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Hippocrates · On Regimen in Acute Diseases (Appendix) §9

Calculation of Critical Days and Prognosis in Fevers

Passage 5 of 12 · Greek

Summary

The passage discusses the examination of the patient's aspects and critical days, the inspection of body parts, the significance of the third and fourth days in fevers, and prognostic signs such as stool condition and convulsions.

§99.
9.
Εἰσὶ δὲ ὄψιες πολλαὶ τῶν καμνόντων· διὸ προσεκτέον τῷ ἰωμένῳ, ὅκως μὴ διαλήσεται τῶν προφασίων, μήτε τῶν κατὰ λογισμὸν, μήτε ὁκόσα ἐς ἀριθμὸν ἄρτιον ἢ περισσὸν δεῖ φανῆναι·
And there are many appearances of the sick; therefore the physician must pay attention so that he does not miss the symptoms, nor those things arrived at by calculation, nor those which must appear on an even or odd number of days.
μάλιστα μὲν οὖν δεῖ τὸν περισσὸν ἀριθμὸν εὐλαβέεσθαι, ὡς αὗται αἱ ἡμέραι ἑτεροῤῥοπέας ποιέουσι τοὺς κάμνοντας.
Above all, therefore, one must guard against the odd number of days, since these days make the sick turn one way or the other.
Φυλάσσεσθαι οὖν δεῖ τὴν πρώτην ἡμέρην, ᾗ ἦρκται ἀσθενέειν ὁ κάμνων, ἰδόντα τὴν ἀρχὴν ἐξ ὅτου καὶ διότι· ἡγέεται γὰρ τοῦτο πρῶτον εἰδῆσαι.
One must therefore watch the first day on which the patient began to be sick, having observed the beginning, from what cause and for what reason it began; for it is considered that this is the first thing to know.
Ὁκόταν δὲ ἔρῃ αὐτὸν καὶ διασκέψῃ ταῦτα πάντα, πρῶτον μὲν κεφαλὴν ὅκως ἔχει, εἰ ἀνάλγητος καὶ μὴ βάρος ἔχει ἐν ἑωυτῇ· ἔπειτα ὑποχόνδρια καὶ πλευρὰ, εἰ ἀνάλγητα· ὑποχόνδριον μὲν γὰρ, εἰ ἐπίπονόν ἐστιν ἢ ἐπηρμένον ἢ ἔχει τινὰ σκολιότητα ἢ κόρον, ἢ πλευροῦ ἀλγηδὼν ἐνείη, καὶ ἅμα τῷ ἀλγήματι ἢ βηχίον, ᾖ στρόφος ἠ πόνος κοιλίης· ὅταν δέ τι τούτέων παρῇ, ἐν ὑποχονδρίῳ μὲν μάλιστα, λύειν τὴν κοιλίην κλυσμοῖσιν· πινέτω δὲ. μελίκρητον θερμὸν ἀφηψημένον.
And when you have questioned him and examined all these things, first indeed observe how the head is, whether it is free from pain and has no heaviness in itself; then the hypochondria and the sides, whether they are free from pain; for as to the hypochondrium, observe if it is painful or swollen, or has any distortion or fullness, or if there be pain in the side, and along with the pain either a slight cough, or colic or pain in the belly; and when any of these is present, especially in the hypochondrium, loosen the belly with clysters; and let him drink hot boiled hydromel.
Καταμανθάνειν δὲ καὶ ἐν τῇσιν ἐξαναστάσεσιν εἰ λειποθυμέει, καὶ εἰ τοῦ πνεύματος εὐφορίη αὐτὸν ἔχει, ἰδεῖν τε τὴν διαχώρησιν, μή τι μέλαν διεχώρησεν ἰσχυρῶς χρῶμα, καὶ εἰ καθαρὸν, ὁκοῖα ὑγιαίνοντος ἂν εἴη διαχωρήματα, καὶ ὁ πυρετὸς ἐς τὴν τρίτην ἐπιπαροξυνόμενος· κατιδὼν δὲ εὖ μάλα τοὺς τοιούσδε ἐν ταύτῃσι τῇσι νούσοιστ τριταίους, πρὸς ταάτην ἤδη καὶ τὰ ἄλλα συνορῇν· καὶ ἢν ἡ τετάρτη τῇ τρίτῃ ἡμέρῃ ὅμοιον ἔχῃ τι τῶν αὐτῶν τουτέων, κινδυνώδης ὁ κάμνων γίγνεται.
And one must also observe whether he faints when getting up, and whether he has ease of breathing, and see the stool, whether any stool of a very dark color has passed, and whether it is clear, such as the stools of a healthy person would be, and whether the fever is exacerbated on the third day; and having observed such patients very well on the third day in these diseases, already from this day onward examine also the other symptoms; and if the fourth day has any of these same symptoms similar to the third day, the patient becomes in a dangerous state.
Τὰ δὲ σημεῖα· ἡ μὲν μέλαινα διαχώρησις θάνατον σημαίνει, ἡ δὲ ὁμοίη τῷ ὑγιαίνοντι ὁκόταν πάσας τὰς ἡμέρας φαίνηται, σωτήριον· ὁκόταν δὲ μὴ ὑπακούῃ τῇ βαλάνῳ, ἐνῇ δὲ τοῦ πνεύματος εὐφορίη, διαναστὰς ἐπὶ τὸν θρόνον ἢ αὐτοῦ ἐν τῇ κλίνῃ, ἢν ἀψυχίη ἐγγένηται, ταῦτα ὁκόταν προσῇ τῷ κάμνοντι ἢ τῇ καμνούσῃ κατ᾿ ἀρχὰς, παραφροσύνην οἴου ἐσομένην.
The signs are as follows: dark stool indicates death, but that which is similar to a healthy person's, when it appears on all days, indicates recovery; but when the patient does not respond to the suppository, yet there is ease of breathing, and upon rising to the stool or right there on the bed, if fainting occurs—when these symptoms are present in a male or female patient at the beginning, expect that delirium will occur.
Προσέχειν δὲ χρὴ καὶ τῇσι χερσίν· ἢν γὰρ τρομεραὶ ἔωσι, προσδέχου τῷ τοιῷδε ἀπόσταξιν αἵματος ἐκ ῥινῶν ἐσομένην· ὁρῇν δὲ χρὴ καὶ τοὺς μυκτῆρας· ἢν ὁμοίως τὸ πνεῦμα δι᾿ ἀμφοτέρων ἕλκηται, καὶ ἢν πουλὺ φέρηται ἐκ τῶν μυκτήρων, φιλέει γίγνεσθαι σπασμός· ἢν δὲ σπκσμὸς γένηται τῷ τοιῷδε, θάνατος προσδόκιμος, καὶ καλῶς ἔχει προλέγειν.
And one must also pay attention to the hands; for if they are trembling, expect in such a patient that a dripping of blood from the nose will occur; and one must also observe the nostrils; if the breath is drawn equally through both, and if much is carried from the nostrils, convulsion is accustomed to occur; and if convulsion occurs in such a patient, death is to be expected, and it is well to predict it.

Notes

  1. p.436ὅκως μὴ διαλήσεται τῶν προφασίων — The clause ὅκως μὴ is followed by the future indicative (διαλήσεται, future middle of διαλανθάνω), forming an effort or caution clause dependent on the preceding verbal adjective προσεκτέον. The verb διαλανθάνω governs the genitive cases, hence τῶν προφασίων and the subsequent phrases.
  2. p.438κεφαλὴν ὅκως ἔχει — An instance of prolepsis (anticipation), where the accusative κεφαλὴν, which logically serves as the subject of the indirect question ὅκως ἔχει, is anticipated and placed before the clause.
  3. p.440κατιδὼν δὲ εὖ μάλα τοὺς τοιούσδε ἐν ταύτῃσι τῇσι νούσοιστ τριταίους, πρὸς ταύτην ἤδη καὶ τὰ ἄλλα συνορῇν — The adjective τριταίους is used adverbially to indicate time ('on the third day'). πρὸς ταύτην means 'in relation to this (third) day' or 'basing on this day.' The infinitive συνορῇν is used with imperative force (imperative infinitive).
  4. p.440παραφροσύνην οἴου ἐσομένην — οἴου is the second-person singular present imperative of οἴομαι ('expect', 'think'). It governs an accusative and participle construction, where παραφροσύνην is the subject accusative and ἐσομένην is the future participle, indicating indirect discourse ('expect that delirium will occur').

Cite this passage

Hippocrates, On Regimen in Acute Diseases (Appendix) §9. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg005.humanitext-grc1:9

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