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400 BC
OF THE EPIDEMICS
by Hippocrates
translated by Francis Adams
OF THE EPIDEMICS
BOOK I。 Sect。 I。 First Constitution
1。 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。
2。 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。
3。 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。
Sect。 II。 Second Constitution
1。 In Thasus； early in autumn； the winter suddenly set in rainy
before the usual time； with much northerly and southerly winds。
These things all continued so during the season of the Pleiades； and
until their setting。 The winter was northerly； the rains frequent；
in torrents； and large； with snow； but with a frequent mixture of fair
weather。 These things were all so； but the setting in of the cold
was not much out of season。 After the winter solstice； and at the time
when the zephyr usually begins to blow； severe winterly storms out
of season； with much northerly wind； snow； continued and copious
rains； the sky tempestuous and clouded； these things were
protracted； and did not remit until the equinox。 The spring was
cold； northerly； rainy； and clouded； the summer was not very sultry；
the Etesian winds blew constant； but quickly afterwards； about the
rising of Arcturus； there were again many rains with north winds。
The whole season being wet； cold； and northerly； people were； for
the most part； healthy during winter； but early in the spring very
many； indeed； the greater part； were valetudinary。 At first
ophthalmies set in； with rheums； pains； unconcocted discharges；
small concretions； generally breaking with difficulty； in most
instances they relapsed； and they did not cease until late in
autumn。 During summer and autumn there were dysenteric affections；
attacks of tenesmus and lientery； bilious diarrhoea； with thin；
copious； undigested； and acrid dejections； and sometimes with watery
stools； many had copious defluxions； with pain； of a bilious；
watery； slimy； purulent nature； attended with strangury； not connected
with disease of the kidneys； but one complaint succeeding the other；
vomitings of bile； phlegm； and undigested food； sweats； in all cases a
reduncance of humors。 In many instances these complaints were
unattended with fever； and did not prevent the patients from walking
about； but some cases were febrile； as will be described。 In some
all those described below occurred with pain。 During autumn； and at
the commencement of winter； there were phthisical complaints；
continual fevers； and； in a few cases； ardent； some diurnal； others
nocturnal； semi…tertians； true tertians； quartans； irregular fevers。
2。 All these fevers described attacked great numbers。 All these
fevers attacked the smallest numbers； and the patients suffered the
least from them； for there were no hemorrhages； except a few and to
a small amount； nor was there delirium； all the other complaints
were slight； in these the crises were regular； in most instances； with
the intermittents； in seventeen days； and I know no instance of a
person dying of causus； nor becoming phrenitic。 The tertians were more
numerous than the ardent fevers； and attended with more pain； but
these all had four periods in regular succession from the first
attack； and they had a complete crisis in seven； without a relapse
in any instance。 The quartans attacked many at first； in the form of
regular quartans； but in no few cases a transition from other fevers
and diseases into quartans took place； they were pro