On the Causes and Symptoms of Acute Diseases (1.5)

* * * * sluggishness, vertigo, heaviness of the tendons, plethora and distension of the veins in the neck; and much nausea indeed after food, but also, not unfrequently, with abstinence, there is a faint nausea; and phlegm is often vomited; want of appetite and indigestion after little food: they have flatulence and meteorism in the hypochondria. These symptoms, indeed, are constant.

But, if it be near the accession of the paroxysm, there are before the sight circular flashes of purple or black colours, or of all mixed together, so as to exhibit the appearance of the rainbow expanded in the heavens; noises in the ears; a heavy smell; they are passionate, and unreasonably peevish. They fall down then, some from any such cause as lowness of spirits, but others from gazing intently on a running stream, a rolling

wheel, or a turning top. But sometimes the smell of heavy odours, such as of the gagate stone (jet), makes them fall down. In these cases, the ailment is fixed in the head, and from it the disorder springs; but, in others, it arises also from the nerves remote from the head, which sympathise with the primary organ. Wherefore the great fingers of the hands, and the great toes of the feet are contracted; pain, torpor, and trembling succeed, and a rush of them to the head takes place. If the mischief spread until it reach the head, a crash takes place, in these cases, as if from the stroke of a piece of wood, or of stone; and, when they rise up, they tell how they have been maliciously struck by some person. This deception occurs to those who are attacked with the ailment for the first time. But those to whom the affection has become habitual, whenever the disease recurs, and has already seized the finger, or is commencing in any part, having from experience a foreknowledge of what is about to happen, call, from among those who are present, upon their customary assistants, and entreat them to bind, pull aside, and stretch the affected members; and they themselves tear at their own members, as if pulling out the disease; and such assistance has sometimes put off the attack for a day. But, in many cases, there is the dread as of a wild beast rushing upon them, or the phantasy of a shadow; and thus they have fallen down.

In the attack, the person lies insensible; the hands are clasped together by the spasm; the legs not only plaited together, but also dashed about hither and thither by the tendons. The calamity bears a resemblance to slaughtered bulls; the neck bent, the head variously distorted, for sometimes it is arched, as it were, forwards, so that the chin rests upon the breast; and sometimes it is retracted to the back, as if forcibly drawn thither by the hair, when it rests on this shoulder or on that. They gape wide, the mouth is dry; the tongue protrudes, so as to incur the risk of a great wound, or

of a piece of it being cut off, should the teeth come forcibly together with the spasm; the eyes rolled inwards, the eyelids for the most part are separated, and affected with palpitation; but should they wish to shut the lids they cannot bring them together, insomuch that the white of the eyes can be seen from below. The eyebrows sometimes relaxed towards the mesal space, as in those who are frowning, and sometimes retracted to the temples abnormally, so that the skin about the forehead is greatly stretched, and the wrinkles in the intersuperciliary space disappear: the cheeks are ruddy and quivering; the lips sometimes compressed together to a sharp point, and sometimes separated towards the sides, when they are stretched over the teeth, like as in persons smiling.

As the illness increases lividity of countenance also supervenes, distension of the vessels in the neck, inability of speech as in suffocation; insensibility even if you call loudly. The utterance a moaning and lamentation; and the respiration a sense of suffocation, as in a person who is throttled; the pulse strong, and quick, and small in the beginning,—great, slow, and feeble in the end, and irregular throughout; tentigo of the genital organs. Such sufferings do they endure towards the end of the attack.

But when they come to the termination of the illness, there are unconscious discharges of the urine, and watery discharges from the bowels, and in some cases an evacuation also of the semen, from the constriction and compression of the vessels, or from the pruriency of the pain, and titillation of the humours; for in these cases the pains are seated in the nerves. The mouth watery; phlegm copious, thick, cold, and, if you should draw it forth, you might drag out a quantity of it in the form of a thread. But, if with length of time and much pain, the matters within the chest ferment, but the restrained spirit (pneuma) agitates all things, and there is a convulsion and disorder of the same, a flood, as it were, of humours swells up to

the organs of respiration, the mouth, and the nose; and if along with the humours the spirit be mixed, it appears like the relief of all the former feelings of suffocation. They accordingly spit out foam, as the sea ejects froth in mighty tempests; and then at length they rise up, the ailment now being at an end. At the termination, they are torpid in their members at first, experience heaviness of the head, and loss of strength, and are languid, pale, spiritless, and dejected, from the suffering and shame of the dreadful malady.