§2#2δεύτερον δὲ τεκμήριον ἐκ τῆς τοῦ αἵματος οὐσίας· οὐ γὰρ ὥσπερ πίττα καὶ ῥητίνη καὶ κηρὸς ὑπὸ ψύξεως πέπηγεν, ἀλλ’ ἔστιν ἀεί τε καὶ φύσει θερμότερον.
And the second proof is from the substance of the blood; for it has not coagulated by cooling like pitch, resin, and wax, but is always and by nature warmer.
ἐκείνοις μὲν οὖν θερμαινομένοις εἰς τοὐναντίον ἡ μετάστασις· αἵματι δὲ κατὰ φύσιν ὑπάρχοντι θερμῷ γένοιτο μὲν ὀλίγῳ τινὶ ὁ μείζων ὄγκος, οὐ μὴν ἐπὶ τοσοῦτον, ὅσον ἐξαίρουσιν αἱ φλεγμοναὶ τὰ πάσχοντα μόρια.
Therefore, for those things, when heated, the transition is to the opposite; but for blood, which is naturally hot, a somewhat larger bulk might occur, yet not to such an extent as inflammations raise the affected parts.
καίτοι γε πίττα καὶ ῥητίνη καὶ κηρὸς, εἰς τοσαύτην ἀφικνούμενα θερμασίαν, εἰς ὅσην ἥκει τὰ φλεγμαίνοντα, βραχὺ τοῦ ἐξ ἀρχῆς ἐπαύξεται.
And yet pitch, resin, and wax, even if they reach as great a heat as the inflamed parts have come to, increase only slightly from their original size.
καί σοι καὶ τοῦτό ἐστι τεκμήριον ἕτερον ἐπὶ τοῖς εἰρημένοις οὐ σμικρὸν τοῦ τὸν ὄγκον τῶν φλεγμαινόντων μορίων μὴ διὰ μόνην γίνεσθαι τὴν χύσιν.
And this too is for you another proof of no small weight, in addition to what has been said, that the swelling of the inflamed parts does not occur because of diffusion alone.
ὀλίγη μὲν γάρ ἐστιν ἡ κατὰ θερμασίαν ἀλλοίωσις τοῦ αἵματος, οὐκ ὀλίγῳ δὲ μείζων ὁ ὄγκος.
For the alteration of the blood due to heat is small, but the swelling is not small but larger.
ἱκανὸν δὲ τεκμήριον ἔστω σοι καὶ αὐτὸ τὸ φαινόμενον.
And let the phenomenon itself be a sufficient proof for you.
οὐ γὰρ ὥσπερ ἡ ῥητίνη καὶ ἡ πίττα καὶ ὁ κηρὸς θερμαινόμενα σφοδρότερον ἐπιπλεῖστον ἥκουσι χύσεως, οὕτω καὶ τὸ αἷμα· φυλάττει δὲ, κᾂν ἐπὶ πυρὸς ἕψηται, τὸν ἔμπροσθεν ὄγκον, ἢ οὐδ’ ὅλως ἢ παντάπασιν ἐλάχιστον εἰς μέγεθος ἐξαιρόμενον.
For blood does not act like resin, pitch, and wax, which, when heated more violently, arrive at the greatest diffusion; rather, even if it is boiled over a fire, it preserves its former volume, either not rising in size at all or doing so to an altogether minimal degree.
εἴρηται δέ μοι καὶ πρόσθεν, ὅτι ψυχομέναις ταῖς φλεγμοναῖς οὐκ ἀεὶ καθίστασθαι συμβαίνει.
And it has also been said by me before that when inflammations are cooled, it does not always happen that they subside.
τὴν γὰρ ἀκμάζουσάν τε καὶ μεγάλην, ἐφ’ ἧς ἐσφήνωται τὸ ῥεῦμα, κᾂν ἐπὶ πλέον ψύξῃς, οὐ καθαιρήσεις τὸν ὄγκον, ἀλλὰ πελιδνὸν ἐργάσῃ τὸ μέρος καὶ ψυχρὸν, εἰς σκίῤῥον τε μεταστήσεις τὸ πάθος.
For in the case of a peak and large one, in which the influx has been wedged, even if you cool it further, you will not reduce the swelling, but you will make the part livid and cold, and you will convert the affection into a scirrhus.
εὐκολώτατα δὲ πρὶν μὲν σφηνωθῆναι τὸ ῥεῦμα τοῖς ψύχουσί τε καὶ στύφουσιν ἀναστέλλεται, καὶ μάλισθ’ ὅταν ὀλίγον ᾖ· δυσλύτως δὲ ἔμπροσθεν ἐμπλασθὲν, ὑπὸ μὲν τῶν στυφόντων καὶ ψυχόντων οὐδὲν ὀνίναται, κενωθῆναι δὲ δεῖται.
For before the influx is wedged, it is most easily checked by cooling and astringent means, and especially when it is small; but when it has been blocked beforehand and is difficult to resolve, it benefits nothing from astringents and coolants, but requires to be evacuated.
ἐξεύρηται τοιγαροῦν τηνικαῦτα τοῖς ἰατροῖς οὐ μόνον τοῖς θερμαίνουσι διαφορεῖν, ἀλλὰ καὶ αὐτοῦ τι τοῦ αἵματος αἰσθητῶς ἐκκενοῦν, ἀμυχὰς εἰς τὸ δέρμα ποιούντων.
Therefore, at that time, it has been devised by physicians not only to disperse it by warming agents, but also to evacuate some of the blood itself perceptibly, by making scarifications on the skin.
πάντα ταῦτα οὖν μεγάλα γνωρίσματα τοῦ πεπληρῶσθαι τὸ φλεγμαῖνον αἱματώδους χυμοῦ.
Therefore, all these are great indicators that the inflamed part is filled with bloody humor.
θερμὸν δὲ ἀμέτρως οὐκ εὐθὺς ἐξ ἀρχῆς, ἀλλ’ ἐν τῷ χρόνῳ γίνεται, διὰ τὴν ἔμφραξιν ἁπάντων τῶν πόρων ἰσχομένης τῆς ἀρχαίας ἀναπνοῆς.
And it becomes immoderately hot not immediately from the beginning, but in course of time, because of the obstruction of all the pores, whereby the original respiration is checked.
ἀναγκαῖον οὖν δήπου καὶ σήπεσθαι χρονίζοντι τῷ αἵματι.
Therefore, it is surely necessary that the blood also putrefies when it lingers.
πάντα γὰρ ὅσα θερμὰ καὶ ὑγρὰ σώματα, κατὰ θερμὸν ἀθροιζόμενα τόπον ἑτοίμως σήπεται, μήτε κενούμενα μήτε ἐμψυχόμενα, ὥστε καὶ ἡ ἐκ τῆς σηπεδόνος αὐτοῦ προέρχεται θερμότης, ἐφ’ ᾗ πρόσθεν εἶχεν.
For all bodies that are hot and moist, when accumulated in a hot place, easily putrefy, being neither evacuated nor cooled, so that the heat arising from its putrefaction is superadded to that which it had before.
ὅτι μὲν οὖν ἐν τοῖς ἀγγείοις αἷμα πλεῖον ἤθροισται κατὰ τὰ φλεγμαίνοντα μόρια, τοῖς ὄγκοις αὐτῶν τεκμαρτέον, οὐχ ἥκιστα δὲ καὶ τῷ φαίνεσθαι φλέβας ἐν αὐτοῖς ἀοράτους ἔμπροσθεν οὔσας ὑπὸ σμικρότητος, οὐ γεννηθείσας δήπου κατὰ τὴν φλεγμονὴν, ἀλλ’ ἐκ τοῦ πληρωθῆναι τοῦ αἵματος εἰς μέγεθος ἀρθείσας τοσοῦτον, ὡς αἰσθητὰς γενέσθαι.
Therefore, that more blood has accumulated in the vessels in the inflamed parts must be inferred from their swellings, and not least also from the appearance in them of veins that were previously invisible because of their smallness; which were surely not generated during the inflammation, but, from being filled with blood, were raised to such a size as to become perceptible.
μάλιστα δὲ ἐν ὀφθαλμοῖς φαίνεται τοῦτο συμπῖπτον καὶ πόσθῃ καὶ τιτθοῖς.
And this is seen to happen especially in the eyes, the foreskin, and the breasts.
ὅτι δὲ καὶ ἡ σύμπασα φαίνεται σὰρξ, ἧς ἤδη καὶ μάλιστα πάθος ἐστὶν ἡ φλεγμονὴ, πληροῦσθαι ῥεύματος αἱματώδους, ἥ τε χροιὰ καὶ ὁ ὄγκος αὐτὸς ἐνδείκνυται.
And that the whole flesh, of which inflammation is indeed especially an affection, is seen to be filled with bloody influx, is indicated both by the color and by the swelling itself.
διὰ τοῦτο δὲ καὶ ὑγρὰ πᾶσα καὶ διάβροχος ὥσπερ ἔριον καὶ σπόγγος φαίνεται, καὶ τούτῳ μαρτυροῦσι καὶ οἱ ἐκρέοντες ἰχῶρες, ἐπειδὰν ἔχῃ στόμιον ἡ φλεγμονή.
For this reason also, it all appears moist and soaked like wool and sponge, and to this the escaping ichors also bear witness, whenever the inflammation has an opening.
εἰκότως δὲ, οἶμαι, καὶ τὸ δέρμα σὺν τοῖς ὄγκοις τῶν ὑποκειμένων ἐξαίρεται καὶ περιτείνεται, καὶ τῷ χρόνῳ δὲ δέχεται καὶ αὐτὸ τοῦ ῥεύματος, ὥσπερ καὶ οἱ τῶν ἀγγείων χιτῶνες.
And reasonably, I think, the skin also is raised up and stretched tight along with the swellings of the underlying parts, and in course of time it too receives some of the influx, just like the coats of the vessels.
οὕτω δὲ καὶ οἱ ὑμένες οἱ κατὰ τὸ φλεγμαῖνον μέρος, ἔτι δὲ καὶ τὰ νεῦρα καὶ οἱ τένοντες ἀπολαύουσιν ἐν τῷ χρόνῳ τῆς φλεγμονῆς, ἐνίοτε μέν τοι τρωθέντων αὐτῶν ἢ καὶ ἄλλως παθόντων, ἐξ αὐτῶν ἐκείνων πρῶτον ἄρχεται τὸ κακόν.
And thus also the membranes in the inflamed part, and furthermore the nerves and tendons, partake in course of time of the inflammation, though sometimes when they have been wounded or otherwise affected, the evil begins first from those very things.
ὅλως δὲ οὐδὲν τῷ φλεγμαίνοντι μορίῳ κατὰ φύσιν ἔχον ἀκριβῶς διαμένει χρονιζούσης τῆς φλεγμονῆς, ἀλλὰ συναπολαύει τῇ σαρκὶ πάντα τοῦ ῥεύματος, ὥστ’ ἐνίοτε καὶ τῶν ὀστῶν ἅπτεται, ἐν γοῦν τῷ κατὰ φύσιν ἔχειν χαλαρόν τέ πασχόντων.
On the whole, nothing in the inflamed part remains exactly in a natural state when the inflammation lingers, but all things partake of the influx along with the flesh, so that sometimes it even touches the bones, at least when naturally they are loose as they suffer.
ἐν γοῦν τῷ κατὰ φύσιν ἔχειν χαλαρόν τέ ἐστι τὸ δέρμα τοῖς γε μὴ παχέσιν, ἥ τ’ ἐν τῷ μεταξὺ χώρα κενὴ, καθ’ ἧς ἐπιπέπτωκεν·
At least, when in a natural state, the skin is loose in those who are not fat, and the space in between is empty, over which it has fallen.
ὡσαύτως δὲ καὶ αἱ κατὰ τὴν σάρκα χῶραι, περὶ ὧν ἐπὶ πλέον ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσι λέλεκται, κεναὶ πᾶσαι τυγχάνουσιν οὖσαι, καὶ μάλιστά γε αἱ περὶ τὰς ἀρτηρίας ἐν κύκλῳ ταῖς διαστολαῖς αὐτῶν ἀνακείμεναι·
And likewise, the spaces throughout the flesh, about which more has been said in the Anatomical Procedures, all happen to be empty, and especially those around the arteries in a circle, reserved for their dilations.
κατὰ δὲ τὰς φλεγμονὰς ἅπασαι πληροῦνται τοῦ αἵματος, ἐκ μὲν τῶν ἀγγείων διιδρουμένου κατὰ τοὺς χιτῶνας αὐτῶν, ἐν παντὶ δὲ μορίῳ τῆς σαρκὸς ἀναμιγνυμένου δροσοειδῶς.
But during inflammations, all of them are filled with blood, which transudes from the vessels through their coats, and is mixed in every part of the flesh like dew.