§1515.
15.
Ὁκόσα δὲ τῶν ἀλγημάτων ἐκ τουτέων τῶν χωρίων μὴ παύηται, μήτε πρὸς τὰς τῶν πτυέλων καθάρσιας, μήτε πρὸς τὴν τῆς κοιλίης ἐκκόπρωσιν, μήτε πρὸς τὰς φλεβοτομίας τε καὶ φαρμακείας καὶ διαίτας, εἰδέναι δεῖ ἐκπυήσοντα.
As for the pains from these parts, those which are not stopped, neither by evacuations of sputum, nor by clearing of the bowels, nor by venesections, drug treatments, and regimens, one must know that they will suppurate.
Τῶν δὲ ἐκπυημάτων ὁκόσα μὲν ἔτι χολώδεος ἐόντος τοῦ πτυέλου ἐκπυΐσκεται, ὀλέθρια κάρτα, ἤν τε ἐν μέρει τὸ χολῶδες τῷ πύῳ ἀναπτύοιτο, ἤν τε ὁμοῦ· μάλιστα δὲ, ἢν ἄρξηται χωρέειν τὸ ἐμπύημα ἀπὸ τουτέου τοῦ πτυέλου, ἑβδομαίου ἐόντος τοῦ νουσήματος.
Of the suppurations, those that form pus while the sputum is still bilious are highly fatal, whether the bilious matter is spit up separately with the pus, or together; and especially if the empyema begins to discharge from such sputum when the disease is on its seventh day.
Ἐλπὶς δὲ τὸν τὰ τοιαῦτα πτύοντα ἀποθανεῖσθαι τεσσαρεσκαιδεκαταῖον, ἢν μή τι αὐτέῳ ἐπιγένηται ἀγαθόν.
There is expectation that the patient who spits up such things will die on the fourteenth day, unless some favorable sign supervenes upon him.
Ἔστι δὲ τὰ μὲν ἀγαθὰ τάδε· εὐπετέως φέρειν τὸ νούσημα, εὔπνοον εἶναι, τῆς ὀδύνης ἀπηλλάχθαι, τό τε πτύελον ῥηϊδίως ἀναβήσσειν, τό τε σῶμα ὁμαλῶς φαίνεσθαι θερμόν τε εἶναι καὶ μαλθακὸν, καὶ δίψαν μὴ ἔχειν, οὖρά τε καὶ διαχωρήματα καὶ ὕπνους καὶ ἱδρῶτας, ὡς διαγέγραπται ἕκαστα εἶναι ἀγαθὰ, ἐπιγίγνεσθαι·
Favorable signs are as follows: to bear the disease easily, to be easy of breathing, to be free from pain, to cough up sputum easily, and the body to appear evenly warm and soft, and to have no thirst, and that urine, stools, sleep, and sweats supervene, each being good as has been described.
οὕτω μὲν γὰρ ἁπάντων τουτέων ἐπιγιγνομένων, οὐκ ἂν ἀποθάνοι ὁ ἄνθρωπος· ἢν δὲ τὰ μέν τοι αὐτέων ἐπιγίγνοιτο, τὰ δὲ μὴ, οὐ πλείονα χρόνον ζήσας, ἢ τεσσαρεσκαίδεκα ἡμέρας, ἀπόλοιτ᾿ ἂν ὁ ἄνθρωπος, Κακὰ δὲ τὰ ἐναντία τουτέων, ἤγουν δυσπετέως φέρειν τὴν νοῦσον, πνεῦμα μέγα καὶ πυκνὸν εἶναι, τὴν ὀδύνην, μὴ παύεσθαι, τὸ πτύελον μόλις ἀναβήσσειν, διψῇν κάρτα, τό τε σῶμα ὑπὸ πυρὸς ἀνωμάλως ἔχεσθαι, καὶ τὴν μὲν κοιλίην καὶ τὰς πλευρὰς θερμὰς εἶναι ἰσχυρῶς, τὸ δὲ μέτωπον καὶ τὰς χεῖρας καὶ τοὺς πόδας ψυχροὺς, οὖρα δὲ καὶ διαχωρήματα καὶ ὕπνους καὶ ἱδρῶτας, ὡς διαγέγραπται ἔκαστα εἶναι κακὰ, ἐπιγίγνεσθαι οὕτω γὰρ εἰ ἐπιγένοιτό τι τῷ πτυέλῳ τουτέῳ; ἀπόλοιτα ἂν ὁ ἄνθρωπος πρὶν ἢ ἐς τὰς τεσσαρεσκαίδεκα ἡμέρας ἀφικέσθαι, ἢ ἐναταῖος, ἢ ἑνδεκαταῖος.
For if all these things supervene in this way, the patient would not die; but if some of these should supervene and others not, the patient would die, having lived no longer than fourteen days. Bad signs are the opposite of these, namely: to bear the disease with difficulty, breathing to be deep and rapid, pain not to cease, to cough up sputum with difficulty, to be very thirsty, and the body to be affected unevenly by fever, the abdomen and flanks being very hot, but the forehead, hands, and feet cold, and that urine, stools, sleep, and sweats supervene, each being bad as has been described. For if any such thing should supervene upon this sputum, the patient would die before arriving at fourteen days, either on the ninth or eleventh day.
Οὕτως οὖν ξυμβάλλεσθαι χρὴ, ὡς τοῦ πτυέλου τουτέου θανατώδεος, ἐόντος μάλα, καὶ οὐ φθάνοντος ἐς τεσσαρεσκαίδεκα ἡμέρας.
Thus, then, one must conclude that this sputum is highly deadly, and does not last until fourteen days.
Τὰ δὲ ἐπιγενόμενα κακά τε καὶ ἀγαθὰ ξυλλογιζόμενον ἐκ τουτέων χρὴ τὰς προῤῥήσιας προλέγειν οὕτω γὰρ ἄν τις ᾶληθεύοι μάλιστα.
Reckoning up the bad and good symptoms that supervene from these, one must predict the prognoses; for in this way one would most speak the truth.
Αἱ δὲ ἄλλαι ἐκπυήσιες ῥήγνυνται αἱ πλεῖσται, αἱ μὲν εἰκοσταῖαι, αἱ δὲ τριηκοσταῖαι, αἱ δὲ τεσσαρακονθήμεροι, αἱ δὲ πρὸς τὰς ἑξήκοντα ἡμέρας ἀφικνέονται.
Most of the other suppurations burst, some on the twentieth, some on the thirtieth, some on the fortieth day, while some reach toward sixty days.
§1616.
16.
Ἐπισκέπτεσθαι δὲ χρὴ τὴν ἀρχὴν τοῦ ἐμπυήματος ἔσεσθαι λογιζόμενον ἀπὸ τῆς ἡμέρης ἧς τὸ πρῶτον ὁ ἄνθρωπος ἐπύρεξεν, ἢ εἴ ποτε αὐτὸν ῥῖγος ἔλαβε, καὶ εἰ φαίη ἀντὶ τῆς ὀδύνης αὐτέῳ βάρος γεγενῆσθαι ἐν τῷ τόπῳ ἐν ᾧ ἤλγεεν· ταῦτα γὰρ ἐν ἀρχῇσι γίγνεται τῶν ἐμπυημάτων.
And one must investigate the beginning of the empyema, reckoning from the day on which the patient first had fever, or if ever a chill seized him, and if he should say that, instead of the pain, a heaviness has arisen for him in the place where he was pained; for these things happen at the beginnings of empyemas.
Ἐξ οὖν τουτέων τῶν χρόνων τὴν ῥῆξιν χρὴ προσδέχεσθαι τῶν ἐμπυημάτων ἔσεσθαι ἐς τοὺς χρόνους τοὺς προειρημένους.
From these times, therefore, one must expect the bursting of the empyemas to be in the times mentioned before.
Εἰ δὲ εἴη τὸ ἐμπύημα ἐπὶ θάτερα μοῦνον, στρέφειν τε καὶ καταμανθάνειν χρὴ ἐπὶ τουτέοισι, μή τι ἔχῃ ἄλγημα ἐν τῷ ἑτέρῳ πλευρῷ· καὶ ἢν θερμότερον ᾖ τὸ ἕτερον τοῦ ἑτέρου, κατακλινομένου ἐπὶ τὸ ὑγιαῖνον πλευρὸν, ἐρωτᾷν εἴ τι αὐτέῳ δοκέει βαρὺ ἀποκρέμασθαι ἐκ τοῦ ἄνωθεν.
And if the empyema should be on one side only, one must turn the patient and observe closely on these points, whether he has any pain in the other flank; and if one side should be hotter than the other, when he lies down on the healthy flank, to ask if any heavy thing seems to him to hang down from above.
Εἰ γὰρ εἴη τοῦτο, ἐπὶ θάτερόν ἐστι τὸ ἐμπύημα, ἐπὶ ὁκοῖον ἂν πλευρὸν τὸ βάρος γίγνηται.
For if this should be so, the empyema is on that side, on whichever flank the weight occurs.