From b98622ac23f77f2301a98421314231b391afc0f1 Mon Sep 17 00:00:00 2001 From: lcerrato Date: Mon, 25 Nov 2024 16:11:38 -0500 Subject: [PATCH] (grc_conversion) tlg0627 further file conversion work: new files #1399 --- data/tlg0627/tlg011/__cts__.xml | 5 + .../tlg011/tlg0627.tlg011.perseus-eng1.xml | 926 +---- .../tlg011/tlg0627.tlg011.perseus-eng2.xml | 162 + data/tlg0627/tlg012/__cts__.xml | 5 + .../tlg012/tlg0627.tlg012.perseus-eng1.xml | 3198 +++++------------ .../tlg012/tlg0627.tlg012.perseus-eng2.xml | 916 +++++ .../tlg012/tlg0627.tlg012.perseus-grc2.xml | 7 +- data/tlg0627/tlg013/__cts__.xml | 5 + .../tlg013/tlg0627.tlg013.perseus-eng1.xml | 96 +- .../tlg013/tlg0627.tlg013.perseus-eng2.xml | 10 +- .../tlg013/tlg0627.tlg013.perseus-eng4.xml | 83 + 11 files changed, 2224 insertions(+), 3189 deletions(-) create mode 100644 data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml create mode 100644 data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml create mode 100644 data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml diff --git a/data/tlg0627/tlg011/__cts__.xml b/data/tlg0627/tlg011/__cts__.xml index 6e4006337..b43f4de9f 100644 --- a/data/tlg0627/tlg011/__cts__.xml +++ b/data/tlg0627/tlg011/__cts__.xml @@ -5,4 +5,9 @@ Μοχλικός Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + + Mochlicus + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng1.xml b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng1.xml index 809c3db99..c9f226b08 100644 --- a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng1.xml +++ b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng1.xml @@ -1,18 +1,36 @@ + - + - Mochlicus or Instruments of Reduction + Mochlicus Hippocrates Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + National Library of Medicine History of Medicine Division - Cultural Heritage Langauge Technologies + Cultural Heritage Language Technologies Kansas City Missouri - February 20, 2003 + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg011.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + @@ -21,10 +39,12 @@ Francis Adams New York - William Wood & Company + William Wood and Company 1886 + 2 + HathiTrust @@ -34,812 +54,108 @@

Data Entry

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This pointer pattern extracts section.

 + - + - English + English + + CTS and EpiDoc conversion. + - - -
- Part 1 -

With regard to the construction of bonesThe brief description of the bones - given in this paragraph is evidently condensed from a larger work on the - subject. A considerable portion of the matter which is found here in an - abridged form, is taken from the preceding treatises, On Fractures and On - the Articulations, but not the whole of it., the bones and joints of - the fingers are simple, the bones of the hand and foot are numerous, and - articulated in various ways; the uppermost are the largest; the heel consists of - one bone which is seen to project outward, and the back tendons are attached to - it. The leg consists of two bones, united together above and below, but slightly - separated in the middle; the external bone (fibula), where - it comes into proximity with the little toe, is but slightly smaller than the - other, more so where they are separated, and at the knee, the outer hamstring - arises from itThe tendon of the biceps.; these bones have a common - epiphysis below, with which the foot is moved, and another epiphys is - aboveIt will be here perceived that by epiphysis is merely meant a - close union of the two bones by means of a ligament. Ther term in this - paragraph is not always used in this sense. Strictly speaking, its - signification would appear to be a protuberance of a bone. It is applied to - the malleoli, to the head of the tibia, to the head and neck of the femur, - to the spinous processes of the vertebrae, to the upper and lower - extremities of the humerus and to the lower extremity of the radius. - in which is moved the articular extremity of the femur, which is simple and - light in proportion to its length, in the form of a condyle, and having the - patella (connected with it?), the femur itself bends outward and forward; its - head is a round epiphysis which gives origin to ligament inserted in the - acetabulum of the hip-jointAllusion is evidently made to the ligamentum - teres.. This bone is articulated somewhat obliquely, but less so than - the humerus. The ischium is united to the great vertebra - contiguous to the os sacrum by a cartilaginous ligamentIt will readily - perceived that the term ischium is not used here exactly as applied by - modern anatomists. It is applied in this place to the ilium where it is - articulated with the os sacrum. By the great verebra, as stated in the - preceding work, is meant the last vertebra of the loins.. The spine, - from the os sacrum to the great vertebra, is curved backward; in this quarter - are situated the bladder, the organs of generation, and the inclined portion of - the rectum; from this to the diaphragm it proceeds in a straight line inclining - forward, and the psoae are situated there; from this point, to the great - vertebra above the tops of the shoulders, it rises in a line that is curved - backward, and the curvature appears greater than it is in reality, for the - posterior processes of the spine are there highest; the articulation of the neck - inclines forward. The vertebrae on the insideMeaning before, that is to - say, at their anterior part. are regularly placed upon one another, - but behind they are connected by a cartilaginous ligament; they are articulated - in the form of synarthrosis at the back part of the spinal marrow; behind they - have a sharp process having a cartilaginous epiphysis, whence proceeds the roots - of nerves running downward, as also muscles extending from the neck to the - loins, and filling the space between the ribs and the spine. The ribs are - connected to all the intervertebral spaces on the inside, from the neck to the - lumbar region, by a small ligament, and before to the sternum, their extremities - being spongy and soft; their form is the most arched in man of all animals; for - in this part, man is, of all animals, the narrowest in proportion to his bulk. - The ribs are united to each vertebra by a small ligament at the place from which - the short and broad lateral processes (transverse - processes?) arise. The sternum is one continuous bone, having lateral - pits for the insertion of the ribs; it is of a spongy and cartilaginous - structure. The clavicles are rounded in front, having some slight movements at - the sternum, but more free at the acromion. The acromion, in man, arises from - the scapula differently from most other animals. The scapula is cartilaginous - toward the spine, and spongy elsewhere, having an irregular figure externally; - its neck and articular cavity cartilaginous; it does not - interfere with the movements of the ribs, and is free of all connection with the - other bones, except the humerus. The head of the humerus is articulated with its - (glenoid?) cavity, by means of a small ligament, and it - consists of a rounded epiphysis composed of spongy cartilage, the humerus itself - is bent outward and forward, and it is articulated with its (glenoid?) cavity by its side, and not in a straight line. At the elbow - it is broad, and has condyles and cavities, and is of a solid consistence; - behind it is a cavity in which the coronoid process (olecranon?) of the ulna is lodged, when the arm is extended; here, - too, is inserted the benumbling nerve, which arises from between the two bones - of the forearm at their junction, and terminates there.

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- Part 2 -

When the nose is fractured, the parts should be modeled instantly, if possible. - If the fracture be in its cartilaginous part, introduce into the nostrils a tent - formed of caddis, inclosed in the outer skin of a Carthaginian hide, or anything - else which does not irritate; the skin is to be glued to the parts displaced, - which are to be thus rectified. Bandaging in this case does mischief. The - treatment is to consist of flour with manna, or of sulphur with cerate. You will - immediately adjust the fragments, and afterward retain them in place with your - fingers introduced into the nostrils, and turning the parts into place; then the - Carthaginian skin is to be used. Callius forms even when there is a wound; and - the same things are to be done, even when there is to be exfoliation of the - bones, for this is not of a serious nature.

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- Part 3 -

In fractures of the ears, neither bandages nor cataplasms should be used; or, if - any bandage be used, it should be put on very tight; the cerate and sulphur - should be applied to agglutinate the bandages. When matter forms in the ears, it - is found to be more deeply seated than might be supposed, for all parts that are - pulpy, and consist of juicy flesh, prove deceptious in such a case. But no harm - will result from making an opening, for the parts are lean, watery, and full of - mucus. No mention is here made of the places and circumstances which render it - fatal to make an opening. The cure is soonest effected by transfixing the ear with a cautery; but the ear is maimed and diminished in - size, if burned across. If opened, one of the gentle medicines for flesh wounds - should be used as a dressing.

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- Part 4 -

The jaw-bone is often slightly displaced (subluxated?), and - is restored again; it is dislocated but rarely, especially in gaping; in fact, - the bone is never dislocated unless it slips while the mouth is opened wide. It - slips, however, the more readily from its ligaments being oblique, supple, and - of a yielding nature. The symptoms are: the lower jaw protrudes, it is distorted - to the side opposite the dislocation, and the patient cannot shut his mouth; - when both sides are dislocated, the jaw projects more, the mouth can be less - shut, but there is no distortion; this is shown by the rows of the teeth in the - upper and lower jaw corresponding with one another. If, then, both sides be - dislocated, and not immediately reduced, the patient for the most part dies on - the tenth day, with symptoms of continued fever, stupor, and coma, for the - muscles there induce such effects; there is disorder of the bowels attended with - scanty and unmixed dejection; and the vomitings, if any, are of the same - character. The other variety is less troublesome. The method of reduction is the - same in both:-The patient being laid down or seated, the physician is to take - hold of his head, and grasping both sides of the jaw-bone with both hands, - within and without, he must perform three manoeuvres at once,-rectify the - position of the jaw, push it backward, and shut the mouth. The treatment should - consist of soothing applications, position, and applying a suitable bandage to - support the jaw-bone, so as to cooperate with the reduction.

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- Part 5 -

The bone of the shoulder is dislocated downward. I have never heard of any other - mode. The parts put on the appearance of dislocation forward, when the flesh - about the joint is wasted during consumption, as also seems to be the case with - cattle when in a state of leanness after winter. Those persons are most liable - to dislocations who are thin, slender, and have humidities about their joints - without inflammation, for it knits the joints. Those who attempt to reduce and - rectify dislocations in oxen, commit a blunder, as forgetting that the symptoms - arise from the manner in which the ox uses the limb, and that the appearance is the same in a man who is in a similar condition, and - forgetting also that Homer has said, that oxen are most lean at that season. In - this dislocation, then, when not reduced, the patient cannot perform any of - those acts which others do, by raising the arm from the side. I have thus stated - who are the persons most subject to this dislocation, and how they are affected. - In congenital dislocations the nearest bones are most shortened, as is the case - with persons who are weasel-armed; the fore-arm less so, - and the hand still less; the bones above are not affected. And the parts (near - the seat of the injury) are most wasted in flesh; and this happens more - especially on the side of the arm opposite the dislocation, and that during - adolescence, yet in a somewhat less degree than in congenital cases. The - deep-seated suppurations occur most frequently to new-born infants about the - joint of the shoulder, and these produce the same consequences as dislocations. - In adults, the bones are not so diminished in size, and justly, seeing that the - others will not increase as in the former case; but wasting of the flesh takes - place, for it is increased, and is diminished every day, and at all ages. And - attention should be paid to the force of habit, and to the symptom produced by - the tearing away of the acromion, whereby a void is left, which makes people - suppose that the humerus is dislocated. The head of the humerus is felt in the - armpit, and the patient cannot raise his arm, nor swing it to this side and - that, as formerly. The other shoulder shows the difference. Modes of - reduction:-The patient himself having placed his fist in the arm pit, pushes up - the head of the humerus with it, and brings the hand forward to the breast. - Another:-Force it backward, so that you may turn it round. Another:-Apply your - head to the acromion, and your hands to the armpit, separate the head of the - humerus (from the side?), and push the elbow in the - opposite direction; or, instead of your knees, another person may turn aside the - elbow, as formerly directed. Or, place the patient on your shoulder, with the - shoulder in his armpit. Or, with the heel, something being introduced to fill up - the hollow of the armpit, and using the right foot to the right shoulder. Or, - with a pestle. Or, with the step of a ladder. Or, by rotation made with piece of - wood stretched below the arm. Treatment:-As to attitude, the arm - placed by the side, the hand and shoulder raised; the bandaging and adjustment - of the parts while in this attitude. If not reduced, the top of the shoulder - becomes attenuated.

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- Part 6 -

When the acromion is torn away, the appearance is the same as in dislocation of - the shoulder; but there is no impediment, except that the bone does not return - to its position. The figure should be the same as in dislocation, both as - regards bandaging and suspending the limb. The bandaging according to rule.

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- Part 7 -

When partial displacement (sub-luxation?) takes place at - the elbow, either inside or outside, but the sharp point (olecranon?) remains in the cavity of the humerus, make extension in a - straight line, and push the projecting parts backward and to the sides.

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- Part 8 -

In complete dislocations to either side, make extension while the arm is in the - position it is put in to be bandaged for a fracture, for thus the rounded part - of the elbow will not form an obstacle to it. Dislocation most commonly takes - place inward. The parts are to be adjusted by separating the bones as much as - possible, so that the end of the humerus may not come in contact with the - olecranon, but it is to be carried up and turned round, and not forced in a - straight line; at the same time the opposite sides are to be pushed together, - and the bones reduced to their place. In these cases rotation of the elbow - cooperates; that is to say, turning the arm into a state of supination and - pronation; so much for the reduction. With regard to the attitude in which it is - to be put,-the hand is to be placed somewhat higher than the elbow, and the arm - by the side; this position suits with it when slung from the neck, is easily - borne, is its natural position, and one adapted for ordinary purposes, unless - callus form improperly: the callus soon forms. Treatment:-By bandages according - to the common rule for articulations, and the point of the elbow is to be - included in the bandage.

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- Part 9 -

The elbow, when luxated, induces the most serious consequences, fevers, pain, - nausea, vomiting of pure bile; and this especially in dislocations backward, - from pressure on the nerve which occasions numbness; next to it is dislocation - forward. The treatment is the same. The reduction of dislocation - backward is by extension and adaptation: the symptom of this variety, loss of - the power of extension; of dislocation forward, loss of the power of flexion. In - it a hard ball is to be placed in the bend of the elbow, and the fore-arm is to - be bent over this while sudden extension is made.

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- Part 10 -

Diastasis of the bones may be recognized by examining the part where the vein - which runs along the arm divides.

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- Part 11 -

In these cases callus is speedily formed. In congenital dislocations, the bones - below the seat of the injury are shorter than natural; in this case, the - greatest shortening is in the nearest, namely, those of the fore-arm; second, - those of the hand; third, those of the fingers. The arm and shoulders are - stronger, owing to the nourishment which they receive, and the other arm, from - the additional work it has to perform, is still more strong. The wasting of the - flesh, if the dislocation was outward, is on the inside; or if otherwise, on the - side opposite the dislocation.

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- Part 12 -

In dislocation at the elbow, whether outward or inward, extension is to be made - with the fore-arm at right angles to the arm; the arm is to be suspended by a - shawl passed through the armpit, and a weight is to be attached to the extremity - of the elbow; or force is to be applied with the hands. The articular extremity - being properly raised, the parts are to be adjusted with the palms of the hands, - as in dislocations of the hands. It is to be bandaged, suspended in a sling, and - placed, while in this attitude.

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- Part 13 -

Dislocations backward are to be rectified with the palms of the hands along with - sudden extension. These two acts are to be performed together, as in other cases - of the kind. In dislocation forward, the arm is to bend around a ball of cloth, - of proper size, and at the same time replaced.

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- Part 14 -

If the displacement be on the other side both these operations are to be - performed in effecting the adjustment of the arm. With regard to the - treatment,-the position and the bandaging are the same as in the other cases. - For all these cases may be reduced by ordinary distention.

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- Part 15 -

With regard to the modes of reduction, some act upon the principle of carrying the one piece of bone over the other, some by extension, - and some by rotation: these last consist in rapidly turning the arm to this side - and that.

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- Part 16 -

The joint of the hand is dislocated inward or outward, but most frequently - inward. The symptoms are easily recognized; if inward, the patient cannot at all - bend his fingers, but if outward, he cannot extend them. Reduction:-By placing - the fingers above a table, extension and counter-extension are to be made by - assistance, while, with the palm of the hand or the heel on the projecting bone, - one presses forward, and from behind, upon the other bone, and lays some soft - substance on it; and, if the dislocation be above, the hand is to be turned into - a state of pronation; or, if backward, into a state of supination. The treatment - is to be conducted with bandages.

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- Part 17 -

The whole hand is dislocated either inward, or outward, but especially inward, - or to this side or that. Sometimes the epiphysis is displaced, and sometimes - there is displacement (diastasis) of the one bone from the - other. Powerful extension is to be made in this case; and the projecting part is - to be pressed upon, and counter-pressure made on the opposite side: both modes - being performed at the same time, both backward and laterally, either with the - hands on a table, or with the heel. These accidents give rise to serious - consequences and deformities; but in time the parts get so strong as to admit of - being used. The treatment consists of bandages comprehending the hand and - forearm, and splints are to be applied as far as the fingers; when put in - splints, they are to be more frequently loosed than in fractures, and more - copious allusions of water are to be used.

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- Part 18 -

In congenital dislocations the hand becomes shortened, and the atrophy of the - flesh is generally on the side opposite the dislocation. In the adult the bones - remain of their proper size.

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- Part 19 -

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

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- Part 20 -

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

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- Part 21 -

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

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- Part 22 -

When there is a dislocation on both sides, the affections of the bones are the - same; the flesh is well developed, except within, the nates protrude, the thighs - are arched, unless there be sphacelus. If there be curvature of the spine above - the hip-joint, the patients enjoy good health, but the body does not grow, with - the exception of the head.

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- Part 23 -

The symptoms of dislocation backward are:-The parts before more empty, behind - they protrude, the foot straight, flexion impossible, except with pain, - extension least of all: in these the limb is shortened. They can neither extend - the limb at the ham, nor at the groin, unless it be much raised, nor can they - bend it. The uppermost joint, in most cases, takes the lead: this is common in - joints, nerves, muscles, intestines, uteri, and other parts. There the bone of - the hip-joint is carried backward to the nates, and on that account it is - shortened, and because the patient cannot extend it. The flesh of the whole leg - is wasted in all cases, in which most, and to what extent, has been already - stated. Every part of the body which performs its functional work is strong, - but, not withstanding, if inactive, it gets into a bad condition, - unless its inactivity arise from fatigue, fever, or inflammation. And in - dislocations outward, the limb is shortened, because the bone is lodged in flesh - which yields; but, not withstanding, in dislocations inward, it is longer, - because the bone is lodged on a projecting bone. Adults, then, who have this - dislocation unreduced, are bent at the groins in walking, and the other ham is - flexed; they scarcely reach the ground with the ball of the foot; they grasp the - limb with the hand, and walk without a staff if they choose; if the staff be too - long, their foot cannot reach the grounds-if they wish to reach the ground, they - must use a short staff. There is wasting of the flesh in cases attended with - pain; and the inclination of the leg is forward, and the sound leg in - proportion. In congenital cases, or when in adolescence, or from disease, the - bone is dislocated (under what circumstances will be explained afterward), the - limb is particularly impaired, owing to the nerves and joints not being - exercised, and the knee is impaired for the reasons stated. These persons, - keeping the limb bent, walk with one staff or two. But the sound limb is in good - flesh from usage.

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- Part 24 -

In dislocations forward the symptoms are the opposite: a vacuity behind, a - protuberance before; of all motions they can least perform flexion, and - extension best; the foot is straight, the limb is of the proper length at the - heel; at its extremity the foot a little turned up; they are especially pained - at first: of all these dislocations retention of urine occurs most frequently in - this variety, because the bone is lodged among important nerves. The fore parts - are stretched, do not grow, are diseased, and are obnoxious to premature decay; - the back parts are wrinkled. In the case of adults, they walk erect, resting - merely on the heel, and this they do decidedly if they can take great steps; but - they drag it along; the wasting is least of all in this variety of dislocation, - owing to their being able to use the limb, but the wasting is most behind. The - whole limb being straighter than natural they stand in need of a staff on the - affected side. When the dislocation is congenital, or has occurred during - adolescence, if properly managed, the patient has the use of the limb as well as - adults (otherwise?) have of it. But, if neglected, it is shortened and extended, for in such cases the joint is generally in a straight position. - The diminution of the bones, and wasting of the fleshy parts, are analogous. -

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- Part 25 -

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

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- Part 26 -

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

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- Part 27 -

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

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- Part 28 -

Dislocations of the bones of the foot are to be treated like those of the hand. -

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- Part 29 -

Dislocations of the bones connected with the leg, if not reduced, whether - occurring at birth or during adolescence, are of the same character as those in - the hand.

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- Part 30 -

Persons who, in jumping from a height, have pitched on the heel, so as to - occasion diastasis (separation) of the bones, ecchymosis of the veins, and - contusion of the nerves,-when these symptoms are very violent, there is danger - that the parts may sphacelate, and give trouble to the patient during the - remainder of his life; for these bones are so constructed as to slip past one - another, and the nerves communicate together. And, likewise in cases of - fracture, either from an injury in the leg or thigh, or in paralysis of the - nerves connected with these parts, or, when in any other case of confinement to - bed the heel, from neglect, becomes blackened, in all these cases serious - effects result therefrom. Sometimes, in addition to the sphacelus, very acute - fevers supervene, attended with hiccup, tumors, aberration of intellect, and - speedy death, along with lividity of the large bloodvessels, and gangrene. The - symptoms of the exacerbations are these: if the ecchymosis, the blackened parts, - and those around them, be somewhat hard and red, and if lividity be combined - with the hardness, there is danger of mortification; but, not withstanding, if - the parts are sublivid, or even very livid and diffused, or greenish and soft, - these symptoms, in all such cases, are favorable. The treatment consists in the - administration of hellebore, if they be free from fever, but otherwise, they are - to have oxyglyky for drink, if re-quired. - Bandaging,-agreeably to the rule in other joints; but this is to be attended to - also,-the bandages should be numerous, and softer than usual; compression less; - more water than usual to be used in the allusions; to be applied especially to - the heel. The same object should be sought after in the position as in the - bandaging, namely, that the humors may not be determined to the heel; the limb - to be well laid should have the heel higher than the knee. Splints not to be - used.

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- Part 31 -

When the foot is dislocated, either alone, or with the epiphysis, the - displacement is more apt to be inward. If not reduced, in the course of time the - parts of the hips, thigh, and leg, opposite the dislocation, become attenuated. - Reduction:-As in dislocation at the wrist; but the extension requires to be very - powerful. Treatment:-Agreeably to the rule laid down for the other joints. Less - apt to be followed by serious consequences than the wrist, if kept quiet. Diet - restricted, as being in an inactive state. Those occurring at birth, or during - adolescence, observe the rule formerly stated.

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- Part 32 -

With regard to slight congenital dislocations, some of them can be rectified, - especially club-foot. There is more than one variety of club-foot. The treatment - consists in modeling the foot like a piece of wax; applying resinous cerate, and - numerous bandages; or a sole, or a piece of lead is to be bound on, but not upon - the bare skin; the adjustment and attitudes to correspond.

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- Part 33 -

If the dislocated bones cause a wound in the skin, and protrude, it is better to - let them alone, provided only they are not allowed to hang, nor are compressed. - The treatment consists in applying pitched cerate, or compresses dipped in hot - wine (for cold is bad in all such cases), and certain leaves; but in winter - unwashed wool may be applied as a cover to the part; neither cataplasms nor - bandaging; restricted diet. Cold, great weight, compression, violence, - restricted position, all such are to be accounted as fatal measures. When - treated moderately (they escape), maimed and deformed; for, if the dislocation - be at the ankle, the foot is drawn upward, and, if elsewhere, according to the - same rule. The bones do not readily exfoliate; for only small portions of them - are denuded, and they heal by narrow cicatrices. The danger is - greatest in the greatest joints, and those highest up. The only chance of - recovery is, if they are not reduced, except at the fingers and hand, and in - these cases the danger should be announced beforehand. Attempts at reduction to - be made on the first or second day; or, if not accomplished then, on the tenth, - by no means on the fourth. Reduction by levers. Treatment:-As in injuries of the - bones of the head, and the part is to be kept hot; and it is better to give - hellebore immediately after the parts have been reduced. With regard to the - other bones, it should be well known, that, if replaced, death will be the - consequence; the more surely and expeditiously, the greater the articulation, - and the more high its situation. Dislocation of the foot is attended with spasm - (tetanus) and gangrene; and if, upon its being replaced, any of these symptoms - come on, the chance of recovery, if there be any chance, is in displacing it - anew; for spasms do not arise from relaxation, but from tension of the parts. -

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- Part 34 -

Excision, either of articular bones or of pieces of bones, when not high up in - the body, but about the foot or the hand, is generally followed by recovery, - unless the patient die at once from deliquium animi. Treatment:-As in injuries - of the head; warmth.

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- Part 35 -

Sphacelus of the fleshy parts is produced by the tight compression of bleeding - wounds, and by pressure in the fractures of bones, and by blackening, arising - from bandages. And in those cases in which a portion of the thigh or arm, both - the bones and the flesh drop off, many recover, the case being less dangerous - than many others. In cases, then, connected with fracture of the bones, the - separation of the flesh quickly takes place, but the separation of the bone, at - the boundary of its denuded part, is slower in taking place. But the parts below - the seat of the injury, and the sound portion of the body, are to be previously - taken away (for they die previously), taking care to avoid producing pain, for - deliquium animi may occasion death. The bone of the - thigh in such a case came away on the eightieth day, but the leg was removed on - the twentieth day. The bones of the leg, in a certain case, came away at the - middle of the sixtieth day. In these cases the separation is - quick or slow, according to the compression applied by the physician. When the - compression is gently applied the bones do not drop off at all, neither are they - denuded of flesh, but the gangrene is confined in the more superficial parts. - The treatment of such cases must be undertaken; for most of them are more - formidable in appearance than in reality. The treatment should be mild, but, not - withstanding, with a restricted diet; hemorrhages and cold are to be dreaded; - the position, so as that the limb may be inclined upward, and afterward, on - account of the purulent abscess, horizontally, or such as may suit with it. In - such cases, and in mortifications, there are usually, about the crisis, - hemorrhages and crisis, hemorrhages and violent diarrhoeas, which, however, only - last for a few days; the patients do not lose their appetite, neither are they - feverish, nor should they be put upon a reduced diet.

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- Part 36 -

Displacement of the spine, if inward, threatens immediate death, attended with - retention of urine and loss of sensibility. Outward, the accident is free from - most of these bad effects, much more so than where there is merely concussion - without displacement; the effects in the former case being confined to the spot - affected, whereas in the latter they are further communicated to the whole body, - and are of a mortal character. In like manner, when the ribs are fractured, - whether one or more, provided there be no splinters, there is rarely fever, - spitting of blood, and sphacelus, and ordinary treatment without evacuation will - suffice, provided there be no fever;-bandaging, according to rule; and the - callus forms in twenty days, the bone being of a porous nature. But in cases of - contusion, tubercles form, along with cough, suppurating sores, and sphacelus of - the ribs, for nerves from all the parts run along each rib. In many of these - cases haemoptysis and empyema also take place. The management of this case - consists in careful treatment, bandaging according to rule, diet at first - restricted, but afterward more liberal, quiet, silence, position, bowels, and - venereal matters regulated. Even when there is no spitting of blood, these - contusions are more painful than fractures, and are more subject in time to - relapses; and when any mucous collection is left in the part, it makes itself be - felt in disorders of the body. Treatment:-burning, when the bone is affected, down to the bone, but not touching the bone itself; if - in the intercostal space, the burning must not extend through it, nor be too - superficial. In sphacelus of the ribs, tents are to be tried, all other - particulars will be stated afterward: but they should be learned by sight rather - than by words, namely, food, drink, heat, cold, attitude; medicines, dry, - liquid, red, dark, white, sour, for the ulcers, and so with regard to the diet. -

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- Part 37 -

Displacements (of the vertebrae) from a fall rarely admit - of being rectified, and those above the diaphragm are most difficult to rectify. - When the accident happens to children, the body does not grow, with the - exception of the legs, the arms, and head. Excurvation, in adults, speedily - relieves the individual from the disease he is laboring under, but in time it - renews its attack, with the same symptoms as in children, but of a less serious - nature. Some individuals have borne this affection well, and have turned out to - be brawny and fat. But few of them have lived to the age of sixty. Lateral - curvatures also occur, the proximate cause of which is the attitudes in which - these persons lie. These cases have their prognostics accordingly.

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- Part 38 -

The rule for the reduction and adjustment:-The axle, the lever, the wedge, - pressure above; the axle to separate, the lever to push aside. Reduction and - adjustment are to be accomplished by forcible extension, the parts being placed - in such a position as will facilitate the conveying of the displaced bone over - the extremity of the bone from which it was displaced: this is to be - accomplished either with the hands, or by suspension, or axles, or turned round - something. With the hands this is to be effected properly, according to the - structure of the parts. In the case of the wrist and elbow, the parts are to be - forced asunder, at the wrist in the line of the elbow, and the elbow with the - fore-arm at a right angle with the arm, as when it is suspended in a sling. When - we want to separate the protruding bones, and force them into place, in the case - of the fingers, the toes, or the wrist, the proper separation may be made by - hands, while the projecting part is forced into its place by pressing down with - the heel or the palm of the hand upon some resisting object, while something - moderately soft is laid under the projecting part, but nothing such under the other, and then pressure is to be made backward and downward, - whether the dislocation be inward or outward. In lateral displacement, pressure - and counter-pressure must be made on the opposite sides. Displacements forward - can be reduced neither by sneezing, nor coughing, nor by the injection of air, - nor by the cupping-instrument; and if anything can do good in such a case, it is - extension. People are deceived in fractures of the spinal processes, the pain of - which causing the patient to stoop forward, the case is taken for dislocation - inward; these fractures heal speedily and easily. Dislocation outward is to be - remedied by succussion, when high up, toward the feet; and when situated low - down, in the contrary direction; the part is to be pressed back into its place, - either with the foot or a board. Dislocations to either side, if they admit of - any remedy, are to be treated by extension, and suitable attitudes, with - regimen. The whole apparatus should be broad, soft, and strong; or otherwise, - they should be wrapped in rags; before being used, they should all be prepared - proportionately to the length, height, and breadth. In applying extension to the - thigh, for example, the bands should be fastened at the ankle and above the - knee, these stretching in the same direction, another band to be passed by the - loins, and around the armpits, and by the perineum and thigh, one end passing up - the breast and the other along the back, these all stretching in the same - direction and being fastened either to a piece of wood resembling a pestle or to - an axle. When this is done on a couch, either of its feet is to be fastened to - the threshold, and a strong block of wood is to be laid across the other, and - the pieces of wood resembling a pestle are to be raised on these, to make - extension and counter-extension; the naves of a wheel are to be fastened in the - floor, or a ladder is to be adjusted, so that extension may be made in both - directions. The thing commonly used is a bench six cubits long, two cubits - broad, one fathom in thickness, having two low axles at this end and that, and - having at its middle two moderate sized pillars, to which is to be adjusted a - transverse piece of wood like the step of a ladder, which is to receive the - piece of wood tied below the limb, as is done in dislocation at the shoulder; - and the bench is to have excavations like trays, smooth, four - inches in breadth and depth, and at such an interval as to leave room for the - lever used to reduce the limb. In the middle of the bench a square hole is to be - scooped out to receive a small pillar, which, being adjusted to the perineum, - will obviate the tendency of the body to slip downward, and being rather loose - may act somewhat as a lever. In certain occasions a piece of wood is required, - which is inserted into a hole scooped out of the wall; the other end of it is - then to be pressed down, something moderately soft being placed under it.

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- Part 39 -

In those cases where the bone of the palate has exfoliated, the nose sinks in - its middle. In contusions of the head without a wound, either from a fall, a - fracture, or pressure, in certain of these cases acrid humors descend from the - head to the throat, and from the wound in the head to the liver and thigh.

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- Part 40 -

The symptoms of subluxations and luxations, and where, and how, and how much - these differ from one another. And the cases in which the articular cavity has - been broke off, and in which the ligament has been torn, and in which the - epiphysis has broken in which, and how, when the limb consists of two bones, one - or both are broken: in consequence of these the dangers, chances in which bad, - and when the injuries will result in death, and when in recovery. What cases are - to be reduced or attempted, and when, and which, and when not; the hopes and - dangers in these cases. Which and when congenital dislocations are to be - undertaken: the parts in a state of growth, the parts fully grown, and why - sooner, or slower: and why a part becomes maimed, and how, and how not: and why - a certain part is atrophied, and where, and how, and in what cases to a less - extent. And why fractured parts unite sooner or slower, how distortions and - callosities form, and the remedy for them. In what cases there are external - wounds, either at first or afterwards: in what fractures the bones are - shortened, and in what not: in what cases the fractured bones protrude, and when - they protrude most: in what cases dislocated bones protrude. That physicians are - deceived, and by what means, in what they see, and in what they devise, - regarding affections, and regarding cures. Established rules with regard to - bandaging: preparation, presentation of the part, extension, - adjustment, friction, bandaging, suspension and placing of the limb, attitude, - seasons, diet. The more porous parts heal fastest, and vice versa. Distortions, - where the bones are crooked. Flesh and tendons wasted on the side of the - dislocation. The force used in reduction to be applied at as great a distance as - possible from the seat of the displacement. Of nerves (ligaments?), those which are in motion and in humidity (flabby?) are of a yielding nature; those that are not, less - so. In every dislocation the most speedy reduction is best. Reduction not to be - made while the patient is in a febrile state, nor on the fourth or fifth day; - and least of all, in those of the elbow, and all cases which induce torpor; the - soonest the best, provided the inflammatory stage be avoided. Parts torn - asunder, whether nerves, or cartilages, or epiphyses, or parts separated at - symphyses, cannot possibly be restored to their former state; but callus is - quickly formed in most cases, yet the use of the limb is preserved. Of - luxations, those nearest the extremities are least dangerous. Those joints which - are most easily dislocated are the least subject to inflammation. Those which - have been least inflamed, and have not been subjected to after-treatment, are - most liable to be dislocated anew. Extension should be made in the position most - calculated to enable the one bone to clear the extremity of the other, attention - being paid to configuration and place. Adjustment to be made in the direction of - the displacement; to push the displaced limb straight backward and sideways. - Parts suddenly drawn aside are to be suddenly drawn back by a rotatory motion. - Articulations which have been oftenest dislocated are the most easily reduced; - the cause is the conformation of the nerves (ligaments?) or - of the bones; of the ligaments that they are long and yielding; and of the - bones, the shallowness of the articular cavity, and roundness of the head [of - the bone that enters it]. Usage, by its friction, forms a new socket. The - cause-the disposition, and habit, and age. A part somewhat mucous is not subject - to inflammation.

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- Part 41 -

In those cases where there are wounds, either at first, or from protrusion of - the bones; or afterwards, from pruritus, or irritation; in the - latter case you are immediately to unloose the bandages, and having applied - pitched cerate to the wound, bandage the limb, placing the head of the roller - upon the wound, and proceeding otherwise as if there were no wound in the case; - for thus will the swelling be reduced as much as possible, and the wound will - suppurate most quickly, and the diseased parts will separate, and when it - becomes clean the wound will most quickly heal. Splints are not to be applied to - the place, nor is it to be bound tight. Proceed thus when no large bones - exfoliate, but not in the latter case, for then there is great suppuration, and - the same treatment is not applicable, but the parts require to be exposed to the - air on account of the abscesses. In such cases where the bones protrude, and - whether reduced or not, bandaging is not befitting, but distention is to be - practiced by means of rolls of cloth, made like those used upon shackles; one of - these is to be placed at the ankle, and the other at the knee; they are to be - flattened toward the leg, soft, strong, and having rings; and rods made of - cornel, and of a proper length and thickness are to be adjusted to them, so as - to keep the parts distended; and straps, attached to both extremities, are to be - inserted into the rings, so that the extremities being fixed into the rolls, may - effect distention. Treatment:-Pitched cerate, in a hot state; the attitudes, - position of the foot and hip; regulated diet. The bones which have protruded - through the skin are to be replaced the same day, or next; not on the fourth or - fifth, but when the swelling has subsided. Reduction is to be performed with - levers; when the bone does not present any place upon which the lever can rest, - a portion of the part which prevents this is to be sawed off. But the denuded - parts will drop off, and the limb become shortened.

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- Part 42 -

Dislocations at the joints are to a greater and less extent. Those that are to a - less extent are the most easily reduced; those that are to a greater extent - occasion lesions of the bones, of the ligaments, of the joints, of the fleshy - parts, and of the attitudes. The thigh and arm resemble one another very much in - their dislocations. -

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With regard to the construction of bonesThe brief description of the bones given in this paragraph is evidently condensed from a larger work on the subject. A considerable portion of the matter which is found here in an abridged form, is taken from the preceding treatises, On Fractures and On the Articulations, but not the whole of it., the bones and joints of the fingers are simple, the bones of the hand and foot are numerous, and articulated in various ways; the uppermost are the largest; the heel consists of one bone which is seen to project outward, and the back tendons are attached to it. The leg consists of two bones, united together above and below, but slightly separated in the middle; the external bone (fibula), where it comes into proximity with the little toe, is but slightly smaller than the other, more so where they are separated, and at the knee, the outer hamstring arises from itThe tendon of the biceps.; these bones have a common epiphysis below, with which the foot is moved, and another epiphys is aboveIt will be here perceived that by epiphysis is merely meant a close union of the two bones by means of a ligament. Ther term in this paragraph is not always used in this sense. Strictly speaking, its signification would appear to be a protuberance of a bone. It is applied to the malleoli, to the head of the tibia, to the head and neck of the femur, to the spinous processes of the vertebrae, to the upper and lower extremities of the humerus and to the lower extremity of the radius. in which is moved the articular extremity of the femur, which is simple and light in proportion to its length, in the form of a condyle, and having the patella (connected with it?), the femur itself bends outward and forward; its head is a round epiphysis which gives origin to ligament inserted in the acetabulum of the hip-jointAllusion is evidently made to the ligamentum teres.. This bone is articulated somewhat obliquely, but less so than the humerus. The ischium is united to the great vertebra contiguous to the os sacrum by a cartilaginous ligamentIt will readily perceived that the term ischium is not used here exactly as applied by modern anatomists. It is applied in this place to the ilium where it is articulated with the os sacrum. By the great verebra, as stated in the preceding work, is meant the last vertebra of the loins.. The spine, from the os sacrum to the great vertebra, is curved backward; in this quarter are situated the bladder, the organs of generation, and the inclined portion of the rectum; from this to the diaphragm it proceeds in a straight line inclining forward, and the psoae are situated there; from this point, to the great vertebra above the tops of the shoulders, it rises in a line that is curved backward, and the curvature appears greater than it is in reality, for the posterior processes of the spine are there highest; the articulation of the neck inclines forward. The vertebrae on the insideMeaning before, that is to say, at their anterior part. are regularly placed upon one another, but behind they are connected by a cartilaginous ligament; they are articulated in the form of synarthrosis at the back part of the spinal marrow; behind they have a sharp process having a cartilaginous epiphysis, whence proceeds the roots of nerves running downward, as also muscles extending from the neck to the loins, and filling the space between the ribs and the spine. The ribs are connected to all the intervertebral spaces on the inside, from the neck to the lumbar region, by a small ligament, and before to the sternum, their extremities being spongy and soft; their form is the most arched in man of all animals; for in this part, man is, of all animals, the narrowest in proportion to his bulk. The ribs are united to each vertebra by a small ligament at the place from which the short and broad lateral processes (transverse processes?) arise. The sternum is one continuous bone, having lateral pits for the insertion of the ribs; it is of a spongy and cartilaginous structure. The clavicles are rounded in front, having some slight movements at the sternum, but more free at the acromion. The acromion, in man, arises from the scapula differently from most other animals. The scapula is cartilaginous toward the spine, and spongy elsewhere, having an irregular figure externally; its neck and articular cavity cartilaginous; it does not interfere with the movements of the ribs, and is free of all connection with the other bones, except the humerus. The head of the humerus is articulated with its (glenoid?) cavity, by means of a small ligament, and it consists of a rounded epiphysis composed of spongy cartilage, the humerus itself is bent outward and forward, and it is articulated with its (glenoid?) cavity by its side, and not in a straight line. At the elbow it is broad, and has condyles and cavities, and is of a solid consistence; behind it is a cavity in which the coronoid process (olecranon?) of the ulna is lodged, when the arm is extended; here, too, is inserted the benumbling nerve, which arises from between the two bones of the forearm at their junction, and terminates there.

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When the nose is fractured, the parts should be modeled instantly, if possible. If the fracture be in its cartilaginous part, introduce into the nostrils a tent formed of caddis, inclosed in the outer skin of a Carthaginian hide, or anything else which does not irritate; the skin is to be glued to the parts displaced, which are to be thus rectified. Bandaging in this case does mischief. The treatment is to consist of flour with manna, or of sulphur with cerate. You will immediately adjust the fragments, and afterward retain them in place with your fingers introduced into the nostrils, and turning the parts into place; then the Carthaginian skin is to be used. Callius forms even when there is a wound; and the same things are to be done, even when there is to be exfoliation of the bones, for this is not of a serious nature.

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In fractures of the ears, neither bandages nor cataplasms should be used; or, if any bandage be used, it should be put on very tight; the cerate and sulphur should be applied to agglutinate the bandages. When matter forms in the ears, it is found to be more deeply seated than might be supposed, for all parts that are pulpy, and consist of juicy flesh, prove deceptious in such a case. But no harm will result from making an opening, for the parts are lean, watery, and full of mucus. No mention is here made of the places and circumstances which render it fatal to make an opening. The cure is soonest effected by transfixing the ear with a cautery; but the ear is maimed and diminished in size, if burned across. If opened, one of the gentle medicines for flesh wounds should be used as a dressing.

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The jaw-bone is often slightly displaced (subluxated?), and is restored again; it is dislocated but rarely, especially in gaping; in fact, the bone is never dislocated unless it slips while the mouth is opened wide. It slips, however, the more readily from its ligaments being oblique, supple, and of a yielding nature. The symptoms are: the lower jaw protrudes, it is distorted to the side opposite the dislocation, and the patient cannot shut his mouth; when both sides are dislocated, the jaw projects more, the mouth can be less shut, but there is no distortion; this is shown by the rows of the teeth in the upper and lower jaw corresponding with one another. If, then, both sides be dislocated, and not immediately reduced, the patient for the most part dies on the tenth day, with symptoms of continued fever, stupor, and coma, for the muscles there induce such effects; there is disorder of the bowels attended with scanty and unmixed dejection; and the vomitings, if any, are of the same character. The other variety is less troublesome. The method of reduction is the same in both:—The patient being laid down or seated, the physician is to take hold of his head, and grasping both sides of the jaw-bone with both hands, within and without, he must perform three manoeuvres at once,-rectify the position of the jaw, push it backward, and shut the mouth. The treatment should consist of soothing applications, position, and applying a suitable bandage to support the jaw-bone, so as to cooperate with the reduction.

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The bone of the shoulder is dislocated downward. I have never heard of any other mode. The parts put on the appearance of dislocation forward, when the flesh about the joint is wasted during consumption, as also seems to be the case with cattle when in a state of leanness after winter. Those persons are most liable to dislocations who are thin, slender, and have humidities about their joints without inflammation, for it knits the joints. Those who attempt to reduce and rectify dislocations in oxen, commit a blunder, as forgetting that the symptoms arise from the manner in which the ox uses the limb, and that the appearance is the same in a man who is in a similar condition, and forgetting also that Homer has said, that oxen are most lean at that season. In this dislocation, then, when not reduced, the patient cannot perform any of those acts which others do, by raising the arm from the side. I have thus stated who are the persons most subject to this dislocation, and how they are affected. In congenital dislocations the nearest bones are most shortened, as is the case with persons who are weasel-armed; the fore-arm less so, and the hand still less; the bones above are not affected. And the parts (near the seat of the injury) are most wasted in flesh; and this happens more especially on the side of the arm opposite the dislocation, and that during adolescence, yet in a somewhat less degree than in congenital cases. The deep-seated suppurations occur most frequently to new-born infants about the joint of the shoulder, and these produce the same consequences as dislocations. In adults, the bones are not so diminished in size, and justly, seeing that the others will not increase as in the former case; but wasting of the flesh takes place, for it is increased, and is diminished every day, and at all ages. And attention should be paid to the force of habit, and to the symptom produced by the tearing away of the acromion, whereby a void is left, which makes people suppose that the humerus is dislocated. The head of the humerus is felt in the armpit, and the patient cannot raise his arm, nor swing it to this side and that, as formerly. The other shoulder shows the difference. Modes of reduction:—The patient himself having placed his fist in the arm pit, pushes up the head of the humerus with it, and brings the hand forward to the breast. Another:—Force it backward, so that you may turn it round. Another:—Apply your head to the acromion, and your hands to the armpit, separate the head of the humerus (from the side?), and push the elbow in the opposite direction; or, instead of your knees, another person may turn aside the elbow, as formerly directed. Or, place the patient on your shoulder, with the shoulder in his armpit. Or, with the heel, something being introduced to fill up the hollow of the armpit, and using the right foot to the right shoulder. Or, with a pestle. Or, with the step of a ladder. Or, by rotation made with piece of wood stretched below the arm. Treatment:—As to attitude, the arm placed by the side, the hand and shoulder raised; the bandaging and adjustment of the parts while in this attitude. If not reduced, the top of the shoulder becomes attenuated.

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When the acromion is torn away, the appearance is the same as in dislocation of the shoulder; but there is no impediment, except that the bone does not return to its position. The figure should be the same as in dislocation, both as regards bandaging and suspending the limb. The bandaging according to rule.

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When partial displacement (sub-luxation?) takes place at the elbow, either inside or outside, but the sharp point (olecranon?) remains in the cavity of the humerus, make extension in a straight line, and push the projecting parts backward and to the sides.

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In complete dislocations to either side, make extension while the arm is in the position it is put in to be bandaged for a fracture, for thus the rounded part of the elbow will not form an obstacle to it. Dislocation most commonly takes place inward. The parts are to be adjusted by separating the bones as much as possible, so that the end of the humerus may not come in contact with the olecranon, but it is to be carried up and turned round, and not forced in a straight line; at the same time the opposite sides are to be pushed together, and the bones reduced to their place. In these cases rotation of the elbow cooperates; that is to say, turning the arm into a state of supination and pronation; so much for the reduction. With regard to the attitude in which it is to be put,-the hand is to be placed somewhat higher than the elbow, and the arm by the side; this position suits with it when slung from the neck, is easily borne, is its natural position, and one adapted for ordinary purposes, unless callus form improperly: the callus soon forms. Treatment:—By bandages according to the common rule for articulations, and the point of the elbow is to be included in the bandage.

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The elbow, when luxated, induces the most serious consequences, fevers, pain, nausea, vomiting of pure bile; and this especially in dislocations backward, from pressure on the nerve which occasions numbness; next to it is dislocation forward. The treatment is the same. The reduction of dislocation backward is by extension and adaptation: the symptom of this variety, loss of the power of extension; of dislocation forward, loss of the power of flexion. In it a hard ball is to be placed in the bend of the elbow, and the fore-arm is to be bent over this while sudden extension is made.

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Diastasis of the bones may be recognized by examining the part where the vein which runs along the arm divides.

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In these cases callus is speedily formed. In congenital dislocations, the bones below the seat of the injury are shorter than natural; in this case, the greatest shortening is in the nearest, namely, those of the fore-arm; second, those of the hand; third, those of the fingers. The arm and shoulders are stronger, owing to the nourishment which they receive, and the other arm, from the additional work it has to perform, is still more strong. The wasting of the flesh, if the dislocation was outward, is on the inside; or if otherwise, on the side opposite the dislocation.

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In dislocation at the elbow, whether outward or inward, extension is to be made with the fore-arm at right angles to the arm; the arm is to be suspended by a shawl passed through the armpit, and a weight is to be attached to the extremity of the elbow; or force is to be applied with the hands. The articular extremity being properly raised, the parts are to be adjusted with the palms of the hands, as in dislocations of the hands. It is to be bandaged, suspended in a sling, and placed, while in this attitude.

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Dislocations backward are to be rectified with the palms of the hands along with sudden extension. These two acts are to be performed together, as in other cases of the kind. In dislocation forward, the arm is to bend around a ball of cloth, of proper size, and at the same time replaced.

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If the displacement be on the other side both these operations are to be performed in effecting the adjustment of the arm. With regard to the treatment,-the position and the bandaging are the same as in the other cases. For all these cases may be reduced by ordinary distention.

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With regard to the modes of reduction, some act upon the principle of carrying the one piece of bone over the other, some by extension, and some by rotation: these last consist in rapidly turning the arm to this side and that.

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The joint of the hand is dislocated inward or outward, but most frequently inward. The symptoms are easily recognized; if inward, the patient cannot at all bend his fingers, but if outward, he cannot extend them. Reduction:—By placing the fingers above a table, extension and counter-extension are to be made by assistance, while, with the palm of the hand or the heel on the projecting bone, one presses forward, and from behind, upon the other bone, and lays some soft substance on it; and, if the dislocation be above, the hand is to be turned into a state of pronation; or, if backward, into a state of supination. The treatment is to be conducted with bandages.

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The whole hand is dislocated either inward, or outward, but especially inward, or to this side or that. Sometimes the epiphysis is displaced, and sometimes there is displacement (diastasis) of the one bone from the other. Powerful extension is to be made in this case; and the projecting part is to be pressed upon, and counter-pressure made on the opposite side: both modes being performed at the same time, both backward and laterally, either with the hands on a table, or with the heel. These accidents give rise to serious consequences and deformities; but in time the parts get so strong as to admit of being used. The treatment consists of bandages comprehending the hand and forearm, and splints are to be applied as far as the fingers; when put in splints, they are to be more frequently loosed than in fractures, and more copious allusions of water are to be used.

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In congenital dislocations the hand becomes shortened, and the atrophy of the flesh is generally on the side opposite the dislocation. In the adult the bones remain of their proper size.

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

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

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

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When there is a dislocation on both sides, the affections of the bones are the same; the flesh is well developed, except within, the nates protrude, the thighs are arched, unless there be sphacelus. If there be curvature of the spine above the hip-joint, the patients enjoy good health, but the body does not grow, with the exception of the head.

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The symptoms of dislocation backward are:—The parts before more empty, behind they protrude, the foot straight, flexion impossible, except with pain, extension least of all: in these the limb is shortened. They can neither extend the limb at the ham, nor at the groin, unless it be much raised, nor can they bend it. The uppermost joint, in most cases, takes the lead: this is common in joints, nerves, muscles, intestines, uteri, and other parts. There the bone of the hip-joint is carried backward to the nates, and on that account it is shortened, and because the patient cannot extend it. The flesh of the whole leg is wasted in all cases, in which most, and to what extent, has been already stated. Every part of the body which performs its functional work is strong, but, not withstanding, if inactive, it gets into a bad condition, unless its inactivity arise from fatigue, fever, or inflammation. And in dislocations outward, the limb is shortened, because the bone is lodged in flesh which yields; but, not withstanding, in dislocations inward, it is longer, because the bone is lodged on a projecting bone. Adults, then, who have this dislocation unreduced, are bent at the groins in walking, and the other ham is flexed; they scarcely reach the ground with the ball of the foot; they grasp the limb with the hand, and walk without a staff if they choose; if the staff be too long, their foot cannot reach the grounds-if they wish to reach the ground, they must use a short staff. There is wasting of the flesh in cases attended with pain; and the inclination of the leg is forward, and the sound leg in proportion. In congenital cases, or when in adolescence, or from disease, the bone is dislocated (under what circumstances will be explained afterward), the limb is particularly impaired, owing to the nerves and joints not being exercised, and the knee is impaired for the reasons stated. These persons, keeping the limb bent, walk with one staff or two. But the sound limb is in good flesh from usage.

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In dislocations forward the symptoms are the opposite: a vacuity behind, a protuberance before; of all motions they can least perform flexion, and extension best; the foot is straight, the limb is of the proper length at the heel; at its extremity the foot a little turned up; they are especially pained at first: of all these dislocations retention of urine occurs most frequently in this variety, because the bone is lodged among important nerves. The fore parts are stretched, do not grow, are diseased, and are obnoxious to premature decay; the back parts are wrinkled. In the case of adults, they walk erect, resting merely on the heel, and this they do decidedly if they can take great steps; but they drag it along; the wasting is least of all in this variety of dislocation, owing to their being able to use the limb, but the wasting is most behind. The whole limb being straighter than natural they stand in need of a staff on the affected side. When the dislocation is congenital, or has occurred during adolescence, if properly managed, the patient has the use of the limb as well as adults (otherwise?) have of it. But, if neglected, it is shortened and extended, for in such cases the joint is generally in a straight position. The diminution of the bones, and wasting of the fleshy parts, are analogous.

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

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

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

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Dislocations of the bones of the foot are to be treated like those of the hand.

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Dislocations of the bones connected with the leg, if not reduced, whether occurring at birth or during adolescence, are of the same character as those in the hand.

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Persons who, in jumping from a height, have pitched on the heel, so as to occasion diastasis (separation) of the bones, ecchymosis of the veins, and contusion of the nerves,-when these symptoms are very violent, there is danger that the parts may sphacelate, and give trouble to the patient during the remainder of his life; for these bones are so constructed as to slip past one another, and the nerves communicate together. And, likewise in cases of fracture, either from an injury in the leg or thigh, or in paralysis of the nerves connected with these parts, or, when in any other case of confinement to bed the heel, from neglect, becomes blackened, in all these cases serious effects result therefrom. Sometimes, in addition to the sphacelus, very acute fevers supervene, attended with hiccup, tumors, aberration of intellect, and speedy death, along with lividity of the large bloodvessels, and gangrene. The symptoms of the exacerbations are these: if the ecchymosis, the blackened parts, and those around them, be somewhat hard and red, and if lividity be combined with the hardness, there is danger of mortification; but, not withstanding, if the parts are sublivid, or even very livid and diffused, or greenish and soft, these symptoms, in all such cases, are favorable. The treatment consists in the administration of hellebore, if they be free from fever, but otherwise, they are to have oxyglyky for drink, if required. Bandaging,-agreeably to the rule in other joints; but this is to be attended to also,-the bandages should be numerous, and softer than usual; compression less; more water than usual to be used in the allusions; to be applied especially to the heel. The same object should be sought after in the position as in the bandaging, namely, that the humors may not be determined to the heel; the limb to be well laid should have the heel higher than the knee. Splints not to be used.

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When the foot is dislocated, either alone, or with the epiphysis, the displacement is more apt to be inward. If not reduced, in the course of time the parts of the hips, thigh, and leg, opposite the dislocation, become attenuated. Reduction:—As in dislocation at the wrist; but the extension requires to be very powerful. Treatment:—Agreeably to the rule laid down for the other joints. Less apt to be followed by serious consequences than the wrist, if kept quiet. Diet restricted, as being in an inactive state. Those occurring at birth, or during adolescence, observe the rule formerly stated.

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With regard to slight congenital dislocations, some of them can be rectified, especially club-foot. There is more than one variety of club-foot. The treatment consists in modeling the foot like a piece of wax; applying resinous cerate, and numerous bandages; or a sole, or a piece of lead is to be bound on, but not upon the bare skin; the adjustment and attitudes to correspond.

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If the dislocated bones cause a wound in the skin, and protrude, it is better to let them alone, provided only they are not allowed to hang, nor are compressed. The treatment consists in applying pitched cerate, or compresses dipped in hot wine (for cold is bad in all such cases), and certain leaves; but in winter unwashed wool may be applied as a cover to the part; neither cataplasms nor bandaging; restricted diet. Cold, great weight, compression, violence, restricted position, all such are to be accounted as fatal measures. When treated moderately (they escape), maimed and deformed; for, if the dislocation be at the ankle, the foot is drawn upward, and, if elsewhere, according to the same rule. The bones do not readily exfoliate; for only small portions of them are denuded, and they heal by narrow cicatrices. The danger is greatest in the greatest joints, and those highest up. The only chance of recovery is, if they are not reduced, except at the fingers and hand, and in these cases the danger should be announced beforehand. Attempts at reduction to be made on the first or second day; or, if not accomplished then, on the tenth, by no means on the fourth. Reduction by levers. Treatment:—As in injuries of the bones of the head, and the part is to be kept hot; and it is better to give hellebore immediately after the parts have been reduced. With regard to the other bones, it should be well known, that, if replaced, death will be the consequence; the more surely and expeditiously, the greater the articulation, and the more high its situation. Dislocation of the foot is attended with spasm (tetanus) and gangrene; and if, upon its being replaced, any of these symptoms come on, the chance of recovery, if there be any chance, is in displacing it anew; for spasms do not arise from relaxation, but from tension of the parts.

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Excision, either of articular bones or of pieces of bones, when not high up in the body, but about the foot or the hand, is generally followed by recovery, unless the patient die at once from deliquium animi. Treatment:—As in injuries of the head; warmth.

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Sphacelus of the fleshy parts is produced by the tight compression of bleeding wounds, and by pressure in the fractures of bones, and by blackening, arising from bandages. And in those cases in which a portion of the thigh or arm, both the bones and the flesh drop off, many recover, the case being less dangerous than many others. In cases, then, connected with fracture of the bones, the separation of the flesh quickly takes place, but the separation of the bone, at the boundary of its denuded part, is slower in taking place. But the parts below the seat of the injury, and the sound portion of the body, are to be previously taken away (for they die previously), taking care to avoid producing pain, for deliquium animi may occasion death. The bone of the thigh in such a case came away on the eightieth day, but the leg was removed on the twentieth day. The bones of the leg, in a certain case, came away at the middle of the sixtieth day. In these cases the separation is quick or slow, according to the compression applied by the physician. When the compression is gently applied the bones do not drop off at all, neither are they denuded of flesh, but the gangrene is confined in the more superficial parts. The treatment of such cases must be undertaken; for most of them are more formidable in appearance than in reality. The treatment should be mild, but, not withstanding, with a restricted diet; hemorrhages and cold are to be dreaded; the position, so as that the limb may be inclined upward, and afterward, on account of the purulent abscess, horizontally, or such as may suit with it. In such cases, and in mortifications, there are usually, about the crisis, hemorrhages and crisis, hemorrhages and violent diarrhoeas, which, however, only last for a few days; the patients do not lose their appetite, neither are they feverish, nor should they be put upon a reduced diet.

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Displacement of the spine, if inward, threatens immediate death, attended with retention of urine and loss of sensibility. Outward, the accident is free from most of these bad effects, much more so than where there is merely concussion without displacement; the effects in the former case being confined to the spot affected, whereas in the latter they are further communicated to the whole body, and are of a mortal character. In like manner, when the ribs are fractured, whether one or more, provided there be no splinters, there is rarely fever, spitting of blood, and sphacelus, and ordinary treatment without evacuation will suffice, provided there be no fever;-bandaging, according to rule; and the callus forms in twenty days, the bone being of a porous nature. But in cases of contusion, tubercles form, along with cough, suppurating sores, and sphacelus of the ribs, for nerves from all the parts run along each rib. In many of these cases haemoptysis and empyema also take place. The management of this case consists in careful treatment, bandaging according to rule, diet at first restricted, but afterward more liberal, quiet, silence, position, bowels, and venereal matters regulated. Even when there is no spitting of blood, these contusions are more painful than fractures, and are more subject in time to relapses; and when any mucous collection is left in the part, it makes itself be felt in disorders of the body. Treatment:—burning, when the bone is affected, down to the bone, but not touching the bone itself; if in the intercostal space, the burning must not extend through it, nor be too superficial. In sphacelus of the ribs, tents are to be tried, all other particulars will be stated afterward: but they should be learned by sight rather than by words, namely, food, drink, heat, cold, attitude; medicines, dry, liquid, red, dark, white, sour, for the ulcers, and so with regard to the diet.

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Displacements (of the vertebrae) from a fall rarely admit of being rectified, and those above the diaphragm are most difficult to rectify. When the accident happens to children, the body does not grow, with the exception of the legs, the arms, and head. Excurvation, in adults, speedily relieves the individual from the disease he is laboring under, but in time it renews its attack, with the same symptoms as in children, but of a less serious nature. Some individuals have borne this affection well, and have turned out to be brawny and fat. But few of them have lived to the age of sixty. Lateral curvatures also occur, the proximate cause of which is the attitudes in which these persons lie. These cases have their prognostics accordingly.

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The rule for the reduction and adjustment:—The axle, the lever, the wedge, pressure above; the axle to separate, the lever to push aside. Reduction and adjustment are to be accomplished by forcible extension, the parts being placed in such a position as will facilitate the conveying of the displaced bone over the extremity of the bone from which it was displaced: this is to be accomplished either with the hands, or by suspension, or axles, or turned round something. With the hands this is to be effected properly, according to the structure of the parts. In the case of the wrist and elbow, the parts are to be forced asunder, at the wrist in the line of the elbow, and the elbow with the fore-arm at a right angle with the arm, as when it is suspended in a sling. When we want to separate the protruding bones, and force them into place, in the case of the fingers, the toes, or the wrist, the proper separation may be made by hands, while the projecting part is forced into its place by pressing down with the heel or the palm of the hand upon some resisting object, while something moderately soft is laid under the projecting part, but nothing such under the other, and then pressure is to be made backward and downward, whether the dislocation be inward or outward. In lateral displacement, pressure and counter-pressure must be made on the opposite sides. Displacements forward can be reduced neither by sneezing, nor coughing, nor by the injection of air, nor by the cupping-instrument; and if anything can do good in such a case, it is extension. People are deceived in fractures of the spinal processes, the pain of which causing the patient to stoop forward, the case is taken for dislocation inward; these fractures heal speedily and easily. Dislocation outward is to be remedied by succussion, when high up, toward the feet; and when situated low down, in the contrary direction; the part is to be pressed back into its place, either with the foot or a board. Dislocations to either side, if they admit of any remedy, are to be treated by extension, and suitable attitudes, with regimen. The whole apparatus should be broad, soft, and strong; or otherwise, they should be wrapped in rags; before being used, they should all be prepared proportionately to the length, height, and breadth. In applying extension to the thigh, for example, the bands should be fastened at the ankle and above the knee, these stretching in the same direction, another band to be passed by the loins, and around the armpits, and by the perineum and thigh, one end passing up the breast and the other along the back, these all stretching in the same direction and being fastened either to a piece of wood resembling a pestle or to an axle. When this is done on a couch, either of its feet is to be fastened to the threshold, and a strong block of wood is to be laid across the other, and the pieces of wood resembling a pestle are to be raised on these, to make extension and counter-extension; the naves of a wheel are to be fastened in the floor, or a ladder is to be adjusted, so that extension may be made in both directions. The thing commonly used is a bench six cubits long, two cubits broad, one fathom in thickness, having two low axles at this end and that, and having at its middle two moderate sized pillars, to which is to be adjusted a transverse piece of wood like the step of a ladder, which is to receive the piece of wood tied below the limb, as is done in dislocation at the shoulder; and the bench is to have excavations like trays, smooth, four inches in breadth and depth, and at such an interval as to leave room for the lever used to reduce the limb. In the middle of the bench a square hole is to be scooped out to receive a small pillar, which, being adjusted to the perineum, will obviate the tendency of the body to slip downward, and being rather loose may act somewhat as a lever. In certain occasions a piece of wood is required, which is inserted into a hole scooped out of the wall; the other end of it is then to be pressed down, something moderately soft being placed under it.

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In those cases where the bone of the palate has exfoliated, the nose sinks in its middle. In contusions of the head without a wound, either from a fall, a fracture, or pressure, in certain of these cases acrid humors descend from the head to the throat, and from the wound in the head to the liver and thigh.

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The symptoms of subluxations and luxations, and where, and how, and how much these differ from one another. And the cases in which the articular cavity has been broke off, and in which the ligament has been torn, and in which the epiphysis has broken in which, and how, when the limb consists of two bones, one or both are broken: in consequence of these the dangers, chances in which bad, and when the injuries will result in death, and when in recovery. What cases are to be reduced or attempted, and when, and which, and when not; the hopes and dangers in these cases. Which and when congenital dislocations are to be undertaken: the parts in a state of growth, the parts fully grown, and why sooner, or slower: and why a part becomes maimed, and how, and how not: and why a certain part is atrophied, and where, and how, and in what cases to a less extent. And why fractured parts unite sooner or slower, how distortions and callosities form, and the remedy for them. In what cases there are external wounds, either at first or afterwards: in what fractures the bones are shortened, and in what not: in what cases the fractured bones protrude, and when they protrude most: in what cases dislocated bones protrude. That physicians are deceived, and by what means, in what they see, and in what they devise, regarding affections, and regarding cures. Established rules with regard to bandaging: preparation, presentation of the part, extension, adjustment, friction, bandaging, suspension and placing of the limb, attitude, seasons, diet. The more porous parts heal fastest, and vice versa. Distortions, where the bones are crooked. Flesh and tendons wasted on the side of the dislocation. The force used in reduction to be applied at as great a distance as possible from the seat of the displacement. Of nerves (ligaments?), those which are in motion and in humidity (flabby?) are of a yielding nature; those that are not, less so. In every dislocation the most speedy reduction is best. Reduction not to be made while the patient is in a febrile state, nor on the fourth or fifth day; and least of all, in those of the elbow, and all cases which induce torpor; the soonest the best, provided the inflammatory stage be avoided. Parts torn asunder, whether nerves, or cartilages, or epiphyses, or parts separated at symphyses, cannot possibly be restored to their former state; but callus is quickly formed in most cases, yet the use of the limb is preserved. Of luxations, those nearest the extremities are least dangerous. Those joints which are most easily dislocated are the least subject to inflammation. Those which have been least inflamed, and have not been subjected to after-treatment, are most liable to be dislocated anew. Extension should be made in the position most calculated to enable the one bone to clear the extremity of the other, attention being paid to configuration and place. Adjustment to be made in the direction of the displacement; to push the displaced limb straight backward and sideways. Parts suddenly drawn aside are to be suddenly drawn back by a rotatory motion. Articulations which have been oftenest dislocated are the most easily reduced; the cause is the conformation of the nerves (ligaments?) or of the bones; of the ligaments that they are long and yielding; and of the bones, the shallowness of the articular cavity, and roundness of the head [of the bone that enters it]. Usage, by its friction, forms a new socket. The cause-the disposition, and habit, and age. A part somewhat mucous is not subject to inflammation.

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In those cases where there are wounds, either at first, or from protrusion of the bones; or afterwards, from pruritus, or irritation; in the latter case you are immediately to unloose the bandages, and having applied pitched cerate to the wound, bandage the limb, placing the head of the roller upon the wound, and proceeding otherwise as if there were no wound in the case; for thus will the swelling be reduced as much as possible, and the wound will suppurate most quickly, and the diseased parts will separate, and when it becomes clean the wound will most quickly heal. Splints are not to be applied to the place, nor is it to be bound tight. Proceed thus when no large bones exfoliate, but not in the latter case, for then there is great suppuration, and the same treatment is not applicable, but the parts require to be exposed to the air on account of the abscesses. In such cases where the bones protrude, and whether reduced or not, bandaging is not befitting, but distention is to be practiced by means of rolls of cloth, made like those used upon shackles; one of these is to be placed at the ankle, and the other at the knee; they are to be flattened toward the leg, soft, strong, and having rings; and rods made of cornel, and of a proper length and thickness are to be adjusted to them, so as to keep the parts distended; and straps, attached to both extremities, are to be inserted into the rings, so that the extremities being fixed into the rolls, may effect distention. Treatment:—Pitched cerate, in a hot state; the attitudes, position of the foot and hip; regulated diet. The bones which have protruded through the skin are to be replaced the same day, or next; not on the fourth or fifth, but when the swelling has subsided. Reduction is to be performed with levers; when the bone does not present any place upon which the lever can rest, a portion of the part which prevents this is to be sawed off. But the denuded parts will drop off, and the limb become shortened.

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Dislocations at the joints are to a greater and less extent. Those that are to a less extent are the most easily reduced; those that are to a greater extent occasion lesions of the bones, of the ligaments, of the joints, of the fleshy parts, and of the attitudes. The thigh and arm resemble one another very much in their dislocations.

 diff --git a/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml new file mode 100644 index 000000000..b593ee41e --- /dev/null +++ b/data/tlg0627/tlg011/tlg0627.tlg011.perseus-eng2.xml @@ -0,0 +1,162 @@ + + + + + + + Mochlicus + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg011.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + +

Data Entry

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This pointer pattern extracts section.

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With regard to the construction of bonesThe brief description of the bones given in this paragraph is evidently condensed from a larger work on the subject. A considerable portion of the matter which is found here in an abridged form, is taken from the preceding treatises, On Fractures and On the Articulations, but not the whole of it., the bones and joints of the fingers are simple, the bones of the hand and foot are numerous, and articulated in various ways; the uppermost are the largest; the heel consists of one bone which is seen to project outward, and the back tendons are attached to it. The leg consists of two bones, united together above and below, but slightly separated in the middle; the external bone (fibula), where it comes into proximity with the little toe, is but slightly smaller than the other, more so where they are separated, and at the knee, the outer hamstring arises from itThe tendon of the biceps.; these bones have a common epiphysis below, with which the foot is moved, and another epiphys is aboveIt will be here perceived that by epiphysis is merely meant a close union of the two bones by means of a ligament. Ther term in this paragraph is not always used in this sense. Strictly speaking, its signification would appear to be a protuberance of a bone. It is applied to the malleoli, to the head of the tibia, to the head and neck of the femur, to the spinous processes of the vertebrae, to the upper and lower extremities of the humerus and to the lower extremity of the radius. in which is moved the articular extremity of the femur, which is simple and light in proportion to its length, in the form of a condyle, and having the patella (connected with it?), the femur itself bends outward and forward; its head is a round epiphysis which gives origin to ligament inserted in the acetabulum of the hip-jointAllusion is evidently made to the ligamentum teres.. This bone is articulated somewhat obliquely, but less so than the humerus. The ischium is united to the great vertebra contiguous to the os sacrum by a cartilaginous ligamentIt will readily perceived that the term ischium is not used here exactly as applied by modern anatomists. It is applied in this place to the ilium where it is articulated with the os sacrum. By the great verebra, as stated in the preceding work, is meant the last vertebra of the loins.. The spine, from the os sacrum to the great vertebra, is curved backward; in this quarter are situated the bladder, the organs of generation, and the inclined portion of the rectum; from this to the diaphragm it proceeds in a straight line inclining forward, and the psoae are situated there; from this point, to the great vertebra above the tops of the shoulders, it rises in a line that is curved backward, and the curvature appears greater than it is in reality, for the posterior processes of the spine are there highest; the articulation of the neck inclines forward. The vertebrae on the insideMeaning before, that is to say, at their anterior part. are regularly placed upon one another, but behind they are connected by a cartilaginous ligament; they are articulated in the form of synarthrosis at the back part of the spinal marrow; behind they have a sharp process having a cartilaginous epiphysis, whence proceeds the roots of nerves running downward, as also muscles extending from the neck to the loins, and filling the space between the ribs and the spine. The ribs are connected to all the intervertebral spaces on the inside, from the neck to the lumbar region, by a small ligament, and before to the sternum, their extremities being spongy and soft; their form is the most arched in man of all animals; for in this part, man is, of all animals, the narrowest in proportion to his bulk. The ribs are united to each vertebra by a small ligament at the place from which the short and broad lateral processes (transverse processes?) arise. The sternum is one continuous bone, having lateral pits for the insertion of the ribs; it is of a spongy and cartilaginous structure. The clavicles are rounded in front, having some slight movements at the sternum, but more free at the acromion. The acromion, in man, arises from the scapula differently from most other animals. The scapula is cartilaginous toward the spine, and spongy elsewhere, having an irregular figure externally; its neck and articular cavity cartilaginous; it does not interfere with the movements of the ribs, and is free of all connection with the other bones, except the humerus. The head of the humerus is articulated with its (glenoid?) cavity, by means of a small ligament, and it consists of a rounded epiphysis composed of spongy cartilage, the humerus itself is bent outward and forward, and it is articulated with its (glenoid?) cavity by its side, and not in a straight line. At the elbow it is broad, and has condyles and cavities, and is of a solid consistence; behind it is a cavity in which the coronoid process (olecranon?) of the ulna is lodged, when the arm is extended; here, too, is inserted the benumbling nerve, which arises from between the two bones of the forearm at their junction, and terminates there.

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When the nose is fractured, the parts should be modeled instantly, if possible. If the fracture be in its cartilaginous part, introduce into the nostrils a tent formed of caddis, inclosed in the outer skin of a Carthaginian hide, or anything else which does not irritate; the skin is to be glued to the parts displaced, which are to be thus rectified. Bandaging in this case does mischief. The treatment is to consist of flour with manna, or of sulphur with cerate. You will immediately adjust the fragments, and afterward retain them in place with your fingers introduced into the nostrils, and turning the parts into place; then the Carthaginian skin is to be used. Callius forms even when there is a wound; and the same things are to be done, even when there is to be exfoliation of the bones, for this is not of a serious nature.

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In fractures of the ears, neither bandages nor cataplasms should be used; or, if any bandage be used, it should be put on very tight; the cerate and sulphur should be applied to agglutinate the bandages. When matter forms in the ears, it is found to be more deeply seated than might be supposed, for all parts that are pulpy, and consist of juicy flesh, prove deceptious in such a case. But no harm will result from making an opening, for the parts are lean, watery, and full of mucus. No mention is here made of the places and circumstances which render it fatal to make an opening. The cure is soonest effected by transfixing the ear with a cautery; but the ear is maimed and diminished in size, if burned across. If opened, one of the gentle medicines for flesh wounds should be used as a dressing.

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The jaw-bone is often slightly displaced (subluxated?), and is restored again; it is dislocated but rarely, especially in gaping; in fact, the bone is never dislocated unless it slips while the mouth is opened wide. It slips, however, the more readily from its ligaments being oblique, supple, and of a yielding nature. The symptoms are: the lower jaw protrudes, it is distorted to the side opposite the dislocation, and the patient cannot shut his mouth; when both sides are dislocated, the jaw projects more, the mouth can be less shut, but there is no distortion; this is shown by the rows of the teeth in the upper and lower jaw corresponding with one another. If, then, both sides be dislocated, and not immediately reduced, the patient for the most part dies on the tenth day, with symptoms of continued fever, stupor, and coma, for the muscles there induce such effects; there is disorder of the bowels attended with scanty and unmixed dejection; and the vomitings, if any, are of the same character. The other variety is less troublesome. The method of reduction is the same in both:—The patient being laid down or seated, the physician is to take hold of his head, and grasping both sides of the jaw-bone with both hands, within and without, he must perform three manoeuvres at once,-rectify the position of the jaw, push it backward, and shut the mouth. The treatment should consist of soothing applications, position, and applying a suitable bandage to support the jaw-bone, so as to cooperate with the reduction.

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The bone of the shoulder is dislocated downward. I have never heard of any other mode. The parts put on the appearance of dislocation forward, when the flesh about the joint is wasted during consumption, as also seems to be the case with cattle when in a state of leanness after winter. Those persons are most liable to dislocations who are thin, slender, and have humidities about their joints without inflammation, for it knits the joints. Those who attempt to reduce and rectify dislocations in oxen, commit a blunder, as forgetting that the symptoms arise from the manner in which the ox uses the limb, and that the appearance is the same in a man who is in a similar condition, and forgetting also that Homer has said, that oxen are most lean at that season. In this dislocation, then, when not reduced, the patient cannot perform any of those acts which others do, by raising the arm from the side. I have thus stated who are the persons most subject to this dislocation, and how they are affected. In congenital dislocations the nearest bones are most shortened, as is the case with persons who are weasel-armed; the fore-arm less so, and the hand still less; the bones above are not affected. And the parts (near the seat of the injury) are most wasted in flesh; and this happens more especially on the side of the arm opposite the dislocation, and that during adolescence, yet in a somewhat less degree than in congenital cases. The deep-seated suppurations occur most frequently to new-born infants about the joint of the shoulder, and these produce the same consequences as dislocations. In adults, the bones are not so diminished in size, and justly, seeing that the others will not increase as in the former case; but wasting of the flesh takes place, for it is increased, and is diminished every day, and at all ages. And attention should be paid to the force of habit, and to the symptom produced by the tearing away of the acromion, whereby a void is left, which makes people suppose that the humerus is dislocated. The head of the humerus is felt in the armpit, and the patient cannot raise his arm, nor swing it to this side and that, as formerly. The other shoulder shows the difference. Modes of reduction:—The patient himself having placed his fist in the arm pit, pushes up the head of the humerus with it, and brings the hand forward to the breast. Another:—Force it backward, so that you may turn it round. Another:—Apply your head to the acromion, and your hands to the armpit, separate the head of the humerus (from the side?), and push the elbow in the opposite direction; or, instead of your knees, another person may turn aside the elbow, as formerly directed. Or, place the patient on your shoulder, with the shoulder in his armpit. Or, with the heel, something being introduced to fill up the hollow of the armpit, and using the right foot to the right shoulder. Or, with a pestle. Or, with the step of a ladder. Or, by rotation made with piece of wood stretched below the arm. Treatment:—As to attitude, the arm placed by the side, the hand and shoulder raised; the bandaging and adjustment of the parts while in this attitude. If not reduced, the top of the shoulder becomes attenuated.

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When the acromion is torn away, the appearance is the same as in dislocation of the shoulder; but there is no impediment, except that the bone does not return to its position. The figure should be the same as in dislocation, both as regards bandaging and suspending the limb. The bandaging according to rule.

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When partial displacement (sub-luxation?) takes place at the elbow, either inside or outside, but the sharp point (olecranon?) remains in the cavity of the humerus, make extension in a straight line, and push the projecting parts backward and to the sides.

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In complete dislocations to either side, make extension while the arm is in the position it is put in to be bandaged for a fracture, for thus the rounded part of the elbow will not form an obstacle to it. Dislocation most commonly takes place inward. The parts are to be adjusted by separating the bones as much as possible, so that the end of the humerus may not come in contact with the olecranon, but it is to be carried up and turned round, and not forced in a straight line; at the same time the opposite sides are to be pushed together, and the bones reduced to their place. In these cases rotation of the elbow cooperates; that is to say, turning the arm into a state of supination and pronation; so much for the reduction. With regard to the attitude in which it is to be put,-the hand is to be placed somewhat higher than the elbow, and the arm by the side; this position suits with it when slung from the neck, is easily borne, is its natural position, and one adapted for ordinary purposes, unless callus form improperly: the callus soon forms. Treatment:—By bandages according to the common rule for articulations, and the point of the elbow is to be included in the bandage.

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The elbow, when luxated, induces the most serious consequences, fevers, pain, nausea, vomiting of pure bile; and this especially in dislocations backward, from pressure on the nerve which occasions numbness; next to it is dislocation forward. The treatment is the same. The reduction of dislocation backward is by extension and adaptation: the symptom of this variety, loss of the power of extension; of dislocation forward, loss of the power of flexion. In it a hard ball is to be placed in the bend of the elbow, and the fore-arm is to be bent over this while sudden extension is made.

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Diastasis of the bones may be recognized by examining the part where the vein which runs along the arm divides.

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In these cases callus is speedily formed. In congenital dislocations, the bones below the seat of the injury are shorter than natural; in this case, the greatest shortening is in the nearest, namely, those of the fore-arm; second, those of the hand; third, those of the fingers. The arm and shoulders are stronger, owing to the nourishment which they receive, and the other arm, from the additional work it has to perform, is still more strong. The wasting of the flesh, if the dislocation was outward, is on the inside; or if otherwise, on the side opposite the dislocation.

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In dislocation at the elbow, whether outward or inward, extension is to be made with the fore-arm at right angles to the arm; the arm is to be suspended by a shawl passed through the armpit, and a weight is to be attached to the extremity of the elbow; or force is to be applied with the hands. The articular extremity being properly raised, the parts are to be adjusted with the palms of the hands, as in dislocations of the hands. It is to be bandaged, suspended in a sling, and placed, while in this attitude.

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Dislocations backward are to be rectified with the palms of the hands along with sudden extension. These two acts are to be performed together, as in other cases of the kind. In dislocation forward, the arm is to bend around a ball of cloth, of proper size, and at the same time replaced.

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If the displacement be on the other side both these operations are to be performed in effecting the adjustment of the arm. With regard to the treatment,-the position and the bandaging are the same as in the other cases. For all these cases may be reduced by ordinary distention.

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With regard to the modes of reduction, some act upon the principle of carrying the one piece of bone over the other, some by extension, and some by rotation: these last consist in rapidly turning the arm to this side and that.

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The joint of the hand is dislocated inward or outward, but most frequently inward. The symptoms are easily recognized; if inward, the patient cannot at all bend his fingers, but if outward, he cannot extend them. Reduction:—By placing the fingers above a table, extension and counter-extension are to be made by assistance, while, with the palm of the hand or the heel on the projecting bone, one presses forward, and from behind, upon the other bone, and lays some soft substance on it; and, if the dislocation be above, the hand is to be turned into a state of pronation; or, if backward, into a state of supination. The treatment is to be conducted with bandages.

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The whole hand is dislocated either inward, or outward, but especially inward, or to this side or that. Sometimes the epiphysis is displaced, and sometimes there is displacement (diastasis) of the one bone from the other. Powerful extension is to be made in this case; and the projecting part is to be pressed upon, and counter-pressure made on the opposite side: both modes being performed at the same time, both backward and laterally, either with the hands on a table, or with the heel. These accidents give rise to serious consequences and deformities; but in time the parts get so strong as to admit of being used. The treatment consists of bandages comprehending the hand and forearm, and splints are to be applied as far as the fingers; when put in splints, they are to be more frequently loosed than in fractures, and more copious allusions of water are to be used.

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In congenital dislocations the hand becomes shortened, and the atrophy of the flesh is generally on the side opposite the dislocation. In the adult the bones remain of their proper size.

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

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

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

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When there is a dislocation on both sides, the affections of the bones are the same; the flesh is well developed, except within, the nates protrude, the thighs are arched, unless there be sphacelus. If there be curvature of the spine above the hip-joint, the patients enjoy good health, but the body does not grow, with the exception of the head.

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The symptoms of dislocation backward are:—The parts before more empty, behind they protrude, the foot straight, flexion impossible, except with pain, extension least of all: in these the limb is shortened. They can neither extend the limb at the ham, nor at the groin, unless it be much raised, nor can they bend it. The uppermost joint, in most cases, takes the lead: this is common in joints, nerves, muscles, intestines, uteri, and other parts. There the bone of the hip-joint is carried backward to the nates, and on that account it is shortened, and because the patient cannot extend it. The flesh of the whole leg is wasted in all cases, in which most, and to what extent, has been already stated. Every part of the body which performs its functional work is strong, but, not withstanding, if inactive, it gets into a bad condition, unless its inactivity arise from fatigue, fever, or inflammation. And in dislocations outward, the limb is shortened, because the bone is lodged in flesh which yields; but, not withstanding, in dislocations inward, it is longer, because the bone is lodged on a projecting bone. Adults, then, who have this dislocation unreduced, are bent at the groins in walking, and the other ham is flexed; they scarcely reach the ground with the ball of the foot; they grasp the limb with the hand, and walk without a staff if they choose; if the staff be too long, their foot cannot reach the grounds-if they wish to reach the ground, they must use a short staff. There is wasting of the flesh in cases attended with pain; and the inclination of the leg is forward, and the sound leg in proportion. In congenital cases, or when in adolescence, or from disease, the bone is dislocated (under what circumstances will be explained afterward), the limb is particularly impaired, owing to the nerves and joints not being exercised, and the knee is impaired for the reasons stated. These persons, keeping the limb bent, walk with one staff or two. But the sound limb is in good flesh from usage.

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In dislocations forward the symptoms are the opposite: a vacuity behind, a protuberance before; of all motions they can least perform flexion, and extension best; the foot is straight, the limb is of the proper length at the heel; at its extremity the foot a little turned up; they are especially pained at first: of all these dislocations retention of urine occurs most frequently in this variety, because the bone is lodged among important nerves. The fore parts are stretched, do not grow, are diseased, and are obnoxious to premature decay; the back parts are wrinkled. In the case of adults, they walk erect, resting merely on the heel, and this they do decidedly if they can take great steps; but they drag it along; the wasting is least of all in this variety of dislocation, owing to their being able to use the limb, but the wasting is most behind. The whole limb being straighter than natural they stand in need of a staff on the affected side. When the dislocation is congenital, or has occurred during adolescence, if properly managed, the patient has the use of the limb as well as adults (otherwise?) have of it. But, if neglected, it is shortened and extended, for in such cases the joint is generally in a straight position. The diminution of the bones, and wasting of the fleshy parts, are analogous.

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

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

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

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Dislocations of the bones of the foot are to be treated like those of the hand.

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Dislocations of the bones connected with the leg, if not reduced, whether occurring at birth or during adolescence, are of the same character as those in the hand.

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Persons who, in jumping from a height, have pitched on the heel, so as to occasion diastasis (separation) of the bones, ecchymosis of the veins, and contusion of the nerves,-when these symptoms are very violent, there is danger that the parts may sphacelate, and give trouble to the patient during the remainder of his life; for these bones are so constructed as to slip past one another, and the nerves communicate together. And, likewise in cases of fracture, either from an injury in the leg or thigh, or in paralysis of the nerves connected with these parts, or, when in any other case of confinement to bed the heel, from neglect, becomes blackened, in all these cases serious effects result therefrom. Sometimes, in addition to the sphacelus, very acute fevers supervene, attended with hiccup, tumors, aberration of intellect, and speedy death, along with lividity of the large bloodvessels, and gangrene. The symptoms of the exacerbations are these: if the ecchymosis, the blackened parts, and those around them, be somewhat hard and red, and if lividity be combined with the hardness, there is danger of mortification; but, not withstanding, if the parts are sublivid, or even very livid and diffused, or greenish and soft, these symptoms, in all such cases, are favorable. The treatment consists in the administration of hellebore, if they be free from fever, but otherwise, they are to have oxyglyky for drink, if required. Bandaging,-agreeably to the rule in other joints; but this is to be attended to also,-the bandages should be numerous, and softer than usual; compression less; more water than usual to be used in the allusions; to be applied especially to the heel. The same object should be sought after in the position as in the bandaging, namely, that the humors may not be determined to the heel; the limb to be well laid should have the heel higher than the knee. Splints not to be used.

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When the foot is dislocated, either alone, or with the epiphysis, the displacement is more apt to be inward. If not reduced, in the course of time the parts of the hips, thigh, and leg, opposite the dislocation, become attenuated. Reduction:—As in dislocation at the wrist; but the extension requires to be very powerful. Treatment:—Agreeably to the rule laid down for the other joints. Less apt to be followed by serious consequences than the wrist, if kept quiet. Diet restricted, as being in an inactive state. Those occurring at birth, or during adolescence, observe the rule formerly stated.

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With regard to slight congenital dislocations, some of them can be rectified, especially club-foot. There is more than one variety of club-foot. The treatment consists in modeling the foot like a piece of wax; applying resinous cerate, and numerous bandages; or a sole, or a piece of lead is to be bound on, but not upon the bare skin; the adjustment and attitudes to correspond.

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If the dislocated bones cause a wound in the skin, and protrude, it is better to let them alone, provided only they are not allowed to hang, nor are compressed. The treatment consists in applying pitched cerate, or compresses dipped in hot wine (for cold is bad in all such cases), and certain leaves; but in winter unwashed wool may be applied as a cover to the part; neither cataplasms nor bandaging; restricted diet. Cold, great weight, compression, violence, restricted position, all such are to be accounted as fatal measures. When treated moderately (they escape), maimed and deformed; for, if the dislocation be at the ankle, the foot is drawn upward, and, if elsewhere, according to the same rule. The bones do not readily exfoliate; for only small portions of them are denuded, and they heal by narrow cicatrices. The danger is greatest in the greatest joints, and those highest up. The only chance of recovery is, if they are not reduced, except at the fingers and hand, and in these cases the danger should be announced beforehand. Attempts at reduction to be made on the first or second day; or, if not accomplished then, on the tenth, by no means on the fourth. Reduction by levers. Treatment:—As in injuries of the bones of the head, and the part is to be kept hot; and it is better to give hellebore immediately after the parts have been reduced. With regard to the other bones, it should be well known, that, if replaced, death will be the consequence; the more surely and expeditiously, the greater the articulation, and the more high its situation. Dislocation of the foot is attended with spasm (tetanus) and gangrene; and if, upon its being replaced, any of these symptoms come on, the chance of recovery, if there be any chance, is in displacing it anew; for spasms do not arise from relaxation, but from tension of the parts.

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Excision, either of articular bones or of pieces of bones, when not high up in the body, but about the foot or the hand, is generally followed by recovery, unless the patient die at once from deliquium animi. Treatment:—As in injuries of the head; warmth.

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Sphacelus of the fleshy parts is produced by the tight compression of bleeding wounds, and by pressure in the fractures of bones, and by blackening, arising from bandages. And in those cases in which a portion of the thigh or arm, both the bones and the flesh drop off, many recover, the case being less dangerous than many others. In cases, then, connected with fracture of the bones, the separation of the flesh quickly takes place, but the separation of the bone, at the boundary of its denuded part, is slower in taking place. But the parts below the seat of the injury, and the sound portion of the body, are to be previously taken away (for they die previously), taking care to avoid producing pain, for deliquium animi may occasion death. The bone of the thigh in such a case came away on the eightieth day, but the leg was removed on the twentieth day. The bones of the leg, in a certain case, came away at the middle of the sixtieth day. In these cases the separation is quick or slow, according to the compression applied by the physician. When the compression is gently applied the bones do not drop off at all, neither are they denuded of flesh, but the gangrene is confined in the more superficial parts. The treatment of such cases must be undertaken; for most of them are more formidable in appearance than in reality. The treatment should be mild, but, not withstanding, with a restricted diet; hemorrhages and cold are to be dreaded; the position, so as that the limb may be inclined upward, and afterward, on account of the purulent abscess, horizontally, or such as may suit with it. In such cases, and in mortifications, there are usually, about the crisis, hemorrhages and crisis, hemorrhages and violent diarrhoeas, which, however, only last for a few days; the patients do not lose their appetite, neither are they feverish, nor should they be put upon a reduced diet.

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Displacement of the spine, if inward, threatens immediate death, attended with retention of urine and loss of sensibility. Outward, the accident is free from most of these bad effects, much more so than where there is merely concussion without displacement; the effects in the former case being confined to the spot affected, whereas in the latter they are further communicated to the whole body, and are of a mortal character. In like manner, when the ribs are fractured, whether one or more, provided there be no splinters, there is rarely fever, spitting of blood, and sphacelus, and ordinary treatment without evacuation will suffice, provided there be no fever;-bandaging, according to rule; and the callus forms in twenty days, the bone being of a porous nature. But in cases of contusion, tubercles form, along with cough, suppurating sores, and sphacelus of the ribs, for nerves from all the parts run along each rib. In many of these cases haemoptysis and empyema also take place. The management of this case consists in careful treatment, bandaging according to rule, diet at first restricted, but afterward more liberal, quiet, silence, position, bowels, and venereal matters regulated. Even when there is no spitting of blood, these contusions are more painful than fractures, and are more subject in time to relapses; and when any mucous collection is left in the part, it makes itself be felt in disorders of the body. Treatment:—burning, when the bone is affected, down to the bone, but not touching the bone itself; if in the intercostal space, the burning must not extend through it, nor be too superficial. In sphacelus of the ribs, tents are to be tried, all other particulars will be stated afterward: but they should be learned by sight rather than by words, namely, food, drink, heat, cold, attitude; medicines, dry, liquid, red, dark, white, sour, for the ulcers, and so with regard to the diet.

+
+

Displacements (of the vertebrae) from a fall rarely admit of being rectified, and those above the diaphragm are most difficult to rectify. When the accident happens to children, the body does not grow, with the exception of the legs, the arms, and head. Excurvation, in adults, speedily relieves the individual from the disease he is laboring under, but in time it renews its attack, with the same symptoms as in children, but of a less serious nature. Some individuals have borne this affection well, and have turned out to be brawny and fat. But few of them have lived to the age of sixty. Lateral curvatures also occur, the proximate cause of which is the attitudes in which these persons lie. These cases have their prognostics accordingly.

+
+

The rule for the reduction and adjustment:—The axle, the lever, the wedge, pressure above; the axle to separate, the lever to push aside. Reduction and adjustment are to be accomplished by forcible extension, the parts being placed in such a position as will facilitate the conveying of the displaced bone over the extremity of the bone from which it was displaced: this is to be accomplished either with the hands, or by suspension, or axles, or turned round something. With the hands this is to be effected properly, according to the structure of the parts. In the case of the wrist and elbow, the parts are to be forced asunder, at the wrist in the line of the elbow, and the elbow with the fore-arm at a right angle with the arm, as when it is suspended in a sling. When we want to separate the protruding bones, and force them into place, in the case of the fingers, the toes, or the wrist, the proper separation may be made by hands, while the projecting part is forced into its place by pressing down with the heel or the palm of the hand upon some resisting object, while something moderately soft is laid under the projecting part, but nothing such under the other, and then pressure is to be made backward and downward, whether the dislocation be inward or outward. In lateral displacement, pressure and counter-pressure must be made on the opposite sides. Displacements forward can be reduced neither by sneezing, nor coughing, nor by the injection of air, nor by the cupping-instrument; and if anything can do good in such a case, it is extension. People are deceived in fractures of the spinal processes, the pain of which causing the patient to stoop forward, the case is taken for dislocation inward; these fractures heal speedily and easily. Dislocation outward is to be remedied by succussion, when high up, toward the feet; and when situated low down, in the contrary direction; the part is to be pressed back into its place, either with the foot or a board. Dislocations to either side, if they admit of any remedy, are to be treated by extension, and suitable attitudes, with regimen. The whole apparatus should be broad, soft, and strong; or otherwise, they should be wrapped in rags; before being used, they should all be prepared proportionately to the length, height, and breadth. In applying extension to the thigh, for example, the bands should be fastened at the ankle and above the knee, these stretching in the same direction, another band to be passed by the loins, and around the armpits, and by the perineum and thigh, one end passing up the breast and the other along the back, these all stretching in the same direction and being fastened either to a piece of wood resembling a pestle or to an axle. When this is done on a couch, either of its feet is to be fastened to the threshold, and a strong block of wood is to be laid across the other, and the pieces of wood resembling a pestle are to be raised on these, to make extension and counter-extension; the naves of a wheel are to be fastened in the floor, or a ladder is to be adjusted, so that extension may be made in both directions. The thing commonly used is a bench six cubits long, two cubits broad, one fathom in thickness, having two low axles at this end and that, and having at its middle two moderate sized pillars, to which is to be adjusted a transverse piece of wood like the step of a ladder, which is to receive the piece of wood tied below the limb, as is done in dislocation at the shoulder; and the bench is to have excavations like trays, smooth, four inches in breadth and depth, and at such an interval as to leave room for the lever used to reduce the limb. In the middle of the bench a square hole is to be scooped out to receive a small pillar, which, being adjusted to the perineum, will obviate the tendency of the body to slip downward, and being rather loose may act somewhat as a lever. In certain occasions a piece of wood is required, which is inserted into a hole scooped out of the wall; the other end of it is then to be pressed down, something moderately soft being placed under it.

+
+

In those cases where the bone of the palate has exfoliated, the nose sinks in its middle. In contusions of the head without a wound, either from a fall, a fracture, or pressure, in certain of these cases acrid humors descend from the head to the throat, and from the wound in the head to the liver and thigh.

+
+

The symptoms of subluxations and luxations, and where, and how, and how much these differ from one another. And the cases in which the articular cavity has been broke off, and in which the ligament has been torn, and in which the epiphysis has broken in which, and how, when the limb consists of two bones, one or both are broken: in consequence of these the dangers, chances in which bad, and when the injuries will result in death, and when in recovery. What cases are to be reduced or attempted, and when, and which, and when not; the hopes and dangers in these cases. Which and when congenital dislocations are to be undertaken: the parts in a state of growth, the parts fully grown, and why sooner, or slower: and why a part becomes maimed, and how, and how not: and why a certain part is atrophied, and where, and how, and in what cases to a less extent. And why fractured parts unite sooner or slower, how distortions and callosities form, and the remedy for them. In what cases there are external wounds, either at first or afterwards: in what fractures the bones are shortened, and in what not: in what cases the fractured bones protrude, and when they protrude most: in what cases dislocated bones protrude. That physicians are deceived, and by what means, in what they see, and in what they devise, regarding affections, and regarding cures. Established rules with regard to bandaging: preparation, presentation of the part, extension, adjustment, friction, bandaging, suspension and placing of the limb, attitude, seasons, diet. The more porous parts heal fastest, and vice versa. Distortions, where the bones are crooked. Flesh and tendons wasted on the side of the dislocation. The force used in reduction to be applied at as great a distance as possible from the seat of the displacement. Of nerves (ligaments?), those which are in motion and in humidity (flabby?) are of a yielding nature; those that are not, less so. In every dislocation the most speedy reduction is best. Reduction not to be made while the patient is in a febrile state, nor on the fourth or fifth day; and least of all, in those of the elbow, and all cases which induce torpor; the soonest the best, provided the inflammatory stage be avoided. Parts torn asunder, whether nerves, or cartilages, or epiphyses, or parts separated at symphyses, cannot possibly be restored to their former state; but callus is quickly formed in most cases, yet the use of the limb is preserved. Of luxations, those nearest the extremities are least dangerous. Those joints which are most easily dislocated are the least subject to inflammation. Those which have been least inflamed, and have not been subjected to after-treatment, are most liable to be dislocated anew. Extension should be made in the position most calculated to enable the one bone to clear the extremity of the other, attention being paid to configuration and place. Adjustment to be made in the direction of the displacement; to push the displaced limb straight backward and sideways. Parts suddenly drawn aside are to be suddenly drawn back by a rotatory motion. Articulations which have been oftenest dislocated are the most easily reduced; the cause is the conformation of the nerves (ligaments?) or of the bones; of the ligaments that they are long and yielding; and of the bones, the shallowness of the articular cavity, and roundness of the head [of the bone that enters it]. Usage, by its friction, forms a new socket. The cause-the disposition, and habit, and age. A part somewhat mucous is not subject to inflammation.

+
+

In those cases where there are wounds, either at first, or from protrusion of the bones; or afterwards, from pruritus, or irritation; in the latter case you are immediately to unloose the bandages, and having applied pitched cerate to the wound, bandage the limb, placing the head of the roller upon the wound, and proceeding otherwise as if there were no wound in the case; for thus will the swelling be reduced as much as possible, and the wound will suppurate most quickly, and the diseased parts will separate, and when it becomes clean the wound will most quickly heal. Splints are not to be applied to the place, nor is it to be bound tight. Proceed thus when no large bones exfoliate, but not in the latter case, for then there is great suppuration, and the same treatment is not applicable, but the parts require to be exposed to the air on account of the abscesses. In such cases where the bones protrude, and whether reduced or not, bandaging is not befitting, but distention is to be practiced by means of rolls of cloth, made like those used upon shackles; one of these is to be placed at the ankle, and the other at the knee; they are to be flattened toward the leg, soft, strong, and having rings; and rods made of cornel, and of a proper length and thickness are to be adjusted to them, so as to keep the parts distended; and straps, attached to both extremities, are to be inserted into the rings, so that the extremities being fixed into the rolls, may effect distention. Treatment:—Pitched cerate, in a hot state; the attitudes, position of the foot and hip; regulated diet. The bones which have protruded through the skin are to be replaced the same day, or next; not on the fourth or fifth, but when the swelling has subsided. Reduction is to be performed with levers; when the bone does not present any place upon which the lever can rest, a portion of the part which prevents this is to be sawed off. But the denuded parts will drop off, and the limb become shortened.

+
+

Dislocations at the joints are to a greater and less extent. Those that are to a less extent are the most easily reduced; those that are to a greater extent occasion lesions of the bones, of the ligaments, of the joints, of the fleshy parts, and of the attitudes. The thigh and arm resemble one another very much in their dislocations.

+ + diff --git a/data/tlg0627/tlg012/__cts__.xml b/data/tlg0627/tlg012/__cts__.xml index 60968a9b2..7891962ef 100644 --- a/data/tlg0627/tlg012/__cts__.xml +++ b/data/tlg0627/tlg012/__cts__.xml @@ -5,4 +5,9 @@ Ἀφορισμοί Hippocrates. Oeuvres complètes d'Hippocrate, Vol. 4. Littré, Émile, editor. Adolf M. Hakkert: Amsterdam, 1961 (printing). + + + Aphorisms + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng1.xml b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng1.xml index 990625a5d..1061f9fa9 100644 --- a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng1.xml +++ b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng1.xml @@ -1,18 +1,36 @@ + - + Aphorisms Hippocrates Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + National Library of Medicine History of Medicine Division - Cultural Heritage Langauge Technologies + Cultural Heritage Language Technologies Kansas City Missouri - February 20, 2003 + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg012.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + @@ -21,2338 +39,878 @@ Francis Adams New York - William Wood & Company + William Wood and Company 1886 + 2 + HathiTrust + +

Data Entry

 - - - - - - - - - - - - - - - - - - - + + + +

This pointer pattern extracts section and aphorism.

+ + +

This pointer pattern extracts section.

+ + - + - English + English - - - -
- SECTION I -
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 6 -

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

-
-
- Part 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.

-
-
- Part 8 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 16 -

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

-
-
- Part 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.

-
-
- Part 18 -

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

-
-
- Part 19 -

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

-
-
- Part 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.

-
-
- Part 21 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 24 -

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

-
-
- Part 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.

-
-
- - -
- SECTION II - -
- Part 1 -

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

-
-
- Part 2 -

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

-
-
- Part 3 -

Both sleep and insomnolency, when immoderate, are bad.

-
-
- Part 4 -

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

-
-
- Part 5 -

Spontaneous lassitude indicates disease.

-
-
- Part 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.

-
-
- Part 7 -

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

-
-
- Part 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. -

-
-
- Part 9 -

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

-
-
- Part 10 -

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

-
-
- Part 11 -

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

-
-
- Part 12 -

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

-
-
- Part 13 -

Persons in whom a crisis takes place pass the night preced-ing - the paroxysm uncomfortably, but the succeeding night generally more - comfortably.

-
-
- Part 14 -

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

-
-
- Part 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.

-
-
- Part 16 -

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

-
-
- Part 17 -

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

-
-
- Part 18 -

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

-
-
- Part 19 -

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

-
-
- Part 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.

-
-
- Part 21 -

Drinking strong wine cures hunger.

-
-
- Part 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.

-
-
- Part 23 -

Acute disease come to a crisis in fourteen days.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 26 -

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

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 30 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 36 -

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

-
-
- Part 37 -

Purgative medicines agree ill with persons in good health.

-
-
- Part 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. -

-
-
- Part 39 -

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

-
-
- Part 40 -

Catarrhs and coryza in very old people are not concocted.

-
-
- Part 41 -

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

-
-
- Part 42 -

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

-
-
- Part 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.

-
-
- Part 44 -

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

-
-
- Part 2 -

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

-
-
- Part 46 -

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

-
-
- Part 47 -

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

-
-
- Part 48 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 54 -

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

-
-
- -
- SECTION III - -
- Part 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. -

-
-
- Part 2 -

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

-
-
- Part 3 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 6 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 9 -

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

-
-
- Part 10 -

Autumn is a bad season for persons in consumption.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 15 -

Of the constitutions of the year, the dry, upon the whole, are more healthy - than the rainy, and attended with less mortality.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 23 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 29 -

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

-
-
- Part 30 -

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

-
-
- Part 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.

-
-
- -
- SECTION IV - -
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 4 -

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

-
-
- Part 5 -

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

-
-
- Part 6 -

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

-
-
- Part 7 -

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

-
-
- Part 8 -

We must be guarded in purging phthisical persons upward.

-
-
- Part 9 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 12 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 15 -

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

-
-
- Part 16 -

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

-
-
- Part 17 -

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

-
-
- Part 18 -

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

-
-
- Part 19 -

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

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 22 -

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

-
-
- Part 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.

-
-
- Part 24 -

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

-
-
- Part 25 -

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

-
-
- Part 26 -

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

-
-
- Part 27 -

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

-
-
- Part 28 -

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

-
-
- Part 29 -

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

-
-
- Part 30 -

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

-
-
- Part 31 -

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

-
-
- Part 32 -

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

-
-
- Part 33 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 37 -

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

-
-
- Part 38 -

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

-
-
- Part 39 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 42 -

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

-
-
- Part 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.

-
-
- Part 44 -

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

-
-
- Part 45 -

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

-
-
- Part 46 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 50 -

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

-
-
- Part 51 -

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

-
-
- Part 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. -

-
-
- Part 53 -

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

-
-
- Part 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.

-
-
- Part 55 -

All fevers complicated with buboes are bad, except ephemerals.

-
-
- Part 56 -

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

-
-
- Part 57 -

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

-
-
- Part 58 -

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

-
-
- Part 59 -

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

-
-
- Part 60 -

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

-
-
- Part 61 -

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

-
-
- Part 62 -

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

-
-
- Part 63 -

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

-
-
- Part 64 -

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

-
-
- Part 65 -

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

-
-
- Part 66 -

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

-
-
- Part 67 -

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

-
-
- Part 68 -

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

-
-
- Part 68 -

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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 72 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 75 -

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

-
-
- Part 76 -

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

-
-
- Part 77 -

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

-
-
- Part 78 -

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

-
-
- Part 79 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 82 -

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

-
-
- Part 83 -

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

-
-
- -
- SECTION V - -
- Part 1 -

A spasm from taking hellebore is of a fatal nature.

-
-
- Part 2 -

Spasm supervening on a wound is fatal.

-
-
- Part 3 -

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

-
-
- Part 4 -

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

-
-
- Part 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.

-
-
- Part 6 -

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

-
-
- Part 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.

-
-
- Part 8 -

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

-
-
- Part 9 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 12 -

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

-
-
- Part 13 -

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

-
-
- Part 14 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 17 -

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

-
-
- Part 18 -

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

-
-
- Part 19 -

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

-
-
- Part 20 -

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

-
-
- Part 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.

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 24 -

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

-
-
- Part 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.

-
-
- Part 26 -

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

-
-
- Part 27 -

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

-
-
- Part 28 -

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

-
-
- Part 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.

-
-
- Part 30 -

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

-
-
- Part 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.

-
-
- Part 32 -

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

-
-
- Part 33 -

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

-
-
- Part 34 -

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

-
-
- Part 35 -

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

-
-
- Part 36 -

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

-
-
- Part 37 -

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

-
-
- Part 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.

-
-
- Part 39 -

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

-
-
- Part 40 -

In women, blood collected in the breasts indicates madness.

-
-
- Part 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.

-
-
- Part 42 -

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

-
-
- Part 43 -

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

-
-
- Part 44 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 47 -

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

-
-
- Part 48 -

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

-
-
- Part 49 -

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

-
-
- Part 50 -

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

-
-
- Part 51 -

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

-
-
- Part 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.

-
-
- Part 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. -

-
-
- Part 54 -

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

-
-
- Part 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.

-
-
- Part 56 -

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

-
-
- Part 57 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 60 -

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

-
-
- Part 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. -

-
-
- Part 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. -

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 66 -

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

-
-
- Part 67 -

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

-
-
- Part 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.

-
-
- Part 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.

-
-
- Part 70 -

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

-
-
- Part 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.

-
-
- Part 72 -

Persons disposed to jaundice are not very subject to flatulence.

-
-
- - -
- SECTION VI - -
- Part 1 -

In cases of chronic lientery, acid eructations supervening when there were - none previously, is a good symptom.

-
-
- Part 2 -

Persons whose noses are naturally watery, and their seed watery, have rather - a deranged state of health; but those in the opposite state, a more - favorable.

-
-
- Part 3 -

In protracted cases of dysentery, loathing of food is a bad symptom, and - still worse, if along with fever.

-
-
- Part 4 -

Ulcers, attended with a falling off of the hair, are mali moris.

-
-
- Part 5 -

It deserves to be considered whether the pains in the sides, and in the - breasts, and in the other parts, differ much from one another.

-
-
- Part 6 -

Diseases about the kidneys and bladder are cured with difficulty in old men. -

-
-
- Part 7 -

Pains occurring about the stomach, the more superficial they are, the more - slight are they; and the less superficial, the more severe.

-
-
- Part 8 -

In dropsical persons, ulcers forming on the body are not easily healed.

-
-
- Part 9 -

Broad exanthemata are not very itchy.

-
-
- Part 10 -

In a person having a painful spot in the head, with intense cephalalgia, pus - or water running from the nose, or by the mouth, or at the ears, removes the - disease.

-
-
- Part 11 -

Hemorrhoids appearing in melancholic and nephritic affections are favorable. -

-
-
- Part 12 -

When a person has been cured of chronic hemorrhoids, unless one be left, - there is danger of dropsy or phthisis supervening.

-
-
- Part 13 -

Sneezing coming on, in the case of a person afflicted with hiccup, removes - the hiccup. -

-
-
- Part 14 -

In a case of dropsy, when the water runs by the veins into the belly, it - removes the disease.

-
-
- Part 15 -

In confirmed diarrhoea, vomiting, when it comes on spontaneously, removes the - diarrhoea.

-
-
- Part 16 -

A diarrhoea supervening in a confirmed case of pleurisy or pneumonia is bad. -

-
-
- Part 17 -

It is a good thing in ophthalmy for the patient to be seized with diarrhoea. -

-
-
- Part 18 -

A severe wound of the bladder, of the brain, of the heart, of the diaphragm, - of the small intestines, of the stomach, and of the liver, is deadly.

-
-
- Part 19 -

When a bone, cartilage, nerve, the slender part of the jaw, or prepuce, are - cut out, the part is neither restored, nor does it unite.

-
-
- Part 20 -

If blood be poured out preternaturally into a cavity, it must necessarily - become corrupted.

-
-
- Part 21 -

In maniacal affections, if varices or hemorrhoids come on, they remove the - mania.

-
-
- Part 22 -

Those ruptures in the back which spread down to the elbows are removed by - venesection.

-
-
- Part 23 -

If a fright or despondency lasts for a long time, it is a melancholic - affection.

-
-
- Part 24 -

If any of the intestines be transfixed, it does not unite.

-
-
- Part 25 -

It is not a good sign for an erysipelas spreading outwardly to be determined - inward; but for it to be determined outward from within is good.

-
-
- Part26 -

In whatever cases of ardent fever tremors occur, they are carried off by a - delirium.

-
-
- Part 27 -

Those cases of empyema or dropsy which are treated by incision or the - cautery, if the water or pus flow rapidly all at once, certainly prove - fatal.

-
-
- Part 28 -

Eunuchs do not take the gout, nor become bald.

-
-
- Part 29 -

A woman does not take the gout, unless her menses be stopped.

-
-
- Part 30 -

A young man does not take the gout until he indulges in coition. -

-
-
- Part 31 -

Pains of the eyes are removed by drinking pure wine, or the bath, or a - fomentation, or venesection, or purging.

-
-
- Part 32 -

Persons whose speech has become impaired are likely to be seized with chronic - diarrhoea.

-
-
- Part 33 -

Persons having acid eructations are not very apt to be seized with pleurisy. -

-
-
- Part 34 -

Persons who have become bald are not subject to large varices; but should - varices supervene upon persons who are bald, their hair again grows thick. -

-
-
- Part 35 -

Hiccup supervening in dropsical cases is bad.

-
-
- Part 36 -

Venesection cures dysuria; open the internal veins of the arm.

-
-
- Part 37 -

It is a good symptom when swelling on the outside of the neck seizes a person - very ill of quinsy, for the disease is turned outwardly.

-
-
- Part 38 -

It is better not to apply any treatment in cases of occult cancer; for, if - treated, the patients die quickly; but if not treated, they hold out for a - long time.

-
-
- Part 39 -

Convulsions take place either from repletion or depletion; and so it is with - hiccup.

-
-
- Part 40 -

When pains, without inflammation, occur about the hypochondria, in such - cases, fever supervening removes the pain.

-
-
- Part 41 -

When pus formed anywhere in the body does not point, this is owing to the - thickness of the part.

-
-
- Part 42 -

In cases of jaundice, it is a bad symptom when the liver becomes indurated. -

-
-
- Part 43 -

When persons having large spleens are seized with dysentery, and if the - dysentery pass into a chronic state, either dropsy or lientery supervenes, - and they die.

-
-
- Part 44 -

When ileus comes on in a case of strangury, they prove fatal in seven days, - unless, fever supervening, there be a copious discharge of urine.

-
-
- Part 45 -

When ulcers continue open for a year or upward, there must necessarily be - exfoliation of bone, and the cicatrices are hollow.

-
-
- Part 46 -

Such persons as become hump-backed from asthma or cough before puberty, die. - -

-
-
- Part 47 -

Persons who are benefited by venesection or purging, should be bled or purged - in spring.

-
-
- Part 48 -

In enlargement of the spleen, it is a good symptom when dysentery comes on. -

-
-
- Part 49 -

In gouty affections, the inflammation subsides in the course of forty days. -

-
-
- Part 50 -

When the brain is severely wounded, fever and vomiting of bile necessarily - supervene.

-
-
- Part 51 -

When persons in good health are suddenly seized with pains in the head, and - straightway are laid down speechless, and breathe with stertor, they die in - seven days, unless fever come on.

-
-
- Part 52 -

We must attend to the appearances of the eyes in sleep, as presented from - below; for if a portion of the white be seen between the closed eyelids, and - if this be not connected with diarrhaea or severe purging, it is a very bad - and mortal symptom.

-
-
- Part 53 -

Delirium attended with laughter is less dangerous than delirium attended with - a serious mood.

-
-
- Part 54 -

In acute diseases, complicated with fever, a moaning respiration is bad.

-
-
- Part 55 -

For the most part, gouty affections rankle in spring and in autumn.

-
-
- Part 56 -

In melancholic affections, determinations of the humor which occasions them - produce the following diseases; either apoplexy of the whole body, or - convulsion, or madness, or blindness.

-
-
- Part 57 -

Persons are most subject to apoplexy between the ages of forty and sixty. -

-
-
- Part 58 -

If the omentum protrude, it necessarily mortifies and drops off.

-
-
- Part 59 -

In chronic diseases of the hip-joint, if the bone protrude and return again - into its socket, there is mucosity in the place.

-
-
- Part 60 -

In persons affected with chronic disease of the hip-joint, if the bone - protrude from its socket, the limb becomes wasted and maimed, unless the - part be cauterized.

-
-
- -
- SECTION VII - -
- Part 1 -

In acute diseases, coldness of the extremities is bad.

-
-
- Part 2 -

Livid flesh on a diseased bone is bad. -

-
-
- Part 3 -

Hiccup and redness of the eyes, when they supervene on vomiting, are bad. -

-
-
- Part 4 -

A chill supervening on a sweat is not good.

-
-
- Part 5 -

Dysentery, or dropsy, or ecstacy coming on madness is good.

-
-
- Part 6 -

In a very protracted disease, loss of appetite and unmixed discharges from - the bowels are bad symptoms.

-
-
- Part 7 -

A rigor and delirium from excessive drinking are bad.

-
-
- Part 8 -

From the rupture of an internal abscess, prostration of strength, vomiting, - and deliquium animi result.

-
-
- Part 9 -

Delirium or convulsion from a flow of blood is bad.

-
-
- Part 10 -

Vomiting, or hiccup, or convulsion, or delirium, in ileus, is bad.

-
-
- Part 11 -

Pneumonia coming on pleurisy is bad.

-
-
- Part 12 -

Phrenitis along with pneumonia is bad.

-
-
- Part 13 -

Convulsion or tetanus, coming upon severe burning, is bad.

-
-
- Part 14 -

Stupor or delirium from a blow on the head is bad.

-
-
- Part 15 -

From a spitting of blood there is a spitting of pus.

-
-
- Part 16 -

From spitting of pus arise phthisis and a flux; and when the sputa are - stopped, they die.

-
-
- Part 17 -

Hiccup in inflammation of the liver bad.

-
-
- Part 18 -

Convulsion or delirium supervening upon insomnolency is bad.

-
-
- Part 18a -

Trembling upon lethargus is bad.

-
-
- Part 19 -

Erysipelas upon exposure of a bone (is bad?).

-
-
- Part 20 -

Mortification or suppuration upon erysipelas is bad.

-
-
- Part 21 -

Hemorrhage upon a strong pulsation in wounds is bad.

-
-
- Part 22 -

Suppuration upon a protracted pain of the parts about the bowels is bad.

-
-
- Part 23 -

Dysentery upon unmixed alvine discharges is bad.

-
-
- Part 24 -

Delirium upon division of the cranium, if it penetrate into the cavity of the - head, is bad.

-
-
- Part 25 -

Convulsion upon severe purging is mortal.

-
-
- Part 26 -

Upon severe pain of the parts about the bowels, coldness of the extremities - coming on is bad.

-
-
- Part 27 -

Tenesmus coming on in a case of pregnancy causes abortion.

-
-
- Part 28 -

Whatever piece of bone, cartilage, or nerve (tendon?) is - cut off, it neither grows nor unites. -

-
-
- Part 29 -

When strong diarrhoea supervenes in a case of leucophlegmatia, it removes the - disease.

-
-
- Part 30 -

In those cases in which frothy discharges occur in diarrhoea there are - defluxions from the head.

-
-
- Part 31 -

When there is a farinaceous sediment in the urine during fever, it indicates - a protracted illness.

-
-
- Part 32 -

In those cases in which the urine is thin at first, and the sediments become - bilious, an acute disease is indicated.

-
-
- Part 33 -

In those cases in which the urine becomes divided there is great disorder in - the body.

-
-
- Part 34 -

When bubbles settle on the surface of the urine, they indicate disease of the - kidneys, and that the complaint will be protracted.

-
-
- Part 35 -

When the scum on the surface is fatty and copious, it indicates acute - diseases of the kidneys.

-
-
- Part 36 -

Whenever the aforementioned symptoms occur in nephritic diseases, and along - with them acute pains about the muscles of the back, provided these be - seated about the external parts, you may expect that there will be an - abscess; but if the pains be rather about the internal parts, you may also - rather expect that the abscess will be seated internally.

-
-
- Part 37 -

Haematemesis, without fever, does not prove fatal, but with fever it is bad; - it is to be treated with refrigerant and styptic things.

-
-
- Part 38 -

Defluxions into the cavity of the chest suppurate in twenty days.

-
-
- Part 39 -

When a patient passes blood and clots, and is seized with strangury and pain - in the perineum and pubes, disease about the bladder is indicated.

-
-
- Part 40 -

If the tongue suddenly lose its powers, or a part of the body become - apoplectic, the affection is of a melancholic nature.

-
-
- Part 41 -

In hypercatharsis, of old persons, hiccup supervening is not a good symptom. -

-
-
- Part 42 -

In a fever, is not of a bilious nature, a copious allusion of hot water upon - the head removes the fever.

-
-
- Part 43 -

A woman does not become ambidexterous.

-
-
- Part 44 -

When empyema is treated either by the cautery or incision, if - pure and white pus flow from the wound, the patients recover; but if mixed - with blood, slimy and fetid, they die.

-
-
- Part 45 -

When abscess of the liver is treated by the cautery or incision, if the pus - which is discharged be pure and white, the patients recover, (for in this - case it is situated in the coats of the liver;) but if it resemble the lees - of oil as it flows, they die.

-
-
- Part 46 -

Pains of the eyes are removed by drinking undiluted wine, plenteous bathing - with hot water, and venesection.

-
-
- Part 47 -

If a dropsical patient be seized with hiccup the case is hopeless.

-
-
- Part 48 -

Strangury and dysuria are cured by drinking pure wine, and venesection; open - the vein on the inside.

-
-
- Part 49 -

It is a good sign when swelling and redness on the breast seize a person very - ill of quinsy, for in this case the disease is diverted outwardly.

-
-
- Part 50 -

When the brain is attacked with sphacelus, the patients die in three days; or - if they escape these, they recover.

-
-
- Part 51 -

Sneezing arises from the head, owing to the brain being heated, or the cavity - (ventricle) in the head being filled with humors; - the air confined in it then is discharged, and makes a noise, because it - comes through a narrow passage.

-
-
- Part 52 -

Fever supervening on painful affections of the liver removes the pain.

-
-
- Part 53 -

Those persons to whom it is beneficial to have blood taken from their veins, - should have it done in spring.

-
-
- Part 54 -

In those cases where phlegm is collected between the diaphragm and the - stomach, and occasions pain, as not finding a passage into either of the - cavities, the disease will be carried off if the phlegm be diverted to the - bladder by the veins.

-
-
- Part 55 -

When the liver is filled with water and bursts into the epiploon, in this - case the belly is filled with water and the patient dies.

-
-
- Part 56 -

Anxiety, yawning, rigor,-wine drunk with an equal proportion of water, - removes these complaints.

-
-
- Part 57 -

When tubercles (phymata) form in the urethra, if they - suppurate and burst, the pain is carried off. -

-
-
- Part 58 -

In cases of concussion of the brain produced by any cause, the patients - necessarily lose their speech.

-
-
- Part 59 -

In a person affected with fever, when there is no swelling in the fauces, - should suffocation suddenly come on, and the patient not be able to swallow, - except with difficulty, it is a mortal symptom.

-
-
- Part 59a -

In the case of a person oppressed by fever, if the neck be turned aside, and - the patient cannot swallow, while there is no swelling in the neck, it is a - mortal sign.

-
-
- Part 60 -

Fasting should be prescribed the those persons who have humid flesh; for - fasting dries bodies.

-
-
- Part 61 -

When there are changes in the whole body, and the body becomes sometimes cold - and sometimes hot, and the color changes, a protracted disease is indicated. -

-
-
- Part 62 -

A copious sweat, hot or cold, constantly flowing, indicates a superabundance - of humidity; we must evacuate then, in a strong person upward, and in a - weak, downward.

-
-
- Part 63 -

Fevers, not of the intermittent type, if they become exacerbated every third - day are dangerous; but if they intermit in any form whatever, this shows - that they are not dangerous.

-
-
- Part 64 -

In cases of protracted fever, either chronic abscesses or pains in the joints - come on.

-
-
- Part 65 -

When chronic abscesses (phymata) or pains in the joints - take place after fevers, the patients are using too much food.

-
-
- Part 66 -

If one give to a person in fever the same food which is given to a person in - good health, what is strength to the one is disease to the other.

-
-
- Part 67 -

We must look to the urinary evacuations, whether they resemble those of - persons in health; if not at all so, they are particularly morbid, but if - they are like those of healthy persons, they are not at all morbid.

-
-
- Part 68 -

When the dejections are allowed to stand and not shaken, and a sediment is - formed like scrapings (of the bowels), in such a case it is proper to purge - the bowels; and if you give ptisans before purging, the more you give the - more harm you will do.

-
-
- Part 69 -

Crude dejections are the product of black bile; if abundant, of more copious, - and if deficient, of less copious collections of it.

-
-
- Part 70 -

The sputa in fevers, not of an intermittent type, which are - livid, streaked with blood, and fetid, are all bad, it is favorable when - this evacuation, like the urinary and alvine, passes freely; and whenever - any discharge is suppressed and not purged off it is bad.

-
-
- Part 71 -

When you wish to purge the body, you must bring it into a state favorable to - evacuations; and if you wish to dispose it to evacuations upward, you must - bind the belly; and if you wish to dispose it to evacuations downward, you - must moisten the belly.

-
-
- Part 72 -

Sleep and watchfulness, both of them, when immoderate, constitute disease. -

-
-
- Part 73 -

In fevers which do not intermit, if the external parts be cold, and the - internal burning hot, and fever prevail, it is a mortal sign.

-
-
- Part 74 -

In a fever which does not intermit, if a lip, the nose, or an eye be - distorted, if the patient lose his sense of sight or of hearing, while now - in a weak state,-whatever of these symptoms occurs it is mortal.

-
-
- Part 75 -

Upon leucophlegmatia dropsy supervenes.

-
-
- Part 76 -

Upon diarrhoea dysentery.

-
-
- Part 77 -

Upon dysentery lientery.

-
-
- Part 78 -

Upon sphacelus exfoliation of the bone.

-
-
- Part 79 and 80 -

Upon vomiting of blood consumption, and a purging of pus upward; upon - consumption a defluxion from the head; upon a defluxion diarrhoea; upon - diarrhoea a stoppage of the purging upward; upon the stoppage of it death. -

-
-
- Part 81 -

In the discharges by the bladder, the belly, and the flesh (the skin?) if the body has departed slightly from its natural - condition, the disease is slight; if much, it is great; if very much, it is - mortal.

-
-
- Part 82 -

Persons above forty years of age who are affected with frenzy, do not readily - recover; the danger is less when the disease is cognate to the constitution - and age.

-
-
- Part 83 -

In whatever diseases the eyes weep voluntarily, it is a good symptom, but - when involuntarily, it is a bad.

-
-
- Part 84 -

When in quartan fevers blood flows from the nostrils it is a bad symptom. -

-
-
- Part 85 -

Sweats are dangerous when they do not occur on critical days, - when they are strong, and quickly forced out of the forehead, either in the - form of drops or in streams, and if excessively cold and copious; for such a - sweat must proceed from violence, excess of pain, and prolonged squeezing - (affliction?).

-
-
- Part 86 -

In a chronic disease an excessive flux from the bowels is bad.

-
-
- Part 87 -

Those diseases which medicines do not cure, iron (the - knife?) cures; those which iron cannot cure, fire cures; and those - which fire cannot cure, are to be reckoned wholly incurable.

-
-
- - - + + CTS and EpiDoc conversion. + + + + + +
+
SECTION I +
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
SECTION II +
+

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

+
+

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

+
+

Both sleep and insomnolency, when immoderate, are bad.

+
+

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

+
+

Spontaneous lassitude indicates disease.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

Persons in whom a crisis takes place pass the night preced-ing the paroxysm uncomfortably, but the succeeding night generally more comfortably.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

Drinking strong wine cures hunger.

+
+

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.

+
+

Acute disease come to a crisis in fourteen days.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

Purgative medicines agree ill with persons in good health.

+
+

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.

+
+

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

+
+

Catarrhs and coryza in very old people are not concocted.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
SECTION III +
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

Autumn is a bad season for persons in consumption.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

Of the constitutions of the year, the dry, upon the whole, are more healthy than the rainy, and attended with less mortality.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
SECTION IV +
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

We must be guarded in purging phthisical persons upward.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

All fevers complicated with buboes are bad, except ephemerals.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
SECTION V +
+

A spasm from taking hellebore is of a fatal nature.

+
+

Spasm supervening on a wound is fatal.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

In women, blood collected in the breasts indicates madness.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

Persons disposed to jaundice are not very subject to flatulence.

+
SECTION VI +
+

In cases of chronic lientery, acid eructations supervening when there were none previously, is a good symptom.

+
+

Persons whose noses are naturally watery, and their seed watery, have rather a deranged state of health; but those in the opposite state, a more favorable.

+
+

In protracted cases of dysentery, loathing of food is a bad symptom, and still worse, if along with fever.

+
+

Ulcers, attended with a falling off of the hair, are mali moris.

+
+

It deserves to be considered whether the pains in the sides, and in the breasts, and in the other parts, differ much from one another.

+
+

Diseases about the kidneys and bladder are cured with difficulty in old men.

+
+

Pains occurring about the stomach, the more superficial they are, the more slight are they; and the less superficial, the more severe.

+
+

In dropsical persons, ulcers forming on the body are not easily healed.

+
+

Broad exanthemata are not very itchy.

+
+

In a person having a painful spot in the head, with intense cephalalgia, pus or water running from the nose, or by the mouth, or at the ears, removes the disease.

+
+

Hemorrhoids appearing in melancholic and nephritic affections are favorable.

+
+

When a person has been cured of chronic hemorrhoids, unless one be left, there is danger of dropsy or phthisis supervening.

+
+

Sneezing coming on, in the case of a person afflicted with hiccup, removes the hiccup.

+
+

In a case of dropsy, when the water runs by the veins into the belly, it removes the disease.

+
+

In confirmed diarrhoea, vomiting, when it comes on spontaneously, removes the diarrhoea.

+
+

A diarrhoea supervening in a confirmed case of pleurisy or pneumonia is bad.

+
+

It is a good thing in ophthalmy for the patient to be seized with diarrhoea.

+
+

A severe wound of the bladder, of the brain, of the heart, of the diaphragm, of the small intestines, of the stomach, and of the liver, is deadly.

+
+

When a bone, cartilage, nerve, the slender part of the jaw, or prepuce, are cut out, the part is neither restored, nor does it unite.

+
+

If blood be poured out preternaturally into a cavity, it must necessarily become corrupted.

+
+

In maniacal affections, if varices or hemorrhoids come on, they remove the mania.

+
+

Those ruptures in the back which spread down to the elbows are removed by venesection.

+
+

If a fright or despondency lasts for a long time, it is a melancholic affection.

+
+

If any of the intestines be transfixed, it does not unite.

+
+

It is not a good sign for an erysipelas spreading outwardly to be determined inward; but for it to be determined outward from within is good.

+
+

In whatever cases of ardent fever tremors occur, they are carried off by a delirium.

+
+

Those cases of empyema or dropsy which are treated by incision or the cautery, if the water or pus flow rapidly all at once, certainly prove fatal.

+
+

Eunuchs do not take the gout, nor become bald.

+
+

A woman does not take the gout, unless her menses be stopped.

+
+

A young man does not take the gout until he indulges in coition.

+
+

Pains of the eyes are removed by drinking pure wine, or the bath, or a fomentation, or venesection, or purging.

+
+

Persons whose speech has become impaired are likely to be seized with chronic diarrhoea.

+
+

Persons having acid eructations are not very apt to be seized with pleurisy.

+
+

Persons who have become bald are not subject to large varices; but should varices supervene upon persons who are bald, their hair again grows thick.

+
+

Hiccup supervening in dropsical cases is bad.

+
+

Venesection cures dysuria; open the internal veins of the arm.

+
+

It is a good symptom when swelling on the outside of the neck seizes a person very ill of quinsy, for the disease is turned outwardly.

+
+

It is better not to apply any treatment in cases of occult cancer; for, if treated, the patients die quickly; but if not treated, they hold out for a long time.

+
+

Convulsions take place either from repletion or depletion; and so it is with hiccup.

+
+

When pains, without inflammation, occur about the hypochondria, in such cases, fever supervening removes the pain.

+
+

When pus formed anywhere in the body does not point, this is owing to the thickness of the part.

+
+

In cases of jaundice, it is a bad symptom when the liver becomes indurated.

+
+

When persons having large spleens are seized with dysentery, and if the dysentery pass into a chronic state, either dropsy or lientery supervenes, and they die.

+
+

When ileus comes on in a case of strangury, they prove fatal in seven days, unless, fever supervening, there be a copious discharge of urine.

+
+

When ulcers continue open for a year or upward, there must necessarily be exfoliation of bone, and the cicatrices are hollow.

+
+

Such persons as become hump-backed from asthma or cough before puberty, die.

+
+

Persons who are benefited by venesection or purging, should be bled or purged in spring.

+
+

In enlargement of the spleen, it is a good symptom when dysentery comes on.

+
+

In gouty affections, the inflammation subsides in the course of forty days.

+
+

When the brain is severely wounded, fever and vomiting of bile necessarily supervene.

+
+

When persons in good health are suddenly seized with pains in the head, and straightway are laid down speechless, and breathe with stertor, they die in seven days, unless fever come on.

+
+

We must attend to the appearances of the eyes in sleep, as presented from below; for if a portion of the white be seen between the closed eyelids, and if this be not connected with diarrhaea or severe purging, it is a very bad and mortal symptom.

+
+

Delirium attended with laughter is less dangerous than delirium attended with a serious mood.

+
+

In acute diseases, complicated with fever, a moaning respiration is bad.

+
+

For the most part, gouty affections rankle in spring and in autumn.

+
+

In melancholic affections, determinations of the humor which occasions them produce the following diseases; either apoplexy of the whole body, or convulsion, or madness, or blindness.

+
+

Persons are most subject to apoplexy between the ages of forty and sixty.

+
+

If the omentum protrude, it necessarily mortifies and drops off.

+
+

In chronic diseases of the hip-joint, if the bone protrude and return again into its socket, there is mucosity in the place.

+
+

In persons affected with chronic disease of the hip-joint, if the bone protrude from its socket, the limb becomes wasted and maimed, unless the part be cauterized.

+
SECTION VII +
+

In acute diseases, coldness of the extremities is bad.

+
+

Livid flesh on a diseased bone is bad.

+
+

Hiccup and redness of the eyes, when they supervene on vomiting, are bad.

+
+

A chill supervening on a sweat is not good.

+
+

Dysentery, or dropsy, or ecstacy coming on madness is good.

+
+

In a very protracted disease, loss of appetite and unmixed discharges from the bowels are bad symptoms.

+
+

A rigor and delirium from excessive drinking are bad.

+
+

From the rupture of an internal abscess, prostration of strength, vomiting, and deliquium animi result.

+
+

Delirium or convulsion from a flow of blood is bad.

+
+

Vomiting, or hiccup, or convulsion, or delirium, in ileus, is bad.

+
+

Pneumonia coming on pleurisy is bad.

+
+

Phrenitis along with pneumonia is bad.

+
+

Convulsion or tetanus, coming upon severe burning, is bad.

+
+

Stupor or delirium from a blow on the head is bad.

+
+

From a spitting of blood there is a spitting of pus.

+
+

From spitting of pus arise phthisis and a flux; and when the sputa are stopped, they die.

+
+

Hiccup in inflammation of the liver bad.

+
+

Convulsion or delirium supervening upon insomnolency is bad.

+
+

Trembling upon lethargus is bad.

+
+

Erysipelas upon exposure of a bone (is bad?).

+
+

Mortification or suppuration upon erysipelas is bad.

+
+

Hemorrhage upon a strong pulsation in wounds is bad.

+
+

Suppuration upon a protracted pain of the parts about the bowels is bad.

+
+

Dysentery upon unmixed alvine discharges is bad.

+
+

Delirium upon division of the cranium, if it penetrate into the cavity of the head, is bad.

+
+

Convulsion upon severe purging is mortal.

+
+

Upon severe pain of the parts about the bowels, coldness of the extremities coming on is bad.

+
+

Tenesmus coming on in a case of pregnancy causes abortion.

+
+

Whatever piece of bone, cartilage, or nerve (tendon?) is cut off, it neither grows nor unites.

+
+

When strong diarrhoea supervenes in a case of leucophlegmatia, it removes the disease.

+
+

In those cases in which frothy discharges occur in diarrhoea there are defluxions from the head.

+
+

When there is a farinaceous sediment in the urine during fever, it indicates a protracted illness.

+
+

In those cases in which the urine is thin at first, and the sediments become bilious, an acute disease is indicated.

+
+

In those cases in which the urine becomes divided there is great disorder in the body.

+
+

When bubbles settle on the surface of the urine, they indicate disease of the kidneys, and that the complaint will be protracted.

+
+

When the scum on the surface is fatty and copious, it indicates acute diseases of the kidneys.

+
+

Whenever the aforementioned symptoms occur in nephritic diseases, and along with them acute pains about the muscles of the back, provided these be seated about the external parts, you may expect that there will be an abscess; but if the pains be rather about the internal parts, you may also rather expect that the abscess will be seated internally.

+
+

Haematemesis, without fever, does not prove fatal, but with fever it is bad; it is to be treated with refrigerant and styptic things.

+
+

Defluxions into the cavity of the chest suppurate in twenty days.

+
+

When a patient passes blood and clots, and is seized with strangury and pain in the perineum and pubes, disease about the bladder is indicated.

+
+

If the tongue suddenly lose its powers, or a part of the body become apoplectic, the affection is of a melancholic nature.

+
+

In hypercatharsis, of old persons, hiccup supervening is not a good symptom.

+
+

In a fever, is not of a bilious nature, a copious allusion of hot water upon the head removes the fever.

+
+

A woman does not become ambidexterous.

+
+

When empyema is treated either by the cautery or incision, if pure and white pus flow from the wound, the patients recover; but if mixed with blood, slimy and fetid, they die.

+
+

When abscess of the liver is treated by the cautery or incision, if the pus which is discharged be pure and white, the patients recover, (for in this case it is situated in the coats of the liver;) but if it resemble the lees of oil as it flows, they die.

+
+

Pains of the eyes are removed by drinking undiluted wine, plenteous bathing with hot water, and venesection.

+
+

If a dropsical patient be seized with hiccup the case is hopeless.

+
+

Strangury and dysuria are cured by drinking pure wine, and venesection; open the vein on the inside.

+
+

It is a good sign when swelling and redness on the breast seize a person very ill of quinsy, for in this case the disease is diverted outwardly.

+
+

When the brain is attacked with sphacelus, the patients die in three days; or if they escape these, they recover.

+
+

Sneezing arises from the head, owing to the brain being heated, or the cavity (ventricle) in the head being filled with humors; the air confined in it then is discharged, and makes a noise, because it comes through a narrow passage.

+
+

Fever supervening on painful affections of the liver removes the pain.

+
+

Those persons to whom it is beneficial to have blood taken from their veins, should have it done in spring.

+
+

In those cases where phlegm is collected between the diaphragm and the stomach, and occasions pain, as not finding a passage into either of the cavities, the disease will be carried off if the phlegm be diverted to the bladder by the veins.

+
+

When the liver is filled with water and bursts into the epiploon, in this case the belly is filled with water and the patient dies.

+
+

Anxiety, yawning, rigor,-wine drunk with an equal proportion of water, removes these complaints.

+
+

When tubercles (phymata) form in the urethra, if they suppurate and burst, the pain is carried off.

+
+

In cases of concussion of the brain produced by any cause, the patients necessarily lose their speech.

+
+

In a person affected with fever, when there is no swelling in the fauces, should suffocation suddenly come on, and the patient not be able to swallow, except with difficulty, it is a mortal symptom.

+
+

In the case of a person oppressed by fever, if the neck be turned aside, and the patient cannot swallow, while there is no swelling in the neck, it is a mortal sign.

+
+

Fasting should be prescribed the those persons who have humid flesh; for fasting dries bodies.

+
+

When there are changes in the whole body, and the body becomes sometimes cold and sometimes hot, and the color changes, a protracted disease is indicated.

+
+

A copious sweat, hot or cold, constantly flowing, indicates a superabundance of humidity; we must evacuate then, in a strong person upward, and in a weak, downward.

+
+

Fevers, not of the intermittent type, if they become exacerbated every third day are dangerous; but if they intermit in any form whatever, this shows that they are not dangerous.

+
+

In cases of protracted fever, either chronic abscesses or pains in the joints come on.

+
+

When chronic abscesses (phymata) or pains in the joints take place after fevers, the patients are using too much food.

+
+

If one give to a person in fever the same food which is given to a person in good health, what is strength to the one is disease to the other.

+
+

We must look to the urinary evacuations, whether they resemble those of persons in health; if not at all so, they are particularly morbid, but if they are like those of healthy persons, they are not at all morbid.

+
+

When the dejections are allowed to stand and not shaken, and a sediment is formed like scrapings (of the bowels), in such a case it is proper to purge the bowels; and if you give ptisans before purging, the more you give the more harm you will do.

+
+

Crude dejections are the product of black bile; if abundant, of more copious, and if deficient, of less copious collections of it.

+
+

The sputa in fevers, not of an intermittent type, which are livid, streaked with blood, and fetid, are all bad, it is favorable when this evacuation, like the urinary and alvine, passes freely; and whenever any discharge is suppressed and not purged off it is bad.

+
+

When you wish to purge the body, you must bring it into a state favorable to evacuations; and if you wish to dispose it to evacuations upward, you must bind the belly; and if you wish to dispose it to evacuations downward, you must moisten the belly.

+
+

Sleep and watchfulness, both of them, when immoderate, constitute disease.

+
+

In fevers which do not intermit, if the external parts be cold, and the internal burning hot, and fever prevail, it is a mortal sign.

+
+

In a fever which does not intermit, if a lip, the nose, or an eye be distorted, if the patient lose his sense of sight or of hearing, while now in a weak state,-whatever of these symptoms occurs it is mortal.

+
+

Upon leucophlegmatia dropsy supervenes.

+
+

Upon diarrhoea dysentery.

+
+

Upon dysentery lientery.

+
+

Upon sphacelus exfoliation of the bone.

+
+

Upon vomiting of blood consumption, and a purging of pus upward; upon consumption a defluxion from the head; upon a defluxion diarrhoea; upon diarrhoea a stoppage of the purging upward; upon the stoppage of it death.

+
+

In the discharges by the bladder, the belly, and the flesh (the skin?) if the body has departed slightly from its natural condition, the disease is slight; if much, it is great; if very much, it is mortal.

+
+

Persons above forty years of age who are affected with frenzy, do not readily recover; the danger is less when the disease is cognate to the constitution and age.

+
+

In whatever diseases the eyes weep voluntarily, it is a good symptom, but when involuntarily, it is a bad.

+
+

When in quartan fevers blood flows from the nostrils it is a bad symptom.

+
+

Sweats are dangerous when they do not occur on critical days, when they are strong, and quickly forced out of the forehead, either in the form of drops or in streams, and if excessively cold and copious; for such a sweat must proceed from violence, excess of pain, and prolonged squeezing (affliction?).

+
+

In a chronic disease an excessive flux from the bowels is bad.

+
+

Those diseases which medicines do not cure, iron (the knife?) cures; those which iron cannot cure, fire cures; and those which fire cannot cure, are to be reckoned wholly incurable.

 diff --git a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml new file mode 100644 index 000000000..4287e5db9 --- /dev/null +++ b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-eng2.xml @@ -0,0 +1,916 @@ + + + + + + + Aphorisms + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg012.perseus-eng2.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + + +

Data Entry

+ + + + + +

This pointer pattern extracts section and aphorism.

+ + +

This pointer pattern extracts section.

+ + + + + + + English + + + + CTS and EpiDoc conversion. + + + + + +
+
SECTION I +
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
SECTION II +
+

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

+
+

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

+
+

Both sleep and insomnolency, when immoderate, are bad.

+
+

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

+
+

Spontaneous lassitude indicates disease.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

Persons in whom a crisis takes place pass the night preced-ing the paroxysm uncomfortably, but the succeeding night generally more comfortably.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

Drinking strong wine cures hunger.

+
+

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.

+
+

Acute disease come to a crisis in fourteen days.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

Purgative medicines agree ill with persons in good health.

+
+

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.

+
+

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

+
+

Catarrhs and coryza in very old people are not concocted.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
SECTION III +
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

Autumn is a bad season for persons in consumption.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

Of the constitutions of the year, the dry, upon the whole, are more healthy than the rainy, and attended with less mortality.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
SECTION IV +
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

We must be guarded in purging phthisical persons upward.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

All fevers complicated with buboes are bad, except ephemerals.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
SECTION V +
+

A spasm from taking hellebore is of a fatal nature.

+
+

Spasm supervening on a wound is fatal.

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

In women, blood collected in the breasts indicates madness.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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.

+
+

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.

+
+

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.

+
+

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.

+
+

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

+
+

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

+
+

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

+
+

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.

+
+

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

+
+

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.

+
+

Persons disposed to jaundice are not very subject to flatulence.

+
SECTION VI +
+

In cases of chronic lientery, acid eructations supervening when there were none previously, is a good symptom.

+
+

Persons whose noses are naturally watery, and their seed watery, have rather a deranged state of health; but those in the opposite state, a more favorable.

+
+

In protracted cases of dysentery, loathing of food is a bad symptom, and still worse, if along with fever.

+
+

Ulcers, attended with a falling off of the hair, are mali moris.

+
+

It deserves to be considered whether the pains in the sides, and in the breasts, and in the other parts, differ much from one another.

+
+

Diseases about the kidneys and bladder are cured with difficulty in old men.

+
+

Pains occurring about the stomach, the more superficial they are, the more slight are they; and the less superficial, the more severe.

+
+

In dropsical persons, ulcers forming on the body are not easily healed.

+
+

Broad exanthemata are not very itchy.

+
+

In a person having a painful spot in the head, with intense cephalalgia, pus or water running from the nose, or by the mouth, or at the ears, removes the disease.

+
+

Hemorrhoids appearing in melancholic and nephritic affections are favorable.

+
+

When a person has been cured of chronic hemorrhoids, unless one be left, there is danger of dropsy or phthisis supervening.

+
+

Sneezing coming on, in the case of a person afflicted with hiccup, removes the hiccup.

+
+

In a case of dropsy, when the water runs by the veins into the belly, it removes the disease.

+
+

In confirmed diarrhoea, vomiting, when it comes on spontaneously, removes the diarrhoea.

+
+

A diarrhoea supervening in a confirmed case of pleurisy or pneumonia is bad.

+
+

It is a good thing in ophthalmy for the patient to be seized with diarrhoea.

+
+

A severe wound of the bladder, of the brain, of the heart, of the diaphragm, of the small intestines, of the stomach, and of the liver, is deadly.

+
+

When a bone, cartilage, nerve, the slender part of the jaw, or prepuce, are cut out, the part is neither restored, nor does it unite.

+
+

If blood be poured out preternaturally into a cavity, it must necessarily become corrupted.

+
+

In maniacal affections, if varices or hemorrhoids come on, they remove the mania.

+
+

Those ruptures in the back which spread down to the elbows are removed by venesection.

+
+

If a fright or despondency lasts for a long time, it is a melancholic affection.

+
+

If any of the intestines be transfixed, it does not unite.

+
+

It is not a good sign for an erysipelas spreading outwardly to be determined inward; but for it to be determined outward from within is good.

+
+

In whatever cases of ardent fever tremors occur, they are carried off by a delirium.

+
+

Those cases of empyema or dropsy which are treated by incision or the cautery, if the water or pus flow rapidly all at once, certainly prove fatal.

+
+

Eunuchs do not take the gout, nor become bald.

+
+

A woman does not take the gout, unless her menses be stopped.

+
+

A young man does not take the gout until he indulges in coition.

+
+

Pains of the eyes are removed by drinking pure wine, or the bath, or a fomentation, or venesection, or purging.

+
+

Persons whose speech has become impaired are likely to be seized with chronic diarrhoea.

+
+

Persons having acid eructations are not very apt to be seized with pleurisy.

+
+

Persons who have become bald are not subject to large varices; but should varices supervene upon persons who are bald, their hair again grows thick.

+
+

Hiccup supervening in dropsical cases is bad.

+
+

Venesection cures dysuria; open the internal veins of the arm.

+
+

It is a good symptom when swelling on the outside of the neck seizes a person very ill of quinsy, for the disease is turned outwardly.

+
+

It is better not to apply any treatment in cases of occult cancer; for, if treated, the patients die quickly; but if not treated, they hold out for a long time.

+
+

Convulsions take place either from repletion or depletion; and so it is with hiccup.

+
+

When pains, without inflammation, occur about the hypochondria, in such cases, fever supervening removes the pain.

+
+

When pus formed anywhere in the body does not point, this is owing to the thickness of the part.

+
+

In cases of jaundice, it is a bad symptom when the liver becomes indurated.

+
+

When persons having large spleens are seized with dysentery, and if the dysentery pass into a chronic state, either dropsy or lientery supervenes, and they die.

+
+

When ileus comes on in a case of strangury, they prove fatal in seven days, unless, fever supervening, there be a copious discharge of urine.

+
+

When ulcers continue open for a year or upward, there must necessarily be exfoliation of bone, and the cicatrices are hollow.

+
+

Such persons as become hump-backed from asthma or cough before puberty, die.

+
+

Persons who are benefited by venesection or purging, should be bled or purged in spring.

+
+

In enlargement of the spleen, it is a good symptom when dysentery comes on.

+
+

In gouty affections, the inflammation subsides in the course of forty days.

+
+

When the brain is severely wounded, fever and vomiting of bile necessarily supervene.

+
+

When persons in good health are suddenly seized with pains in the head, and straightway are laid down speechless, and breathe with stertor, they die in seven days, unless fever come on.

+
+

We must attend to the appearances of the eyes in sleep, as presented from below; for if a portion of the white be seen between the closed eyelids, and if this be not connected with diarrhaea or severe purging, it is a very bad and mortal symptom.

+
+

Delirium attended with laughter is less dangerous than delirium attended with a serious mood.

+
+

In acute diseases, complicated with fever, a moaning respiration is bad.

+
+

For the most part, gouty affections rankle in spring and in autumn.

+
+

In melancholic affections, determinations of the humor which occasions them produce the following diseases; either apoplexy of the whole body, or convulsion, or madness, or blindness.

+
+

Persons are most subject to apoplexy between the ages of forty and sixty.

+
+

If the omentum protrude, it necessarily mortifies and drops off.

+
+

In chronic diseases of the hip-joint, if the bone protrude and return again into its socket, there is mucosity in the place.

+
+

In persons affected with chronic disease of the hip-joint, if the bone protrude from its socket, the limb becomes wasted and maimed, unless the part be cauterized.

+
SECTION VII +
+

In acute diseases, coldness of the extremities is bad.

+
+

Livid flesh on a diseased bone is bad.

+
+

Hiccup and redness of the eyes, when they supervene on vomiting, are bad.

+
+

A chill supervening on a sweat is not good.

+
+

Dysentery, or dropsy, or ecstacy coming on madness is good.

+
+

In a very protracted disease, loss of appetite and unmixed discharges from the bowels are bad symptoms.

+
+

A rigor and delirium from excessive drinking are bad.

+
+

From the rupture of an internal abscess, prostration of strength, vomiting, and deliquium animi result.

+
+

Delirium or convulsion from a flow of blood is bad.

+
+

Vomiting, or hiccup, or convulsion, or delirium, in ileus, is bad.

+
+

Pneumonia coming on pleurisy is bad.

+
+

Phrenitis along with pneumonia is bad.

+
+

Convulsion or tetanus, coming upon severe burning, is bad.

+
+

Stupor or delirium from a blow on the head is bad.

+
+

From a spitting of blood there is a spitting of pus.

+
+

From spitting of pus arise phthisis and a flux; and when the sputa are stopped, they die.

+
+

Hiccup in inflammation of the liver bad.

+
+

Convulsion or delirium supervening upon insomnolency is bad.

+
+

Trembling upon lethargus is bad.

+
+

Erysipelas upon exposure of a bone (is bad?).

+
+

Mortification or suppuration upon erysipelas is bad.

+
+

Hemorrhage upon a strong pulsation in wounds is bad.

+
+

Suppuration upon a protracted pain of the parts about the bowels is bad.

+
+

Dysentery upon unmixed alvine discharges is bad.

+
+

Delirium upon division of the cranium, if it penetrate into the cavity of the head, is bad.

+
+

Convulsion upon severe purging is mortal.

+
+

Upon severe pain of the parts about the bowels, coldness of the extremities coming on is bad.

+
+

Tenesmus coming on in a case of pregnancy causes abortion.

+
+

Whatever piece of bone, cartilage, or nerve (tendon?) is cut off, it neither grows nor unites.

+
+

When strong diarrhoea supervenes in a case of leucophlegmatia, it removes the disease.

+
+

In those cases in which frothy discharges occur in diarrhoea there are defluxions from the head.

+
+

When there is a farinaceous sediment in the urine during fever, it indicates a protracted illness.

+
+

In those cases in which the urine is thin at first, and the sediments become bilious, an acute disease is indicated.

+
+

In those cases in which the urine becomes divided there is great disorder in the body.

+
+

When bubbles settle on the surface of the urine, they indicate disease of the kidneys, and that the complaint will be protracted.

+
+

When the scum on the surface is fatty and copious, it indicates acute diseases of the kidneys.

+
+

Whenever the aforementioned symptoms occur in nephritic diseases, and along with them acute pains about the muscles of the back, provided these be seated about the external parts, you may expect that there will be an abscess; but if the pains be rather about the internal parts, you may also rather expect that the abscess will be seated internally.

+
+

Haematemesis, without fever, does not prove fatal, but with fever it is bad; it is to be treated with refrigerant and styptic things.

+
+

Defluxions into the cavity of the chest suppurate in twenty days.

+
+

When a patient passes blood and clots, and is seized with strangury and pain in the perineum and pubes, disease about the bladder is indicated.

+
+

If the tongue suddenly lose its powers, or a part of the body become apoplectic, the affection is of a melancholic nature.

+
+

In hypercatharsis, of old persons, hiccup supervening is not a good symptom.

+
+

In a fever, is not of a bilious nature, a copious allusion of hot water upon the head removes the fever.

+
+

A woman does not become ambidexterous.

+
+

When empyema is treated either by the cautery or incision, if pure and white pus flow from the wound, the patients recover; but if mixed with blood, slimy and fetid, they die.

+
+

When abscess of the liver is treated by the cautery or incision, if the pus which is discharged be pure and white, the patients recover, (for in this case it is situated in the coats of the liver;) but if it resemble the lees of oil as it flows, they die.

+
+

Pains of the eyes are removed by drinking undiluted wine, plenteous bathing with hot water, and venesection.

+
+

If a dropsical patient be seized with hiccup the case is hopeless.

+
+

Strangury and dysuria are cured by drinking pure wine, and venesection; open the vein on the inside.

+
+

It is a good sign when swelling and redness on the breast seize a person very ill of quinsy, for in this case the disease is diverted outwardly.

+
+

When the brain is attacked with sphacelus, the patients die in three days; or if they escape these, they recover.

+
+

Sneezing arises from the head, owing to the brain being heated, or the cavity (ventricle) in the head being filled with humors; the air confined in it then is discharged, and makes a noise, because it comes through a narrow passage.

+
+

Fever supervening on painful affections of the liver removes the pain.

+
+

Those persons to whom it is beneficial to have blood taken from their veins, should have it done in spring.

+
+

In those cases where phlegm is collected between the diaphragm and the stomach, and occasions pain, as not finding a passage into either of the cavities, the disease will be carried off if the phlegm be diverted to the bladder by the veins.

+
+

When the liver is filled with water and bursts into the epiploon, in this case the belly is filled with water and the patient dies.

+
+

Anxiety, yawning, rigor,-wine drunk with an equal proportion of water, removes these complaints.

+
+

When tubercles (phymata) form in the urethra, if they suppurate and burst, the pain is carried off.

+
+

In cases of concussion of the brain produced by any cause, the patients necessarily lose their speech.

+
+

In a person affected with fever, when there is no swelling in the fauces, should suffocation suddenly come on, and the patient not be able to swallow, except with difficulty, it is a mortal symptom.

+
+

In the case of a person oppressed by fever, if the neck be turned aside, and the patient cannot swallow, while there is no swelling in the neck, it is a mortal sign.

+
+

Fasting should be prescribed the those persons who have humid flesh; for fasting dries bodies.

+
+

When there are changes in the whole body, and the body becomes sometimes cold and sometimes hot, and the color changes, a protracted disease is indicated.

+
+

A copious sweat, hot or cold, constantly flowing, indicates a superabundance of humidity; we must evacuate then, in a strong person upward, and in a weak, downward.

+
+

Fevers, not of the intermittent type, if they become exacerbated every third day are dangerous; but if they intermit in any form whatever, this shows that they are not dangerous.

+
+

In cases of protracted fever, either chronic abscesses or pains in the joints come on.

+
+

When chronic abscesses (phymata) or pains in the joints take place after fevers, the patients are using too much food.

+
+

If one give to a person in fever the same food which is given to a person in good health, what is strength to the one is disease to the other.

+
+

We must look to the urinary evacuations, whether they resemble those of persons in health; if not at all so, they are particularly morbid, but if they are like those of healthy persons, they are not at all morbid.

+
+

When the dejections are allowed to stand and not shaken, and a sediment is formed like scrapings (of the bowels), in such a case it is proper to purge the bowels; and if you give ptisans before purging, the more you give the more harm you will do.

+
+

Crude dejections are the product of black bile; if abundant, of more copious, and if deficient, of less copious collections of it.

+
+

The sputa in fevers, not of an intermittent type, which are livid, streaked with blood, and fetid, are all bad, it is favorable when this evacuation, like the urinary and alvine, passes freely; and whenever any discharge is suppressed and not purged off it is bad.

+
+

When you wish to purge the body, you must bring it into a state favorable to evacuations; and if you wish to dispose it to evacuations upward, you must bind the belly; and if you wish to dispose it to evacuations downward, you must moisten the belly.

+
+

Sleep and watchfulness, both of them, when immoderate, constitute disease.

+
+

In fevers which do not intermit, if the external parts be cold, and the internal burning hot, and fever prevail, it is a mortal sign.

+
+

In a fever which does not intermit, if a lip, the nose, or an eye be distorted, if the patient lose his sense of sight or of hearing, while now in a weak state,-whatever of these symptoms occurs it is mortal.

+
+

Upon leucophlegmatia dropsy supervenes.

+
+

Upon diarrhoea dysentery.

+
+

Upon dysentery lientery.

+
+

Upon sphacelus exfoliation of the bone.

+
+

Upon vomiting of blood consumption, and a purging of pus upward; upon consumption a defluxion from the head; upon a defluxion diarrhoea; upon diarrhoea a stoppage of the purging upward; upon the stoppage of it death.

+
+

In the discharges by the bladder, the belly, and the flesh (the skin?) if the body has departed slightly from its natural condition, the disease is slight; if much, it is great; if very much, it is mortal.

+
+

Persons above forty years of age who are affected with frenzy, do not readily recover; the danger is less when the disease is cognate to the constitution and age.

+
+

In whatever diseases the eyes weep voluntarily, it is a good symptom, but when involuntarily, it is a bad.

+
+

When in quartan fevers blood flows from the nostrils it is a bad symptom.

+
+

Sweats are dangerous when they do not occur on critical days, when they are strong, and quickly forced out of the forehead, either in the form of drops or in streams, and if excessively cold and copious; for such a sweat must proceed from violence, excess of pain, and prolonged squeezing (affliction?).

+
+

In a chronic disease an excessive flux from the bowels is bad.

+
+

Those diseases which medicines do not cure, iron (the knife?) cures; those which iron cannot cure, fire cures; and those which fire cannot cure, are to be reckoned wholly incurable.

 + diff --git a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml index 40f3815a1..10930f6c9 100644 --- a/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml +++ b/data/tlg0627/tlg012/tlg0627.tlg012.perseus-grc2.xml @@ -1535,8 +1535,9 @@

ἐπὶ φλεγμονῇ τοῦ ἥπατος λὺγξ, κακόν.

-

ἐπὶ ἀγρυπνίῃ σπασμὸς ἢ παραφροσύνη, κακόν. 18 βις. Ἐπὶ -ληθάργῳ τρόμος, κακόν.

+

ἐπὶ ἀγρυπνίῃ σπασμὸς ἢ παραφροσύνη, κακόν.

+
+

Ἐπὶ ληθάργῳ τρόμος, κακόν.

ἐπὶ ὀστέου ψιλώσει, ἐρυσίπελας.

@@ -1817,7 +1818,7 @@

ὁκόσα φάρμακα οὐκ ἰῆται, σίδηρος ἰῆται· ὅσα σίδηρος οὐκ ἰῆται, πῦρ ἰῆται· ὅσα δὲ πῦρ οὐκ ἰῆται, ταῦτα χρὴ νομίζειν ἀνίατα.

- + diff --git a/data/tlg0627/tlg013/__cts__.xml b/data/tlg0627/tlg013/__cts__.xml index 090402a85..da8d6fdf8 100644 --- a/data/tlg0627/tlg013/__cts__.xml +++ b/data/tlg0627/tlg013/__cts__.xml @@ -5,4 +5,9 @@ Ὅρκος Hippocrates, Vol. 1. Jones, William Henry Samuel, editor. London: William Heinemann Ltd.; Cambridge, MA: Harvard University Press, 1923. + + + The Oath + Hippocrates, The Genuine Works of Hippocrates, Vol. 2. Adams, Francis, translator. New York: William Wood and Company, 1886. + diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng1.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng1.xml index 316e63983..9a0eeea1e 100644 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng1.xml +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng1.xml @@ -1,17 +1,34 @@ + - + The Oath Hippocrates Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + National Library of Medicine History of Medicine Division - Cultural Heritage Langauge Technologies + Cultural Heritage Language Technologies Kansas City Missouri - February 20, 2003 + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg013.perseus-eng4.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + @@ -21,79 +38,46 @@ Francis Adams New York - William Wood & Company + William Wood and Company 1886 + 2 + HathiTrust +

Data Entry

 - - - - - - - - - - - - - - - - - - - + + +

This pointer pattern extracts oath.

+ + - - English + English + + CTS and EpiDoc conversion. + - - -
-

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and - all the gods and goddesses, that, according to my ability and judgment, I will - keep this Oath and this stipulation- to reckon him who taught me this Art - equally dear to me as my parents, to share my substance with him, and relieve - his necessities if required; to look upon his offspring in the same footing as - my own brothers, and to teach them this art, if they shall wish to learn it, - without fee or stipulation; and that by precept, lecture, and every other mode - of instruction, I will impart a knowledge of the Art to my own sons, and those - of my teachers, and to disciples bound by a stipulation and oath according to - the law of medicine, but to none others. I will follow that system of regimen - which, according to my ability and judgment, I consider for the benefit of my - patients, and abstain from whatever is deleterious and mischievous. I will give - no deadly medicine to any one if asked, nor suggest any such counsel; and in - like manner I will not give to a woman a pessary to produce abortion. With - purity and with holiness I will pass my life and practice my Art. I will not cut - persons laboring under the stone, but will leave this to be done by men who are - practitioners of this work. Into whatever houses I enter, I will go into them - for the benefit of the sick, and will abstain from every voluntary act of - mischief and corruption; and, further from the seduction of females or males, of - freemen and slaves. Whatever, in connection with my professional practice or - not, in connection with it, I see or hear, in the life of men, which ought not - to be spoken of abroad, I will not divulge, as reckoning that all such should be - kept secret. While I continue to keep this Oath unviolated, may it be granted to - me to enjoy life and the practice of the art, respected by all men, in all - times! But should I trespass and violate this Oath, may the reverse be my lot! -

-
+ + + +
+
+

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

+
- diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml index 0e1e08e72..d5fd7b966 100644 --- a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng2.xml @@ -77,10 +77,10 @@

I SWEAR by Apollo Physician, by Asclepius, by Health, by Panacea and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. - To hold my teacher in this art equal to my own parents ; to make him partner in - my livelihood ; when he is in need of money to share mine with him ; to consider + To hold my teacher in this art equal to my own parents; to make him partner in + my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn - it, without fee or indenture ; to impart precept,Apparently the written + it, without fee or indenture; to impart precept,Apparently the written rules of the art, examples of which are to be found in several Hippocratie treatises. These books were not published in the strict sense of the word, but copies would be circulated among the members of the " physicians' @@ -101,11 +101,11 @@ the course of my profession, as well as outside my profession in my intercourse with men,This remarkable addition is worthy of a passing notice. The physician must not gossip, no matter how or where the subject-matter for - gossip may have been acquired ; whether it be in practice or in private life + gossip may have been acquired; whether it be in practice or in private life makes no difference. if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets. Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my - life and for my art ; but if I transgress it and forswear myself, may the + life and for my art; but if I transgress it and forswear myself, may the opposite befall me.

diff --git a/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml new file mode 100644 index 000000000..9a0eeea1e --- /dev/null +++ b/data/tlg0627/tlg013/tlg0627.tlg013.perseus-eng4.xml @@ -0,0 +1,83 @@ + + + + + + + The Oath + Hippocrates + Francis Adams + Gregory Crane + + Prepared under the supervision of + Bridget Almas + Lisa Cerrato + Rashmi Singhal + + National Library of Medicine History of Medicine Division + + + Cultural Heritage Language Technologies + Kansas City Missouri + February 20, 2003 + + Trustees of Tufts University + Medford, MA + Perseus Digital Library Project + Perseus 4.0 + tlg0627.tlg013.perseus-eng4.xml + + Available under a Creative Commons Attribution-ShareAlike 4.0 International License + + + + + + The Genuine Works of Hippocrates + Hippocrates + Francis Adams + + New York + William Wood and Company + 1886 + + 2 + + HathiTrust + + + + + + + +

Data Entry

+ + + + +

This pointer pattern extracts oath.

+ + + + + + English + + + + CTS and EpiDoc conversion. + + + + + +
+
+

I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!

+
+ + + + +