§2#1Λέγεσθαι δὲ εἴθισται τοῖς Ἕλλησι τοὔνομα τοῦτο κατὰ τῶν ἐν ὄγκῳ μείζονι μορίων σαρκωδῶν, ἅμα τάσει καὶ ἀντιτυπίᾳ καὶ ὀδύνῃ σφυγματώδει καὶ θερμῇ καὶ μετ’ ἐρυθήματος·
Among the Greeks, this name (inflammation) is customarily used for fleshy parts that are in a larger swelling, accompanied by tension, resistance, throbbing and hot pain, and redness.
ἥτις δ’ ἐστὶν ἡ αἰτία, δι’ ἣν ταῦτα ἐγένετο τὰ συμπτώματα, μὴ ὅτι τοῖς πολλοῖς, ἀλλ’ οὐδ’ αὐτοῖς τοῖς ἰατροῖς ἔγνωσται πᾶσιν.
But what the cause is, through which these symptoms arose, is not known, not to mention the multitude, but not even to all the physicians themselves.
οὐδὲ γὰρ ὁδῷ τινι ποιοῦνται τὴν ζήτησιν οἱ πλείους αὐτῶν, ἀλλὰ τὸ δόξαν αὐτοῖς ἁπλῶς ἀποφαίνονται.
For most of them do not conduct their inquiry in any systematic way, but simply declare what seems good to them.
γίγνοιτο δ’ ἂν ἡ σκέψις, εἴπερ τις ὁδῷ προέρχοιτο, τοιαδί.
The examination would proceed, if someone were to advance in a systematic way, as follows.
μείζων ὄγκος οὐκ ἄν ποτε γένοιτο περὶ σῶμα οὐδὲν ἄνευ τοῦ τὴν οὐσίαν αὐτοῦ δυοῖν τούτων παθεῖν θάτερον, ἢ ὑπὸ θερμότητος πολλῆς οἷον περιζέσασαν χυθῆναι, ἢ ἔξωθέν τινα νεωτέραν οὐσίαν ἐπικτήσασθαι.
A larger swelling would never occur around any body without its substance suffering one of these two things: either being as it were boiled up by great heat and diffused, or acquiring some newer substance from without.
χεομένη μὲν γὰρ πνευματοῦται καὶ ψυχθεῖσά γε αὕτη τὸν ἀρχαῖον ὄγκον ἀνακτᾶται ῥᾳδίως.
For when it is diffused, it becomes aerated, and when cooled, this easily recovers its ancient bulk.
οὔτε δὲ πνεῦμα περιεχόμενον ἐν τοῖς φλεγμαίνουσιν ὁρᾶται, καθάπερ ἐν ἄλλοις ὄγκοις πολλοῖς, καὶ ψυχόμενα πρὸς τὴν ἐξ ἀρχῆς κατάστασιν οὔτ’ εὐθὺς οὔτ’ ἐξ ἅπαντος ἐπανέρχεται.
But neither is pneuma seen contained in those parts that are inflamed, as in many other swellings, nor, when cooled, do they return to their original condition either immediately or entirely.
ὅτι δ’ οὐ περιέχεται πνεῦμα, δῆλον ἐκ τῆς τομῆς.
And that pneuma is not contained is clear from incision.
φαίνεται γὰρ εἰ τμηθείη τὸ φλεγμαῖνον, αἷμα μὲν ἐκχεόμενον πάμπολυ καὶ τὸ χωρίον ὅλον ἐναργῶς αἵματος μεστὸν, ὥσπερ οἱ διάβροχοι σπόγχοι, πνεῦμα δὲ οὔτ’ εὐθὺς ἐκπῖπτον οὔτ’ αὖθις.
For if the inflamed part is incised, blood is seen pouring out in great abundance and the whole place is clearly full of blood, like soaked sponges, but pneuma does not escape either immediately or afterwards.
ἀλλὰ καὶ ἡ χροιὰ μόνη τοῦ αἵματος οἰκεία τε ἅμα καὶ ἀχώριστος.
Indeed, the color alone is both peculiar to blood and inseparable from it.
οὐδὲ γὰρ ἄλλο τῶν ἐν τῷ σώματι μορίων ἢ χυμῶν ἐρυθρὸν, πλὴν σαρκός τε καὶ αἵματος.
For no other of the parts or humors in the body is red, except flesh and blood.
ἀλλ’ οὔτε πολυσαρκία ἐστὶ τὸ πάθημα τῆς φλεγμονῆς, καὶ εἴπερ συσταίη ποτὲ πολυσαρκία κατὰ τὸ σῶμα μόνη, χωρὶς αἵματος πλήθους, ὁ μὲν ὄγκος μείζων γίνεται τοῦ κατὰ φύσιν, ἡ χροιὰ δὲ ἐν ὅροις ὑγιεινοῖς διαμένει, μηδὲν τῆς ἀρχαίας ἐξαλλάττουσα φύσεως.
But the affection of inflammation is not excess of flesh (polysarkia), and even if an excess of flesh alone should ever form in the body, without an abundance of blood, the bulk indeed becomes larger than natural, but the color remains within healthy limits, altering nothing of its original nature.
οὐδενὶ γὰρ αὐξανομένῳ κατὰ τὴν οὐσίαν ἐπιτείνεται τὸ πρόσθεν χρῶμα.
For in nothing that increases in substance is its former color intensified.
οὕτω γὰρ ἂν ἥ τε χιὼν ἐγίνετο λευκοτέρα καὶ ἡ πίττα μελαντέρα καὶ ὁ χρυσὸς ξανθότερος.
For in this way snow would become whiter, pitch blacker, and gold yellower.
ἕτερον οὖν ἐστι προφανῶς αὔξησις οὐσίας ἀλλοιώσεως.
Therefore, increase of substance is clearly different from alteration.
αὐξάνεται μὲν γὰρ κατὰ τὸ ποσὸν, ἀλλοιοῦται δὲ κατὰ τὸ ποιόν.
For it increases in quantity, but is altered in quality.
ἔστι δέ που καὶ τὸ χρῶμα ποιᾶς οὐσίας, οὐ ποσῆς γνώρισμα.
And color, presumably, is an indicator of qualitative substance, not of quantitative substance.
διὰ ταῦτα μὲν οὖν πολυσαρκία ἕτερον φλεγμονῆς, δι’ αὐτὰ δὲ ταῦτα πλεονάζειν ἄν τις ἐν αὐτῇ τὸν τοῦ αἵματος ὑπολάβοι χυμόν.
Therefore, for these reasons, excess of flesh is different from inflammation, and for these very reasons, one would suppose that the humor of blood superabounds in it.
ἀλλὰ καὶ μεθ’ ἑλκῶν ἐνίοτε μέγισται γίνονται φλεγμοναὶ, καὶ φαίνεταί τις ἐκρέων ἰχὼρ ὑδατώδης λεπτὸς, αἱματώδους φαινομένου τοῦ πέριξ χωρίου.
But also, sometimes very great inflammations occur with ulcers, and a certain thin, watery ichor is seen flowing out, while the surrounding area appears bloody.
ἀναγκαῖον οὖν ἐν τῷδε τὴν πύκνωσιν τῆς σαρκὸς, ἣν ἐν τοῖς κατὰ τὸ τραῦμα πέρασιν ἑαυτῇ ἐπεκτήσατο, συμμετρίας εἰς τοσοῦτον ἥκειν, ὡς διεκπίπτειν ἐπιτρέπουσαν τοῖς ἰχῶρσιν, ἐναποστέγειν δ’ ἔνδον ἑαυτῆς τὸ αἷμα.
Therefore, in this case, it is necessary that the condensation of the flesh, which it acquired for itself at the limits of the wound, has come to such a proportion as to permit the ichors to escape, but to shut up the blood within itself.
καὶ μὴν ὅσον αἵματος ἰχὼρ λεπτομερέστερός ἐστι, τοσοῦτον ἢ καὶ πλέον ἔτι παχυμερέστερος ὑπάρχει πνεύματος.
And indeed, by as much as ichor is finer-particled than blood, by so much or even more it is coarser-particled than pneuma.
ὥστε εἴπερ ἡ κατὰ τὸ τραῦμα σὰρξ ἐπιτρέπει ἐκπίπτειν τοῖς ἰχῶρσιν, ἐπέτρεπεν ἂν δήπου τῷ πνεύματι.
So that if the flesh at the wound permits the ichors to escape, it would surely permit the pneuma.
κενωθέντος δὲ ἅπαξ αὐτοῦ, καθίστατο ἂν εὐθέως καὶ ὁ τῆς φλεγμονῆς ὄγκος.
And once it was emptied, the swelling of the inflammation would also immediately subside.
ἀμέλει καὶ φαίνεται γιγνόμενον οὕτως ἐν οἷς ἂν μορίοις ὄντως ἀθροισθῇ τὸ πνεῦμα.
Undoubtedly, it is seen to happen thus in whatever parts pneuma is truly accumulated.
τμηθέντων γὰρ αὐτῶν αὐτίκα συστέλλεται πᾶς ὄγκος.
For when they are incised, all the swelling immediately contracts.
ἀλλὰ καὶ ἡ γένεσις αὐτῆς τῆς ἐπὶ τραύμασι γενομένης φλεγμονῆς μαρτυρεῖ.
But also the generation of the inflammation itself that occurs upon wounds bears witness.
ἐν ἀρχῇ μὲν γὰρ ἔτι νεοτρώτων ὄντων ἐκπίπτει πλῆθος αἵματος· ἴσχεται δ’ αὖθις ἤτοι ψυξάντων ἡμῶν, ἢ αὐτομάτως ὑπὸ τοῦ περιέχοντος ψυχθέν.
For in the beginning, while they are still freshly wounded, an abundance of blood flows out; and is checked again, either when we cool it, or when it is cooled spontaneously by the surrounding environment.
ἀλλὰ καὶ πιλησάντων ἡμῶν ταῖς χερσὶν ἢ ἐπιδησάντων, ἴσχεται κωλυόμενον ἐκρεῖν.
But also when we compress it with our hands or bind it, it is checked, being prevented from flowing out.
εἶτ’ ἐν τοῖς στόμασι τῶν διῃρημένων ἀγγείων ἰσχόμενόν τε καὶ φραττόμενον πιλοῦταί τε καὶ πήγνυται, παραπλήσιόν τι πάσχον θρόμβῳ, πλὴν ὅτι θρόμβος μὲν ἀθρόα τοῦ αἵματός ἐστι πῆξις αἰσθητὴ, τὸ δ’ ἐπὶ τῶν ἑλκῶν γιγνόμενον οὐκέτ’ ἀθρόως, ἀλλὰ κατὰ σμικρὰ καὶ πολλὰ πέρατα τῶν διῃρημένων ἀγγείων ἵστησι καὶ παχύνει τὸ αἷμα.
Then, being checked and blocked in the mouths of the divided vessels, it is compressed and coagulated, suffering something very similar to a clot, except that while a clot is a sudden, sensible coagulation of blood, that which happens in ulcers does not do so suddenly, but stops and thickens the blood at many small limits of the divided vessels.
ὅταν οὖν ἅμα μὲν τοῦτο παχύτερον, ἅμα δὲ τῶν ἀγγείων τὸ πέρας γένηται στενότερον, ἴσχεται μὲν ἤδη τὸ αἷμα, διεκπίπτουσι δὲ ἰχῶρες.
Therefore, when this becomes thicker, and at the same time the limit of the vessels becomes narrower, the blood is already checked, but the ichors escape.
ταῦτα πάντα τεκμήρια μέγιστα τοῦ πληθύνειν ἐν τοῖς φλεγμαίνουσι μορίοις τὸ αἷμα.
All these are the greatest proofs that blood superabounds in the inflamed parts.
θερμότερον μὲν οὖν ἐστι τοῦ κατὰ φύσιν ἐν τοῖς οὕτω διακειμένοις, οὐ μὴν τοσοῦτον θερμότερον, ὡς μόνῃ τῇ χύσει τηλικοῦτον ἐργάσασθαι τὸν ὄγκον.
Therefore, it is hotter than natural in those so disposed, yet not so much hotter as to produce by diffusion alone a bulk of such size.
πολλὰ δ’ ἂν εἴη σοι καὶ τὰ τοῦδε τεκμήρια.
And there would be many proofs of this for you.
πρῶτον μὲν οἱ διακαέστατοι τῶν πυρετῶν· ὅσον γὰρ ἐπὶ τούτων ἡ θερμασία σφοδροτέρα τῆς κατὰ τὰ φλεγμαίνοντα μόριά ἐστι, τοσοῦτον τὸν ὄγκον ἐχρῆν εἶναι μείζονα.
First, indeed, the most burning of fevers; for by as much as the heat in these is more violent than that in the inflamed parts, by so much ought the bulk to be larger.