---
title: "On the Causes and Symptoms of Acute Diseases · Περὶ αἰτίων καὶ σημείων ὀξέων παθών"
author: "Aretaeus"
translator: "Francis Adams"
languages: [grc, en]
shelf: "Classical Greek"
url: https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/
cite: "Aretaeus, tr. Francis Adams, On the Causes and Symptoms of Acute Diseases · Περὶ αἰτίων καὶ σημείων ὀξέων παθών. Scriptura (scriptura.si), https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/"
---

# On the Causes and Symptoms of Acute Diseases · Περὶ αἰτίων καὶ σημείων ὀξέων παθών

*Aretaeus, tr. Francis Adams*

Clear descriptions of tetanus, pneumonia, pleurisy, cholera and other acute diseases.

> Greek: ed. Francis Adams, from the Perseus Digital Library (canonical-greekLit, tlg0719.tlg001, CC BY-SA 4.0).

> English: Francis Adams, from the Perseus Digital Library (tlg0719.tlg001.perseus-eng2). Notes are not included.

> Rows follow the references the two texts share (books, chapters and sections), cut where both reach the end of a sentence.

## Contents

1. [Book I](https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/1.md)
2. [Book II · chapters 1–6](https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/2.md)
3. [Book II · chapters 7–12](https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/3.md)

## 1. Book I

Source: https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/1/ · cite a paragraph as https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/1/#p-N

[¶0] 5. * * * * sluggishness, vertigo, heaviness of the tendons, plethora and distension of the veins in the neck; and much nausea indeed after food, but also, not unfrequently, with abstinence, there is a faint nausea; and phlegm is often vomited; want of appetite and indigestion after little food: they have flatulence and meteorism in the hypochondria. These symptoms, indeed, are constant. But, if it be near the accession of the paroxysm, there are before the sight circular flashes of purple or black colours, or of all mixed together, so as to exhibit the appearance of the rainbow expanded in the heavens; noises in the ears; a heavy smell; they are passionate, and unreasonably peevish. They fall down then, some from any such cause as lowness of spirits, but others from gazing intently on a running stream, a rolling wheel, or a turning top. But sometimes the smell of heavy odours, such as of the gagate stone (jet), makes them fall down. In these cases, the ailment is fixed in the head, and from it the disorder springs; but, in others, it arises also from the nerves remote from the head, which sympathise with the primary organ. Wherefore the great fingers of the hands, and the great toes of the feet are contracted; pain, torpor, and trembling succeed, and a rush of them to the head takes place. If the mischief spread until it reach the head, a crash takes place, in these cases, as if from the stroke of a piece of wood, or of stone; and, when they rise up, they tell how they have been maliciously struck by some person. This deception occurs to those who are attacked with the ailment for the first time. But those to whom the affection has become habitual, whenever the disease recurs, and has already seized the finger, or is commencing in any part, having from experience a foreknowledge of what is about to happen, call, from among those who are present, upon their customary assistants, and entreat them to bind, pull aside, and stretch the affected members; and they themselves tear at their own members, as if pulling out the disease; and such assistance has sometimes put off the attack for a day. But, in many cases, there is the dread as of a wild beast rushing upon them, or the phantasy of a shadow; and thus they have fallen down. In the attack, the person lies insensible; the hands are clasped together by the spasm; the legs not only plaited together, but also dashed about hither and thither by the tendons. The calamity bears a resemblance to slaughtered bulls; the neck bent, the head variously distorted, for sometimes it is arched, as it were, forwards, so that the chin rests upon the breast; and sometimes it is retracted to the back, as if forcibly drawn thither by the hair, when it rests on this shoulder or on that. They gape wide, the mouth is dry; the tongue protrudes, so as to incur the risk of a great wound, or of a piece of it being cut off, should the teeth come forcibly together with the spasm; the eyes rolled inwards, the eyelids for the most part are separated, and affected with palpitation; but should they wish to shut the lids they cannot bring them together, insomuch that the white of the eyes can be seen from below. The eyebrows sometimes relaxed towards the mesal space, as in those who are frowning, and sometimes retracted to the temples abnormally, so that the skin about the forehead is greatly stretched, and the wrinkles in the intersuperciliary space disappear: the cheeks are ruddy and quivering; the lips sometimes compressed together to a sharp point, and sometimes separated towards the sides, when they are stretched over the teeth, like as in persons smiling. As the illness increases lividity of countenance also supervenes, distension of the vessels in the neck, inability of speech as in suffocation; insensibility even if you call loudly. The utterance a moaning and lamentation; and the respiration a sense of suffocation, as in a person who is throttled; the pulse strong, and quick, and small in the beginning,—great, slow, and feeble in the end, and irregular throughout; tentigo of the genital organs. Such sufferings do they endure towards the end of the attack. But when they come to the termination of the illness, there are unconscious discharges of the urine, and watery discharges from the bowels, and in some cases an evacuation also of the semen, from the constriction and compression of the vessels, or from the pruriency of the pain, and titillation of the humours; for in these cases the pains are seated in the nerves. The mouth watery; phlegm copious, thick, cold, and, if you should draw it forth, you might drag out a quantity of it in the form of a thread. But, if with length of time and much pain, the matters within the chest ferment, but the restrained spirit (pneuma) agitates all things, and there is a convulsion and disorder of the same, a flood, as it were, of humours swells up to the organs of respiration, the mouth, and the nose; and if along with the humours the spirit be mixed, it appears like the relief of all the former feelings of suffocation. They accordingly spit out foam, as the sea ejects froth in mighty tempests; and then at length they rise up, the ailment now being at an end. At the termination, they are torpid in their members at first, experience heaviness of the head, and loss of strength, and are languid, pale, spiritless, and dejected, from the suffering and shame of the dreadful malady.

> Greek: 5. … ἀμβλύτητες, ἴλιγγοι, τενόντων βάρεα, φλεβῶν ἐν τῷ τραχήλῳ πληρώσιες καὶ διατάσιες, ναυτία τε πολλὴ μὲν ἐπὶ σιτίοις, οὐχ ἥκιστα δὲ καὶ ἐπʼ ἀσιτίῃσι καὶ βληχρή· καὶ φλέγμα ἐμεῖται συχνόν· ἀποσιτίη καὶ ἀπεψίη ἐπὶ σμικροῖσι ἐδέσμασι· φυσώδεες, ἐπηρμένοι ὑποχόνδρια. τάδε μὲν οὖν διηνεκέα. Ἢν δὲ πλησίον ἤδη ᾖ τοῦ παροξυσμοῦ, κύκλῳ μαρμαρυγαὶ πρὸ τῆς ὄψιος πορφυρέων ἢ μελάνων, ἢ πάντων ὁμοῦ συμμεμιγμένων, ὡς δοκέειν τὴν ἐν οὐρανῷ τετανύσθαι ἶριν. ἦχοι ὤτων, βαρυοδμίη· ὀργίλοι, πικρόχολοι παραλόγως· κατέπεσον γοῦν τινες ὑπὸ προφάσιος, ἐξ ἀθυμίης· μετεξέτεροι δὲ Ῥεύματι ποταμοῦ ἀτενὲς ἐνιδόντες, ἢ τροχῷ δινευμένῳ, ἢ βέμβικι ἑλισσομένῃ· ἄλλοτε δὲ ὄσφρησις βαρεῶν ὀσμῶν κατέβαλε, ὥσπερ γαγάτου λίθου. τοῖσδε μὲν οὖν ἐν τῇ κεφαλῇ τὸ κακὸν ἐστηρίχθητε, καὶ ἐντεῦθεν πημανθὲν ἄρχεται· μετεξετέροισι δὲ καὶ ἀπὸ τῶν πορρωτέρῳ τῆς κεφαλῆς νεύρων, ὁκόσα ξυμπαθέα τῇ ἀρχῇ γίγνεται. δάκτυλοι γοῦν μεγάλοι χειρῶν ἢ ποδῶν ξυνέλκονται, καὶ πόνος καὶ νάρκη καὶ τρόμος ἕπεται, καὶ ἐς κεφαλὴν τουτέων ἡ ὁρμὴ ἧκεν. ἢν ἕρπον τὸ κακὸν εἰς τὴν κεφαλὴν ἵκηται, πάταγος τουτέοισι γίγνεται ὡς ἀπὸ πληγῆς ἢ ξύλου, ἢ λίθου. καὶ ἐξαναστάντες ἐκδιηγεῦνται, ὡς ὑπό τευ ἐξ ἐπιβουλῆς παταχθέντες. ἥδε μέντοι ἀπάτη γίγνεται ὁκόσοισι τόδε πρῶτον τὸ κακὸν ξυνέπεσε· οἷς δὲ ξύνηθες τὸ πάθος, ἢν ἐπίῃ μὲν ἡ νοῦσος, ἐς δάκτυλον δὲ ἤδη ἀφίκηται, ἢ ἀπό τευ ἄρξηται, ξυνήθεας ἀρωγοὺς καλέουσι τοὺς παρεόντας, προγνώσι τοῦ μέλλοντο ὑπʼ ἐμπειρίης· διασφίγγειν τε καὶ ἀνακλάειν καὶ συντείνειν δέονται τὰ κατάρχοντα μέρεα· καὶ αὐτοὶ δὲ ἑωυτέοισιν ἕλκουσι τὰ μέρεα, ὅκωσπερ τὴν νοῦσον ἐξαιρούμενοι· καὶ σφέων ἡ τοιήδε ἐπικουρίη κοτὲ καὶ ἐς ἡμέρην τῆν σημασίην διώσατο. πολλοῖσι δὲ φόβος ἐστὶ ὡς ἐπιόντος θηρίου, ἢ σκιῆς φαντασίη, καὶ οὕτω κατέπεσον. ἐν δὲ τῇ σημασίῃ ἀναισθήτως μὲν κέεται ὥνθρωπος, χεῖρες δέ οἱ σπασμῷ ξυνέρχονται, σκέλεα οὐ διαπεπλιγμένα μοῦνον, ἀλλὰ τῇδε κἀκεῖσε βαλλόμενα αὐτοῖς ἀπὸ τῶν τενόντων. ἐσφαγμένοισι ταύροισι ἥδε ἰκέλη ἡ ξυμφορή· αὐχὴν ἀγκύλος, κεφαλὴ ποικίλως διάστροφος· ἄλλοτε μὲν γὰρ ἐς τὸ πρηνὲς τοξοῦται, εὖτε ἐς τὸ στέρνον ἡ γένυς ἐρείδει, ἄλλοτε δὲ ἐς τὸ μετάφρενον ἀνακλᾶται, ὅκως τοῖς ἀπὸ τῆς κόμης ἑλκομένοισι βίῃ, εὖτε ἔνθα ἢ ἔνθα ἐπὶ τοὺς ὤμους ἱζάνει. χάσκουσι μέγα, στόμα ξηρὸν, γλῶσσα προμήκης, ὡς καὶ κίνδυνον τρώματος μεγάλου γίγνεσθαι, ἢ ἀποτομῆς, εἴ κοτε σπασμῷ ξυνερείσουσιν οἱ ὀδόντες. ὀφθαλμοὶ ἐνδεδινημένοι, βλέφαρα τὰ πολλὰ διέχοντα ξὺν παλμῷ· ἢν δὲ ἐπιμύσαι κοτὲ ἐθέλοιεν, οὐ ξυμβάλλουσι τὰ βλέφαρα, ὡς καὶ τὰ λευκὰ ὁρῆσθαι ἐξ ὑποφάσιος. ὀφρύες ἄλλοτε μὲν ἐς τὸ μεσόφρυον ἀνειμέν αι, ὅκως τοῖς χαλεπαίνουσι, ἄλλοτε δὲ ἐς τοὺς κροτάφους ἀπηγμέναι, πολλόν τι μᾶλλον, ὡς τὸ δέρμα περὶ τὸ μέτωπον σφόδρα περιτετάσθαι καὶ τὰς τοῦ μεσοφρύου Ῥυτίδας ἐξαληλίφθαι· μῆλα ἐρυθρὰ, παλλόμενα· χείλεα, κοτὲ μὲν ἄμφω ἐς ὀξὺ μεμυκότ α, ἄλλοτε δὲ ἐς τὰ πλάγια ἀπηγμένα, εὖτε τοῖσι ὀδοῦσι περιτείνεται, τοῖσι μειδιῶσι ὁμοίως. ἐν αὔξῃ δὲ τοῦ κακοῦ καὶ πελιδνότης τοῦ προσώπου προσγίγνεται, ἀγγείων τῶν ἐν τῷ αὐχένι διάτασις, ὡς ἐν πνιγὶ ἀφωνίη, ἀναισθησίη, καὶ εἰ μέγα ἐμβοῇς· μυγμὸς δὲ καὶ στεναγμὸς ἡ φωνὴ, καὶ ἡ ἀναπνοὴ πνὶξ, ὡς ἀπαγχομένῳ· σφυγμοὶ σφοδροὶ καὶ ταχέες, καὶ σμικροὶ ἐν τῇσι ἀρχῇσι· μεγάλοι δὲ καὶ βραδέες καὶ νωθροὶ ἐπὶ τῷ τέλει, ἄτακτοι δὲ ἐς τὸ ξύνολον· αἰδοίων ξύντασι ς. τάδε μὲν οὖν ἐς τέλος τῆς σημασίης πάσχουσι. ἢν δὲ ἐς ἄφεσιν ἀφικνέωνται τοῦ κακοῦ, οὖρα αὐτόματα, κοιλίης περίπλυσι ς· μετεξετ έροισι δὲ καὶ γονῆς ἀπόκρισις τῇ θλίψι καὶ πιέσι τῶν ἀγγείων, ἢ γαργαλισμῷ τοῦ πόνου, καὶ ὑγρασίης προκλήσι. γίγνονται γὰρ ἐν νεύροισι πόνοι καὶ τοῖσδε. στόμα δίυγρον, φλέγμα πολλὸν, παχὺ καὶ ψυχρὸν, καὶ εἰ ἕλκοις αὐτὸ, ἐπὶ μᾶλλον ἂν πλῆθος αὐτέου μηρύσαιο. ἢν δὲ χρόνῳ μακρῷ καὶ πόνῳ πολλῷ βρασθῇ μὲν τὰ ἔνδον τοῦ θώρηκος, πνεῦμα δὲ ἐγκατειρχθὲν τὰ πάντα σείσῃ, σπασμὸς δὲ καὶ τάραχος τῶν αὐτέων ἔῃ, κλύδων δὲ ὑγρῶν ἀναπλἔῃ ἐς τὰς διαπνοὰς, στόμα καὶ Ῥῖνα, σὺν ὑγρῷ δὲ τὸ πνεῦμα, ἄνεσις δὴ τῆς πρόσθεν πνίξιος ἁπάντων ἔοικε. ἀφρὸν δὲ ἀποπτύουσι ὥσπερ ἐπὶ τοῖσι μεγάλοισι πνεύμασι ἡ θάλασσα τὴν ἄχνην· εὖτε καὶ ἐξανίστανται δῆθεν ὡς τελευτήσαν τος τοῦ κακοῦ· ἐπὶ δὲ τῇ ἀποπαύσι νωθροὶ τὰ μέλεα τὰ πρῶτα, καρηβαρικοὶ, διαλελυμένοι, πάρετοι, ὠχροὶ, δύσθυμοι, κατηφέες, καμάτῳ καὶ αἰσχύνῃ τοῦ δεινοῦ.

[¶1] 6. TETANUS, in all its varieties, is a spasm of an exceedingly painful nature, very swift to prove fatal, but neither easy to be removed. They are affections of the muscles and tendons about the jaws; but the illness is communicated to the whole frame, for all parts are affected sympathetically with the primary organs. There are three forms of the convulsion, namely, in a straight line, backwards, and forwards. Tetanus is in a direct line, when the person labouring under the distention is stretched out straight and inflexible. The contractions forwards and backwards have their appellation from the tension and the place; for that backwards we call Opisthotonos; and that variety we call Emprosthotonos in which the patient is bent forwards by the anterior nerves. For the Greek word τόνος is applied both to a nerve, and to signify tension. The causes of these complaints are many; for some are apt to supervene on the wound of a membrane, or of muscles, or of punctured nerves, when, for the most part, the patients die; for, “spasm from a wound is fatal.” And women also suffer from this spasm after abortion; and, in this case, they seldom recover. Others are attacked with the spasm owing to a severe blow in the neck. Severe cold also sometimes proves a cause; for this reason, winter of all the seasons most especially engenders these affections; next to it, spring and autumn, but least of all summer, unless when preceded by a wound, or when any strange diseases prevail epidemically. Women are more disposed to tetanus than men, because they are of a cold temperament; but they more readily recover, because they are of a humid. With respect to the different ages, children are frequently affected, but do not often die, because the affection is familiar and akin to them; striplings are less liable to suffer, but more readily die; adults least of all, whereas old men are most subject to the disease, and most apt to die; the cause of this is the frigidity and dryness of old age, and the nature of the death. But if the cold be along with humidity, these spasmodic diseases are more innocent, and attended with less danger. In all these varieties, then, to speak generally, there is a pain and tension of the tendons and spine, and of the muscles connected with the jaws and cheek; for they fasten the lower jaw to the upper, so that it could not easily be separated even with levers or a wedge. But if one, by forcibly separating the teeth, pour in some liquid, the patients do not drink it but squirt it out, or retain it in the mouth, or it regurgitates by the nostrils; for the isthmus faucium is strongly compressed, and the tonsils being hard and tense, do not coalesce so as to propel that which is swallowed. The face is ruddy, and of mixed colours, the eyes almost immoveable, or are rolled about with difficulty; strong feeling of suffocation; respiration bad, distension of the arms and legs; subsultus of the muscles; the countenance variously distorted; the cheeks and lips tremulous; the jaw quivering, and the teeth rattling, and in certain rare cases even the ears are thus affected. I myself have beheld this and wondered! The urine is retained, so as to induce strong dysuria, or passes spontaneously from contraction of the bladder. These symptoms occur in each variety of the spasms. But there are peculiarities in each; in Tetanus there is tension in a straight line of the whole body, which is unbent and inflexible; the legs and arms are straight. Opisthotonos bends the patient backward, like a bow, so that the reflected head is lodged between the shoulder-blades; the throat protrudes; the jaw sometimes gapes, but in some rare cases it is fixed in the upper one; respiration stertorous; the belly and chest prominent, and in these there is usually incontinence of urine; the abdomen stretched, and resonant if tapped; the arms strongly bent back in a state of extension; the legs and thighs are bent together, for the legs are bent in the opposite direction to the hams. But if they are bent forwards, they are protuberant at the back, the loins being extruded in a line with the back, the whole of the spine being straight; the vertex prone, the head inclining towards the chest; the lower jaw fixed upon the breast bone; the hands clasped together, the lower extremities extended; pains intense; the voice altogether dolorous; they groan, making deep moaning. Should the mischief then seize the chest and the respiratory organs, it readily frees the patient from life; a blessing this, to himself, as being a deliverance from pains, distortion, and deformity; and a contingency less than usual to be lamented by the spectators, were he a son or a father. But should the powers of life still stand out, the respiration, although bad, being still prolonged, the patient is not only bent up into an arch but rolled together like a ball, so that the head rests upon the knees, while the legs and back are bent forwards, so as to convey the impression of the articulation of the knee being dislocated backwards. An inhuman calamity! an unseemly sight! a spectacle painful even to the beholder! an incurable malady! owing to the distortion, not to be recognised by the dearest friends; and hence the prayer of the spectators, which formerly would have been reckoned not pious, now becomes good, that the patient may depart from life, as being a deliverance from the pains and unseemly evils attendant on it. But neither can the physician, though present and looking on, furnish any assistance, as regards life, relief from pain or from deformity. For if he should wish to straighten the limbs, he can only do so by cutting and breaking those of a living man. With them, then, who are overpowered by the disease, he can merely sympathise. This is the great misfortune of the physician.

> Greek: 6. σπασμοὶ οἱ τέτανοι, κάρτα μὲν ἐπίπονοι, ὀξύτατοι δὲ κτεῖναι, ἀτὰρ οὐδὲ Ῥηΐδιοι λυθῆναι. μυῶν τῶν ἐν γνάθοισι καὶ τενόντων τάδε πάθεα· ξυνδιδοῖ δὲ τὸ κακὸν εἰς τὸ πᾶν· ἅπαντα γὰρ ξυμπαθέα τῇσι ἀρχῇσι γίγνεται· ἰδέαι δὲ τῆς ξυνολκῆς ἔασι τρεῖς· ἐς εὐθὺ, ἐς τὸ κατόπιν, ἐς τοὔμπροσθεν. ἐς εὐθὺ μὲν ὁ τέτανος, εὖτε ἀστραβὴς ὥνθρωπος καὶ ἀκαμπὴς ἐντεταται· αἱ δὲ ἐς τοὐπίσω, ἢ ἐς τοὔμπρος θεν ξυνολκαὶ ξὺν τῇ τάσι καὶ τῷ χωρίῳ ἴσχουσι τὴν ἐπίκλησιν. τὴν μὲν γὰρ κατόπιν τοῦ νοσέοντος ἀνάκλισιν ὀπισθότονον καλέομεν, τῶν τῇδε πεπονθότων νεύρων. ἐμπροσθότονον δὲ, ἢν ἐς τοὔμπροσθεν καμπύλληται ὥνθρωπος ἐπὶ τοῖσι πρόσθεν νεύροισι· τόνος γὰρ νεύρων καὶ ἐντάσιος οὔνομα. προφάσιες δὲ τῶνδε μυρίαι. καὶ γὰρ ἐπὶ τρώματι φιλέουσι γίγνεσθαι ὑμένος, ἢ μυῶν, ἢ νεύρων νυγέντων, εὖτε τὰ πολλὰ θνήσκουσι, ἐπὶ τρώματι γὰρ σπασμὸς θανάσιμον· σπᾶται δὲ καὶ ἐπὶ ἀμβλώμα τι ἡ γυνὴ, ἀτὰρ καὶ ἥδε οὐ μάλα περιγίγνεται. καί τευ πατάξαντος μεγάλως τὸν αὐχένα μετεξέτεροι σπῶνται. καὶ ψύξις δὲ κάρτα ἰσχυρὴ γίγνεται αἰτίη. διὰ τόδε χεῖμα μὲν μάλιστα πάντων τίκτει τάδε τὰ πάθεα, δεύτερον δὲ ἦρ σὺν τῷ μετοπώρῳ, θέρος δὲ ἥκιστα, εἰ μὴ κατάρξῃ τρῶμα ἢ νούσων ἀλλοδαπῶν ἐπιδημίη· γυναῖκες δὲ ἀνδρῶν σπῶνται μὲν μᾶλλον, ὅτι ψυχραί· ἀτὰρ αἵδε περιγίγνονται μᾶλλον, ὅτι ὑγραί. ἡλικίαι δὲ, παῖδες μὲν συνεχὲς, ἀλλʼ οὐ μᾶλλον θνήσκου σι, ὅτι ξύνηθες καὶ οἰκεῖον πάθος· νέοι δὲ τουτέων ἧσσον πάσχουσι, μᾶλλον δὲ θνήσκουσι, ἀκμάζοντες ἥκιστα· γέροντες δὲ πάντων μᾶλλον καὶ πάσχουσι καὶ θνήσκου σι. αἰτίη γὰρ ψύξις καὶ ξηρότης γήραος, καὶ θανάτου ἥδε φύσις. ἢν δὲ ἡ ψύξις ἔῃ σὺν ὑγρῷ, ἀσινέστεροί τε καὶ ἀσφαλέστεροι εἰς κίνδυνον οἱ σπασμοί. ξύνεστι μὲν αὐτέοισι, ἀθρόον μὲν εἰρῆσθαι, ἅπασι πόνος καὶ ἔντασις τενόντων καὶ Ῥάχεος, καὶ μυῶν τῶν ἐν γνάθοισι καὶ θώρηκι, ἐρείδουσι γὰρ τὴν κάτω γένυν πρὸς τὴν ἄνω, ὡς μηδὲ μοχλοῖσιν ἢ σφηνὶ διὰ Ῥηϊδίως στῆσαι δύνασθα ι. ἢν δὲ καὶ βίῃ διαγαγὼν τοὺς ὀδόντας ἐνστάξῃ τις ὑγρὸν, οὐ καταπίνουσι, ἀλλʼ ἐκχέουσι, ἢ ἐν τῷ στόματι ἴσχουσι, ἤ ἐς τὰς Ῥῖνας ἀνακόπτεται. ὅ τε γὰρ ἰσθμὸς συνερείδεται καὶ τὰ παρίσθμια σκληρὰ καὶ ἐντεταμένα ἐόντα οὐ ξυμπίπτει εἰς τὴν ἔνθλιψιν τοῦ καταπινομένου. πρόσωπα ἐρυθρὰ, πεποικιλμένα, ὀφθαλμοὶ μικροῦ δεῖν ἀτενέες, μόλις περιδινούμενοι, πνὶξ ἰσχυρὴ, ἀναπνοὴ κακὴ, χειρῶν καὶ σκελέων τάσις, μύες παλλόμενοι, πρόσωπα ποικίλως διάστροφα, μῆλα καὶ χείλεα τρομώδεα, γένυς παλλομένη, ὀδόντων ἄραβος· ἐπʼ ἄλλῳ δʼ ἄν τινι καὶ τὰ ὦτα, ἐγὼ δὲ ἐθηεύμην καὶ ἐθωύμαζον. οὖρα ἐπισχόμε να μέχρι δυσουρίης καρτερῆς, ἢ αὐτομάτως ἐκχεόμενα θλιβομένης τῆς κύστεος. τάδε μὲν οὖν ξὺν πάσῃ ἰδέῃ σπασμῶν. ἴδια δὲ ἑκάστης, τετάνου μὲν ἡ ἐς εὐθὺ ἀπότασις ὅλου ἀστραβὴς πάντη καὶ ἀκλινὴς, εὐθέα δὲ καὶ σκέλεα καὶ χεῖρες. Ὀπισθότονος δὲ κατόπιν ἀγκύλλει τὸν ἄνθρωπον, ὡς τὴν κεφαλὴν ἀνακεκλασμένην μεσσηγὺ τῶν ὠμοπλατέων κέεσθαι, βρόγχος ἐξέχει, γένυς τὰ πολλὰ διΐσταται, σπάνιον δὲ εὖτε ξυνερεί δει τῇ ἄνω, Ῥωχμὸς ἡ ἀναπνοὴ, προπετέες κοιλίην καὶ θώρηκα. οὖρον τουτέοισι μᾶλλον ἀκρατές. ἐπιγάστριον ἐπιτεταμένον καὶ, εἰ ἐπικρούοις, ἐνηχοῦν· χεῖρες ἐν ἐκτάσι κατόπιν κεκλασμέναι, σκέλεα ξυγκεκαμμένα· ἐναντίως γὰρ ἰγνύῃ κατόπιν κάμπτεται. ἢν δὲ ἐς τὸ ἔμπροσθεν ἕλκωνται, κυρτοὶ μὲν τὰ νῶτα, ἐπʼ ἶσον τοῖσι μεταφρένοισι τῶν ἰσχίων ἐξωθευμένων· ῥάχις ὅλη ἐς εὐθύ· κορυφὴ πρηνὴς, κεφαλὴ ἐς θώρηκα συννενευκυῖα, γένυς ἐπὶ τοῖσι στέρνοισι πεπηγυῖα, χεῖρες συνηρεισμέναι, σκέλεα ἐκτεταμένα. πόνοι καρτεροὶ, φωνὴ ἁπάντων κλαυθμώδης· στενάζουσι δὲ μύζοντες βύθιον. ἢν μὲν οὖν τοῦ θώρηκος καὶ τῆς ἀναπνοῆς λάβηται τὸ κακὸν, Ῥηϊδίως τοῦ ζῆν ἀπήγαγε· ἀγαθὸν μὲν τῷ νοσέοντι ἐς πόνων καὶ διαστροφῆς καὶ αἰσχύνης ἀπαλλαγὴ ν, ἀλυπότερον δὲ καὶ τοῖσι παρεοῦσι, κἢν υἱὸς, ἢ πατὴρ ἔῃ. ἢν δὲ ἐς τὸ ζῆν ἔτι διαρκέῃ, τῆς ἀναπνοῆς, εἰ καὶ κακῆς, συντελουμένης δʼ οὖν, ἐς τὸ πρόσθεν οὐ τοξοῦνται μόνον, ἀλλὰ καὶ σφαιροῦνται, ὡς τὴν κεφαλὴν ἐπὶ τοῖσι γούνασι ἔχειν, καὶ τὰ σκέλεα καὶ τὰ νῶτα ἐς τὸ πρόσθεν κεκλάσθαι, ὡς δοκέειν ἐς ἰγνύην κατὰ γόνυ τὸ ἄρθρον ἐξῶσθαι. Ἐξάνθρωπος ἡ συμφορὴ, καὶ ἀτερπὴς μὲν ἡ ὄψις, ὀδυνηρὴ δὲ καὶ τῷ ὀρέοντι θέη· ἀνήκεστον δὲ τὸ δεινόν· ἀγνωσία δὲ ὑπὸ διαστροφῆς καὶ τοῖς φιλτάτοις ἀνθρώποις· εὐχὴ δὲ τοῖσι παρεοῦσι ἡ πρόσθεν οὐχ ὁσίη, νῦν ἀγαθὴ γίγνετα ι, ἀπελθέμεναι τοῦ βίου τὸν κάμνοντα, ἐς ἀπαλλαγὴν ξὺν τῷ ζῆν καὶ τῶν πόνων καὶ τῶν ἀτερπέων κακῶν. ἀτὰρ οὐδὲ ἰητρὸς παρεὼν καὶ ὁρέων, οὔτε ἐς ζωὴν, οὔτε ἐς ἀπονίην, ἀτὰρ οὔτε ἐς μορφὴν ἔτι ἐπαρκέει. εἰ γὰρ καὶ ἐπευθῦναι ἐθέλοι τὰ μέλη, ζῶντα ἄν διατμήξαι καὶ κατάξαι τὸν ἄνθρωπον. τοῖσι οὖν κεκρατη μέν οισι οὐκέτι ἐγχειρέ ων ξυνάχθε ται μοῦνον. ἥδε ἐστὶ τοῦ ἰητροῦ μεγάλη ξυμφορή.

[¶2] 7. ANGINA is indeed a very acute affection, for it is a compression of the respiration. But there are two species of it; for it is either an inflammation of the organs of respiration, or an affection of the spirit (pneuma) alone, which contains the cause of the disease in itself. The organs affected are, the tonsils, epiglottis, pharynx, uvula, top of the trachea; and, if the inflammation spread, the tongue also, and internal part of the fauces, when they protrude the tongue outside the teeth, owing to its abnormal size; for it fills the whole of the mouth, and the protuberance thereof extends beyond the teeth. This species is called Cynanche, either from its being a common affection of those animals, or from its being a customary practice for dogs to protrude the tongue even in health. The opposite symptoms attend the other species; namely, collapse of the organs, and diminution of the natural size, with intense feeling of suffocation, insomuch that it appears to themselves as if the inflammation had disappeared to the internal parts of the thorax, and had seized upon the heart and lungs. This we call Synanche, as if from the disease inclining inwardly and producing suffocation. It appears to me that this is an illness of the spirit (pneuma) itself, which has under-gone a morbid conversion to a hotter and drier state, without any inflammation of the organ itself. Nor is this any great wonder. For in the Charonæan caves the most sudden suffocations occur from no affection of any organ, but the persons die from one inspiration, before the body can sustain any injury. But likewise a man will be seized with rabies, from respiring the effluvia of the tongue of a dog, without having been bitten. It is not impossible then, that such a change of the respiration should occur within, since many other phenomena which occur in a man bear a resemblance to external causes, such as juices which become spoiled both within and without. And diseases resemble deleterious substances, and men have similar vomitings from medicines and from fevers. Hence, also, it was not a wonderful thing, that in the plague of Athens, certain persons fancied that poisonous substances had been thrown into the wells in the Piræus by the Peloponnesians; for these persons did not perceive the affinity between a pestilential disease and deleterious substances. Cases of Cynanche are attended with inflammation of the tonsils, of the fauces, and of the whole mouth; the tongue protrudes beyond the teeth and lips; they have salivation, the phlegm running out very thick and cold; they have their faces ruddy and swollen; their eyes protuberant, wide open, and red; the drink regurgitates by the nostrils. The pains violent, but obscured by the urgency of the suffocation; the chest and heart are in a state of inflammation; there is a longing for cold air, yet they inspire but little, until they are suffocated from the obstruction of the passage to the chest. In certain cases, there is a ready transference of the disease to the chest, and these die from the metastasis; the fevers feeble, slight, bringing no relief. But if, in any case, there is a turn to the better, abscesses form on either side, near the ears externally, or internally about the tonsils; and if these occur with torpor, and are not very protracted, the patients recover, indeed, but with pain and danger. But, if a particularly large swelling should occur, in such cases as are converted to an abscess, and the abscess is raised to a point, they are quickly suffocated. Such are the peculiar symptoms of cynanche. Those of Synanche are, collapse, tenuity, and paleness; the eyes hollow, sunk inwardly; the fauces and uvula retracted upwards, the tonsils approaching one another still more; loss of speech: the feeling of suffocation is much stronger in this species than in the former, the mischief being seated in the chest whence the source of respiration. In the most acute cases, the patients die the same day, in some instances, even before calling in the physician; and in others, although called in, he could afford them no relief, for they died before the physician could apply the resources of his art. In those in which the disease takes a favourable turn, all the parts become inflamed, the inflammation being determined outwardly, so that the disease becomes cynanche in place of synanche. It is also a good thing when a strong swelling, or erysipelas, appears externally on the chest. And the skilful physician diverts the mischief to the chest by means of the cupping-instrument, or by applying mustard to the breast and the parts near the jaws he determines outwardly and discusses the disease. In certain cases, indeed, the evil by these means has been for a time driven outwards, but when so driven out it speedily reverts, and produces suffocation. The causes are infinite, more especially exposure to cold, and, less frequently, to heat; blows; fish-bones fixed in the tonsils, cold draughts, intoxication, repletion, and the ills from respiration.

> Greek: 7. Ἡ συνάγχη κάτοξυ μέντοι πάθος· ἀναπνοῆς γὰρ ἡ πίεσις. δύο δὲ τὰ εἴδεα· ἢ γὰρ τῶν ὀργάνων τῶν τῆς ἀναπνοῆς ἐστι φλεγμον ὴ, ἢ μούνου τοῦ πνεύματος πάθος, ἐφʼ ὡυτέου την αἰτίην ἴσχοντος. ὀργάνων δὲ, παρισθμίων, ἐπιγλωσσίδος, φαρυγγέθρου, κίονος, ἄκρης ἀρτηρίης· ἢν δὲ ἐπινέμηται ἡ φλεγμονὴ, καὶ γλώττης καὶ γνάθων τῶν εἴσω· εὖτε προβάλλουσι τῶν ὀδόντων τὴν γλῶτταν ὑπερβολῇ μεγέθεος. πίμπλησι γὰρ τὴν χώρην τοῦ στόματος, καὶ τὸ περιττὸν αὐτέης ὑπὲρ τοὺς ὀδόντας ἐκχεῖται. κυνάγχη τόδε καλέεται, ἤτοι τῷ ξυνεχέϊ πάθεϊ τῶνδε τῶν ζώων, ἢ τῷ ξυνήθεϊ τῆς προβολῆς τῆς γλώσσης, καὶ ἐν ὑγείῃ. τῷ ἑτέρῳ δὲ εἴδεϊ τὰ ἐναντία ξύνεστι· ξύμπτωσις τῶν ὀργάνων, καὶ ἰσχνότης ἐπὶ μᾶλλον τῆς ἑκάστου φύσιος· καὶ πνὶξ καρτερὴ, ὡς δοκέειν σφίσι αὐτέοισι ἐς θώρηκα ἐς τὸ ἀφανὲς ἐγκεκρύφθαι τὴν φλεγμον ὴν ἀμφὶ καρδίην καὶ πνεύμονα· συνάγχην τήνδε καλέομεν, οἷον συνεύουσαν ἔνδον καὶ ἄγχουσαν. ἐμοὶ δὲ δοκέει αὐτέου τοῦ πνεύματος μούνου τὸ κακὸν ἔμμεναι, τροπὴν πονηρὴν ἐς τὸ θερμότα τον καὶ ξηρότατον τρεπομένου, ἄνευθεν τοῦ σώματός τινος φλεγμον ῆς. ἔστι δὲ οὐ μέγα τὸ θωῦμα. καὶ γὰρ ἐν Χαρωνίοισιν αἱ πνίξιες οὐ σωμάτων πάθεϊ ὀξυτάτῳ γίγνονται, ἀλλὰ καὶ μιᾷ εἰσπνοῇ θνήσκουσι ὥνθρωποι, πρὶν τὸ σῶμα κακόν τι παθέειν. ἀτὰρ καὶ ἀπὸ γλώσσης κυνὸς εἰσπνεύσαντος μοῦνον ἐς τὴν ἀναπνοὴν, οὔτι μὴν ἐνδακόντος, λυσσᾷ ὁ ἄνθρωπος. τοιήνδε οὖν τῆς ἀναπνοῆς τὴν τροπὴν οὐκ ἀδύνατον γίγνεσθαι ἔνδοθεν· ἐπεὶ καὶ ἄλλα μυρία τῶν ἐν ἀνθρώπῳ τὴν αὐτὴν ἰδέην τοῖς ἔξωθεν αἰτίοις ἴσχει. χυλοὶ φθείροντες ἔσωθεν καὶ ἔξωθεν· ἀτὰρ καὶ νοῦσοι φαρμάκοισι δηλητηρίοισι ἴκελαι, καὶ ἀπὸ φαρμάκων ἐμέουσι ὁκοῖα πυρετῶν εἵνεκα. ὅθεν οὐδʼ ἀπεοικὸς ἐν τῷ λοιμῷ τῷ ἐν Ἀθήνῃσι μετεξετέρους δοκέειν εἰς τὰ φρέατα ἐν τῷ Πειραιεῖ ὑπὸ Πελοποννησίων ἐμβεβλῆσθαι φάρμακα. οὐ γὰρ ξυνίεσαν ὥνθρωποι τὸ ξυνὸν τοῦ κακοῦ τοῦ λοιμώδεος πρὸς τὰ δηλητήρ ια. ξύνεστι δὲ τοῖσι μὲν κυναγχικοῖσι φλεγμονὴ παρισθμίων, φαρυγγέθρου, παντὸς τοῦ στόματος. γλῶσσα προπετὴς ὑπὲρ τοὺς ὀδόντας καὶ τὰ χείλεα· σιελοχόοι, φλέγμα παχύτατον, ἀπορρέον καὶ ψυχρόν· ἐρυθροὶ τὰ πρόσωπα, καὶ ἐπηρμένοι, ὀφθαλμοὶ ἐξίσχοντες, ἀναπετέες, ἐξέρυθροι· τὸ ποτὸν ἐς τὰς Ῥῖνας ἀνακόπτεται· πόνοι καρτεροὶ, ἀλλὰ καὶ ὑπὸ τῆς πνιγὸς συνδιωκόμενοι ἀμαυροῦνται. θώρηξ καὶ καρδίη φλέγεται· ποθὴ ψυχροῦ ἠέρος· εἰσπνέουσι δὲ μικρὸν πάνυ, ἔς τε καὶ ἀπεπνίχθησαν, ἐμφραγείσης τῆς ἐς τὸν θώρηκα διόδου. ἐνίοισι δὲ ἐς πνεύμονα ἡ ξύνδοσις Ῥηϊδίως· οἱ δὲ μεταστάσι θνήσκουσι· πυρετοὶ νωθροὶ, μαλακοὶ, οὐδὲν ὠφελέοντες. εἰ δέ τῳ ἐς ἀγαθὸν τρέποιτο, ἀποστάσιες γίγνονται ἔνθα καὶ ἔνθα παρʼ οὖς ἔξω, ἢ ἔνδον ἐς τὰ παρίσθμια· κἢν μὲν ξὺν νάρκῃ, μὴ κάρτα βραδέως, περιγίγνονται μὲν, ξὺν πόνῳ δὲ καὶ κινδύνῳ· ἢν δὲ τρεπομένων ἐς ἀπόστασιν ὄγκος μέζων ὑπογίγνηται, ἐς κορυφὴν τῆς ἀποστάσιος ἀνισταμένης, ἀθρόον πνίγονται. τάδε μὲν τὰ κυνάγχης εἴδεα. Ξυνάγχης δὲ, σύμπτωσις, ἰσχνότης, ὠχρότης σύνεστι· ὀφθαλμοὶ κοῖλοι, εἴσω δεδυκότες· φάρυγξ καὶ γαργαρέων ἀνεσπασμένοι, παρίσθμια ἐπὶ μᾶλλον προσίζοντα, ἀφωνίη· πνὶξ ἡ τοῦδε τοῦ εἴδεος τῆς πρόσθεν πολλόν τι κραταιοτέρη, ἐν θώρηκι ἐόντος τοῦ κακοῦ, ἔνθα ἡ ἀρχὴ τῆς ἀναπνοῆς· οἱ δὲ ὀξύτατοι θνήσκουσι αὐτῆμαρ, ἔσθʼ ὅπη καὶ πρὶν καλέσασθαι τὸν ἰητρὸν, οἱ δὲ καὶ ἐσκαλεσάμενοι οὐδὲν ὤναντο. ἀπέθανον γὰρ πρὶν ἢ τὸν ἰητρὸν ἐπὶ τέχνῃ χρήσασθαι. ὁκόσος δὲ ἐς ἀγαθὸν τρέπεται, ἐπιφλεγμαίνει πάντα, ἐς ἅπερ ἐς τὸ ἔξω ἡ φλεγμον ὴ ἐξωκείλει, ὡς κυνάγχην ἀπὸ συνάγχης γίγνεσθαι ἀγαθὸν δὲ καὶ ἐν θώρηκι οἴδημα καρτερὸν, ἢ ἐρυσίπελας ἐμφανέως. καὶ ἰητρὸς δὲ ἀγαθὸς ἢ σικύῃ εἰς τὸν θώρηκα τὸ κακὸν ἀνήγαγε, ἢ σίνηπι ἐς τὰ στέρνα καὶ ἐς τὰ παρὰ γνάθους μέρεα ἐπιθεὶς, εἵλκυσε ἔξω καὶ διέπνευσε· μετεξετέροισι δὲ ἐς μὲν βραχὺ τὸ κακὸν ὑπὸ τουτέων ἀπελάθη ἔξω, ἀπεταθὲν δὲ ἀθρόως ἐπαλινδρόμησε καὶ ἔπνιξε. προφάσιες δὲ μυρίαι, ψύξιες μᾶλλον, ἧσσον ἐκκαύσιες, πληγαὶ, ὀστέων ἰχθύων διαπάρσιες ἐς τὰ παρίσθμια, ψυχροποσίαι, μέθαι, πλησμοναὶ, καὶ τὰ ἀπὸ τῆς ἀναπνοῆς κακά.

[¶3] 8. THE solid body suspended from the roof of the mouth between the two tonsils is called columella and gurgulio. Uva is the name of the affection. The columella (uvula) is of a nervous nature, but humid, for it is situated in a humid region. Wherefore this body, the columella, suffers from various affections, for it becomes thickened from inflammation, being elongated and of equal thickness from the base to the extremity, and is attended with redness. Columna is the appellation of this affection. If it be rounded towards the extremity alone, and with its enlargement become livid and darkish, the name of the affection is Uva; for it altogether resembles a grape in figure, colour, and size. A third affection is that of the membranes when they have the appearance of broad sails, or the wings of bats, on this side and on that. This is called Lorum, for the lengthened folds of the membranes resemble thongs. But if the columella terminates in a slender and elongated membrane, having at its extremity a resemblance to the butt-end of a spear, it gets the name of Fimbria. This affection arises spontaneously from a defluxion, like the others, but also from an oblique incision when the surgeon leaves the membrane at one side. But if the organ (uvula) become bifid with two membranes hanging on this side and on that, it has no distinct appellation, but it is an easy matter for any one who sees it to recognise the nature of the disease. A sense of suffocation accompanies all these affections, and they can by no means swallow with freedom. There is cough in all the varieties, but especially in those named lorum and fimbria. For a titillation of the trachea is produced by the membrane, and in some cases it secretly instils some liquid into the windpipe, whence they cough. But in uva and columella there is still more dyspnœa and very difficult deglutition; for, in these cases, the fluid is squeezed up to the nostrils, from sympathy of the tonsils. The columella is common in old persons, the uva in the young and in adults; for they abound in blood, and are of a more inflammatory nature. The affections of the membranes are common in puberty and infancy. It is safe to apply the knife in all these varieties; but in the uva, while still red, hemorrhage, pains, and increase of inflammation supervene.

> Greek: 8. τὸ ἀπὸ τῆς ὑπερώης ἐκκρεμὲν σῶμα στερρὸν, μεσηγὺτῶν παρισθμίων, κίων καὶ γαργαρεὼν καλέεται. σταφυλὴ γὰρ πάθεός ἐστιν οὔνομα. νεῦρον δέ ἐστι ἡ κιονὶς τὴν φύσιν, ἀλλʼ ὑγρόν· ἐν γὰρ ὑγρῷ κέεται χωρίῳ. ὅδε οὖν ὁ γαργαρε ὼν πλεῦνα πάσχει πάθεα. καὶ γὰρ ἐπὶ φλεγμον ῇ παχύνεται, ἶσος ἀπὸ τῆς βάσιος ἄχρι τοῦ πέρατος ἄκρου, ἐπιμήκης γιγνόμενος, καὶ ἐρύθημα ἴσχει. κίων δὲ τοῦδε τοῦ πάθεος ἡ ἐπίκλησις. εἰ κατὰ πέρας μοῦνον στρογγύ λλεται, καὶ μεγέθεϊ πελιδνὸς γίγνεται, καὶ ὑπομελαν ίζει, σταφυλὴ ἐπώνυμον τόδε τὸ πάθος. πάντα γὰρ ἴκελα αὐτέῃ, καὶ σχῆμα, καὶ χροιὴ, καὶ μέγεθος. τρίτον πάθος ἐστὶ ὑμένων, ἔνθα καὶ ἔνθα, οἷόν τι λέπεα πλατέα, ἢ νυκτερίδων πτέρυγες ἐκφαίνονται· ἱμάντιον τόδε καλέεται. ἱμᾶσι γὰρ ἴκελαι αἱ τῶν ὑμένων εἰς πλάτος ἑξαπλώσιες. ἐι δὲ ἐς λεπτὸν καὶ εὐμήκη ὑμένα τελευτᾷ κιονὶς, οἷόν τι οὐρίαχον κατὰ πέρας ἴσχουσα, κράσπεδον τὴν ἐπωνυμίην ἴσχει. γίγνεται δὲ τόδε καὶ αὐτομάτως μὲν ἐκ Ῥεύματος, ὅκωσπερ καὶ ἕτερα· ἀτὰρ καὶ ἀπὸ τομῆς ἐπικαρσίης, ἐγκαταλιπόντος τοῦ ἰητροῦ ὑμένα κατὰ μίαν πλευρήν. ἢν δὲ δικρόα ὑμέσι δισσοῖσι ἐκκρεμέσι ἔνθα καὶ ἔνθα γίγνηται, οὔνομα μὲν οὐκ ἴσχει τόδε πάθος ἔκδηλον, ἅπαντι δὲ Ῥηΐδιον θεησαμένῳ γιγνώσκειν. πνὶξ δὲ ἐπʼ αὐτέοισι πᾶσι, καὶ ἥκιστα Ῥηϊδίως καταπίνους ι. βὴξ ἐπὶ πᾶσι μὲν, μάλιστα δὲ ἐπὶ τοῖσι ἱμαντίοισι, καὶ ἐπὶ τοῖς κρασπέδοισι. γαργαλισμὸς γὰρ τῆς ἀρτηρίης ἀπὸ τῶν ὑμένων γίγνεται· ἔσθʼ ὅπη δὲ καὶ ἐνστάζει τι τοῦ ὑγροῦ λάθρη ἐς τὴν ἀρτηρίην ὅθεν ἀναβήσσουσι· ἐπὶ δὲ τῇ σταφυλῇ καὶ τῷ κίονι δύσπνοια ἐπὶ μᾶλλον, καὶ κάρτα πονηρὴ κατάποσις. καὶ γὰρ ἐς τὰς Ῥῖνας ἐπὶ τῶνδε τὸ ὑγρὸν ἀναθλίβεται, συμπαθίῃ τῶν παρισθμίων. γηραιοῖσι ὁ κίων συνήθης, σταφυλὴ δὲ νέοισι καὶ ἀκμάζουσι· πολύαιμοι γὰρ καὶ ἐπιφλεγμαίνει μᾶλλον. ἡβάσκουσι δὲ καὶ παισὶ τὰ ὑμενώδεα. τάμνειν δὲ πάντα ἀσινέα· ἐπὶ δὲ τῇ σταφυλῇ ἔτι ἐρυθριώσῃ, αἱμορραγίη καὶ πόνοι καὶ φλεγμον ῆς ἐπίδοσις.

[¶4] 9. ULCERS occur on the tonsils; some, indeed, of an ordinary nature, mild and innocuous; but others of an unusual kind, pestilential, and fatal. Such as are clean, small, superficial, without inflammation and without pain, are mild; but such as are broad, hollow, foul, and covered with a white, livid, or black concretion, are pestilential. Aphtha is the name given to these ulcers. But if the concretion has depth, it is an Eschar and is so called: but around the eschar there is formed a great redness, inflammation, and pain of the veins, as in carbuncle; and small pustules form, at first few in number, but others coming out, they coalesce, and a broad ulcer is produced. And if the disease spread outwardly to the mouth, and reach the columella (uvula) and divide it asunder, and if it extend to the tongue, the gums, and the alveoli, the teeth also become loosened and black; and the inflammation seizes the neck; and these die within a few days from the inflammation, fever, fœtid smell, and want of food. But, if it spread to the thorax by the windpipe, it occasions death by suffocation within the space of a day. For the lungs and heart can neither endure such smells, nor ulcerations, nor ichorous discharges, but coughs and dyspnœa supervene. The cause of the mischief in the tonsils is the swallowing of cold, rough, hot, acid, and astringent substances; for these parts minister to the chest as to the purposes of voice and respiration; and to the belly for the conveyance of food; and to the stomach for deglutition. But if any affection occur in the internal parts, namely, the belly, the stomach, or the chest, an ascent of the mischief by the eructations takes place to the isthmus faucium, the tonsils, and the parts there; wherefore children, until puberty, especially suffer, for children in particular have large and cold respiration; for there is most heat in them; moreover, they are intemperate in regard to food, have a longing for varied food and cold drink; and they bawl loud both in anger and in sport; and these diseases are familiar to girls until they have their menstrual purgation. The land of Egypt especially engenders it, the air thereof being dry for respiration, and the food diversified, consisting of roots, herbs of many kinds, acrid seeds, and thick drink; namely, the water of the Nile, and the sort of ale prepared from barley. Syria also, and more especially Cœlosyria, engenders these diseases, and hence they have been named Egyptian and Syrian ulcers. The manner of death is most piteous; pain sharp and hot as from carbuncle; respiration bad, for their breath smells strongly of putrefaction, as they constantly inhale the same again into their chest; they are in so loathsome a state that they cannot endure the smell of themselves; countenance pale or livid; fever acute, thirst is if from fire, and yet they do not desire drink for fear of the pains it would occasion; for they become sick if it compress the tonsils, or if it return by the nostrils; and if they lie down they rise up again as not being able to endure the recumbent position, and, if they rise up, they are forced in their distress to lie down again; they mostly walk about erect, for in their inability to obtain relief they flee from rest, as if wishing to dispel one pain by another. Inspiration large, as desiring cold air for the purpose of refrigeration, but expiration small, for the ulceration, as if produced by burning, is inflamed by the heat of the respiration. Hoarseness, loss of speech supervene; and these symptoms hurry on from bad to worse, until suddenly falling to the ground they expire.

> Greek: 9. ἕλκεα ἐν τοῖσι παρισθμίοισι γίγνεται, τὰ μὲν ξυνήθεα, εὐήθεα καὶ ἀσινέα, τὰ δὲ ξενὰ, λοιμώδεα καὶ κτείνοντα. εὐήθεα μὲν ὁκοῖα καθαρά ἐστι καὶ σμικρὰ καὶ ἀβαθῆ, οὐδὲ ἐπιφλεγμαίνει, καὶ ἀνώδυνα· λοιμώδεα δὲ ὁκόσα πλατέα, κοῖλα, Ῥυπαρὰ, ἐπιπάγῳ λευκῷ, ἢ πελιδνῷ, ἢ μέλανι συνεχόμενα· ἄφθαι τοὔνομα τοῖσι ἕλκεσι. ἢν δὲ καὶ ὁ ἐπίπαγος ἴσχῃ βάθος, ἐσχάρη τὸ πάθος καὶ ἔστι καὶ καλέεται· ἐν κύκλῳ δὲ τῆς ἐσχάρης ἐρύθημα γίγνεται καρτερὸν καὶ φλεγμονὴ καὶ πόνος φλεβῶν, ὡς ἐπʼ ἄνθρακος, καὶ μικρὰ δὲ ἐξανθήματα ἀραιὰ γιγνόμενα, ἔπειτα προσεπιγιγνόμενα συνήφθη τε ἂν καὶ πλατὺ ἕλκος ἐγένετο. κἢν μὲν ἔξω ἐς τὸ στόμα νέμηται, ἐπὶ τὴν κιονίδα ἧκέ τε μὴν, καὶ τὴν ἀπέταμεν, καὶ ἐς τὴν γλῶσσαν ἐσκεδάσθη, καὶ ἐς οὖλα, καὶ ἐς χαλινούς· καὶ ὀδόντες ἐκινήθησαν καὶ ἐμελάνθησαν· καὶ ἐς τὸν τράχηλον ἡ φλεγμονὴ ἐξώκειλε. καὶ οἵδε μὲν οὐ πολυήμεροι θνήσκουσι φλεγμονῇ καὶ πυρετοῖσι, κακωδίῃ καὶ ἀποσιτίῃ. ἢν δὲ ἐς τὸν θώρηκα νέμηται διὰ τῆς ἀρτηρίης, καὶ αὐτῆμαρ ἀπέπνιξε. πνεύμων γὰρ καὶ καρδίη, οὔτε ὀδμῆς τοιῆσδε, οὔτε ἑλκέων, οὔτε ἰχώρων ἀνέχονται, ἀλλὰ βῆχες καὶ δύσπνοιαι γίγνονται. αἰτίη μὲν οὖν τοῦ ἔργου τῶν παρισθμίων, κατάποσις ψυχρῶν, τρηχέων, θερμῶν, ὀξέων, στυφόντων· τάδε γὰρ τὰ μέρεα καὶ θώρηκι εἰς φωνὴν καὶ ἀναπνοὴν, καὶ κοιλίῃ ἐς τροφῆς διαπομπὴν, καὶ στομάχῳ ἐς κατάποσιν διακονέεται. εἰ δὲ καὶ τοῖσι ἔνδον τι συμβαίη πάθος, κοιλίῃ, καὶ στομάχῳ, καὶ θώρηκι, ἐς τὸν ἰσθμὸν καὶ τὰ παρίσθμια καὶ τὰ τῇδε χωρία τοῦ κακοῦ ἡ ἀναφορὴ καὶ ἀπερεύξιες. διὰ τόδε παιδία μάλιστα πάσχει ἄχρις ἥβης· μάλιστα γὰρ παιδία καὶ μέγα καὶ ψυχρὸν ἀναπνέει· πλεῖστον γὰρ τὸ θερμὸν ἐν τουτέοισι· ἀκρατέα δὲ καὶ ἐδωδῆς, καὶ ποικίλων ἐπιθυμία, καὶ ψυχροποσίη· καὶ βοῆσαι μέγα καὶ ἐν ὀργῇ καὶ ἐν παιδιῇ. καὶ κούρῃσι δὲ μέχρι καθάρσιος ἐπιμηνίων τάδε ξυνήθεα. χώρη δὲ τίκτει Αἴγυπτος μάλιστα, καὶ γὰρ ἐς ἀναπνοὴν ἀὴρ ξηρὴ καὶ ἡ ἐδωδὴ ποικίλη. ῥίζαι γὰρ καὶ βοτάναι καὶ λάχανα πολλὰ καὶ σπέρματα δριμέα, καὶ ποτὸν παχὺ, ὕδωρ μὲν ὁ Νεῖλος, δριμὺ δὲ τὸ ἀπὸ τῶν κριθέων τὸ τῶν βρυτέων πόμα. τίκτει δὲ καὶ ἡ Συρίη, μάλιστα κοίλη· ὅθεν Αἰγύπτια καὶ Συριακὰ ἕλκεα τάδε κικλήσκουσι. τρόπος δὲ θανάτου οἴκτιστος· πόνος μὲν δριμὺς καὶ θερμὸς, ὡς ἐπʼ ἄνθρακος, ἀναπνοὴ κακή. ἀναπνέουσι γὰρ ὀδωδὸς σηπεδόνα καρτερήν· τὸ αὐτὸ δὲ πάλιν συντόνως ἐς τὸν θώρηκα ἐμπνέουσι· ἀσηροὶ, ὡς μηδὲ ἑωυτέων τὴν ὀδμὴν ἀνέχεσθαι· ὠχροὶ ἢ πελιδνοὶ τὰ πρόσωπα, πυρετοὶ ὀξέες, δίψος, ὡς ἐκ πυρός, τὸ δὲ ποτὸν οὐ προσίενται, δέεϊ τῶν ἔνθεν πόνων. ἄσσονται γὰρ, ἢν τοῖσι παρισθμίοισι ἐνθλίβωσι, ἢ ἐς τὰς Ῥῖνας ἀνατρέχῃ. καὶ ἢν μὲν κατακέωνται, ἀνακαθίζουσι, ἀνακεκλίσθαι οὐκ ἀνεχόμενοι· ἢν δὲ ἀνακαθίσωσι, ὑπὸ ἀπορίης αὖθις ἀνακλίνονται. τά πολλὰ δὲ ὀρθοστάδην περιΐασι· ἀκρασίῃ γὰρ ἡσυχίης τὴν ἠρεμίην φεύγουσι, πόνῳ πόνον λῦσαι θέλοντες. ἀναπνοὴ εἴσω μεγάλη· ψυχρὸν γὰρ ἠέρα ποθέουσι ἐς ἔμψυξιν· ἔξω δὲ σμικρή. πυρίκαυτα γὰρ ἐόντα τὰ ἕλκεα προσεμπίπραται ὑπὸ θέρμης τῆς ἀναπνοῆς. βράγχος, ἀφωνίη, καὶ τάδε ἐπὶ τὸ κάκιον ἐπείγει, εὖτε ἀθρόον καταπεσόντες εἰς τὴν γῆν ἐξέλιπον.

[¶5] 10. UNDER the ribs, the spine, and the internal part of the thorax as far as the clavicles, there is stretched a thin strong membrane, adhering to the bones, which is named succingens. When inflammation occurs in it, and there is heat with cough and parti-coloured sputa, the affection is named Pleurisy. But all these symptoms must harmonise and conspire together as all springing from one cause; for such of them as occur separately from different causes, even if they all occur together, are not called pleurisy. It is accompanied by acute pain of the clavicles; heat acrid; decubitus on the inflamed side easy, for thus the membrane (pleura) remains in its proper seat, but on the opposite side painful; for by its weight, the inflammation and suspension of the membrane, the pain stretches to all its adhesions at the shoulders and clavicles; and in certain cases even to the back and shoulder blade; the ancients called this affection Dorsal pleurisy. It is attended with dyspnœa, insomnolency, anorexia, florid redness of the cheeks, dry cough, difficult expectoration of phlegm, or bilious, or deeply tinged with blood, or yellowish; and these symptoms observe no order, but come and go irregularly; but, worst of all, if the bloody sputa cease, and the patients become delirious; and sometimes they become comatose, and in their somnolency the mind wavers. But if the disease take a bad turn, all the symptoms getting worse, they die within the seventh day by falling into syncope; or, if the commencement of the expectoration, and the more intense symptoms occurred with the second hebdomad, they die on the fourteenth day. It sometimes happens that in the intermediate period there is a transference of all the symptoms to the lungs; for the lung attracts to itself, being both porous and hot, and being moved for the attraction of the substances around, when the patient is suddenly suffocated by metastasis of the affection. But if the patient pass this period, and do not die within the twentieth day, he becomes affected with empyema. These, then, are the symptoms if the disease get into a bad state. But if it take a favourable turn, there is a profuse hemorrhage by the nostrils, when the disease is suddenly resolved; then follow sleep and expectoration of phlegm, and afterwards of thin, bilious matters; then of still thinner, and again of bloody, thick, and flesh-like; and if, with the bloody, the bile return, and with it the phlegm, the patient’s convalescence is secure; and these symptoms, if they should commence on the third day, with an easy expectoration of smooth, consistent, liquid, and (not) rounded sputa, the resolution takes place on the seventh day, when, after bilious discharges from the bowels, there is freedom of respiration, the mind settled, fever diminishing, and return of appetite. But if these symptoms commence with the second week, the resolution occurs on the fourteenth day. But if not so, it is converted into Empyema, as indicated by rigors, pungent pains, the desire of sitting erect, and the respiration becoming worse. It is then to be dreaded, lest, the lungs suddenly attracting the pus, the patient should be thereby suffocated, after having escaped the first and greater evils. But if the abscess creep in between the ribs and separate them, and point outwardly; or, if it burst into an intestine, for the most part the patient recovers. Among the seasons of the year winter most especially engenders the disease; next, autumn; spring, less frequently; but summer most rarely. With regard to age, old men are most apt to suffer, and most readily escape from an attack; for neither is there apt to be a great inflammation in an arid frame; nor is there a metastasis to the lungs, for old age is more frigid than any other age, and the respiration small, and the attraction of all things deficient. Young men and adults are not, indeed, very apt to suffer attacks; but neither, also, do they readily recover, for from a slight cause they would not experience even a slight attack of inflammation, and from great attacks there is greater danger. Children are least of all liable to pleurisy, and in their case it is less frequently fatal; for their bodies are rare, secretions copious, perspiration and exhalation abundant; hence neither is a great inflammation formed. This is the felicity of their period of life in the present affection.

> Greek: 10. ὑπὸ τῇσι πλευρῇσι καὶ τῇ Ῥάχει καὶ τῷ ἔνδον θώρηκι ἄχρι κλειδῶν ὑμὴν λεπτὸς κραταιὸς ὑπέστρωται, τοῖσι ὀστέοισι προσπεφυκὼς, ὑπεζωκὼς τοὔνομα. ὧδε ἐπὴν φλεγμονὴ γένηται, πῦρ ξὺν βηχὶ καὶ πτυάλοισι ποικίλοισι, πλευρῖτις τὸ πάθος καλέεται. χρὴ δὲ ταῦτα ἀλλήλοισι ξυνωδὰ καὶ ξύμπνοα ἔμμεναι, ἀπὸ μιῆς αἰτίης ξύμπαντα· ὁκόσα γὰρ τουτέων σποράδην ἄλλο ὑπʼ ἄλλης αἰτίης γίγνεται, κἢν τὰ πάντα ἅμα ἐπιφοιτήσῃ, οὐ καλέεται πλευρῖτις· ξύνεστι δὲ πόνος ὀξὺς κληϊδέων, πῦρ δριμὺ, κατάκλισις ἐπὶ μὲν τὴν φλεγμαίνουσαν πλευρὴν εὔφορος· ἐν ἕδρῃ γὰρ ἵζει τῇ ἑωυτέου ὁ ὑμήν· εἰς τὸ ἐπέκεινα δὲ ἐπώδυνος· ὑπὸ γὰρ τοῦ ἄχθεος καὶ τῆς φλεγμον ῆς καὶ τῆς ἐξαρτήσιος ἀποτέταται ἡ ὀδύνη ἄχρι τῆς ἁπάσης ξυναφίης τοῦ ὑμένος ἐς ὤμους καὶ κληΐδας, μετεξετέροισι δὲ καὶ ἐς νῶτα καὶ ἐς ὠμοπλάτην. νωτιαίην τὴν δὲ πλευρῖτιν ἐκάλεον οἱ πρόσθεν. παρέπεται δὲ δύσπνοια, ἀγρυπνίη, ἀποσιτίη, μήλων ἐρύθημα φαιδρὸν, βὴξ ξηρὴ, πτύελα μόλις ἀναγόμενα, φλέγμα ἢ χολῶδες, ἢ δίαιμον κατακορέως, ἢ ὑπόξανθον· καὶ τάδε τάξιν οὐκ ἴσχοντα, ἄλλοτε δὲ ἄλλα ἐπιφοιτέοντα καὶ ἀπογιγνόμενα· κάκιον δὲ ἁπάντων, ἢν τὸ δίαιμον ἐκλείπῃ, γίγνονται δὲ παράληροι· ἔστι δʼ ὅτε καὶ κωματώδεες, καὶ ἐν τῇ καταφορῇ παράφοροι. ἢν μὲν οὖν ἐς κακὸν τρέπηται ἡ νοῦσος, πάντων ἐπὶ τὸ κάκιον ἐπιδιδόντων, ἐντὸς ἑβδόμης οἵδε θνήσκουσι ἐς συγκοπὴν ἐμπεσόντες. ἢν δὲ ἀπὸ τῆς δευτέρας ἑβδομάδος ἡ ἀρχὴ τῆς ἀναγωγῆς τῶν πτυέλων γίγνηται καὶ τῶν ξυντεινόντων κακῶν, ἐς τὴν τεσσαρεσκαιδεκάτην θνήσκουσι. ἔσθʼ ὅπη δὲ μεσηγὺ τουτέου τοῦ χρόνου ἐς πνεύμονα πάντων ξύνδοσις γίγνεται. ἕλκει γὰρ πνεύμων ἐς ἑωυτὸν, καὶ μανὸς καὶ θερμὸς ἐὼν, καὶ ἐς ὁλκὴν τῶν πέλας κινεύμενος, εὖτε ἀθρόον ἀπεπνίγη ὥνθρωπος, μεταστάσι τοῦ πάθεος. ἢν δὲ ταύτην ὑπερέλθῃ ὁ νοσέων, καὶ ἐντὸς εἰκοστῆς μὴ ἀποθνήσκῃ, ἔμπυος γίγνεται. τάδε μὲν οὖν, ἢν ἐς κακὸν ἐπιδιδῷ. ἢν δὲ ἐπὶ τὸ ἀγαθὸν τράπηται, αἱμορραγίη διὰ Ῥινῶν λάβρως, εὖτε ἀθρόον λύεται ἡ νοῦσος· ἕπεται καὶ ὕπνος καὶ ἀναγωγὴ φλεγμάτων, ἔπειτα δὲ χολωδέων λεπτῶν, ἐπὶ δὲ μᾶλλον λεπτοτέρων, αὖθις δὲ διαίμων, παχέων, σαρκοειδέων. κἢν ἐπὶ τῶν διαίμων παλινδρομέῃ μὲν ἡ χολὴ, ἐπʼ αὐτῇ δὲ φλέγμα, ἀσφαλὴς ἡ ἀποκατάστασις· καὶ τάδε, ἢν ἀπὸ τρίτης ἡμέρης ἄρχηται, καὶ Ῥηϊδίως ἀναβήσσουσι, λεῖα, ὁμαλὰ, ὑγρὰ, 〈οὐ〉 στρογγύλα. ἐς ἑβδόμην γὰρ καθίστανται, εὖτε καὶ κοιλίης ἐκταραχθείσης χολωδέων, ἀναπνοῆς κατάστασις, γνώμη εὐσταθὴς, πυρετοὶ ἐνδιδόντες, εὔσιτοι· ἢν δὲ ἀπὸ τῆς δευτέρης ἑβδομάδος τάδε ἄρξηται, ἐς τὴν τεσσαρεσκαιδεκάτην καθίστανται. ἢν δὲ μὴ, εἰς ἐμπύημα τρέπεται, εὖτε Ῥίγεα ἐνδείκνυται, πόνοι νυγματώδεες, ἀνακαθίγνυσθαι θέλουσι, ἀναπνοὴ κακίων· δέος τότε μᾶλλον μὴ πνεύμων ἀθρόον τὸ πῦον ἑλκύσας ἀποπνίξῃ τὸν ἄνθρωπον, τὰ πρῶτα καὶ τὰ μείζω διαφυγόντα κακά. ἢν δὲ ἐς τὸ μεσηγὺ τῶν πλευρέων Ῥέψῃ, καὶ διαστήσῃ τάσδε, καὶ κορυφὴν ἐς τὸ ἔξω προβάληται, ἢ ἐς ἔντερον ἐνραγῇ, τὰ πολλὰ περιγίγνεται ὁ ἄνθρωπος. φέρει δὲ τὴν νοῦσον, ὥρη μὲν, χειμὼν μάλιστα πάντων, δεύτερον φθινόπωρον, ἦρ δὲ ἧσσον, ἢν μή κοτε ψυχρὸν γίγνοιτο· θέρος δὲ ἥκιστα. ἡλικίη, πρῶτον τῶν ἄλλων πάσχουσι γέροντες, οἳ καὶ μᾶλλον ἑτέρων τὸ πάθος διαδιδράσκουσι. οὔτε γὰρ μεγάλη ἂν γίγνοιτο φλεγμονὴ ἐν ξηρῷ τῷ σκήνεϊ, οὔτε ἐς πνεύμονα ἡ μετάστασις. ψυχρότερος γὰρ ἢ ἐπὶ ἄλλης ἡλικίης, καὶ ἀναπνοὴ σμικρὴ, καὶ ἡ ὁλκὴ ἁπάντων ὀλίγη. νέοι δὲ καὶ οἱ ἐπὶ ἀκμῆς, οὐ μάλα μὲν πάσχουσι, ἀτὰρ οὐδὲ μάλα περιγίγνονται· οὐ γὰρ ἂν πάθοιεν ἐπὶ σμικρῇ αἰτίῃ οὐδὲ σμικρὴν φλεγμονήν· ἐπὶ δὲ τοῖσι μεγάλοισι μείζων ὁ κίνδυνος. παῖδες ἥκιστα νοσέουσι πλευρῖτιν· ἀτὰρ καὶ ἧσσον θνήσκουσι. τά τε γὰρ σώματα μανὰ, καὶ τὰ ὑγρὰ εὔροα, καὶ πολλὴ ἡ διαπνοὴ καὶ ἀποφορή. ὅθεν οὐδὲ μεγάλη ξυνίσταται φλεγμονή· ἥδε τῆς ἡλικίης εὐτυχίη ἐν τῷδε τῷ πάθεϊ.

## 2. Book II · chapters 1–6

Source: https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/2/ · cite a paragraph as https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/2/#p-N

[¶0] 1. ANIMALS live by two principal things, food and breath (spirit, pneuma); of these by far the most important is the respiration, for if it be stopped, the man will not endure long, but immediately dies. The organs of it are many, the commencement being the nostrils; the passage, the trachea; the containing vessel, the lungs; the protection and receptacle of the lungs, the thorax. But the other parts, indeed, minister only as instruments to the animal; but the lungs also contain the cause of attraction, for in the midst of them is seated a hot organ, the heart, which is the origin of life and respiration. It imparts to the lungs the desire of drawing in cold air, for it raises a heat in them; but it is the heart which attracts. If, therefore, the heart suffer primarily, death is not far off. But if the lungs be affected, from a slight cause there is difficulty of breathing; the patient lives miserably, and death is the issue, unless some one effects a cure. But in a great affection, such as inflammation, there is a sense of suffocation, loss of speech and of breathing, and a speedy death. This is what we call Peripneumonia, being an inflammation of the lungs, with acute fever, when they are attended with heaviness of the chest, freedom from pain, provided the lungs alone are inflamed; for they are naturally insensible, being of loose texture, like wool. But branches of the aspera arteria are spread through them, of a cartilaginous nature, and these, also, are insensible; muscles there are nowhere, and the nerves are small, slender, and minister to motion. This is the cause of the insensibility to pain. But if any of the membranes, by which it is connected with the chest, be inflamed, pain also is present; respiration bad, and hot; they wish to get up into an erect posture, as being the easiest of all postures for the respiration. Ruddy in countenance, but especially the cheeks; the white of the eyes very bright and fatty; the point of the nose flat; the veins in the temples and neck distended; loss of appetite; pulse, at first, large, empty, very frequent, as if forcibly accelerated; heat indeed, externally, feeble, and more humid than natural, but, internally, dry, and very hot, by means of which the breath is hot; there is thirst, dryness of the tongue, desire of cold air, aberration of mind; cough mostly dry, but if anything be brought up it is a frothy phlegm, or slightly tinged with bile, or with a very florid tinge of blood. The blood-stained is of all others the worst. But if the disease tend to a fatal termination, there is insomnolency; sleep brief, heavy, of a comatose nature; vain fancies; they are in a doting state of mind, but not violently delirious; they have no knowledge of their present sufferings. If you interrogate them respecting the disease, they will not acknowledge any formidable symptom; the extremities cold; the nails livid, and curved; the pulse small, very frequent, and failing, in which case death is near at hand, for they die mostly on the seventh day. But if the disease abate and take a favourable turn, there is a copious hemorrhage from the nose, a discharge from the bowels of much bilious and frothy matters, such as might seem to be expelled from the lungs to the lower belly, provided it readily brings off much in a liquid state. Sometimes there is a determination to the urine. But they recover the most speedily in whose cases all these occur together. In certain cases much pus is formed in the lungs, or there is a metastasis from the side, if a greater symptom of convalescence be at hand. But if, indeed, the matter be translated from the side to the intestine or bladder, the patients immediately recover from the peripneumony; but they have a chronic abscess in the side, which, however, gets better. But if the matter burst upon the lungs, some have thereby been suffocated, from the copious effusion and inability to bring it up. But such as escape suffocation from the bursting of the abscess, have a large ulceration in the lungs, and pass into phthisis; and from the abscess and phthisis old persons do not readily recover; but from the peripneumony, youths and adults.

> Greek: 1. δυοῖσι τοῖσι πρώτοισι, τροφῇ καὶ πνεύματι, τὰ ζῷα ζῆ, τουτέων δὲ πολλὸν ἐπικαιροτέρη ἡ ἀναπνοή. ἢν γὰρ ἐπίσχῃ τις ὠυτὴν, οὐκ εἰς μακρὰν διαρκέσει, ἀλλʼ αὐτίκα θνήσκει ὥνθρωπος. ὄργανα δὲ μυρία, ἀρχὴ μὲν Ῥῖνες, ὁδὸς ἀρτηριη, χώρη δὲ πνεύμων, θώρηξ δὲ πνεύμονος ἔρυμα καὶ δοχή· ἀλλὰ τἄλλα μὲν ὅκως ὄργανα μοῦνον διακονέεται τῷ ζῴῳ· πνεύμων δὲ καὶ τὴν αἰτίην ἴσχει τῆς ὁλκῆς. ἐνίζει γὰρ αὐτέου μέσον σπλάγχον θερμὸν ἡ καρδία, ζωῆς καὶ ἀναπνοῆς ἀρχή. ἥδε καὶ τῷ πνεύμονι τῆς ὁλκῆς τοῦ ψυχροῦ ἠέρος τὴν ποθὴν ἐνδιδοῖ· ἐκφλέγει γὰρ αὐτὸν, ἕλκει δὲ καρδίη. πρῶτον τοιγαροῦν ἢν μὲν ἡ καρδίη πάθῃ, οὐκ εἰς μακρὸν τοῦ θανάτου ἡ ἐμβολή. ἢν δὲ πνεύμων, ἐπὶ μὲν σμικρῇ τῇ αἰτίῃ, δύσπνοια· ζώει κακῶς, θάνατος μήκιστος, ἢν μή τις ἀκέηται· ἐπὶ δὲ μεγάλῳ πάθεϊ, ὁκοῖον ἡ φλεγμον ὴ, πνιγμὸς, ἀφωνίη, ἄπνοια, ὄλεθρος αὐτίκα· ἥδε ἐστὶν ἥν καλέομεν περιπνευμονίην, φλεγμονὴ τοῦ πνεύμονος, ξὺν ὀξέϊ πυρετῷ, εὖτε ξύνεστιν αὐτέοισι βάρος τοῦ θώρηκος, ἀπονίη, ἢν μοῦνος φλεγμήνῃ ὁ πνεύμων, ἄπονος γὰρ ἡ φύσις αὐτέου· μανὸς μὲν γὰρ τὴν οὐσίην, εἰρίοισιν ἴκελος. ἀρτηρίαι δὲ διελήλανται τρηχεῖαι, χονδρώδεες, καὶ αἵδε ἄπονοι· μύες δὲ οὐδαμῆ, σμικρὰ δὲ νεῦρα, λεπτὰ, ἐς κίνησιν ἐπίκαιρα. ἥδε τῆς ἀπονίης αὐτὴ ἡ αἰτίη. ἢν δὲ καί τις τῶν ἀμφʼ αὐτὸν ὑμένων ἐπιφλεγμήνῃ, οἷσι πρὸς τὸν θώρηκα προσέρχεται, ξύνεστι καὶ πόνος, ἀναπνοὴ κακὴ, θερμὴ, ἀνακαθίγνυσθαι ἐθέλουσι σχῆμα ὄρθιον ἐς ἀναπνοήν. τόδε γὰρ Ῥήϊστον τῶν σχημάτων. ἐρυθροὶ τὰ πρόσωπα· ἐπὶ δὲ μᾶλλον τὰ μῆλα· τὰ λευκὰ τῶν ὀφθαλμῶν λαμυρώτατα καὶ πίονα. Ῥὶς ἄκρη σιμὴ, φλέβες ἐν κροτάφοισιν ἢ καὶ τραχήλῳ διηρμέναι, ἀποσιτίη, σφυγμοὶ τὰ πρῶτα μεγάλοι, κενοὶ, πυκνότατοι, ὁκοῖόν τι συνεληλαμένοι· θερμασίη ἡ μὲν ἐς τὸ ἔξω ἀμυδρὴ, ὑγροτέρη· ἡ δὲ ἐς τὸ ἔνδον ξηρὴ, θερμοτάτη· ἐφʼ ᾗ ἀναπνοὴ θερμὴ, δίψος, γλώσσης ξηρότης, ἐπιθυμίη ψυχροῦ ἠέρος, γνώμης ἀπορίη, βὴξ ξηρὰ τὰ πολλά. ἢν δέ τι ἀνάγηται, φλέγμα ἀφρῶδες, ἢ ὑπόχολον κατακορὲς, ἢ δίαιμον ἀνθηρὸν σφόδρα· τόδε ἔστι τὸ δίαιμον τῶν ἄλλων κάκιον. Ἠν δὲ ἐπὶ τὸ θανατῶδες ἐπιδιδοῖ, ἀγρυπνίη, ὕπνοι σμικροὶ, νωθροὶ, κωματώδεες, φαντασίαι ἀξύνετοι· παράληροι τὴν γνώμην, ἐκστατικοὶ οὐ μάλα. ἀγνωσίη τῶν παρεόντων κακῶν. ἢν γοῦν ἐπανείρῃ περὶ τῆς νούσου, οὐδὲν ὁμολογέουσι δεινόν· ἄκρεα ψυχρὰ, ὄνυχες πελιδνοὶ, γρυποί· σφυγμοὶ μικροὶ, πυκνότατοι, ἐκλείποντες, εὖτε ἀγχοῦ τουτέου ὄλεθρος. ἑβδομαῖοι γὰρ τὸ πλέον θνήσκουσιν. ἢν δέ κοτε ἐπαναφέρῃ ἡ νοῦσος, καί τι ἐς ἀγαθὸν τρέπηται, αἱμορραγίη λάβρως ἐκ Ῥινῶν, κοιλίης ἐκτάραξις πολλῶν χολωδέων, ἐπάφρων, οἷα δοκέειν ἀπὸ πνεύμονος εἰς τὴν νειαιρὴν γαστέρα ἐξεῶσθαι, ἢν ἀγάγῃ πολλὸν ὑγρότερον Ῥηϊδίως. ἔστι δὲ ὅτε καὶ ἐς οὖρα ἐτράπετο. ὁκόσοισι δὲ πάντα ὁμοῦ ξυμπίπτει, οἵδε ὀξύτατοι Ῥηΐζουσι. μετεξετέροισι δὲ πῦον πολλὸν γίγνεται ἐν πνεύμονι, ἢ μετάστασις ἀπὸ τοῦ πλευρέου, ἢν μέζον τὸ ἀγαθὸν ὑπογίγνηται. κἢν μὲν ἐς ἔντερον ἢ κύστιν τὸ ἀπὸ τῆς πλευρῆς παρωχετεύθῃ πῦον, ἐς μὲν τὸ παραυτίκα ἐρήϊσαν ἀπὸ τῆς περιπνευμονίης· ἕλκος δὲ μακροχρόνιον ἴσχουσιν ἐν πλευρῇ, ἀλλὰ περιγίγνονται. ἢν δὲ ἐς τὸν πνεύμονα ὁρμήσῃ τὸ πῦον, εἰσὶν οἳ ἀπεπνίγησαν καὶ ἀθρόῃ ἐκχύσι, καὶ ἀναγωγῆς ἀπορίῃ. ὁκόσοι δὲ διαδιδράσκουσι τὴν ἐκ τῆς ἀπορρήξεως πνίγα, ἕλκος οἵδε πολλὸν ἴσχουσι ἐν πνεύμονι, καὶ ἐς φθόην μεθίστανται· καὶ ἀπὸ μὲν τῆς ἀποστάσιος καὶ τῆς φθόης γέροντες οὐ πάνυ τοι περιγίγνον ται· ἀπὸ δὲ τῆς περιπνευμονίης νέοι καὶ ἀκμάζοντες.

[¶1] 2. THERE are two species of the discharge of blood by the mouth. The one that by the mouth from the head and the vessels there; the passage is by the palate and fauces, where are situated the commencement of the œsophagus and trachea; and with hawking, and small and more urgent cough, they eructate the blood into the mouth; whereas, in that from the mouth, neither does hawking accompany, and it is called Emptysis [or spitting of blood]. But when the discharge is more scanty, and by drops, or when it comes more copiously from the head, or from the mouth, it is no longer called a bringing up, but either the same, or a spitting, or a hemorrhage. But if it ascend from the chest, and the viscera there, the lungs, aspera arteria, the parts about the spine, the discharge from these is not called a spitting, but a bringing up (in Greek, ἀναγωγή, the name being expressive of its coming upwards).

> Greek: 2. αἵματος φορῆς τῆς διὰ στόματος ἰδέαι δύο· ἡ μὲν διὰ στόματος ἀπὸ κεφαλῆς καὶ τῶν τῇδε ἀγγείων· ὁδὸς δὲ ὑπερώη, φαρύγγεθρον, ἔνθα καὶ ἀρχαὶ στομάχου καὶ ἀρτηρίης. ἀναχρέμψισι δὲ καὶ βηχὶ σμικρῇ καὶ προχειροτέρῃ ἐς τὸ στόμα ἀπερεύγονται τὸ αἷμα· ὡς τῇ γε ἀπὸ στόματος, οὐδὲ ἀνάχρεμψις παρομαρτεῖ· ἔμπτυσις ἥδε καλέεται· ἐπὶ δὲ μᾶλλον, ἢν βραχέη ἡ φορὴ τοῦ αἵματος, καὶ στάγδην καὶ ἀθρόον ἀπὸ τῆς κεφαλῆς, ἢ ἀπὸ τοῦ στόματος ἔῃ, οὔ κοτε ἀναγωγὴ καλέεται, ἀλλʼ ἢ τὸ αὐτὸ, ἢ πτύσις, ἢ αἱμορραγίη. ἢν δὲ νέρθεν ἀνίῃ ἀπὸ θώρηκος καὶ τῶν τῇδε σπλάγχνων, πνεύμονος, τρηχείη ς ἀρτηρίης, τῶν παρὰ τὴν Ῥάχιν, ἡ ἀπὸ τουτέων φορὴ οὐ πτύσις, ἀλλʼ ἀναγωγὴ καλέεται, τῆς ἄνω ἴξιος τῆς ὁδοῦ τοὔνομα ἔχουσα.

[¶2] The symptoms of both are partly common, small and few in number, such as the seat of them, in which there is a coincidence between the bringing up and the spitting. But the peculiarities of each are great, many, and of vital importance, by which it is easy to distinguish either of them from the other. If, therefore, it came from the head, with a large discharge of blood, greater and more numerous symptoms will arise, but scanty from a slight and small spitting; in these cases, there is heaviness of the head, pain, noises of the ears, redness of countenance, distension of the veins, vertigo; and these are preceded by some obvious cause, such as a blow, exposure to cold, or heat, or intoxication; for drinking of wine speedily fills the head, and speedily empties it, by the bursting of a vessel; but from a slight intoxication there may be spitting, proceeding from rarefaction. Occasionally an habitual hemorrhage from the nostrils is stopped, and being diverted to the palate, produces the semblance of a bringing up of blood. If, therefore, it be from the head, there is titillation of the palate, frequent hawking, and with it a copious spitting takes place; a desire supervenes, and they readily cough. But if it flow into the aspera arteria from the palate, they then bring it up by coughing, and this it is which deceives them into the supposition that it comes from the viscera below. It runs, also, from the head into the stomach, when it is vomited up with nausea, and thus proves a source of deception, as appearing to come from the stomach. The blood brought up by spitting is not very thick, but dark in colour, smooth, consistent, unmixed with other substances; for, being hawked up, it comes immediately upon the tongue in a round shape, being readily separated; and if you examine the roof of the palate, you will find it thickened and ulcerated, and, for the most part, bloody; and a slight and simple plan of treatment will suffice, namely, astringents applied to the palate in a cold state; for by hot, relaxing, and dilating applications the flow is increased, and this is an indication that the spitting is from the head, in which case evacuations are to be made from the head by the veins, the nostrils, or by any other channel of discharge. And these things must be done speedily; for if the blood is discharged a considerable time, the flow will become permanent, and the parts there will contract the habit of receiving the blood. The trachea, also, becomes ulcerated, and the patients cough instead of hawking; and this proves the commencement of a consumption.

> Greek: σημεῖα δʼ ἀμφοῖν τὰ μὲν ξυνὰ σμικρὰ καὶ παῦρα, ὁκόσον καὶ τὸ χωρίον, ἔνθα καὶ ἀναγωγῆς καὶ πτύσιος ἡ ξυναγωγή· τὰ δὲ ἑκάστης ἴδια μεγάλα καὶ πολλὰ καὶ ἐπίκαιρα, οἷσιν ἑκατέρην Ῥηΐδιον διαγνῶναι. ἢν οὖν ἀπὸ κεφαλῆς ἔῃ, ἐπὶ μὲν πολλῷ τῷ αἵματι μέζω καὶ πλέω τὰ παρεόντα, σμικρὰ δὲ ἐν ὀλίγῃ καὶ σμικρῇ τῇ πτύσι· βάρος αὐτέοισι, πόνος, ὤτων ἦχοι, ἐρύθημα προσώπου, φλεβῶν διαστάσιες, σκοτόδινος· καὶ πρὸ τούτων δὲ ἡ αἰτίη εὔσημος, πληγὴ, ψύξιες, ἐγκαύσιες, οἰνοφλυγίη· ἥδε γὰρ ἀθρόον πίμπλησι τὴν κεφαλὴν, ἀθρόον καὶ ἐκχέει ἐκραγέντος ἀγγείου· ἐπὶ δὲ σμικρῇ μέθῃ πτύσιες ἐξ ἀραιώσι ος. ἴσχεταί ποτε διὰ Ῥινῶν αἱμορραγίη ξυνήθης· εἰς ὑπερώην δὲ τρεπομένη ἀναγωγῆς φαντασίην παρέχει. ἢν οὖν ἀπὸ κεφαλῆς ἔῃ, γαργαλισμὸς ὑπερώης, ἀνάχρεμψις πυκνὴ, καὶ ἐπὶ τῇδε ἡ πτύσις βύζεται· θυμὸς ἐγγίγνεται, καὶ εὖ μάλα βήσσουσι. ἢν δὲ ἐς τὴν ἀρτηρίην ἀπὸ τῆς ὑπερώης ἐσρυῇ, τότε βήσσοντες ἀνάγουσι· καὶ ἥδε ἐστὶ ἡ ἀπάτη τοῖσι ἡγευμένοισι ἀπὸ σπλάγχνων τῶν κάτωθεν ἀνάγεσθαι. ἐσρέει δὲ καὶ ἐς τὸν στόμαχον ἀπὸ τῆς κεφαλῆς, εὖτε ξὺν ναυτίῃ ἐμέουσι· ἔστι δὲ καὶ ἥδε ἀπάτη, ὡς ἀπὸ στομάχου φέρεσθαι δοκέειν. ἢν δὲ τὸ ἀπὸ τῆς πτύσιος αἷμα, παχὺ μὲν οὐ κάρτα, χροιῇ δὲ μέλαν, λεῖον, ὁμαλὸν, ἀμιγὲς ἑτέρης οὐσίης. χρεμπτομένοισι γὰρ εὐθὺς ἐπὶ τὴν γλῶσσαν ἔρχεται στρογγύλον, Ῥηϊδίως ἀπολυόμενον· ἢν δὲ καὶ τὴν ὑπερώην καθορέῃς, δασυτέρην καὶ ἑλκώδεα ὄψεαι, καὶ τὰ πολλὰ ὕφαιμον· ἰητρίη δὲ ἀρκέσει ἁπλῆ, σμικρὴ, στύμματα μὲν ἐς τὴν ὑπερώην, καὶ τάδε ψυχρά. ἐπὶ γὰρ τοῖσι θερμαίνουσι καὶ τοῖσι ἀραιοῦσι καὶ εὐρύνουσι ἡ φορὴ μέζων· καὶ τόδε τὸ τέκμαρτῆς ἀπὸ τῆς κεφαλῆς πτύσιος· ἐς δὲ τὴν κεφαλὴν κενώσιες ἢ διὰ φλεβῶν,ἢ διὰ Ῥινέων, ἢ διʼ ἑτέρης διαπνοῆς. καὶ τάδε χρὴ ταχέως δρῆν, ἢν γὰρ τὸ αἷμα ἐπὶ πολλὸν χρόνον ἴῃ, μελέτη μὲν ἐγγίνεται τῇ φορῇ· ἔθος δὲ τοῖσι τῇδε χωρίοισι ἐς ὑπόδεξιν τοῦ αἵματος· ἑλκοῦται δὲ καὶ ἀρτηρία, καὶ βήσσουσι ἀντὶ τῆς χρέμψιος. τοὐντεῦθεν δὲ φθορῆς γίγνεται ἡ ἀρχή. Ἡ δὲ ἀπὸ θώρηκος καὶ τῶν νέρθεν σπλάγχνων αἵματος φορὴ ἀναγωγὴ καλέεται·

[¶3] The flow of blood from the chest and viscera below is called a bringing up (in Greek, ἀναγωγή). It is truly of a fatal nature, if it proceed from any of the vital parts which are ruptured—either the vena cava in the heart, which conveys the blood from the liver, or from the large vein which lies along the spine. For from hemorrhage, as from slaughtering or impeded respiration, death is very speedy. But in those cases in which the blood comes from the lungs, the side, or the trachea, they do not die so speedily; but, nevertheless, they become affected with Empyema and Phthisis. Of these the least formidable is that from the trachea. But if the vomiting come from the stomach or bowels, the cases are not of a very fatal nature, even though the hemorrhage be large; neither is the recovery slow and changeable. But if it proceed from the liver and spleen, it is neither readily nor constantly discharged upwards, but the defluxion is more easy into the stomach and intestines. Yet neither is the discharge upwards by the lungs impossible or incredible, for in fevers there occur hemorrhages of blood from the liver and spleen by the nostrils, the blood flowing from the nostril on the same side as the viscus from which it comes. These, then, are the places from which the blood comes in the bringing up, and such the differences as to danger or mortality.

> Greek: ἔστι δὲ κάρτα μὲν ὀλεθρίη, ἢν ἀπό του τῶν ἐπικαίρων ἐκραγέν των ἔῃ, ἢ κοίλης φλεβὸς τῆς ἐν καρδίῃ ἀπὸ τοῦ ἥπατος διακονευμένης τὸ αἷμα, ἢ τῆς τῇ Ῥάχι παρατετα μένης παχείης ἀρτηρίης. αἱμορραγίῃ γὰρ ὅκωσπερ ἐν σφαγῇ καὶ δυσπνοῇ ὤκιστος ὄλεθρος· οἷσι δὲ ἀπὸ πνεύμονος, ἢ πλευρῆς, ἢ ἀρτηρίης τῆς τρηχείης, ἧσσον μὲν ὀξέως θνήσκουσι, οὐχ ἥκιστα δὲ ἔμπυαι καὶ φθίσιες γίγνονται. τουτέων δὲ ἀσθενεστέρη ἡ ἀπὸ τῆς τρηχείης ἀρτηρίης· ἢν δὲ ἀπὸ στομάχου ἢ κοιλίης ἐμέηται, οὔτε κάρτα ὀλεθρίως ἴσχουσι, κἢν πάνυ πολλὴ αἱμορραγίη ἔῃ, οὔτε ἡ ἄλθεξις μακρὴ καὶ ποικίλη· ἢν δὲ ἀπὸ ἥπατος καὶ σπληνὸς, οὐ Ῥηϊδίη μὲν, οὐδὲ ξυνεχής· ἐς γὰρ τὴν κοιλίην καὶ ἔντερα τουτέων ἡ ἀπόκρισις ἑτοιμοτέρη. οὐ μὴν οὐδὲ ἡ ἄνωθεν διὰ πνεύμονος καὶ ἀρτηρίης, ἀδύνατος, ἢ ἄπιστος. καὶ γὰρ ἐν πυρετοῖς ἀπὸ σπληνὸς καὶ ἥπατος διὰ Ῥινῶν αἱμορρα γέουσι, κατʼ ἴξιν τοῦ σπλάγχνου τοῦ μυκτῆρος Ῥέοντος. τόποι μὲν οὖν ἀφʼ ὧνπερ ἡ ἀγωγὴ οἵδε· καὶ ἡ ἐς κίνδυνον ἢ ὄλεθρον διαφορή. οἱ δὲ τρόποι τρεῖς ἔασι· ἢ γὰρ ἀπὸ Ῥήξιος ἀγγείου, ἢ διαβρώσιος, ἢ ἀραιώσιος ἀνάγεται.

[¶4] But the modes are three; for it is brought up either from rupture of a vessel, or from erosion, or from rarefaction. Rupture, then, takes place suddenly, either from a blow, straining at a load, or lifting a weight upward, or a leap from a height, or from bawling aloud, from violent passion, or some other similar cause, when blood is instantly poured forth from the vessel in great quantity.

> Greek: ῥήγνυται μὲν οὖν ἐξαπιναίως, ἢ πληγῇ, ἢ ἐντάσι ἄχθεος, ἢ ἀνωθήσει, ἢ ἀπὸ ὕψους ἅλματι, ἢ καὶ βοῇ, καὶ ὀργῇ μεγάλῃ, ἤ τεῳ ἄλλῃ ὁμοίῃ αἰτίῃ, εὖτε αὐτίκα ἐπὶ τῇ ἀρτηρίᾳ λάβρως τὸ αἷμα ἐκχέεται· ἢν δὲ ἀπὸ βρώσιος, χρὴ ἐπανερωτῆν, εἴ κοτε πρόσθεν ἔβηξε ὥνθρωπος, ἢ δύσπνους γέγονε, ἢ ναυτίη, ἢ ἔμετος ἦγχε πάρος.

[¶5] But if it proceed from erosion, the patient is to be interrogated if he ever had a cough before, or was affected with dyspnœa, and whether nausea or vomiting ever afflicted him previously. For from such chronic affections the vessels are corroded by a continued, copious, and acrid defluxion. When, therefore, the containing vessels, having been long wasted and attenuated, at length give way, they pour forth blood.

> Greek: ἐκ γὰρ τοιῶνδε πολυχρονίων διεσθίεται τὰ ἀγγεῖα Ῥεύματι ξυνεχέϊ καὶ πολλῷ καὶ δριμέϊ. ἐπὴν οὖν πολλὸν ξυντακέντα καὶ λεπτυνθέντα ἐς τέλος ἀπαναλωθῇ τὰ ἀμπέχοντα ὑμένια, τὸ αἷμα ἐκχέει· ἡ δὲ ἐξ ἀραιώσι ος ἀρραγὴς μὲν, διὰ τόδε οὔτε πολλὴ, οὔτε ἀθρόη, οὔτε παχέος αἵματος· ἀραιώσι δὲ τῶν ἀγγείων τὸ λεπτὸν ἀποτιθέεται·

[¶6] But the mode by rarefaction is, indeed, unattended by rupture, and on that account the discharge is neither copious nor sudden, nor does it consist of thick blood; for by the rarefaction of the vessels, the thin portion is excreted. But if much collect in a cavity, and be again brought up, it becomes thicker than natural, but yet not very thick, neither black, like a clot; but it is quickly brought up in greater quantity, as being from a collection. This mode of bringing up blood is common with women who have not their monthly purgation, and appears at the periods of the purgation, and stops during the intervals between them; and if the woman is not cured, the discharge upwards of blood will revert for many periods, and also, in certain cases, the vessels burst from fulness.

> Greek: ἢν δὲ πολλὸν αὐλισθὲν ἐν κοίλῃ χώρῃ αὖθις ἀνάγηται, παχύτερον μὲν ἑωυτοῦ γίγνεται, οὐ μὴν παχὺ κάρτα, οὐδὲ μέλαν, ὁκοῖον αἱμάλωψ· πλεῖον δὲ τῷ πλήθεϊ, ὡς ἀπὸ ἀθροίσιος, εὐθὺς ἀναφέροιτο. τόδε τὸ εἶδος τῆς ἀγωγῆς, γυναιξὶ ὡς ἐπίπαν οὐ καθαιρομένῃσι τάδε ἐπιμήνια γίγνεται, καὶ ἐν τῇσι αὐτῇσι περιόδοισι τῆς καθάρσιος ἐπιφαίνεται, καὶ ἐπὶ τῇσι προθεσμίῃσι τῆς ἀποπαύσιος ἴσχεται· κἢν μὴ ἰηθῇ ἡ γυνὴ, ἐς πολλὰς περιόδους ἀντιπεριεῖσι ἡ ἀναγωγή· μετεξετέρῃσι δὲ καὶ ἀπερράγη τὰ ἀγγεῖα τῷ πλήθεϊ. διαφορὴ τῆς ἀναγωγῆς, καὶ εἰ ἐξ ἀρτηρίης, ἢ φλεβὸς ἀνάγοιτο. μέλαν μὲν γὰρ καὶ παχὺ καὶ Ῥηϊδίως πηγνύμενον, ἢν ἀπὸ φλεβὸς, καὶ ἧσσον ἐς κίνδυνον Ῥέπει, καὶ ἐπίσχεται θᾶσσον.

[¶7] And there is a difference of the discharge, whether it be brought up from an artery or a vein. For it is black, thick, and readily coagulates, if from a vein; it is less dangerous, and is more speedily stopped; but if from an artery, it is of a bright yellow colour and thin, does not readily coagulate, the danger is more imminent, and to stop it is not so easy; for the pulsations of the artery provoke the hemorrhage, and the lips of the wound do not coalesce from the frequent movements of the vessel.

> Greek: ἢν δὲ ἀπʼ ἀρτηρίης, ξανθὸν καὶ λεπτὸν, καὶ οὐ μάλα πήγνυται, καὶ ὁ κίνδυνος ὠκύτερος, καὶ ἡ ἐπίσχεσις οὐ μάλα Ῥηϊδίη. αἱ γὰρ διασφύξιες τῆς ἀρτηρίης αἱμορραγίης πρόκλησιν ποιέονται, καὶ τὸ τρῶμα οὐ συμφύει τῇ πολυκινησίῃ. ἄλθεξις δὲ, ἢν μὲν ἀπὸ διαβρώσιος μακρὴ, καὶ οὐ Ῥηϊδίη, καὶ σφαλερή· ὑπὸ γὰρ ἐλλείψεως ἐς σύμφυσιν τὸ ἕλκος οὐκ ἀφικνέεται·

[¶8] Recovery, if from erosion, is protracted, difficult, and doubtful; for, owing to loss of substance, the parts of the ulcer do not come together, for it is an ulcer, and not a wound; and adhesion takes place more readily in ruptures, for the lips of the wound touch one another. This, then, is another difference as to danger. The mode attended with least danger is that from rarefaction; and in it the styptic and refrigerant method of treatment is sufficient.

> Greek: ἕλκος γὰρ, οὐ τρῶμα γίγνεται· ἐπὶ δὲ τῇσι Ῥήξισι ἡ σύμφυσις ἑτοιμοτέρη. ψαύει γὰρ ἀλλήλων τοῦ τρώματος τὰ χείλεα· ἔστι ἥδε ὦν ἡ διαφορὴ δευτέρη ἐς κίνδυνον. ἀσινεστάτη δὲ ἡ ἐπὶ τῇσι ἀραιώσισι· ἴσχεται γὰρ αὐτομάτως, καὶ ἰητρίη στύψις καὶ ἔκψυξις ἱκανή. Σημαντέ οι δὲ καὶ οἱ τόποι, ἀφʼ ὧνπερ ἀνάγεται. ξυνὰ γὰρ πολλὰ σημεῖα, καὶ ἡ ἀπάτη Ῥηϊδίη, καὶ ἰητρίη ἑτέρη.

[¶9] The places are to be indicated from which the blood is brought up; for many of the symptoms are common, deception is easy, and the cure different. Blood, then, from erosion is not readily brought up from the stomach, for the coldness and stypticity of the articles of food and drink bring the parts to a state of condensation. Neither, also, are cases from erosion common, although more so than the former; for acrid defluxions do not adhere for any length of time, but are either brought up or are passed downwards. Rupture is more common in the stomach. If, then, any rupture take place, the hemorrhage is not very great, such as that from the thorax; for the veins there are slender, and the arteries also are small. But in appearance the blood is not very black, not intensely yellowish, smooth, or mixed with saliva, being brought up with nausea and vomiting, slight cough, sometimes with some discharge, and sometimes alone, without any expectoration; for the trachea sympathises with the gullet, being extended along and connected with it. There is pinching or constriction of the ulcer from the things swallowed, more especially if they are very cold, hot, or austere; and in certain cases pain is produced in the stomach, extending as far as the back; vomitings of phlegm, and sometimes, when the disease is long protracted, and there has been long abstinence from food, they bring up a great quantity of them; fevers, not of a continual type, but of an irregular kind.

> Greek: ἀπὸ στομάχου μὲν οὖν οὔτε λίην ἐξ ἀραιώσιος ἀνάγεται· ἡ γὰρ τῶν βρωμάτων τε καὶ τῶν πομάτων ψύξις τε καὶ στύψις ἐς πύκνωσιν ἄγει τὰ μέρεα· ἀτὰρ οὐδὲ διαβρώσιες ξυνεχέες εἰσὶ, καί τοι μᾶλλον τῆς προτέρης· τὰ γὰρ ἀναδάκνοντα τῶν Ῥευμάτων οὐ προσίσχεται πολλὸν χρόνον, ἀλλʼ ἤ ἀπεπτύσθη, ἢ διηλάθη κάτω. συνηθεστέρη δὲ στομάχῳ ἐστὶν ἡ Ῥῆξις. εἰ οὖν ἀπορραγῇ κοτε, αἱμορραγίαι οὐ κάρτα μεγάλαι, ὁκοῖαι ἀπὸ θώρηκος. ἰσχνὰ γὰρ τῇδε τὰ φλεβία, σμικραὶ δὲ καὶ ἀρτηρίαι· ἰδέῃ δὲ τὸ αἷμα οὐ κάρτα μέλαν, ἢ ὑπόξανθον οὐ κατακορέως, λεῖον, ἢ σιάλοισι μεμιγμένον, ξὺν ναυτίῃ καὶ ἐμέτῳ ἀναφερόμενον. βὴξ μικρὴ, ἄλλοτε μὲν ξύν τῳ, ἄλλοτε δὲ μούνη ἄνευθεν ἀναγωγῆς· ξυνταλαιπωρέει γὰρ ἡ ἀρτηρίη τῷ στομάχῳ, παρατεταμένη καὶ ξυνημμένη· δῆξις, ἢ στύψις τοῦ ἕλκεος ἐπὶ τοῖσι καταπινομένοισι· πολλὸν δὲ μᾶλλον, ἢν ψυχρὰ κάρτα ἢ θερμὰ ἢ στρυφνὰ ἔῃ· ἐγγίγνεται δὲ καὶ πόνος τοῦ στομάχου, μετεξετέροισι δὲ μέσφι μεταφρένου· ἔμετοι φλεγματώδεες· ἐπαναφέρουσι δέ κοτε, ἐπὴν ἐς μῆκος ἡ νοῦσος ἐπιταθῇ, καὶ μέζων ἔῃ ἀποσιτίη, τουτέων πλῆθος πολύ· πυρετοὶ οὐ μάλα ξυνεχέες, ἀλλὰ Ῥεμβώδεες. ἀπὸ δὲ κοιλίης ἀνάγοιτο μέλαν καὶ πηγνύμενον, κἢν ἀπὸ ἀρτηρίης ᾖ·

[¶10] But, from the stomach, what is brought up may be black and coagulated, even if it proceed from an artery; but if it proceed from a vein, it is much blacker and much more compact; much nausea and vomiting of pituitous and bilious matter; blood mixed up with the food, provided the man had eaten previously, for both the food and the blood are collected together in the same place; eructations frequent and fœtid, and, if much collect together, there is anxiety of mind and vertigo; but if these be vomited they are relieved. They are prostrate in strength, generally affected with a burning heat, and constant pain of the stomach.

> Greek: ἢν δὲ ἀπὸφλεβὸς, πολλόν τι μελάντερον, πολλὸν δὲ καὶ παγετώτερον· ναυτίη πολλὴ καὶ ἔμετος φλεγμάτων καὶ χολωδέων, τοῖσι σιτίοισι συμμιγνύμενον τὸ αἷμα, ἢν προβεβρώκῃ ὥνθρωπος· ἐν γὰρ τῇ αὐτῇ χώρῃ ἄμφω ἅμα ἀλίζεται καὶ ἡ τροφὴ καὶ τὸ αἷμα. ἐξερεύξιες πολλαὶ, βρωμώδεες· κἢν μὲν πολλὴ ξυλλεγῇ, ἀπορίη, σκοτόδινος· ἢν δὲ ἐμεθῇ τάδε, Ῥηΐζουσι. ἔκλυτοι, καυσώδεες τὸ σύμπαν, πόνος ξυνεχὴς τῆς κοιλίης. ἀπὸ δὲ τῆς τρηχείης ἀρτηρίης μικρὸν καὶ σφόδρα ξανθὸν τὸ αἷμα καὶ ξὺν βηχὶ ἀνάγουσι·

[¶11] But from the aspera arteria they bring up scanty and very fluid blood, with a cough; or, if they do not bring it up, they cough incessantly. There is a painful feeling in the throat, either a little below or above; voice hoarse and indistinct.

> Greek: κἢν μὴ ἀνάγωσι δὲ, διηνεκέως βήσσους ι· αἴσθησις δὲ καὶ πόνου, ἔνθα ὁ βρόγχος, ἢ μικρόν τι νέρθεν ἢ ὕπερθεν· φωνὴν βραγχώδεες, ἀσαφέες·

[¶12] But if it be from the lungs, the discharge is copious, especially if from erosion, with much cough, of an intense yellow colour, frothy, rounded; so that what is brought up from one part may be distinguished from what is brought up from another. But the defluxion, though contained in a common vessel, from the chest, is diversified after mixture, and you may distinguish parts of them as being portions of the thorax, and parts which have a fleshy appearance as being portions of the lungs. There is heaviness of the chest, freedom from pain, and much redness of the face, particularly in these cases.

> Greek: ἢν δὲ ἀπὸ πνεύμονος ᾖ, ἀθρόως ἡ ἀναγωγὴ, ἐπὶ δὲ μᾶλλον, εἰ ἐκ διαβρώσιος, ξὺν βηχὶ πολλῇ ξανθὸν κατακορέως, ἀφρῶδες, στρογγύλον, ὡς ἄλλην ἀπʼ ἄλλης ἀναγωγὴν διακεκρίσθαι· ἀλλὰ καὶ ἡ ἐν ξυνῷ ἀγγείῳ φορὴτῶν τοῦ θώρηκος ἀναγομένων ἄλλη· καὶ διαστήσαις ἂν τὰ ξυμμεμιγμένα ἐκ παραθέσιος, ὡς ὄντα μέρεα θώρηκος· τὴς τὰ δὲ ἰδέην σαρκοει δέα δοκοίης ἂν πλεύμονος ἔμμεναι μέρεα. θώρηκος βάρος, ἀπονίη, ἐρύθημα προσώπου πολλόν τι μᾶλλον τουτέοισι. ἢν δὲ ἀπὸ θώρηκος ἐπανίῃ, ἐς τὸ πρόσθεν κατὰ τὸ στέρνον πόνος διασημαίνει τοῦ ἐρρωγότος μέρεος.

[¶13] But if brought up from the thorax, pain stretching to the anterior part of the breast is indicative of the ruptured part; cough intense, expectoration difficult, the blood not very fluid, moderately thick, without froth. But if, in passing, the lung be affected by consent, a certain amount of froth is imparted to it, for the passage from the chest to the trachea is by the lungs.

> Greek: βὴξ σύντονος καὶ μόλις ἀνάγουσα. τὸ δὲ αἷμα ξανθὸν οὐ κάρτα, μέσως παχὺ, ἄναφρον. ἢν δὲ καὶ πνεύμων ἐκ τῆς παρόδου ξυμπαθήσῃ, προσδιδοῖ τοῦ ἀφρώδεος· ὁδὸς γὰρ θώρηκος ἐς ἀρτηρίην πνεύμων.

[¶14] But if, indeed, from the side there be discharged with cough blood which is black, smooth, fœtid, stinking, as from putrefaction, with acute pain of the side, many die after the manner of pleuritics with fever.

> Greek: ἢν δὲ ἀπὸ πλευρῆς, ξὺν βηχὶ μὲν, μέλαν δὲ καὶ λεῖον, κάκοδμον, βρωμῶδες, ὁκοῖον τῆς σηπεδόνος, πόνος τῆς πλευρῆς ὀξύς. πολλοὶ γοῦν θνήσκουσι πλευριτικὸν τρόπον ξὺν πυρετῷ. ὥρη δὲ φέρει ὑγρὴ καὶ θερμή.

[¶15] A season that is humid and hot engenders these affections. Spring is thus humid and hot. Next the summer; autumn less, but winter least of all. They die in summer mostly from hemorrhage, for great inflammations do not readily occur then; secondly, in spring, from inflammation and ardent fevers; but in autumn, attacks of phthisis readily occur.

> Greek: τοιόνδε τὸ ὑγρὸν καὶ θερμὸν ἔαρ. δεύτερον τὸ θέρος· μετόπωρον ἧσσον, χειμὼν δὲ ἥκιστα· θνήσκουσι δὲ θέρους μὲν μάλιστα αἱμορραγίῃ· φλεγμοναὶ γὰρ οὐ κάρτα μεγάλαι γίγνονται τότε· ἔαρος δεύτερον, φλεγμον ῇ καὶ πυρετοῖσι καυσώδεσι. φθινοπώρῳ δὲ ὡς ἐπίπαν Ῥηϊδίως φθόαι γίγνονται.

[¶16] In a word, every discharge of blood upwards, even if small, and although the ruptured vessels may have already united, is attended with lowness of spirits, dejection, and despair of life. For who is so firm in mind as to see himself enduring a state resembling that of a slaughtered animal, and yet have no fear of death? For the largest and most powerful animals, such as bulls, die very quickly from loss of blood. That, however, is no great wonder. But this is a mighty wonder: in the discharge from the lungs alone, which is particularly dangerous, the patients do not despair of themselves, even although near the last. The insensibility of the lungs to pain appears to me to be the cause of this; for pain, even although slight, makes one to fear death, and yet, in most cases, it is more dreadful than pernicious; whereas the absence of pain, even in the great illnesses, is attended with absence of the fear of death, and is more dangerous than dreadful.

> Greek: ἀθρόον δὲ εἰρῆσθαι, ἐπὶ πάσῃ αἵματος ἀναγωγῇ, κἢν μικρὴ ἔῃ, κἢν ἤδη μεμύκῃ τὰ Ῥαγέντα, ἕπεται δυσθυμίη, δυσελπιστίη, ἀπόγνωσις τοῦ βίου. τίς γὰρ οὕτως εὐσταθὴς ὡς ὁρῆν μὲν ἑωυτὸν σφαγῇ ἴκελον πεπονθότα, μὴ ὀρρωδέῃ δὲ ἀμφὶ θανάτου; καὶ γὰρ καὶ τὰ μέζω τῶν ζῴων καὶ τὰ ἀλκιμώτ ερα, ὁκοῖον οἱ ταῦροι, αἱμορραγίῃ θνήσκουσι ὤκιστα. ἀλλὰ τόδε μὲν οὐ μέγα τὸ θώϋμα. θώϋμα δὲ μέγα τόδε. ἐπὶ γὰρ τῇ ἀπὸ πνεύμονος φορῇ μούνῃ χαλεπωτά τῃ ἐούσῃ οὐκ ἀπογιγνώσκουσι ἑωυτῶν οἱ ἄνθρωποι, κἢν ἐν τῷ ἐσχάτῳ ἔωσι. δοκέω δὲ ἔγωγε τὴν τοῦ πνεύμονος ἀπονίην αἰτίην ἔμμεναι· πόνος γὰρ κἢν σμικρὸς ἔῃ, θάνατον ὀρρωδέει· καὶ ἔστι ἐν τοῖσι πλείστοισι φοβερώτερος ἢ κακίων· ἀπονίη δὲ καὶ ἐν τοῖσι μεγάλοισι κακοῖσι, ἀφοβίη θανάτου, καὶ ἔστι κακίων ἢ φοβερωτέρη.

[¶17] 3. WELL by all means has the physician, and well have the common people succeeded in the appellation of this affection! It is, indeed, the name of a very acute malady; for what is there greater or more acute than the power of Syncope? and what other name more appropriate for the designation of this matter? what other organ more important than the heart for life or for death? Neither is it to be doubted that syncope is a disease of the heart, or that it is an injury of the vital powers thereof—such is the rapidity and such the mode of the destruction. For the affection is the solution of the bonds of the vital power, being antagonistic to the constitution of the man; for having seized fast thereon, it does not let go its hold, but brings him to dissolution. Nor is it any great wonder; for other diseases are peculiar to, and prove fatal to, certain organs, in which they are engendered, and to which they attach themselves. Thus pestilential and very malignant buboes derive their origin from the liver, but from no other part; tetanus, in like manner, from the nerves, and epilepsy from the head. Thus, therefore, syncope is a disease of the heart and of life. But such persons as regard it to be an affection of the stomach, because by means of food and wine, and in certain cases by cold substances, the powers have been restored and the mischief expelled—these, it would seem to me, ought to hold phrenitis to be a disease of the hair and skin of the head, since the phrenitics are relieved by the shaving and wetting thereof. But to the heart the vicinity of the stomach is most important, for from it the heart draws both what is suitable and what is unsuitable to itself. And by the lungs the heart draws spirit (pneuma) for respiration, but yet the lungs do not hold a primary place in respiration; for the powers are not in the organs, but there where is the original of life and strength: But the stomach is neither the original nor seat of life; and yet one would be injured by atony thereof: for food which proves injurious to the heart does not hurt the stomach itself, but by it the heart; since those dying in such cases have symptoms of heart-affections, namely, pulse small and feeble, bruit of the heart, with violent palpitation, vertigo, fainting, torpor, loss of tone in their limbs, sweating copious and unrestrainable, coldness of the whole body, insensibility, loss of utterance. How should the stomach endure such symptoms? For those peculiar to it are nausea, vomiting, loss of appetite, hiccup, eructation, acidity; whereas in cardiac affections the patients are more acute in their senses, so that they see and hear better than formerly; they are also in understanding more sound, and in mind more pure, not only regarding present things, but also with regard to futurity they are true prophets. These, then, are the powers, not of the stomach, but of the heart, where is the soul and the nature thereof, and to it is to be referred this affection of its powers. But this form of disease is a solution of the natural tone from a cold cause and humidity, and therefore they are not affected with heat, either internally or externally, neither do they suffer from thirst, and their breath is cold even when the disease proceeds from strong and ardent fevers, by which syncope is usually kindled up. For when nature is strong, and of the proper temperament, it rules all and commands all, whether humour, spirit (pneuma), or solid, and, by their good order and symmetry, regulates the man in life; but if the bond of nature—that is to say, its tone—be dissolved, then this affection is produced. The original of it is causus, which is in this form.

> Greek: 3. εὖ γε ὅλως ὁ ἰητρὸς, ἠδὲ ὁ δημότης, εὖ γε ἐπικλήσιος τοῦδε τοῦ πάθεος. ὠκυτάτου κακοῦ ἐστι οὔνομα· τί μὲν γὰρ μέζον ἢ ὠκύτερο ν συγκοπῆς δυνάμιος; τί δὲ οὔνομα ἕτερον εἰς ἐπίκλησιν τοῦδε τοῦ πράγματος μᾶλλον εὔσημον; τί δὲ καρδίης ἄλλο καιριώτερον ἐς ζωὴν ἢ ἐς θάνατον; οὐδὲ τὴν συγκοπὴν ἄπιστον τῆς καρδίης νοῦσον ἔμμεναι, ἢ αὐτὴν σίνος τῆς ἐν αὐτέῃ τοῦ ζῆν δυνάμιος· τόσον τε τάχος τοῦ ὀλέθρου, τοιήδε καὶ ἰδέη. ἔστι γὰρ τὸ πάθος λύσις τῶν δεσμῶν τῆς εἰς ζωὴν δυνάμιος, ἀντίξουν τῇ συστάσει τοῦ ἀνθρώπου ἐόν. τῆσδε γὰρ ἀπρὶξ λαβόμεν ον οὐ μεθίησι, ἀλλʼ ἐς διάλυσιν τρέπει. καὶ οὐ μέγα τὸ θώϋμα. καὶ γὰρ καὶ ἕτερα πάθεα ἴδια καὶ ἐπίκαιράτινων μερέων ἐστὶ, οἷσίπερ ἐμφύνει, καὶ τουτέων ἐξάπτεται· βουβῶνες μὲν οἱ λοιμώδεες καὶ σφόδρα κακοήθεες ἐξ ἥπατος ἐξ ἄλλου δὲ γίγνονται οὐδενός. νεύρων δὲ τέτανος, ἐπιληψίη δὲ κεφαλῆς. ὧδε οὖν καὶ ἡ συγκοπὴ καρδίης ἐστὶ καὶ ζωῆς νοῦσος. ὁκόσοι δὲ στομάχου ἡγέονται τὸ πάθος ἔμμεναι, οὕνεκα σιτίοισί τε καὶ οἴνῳ, μετεξετέροισι δὲ καὶ ψυχρῷ, ἡ δύναμις ἐστάθη, καὶ τὸ κακὸν ἐξηλάθη, οἱ δέ μοι δοκέουσι καὶ τὴν φρενῖτιν τριχῶν τῆς κεφαλῆς, καὶ τοῦ δέρματος νοῦσον ἡγέεσθαι, οὕνεκεν κουρῇ καὶ τέγξι αὐτέων Ῥηίζουσι οἱ φρενιτι κοί. ἀλλὰ γὰρ τῆς καρδίης γειτόνη μα καίριόν ἐστι ὁ στόμαχος, ἐξ οὗπερ ἕλκει ἡ καρδίη οἰκεῖον ἢ ἀξύμφορον. καὶ γὰρ καὶ διὰ πνεύμονος ἕλκει πνεῦμα εἰς ἀναπνοὴν ἡ καρδίη, ἀλλʼ οὐχὶ πνεύμων ἐξ ἴσης ἀρχῆς ἀναπνέει. οὐ γὰρ ἐν τοῖσι ὀργάνοισι αἱ δυνάμιες, ἀλλʼ ἔνθα ἀρχὴ ζωῆς ἦν καὶ ἰσχύος. στόμαχος δὲ οὔτε ἀρχὴ οὔτε χωρίον ζωῆς· βλαβήσεται δέ τις διὰ ἀτονίην. καὶ γὰρ καὶ τὰ καρδιοβόλα βρώματα οὐ τὸν στόμαχον σίνεται, ἀλλὰ διʼ αὐτέου τὴν καρδίην· ἐπεὶ καὶ οἱ ἐπὶ τοῖσδε θνήσκοντες σημεῖα ἴσχουσι καρδίης πάθεος, σφυγμοὺς μικροὺς, ἀδρανέας, πάταγον τῆς καρδίης, ἐπὶ πηδήσι καρτερῇ, σκοτόδινος, λειποθυμίη, νάρκη, καὶ παρέσιες μελέων, ἱδρὼς ἄσχετος, πουλὺς, ψύξις ὅλου, ἀναισθησίη, ἀφωνίη. ποῦ δὴ τὸν στόμαχον πάσχειν τάδε; ἅττα δὲ αὐτέου ἴδια, ναυτίη, ἔμετος, ἀποσιτίη, λὺγξ, ἐρεύξιες, ὀξυρεγμίη· ἐπὶ δὲ τοῖσι καρδιώσσουσι καὶ αἰσθήσι ὀξύτεροι, ὡς ἰδεῖν καὶ ἀκοῦσαι μᾶλλον ἢ πρόσθεν, καὶ γνώμῃ εὐσταθέστεροι, καὶ ψυχῇ καθαρώτεροι, καὶ τάδε οὐκ εἰς τὰ παρεόντα μοῦνον, καὶ ἐς τὰ μέλλοντα μάντιες ἀτρεκέες. μὴ οὖν καὶ αἵδε στομάχου αἱ δυνάμιες, ἀλλὰ καρδίης, ἔνθα καὶ ἡ ψυχὴ καὶ ἡ φύσις αὐτέης, εἰς ἣν καὶ τὸ πάθος ᾖ τῶν τῇδε δυνάμεων. ἔστι δὲ ἡ τῆς νούσου ἰδέη ἔκλυσις τοῦ τόνου τῆς φύσιος ἐπʼ αἰτίῃ ψύξι καὶ ὑγρότητι. καὶ γὰρ ἄθερμοι, καὶ τὰ εἴσω καὶ τὰ ἔξω, καὶ ἄδιψοι· καὶ ψυχρὸν ἀναπνέουσι, κἢν ἐκ μεγάλων καὶ καυσωδέων ἐστὶ πυρετῶν, ἐξ ὧνπερ ἐξάπτεται ἡ ξυγκοπή. εὖτε μὲν γὰρ ἔρρωται ἡ φύσις, καί ἐστιν εὔκρατος, πάντων μὲν κρατέει, πᾶσι δὲ σημαίνει, καὶ ὑγρῷ, καὶ πνεύματι, καὶ στερεοῖσι, καὶ τῇ τούτων εὐταξίῃ καὶ ξυμμετρίῃ ἐς ζωὴν διέπει τὸν ἄνθρωπον· ἢν δὲ τῆς φύσιος ὁ δεσμὸς, τουτέστι ὁ τόνος, λυθῇ, τότε γίγνεται τὸ πάθος. κατάρχει δὲ αὐτέου καῦσος, ὅς ἐστι τοιόσδε.

[¶18] 4. HEAT, indeed, everywhere, both acrid and subtil, but especially in the internal parts; respiration hot, as if from fire; inhalation of air large; desire of cold; dryness of tongue; parchedness of lips and skin; extremities cold; urine intensely tinged with bile; insomnolency; pulse frequent, small, and feeble; eyes clear, glancing, reddish; healthy colour of the countenance. But if the affection increase, all appearances become greater and worse; the pulse very small and very frequent; heat very dry and very acrid; intellect wavering; ignorance of all things; they are thirsty; a desire to touch anything cold, whether a wall, a garment, the floor, or a fluid; hands cold, palms thereof very hot, nails livid; breathing thick; perspiration like dew about the forehead and clavicles. But if nature attain the extremity of dryness and of heat, the hot is converted into cold, and the parched into humidity; for extreme intensities of things change to the opposite state. When, therefore, the bonds of life are dissolved, this is syncope. Then is there an irrestrainable sweat over all the body; respiration cold, much vapour about the nostrils; they have no thirst, and yet the other parts are parched except the organs of thirst, namely, the mouth and stomach; the urine thin and watery; belly for the most part dry, yet in certain cases the discharges are scanty and bilious; a redundancy of humours; even the bones, being dissolved, run off; and from all parts, as in a river, there is a current outwards. As to the state of the soul, every sense is pure, the intellect acute, the gnostic powers prophetic; for they prognosticate to themselves, in the first place, their own departure from life; then they foretell what will afterwards take place to those present, who fancy sometimes that they are delirious; but these persons wonder at the result of what has been said. Others, also, talk to certain of the dead, perchance they alone perceiving them to be present, in virtue of their acute and pure sense, or perchance from their soul seeing beforehand, and announcing the men with whom they are about to associate. For formerly they were immersed in humours, as if in mud and darkness; but when the disease has drained these off, and taken away the mist from their eyes, they perceive those things which are in the air, and with the naked soul become true prophets. But those who have attained such a degree of refinement in their humours and understanding will scarcely recover, the vital power having been already evaporated into air.

> Greek: 4. πῦρ μὲν πάντη καὶ δριμὺ καὶ λεπτὸν, μάλιστα δὲ τὰ εἴσω· ἀναπνοὴ θερμὴ, ὡς ἐκ πυρὸς, ἠέρος ὁλκὴ μεγάλη, ψυχροῦ ἐπιθυμίη, γλώσσης ξηρότης, αὐασμὸς χειλέων καὶ δέρματος, ἄκρεα ψυχρὰ, οὖρα χολόβαφα κατακορέως, ἀγρυπνίη, σφυγμοὶ πυκνοὶ, σμικροὶ, ἔκλυτοι· ὀφθαλμοὶ εὐαγέες, λαμπροὶ, ὑπέρυθροι· προσώπου εὐχροίη. ἢν δὲ ἐπὶ μᾶλλον αὔξῃ τὸ πάθος, μέζω τὰ πάντα καὶ κακίω· σφυγμοὶ σμικρότατοι καὶ πυκνότατοι, πῦρ ξηρότατον καὶ δριμύτατον, γνώμη παράφορος, πάντων ἀγνωσίη, διψώδεες, ψαῦσαι ψυχροῦ ἐπιθυμίη, τοίχου, ἐσθῆτος, ἐδάφεος, ὑγροῦ· χεῖρες ψυχραὶ, θέναρα θερμότατα, ὄνυχες πελιδνοὶ, ἀναπνοὴ πυκινὴ, νοτὶς περὶ μέτωπα καὶ κληΐδας. ἢν δὲ ἐς ἄκρον ξηρότητος καὶ θερμασίης ἥκῃ ἡ φύσις, τὸ μὲν θερμὸν ἐς ψυχρὸν, ὁ δὲ αὐχμὸς ἐς ἐπομβρίην τρέπεται. αἱ γὰρ τῶν πρηγμάτων ἐς τὸ ἔσχατον ἐπιτάσιες εἰς τὴν ἐναντίην μεταβάλλουσι ἰδέην. ἐπὴν οὖν λυθῇ τῆς φύσιος τὰ δεσμὰ, τόδε ἐστὶ ἡ συγκοπὴ, τότε ἱδρὼς ἄσχετος πάντη τοῦ σώματος, ἀναπνοὴ ψυχρὴ, ἀτμὸς ἀνὰ Ῥῖνας πουλὺς, ἄδιψοι, ἐξήρανται γὰρ τά τʼ ἄλλα, ἀτὰρ καὶ τὰ ἄλλα διψαλέα ὄργανα, στόμα, στόμαχος· οὖρα λεπτὰ, ὑδατώδεα· κοιλίη τὰ πολλὰ μὲν ξηρὴ, ἔστι δὲ καὶ οἷσι ὑποφέρει βραχέα χολώδεα, πουλὺς πλάδος, διαρρέει δὲ καὶ τὰ ὀστέα λυόμενα· καὶ ἀπὸ πάντων ὡς ἐν ποταμῷ ἐς τὰ ἔξω ἡ φορή. ψυχῆς κατάστασις, αἴσθησις σύμπασα καθαρὴ, διάνοια λεπτὴ, γνώμη μαντική. προγιγνώσκουσι μὲν οὖν πρώτιστα μὲν ὡυτέοισι τοῦ βίου τὴν μεταλλαγήν· ἔπειτα τοῖσι παρεοῦσι προλέγουσι τὰ αὖθις ἐσόμενα· οἱ δὲ αὐτέους μὲν ἔσθʼ ὅτε καὶ ἀλλοφάσσειν δοκέουσι· τῇ ἀποβάσι δὲ τῶν εἰρημένων θωϋμάζουσι ὥνθρωποι. μετεξέτεροι δὲ καὶ προσλαλέουσι τῶν κατοιχομένων τισὶ, τάχα μὲν παρεόντας ὁρεῦντες αὐτοὶ μοῦνοι, ὑπὸ λεπτῆς καὶ καθαρῆς αἰσθήσιος, τάχα δʼ αὐτῶν τῆς ψυχῆς προγγινωσκούσης, καὶ διηγευμένης τοὺς ἄνδρας οἷσι ξυνέσονται. πρόσθεν μὲν γὰρ ἐν τοῖσι ὑγροῖσι ὡς ἐν ἰλύϊ ἔνην καὶ ζόφῳ. ἐπεὶ δὲ τάδε ἐξήντλησε ἡ νοῦσος, καὶ ἀπὸ τῶν ὀφθαλμῶν τὴν ἀχλὺνἕλε, ὁρέουσι τά τε ἐν τῷ ἠέρι, καὶ γυμνῇ τῇ ψυχῇ γίγνονται μάντιες ἀτρεκέες· οἱ δὲ ἐς τοσόνδε λεπτότητος ὑγρῶν καὶ τῆς γνώμης ἀφιγμένοι οὐ μάλα τοι περιγίγνονται, ἐξηερωμ ένης ἤδη τῆς ζωτικῆς δυνάμιος.

[¶19] 5. CHOLERA is a retrograde movement of the materiel in the whole body on the stomach, the belly, and the intestines; a most acute illness. Those matters, then, which collect in the stomach, rush upwards by vomiting; but those humours in the belly, and intestines, by the passages downwards. With regard to appearance, then, those things which are first discharged by vomiting, are watery; but those by the anus, liquid and fetid excrement, (for continued indigestion is the cause of this disease); but if these are washed out, the discharges are pituitous, and then bilious. At first, indeed, they are borne easily, and without pain; but afterwards the stomach is affected with retchings, and the belly with tormina. But, if the disease become worse, the tormina get greater; there is fainting, prostration of strength in the limbs, anxiety, loss of appetite; or, if they take anything, with much rumbling and nausea, there is discharged by vomiting bile intensely yellow, and the downward discharges are of like kind; spasm, contractions of the muscles in the legs and arms; the fingers are bent; vertigo, hiccup, livid nails, frigidity, extremities cold, and altogether they are affected with rigors. But if the disease tend to death, the patient falls into a sweat; black bile, upwards and downwards; urine retained in the bladder by the spasm; but, in fact, sometimes neither is there any urine collected in the bladder, owing to the metastasis of the fluids to the intestine; loss of utterance; pulse very small, and very frequent in the cases affected with syncope; continual and unavailing strainings to vomit; the bowels troubled with tenesmus, dry, and without juices; a painful and most piteous death from spasm, suffocation, and empty vomiting. The season of summer, then, engenders this affection; next autumn; spring, less frequently; winter, least of all. With regard to the ages, then, those of young persons and adults; old age least of all; children more frequently than these, but their complaints are not of a deadly nature.

> Greek: 5. Ἡ χολέρη παλίνορσός ἐστι φορὴ τῆς ὕλης τῆς ἐν τῳ παντὶ ἐς τὸν στόμαχον καὶ τὴν κοιλίην καὶ τὰ ἔντερα, ὀξύτατον κακόν· διεκθέει δὲ ὕπερθεν μὲν ἐς ἔμετον τὰ ἐν τῷ στομάχῳ ἁλιζόμενα· διὰ δὲ τῆς κάτω διεξόδου τὰ ἐν τῇ κοιλίῃ καὶ τοῖς ἐντέροις ὑγρά. ἰδέην δὲ τὰ πρῶτα μὲν ὑδατώδεα τὰ διʼ ἐμέτου, τὰ δὲ διʼ ἕδρης κόπρανα ὑγρὰ, δυσώδεα· ἀπέψιες γὰρ ξυνεχέες αἱ τῆσδε προφάσιες· ἢν δὲ τάδε ἀποκλυσθῇ, φλεγματώδεα, ἔπειτα χολώδεα· τὰ πρῶτα μὲν Ῥηϊδίως, ἀπόνως· ἔπειτα δὲ ξὺν ἐντάσεσι μὲν ὁ στόμαχος, γαστὴρ δὲ μετὰ στρόφων. ἢν δὲ ἐς τὸ κάκιον ἐπιδιδῷ, καὶ στρόφοι μείζονες, λειποθυμίη, ἔκλυσις μελέων, ἀπορίη, ἀποσιτίη· ἢν δὲ καί τι προσενέγ κωνται, πολλῷ Ῥοίζῳ ξὺν ναυτίῃ ἐς ἔμετον διεκθέει ξανθὴ χολὴ κατακορέως καὶ τὰ διαχωρήματα ὅμοια· σπασμοὶ, ξυνολκαὶ μυῶν τῶν ἐν τῇ κνήμῃ καὶ βραχιόνων· δάκτυλοι καμπύλοι, σκοτόδινος, λὺγξ, ὄνυχες πελιδνοὶ, κατάψυξις, ἄκρεα ψυχρὰ, καὶ τὸ ὅλον Ῥιγώδεες. ἢν δὲ ἐς τελευτὴν ἥκῃ τὸ κακὸν, ἀτὰρ ἱδροῖ ὥνθρωπος, χολὴ μέλαινα ἄνω καὶ κάτω. οὖρα σχεθεῖσα κύστις ὑπὸ σπασμοῦ· ἀλλʼ οὐδὲ οὖρον ἁλίζεται ὑπὸ τῆς ἐς τὸ ἔντερον τῶν ὑγρῶν μετοχετεύσεως· ἀφωνίη, σφυγμοὶ σμικρότατοι καὶ πυκνότατοι, ὁκόσοι ἐπὶ ξυγκοπῇ· ἐντάσιες ἐμέτου ξυνεχέες κενεαὶ, προθυμίαι τεινεσμώδεες, ξηραὶ, ἄχυλοι· θάνατος ἐπώδυνος καὶ οἴκτιστος, σπασμῷ καὶ πνιγὶ καὶ ἐμέτῳ κενῷ. φέρει μὲν τὸ πάθος ὥρη μὲν θέρεος, δεύτερον δὲ φθινόπωρον, ἦρἧσσον, χειμὼν ἥκιστα· ἡλικίαι δὲ, αἱ τῶν νέων καὶ ἀκμαζόντων· γῆρας ἥκιστα, παιδία δὲ τουτέων μᾶλλον, ἀλλʼ οὐ θανατώδεα.

[¶20] 6. AN inflammation takes place in the intestines, creating a deadly pain, for many die of intense tormina; but there is also formed a cold dull flatus (pneuma), which cannot readily pass either upwards or downwards, but remains, for the most part rolled up in the small convolutions of the upper intestines, and hence the disease has got the appellation of Ileus (or Volvulus). But if in addition to the tormina, there be compression and softening of the intestines, and the abdomen protrude greatly, it is called Chordapsus, from the Greek word ἕψησις, which signifies softening, and χορδὴ, which is a name for the intestines; and hence the Mesentery, which contains all the nerves, vessels, and membranes that support the intestines, was called ἐπιχορδὶς by the ancients. The cause of Ileus is a continued corruption of much multifarious and unaccustomed food, and repeated acts of indigestion, especially of articles which are apt to excite Ileus, as the ink of the cuttle-fish. And the same effects may be expected from a blow, or cold, or the drinking of cold water largely and greedily in a state of sweating; and in those cases, in which the gut has descended into the scrotum with fæces, and has not been replaced into the belly, or has been restored to its place with violence, in such cases it is customary for the lower intestines to get inflamed. This affection is customary with children, who are subject to indigestion, and they more readily escape from the mischief, owing to their habits and the humidity of their intestines, for they are loose. Old persons do not readily suffer from the complaint, but rarely recover. The season of summer engenders the disease rather than that of spring; autumn, than winter; but the summer more than both. Many therefore die speedily of these tormina. But in other cases pus is formed; and then again, the intestine having become black and putrified, has separated, and thus the patients have died. In these cases, provided the Ileus is mild, there is a twisting pain, copious humours in the stomach, loss of tone, languor, vacant eructations bringing no relief, borborygmi in the bowels, the flatus passing down to the anus, but not making its escape. But if the attack of Ileus acquire intensity, there is a determination upwards of everything, flatus, phlegm, and bile; for they vomit all these; they are pale, cold over the whole body; much pain; respiration bad, they are affected with thirst. If they are about to die, there is cold sweat, dysuria, anus constricted, so that you could not pass a slender metal plate by it; vomiting of fæces; the patients are speechless; pulse, at last rare and small, but before death very small, very dense, and failing. These symptoms attend the disease in the small intestines. But the same affections occur also in the colon, and the symptoms are similar, as also the issue; some of these escape if pus form in the colon, the reason of which is the fleshy thickness of this intestine. The pain is slender and sharp in the small intestines, but broad and heavy in the colon; the pain also sometimes darts up to the ribs, when the disease puts on the appearance of pleurisy; and these, moreover, are affected with fever; but sometimes it extends to the false ribs, on this side or on that, so that the pain appears to be seated in the liver and spleen; again it affects the loins, for the colon has many convolutions in all directions; but in other cases it fixes on the sacrum, the thighs, and the cremasters of the testicles. But in colic affections, they have rather retchings; and what is vomited is then bilious and oily. And the danger therefrom is so much the less, as the colon is more fleshy, and thicker than the small intestines, and consequently more tolerant of injury.

> Greek: 6. ἐντέροισι γίγνεται μὲν φλεγμονὴ, ὀδύνην ὀλεθρίην ἐμποιοῦσα. θνήσκουσι γὰρ μυρίοι στρόφοισι καρτεροῖσι· ἐγγίγνεται δὲ καὶ πνεῦμα ψυχρὸν, ἀργὸν, οὔτε κάτω περῆσαι Ῥηΐδιον οὔτε ἄνω ἀνελθέμεναι· μίμνει δὲ ἐπιπολὺ ἑλισσόμενον ἐν ὀλίγῃσι τῶν ἄνω ἑλίξεσι· τοὔνεκεν καὶ τὸ πάθος ἐπίκλησιν ἔσχεν εἵλεόν. κἢν πρὸς τοῖς στρόφοις δὲ καὶ πίεσις καὶ μάλθαξις τῶν ἐντέρων ἔῃ, καὶ πουλὺ τὸ ὑπογάστριον ὑπερίσχῃ, χορδαψὸς τὸ τοιοῦτόν ἐστι οὔνομα· ἕψησις μὲν γὰρ ἡ μάλθαξις· χορδὴ δὲ ἐντέρων ἐπώνυμον. καὶ γὰρ καὶ ἐπιχορδί δα τὸ μεσεντέριον ἐκίκλησκον οἱ πρόσθεν, τά τε μεσηγὺ νεῦρα καὶ τὰ ἀγγεῖα καὶ τοὺς ὑμένας τοὺς ἀνοχῆας τῶν ἐντέρων. αἰτίη τοῦ εἱλεοῦ συνεχὴς μὲν διαφθορὴ σιτίων πολλῶν τε καὶ ποικίλων καὶ οὐ ξυνηθέων, καὶ ἄλλη ἐπʼ ἄλλῃ ἀπεψίη, μάλιστα δʼ ἐπὶ τοῖσι εἱλεώδεσι, ὁκοῖόν τι μελὰν σηπίης. οὐκ ἀδόκητος δὲ πληγὴ, ἢ ψύξις, ἢ ψυχροποσίη ἐφʼ ἱδρῶτι, ἄδην ἢ χανδόν· καὶ οἷσι δὲ ἔντερον ἐς τὸν ὄσχεον ξὺν κόπρῳ κατέβη, καὶ οὐκ ἀνώσθη ἐς τὴν κοιλίην, ἀλλʼ ἀνελήφθηβίῃ, τουτέοισι ἔθος ἐπιφλεγμαίνειν τὰ κάτω ἔντερα. ξύνηθες δὲ τὸ πάθος παιδίοισι, οἷσίπερ ἂν καὶ ἀπεψίη ᾖ, καὶ τὸ βλάβος διαδιδράσκουσι μᾶλλον διά τε τὸ ἔθος καὶ τὴν ὑγρότητα τῶν ἐντέρων· ὀλισθηρὰ γάρ· γέροντες δὲ οὐ μάλα μὲν πάσχουσι, περιγίγνονται δὲ ἥκιστα. ὥρη θέρεος τίκτει μᾶλλον ἦρος, φθινόπωρον δὲ χειμῶνος, ἀμφοῖν δὲ ἐπὶ μᾶλλον θέρος. πολλοὶ μὲν οὖν ἐπὶ τούτοισι στρόφοισι θνήσκουσι αὐτίκα· μετεξετέροισι δὲ καὶ πῦον ἐγγίγνεται, καὶ αὖθις μελανθὲν τότε τὸ ἔντερον καὶ διασαπὲν ἐξέπεσε, καὶ οὕτως ἐξέλιπον. ξύνεστι δὲ αὐτέοισι, εἰ μὲν ἐπιεικὴς εἱλεὸς εἴη, πόνος ἑλισσόμενος, στομάχου πλάδος, ἔκλυσις, μαλακίη, ἐρεύξιες κεναὶ καὶ οὐδὲν ὠφελοῦσαι, κοιλίη ὑποβορβορίζουσα φύσῃσι, ὁδοιπορίη μεσφὶ ἕδρης, διέξοδοι δὲ ἀτελέες. ἢν δὲ ἐπίτασιν ἴσχῃ ὁ εἱλεὸς, πάντων ἄνω ἡ φορὴ, πνευμάτων, φλέγματος, χολῆς. ἐμοῦσι γοῦν τάδε· ἔξωχροι, ψυχροὶτὸ πᾶν σκῆνος· πόνος πουλὺς, ἀναπνοὴ κακὴ, διψαλέοι· ἢν δὲ καὶ θνήσκειν μέλλωσι, ἱδρὼς ψυχρὸς, δυσουρίη, ἕδρη ἀπολελημμένη, ὡς μηδὲ ἰσχνὸν ἔλασμα διελάσαι· κόπρων ἔμετοι, ὥνθρωποι ἄφωνοι, σφυγμοὶ πρόσθεν μὲν ἀραιοὶ, σμικροί· πρὸ θανάτου δὲ σμικρότατοι, καὶ πυκνότατοι καὶ ἐκλείποντες. τάδε μὲν οὖν τοῖσι λεπτοῖσι ἐντέροισι ξυμπίπτει. ἀτὰρ καὶ κώλῳ τὰ αὐτὰ πάθεα γίγνεται, καὶ τὰ ξυνόντα ὅμοια, καὶ ἡ αὐτὴ συμφορή. τουτέων δὲ μετεξέτεροι διαδιδράσκ ουσί κοτε, ἢν πῦον ἐγγένηται τῷ κώλῳ. αἰτίη δὲ τὸ βάθος τὸ σαρκοειδὲς τοῦ ἐντέρου. πόνος δὲ ἰσχνὸς μὲν, ἠδὲ ὀξὺς ἐπὶ τοῖσι λεπτοῖσι ἐντέροισι, πλάτος δὲ καὶ βάρος ἴσχων ἐπὶ τῷ κώλῳ. διαΐσσει δὲ ὁ πόνος, ἄλλοτε μὲν ἐπὶ τῇσι πλευρῇσι, εὖτε φαντασί η ἐγγίγνεται πλευρίτιδος· καὶ γὰρ καὶ πυρεταίνουσι οἵδε· ἄλλοτε δὲ ὑπὸ τῇσι νοθῇσι ἐνθάδε καὶ ἔνθα, ὡς δοκέειν τὴν ὀδύνην ἥπατος ἢ σπληνὸς ἔμμεναι· αὖθίς κοτε ἐν τοῖσι κενεῶσι, πολλὸν γὰρ τὸ κῶλον καὶ πάντη ἕλικας ποιεύμενον· μετεξετέροισι δὲ καὶ ἐς τὸ ἱερὸν ὀστέον ἐρείδει, καὶ ἐς μηροὺς, καὶ διδύμων κρεμαστῆρας. ἐπὶ δὲ τοῖσι κωλικοῖσι ἔμετοι πλεῦνες κενοὶ, τὰ δὲ ἐμεύμενα λεπτὰ, χολώδεα, ἐλαιοει δέα. ἔστι δὲ ὁ ἐντεῦθεν κίνδυνος τοσόνδε ἀσινέστερος, ὁκόσον καὶ τὸ κῶλον τῶν λεπτῶν ἐντέρων σαρκοει δέστερον καὶ παχύτερον καὶ ἀνεξικα κώτερον.

## 3. Book II · chapters 7–12

Source: https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/3/ · cite a paragraph as https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/3/#p-N

[¶0] 7. IN the affections of the liver, the patients do not die, indeed, more quickly than in those of the heart; but yet they suffer more pain; for the liver is, in a great measure, a concretion of blood. But if the cause of death happen to be situated in its Portæ, they die no less speedily than from the heart; for these parts are tissues formed of membranes, of important and slender nerves, and of large veins. Hence certain of the philosophers have held that the desires of the soul are seated there. In hemorrhage it greatly surpasses all the others; “for the liver is made up from the roots of veins.” Wherefore a great inflammation does form in it, but not very frequently, nor in its vital parts, for the patient would die previously. But a smaller inflammation often takes place, whence it happens that they escape death, indeed, but experience a more protracted state of disease. For of its office, as regards sanguification, there is no stop nor procrastination, as from it a supply of blood is sent to the heart, and to the parts below the diaphragm. If from a greater cause—a stroke, or continued indigestion of much and bad food, and intoxication, or great cold—an inflammation forms in the portal system, a very speedy death is the result. For there is a latent, smothered, and acrid heat; pulse languid; the kind of pain varied, and every way diversified, sometimes darting to the right side, so as to resemble a sharp weapon fixed in the place, and sometimes resembling tormina; again, at other times the pain is deep—nay, very deep; and, intermediate between the pain, atony and loss of utterance. The diaphragm and succingens (pleura) are dragged downwards; for from them the liver is suspended as a weight. For this reason, a strong pain extends to the clavicle on the same side; an ineffectual cough, or only a desire thereof, and when it comes to a conclusion, dry; respiration bad, for the diaphragm does not co-operate with the lungs, by assisting them in contraction and dilatation. They draw in a small breath, but expire a larger; colour, a dark-green, leaden; they loathe food, or if they force themselves to take any, they become flatulent in the epigastrium; eructations bilious, acid, fetid; nausea, retchings, belly mostly loose, discharges bilious, viscid, small in quantity. The affections always go on increasing; mind not very much deranged, but torpid, unsettled, stupid; much timidity; coldness of the extremities, tremblings, rigors, hiccup of a spasmodic nature, jaundice, bile intense, the whole body tinged with bile. But if it appear before the seventh day, it proves fatal in many cases. But those who have escaped a fatal termination, either by a hemorrhage, or a rapid discharge from the bowels of bilious matters, or from frequent discharges of intense urine, in these cases, after three weeks, the liver is converted into a purulent abscess. But if it pass considerably this period without an abscess, it ends inevitably in dropsy; the patients are thirsty, drink little, are dried in body, lose fat; there is a desire for acids, and an insensibility to taste. Autumn engenders this affection, along with the indigestion produced by much summer-fruit and multifarious food. Of all ages, the adult is most subject to it.

> Greek: 7. τῶν ἀπὸ καρδίης οἱ ἀπὸ ἥπατος οὐκ ὠκύτερον μὲν, ἐπιπονώτερον δὲ θνήσκουσι. ἔστι γὰρ αἵματος πάγος τὸ πλεῖστον ἧπαρ· ἢν δὲ ἐν τῇσι πύλῃσι αὐτέου ξυμπέσῃ τις θανάτου αἰτίη, οὐ μεῖον ὀξέως ἢ οἱ ἀπὸ καρδίης θνήσκουσι. ὑμέσι γὰρ, καὶ τόνοισι ἐπικαίροισι καὶ λεπτοῖσι, καὶ φλεψὶ μεγάλῃσι ἐξύφανται τάδε τὰ μέρεα. ὡς δὲ καὶ τῶν σοφῶν ἀφηγέον ταί τινες, καὶ ψυχῆς ἐπιθυμίη τῇδε ἐγκάθηται. αἱμορραγίῃ μὲν γὰρ ὑπερίσχει πάντα πολλόν· Ῥίζωσις γὰρ φλεβῶν ἧπαρ. γίγνεται ὦν ἐν αὐτέῳ μεγάλη μὲν φλεγμονὴ, οὐ κάρτα ξυνεχέως, οὐδὲ ἐν τοῖσιν ἐς τὰ ἐπίκαιρα χωρία. φθάνει γὰρ ἐξελθὼν τοῦ ζῆν ὥνθρωπος. σμικροτέρη δὲ θαμινά· τοὔνεκεν διαδιδράσκουσι μὲν τὸν ὄλεθρον, μακρότερα δὲ νοσέουσι. ἔργου γὰρ αὐτέου τοῦ κατὰ τὴν ἐξαιμάτωσιν οὐκ ἔστιν ἀνάπαυλα, οὐδὲ ἀμβολή· ἐπὶ δὲ τὴν καρδίην καὶ τὰ νέρθεν τοῦ διαφράγματος ἐντεῦθεν γὰρ τοῦ αἵματος ἀφέσιες. ἢν ἐπὶ μέζονι αἰτίῃ, πληγῇ, ἢ διαφθορῇσι ξυνεχέσι πολλῶν καὶ κακῶν σιτίων, καὶ οἰνοφλυγίῃ, ἢ ψύξι καρτερῇ, καὶ ἐν τῇσι πύλῃσι γίγνεται φλεγμονὴ, ὤκιστος ὄλεθρος. πῦρ μὲν γὰρ ὑποβρύχιον, ἀλαμπὲς, δριμὺ, σφυγμοὶνωθροὶ, πόνου ἰδέη ποικίλη καὶ παντοίη, ἄλλοτε μὲν ἡ ὀδύνη ἐπὶ τὰ δεξιὰ διεληλαμένη, ὡς δοκέειν ὀξὺ βέλος ἐγκέεσθαι, ἄλλοτε δὲ στρόφῳ ἰκέλη· αὖθις δέ κοτε πόνος βαρὺς, βαρύτατος· μεσηγὺ δὲ τῆς ὀδύνης ἀτονίη καὶ ἀφωνίη· διάφραγμα καὶ ὑπεζωκὼς ἕλκονται· ἀπὸ τῶνδε γὰρ ἄχθος τὸ ἧπαρ ἤρτητο· διὰ τόδε ἐς τὴν κατʼ ἴξιν κληΐδα ὀδύνη καρτερή· βὴξ δὲ ἀτελής· προθυμίη δὲ μοῦνον· κἢν ἐς τέλος κοτὲ ἀφίκηται, ξηρή. ἀναπνοὴ κακή· οὐ γὰρ ξυντιμωρέει τῷ πνεύμονι τὸ διάφραγμα, ξυνομαρτέον ἐς ξυναγωγὴν καὶ διάστασιν. πνεῦμα σμικρὸν ἕλκουσι, ἐκπνέουσι μέζον· χροιὴν μελάγχλωροι, μολιβδοειδέες· ἀπόσιτοι· ἢν δέ τι προσενέγκωνται φυσώδεες τῷ ὑποχονδρίῳ, ἐρεύξιες χολώδεες, ὀξίζουσαι, βρωμώδεες· ναυτίη, διάστασις κενεὴ, γαστὴρ ἀπολελυμένη τὰ πολλὰ, χολώδεα, γλίσχρα, βραχέα· ἀεὶ δὲ ἐπαυξέα γίγνεται τὰ πάθεα· γνώμη οὐ κάρτα παράφορος, νωθρὴ, μετέωρος, τετυφωμένη, ὄκνος πουλὺς, ψύξις ἀκρέων, τρόμοι, Ῥίγεα, λὺγξ κενὴ, σπασμώδης, ἴκτερος, χολὴ ἄκρητος, χολόβαφοι τὸ πᾶν. ἢν δὲ καὶ πρὸ ἑβδόμης φανῇ, καὶ ἄλλους ἔκτεινε συχνούς. ὁκόσοι δὲ ἢ αἱμορραγίῃ, ἢ κοιλίης ταράχῳ πολλοῖσι χολώδεσι, ἢ οὔροισι ἀκρήτοισι συχνοῖσι τὸν ὄλεθρον διηλλάξαντο, τουτέοισι δὲ μετὰ τρεῖς ἑβδομάδας ἐς ἀπόστασιν πύου τὸ ἧπαρ τρέπεται· ἢν δὲ ἔτι πολλὸν ὑπερβάλλῃ χρόνον ἄνευ ἀποστάσιος, ἐς ὕδρωπα ἄφυκτον τελευτᾷ· διψαλέοι, βραχυπόται, ξηροὶ τὸ σκῆνος, ἀλιπέες. ὀξέων ἐπιθυμίη, ἄποιος ἡ γεῦσις. τίκτει δὲ τόδε τὸ πάθος φθινόπωρον σὺν πλήθους ὡραίων, καὶ ποικίλων ἀπεψίη· ἡλικίη δὲ, πασέων μᾶλλον ἀκμή.

[¶1] 8. FROM the portæ of the liver, there passes a wide vein through the space intermediate between its extremities, which, being always divided into slender and more numerous branches, is distributed at last all over the liver in vessels imperceptible to the sight; and with their extremities anastomose the extremities of other veins, which, at first, are slender and numerous, grow larger and fewer in number, and, at last, they are collected into one large vein; hence, having become two by division, these pass through the liver. The upper one, then, having passed through the first lobe, appears on its convex side; then, having passed the diaphragm, it is inserted into the heart: this is called the vena cava. The other, having passed through the lower lobe, the fifth, to its concave side, makes its exit near the spine, and is extended along it as far as the ischiatic region; and it, also, is called vena cava. It obtains the same name, as being one and the same vein, which derives its origin from the liver. For if one choose, one may pass a plate of metal from the vena cava connected with the heart to that by the spine, and from the spine through the liver to the heart; for it is the same passage leading upwards. This vein, then, as I think, is all diseased in acute and strong affections; for it is altogether one vein. But other physicians fancy that only the part along the spine is affected, because there are no manifest symptoms in regard to the portion about the heart; for it is extended through the chest, having no adhesions, but floating in the chest, until, from the diaphragm, it adheres to the heart. If, then, any of the great ailments seize this vein, they are concealed by the thorax surrounding it. Wherefore kedmata also form about this vein when a hemorrhage, bursting forth quickly proves fatal, the blood being discharged by the lungs and the arteria aspera, if it burst in the chest; but if, at its origin, the blood is poured into the lower belly, so that the bowels float in it, when the patients die before the blood makes its appearance, the belly being filled with blood. Inflammation likewise forms about the vein, and it, also, proves fatal, if it be great; for there is an acrid and pungent heat enclosed in the cavities of both, but little surpassing what is natural, so that to the touch the heat appears to be slight; but the patient fancies himself burning hot; pulse small, very frequent, so as to appear compressed and forcibly accelerated; coldness of the extremities; intense thirst; dryness of the mouth; redness of countenance, along with paleness; he is reddish over the whole body; hypochondriac region hard, and retracted upwards; pain principally on the right side, and palpitation therein, extending to the flanks; and in certain cases, also, of the artery along the spine, provided the pulsation displays itself in the other hypochondriac region; for lying, as it does, on the left side, it sympathises with the other; the exhalation in the general system affording no relief, and not even making the skin soft, for it is dry, shrivelled, and rough; and more especially in the regions of the body where the bones are prominent, such as the back part of the elbow, the knees, or the knuckles. Sleep disturbed; the bowels, in certain cases, discharging nothing, and in others, the discharges small, acrid, bilious; urine, a bright yellow and pungent; not disordered, indeed, in mind, but they are torpid and wasted. Hence, those who have seen this constitution of disease have called it Causus, for the present symptoms are those of a species of Causus; and in autumn there is a tendency to malignity, both in adults and the young, in whom the habit of body is slender, from bad diet and hard labour. These, for the most part, die on the fourteenth day; but when the disease is protracted, they die in double that period. But those who either originally have a slight inflammation, or when a great inflammation is gradually resolved, escape the disease indeed, but never get rid of the mischief; for they labour under causus a long time. But the dangerous symptoms cease, namely, the pains, distension of the hypochondria, the bad pulse, and torpor of the intellect; but still they have nausea, are ill at ease, with distress of mind; and, moreover, these are attended with an accession of causus and thirst, dryness of the tongue and mouth; they inspire largely, drawing in a long and copious breath, as if wishing to draw in the whole atmosphere, for the purpose of refrigeration. And if they drink a large draught of cold water, they are relieved, indeed, for a short time; but then again the thirst is kindled up, and again they drink copiously. And this is the successive course of the malady. And a good physician would give with impunity a copious cold draught, as in other species of causus, and even with less risk, in the case of those labouring under causus from disease of the vena cava. And if either the bowels or the bladder carry off the drink, there is no necessity for inducing vomiting; but if not, after much cold drink much vomiting must be induced. For the patient would burst, if, after drinking so much, he should have no discharges by sweating, by urine, or by the bowels.

> Greek: 8. ἀπὸ τῶν πυλέων τοῦ ἥπατος εὐρεῖα φλὲψ διαΐσσειμέση τῶν τοῦδε περάτων. ἀεὶ γὰρ ἐς λεπτὰ καὶ πλεῦνα σχιζομένη ἐπὶ τέλος ἐς ἀφανέα τῇσι ὄψισι πάντη τοῦ ἥπατος σκίδνατ αι· τοῖσι δὲ τουτέων πέρασι ἄλλων φλεβῶν περατώσιες κατὰ τὸ στόμα ξυγκέονται, αἵπερ ἐκ λεπτῶν καὶ πλεύνων μέζονες καὶ ἐλάσσονες γίγνονται· ἐπὶ τέλεος ἐν μέσῳ τῷ ἥπατι ἐς μίαν φλέβα μεγάλην συναγείρονται. ἐντεῦθεν δὲ δοιαὶ ἐξ ἀποσχίσιος γιγνόμεναι πέρην τοῦ ἥπατος ἀφικνέονται. ἡ μὲν γὰρ ἄνω τὸν πρῶτον λοβὸν διαπερήσασα ἐς τὰ κυρτὰ αὐτέου ἐξεφαάνθη· ἔπειτα περήνασα τὸ διάφραγμα ἐμφύνει τῇ καρδίῃ· κοίλη φλὲψ ἥδε καλέεται. ἡ δὲ ἑτέρη, τὸν κάτω λοβὸν τὸν πέμπτον διαπερήνασα μέχρι τῶν κυρτῶν, ἐπὶ τὴν Ῥάχιν ἔξεισι, καὶ τῇδε παρατέταται μέχρι τῶν ἰσχίων. ἀτὰρ καὶ ἥδε κοίλη. οὔνομα τὸ αὐτὸ, οὕνεκεν μία καὶ ὡυτή ἐστιν ἡ φλὲψ τὴν ἀρχὴν ἀπὸ τοῦ ἥπατος ἴσχουσα. εἰ γάρ τις ἐθέλοι, διελάσαι ἂν ἔλασμα καὶ ἀπὸ τῆς ἄνωθεν τῆς ἐπὶ τὴν καρδίην κοίλης φλεβὸς ἐς τὴν παρὰ τὴν Ῥάχιν, καὶ ἀπὸ τῆς Ῥάχεος διὰ τοῦ ἥπατος ἐπὶ τὴν καρδίην. ἄνοδος γὰρ ἡ αὐτή. ἥδε οὖν ἡ φλὲψ, ὡς ἐγὼ δοκέω, ἡ ξύμπασα νοσέει ὀξέσι πάθεσι, καρτεροῖσι· μία γάρ ἐστι πᾶσα· μετεξετέροισι δὲ ἰητροῖσι μούνη δοκέει παρὰ τὴν Ῥάχιν νοσέειν, οὕνεκα τῆς ἐς τὴν καρδίην τὰ σημεῖα οὐ προφανέα. ἐντὸς γὰρ τοῦ θώρηκος διατέτα ται πρὸς οὐδὲν προσισχο μένη, ἀλλʼ ἐναιωρευμένη τῷ θώρηκι, ἔς τʼ ἂν ἀπὸ τοῦ διαφράγματος ἐμφύῃ τῇ καρδίῃ. ἢν οὖν τι μεγάλων κακῶν ἴσχῃ τήνδε τὴν φλέβα, ξυνέκρυψε ἀμπέχων ὁ θώρηξ. γίγνεται δʼ οὖν ἀμφὶ τήνδε τὴν φλέβα καὶ κέδματα· εὖτε Ῥηγνυμένη αἱμορραγίῃ ὤκιστα κτείνει· ὕπερθεν μὲν διὰ πλεύμονος καὶ ἀρτηρίης ἐκχεομένου, ἢν ἐν τῷ θώρηκι Ῥαγῇ· ἢν δὲ παρὰ τὴν ἀρχὴν, ἐς τὴν κάτω κοιλίην τοῖσι ἐντέροισι περιχέεται, ὡς ἐμπλείειν τὰ ἔντερα, εὖτε πρὶν ἢ καθὲν ἐκφανῆναι τὸ αἷμα, θνήσκουσι οἵδε· ἦν δὲ ἡ κοιλίη πληρευμένη αἵματος. γίγνεται δὲ καὶ φλεγμονὴ ἀμφὶ τὴν φλέβα, ἀτὰρ καὶ ἥδε ὀξέως κτείνει, ἢν μεγάλη ἔῃ· πῦρ μὲν γὰρ δριμὺ, δακνῶδες, ἐν τῇσι κοιλίῃσι ἀμφοῖν ἐγκαθειργμένον, βραχὺ δὲ μοῦνον ὑπερίσχον, ὡς δοκέειν ἁπτομένῳ λεπτὴν ἔμμεναι θέρμην· ὁ δὲ ἄνθρωπος καίεσθαι δοκέει· σφυγμοὶ σμικροὶ, πυκνότατοι, ὁκοῖόν τι πεπιεσμένοι καὶ δεδιωγμένοι. ψύξις ἀκρέων, δίψος καρτερὸν, στόματος ξηρότης, προσώπου ἐρύθημα ξὺν ἀχροίῃ· ὑπέρυθροι δὲ τὸ ξύμπαν σῶμα· ὑποχόνδρια σκληρὰ, ἀνεσπασμένα, ὀδύνη ἐπὶ δεξιὰ μᾶλλον, καὶ παλμὸς τῇδε παραμήκης, μέχρι τῆς λαγόνος· μετεξετέροισι δὲ καὶ τῆς ἀρτηρίης τῆς παρὰ τὴν Ῥάχιν, ἢν ὁ σφυγμὸς ἐς τὸ ἕτερον ὑποχόνδριον διασημαίνῃ. ξυμπαθὴς γὰρ καὶ ἥδε γίγνεται παρʼ αὐτέην ἐπʼ ἀριστερὰ κειμένη, ὡς τῆς ἐπὶ τῷ παντὶ διαπνοῆς οὐδὲν ἐπικουφιζούσης, ἀλλʼ οὐδὲ τὸ δέρμα μαλθα· ζούσης· ξηρὸν δὲ τόδε καὶ Ῥυσὸν καὶ τρηχύ· καὶ ἐπὶ δὲ μᾶλλον ἐν τοῖσι ἐξίσχουσι ὀστώδεσι· οἷον ὀλεκράνῳ, γούνασι, ἢ κονδύλοισι· ὕπνοι ταραχώδεες, κοιλίη τοῖς μὲν οὐδὲν ἐκδιδοῖ, τοῖς δὲ σμικρὸν, δριμὺ, χολῶδες· οὖρα ξανθὰ, δακνώδεα· τὴν γνώμην οὐ παράφοροιμὲν, νωθροὶ δὲ καὶ μαρασμώδεες. εὖτε ὁκόσοι τήνδε τὴν κατάστασιν εἶδον, καῦσον ἐκάλεον. καὶ γὰρ καὶ τοῦ γένους τοῦ καύσου τὰ παρεόντα, καὶ ἐν φθινοπώρῳ γίγνεται ἐπὶ τὸ θηριῶδες καὶ ἀκμάζουσι καὶ νέοισι, οἷσι ἰσχνὴ ὑπὸ διαίτης πονηρῆς καὶ ταλαιπωρίης ἡ ἕξις. τεσσαρεσκαιδεκαταῖοι οἵδε τὰ πολλὰ θνήσκουσι· οἷσι δʼ ἂν ἐς μῆκος ἡ νοῦσος ἀφίκηται, ἐν διπλασίοισι ὄλλυνται. ὁκόσοι δὲ ἢ σμικρὴν ἀρχῆθεν ἴσχουσι τὴν φλεγμονὴν, ἢ τῆς μεγάλης κατὰ βραχὺ διαλυομένης, διαδιδράσκουσι μὲν τὸν ὄλεθρον, οὐδέκω δὲ ἀφίενται τοῦ κακοῦ. οἱ δὲ μακρὸν μὲν τὸν χρόνον τὸν καῦσον νοσέουσι· ἀποπαύεται δὲ τὰ κινδυνώ δεα, αἱ ὀδύναι καὶ ξυντάσιες τῶν ὑποχονδρίων, καὶ ἡ κακοσφυξίη, καὶ τῆς γνώμης τὸ νωθές· ἔτι δὲ ἔμπης ἔασιν ἀσώδεες, ἀλύοντες ξὺν ἀπορίῃ· ξύνεστι δὲ ὅ τε καῦσος καὶ τὸ δίψος καὶ τῆς γλώσσης καὶ τοῦ στόματος ἡ ξηρότης· ἀναπνέουσι πολλὸν, μακρὸν ἕλκοντες καὶ ἀθρόον, ὅλον τὸν ἠέρα ἐς ἔμψυξιν ἐπισπώμενοι· ἀτὰρ εἴτε πίνουσι ψυχρὸν χανδὸν πολὺ πλεῖστον, καὶ ἐς μὲν βραχὺ ἀνεκουφίσθησαν, εἶτʼ αὐτοῖς ἐξάπτεται τὸ δίψος, αὖθις ἄδην πίνουσι· καὶ ἥδε ἡ διαδοχὴ τοῦ κακοῦ· καὶ ἰητρὸς δὲ ἀγαθὸς ψυχρὸν ἂν δῴη πολλὸν ἀσινέως, ὅκως ἐν τοῖσι ἄλλοισι καύσοισι· ἀσφαλέστερον δὲ τοῖσι ἀπὸ τῆς κοίλης φλεβὸς νοσέουσι τὸν καῦσον. κἢν μὲν ἡ γαστὴρ ἢ ἡ κύστις τὸ ποτὸν ὑποφέρῃ, οὐδὲ ἐμέτου δεῖ· εἰ δὲ μὴ, ἐπὶ πολλῷ τῷ ψυχρῷ τὸ πολλὸν ἐμέσαι χρή. ἐκραγείη γὰρ ἂν ὥνθρωπος, εἰ τοσόνδε πίνων μηδὲν διαχωροίη, ἢ ἱδρῶσι, ἢ οὔροισι, ἢ κοιλίῃ.

[¶2] 9. THE kidneys, as far as regards the peculiar structure of the organ, are not productive of any great danger, even if they should suffer acutely; for, being of a glandular nature, they are mild and do not experience deadly diseases. But their office is important, namely, the secretion of the urine from the blood, and its expulsion. It is stopped either by a stone, or an inflammation arising there, or a clot of blood, or something such; when no mischief arises from sympathy, owing to the peculiar nature of the organ affected, but the retention of the urine produces all sorts of dreadful symptoms. Heat, which is acrid, and induces nausea; a heavy pain along the spine at the loins; distention of the parts, especially of those about the hypochondrium; suppression of urine, not entirely, but they pass urine in drops, and have a desire to pass more, for there is the sensation of an overflow. But if the urine become acrid and pungent, coldness, tremblings, spasms, distention and fulness of the hypochondria supervene. This miserable state and the conjoined feeling become similar to that of tympanites produced by indigestion, from the taking of too much food. Pulse, at first, indeed, slow and languid; but, if the evil press harder, small, frequent, tumultuous, and irregular: sleep slight, painful, not continued; and suddenly starting up as if from the stroke of a sharp instrument, they fall over again into a deep sleep as if from fatigue: they are not much deranged in intellect, but talk incoherently; the countenance livid. But if the desire of making water return again, the patients pass a small quantity in drops, along with spasms and great pains, when, for a short time, they are relieved from their sufferings, and again they experience a relapse. Of those that die, they sink most quickly who pass no urine; but the greater part recover, either from the stone dropping down into the bladder along with the urine, or from the inflammation being converted into pus, or from being gradually dispelled. For, if the urine pass easily even in small quantity, they escape death; but for a length of time they waste in constitution; the patients undergo these sufferings while still able to keep up, but gradually fall into a state of consumption. The same seasons, places, and ages induce these affections as induce those in connection with the venæ cavæ. Sometimes blood bursts from the kidneys suddenly in large quantity, and flows continuously for many days. None, however, die from the hemorrhage itself, but from the inflammation accompanying the hemorrhage, if the bleeding is stopped; but most frequently they die of strong inflammation induced by the stoppage.

> Greek: 9. νεφροὶ, τὴν μὲν τοῦ σώματος ἰδέην, οὐ κάρτα ἐπίκαιροι ἐς κίνδυνον, ἢν καί τι πάθωσι ὀξέως. ἀδενώδεες γὰρ τὴν φύσιν, ἐς δὲ ὄλεθρον εὐήθεες· ἐπίκαιρον δὲ αὐτέων τὸ ἔργον, ἥ τε διάκρισις τῶν οὔρων ἀπὸ τοῦ αἵματος καὶ ἡ ἀπόκρισις. ἐπέχει δὲ τήνδε ἢ λίθος, ἢ ἐγγιγνομένη φλεγμονὴ, ἢ αἱμάλωψ, ἤ τι τοιόνδε· εὖτε ἐκ ξυμπαθίης μὲν τῆς διὰ τὴν ἰδέην τοῦ σώματος κακὸν γίγνεται οὐδὲν, ἡ δὲ ἐπίσχεσις τῶν οὔρων πάντα τὰ δεινὰ πρήσσει. πῦρ μὲν γὰρ δριμὺ, ἀσῶδες, ὀδύνη κατʼ ὀσφὺν ἐπὶ Ῥάχι βαρεῖα, διάτασις τῶν μερῶν, μᾶλλον δὲ τῶν ἀμφὶ τὸ ὑποχόνδριον· οὔρου ἐπίσχεσις, οὐκ ἐς τὸ πάμπαν, ἀλλὰ στάγδην μὲν οὐρέουσι, ἐπιθυμίη δὲ πολλὸν ἐκχέαι· πλημμύρης γὰρ αἴσθησις. ἢν δὲ καὶ τὸ οὖρον δριμὺ καὶ δακνῶδες ἐγγένηται, ψύξιες, τρόμοι, σπασμοὶ, διατάσιες καὶ πληρώσιες τῶν ὑποχονδρίων· ἰκέλη ἡ ξυμφορὴ ἥδε καὶ ξυναίσθησις γίγνεται τοῖσι ἀπὸ πλήθεος σιτίων καὶ διαφθορῆς ἐμφυσηθεῖσι τὴν κοιλίην· σφυγμοὶ τὰ πρῶτα μὲν ἀραιοὶ, νωθροί· ἢν δὲ ἐπὶ μᾶλλον τὸ κακὸν πιέζῃ, σμικροὶ, πυκνοὶ, ταραχώδεες, ἄτακτοι, ὕπνοι λεπτοὶ, ὀδυνώδεες, οὐ διηνεκέες, καὶ ἐξαπίνης ἐκθορνύμενοι ὡς ὑπὸ νύξιος, εἶτα ὑποφέρονται ἐς κῶμα, ὡς ὑπὸ καμάτου· τὴν γνώμην οὐ κάρτα παράφοροι, ληρώδεες, πελιδνοὶ τὰ πρόσωπα· ἢν δὲ ἥκῃ αὖθίς κοτε τῆς οὐρήσιος ἡ προθυμίη, ἐπὶ σπασμοῖσι καὶ μεγάλῃσι ὀδύνῃσι βραχὺ ἂν καὶ στάγδην ἐξέκρινε, εὖτε σμικρὸν ἐπανῆκε τῶν πόνων· εἶτα ἐς τὰ αὐτὰ παλινδρομέες· ὀξύτατα δὲ θνήσκουσι τῶνδε οἷσιν οὐδὲν ἐκκρίνει, ὁκόσοι δὴ θνήσκουσι· οἱ πλεῦνες γὰρ περιγίγνονται, ἢ τοῦ λίθου ἐς τὴν κύστιν διὰ τῶν οὔρων ἐκπεσόντος, ἢ τῆς φλεγμονῆς ἐς πῦον τρεπομένης, ἢ κατὰ βραχὺ διαπνεομένης. ἢν γὰρ καὶ ἐπὶ σμικρὸν ἐνδεῶς διεξίῃ τὸ οὖρον Ῥηϊδίως διαδιδρήσκουσι τὸν ὄλεθρον· χρόνῳ δὲ μακρῷ φθίνουσι τὴν ἕξιν. ὀρθῶς τάδε οἱ νοσέοντες πάσχουσι, καὶ καταγίγνονται ἐς σύντηξιν ὑποφερόμενοι. ὧραι δὲ καὶ χῶραι καὶ ἡλικίαι φέρουσι, αἵπερ καὶ τὰ κατὰ τὰς κοίλας φλέβας. ἐξερράγη κοτὲ αἷμα ἀπὸ τῶν νεφρῶν πολλὸν ἀθρόον, καὶ πολλῇσι ἡμέρῃσι ξυνεχὲς ἔρρεε· ἀλλʼ οὔ τινες αἱμορραγίῃ θνήσκου σι, ἀλλὰ τῇ φλεγμονῇ τῇ ξὺν αἱμορραγίῃ γιγνομένῃ, ἢν ἐπισχεθῇ τὸ αἷμα· τὰ πολλὰ δὲ ἐξ ἐπισχέσιος ἐπὶ μεγάλῃ φλεγμονῇ θνήσκουσι.

[¶3] 10. THE bladder is a dangerous part to suffer in acute diseases, even when it merely sympathizes with other parts; but more dangerous and fatal if the affection begin with itself; for it is very potent to make the other parts sympathise with it, as the nerves and the understanding: for the bladder is a cold and white nerve, at a very great distance from the innate heat, but very near the external cold: for it is situated in the lowest part of the belly, at the greatest distance from the chest. But, also, its office is of vital importance, namely, the passage of the urine. Even, then, when the passage is only stopped by stones, or clots, or from any native or foreign mischief, it is of a deadly nature. In women, the phlegmonous tumour of the uterus may compress it; and in men, the straight intestine at the end bowels, called the Rectum. In many cases, too, owing to involuntary restraint from modesty in assemblies and at banquets, being filled it becomes distended; and, from the loss of its contractile power, it no longer evacuates the urine. When, then, the urine is stopped, there is fulness of the parts above, namely, the kidneys; distension of the ureters, grievous pain of the loins, spasms, tremblings, rigors, alienation of mind. But if it suffer from an ulcer or inflammation, there are, indeed, many bad symptoms; but death from the ulcers is by far the most speedy. With regard, however, to the ulceration and purulent abscess, and those other affections which are not very acute, they will be treated of among the chronic diseases; but such as are acute, and prove fatal in fourteen days, or a little earlier or later, such as inflammation, thrombus, or a stone falling down to the neck of the bladder, of these I will now treat. If, therefore, any of these occur, there is retention of urine; swelling in the hypogastric region; acute pain all over the abdomen; distension of the bladder; a sallow sweat on the tenth day; vomitings of phlegm, then of bile; coldness of the whole body, but especially of the feet: but, if the mischief spread farther, there come on fevers attended with hiccup, pulse irregularly frequent and small, redness of the countenance, thirst, distress of mind, delirium, spasms. From deleterious substances, such as cantharides and buprestis, both the bladder is distended with flatus, and the whole belly suffers violence; and all things get worse, and death cannot be long delayed. The bladder also sometimes suffers from hemorrhage; the blood there is bright and thin, but the patients never die from it, although it may not be easy to stop. But from the clots and the inflammation there is danger; for the coldness, mortification, gangrene, and the other evils consequent upon it readily prove fatal. Winter and autumn bring on these diseases. As to age, manhood, but still more old age. The other seasons and periods of life do not generally produce the diseases, and they very rarely prove fatal. Of all others, infants are most free from danger.

> Greek: 10. κύστις χαλεπὴ μὲν ἐν νούσοισι ὀξέῃσι πονῆσαι· κἢν ἄλλοισι ξυμπεπόνθῃ· χαλεπωτέρη δὲ καὶ θανατωδεστέρη, ἢν ἀφʼ ἑωυτῆς ἄρξηται. καὶ γὰρ καὶ δυνατωτάτη πάντα ξυμπαθέα ποιῆσαι, καὶ νεῦρα, καὶ γνώμην. νεῦρον γὰρ ἡ κύστις ψυχρὸν καὶ λευκὸν, ἀτὰρ καὶ πορρωτάτω τοῦ οἰκείου θάλπεος· ἐγγυτάτω δὲ τῆς ἔξω ψύξιος. ἐν γὰρ τῇ νειαιρῇ γαστρὶ κατωτάτω ἵζει προσωτάτω τοῦ θώρηκος· ἀλλὰ καὶ ἔργον αὐτέης ἐπίκαιρον ἡ τῶν οὔρων ἔξοδος. κἢν οὖν μοῦνον ἥδε ἐπισχεθῇ λίθοισι, ἢ θρόμβοισι, ἤ τεῳ ἄλλῃ ἰδίῃ, ἢ ἀλλοτρίῃ ξυμφορῇ, θανατῶδες. ἐπὶ γυναικῶν μὲν γὰρ αὐτέων καὶ ὑστέρων φλεγμονὴ ἀναπιέζει, ἐπʼ ἀνδρῶν δὲ, τὸ ἔσχατον, τὸ εὐθὺ, τὸ παράμηκε ς ἔντερον. ἐν πολλοῖσι δὲ ἐκ καρτερίης ἀεκουσίου ὑπʼ αἰδοῦς ἐν ξυλλόγοισι ἢ ξυνδείπνοισι πληρουμένη διατέταται, ἀδρανίῃ τε περιστολῆς οὐκέτι μεθίησι. ἐπὴν οὖν ἐπίσχῃ τὰ οὖρα, πληρώσιες καὶ τῶν ὕπερθεν μερέων· νεφρῶν, οὐρητήρων διατάσιες· λαγόνων ὀδύνη βαρείη, σπασμὸς, τρόμος, Ῥίγεα, γνώμην παράφοροι. ἢν δὲ πρὸς τοῖσι καὶ ἕλκος πεπόνθῃ ἢ φλεγμονὴν, πολλὰ μὲν τὰ κακὰ, ὄλεθρος δὲ πολλόντι ἑλκέων ὤκιστος. ἀλλʼ ἀμφὶ μὲν ἕλκεος καὶ ἀποστάσιος πυώδεος, καὶ τῶν ὁκόσα μὴ ὀξύταταᾖ, ἐν τοῖσι χρονίοισι λελέξεται· ὁκόσα δὲ κατόξεα, καὶ ἐν ιδʼ ἡμέρῃσιν, ἢ ὀλίγῳ θᾶσσον, ἢ βράδιον κτείνει, ὁκοῖον φλεγμονὴ, ἢ θρόμβοι, ἢ λίθος ἐς τὸν τράχηλον ἐμπεσὼν, περὶ τῶνδε νῦν ἐρέω. ἢν οὖν τι τουτέων ξυμβῇ, οὔρων ἐπισχέσιες, ὄγκος ἐν τῷ ὑπογαστρίῳ, ὀδύνη ὀξείη, πάντη τῆς κοιλίης· περίτασις τῆς κύστιος, ὁ ὠχρὸς ἱδρὼς τῇ δεκάτῃ, ἔμετοι φλεγματώδεες, ἔπειτα χολώδεες, ψύξις ὅλου, ποδῶν δὲ μᾶλλον· ἢν δὲ ἐπὶ μέζον τὸ κακὸν ἕρπῃ, πυρετοὶ λυγγώδεες, σφυγμοὶ, ἀταξίῃ πυκνοὶ, καὶ μικροὶ, ἐρύθημα τοῦ προσώπου, διψώδεες, ἀπορίη, γνώμην παράφοροι, σπασμοί. ἐπὶ δὲ φαρμάκοισι δηλητηρίοισι, κανθαρίσι, ἢ βουπρήστι, καὶ πνεύμασι ἐμπίπραται ἡ κύστις, καὶ ἡ ξύμπασα κοιλίη βιαιοτέρη, καὶ πάντα κακίω, καὶ οὐκ εἰς μακρὸν ἡ τοῦ θανάτου ἀμβολή. Αἱμορραγέει κοτὲ κύστις· ξανθόντε καὶ λεπτὸν τῇδε τὸ αἷμα· ἀλλʼ οὐδέν τι διὰ τήνδε θνήσκουσι, κἂν μὴ Ῥηϊδίη ἡ ἐπίσχεσις· ἀλλʼ ἐπὶ τοῖσι θρόμβοισι καὶ τῇ φλεγμονῇ ὁ κίνδυνος. ψύξις γὰρ καὶ νέκρωσις, καὶ γαγγραινώσιες, καὶ τὰ ἐπὶ τῇδε κακὰ Ῥηϊδίως κτείνει. φέρει δὲ τὰς νόσους, χεῖμα, καὶ μετόπωρον. ἡλικίη δὲ ἀκμὴ, ἔτι δὲ μᾶλλον γῆρας· αἱ δὲ ἄλλαι ὧραι καὶ αἱ ἡλικίαι οὔτε ξυνεχέως καὶ ἥκιστα κτείνουσι. ἀσινέστατα δὲ πάντων τὰ παιδία.

[¶4] 11. IN the middle of the flanks of women lies the womb, a female viscus, closely resembling an animal; for it is moved of itself hither and thither in the flanks, also upwards in a direct line to below the cartilage of the thorax, and also obliquely to the right or to the left, either to the liver or spleen; and it likewise is subject to prolapsus downwards, and, in a word, it is altogether erratic. It delights, also, in fragrant smells, and advances towards them; and it has an aversion to fetid smells, and flees from them; and, on the whole, the womb is like an animal within an animal. When, therefore, it is suddenly carried upwards, and remains above for a considerable time, and violently compresses the intestines, the woman experiences a choking, after the form of epilepsy, but without convulsions. For the liver, diaphragm, lungs and heart, are quickly squeezed within a narrow space; and therefore loss of breathing and of speech seems to be present. And, moreover, the carotids are compressed from sympathy with the heart, and hence there is heaviness of head, loss of sensibility, and deep sleep. And in women there also arises another affection resembling this form, with sense of choking and loss of speech, but not proceeding from the womb; for it also happens to men, in the manner of catochus. But those from the uterus are remedied by fetid smells, and the application of fragrant things to the female parts; but in the others these things do no good; and the limbs are moved about in the affection from the womb, but in the other affection not at all. Moreover, voluntary and involuntary tremblings........... but from the application of a pessary to induce abortion, powerful congelation of the womb, the stoppage of a copious hemorrhage, and such like. If, therefore, upon the womb’s being moved upwards, she begin to suffer, there is sluggishness in the performance of her offices, prostration of strength, atony, loss of the faculties of her knees, vertigo, and the limbs sink under her; headache, heaviness of the head, and the woman is pained in the veins on each side of the nose. But if they fall down they have heartburn..... in the hypochondriac regions; flanks empty, where is the seat of the womb; pulse intermittent, irregular, and failing; strong sense of choking; loss of speech and of sensibility; respiration imperceptible and indistinct; a very sudden and incredible death, for they have nothing deadly in their appearance; in colour like that of life, and for a considerable time after death they are more ruddy than usual; eyes somewhat prominent, bright, not entirely fixed, but yet not very much turned aside. But if the uterus be removed back to its seat before the affection come to a conclusion, they escape the suffocation. When the belly rumbles there is moisture about the female parts, respiration thicker and more distinct, a very speedy rousing up from the affection, in like manner as death is very sudden; for as it readily ascends to the higher regions, so it readily recedes. For the uterus is buoyant, but the membranes, its supporters, are humid, and the place is humid in which the uterus lies; and, moreover, it flees from fetid things, and seeks after sweet: wherefore it readily inclines to this side and to that, like a log of wood, and floats upwards and downwards. For this reason the affection occurs in young women, but not in old. For in those in whom the age, mode of life, and understanding is more mobile, the uterus also is of a wandering nature; but in those more advanced in life, the age, mode of living, understanding, and the uterus are of a steady character. Wherefore this suffocation from the womb accompanies females alone. But the affections common to men happen also to the uterus, such as inflammation and hemorrhage, and they have the common symptoms; namely, fever, asphexy, coldness, loss of speech. But in hemorrhage the death is even more sudden, being like that of a slaughtered animal.

> Greek: 11. ἐν τῇσι λαγόσι τῶν γυναικῶν μέσῃσι ἐγκέεται ἡ μήτρη, σπλάγχνον γυναικήϊον ἄγχιστα ζωῶδες. κινέεται γὰρ ἐξ ἑωυτέης ἔνθα καὶ ἔνθα ἐπὶ τὰς λαγόνας· ἀτὰρ καὶ ἐς τὰ ἄνω, κατʼ ἴξιν μὲν ὑπὸ τὸν χόνδρον τοῦ θώρηκος, ἐς τὰ πλάγια δὲ ἐπὶ δεξιὰ, ἢ ἐς ἀριστερ ὰ, ἢ ἐς ἧπαρ, ἢ σπλῆνα, γίγνεται δὲ καὶ προπετεστέρη ἐς τὰ κάτω, καὶ ξυλλήβδην εἴπωμεν, πάντη ἐστὶ πλανώδης· καὶ εὐώδεσι ὀσμήσεσι τέρπεται, καὶ ἐπʼ αὐτὰ ἵεται· ἄχθεται δὲ τοῖσι κακόδμοισι, καὶ αὐτὰ φεύγει· καὶ τὸ ξύμπαν ἐν τῇ ἀνθρώπῳ ἐστὶ ἡ ὑστέρη, ὁκοῖόντι ζῷον ἐν ζῴῳ. ἥδε οὖν ἢν ἐξαπίνης ἀνώϊστος γένηται, καὶ ἐπιπολὺ ἄνω μείνῃ, καὶ ἐκβιάσηται τὰ σπλάγχνα, ἀπεπνίχθη κοτὲ ἡ ἄνθρωπος, τρόπον τὸν ἐπιληπτικὸν, ἄνευθεν σπασμῶν· ἐπιέζετο γὰρ ὠκέως στενοχωρίῃ ἧπαρ, διάφραγμα, πνεύμων, καρδίη. τοὔνεκεν ἀπνοίη ξυνεῖναι δοκέει καὶ ἀφωνίη. ἀτὰρ καὶ αἱ καρωτίδες ξυμπαθίῃ τῆς καρδίης πιέζονται. διὰ τόδε καρηβαρίαιτε, καὶ ἀναισθησία ξύνεστι καὶ κάρος. γίγνεται δὲ καὶ ἄλλο πάθος αὐτέῃσι ἴκελον τῇδε ξυμμορφῇ, ξὺν πνιγὶ καὶ ἀφωνίῃ, ἀλλʼ οὐκ ἀπὸ ὑστέρης. καὶ γὰρ τόδε καὶ ἀνδράσι γίγνεται κατοχώδεα τρόπον. ἀλλὰ τῇσι μὲν ἀπὸ ὑστέρης κακώδεες ἐπαρήγουσι ὀδμαὶ, καὶ εὐωδέων πρὸς τὰ γυναικήϊα ὑποθέσιες· τῇσι δὲ ἑτέρῃσι τάδε οὐδὲν ἐπαρήγει· καὶ τὰ μέλεα κινέονται ἀπὸ ὑστέρης, ἀπὸ δὲ τοῦ ἑτέρου πάθεος ἥκιστα. ἔτι δὲ τρόμοι αὐτόματοι καὶ οὐκ αὐτόματοι, … ἀλλʼ ἐξ ὑποθέσιος ἀμβλωθριδίου. ψύξιες καρτεραὶ τῆς ὑστέρης, αἱμορραγίης ἀθρόης ἐπίσχεσις καὶ ὁκόσα τοιάδε. ἢν οὖν ἄρξηται πάσχειν κινευμέ νης ἄνω τῆς ὑστέρης, ὄκνος ἔργων πρήξιος, ἔκλυσις, ἀτονίη, γουνάτων ἀκρασίη, σκοτόδινος, καὶ τὰ γυῖα λύονται, κεφαλῆς πόνος, καρηβαρίη. τὰς φλέβας τὰς ἑκατέρωθεν τῆς Ῥινὸς ἀλγέει ἡ γυνή. ἢν δὲ καταπέσωσι, καρδιώσσουσι, … ἐν τοῖσι ὑποχονδρίοισι, λαγόνες κεναὶ, ἔνθα ἡ ἕδρη τῆς ὑστέρης, σφυγμοὶ διαλείποντες, ἄτακτοι, ἐκλείποντες, πνὶξ καρτερὴ, ἀφωνίη, ἀναισθησίη, ἡ ἀναπνοὴ ἄσημος, ἀσαφὴς, ὤκιστος καὶ ἄπιστος ὁ θάνατος. οὐδὲν γὰρ ἴσχουσι νεκρῶδες· ἐς χροιὴν ζωώδεες. ἐρυθρότεραι μᾶλλον μέχρι πολλοῦ τοῦ θανάτου· ὀφθαλμοὶ μικρόντι ἐξίσχοντες, λαμπροὶ, οὐ κάρτα μὲν ἀτενέες, ἀτὰρ οὐδὲ κάρτα κεκαμμένοι. ἢν δὲ μετακινέηταί κοτε ἐς ἕδρην ἡ ὑστέρη, πρὶν ἐς τέλος ἰέναι τὸ πάθος, διαδιδράσκουσι τὴν πνίγα· εὖτε κοιλίη ὑποβορβορύζει, ὑγρότης τῶν γυναικηΐων τόπων, ἀναπνοὴ δασυτέρη καὶ σαφεστέρη· ὠκίστη ἐκ τοῦ πάθεος ἡ ἔγερσις, ὅκως καὶ ὁ θάνατος ὤκιστος. καὶ γὰρ Ῥηϊδίως τοῖσι ἄνω προσχωρέει· ἀτὰρ ἠδὲ Ῥηϊδίως ἀφίσταται· ἀκρόπλοός τε γὰρ ἡ ὑστέρη· ὑγροὶ δὲ καὶ οἱ ὑμένες οἱ ὀχῆες αὐτῆς· ὑγρὸν δὲ καὶ τὸ χωρίον, ἔνθα κέεται ἡ ὑστέρη· πρὸς δὲ φυγῇ τε καὶ ὁρμῇ χρέεται ἡδέων τε καὶ ἀηδέων. Ῥηϊδίως οὖν νεύει ὅκως πρέμνον ἔνθα καὶ ἔνθα, ἄνω τε καὶ κάτω πλώει. διὰ τόδε νεήνισι τὸ πάθος γίγνεται, γεραιτέρῃσι δὲ ἥκιστα. ᾗσι γὰρ ἡλικίητε καὶ βιοτὴ καὶ γνώμη πλανωδεστέρη, τῇσι καὶ ὑστέρη ἐστὶ Ῥεμβώδης· ἀπηλικεστέρῃσι δὲ εὐσταθέα καὶ ἡλικίη καὶ βίος, καὶ γνώμη, καὶ ὑστέρη. ἥδε μὲν οὖν ἡ ἀπὸ ὑστέρης πνὶξ μούνῃσι γυναιξὶ παρομαρτέει. γίγνεται δὲ καὶ ξυνὰ πρὸς ἄνδρας πάθεα τῇ ὑστέρῃ, φλεγμονὴ, αἱμορραγίη· ξυνὰ δὲ καὶ τὰ παρεόντα σημεῖα, πυρετοὶ, ἀσφυξίη, ψύξις, ἀφωνίη· ἐπὶ δὲ τῇ αἱμορραγίῃ καὶ ὀξύτεροι οἱ θάνατοι, ὁκοῖόν τι ἐν ζῴῳ σφαγή.

[¶5] 12. THE Satyrs, sacred to Bacchus, in the paintings and statues, have the member erect, as the symbol of the divine performance. It is also a form of disease, in which the patient has erection of the genital organ, the appellation of Satyriasis being derived from its resemblance to the figure of the god. It is an unrestrainable impulse to connection; but neither are they at all relieved by these embraces, nor is the tentigo soothed by many and repeated acts of sexual intercourse. Spasms of all the nerves, and tension of all the tendons, groins, and perineum, inflammation and pain of the genital parts, redness of countenance, and a dewy moisture. Wrapped up in silent sorrow, they are stupid, as if grievously afflicted with their calamity. But if the affection overcome the patient’s sense of shame, he will lose all restraint of tongue as regards obscenity, and likewise all restraint in regard to the open performance of the act, being deranged in understanding as to indecency; for they cannot restrain themselves, are thirsty, and vomit much phlegm. Afterwards, froth settles on their lips, as is the case with goats in the season of rutting, and the smell likewise is similar. The urine, after long retention, is white, thick, and like semen; bowels constipated; spontaneous titillations of the sides and arm-pits; they have convulsions, loathe food, or, if presented to them, they snatch it confusedly. But if the illness tend to death, they become flatulent, belly protuberant, tension of the tendons and of all the muscles, difficulty of movement, contraction of the limbs, pulse small, weak, and irregular. All these symptoms have been sometimes removed by copious discharges from the bowels of phlegm and bile, and by vomiting in like manner, not without danger. The proper cure is deep and very protracted sleep; for much sleep induces coldness, paralysis, and torpor of the nerves; and torpidity and refrigeration cure Satyriasis. The affection, for the most part, is formed in spring and summer. Of the periods of life, it occurs principally in boys and striplings, more especially in such as are naturally prone to sexual intercourse. It is a most acute, disgusting, and unseemly ailment. For the most part, the patients die on the seventh day. It is said, that women also suffer from this affection; that they have the same impulse to venery, and the other symptoms the same. I believe, indeed, that lust is engendered in women of a humid temperament, so as to induce a copious discharge of the superfluous humours; but I do not at all believe that they are affected with Satyriasis, for their nature, being cold, is not adapted to it. But neither, also, has woman the parts necessary for erection, like those of a Satyr, whence the affection derives its name; and neither also are men subject to suffocation from the womb, because men have not an uterus.

> Greek: 12. οἱ σάτυροι τοῦ Διονύσου ἱεροὶ ἐν τῇσι γραφῇσι καὶ τοῖσι ἀγάλμασι ὄρθια ἴσχουσι τὰ αἰδοῖα, ξύμβολον τοῦ θείου πρήγματος. ἔστι δὲ καὶ πάθεος ἰδέη, ἀνίσχοντος ὄρθια τοῦ πάσχοντος τὰ αἰδοῖα· ἐπίκλησις σατυρίησις ἐς ὁμοιότητα τοῦ θεοῦ σχήματος. ὁρμὴ δέ ἐστι ἄσχετος ἐς ὁμιλίην· ἀτὰρ οὐδʼ ἐν τῇσι προσόδοισι οὐδὲν ὠφελέονται· οὐδὲ ἐπὶ πολλῇσι καὶ συνεχέεσι ὁμιλίῃσι πρηο̈́νονται τὸ ὄρθιον. σπασμοὶ δὲ ἁπάντων τῶν νεύρων, καὶ ἔντασις τενόντων, καὶ βουβώνων, καὶ πληχάδος, φλεγμονὴ τῶν αἰδοίων καὶ πόνος, ἐρύθημα προσώπου, καὶ ἰκμὰς νοτίδι ἰκέλη. περιστελλό μενοι, ἡσυχῇ ἐπίλυποι, κατηφέες, ὥσπερ ἀχθόμενοι τῇ ξυμφορῇ· ἢν δὲ ὑπερίσχῃ καὶ τὴν αἰδῶ τοῦ ἀνθρώπου τὸ πάθος, ἀκρατέες μὲν γλώσσης ἐς τὸ ἄκοσμον· ἀκρατέες δὲ ἐς τὸ ἄμφαδον καὶ τῆς τοῦ ἔργου πρήξιος, παράφοροι τὴν γνώμην ἐς τὸ ἄσχημον. κατέχειν γὰρ οὐ δύνανται· διψώδεες, φλέγμα πολλὸν ἐμέουσι· ἔπειτεν τοῖσι χείλεσι ἀφρὸς ἐφιζάνει, ὅκωσπερ τοῖσι ὀργῶσι τῶν τράγων· ἀτὰρ ἠδὲ ὀσμὴ ὁμοίη. οὖρον ἐξ ἐπισχέσιος πολλῆς, λευκὸν, παχὺ, γονοειδές. κοιλίη ἀπολελημμένη, γαργαλισμοὶ αὐτόματοι πλευρέων καὶ μασχαλῶν, σπασμώδεες, ἀπόσιτοι, εἰ δὲ προσφέροιν το, ἁρπάγδην, ταραχώδεες. ἢν δὲ ἐς ὄλεθρον ἥκῃ τὸ κακὸν, φυσώδεες· κοιλίην ἐπηρμένοι, τενόντων καὶ μυῶν τῶν πάντων ξύντασις, δυσκινησίη, ξυνολκαὶ μελέων, σφυγμοὶ μικροὶ, ἀσθενέες, ἄτακτοι. ἔλυσέ κοτε τάδε πάντα κοιλίη ἐκταραχθεῖσα πολλοῖσι φλεγματώδεσι, χολώδεσι, ἔμετος ὁμοίως. οὐκ ἄνευθεν κινδύνου ἴησις, ὕπνος βαθὺς καὶ μήκιστος· ψύξις γὰρ καὶ πάρεσις και νάρκη νεύρων, ὕπνος πουλύς. νάρκη δὲ καὶ ψύξις σατυρίησιν ἰῆται. γίγνεται δὲ τὸ πάθος ἦρος μάλιστα καὶ θέρεος· ἡλικίῃσι δὲ, μειρακίοισι καὶ νέοισι. μάλιστα δὲ ὁκόσοισι ἡ φύσις ἐς ξυνουσίην ἐτοίμη· ὀξύτατον ἠδὲ ἀτερπὲς, ἠδὲ ἄκοσμον κακόν. τὰ πολλὰ γὰρ ἐν ἑβδόμῃ θνήσκουσι. λόγος δὲ ὅτι καὶ γυναῖκες πάσχουσι τοῦτο τὸ πάθος, καὶ ἥ τε ἐς τὰ ἀφροδίσια ὁρμὴ ὁμοίη καὶ τὰ λοιπὰ ξύμπαντα τὰ αὐτά· ἐγὼ δὲ μαχλοσύνην μὲν γυναιξὶ ὑγρῇσι πείθομαι γίγνεσθαι, ἐς ἔκχυσιν τοῦ πλήθεος τούτων· σατυρίησιν δὲ ἥκιστα. οὔτε γὰρ ἡ φύσις αὐτέων ἑτοίμη· ψυχρὴ γάρ· ἀλλʼ οὐδὲ μόρια ἐς ὀρθίησιν, ὅκωσπερ σάτυρος, ἴσχει γυνὴ, ὥσπερ τὸ πάθος ἐπώνυμον. οὐδὲ γὰρ οὐδὲ πνίγα τὴν ἀπὸ ὑστέρης νοσέουσι ἄνδρες, οὕνεκεν οὐκ ἴσχει ὑστέρην ἀνήρ.