First draft. This English translation was generated by
Claude Sonnet 4.6, critiqued by Claude Haiku 4.5, and adjudicated/corrected
once by Claude Sonnet 4.6. It is published for reading and review, not as a
final scholarly edition. Hippocratic medical recipes and treatments are
historical text, not medical advice.
COAN PROGNOSTICS.
1
Those who become thoroughly chilled from rigors, suffering headache, pain in the neck, voiceless, breaking into sweats, and who then rally — die.
2
Distresses accompanied by chilling are the worst. Chilling with hardening: deadly.
4
From chilling, fear and unreasoning despondency end in convulsion. Retention of urine arising from chilling: worst.
6
Ignorance after a rigor is bad; so too is forgetfulness. Rigor-attacks accompanied by stupor are near-deadly; and the fiery flush in the face with sweating in such cases is malignant. Following these, chilling of the posterior parts calls forth convulsion; and in general, chilling of the posterior parts tends to convulsion.
8
Frequent shiverings from the back, rapidly shifting, hard to bear — they signal a painful retention of urine; sweating through in such cases is worst. Rigor in a continuous fever, when the body is already weakened: deadly.
10
Those who frequently sweat through and shiver upon it: deadly; and at the end they turn out to have suppuration and disturbed bowels. Rigors from the back are harder to bear; those that, having shivered on the seventeenth day, shiver again on the twenty-fourth: troublesome.
12
Those who are shivery, headache-prone, and sweating through are malignant. Those who are shivery and sweating through profusely: troublesome.
14
Rigors that are for the most part sluggish: malignant. Those in whom rigors occur on the sixth day: hard to bring to a crisis.
16
Those in whom frequent shiverings occur while healthy — these develop suppuration from a flow of blood. Shivering and labored breathing in the midst of toils: signs of phthisis (wasting).
18
From suppuration in the lung, and sometimes pains in the belly and at the collarbone, and a kind of troubled snoring with nausea, these indicate an abundance of sputum in the lung. Those who are shivery, nauseous, weary, with pain in the loins, have their bowels loosened.
20
Those who shiver upon it, with exacerbation more toward night, sleepless, babbling, at times letting urine pass under themselves during sleep: this ends in convulsion. Continuous rigors in acute cases: bad.
22
Collapse from rigor with headache: deadly; bloody urine in such cases is bad. Rigor of the opisthotonic kind kills.
24
Cases that have had a shivering followed by sweating at a critical point, then shiver again the next day without reason, staying sleepless, with no signs of ripening — I think these will hemorrhage. Urine retained in conjunction with rigor is bad and tends to convulsion, especially in one who has been previously affected with stupor; hope in such cases lies also in swellings beside the ears.
26
Rigors that follow a tertian pattern, exacerbating in the interval with irregular fever: wholly malignant; those exacerbating oppositely ..... Of convulsive conditions, those accompanied by rigor and fever: deadly.
28
Voicelessness from rigor is resolved by trembling; and those who shiver upon it, becoming trembling, come to a crisis. Those who collapse from rigor with headache: precarious; bloody urine in these cases is bad.
30
In those who have rigor: retention of urine. Convulsion in fever and pains in hands and feet: malignant; malignant too is pain shooting from the thigh; nor indeed is pain in the knees sound; moreover pains in the calves are malignant, and sometimes also indicate disordered judgment, especially if urine is held in suspension.
32
Fevers from pain in the hypochondria: malignant; stupor in these cases: worst. Those with no intermission, sweating through frequently, with tension of the hypochondrium: for the most part malignant; and pains lodging in the shoulder-top and collarbone in such cases are bad.
34
Fever of tertian character with nausea: malignant. Loss of voice during fever: bad.
36
Weary, dimly-sighted, sleepless, stuporous, sweating through, reheating: bad. Those who are weary, with shivering, who have sweated through at a critical moment and reheated, in an acute case: bad, especially if there is also dripping from the nose; around such times those who are jaundiced and deeply colored die, and a white evacuation passes through them beforehand.
38
Fever of tertian character that wanders and shifts to even-day periods: troublesome. Bouts of restlessness at critical times, chilling without sweat, and in general all those that chill without sweat and without crisis: bad; and those who shiver after these events, who vomit unmixed bilious matter, are nauseous, trembling, in fever: bad; and the voice as if from a rigor.
40
Cases that chill from the nose with small sweats: bad. Those sweating through, sleepless, reheating: bad.
42
Those sweating through in fever: malignant. Those in whom, with bilious evacuation, there is biting and bitterness around the chest: bad.
44
In fever, when the belly is inflated and pneuma is not passing through: bad. Weary, hiccoughing, in fixed trance: bad.
46
Those who sweat through from frequent and fine shiverings from the back: hard to bear; it signals a painful retention of urine; sweating through in these cases: bad. To act contrary to custom — such as being eager to accept something formerly not accustomed to, or the opposite — is bad and close to derangement.
48
Cases that lighten in the presence of bad signs, and those that do not yield in the presence of good signs: troublesome. Those sweating through, especially over the head, in acute cases: somewhat distressing, bad, especially with dark urine; and the turbid pneuma in such cases: bad.
50
Extremities rapidly shifting to both sides, and thirst of the same kind: bad. A bold answer from a quiet person, a sharp voice: bad; the hypochondria in such people are drawn inward.
52
Cases of chilling with sweating that warm up again quickly: bad. Those sweating through in acute cases: somewhat distressing, bad.
54
Those who are without strength without reason, without empty vessels: bad. In fever, a drawing-sensation as if from vomiting that ends in throat-clearing: bad.
56
Numbnesses that rapidly shift to both sides: bad. The smallest dribbling flows: bad.
58
Altogether bad in an acute case: thirst unreasonably resolved. Those who start up against a hand: bad.
60
In those where together with a burning fever there are swellings that are sleep-heavy and sluggish, and pain in the side then comes on: it kills in the manner of a stroke. Choking in acute cases in lean persons: deadly.
62
In cases already deadly: small tremors, vomit the color of verdigris, those who make faint sounds and rumblings in drinking dry, and those who swallow with difficulty in the midst of cough-prone breathing: deadly. In acute cases with chilling, redness in the hands and feet: deadly.
64
Those who puff out and lie back in sleep looking up from below, die deeply jaundiced and saturated in color; a white evacuation passes through them beforehand. Departures from reason in fevers that are silent but not in a voiceless person: deadly.
66
Lividness developing in fever signals swift death. Those in whom, during fever, pain in the side has come on and the bowels are passing much watery-bilious matter — they get easier, but loss of appetite follows, and sweats with good color of the face, and loose bowels, and some heartburn; these, after a prolonged illness, end in a peripneumonic manner.
68
For one who is feverish at the onset, black bile passing off upward or downward: deadly. Those with chillings who are not fever-free and who sweat through in the upper parts: hard to bear, phrenitic and deadly.
70
In an acute case, briefly acute pains falling on the collarbone and back: deadly. In prolonged deadly cases, pain in the rectum: deadly.
72
In those already disposed weakly, failure to see, or to hear, or distortion of lip, eye, or nostril: deadly. In fevers, pain in the groin signals a prolonged illness.
74
Lack of crisis in fevers produces long courses but is not deadly. Fevers arising from severe pains: long-lasting.
76
Trembling, groping deliria: phrenitic; and pains in the calves in such cases indicate disordered judgment. Those who lie in a continuous voiceless state, blinking with closed eyes — if, with blood flowing from the nostrils, they vomit and then speak and come to themselves: they are saved; if these things do not occur, they become labored in breathing and die quickly.
78
Those who are taken ill, exacerbate the next day, pause on the third, exacerbate on the fourth: bad; are such exacerbations not phrenitic? Those whose fevers remit without following critical days tend to relapse.
80
Those who are slight at the onset with throbbing in the head and thin urine exacerbate toward a crisis; no wonder if there is also derangement and sleeplessness. In acute cases, agitation, tossing, disturbed sleep: signal convulsion in some.
82
Disturbed wakings with wild boldness, wandering in mind: bad, and tending to convulsion, especially with sweating; and cooling of the neck and mid-back seem to tend to convulsion, as do coolings of the whole body; in such cases there are film-like (membranous) urinations. Bouts of derangement in intense heat: tending to convulsion.
84
Boldness of short duration in derangements, beast-like, also presage convulsions. Unreasonable swellings of the belly in prolonged cases: tending to convulsion.
86
Cases that are immediately disturbed, sleepless, dripping from the nose, that are eased on the sixth day, then suffer toward the next day, sweat through, are overwhelmed, become deranged — these hemorrhage freely and this resolves the suffering; watery urine in such cases carries this meaning, if it occurs together with the aforesaid signs. Of those who become mentally disturbed in a melancholic manner, those who become trembling are malignant.
88
Derangement of mind with disordered pneuma and sweat: deadly; deadly too with disordered pneuma and hiccough. Dreams in phrenitis: vivid.
90
White evacuations and sluggishness in phrenitis: bad; rigor in such cases: worst. In phrenitic cases, at the outset those that are moderately well but frequently shifting: bad.
92
In those mentally deranged in a melancholic manner, when tremors come on: bad. Those who become mentally deranged in a melancholic manner and become trembling and salivating — are these not phrenitic? Those who are suddenly mentally deranged and then acutely feverish become phrenitic.
95
Phrenitic patients, drinking little, startled by noise, trembling or convulsing. Vigorously trembling signs in phrenitic cases: deadly.
97
Derangements around the necessary functions: worst; those who are exacerbated from these: deadly. Bouts of derangement, with a clanging voice, tongue tending to convulsion, and the patients themselves becoming trembling, become mentally deranged; hardening in such cases: deadly.
99
Derangements in those who were already utterly weakened beforehand: worst. In phrenitic cases, frequent shifts tending to convulsion: bad.
101
Phrenitic patients who salivate with chilling indicate a dark vomit. In those who are variously ill and deranged, frequently stuporous, predict and announce a dark vomit.
103
Those exacerbating in a convulsive manner: in fixed trance. Swellings beside the ears in prolonged cases, appearing small, with hemorrhagic tendency and dizziness: deadly.
105
Fever with hiccough, both without and with ileus: deadly. Those who, being flatulent, have jaundice and acute fever, with a tense hypochondrium, and who then chill — a large swelling beside the ear.
107
In those in whom, during fever, pains occurring about the loin and lower regions then touch on the diaphragm area, leaving the lower parts behind: deadly, especially if any other bad sign is also present; but if the other signs do not turn bad, there is hope of suppuration forming. In children: acute fever, stoppage of the bowels with sleeplessness, kicking, change of color, and holding a flush — tending to convulsion.
109
Cases that are immediately disturbed, sleepless, with the composed features dark — some of these hemorrhage. Those who, from sleeplessness, suddenly break into restlessness: hemorrhage, especially if something has previously flowed; or also perhaps after further shivering? Those who chill briefly, cough around the exacerbations, and sweat through a little: malignant; with pain in the side and choking added, these develop suppuration.
112
In those in whom small blisters break out over the whole body in continuous fevers, it is deadly if no purulent abscess forms; and most commonly such an abscess is accustomed to form beside the ear. In an acute case: for the outer parts to be chilling while the inner parts burn, and to be thirsty: bad.
114
Continuous fevers intensifying through every third day: dangerous; but in whomsoever the fever at any point intermits: not dangerous. In prolonged fevers, either growths or pains in the joints arise; and if they do arise, they are not without use.
116
Headache in an acute case, hypochondrium drawn up, with no blood flowing from the nostrils: turns around into phrenitis. Remittent fever types, without cholera supervening, are not resolved.
118
Jaundice coming on before the seventh day: bad; but on the seventh, ninth, eleventh, and fourteenth days: tending to crisis, provided it does not harden the hypochondria; if it does, doubtful. Frequent relapses through the same symptoms, vomit-prone around a crisis, produce a dark vomit; the patients also become trembling.
120
Pains exacerbating together with tertian fevers, themselves of tertian origin, produce clotted blood in the evacuations. In fevers, throbbing and pain along the vein in the neck ends in dysentery.
122
Frequent change of color and heat: useful. In bilious patients, large pneuma, and acute fever with tension of the hypochondrium: raises swellings beside the ears.
124
Those recovering from prolonged illnesses, eating well, making no further progress, relapse malignantly. Those in fevers whose temporal veins are pulsating, with a vigorous face and the hypochondrium not slack: prolonged; and these do not cease without a large flow of blood from the nostrils, or hiccough, or convulsion, or hip pain.
126
In burning fever, the bowels bursting open: deadly. Burning caustic fever from pain in the bowels: deadly.
128
In burning fevers, when ringings come on with dimness of vision and heaviness in the nostrils, they become mentally deranged in a melancholic manner without having hemorrhaged. In burning fevers, derangement resolves tremors.
130
In burning fever, a flow from the nostrils on the fourth day: bad, unless some other good thing concurs; on the fifth day: less dangerous. In burning fevers with moderate chilling, with watery-bilious evacuations, frequent, with squinting of the eyes: bad, especially if they fall into a fixed trance.
132
Burning fever, when rigor supervenes: resolves. Burning fevers tend to relapse, and having flared for four days, then sweat out; if not, on the seventh day.
134
Fourteen days decide burning fever cases, either easing or destroying them. From burning fever, without a purulent abscess forming beside the ear, recovery is not common.
136
Lethargic patients, trembling from the hands, drowsy, ill-complexioned, swollen, with sluggish pulses, and puffiness under the eyes, sweating comes on, and they have bilious and loose bowels or completely dry ones; urine and evacuations pass out unnoticed; the urine of a beast of burden; they do not ask to drink, nor for anything else; but when they come to their senses, they say they have a painful neck and that sounds are darting through their ears. Of those lethargic patients who are saved, most tend to develop suppuration. In those whose tremors cease during fevers without crisis: in time, a painful abscess in the joints suppurates, and the bladder becomes painful.
138
Among the feverish: those with redness on their faces and severe head pain and throbbing of the veins — in most cases a flow of blood occurs; those with nausea, heartburn, and salivation — vomiting. Those with belching, flatulence, rumblings of the bowels, swellings, and disturbance of the bowels — disturbance of the bowels. For those who persist safely (without crisis) throughout a continuous fever, without pain, or inflammation, or other manifest cause, one should expect an abscess with pain and swelling, and more so in the lower regions; one should expect abscesses more in those under thirty years; one should watch for abscesses in these if the fever exceeds twenty days; in the older they occur less, and only when the fevers have gone on for a long time; those with intermittent and irregularly occurring fevers shift fairly readily in autumn into a quartan, and more so in those over thirty years old; abscesses in winter both form more readily and cease more slowly, and relapse less.
140
In those who relapse frequently, if they exceed six months, wasting of the hip joint tends fairly to occur. Such conditions as are traded off against fever without signs of abscess formation: malignant.
142
Fevers that remit neither on critical days nor after a resolving sign tend to relapse. Acute diseases are decided in fourteen days.
144
A precise tertian is decided in five, or seven cycles, or at the longest in nine. In those who at the onset of fever, with blood dripping from the nostrils or sneezing occurring, show a white sediment in the urine on the fourth day: resolution on the seventh day is signaled.
146
Acute cases are decided when blood flows from the nostrils at a critical time, and when much sweat occurs, and when the urine becomes purulent and glass-clear, having a good sediment, and comes in an abundant stream, and when a significant abscess occurs, and when the bowels produce slimy and bloody evacuations or burst open suddenly, and when vomiting is not harmful at the time of crisis. Deep sleeps, undisturbed, signal a definite crisis; but disturbed ones with bodily pain are uncertain.
148
On the seventh, or ninth, or fourteenth day, flows from the nostrils for the most part resolve fevers; likewise a bilious and dysenteric flow from the bowels, and pain in the knees or hips, and urine that has ripened toward the crisis — and in a woman, the flow of the menses too. Those who have hemorrhaged sufficiently from any source during fevers find their bowels loosened during recovery.
150
Those sweating through in fevers, headache-prone, with bowels stopped up: tending to convulsion. Boldness of short duration in bouts of derangement signals both a beast-like state and convulsion.
152
Convulsion occurring in fever stops the fever on the same day, or the next day, or the third. Convulsion occurring in fever and stopping on the same day: good; but if it exceeds the hour in which it began and does not pause: bad.
154
Those with intermittent fevers, warming unevenly, with the belly inflated and passing small amounts, who suffer loin-pain after a crisis — in these cases the bowels break open; but those burning hot to the touch, sluggish, thirsty, nauseous, with bowels stopped, feeling heavy, turn greenish-pale; and sometimes the intensely red burning-spots on the feet signal the same thing. Winter quartan fevers fairly readily shift into acute diseases.
156
Severe head pain with acute fever and one other bad sign: deadly; without a bad sign, if the fever exceeds twenty days, it signals a flow of blood or discharge of pus from the nostril, or abscesses forming in the lower parts; in the younger, below thirty-five, expect flows, and in the older expect abscesses; when the pain is about the forehead and temples, expect flows. Those with headache and ringings without fever, also giddiness, slowness of voice, and numbness of the hands — expect these people to become either apoplectic (suddenly incapacitated), or epileptic, or also given to forgetting.
158
Those with headache who are deranged in a fixed way, with bowels stopped up, with eyes made bold, florid-looking, become opisthotonic. Those that shake the head, with eyes very red, deranged clearly: deadly; this does not kill with it, but produces a swelling beside the ear.
160
Headache with pain in the rectum and genitals brings on sluggishness and loss of control, and paralyzes the voice; these are not severe; but the patients become sleepy and hiccoughing. In the ninth month from these, when the voice is freed, they return to the same state, having become infested with ascarid-worms. In headache, deafness and stupor accompanying: raises swellings beside the ears.
162
Those with headache, in fixed painful trance, with very red eyes: prone to hemorrhage. Those with head-shaking, with ringing, hemorrhage, or in a woman the menses are brought down, especially if a burning sensation also follows along the spine; perhaps dysenteric too.
164
Those heavy-headed, in pain about the crown, sleepless: hemorrhage, especially if there is some tension toward the neck. Vomiting verdigris-colored matter with deafness, in the sleepless, during headache: quickly drives them mad.
166
In those with pain of head and neck, and a general trembling loss of control, hemorrhage resolves it; yet these too are in time resolved; and in the meantime the bladders are stopped up. In acute headaches, and those with numbness and heaviness, they tend to become convulsive.
168
Headache is resolved by pus through the nostrils, or by thick odorless spitting; resolved too by the eruption of sores, sometimes by sleep, and by a flow from the bowels. A moderate pain in the head with thirst, in those not sweating, or with sweat that does not resolve the fever, signals abscesses in the gums or beside the ear, if the bowels are not violently disturbed.
170
A stupor-prone headache with heaviness produces something convulsive. Those headache-prone, thirsty, somewhat sleepless, unclear, weak, weary with loose bowels — do these not become mentally deranged? Those with headache, somewhat deaf, with trembling hands, pain in the neck, passing dark and hairy urine, vomiting dark matter: deadly.
173
Those with headache, sweating through, with bowels stopped up: tending to convulsion. Stupor everywhere: bad.
175
Those in stupor at the onset together with pain of head, loin, neck, and hypochondrium, staying sleepless — are these not phrenitic? A dripping nostril in such cases: deadly, especially in those on the fourth day, or at the onset; and a reddish rinsing from the bowels is also bad. Those who from the beginning sweat through, with ripened urine, burning-hot, chilling without crisis, quickly becoming extremely hot again, sluggish, stuporous, tending to convulsion: deadly.
177
Stuporous sleep and chillings: deadly. In the stuporous, weary, deafened, with bowels burst open — red matter passing through them around a crisis is beneficial.
179
Stuporous, nauseous, with painful hypochondria, slightly vomit-prone: they develop swellings beside the ears, and before that, swellings about the face. Those that suddenly become deranged with restlessness out of stupor: prone to hemorrhage.
181
Stuporous cases, with nausea, painful hypochondria, frequently spitting small amounts: develop swellings beside the ears; does stupor carry something convulsive in it? Stuporous cases, dulled in mind, in fixed trance, showing varied disturbance in the hypochondria and the belly raised, with no appetite, stopped up, sweating through — does turbid pneuma in these, and the passing of a seminal-like matter, signal hiccough? And does a bilious bowel also pass through? A bright and gleaming urine passed in such cases is beneficial, and in these cases the bowels also fall into disturbance.
183
When the brain has mortified, some die within three days, others within seven; those who escape these are saved; but among such cases, in whomever the bone is found separated upon incision, the patient perishes. In patients with headache and fractured bones from behind, a free, thick flow from the nostril: bad; these patients ache in the eye beforehand and then shiver — are fractures of the temporal bones tending to convulsion? Severe pain in the ear, with acute fever and one other somewhat troublesome sign: in the young it kills on the seventh day and sooner, with mental derangement, if much pus does not flow from the ear, or blood from the nostrils, nor any other good sign occurs; in the older it destroys more slowly and less readily — for the ears tend to suppurate first, and they are deranged less; most of these relapse and thus perish.
186
Deafness persisting in acute and disturbed cases: bad; bad too in prolonged cases; and it also leads in such cases to pains in the hips. Deafness in fevers stops up the bowels.
188
Ears cold, transparent, and shrunken: deadly. Booming in acute cases, and ringing in the ears: deadly.
190
Ringings with dimness of sight and heaviness in the nostrils: tending to derangement, and hemorrhage follows. Those with deafness together with heaviness of the head, tension of the hypochondrium, and discomfort toward bright light: hemorrhage.
192
To become deaf in an acute fever: a sign of madness. Those who are hard of hearing, trembling during the attack, with tongue loosened from its function, sluggish: bad.
194
In a sickness already advanced: deafness, and urine somewhat red, unstable, held in suspension — tending to derangement; to become jaundiced in such cases is bad; bad too is dullness of mind in the context of jaundice; it turns out that these become voiceless while still perceiving; and perhaps the bowels also become troublesome in them. Swellings beside the ears that rise up painfully: deadly.
196
Redness beside the ears arising from pain in the front in fevers: a sign of erysipelas about to come on the face; but also convulsions arise from such things with voicelessness and collapse. Swellings beside the ears with foul-smelling ileus, acute fever, tense hypochondrium lasting longer — when they arise: kill.
198
Swellings beside the ears: bad for those with apoplectic conditions. Swellings beside the ears in prolonged cases that do not suppurate: deadly; and in such patients the bowels are carried downward.
200
In those with swellings beside the ears — do they have headache? Do the upper parts sweat through somewhat? Do they shiver upon it somewhat? Do the bowels burst open? Are they also somewhat in stupor? And does a watery urine, held in suspension with white particles, and with somewhat varied and whitish, foul-smelling deposits, occur? Swellings beside the ears are eased by small coughs that come with salivation.
202
Urine in those with swellings beside the ears that ripens quickly and only a little: poor; and to chill in such a way: bad. Swellings beside the ears that suppurate in prolonged cases with pus neither strongly white nor odorless (i.e., fetid): kill — and especially in women.
204 [5]
Swellings beside the ears arise most of all in acute fevers among the burning fevers; and if no crisis occurs, and the swelling has ripened, or blood has not flowed from the nostrils, or the urine has not acquired a thick sediment, they perish. Most such swellings, however, subside beforehand. One must also observe whether the fevers are intensifying or abating, and pronounce accordingly. When there is dripping from the nostrils together with deafness and sluggishness, it presents some difficulty; vomiting and disturbance of the bowel will be fitting for these cases.
206
Following deafness, swellings beside the ears are fairly expected — especially if there is also some nausea; and in those who are drowsy on top of these conditions, swellings beside the ears are even more to be expected. In fever, a flow from the nostrils and disturbance of the bowel resolve deafness.
208 [5]
The face sinking from a raised position, the voice becoming smoother and weaker, and the pneuma becoming more sparse and lighter, signify remission toward the coming day. Deterioration of the face is fatal; less so if it arises from sleeplessness, hunger, or violent disturbance of the bowel — and what has deteriorated on account of these things settles within a day and night. Such deterioration might present as: eyes sunken, nose sharp, temples collapsed, ears cold and contracted, skin hard, complexion pale or dark; and if in addition to these the eyelid, or lip, or nose becomes livid, this is swiftly fatal.
210
Good color of the face together with a gloomy expression in acute fever is bad; contraction of the brow on top of these is indicative of phrenitis. Good color of the face and sweating in those without fever signifies old fecal matter accumulating, or disorder of the diaita.
212
Redness about the nostrils is a sign of the bowel becoming moist; it is bad in those with pains about the hypochondria or the lung, or in those suppurating. Clarity of the eyes, and the whites of them becoming clear from dark or livid, is indicative of crisis: if they clear quickly, it signifies a rapid crisis; if slowly, a slower one.
214 [10]
A dim or clouded appearance of the eyes, or the white becoming reddened or livid, or filling with dark little veins, is not good; it is also unfavorable to shun the light, or to weep, or to be turned askew, and for one eye to become smaller; it is a bad sign for the line of sight to be frequently darting about, or for small crusts to form around them, or for a thin film to be present, or for the white to grow larger while the dark shrinks, or for the dark to be hidden under the upper eyelid; also bad is hollowing of the eyes, and violent protrusion outward, and protrusion of the bright part so that the pupil cannot extend, and curling of the eyelashes and fixation of the eyes, continuous closing of the eyes, and change of colors; and failure of the eyelids to close during sleep is fatal. A squinting eye is also bad. Redness of the eyes arising in fever signifies a prolonged malfunction of the bowel.
216
Swellings beside the eye during recovery break the bowel open. Rigor following distortion of the eyes with fatigue and fever is fatal; and the drowsy in such conditions are also bad.
218
For a man with inflamed eyes, if fever supervenes, it is a resolution; if not, there is danger of being blinded, or of dying, or both. For those with inflamed eyes who develop headache, and it persists for a long time, there is danger of going blind.
220
For one with inflamed eyes, spontaneous diarrhea is beneficial. Dimming of the eyes, together with fixation and cloudiness, is bad.
222
Dimming of the eyes together with loss of consciousness tends quickly toward convulsion. Fixed staring of the eyes in acute fever, or rapid movement, together with troubled sleep or sleeplessness, and sometimes dripping from the nostrils — nothing good; those not burning to the touch become phrenitic, and more so if blood flows.
224 [5]
A tongue that at first has a ruffled surface yet retains its color, but as time passes becomes roughened, then livid, then cracked — this is fatal. When it becomes very black, this indicates that crisis will come on the fourteenth day; the most dangerous condition is one that is both black and greenish-yellow. A coating alongside the forked part of the tongue as if smeared with white saliva is a sign of fever remitting: if the coating is thick, on the same day; if thinner, on the following day; if thinner still, on the third day. The same signs hold when they appear on the tip of the tongue, but less so.
226
A trembling tongue, with redness about the nostrils and a moist bowel, while the other indications regarding the lung are unclear, is a bad sign and indicates sharp, fatal purgings. A tongue softening beyond reason, with nausea, accompanied by cold sweat and moist bowel, is a sign of vomiting of black matter; the appearance of fatigue in these cases is bad.
228
Trembling tongues sometimes produce a moist bowel; if they turn black in such cases, they indicate swift death. Can a trembling tongue indicate an unsettled mind? Tongues that are rough and exceedingly dry indicate phrenitis.
230
Grinding or clenching the teeth — for one not accustomed to it from childhood — is indicative of madness and is fatal; if one already delirious does this, it is wholly destructive. Drying out of the teeth is also destructive. Mortification of a tooth is resolved by an abscess forming beside the gum.
232
A violent fever supervening on mortification of a tooth, together with delirium, is fatal; if they survive, ulcers will suppurate and bone will separate. In those where there is a gathering of fluid around the palate, it usually suppurates.
234
Severe pains about the jaw are at risk of coming to a floating-up of bone. A lip being drawn together signifies a bilious rupture of the bowel.
236
Bleeding from the gums with a moist bowel is fatal. Expectorations of sputum in fever that are livid, black, bilious — if they persist, bad; if they pass off in due measure, beneficial.
238
In those who develop salty sputum and cough, the skin flushes as if breaking out in an eruption, but roughens before the end. Frequent expectoration, if any other sign is also present, indicates phrenitis.
240
Loss of voice with collapse is the worst. Brief bold episodes of delirium are a bad and brutish sign.
242
In those whose voice fails together with fever and without crisis, they die in tremor. Loss of voice in fever that goes out convulsively and passes into silence is fatal.
244
Losses of voice arising from pain make for a hard death. Losses of voice with collapse, in a state of rigidity, are fatal.
246
Voices that break after purgation — is this bad? Most of these patients sweat and the bowel becomes moist. In voicelessness, pneuma that comes readily as in those being choked is bad; is this also indicative of delirium? Losses of voice arising from headache, accompanied by fever with sweating, with the condition easing and remitting under them — these are more prolonged; additional shivering in these cases is not bad.
249
Ectases accompanied by loss of voice are fatal. Loss of voice in those with supervening rigors is fatal; and these patients tend to have fairly severe headache.
251 [5]
Losses of voice with collapse in acute fever without sweating are indeed fatal, though less so in one who is sweating — and it indicates a prolonged course; perhaps also those who suffer such a thing after a relapse are the most safe of such cases, while the most fatal are those in whom there is nasal discharge and those in whom the bowel becomes moist. A shrill, weeping voice together with dimming of the eyes tends toward convulsion; pains directed downward in these cases are more bearable.
253
Along with a trembling voice, an abnormal loosening of the bowel in prolonged cases with intermittent episodes is fatal. Frequent episodes of near-stupor with loss of voice presage a phthisis-like constitution.
255 [5]
Pneuma that is rapid and small signifies inflammation and pain in the vital places; large and infrequent, delirium or convulsion; cold, fatal. Also fatal is a feverish and smoky pneuma, though less so than cold; and pneuma that is breathed out largely but inhaled with little force, and pneuma that goes out small but comes in large — this last is the very worst and close to death; also bad is pneuma that stretches out and presses urgently and grows dim, and a double inhalation as when one draws breath a second time. Easy breathing in all cases of acute fever — even if crisis occurs within forty days — carries great weight toward survival. A hard and painful neck, clenching of the jaws, a strong throbbing of the jugular veins, and tension of the tendons: fatal.
257
Choking pains in a thin pharynx, arising from pain of the head, tend toward convulsion. Chilling of the neck and the back — felt as if of the whole body — tends toward convulsion; in these cases the urine is of coarse-grained consistency.
259
In those with irritations about the pharynx, swellings beside the ears fairly follow. A painful, thin pharynx with distress is swiftly fatal.
261
In those where pneuma is drawn up with difficulty and the voice is choked, and a vertebra has settled inward, toward the end their pneuma becomes as though something is contracting it. A pharynx roughened to a slight degree, and a bowel with empty upward movements, pains of the forehead — probing and painful; those arising from this and growing worse are troublesome.
263
Strong pains about the pharynx produce swelling beside the ear and convulsions. And pains of the neck and back, together with acute fever, ending in convulsion: fatal.
265 [5]
Pains of the neck and forearms tend toward convulsion; these arise from the face and about the pharynx. Pale, thin, and salivating patients with these conditions: sweats during sleep are a good sign; is it also generally not bad for the majority to find relief through sweating? Pains directed downward in these cases are bearable. Bloody urination supervening on pain of the back and chest is fatal with much suffering.
267
Pain of the neck is bad in every fever, worst in those in whom there is also hope of full madness. With a feverish chest pain, a bowel that is disordered and numb is a sign of dark stools.
269
In acute fevers, small painful sensations about the pharynx — when one opens the mouth and does not close it easily, in one who is thin — indicate delirium; phrenitis arising from these conditions is fatal. A pharynx ulcerating in fever together with another difficult sign is dangerous.
271
In fevers, suddenly being choked and unable to swallow, without swelling, is bad. Being unable to turn the neck or to swallow is, for the most part, fatal.
273 [10]
The hypochondrium ought to be soft, painless, and even; if it is inflamed, or uneven, or painful, it is a sign of no mild illness. Swelling in the hypochondria that is hard and painful is worst of all if it is on both sides; of those arising on one side, that on the left is less dangerous. Such signs at the outset indicate swift death; if they persist beyond twenty days with the fever continuing, they indicate suppuration. In these cases a rupture of blood through the nostrils occurs in the first period and is greatly beneficial; for these patients for the most part suffer headache and the vision becomes dim, and you should expect the rupture to come toward these signs more so — in those of about thirty-five years of age; and less in the older.
275 [15]
Swellings that are soft and without pain bring about crises more slowly and are less dangerous; but if they persist beyond sixty days with fever continuing, they suppurate. The signs around the belly resemble those in the hypochondria, except that these suppurate less than those, and least of all below the navel; and these form within a membrane, while the upper ones are more diffuse. Fatal are those that rupture inward. Of the remaining suppurations, those rupturing outward — it is best for them to gather into the smallest and most acute point; those rupturing inward make no clear external sign in mass, pain, or color; the contrary of this — making themselves plainly evident outside — is worst of all. Some of these do not show clearly on account of the thickness of the pus. Fresh swellings in the hypochondria — if not accompanied by inflammation — and the pains arising from them are resolved by rumbling occurring in the hypochondrium, and best of all if it passes through by way of urine and stools; if not, even if it simply passes through of itself; it also helps if it descends into the lower regions. Throbbing in the hypochondrium with commotion is indicative of delirium, and more so if the eyes are moving frequently.
277
Pain about the heart and throbbing of the hypochondria, after fever has cooled, is bad — especially if there is also sweating. Pains falling into the hypochondrium are otherwise bad, and especially if they moisten the bowel; worse when they arise rapidly; and swellings beside the ears arising from these are malignant, as are other suppurations.
279
Cardiac pains with colic bring about violent discharge from the bowel of worm-like matter. Pain of the heart recurring frequently in an older person signifies sudden death.
281
In those where the hypochondria are distended when the bowel is checked, bad; especially in those wasting in prolonged illnesses, and in those whose bowel is moist. An inflammatory suppurating condition in the hypochondrium: in some cases, dark stools pass before death.
283
Tension of the hypochondria, with nauseating stupor, in one suffering from headache, raises swellings beside the ears. With lifting of the hypochondria in bilious patients, large pneuma and acute fever raise swellings beside the ears.
285
In pain of the hypochondrium with underlying rumbling, a pain of the loins supervening in fevers greatly moistens the bowel, unless wind breaks through, or a large quantity of urine comes. On a prolonged hypochondriac condition with foul-smelling bowel, an abscess beside the ear kills.
287 [5]
In those with pains from the hypochondria, a bowel that gradually passes small, slightly viscous, fecal discharges causes the patient to become pale; does it also cause hemorrhage? In those who suddenly, being without fever, have pain of the hypochondrium and heart, and about the legs and lower parts, and the bowel is distended — venesection and flux of the bowel resolve it; to have fever is harmful to these, for the fevers that arise are prolonged and strong, and coughs and pneuma and hiccup arise; and as these are about to be resolved, strong pain of the hips or legs, or a spitting of pus, or loss of the eyes supervenes.
289
In those with pains of the hypochondria, heart, liver, and the parts around the navel: if blood passes through the bowel, they survive; if not, they die. In those whose hypochondria are not soft and the face is robust, resolution does not occur without a copious flow of blood from the nostrils, or convulsion, or pain of the hips.
291
Pains about the hypochondria in fever, resolved in one who is voiceless and without sweating: bad; these patients develop pains in the hips. Pulsations in the belly in fever produce ecstatic episodes; hemorrhage with shivering.
293
Pains shooting up into the hypochondria in fever, resolved without sweating, are malignant; these patients develop pains in the hips; together with burning fever, a bowel burst open: fatal. Pulsating pains around the navel carry some mental aberration; about the time of crisis, much salty phlegm passes through with pain in these cases.
295
After checking of the bowel, the hypochondria becoming raised: bad; especially in those wasting in prolonged illnesses, and those whose bowel is moist. In those with restless distress in the hypochondrium, swellings beside the ears when raised kill.
297
Hardenings about the belly with pain, in patients with shivering fevers who are off food and with the bowel becoming slightly moist, not giving way to purging, will come to suppuration. Pain above the navel and pain of the loins, not resolved by purging, end in a dry dropsical condition.
299
Pains arising from the loins, more prolonged, exacerbated by fever in a tertian-like pattern, cause clotted blood to pass through the bowel. Pains in the loins tend toward hemorrhage.
301
Hemorrhages arising from loin pain are copious and rushing. In those with pain shooting up from the loins to the head, with numbing of the hands, cardiac pain, and ringing in the ears — hemorrhage is violent and rushing, the bowel breaks loose in these patients, and disturbance of the mind is prolonged.
303
Onset of illness from pain in the back is troublesome. In a severe, sustained pain of the loins with a fairly heavy downward discharge, vomiting up copious frothy matter after hellebore is beneficial.
305
A flow of blood resolves distortion of the spine and difficulty of breathing. When cardiac pains come on in one already suffering from painful loins, they are signs of hemorrhage — or of hemorrhage already having occurred.
307 [5]
Conditions spreading from the loins up to the neck and head, causing loosening of parts in a manner resembling paralytic stroke, tend toward convulsion and delirium; can such conditions also be resolved by convulsions? Or do the bowels of such patients fall ill, the same things passing through? An upward run of pain from the loins with squinting of the eyes: bad.
309
Pain settled in the chest with sluggishness: bad; these patients in fever perish quickly. Upward runs of pain from the loins to the heart — feverish, with shivering, vomiting thin watery matter — then passing into delirium, voiceless, then vomiting black matter: they die.
311
Chronic pains about the loins and the flank, and pains toward the hypochondria, with loss of appetite, together with fever — in these, a severe pain coming on suddenly to the head kills swiftly in a convulsive manner. Those with pain of the loins are in bad condition; do tremors occur in these, and the voice as in rigor? Can those with loin pain, nausea, no vomiting, and who have briefly raved boldly be expected to pass dark matter? Loin pain in one with cardiac pain, with violent expectoration, has something convulsive about it.
315
A subdued voice together with rigor at the time of crisis. Loin pain recurring frequently without cause is a sign of a malignant illness.
317
Loin pain with a nauseating burning sensation: bad. Tension of the loins from excess of menstrual discharge tends toward suppuration; and discharges passing in a varied way, viscous, foul-smelling, and suffocating, on top of the conditions just described, tend toward suppuration; I think such women also become somewhat delirious.
319
In those with pain of the loins and the side without apparent cause, jaundice develops. Vigorous chilling of the body at the time of crisis, after hemorrhages, is the very worst sign.
321
To hemorrhage in the opposite direction is bad — for example, on the right side in the case of a large spleen; and similarly with regard to the hypochondria. Wounds that hemorrhage and then shiver are malignant; patients pass away while speaking in a low murmur.
323
Patients who hemorrhage copiously on the fifth day, shiver on the sixth, become chilled on the seventh, and are quickly rewarmed — in these, the bowel is troubled. Passage of dark stools after hemorrhage is bad; and discharges that are reddish are also bad; hemorrhages of this kind tend to come on the fourth day; those in a stuporous state, when convulsed after such events, die after dark stools have passed first and the bowel has distended.
325 [5]
After hemorrhage and passage of dark stools in acute fever, deafness is bad; passage of blood in these patients is fatal, but it does resolve the deafness. In those where multiple hemorrhages occur as time goes on, the bowel becomes troubled unless a concocted urine comes; does watery urine signify something like this? In those where, after copious repeated hemorrhage together with much dark passage, the hemorrhage stops and then starts again — these patients have a painful bowel, but with some relief of wind they are more comfortable; do such patients sweat with much cold sweat? Turbid urine is not bad in these cases, nor is a semen-like deposit forming; these patients for the most part pass watery urine.
328
In those where small drops fall from the nostrils on top of deafness and sluggishness, this presents some difficulty; vomiting is beneficial to these patients, as is disturbance of the bowel. Large hemorrhages at the beginning moisten the bowel around the time of recovery.
330
Copious nasal flows that are forcibly stopped sometimes bring on convulsion; venesection resolves it. Drippings on the eleventh day are troublesome, especially if the dripping occurs twice.
332
After copious flow of blood, either hiccup or convulsion is bad. In children of seven years, weakness with pallor, and pneuma faltering on the roads, and a craving for earth, signify corruption and collapse of the blood.
334
In prolonged illnesses, small signs of hemorrhage appearing are fatal. Dark episodes from the outset are resolved by nasal hemorrhage.
336
Nasal flows that cool with small sweats are malignant. Removal of blood in a torpid state of chilling: bad.
338
In those whose bowel is checked and who hemorrhage, and shiver at the same time as hemorrhaging, this produces in them a smooth, somewhat hardened bowel, and threadworms, or both. Those whose hemorrhages occur at regular intervals and who are thirsty but fail to hemorrhage die in an epileptic manner.
340
From a hemorrhoid that has barely appeared, dark episodes coming on indicate a small and brief tendency toward paralytic stroke; venesection resolves it; and every such appearance is a sign of something bad. Those with pulsations throughout the body — do they also die voiceless? Trembling conditions, when they become convulsive, cause sweating and are prone to relapse; in these, crisis comes with supervening shivering; and they shiver when provoked by the bowel's burning; much sleep in these cases tends toward convulsion, and heaviness directed toward the forehead, and difficulty with urination.
343
Convulsions without fever in conditions of the womb are easy. Convulsive symptoms in a patient who is not sweating, with sputum flowing alongside, and who is feverish, are mild; in these patients, since the bowel becomes somewhat moist, perhaps there will also be a departure to the joints.
345
In those with convulsive conditions whose eyes flash out fixedly, they are not in their right minds and the illness runs a longer course. Convulsive symptoms exacerbated in a fixed, rigid manner raise swellings beside the ears.
347
In trembling, nauseating patients, small swellings beside the ears signify convulsion when the bowel is troubled. A fever supervening on convulsive and tetanic conditions resolves them.
349
Convulsion following a wound: fatal. Convulsion arising after fever: fatal, least so in children.
351 [5]
Those older than seven years are not seized by convulsion in fever; if they are, it is fatal. What resolves convulsion is an acute fever supervening that had not previously occurred; or if it had previously occurred, an exacerbation of it. A large glassy passage of urine also helps, and flow of the bowel, and sleep. For convulsions arising suddenly, what resolves them is fever and flow of the bowel.
353
In convulsions, prolonged speechlessness is bad; brief speechlessness indicates either apoplexy of the tongue or apoplexy of the arm and the right-side parts; it is resolved by urine coming on suddenly in large, copious quantities. Sweats — those coming gradually are beneficial; those coming in a rush, and the removal of blood in a rush, are harmful.
355
In tetanic and opisthotonic conditions, the jaws becoming slack: fatal. Also fatal in opisthotonus is sweating and dissolution of the body, and vomiting through the nostrils in opisthotonus, or one who was voiceless from the outset crying out or babbling — for this indicates death on the following day. Semen-like urine resolves feverish opisthotonic conditions.
357
Kynanche conditions that produce nothing visible either in the neck or in the pharynx, but cause violent choking and difficulty of breathing, kill on the same day or on the third day. Those that take on swelling and redness in the neck are otherwise similar but more prolonged.
359 [5]
In those where both the pharynx and the throat and the chest flush together, the course is more prolonged; and most of these patients survive, provided the redness does not turn back inward. But if it disappears without an external swelling having formed on the outside, or without pus being expectorated gently and without pain, and without this happening on critical days — these become fatal; can they become full of pus internally? The safest outcome is for the redness and the abscessions to turn as fully as possible outward. Erysipelas arising on the outside is beneficial; turning inward is fatal; it turns inward when, as the redness disappears, the chest becomes heavy and breathing becomes more difficult.
361
In those whose kynanche turns toward the lung, some perish within seven days; those who escape become full of internal pus, if no phlegm-laden discharge comes up for them. In those where, because of violent throbbing, fecal matter is suddenly discharged, it is fatal.
363
In kynanche cases, slightly dry sputum in thin patients is bad. Swellings on the tongue in kynanche cases, disappearing without apparent cause, are fatal; and pains disappearing without cause are fatal.
365
In kynanche cases, those who do not quickly expectorate concocted matter are in danger. In kynanche, pains going to the head without apparent cause, together with fever, are fatal.
367
In kynanche, pains going to the legs without apparent cause, together with fever, are fatal. After kynanche conditions, pain of the hypochondrium arising without crisis, together with incontinence and sluggishness, kills in a quiet manner, even if they seem to be faring fairly well.
369
After kynanche conditions, in those who have grown thin without apparent cause, a severe pain coming to the chest and belly causes pus-like matter to pass through the bowel, and in general such a condition is when resolution is occurring. After kynanche, all conditions are fatal that did not produce a clear pain; moreover, prolonged pains keep visiting the legs, and suppuration proceeds with difficulty.
371
Sputum from kynanche that is viscous, thick, off-white, and brought up forcibly is bad, and every such pepsis is bad; copious purging downward destroys such patients in a stroke-like manner. After kynanche, slightly dry, frequent, cough-ridden, side-painful sputum is fatal; and slight coughing during swallowing of drinks, and forced swallowing, are bad.
373
Among pleurisy patients in whom the sputa are entirely pus-laden from the outset, death comes on the third or fifth day; those who escape this, if not much improved, begin to suppurate on the seventh, ninth, or eleventh day. Among pleurisy patients in whom there is redness on the back, and the shoulders grow warm, and the belly is disordered with bilious and foul-smelling discharges, danger comes on the twenty-first day; those who escape this are saved.
375
The dry pleurisies that produce no spitting are the most severe; and those in which the pains are situated higher up are alarming. Pleurisies without spasms are more severe than those with spasms.
377
Among pleurisy patients in whom the tongue becomes bilious from the outset, crisis comes on the seventh day; in those in whom this happens on the third or fourth day, crisis comes around the ninth. When a blister of a livid-bluish color forms on the tongue from the outset, like what forms when iron is dipped in oil, resolution becomes more difficult, and the crisis extends to the fourteenth day; and they spit blood for the most part.
379
Sputum in pleurisies, when it begins to ripen and be expectorated on the third day, brings about quicker resolutions; when later, slower ones. For the pains in pleurisy patients, it is beneficial for the belly to be loosened, for the sputum to take on color, for there to be no rattling sounds in the chest, and for urine to flow freely; the opposites of these are troublesome, as is sputum that turns sweet.
381
The bilious and blood-tinged pleurisies are for the most part resolved on the ninth or eleventh day, and these patients recover best. Among pleurisy patients in whom the pains are mild at the outset but intensify on the fifth or sixth day, these tend more toward the twelfth day and do not recover well; they are in greatest danger on the seventh and twelfth days, but those who escape twice seven days are saved. Among pleurisy patients in whom there is much rattling of sputum in the chest, and the face is downcast, and the eye is jaundiced and clouded over, these perish.
383
Those who become suppurant from pleurisy expectorate pus within forty days from the rupture. In all pleurisy and pneumonia patients, the sputum ought to be expectorated easily and quickly, and the yellow should be mixed into the sputum; yellow sputum brought up long after the pain, or unmixed, and causing much coughing, is a bad sign. Bad in every respect also is sputum that is pure yellow unmixed, and that which is viscous and white, and that which is globular, and that which is very pale-green, and that which is frothy, and that which is livid-colored and rust-colored; worse still is what is so unmixed as to appear black. Yellow sputum mixed with no great amount of blood is a preserving sign at the outset, but less safe on the seventh day or later; sputum that is highly bloody or immediately livid at the outset is dangerous. Bad also are the frothy, the yellow, the black, the rust-colored, the viscous-adhesive, and those that take on color quickly; mucous and sooty sputa take on color quickly, yet are safer; those that take on the coloring of pepsis (concoction) within five days are better.
385
Any sputum that does not resolve the pain is bad; that which does resolve it is beneficial. Those who bring up pus together with bile—whether separate or mixed—for the most part die on the fourteenth day (unless some adverse or favorable sign from those listed above intervenes; if not, then the prognosis holds accordingly), and especially those in whom such sputum begins on the seventh day.
387
It is a good sign for these patients and for all those with lung conditions to bear the illness without distress, to be freed from pain, to expectorate sputum easily, to breathe freely and be without thirst, to have the whole body warm evenly and soft, and in addition to these things, for sleep, sweating, urine, and a wholesome passage from the bowels to occur. The opposites of these are bad signs. If therefore all the beneficial signs accompany this sputum, the patient may be saved; but if some are present and others not, he will not live beyond fourteen days; if the opposing signs supervene, he will die sooner. Those pains in these regions that cease neither with expectoration, nor with blood-letting, nor with diaita (regimen / ordering of life), end in suppuration.
389
Those in whom, following pneumonia, there are abscess-formations (ἀποστάσιες) near the ear or toward the lower parts, and these suppurate and form fistulas, survive; these occur in patients in whom fever and pain persist, the sputum does not proceed according to expectation, the bowel discharges are not bilious but loose and unmixed, the urine is not very thick nor bearing much sediment, and all else is otherwise favorable. Those abscesses toward the lower parts occur in patients in whom inflammation develops around the hypochondria; those toward the upper parts occur in patients in whom the hypochondrium is slack and painless, and who, having become somewhat breathless for a time, then cease without evident cause. The abscesses toward the legs in dangerous pneumonia cases are all beneficial, the best being when pus-laden sputum replaces the yellow; when the sputum does not proceed as expected and the urine does not have a wholesome sediment, there is danger that the person becomes lame or suffers much trouble. If the abscesses relapse, with fever persisting and sputum not proceeding rightly, there is danger of death and derangement of mind.
390
Those among pneumonia patients who were not cleared out on the decisive days but, after becoming disordered in mind, escaped beyond fourteen days, are in danger of becoming suppurant. Pneumonias that have shifted from pleurisy are safer than those arising from the outset.
392
Among bodies, those that are exercised and dense perish more quickly from pleurisy and pneumonia than those that are unexercised. That nasal discharge and sneezing should occur either before or after lung conditions is a bad sign; in other conditions, sneezing is not without benefit.
394
Among pneumonia patients, those in whom the whole tongue becomes white and rough, both portions of the lung are inflamed; those in whom only half is so, only the one portion on which it appears; those in whom the pain is toward one collarbone, the upper lobe of the lung on that one side is diseased; those in whom the pain is toward both collarbones, the upper lobes of the lung on both sides are diseased; those in whom it is along the middle of the rib, the middle lobe; those in whom it is toward the stretching below, the lower lobe; those in whom the whole of one side is in pain, all the parts on that side are diseased. If the aortai (great vessels) are severely inflamed such that they press against the side, the part of the body on that corresponding side becomes paralyzed, and livid bruises form externally about the rib; such patients the ancients called 'thunderstruck' (βλητούς). If they are not so severely inflamed as to press against the side, pain runs along the whole length, yet there is no paralysis, nor do they acquire livid marks. If the whole lung is inflamed together with the heart such that it falls against the side, the entire patient is paralyzed and lies cold and without sensation; he dies on the second or third day. If it occurs apart from the heart and to a lesser degree, they live longer, and some even survive.
396
In those becoming suppurant, especially from pleurisy and pneumonia, fevers attend them—slight during the day, more intense at night—and they spit nothing worth noting; they sweat about the neck and collarbones, their eyes become sunken, their cheeks flush, the tips of their fingers grow warm and roughen, their nails become curved and turn cold, they have swellings about the feet and small blisters on the body, and they lose their appetite for food. These are the signs of long-standing suppurations. Those that are about to rupture quickly are to be recognized from the signs that appear in them and from the pains at the outset, and also if the patient becomes more breathless. Most suppurations rupture—some by the twentieth day, some by the fortieth, some around the sixtieth. For those in whom intense pain is present from the outset along with breathlessness and cough with expectoration, expect rupture by the twentieth day or sooner; in those in whom these signs are milder, in proportion. Reckon the time from when the patient first felt pain, whether there was heaviness, whether fever occurred, or whether shivering ever seized him; for pain, breathlessness, and expectoration must necessarily precede the rupture. In those in whom fever immediately ceases after rupture, who desire food, and in whom the pus is brought up easily, being white, odorless, smooth, uniform in color, and without admixture of phlegm, and in whom the bowel passes small, formed stools, these for the most part are saved quickly. In those in whom fever and thirst persist, along with loss of appetite, and the pus is livid or pale-green or phlegm-laden or frothy, and the bowel becomes loosened, these die. In those in whom some of the aforementioned signs occur but not others, some die and some are saved after a long time. Those about to become suppurant spit first something salty, then something sweeter.
398
In those in whom nodules (φύματα) form in the lung, they bring up pus for forty days after the rupture; those who pass beyond this time for the most part become phthisic (φθισικοί; wasting / consumptive). Dripping of blood from the nostrils with pain in the side is a bad sign.
400
Among suppurant patients who are faring rather well, when foul odor of the sputa persists, a relapse kills them. Those among pleurisy patients who expectorate material that is pus-like, somewhat bilious, globular, or pus-like with traces of blood, after time has passed, are doomed; doomed likewise are those who spit black, sooty matter, or those in whom the sputa resemble what comes from dark wine.
402
Those who spit frothy blood while suffering in the right hypochondrium are spitting from the liver, and most of them perish. Those in whom pus that is muddy and foul-smelling comes out under cautery for the most part perish.
404
Those in whom the probe (μήλη) is colored from the pus as though from fire for the most part perish. With pain in the side—not pleuritic—together with a moderately disordered thin condition, these patients end in phrenitis (φρενιτικοί).
406
In lung conditions, drippings that are excessively red are a bad sign. Viscous, briny sputum with hoarseness is bad; if there is also some elevation in the chest in addition to this, it is a bad sign; pains toward the neck in these patients when they have become emaciated are fatal.
408
Hoarseness with cough and a loose bowel brings up pus. In those with pneumonia in whom urine is thick from the outset, then becomes thin before the fourth day, this is a deadly sign.
410
Those with dry pneumonia who bring up few ripened sputa are alarming; redness broad and flat in the chest in such patients is fatal. A pain in the side that has disappeared without cause during bilious spitting leads to derangement.
412
Fevers that are intermittent on account of suppuration tend in most cases to be accompanied by sweating. Deafness occurring in suppurant patients signifies bloody bowel discharges; toward the end, these patients pass black stools.
414
Pain in the side with prolonged fever indicates that pus will be brought up. Those with frequent shivering-fits readily come to suppuration; and fever of that kind too leads the patient to suppuration.
416
In those in whom loss of appetite follows from pain in the side, together with a somewhat cardiac distress, sweating, a flushed face, and a rather loose bowel, suppurations within the lung develop. Conditions of orthopnea (ὀρθοπνοϊκά) produce hard dropsical states.
418
All spasms (σπάσματα) are troublesome, causing intense pains at first and in some cases recalling them later; the most difficult are those about the thorax, and in greatest danger are those in whom there is vomiting of blood, high fever, and pain about the breast, thorax, and back; for those in whom all these occur die quickly; those in whom not all are present, nor severely, die more slowly. The inflammation lasts at most fourteen days. For those spitting blood it is beneficial to be without fever, to cough and feel pain mildly, and for the sputum to become thin toward twice seven days; but to have fever, to cough and feel intense pain, and to spit fresh blood continually is unfavorable.
420
In those in whom the side is raised up and warmer, such that when they lie on one side the weight seems to be suspended on that side, the pus is coming from that one side. In suppurant patients, pus passing down through the bowel is a deadly sign.
422
Those wounded in the thorax in whom the outer part of the wound has healed but the inner has not are at risk of becoming suppurant; in those in whom the inner scar is weak, it easily breaks open again. Of those who die from suppurations arising from pneumonia, the older are more often lost; from other suppurations, the younger.
424
Among suppurant patients, those in whom a loud sound is produced when they are shaken by the shoulders have less pus than those in whom the sound is slight but who are more breathless and have better color; those in whom no sound whatever is produced but breathlessness is severe and the nails are livid—these are full of pus and are doomed. Those who vomit frothy blood while having no pain below the diaphragm are vomiting from the lung; and those in whom the great vessel within it ruptures vomit much and are at serious risk; those in whom the lesser vessel ruptures bring up less and are safer.
426
Among phthisis patients (φθισικῶν; wasting / consumptive) in whom the sputum smells heavily of burnt fat when placed on fire, and the hair falls from the head, these perish. Among phthisis patients in whom, when they spit into the sea, the pus sinks to the bottom, destruction is swift; let the sea-water be in a bronze vessel.
428
Among phthisis patients in whom the hair falls from the head, they perish from diarrhea; and those phthisis patients in whom diarrhea supervenes die. In those wasting, suppression of sputa brings on dull-witted rambling; there is hope that hemorrhoids will appear in such patients.
430
The most dangerous phthisies (wasting conditions) are those arising from rupture of the thick vessels, and those from catarrh coming down from the head. Among age-groups, the most dangerous for phthisis are from eighteen years up to thirty-five.
432
Itching bodies together with bowel stoppage in phthisis patients—a bad sign. In wasting conditions, with fever, fluxes appearing to the gums and teeth—a bad sign.
434
In all conditions, hypochondria raised up high—a bad sign; worst in those with the prolonged phthisis; in those who are dissolving away, a fatal sign; some have chills before death. Scratch-like eruptions signify a phthisic bodily disposition.
436
Those who are breathless in a dry way, or who bring up much unconcocted matter in phthisis, are doomed. In those with liver disease, much blood-stained sputum—whether somewhat putrid or purely bilious and unmixed—is immediately fatal.
438
Wasting with hoarseness in liver disease is a bad sign, especially if there is also a tendency to cough. Those who have painful conditions about the liver, with cardiac distress, heaviness of head, shivering-fits, disordered bowels, thinness, loss of appetite, and much drenching sweat, discharge pus through the bowel.
440
In those suddenly seized with intense pain in the liver, fever supervening resolves it. Those who spit frothy blood while in pain in the right hypochondrium are spitting from the liver and die.
442
In those in whom, after the liver is cauterized, something like olive-oil lees comes away—this is a deadly sign. Dropsies arising from acute diseases become distressing and fatal; most begin from the flanks, and some also from the liver.
443
In those in which the dropsy begins from the flanks, the feet swell, and prolonged diarrheas persist, not relieving the belly nor resolving the pains from the loins and flanks. In those in which it arises from the liver, there is an impulse to cough, the feet swell, the belly communicates hardness and resistance under pressure, swellings arise about it—some on the right, some on the left—and again subside. In dry dropsies, strangury is a troublesome additional sign; and those with small sediment in the urine are also unpromising.
445
In dropsical patients, epileptic fits supervening are fatal; they are a mutually bad sign for each condition, and they moisten the bowel. In bilious conditions, a disordered bowel passing small, seed-like, mucous stools causing pain about the lower belly, and urine not flowing freely, ends in dropsy from such conditions.
447
In a dropsical patient with fever, scant and turbid urine is fatal. But at the onset of dropsy, the occurrence of watery diarrhea without indigestion resolves the disease.
449
In dry dropsical patients, colicky griping pains falling on the small intestine as a forewarning—a bad sign. Epileptic fits arising from dropsical conditions are fatal.
451
Dropsy yielding to treatment, then relapsing—hopeless. In dropsical patients, when the water breaks through the veins into the belly—resolution.
453
Dysentery coming on at an inopportune time produces an abscess-formation in the sides, or the viscera, or the joints. Is it the case that the bilious form produces it in the joints, and the bloody form in the sides or viscera? Bilious vomiting in dysentery patients at the outset—a bad sign.
455
In those in whom from acute dysentery the fluid reaches a pus-like state, the layer on top will be whitish and abundant. Dysenteric discharges that are reddish, sediment-laden, and violent, resolving with inflammatory red colorings, raise the hope of madness (ἐκμανῆναι).
457
Dysentery in patients with enlarged spleen—if short, beneficial; if long, bad; for if, once it stops, dropsy or lientery arise, it is deadly. In lientery patients with worms, pains resolved by colic move the condition to the joints; from such conditions, red scaly patches, blistering; when these patients sweat they become flushed as though from blows.
459
Those in prolonged lientery together with worms who have colic and pain—when these resolve, swellings arise; the addition of chills in such patients is bad. Lienteric conditions with breathlessness, and if the side is in any way irritated, end in phthisis (wasting).
461
In ileus patients, vomiting and deafness—a bad sign. Hard and painful bladders are in every case bad, worst with continuous fever; for the pains arising from these are sufficient to destroy; and the bowels of such patients do not pass well. Resolution comes when pus-laden urine arrives bearing a white, smooth sediment; if these conditions do not resolve and the bladder is not relieved in the first cycles, there is hope the patient will perish. This occurs most often in those from seven to fifteen years.
463
Those with stones, if positioned so that the stone does not press against the ureter, urinate easily; those in whom there is a nodule about the bladder that causes the difficulty in urination are troubled in every position; resolution comes when the pus bursts open. Those in whom urine escapes without their noticing and whose genitals are drawn up—these are without hope.
465
Ileus supervening on strangury destroys within seven days, unless, with fever supervening, urine comes all at once. Numbnesses and insensibilities occurring contrary to habit are a sign that apoplexy (ἀποπληξίη) will occur.
467
Those who lose control of their body from a wound are cured if fever comes on without shivering; if it does not come on, they develop apoplexy on the right or left side. In apoplectic patients, hemorrhoids supervening are beneficial; but chills and numbings are bad.
469
In apoplectic patients, sweating supervening upon distress of the pneuma (breath / moving air) is a deadly sign; but in these very same patients, if fever then supervenes, it brings resolution. Cases of sudden apoplexy that develop fever in a loose and uncontrolled way are fatal in time.
471
In those who pass from some illness into dropsy, the bowels move dry, pellet-like stools with a mucous melting away and urine that is not good; distensions about the hypochondria, and pains and swellings about the belly, and pains about the flanks and the spinal muscles press upon them; fevers, thirst, and dry coughs accompany them; there is breathlessness with movement and heaviness of the legs; they lose their appetite for food and are filled up after taking in a little. Diarrhea cures those with white-phlegm swelling (λευκοφλεγματοῦντας); silent despondencies and withdrawal from human company are fairly effective at finishing them off.
473
Those who become disordered out of fear with chilling—fevers with sweating, and sleeping through the night resolve these. From madness (μανίης), an abscess-formation moves to hoarseness with cough.
475
In conditions of madness, convulsion supervening brings dimming of sight. Silent mental disturbances—not resting still, looking about with the eyes, bringing the pneuma (breath) up outward—are fatal; they produce chronic paralytic conditions; and these patients also become maniacal; those among them who are intensified by bowel disturbance—around the crisis they pass black stools.
477
In those who are in good health but who, when winter is on, develop coldness and heaviness about the loins from a slight cause, together with stopping of the lower bowel while the upper serves well, sciatica, or pain of the kidneys, or strangury would likely follow. In those in whom the lower parts are affected, with strong itching occurring beforehand, sandy urine forms and settles; in those of them who are doomed, the mind grows numb.
479
Those whose joints blister with superficial reddish eruptions, then develop shivering-fits—these become flushed in the belly and groins, as though from painful blows, and die. Jaundiced conditions, not much perceived, in whom hiccups occur, the bowels break open; possibly also stoppages; these patients turn pale-green.
481
Pains in the side in fevers that have persisted in an emaciated state without clear significance—blood-letting harms them, even if they have no appetite and even if the hypochondrium is raised; and in cases of chilling without fever in sluggish patients, blood-letting harms; and those who seem to be doing rather well in such cases—these die. Head, feet, and hands being cold while the belly and sides are warm—a bad sign; best is for the whole body to be uniformly warm and soft.
483
The sick person ought to be able to turn easily and be light in raising himself; heaviness of the whole body and of hands and feet is a bad sign; if in addition to the heaviness the fingers and nails become livid, death is near; those that turn completely black are less fatal than the livid ones—but observe the rest of the signs; for if the patient bears the illness with ease and shows some other beneficial indication, the disease turns toward an abscess-formation, and the blackened parts of the body fall off. Testes and genitals drawn upward signify something bad.
485
For flatus to pass through without sound and without breaking wind is the best; but it is better for it to pass with sound than to be pent up within; yet flatus passing out in that way signifies something bad and mental derangement, unless the patient is deliberately letting the flatus out in that way. A wound turning livid and dry or pale-green—a deadly sign.
487
The best position for reclining is that to which one is accustomed when healthy; to lie on the back with legs extended is not good; if one also slides forward headlong toward the feet, it is worse; and to lie gaping open and sleeping always is deadly; also, for one lying on the back, the legs strongly bent and intertwined is a bad sign. To lie on the belly in those unaccustomed to it signifies mental derangement and pains about the belly. To have bare feet and hands without being strongly feverish, and for the legs to be sprawled out—bad, for it signifies restless anguish. To wish to sit up is bad in acute conditions, worst in pneumonia and pleurisy. One ought to sleep at night and be awake in the daytime; the reverse is bad. Sleeping in the morning until the third part of the day would cause the least harm; sleeps after that are bad; worst is not to sleep at all, neither by day nor by night—for the patient would be kept awake by pain and suffering, or from this sign will develop mental derangement. In those whose temple is cut, convulsion comes from the side opposite the incision.
489
In all those whose brain has been shaken and has suffered injury by a blow or by some other cause, they fall down immediately, become speechless, neither see nor hear, and for the most part die. In those whose brain is wounded, fever for the most part and vomiting of bile supervene, along with apoplexy of the body; and such cases are fatal.
491
Of bones fractured in the head, those fractured along the sutures are hardest to recognize. They are fractured chiefly by heavy, rounded projectiles, and by those coming from directly opposite and not on a level course. Those cases where it is uncertain whether a fracture has occurred or not must be judged by giving the patient an asphodel stalk or a fennel stalk to chew on each side of the jaw, and directing him to attend to whether the bone seems to make a noise to him; for those that are broken seem to make a sound. As time goes on, those that are fractured give signs on the seventh day, others on the fourteenth, and others at other times; for separation of flesh from the bone occurs, and the bone becomes livid, and there are pains, with ichorous fluids seeping beneath; and these cases are already difficult to help. In all those in whom the omentum prolapses, it must of necessity mortify.
493
If any of the small intestines is cut through, it does not grow back together. A tendon when cut through, or the thin part of the jaw, or the foreskin, does not grow back together.
495
Whatever bone in the body is cut off, or cartilage, does not grow again. Convulsion supervening upon a wound is bad.
497
Vomiting of bile supervening upon a wound is bad, and most especially upon wounds of the head. All thick tendons when wounded generally result in lameness, especially those wounded obliquely, and the heads of the muscles, most of all those in the thighs.
499
Deaths from wounds occur most of all if someone is wounded in the brain, or the spinal marrow, or the liver, or the diaphragm, or the heart, or the bladder, or one of the large vessels. Death also occurs if the blows to the windpipe and the lung are very great, such that, when the lung is struck, less pneuma (breath / air-movement) comes out through the mouth than escapes from the wound. Death also occurs in those wounded in the intestines, whether any of the small or the large intestines are wounded, if the blow falls across them and is great; but if it is small and straight, some survive. Those wounded in parts of the body where none of these structures are present, or most distant from them, are least likely to die. Vision is dimmed in wounds to the eyebrow and a little above it; the more recent the wound, the better they see, but as the scar grows old it tends to happen that vision is further dimmed.
501
Fistulas are hardest to treat when they grow in cartilaginous and fleshless places, are hollow, are continually suppurating and discharging ichorous fluid, and have a small growth of flesh at their mouth. Those that grow in soft, fleshy, and tendon-free places are more amenable to treatment. The following diseases do not occur before puberty: pneumonic conditions, pleuritic conditions, gouty conditions, kidney disease, varicose veins around the shin, bloody flux, cancer not present from birth, vitiligo not congenital, spinal catarrh, hemorrhoids, intestinal colic not congenital. None of these diseases should be expected to arise before puberty.
502
From fourteen up to forty-two years of age, the natural constitution becomes susceptible to every kind of bodily disease. From that age again up to sixty-three years, scrofulous swellings do not occur, nor stone in the bladder unless one chances to have had it before, nor spinal catarrh, nor kidney disease unless it follows from another period of life, nor hemorrhoids, nor bloody flux unless one chances to have had it before; these diseases keep away until old age. In women, watery discharges occurring before childbirth are bad.
504
Aphthous sores in the mouth in pregnant women are not good; do they also cause the bowels to become moist? Pains shifting from the flanks into the small intestine in prolonged cases, arising from a corruption not very thoroughly purged, are fatal.
506
The many things arising from childbirth and miscarriage that rush on quickly and then stop are difficult. Rigors are hostile to such women, as is disturbance of the bowel, especially with pain in the hypochondrium. In pregnant women, headache with stupor, occurring with heaviness and convulsion, is for the most part bad.
508
In those women who suffer intense pains around the upper region and the small intestine from uterine causes, who moisten the bowels and are somewhat nauseated, there occur around the time of crisis states of torpor, and with empty vessels they sweat on the surface and become chilled; when such relapses occur to most of these women after the discharge, they die quickly. Pneumata (breath / moving air) rising outward with a snorting sound, and paradoxical wasting, cause miscarriage in pregnant women; pain of the bowel after childbirth purges pus-like matter in such cases.
510
Those who are in a numbed state of prostration, especially during movements, being broken down with weakness, disturbed around the time of crisis, nauseated, and sweating on the surface with much perspiration — if the bowels become moist in them, that is bad. But for the uterine discharge not to stop is useful. Some of these cases, I think, develop epileptic conditions; in some there are prolonged downward discharges, and in some hemorrhoids.
512
In pregnant women, pain in the hypochondrium is bad; and when their bowels are carried off, that is bad; and shivering fits in them are bad; pain of the bowel in such cases is less bad if it purges muddy matter. Those among such women who give birth easily have great distress after the birth. In pregnant women with phthisis (wasting / consumption), in whom redness appears on the face, drops of blood from the nostrils occurring turn this aside.
514
In those women who after childbirth have white discharges, but when these stop have deafness together with fever and sharp pain in the side, they become deranged and die. The salty discharges in pregnant women indicate difficult conditions after birth with biting white discharges; such purgings cause hardening; hiccup supervening on these is bad, as is folding of the uterus, and it causes tension.
516
Tensions extending to the feet and loins from uterine causes tend toward suppuration, as do the viscous, foul-smelling things passing from the bowel with difficulty; choking fits on top of what has been described above indicate suppuration. Hard, painful uterine masses in the bowels rapidly become fatal.
518
In pregnant women, painful aphthous fluxes are bad; hemorrhoids in such women are worst of all. Those in whom, after the bowel has become distended, redness comes to the genitals and white watery uterine discharge suddenly descends — these die in prolonged fevers.
520
In a case of convulsion, when uterine discharge appears at the onset without fever supervening, there is resolution. Thin, slightly cloudy urines suspended in the middle of the vessel indicate rigors.
522
If a flow of blood occurs from the fourth day, it indicates a prolonged course, and the bowel breaks out, and swellings of the limbs. In pregnant women, headache with stupor occurring with heaviness is bad; perhaps these women ought also simultaneously to suffer something convulsive.
524
Those women who have suffered pains in a bilious-cholera-like manner before childbirth give birth easily, but when they become feverish they are malignant cases, especially if there is any trouble in the throat or any of the malignant signs in fever appear. Waters breaking in a watery manner before childbirth are bad.
526
In pregnant women, salty fluxes in the throat are bad. Shivering before childbirth, and births that occur without pain, are dangerous.
528
In pregnant women, the aphthous fluxes are bad. Those seized with convulsion, dissolved with exhaustion, and subsequently chilled, quickly become heated again. And moreover in pregnant women swellings around the small intestine, of the kind that occur around the scrotum, are difficult when cut off by orthopnoea; do such swellings indicate twin birth? Do such swellings also cause something convulsive? Those who exhale pneuma (breath / moving air) with a snorting sound in fevers miscarry.
530
In women with shivering fits, fatigue, and heaviness of head, the uterine discharge breaks through. Those who are sluggish on examination, quite dry, unthirsty, and who release much uterine discharge, tend toward suppuration.
532
When white discharges suddenly run down following a miscarriage, and if there is any shivering and trembling rushes to the thigh, it is difficult. Aphthous mouths in pregnant women moisten the bowels.
534
Those pregnant women who fall ill beforehand shiver before their deliveries. Numbing prostrations produce difficult outcomes from childbirths and are accompanied by mental confusion, yet are not fatal; they also give advance warning of an abundance of uterine discharge.
536
Those women who suffer pain at the heart before delivery lose the child shortly afterward. Shivering conditions, with fatigue, heaviness of head, and pain in the neck, cause the uterine discharge to break through; when this occurs around the time of crisis with a slight cough, there are shivering fits.
538
In young girls in whom orthopnoea occurs, during their periods they suppurate in the breasts; the appearance of uterine discharge at the beginning is bad. Manic conditions resolve acute disturbed fevers with non-bilious pain at the stomach.
540
In childless women, vomiting of blood helps toward conception. Dim-sighted conditions resolve when frequent uterine discharges appear.
542
In those women in whom pain of the breasts arises from fevers, expectoration of bright bloody sputum — not lees-like — resolves the pains. Convulsions in uterine conditions without fever are manageable, as for example with Dorcas.
544
In those who develop a fatiguing fever from a rigor, uterine discharge runs down; a painful neck in such cases is a sign of hemorrhage. The most painless kind of vomiting is that of phlegm and bile mixed together; let it not be vomited in too great a quantity. The more unmixed the things vomited, the worse. Leek-green vomiting, and black, and livid, are bad. If the same person vomits all the colors, it is fatal. The swiftest death is indicated by livid and foul-smelling vomiting. Red vomiting is also fatal, and most so if it is vomited under painful compulsion.
546
Those who are nauseated with paroxysms but without vomiting — that is bad; and those who are racked without vomiting likewise. Small bilious vomitings are bad, especially if there is also sleeplessness.
548
In cases of black vomiting, deafness does no harm. Frequent swift vomitings that are small, bilious, and unmixed are bad in cases of more extensive downward flux and intense loin pain.
550
Nausea after vomiting, accompanied by a shrieking sound and eyes having a filmy look, indicates madness; those who go mad quickly die speechless. In a case where vomiting is accompanied by thirst, to become without thirst is bad.
552
In nauseated, sleepless patients, swellings by the ear appear most. In nauseated patients, a disturbed stoppage of the bowels quickly breaks out in eruptions like gnat-bites, and a tearful separation comes to the eyes.
554
Hiccup upon unmixed vomiting is bad; convulsion is also bad; similarly in excessive purgings from drug treatments. Those about to vomit salivate beforehand.
556
Convulsion upon hellebore is fatal. In every excessive purging, chilling with sweating is fatal; those who vomit again with thirst in such cases are bad. Those who are nauseated and suffer loin pain have their bowels moistened.
558
Purgings of bright red and black matter under hellebore are bad; and prostration along with such things is bad. To vomit red, frothy matter in small quantity under hellebore is beneficial; it does, however, produce hardenings, and causes large suppurations to separate. Those who vomit such things are also in general painful in the chest, and sweat during rigor, and have the testicles drawn up; when this occurs additionally, they have shivering fits and become emaciated.
560
Frequent relapses through the same vomiting episodes around the crisis produce black vomiting; the patients also become tremulous. Sweating is best when it resolves the fever on a critical day, and also useful when it gives relief; but cold sweating occurring only around the head and neck is bad, for it indicates both a prolonged course and danger.
562
Cold sweating in an acute fever is fatal; in a milder one it indicates a prolonged course. Sweating occurring simultaneously with fever in an acute case is bad.
564
Urine in fever having a white and smooth sediment that has settled is a sign of speedy resolution; speedy resolution too is indicated by urine that in an uncritical stage has an oily quality and becomes more watery. Urine that is somewhat red and has a somewhat red and smooth sediment, if it appears before the seventh day, brings resolution on the seventh day; if after the seventh day, a longer course, or in any case a prolonged one. Urine that on the fourth day takes on a slightly cloudy reddish appearance brings resolution on the seventh day, the other signs being in proportion. Thin and bilious urine, and urine that barely has a viscous sediment, and urine that alternates between better and worse, indicates a prolonged course; if this persists for a longer time, or if things worsen around the crisis, it is not without danger. Consistently watery and white urine throughout prolonged illnesses is difficult to bring to a crisis and is not safe.
566
Clouds in the urine — white and in the lower part — are beneficial; red, black, and livid ones are difficult. Among urines in acute cases, the bilious urine that is not somewhat red is dangerous, as is that which is bran-like with white sediments, and that which is varied in color and sediment, and most of all in cases of fluxes from the head.
567
Dangerous also is the urine shifting from black to thin and bilious, and that being drawn apart from its sediment, and that which has changed from a nutritive sediment to a somewhat livid muddy sediment; do patients with such urines suffer pain in the hypochondrium — I think on the right side — or do they also become yellowish, and have they pain by the ear? In these cases, if the bowel breaks out briefly, it is fatal. Urines that suddenly and paradoxically ripen a little are bad, and in general anything that ripens paradoxically in an acute case is bad; and bad too is the eruption that is very red, held down by a violet-like covering.
568
Urine that is white and poured out transparent is bad; it appears especially in phrenitic patients. Bad also is that which is passed quickly after drinking, and especially in pleuritic and pneumonic patients. Bad also is that which is passed oily before a rigor. Bad in acute cases also is the yellowish-green that does not match the body's color. Fatal among urines is that which has a black sediment, and that which is black; more so in children is the thin urine than the thick, but in thin patients the reverse. In those with a concentrated urine, the hail-like sediment when dissolved is the same thing and also painful. Fatal is also all urine that is passed without the patient's awareness. In pneumonic patients, urine that is ripe at the beginning but becomes thin after the fourth day is also fatal.
570
In pleuritic patients, urine that is blood-like and dark with an undifferentiated varied sediment is for the most part fatal within fourteen days. Also quickly fatal in pleuritic patients is urine that is leek-green with a black or bran-like sediment. In obstinate burning-fever cases, the worst urine is the completely white. Urine that is raw for a longer time, the other signs being favorable, indicates a separation and pain, and more so in those with conditions below the diaphragm; and in cases of pains wandering in the loin, extending to the hip, both with and without fever.
571
Urine that is passed with a fatty sediment indicates fever. That which is blood-like and passed at the beginning indicates a prolonged course. That which is disturbed along with sweating indicates a relapse. That which is white like that of draft animals indicates headache. That which is membrane-like indicates convulsion. Urine having spit-like or muddy sediments is indicative of rigor. That which is cobweb-like indicates wasting. Black cloudlets in wandering fevers indicate quartan fever. Those without color, suspended in black matter, with sleeplessness and disturbance, are phrenitic. Those dusty with labored breathing are watery. Urine that is watery or disturbed with a crumbly roughness indicates that the bowel will be loose. The lean urine becoming rough — does this indicate impending sweating? Once it has occurred, does the frothy matter settling by itself indicate this? Black cloudlet-like appearances in tertian fevers with chills are indicative of unstable chills; and membrane-like passages of urine, and those settling with rigor, are convulsive.
574
Urine having a good sediment that suddenly has none indicates pain and a change. Urine having sediment, when it is disturbed and then settles again, indicates rigor around the crisis, and perhaps also a shift to a tertian or quartan. In pleuritic patients, somewhat red urine having a smooth sediment indicates a safe crisis; somewhat green and fresh-looking urine with a white sediment indicates a quick and safe one. Strongly red and fresh-looking urine with a green, smooth, pure sediment indicates a very prolonged, disturbed disease shifting into another form, but not fatal. White, watery urine having a coarse reddish sediment indicates pain and danger. And green urine having a coarse reddish sediment indicates a prolonged course and danger.
576
Urines in cases of swellings by the ear that quickly ripen only a little are bad; and being chilled in this way is bad. Bladder retention, especially with headache, has something convulsive about it; numbing prostrations that dissolve in such cases are difficult, though not fatal; do these patients also have some mental confusion? Sudden pain of the kidneys with suppression of urine indicates passage of small stones or thick urine; tremulous conditions appearing thus in older patients with fever indicate that small stones are somewhere being passed.
579
Suppression of urine and heaviness in the lower belly indicates for the most part that strangury will occur; if not, some other illness to which the patient is accustomed. In bilious conditions, suppression of urine quickly kills.
581
Urine in fever that has a shaggy appearance and is being dispersed is liable to relapse, or sweaty. In prolonged, thin, wandering fevers, passages of thin urine indicate splenic conditions.
583
In fever, passages of urines of varying kinds from one time to another are prolonged. ⟨The things passed in urine, if one calls them to mind — otherwise they are fatal⟩ ⟨text uncertain⟩: does urine pass in these patients such as would be produced if you stirred up the sediment?
585
In patients whose urine is scant and clotted, and who are not without fever, an abundance of thin urine coming on from these conditions is beneficial; such urine comes in those who from the beginning or quickly develop a sediment. In those whose urine quickly develops a sediment, these are quickly brought to a crisis.
587
In epileptic patients, thin and unconcocted urines contrary to habit and without fullness indicate a seizure, especially if some pain has fallen upon the shoulder-tip, neck, or back, or a convulsion has occurred, or numbness comes over the body, or a disturbing dream has been seen. The appearance of small amounts, like drops — of urine, of vomiting, of bowel movements — is bad in all cases, and worst when they succeed one another closely.
589
The best bowel movement is soft, formed, somewhat reddish, not very foul-smelling, and passing at the accustomed hour; the quantity proportionate to what has been taken in; let it thicken toward the crisis. It is also useful for round worms to pass through as the crisis approaches. In acute cases, frothy excrement mixed with bile is bad; bad also is the quite white; still worse is the mealy, dung-like. Stupor on top of these is bad, as is bloody passage and paradoxical emptying of the vessels.
591
Suppression of the bowel that releases small, black, pellet-like matter under compulsion — nosebleed occurring in such patients is bad. Viscous, unmixed, or white bowel movement is bad; bad also is that which is salty-fermented and somewhat phlegmatic; bad also is a somewhat livid, pus-like sediment from nutritive matter combined with a bilious one.
593
To pass bright blood through the bowel is bad, especially if any pain is present. The frothy, bile-mixed bowel movement is bad; jaundice also occurs from such things.
595
On top of bilious matters, the frothy eruption is bad, and most especially in one who has suffered with the loins and has become confused; but such pains in these patients are sparse. Thin, slightly foamy bowel movement with a watery-green sediment is bad; pus-like is also bad. Black and blood-like is bad with fever and otherwise. Varied, intensely colored bowel movement is bad, and worse in proportion as it is more alarming in color, except in the context of drug treatments, in which it is not dangerous unless it exceeds in quantity; and crumbly, soft bowel movement in fever is bad; bad also is dry, crumbly, pale-colored matter — especially if it also moistens the bowel. If black matter has passed previously, it kills.
597
Liquid bowel movement and concentrated, a little at a time, is bad; the first may produce sleeplessness, the second prostration. A moist, slightly crumbly bowel movement with chilling in one not without fever is bad; rigors following upon such things take hold of the bladder and bowel.
599
Exceedingly watery bowel movement that does not cease in acute cases is bad, and more so if the patient is also without thirst. Highly reddish bowel movement in watery flux is bad; bad also is the very green, or white, or frothy, or watery. The small, viscous, smooth, and somewhat greenish is bad; and the moist bowel movement in drowsy, sluggish patients is worst. Fatal also is hemorrhaging much clotted blood; and white, moist matter together with a distended bowel.
601
A bowel movement black like blood, both with fever and without, is bad; bad also are all varied ones, and the intensely colored ones are bad. Bowel movements ending in frothy, unmixed matter are a cause of paroxysm in all, and most especially in those with convulsive tendencies; from such conditions swellings by the ear arise. Those that become more liquid and then solidify again, unmixed and dung-like, indicate a prolonged illness. The highly reddish one in fever indicates mental confusion. The white, dung-like one with jaundice is difficult. That which is liquid and on standing takes on redness indicates hemorrhage.
603
Viscous bowel movement variegated with black is malignant, and most so with pale-white matter. Pale-white bowel movement in fever does not lead to an easy crisis.
605
A disturbed bowel with small, frequent trips strains the jaws; and reddening appearing on the face resolves it. Dung-like bowel movement with straining indicates a diseased bowel; phlegmatic matter rapidly passed with heartburn indicates dysentery, and perhaps also loin pain; in such patients, distension of the bowel releasing liquid under compulsion and quickly swelling up has something convulsive about it; shivering fits in these patients are fatal.
607
In those who pass black matter through the bowel, cold sweats occur. In those whose bowel is disturbed at the beginning and whose urine is scant — as the illness advances the bowel becomes dry while the urine increases in thin quantity — in these patients, separations occur toward the joints.
609
Small, shivery trips to the stool, and patients with bad bowel movements, are most difficult when quartan fever is beginning. Frequent small trips that are slightly viscous, containing small dung-like particles, accompanied by pain of the hypochondrium and side, are jaundice-producing; do these patients, when the discharge stops, become yellowish? I think these patients also hemorrhage; and pains in the loin in such cases bleed.
611
In those who pass bright blood through the bowel with stupor and headache, warming up is fatal. Viscous, bilious matters more particularly produce separations by the ear.
613
When swellings rise up with pains while the bowel is being moistened, that is bad; when the bowel stops and nothing else has changed, it breaks out again quickly, and is more malignant; the things vomited on top of these are bad and monstrous. In those where a foul-smelling, violent, very red flux resolves an inflamed and very red condition, there is hope of going mad.
615
A squalid skin color indicates a diseased bowel; on top of this, very red, flesh-pus-like discharges pass most. Upon a bilious, soft, dung-like bowel, coma appearing causes a swelling by the ear.
617
Deafness stops bilious bowel movements; bilious bowel movement stops deafness. Creeping things above the groin, appearing toward the flanks and the pubis, indicate a diseased bowel.
619
Prostration resolving pain greatly moistens the bowel. Painful suppurating conditions at the seat disturb the bowel.
621
Fatal among bowel movements are: the fatty, the black, the livid with foul smell, the bilious one containing within itself things resembling fragments of lentils or chickpeas, or like fresh clots of blood, resembling the odor of infants' feces, and the varied — and the same is also prolonged; such matter may be blood-like, scrapings-like, bilious, black, leek-green, both together and alternating. Fatal also is everything that passes without the patient's awareness. In a patient who gulps down a drink with difficulty, with a coughing breath, a belch being drawn inward and coiling inside indicates pain of the bowel.
623
Bad also are very red appearances in quartan patients, and such hemorrhagic conditions, which are coma-like; from these signs such patients end in convulsion, after black matter has passed. In those who pass black matter through the bowel, cold sweats occur.
625 [5]
Sudden, irrational collapses of the bowel in those who have been wasting away over long periods, accompanied by tremulous loss of voice, are fatal. Thin passages of black matter with shivering are better for such patients; such passages are most beneficial in the age at which they are declining from their prime. In all cases, itching-sensations signify a passage of black matter and clotted vomiting; and tremulous symptoms with gnawing accompanied by headache signal black stools; vomiting passes through before such things, and after vomiting, such material is frequently drawn down further.
627
In those in whom, during a bowel disturbance, there is an intensification around the crisis, black matter passes downward. In cases of prolonged bowel trouble with nausea, bilious stools, and refusal to eat, an abundance of sweat accompanied by sudden weakness kills.
629
In the course of purgative treatments, thin blood dissolving out frequently amid the discharge is a bad sign. Hardened masses in the bowel accompanied by pain, together with fevers with shivering, refusal to eat, and slight moistening of the bowel that does not yield a proper purging — these will end in suppuration.
631
A disturbed bowel simultaneously with fever, of a saltish character, does not altogether accompany those who are comatose and sluggish. In cases of moist bowel with fatigue, headache, thirst, sleeplessness, and a flushed complexion, when these resolve, there is the expectation of madness.
633
[Text appears corrupt or lacunose.] If they are breathing with difficulty — toward pallid-greenish discoloration, easy breathing, and refusal to eat — when the bowel intervenes. ⟨...⟩ Burning-hot stools that have tension signify a bowel badly afflicted.
635
In bilious patients, a disturbed bowel passing small, frequent, tense, slightly mucous stools causing pain around the small intestine, and urine not flowing freely — such conditions terminate in dropsy. Tremulous tongues are a sign, in some, that the bowel is about to break loose.
637
In those in whom burning heat arises after foamy matter has passed through, fever intensifies. In cases of moist bowels, chilling accompanied by sweat is a bad sign.
639
In cases of moist bowels, blood from the gums flowing into the bowel is fatal. A clean evacuation occurring afterward resolves an acute fever accompanied by sweat.