since even those who had no hemorrhage near the crisis, but - swellings by the ears which disappeared--and after their disappearance - there was a heaviness along the left flank up to the extremity of the - hip--after the crisis had pain and passed thin urine, and then began to - suffer slight hemorrhage about the twenty-fourth day, and

- -

abscessions into hemorrhage occurred. In the case of Antipho, son of - Critobulus, the illness ceased and came to a complete crisis about the - fortieth day.

-
-
- PART 16 -

XVI. Though many women fell ill, they were fewer than the men and less - frequently died. But the great majority had difficult childbirth, and - after giving birth they would fall ill, and these especially died, as - did the daughter of Telebulus on the sixth day after delivery. Now - menstruation appeared during the fevers in most cases, and with many - maidens it occurred then for the first time. Some bled from the nose. - Sometimes both epistaxis and menstruation appeared together; for - example, the maiden daughter of Daitharses had her first menstruation - during fever and also a violent discharge from the nose. I know of no - woman who died if any of these symptoms showed themselves properly, but - all to my knowledge had abortions if they chanced to fall ill when with - child.

-
-
- PART 17 -

XVII. Urine in most cases was of good colour, but thin and with slight - sediments, and the bowels of most were disordered with thin, bilious - excretions. Many after a crisis of the other symptoms ended with - dysentery, as did Xenophanes and Critias. I will mention cases in which - was passed copious, watery, clear and thin urine, even after a crisis in - other respects favourable, and a favourable sediment : Bion, who lay - sick at the house of Silenus, Cratis, who lodged with Xenophanes, the - slave of Areto, and the wife of Mnesistratus. Afterwards all these - suffered from dysentery.

-

About the season of Arcturus many had crisis on

- -

the eleventh day, and these did not suffer even the normal relapses. - There were also comatose fevers about this time, usually in children, - and of all patients these showed the lowest mortality.

-
-
- PART 18 -

XVIII. About the equinox up to the setting of the Pleiades, and during - winter, although the ardent fevers continued, yet cases of phrenitis - were most frequent at this time, and most of them were fatal. In summer, - too, a few cases had occurred. Now the sufferers from ardent fever, when - fatal symptoms attended, showed signs at the beginning. For right from - the beginning there was acute fever with slight rigors, sleeplessness, - thirst, nausea, slight sweats about the forehead and collar-bones, but - in no case general, much delirium, fears, depression, very cold - extremities, toes and hands, especially the latter. The exacerbations on - the even days; but in most cases the pains were greatest on the fourth - day, with sweat for the most part chilly, while the extremities could - not now be warmed again, remaining livid and cold; and in these cases - the thirst ceased. Their urine was scanty, black, thin, with - constipation of the bowels. Nor was there hemorrhage from the nose in - any case when these symptoms occurred, but only slight epistaxis. None - of these cases suffered relapse, but they died on the sixth day, with - sweating. The cases of phrenitis had all the above symptoms, but the - crises generally occurred on the eleventh day. Some had their crises on - the twentieth day, namely those in whom the phrenitis did not begin at - first, or began about the third or fourth day, but

- -

though these fared tolerably at the beginning, yet the disease assumed an - acute form about the seventh day.

-
-
- PART 19 -

XIX. Now the number of illnesses was great. And of the patients there - died chiefly striplings, young people, people in their prime, the - smooth, the fair-skinned, the straight-haired, the black-haired, the - black-eyed, those who had lived recklessly and care-lessly, the - thin-voiced, the rough-voiced, the lispers, the passionate. Women too - died in very great numbers who were of this kind. In this constitution - there were four symptoms especially which denoted recovery :--a proper - hemorrhage through the nostrils; copious discharges by the bladder of - urine with much sediment of a proper character; disordered bowels with - bilious evacuations at the right time; the appearance of dysenteric - characteristics. The crisis in many cases did not come with one only of - the symptoms described above, but in most cases all symptoms were - experienced, and the patients appeared to be more distressed; but all - with these symptoms got well. Women and maidens experienced all the - above symptoms, but besides, whenever any took place properly, and - whenever copious menstruation supervened, there was a crisis therefrom - which resulted in recovery; in fact I know of no woman who died when - any of these symptoms took place properly. For the daughter of Philo, - who died, though she had violent epistaxis, dined rather unseasonably on - the seventh day.

-

In acute fevers, more especially in ardent fevers, when involuntary - weeping occurs, epistaxis is to be

- -

expected it the patient have no fatal symptoms besides; for when he is - in a bad way such weeping portends not hemorrhage but death.

-
-
- PART 20 -

XX. The painful swellings by the ears in fevers in some cases neither - subsided nor suppurated when the fever ceased with a crisis. They were - cured by bilious diarrhœa, or dysentery, or a sediment of thick urine - such as closed the illness of Hermippus of Clazomenæ. The circumstances - of the crises, from which too I formed my judgments, were either similar - or dissimilar; for example, the two brothers, who fell sick together at - the same time, and lay ill near the bungalow of Epigenes. The elder of - these had a crisis on the sixth day, the younger on the seventh. Both - suffered a relapse together at the same time with an intermission of - five days. After the relapse both had a complete crisis together on the - seventeenth day. But the great majority had a crisis on the sixth day, - with an intermission of six days followed by a crisis on the fifth day - after the relapse. Those who had a crisis on the seventh day had an - intermission of seven days, with a crisis on the third day after the - relapse. Others with a crisis on the seventh had an intermission of - three days, with a crisis on the seventh day after the relapse. Some who - had a crisis on the sixth day had an intermission of six and a relapse - of three, an intermission of one and a relapse of one, followed by a - crisis; for example, Euagon the son of Daitharses. Others with a crisis - on the sixth had an intermission of seven days, and after the relapse a - crisis on the fourth; for example, the daughter of Aglai+das. Now most - of those who fell ill in this constitution went through their illness in - this manner, and none of

- -

those who recovered, so far as I know, failed to suffer the relapses - which were normal in these cases, but all, so far as I know, recovered - if their relapses took place after this fashion. Further, I know of none - who suffered a fresh relapse after going through the illness in the - manner described above.

-
-
- PART 21 -

XXI. In these diseases most died on the sixth day, as did Epaminondas, - Silenus and Philiscus the son of Antagoras. Those who had the swellings - by the ears had a crisis on the twentieth day, but these subsided in all - cases without suppuration, being diverted to the bladder. There were two - cases of suppuration, both fatal, Cratistonax, who lived near the temple - of Heracles, and the serving-maid of Scymnus the fuller. When there was - a crisis on the seventh day, with an intermission of nine days followed - by a relapse, there was a second crisis on the fourth day after the - relapse--in the case of Pantacles, for example, who lived by the temple - of Dionysus. When there was a crisis on the seventh day, with an - intermission of six days followed by a relapse, there was a second - crisis on the seventh day after the relapse--in the case of Phanocritus, - for example, who lay sick at the house of Gnathon the fuller.

-
-
- PART 22 -

XXII. During winter, near the time of the winter solstice, and continuing - until the equinox, the ardent fevers and the phrenitis still caused many - deaths, but their crises changed. Most cases had a crisis on the fifth - day from the outset, then intermitted four days, relapsed, had a crisis - on the fifth day after the relapse, that is, after thirteen days - altogether. Mostly children experienced crises thus, but older people - did so too. Some had a crisis

- -

on the eleventh day, a relapse on the fourteenth, and a complete crisis - on the twentieth. But if rigor came on about the twentieth day the - crisis came on the fortieth. Most had rigors near the first crisis, and - those who had rigors at first near the crisis, had rigors again in the - relapses at the time of the crisis. Fewest experienced rigors in the - spring, more in summer, more still in autumn, but by far the most during - winter. But the hemorrhages tended to cease.

-
-
- PART 23 -

XXIII. The following were the circumstances attending the diseases, from - which I framed my judgments, learning from the common nature of all and - the particular nature of the individual, from the disease, the patient, - the regimen prescribed and the prescriber--for these make a diagnosis - more favourable or less; from the constitution, both as a whole and - with respect to the parts, of the weather and of each region; from the - custom, mode of life, practices and ages of each patient; from talk, - manner, silence, thoughts, sleep or absence of sleep, the nature and - time of dreams, pluckings, scratchings, tears; from the exacerbations, - stools, urine, sputa, vomit, the antecedents and consequents of each - member in the successions of diseases, and the abscessions to a fatal - issue or a crisis, sweat, rigor, chill, cough, sneezes, hiccoughs, - breathing, belchings, flatulence, silent or noisy, hemorrhages, and - hemorrhoids. From these things must we consider what their consequents - also will be.

-
-
- PART 24 -

XXIV. Some fevers are continuous, some have an access during the day and - an intermission during the night, or an access during the night and an - intermission during the day; there are semitertians,

- -

tertians, quartans, quintans, septans, nonans. The most acute diseases, - the most severe, difficult and fatal, belong to the continuous fevers. - The least fatal and least difficult of all, but the longest of all, is - the quartan. Not only is it such in itself, but it also ends other, and - serious, diseases. In the fever called semitertian, which is more fatal - than any other, there occur also acute diseases, while it especially - precedes the illness of consumptives, and of those who suffer from other - and longer diseases. The nocturnal is not very fatal, but it is long. - The diurnal is longer still, and to some it also brings a tendency to - consumption. The septan is long but not fatal. The nonan is longer still - but not fatal. The exact tertian has a speedy crisis and is not fatal. - But the quintan is the worst of all. For if it comes on before - consumption or during consumption the patient dies.

-
-
- PART 25 -

XXV. Each of these fevers has its modes, its constitutions and its - exacerbations. For example, a continuous fever in some cases from the - beginning is high and at its worst, leading up to the most severe stage, - but about and at the crisis it moderates. In other cases it begins - gently and in a suppressed manner, but rises and is exacerbated each - day, bursting out violently near the crisis. In some cases it begins - mildly, but increases and is exacerbated, reaching its height after a - time; then it declines again until the crisis or near the crisis. These - characteristics may show themselves in any fever and in any disease. It - is necessary also to consider the patient's mode of life and to take - it

- -

into account when prescribing. Many other important symptoms there are - which are akin to these, some of which I have described, while others I - shall describe later. These must be duly weighed when considering and - deciding who is suffering from one of these diseases in an acute, fatal - form, or whether the patient may recover; who has a chronic, fatal - illness, or one from which he may recover; who is to be prescribed for - or not, what the prescription is to be, the quantity to be given and the - time to give it.

-
-
- PART 26 -

XXVI. When the exacerbations are on even days, the crises are on even - days. But the diseases exacerbated on odd days have their crises on odd - days. The first period of diseases with crises on the even days is the - fourth day, then the sixth, eighth, tenth, fourteenth, twentieth, - twenty-fourth, thirtieth, fortieth, sixtieth, eightieth, hundred and - twentieth. Of those with a crisis on the odd days the first period is - the third, then the fifth, seventh, ninth, eleventh, seventeenth, - twenty-first, twenty-seventh, thirty-first. Further, one must know that, - if the crises be on other days than the above, there will be relapses, - and there may also be a fatal issue. So one must be attentive and know - that at these times there will be the crises resulting in recovery, or - death, or a tendency for better or worse. One must also consider in what - periods the crises occur of irregular fevers, of quartans, of quintans, - of septans and of nonans.

-
-
- -
- FOURTEEN CASES -
- CASE I -

Philiscus lived by the wall. He took to his bed with acute fever on the - first day and sweating; night uncomfortable.

-

Second day. General exacerbation, later a small - clyster moved the bowels well. A restful night.

-

Third day. Early and until mid-day he appeared to - have lost the fever; but towards evening acute fever with sweating; - thirst; dry tongue; black urine. An uncomfortable night, without sleep - ; completely out of his mind.

-

Fourth day. All symptoms exacerbated; black urine; - a more comfortable night, and urine of a better colour.

-

Fifth day. About mid-day slight epistaxis of unmixed - blood. Urine varied, with scattered, round particles suspended in it, - resembling semen; they did not settle. On the application of a - suppository the patient passed, with flatulence, scanty excreta. A - distressing night, snatches of sleep, irrational talk; extremities - everywhere cold, and would not get warm again; black urine; snatches - of sleep towards dawn; speechless; cold sweat; extremities livid. - About mid-day on the sixth day the patient died. The breathing - throughout, as though he were recollecting to do it,The patient - seemed to forget the necessity of breathing, and then to remember it - and to breathe consciously. was rare and large. Spleen raised - in a round swelling; cold sweats all the time. The exacerbations on - even days.

-
-
- CASE II -

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

- -

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 - tightnessThe word U(POLA/PAROS2 is often applied to S1U/NTAS1IS2 or E)/NTAS1IS2 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 LAPA/ZW. 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 FLEGMONH\ U(POLA/PAROS2 E)K TOU= E)/S1W - ME/REOS2, from which it seems that the prefix U(PO- 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. 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

- -

there came a copious discharge of solid stools, thin,I take - LEPTO/S2 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). 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.

-
-
- CASE III -

Herophon had acute fever; scanty stools with tenesmus at the beginning, - afterwards becoming thin, bilious and fairly frequent. No sleep; urine - black and thin.

-

Fifth day. Deafness early in the day; general - exacerbation; spleen swollen; tension of the hypochondrium; scanty - black stools; delirium.

-

Sixth day. Wandering talk; at night sweat and chill - ; the wandering persisted.

-

Seventh Day. Chill all over; thirst; out of his - mind. During the night he was rational, and slept.

-

Eighth day. Fever; spleen lessened; quite rational - ; pain at first in the groin, on the side of the spleen; then the pains - extended to both legs. Night comfortable; urine of a better colour, - with a slight deposit.

-

Ninth day. Sweat, crisis, intermission.

- -

On the fifth day after the crisis the patient relapsed. Immediately the - spleen swelled; acute fever; return of deafness. On the third day - after the relapse the spleen grew less and the deafness diminished, but - there was pain in the legs. During the night he sweated. The crisis was - about the seventeenth day. There was no delirium during the relapse.

-
-
- CASE IV -

In Thasos the wife of Philinus gave birth to a daughter. The lochial - discharge was normal, and the mother was doing well when on the - fourteenth day after delivery she was seized with fever attended with - rigor. At first she suffered in the stomach and the right hypochondrium. - Pains in the genital organs. The discharge ceased. By a pessary these - troubles were eased, but pains persisted in the head, neck and loins. No - sleep; extremities cold; thirst; bowels burnt; scanty stools; urine - thin, and at first colourless.

-

Sixth day. Much delirium at night, followed by - recovery of reason.

-

Seventh day. Thirst; stools scanty, bilious, highly - coloured.

-

Eighth day. Rigor; acute fever; many painful - convulsions; much delirium. The application of a suppository made her - keep going to stool, and there were copious motions with a bilious flux. - No sleep.

-

Ninth day. Convulsions.

-

Tenth day. Lucid intervals.

-

Eleventh day. Slept; complete recovery of her - memory, followed quickly by renewed delirium.

- -

A copious passing of urine with convulsions--her attendants seldom - reminding her--which was white and thick, like urine with a sediment and - then shaken; it stood for a long time without forming a sediment; - colour and consistency like that of the urine of cattle. Such was the - nature of the urine that I myself saw.

-

About the fourteenth day there were twitchings over all the body; much - wandering, with lucid intervals followed quickly by renewed delirium. - About the seventeenth day she became speechless.

-

Twentieth day. Death.

-
-
- CASE V -

The wife of Epicrates, who lay sick near the founder,I. e. near the statue of the founder of the - city, or near the temple of the god who presided over the founding - of the city. when near her delivery was seized with severe - rigor without, it was said, becoming warm, and the same symptoms - occurred on the following day. On the third day she gave birth to a - daughter, and the delivery was in every respect normal. On the second - day after the delivery she was seized with acute fever, pain at the - stomach and in the genitals. A pessary relieved these symptoms, but - there was pain in the head, neck and loins. No sleep. From the bowels - passed scanty stools, bilious, thin and unmixed. Urine thin and - blackish. Delirium on the night of the sixth day from the day the fever - began.

-

Seventh day. All symptoms exacerbated; - sleeplessness; delirium; thirst; bilious, highly-coloured stools.

-

Eighth day. Rigor; more sleep.

-

Ninth day. The same symptoms.

- -

Tenth day. Severe pains in the legs; pain again at - the stomach; heaviness in the head; no delirium; more sleep; - constipation.

-

Eleventh day. Urine of better colour, with a thick - deposit; was easier.

-

Fourteenth day. Rigor; acute fever.

-

Fifteenth day. Vomited fairly frequently bilious, - yellow vomit; sweated without fever; at night, however, acute fever; - urine thick, with a white sediment.

-

Sixteenth day. Exacerbation; an uncomfortable night - ; no sleep; delirium.

-

Eighteenth day. Thirst; tongue parched; no sleep; - much delirium; pain in the legs.

-

About the twentieth day. Slight rigors in the early morning; coma; - quiet sleep; scanty, bilious, black vomits; deafness at night.

-

About the twenty-first day. Heaviness all over the left side, with pain; - slight coughing; urine thick, turbid, reddish, no sediment on standing. - In other respects easier; no fever. From the beginning she had pain in - the throat; redness; uvula drawn back; throughout there persisted an - acrid flux, smarting, and salt.

-

About the twenty-seventh day. No fever; sediment in urine; some pain in - the side.

-

About the thirty-first day. Attacked by fever; bowels disordered and - bilious.

-

Fortieth day. Scanty, bilious vomits.

-

Eightieth day. Complete crisis with cessation of - fever.

-
-
- CASE VI -

Cleanactides, who lay sick above the temple of Heracles, was seized by an - irregular fever. He had

- -

at the beginning pains in the head and the left side, and in the other - parts pains like those caused by fatigue. The exacerbations of the fever - were varied and irregular; sometimes there were sweats, sometimes there - were not. Generally the exacerbations manifested themselves most on the - critical days.

-

About the twenty-fourth day. Pain in the hands; bilious, yellow vomits, - fairly frequent, becoming after a while like verdigris; general - relief.

-

About the thirtieth day. Epistaxis from both nostrils began, and - continued, irregular and slight, until the crisis. All the time he - suffered no thirst, nor lack of appetite or sleep. Urine thin, and not - colourless.

-

About the fortieth day. Urine reddish, and with an abundant, red deposit. - Was eased. Afterwards the urine varied, sometimes having, sometimes not - having, a sediment.

-

Sixtieth day. Urine had an abundant sediment, white - and smooth; general improvement; fever intermitted; urine again thin - but of good colour.

-

Seventieth day. Fever, which intermitted for ten - days.

-

Eightieth day. Rigor; attacked by acute fever; - much sweat; in the urine a red, smooth sediment. A complete crisis.

-
-
- CASE VII -

Meton was seized with fever, and painful heaviness in the loins.

-

Second day. After a fairly copious draught of water - had his bowels well moved.

-

Third day. Heaviness in the head; stools thin, - bilious, rather red.

- -

Fourth day. General exacerbation; slight epistaxis - twice from the right nostril. An uncomfortable night; stools as on the - third day; urine rather black; had a rather black cloud floating in - it, spread out, which did not settle.

-

Fifth day. Violent epistaxis of unmixed blood from - the left nostril; sweat; crisis. After the crisis sleeplessness; - wandering; urine thin and rather black. His head was bathed; sleep; - reason restored. The patient suffered no relapse, but after the crisis - bled several times from the nose.

-
-
- CASE VIII -

Erasinus lived by the gully of Boétes. Was seized with fever after supper - ; a troubled night.

-

First day. Quiet, but the night was painful.

-

Second day. General exacerbation; delirium at - night.

-

Third day. Pain and much delirium.

-

Fourth day. Very uncomfortable; no sleep at night; - dreams and wandering. Then worse symptoms, of a striking and significant - character; fear and discomfort.

-

Fifth day. Early in the morning was composed, and in - complete possession of his senses. But long before mid-day was madly - delirious; could not restrain himself; extremities cold and rather - livid; urine suppressed; died about sunset.

-

In this patient the fever was throughout accompanied by sweat; the - hypochondria were swollen, distended and painful. Urine black, with - round, suspended particles which did not settle. There were solid - discharges from the bowels. Thirst

- -

throughout not very great. Many convulsions with sweating about the time - of death.

-
-
- CASE IX -

Crito, in Thasos, while walking about, was seized with a violent pain in - the great toe. He took to bed the same day with shivering and nausea; - regained a little warmth; at night was delirious.

-

Second day. Swelling of the whole foot, which was - rather red about the ankle, and distended; black blisters; acute fever - ; mad delirium. Alvine discharges unmixed, bilious and rather frequent. - He died on the second day from the commencement.

-
-
- CASE X -

The man of Clazomenae, who lay sick by the well of Phrynichides, was - seized with fever. Pain at the beginning in head, neck and loins, - followed immediately by deafness. No sleep; seized with acute fever; - hypochondrium swollen, but not very much; distension; tongue dry.

-

Fourth day. Delirium at night.

-

Fifth day. Painful.

-

Sixth day. All symptoms exacerbated.

-

About the eleventh day slight improvement. From the beginning to the - fourteenth day there were from the bowels thin discharges, copious, of a - watery biliousness; they were well supported by the patient. Then the - bowels were constipated. Urine throughout thin, but of good colour. It - had much cloud spread through it, which did not settle in a sediment. - About the sixteenth day the urine was a little thicker, and had a slight - sediment.

- -

The patient became a little easier, and was more rational.

-

Seventeenth day. Urine thin again; painful - swellings by both ears. No sleep; wandering; pain in the legs.

-

Twentieth day. A crisis left the patient free from - fever; no sweating; quite rational. About the twenty-seventh day - violent pain in the right hip, which quickly ceased. The swellings by - the ears neither subsided nor suppurated, but continued painful. About - the thirty-first day diarrhéa with copious, watery discharges and signs - of dysentery. Urine thick; the swellings by the ears subsided.

-

Fortieth day. Pain in the right eye; sight rather - impaired; recovery.

-
-
- CASE XI -

The wife of Dromeades, after giving birth to a daughter, when everything - had gone normally, on the second day was seized with rigor; acute - fever. On the first day she began to feel pain in the region of the - hypochondrium; nausea; shivering; restless; and on the following - days did not sleep. Respiration rare, large, interrupted at once as by - an inspiration.As we might say, "with a catch in it."

-

Second day from rigor. Healthy action of the bowels. - Urine thick, white, turbid, like urine which has settled, stood a long - time, and then been stirred up. It did not settle. No sleep at - night.

-

Third day. At about mid-day rigor; acute fever; - urine similar; pain in the hypochondrium; nausea; an uncomfortable - night without sleep; a cold sweat all over the body, but the patient - quickly recovered heat.

- -

Fourth day. Slight relief of the pains about the - hypochondrium; painful heaviness of the head; somewhat comatose; - slight epistaxis; tongue dry; thirst; scanty urine, thin and oily; - snatches of sleep.

-

Fifth day. Thirst; nausea; urine similar; no - movement of the bowels; about mid-day much delirium, followed quickly - by lucid intervals; rose, but grew somewhat comatose; slight - chilliness; slept at night; was delirious.

-

Sixth day. In the morning had a rigor; quickly - recovered heat; sweated all over; extremities cold; was delirious; - respiration large and rare. After a while convulsions began from the - head, quickly followed by death.

-
-
- CASE XII -

A man dined when hot and drank too much. During the night he vomited - everything; acute fever; pain in the right hypochondrium; - inflammation, soft underneath, from the inner partSee note, p. - 188.; an uncomfortable night; urine at the first thick and - red; on standing it did not settle; tongue dry; no great thirst.

-

Fourth day. Acute fever; pains all over.

-

Fifth day. Passed much smooth, oily urine; acute - fever.

-

Sixth day. In the afternoon much delirium. No sleep - at night.

-

Seventh day. General exacerbation; urine similar; - much rambling; could not restrain himself; on stimulation the bowels - passed watery, disturbed discharges, with worms. An uncomfortable night, - with rigor in the morning. Acute fever. Hot sweat, and the patient - seemed to lose his fever;

- -

little sleep, followed by chilliness; expectoration. In the evening much - delirium, and shortly afterwards he vomited black, scanty, bilious - vomits.

-

Ninth day. Chill; much wandering; no sleep.

-

Tenth day. Legs painful; general exacerbation; - wandering.

-

Eleventh day. Death.

-
-
- CASE XIII -

A woman lying sick by the shore, who was three months gone with child, - was seized with fever, and immediately began to feel pains in the - loins.

-

Third day. Pain in the neck and in the head, and in - the region of the right collar-bone. Quickly she lost her power of - speech, the right arm was paralyzed, with a convulsion, after the manner - of a stroke; completely delirious. An uncomfortable night, without - sleep; bowels disordered with bilious, unmixed, scanty stools.

-

Fourth day. Her speech was recovered, but was - indistinct; convulsions; pains of the same parts remained; painful - swelling in the hypochondrium; no sleep; utter delirium; bowels - disordered; urine thin, and not of good colour.

-

Fifth day. Acute fever; pain in the hypochondrium; - utter delirium; bilious stools. At night sweated; was without - fever.

-

Sixth day. Rational; general relief, but pain - remained about the left collar-bone; thirst; urine thin; no - sleep.

-

Seventh day. Trembling; some coma; slight delirium - ; pains in the region of the collar-bone and left upper arm remained; - other symptoms

- -

relieved; quite rational. For three days there was an intermission of - fever.

-

Eleventh day. Relapse; rigor; attack of fever. But - about the fourteenth day the patient vomited bilious, yellow matter - fairly frequently; sweated; a crisis took off the fever.

-
-
- CASE XIV -

Melidia, who lay sick by the temple of Hera, began to suffer violent pain - in the head, neck and chest. Immediately she was attacked by acute - fever, and there followed a slight menstrual flow. There were continuous - pains in all these parts.

-

Sixth day. Coma; nausea; shivering; flushed - cheeks; slight delirium.

-

Seventh day. Sweat; intermittence of fever; the - pains persisted; relapse; snatches of sleep; urine throughout of good - colour but thin; stools thin, bilious, irritating, scanty, black and of - bad odour; sediment in the urine white and smooth; sweating.

-

Eleventh day. Perfect crisis.

-
-
-
- -
- EPIDEMICS III: THE CHARACTERS -

SOME MSS., the most important being V, have certain characters - at the end of the medical histories in Book III of the Epidemics. These characters were known to Galen, who wrote, or - contemplated writing, a treatise about them. There is no doubt, therefore, that - they are ancient; Galen indeed in his commentary tells us that his predecessors - had been much exercised over them. Zeuxis, he says, had written a history of - them in which they were traced back to Mnemon, who either added them to a - manuscript in the Library at Alexandria or else brought to the Library a copy - with the characters inserted.

-

These characters are of no real value for the interpretation of the text, but - they bear witness to the interest taken in the "medical histories" from very - early times. Somebody or other invented a shorthand script in order to summarize - these histories, or rather the main teaching of them. For some reason they were - only applied to the histories of the third book, and Galen says that the older - manuscripts of his time had no characters inserted until the seventh case (woman - with angina).

-

Galen gives the following explanation of the characters :--

-

*(HGEI=TAI ME\N OU)=N, W(S2 E)/FHN, A(PA/NTWN TO\ TH\N - DIA/METRON GRAMMH\N E)/XON *P, S1HMAI=NON - A)EI\ TO\ PIQANO/N. TELEUTAI=ON - D/

- -

H)/TOI TO\ *U GRA/MMA FAI/NETAI GEGRAMME/NON H)\ TO\ - *Q, TO\ ME\N U(GEI/AN, TO\ DE\ QA/NATON S1HMAI=NON. E)/MPROS1QEN D' AU)TW=N O( TW=N H(MERW=N - A)RIQMO/S2, E)N AI)=S2 E)NO/S1HS1EN H)\ - A)PE/QANEN O( KA/MNWN. OI( DE\ E)N TW=| - METACU\ TOU/TWN XARAKTH=RES2 A)/PANTES2 ME/N EI)S1I DIA\ TW=N - GRAMMA/TWN, A(\ S1HMAI/NEI TA\ S1TOIXEI=A - TH=S2 FWNH=S2, PLH\N TOU= KA/TWQEN - A)PES1TIGME/NOU DE/LTA. TI/NA DE\ - DIA/NOIAN E(/KAS1TOS2 AU)TW=N E)/XEI, DHLW/S1W. MEMNHME/NWN OU)\N - H(MW=N, O(/TI TA\ PRO\ TOU= TELEUTAI/OU - TW=N XARAKTH/RWN, U(F' OU(= QA/NATON H)\ - U(GEI/AN E)/FAMEN DHLOU=S1QAI, GEGRAMME/NA - TO\N A)RIQMO\N TW=N H(MERW=N S1HMAI/NEI, PERI\ TW=N A)/LLWN, O)/S1A METACU\ - TOU/TWN TE KAI\ TH=S2 A)RXH=S2 GE/GRAPTAI, POIH/S1OMAI TO\N LO/GON. TO\ ME\N *A - DHLOI= A)POFQORA(N, A)PW/LEIAN, - TO\ DE\ *G GONOEIDE\S2 OU)=RON, TO\ D) A)PES1TIGME/NON, OI)A/PER E)/S1TIN A(\ KA/TWQEN E)/XEI,This sentence is - evidently corrupt. - TRO/PW| TOIW=|DE GEGRAMME(NON *D| DIAXWROU/MENA DI) - I(DRW/TWN KAI\ DIA/RROIAN KAI\ DIAFO/RHS1INLittré would read - DIAXW/RHS1IN. - KAI\ S1UNELO/NTI FA/NAI KE/NWS1IN H(NTINAOU=N - S1HMAI/NEIN *BOU/LONTAI, TO\ DE\ *E - E)POXH/N, E)/DRAN, TO\ DE\ *Z CH/THMA, TO\ DE\ - *Q QA/NATON, W(S2 PROEI/RHTAI, - TO\ DE\ I I(DRW=TA, TO\ DE\ *K KRI/S1IN H)\ - KOILIAKH\N DIA/QES1IN, TO\ DE\ *M MANI/AN - H)\ MH/TRAN, TO\ DE\ *N NEO/THTA KAI\ - NE/KRWS1IN, TO\ DE\ *C CANQH\N XOLH\N KAI\ - CE/NON TI KAI\ S1PA/NION KAI\ CUS1MO\N KAI\ CHRO/THTA, TO\ DE\ *O O)DU/NAS2 H)\ OU)=RON--E)/NIOI DE/ FAS1IN, O)/TAN - E)PIKEI/MENON A)/NWQEN E)/XH| TO\ *U, TO/TE S1HMAI/NEIN TO\ OU)\RON AU)TO/, GRAFO/MENON W(S2 EI)W/QAS1I TO\ OU)/TWS1 GRA/FEIN--, TO\ DE\ II PLH=QOS2 H)\ - PTU/ELON H)\ PURO\NLittré would read??URRO/N. - H)\ PURETO\N H)\ PNEU/MONOS2 PA/QOS2, TO\ [*P] D' E)N AU(TW=| ME/S1ON E)/XON TO\ I, KAQO/TI PROEI/RHTAI, TO\ - PIQANO\N DHLOI=, TO\ DE\ *R R(U/S1IN H)\ - R(I=GOS2, TO\ DE\ *F FRENI=TIN H)\ - FQI/S1IN, TO\ DE\ *S S1PAS1MO\N H)\ - S1TOMA/XON KA/KWS1IN H)\ S1TO/MATOS2, TO\ - DE\ *T TO/KON, TO\ DE\ *U U(GEI/AN H)\ - U(POXO/NDRION, TO\ DE\ *X XOLH\N H)\ - XOLW=DES2, TO\ DE\ *Y YU/CIN, - TO\ DE\ *W W)MO/THTA.

-

Kéhn XVII, A 611-613.

- -

Now the first character, as I said, is always the letter II with the intersecting - line, meaning in all cases "probable." At the end we see written either *U or *Q, meaning - "recovery" and "death" respectively. Before them is the number of the days at - the end of which the patient recovered or died. The characters in the middle are - in all cases (except the delta with a mark below it) the letters indicating the - elements of the word.That is, each middle character except one is a letter - of the alphabet, and that letter is significant, being the initial of a - word, or of several alternative words. I will now state the meaning - of each. Remember that the last character was said to signify recovery or death, - and the last but one the number of the days, and I will now give a list of the - others written between the number and the beginning. A signifies "miscarriage," - "destruction"; *G "urine like semen"; the - letter with the mark underneath,The text is probably mutilated, but the - general meaning is clear. written thus *D, means "evacuations by sweats," "diarrhoea" and - "perspiration,"Surely this is wrong. Littré's suggestion ("stools") - may possibly be correct. and in general any evacuation; *E "retention," "seat"; *Z "object of search"; *Q - "death," as I said before; *I "sweat"; - *K "crisis" or "condition of the bowels"; - *M "madness" or "womb"; *N "youth" or "mortification"; *C "yellow bile," "something strange and rare," - "irritation," "dryness"; *O "pains" or - "urine," though some say it means urine only when it has the *U placed above, written as the word OU(/TWS2 is generally written; *P means "abundance," "sputum," "wheat,"This - again can surely not be correct. Littré's emendation is unconvincing. - "fever,"

- -

"affection of the lung"; with a vertical stroke in the centre it means as - *I said "probable"; *R means "flux," "rigor"; *F "phrenitis" or "consumption"; *S "convulsion" or "morbid condition of oesophagus or mouth"; - *T "delivery"; *U "recovery of health" or "hypochondrium"; *X "bile" or "bilious"; *Y "chill"; *W "crudity."

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For more information about the characters see Littré, III. pp. 28-33, and various - notes at the end of the cases, and also Ilberg in Kéhlewein's edition, p. - 245.

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As might have been expected, there is considerable doubt as to the right readings - of these characters. Thus in V the characters at the end of Case I (first series) are :--

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?? *Z*S*M*O*N

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where the first character is obviously another form of Galen's??. Ilberg emends - to :--

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?? *Z*S*M*O*N*U>

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Galen reads :--

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?? *P*O*U*M*U

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i. e. - PIQANO/N.

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PLH=QOS2.

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OU)=RA.

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TES1S1ARA/KONTA.

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U(GI/EIA.

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"It is probable that abundance of urine caused recovery in forty days."

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Galen's reading makes it necessary to take the words of the text, META\ DE\ KRI/S1IN, TES1S1ARA/KONTA

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H(ME/RH|S1IN U(=S1TERON, in the unnatural sense - of "after the crisis, forty days from the beginning of the illness." So Littré - and Adams, but the Greek scarcely allows it.

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It appears certain that there were varieties of this shorthand, and that Galen's - account deals with one only.

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- -
- EPIDEMICS III -
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- CASE I -

PythionThe third book of the Epidemics has - always been regarded as a continuation of the first book. Even a - casual glance will convince any reader that the two books are really - one work. The Paris manuscript called A, which breaks off after the - opening words of Epidemics III, nevertheless - joins these words without interruption to the end of the first - book., who lived by the temple of Earth, was seized with - trembling which began in the hands.

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First day. Acute fever; wandering.

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Second day. General exacerbation.

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Third day. Same symptoms.

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Fourth day. Stools scanty, uncompounded and - bilious.

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Fifth day. General exacerbation; fitful sleep; - constipation.

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Sixth day. Varied, reddish sputa.

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Seventh day. Mouth drawn awry.

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Eighth day. General exacerbation; tremblings - persisted; urine from the beginning to the eighth day thin, colourless, - with a cloudy substance floating in it.

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Tenth day. Sweat; sputa somewhat concocted; crisis - ; urine somewhat thin about the time of the crisis. After the crisis, - forty days subsequent to it, abscess in the seat, and an abscession - through strangury.

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- CASE II -

Hermocrates, who lay sick by the new wall, was seized with fever. He - began to feel pain in the head and loins; tension of the hypochondrium - without

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swellingBut see note on p. 188.; tongue at the beginning - parched; deafness at once; no sleep; no great thirst; urine thick, - red, with no sediment on standing; stools not scanty, and burnt.

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Fifth day. Urine thin, with particles floating in - it, without sediment; at night delirium.

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Sixth day. Jaundice; general exacerbation; not - rational.

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Seventh day. Discomfort; urine thin, and as before. - The following days similar. About the eleventh day there seemed to be - general relief; coma began; urine thicker, reddish, thinGalen - says that the meaning of LEPTA\ is - here "small," i. e. he thinks that there wore - small particles at the bottom. Such is not the meaning of the word - in Hippocrates when applied to urine. at the bottom, without - sediment; by degrees grew more rational.

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Fourteenth day. No fever; no sweat; sleep; reason - quite recovered; urine as before.

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About the seventeenth day there was a relapse, and the patient grew hot. - On the following days there was acute fever; urine thin; delirium.

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Twentieth day. A fresh crisis; no fever; no sweat. - All the time the patient had no appetite; was perfectly collected but - could not talk; tongue dry; no thirst; snatches of sleep; coma. - About the twenty-fourth day he grew hot; bowels loose with copious, - thin discharges. On the following days acute fever; tongue parched.

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Twenty-seventh day. Death.

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In this case deafness persisted throughout; urine thick, red, without - settling, or thin, colourless, with substances floating in it. The - patient had no power to take food.

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- -
- CASE III -

The man lying sick in the garden of Delearces had for a long time - heaviness in the head and pain in the right temple. From some exciting - cause he was seized with fever, and took to his bed.

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Second day. Slight flow of unmixed blood from the - left nostril. The bowels were well moved; urine thin and varied, with - particles in small groups, like barley-meal or semen, floating in - it.

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Third day. Acute fever; stools black, thin, frothy, - with a livid sediment in them; slight stupor; getting up caused - distress; in the urine a livid, rather viscous sediment.

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Fourth day. Vomited scanty, bilious, yellow vomits, - and after a short interval, verdigris-coloured ones; slight flow of - unmixed blood from the left nostril; stools unaltered and urine - unaltered; sweat about the head and collar-bones; spleen enlarged; - pain in the direction of the thigh; tension, soft under-neath, of the - right hypochondrium;See note, p. 188. no sleep at night; - slight delirium.

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Fifth day. Stools more copious, black, frothy; a - black sediment in the stools; no sleep at night; delirium.

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Sixth day. Stools black, oily, viscid, foul-smelling - ; slept; was more rational.

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Seventh day. Tongue dry; thirsty; no sleep; - delirium; urine thin, not of a good colour.

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Eighth day. Stools black, scanty, compact; sleep; - was collected; not very thirsty.

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Ninth day. Rigor, acute fever; sweat; chill; - delirium; squinting of the right eye; tongue dry; thirsty; - sleepless.

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Tenth day. Symptoms about the same.

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Eleventh day. Quite rational; no fever; slept, - urine thin about the time of the crisis.

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The patient remained free from fever for two days, relapsed on the - fourteenth day, and immediately had no sleep at night and was completely - delirious.

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Fifteenth day. Urine muddy, like that which has been - stirred up after settling; acute fever; completely delirious; no - sleep; pain in knees and legs. On the application of a suppository, - black, solid motions were passed.

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Sixteenth day. Urine thin, with a cloudy substance - floating in it; delirium.

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Seventeenth day. Extremities cold in the early - morning; would wrap himself up; acute fever; sweated all over; was - relieved; more rational; some fever; thirst; vomited bilious - matters, yellow and scanty; solid motions from the bowels; after a - while they became black, scanty and thin; urine thin, and not of a good - colour.

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Eighteenth day. Was not rational; comatose.

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Nineteenth day. The same symptoms.

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Twentieth day. Slept; completely rational; sweated - ; no fever; no thirst; urine thin.

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Twenty-first day. Slightly delirious; rather - thirsty; pain in the hypochondrium and throbbing about the navel - continuously.

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Twenty-fourth day. Sediment in urine; completely - rational.

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Twenty-seventh day. Pain in the right hip, but in - other respects very comfortable; sediment in the urine.

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About the twenty-ninth day pain in the right eye; urine thin.

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Fortieth day. Passed motions full of phlegm, white - and rather frequent; copious sweat all over; a perfect crisis.

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- CASE IV -

Philistes in Thasos had for a long time pain in the head, and at last - fell into a state of stupor and took to his bed. Heavy drinking having - caused continuous fevers the pain grew worse. At night he grew hot at - the first.

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First day. Vomited bilious matters, scanty, at first - yellow, afterwards increasing and of the colour of verdigris; solid - motions from the bowels; an uncomfortable night.

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Second day. Deafness; acute fever; tension of the - right hypochondrium, which fell inwards. Urine thin, transparent, with a - small quantity of substance, like semen, floating in it. About mid-day - became raving.

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Third day. Uncomfortable.

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Fourth day. Convulsions; exacerbation.

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Fifth day. Died early in the morning.

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- CASE V -

Chaerion, who lay sick in the house of Demaenetus,The variants - indicate corruption. Can *DHLI/AN - be "Delian goddess" or "Delias"? The form is not Ionic. was - seized with fever after drinking. At once there was painful heaviness of - the head; no sleep; bowels disturbed with thin, rather bilious - stools.

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Third day. Acute fever, trembling of the head, - particularly of the lower lip; after a while rigor, convulsions, - complete delirium; an uncomfortable night.

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Fourth day. Quiet; snatches of sleep; - wandering.

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Fifth day. Pain; general exacerbation; irrational - talk; uncomfortable night; no sleep.

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Sixth day. The same symptoms.

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Seventh day. Rigor; acute fever; sweating all over - ; crisis.

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This patient's stools were throughout bilious, scanty and uncompounded. - Urine thin, not of a good colour, with a cloudy substance floating in - it. About the eighth day the urine had a better colour, with a slight, - white sediment; quite rational and no fever; an intermission.

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Ninth day. Relapse.

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About the fourteenth day acute fever.

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Sixteenth day. Vomited bilious, yellow matters - rather frequently.

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Seventeenth day. Rigor; acute fever; sweating; - crisis ended the fever.

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Urine after relapse and crisis of a good colour, with a sediment; no - delirium during the relapse.

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Eighteenth day. Slight heat; rather thirsty; urine - thin, with cloudy substance floating in it; slight delirium.

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Nineteenth day. No fever; pain in the neck; - sediment in urine.

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Twentieth day. Complete crisis.

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- CASE VI -

The maiden daughter of Euryanax was seized with fever. Throughout the - illness she suffered no thirst and had no inclination for food. Slight - alvine discharges; urine thin, scanty, and not of a good colour. At the - beginning of the fever suffered pain in the seat. On the sixth day did - not sweat, being

- -

without fever; a crisis. The sore near the seat suppurated slightly, and - burst at the crisis. After the crisis, on the seventh day, she had a - rigor; grew slightly hot; sweated. Afterwards the extremities always - cold. About the tenth day, after the sweating that occurred, she grew - delirious, but was soon rational again. They said that the trouble was - due to eating grapes. After an intermission, on the twelfth day she - again wandered a great deal; the bowels were disturbed, with bilious, - uncompounded, scanty, thin, irritating stools, which frequently made her - get up. She died the seventh day from the second attack of delirium. - This patient at the beginning of the illness had pain in the throat, - which was red throughout. The uvula was drawn back. Many - fluxes,Here R(EU/MATA POLLA\ - must mean "many fluxes," but in Epidemics III. - iv. it means "copions fluxes." scanty and acrid. She had a - cough with signs of coction, but brought up nothing.Or, with - Galen's reading, "she had a cough, but brought up no concocted - suptum." No appetite for any food the whole time, nor did she - desire anything. No thirst, and she drank nothing worth mentioning. She - was silent, and did not converse at all. Depression, the patient - despairing of herself. There was also some inherited tendency to - consumption.

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- CASE VII -

The woman suffering from angina who lay sick in the house of Aristion - began her complaint with indistinctness of speech. Tongue red, and grew - parched.

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First day. Shivered, and grew hot.

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Third day. Rigor; acute fever; a reddish, hard - swelling in the neck, extending to the breast on either side; - extremities cold and livid, breathing elevated;The ancient - commentators did not know the meaning of this word when applied to - respiration, and a modern can only guess. drink returned - through the nostrils--she could not swallow--stools and urine - ceased.

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Fourth day. General exacerbation.

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Fifth day. Death.

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-
- CASE VIII -

The youth who lay sick by the Liars' Market was seized with fever after - unaccustomed fatigue, toil and running.

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First day. Bowels disturbed with bilious, thin, - copious stools; urine thin and blackish; no sleep; thirst.

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Second day. General exacerbation; stools more - copious and more unfavourable. No sleep; mind disordered; slight - sweating.

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Third day. Uncomfortable; thirst; nausea; much - tossing; distress; delirium; extremities livid and cold; tension, - soft underneath, of the hypochondriumSee note, p. 188. on - both sides.

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Fourth day. No sleep; grew worse.

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Seventh day. Died, being about twenty years old.

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- CASE IX -

The woman who lodged with Tisamenus was in bed with a troublesome attack - of inflammation of the upper bowel. Copious vomits; could not retain - her drink. Pains in the region of the hypochondria. The pains were also - lower, in the region of the bowels. Constant tormina. No thirst. She - grew hot, though the extremities were cold all the time.

- -

Nausea; sleeplessness. Urine scanty and thin. Excreta crude, thin and - scanty. It was no longer possible to do her any good, and she died.

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-
- CASE X -

A woman who was one of the house of Pantimides after a miscarriage was - seized with fever on the first day. Tongue dry; thirst; nausea; - sleeplessness. Bowels disordered, with thin, copious and crude - stools.

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Second day. Rigor; acute fever; copious stools; - no sleep.

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Third day. The pains greater.

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Fourth day. Delirium.

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Seventh day. Death.

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The bowels were throughout loose, with copious, thin, crude stools. Urine - scanty and thin.

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- CASE XI -

Another woman, after a miscarriage about the fifth month, the wife of - Hicetas, was seized with fever. At the beginning she had alternations of - coma and sleeplessness; pain in the loins; heaviness in the head.

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Second day. Bowels disordered with scanty, thin - stools, which at first were uncompounded.

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Third day. Stools more copious and worse; no sleep - at night.

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Fourth day. Delirium; fears; depression. Squinting - of the right eye; slight cold sweat about the head; extremities - cold.

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Fifth day. General exacerbation; much wandering, - with rapid recovery of reason; no thirst; no

- -

sleep; stools copious and unfavourable throughout; urine scanty, thin - and blackish; extremities cold and rather livid.

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Sixth day. Same symptoms.

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Seventh day. Death.

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-
- CASE XII -

A woman who lay sick by the Liars' Market, after giving birth in a first - and painful delivery to a male child, was seized with fever. From the - very first there was thirst, nausea, slight pain at the stomach, dry - tongue, bowels disordered with thin and scanty discharges, no sleep.

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Second day. Slight rigor; acute fever; slight, - cold sweating around the head.

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Third day. In pain; crude, thin, copious discharges - from the bowels.

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Fourth day. Rigor; general exacerbation; - sleepless.

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Fifth day. In pain.

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Sixth day. The same symptoms; copious, fluid - discharges from the bowels.

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Seventh day. Rigor; acute fever; thirst; much - tossing; towards evening cold sweat all over; chill; extremities - cold, and would not be warmed. At night she again had a rigor; the - extremities would not be warmed; no sleep; slight delirium, but - quickly was rational again.

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Eighth day. About mid-day recovered her heat; - thirst; coma; nausea; vomited bilious, scanty, yellowish matters. An - uncomfortable night; no sleep; unconsciously passed a copious - discharge of urine.

- -

Ninth day. General abatement of the symptoms; coma. - Towards evening slight rigor; vomited scanty, bilious matters.

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Tenth day. Rigor; exacerbation of the fever; no - sleep whatsoever. In the early morning a copious discharge of urine - without sediment; extremities were warmed.

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Eleventh day. Vomited bilious matters, of the colour - of verdigris. A rigor shortly afterwards, and the extremities became - cold again; in the evening sweat, rigor and copious vomiting; a - painful night.

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Twelfth day. Vomited copious, black, fetid matters; - much hiccoughing; painful thirst.

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Thirteenth day. Vomited black, fetid, copious - matters; rigor. About mid-day lost her speech.

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Fourteenth day. Epistaxis; death.

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The bowels of this patient were throughout loose, and there were - shivering fits. Age about seventeen.

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-
-
-
- PART 2 -

- CONSTITUTION

-

II. The year was southerly and rainy, with no winds throughout. About the - rising of Arcturus, while during the immediately preceding period - droughts had prevailed, there were now heavy rains, with southerly - winds. Autumn dark and cloudy, with abundance of rain. The winter - southerly, humid, and mild after the solstice. Long after the solstice, - near the equinox, wintry weather returned, and at the actual equinoctial - period there were northerly winds with snow, but not for long. The - spring southerly again, with no winds; many rains throughout until the - Dog Star. The summer was clear and warm, with waves of stifling heat. - The

- -

Etesian winds were faint and intermittent. But, on the other hand, near - the rising of Arcturus there were heavy rains with northerly winds.

-

The year having proved southerly, wet and mild, in the winter the general - health was good except for the consumptives, who will be described in - due course.

-
-
- PART 3 -

III. Early in the spring, at the same time as the cold snaps which - occurred, were many malignant casesOr, "forms." of - erysipelas, some from a known exciting cause and some not. Many died, - and many suffered pain in the throat. Voices impaired; ardent fevers; - phrenitis; aphthae in the mouth; tumours in the private parts; - inflammations of the eyes; carbuncles; disordered bowels; loss of - appetite; thirst in some cases, though not in all; urine disordered, - copious, bad; long coma alternating with sleeplessness; absence of - crisis in many cases, and obscure crises; dropsies; many consumptives. - Such were the diseases epidemic. There were patients suffering from each - of the above types, and fatal cases were many. The symptoms in each type - were as follow.

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-
- PART 4 -

IV. Many were attacked by the erysipelas all over the body when the - exciting cause was a trivial accident or a very small wound; especially - when the patients were about sixty years old and the wound was in the - head, however little the neglect might have been. Many even while - undergoing treatment suffered from severe inflammations,With - Littré's punctuation the meaning is, "however slight the neglect, - and even when a patient was actually undergoing treatment. There - were severe inflammations," etc. and the erysipelas would - quickly spread widely in all directions. Most of the patients - experienced abscessions ending in suppurations. Flesh, sinews and - bones

- -

fell away in large quantities. The flux which formed was not like pus, - but was a different sort of putre-faction with a copious and varied - flux. If any of these symptoms occurred in the head, there was loss of - hair from all the head and from the chin; the bones were bared and fell - away, and there were copious fluxes. Fever was sometimes present and - sometimes absent. These symptoms were terrifying rather than dangerous. - For whenever they resulted in suppuration or some similar coction the - cases usually recovered. But whenever the inflammation and the - erysipelas disappeared without producing any such abscession, there were - many deaths. The course of the disease was the same to whatever part of - the body it spread. Many lost the arm and the entire forearm. If the - malady settled in the sides there was rotting either before or behind. - In some cases the entire thigh was bared, or the shin and the entire - foot. But the most dangerous of all such cases were when the pubes and - genital organs were attacked. Such were the sores which sprang from an - exciting cause. In many cases, however, sores occurred in fevers, before - a fever, or supervening on fevers. In some of these also, when an - abscession took place through suppuration, or when a seasonable - disturbance of the bowels occurred or a passing of favourable urine, - this gave rise to a solution; but when none of these events happened, - and the symptoms disappeared without a sign, death resulted. It was in - the spring that by far the greater number of cases of erysipelas - occurred, but they continued throughout the summer and during - autumn.

- -
-
- PART 5 -

V. Much trouble was caused to some patients by the tumours in the throat, - inflammations of the tongue and the abscesses about the teeth. Many had - the symptom of impaired and muffledThe word so rendered has - puzzled the commentators from very early times. See the full - disoussion of Littré ad loc. The ancients - interpreted either "cooped up" or "altered," "faussée" (Littré). See - Erotian sub voce - FWNAI\ KATEI/LLOUS1AI. I think - that H. used a strange word metaphorically on purpose to describe a - strange alteration in the voice, which was as it were "imprisoned" - or (to borrow a motoring expression) "silenced." voice, at - first at the beginning of the cases of consumption, but also in the - ardent fevers and in phrenitis.

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-
- PART 6 -

VI. Now the ardent fevers and phrenitis began early in the spring after - the cold snaps which occurred, and very many fell sick at that time. - These suffered acute and fatal symptoms. The constitution of the ardent - fevers that occurred was as follows. At the beginning coma, nausea, - shivering, acute fever, no great thirst, no delirium, slight epistaxis. - The exacerbations in most cases on even days, and about the time of the - exacerbations there was loss of memory with prostration and - speechlessness. The feet and hands of these patients were always colder - than usual, most especially about the times of exacerbation. Slowly and - in no healthy manner they recovered their heat, becoming rational again - and conversing. Either the coma held them continuously without sleep, or - they were wakeful and in pain. Bowels disordered in the majority of - these cases, with crude, thin, copious stools. Urine copious, thin, with - no critical or favourable sign, nor did any other critical sign appear - in these patients. For there occurred neither favourable hemorrhage

- -

nor any other of the usual critical abscessions. The manner of their - dying varied with the individual; it was usually irregular, at the - crises, but in some cases after long loss of speech and in many with - sweating. These were the symptoms attending the fatal cases of ardent - fever, and the cases of phrenitis were similar. These suffered from no - thirst at all, and no case showed the mad delirium that attacked others, - but they passed away overpowered by a dull oppression of stupor.

-
-
- PART 7 -

VII. There were other fevers also, which I shall describe in due course. - Many had aphthae and sores in the mouth. Fluxes about the genitals were - copiousPossibly "frequent," "common." So Littré. This is one - of the most doubtful cases of those difficult words in a medical - context, POLU/S and O)LI/GOS in the plural. See General - Introduction, p. lxi.; sores, tumours external and internal; - the swellings which appear in the groin.A curious phrase. I - suspect that TA\ hides a - corruption of the text. Watery inflammations of the eyes, - chronic and painful. Growths on the eyelids, external and internal, in - many cases destroying the sight, which are called "figs." There were - also often growths on other sores, particularly in the genitals. Many - carbuncles in the summer, and other affections called "rot." Large - pustules. Many had large tetters.

-
-
- PART 8 -

VIII. The bowel troubles in many cases turned out many and harmful. In - the first place many were attacked by painful tenesmus, mostly - children--all in fact who were approaching puberty--and most of these - died. Many lienteries. Cases of dysentery, but they tooI. c. as Galen suggests in his commentary, they - were like the lienteries in not causing much pain. Lientery is not - particularly painful. were not very painful. Stools bilious, - greasy, thin and watery. In many

- -

cases this condition of the bowels constituted the disease itself, fever - being sometimes absent and sometimes present.Littré in a long and - obscure note argues that only A)/NEU - PURETW=N and not E)N - PURETOI=S1I can belong to the preceding phrase, - apparently because it is illogical to say that fever was present - when the disease consisted merely of unhealthy stools. But the - writer does not wish to exclude fever; he merely wishes to exclude - from this class of patient tenesmus, lientery and dysentery. The - commentary of Galen, POLLOI=S U=E/ FHS1IN - AU)TO\ TOU=TO GENE/S1QAI TO\ NO/S1HMA, TOUTE/S1TI TO\ DIAXWREI=N TA\ TOIAU=TA: KAI\ GA\R - KAI\ XWRI\S PURETW=N E)NI/OIS TOU=TO GENE/S1QAI - *FHS1I, does not, as Littré supposes, support his - contention. The phrase KAI\ XWRI\S PURETW=N - E)NI/OIS TOU=TO GENE/S1QAI FHS1I\ implies KAI\ E)N PURETOI=S TOU=TO - E)GE/NETO. Painful tormina and malignant colic. - There were evacuations, though the bulk of the contents remained - behind.It is hard to separate DIE/CODOI from TW=N - POLLW=N, yet the sense seems to require it. The next - sentence states that these evacuations caused no relief, evidently - because they did not clear the trouble from the bowel. Now if - DIE/CODOI be taken with - TW=N POLLW=N, the only - possible translation is " evacuations of the many contents which - were retained there," implying complete evacuation. Galen's comment - (Kéhn XVII, Part I, p. 708) bears out the former interpretation : - TA\S DE\ DIECO/DOUS, TOUTE/S1TI\ TA\S KENW/S1EIS, AU)TOI=S S1UMBH=NAI, POLLW=N E)NO/NTWN KAI\ E)PIS1XO/NTWN . - . . . . KAI\ DIA\ TOU=TO MHDE\ TOU\S PO/NOUS - LU/EIN TA\ DIECIO/NTA. PW=S - GAR O)=O/N TE LU/EIN AU)TA/, POLLW=N E)/TI TW=N E)PEXOME/NWN O/NTWN; It should be - noticed that E)PIS1XO/NTWN is - probably from E)PI/S1XW (Galen's - E)PEXOME/NWN) and not from - E)PE/XW, although I cannot - find a parallel for intransitive E)PI/S1XW in this sense. The evacuations did - not take away the pains, and yielded with difficulty to the remedies - administered. Purgings, in fact, did harm in most cases. Of those in - this condition many died rapidly, though a few held out longer. In - brief, all patients, whether the disease was prolonged or acute, died - chiefly from the bowel complaints. For the bowels carried all off - together.The writer has not expressed himself clearly in this - chapter, which seems to be the roughest of rough notes. The last two - sentences apparently mean :--

(a) It was - always the bowel complaints which caused most deaths. This was - natural, since (b) all attacked by bowel - complaints died.

-
-
- PART 9 -

IX. Loss of appetite, to a degree that I never met before, attended all - the cases described above, but most especially the last, and of them, - and of the others also, especially such as were fatally - stricken.The emendation of Blass permits the translator of - this passage to harmonize both sense and grammar. Before it was - impossible to do so.

- -

Thirst afflicted some, but not others; of the fever patients, as well as - of the other cases, none were unseasonably affected, but as far as drink - was concerned you could diet them as you pleased.

-
-
- PART 10 -

X. The urine that was passed was copious, not in proportion to, but far - exceeding, the drink administered. Yet the urine too that was passed - showed a great malignancy. For it had neither the proper consistency, - nor coction, nor cleansing powers; it signified for most patients - wasting, trouble,Probably "disordered bowels," a common meaning of - TARAXH\ in the Corpus. pains, and absence of crisis.

-
-
- PART 11 -

XI. Coma attended mostly the phrenitis and ardent fevers, without - excluding, however, all the other diseases of the most severe sort that - were accompanied by fever. Most patients throughout either were sunk in - heavy coma or slept only in fitful snatches.

-
-
- PART 12 -

XII. Many other forms also of fever were epidemic : -- tertians, - quartans, night fevers, fevers continuous, protracted, irregular, fevers - attended with nausea, fevers of no definite character. All these cases - suffered severely from trouble.See the preceding note. For - the bowels in most cases were disordered, with shivering fits. Sweats - portended no crisis, and the character of the urine was as I have - described. Most of these cases were protracted, for the abscessions too - which took place did not prove critical as in other cases; nay rather, - in all cases all symptoms marked obscurity of crisis,For DU/S1KRITON see Foes' Oeconomia, sub voce. It means that it was hard to see when - a crisis took place, or that the crisis was not a marked one. - or absence of crisis, or protraction of the disease, but most especially - in the patients last described. A few

- -

of these had a crisis about the eightieth day; with most recovery - followed no rule. A few of them died of dropsy, without taking to their - bed; many sufferers from the other diseases too were troubled with - swellings, most particularly the consumptives.

-
-
- PART 13 -

XIII. The severest and most troublesome disease, as well as the most - fatal, was the consumption. Many cases began in the winter, and of these - several took to their bed, though some went about ailing without doing - so. Early in the spring most of those who had gone to bed died, while - none of the others lost their cough, though it became easier in the - summer. During autumn all took to bed and many died. Most of these were - ill for a long time. Now most of these began suddenly to grow worse, - showing the following symptoms :--frequent shivering; often continuous - and acute fever; unseasonable, copious,I am often doubtful as to - the meaning of POLLOI\ in - instances like these; does it refer to quantity or frequency? In - these two examples either meaning would give excellent sense. See - General Introduction, p. lxi. cold sweats throughout; great - chill with difficult recovery of heat; bowels variously constipated, - then quickly relaxing, and violently relaxing in all cases near the end - ; the humours about the lungs spread downwards; abundance of - unfavourable urine; malignant wasting. The coughs throughout were - frequent, bringing up copious,I am often doubtful as to the - meaning of POLLOI\ in instances - like these; does it refer to quantity or frequency? In these two - examples either meaning would give excellent sense. See General - Introduction, p. lxi. concocted and liquid sputa, but without - much pain; but even if there was pain, in all cases the purging from - the lungs took place very mildly. The throat did not smart very much, - nor did salt humours cause any distress at all. The fluxes, however, - viscid, white,

- -

moist, frothy, which came from the head, were abundant. But by far the - worst symptom that attended both these cases and the others was the - distaste for food, as has been mentioned. They had no relish either for - drink with nourishment, but they remained entirely without thirst. - Heaviness in the body. Coma. In most of them there was swelling, which - developed into dropsy. Shivering fits and delirium near death.

-
-
- PART 14 -

XIV. The physical characteristics of the consumptives were :--skin - smooth, whitish, lentil-coloured, reddish; bright eyes;It seems - impossible to decide whether the adjective XAROPO/S refers here to the brightness of the eyes or - to their colour (blue or grey). a leucophlegmaticSee - General Introduction, p. xlvi-li, on the humours. "Bitter bile" was - the same as that sometimes called "yellow." condition; - shoulder-blades projecting like wings. Women too so.This brief - phrase seems to mean that the same characteristics marked - consumptive women as consumptive men. As to those with a - melancholicSee General Introduction, p. xlvi-li, on the - humours. "Bitter bile" was the same as that sometimes called - "yellow." or a rather sanguineSee General Introduction, - p. xlvi-li, on the humours. "Bitter bile" was the same as that - sometimes called "yellow." complexion, they were attacked by - ardent fevers, phrenitis and dysenteric troubles. Tenesmus affected - young, phlegmaticSee General Introduction, p. xlvi-li, on the - humours. "Bitter bile" was the same as that sometimes called - "yellow." people; the chronic diarrhoea and acrid, greasy - stools affected persons of a biliousSee General Introduction, p. - xlvi-li, on the humours. "Bitter bile" was the same as that - sometimes called "yellow." temperament.

-
-
- PART 15 -

XV. In all the cases described spring was the worst enemy, and caused the - most deaths; summer was the most favourable season, in which fewest - died. In autumn and during the season of the Pleiades, on the other - hand, there were again deaths, usually on the fourth day. And it seems - to me natural that the coming on of summer should have been helpful. For - the coming on of winter resolves the diseases of summer, and the coming - on of summer removes those of winter. And yet in

- -

itself the summer in question was not healthful;"Of a good - constitution." in fact it was suddenly hot, southerly, and - calm. But nevertheless the change from the other constitution proved - beneficial.

-
-
- PART 16 -

XVI. The power, too, to study correctly what has been written I consider - to be an important part of the art of medicine. The man who has learnt - these things and uses them will not, I think, make great mistakes in the - art. And it is necessary to learn accurately each constitution of the - seasons as well as the disease; what common element in the constitution - or in the disease is good, and what common element in the constitution - or in the disease is bad; what malady is protracted and fatal, what is - protracted and likely to end in recovery; what acute illness is fatal, - what acute illness is likely to end in recovery. With this knowledge it - is easy to examine the order of the critical days, and to prognosticate - therefrom. One who has knowledge of these matters can know whom he ought - to treat, as well as the time and method of treatment.This chapter - does not fit in with the context, and occurs again at the beginning - of the book PERI\ KRIS1I/MWN. - Ermerins brackets it.

-
-
-
- SIXTEEN CASES -
- CASE I -

XVII. In Thasos the Parian who lay sick beyond the temple of Artemis was - seized with acute fever, which at the beginning was continuous and - ardent. Thirst. At the beginning coma followed by sleeplessness. Bowels - disordered at the beginning; urine thin.

-

Sixth day. Oily urine; delirium.

-

Seventh day. General exacerbation; no sleep;

- -

urine similar and mind disordered; stools bilious and fatty.

-

Eighth day. Slight epistaxis; vomited scanty - matters of the colour of verdigris; snatches of sleep.

-

Ninth day. Same symptoms.

-

Tenth day. General improvement.

-

Eleventh day. Sweated all over; grew chilly, but - quickly recovered heat.

-

Fourteenth day. Acute fever; stools bilious, thin, - copious; substance floating in urine; delirium.

-

Seventeenth day. In pain; no sleep, while the fever - grew worse.

-

Twentieth day. Sweated all over; no fever; stools - bilious; aversion to food; coma.

-

Twenty-fourth day. Relapse.

-

Thirty-fourth day. No fever; no constipation; - recovered heat.

-

Fortieth day. No fever; bowels constipated for a - short time; aversion to food; became slightly feverish again, - throughout irregularly, the fever being sometimes absent, sometimes - present; for if the fever intermitted and was alleviated there was a - relapse soon afterwards. He took little bits of food, and that of an - unsuitable sort. Sleep bad; delirium at the relapses. Urine at these - times had consistency, but was troubled and bad. Bowels constipated, but - afterwards relaxed. Continuous slight fevers. Stools thin and - copious.

-

Hundred and twentieth day. Death.

-

In this case the bowels continuously from the first day loose with - bilious, loose, copious stools, or

- -

constipated with hot,Lit. "seething" or "boiling." The reference is - possibly not so much to heat as to the steaming, frothy nature of - the stools. undigested stools. Urine throughout bad; mostly - comatose; painful sleeplessness;The meaning apparently is that - the patient was generally in a state of coma; if not comatose, he - was in pain and could not sleep. continued aversion to - food.

-
-
- CASE II -

In Thasos the woman who lay sick by the Cold Water, on the third day - after giving birth to a daughter without lochial discharge, was seized - with acute fever accompanied by shivering. For a long time before her - delivery she had suffered from fever, being confined to bed and averse - to food. After the rigor that took place, the fevers were continuous, - acute, and attended with shivering.

-

Eighth and following days. Much delirium, quickly - followed by recovery of reason; bowels disturbed with copious, thin, - watery and bilious stools; no thirst.

-

Eleventh day. Was rational, but comatose. Urine - copious, thin and black; no sleep.

-

Twentieth day. Slight chills,This sentence - shows that PERI/ in PERIYU/XW means not "very," but "all - over." The phrase may mean "slight chilliness." but heat - quickly recovered; slight wandering; no sleep; bowels the same; - urine watery and copious.

-

Twenty-seventh day. No fever; bowels constipated; - not long afterwards severe pain in the right hip for a long time. Fevers - again attended; urine watery.

-

Fortieth day. Pain in the hip relieved; continuous - coughing, with watery, copious sputa; bowels constipated; aversion to - food; urine the same. The fevers, without entirely intermitting, were - exacerbated

- -

irregularly, sometimes increasing and sometimes not doing so.

-

Sixtieth day. The coughing ceased without any - critical sign; there was no coction of the sputa, nor any of the usual - abscessions; jaw on the right side convulsed; comatose; wandering, - but reason quickly recovered; desperately averse to food; jaw relaxed - ; passed small, bilious stools; fever grew more acute, with shivering. - On the succeeding days she lost power of speech, but would afterwards - converse.

-

Eightieth day. Death.

-

The urine of this patient was throughout black, thin and watery. Coma was - present, aversion to food, despondency, sleeplessness, irritability, - restlessness, the mind being affected by melancholy.For - "melancholy" see General Introduction, p. lviii.

-
-
- CASE III -

In Thasos Pythion, who lay sick above the shrine of Heracles, after - labour, fatigue and careless living, was seized by violent rigor and - acute fever. Tongue dry; thirst; bilious; no sleep; urine rather - black, with a substance suspended in it, which formed no sediment.

-

Second day. About mid-day chill in the extremities, - especially in the hands and head; could not speak or utter a sound; - respiration short for a long time; recovered warmth; thirst; a quiet - night; slight sweats about the head.

-

Third day. A quiet day, but later, about sunset, - grew rather chilly; nausea; distress;Probably bowel trouble. - See p. 250 painful night without sleep; small, solid stools - were passed.

-

Fourth day. Early morning peaceful, but about - mid-day all symptoms were exacerbated; chill;

- -

speechless and voiceless; grew worse; recovered warmth after a time; - black urine with a substance floating in it; night peaceful; - slept.

-

Fifth day. Seemed to be relieved, but there was - heaviness in the bowels with pain; thirst; painful night.

-

Sixth day. Early morning peaceful; towards evening - the pains were greater; exacerbation; but later a little clyster - caused a good movement of the bowels. Slept at night.

-

Seventh day. Nausea; rather uneasy; urine oily; - much distressProbably bowel trouble. See p. 250. at night; - wandering; no sleep at all.

-

Eighth day. Early in the morning snatches of sleep; - but quickly there was chill; loss of speech; respiration thin and weak - ; in the evening he recovered warmth again; was delirious; towards - morning slightly better; stools uncompounded, small, bilious.

-

Ninth day. Comatose; nausea whenever he woke up. - Not over-thirsty. About sunset was uncomfortable; wandered; a bad - night.

-

Tenth day. In the early morning was speechless; - great chill; acute fever; much sweat; death.

-

In this case the pains on even days.

-
-
- CASE IV -

The patient suffering from phrenitis on the first day that he took to bed - vomited copiously thin vomits of the colour of verdigris; much fever - with shivering; continuous sweating all over; painful heaviness of - head and neck; urine thin, with small, scattered substances floating in - it, which did not settle. Copious excreta at a single evacuation; - delirium; no sleep.

- -

Second day. In the early morning speechless; acute - fever; sweating; no intermission; throbbing all over the body; - convulsions at night.

-

Third day. General exacerbation.

-

Fourth day. Death.

-
-
- CASE V -

In Larisa a bald man suddenly experienced pain in the right thigh. No - remedy did any good.

-

First day. Acute fever of the ardent type; the - patient was quiet, but the pains persisted.

-

Second day. The pains in the thigh subsided, but the - fever grew worse; the patient was rather uncomfortable and did not - sleep; extremities cold; copious and unfavourable urine was - passed.

-

Third day. The pain in the thigh ceased, but there - was derangement of the intellect, with distressProbably trouble in - the bowels. and much tossing.

-

Fourth day. Death about mid-day.

-
-
- CASE VI -

In Abdera Pericles was seized with acute fever, continuous and painful; - much thirst; nausea; could not retain what he drank. There was slight - enlargement of the spleen and heaviness in the head.

-

First day. Epistaxis from the left nostril; the - fever, however, increased greatly. Copious urine, turbid and white. On - standing it did not settle.

-

Second day. General exacerbation; the urine, - however, had consistency, but there was some sediment; the nausea was - relieved and the patient slept.

-

Third day. The fever went down; abundance of urine, - with concocted and copious sediment; a quiet night.

- -

Fourth day. About mid-day a hot, violent sweating - all over; no fever; crisis; no relapse.

-
-
- CASE VII -

In Abdera the maiden who lay sick by the Sacred Way was seized with a - fever of the ardent type. She was thirsty and sleepless. Menstruation - occurred for the first time.

-

Sixth day. Much nausea; redness; shivering; - restlessness.

-

Seventh day. Same symptoms. Urine thin but of good - colour; no trouble in the bowels.

-

Eighth day. Deafness; acute fever; sleeplessness; - nausea; shivering; was rational; urine similar.

-

Ninth day Same symptoms, and also on the following - days. The deafness persisted.

-

Fourteenth day. Reason disturbed; the fever - subsided.

-

Seventeenth day. Copious epistaxis; the deafness - improved a little. On the following days nausea and deafness, while - there was also delirium.

-

Twentieth day. Pain in the feet; deafness; the - delirium ceased; slight epistaxis; sweating; no fever.

-

Twenty-fourth day. The fever returned, with the - deafness; pain in the feet persisted; delirium.

-

Twenty-seventh day. Copious sweating; no fever; - the deafness ceased; the pain in the feet remained, but in other - respects there was a perfect crisis.

-
-
- CASE VIII -

In Abdera Anaxion, who lay sick by the Thracian gate, was seized with - acute fever. Continuous pain

- -

in the right side; a dry cough, with no sputa on the first days. Thirst - ; sleeplessness; urine of good colour, copious and thin.

-

Sixth day. Delirium; warm applications gave no - relief.

-

Seventh day. In pain, for the fever grew worse and - the pains were not relieved, while the coughing was troublesome and - there was difficulty in breathing.

-

Eighth day. I bled him in the arm. There was an - abundant, proper flow of blood; the pains were relieved, although the - dry coughing persisted.

-

Eleventh day. The fever went down; slight sweating - about the head; the coughing and the sputa more moist.

-

Seventeenth day. Began to expectorate small, - concocted sputa; was relieved.

-

Twentieth day. Sweated and was free from fever; - after a crisis was thirsty, and the cleansings from the lungs were not - favourable.

-

Twenty-seventh day. The fever returned; coughing, - with copious, concocted sputa; copious, white sediment in urine; - thirst and difficulty in breathing disappeared.

-

Thirty-fourth day. Sweated all over; no fever; - general crisis.I am conscious of a slight change in diction and - method in this part of the Epidcmics. I mention - four points :--

(1) The frequent use of PURETO\S in the plural, which is unusual when it - simply means "feverishness" (Cases VIII, IX, XII, XIII).

-

(2) KATABAI/NW is used of - evacuations (Cases VII, IX - OU)/RA . . . KATE/BAINEN, XII).

-

(3) Treatment is mentioned (Case VIII, - QERMA/S1MATA, and A)GKW=NA E)/TAMON, where note the - personal touch).

-

(4) I(DRU/NOMAI used of - recovery of reason, = KATANOW= - (Case XV). The change is marked enough to - lead one to suppose that these histories were composed at a - different period in the writer's life.

-
-
- CASE IX -

In Abdera Heropythus had pain in the head without taking to bed, but - shortly afterwards was

- -

compelled to do so. He lived close to the Upper Road.With Blass' - reading, "Upper Market-place." An acute, ardent fever seized - him. Vomited at the beginning copious, bilious matters; thirst; great - discomfort; urine thin and black, sometimes with, sometimes without, - substances suspended in it. Painful night, with fever rising now in this - way, now in that, but for the most part irregularly. About the - fourteenth day, deafness; the fever grew worse; urine the same.

-

Twentieth day. Much delirium, also on the following - days.

-

Fortieth day. Copious epistaxis; more rational; - some deafness, but less than before; the fever went down. Frequent, but - slight, epistaxis on the following days. About the sixtieth day the - bleedings from the nose ceased, but there was violent pain in the right - hip and the fever increased. Not long afterwards, pains in all the lower - parts. It happened that either the fever was higher and the deafness - great, or else, though these symptoms were relieved and less severe, yet - the pains in the lower parts about the hips grew worse. But from about - the eightieth day all the symptoms were relieved without any - disappearing. The urine that was passed was of good colour and had - greater deposits, while the delirious mutterings were less. About the - hundredth day the bowels were disordered with copious, bilious stools, - and copious evacuations of this nature were passed for a long time. Then - followed painful symptoms of dysentery, with relief of the other - symptoms. In brief, the fever disappeared and the deafness ceased.

-

Hundred and twentieth day. Complete crisis.

-
- -
- CASE X -

In Abdera Nicodemus after venery and drunkenness was seized with fever. - At the beginning he had nausea and cardialgia; thirst; tongue parched - ; urine thin and black.

-

Second day. The fever increased; shivering; nausea - ; no sleep; bilious, yellow vomits; urine the same; a quiet night; - sleep.

-

Third day. All symptoms less severe; relief. But - about sunset he was again somewhat uncomfortable; painful night.

-

Fourth day. Rigor; much fever; pains every-where; - urine thin, with floating substance in it; the night, on the other - hand, was quiet.

-

Fifth day. All symptoms present, but relieved.

-

Sixth day. Same pains everywhere; substance - floating in urine; much delirium.

-

Seventh day. Relief.

-

Eighth day. All the otherWhat other symptoms? - It is clear that some symptoms are excepted, but there is no hint - what these are. As V has TA\ D' - A)/LLA, " but all the other symptoms were relieved," I - believe that after 0)GDO/H| has - fallen out a phrase containing the symptoms which were not - relieved. symptoms less severe.

-

Tenth day and following days. The pains were - present, but all less severe. The exacerbations and the pains in the - case of this patient tended through-out to occur on the even days.

-

Twentieth day. Urine white, having consistency; no - sediment on standing. Copious sweating; seemed to lose his fever, but - towards evening grew hot again, with pains in the same parts; shivering - ; thirst; slight delirium.

-

Twenty-fourth day. Much white urine, with much - sediment. Hot sweating all over; the fever passed away in a crisis.

-
- -
- CASE XI -

In Thasos a woman of gloomy temperament, after a grief with a reason for - it, without taking to bed lost sleep and appetite, and suffered thirst - and nausea. She lived near the place of Pylades on the plain.

-

First day. As night began there were fears, much - rambling, depression and slight feverishness. Early in the morning - frequent convulsions; whenever these frequent convulsions intermitted, - she wandered and uttered obscenities; many pains, severe and - continuous.

-

Second day. Same symptoms; no sleep; fever more - acute.

-

Third day. The convulsions ceased, but were - succeeded by coma and oppression, followed in turn by wakefulness. She - would jump up; could not restrain herself; wandered a great deal; - fever acute; on this night a copious, hot sweating all over; no fever - ; slept, was perfectly rational, and had a crisis. About the third day - urine black and thin, with particles mostly round floating in it, which - did not settle. Near the crisis copious menstruation.

-
-
- CASE XII -

In Larisa a maiden was seized with an acute fever of the ardent type. - Sleeplessness; thirst; tongue sooty and parched; urine of good - colour, but thin.

-

Second day. In pain; no sleep.

-

Third day. Copious stools, watery and of a yellowish - green; similar stools on the following days, passed without - distress.

-

Fourth day. Scanty, thin urine, with a substance

- -

suspended in it which did not settle; delirium at night.

-

Sixth day. Violent and abundant epistaxis; after a - shivering fit followed a hot, copious sweating all over; no fever; a - crisis. In the fever and after the crisis menstruation for the first - time, for she was a young maiden. Throughout she suffered nausea and - shivering; redness of the face; pain in the eyes; heaviness in the - head. In this case there was no relapse, but a definite crisis. The - pains on the even days.

-
-
- CASE XIII -

Apollonius in Abdera was ailing for a long time without being confined to - bed. He had a swollen abdomen, and a continual pain in the region of the - liver had been present for a long time; moreover, he became during this - period jaundiced and flatulent; his complexion was whitish. After - dining and drinking unseasonably cow's milkFAGW\M according to this translation has no expressed - object. Furthermore, BO/EION is - more naturally " beef." As the words stand the above version is the - natural one, but I suspect that either BO/EION should be transposed to between DE\ and KAI/, or else it is used A)PO\ KOINOU= and zengmatically with both FAGW\N and PIW/N, " after eating beef and drinking oow's milk." - So Littré and, apparently, from his translation, Calvus. he - at first grew rather hot; he took to his bed. Having drunk copiously of - milk, boiled and raw, both goat's and sheep's, and adopting a thoroughly - bad regimen,Or, changing the comma at PA/NTWN to KAKH=, " - adopting a bad regimen, he suffered great harm in every way." - he suffered much therefrom. For there were exacerbations of the fever; - the bowels passed practically nothing of the food taken; the urine was - thin and scanty. No sleep. Grievous distension; much thirst; coma; - painful swelling of the right hypochondrium; extremities all round - rather cold; slight delirious mutterings; forgetfulness of every-thing - he said; he was not himself. About the

- -

fourteenth day from his taking to bed, after a rigor, he grew hot; - wildly delirious; shouting, distress,Here perhaps not bowel - trouble. much rambling, followed by calm; the coma came on - at this time. Afterwards the bowels were disordered with copious stools, - bilious, uncompounded and crude; urine black, scanty and thin. Great - discomfort. The evacuations showed varying symptoms; they were either - black, scanty and verdigris-coloured, or else greasy, crude and smarting - ; at times they seemed actually to be like milk. About the twenty-fourth - day comfortable; in other respects the same, but he had lucid - intervals. He remembered nothing since he took to bed. But he quickly - was again delirious, and all symptoms took a sharp turn for the worse. - About the thirtieth day acute fever; copious, thin stools; wandering; - cold extremities; speechlessness.

-

Thirty-fourth day. Death.

-

This patient throughout, from the time I had knowledge of the case, - suffered from disordered bowels; urine thin and black; coma; - sleeplessness; extremities cold; delirious throughout.

-
-
- CASE XIV -

In Cyzicus a woman gave birth with difficult labour to twin daughters, - and the lochial discharge was far from good.

-

First day. Acute fever with shivering; painful - heaviness of head and neck. Sleepless from the first, but silent, sulky - and refractory. Urine thin and of no colour; thirsty; nausea generally - ; bowels irregularly disturbed with constipation following.

-

Sixth day. Much wandering at night; no sleep.

- -

About the eleventh day she went out of her mind and then was rational - again; urine black, thin, and then, after an interval, oily; copious, - thin, disordered stools.

-

Fourteenth day. Many convulsions; extremities cold - ; no further recovery of reason; urine suppressed.

-

Sixteenth day. Speechless.

-

Seventeenth day. Death.

-
-
- CASE XV -

In Thasos the wife of Delearces, who lay sick on the plain, was seized - after a grief with an acute fever with shivering. From the beginning she - would wrap herself up, and throughout, without speaking a word, she - would fumble, pluck, scratch, pick hairs, weep and then laugh, but she - did not sleep; though stimulated, the bowels passed nothing. She drank - a little when the attendants suggested it. Urine thin and scanty; fever - slight to the touch; coldness of the extremities.

-

Ninth day. Much wandering followed by return of - reason; silent.

-

Fourteenth day. Respiration rare and large with long - intervals,I take this, in apite of Galen, to mean " with extra - long intervals between each breath." The phrase is rather care-less - but scarcely tautological. " At intervals" or " after a long - interval" are possible meanings, but inconsistent with DIA\ TE/LEOS later on. becoming - afterwards short.

-

Seventeenth day. Bowels under a stimulus passed - disordered matters, then her very drink passed unchanged; nothing - coagulated. The patient noticed nothing; the skin tense and dry.

-

Twentieth day. Much rambling followed by recovery of - reason; speechless; respiration short.

-

Twenty-first day. Death.

-

The respiration of this patient throughout was

- -

rare and large; took no notice of anything; she constantly wrapped - herself up; either much rambling or silence throughout.In many - ways this case, though one of the most picturesque, is also one of - the most carelessly written. Galen points out that DIA\ *XPO/NON is ambiguous, and that - its possible meanings are inconsistent with the rest of the - description. How can the respiration be A)RAIO/N throughout, when on both the fourteenth and - the twentieth days the patient was BRAXU/PNOOS2? It is strange that the writer - specifies the fourteenth day as the day when the respiration was - rare and large, seeing that it had these characteristics throughout. - A similar remark applies to A)NAIS1QH/TWS - EI)XE PA/NTWN of the seventeenth day. Further, - A)EI\ S1IGW=S1A of the second - sentence becomes strangely H(\ LO/GOI - XOLLOI\ H(\ S1IGW=S1A DIA\ TE/LEOS2 in the last. I - conclude that this medical history was hastily written and never - revised. A slight revision could easily have cleared away the - inconsistencies, which are, as Galen seems to have seen, more - apparent than real.

-
-
- CASE XVI -

In Meliboea a youth took to his bed after being for a long time heated by - drunkenness and sexual indulgence. He had shivering fits, nausea, - sleeplessness, but no thirst.

-

First day. Copious, solid stools passed in abundance - of fluid, and on the following days the excreta were copious, watery and - of a greenish yellow. Urine thin, scanty and of no colour; respiration - rare and large with long intervals; tension, soft underneath, of the - hypochondrium,See note, p. 188. extending out to either - side; continual throbbing throughout of the epigastrium;So - Littré, following Galen. Perhaps, however, it means " heart," i. e. there was violent palpitation. - urine oily.

-

Tenth day. Delirious but quiet, for he was orderly - and silent;Said by Galen, followed by Littré (who reads H(/S1UXOS2 for S1IGW=N), to refer to the character of the young man - when well, which interpretation to modern minds is rather - inconsistent with the first sentence. They would paraphrase, " the - delirium was really serious, but appeared slight because the patient - was naturally self-controlled and calm." I take the meaning to be - that though delirious he remained quiet and comparatively - silent. skin dry and tense; stools either copious and thin - or bilious and greasy.

- -

Fourteenth day. General exacerbation; delirious - with much wandering talk.

-

Twentieth day. Wildly out of his mind; much tossing - ; urine suppressed; slight quantities of drink were retained.

-

Twenty-fourth day. Death.

-
-
-
- - - - - - diff --git a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng3.xml b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng3.xml index dad744a58..dbc58a7ca 100644 --- a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng3.xml +++ b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng3.xml @@ -109,7 +109,7 @@

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 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. I need scarcely remark that this passage is of classical celebrity. Galen, in his Commentary, remarks that the first time he read it he thought it unworthy of Hippocrates to lay it down as a rule of practice, that the physician should do good to his patient, or at least no harm; but that, after having seen a good deal of the practice of other physicians, and observed how often they were justly exposed to censure for having bled, or applied the bath, or given medicines, or wine unseaonably, he came to recognize the propriety and importance of the rule laid down by Hippocrates. The practice of certain physicians, Galen remarks, is like playing at the dice, when what turns up may occasion the greatest mischief to their patients. The last clause of this passage is very forcibly put. Galen, however, informs us that in some of th MSS. instead of art he found nature; that is to say, that the physician is the minister (or servant) of nature. Either of the readings, he remarks, will agree very well with the meaning of the passage.

+

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. I need scarcely remark that this passage is of classical celebrity. Galen, in his Commentary, remarks that the first time he read it he thought it unworthy of Hippocrates to lay it down as a rule of practice, that the physician should do good to his patient, or at least no harm; but that, after having seen a good deal of the practice of other physicians, and observed how often they were justly exposed to censure for having bled, or applied the bath, or given medicines, or wine unseaonably, he came to recognize the propriety and importance of the rule laid down by Hippocrates. The practice of certain physicians, Galen remarks, is like playing at the dice, when what turns up may occasion the greatest mischief to their patients. The last clause of this passage is very forcibly put. Galen, however, informs us that in some of th MSS. instead of art he found nature; that is to say, that the physician is the minister (or servant) of nature. Either of the readings, he remarks, will agree very well with the meaning of the passage.

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 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.

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In these diseases death generally happened on the sixth day, as with Epaminondas, Silenus, and Philiscus the son of Antagoras. Those who had parotid swellings experienced a crisis on the twentieth day, but in all these cases the disease went off without coming to a suppuration, and was turned upon the bladder. But in Cratistonax, who lived by the temple of Hercules, and in the maid servant of Scymnus the fuller, it turned to a suppuration, and they died. Those who had a crisis on the seventh day, had an intermission of nine days, and a relapse which came to a crisis on the fourth day from the return of the fever, as was the case with Pantacles, who resided close by the temple of Bacchus. Those who had a crisis on the seventh day, after an interval of six days had a relapse, from which they had a crisis on the seventh day, as happened to Phanocritus, who was lodged with Gnathon the fuller. During the winter, about the winter solstices, and until the equinox, the ardent fevers and frenzies prevailed, and many died. The crisis, however, changed, and happened to the greater number on the fifth day from the commencement, left them for four days and relapsed; and after the return, there was a crisis on the fifth day, making in all fourteen days. The crisis took place thus in the case of most children, also in elder persons. Some had a crisis on the eleventh day, a relapse on the fourteenth, a complete crisis on the twentieth; but certain persons, who had a rigor about the twentieth, had a crisis on the fortieth. The greater part had a rigor along with the original crisis, and these had also a rigor about the crisis in the relapse. There were fewest cases of rigor in the spring, more in summer, still more in autumn, but by far the most in winter; then hemorrhages ceased.

PART 8 -

With regard to diseases, the circumstances from which we form a judgment of them are,- by attending to the general nature of all, and the peculiar nature of each individual,- to the disease, the patient, and the applications,- to the person who applies them, as that makes a difference for better or for worse,- to the whole constitution of the season, and particularly to the state of the heavens, and the nature of each country;- to the patient’s habits, regimen, and pursuits;- to his conversation, manners, taciturnity, thoughts, sleep, or absence of sleep, and sometimes his dreams, what and when they occur;- to his picking and scratching;- to his tears;- to the alvine discharges, urine, sputa, and vomitings; and to the changes of diseases from the one into the other;- to the deposits, whether of a deadly or critical character;- to the sweat, coldness, rigor, cough, sneezing, hiccup, respiration, eructation, flatulence, whether passed silently or with a noise;- to hemorrhages and hemorrhoids;- from these, and their consequences, we must form our judgment.

+

With regard to diseases, the circumstances from which we form a judgment of them are,—by attending to the general nature of all, and the peculiar nature of each individual,—to the disease, the patient, and the applications,—to the person who applies them, as that makes a difference for better or for worse,—to the whole constitution of the season, and particularly to the state of the heavens, and the nature of each country;—to the patient’s habits, regimen, and pursuits;—to his conversation, manners, taciturnity, thoughts, sleep, or absence of sleep, and sometimes his dreams, what and when they occur;—to his picking and scratching;—to his tears;—to the alvine discharges, urine, sputa, and vomitings; and to the changes of diseases from the one into the other;—to the deposits, whether of a deadly or critical character;—to the sweat, coldness, rigor, cough, sneezing, hiccup, respiration, eructation, flatulence, whether passed silently or with a noise;—to hemorrhages and hemorrhoids;—from these, and their consequences, we must form our judgment.

PART 9 -

Fevers are,- the continual, some of which hold during the day and have a remission at night, and others hold a remission during the day; semi-tertians, tertians, quartans, quintans, septans, nonans. The most acute, strongest, most dangerous, and fatal diseases, occur in the continual fever. The least dangerous of all, and the mildest and most protracted, is the quartan, for it is not only such from itself, but it also carries off other great diseases. In what is called the semi-tertian, other acute diseases are apt to occur, and it is the most fatal of all others, and moreover phthisical persons, and those laboring under other protracted diseases, are apt to be attacked by it. The nocturnal fever is not very fatal, but protracted; the diurnal is still more protracted, and in some cases passes into phthisis. The septan is protracted, but not fatal; the nonan more protracted, and not fatal. The true tertian comes quickly to a crisis, and is not fatal; but the quintan is the worst of all, for it proves fatal when it precedes an attack of phthisis, and when it supervenes on persons who are already consumptive. There are peculiar modes, and constitutions, and paroxysms, in every one of these fevers; for example,- the continual, in some cases at the very commencement, grows, as it were, and attains its full strength, and rises to its most dangerous pitch, but is diminished about and at the crisis; in others it begins gentle and suppressed, but gains ground and is exacerbated every day, and bursts forth with all its heat about and at the crisis; while in others, again, it commences mildly, increases, and is exacerbated until it reaches its acme, and then remits until at and about the crisis. These varieties occur in every fever, and in every disease. From these observations one must regulate the regimen accordingly. There are many other important symptoms allied to these, part of which have been already noticed, and part will be described afterwards, from a consideration of which one may judge, and decided in each case, whether the disease be acute, and whether it will end in death or recovery; or whether it will be protracted, and will end in death or recovery; and in what cases food is to be given, and in what not; and when and to what amount, and what particular kind of food is to be administered.

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Fevers are,—the continual, some of which hold during the day and have a remission at night, and others hold a remission during the day; semi-tertians, tertians, quartans, quintans, septans, nonans. The most acute, strongest, most dangerous, and fatal diseases, occur in the continual fever. The least dangerous of all, and the mildest and most protracted, is the quartan, for it is not only such from itself, but it also carries off other great diseases. In what is called the semi-tertian, other acute diseases are apt to occur, and it is the most fatal of all others, and moreover phthisical persons, and those laboring under other protracted diseases, are apt to be attacked by it. The nocturnal fever is not very fatal, but protracted; the diurnal is still more protracted, and in some cases passes into phthisis. The septan is protracted, but not fatal; the nonan more protracted, and not fatal. The true tertian comes quickly to a crisis, and is not fatal; but the quintan is the worst of all, for it proves fatal when it precedes an attack of phthisis, and when it supervenes on persons who are already consumptive. There are peculiar modes, and constitutions, and paroxysms, in every one of these fevers; for example,- the continual, in some cases at the very commencement, grows, as it were, and attains its full strength, and rises to its most dangerous pitch, but is diminished about and at the crisis; in others it begins gentle and suppressed, but gains ground and is exacerbated every day, and bursts forth with all its heat about and at the crisis; while in others, again, it commences mildly, increases, and is exacerbated until it reaches its acme, and then remits until at and about the crisis. These varieties occur in every fever, and in every disease. From these observations one must regulate the regimen accordingly. There are many other important symptoms allied to these, part of which have been already noticed, and part will be described afterwards, from a consideration of which one may judge, and decided in each case, whether the disease be acute, and whether it will end in death or recovery; or whether it will be protracted, and will end in death or recovery; and in what cases food is to be given, and in what not; and when and to what amount, and what particular kind of food is to be administered.

PART 10

Those diseases which have their paroxysms on even days have their crises on even days; and those which have their paroxysms on uneven days have their crises on uneven days. The first period of those which have the crisis on even days, is the 4th, 6th, 8th, 10th, 14th, 20th, 30th, 40th, 60th, 80th, 100th; and the first period of those which have their crises on uneven days, is the 1st, 3d, 5th, 7th, 9th, 11th, 17th, 21th, 27th, 31st. It should be known, that if the crisis take place on any other day than on those described, it indicates that there will be a relapse, which may prove fatal. But one ought to pay attention, and know in these seasons what crises will lead to recovery and what to death, or to changes for the better or the worse. Irregular fevers, quartans, quintans, septans, and nonans should be studied, in order to find out in what periods their crises take place.

diff --git a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng4.xml b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng4.xml new file mode 100644 index 000000000..db9c4af3c --- /dev/null +++ b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng4.xml @@ -0,0 +1,644 @@ + + + + + + +Epidemics I and III +Hippocrates +William Henry Samuel Jones + +Gregory Crane + +Prepared under the supervision of +Bridget Almas +Lisa Cerrato +Rashmi Singhal + +National Library of Medicine History of Medicine Division + + + +Cultural Heritage Language Technologies +Kansas City Missouri +February 1, 2005 + +Trustees of Tufts University +Medford, MA +Perseus Digital Library Project +Perseus 4.0 +tlg0627.tlg006.perseus-eng4.xml + +Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + +Hippocrates +Hippocrates +William Henry Samuel Jones + +London +William Heinemann Ltd. +Cambridge, MA +Harvard University Press +1923 + +1 + +Loeb Classical Library +Internet Archive + + + + + + + +

Data Entry

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This pointer pattern extracts book, section, and subsection.

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This pointer pattern extracts book and section.

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This pointer pattern extracts book.

 + + + + + + +English +Greek + + + +CTS and EpiDoc conversion. + + + + + + +
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+EPIDEMICS I +
+FIRST CONSTITUTION +
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IN Thasos during autumn, about the time of the equinox to near the setting of the Pleiades,ὑπδ in expressions denoting time seems in Hippocrates to mean about or during. The period is roughly from September 21 to November 8. there were many rains, gently continuous, with southerly winds. Winter southerly,That is, the winds were generally from the south, and such north winds as blew were light. north winds light, droughts; on the whole, the winter was like a spring. Spring southerly and chilly; slight showers. Summer in general cloudy. No rain. Etesian winds few, light and irregular.

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The whole weather proved southerly, with droughts, but early in the spring, as the previous constitution had proved the opposite and northerly, a few patients suffered from ardent fevers, and these very mild, causing hemorrhage in few cases and no deaths. Many had swellings beside one ear, or both ears, in most cases unattended with fever,Or, punctuating after ͂̔ωτα and πλείστοισιν, There were swellings beside the ears, in many cases on one side, but in most on both. The epidemio was obviously mumps. so that confinement to bed was unnecessary. In some cases there was slight heat, but in all the swellings subsided without causing harm; in no case was there suppuration such as attends swellings of other origin. This was the character of them:—-flabby, big, spreading, with neither inflammation nor pain; in every case they disappeared without a sign.That is, with no symptoms indicative of a crisis. The sufferers were youths, young men, and men in their prime, usually those who frequented the wrestling school and gymnasia. Few women were attacked. Many had dry coughs which brought up nothing when they coughed, but their voices were hoarse. Soon after, though in some cases after some time, painful inflammations occurred either in one testicle or in both, sometimes accompanied with fever, in other cases not. Usually they caused much suffering. In other respects the people had no ailments requiring medical assistance.That is, nobody was ill enough to make a visit to the physician’s surgery (ἱητρεῖον) necessary.

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Beginning early in the summer, throughout the summer and in winter many of those who had been ailing a long time took to their beds in a state of consumption, while many also who had hitherto been doubtful sufferers at this time showed undoubted symptoms. Some showed the symptoms now for the first time; these were those whose constitution inclined to be consumptive. Many, in fact most of these, died; of those who took to their beds I do not know one who survived even for a short time. Death came more promptly than is usual in consumption, and yet the other complaints, which will be described presently, though longer and attended with fever, were easily supported and did not prove fatal. For consumption was the worst of the diseases that occurred, and alone was responsible for the great mortality.

+

In the majority of cases the symptoms were these. Fever with shivering, continuous, acute, not completely intermitting, but of the semitertian type; remitting during one day they were exacerbated on the next, becoming on the whole more acute. Sweats were continual, but not all over the body. Severe chill in the extremities, which with difficulty recovered their warmth. Bowels disordered, with bilious, scanty, unmixed, thin, smarting stools, causing the patient to get up often. Urine either thin, colourless,Throughout Epidemics ἂχρως may mean, not merely without colour, but of bad colour. It certainly has this meaning in Airs Waters Places, VII, l. ii. See p. 85. unconcocted and scanty, or thick and with a slight deposit, not settling favourably, but with a crude and unfavourable deposit. The patients frequently coughed up small, concocted sputa, brought up little by little with difficulty. Those exhibiting the symptoms in their most violent form showed no concoction at all, but continued spitting crude sputa. In the majority of these cases the throat was throughout painful from the beginning, being red and inflamed. Fluxes slight, thin, pungent. Patients quickly wasted away and grew worse, being throughout averse to all food and experiencing no thirst. Delirium in many cases as death approached. Such were the symptoms of the consumption.

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+

But when summer came, and during autumn occurred many continuous but not violent fevers, which attacked persons who were long ailing without suffering distress in any other particular manner; for the bowels were in most cases quite easy, and hurt to no appreciable extent. Urine in most cases of good colour and clear, but thin, and after a time near the crisis it grew concocted. Coughing was slight, and caused no distress. No lack of appetite; in fact it was quite possible even to give food. In general the patients did not sicken, as did the consumptives, with shivering fevers, but with slight sweats, the paroxysms being variable and irregular.The words omitted by Kéhlewein mean not intermitting altogether, but with exacerbations after the manner of tertians. The earliest crisis was about the twentieth day; in most cases the crisis was about the fortieth day, though in many it was about the eightieth. In some cases the illness did not end in this way, but in an irregular manner without a crisis. In the majority of these cases the fevers relapsed after a brief interval, and after the relapse a crisis occurred at the end of the same periods as before. The disease in many of these instances was so protracted that it even lasted during the winter.

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Out of all those described in this constitution only the consumptives showed a high mortality-rate; for all the other patients bore up well, and the other fevers did not prove fatal.

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+SECOND CONSTITUTION +
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In Thasos early in autumn occurred unseasonable wintry storms, suddenly with many north and south winds bursting out into rains. These conditions continued until the setting of the Pleiades and during their season. Winter was northerly; many violent and abundant rains; snows; generally there were fine intervals. With all this, however, the cold weather was not exceptionally unseasonable. But immediately after the winter solstice, when the west wind usually begins to blow, there was a return of severe wintry weather, much north wind, snow and copious rains continuously, sky stormy and clouded. These conditions lasted on, and did not remit before the equinox. Spring cold, northerly, wet, cloudy. Summer did not turn out excessively hot, the Etesian winds blowing continuously. But soon after, near the rising of Arcturus, there was much rain again, with northerly winds.

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The whole year having been wet, cold and northerly, in the winter the public health in most respects was good, but in early spring many, in fact most, suffered illnesses. Now there began at first inflammations of the eyes, marked by rheum, pain, and unconcocted discharges. Small gummy sores, in many cases causing distress when they broke out; the great majority relapsed, and ceased late on the approach of autumn. In summer and autumn dysenteric diseases, tenesmus and lientery; bilious diarrhœa, with copious, thin, crude, smarting stools; in some cases it was also watery. In many cases there were also painful, bilious defluxions, watery, full of thin particles, purulent and causing strangury. No kidney trouble, but their various symptoms succeeded in various orders. Vomitings of phlegm, bile, and undigested food. Sweats; in all cases much moisture over all the body. These complaints in many cases were unattended with fever, and the sufferers were not confined to bed; but in many others there was fever, as I am going to describe. Those who showed all the symptoms mentioned above were consumptives who suffered pain. When autumn came, and during winter, continuous feversin some few cases ardentday fevers, night fevers, semitertians, exact tertians, quartans, irregular fevers. Each of the fevers mentioned found many victims.

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Now the ardent fevers attacked the fewest persons, and these were less distressed than any of the other sick. There was no bleeding from the nose, except very slight discharges in a few cases, and no delirium. All the other symptoms were slight. The crises of these diseases were quite regular, generally in seventeen days, counting the days of intermission, and I know of no ardent fever proving fatal at this time, nor of any phrenitis. The tertians were more numerous than the ardent fevers and more painful. But all these had four regular periods from the first onset, had complete crises in seven, and in no case relapsed. But the quartans, while in many instances they began at first with quartan periodicity, yet in not a few they became quartan by an abscession from other fevers or illnesses.There are often mixed infections in malaria. If the quartan be one of these, being the longest it outlasts the others. So the disease appears to have turned into a quartan. They were protracted, as quartans usually are, or even more protracted than usual. Many fell victims to quotidians, night fevers, or irregular fevers, and were ill for a long time, either in bed or walking about. In most of these cases the fevers continued during the season of the Pleiades or even until winter. In many patients, especially children, there were convulsions and slight feverishness from the beginning; sometimes, too, convulsions supervened upon fevers. Mostly these illnesses were protracted, but not dangerous, except for those who from all other causes were predisposed to die.

+
+

But those fevers which were altogether continuous and never intermitted at all, but in all cases grew worse after the manner of semitertians, with remission during one day followed by exacerbation during the next, were the most severe of all the fevers which occurred at this time, the longest and the most painful. Beginning mildly, and on the whole increasing always, with exacerbation, and growing worse, they had slight remissions followed quickly after an abatement by more violent exacerbations, generally becoming worse on the critical days. All patients had irregular rigors that followed no fixed law, most rarely and least in the semitertians,I take the pronoun αὖτος throughout this chapter to refer to the remittent semitertian, or to sufferers from it. but more violent in the other fevers. Copious sweats, least copious in the semitertians; they brought no relief, but on the contrary caused harm. These patients suffered great chill in the extremities, which grew warm again with difficulty. Generally there was sleeplessness, especially with the semitertians, followed afterwards by coma. In all the bowels were disordered and in a bad state, but in the semitertians they were far the worst. In most of them urine either (a) thin, crude, colourless, after a time becoming slightly concocted with signs of crisis, or (b) thick enough but turbid, in no way settling or forming sediment, or (c) with small, bad, crude sediments, these being the worst of all. Coughs attended the fevers, but I cannot say that either harm or good resulted from the coughing on this occasion.

+
+

Now the greatest number of these symptoms continued to be protracted, troublesome, very disordered, very irregular, and without any critical signs, both in the case of those who came very near death and in the case of those who did not. For even if some patients enjoyed slight intermissions, there followed a quick relapse. A few of them experienced a crisis, the earliest being about the eightieth day, some of the latter having a relapse, so that most of them were still ill in the winter. The greatest number had no crisis before the disease terminated. These symptoms occurred in those who recovered just as much as in those who did not. The illnesses showed a marked absence of crisis and a great variety; the most striking and the worst symptom, which throughout attended the great majority, was a complete loss of appetite, especially in those whose general condition exhibited fatal signs, but in these fevers they did not suffer much from unseasonable thirst. After long intervals, with many pains and with pernicious wasting, there supervened abscessions either too severe to be endured, or too slight to be beneficial, so that there was a speedy return of the original symptoms, and an aggravation of the mischief.That is, the abscessions did not carry off the morbid humours, which spread again throughout the system.

+
+

The symptoms from which these patients suffered were dysenteries and tenesmus, lienteries also and fluxes. Some had dropsies also, either with or without these. Whenever any of these attacked violently they were quickly fatal, or, if mild, they did no good. Slight eruptions, which did not match the extent of the diseases and quickly disappeared again, or swellings by the ears that grew smallerμωλυόμενα would mean remained crude. and signified nothing, in some cases appearing at the joints, especially the hip-joint, in few instances leaving with signs of crisis, when they quickly re-established themselves in their original state.

+
+

From all the diseases some died, but the greatest number from these fevers,It is not clear to what πάντων and τούτων refer. Probably πάντων refers to all the semitertians, and τούτων to the special type of them described in Chapter IX. especially childrenthose just weaned, older children of eight or ten years, and those approaching puberty. These victims never suffered from the latter symptoms without the first I have described above, but often the first without the latter. The only good sign, the most striking that occurred, which saved very many of those who were in the greatest danger, was when there was a change to strangury, into which abscessions took place. The strangury, too, came mostly to patients of the ages mentioned, though it did happen to many of the others, either without their taking to bed or when they were ill. Rapid and great was the complete change that occurred in their case. For the bowels, even if they were perniciously loose, quickly recovered; their appetite for everything returned, and hereafter the fever abated. But the strangury, even in these cases, was long and painful. Their urine was copious, thick, varied, red, mixed with pus, and passed with pain. But they all survived, and I know of none of these that died.

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+

In all dangerous cases you should be on the watch for all favourable coctions of the evacuations from all parts, or for fair and critical abscessions. Coctions signify nearness of crisis and sure recovery of health, but crude and unconcocted evacuations, which change into bad abscessions, denote absence of crisis, pain, prolonged illness, death, or a return of the same symptoms. But it is by a consideration of other signs that one must decide which of these results will be most likely. Declare the past, diagnose the present, foretell the future; practise these acts. As to diseases, make a habit of two thingsto help, or at least to do no harm. The art has three factors, the disease, the patient, the physician. The physician is the servant of the art. The patient must co-operate with the physician in combating the disease.

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+

Pains about the head and neck, and heaviness combined with pain, occur both without and with fever. Sufferers from phrenitis have convulsions, and eject verdigris-coloured vomit; some die very quickly. But in ardent and the other fevers, those with pain in the neck, heaviness of the temples, dimness of sight, and painless tension of the hypochondrium, bleed from the nose; those with a general heaviness of the head, cardialgia, and nausea, vomit afterwards bile and phlegm. Children for the most part in such cases suffer chiefly from the convulsions. Women have both these symptoms and pains in the womb. Older people, and those whose natural heat is failing, have paralysis or raving or blindness.

+
+THIRD CONSTITUTION +
+

In Thasos a little before and at the season of Arcturus many violent rains with northerly winds. About the equinox until the setting of the Pleiades slight, southerly rains. Winter northerly, droughts, cold periods, violent winds, snow. About the equinox very severe storms. Spring northerly, droughts, slight rains, periods of cold. About the summer solstice slight showers, periods of great cold until near the Dog Star. After the Dog Star, until Arcturus, hot summer. Great heat, not intermittent but continuous and severe. No rain fell. The Etesian winds blew. About Arcturus southerly rains until the equinox.

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+

In this constitution during winter began paralyses which attacked many, a few of whom quickly died. In fact, the disease was generally epidemic. In other respects the public health continued good. Early in spring began ardent fevers which continued until the equinox and on to summer. Now those who began to be ill at once, in spring or the beginning of summer, in most cases got well, though a few died; but when autumn and the rains came the cases were dangerous, and more died.

+

As to the peculiarities of the ardent fevers, the most likely patients to survive were those who had a proper and copious bleeding from the nose, in fact I do not know of a single case in this constitution that proved fatal when a proper bleeding occurred, For Philiscus and Epaminon and Silenus, who died, had only a slight epistaxis on the fourth and fifth days. Now the majority of the patients had rigors near the crisis, especially such as had no epistaxis, but these had sweats also as well as rigors.

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+

Some had jaundice on the sixth day, but these were benefited by either a purging through the bladder or a disturbance of the bowels or a copious hemorrhage, as was the case with Heraclides, who lay sick at the house of Aristocydes. This patient, however, who had a crisis on the twentieth day, not only bled from the nose, but also experienced disturbance of the bowels and a purging through the bladder. Far otherwise was it with the servant of Phanagoras, who had none of these symptoms, and died. But the great majority had hemorrhage, especially youths and those in the prime of life, and of these the great majority who had no hemorrhage died. Older people had jaundice or disordered bowels, for example Bion, who lay sick at the house of Silenus. Dysenteries also were general in summer, and some too of those who had fallen ill, and also suffered from hemorrhage, finally had dysentery; for example, the slave of Erato and Myllus, after copious hemorrhage, lapsed into dysentery. They recovered.

+

This humour,That is, blood. then, especially was in great abundance, since even those who had no hemorrhage near the crisis, but swellings by the ears which disappearedand after their disappearance there was a heaviness along the left flank up to the extremity of the hipafter the crisis had pain and passed thin urine, and then began to suffer slight hemorrhage about the twenty-fourth day, and abscessions into hemorrhage occurred. In the case of Antipho, son of Critobulus, the illness ceased and came to a complete crisis about the fortieth day.

+
+

Though many women fell ill, they were fewer than the men and less frequently died. But the great majority had difficult childbirth, and after giving birth they would fall ill, and these especially died, as did the daughter of Telebulus on the sixth day after delivery. Now menstruation appeared during the fevers in most cases, and with many maidens it occurred then for the first time. Some bled from the nose. Sometimes both epistaxis and menstruation appeared together; for example, the maiden daughter of Daitharses had her first menstruation during fever and also a violent discharge from the nose. I know of no woman who died if any of these symptoms showed themselves properly, but all to my knowledge had abortions if they chanced to fall ill when with child.

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+

Urine in most cases was of good colour, but thin and with slight sediments, and the bowels of most were disordered with thin, bilious excretions. Many after a crisis of the other symptoms ended with dysentery, as did Xenophanes and Critias. I will mention cases in which was passed copious, watery, clear and thin urine, even after a crisis in other respects favourable, and a favourable sediment: Bion, who lay sick at the house of Silenus, Cratis, who lodged with Xenophanes, the slave of Areto, and the wife of Mnesistratus. Afterwards all these suffered from dysentery.

+

About the season of Arcturus many had crisis on the eleventh day, and these did not suffer even the normal relapses. There were also comatose fevers about this time, usually in children, and of all patients these showed the lowest mortality.

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+

About the equinox up to the setting of the Pleiades, and during winter, although the ardent fevers continued, yet cases of phrenitis were most frequent at this time, and most of them were fatal. In summer, too, a few cases had occurred. Now the sufferers from ardent fever, when fatal symptoms attended, showed signs at the beginning. For right from the beginning there was acute fever with slight rigors, sleeplessness, thirst, nausea, slight sweats about the forehead and collar-bones, but in no case general, much delirium, fears, depression, very cold extremities, toes and hands, especially the latter. The exacerbations on the even days; but in most cases the pains were greatest on the fourth day, with sweat for the most part chilly, while the extremities could not now be warmed again, remaining livid and cold; and in these cases the thirst ceased. Their urine was scanty, black, thin, with constipation of the bowels. Nor was there hemorrhage from the nose in any case when these symptoms occurred, but only slight epistaxis. None of these cases suffered relapse, but they died on the sixth day, with sweating. The cases of phrenitis had all the above symptoms, but the crises generally occurred on the eleventh day. Some had their crises on the twentieth day, namely those in whom the phrenitis did not begin at first, or began about the third or fourth day, but though these fared tolerably at the beginning, yet the disease assumed an acute form about the seventh day.

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+

Now the number of illnesses was great. And of the patients there died chiefly striplings, young people, people in their prime, the smooth, the fair-skinned, the straight-haired, the black-haired, the black-eyed, those who had lived recklessly and care-lessly, the thin-voiced, the rough-voiced, the lispers, the passionate. Women too died in very great numbers who were of this kind. In this constitution there were four symptoms especially which denoted recovery:—-a proper hemorrhage through the nostrils; copious discharges by the bladder of urine with much sediment of a proper character; disordered bowels with bilious evacuations at the right time; the appearance of dysenteric characteristics. The crisis in many cases did not come with one only of the symptoms described above, but in most cases all symptoms were experienced, and the patients appeared to be more distressed; but all with these symptoms got well. Women and maidens experienced all the above symptoms, but besides, whenever any took place properly, and whenever copious menstruation supervened, there was a crisis therefrom which resulted in recovery; in fact I know of no woman who died when any of these symptoms took place properly. For the daughter of Philo, who died, though she had violent epistaxis, dined rather unseasonably on the seventh day.

+

In acute fevers, more especially in ardent fevers, when involuntary weeping occurs, epistaxis is to be expected it the patient have no fatal symptoms besides; for when he is in a bad way such weeping portends not hemorrhage but death.

+
+

The painful swellings by the ears in fevers in some cases neither subsided nor suppurated when the fever ceased with a crisis. They were cured by bilious diarrhœa, or dysentery, or a sediment of thick urine such as closed the illness of Hermippus of Clazomenæ. The circumstances of the crises, from which too I formed my judgments, were either similar or dissimilar; for example, the two brothers, who fell sick together at the same time, and lay ill near the bungalow of Epigenes. The elder of these had a crisis on the sixth day, the younger on the seventh. Both suffered a relapse together at the same time with an intermission of five days. After the relapse both had a complete crisis together on the seventeenth day. But the great majority had a crisis on the sixth day, with an intermission of six days followed by a crisis on the fifth day after the relapse. Those who had a crisis on the seventh day had an intermission of seven days, with a crisis on the third day after the relapse. Others with a crisis on the seventh had an intermission of three days, with a crisis on the seventh day after the relapse. Some who had a crisis on the sixth day had an intermission of six and a relapse of three, an intermission of one and a relapse of one, followed by a crisis; for example, Euagon the son of Daitharses. Others with a crisis on the sixth had an intermission of seven days, and after the relapse a crisis on the fourth; for example, the daughter of Aglai+das. Now most of those who fell ill in this constitution went through their illness in this manner, and none of those who recovered, so far as I know, failed to suffer the relapses which were normal in these cases, but all, so far as I know, recovered if their relapses took place after this fashion. Further, I know of none who suffered a fresh relapse after going through the illness in the manner described above.

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+

In these diseases most died on the sixth day, as did Epaminondas, Silenus and Philiscus the son of Antagoras. Those who had the swellings by the ears had a crisis on the twentieth day, but these subsided in all cases without suppuration, being diverted to the bladder. There were two cases of suppuration, both fatal, Cratistonax, who lived near the temple of Heracles, and the serving-maid of Scymnus the fuller. When there was a crisis on the seventh day, with an intermission of nine days followed by a relapse, there was a second crisis on the fourth day after the relapsein the case of Pantacles, for example, who lived by the temple of Dionysus. When there was a crisis on the seventh day, with an intermission of six days followed by a relapse, there was a second crisis on the seventh day after the relapsein the case of Phanocritus, for example, who lay sick at the house of Gnathon the fuller.

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+

During winter, near the time of the winter solstice, and continuing until the equinox, the ardent fevers and the phrenitis still caused many deaths, but their crises changed. Most cases had a crisis on the fifth day from the outset, then intermitted four days, relapsed, had a crisis on the fifth day after the relapse, that is, after thirteen days altogether. Mostly children experienced crises thus, but older people did so too. Some had a crisis on the eleventh day, a relapse on the fourteenth, and a complete crisis on the twentieth. But if rigor came on about the twentieth day the crisis came on the fortieth. Most had rigors near the first crisis, and those who had rigors at first near the crisis, had rigors again in the relapses at the time of the crisis. Fewest experienced rigors in the spring, more in summer, more still in autumn, but by far the most during winter. But the hemorrhages tended to cease.

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+

The following were the circumstances attending the diseases, from which I framed my judgments, learning from the common nature of all and the particular nature of the individual, from the disease, the patient, the regimen prescribed and the prescriberfor these make a diagnosis more favourable or less; from the constitution, both as a whole and with respect to the parts, of the weather and of each region; from the custom, mode of life, practices and ages of each patient; from talk, manner, silence, thoughts, sleep or absence of sleep, the nature and time of dreams, pluckings, scratchings, tears; from the exacerbations, stools, urine, sputa, vomit, the antecedents and consequents of each member in the successions of diseases, and the abscessions to a fatal issue or a crisis, sweat, rigor, chill, cough, sneezes, hiccoughs, breathing, belchings, flatulence, silent or noisy, hemorrhages, and hemorrhoids. From these things must we consider what their consequents also will be.

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+

Some fevers are continuous, some have an access during the day and an intermission during the night, or an access during the night and an intermission during the day; there are semitertians, tertians, quartans, quintans, septans, nonans. The most acute diseases, the most severe, difficult and fatal, belong to the continuous fevers. The least fatal and least difficult of all, but the longest of all, is the quartan. Not only is it such in itself, but it also ends other, and serious, diseases. In the fever called semitertian, which is more fatal than any other, there occur also acute diseases, while it especially precedes the illness of consumptives, and of those who suffer from other and longer diseases. The nocturnal is not very fatal, but it is long. The diurnal is longer still, and to some it also brings a tendency to consumption. The septan is long but not fatal. The nonan is longer still but not fatal. The exact tertian has a speedy crisis and is not fatal. But the quintan is the worst of all. For if it comes on before consumption or during consumption the patient dies.

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+

Each of these fevers has its modes, its constitutions and its exacerbations. For example, a continuous fever in some cases from the beginning is high and at its worst, leading up to the most severe stage, but about and at the crisis it moderates. In other cases it begins gently and in a suppressed manner, but rises and is exacerbated each day, bursting out violently near the crisis. In some cases it begins mildly, but increases and is exacerbated, reaching its height after a time; then it declines again until the crisis or near the crisis. These characteristics may show themselves in any fever and in any disease. It is necessary also to consider the patient’s mode of life and to take it into account when prescribing. Many other important symptoms there are which are akin to these, some of which I have described, while others I shall describe later. These must be duly weighed when considering and deciding who is suffering from one of these diseases in an acute, fatal form, or whether the patient may recover; who has a chronic, fatal illness, or one from which he may recover; who is to be prescribed for or not, what the prescription is to be, the quantity to be given and the time to give it.

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+

When the exacerbations are on even days, the crises are on even days. But the diseases exacerbated on odd days have their crises on odd days. The first period of diseases with crises on the even days is the fourth day, then the sixth, eighth, tenth, fourteenth, twentieth, twenty-fourth, thirtieth, fortieth, sixtieth, eightieth, hundred and twentieth. Of those with a crisis on the odd days the first period is the third, then the fifth, seventh, ninth, eleventh, seventeenth, twenty-first, twenty-seventh, thirty-first. Further, one must know that, if the crises be on other days than the above, there will be relapses, and there may also be a fatal issue. So one must be attentive and know that at these times there will be the crises resulting in recovery, or death, or a tendency for better or worse. One must also consider in what periods the crises occur of irregular fevers, of quartans, of quintans, of septans and of nonans.

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+FOURTEEN CASES +
+CASE I +

Philiscus lived by the wall. He took to his bed with acute fever on the first day and sweating; night uncomfortable.

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Second day. General exacerbation, later a small clyster moved the bowels well. A restful night.

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Third day. Early and until mid-day he appeared to have lost the fever; but towards evening acute fever with sweating; thirst; dry tongue; black urine. An uncomfortable night, without sleep ; completely out of his mind.

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Fourth day. All symptoms exacerbated; black urine; a more comfortable night, and urine of a better colour.

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Fifth day. About mid-day slight epistaxis of unmixed blood. Urine varied, with scattered, round particles suspended in it, resembling semen; they did not settle. On the application of a suppository the patient passed, with flatulence, scanty excreta. A distressing night, snatches of sleep, irrational talk; extremities everywhere cold, and would not get warm again; black urine; snatches of sleep towards dawn; speechless; cold sweat; extremities livid. About mid-day on the sixth day the patient died. The breathing throughout, as though he were recollecting to do it,The patient seemed to forget the necessity of breathing, and then to remember it and to breathe consciously. was rare and large. Spleen raised in a round swelling; cold sweats all the time. The exacerbations on even days.

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+CASE II +

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

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

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Third day. General exacerbation; oblong tightnessThe word ὑπολάπαρος is often applied to σύντασις or ἔντασις 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 ὑπολάπαρος ἐκ τοῦ ἔσω μέρεος, 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. 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.

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Fourth day. Same symptoms.

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

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

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

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Eighth day. Cold sweat all over; red spots with sweat, round, small like acne, which persisted without subsiding. From the bowels with slight stimulus there came a copious discharge of solid stools, thin,I take λεπτός 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). as it were unconcocted, painful. Urine painful and irritating. Extremities grow a little warmer; fitful sleep; coma; speechlessness; thin, transparent urine.

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Ninth day. Same symptoms.

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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.

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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.

+
+CASE III +

Herophon had acute fever; scanty stools with tenesmus at the beginning, afterwards becoming thin, bilious and fairly frequent. No sleep; urine black and thin.

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Fifth day. Deafness early in the day; general exacerbation; spleen swollen; tension of the hypochondrium; scanty black stools; delirium.

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Sixth day. Wandering talk; at night sweat and chill ; the wandering persisted.

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Seventh Day. Chill all over; thirst; out of his mind. During the night he was rational, and slept.

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Eighth day. Fever; spleen lessened; quite rational ; pain at first in the groin, on the side of the spleen; then the pains extended to both legs. Night comfortable; urine of a better colour, with a slight deposit.

+

Ninth day. Sweat, crisis, intermission.

On the fifth day after the crisis the patient relapsed. Immediately the spleen swelled; acute fever; return of deafness. On the third day after the relapse the spleen grew less and the deafness diminished, but there was pain in the legs. During the night he sweated. The crisis was about the seventeenth day. There was no delirium during the relapse.

+
+CASE IV +

In Thasos the wife of Philinus gave birth to a daughter. The lochial discharge was normal, and the mother was doing well when on the fourteenth day after delivery she was seized with fever attended with rigor. At first she suffered in the stomach and the right hypochondrium. Pains in the genital organs. The discharge ceased. By a pessary these troubles were eased, but pains persisted in the head, neck and loins. No sleep; extremities cold; thirst; bowels burnt; scanty stools; urine thin, and at first colourless.

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Sixth day. Much delirium at night, followed by recovery of reason.

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Seventh day. Thirst; stools scanty, bilious, highly coloured.

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Eighth day. Rigor; acute fever; many painful convulsions; much delirium. The application of a suppository made her keep going to stool, and there were copious motions with a bilious flux. No sleep.

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Ninth day. Convulsions.

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Tenth day. Lucid intervals.

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Eleventh day. Slept; complete recovery of her memory, followed quickly by renewed delirium.

A copious passing of urine with convulsionsher attendants seldom reminding herwhich was white and thick, like urine with a sediment and then shaken; it stood for a long time without forming a sediment; colour and consistency like that of the urine of cattle. Such was the nature of the urine that I myself saw.

+

About the fourteenth day there were twitchings over all the body; much wandering, with lucid intervals followed quickly by renewed delirium. About the seventeenth day she became speechless.

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Twentieth day. Death.

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+CASE V +

The wife of Epicrates, who lay sick near the founder,I. e. near the statue of the founder of the city, or near the temple of the god who presided over the founding of the city. when near her delivery was seized with severe rigor without, it was said, becoming warm, and the same symptoms occurred on the following day. On the third day she gave birth to a daughter, and the delivery was in every respect normal. On the second day after the delivery she was seized with acute fever, pain at the stomach and in the genitals. A pessary relieved these symptoms, but there was pain in the head, neck and loins. No sleep. From the bowels passed scanty stools, bilious, thin and unmixed. Urine thin and blackish. Delirium on the night of the sixth day from the day the fever began.

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Seventh day. All symptoms exacerbated; sleeplessness; delirium; thirst; bilious, highly-coloured stools.

+

Eighth day. Rigor; more sleep.

+

Ninth day. The same symptoms.

+ +

Tenth day. Severe pains in the legs; pain again at the stomach; heaviness in the head; no delirium; more sleep; constipation.

+

Eleventh day. Urine of better colour, with a thick deposit; was easier.

+

Fourteenth day. Rigor; acute fever.

+

Fifteenth day. Vomited fairly frequently bilious, yellow vomit; sweated without fever; at night, however, acute fever; urine thick, with a white sediment.

+

Sixteenth day. Exacerbation; an uncomfortable night ; no sleep; delirium.

+

Eighteenth day. Thirst; tongue parched; no sleep; much delirium; pain in the legs.

+

About the twentieth day. Slight rigors in the early morning; coma; quiet sleep; scanty, bilious, black vomits; deafness at night.

+

About the twenty-first day. Heaviness all over the left side, with pain; slight coughing; urine thick, turbid, reddish, no sediment on standing. In other respects easier; no fever. From the beginning she had pain in the throat; redness; uvula drawn back; throughout there persisted an acrid flux, smarting, and salt.

+

About the twenty-seventh day. No fever; sediment in urine; some pain in the side.

+

About the thirty-first day. Attacked by fever; bowels disordered and bilious.

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Fortieth day. Scanty, bilious vomits.

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Eightieth day. Complete crisis with cessation of fever.

+
+CASE VI +

Cleanactides, who lay sick above the temple of Heracles, was seized by an irregular fever. He had at the beginning pains in the head and the left side, and in the other parts pains like those caused by fatigue. The exacerbations of the fever were varied and irregular; sometimes there were sweats, sometimes there were not. Generally the exacerbations manifested themselves most on the critical days.

+

About the twenty-fourth day. Pain in the hands; bilious, yellow vomits, fairly frequent, becoming after a while like verdigris; general relief.

+

About the thirtieth day. Epistaxis from both nostrils began, and continued, irregular and slight, until the crisis. All the time he suffered no thirst, nor lack of appetite or sleep. Urine thin, and not colourless.

+

About the fortieth day. Urine reddish, and with an abundant, red deposit. Was eased. Afterwards the urine varied, sometimes having, sometimes not having, a sediment.

+

Sixtieth day. Urine had an abundant sediment, white and smooth; general improvement; fever intermitted; urine again thin but of good colour.

+

Seventieth day. Fever, which intermitted for ten days.

+

Eightieth day. Rigor; attacked by acute fever; much sweat; in the urine a red, smooth sediment. A complete crisis.

+
+CASE VII +

Meton was seized with fever, and painful heaviness in the loins.

+

Second day. After a fairly copious draught of water had his bowels well moved.

+

Third day. Heaviness in the head; stools thin, bilious, rather red.

+ +

Fourth day. General exacerbation; slight epistaxis twice from the right nostril. An uncomfortable night; stools as on the third day; urine rather black; had a rather black cloud floating in it, spread out, which did not settle.

+

Fifth day. Violent epistaxis of unmixed blood from the left nostril; sweat; crisis. After the crisis sleeplessness; wandering; urine thin and rather black. His head was bathed; sleep; reason restored. The patient suffered no relapse, but after the crisis bled several times from the nose.

+
+CASE VIII +

Erasinus lived by the gully of Boétes. Was seized with fever after supper ; a troubled night.

+

First day. Quiet, but the night was painful.

+

Second day. General exacerbation; delirium at night.

+

Third day. Pain and much delirium.

+

Fourth day. Very uncomfortable; no sleep at night; dreams and wandering. Then worse symptoms, of a striking and significant character; fear and discomfort.

+

Fifth day. Early in the morning was composed, and in complete possession of his senses. But long before mid-day was madly delirious; could not restrain himself; extremities cold and rather livid; urine suppressed; died about sunset.

+

In this patient the fever was throughout accompanied by sweat; the hypochondria were swollen, distended and painful. Urine black, with round, suspended particles which did not settle. There were solid discharges from the bowels. Thirst throughout not very great. Many convulsions with sweating about the time of death.

+
+CASE IX +

Crito, in Thasos, while walking about, was seized with a violent pain in the great toe. He took to bed the same day with shivering and nausea; regained a little warmth; at night was delirious.

+

Second day. Swelling of the whole foot, which was rather red about the ankle, and distended; black blisters; acute fever ; mad delirium. Alvine discharges unmixed, bilious and rather frequent. He died on the second day from the commencement.

+
+CASE X +

The man of Clazomenae, who lay sick by the well of Phrynichides, was seized with fever. Pain at the beginning in head, neck and loins, followed immediately by deafness. No sleep; seized with acute fever; hypochondrium swollen, but not very much; distension; tongue dry.

+

Fourth day. Delirium at night.

+

Fifth day. Painful.

+

Sixth day. All symptoms exacerbated.

+

About the eleventh day slight improvement. From the beginning to the fourteenth day there were from the bowels thin discharges, copious, of a watery biliousness; they were well supported by the patient. Then the bowels were constipated. Urine throughout thin, but of good colour. It had much cloud spread through it, which did not settle in a sediment. About the sixteenth day the urine was a little thicker, and had a slight sediment.

+ +

The patient became a little easier, and was more rational.

+

Seventeenth day. Urine thin again; painful swellings by both ears. No sleep; wandering; pain in the legs.

+

Twentieth day. A crisis left the patient free from fever; no sweating; quite rational. About the twenty-seventh day violent pain in the right hip, which quickly ceased. The swellings by the ears neither subsided nor suppurated, but continued painful. About the thirty-first day diarrhéa with copious, watery discharges and signs of dysentery. Urine thick; the swellings by the ears subsided.

+

Fortieth day. Pain in the right eye; sight rather impaired; recovery.

+
+CASE XI +

The wife of Dromeades, after giving birth to a daughter, when everything had gone normally, on the second day was seized with rigor; acute fever. On the first day she began to feel pain in the region of the hypochondrium; nausea; shivering; restless; and on the following days did not sleep. Respiration rare, large, interrupted at once as by an inspiration.As we might say, with a catch in it.

+

Second day from rigor. Healthy action of the bowels. Urine thick, white, turbid, like urine which has settled, stood a long time, and then been stirred up. It did not settle. No sleep at night.

+

Third day. At about mid-day rigor; acute fever; urine similar; pain in the hypochondrium; nausea; an uncomfortable night without sleep; a cold sweat all over the body, but the patient quickly recovered heat.

+ +

Fourth day. Slight relief of the pains about the hypochondrium; painful heaviness of the head; somewhat comatose; slight epistaxis; tongue dry; thirst; scanty urine, thin and oily; snatches of sleep.

+

Fifth day. Thirst; nausea; urine similar; no movement of the bowels; about mid-day much delirium, followed quickly by lucid intervals; rose, but grew somewhat comatose; slight chilliness; slept at night; was delirious.

+

Sixth day. In the morning had a rigor; quickly recovered heat; sweated all over; extremities cold; was delirious; respiration large and rare. After a while convulsions began from the head, quickly followed by death.

+
+CASE XII +

A man dined when hot and drank too much. During the night he vomited everything; acute fever; pain in the right hypochondrium; inflammation, soft underneath, from the inner partSee note, p. 188.; an uncomfortable night; urine at the first thick and red; on standing it did not settle; tongue dry; no great thirst.

+

Fourth day. Acute fever; pains all over.

+

Fifth day. Passed much smooth, oily urine; acute fever.

+

Sixth day. In the afternoon much delirium. No sleep at night.

+

Seventh day. General exacerbation; urine similar; much rambling; could not restrain himself; on stimulation the bowels passed watery, disturbed discharges, with worms. An uncomfortable night, with rigor in the morning. Acute fever. Hot sweat, and the patient seemed to lose his fever; little sleep, followed by chilliness; expectoration. In the evening much delirium, and shortly afterwards he vomited black, scanty, bilious vomits.

+

Ninth day. Chill; much wandering; no sleep.

+

Tenth day. Legs painful; general exacerbation; wandering.

+

Eleventh day. Death.

+
+CASE XIII +

A woman lying sick by the shore, who was three months gone with child, was seized with fever, and immediately began to feel pains in the loins.

+

Third day. Pain in the neck and in the head, and in the region of the right collar-bone. Quickly she lost her power of speech, the right arm was paralyzed, with a convulsion, after the manner of a stroke; completely delirious. An uncomfortable night, without sleep; bowels disordered with bilious, unmixed, scanty stools.

+

Fourth day. Her speech was recovered, but was indistinct; convulsions; pains of the same parts remained; painful swelling in the hypochondrium; no sleep; utter delirium; bowels disordered; urine thin, and not of good colour.

+

Fifth day. Acute fever; pain in the hypochondrium; utter delirium; bilious stools. At night sweated; was without fever.

+

Sixth day. Rational; general relief, but pain remained about the left collar-bone; thirst; urine thin; no sleep.

+

Seventh day. Trembling; some coma; slight delirium ; pains in the region of the collar-bone and left upper arm remained; other symptoms relieved; quite rational. For three days there was an intermission of fever.

+

Eleventh day. Relapse; rigor; attack of fever. But about the fourteenth day the patient vomited bilious, yellow matter fairly frequently; sweated; a crisis took off the fever.

+
+CASE XIV +

Melidia, who lay sick by the temple of Hera, began to suffer violent pain in the head, neck and chest. Immediately she was attacked by acute fever, and there followed a slight menstrual flow. There were continuous pains in all these parts.

+

Sixth day. Coma; nausea; shivering; flushed cheeks; slight delirium.

+

Seventh day. Sweat; intermittence of fever; the pains persisted; relapse; snatches of sleep; urine throughout of good colour but thin; stools thin, bilious, irritating, scanty, black and of bad odour; sediment in the urine white and smooth; sweating.

+

Eleventh day. Perfect crisis.

+ + + +
+EPIDEMICS III +
+
+CASE I +

PythionThe third book of the Epidemics has always been regarded as a continuation of the first book. Even a casual glance will convince any reader that the two books are really one work. The Paris manuscript called A, which breaks off after the opening words of Epidemics III, nevertheless joins these words without interruption to the end of the first book., who lived by the temple of Earth, was seized with trembling which began in the hands.

+

First day. Acute fever; wandering.

+

Second day. General exacerbation.

+

Third day. Same symptoms.

+

Fourth day. Stools scanty, uncompounded and bilious.

+

Fifth day. General exacerbation; fitful sleep; constipation.

+

Sixth day. Varied, reddish sputa.

+

Seventh day. Mouth drawn awry.

+

Eighth day. General exacerbation; tremblings persisted; urine from the beginning to the eighth day thin, colourless, with a cloudy substance floating in it.

+

Tenth day. Sweat; sputa somewhat concocted; crisis ; urine somewhat thin about the time of the crisis. After the crisis, forty days subsequent to it, abscess in the seat, and an abscession through strangury.

+
+CASE II +

Hermocrates, who lay sick by the new wall, was seized with fever. He began to feel pain in the head and loins; tension of the hypochondrium without swellingBut see note on p. 188.; tongue at the beginning parched; deafness at once; no sleep; no great thirst; urine thick, red, with no sediment on standing; stools not scanty, and burnt.

+

Fifth day. Urine thin, with particles floating in it, without sediment; at night delirium.

+

Sixth day. Jaundice; general exacerbation; not rational.

+

Seventh day. Discomfort; urine thin, and as before. The following days similar. About the eleventh day there seemed to be general relief; coma began; urine thicker, reddish, thinGalen says that the meaning of λεπτὰ is here small, i. e. he thinks that there wore small particles at the bottom. Such is not the meaning of the word in Hippocrates when applied to urine. at the bottom, without sediment; by degrees grew more rational.

+

Fourteenth day. No fever; no sweat; sleep; reason quite recovered; urine as before.

+

About the seventeenth day there was a relapse, and the patient grew hot. On the following days there was acute fever; urine thin; delirium.

+

Twentieth day. A fresh crisis; no fever; no sweat. All the time the patient had no appetite; was perfectly collected but could not talk; tongue dry; no thirst; snatches of sleep; coma. About the twenty-fourth day he grew hot; bowels loose with copious, thin discharges. On the following days acute fever; tongue parched.

+

Twenty-seventh day. Death.

+

In this case deafness persisted throughout; urine thick, red, without settling, or thin, colourless, with substances floating in it. The patient had no power to take food.

+
+CASE III +

The man lying sick in the garden of Delearces had for a long time heaviness in the head and pain in the right temple. From some exciting cause he was seized with fever, and took to his bed.

+

Second day. Slight flow of unmixed blood from the left nostril. The bowels were well moved; urine thin and varied, with particles in small groups, like barley-meal or semen, floating in it.

+

Third day. Acute fever; stools black, thin, frothy, with a livid sediment in them; slight stupor; getting up caused distress; in the urine a livid, rather viscous sediment.

+

Fourth day. Vomited scanty, bilious, yellow vomits, and after a short interval, verdigris-coloured ones; slight flow of unmixed blood from the left nostril; stools unaltered and urine unaltered; sweat about the head and collar-bones; spleen enlarged; pain in the direction of the thigh; tension, soft under-neath, of the right hypochondrium;See note, p. 188. no sleep at night; slight delirium.

+

Fifth day. Stools more copious, black, frothy; a black sediment in the stools; no sleep at night; delirium.

+

Sixth day. Stools black, oily, viscid, foul-smelling ; slept; was more rational.

+

Seventh day. Tongue dry; thirsty; no sleep; delirium; urine thin, not of a good colour.

+

Eighth day. Stools black, scanty, compact; sleep; was collected; not very thirsty.

+

Ninth day. Rigor, acute fever; sweat; chill; delirium; squinting of the right eye; tongue dry; thirsty; sleepless.

+ +

Tenth day. Symptoms about the same.

+

Eleventh day. Quite rational; no fever; slept, urine thin about the time of the crisis.

+

The patient remained free from fever for two days, relapsed on the fourteenth day, and immediately had no sleep at night and was completely delirious.

+

Fifteenth day. Urine muddy, like that which has been stirred up after settling; acute fever; completely delirious; no sleep; pain in knees and legs. On the application of a suppository, black, solid motions were passed.

+

Sixteenth day. Urine thin, with a cloudy substance floating in it; delirium.

+

Seventeenth day. Extremities cold in the early morning; would wrap himself up; acute fever; sweated all over; was relieved; more rational; some fever; thirst; vomited bilious matters, yellow and scanty; solid motions from the bowels; after a while they became black, scanty and thin; urine thin, and not of a good colour.

+

Eighteenth day. Was not rational; comatose.

+

Nineteenth day. The same symptoms.

+

Twentieth day. Slept; completely rational; sweated ; no fever; no thirst; urine thin.

+

Twenty-first day. Slightly delirious; rather thirsty; pain in the hypochondrium and throbbing about the navel continuously.

+

Twenty-fourth day. Sediment in urine; completely rational.

+

Twenty-seventh day. Pain in the right hip, but in other respects very comfortable; sediment in the urine.

+

About the twenty-ninth day pain in the right eye; urine thin.

+

Fortieth day. Passed motions full of phlegm, white and rather frequent; copious sweat all over; a perfect crisis.

+
+CASE IV +

Philistes in Thasos had for a long time pain in the head, and at last fell into a state of stupor and took to his bed. Heavy drinking having caused continuous fevers the pain grew worse. At night he grew hot at the first.

+

First day. Vomited bilious matters, scanty, at first yellow, afterwards increasing and of the colour of verdigris; solid motions from the bowels; an uncomfortable night.

+

Second day. Deafness; acute fever; tension of the right hypochondrium, which fell inwards. Urine thin, transparent, with a small quantity of substance, like semen, floating in it. About mid-day became raving.

+

Third day. Uncomfortable.

+

Fourth day. Convulsions; exacerbation.

+

Fifth day. Died early in the morning.

+
+CASE V +

Chaerion, who lay sick in the house of Demaenetus,The variants indicate corruption. Can Δηλίαν be Delian goddess or Delias? The form is not Ionic. was seized with fever after drinking. At once there was painful heaviness of the head; no sleep; bowels disturbed with thin, rather bilious stools.

+

Third day. Acute fever, trembling of the head, particularly of the lower lip; after a while rigor, convulsions, complete delirium; an uncomfortable night.

+

Fourth day. Quiet; snatches of sleep; wandering.

+

Fifth day. Pain; general exacerbation; irrational talk; uncomfortable night; no sleep.

+

Sixth day. The same symptoms.

+

Seventh day. Rigor; acute fever; sweating all over ; crisis.

+

This patient’s stools were throughout bilious, scanty and uncompounded. Urine thin, not of a good colour, with a cloudy substance floating in it. About the eighth day the urine had a better colour, with a slight, white sediment; quite rational and no fever; an intermission.

+

Ninth day. Relapse.

+

About the fourteenth day acute fever.

+

Sixteenth day. Vomited bilious, yellow matters rather frequently.

+

Seventeenth day. Rigor; acute fever; sweating; crisis ended the fever.

+

Urine after relapse and crisis of a good colour, with a sediment; no delirium during the relapse.

+

Eighteenth day. Slight heat; rather thirsty; urine thin, with cloudy substance floating in it; slight delirium.

+

Nineteenth day. No fever; pain in the neck; sediment in urine.

+

Twentieth day. Complete crisis.

+
+CASE VI +

The maiden daughter of Euryanax was seized with fever. Throughout the illness she suffered no thirst and had no inclination for food. Slight alvine discharges; urine thin, scanty, and not of a good colour. At the beginning of the fever suffered pain in the seat. On the sixth day did not sweat, being without fever; a crisis. The sore near the seat suppurated slightly, and burst at the crisis. After the crisis, on the seventh day, she had a rigor; grew slightly hot; sweated. Afterwards the extremities always cold. About the tenth day, after the sweating that occurred, she grew delirious, but was soon rational again. They said that the trouble was due to eating grapes. After an intermission, on the twelfth day she again wandered a great deal; the bowels were disturbed, with bilious, uncompounded, scanty, thin, irritating stools, which frequently made her get up. She died the seventh day from the second attack of delirium. This patient at the beginning of the illness had pain in the throat, which was red throughout. The uvula was drawn back. Many fluxes,Here ῥεύματα πολλὰ must mean many fluxes, but in Epidemics III. iv. it means copions fluxes. scanty and acrid. She had a cough with signs of coction, but brought up nothing.Or, with Galen’s reading, she had a cough, but brought up no concocted suptum. No appetite for any food the whole time, nor did she desire anything. No thirst, and she drank nothing worth mentioning. She was silent, and did not converse at all. Depression, the patient despairing of herself. There was also some inherited tendency to consumption.

+
+CASE VII +

The woman suffering from angina who lay sick in the house of Aristion began her complaint with indistinctness of speech. Tongue red, and grew parched.

+

First day. Shivered, and grew hot.

+

Third day. Rigor; acute fever; a reddish, hard swelling in the neck, extending to the breast on either side; extremities cold and livid, breathing elevated;The ancient commentators did not know the meaning of this word when applied to respiration, and a modern can only guess. drink returned through the nostrilsshe could not swallowstools and urine ceased.

+

Fourth day. General exacerbation.

+

Fifth day. Death.

+
+CASE VIII +

The youth who lay sick by the Liars’ Market was seized with fever after unaccustomed fatigue, toil and running.

+

First day. Bowels disturbed with bilious, thin, copious stools; urine thin and blackish; no sleep; thirst.

+

Second day. General exacerbation; stools more copious and more unfavourable. No sleep; mind disordered; slight sweating.

+

Third day. Uncomfortable; thirst; nausea; much tossing; distress; delirium; extremities livid and cold; tension, soft underneath, of the hypochondriumSee note, p. 188. on both sides.

+

Fourth day. No sleep; grew worse.

+

Seventh day. Died, being about twenty years old.

+
+CASE IX +

The woman who lodged with Tisamenus was in bed with a troublesome attack of inflammation of the upper bowel. Copious vomits; could not retain her drink. Pains in the region of the hypochondria. The pains were also lower, in the region of the bowels. Constant tormina. No thirst. She grew hot, though the extremities were cold all the time.

+

Nausea; sleeplessness. Urine scanty and thin. Excreta crude, thin and scanty. It was no longer possible to do her any good, and she died.

+
+CASE X +

A woman who was one of the house of Pantimides after a miscarriage was seized with fever on the first day. Tongue dry; thirst; nausea; sleeplessness. Bowels disordered, with thin, copious and crude stools.

+

Second day. Rigor; acute fever; copious stools; no sleep.

+

Third day. The pains greater.

+

Fourth day. Delirium.

+

Seventh day. Death.

+

The bowels were throughout loose, with copious, thin, crude stools. Urine scanty and thin.

+
+CASE XI +

Another woman, after a miscarriage about the fifth month, the wife of Hicetas, was seized with fever. At the beginning she had alternations of coma and sleeplessness; pain in the loins; heaviness in the head.

+

Second day. Bowels disordered with scanty, thin stools, which at first were uncompounded.

+

Third day. Stools more copious and worse; no sleep at night.

+

Fourth day. Delirium; fears; depression. Squinting of the right eye; slight cold sweat about the head; extremities cold.

+

Fifth day. General exacerbation; much wandering, with rapid recovery of reason; no thirst; no sleep; stools copious and unfavourable throughout; urine scanty, thin and blackish; extremities cold and rather livid.

+

Sixth day. Same symptoms.

+

Seventh day. Death.

+
+CASE XII +

A woman who lay sick by the Liars’ Market, after giving birth in a first and painful delivery to a male child, was seized with fever. From the very first there was thirst, nausea, slight pain at the stomach, dry tongue, bowels disordered with thin and scanty discharges, no sleep.

+

Second day. Slight rigor; acute fever; slight, cold sweating around the head.

+

Third day. In pain; crude, thin, copious discharges from the bowels.

+

Fourth day. Rigor; general exacerbation; sleepless.

+

Fifth day. In pain.

+

Sixth day. The same symptoms; copious, fluid discharges from the bowels.

+

Seventh day. Rigor; acute fever; thirst; much tossing; towards evening cold sweat all over; chill; extremities cold, and would not be warmed. At night she again had a rigor; the extremities would not be warmed; no sleep; slight delirium, but quickly was rational again.

+

Eighth day. About mid-day recovered her heat; thirst; coma; nausea; vomited bilious, scanty, yellowish matters. An uncomfortable night; no sleep; unconsciously passed a copious discharge of urine.

+

Ninth day. General abatement of the symptoms; coma. Towards evening slight rigor; vomited scanty, bilious matters.

+

Tenth day. Rigor; exacerbation of the fever; no sleep whatsoever. In the early morning a copious discharge of urine without sediment; extremities were warmed.

+

Eleventh day. Vomited bilious matters, of the colour of verdigris. A rigor shortly afterwards, and the extremities became cold again; in the evening sweat, rigor and copious vomiting; a painful night.

+

Twelfth day. Vomited copious, black, fetid matters; much hiccoughing; painful thirst.

+

Thirteenth day. Vomited black, fetid, copious matters; rigor. About mid-day lost her speech.

+

Fourteenth day. Epistaxis; death.

+

The bowels of this patient were throughout loose, and there were shivering fits. Age about seventeen.

+
+
+

CONSTITUTION

+

The year was southerly and rainy, with no winds throughout. About the rising of Arcturus, while during the immediately preceding period droughts had prevailed, there were now heavy rains, with southerly winds. Autumn dark and cloudy, with abundance of rain. The winter southerly, humid, and mild after the solstice. Long after the solstice, near the equinox, wintry weather returned, and at the actual equinoctial period there were northerly winds with snow, but not for long. The spring southerly again, with no winds; many rains throughout until the Dog Star. The summer was clear and warm, with waves of stifling heat. The Etesian winds were faint and intermittent. But, on the other hand, near the rising of Arcturus there were heavy rains with northerly winds.

+

The year having proved southerly, wet and mild, in the winter the general health was good except for the consumptives, who will be described in due course.

+
+

Early in the spring, at the same time as the cold snaps which occurred, were many malignant casesOr, forms. of erysipelas, some from a known exciting cause and some not. Many died, and many suffered pain in the throat. Voices impaired; ardent fevers; phrenitis; aphthae in the mouth; tumours in the private parts; inflammations of the eyes; carbuncles; disordered bowels; loss of appetite; thirst in some cases, though not in all; urine disordered, copious, bad; long coma alternating with sleeplessness; absence of crisis in many cases, and obscure crises; dropsies; many consumptives. Such were the diseases epidemic. There were patients suffering from each of the above types, and fatal cases were many. The symptoms in each type were as follow.

+
+

Many were attacked by the erysipelas all over the body when the exciting cause was a trivial accident or a very small wound; especially when the patients were about sixty years old and the wound was in the head, however little the neglect might have been. Many even while undergoing treatment suffered from severe inflammations,With Littré’s punctuation the meaning is, however slight the neglect, and even when a patient was actually undergoing treatment. There were severe inflammations, etc. and the erysipelas would quickly spread widely in all directions. Most of the patients experienced abscessions ending in suppurations. Flesh, sinews and bones fell away in large quantities. The flux which formed was not like pus, but was a different sort of putre-faction with a copious and varied flux. If any of these symptoms occurred in the head, there was loss of hair from all the head and from the chin; the bones were bared and fell away, and there were copious fluxes. Fever was sometimes present and sometimes absent. These symptoms were terrifying rather than dangerous. For whenever they resulted in suppuration or some similar coction the cases usually recovered. But whenever the inflammation and the erysipelas disappeared without producing any such abscession, there were many deaths. The course of the disease was the same to whatever part of the body it spread. Many lost the arm and the entire forearm. If the malady settled in the sides there was rotting either before or behind. In some cases the entire thigh was bared, or the shin and the entire foot. But the most dangerous of all such cases were when the pubes and genital organs were attacked. Such were the sores which sprang from an exciting cause. In many cases, however, sores occurred in fevers, before a fever, or supervening on fevers. In some of these also, when an abscession took place through suppuration, or when a seasonable disturbance of the bowels occurred or a passing of favourable urine, this gave rise to a solution; but when none of these events happened, and the symptoms disappeared without a sign, death resulted. It was in the spring that by far the greater number of cases of erysipelas occurred, but they continued throughout the summer and during autumn.

+
+

Much trouble was caused to some patients by the tumours in the throat, inflammations of the tongue and the abscesses about the teeth. Many had the symptom of impaired and muffledThe word so rendered has puzzled the commentators from very early times. See the full disoussion of Littré ad loc. The ancients interpreted either cooped up or altered, faussée (Littré). See Erotian sub voce φωναὶ κατείλλουσαι. I think that H. used a strange word metaphorically on purpose to describe a strange alteration in the voice, which was as it were imprisoned or (to borrow a motoring expression) silenced. voice, at first at the beginning of the cases of consumption, but also in the ardent fevers and in phrenitis.

+
+

Now the ardent fevers and phrenitis began early in the spring after the cold snaps which occurred, and very many fell sick at that time. These suffered acute and fatal symptoms. The constitution of the ardent fevers that occurred was as follows. At the beginning coma, nausea, shivering, acute fever, no great thirst, no delirium, slight epistaxis. The exacerbations in most cases on even days, and about the time of the exacerbations there was loss of memory with prostration and speechlessness. The feet and hands of these patients were always colder than usual, most especially about the times of exacerbation. Slowly and in no healthy manner they recovered their heat, becoming rational again and conversing. Either the coma held them continuously without sleep, or they were wakeful and in pain. Bowels disordered in the majority of these cases, with crude, thin, copious stools. Urine copious, thin, with no critical or favourable sign, nor did any other critical sign appear in these patients. For there occurred neither favourable hemorrhage nor any other of the usual critical abscessions. The manner of their dying varied with the individual; it was usually irregular, at the crises, but in some cases after long loss of speech and in many with sweating. These were the symptoms attending the fatal cases of ardent fever, and the cases of phrenitis were similar. These suffered from no thirst at all, and no case showed the mad delirium that attacked others, but they passed away overpowered by a dull oppression of stupor.

+
+

There were other fevers also, which I shall describe in due course. Many had aphthae and sores in the mouth. Fluxes about the genitals were copiousPossibly frequent, common. So Littré. This is one of the most doubtful cases of those difficult words in a medical context, πολύς and ὀλίγος in the plural. See General Introduction, p. lxi.; sores, tumours external and internal; the swellings which appear in the groin.A curious phrase. I suspect that τὰ hides a corruption of the text. Watery inflammations of the eyes, chronic and painful. Growths on the eyelids, external and internal, in many cases destroying the sight, which are called figs. There were also often growths on other sores, particularly in the genitals. Many carbuncles in the summer, and other affections called rot. Large pustules. Many had large tetters.

+
+

The bowel troubles in many cases turned out many and harmful. In the first place many were attacked by painful tenesmus, mostly childrenall in fact who were approaching pubertyand most of these died. Many lienteries. Cases of dysentery, but they tooI. c. as Galen suggests in his commentary, they were like the lienteries in not causing much pain. Lientery is not particularly painful. were not very painful. Stools bilious, greasy, thin and watery. In many cases this condition of the bowels constituted the disease itself, fever being sometimes absent and sometimes present.Littré in a long and obscure note argues that only ἄνευ πυρετῶν and not ἐν πυρετοῖσι can belong to the preceding phrase, apparently because it is illogical to say that fever was present when the disease consisted merely of unhealthy stools. But the writer does not wish to exclude fever; he merely wishes to exclude from this class of patient tenesmus, lientery and dysentery. The commentary of Galen, πολλοῖς ῦέ φησιν αὐτὸ τοῦτο γενέσθαι τὸ νόσημα, τουτέστι τὸ διαχωρεῖν τὰ τοιαῦτα· καὶ γὰρ καὶ χωρὶς πυρετῶν ἐνίοις τοῦτο γενέσθαι Φησι, does not, as Littré supposes, support his contention. The phrase καὶ χωρὶς πυρετῶν ἐνίοις τοῦτο γενέσθαι φησὶ implies καὶ ἐν πυρετοῖς τοῦτο ἐγένετο. Painful tormina and malignant colic. There were evacuations, though the bulk of the contents remained behind.It is hard to separate διέξοδοι from τῶν πολλῶν, yet the sense seems to require it. The next sentence states that these evacuations caused no relief, evidently because they did not clear the trouble from the bowel. Now if διέξοδοι be taken with τῶν πολλῶν, the only possible translation is evacuations of the many contents which were retained there, implying complete evacuation. Galen’s comment (Kéhn XVII, Part I, p. 708) bears out the former interpretation: τὰς δὲ διεξόδους, τουτέστὶ τὰς κενώσεις, αὐτοῖς συμβῆναι, πολλῶν ἐνόντων καὶ ἐπισχόντων . . . . . καὶ διὰ τοῦτο μηδὲ τοὺς πόνους λύειν τὰ διεξιόντα. πῶς γαρ ὀ͂όν τε λύειν αὐτά, πολλῶν ἔτι τῶν ἐπεχομένων όντων; It should be noticed that ἐπισχόντων is probably from ἐπίσχω (Galen’s ἐπεχομένων) and not from ἐπέχω, although I cannot find a parallel for intransitive ἐπίσχω in this sense. The evacuations did not take away the pains, and yielded with difficulty to the remedies administered. Purgings, in fact, did harm in most cases. Of those in this condition many died rapidly, though a few held out longer. In brief, all patients, whether the disease was prolonged or acute, died chiefly from the bowel complaints. For the bowels carried all off together.The writer has not expressed himself clearly in this chapter, which seems to be the roughest of rough notes. The last two sentences apparently mean:— +

(a) It was always the bowel complaints which caused most deaths. This was natural, since (b) all attacked by bowel complaints died.

+
+

Loss of appetite, to a degree that I never met before, attended all the cases described above, but most especially the last, and of them, and of the others also, especially such as were fatally stricken.The emendation of Blass permits the translator of this passage to harmonize both sense and grammar. Before it was impossible to do so.

+

Thirst afflicted some, but not others; of the fever patients, as well as of the other cases, none were unseasonably affected, but as far as drink was concerned you could diet them as you pleased.

+
+

The urine that was passed was copious, not in proportion to, but far exceeding, the drink administered. Yet the urine too that was passed showed a great malignancy. For it had neither the proper consistency, nor coction, nor cleansing powers; it signified for most patients wasting, trouble,Probably disordered bowels, a common meaning of ταραχὴ in the Corpus. pains, and absence of crisis.

+
+

Coma attended mostly the phrenitis and ardent fevers, without excluding, however, all the other diseases of the most severe sort that were accompanied by fever. Most patients throughout either were sunk in heavy coma or slept only in fitful snatches.

+
+

Many other forms also of fever were epidemic: tertians, quartans, night fevers, fevers continuous, protracted, irregular, fevers attended with nausea, fevers of no definite character. All these cases suffered severely from trouble.See the preceding note. For the bowels in most cases were disordered, with shivering fits. Sweats portended no crisis, and the character of the urine was as I have described. Most of these cases were protracted, for the abscessions too which took place did not prove critical as in other cases; nay rather, in all cases all symptoms marked obscurity of crisis,For δύσκριτον see Foes’ Oeconomia, sub voce. It means that it was hard to see when a crisis took place, or that the crisis was not a marked one. or absence of crisis, or protraction of the disease, but most especially in the patients last described. A few of these had a crisis about the eightieth day; with most recovery followed no rule. A few of them died of dropsy, without taking to their bed; many sufferers from the other diseases too were troubled with swellings, most particularly the consumptives.

+
+

The severest and most troublesome disease, as well as the most fatal, was the consumption. Many cases began in the winter, and of these several took to their bed, though some went about ailing without doing so. Early in the spring most of those who had gone to bed died, while none of the others lost their cough, though it became easier in the summer. During autumn all took to bed and many died. Most of these were ill for a long time. Now most of these began suddenly to grow worse, showing the following symptoms:—-frequent shivering; often continuous and acute fever; unseasonable, copious,I am often doubtful as to the meaning of πολλοὶ in instances like these; does it refer to quantity or frequency? In these two examples either meaning would give excellent sense. See General Introduction, p. lxi. cold sweats throughout; great chill with difficult recovery of heat; bowels variously constipated, then quickly relaxing, and violently relaxing in all cases near the end ; the humours about the lungs spread downwards; abundance of unfavourable urine; malignant wasting. The coughs throughout were frequent, bringing up copious,I am often doubtful as to the meaning of πολλοὶ in instances like these; does it refer to quantity or frequency? In these two examples either meaning would give excellent sense. See General Introduction, p. lxi. concocted and liquid sputa, but without much pain; but even if there was pain, in all cases the purging from the lungs took place very mildly. The throat did not smart very much, nor did salt humours cause any distress at all. The fluxes, however, viscid, white, moist, frothy, which came from the head, were abundant. But by far the worst symptom that attended both these cases and the others was the distaste for food, as has been mentioned. They had no relish either for drink with nourishment, but they remained entirely without thirst. Heaviness in the body. Coma. In most of them there was swelling, which developed into dropsy. Shivering fits and delirium near death.

+
+

The physical characteristics of the consumptives were:—-skin smooth, whitish, lentil-coloured, reddish; bright eyes;It seems impossible to decide whether the adjective χαροπός refers here to the brightness of the eyes or to their colour (blue or grey). a leucophlegmaticSee General Introduction, p. xlvi-li, on the humours. Bitter bile was the same as that sometimes called yellow. condition; shoulder-blades projecting like wings. Women too so.This brief phrase seems to mean that the same characteristics marked consumptive women as consumptive men. As to those with a melancholicSee General Introduction, p. xlvi-li, on the humours. Bitter bile was the same as that sometimes called yellow. or a rather sanguineSee General Introduction, p. xlvi-li, on the humours. Bitter bile was the same as that sometimes called yellow. complexion, they were attacked by ardent fevers, phrenitis and dysenteric troubles. Tenesmus affected young, phlegmaticSee General Introduction, p. xlvi-li, on the humours. Bitter bile was the same as that sometimes called yellow. people; the chronic diarrhoea and acrid, greasy stools affected persons of a biliousSee General Introduction, p. xlvi-li, on the humours. Bitter bile was the same as that sometimes called yellow. temperament.

+
+

In all the cases described spring was the worst enemy, and caused the most deaths; summer was the most favourable season, in which fewest died. In autumn and during the season of the Pleiades, on the other hand, there were again deaths, usually on the fourth day. And it seems to me natural that the coming on of summer should have been helpful. For the coming on of winter resolves the diseases of summer, and the coming on of summer removes those of winter. And yet in itself the summer in question was not healthful;Of a good constitution. in fact it was suddenly hot, southerly, and calm. But nevertheless the change from the other constitution proved beneficial.

+
+

The power, too, to study correctly what has been written I consider to be an important part of the art of medicine. The man who has learnt these things and uses them will not, I think, make great mistakes in the art. And it is necessary to learn accurately each constitution of the seasons as well as the disease; what common element in the constitution or in the disease is good, and what common element in the constitution or in the disease is bad; what malady is protracted and fatal, what is protracted and likely to end in recovery; what acute illness is fatal, what acute illness is likely to end in recovery. With this knowledge it is easy to examine the order of the critical days, and to prognosticate therefrom. One who has knowledge of these matters can know whom he ought to treat, as well as the time and method of treatment.This chapter does not fit in with the context, and occurs again at the beginning of the book περὶ κρισίμων. Ermerins brackets it.

+
+SIXTEEN CASES +
+CASE I

In Thasos the Parian who lay sick beyond the temple of Artemis was seized with acute fever, which at the beginning was continuous and ardent. Thirst. At the beginning coma followed by sleeplessness. Bowels disordered at the beginning; urine thin.

+

Sixth day. Oily urine; delirium.

+

Seventh day. General exacerbation; no sleep; urine similar and mind disordered; stools bilious and fatty.

+

Eighth day. Slight epistaxis; vomited scanty matters of the colour of verdigris; snatches of sleep.

+

Ninth day. Same symptoms.

+

Tenth day. General improvement.

+

Eleventh day. Sweated all over; grew chilly, but quickly recovered heat.

+

Fourteenth day. Acute fever; stools bilious, thin, copious; substance floating in urine; delirium.

+

Seventeenth day. In pain; no sleep, while the fever grew worse.

+

Twentieth day. Sweated all over; no fever; stools bilious; aversion to food; coma.

+

Twenty-fourth day. Relapse.

+

Thirty-fourth day. No fever; no constipation; recovered heat.

+

Fortieth day. No fever; bowels constipated for a short time; aversion to food; became slightly feverish again, throughout irregularly, the fever being sometimes absent, sometimes present; for if the fever intermitted and was alleviated there was a relapse soon afterwards. He took little bits of food, and that of an unsuitable sort. Sleep bad; delirium at the relapses. Urine at these times had consistency, but was troubled and bad. Bowels constipated, but afterwards relaxed. Continuous slight fevers. Stools thin and copious.

+

Hundred and twentieth day. Death.

+

In this case the bowels continuously from the first day loose with bilious, loose, copious stools, or constipated with hot,Lit. seething or boiling. The reference is possibly not so much to heat as to the steaming, frothy nature of the stools. undigested stools. Urine throughout bad; mostly comatose; painful sleeplessness;The meaning apparently is that the patient was generally in a state of coma; if not comatose, he was in pain and could not sleep. continued aversion to food.

+
+CASE II +

In Thasos the woman who lay sick by the Cold Water, on the third day after giving birth to a daughter without lochial discharge, was seized with acute fever accompanied by shivering. For a long time before her delivery she had suffered from fever, being confined to bed and averse to food. After the rigor that took place, the fevers were continuous, acute, and attended with shivering.

+

Eighth and following days. Much delirium, quickly followed by recovery of reason; bowels disturbed with copious, thin, watery and bilious stools; no thirst.

+

Eleventh day. Was rational, but comatose. Urine copious, thin and black; no sleep.

+

Twentieth day. Slight chills,This sentence shows that περί in περιψύχω means not very, but all over. The phrase may mean slight chilliness. but heat quickly recovered; slight wandering; no sleep; bowels the same; urine watery and copious.

+

Twenty-seventh day. No fever; bowels constipated; not long afterwards severe pain in the right hip for a long time. Fevers again attended; urine watery.

+

Fortieth day. Pain in the hip relieved; continuous coughing, with watery, copious sputa; bowels constipated; aversion to food; urine the same. The fevers, without entirely intermitting, were exacerbated irregularly, sometimes increasing and sometimes not doing so.

+

Sixtieth day. The coughing ceased without any critical sign; there was no coction of the sputa, nor any of the usual abscessions; jaw on the right side convulsed; comatose; wandering, but reason quickly recovered; desperately averse to food; jaw relaxed ; passed small, bilious stools; fever grew more acute, with shivering. On the succeeding days she lost power of speech, but would afterwards converse.

+

Eightieth day. Death.

+

The urine of this patient was throughout black, thin and watery. Coma was present, aversion to food, despondency, sleeplessness, irritability, restlessness, the mind being affected by melancholy.For melancholy see General Introduction, p. lviii.

+
+CASE III +

In Thasos Pythion, who lay sick above the shrine of Heracles, after labour, fatigue and careless living, was seized by violent rigor and acute fever. Tongue dry; thirst; bilious; no sleep; urine rather black, with a substance suspended in it, which formed no sediment.

+

Second day. About mid-day chill in the extremities, especially in the hands and head; could not speak or utter a sound; respiration short for a long time; recovered warmth; thirst; a quiet night; slight sweats about the head.

+

Third day. A quiet day, but later, about sunset, grew rather chilly; nausea; distress;Probably bowel trouble. See p. 250 painful night without sleep; small, solid stools were passed.

+

Fourth day. Early morning peaceful, but about mid-day all symptoms were exacerbated; chill; speechless and voiceless; grew worse; recovered warmth after a time; black urine with a substance floating in it; night peaceful; slept.

+

Fifth day. Seemed to be relieved, but there was heaviness in the bowels with pain; thirst; painful night.

+

Sixth day. Early morning peaceful; towards evening the pains were greater; exacerbation; but later a little clyster caused a good movement of the bowels. Slept at night.

+

Seventh day. Nausea; rather uneasy; urine oily; much distressProbably bowel trouble. See p. 250. at night; wandering; no sleep at all.

+

Eighth day. Early in the morning snatches of sleep; but quickly there was chill; loss of speech; respiration thin and weak ; in the evening he recovered warmth again; was delirious; towards morning slightly better; stools uncompounded, small, bilious.

+

Ninth day. Comatose; nausea whenever he woke up. Not over-thirsty. About sunset was uncomfortable; wandered; a bad night.

+

Tenth day. In the early morning was speechless; great chill; acute fever; much sweat; death.

+

In this case the pains on even days.

+
+CASE IV +

The patient suffering from phrenitis on the first day that he took to bed vomited copiously thin vomits of the colour of verdigris; much fever with shivering; continuous sweating all over; painful heaviness of head and neck; urine thin, with small, scattered substances floating in it, which did not settle. Copious excreta at a single evacuation; delirium; no sleep. Second day. In the early morning speechless; acute fever; sweating; no intermission; throbbing all over the body; convulsions at night.

+

Third day. General exacerbation.

+

Fourth day. Death.

+
+CASE V +

In Larisa a bald man suddenly experienced pain in the right thigh. No remedy did any good.

+

First day. Acute fever of the ardent type; the patient was quiet, but the pains persisted.

+

Second day. The pains in the thigh subsided, but the fever grew worse; the patient was rather uncomfortable and did not sleep; extremities cold; copious and unfavourable urine was passed.

+

Third day. The pain in the thigh ceased, but there was derangement of the intellect, with distressProbably trouble in the bowels. and much tossing.

+

Fourth day. Death about mid-day.

+
+CASE VI +

In Abdera Pericles was seized with acute fever, continuous and painful; much thirst; nausea; could not retain what he drank. There was slight enlargement of the spleen and heaviness in the head.

+

First day. Epistaxis from the left nostril; the fever, however, increased greatly. Copious urine, turbid and white. On standing it did not settle.

+

Second day. General exacerbation; the urine, however, had consistency, but there was some sediment; the nausea was relieved and the patient slept.

+

Third day. The fever went down; abundance of urine, with concocted and copious sediment; a quiet night.

+

Fourth day. About mid-day a hot, violent sweating all over; no fever; crisis; no relapse.

+
+CASE VII +

In Abdera the maiden who lay sick by the Sacred Way was seized with a fever of the ardent type. She was thirsty and sleepless. Menstruation occurred for the first time.

+

Sixth day. Much nausea; redness; shivering; restlessness.

+

Seventh day. Same symptoms. Urine thin but of good colour; no trouble in the bowels.

+

Eighth day. Deafness; acute fever; sleeplessness; nausea; shivering; was rational; urine similar.

+

Ninth day Same symptoms, and also on the following days. The deafness persisted.

+

Fourteenth day. Reason disturbed; the fever subsided.

+

Seventeenth day. Copious epistaxis; the deafness improved a little. On the following days nausea and deafness, while there was also delirium.

+

Twentieth day. Pain in the feet; deafness; the delirium ceased; slight epistaxis; sweating; no fever.

+

Twenty-fourth day. The fever returned, with the deafness; pain in the feet persisted; delirium.

+

Twenty-seventh day. Copious sweating; no fever; the deafness ceased; the pain in the feet remained, but in other respects there was a perfect crisis.

+
+CASE VIII +

In Abdera Anaxion, who lay sick by the Thracian gate, was seized with acute fever. Continuous pain in the right side; a dry cough, with no sputa on the first days. Thirst ; sleeplessness; urine of good colour, copious and thin.

+

Sixth day. Delirium; warm applications gave no relief.

+

Seventh day. In pain, for the fever grew worse and the pains were not relieved, while the coughing was troublesome and there was difficulty in breathing.

+

Eighth day. I bled him in the arm. There was an abundant, proper flow of blood; the pains were relieved, although the dry coughing persisted.

+

Eleventh day. The fever went down; slight sweating about the head; the coughing and the sputa more moist.

+

Seventeenth day. Began to expectorate small, concocted sputa; was relieved.

+

Twentieth day. Sweated and was free from fever; after a crisis was thirsty, and the cleansings from the lungs were not favourable.

+

Twenty-seventh day. The fever returned; coughing, with copious, concocted sputa; copious, white sediment in urine; thirst and difficulty in breathing disappeared.

+

Thirty-fourth day. Sweated all over; no fever; general crisis.I am conscious of a slight change in diction and method in this part of the Epidcmics. I mention four points:— +

(1) The frequent use of πυρετὸς in the plural, which is unusual when it simply means feverishness (Cases VIII, IX, XII, XIII).

+

(2) καταβαίνω is used of evacuations (Cases VII, IX οὔρα . . . κατέβαινεν, XII).

+

(3) Treatment is mentioned (Case VIII, θερμάσματα, and ἀγκῶνα ἔταμον, where note the personal touch).

+

(4) ἱδρύνομαι used of recovery of reason, = κατανοῶ (Case XV). The change is marked enough to lead one to suppose that these histories were composed at a different period in the writer’s life.

+
+CASE IX +

In Abdera Heropythus had pain in the head without taking to bed, but shortly afterwards was compelled to do so. He lived close to the Upper Road.With Blass’ reading, Upper Market-place. An acute, ardent fever seized him. Vomited at the beginning copious, bilious matters; thirst; great discomfort; urine thin and black, sometimes with, sometimes without, substances suspended in it. Painful night, with fever rising now in this way, now in that, but for the most part irregularly. About the fourteenth day, deafness; the fever grew worse; urine the same.

+

Twentieth day. Much delirium, also on the following days.

+

Fortieth day. Copious epistaxis; more rational; some deafness, but less than before; the fever went down. Frequent, but slight, epistaxis on the following days. About the sixtieth day the bleedings from the nose ceased, but there was violent pain in the right hip and the fever increased. Not long afterwards, pains in all the lower parts. It happened that either the fever was higher and the deafness great, or else, though these symptoms were relieved and less severe, yet the pains in the lower parts about the hips grew worse. But from about the eightieth day all the symptoms were relieved without any disappearing. The urine that was passed was of good colour and had greater deposits, while the delirious mutterings were less. About the hundredth day the bowels were disordered with copious, bilious stools, and copious evacuations of this nature were passed for a long time. Then followed painful symptoms of dysentery, with relief of the other symptoms. In brief, the fever disappeared and the deafness ceased.

+

Hundred and twentieth day. Complete crisis.

+
+CASE X +

In Abdera Nicodemus after venery and drunkenness was seized with fever. At the beginning he had nausea and cardialgia; thirst; tongue parched ; urine thin and black.

+

Second day. The fever increased; shivering; nausea ; no sleep; bilious, yellow vomits; urine the same; a quiet night; sleep.

+

Third day. All symptoms less severe; relief. But about sunset he was again somewhat uncomfortable; painful night.

+

Fourth day. Rigor; much fever; pains every-where; urine thin, with floating substance in it; the night, on the other hand, was quiet.

+

Fifth day. All symptoms present, but relieved.

+

Sixth day. Same pains everywhere; substance floating in urine; much delirium.

+

Seventh day. Relief.

+

Eighth day. All the otherWhat other symptoms? It is clear that some symptoms are excepted, but there is no hint what these are. As V has τὰ δʼ ἄλλα, but all the other symptoms were relieved, I believe that after ?̓γδόῃ has fallen out a phrase containing the symptoms which were not relieved. symptoms less severe.

+

Tenth day and following days. The pains were present, but all less severe. The exacerbations and the pains in the case of this patient tended through-out to occur on the even days.

+

Twentieth day. Urine white, having consistency; no sediment on standing. Copious sweating; seemed to lose his fever, but towards evening grew hot again, with pains in the same parts; shivering ; thirst; slight delirium.

+

Twenty-fourth day. Much white urine, with much sediment. Hot sweating all over; the fever passed away in a crisis.

+
+CASE XI +

In Thasos a woman of gloomy temperament, after a grief with a reason for it, without taking to bed lost sleep and appetite, and suffered thirst and nausea. She lived near the place of Pylades on the plain.

+

First day. As night began there were fears, much rambling, depression and slight feverishness. Early in the morning frequent convulsions; whenever these frequent convulsions intermitted, she wandered and uttered obscenities; many pains, severe and continuous.

+

Second day. Same symptoms; no sleep; fever more acute.

+

Third day. The convulsions ceased, but were succeeded by coma and oppression, followed in turn by wakefulness. She would jump up; could not restrain herself; wandered a great deal; fever acute; on this night a copious, hot sweating all over; no fever ; slept, was perfectly rational, and had a crisis. About the third day urine black and thin, with particles mostly round floating in it, which did not settle. Near the crisis copious menstruation.

+
+CASE XII +

In Larisa a maiden was seized with an acute fever of the ardent type. Sleeplessness; thirst; tongue sooty and parched; urine of good colour, but thin.

+

Second day. In pain; no sleep.

+

Third day. Copious stools, watery and of a yellowish green; similar stools on the following days, passed without distress.

+

Fourth day. Scanty, thin urine, with a substance suspended in it which did not settle; delirium at night.

+

Sixth day. Violent and abundant epistaxis; after a shivering fit followed a hot, copious sweating all over; no fever; a crisis. In the fever and after the crisis menstruation for the first time, for she was a young maiden. Throughout she suffered nausea and shivering; redness of the face; pain in the eyes; heaviness in the head. In this case there was no relapse, but a definite crisis. The pains on the even days.

+
+CASE XIII +

Apollonius in Abdera was ailing for a long time without being confined to bed. He had a swollen abdomen, and a continual pain in the region of the liver had been present for a long time; moreover, he became during this period jaundiced and flatulent; his complexion was whitish. After dining and drinking unseasonably cow’s milkφαγὼμ according to this translation has no expressed object. Furthermore, βόειον is more naturally beef. As the words stand the above version is the natural one, but I suspect that either βόειον should be transposed to between δὲ and καί, or else it is used ἀπὸ κοινοῦ and zengmatically with both φαγὼν and πιών, after eating beef and drinking cow’s milk. So Littré and, apparently, from his translation, Calvus. he at first grew rather hot; he took to his bed. Having drunk copiously of milk, boiled and raw, both goat’s and sheep’s, and adopting a thoroughly bad regimen,Or, changing the comma at πάντων to κακῆ, adopting a bad regimen, he suffered great harm in every way. he suffered much therefrom. For there were exacerbations of the fever; the bowels passed practically nothing of the food taken; the urine was thin and scanty. No sleep. Grievous distension; much thirst; coma; painful swelling of the right hypochondrium; extremities all round rather cold; slight delirious mutterings; forgetfulness of every-thing he said; he was not himself. About the fourteenth day from his taking to bed, after a rigor, he grew hot; wildly delirious; shouting, distress,Here perhaps not bowel trouble. much rambling, followed by calm; the coma came on at this time. Afterwards the bowels were disordered with copious stools, bilious, uncompounded and crude; urine black, scanty and thin. Great discomfort. The evacuations showed varying symptoms; they were either black, scanty and verdigris-coloured, or else greasy, crude and smarting ; at times they seemed actually to be like milk. About the twenty-fourth day comfortable; in other respects the same, but he had lucid intervals. He remembered nothing since he took to bed. But he quickly was again delirious, and all symptoms took a sharp turn for the worse. About the thirtieth day acute fever; copious, thin stools; wandering; cold extremities; speechlessness.

+

Thirty-fourth day. Death.

+

This patient throughout, from the time I had knowledge of the case, suffered from disordered bowels; urine thin and black; coma; sleeplessness; extremities cold; delirious throughout.

+
+CASE XIV +

In Cyzicus a woman gave birth with difficult labour to twin daughters, and the lochial discharge was far from good.

+

First day. Acute fever with shivering; painful heaviness of head and neck. Sleepless from the first, but silent, sulky and refractory. Urine thin and of no colour; thirsty; nausea generally ; bowels irregularly disturbed with constipation following.

+

Sixth day. Much wandering at night; no sleep.

+

About the eleventh day she went out of her mind and then was rational again; urine black, thin, and then, after an interval, oily; copious, thin, disordered stools.

+

Fourteenth day. Many convulsions; extremities cold ; no further recovery of reason; urine suppressed.

+

Sixteenth day. Speechless.

+

Seventeenth day. Death.

+
+CASE XV +

In Thasos the wife of Delearces, who lay sick on the plain, was seized after a grief with an acute fever with shivering. From the beginning she would wrap herself up, and throughout, without speaking a word, she would fumble, pluck, scratch, pick hairs, weep and then laugh, but she did not sleep; though stimulated, the bowels passed nothing. She drank a little when the attendants suggested it. Urine thin and scanty; fever slight to the touch; coldness of the extremities.

+

Ninth day. Much wandering followed by return of reason; silent.

+

Fourteenth day. Respiration rare and large with long intervals,I take this, in apite of Galen, to mean with extra long intervals between each breath. The phrase is rather care-less but scarcely tautological. At intervals or after a long interval are possible meanings, but inconsistent with διὰ τέλεος later on. becoming afterwards short.

+

Seventeenth day. Bowels under a stimulus passed disordered matters, then her very drink passed unchanged; nothing coagulated. The patient noticed nothing; the skin tense and dry.

+

Twentieth day. Much rambling followed by recovery of reason; speechless; respiration short.

+

Twenty-first day. Death.

+

The respiration of this patient throughout was rare and large; took no notice of anything; she constantly wrapped herself up; either much rambling or silence throughout.In many ways this case, though one of the most picturesque, is also one of the most carelessly written. Galen points out that διὰ Χπόνον is ambiguous, and that its possible meanings are inconsistent with the rest of the description. How can the respiration be ἀραιόν throughout, when on both the fourteenth and the twentieth days the patient was βραχύπνοος? It is strange that the writer specifies the fourteenth day as the day when the respiration was rare and large, seeing that it had these characteristics throughout. A similar remark applies to ἀναισθήτως εἰχε πάντων of the seventeenth day. Further, ἀεὶ σιγῶσα of the second sentence becomes strangely ἣ λόγοι χολλοὶ ἣ σιγῶσα διὰ τέλεος in the last. I conclude that this medical history was hastily written and never revised. A slight revision could easily have cleared away the inconsistencies, which are, as Galen seems to have seen, more apparent than real.

+
+CASE XVI +

In Meliboea a youth took to his bed after being for a long time heated by drunkenness and sexual indulgence. He had shivering fits, nausea, sleeplessness, but no thirst.

+

First day. Copious, solid stools passed in abundance of fluid, and on the following days the excreta were copious, watery and of a greenish yellow. Urine thin, scanty and of no colour; respiration rare and large with long intervals; tension, soft underneath, of the hypochondrium,See note, p. 188. extending out to either side; continual throbbing throughout of the epigastrium;So Littré, following Galen. Perhaps, however, it means heart, i. e. there was violent palpitation. urine oily.

+

Tenth day. Delirious but quiet, for he was orderly and silent;Said by Galen, followed by Littré (who reads ἥσυχος for σιγῶν), to refer to the character of the young man when well, which interpretation to modern minds is rather inconsistent with the first sentence. They would paraphrase, the delirium was really serious, but appeared slight because the patient was naturally self-controlled and calm. I take the meaning to be that though delirious he remained quiet and comparatively silent. skin dry and tense; stools either copious and thin or bilious and greasy.

+

Fourteenth day. General exacerbation; delirious with much wandering talk.

+

Twentieth day. Wildly out of his mind; much tossing ; urine suppressed; slight quantities of drink were retained.

+

Twenty-fourth day. Death.

+ +
+ + + diff --git a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-grc2.xml b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-grc2.xml index df268e801..66a721077 100644 --- a/data/tlg0627/tlg006/tlg0627.tlg006.perseus-grc2.xml +++ b/data/tlg0627/tlg006/tlg0627.tlg006.perseus-grc2.xml @@ -44,7 +44,7 @@ William Heinemann Ltd. Cambridge, MA Harvard University Press -1923 +1923 1 diff --git a/data/tlg0627/tlg007/__cts__.xml b/data/tlg0627/tlg007/__cts__.xml index 94576b176..f48cb4ff8 100644 --- a/data/tlg0627/tlg007/__cts__.xml +++ b/data/tlg0627/tlg007/__cts__.xml @@ -3,7 +3,7 @@ Περὶ τῶν ἐν κεφαλῇ τρωμάτων - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg007/tlg0627.tlg007.perseus-eng2.xml b/data/tlg0627/tlg007/tlg0627.tlg007.perseus-eng2.xml index 7541125ee..94aade067 100644 --- a/data/tlg0627/tlg007/tlg0627.tlg007.perseus-eng2.xml +++ b/data/tlg0627/tlg007/tlg0627.tlg007.perseus-eng2.xml @@ -89,8 +89,8 @@

In the first place, one must examine the wounded person, in what part of the head the wound is situated, whether in the stronger or weaker parts; and ascertain respecting the hairs about the wound, whether they have been cut off by the instrument, and have gone into the wound; and if so, one should declare that the bone runs the risk of being denuded of flesh, and of having sustained some injury from the weapon. These things one should say from a distant inspection, and before laying a hand on the man; but on a close examination one should endeavor to ascertain clearly whether the bone be denuded of flesh or not; and if the denuded bone be visible to the eyes, this will be enough; but otherwise an examination must be made with the sound. And if you find the bone denuded of the flesh, and not safe from the wound, you must first ascertain the state of the bone, and the extent of the mischief, and of what assistance it stands in need. One should also inquire of the wounded person how and in what way he sustained the injury; and if it be not apparent whether the bone has sustained an injury or not, it will be still more necessary, provided the bone be denuded, to make inquiry how the wound occurred, and in what manner; for when contusions and fractures existin the bone, but are not apparent, we must ascertain, in the first place from the patient’s answers, whether or not the bone has sustained any such injuries, and then find out the nature of the case by word and deed, with the exception of sounding. For sounding does not discover to us whether the bone has sustained any of these injuries or not; but sounding discovers to us an indentation inflicted by a weapon, and whether a bone be depressed from its natural position, and whether the bone be strongly fractured; all which may also be ascertained visibly with the eyes.

And a bone sustains fractures, either so fine as to escape the sight, or such as are apparent, and contusions which are not apparent, and depression from its natural position, especially when one person is intentionally wounded by another, or when, whether intentionally or not, a blow or stroke is received from an elevated place, and if the instrument in the hand, whether used in throwing or striking, be of a powerful nature, and if a stronger person wound a weaker. Of those who are wounded in the parts about the bone, or in the bone itself, by a fall, he who falls from a very high place upon a very hard and blunt object is in most danger of sustaining a fracture and contusion of the bone, and of having it depressed from its natural position; whereas he that falls upon more level ground, and upon a softer object, is likely to suffer less injury in the bone, or it may not be injured at all. Of those instruments which, falling upon the head, wound the parts about the bone, or the bone itself, that which falls from a very high place, and the least on a level with the person struck, and which is at the same time very hard, very blunt, and very heavy, and which is the least light, sharp, and soft, such an instrument would occasion a fracture and contusion of the bone. And there is most danger that the bone may sustain these injuries, under such circumstances, when the wound is direct and perpendicular to the bone, whether struck from the hand or from a throw, or when any object falls upon the person, or when he is wounded by falling, or in whatever way the bone sustains a direct wound from this instrument. Those weapons which graze the bone obliquely are less apt to fracture, contuse, or depress the bone, even when the bone is denuded of flesh; for in some of those wounds thus inflicted the bone is not laid bare of the flesh. Those instruments more especially produce fractures in the bone, whether apparent or not, and contusions, and inward depression of the bone, which are rounded, globular, smooth on all sides, blunt, heavy, and hard; and such weapons bruise, compress, and pound the flesh; and the wounds inflicted by such instruments, whether obliquely or circularly, are round, and are more disposed to suppurate, and to have a discharge, and take longer time to become clean; for the flesh which has been bruised and pounded must necessarily suppurate and slough away. But weapons of an oblong form, being, for the most part, slender, sharp, and light, penetrate the flesh rather than bruise it, and the bone in like manner; and such an instrument may occasion a hedra and a cut (for a hedra and a cut are same thing); but weapons of this description do not produce contusions, nor fractures, nor depressions inwardly. And in addition the appearances in the bone, which you call detect by the sight, you should make inquiry as to all these particulars (for they are symptoms of a greater or less injury), whether the wounded person was stunned, and whether darkness was diffused over his eyes, and whether he had vertigo, and fell to the ground.

When the bone happens to be denuded of flesh by the weapon, and when the wound occurs upon the sutures, it is difficult to distinguish the indentation (hedra) of a weapon which is clearly recognized in other parts of the bone, whether it exist or not, and especially if the hedra be seated in the sutures themselves. For the suture being rougher than the rest of the bone occasions confusion, and it is not clear which is the suture, and which the mark inflicted by the instrument, unless the latter (hedra) be large. Fracture also for the most part is combined with the indentation when it occurs in the sutures; and this fracture is more difficult to discern when the bone is broken, on this account, that if there be a fracture, it is situated for the most part in the suture. For the bone is liable to be broken and slackened there, owing to the natural weakness of the bone there, and to its porosity, and from the suture being readily ruptured and slackened: but the other bones which surround the suture remain unbroken, because they are stronger than the suture. For the fracture which occurs at the suture is also a slackening of the suture, and it is not easy to detect whether the bone be broken and slackened by the indentation of a weapon occurring in the suture, or from a contusion of the bone at the sutures; but it is still more difficult to detect a fracture connected with contusion. For the sutures, having the appearance of fissures, elude the discernment and sight of the physician, as being rougher than the rest of the bone, unless the bone be strongly cut and slackened (for a cut and a hedra are the same thing). But it is necessary, if the wound has occurred at the sutures, and the weapon has impinged on the bone or the parts about it, to pay attention and find out what injury the bone has sustained. For a person wounded to the same, or a much smaller, extent, and by weapons of the same size and quality, and even much less, will sustain a much greater injury, provided he has received the blow at the sutures, than if it was elsewhere. And many of these require trepanning, but you must not apply the trepan to the sutures themselves, but on the adjoining bone.

-

And with regard to the cure of wounds in the head, and the mode of detecting injuries in the bone which are not apparent, the following is my opinion:- In a wound of the head, you must not apply anything liquid, not even wine, but as little as possible, nor a cataplasm, nor conduct the treatment with tents, nor apply a bandage to an ulcer on the head, unless it be situated on the forehead, in the part which is bare of hairs, or about the eyebrow and eye, for wounds occurring there require cataplasms and bandages more than upon any other part of the head. For the rest of the head surrounds the whole forehead, and the wounds wherever situated become inflamed and swelled, owing to an influx of blood from surrounding parts. And neither must you apply cataplasms and bandages to the forehead at all times; but when the inflammation is stopped and the swelling has subsided, you must give up the cataplasms and bandages. A wound in any other part of the head must not be treated with tents, bandages, or cataplasms, unless it also requires incision. You must perform incision on wounds situated on the head and forehead, whenever the bone is denuded of flesh, and appears to have sustained some injury from the blow, but the wound has not sufficient length and breadth for the inspection of the bone, so that it may be seen whether it has received any mischief from the blow, and of what nature the injury is, and to what extent the flesh has been contused, and whether the bone has sustained any injury, or whether it be uninjured by the blow, and has suffered no mischief; and with regard to the treatment, what the wound, and the flesh, and the injury of the bone stand in need of. Ulcers of this description stand in need of incision; and, if the bone be denuded of the flesh, and if it be hollow, and extend far obliquely, we cut up the cavity wherever the medicine cannot penetrate readily, whatever medicine it may be; and wounds which are more inclined to be circular and hollow, and for the most part others of the like shape, are cut up by making double incision in the circle lengthways, according to the figure of the man, so as to make the wound of a long form. Incisions may be practiced with impunity on other parts of the head, with the exception of the temple and the parts above it, where there is a vein that runs across the temple, in which region an incision is not to be made. For convulsions seize on a person who has been thus treated; and if the incision be on the left temple, the convulsions seize on the right side; and if the incision be on the right side, the convulsions take place on the left side.

-

When, then, you lay open a wound in the head on account of the bones having been denuded of the flesh, as wishing to ascertain whether or not the bone has received an injury from the blow, you must make an incision proportionate to the size of the wound, and as much as shall be judged necessary. And in making the incision you must separate the flesh from the bone where it is united to the membrane (pericranium?) and to the bone, and then fill the whole wound with a tent, which will expand the wound very wide next day with as little pain as possible; and along with the tents apply a cataplasm, consisting of a mass (maza) of fine flour pounded in vinegar, or boiled so as to render it as glutinous as possible. On the next day, when you remove the tent, having examined the bone to see what injury it has sustained, if the wound in the bone be not right seen by you, nor can you discover what mischief the bone itself has sustained, but the instrument seems to have penetrated to the bone so as to have injured it, you must scrape the bone with a raspatory to a depth and length proportionate to the suture of the patient, and again in a transverse direction, for the sake of the fractures which are not seen, and of the contusions which are not discovered, as not being accompanied with depression of the bone from its natural position. For the scraping discovers the mischief, if the injuries in the bone be not otherwise manifest. And if you perceive an indentation (hedra) left in the bone by the blow, you must scrape the dint itself and the surrounding bones, lest, as often happens, there should be a fracture and contusion, or a contusion alone, combined with the dint, and escape observation. And when you scrape the bone with the raspatory, and it appears that the wound in the bone requires the operation, you must not postpone it for three days, but do it during this period, more especially if the weather be hot, and you have had the management of the treatment from commencement. If you suspect that the bone is broken or contused, or has sustained both these injuries, having formed your judgement from the severity of the wound, and from the information of the patient, as that the person who inflicted the wound, provided it was done by another person, was remarkably strong, and that the weapon by which he was wounded was of a dangerous description, and then that the man had been seized with vertigo, dimness of vision, and stupor, and fell to the ground,- under these circumstances, if you cannot discover whether the bone be broken, contused, or both the one and the other, nor can see the truth of the matter, you must dissolve the jet-black ointment, and fill the wound with it when this dissolved, and apply a linen rag smeared with oil, and then a cataplasm of the maza with a bandage; and on the next day, having cleaned out the wound, scrape the bone with the raspatory. And if the bone is not sound, but fractured and contused, the rest of it which is scraped will be white; but the fracture and contusion, having imbibed the preparation, will appear black, while the rest of the bone is white. And you must again scrape more deeply the fracture where it appears black; and, if you thus remove the fissure, and cause it to disappear, you may conclude that there has been a contusion of the bone to a greater or less extent, which has occasioned the fracture that has disappeared under the raspatory; but it is less dangerous, and a matter of less consequence, when the fissure has been effaced. But if the fracture extend deep, and do not seem likely to disappear when scraped, such an accident requires trepanning. But having performed this operation, you must apply the other treatment to the wound.

+

And with regard to the cure of wounds in the head, and the mode of detecting injuries in the bone which are not apparent, the following is my opinion:— In a wound of the head, you must not apply anything liquid, not even wine, but as little as possible, nor a cataplasm, nor conduct the treatment with tents, nor apply a bandage to an ulcer on the head, unless it be situated on the forehead, in the part which is bare of hairs, or about the eyebrow and eye, for wounds occurring there require cataplasms and bandages more than upon any other part of the head. For the rest of the head surrounds the whole forehead, and the wounds wherever situated become inflamed and swelled, owing to an influx of blood from surrounding parts. And neither must you apply cataplasms and bandages to the forehead at all times; but when the inflammation is stopped and the swelling has subsided, you must give up the cataplasms and bandages. A wound in any other part of the head must not be treated with tents, bandages, or cataplasms, unless it also requires incision. You must perform incision on wounds situated on the head and forehead, whenever the bone is denuded of flesh, and appears to have sustained some injury from the blow, but the wound has not sufficient length and breadth for the inspection of the bone, so that it may be seen whether it has received any mischief from the blow, and of what nature the injury is, and to what extent the flesh has been contused, and whether the bone has sustained any injury, or whether it be uninjured by the blow, and has suffered no mischief; and with regard to the treatment, what the wound, and the flesh, and the injury of the bone stand in need of. Ulcers of this description stand in need of incision; and, if the bone be denuded of the flesh, and if it be hollow, and extend far obliquely, we cut up the cavity wherever the medicine cannot penetrate readily, whatever medicine it may be; and wounds which are more inclined to be circular and hollow, and for the most part others of the like shape, are cut up by making double incision in the circle lengthways, according to the figure of the man, so as to make the wound of a long form. Incisions may be practiced with impunity on other parts of the head, with the exception of the temple and the parts above it, where there is a vein that runs across the temple, in which region an incision is not to be made. For convulsions seize on a person who has been thus treated; and if the incision be on the left temple, the convulsions seize on the right side; and if the incision be on the right side, the convulsions take place on the left side.

+

When, then, you lay open a wound in the head on account of the bones having been denuded of the flesh, as wishing to ascertain whether or not the bone has received an injury from the blow, you must make an incision proportionate to the size of the wound, and as much as shall be judged necessary. And in making the incision you must separate the flesh from the bone where it is united to the membrane (pericranium?) and to the bone, and then fill the whole wound with a tent, which will expand the wound very wide next day with as little pain as possible; and along with the tents apply a cataplasm, consisting of a mass (maza) of fine flour pounded in vinegar, or boiled so as to render it as glutinous as possible. On the next day, when you remove the tent, having examined the bone to see what injury it has sustained, if the wound in the bone be not right seen by you, nor can you discover what mischief the bone itself has sustained, but the instrument seems to have penetrated to the bone so as to have injured it, you must scrape the bone with a raspatory to a depth and length proportionate to the suture of the patient, and again in a transverse direction, for the sake of the fractures which are not seen, and of the contusions which are not discovered, as not being accompanied with depression of the bone from its natural position. For the scraping discovers the mischief, if the injuries in the bone be not otherwise manifest. And if you perceive an indentation (hedra) left in the bone by the blow, you must scrape the dint itself and the surrounding bones, lest, as often happens, there should be a fracture and contusion, or a contusion alone, combined with the dint, and escape observation. And when you scrape the bone with the raspatory, and it appears that the wound in the bone requires the operation, you must not postpone it for three days, but do it during this period, more especially if the weather be hot, and you have had the management of the treatment from commencement. If you suspect that the bone is broken or contused, or has sustained both these injuries, having formed your judgement from the severity of the wound, and from the information of the patient, as that the person who inflicted the wound, provided it was done by another person, was remarkably strong, and that the weapon by which he was wounded was of a dangerous description, and then that the man had been seized with vertigo, dimness of vision, and stupor, and fell to the ground,—under these circumstances, if you cannot discover whether the bone be broken, contused, or both the one and the other, nor can see the truth of the matter, you must dissolve the jet-black ointment, and fill the wound with it when this dissolved, and apply a linen rag smeared with oil, and then a cataplasm of the maza with a bandage; and on the next day, having cleaned out the wound, scrape the bone with the raspatory. And if the bone is not sound, but fractured and contused, the rest of it which is scraped will be white; but the fracture and contusion, having imbibed the preparation, will appear black, while the rest of the bone is white. And you must again scrape more deeply the fracture where it appears black; and, if you thus remove the fissure, and cause it to disappear, you may conclude that there has been a contusion of the bone to a greater or less extent, which has occasioned the fracture that has disappeared under the raspatory; but it is less dangerous, and a matter of less consequence, when the fissure has been effaced. But if the fracture extend deep, and do not seem likely to disappear when scraped, such an accident requires trepanning. But having performed this operation, you must apply the other treatment to the wound.

You must be upon your guard lest the bone sustain any injury from the fleshy parts if not properly treated. When the bone has been sawed and otherwise denuded, whether it be actually sound, or only appears to be so, but has sustained some injury from the blow, there may be danger of its suppurating (although it would not otherwise have done so), if the flesh which surrounds the bone be ill cured, and become inflamed and strangled; for it gets into a febrile state, and becomes much inflamed. For the bone acquires heat and inflammation from the surrounding flesh, along with irritation and throbbing, and the other mischiefs which are in the flesh itself, and from these it gets into a state of suppuration. It is a bad thing for the flesh (granulations?) in an ulcer to be moist and mouldy, and to require a long time to become clean. But the wound should be made to suppurate as quickly as possible; for, thus the parts surrounding the wound would be the least disposed to inflammation, and would become the soonest clean; for the flesh which has been chopped and bruised by the blow, must necessarily suppurate and slough away. But when cleaned the wound must be dried, for thus the wound will most speedily become whole, when flesh devoid of humors grows up, and thus there will be no fungous flesh in the sore. The same thing applies to the membrane which surrounds the brain: for when, by sawing the bone, and removing it from the meninx, you lay the latter bare, you must make it clean and dry as quickly as possible, lest being in a moist state for a considerable time, it become soaked therewith and swelled; for when these things occur, there is danger of its mortifying.

A piece of bone that must separate from the rest of the bone, in consequence of a wound in the head, either from the indentation (hedra) of a blow in the bone, or from the bone being otherwise denuded for a long time, separates mostly by becoming exsanguous. For the bone becomes dried up and loses its blood by time and a multiplicity of medicines which are used; and the separation will take place most quickly, if one having cleaned the wound as quickly as possible will next dry it, and the piece of bone, whether larger or smaller. For a piece of bone which is quickly dried and converted, as it were, into a shell, is most readily separated from the rest of the bone which retains its blood and vitality; for, the part having become exsanguous and dry, more readily drops off from that which retains its blood and is alive.

Such pieces of bone as are depressed from their natural position, either being broken off or chopped off to a considerable extent, are attended with less danger, provided the membrane be safe; and bones which are broken by numerous and broader fractures are still less dangerous and more easily extracted. And you must not trepan any of them, nor run any risks in attempting to extract the pieces of bone, until they rise up of their own accord, upon the subsidence of the swelling. They rise up when the flesh (granulations) grows below, and it grows from the diploe of the bone, and from the sound portion, provided the upper table alone be in a state of necrosis. And the flesh will shoot up and grow below the more quickly, and the pieces of bone ascend, if one will get the wound to suppurate and make it clean as quickly as possible. And when both the tables of the bone are driven in upon the membrane, I mean the upper and lower, the wound, if treated in the same way, will very soon get well, and the depressed bones will quickly rise up.

diff --git a/data/tlg0627/tlg007/tlg0627.tlg007.perseus-grc2.xml b/data/tlg0627/tlg007/tlg0627.tlg007.perseus-grc2.xml index fcda30b92..d203a71a9 100644 --- a/data/tlg0627/tlg007/tlg0627.tlg007.perseus-grc2.xml +++ b/data/tlg0627/tlg007/tlg0627.tlg007.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg008/__cts__.xml b/data/tlg0627/tlg008/__cts__.xml index d9cd8e855..d9ecf61b9 100644 --- a/data/tlg0627/tlg008/__cts__.xml +++ b/data/tlg0627/tlg008/__cts__.xml @@ -2,8 +2,8 @@ De officina medici - Κατ' ἰητρεῖον - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Κατ’ ἰητρεῖον + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg008/tlg0627.tlg008.perseus-eng2.xml b/data/tlg0627/tlg008/tlg0627.tlg008.perseus-eng2.xml index 007aee646..566f2174b 100644 --- a/data/tlg0627/tlg008/tlg0627.tlg008.perseus-eng2.xml +++ b/data/tlg0627/tlg008/tlg0627.tlg008.perseus-eng2.xml @@ -75,13 +75,13 @@

It’s the business of the physician to know, in the first place, things similar and things dissimilar; those connected with things most important, most easily known, and in anywise known;The meaning of the first clause of this sentence, according to Galen, is, that the first thing which the medical practitioner must do is to make himself well acquainted with semeiology, by comparing carefully the condition of disease with that of health. In all cases of accident, it was the practice of the ancient surgeons to compare carefully the injured part with its fellow or corresponding part on the opposite side. which are to be seen, touched, and heard; which are to be perceived in the sight, and the touch, and the hearing, and the nose, and the tongue, and the understanding; which are to be known by all the means we know other things.

-

The things relating to surgery, are- the patient; the operator; the assistants; the instruments; the light, where and how; how many things, and how; where the body, and the instruments; the time; the manner; the place.

+

The things relating to surgery, are—the patient; the operator; the assistants; the instruments; the light, where and how; how many things, and how; where the body, and the instruments; the time; the manner; the place.

The operator is either sitting or standing, conveniently for himself, for the person operated upon, for the light. There are two kinds of light, the common and the artificial; the common is not at our disposal, the artificial is at our disposal. There are two modes of using each, either to the light, or from the light (to the side?). There is little use of that which is from (or oblique to the light), and the degree of it is obvious. As to opposite the light, we must turn the part to be operated upon to that which is most brilliant of present and convenient lights, unless those parts which should be concealed, and which it is a shame to look upon; thus the part that is operated upon should be opposite the light, and the operator opposite the part operated upon, except in so far as he does not stand in his own light; for in this case the operator will indeed see, but the thing operated upon will not be seen. With regard to himself when sitting, his feet should be raised to a direct line with his knees, and nearly in contact with one another; the knees a little higher than the groins, and at some distance from one another, for the elbows to rest upon them. The robe, in a neat and orderly manner, is to be thrown over the elbows and shoulders equally and proportionally. With regard to the part operated upon; we have to consider how far distant, and how near, above, below, on this side on that side, or in the middle. The measure as to distance and proximity is, that the elbows do not press the knees before, nor the sides behind; that the hands be not raised higher than the breasts, nor lower than so as that when the breast reposes on the knees he may have the hands at right angles with the arm: thus it is as regards the medium; but as concerns this side or that, the operator must not be beyond his seat, but in proportion as he may require turning he must shift the body, or part of the body, that is operated upon. When standing, he must make his inspection, resting firmly and equally on both feet; but he must operate while supporting himself upon either leg, and not the one on the same side with the hand which he makes use of; the knee being raised to the height of the groins as while sitting; and the other measures in like manner. The person operated upon should accommodate the operator with regard to the other parts of his body, either standing, sitting, or lying; so as that he may continue to preserve his figure, avoid sinking down, shrinking from, turning away; and may maintain the figure and position of the part operated upon, during the act of presentation, during the operation, and in the subsequent position.

The nails should be neither longer nor shorter than the points of the fingers; and the surgeon should practice with the extremities of the fingers, the index-finger being usually turned to the thumb; when using the entire hand, it should be prone; when both hands, they should be opposed to one another. It greatly promotes a dexterous use of the fingers when the space between them is large, and when the thumb is opposed to the index. But it is clearly a disease when the thumb is impaired from birth, or when, from a habit contracted during the time of nursing, it is impeded in its motions by the fingers. One should practice all sorts of work with either of them, and with both together (for they are both alike), endeavouring to do them well, elegantly, quickly, without trouble, neatly, and promptly.

The instruments, and when and how they should be prepared, will be treated of afterwards; so that they may not impede the work, and that there may be no difficulty in taking hold of them, with the part of the body which operates. But if another gives them, he must be ready a little beforehand, and do as you direct.

Those about the patient must present the part to be operated upon as may seem proper, and they must hold the rest of the body steady, in silence, and listening to the commands of the operator.

There are two views of bandaging: that which regards it while doing, and that which regards it when done. It should be done quickly, without pain, with ease, and with elegance; quickly, by despatching the work; without pain, by being readily done; with ease, by being prepared for everything; and with elegance, so that it may be agreeable to the sight. By what mode of training these accomplishments are to be acquired has been stated. When done, it should fit well and neatly; it is neatly done when with judgment, and when it is equal and unequal, according as the parts are equal or unequal. The forms of it (the bandage?) are the simple, the slightly winding (called ascia), the sloping (sima), the monoculus, the rhombus, and the semi-rhombus. The form of bandage should be suitable to the form and the affection of the part to which it is applied.

-

There are two useful purposes to be fulfilled by bandaging: (first,) strength, which is imparted by the compression and the number of folds. In one case the bandage effects the cure, and in another it contributes to the cure. For these purposes this is the rule- that the force of the constriction be such as to prevent the adjoining parts from separating, without compressing them much, and so that the parts may be adjusted but not forced together; and that the constriction be small at the extremities, and least of all in the middle. The knot and the thread that is passed through should not be in a downward but in an upward direction, regard being had to the circumstances under which the case is presented; to position, to the bandaging, and to the compression. The commencement of the ligatures is not to be placed at the wound, but where the knot is situated. The knot should not be placed where it will be exposed to friction, nor where it will be in the way, nor where it will be useless. The knot and the thread should be soft, and not large.

+

There are two useful purposes to be fulfilled by bandaging: (first,) strength, which is imparted by the compression and the number of folds. In one case the bandage effects the cure, and in another it contributes to the cure. For these purposes this is the rule—that the force of the constriction be such as to prevent the adjoining parts from separating, without compressing them much, and so that the parts may be adjusted but not forced together; and that the constriction be small at the extremities, and least of all in the middle. The knot and the thread that is passed through should not be in a downward but in an upward direction, regard being had to the circumstances under which the case is presented; to position, to the bandaging, and to the compression. The commencement of the ligatures is not to be placed at the wound, but where the knot is situated. The knot should not be placed where it will be exposed to friction, nor where it will be in the way, nor where it will be useless. The knot and the thread should be soft, and not large.

(Second.) One ought to be well aware that every bandage has a tendency to fall off towards the part that declines or becomes smaller; as, for example, upwards, in the case of the head, and downwards, in the case of the leg. The turns of the bandage should be made from right to left, and from left to right, except on the head, where it should be in a straight direction. When opposite parts are to be bandaged together, we must use a bandage with two heads; or if we make use of a bandage with one head, we must attach it in like manner at some fixed point: such, for example, as the middle of the head; and so in other cases. Those parts which are much exposed to motion, such as the joints, where there is a flexion, should have few and slight bandages applied to them, as at the ham; but where there is much extension, the bandage should be single and broad, as at the kneepan; and for the maintenance of the bandage in its proper place, some turns should be carried to those parts which are not much moved, and are lank, such as the parts above and below the knee. In the case of the shoulder; a fold should be carried round by the other armpit; in that of the groin, by the flanks of the opposite side; and of the leg, to above the calf of the leg. When the bandage has a tendency to escape above, it should be secured below, and vice versa; and where there is no means of doing this, as in the case of the head, the turns are to be made mostly on the most level part of the head, and the folds are to be done with as little obliquity as possible, so that the firmest part being last applied may secure the portions which are more movable. When we cannot secure the bandaging by means of folds of the cloth, nor by suspending them from the opposite side, we must have recourse to stitching it with ligatures, either passed circularly or in the form of a seam.

The bandages should be clean, light, soft, and thin. One should practice rolling with both hands together, and with either separately. One should also choose a suitable one, according to the breadth and thickness of the parts. The heads of the bandages should be hard, smooth, and neatly put on. That sort of bandaging is the worst which quickly falls off; but those are bad bandages which neither compress nor yet come off.

The following are the object which the upper bandage, the under bandage, or both aim at: The object of the under bandage is either to bring together parts that are separated, or to compress such as are expanded, or to separate what are contracted, or to restore to shape what are distorted, or the contrary. It is necessary to prepare pieces of linen cloth, which are light, thin, soft, clean, having no seams nor protuberances on them, but sound, and able to bear some stretching, or even a little more than required; not dry, but wetted with a juice suitable to the purpose required. We must deal with parts separated (in a sinus?) in such wise, that the parts which are raised may touch the bottom without producing pressure; we must begin on the sound part, and terminate at the wound; so that whatever humor is in it may be expelled, and that it may be prevented from collecting more. And straight parts are to be bandaged in a straight direction, and oblique obliquely, in such a position as to create no pain; and so that there may be no constriction nor falling off on a change of position, either for the purpose of taking hold of anything, or laying the limb; and that muscles, veins, nerves, and bones may be properly placed and adjusted to one another. It should be raised or laid in a natural position, so as not to occasion pain. In those cases in which an abscess is formed, we must act in a contrary way. When our object is to bring together parts which have become expanded, in other respects we must proceed on the same plain; and we must commence the bringing together from some considerable distance; and after their approach, we must apply compression, at first slight, and afterwards stronger, the limit of it being the actual contact of the parts. In order to separate parts which are drawn together, when attended with inflammation, we must proceed on the opposite plan; but when without inflammation, we must use the same preparations, but bandage in the opposite direction. In order to rectify distorted parts, we must proceed otherwise on the same principles; but the parts which are separated must be brought together by an underbandage, by agglutinants, and by suspending it (the limb?) in its natural position. And when the deformities are the contrary, this is to be done on the contrary plan.

diff --git a/data/tlg0627/tlg008/tlg0627.tlg008.perseus-grc2.xml b/data/tlg0627/tlg008/tlg0627.tlg008.perseus-grc2.xml index 50df861da..eacca9218 100644 --- a/data/tlg0627/tlg008/tlg0627.tlg008.perseus-grc2.xml +++ b/data/tlg0627/tlg008/tlg0627.tlg008.perseus-grc2.xml @@ -4,7 +4,7 @@ -Κατ' ἰητρεῖον +Κατ’ ἰητρεῖον Hippocrates Émile Littré Gregory Crane @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg009/__cts__.xml b/data/tlg0627/tlg009/__cts__.xml index 4bd89d1ed..7d4c48f33 100644 --- a/data/tlg0627/tlg009/__cts__.xml +++ b/data/tlg0627/tlg009/__cts__.xml @@ -3,7 +3,7 @@ Περὶ ἀγμῶν - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 3. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg009/tlg0627.tlg009.perseus-eng2.xml b/data/tlg0627/tlg009/tlg0627.tlg009.perseus-eng2.xml index a2899b605..9b0980bf7 100644 --- a/data/tlg0627/tlg009/tlg0627.tlg009.perseus-eng2.xml +++ b/data/tlg0627/tlg009/tlg0627.tlg009.perseus-eng2.xml @@ -139,7 +139,7 @@

Moreover, the greater part of physicians treat fractures, both with and without an external wound, during the first days, by means of unwashed wool, and there does not appear to be anything improper in this. It is very excusable for those who are called upon to treat newly-received accidents of this kind, and who have no cloth for bandages at hand, to do them up with wool; for, except cloth for bandages, one could not have anything better than wool in such cases; but a good deal should be used for this purpose, and it should be well carded and not rough, for in small quantity and of a bad quality it has little power. But those who approve of binding up the limb with wool for a day or two, and on the third and fourth apply bandages, and make the greatest compression and extension at that period, such persons show themselves to be ignorant of the most important principles of medicine; for, in a word, at no time is it so little proper to disturb all kinds of wounds as on the third and fourth day; and all sort of probing should be avoided on these days in whatever other injuries are attended with irritation. For, generally, the third and fourth day in most cases of wounds, are those which give rise to exacerbations, whether the tendency be to inflammation, to a foul condition of the sore, or to fevers. And if any piece of information be particularly valuable this is; to which of the most important cases in medicine does it not apply? and that not only in wounds but in many other diseases, unless one should call all other diseases wounds. And this doctrine is not devoid of a certain degree of plausibility, for they are allied to one another in many respects. But those who maintain that wool should be used until after the first seven days, and then that the parts should be extended and adjusted, and secured with bandages, would appear not to be equally devoid of proper judgment, for the proper judgment, for the most dangerous season for inflammation is then past, and the bones being loose can be easily set after the lapse of these days. But still this mode of treatment is far inferior to that with bandages from the commencement; for, the latter method exhibits the patient on the seventh day free from inflammation, and ready for complete bandaging with splints; while the former method is far behind in this respect, and is attended with many other bad effects which it would be tedious to describe.

-

In those cases of fracture in which the bones protrude and cannot be restored to their place, the following mode of reduction may be practiced:- Some small pieces of iron are to be prepared like the levers which the cutters of stone make use of, one being rather broader and another narrower; and there should be three of them at least, and still more, so that you may use those that suit best; and then, along with extension, we must use these as levers, applying the under surface of the piece of iron to the under fragment of the bone, and the upper surface to the upper bone; and, in a word, we must operate powerfully with the lever as we would do upon a stone or a piece of wood. The pieces of iron should be as strong as possible, so that they may not bend. This is a powerful assistance, provided the pieces of iron be suitable, and one use them properly as levers. Of all the mechanical instruments used by men, the most powerful are these three, the axis in peritrochio, the lever, and the wedge. Without these, one or all, men could not perform any of their works which require great force. Wherefore, reduction with the lever is not to be despised, for the bones will be reduced in this way, or not at all. But if the upper fragment which rides over the other does not furnish a suitable point of support a suitable point of support for the lever, but the protruding part is sharp, you must scoop out of the bone what will furnish a proper place for the lever to rest on. The lever, along with extension, may be had recourse to on the day of the accident, or next day, but by no means on the third, the fourth, and the fifth. For if the limb is disturbed on these days, and yet the fractured bones not reduced, inflammation will be excited, and this no less if they are reduced; for convulsions are more apt to occur if reduction take place, than if the attempt should fail. These facts should be well known, for if convulsions should come on when reduction is effected, there is little hope of recovery; but it is of use to displace the bones again if this can be done with out trouble. For it is not at the time when the parts are in a particularly relaxed condition that convulsions and tetanus are apt to supervene, but when they are more than usually tense. In the case we are now treating of, we should not disturb the limb on the aforesaid days, but strive to keep the wound as free from inflammation as possible, and especially encourage suppuration in it. But when seven days have elapsed, or rather more, if there be no fever, and if the wound be not inflamed, then there will be less to prevent an attempt at reduction, if you hope to succeed; but otherwise you need not take and give trouble in vain.

+

In those cases of fracture in which the bones protrude and cannot be restored to their place, the following mode of reduction may be practiced:— Some small pieces of iron are to be prepared like the levers which the cutters of stone make use of, one being rather broader and another narrower; and there should be three of them at least, and still more, so that you may use those that suit best; and then, along with extension, we must use these as levers, applying the under surface of the piece of iron to the under fragment of the bone, and the upper surface to the upper bone; and, in a word, we must operate powerfully with the lever as we would do upon a stone or a piece of wood. The pieces of iron should be as strong as possible, so that they may not bend. This is a powerful assistance, provided the pieces of iron be suitable, and one use them properly as levers. Of all the mechanical instruments used by men, the most powerful are these three, the axis in peritrochio, the lever, and the wedge. Without these, one or all, men could not perform any of their works which require great force. Wherefore, reduction with the lever is not to be despised, for the bones will be reduced in this way, or not at all. But if the upper fragment which rides over the other does not furnish a suitable point of support a suitable point of support for the lever, but the protruding part is sharp, you must scoop out of the bone what will furnish a proper place for the lever to rest on. The lever, along with extension, may be had recourse to on the day of the accident, or next day, but by no means on the third, the fourth, and the fifth. For if the limb is disturbed on these days, and yet the fractured bones not reduced, inflammation will be excited, and this no less if they are reduced; for convulsions are more apt to occur if reduction take place, than if the attempt should fail. These facts should be well known, for if convulsions should come on when reduction is effected, there is little hope of recovery; but it is of use to displace the bones again if this can be done with out trouble. For it is not at the time when the parts are in a particularly relaxed condition that convulsions and tetanus are apt to supervene, but when they are more than usually tense. In the case we are now treating of, we should not disturb the limb on the aforesaid days, but strive to keep the wound as free from inflammation as possible, and especially encourage suppuration in it. But when seven days have elapsed, or rather more, if there be no fever, and if the wound be not inflamed, then there will be less to prevent an attempt at reduction, if you hope to succeed; but otherwise you need not take and give trouble in vain.

When you have reduced the bones to their place, the modes of treatment, whether you expect the bones to exfoliate or not, have been already described. All those cases in which an exfoliation of bone is expected, should be treated by the method of bandaging with cloths, beginning for the most part at the middle of the bandage, as is done with the double-headed bandage; but particular attention should be paid to the shape of the wound, so that its lips may gape or be distorted as little as possible under the bandage. Sometimes the turns of the bandage have to be made to the right, and sometimes to the left, and sometimes a double-headed bandage is to be used.

diff --git a/data/tlg0627/tlg009/tlg0627.tlg009.perseus-grc2.xml b/data/tlg0627/tlg009/tlg0627.tlg009.perseus-grc2.xml index 833ffa7bc..2eb8e3ad7 100644 --- a/data/tlg0627/tlg009/tlg0627.tlg009.perseus-grc2.xml +++ b/data/tlg0627/tlg009/tlg0627.tlg009.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg010/__cts__.xml b/data/tlg0627/tlg010/__cts__.xml index 4d2027797..d921f886a 100644 --- a/data/tlg0627/tlg010/__cts__.xml +++ b/data/tlg0627/tlg010/__cts__.xml @@ -3,7 +3,7 @@ Περὶ ἄρθρων - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). On the Articulations diff --git a/data/tlg0627/tlg010/tlg0627.tlg010.perseus-eng2.xml b/data/tlg0627/tlg010/tlg0627.tlg010.perseus-eng2.xml index 474bf26bb..6069f03ed 100644 --- a/data/tlg0627/tlg010/tlg0627.tlg010.perseus-eng2.xml +++ b/data/tlg0627/tlg010/tlg0627.tlg010.perseus-eng2.xml @@ -93,7 +93,7 @@

In cases of dislocation those persons who are not attacked with inflammation of the surrounding parts, can use the shoulder immediately without pain, and do not think it necessary to take any precautions with themselves; it is therefore the business of the physician to warn them beforehand that dislocation is more likely to return in such cases than when the tendons have been inflamed. This remark applies to all the articulations, but particularly to those of the shoulder and knee, for these are the joints most subject to luxations. But those who have inflammation of the ligaments cannot use the shoulder, for the pain and the tension induced by the inflammation prevent them. Such cases are to be treated with cerate, compresses, and plenty of bandages; but a ball of soft clean wool is to be introduced into the armpit, to fill up the hollow of it, that it may be a support to the bandaging, and maintain the joint in situ. The arm, in general, should be inclined upward as much as possible, for thus it will be kept at the greatest possible distance from the place at which the head of the humerus escaped. And when you bandage the shoulder you must fasten the arms to the sides with a band, which is to be carried round the body. The shoulder should be rubbed gently and softly. The physician ought to be acquainted with many things, and among others with friction; for from the same name the same results are not always obtained; for friction could brace a joint when unseasonably relaxed, and relax it when unseasonably hard; but we will define what we know respecting friction in another place. The shoulder, then, in such a state, should be rubbed with soft hands; and, moreover, in a gentle manner, and the joint should be moved about, but not roughly, so as to excite pain. Things get restored sometimes in a greater space of time, and sometimes in a smaller.

-

A dislocation may be recognized by the following symptoms:-Since the parts of a man’s body are proportionate to one another, as the arms and the legs, the sound should always be compared with the unsound, and the unsound with the sound, not paying regard to the joints of other individuals (for one person’s joints are more prominent than another’s), but looking to those of the patient, to ascertain whether the sound joint be unlike the unsound. This is a proper rule, and yet it may lead to much error; and on this account it is not sufficient to know this art in theory, but also by actual practice; for many persons from pain, or from any other cause, when their joints are not dislocated, cannot put the parts into the same positions as the sound body can be put into; one ought therefore to know and be acquainted beforehand with such an attitude. But in a dislocated joint the head of the humerus appears lying much more in the armpit than it is in the sound joint; and also, above, at the top of the shoulder, the part appears hollow, and the acromion is prominent, owing to the bone of the joint having sunk into the part below; there is a source of error in this case also, as will be described afterward, for it deserves to be described; and also, the elbow of the dislocated arm is farther removed from the ribs than that of the other; but by using force it may be approximated, though with considerable pain; and also they cannot, with the elbow extended, raise the arm to the ear, as they can the sound arm, nor move it about as formerly in this direction and that. These, then, are the symptoms of dislocation at the shoulder. The methods of reduction and the treatment are as described.

+

A dislocation may be recognized by the following symptoms:—Since the parts of a man’s body are proportionate to one another, as the arms and the legs, the sound should always be compared with the unsound, and the unsound with the sound, not paying regard to the joints of other individuals (for one person’s joints are more prominent than another’s), but looking to those of the patient, to ascertain whether the sound joint be unlike the unsound. This is a proper rule, and yet it may lead to much error; and on this account it is not sufficient to know this art in theory, but also by actual practice; for many persons from pain, or from any other cause, when their joints are not dislocated, cannot put the parts into the same positions as the sound body can be put into; one ought therefore to know and be acquainted beforehand with such an attitude. But in a dislocated joint the head of the humerus appears lying much more in the armpit than it is in the sound joint; and also, above, at the top of the shoulder, the part appears hollow, and the acromion is prominent, owing to the bone of the joint having sunk into the part below; there is a source of error in this case also, as will be described afterward, for it deserves to be described; and also, the elbow of the dislocated arm is farther removed from the ribs than that of the other; but by using force it may be approximated, though with considerable pain; and also they cannot, with the elbow extended, raise the arm to the ear, as they can the sound arm, nor move it about as formerly in this direction and that. These, then, are the symptoms of dislocation at the shoulder. The methods of reduction and the treatment are as described.

It deserves to be known how a shoulder which is subject to frequent dislocations should be treated. For many persons owing to this accident have been obliged to abandon gymnastic exercises, though otherwise well qualified for them; and from the same misfortune have become inept in warlike practices, and have thus perished. And this subject deserves to be noticed, because I have never known any physician treat the case properly; some abandon the attempt altogether, and others hold opinions and practice the very what is proper. For physicians have burned the shoulders subject to dislocation, at the top of the shoulder, at the anterior part where the head of the humerus protrudes, and a little behind the top of the shoulder; these burnings, if the dislocation of the arm were upward, or forward, or backward, would have been properly performed; but now, when the dislocation is downward, they rather promote than prevent dislocations, for they shut out the head of the humerus from the free space above. The cautery should be applied thus: taking hold with the hands of the skin at the armpit, it is to be drawn into the line, in which the head of the humerus is dislocated; and then the skin thus drawn aside is to be burnt to the opposite side. The burnings should be performed with irons, which are not thick nor much rounded, but of an oblong form (for thus they pass the more readily through), and they are to be pushed forward with the hand; the cauteries should be red-hot, that they may pass through as quickly as possible; for such as are thick pass through slowly, and occasion eschars of a greater breadth than convenient, and there is danger that the cicatrices may break into one another; which, although nothing very bad, is most unseemly, or awkward. When you have burnt through, it will be sufficient, in most cases, to make eschars only in the lower part; but if there is no danger of the ulcers passing into one another, and there is a considerable piece of skin between them, a thin spatula is to be pushed through these holes which have been burned, while, at the same time, the skin is stretched, for otherwise the instrument could not pass through; but when you have passed it through you must let go the skin, and then between the two eschars you should form another eschar with a slender iron, and burn through until you come in contact with the spatula. The following directions enable you to determine how much of the skin of the armpit should be grasped; all men have glands in the armpit greater or smaller, and also in many other parts of the body. But I will treat in another work of the whole constitution of the glands, and explain what they are, what they signify, and what are their offices. The glands, then, are not to be taken hold of, nor the parts internal to the glands; for this would be attended with great danger, as they are adjacent to the most important nerves. But the greater part of the substances external to the glands are to be grasped, for there is no danger from them. And this, also, it is proper to know, that if you raise the arm much, you will not be able to grasp any quantity of skin worth mentioning, for it is all taken up with the stretching; and also the nerves, which by all means you must avoid wounding, become exposed and stretched in this position; but if you only raise the arm a little, you can grasp a large quantity of skin, and the nerves which you ought to guard against are left within, and at a distance from the operation. Should not, then, the utmost pains be taken in the whole practice of the art to find out the proper attitude in every case? So much regarding the armpit, and these contractions will be sufficient, provided the eschars be properly placed. Without the armpit there are only two places where one might place the eschars to obviate this affection; the one before and between the head of the humerus and the tendon at the armpit; and then the skin may be fairly burned through, but not to any great depth, for there is a large vein adjacent, and also nerves, neither of which must be touched with the heat. But externally, one may form another eschar considerably above the tendon at the armpit, but a little below the head of the humerus; and the skin must be burned fairly through, but it must not be made very deep, for fire is inimical to the nerves. Through the whole treatment the sores are to be so treated, as to avoid all strong extension of the arm, and this is to be done moderately, and only as far as the dressing requires; for thus they will be less cooled (for it is of importance to cover up all sorts of burns if one would treat them mildly), and then the lips of them will be less turned aside; there will be less hemorrhage and fear of convulsions. But when the sores have become clean, and are going on to cicatrization, then by all means the arm is to be bound to the side night and day; and even when the ulcers are completely healed, the arm must still be bound to the side for a long time; for thus more especially will cicatrization take place, and the wide space into which the humerus used to escape will become contracted.

@@ -159,7 +159,7 @@

When the spine protrudes backward, in consequence of a fall, it seldom happens that one succeeds in straightening it. Wherefore succussion on a ladder has never straightened anybody, as far as I know, but it is principally practiced by those physicians who seek to astonish the mob-for to such persons these things appear wonderful, for example, if they see a man suspended or thrown down, or the like; and they always extol such practices, and never give themselves any concern whatever may result from the experiment, whether bad or good. But the physicians who follow such practices, as far as I have known them, are all stupid. The device, however, is an old one, and I give great praise to him who first invented this, and any other mechanical contrivance which is according to nature. For neither would I despair, but that if succussion were properly gone about, the spine, in certain cases, might be thereby rectified. But, indeed, for my own part, I have been ashamed to treat all such cases in this way, because such modes of procedure are generally practiced by charlatans.

-

Those cases in which the gibbosity is near the neck, are less likely to be benefited by these succussions with the head downward, for the weight of the head, and tops of the shoulders, when allowed to hang down, is but small; and such cases are more likely to be made straight by succussion applied with the feet hanging down, since the inclination downward is greater in this way. When the hump is lower down, it is more likely in this case that succussion with the head downward should do good. If one, then, should think of trying succussion, it may be applied in the following manner:-The ladder is to be padded with leather lined cushions, laid across, and well secured to one another, to a somewhat greater extent, both in length and breadth, than the space which the man’s body will occupy; he is then to be laid on the ladder upon his back, and the feet, at the ankles, are to be fastened, at no great distance from one another, to the ladder, with some firm but soft band; and he is further to be secured, in like manner, both above and below the knee, and also at the nates; and at the groins and chest loose shawls are to be put round in such a fashion as not to interfere with the effect of the succussion; and his arms are to be fastened along his sides to his own body, and not to the ladder. When you have arranged these matters thus, you must hoist up the ladder, either to a high tower or to the gable-end of a house; but the place where you make the succussion should be firm, and those who perform the extension should be well instructed, so that they may let go their hold equally to the same extent, and suddenly, and that the ladder may neither tumble to the ground on either side, nor they themselves fall forward. But, if the ladder be let go from a tower, or the mast of a ship, fastened into the ground with its cordage, it will be better, so that the ropes run upon a pulley or axle-tree. But it is disagreeable even to enlarge upon these matters; and yet, by the contrivances now described, the proper succussion may be made.

+

Those cases in which the gibbosity is near the neck, are less likely to be benefited by these succussions with the head downward, for the weight of the head, and tops of the shoulders, when allowed to hang down, is but small; and such cases are more likely to be made straight by succussion applied with the feet hanging down, since the inclination downward is greater in this way. When the hump is lower down, it is more likely in this case that succussion with the head downward should do good. If one, then, should think of trying succussion, it may be applied in the following manner:—The ladder is to be padded with leather lined cushions, laid across, and well secured to one another, to a somewhat greater extent, both in length and breadth, than the space which the man’s body will occupy; he is then to be laid on the ladder upon his back, and the feet, at the ankles, are to be fastened, at no great distance from one another, to the ladder, with some firm but soft band; and he is further to be secured, in like manner, both above and below the knee, and also at the nates; and at the groins and chest loose shawls are to be put round in such a fashion as not to interfere with the effect of the succussion; and his arms are to be fastened along his sides to his own body, and not to the ladder. When you have arranged these matters thus, you must hoist up the ladder, either to a high tower or to the gable-end of a house; but the place where you make the succussion should be firm, and those who perform the extension should be well instructed, so that they may let go their hold equally to the same extent, and suddenly, and that the ladder may neither tumble to the ground on either side, nor they themselves fall forward. But, if the ladder be let go from a tower, or the mast of a ship, fastened into the ground with its cordage, it will be better, so that the ropes run upon a pulley or axle-tree. But it is disagreeable even to enlarge upon these matters; and yet, by the contrivances now described, the proper succussion may be made.

But if the hump be situated very high up, and if succussion be by all means to be used, it will be better to do it with the feet downward, as has been said, for the force downward will be the greater in this case. The patient is to be well fastened to the ladder by cords at the breast, at the neck by means of a very loose shawl so as merely to keep the part properly on the ladder, and the head is to be fastened to the ladder at the forehead, the arms are to be stretched along and attached to the patient’s body, and not to the ladder, and the rest of the body is not to be bound, except so as to keep it in place by means of a loose shawl wrapped round it and the ladder; attention, moreover, should be paid that these ligatures do not interfere with the force of the succussion, and the legs are not to be fastened to the ladder, but should be placed near one another, so as to be in line with the spine. These matters should be thus arranged, if recourse is to be had at all to succussion on a ladder; for it is disgraceful in every art, and more especially in medicine, after much trouble, much display, and much talk, to do no good after all.

@@ -219,21 +219,21 @@

It has been formerly stated by us that it will be of importance for any person who practices medicine in a populous city to get prepared a quadrangular board, about six cubits or a little more in length, and about two cubits in breadth; a fathom will be sufficient thickness for it; and then along it from the one end to the other, an excavation must be made, so that the working of the levers may not be higher than is proper; then at both sides we are to raise short, strong, and strongly-fixed posts, having axles; and in the middle of the bench five or six long grooves are to be scooped out about four inches distant from one another, three inches will be a sufficient breadth for them, and the depth in like manner; and although the number of grooves I have mentioned will be sufficient, there is nothing to prevent their being made all over the bench. And the bench should have in its middle a pretty deep hole, of a square shape, and of about three inches in size; and into this hole, when judged necessary, is to be adjusted a corresponding piece of wood, rounded above, which, at the proper time, is to be adjusted between the perineum and the head of the thigh-bone. This upright piece of wood prevents the body from yielding to the force dragging downward by the feet; for sometimes this piece of wood serves the purpose of counter-extension upward; and sometimes, too, when extension and counter-extension are made, this piece of wood, if susceptible of some motion to this side or that, will serve the purpose of a lever for pushing the head of the thigh-bone outward. It is on this account that several grooves are scooped out on the bench, so that this piece of wood, being erected at the one which answers, may act as a lever, either on the sides of the articular heads of bones, or may make pressure direct on the heads along with the extension, according as it may suit to push inward or outward with the lever; and the lever may be either of a round or broad form, as may be judged proper; for sometimes the one form and sometimes the other suits with the articulation. This mode of applying the lever along with extension is applicable in the reduction of all dislocations of the thigh. In the case now on hand, a round lever is proper; but in dislocations outward a flat lever will be the suitable one. By means of such machines and of such powers, it appears to me that we need never fail in reducing any dislocation at a joint.

-

And one might find out other modes of reduction for this joint. If the large bench were to have raised on it two posts about a foot (in diameter?), and of a suitable height, on each side near its middle, and if a transverse piece of wood like the step of a ladder, were inserted in the posts, then if the sound leg were carried through between the posts, and the injured limb were brought over the transverse piece of wood, which should be exactly adapted in height to the joint which is dislocated (and it is an easy matter so to adjust it, for the step of the ladder should be made a little higher than required, and a convenient robe, folded several times, is to be laid below the patient’s body), then a piece of wood, of suitable breadth and length, is to be laid below the limb, and it should reach from the ankle to beyond the head of the thigh-bone, and should be bound moderately tight to the limb. Then the limb being extended, either by means of the pestle-like piece of wood (formerly described), or by any of the other methods of extension, the limb which is carried over the step with the piece of wood attached to it, is to be forced downward, while somebody grasps the patient above the hip-joint. In this manner the extension will carry the head of the thighbone above the acetabulum, while the lever power that is exercised will push the head of the thigh-bone into its natural seat. All the above-mentioned powers are strong, and more than sufficient to rectify the accident, if properly and skill- fully applied. For, as formerly stated, in most cases reduction may be effected by much weaker extension, and an inferior apparatus.

+

And one might find out other modes of reduction for this joint. If the large bench were to have raised on it two posts about a foot (in diameter?), and of a suitable height, on each side near its middle, and if a transverse piece of wood like the step of a ladder, were inserted in the posts, then if the sound leg were carried through between the posts, and the injured limb were brought over the transverse piece of wood, which should be exactly adapted in height to the joint which is dislocated (and it is an easy matter so to adjust it, for the step of the ladder should be made a little higher than required, and a convenient robe, folded several times, is to be laid below the patient’s body), then a piece of wood, of suitable breadth and length, is to be laid below the limb, and it should reach from the ankle to beyond the head of the thigh-bone, and should be bound moderately tight to the limb. Then the limb being extended, either by means of the pestle-like piece of wood (formerly described), or by any of the other methods of extension, the limb which is carried over the step with the piece of wood attached to it, is to be forced downward, while somebody grasps the patient above the hip-joint. In this manner the extension will carry the head of the thighbone above the acetabulum, while the lever power that is exercised will push the head of the thigh-bone into its natural seat. All the above-mentioned powers are strong, and more than sufficient to rectify the accident, if properly and skillfully applied. For, as formerly stated, in most cases reduction may be effected by much weaker extension, and an inferior apparatus.

If the head of the bone slip outward, extension and counter-extension must be made as described, or in a similar manner. But along with the extension a broad lever is to be used to force the bone from without inward, the lever being placed at the nates or a little farther up, and some person is to steady the patient’s body, so that it may not yield, either by grasping him at the buttocks with his hands, or this may be effected by means of another similar lever, adjusted to one of the grooves, while the patient has something laid below him, and he is secured, and the dislocated thigh is to be turned gently from within outward at the knee. Suspension will not answer in this form of dislocation, for, in this instance, the arm of the person suspended from him, would push the head of the thigh-bone from the acetabulum. But one might use the piece of wood placed below him as a lever, in such a manner as might suit with this mode of dislocation; it must work from without. But what use is there for more words? For if the extension be well and properly done, and if the lever be properly used, what dislocation of the joint could occur, that might not be thus reduced?

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In dislocation of the thigh, backward, extension and counter-extension should be made as has been described; and having laid on the bench a cloth which has been folded several times, so that the patient may lie soft, he is to be laid on his face, and extension thus made, and, along with the extension, pressure is to be made with a board, as in the case of humpback, the board being placed on the region of the nates, and rather below than above the hip-joint; and the hole made in the wall for the board should not be direct over, but should be inclined a little downward, toward the feet. This mode of reduction is particularly appropriate to this variety of dislocation, and at the same time is very strong. But perhaps, instead of the board, it might be sufficient to have a person sitting (on the seat of luxation?), or pressing with his hands, or with his foot, and suddenly raising himself up, along with the extension. None of the other afore- mentioned modes of reduction are natural in this form of dislocation.

+

In dislocation of the thigh, backward, extension and counter-extension should be made as has been described; and having laid on the bench a cloth which has been folded several times, so that the patient may lie soft, he is to be laid on his face, and extension thus made, and, along with the extension, pressure is to be made with a board, as in the case of humpback, the board being placed on the region of the nates, and rather below than above the hip-joint; and the hole made in the wall for the board should not be direct over, but should be inclined a little downward, toward the feet. This mode of reduction is particularly appropriate to this variety of dislocation, and at the same time is very strong. But perhaps, instead of the board, it might be sufficient to have a person sitting (on the seat of luxation?), or pressing with his hands, or with his foot, and suddenly raising himself up, along with the extension. None of the other aforementioned modes of reduction are natural in this form of dislocation.

In dislocation forward, the same mode of extension should be made; but a person who has very strong hands, and is well trained, should place the palm of the one hand on the groin, and taking hold of this hand with the other, is at the same time to push the dislocated part downward, and at the same time to the fore part of the knee. This method of reduction is most especially conformable to this mode of dislocation. And the mode of suspension is also not far removed from being natural, but the person suspended should be well trained, so that his arm may not act as a lever upon the joint, but that the force of the suspension may act about the middle of the perineum, and at the os sacrum.

Reduction by the bladder is also celebrated in dislocations at this joint, and I have seen certain persons who, from ignorance, attempted to reduce both dislocations outward and backward therewith, not knowing that they were rather displacing than replacing the parts; it is clear, however, that he who first invented this method intended it for dislocation inward. It is proper, then, to know how the bladder should be used, if it is to be used, and it should be understood that many other methods are more powerful than it. The bladder should be placed between the thighs uninflated, so that it may be carried as far up the perineum as possible, and the thighs beginning at the patella are to be bound together with a swathe, as far up as the middle of the thigh, and then a brass pipe is to be introduced into one of the loose feet of the bladder, and air forced into it, the patient is to lie on his side with the injured limb uppermost. This, then, is the preparation; some, however, do the thing worse than as I have described, for they do not bind the thighs together to any extent, but only at the knees, neither do they make extension, whereas extension should be made, and yet some people by having the good fortune to meet with a favorable case, have succeeded in making reduction. But it is not a convenient method of applying force, for the bladder, when inflated, does not present its most prominent part to the articular extremity of the femur, which is the place that ought to be more especially pressed outward, but its middle, which probably corresponds with the middle of the thigh, or still lower down, for the thighs are naturally curved, being fleshy, and in contact above, and becoming smaller downward, so that the natural configuration of the parts forces the bladder from the most proper place. And if a small bladder be introduced, its power will be small, and unable to overcome the resistance of the articular bone. But if the bladder must be used, the thighs are to be bound together to a considerable extent, and the bladder is to be inflated along with the extension of the body, and in this method of reduction both legs are to be bound together at their extremity.

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The prime object of the physician in the whole art of medicine should be to cure that which is diseased; and if this can be accomplished in various ways, the least troublesome should be selected; for this is more becoming a good man, and one well skilled in the art, who does not covet popular coin of base alloy. With regard to the subject now on hand, the following are domestic means of making extension of the body, so that it is easy to choose from among the things at hand:-In the first place, when soft and supple thongs are not at hand for ligatures, either iron chains, or cords, or cables of ships, are to be wrapped round with scarfs or pieces of woolen rags, especially at the parts of them which are to be applied, and in this state they are to be used as bands. In the second place, the patient is to be comfortably laid on the strongest and largest couch that is at hand, and the feet of the couch, either those at the (patient’s?) head, or those at the feet, are to be fastened to the threshold, either within or without, as is most suitable; and a square piece of wood is to be laid across, and extending from the one foot to the other; and if this piece of wood be slender, it should be bound to the feet of the couch, but, not withstanding, if it be thick, there will be no necessity for this; then the heads of the ligatures, both of those at the head and those at the feet, are to be fastened to a pestle, or some such piece of wood, difficult to reduce at either end; the ligatures should run along the line of the body, or be a little elevated above it, and it should be stretched proportionally to the pestles, so that, standing erect, the one may be fastened to the threshold, and the other to the transverse piece of wood. Extension is then to be made by bending back the ends of the pestles. A ladder, having strong steps, if laid below the bed, will serve the purpose of the threshold and the piece of wood laid along (the foot of the couch?), as the pestles can be fastened to the steps at either end, and when drawn back they thus make extension of the ligatures. Dislocation, inward or forward, may be reduced in the following manner: a ladder is to be fastened in the ground, and the man is to be seated upon it, and then the sound leg is to be gently stretched along and bound to it, wherever it is found convenient; and water is to be poured into an earthen vessel, or stones put into a hamper and slung from the injured leg, so as to effect the reduction. Another mode of reduction: a cross-beam is to be fastened between two pillars of moderate height; and at one part of the cross-beam there should be a protuberance proportionate to the size of the nates; and having bound a coverlet round the patient’s breast, he is to be seated on the protuberant part of the cross-beam, and afterward the breast is to be fastened to the pillar by some broad ligature; then some one is to hold the sound leg so that he may not fall off, and from the injured limb is to be suspended some convenient weight, as formerly described.

+

The prime object of the physician in the whole art of medicine should be to cure that which is diseased; and if this can be accomplished in various ways, the least troublesome should be selected; for this is more becoming a good man, and one well skilled in the art, who does not covet popular coin of base alloy. With regard to the subject now on hand, the following are domestic means of making extension of the body, so that it is easy to choose from among the things at hand:—In the first place, when soft and supple thongs are not at hand for ligatures, either iron chains, or cords, or cables of ships, are to be wrapped round with scarfs or pieces of woolen rags, especially at the parts of them which are to be applied, and in this state they are to be used as bands. In the second place, the patient is to be comfortably laid on the strongest and largest couch that is at hand, and the feet of the couch, either those at the (patient’s?) head, or those at the feet, are to be fastened to the threshold, either within or without, as is most suitable; and a square piece of wood is to be laid across, and extending from the one foot to the other; and if this piece of wood be slender, it should be bound to the feet of the couch, but, not withstanding, if it be thick, there will be no necessity for this; then the heads of the ligatures, both of those at the head and those at the feet, are to be fastened to a pestle, or some such piece of wood, difficult to reduce at either end; the ligatures should run along the line of the body, or be a little elevated above it, and it should be stretched proportionally to the pestles, so that, standing erect, the one may be fastened to the threshold, and the other to the transverse piece of wood. Extension is then to be made by bending back the ends of the pestles. A ladder, having strong steps, if laid below the bed, will serve the purpose of the threshold and the piece of wood laid along (the foot of the couch?), as the pestles can be fastened to the steps at either end, and when drawn back they thus make extension of the ligatures. Dislocation, inward or forward, may be reduced in the following manner: a ladder is to be fastened in the ground, and the man is to be seated upon it, and then the sound leg is to be gently stretched along and bound to it, wherever it is found convenient; and water is to be poured into an earthen vessel, or stones put into a hamper and slung from the injured leg, so as to effect the reduction. Another mode of reduction: a cross-beam is to be fastened between two pillars of moderate height; and at one part of the cross-beam there should be a protuberance proportionate to the size of the nates; and having bound a coverlet round the patient’s breast, he is to be seated on the protuberant part of the cross-beam, and afterward the breast is to be fastened to the pillar by some broad ligature; then some one is to hold the sound leg so that he may not fall off, and from the injured limb is to be suspended some convenient weight, as formerly described.

It should be particularly known that the union of all bones is, for the most part, by a head and socket (cotyle); in some of these the place (socket?) is cotyloid and oblong, and in some the socket is glenoid (shallow?). In all dislocations reduction is to be effected, if possible, immediately, while still warm, but otherwise, as quickly as it can be done; for reduction will be a much easier and quicker process to the operator, and a much less painful one to the patient, if effected before swelling comes on. But all the joints when about to be reduced should be first softened, and gently moved about; for, thus they are more easily reduced. And, in all cases of reduction at joints, the patient must be put on a spare diet, but more especially in the case of the greatest joints, and those most difficult to reduce, and less so in those which are very small and easily reduced.

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If any joint of the fingers is dislocated, whether the first, second, or the third, the same method of reduction is to be applied, but the largest joints are the most difficult to reduce. There are four modes of displacement-either upward, downward, or to either side; most commonly upward, and most rarely laterally, and in consequence of violent motion. On both sides of its articular cavity there is a sort of raised border. When the dislocation is upward or downward, owing to the articular cavity having smoother edges there than at the sides, if the joint of it be dislocated, it is more easily reduced. This is the mode of reduction:-The end of the finger is to be wrapped round with a fillet, or something such, that, when you lay hold of it and make extension, it will not slip; and when this is done, some person is to grasp the arm at the wrist, and another is to take hold of the finger which is wrapped in the fillet, and then each is to make considerable extension toward himself, and at the same time the projecting bone is to be pushed into its place. But, if the dislocation be lateral, the same mode of reduction is to be used; but when you think that the extremity of the bone has cleared the rim, at the same time that extension is made, the bone is to be pushed direct into its place, while another person on the other side of the finger is to take care and make counter-pressure, so that it may not again slip out there. The twisted nooses formed from palm-shoots are convenient for effecting reduction, if you will make extension and counter-extension by holding the twisted string in the one hand and the wrist in the other. When reduced, you must bind the part as quickly as possible with bandages; these are to be very slender and waxed with cerate, neither very soft nor very hard, but of middle consistence; for that which is hard drops off from the finger, while that which is soft and liquid is melted and lost by the increased heat of the finger. The bandage is to be loosed on the third or fourth day; but on the whole, if inflamed, it is to be the more frequently loosed, and if otherwise, more rarely; this I say respecting all the joints. The articulation of a finger is restored in fourteen days. The treatment of the fingers and of the toes is the same.

+

If any joint of the fingers is dislocated, whether the first, second, or the third, the same method of reduction is to be applied, but the largest joints are the most difficult to reduce. There are four modes of displacement-either upward, downward, or to either side; most commonly upward, and most rarely laterally, and in consequence of violent motion. On both sides of its articular cavity there is a sort of raised border. When the dislocation is upward or downward, owing to the articular cavity having smoother edges there than at the sides, if the joint of it be dislocated, it is more easily reduced. This is the mode of reduction:—The end of the finger is to be wrapped round with a fillet, or something such, that, when you lay hold of it and make extension, it will not slip; and when this is done, some person is to grasp the arm at the wrist, and another is to take hold of the finger which is wrapped in the fillet, and then each is to make considerable extension toward himself, and at the same time the projecting bone is to be pushed into its place. But, if the dislocation be lateral, the same mode of reduction is to be used; but when you think that the extremity of the bone has cleared the rim, at the same time that extension is made, the bone is to be pushed direct into its place, while another person on the other side of the finger is to take care and make counter-pressure, so that it may not again slip out there. The twisted nooses formed from palm-shoots are convenient for effecting reduction, if you will make extension and counter-extension by holding the twisted string in the one hand and the wrist in the other. When reduced, you must bind the part as quickly as possible with bandages; these are to be very slender and waxed with cerate, neither very soft nor very hard, but of middle consistence; for that which is hard drops off from the finger, while that which is soft and liquid is melted and lost by the increased heat of the finger. The bandage is to be loosed on the third or fourth day; but on the whole, if inflamed, it is to be the more frequently loosed, and if otherwise, more rarely; this I say respecting all the joints. The articulation of a finger is restored in fourteen days. The treatment of the fingers and of the toes is the same.

After all reductions of joints the patient should be confined to a restricted diet and abstinence until the seventh day; and if there be inflammation, the bandages are to be the more frequently loosed, but otherwise, less frequently, and the pained joint is to be kept constantly in a state of rest, and is to be laid in the most convenient position possible.

diff --git a/data/tlg0627/tlg010/tlg0627.tlg010.perseus-grc2.xml b/data/tlg0627/tlg010/tlg0627.tlg010.perseus-grc2.xml index b3f3f7a44..f9b7c816c 100644 --- a/data/tlg0627/tlg010/tlg0627.tlg010.perseus-grc2.xml +++ b/data/tlg0627/tlg010/tlg0627.tlg010.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg011/__cts__.xml b/data/tlg0627/tlg011/__cts__.xml index b43f4de9f..a1caa61ea 100644 --- a/data/tlg0627/tlg011/__cts__.xml +++ b/data/tlg0627/tlg011/__cts__.xml @@ -3,7 +3,7 @@ Μοχλικός - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml index b593ee41e..aabde0bc5 100644 --- a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml +++ b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml @@ -113,7 +113,7 @@

The symptoms of dislocation of the finger are obvious, and need not be described. This is the mode of reduction:—By stretching in a straight line, and making pressure on the projecting part, and counter-pressure, at the opposite side, on the other. The proper treatment consists in the application of bandages. When not reduced, the parts unite by callus outside of the joints. In congenital dislocations, and in those which occur during bones below the dislocation are shortened, and the flesh is wasted principally on the side opposite to the dislocation; in the adult the bones remain of their proper size.

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Dislocation at the hip-joint occurs in four modes, inward most frequently, outward next, the others of equal frequency. The symptoms:—The common, a comparison with the sound leg. The peculiar symptoms of dislocations inward; the head of the bone is felt at the perineum; the patient cannot bend his leg as formerly; the limb appears elongated, and to a great extent, unless you bring both limbs into the middle space between them in making a comparison of them; and the foot and the knee are inclined outward. If the dislocation has taken place from birth, or during one's growth, the thigh is shortened, the leg less so, and the others according to the same rule; the fleshy parts are atrophied, especially on the outside. Such persons are afraid to stand erect, and crawl along on the sound limb; or, if compelled, they walk with one or two staves, and bear up the affected limb; and the smaller the limb so much the more do they walk. If the accident happens to adults the bones remain of their proper size, but the flesh is wasted, as formerly described; the patients walk in a wriggling manner, like oxen; they are bent toward the flank, and the buttock on the uninjured side is prominent; for the uninjured limb must necessarily come below that it may support the body, whilst the other must be carried out of the way, as it cannot support the body, like those who have an ulcer in the foot. They poise the body by means of a staff on the sound side, and grasp the affected limb with the hand above the knee so as to carry the body in shifting from one place to another. If the parts below the hip-joint be used, the bones below are less atrophied, but the flesh more.

+

Dislocation at the hip-joint occurs in four modes, inward most frequently, outward next, the others of equal frequency. The symptoms:—The common, a comparison with the sound leg. The peculiar symptoms of dislocations inward; the head of the bone is felt at the perineum; the patient cannot bend his leg as formerly; the limb appears elongated, and to a great extent, unless you bring both limbs into the middle space between them in making a comparison of them; and the foot and the knee are inclined outward. If the dislocation has taken place from birth, or during one’s growth, the thigh is shortened, the leg less so, and the others according to the same rule; the fleshy parts are atrophied, especially on the outside. Such persons are afraid to stand erect, and crawl along on the sound limb; or, if compelled, they walk with one or two staves, and bear up the affected limb; and the smaller the limb so much the more do they walk. If the accident happens to adults the bones remain of their proper size, but the flesh is wasted, as formerly described; the patients walk in a wriggling manner, like oxen; they are bent toward the flank, and the buttock on the uninjured side is prominent; for the uninjured limb must necessarily come below that it may support the body, whilst the other must be carried out of the way, as it cannot support the body, like those who have an ulcer in the foot. They poise the body by means of a staff on the sound side, and grasp the affected limb with the hand above the knee so as to carry the body in shifting from one place to another. If the parts below the hip-joint be used, the bones below are less atrophied, but the flesh more.

The symptoms and attitudes in dislocation outward are the opposite, and the knee and foot incline a little inward. When it is congenital, or occurs during adolescence, the bones do not grow properly; according to the same rule, the bone of the hip-joint is somewhat higher than natural, and does not grow proportionally. In those who have frequent dislocations outward, without inflammation, the limb is of a more humid (flabby?) temperament than natural, like the thumb, for it is the part most frequently dislocated, owing to its configuration; in what persons the dislocation is to a greater or less extent; and in what persons it is more difficultly or easily produced; in what there is reason to hope that it can be speedily reduced, and in what not; and the remedy for this; and in what cases the dislocation frequently happens, and treatment of this. In dislocation outward from birth, or during adolescence, or from disease, (and it happens most frequently from disease, in which case there is sometimes exfoliation of the bone, but even where there is no exfoliation), the patients experience the same symptoms, but to an inferior degree to those in dislocations inward, if properly managed so that in walking they can put the whole foot to the ground and lean to either side. The younger the patient is, the greater care should be bestowed on him; when neglected, the case gets worse; when attended to, it improves; and, although there be atrophy in all parts of the limb, it is to a less extent.

@@ -125,7 +125,7 @@

In reduction-the extension of the thigh is to be powerful, and the adjustment what is common in all such cases, with the hands, or a board, or a lever, which, in dislocations inward, should be round, and in dislocations outward, flat; but it is mostly applicable in dislocations outward. Dislocations inward are to be remedied by means of bladders, extending to the bare part of the thigh, along with extension and binding together of the limbs. The patient may be suspended, with his feet a little separated from one another, and then a person inserting his arm within the affected limb, is to suspend himself from it, and perform extension and readjustment at the same time; and this method is sufficient in dislocations forward and the others, but least of all in dislocations backward. A board fastened under the limb, like the board fastened below the arm in dislocations at the shoulder, answers in dislocations inward, but less so in the other varieties. Along with extension you will use pressure either with the foot, the hand, or a board, especially in dislocations forward and backward.

-

Dislocations at the knee are of a milder character than those of the elbow, owing to the compactness and regularity of the joint; and hence it is more readily dislocated and reduced. Dislocation generally takes place inward, but also outward and backward. The methods of reduction are-by circumflexion, or by rapid excalcitration, or by rolling a fillet into a ball, placing it in the ham, and then letting the patient's body suddenly drop down on his knees: this mode applies best in dislocations backward. Dislocations backward, like those of the elbows, may also be reduced by moderate extension. Lateral dislocations may be reduced by circumflexion or excalcitration, or by extension (but this is most applicable in dislocation backward), but also by moderate extension. The adjustment is what is common in all. If not reduced, in dislocations backward, they cannot bend the leg and thigh upon one another, but neither can they do this in the others except to a small extent; and the fore parts of the thigh and leg are wasted. In dislocations inward they are bandy-legged, and the external parts are atrophied. But, in dislocations outward, they incline more outward, but are less lame, for the body is supported on the thicker bone, and the inner parts are wasted. The consequences of a congenital dislocation, or one occurring during adolescence, are analogous to the rule formerly laid down.

+

Dislocations at the knee are of a milder character than those of the elbow, owing to the compactness and regularity of the joint; and hence it is more readily dislocated and reduced. Dislocation generally takes place inward, but also outward and backward. The methods of reduction are-by circumflexion, or by rapid excalcitration, or by rolling a fillet into a ball, placing it in the ham, and then letting the patient’s body suddenly drop down on his knees: this mode applies best in dislocations backward. Dislocations backward, like those of the elbows, may also be reduced by moderate extension. Lateral dislocations may be reduced by circumflexion or excalcitration, or by extension (but this is most applicable in dislocation backward), but also by moderate extension. The adjustment is what is common in all. If not reduced, in dislocations backward, they cannot bend the leg and thigh upon one another, but neither can they do this in the others except to a small extent; and the fore parts of the thigh and leg are wasted. In dislocations inward they are bandy-legged, and the external parts are atrophied. But, in dislocations outward, they incline more outward, but are less lame, for the body is supported on the thicker bone, and the inner parts are wasted. The consequences of a congenital dislocation, or one occurring during adolescence, are analogous to the rule formerly laid down.

Dislocations at the ankle-joint require strong extension, either with the hands or some such means, and adjustment, which at the same time effects both acts; this is common in all cases.

diff --git a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-grc2.xml b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-grc2.xml index b20d129fd..6a97db768 100644 --- a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-grc2.xml +++ b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg012/__cts__.xml b/data/tlg0627/tlg012/__cts__.xml index 7891962ef..42a47ea10 100644 --- a/data/tlg0627/tlg012/__cts__.xml +++ b/data/tlg0627/tlg012/__cts__.xml @@ -3,7 +3,7 @@ Ἀφορισμοί - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). diff --git a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml index 4287e5db9..d0c5963b3 100644 --- a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml +++ b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml @@ -86,7 +86,7 @@

In disorders of the bowels and vomitings, occurring spontaneously, if the matters purged be such as ought to be purged, they do good, and are well borne; but if not, the contrary. And so artificial evacuations, if they consist of such matters as should be evacuated, do good, and are well borne; but if not, the contrary. One, then, ought to look to the country, the season, the age, and the diseases in which they are proper or not.

-

In the athletae, embonpoint, if carried to its utmost limit, is dangerous, for they cannot remain in the same state nor be stationary; and since, then, they can neither remain stationary nor improve, it only remains for them to get worse; for these reasons the embonpoint should be reduced without delay, that the body may again have a commencement of reparation. Neither should the evacuations, in their case, be carried to an extreme, for this also is dangerous, but only to such a point as the person's constitution can endure. In like manner, medicinal evacuations, if carried to an extreme, are dangerous; and again, a restorative course, if in the extreme, is dangerous.

+

In the athletae, embonpoint, if carried to its utmost limit, is dangerous, for they cannot remain in the same state nor be stationary; and since, then, they can neither remain stationary nor improve, it only remains for them to get worse; for these reasons the embonpoint should be reduced without delay, that the body may again have a commencement of reparation. Neither should the evacuations, in their case, be carried to an extreme, for this also is dangerous, but only to such a point as the person’s constitution can endure. In like manner, medicinal evacuations, if carried to an extreme, are dangerous; and again, a restorative course, if in the extreme, is dangerous.

A slender restricted diet is always dangerous in chronic diseases, and also in acute diseases, where it is not requisite. And again, a diet brought to the extreme point of attenuation is dangerous; and repletion, when in the extreme, is also dangerous.

@@ -197,9 +197,9 @@

For the most part, all persons in ill health, who have a good appetite at the commencement, but do not improve, have a bad appetite again toward the end; whereas, those who have a very bad appetite at the commencement, and afterward acquire a good appetite, get better off.

-

In every disease it is a good sign when the patient's intellect is sound, and he is disposed to take whatever food is offered to him; but the contrary is bad.

+

In every disease it is a good sign when the patient’s intellect is sound, and he is disposed to take whatever food is offered to him; but the contrary is bad.

-

In diseases, there is less danger when the disease is one to which the patient's constitution, habit, age, and the season are allied, than when it is one to which they are not allied.

+

In diseases, there is less danger when the disease is one to which the patient’s constitution, habit, age, and the season are allied, than when it is one to which they are not allied.

In all diseases it is better that the umbilical and hypogastric regions preserve their fullness; and it is a bad sign when they are very slender and emaciated; in the latter case it is dangerous to administer purgatives.

@@ -592,7 +592,7 @@

If woman with a child have her courses, it is impossible that the child can be healthy.

-

If a woman's courses be suppressed, and neither rigor nor fever has followed, but she has been affected with nausea, you may reckon her to be with child.

+

If a woman’s courses be suppressed, and neither rigor nor fever has followed, but she has been affected with nausea, you may reckon her to be with child.

Women who have the uterus cold and dense (compact?) do not conceive; and those also who have the uterus humid, do not conceive, for the semen is extinguished, and in women whose uterus is very dry, and very hot, the semen is lost from the want of food; but women whose uterus is in an intermediate state between these temperaments prove fertile.

diff --git a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml index 10930f6c9..67541613c 100644 --- a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml +++ b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml @@ -35,7 +35,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg013/__cts__.xml b/data/tlg0627/tlg013/__cts__.xml index da8d6fdf8..c5e3097f5 100644 --- a/data/tlg0627/tlg013/__cts__.xml +++ b/data/tlg0627/tlg013/__cts__.xml @@ -3,11 +3,16 @@ Ὅρκος - Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923. + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). The Oath Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + + + Oath + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.tracking.json b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.tracking.json deleted file mode 100644 index 0df74b7fe..000000000 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0251", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.jones_eng.xml---subdoc---text=Jusj.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml deleted file mode 100644 index d5fd7b966..000000000 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml +++ /dev/null @@ -1,116 +0,0 @@ - - - - - - THE OATH - Hippocrates - W. H. S. Jones - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 1, 2005 - - - - - Hippocrates Collected Works I - Hippocrates - W. H. S. Jones - - Cambridge - Harvard University Press - 1923 - - - - - - - - - -

Data Entry

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - English - Greek - - - - - - -
- OATH -

I SWEAR by Apollo Physician, by Asclepius, by Health, by - Panacea and by all the gods and goddesses, making them my witnesses, that I will - carry out, according to my ability and judgment, this oath and this indenture. - To hold my teacher in this art equal to my own parents; to make him partner in - my livelihood; when he is in need of money to share mine with him; to consider - his family as my own brothers, and to teach them this art, if they want to learn - it, without fee or indenture; to impart precept,Apparently the written - rules of the art, examples of which are to be found in several Hippocratie - treatises. These books were not published in the strict sense of the word, - but copies would be circulated among the members of the " physicians' - union." oral instruction, and all other instructionProbably, in - modern English, " instruction, written, oral and practical." to my - own sons, the sons of my teacher, and to indentured pupils who have taken the - physician's oath, but to nobody else. I will use treatment to help the sick - according to my ability and judgment, but never with a view to injury and - wrong-doing. Neither will I administer a poison to anybody when asked to do so, - nor will I suggest such a course. Similarly I will not give to a woman a pessary - to cause abortion. But I will keep pure and holy both my life and my art. I will - not use the knife, not even, verily, on sufferers from stone, but I will give - place to such as are craftsmen

- -

therein. Into whatsoever houses I enter, I will enter to help the sick, and I - will abstain from all intentional wrong-doing and harm, especially from abusing - the bodies of man or woman, bond or free. And whatsoever I shall see or hear in - the course of my profession, as well as outside my profession in my intercourse - with men,This remarkable addition is worthy of a passing notice. The - physician must not gossip, no matter how or where the subject-matter for - gossip may have been acquired; whether it be in practice or in private life - makes no difference. if it be what should not be published abroad, I - will never divulge, holding such things to be holy secrets. Now if I carry out - this oath, and break it not, may I gain for ever reputation among all men for my - life and for my art; but if I transgress it and forswear myself, may the - opposite befall me.

-
- - - - - - diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml index 6e1f44c6a..84224224b 100644 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml @@ -74,7 +74,7 @@
-

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

+

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation—to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng5.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng5.xml new file mode 100644 index 000000000..bf1d367b1 --- /dev/null +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng5.xml @@ -0,0 +1,118 @@ + + + + + + + Oath + Hippocrates + William Henry Samuel Jones + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 1, 2005 + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg013.perseus-eng5.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + Hippocrates + Hippocrates + William Henry Samuel Jones + + London + William Heinemann Ltd. + Cambridge, MA + Harvard University Press + 1923 + + 1 + + Loeb Classical Library + Internet Archive + + + + + + + + +

Data Entry

+ + + + + + + + +

This pointer pattern extracts oath.

+ + + + + + + English + Greek + + + + CTS and EpiDoc conversion. + + + + + +
+ +
+OATH +

I swear by Apollo Physician, by Asclepius, by Health, by Panacea and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept,Apparently the written rules of the art, examples of which are to be found in several Hippocratie treatises. These books were not published in the strict sense of the word, but copies would be circulated among the members of the physicians’ union. oral instruction, and all other instructionProbably, in modern English, instruction, written, oral and practical. to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else. I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein. Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men,This remarkable addition is worthy of a passing notice. The physician must not gossip, no matter how or where the subject-matter for gossip may have been acquired; whether it be in practice or in private life makes no difference. if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets. Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I transgress it and forswear myself, may the opposite befall me.

+
+ + + diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-grc2.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-grc2.xml index d727057be..ad68d21a4 100644 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-grc2.xml +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-grc2.xml @@ -43,7 +43,7 @@ William Heinemann Ltd. Cambridge, MA Harvard University Press -1923 +1923 1 diff --git a/data/tlg0627/tlg027/__cts__.xml b/data/tlg0627/tlg027/__cts__.xml index 7659bf1b8..62d70feee 100644 --- a/data/tlg0627/tlg027/__cts__.xml +++ b/data/tlg0627/tlg027/__cts__.xml @@ -3,6 +3,11 @@ Περὶ ἱερῆς νούσου - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + + On the Sacred Disease + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.tracking.json b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.tracking.json deleted file mode 100644 index 0ba5841de..000000000 --- a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0248", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.adams_eng.xml---subdoc---text=Morb. Sacr.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.xml b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.xml deleted file mode 100644 index 2c74b2175..000000000 --- a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng1.xml +++ /dev/null @@ -1,534 +0,0 @@ - - - - - - On the Sacred Disease - Hippocrates - Francis Adams - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 20, 2003 - - - - - The Genuine Works of Hippocrates - Hippocrates - Francis Adams - - New York - William Wood & Company - 1886 - - - - - - - - -

Data Entry

- - - - - - - - - - - - - - - - - - - - - - - - - - English - - - - - -
-

It is thus with regard to the disease called Sacred: it appears to me to be - nowise more divine nor more sacred than other diseases, but has a natural cause - from the originates like other affections. Men regard its nature and cause as - divine from ignorance and wonder, because it is not at all like to other - diseases. And this notion of its divinity is kept up by their inability to - comprehend it, and the simplicity of the mode by which it is cured, for men are - freed from it by purifications and incantations. But if it is reckoned divine - because it is wonderful, instead of one there are many diseases which would be - sacred; for, as I will show, there are others no less wonderful and prodigious, - which nobody imagines to be sacred. The quotidian, tertian, and quartan fevers, - seem to me no less sacred and divine in their origin than this disease, although - they are not reckoned so wonderful. And I see men become mad and demented from - no manifest cause, and at the same time doing many things out of place; and I - have known many persons in sleep groaning and crying out, some in a state of - suffocation, some jumping up and fleeing out of doors, and deprived of their - reason until they awaken, and afterward becoming well and rational as before, - although they be pale and weak; and this will happen not once but frequently. - And there are many and various things of the like kind, which it would be - tedious to state particularly.

- -

They who first referred this malady to the gods appear to me to have been just - such persons as the conjurors, purificators, mountebanks, and charlatans now - are, who give themselves out for being excessively religious, and as knowing - more than other people. Such persons, then, using the divinity as - a pretext and screen of their own inability to afford - any assistance, have given out that the disease is sacred, adding suitable - reasons for this opinion, they have instituted a mode of treatment which is safe - for themselves, namely, by applying purifications and incantations, and - enforcing abstinence from baths and many articles of food which are unwholesome - to men in diseases. Of sea substances, the surmullet, the blacktail, the mullet, - and the eel; for these are the fishes most to be guarded against. And of - fleshes, those of the goat, the stag, the sow, and the dog: for these are the - kinds of flesh which are aptest to disorder the bowels. Of fowls, the cock, the - turtle, and the bustard, and such others as are reckoned to be particularly - strong. And of potherbs, mint, garlic, and onions; for what is acrid does not - agree with a weak person. And they forbid to have a black robe, because black is - expressive of death; and to sleep on a goat's skin, or to wear it, and to put - one foot upon another, or one hand upon another; for all these things are held - to be hindrances to the cure. All these they enjoin with reference to its - divinity, as if possessed of more knowledge, and announcing beforehand other - causes so that if the person should recover, theirs would be the honor and - credit; and if he should die, they would have a certain defense, as if the gods, - and not they, were to blame, seeing they had administered nothing either to eat - or drink as medicines, nor had overheated him with baths, so as to prove the - cause of what had happened. But I am of opinion that (if this were true) none of - the Libyans, who live in the interior, would be free from this disease, since - they all sleep on goats' skins, and live upon goats' flesh; neither have they - couch, robe, nor shoe that is not made of goat's skin, for they have no other - herds but goats and oxen. But if these things, when administered in food, - aggravate the disease, and if it be cured by abstinence from them, godhead is - not the cause at all; nor will purifications be of any avail, but it is the food - which is beneficial and prejudicial, and the influence of the divinity - vanishes.

- -

Thus, they who try to cure these maladies in this way, appear to me neither to - reckon them sacred nor divine. For when they are removed by such purifications, - and this method of cure, what is to prevent them from being - brought upon men and induced by other devices similar to these? So that the - cause is no longer divine, but human. For whoever is able, by purifications - conjurations, to drive away such an affection, will be able, by other practices, - to excite it; and, according to this view, its divine nature is entirely done - away with. By such sayings and doings, they profess to be possessed of superior - knowledge, and deceive mankind by enjoining lustrations and purifications upon - them, while their discourse turns upon the divinity and the godhead. And yet it - would appear to me that their discourse savors not of piety, as they suppose, - but rather of impiety, and as if there were no gods, and that what they hold to - be holy and divine, were impious and unholy. This I will now explain.

- -

For, if they profess to know how to bring down the moon, darken the sun, induce - storms and fine weather, and rains and droughts, and make the sea and land - unproductive, and so forth, whether they arrogate this power as being derived - from mysteries or any other knowledge or consideration, they appear to me to - practice impiety, and either to fancy that there are no gods, or, if there are, - that they have no ability to ward off any of the greatest evils. How, then, are - they not enemies to the gods? For if a man by magical arts and sacrifices will - bring down the moon, and darken the sun, and induce storms, or fine weather, I - should not believe that there was anything divine, but human, in these things, - provided the power of the divine were overpowered by human knowledge and - subjected to it. But perhaps it will be said, these things are not so, but, not - withstanding, men being in want of the means of life, invent many and various - things, and devise many contrivances for all other things, and for this disease, - in every phase of the disease, assigning the cause to a god. Nor do they - remember the same things once, but frequently. For, if they imitate a goat, or - grind their teeth, or if their right side be convulsed, they say that the mother - of the gods is the cause. But if they speak in a sharper and more intense tone, - they resemble this state to a horse, and say that Poseidon(Neptune) is the cause. Or if any excrement be passed, which is often - the case, owing to the violence of the disease, the appellation of Enodia (Hecate?)is adhibited; or, if it be passed in - smaller and denser masses, like bird's, it is said to be from Apollo Nomius. But - if foam be emitted by the mouth, and the patient kick with his feet, Ares(Mars) then gets the blame. But terrors which happen during - the night, and fevers, and delirium, and jumpings out of bed, and frightful - apparitions, and fleeing away,-all these they hold to be the plots of Hecate, - and the invasions the and use purifications and incantations, and, as appears to - me, make the divinity to be most wicked and most impious. For they purify those - laboring under this disease, with the same sorts of blood and the other means - that are used in the case of those who are stained with crimes, and of - malefactors, or who have been enchanted by men, or who have done any wicked act; - who ought to do the very reverse, namely, sacrifice and pray, and, bringing - gifts to the temples, supplicate the gods. But now they do none of these things, - but purify; and some of the purifications they conceal in the earth, and some - they throw into the sea, and some they carry to the mountains where no one can - touch or tread upon them. But these they ought to take to the temples and - present to the god, if a god be the cause of the disease. Neither truly do I - count it a worthy opinion to hold that the body of man is polluted by god, the - most impure by the most holy; for were it defiled, or did it suffer from any - other thing, it would be like to be purified and sanctified rather than polluted - by god. For it is the divinity which purifies and sanctifies the greatest of - offenses and the most wicked, and which proves our protection from them. And we - mark out the boundaries of the temples and the groves of the gods, so that no - one may pass them unless he be pure, and when we enter them we are sprinkled - with holy water, not as being polluted, but as laying aside any other pollution - which we formerly had. And thus it appears to me to hold, with regard to - purifications.

- -

But this disease seems to me to be no more divine than others; but it has its - nature such as other diseases have, and a cause whence it originates, and its - nature and cause are divine only just as much as all others are, and it is - curable no less than the others, unless when, the from of time, it is confirmed, - and has became stronger than the remedies applied. Its origin is hereditary, like that of other diseases. For if a phlegmatic person be born - of a phlegmatic, and a bilious of a bilious, and a phthisical of a phthisical, - and one having spleen disease, of another having disease of the spleen, what is - to hinder it from happening that where the father and mother were subject to - this disease, certain of their offspring should be so affected also? As the - semen comes from all parts of the body, healthy particles will come from healthy - parts, and unhealthy from unhealthy parts. And another great proof that it is in - nothing more divine than other diseases is, that it occurs in those who are of a - phlegmatic constitution, but does not attack the bilious. Yet, if it were more - divine than the others, this disease ought to befall all alike, and make no - distinction between the bilious and phlegmatic.

- -

But in them, the brain is the cause of this affection, as it is of other very - great diseases, and in what manner and from what cause it is formed, I will now - plainly declare. The brain of man, as in all other animals, is double, and a - thin membrane (meninx)divides it through the middle, and - therefore the pain is not always in the same part of the head; for sometimes it - is situated on either side, and sometimes the whole is affected; and veins run - toward it from all parts of the body, many of which are small, but two are - thick, the one from the liver, and the other from the spleen. And it is thus - with regard to the one from the liver: a portion of it runs downward through the - parts on the side, near the kidneys and the psoas muscles, to the inner part of - the thigh, and extends to the foot. It is called vena cava. The other runs - upward by the right veins and the lungs, and divides into branches for the heart - and the right arm. The remaining part of it rises upward across the clavicle to - the right side of the neck, and is superficial so as to be seen; near the ear it - is concealed, and there it divides; its thickest, largest, and most hollow part - ends in the brain; another small vein goes to the right ear, another to the - right eye, and another to the nostril. Such are the distributions of the hepatic - vein. And a vein from the spleen is distributed on the left side, upward and - downward, like that from the liver, but more slender and feeble.

- -

By these veins we draw in much spirit(gas?), since they are - the spiracles of our bodies inhaling air to themselves and - distributing it to the rest of the body, and to the smaller veins, and they and - afterwards exhale it. For the breath (pneuma)cannot be - stationary, but it passes upward and downward, for if stopped and intercepted, - the part where it is stopped becomes powerless. In proof of this, when, in - sitting or lying, the small veins are compressed, so that the breath(pneuma) from the larger vein does not pass into them, the - part is immediately seized with numbness; and it is so likewise with regard to - the other veins.

- -

This malady, then, affects phlegmatic people, but not bilious. It begins to be - formed while the foetus is still in utero. For the brain, - like the other organs, is depurated and grows before birth. If, then, in this - purgation it be properly and moderately depurated, and neither more nor less - than what is proper be secreted from it, the head is thus in the most healthy - condition. If the secretion (melting) the from the brain be greater than - natural, the person, when he grows up, will have his head diseased, and full of - noises, and will neither be able to endure the sun nor cold. Or, if the melting - take place from any one part, either from the eye or ear, or if a vein has - become slender, that part will be deranged in proportion to the melting. Or, - should depuration not take place, but it (the secretion?) - accumulate in the brain, it necessarily becomes phlegmatic. And such children as - have an eruption of ulcers on the head, on the ears, and along the rest of the - body, with copious discharges of saliva and mucus,-these, in after life, enjoy - best health; for in this way the phlegm which ought to have been purged off in - the womb, is discharged and cleared away, and persons so purged, for the most - part, are not subject to attacks of this disease. But such as have had their - skin free from eruptions, and have had no discharge of saliva or mucus, nor have - undergone the proper purgation in the womb, these persons run the risk of being - seized with this disease.

- -

But should the defluxion make its way to the heart, the person is seized with - palpitation and asthma, the chest becomes diseased, and some also have curvature - of the spine. For when a defluxion of cold phlegm takes place on the lungs and - heart, the blood is chilled, and the veins, being violently chilled, palpitate - in the lungs and heart, and the heart palpitates, so that from - this necessity asthma and orthopnoea supervene. For it does not receive the - spirits (pneuma) as much breath as he needs until the - defluxion of phlegm be mastered, and being heated is distributed to the veins, - then it ceases from its palpitation and difficulty of breathing, and this takes - place as soon as it obtains an abundant supply; and this will be more slowly, - provided the defluxion be more abundant, or if it be less, more quickly. And if - the defluxions be more condensed, the epileptic attacks will be more frequent, - but otherwise if it be rarer. Such are the symptoms when the defluxion is upon - the lungs and heart; but if it be upon the bowels, the person is attacked with - diarrhoea.

- -

And if, being shut out from all these outlets, its defluxion be determined to the - veins I have formerly mentioned, the patient loses his speech, and chokes, and - foam issues by the mouth, the teeth are fixed, the hands are contracted, the - eyes distorted, he becomes insensible, and in some cases the bowels are - evacuated. And these symptoms occur sometimes on the left side, sometimes on the - right, and sometimes in both. The cause of everyone of these symptoms I will now - explain. The man becomes speechless when the phlegm, suddenly descending into - the veins, shuts out the air, and does not admit it either to the brain or to - the vena cava, or to the ventricles, but interrupts the inspiration. For when a - person draws in air by the mouth and nostrils, the breath (pneuma)goes first to the brain, then the greater part of it to the - internal cavity, and part to the lungs, and part to the veins, and from them it - is distributed to the other parts of the body along the veins; and whatever - passes to the stomach cools, and does nothing more; and so also with regard to - the lungs. But the air which enters the veins is of use (to the body) by - entering the brain and its ventricles, and thus it imparts sensibility and - motion to all the members, so that when the veins are excluded from the air by - the phlegm and do not receive it, the man loses his speech and intellect, and - the hands become powerless, and are contracted, the blood stopping and not being - diffused, as it was wont; and the eyes are distorted owing to the veins being - excluded from the air; and they palpitate; and froth from the lungs issues by - the mouth. For when the breath (pneuma) does not find entrance to him, he foams and sputters like a dying person. And - the bowels are evacuated in consequence of the violent suffocation; and the - suffocation is produced when the liver and stomach ascend to the diaphragm, and - the mouth of the stomach is shut up; this takes place when the breath (pneuma) does not enter by the mouth, as it is wont. The - patient kicks with his feet when the air is shut up in the lungs and cannot find - an outlet, owing to the phlegm; and rushing by the blood upward and downward, it - occasions convulsions and pain, and therefore he kicks with his feet. All these - symptoms he endures when the cold phlegm passes into the warm blood, for it - congeals and stops the blood. And if the deflexion be copious and thick, it - immediately proves fatal to him, for by its cold it prevails over the blood and - congeals it; or, if it be less, it in the first place obtains the mastery, and - stops the respiration; and then in the course of time, when it is diffused along - the veins and mixed with much warm blood, it is thus overpowered, the veins - receive the air, and the patient recovers his senses.

- -

Of little children who are seized with this disease, the greater part die, - provided the defluxion be copious and humid, for the veins being slender cannot - admit the phlegm, owing to its thickness and abundance; but the blood is cooled - and congealed, and the child immediately dies. But if the phlegm be in small - quantity, and make a defluxion into both the veins, or to those on either side, - the children survive, but exhibit notable marks of the disorder; for either the - mouth is drawn aside, or an eye, the neck, or a hand, wherever a vein being - filled with phlegm loses its tone, and is attenuated, and the part of the body - connected with this vein is necessarily rendered weaker and defective. But for - the most it affords relief for a longer interval; for the child is no longer - seized with these attacks, if once it has contracted this impress of the - disease, in consequence of which the other veins are necessarily affected, and - to a certain degree attenuated, so as just to admit the air, but no longer to - permit the influx of phlegm. However, the parts are proportionally enfeebled - whenever the veins are in an unhealthy state. When in striplings the defluxion - is small and to the right side, they recover without leaving any marks of the - disease, but there is danger of its becoming habitual, and even - increasing if not treated by suitable remedies. Thus, or very nearly so, is the - case when it attacks children.

- -

To persons of a more advanced age, it neither proves fatal, nor produces - distortions. For their veins are (large?) and filled with - hot blood; and therefore the phlegm can neither prevail nor cool the blood, so - as to coagulate it, but it is quickly overpowered and mixed with the blood, and - thus the veins receive the air, and sensibility remains; and, owing to their - strength, the aforesaid symptoms are less likely to seize them. But when this - disease attacks very old people, it therefore proves fatal, or induces - paraplegia, because the veins are empty, and the blood scanty, thin, and watery. - When, therefore, the defluxion is copious, and the season winter, it proves - fatal; for it chokes up the exhalents, and coagulates the blood if the defluxion - be to both sides; but if to either, it merely induces paraplegia. For the blood - being thin, cold, and scanty, cannot prevail over the but being itself - overpowered, it is coagulated, so that those parts in which the blood is - corrupted, lose their strength.

- -

The flux is to the right rather than to the left because the veins there are more - capacious and numerous than on the left side, for on the one side they spring - from the liver, and on the other from the spleen. The defluxion and melting down - take place most especially in the case of children in whom the head is heated - either by the sun or by fire, or if the brain suddenly contract a rigor, and - then the phlegm is excreted. For it is melted down by the heat and diffusion of - the but it is excreted by the congealing and contracting of it, and thus a - defluxion takes place. And in some this is the cause of the disease, and in - others, when the south wind quickly succeeds to northern breezes, it suddenly - unbinds and relaxes the brain, which is contracted and weak, so that there is an - inundation of phlegm, and thus the defluxion takes place. The defluxion also - takes place in consequence of fear, from any hidden cause, if we are the at any - person's calling aloud, or while crying, when one cannot quickly recover one's - breath, such as often happens to children. When any of these things occur, the - body immediately shivers, the person becoming speechless cannot - draw his breath, but the breath (pneuma) stops, the brain - is contracted, the blood stands still, and thus the excretion and defluxion of - the phlegm take place. In children, these are the causes of the attack at first. - But to old persons winter is most inimical. For when the head and brain have - been heated at a great fire, and then the person is brought into cold and has a - rigor, or when from cold he comes into warmth, and sits at the fire, he is apt - to suffer in the same way, and thus he is seized in the manner described above. - And there is much danger of the same thing occurring, if his head be exposed to - the sun, but less so in summer, as the changes are not sudden. When a person has - passed the twentieth year of his life, this disease is not apt to seize him, - unless it has become habitual from childhood, or at least this is rarely or - never the case. For the veins are filled with blood, and the brain consistent - and firm, so that it does not run down into the veins, or if it do, it does not - master the blood, which is copious and hot.

- -

But when it has gained strength from one's childhood, and become habitual, such a - person usually suffers attacks, and is seized with them in changes of the winds, - especially in south winds, and it is difficult of removal. For the brain becomes - more humid than natural, and is inundated with phlegm, so that the defluxions - become more frequent, and the phlegm can no longer be the nor the brain be dried - up, but it becomes wet and humid. This you may ascertain in particular, from - beasts of the flock which are seized with this disease, and more especially - goats, for they are most frequently attacked with it. If you will cut open the - head, you will find the brain humid, full of sweat, and having a bad smell. And - in this way truly you may see that it is not a god that injures the body, but - disease. And so it is with man. For when the disease has prevailed for a length - of time, it is no longer curable, as the brain is corroded by the phlegm, and - melted, and what is melted down becomes water, and surrounds the brain - externally, and overflows it; wherefore they are more frequently and readily - seized with the disease. And therefore the disease is protracted, because the - influx is thin, owing to its quantity, and is immediately overpowered by the - blood and heated all through.

- -

But such persons as are habituated to the disease know beforehand when they are - about to be seized and flee from men; if their own house be at hand, they run - home, but if not, to a deserted place, where as few persons as possible will see - them falling, and they immediately cover themselves up. This they do from shame - of the affection, and not from fear of the divinity, as many suppose. And little - children at first fall down wherever they may happen to be, from inexperience. - But when they have been often seized, and feel its approach beforehand, they - flee to their mothers, or to any other person they are acquainted with, from - terror and dread of the affection, for being still infants they do not know yet - what it is to be ashamed.

- -

Therefore, they are attacked during changes of the winds, and especially south - winds, then also with north winds, and afterwards also with the others. These - are the strongest winds, and the most opposed to one another, both as to - direction and power. For, the north wind condenses the air, and separates from - it whatever is muddy and nebulous, and renders it clearer and brighter, and so - in like manner also, all the winds which arise from the sea and other waters; - for they extract the humidity and nebulosity from all objects, and from men - themselves, and therefore it (the north wind) is the most wholesome of the - winds. But the effects of the south are the very reverse. For in the first place - it begins by melting and diffusing the condensed air, and therefore it does not - blow strong at first, but is gentle at the commencement, because it is not able - at once to overcome the and compacted air, which yet in a while it dissolves. It - produces the same effects upon the land, the sea, the fountains, the wells, and - on every production which contains humidity, and this, there is in all things, - some more, some less. For all these feel the effects of this wind, and from - clear they become cloudy, from cold, hot; from dry, moist; and whatever ear then - vessels are placed upon the ground, filled with wine or any other fluid, are - affected with the south wind, and undergo a change. And the a change. And the - sun, and the moon, it renders blunter appearance than they naturally are. When, - then, it possesses such powers over things so great and strong, and the body is made to feel and undergo changes in the changes of the - winds, it necessarily follows that the brain should be disolved and overpowered - with moisture, and that the veins should become more relaxed by the south winds, - and that by the north the healthiest portion of the brain should become - contracted, while the most morbid and humid is secreted, and overflows - externally, and that catarrhs should thus take place in the changes of these - winds. Thus is this disease formed and prevails from those things which enter - into and go out of the body, and it is not more difficult to understand or to - cure than the others, neither is it more divine than other diseases.

- -

And men ought to know that from nothing else but (from the - brain) come joys, delights, laughter and sports, and sorrows, griefs, - despondency, and lamentations. And by this, in an especial manner, we acquire - wisdom and knowledge, and see and hear, and know what are foul and what are - fair, what are bad and what are good, what are sweet, and what unsavory; some we - discriminate by habit, and some we perceive by their utility. By this we - distinguish objects of relish and disrelish, according to the seasons; and the - same things do not always please us. And by the same organ we become mad and - delirious, and fears and terrors assail us, some by night, and some by day, and - dreams and untimely wanderings, and cares that are not suitable, and ignorance - of present circumstances, desuetude, and unskilfulness. All these things we - endure from the brain, when it is not healthy, but is more hot, more cold, more - moist, or more dry than natural, or when it suffers any other preternatural and - unusual affection. And we become mad from humidity (of the - brain). For when it is more moist than natural, it is necessarily put - into motion, and the affection being moved, neither the sight nor hearing can be - at rest, and the tongue speaks in accordance with the sight and hearing.

- -

As long as the brain is at rest, the man enjoys his reason, but the depravement - of the brain arises from phlegm and bile, either of which you may recognize in - this manner: Those who are mad from phlegm are quiet, and do not cry out nor - make a noise; but those from bile are vociferous, malignant, and will not be - quiet, but are always doing something improper. If the madness be - constant, these are the causes thereof. But if terrors and fears assail, they - are connected with derangement of the brain, and derangement is owing to its - being heated. And it is heated by bile when it is determined to the brain along - the bloodvessels running from the trunk; and fear is present until it returns - again to the veins and trunk, when it ceases. He is grieved and troubled when - the brain is unseasonably cooled and contracted beyond its wont. This it suffers - from phlegm, and from the same affection the patient becomes oblivious. He calls - out and screams at night when the brain is suddenly heated. The bilious endure - this. But the phlegmatic are not heated, except when much blood goes to the - brain, and creates an ebullition. Much blood passes along the aforesaid veins. - But when the man happens to see a frightful dream and is in fear as if awake, - then his face is in a greater glow, and the eyes are red when the patient is in - fear. And the understanding meditates doing some mischief, and thus it is - affected in sleep. But if, when awakened, he returns to himself, and the blood - is again distributed along the veins, it ceases.

- -

In these ways I am of the opinion that the brain exercises the greatest power in - the man. This is the interpreter to us of those things which emanate from the - air, when it (the brain) happens to be in a sound state. - But the air supplies sense to it. And the eyes, the ears, the tongue and the - feet, administer such things as the brain cogitates. For in as much as it is - supplied with air, does it impart sense to the body. It is the brain which is - the messenger to the understanding. For when the man draws the breath (pneuma) into himself, it passes first to the brain, and - thus the air is distributed to the rest of the body, leaving in the brain its - acme, and whatever has sense and understanding. For if it passed first to the - body and last to the brain, then having left in the flesh and veins the - judgment, when it reached the brain it would be hot, and not at all pure, but - mixed with the humidity from flesh and blood, so as to be no longer pure.

- -

Wherefore, I say, that it is the brain which interprets the understanding. But - the diaphragm has obtained its name (frenes) from accident - and usage, and not from reality or nature, for I know no power which it - possesses, either as to sense or understanding, except that when - the man is affected with unexpected joy or sorrow, it throbs and produces - palpitations, owing to its thinness, and as having no belly to receive anything - good or bad that may present themselves to it, but it is thrown into commotion - by both these, from its natural weakness. It then perceives beforehand none of - those things which occur in the body, but has received its name vaguely and - without any proper reason, like the parts about the heart, which are called - auricles, but which contribute nothing towards hearing. Some say that we think - with the heart, and that this is the part which is grieved, and experiences - care. But it is not so; only it contracts like the diaphragm, and still more so - for the same causes. For veins from all parts of the body run to it, and it has - valves, so as to as to perceive if any pain or pleasurable emotion befall the - man. For when grieved the body necessarily shudders, and is contracted, and from - excessive joy it is affected in like manner. Wherefore the heart and the - diaphragm are particularly sensitive, they have nothing to do, however, with the - operations of the understanding, but of all but of all these the brain is the - cause. Since, then, the brain, as being the primary seat of sense and of the - spirits, perceives whatever occurs in the body, if any change more powerful than - usual take place in the air, owing to the seasons, the brain becomes changed by - the state of the air. For, on this account, the brain first perceives, because, - I say, all the most acute, most powerful, and most deadly diseases, and those - which are most difficult to be understood by the inexperienced, fall upon the - brain.

- -

And the disease called the Sacred arises from causes as the others, namely, those - things which enter and quit the body, such as cold, the sun, and the winds, - which are ever changing and are never at rest. And these things are divine, so - that there is no necessity for making a distinction, and holding this disease to - be more divine than the others, but all are divine, and all human. And each has - its own peculiar nature and power, and none is of an ambiguous nature, or - irremediable. And the most of them are curable by the same means as those by - which any other thing is food to one, and injurious to another. Thus, then, the - physician should under-stand and distinguish the season of each, - so that at one time he may attend to the nourishment and increase, and at - another to abstraction and diminution. And in this disease as in all others, he - must strive not to feed the disease, but endeavor to wear it out by - administering whatever is most opposed to each disease, and not that which - favors and is allied to it. For by that which is allied to it, it gains vigor - and increase, but it wears out and disappears under the use of that which is - opposed to it. But whoever is acquainted with such a change in men, and can - render a man humid and dry, hot and cold by regimen, could also cure this - disease, if he recognizes the proper season for administering his remedies, - without minding purifications, spells, and all other illiberal practices of a - like kind.

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- - - - diff --git a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng2.xml b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng2.xml new file mode 100644 index 000000000..532c49dba --- /dev/null +++ b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng2.xml @@ -0,0 +1,121 @@ + + + + + + +On the Sacred Disease +Hippocrates +Francis Adams +Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + +National Library of Medicine History of Medicine Division + + +Cultural Heritage Language Technologies +Kansas City Missouri +February 20, 2003 + +Trustees of Tufts University +Medford, MA +Perseus Digital Library Project +Perseus 4.0 +tlg0627.tlg027.perseus-eng2.xml + +Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + +

Data Entry

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+ + + + + + +English + + + + CTS and EpiDoc conversion. + + + + + +
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It is thus with regard to the disease called Sacred: it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder, because it is not at all like to other diseases. And this notion of its divinity is kept up by their inability to comprehend it, and the simplicity of the mode by which it is cured, for men are freed from it by purifications and incantations. But if it is reckoned divine because it is wonderful, instead of one there are many diseases which would be sacred; for, as I will show, there are others no less wonderful and prodigious, which nobody imagines to be sacred. The quotidian, tertian, and quartan fevers, seem to me no less sacred and divine in their origin than this disease, although they are not reckoned so wonderful. And I see men become mad and demented from no manifest cause, and at the same time doing many things out of place; and I have known many persons in sleep groaning and crying out, some in a state of suffocation, some jumping up and fleeing out of doors, and deprived of their reason until they awaken, and afterward becoming well and rational as before, although they be pale and weak; and this will happen not once but frequently. And there are many and various things of the like kind, which it would be tedious to state particularly.

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They who first referred this malady to the gods appear to me to have been just such persons as the conjurors, purificators, mountebanks, and charlatans now are, who give themselves out for being excessively religious, and as knowing more than other people. Such persons, then, using the divinity as a pretext and screen of their own inability to afford any assistance, have given out that the disease is sacred, adding suitable reasons for this opinion, they have instituted a mode of treatment which is safe for themselves, namely, by applying purifications and incantations, and enforcing abstinence from baths and many articles of food which are unwholesome to men in diseases. Of sea substances, the surmullet, the blacktail, the mullet, and the eel; for these are the fishes most to be guarded against. And of fleshes, those of the goat, the stag, the sow, and the dog: for these are the kinds of flesh which are aptest to disorder the bowels. Of fowls, the cock, the turtle, and the bustard, and such others as are reckoned to be particularly strong. And of potherbs, mint, garlic, and onions; for what is acrid does not agree with a weak person. And they forbid to have a black robe, because black is expressive of death; and to sleep on a goat’s skin, or to wear it, and to put one foot upon another, or one hand upon another; for all these things are held to be hindrances to the cure. All these they enjoin with reference to its divinity, as if possessed of more knowledge, and announcing beforehand other causes so that if the person should recover, theirs would be the honor and credit; and if he should die, they would have a certain defense, as if the gods, and not they, were to blame, seeing they had administered nothing either to eat or drink as medicines, nor had overheated him with baths, so as to prove the cause of what had happened. But I am of opinion that (if this were true) none of the Libyans, who live in the interior, would be free from this disease, since they all sleep on goats’ skins, and live upon goats’ flesh; neither have they couch, robe, nor shoe that is not made of goat’s skin, for they have no other herds but goats and oxen. But if these things, when administered in food, aggravate the disease, and if it be cured by abstinence from them, godhead is not the cause at all; nor will purifications be of any avail, but it is the food which is beneficial and prejudicial, and the influence of the divinity vanishes.

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Thus, they who try to cure these maladies in this way, appear to me neither to reckon them sacred nor divine. For when they are removed by such purifications, and this method of cure, what is to prevent them from being brought upon men and induced by other devices similar to these? So that the cause is no longer divine, but human. For whoever is able, by purifications conjurations, to drive away such an affection, will be able, by other practices, to excite it; and, according to this view, its divine nature is entirely done away with. By such sayings and doings, they profess to be possessed of superior knowledge, and deceive mankind by enjoining lustrations and purifications upon them, while their discourse turns upon the divinity and the godhead. And yet it would appear to me that their discourse savors not of piety, as they suppose, but rather of impiety, and as if there were no gods, and that what they hold to be holy and divine, were impious and unholy. This I will now explain.

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For, if they profess to know how to bring down the moon, darken the sun, induce storms and fine weather, and rains and droughts, and make the sea and land unproductive, and so forth, whether they arrogate this power as being derived from mysteries or any other knowledge or consideration, they appear to me to practice impiety, and either to fancy that there are no gods, or, if there are, that they have no ability to ward off any of the greatest evils. How, then, are they not enemies to the gods? For if a man by magical arts and sacrifices will bring down the moon, and darken the sun, and induce storms, or fine weather, I should not believe that there was anything divine, but human, in these things, provided the power of the divine were overpowered by human knowledge and subjected to it. But perhaps it will be said, these things are not so, but, not withstanding, men being in want of the means of life, invent many and various things, and devise many contrivances for all other things, and for this disease, in every phase of the disease, assigning the cause to a god. Nor do they remember the same things once, but frequently. For, if they imitate a goat, or grind their teeth, or if their right side be convulsed, they say that the mother of the gods is the cause. But if they speak in a sharper and more intense tone, they resemble this state to a horse, and say that Poseidon (Neptune) is the cause. Or if any excrement be passed, which is often the case, owing to the violence of the disease, the appellation of Enodia (Hecate?) is adhibited; or, if it be passed in smaller and denser masses, like bird’s, it is said to be from Apollo Nomius. But if foam be emitted by the mouth, and the patient kick with his feet, Ares (Mars) then gets the blame. But terrors which happen during the night, and fevers, and delirium, and jumpings out of bed, and frightful apparitions, and fleeing away,-all these they hold to be the plots of Hecate, and the invasions the and use purifications and incantations, and, as appears to me, make the divinity to be most wicked and most impious. For they purify those laboring under this disease, with the same sorts of blood and the other means that are used in the case of those who are stained with crimes, and of malefactors, or who have been enchanted by men, or who have done any wicked act; who ought to do the very reverse, namely, sacrifice and pray, and, bringing gifts to the temples, supplicate the gods. But now they do none of these things, but purify; and some of the purifications they conceal in the earth, and some they throw into the sea, and some they carry to the mountains where no one can touch or tread upon them. But these they ought to take to the temples and present to the god, if a god be the cause of the disease. Neither truly do I count it a worthy opinion to hold that the body of man is polluted by god, the most impure by the most holy; for were it defiled, or did it suffer from any other thing, it would be like to be purified and sanctified rather than polluted by god. For it is the divinity which purifies and sanctifies the greatest of offenses and the most wicked, and which proves our protection from them. And we mark out the boundaries of the temples and the groves of the gods, so that no one may pass them unless he be pure, and when we enter them we are sprinkled with holy water, not as being polluted, but as laying aside any other pollution which we formerly had. And thus it appears to me to hold, with regard to purifications.

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But this disease seems to me to be no more divine than others; but it has its nature such as other diseases have, and a cause whence it originates, and its nature and cause are divine only just as much as all others are, and it is curable no less than the others, unless when, the from of time, it is confirmed, and has became stronger than the remedies applied. Its origin is hereditary, like that of other diseases. For if a phlegmatic person be born of a phlegmatic, and a bilious of a bilious, and a phthisical of a phthisical, and one having spleen disease, of another having disease of the spleen, what is to hinder it from happening that where the father and mother were subject to this disease, certain of their offspring should be so affected also? As the semen comes from all parts of the body, healthy particles will come from healthy parts, and unhealthy from unhealthy parts. And another great proof that it is in nothing more divine than other diseases is, that it occurs in those who are of a phlegmatic constitution, but does not attack the bilious. Yet, if it were more divine than the others, this disease ought to befall all alike, and make no distinction between the bilious and phlegmatic.

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But in them, the brain is the cause of this affection, as it is of other very great diseases, and in what manner and from what cause it is formed, I will now plainly declare. The brain of man, as in all other animals, is double, and a thin membrane (meninx) divides it through the middle, and therefore the pain is not always in the same part of the head; for sometimes it is situated on either side, and sometimes the whole is affected; and veins run toward it from all parts of the body, many of which are small, but two are thick, the one from the liver, and the other from the spleen. And it is thus with regard to the one from the liver: a portion of it runs downward through the parts on the side, near the kidneys and the psoas muscles, to the inner part of the thigh, and extends to the foot. It is called vena cava. The other runs upward by the right veins and the lungs, and divides into branches for the heart and the right arm. The remaining part of it rises upward across the clavicle to the right side of the neck, and is superficial so as to be seen; near the ear it is concealed, and there it divides; its thickest, largest, and most hollow part ends in the brain; another small vein goes to the right ear, another to the right eye, and another to the nostril. Such are the distributions of the hepatic vein. And a vein from the spleen is distributed on the left side, upward and downward, like that from the liver, but more slender and feeble.

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By these veins we draw in much spirit (gas?), since they are the spiracles of our bodies inhaling air to themselves and distributing it to the rest of the body, and to the smaller veins, and they and afterwards exhale it. For the breath (pneuma) cannot be stationary, but it passes upward and downward, for if stopped and intercepted, the part where it is stopped becomes powerless. In proof of this, when, in sitting or lying, the small veins are compressed, so that the breath (pneuma) from the larger vein does not pass into them, the part is immediately seized with numbness; and it is so likewise with regard to the other veins.

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This malady, then, affects phlegmatic people, but not bilious. It begins to be formed while the foetus is still in utero. For the brain, like the other organs, is depurated and grows before birth. If, then, in this purgation it be properly and moderately depurated, and neither more nor less than what is proper be secreted from it, the head is thus in the most healthy condition. If the secretion (melting) the from the brain be greater than natural, the person, when he grows up, will have his head diseased, and full of noises, and will neither be able to endure the sun nor cold. Or, if the melting take place from any one part, either from the eye or ear, or if a vein has become slender, that part will be deranged in proportion to the melting. Or, should depuration not take place, but it (the secretion?) accumulate in the brain, it necessarily becomes phlegmatic. And such children as have an eruption of ulcers on the head, on the ears, and along the rest of the body, with copious discharges of saliva and mucus,-these, in after life, enjoy best health; for in this way the phlegm which ought to have been purged off in the womb, is discharged and cleared away, and persons so purged, for the most part, are not subject to attacks of this disease. But such as have had their skin free from eruptions, and have had no discharge of saliva or mucus, nor have undergone the proper purgation in the womb, these persons run the risk of being seized with this disease.

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But should the defluxion make its way to the heart, the person is seized with palpitation and asthma, the chest becomes diseased, and some also have curvature of the spine. For when a defluxion of cold phlegm takes place on the lungs and heart, the blood is chilled, and the veins, being violently chilled, palpitate in the lungs and heart, and the heart palpitates, so that from this necessity asthma and orthopnoea supervene. For it does not receive the spirits (pneuma) as much breath as he needs until the defluxion of phlegm be mastered, and being heated is distributed to the veins, then it ceases from its palpitation and difficulty of breathing, and this takes place as soon as it obtains an abundant supply; and this will be more slowly, provided the defluxion be more abundant, or if it be less, more quickly. And if the defluxions be more condensed, the epileptic attacks will be more frequent, but otherwise if it be rarer. Such are the symptoms when the defluxion is upon the lungs and heart; but if it be upon the bowels, the person is attacked with diarrhoea.

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And if, being shut out from all these outlets, its defluxion be determined to the veins I have formerly mentioned, the patient loses his speech, and chokes, and foam issues by the mouth, the teeth are fixed, the hands are contracted, the eyes distorted, he becomes insensible, and in some cases the bowels are evacuated. And these symptoms occur sometimes on the left side, sometimes on the right, and sometimes in both. The cause of everyone of these symptoms I will now explain. The man becomes speechless when the phlegm, suddenly descending into the veins, shuts out the air, and does not admit it either to the brain or to the vena cava, or to the ventricles, but interrupts the inspiration. For when a person draws in air by the mouth and nostrils, the breath (pneuma) goes first to the brain, then the greater part of it to the internal cavity, and part to the lungs, and part to the veins, and from them it is distributed to the other parts of the body along the veins; and whatever passes to the stomach cools, and does nothing more; and so also with regard to the lungs. But the air which enters the veins is of use (to the body) by entering the brain and its ventricles, and thus it imparts sensibility and motion to all the members, so that when the veins are excluded from the air by the phlegm and do not receive it, the man loses his speech and intellect, and the hands become powerless, and are contracted, the blood stopping and not being diffused, as it was wont; and the eyes are distorted owing to the veins being excluded from the air; and they palpitate; and froth from the lungs issues by the mouth. For when the breath (pneuma) does not find entrance to him, he foams and sputters like a dying person. And the bowels are evacuated in consequence of the violent suffocation; and the suffocation is produced when the liver and stomach ascend to the diaphragm, and the mouth of the stomach is shut up; this takes place when the breath (pneuma) does not enter by the mouth, as it is wont. The patient kicks with his feet when the air is shut up in the lungs and cannot find an outlet, owing to the phlegm; and rushing by the blood upward and downward, it occasions convulsions and pain, and therefore he kicks with his feet. All these symptoms he endures when the cold phlegm passes into the warm blood, for it congeals and stops the blood. And if the deflexion be copious and thick, it immediately proves fatal to him, for by its cold it prevails over the blood and congeals it; or, if it be less, it in the first place obtains the mastery, and stops the respiration; and then in the course of time, when it is diffused along the veins and mixed with much warm blood, it is thus overpowered, the veins receive the air, and the patient recovers his senses.

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Of little children who are seized with this disease, the greater part die, provided the defluxion be copious and humid, for the veins being slender cannot admit the phlegm, owing to its thickness and abundance; but the blood is cooled and congealed, and the child immediately dies. But if the phlegm be in small quantity, and make a defluxion into both the veins, or to those on either side, the children survive, but exhibit notable marks of the disorder; for either the mouth is drawn aside, or an eye, the neck, or a hand, wherever a vein being filled with phlegm loses its tone, and is attenuated, and the part of the body connected with this vein is necessarily rendered weaker and defective. But for the most it affords relief for a longer interval; for the child is no longer seized with these attacks, if once it has contracted this impress of the disease, in consequence of which the other veins are necessarily affected, and to a certain degree attenuated, so as just to admit the air, but no longer to permit the influx of phlegm. However, the parts are proportionally enfeebled whenever the veins are in an unhealthy state. When in striplings the defluxion is small and to the right side, they recover without leaving any marks of the disease, but there is danger of its becoming habitual, and even increasing if not treated by suitable remedies. Thus, or very nearly so, is the case when it attacks children.

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To persons of a more advanced age, it neither proves fatal, nor produces distortions. For their veins are (large?) and filled with hot blood; and therefore the phlegm can neither prevail nor cool the blood, so as to coagulate it, but it is quickly overpowered and mixed with the blood, and thus the veins receive the air, and sensibility remains; and, owing to their strength, the aforesaid symptoms are less likely to seize them. But when this disease attacks very old people, it therefore proves fatal, or induces paraplegia, because the veins are empty, and the blood scanty, thin, and watery. When, therefore, the defluxion is copious, and the season winter, it proves fatal; for it chokes up the exhalents, and coagulates the blood if the defluxion be to both sides; but if to either, it merely induces paraplegia. For the blood being thin, cold, and scanty, cannot prevail over the but being itself overpowered, it is coagulated, so that those parts in which the blood is corrupted, lose their strength.

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The flux is to the right rather than to the left because the veins there are more capacious and numerous than on the left side, for on the one side they spring from the liver, and on the other from the spleen. The defluxion and melting down take place most especially in the case of children in whom the head is heated either by the sun or by fire, or if the brain suddenly contract a rigor, and then the phlegm is excreted. For it is melted down by the heat and diffusion of the but it is excreted by the congealing and contracting of it, and thus a defluxion takes place. And in some this is the cause of the disease, and in others, when the south wind quickly succeeds to northern breezes, it suddenly unbinds and relaxes the brain, which is contracted and weak, so that there is an inundation of phlegm, and thus the defluxion takes place. The defluxion also takes place in consequence of fear, from any hidden cause, if we are the at any person’s calling aloud, or while crying, when one cannot quickly recover one’s breath, such as often happens to children. When any of these things occur, the body immediately shivers, the person becoming speechless cannot draw his breath, but the breath (pneuma) stops, the brain is contracted, the blood stands still, and thus the excretion and defluxion of the phlegm take place. In children, these are the causes of the attack at first. But to old persons winter is most inimical. For when the head and brain have been heated at a great fire, and then the person is brought into cold and has a rigor, or when from cold he comes into warmth, and sits at the fire, he is apt to suffer in the same way, and thus he is seized in the manner described above. And there is much danger of the same thing occurring, if his head be exposed to the sun, but less so in summer, as the changes are not sudden. When a person has passed the twentieth year of his life, this disease is not apt to seize him, unless it has become habitual from childhood, or at least this is rarely or never the case. For the veins are filled with blood, and the brain consistent and firm, so that it does not run down into the veins, or if it do, it does not master the blood, which is copious and hot.

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But when it has gained strength from one’s childhood, and become habitual, such a person usually suffers attacks, and is seized with them in changes of the winds, especially in south winds, and it is difficult of removal. For the brain becomes more humid than natural, and is inundated with phlegm, so that the defluxions become more frequent, and the phlegm can no longer be the nor the brain be dried up, but it becomes wet and humid. This you may ascertain in particular, from beasts of the flock which are seized with this disease, and more especially goats, for they are most frequently attacked with it. If you will cut open the head, you will find the brain humid, full of sweat, and having a bad smell. And in this way truly you may see that it is not a god that injures the body, but disease. And so it is with man. For when the disease has prevailed for a length of time, it is no longer curable, as the brain is corroded by the phlegm, and melted, and what is melted down becomes water, and surrounds the brain externally, and overflows it; wherefore they are more frequently and readily seized with the disease. And therefore the disease is protracted, because the influx is thin, owing to its quantity, and is immediately overpowered by the blood and heated all through.

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But such persons as are habituated to the disease know beforehand when they are about to be seized and flee from men; if their own house be at hand, they run home, but if not, to a deserted place, where as few persons as possible will see them falling, and they immediately cover themselves up. This they do from shame of the affection, and not from fear of the divinity, as many suppose. And little children at first fall down wherever they may happen to be, from inexperience. But when they have been often seized, and feel its approach beforehand, they flee to their mothers, or to any other person they are acquainted with, from terror and dread of the affection, for being still infants they do not know yet what it is to be ashamed.

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Therefore, they are attacked during changes of the winds, and especially south winds, then also with north winds, and afterwards also with the others. These are the strongest winds, and the most opposed to one another, both as to direction and power. For, the north wind condenses the air, and separates from it whatever is muddy and nebulous, and renders it clearer and brighter, and so in like manner also, all the winds which arise from the sea and other waters; for they extract the humidity and nebulosity from all objects, and from men themselves, and therefore it (the north wind) is the most wholesome of the winds. But the effects of the south are the very reverse. For in the first place it begins by melting and diffusing the condensed air, and therefore it does not blow strong at first, but is gentle at the commencement, because it is not able at once to overcome the and compacted air, which yet in a while it dissolves. It produces the same effects upon the land, the sea, the fountains, the wells, and on every production which contains humidity, and this, there is in all things, some more, some less. For all these feel the effects of this wind, and from clear they become cloudy, from cold, hot; from dry, moist; and whatever ear then vessels are placed upon the ground, filled with wine or any other fluid, are affected with the south wind, and undergo a change. And the a change. And the sun, and the moon, it renders blunter appearance than they naturally are. When, then, it possesses such powers over things so great and strong, and the body is made to feel and undergo changes in the changes of the winds, it necessarily follows that the brain should be disolved and overpowered with moisture, and that the veins should become more relaxed by the south winds, and that by the north the healthiest portion of the brain should become contracted, while the most morbid and humid is secreted, and overflows externally, and that catarrhs should thus take place in the changes of these winds. Thus is this disease formed and prevails from those things which enter into and go out of the body, and it is not more difficult to understand or to cure than the others, neither is it more divine than other diseases.

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And men ought to know that from nothing else but (from the brain) come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations. And by this, in an especial manner, we acquire wisdom and knowledge, and see and hear, and know what are foul and what are fair, what are bad and what are good, what are sweet, and what unsavory; some we discriminate by habit, and some we perceive by their utility. By this we distinguish objects of relish and disrelish, according to the seasons; and the same things do not always please us. And by the same organ we become mad and delirious, and fears and terrors assail us, some by night, and some by day, and dreams and untimely wanderings, and cares that are not suitable, and ignorance of present circumstances, desuetude, and unskilfulness. All these things we endure from the brain, when it is not healthy, but is more hot, more cold, more moist, or more dry than natural, or when it suffers any other preternatural and unusual affection. And we become mad from humidity (of the brain). For when it is more moist than natural, it is necessarily put into motion, and the affection being moved, neither the sight nor hearing can be at rest, and the tongue speaks in accordance with the sight and hearing.

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As long as the brain is at rest, the man enjoys his reason, but the depravement of the brain arises from phlegm and bile, either of which you may recognize in this manner: Those who are mad from phlegm are quiet, and do not cry out nor make a noise; but those from bile are vociferous, malignant, and will not be quiet, but are always doing something improper. If the madness be constant, these are the causes thereof. But if terrors and fears assail, they are connected with derangement of the brain, and derangement is owing to its being heated. And it is heated by bile when it is determined to the brain along the bloodvessels running from the trunk; and fear is present until it returns again to the veins and trunk, when it ceases. He is grieved and troubled when the brain is unseasonably cooled and contracted beyond its wont. This it suffers from phlegm, and from the same affection the patient becomes oblivious. He calls out and screams at night when the brain is suddenly heated. The bilious endure this. But the phlegmatic are not heated, except when much blood goes to the brain, and creates an ebullition. Much blood passes along the aforesaid veins. But when the man happens to see a frightful dream and is in fear as if awake, then his face is in a greater glow, and the eyes are red when the patient is in fear. And the understanding meditates doing some mischief, and thus it is affected in sleep. But if, when awakened, he returns to himself, and the blood is again distributed along the veins, it ceases.

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In these ways I am of the opinion that the brain exercises the greatest power in the man. This is the interpreter to us of those things which emanate from the air, when it (the brain) happens to be in a sound state. But the air supplies sense to it. And the eyes, the ears, the tongue and the feet, administer such things as the brain cogitates. For in as much as it is supplied with air, does it impart sense to the body. It is the brain which is the messenger to the understanding. For when the man draws the breath (pneuma) into himself, it passes first to the brain, and thus the air is distributed to the rest of the body, leaving in the brain its acme, and whatever has sense and understanding. For if it passed first to the body and last to the brain, then having left in the flesh and veins the judgment, when it reached the brain it would be hot, and not at all pure, but mixed with the humidity from flesh and blood, so as to be no longer pure.

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Wherefore, I say, that it is the brain which interprets the understanding. But the diaphragm has obtained its name (frenes) from accident and usage, and not from reality or nature, for I know no power which it possesses, either as to sense or understanding, except that when the man is affected with unexpected joy or sorrow, it throbs and produces palpitations, owing to its thinness, and as having no belly to receive anything good or bad that may present themselves to it, but it is thrown into commotion by both these, from its natural weakness. It then perceives beforehand none of those things which occur in the body, but has received its name vaguely and without any proper reason, like the parts about the heart, which are called auricles, but which contribute nothing towards hearing. Some say that we think with the heart, and that this is the part which is grieved, and experiences care. But it is not so; only it contracts like the diaphragm, and still more so for the same causes. For veins from all parts of the body run to it, and it has valves, so as to as to perceive if any pain or pleasurable emotion befall the man. For when grieved the body necessarily shudders, and is contracted, and from excessive joy it is affected in like manner. Wherefore the heart and the diaphragm are particularly sensitive, they have nothing to do, however, with the operations of the understanding, but of all but of all these the brain is the cause. Since, then, the brain, as being the primary seat of sense and of the spirits, perceives whatever occurs in the body, if any change more powerful than usual take place in the air, owing to the seasons, the brain becomes changed by the state of the air. For, on this account, the brain first perceives, because, I say, all the most acute, most powerful, and most deadly diseases, and those which are most difficult to be understood by the inexperienced, fall upon the brain.

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And the disease called the Sacred arises from causes as the others, namely, those things which enter and quit the body, such as cold, the sun, and the winds, which are ever changing and are never at rest. And these things are divine, so that there is no necessity for making a distinction, and holding this disease to be more divine than the others, but all are divine, and all human. And each has its own peculiar nature and power, and none is of an ambiguous nature, or irremediable. And the most of them are curable by the same means as those by which any other thing is food to one, and injurious to another. Thus, then, the physician should understand and distinguish the season of each, so that at one time he may attend to the nourishment and increase, and at another to abstraction and diminution. And in this disease as in all others, he must strive not to feed the disease, but endeavor to wear it out by administering whatever is most opposed to each disease, and not that which favors and is allied to it. For by that which is allied to it, it gains vigor and increase, but it wears out and disappears under the use of that which is opposed to it. But whoever is acquainted with such a change in men, and can render a man humid and dry, hot and cold by regimen, could also cure this disease, if he recognizes the proper season for administering his remedies, without minding purifications, spells, and all other illiberal practices of a like kind.

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+ + + + diff --git a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-grc2.xml b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-grc2.xml index 40af977ff..c3cb7a0a4 100644 --- a/data/tlg0627/tlg027/tlg0627.tlg027.perseus-grc2.xml +++ b/data/tlg0627/tlg027/tlg0627.tlg027.perseus-grc2.xml @@ -34,7 +34,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg028/__cts__.xml b/data/tlg0627/tlg028/__cts__.xml index 278a73271..d27e7fbe8 100644 --- a/data/tlg0627/tlg028/__cts__.xml +++ b/data/tlg0627/tlg028/__cts__.xml @@ -3,6 +3,11 @@ Περὶ ἑλκῶν - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + + On Ulcers + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.tracking.json b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.tracking.json deleted file mode 100644 index fe0be299c..000000000 --- a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0248", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.adams_eng.xml---subdoc---text=Ulc.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.xml b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.xml deleted file mode 100644 index 468cddd1f..000000000 --- a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng1.xml +++ /dev/null @@ -1,469 +0,0 @@ - - - - - - On Ulcers - Hippocrates - Francis Adams - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 20, 2003 - - - - - The Genuine Works of Hippocrates - Hippocrates - Francis Adams - - New York - William Wood & Company - 1886 - - - - - - - - -

Data Entry

- - - - - - - - - - - - - - - - - - - - - - - - - - English - - - - - -
- Part 1 -

We must avoid wetting all sorts of ulcers except with wine, unless the ulcer be - situated in a joint. For, the dry is nearer to the sound, and the wet to the - unsound, since an ulcer is wet, but a sound part is dry. And it is better to - leave the part without a bandage unless a unless a cataplasm be applied. Neither - do certain ulcers admit of cataplasms, and this is the case with the recent - rather than the old, and with those situated in joints. A spare diet and water - agree with all ulcers, and with the more recent rather than the older; and with - an ulcer which either is inflamed or is about to be so; and where there is - danger of gangrene; and with the ulcers an inflammation in joints; and where - there is danger of convulsion; and in wounds of the belly; but most especially - in fractures of the head and thigh, or any other member in which a fracture may - have occurred. In the case of an ulcer, it is not expedient to stand; more - especially if the ulcer be situated in the leg; but neither, also, is it proper - to sit or walk. But quiet and rest are particularly expedient. Recent ulcers, - both the ulcers themselves and the surrounding parts, will be least exposed to - inflammation, if one shall bring them to a suppuration as expeditiously as - possible, and if the matter is not prevented from escaping by the mouth of the - sore; or, if one should restrain the suppuration, so that only a small and - necessary quantity of pus may be formed, and the sore may be kept dry by a - medicine which does not create irritation. For the part becomes inflamed when - rigor and throbbing supervene; for ulcers then get inflamed when suppuration is - about to form. A sore suppurates when the blood is changed and be-comes heated; so that becoming putrid, it constitutes the pus of such ulcers. - When you seem to require a cataplasm, it is not the ulcer itself to which you - must apply the cataplasm, but to the surrounding parts, so that the pus may - escape and the hardened parts may become soft. Ulcers formed either from the - parts having been cut through by a sharp instrument, or excised, admit of - medicaments for bloody wounds ('enaima), and which will - prevent suppuration by being desiccant to a certain degree. But, when the flesh - has been contused and roughly cut by the weapon, it is to be so treated that it - may suppurate as quickly as possible; for thus the inflammation is less, and it - is necessary that the pieces of flesh which are bruised and cut should melt away - by becoming putrid, being converted into pus, and that new flesh should then - grow up. In every recent ulcer, except in the belly, it is expedient to cause - blood to flow from it abundantly, and as may seem seasonable; for thus will the - wound and the adjacent parts be less attacked with inflammation. And, in like - manner, from old ulcers, especially if situated in the leg, in a toe or finger, - more than in any other part of the body. For when the blood flows they become - drier and less in size, as being thus dried up. It is this ( - blood?) especially which prevents such ulcers from healing, by getting - into a state of putrefaction and corruption. But, it is expedient, after the - flow of the blood, to bind over the ulcer a thick and soft piece of sponge, - rather dry than wet, and to place above the sponge some slender leaves. Oil, and - all things of an emollient and oily nature, disagree with such ulcers, unless - they are getting nearly well. Neither does oil agree with wounds which have been - recently inflicted, nor yet do medicines formed with oil or suet, more - especially if the ulcer stands in need of more cleansing. And, in a word, it is - in summer and in winter that we are to smear with oil these sores that require - such medicines.

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- Part 2 -

Gentle purging of the bowels agrees with most ulcers, and in wounds of the head, - belly, or joints, where there is danger of gangrene, in such as require sutures, - in phagedaenic, spreading and in otherwise inveterate ulcers. And when you want - to apply a bandage, no plasters are to be used until you have rendered the sore dry, and then indeed you may apply them. The ulcer is to be - frequently cleaned with a sponge, and then a dry and clean piece of cloth is to - be frequently applied to it, and in this way the medicine which it is supposed - will agree with it is to be applied, either with or without a bandage. The hot - season agrees better than winter with most ulcers, except those situated in the - head and belly; but the equinoctial season agrees still better with them. Ulcers - which have been properly cleansed and dried as they should be, do not usually - get into a the state. When a bone has exfoliated, or has been burned, or sawed, - or removed in any other way, the cicatrices of such ulcers become deeper than - usual. Ulcers which are not cleansed, are not disposed to unite if brought - together, nor do the lips thereof approximate of their own accord. When the - points adjoining to an ulcer are inflamed, the ulcer is not disposed to heal - until the inflammation subside, nor when the surrounding parts are blackened by - mortification, nor when a varix occasions an overflow of blood in the part, is - the ulcer disposed to heal, unless you bring the surrounding parts into a - healthy condition.

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- Part 3 -

Circular ulcers, if somewhat hollow, you must scarify all along their edges, or - to the extent of half the circle, according to the natural stature of the man. - When erysipelas supervenes upon any sore, you must purge the body, in the way - most suitable to the ulcer, either upward or downward. When swelling arises - around an. ulcer, and if the ulcer remain free from inflammation, there will be - a deposit of matter in process of time. And whatever ulcer gets swelled along - with inflammation and does not subside as the other parts subside which became - inflamed and swelled at the same time, there is a danger that such an ulcer may - not unite. When from a fall, or in any other way, a part has been torn or - bruised, and the parts surrounding the ulcer have become swelled, and, having - suppurated, matter flows from the swelling by the ulcer, if in such cases a - cataplasm be required, it should not be applied to the sore itself, but to the - surrounding parts, so that the pus may have free exit, and the indurated parts - may be softened. But when the parts are softened as the inflammation ceases, - then the parts which are separated are to be brought toward one - another, binding on sponges and applying them, beginning from the sound parts - and advancing to the ulcer by degrees. But plenty of leaves are to be bound - above the sponge. When the parts are prevented from coming together by a piece - of flesh full of humors, it is to be removed. When the ulcer is deep seated in - the flesh, it is swelled up, both from the bandaging and the compression. Such - an ulcer should be cut up upon a director (specillum) if possible, at the proper - time, so as to admit a free discharge of the matter, and then the proper - treatment is to be applied as may be needed. For the most part, in every hollow - ulcer which can be seen into which can be seen into direct without being any - swelling present, if there be putrefaction in it, or if the flesh be flabby and - putrid, such an ulcer, and the parts which surround it, will be seen to be black - and somewhat livid. And of corroding ulcers, those which are phagedaenic, spread - and corrode most powerfully, and, in this case, the parts surrounding the sore - will have a black and sub-livid appearance.

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- Part 4 -

Cataplasms for swellings and inflammation in the surrounding parts. Boiled - mullein, the raw leaves of the trefoil, and the boiled leaves of the epipetrum, - and the poley, and if the ulcer stand in need of cleansing, all these things - also cleanse; and likewise the leaves of the fig-tree, and of the olive, and the - horehound, all these are to be boiled; and more especially the chaste-tree, and - the fig, and the olive, and the leaves of the pomegranate are to be boiled in - like manner. These are to be used raw: and the leaves of the mallow pounded with - wine, and the leaves of rue, and those of the green origany. With all these, - linseed is to be boiled up and mixed by pounding it as a very fine powder. When - there is danger of erysipelas seizing the ulcers, the leaves of woad are to be - pounded and applied raw in a cataplasm along with linseed, or the linseed is to - be moistened with the juice of strychnos or of woad, and applied as a cataplasm. - When the ulcer is clean, but both it and the surrounding parts are inflamed, - lentil is to be boiled in wine and finely triturated, and, being mixed with a - little oil, it is to be applied as a cataplasm; and the leaves of the hip-tree - are to be boiled in water and pounded in a fine powder and made into a - cataplasm; and apply below a thin, clean piece of cloth wetted in - wine and oil; and when you wish to produce contraction, prepare the leaves of - the hip-tree like the lentil, and the cress; wine and finely-powdered linseed - are to be mixed together. And this is proper: linseed, and raw chaste-tree, and - Melian alum, all these things being macerated in vinegar.

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- Part 5 -

Having pounded the white unripe grape in a mortar of red bronze, and passed it - through the strainer, expose it to the sun during the day, but remove it during - the night, that it may not suffer from the dew; rub it constantly during the - day, so that it may dry equally, and may contract as much virtue as possible - from the bronze: let it be exposed to the sun for as great a length of time as - till it acquire the thickness of honey; then put it into a bronze pot with the - fresh honey and sweet wine, in which turpentine resin has been previously - boiled, boil the resin in the wine until it become hard like boiled honey; then - take out the resin and pour off the wine: there should be the greatest - proportion of the juice of unripe grape, next of the wine, and third of the - honey and myrrh, either the liquid (stacte) or otherwise. - The finest kind is to be levigated and moistened by having a small quantity of - the same wine poured on it; and then the myrrh is to be boiled by itself, - stirring it in the wine; and when it appears to have attained the proper degree - of thickness, it is to be poured into the juice of the unripe grape; and the - finest natron is to be toasted, and gently added to the medicine, along with a - smaller quantity of the flowers of copper (flos aeris) than - of the natron. When you have mixed these things, boil for not less than three - days, on a gentle fire made with fuel of the fig-tree or with coals, lest it - catch fire. The applications should all be free from moisture, and the sores - should not be wetted when this medicine is applied in the form of liniment. This - medicine is to be used for old ulcers, and also for recent wounds of the glans - penis, and ulcers on the head and ears. Another medicine for the same - ulcers:-The dried gall of an ox, the finest honey, white wine, in which the - shavings of the lotus have been boiled, frankincense, of myrrh an equal part, of - saffron an equal part, the flowers of copper, in like manner of liquids, the - greatest proportion of wine, next of honey, and least of the gall. - Another:-Wine, a little cedar honey, of dried things, the flowers - of copper, myrrh, dried pomegranate rind. Another:-Of the roasted flower of - copper half a drachm, of myrrh two half-drachms, of saffron three drachms, of - honey a small quantity, to be boiled with wine. Another:-Of frankincense a - drachm, of gall a drachm, of saffron three drachms; let each of these be dried - and finely levigated, then, having mixed, triturate in a very strong sun, - pouring in the juice of an unripe grape, until it become of a gelatinous - consistence, for three days; then let them be allowed to macerate in an austere, - dark-colored, fragrant wine, which is gradually poured upon them. Another:-Boil - the roots of the holmoak in sweet white wine; and when it appears to be properly - done, having poured off two parts of the wine, and of the lees of wine as free - of water as possible one part; then boil, stirring it, so that it may not be - burnt, at a gentle fire, until it appear to have attained the proper - consistence. Another:-The other things are to be the same; but, not - withstanding, instead of the wine, use the strongest white vinegar, and dip into - it wool as greasy as can be procured, and then, moistening it with the lees of - oil, boil, and pour in the juice of the wild fig-tree, and add Melian alum, and - natron, and the flowers of copper, both toasted. This cleanses the ulcers better - than the former, but the other is no less desiccant. Another:-Dip the wool in a - very little water; and then, having added a third part of wine, boil until it - attain the proper consistence. By these, recent ulcers are most speedily - prevented from getting into a state of suppuration.

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- Part 6 -

Another:-Sprinkle on it dried wakerobin, and add the green bark of the fig-tree, - pounding it in the juice: do this with or without wine, and along with honey. - Another:-Boiling the shavings of lotus with vinegar (the vinegar should be - white); then mix the lees of oil and raw tar-water, and use it as a liniment or - wash, and bandage above. These things in powder prevent recent wounds from - suppurating, or they may be used for cleansing the sore along with vinegar, or - for sponging with wine.

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- Part 7 -

Another:-Sprinkle (on the sore?) lead finely triturated - with the recrement of copper; and sprinkle on it, also, the shavings of lotus, - and the scales of copper, and alum, and chalcitis, with copper, both alone, and - with the shavings of lotus. And other-wise, when it is wanted to - use these in a dry state, do it with the Illyrian spodos triturated with the - shavings, and with the shavings alone. And the flowers of silver alone, in the - finest powder; and birthwort, when scraped and finely pounded, may be sprinkled - on the part. Another, for bloody sores myrrh, frankincense, galls, verdigris the - roasted flower of copper, Egyptian alum roasted, vine flowers, grease of wool, - plumbago, each of these things is to be diluted, in equal proportions, with wine - like the former. And there is another preparation of the same:-The strongest - vinegar of a white color, honey, Egyptian alum, the finest natron; having - toasted these things gently, pour in a little gall; this cleanses fungous - ulcers, renders them hollow, and is not pungent. Another:-The herb with the - small leaves, which gets the name of Parthenium parviflorum, and is used for - removing thymia (warts?) from the glans penis, alum, - chalcitis, a little crude Melian alum (?); sprinkle a little dried elaterium, - and a little dried pomegranate rind in like manner.

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- Part 8 -

The herb which has got the name of lagopyrus, fills up hollow and clean ulcers; - (when dried it resembles wheat; it has a small leaf like that of the olive, and - more long;) and the leaf of horehound, with oil. Another:-The internal fatty - part, resembling honey, of a fig much dried, of water two parts, of linseed not - much toasted and finely levigated, one part. Another:-Of the dried fig, of the - flower of copper levigated a little, and the juice of the fig. The preparation - from dried fig:-The black chamaeleon, the dried gall of an ox, the other things - the same. Of the powders:-Of the slender cress in a raw state, of horehound, of - each equal parts; of the dried fig, two parts; of linseed, two parts; the juice - of the fig. When you use any of these medicines, apply above it compresses - wetted in vinegar, apply a sponge about the compresses and make a If the - surrounding parts be in an inflamed state, apply to them any medicine which may - appear suitable.

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- Part 9 -

If you wish to use a liquid application, the medicine called caricum may be rubbed in, and the bandages may be applied as formerly - described upon the same principle. The medicine is prepared of the following - ingredients:-Of black hellebore, of sandarach, of the flakes of - copper, of lead washed, with much sulphur, arsenic, and cantharides. This may be - compounded so as may be judged most proper, and it is to be diluted with oil of - juniper. When enough has been rubbed in, lay aside the medicine, and apply - boiled wakerobin in a soft state, either rubbing it in dry, or moistening it - with honey. But if you use the caricum in a dry state, you must abstain from - these things, and sprinkle the medicine on the sore. The powder from hellebore - and sandarach alone answers. Another liquid medicine:-The herb, the leaf of - which resembles the arum (wakerobin) in nature, but is white, downy, of the size - of the ivy-leaf: this herb is applied with wine, or the substance which forms - upon the branches of the ilex, when pounded with wine, is to be applied. - Another:-The juice of the grape, the strongest vinegar, the flower of copper, - natron, the juice of the wild fig-tree. Alum, the most finely levigated, is to - be put into the juice of the wild grape, and it is to be put into a red bronze - mortar and stirred in the sun, and removed when it appears to have attained - proper consistence.

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- Part 10 -

These are other powders:-Black hellebore, as finely levigated as possible, is to - be sprinkled on the sore while any humidity remains about it, and while it - continues to spread. The bandaging is the same as when plasters are used. - Another, in like manner:-The driest lumps of salt are to be put into a copper, - or earthen pot, of equal size, as much as possible, and not large, and the - finest honey, of double the size of the salt, as far as can be guessed, is to be - poured upon the lumps of salt, then the vessel is to be put upon coals and - allowed to sit there until the whole is consumed. Then, having sponged the ulcer - and cleansed it, bandage it as before, and compress it a little more. Next day, - wherever the medicine has not been taken in, sprinkle it on, press it down, and - bandage. But when you wish to remove the medicine, pour in hot vinegar until it - separate, and again do the same things, sponging it away, if necessary. Another - corrosive powder:-Of the most finely-levigated misy, sprinkle upon the moist and - gangrenous parts, and a little of the flower of copper, not altogether - levigated. Another powder equally corrosive:-Having sponged the ulcer, burn the - most greasy wool upon a shell placed on the fire until the whole - be consumed; having reduced this to a fine powder, and sprinkled it on the sore, - apply the bandage in the same manner. Another powder for the same ulcers:-The - black chamaeleon, when prepared with the juice of the fig. It is to be prepared - roasted, and alkanet mixed with it. Or, pimpernel, and Egyptian alum roasted, - and sprinkle on them the Orchomenian powder. For spreading ulcers:-Alum, both - the Egyptian roasted, and the Melian; but the part is to be first cleansed with - roasted natron and sponged; and the species of alum called chalcitis roasted. It - is to be roasted until it catch fire.

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- Part 11 -

For old ulcers which occur on the fore part of the legs; they become bloody and - black:-Having pounded the flower of the melilot and mixed it with honey, use as - a plaster. For nerves (tendons?) which have been cut - asunder:-Having pounded, sifted, and mixed with oil the roots of the wild - myrtle, bind on the part; and the herb cinquefoil (it is white and downy, and - more raised above the ground than the black cinquefoil), having pounded this - herb in oil bind it on the part, and then remove it on the third day.

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- Part 12 -

- Emollients (?):-These medicines are to be used in winter - rather than in summer. Emollient medicines which make the cicatrices fair:-Pound - the inner mucous part of the squill and pitch, with fresh swine's seam, and a - little oil, and a little resin, and ceruse. And the grease of a goose, fresh - swine's seam, and squill, and a little oil. The whitest wax, fresh clean grease, - or squill and white oil, and a little resin. Wax, swine's seam (old and fresh), - and oil, and verdigris, and squill and resin. Let there be two parts of the old - grease to the fresh, and of the other things, q. s. Having melted the grease - that is fresh, pour it into another pot; having levigated plumbago finely and - sifted it, and mixed them together, boil and stir at first; boil until when - poured upon the ground it concretes; then taking it off the fire, pour it all - into another vessel, with the exception of the stony sediment, and add resin and - stir, and mix a little oil of juniper, and what has been taken off. In all the - emollient medicines to which you add the resin, when you remove the medicine - from the fire, pour in and mix the resin while it is still warm. Another:-Old - swine's seam, wax, and oil, the dried shavings of the lotus, frankincense, - plumbago,-namely, of the frankincense one part, and of the other one part, and - of the shavings of the lotus one part; but let there be two parts of the old - grease, one of wax, and of fresh swine's seam one part. Another:-Or old swine's - seam along with the fresh grease of a goat; when cleaned, let it retain as - little as possible of its membrane: having triturated or pounded it smooth, pour - in oil, and sprinkle the lead with the spodium and half the shavings of the - lotus. Another:-Swine's seam, spodium, blue chalcitis, oil.

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- Part 13 -

- For Burns:-You must boil the tender roots of the ilex, and - if their bark be very thick and green, it must be cut into small parts, and - having poured in white wine, boil upon a gentle fire, until it appear to you to - be of the proper consistence, so as to be used for a liniment. And it may be - prepared in water after the same manner. Another, not corrosive:-Old swine's seam is to be rubbed in by itself, and it is to be melted along - with squill, the root of which is to be divided and applied with a bandage. Next - day it is to be fomented; and having melted old swine's seam and wax, and mixed - with them oil, frankincense, and the shavings of lotus and vermilion, this is to - be used as a liniment. Having boiled the leaves of the wakerobin in wine and - oil, apply a bandage. Another:-When you have smeared the parts with old swine's - seam let the roots of asphodel be pounded in wine and triturated, and rubbed in. - Another:-Having melted old swine's seam, and mixed with resin and bitumen, and - having spread it on a piece of cloth and warmed it at the fire, apply a bandage. - When an ulcer has formed on the back from stripes or otherwise, let squill, - twice boiled, be pounded and spread upon a linen cloth and bound on the place. - Afterward the grease of a goat, and fresh swine's seam, spodium, oil, and - frankincense are to be rubbed in.

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- Part 14 -

Swellings which arise on the feet, either spontaneously or otherwise, when - neither the swellings nor the inflammation subside under the use of cataplasms, - and although sponges or wool, or anything else be bound upon the sound part; but - the swelling and inflammation return of themselves again, an influx of blood into the veins is the cause, when not occasioned by a bruise. And - the same story applies if this happen in any other part of the body. But blood - is to be abstracted, especially the from the veins, which are the seat of the - influx, if they be conspicuous; but if not, deeper and more numerous - scarifications are to be made in the swellings; and whatever part you scarify, - this is to be done with the sharpest and most slender instruments of iron. When - you have removed the blood, you must not press hard upon the part with the - specillum, lest you produce contusion. Bathe with vinegar, and do not allow a - clot of blood to remain between the lips of the wounds, and having spread greasy - wool with a medicine for bloody wounds, and having carded the woof and made it - soft, bind it on, having wetted it with wine and oil. And let the scarified part - be so placed that the determination of the blood may be upward and not downward; - and do not wet the part at all, and let the patient be put upon a restricted - diet and drink water. If upon loosing the bandages you find the scarifications - inflamed, apply a cataplasm of the fruit of the chaste-tree and linseed. But if - the scarifications become ulcerated and break into one another, we must be - regulated by circumstances, and otherwise apply whatever else appears to be - proper.

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- Part 15 -

When a varix is on the fore part of the leg, and is very superficial, or below - the flesh, and the leg is black, and seems to stand in need of having the blood - evacuated from it, such swellings are not, by any means, to be cut open; for, - generally, large ulcers are the consequence of the incisions, owing to the - influx from the varix. But the varix itself is to be punctured in many places, - as circumstances may indicate.

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- Part 16 -

When you have opened a vein and abstracted blood, and although the fillet be - loosed the bleeding does not stop, the member, whether the arm or leg, is to be - put into the reverse position to that from which the blood flows; so that the - blood may flow backward, and it is to be allowed to remain in this position for - a greater or less space of time. Then bind up the part while matters are so, no - clots of blood being allowed to remain in the opening. Then having applied a - double compress, and wetted it with wine, apply above it clean wool which has - been smeared with oil. For, although the flow of blood be - violent, it will be stopped in this way. If a thrombus be formed in the opening, - it will inflame and suppurate. Venesection is to be practiced when the person - has dined more or less freely and drunk, and when somewhat heated, and rather in - hot weather than in cold.

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- Part 17 -

When in cupping, the blood continues to flow after the cupping-instrument has - been removed, and if the flow of blood, or serum be copious, the instrument is - to be applied again before the part is healed up, so as to abstract what is left - behind. Otherwise coagula of blood will be retained in the incisions and - inflammatory ulcers will arise from them. In all such cases the parts are to be - bathed with vinegar, after which they are not to be wetted; neither must the - person lie upon the scarifications, but they are to be anointed with some of the - medicines for bloody wounds. When the cupping instrument is to be applied below - the knee, or at the knee, it should be done, if possible, while the man stands - erect.

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- - - - diff --git a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng2.xml b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng2.xml new file mode 100644 index 000000000..2de404422 --- /dev/null +++ b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng2.xml @@ -0,0 +1,141 @@ + + + + + + + On Ulcers + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg028.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + + +

Data Entry

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This pointer pattern extracts section.

+ + + + + + + English + Greek + + + + CTS and EpiDoc conversion. + + + + + +
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We must avoid wetting all sorts of ulcers except with wine, unless the ulcer be situated in a joint. For, the dry is nearer to the sound, and the wet to the unsound, since an ulcer is wet, but a sound part is dry. And it is better to leave the part without a bandage unless a unless a cataplasm be applied. Neither do certain ulcers admit of cataplasms, and this is the case with the recent rather than the old, and with those situated in joints. A spare diet and water agree with all ulcers, and with the more recent rather than the older; and with an ulcer which either is inflamed or is about to be so; and where there is danger of gangrene; and with the ulcers an inflammation in joints; and where there is danger of convulsion; and in wounds of the belly; but most especially in fractures of the head and thigh, or any other member in which a fracture may have occurred. In the case of an ulcer, it is not expedient to stand; more especially if the ulcer be situated in the leg; but neither, also, is it proper to sit or walk. But quiet and rest are particularly expedient. Recent ulcers, both the ulcers themselves and the surrounding parts, will be least exposed to inflammation, if one shall bring them to a suppuration as expeditiously as possible, and if the matter is not prevented from escaping by the mouth of the sore; or, if one should restrain the suppuration, so that only a small and necessary quantity of pus may be formed, and the sore may be kept dry by a medicine which does not create irritation. For the part becomes inflamed when rigor and throbbing supervene; for ulcers then get inflamed when suppuration is about to form. A sore suppurates when the blood is changed and becomes heated; so that becoming putrid, it constitutes the pus of such ulcers. When you seem to require a cataplasm, it is not the ulcer itself to which you must apply the cataplasm, but to the surrounding parts, so that the pus may escape and the hardened parts may become soft. Ulcers formed either from the parts having been cut through by a sharp instrument, or excised, admit of medicaments for bloody wounds (ἔναιμα), and which will prevent suppuration by being desiccant to a certain degree. But, when the flesh has been contused and roughly cut by the weapon, it is to be so treated that it may suppurate as quickly as possible; for thus the inflammation is less, and it is necessary that the pieces of flesh which are bruised and cut should melt away by becoming putrid, being converted into pus, and that new flesh should then grow up.

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In every recent ulcer, except in the belly, it is expedient to cause blood to flow from it abundantly, and as may seem seasonable; for thus will the wound and the adjacent parts be less attacked with inflammation. And, in like manner, from old ulcers, especially if situated in the leg, in a toe or finger, more than in any other part of the body. For when the blood flows they become drier and less in size, as being thus dried up. It is this ( blood?) especially which prevents such ulcers from healing, by getting into a state of putrefaction and corruption. But, it is expedient, after the flow of the blood, to bind over the ulcer a thick and soft piece of sponge, rather dry than wet, and to place above the sponge some slender leaves. Oil, and all things of an emollient and oily nature, disagree with such ulcers, unless they are getting nearly well. Neither does oil agree with wounds which have been recently inflicted, nor yet do medicines formed with oil or suet, more especially if the ulcer stands in need of more cleansing. And, in a word, it is in summer and in winter that we are to smear with oil these sores that require such medicines.

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Gentle purging of the bowels agrees with most ulcers, and in wounds of the head, belly, or joints, where there is danger of gangrene, in such as require sutures, in phagedaenic, spreading and in otherwise inveterate ulcers.

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And when you want to apply a bandage, no plasters are to be used until you have rendered the sore dry, and then indeed you may apply them. The ulcer is to be frequently cleaned with a sponge, and then a dry and clean piece of cloth is to be frequently applied to it, and in this way the medicine which it is supposed will agree with it is to be applied, either with or without a bandage.

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The hot season agrees better than winter with most ulcers, except those situated in the head and belly; but the equinoctial season agrees still better with them.

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Ulcers which have been properly cleansed and dried as they should be, do not usually get into a the state.

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When a bone has exfoliated, or has been burned, or sawed, or removed in any other way, the cicatrices of such ulcers become deeper than usual.

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Ulcers which are not cleansed, are not disposed to unite if brought together, nor do the lips thereof approximate of their own accord. When the points adjoining to an ulcer are inflamed, the ulcer is not disposed to heal until the inflammation subside, nor when the surrounding parts are blackened by mortification, nor when a varix occasions an overflow of blood in the part, is the ulcer disposed to heal, unless you bring the surrounding parts into a healthy condition.

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Circular ulcers, if somewhat hollow, you must scarify all along their edges, or to the extent of half the circle, according to the natural stature of the man.

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When erysipelas supervenes upon any sore, you must purge the body, in the way most suitable to the ulcer, either upward or downward.

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When swelling arises around an. ulcer, and if the ulcer remain free from inflammation, there will be a deposit of matter in process of time. And whatever ulcer gets swelled along with inflammation and does not subside as the other parts subside which became inflamed and swelled at the same time, there is a danger that such an ulcer may not unite. When from a fall, or in any other way, a part has been torn or bruised, and the parts surrounding the ulcer have become swelled, and, having suppurated, matter flows from the swelling by the ulcer, if in such cases a cataplasm be required, it should not be applied to the sore itself, but to the surrounding parts, so that the pus may have free exit, and the indurated parts may be softened. But when the parts are softened as the inflammation ceases, then the parts which are separated are to be brought toward one another, binding on sponges and applying them, beginning from the sound parts and advancing to the ulcer by degrees. But plenty of leaves are to be bound above the sponge. When the parts are prevented from coming together by a piece of flesh full of humors, it is to be removed. When the ulcer is deep seated in the flesh, it is swelled up, both from the bandaging and the compression. Such an ulcer should be cut up upon a director (specillum) if possible, at the proper time, so as to admit a free discharge of the matter, and then the proper treatment is to be applied as may be needed. For the most part, in every hollow ulcer which can be seen into which can be seen into direct without being any swelling present, if there be putrefaction in it, or if the flesh be flabby and putrid, such an ulcer, and the parts which surround it, will be seen to be black and somewhat livid. And of corroding ulcers, those which are phagedaenic, spread and corrode most powerfully, and, in this case, the parts surrounding the sore will have a black and sub-livid appearance.

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Cataplasms for swellings and inflammation in the surrounding parts. Boiled mullein, the raw leaves of the trefoil, and the boiled leaves of the epipetrum, and the poley, and if the ulcer stand in need of cleansing, all these things also cleanse; and likewise the leaves of the fig-tree, and of the olive, and the horehound, all these are to be boiled; and more especially the chaste-tree, and the fig, and the olive, and the leaves of the pomegranate are to be boiled in like manner. These are to be used raw: and the leaves of the mallow pounded with wine, and the leaves of rue, and those of the green origany. With all these, linseed is to be boiled up and mixed by pounding it as a very fine powder. When there is danger of erysipelas seizing the ulcers, the leaves of woad are to be pounded and applied raw in a cataplasm along with linseed, or the linseed is to be moistened with the juice of strychnos or of woad, and applied as a cataplasm. When the ulcer is clean, but both it and the surrounding parts are inflamed, lentil is to be boiled in wine and finely triturated, and, being mixed with a little oil, it is to be applied as a cataplasm; and the leaves of the hip-tree are to be boiled in water and pounded in a fine powder and made into a cataplasm; and apply below a thin, clean piece of cloth wetted in wine and oil; and when you wish to produce contraction, prepare the leaves of the hip-tree like the lentil, and the cress; wine and finely-powdered linseed are to be mixed together. And this is proper: linseed, and raw chaste-tree, and Melian alum, all these things being macerated in vinegar.

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Having pounded the white unripe grape in a mortar of red bronze, and passed it through the strainer, expose it to the sun during the day, but remove it during the night, that it may not suffer from the dew; rub it constantly during the day, so that it may dry equally, and may contract as much virtue as possible from the bronze: let it be exposed to the sun for as great a length of time as till it acquire the thickness of honey; then put it into a bronze pot with the fresh honey and sweet wine, in which turpentine resin has been previously boiled, boil the resin in the wine until it become hard like boiled honey; then take out the resin and pour off the wine: there should be the greatest proportion of the juice of unripe grape, next of the wine, and third of the honey and myrrh, either the liquid (stacte) or otherwise. The finest kind is to be levigated and moistened by having a small quantity of the same wine poured on it; and then the myrrh is to be boiled by itself, stirring it in the wine; and when it appears to have attained the proper degree of thickness, it is to be poured into the juice of the unripe grape; and the finest natron is to be toasted, and gently added to the medicine, along with a smaller quantity of the flowers of copper (flos aeris) than of the natron. When you have mixed these things, boil for not less than three days, on a gentle fire made with fuel of the fig-tree or with coals, lest it catch fire. The applications should all be free from moisture, and the sores should not be wetted when this medicine is applied in the form of liniment. This medicine is to be used for old ulcers, and also for recent wounds of the glans penis, and ulcers on the head and ears. Another medicine for the same ulcers:—The dried gall of an ox, the finest honey, white wine, in which the shavings of the lotus have been boiled, frankincense, of myrrh an equal part, of saffron an equal part, the flowers of copper, in like manner of liquids, the greatest proportion of wine, next of honey, and least of the gall. Another:—Wine, a little cedar honey, of dried things, the flowers of copper, myrrh, dried pomegranate rind. Another:—Of the roasted flower of copper half a drachm, of myrrh two half-drachms, of saffron three drachms, of honey a small quantity, to be boiled with wine. Another:—Of frankincense a drachm, of gall a drachm, of saffron three drachms; let each of these be dried and finely levigated, then, having mixed, triturate in a very strong sun, pouring in the juice of an unripe grape, until it become of a gelatinous consistence, for three days; then let them be allowed to macerate in an austere, dark-colored, fragrant wine, which is gradually poured upon them. Another:—Boil the roots of the holmoak in sweet white wine; and when it appears to be properly done, having poured off two parts of the wine, and of the lees of wine as free of water as possible one part; then boil, stirring it, so that it may not be burnt, at a gentle fire, until it appear to have attained the proper consistence. Another:—The other things are to be the same; but, not withstanding, instead of the wine, use the strongest white vinegar, and dip into it wool as greasy as can be procured, and then, moistening it with the lees of oil, boil, and pour in the juice of the wild fig-tree, and add Melian alum, and natron, and the flowers of copper, both toasted. This cleanses the ulcers better than the former, but the other is no less desiccant. Another:—Dip the wool in a very little water; and then, having added a third part of wine, boil until it attain the proper consistence. By these, recent ulcers are most speedily prevented from getting into a state of suppuration.

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Another:—Sprinkle on it dried wakerobin, and add the green bark of the fig-tree, pounding it in the juice: do this with or without wine, and along with honey. Another:—Boiling the shavings of lotus with vinegar (the vinegar should be white); then mix the lees of oil and raw tar-water, and use it as a liniment or wash, and bandage above.

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These things in powder prevent recent wounds from suppurating, or they may be used for cleansing the sore along with vinegar, or for sponging with wine.

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Another:—Sprinkle (on the sore?) lead finely triturated with the recrement of copper; and sprinkle on it, also, the shavings of lotus, and the scales of copper, and alum, and chalcitis, with copper, both alone, and with the shavings of lotus. And otherwise, when it is wanted to use these in a dry state, do it with the Illyrian spodos triturated with the shavings, and with the shavings alone. And the flowers of silver alone, in the finest powder; and birthwort, when scraped and finely pounded, may be sprinkled on the part.

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Another, for bloody sores myrrh, frankincense, galls, verdigris the roasted flower of copper, Egyptian alum roasted, vine flowers, grease of wool, plumbago, each of these things is to be diluted, in equal proportions, with wine like the former. And there is another preparation of the same:—The strongest vinegar of a white color, honey, Egyptian alum, the finest natron; having toasted these things gently, pour in a little gall; this cleanses fungous ulcers, renders them hollow, and is not pungent. Another:—The herb with the small leaves, which gets the name of Parthenium parviflorum, and is used for removing thymia (warts?) from the glans penis, alum, chalcitis, a little crude Melian alum (?); sprinkle a little dried elaterium, and a little dried pomegranate rind in like manner.

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The herb which has got the name of lagopyrus, fills up hollow and clean ulcers; (when dried it resembles wheat; it has a small leaf like that of the olive, and more long;) and the leaf of horehound, with oil. Another:—The internal fatty part, resembling honey, of a fig much dried, of water two parts, of linseed not much toasted and finely levigated, one part. Another:—Of the dried fig, of the flower of copper levigated a little, and the juice of the fig. The preparation from dried fig:—The black chamaeleon, the dried gall of an ox, the other things the same. Of the powders:—Of the slender cress in a raw state, of horehound, of each equal parts; of the dried fig, two parts; of linseed, two parts; the juice of the fig. When you use any of these medicines, apply above it compresses wetted in vinegar, apply a sponge about the compresses and make a If the surrounding parts be in an inflamed state, apply to them any medicine which may appear suitable.

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If you wish to use a liquid application, the medicine called caricum may be rubbed in, and the bandages may be applied as formerly described upon the same principle. The medicine is prepared of the following ingredients:—Of black hellebore, of sandarach, of the flakes of copper, of lead washed, with much sulphur, arsenic, and cantharides. This may be compounded so as may be judged most proper, and it is to be diluted with oil of juniper. When enough has been rubbed in, lay aside the medicine, and apply boiled wakerobin in a soft state, either rubbing it in dry, or moistening it with honey. But if you use the caricum in a dry state, you must abstain from these things, and sprinkle the medicine on the sore. The powder from hellebore and sandarach alone answers.

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Another liquid medicine:—The herb, the leaf of which resembles the arum (wakerobin) in nature, but is white, downy, of the size of the ivy-leaf: this herb is applied with wine, or the substance which forms upon the branches of the ilex, when pounded with wine, is to be applied. Another:—The juice of the grape, the strongest vinegar, the flower of copper, natron, the juice of the wild fig-tree. Alum, the most finely levigated, is to be put into the juice of the wild grape, and it is to be put into a red bronze mortar and stirred in the sun, and removed when it appears to have attained proper consistence.

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These are other powders:—Black hellebore, as finely levigated as possible, is to be sprinkled on the sore while any humidity remains about it, and while it continues to spread. The bandaging is the same as when plasters are used. Another, in like manner:—The driest lumps of salt are to be put into a copper, or earthen pot, of equal size, as much as possible, and not large, and the finest honey, of double the size of the salt, as far as can be guessed, is to be poured upon the lumps of salt, then the vessel is to be put upon coals and allowed to sit there until the whole is consumed. Then, having sponged the ulcer and cleansed it, bandage it as before, and compress it a little more. Next day, wherever the medicine has not been taken in, sprinkle it on, press it down, and bandage. But when you wish to remove the medicine, pour in hot vinegar until it separate, and again do the same things, sponging it away, if necessary. Another corrosive powder:—Of the most finely-levigated misy, sprinkle upon the moist and gangrenous parts, and a little of the flower of copper, not altogether levigated. Another powder equally corrosive:—Having sponged the ulcer, burn the most greasy wool upon a shell placed on the fire until the whole be consumed; having reduced this to a fine powder, and sprinkled it on the sore, apply the bandage in the same manner. Another powder for the same ulcers:—The black chamaeleon, when prepared with the juice of the fig. It is to be prepared roasted, and alkanet mixed with it. Or, pimpernel, and Egyptian alum roasted, and sprinkle on them the Orchomenian powder.

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For spreading ulcers:—Alum, both the Egyptian roasted, and the Melian; but the part is to be first cleansed with roasted natron and sponged; and the species of alum called chalcitis roasted. It is to be roasted until it catch fire.

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For old ulcers which occur on the fore part of the legs; they become bloody and black:—Having pounded the flower of the melilot and mixed it with honey, use as a plaster.

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For nerves (tendons?) which have been cut asunder:—Having pounded, sifted, and mixed with oil the roots of the wild myrtle, bind on the part; and the herb cinquefoil (it is white and downy, and more raised above the ground than the black cinquefoil), having pounded this herb in oil bind it on the part, and then remove it on the third day.

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Emollients (?):—These medicines are to be used in winter rather than in summer. Emollient medicines which make the cicatrices fair:—Pound the inner mucous part of the squill and pitch, with fresh swine’s seam, and a little oil, and a little resin, and ceruse. And the grease of a goose, fresh swine’s seam, and squill, and a little oil. The whitest wax, fresh clean grease, or squill and white oil, and a little resin. Wax, swine’s seam (old and fresh), and oil, and verdigris, and squill and resin. Let there be two parts of the old grease to the fresh, and of the other things, q. s. Having melted the grease that is fresh, pour it into another pot; having levigated plumbago finely and sifted it, and mixed them together, boil and stir at first; boil until when poured upon the ground it concretes; then taking it off the fire, pour it all into another vessel, with the exception of the stony sediment, and add resin and stir, and mix a little oil of juniper, and what has been taken off. In all the emollient medicines to which you add the resin, when you remove the medicine from the fire, pour in and mix the resin while it is still warm. Another:—Old swine’s seam, wax, and oil, the dried shavings of the lotus, frankincense, plumbago,-namely, of the frankincense one part, and of the other one part, and of the shavings of the lotus one part; but let there be two parts of the old grease, one of wax, and of fresh swine’s seam one part. Another:—Or old swine’s seam along with the fresh grease of a goat; when cleaned, let it retain as little as possible of its membrane: having triturated or pounded it smooth, pour in oil, and sprinkle the lead with the spodium and half the shavings of the lotus. Another:—Swine’s seam, spodium, blue chalcitis, oil.

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For Burns:—You must boil the tender roots of the ilex, and if their bark be very thick and green, it must be cut into small parts, and having poured in white wine, boil upon a gentle fire, until it appear to you to be of the proper consistence, so as to be used for a liniment. And it may be prepared in water after the same manner. Another, not corrosive:—Old swine’s seam is to be rubbed in by itself, and it is to be melted along with squill, the root of which is to be divided and applied with a bandage. Next day it is to be fomented; and having melted old swine’s seam and wax, and mixed with them oil, frankincense, and the shavings of lotus and vermilion, this is to be used as a liniment. Having boiled the leaves of the wakerobin in wine and oil, apply a bandage. Another:—When you have smeared the parts with old swine’s seam let the roots of asphodel be pounded in wine and triturated, and rubbed in. Another:—Having melted old swine’s seam, and mixed with resin and bitumen, and having spread it on a piece of cloth and warmed it at the fire, apply a bandage.

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When an ulcer has formed on the back from stripes or otherwise, let squill, twice boiled, be pounded and spread upon a linen cloth and bound on the place. Afterward the grease of a goat, and fresh swine’s seam, spodium, oil, and frankincense are to be rubbed in.

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Swellings which arise on the feet, either spontaneously or otherwise, when neither the swellings nor the inflammation subside under the use of cataplasms, and although sponges or wool, or anything else be bound upon the sound part; but the swelling and inflammation return of themselves again, an influx of blood into the veins is the cause, when not occasioned by a bruise. And the same story applies if this happen in any other part of the body. But blood is to be abstracted, especially the from the veins, which are the seat of the influx, if they be conspicuous; but if not, deeper and more numerous scarifications are to be made in the swellings; and whatever part you scarify, this is to be done with the sharpest and most slender instruments of iron. When you have removed the blood, you must not press hard upon the part with the specillum, lest you produce contusion. Bathe with vinegar, and do not allow a clot of blood to remain between the lips of the wounds, and having spread greasy wool with a medicine for bloody wounds, and having carded the woof and made it soft, bind it on, having wetted it with wine and oil. And let the scarified part be so placed that the determination of the blood may be upward and not downward; and do not wet the part at all, and let the patient be put upon a restricted diet and drink water. If upon loosing the bandages you find the scarifications inflamed, apply a cataplasm of the fruit of the chaste-tree and linseed. But if the scarifications become ulcerated and break into one another, we must be regulated by circumstances, and otherwise apply whatever else appears to be proper.

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When a varix is on the fore part of the leg, and is very superficial, or below the flesh, and the leg is black, and seems to stand in need of having the blood evacuated from it, such swellings are not, by any means, to be cut open; for, generally, large ulcers are the consequence of the incisions, owing to the influx from the varix. But the varix itself is to be punctured in many places, as circumstances may indicate.

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When you have opened a vein and abstracted blood, and although the fillet be loosed the bleeding does not stop, the member, whether the arm or leg, is to be put into the reverse position to that from which the blood flows; so that the blood may flow backward, and it is to be allowed to remain in this position for a greater or less space of time. Then bind up the part while matters are so, no clots of blood being allowed to remain in the opening. Then having applied a double compress, and wetted it with wine, apply above it clean wool which has been smeared with oil. For, although the flow of blood be violent, it will be stopped in this way. If a thrombus be formed in the opening, it will inflame and suppurate. Venesection is to be practiced when the person has dined more or less freely and drunk, and when somewhat heated, and rather in hot weather than in cold.

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When in cupping, the blood continues to flow after the cupping-instrument has been removed, and if the flow of blood, or serum be copious, the instrument is to be applied again before the part is healed up, so as to abstract what is left behind. Otherwise coagula of blood will be retained in the incisions and inflammatory ulcers will arise from them. In all such cases the parts are to be bathed with vinegar, after which they are not to be wetted; neither must the person lie upon the scarifications, but they are to be anointed with some of the medicines for bloody wounds. When the cupping instrument is to be applied below the knee, or at the knee, it should be done, if possible, while the man stands erect.

+ + + + diff --git a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-grc2.xml b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-grc2.xml index 671502476..ac2e6df6f 100644 --- a/data/tlg0627/tlg028/tlg0627.tlg028.perseus-grc2.xml +++ b/data/tlg0627/tlg028/tlg0627.tlg028.perseus-grc2.xml @@ -34,7 +34,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg029/__cts__.xml b/data/tlg0627/tlg029/__cts__.xml index c2e4a36e8..9527677b5 100644 --- a/data/tlg0627/tlg029/__cts__.xml +++ b/data/tlg0627/tlg029/__cts__.xml @@ -3,6 +3,11 @@ Περὶ αἱμοῤῥοίδων - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + + On Hemorrhoids + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.tracking.json b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.tracking.json deleted file mode 100644 index e1655cd02..000000000 --- a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0248", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.adams_eng.xml---subdoc---text=Haem.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.xml b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.xml deleted file mode 100644 index 276ba0b9e..000000000 --- a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng1.xml +++ /dev/null @@ -1,193 +0,0 @@ - - - - - - On Hemorrhoids - Hippocrates - Francis Adams - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 20, 2003 - - - - - The Genuine Works of Hippocrates - Hippocrates - Francis Adams - - New York - William Wood & Company - 1886 - - - - - - - - -

Data Entry

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- Part 1 -

The disease of the hemorrhoids is formed in this way: if bile or phlegm be - determined to the veins in the rectum, it heats the blood in the veins; and - these veins becoming heated attract blood from the nearest veins, and being - gorged the inside of the gut swells outwardly, and the heads of the veins are - raised up, and being at the same time bruised by the faeces passing out, and - injured by the blood collected in them, they squirt out blood, most frequently - along with the faeces, but sometimes without faeces. It is to be cured thus: -

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- Part 2 -

In the first place it should be known in what sort of a place they are formed. - For cutting, excising, sewing, binding, applying putrefacient means to the - anus,-all these appear to be very formidable things, and yet, after all, they - are not attended with mischief. I recommend seven or eight small pieces of iron - to be prepared, a fathom in size, in thickness like a thick specillum, and bent - at the extremity, and a broad piece should be on the extremity, like a small - obolusI would direct the attention of my surgical readers to the form - of the ancient cautery orburning iron; it resembles a - small coin, that is to say, it was a disk. I have often thought that modern - practitioners in surgery erred in making their cauteries globular, instead - of making them flat disks like the ancient.. Having on the preceding - day first purged the man with medicine, on the day of the operation apply the - cautery. Having laid him on his back, and placed a pillow below the breech, - force out the anus as much as possible with the fingers, and make the irons - red-hot, and burn the pile until it be dried up, and so as that no part may be - left behind. And burn so as to leave none of the hemorrhoids unburnt, for you should burn them all up. You will recognize the hemorrhoids - without difficulty, for they project on the inside of the gut like dark-colored - grapes, and when the anus is forced out they spurt blood. When the cautery is - applied the patient's head and hands should be held so that he may not stir, but - he himself should cry out, for this will make the rectum project the more. When - you have performed the burning, boil lentils and tares, finely triturated in - water, and apply as a cataplasm for five or six days. But on the seventh, cut a - soft sponge into a very slender slice, its width should be about six inches - square. Then a thin smooth piece of cloth, of the same size as the sponge, is to - be smeared with honey and applied; and with the index finger of the left hand - the middle of the sponge is to be pushed as far up as possible; and afterward - wool is to be placed upon the sponge so that it may remain in the anus. And - having girded the patient about the loins and fastened a shawl to the girdle, - bring up this band from behind between the legs and attach it to the girdle at - the navel. Then let the medicine which I formerly said is calculated to render - the skin thick and strong, be bound on. These things should be kept on for not - less than twenty days. The patient should once a day take a draught from flour - or millet, or bran, and drink water. When the patient goes to stool the part - should be washed with hot water. Every third day he should take the bath.

-
-
- Part 3 -

Another method of cure:-Having got the anus to protrude as much as possible, - foment with hot water, and then cut off the extremities of the hemorrhoids. But - this medicine should be prepared beforehand, as an application to the - wound:-Having put urine into a bronze vessel, sprinkle upon the urine the flower - of bronze calcined and finely triturated; then, when it is moistened, shake the - vessel and dry in the sun. When it becomes dry, let it be scraped down and - levigated, and apply with the finger to the part, and having oiled compresses, - apply them, and bind a sponge above.

-
-
- Part 4 -

Another method:-There grows upon the bleeding condyloma, a protuberance like the - fruit of the mulberry, and if the condyloma be far without, an envelope of flesh - is adherent to it. Having placed the man over two round stones - upon his knees, examine, for you will find the parts near the anus between the - buttocks inflated, and blood proceeding from within. If, then, the condyloma - below the cover be of a soft nature, bring it away with the finger, for there is - no more difficulty in this than in skinning a sheep, to pass the finger between - the hide and the flesh. And this should be accomplished without the patient's - knowledge, while he is kept in conversation. When the condyloma is taken off, - streaks of blood necessarily flow from the whole of the torn part. It must be - speedily washed with a decoction of galls, in a dry wine, and the bleeding vein - will disappear along with the condyloma, and its cover will be replaced. The - older it is, the more easy the cure.

-
-
- Part 5 -

But if the condyloma be higher up, you must examine it with the speculum, and - you should take care not to be deceived by the speculum; for when expanded, it - renders the condyloma level with the surrounding parts, but when contracted, it - shows the tumor right again. It is to be removed by smearing it with black - hellebore on the finger. Then, on the third day, wash it out with a dry wine. - You need not be surprised that there is no discharge of blood when you remove - the condyloma, for neither, if you cut off the hands or legs at the - articulations will there be any flow of blood; but if you cut them off above or - below the joints, you will find there hollow veins which pour out blood, and you - will have difficulty in stopping the bleeding. In the same manner, the bleeding - vein in the anus, if you cut it above or below the point of separation of the - condyloma, will pour forth blood; but if you take away the condyloma at its - junction (with the natural parts?) there will be no flow of - blood. If matters then be thus put to rights, it will be well; but otherwise - burn it, taking care not to touch the place with the iron, but bringing it close - so as to dry it up, and apply the flos aeris in the urine.

-
-
- Part 6 -

Another method of curing hemorrhoids:-You must prepare a cautery like the arundo phragmites, and an iron that exactly fits is to be - adapted to it; then the tube being introduced into the anus, the iron, red hot, - is to be passed down it, and frequently drawn out, so that the part may bear the - more heat, and no sore may result from the heating, and the dried - veins may heal up. But if you are neither disposed to burn nor excise, having - first fomented with plenty hot water and turned out the anus, levigate myrrh, - and having burnt galls and Egyptian alum, in the proportion of one and a half to - the other things, and as much of melanteria; these things are all to be used in - a dry state. The hemorrhoid will separate under the use of these medicines, like - a piece of burnt hide. You are to proceed thus until the whole are removed, and - a half part of burnt chalcitis does the same thing. But if you wish to effect - the cure by suppositories, take the shell of the part fish a third part of - plumbago, bitumen, alum, a little of the flos aeris, galls, a little verdigris; - having poured a small quantity of boiled honey on these, and formed an oblong - suppository, apply until you remove them.

-
-
- Part 7 -

An hemorrhoid in a woman may be thus cured. Having fomented with plenty of hot - water, boil in the water certain of the fragrant medicines, add pounded - tamarisk, roasted litharge and galls, and pour on them white wine, and oil, and - the grease of a goose, pounding all together. Give to use after fomenting. In - fomenting the anus is to be made to protrude as much as possible.

-
- - - - diff --git a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng2.xml b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng2.xml new file mode 100644 index 000000000..d286e0b7e --- /dev/null +++ b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng2.xml @@ -0,0 +1,99 @@ + + + + + + + On Hemorrhoids + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg029.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + +

Data Entry

+ + + + +

This pointer pattern extracts section.

+ + + + + + + English + + + + CTS and EpiDoc conversion. + + + + + +
+
+

The disease of the hemorrhoids is formed in this way: if bile or phlegm be determined to the veins in the rectum, it heats the blood in the veins; and these veins becoming heated attract blood from the nearest veins, and being gorged the inside of the gut swells outwardly, and the heads of the veins are raised up, and being at the same time bruised by the faeces passing out, and injured by the blood collected in them, they squirt out blood, most frequently along with the faeces, but sometimes without faeces.

+
+

It is to be cured thus:

+

In the first place it should be known in what sort of a place they are formed. For cutting, excising, sewing, binding, applying putrefacient means to the anus,—all these appear to be very formidable things, and yet, after all, they are not attended with mischief. I recommend seven or eight small pieces of iron to be prepared, a fathom in size, in thickness like a thick specillum, and bent at the extremity, and a broad piece should be on the extremity, like a small obolusI would direct the attention of my surgical readers to the form of the ancient cautery orburning iron; it resembles a small coin, that is to say, it was a disk. I have often thought that modern practitioners in surgery erred in making their cauteries globular, instead of making them flat disks like the ancient.. Having on the preceding day first purged the man with medicine, on the day of the operation apply the cautery. Having laid him on his back, and placed a pillow below the breech, force out the anus as much as possible with the fingers, and make the irons red-hot, and burn the pile until it be dried up, and so as that no part may be left behind. And burn so as to leave none of the hemorrhoids unburnt, for you should burn them all up. You will recognize the hemorrhoids without difficulty, for they project on the inside of the gut like dark-colored grapes, and when the anus is forced out they spurt blood. When the cautery is applied the patient’s head and hands should be held so that he may not stir, but he himself should cry out, for this will make the rectum project the more. When you have performed the burning, boil lentils and tares, finely triturated in water, and apply as a cataplasm for five or six days. But on the seventh, cut a soft sponge into a very slender slice, its width should be about six inches square. Then a thin smooth piece of cloth, of the same size as the sponge, is to be smeared with honey and applied; and with the index finger of the left hand the middle of the sponge is to be pushed as far up as possible; and afterward wool is to be placed upon the sponge so that it may remain in the anus. And having girded the patient about the loins and fastened a shawl to the girdle, bring up this band from behind between the legs and attach it to the girdle at the navel. Then let the medicine which I formerly said is calculated to render the skin thick and strong, be bound on. These things should be kept on for not less than twenty days. The patient should once a day take a draught from flour or millet, or bran, and drink water. When the patient goes to stool the part should be washed with hot water. Every third day he should take the bath.

+
+

Another method of cure:—Having got the anus to protrude as much as possible, foment with hot water, and then cut off the extremities of the hemorrhoids. But this medicine should be prepared beforehand, as an application to the wound:—Having put urine into a bronze vessel, sprinkle upon the urine the flower of bronze calcined and finely triturated; then, when it is moistened, shake the vessel and dry in the sun. When it becomes dry, let it be scraped down and levigated, and apply with the finger to the part, and having oiled compresses, apply them, and bind a sponge above.

+
+

Another method:—There grows upon the bleeding condyloma, a protuberance like the fruit of the mulberry, and if the condyloma be far without, an envelope of flesh is adherent to it. Having placed the man over two round stones upon his knees, examine, for you will find the parts near the anus between the buttocks inflated, and blood proceeding from within. If, then, the condyloma below the cover be of a soft nature, bring it away with the finger, for there is no more difficulty in this than in skinning a sheep, to pass the finger between the hide and the flesh. And this should be accomplished without the patient’s knowledge, while he is kept in conversation. When the condyloma is taken off, streaks of blood necessarily flow from the whole of the torn part. It must be speedily washed with a decoction of galls, in a dry wine, and the bleeding vein will disappear along with the condyloma, and its cover will be replaced. The older it is, the more easy the cure.

+
+

But if the condyloma be higher up, you must examine it with the speculum, and you should take care not to be deceived by the speculum; for when expanded, it renders the condyloma level with the surrounding parts, but when contracted, it shows the tumor right again. It is to be removed by smearing it with black hellebore on the finger. Then, on the third day, wash it out with a dry wine. You need not be surprised that there is no discharge of blood when you remove the condyloma, for neither, if you cut off the hands or legs at the articulations will there be any flow of blood; but if you cut them off above or below the joints, you will find there hollow veins which pour out blood, and you will have difficulty in stopping the bleeding. In the same manner, the bleeding vein in the anus, if you cut it above or below the point of separation of the condyloma, will pour forth blood; but if you take away the condyloma at its junction (with the natural parts?) there will be no flow of blood. If matters then be thus put to rights, it will be well; but otherwise burn it, taking care not to touch the place with the iron, but bringing it close so as to dry it up, and apply the flos aeris in the urine.

+
+

Another method of curing hemorrhoids:—You must prepare a cautery like the arundo phragmites, and an iron that exactly fits is to be adapted to it; then the tube being introduced into the anus, the iron, red hot, is to be passed down it, and frequently drawn out, so that the part may bear the more heat, and no sore may result from the heating, and the dried veins may heal up.

+
+

But if you are neither disposed to burn nor excise, having first fomented with plenty hot water and turned out the anus, levigate myrrh, and having burnt galls and Egyptian alum, in the proportion of one and a half to the other things, and as much of melanteria; these things are all to be used in a dry state. The hemorrhoid will separate under the use of these medicines, like a piece of burnt hide. You are to proceed thus until the whole are removed, and a half part of burnt chalcitis does the same thing.

+
+

But if you wish to effect the cure by suppositories, take the shell of the part fish a third part of plumbago, bitumen, alum, a little of the flos aeris, galls, a little verdigris; having poured a small quantity of boiled honey on these, and formed an oblong suppository, apply until you remove them.

+
+

An hemorrhoid in a woman may be thus cured. Having fomented with plenty of hot water, boil in the water certain of the fragrant medicines, add pounded tamarisk, roasted litharge and galls, and pour on them white wine, and oil, and the grease of a goose, pounding all together. Give to use after fomenting. In fomenting the anus is to be made to protrude as much as possible.

+ + + + diff --git a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-grc2.xml b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-grc2.xml index a10aa1ae0..bd3a69497 100644 --- a/data/tlg0627/tlg029/tlg0627.tlg029.perseus-grc2.xml +++ b/data/tlg0627/tlg029/tlg0627.tlg029.perseus-grc2.xml @@ -33,7 +33,7 @@ - Oeuvres complètes d'Hippocrate + Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg030/__cts__.xml b/data/tlg0627/tlg030/__cts__.xml index 771b065e6..67cfa32f4 100644 --- a/data/tlg0627/tlg030/__cts__.xml +++ b/data/tlg0627/tlg030/__cts__.xml @@ -3,6 +3,10 @@ Περὶ συρίγγων - Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + Hippocrates. Oeuvres complètes d’Hippocrate, Vol. 6. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + On Fistulae + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.tracking.json b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.tracking.json deleted file mode 100644 index 0b87e62fd..000000000 --- a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0248", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.adams_eng.xml---subdoc---text=Fist.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.xml b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.xml deleted file mode 100644 index 627576178..000000000 --- a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng1.xml +++ /dev/null @@ -1,275 +0,0 @@ - - - - - - On Fistulae - Hippocrates - Francis Adams - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 20, 2003 - - - - - The Genuine Works of Hippocrates - Hippocrates - Francis Adams - - New York - William Wood & Company - 1886 - - - - - - - - -

Data Entry

- - - - - - - - - - - - - - - - - - - - - - - - - - English - - - - - - -
- Part 1 -

Fistulae are produced by contusions and tubercles, and they are also occasioned - by rowing, on horseback, when blood accumulates in the nates near the anus. For, - having become putrid, it spreads to the soft parts (the breech being of a humid - nature, and the flesh in which it spreads being soft), until the tubercle break - and corrupt below at the anus. When this happens, a fistula is formed, having an - ichorous discharge, and faeces pass by it, with flatus and much and abomination. - It is produced, then, by contusions when any of the parts about the anus are - bruised by a blow, or a fall, or a wound, or by riding, or rowing, or any such - cause. For blood is collected, and it, becoming corrupted, suppurates; and the - from the the same accidents happen, as have been described in the case of - tubercles.

-
-
- Part 2 -

In the first place, then, when you see any such tubercle formed, you must cut it - open while still unripe, before it suppurate and burst into the rectum. But if a - fistula be already formed when you undertake the case, take a stalk of fresh - garlic, and having laid the man on his back, and separated his thighs on both - sides, push down the stalk as far as it will go, and thereby measure the depth - of the fistula. Then, having bruised the root of seseli to a very fine powder, - and poured in some water, let it macerate for four days, and, mixing the water - with honey, let the patient drink it, fasting, to the amount of three cyathi, - and at the same time purge away the ascarides. Those who are left without - treatment die.

-
-
- Part 3 -

In the next place, having moistened the strip of cotton cloth, with the juice of the great tithymallus, and sprinkling on it the flos aeris, - roasted and triturated, and having made it into a tent equal in length to the - fistula, and having passed a thread through the ends of the tent again through - the stalk, and having placed the patient in a reclining position, and having - examined the ulcerated parts of the rectum with a speculum, pass the stalk by - it, and when it reaches the rectum, take hold of it and draw it out until the - tent be pushed through, and be brought on a level above and below. When it (the tent?) has been pushed inward, introduce a ball of horn - into the rectum (the rectum having been previously smeared with Cimolian chalk), - and leave it there, and when the patient wants to go to stool, let it be taken - out and again replaced, and let this practice be continued for five days. On the - sixth day let it be removed, and drawing the tent out of the flesh, and - afterwards pounding alum and filling the ball (pessary) and - introducing it into the rectum, leave it until the alum melts. Anoint the rectum - with myrrh until the parts appear to be united.

-
-
- Part 4 -

Another method of cure:-Taking a very slender thread of raw lint, and uniting it - into five folds of the length of a span, and wrapping them round with a horse - hair; then having made a director (specillum) of tin, with an eye at its - extremity, and having passed through it the end of raw lint wrapped round as - above described, introduce the director into the fistula, and, at the same time, - introduce the index finger of the left hand per anum; and - when the director touches the finger, bring it out with the finger, bending the - extremity of the director and the end of the threads in it, and the director is - to be withdrawn, but the ends of the threads are to be knotted twice or thrice, - and the rest of the raw threads is to be twisted around and fastened into a - knot. Then the patient is to be told that he may go and attend to his matters. - The rest of the treatment:-Whenever any part of the thread gets loose owing to - the fistula becoming putrid, it is to be tightened and twisted every day; and - should the raw thread rot before the fistula is eaten through, you must attach - another piece of raw thread to the hair, pass it through, and tie it, for it was - for this purpose that the hair was rolled round the raw lint, as it is not liable to rot. When the fistula has sloughed through, a soft - sponge is to be cut into very slender pieces and applied, and then the flowers - of copper, roasted, are to be frequently applied with a director; and the sponge - smeared with honey is to be introduced with the index finger of the left hand, - and pushed forward; and another bit of added, it is to be bound on in the same - manner as in the operation for hemorrhoids. Next day, having loosed the - bandages, the fistula is to be washed with hot water, and cleansed, as far as - possible, with the finger of the left hand by means of the sponge, and again the - flos aeris is to be applied. This is to be done for seven days, for generally - the coat of the fistula takes that time to fistula takes that time to slouch - through. The same mode of bandaging is to be persevered in afterwards, until the - cure be completed. For in this way, the fistula being forcibly expanded by the - sponge will not fill up and heal unequally, but it will all become whole - together. During the treatment, the part should be bathed with plenty of warm - water, and the patient kept on a spare diet.

-
-
- Part 5 -

When the fistula does not get eaten through, having first examined it with a - sound, cut down as far as it passes, and sprinkle with the flos aeris, and let - it remain for five days. Then pour warm water upon it, and above lay flour mixed - with water, and bind on it the leaves of beet. When the flos aeris comes away, - and the fistulous sore becomes clean, cure it as before described. But if the - fistula be in a part which does not admit of this treatment, and if it be deep, - syringe it with the flowers of copper, and myrrh, and natron, diluted with - urine, and introduce a piece of lead into the orifice of the fistula so that it - may not close. Syringe the fistula by means of a quill attached to a bladder, so - that the injection may distend the fistula. But it does not heal unless it be - cut open.

-
-
- Part 6 -

If the anus gets inflamed, and there is pain, fever, a frequent desire of going - to stool without passing anything, and the anus appears to protrude, owing to - the inflammation, and if at times strangury come on, this disease is formed, - when phlegm, collected from the whole body, is determined to the rectum. Warm - things are beneficial in this case; for these, when applied, can attenuate and dissolve the phlegm, and dilute the acrid and salt particles, - so that the heat subsides, and the irritation in the rectum is removed. - Wherefore it is to be treated thus: The patient is to be put into a hip-bath of - hot water, and sixty grains of the grana gnidia are to be pounded and infused in - a hemina of wine, with half a hemina of oil, and injected. This brings away - phlegm and faeces. When the patient does not take the hip-bath, boil eggs in - dark-colored fragrant wine, and apply to the anus, and spread to the anus, and - spread something warm below, either a bladder filled with warm water, or linseed - toasted and ground, and its meal stirred up and mixed equally with dark, - fragrant wine, and oil, and this applied very warm as a cataplasm; or, having - mixed barley and Egyptian alum pulverized, form into an oblong ball (suppository?) and warming it gently at the fire, make it - into a cataplasm, foment, form it into shape with the fingers, and then making - it quite tepid, introduce it into the anus. The external parts are to be - anointed with cerate, and a cataplasm of boiled garlic, with dark wine diluted, - is to be applied. But if you remove these things, let him take the hip-bath of - hot water, and having mixed together the juice of srychnos, the grease of a - goose, swine's seam, chrysocolla, resin, and white wax, and then having melted - in the same and mixed together, anoint with these things, and while the - inflammation lasts, use the cataplasm of boiled garlic. And if by these means he - be freed from the pain, it is enough; but if not, give him the white meconium - (Euphorbia peplus?), or, if not it, any other - phlegmagogue medicine. While the inflammation lasts, the diet should be light. -

-
-
- Part 7 -

The strangury comes on in this way:-The bladder being heated from the rectum, - phlegm is attracted by the heat, and by the phlegm (inflammation?) the strangury is occasioned. If, then, as is frequently - the case, it cease with the disease, well; but, not withstanding, if not, give - any of the medicines for strangury.

-
-
- Part 8 -

If procidentia ani take place, having fomented the part with a soft sponge, and - anointed it with a snail, bind the man's hands together, and suspend him for a - short time, and the gut will return. But if it still prolapse, and will not - remain up, fasten a girdle round his loins and attach a shawl behind, and having - pushed up the anus, apply to it a soft sponge, moistened with - hot water in which the shavings of lotus have been boiled; pour of this - decoction upon the anus by squeezing the sponge, then, bringing the shawl below - between the legs, fasten it at the navel. But if he wish to evacuate the bowels, - let him do so upon a very narrow night-stool. Or, if the patient be a child, let - him be placed on the feet of a woman, with his back reclined to her knees, and - when the bowels are evacuated, let the legs be extended. In this way the anus - will be the least disposed to fall out. When a watery and ichorous discharge - flows from the rectum, wash it out with burnt lees of wine, and water from - myrtle, and having dried maiden-hair, pound and sift it, and apply as a - cataplasm. But if there be a discharge of blood, having washed with the same, - and pounded chalcitis, and the shavings of cypress, or of juniper, or of - stone-pine, or of turpentine, the in equal proportions the apply as a cataplasm. - Anoint the external parts with thick cerate.

-
-
- Part 9 -

When the gut protrudes and will not remain in its place, scrape the finest and - most compact silphium (assafoetida?) into small pieces and - apply as a cataplasm, and apply a sternutatory medicine to the nose and provoke - sneezing, and having moistened pomegranate rind with hot water, and having - powdered alum in white wine, pour it on the gut, then apply rags, bind the - thighs together for three days, and let the patient fast, only he may drink - sweet wine. If even thus matters do not proceed properly, having mixed - vermillion with honey, anoint.

-
-
- Part 10 -

If procidentia ani be attended with a discharge of blood, pare off the rind of - the root of wakerobin, then pound and mix flour with it, and apply it warm as a - cataplasm. Another: Having scraped off the rind of the most tender roots of the - wild vine, which some call psilothrion, boil in a dark - austere wine undiluted; then having pounded, apply as a tepid cataplasm; but mix - also flour and stir it up with white wine and oil in a tepid state. - Another:-Having pounded the seed of hemlock, pour on it a fragrant white wine, - and then apply in a tepid state as a cataplasm.

-
-
- Part 11 -

But if it be inflamed, having boiled in water the root of the ivy, finely powdered, and mixing the finest flour, and stirring it up with - white wine, apply as a cataplasm, and mix up some fat with these things. - Another:-Take the root of the mandrake, especially the green (fresh) root, but - otherwise the dried, and having cleaned the green root and cut it down, boil in - diluted wine, and apply as a cataplasm; but the dry may be pounded and applied - as a cataplasm in the manner. Another:-Having bruised the inner part of a ripe - cucumber to a soft state, apply as a cataplasm.

-
-
- Part 12 -

If there be pain without inflammation, having roasted red natron, and pounded it - to a fine powder, and added alum and roasted salts, finely triturated, mix - together in equal proportions; then having mixed it up with the best pitch and - spread upon a rag, apply, and bind. Another:-Having pounded the green leaves of - capers, put into a bag and bind on the part; and when it appears to burn, take - it away and apply it afterward; or, if you have not the leaves of capers, pound - the rind of its roots, and having mixed it up with dark-colored wine, bind on - the part in the same manner. This is a good application also for pains of the - spleen. Of these poultices, those which are cooling, stop the discharge; those - which are emollient and heating, discuss; and those which are attractive, dry up - and attenuate. This disease is formed when bile and phlegm become seated in the - parts. When the anus is inflamed, it should be anointed with the ointment, the - ingredients of which are resin, oil, wax, plumbago, and suet, these being all - melted and applied quite hot as a cataplasm.

-
- - - - diff --git a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng2.xml b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng2.xml new file mode 100644 index 000000000..219554e58 --- /dev/null +++ b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng2.xml @@ -0,0 +1,105 @@ + + + + + + + On Fistulae + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg030.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + +

Data Entry

+ + + + + +

This pointer pattern extracts section.

+ + + + + + + English + + + + CTS and EpiDoc conversion. + + + + + +
+
+

Fistulae are produced by contusions and tubercles, and they are also occasioned by rowing, on horseback, when blood accumulates in the nates near the anus. For, having become putrid, it spreads to the soft parts (the breech being of a humid nature, and the flesh in which it spreads being soft), until the tubercle break and corrupt below at the anus. When this happens, a fistula is formed, having an ichorous discharge, and faeces pass by it, with flatus and much and abomination. It is produced, then, by contusions when any of the parts about the anus are bruised by a blow, or a fall, or a wound, or by riding, or rowing, or any such cause. For blood is collected, and it, becoming corrupted, suppurates; and the from the the same accidents happen, as have been described in the case of tubercles.

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+

In the first place, then, when you see any such tubercle formed, you must cut it open while still unripe, before it suppurate and burst into the rectum.

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But if a fistula be already formed when you undertake the case, take a stalk of fresh garlic, and having laid the man on his back, and separated his thighs on both sides, push down the stalk as far as it will go, and thereby measure the depth of the fistula. Then, having bruised the root of seseli to a very fine powder, and poured in some water, let it macerate for four days, and, mixing the water with honey, let the patient drink it, fasting, to the amount of three cyathi, and at the same time purge away the ascarides. Those who are left without treatment die.

+

In the next place, having moistened the strip of cotton cloth, with the juice of the great tithymallus, and sprinkling on it the flos aeris, roasted and triturated, and having made it into a tent equal in length to the fistula, and having passed a thread through the ends of the tent again through the stalk, and having placed the patient in a reclining position, and having examined the ulcerated parts of the rectum with a speculum, pass the stalk by it, and when it reaches the rectum, take hold of it and draw it out until the tent be pushed through, and be brought on a level above and below. When it (the tent?) has been pushed inward, introduce a ball of horn into the rectum (the rectum having been previously smeared with Cimolian chalk), and leave it there, and when the patient wants to go to stool, let it be taken out and again replaced, and let this practice be continued for five days. On the sixth day let it be removed, and drawing the tent out of the flesh, and afterwards pounding alum and filling the ball (pessary) and introducing it into the rectum, leave it until the alum melts. Anoint the rectum with myrrh until the parts appear to be united.

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Another method of cure:—Taking a very slender thread of raw lint, and uniting it into five folds of the length of a span, and wrapping them round with a horse hair; then having made a director (specillum) of tin, with an eye at its extremity, and having passed through it the end of raw lint wrapped round as above described, introduce the director into the fistula, and, at the same time, introduce the index finger of the left hand per anum; and when the director touches the finger, bring it out with the finger, bending the extremity of the director and the end of the threads in it, and the director is to be withdrawn, but the ends of the threads are to be knotted twice or thrice, and the rest of the raw threads is to be twisted around and fastened into a knot. Then the patient is to be told that he may go and attend to his matters. The rest of the treatment:—Whenever any part of the thread gets loose owing to the fistula becoming putrid, it is to be tightened and twisted every day; and should the raw thread rot before the fistula is eaten through, you must attach another piece of raw thread to the hair, pass it through, and tie it, for it was for this purpose that the hair was rolled round the raw lint, as it is not liable to rot. When the fistula has sloughed through, a soft sponge is to be cut into very slender pieces and applied, and then the flowers of copper, roasted, are to be frequently applied with a director; and the sponge smeared with honey is to be introduced with the index finger of the left hand, and pushed forward; and another bit of added, it is to be bound on in the same manner as in the operation for hemorrhoids. Next day, having loosed the bandages, the fistula is to be washed with hot water, and cleansed, as far as possible, with the finger of the left hand by means of the sponge, and again the flos aeris is to be applied. This is to be done for seven days, for generally the coat of the fistula takes that time to fistula takes that time to slouch through. The same mode of bandaging is to be persevered in afterwards, until the cure be completed. For in this way, the fistula being forcibly expanded by the sponge will not fill up and heal unequally, but it will all become whole together. During the treatment, the part should be bathed with plenty of warm water, and the patient kept on a spare diet.

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+

When the fistula does not get eaten through, having first examined it with a sound, cut down as far as it passes, and sprinkle with the flos aeris, and let it remain for five days. Then pour warm water upon it, and above lay flour mixed with water, and bind on it the leaves of beet. When the flos aeris comes away, and the fistulous sore becomes clean, cure it as before described.

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But if the fistula be in a part which does not admit of this treatment, and if it be deep, syringe it with the flowers of copper, and myrrh, and natron, diluted with urine, and introduce a piece of lead into the orifice of the fistula so that it may not close. Syringe the fistula by means of a quill attached to a bladder, so that the injection may distend the fistula. But it does not heal unless it be cut open.

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If the anus gets inflamed, and there is pain, fever, a frequent desire of going to stool without passing anything, and the anus appears to protrude, owing to the inflammation, and if at times strangury come on, this disease is formed, when phlegm, collected from the whole body, is determined to the rectum. Warm things are beneficial in this case; for these, when applied, can attenuate and dissolve the phlegm, and dilute the acrid and salt particles, so that the heat subsides, and the irritation in the rectum is removed. Wherefore it is to be treated thus: The patient is to be put into a hip-bath of hot water, and sixty grains of the grana gnidia are to be pounded and infused in a hemina of wine, with half a hemina of oil, and injected. This brings away phlegm and faeces. When the patient does not take the hip-bath, boil eggs in dark-colored fragrant wine, and apply to the anus, and spread to the anus, and spread something warm below, either a bladder filled with warm water, or linseed toasted and ground, and its meal stirred up and mixed equally with dark, fragrant wine, and oil, and this applied very warm as a cataplasm; or, having mixed barley and Egyptian alum pulverized, form into an oblong ball (suppository?) and warming it gently at the fire, make it into a cataplasm, foment, form it into shape with the fingers, and then making it quite tepid, introduce it into the anus. The external parts are to be anointed with cerate, and a cataplasm of boiled garlic, with dark wine diluted, is to be applied. But if you remove these things, let him take the hip-bath of hot water, and having mixed together the juice of srychnos, the grease of a goose, swine’s seam, chrysocolla, resin, and white wax, and then having melted in the same and mixed together, anoint with these things, and while the inflammation lasts, use the cataplasm of boiled garlic. And if by these means he be freed from the pain, it is enough; but if not, give him the white meconium (Euphorbia peplus?), or, if not it, any other phlegmagogue medicine. While the inflammation lasts, the diet should be light.

+
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The strangury comes on in this way:—The bladder being heated from the rectum, phlegm is attracted by the heat, and by the phlegm (inflammation?) the strangury is occasioned. If, then, as is frequently the case, it cease with the disease, well; but, not withstanding, if not, give any of the medicines for strangury.

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If procidentia ani take place, having fomented the part with a soft sponge, and anointed it with a snail, bind the man’s hands together, and suspend him for a short time, and the gut will return. But if it still prolapse, and will not remain up, fasten a girdle round his loins and attach a shawl behind, and having pushed up the anus, apply to it a soft sponge, moistened with hot water in which the shavings of lotus have been boiled; pour of this decoction upon the anus by squeezing the sponge, then, bringing the shawl below between the legs, fasten it at the navel. But if he wish to evacuate the bowels, let him do so upon a very narrow night-stool. Or, if the patient be a child, let him be placed on the feet of a woman, with his back reclined to her knees, and when the bowels are evacuated, let the legs be extended. In this way the anus will be the least disposed to fall out. When a watery and ichorous discharge flows from the rectum, wash it out with burnt lees of wine, and water from myrtle, and having dried maiden-hair, pound and sift it, and apply as a cataplasm. But if there be a discharge of blood, having washed with the same, and pounded chalcitis, and the shavings of cypress, or of juniper, or of stone-pine, or of turpentine, the in equal proportions the apply as a cataplasm. Anoint the external parts with thick cerate.

+

When the gut protrudes and will not remain in its place, scrape the finest and most compact silphium (assafoetida?) into small pieces and apply as a cataplasm, and apply a sternutatory medicine to the nose and provoke sneezing, and having moistened pomegranate rind with hot water, and having powdered alum in white wine, pour it on the gut, then apply rags, bind the thighs together for three days, and let the patient fast, only he may drink sweet wine. If even thus matters do not proceed properly, having mixed vermillion with honey, anoint.

+

If procidentia ani be attended with a discharge of blood, pare off the rind of the root of wakerobin, then pound and mix flour with it, and apply it warm as a cataplasm. Another: Having scraped off the rind of the most tender roots of the wild vine, which some call psilothrion, boil in a dark austere wine undiluted; then having pounded, apply as a tepid cataplasm; but mix also flour and stir it up with white wine and oil in a tepid state. Another:—Having pounded the seed of hemlock, pour on it a fragrant white wine, and then apply in a tepid state as a cataplasm.

+

But if it be inflamed, having boiled in water the root of the ivy, finely powdered, and mixing the finest flour, and stirring it up with white wine, apply as a cataplasm, and mix up some fat with these things. Another:—Take the root of the mandrake, especially the green (fresh) root, but otherwise the dried, and having cleaned the green root and cut it down, boil in diluted wine, and apply as a cataplasm; but the dry may be pounded and applied as a cataplasm in the manner. Another:—Having bruised the inner part of a ripe cucumber to a soft state, apply as a cataplasm.

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If there be pain without inflammation, having roasted red natron, and pounded it to a fine powder, and added alum and roasted salts, finely triturated, mix together in equal proportions; then having mixed it up with the best pitch and spread upon a rag, apply, and bind. Another:—Having pounded the green leaves of capers, put into a bag and bind on the part; and when it appears to burn, take it away and apply it afterward; or, if you have not the leaves of capers, pound the rind of its roots, and having mixed it up with dark-colored wine, bind on the part in the same manner. This is a good application also for pains of the spleen. Of these poultices, those which are cooling, stop the discharge; those which are emollient and heating, discuss; and those which are attractive, dry up and attenuate. This disease is formed when bile and phlegm become seated in the parts. When the anus is inflamed, it should be anointed with the ointment, the ingredients of which are resin, oil, wax, plumbago, and suet, these being all melted and applied quite hot as a cataplasm.

+ + + + diff --git a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-grc2.xml b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-grc2.xml index 81422a1de..7323ba839 100644 --- a/data/tlg0627/tlg030/tlg0627.tlg030.perseus-grc2.xml +++ b/data/tlg0627/tlg030/tlg0627.tlg030.perseus-grc2.xml @@ -34,7 +34,7 @@ -Oeuvres complètes d'Hippocrate +Oeuvres complètes d’Hippocrate Hippocrates Émile Littré diff --git a/data/tlg0627/tlg046/__cts__.xml b/data/tlg0627/tlg046/__cts__.xml index 7a475b548..ceed1091d 100644 --- a/data/tlg0627/tlg046/__cts__.xml +++ b/data/tlg0627/tlg046/__cts__.xml @@ -3,6 +3,11 @@ Περὶ τροφῆς - Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923. + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + + + Nutriment + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + diff --git a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.tracking.json b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.tracking.json deleted file mode 100644 index 5bcfcd023..000000000 --- a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0251", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.jones_eng.xml---subdoc---text=Alim.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.xml", - "valid_xml": false -} \ No newline at end of file diff --git a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.xml b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.xml deleted file mode 100644 index 8257878b9..000000000 --- a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng1.xml +++ /dev/null @@ -1,374 +0,0 @@ - - - - - Nutrimen - Hippocrates - W. H. S. Jones - National Library of Medicine History of Medicine Division - Trustees of Tufts UniversityMedford, MAPerseus Project - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 1, 2005 - - - - - Hippocrates Collected Works I - Hippocrates - W. H. S. Jones - - Cambridge - Harvard University Press - 1923 - - - - - - - - - -

Data Entry

- - - - > - refState unit="text"/> - refState unit="section" n="chunk"/> - - n="text=Aph."> - refState unit="text"/> - refState unit="chapter"/> - refState unit="section" n="chunk"/> - - n="text=intro"> - refState unit="text"/> - refState unit="chapter"/> - refState unit="section" n="chunk"/> - - n="text=Epid."> - refState unit="text"/> - refState unit="book"/> - refState unit="chapter"/> - refState unit="section" n="chunk"/> - - - > - refState unit="page" n="chunk"/> - - - - - - English - Greek - - - -
PART 1

I. NUTRIMENT and form of nutriment, one and - many. One, inasmuch as its kind is one ; form - varies with moistness or dryness. These foods too - have their formsOr "figures." and quantities ; they are for - certain things, and for a certain number of things.

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PART 2

II. It increases, strengthens, clothes with flesh, - makes like, makes unlike, what is in the several - parts, according to the nature of each part and its - original power.

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PART 3

III. It makes into the likeness of a power, when - the nutriment that comes in has the mastery, and - when that is mastered which was there to begin - with.

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PART 4

IV. It also loses its qualities ; sometimes the - earlier nutriment, when in time it has been liberated - or added, sometimes the later, when in time it has - been liberated or added.

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PART 5

V. Both are weakened in time and after a time by - the nutriment from without which has continuously - entered in, and for a long time firmly has interwoven - itself with all the limbs.

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PART 6

VI. And it sends forth shoots of its own proper - form. It changes the old form and descends ; it - nourishes as it is digested. Sometimes it alters - the earlier form, and completely obscures the former - ones.

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PART 7

VII. Power of nutriment reaches to bone and to - all the parts of bone, to sinew, to vein, to artery, - to muscle, to membrane, to flesh, fat, blood, phlegm, - marrow, brain, spinal marrow, the intestines and all - their parts ; it reaches also to heat, breath, and - moisture.

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PART 8

VIII. Nutriment is that which is nourishing ; - nutriment is that which is fit to nourish ; nutriment - is that which is about to nourish.

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PART 9

IX. The beginning of all things is one and the - end of all things is one, and the end and beginning - are the same.

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PART 10

X. And all the particular details in nourishment - are managed well or ill ; well if as aforesaid, ill if - ordered in the opposite way to these.

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PART 11

XI. Juices varied in colours and in powers, to - harm or to help, or neither to harm nor to help, - varied in amount, excess or defect, in combination of - some but not of others.

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PART 12

XII. And to the warming of all it harms or helps, - to the cooling it harms or helps, to the power it - harms or helps.

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PART 13

XIII. Of power varied natures.

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PART 14

XIV. Humours corrupting whole, part, from without, - from within, spontaneous, not spontaneous ; - spontaneous for us, not spontaneous for the cause. - Of the cause, part is clear, part is obscure, part is - within our power and part is not.

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PART 15

XV. Nature is sufficient in all for all.

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PART 16

XVI. To deal with nature from without : plaster, - anointing, salve, uncovering of whole or part, - covering of whole or part, warming or cooling - similarly, astriction, ulceration, biting,Apparently, such things - as a mustard plaster. grease ; from - within : some of the aforesaid, and in addition an - obscure cause in part or whole, in some cases but not - in all.

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PART 17

XVII. Secretions in accordance with nature, by - the bowels, urine, sweat, sputum, mucus, womb, - through hemorrhoid, wart, leprosy, tumour, carcinoma, - from nostrils, lungs, bowels, seat, penis, in - accordance with nature or contrary to nature. The - peculiar differences in these things depend on - differences in the individual, on times and on - methods. All these things are one nature and not - one. All these things are many natures and one - nature.

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PART 18

XVIII. Purging upward or downward, neither - upward nor downward.

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PART 19

XIX. In nutriment purging excellent, in nutriment - purging bad ; bad or excellent according to - circumstances.

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PART 20

XX. Ulceration, burn-scab, blood, pus, lymph, - leprosy, scurf, dandruff, scurvy, white leprosy, - freckles, sometimes harm and sometimes help, and - sometimes neither harm nor help.

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PART 21

XXI. Nutriment not nutriment if it have not its - power. Not nutriment nutriment if it can nourish. - Nutriment in name, not in deed ; nutriment in deed, - not in name.

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PART 22

XXII. It travels from within to hair, nails, and to - the extreme surface ; from without nutriment travels - from the extreme surface to the innermost parts.

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PART 23

XXIII. Conflux one, conspiration one, all things - in sympathy ; all the parts as forming a whole, and - severally the parts in each part, with reference to - the work.

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PART 24

XXIV. The great beginning travels to the - extreme part ; from the extreme part there is - travelling to the great beginning. One nature to - be and not to be.

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PART 25

XXV. Differences of diseases depend on nutriment, - on breath, on heat, on blood, on phlegm, on - bile, on humours, on flesh, on fat, on vein, on - artery, on sinew, muscle, membrane, bone, brain, - spinal marrow, mouth, tongue, oesophagus, stomach, - bowels, midriff, peritoneum, liver, spleen, kidneys, - bladder, womb, skin. All these things both as a - whole and severally. Their greatness great and not - great.

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PART 26

XXVI. Signs : tickling, ache, rupture, mind, sweat, - sediment in urine, rest, tossing, conditionOr, "staring." of - the eyes, - imaginations, jaundice, hiccoughs, epilepsy, blood - entire, sleep, from both these and all other things in - accordance with nature, and everything else of a - similar nature that tends to harm or help. Pains of - the whole or of a part, indications of severity : of the - one, greater severity, of the other, less, and from - both come signs of greater severity, and from both - come signs of less.

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PART 27

XXVII. Sweet, not sweet ; sweet in power, like - water, sweet to the taste, like honey. Signs of - either are sores, eyes and tastings, which can also - distinguish degrees. Sweet to sight, in colours and - in combinations generally, sweet to a greater or - less degree.

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PART 28

XXVIII. Porousness of a body for transpiration - healthy for those from whom more is taken ; denseness - of body for transpiration unhealthy for those - from whom less is taken. Those who transpire - freely are weaker, healthier, and recover easily ; - those who transpire hardly are stronger before they - are sick, but on falling sick they make difficult - recovery. These for both whole and part.

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PART 29

XXIX. The lungs draw a nourishment which is - the opposite of that of the body, all other parts draw - the same.

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PART 30

XXX. Beginning of nutriment of breath, nostrils, - mouth, throat, lungs, and the transpiratory system - generally. Beginning of nutriment, both wet and - dry, mouth, oesophagus, stomach. The more ancient - nutriment, through the epigastrium, where the - navel is.

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PART 31

XXXI. Root of veins, liver ; root of arteries, heart. - Out of these travel to all parts blood and breath, and - heat passes through them.

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PART 32

XXXII. Power one, and not one, by which all - these things and those of a different sort are - managed ; one for the life of whole and part, not - one for the sensation of whole and part.

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PART 33

XXXIII. Milk nutriment, for those to whom milk - is a natural nutriment, but for others it is not. For - some wine is nutriment, for others not. So with - meats and the other many forms of nutriment, the - differences being due to place and habit.

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PART 34

XXXIV. Nourishment is sometimes into growth - and being, sometimes into being only, as is the case - with old men ; sometimes in addition it is into - strength. The condition of the athlete is not natural. - A healthy state is superior in all.

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PART 35

XXXV. It is a great thing successfully to adapt - quantity to power.

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PART 36

XXXVI. Milk and blood are what is left over - from nutriment.

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PART 37

XXXVII. Periods generally harmonise for the - embryo and its nutriment ; and again nutriment - tends upwards to milk and the nourishment of - the baby.

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PART 38

XXXVIII. Inanimates get life, animates get life, - the parts of animates get life.

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PART 39

XXXIX. The natures of all are untaught.

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PART 40

XL. Blood of another is useful, one's own blood - is useful ; blood of another is harmful, one's own - blood is harmful ; one's own humours are harmful, - humours of another are harmful ; humours of another - are beneficial, one's own humours are beneficial ; the - harmonious is unharmonious, the unharmonious is - harmonious ; another's milk is good, one's own milk - is bad ; another's milk is harmful, one's own milk is - useful.

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PART 41

XLI. Food for the young partly digested, for the - old completely changed, for adults unchanged.

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PART 42

XLII. For formation, thirty-five days ; for movement, - seventy days ; for completion, two hundred - and ten days. Others, for form, forty-five days ; for - motion, ninety days ; for delivery, two hundred and - seventy days. Others, fifty for form ; for the first - leap, one hundred ; for completion, three hundred - days. For distinction of limbs, forty ; for shifting, - eighty ; for detachment, two hundred and forty days. - It is not and is. There are found therein both more - and less, in respect of both the whole and the parts, - but the more is not much more, and the less not - much less.

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PART 43

XLIII. Nutriment of bones after breaking ; for - the nostril, twice five ; for jaw, collar-bone and ribs, - twice this ; for the fore-arm, thrice ; for the leg and - upper-arm, four times ; for the thigh, five times ; - there may be, however, in these a little more or less.

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PART 44

XLIV. Blood is liquid and blood is solid. Liquid - blood is good, liquid blood is bad. Solid blood is - good, solid blood is bad. All things are good or bad - relatively.

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PART 45

XLV. The way up, down.

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PART 46

XLVI. Power of nutriment superior to mass ; mass - of nutriment superior to power ; both in moist things - and in dry.

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PART 47

XLVII. It takes away and adds not the same - thing ; it takes away from one, and adds to another, - the same thing.

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PART 48

XLVIII. Pulsations of veins and breathing of the - lungs according to age, harmonious and unharmonious, - signs of disease and of health, and - of health more than of disease, and of disease - more than of health. For breath too is nutriment.

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PART 49

XLIX. Liquid nutriment more easily changed - than solid ; solid nutriment more easily changed - than liquid. That which is hardly altered is hard of - digestion, and that which is easily added is easy of - digestion.

- -
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PART 50

L. And for such as need a quick reinforcement, a - liquid remedy is best for recovery of power ; for such - as need a quicker, a remedy through smell ; for - those who need a slower reinforcement, solid - nutriment.

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PART 51

LI. Muscles being more solid waste less easily - than other parts, save bone and sinew. Parts that - have been exercised resist change, being according - to their kind stronger than they otherwise would - have been, and therefore less liable to waste.

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PART 52

LII. Pus comes from flesh ; pus-like lymph comes - from blood and moisture generally. Pus is nutriment - for a sore ; lymph is nutriment for vein and - artery.

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PART 53

LIII. Marrow nutriment of bone, and through this - a callus forms.

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PART 54

LIV. Power gives to all things increase, nourishment - and birth.

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PART 55

LV. Moisture the vehicle of nutriment.

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- - - - diff --git a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng2.xml b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng2.xml new file mode 100644 index 000000000..8655e6e7c --- /dev/null +++ b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng2.xml @@ -0,0 +1,228 @@ + + + + + + + Nutrimen + Hippocrates + William Henry Samuel Jones + + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 1, 2005 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg046.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + + Hippocrates + Hippocrates + William Henry Samuel Jones + + London + William Heinemann Ltd. + Cambridge, MA + Harvard University Press + 1923 + + 1 + + Loeb Classical Library + Internet Archive + + + + + + + + +

Data Entry

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This pointer pattern extracts section.

+ + + + + + + + + English + Greek + + + + CTS and EpiDoc conversion. + + + + + + +
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Nutriment and form of nutriment, one and many. One, inasmuch as its kind is one; form varies with moistness or dryness. These foods too have their formsOr figures. and quantities; they are for certain things, and for a certain number of things.

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It increases, strengthens, clothes with flesh, makes like, makes unlike, what is in the several parts, according to the nature of each part and its original power.

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It makes into the likeness of a power, when the nutriment that comes in has the mastery, and when that is mastered which was there to begin with.

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It also loses its qualities; sometimes the earlier nutriment, when in time it has been liberated or added, sometimes the later, when in time it has been liberated or added.

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Both are weakened in time and after a time by the nutriment from without which has continuously entered in, and for a long time firmly has interwoven itself with all the limbs.

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And it sends forth shoots of its own proper form. It changes the old form and descends; it nourishes as it is digested. Sometimes it alters the earlier form, and completely obscures the former ones.

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Power of nutriment reaches to bone and to all the parts of bone, to sinew, to vein, to artery, to muscle, to membrane, to flesh, fat, blood, phlegm, marrow, brain, spinal marrow, the intestines and all their parts; it reaches also to heat, breath, and moisture.

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Nutriment is that which is nourishing; nutriment is that which is fit to nourish; nutriment is that which is about to nourish.

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The beginning of all things is one and the end of all things is one, and the end and beginning are the same.

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And all the particular details in nourishment are managed well or ill; well if as aforesaid, ill if ordered in the opposite way to these.

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Juices varied in colours and in powers, to harm or to help, or neither to harm nor to help, varied in amount, excess or defect, in combination of some but not of others.

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And to the warming of all it harms or helps, to the cooling it harms or helps, to the power it harms or helps.

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Of power varied natures.

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Humours corrupting whole, part, from without, from within, spontaneous, not spontaneous; spontaneous for us, not spontaneous for the cause. Of the cause, part is clear, part is obscure, part is within our power and part is not.

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Nature is sufficient in all for all.

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To deal with nature from without: plaster, anointing, salve, uncovering of whole or part, covering of whole or part, warming or cooling similarly, astriction, ulceration, biting,Apparently, such things as a mustard plaster. grease; from within: some of the aforesaid, and in addition an obscure cause in part or whole, in some cases but not in all.

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Secretions in accordance with nature, by the bowels, urine, sweat, sputum, mucus, womb, through hemorrhoid, wart, leprosy, tumour, carcinoma, from nostrils, lungs, bowels, seat, penis, in accordance with nature or contrary to nature. The peculiar differences in these things depend on differences in the individual, on times and on methods. All these things are one nature and not one. All these things are many natures and one nature.

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Purging upward or downward, neither upward nor downward.

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In nutriment purging excellent, in nutriment purging bad; bad or excellent according to circumstances.

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Ulceration, burn-scab, blood, pus, lymph, leprosy, scurf, dandruff, scurvy, white leprosy, freckles, sometimes harm and sometimes help, and sometimes neither harm nor help.

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Nutriment not nutriment if it have not its power. Not nutriment nutriment if it can nourish. Nutriment in name, not in deed; nutriment in deed, not in name.

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It travels from within to hair, nails, and to the extreme surface; from without nutriment travels from the extreme surface to the innermost parts.

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Conflux one, conspiration one, all things in sympathy; all the parts as forming a whole, and severally the parts in each part, with reference to the work.

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The great beginning travels to the extreme part; from the extreme part there is travelling to the great beginning. One nature to be and not to be.

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Differences of diseases depend on nutriment, on breath, on heat, on blood, on phlegm, on bile, on humours, on flesh, on fat, on vein, on artery, on sinew, muscle, membrane, bone, brain, spinal marrow, mouth, tongue, oesophagus, stomach, bowels, midriff, peritoneum, liver, spleen, kidneys, bladder, womb, skin. All these things both as a whole and severally. Their greatness great and not great.

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Signs: tickling, ache, rupture, mind, sweat, sediment in urine, rest, tossing, conditionOr, staring. of the eyes, imaginations, jaundice, hiccoughs, epilepsy, blood entire, sleep, from both these and all other things in accordance with nature, and everything else of a similar nature that tends to harm or help. Pains of the whole or of a part, indications of severity: of the one, greater severity, of the other, less, and from both come signs of greater severity, and from both come signs of less.

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Sweet, not sweet; sweet in power, like water, sweet to the taste, like honey. Signs of either are sores, eyes and tastings, which can also distinguish degrees. Sweet to sight, in colours and in combinations generally, sweet to a greater or less degree.

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Porousness of a body for transpiration healthy for those from whom more is taken; denseness of body for transpiration unhealthy for those from whom less is taken. Those who transpire freely are weaker, healthier, and recover easily; those who transpire hardly are stronger before they are sick, but on falling sick they make difficult recovery. These for both whole and part.

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The lungs draw a nourishment which is the opposite of that of the body, all other parts draw the same.

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Beginning of nutriment of breath, nostrils, mouth, throat, lungs, and the transpiratory system generally. Beginning of nutriment, both wet and dry, mouth, oesophagus, stomach. The more ancient nutriment, through the epigastrium, where the navel is.

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Root of veins, liver; root of arteries, heart. Out of these travel to all parts blood and breath, and heat passes through them.

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Power one, and not one, by which all these things and those of a different sort are managed; one for the life of whole and part, not one for the sensation of whole and part.

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Milk nutriment, for those to whom milk is a natural nutriment, but for others it is not. For some wine is nutriment, for others not. So with meats and the other many forms of nutriment, the differences being due to place and habit.

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Nourishment is sometimes into growth and being, sometimes into being only, as is the case with old men; sometimes in addition it is into strength. The condition of the athlete is not natural. A healthy state is superior in all.

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It is a great thing successfully to adapt quantity to power.

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Milk and blood are what is left over from nutriment.

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Periods generally harmonise for the embryo and its nutriment; and again nutriment tends upwards to milk and the nourishment of the baby.

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Inanimates get life, animates get life, the parts of animates get life.

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The natures of all are untaught.

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Blood of another is useful, one’s own blood is useful; blood of another is harmful, one’s own blood is harmful; one’s own humours are harmful, humours of another are harmful; humours of another are beneficial, one’s own humours are beneficial; the harmonious is unharmonious, the unharmonious is harmonious; another’s milk is good, one’s own milk is bad; another’s milk is harmful, one’s own milk is useful.

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Food for the young partly digested, for the old completely changed, for adults unchanged.

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For formation, thirty-five days; for movement, seventy days; for completion, two hundred and ten days. Others, for form, forty-five days; for motion, ninety days; for delivery, two hundred and seventy days. Others, fifty for form; for the first leap, one hundred; for completion, three hundred days. For distinction of limbs, forty; for shifting, eighty; for detachment, two hundred and forty days. It is not and is. There are found therein both more and less, in respect of both the whole and the parts, but the more is not much more, and the less not much less.

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Nutriment of bones after breaking; for the nostril, twice five; for jaw, collar-bone and ribs, twice this; for the fore-arm, thrice; for the leg and upper-arm, four times; for the thigh, five times; there may be, however, in these a little more or less.

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Blood is liquid and blood is solid. Liquid blood is good, liquid blood is bad. Solid blood is good, solid blood is bad. All things are good or bad relatively.

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The way up, down.

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Power of nutriment superior to mass; mass of nutriment superior to power; both in moist things and in dry.

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It takes away and adds not the same thing; it takes away from one, and adds to another, the same thing.

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Pulsations of veins and breathing of the lungs according to age, harmonious and unharmonious, signs of disease and of health, and of health more than of disease, and of disease more than of health. For breath too is nutriment.

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Liquid nutriment more easily changed than solid; solid nutriment more easily changed than liquid. That which is hardly altered is hard of digestion, and that which is easily added is easy of digestion.

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And for such as need a quick reinforcement, a liquid remedy is best for recovery of power; for such as need a quicker, a remedy through smell; for those who need a slower reinforcement, solid nutriment.

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Muscles being more solid waste less easily than other parts, save bone and sinew. Parts that have been exercised resist change, being according to their kind stronger than they otherwise would have been, and therefore less liable to waste.

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Pus comes from flesh; pus-like lymph comes from blood and moisture generally. Pus is nutriment for a sore; lymph is nutriment for vein and artery.

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Marrow nutriment of bone, and through this a callus forms.

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Power gives to all things increase, nourishment and birth.

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Moisture the vehicle of nutriment.

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+ + + diff --git a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-grc2.xml b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-grc2.xml index 81f2b78b9..104bd857d 100644 --- a/data/tlg0627/tlg046/tlg0627.tlg046.perseus-grc2.xml +++ b/data/tlg0627/tlg046/tlg0627.tlg046.perseus-grc2.xml @@ -43,7 +43,7 @@ William Heinemann Ltd. Cambridge, MA Harvard University Press - 1923 + 1923 1 diff --git a/data/tlg0627/tlg051/__cts__.xml b/data/tlg0627/tlg051/__cts__.xml index 2fea3920d..6aca34898 100644 --- a/data/tlg0627/tlg051/__cts__.xml +++ b/data/tlg0627/tlg051/__cts__.xml @@ -3,6 +3,11 @@ Παραγγελίαι - Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923. + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + + + Precepts + Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923 (printing). + diff --git a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.tracking.json b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.tracking.json deleted file mode 100644 index 1630e800a..000000000 --- a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.tracking.json +++ /dev/null @@ -1,14 +0,0 @@ -{ - "epidoc_compliant": false, - "fully_unicode": true, - "git_repo": "canonical-greekLit", - "has_cts_metadata": false, - "has_cts_refsDecl": false, - "id": "1999.01.0251", - "last_editor": "", - "note": "", - "src": "texts/Classics/Hippocrates/opensource/hp.jones_eng.xml---subdoc---text=Praec.", - "status": "migrated", - "target": "canonical-greekLit/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.xml", - "valid_xml": true -} \ No newline at end of file diff --git a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.xml b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.xml deleted file mode 100644 index 6faa39ff8..000000000 --- a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng1.xml +++ /dev/null @@ -1,437 +0,0 @@ - - - - - Precepts - Hippocrates - W. H. S. Jones - National Library of Medicine History of Medicine Division - - - Cultural Heritage Langauge Technologies - Kansas City Missouri - February 1, 2005 - - - - - Hippocrates Collected Works I - Hippocrates - W. H. S. Jones - - Cambridge - Harvard University Press - 1923 - - - - - - - - - -

Data Entry

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PART 1

I. TIME is that wherein there is opportunity, and - opportunity is that wherein there is no great time. - Healing is a matter of time, but it is sometimes - also a matter of opportunity. However, knowing - this, one must attend in medical practice not - primarily to plausible theories,The definition shows that in this - passage LOGIS1MO/S2 is a - generalisation, like the PRO/LHYIS2 of Epicurus, whose language - is borrowed. But whereas PRO/LHYIS2 corresponds to a general - term (e. g. " man "), LOGIS1MO/S2 here seems to mean a - general - proposition (e. g. " man is mortal "). Later on it means the - use of LOGIS1MOI/ in making S1ULLOGIS1MOI/, that is, - deduction. - " Theory " and "theorising " are the nearest equivalents I - can think of. but to experience - combined with reason. For a theory is a - composite memory of things apprehended with - sense-perception. For the sense-perception, coming - first in experience and conveying to the intellect - the things subjected to it, is clearly imaged, and - the intellect, receiving these things many times, - noting the occasion, the time and the manner, stores - them up in itself and remembers. Now I approve - of theorising also if it lays its foundation in incident, - and deduces its conclusions in accordance with phenomena. - For if theorising lays its foundation in - clear fact, it is found to exist in the domain of intellect, - which itself receives from other sources each - of its impressions. So we must conceive of our nature - as being stirred and instructed under compulsion - by the great variety of things ; and the intellect, as - I have said, taking over from nature the impressions, - leads us afterwards into truth. But if it

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begins, not from a clear impression, but from a - plausible fiction,I. e., if the general statement from which - we deduce - conclusions be a plausible but untrue hypothesis. Conclusions - drawn from such hypotheses lead to nowhere. it often induces a grievous - and - troublesome condition. All who so act are lost in a - blind alley. Now no harm would be done if bad - practitioners received their due wages. But as it is - their innocent patients suffer, for whom the violence - of their disorder did not appear sufficient without - the addition of their physician's inexperience. I - must now pass on to another subject.

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PART 2

II. But conclusions which are merely verbal cannot - bear fruit, only those do which are based on demonstrated - fact. For affirmation and talk are deceptive - and treacherous. Wherefore one must hold fast to - facts in generalisations also,Or, possibly, " even from beginning - to end." and occupy oneself with - facts persistently, if one is to acquire that ready and - infallible habit which we call " the art of medicine." - For so to do will bestow a very great advantage - upon sick folk and medical practitioners. Do not - hesitate to inquire of laymen, if thereby there - seems likely to result any improvement in treatment. - For so I think the whole art has been set - forth, by observing some part of the final end in - each of many particulars, and then combining all - into a single whole. So one must pay attention to - generalities in incidents, with help and quietness - rather than with professions and the excuses that - accompany ill-success.

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PART 3

III. Early determination of the patient's treatment--since - only what has actually been administered - will benefit ; emphatic assertion is of no - use--is beneficial but complicated. For it is through - many turns and changes that all diseases settle into - some sort of permanence.Because changes and turns are common in the - early - stages, to fix the proper treatment early is a complicated - matter.

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PART 4

IV. This piece of advice also will need our consideration, - as it contributes somewhat to the whole. - For should you begin by discussing fees, you will - suggest to the patient either that you will go away - and leave him if no agreement be reached, or that - you will neglect him and not prescribe any immediate - treatment. So one must not be anxious about fixing - a fee. For I consider such a worry to be harmful - to a troubled patient, particularly if the disease be - acute. For the quickness of the disease, offering no - opportunity for turning back,I. e. from missed opportunities - that have passed away - while haggling over fees. It is possible that A)NAS1TROFH/ has - here the sense of A)NAS1TRE/FEIN KARI/DAN in Thucydides II. 49, - " to upset." An acute disease is not the time to upset a - patient with financial worries. spurs on the good - physician not to seek his profit but rather to lay - hold on reputation. Therefore it is better to reproach - a patient you have saved than to extort money fromOr, if Coray's - emendation be adopted, " to tease." - those who are at death's door.

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PART 5

V. And yet some patients ask for what is out of - the way and doubtful, through prejudice, deserving - indeed to be disregarded, but not to be punished. - Wherefore you must reasonably oppose them, as - they are embarked upon a stormy sea of change.

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For, in heaven's name, who that is a brotherlyThe word so - translated is fairly common in the Corpus in - the sense of " related." Here it evidently means " a loyal - member of the family of physicians." physician - practises with such hardness of heart as not at - the beginning to conduct a preliminary examination - of every illnessWith Ermerins' reading, " all the illness." and - prescribe what will help towards - a cure, to heal the patient and not to overlook the - reward, to say nothing of the desire that makes a - man ready to learn?

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PART 6

VI. I urge you not to be too unkind, but to consider - carefully your patient's superabundance or - means. Sometimes give your services for nothing, - calling to mind a previous benefaction or present - satisfaction.Or, with EU)DOKIMI/HN, " your present - reputation." And if there be an opportunity of - serving one who is a stranger in financial straits, - give full assistance to all such. For where there is - love of man, there is also love of the art. For some - patients, though conscious that their condition is - perilous, recover their health simply through their - contentment with the goodness of the physician. - And it is well to superintend the sick to make them - well, to care for the healthy to keep them well, but - also to care for one's own self, so as to observe what - is seemly.

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PART 7

VII. Now those who are buried in deep ignorance - of the art cannot appreciate what has been said. - In fact such men will be shown up as ignorant of

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medicine, suddenly exalted yet needing good luck. - For should wealthy men gain some remission of their - trouble, these quacks win reputation through a - double good fortune, and if a relapse occurs - they stand upon their dignity, having neglected - the irreproachable methods of the art, wherewith - a good physician, a " brother of the art " as he is - called, would be at his best. But he who accomplishes - his cures easily without making a mistake - would transgress none of these methods through want - of power ;He is trusted, and so can do as he likes. Therefore want - of power to influence a patient never compels him to transgress - the medical code. for he is not distrusted on the ground of - wickedness. For quacks do not attempt treatment - when they see an alarmingIt is quite uncertain whether - FLEBONW/DEA is the correct - reading, and equally uncertain what it means if it be correct. - Erotian's note recognises two ancient readings, FLEDONW/DEA, - explained as TA\ META\ FLUARI/AS2 KAI\ PNEUMATW/DOUS2 TARAXH=S2 - E)KKRINO/MENA, and FLEBONW/DEA, explained as TA\ MET' - A)LGH/MATOS2 - OI)DH/MATA. But the general meaning must be " serious," - " alarming." condition, and avoid - calling in other physicians, because they wickedly - hate help. And the patients in their pain drift on a - sea of twofold wretchedness for not having intrusted - themselves to the end to the fuller treatment that - is given by the art. For a remission of a disease - affords a sick man much relief. Wherefore wanting - a healthy condition they do not wish always to submit - to the same treatment, therein being in accord - with a physician's versatility.The reader must suspect that in the - words I)HTROU= POIKILI/H - is concealed an allusion to frequent changes of the medical - attendant. " Changing their doctor every day." The - version in the text means that the patients frequently - change their minds as do quacks, or as doctors must be ready - to change their treatment at a moment's notice. For the patients

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are in need through heavy expenditure, worshipping - incompetence and showing no gratitude when they - meet it ;These patients A)PORE/OUS1IN, and so can scarcely be - the same - as the EU)/POROI of the earlier part of the chapter. Perhaps - OU)K should be read before A)XARIS1TE/ONTES2, and the sense - would - then be, " they become poor by showing gratitude to quacks, - when they might be well off by employing qualified men." when they have - the power to be well off, - they exhaust themselves about fees, really wishing - to be well for the sake of managing their investments - or farms, yet without a thought in these matters to - receive anything.The greater part of this chapter is hopeless. - There - seems to be no connexion between the quack doctors of the - first part and the wayward patients of the latter part. I - suspect that an incongruous passage has been inserted here - by some compiler, just as chapter fourteen was so inserted. - Perhaps there are gaps in the text, the filling up of which - would clear away the difficulty. Probably there is one after - EI(/NEKEN. If the latter part be not an interpolation, the - general meaning seems to be that when patients grow worse - under quack treatment, they change their doctor and hire - another quack. So they both grow worse and lose money. - They really want to get well to look after their business, - but do not think of the right way to return to work again, - i. e. of employing a qualified medical man.

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PART 8

VIII. So much for such recommendations. For - remission and aggravation of a disease require respectively - less or more medical assistance. A - physician does not violate etiquette even if, being - in difficulties on occasion over a patient and in the - dark through inexperience, he should urge the calling - in of others, in order to learn by consultation the - truth about the case, and in order that there may - be fellow-workers to afford abundant help. For - when a diseased condition is stubborn and the evil - grows, in the perplexity of the moment most things - go wrong. So on such occasions one must be bold.Or (reading - OU)) " on such occasions one must not be - self-confident." - For never will I lay it down that the art has been

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condemned in this matter.I. e. that because a consultant - is necessary the fault lies - with the art of medicine. Physicians who meet - in consultation must never quarrel, or jeer at one - another. For I will assert upon oath, a physician's - reasoning should never be jealous of another. To - be so will be a sign of weakness. Those who act - thus lightly are rather those connected with the - business of the market-place. Yet it is no mistaken - idea to call in a consultant. For in all abundance - there is lack.No matter how much help you have you can never have - enough.

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PART 9

IX. With all these things it will appear strong - evidence for the reality of the art if a physician, - while skilfully treating the patient, does not refrain - from exhortations not to worry in mind in the - eagerness to reach the hour of recovery. For we - physicians take the lead in what is necessary for - health. And if he be under orders the patient will - not go far astray. For left to themselves patients - sink through their painful condition, give up the - struggle and depart this life. But he who has taken - the sick man in hand, if he display the discoveries - of the art, preserving nature, not trying to alter it, - will sweep away the present depression or the distrust - of the moment. For the healthy condition of - a human being is a nature that has naturally attained - a movement, not alien but perfectly adapted, having

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produced it by means of breath, warmth and coction - of humours, in every way, by complete regimen and - by everything combined, unless there be some congenital - or early deficiency. Should there be such a - thing in a patient who is wasting, try to assimilate - to the fundamental nature.I. e. try to bring the patient - back to his normal condition. For the wasting, even - of long standing, is unnatural.

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PART 10

X. You must also avoid adopting, in order to gain a - patient,Apparently, in order to increase your practice by - fastidiousness in the matter of dress. But the expression - is very strange, and should mean, " in order to effect a cure." - luxurious headgear and elaborate perfume. - For excess of strangeness will win you ill-repute, but - a little will be considered in good taste, just as pain - in one part is a trifle, while in every part it is serious. - Yet I do not forbid your trying to please, for it is - not unworthy of a physician's dignity.

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PART 11

XI. Bear in mind the employment of instruments - and the pointing out of significant symptoms, and - so forth.

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PART 12

XII. And if for the sake of a crowded audience - you do wish to hold a lecture, your ambition is no - laudable one, and at least avoid all citations from - the poets, for to quote them argues feeble industry. - For I forbid in medical practice an industry not - pertinent to the art, and laboriously far-fetched,See p. 308. - and which therefore has in itself alone an attractive - grace. For you will achieve the empty toil of a - drone and a drone's spoils.See p. 308.

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PART 13

XIII. A condition too is desirable free from the - late-learner's faults. For his state accomplishes - nothing that is immediate, and its remembrance - of what is not before the eyes is but tolerable. So - there arises a quarrelsome inefficiency, with headstrong - outrage, that has no thought for what is - seemly, while definitions, professions, oaths, great as - far as the gods invoked are concerned,That is, the oaths - frantically appeal to all the great gods. come from - the physician in charge of the disease, bewildered - laymen being lost in admiration of flowery language - spoken in continuous reading and instruction, - crowding together even before they are troubled by - a disease.The construction and translation are uncertain. I believe - that DRIS1MOI=S2 and the other datives are a Roman's efforts at - rendering into Greek "ablatives of attendant circumstances," - but E)K METAFORH=S2 is puzzling, and can hardly be taken with - LO/GONS2. Perhaps it is a Latinism. Cf. "pastor ab Amphryso." - Wherever I may be in charge of a case, - with no confidence should I call in such men to - help as consultants. For in them comprehension of - seemly learning is far to seek. Seeing then that they - cannot but be unintelligent, I urge that experience - is useful, the learning of opinions coming far after. - For who is desirous and ambitious of learning truly - subtle diversities of opinion, to the neglect of calm - and practised skill? Wherefore I advise you to - listen to their words but to oppose their acts.

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PART 14

XIV. When regimen has been restricted you must

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not suppress for long a long-standing desire of the - patient.Too strict a regimen may do harm by the patient's using - up his strength in conquering his appetites. Some such verb - as KATE/XEIN must be substituted for E)GXEIREI=N. In a - chronic disease indulgence too helps - to set a man on his feet again, if one pay the - necessary attention to one who is blind.I. e. the patient - does not know what is good for him. As great - fear is to be guarded against, so is excessive joy. - A sudden disturbance of the air is also to be guarded - against.I. e. either (a) a draught or (b) a - sudden change in - the weather. The prime of life has everything lovely, - the decline has the opposite. Incoherence of speech - comes from an affection, or from the ears, or from - the speaker's talking of something fresh before he - has uttered what was in his mind before, or from - his thinking of fresh things before he has expressed - what was in his thoughts before. Now this is a thing - that happens without any "visible affection" socalled, - mostly to those who are in love with their - art. The power of youth, when the matter is - trifling,Possibly, "when the patient is not a big man." - U(POKEI/MENON, - can mean "patient" in later Greek. is sometimes supremely great. - Irregularity - in a disease signifies that it will be a long one. A - crisis is the riddance of a disease. A slight cause - turns into a cure unless the affection be in a vital - part. BecausePossibly, "for the same reason that." - fellow-feeling at grief causes distress, - some are distressed through the fellow-feeling

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of another. Loud talking is painful. Overwork - calls for gentle dissuasion.U(POPARAI/THS1IS2 is not found - in the dictionaries, but may be - correct. A woodedA)LUW/DHS2 is unmeaning, and I - translate as though A)LS1W/DHS2 - were in the text. district - benefits.

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- - - - diff --git a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng2.xml b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng2.xml new file mode 100644 index 000000000..51b334718 --- /dev/null +++ b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng2.xml @@ -0,0 +1,142 @@ + + + + + + + Precepts + Hippocrates + William Henry Samuel Jones + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 1, 2005 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg051.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + Hippocrates + Hippocrates + William Henry Samuel Jones + + London + William Heinemann Ltd. + Cambridge, MA + Harvard University Press + 1923 + + 1 + + Loeb Classical Library + Internet Archive + + + + + + + +

Data Entry

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This pointer pattern extracts section.

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Time is that wherein there is opportunity, and opportunity is that wherein there is no great time. Healing is a matter of time, but it is sometimes also a matter of opportunity. However, knowing this, one must attend in medical practice not primarily to plausible theories,The definition shows that in this passage λογισμός is a generalisation, like the πρόληψις of Epicurus, whose language is borrowed. But whereas πρόληψις corresponds to a general term (e. g. man), λογισμός here seems to mean a general proposition (e. g. man is mortal). Later on it means the use of λογισμοί in making συλλογισμοί, that is, deduction. Theory and theorising are the nearest equivalents I can think of. but to experience combined with reason. For a theory is a composite memory of things apprehended with sense-perception. For the sense-perception, coming first in experience and conveying to the intellect the things subjected to it, is clearly imaged, and the intellect, receiving these things many times, noting the occasion, the time and the manner, stores them up in itself and remembers. Now I approve of theorising also if it lays its foundation in incident, and deduces its conclusions in accordance with phenomena. For if theorising lays its foundation in clear fact, it is found to exist in the domain of intellect, which itself receives from other sources each of its impressions. So we must conceive of our nature as being stirred and instructed under compulsion by the great variety of things; and the intellect, as I have said, taking over from nature the impressions, leads us afterwards into truth. But if it begins, not from a clear impression, but from a plausible fiction,I. e., if the general statement from which we deduce conclusions be a plausible but untrue hypothesis. Conclusions drawn from such hypotheses lead to nowhere. it often induces a grievous and troublesome condition. All who so act are lost in a blind alley. Now no harm would be done if bad practitioners received their due wages. But as it is their innocent patients suffer, for whom the violence of their disorder did not appear sufficient without the addition of their physician’s inexperience. I must now pass on to another subject.

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But conclusions which are merely verbal cannot bear fruit, only those do which are based on demonstrated fact. For affirmation and talk are deceptive and treacherous. Wherefore one must hold fast to facts in generalisations also,Or, possibly, even from beginning to end. and occupy oneself with facts persistently, if one is to acquire that ready and infallible habit which we call the art of medicine. For so to do will bestow a very great advantage upon sick folk and medical practitioners. Do not hesitate to inquire of laymen, if thereby there seems likely to result any improvement in treatment. For so I think the whole art has been set forth, by observing some part of the final end in each of many particulars, and then combining all into a single whole. So one must pay attention to generalities in incidents, with help and quietness rather than with professions and the excuses that accompany ill-success.

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Early determination ofthe patient’s —since only what has actually been administered will benefit; emphatic assertion is of no use—is beneficial but complicated. For it is through many turns and changes that all diseases settle into some sort of permanence.Because changes and turns are common in the early stages, to fix the proper treatment early is a complicated matter.

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This piece of advice also will need our consideration, as it contributes somewhat to the whole. For should you begin by discussing fees, you will suggest to the patient either that you will go away and leave him if no agreement be reached, or that you will neglect him and not prescribe any immediate treatment. So one must not be anxious about fixing a fee. For I consider such a worry to be harmful to a troubled patient, particularly if the disease be acute. For the quickness of the disease, offering no opportunity for turning back,I. e. from missed opportunities that have passed away while haggling over fees. It is possible that ἀναστροφή has here the sense of ἀναστρέφειν καρίδαν in Thucydides II. 49, to upset. An acute disease is not the time to upset a patient with financial worries. spurs on the good physician not to seek his profit but rather to lay hold on reputation. Therefore it is better to reproach a patient you have saved than to extort money fromOr, if Coray’s emendation be adopted, to tease. those who are at death’s door.

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And yet some patients ask for what is out of the way and doubtful, through prejudice, deserving indeed to be disregarded, but not to be punished. Wherefore you must reasonably oppose them, as they are embarked upon a stormy sea of change. For, in heaven’s name, who that is a brotherlyThe word so translated is fairly common in the Corpus in the sense of related. Here it evidently means a loyal member of the family of physicians. physician practises with such hardness of heart as not at the beginning to conduct a preliminary examination of every illnessWith Ermerins’ reading, all the illness. and prescribe what will help towards a cure, to heal the patient and not to overlook the reward, to say nothing of the desire that makes a man ready to learn?

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I urge you not to be too unkind, but to consider carefully your patient’s superabundance or means. Sometimes give your services for nothing, calling to mind a previous benefaction or present satisfaction.Or, with εὐδοκιμίην, your present reputation. And if there be an opportunity of serving one who is a stranger in financial straits, give full assistance to all such. For where there is love of man, there is also love of the art. For some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician. And it is well to superintend the sick to make them well, to care for the healthy to keep them well, but also to care for one’s own self, so as to observe what is seemly.

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Now those who are buried in deep ignorance of the art cannot appreciate what has been said. In fact such men will be shown up as ignorant of medicine, suddenly exalted yet needing good luck. For should wealthy men gain some remission of their trouble, these quacks win reputation through a double good fortune, and if a relapse occurs they stand upon their dignity, having neglected the irreproachable methods of the art, wherewith a good physician, a brother of the art as he is called, would be at his best. But he who accomplishes his cures easily without making a mistake would transgress none of these methods through want of power;He is trusted, and so can do as he likes. Therefore want of power to influence a patient never compels him to transgress the medical code. for he is not distrusted on the ground of wickedness. For quacks do not attempt treatment when they see an alarmingIt is quite uncertain whether φλεβονώδεα is the correct reading, and equally uncertain what it means if it be correct. Erotian’s note recognises two ancient readings, φλεβονώδεα, explained as τὰ μετὰ φλυαρίας καὶ πνευματώδους ταραχῆς ἐκκρινόμενα, and φλεβονώδεα, explained as τὰ μετ’ ἀλγήματος οἰδήματα. But the general meaning must be serious, alarming. condition, and avoid calling in other physicians, because they wickedly hate help. And the patients in their pain drift on a sea of twofold wretchedness for not having intrusted themselves to the end to the fuller treatment that is given by the art. For a remission of a disease affords a sick man much relief. Wherefore wanting a healthy condition they do not wish always to submit to the same treatment, therein being in accord with a physician’s versatility.The reader must suspect that in the words ἰητροῦ ποικιλίη is concealed an allusion to frequent changes of the medical attendant. Changing their doctor every day. The version in the text means that the patients frequently change their minds as do quacks, or as doctors must be ready to change their treatment at a moment’s notice. For the patients are in need through heavy expenditure, worshipping incompetence and showing no gratitude when they meet it;These patients ἀπορέουσιν, and so can scarcely be the same as the εὔποροι of the earlier part of the chapter. Perhaps οὐκ should be read before ἀχαριστέοντες, and the sense would then be, they become poor by showing gratitude to quacks, when they might be well off by employing qualified men. when they have the power to be well off, they exhaust themselves about fees, really wishing to be well for the sake of managing their investments or farms, yet without a thought in these matters to receive anything.The greater part of this chapter is hopeless. There seems to be no connexion between the quack doctors of the first part and the wayward patients of the latter part. I suspect that an incongruous passage has been inserted here by some compiler, just as chapter fourteen was so inserted. Perhaps there are gaps in the text, the filling up of which would clear away the difficulty. Probably there is one after εἵνεκεν. If the latter part be not an interpolation, the general meaning seems to be that when patients grow worse under quack treatment, they change their doctor and hire another quack. So they both grow worse and lose money. They really want to get well to look after their business, but do not think of the right way to return to work again, i. e. of employing a qualified medical man.

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So much for such recommendations. For remission and aggravation of a disease require respectively less or more medical assistance. A physician does not violate etiquette even if, being in difficulties on occasion over a patient and in the dark through inexperience, he should urge the calling in of others, in order to learn by consultation the truth about the case, and in order that there may be fellow-workers to afford abundant help. For when a diseased condition is stubborn and the evil grows, in the perplexity of the moment most things go wrong. So on such occasions one must be bold.Or (reading οὐ) on such occasions one must not be self-confident. For never will I lay it down that the art has been condemned in this matter.I. e. that because a consultant is necessary the fault lies with the art of medicine. Physicians who meet in consultation must never quarrel, or jeer at one another. For I will assert upon oath, a physician’s reasoning should never be jealous of another. To be so will be a sign of weakness. Those who act thus lightly are rather those connected with the business of the market-place. Yet it is no mistaken idea to call in a consultant. For in all abundance there is lack.No matter how much help you have you can never have enough.

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With all these things it will appear strong evidence for the reality of the art if a physician, while skilfully treating the patient, does not refrain from exhortations not to worry in mind in the eagerness to reach the hour of recovery. For we physicians take the lead in what is necessary for health. And if he be under orders the patient will not go far astray. For left to themselves patients sink through their painful condition, give up the struggle and depart this life. But he who has taken the sick man in hand, if he display the discoveries of the art, preserving nature, not trying to alter it, will sweep away the present depression or the distrust of the moment. For the healthy condition of a human being is a nature that has naturally attained a movement, not alien but perfectly adapted, having produced it by means of breath, warmth and coction of humours, in every way, by complete regimen and by everything combined, unless there be some congenital or early deficiency. Should there be such a thing in a patient who is wasting, try to assimilate to the fundamental nature.I. e. try to bring the patient back to his normal condition. For the wasting, even of long standing, is unnatural.

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You must also avoid adopting, in order to gain a patient,Apparently, in order to increase your practice by fastidiousness in the matter of dress. But the expression is very strange, and should mean, in order to effect a cure. luxurious headgear and elaborate perfume. For excess of strangeness will win you ill-repute, but a little will be considered in good taste, just as pain in one part is a trifle, while in every part it is serious. Yet I do not forbid your trying to please, for it is not unworthy of a physician’s dignity.

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Bear in mind the employment of instruments and the pointing out of significant symptoms, and so forth.

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And if for the sake of a crowded audience you do wish to hold a lecture, your ambition is no laudable one, and at least avoid all citations from the poets, for to quote them argues feeble industry. For I forbid in medical practice an industry not pertinent to the art, and laboriously far-fetched,See p. 308. and which therefore has in itself alone an attractive grace. For you will achieve the empty toil of a drone and a drone’s spoils.See p. 308.

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A condition too is desirable free from the late-learner’s faults. For his state accomplishes nothing that is immediate, and its remembrance of what is not before the eyes is but tolerable. So there arises a quarrelsome inefficiency, with headstrong outrage, that has no thought for what is seemly, while definitions, professions, oaths, great as far as the gods invoked are concerned,That is, the oaths frantically appeal to all the great gods. come from the physician in charge of the disease, bewildered laymen being lost in admiration of flowery language spoken in continuous reading and instruction, crowding together even before they are troubled by a disease.The construction and translation are uncertain. I believe that δρισμοῖς and the other datives are a Roman’s efforts at rendering into Greek ablatives of attendant circumstances, but ἐκ μεταφορῆς is puzzling, and can hardly be taken with λόγονς. Perhaps it is a Latinism. Cf. pastor ab Amphryso. Wherever I may be in charge of a case, with no confidence should I call in such men to help as consultants. For in them comprehension of seemly learning is far to seek. Seeing then that they cannot but be unintelligent, I urge that experience is useful, the learning of opinions coming far after. For who is desirous and ambitious of learning truly subtle diversities of opinion, to the neglect of calm and practised skill? Wherefore I advise you to listen to their words but to oppose their acts.

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When regimen has been restricted you must not suppress for long a long-standing desire of the patient.Too strict a regimen may do harm by the patient’s using up his strength in conquering his appetites. Some such verb as κατέχειν must be substituted for ἐγχειρεῖν. In a chronic disease indulgence too helps to set a man on his feet again, if one pay the necessary attention to one who is blind.I. e. the patient does not know what is good for him. As great fear is to be guarded against, so is excessive joy. A sudden disturbance of the air is also to be guarded against.I. e. either (a) a draught or (b) a sudden change in the weather. The prime of life has everything lovely, the decline has the opposite. Incoherence of speech comes from an affection, or from the ears, or from the speaker’s talking of something fresh before he has uttered what was in his mind before, or from his thinking of fresh things before he has expressed what was in his thoughts before. Now this is a thing that happens without any visible affection socalled, mostly to those who are in love with their art. The power of youth, when the matter is trifling,Possibly, when the patient is not a big man. ὑποκείμενον, can mean patient in later Greek. is sometimes supremely great. Irregularity in a disease signifies that it will be a long one. A crisis is the riddance of a disease. A slight cause turns into a cure unless the affection be in a vital part. BecausePossibly, for the same reason that. fellow-feeling at grief causes distress, some are distressed through the fellow-feeling of another. Loud talking is painful. Overwork calls for gentle dissuasion.ὑποπαραίτησις is not found in the dictionaries, but may be correct. A woodedἀλυώδης is unmeaning, and I translate as though ἀλσώδης were in the text. district benefits.

+ diff --git a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-grc2.xml b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-grc2.xml index 6896c6c1c..024170386 100644 --- a/data/tlg0627/tlg051/tlg0627.tlg051.perseus-grc2.xml +++ b/data/tlg0627/tlg051/tlg0627.tlg051.perseus-grc2.xml @@ -4,7 +4,7 @@ - Παραγγελίαι + Παραγγελίαι Hippocrates William Henry Samuel Jones @@ -43,7 +43,7 @@ William Heinemann Ltd. Cambridge, MA Harvard University Press -1923 +1923 1 diff --git a/manifest.txt b/manifest.txt index 6e7328b41..35e20623b 100644 --- a/manifest.txt +++ b/manifest.txt @@ -2341,6 +2341,7 @@ /data/tlg0627/tlg005/tlg0627.tlg005.perseus-grc2.xml /data/tlg0627/tlg006/__cts__.xml /data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng3.xml +/data/tlg0627/tlg006/tlg0627.tlg006.perseus-eng4.xml /data/tlg0627/tlg006/tlg0627.tlg006.perseus-grc2.xml /data/tlg0627/tlg007/__cts__.xml /data/tlg0627/tlg007/tlg0627.tlg007.perseus-eng2.xml @@ -2359,22 +2360,30 @@ /data/tlg0627/tlg011/tlg0627.tlg011.perseus-grc2.xml /data/tlg0627/tlg012/__cts__.xml /data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml +/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml /data/tlg0627/tlg013/__cts__.xml /data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml +/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng5.xml /data/tlg0627/tlg013/tlg0627.tlg013.perseus-grc2.xml /data/tlg0627/tlg014/__cts__.xml /data/tlg0627/tlg014/tlg0627.tlg014.perseus-eng2.xml /data/tlg0627/tlg027/__cts__.xml +/data/tlg0627/tlg027/tlg0627.tlg027.perseus-eng2.xml /data/tlg0627/tlg027/tlg0627.tlg027.perseus-grc2.xml /data/tlg0627/tlg028/__cts__.xml +/data/tlg0627/tlg028/tlg0627.tlg028.perseus-eng2.xml /data/tlg0627/tlg028/tlg0627.tlg028.perseus-grc2.xml /data/tlg0627/tlg029/__cts__.xml +/data/tlg0627/tlg029/tlg0627.tlg029.perseus-eng2.xml /data/tlg0627/tlg029/tlg0627.tlg029.perseus-grc2.xml /data/tlg0627/tlg030/__cts__.xml +/data/tlg0627/tlg030/tlg0627.tlg030.perseus-eng2.xml /data/tlg0627/tlg030/tlg0627.tlg030.perseus-grc2.xml /data/tlg0627/tlg046/__cts__.xml +/data/tlg0627/tlg046/tlg0627.tlg046.perseus-eng2.xml /data/tlg0627/tlg046/tlg0627.tlg046.perseus-grc2.xml /data/tlg0627/tlg051/__cts__.xml +/data/tlg0627/tlg051/tlg0627.tlg051.perseus-eng2.xml /data/tlg0627/tlg051/tlg0627.tlg051.perseus-grc2.xml /data/tlg0638/__cts__.xml /data/tlg0638/tlg001/__cts__.xml