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Hippocrates · Prognostic §3-6

Prognosis by Posture, Movements, Respiration, and Sweat

Passage 2 of 10 · Greek

Summary

This passage explains how to interpret the patient's lying postures and involuntary hand movements as signs of death or delirium, and discusses the prognostic significance of respiration patterns and types of sweat.

§33.
3.
Κεκλιμένον δὲ χρὴ καταλαμβάνεσθαι τὸν νοσέοντα ὑπὸ τοῦ ἰητροῦ ἐπὶ τὸ πλευρὸν τὸ δεξιὸν, ἢ τὸ ἀριστερὸν, καὶ τὰς χεῖρας καὶ τὸν τράχηλον καὶ τὰ σκέλεα ὀλίγον ἐπικεκαμμένα ἔχοντα, καὶ τὸ ξύμπαν σῶμα ὑγρὸν κείμενον· οὕτω γὰρ καὶ οἱ πλεῖστοι τῶν ὁγιαινόντων κατακλίνονται· ἄρισται δέ εἰσι τῶν κατακλίσιων αἱ ὅμοιαι τῇσι τῶν ὁγιαινόντων.
The sick man should be found by the physician lying on his right or left side, having his hands, neck, and legs slightly bent, and the whole body lying relaxed; for thus also most people in health lie down, and the best of positions are those which are like the positions of people in health.
Ὕπτιον δὲ κέεσθαι καὶ τὰς χεῖρας καὶ τὸν τράχηλον καὶ τὰ σκέλεα ἐκτεταμένα ἔχοντα, ἧσσον ἀγαθόν.
But to lie on the back, keeping the hands, neck, and legs stretched out, is less good.
Εἰ δὲ καὶ προπετὴς γένοιτο, καὶ καταῤῥέοι ἐπὶ τῆς κλίνης ἐπὶ τοὺς πόδας, δεινότερόν ἐστιν.
And if he should slip forward, and slide down in the bed towards the feet, it is more dangerous.
Εἰ δὲ καὶ γυμνοὺς τοὺς πόδας εὁρίσκοιτο ἔχων, μὴ θερμοὺς κάρτα ἐόντας, καὶ τὰς χεῖρας, καὶ τὸν τράχηλον, καὶ τὰ σκέλεα ἀνωμάλως διεῤῥιμμένα καὶ γυμνὰ, κακόν· ἀλυσμὸν γὰρ σημαίνει.
And if he should be found having his feet bare, though they are not very warm, and his hands, neck, and legs irregularly tossed about and bare, it is bad; for it signifies restlessness.
Θανατῶδες δὲ καὶ τὸ κεχηνότα καθεύδειν αἰεὶ, καὶ τὰ σκέλεα ὑπτίου κειμένου ξυγκεκαμμένα εἶναι ἰσχυρῶς, καὶ διαπεπλεγμένα.
It is fatal also to sleep always with the mouth open, and for the legs to be strongly bent and crossed while he is lying on his back.
Ἐπὶ γαστέρα δὲ κέεσθαι ᾧ μὴ ξύνηθές ἐστι καὶ ὑγιαίνοντι οὕτω κοιμᾶσθαι, παραφροσύνην τινὰ σημαίνει, ἢ ὀδύνην τῶν ἀμφὶ τὴν κοιλίην τόπων.
To lie on the stomach, for one to whom it is not customary even when healthy to sleep thus, signifies some delirium, or pain in the parts about the abdomen.
Ἀνακαθίζειν δὲ βούλεσθαι τὸν νοσέοντα, τῆς νούσου ἀκμαζούσης, πονηρὸν μὲν ἐν πᾶσι τοῖσιν ὀξέσι νουσήμασι, κάκιστον δὲ ἐν τοῖσι περιπλευμονικοῖσιν.
For the sick man to wish to sit up when the disease is at its height is bad in all acute diseases, but worst in cases of pneumonia.
Ὀδόντας δὲ πρίειν ἐν πυρετοῖσιν, ὁκόσοισι μὴ ξύνηθές ἐστιν ἀπὸ παίδων, μανικὸν καὶ θανατῶδες, ἀλλὰ προλέγειν ἀπ᾿ ἀμφοῖν κίνδυνον ἐσόμενον· ἢν δὲ καὶ παραφρονέων τοῦτο ποιέῃ, ὀλέθριον γίγεται κάρτα ἤδη.
To grind the teeth in fevers, for those to whom it has not been customary from childhood, is a sign of madness and fatal, but one should foretell that danger will arise from both; and if he should do this while also being delirious, it becomes indeed extremely fatal.
Ἕλκος δὲ ἥν τε καὶ προγεγονὸς τύχῃ ἔχων, ἤν τε καὶ ἐν τῇ νούσῳ γένηται, καταμανθάνειν δεῖ· ἢν γὰρ μέλλῃ ἀπόλλυσθαι ὁ ἄνθρωπος, πρὸ τοῦ θανάτου πελιδνόν τε καὶ ξηρὸν ἔσται, ἢ ὠχρόν τε καὶ ξηρόν.
One must also closely observe an ulcer, whether he happens to have had it beforehand, or it arises during the disease; for if the man is about to die, before death it will become livid and dry, or pale and dry.
§44.
4.
Περὶ δὲ χειρῶν φορῆς τάδε γιγνώσκω· ὁκόσοισιν ἐν πυρετοῖσιν ὀξέσιν, ἢ ἐν περιπλευμονίῃσιν, ἢ ἐν φρενίτισιν, ἢ ἐν κεφαλαλγίῃσι, πρὸ τοῦ προσώπου φερομένας καὶ θηρευούσας διὰ κενῆς, καὶ ἀποκαρφολογεούσας, καὶ κροκίδας ἀπὸ τῶν ἱματίων ἀποτιλλούσας, καὶ ἀπὸ τοῦ τοίχου ἄχυρα ἀποσπώσας, πάσας εἶναι κακὰς καὶ θανατώδεας.
And concerning the movement of the hands, I judge as follows: in those who, in acute fevers, or in pneumonia, or in phrenitis, or in headaches, have their hands carried before their face, clutching at the empty air, plucking off bits of straw, pulling threads from the clothes, and tearing chaff from the wall, all these movements are bad and fatal.
§55.
5.
Πνεῦμα δὲ πυκνὸν μὲν ἐὸν πόνον σημαίνει ἢ φλεγμονὴν ἐν τοῖσιν ὑπὲρ τῶν φρενῶν χωρίοισι· μέγα δὲ ἀναπνεόμενον καὶ διὰ πολλοῦ χρόνου παραφροσύνην δηλοῖ· ψυχρὸν δὲ ἐκπνεόμενον ἐκ τῶν ῥινῶν καὶ τοῦ στόματος ὀλέθριον κάρτα ἤδη γίγνεται.
And respiration being frequent signifies pain or inflammation in the parts above the diaphragm; and respiration being deep and at long intervals indicates delirium; and cold respiration being exhaled from the nostrils and the mouth becomes indeed extremely fatal.
Εὔπνοιαν δὲ χρὴ νομίζειν κάρτα μεγάλην δύναμιν ἔχειν ἐς σωτηρίην ἐν ἅπασι τοῖσιν ὀξέσι νουσήμασιν, ὅσα ξὺν πυρετοῖσίν ἐστι καὶ ἐν τεσσαράκοντα ἡμέρῃσι κρίνεται.
And one must consider that easy respiration has very great power for recovery in all acute diseases which are accompanied by fevers and are decided within forty days.
§66.
6.
Οἱ δὲ ἱδρῶτες ἄριστοι μέν εἰσιν ἐν πᾶσι τοῖσιν ὀξέσι νουσήμασιν, ὁκόσοι ἐν ἡμέρῃσί τε κρισίμοισι γίγνονται καὶ τελείως τὸν πυρετὸν ἀπαλλάσσουσιν.
And sweats are best in all acute diseases, those which occur on critical days and completely rid of the fever.
Ἀγαθοὶ δὲ καὶ ὁκόσοι διὰ παντὸς τοῦ σώματος γιγνόμενοι ἀπέδειξαν τὸν ἄνθρωπον εὐπετέστερον φέροντα τὸ νούσημα.
And those are also good which, occurring through the whole body, show that the man bears the disease more easily.
Οἳ δ᾿ ἂν μὴ τοιοῦτόν τι ἐξεργάσωνται, οὐ λυσιτελέες.
But those which do not effect any such thing are not beneficial.
Κάκιστοι δὲ οἱ ψυχροί τε καὶ μοῦνον περὶ τὴν κεφαλήν τε καὶ τὸ πρόσωπον γιγνόμενοι καὶ τὸν αὐχένα· οὗτοι γὰρ ξὺν μὲν ὀξεῖ πυρετῷ θάνατον προσημαίνουσι, ξὺν δὲ πρηϋτέρῳ, μῆκος νούσου.
And worst are those which are cold and occur only about the head, face, and neck; for these, with acute fever, portend death, but with a milder fever, length of the disease.
Καὶ οἱ κατὰ πᾶν τὸ σῶμα ὡσαύτως γιγνόμενοι τοῖσι περὶ τὴν κεφαλήν· οἱ δὲ κεγχροειδέες καὶ μοῦνον περὶ τὸν τράχηλον γιγνόμενοι πονηροί.
And those occurring through the whole body in the same manner as those about the head are also bad; and those which are millet-like and occur only about the neck are bad.
Οἱ δὲ μετὰ σταλαγμῶν καὶ ἀτμίζοντες, ἀγαθοί.
But those which are in drops and accompanied by vapor are good.
Κατανοέειν δὲ χρὴ τὸ ξύνολον τῶν ἱδρώτων. Γίγνονται γὰρ οἱ μὲν δι᾿ ἔκλυσιν σωμάτων, οἱ δὲ διὰ ξυντονίην φλεγμονῆς.
And one must observe the general character of sweats; for some arise from the exhaustion of the body, and others from the intensity of inflammation.

Notes

  1. 3χρὴ καταλαμβάνεσθαι τὸν νοσέοντα — The impersonal verb χρὴ takes an accusative with infinitive (A.C.I.) construction, where τὸν νοσέοντα is the subject accusative of the passive infinitive καταλαμβάνεσθαι ('the sick man should be found [by the physician] lying...').
  2. 3ᾧ μὴ ξύνηθές ἐστι — The dative relative pronoun ᾧ functions as a dative of reference ('for whom'). Although the antecedent is implied, it refers to the patient who does not have the habit of sleeping in this posture even when healthy.
  3. 3ἀπ᾿ ἀμφοῖν — The phrase ἀπ᾿ ἀμφοῖν ('from both') has been interpreted in various ways, but here it most naturally refers to the two outcomes just mentioned, 'madness' (μανικόν) and 'death' (θανατῶδες), meaning that danger is imminent from either condition.
  4. 5μέγα δὲ ἀναπνεόμενον — The participle ἀναπνεόμενον is a neuter singular agreeing with the preceding subject πνεῦμα (respiration). The adjective μέγα functions adverbially, meaning 'being deeply inhaled' or 'deep respiration'.
  5. 6οὗτοι γὰρ ξὺν μὲν ὀξεῖ πυρετῷ... — The demonstrative pronoun οὗτοι refers to the cold sweats localized around the head, face, and neck mentioned in the previous clause. The parallel structure with μὲν... δέ... contrasts the outcome under an acute fever (death) with that under a milder fever (prolonged illness).

Cite this passage

Hippocrates, Prognostic §3-6. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg003.humanitext-grc1:3-6

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