§3Ὅταν δὲ ἐν τῷ χρόνῳ κρατήσῃ μὲν ἡ φύσις, πεφθῇ δὲ σύμπαν τὸ ῥεῦμα, καὶ γένηται πύον, ἐκτὸς ὠθεῖται τῆς σαρκὸς, ὑπὸ τῆς ἐν αὐτῇ δυνάμεως ἀποκριτικῆς τῶν ἀλλοτρίων.
And when in course of time nature prevails, and the whole influx is concocted and becomes pus, it is pushed out of the flesh by the power within it that excretes foreign matters.
ἔνθα μὲν οὖν ἤτοι πόρος ἐστὶ φυσικὸς ἀξιόλογος, οἷον ὀχετός τις ἐκροῆς περιττωμάτων παρεσκευασμένος, ἢ αὐτὸ τὸ χωρίον ἐνταῦθα ἀραιὸν, τοῦ πύου τὸ μέν τι διαπνεῖται, τὸ δὲ αἰσθητῶς ἐκρεῖ·
Therefore, where there is either a notable natural pore, like a sort of channel prepared for the outflow of residues, or the place itself is loose there, some of the pus is transpired and some flows out perceptibly.
ἔνθα δὲ περίκειται τὸ δέρμα πυκνὸν καὶ σκληρὸν, οἷον τὸ ἔξωθεν ἡμῶν ἐστιν, ἴσχεται ἐνταῦθα τὸ πύον, ἀφίστησί τε τῆς ὑποκειμένης αὐτῷ σαρκὸς, εἶτα καὶ διαβιβρώσκει τῇ δριμύτητι καὶ διεξέρχεται πρὸς τοὐκτὸς, εἰ μή τις φθάσῃ σχάσας αὐτό.
But where the skin lies around dense and hard, such as our outer skin is, the pus is retained there, and separates the skin from the underlying flesh, and then also corrodes it by its acridity and passes through to the outside, unless someone anticipates it by incising it.
κρατηθείσης δὲ τῆς φύσεως ὑπὸ τοῦ ῥεύματος, οὐκέτι εἰς πύον, ἀλλ’ εἰς ἀλλόκοτόν τινα μεταβολὴν ἄλλοτε ἀλλοίαν ἀφικνεῖται τὸ αἷμα.
But when nature is overcome by the influx, the blood no longer arrives at pus, but at some strange alteration, different at different times.
καλεῖται δὲ κοινῇ μὲν σύμπαντα τὰ τοιαῦτα πρὸς τῶν πλείστων ἰατρῶν ἀποστήματα, καὶ μάλισθ’ ὅσα διὰ βάθους ἔνδον ἐστίν· ἔνιοι δὲ οὐχ ἅπαντα προσαγορεύειν οὕτω δικαιοῦσιν, ἀλλ’ ἐκεῖνα μόνον, ὅσα τὴν ἀλλοίωσιν εἰς διαφθορὰν ἑτέραν τινὰ, οὐκ εἰς τὸ συνηθές τε καὶ χρηστὸν ἴσχει πύον.
And all such things are commonly called by most physicians abscesses, and especially those that are deep within; but some do not deem it right to address all of them thus, but only those which have their alteration into some other corruption, and not into the usual and good pus.
ὡς τά γε ἐκπυΐσκοντα ἅπαντα τινὲς μὲν ἐμπυήματα προσαγορεύουσιν, ἔνιοι δὲ διαπυήματα, καθάπερ καὶ αὐτὸ ἐκπυΐσκειν, καὶ διαπυΐσκειν· ἔνιοι δὲ οὐχ οὕτως, ἀλλ’ ὅταν ἐν σπλάγχνῳ γένηταί τι τοιοῦτον, ἐκεῖνο μόνον ἐμπύημα προσαγορεύουσι, καὶ τοὺς οὕτω πάσχοντας ἐμπύους· ἄλλοι δ’ αὖ τινες ἰατροὶ μόνους ἐκείνους ὀνομάζειν ἐμπύους δικαιοῦσιν, οἷς ἤθροισται πύον ἐν τῇ μεταξὺ θώρακός τε καὶ πνεύμονος χώρᾳ.
For all those that suppurate are addressed by some as empyemas, and by some as diapyemas, just as they also use the terms "to suppurate" and "to suppurate through." But some do not do so, but when such a thing occurs in a viscus, they address that alone as an empyema, and those so affected as empyic; while some other physicians deem it right to call only those empyic in whom pus has accumulated in the space between the chest and the lung.
τῶν μὲν οὖν ὀνομάτων, ὅπερ ἀεί μοι λέλεκται, φροντίζειν χρὴ τοσοῦτον, ὡς ἑρμηνεύεσθαι σαφῶς τὸ δηλούμενον· αὐτὰ δὲ τὰ πράγματα, περὶ ὧν ὁ λόγος, εὑρίσκειν οὕτως σπουδαστέον, ὡς μηδὲν ἐξ αὐτῶν διαλάθοι.
Therefore, of the names, as has always been said by me, one must care only so much as to have the meaning clearly interpreted; but the things themselves, about which the discourse is, must be so studied to find that nothing of them escapes notice.
σύμπαντα γὰρ ταῦτα παρασκευαστικὰ πρὸς τὴν θεραπευτικήν εἰσι μέθοδον, ἐν ᾗ τὰς διαθέσεις, οὐ τὰς προσηγορίας αὐτῶν ἰώμεθα.
For all these are preparatory to the therapeutic method, in which we cure the dispositions, not their names.
τούτων τοίνυν ἀεὶ μεμνημένους ἐπὶ τὰ λείποντα αὖθις τῶν πραγμάτων ἰτέον.
Remembering these things, then, we must go again to the remaining matters.
§4Ὅταν ἀποδείρῃ τὰ σώματα τὸ πύον, ἀποστήσῃ τε καὶ διαστήσῃ τῶν ὑποκειμένων τὰ περιέχοντα, κᾄπειτα κενωθέντος αὐτοῦ καθ’ ὁντιναοῦν τρόπον, ἀδυνατήσει τὰ διαστάντα τὴν ἀρχαίαν ἀπολαβεῖν κατάστασιν, ὀνομάζεται τὸ πάθος κόλπος.
When the pus strips the bodies, and separates and stands apart the surrounding parts from the underlying ones, and then, after it has been evacuated in whatever way, the separated parts are unable to recover their ancient state, the affection is named sinus.
εἰ δὲ μὴ ταχέως τις αὐτὸν θεραπεύσῃ, τυλοῦται καὶ σκληρὸς γίνεται τῷ χρόνῳ, καὶ οὐχ οἷός τέ ἐστι κολλᾶσθαι τοῖς ὑποκειμένοις αὐτῷ.
And if someone does not cure it quickly, it becomes calloused and hard in course of time, and is unable to glue itself to the underlying parts.
προστέλλεται μέντοι ξηρανθεὶς ὑπό τε φαρμάκων καὶ διαίτης, ὡς δοκεῖν ὑγιὲς ἀμέμπτως ὑπάρχειν τὸ μόριον.
However, when dried by medicines and diet, it contracts so that the part seems to be irreproachably healthy.
εἰ μὲν δὴ διὰ παντὸς ἀκριβῶς τις διαιτώμενος, ὑγιεινὸν ἀληθῶς ἔχει καὶ ἀπέριττον τὸ σῶμα, προσεσταλμένος ὁ κόλπος μένει· περιττώματος δέ τινος ὑποτραφέντος, αὖθις πληροῦται καὶ γίνεται πάλιν ὅ περ ἐξ ἀρχῆς ἦν ἀπόστημα·
If indeed someone, by dieting strictly throughout, keeps his body truly healthy and free from residue, the contracted sinus remains so; but when some residue is secretly nourished, it is filled again and becomes once more the abscess that it was from the beginning.
καὶ αὖθίς γε, δεόντως ἰωμένων, ἐκκενοῦται καὶ ξηραίνεται καὶ προστέλλεται, καὶ ἀεὶ πολὺ ῥᾴονα ἅπαντ’ αὐτῷ γίνεται ταῦτα τῶν ἐξ ἀρχῆς ἀποστάντων.
And again, when they treat it properly, it is evacuated, dried, and contracted, and all these things always become much easier for him than those that separated from the beginning.
οὔτε γὰρ ὀδυνᾶται διασπώμενα τὰ μόρια, διέστηκε γὰρ ἤδη· καὶ πληροῦται τάχιστα, ῥᾳδίως ὑποδεχομένου τοῦ κόλπου τὸ ῥεῦμα· καὶ δὴ καὶ κενοῦται ταχέως, ὡδοποιημένων αὐτῷ τῶν ἐκροῶν, ὡς ὅταν γε κολληθῶσιν αὐτὰ, πάλιν ὀδυνῶνται, ῥηγνυμένου τοῦ ἀποστήματος.
For the parts are not pained when torn apart, for they have already separated; and it is filled very quickly, the sinus easily receiving the influx; and indeed it is evacuated quickly, the outflows having been paved for it, so that when they are glued together, they are pained again as the abscess breaks.
οὐ μόνον δὲ ἐκ φλεγμονῆς ἡ γένεσις τοῖς ἀποστήμασιν, ἀλλὰ καὶ εὐθὺς ἐξ ἀρχῆς ἐνίοτε δι’ ἄλλον χυμὸν ὁντιναοῦν ἀποδέροντα τῷ χρόνῳ καὶ ἀφιστάντα τῶν ὑποκειμένων τὰ περιέχοντα.
And the generation of abscesses is not only from inflammation, but sometimes also straight from the beginning because of any other humor that in course of time strips and separates the surrounding parts from the underlying ones.
καὶ τοίνυν καὶ τμηθέντων, παντοίαν ἰδέαν ὑγρῶν τε καὶ στερεῶν σωμάτων ἐντὸς ἔχοντα φαίνεται.
And indeed, when they are cut, they are seen to have inside every form of liquid and solid bodies.
καὶ γὰρ βορβόρῳ, καὶ οὔρῳ, καὶ θρόμβῳ καὶ χυλῷ μελιτώδει, καὶ μυξώδει, καὶ ὀστοῖς, καὶ λίθοις, καὶ πώροις, ὄνυξί τε καὶ θριξὶν, ἐν ἀποστήμασιν εὑρίσκεται παραπλήσια σώματα, καὶ μὴν καὶ ζῶα πολλάκις εὕρηνται, σχεδὸν ἅπασι τοῖς ἐκ σηπεδόνος ἔχουσι τὴν γένεσιν ὁμοιότατα.
For indeed, bodies resembling mud, urine, clot, honey-like juice, mucus, bones, stones, tuffs, nails, and hairs are found in abscesses, and indeed animals have often been found, most similar to almost all those that have their generation from putrefaction.