Kitap 2
7
Now these signs, though even in the absence of fever, they afford indications of latent or oncoming affections, do so with much more certainty when there is fever in addition; and then signs of other diseases besides may develop. Thus madness is to be apprehended immediately: when a patient speaks more hurriedly than he did when well, and of a sudden becomes loquacious, and that with more audacity than was his wont; or when he breathes slowly and forcibly, and has dilated blood-vessels, while the parts below the ribs are hard and swollen. Further signs of madness are: frequent movement of the eyes, and, in cases of headache, shadows passing before the eyes; or loss of sleep in the absence of pain, the wakefulness persisting night and day; or lying on the belly contrary to habit without being obliged to do so by abdominal pain; or, while the body is still vigorous, an unaccustomed grinding of the teeth. If also there has been congestion which has subsided without the formation of pus, whilst fever persists, there is brought about danger first of delirium, then of death. Acute pain in ear with continuous severe fever also often disturbs the mind; from which affection younger patients die at times within seven days; older ones later, for they experience neither such high fever, nor are equally delirious, hence they hold out until this condition is converted into pus. The breasts of a woman, when they become suffused with blood, also indicate that delirium is about to supervene. But in those in whom fevers are prolonged, there will be an abscess somewhere or pains in the joints. When during fever the breathing in the throat becomes impeded, spasms are impending. If angina subsides suddenly, the malady has passed into the lung; and it is then often fatal within seven days. If that does not happen, it follows that somewhere there is suppuration. Again after a prolonged looseness of the bowels there arise dysenteries, and after these intestinal lubricity; phthisis after excessive runnings from the nose; lung diseases after pain in the side; and from these madness; after ardent fevers rigor or spasm of sinews; after a head wound, delirium; when wakefulness tortures, spasms of sinews; when in wounds blood-vessels throb violently, haemorrhage. But suppuration is induced by many diseases; for if fever continues for a long while without pain and without evident cause, suppuration is developing in some part — in younger patients, however; for generally in the elderly from a self-same malady a quartan fever is developed. Suppuration is likewise being produced if the parts below the ribs are hard and painful, and have not carried off the patient by the twentieth day, or nose-bleeding has not occurred, and this chiefly in the case of adolescents, especially if from the commencement there has been dimness of vision, or headache; but in these cases something is abscessing in the lower parts of the abdomen. Or if the parts below the ribs present a soft swelling which persists and does not subside within sixty days, and fever holds all that time; but in these cases an abscess is being produced in the upper parts of the abdomen. And if it is not produced in the actual viscera, it breaks out around the ears. Whilst every swelling of long standing is generally an expectant abscess, it tends more to this in the region in front of the heart, than in the abdomen, and in the abdomen rather above than below the navel. Something is abscessing, either in the jaws or in the joints, if there is with the fever also a feeling of lassitude. At times too the urine remains thin and unconcocted for so long that other signs are salutary, and from this condition an abscess often occurs below the transverse membrane which the Greeks call diaphragma. Pain in the lung again, when not terminated by expectoration or by blood-letting, or by regulation of the diet, may excite some abscesses in it about the twentieth, thirtieth, fortieth, occasionally sixtieth day. But we will count from the day when there is first fever or shivering or sense of weight in that part. These abscesses originate sometimes from the lung, sometimes from the opposite side. Whichever side is affected the suppuration gives rise to pain in inflammation; it is hotter there, and if the patient lies on the sound side he seems to oppress it by some weight. Further, any suppuration, not yet evident to the eye, can be detected as follows: if the fever does not remit, but whilst diminishing by day, increases at night, there is profuse sweating, a desire to cough, yet hardly anything is expectorated in coughing; the eyes are sunken, the cheeks flushed, the veins under the tongue pale; the finger nails become curved, the fingers hot, especially at their tips; there are swellings in the feet; there is greater difficulty in breathing, and distaste for food; pustules spring up all over the body. But if there was pain from the commencement with cough and difficult breathing, the abscess will burst before or about the twentieth day; if these signs happen later they necessarily have to develop, but the less quickly they come to a head, the later the relief. In a grave disease the feet, toes and nails also tend to blacken; and when death does not follow, and the rest of the body recovers, nevertheless the feet fall off.
