Book 1
8
IF an ulcer form in the lungs from an abscess, or from a chronic cough, or from the rejection of blood, and if the patient spit up pus, the disease is called Pye and Phthisis. But if matter form in the chest or side, or be brought up by the lungs, the name is Empyema. But if, in addition to these symptoms, the lungs contract an ulcer, being corroded by the pus passing through it, the disease no longer gets the name of empyema, but takes that of Phthoe instead of it. It is accompanied with febrile heat of a continual character, but latent ceasing, indeed, at no time, but concealed during the day by the sweating and coldness of the body; for the characteristics of phthoe are, that a febrile heat is lighted up, which breaks out at night, but during the day again lies concealed in the viscera, as is manifested by the uneasiness, loss of strength, and colliquative wasting. For had the febrile heat left the body during the day, how should not the patient have acquired flesh, strength, and comfortable feeling? For when it retires inwardly, the bad symptoms are all still further exacerbated, the pulse small and feeble; insomnolency, paleness, and all the other symptoms of persons in fever. The varieties of the sputa are numerous: livid, black, streaked, yellowish-white, or whitish-green; broad, round; hard, or glutinous; rare, or diffluent; devoid of smell, fetid. There are all these varieties of pus. But those who test the fluids, either with fire or water, would appear to me not to be acquainted with phthoe;Our author would appear to allude here to certain passages in the pseudo-Hippocratic treatises, wherein these tests of pus are recommended. See de Morbis, ii. 47, t. vii. p. 72, ed. Littré; Coæ prænot. et alibi. See also Paulus Ægineta, t.i. 452, etc., Syd. Soc. edit. for the sight is more to be trusted than any other sense, not only with regard to the sputa, but also respecting the form of the disease. For if one of the common people see a man pale, weak, affected with cough, and emaciated, he truly augurs that it is phthoe (consumption). But in those who have no ulcer in the lungs, but are wasted with chronic fevers—with frequent, hard, and ineffectual coughing, and bringing up nothing, these, also, are called consumptive, and not without reason. There is present weight in the chest (for the lungs are insensible of pain),—anxiety, discomfort, loss of appetite; in the evening coldness, and heat towards morning; sweat more intolerable than the heat as far as the chest; expectoration varied, as I have described.
