The varieties of paralysis are these: sometimes the limbs lose their faculties while in a state of extension, nor can they be brought back into the state of flexion, when they appear very much lengthened; and sometimes they are flexed and cannot be extended; or if forcibly extended, like a piece of wood on a rule, they become shorter than natural. The pupil of the eye is subject to both these varieties, for sometimes it is much expanded in magnitude, when we call it Platycoria; but the pupil is also contracted to a small size, when I call it Phthisis and Mydriasis. The bladder, also, is paralysed in respect to its peculiar functions; for either it loses its powers as regards distension, or it loses its retentive powers, or it becomes contracted in itself, when being filled with urine, it cannot expel the same. There are six causes of paralytic disorders; for they arise from a wound, a blow, exposure to cold, indigestion, venery, intoxication.
εἴδεα δὲ παραπληκτικὰ τάδε. ἄλλοτε μὲν ἐς ἔκτασιν λέλυται τὰ μέλεα, οὐδὲ παλινδρομέει ἐς κάμψιν, εὖτε μήκιστα κῶλα φαίνεται· ἄλλοτε δὲ κυλλὰ γίγνεται, οὐδὲ ἐς μῆκος ἀποτείνεται· εἰ δὲ ἐκτανύσαι βιᾶται, ὅκως ξύλα ἐς κανόνα καταξέω ν, τὰ μέλεα βραχύτερα ἑωυτέων γίγνεται· τάδε πάσχει ἄμφω τὰ εἴδεα, καὶ ἡ ἐν τοῖς ὀφθαλμοῖσι παρθένος. καὶ γὰρ ἐκχέεται πολλὸν ἐς μέγεθος, εὖτε πλατυκορίην ὀνομάζομεν. ἀτὰρ ἠδὲ ξυνάγεται ἐς σμικρὸν ἡ κούρη, εὖτε φθίσιν ἣν ἠδὲ μυδρίησιν ἐγὼ κικλήσκω. ἀλλὰ καὶ κύστις παρίεται ἐπὶ τοῖσι ἰδίοισι ἔργοισι. ἢ γὰρ εἰς ἔκτασιν λύεται, ἢ ἀκρατὶ τὰ οὖρα ἐκχέει, ἢ ξυνειλέεται ἐς ἑωυτέην, εὖτε, ὅταν πλησθῇ οὔρου, οὐ διΐησιν.
But so likewise the vehement affections of the soul, such as astonishment, fear, dejection of spirits, and, in children, frights. Great and unexpected joy has also occasioned paralysis, as, likewise, unrestrained laughter, even unto death. These, indeed, are the primary causes; but the ultimate and vital cause is refrigeration of the innate heat. It suffers from humidity, or dryness, and is more incurable than the other; but if also in connection with a wound, and complete cutting asunder of a nerve, it is incurable. In respect to age, the old are peculiarly subject, and difficult to cure; in children, the cases are easily restored. As to seasons, the winter; next, the spring; afterwards, the autumn; least of all, the summer. Of habits, those naturally gross, the humid, indolent, brutish.
αἰτίαι δὲ παρέσιος μὲν ἕξ· ἄρχονται δὲ τρώματι, πληγῇ, ψύξι, ἀπεψίῃ, λαγνείῃ, οἰνοφλυγίῃ· ἀτὰρ καὶ ψυχῆς ἀκρατέα πάθεα, ἐκπλήξιες, φόβοι, δυσθυμίαι· ἀτὰρ καὶ παιδίοισι δείματα. παρέλυσέ κοτε καὶ χάρμα ἀδόκητον καὶ μέγα, καὶ γέλως ἄσβεστος μέχρι θανάτου. ἀλλὰ τάδε μὲν ἀρχὴ πρώτη· ὑστάτη δὲ καὶ καιρίη, ψύξις ἐμφύτου θερμοῦ· ἐπὶ ὑγρότητι ἢ ξηρότητι πάσχει ἥδε, καὶ δυσαλθὴς τῆς ἑτέρης μᾶλλον· ἀτὰρ καὶ ἐπὶ τρώματι καὶ διακοπῇ νεύρου ἀναλθής· ἡλικίη, γέροντες, καὶ οἵδε δυσαλθέες· παιδίοισι δὲ εὐανάκλητοι· ὥρη, χειμὼν, ἔαρ δεύτερον, ἔπειτα μετόπωρον, θέρος ἥκιστα· ἕξεις, οἱ παχέες κατὰ φύσιν, ὑγροὶ, ἀργοὶ, ζωώδεες.
When the affections are confirmed, they are made manifest by loss of motion, insensibility of heat and cold; and also of plucking the hair, of tickling, and of touching. It is rare indeed when in them the extremities are painful; but insensibility to pain is not worse as regards recovery. Wherefore the disease occurs suddenly; but if at any time it have prolonged onsets, there supervene heaviness, difficulty of motion, torpor, a sensation of cold, sometimes an excess of heat, short sleeps, greater phantasies, when they become suddenly paralytic.
Τελεσθέντα μὲν οὖν τὰ πάθεα ἔκδηλα ἀκινησίῃ καὶ ἀναισθησίῃ θερμοῦ τε καὶ ψυχροῦ, ἀτὰρ καὶ τιλμῶν καὶ κνησμῶν καὶ ψαυσίων. σπάνιον εὖτε τοῖσι τὰ πέρατα ἀλγέει, ἀλλὰ ἐς ἀνάκλησιν οὐ κακίων ἡ ἀπονίη. γίγνεται μὲν οὖν ἐξαπίνης· ἢν δέ κοτε καὶ ἀρχὰς ἴσχῃ ἐπιμήκεας, βάρος, δυσκινησίη, νάρκη· ψύξιος αἴσθησις, ἄλλοτε θάλπεος ὑπερβολὴ, ὕπνοι σμικροὶ, φαντασίαι μέζονες, εὖτε ἀθρόον παρελύθησαν.
But in the Cynic spasm, it is not usual for all parts of the face to be cramped; but those of the left side are turned to the right, and those of the right to the left, when there is a considerable distortion of the jaw to this side or to that, as if the jawbone were dislocated. And in certain of these cases, also, there is luxation at the joint, when in yawning the jaw is displaced to the opposite side: strabismus of the affected eye, and palpitation in the under eyelid; the upper eyelid also palpitates, sometimes along with the eye, and at other times alone. The lips are distended, each on its own side; but sometimes both being collapsed, they splutter; in others, they are closely compressed, and are suddenly separated so as to expel the common spittle with a noise. The tongue, also, is drawn aside;
ἐπὶ δὲ κυνικῷ σπασμῷ ἅπαντα μὲν τὰ τοῦ προσώπου μέρεα σπᾶσθαι οὐ κάρτα ξύνηθες· ἐπὶ δεξιὰ δὲ τὰ ἀριστερὰ, καὶ ἐς ἀριστερὰ τὰ δεξιὰ φοιτῇ, εὖτε καὶ τῆς γένυος ἔνθα ἢ ἔνθα ἐπὶ πολλὸν ἡ παραγωγὴ, ὅκως ἐξ ἕδρης κινουμένης τῆς γνάθου. καὶ γὰρ καὶ τοῖσί κοτε ἐξέβη τὸ ἄρθρον, εὖτε μέγα χανόντων ἐπὶ τὸ ἕτερον ἡ γένυς παρήχθη· ἵλλωσις τοῦ ὀφθαλμοῦ τοῦ σιναροῦ μήλου, ξὺν τῇ ὑποκοιλίδι παλμός· πάλλεται δὲ καὶ τὸ ἄνω βλέφαρον, ἄλλοτε μὲν ξὺν τῷ ὀφθαλμῷ, ἄλλοτε δὲ μοῦνον· ξυντείνεται δὲ καὶ τὰ χείλεα ἰδίῃ ἑκάτερον· ἄλλοτε δὲ ἄμφω ξυμπεσόν τα παφλάζει. ἔστι δὲ οἷς μέμυκε κάρτα, ἀθρόον δὲ διΐσταται, καὶ τὸν ξυνήθεα πτυσμὸν ψοφέει.
for it consists of a muscle and nerves, and at certain times, along its whole extent, it starts up to the palate, and makes an unusual sound. The uvula, also, is drawn aside; and if the mouth is shut, there is an unexpected noise within. And if you separate the mouth, you will perceive the uvula sometimes attached to the palate through its whole surface, and sometimes swiftly palpitating with force, like a bag-fish, when likewise a sound is produced. But there is apt to be deception in cynic spasms; for to the spectator it appears as if the parts unaffected were those possessed by the disease; for owing to the tension and colour of the affected parts, and the enlargement of the eye, they appear as if they were diseased. But in laughter, speaking, or winking, the true state of matters becomes manifest; for the parts affected are all drawn aside with a smack; the lip expresses no smile, and is motionless in talking; the eyelid is immoveable, the eye fixed, and the sense of touch is lost; while the sound parts speak, wink, feel, laugh.
σπᾶται καὶ γλῶσσα· καὶ γὰρ ἥδε μῦς ἐστι καὶ νεῦρα· εὖτε πρὸς τὸν οὐρανὸν ἐς πλάτος ὅλη ἡ ξύμφυσις ἀθρόον ἀφήλατο, καὶ κλόνου πάταγον ἐποίησε. σπᾶται δὲ καὶ κίων, καὶ εἰ μὲν τὸ στόμα συνάγει, τἄνδοθεν ἀδόκητος ὁ πάταγος· ἢν δὲ διαστής ῃ τὸ στόμα, ὄψεαι τὴν κιονίδα, ἄλλοτε μὲν προσφυομένην ἐς πλάτος τῷ οὐρανῷ, ἄλλοτε δὲ ἀποπαλλομένην βίῃ ὠκέως σωλῆνι ὁμοίως, εὖτε καὶ ἤδη παταγεῖ. ἀπάτη δέ τοι ξύνεστι τοῖσι κυνικοῖσι σπασμοῖσι. δοκέει γὰρ τοῖσι θεωμένοισι τὰ ἀπάθεα τὴν νοῦσον ἴσχειν. τῇ γὰρ περιτάσει καὶ τῇ χροιῇ καὶ τῷ τοῦ ὀφθαλμοῦ μέζονι, ὑγιέα τὰ σιναρὰ φαίνεται. ἐλέγχεται δὲ καὶ ἐνγέλωτι καὶ λαλιῇ καὶ καταμύσει. τὰ μέν γε σιναρὰ σπᾶται πάντα πατάγῳ, χεῖλος ἀμειδὲς, ἀκίνητον ἢν λαλῇ, βλέφαρον οὐκ ἐπίτροχον, ὀφθαλμὸς ἀτενὴς, ἀναίσθητος ἡ ἁφή· τὰ δὲ ὑγιέα λαλεῖ, καταμύει, αἰσθάνεται, γελᾷ.
8. IF an ulcer form in the lungs from an abscess, or from a chronic cough, or from the rejection of blood, and if the patient spit up pus, the disease is called Pye and Phthisis. But if matter form in the chest or side, or be brought up by the lungs, the name is Empyema. But if, in addition to these symptoms, the lungs contract an ulcer, being corroded by the pus passing through it, the disease no longer gets the name of empyema, but takes that of Phthoe instead of it. It is accompanied with febrile heat of a continual character, but latent ceasing, indeed, at no time, but concealed during the day by the sweating and coldness of the body; for the characteristics of phthoe are, that a febrile heat is lighted up, which breaks out at night, but during the day again lies concealed in the viscera, as is manifested by the uneasiness, loss of strength, and colliquative wasting. For had the febrile heat left the body during the day, how should not the patient have acquired flesh, strength, and comfortable feeling? For when it retires inwardly, the bad symptoms are all still further exacerbated, the pulse small and feeble; insomnolency, paleness, and all the other symptoms of persons in fever. The varieties of the sputa are numerous: livid, black, streaked, yellowish-white, or whitish-green; broad, round; hard, or glutinous; rare, or diffluent; devoid of smell, fetid. There are all these varieties of pus. But those who test the fluids, either with fire or water, would appear to me not to be acquainted with phthoe; for the sight is more to be trusted than any other sense, not only with regard to the sputa, but also respecting the form of the disease. For if one of the common people see a man pale, weak, affected with cough, and emaciated, he truly augurs that it is phthoe (consumption). But in those who have no ulcer in the lungs, but are wasted with chronic fevers—with frequent, hard, and ineffectual coughing, and bringing up nothing, these, also, are called consumptive, and not without reason. There is present weight in the chest (for the lungs are insensible of pain),—anxiety, discomfort, loss of appetite; in the evening coldness, and heat towards morning; sweat more intolerable than the heat as far as the chest; expectoration varied, as I have described. Voice hoarse; neck slightly bent, tender, not flexible, somewhat extended; fingers slender, but joints thick; of the bones alone the figure remains, for the fleshy parts are wasted; the nails of the fingers crooked, their pulps are shrivelled and flat, for, owing to the loss of flesh, they neither retain their tension nor rotundity; and, owing to the same cause, the nails are bent, namely, because it is the compact flesh at their points which is intended as a support to them; and the tension thereof is like that of the solids. Nose sharp, slender; cheeks prominent and red; eyes hollow, brilliant and glittering; swollen, pale, or livid in the countenance; the slender parts of the jaws rest on the teeth, as if smiling; otherwise of a cadaverous aspect. So also in all other respects; slender, without flesh; the muscles of the arms imperceptible; not a vestige of the mammæ, the nipples only to be seen; one may not only count the ribs themselves, but also easily trace them to their terminations; for even the articulations at the vertebræ are quite visible; and their connections with the sternum are also manifest; the intercostal spaces are hollow and rhomboidal, agreeably to the configuration of the bone; hypochondriac region lank and retracted; the abdomen and flanks contiguous to the spine. Joints clearly developed, prominent, devoid of flesh, so also with the tibia, ischium, and humerus; the spine of the vertebræ, formerly hollow, now protrudes, the muscles on either side being wasted; the whole shoulder-blades apparent like the wings of birds. If in these cases disorder of the bowels supervene, they are in a hopeless state. But, if a favourable change take place, symptoms the opposite of those fatal ones occur. The old seldom suffer from this disease, but very rarely recover from it; the young, until manhood, become phthisical from spitting of blood, and do recover, indeed, but not readily; children continue to cough even until the cough pass into phthoe, and yet readily recover. The habits most prone to the disease are the slender; those in which the scapulæ protrude like folding doors, or like wings; in those which have prominent throats; and those which are pale and have narrow chests. As to situations, those which are cold and humid, as being akin to the nature of the disease.
8. ἢν ἕλκος ἐξ ἀποστάσιος ἐν τῷ πνεύμονι γένηται, ἢ ἐκ βηχὸς χρονίης, ἢ ἀναγωγῆς αἵματος, καὶ ἀναβήσσῃ πῦον, πύη, καὶ φθίσις κικλήσκεται· ἢν δὲ θώρηξ ἢ πλευρὸν ἐμπυήσῃ, ἐπανάγηται δὲ διὰ τοῦ πνεύμονος, ἐμπύη ἥδε τοὔνομα. ἢν δὲ ἐπὶ τοῖσι καὶ ὁ πνεύμων ἕλκος ἵσχῃ, ἀναβρωθεὶς ὑπὸ τοῦ διενεχθέντος πύου, τοὔνομα οὐκέτι ἐμπύη, ἀλλὰ φθόην μεταλαμβάνει· ξύνεστι δὲ καὶ πῦρ ξυνεχὲς, ὡς μὴ δοκέειν, λῆγον μὲν οὔκοτε, λῆθον δὲ διʼ ἡμέρης ἱδρῶτι καὶ ψύξι τοῦ σκήνεος. καὶ γὰρ καὶ τὰ ἴδια φθόης ἐστὶ, ἢν ἡ θέρμη ζωπυρῇ, καὶ ἐς νύκτα ἐκλάμπῃ, ἡμέρην δὲ αὖθις ἐν τοῖσι σπλάγχνοισι φωλεύει· δηλοῖ δὲ ἡ δυσφορίη, καὶ ἡ ἀδυναμίη, καὶ αἱ ξυντήξιες. ἢν γὰρ ἀπεδίδρησκε τοῦ σκήνεος διʼ ἡμέρης τὸ πῦρ, πῶς οὐκ ἂν ἐσαρκοῦ τό τε καὶ ἠδύνατο, καὶ εὐφόρως εἶχεν ὥνθρωπος; εὖτε γὰρ ἀνάγει, ἐπὶ μᾶλλον τὰ δεινὰ αὐξέεται. σφυγμοὶ σμικροὶ καὶ ἀμυδροὶ, ἀγρυπνὴ, ἄχροια, καὶ τἄλλα πάντα ὁκόσα οἱ πυρεταίνοντες· ἰδέαι δὲ ὑγρῶν μυρίαι, πελιδνῶν, μελάνων κατακορέων, ἢ ὠχρολεύκων, ἢ λευκοχλωρέων· πλατέων, στρογγύλων· σκληρῶν, δυσλύτων, ἢ μανῶν, λυομένων· ἢ ἀνόσμων, ἢ κακωδέων· ἅπαντα δὲ τάδε πύου ἔασι ἰδέαι. ὁκόσοι γὰρ ἢ πυρὶ ἢ ὕδατι τὰ ὑγρὰ τεκμαίρονται, οὐ κάρτα μοι δοκέουσι φθόην οἵδε γιγνώσκειν· πιστοτέρη γὰρ ἡ ὄψις ἁπάσης ἄλλης αἰσθήσιος, οὐ τῶν ἀναγομένων μοῦνον, ἀλλὰ καὶ τοῦ εἴδεος τοῦ νοσέοντος. ἢν γὰρ καὶ δημότης ἴδῃ τὸν ἄνθρωπον ὠχρὸν, ἀδρανῆ, ἀναβήσσοντα, ξυντετηκότα, ἀτρεκέα μαντεύεται φθόην· ἀτὰρ ἠδὲ ὁκόσοισι μὲν ἕλκος μὲν οὐκ ἔστι ἐν πνεύμονι, ξυντετήκασι δὲ πυρετοῖσι χρονίοισι, πυκνὰ δὲ καὶ σκληρὰ καὶ ἀτελέα βήσσουσι, καὶ ἀνάγουσι οὐδὲν, καὶ τούσδε φθισικοὺς κικλήσκουσι, οὐ πάνυ ἀσήμως. ξύνεστι δὲ τοῦ θώρηκος βάρος· πλεύμων γὰρ ἄπονος, ἄση, δυσφορίη, ἀποσιτίη, ἑσπέρῃ περίψυξις, καὶ θέρμη ἐς τὴν ἕω· ἱδρὼς ἄχρι θώρηκος τῆς θέρμης δυσφορώτερος· βηχὸς ἀναγωγαὶ ποικίλαι, ὁκοίας ἔλεξα. φωνὴ βραγχώδης· αὐχὴν ὑποσκόλιος, Ῥαδινὸς, οὐκ εὐπαράγωγος· ὁκοῖόν τι ξυντετα μένος· δάκτυλοι ἰσχνοὶ, τὰ δὲ ἄρθρα παχέα· ὀστέων μούνων ἡ ἰδέη· σμύχονται γὰρ καὶ σάρκες· ὄνυχες γρυποὶ δακτύλων, αἱ κοιλίαι Ῥυσαὶ καὶ πλατέες· ὑπʼ ἀσαρκίας γὰρ οὔτε τὴν περιταινίην οὔτε τὸ στρογγύλον ἴσχουσι. διὰ τόδε καὶ ὄνυχες γρυποί· ἥδε γὰρ ἡ ἀνακωχὴ, καὶ ἡ ὑπόστασις αὐτέων, ἥτις ἐν τῇσι κορυφῇσι πεπλησμένη εἵνεκεν αὐτῶν· ἔστι καὶ ὁ τόνος, ὥσπερ καὶ τὰ στερεά· Ῥὶς ὀξείη, ἰσχνὴ, μῆλα ὑπερίσχοντα καὶ ἐρυθρὰ, ὀφθαλμοὶ κοῖλοι, στιλπνοὶ, γανόωντες· οἰδαλέοι, καὶ ὠχροὶ, ἢ πελιδνοὶ τὰ πρόσωπα. γνάθων τὰ λεπτὰ τοῖσι ὀδοῦσι προσιζάνσει μειδιῶσι ἴκελον, τὰ πάντα νεκρώδεες. ὧδε καὶ τὰ πάντα ἴσχει· ἰσχνοὶ, ἄσαρκοι, βραχιόνων μύες ἄδηλοι, μαζῶν οὐδὲ ἴχνη, ἐκφανέες δὲ μοῦναι θηλαί. πλευρὰς οὐ καταλέξαι μοῦνον εὔσημον, ἀλλὰ καὶ ὅπη κραίνουσι, ἐσιδεῖν Ῥηΐδιον· οὐδὲ γὰρ αἱ πρὸς τοὺς σπονδύλους συναθρώσιες εὐξύγκρυπτοι· δῆλαι δὲ καὶ αἱ εἰς τὸ στέρνον ἐπιβολαί· τὰ μέσα τῶν πλευρέων κοῖλα, Ῥομβοειδέα. ὡς ἐς τὴν τῶν ὀστέων περιαγωγὴν ὑποχόνδρια λαγαρὰ, ἀνεσπασμένα, ἐπιγάστριον τῇ Ῥάχει προσφυὲς καὶ λαγών. ἄρθρα ἐναργῆ, ἔξαρθρα, ἀσαρκώδεα, καὶ ἡ κνήμη, ἰσχίον τε καὶ βραχίων. ὑπερίσχει ἡ ἄκανθα τῶν σπονδύλων ἡ πρόσθεν κοίλη τῶν ἑκατέρων ἐκτετηκότων μνῶν· ὡμοπλάται ἐκφανέες ὅλαι, ὅκως πτέρυγες ὀρνίθων. τουτέοισι ἢν κοιλίη ἐκταραχθῇ, ἀνέλπιστοι· ἢν δὲ ἐς ὑγείην τρέπηται, τὰ ἐναντία τοῖσι ὀλεθρίοισι ἐπιφοιτῇ. γηραιοὶ μὲν οὐ ξυνεχέες πάσχειν· διαδιδρήσκουσι δὲ ἥκιστα· νέοι δὲ μέχρι ἀκμῆς ἀπὸ αἵματος ἀναγωγῆς φθινώδεες γίγνονται, καὶ ὑγιάζον ται μὲν, οὐ Ῥηϊδίως δέ· παιδία ξυνεχῶς τῇ βηχὶ μέχρι φθόης κοτὲ Ῥηϊδίως ὑγιάζεται· ἕξιες δὲ Ῥαδινοὶ, σανιδώδεες, πτερυγώδεες, ἐξεχέβρογχοι, λευκοὶ, ἀραιότεροι τὸν θώρηκα· χῶραι δὲ ψυχραὶ καὶ ὑγραὶ, ὁκόσαι τῷ εἴδεϊ τοῦ πάθεος ἀδελφαί.
9. THOSE persons in whose cavities above, along the region of the chest, or, in those below the diaphragm, abscesses of matter form, if they bring it up, they are said to be affected with Empyema; but if the matter pass downwards, they are said to labour under Apostemes. And in the ulcers in the chest, or in the lungs, if phthoe supervene, or in the pleura, or the sternum, or anywhere below at the junction of the lungs with the spine — in all these cases the passage for the matter upwards is by the lungs. But in the viscera below the diaphragm, the liver, spleen, and kidneys, it is by the bladder; and in women by the womb. And I once made an opening into an abscess in the colon on the right side near the liver, and much pus rushed out, and much also passed by the kidneys and bladder for several days, and the man recovered. The common causes of all are a blow, indigestion, cold and the like. Of those in the chest also, chronic cough, pleuritis, peripneumony, and protracted defluxion; but also the determination of some acute diseases to any one of them. The humour is sometimes inert, weak, and rests on something else; sometimes bitingly acrid, and occasioning putrefactions even unto death. And there are many other varieties, as I shall presently declare. It is a wonder how from a thin, slender membrane, having no depth, like that which lines the chest, so much pus should flow; for in many cases there is a great collection. The cause is an inflammation from redundancy of blood, by which the membrane is thickened; but from much blood much pus is formed intermediately. But if it be determined inwards, the ribs being the bones in this region....... I have said above, that another species of phthisis would naturally occur. But if it point outwards, the bones are separated, for the top of the abscess is raised in one of the intercostal spaces, when the ribs are pushed to this side or to that. There are certain symptoms common to all, and certain ones peculiar to each. A heaviness rather than pain is a common symptom (for the lungs are insensible), weak fevers, rigor towards evening, sweats in the remission, insomnolency, swellings in the extremities of the feet, and fingers of the hands, which at one time abate and at another increase; uncomfortable feeling; loss of appetite; wasting of the whole body; and if the change be prolonged, the phthisical habit is formed; for Nature can no longer perform her office, for the digestion is not as before, nor is there the plump habit of body; the colour dark; respiration in all cases bad, but worse in those affecting the upper cavity; but also cough at first as long as the inflammation is urgent, when the pains also are greater, and rigor, and heat, and watchfulness, and dyspnœa still more; pulse small, sluggish, feeble; they are disordered in the intellect; distension of the thorax. But if it be already come to the formation of pus, all the the greatest symptoms take place. Expectoration small with greater cough, and from an urgent abscess, at first of pituitous matters, tinged with bile of a darker colour as if from soot, but likewise tinged with blood, and thick; but if about to burst, of fleshy and deep-seated matter. And, if it burst, there is danger of suffocation should much pus be suddenly poured forth; but if gradually, there is no danger. If then the pus is going to pass downwards, the upper part, where the abscess is situated, experiences sharp pain; discharges from the bowels fluid, at first watery with phlegm, afterwards bloody matter; and then again, substances resembling flesh floating in a fluid, if it has already burst. Pus follows them either by the bowels or the urine. Metastasis to the kidneys and bladder peculiarly favourable. The pus, whether it be carried upwards or downwards, is of various colours—pale, white, ash-coloured, or livid, black and fetid; or devoid of smell and very thick; or intermediate; or smooth and consistent; or rough and unequal, with fleshy substances floating in it, these being round or broad, readily separated or viscid. To say all in a word respecting the pus, such kinds as are white, concocted, devoid of smell, smooth, rounded, and are quickly coughed up, or pass downwards, are of a salutary character; but such as are very pale, bilious, and inconsistent, are bad. Of these by far the worst are the livid and black, for they indicate putrefaction and phagedenic ulcers. Along with these things, it will be proper to know also the habit and other concomitants of the disease. If at the time of the discharge, he feels comfortable, and gets rid of the fever; has good digestion, good colour, and a good appetite, if he coughs up readily, has a good pulse, and good strength; the patient is free from danger. But if fever supervene, and all the other symptoms turn worse, he is in a hopeless state. One ought also to consider the places in which the abscesses are seated. For where the matter forms in the sternum, it is slowly turned to a suppuration; for the parts are slender, devoid of flesh and cartilaginous; and such parts do not readily receive the superfluities of inflammation, but remain a long time without being formed into pus; for cartilage is of a cold nature, but the inflammations thereof are innocuous. The wasting of the constitution is bad; for the suppuration lasts a long time; the spleen, the liver, the lungs, and diaphragm pass more quickly into suppuration, but they are dangerous and fatal.
9. οἷσι ἐν τῇσι κοιλίῃσι τὰ ἄνω κατʼ ἴξιν τοῦ θώρηκος ἢ τὰ κάτω ὑπὸ τὸ διάφραγμα πύου ἀποστάσιες γίγνονται, ἢν μὲν ἀνάγωσι, ἔμπυοι οἵδε καλέονται· ἢν δὲ τὸ πῦον διεξίῃ κάτω, ἀποστηματίαι κικλήσκονται· καὶ ἐν μὲν θώρηκι ἐν τοῖσι ἕλκεσι, ἤτοι ἐν πλεύμονι, ἣν ἐκδέχεται φθόη, ἢ ὑπεζωκότι ἐν πλευρῷ, ἢ στέρνῳ, ἢ κάτωπη πρὸς τῇ ξυμφύσι τοῦ πνεύμονος κατὰ Ῥάχιν, ἤ πη τοῦ θώρηκος ἄλλῃ, — ξυμπάντων δὲ ἐς ἀναγωγὴν ὁδὸς τῷ πύῳ πνεύμων. ὑπὸ δὲ τὸ διάφραγμα ἐν τοῖσι σπλάγχνοισι, ἥπατι, σπληνὶ, νεφροῖσι, κύστις· ἐπὶ γυναικῶν δὲ καὶ ὑστέρη· ἔταμον δὲ καὶ ἐγὼ ἐν κώλῳ τινί κοτε ἀπόστασιν τὰ ἐπὶ δεξιὰ πρὸς ἥπατι· καὶ πολλόν τι ἐσσύθη ἔξω πῦον· πολλὸν δὲ καὶ διὰ νεφρῶν καὶ κύστιος ἐς ἡμέρας πλεῦνας ἐρρύη, καὶ περιεγένετο ὥνθρωπος. αἰτίαι δὲ ξυναὶ μὲν ἁπάντων πληγὴ, ἀπεψίη, ψύξις, ἠδὲ ὁκοῖα τοιάδε. τοῖσι δὲ ἐν θώρηκι, βὴξ χρονίη, καὶ πλευρῖτις, καὶ περιπνευμονίη, καὶ Ῥεῦμα χρόνιον· ἀτὰρ ἠδὲ ὀξείας νούσου ἐς ἕν τι τουτέων ἀπόσκηψις. τὸ δὲ ὑγρὸν ἄλλοτε μὲν ἀεργὸν, ἀδρανὲς, ἐγκέεταί τῳ ἄλλῳ· ἄλλοτε μὲν δριμὺ δαπτῶς, καὶ σηπεδόνας ἐμποιέον μέσφι θανάτου. καὶ γὰρ καὶ ἰδέαι μυρίαι, ὁκόσας αὖθις φράσω. θώϋμα δὲ ὅκως ἐξ ὑμένος λεπτοῦτε καὶ ἰσχνοῦ, βάθος οὐκ ἴσχοντος, τοῦ ὑπεζωκότος, τοσόνδε Ῥέει πῦον· πολλὸν γὰρ πολλοῖσι ξυνελέγη. αἰτίη δὲ φλεγμασίη ἀπὸ περιουσίης αἵματος, ἐφʼ ᾗ παχύνεται ὁ ὑμὴν, ἀτὰρ ἠδὲ ἐκ πολλοῦ αἵματος πολλὸν γίγνεται ἐν μέσῳ πῦον· κἢν μὲν εἴσω Ῥέπῃ, αἱ πλευραὶ τὰ ὀστέα κατὰ χώραν τὴν σφῶν αὐτέων, … φθίσιν ἔλεξα πρόσθεν ἑτέραν ἔμμεναι συμβεβῶ σαν κατὰ φύσιν· ἢν δὲ ἔξω Ῥέπῃ, διΐσταται τὰ ὀστέα. ἐς γὰρ ἕν τι τῶν μέσων πλευρῶν τῆς ἀποστάσιος ἡ κορυφὴ ἐγείρεται, εὖτε ἔνθα καὶ ἔνθα πλευρὰ παρωθέεται. σημήϊα δὲ τὰ μὲν ἁπάντων ξυνὰ, τὰ δὲ ἑκάστου ἴδια· βάρος ἢ πόνος γε ξυνόν· πνεύμων γὰρ ἄπονος· πυρετοὶ ἀμυδροὶ, Ῥίγεα πρὸς ἑσπέρην, ἱδρῶτες ἐπʼ ἀνέσι, ἀγρυπνίη, οἰδήματα ἐν ἄκροισι ποσὶ καὶ χειρῶν δακτύλοισι, ἄλλοτε καὶ ἄλλοτε καθιστάμενα, καὶ ἐπαιρόμενα· δυσφορίη, ἀποσιτίη, ἰσχνότη ς ὅλου· ἢν δὲ καὶ μῆκος ἴσχῃ ἡ μεταβολὴ, ἕξις φθινώδης. οὐ γὰρ ἔτι φύσις ἔργου ἔχεται. οὐ γὰρ πέψις ὁκοίη πρόσθεν, οὐκ εὐσαρκίη, χροιὴ ζοφώδης· ἀναπνοὴ πᾶσι μὲν κακὴ, κακίων δὲ οἷσι ἐς τὴν ἄνω κοιλίην. ἀτὰρ καὶ βὴξ τὰ πρῶτα, μέσφι ἂν ἡ φλεγμασίη πιέζει, εὖτε καὶ πόνοι μέζονες καὶ Ῥίγεα, καὶ θέρμη, καὶ ἀγρυπνίη, καὶ δύσπνοια ἔτι μᾶλλον· σφυγμοὶ σμικροὶ, νωθροὶ, ἀδρανέες, τὴν γνώμην παράληροι, διάτασις τοῦ θώρηκος. ἢν δὲ ἤδη εἰς γέννησιν ἥκῃ πύου, πάντα μέγιστα· ἀναγωγὴ δὲ σμικρὴ ἐπὶ βηχὶ μέζονι, καὶ ἐξ ἀποστάσιος βιαίης. τὰ πρῶτα φλεγματωδέ ων χολοβάφων ἐπὶ τὸ μελάντερον, ὅκως ἐξ αἰθάλης· ἔτι δὲ διαίμων καὶ παχέων· ἢν δὲ καὶ Ῥαγήσεσθαι μέλλῃ, καὶ σαρκοειδέων βαθέων· καὶ ἢν Ῥαγῇ, κίνδυνος μὲν πνίξιος, ἢν πολλὸν καὶ ἀθρόον ἐκχυθῇ πῦον· ἢν δʼ οὖν ἐκρέῃ σχέδην, ἀτρεκέει· πῦον ἢν κάτω περῆσαι θέλῃ, τὰ μὲν ἄνω μέρεα ἔνθα ἡ ἀπόστασις, ὀξὺς πόνος, κοιλίη ὑγρὴ, τὰ πρῶτα ὑδατώδεα ξὺν φλεγματώδεσι· ἔπειτα περίρροια αἱματωδέων, καὶ αὖθις σαρκοει δέων, ἢν ἤδη Ῥαγῇ. ἕπεται δὲ τουτέοισι πῦον, ἢ διὰ κοιλίης, ἢ οὔρων· ἀγαθαὶ δὲ πάντων μᾶλλον, αἱ ἐς νεφροὺς καὶ κύστιας μεταλήψιες. φέρεται δὲ, ἤν τε ἄνω, ἤν τε κάτω, χρόος πύου ποικίλον, ὠχρὸν, ἢ λευκὸν, ἢ τεφρίζον, ἢ πελιδνὸν, ἢ μέλαν, καὶ κακῶδες· ἢ ἄνοσμον καὶ παχύτατον· ἢ μέσως ἴσχον, ἢ λεῖον, ὁμαλὸν, ἢ τρηχὺ, ἀνώμαλον, καὶ σαρκοει δέα τὰ ἐμπλόωντα, στρογγύλα, ἢ πλατέα, Ῥηϊδίως ἀποπλυνόμενα, ἢ ἰξώδεα· ἀθρόον δὲ περὶ πύου εἰρῆσθαι, ὁκόσα μὲν λευκὰ, πέπονα, ἄνοσμα, λεῖα, στρογγύλα, καὶ ἀναβήσσεται θᾶσσον, ἢ ὑποφέρεται, περιεστηκότα· ὁκόσα δὲ ἔξωχρα, χολώδεα, ἀνώμαλα, μοχθηρά. πολλὸν δὲ τουτέων κακίω, τὰ πελιδνὰ καὶ μέλανα. σηπεδόνα γὰρ καὶ ἀνεσθιόμενα σημαίνουσι τὰ ἕλκεα. Προσξυν ιέναι δὲ τουτέοισι καὶ τὴν ἕξιν, καὶ τὰ ξυνομαρτέοντατῇ νούσῳ. ἢν γὰρ ἐπὶ τῇ ἐκκρίσι εὐφόρως φέρῃ, ἄπυρος γίγνηται, εὖτε πέσσῃ, εὔχρους, εὔσιτος· ἢrend="indent"ν ἀναβήσσῃ εὐμαρῶς, εὔσφυκτος, εὔτονος γίγνηται, ἀνώλεθρος ὁ νοσέων· ἢν δὲ ἐπιπυρεταίνῃ, καὶ πάντα ἐς κακὸν τρέπηται, ἀνέλπιστος. προσξυνιέναι δὲ καὶ τὰ χωρία, ἔνθα αἱ ἀποστάσιες· ὁκόσοισι γὰρ ἐν τῷ στέρνῳ τὸ ἐμπύημα γίγνεται, βραδέως ἀφίσταται. ψιλὰ γὰρ καὶ ἄσαρκα καὶ χονδρώδεα τὰ μέρεα· τὰ δὲ τοιάδε οὐ Ῥηϊδίως δέχεται φλεγμον ῆς περιουσίην· ἀνεκπύητα δὲ μίμνει πουλὺν χρόνον· ψυχρὸν γὰρ οἱ χόνδροι, ἀλλὰ τῶνδε ἀσινέες μὲν αἱ φλεγμοναί, τῆς ἕξιος δὲ κακαὶ συντήξιες, μακρὸν γὰρ διαπυΐσκει χρόνον. σπλὴν καὶ ἧπαρ καὶ πνεύμων καὶ διάφραγμα ὀξύτερα μὲν ἐς ἐμπύησιν, ἐπικίνδυνα δὲ καὶ θανατώδεα.
10. WHEN, in cases of peripneumonia, the patients survive, though the inflammation be not discussed, those who escape the acute stage of the affection have suppurations. The symptoms, then, of an incipient and of a formed abscess have been stated by me under Empyema. If formed, then, there is no necessity for the same harsh measures and pains to procure the rupture and discharge of it as in the solid parts of the body, as it is readily brought up; for the distension of its pores is required rather than of the solid texture of its parts; for the lungs being a porous body and full of perforations like a sponge, it is not injured by the humour, but transmits it from pore to pore, until it reach the trachea. Thus the fluid finds a ready outlet, the pus being a flexible and slippery substance, and the respiration blows the breath (pneuma) upwards. For the most part they recover, unless at any time one be suffocated by the copious influx of the fluid, when, owing to the quantity of the pus, the trachea does not admit the air. Others die a protracted death, after the manner of those labouring under phthisis and empyema. The pus is white and frothy, being mixed with saliva, but sometimes ash-coloured or blackish. And sometimes one of the bronchia has been spit up in a case of large ulceration, if the abscess is deep, when portions of the viscus are also brought up. Hoarse, breathing short, voice heavy-toned, their chest becomes broad, and yet they stand in need of its being still broader, owing to the collection of fluid; the dark parts of the eyes glancing, the whites are very white and fatty; cheeks ruddy; veins in the forehead protuberant. There is a marvel in connection with these cases, how the strength is greater than the condition of the body, and the buoyancy of spirits surpasses the strength.
10. εὖτε ὁκόσοισι περιπνευμον ικοῖσι ἂν φλέγμα ἔῃ, καὶ μὴ διαχέηται, περιγίγνονται· οἱ δὲ διαδιδρήσκοντες τὸ κάτοξυ τοῦ πάθεος ἔμπυοι γίγνονται. τὰ μὲν οὖν μελλούσης ἢ τετελες μένης ἀποστάσιος σημεῖα ἐν τοῖσι ἐμπύοισι ἔλεξα· ἢν δὲ τελεσθῇ, οὐ βίης καὶ πόνων ἐς ἀπόρρηξιν καὶ ἀναγωγὴν χρέος, ὅπωσπερ ἐν τοῖσι σώμασι· ἀλλὰ γὰρ Ῥηϊδίως ἀναφέρεται, διατάσιος μᾶλλον τῶν ἀραιωσίων γενομένης, ἤπερ ἕξιος σωμάτων. μανὸς γὰρ καὶ πολύτρητος ὁ πνεύμων, σπογγίῃ ἴκελος, οὐ χαλεπαίνων τῷ ὑγρῷ, ἄλλην ἀπʼ ἄλλης εὐρυχωρίην ἀμείβοντι, μέσφι τῆς τρηχείης ἀρτηρίης ἥκειν. περίοδοι δὲ τῷ ὑγρῷ Ῥηΐδιαι. εὐκαμπὲς γὰρ ἠδὲ ὀλισθηρὸν πῦον. ἀτὰρ καὶ ἡ ἀναπνοὴ ἄνω τὸ πνεῦμα φυσῇ. περιγίγνονται δὲ τὰ πολλὰ, εἰ μή κοτέ τις ἀπεπνιγῆ ἀθρόῃ ἑλκύσι τοῦ ὑγροῦ, τῆς ἀρτηρίης οὐ δεχομένης τὸν ἠέρα πλήθεϊ τοῦ πύου. θνήσκου σι δὲ μετεξέτεροι χρόνῳ τὸν φθινώδεα καὶ τὸν ἐμπυϊκῶν τρόπον· τὰ δὲ πῦα λευκὰ, ἔπαφρα, σιάλῳ μεμιγμένα· ἄλλοτε δʼ αὖ τεφροειδέα, ἢ ὑπομελανίζοντα· καὶ βρογχίον κοτὲ ἀνεπτύσθη ἐπὶ ποικίλῳ ἕλκεϊ, ἢν βάθος ἴσχῃ ἡ ἀπόστασις, εὖτε καὶ ἀπορρῶγες ἀναφέρονται τοῦ σπλάγχνου. βραγχώδεες, βραχύπνοοι, βαρύφωνοι, τὰ στήθεά σφιν εὐρέα γίγνεται, καὶ εὐρυτέρων τῆς ὑγρασίης δέονται. ὀφθαλμῶν τὰ μέλανα στιλπνά· τὰ δὲ λευκὰ, λευκότα τα καὶ πίονα· μῆλα ἐρευθῆ, φλέβες ἐν τῷ προσώπῳ κυρταί. θώϋμα δὲ ἐπὶ τουτέων. τόνος μὲν γὰρ εὐσαρκίης μείζων, εὐψυχίν δὲ τόνου δυνατωτέρη.
11. IF from running, gymnastic exercises, or any other work, the breathing become difficult, it is called Asthma (ἆσθμα); and the disease Orthopnœa (ὀρθόπνοια) is also called Asthma, for in the paroxysms the patients also pant for breath. The disease is called Orthopnœa, because it is only when in an erect position (ὀρθίῳ σχήματι) that they breathe freely; for when reclined there is a sense of suffocation. From the confinement in the breathing, the name Orthopnœa is derived. For the patient sits erect on account of the breathing; and, if reclined, there is danger of being suffocated. The lungs suffer, and the parts which assist in respiration, namely the diaphragm and thorax, sympathise with them. But if the heart be affected, the patient could not stand out long, for in it is the origin of respiration and of life. The cause is a coldness and humidity of the spirit (pneuma); but the materiel is a thick and viscid humour. Women are more subject to the disease than men, because they are humid and cold. Children recover more readily than these, for nature in the increase is very powerful to heat. Men, if they do not readily suffer from the disease, die of it more speedily. There is a postponement of death to those in whom the lungs are warmed and heated in the exercise of their trade, from being wrapped in wool, such as the workers in gypsum, or braziers, or blacksmiths, or the heaters of baths. The symptoms of its approach are heaviness of the chest; sluggishness to one’s accustomed work, and to every other exertion; difficulty of breathing in running or on a steep road; they are hoarse and troubled with cough; flatulence and extraordinary evacuations in the hypochondriac region; restlessness; heat at night small and imperceptible; nose sharp and ready for respiration. But if the evil gradually get worse, the cheeks are ruddy; eyes protuberant, as if from strangulation; a a râle during the waking state, but the evil much worse in sleep; voice liquid and without resonance; a desire of much and of cold air; they eagerly go into the open air, since no house sufficeth for their respiration; they breathe standing, as if desiring to draw in all the air which they possibly can inhale; and, in their want of air, they also open the mouth as if thus to enjoy the more of it; pale in the countenance, except the cheeks, which are ruddy; sweat about the forehead and clavicles; cough incessant and laborious; expectoration small, thin, cold, resembling the efflorescence of foam; neck swells with the inflation of the breath (pneuma); the præcordia retracted; pulse small, dense, compressed; legs slender: and if these symptoms increase, they sometimes produce suffocation, after the form of epilepsy. But if it takes a favourable turn, cough more protracted and rarer; a more copious expectoration of more fluid matters; discharges from the bowels plentiful and watery; secretion of urine copious, although unattended with sediment; voice louder; sleep sufficient; relaxation of the præcordia; sometimes a pain comes into the back during the remission; panting rare, soft, hoarse. Thus they escape a fatal termination. But, during the remissions, although they may walk about erect, they bear the traces of the affection.
11. εἰ ἀπὸ δρόμου καὶ γυμνασίων καὶ παντὸς ἔργου δυσπνοεῖ ἡ ἀναπνοὴ, ἆσθμα καλεῖται· καὶ ἡ νοῦσος δὲ ὀρθόπνοια, καὶ ἥδε κικλήσκεται ἆσθμα· ἐν γὰρ τοῖσι παροξυσμοῖσι ἀσθμαίνουσι καὶ οἵδε. ὀρθόπνοιαν δὲ ἐκάλεον, οὕνεκεν ὀρθίῳ σχήματι μοῦνον ἀναπνέουσι εὐφόρως· πνὶξ γὰρ ἐν κατακλίσι. εἵνεκεν τοῦ τόνου τοῦ ἐπὶ τῷ πνεύματι ὀρθόπνοια τοὔνομα. ὄρθιος γὰρ ἀνατέταται ἐς ἀναπνοὴν, κἢν ὕπτιος κατακλινθῇ ὥνθρωπος, κίνδυνος πνιγῆναι. πάσχει δὲ πλεύμων· ξυμπαθέει δὲ καὶ τὰ ξυντελοῦντα ἐς ἀναπνοὴν, διάφραγμα, θώρηξ· ἢν δὲ καρδίη πάθῃ, οὔκοτε ἐς πολλὸν διαρκέσειε. τῇδε γὰρ ἡ τῆς ἀναπνοῆς καὶ τῆς ζωῆς ἀρχή. αἰτίη δὲ ψύξις καὶ ὑγρότης τοῦ πνεύματος· ὕλη δὲ ὑγρὰ, παχέα, κολλώδεα· εὐπαθέες δὲ γυναῖκες ἀνδρῶν μᾶλλον, ὅτι περ ὑγραί τε καὶ ψυχραί· οἱ δὲ παῖδες τούτων περιγίγνονται Ῥηΐτερον, ἡ γὰρ φύσις ἐν αὐξήσι θερμῆναι δυνατωτάτη. ἄνδρες δὲ εἰ καὶ μὴ Ῥηΐδιοι παθεῖν, ἀλλὰ θνήσκουσι θᾶσσον. ἀμβολὴ δὲ θανάτου ὅσοισι ἐν ἔργου πρήξι, ἢ ἐν εἰρίοισι πλεύμων θάλπεται καὶ διαίθεται, ὁκοῖόν τι τοῖσι τῆς τιτάνου ἐργάτῃσι, ἢ χαλκεῦσι, ἢ σιδηρεῦσι, ἢ καὶ λουτρῶν πυρσευτῆρσι. Μελλησμοῦ δὲ σημήϊα, βάρος τοῦ θώρηκος, ὄκνος ἐς τὸ ξύνηθες ἔργον, ἀτὰρ ἠδὲ ἐς ἅπασαν πρῆξιν, δύσπνοια ἐν δρόμῳ, ἢ πρὸς ὁδὸν ὀρθήν· βραγχώδεες καὶ βηχώδεες, φῦσα ἐν τοῖσι ὑποχονδρίοισι καὶ ἐρυγαὶ παράλογοι, ἀγρυπνίη, θερμασίη νύκτωρ σμικρὴ, ἀσαφής· Ῥὶς ὀξείη, ἐς ἀναπνοὴν ἑτοίμη. ἢν δὲ ἐπὶ μέζον τὸ κακὸν ἕρπῃ, μῆλα ἐρυθρά· ὀφθαλμοὶ προπετέες, ὡς ἐπʼ ἀγχόνῃ, Ῥωγμὸς ἐν ἐγρηγόρσι· πολλὸν δὲ μέζον τὸ κακὸν ἐν ὕπνῳ· ὑγρὴ καὶ ἄηχος ἡ φωνή· πολλοῦ καὶ ψυχροῦ ἠέρος ἐπιθυμίη· ἐς τὸ ὕπαιθρον ἴενται, πᾶς γὰρ αὐτέοισι οἶκος ἐς ἀναπνοὴν οὐ διαρκής· ἀναπνέουσι ὄρθιοι, ὅκως ἅπαντα σπάσαι τὸν ἑλκόμενον ἠέρα ποθέοντες, ὑπʼ ἀπορίης δὲ τοῦ ἠέρος καὶ διοίγουσι τὸ στόμα, ὡς τῷδε μέζονι χρεόμενοι· ὠχροὶ τὰ πρόσωπα, πλὴν τῶν μήλων. τάδε γὰρ ἐρευθῆ. ἱδρῶς περὶ μέτωπον καὶ κληϊδας· βὴξ συνεχὴς, βιαίη· ἀναγωγὴ σμικρὴ, λεπτὴ, ψυχρὴ, ἰκέλη ὁκοῖόν τι καὶ ἀφροῦ ἐπάνθισμα. τράχηλος οἰδέει πνεύματος πρήσι. ὑποχόνδρια ἀνεσπασμένα. σφυγμοὶ σμικροὶ, πυκινοὶ, πιεζεύμενοι· ἰσχνὰ σκέλεα· κἢν ὑπερταθῇ τάδε, ἀπέπνιξέ κοτε ἐπιληπτικῷ τρόπῳ. ἢν δὲ ἐς ἀγαθὸν τρέπηται, βὴξ μακροτέρη καὶ ἀραιοτέρη. ἀναγωγὴ πλεύνων τε πύων καὶ ὑγροτέρων· κοιλίης τάραχος πολλῶν ὑδατωδέων· οὔρων ἔκκρισις πολλὴ, κἢν ἐς ὑπόστασιν μηδέκω ἥκῃ· φωνὴ γεγωνοτέρη, ὕπνοι αὐταρκέες, ὑποχονδρίων ἄνεσις· ἧκέ ποτε πόνος ἐς μετάφρενον ἐπʼ ἀνέσι. ἆσθμα ἀραιὸν, λεῖον, κερχνῶδες. ὧδε μὲν οὖν διαδιδρήσκουσι τὸν ὄλεθρον ἐν δὲ τῇσι ἐπανέσεσι, κἢν περιΐωσι ὀρθοστάδην, τοῦ πάθεος φέρουσι ξύμβολα.
12. PNEUMODES is a species of asthma; and the affection is connected with the lungs as is the case in asthma. The attendant symptoms are common, and there is but little difference; for dyspnœa, cough, insomnolency, and heat are common symptoms, as also loss of appetite and general emaciation. Moreover, the disease is protracted for a time, yet not longer than one year; for, if the autumn begin it, the patients die in the spring or in the summer; or if the winter, they terminate their life towards the autumn. Old persons also are at certain times readily seized; and being seized with rigors, it requires but a slight inclination of the scale to lay them on the bed of death. All labour in particular under want of breath; pulse small, frequent, feeble. But these symptoms are also common to asthma; they have this as peculiar; they cough as if going to expectorate, but their effort is vain, for they bring up nothing; or if anything is forcibly separated from the lungs, it is a small, white, round substance, resembling a hailstone. The thorax is broader, indeed, than natural, but not altered in shape, and is free from ulceration; yet, though the lungs be free from suppuration, they are filled with humours, which are, as it were, compacted. The intervals of the paroxysms in this affection are greater. Some, indeed, die speedily of suffocation before anything worse is transferred to the general system. In other cases the affection terminates in dropsy about the loins, or in anasarca.
12. ἄσθματος ἰδέη τὸ πνευμῶδες, καὶ ἀπὸ τοῦ πνεύμονος τὸ πάθος ὅκως ἐπʼ ἄσθματι. ξυνὰ γὰρ καὶ τὰ παρεόντα· σμικρὸν δὲ καὶ τὸ διάφορον. δύσπνοια μὲν γὰρ καὶ βὴξ καὶ ἀγρυπνίη καὶ θέρμη ξυνά· καὶ ἀποσιτίη καὶ ἰσχνότης ὅλου. καὶ γὰρ ἐς χρόνον τὸ κακὸν ἀποτείνεται, πλὴν οὐ περαιτέρω ἑνὸς ἔτεος. ἤν τε γὰρ τὸ μετόπωρον ἄρξῃ, εἰς τὸ ἔαρ ἢ τὸ θέρος ἀπογίγνονται· ἤν τε χειμὼν, ἐς τὸ μετόπωρον τελευτῶσι τὸν βίον. κοτὲ καὶ γέροντες ἁλῶναι Ῥηΐδιοι καὶ ἀπόφρικτοι ἁλόντες, ὅσον βραχείης Ῥοπῆς ἐς εὐνὴν θανάτου χρέος· ἄγχιστα ἅπαντες ἄπνοοι, σφυγμοὶ σμικροὶ, πυκνοὶ, ἀμυδροί. ἀλλὰ τάδε μὲν ξυνὰ πρὸς τὸ ἆσθμα· ἰδίᾳ δὲ ἀναβήσσουσι ὡς ἀνάξοντες. ματαιοπονέουσι δέ· οὐδὲν γὰρ ἀνάγουσι. εἰ δέ τι τοῦ πλεύμονος ἀπορραγείη βίῃ, σμικρὸν, λευκὸν, στρογγύλον, χαλαζῶδες· θώρηξ εὐρύτερος μὲν, ἀδιάστροφος, ἠδὲ ἀνέλκωτος· ἢν δὲ ἀνεκπύητος ὁ πνεύμων ᾖ, ὑγρῶν δὲ ὁκοῖόν τι πεπηγότων ἔμπλεως, διαλήψιες τῶν παροξυσμῶν τοῦδε μέζονες. οἱ μὲν οὖν ἀπεπνίγησαν θᾶσσον, πρίν τι κάκιον ἐς τὸ πᾶν ἀποσκῆψαι· μετεξετέροισι δὲ ἐς ὕδερον περὶ λαγόνα ἢ ἀνὰ σάρκα τὸ πάθος τελευτᾷ.