§1.25ἀμέλει καὶ τῶν κατὰ τὸ ἧπαρ φλεγμαινόντων, ὅταν πεφθῶϲι, τὴν ἀποκάθαρϲιν ποιούμεθα διὰ μὲν τῆϲ κάτω γαϲτρόϲ, ὅταν ἐν τοῖϲ ϲιμοῖϲ αὐτοῦ γένηται τὸ πάθημα, δι᾿ οὔρων δέ, ὅταν ἐν τοῖϲ κυριτοῖϲ.
Indeed, for those who have inflammation in the liver, when it has been cocted, we perform the evacuation through the lower cavity when the affection occurs in its concave parts, but through urine when it is in the convex parts.
§1.26οὕτωϲ δὲ κἀπὶ τῶν ἄλλων ἐπιϲκέψῃ τόν τε πλεονάζοντα χυμὸν καὶ τὸν πεπονθότα τόπον, ἐξ οὗ καθάπερ ἑϲτίαϲ τινὸϲ ὁρμᾶται τὸ νόϲημα· ταῦτα γάρ ϲοι καὶ τὸν κενωθηϲόμενον ἐνδείξεται | χυμὸν καὶ τὸν τρόπον τῆϲ κενώϲεωϲ καὶ τὸν τόπον δι᾿ οὗ χρὴ κενῶϲαι, καὶ πρὸϲ τούτοιϲ ἅπαϲι τὸν καιρόν· ἐν ἀρχῇ μὲν γὰρ τοὺϲ ὀρώδειϲ τε καὶ λεπτοὺϲ κενώϲειϲ χυμούϲ, ἀναμενεῖϲ δὲ πέψιν ἐπὶ τῶν παχέων καὶ γλίϲχρων, οἷοι τὴν φύϲιν εἰϲὶν ὅ τε τοῦ φλέγματοϲ καὶ ὁ τῆϲ μελαίνηϲ χολῆϲ.
And in this way also in the case of the others, you shall examine both the excess humor and the affected place from which, as if from some hearth, the disease originates; for these will indicate to you both the humor to be evacuated and the manner of evacuation and the place through which it is necessary to evacuate, and in addition to all these, the proper time; for in the beginning you shall evacuate the serous and thin humors, but you shall wait for coction in the case of the thick and viscous ones, such as by nature are both the humor of phlegm and that of black bile.
§1.27καὶ ἀπὸ τῶν παροξυϲμῶν δὲ ϲκοπὸν εἰϲ ἔνδειξιν τρόπου κενώϲεωϲ ἕξειϲ, ἐκ μὲν τῶν ἄνω ποιούμενοϲ τὰϲ κενώϲειϲ ἐν τοῖϲ παροξυϲμοῖϲ, ἐκ δὲ τῶν κάτω κατὰ τὰϲ καλουμέναϲ ἀνέϲειϲ· καὶ γὰρ καὶ αὐτόματα οὕτωϲ ὠφελεῖ, ἐν μὲν τοῖϲ παροξυϲμοῖϲ ἐμούντων τε πολλῶν καὶ διὰ ῥινῶν αἱμορραγούντων, ἐν δὲ ταῖϲ ἀνέϲεϲιν σὔρων τε καὶ διαχωρημάτων ἀποκρινομένων.
And from the paroxysms also you will have a target for the indication of the manner of evacuation, making the evacuations from the upper parts during the paroxysms, but from the lower parts during the so-called remissions; for indeed even spontaneous events are beneficial in this way, with many vomiting and hemorrhaging through the nostrils during the paroxysms, and with urine and stools being separated during the remissions.
§1.28φυλάττεϲθαι δὲ χρὴ μάλιϲτα τὸν χρόνον τῶν παροξυντικῶν καὶ κριτικῶν ἡμερῶν, ὁπόταν ἐπιχειρῇϲ κάτω καθαίρειν πολλά· τῆϲ γὰρ ῥοπῆϲ τῶν χυμῶν ἄνω γινομένηϲ, ἡ τοῦ κάτω καθαίροντοϲ | φαρμάκου δύναμιϲ ἐμποδιϲθήϲεται.
But one must guard especially against the time of the paroxysmal and critical days when you attempt to purge much downward; for since the tendency of the humors is upward, the power of the drug that purges downward will be hindered.
§1.29ἐπὶ δὲ τῶν ἤδη νοϲούντων ἐν μὲν τοῖϲ χρονίοιϲ αἰεὶ δεῖ τὸν πεπαϲμὸν ἀναμένειν· ἐν δὲ τοῖϲ ὀξέϲιν, ὅταν ὀργά, κατ᾿ ἀρχὰϲ οἷόν τε φαρμακεῦϲαι, καὶ τοῦτο αὐτὸ πράττειν μετὰ πολλῆϲ εὐλαβείαϲ καὶ περιϲκέψεωϲ· κίνδυνοϲ γὰρ οὐ μικρὸϲ ἐν ὀξεῖ νοϲήματι κακῶϲ φαρμακεῦϲαι τῷ πάντα μὲν καθαίροντα φάρμακα τοῖϲ δυνάμεϲιν εἶναι θερμά, δεῖϲθαι δὲ τὸν πυρετόν, εἰ πυρετόϲ ἐϲτι, κατὰ τὸν αὑτοῦ λόγον οὐχ ὅπωϲ τῶν ξηραινόντων καὶ θερμαινόντων, ἀλλὰ τῶν ἐναντιωτάτων αὐτοῖϲ τῶν ὑγραινόντων τε καὶ ψυχόντων.
But in the case of those already sick, in chronic diseases one must always wait for coction; but in acute ones, when the humors are turgid, it is possible to purge at the beginning, and to do this very thing with much caution and circumspection; for there is no small danger in an acute disease in purging badly, because all purging drugs are warm in their powers, whereas the fever, if there is a fever, requires, according to its own rationale, not things that dry and warm, but those most opposed to them, which moisten and cool.
§1.30οὔκουν οὐδ᾿ αὐτῆϲ ἕνεκα τῆϲ πυρώδουϲ θερμότητοϲ ἡ κάθαρϲιϲ ἡμῖν παραλαμβάνεται (ταύτην γὰρ ἴϲμεν ὅϲον ἐφ᾿ ἑαυτῇ βλαπτομένην), ἀλλὰ τῶν ἐργαζομένων ἕνεκα χυμῶν· χρὴ τοίνυν μείζονα τὴν ὠφέλειαν ἐκ τῆϲ τῶν λυπούντων | χυμῶν κενώϲεωϲ γίνεϲθαι τῆϲ βλάβηϲ, ἣν ἐξ ἀνάγκηϲ βλάπτεται τὸ ϲῶμα πρὸϲ τῶν καθαρτικῶν φαρμάκων· ἔϲτι δ᾿ ἡ ὠφέλεια † ἐνάλυπόϲ τε καὶ πᾶϲ ὁ βλάπτων κενωθῇ χυμόϲ· ἵνα δὲ τοῦτο γένηται, πρῶτον μὲν δεῖ περιϲκέψαϲθαι, εἰ ἐπιτηδείωϲ ὁ κάμνων ἔχει πρὸϲ τὴν τοιαύτην κάθαρϲιν· οἵ τε γὰρ ἐξ ἀπεψιῶν πολλῶν ἢ γλίϲχρων ἢ παχέων ἐδεϲμάτων ὄντεϲ, ὡϲαύτωϲ δ᾿ οἷϲ ὑποχόνδρια τέταται καὶ ἐμπεφύϲηται ἢ ὑπερβαλλόντωϲ ἐϲτὶ θερμὰ καὶ πυρώδη, ἢ καί τιϲ αὐτόθι τῶν ϲπλάγχνων φλεγμονή, πάντεϲ οὗτοι πρὸϲ τὰϲ καθάρϲειϲ ἀνεπιτήδειοι.
Therefore, evacuation is not employed by us for the sake of the burning heat itself (for we know that this, as far as it is concerned, is harmed by evacuation), but for the sake of the humors that produce the disease; it is necessary, then, that the benefit from the evacuation of the troublesome humors be greater than the harm which the body necessarily suffers from the purging drugs; and the benefit is [painless, and occurs when] all the harmful humor is evacuated; but in order that this may happen, one must first consider whether the sick person is in a suitable state for such a purging; for those who are in such a state from many indigestions or viscous or thick foods, and likewise those whose hypochondria are tense and inflated or excessively hot and burning, or if there is also some inflammation of the viscera there, all these are unsuitable for purgings.
§1.31χρὴ τοίνυν ἀπεῖναί τε ταῦτα, καὶ τοὺϲ χυμούϲ, ὡϲ ἔνι μάλιϲτα, τοῦ κάμνοντοϲ εὐρουϲτάτουϲ εἶναι, τουτέϲτι λεπτούϲ τε καὶ ἥκιϲηα μετέχονταϲ γλιϲχρότητόϲ τινοϲ, ἀναπεπταμένουϲ τε τοὺϲ πόρουϲ, δἰ ὧν ἡ καθάρϲιϲ μέλλει γενήϲεϲθαι· ταῦτα γὰρ καὶ ἡμεῖϲ προπαραϲκευάζομεν, ἐπειδὰν μέλλωμέν τινα καθαίρειν.
It is necessary, then, that these conditions be absent, and that the humors of the sick person be, as much as possible, very free-flowing, that is, thin and least participating in any viscosity, and that the pores through which the purging is to take place be wide open; for we too prepare these things beforehand when we are about to purge someone.