§3Κείσθω τοίνυν πρῶτον ἀρχὴν φλεγμονῆς ζητεῖσθαι.
Let it be assumed, then, first that the beginning of inflammation is being sought.
τίς οὐκ ἂν φαίη τὴν οἱονεὶ γένεσιν αὐτῆς ὑπάρχειν ἐν ἐκείνῳ παντὶ τῷ χρόνῳ, καθ’ ὃν πληροῦται τὸ μόριον αἱματώδους οὐσίας;
Who would not say that its so-to-speak genesis exists in all that time during which the part is filled with blood-like substance?
εἴτε γὰρ ἐπὶ παρεμπτώσει συμβαίνει τὸ τοιοῦτον, εἴτ’ ἐπὶ τῇ σφηνώσει πάντων τῶν ἀγγείων, εἴτε ἐπὶ περιστάσει τινὶ τῶν ὄγκων ἐν τοῖς πόροις, εἴθ’, ὡς ἡμεῖς ἐδιδάξαμεν ἔν τε τῷ περὶ τῆς ἀνωμάλου δυσκρασίας καὶ τῷ περὶ τῶν παρὰ φύσιν ὄγκων ὑπομνήματι, πλεονεξία τις αἵματος ἐν τῷ μορίῳ συνίσταται, γεννωμένης τῆς φλεγμονῆς, οὗτος ἔσται πρῶτος καιρὸς, ἐν ᾧ πληροῦται τὸ μέρος ἀνακείμενον τῷ μεγέθει τοῦ πάθους.
For whether such a thing occurs because of transfusion, or because of the wedging of all the vessels, or because of some congestion of masses in the passages, or whether, as we taught in the treatise On Unequal Dyscrasia and that On Unnatural Swellings, a certain excess of blood is established in the part while the inflammation is being generated, this will be the first season, in which the part is filled, corresponding to the magnitude of the affection.
ὅταν δὲ τὸ μὲν ἐπιῤῥέον παύσηται, τὸ δ’ ἐν τῷ φλεγμαίνοντι περιεχόμενον ὑπάρξηται σήπεσθαι, θερμασία τις γίνεται διὰ τὴν σηπεδόνα, καὶ ἡ χύσις ἐπιπλέον διὰ τὴν θερμασίαν, ἐφ’ ᾗ καὶ πνεῦμα γεννᾶται, καὶ δι’ ἄμφω ταῦτα διατείνεται μᾶλλον ἢ πρόσθεν τὸ μόριον, εἰ καὶ μηδὲν ἐπιῤῥέοι· δεύτερος οὗτός ἐστι χρόνος ὁ τῆς αὐξήσεως τῆς φλεγμονῆς.
But when the flowing-in ceases, and what is contained in the inflamed part begins to putrefy, a certain heat arises because of the putrefaction, and further liquefaction because of the heat, upon which pneuma also is generated, and because of both of these the part is stretched more than before, even if nothing should flow in; this is the second time, that of the increase of the inflammation.
ὅταν δὲ εἰς πῦον ἤδη μεταβάλλῃ, μέγιστοι μὲν δή που πόνοι τηνικαῦτα καταλαμβάνουσι.
But when it already changes into pus, then indeed the greatest pains seize.
περὶ γὰρ τὰς γενέσιας τοῦ πύου οἱ πόνοι καὶ οἱ πυρετοὶ συμβαίνουσι μᾶλλον ἢ γενομένου· καλεῖται δ’ ἀκμὴ τοῦ πάθους ὁ τοιοῦτος καιρός.
For around the generations of pus, pains and fevers occur more than when it has been generated; and such a season is called the peak of the affection.
εἰ δὲ ἐκπυϊσκόμενον ἢ διαφορούμενον τὸ ῥεῦμα τόν τ’ ὄγκον ἐλάττω καὶ τὴν τάσιν ἀποφαίνει, παρακμῆς ἀρχὴ τὸ τοιοῦτόν ἐστιν.
But if the flux, by turning into pus or being dispersed, makes the swelling smaller and the tension less, such a thing is the beginning of the decline.
οὕτω μὲν ἐπὶ τῆς φλεγμονῆς οἱ καιροὶ διαιροῦνται.
Thus, indeed, the seasons are divided in the case of inflammation.
ἐπὶ πυρετοῦ δὲ τοῦ μὲν ἐπὶ φλεγμονῇ συνισταμένου τοὺς αὐτοὺς ἐκείνῃ τίθεσθαι καιρούς· τοῦ δ’ ἐπὶ χυμοῦ ἄνευ φλεγμονῆς, τὸν μὲν τῆς ἀπεψίας τῶν λυπούντων χυμῶν χρόνον, ἀρχήν· ὅταν δ’ ἄρξηται πέττεσθαι, πεπαῦσθαι μὲν τὴν ἀρχὴν, τὸν δεύτερον δ’ ἥκειν καιρὸν, τὸν τῆς ἀναβάσεως ὀνομαζόμενον· ὁπότε δὲ ἡ πέψις αὐτὴ συντελεῖται μάλιστα, τὸν τῆς ἀκμῆς· εἶθ’ ἑξῆς τὸν τῆς παρακμῆς, ἐν ᾧ πέπαυται μὲν ἤδη τό τε μέγεθος τῶν συμπτωμάτων καὶ τὸ πλῆθος τῶν πεττομένων, ὀλίγον δ’ ἐστὶν ἔτι λείψανον τῶν πεφθῆναι δεομένων χυμῶν.
And in the case of fever, for the one established upon inflammation, the same seasons as for that must be posited; but for the one upon humor without inflammation, the time of the indigestion of the offending humors is the beginning; and when they begin to be cocted, the beginning has ceased, and the second season has come, called the increase; and when the coction itself is accomplished most of all, it is the peak; then next is the decline, in which both the magnitude of the symptoms and the quantity of the things being cocted have already ceased, and there is still a small remnant of the humors needing to be cocted.
ἐδήλωσα δ’ ἐν τῇ περὶ κρίσεων πραγματείᾳ καὶ τὰ γνωρίσματα πάντα, τά τε τῆς πέψεως τῆς ἀμυδρᾶς καὶ τὰ τῆς παντελοῦς ἀπεψίας, καὶ τὰ τῆς ἐναργοῦς καὶ τὰ τῆς τελείας, ἴδια μὲν ὑπάρχοντα τῶν κατὰ τὴν γαστέρα πέψεων, ἴδια δὲ τῶν κατὰ τὰς φλέβας, ἴδια δὲ ἄλλα τῶν ἀναπνευστικῶν.
And I showed in the treatise On Crises all the diagnostic signs as well, both those of faint coction and those of complete indigestion, and those of manifest and those of perfect coction, being peculiar on the one hand to the coctions in the stomach, peculiar on the other to those in the veins, and others peculiar to the respiratory organs.
ἐλαμβάνετο δὲ τὰ μὲν ἐκ τῶν διαχωρημάτων, τὰ δὲ ἐκ τῶν οὔρων, τὰ δὲ ἐκ τῶν πτυσμάτων.
And some were taken from the excretions, others from the urine, others from the sputa.
καὶ ταῦτα ἐπιπλεῖστον ἐν ἐκείνῳ τῷ λόγῳ διῆλθον ἅμα ταῖς Ἱπποκρατείαις ῥήσεσιν, ἀρκεῖ δὲ ἐν τῷ νῦν ἐνεστῶτι τοσοῦτον μόνον εἰπεῖν, ὡς καὶ τῶν ἑλκῶν οἱ αὐτοὶ καιροί.
And I went through these at great length in that discourse along with the Hippocratic sayings, but in the present one it is sufficient to say only this much, that the seasons of ulcers also are the same.
πρῶτον μὲν γὰρ ἰχῶρες ὑδατώδεις ἄπεπτοι καὶ λεπτοὶ ῥέουσιν ἐξ αὐτῶν· εἶθ’ ἑξῆς ἐλάττους τε καὶ παχύτεροι· κᾄπειτα ἤδη πῦον λεπτόν· εἶτα ἔλαττον μὲν τῷ πλήθει τοῦτο γίνεται, παχύτερον δὲ καὶ λευκότερον· ὥστε οὐδέν ἐστι τῶν λυομένων παθῶν, ὃ μὴ διεξέρχεται τοὺς καιρούς.
For first, watery, raw, and thin serous discharges flow from them; then next, less and thicker; and then already thin pus; then this becomes less in quantity, but thicker and whiter; so that there is none of the resolving affections that does not pass through the seasons.
οὐ μὴν οὐδ’ ἐξ ἄλλου τινὸς ἡ γνῶσις αὐτῶν, ὅτι μὴ τῶν τῆς ἀπεψίας τε καὶ πέψεως σημείων, ἃ διὰ τῶν περιττωμάτων γνωρίζεται.
Indeed, nor is the knowledge of them from anything else, except from the signs of indigestion and coction, which are recognized through the excretions.
τίς γὰρ οὐκ οἶδεν ἠπεπτηκέναι τὴν γαστέρα, διαχωρήματα θεασάμενος ἀχύλωτα;
For who does not know that the stomach has failed to digest, upon seeing chyle-less excretions?
τίς δὲ οὐκ οἶδεν, οὖρον ὑδατῶδες ἰδὼν, ἠτυχῆσθαι τὴν ἐν τοῖς ἀγγείοις πέψιν;
And who does not know, upon seeing watery urine, that the coction in the vessels has been unsuccessful?
τίς δὲ λεπτὸν ἀναβηττόμενον πτύσμα κατὰ πλευρῖτιν, ἢ περιπνευμονίαν ἑωρακὼς, ὁμοίως οὐ συνήσει ὡς ἀρχή ἐστιν ἔτι τοῦ πάθους;
And who, having seen thin sputum coughed up during pleurisy or pneumonia, will not likewise understand that it is still the beginning of the affection?
οὕτω δὲ κᾀν ταῖς ὀφθαλμίαις ἐν ἀρχῇ μὲν ἀποῤῥεῖ πολὺ καὶ λεπτὸν, ἄπεπτον ἱκανῶς· ἐφεξῆς δὲ, ἔλαττόν τε καὶ παχύτερον, ὑπογραφήν τινα πέψεως λαμβάνον· εἶτα ἐν τῷ χρόνῳ προϊόντι, τοῦ μὲν πλήθους μειουμένου, τῆς συστάσεως δὲ ἐπὶ τὸ παχύτερον ἰούσης, αὐξάνεται τὰ τῆς πέψεως εἰς τοσοῦτον, ὡς καὶ κολλᾶσθαι τὰ βλέφαρα κοιμηθέντων ὑπὸ τῆς γενομένης λήμης, ἥτις καὶ αὐτὴ καταρχὰς μὲν λεπτὴ καὶ πολλὴ, τῷ χρόνῳ δὲ ἐλάττων τε καὶ παχυτέρα γενομένη, τήν τε πέψιν τοῦ νοσήματος ἐνδείκνυται καὶ τὴν παρακμὴν τούτου.
And so too in ophthalmias, at the beginning much and thin discharge flows, sufficiently raw; but next, less and thicker, receiving a certain outline of coction; then as time goes on, while the quantity decreases and the consistency goes towards the thicker, the signs of coction increase to such an extent that even the eyelids of those who sleep are glued together by the generated rheum, which itself is also at first thin and much, but as time goes on, becoming less and thicker, indicates both the coction of the disease and the decline of this.
καὶ μὴν καὶ τῶν ἐξ ἐγκεφάλου καταῤῥεόντων δι’ ὑπερῴας καὶ ῥινῶν ἀρχὴ μὲν, ὅταν ὑδατῶδές τε καὶ λεπτὸν ᾖ καὶ πολὺ καὶ δριμὺ τὸ φερόμενον· ἐσχάτην γὰρ ἀπεψίαν ἐνδείκνυται ταῦτα· πέψεως δέ ἐστιν ἤδη γνωρίσματα παχύτερόν τε καὶ ἧττον δριμὺ καὶ ὀλίγον κενούμενον· εἰ δὲ καὶ ἡ καλουμένη μύξα καὶ βλέννα συναπέρχοιτο, βεβαιότερον ἤδη τοῦτό ἐστι πέψεως σημεῖον· ὥσπερ δὴ καὶ (εἰ) παχυτέρα μὲν αὐτῆς καὶ ἐλάττων γινομένη, πολὺ δὴ καὶ μᾶλλον πέψιν ἐνδείκνυται.
And indeed, in the case of discharges flowing down from the brain through the palate and nostrils, the beginning is when what is carried is watery, thin, much, and acrid; for these indicate extreme indigestion; but there are already signs of coction when it is thicker, less acrid, and evacuated in small amounts; and if what is called nasal discharge and mucus should come out together, this is already a surer sign of coction; just as indeed if it becomes thicker than this and less, it indicates coction much more.
καὶ οὗτοι μὲν οἱ καιροὶ τῶν νοσημάτων εἰσὶν, ἐξ ὧν οἱ κάμνοντες σώζονται.
And these are the seasons of diseases from which the patients are saved.