The Epidemics (1.1.1-1.1.3)

IN THASUS, about the autumn equinox, and under the Pleiades, the rains were abundant, constant, and soft, with southerly winds; the winter southerly, the northerly winds faint, droughts; on the whole, the winter having the character of spring. The spring was southerly, cool, rains small in quantity. Summer, for the most part, cloudy, no rain, the Etesian winds, rare and small, blew in an irregular manner. The whole constitution of the season being thus inclined to the southerly, and with droughts early in the spring, from the preceding opposite and northerly state, ardent fevers occurred in a few instances, and these very mild, being rarely attended with hemorrhage, and never proving fatal. Swellings appeared about the ears, in many on either side, and in the greatest number on both sides, being unaccompanied by fever so as not to confine the patient to bed; in all cases they disappeared without giving trouble, neither did any of them come to suppuration, as is common in swellings from other causes. They were of a lax, large, diffused character, without inflammation or pain, and they went away without any critical sign. They seized children, adults, and mostly those who were engaged in the exercises of the palestra and gymnasium, but seldom attacked women. Many had dry coughs without expectoration, and accompanied with hoarseness of voice. In some instances earlier, and in others later, inflammations with pain seized sometimes one of

the testicles, and sometimes both; some of these cases were accompanied with fever and some not; the greater part of these were attended with much suffering. In other respects they were free of disease, so as not to require medical assistance.

Early in the beginning of spring, and through the summer, and towards winter, many of those who had been long gradually declining, took to bed with symptoms of phthisis; in many cases formerly of a doubtful character the disease then became confirmed; in these the constitution inclined to the phthisical. Many, and, in fact, the most of them, died; and of those confined to bed, I do not know if a single individual survived for any considerable time; they died more suddenly than is common in such cases. But other diseases, of a protracted character, and attended with fever, were well supported, and did not prove fatal: of these we will give a description afterwards. Consumption was the most considerable of the diseases which then prevailed, and the only one which proved fatal to many persons. Most of them were affected by these diseases in the following manner: fevers accompanied with rigors, of the continual type, acute, having no complete intermissions, but of the form of the semi-tertians, being milder the one day, and the next having an exacerbation, and increasing in violence; constant sweats, but not diffused over the whole body; extremities very cold, and warmed with difficulty; bowels disordered, with bilious, scanty, unmixed, thin, pungent, and frequent dejections. The urine was thin, colorless, unconcocted, or thick, with a deficient sediment, not settling favorably, but casting down a crude and unseasonable sediment. Sputa small, dense, concocted, but brought up rarely and with difficulty; and in those who encountered the most violent symptoms there was no concoction at all, but they continued throughout spitting crude matters. Their fauces, in most of them, were painful from first to last, having redness with inflammation; defluxions thin, small and acrid; they were soon wasted and became worse, having no appetite for any kind of food throughout; no thirst; most persons delirious when near death. So much concerning the phthisical affections.

In the course of the summer and autumn many fevers of the

continual type, but not violent; they attacked persons who had been long indisposed, but who were otherwise not in an uncomfortable state. In most cases the bowels were disordered in a very moderate degree, and they did not suffer thereby in any manner worth mentioning; the urine was generally well colored, clear, thin, and after a time becoming concocted near the crisis. They had not much cough, nor it troublesome; they were not in appetite, for it was necessary to give them food (on the whole, persons laboring under phthisis were not affected in the usual manner). They were affected with fevers, rigors, and deficient sweats, with varied and irregular paroxysms, in general not intermitting, but having exacerbations in the tertian form. The earliest crisis which occurred was about the twentieth day, in most about the fortieth, and in many about the eightieth. But there were cases in which it did not leave them thus at all, but in an irregular manner, and without any crisis; in most of these the fevers, after a brief interval, relapsed again; and from these relapses they came to a crisis in the same periods; but in many they were prolonged so that the disease was not gone at the approach of winter. Of all those which are described under this constitution, the phthisical diseases alone were of a fatal character; for in all the others the patients bore up well, and did not die of the other fevers.