Humanitext Reader

Galen · The Opportune Moments in Diseases §6

Division into Paroxysm and Remission and Diet

Passage 7 of 11 · Greek

Summary

An alternative method of dividing the entire disease period into two major parts, "paroxysm" and "relaxation," is proposed, and it is argued that Hippocrates' famous dictum on diet during paroxysms corresponds to this division.

§6Ἔξεστι δὲ καὶ κατ’ ἄλλον τινα τρόπον εἰς μείζω μέρη διελεῖν ὅλην τὴν περίοδον, εἴ γε εἰς δύο  δυνατὸν αὐτὴν ὅλην διελεῖν, ἓν μὲν τὸ τοῦ πρώτου παροξυσμοῦ ποιοῦντας, ἀπὸ τῆς πρώτης εἰσβολῆς ἄχρι τῆς ἐσχάτης ἀνέσεως· τὸ δὲ (μετὰ) μεταξὺ (ἐστὶ) τῆς παρακμῆς καὶ τῆς εἰσβολῆς τοῦ δευτέρου παροξυσμοῦ.
It is also possible to divide the whole period in another way into larger parts, if indeed it is possible to divide it as a whole into two parts, making one the part of the first paroxysm, from the first onset until the last relaxation; and the other the part between the decline and the onset of the second paroxysm.
καλῶ δὲ εἰσβολὴν παροξυσμοῦ τὸν ἀκριβῶς ἤδη πρῶτον χρόνον ἀπλατῆ, τὸν δ’ αὐτὸν τοῦτον ἐπισημασίαν εἰώθασιν ὀνομάζειν.
And I call the onset of a paroxysm the precisely first indivisible time, and this very same thing they are accustomed to name the premonition.
καὶ τό γε πρὸς Ἱπποκράτους εἰρημένον· ἐν τοῖσι παροξυσμοῖσιν ὑποστέλλεσθαι· κατὰ ταύτην ἡγοῦμαι λελέχθαι τὴν τομήν.
And indeed, what was said by Hippocrates: "in paroxysms, to withhold food," I think has been said according to this division.
προειπὼν γὰρ, ὡς προσήκει, οἷς μὲν αὐτίκα ἡ ἀκμὴ, αὐτίκα λεπτῶς διαιτᾷν, οἷς δ’ ὕστερον, εἰς εἰκεῖνο μὲν καὶ πρὸ ἐκείνου λεπτῶς, ἔμπροσθεν δὲ πιότερον διαιτᾷν, ὡς ἂν ἐξαρκέσοι ὁ νουσέων, ἐπήνεγκεν· ἐν δὲ τοῖσι παροξυσμοῖσιν ὑποστέλλεσθαι χρή· διδάσκων ἡμᾶς δηλονότι μόνον ἐκεῖνον τὸν καιρὸν φυλάττεσθαι, τὸν ὑπ’ αὐτοῦ καλούμενον παροξυσμόν. οὐδέποτε γὰρ ἐν αὐτῷ τρέφομεν, ἐν δὲ τῷ λοιπῷ παντὶ τῆς ἀνέσεως ἄλλοτε κατ’ ἄλλο μόριον αὐτοῦ· ποτὲ μὲν γὰρ ἁπλοῦς ἐστιν ἐκ παρακμῆς μόνον ὑπάρχων, ἐνίοτε δ’ ἐκ παρακμῆς καὶ διαλείμματος σύγκειται.
For having said beforehand, as is proper, that for those who have the height immediately, one should immediately diet them thinly, but for those who have it later, thinly up to that time and before it, but beforehand more richly, so that the sick person might hold out, he added: "but in paroxysms it is necessary to withhold." He was teaching us, clearly, to guard against only that period which is called by him "paroxysm." For we never nourish during it, but in all the remaining part of the relaxation, at one time or another in its various parts; for sometimes it is simple, existing from the decline alone, and sometimes it is composed of decline and intermission.
αὕτη μέν ἐστιν ἡ εἰς δύο μέρη τομὴ τῆς μιᾶς περιόδου, τὸ μὲν ἕτερον μέρος αὐτῆς τὸ πρότερον, ὀνομαζόντων ἡμῶν παροξυσμὸν, τὸ δὲ ἐπ’ αὐτῷ δεύτερον, ἤτοι γε ἄνεσιν, ὡς ἀρτίως, ἢ ὡς ἔνιοι, διάλειμμα. διάλειμμα γὰρ καλοῦσιν οὐκ ὀλίγοι τῶν ἰατρῶν τὸ μετὰ τὴν ἀκμὴν ἅπαν, ὅπως ἂν ἔχῃ φύσεως, εἶτ’ οὖν εἰς ἀπυρεξίαν παυόμενον, εἴτε καὶ μή.
This is the division into two parts of the single period, as we call its former part "paroxysm," and the second part following it either "relaxation," as just now, or as some do, "intermission." For not a few of the doctors call the whole part after the height "intermission," however its nature may be, whether it ends in apyrexia or not.
ἀλλ’ ἡμῖν γε φυλαττέσθωσαν αἱ προειρημέναι κλήσεις, ὑπὲρ τοῦ μηδεμίαν ἀσάφειαν γίνεσθαι κατὰ τὸν λόγον, καὶ προσαγορευέσθω τὸ μετὰ τὸν παροξυσμὸν ἅπαν ἄνεσις, οὐ κωλυόντων ἡμῶν, ὡς ἔφην, εἰ καὶ διάλειμμά τις αὐτὸν καλεῖν ὅλον, ἢ παρακμὴν, ἢ ἔνδοσιν, ἢ ὕφεσιν, ἢ ἀφαίρεσιν ἐθέλοι. πρόκειται γὰρ οὐ περὶ τῶν ὀνομάτων ζυγομαχεῖν, ἀλλὰ τὰ μέρη τῆς περιόδου σκοπεῖν ὁπόσα τε τὸν ἀριθμόν ἐστι καὶ ὅπῃ διενήνοχεν ἀλλήλων.
But for us, let the aforementioned names be preserved, so that no obscurity may arise in the argument, and let the whole part after the paroxysm be addressed as "relaxation," without us preventing, as I said, if anyone should wish to call the whole of it "intermission," or "decline," or "yielding," or "remission," or "withdrawal." For our purpose is not to fight over names, but to consider how many in number the parts of the period are and in what way they differ from each other.

Notes

  1. p.426ποιοῦντας — The accusative participle ποιοῦντας agrees with the implied subject of the infinitive διελεῖν (people in general, or "us"). This construction continues the infinitive phrase introduced by ἔξεστι ... διελεῖν, with the subject of the infinitive being in the accusative.
  2. p.426ὡς ἂν ἐξαρκέσοι — A rare construction where the conjunction ὡς and the particle ἄν are followed by the future optative ἐξαρκέσοι. This represents an expectation or purpose in indirect speech ("so that he might hold out"), where the optative is triggered by the past/historical context of the main verb (προειπὼν).
  3. p.426ὑποστέλλεσθαι — The intransitive use of ὑποστέλλεσθαι in a medical context means "to withhold (food)" or "to restrict one's diet." This is a quotation of a famous Hippocratic aphorism regarding dietary management during febrile paroxysms.
  4. p.427ὅπως ἂν ἔχῃ φύσεως — An idiomatic expression consisting of the relative adverb ὅπως with ἔχω followed by the partitive genitive φύσεως, meaning "however its nature may be" or "regardless of what its state of nature is."

Cite this passage

Galen, The Opportune Moments in Diseases §6. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0057.tlg046.humanitext-grc1:6

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