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Hippokrates Aphorismen

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ama:
Francis Adams
(1796 - 1861)

Schottischer Arzt und √úbersetzer griechischer medizinischer Texte
Scottish medical doctor and translator of Greek medical works

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Hippocrates

Aphorisms


translated by Francis Adams

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SECTION I

1. Life is short, and Art long; the crisis fleeting; experience perilous,
and decision difficult. The physician must not only be prepared to
do what is right himself, but also to make the patient, the attendants,
and externals cooperate.

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

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

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

5. In a restricted diet, patients who transgress are thereby more
hurt (than in any other?); for every such transgression, whatever
it may be, is followed by greater consequences than in a diet somewhat
more generous. On this account, a very slender, regulated, and restricted
diet is dangerous to persons in health, because they bear transgressions
of it more difficultly. For this reason, a slender and restricted
diet is generally more dangerous than one a little more liberal.

6. For extreme diseases, extreme methods of cure, as to restriction,
are most suitable.

7. When the disease is very acute, it is attended with extremely severe
symptoms in its first stage; and therefore an extremely attenuating
diet must be used. When this is not the case, but it is allowable
to give a more generous diet, we may depart as far from the severity
of regimen as the disease, by its mildness, is removed from the extreme.

8. When the disease is at its height, it will then be necessary to
use the most slender diet.

9. We must form a particular judgment of the patient, whether he will
support the diet until the acme of the disease, and whether he will
sink previously and not support the diet, or the disease will give
way previously, and become less acute.

10. In those cases, then, which attain their acme speedily, a restricted
diet should be enjoined at first; but in those cases which reach their
acme later, we must retrench at that period or a little before it;
but previously we must allow a more generous diet to support the patient.

11. We must retrench during paroxysms, for to exhibit food would be
injurious. And in all diseases having periodical paroxysms, we must
restrict during the paroxysms.

12. The exacerbations and remissions will be indicated by the diseases,
the seasons of the year, the reciprocation of the periods, whether
they occur every day, every alternate day, or after a longer period,
and by the supervening symptoms; as, for example, in pleuritic cases,
expectoration, if it occur at the commencement, shortens the attack,
but if it appear later, it prolongs the same; and in the same manner
the urine, and alvine discharges, and sweats, according as they appear
along with favorable or unfavorable symptoms, indicate diseases of
a short or long duration.

13. Old persons endure fasting most easily; next, adults; young persons
not nearly so well; and most especially infants, and of them such
as are of a particularly lively spirit.

14. Growing bodies have the most innate heat; they therefore require
the most food, for otherwise their bodies are wasted. In old persons
the heat is feeble, and therefore they require little fuel, as it
were, to the flame, for it would be extinguished by much. On this
account, also, fevers in old persons are not equally acute, because
their bodies are cold.

15. In winter and spring the bowels are naturally the hottest, and
the sleep most prolonged; at these seasons, then, the most sustenance
is to be administered; for as the belly has then most innate heat,
it stands in need of most food. The well-known facts with regard to
young persons and the athletae prove this.

16. A humid regimen is befitting in all febrile diseases, and particularly
in children, and others accustomed to live on such a diet.

17. We must consider, also, in which cases food is to be given once
or twice a day, and in greater or smaller quantities, and at intervals.
Something must be conceded to habit, to season, to country, and to
age.

18. Invalids bear food worst during summer and autumn, most easily
in winter, and next in spring.

19. Neither give nor enjoin anything to persons during periodical
paroxysms, but abstract from the accustomed allowance before the crisis.

20. When things are at the crisis, or when they have just passed it,
neither move the bowels, nor make any innovation in the treatment,
either as regards purgatives or any other such stimulants, but let
things alone.

21. Those things which require to be evacuated should be evacuated,
wherever they most tend, by the proper outlets.

22. We must purge and move such humors as are concocted, not such
as are unconcocted, unless they are struggling to get out, which is
mostly not the case.

23. The evacuations are to be judged of not by their quantity, but
whether they be such as they should be, and how they are borne. And
when proper to carry the evacuation to deliquium animi, this also
should be done, provided the patient can support it.

24. Use purgative medicines sparingly in acute diseases, and at the
commencement, and not without proper circumspection.

25. If the matters which are purged be such as should be purged, the
evacuation is beneficial, and easily borne; but, not withstanding,
if otherwise, with difficulty.
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SECTION II

1. In whatever disease sleep is laborious, it is a deadly symptom;
but if sleep does good, it is not deadly.

2. When sleep puts an end to delirium, it is a good symptom.

3. Both sleep and insomnolency, when immoderate, are bad.

4. Neither repletion, nor fasting, nor anything else, is good when
more than natural.

5. Spontaneous lassitude indicates disease.

6. Persons who have a painful affection in any part of the body, and
are in a great measure sensible of the pain, are disordered in intellect.

7. Those bodies which have been slowly emaciated should be slowly
recruited; and those which have been quickly emaciated should be quickly
recruited.

8. When a person after a disease takes food, but does not improve
in strength, it indicates that the body uses more food than is proper;
but if this happen when he does not take food, it is to be understood
evacuation is required.

9. When one wishes to purge, he should put the body into a fluent
state.

10. Bodies not properly cleansed, the more you nourish the more you
injure.

11. It is easier to fill up with drink than with food.

12. What remains in diseases after the crisis is apt to produce relapses.

13. Persons in whom a crisis takes place pass the night preceding
the paroxysm uncomfortably, but the succeeding night generally more
comfortably.

14. In fluxes of the bowels, a change of the dejections does good,
unless the change be of a bad character.

15. When the throat is diseased, or tubercles (phymata) form on the
body, attention must paid to the secretions; for if they be bilious,
the disease affects the general system; but if they resemble those
of a healthy person, it is safe to give nourishing food.

16. When in a state of hunger, one ought not to undertake labor.

17. When more food than is proper has been taken, it occasions disease;
this is shown by the treatment.

18. From food which proves nourishing to the body either immediately
or shortly, the dejections also are immediate.

19. In acute diseases it is not quite safe to prognosticate either
death or recovery.

20. Those who have watery discharges from their bowels when young
have dry when they are old; and those who have dry discharges when
they are young will have watery when they are old.

21. Drinking strong wine cures hunger.

22. Diseases which arise from repletion are cured by depletion; and
those that arise from depletion are cured by repletion; and in general,
diseases are cured by their contraries.

23. Acute disease come to a crisis in fourteen days.

24. The fourth day is indicative of the seventh; the eighth is the
commencement of the second week; and hence, the eleventh being the
fourth of the second week, is also indicative; and again, the seventeenth
is indicative, as being the fourth from the fourteenth, and the seventh
from the eleventh.

25. The summer quartans are, for the most part, of short duration;
but the autumnal are protracted, especially those occurring near the
approach of winter.

26. It is better that a fever succeed to a convulsion, than a convulsion
to a fever.

27. We should not trust ameliorations in diseases when they are not
regular, nor be much afraid of bad symptoms which occur in an irregular
form; for such are commonly inconstant, and do not usually continue,
nor have any duration.

28. In fevers which are not altogether slight, it is a bad symptom
for the body to remain without any diminution of bulk, or to be wasted
beyond measure; for the one state indicates a protracted disease,
and the other weakness of body.

29. If it appear that evacuations are required, they should be made
at the commencement of diseases; at the acme it is better to be quiet.

30. Toward the commencement and end of diseases all the symptoms are
weaker, and toward the acme they are stronger.

31. When a person who is recovering from a disease has a good appetite,
but his body does not improve in condition, it is a bad symptom.

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

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

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

35. In all diseases it is better that the umbilical and hypogastric
regions preserve their fullness; and it is a bad sign when they are
very slender and emaciated; in the latter case it is dangerous to
administer purgatives.

36. Persons in good health quickly lose their strength by taking purgative
medicines, or using bad food.

37. Purgative medicines agree ill with persons in good health.

38. An article of food or drink which is slightly worse, but more
palatable, is to be preferred to such as are better but less palatable.

39. Old have fewer complaints than young; but those chronic diseases
which do befall them generally never leave them.

40. Catarrhs and coryza in very old people are not concocted.

41. Persons who have had frequent and severe attacks of swooning,
without any manifest cause, die suddenly.

42. It is impossible to remove a strong attack of apoplexy, and not
easy to remove a weak attack.

43. Of persons who have been suspended by the neck, and are in a state
of insensibility, but not quite dead, those do not recover who have
foam at the mouth.

44. Persons who are naturally very fat are apt to die earlier than
those who are slender.

45. Epilepsy in young persons is most frequently removed by changes
of air, of country, and of modes of life.

46. Of two pains occurring together, not in the same part of the body,
the stronger weakens the other.

47. Pains and fevers occur rather at the formation of pus than when
it is already formed.

48. In every movement of the body, whenever one begins to endure pain,
it will be relieved by rest.

49. Those who are accustomed to endure habitual labors, although they
be weak or old, bear them better than strong and young persons who
have not been so accustomed.

50. Those things which one has been accustomed to for a long time,
although worse than things which one is not accustomed to, usually
give less disturbance; but a change must sometimes be made to things
one is not accustomed to.

51. To evacuate, fill up, heat, cool, or otherwise, move the body
in any way much and suddenly, is dangerous; and whatever is excessive
is inimical to nature; but whatever is done by little and little is
safe, more especially when a transition is made from one thing to
another.

52. When doing everything according to indications, although things
may not turn out agreeably to indication, we should not change to
another while the original appearances remain.

53. Those persons who have watery discharges from the bowels when
they are young, come off better than those who have dry; but in old
age they come off worse, for the bowels in aged persons are usually
dried up.

54. Largeness of person in youth is noble and not unbecoming; but
in old age it is inconvenient, and worse than a smaller structure.
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SECTION III

1. The changes of the season mostly engender diseases, and in the
seasons great changes either of heat or of cold, and the rest agreeably
to the same rule.

2. Of natures (temperaments?), some are well- or ill-adapted for summer,
and some for winter.

3. Of diseases and ages, certain of them are well- or ill-adapted
to different seasons, places, and kinds of diet.

4. In the seasons, when during the same day there is at one time heat
and at another time cold, the diseases of autumn may be expected.

5. South winds induce dullness of hearing, dimness of visions, heaviness
of the head, torpor, and languor; when these prevail, such symptoms
occur in diseases. But if the north wind prevail, coughs, affections
of the throat, hardness of the bowels, dysuria attended with rigors,
and pains of the sides and breast occur. When this wind prevails,
all such symptoms may be expected in diseases.

6. When summer is like spring, much sweating may be expected in fevers.

7. Acute diseases occur in droughts; and if the summer be particularly
such, according to the constitution which it has given to the year,
for the most part such diseases maybe expected.

8. In seasons which are regular, and furnish the productions of the
season at the seasonable time, the diseases are regular, and come
readily to a crisis; but in inconstant seasons, the diseases are irregular,
and come to a crisis with difficulty.

9. In autumn, diseases are most acute, and most mortal, on the whole.
The spring is most healthy, and least mortal.

10. Autumn is a bad season for persons in consumption.

11. With regard to the seasons, if the winter be of a dry and northerly
character, and the spring rainy and southerly, in summer there will
necessarily be acute fevers, ophthalmies, and dysenteries, especially
in women, and in men of a humid temperament.

12. If the but the spring dry and northerly, women whose term of delivery
should be in spring, have abortions from any slight cause; and those
who reach their full time, bring forth children who are feeble, and
diseased, so that they either die presently, or, if they live, are
puny and unhealthy. Other people are subject to dysenteries and ophthalmies,
and old men to catarrhs, which quickly cut them off.

13. If the summer be dry and northerly and the autumn rainy and southerly,
headaches occur in winter, with coughs, hoarsenesses, coryzae, and
in some cases consumptions.

14. But if the autumn be northerly and dry, it agrees well with persons
of a humid temperament, and with women; but others will be subject
to dry ophthalmies, acute fevers, coryzae, and in some cases melancholy.

15. Of the constitutions of the year, the dry, upon the whole, are
more healthy than the rainy, and attended with less mortality.
16. The diseases which occur most frequently in rainy seasons are,
protracted fevers, fluxes of the bowels, mortifications, epilepsies,
apoplexies, and quinsies; and in dry, consumptive diseases, ophthalmies,
arthritic diseases, stranguries, and dysenteries.

17. With regard to the states of the weather which continue but for
a day, that which is northerly, braces the body, giving it tone, agility,
and color, improves the sense of hearing, dries up the bowels, pinches
the eyes, and aggravates any previous pain which may have been seated
in the chest. But the southerly relaxes the body, and renders it humid,
brings on dullness of hearing, heaviness of the head, and vertigo,
impairs the movements of the eyes and the whole body, and renders
the alvine discharges watery.

18. With regard to the seasons, in spring and in the commencement
of summer, children and those next to them in age are most comfortable,
and enjoy best health; in summer and during a certain portion of autumn,
old people; during the remainder of the autumn and in winter, those
of the intermediate ages.

19. All diseases occur at all seasons of the year, but certain of
them are more apt to occur and be exacerbated at certain seasons.

20. The diseases of spring are, maniacal, melancholic, and epileptic
disorders, bloody flux, quinsy, coryza, hoarseness, cough, leprosy,
lichen alphos, exanthemata mostly ending in ulcerations, tubercles,
and arthritic diseases.

21. Of summer, certain of these, and continued, ardent, and tertian
fevers, most especially vomiting, diarrhoea, ophthalmy, pains of the
ears, ulcerations of the mouth, mortifications of the privy parts,
and the sudamina.

22. Of autumn, most of the summer, quartan, and irregular fevers,
enlarged spleen, dropsy, phthisis, strangury, lientery, dysentery,
sciatica, quinsy, asthma, ileus, epilepsy, maniacal and melancholic
disorders.

23. Of winter, pleurisy, pneumonia, coryza, hoarseness, cough, pains
of the chest, pains of the ribs and loins, headache, vertigo, and
apoplexy.

24. In the different ages the following complaints occur: to little
and new-born children, aphthae, vomiting, coughs, sleeplessness, frights
inflammation of the navel, watery discharges from the ears.

25. At the approach of dentition, pruritus of the gums, fevers, convulsions,
diarrhoea, especially when cutting the canine teeth, and in those
who are particularly fat, and have constipated bowels.

26. To persons somewhat older, affections of the tonsils, incurvation
of the spine at the vertebra next the occiput, asthma, calculus, round
worms, ascarides, acrochordon, satyriasmus, struma, and other tubercles
(phymata), but especially the aforesaid.

27. To persons of a more advanced age, and now on the verge of manhood,
the most of these diseases, and, moreover, more chronic fevers, and
epistaxis.

28. Young people for the most part have a crisis in their complaints,
some in forty days, some in seven months, some in seven years, some
at the approach to puberty; and such complaints of children as remain,
and do not pass away about puberty, or in females about the commencement
of menstruation, usually become chronic.

29. To persons past boyhood, haemoptysis, phthisis, acute fevers,
epilepsy, and other diseases, but especially the aforementioned.

30. To persons beyond that age, asthma, pleurisy, pneumonia, lethargy,
phrenitis, ardent fevers, chronic diarrhoea, cholera, dysentery, lientery,
hemorrhoids.

31. To old people dyspnoea, catarrhs accompanied with coughs, dysuria,
pains of the joints, nephritis, vertigo, apoplexy, cachexia, pruritus
of the whole body, insomnolency, defluxions of the bowels, of the
eyes, and of the nose, dimness of sight, cataract (glaucoma), and
dullness of hearing.
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SECTION IV

1. We must purge pregnant women, if matters be turgid (in a state
of orgasm?), from the fourth to the seventh month, but less freely
in the latter; in the first and last stages of pregnancy it should
be avoided.

2. In purging we should bring away such matters from the body as it
would be advantageous had they come away spontaneously; but those
of an opposite character should be stopped.

3. If the matters which are purged be such as should be purged, it
is beneficial and well borne; but if the contrary, with difficulty.

4. We should rather purge upward in summer, and downward in winter.

5. About the time of the dog-days, and before it, the administration
of purgatives is unsuitable.

6. Lean persons who are easily made to vomit should be purged upward,
avoiding the winter season.

7. Persons who are difficult to vomit, and are moderately fat, should
be purged downward, avoiding the summer season.

8. We must be guarded in purging phthisical persons upward.

9. And from the same mode of reasoning, applying the opposite rule
to melancholic persons, we must purge them freely downward.

10. In very acute diseases, if matters be in a state of orgasm, we
may purge on the first day, for it is a bad thing to procrastinate
in such cases.

11. Those cases in which there are tormina, pains about the umbilicus,
and pains about the loins, not removed either by purgative medicines
or otherwise, usually terminate in dry dropsy.

12. It is a bad thing to purge upward in winter persons whose bowels
are in a state of lientery.

13. Persons who are not easily purged upward by the hellebores, should
have their bodies moistened by plenty of food and rest before taking
the draught.

14. When one takes a draught of hellebore, one should be made to move
more about, and indulge less in sleep and repose. Sailing on the sea
shows that motion disorders the body.

15. When you wish the hellebore to act more, move the body, and when
to stop, let the patient get sleep and rest.

16. Hellebore is dangerous to persons whose flesh is sound, for it
induces convulsion.

17. Anorexia, heartburn, vertigo, and a bitter taste of the mouth,
in a person free from fever, indicate the want of purging upward.

18. Pains seated above the diaphragm indicate purging upward, and
those below it, downward.

19. Persons who have no thirst while under the action of a purgative
medicine, do not cease from being purged until they become thirsty.

20. If persons free from fever be seized with tormina, heaviness of
the knees, and pains of the loins, this indicates that purging downward
is required.

21. Alvine dejections which are black, like blood, taking place spontaneously,
either with or without fever, are very bad; and the more numerous
and unfavorable the colors, so much the worse; when with medicine
it is better, and a variety of colors in this case is not bad.

22. When black bile is evacuated in the beginning of any disease whatever,
either upward or downward, it is a mortal symptom.

23. In persons attenuated from any disease, whether acute or chronic,
or from wounds, or any other cause, if there be a discharge either
of black bile, or resembling black blood, they die on the following
day.

24. Dysentery, if it commence with black bile, is mortal.

25. Blood discharged upward, whatever be its character, is a bad symptom,
but downward it is (more?) favorable, and so also black dejections.

26. If in a person ill of dysentery, substances resembling flesh be
discharged from the bowels, it is a mortal symptom.

27. In whatever cases of fever there is a copious hemorrhage from
whatever channel, the bowels are in a loose state during convalescence.

28. In all cases whatever, bilious discharges cease if deafness supervenes,
and in all cases deafness ceases when bilious discharges supervene.

29. Rigors which occur on the sixth day have a difficult crisis.

30. Diseases attended with paroxysms, if at the same hour that the
fever leaves it return again next day, are of difficult crisis.

31. In febrile diseases attended with a sense of lassitude, deposits
form about the joints, and especially those of the jaws.

32. In convalescents from diseases, if any part be pained, there deposits
are formed.

33. But if any part be in a painful state previous to the illness,
there the disease fixes.

34. If a person laboring under a fever, without any swelling in the
fauces, be seized with a sense of suffocation suddenly, it is a mortal
symptom.

35. If in a person with fever, the become suddenly distorted, and
he cannot swallow unless with difficulty, although no swelling be
present, it is a mortal symptom.

36. Sweats, in febrile diseases, are favorable, if they set in on
the third, fifth, seventh, ninth, eleventh, fourteenth, seventeenth,
twenty-first, twenty-seventh, and thirty-fourth day, for these sweats
prove a crisis to the disease; but sweats not occurring thus, indicate
pain, a protracted disease, and relapses.

37. Cold sweats occurring with an acute fever, indicate death; and
along with a milder one, a protracted disease.

38. And in whatever part of the body there is a sweat, it shows that
the disease is seated there.

39. And in whatever part of the body heat or cold is seated, there
is disease.

40. And wherever there are changes in the whole body, and if the body
be alternately cold and hot, or if one color succeed another, this
indicates a protracted disease.

41. A copious sweat after sleep occuring without any manifest cause,
indicates that the body is using too much food. But if it occur when
one is not taking food, it indicates that evacuation is required.

42. A copious sweat, whether hot or cold, flowing continuously, indicates,
the cold a greater, and the hot a lesser disease.

43. Fevers, not of the intermittent type, which are exacerbated on
the third day, are dangerous; but if they intermit in any form, this
indicates that they are not dangerous.

44. In cases attended with protracted fevers, tubercles (phymata)
or pains occur about the joints.

45. When tubercles (phymata) or pains attack the joints after fevers,
such persons are using too much food.

46. If in a fever not of the intermittent type a rigor seize a person
already much debilitated, it is mortal.

47. In fevers not of the intermittent type, expectorations which are
livid bloody, fetid and bilious, are all bad; but if evacuated properly,
they are favorable. So it is with the alvine evacuations and the urine.
But if none of the proper excretions take place by these channels,
it is bad.

48. In fevers not of the intermittent type, if the external parts
be cold, but the internal be burnt up, and if there be thirst, it
is a mortal symptom.

49. In a fever not of the intermittent type, if a lip, an eye-brow,
an eye, or the nose, be distorted; or if there be loss of sight or
of hearing, and the patient be in a weak state-whatever of these symptoms
occur, death is at hand.

50. Apostemes in fevers which are not resolved at the first crisis,
indicate a protracted disease.

51. When in a fever not of the intermittent type dyspnoea and delirium
come on, the case is mortal.

52. When persons in fevers, or in other illnesses, shed tears voluntarily,
it is nothing out of place; but when they shed tears involuntarily,
it is more so.

53. In whatever cases of fever very viscid concretions form about
the teeth, the fevers turn out to be particularly strong.

54. In whatever case of ardent fever dry coughs of a tickling nature
with slight expectoration are long protracted, there is usually not
much thirst.

55. All fevers complicated with buboes are bad, except ephemerals.

56. Sweat supervening in a case of the fever ceasing, is bad, for
the disease is protracted, and it indicates more copious humors.

57. Fever supervening in a case of confirmed spasm, or of tetanus,
removes the disease.

58. A rigor supervening in a case of ardent fever, produces resolution
of it.

59. A true tertian comes to a crisis in seven periods at furthest.

60. When in fevers there is deafness, if blood run from the nostrils,
or the bowels become disordered, it carries off the disease.

61. In a febrile complaint, if the fever do not leave on the odd days,
it relapses.

62. When jaundice supervenes in fevers before the seventh day, it
a bad symptom, unless there be watery discharges from the bowels.

63. In whatever cases of fever rigors occur during the day, the fevers
come to a resolution during the day.

64. When in cases of fever jaundice occurs on the seventh, the ninth,
the eleventh, or the fourteenth day, it is a good symptom, provided
the hypochondriac region be not hard. Otherwise it is not a good symptom.

65. A strong heat about the stomach and cardialgia are bad symptoms
in fevers.

66. In acute fevers, spasms, and strong pains about the bowels are
bad symptoms.

67. In fevers, frights after sleep, or convulsions, are a bad symptom.

68. In fevers, a stoppage of the respiration is a bad symptom, for
it indicates convulsions.

69. When the urine is thick, grumoss, and scanty in cases not free
from fever a copious discharge of thinner urine proves beneficial.
Such a discharge more commonly takes place when the urine has had
a sediment from the first, or soon after the commencement.

70. When in fevers the urine is turbid, like that of a beast of burden,
in such a case there either is or will be headache.

71. In cases which come to a crisis on the seventh day, the urine
has a red nubecula on the fourth day, and the other symptoms accordingly.

72. When the urine is transparent and white, it is bad; it appears
principally in cases of phrenitis.

73. When the hypochondriac region is affected with meteorism and borborygmi,
should pain of the loins supervene, the bowels get into a loose and
watery state, unless there be an eruption of flatus or a copious evacuation
of urine. These things occur in fevers.

74. When there is reason to expect that an abscess will form in joints,
the abscess is carried off by a copious discharge of urine, which
is thick, and becomes white, like what begins to form in certain cases
of quartan fever, attended with a sense of lassitude. It is also speedily
carried off by a hemorrhage from the nose.

75. Blood or pus in the urine indicates ulceration either of the kidneys
or of the bladder.

76. When small fleshy substances like hairs are discharged along with
thick urine, these substances come from the kidneys.

77. In those cases where there are furfuraceous particles discharged
along with thick urine, there is scabies of the bladder.

78. In those cases where there is a spontaneous discharge of bloody
urine, it indicates rupture of a small vein in the kidneys.

79. In those cases where there is a sandy sediment in the urine, there
is calculus in the bladder (or kidneys).

80. If a patient pass blood and clots in his urine, and have strangury,
and if a pain seize the hypogastric region and perineum, the parts
about the bladder are affected.

81. If a patient pass blood, pus, and scales, in the urine, and if
it have a heavy smell, ulceration of the bladder is indicated.

82. When tubercles form in the urethra, if these suppurate and burst,
there is relief.

83. When much urine is passed during the night, it indicates that
the alvine evacuations are scanty.
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SECTION V

1. A spasm from taking hellebore is of a fatal nature.

2. Spasm supervening on a wound is fatal.

3. A convulsion, or hiccup, supervening on a copious discharge of
blood is bad.

4. A convulsion, or hiccup, supervening upon hypercatharsis is bad.

5. If a drunken person suddenly lose his speech, he will die convulsed,
unless fever come on, or he recover his speech at the time when the
consequences of a debauch pass off.

6. Such persons as are seized with tetanus die within four days, or
if they pass these they recover.

7. Those cases of epilepsy which come on before puberty may undergo
a change; but those which come on after twenty-five years of age,
for the most part terminate in death.

8. In pleuritic affections, when the disease is not purged off in
fourteen days, it usually terminates in empyema.

9. Phthisis most commonly occurs between the ages of eighteen and
thirty-five years.

10. Persons who escape an attack of quinsy, and when the disease is
turned upon the lungs, die in seven days; or if they pass these they
become affected with empyema.

11. In persons affected with phthisis, if the sputa which they cough
up have a heavy smell when poured upon coals, and if the hairs of
the head fall off, the case will prove fatal.

12. Phthisical persons, the hairs of whose head fall off, die if diarrhoea
set in.

13. In persons who cough up frothy blood, the discharge of it comes
from the lungs.

14. Diarrhoea attacking a person affected with phthisis is a mortal
symptom.

15. Persons who become affected with empyema after pleurisy, if they
get clear of it in forty days from the breaking of it, escape the
disease; but if not, it passes into phthisis.

16. Heat produces the following bad effects on those who use it frequently:
enervation of the fleshy parts, impotence of the nerves, torpor of
the understanding, hemorrhages, deliquia, and, along with these, death.

17. Cold induces convulsions, tetanus, mortification, and febrile
rigors.

18. Cold is inimical to the bones, the teeth, the nerves, the brain,
and the spinal marrow, but heat is beneficial.

19. Such parts as have been congealed should be heated, except where
there either is a hemorrhage, or one is expected.

20. Cold pinches ulcers, hardens the skin, occasions pain which does
not end in suppuration, blackens, produces febrile rigors, convulsions,
and tetanus.

21. In the case of a muscular youth having tetanus without a wound,
during the midst of summer, it sometimes happens that the allusion
of a large quantity of cold water recalls the heat. Heat relieves
these diseases.

22. Heat is suppurative, but not in all kinds of sores, but when it
is, it furnishes the greatest test of their being free from danger.
It softens the skin, makes it thin, removes pain, soothes rigor, convulsions,
and tetanus. It removes affections of the head, and heaviness of it.
It is particularly efficacious in fractures of the bones, especially
of those which have been exposed, and most especially in wounds of
the head, and in mortifications and ulcers from cold; in herpes exedens,
of the anus, the privy parts, the womb, the bladder, in all these
cases heat is agreeable, and brings matters to a crisis; but cold
is prejudicial, and does mischief.

23. Cold water is to be applied in the following cases; when there
is a hemorrhage, or when it is expected, but not applied to the spot,
but around the spot whence the blood flows; and in inflammations and
inflammatory affections, inclining to a red and subsaguineous color,
and consisting of fresh blood, in these cases it is to be applied
but it occasions mortification in old cases; and in erysipelas not
attended with ulceration, as it proves injurious to erysipelas when
ulcerated.

24. Cold things, such as snow and ice, are inimical to the chest,
being provocative of coughs, of discharges of blood, and of catarrhs.

25. Swellings and pains in the joints, ulceration, those of a gouty
nature, and sprains, are generally improved by a copious affusion
of cold water, which reduces the swelling, and removes the pain; for
a moderate degree of numbness removes pain.

26. The lightest water is that which is quickly heated and quickly
cooled.

27. When persons have intense thirst, it is a good thing if they can
sleep off the desire of drinking.

28. Fumigation with aromatics promotes menstruation, and would be
useful in many other cases, if it did not occasion heaviness of the
head.

29. Women in a state of pregnancy may be purged, if there be any urgent
necessity (or, if the humors be in a state of orgasm?), from the fourth
to the seventh month, but less so in the latter case. In the first
and last periods it must be avoided.

30. It proves fatal to a woman in a state of pregnancy, if she be
seized with any of the acute diseases.

31. If a woman with child be bled, she will have an abortion, and
this will be the more likely to happen, the larger the foetus.

32. Haemoptysis in a woman is removed by an eruption of the menses.

33. In a woman when there is a stoppage the menses, a discharge of
blood from the nose is good.

34. When a pregnant woman has a violent diarrhoea, there is danger
of her miscarrying.

35. Sneezing occurring to a woman affected with hysterics, and in
difficult labor, is a good symptom.

36. When the menstrual discharge is of a bad color and irregular,
it indicates that the woman stands in need of purging.

37. In a pregnant woman, if the breasts suddenly lose their fullness,
she has a miscarriage.

38. If, in a woman pregnant with twins, either of her breasts lose
its fullness, she will part with one of her children; and if it be
the right breast which becomes slender, it will be the male child,
or if the left, the female.

39. If a woman who is not with child, nor has brought forth, have
milk, her menses are obstructed.

40. In women, blood collected in the breasts indicates madness.

41. If you wish to ascertain if a woman be with child, give her hydromel
to drink when she is going to sleep, and has not taken supper, and
if she be seized with tormina in the belly, she is with child, but
otherwise she is not pregnant.

42. A woman with child, if it be a male, has a good color, but if
a female, she has a bad color.

43. If erysipelas of the womb seize a woman with child, it will probably
prove fatal.

44. Women who are very lean, have miscarriages when they prove with
child, until they get into better condition.

45. When women, in a moderate condition of body, miscarry in the second
or third month, without any obvious cause, their cotyledones are filled
with mucosity, and cannot support the weight of the foetus, but are
broken asunder.

46. Such women as are immoderately fat, and do not prove with child,
in them it is because the epiploon (fat?) blocks up the mouth of the
womb, and until it be reduced, they do not conceive.

47. If the portion of the uterus seated near the hip-joint suppurate,
it gets into a state requiring to be treated with tents.

48. The male foetus is usually seated in the right, and the female
in the left side.

49. To procure the expulsion of the secundines, apply a sternutatory,
and shut the nostrils and mouth.

50. If you wish to stop the menses in a woman, apply as large a cupping
instrument as possible to the breasts.

51. When women are with child, the mouth of their womb is closed.

52. If in a woman with child, much milk flow from the breasts, it
indicates that the foetus is weak; but if the breasts be firm, it
indicates that the foetus is in a more healthy state.

53. In women that are about to miscarry, the breasts become slender;
but if again they become hard, there will be pain, either in the breasts,
or in the hip-joints, or in the eyes, or in the knees, and they will
not miscarry.

54. When the mouth of the uterus is hard, it is also necessarily shut.

55. Women with child who are seized with fevers, and who are greatly
emaciated, without any (other?) obvious cause, have difficult and
dangerous labors, and if they miscarry, they are in danger.

56. In the female flux (immoderate menstruation?), if convulsion and
deliquium come on, it is bad.

57. When the menses are excessive, diseases take place, and when the
menses are stopped, diseases from the uterus take place.

58. Strangury supervenes upon inflammation of the rectum, and of the
womb, and strangury supervenes upon suppuration of the kidney, and
hiccup upon inflammation of the liver.

59. If a woman do not conceive, and wish to ascertain whether she
can conceive, having wrapped her up in blankets, fumigate below, and
if it appear that the scent passes through the body to the nostrils
and mouth, know that of herself she is not unfruitful.

60. If woman with a child have her courses, it is impossible that
the child can be healthy.

61. If a woman's courses be suppressed, and neither rigor nor fever
has followed, but she has been affected with nausea, you may reckon
her to be with child.

62. Women who have the uterus cold and dense (compact?) do not conceive;
and those also who have the uterus humid, do not conceive, for the
semen is extinguished, and in women whose uterus is very dry, and
very hot, the semen is lost from the want of food; but women whose
uterus is in an intermediate state between these temperaments prove
fertile.

63. And in like manner with respect to males; for either, owing to
the laxity of the body, the pneuma is dissipated outwardly, so as
not to propel the semen, or, owing to its density, the fluid (semen?)
does not pass outwardly; or, owing to coldness, it is not heated so
as to collect in its proper place (seminal vessels?), or, owing to
its heat, the very same thing happens.

64. It is a bad thing to give milk to persons having headache, and
it is also bad to give it in fevers, and to persons whose hypochondria
are swelled up, and troubled with borborygmi, and to thirsty persons;
it is bad also, when given to those who have bilious discharges in
acute fevers, and to those who have copious discharges of blood; but
it is suitable in phthisical cases, when not attended with very much
fever; it is also to be given in fevers of a chronic and weak nature,
when none of the aforementioned symptoms are present, and the patients
are excessively emaciated.

65. When swellings appear on wounds, such cases are not likely to
be attacked either with convulsions, or delirium, but when these disappear
suddenly, if situated behind, spasms and tetanus supervene, and if
before, mania, acute pains of the sides, or suppurations, or dysentery,
if the swellings be rather red.

66. When no swelling appears on severe and bad wounds, it is a great
evil.

67. In such cases, the soft are favorable; and crude, unfavorable.

68. When a person is pained in the back part of the head, he is benefited
by having the straight vein in the forehead opened.

69. Rigors commence in women, especially at the loins, and spread
by the back to the head; and in men also, rather in the posterior
than the anterior side of the body, as from the arms and thighs; the
skin there is rare, as is obvious from the growth of hair on them.

70. Persons attacked with quartans are not readily attacked with convulsions,
or if previously attacked with convulsions, they cease if a quartan
supervene.

71. In those persons in whom the skin is stretched, and parched and
hard, the disease terminates without sweats; but in those in whom
the skin is loose and rare, it terminates with sweats.

72. Persons disposed to jaundice are not very subject to flatulence.
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