§3Αὐτίκα γέ τοι ῥεύματος θερμοῦ κατασκήψαντος εἰς μῦν, πρῶτον μὲν αἱ μείζους ἀρτηρίαι καὶ φλέβες ἐμπίπλανταί τε καὶ διατείνονται, μετὰ ταῦτα δὲ αἱ μικρότεραι, καὶ τοῦτο γίνεται μέχρι τῶν σμικροτάτων· ἐν αἷς ὅταν ἰσχυρῶς σφηνωθῇ καὶ μηκέτι στέγηται τὸ ῥεῦμα, τὸ μέν τι κατὰ τὸ στόμα, τὸ δέ τι καὶ διὰ τῶν χιτώνων αὐτῶν διηθεῖται πρὸς τὸ ἐκτός·
For example, when a warm fluxion falls down into a muscle, first the larger arteries and veins are filled and distended, and after these the smaller ones, and this happens down to the smallest ones; in which, when the fluxion is forcefully wedged and can no longer be contained, part of it is filtered out through the orifices, and another part also through their tunics themselves, towards the outside.
κᾀν τούτῳ πίμπλανται ῥεύματος αἱ μεταξὺ χῶραι τῶν πρώτων σωμάτων, ὥστε καὶ θερμαίνεσθαι καὶ περικλύζεσθαι πανταχόθεν ὑπὸ τῆς ὑγρότητος ἅπαντα.
And in this process, the spaces between the primary bodies are filled with the fluxion, so that everything is warmed and washed from all sides by the moisture.
τὰ νεῦρα δέ ἐστι ταῦτα καὶ ὑμένες καὶ σύνδεσμοι καὶ σάρκες αὐταί.
These parts are the nerves, membranes, ligaments, and the flesh itself.
πρὸ δὲ τούτων αἱ ἀρτηρίαι καὶ φλέβες, αἳ δὴ καὶ πρώτως καὶ μάλιστα ποικίλως ὀδυνῶνται.
But before these are the arteries and veins, which indeed are pained first and most diversely.
καὶ γὰρ ἔνδοθεν ὑπὸ τοῦ ῥεύματος θερμαίνονταί τε καὶ διατείνονται καὶ διασπῶνται, κᾀκ τῶν ἔξωθεν θερμαίνονται ἅμα καὶ θλίβονται καὶ βαρύνονται· τὰ δ’ ἄλλα μόρια, τὰ μὲν ἐν τῷ θερμαίνεσθαι μόνον ἢ θλίβεσθαι, τὰ δὲ τῷ συναμφοτέρῳ κάμνει.
For indeed, they are warmed, distended, and torn from within by the fluxion, and from without they are simultaneously warmed, compressed, and weighed down; while the other parts, some suffer from being warmed or compressed alone, and others from both together.
καὶ καλεῖται μὲν τὸ νόσημα φλεγμονὴ, δυσκρασία δέ ἐστιν ἀνώμαλος τοῦ μυός.
And the disease is called inflammation, but it is an unequal dyscrasia of the muscle.
τὸ μὲν γὰρ αἷμα τὸ κατ’ αὐτὸν ἤδη ζέει· συνεκθερμαίνει δὲ αὐτῷ πρώτους μὲν καὶ μάλιστα τοὺς χιτῶνας τῶν ἀρτηριῶν καὶ φλεβῶν· ἤδη δὲ καὶ τὰ ἐκτὸς αὐτῶν, οἷς περικέχυται, πάντα.
For the blood in it is already boiling; and it heats up with itself, first and foremost, the tunics of the arteries and veins, and already also all the external parts by which they are surrounded.
καὶ δυοῖν γε θάτερον ἀναγκαῖον ἀπαντῆσαι· νικήσαντος μὲν τοῦ ῥεύματος, φθορὰν γίνεσθαι τῶν νικηθέντων σωμάτων· νικηθέντος δὲ, τὴν εἰς τὸ κατὰ φύσιν ἐπάνοδον τῷ μυΐ.
And one of two things must necessarily happen: if the fluxion conquers, there will be destruction of the conquered bodies; but if it is conquered, there will be a return to the natural state for the muscle.
καὶ δὴ νικάσθω πρότερον τὸ ῥεῦμα, βέλτιον γὰρ ἀπὸ τῶν κρειττόνων ἄρχεσθαι, διττὸς ἐν τούτῳ τρόπος ἔσται τῆς ἰάσεως, ἢ διαφορηθέντος ἅπαντος τοῦ κατασκήψαντος ὑγροῦ, ἢ πεφθέντος.
And indeed, let the fluxion be conquered first—for it is better to begin with the preferable outcomes—and in this case there will be a twofold mode of cure: either by the complete dissipation of the inflowing liquid, or by its concoction.
ἀλλ’ ἡ μὲν διαφόρησις εὐκταιοτάτη τῶν ἰάσεών ἐστι· τῇ πέψει δὲ ἕπεται δύο ταῦτ’ ἐξ ἀνάγκης, πύου γένεσις καὶ ἀπόστασις.
But dissipation is the most desirable of cures; whereas concoction is necessarily followed by these two things: the generation of pus and abscess.
ἀφίσταται δὲ ποτὲ μὲν εἰς τὴν μεγίστην καὶ ἀκυροτάτην τῶν παρακειμένων κοιλοτήτων, ἥπερ δὴ καὶ βελτίστη τῶν ἀποστάσεών ἐστιν· ἐνίοτε δὲ εἰς τὴν μεγίστην μὲν οὐ μὴν ἄκυρον, ἢ εἰς ἄκυρον μὲν οὐ μεγίστην δέ.
And an abscess sometimes directs itself towards the largest and least vital of the adjacent cavities, which is indeed the best of abscesses; but sometimes towards one that is largest but not non-vital, or towards one that is non-vital but not largest.
τοῖς μὲν οὖν κατὰ γαστέρα καλλίστη τῶν ἀποστάσεών ἐστιν ἡ εἰς τὴν ἐντὸς εὐρυχωρίαν, εἰς ἣν καὶ συῤῥήγνυνται τὰ πολλά· μοχθηρὰ δὲ ἡ ὑπὸ τὸ περιτόναιον.
Thus, for things in the abdomen, the finest of abscesses is that into the internal space, into which most of them indeed rupture; but that under the peritoneum is troublesome.
οὕτω δὲ καὶ τοῖς κατὰ τὸν ἐγκέφαλον ἡ μὲν εἰς τὰς ἐμπροσθίους κοιλίας ἀγαθὴ, μοχθηρὰ δὲ ἡ ὑπὸ τὰς μήνιγγας καὶ εἰς τὴν ὄπισθεν κοιλίαν.
Likewise, for things in the brain, that into the anterior ventricles is good, but that under the meninges and into the posterior ventricle is troublesome.
αἱ δὲ κατὰ τὰς πλευρὰς ἀποστάσεις εἰς τὰς τοῦ θώρακος εὐρυχωρίας ἐκρήγνυνται· καὶ τῶν μὲν μυῶν ὑπὸ τὸ δέρμα, τῶν δὲ σπλάγχνων ἢ εἰς τὰς ἀρτηρίας καὶ τὰς φλέβας τὰς ἐν αὐτοῖς, ἢ ὑπὸ τὸν ὑμένα τὸν περιέχοντα, καθάπερ τι δέρμα καὶ αὐτὸν ὑπάρχοντα τοῖς σπλάγχνοις.
And abscesses along the ribs rupture into the spaces of the thorax; and those of the muscles under the skin, while those of the viscera rupture either into the arteries and veins within them, or under the membrane surrounding them, which itself exists as a kind of skin for the viscera.
εἰ δὲ νικηθείη τὰ σώματα πρὸς τοῦ ῥεύματος, εἰς τοσαύτην μὲν ἀφίξεται δηλονότι δυσκρασίαν, ὡς καὶ τὴν ἐνέργειαν αὐτῶν ἀπολέσθαι καὶ φθαρῆναι τῷ χρόνῳ· παύσεται δὲ ὀδυνώμενα τότε πρῶτον, ὅταν ἐξομοιωθῇ τῷ μεταβάλλοντι.
But if the bodies should be conquered by the fluxion, they will obviously arrive at such a great dyscrasia that their activity is lost and they are destroyed over time; and they will first cease to be pained when they have been assimilated to that which is changing them.
οὐ γὰρ ἐν τῷ μεταβεβλῆσθαι τὴν κρᾶσιν, ἀλλ’ ἐν τῷ μεταβάλλεσθαι πονεῖ τὰ μόρια, καθότι καὶ ὁ θαυμαστὸς Ἱπποκράτης ἔλεγεν· τοῖσι γὰρ τὴν φύσιν διαλλαττομένοισι καὶ διαφθειρομένοισιν αἱ ὀδύναι γίγνονται. διαλλάττεται δὲ καὶ διαφθείρεται τὴν φύσιν ἕκαστον θερμαινόμενον, ἢ ψυχόμενον, ἢ ξηραινόμενον, ἢ ὑγραινόμενον, ἢ τῆς συνεχείας λυόμενον· ἐπὶ μὲν ταῖς ἀνωμάλοις δυσκρασίαις διὰ τὸ θερμαίνεσθαι ἢ ψύχεσθαι μάλιστα, δραστικώταται γὰρ αὗται αἱ ποιότητες, ἤδη δὲ καὶ διὰ τὸ ὑγραίνεσθαί τε καὶ ξηραίνεσθαι· ἐν δὲ τῷ πεινῇν ἢ διψῇν, ἐπιλειπούσης ἔνθα μὲν τῆς ὑγρᾶς οὐσίας, ἔνθα δὲ τῆς ξηρᾶς· ἐν δὲ τῷ τιτρώσκεσθαι καὶ διαβιβρώσκεσθαι καὶ τείνεσθαι καὶ θλίβεσθαι καὶ ἀνασπᾶσθαι, τῆς συνεχείας λυομένης.
For it is not in having been changed in mixture, but in the process of being changed that the parts suffer pain, just as the admirable Hippocrates said: "For pains occur to those whose nature is being altered and destroyed." And each part is altered and destroyed in its nature by being warmed, or chilled, or dried, or moistened, or by having its continuity dissolved; in unequal dyscrasias, this is due mostly to being warmed or chilled, for these are the most active qualities, but already also to being moistened and dried; in hunger or thirst, as the moist substance fails in the one case, and the dry in the other; and in being wounded, corroded, stretched, compressed, and torn away, as continuity is dissolved.