§1## ΓΑΛΗΝΟΥ ΠΕΡΙ ΤΩΝ ΟΛΟΥ ΤΟΥ ΝΟΣΗΜΑΤΟΣ ΚΑΙΡΩΝ ΒΙΒΛΙΟΝ.
Ὅλου τοίνυν τοῦ νοσήματος ἐπινοοῦμεν καιροὺς ἀνάλογον ταῖς ἡλικίαις τῶν ζώων· ἕνα μὲν καὶ πρῶτον τῆς γενέσεως αὐτοῦ· δεύτερον δὲ τὸν τῆς ἀναβάσεως· τρίτον δὲ τὸν τῆς ἀκμῆς· καὶ τέταρτον τὸν τῆς παρακμῆς, ὅταν γε μέλλωσιν οἱ κάμνοντες σώζεσθαι· φθασάντων γὰρ ἀποθανεῖν αὐτῶν, ἤτοι κατὰ τὴν ἀνάβασιν, ἢ τὴν ἀκμὴν, εὔδηλον ὡς οὐ διεξῆλθεν ἅπαντας τοὺς καιροὺς ἡ τοιαύτη νόσος.
## GALEN: ON THE SEASONS OF THE DISEASE AS A WHOLE. We conceive of the seasons of the disease as a whole by analogy with the ages of animals; one and first, its genesis; second, its increase; third, its peak; and fourth, its decline, when indeed the patients are to be saved; for if they die beforehand, either during the increase or the peak, it is clear that such a disease did not pass through all its seasons.
ἀλλ’ ἥ γε διεξερχομένη σχεδόν τι περὶ πάντων αὐτῆς τῶν μορίων ἀμφισβητήσεις ἔχει, τινῶν μὲν ἕνα χρόνον εἶναι λεγόντων τὴν ἀκμὴν, ἐπινοίᾳ μόνῃ λαμβανόμενον· ἐνίων δὲ, ὡς ἐν τοῖς συνόχοις, ἀκμὴν μὴ εἶναι τὸ σύμπαν· ἐνίων δὲ εἰς ἀρχὴν ὀλιγοχρόνιον εἰσάγειν τὴν ἀκμήν· ἄλλων δ’ οὐκ ἐν τούτοις μόνον, ἀλλὰ καὶ τοῖς λοιποῖς ἅπασι νοσήμασιν, ἀφαιρούντων, τὴν ἀρχήν· ἄλλων δ’ ἐνίοτε καὶ τὴν παρακμὴν ἀφαιρούντων, ἂν ἐξ ἀποκοπῆς, ὡς ἐκεῖνοι καλοῦσιν, ἡ νόσος λυθῇ.
But the one that does run its full course has disputes, so to speak, about almost all of its parts, some saying that the peak is a single moment of time, apprehended by thought alone; others that, as in continuous fevers, there is no peak at all; others introducing the peak into a short-lasting beginning; others taking away the beginning, not only in these but also in all other diseases; and others sometimes taking away even the decline, if the disease is resolved by "abrupt cutoff," as they call it.
πρῶτον μὲν οὖν χρὴ τὰς ἀμφισβητήσεις διαλύεσθαι ταύτας, εἶτα ἀκριβῶς διαρθρῶσαι τὰς ἐννοίας τῶν καιρῶν τῆς ὅλης νόσου, καὶ μετὰ ταῦτ’ εἰπεῖν αὐτῶν τὰ γνωρίσματα, κᾄπειθ’ ἑξῆς εἴη δεῖξαι τὸ χρήσιμον, ἀναμίξαντας τοῖς κατὰ τὰς περιόδους.
First, then, we must resolve these disputes, next precisely articulate the concepts of the seasons of the disease as a whole, after this state their diagnostic signs, and then next demonstrate their utility, mixing them with those according to the periods.
§2Ἡ τοίνυν ἀρχὴ τῆς νόσου, καθ’ ὅσον εἰσβάλλει ποτὲ καταπιπτούσης τῆς ὑγιεινῆς καταστάσεως, ἐν ἁπάσαις αὐταῖς ἐστιν ἄνευ χρόνου παρατάσεως ἐπινοουμένη· σὺν τούτῳ μέντοι γε οὐ συγχωρεῖται παντὸς νοσήματος ὑπάρχειν οἷον γένεσιν, ὥσπερ ἐν τοῖς ζώοις ἐπινοοῦμεν.
The beginning of the disease, then, insofar as it attacks when the healthy state collapses, is conceived in all of them without duration of time; yet along with this, it is not conceded that a kind of genesis exists for every disease, as we conceive it in animals.
οὐ γὰρ ἐκ μορίων δή τινων ὥσπερ τὸ ζῶον ἐκ κεφαλῆς, καὶ θώρακος, καὶ κώλων, οὕτω καὶ τὰ νοσήματα σύγκειται.
For diseases are not composed of certain parts, just as an animal is composed of head, chest, and limbs.
ἐκπίπτοντα γὰρ τοῦ κατὰ φύσιν, ἐν ἀκαρεῖ μέν τινι χρόνῳ τὴν γένεσιν ἔχει, τοὐντεῦθεν δὲ ἀναβαίνει μέχρι τῆς ἀκμῆς.
For by falling away from the natural state, they have their genesis in an instant of time, and from then on they increase up to the peak.
ἔστω γὰρ εἰ τύχοι κατὰ δυσκρασίαν τὸ νόσημα, καθ’ ἣν ἡμῖν ἐπιδέδεικται καὶ ὁ πυρετὸς συνιστάμενος.
For let there be, for instance, a disease due to dyscrasia, by which we have shown that fever also is constituted.
ἀναγκαῖον οὖν ἐπειδὰν πρῶτον ἡ παρὰ φύσιν αὕτη γένηται θερμασία, πυρέττειν τε τὸν ἄνθρωπον, ἐπιτείνεσθαί τε μέχρι τῆς ἀκμῆς τὴν θερμασίαν.
Therefore, as soon as this unnatural heat first arises, it is necessary both that the human being fever and that the heat intensify up to the peak.
οὗ γὰρ οὐκ ἔστι μέρη, πῶς ἂν εἴη γένεσις ἐν χρόνῳ τοῦδε;
For of that which has no parts, how could there be a genesis of it in time?
ταῦτ’ εἴρηταί μοι καὶ κατ’ ἀρχὰς εὐθέως, ἀπήντησά τε πρὸς αὐτὰ, τῶν μετὰ περιψύξεως εἰσβαλλόντων πυρετῶν ἀναμνήσας.
These things have been said by me immediately at the beginning as well, and I answered them by reminding of fevers that attack with chilling.
ἀλλ’ ἐν μὲν ταῖς περιόδοις αὐτάρκης ἡ ἀπάντησις· εἷς γὰρ τῶν ἐν μέρει καιρῶν καὶ τῇ τάξει πρῶτος ὁ τῆς περιψύξεως τῆς συμπάσης νόσου·
But in the periods, the answer is sufficient; for the period of chilling is one of the particular seasons and the first in order of the whole disease.
γελοιότατον δ’ ἂν εἴη τὸν τοῦ πρώτου παροξυσμοῦ πρῶτον καιρὸν ἀρχὴν ἡγεῖσθαι τοῦ νοσήματος ὅλου.
But it would be most ridiculous to consider the first season of the first paroxysm as the beginning of the whole disease.
τὸ γάρ τοι χρήσιμον ὁ καιρὸς οὗτος, ὃν ὀνομάζουσιν ἀρχὴν νοσήματος, εἰς τὰ βοηθήματα κέκτηται, καὶ πρὸς τοῦτον ἀποβλέπων εἶπεν· ἀρχομένων τῶν νούσων, ἤν τι δοκέῃ κινέειν, κίνει, ἀκμαζουσῶν δὲ, ἡσυχίαν ἔχειν βέλτιόν ἐστιν. ὡσαύτως δὲ κᾀκεῖνο λέλεκται αὐτῷ· περὶ τὰς ἀρχὰς καὶ τὰ τέλεα πάντα ἀσθενέστερα. καὶ μέντοι καὶ τὸ περὶ φαρμακείας εἰρημένον, ὡς πέπονα χρὴ φαρμακεύειν καὶ κινέειν, μὴ ὠμὰ, μηδὲ ἐν ἀρχῇσιν, ἢν μὴ ὀργᾷ.
For indeed this season, which they call the beginning of a disease, possesses utility for remedies, and looking to this he said: "At the beginning of diseases, if it seems good to move something, move it; but when they are at their peak, it is better to keep quiet." And likewise that other thing has been said by him: "Around the beginnings and the ends, all things are weaker." And indeed also what was said about purging, that one must purge and move what is cocted, not raw things, nor in the beginnings, unless it is swelling.
καὶ πρὸς τούτοις γε ἔτι τὸ, ἐν τοῖσιν ὀξέσι πάθεσιν ὀλιγάκις καὶ ἐν ἀρχῇσι τῇσι φαρμακείῃσι χρέεσθαι· πολλά τε πρὸς τούτοις ἕτερα, τὰ μὲν Ἱπποκράτει, τὰ δὲ τοῖς ἄλλοις ἰατροῖς ἅπασι τοῖς παλαιοῖς εἰρημένα, τὴν ἀρχὴν ἡμᾶς οὐκ ἐπιτρέπει νοεῖν τοῦ πρώτου παροξυσμοῦ τὴν εἰσβολὴν, ἀλλ’ ἐπὶ μακροτέρου, ὡς καὶ φλεβοτομῆσαι δύνασθαι, καὶ κλυστηρίῳ χρήσασθαι, ποτὲ δὲ εἰ κατεπείγει, καὶ καθῆραι, πρὸς τῷ καὶ γελοῖον εἶναι τῶν ἐντὸς τῆς ἑβδόμης ἡμέρας λυομένων νοσημάτων καὶ τῶν εἰς ἐνιαυτὸν παραμενόντων, ὥσπερ καὶ ὁ τεταρταῖος ἔστιν ὅτε, τὴν ἴσην ἀρχὴν τίθεσθαι.
And in addition to these, further: "In acute affections, use purges rarely and in the beginnings;" and many other things besides these, some said by Hippocrates, others by all the other ancient physicians, do not permit us to understand the "beginning" as the onset of the first paroxysm, but over a longer span, so that one can even perform venesection, and use a clyster, and sometimes, if it is urgent, even purge, in addition to its being ridiculous to posit an equal beginning for diseases resolved within the seventh day and those persisting for a year, as indeed the quartan fever sometimes does.
πολλὰ μὲν οὖν εἴρηταί μοι περὶ τῆσδε τῆς ἀρχῆς καὶ κατὰ τὸ περὶ κρίσεων πρῶτον, ἐπιδεικνύντι τὸν πρῶτον τοῦτον καιρὸν ὡς ἄν τις γνωρίσειεν.
Therefore, many things have been said by me about this beginning also in the first book of On Crises, showing how one might recognize this first season.
ἦν δ’ αὐτοῦ κεφάλαιον ἡ ἀπεψία τῆς νόσου.
And its main point was the raw state of the disease.
βέλτιον δὲ κᾀνταῦθα πρὸς ἐκείνοις εἰπεῖν, ὅσα τῇ παρούσῃ διεξόδῳ χρήσιμα.
But it is better to say here, in addition to those things, as many as are useful for the present treatise.