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The first class of them as to violence ends thus： the second is
protracted to the seventh day； the third to the eleventh； the fourth
to the fourteenth； the fifth to the seventeenth； and the sixth to
the twentieth。 Thus these periods from the most acute disease ascend
by fours up to twenty。 But none of these can be truly calculated by
whole days； for neither the year nor the months can be numbered by
entire days。 After these in the same manner； according to the same
progression； the first period is of thirty…four days； the second of
forty days； and the third of sixty days。 In the commencement of
these it is very difficult to determine those which will come to a
crisis after a long interval； for these beginnings are very similar；
but one should pay attention from the first day； and observe further
at every additional tetrad； and then one cannot miss seeing how the
disease will terminate。 The constitution of quartans is agreeable to
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 symptoms precede； such as those which occur in
frenzy。 One must judge of children as of others； which will die and
which recover； from the whole of the symptoms； as they have been
specially described。 These things I say respecting acute diseases； and
the affections which spring from them。
25。 He who would correctly beforehand those that will recover； and
those that will die； and in what cases the disease will be
protracted for many days； and in what cases for a shorter time； must
be able to form a judgment from having made himself acquainted with
all the symptoms； and estimating their powers in comparison with one
another； as has been described； with regard to the others； and the
urine and sputa； as when the patient coughs up pus and pus and bile
together。 One ought also to consider promptly the influx of epidemical
diseases and the constitution of the season。 One should likewise be
well acquainted with the particular signs and the other symptoms；
and not be ignorant how that； in every year； and at every season；
bad symptoms