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Galen · The Uneven Bad-Mixture §8-9

Unequal Dyscrasia in Epialos Fever and Local Tumors

Passage 6 of 6 · Greek

Summary

The author explains the mechanism of pain caused by sudden temperature changes and the unequal dyscrasia of epialos fever, where chill and fever occur simultaneously. He then discusses how various local diseases accompanied by swelling also arise from unequal dyscrasia due to the influx of humors.

§8Ἀλγοῦσι δὲ καὶ ὅσοι καταψυχόμενοι σφοδρῶς ὑπὸ κρύους καρτεροῦ προεθυμήθησαν ἐκθερμῆναι ταχέως ἑαυτοὺς, καὶ πολλοί γε αὐτῶν ἐπενέγκαντες ἀθρόως τῷ πυρὶ τὰς χεῖρας, ἀλγήματος αἰσθάνονται σφοδροῦ κατὰ τὰς ῥίζας τῶν ὀνύχων.
Those also suffer pain who, being severely chilled by severe cold, have hastened to warm themselves quickly, and many of them indeed, having suddenly brought their hands to the fire, feel a severe pain at the roots of their nails.
εἶτά τις οὕτως ὁρῶν ἐναργῶς ὀδύνης αἰτίαν γιγνομένην τὴν ἀνώμαλον δυσκρασίαν, ἔτ’ ἀπιστεῖ περὶ τῶν ἐντὸς ἀλγημάτων, ἢ θαυμάζει, πῶς χωρὶς φλεγμονῆς ὀδυνῶνται πολλάκις, ἢ τὸ κῶλον, ἢ τοὺς ὀδόντας, ἢ τῶν ἄλλων τι μορίων;
Then, does anyone who sees so clearly that unequal dyscrasia is the cause of pain still disbelieve concerning internal pains, or wonder how they often suffer pain without inflammation, either in the colon, or the teeth, or any other of the parts?
οὔτε γὰρ τῶν τοιούτων διαθέσεων οὐδὲν θαυμαστὸν, οὐδὲ πῶς ἅμα ῥιγοῦσι καὶ πυρέττουσιν ἔνιοι τῶν νοσούντων.
For indeed, none of such conditions is at all wonderful, nor how some of the sick chill and fever at the same time.
καὶ γὰρ εἰ φλεγματώδης χυμὸς ψυχρὸς, ὃν ὁ Πραξαγόρας ὑαλοειδῆ καλεῖ, καὶ πικρόχολος καὶ θερμὸς ἅμα πλεονάζοιέν τε καὶ κινοῖντο διὰ τῶν αἰσθητικῶν σωμάτων, οὐδὲν θαυμαστὸν ἀμφοτέρων ὁμοίως αἰσθάνεσθαι τὸν ἄῤῥωστον.
For if a cold phlegmatic humor, which Praxagoras calls glassy, and a bitter-choleric and hot one at the same time should superabound and move through the sensory bodies, it is not at all wonderful that the patient feels both qualities equally.
οὐδὲ γὰρ εἰ στήσαις ἄνθρωπον ἐν ἡλίῳ θερμῷ, καὶ προσβρέχοις ὕδωρ ψυχρὸν, ἀδύνατον αὐτὸν μὴ οὐχ ἅμα καὶ τῆς ἀπὸ τοῦ ἡλίου θερμότητος αἰσθάνεσθαι καὶ τῆς ἀπὸ τοῦ ὕδατος ψυχρότητος.
For indeed, if you should stand a person in the hot sun and pour cold water over him, it is impossible for him not to feel at the same time both the heat from the sun and the cold from the water.
ἀλλ’ ἐνταῦθα μὲν ἔξωθέν ἐστιν ἀμφότερα καὶ κατὰ τὰ μεγάλα προσπίπτει μόρια· κατὰ δὲ τοὺς ἠπιάλους πυρετοὺς ἔνδοθέν τε καὶ κατὰ μικρὸν, καὶ διὰ τοῦτο σύμπαν ἀμφοτέρων αἰσθάνεσθαι τὸ σῶμα δοκεῖ.
But in this case indeed, both are from without and strike upon large parts; but in epialos fevers, both from within and in minute parts, and for this reason the whole body seems to feel both.
τῷ γὰρ δὴ ἐλαχίστῳ παρεσπάρθαι τό τε θερμὸν καὶ ψυχρὸν οὐδέν ἐστιν αὐτῆς λαβεῖν μόριον αἰσθητὸν, ἐν ᾧ θάτερον οὐχ ὑπάρχει.
For indeed, because of the hot and cold being scattered in the smallest parts, it is impossible to find any sensible part of it, in which either one is not present.
κατὰ μέντοι τὴν εἰσβολὴν τῶν παροξυσμῶν ἔνιοι τῶν πυρεττόντων καὶ ῥιγοῦσι καὶ διψῶσι καὶ ἀμφοτέρων αἰσθάνονται, ψύξεως ἀμέτρου καὶ θέρμης, ἀλλ’ οὐ κατ’ αὐτὸν τὸν τόπον·
However, during the onset of paroxysms, some of those with fever both chill and thirst and feel both, namely immoderate cold and heat, but not in the same place; for they are clearly able to distinguish the heated parts from the chilled ones.
ἐναργῶς γὰρ ἔχουσι διορίσαι τὰ θερμαινόμενα μόρια τῶν ψυχομένων. ἔνδοθεν μὲν γὰρ καὶ κατ’ αὐτὰ τὰ σπλάγχνα θερμασίας, ἐν δὲ τοῖς ἔξωθεν μορίοις ἅπασι τῆς ψύξεως αἰσθάνονται.
For internally indeed, and in the very viscera, they feel heat, but in all the external parts they feel chill.
ἔτι δὲ καὶ οἱ λειπυρίαι καλούμενοι πυρετοὶ διὰ παντὸς τοιοῦτοι, καί τι γένος ὀλεθρίων καύσων.
Moreover, the fevers called leipyriai are always of this kind, and also a certain class of fatal burning fevers.
ὅπερ οὖν ἐν τούτοις κατὰ τὰ μεγάλα μόρια, τοῦτ’ ἐν τοῖς ἠπιάλοις κατὰ σμικρὰ συμπέπτωκεν.
What therefore happens in these fevers in large parts, this has happened in epialos fevers in small parts.
ἀνώμαλος μὲν γὰρ δυσκρασία καὶ ἡ τούτων τῶν πυρετῶν· ἀνώμαλος δὲ καὶ ἡ τῶν ἄλλων ἁπάντων, πλὴν τῶν ἑκτικῶν ὀνομαζομένων· ἀνώμαλος δὲ καὶ τοῖς ῥιγοῦσι μὲν, οὐκ ἐπιπυρέττουσι δέ.
For the dyscrasia of these fevers also is unequal; and unequal also is that of all other fevers, except those called hectic; and unequal also in those who indeed chill, but do not have an ensuing fever.
σπάνιον μὲν γὰρ τὸ σύμπτωμα, γίνεται μὴν ὅλως καὶ γυναιξὶ καί τισιν ἀνδράσιν ἐνίοτε.
For although the symptom is rare, it does happen entirely both in women and sometimes in some men.
χρὴ δὲ πάντως ἀργὸν προηγεῖσθαι βίον, ἤ τι πλῆθος ἐδεσμάτων ἐν χρόνῳ πλείονι προσενηνέχθαι τὸν ἄνθρωπον, ἔξ οὗ χυμὸς ἀργὸς καὶ ψυχρὸς καὶ ὠμὸς καὶ φλεγματώδης γεννᾶται, ὁποῖόν τινα καὶ Πραξαγόρας ἡγήσατο τὸν ὑαλοειδῆ.
But it is absolutely necessary that an inactive life precede, or that the person has consumed a quantity of food over a longer period, from which an inactive, cold, raw, and phlegmatic humor is generated, of such a kind as Praxagoras indeed thought the glassy one to be.
πάλαι δὲ, ὡς ἔοικεν, οὐδεὶς οὕτως ἔπασχεν, ὅτι μηδεὶς τοσοῦτον ἀργῶς καὶ πλησμίως διῃτᾶτο, καὶ διὰ τοῦτο γέγραπται παρὰ τοῖς παλαιοῖς ἰατροῖς ἕπεσθαι ῥίγει πυρετόν· ἀλλὰ καὶ ἡμῖν αὐτοῖς καὶ ἄλλοις πολλοῖς τῶν νεωτέρων ἰατρῶν ὦπται πολλάκις ῥῖγος ᾧ πυρετὸς οὐκ ἐπηκολούθησε.
But in ancient times, as it seems, no one suffered thus, because no one lived so inactively and in such satiety, and for this reason it has been written by ancient physicians that a fever follows a chill; but both to ourselves and to many other of the younger physicians, a chill which was not followed by a fever has often been observed.
σύνθετος δ’ ἐκ ταύτης ἐστὶ τῆς δυσκρασίας καὶ προσέτι τῆς τῶν πυρεττόντων ὁ ἠπίαλος.
And the epialos is composed of this dyscrasia and additionally of that of those with fever.
οὕτω δ’ ὀνομάζω τὸν πυρετὸν ἐκεῖνον, ᾧ διὰ παντὸς ἄμφω συμβέβηκεν· ᾧ δὲ ἡγεῖται μὲν ῥῖγος, ἕπεται δ’ ὁ πυρετὸς, ὡς ἐν τριταίοις καὶ τεταρταίοις, οὐ καλῶ τοῦτον ἠπίαλον.
And I call that fever epialos in which both have occurred throughout; but that in which a chill indeed precedes and the fever follows, as in tertians and quartans, I do not call epialos.
ὥστε διὰ τῶν ἀνωμάλων δυσκρασιῶν ὁ ἠπίαλος συμπέπλεκται, καὶ οἱ λοιποὶ δὲ πυρετοὶ σχεδὸν ἅπαντες, πλὴν τῶν ἑκτικῶν ὀνομαζομένων.
So the epialos is interwoven through the unequal dyscrasias, and indeed almost all the remaining fevers, except those called hectic.
§9Ὡσαύτως καὶ ὅσα μορίου τινός ἐστι νοσήματα μετ’ ὄγκου, καὶ ταῦτα σύμπαντα παραπλησίως τῇ φλεγμονῇ κατὰ δυσκρασίαν ἀνώμαλον ἀποτελεῖται, καρκῖνος, ἐρυσίπελας, ἄνθραξ, ἕρπης, οἴδημα, φλεγμονὴ, φαγέδαινα, γάγγραινα.
Likewise, all such diseases of any part as are with a tumor, these also are entirely accomplished in a manner similar to inflammation according to an unequal dyscrasia: cancer, erysipelas, anthrax, herpes, edema, inflammation, phagedena, gangrene.
κοινὸν μὲν γὰρ αὐτοῖς ἅπασι τὸ ἐξ ἐπιῤῥοῆς ὑγρῶν γεγονέναι· διαφέρει δὲ τῷ τὰ μὲν ἀπὸ τοῦ φλεγματικοῦ χυμοῦ, τὰ δὲ ὑπὸ χολώδους, ἢ μελαγχολικοῦ χυμοῦ, τὰ δὲ ὑφ’ αἵματος ἤτοι θερμοῦ καὶ λεπτοῦ καὶ ζέοντος, ἢ ψυχροῦ καὶ παχέος, ἤ πως ἄλλως διακειμένου γίγνεσθαι.
For common indeed to all of them is to have arisen from an influx of fluids; but they differ in that some arise from the phlegmatic humor, others from a choleric or melancholic humor, and others from blood that is either hot, thin, and boiling, or cold and thick, or disposed in some other way.
δηλωθήσεται γὰρ ἀκριβῶς ὑπὲρ τῆς κατ’ εἶδος ἐν τούτοις διαφορᾶς ἑτέρωθι· πρὸς δὲ τὸν ἐνεστῶτα λόγον ἀρκεῖ καὶ τοῦτ’ εἰρῆσθαι μόνον, ὡς ὁποῖον ἂν ᾖ τὸ ῥεῦμα, κατὰ τὸν αὐτὸν λόγον ἕκαστον τῶν εἰρημένων ἐργάσεται παθῶν, καθ’ οἷον ἔμπροσθεν ὑπὸ τοῦ θερμοῦ καὶ αἱματώδους ἐδείκνυτο γενέσθαι φλεγμονή· καὶ ὡς τῶν ὁμοιομερῶν τε καὶ ἁπλῶν σωμάτων ἕκαστον, ὑπὸ τοῦ ῥεύματος διατεθειμένον, εἰς ἀνώμαλον ἀφίξεται καὶ αὐτὸ δυσκρασίαν, ἔξωθεν μέντοι θερμαινόμενον, ἢ ψυχόμενον, ἢ ξηραινόμενον, ἢ ὑγραινόμενον, ὁποῖον ἂν ᾖ τὸ ῥεῦμα, μέχρι τοῦ βάθους μηδέπω διακείμενον ὁμοίως· εἰ δὲ πᾶν ὅλον δι’ ὅλου μεταβάλλοι καὶ ἀλλοιωθείη, γενήσεται μὲν εὐθέως ἀνώδυνον, ἐν χαλεπωτέρᾳ δὲ ἂν οὕτω γε διαθέσει κατασταίη.
For it will be clearly shown concerning the specific difference among these elsewhere; but for the present discourse it is sufficient that this alone also has been said: that whatever the flux may be, it will produce each of the said affections according to the same principle as it was shown before that inflammation arises from the hot and bloody fluid; and that each of the homoeomerous and simple bodies, being affected by the flux, will itself also arrive at an unequal dyscrasia, being indeed heated, or chilled, or dried, or moistened from without, according to whatever the flux may be, as long as it is not yet affected in the same way to its depth; but if the whole should change throughout and be altered, it will indeed immediately become painless, but it would thus be established in a more difficult condition.
ταῦτα ἀρκεῖν μοι δοκεῖ προεγνῶσθαι τοῖς μέλλουσι τῆ τε περὶ φαρμάκων ἀκολουθήσειν πραγματείᾳ καὶ μετ’ αὐτὴν τῇ τῆς θεραπευτικῆς μεθόδου.
These things seem to me to be sufficient to be known beforehand for those who intend to follow both the study of drugs and after it the method of therapeutics.

Notes

  1. p.749μὴ οὐχ ἅμα καὶ — Double negative construction. Following the adjective ἀδύνατον, which has a negative meaning, μὴ οὐ is placed before the infinitive to express a strong affirmative meaning ('it is impossible for him not to feel...', i.e., 'he must feel').
  2. p.749τῷ γὰρ δὴ ἐλαχίστῳ παρεσπάρθαι — Dative articular infinitive (perfect passive infinitive παρεσπάρθαι) expressing cause ('because of...'). The phrase τῷ ἐλαχίστῳ is a neuter dative adjective acting adverbially to modify the infinitive, meaning 'at the most minute level'.
  3. p.750χρὴ δὲ πάντως ἀργὸν προηγεῖσθαι βίον — Infinitive construction led by the impersonal verb χρή. Two accusative-with-infinitive clauses (1. βίον as subject of προηγεῖσθαι; 2. τὸν ἄνθρωπον as subject of προσενηνέχθαι) are coordinated by ἤ. In the latter, the perfect middle-passive infinitive προσενηνέχθαι has an active sense of consumption.
  4. p.752μέχρι τοῦ βάθους μηδέπω διακείμενον ὁμοίως — The present participle διακείμενον agrees with the nominative subject ἕκαστον, describing conditionally the state of the tissues affected by the flux (ῥεῦμα). It is best translated as 'as long as it is not yet affected in the same way to its depth'.

Cite this passage

Galen, The Uneven Bad-Mixture §8-9. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0057.tlg055.humanitext-grc1:8-9

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