Signs of hectica. The pulse and the heat126 of the sick
p.75man should be noted at the end of three hours after taking food, and observe whether it (the heat) is greater in the nerves (?) than in the veins127 or in the places nearest to them; for when the heat is equal there is no difference between them, as regards its own nature. The skin becomes withered, the which is a sign of the first form of hectica, which is hard to recognise and easy to cure, according to Avicenna; for he says, the first form may be recognised through its want of dryness.128 And Galen says, the heat increases in sufferers from hectica when they eat food; and Averroes says, this occurs three hours thereafter, that is, when it is digesting.129 And130 I say, when the patient consumes food, i.e. extra food, it cools the body forthwith, and when he consumes food in the natural way of digestion in the stomach, along with a kind of digestion in the liver, then it is dispersed throughout the members, so that it heats then, and thereafter heats the members as a cloth that is in the day about a man, takes heat from the body, and itself heats the body thereafter. In the second variety of hectica understand that dryness is apparent therein, and whatever time he takes food, so much the greater is the inflammation and his pulse is the less thereof, and there is no sign of hectica more certain than that. In the third form of hectica, the eyes are sunken, the skin drawn, and the belly adheres to the back, the pulse is hard and taut as it were a
p.77cord being stretched, the urine is like oil, and should it strike against a stone it emits a dull sound.131 Therefore when the fever sets in, it impoverishes the body, dries the skin, the face becomes deformed, and the eyes deepen. When it reaches the last stage of hectica, you will see his eyes as though there were ashes scattered on them, and the lids are drawn down like one who has spasmus;132 the skin of the forehead is drawn and dry; the ears become yellow, and the skin of that part called mirach is dry and wrinkled. Mirach is the membrane that lies outside siphac on the belly, with siphac within, the which separates the nutritive organs from those of generation, and the intestines are contained therein. The pulse is stretched like a cord, weak and rapid, and the urine like oil.