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the book of prognostics-第5章

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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 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。

  21。 Strong and continued headaches with fever; if any of the

deadly symptoms be joined to them; are very fatal。 But if without such

symptoms the pain be prolonged beyond twenty days; a discharge of

blood from the nose or some abscess in the inferior parts may be

anticipated; but while the pain is recent; we may expect in like

manner a discharge of blood from the nose; or a suppuration;

especially if the pain be seated above the temples and forehead; but

the hemorrhage is rather to be looked for in persons younger than

thirty years; and the suppuration in more elderly persons。

  22。 Acute pain of the ear; with continual and strong fever; is to be

dreaded; for there is danger that the man may become delirious and

die。 Since; then; this is a hazardous spot; one ought to pay

particular attention to all these symptoms from the commencement。

Younger persons die of this disease on the seventh day; or still

earlier; but old persons much later; for the fevers and delirium

less frequently supervene upon them; and on that account the ears

previously come to a suppuration; but at these periods of life;

relapses of the disease coming on generally prove fatal。 Younger

persons die before the ear suppurates; only if white matter run from

the ear; there may be hope that a younger person will recover;

provided any other favorable symptom be combined。

  23。 Ulceration of the throat with fever; is a serious affection; and

if any other of the symptoms formerly described as being bad; be

present; the physician ought to announce that his patient is in

danger。 Those quinsies are most dangerous; and most quickly prove

fatal; which make no appearance in the fauces; nor in the neck; but

occasion very great pain and difficulty of breathing; these induce

suffocation on the first day; or on the second; the third; or the

fourth。 Such as; in like manner; are attended with pain; are swelled

up; and have redness (erythema) in the throat; are indeed very

fatal; but more protracted than the former; provided the redness be

great。 Those cases in which both the throat and the neck are red;

are more protracted; and certain persons recover from them; especially

if the neck and breast be affected with erythema; and the erysipelas

be not determined inwardly。 If neither the erysipelas disappear on the

critical day; nor any abscess form outwardly; nor any pus be spit

up; and if the patient fancy himself well; and be free from pain;

death; or a relapse of the erythema is to be apprehended。 It is much

less hazardous when the swelling and redness are determined outwardly;

but if determined to the lungs; they superinduce delirium; and

frequently some of these cases terminate in empyema。 It is very

dangerous to cut off or scarify enlarged uvulae while they and red and

large; for inflammations and hemorrhages supervene; but one should try

to reduce such swellings by some other means at this season。 When

the whole of it is converted into an abscess; which is called Uva;

or when the extremity of the variety called Columella is larger and

round; but the upper part thinner; at this time it will be safe to

operate。 But it will be better to open the bowels gently before

proceeding to the operation; if time will permit; and the patient be

not in danger of being suffocated。

  24。 When the fevers cease without any symptoms of resolution

occurring; and not on the critical days; in such cases a relapse may

be anticipated。 When any of the fevers is protracted; although the man

exhibits symptoms of recovery; and there is no longer pain from any

inflammation; nor from any other visible cause; in such a case a

deposit; with swelling and pain; may be expected in some one of the

joints; and not improbably in those below。 Such deposits occur more

readily and in less time to persons under thirty years of age; and one

should immediately suspect the formation of such a deposit; if the

fever be protracted beyond twenty days; but to aged persons these less

seldom happen; and not until the fever be much longer protracted。 Such

a deposit may be expected; when the fever is of a continual type;

and that it will pass into a quartan; if it become intermittent; and

its paroxysms come on in an irregular manner; and if in this form it

approach autumn。 As deposits form most readily in persons below thirty

years of age; so quartans most commonly occur to persons beyond that

age。 It is proper to know that deposits occur most readily in

winter; that then they are most protracted; but are less given to

return。 Whoever; in a fever that is not of a fatal character; says

that he has pain in his head; and that something dark appears to be

before his eyes; and that he has pain at the stomach; will be seized

with vomiting of bile; but if rigor also attack him; and the

inferior parts of the hypochondrium are cold; vomiting is still nearer

at hand; and if he eat or drink anything at such a season; it will

be quickly vomited。 In these cases; when the pain commences on the

first day; they are particularly oppressed on the fourth and the

fifth; and they are relieved on the seventh; but the greater part of

them begin to have pain on the third day; and are most especially

tossed on the fifth; but are relieved on the ninth or eleventh; but in

those who begin to have pains on the fifth day; and other matters

proceed properly with them; the disease comes to a crisis on the

fourteenth day。 But when in such a fever persons affected with

headache; instead of having a dark appearance before their eyes;

have dimness of vision; or flashes of light appear before their

eyes; and instead of pain at the pit of the stomach; they have in

their hypochondrium a fullness stretching either to the right or

left side; without either pain or inflammation; a hemorrhage from

the nose is to be expected in such a case; rather than a vomiting。 But

it is in young persons particularly that the hemorrhage is to be

expected; for in persons beyond the age of thirty…five; vomitings

are rather to be anticipated。 Convulsions occur to children if acute

fever be present; and the belly be they cannot sleep; are agitated;

and moan; and change color; and become green; livid; or ruddy。 These

complaints occur most readily to children which are very young up to

their seventh year; older children and adults are not equally liable

to be seized with convulsions in fevers; unless some of the

strongest and worst
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