Crisis, its essence, varieties and qualities

The word crisis in everyday speech means a court decision, and it is interpreted as a sudden change either in the direction of health or in the direction of illness; A crisis has signs by which the doctor knows what the crisis will be.

The explanation for this is this. Disease for the body is like an external enemy for the city, and nature is like a ruler guarding the city. Sometimes light skirmishes occur between them, which can be ignored, and often the battle intensifies, and then various circumstances and phenomena are observed as a sign of intensification of the battle: columns of dust, confusion, screams, streams of blood. Then, in an imperceptibly long period of time, as if in an instant, a turning point occurs, and either the ruler defending the city wins, or the rebellious enemy is defeated.

Victory is either complete, when one of the sides, completely defeated, flees and leaves the city to the enemy, or incomplete, when defeat does not prevent them from returning and attacking again. Then the battle takes place again, or many times, and the outcome is determined in the last battle. The ruler, when he defeats and repels the enemy, either completely expels him and frees the area and space of the city and all the outskirts adjacent to it, or he does not expel him completely, but only throws him away from the city, but cannot force him out of the outskirts adjacent to the city. Likewise, the force that brings a good crisis either drives away harmful matter from the best parts of the body, that is, from the heart and the dominant organs, and from its outskirts, that is, the limbs, or drives it away, but cannot drive it away from the limbs, and the matter is even directed to them; this is called a matter transformation crisis.

Every passing illness ends either through crisis or through resorption, when matter little by little dissolves and disappears. Most often this happens with chronic diseases and cold juices, and this is not preceded by frightening signs and sudden movements of matter. Every destructive disease also kills either through crisis or through exhaustion, that is, when strength gradually dissipates.

The best crisis is a complete, reliable, obvious and distinct crisis, with safe manifestations; it is heralded by one of the days of the omen, and it occurs on a day favorable to the crisis. Every crisis is either good or bad, and each of them can be either complete or incomplete. In a complete, good crisis, nature either completely drives away matter or moves it: sometimes an incomplete crisis, if it is good, is followed by the resorption of matter, and if it is bad, exhaustion. A day of incomplete crisis foreshadows a day of complete crisis, if the omen is such as we will explain when discussing the qualities of days of crisis and days of omen; this applies to both good and bad crises. A crisis that completely expels matter should be expected in diseases caused by liquid hot juices, when the patient’s strength is significant, but a crisis with movement should be expected if the strength is weaker and the matter is denser. In the first case, the qualities of the crisis are also not always the same: if the matter is very liquid, then the crisis manifests itself in perspiration, and if it is less liquid and very acute, then the crisis manifests itself either in bleeding from the nose, or increased urination, or diarrhea and vomiting.

Know that an abundance of nasal mucus, pus in the ears and eyes, as well as lacrimation sometimes expresses a crisis of head diseases, and an abundance of sputum is one of the manifestations of a crisis of chest diseases. Hemorrhage during renal ulceration is a good crisis for many diseases, but most often it occurs in those for whom it is common. The sharpest and closest crisis to a turning point is a nosebleed, because with it the expulsion of matter is achieved at once; it is followed in strength by weakness, then vomiting, then urination, then perspiration and then abscesses. Boils are among the displacement crises; Sometimes boils in relation to the crisis turn out to be stronger than perspiration, and often the disease disappears immediately after their appearance, if they are benign. Or they are malignant and kill the organs, for there are many varieties of abscesses that manifest a crisis: these are boils, ulcers, buboes, herpes, erysipelas, Persian fire, corrosive gangrene, smallpox, sore throats, as well as ulcers that form in large numbers on the body.

Sometimes the crisis, complete or partial, manifests itself in hardening of the muscles and nerves, in all varieties of jarab, in lichen, cancer, baras, glandular lumps, elephantiasis, dilated veins, swelling of the limbs and other diseases. In some cases, the movement of matter does not lead to abscesses, but causes facial paralysis, spasms, muscle relaxation, pain in the hips, back and knees, as well as jaundice, elephantiasis and varicose veins.

Know that in a crisis, expressed in the movement of matter, recovery does not occur until the movement occurs, which resolves the disease; as for the concentration of displaced matter in an abscess on any organ or its release in another rash, this sometimes occurs after recovery. The best movement is that which is directed downward, and the most praiseworthy is the exit and movement of matter outward after full maturation, away from the noble organs.

Anyone who wishes to form an opinion as to what should follow - the victory of a protecting ruler or the victory of a criminal enemy - must draw conclusions from apparent circumstances; It is also appropriate for a doctor to draw conclusions from visible circumstances about whether a crisis is good or bad. When an adversary makes an attack on a city and starts a stubborn battle, and pushes back its defenders, and turmoil arises, and there are clear signs of a violent clash, and the ruler, the defender of the city, has still not collected equipment and cannot use weapons, then visible signs indicate that the ruler’s affairs are bad; under circumstances opposite to this, the conclusion will be opposite. Also, if the disease sets in motion the signs of crisis, which we will mention shortly, before maturity sets in, this indicates a bad crisis, and if there is some maturity, this indicates an incomplete crisis, while the presence of complete maturity indicates a good one. complete crisis. A complete crisis occurs at a period of extremes, but sometimes it comes at the beginning of a recession; For this reason, the full crisis is delayed during severe cold, since the period of the limit, and even more so the decline of the disease, then occurs with difficulty. To compensate for the damage caused by the cold, the doctor often has to warm the room and pour hot oil on the patient’s stomach until he sees that he begins to sweat. Then he stops pouring oil, wipes away the sweat and keeps the room moderately warm.

Know that if the movements of a crisis take place in those days and hours when nature usually rises up against the disease and fights it, choosing for protection, with the permission of the great Allah, the proper time corresponding to the condition of the patient, then you can hope for a good crisis. If the performance of nature does not occur at the time when it rises on its own, then this performance is violent, to which illness pushed it. This is one of the signs of a strong onslaught of illness and burden of the nature with matter, and this happens when the nature rises when the juice of the mouth of the stomach is irritated and causes vomiting, or when the bottom of the stomach is irritated, when the nature causes weakness. The same is true when coughing and sneezing are excited.

The same thing happens when signs indicate that a crisis will occur on some day, say, the fourteenth, but it is ahead of schedule, and it turns out that the movements of the crisis began earlier, on another day, although it sometimes happens to be good, because such advance also indicates that nature hastened to rise. If the disease is bad, nasty, then there is no hope for a good crisis, and if the disease is benign, then one cannot hope that the crisis will be complete. In general, the beginning of the movements of a crisis before the period of the limit corresponding to a given disease is determined either by the strength of the disease, or by the speed and sharpness of its movements, or by some external cause that excites the disease, which is in a calm state, for example, an error in food, drink or attitude. physical exercise. This happens as a result of mental phenomena, because mental experiences influence the initiation of a crisis and a change in its direction. Thus, when frightened, the crisis is expressed in diarrhea, vomiting or urination, and joy makes it sweat; it depends on whether the pneuma is moving inward or outward. If the premature rise of nature to fight weakens the strength so much that the patient cannot withstand the period of the limit, then this is a sign of imminent death; however, sometimes the strength is preserved and remains until the period of limit, and in this case prosperity comes.

Know that a crisis only rarely occurs during a period of rest and cessation of fever or when its strength weakens. The first case is the least common; Archogen saw him in his practice twice, and Galen once. The best crisis is the one that happens in the period of true limit, and the crisis that precedes it is not reliable: it is either insufficient, or bad, painful. In the initial period, the crisis cannot be disastrous; the appearance of signs of crisis in the first days of the disease generally portends death, while in a period of intensification such signs, if they are commendable, indicate an incomplete crisis, and in a period of decline there is never a crisis. We will talk later about how death or a state similar to a good crisis occurs during a crisis.

Know that in benign diseases the crisis is sometimes delayed, because nothing urges nature and it can wait until the full maturation of matter occurs, but in murderous diseases it is ahead of schedule. The patient is immediately relieved of the severity of the illness, which does not go away due to the dissolution of matter, only if there has been a commendable evacuation or a favorable rash; as for saving dissolution or disastrous exhaustion, they are not preceded by frightening phenomena and tangible emptyings.

Know that diseases are different from each other. Some of them move at first, and then calm down and stop, while others proceed in the opposite way. Often signs indicate that the crisis will be expressed in the expulsion by nature of matter into a region of the body in which the accumulation of matter is harmful; then it is necessary to strengthen this area or organ and deflect the matter in another direction.

Know that there are cases when a good crisis occurs and it is believed that he came on the sixth day, but in fact it is the seventh day, since the patient seemed healthy at the beginning of the illness; After all, a good crisis rarely comes on the sixth day.

Know that there are six types of disease transition. A disease either immediately turns into health, or immediately turns into death, or it little by little turns into health or little by little turns into death, or it combines both qualities and it ends in recovery, or it combines both qualities and it leads to to death.

Know that, according to people whose words you can rely on, the name crisis in the Greek language is derived from a decision made by judges in favor of one of the litigants or arguing against another, and means, as it were, a denouement and release from responsibility.

General discussion about the signs of a crisis. A crisis is preceded by day, if it happens at night, or by night, if it happens during the day, by various phenomena and circumstances that serve as its signs. These are, for example, anxiety, melancholy, tossing in bed, heaviness in the head, confusion of mind, headache, neck pain, dizziness, darkening of the eyes, ghosts in the eyes, noise and ringing in the ears, itching in the nose, sudden change in complexion and the tip of the nose in red or yellow, twitching of the lips and eyes, thirst, interruptions, pain in the mouth of the stomach, sudden tightness and difficulty breathing, heaviness, tension, pain and twitching in the hypochondrium, back pain, muscle twitching, pain and rumbling in the intestines. Sometimes the patient begins to feel chills, indicating a crisis, and pain from exhaustion appears, and sometimes changes in the quality of the pulse occur, indicating a crisis. Nighttime symptoms are stronger than daytime ones.

Sometimes, due to a crisis, discharges that usually tend to be released, for example, blood during menstruation, kidney and bloody diarrhea, are blocked. This indicates that the movement of matter is not in the proper direction, and the reason here is that the disease-causing matter, due to its movement, gives rise to phenomena and signs indicative of the crisis, but they differ from the usual either because of the difference in the matter or because of the difference in the direction of movement.

As for the difference in signs due to differences in matter, if, for example, the movement of matter is directed upward, and the signs - type of disease, age, nature, etc. - indicate blood matter, the doctor expects bleeding from the nose, and when the signs indicate that the matter is yellow-billed, in most cases he expects vomiting, unless, of course, other special signs portend nosebleeds. Then the crisis, even with yellow bile matter, is often expressed in bleeding from the nose and is preceded by yellow and fiery ghosts in the eyes. A frightening nosebleed often completely expels the matter of malignant diseases, and the patient is immediately cured.

And the difference in signs due to the direction of movement is explained by the fact that matter sometimes moves towards the dominant organs and attacks them and the viscera adjacent to them, causing disturbances in their actions and damage affecting them; Thus, in the area of ​​the brain, clouding of the mind, headache and other phenomena we mentioned occur, and in the area of ​​the heart, interruptions, respiratory distress and other phenomena we mentioned.

Or matter moves towards the organs of excretion, and then this happens in two ways: matter either rushes in all directions and then is released on the entire surface of the body, that is, by perspiration, or it rushes in one direction, and when it rushes there , it often moves in such a direction that it cannot but pass by the dominant organs, this happens, for example, in the upper part of the body: matter heading there passes in the area of ​​the chest and respiratory organs or near the brain and causes the same phenomena as if it would not pass by, but would accumulate in these areas. And sometimes the direction leads towards organs located below the dominant ones, such as, for example, to the mouth of the stomach, when matter, driven by a crisis, strives to come out in vomit, or organs that belong to the dominant ones, but are resilient in trials and do not soon come to death; This happens, for example, when matter enters the liver area and exits through the urinary or gall bladder. After all, in any part of the body it is possible to remove crisis secretions: in the stomach - through vomiting, in the head area - by nasal flow and similar methods, in the liver area - through urine, in the intestinal area - through relaxation. Since this is the case, it is quite possible that the movement of matter in any direction is accompanied by a sign indicating that if a good crisis is expected, the expected release of it will occur in exactly this way, and if the crisis is bad - a sign that the initial harmfulness of bad matter consists in its accumulation in a given organ. Often one sign can indicate many directions: for example, interruptions sometimes indicate that matter is rushing to the mouth of the stomach, and sometimes indicates that it has rushed to the region of the heart, and it also happens that one sign indicates only which - a general circumstance inherent in any movement of matter in any direction, and one has to wait for other signs that allow one to judge exactly how matter will be released from a given direction. Such as, for example, headache, shortness of breath and upward tension in the hypochondrium - all this indicates that the matter is moving upward, but it is possible to recognize whether it will come out through vomiting or through nosebleeds only if other signs are present.

Sometimes an indication that a crisis will go in a certain direction is the detention of what is moving away and emerging from the opposite side. So, for example, constipation of nature in the presence of signs of a good crisis indicates that the crisis movement is directed upward, not downward, and that the crisis will be expressed in increased urination, or perspiration, or vomiting, or nosebleeds.

The type of disease also sometimes indicates the direction of the crisis. Thus, for example, if a tumor in the liver is on the convex side, then the crisis will be expressed either in bleeding from the right nostril, or in beneficial perspiration, or in urination, and if it is on the concave side, the crisis will be resolved by diarrhea or vomiting, or perspiration. Or take, for example, a burning fever. The crisis with it is most often expressed in nosebleeds or perspiration, and is preceded by chills, but sometimes, especially with three-day fever, it is accompanied by vomiting and diarrhea. With fevers from tumors in the head, the crisis is also resolved by nosebleeds or profuse perspiration. With mucous and cold fevers, the crisis is never expressed in nosebleeds, just as with pneumonia and lithargus, but with pleurisy both happen.

Often, with an illness, there are several different crises, the combination of which gives a complete crisis; this happens, for example, with a burning fever, when it first causes nosebleeds and then the crisis ends with profuse perspiration. In pregnant women, the crisis often results in miscarriage.

Know that not every time there are signs of a crisis, there is necessarily a crisis, good or bad. Often a crisis does not immediately follow them, and if a crisis, good or bad, must necessarily and necessarily follow, it does not occur at the time with which the signs are associated. Not every time you observe perspiration, vomiting, diarrhea, headache, confusion of mind, difficulty breathing, hibernation or all the other signs that we will list, after them there is a crisis, although in most cases they still indicate it. Some of them, such as headaches, are only a sign of a crisis, while others, such as nausea, indicate both the crisis and its direction.

When signs of a crisis appear, but there is no crisis, this indicates, as Hippocrates says, either the proximity of death or the difficulty of the crisis. Sometimes a symptom that belongs to the signs of a crisis does not arise as a result of the approach of a crisis, although it happens at a time when signs of a crisis appear. For example, with a prolonged three-day fever before the attack and in the hours preceding the attack, in most cases there is a serious condition and anxiety that does not indicate a crisis, whereas with a pure three-day fever such phenomena most often serve as signs of a crisis.

On the path of knowledge - whether the patient will recover or die with a crisis or without a crisis - can lead you, among other things, by observing the movement of the disease, the strength of the patient, his nature and condition at a given time. This will indicate to you that the patient's condition either causes a strong struggle between matter and nature, or allows it to cease.

Know that the signs of a good crisis are indications that indicate the victory of nature, and they do not deceive, and the signs of a bad or insufficient crisis are Indications that indicate strife and skirmishes between nature and what is fighting it, and you cannot decisively say that nature will certainly submit, unless these signs multiply and intensify. How many times have we seen all sorts of frightening signs - hibernation, a drop in pulse, a cessation of perspiration, but after a few hours the matter ended in a complete, good crisis. After all, during such phenomena, nature neglects all its actions and completely devotes itself to the disease, and when it turns all its forces against the disease, it overthrows and drives it away. But sometimes it cannot cope with it, and this in most cases happens because nature stops all its actions only because of a very significant reason, and such a significant reason will hardly overcome it.

Know that the violent continuous manifestation of signs of crisis for two days in a row, for example, on the third and fourth day, indicates that the crisis will soon come, and whether it will be good or bad depends on the accompanying phenomena, which we will talk about shortly, especially if the attack fever will occur much earlier than time, and even more so if a change in the pulse suddenly appears. If it is directed in the direction of increase and the pulse does not fall, you can be happy.

Know that dryness and desiccation of the body during days of illness indicate that the crisis will be late; Very debilitating diseases either kill or the crisis is delayed. Most often, the state in which you find the sick speaks about the time of crisis, all its qualities and how to judge its signs. Know that a rising pulse is a general sign of all types of crisis, expressed in emptying, but a large pulse indicates the movement of matter outward, through perspiration and nosebleeds, and a small pulse that quickly goes inward indicates vomiting and diarrhea. In general, whenever the nature is preparing to drive away matter, if it has already become stronger, this does not happen without a rise in the pulse, although its expansion and deviation in both directions is not observed, but before the nature becomes stronger, the lowering and contraction of the pulse is inevitable. Sometimes two signs appear at the same time and two types of bowel movements occur, for example, vomiting with sweat or vomiting with nosebleeds.

So we're done with these general rules. Let us now proceed to a somewhat more detailed presentation.