Humanitext Reader

Galen · The Opportune Moments in Diseases §4

Naming the Six Periods of Fever and Causes of Error

Passage 4 of 11 · Greek

Summary

The author systemizes the cycle of tertian fever into six periods (beginning, irregularity, increase, standstill, decrease, and intermission), criticizes the terminological negligence of newer doctors, and argues that the primary cause of medical errors is ignorance of the differences between various diseases.

§4Νυνὶ δὲ ἐπὶ τούτου πρῶτον, οὗ πρῶτον παρεθέμην, ὁ λόγος ἐξεταζέσθω.
Now, first concerning this, which I first presented, let the discussion be examined.
πρῶτος οὖν ἦν καιρὸς ὁ συνάπτων τῇ ἀπυρεξίᾳ, ψύξεως αἴσθησιν παρέχων, ὃν ἀρχὴν ὠνομάσαμεν· δεύτερος ὁ ἀποτιθέμενος τὴν ψύξιν, ὡς εἴρηται, κατὰ βραχὺ, καὶ καλείσθω συντόμου διδασκαλίας ἕνεκεν ἀνωμαλίας καιρός· εἶτ’ ἐπ’ αὐτῷ τρίτος ὁ τῆς ὁμαλοῦς αὐξήσεως.
The first period, then, was the one adjoining the apyrexia, offering the sensation of cooling, which we named the beginning; the second, putting away the chill, as has been said, gradually, and let it be called, for the sake of concise teaching, the period of irregularity; then third after it, the one of uniform increase.
ἐφ’ ᾗ τέταρτος ὁ τῆς στάσεως, καὶ πέμπτος ὁ τῆς μειώσεως· εἶθ’ ἕκτος ὁ τῆς ἀπυρεξίας.
After which, the fourth is that of standstill, and the fifth that of decrease; then sixth, that of apyrexia.
ὅτι μὲν οὖν ἕξ εἰσιν αἱ εἰρημέναι κανονικαὶ διαφοραὶ κατὰ τὰς τῶν τριταίων πυρετῶν περιόδους, αἰσθήσεως δεῖ καὶ μνήμης, οὐκ ἀποδείξεως λογικῆς.
Therefore, that the mentioned standard differences in the periods of tertian fevers are six, requires perception and memory, not logical demonstration.
ἓξ δ’ οὐσῶν αὐτῶν, ὀνόματα συνθέσθαι κάλλιον ἕνεκα συντόμου θ’ ἅμα καὶ σαφοῦς δηλώσεως· καθάπερ τις νόμος ἐστὶ κοινὸς ἅπασι τοῖς Ἕλλησιν, ὧν μὲν ἂν ἔχωμεν ὀνόματα πραγμάτων παρὰ τοῖς πρεσβυτέροις εἰρημένα, χρῆσθαι τούτοις· ὧν δ’ οὐκ ἔχομεν, ἤτοι μεταφέρειν ἀπό τινος ὧν ἔχομεν, ἢ ποιεῖν αὐτοὺς κατὰ ἀναλογίαν τινὰ τὴν πρὸς τὰ κατωνομασμένα τῶν πραγμάτων, ἢ καὶ καταχρῆσθαι τοῖς ἐφ’ ἑτέρων κειμένοις.
And since they are six, it is better to establish names for the sake of both a concise and clear indication; just as there is a common law for all Greeks, to use those names of things which we have spoken of among the elders; and of those we do not have, either to transfer metaphorically from some of those we have, or to make them ourselves according to some analogy to the named things, or even to misuse those laid down for other things.
ἔξεστι μὲν τῷ βουλομένῳ μήτε φυλάττειν τὰ συνήθη τοῖς Ἕλλησιν, εἴ που δεήσειε ποιεῖν αὐτὸν, εἰς τοὺς εἰρημένους ἀποβλέπειν σκοποὺς, καὶ πολὺ τοῦτ’ ἔστι παρὰ τοῖς νεωτέροις ἰατροῖς, ὡς ἂν μὴ παιδευθεῖσι τὴν ἐν παισὶ παιδείαν, ὥσπερ οἱ παλαιοί.
For it is permitted to whoever wishes not even to guard the customs of the Greeks, if he should ever need to make them, to look to the mentioned targets, and this is very common among the newer doctors, as if they had not been educated in the child's education, like the ancients.
συγχωρητέον οὖν αὐτοῖς ὡς ἂν ἐθέλωσιν ὀνομάζειν, ἐπειδὴ μάχιμοί τ’ εἰσὶ καὶ ἀναιδεῖς, καὶ πολλάκις γε χρηστέον τοῖς ὀνόμασιν, ὡς ἂν ἐκεῖνοι κελεύωσιν, ὑπὲρ τοῦ φυγεῖν αὐτῶν τὴν γλωσσαλγίαν· οὐδὲ γὰρ οὐδὲ βλαβήσονταί τι διὰ τὴν ἐν τοῖς ὀνόμασι παρανομίαν οἱ κάμνοντες·
We must therefore indulge them to name as they wish, since they are combative and shameless, and we must often use the names as they command, for the sake of avoiding their word-battle; for the sick will not be harmed at all because of the lawlessness in the names.
ὅταν δὲ ἤτοι κλέπτωσί τινα καιρὸν ὅλον ὑπερβαίνοντες, ἢ τοῖς εἰρημένοις ἐπεισάγωσι τὸ μὴ φαινόμενον, οὐκ ἐπιτρεπτέον αὐτοῖς, ὡς ἂν εἰς βλάβην ἤδη τῶν νοσούντων τῆς τοιαύτης ἁμαρτίας διαφερούσης.
But when they either steal away some period by completely skipping it, or introduce what is not apparent into those mentioned, we must not permit them, as such an error already contributes to the harm of the sick.
ἄμεινον οὖν ἐστιν ἐν τῷδε, προδιεσκέφθαι τὰς τῶν σφαλμάτων αἰτίας, παρ’ αἷς οἱ πλεῖστοι τῶν ἰατρῶν σφάλλονται, πρὸς τὸ μήτ’ αὐτούς τι σφαλῆναι κᾀκείνοις ἐπιδεῖξαι τὴν ἀληθῆ τοῦ πράγματος ὁδὸν, εἰ βουληθεῖεν.
It is better, therefore, in this matter, to have pre-examined the causes of the errors, in which most of the doctors fail, in order neither to fail ourselves in anything, and to show them the true road of the matter, if they should wish.
ἔνιοι γὰρ αὐτῶν οὕτω πεφύκασιν, ὡς μηδ’ ἂν τὸν Ἀπόλλωνα αὐτὸν ἢ τὸν Ἀσκληπιὸν σχῶσιν ἐπιθυμοῦντάς τε διδάσκειν αὐτοὺς καὶ παρακαλοῦντας, ὑπακοῦσαί ποτε καὶ παρασχεῖν δύνασθαι τὰ ὦτα, μήτοι γε δὴ καταδέξασθαι τῇ ψυχῇ τὰ λεχθέντα.
For some of them are so designed by nature that, not even if they had Apollo himself or Asclepius wishing to teach and exhorting them, would they ever be able to obey and lend their ears, let alone accept in their soul what is said.
ἀλλ’ οὐκ ἐκείνοις γε ταῦτα γεγράψεται.
But these things will certainly not be written for them.
τοῦτο τοίνυν σφάλματος αὐτῶν αἰτία πρώτη καὶ μάλιστ’ ἐστὶν, ἡ τῆς τῶν νοσημάτων διαφορᾶς ἄγνοια.
This, then, is the first and greatest cause of their error: the ignorance of the difference of diseases.
τριταῖος μὲν γὰρ, ὡς εἴρηται νῦν, εἴωθε κινεῖσθαί τε καὶ τὰς ὥσπερ ἡλικίας αὐτοῦ διανύειν, οὐ μὴν ὁμοίαν γε κίνησιν ἔχει πᾶν νόσημα· διόπερ οὔθ’ ἡμεῖς ὀρθῶς, ἃ περὶ τριταίων εἰρήκαμεν, ἐπὶ πάντα μετοίσομεν, οὔτ’ ἄλλος τις ἀπ’ ἄλλου πάθους ὁρμηθεὶς, ἕνα κοινὸν ἀξιώσει λόγον ἁπάντων ὑπάρχειν.
For the tertian fever, as has just been said, is accustomed both to move and to complete its as-it-were ages, yet not every disease has a similar movement; wherefore neither shall we correctly transfer what we have said about tertian fevers to all, nor will anyone else, starting from another affection, deem that there is one common account for all.
αὕτη μὲν οὖν ἡ πρώτη καὶ μεγίστη τῆς ἁμαρτίας αὐτῶν αἰτία.
This, then, is the first and greatest cause of their error.

Notes

  1. 296ἐπὶ τούτου ... οὗ — The relative pronoun οὗ is in the genitive case because it is attracted (by attraction) to the case of its antecedent τούτου. Syntactically, it represents an original accusative ὃ, which would function as the direct object of the verb παρεθέμην ('which I presented').
  2. p.418χρῆσθαι τούτοις — The infinitive χρῆσθαι, along with the subsequent infinitives μεταφέρειν, ποιεῖν, and καταχρῆσθαι, functions as an appositive or descriptive infinitive that explains the specific content of the 'common law' (νόμος ἐστὶ κοινὸς) mentioned at the beginning of the sentence.
  3. p.418εἴ που δεήσειε ποιεῖν αὐτὸν, εἰς τοὺς εἰρημένους ἀποβλέπειν σκοπούς — In the conditional clause εἴ που δεήσειε using the optative of general/present assumption, the accusative pronoun αὐτόν acts as the subject of the infinitive ποιεῖν. The main infinitive ἀποβλέπειν depends on the impersonal verb ἔξεστι ('it is permitted') carried over from the preceding clause.
  4. p.419ὡς μηδ’ ἂν ... ὑπακοῦσαί ποτε καὶ παρασχεῖν δύνασθαι ... μήτοι γε δὴ καταδέξασθαι — Within the result clause introduced by οὕτω... ὡς, the particle ἂν combined with the infinitives (ὑπακοῦσαι, δύνασθαι) represents a potential optative or unreal past indicative transferred into an infinitive construction. This is followed by the idiomatic expression μήτοι γε δὴ ('much less', 'let alone'), which governs the subsequent infinitive καταδέξασθαι.
  5. p.419τὰς ὥσπερ ἡλικίας αὐτοῦ διανύειν — The noun ἡλικία, which properly refers to the stages of human life or ages, is used metaphorically to describe the sequential stages of the disease's progress. This metaphorical usage is qualified and softened by the limiting particle ὥσπερ ('as-it-were', 'so to speak').

Cite this passage

Galen, The Opportune Moments in Diseases §4. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0057.tlg046.humanitext-grc1:4

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