the book of prognostics-第2章

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turn　round　easily；　and　to　be　agile　when　raised　up；　but　if　he　appear

heavy　in　the　rest　of　his　body　as　well　as　in　his　hands　and　feet；　it

is　more　dangerous；　and　if；　in　addition　to　the　weight；　his　nails　and

fingers　become　livid；　immediate　death　may　be　anticipated；　and　if　the

hands　and　feet　be　black　it　is　less　dangerous　than　if　they　be　livid；

but　the　other　symptoms　must　be　attended；　to；　for　if　he　appear　to

bear　the　illness　well；　and　if　certain　of　the　salutary　symptoms

appear　along　with　these　there　may　be　hope　that　the　disease　will　turn

to　a　deposition；　so　that　the　man　may　recover；　but　the　blackened

parts　of　the　body　will　drop　off。　When　the　testicles　and　members　are

retracted　upwards；　they　indicate　strong　pains　and　danger　of　death。

　　10。　With　regard　to　sleep…　as　is　usual　with　us　in　health；　the　patient

should　wake　during　the　day　and　sleep　during　the　night。　If　this　rule　be

anywise　altered　it　is　so　far　worse：　but　there　will　be　little　harm

provided　he　sleep　in　the　morning　for　the　third　part　of　the　day；　such

sleep　as　takes　place　after　this　time　is　more　unfavorable；　but　the

worst　of　all　is　to　get　no　sleep　either　night　or　day；　for　it　follows

from　this　symptom　that　the　insomnolency　is　connected　with　sorrow　and

pains；　or　that　he　is　about　to　become　delirious。

　　11。　The　excrement　is　best　which　is　soft　and　consistent；　is　passed　at

the　hour　which　was　customary　to　the　patient　when　in　health；　in

quantity　proportionate　to　the　ingests；　for　when　the　passages　are　such；

the　lower　belly　is　in　a　healthy　state。　But　if　the　discharges　be　fluid；

it　is　favorable　that　they　are　not　accompanied　with　a　noise；　nor　are

frequent；　nor　in　great　quantity；　for　the　man　being　oppressed　by

frequently　getting　up；　must　be　deprived　of　sleep；　and　if　the

evacuations　be　both　frequent　and　large；　there　is　danger　of　his　falling

into　deliquium　animi。　But　in　proportion　to　the　ingesta　he　should

have　evacuations　twice　or　thrice　in　the　day；　once　at　night　and　more

copiously　in　the　morning；　as　is　customary　with　a　person　in　health。　The

faeces　should　become　thicker　when　the　disease　is　tending　to　a

crisis；　they　ought　to　be　yellowish　and　not　very　fetid。　It　is　favorable

that　round　worms　be　passed　with　the　discharges　when　the　disease　is

tending　to　a　crisis。　The　belly；　too；　through　the　whole　disease；　should

be　soft　and　moderately　distended；　but　excrements　that　are　very　watery；

or　white；　or　green；　or　very　red；　or　frothy；　are　all　bad。　It　is　also

bad　when　the　discharge　is　small；　and　viscid；　and　white；　and

greenish；　and　smooth；　but　still　more　deadly　appearances　are　the　black；

or　fatty；　or　livid；　or　verdigris…green；　or　fetid。　Such　as　are　of

varied　characters　indicate　greater　duration　of　the　complaint；　but

are　no　less　dangerous；　such　as　those　which　resemble　scrapings；　those

which　are　bilious；　those　resembling　leeks；　and　the　black；　these

being　sometimes　passed　together；　and　sometimes　singly。　It　is　best　when

wind　passes　without　noise；　but　it　is　better　that　flatulence　should

pass　even　thus　than　that　it　should　be　retained；　and　when　it　does

pass　thus；　it　indicates　either　that　the　man　is　in　pain　or　in　delirium；

unless　he　gives　vent　to　the　wind　spontaneously。　Pains　in　the

hypochondria；　and　swellings；　if　recent；　and　not　accompanied　with

inflammation；　are　relieved　by　borborygmi　supervening　in　the

hypochondrium；　more　especially　if　it　pass　off　with　faeces；　urine；

and　wind；　but　even　although　not；　it　will　do　good　by　passing　along；　and

it　also　does　good　by　descending　to　the　lower　part　of　the　belly。

　　12。　The　urine　is　best　when　the　sediment　is　white；　smooth；　and

consistent　during　the　whole　time；　until　the　disease　come　to　a

crisis；　for　it　indicates　freedom　from　danger；　and　an　illness　of

short　duration；　but　if　deficient；　and　if　it　be　sometimes　passed　clear；

and　sometimes　with　a　white　and　smooth　sediment；　the　disease　will　be

more　protracted；　and　not　so　void　of　danger。　But　if　the　urine　be

reddish；　and　the　sediment　consistent　and　smooth；　the　affection；　in

this　case；　will　be　more　protracted　than　the　former；　but　still　not

fatal。　But　farinaceous　sediments　in　the　urine　are　bad；　and　still　worse

are　the　leafy；　the　white　and　thin　are　very　bad；　but　the　furfuraceous

are　still　worse　than　these。　Clouds　carried　about　in　the　urine　are　good

when　white；　but　bad　if　black。　When　the　urine　is　yellow　and　thin；　it

indicates　that　the　disease　is　unconcocted；　and　if　it　（the　disease）

should　be　protracted；　there　maybe　danger　lest　the　patient　should　not

hold　out　until　the　urine　be　concocted。　But　the　most　deadly　of　all

kinds　of　urine　are　the　fetid；　watery；　black；　and　thick；　in　adult　men

and　women　the　black　is　of　all　kinds　of　urine　the　worst；　but　in

children；　the　watery。　In　those　who　pass　thin　and　crude　urine　for　a

length　of　time；　if　they　have　otherwise　symptoms　of　convalescence；　an

abscess　may　be　expected　to　form　in　the　parts　below　the　diaphragm。

And　fatty　substances　floating　on　the　surface　are　to　be　dreaded；　for

they　are　indications　of　melting。　And　one　should　consider　respecting

the　kinds　of　urine；　which　have　clouds；　whether　they　tend　upwards　or

downwards；　and　upwards　or　downwards；　and　the　colors　which　they　have

and　such　as　fall　downwards；　with　the　colors　as　described；　are　to　be

reckoned　good　and　commended；　but　such　as　are　carried　upwards；　with　the

colors　as　described；　are　to　be　held　as　bad；　and　are　to　be

distrusted。　But　you　must　not　allow　yourself　to　be　deceived　if　such

urine　be　passed　while　the　bladder　is　diseased；　for　then　it　is　a

symptom　of　the　state；　not　of　the　general　system；　but　of　a　particular

viscus。

　　13。　That　vomiting　is　of　most　service　which　consists　of　phlegm　and

bile　mixed　together；　and　neither　very　thick　nor　in　great　quantity；　but

those　vomitings　which　are　more　unmixed　are　worse。　But　if　that　which　is

vomited　be　of　the　color　of　leeks　or　livid；　or　black；　whatever　of　these

colors　it　be；　it　is　to　be　reckoned　bad；　but　if　the　same　man　vomit

all　these　colors；　it　is　to　be　reckoned　a　very　fatal　symptom。　But　of

all　the　vomitings；　the　livid　indicates　the　danger　of　death；　provided

it　be　of　a　fetid　smell。　But　all　the　smells　which　are　somewhat　putrid

and　fetid；　are　bad　in　all　vomitings。

　　14。　The　expectoration　in　all　pains　about　the　lungs　and　sides；　should

be　quickly　and　easily　brought　up；　and　a　certain　degree　of　yellowness

should　appear　strongly　mixed　up　with　the　sputum。　But　if　brought　up

long　after　the　commencement　of　the　pain；　and　of　a　yellow　or　ruddy

color；　or　if　it　occasions　much　cough；　or　be　not　strongly　mixed；　it

is　worse；　for　that　which　is　intensely　yellow　is　dangerous；　but　the

white；　and　viscid；　and　round；　do　no　good。　But　that　which　is　very　green

and　frothy　is　bad；　but　if　so　intense　as　to　appear　black；　it　is　still

more　dangerous　than　these；　it　is　dangerous　than　these；　it　is　bad；　if

nothing　is　expectorated；　and　the　lungs　discharge　nothing；　but　are

gorged　with　matters　which　boil　（as　it　were）　in　the　air…passages。　It　is

bad　when　coryza　and　sneezing　either　precede　or　follow　affections　of

the　lungs；　but　in　all　other　affections；　even　the　most　deadly；　sneezing

is　a　salutary　symptom。　A　yellow　spittle　mixed　up　with　not　much　blood

in　cases　of　pneumonia；　is　salutary　and　very　beneficial　if　spit　up　at

the　commencement　of　the　disease；　but　if　on　the　seventh　day；　or　still

later；　it　is　less　favorable。　And　all　sputa　are　bad　which　do　not　remove

the　pain。　But　the　worst　is　the　black；　as　has　been　described。　Of　all

others　the　sputa　which　remove　the　pain　are　the　best。

　　15。　When　the　pains　in　these　regions　do　not　cease；　either　with　the

discharge　of　the　sputa；　nor　with　alvine　evacuations；　nor　from

venesection；　purging　with　medicine；　nor　a　suitable　regimen；　it　is　to

be　held　that　they　will　terminate　in　suppurations。　Of　empyemata　such　as

are　spit　up　while　the　sputum　is　still　bilious；　are　very　fatal；　whether

the　bilious　portion　be　expectorated　separate；　or　along　with　the　other；

but　more　especially　if　the　empyema　begin　to　advance　after　this

sputum　on　the　seventh　day　of　the　disease。　It　is　to　be　expected　that

a　person　with　such　an　expectoration　shall　die　on　the　fourteenth　day；

unless　something　favorable　supervene。　The　following　are　favorable

symptoms：　to　support　the　disease　easily；　to　have　free　respiration；

to　be　free　from　pain；　to　have　the　sputa　readily　brought　up；　the

whole　body　to　appear　equally　warm　and　soft；　to　have　no　thirst；　the

urine；　and　faeces；　sleep；　and　sweats　to　be　all　favorable；　as　described

before；　when　all　these　symptoms　concur；　the　patient　certainly　will　not

die；　but　if　some　of　these　be　present　and　some　not；　he　will　not　survive

longer　than　the　fourteenth　day。　The　bad　symptoms　are　the　opposite　of

these；　namely；　to　bear　the　disease　with　difficulty；　respiration

large　and　dense；　the　pain　not　ceasing；　the　sputum　scarcely　coughed　up；

strong　thirst；　to　have　the　body　unequally　affected　by　the　febrile

heat；　the　belly　and　sides　intensely　hot；　the　forehead；　hands；　and　feet

cold；　the　urine；　and　excrements；　the　sleep；　and　sweats；　all　bad；

agreeably　to　the　characters　described　above；　if　such　a　combination

of　symptoms　accompany　the　expectoration；　the　man　will　certainly　die

before　the　fourteenth　day；　and　either　on　the　ninth　or　eleventh。　Thus

then　one　may　conclude　regarding　this　expectoration；　that　it　is　very

deadly；　and　that　the　patient　will　not　survive　until　the　fourteenth

day。　It　is　by　balancing　the　concomitant　symptoms　whether　good　or

bad；　that　one　is　to　form　a　prognosis；　for　thus　it　will　most　probably

prove　to　be　a　true　one。　Most　other　suppurations　burst；　some　on　the

twentieth；　some　on　the　thirtieth；　some　on　the　fortieth；　and　some　as

late　as　the　sixtieth　day。

　　16。　One　should　estimate　when　the　commencement　of　the　suppuration

will　take　place；　by　calculating　from　the　day　on　which　the　patient

was　first　seized　with　fever；　or　if　he　had　a　rigor；　and　if　he　says；

that　there　is　a　weight　in　the　place　where　he　had　pain　formerly；　for

these　symptoms　occur　in　the　commencement　of　suppurations。　One　then　may

expect　the　rupture　of　the　abscesses　to　take　place　from　these　times

according　to　the　periods　formerly　stated。　But　if　the　empyema　be　only

on　either　side；　one　should　turn　him　and　inquire　if　he　has　pain　on

the　other　side；　and　if　the　one　side　be　hotter　than　the　other；　and　when

laid　upon　the　sound　side；　one　should　inquire　if　he　has　the　feeling

of　a　weight　hanging　from　above；　for　if　so；　the　empyema　will　be　upon

the　opposite　side　to　that　on　which　the　weight　was　felt。

　　17。　Empyema　may　be　recognized　in　all　cases　by　the　following

symptoms：　In　the　first　place；　the　fever　does　not　go　off；　but　is　slight

during　the　day；　and　increases　at　night；　and　copious　sweats

supervene；　there　is　a　desire　to　cough；　and　the　patients　expectorate

nothing　worth　mentioning；　the　eyes　become　hollow；　the　cheeks　have

red　spots　on　them；　the　nails　of　the　hands　are　bent；　the　fingers　are

hot　especially　their　extremities；　there　are　swellings　in　the　feet；

they　have　no　desire　of　food；　and　small　blisters　（phlyctaenae）　occur

over　the　body。　These　symptoms　attend　chronic　empyemata；　and　may　be

much　trusted　to；　and　such　as　are　of　short　standing　are　indicated　by

the　same；　provided　they　be　accompanied　by　those　signs　which　occur