Articella (The Little Art of Medicine)

"All these and similar things pertaining to the relevant places are called proper accidents, and as if substantial and critical, and signifying a swift and rapid movement." They are announcers of a future thing in two ways. For if critical signs appear after the digestion of the disease, they are signifiers of certain health. If they are before the digestion of the disease, they are unpraiseworthy, portending perdition or the length of the disease. Moreover, signs of a crisis are not similar to signs of digestions, as Hippocrates testifies in the first part of the Epidemics: "Digestion," he says, "portends a swift crisis and assurance of health; but not similarly crudity, especially if future things are going to proceed badly." Johannitius: By "things going to proceed badly," he intends the apostemes of any part of the body, which occur in two ways. For either they proceed from the whole body or from the exterior parts to the interior, from which evil apostemes are made, or those not signifying a crisis, or signifying a bad one, or signifying the length of the disease, or the recurrence of the disease. Hippocrates praised digestion in this way universally here, but in the Prognostics, he does so particularly: "Urine in which there is a white and equal sediment until the critical day is more praiseworthy, for it signifies security and the brevity of the disease." And he praised the digestion of urine in vessels in such a way. He praises digestion in the stomach when he says: "Digestion," he says, "is to be praised, joined and tender, at the same time as it had been accustomed in health, the quantity of which is according to what the sick person receives." He praises digestion in the instruments themselves, when he said: "In pains of the lungs and ribs, sputum that exits swiftly, easily, and mixed with redness is good." For all significations of digestion are praiseworthy, but not all signs signifying a crisis are praiseworthy, as the same Hippocrates signifies. For in the time of a crisis, signs appearing, if the crisis is not present, are hinting at death or critical molestation. Which Hippocrates showed when he said: "Signs of a good crisis do not appear suddenly; but signs of digestion, whenever they appear, are good, since they undoubtedly signify good." Therefore, where he said, "And from those appearing," just as in pleuritic patients, if sputum appears continuously, it shortens the beginning, etc., it was not contrary to those things which he just said. Signs signifying a good crisis do not need to be sudden, since sometimes signs of a crisis are bad, but signs of digestion are never bad; if they appear quickly, they show the speed of the digestion. The brevity of this exposition suffices for these places, because I have explained them most perfectly in the book of crises. But because I made a division, which I wished to be semi-full in explaining, the significations existing with the disease and accompanying the disease with pleurisy are to be explained with their differences. Fever is acute, anguish of the spirit, cough, pain of the side with puncturing. These are the substantial significations of pleurisy. Signs following the disease of pleurisy are pains descending into the diaphragm or ascending into the collarbones. Johannitius: "The pains of these two places are confirming a future pleurisy; similarly, if the sick person lies better on the side of the infirmity than on the healthy side." Pythagoras of Epistigensis composed two books on signs following diseases. One on those appearing after, about which Hippocrates says here: "If they appear after," he says, "they show a good and decided or 'judged' crisis, and the length and brevity of the disease." Not only will sputum do this, but urine, evacuations, and sweats, which he introduced to make a likeness, so that we might remember what he said in the Prognostics. We, however, have opened these things in the books of crises and in the Prognostics as it was fitting.

The elderly bear fasting most easily; those in the second consistency less so; but children less; and of all these, most of all the infants; and of these very ones, whichever are more spirited.

The diversities of ages understood are helpful in ordering a diet. For abstinence from food is easy for the elderly, but hard for children. He spoke of "ease" when they are neither hungry nor does fasting harm them in any way. "Hardness," conversely, is to be understood in children. For children hunger more quickly and undergo the harm of hunger more quickly, abstaining from food for a long time; more quickly, I say, than those in the second consistency, who are intermediate between children and the elderly. According to the proximity to the extremities of ages, the ease and hardness of abstinence in ages are to be understood, which Hippocrates showed in this aphorism and the next, who says: "Those who are growing have most innate heat." Johannitius: What he said, "most innate heat," can be understood in two ways: either they have the most compared to other ages, or compared to other men. If anyone should make these two aphorisms one, it is no anathema. It can indeed be made thus: "The elderly bear fasting most easily; those in the second consistency more easily; but children less; and of all these, most of all the infants; and of these very ones, whichever are more spirited. For those who are growing have most innate heat." Those in the second consistency are understood to be those whose age is intermediate between perfect youth and old age, such as those who, when they have passed perfect youth, have not yet become old; whom Theophilus calls "those in the second consistency." Between these and children, there is another age, the middle of these two, which, just as it is middle, so it is necessary that it abstains moderately; neither easily like the elderly, nor hard like children, but they are moderately impatient. Hippocrates omitted this age, where the reader may understand it by himself. And he said that the infants who are more spirited are less patient, showing the natural diversity, since those who are more spirited have greater heat, natural, whence it harms them much if they abstain beyond measure. Note, however, that he said "the elderly," not "the oldest." For if he had denoted both among the elderly, then he would have said they bear fasting easily, content with little food; since the decrepit do not easily bear fasting, nor do they take a large quantity of food, because their nature is like a lamp prepared to be extinguished, which, when it is almost extinguished, seeks that little oil be administered. If it abounds more than is necessary, it extinguishes it very quickly. Likewise, an age of this kind seeks little food for itself, nor does it indicate much time for receiving it, which, when it happens, he begins to state the causes by saying: