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Hippocrates : medical wisdom

Permission has been gratefully received from US herbalist Andrew Bentley
to reproduce here this wonderful collection of the aphorisms of Hippocrates
© 2007 by Andrew Bentley - Support for this project was provided by the O’Mara Foundation.

Foreword

 Few people in the history of Western Civilization have been as influential as Hippocrates, often called “The Father of Medicine”.  Coming from a family of healers, he integrated the knowledge and wisdom of the various medical schools of thought at the time into a more coherent and expansive tradition. This has formed the basis for the traditional medical systems of much of Europe, and was the roots of the conventional medicine that is now practiced around the world.

In those days, medicine and poetry and prophecy were not wholly separate disciplines. So Apollo the physician is also Apollo the lyricist, and Apollo the god of the oracles.  It has often been said that Hippocrates was the first Greek writer to separate magic from medicine. This may be true—for there were precious few writers on the subject before him--but even for him they are not wholly distinct. The Aphorisms of Hippocrates comprise an empirical work on clinical observation and practice. At the same time, they also comprise a long poem about the art of prophecy and the transformational magic of healing.

Medicine, in the days of Hippocrates, was not so simplistic or crude as we moderns might be inclined to imagine it. Already, people were informed by an ancient tradition of practice, and the same medicines were familiar to one generation after another. While Hippocrates is known to us as the father of medicine, he was known to his contemporaries as the son of a long line of physicians. Countless herbs and mineral drugs would have been available to the practitioner, including almost every class of drugs known to modern science—anesthetics and narcotics, remedies that promoted sleep or countered depression, substances that controlled seizures and those that fought infections of all types. Surgery was also practiced, and there were specialists trained in particular aspects of medicine, as there are today.

Of course, there have been countless important advances in medicine since the fifth century B.C.—Blood transfusions, sterilization techniques, and diagnostic imaging, more advanced surgery, public health and sanitation measures reducing the incidence of disease, and greater sharing of information among practitioners, to name a few. But we would be wrong to assume that the medicine of Hippocrates’ day was not at all evolved.

The framework for the understanding of how health and illness worked, of course, was different. Rather than focusing on microscopic organisms and physiological processes which could not be directly observed, the ancient Greeks looked for patterns in when illnesses occurred and how they progressed, and what remedies or courses of action could correct them. Much attention was given to the fluids of the body—blood, bile, phlegm and melancholy or black bile (whatever that is; the aphorisms suggest that the term referred to an observable fluid, but no one now knows what it was). Incorrect proportions or movements of these fluids were associated with illness processes, and could result from injuries as well.

Unlike many of his contemporaries and successors, Hippocrates believed in paying keen attention to the signs of an illness, and taking cautious steps to remedy it. Although he was not opposed to taking extreme measures when they were necessary and could be tolerated by the patient, he cautioned against recommending treatments at inappropriate times or in inappropriate situations. He was known for gaining a thorough understanding of each individual case before treating, and he repeatedly recommends acting in this way throughout the Aphorisms.

For centuries, especially after the renaissance, the Aphorisms of Hippocrates were an essential classic of western literature. Anyone who was capable read them. They were part of the standard education for medical practitioners and lay persons alike, as they were held to represent the qualities of a decent physician. Although times have changed much, and the world has grown older, it would be a disservice to the generations yet to come if this important work of literature were allowed to slip into obscurity, as it nearly has over the course of the last century or so.

While we may feel that Hippocrates has nothing left to teach such modern, sophisticated people as ourselves, the book deserves to be read simply for the place it has held in the formation of our society’s values. And, on closer inspection, we might see that Hippocrates, while less technologically advanced than ourselves in many ways, possessed a certain humanity, a certain willingness to take time and do what was right, that is often missing from the way we do things now.   

Contents

Section 1
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Bonus Material
The Life of Hippocrates
The Legend of Asclepius
The Hippocratic Oath

Section 1    

1.  Life is short, art is long. The crisis will pass. Experience is dangerous, and decision is difficult. The physician must be prepared, not only to do what is right himself, but also to make the patient, assistants, and outsiders cooperate.

2. In bowel disorders and vomiting, occurring spontaneously, if the matter evacuated is what needs to be purged, this is beneficial and well tolerated. But if not, the contrary. The same with artificial evacuations—if they consist of matter that should be removed, they are beneficial and well tolerated. But if not, the contrary. One, then, should be mindful of the environment, the season, the age, and the illnesses in which they are appropriate, or not.  

3.  In athletes, obesity is injurious if carried to its extreme limit, since they cannot remain still or stationary. And since they cannot remain stationary to heal, all they can do is get worse. For this reason the obesity should be reduced without delay, so that the body has a chance to heal. Evacuations, in their case, should not be let go to an extreme, since this is also dangerous, but only as far as the individual’s constitution can tolerate. For the same reason, medicinal evacuations, if carried to an extreme, are dangerous, and again, a nutritive regimen, if in the extreme, is harmful.

4.  A narrowly restricted diet is always risky in chronic illnesses, and also in acute illnesses in which it is not required. Furthermore, a diet taken to the extreme of reduction is dangerous, and increase, when in the extreme, is also dangerous.

5. In a restricted diet, patients who break the rules are more hurt, for every such transgression, whatever it is, has greater consequences than in a slightly more generous diet. For this reason, a very rigid, narrowly restricted diet is usually more dangerous than a slightly more liberal one.

6. For extreme illnesses, extreme methods of cure, including restriction, are most appropriate.

7.  When an illness is very severe, it is accompanied by very severe symptoms in the beginning. And so, an extremely decreased diet must be used. When this is no longer the case, and it is possible to give a more generous diet, we may relax the strictness of the diet as the disease, becoming milder, and moves away from the extreme.

8.     When the disease is at its worst, it will be necessary to use the narrowest diet.

9.     We must form an individual judgment of each patient, whether they will tolerate the diet until the height of the illness, or whether they will decline before this and not tolerate the diet, or if the illness will give way first and become less acute.

10. In those cases, then, which reach their height quickly, a restricted diet should be used from the beginning. In those cases that reach their height later, we must restrict at that time or a little before it. But prior to that we must allow a more generous diet to support the patient.

11.  We must restrict during attacks, for to give food would be harmful. So in all diseases having periodic attacks, we must restrict during the attacks.

12. Exacerbation and relief will depend on the illness, the season of the year, the cycles of the disorder— whether they occur daily, every other day, or after a longer period—and by secondary symptoms. For example, in pleurisy, if expectoration occurs at the beginning, it shortens the attack; but if it appears later, it prolongs it. In the same way the urine, and bowel discharges, and sweats, according to whether they show favorable or unfavorable signs, indicate an illness of a long or short duration.

13. Old people tolerate fasting most easily. Next, adults. Juveniles not nearly so well. Least of all infants and especially those of a very active nature.

14. Growing people have the most innate heat, so they require the most food; otherwise their bodies are wasted. In the elderly the heat is feeble, so they require little fuel, so to speak, for the flame, since it would be extinguished by too much. For this same reason, fevers in old people are not equally acute, because their bodies are cold.

15. In the winter and spring, the bowels are naturally the hottest, and sleep most prolonged. At these seasons the most food is to be given. Since the belly has the most heat then, it stands in need of the most food. The well-known facts regarding juveniles and athletes demonstrate this.

16. A humid regimen is appropriate in all febrile conditions, especially in children and others accustomed to living on such a diet.

17.  We must also consider in which cases food is to be given once or twice a day, and in greater or smaller amounts, and at what times. Concessions must be made for habit, season, country, and age..

18. The infirm tolerate food worst during summer and autumn, most easily in winter, and next in spring.

19.  Do not give or recommend anything to people during periodic attacks, but refrain from the usual allowance before the turning point.

20.  When things are at the turning point, and when they have just passed it, do not move the bowels or change the treatment, either with purgatives or any other such stimulants, but leave things alone.

21.  Material which needs to be evacuated should be evacuated by whatever outlets are appropriate to the location of the material.

22.  We must purge and move material that is abnormal, not what is normal, unless it is having difficulty coming out, which is usually not the case.

23.  Evacuations should not be judged by their quantity, but by whether they are as they should be, and how they are tolerated. Carrying the evacuation to the point of fainting can be done when appropriate, as long as the patient can tolerate it.

24.  Use purgative medicines sparingly in acute diseases, and at the beginning, and not without due consideration.

25. If the material evacuated is what should be purged, the evacuation is beneficial and well tolerated, but otherwise, it is troublesome.

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Section 2

1. In any illness where sleep does harm, it is a deadly symptom. But if sleep is beneficial, it is not deadly.

2.  When sleep relieves delirium, it is a good symptom.

3.  Both sleep and lack of sleep, when excessive, are bad.

4.  Neither eating, nor fasting, nor anything else, is good when more than natural.

5.  Sudden weakness indicates disease.

6.  People who have a pretense of pain in any part of the body, or are constantly thinking of the pain, are mentally disordered.

7. Bodies that have been slowly emaciated should be slowly replenished. Those that have been quickly emaciated should be quickly replenished.

8. When a person eats food after an illness, but does not improve in strength, it means that the body is using more food than is normal. But if this happens when he does not take food, it is taken to mean that evacuation is required.
           
9.  When one intends to cleanse, he should put the body into a flowing condition.

10.  In a body that is not properly cleansed, the more you nourish, the more you injure.

11.  It is easier to fill up with drink than with food.

12. What remains of an illness, after the climax, is likely to produce recurrences.

13.  People in whom a turning point takes place, pass the night preceding the event in discomfort, but the following night usually more comfortably.

14. In diarrhea, a change in the nature of the stools is beneficial, unless the change is of a bad sort.

15. When the throat is sore or tumors form on the skin, attention must be paid to the sweat and urine. If they are like bile, the disease affects the whole body; but if they are like those of a healthy person, it is safe to give nourishment.

16. When in a state of hunger, one should not undertake hard work.

17. When more food than is healthy has been eaten, it causes illness. This is proven by the treatment.

18. From food that proves nourishing immediately and for a short term, the suffering is also immediate.

19. In acute illness, it is never really safe to predict either death or recovery.

20. Those who have watery discharges from their bowels while young will have dry ones when they are old, and those who have dry discharges while young will have watery ones when they are old.

21. Drinking strong wine alleviates hunger.

22. Illnesses which arise from excess are cured by depletion. Those that arise from deficiency are cured by repletion.  In general, illnesses are cured by their opposites.

23. Acute illnesses come to a climax in fourteen days.

24. The fourth day is indicative of the seventh. The eighth is the beginning of the second week, and so, the eleventh—being the fourth of the second week—is also indicative. Also, the seventeenth is indicative, being the fourth from the fourteenth, and the seventh from the eleventh.

25.  Fevers with a four-day cycle in summer are, usually, of short duration. But those in autumn are longer, especially those occurring near the onset of winter.

26. It is better for a fever to be followed by a convulsion, than a convulsion by a fever.

27.  We should not trust improvements in illnesses when they are not regular, nor be much worried by bad symptoms which occur sporadically. These are usually inconsistent, and do not usually continue for any duration.

28.  In fevers that are not very mild, it is a bad sign for the body to remain without any loss of weight, or to be wasted beyond reason. The one state indicates a prolonged illness, the other weakness of the body.

29.  If it appears that evacuations are to be performed, they should be performed at the onset of the disease. At the worst time it is better to be calm.

30.  Near the beginning and end of an illness all the symptoms are weaker, and near the high point they are stronger.

31.  When a person recovering from an illness has a good appetite, but the body does not improve materially, it is a bad sign.

32. In most cases, people in ill health who have a good appetite at the beginning, but do not improve, come to have a bad appetite toward the end; Whereas those who have a bad appetite at the beginning, and later acquire a good appetite, get better.

33.  In all illness it is a good sign when the patient’s mind is sound, and he is inclined to take whatever food is offered to him; but the opposite is bad.

34. There is less danger in illnesses when the illness is one to which the patient’s constitution, lifestyle, age, and the season are allied, than when it is one to which they are not allied.

35. In any illness it is better that the belly and abdominal regions preserve their roundness, and it is a bad sign when they are very thin and emaciated. In the latter case it is dangerous to give purgatives.

36. Healthy people quickly lose their strength by using purgative medicines, or eating tainted food.

37. Purgative remedies do not agree with healthy people.

38.  An article of food or drink that is slightly less healthy, but more palatable, is better tolerated than one that is more healthful but less palatable.

39.  Adults have fewer complaints than children, but chronic illnesses which do affect them generally never leave them.

40.  In very old people, mucous and sinus drainage are not abnormal.

41. People who have had frequent and severe attacks of fainting, without any obvious cause, die suddenly.

42. It is impossible to recover from a severe stroke, and difficult to recover from a mild one.

43.  People who have been hanged, and are in an unconscious state, but not quite dead, do not recover if they are foaming at the mouth.

44.  People who are naturally very obese are likely to die earlier than those who are slender.

45.  Epilepsy in children is most frequently controlled by changes of air, of country, and of way of living

46.  When two pains occur together, not in the same part of the body, the stronger weakens the other.

47.  Pain and fever occur during the formation of pus, rather than when it is already formed.

48.  Any time movement of the body causes pain, it will be relieved by rest.
.
49.  Those who are accustomed by habit to hard labor, even if they are weak and old, can bear it better than strong and young people who are not accustomed to it.

50.  Things that someone has been accustomed to for a long time, although worse than things one is not   accustomed to, usually give fewer disturbances. But sometimes a change must be made to thins someone is not accustomed to.

51. To evacuate, fill, heat, cool, or otherwise affect the body in any way strongly and suddenly, is dangerous, and whatever is excessive is opposed to nature. Whatever is done little by little is safe, especially when making a change from one thing to another.

52. When everything is done according to requirements, even though things may not be turning out according to plan, we should not change to other treatments while the original symptoms remain.

53.  People who have watery discharges from the bowels when they are young thrive better than those who have dry; but in old age they do worse, since the bowels in old people are usually dried up.

54.  Largeness of person when young is desirable and not ugly; but in old age it is inconvenient, and worse than a smaller frame.

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Section 3     

1.  The changes of the seasons frequently cause illnesses, and within the seasons major changes of heat or cold do the same.

2.  Constitutionally, some are well- or ill- adapted for summer, and likewise for winter.

3. Certain illnesses and ages are well- or ill-adapted to different seasons, environments, and types of diet.

4.  In any season, when during the same day there is heat at one time and cold at another time, the diseases of autumn may be expected.

5.  South winds induce dullness of hearing, dimness of visions, heaviness of the head, and lethargy. When they are prevailing, these symptoms occur in illnesses. But if the north wind is prevailing, coughs, sore throat, hardness of the stools, dysuria with stiffness and pains of the sides and breasts occur. When this wind is prevailing, all these symptoms may be expected in illnesses.

6.     When summer is like spring, much sweating may be expected in fevers.

7.     Acute illnesses occur in dry times, and if the summer is especially so, then by the influence it has given to the year, mostly these illnesses may be expected.

8.     In seasons that are typical, and produce seasonable conditions at seasonable times, illnesses are predictable, and come readily to a turning point. But in atypical seasons, the illnesses are irregular, and come to a turning point with difficulty.

9.     In autumn, diseases are most acute, and most deadly, on the whole. The spring is most healthy, and least deadly.

10.  Autumn is a bad season for people with wasting illnesses.

11.  Regarding the seasons, if the winter is dry with northerly winds, and the spring rainy with southerly winds, in summer there will certainly be acute fevers, eye disorders, and bowel disorders, especially in women, and in men with a damp constitution.

12.  But if the spring is dry and northerly, women whose date of delivery is in spring have miscarriages from any little cause. Those who reach full term bear children who are weak, and sickly, so that they either die soon or, if they live, are weak and sickly. Other people are subject to bowel disorders and eye disorders, and old men to congestion, which quickly cuts them off.

13.  If the summer is dry and northerly and the autumn rainy and southerly, headaches occur in winter, with coughs, hoarseness, and runny noses and in some cases wasting illnesses.

14.  But if the autumn is northerly and dry, it agrees well with people of a damp constitution, and with women. But others will be subject to dry eye conditions, high fevers, runny noses, and sometimes black bile.

15.  Of the constitutions of the year, the dry, in general, are more healthy than the rainy, and occasion less death.

16.  The illnesses that come on most frequently in rainy seasons are: prolonged fevers, flowing of the bowels, injuries, epilepsy, stroke, and swollen tonsils; and in dry seasons, wasting illnesses, eye disorders, and arthritic diseases, urinary and intestinal difficulties.

17.  Regarding the states of the weather that only last a day, The north wind braces the body, giving it tone, agility, and color, improves the sense of hearing, dries up the bowels, narrows the eyes, and worsens any pain that may have previously existed in the chest. But the south wind relaxes the body and makes it humid, brings on hardness of hearing, heaviness of the head, and vertigo, impairs the movements of the eyes and the body as a whole, and makes the intestinal discharges watery.

18. Regarding the seasons, in spring and the beginning of summer, children and those near to them in age are most comfortable, and enjoy the best health; In summer and part of autumn, old people; during the rest of autumn and winter, people of an intermediate age.

19.  All illnesses occur at all times of the year, but certain of them are more likely to occur or be made worse in certain seasons.

20.  The illnesses of spring are: maniacal, melancholic, and epileptic disorders; bloody stools; swollen tonsils; runny noses; hoarseness, cough; leprosy, skin eruptions, and rashes that lead to sores; cysts, and arthritis.

21.  In summer, certain of these, as well as continued, high fevers; but especially vomiting, diarrhea, eye disorders, pains of the ears, sores in the mouth, disorders of the genitals, and sweat-blisters.

22.  In autumn, most of the summer fevers, cyclical and irregular fevers, enlarged spleen, fluid retention, tuberculosis, difficulty urinating,  spleen and bowel disorders, sciatica, swollen tonsils, asthma, obstructed bowels, epilepsy, and maniacal and melancholic disorders.

23.  In winter, pleurisy, pneumonia, runny noses, hoarseness, cough, pains in the chest, pains in the ribs and sides, headaches, vertigo, and stroke.

24.  In the different ages the following complaints occur: In little and newborn babies, thrush, vomiting, coughs, sleeplessness, frights, soreness of the navel, watery discharge from the ears.

25.  Around the time of cutting teeth—sore gums, fevers, convulsions, diarrhea- especially when cutting the canine teeth, and in those who are especially fat and have constipated bowels.

26.  In people somewhat older, problems with the tonsils, curvature of the spine at the vertebra next to the skull, asthma, stones, pinworms, roundworms, skin tags, excessive arousal swollen glands, and other cysts, but especially those.

27.  In people of a more advanced age, and now on the verge of adulthood, most of these illnesses, and additionally, more chronic fevers and bloody noses.

28.  Juveniles usually have a turning point in their problems, some in forty days, some in seven months, some in seven years, some at the onset of puberty. And those complaints of children that remain, and do not go away around puberty, or in females around menarche, usually become chronic.

29.  In people past childhood, spitting of blood, tuberculosis, acute fevers, epilepsy; other diseases as well, but especially these.

30.  In people beyond that age, asthma, pleurisy, pneumonia, lethargy, encephalitis, high fevers, chronic diarrhea, stomach ache, dysentery, passage of undigested matter, hemorrhoids.

31.  In old people, difficulty breathing, congestion accompanied by cough, difficulty urinating, arthritis, kidney pain, dizziness, stroke, lack of appetite, soreness of the whole body, insomnia, runny bowels, eyes, and nose, dimness of sight, cataracts, and hardness of hearing.

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Section 4     

1.     We must purge pregnant women, if matters are in a state of arousal, between the fourth and seventh month, but less freely in the latter. In the first and last stages of pregnancy it should be avoided.

2.     By purging we should bring out matters such that it would have been beneficial for them to come out on their own. But those of an opposite character should be stopped.

3.     If the material evacuated is what should be purged, the evacuation is beneficial and well tolerated, but otherwise, it is troublesome.

4.     We should prefer to purge upward in summer and downward in winter.

5.  Around the dog days of summer, and before that, the administration of purgatives is inappropriate.

6.  Thin people who are easily made to vomit should be purged upward, avoiding the winter season.

7.  People who are difficult to make vomit, and are medium or fat, should be purged downward, avoiding the summer season.

8.  We must be cautious purging people with tuberculosis upward.

9.  And by the same logic, applying the opposite rule to melancholic people, we must purge them liberally downward.

10.  In very acute illnesses, if things are reaching a climax, we may purge on the first day, since it is a bad thing to delay in such cases.

11.  Cases where there is bellyache, pain around the navel, and pains in the side, not removed either by purging medicines or otherwise, usually end in dryness and swelling.

12.  It is a bad thing to purge upward any people who are passing undigested matter, during winter.

13.  People who are not easily purged upwards with hellebore should have their bodies wetted with plenty of food, and rest before taking the medicine.

14.  When someone takes a drink of hellebore, they should be made to move around more, and indulge less in sleep and rest. Sailing on the sea proves that motion promotes vomiting.

15.  When you want hellebore to act more, move the body, and when you want it to stop, let the patient get sleep and rest.

16.  Hellebore is dangerous to people whose muscles are strong, since it produces convulsions.

17.  Anorexia, heartburn, dizziness, and a bitter taste in the mouth, in a person without a fever, indicate the need to purge upward. 

18.  Pain located above the diaphragm indicates purging upwards, and below it, downward.

19.  People who have no thirst under the influence of purgative medicines should be purged until they become thirsty.

20.  If people without fever are seized with bellyache, heaviness of the legs, and pains in the sides, this means that purging downward is needed.

21.  Bowel droppings which are black, like blood, occurring spontaneously with or without fevers, are very bad. The more numerous and unfavorable the colors, the worse. When a result of medicine it is better, and a variety of colors in that case is not significant.

22.  When black bile is evacuated in the beginning of any disease whatsoever, either upward or downward, it is a deadly omen.

23.  In people weakened by any disease, acute or chronic, or from wounds or any other cause, if there is a discharge of black bile or blackened blood, they die on the following day.

24. Dysentery, if it begins with black bile, is lethal.

25.  Blood discharged upwards, whatever its origin, is a bad symptom, but downward it is better, including black stools.

26.  In a person sick with dysentery, if pieces of flesh are discharged from the bowels, it is a deadly omen.

27.  In any case of fever where there is a hemorrhage from any orifice, the bowels are loose during recovery.

28.  In every case, discharges of bile cease if deafness comes on, and deafness ceases when discharges of bile come on.

29. Stiffness which comes on the sixth day is difficult to turn around.

30.  Diseases of periodic attacks, where an attack leaves then returns at the same hour the next day, are difficult to turn around.

31. In febrile illnesses with a feeling of weakness, deposits form in the joints, especially those of the jaw.

32.  In people recovering from illness, if any part feels pain, a deposit has formed there.

33.  And if any part is in pain before the illness, the illness remains there.

34.  If someone suffering from a fever, with no swelling of the airways, is suddenly seized with a feeling of suffocation, it is a deadly omen.

35.  If someone with a fever suddenly has a spasm of the throat, and cannot swallow without difficulty, although no swelling is present, it is a deadly omen.

36.  Sweats, in illnesses with fevers, are beneficial, if they start on the third, fifth, seventh, ninth, eleventh, fourteenth, seventeenth, twenty-first, twenty-seventh, and thirty-fourth day, since these sweats cause a turning point in the illness. But sweats not occurring then signify a prolonged illness, and relapses.

37.  Cold sweats occurring in a severe fever signify death; and along with a milder one, a prolonged illness.

38. And in whatever part of the body there is sweating, this suggests that the illness is situated there.

39.  And in whatever part of the body heat or cold is situated, illness is there.

40.  And in any case where there are changes in the whole body, or if the body be alternately cold then hot, or if one color succeeds another, this indicates a prolonged illness.

41.  A profuse sweat after sleep, occurring without any obvious cause, means that the body is using too much food. But if it occurs when someone is not eating food, it signifies that evacuation is required.

42. A profuse sweat, hot or cold, flowing continuously, indicates illness—the cold lesser, the hot greater.

43.  Fevers that are not intermittent which get worse on the third day are dangerous. But if they are intermittent this does not in any way indicate that they are severe.

44.  In cases where there is prolonged fever, cysts or pains occur in the joints.

45.  When cysts or pains attack the joints after fevers, the person is eating too much food.

46.  In a fever that is not intermittent, if stiffness comes upon a person that is already very weak, it is deadly.

47.  In fevers that are not the intermittent kind, phlegm that is green, bloody, smelly, or yellow is bad. But if evacuated properly, it is beneficial. The same is true of the stools and the urine. But if none of the proper evacuations take place by these channels, it is detrimental.

48.  In fevers that are not the intermittent kind, if the extremities are cold, but the trunk is burning, and there is thirst, it is a deadly sign.

49.  In fevers that are not the intermittent kind, if a lip, an eye-brow, an eye, or the nose is distorted, or if there is loss of sight or hearing, and the patient is debilitated—when any of these symptoms occur, death is close by.

50.  Relapses in fevers that are not cured at the first turning point, indicate a prolonged illness.

51.  When difficult breathing and delirium occur in a fever that is not of the intermittent type, the case is mortal.

52.  When people with fevers, or other illnesses, shed tears voluntarily, it is nothing out of place. But when they shed tears involuntarily, it certainly is.

53.  In any case of fever where thick scum forms around the teeth, the fever turns out to be especially strong.

54.  Whenever there is high fever with drawn out, dry coughs of a tickling sort, without much coughing up of phlegm, there is usually not much thirst.

55.  All bubonic fevers are bad, except those that are fleeting.

56. Sweat coming on after a fever has ceased is bad, as it means the illness will be prolonged and it indicates an excess of bodily fluids.

57.  Fever coming on in a prolonged case of spasm or tetanus, relieves the illness.

58.  A tremor coming on in the case of a high fever helps to relieve it.

59.  A fever with a true four-day cycle comes to a turning point in seven cycles at the most.

60.  When there is deafness from fevers, and blood runs from the nostrils or the bowels become distressed, it removes the illness.

61.  In a case of fever, if the fever does not remit on the odd numbered days, it relapses.

62. When jaundice appears in fevers before the seventh day, it is a bad sign, unless there are also watery stools.

63. In any case of fever where tremors come on during the day, the fever will break the same day.

64.  In fevers, when jaundice occurs on the seventh, ninth, eleventh, or fourteenth day it is a good sign, provided the upper abdomen is not hardened. Otherwise, it is not a good symptom.

65. Strong heat around the stomach and heart pain are bad symptoms in fevers.

66. In severe fevers, seizures and strong pains in the bowels are bad symptoms.

67.  In fevers, nightmares and seizures are a bad symptom.

68. In fevers, apnea is a bad symptom, as it indicates seizure.

69.  When the urine is thick, lumpy, and scanty in cases that are not without fever, a large volume of thinner urine is beneficial. This sort of discharge happens more often when the urine has had sediment from the beginning, or soon after the beginning.

70.  In fevers, when the urine is cloudy like a donkey’s, there either is or will be headache.

71.  In cases that come to a turning point on the seventh day, the urine has a reddish tinge on the fourth day, and all the other expected symptoms.

72.  When the urine is transparent and white, it is bad; it appears principally in cases of encephalitis.

73. When the upper belly is affected with movement and gurgling, if pains in the sides come on the bowels will get into a loose and watery state, unless there is a lot of flatus or a copious discharge of urine. These things happen in fevers.

74. When there is reason to think an abscess will form in a joint, the abscess can be prevented by a copious discharge of urine, which will be thick and become white, like what starts to form in certain cases of malaria, and be accompanied by a sense of weakness. It is also quickly prevented by bleeding from the nose.

75. Blood or pus in the urine indicates ulceration of either the kidneys or the bladder.

76.  When small fleshy particles like hairs come out in thick urine, these particles come from the kidneys.

77.  In cases where there are scaly particles passed along with thick urine; there is infestation of the bladder.

78.  In cases where there is a spontaneous discharge of bloody urine, it signifies rupture of a small vein in the kidneys.

79. In those cases where there is sandy sediment in the urine, there are stones in the urinary tract.

80.  If a patient passes blood and clots in their urine, and has difficulty urinating, and has pains in the lower belly and pelvic floor, the parts around the bladder are affected.

81. If a patient passes blood, pus, and scales in the urine, it means there is ulceration inside the bladder.

82. When blisters form in the urethra, if they break and open, there is relief.

83. When a lot of urine is passed during the night, it indicates that the bowel movements are scanty.

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Section 5     

1.  Convulsions from taking hellebore are deadly in nature.

2. Convulsion secondary to a wound is deadly.

3.  A convulsion or hiccup secondary to hemorrhage is bad.

4.   A convulsion or hiccup secondary to diarrhea is bad.

5.  If a drunken person suddenly loses his speech, he will die convulsed, unless fever comes on or he recovers his speech when the effects of the drinking wear off.

6.  Those people seized with lockjaw die within four days, or if they pass these they recover.

7. Cases of epilepsy with the onset before puberty may undergo a change at that time, but those which come on after twenty-five years of age, for the most part end at death.

8.  In lung disorders, if the illness is not cleared out in fourteen days, it usually turns into pneumonia.

9.  Tuberculosis most commonly occurs between the ages of eighteen and thirty-five years.

10.  People who survive a case of swollen tonsils, but the disease turns inward upon the lungs, die in seven days. Or, if they pass these, they become infected with pneumonia.

11.  In people affected with tuberculosis, if the phlegm they cough up has a strong smell when poured on embers, and the hair on the head falls off, the case will prove fatal.

12.  People with tuberculosis that lose their hair, die if diarrhea sets in.

13. When people cough up frothy blood, it is coming from the lungs.

14. Diarrhea attacking a person with tuberculosis is a mortal symptom.

15.  People who get pneumonia after swollen tonsils, if they get rid of it in forty days, escape the illness. If not, it turns into tuberculosis.

16.  Heat produces the following symptoms in those who use it excessively: Sensitivity of the flesh, weakness of the sinews, cloudiness of the mind, bleeding, fainting, and, along with these, death.

17.  Cold induces tremors, spasms, gangrene, and febrile seizures.

18.  Cold is detrimental to the bones, the teeth, the nerves, the brain, and the spinal cord, but heat is beneficial.

19. Parts that have been frozen should be heated, except where there is bleeding, or it is expected.

20.  Cold contracts ulcers, hardens the skin, causes pain that does not end in blistering, darkens, and causes tremors seizures and stiffness in fevers.

21.  In the case of a muscular young person having tetanus without a wound, in the middle of summer, it sometimes happens that resorting to the use of cold water revives the heat, and heat relieves the illness.

22.  Heat discharges pus, but not from all types of sores. When it does, it gives the greatest indication of their being free from danger. It softens the skin, makes it thin, relieves pain, soothes stiffness, tremor, and spasms. It relieves headache, and heaviness of the head. It is particularly effective in fractures of the bones, especially those which are open, and most especially in wounds of the head; in gangrene and ulcers from cold; in herpes outbreaks of the anus, the genitals, the vagina, and the urethra; in all these cases heat is beneficial and brings matters to a turning point. But cold is counterproductive, and does harm.

23.  Cold water should be applied in the following cases: when there is blood loss, or when it expected-- not applied on the spot, but around the spot from which the blood flows; in inflammation and inflammatory illnesses tending towards a red and bloody color, and consisting of fresh blood—in these cases it should be applied, but it causes gangrene in old cases; and in infection not complicated by open sores, as it proves damaging in infection with open sores.

24.  Cold things such as snow and ice are detrimental to the chest, provoking coughs, discharge of blood, and congestion.

25.  Swelling and joint pain, sores, gout, and sprains, are usually improved by pouring lots of cold water over them, which reduces the swelling and relieves the pain; a mild numbness relieves pain.

26. The lightest water is that which is quickly heated and quickly cooled.

27. When people crave drink strongly, it is a good thing if they can sleep off the desire for drinking.

28.  Burning aromatic herbs promotes menstruation, and would be useful in many other cases if it did not cause heaviness of the head.

29.  Pregnant women should be purged, if matters are in a state of arousal, between the fourth and seventh month, but less freely in the latter. In the first and last stages of pregnancy it should be avoided.

30.  It proves deadly to a woman in pregnancy if she is seized with any acute disease.

31.  If a pregnant woman is bled, she may have a miscarriage, and this will be more likely to happen the larger the fetus.

32. Frequent nosebleeds in a woman are relieved by menstruation.

33. In a woman, when there is obstruction of the menses, bleeding from the nose is beneficial.

34.  When a pregnant woman has violent diarrhea, there is danger of her miscarrying.

35.  Sneezing occurring to a woman with a weak uterus, or in difficult labor, is beneficial.

36.  When menstrual blood is of a bad color and irregular, it indicates that the woman needs cleansing.

37.  In a pregnant woman, if the breasts suddenly lose their fullness, she has a miscarriage.

38.  In a woman pregnant with twins, if either breast loses its fullness, one of her babies will die. And if it is the right breast, it will be the male child, or if the left, the female.

39. If a woman who is not pregnant, and has not had children, lactates, her menses are obstructed.

40.  In women, blood collected in the breasts indicates a disorder of the uterus.

41.  If you wish to determine if a woman is pregnant, give her honey-water to drink when she is going to sleep, and has not eaten supper. If she is seized with cramps in the belly she is pregnant, but otherwise she is not pregnant.

42. A woman with child, if it is a male, has a fair color; but if it is a female, she will have a dark color.

43.  If infection of the uterus affects a pregnant woman, it will probably prove fatal.

44.  Women who are very thin have miscarriages when they get pregnant, until they get into better shape.

45.  When women of a medium build miscarry in the second or third month, without any obvious cause, their placentas are obstructed by mucus, and cannot support the weight of the fetus, but detach.

46.  Those women who are excessively obese, and do not get pregnant, in them it is because the belly obstructs the mouth of the cervix, and until it is reduced, they do not conceive.

47.  If the part of the uterus situated near the hip joint tears open, it does so in such a way as to require repair with a tent.

48. A male fetus tends to lie on the right side, a female on the left.

49.  To induce expulsion of the placenta, give a medicine that induces sneezing, and shut the nostrils and mouth.

50.  If you intend to stop the menses in a woman, apply as large a cupping instrument as possible to the breasts.

51.  When women are pregnant, the mouth of the cervix is closed.

52.  If much milk leaks from the breasts in a pregnant woman, it means that the fetus is weak. But if the breasts are firm, it means the fetus is in a healthier state.

53.  In women that are about to miscarry, the breasts become thin. But if they become hard again, there will be pain in either the breasts, the hips, the eyes, or the knees, and they will not miscarry.

54. When the mouth of the cervix is hard, it is also shut.

55.  Pregnant women who are affected by fevers, or who are greatly emaciated for no apparent reason, have difficult and dangerous labors, and if they miscarry, they are in danger.

56. During the female flow, if convulsions and fainting come on, it is bad.

57.  When the menses are excessive, illness takes place, and when the menses are stopped, illness of the uterus takes place.

58.  Difficulty urinating results from inflammation of the rectum, and of the womb, and difficulty urinating results from damage to the kidney, and hiccup from inflammation of the liver.

59.  If a woman does not conceive, and wishes to determine whether she can conceive, having wrapped her up in blankets, steam with aromatic herbs below,; If it seems that the scent passes through the body to her nostrils and mouth, know that she is not herself infertile.

60.  If a pregnant woman continues having periods, it is unlikely that the child can be healthy.

61.  If a woman’s periods have stopped, and neither stiffness nor fever has followed, but she has been affected with nausea, you may reckon her to be with child.

62.  Women whose uterus is too cold and dense do not conceive; and those who have a humid uterus do not conceive, for the sperm are extinguished; and in women whose uterus is very dry and very hot, the sperm die from lack of nourishment. But women, whose uterus is in a more moderate state between these constitutions, prove fertile.

63.  The situation is similar with regard to males; Due to laxity of the body, the vital energy is dissipated outward, so as not to propel the sperm, or owing to its thickness, the fluid does not come out, or owing to coldness, it is not heated to collect in the appropriate vesicles, or, owing to excessive heat, the very same thing happens.

64.  It is a bad thing to give milk to people with headaches, and it is also bad to give in fevers, or to people whose bellies are distended and troubled with noisy digestion, or to people who are thirsty. It is also bad when given to those who have jaundice from acute fevers, and to those who have heavy flows of blood. But it is suitable in tuberculosis, when not complicated by much fever. It can also be given in chronic and low-grade fevers, when none of the aforementioned symptoms are present, and the patient is thin and weak.

65.  When swellings appear on wounds, such cases are not likely to be complicated by delirium and seizures. But when these disappear, if they are on the back of the body, tremors and spasms come on, and if on the front, mania, sharp pains in the sides, or opening of the wounds, or dysentery if the swellings were very red.

66.  When no swelling appears on serious and massive wounds, it is a major problem.

67.  In such wounds, soft swellings are favorable and hard unfavorable.

68.  When a person has a pain in the back part of the head, they are benefited by having the straight vein in the forehead opened.

69.  Stiffness in women usually begins in the sides, and spreads by the back to the head. In men also, it is more in the rear than the front side of the body—as from the arms and thighs. The skin there is thin, as can be seen by the growth of hair on them.

70.  People attacked with fevers of a four-day cycle are not usually attacked by seizures, or if they previously had seizures, they cease when such a fever comes on.

71.  In people in whom the skin is stretched, and dry and hard, the illness ends without sweats. But in those in whom the skin is loose and thin, it ends with sweats.

72. People inclined to jaundice are not very inclined to flatulence.

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Section 6     

1.  In cases of chronic indigestion, sour belching coming on when there was none previously is a good sign.

2.  People whose noses are naturally watery, and their semen watery, have a rather disordered state of health. But those in the opposite state, a more favorable one.

3.  In prolonged cases of dysentery, aversion to food is a bad symptom, and still worse if accompanied by fever.

4. Open sores accompanied by hair loss are a deadly omen.

5.  It is worth considering whether the pains in the sides, and in the breasts, and in other parts, differ much from one another.

6. Disorders of the kidneys and bladder are cured with difficulty in old men.

7. Pains occurring around the stomach, the more superficial they are, the milder they are. And the deeper they are, the more severe.

8. In people with fluid retention, sores forming on the body are not easily healed.

9. Rashes covering a wide area are not very itchy.

10.  In people with a painful place in the head, and intense headache, pus or water running from the nose or by the mouth or from the ears removes the illness.

11.  Hemorrhoids appearing in melancholic or kidney disorders are favorable.

12.  When a person has been cured of chronic hemorrhoids, unless one is left, there is danger of fluid retention or tuberculosis coming on.

13. Sneezing beginning, in a person with hiccups, cures the hiccups.

14.  In a case of fluid retention, when the water drains through the vessels into the abdomen, it relieves the illness.

15.  In prolonged diarrhea, vomiting, when it comes on spontaneously, relieves the diarrhea.

16.  Diarrhea coming on in a chronic case of pleurisy or pneumonia is bad.

17. It is good in cases of eye disorders for the patient to get diarrhea.

18.  A severe wound of the bladder, the brain, the heart, the diaphragm, the intestines, the stomach, or the liver is deadly.

19.  When a limb, cartilage, nerve, the lower jaw, or the foreskin is cut off, the part is neither regenerated, nor does it rejoin.

20. If blood is spilled into a cavity where it is not naturally, it must necessarily become rotten.

21. In cases of mania, if varicose veins or hemorrhoids come on, they relieve the mania.

22.  Those ruptures of the back that spread down to the elbow are removed by bloodletting.

23. If anxiety or depression lasts a long time, it is a melancholy disorder.

24. If either of the intestines is punctured, it does not heal.

25.  It is not a good sign for an infection spreading from the outside to be found within. But for it to be found outside from within is good.

26. In any case of high fever where seizures occur, they are taken away by delirium.

27.  Cases of abscess or fluid retention that are treated by incision or cautery, if the water or puss flows all at once and quickly, will certainly prove fatal.

28.  Eunuchs do not get gout, nor become bald.

29.  A woman does not get gout, unless her menses are obstructed.

30. A young man does not get gout until he has intercourse.

31.  Pain of the eyes can be relieved by drinking strong wine, or bathing, or a compress, or bloodletting, or purging.

32.  People whose speech has become impaired are likely to be affected by chronic diarrhea.

33. People inclined to sour belching are not very likely to have pleurisy.

34.  People who have become bald are not subject to large varicose veins. But should varicosities come on in bald people, their hair grows back.

35.  Hiccup coming on in cases of fluid retention is bad.

36.  Bloodletting cures painful urination. Open the veins on the inside of the arm.

37.  It is a good sign when swelling on the outside of the neck occurs in a person with severely swollen tonsils, because the disease is turning outward.

38.  It is better not to apply any treatment in cases of concealed cancer, because, if treated, the patients die quickly, but if not treated, they hold out for a long time.

39. Convulsions take place from either fullness or depletion; this also applies to hiccups.

40.  When pain without inflammation occurs in the upper belly, fever coming on relieves the pain.

41. When pus anywhere in the body does not move, it is due to the thickness of the part.

42.  In cases of jaundice, it is a bad symptom when the liver becomes hardened.

43.  When people with a large spleen have bowel disorders, and the bowel disorders become chronic, either fluid retention or passage of undigested stools comes on, and they die.

44.  When bowel obstruction comes on in a case of urinary obstruction, they cause death in seven days, unless fever comes on and there is a large discharge of urine.

45.  When sores stay open for a year or more, they always cause erosion of the bone, and the scars are sunken.

46. Such persons as become barrel-chested from asthma and cough before puberty, die.
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47. People who benefit from bloodletting or purging should be bled or purged in spring.

48. When the spleen is enlarged, it is a good sign if diarrhea comes on.

49.  In gout, the swelling goes down after forty days.

50.  When the brain is severely wounded, fever and vomiting of bile always come on.

51.  When people in good health are suddenly affected by pains in the head, and immediately rendered unconscious and speechless, they die in seven days unless fever comes on.

52.  We must pay attention to the appearances of the eyes in sleep, as presented from below, because if a portion of the whites can be seen between the closed eyelids, and if this is not connected with diarrhea or extreme purging, it is a very bad and deadly sign.

53.  Delirium accompanied by laughter is less serious than delirium accompanied by a serious mood.

54.  In acute illnesses complicated by fever, stridor upon breathing is bad.

55.  For the most part, gout is aggravated in spring and fall.

56.  In melancholic conditions, depending on the constitution that gives rise to them, the following diseases result: either paralysis of the whole body, or seizures, or insanity, or blindness.

57. People are most susceptible to stroke between the ages of forty and sixty.

58.  If a hernia protrudes, it will turn gangrenous and fall off.

59.  In chronic disorders of the hip joint, if the bone dislocates and returns into its socket, there is an excess of phlegm in the area.

60.  In people affected by chronic disorders of the hip joint, if the bone dislocates from its socket, the leg becomes atrophied and disfigured, unless the part is cauterized.

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Section 7    

1. In acute illnesses, coldness of the extremities is bad. 

2. Discolored flesh on an injured bone is bad.

3. Hiccup and redness of the eyes, following vomiting, are bad.

4.  A chill coming on after a sweat is not good.

5. Dysentery, or fluid retention or ecstasy coming on in madness is good.

6. In a very prolonged illness, lack of appetite and undigested discharges from the bowels are bad symptoms.

7. Stiffness and delirium from excess sleep are bad.

8. From the rupture of an internal abscess, loss of strength, vomiting, and fainting result.

9. Delirium or convulsion from loss of blood is bad.

10.  Vomiting, hiccup, or seizure from obstruction of the bowels is bad.

11.  Pneumonia secondary to pleurisy is bad.

12.  Encephalitis along with pneumonia is bad.

13. Seizure or spasm as a result of severe burning is bad.

14. Stupor or delirium from a blow to the head is bad.

15.  Spitting of blood leads to spitting of pus.

16. After spitting of pus tuberculosis may come on, with a flow. When the spitting ceases, they die.

17. Hiccup secondary to hepatitis is a bad sign.

18. Seizure ore delirium from lack of sleep is bad.

18a. Tremor along with excessive sleep is bad.

19. Infection on an exposed bone,

20. Rot and blistering from the infection, is bad.

21. Bleeding in heavy spurts from a wound is bad.

22. An open sore after prolonged pain in the abdominal area is bad.

23.  Dysentery with undigested bowel movements is bad.

24.  Delirium from a cut in the skull, if it penetrates into the brain cavity, is bad.

25.  Seizure from severe purging is a deadly sign.

26. In severe intestinal pain, coldness of the extremities coming on is a bad sign.

27.  Painful bowel obstruction occurring during pregnancy causes miscarriage.

28.  Any piece of cartilage or tendon that is cut off from the bone, neither mends nor re-grows.

29. When strong diarrhea comes on in a case of congestion, it removes the disease.

30. In instances where there is a frothy discharge in diarrhea, there is a flowing downward from the head.

31. When there is a starchy sediment in urine, it indicates a prolonged illness.

32.  In cases where the urine is clear at first, then becomes more yellow with sediment, an acute disease is indicated.

33.  In cases where the urine separates upon standing, there is great disorder in the body

34.  When bubbles stay on the surface of the urine, they indicate a disorder of the kidneys, and that the problem will be prolonged.

35.  When the scum on the surface is fatty and excessive, it indicates acute illness of the kidneys.

36.  Whenever any of these symptoms occur in kidney disorders, and acute pains in the back occur with them, if these are in the external parts you may expect an abscess. But if they are in the internal parts, you may expect that the abscess will be internal.

37.  Vomiting blood, without fever, does not prove fatal, but with fever it is bad. It is treated with cooling and styptic things.

38. Fluid accumulation in the chest cavity breaks in twenty days.

39.  When a patient passes blood and clots, and is affected with difficulty urinating and pain in the abdomen and pelvic floor, the area around the bladder is disordered.

40.  If the tongue suddenly loses it abilities, or a part of the body becomes paralyzed, the illness is of a melancholic nature.

41. In diarrhea in old people, hiccups coming on are not a good sign.

42.  A fever that is not associated with jaundice can be relieved by pouring a large amount of hot water over the head.

43.  Women do not become ambidextrous.

44.  When an abscess is treated with incision or cautery, if unmixed, light colored pus flows from the wound, the patient recovers. But if it is mixed with blood, slimy and stinking, they die.

45.  When abscess of the liver is treated by cautery or incision, if the pus that flows out is unmixed and of a light color, the patient recovers, but if it looks like the dregs of olive oil flowing out, they die.

46.  Pain of the eyes can be relieved by drinking strong wine, frequent bathing in hot water, and bloodletting.

47.  If a person with fluid retention gets hiccups, the case is hopeless.

48.  Difficult and painful urination may be treated by drinking unmixed wine, and bloodletting. Open the vein on the inside of the thigh.

49.  It is a good sign when swelling and redness on the chest affects a person with severely swollen tonsils, because in this case the disease is moving outward.

50.  When gangrene affects the brain, the patients die in three days; or if they survive these they recover.

51.  Sneezing comes from the head, due to the brain being heated or the sinus in the head being filled with mucus. The air confined in it is forced out, and makes a noise as it passes through a narrow outlet.

52.  Fever coming on in painful liver disorders removes the pain.

53. People for whom it is beneficial to have blood let from their veins should have it done in the spring.

54. In cases where phlegm accumulates between the diaphragm and the stomach, and causes pain, not having a way to move into either cavity, the illness will be removed if the phlegm is diverted to the bladder by the veins.

55. When the liver is filled with fluid and bursts into the abdomen, then the abdomen is filled with the fluid and the patient dies.

56. Anxiety, yawning, stiffness—wine taken with an equal measure of water relieves these complaints.

57.  When cysts form in the urethra, if they burst open, the pain is relieved.

58. In cases of concussion of the brain, from any cause, the patients    always lose their speech.

59.  In a person with a fever, when there is no swelling in the airways, if suffocation suddenly comes on and the patient is unable to swallow, it is a deadly sign.

59. (a) In the case of a person suffering from fever, if the neck is contorted and the patient cannot swallow even though there  is no swelling in the neck, it is a deadly sign.

60.  Fasting should be recommended to those people who have damp constitutions, since fasting dries bodies.

61. When there are changes throughout the entire body, and the body sometimes becomes cold and sometimes becomes hot, and the color changes, it signifies a prolonged illness.

62.  Profuse sweating, hot or cold, constantly flowing, signifies an excess of humidity. We must purge, then, upward in a strong person and downward in a weak person.

63. Fevers that are not the intermittent kind, if they get worse every third day, are dangerous. But if they are intermittent in any way, this does not mean they are dangerous.

64. In cases of prolonged fever, either cysts or pains in the joints come on.

65.  When cysts or pains in the joints take place after fevers, the patients are consuming too much food.

66.  If you give a person with a fever the same food you would give a person in good health, what is strengthening to one is sickening to the other.

67. We must examine the urine, whether it looks like that of a healthy person. If not at all, that is particularly bad; but if it is like that of a healthy person, that is not at all bad.

68. When the stools are allowed to settle and not shaken, and a sediment forms like rinds, in this case it is appropriate to purge the bowels. And if you give teas before purging, the more you give the more harm you will do.

69.  Hard stools are the result of black bile—if abundant, a larger and if scanty, a smaller quantity of it.

70. Phlegm, in fevers not of an intermittent type, which is brightly colored, streaked with blood, or fetid, is bad. It is better when this discharge, like that of the urine and bowels, passes freely. Whenever     any discharge is suppressed and not purged off it is bad.

71. When you wish to cleanse the body, you must bring it into a state favorable to evacuations. If you wish to dispose it to upward evacuation, you may bind the belly. If you wish to dispose it to downward evacuation, you may moisten the belly.

72. Sleep and wakefulness, both of them, when excessive, constitute illness.

73. In fevers that are not intermittent, if the extremities are cold, and the trunk burning hot, and the fever is growing worse, it is a mortal sign.

74. In a fever that is not intermittent, if a lip, the nose, or an eye is distorted, if the patient loses their sense of sight or hearing, while in a weak state—if any of these symptoms occur, it is terminal.

75. Congestion leads to fluid retention.

76. Diarrhea leads to dysentery.

77. Dysentery leads to passage of undigested matter.

78. Gangrene leads to erosion of the bone.

79.  Vomiting of blood leads to malnutrition, and vomiting of pus. Malnutrition leads to a flowing downward from the head. The flowing downward leads to diarrhea.

80.  Diarrhea leads to a stopping of the vomiting. The stopping of it leads to death.

81. In the excretions of the bladder, the bowels, and the skin, if the body departs slightly from its normal habits, the illness is slight. If much, it is severe. If very much, it is deadly.

82.  People over forty years of age who are affected with anxiety, do not readily recover. The danger is less when the illness is related to constitution and age.

83. In any illness, if the eyes weep voluntarily, it is a good sign, but when involuntary, it is bad.

84.  In recurring fevers with four-day cycles, blood flow from the nostrils is a bad sign.

85.  Sweats are dangerous when they do not occur on the day of a turning point, when they are heavy and quickly forced from the forehead in drops or streams, and if they are too cold or copious. For such sweats must come from distress, extreme pain, or prolonged tension.

86.  In a chronic illness a heavy flow from the bowels is bad.

87. Those diseases that medicines do not cure, steel may cure. Those diseases steel does not cure, fire may cure. And those fire cannot cure, must be reckoned wholly incurable.

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~ Bonus Material

The Life of Hippocrates

Hippocrates was born on the Greek island of Kos around 460 B.C. His father was a physician named Heraclites; his grandfather was also a healer, and also named Hippocrates. They traced their descent from Asclepius, one of the Greek gods of healing, who was himself the son of Apollo. Hippocrates would have learned the art of medicine from them, as well as studying at the temple of Asclepius on Kos.

Not much was written about Hippocrates during his own lifetime. The philosopher Plato referred to him, implying that he was something of a legend in his own lifetime. Many of the stories told about him—like the stories told about any other celebrity, ancient or modern-- may be untrue.  There is really no way to be certain, in this case, given the state of record keeping at the time, and the fact that two dozen centuries have elapsed.

It is said that he taught his pupils under the shade of a plane tree on the island of Kos. The tree, or some offshoot of it, is still standing, and is a site of pilgrimages. He also traveled and healed people where he was called, as was the custom of healers’ right up until the age of the automobile. Hippocrates is said to have traveled extensively for his time, having treated the king of Macedonia, and being invited to come and work for the king of the mighty Persian Empire (which he refused to do).

The philosopher Democritus, who made famous the theory that matter is made of elementary particles, which he called atoms, once came to Hippocrates after having been accused of being maniacal. Hippocrates asked whether this mania—Democritus’ tendency to laugh at inappropriate times—was debilitating in any way. Finding that it was not, and in the absence of other physical symptoms, he determined that Democritus was not mad, but merely of a cheerful disposition. This satisfied the philosopher’s detractors on this point, but it would be centuries before his atomic theory was widely accepted.

In the Aphorisms and other writings, Hippocrates describes grave wounds, of the sort that a fighter might receive in battle. During his lifetime, there were a series of conflicts between Athens and Sparta, and it is likely that he would have treated some people from these battles. There was also a plague in Athens, which he is said to have treated victims of, and ultimately driven out the plague by lighting fires to purify the air. 

Most of the references to Hippocrates from ancient times describe him as a gifted and caring, if somewhat stern, doctor. One story, however, tells of a time when Hippocrates was visiting a rival school of medicine. He set a fire, perhaps deliberately, and fled the scene as the building burned down. Exactly what his motivation for doing so might have been is unclear from the modern vantage point. But the story exists to illustrate that even the most respectable and dignified people are sometimes capable of taking extraordinary measures.   

Hippocrates died in Larissa, Greece, and the date of 377 B.C. is sometimes given as the date of his death. Many accounts exist, however, and some say that he lived to over 100 years of age. After he died, a beehive was placed on his grave, so that the bees could make honey from the flowers that grew from it. It is said that this honey had miraculous healing powers.

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The Legend of Asclepius

Asclepius was the son of Apollo, god of medicine, and Coronis, a nymph. Just before Asclepius was born, Coronis ran off with another man. Apollo, having been informed by his crows of her elopement, was enraged and decided to have her killed. It was Artemis who killed her, with an arrow through the heart as revenge for the heartache she had caused Apollo.

Apollo cut Asclepius from his dead mother’s womb, alive. Because he was stricken with despair for Coronis every time he looked at the boy, he sent him to the Centaurs to be fostered. Asclepius learned the healing powers of the plants and everything that grows under the sun from Apollo. He learned the art of surgery from Chiron, The Hand, wisest of the centaurs and son of the Titan Chronos. From his relative Athena, Asclepius received a vial of Gorgon’s blood, which could resurrect the dead.

Having learned from the greatest healers in his age of the world, Asclepius traveled around healing and resurrecting people. This made him famous beyond measure as a healer, and made him adored by people everywhere. This practice also drew the notice of the gods, who considered immortality their exclusive right. Zeus killed Asclepius with a thunderbolt for resurrecting someone that Zeus himself had killed.
In retaliation for the death of his son, Apollo killed the race of the Cyclopes, one-eyed giants who were the fashioners of Zeus’ thunderbolts. This enraged Poseidon, who was the father of the Cyclopes. Poseidon saw to it that Apollo was forced into servitude for a period of nine years to make reparations for this act.

Afterwards, out of regret for what he had done, Zeus placed Asclepius in the sky as the constellation Ophiuchus (the serpent bearer). This constellation can be seen in the night sky on the zodiac, next to the Centaur Chiron, better known as Sagittarius.

Stories similar to the legend of Asclepius have been told about the Gaelic healer-god Miach, and the Egyptian god Imhotep, whom the ancients considered the same person as Asclepius.

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The Hippocratic Oath

I SWEAR by Apollo the physician, and Asclepius, and Hygeia, and Panacea, and all the gods and goddesses, that, according to my strength and wisdom, I will keep this oath and rule:

To consider whoever taught me this craft as dear to me as my parents, to share my wealth with them, and relieve their necessities if required; to view their children on the same level as my own brothers, and to teach them this art, if they will learn it, without fee or restriction; and that by example, lecture, and every other kind of teaching, I will pass the knowledge of this craft to my own children, and those of my teachers, and to disciples bound by  rule and oath to the law of medicine, but to none others.

 I will follow whatever course of treatment, according to my strength and wisdom, I consider for the benefit of my patients, and refrain from whatever is damaging or malicious. I will give no deadly poison to anyone if asked, nor suggest any such course; and in like manner I will not give any woman a drug that will induce abortion.

 With purity and with holiness I will spend my life and practice my Art. I will not cut persons suffering from stones, but will leave this to be done by those who are practitioners of this craft.

Into whatever houses I enter, I will enter for the benefit of the sick, and will refrain from any willful act of malice or corruption; and especially from the seduction of women or men, free or slaves. 

Whatever I see or hear, in connection with my practice or not, of the business of others, which should not be spoken of abroad, I will not reveal, considering that all such matters should be kept secret.

While I continue to keep this oath unbroken, may it be granted to me to enjoy life and the practice of my art, the respect of all men, at all times! But should I trespass and break this oath, may the reverse be my lot!

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© 2011 R.J.Whelan Ltd