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Hippocrates · On the Crises §11-22

Signs of Crisis from Excreta and Swelling in Fevers

Passage 2 of 4 · Greek

Summary

Explains various critical signs in burning and tertian fevers, the analogy between the coction of urine and ulcers, swelling in the hypochondrium and abdomen, and the types of dangerous sweats and excrements.

§1111.
11.
Ἴκτερος δὲ ἢν ἑβδομαίῳ ἐπιγένηται, ἢ ὕστερον ἐν καύσῳ καὶ δυσχέρεια, σιάλου πολλοῦ ἀποχώρησις·
If jaundice supervenes on the seventh day or later in a burning fever, and there is discomfort, a copious discharge of saliva occurs.
ἔν τε τοῖς καυσώδεσι πυρετοῖς καὶ τοῖς ἄλλοις, ἢν, μηδενὸς τουτέων τῶν σημείων γενομένου, ἀφίῃ ὁ πυρετὸς, ἀνάγκη τοιάσδε κρίσιας ἀντὶ τουτέων γενέσθαι, ἢ φυμάτων μεγάλων ἀπόστασιν, ἢ ὀδύνας ἰσχυρὰς ἀπὸ τῆς ἀποστάσιος, ἢ τηκεδόνας τῶν ὑγρῶν ἐκ τοῦ θερμοῦ.
Both in burning fevers and in others, if the fever departs without any of these signs occurring, it is necessary that crises of the following kind should take place instead of them: either the metastasis of large swellings, or severe pains from the metastasis, or the wasting of fluids caused by the heat.
Κρίσιες δὲ καὶ ἀφέσιες τῶν καῦσον σημαινόντων, μακροτέρα ἡ νοῦσος·
In crises and abatements of those showing signs of burning fever, the disease is longer.
τῶν δὲ ἰσχυρῶν, θάνατος ὡς ἐπὶ τὸ πουλύ·
In those of severe signs, death is the general rule.
οἱ δὲ λοιποὶ ἀσφαλέες παύονται καῦσοι ἑβδομαῖοι ἢ τεσσαρεσκαιδεκαταῖοι.
The remaining safe burning fevers cease on the seventh or fourteenth day.
Φιλέει δὲ καὶ ἐς λιπυρίην περιίστασθαι, καὶ λαμβάνει μάλιστα τεσσαράκοντα ἡμέρας καὶ ἐξηπιαλοῦται·
It also tends to turn into lipyria, which lasts for about forty days and becomes a mild fever.
καὶ ἡ λιπυρίη τῆς αὐτῆς ἡμέρης λαμβάνει τε καὶ μεθίησι· γίνεται δὲ καὶ τῆς κεφαλῆς ὀδύνη·
And the lipyria attacks and leaves on the same day; headache also occurs.
ἐὰν δὲ μὴ μεθίῃ αὐτὸν ἡ λιπυρίη ἐν ταῖς τεσσαράκοντα ἡμέραις, ἀλλ’ ἀχθῇ καὶ ὀδύνη ἔχῃ τὴν κεφαλὴν, καὶ φλυηρέῃ, ἐπικάθηρον αὐτόν.
If the lipyria does not leave him within forty days, but he is oppressed, has headache, and talks deliriously, purge him.
Λήγοντος δὲ καύσου, ἂν ἐπιγένηται ἴκτερος, οὐ φιλέει ἔτι ἱδροῦν, οὐδ’ ἄλλῃ ἀφίστασθαι οὐδαμῇ, ἀλλ’ ὑγιὴς γίνεται.
When a burning fever is subsiding, if jaundice supervenes, the body no longer tends to sweat, nor to have metastasis in any other way, but the patient becomes well.
§1212.
12.
Τριταῖος κρίνεται ἐν ἑπτὰ περιόδοισιν ὡς ἐπὶ τὸ πουλύ.
A tertian fever is resolved in seven periods for the most part.
§1313.
13.
Ὁκόσοις ἐν ἀφορήτοις πυρετοῖς τῇ ἑβδόμῃ, ἢ τῇ ἐνάτῃ, ἢ τεσσαρεσκαιδεκάτῃ ἴκτεροι γίνονται, ἀγαθὸν, ἐὰν μὴ τὸ δεξιὸν ὑποχόνδριον σκληρὸν γένηται· εἰ δὲ μὴ, ἐνδοιαστόν.
In those who, in intolerable fevers, develop jaundice on the seventh, ninth, or fourteenth day, it is a good sign, provided the right hypochondrium does not become hard; otherwise, it is doubtful.
§1414.
14.
Τὰ ὀξεὰ νοσήματα κρίνεται ἐν τεσσαρεσκαίδεκα ἡμέρῃσιν ὡς ἐπὶ τὸ πουλύ.
Acute diseases are resolved in fourteen days for the most part.
§1515.
15.
Ἱδρῶτες πυρεταίνουσιν ἢν γίνωνται τριταίοις καὶ πεμπταίοις καὶ ἑβδομαίοις καὶ ἐναταίοις καὶ ἑνδεκαταίοις καὶ τεσσαρεσκαιδεκαταίοις καὶ μίῃ καὶ εἰκοσταίοις καὶ τριηκοσταίοις, οὗτοι οἱ ἱδρῶτες νούσους κρίνουσιν· οἱ δὲ μὴ οὕτως γινόμενοι πόνους σημαίνουσιν.
In feverish patients, if sweats occur on the third, fifth, seventh, ninth, eleventh, fourteenth, twenty-first, and thirtieth days, these sweats resolve the diseases; but those which do not occur in this way signify pain.
§1616.
16.
Αἱ πεπάνσιες τῶν οὔρων κατὰ μικρὸν ἐκπεπαινόμεναι, ἐν τῇσι κρισίμοις ἐὰν πεπανθῶσι, λύουσι τὴν νοῦσον.
The coctions of urine, advancing little by little, if they reach coction on critical days, resolve the disease.
Παράδειγμα δεῖ τῶν οὔρων τὰ ἕλκεα ποιέεσθαι· τά τε γὰρ ἕλκεα, ἢν μὲν ἀνακαθαίρηται πύῳ λευκῷ, ταχείην θεραπείην δηλοῖ· ἐὰν δὲ μεταβάλλῃ ἐς τοὺς ἰχῶρας, κακοήθη γίνεται·
One should take ulcers as an analogy for urine; for if ulcers are cleansed with white pus, they indicate rapid healing, but if they change to ichor, they become malignant.
τὸν αὐτὸν δὲ τρόπον καὶ τὰ οὖρα σημαίνει.
In the same way also urine gives its signs.
Ἐὰν ἐκ πόνου λεπτὰ γένηται, ἀπὸ τῆς προφάσιος δεῖ λογίζεσθαι, ᾖ τὸ νόσημα παρεγένετο, καὶ ταύτην ὁρᾷν ἐπεὶ παύεται· ὡς ταύτης ὑπολειπομένης, τῶν ἄλλων σημείων ἐπιγινομένων οἵων δεῖ, οὐκ εἶναι ἀπαλλαγὴν τῇ νούσῳ οἰητέον.
If urine becomes thin from pain, one must reckon from the exciting cause by which the disease came on, and observe when this cause ceases; for as long as this remains, even if the other signs appear as they should, one must not think there will be a release from the disease.
Ἐὰν ἀλγέῃ ἡ κεφαλὴ, καὶ ἀπὸ τουτέου πυρετὸς ἐπιγένηται, [καὶ] τουτέου μὴ καταπαύσηται, μηδὲ τῆς ὀδύνης παυομένης, οὐ κρίσιμος ὁ πυρετός.
If the head aches, and a fever supervenes upon this, and does not subside, nor does the pain cease, the fever is not critical.
Κρίσεως μακρῆς ἔτι ἐπὶ τὸ ἄμεινον, πλεῖστα ταὐτ’ ἐστὶ καὶ ἐπὶ τουτέων ἅπερ ἐς ὑγίην ἰόντα.
For a prolonged crisis still tending to the better, most of the signs are the same in these cases as in those who are moving toward recovery.
§1717.
17.
Ἐν τοῖσιν ὑποχονδρίοισιν οἰδήματα μαλθακὰ καὶ ἀνώδυνα καὶ ὑπείκοντα ἐπεὶ θιγγάνῃς αὐτέου, χρονιωτέρας μὲν τὰς κρίσιας ποιέει, ἧσσον δὲ φοβερὰς τῶν ἐναντίων τουτέοις φυμάτων·
Swellings in the hypochondria that are soft, painless, and yielding when you touch them, make the crises more prolonged, but are less to be feared than tumors of the opposite character.
ὡσαύτως δὲ ἔχει καὶ περὶ τῶν ἐν τῇ ἄλλῃ κοιλίῃ φυμάτων.
It is the same also with tumors in the rest of the abdomen.
§1818.
18.
Οὔρων δὲ ἢν τὸ μὲν οὐρηθὲν καθαρὸν ᾗ, τὸ δ’ ὑπόστημα λευκόν τε καὶ λεῖον ἔχῃ, χρονιωτέρη ἡ κρίσις, ἢ καὶ ἧσσον ἀσφαλὲς τοῦ βελτίστου οὔρου· ἢν δέ ποτε ὑπέρυθρον [τὸ] οὖρον καὶ τὸ ὑπόστημα ὑπέρυθρον καὶ λεῖον, πουλυχρονιώτερον μὲν τοῦτο τοῦ προτέρου, σωτήριον δὲ κάρτα.
Concerning urine, if the voided liquid is clear, but has a white and smooth sediment, the crisis is more prolonged, and less safe than that of the best urine; but if the urine is reddish, and the sediment is also reddish and smooth, this is more prolonged than the former, but highly saving.
§1919.
19.
Ὁκόσα δὲ ποδαγρικὰ νοσήματα γίνεται, ταῦτα ἐν τεσσαράκονθ’ ἡμέραις ἀφλέγμαντα καθίστανται.
Such diseases as are gouty subside without inflammation within forty days.
§2020.
20.
Ἅπερ ἐς θάνατον ἐν ἡμέρῃ καὶ νυκτὶ κρίνεται, ἅπερ ἀσθενεώσεως σημεῖα, οἷον φαρμακοποσίης, κοιλίης ἐκταράξεως καὶ ἄνω καὶ κάτω, ἄσης, καὶ τῶν ἄλλων τῶν τοιουτέων·
Those crises which lead to death in a day and a night are accompanied by signs of extreme weakness, such as taking medicine, violent disturbance of the bowels both upward and downward, nausea, and other such things.
ἢν μὲν οὖν ἀπαλλάσσηται τούτων τὰ σημεῖα ἐν ἡμέρῃ καὶ νυκτί· εἰ δὲ μὴ, θανατώδη νομίζειν εἶναι.
Therefore, if the patient is freed from these signs within a day and a night, it is well; otherwise, they must be considered fatal.
§2121.
21.
Τῶν ἱδρώτων κάκιστοί εἰσιν οἱ ψυχροί τε καὶ περὶ τὸν αὐχένα γενόμενοι· οὗτοι γὰρ θανάτους καὶ μῆκος νούσων προσημαίνουσιν.
Of sweats, the worst are those that are cold and occur around the neck; for these portend death and prolonged illness.
§2222.
22.
Τὰ ποικίλα ὑποχωρήματα χρονιώτερα μὲν τῶν μελάνων καὶ τῶν ἄλλων θανασίμων ὑποχωρημάτων, οὐδὲν δὲ ἧσσον ὀλέθρια·
Variegated excrements are more prolonged than black ones and other fatal excrements, but are none the less deadly.
ἔστι δὲ τοιάδε, ξυσματώδεα, χολώδεα, αἱματώδεα, πρασοειδέα, μέλανα, καὶ τοτὲ μὲν ὁμοῦ πάντα διαχωρέει, τοτὲ δὲ κατὰ μέρος ἕκαστον.
They are of the following kinds: scrape-like, bilious, bloody, leek-green, and black; and sometimes they are all voided together, and sometimes each in turn.

Notes

  1. 11ἀπόστασιν — Refers to the formation of an abscess or the metastasis and deposition of pathogenic humors in a particular part of the body, presented as an alternative resolution of the disease when standard evacuation paths fail.
  2. 16ἀπὸ τῆς προφάσιος — The preposition ἀπό denotes cause or origin, instructing the physician to trace back and reckon from the initial occasion or exciting cause (such as diet, weather, or fatigue) that brought on the illness.
  3. 20Ἅπερ ἐς θάνατον ἐν ἡμέρῃ καὶ νυκτὶ κρίνεται — The relative pronoun Ἅπερ (neuter plural) at the beginning of the sentence acts as a free relative ('Those which...'), forming the subject clause that refers to lethal crises decided within a single day and night.

Cite this passage

Hippocrates, On the Crises §11-22. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0627.tlg052.humanitext-grc1:11-22

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