§5Ἔστι δὲ καὶ ἡ σύριγξ ὀνομαζομένη στενὸς καὶ προμήκης κόλπος, ὁμοίως τοῖς ἄλλοις κόλποις προστελλομένη τε καὶ αὖθις ἀφισταμένη δι’ ἐπιῤῥοὴν περιττωμάτων, ὥσπερ ἐκεῖνοι.
And what is called a fistula is also a narrow and elongated sinus, contracting and again separating because of the influx of residues, just like those other sinuses, just as they do.
ἀθερώματα δὲ καὶ στεατώματα καὶ μελικηρίδας, ὅσα τε ἄλλα τοιαῦτα, τινὲς μὲν ἐν τοῖς ἀποστήμασι τίθενται, τινὲς δὲ εἰς ἕτερον γένος.
Some place atheromas, steatomas, melicerises, and all other such things among abscesses, while others place them in another class.
εὔδηλος δὲ καὶ ἡ τούτων φύσις ἐκ τῶν ὀνομάτων.
The nature of these is also very clear from their names.
ἀθέρᾳ μὲν γάρ τι παραπλήσιον ἐν τοῖς ἀθερώμασιν εὑρίσκεται· μέλιτι δὲ ἐν τοῖς μελικηρίσι· στέατι δὲ ἐν τοῖς στεατώμασιν.
For something resembling gruel is found in atheromas, honey in melicerises, and tallow in steatomas.
ὡς τὸ πολὺ δὲ χιτών τις ὑμενώδης ἅπαντα τὰ τοιαῦτα περιέχει.
And for the most part, a membranous tunic surrounds all such things.
ταῦτά τε οὖν ἅπαντα παρὰ φύσιν ὄγκοι, καὶ πρὸς τούτοις ἄνθρακες, καὶ γάγγραιναι, καὶ ἕρπητες, ἐρυσιπέλατά τε καὶ σκίῤῥοι, καὶ οἰδήματα, καὶ καρκῖνοι, καὶ πνευματώσεις, ὑπὲρ ὧν οὐδ’ αὐτῶν ἀγνοεῖν χρὴ τὸν ἰατρὸν, ἀλλ’ ἀκριβῶς ἐπισκέπτεσθαι τήν τε γένεσιν ἑκάστου καὶ τὴν οὐσίαν.
All these, then, are tumors contrary to nature, and in addition to them, carbuncles, gangrenes, herpes, erysipelas, scirrhous tumors, edemas, cancers, and flatulent swellings, about which also the physician must not be ignorant, but must study accurately the generation and essence of each.
§6Αἱ μὲν δὴ γάγγραιναι καὶ οἱ ἄνθρακες, ἐπειδὰν οἷον ζέσαν τὸ αἷμα ἐγγύς τε τῆς φλεγμονῆς διακαύσῃ τὸ δέρμα.
Now, gangrenes and carbuncles [occur] when the blood, as if boiling, thoroughly burns the skin near the inflammation.
ταῦτ’ ἄρα καὶ σὺν ἐσχάρᾳ γίγνονται, καὶ φλύκταιναι προηγοῦνται τοῦ ἕλκους, ὥσπερ ἐν τοῖς πυρικαύστοις, ὀξύτατόν τε πυρετὸν ἐπιφέρουσι, καὶ κίνδυνον ὑπόγυιον ἀμφὶ τῇ ζωῇ.
Therefore, they also occur with an eschar, and blisters precede the ulcer, just as in burns, and they bring on a very acute fever and an imminent danger to life.
μέλαινα δὲ τοὐπίπαν καὶ τεφρώδης ἡ ἐσχάρα φαίνεται τοῦ τῶν ἀνθράκων ἕλκους, οὐ μὴν οὐδ’ ἡ χροιὰ τῆς πέριξ φλεγμονῆς ὁμοίως ταῖς ἄλλαις ἐρυθρά ἐστιν, ἀλλ’ ἐπὶ τὸ μελάντερον ῥέπει, τρόπον ἕτερον τῶν ἐκχυμωθέντων, ἢ ὑπὸ κρύους καταψυχθέντων· οὐ σφοδρῶς γὰρ πελιδνὸς, ὥσπερ ἐπ’ ἐκείνοις ὁ ὄγκος, ἀλλ’ ἔχει τι καὶ στίλβον, οἷον ἡ ἄσφαλτός τε καὶ ἡ πίττα.
And the eschar of the ulcer of carbuncles appears for the most part black and ash-colored; indeed, nor is the color of the surrounding inflammation red like the others, but it inclines toward blacker, in a different manner from parts bruised or chilled by cold; for the swelling is not intensely livid, as in those cases, but has also something shining, like asphalt and pitch.
τοιαύτη δέ ἐστι καὶ ἀκριβὴς μέλαινα χολή.
And such also is pure black bile.
καὶ τοίνυν καὶ ἡ κακοήθεια τῶν ἐν τοῖς ἄνθραξιν ἑλκῶν ἐντεῦθέν ἐστιν.
And indeed, the malignancy of the ulcers in carbuncles is from this source.
ἔοικε γὰρ ἤτοι γε ἐξ ἀρχῆς εὐθέως, ἢ ὑπεροπτώμενον ἐν τῇ ζέσει τὸ αἷμα μελαγχολικὸν γίνεσθαι.
For the blood seems either straight from the beginning, or by being over-roasted in the boiling, to become melancholic.
§7Χωρὶς δὲ τοῦ ζεῖν ἡ μέλαινα χολὴ τοὺς καρκίνους ἐργάζεται, καὶ ἢν δριμυτέρα τύχῃ, μεθ’ ἕλκους.
But without boiling, black bile produces cancers, and if it happens to be more acrid, with an ulcer.
ταῦτ’ ἄρα καὶ μελάντεροι τῇ χροιᾷ τῶν φλεγμαινόντων εἰσὶ, καὶ ἥκιστα θερμοί.
Therefore, they are also blacker in color than those that are inflamed, and least hot.
πληροῦνται δὲ αἱ φλεβὲς ἐπ’ αὐτῶν καὶ τείνονται μᾶλλον ἢ ἐν ταῖς φλεγμοναῖς.
And the veins on them are filled and stretched more than in inflammations.
ἧττον γὰρ ἐκπίπτει τῶν ἀγγείων εἰς τὴν πέριξ σάρκα διὰ πάχος ὁ γεννῶν τοὺς καρκίνους χυμός.
For the humor that generates cancers, because of its thickness, falls less out of the vessels into the surrounding flesh.
οὐ μὴν οὐδὲ ἐρυθραὶ καθάπερ ἐν ταῖς φλεγμοναῖς αἱ φλέβες εἰσὶν, ἀλλὰ καὶ αὐταὶ κατὰ τὸν λυποῦντα χυμόν.
Indeed, nor are the veins red as in inflammations, but they too are according to the offending humor.
§8Ἕπεται δὲ ταῖς μεγάλαις φλεγμοναῖς ἡ καλουμένη γάγγραινα, νέκρωσίς τε οὖσα τοῦ πάσχοντος μορίου.
And what is called gangrene follows great inflammations, being a mortification of the affected part.
κᾂν μὴ διὰ ταχέων τις αὐτὴν ἰάσηται, νεκροῦται ῥᾳδίως τὸ παθὸν οὕτω μόριον, ἐπιλαμβάνει τε τὰ συνεχῆ καὶ ἀποκτείνει τὸν ἄνθρωπον.
And unless someone cures it quickly, the part thus affected is easily mortified, and seizes the contiguous parts and kills the human.
ἐπειδὰν γὰρ ἰσχυρῶς φραχθῇ κατὰ τὰς μεγίστας φλεγμονὰς τά τε στόματα τῶν ἀγγείων, οἵ τε πόροι πάντες οἱ κατὰ τὸ δέρμα τῆς κατὰ φύσιν ἀποστερούμενοι διαπνοῆς, τὰ οὕτω κάμνοντα σώματα νεκροῦνται ῥᾳδίως.
For when, during the greatest inflammations, the mouths of the vessels and all the pores in the skin are strongly obstructed, being deprived of their natural transpiration, the bodies thus suffering are easily mortified.
καὶ πρῶτον μὲν αὐτῶν ἀποσβέννυται τὸ τῆς χρόας εὐανθὲς, ὃ συνῆν ταῖς φλεγμοναῖς· ἔπειθ’ ἡ ὀδύνη καὶ ὁ σφυγμὸς οἴχονται, οὐ πεπαυμένης δή που τῆς διαθέσεως, ἀλλὰ τῆς αἰσθήσεως νενεκρωμένης.
And first, the florid color of their skin, which accompanied the inflammations, is extinguished; then the pain and the pulsation depart, not because the disposition has ceased, of course, but because sensation has been mortified.
ἀχώριστος δὲ φλεγμονῆς μεγάλης ὁ σφυγμός.
And pulsation is inseparable from a great inflammation.
οὕτω δὲ ἐοίκασιν ὀνομάζειν οἱ παλαιοὶ τὴν αἰσθητὴν κίνησιν αὐτῷ τῷ κάμνοντι τῶν ἀρτηριῶν, εἴτε χωρὶς ὀδύνης, εἴτε καὶ σὺν ταύτῃ γίγνοιτο.
And the ancients seem to have named thus the perceptible movement of the arteries to the patient himself, whether it occurred without pain or with it.
διὸ καὶ προστιθέασί τινες ἐν τοῖς συμπτώμασι τῆς φλεγμονῆς τῷ σφυγμῷ τὸ σὺν ὀδύνῃ.
Therefore, some also add "with pain" to the pulsation among the symptoms of inflammation.
ταυτὶ μὲν οὖν ἐν ὀνόματι τὴν ἀμφισβήτησιν ἔχει, κάλλιον δὲ ἐπίστασθαι τὴν γένεσιν αὐτῶν καταφρονοῦντα τῆς προσηγορίας.
These things, then, have their dispute in name, but it is better to understand their generation, disregarding the appellation.
ἐν μὲν δὴ τῷ κατὰ φύσιν ἀναίσθητός ἐστιν ἡμῖν ἡ κίνησις τῶν ἀρτηριῶν, ἐν δὲ ταῖς φλεγμοναῖς αἰσθητὴ σὺν ὀδύνῃ.
For in the natural state, the movement of the arteries is imperceptible to us, but in inflammations, it is perceptible with pain.
πλήττει γὰρ ἡ ἀρτηρία διαστελλομένη τὰ πέριξ σώματα, καὶ πρὸς τῆς πληγῆς ὀδυνώμεθα. διὰ τὴν φλεγμονήν.
For the artery, when dilating, strikes the surrounding bodies, and we are pained by the blow because of the inflammation.
ὅταν δὲ καὶ αὐτὸς ὁ χιτὼν ἤδη φλεγμαίνῃ, πλήττουσά τε ἅμα καὶ πληττομένη διπλασιάζει τὴν ὀδύνην.
And when the tunic itself is already inflamed, both striking and being struck at the same time, it doubles the pain.
περὶ μὲν δὴ τούτων αὐτάρκως εἴρηται.
About these things indeed enough has been said.