§8#1Ἀλλὰ νῦν ἐπὶ τοὺς κατὰ περίοδόν τινα παροξύνοντας ἐπανέλθωμεν τῷ λόγῳ, πᾶν ὅσον ὑπόλοιπον ἐν αὐτοῖς ἄσκοπον ἀφεῖται διαιροῦντες.
But now let us return in our discourse to those which have paroxysms according to some period, dividing all that remains unexamined among them.
ἑνὸς μὲν δὴ καὶ πρώτου μεμνῆσθαι κελεύω, τοῦ γεγονέναι τὸν λόγον ἡμῖν ἅπαντα τὸν ἀπ’ ἀρχῆς ἄχρι δεῦρο περὶ τῶν ἁπλῶν περιόδων.
First and foremost, I bid you remember that our entire discourse from the beginning up to this point has been about simple periods.
ἐν γὰρ ταῖς ἐπιπεπλεγμέναις ὁ μετὰ τὴν ἀκμὴν καιρὸς ἐνίοτε στενοῦται, φθανούσης εἰσβάλλειν ἐπισημασίας ἑτέρου παροξυσμοῦ, πρὶν τὴν προτέραν περίοδον ἀκριβῶς πληρωθῆναι, καὶ πολλάκις γε κατὰ μὲν τὴν ἑαυτοῦ φύσιν ὁ πυρετὸς ἐκ τοῦ τῶν διαλειπόντων ἐστὶ γένους, ὥσπερ ὁ τριταῖος, ἡ δ’ ἐπιπλοκὴ χρόνον ἀπυρεξίας οὐδένα καταλείπει τῇ προτέρᾳ περιόδῳ, φθάσαντος εἰσβαλεῖν τοῦ δευτέρου παροξυσμοῦ, πρὶν ἀπολυθῆναι τὸν πρότερον.
For in the case of complex ones, the period after the height is sometimes narrowed, as the indication of another paroxysm forestalls and invades before the prior period is accurately completed, and often indeed, according to its own nature, the fever is of the class of intermittent ones, like the tertian, but the complexity leaves no time of apyrexia for the prior period, as the second paroxysm forestalls and invades before the prior one is released.
εἴρηται δέ μοι περὶ τῶν τοιούτων ἐπιπλοκῶν ἐν δύο πραγματείαις, τῇ τε περὶ κρίσεων καὶ τῇ περὶ διαφορᾶς τῶν πυρετῶν, ἔνθα καὶ διώρισται μίξις ἐπιπλοκῆς.
And concerning such complexities, I have spoken in two treatises, namely, *On Crises* and *On the Difference of Fevers*, where also the difference between mixture and complexity is distinguished.
ὁ γοῦν ἡμιτριταῖος ἐκ μίξεώς τε καὶ κράσεως ἐδείχθη γιγνόμενος ἀμφημερινοῦ τε καὶ τριταίου πυρετοῦ.
At any rate, the semitertian was shown to arise from the mixture and temperament of both quotidian and tertian fever.
πολλάκις δὲ καὶ αὐτῷ τῷ ἡμιτριταίῳ τῶν ἁπλῶν εἷς ἐπιπλέκεται πυρετῶν, ἤτοι τριταῖος, ἢ ἀμφημερινὸς, ἀλλ’ οὐκ ἔστιν ἡ τοιαύτη ποικιλία τῆς ἐνεστώσης οἰκεία πραγματείας, ἀρκεῖ γὰρ ἐνταῦθα τοὺς ἰδίους ἑκάστου τῶν πυρετῶν καιροὺς ἀκριβῶς διαρθρῶσαι· τὸ γὰρ τὸ συμπλεκόμενον αὐτῶν ἑτοίμως δύνασθαι διακρίνειν οὕτως ἂν ἡμῖν μάλισθ’ ὑπάρξειεν.
And often, onto the semitertian itself, one of the simple fevers is super-imposed, either a tertian or a quotidian; but such variety is not proper to the present treatise, for here it is sufficient to articulate accurately the proper periods of each of the fevers; for in this way we would be best able to distinguish readily that which is combined among them.
οἱ μὲν οὖν ἀκριβῶς ἁπλοῖ προείρηνται, περὶ δὲ τῶν ἐπιμίκτων ἑξῆς ἐρῶ.
So, those that are strictly simple have been spoken of before; next I shall speak of the mixed ones.
γίνεται τοίνυν ἐνίοτε φρικώδης εἰσβολὴ, τὰ τῆς ἀρχῆς ἴδια γνωρίσματα πάντα ἔχουσα, πλὴν ῥίγους, ἔστι δ’ ὅτε καὶ τούτου τὴν ἔμφασιν· ἡ γάρ τοι σφοδρὰ φρίκη δόξειεν ἂν ἤτοι γε ἀρχή τις εἶναι ῥίγους, ἢ μικρὸν ῥῖγος, ἀλλὰ τό γε ἀκριβὲς ῥῖγος, οἷον ἐν τριταίοις τε καὶ τεταρταίοις πυρετοῖς ἐστιν, ὁ τοιοῦτος μὴ λαμβάνει, καὶ διὰ τοῦτ’ οὖν αὐτὸν ὀνομάζω φρικώδη· καὶ πολύ γε μᾶλλον ὅτι προδείξας τινὰ σημεῖα τοῦ δευτέρου καιροῦ, πάλιν ἀρχὴν ἑτέρας εἰσβολῆς ἐργάζεται φρικώδη, ὃ καλοῦσιν ἔνιοι μὲν ἐπανάληψιν, ἔνιοι δ’ ἐπαναδίπλωσιν· ἔστιν ὅτε δὲ καὶ δεύτερον ἐργάζεται τοῦτο, καί τισιν ἐνίοτε καὶ τρίτον, εἶτα μόγις ὕστερον ὁμαλῶς ἐξαπλοῦται μέχρι τῆς ἀκμῆς ἀναβαίνων.
Sometimes, then, there occurs a chilly onset, having all the proper signs of the beginning except for shivering, and sometimes even the appearance of this; for indeed severe chill might seem to be either a beginning of shivering, or a small shivering, but such a patient does not experience the exact shivering such as occurs in tertian and quartan fevers, and for this very reason I call it chilly; and much more so because, having previously shown some signs of the second period, it again produces a chilly beginning of another onset, which some call "re-initiation" and others "reduplication." And sometimes it does this a second time, and in some even a third time, and then later with difficulty it unfolds smoothly, ascending to the height.
οὗτος ὁ πυρετὸς εἰς ἀπυρεξίαν οὐδέποτε παύεται.
This fever never ends in apyrexia.
ὅ τε γὰρ ἄχρι τῆς ἀκμῆς αὐτῷ χρόνος ὑπάρχει πάμπολυς ἥ τε παρακμὴ χωρὶς αἰσθητῆς διαπνοῆς· πολὺ δὲ δὴ μᾶλλον ἀποδεῖ τοῦ μεθ’ ἱδρῶτος εἰς ἀπυρεξίαν ἰέναι.
For both the time up to the height is very long for it, and the decline is without perceptible transpiration; and indeed it falls far short of going into apyrexia with sweat.
ὥσπερ οὖν ὁ ἀπὸ τῆς πρώτης εἰσβολῆς παροξυσμὸς ἄχρι τῆς ἀκμῆς ἐν πολλῷ χρόνῳ παραγίνεται, κατὰ τὸν αὐτὸν τρόπον ἀπὸ τῆς ἀκμῆς κατὰ βραχὺ μειοῦται.
Just as, therefore, the paroxysm from the first onset arrives at the height in a long time, in the same way from the height it gradually decreases.
καὶ τοίνυν ἐπὶ τῆς ὑστεραίας ἕτερος αὐτοῖς ἐπιγίνεται παροξυσμὸς, φρικώδης μὲν ὁμοίως, ἀλλ’ οὐκ ἔχων τὰς ἐπαναλήψεις ὡσαύτως τῷ πρόσθεν, ἢ εἴποτε κατὰ τὸ σπάνιον σχοίη, μίαν ποιήσαιτο μόνην, ὀλιγοχρόνιόν τε καὶ σμικράν.
And therefore, on the next day another paroxysm comes upon them, similarly chilly, but not having the re-initiations in the same way as the former, or if ever rarely it should have them, it would make only one, short-lived and small.
ἀναβαίνει δὲ καὶ οὗτος ὁ παροξυσμὸς ἐπὶ τὴν ἀκμὴν ἐν χρόνῳ πολλῷ, καὶ παρακμάζει ὡσαύτως ἐν οὐκ ὀλίγῳ χρόνω, καὶ διὰ τοῦτ’ αὐτὸ ἐπὶ τῆς τρίτης ἡμέρας ὁ αὐτὸς τῷ κατὰ τὴν πρώτην ἐκδέχεται παροξυσμὸς, εἶτ’ αὖθις ὁ κατὰ τὴν τετάρτην ὁ αὐτὸς τῷ κατὰ τὴν δευτέραν, καὶ τοῦτο ἐφεξῆς ἀεί.
And this paroxysm too ascends to the height in a long time, and declines likewise in no short time, and for this very reason on the third day the same paroxysm as that of the first day succeeds, and then again on the fourth that of the second day, and this successively always.