§2#2καὶ μετ’ ὀλίγον· οὔτε γὰρ ᾑμοῤῥάγει καλῶς, οὔτε τις ἄλλη τῶν εἰθισμένων ἀπόστασις ἐγένετο κρίσιμος.
and after a little: "For he did not bleed well from the nose, nor did any other of the customary crises occur." And how were those things said?
ἐκεῖνα δὲ πῶς εἴρηται; ἐπάρματα δὲ παρὰ τὰ ὦτα πολλοῖσιν ἑτερόῤῥοπα ἦν, καὶ ἐξ ἀμφοτέρων τοῖσι πλείστοισιν, ἀπύροισιν ὀρθοστάδην, ἔστι δ’ οἷς καὶ σμικρὰ ἐπεθερμαίνοντο, κατέσβη πᾶσιν ἀσινέως, οὐδ’ ἐξεπύησεν οὐδενὶ, ὥσπερ τὰ ἐξ ἄλλων προφάσεων. ὄντως γὰρ παράλογον, μηδὲν ἐκπυῆσαι, καὶ οὐκ εἰθισμένα πάντως.
"Swellings near the ears were in many cases one-sided, and in most cases on both sides, in those who were free from fever and walking about, but in some they warmed up a little, they subsided in all without harm, nor did they suppurate in anyone, as those from other causes do." For indeed it is contrary to expectation that none suppurated, and altogether unusual.
εἶτ’ ἐπιφέρει, ἦν δ’ ὁ τρόπος αὐτέων, χαῦνα, μεγάλα, κεχυμένα, οὐ μετὰ φλεγμονῆς· παράλογον γὰρ χωρὶς φλεγμονῆς ἅπασι γενέσθαι τὰς περὶ τὰ ὦτα ἀποστάσεις.
Then he adds: "and their nature was: soft, large, diffused, not with inflammation"; for it is contrary to expectation that the abscesses around the ears should occur in all without inflammation.
ὥστε φέρειν πάλιν κᾀνταῦθα τὸ κῶμα φαίνεται ἐπὶ καταφορᾶς τῆς ὑπνώδους, ὅταν λέγῃ· ἦν δὲ τὸ κῶμα συνεχὲς, οὐχ ὑπνῶδες· ὡς γὰρ ὑπνῶδες εἶναι δέον αὐτὸ, καὶ ὡς τοιοῦτο ἀεὶ γιγνόμενον, εἶτα νῦν παραλόγως οὐ γιγνόμενον, ἐπισημαίνεται.
So that here too he appears to apply "coma" to the sleepy sinking-into-sleep (kataphora) when he says: "And the coma was continuous, not sleepy"; for he notes it as something which ought to be sleepy, and which always occurs as such, but now contrary to expectation does not occur so.
τὸ δ’, ὅταν ἐν τῷ αὐτῷ βιβλίῳ τῷ τρίτῳ τῶν ἐπιδημιῶν ἐπὶ τοῦ Πυθίωνος εἴπῃ, ἐννάτῃ κωματώδης, ἀσώδης, ὅτε διεγείροιτο· σαφῶς γὰρ κᾀνταῦθα τὸ κῶμα καταφοράν τινα δηλοῦν ἔοικεν.
And when, in the same third book of Epidemics, in the case of Pythion, he says: "on the ninth day comatose, nauseous when he was awakened"; for clearly here too "coma" seems to indicate a certain sinking-into-sleep.
ἀλλ’ οὐχ οἷόν τέ φασιν ἅμα καταφέρεσθαι καὶ ἀγρυπνεῖν. ταῦτα γὰρ οἱ θαυμαστοὶ λέγουσιν ἐξηγηταὶ, μὴ γιγνώσκοντες, ὅτι δύο εἰσὶν εἴδη καταφορᾶς, ὡς οἵ τε δοκιμώτατοι τῶν ἰατρῶν γεγράφασι καὶ αὐτὰ τὰ γιγνόμενα μαρτυρεῖ.
"But," they say, "it is not possible to sink into sleep and to be sleepless at the same time." For these wonderful commentators say these things, not knowing that there are two kinds of sinking-into-sleep, as both the most esteemed of physicians have written and the phenomena themselves testify.
κοινὸν μὲν γὰρ ἀμφοτέρων ἐστὶν, ὅτι ἐπαίρειν οὐ δύνανται τοὺς ὀφθαλμοὺς, ἀλλ’ εὐθέως βαρύνονται καὶ ὑπνοῦν βούλονται· ἴδιον δὲ θατέρας, ὅτι οἱ μὲν ὑπνοῦσιν εὐθέως, βαθέως τε καὶ χρόνον πολύν· οἱ δὲ ἄγρυπνοι στρεφόμενοί εἰσιν, ἄλλης ἐπ’ ἄλλῃ φαντασίας ἐπιγινομένης, καὶ τὴν γνώμην κινούσης, καὶ τὸν ὕπνον διακοπτούσης, ὅθεν ἀεὶ μὲν ἄγρυπνοι μένουσιν, ἀνίστασθαι δὲ ἀδυνατοῦσι καὶ πράττειν τὰ τῶν ἐγρηγορότων, ἀλλ’ ἐλλιπέστερον ἔχουσιν, ἢ ὡσανεὶ ἐγρηγόρουν, καὶ βαρύνονται καὶ καταφέρονται, ὥστ’ ἐλπίσεις, ἂν συγχωροίης αὐτοῖς, ῥᾳδίως ἂν κατακοιμηθῆναι, συγχωρηθέντος δ’ αὐτοῖς τούτου, οὐχ ὅπως ὑπνοῦσιν, ἀλλ’ οὐδ’ ἣν εἶχον ἐλπίδα, ὡς ὑπνώσοντες, φυλάττουσιν.
For common to both is that they cannot lift their eyes, but are immediately weighed down and wish to sleep; but peculiar to the one kind is that they fall asleep immediately, deeply and for a long time; while those of the other kind remain sleepless and tossing, as one phantom after another arises, moving their mind and interrupting their sleep, whence they always remain sleepless, yet are unable to get up and do the things of those who are awake, but are in a weaker state than if they were awake, and are weighed down and sink into sleep, so that you would expect, if you allowed them, they would easily fall asleep, but when this is allowed to them, far from sleeping, they do not even preserve the hope they had of sleeping.
ἐνταῦθ’ οὖν νόει μοι κῶμα, ὡς κοινὸν ἀμφοτέρων, ὅπερ δὴ καλεῖν ἔθος ἡμῖν καταφοράν· ἂν δὲ τὴν ὑπνώδη μόνην νοήσῃς, ἁμαρτήσεις, τὴν γὰρ οὐχ ὑπνώδη καταφορὰν στερήσεις ὀνόματος, οὐχ ἧττον τῆς ἑτέρας δεομένην τῆς τοῦ κώματος ἐπωνυμίας.
In this context, therefore, understand "coma" as common to both, which indeed we are accustomed to call sinking-into-sleep; and if you understand only the sleepy kind, you will err, for you will deprive the non-sleepy sinking-into-sleep of a name, which has no less need of the appellation of "coma" than the other.
ἄν τε μὲν οὖν ὑπνώδης ἄν τε ἄγρυπνος εἴη καταφορὰ, κῶμα καλεῖν ἔθος ἐστὶν αὐτῷ· καὶ οὐδαμῶς γε ἀλλήλοις μάχεται τὰ κατὰ μέρος, ἀλλ’ εὐλόγως ὁτὲ μὲν ἐν ταῖς σμικραῖς ἀγρυπνίαις εὑρίσκεται τὸ κῶμα, ὁτὲ δ’ ἐν τῷ ὕπνῳ.
Whether, therefore, the sinking-into-sleep be sleepy or sleepless, it is his custom to call it "coma"; and the individual statements in no way conflict with one another, but reasonably the coma is found sometimes in slight sleeplessness, and sometimes in sleep.
καὶ γὰρ ἡ καταφορὰ ὁτὲ μὲν ὑπνώδης ἐστὶν, ὁτὲ δὲ ἄγρυπνος, ὥστε οὐκ ἔχεις εἰπεῖν περὶ τῶν καταφερομένων, ὅτι ἀγρυπνοῦσιν ἢ μή· τοσοῦτόν γε μὴν διαφέρουσιν, ὅσον οἱ μὲν πλείους αὐτῶν ὑπνοῦσιν, ὀλίγοι δὲ τῶν οὕτως ἐχόντων ἄγρυπνοι μένουσιν, ὅθεν καίτοι ἀμφοτέρων τυγχάνον τὸ πάθος, οἰκειότερον μέντοι πολλῷ τῶν ὑπνούντων εὑρίσκεται.
For indeed the sinking-into-sleep is sometimes sleepy, and sometimes sleepless, so that you cannot say of those sinking into sleep whether they are sleepless or not; yet they differ so much, in that the majority of them sleep, and only a few of those in this state remain sleepless, whence, although the condition belongs to both, it is nevertheless found to be much more proper to those who sleep.
διὰ τοῦτο μὲν οὖν φησιν, ἦν δὲ τὸ κῶμα συνεχὲς, οὐχ ὑπνῶδες, ὡς ἂν ἐπὶ τὸ πολὺ ὑπνώδους γιγνομένου.
For this reason, therefore, he says: "and the coma was continuous, not sleepy", as it occurs for the most part sleepy.
ἂν τοίνυν κοινόν ἐστιν ἀμφοτέρων τὸ κῶμα καὶ τοῦ ὕπνου οἰκειότερον, εὐλόγως, ὅταν βούληται τὴν ὑπνώδη σημαίνειν καταφορὰν, ἁπλῶς φάσκει κωματώδεις· ὅταν δὲ πάλιν τὴν ἄγρυπνον, οὐχ ἁπλῶς, ἀλλὰ μετὰ προσθήκης φησὶ κωματώδεις ἀγρύπνους.
If, then, the coma is common to both and more proper to sleep, reasonably, whenever he wishes to signify the sleepy sinking-into-sleep, he simply says "comatose"; and when, on the other hand, he wishes to signify the sleepless kind, he does not say it simply, but with an addition, "comatose, sleepless".
οἶδε γὰρ ἀμφότερα, ὅτι τε οἰκειότερόν ἐστι τῷ ὕπνῳ τὸ κῶμα καὶ τῇ αὐτοῦ φύσει μᾶλλον ὡμοίωται, καὶ ὅτι μετ’ ἀγρυπνίας ἔστιν ὅτε συνίσταται.
For he knows both: that the coma is more proper to sleep and is more like its nature, and that it sometimes occurs with sleeplessness.
κᾂν μὲν τοῦθ’ οὕτως ἔχῃ, θαυμαστὸν οὐδὲν, εἰ μὴ μόνον τοῖς ληθαργικοῖς, ἀλλὰ καὶ τοῖς φρενιτικοῖς συμπίπτῃ.
And if this is so, it is nothing wonderful if it should happen not only to the lethargic, but also to the phrenetic.
τὸ δ’ οὐχ ὑπνῶδες κῶμα τούτοις μὲν οὐκ ἔστιν ἴδιον, γίνεται δ’ ἐνίοτε.
And the non-sleepy coma is not peculiar to the latter, but it occurs sometimes.
εὑρήσεις γὰρ πολλοὺς φρενιτικοὺς οὔτε ἀνισταμένους οὔτε ἐπαίρειν τοὺς ὀφθαλμοὺς ὅλως δυναμένους, ἀλλ’ ἐπὶ τοῦ αὐτοῦ μένοντας ὁμοίους τοῖς ληθαργικοῖς, ὥστε τούτους οἱ πολλοὶ καὶ ἀπαίδευτοι τῶν ἰατρῶν, οὔτε τί δεῖ καλεῖν οἴδασιν, ἀλλὰ παντάπασιν ἀποροῦσι, καὶ ἀλλότριον δοκεῖ αὐτοῖς εἶναι τοῦτο τὸ πάθος καὶ ἀνώνυμον, ἔνιοι δὲ σύμμικτόν ἐκ ληθάργου τε καὶ φρενίτιδος ὑπολαμβάνουσι, καὶ προσαγορεύουσι τυφομανίαν.
For you will find many phrenetics who neither get up nor are able to lift their eyes at all, but remain in the same state, like the lethargic, so that the majority of uneducated physicians do not know what they ought to call them, but are completely at a loss, and this condition seems to them to be foreign and nameless, while some suppose it to be a mixture of lethargy and phrenitis, and address it as "typhomania".
καὶ τὸ κάκιστον πάντων, τινὲς τῶν Ἱπποκρατείων εἶναι προσποιουμένων τοῦτό φασι, καίτοι δήπου σαφῶς οὕτω καὶ φανερῶς γράφοντος Ἱπποκράτους, οὐκ ἐν ἀμφιδόξῳ βιβλίῳ, ἀλλ’ εἴπερ τις ἄλλος τῶν γνησίων εἶναι πεπιστευμένῳ τῷ τρίτῳ τῶν ἐπιδημιῶν, οὔτ’ ἐξεμάνη τῶν φρενιτικῶν οὐδεὶς, ὥσπερ ἐπ’ ἄλλοισιν, ἀλλ’ ἄλλῃ τινὶ καταφορῇ νωθρῇ βαρέως ἀπώλλυντο. οὐ μόνον γὰρ ὅτι καταφορὰ ταῖς φρενίτισιν ἐνίοτε συμπίπτει διήγγειλεν, ἀλλ’ ὅτι καὶ νωθρὰ πολλάκις.
And the worst of all, some of those who pretend to be Hippocratics say this, although Hippocrates indeed writes so clearly and manifestly, not in a doubtful book, but in the third book of Epidemics, which is believed to be genuine if any other is, "none of the phrenetics went violently mad, as in other cases, but they perished heavily with a certain other dull sinking-into-sleep." For he reported not only that sinking-into-sleep sometimes happens in phrenitis, but also that it is often dull.
τίς δ’ ἡ νωθρά;
And what is the dull kind?
μεμνήσῃ πρῶτον μὲν τῆς διαιρέσεως, ἂν μὴ μέλλῃς τὰ παρόντα παρακούειν, ὅταν καταφορὰν τὴν μὲν ὑπνώδη, τὴν δὲ ἄγρυπνον ἐκάλουν, καὶ τὴν μὲν ὑπνώδη ἰδίαν εἶναι τῶν ληθαργικῶν καὶ διαπαντὸς ὑπάρχειν αὐτοῖς, τὴν δὲ οὔτε ἰδίαν εἶναι τῶν φρενιτικῶν οὔτε ὑπάρχειν αὐτοῖς διαπαντός.
You will remember first of all the division, if you are not going to misunderstand the present matters, when they called one kind of sinking-into-sleep "sleepy" and the other "sleepless", and that the sleepy is proper to the lethargic and always present in them, while the other is neither proper to the phrenetic nor always present in them.