§3Παραδείγματος οὖν ἕνεκεν ἐπὶ τριταίου πυρετοῦ πρῶτον ἡμῖν ὁ λόγος γινέσθω.
For the sake of example, then, let our discussion first be concerning the tertian fever.
φρίκη μετρία τῶν τοιούτων πυρετῶν ἄρχεται, εἶτ’ ἄκρων ψύξις ἅμα φρίκαις μείζοσιν, εἶτ’ ἤδη καὶ ῥιγοῦσι καὶ ψύχονται τὰ πλεῖστα τοῦ σώματος.
A moderate shivering of such fevers begins, then a cooling of the extremities along with greater shiverings, then now they both shiver violently and most of the body is cooled.
ὁ δὲ σφυγμὸς αὐτῶν ἐν τῷδε τῷ καιρῷ σκληρότερός τε καὶ μικρότερος γίνεται τοῦ πρόσθεν, ὠκύτερός τε σαφῶς κατὰ τὴν συστολὴν, τοῖς εἰδόσιν αἰσθάνεσθαι συστολῆς· ὡς ἥ γε διαστολὴ τὰ πολλὰ μὲν ἑαυτῆς βραδυτέρα, καὶ μάλιστα κατὰ τὴν εἰσβολὴν, ἐνίοτε δ’ ἄν σοι δόξειεν ὁμοία διαμένειν τῇ προϋπαρχούσῃ καταστάσει.
And their pulse in this season becomes harder and smaller than before, and clearly quicker in the systole, to those who know how to perceive the systole; since the diastole is for the most part slower than its own normal rate, and especially during the onset, though sometimes it might seem to you to remain similar to the pre-existing state.
καὶ μὲν δὴ καὶ τῶν ἠρεμιῶν ἡ μὲν ἐπὶ τῇ συστολῇ μακροτέρα πώς ἐστιν· ἡ δ’ ἐπὶ τῇ διαστολῇ κατὰ τὸν αὐτὸν ἐκείνῃ τρόπον ὡς τὰ πολλὰ μὲν ἴση τῇ πρόσθεν, ἔστι δὲ ὅτε οὐκ ἴση.
And furthermore, of the pauses, the one after the systole is somehow longer, while the one after the diastole, in the same manner as that, is for the most part equal to the previous one, but there are times when it is not equal.
ταῦτα ἐνίοις μὲν ὥραις γίνεσθαι πέφυκεν ἰσημεριναῖς δυσὶ, τισὶ δὲ ἤτοι πλείοσιν αὐτῶν, ἢ ἐλάττοσιν· εἶθ’ ὁ σφυγμὸς, ἀρξάμενος μείζων θ’ ἅμα καὶ θάττων καὶ πυκνότερος γίγνεσθαι, κατὰ βραχὺ προστίθησιν ἑκάστῳ τῶν εἰρημένων.
These things naturally happen to some in two equinoctial hours, and to some in either more or fewer of them; then the pulse, having begun to become larger and at the same time quicker and more frequent, gradually adds to each of the aforementioned qualities.
εὐθὺς δὲ καὶ θερμότεροι σφῶν αὐτῶν ἀποτελοῦνται σὺν ταῖς εἰρημέναις τοῦ σφυγμοῦ μεταβολαῖς, ὥστ’ ἔνιοι πολλῆς αἰσθάνονται θερμασίας ἔνδον, ἔτι κατεψυγμένοι τὰ κῶλα, καὶ τὸ σύμπαν εἰπεῖν ἀνωμαλία τις ἐπικρατεῖ κατὰ τοῦτον τὸν χρόνον οὐ σμικρὰ περὶ τὸ σῶμα· δεύτερος οὗτος ὁ χρόνος ἐκείνου τοῦ πρώτου, καθ’ ὃν ἐκ τῆς πρόσθεν καταστάσεως ἐψύχθη μὲν ὅλον τὸ σῶμα, τοῦ σφυγμοῦ δ’ ἡ μετάπτωσις εἰς τἀναντία τοῖς πρόσθεν ἐγένετο.
And immediately they also become warmer than themselves along with the aforementioned changes of the pulse, so that some feel great heat inside, while their limbs are still chilled, and to speak generally, a not small irregularity prevails over the body during this time; this is the second period after that first one, during which, from the previous condition, the whole body was chilled, and the change of the pulse to the opposites of the previous ones occurred.
κατὰ μέν γε τὴν ἀπυρεξίαν, ἥτις ἡμῖν καλείσθω διάλειμμα, διότι καὶ ὁ Ἱπποκράτης οὕτως ὠνόμασιν, ὁ σφυγμὸς ἐν τῇ κατὰ φύσιν ἐστὶν ὡς πρὸς τὴν ἡμετέραν αἴσθησιν καταστάσει, τοιοῦτον δὲ τὸ κάλλιστον διάλειμμα, μεταβάλλει γὰρ ἐξαίφνης εἰς τὰς εἰρημένας ὀλίγον ἔμπροσθεν διαφορὰς ἅμα τῷ κατεψύχθαι τὸ ζῶον, εἶτ’ αὖθις εἰς τἀναντία τρέπεται μετὰ τοῦ θερμαίνεσθαι.
For during the apyrexia, which let us call intermission, since Hippocrates also named it so, the pulse is in its natural state according to our perception—and such is the best intermission—for it changes suddenly into the differences mentioned a little before as the animal is chilled, and then turns back to the opposites as it warms up.
πρῶτος οὖν χρόνος ἐναργῶς ἐστι τῆς ὅλης περιόδου, καθ’ ὃν ἐψύχθη τὸ σῶμα σὺν ταῖς εἰρημέναις τοῦ σφυγμοῦ μεταβολαῖς, ἤτοι ἐξ ὑγείας, ἢ ἐκ διαλείμματος εἰς τοῦτο ἀφικόμενος· ἕτερος δ’ ἐπὶ τούτῳ δεύτερος, ὁ τῆς εἰς τὰ ἐναντία μεταβολῆς τῶν τε σφυγμῶν καὶ τῆς θερμασίας, ἄχρι περ ἂν ὁμαλῶς γένηται θερμὸς ὁ σύμπας ὄγκος τοῦ σώματος· εἶτ’ ἐπ’ αὐτῷ τρίτος, αὐξανομένης μὲν ἔτι τῆς θερμασίας, ἀνάλογον δ’ αὐτῇ καὶ τῶν σφυγμῶν ἐπιδιδόντων εἰς μέγεθος καὶ τάχος καὶ πυκνότητα· τετάρτη δὲ κατάστασις ἐπὶ ταῖς εἰρημέναις τρισὶν ὁρᾶται, τῶν εἰρημένων ἁπάντων ἴσον ἑαυτοῖς φυλαττόντων τὸ μέγεθος, ὡς πρὸς τὴν ἡμετέραν αἴσθησιν· εἶτ’ ἐντεῦθεν ἄλλος πέμπτος, ὅταν ἤδη μὲν ἐλάττων ἡ θερμασία γίνηται σαφῶς, ἀτμὸς δὲ ἐκκρίνηται διὰ τοῦ δέρματος, ὁ σφυγμὸς δὲ ἐπὶ τὴν κατὰ φύσιν ἐπανέρχηται κατάστασιν, ἀποτιθέμενος ἃ παρὰ φύσιν ἐπεκτήσατο πάντα, μεγέθους τε πέρι καὶ ταχυτῆτος καὶ πυκνότητος.
Therefore, the first period of the whole cycle is clearly that during which the body is chilled along with the aforementioned changes of the pulse, having arrived at this either from health or from intermission; and another, second period after this is that of the change into the opposites of both the pulses and the warmth, until the entire mass of the body becomes uniformly warm; then a third after it, while the warmth is still increasing, and the pulses are correspondingly growing in size, speed, and frequency; and a fourth state is observed after the three mentioned, when all the mentioned things maintain an equal magnitude to themselves, as far as our perception is concerned; then from there another, fifth period, when now the warmth clearly becomes less, and vapor is excreted through the skin, and the pulse returns to its natural state, putting away everything it had acquired unnaturally, regarding size, speed, and frequency.
ἐν τούτῳ τῷ χρόνῳ καὶ ἱδρὼς τοῖς πλείστοις αὐτῶν γίνεται, καὶ μετὰ τοῦτον ὁ τοῦ διαλείμματος ἀφικνεῖται χρόνος, ἕκτος ἐπὶ τοῖς εἰρημένοις.
During this time, sweat also occurs in most of them, and after this, the time of intermission arrives, the sixth after those mentioned.
οὐδὲν δὲ τούτων ὑπόθεσίς ἐστιν ἀδήλου πράγματος, ἀλλ’ ἐναργῶς ὁσημέραι σχεδὸν ἅπασι τοῖς πυρέττουσι τριταῖον πυρετὸν οὕτω φαίνεται γιγνόμενον· καὶ χρὴ προσθεῖναι τῷ λόγῳ τὸ πρὸς Ἱπποκράτους εἰρημένον, ὡς μέχρι μὲν τούτου καὶ μὴ ἰατρὸς ἂν δύναιτο γινώσκειν ὀρθῶς, εἰ τὰς τοῦ σφυγμοῦ τροπὰς ἐξέλοιμεν τοῦ λόγου.
And none of these is a hypothesis of an unclear matter, but clearly every day it appears to happen thus to almost all who suffer from tertian fever; and one must add to the discussion what was said by Hippocrates to the effect that up to this point, even a non-doctor would be able to know correctly, if we were to exclude the turns of the pulse from the discussion.
περιεργότεραι γὰρ ἢ κατὰ τὸν ἰδιώτην αὗταί εἰσιν, ἡ δὲ τῆς θερμασίας μεταβολὴ, κᾂν εἰ μὴ βούλοιντο παρακολουθεῖν οἱ πάσχοντες, αὐτὴ κεντρίζειν τε καὶ νύττειν αὐτοὺς πέφυκεν, ὡς μὴ λαθεῖν.
For these are too detailed for a layman, but the change of warmth, even if the sufferers do not wish to pay attention to it, is naturally designed to stimulate and prick them, so as not to escape their notice.
ἐξηγοῦνται γοῦν πάντες οἱ κάμνοντες οὕτως, ἐξαίφνης μὲν αὐτοῖς ἤτοι γ’ ἀνωμαλίαν ἢ φρίκην διαδραμεῖν, εἶτ’ ἐντεῦθεν ἅμα καταψύξει τῶν ἀκραίων ἐπιτείνεσθαι τὰς φρίκας, ἀκολουθῆσαι δὲ αὐταῖς τὸ ῥῖγος· εἶτ’ αὖθις τοῦ μὲν ῥίγους γενέσθαι ποτὲ καὶ παῦλαν, ἐκλύεσθαι δὲ τὴν περίψυξιν τῶν ἄκρων, αἴσθησιν δὲ φλογώσεως ἔνδον εἶναι καὶ δίψος· ἐπὶ δὲ τούτοις αὖθις οἴχεσθαι μὲν ἅπασαν ἀνωμαλίαν, ὁμαλῶς δὲ καίεσθαι τὸ σύμπαν σῶμα, καὶ τοῦτο ἀεὶ καὶ μᾶλλον αὐτοῖς γίνεσθαι, καὶ στῆναί γέ ποτε καὶ μεῖναι τὴν θερμασίαν ὁμοίαν ἑαυτῇ· εἶθ’ ὕστερον αἴσθησιν αὐτοῖς ἐκλυομένης γενέσθαι, καὶ τοῦτο μέχρι τῆς καταστάσεως ἐκείνης μὴ παύεσθαι γινόμενον, ἐν ᾗ πρῶτον ᾔσθοντο μηκέτι πυρουμένων αὐτῶν.
At any rate, all the sick explain thus: that suddenly either an irregularity or a shivering runs through them, then from there along with the cooling of the extremities the shiverings intensify, and the violent chill follows them; then again, at some point there is a cessation of the violent chill, and the deep cold of the extremities is released, and there is a sensation of burning heat inside and thirst; and after these, again, all irregularity is gone, and the entire body burns uniformly, and this happens more and more to them, and at some point the warmth stands still and remains equal to itself; then later a sensation of it releasing comes to them, and this does not cease happening until that condition in which they first perceived themselves no longer burning.
ἐπὶ μὲν οὖν τῶν τριταίων πυρετῶν αἱ κατὰ μέρος διαφοραὶ τῆς περιόδου τοιαῦταί τινες ὑπάρχουσιν· ἐπ’ ἄλλων δὲ ἄλλαι διαφοραὶ πυρετῶν εἰσιν, ὑπὲρ ὧν ἐφεξῆς ἐρῶ.
So, in the case of tertian fevers, the detailed differences of the period are of this sort; but in other fevers there are other differences, about which I shall speak next.