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OF ARETÆUS, THE CAPPADOCIAN, ON THE CAUSES AND SYMPTOMS OF CHRONIC DISEASE
BOOK I.
CHAPTER VIII. ON PHTHISIS
[p. 311]
somewhat extended; fingers slender, but joints thick; of the
bones alone the figure remains, for the fleshy parts are wasted;
the nails of the fingers crooked, their pulps are shrivelled and
flat, for, owing to the loss of flesh, they neither retain their
tension nor rotundity; and, owing to the same cause, the nails
are bent, namely, because it is the compact flesh at their
points which is intended as a support to them; and the tension
thereof is like that of the solids. Nose sharp, slender; cheeks
prominent and red; eyes hollow, brilliant and glittering;
swollen, pale, or livid in the countenance; the slender parts
of the jaws rest on the teeth, as if smiling; otherwise of a
cadaverous aspect. So also in all other respects; slender,
without flesh; the muscles of the arms imperceptible; not a
vestige of the mammæ, the nipples only to be seen; one may
not only count the ribs themselves, but also easily trace them to
their terminations; for even the articulations at the vertebræ are
quite visible; and their connections with the sternum are also
manifest; the intercostal spaces are hollow and rhomboidal,
agreeably to the configuration of the bone; hypochondriac
region lank and retracted; the abdomen and flanks contiguous
to the spine. Joints clearly developed, prominent, devoid of
flesh, so also with the tibia, ischium, and humerus; the spine
of the vertebræ, formerly hollow, now protrudes, the muscles
on either side being wasted; the whole shoulder-blades
apparent like the wings of birds. If in these cases disorder
of the bowels supervene, they are in a hopeless state. But, if
a favourable change take place, symptoms the opposite of
those fatal ones occur.
The old seldom suffer from this disease, but very rarely
recover from it; the young, until manhood, become phthisical
from spitting of blood, and do recover, indeed, but not
readily; children continue to cough even until the cough
pass into phthoe, and yet readily recover. The habits most
prone to the disease are the slender; those in which the scapulæ
