§4Εἰ μὲν οὖν ἥ τε θερμότης τοῦ αἵματος ἡ κατὰ τὸ φλεγμαῖνον μόριον ἐπιεικὴς ὑπάρχει καὶ τὸ περιεχόμενον αἷμα καθ’ ὅλον τὸ τοῦ ζώου σῶμα μετρίως ἔχει κράσεως, οὐ πάνυ τι ῥᾳδίως συνεκθερμαίνεται τῷ πεπονθότι· εἰ δ’ ἤτοι ζέοι σφοδρότερον, ἢ εἰ καὶ τὸ καθ’ ὅλον τὸ τοῦ ζώου σῶμα αἷμα χολωδέστερον ὑπάρχοι, παραχρῆμα σύμπαν ἐκθερμαίνεται· πολὺ δὲ μᾶλλον, ἐπειδὰν ἄμφω συνδράμοι, καὶ τὸ κατὰ τὴν φλεγμονὴν αἷμα θερμὸν ἱκανῶς εἶναι, καὶ τὸ καθ’ ὅλον τὸ ζῶον χολῶδες.
If indeed, therefore, the heat of the blood in the inflamed part is moderate, and the blood contained throughout the whole body of the animal is moderately tempered, it is not very easily heated up along with the affected part; but if either it should boil more violently, or if indeed the blood throughout the whole body of the animal should be more bilious, immediately the whole is heated up; and much more so, whenever both should concur, namely, both that the blood in the inflammation is sufficiently hot, and that [the blood] throughout the whole animal is bilious.
ἐκθερμαίνεται δὲ πρότερον μὲν τὸ κατὰ τὰς ἀρτηρίας, ὅτι καὶ φύσει θερμότερόν ἐστι καὶ πνευματωδέστερον, ἐφεξῆς δὲ καὶ τὸ κατὰ τὰς φλέβας.
And first indeed the [blood] in the arteries is heated up, because it is both by nature warmer and more spirituous, and next also that in the veins.
εἰ δ’ ἐγγὺς εἴη τῶν πολυαίμων σπλάγχνων τὸ φλεγμαῖνον μόριον, ἔτι καὶ θᾶττον αὐτῷ συνεκθερμαίνεται τὸ καθ’ ὅλον τὸ ζῶον αἷμα.
And if the inflamed part should be near the blood-rich viscera, still quicker is the blood throughout the whole animal heated up along with it.
συνελόντι δὲ εἰπεῖν, ἐπὶ παντὸς τοῦ θερμαίνοντος ὅσον εὐαλλοίωτον ἦν, ἢ τῇ φύσει θερμὸν, ἐκθερμαίνεται πρῶτον· ὥσπέρ γε κᾀπὶ τοῦ ψύχοντος ὅσον εὐαλλοίωτον ἦν, ἢ τῇ φύσει ψυχρὸν, ἐκεῖνο πρῶτον καταψύχεται.
To speak briefly, in the case of everything that heats, whatever was easily alterable, or warm by nature, is heated first; just as indeed in the case of that which chills, whatever was easily alterable, or cold by nature, that is first chilled.
εὐαλλοίωτον μὲν οὖν τὸ πνεῦμα, διότι καὶ λεπτομερέστατον· θερμότατον δὲ φύσει χολὴ ξανθὴ, ψυχρότατον δὲ φλέγμα.
Now, the pneuma is easily alterable, because it is also most fine-particled; and yellow bile is by nature warmest, and phlegm is coldest.
τῶν δ’ ἄλλων χυμῶν αἷμα μὲν ἐφεξῆς τῇ ξανθῇ χολῇ θερμόν· ἡ μέλαινα δὲ ψυχρὸν μετὰ τὸ φλέγμα.
Of the other humors, blood is warm next to yellow bile; and black [bile] is cold after phlegm.
καὶ δὴ ἀλλοιοῦται μὲν ἡ ξανθὴ χολὴ ῥᾳδίως ὑπὸ παντὸς τοῦ δρῶντος εἰς αὐτήν· ἡ μέλαινα δὲ δυσκόλως.
And indeed, yellow bile is easily altered by everything acting upon it; but black [bile] with difficulty.
ἑνὶ δὲ λόγῳ τὸ μὲν λεπτομερὲς ἅπαν εὐαλλοίωτον, τὸ δὲ παχυμερὲς δυσαλλοίωτον.
In a word, everything fine-particled is easily alterable, but the thick-particled is difficult to alter.
ὥστ’ ἀνάγκη πολυειδεῖς γίνεσθαι τὰς ἐπὶ ταῖς φλεγμοναῖς ἀλλοιώσεις, ὅτι καὶ πολυειδῶς διάκεινται τὰ σώματα.
So that it is necessary that the alterations in inflammations become manifold, because the bodies also are multifariously disposed.
πρῶτον μὲν γὰρ ὁ τὴν φλεγμονὴν ἐργαζόμενος χυμὸς ἢ μᾶλλον ἢ ἧττόν ἐστι θερμός· ἐφεξῆς δὲ σῆψις αὐτοῦ κατὰ τὴν οἰκείαν ἀπαντᾷ φύσιν· οὐχ ἥκιστα δὲ καὶ παρὰ τὸ μᾶλλόν τε καὶ ἧττον ἐσφηνῶσθαι.
For first, the humor producing the inflammation is either more or less hot; and next, its putrefaction occurs according to its own nature; and not least, also on account of its being wedged in more or less.
τὰ γὰρ μὴ διαπνεόμενα θᾶττον σήπεται, ὥσπερ κᾀπὶ τῶν ἐκτὸς ἁπάντων· ὅταν δὲ καὶ θερμὰ καὶ ὑγρὰ τὴν κρᾶσίν ἐστι, τότε δὴ καὶ μάλιστα.
For things that are not transpired putrefy more quickly, just as in the case of all external things; and whenever they are also warm and moist in their mixture, then indeed most of all.
καὶ μὲν δὴ καὶ τὸ φλεγμαῖνον μόριον ἢ ἐγγὺς ἢ πόῤῥω τῶν πολυαίμων σπλάγχνων ἐστὶ, καὶ τὸ πᾶν αἷμα πικρόχολον, ἢ μελαγχολικὸν, ἢ φλεγματῶδες, ἢ πνευματῶδες, καὶ ταῦτα πάντα μᾶλλόν τε καὶ ἧττον, ὥστ’ ἀνάγκη πολυειδεῖς γίνεσθαι τὰς ἀλλοιώσεις, ἑτέρου τε πρὸς ἕτερον παραβαλλομένου καὶ αὐτοῦ τινος πρὸς ἑαυτό.
And furthermore, the inflamed part is either near or far from the blood-rich viscera, and the whole blood is either bitter-bilious, or melancholic, or phlegmatic, or spirituous, and all these both more and less, so that it is necessary that the alterations become manifold, both when one thing is compared to another and when any one thing is compared to itself.
§5Αὗται πᾶσαι δυσκρασίαι τοῦ σώματος ἀνώμαλοι γίγνονται, μάλιστα μὲν ἐκπυρουμένου τοῦ κατὰ τὴν φλεγμονὴν αἵματος, ἐφεξῆς δὲ τοῦ κατὰ τὰ σπλάγχνα καὶ τοῦ κατὰ τὴν καρδίαν, καὶ ταύτης μάλιστα τοῦ κατὰ τὴν ἀριστερὰν κοιλίαν, εἰς ἣν εἰ καὶ ζῶντος τοῦ ζώου καὶ μηδέπω πυρέττοντος ἐθελήσεις ἐμβαλεῖν τοὺς δακτύλους, ὡς ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσι γέγραπται, σφοδροτάτης αἰσθήσῃ θερμασίας.
All these dyscrasias of the body become unequal, especially when the blood in the inflammation is set on fire, and next that in the viscera and that in the heart, and of this especially that in the left ventricle, into which if, even while the animal is alive and not yet feverish, you should wish to insert your fingers, as is written in the Anatomical Procedures, you will perceive the most vehement heat.
οὔκουν ἀπεικός ἐστιν οὐδ’ ὁπότε σύμπαν ἐκθερμαίνεται τὸ σῶμα παρὰ φύσιν, εἰς ἄκρον ἥκειν τὴν θερμότητα ἐκείνην μάλιστα.
Therefore, it is not unlikely that, also whenever the whole body is heated contrary to nature, that heat reaches the highest point especially there.
καὶ γὰρ λεπτομερέστατον αἷμα καὶ πνευματωδέστατον ἔχει, καὶ κινεῖται διαπαντός.
For indeed it contains the most fine-particled and most spirituous blood, and it is in motion constantly.
ἀλλ’ ἐν τοῖς τοιούτοις ἅπασι πυρετοῖς ἐκθερμαίνεται μὲν ἐνίοτε σύμπαν ἤδη τὸ αἷμα, καὶ δέδεκται τὴν παρὰ φύσιν ἐκείνην θερμασίαν, τὴν ἐκ τῆς σηπεδόνος τῶν χυμῶν ὁρμηθεῖσαν· οὐ μὴν οὔθ’ οἱ χιτῶνες τῶν ἀρτηριῶν ἢ τῶν φλεβῶν οὔτ’ ἄλλό τι τῶν περικειμένων σωμάτων ἤδη πω τελέως ἠλλοίωται τὴν κρᾶσιν, ἀλλ’ ἔτι μεταβάλλεται καὶ ἀλλοιοῦται θερμαινόμενα.
But in all such fevers, sometimes indeed the whole blood is already heated up, and has received that unnatural heat which originated from the putrefaction of the humors; nevertheless, neither the tunics of the arteries or of the veins, nor any other of the surrounding bodies has yet completely altered its mixture, but they are still changing and being altered as they are heated.
εἰ δ’ ἐν χρόνῳ πλείονι τοῦτο πάσχοι, κᾂν νικηθείη ποτὲ καὶ μεταβληθείη παντάπασιν, ὡς μηκέτι θερμαίνεσθαι μόνον, ἀλλ’ ἤδη τεθερμάνθαι παρὰ φύσιν.
And if they should suffer this for a longer time, they might also eventually be conquered and completely changed, so as no longer to be merely in the process of being heated, but already to have been heated contrary to nature.
ὅρος δέ ἐστι τῆς ἀλλοιώσεως ἑκάστῳ τῶν μορίων ἡ τῆς ἐνεργείας αὐτοῦ βλάβη· τὸ δ’ ἄχρι τοῦδε πλάτος ἐπάνοδός ἐστιν εἶς τὸ παρὰ φύσιν, οἷον ἐπίμικτόν τε καὶ κοινὸν καὶ μέσον ἐξ ἀμφοῖν τῶν ἐναντίων γεγονὸς, αὐτοῦ τε τοῦ κατὰ φύσιν ἀκριβῶς καὶ τοῦ τελέως ἤδη παρὰ φύσιν.
And the limit of alteration for each of the parts is the impairment of its activity; and the latitude up to this point is a transition into the unnatural state, as it were, a mixed and common and middle state arising from both opposites, namely, the strictly natural state itself and that which is already completely unnatural.
ἐν δὲ τούτῳ παντὶ τῷ χρόνῳ τὸ θερμαινόμενον σῶμα τῷ ποσῷ τῆς ἀλλοιώσεως ἀνάλογον ἔχει τὴν ὀδύνην.
And during all this time, the body being heated has pain proportional to the quantity of the alteration.
ὅταν δ’ ἐκθερμανθῇ τελέως ἅπαντα τοῦ σώματος τὰ στερεὰ μόρια, καλεῖται ὁ τοιοῦτος πυρετὸς ἑκτικὸς, ὡς ἂν μηκέτι τοῖς ὑγροῖς τε καὶ τῷ πνεύματι μόνον, ἀλλ’ ἤδη καὶ τοῖς ἕξιν ἔχουσι σώμασι περιεχόμενος· ἀνώδυνος δ’ ἐστὶ καὶ νομίζουσιν οἱ πυρέττοντες οὕτως ὡς μηδὲ πυρέττειν ὅλως.
But when all the solid parts of the body are completely heated, such a fever is called hectic, since it is no longer contained only in the fluids and the pneuma, but already also in the bodies that have a state; and it is painless, and those who are feverish in this way think that they are not feverish at all.
οὐ γὰρ αἰσθάνονται τῆς θερμασίας, ἁπάντων ὁμοίως τεθερμασμένων αὐτοῖς τῶν μορίων.
For they do not perceive the heat, because all their parts have been heated in like manner.
καὶ δὴ καὶ ὁμολογεῖται ταῦτα τοῖς φυσικοῖς ἀνδράσιν ἐν τοῖς περὶ τῶν αἰσθήσεων λογισμοῖς.
And indeed, these things are agreed upon by the natural philosophers in their treatises on the senses.
οὔτε γὰρ χωρὶς ἀλλοιώσεως ἡ αἴσθησις οὔτ’ ἐν τοῖς ἤδη τελείως ἠλλοιωμένοις ἡ ὀδύνη.
For neither is there sensation without alteration, nor is there pain in things that have already been completely altered.
ταῦτ’ ἄρα καὶ οἱ ἑκτικοὶ πυρετοὶ πάντες ἄπονοί τε καὶ τελέως εἰσὶν ἀναίσθητοι τοῖς κάμνουσιν.
For this very reason indeed, all hectic fevers are both painless and completely unperceived by the patients.
οὐ γὰρ ἔτι τῶν ἐν αὐτοῖς μορίων τὸ μὲν ποιεῖ, τὸ δὲ πάσχει, πάντων ὁμοίων ἀλλήλοις ἤδη γεγονότων, καὶ μίαν ἐχόντων ὁμόλογον κρᾶσιν.
For no longer does one of the parts in them act while another suffers, since all have already become like one another, and have one uniform mixture.