---
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"
section: 2 of 3
url: https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/2/
cite: "Aretaeus, tr. Francis Adams, On the Causes and Symptoms of Acute Diseases · Περὶ αἰτίων καὶ σημείων ὀξέων παθών, section 2. Scriptura (scriptura.si), https://scriptura.si/works/aretaeus-causes-and-symptoms-of-acute-diseases/2/"
---

# 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.

## 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.