Epidemics, Twelve

HISTORY 135F

Infectious and Epidemic Disease in History

Department of History
University of California, Irvine
Instructor: Dr. Barbara J. Becker

Twelve Cases of Disease
from Book III
Of the Epidemics (400 BCE)
by Hippocrates (460-377 BCE)

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Case I. Pythion, who lived by the Temple of the Earth:

Day 1	trembling commencing from his hands; acute fever, delirium
Day 2	all the symptoms were exacerbated
Day 3	the same
Day 4	stools scanty, unmixed, and bilious
Day 5	all the symptoms were exacerbated, the tremors remained; little sleep, the bowels constipated
Day 6	sputa mixed, reddish
Day 7	mouth drawn aside
Day 8	all the symptoms were exacerbated; the tremblings were again constant; urine, from the beginning to the eighth day, thin, and devoid of color; substances floating in it, cloudy
Day 10	he sweated; sputa somewhat digested, had a crisis; urine thinnish about the crisis
Day 40	after the crisis, an abscess about the anus, which passed off by a strangury

Explanation of the characters. It is probably that the great discharge of urine brought about the resolution of the disease, and the cure of the patient on the fortieth day.

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Case II. Hermocrates, who lived by the New Wall, was seized with fever. He began to have pain in the head and loins; an empty distention of the hypochondrium; the tongue at first was parched; deafness at the commencement; there was no sleep; not very thirsty; urine thick and red, when allowed to stand it did not subside; stool very dry, and not scanty.

Day 5	urine thin, had substances floating in it which did not fall to the bottom; at night he was delirious
Day 6	had jaundice; all the symptoms were exacerbated; had no recollection
Day 7	in an uncomfortable state; urine thin, as formerly
Day 11	all the symptoms appeared to be lightened; coma set in; urine thicker, reddish, thin substances below, had no sediment; by degrees he became collected
Day 14	fever gone; had no sweat; slept, quite collected; urine of the same characters
Day 17	had a relapse, became hot
--	acute fever, urine thin, was delirious
Day 20	had a crisis; free of fever; had no sweat; no appetite through the whole time; was perfectly collected; could not speak, tongue dry, without thirst; deep sleep
Day 24	became heated; bowels loose, with a thin, watery stool; on the following days acute fever, tongue parched
Day 27	he died

In this patient deafness continued throughout; the urine either thick and red, without sediment, or thin, devoid of color, and, having substances floating in it: he could taste nothing.

Explanation of the characters. It is probably that it was the suppression of the stools which occasioned death on the twenty-seventh day.

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Case III. The man who was lodged in the Garden of Dealces: had heaviness of the head and pain in the right temple for a considerable time, from some accidental cause, was seized with fever, and took to bed.

Day 2	there was a trickling of pure blood from the left nostril, but the stools were proper, urine thin, mixed, having small substances floating in it, like coarse barley meal, or semen
Day 3	acute fever; stools black, thin, frothy, a livid sediment in the stools; slight coma; uneasiness at the times he had to get up; sediment in the urine livid, and somewhat viscid
Day 4	slight vomiting of bilious, yellow matters, and, after a short interval, of the color of verdigris; a few drops of pure blood ran from the left nostril; stools the same; urine the same; sweated about the head and clavicles; spleen enlarged, pain of the thigh on the same side; loose swelling of the right hypochondrium; at night had no sleep, slight delirium
Day 6	stools black, fatty, viscid, fetid; slept, more collected
Day 7	tongue dry, thirsty, did not sleep; was somewhat delirious; urine thin, not of a good color
Day 8	stools black, scanty, and compact; slept, became collected; not very thirsty
Day 9	had shivering, acute fever, sweated, a chill, was delirious, strabismus of the right eye, tongue dry, thirsty, without sleep
Day 10	much the same
Day 11	became quite collected; free from fever, slept, urine thin about the crisis
Day 14	fever returned, then sleeplessness and complete delirium
Day 15	urine muddy, like that which has been shaken after the sediment has fallen to the bottom; acute fever, quite delirious, did not sleep; knees and legs painful; after a suppository, had stools of a black color
Day 16	urine thin, had a cloudy eneorema, was delirious
Day 17	in the morning, extremities cold, was covered up with the bedclothes, acute fever, general sweat, felt relieved, more collected; not free of fever, thirsty, vomited yellow bile, in small quantities; formed feces passed from the bowels, but soon afterwards black, scanty, and thin; urine thin, not well colored
Day 18	not collected, comatose
Day 19	in the same state
Day 20	slept; quite collected, sweated, free from fever, not thirsty, but the urine thin
Day 21	slight delirium; somewhat thirsty, pain of the hypochondrium, and throbbing about the navel throughout; on sediment in the urine, quite collected
Day 27	pain of the right hip joint; urine thin and bad, a sediment; all the other symptoms milder
Day 29	pain of the right eye; urine thin
Day 40	stools full of phlegm, white, rather frequent; sweated abundantly all over; had a complete crisis

Explanation of the characters. It is probable that, by means of the stools, the urine, and the sweat, this patient was cured in forty days.

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Case IV. In Thasos, Philistes had headache of long continuance, and sometimes was confined to bed, with a tendency to deep sleep; having been seized with continual fevers from drinking, the pain was exacerbated; during the night he, at first, became hot.

Day 1	he vomited some bilious matters, at first yellow, but afterwards of a verdigris-green color, and in greater quantity; formed feces passed from the bowels; passed the night uncomfortably
Day 2	deafness, acute fever; retraction of the right hypochondrium; urine thin, transparent, had some small substances like semen floating in it; wild delirium about mid-day
Day 3	in an uncomfortable state
Day 4	convulsions; all the symptoms exacerbated
Day 5	early in the morning, died

Explanation of the characters. It is probable that the death of the patient on the fifth day is to be attributed to a phrenitis, with unfavorable evacuations.

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Case V. Charion, who was lodged at the house of Demaenetus, contracted a fever from drinking. Immediately he had a painful heaviness of the head; did not sleep; bowels disordered, with thin and somewhat bilious stools.

Day 3	acute fever; trembling of the head, but especially of the lower lip; after a little time shivering, convulsions; he was quite delirious; passed the night uncomfortably
Day 4	quiet, slept little, talked incoherently
Day 5	in pain; all the symptoms exacerbated; delirium; passed the night uncomfortably; did not sleep
Day 6	in the same state
Day 7	had shivering, acute fever, sweated all over his body; had a crisis; throughout the stools were bilious, scanty, and unmixed; urine thin, well colored, having cloudy substances floating in it
Day 8	passed urine of a better color, having a white scanty sediment; was collected, free from fever for a season
Day 9	fever relapsed
Day 14	acute fever
Day 16	vomited pretty frequently yellow, bilious matters
Day 17	had shivering, acute fever, sweated, free of fever; had a crisis; urine, after the relapse and the crisis, well-colored, having a sediment; neither was he delirious in the relapse
Day 18	became a little heated; some thirst, urine thin, with cloudy substances floating in it; slight wandering in his mind
Day 19	free of fever, had a pain in his neck; a sediment in the urine
Day 20	had a complete crisis

Explanation of the characters. It is probable that the patient was cured in twenty days, by the abundance of bilious stools and urine.

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Case VI. The daughter of Euryanax, a maid, was taken ill of fever. She was free of thirst throughout, but had no relish for food. Stools small, urine thin, scanty, not well colored. In the beginning of the fever, had a pain in the seat.

Day 6	was free of fever, did not sweat, had a crisis; the sore near the nates suppurated and burst at the crisis
Day 7	after the crisis, had shivering, became slightly heated, sweated; afterwards the extremities always cold
Day 10	after a sweat which came on, she became delirious, and again immediately afterwards was collected; these symptoms were said to have been brought on by eating grapes
Day 13	she again talked much incoherently; her bowels disordered with bilious, scanty, unmixed, thin, acrid stools; she required to get frequently up
Day 19	she died on the seventh day after the return of the delirium

At the commencement of the disease she had pain in the throat which was red throughout, uvula retracted, defluxions abundant, thin, acrid; coughed, but had no concocted sputa; during the whole time loathed all kinds of food, nor had the least desire of anything; had no thirst, nor drank anything worth mentioning; was silent, and never spoke a word; despondency; had no hopes of herself. She had a congenital tendency to consumption.

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Case VII. The woman affected with quinsy [inflammation of the throat], who lodged in the house of Aristion: her complaint began in the tongue; speech inarticulate; tongue red and parched.

Day 1	felt chilly, and afterwards became heated
Day 3	shivering, acute fever; a reddish and hard swelling on both sides of the neck and chest, extremities cold and livid; and livid; respiration elevated; the drink returned by the nose; she could not swallow; urine and stools suppressed
Day 4	all of the symptoms were exacerbated
Day 5	she died of the quinsy

Explanation of the characters. It is probable that the cause of death on the sixth day was the suppression of the discharges.

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Case VIII. The young man who was lodged by the Liars' Market was seized with fever from fatigue, labor, and running out of season.

Day 1	the bowels disordered, with bilious, thin, and copious stools; urine thin and blackish; had no sleep; was thirsty
Day 2	all the symptoms were exacerbated; stools more copious and unseasonable; he had no sleep; disorder of the intellect; slight sweat
Day 3	restless, thirst, nausea, much tossing about, bewilderment, delirium; extremities livid and cold; softish distention of the hypochondrium on both sides
Day 4	did not sleep; still worse
Day 7	he died

He was about twenty years of age.

Explanation of the characters. It is probable that the cause of his death on the seventh day was the unseasonable practices mentioned above. An acute affection.

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Case IX. The woman who lodged at the house of Tisamenas had a troublesome attack of inflammation of the upper bowel, much vomiting; could not keep her drink; pains about the hypochondria, and pains also in the lower part of the belly; constant tormina [severe griping pains in the bowels]; not thirsty; became hot; extremities cold throughout, with nausea and sleeplessness; urine scanty and thin; stools undigested, thin, scanty. Nothing could do her any good. She died.

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Case X. A woman of Pantimides, from a miscarriage, was taken ill of fever.

Day 1	tongue dry, thirst, nausea, sleeplessness, belly disordered, with thin, copious, undigested stools.
Day 2	had shivering, acute fever; stools copious; had no sleep.
Day 3	pains greater.
Day 4	delirious.
Day 7	she died.

Belly throughout loose, with copious, thin, undigested stools; urine scanty, thin. An ardent fever.

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Case XI. Another woman, after a miscarriage about the fifth month, the wife of Ocetes, was seized with fever. At first had sometimes coma and sometimes sleeplessness; pain of the loins; heaviness of the head.

Day 2	the bowels were disordered, with scanty, thin, and at first unmixed stools
Day 3	more copious, and worse; at night did not sleep
Day 4	was delirious; frights, despondency; squinting of the right eye; a faint cold sweat about the head; extremities cold
Day 5	all the symptoms were exacerbated; talked much incoherently, and again immediately became collected; had no thirst; labored under sleeplessness; stools copious, and unseasonable throughout; urine scanty, thin, darkish; extremities cold, somewhat livid
Day 6	in the same state
Day 7	she died

Phrenitis.

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Case XII. A woman who lodged near the Liars' Market, having then brought forth a son in a first and difficult labor, was seized with fever.

Day 1	immediately on the commencement had thirst, nausea, and cardialgia; tongue dry; bowels disordered, with thin and scanty stools; had no sleep
Day 2	had slight shivering, acute fever; a faint cold sweat about the head
Day 3	painfully affected; stools undigested, thin, and copious
Day 4	had shivering; all the symptoms exacerbated; sleeplessness
Day 5	in a painful state
Day 6	in the same state; stools liquid and copious
Day 7	had shivering, fever acute; much thirst; much tossing about; towards evening a cold sweat over all; extremities cold, could no longer be kept warm; and again at night had shivering; extremities could not be warmed; she did not sleep; was slightly delirious, and again speedily collected
Day 8	about mid-day, she became warm, was thirsty, comatose, had nausea; vomited small quantities of yellowish bile; restless at night, did not sleep; passed frequently large quantities of urine without consciousness
Day 9	all the symptoms gave way; comatose, towards evening slight shivering; small vomitings of bile
Day 10	shivering; exacerbation of the fever, did not sleep at all; in the morning passed much urine having a sediment; extremities recovered their heat
Day 11	vomited bile of a verdigris-green color; not long after had a feverish chill, and again the extremities cold; towards evening shivering, a cold sweat, much vomiting; passed a painful night
Day 12	had copious black and fetid vomitings; much hiccup, painful thirst
Day 13	vomitings black, fetid, and copious; shivering about mid-day, loss of speech
Day 14	some blood ran from her nose, she died

In this case the bowels were loose throughout; with shivering: her age about seventeen. An ardent fever.

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