Epidemics (1.2.7-1.2.9)

But those fevers which were altogether continuous and never intermitted at all, but in all cases

grew worse after the manner of semitertians, with remission during one day followed by exacerbation during the next, were the most severe of all the fevers which occurred at this time, the longest and the most painful. Beginning mildly, and on the whole increasing always, with exacerbation, and growing worse, they had slight remissions followed quickly after an abatement by more violent exacerbations, generally becoming worse on the critical days. All patients had irregular rigors that followed no fixed law, most rarely and least in the semitertians,[*] but more violent in the other fevers. Copious sweats, least copious in the semitertians; they brought no relief, but on the contrary caused harm. These patients suffered great chill in the extremities, which grew warm again with difficulty. Generally there was sleeplessness, especially with the semitertians, followed afterwards by coma. In all the bowels were disordered and in a bad state, but in the semitertians they were far the worst. In most of them urine either (a) thin, crude, colourless, after a time becoming slightly concocted with signs of crisis, or (b) thick enough but turbid, in no way settling or forming sediment, or (c) with small, bad, crude sediments, these being the worst of all. Coughs attended the fevers, but I cannot say that either harm or good resulted from the coughing on this occasion.

Now the greatest number of these symptoms continued to be protracted, troublesome, very disordered, very irregular, and without any critical signs, both in the case of those who came very near death

and in the case of those who did not. For even if some patients enjoyed slight intermissions, there followed a quick relapse. A few of them experienced a crisis, the earliest being about the eightieth day, some of the latter having a relapse, so that most of them were still ill in the winter. The greatest number had no crisis before the disease terminated. These symptoms occurred in those who recovered just as much as in those who did not. The illnesses showed a marked absence of crisis and a great variety; the most striking and the worst symptom, which throughout attended the great majority, was a complete loss of appetite, especially in those whose general condition exhibited fatal signs, but in these fevers they did not suffer much from unseasonable thirst. After long intervals, with many pains and with pernicious wasting, there supervened abscessions either too severe to be endured, or too slight to be beneficial, so that there was a speedy return of the original symptoms, and an aggravation of the mischief.[*]

The symptoms from which these patients suffered were dysenteries and tenesmus, lienteries also and fluxes. Some had dropsies also, either with or without these. Whenever any of these attacked violently they were quickly fatal, or, if mild, they did no good. Slight eruptions, which did not match the extent of the diseases and quickly disappeared again, or swellings by the ears that grew smaller[*] and

signified nothing, in some cases appearing at the joints, especially the hip-joint, in few instances leaving with signs of crisis, when they quickly re-established themselves in their original state.