Humanitext Reader

Hippocrates · On the Nature of Bones §9

Pathways of the Four Pairs of Vessels and Phlebotomy

Passage 3 of 7 · Greek

Summary

This section details the pathways of the four main pairs of vessels in the body, their corresponding bloodletting locations for specific pains, and the general clinical principle of making incisions as far as possible from the affected areas.

§99.
9.
Αἱ παχύταται τῶν φλεβῶν πεφύκασι· τέσσαρα ζεύγεά εἰσιν ἐν τῷ σώματι.
The thickest of the vessels are naturally formed as follows: there are four pairs in the body.
Καὶ αἱ μὲν αὐτέων ἀπὸ τῆς κεφαλῆς ὄπισθεν διὰ τοῦ αὐχένος, ἔξωθεν παρὰ τὴν ῥάχιν ἔνθεν καὶ ἔνθεν εἰς τὰ ἰσχία ἀφικνέεται καὶ ἐς τὰ σκέλεα· ἔπειτα διὰ τῶν κνημέων ἐπὶ τῶν σφυρῶν τὰ ἔξω καὶ ἐς τοὺς πόδας ἀφήκει.
And the first pair of them runs from the back of the head through the neck, along the outside of the spine on either side, and reaches the hips and the legs; then it extends through the shins over the outer ankles and into the feet.
Δεῖ οὖν τὰς φλεβοτομίας ἐπὶ τῶν ἀλγημάτων τῶν ἐν τῷ νώτῳ καὶ ἐν τοῖσιν ἰσχίοισιν ἀπὸ τῶν ἰγνύων ποιέεσθαι καὶ ἀπὸ τῶν σφυρῶν ἔξωθεν.
Therefore, for pains in the back and in the hips, one must perform bloodletting from the hams and from the outer ankles.
Αἱ δὲ δεύτεραι φλέβες ἐκ τῆς κεφαλῆς παρὰ τὰ ὦτα διὰ τοῦ αὐχένος, σφαγίτιδες καλεόμεναι, ἔσωθεν παρὰ τὴν ῥάχιν ἑκατέρωθεν φέρουσι παρὰ τὰς ψόας ἐς τοὺς ὄρχιας καὶ ἐς τοὺς μηροὺς, καὶ [διὰ] ἰγνύων ἐκ τοῦ ἔσωθεν μέρεος· ἔπειτα διὰ τῶν κνημέων ἐπὶ τὰ σφυρὰ τὰ ἔσωθεν καὶ τοὺς πόδας.
The second pair of vessels runs from the head past the ears through the neck—called the jugulars—along the inside of the spine on either side, past the loins to the testicles and the thighs, and through the hams on the inner side; then through the shins to the inner ankles and the feet.
Δεῖ οὖν τὰς φλεβοτομίας ποιέεσθαι πρὸς τὰς ὀδύνας τὰς ἀπὸ τῶν ψοῶν καὶ τῶν ὀρχίων, ἀπὸ τῶν ἰγνύων καὶ ἀπὸ τῶν σφυρῶν ἔσωθεν.
Therefore, one must perform bloodletting for pains arising from the loins and the testicles, from the hams and from the inner ankles.
Αἱ δὲ τρίται φλέβες ἐκ τῶν κροτάφων διὰ τοῦ αὐχένος ἐπὶ τὰς ὠμοπλάτας, ἔπειτα ξυμφέρονται ἐς τὸν πλεύμονα, καὶ ἀφικνέονται ἡ μὲν ἀπὸ τῶν δεξιῶν ἐς τὰ ἀριστερὰ ὑπὸ τὸν μαζὸν καὶ ἐς τὸν σπλῆνα καὶ ἐς τὸν νεφρὸν, ἡ δὲ ἀπὸ τῶν ἀριστερῶν ἐς τὰ δεξιὰ ἐκ τοῦ πνεύμονος ὑπὸ τὸν μαζὸν καὶ ἐς τὸ ἧπαρ καὶ ἐς τὸν νεφρόν· τελευτῶσι δὲ ἐς τὸν ἀρχὸν αὗται ἀμφότεραι.
The third pair of vessels runs from the temples through the neck to the shoulder blades, then they converge in the lung, and the one from the right goes to the left under the breast to the spleen and the kidney, while the one from the left goes from the lung to the right under the breast to the liver and the kidney; and both of these end in the rectum.
Αἱ δὲ τέταρται ἀπὸ τοῦ ἔμπροσθεν τῆς κεφαλῆς καὶ τῶν ὀφθαλμῶν ὑπὸ τὸν αὐχένα καὶ ὑπὸ τὰς κληβδας· ἔπειτα ἀπὸ τῶν βραχιόνων ἄνωθεν ὑπὸ τὰς ξυγκαμπάς· ἔπειτα διὰ τῶν πήχεων ἐς τοὺς καρποὺς καὶ τοὺς δακτύλους· ἔπειτα πάλιν ἀπὸ τῶν δακτύλων διὰ τῶν στηθέων τῶν χειρῶν καὶ τῶν πήχεων ἐς τὰς ξυγκαμπάς· διὰ δὲ τῶν βραχιόνων καὶ τοῦ κάτωθεν μέρεος ἐς τὰς μασχάλας· καὶ ἐκ τῶν πλευρέων ἄνωθεν ἡ μὲν ἐς τὸν σπλῆνα ἀφικνέεται, ἡ δὲ ἐς τὸ ἧπαρ· ἔπειτα ὑπὲρ τῆς γαστρὸς ἐς τὸ αἰδοῖον τελευτῶσιν ἀμφότεραι.
The fourth pair runs from the front of the head and the eyes, under the neck and under the clavicles, then from the upper arm above, under the bend of the elbow, then through the forearms to the wrists and the fingers; then back again from the fingers through the palms of the hands and the forearms to the bend of the elbow; and through the lower part of the upper arms to the armpits; and from the upper ribs, one reaches the spleen and the other the liver; then both end in the privy part above the stomach.
Καὶ αἱ μὲν παχεῖαι τῶν φλεβῶν οὕτω πεφύκασιν.
And the thick vessels are naturally formed in this way.
Εἰσὶ δὲ καὶ ἀπὸ τῆς κοιλίης φλέβες ἀνὰ τὸ σῶμα πολλαί τε καὶ παντοῖαι, δι’ ὧν ἡ τροφὴ τῷ σώματι ἔρχεται.
There are also many various vessels from the belly throughout the body, through which nourishment comes to the body.
Φέρουσι δὲ καὶ ἀπὸ τῶν παχειῶν φλεβῶν ἐς τὴν κοιλίην καὶ τὸ ἄλλο σῶμα καὶ ἀπὸ τῶν ἐξωτάτω καὶ ἀπὸ τῶν ἐσωτάτω, καὶ ἐς ἀλλήλας διαδιδόασιν αἵ τε ἔσωθεν ἔξω καὶ αἱ ἔξωθεν ἔσω.
They also carry from the thick vessels into the belly and the rest of the body, both from the outermost and from the innermost, and they distribute to one another, both from the inside out and from the outside in.
Τὰς οὖν φλεβοτομίας ποιέεσθαι χρὴ κατὰ τούσδε τοὺς τρόπους·
Therefore, one must perform bloodletting in the following ways.
ἐπιτηδεύειν δὲ δεῖ τὰς τομὰς, ὡς προσωτάτω ταμεῖν ἀπὸ χωρίων, ἔνθα ἂν αἱ ὀδύναι μεμαθήκωσι γίνεσθαι καὶ τὸ αἷμα ξυλλέγεσθαι·
And one must practice the incisions so as to cut as far away as possible from the places where the pains are accustomed to occur and the blood to collect.
οὕτω γὰρ ἂν ἥκιστα ἥ τε μεταβολὴ γίνοιτο μεγάλη ἐξαπίνης, καὶ τὸ ἔθος μεταστήσειας ἂν, ὥστε μηκέτι ἐς τωὐτὸ χωρίον ξυλλέγεσθαι.
For in this way, a sudden great change would least of all occur, and you would change the habit so that it would no longer collect in the same place.

Notes

  1. 9[διὰ] ἰγνύων — The preposition διὰ in square brackets is restored before the genitive plural ἰγνύων (of the hams) to clarify the path ('through the hams'), ensuring stylistic and syntactic consistency with the neighboring descriptions of vascular pathways (e.g., διὰ τοῦ αὐχένος, διὰ τῶν κνημέων).
  2. 9ὡς προσωτάτω ταμεῖν — The aorist infinitive ταμεῖν (from τέμνω, 'to cut') is joined with the superlative adverbial phrase ὡς προσωτάτω ('as far as possible') to explain the specific purpose or content of the action ἐπιτηδεύειν ('to practice, take care'), which is itself governed by the impersonal verb δεῖ.
  3. 9ἔνθα ἂν αἱ ὀδύναι μεμαθήκωσι γίνεσθαι — μεμαθήκωσι is the perfect active subjunctive 3rd person plural of μανθάνω ('to learn'). The perfect aspect of this verb functions as a present-state verb meaning 'to be accustomed to' or 'to habitually do'. Triggered by the general relative conjunction ἔνθα ἂν ('wherever'), it expresses a present general condition.

Cite this passage

Hippocrates, On the Nature of Bones §9. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg048.humanitext-grc1:9

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