Crises with pleurisy

If a patient coughs up something liquid and immature on the first day of illness, then we can expect that the tumor will mature on the fourth day and the crisis will occur on the seventh day; if the tumor has not matured on the fourth day, and expectoration did not begin on the first day, then the crisis occurs on the eleventh or fourteenth day. If the patient does not cough up sputum until the fourth day, and then begins to cough up and there is some maturity in the sputum, then the situation is, so to speak, average, and if there is no maturity, then the matter may be delayed, but there is hope, especially when there are signs favorable data: strength, appetite and young age. If the patient does not expectorate until the seventh day, or expectors, but there is no mature matter in the sputum, but only pure juice, and if you see that the strength is weak, then know that the sputum will ripen only after a while, but the strength will fall earlier and the patient will not survive the fourteenth day. Often he dies earlier, because the crisis in such cases occurs on the fortieth or sixtieth day, and a weak nature will not remain prosperous until this time. If the strength turns out to be significant, and you see that both passions are balanced and praiseworthy, sleep and breathing are as they should be, and the urine is mature and good, then you can hope that the patient will pass the fourteenth day; then, after that, he, in most cases, dies. All this happens if the matter causing the disease is acute; in general, the longest period before a crisis with mild pleurisy is fourteen days; sometimes it lasts up to twenty. Galen states that the diseased organ is sometimes cleared by expectoration by the thirtieth day and that on this day he observed a complete crisis. We have already said that clear sputum, similar to saliva, indicates a protracted nature of the disease.

Sometimes it happens that a crisis is expected at such and such a time, but a sign appears indicating that it will come earlier, or a sign that it will come later. This happens, for example, when the sputum and the patient’s condition indicate that there will be a crisis on the fourteenth day, but after the seventh day black sputum appears, especially on some bad day, for example, on the eighth; this indicates that an unfavorable crisis will come sooner. If, instead, a good sign appears, indicating commendable maturation, this indicates that the unfavorable crisis is late and the favorable one will come earlier.