Kitap 2
9
I will now describe the symptoms accompanying each of these states of disease, whether the ulcers be mild or malignant. To speak in general terms, then, if the excoriation is superficial, whether it be above or below, the patients are free from pain and from fever, and get better without being confined to bed, in various ways, by merely some slight changes of diet. But if ulceration supervene, in the upper bowels there are tormina, which are pungent, acrid, as if from the presence of a small amount of hot bile; and occasionally there is suppuration: indeed, for the most part, there is suppuration, or digestions imperfectly performed, though there is no want of appetite. But if the ulcers form in the lower part of the bowels, they are much less dangerous than in those above, for the bowels there are of a much more fleshy nature than those above. But if those above become hollow and phagedænic, there are acute fevers, of a latent kind, which smoulder in the intestines; general coldness, loss of appetite, insomnolency, acid eructations, nausea, vomiting of bile, vertigo: but if the discharge become copious, and consist of more bilious matters, the tormina become permanent, and the other pains increase; sometimes there is prostration of strength, feebleness of the knees; they have ardent fever, are thirsty, and anxious; black vomiting, tongue dry, pulse small and feeble. Akin to these are the fatal symptoms I have stated among those of malignant ulcers; cardiac affections even to deliquium animi, from which some never recover, but thus expire. These dangerous symptoms are common also to erosions of the lower intestines if the ulcers spread, and the discharge be not checked, only that the tormina and pains are below the umbilicus where the ulcers are situated. The forms of the secretions are such as I have said; but if they be small at first, and there be a postponement of their spreading for a long time, various changes take place in the ulcers, some subsiding, and others swelling up, like waves in the sea. Such is the course of these ulcers. But if nature stand out, and the physician co-operate, the spreading may, indeed, be stopped, and a fatal termination is not apprehended, but the intestines remain hard and callous, and the recovery of such cases is protracted.
