Scaife ATLAS

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Of the Prognostics (16-20)

urn:cts:greekLit:tlg0627.tlg003.perseus-eng2:16-20
Refs {'start': {'reference': '16', 'human_reference': 'Section 16'}, 'end': {'reference': '20', 'human_reference': 'Section 20'}}
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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.

Empyema may be recognized in all cases by the following symptoms: In the first place, the fever does not go off, but is

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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 at the commencement, and if at the same time the patient has some difficulty of breathing. Whether they will break earlier or later may be determined by these symptoms; if there be pain at the commencement, and if the dyspnoea, cough, and ptyalism be severe, the rupture may be expected in the course of twenty days or still earlier; but if the pain be more mild, and all the other symptoms in proportion, you may expect from these the rupture to be later; but pain, dyspnoea, and ptyalism, must take place before the rupture of the abscess. Those patients recover most readily whom the fever leaves the same day that the abscess bursts,—when they recover their appetite speedily, and are freed from the thirst,—when the alvine discharges are small and consistent, the matter white, smooth, uniform in color, and free of phlegm, and if brought up without pain or strong coughing. Those die whom the fever does not leave, or when appearing to leave them it returns with an exacerbation; when they have thirst, but no desire of food, and there are watery discharges from the bowels; when the expectoration is green or livid, or pituitous and frothy; if all these occur they die, but if certain of these symptoms supervene, and others not, some patients die and some recover, after a long interval. But from all the symptoms taken together one should form a judgment, and so in all other cases.

When abscesses form about the ears, after peripneumonic affections, or depositions of matter take place in the inferior extremities and end in fistula, such persons recover. The following observations are to be made upon them: if the fever persist, and the pain do not cease, if the expectoration be not

p.54
normal, and if the alvine discharges be neither bilious, nor free and unmixed; and if the urine be neither copious nor have its proper sediment, but if, on the other hand, all the other salutary symptoms be present, in such cases abscesses may be expected to take place. They form in the inferior parts when there is a collection of phlegm about the hypochondria; and in the upper when the hypochondria continue soft and free of pain, and when dyspnoea having been present for a certain time, ceases without any obvious cause. All deposits which take place in the legs after severe and dangerous attacks of pneumonia, are salutary, but the best are those which occur at the time when the sputa undergo a change; for if the swelling and pain take place while the sputa are changing from yellow and becoming of a purulent character, and are expectorated freely, under these circumstances the man will recover most favorably and the abscess becoming free of pain, will soon cease; but if the expectoration is not free, and the urine does not appear to have the proper sediment, there is danger lest the limb should be maimed, or that the case otherwise should give trouble. But if the abscesses disappear and go back, while expectoration does not take place, and fever prevails, it is a bad symptom; for there is danger that the man may get into a state of delirium and die. Of persons having empyema after peripneumonic affections, those that are advanced in life run the greatest risk of dying; but in the other kinds of empyema younger persons rather die. In cases of empyema treated by the cautery or incision, when the matter is pure, white, and not fetid, the patient recovers; but if of a bloody and dirty character, he dies.

Pains accompanied with fever which occur about the loins and lower parts, if they attack the diaphragm, and leave the parts below, are very fatal. Wherefore one ought to pay attention to the other symptoms, since if any unfavorable one supervene, the case is hopeless; but if while the disease is determined to the diaphragm, the other symptoms are not bad, there is great reason to expect that it will end in empyema. When the bladder is hard and painful, it is an extremely bad and mortal symptom, more especially in cases attended with continued

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fever; for the pains proceeding from the bladder alone are to kill the patient; and at such a time the bowels are not moved, or the discharges are hard and forced. But urine of a purulent character, and having a white and smooth sediment, relieves the patient. But if no amendment takes place in the characters of the urine, nor the bladder become soft, and the fever is of the continual type, it may be expected that the patient will die in the first stages of the complaint. This form attacks children more especially, from their seventh to their fifteenth year.

Fevers come to a crisis on the same days as to number on which men recover and die. For the mildest class of fevers, and those originating with the most favorable symptoms, cease on the fourth day or earlier; and the most malignant, and those setting in with the most dangerous symptoms, prove fatal on the fourth day or earlier. The first class of them as to violence ends thus: the second is protracted to the seventh day, the third to the eleventh, the fourth to the fourteenth, the fifth to the seventeenth, and the sixth to the twentieth. Thus these periods from the most acute disease ascend by fours up to twenty. But none of these can be truly calculated by whole days, for neither the year nor the months can be numbered by entire days. After these in the same manner, according to the same progression, the first period is of thirty-four days, the second of forty days, and the third of sixty days. In the commencement of these it is very difficult to determine those which will come to a crisis after a long interval; for these beginnings are very similar, but one should pay attention from the first day, and observe further at every additional tetrad, and then one cannot miss seeing how the disease will terminate. The constitution of quartans is agreeable to the same order. Those which will come to a crisis in the shortest space of time, are the easiest to be judged of; for the differences of them are greatest from the commencement, thus those who are going to recover breathe freely, and do not suffer pain, they sleep during the night, and have the other salutary symptoms, whereas those that are to die have difficult respiration, are delirious, troubled with insomnolency, and have other bad symptoms. Matters being thus, one may conjecture, according

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to the time, and each additional period of the diseases, as they proceed to a crisis. And in women, after parturition, the crises proceed agreeably to the same ratio.

Tokens

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estimate 1 w 17
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the 1 w 24
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the 2 w 41
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the 4 w 99
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the 13 w 341
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the 31 w 835
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the 32 w 880
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the 33 w 900
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the 35 w 928
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the 36 w 938
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the 42 w 1085
body 1 w 1089
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may 3 w 1132
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are 4 w 1160
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the 45 w 1249
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if 8 w 1267
at 17 w 1269
the 46 w 1272
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Whether 1 w 1326
they 3 w 1330
will 3 w 1334
break 1 w 1339
earlier 1 w 1346
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later 1 w 1353
may 4 w 1356
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determined 1 w 1368
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if 10 w 1386
there 4 w 1391
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pain 3 w 1397
at 21 w 1399
the 52 w 1402
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the 53 w 1423
dyspnoea 1 w 1431
cough 2 w 1437
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be 11 w 1451
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pain 4 w 1531
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the 64 w 1741
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their 2 w 1790
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the 68 w 1825
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the 71 w 1988
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an 25 w 2047
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a 153 w 2303
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But 2 w 2319
from 7 w 2323
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the 81 w 2329
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taken 1 w 2342
together 1 w 2350
one 4 w 2353
should 4 w 2359
form 4 w 2363
a 157 w 2364
judgment 1 w 2372
and 26 w 2376
so 6 w 2378
in 36 w 2380
all 8 w 2383
other 5 w 2388
cases 2 w 2393
When 1 w 2398
abscesses 2 w 2407
form 5 w 2411
about 1 w 2416
the 84 w 2419
ears 1 w 2423
after 2 w 2429
peripneumonic 1 w 2442
affections 1 w 2452
or 25 w 2455
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take 5 w 2478
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the 85 w 2488
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in 39 w 2515
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such 2 w 2527
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to 19 w 2571
be 16 w 2573
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upon 3 w 2581
them 3 w 2585
if 17 w 2588
the 87 w 2591
fever 5 w 2596
persist 1 w 2603
and 28 w 2607
the 88 w 2610
pain 7 w 2614
do 3 w 2616
not 5 w 2619
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if 18 w 2627
the 89 w 2630
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not 6 w 2648
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the 90 w 2663
alvine 2 w 2669
discharges 3 w 2679
be 18 w 2681
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the 92 w 2722
urine 1 w 2727
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the 94 w 2779
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expected 2 w 2859
to 22 w 2861
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They 1 w 2875
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in 45 w 2881
the 98 w 2884
inferior 2 w 2892
parts 1 w 2897
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there 6 w 2906
is 14 w 2908
a 195 w 2909
collection 1 w 2919
of 16 w 2921
phlegm 2 w 2927
about 2 w 2932
the 100 w 2935
hypochondria 1 w 2947
and 33 w 2951
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the 101 w 2956
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the 102 w 2968
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soft 1 w 2992
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a 205 w 3042
certain 2 w 3049
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take 7 w 3103
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the 103 w 3113
legs 1 w 3117
after 3 w 3122
severe 2 w 3128
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dangerous 1 w 3140
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of 19 w 3149
pneumonia 1 w 3158
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salutary 2 w 3170
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the 104 w 3177
best 1 w 3181
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the 105 w 3204
time 4 w 3208
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the 106 w 3215
sputa 1 w 3220
undergo 1 w 3227
a 224 w 3228
change 1 w 3234
for 11 w 3238
if 22 w 3240
the 107 w 3243
swelling 2 w 3251
and 37 w 3254
pain 9 w 3258
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the 108 w 3275
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becoming 1 w 3312
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a 234 w 3315
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under 2 w 3363
these 7 w 3368
circumstances 1 w 3381
the 110 w 3384
man 1 w 3387
will 4 w 3391
recover 5 w 3398
most 2 w 3402
favorably 1 w 3411
and 40 w 3414
the 111 w 3417
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becoming 2 w 3432
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of 21 w 3438
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soon 1 w 3451
cease 3 w 3456
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free 7 w 3487
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the 113 w 3494
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not 8 w 3506
appear 2 w 3512
to 25 w 3514
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the 114 w 3521
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sediment 2 w 3535
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is 16 w 3543
danger 2 w 3549
lest 1 w 3553
the 116 w 3556
limb 1 w 3560
should 5 w 3566
be 26 w 3568
maimed 1 w 3574
or 38 w 3577
that 4 w 3581
the 117 w 3584
case 4 w 3588
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should 6 w 3603
give 1 w 3607
trouble 1 w 3614
But 3 w 3618
if 24 w 3620
the 119 w 3623
abscesses 4 w 3632
disappear 1 w 3641
and 42 w 3644
go 4 w 3646
back 1 w 3650
while 2 w 3656
expectoration 4 w 3669
does 4 w 3673
not 9 w 3676
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a 267 w 3708
bad 1 w 3711
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is 20 w 3729
danger 3 w 3735
that 5 w 3739
the 121 w 3742
man 2 w 3745
may 8 w 3748
get 2 w 3751
into 1 w 3755
a 273 w 3756
state 2 w 3761
of 22 w 3763
delirium 1 w 3771
and 44 w 3774
die 4 w 3777
Of 1 w 3780
persons 2 w 3787
having 2 w 3793
empyema 4 w 3800
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affections 2 w 3828
those 3 w 3834
that 6 w 3838
are 14 w 3841
advanced 1 w 3849
in 62 w 3851
life 1 w 3855
run 1 w 3858
the 122 w 3861
greatest 1 w 3869
risk 1 w 3873
of 23 w 3875
dying 1 w 3880
but 9 w 3884
in 64 w 3886
the 123 w 3889
other 9 w 3894
kinds 1 w 3899
of 24 w 3901
empyema 5 w 3908
younger 1 w 3915
persons 3 w 3922
rather 1 w 3928
die 5 w 3931
In 2 w 3934
cases 4 w 3939
of 25 w 3941
empyema 6 w 3948
treated 1 w 3955
by 6 w 3957
the 126 w 3960
cautery 1 w 3967
or 41 w 3969
incision 1 w 3977
when 12 w 3982
the 127 w 3985
matter 3 w 3991
is 23 w 3993
pure 1 w 3997
white 2 w 4003
and 45 w 4007
not 10 w 4010
fetid 1 w 4015
the 128 w 4019
patient 6 w 4026
recovers 1 w 4034
but 10 w 4038
if 26 w 4040
of 26 w 4042
a 294 w 4043
bloody 1 w 4049
and 46 w 4052
dirty 1 w 4057
character 2 w 4066
he 153 w 4069
dies 1 w 4073
Pains 1 w 4079
accompanied 2 w 4090
with 5 w 4094
fever 7 w 4099
which 6 w 4104
occur 6 w 4109
about 3 w 4114
the 129 w 4117
loins 1 w 4122
and 47 w 4125
lower 1 w 4130
parts 2 w 4135
if 27 w 4138
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the 131 w 4151
diaphragm 1 w 4160
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leave 4 w 4169
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are 15 w 4186
very 1 w 4190
fatal 1 w 4195
Wherefore 1 w 4205
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pay 1 w 4218
attention 1 w 4227
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symptoms 9 w 4245
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disease 1 w 4318
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determined 2 w 4330
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diaphragm 2 w 4344
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symptoms 10 w 4361
are 16 w 4364
not 11 w 4367
bad 2 w 4370
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great 2 w 4383
reason 1 w 4389
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expect 11 w 4397
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will 6 w 4407
end 3 w 4410
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When 2 w 4424
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bladder 1 w 4434
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hard 1 w 4440
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painful 1 w 4450
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bad 3 w 4469
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mortal 1 w 4478
symptom 12 w 4485
more 2 w 4490
especially 2 w 4500
in 73 w 4502
cases 5 w 4507
attended 1 w 4515
with 6 w 4519
continued 1 w 4528
fever 8 w 4533
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the 142 w 4540
pains 1 w 4545
proceeding 1 w 4555
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are 17 w 4577
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kill 1 w 4583
the 144 w 4586
patient 7 w 4593
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at 54 w 4599
such 4 w 4603
a 347 w 4604
time 5 w 4608
the 145 w 4611
bowels 2 w 4617
are 18 w 4620
not 12 w 4623
moved 1 w 4628
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the 146 w 4634
discharges 4 w 4644
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But 4 w 4664
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character 3 w 4689
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having 3 w 4699
a 358 w 4700
white 3 w 4705
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smooth 2 w 4714
sediment 3 w 4722
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But 5 w 4745
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characters 1 w 4783
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soft 2 w 4817
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fever 9 w 4829
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continual 1 w 4845
type 1 w 4849
it 26 w 4852
may 9 w 4855
be 29 w 4857
expected 3 w 4865
that 8 w 4869
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will 7 w 4883
die 7 w 4886
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stages 1 w 4902
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complaint 1 w 4916
This 1 w 4921
form 7 w 4925
attacks 2 w 4932
children 1 w 4940
more 3 w 4944
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year 1 w 4991
Fevers 1 w 4998
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days 2 w 5024
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number 1 w 5034
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For 1 w 5061
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symptoms 11 w 5132
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setting 1 w 5197
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with 8 w 5203
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dangerous 2 w 5219
symptoms 12 w 5227
prove 1 w 5233
fatal 2 w 5238
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The 4 w 5265
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day 8 w 5338
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the 170 w 5364
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fourteenth 1 w 5385
the 172 w 5389
fifth 1 w 5394
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seventeenth 1 w 5410
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twentieth 1 w 5436
Thus 1 w 5441
these 8 w 5446
periods 2 w 5453
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most 6 w 5464
acute 1 w 5469
disease 2 w 5476
ascend 1 w 5482
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fours 1 w 5489
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But 6 w 5503
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days 3 w 5545
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After 1 w 5606
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manner 1 w 5626
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progression 1 w 5656
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period 3 w 5671
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thirty-four 1 w 5686
days 5 w 5690
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forty 1 w 5707
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third 2 w 5723
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sixty 1 w 5730
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In 3 w 5737
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tetrad 1 w 5946
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seeing 1 w 5973
how 1 w 5976
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disease 3 w 5986
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The 5 w 6003
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order 1 w 6050
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crisis 3 w 6078
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space 1 w 6096
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time 6 w 6102
are 21 w 6106
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do 6 w 6231
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pain 13 w 6244
they 8 w 6249
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night 2 w 6268
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have 6 w 6276
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symptoms 13 w 6300
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respiration 1 w 6349
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insomnolency 1 w 6387
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bad 4 w 6403
symptoms 14 w 6411
Matters 1 w 6419
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may 10 w 6435
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the 207 w 6460
time 7 w 6464
and 67 w 6468
each 1 w 6472
additional 2 w 6482
period 4 w 6488
of 43 w 6490
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diseases 1 w 6501
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they 9 w 6508
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And 1 w 6528
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women 1 w 6535
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parturition 1 w 6552
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ratio 8 w 6592