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Hippocrates · On the Nature of Man §14-15

Urinary Abnormalities and Four Types of Fever

Passage 8 of 8 · Greek

Summary

Anatomically explains the causes of urinary abnormalities from the types of sediments, and describes the etiology of four types of fevers (continuous, quotidian, tertian, and quartan) based on the quantity and qualities of bile and black bile.

§1414.
14.
Ὁκόσοισι ψαμμοειδέα ὑφίσταται ἢ πῶροι ἐν τοῖσιν οὔροισι, τουτέοισι τὴν ἀρχὴν φύματα ἐγένετο πρὸς τῇ φλεβὶ τῇ παχείῃ, καὶ διεπύησεν, ἔπειτα δὲ, ἅτε οὐ ταχέως ἐκραγέντων τῶν φυμάτων, πῶροι ξυνετράφησαν ἐκ τοῦ πύου, οἵτινες ἔξω θλίβονται διὰ τῆς φλεβὸς σὺν τῷ οὔρῳ ἐς τὴν κύστιν.
For those in whose urine sand-like sediment or stones are deposited, in the beginning, swellings arose near the thick vessel and suppurated; and then, because the swellings did not burst quickly, stones were formed from the pus, which are pressed out through the vessel with the urine into the bladder.
Ὁκόσοισι δὲ μοῦνον αἱματώδεα τὰ οὐρήματα, τουτέοισι δὲ αἱ φλέβες πεπονήκασιν·
For those whose urine is merely bloody, their vessels are affected.
ὁκόσοισι δὲ ἐν τῷ οὐρήματι παχεῖ ἐόντι σαρκία σμικρὰ τριχοειδέα συνεξέρχεται, ταῦτα δὲ ἀπὸ τῶν νεφρῶν εἰδέναι χρὴ ἐόντα καὶ ἀπὸ ἀρθριτικῶν·
For those in whose thick urine small hair-like pieces of flesh are discharged together, one must know that these come from the kidneys and from arthritic diseases.
ὁκόσοισι δὲ καθαρὸν τὸ οὖρον ἄλλοτε καὶ ἄλλοτε, ὁκοῖον δὲ πίτυρα ἐπιφέρεται ἐν τῷ οὐρήματι, τουτέων δὲ ἡ κύστις ψωριᾷ.
For those whose urine is sometimes clear and sometimes has bran-like particles floating in it, their bladder is suffering from scabies.
§1515.
15.
Οἱ πλεῖστοι τῶν πυρετῶν γίνονται ἀπὸ χολῆς· εἴδεα δὲ σφέων ἐστὶ τέσσαρα, χωρὶς τῶν ἐν τῇσιν ὀδύνῃσι γινομένων τῇσιν ἀποκεκριμένῃσιν·
Most fevers arise from bile; and there are four kinds of them, apart from those that arise in distinct pains.
οὐνόματα δ’ αὐτέοισίν ἐστι ξύνοχος, ἀμφημερινὸς, τριταῖος, τεταρταῖος.
Their names are continuous, quotidian, tertian, and quartan.
Ὁ μὲν οὖν ξύνοχος καλεόμενος γίνεται ἀπὸ πλείστης χολῆς καὶ ἀκρητεστάτης, καὶ τὰς κρίσιας ἐν ἐλαχίστῳ χρόνῳ ποιέεται· τὸ γὰρ σῶμα οὐ διαψυχόμενον οὐδένα χρόνον συντήκεται ταχέως, ἅτε ὑπὸ πολλοῦ τοῦ θερμοῦ θερμαινόμενον.
Now, that which is called continuous fever arises from the greatest and most unmixed bile, and makes its crises in the shortest time; for the body, not being cooled at any time, wastes away quickly, since it is heated by much heat.
Ὁ δὲ ἀμφημερινὸς μετὰ τὸν ξύνοχον ἀπὸ πλείστης χολῆς γίνεται, καὶ ἀπαλλάσσεται τάχιστα τῶν ἄλλων, μακρότερος δέ ἐστι τοῦ ξυνόχου, ὁκόσῳ ἀπὸ ἐλάσσονος γίνεται χολῆς, καὶ ὅτι ἔχει ἀνάπαυσιν τὸ σῶμα, ἐν δὲ τῷ ξυνόχῳ οὐκ ἀναπαύεται οὐδένα χρόνον.
The quotidian arises from the greatest bile after the continuous, and is rid of the fastest of the others, but is longer than the continuous, by as much as it arises from less bile, and because the body has rest, whereas in the continuous it does not rest at any time.
Ὁ δὲ τριταῖος μακρότερός ἐστι τοῦ ἀμφημερινοῦ, καὶ ἀπὸ χολῆς ἐλάσσονος γίνεται· ὁκόσῳ δὲ πλείονα χρόνον ἐν τῷ τριταίῳ ἢ ἐν τῷ ἀμφημερινῷ τὸ σῶμα διαναπαύεται, τοσούτῳ χρονιώτερος οὗτος ὁ πυρετὸς τοῦ ἀμφημερινοῦ ἐστιν.
The tertian is longer than the quotidian, and arises from less bile; and by as much as the body rests for a longer time in the tertian than in the quotidian, by so much is this fever longer-lasting than the quotidian.
Οἱ δὲ τεταρταῖοι τὰ μὲν ἄλλα κατὰ τὸν αὐτὸν λόγον, χρονιώτεροι δὲ μάλα τῶν τριταίων εἰσὶν, ὁκόσῳ ἔλασσόν τι μέρος μετέχουσι χολῆς τῆς τὴν θερμασίην παρεχούσης, τοῦ τε διαψύχεσθαι τὸ σῶμα πλέον μετέχουσιν· προσγίνεται δὲ αὐτέοισιν ἀπὸ μελαίνης χολῆς τὸ περισσὸν τοῦτο καὶ δυσαπάλλακτον· μέλαινα γὰρ χολὴ τῶν ἐν τῷ σώματι ἐνεόντων χυμῶν γλισχρότατον, καὶ τὰς ἕδρας χρονιωτάτας ποιέεται.
The quartans, while in other respects according to the same reasoning, are much longer-lasting than the tertians, by as much as they participate in a smaller portion of the bile that provides the heat, and participate more in the cooling of the body; and to them is added from black bile this excess and difficulty of riddance; for black bile is the most viscid of the humors present in the body, and makes its seats most long-lasting.
Γνώσῃ δὲ ἐν τῷδε, ὅτι οἱ τεταρταῖοι πυρετοὶ μετέχουσι τοῦ μελαγχολικοῦ· φθινοπώρου γὰρ μάλιστα οἱ ἄνθρωποι ἁλίσκονται ὑπὸ τῶν τεταρταίων καὶ ἐν τῇ ἡλικίῃ τῇ ἀπὸ πέντε καὶ εἴκοσιν ἐτέων ἕως τῶν πέντε καὶ τεσσαράκοντα, ὅτι καὶ ἡ ἡλικίη αὕτη ὑπὸ μελαίνης χολῆς κατέχεται μάλιστα πασέων τῶν ἡλικιῶν, ἥ τε φθινοπωρινὴ ὥρη μάλιστα πασέων τῶν ὡρέων ἐπιτηδειοτάτη.
You will know by this that quartan fevers participate in the melancholic; for in autumn men are especially seized by quartans, and in the age from twenty-five years to forty-five, because this age is dominated by black bile most of all ages, and the autumnal season is the most suitable of all seasons.
Ὁκόσοι δ’ ἂν ἁλῶσιν ἔξω τῆς ὥρης ταύτης καὶ τῆς ἡλικίης ὑπὸ τεταρταίου, εὖ χρὴ εἰδέναι μὴ χρόνιον ἐσόμενον τὸν πυρετὸν, ἢν μὴ ἄλλο τι κακουργῆται ὥνθρωπος.
But for those who are seized by a quartan outside of this season and age, one must know well that the fever will not be long-lasting, unless the man is otherwise harmed.

Notes

  1. 14τὴν ἀρχὴν — Accusative of adverbial use, meaning 'at first' or 'originally.' Here it indicates the temporal and logical starting point in the formation process of urinary stones.
  2. 14ἅτε οὐ ταχέως ἐκραγέντων τῶν φυμάτων — Genitive absolute construction (participle ἐκραγέντων and noun τῶν φυμάτων) accompanied by the conjunction ἅτε ('since,' 'inasmuch as'). It serves to emphasize an objective causal relationship or reason.
  3. 14ταῦτα δὲ ἀπὸ τῶν νεφρῶν εἰδέναι χρὴ ἐόντα — The impersonal verb χρὴ ('one must') governs the infinitive εἰδέναι ('to know'), which in turn takes an accusative with participle construction. The neuter plural ταῦτα acts as the subject of the participle ἐόντα.
  4. 15ὁκόσῳ δὲ πλείονα χρόνον ... τοσούτῳ χρονιώτερος — Comparative correlation construction using the datives of measure of difference (ὁκόσῳ ... τοσούτῳ), meaning 'by as much as... by so much...' The comparative χρονιώτερος does not merely mean that the paroxysm lasts longer, but that the entire duration of the illness is prolonged (becomes chronic) due to the longer periods of intermission.
  5. 15εὖ χρὴ εἰδέναι μὴ χρόνιον ἐσόμενον τὸν πυρετὸν — The infinitive εἰδέναι ('to know'), governed by the impersonal verb χρὴ, takes an indirect discourse construction with the accusative subject τὸν πυρετὸν and the future participle ἐσόμενον. The negator μὴ is used instead of οὐ because it depends on the infinitive clause.

Cite this passage

Hippocrates, On the Nature of Man §14-15. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg019.humanitext-grc1:14-15

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