5. IN Ileus it is pain that kills, along with inflammation of the bowels, or straining and swelling. A most acute and most disgusting form of death! For others, when in a hopeless state of illness, fear nothing except their impending death; but those in ileus, from excess of pain earnestly desire death. The physician, therefore, must neither be inferior to the affection, nor more dilatory; but, if he find inflammation to be the cause, open a vein at the elbow by a large orifice, so that blood, which is the pabulum of the inflammation, may flow copiously; and it may be carried the length of deliquium animi, for this is either the commencement of an escape from pain, or of a torpor ending in insensibility. For in ileus a breathing-time for a short space, even from loss of sensibility, will prove an interval from pain; since, also, to persons enduring these pains, to die is happiness, but to impart it is not permitted to the respectable physician; but at times it is permitted, when he foresees that present symptoms cannot be escaped from, to lull the patient asleep with narcotics and anæsthetics. But if the ileus arise without inflammation, from corruption of the food or intense cold, we are to abstain from bleeding, but at the same time to do all the other things, and procure vomiting frequently by water, and drinking plenty of oil; then, again, we are to procure vomiting, and produce the expulsion of the flatus downwards, by stimulant medicines. Such a stimulant is the juice of sow-bread, and natron, or salts. Cumin and rue are carminatives. Wherefore we must rub in together all these things with turpentine resin, and foment with sponges; or we must inject with these things and oil, honey, hyssop, and the decoction of the fleshy parts of the wild cucumber. And if feculent matter be evacuated, we are again to inject hot oil with rue; for, if this remain inwardly, it proves a grateful fomentation to the bowels: and apply to the suffering parts lotions composed of oil which has been strongly boiled with rue and dill. And the fomentation is also to be applied, either by means of earthen or brazen vessels, or with millet and roasted salts. In addition to the ordinary cataplasms, one may be made of the flour of darnel and cumin, and the hair of hyssop and of marjoram. Cupping, without the abstraction of blood, indeed, but frequently applied, sometimes to one place, and sometimes to another—to the epigastric region, and to the loins as far as the groins, and behind to the ischiatic region as far as the kidneys and spine; for it is expedient to produce revulsion of the pain by all means. They should also get whetters (propomata ) of the decoction of cumin, or of rue, and of sison; or along with these some of the anodyne medicines. Of these there are very many of tried efficacy. The medicine from vipers is also a good one, when drunk to a larger amount than usual. But if neither the pain remit, nor the flatulence nor fæces pass, we must necessarily give of the purgative hiera; for either the medicine is rejected with phlegm and bile, or it passes downwards, bringing off flatus, scybala, phlegm, and bile, which occasion the intensity of the evil. Laxative food: soups of hens, of shell-fish; the juice of ptisan boiled with much oil poured in at first before the boiling; boil along with it cumin, natron, leek with its hair. Or the cure is to be made with some laxative soup: snails much boiled, and their gravy, or that of limpet. Water is to be taken for drink, if there be fever, boiled with asarabacca, or nard, or cachry. For these things dispel flatus, are diuretic, and promote free breathing. But if he be free from pain, wine also is beneficial for the heat of the intestines, and for the restoration of the strength; and likewise the decoction of fennel-root, in a draught, and maiden-hair and cinnamon. But if the inflammation turn to an abscess, it is better to contribute thereto by using the medicine for abscesses. These have been described under chronic diseases, where the treatment of cholics is described.
5. ἐν εἰλεῷ πόνος ἐστὶ ὁ κτείνων ἐπὶ φλεγμονῇ ἐντέρων, ἢ ἔντασις καὶ πρῆσις· ὤκιστος ἠδὲ κάκιστος ὄλεθρος. μετεξέτεροι μὲν γὰρ ἀνελπίστως νοσέοντες θάνατον προφανέα μοῦνον ὀρρωδέουσι· οἱ δʼ ἐν εἰλεῷ πόνου ὑπερβολῇ, θανάτου ἔρανται. χρὴ ὦν μήτε σμικρότερόν τι γίγνεσθαι τὸν ἰητρὸν τοῦ πάθεος, μήτε βραδύτερον. ἀλλὰ, ἢν μὲν φλεγμασίην αἰτίην εὕρηται, τάμνειν φλέβα τὴν ἐπʼ ἀγκῶνι μεγάλῃ τῇ σχάσι, ὅκως ἀθρόως διεκρέῃ τὸ αἷμα, τῆς φλεγμασίης ἡ τροφὴ, κἢν μέσφι λειποθυμίης· τόδε γὰρ ἢ ἀπονίης ἀρχὴ γιγνεται, ἢ νάρκης ἐς ἀναισθησίην· ἀνάπνευσις δὲ ἐν εἰλεῷ, κἢν ὑπʼ ἀγνοίης ἐς βαιὸν χρόνον ἔῃ τοῦ πόνου ἀμβολή· ἐπεὶ καὶ τὸ θνήσκειν τοῖς μὲν ὧδε πονέουσι εὐδαιμονίη· τῳ ἀρχιητρῷ δὲ οὐ θέμις πρήσσειν. θέμις δέ κοτε προγιγνώσκοντα σκοντα σάφα τὰ παρεόντα ὡς οὐ φύξιμα, καρηβαρ έῃ νωθρῇ εὐνᾶσθαι. ἢν δὲ ἄνευ φλεγμασίης, ἐπὶ διαφθορῇ ἢ ψύξι κραταιῇ γίγνεται ὁ εἰλεὸς, φλεβοτομίην μὲν ἴσχειν, τὰ δὲ λοιπὰ ἅμα πάντα πρήσσειν· ἐμέειν ἀπὸ ὕδατος θαμινὰ, συχνὸν πίνειν ἔλαιον, εἶτα αὖθις ἐξεμέειν. φύσας ἄγειν κάτω ἐρεθίσμασι· ἐρεθιστικὸν μὲν κυκλαμίνου χυλὸς, καὶ νίτρον, ἢ ἅλες· φυσέων δὲ ἀγωγὰ κύμινον, ἠδὲ πήγανον. χρὴ ὦν πάντα ὁμοῦ ξὺν Ῥητίνῃ τῇ τοῦ τερμίνθου διαχρίειν τάδε, καὶ σπόγγοισι πυριῆν, ἢ τοῖσδε ὑποκλύζειν ξὺν ἐλαίῳ καὶ μέλιτι, καὶ ὑσσώπῳ, καὶ κολοκύν της ἀγρίας τῆς σαρκὸς ἑψήματι· κἢν ἐκκριθῇ κόπρος, αὖθις ἔλαιον θερμὸν ξὺν πηγάνῳ ἐνιέναι· τόδε γὰρ ἢν εἴσω μίμνῃ, πυρίημα τοῖσι ἐντέροισι εὐμενές. τέγγειν δὲ τὰ πονέοντα χωρία ἐλαίῳ ξὺν πηγάνῳ καὶ ἀνήθῳ ἄδην ἑψηθέντι. ἔστω δὲ καὶ πυρίη, φακῶν τῶν κεραμήων, ἢ χαλκέων, ἢ κέγχρου καὶ ἁλῶν φωχθέντων. ἐπιπλάσματα πρὸς τοῖσι ξυνοῖσι ἔστω αἴρης ἄλητον καὶ κύμινον καὶ ὑσσώπου ἢ ὀριγάνου κόμη· σικύαι δὲ κοῦφαι μὲν, συχναὶ δὲ, ἄλλη πρὸς ἄλλας τιθεμένη, ἐς τὸ ἐπιγάστριον, ἐς τὰς ἰξύας μέσφι βουβώνων· ἠδὲ κατόπιν ἐς ἰσχία πρὸς νεφροὺς καὶ Ῥάχιν. πάντη γὰρ ἀντισπᾶν τὸν πόνον ξυμφέροι. προπίνειν δὲ κυμίνου ἢ πηγάνου ἀφεψήματος, καὶ τοῦ σίσωνος, ἢ ξὺν τουτέοισι τῶν φαρμάκων τῶν ἀνωδύνων τινά· μυρία δὲ ἄλλοισι ἄλλα πείρῃ γεγόνασι πιστά. ἀγαθὸν δὲ καὶ τὸ διʼ ἐχιδνῶν φάρμακον, μέζον τοῦ μέτρου πρὸς τὸ ξύνηθες ποθέν· ἢν δὲ μήτε ὁ πόνος ἐνδιδῷ, μήτε φῦσα, μήτε κόπριον ἀναδοίη, τοῦ καθαρτηρίου τῆς ἱερῆς ὑπʼ ἀνάγκης διδόναι. ἢ γὰρ ἀπηλάθη ξὺν φλέγματι καὶ χολῇ τὸ φάρμακον, ἢ διῆλθεν ἐξάγον φύσας, σκύβαλα, φλέγμα, χολὴν, τοῦ κακοῦ τὰς ἐντάσιας. τροφὴ διεξάγουσα· ζωμοὶ ἀλεκτορίδων, κογχαρίων, πτισάνης ὁ χυλὸς κάθεφθος, ξὺν πολλῷ λίπαϊ ἀρχῆθεν προσεγχυθέντι τῆς ἑψήσιος· συνεψεῖν τῷδε, κύμινον, λίτρον, πράσον ξὺν τῇ κόμῃ· ἢ ἰητρείη ξὺν ζωμῷ τινι διαχωρητικῷ, κοχλίαι ἄκρως ἑφθοὶ, καὶ ωὐτῶν δὲ χυμὸς ἢ τελλίνης· ὕδωρ ποτὸν, ἢν πυρεταίνῃ, ξὺν ἀσάρῳ, ἢ νάρδῳ, ἢ κάγχρυ ἑψηθέν. καὶ γὰρ φύσης ἀγωγὰ, καὶ οὐρητικὰ, καὶ εὔπνοα· ἢν δὲ ἄπυρος ἔῃ, καὶ οἶνος ἔς τε τὴν τῶν ἐντέρων θέρμην, ἀτὰρ ἠδὲ ἐς ἀνάκλησιν τῆς δυνάμιος, ἀρήγει· καὶ μαράθρου Ῥίζης ἕψημα ποθὲν, καὶ ἀδίαντον, καὶ κινάμωμον. ἢν δὲ ἐς ἀπόστασιν τρέπηται ἡ φλεγμασίη, τῇδε ξυμβάλλειν ἄμεινον, τοῖσι ἐς ἀπόστασιν φαρμάκοισι χρεόμενον· γεγράφαται δὲ τάδε ἐν τοῖσι χρονίοισι, ἔνθα κωλικῶν θεραπείη ἐγράφη.
6. THE formation of the blood is in the liver, and hence the distribution of it over the whole system. And the entire liver is, as it were, a concretion of blood. Wherefore the inflammations there are most acute; for nutrition is seated in this place. If, therefore, inflammation form anywhere else, it is not remarkably acute; for it is an influx of blood that is inflamed; but in the liver there is no necessity for its coming from another quarter. For if any obstruction shut the outlets, the liver becomes inflamed by being deprived of its efflux, since the entrance of the food to the liver still continues patent; for there is no other passage of the food but this from the stomach and intestines to the whole body. It is necessary, therefore, to make a copious evacuation, by opening the veins at the elbow, and taking away blood frequently, but not in large quantity at a time. Total abstinence from food at first, but restricted diet afterwards, so that the liver may be devoid of its customary ingesta. It is necessary, also, by external applications to dispel the matters impacted in the liver. Lotions, therefore, with aloe or natron are proper, and unwashed wool is to be applied. There is need, then, of cooling means, because the liver is inflamed by the blood; for the blood is hot. The cataplasms, also, should be of such a nature, consisting of the meal of darnel, or of hedge-mustard, or of barley, or of linseed; and of liquid substances, such as acid wine, the juice of apples, of the tendrils of the vine, or of the leaves of the vine in season, or of the oil prepared with it. Fomentations are to be applied on sponges, of the decoction of the fruit of bays, of the lentisk, of penny-royal, and of iris. When you have soothed by these means, you must apply a cupping-instrument, unusually large, so as to comprehend the whole hypochondriac region, and make deeper incisions than usual, that you may attract much blood. And, in certain cases, leeches are better than scarifications; for the bite of the animal sinks deeper, and it makes larger holes, and hence the flow of blood from these animals is difficult to stop. And when the animals fall off quite full, we may apply the cupping-instrument, which then attracts the matters within. And if there be sufficient evacuation, we are to apply styptics to the wounds; but these not of a stimulant nature, such as spiders’ webs, the manna of frankincense, and aloe, which are to be sprinkled in powder on the part; or bread boiled with rue or melilot, and the roots of marsh-mallow; but on the third day a cerate, made with nut-ben, or the hairy leaves of wormwood and iris. The malagmata should be such as are calculated to attenuate, rarify, or prove diuretic. Of these the best is that “from seeds” (diaspermatôn) well known to all physicians from experience. That also is a good one of which marjoram and melilot are ingredients. The food should be light, digestible, possessed of diuretic qualities, and which will quickly pass through the bowels; such as granulated seeds of spelt (alica ) with honeyed-water, and a draught of these articles with salts and dill. The juice of ptisan, also, is detergent; and if you will add some of the seeds of carrot, you will make it more diuretic: for it evacuates by the passages which lead from the liver to the kidneys; and this is the most suitable outlet for matters passing out from the liver, owing to the wideness of the vessels and the straightness of the passage. We must also attract thither by cupping, applying the instrument to the region of the kidneys in the loins. To these parts, lotions are also to be applied, prepared with rue, the juncus, or calamus aromaticus. By these means, it is to be hoped that the patient may escape death. But when it is turning to a suppuration, we must use the suppurative medicines which will be described by me under the head of colics. But if pus is formed, how the collection is to be opened, and how treated, will be explained by me in another place. The same observations apply to the spleen, in the event of an inflammation seizing this part also.
6. ἐν ἥπατι τοῦ αἵματος ἡ γέννα, καὶ ἐς τὸ πᾶν ἔνθεν ἡ τοῦδε ἄφεσις. καὶ τὸ ξύμπαν ἧπαρ ὁκοῖον αἵματος πάγος. ὀξύταται ὦν αἱ τῇδε φλεγμοναί. ἐγκέεται γὰρ τῷ χωρίῳ τῷδε ἡ τροφή. ἢν μὲν ἑτέρωθί πη φλεγμονὴ συστῇ, οὐ κάρτα γίγνεται ὀξέη· ζέει γὰρ ἡ τοῦ αἵματος ἐπιρροή. ἐπὶ δὲ τῷ ἥπατι οὐ χρέος ἑτέρωθεν ἥκειν· ἢν γάρ τις ἔμφραξις τὰς ἐξόδους ἐπίσχῃ, πίμπραται τὸ ἧπαρ τῆς ἐκροῆς ἀμερθέν· ὁ δὲ τῆς τροφῆς εἴσρους ἐς τὸ ἧπαρ ἔτι μίμνει· οὐχ ἑτέρη γὰρ ὁδὸς τῆς τροφῆς ἐς τὸ πᾶν σκῆνος ἀπὸ τῆς κοιλίης καὶ τῶν ἐντέρων. εὐπόρως ὦν χρὴ τὴν κένωσιν ἐμποιέειν, τάμνοντα φλέβας τὰς ἐπʼ ἀγκῶνι, συχνὸν μὲν ἀφαιρέοντα, μὴ ἀθρόον δέ. ἀποσιτίη μὲν τὰ πρῶτα, ὀλιγοσι τίη δὲ αὖθις, ὅκως καὶ τοῖσι εἰσιοῦσι τὸ ἧπαρ κενεὸν ᾖ. χρὴ δὲ καὶ τοῖσι ἐπιθέτοισι διασκιδνάναι τὰ ἐν τῷ ἥπατι σταθέντα. τέγξις μὲν ὦν ξὺν ἀλόῃ ἤ λίτρῳ· εἴρια πινόεντα οἰσύπῳ. χρέος ὦν ἐμψύξιος, οὕνεκα τῷ αἵματι αἴθεται τὸ ἧπαρ· θερμὸν γὰρ τὸ αἷμα. τοιάδε χρὴ καὶ τὰ ἐπιπλάσματα ἔμμεναι, ἀλήτων μὲν αἰρίνων, ἢ ἐρυσίμων, ἢ κριθῆς, καὶ λίνου σπέρματος· χυμῶν δὲ, οἴνου ὀξέος, μήλων τοῦ χυλοῦ, ἑλίκων τῆς ἀμπέλου, οἰνάνθης τῆς ὡραίης, ἢ τοῦ σὺν τῇδε λίπαος· πυρίη, σπόγγοισι καρποῦ δαφνῆς ἑψήματος, σχίνου, γλήχωνος, ἴριδος. ἐπὴν δὲ τουτέοισι πρηο̈́νῃς, σικύην προσβάλλειν μέζονα ὡς ἀμφιλαβεῖν πάντη τὸ ὑποχόνδριον, ἐντάμνειν δὲ βαθύτερα ὡς πολλὸν ἑλκύσειας αἷμα· μετεξετέροισι δὲ αἱ βδέλλαι, ἢ σχάσαι, κρέσσον. παρεισδύεται δὲ τοῦ ζῴου ἡ δῆξις· ἀτὰρ ἠδὲ μέζονας διαβρώσιας ποιέεται· τῇδε καὶ δυσεπίσχετος ἡ ἀπὸ τῶν ζῴων αἱμόρροια· κἢν ἄδην πιὸν ἐκπέσῃ τὸ θηρίον, σικύην προσβάλλειν· νέρθεν γὰρ ἕλκει τὸ νῦν. κἢν ἅλις ἔχῃ κενώσιος, ἐς μὲν τὰ τρώματα ἰσχαίμασι χρέεσθαι ἀδήκτοισι, ἀραχνίων ὑφάσμασι, μάννῃ, ἀλόῃ, ἐπιπάσσειν· ἠδὲ ἄρτῳ ἑφθῷ ξὺν πηγάνῳ ἢ μελιλώτῳ, ἀλθαίης Ῥίζῃσιν. ἐς δὲ τὴν τρίτην ἡμέρην, κήρωμα ξὺν μυροβαλάνῳ, ἢ ἀψινθίου κόμῃ καὶ ἴριδι. ἀτὰρ καὶ τὰ μαλάγμα τα τοιάδε χρὴ ἔμμεναι ὁκοῖα λεπτῦναι, ἢ ἐξαραιῶσαι, ἢ οὔρησιν τρέψαι. ἄριστον μὲν ὦν τὸ διὰ τῶν σπερμάτων, ὧν ἅπασι ἰητροῖσι ἡ πείρη εὔγνωστος. ἀγαθὸν δὲ καὶ ἔνθα ἡ σάμψυχος, ἢ τὸ μελίλωτον ἐγκέεται. τροφαὶ δὲ λεπταὶ, εὔδρομοι, οὐρήσιος προκλητικαὶ, εὐδίοδοι· χόνδροι ξὺν μελικρήτῳ, καὶ Ῥόφημα ἐκ τῶνδε ξὺν ἁλσὶ ἠδὲ ἀνήθῳ. πτισάνης δὲ χυλὸς καὶ σμηγματώδης. ἢν δὲ καὶ δαύκου τοῦ καρποῦ ἐγχέῃς τι, κρέσσον ἐς οὔρησιν. ὑπεξάγει γὰρ διὰ τῶν ὀχετῶν, οἵπερ ἀπὸ ἥπατος ἐς νεφροὺς κραίνουσι· καιρίη δὲ τοῖς ἀπὸ ἥπατος ἐκρέουσι ἡ τῇδε ἔξοδος, εὐρύτητίτε τῶν ἀγγείων καὶ ἰθύτητι τῆς ὁδοῦ. χρὴ ὦν καὶ σικύῃ τῇδε ἕλκειν ἐς τὴν χώραν προσβάλλοντα τῶν νεφρῶν κατʼ ἰσχίον ἀτὰρ καὶ τέγγειν τάδε λίπαϊ ξὺν πηγάνῳ, ἢ σχοίνῳ, ἢ καλάμῳ τῷ ἀρωματικῷ. ἐπὶ δὲ τοῖσδε ἐλπὶς τὸν νοσέοντα διαδρᾶναι τὸν ὄλεθρον. ἢν δὲ ἐς ἐμπύησιν τρέπηται, τοῖσι πυοποιοῖσι χρέεσθαι, ὁκόσα μοι ἐπὶ κωλικοῖσι λελέξεται. ἢν δὲ καὶ πῦον γένηται, ὅκως μὲν τάμνειν, ὅκως δὲ ἰητρεύειν, ἄλλῃ πηγεγράψεται· τάδε μοι καὶ ἐπὶ σπληνὶ γεγράφθω, ἤν κοτε ξυμφορὴ φλεγμασίης ὀξέης καὶ τόνδε καταλάβῃ.
7. THE inflammation of the vena cava and large artery, which extend along the spine, was called a species of Causus by those of former times. For in these cases the affections are similar: febrile heat acute and acrid, loathing of food, thirst, restlessness; a palpitating pulsation in the hypochondriac region and in the back, and the other symptoms described by me under this head. Moreover, the febrile heat tends to syncope, as in cases of causus. For, indeed, the liver is formed by the roots of the veins, and the heart is the original of the artery. You may suppose, then, that the upper portions of these viscera are subject to fatal ailments; for it is the heart which imparts heat to the artery, and the liver which conveys blood to the vein; and being both mighty parts, the inflammations, likewise, which spring from them are great. Wherefore we are to open the veins at the elbow, and abstract a considerable amount of blood; not all at once, however, but at two or three times, and on a different day, so that the strength may recruit during the interval. Then we are to apply a cupping-instrument and cataplasms to the hypochondrium, where is the pulsation of the artery; and also between the scapulæ, for there, too, there are pulsations. We are to scarify unsparingly, and abstract much blood; for from this sort of evacuation the patients are not much prone to deliquium. The bowels, also, are apt to be unusually confined, and emollient clysters are to be used to lubricate them, but not on any account acrid ones; for they suffer an increase of fever from brine and the melting of the natron. The juice, therefore, of linseed and of fenugreek, and the decoction of the roots of mallows, are sufficient to rouse and stimulate the bowels. The extremities, namely, the feet and hands, are to be warmed with gleucinum, or Sicyonian oil, or with the liniment from lemnestis; for these parts of them become very cold. And before the administration of food, we must give draughts to promote the urinary discharge, containing spignel, asarabacca, and wormwood, to which some natron in powder is to be added. But of all such medicines the strongest are cassia and cinnamon, provided one has plenty of it. In such cases, milk is both food and medicine; for they stand in need of refrigeration, a sort of fire being wrapped up within; and also of sweet food, and of that a copious supply in small bulk. Such virtues milk possesses as an article of food. Plenty of the milk of an ass which has just had a foal is to be given, and to two cupfuls of the milk one of water is to be added. That of the cow is also very good; and, thirdly, that of a goat. The articles of food should be of easy digestion; for the most part juices, such as that from the juice of the fennel; and let parsley seed be added to it, and honey. And the water which is drunk should contain these things. But we must also promote sweats, and in every way make the perspiration moist and free. Lotions to the head, as in cases of causus. An epitheme to the chest and left mamma, such as in syncope. To lie in bed with the head elevated, so that everything may be alike as in causus. Gestation to a small extent, so as to provoke sweats; a bath, also, if he be burned up within. For these affections do not pass off by crises, even though they be forms of causus.
7. τὴν τῆς κοίλης φλεβὸς φλεγμασίην καὶ παχείης ἀρτηρίης, αἳ παρὰ τὴν Ῥάχιν τέτανται, καύσου ἰδέην ἐκάλεον οἱ πρόσθεν. καὶ γὰρ καὶ καύσοισι ἴκελα πάθεα ἐπὶ τοῖσι γίγνεται· πῦρ ὀξὺ καὶ δριμὺ, ἄση, δίψος, ἀπορίη, σφυγμὸς παλμώδης ἐν ὑποχονδρίῳ ἠδὲ τοῖσι μεταφρένοισι· ἄλλα, ὁκόσα μοι ἐπὶ τοῖσι σημείοισι γεγράφαται. ἀτὰρ καὶ ἐς ξυγκοπὴν ὀκέλλει τὸ πῦρ, ὅκως ἐπὶ τῇσι καύσεσι. τῆς μὲν γὰρ φλεβὸς Ῥίζωσις ἧπαρ, τῆς δʼ ἀρτηρίης ἀρχὴ, κραδίη. δοκέοις ἂν ὦν μὲν τὰ ἄνω μέρεα τῶνδε τῶν σπλάγχνων νοσέειν τὰ καίρια. θέρμην μὲν γὰρ ἡ κραδίη ἐνδιδοῖ τῇ ἀρτηρίῃ, τῇ φλεβὶ δὲ τὸ ἧπαρ αἷμα. ἀμφοῖν δὲ μεγάλοιν μεγάλα τὰ ἔγγονα αἱ φλεγμοναί. τάμνειν ὦν αὐτίκα τὰς ἐπʼ ἀγκῶνι φλέβας· καὶ συχνὸν μὲν ἀφαιρέειν αἷμα, μὴ ἀθρόον δὲ, ἀλλὰ καὶ δὶς, καὶ τρὶς, καὶ τῆς ἄλλης ἡμέρης, ὡς μεσηγὺ ἡ δύναμις ἀναλάβῃ· ἔπειτα ἐπιπλάσμασι χρέεσθαι καὶ σικύῃ ἐς τὸ ὑποχόνδριον, ἔνθα ἡ διάσφυξις τῆς ἀρτηρίης· ἀτὰρ ἠδὲ μεσηγὺ τῶν ὠμοπλατέων. καὶ γὰρ καὶ τῇδε σφύξιες ἔασι· σχάζειν τε ἀφειδῶς, ἠδὲ πολλὸν ἀφαιρέειν αἷμα. οὐ κάρτα γὰρ ἐκ τῆς κενώσιος τῶνδε λειποθυμέουσι ὥνθρωποι· ἰσχομένη δὲ καὶ γαστὴρ πολλόν τι τοῦ ξυνήθεος· κλυσμοῖσι ἐς ὄλισθον χρέεσθαι μαλθακοῖσι, δριμέσι δὲ ἥκιστα· ἐπιπυρεταίν ουσι γὰρ οἵδε ἅλμῃ καὶ νίτρου τήξι. λίνου ὦν καρποῦ χυλὸς ἔστω, καὶ τήλιος καὶ μαλάχης τῶν Ῥιζῶν ἕψημα, καὶ ἐς πρόκλησιν καὶ δῆξιν ἱκανόν· μέληἄκρεα, πόδες καὶ χεῖρες, τεθάλφθωσανγλευκίνῳ, ἢ σικυωνίῳ λίπαϊ, ἢ τῷ διὰ τῆς λιμνήστιδος χρίσματι. κάρτα γὰρ ψυχρὰ αὐτῶν τάδε γίγνεται. πιπίσκειν τε πρὸ τῶν σιτίων ὁκόσα οὖρον ἐξάγει, μῆον, ἄσαρον, ἀψίνθιον· ἐμπασσέσθω δὲ καὶ λίτρου· πάντων δὲ κράτιστον κασσίη καὶ κιννάμωμον, ἤν τις εὐπορῇ· γάλα τοῖσδε καὶ τροφὴ καὶ φάρμακον. ἐμψύξιος γὰρ δέονται, ἔνδον ὁκοῖόν τι πυρὸς εἰλευμένου· καὶ τροφῆς γλυκείης, ἀτὰρ ἠδʼ ἐν ὀλίγῳ ὄγκῳ πολλῆς. τάσδε μέντοι ἐν τροφῇ τὰς ἀρετὰς ἴσχει τὸ γάλα· εὐπορείσθω δὲ νεοτόκου, καὶ ἐς δύο κυάθους τοῦ γάλακτος ἐμβεβλήσθω εἷς ὕδατος· ἄριστον δὲ καὶ τὸ τῆς βοός· τρίτον δὲ αἰγός· τροφαὶ εὔπεπτοι, τὰ πολλὰ χυλοὶ μαράθρου Ῥίζης, καὶ σελίνου καρπὸς ἐμβεβλήσθω καὶ μέλι· τὸ ὕδωρ δὲ τὸ πινόμενον ἐχέτω τάδε. ἀτὰρ καὶ ἱδρῶτας χρὴ κινέειν, καὶ πάντα διαπνοὰς ὑγρὰς καὶ εὐρόους ποιέειν. τέγξις κεφαλῆς ὁκοῖον ἡ ἐν καύσοισι· ἐπίθημα ἐς θώρηκα καὶ μαζὸν ἀριστερὸν ὁκοῖον ἐν συγκοπῇ· κοίτη, κατάκλισις ὄρθιος, ὅκως ἴκελα πάντα τοῖσι ἐν καύσοισι ᾖ· αἰώρη σμικρὴ ἐς ἱδρώτων πρόκλησιν· ἠδὲ λουτρὸν, ἢν οὗτος ὑπεκκαυθῇ. οὐ γὰρ κρίσεσι τάδε τὰ πάθεα λύεται, εἰ καὶ καύσου ἔασι ἰδέαι.
8. INFLAMMATION in the kidneys is of an acute nature; for the veins passing from the liver to the kidneys are inflamed at the same time, and with these the liver; for these veins are not very long, but are very broad, so as to give the kidneys the appearance of being suspended near the liver. But suppression of urine takes place along with the inflammation, thereby contributing to the intensity of the inflammation; for the cavity of the kidneys is filled by the overflow of the urine which fails to escape. The same happens also with stones, provided one larger than the breadth of the ureters be formed in the kidneys: it then becomes seated there, and, not passing through, it occasions a stoppage of the urine. But we will treat of the formation of calculi among the chronic diseases; how they may either be prevented from forming, or how they may be broken when formed. With regard to heat and obstruction, such of these affections as prove quickly fatal will be described by me in this place. Whether it be impaction of stones, or whether it be inflammation, we must open the vein at the elbow, unless a particular period of life prove an obstacle, and blood must be taken in a full stream and in large quantity. For not only are inflammations alleviated by evacuation, but also impacted stones are slackened by the evacuation of the vessels, and thus the stones escape during the passing of the urine. Then the parts are to be relaxed by bathing them with oil of must or of privet, and by fomentations and cataplasms. The herb southernwood, the schœnus, and calamus aromaticus, should form the ingredients of the cataplasms. Then we are to apply the cupping-instrument over the kidneys, in the loins, more especially if the evacuation from this place has been of service. The bowels are to be softened by lubricating clysters, rather of a viscid than of an acrid nature, such as the juiees either of mallows or of fenugreek. Sometimes, also, diuretic medicines are to be given before food, such as are described respecting the liver, and also similar food of easy digestion: for in such cases indigestion is bad. Milk is a most excellent article, especially that of an ass; next, of a mare; even that of an ewe or a goat is useful, as being a kind of milk. If, then, they be free of fever, it is better also to prescribe the bath; but if not, they are to be placed in a sitz-bath formed of the decoction of herbs, filling the vessel up to their navel. But if it be turned to suppuration, what cataplasms and other medicines we are to use have formerly been laid down by us on many occasions. But, if the stone stick, we are to use the same fomentations and cataplasms, and try to break the stones with medicines taken in the form of drink. The simples are the herbs waterparsnip and prionitis, boiled with oil or edible vinegar, and the juice of it taken for drink: the compound ones are, that named from Vestinus, that from vipers and the reptile the skink, and such as from experience appear to be best. Gestation and succussion are calculated to promote the movement and protrusion of the calculi; for the passage of calculi into the bladder is very painful. But if the stones drop out, the patients become free from pain, which they have not been accustomed to be, not even in their dreams; and, as if escaped from inevitable evils, they feel relieved both in mind and in body.
8. κάτοξυ μὲν ἐν νεφροῖσι φλεγμασίη· συμφλεγ μαίνουσι γὰρ ἀπὸ ἥπατος ἐς νεφροὺς κραίνουσαι φλέβες· τῇσι δὲ τὸ ἧπαρ· οὐ κάρτα ἐπιμήκεες ἐοῦσαι, κάρτα δὲ εὐρεῖαι, ὡς δοκέειν τοὺς νεφροὺς ἐξηρτῆσθαι ἀγχοῦ τοῦ ἥπατος· ἀτὰρ καὶ ἰσχουρίη ἐπὶ φλεγμασίῃ γίνεται ξυντιμωρέουσα τῷ ὀξέϊ τῆς φλεγμασίης· πίμπλαται γὰρ ἡ τῶν νεφρῶν κοιλίη ὑπὸ πλημμυρίης τῶν οὔρων οὐ διεκθεόντων· τόδε μέντοι καὶ ἐπὶ λίθων γίγνεται, ἢν φύῃ μὲν ἐν νεφροῖσι μέζων τῆς εὐρύτητος τῶν οὐρητήρων· ἐνίζει μὲν μὴ διεξιὼν, ἀτὰρ καὶ τὰ οὖρα ὅδε ἐπίσχει. ἀλλὰ ἀμφὶ μὲν τῆς γενέσιος τῶν λίθων ἐν τοῖσι χρονίοισι λελέξεται, ὅκως ἢ μὴ ξυνήσωνται, ἢ θρύπτωνται γιγνόμενοι. ἀμφὶ θερμασίης, ἠδʼ ἐμφράξιος ὁκόσα ὀξέως κτείνει, τῇδέ μοι γεγράψεται. ἢν ἐνστάσιες λίθων ἔωσι, ἤν τε φλεγμασίη, τάμνειν φλέβα τὴν ἐπʼ ἀγκῶνι, ἢν μὴ κωλύῃ τις ἡλικίη· εὔροον δὲ καὶ πολλὸν ἔστω τὸ αἷμα. οὐ γὰρ αἱ φλεγμοναὶ πρηο̈́νονται μοῦνον κενώσι· ἀλλὰ καὶ σφηνώσιες τῶν λίθων χαλῶνται τῇσι τῶν ἀγγείων κενώσεσι. ἀτὰρ ἠδὲ ἐν οὐρήσι διεκθέουσι οἱ λίθοι. ἔπειτα τέγξεσι γλευκίνου λίπαος, ἢ κυπρίνου, καὶ πυρίῃσι, καὶ ἐπιπλάσμασι ἀνίεται τὰ μέρεα. ἀρτεμισίη δʼ ἔστω ἡ βοτάνη, καὶ σχοῖνος, καὶ κάλαμος ὁ εὐώδης ἐν τοῖς καταπλάσμασι· ἔπειτα σικύην προσβάλλειν ἐς νεφροὺς κατʼ ἰσχίον, μάλιστα δʼ ἂν ἡ ἀπὸ τοῦδε τοῦ χωρίου κένωσις ὤνησε· λελαπάχθω δὲ κοιλίη κλυσμοῖσι ὀλισθηροῖσι, γλίσχροισι μᾶλλον ἢ δριμέσι, μαλάχης ἢ τήλιος χυλοῖσι· κοτὲ δὲ φάρμακα πρὸ τῶν σιτίων οὐρητικὰ, ὁκοῖα ἐπὶ ἥπατος λέλεκται· ἀτὰρ καὶ σιτία ἴκελα, εὔπεπτα. κακὸν γὰρ τουτέοισι ἀπεψίη. ἄριστον δὲ γάλα, μάλιστα μὲν ὄνου, ἵππου δὲ δεύτερον καὶ ὄϊος δὲ καὶ αἰγὸς χρήσιμον, ὅτι γάλα. ἢν μὲν οὖν ἄπυροι ἔωσι, καὶ λούειν κρέσσον· ἢν δὲ μὴ, ἐς ἕψημα τῶν βοτανῶν ἐνίζεσθαι, ἄχρις ὀμφαλοῦ τὸ ἄγγος πληροῦντα· ἢν δὲ ἐς πῦον τρέπηται, ὁκοίοισι χρὴ ἐπιπλάσμασι ἠδὲ φαρμάκοισι χρέεσθαι, ἐπὶ πολλοῖσι μὲν καὶ πρόσθεν ὑποκέεται. ἢν δὲ ἐνστήκῃ λίθος, πυρίῃσι μὲν καὶ ἐπιπλάσμασι τοῖσι αὐτέοισι χρέεσθαι. θρύπτειν δὲ τοὺς λίθους τοῖσι πινομένοισι φαρμάκοισι· ἁπλαῖ μὲν, σίον καὶ πριονίτης αἱ βοτάναι, ἑφθαὶ ξὺν ἐλαίῳ, ἢ ὄξεϊ ἐδωδίμῳ καὶ τῶνδε χυλὸς προπινόμενος· ποικίλα δὲ ἡ Βηστίνου καλευμένη καὶ ἡ διʼ ἐχιδνῶν καὶ σκίγκου τοῦ θηρίου, ὁκόσα τε δοκέουσι ἔμμεναι τῇ πείρῃ κράτιστα· αἰῶραι τοῖσδε καὶ σείσιες ἐς κίνησιν καὶ πρόωσιν τῶν λίθων. κάρτα γὰρ ἐπίπονος τῶν λίθων ἡ ἐς τὴν κύστιν ὁδοιπορίη. ἢν δὲ ἐκπέσωσι ἔνθεν, ἄπονοί τε γίγνονται, οὐδʼ ὄναρ ἀπηλλάχθαι δοκέειν τοῦ πόνου εἰθισμένοι· ἀτὰρ καὶ ὡς ἐξ ἀφύκτων κακῶν τὴν ψυχὴν καὶ τὰ μέλεα λύονται.
9. ACUTE affections, resembling those of the kidneys, form also in the bladder; namely, inflammations, ulcerations, calculi, and the obstructions from clots, and, along with these, suppression of urine and strangury. But in this part the pain is more acute, and death most speedy; for the bladder is a broad nerve, whereas the kidneys are like a concretion of blood, of the same species as the liver. But, moreover, the sufferings are most dreadful and most lamentable: for there, by far, On wretched men most cruel pains inflicts the god of war. We must, therefore, straightway make an incision in the flanks, and soothe the bladder by means of a fomentation of much oil, with rue and dill. But if grumous blood be the cause of the pains and stoppage of the urine, we are to give oxymel to drink, or a little quantity of lime with honeyedwater for the solution of the clots, and also such other things, both herbs and seeds, as promote the secretion of urine. But if there be danger from hemorrhage, it is to be stopped without delay, more than in the other cases; for the danger from it is not small. We must remedy it by the medicines which stop bleeding. In this case refrigeration of the bladder is beneficial; bathing with rose-oil and wine, and wrapping the parts in cloths made of unwashed wool. An epitheme may be formed with dates soaked in wine, with pomegranate or the juice of sumach. But if the patient is averse to the weight of the epithemes and the great cooling, they must both be given up; for we must not cool greatly a part naturally thin and cold like the bladder. But we are to anoint the parts with oil of must, or acacia, or hypocistis with wine. But we must not use sponges, unless the hemorrhage be very urgent. The food should be farinaceous, of easy digestion, wholesome, diuretic, such as have been described by me under the head of the kidneys; milk, sweet wine, the Theræan and Scybelitic. Medicines should be drunk which are diuretic, fragrant, and diffusible, and other such things. A very excellent thing for the bladder is cicadœ; roasted, in season, as an article of food; and out of season, when dried and triturated with water. Let also a little of the root of nard be boiled up with the cicadœ. The same things may be used for preparing a bath to sit in for relaxation of the bladder. But, if it be the impaction of calculi which stops the urine, we must push away the calculus and draw off the urine, with the instrument, the catheter, unless there be inflammations; for, in inflammations, neither do the passages well admit the instrument, and in addition they are hurt by the catheter. But if this treatment be inadmissible, and the patient is nearly killed with the sufferings, we must make an incision in the part under the glans penis, and the neck of the bladder, in order to procure an outlet for the stone and the expulsion of the urine. And we must particularly endeavour to cure the part by bringing the wound to cicatrization. But if not, it is better that the patient should have a flux of urine for the remainder of his life, than that he should die most miserably of the pain.
9. καὶ τῇ κύστι πάθεα ὀξέα ἴκελα τοῖσι νεφροῖσι γίγνεται, φλεγμον αὶ καὶ ἕλκεα καὶ λίθοι καὶ θρόμβων ἐμφράξιες, ἐφʼ οἷσι ἰσχουρίη, στραγγουρίη· ἀλλὰ ὀξύτερος τῇδε ὁ πόνος καὶ ὄλεθρος ὤκιστος· νεῦρον γὰρ πλατὺ ἡ κύστις. νεφροὶ δὲ, ὁκοῖον αἱμάλωψ, τῆς ἥπατος ἔασι ἰδέης· ἀλλὰ καὶ αἰνότατοι καὶ οἴκτιστοι, ἔνθα μάλιστα γίγνετʼ Ἄρης ἀλεγεινὸς ὀϊζυροῖσι βροτοῖσι. τάμνειν ὦν αὐτίκα τὸν κενεῶνα, καταιον εῖν δὲ τὴν κύστιν λίπαϊ συχνῷ ξὺν πηγάνῳ καὶ ἀνήθῳ. ἢν δὲ θρόμβοι ἔωσι τοῦ πόνου καὶ τῆς ἰσχουρίης αἴτιοι, ὀξύμελι πιπίσκειν, ἢ τιτάνου μικρὸν ξὺν μελικρήτῳ, ἐς τὴν διάλυσιν τῶν θρόμβων, ἠδὲ ὁκόσα οὐρήσιας προκαλέεται, καὶ βοτάνας, καὶ σπέρματα· ἢν δὲ ἐξ αἱμορραγίης ὁ κίνδυνος, ἴσχειν μὲν οὐκ εἰς ἀμβολὴν τῶνδε μᾶλλον· ἀτὰρ καὶ ὅδε οὐχ ἥκιστα ὁ κίνδυνος. ἀρήγειν μὲν ὦν καὶ τοῖσι αἷμα ἐπέχουσι. ἀρήγει δὲ ἡ ψῦξις τῆς κύστιος· Ῥοδίνου καὶ οἴνου τέγξις, καὶ εἰρίων κατείλησις ἀπὸ οἰσύπου. ἐπίθημα, φοίνικες ἐν οἴνῳ δευθέντες ξὺν Ῥοιῇ, ἢ χυλῷ τοῦ Ῥοός· ἢν δὲ ἐκτρέπηται καὶ τῶν ἐπιθημάτων τὰ βάρεα, καὶ τὰς μεγάλας ψύξιας ἐκτρέπειν· χρὴ γὰρ μὴ κάρτα ψύχειν ψυχρήν τε φύσι καὶ λεπτὴν ἐοῦσαν τὴν κύστιν· καταχρίειν δὲ γλευκίνῳ, ἢ ἀκακίῃ, ἢ ὑποκιστίδι, ξὺν οἴνῳ. σπόγγοισι δὲ, ἢν μὴ σφόδρα ἐπείγῃ ἡ αἱμορραγίη, μὴ χρέεσθαι. τροφαὶ σιτώδεες, εὔπεπτοι, εὔχυμοι, οὐρητικαὶ, ὁκοῖαί μοι ἐπὶ νεφροῖσι λελέχαται· γάλα, οἶνος γλυκὺς, Θηραιὸς ἢ Σκυβαλίτης. φάρμακα πινόμενα, οὐρητικὰ, εὐώδεα, εὔροα· καὶ τἄλλα τὰ τοιαῦτα· ἄριστον δὲ κύστιτέττιγες, ἐφʼ ὥρας μὲν ὁπτοὶ, ἔδεσμα· ἔξωροι δὲ ξηροὶ, λεῖοι, ξὺν ὕδατι. ἔστω δὲ καὶ τῆς Ῥίζης τῆς νάρδου βραχὺ ξὺν τοῖσι τέττιξι ἀφεψηθεῖσι. τοῖσι αὐτέοισι ἐνίζεσθαι ἀντὶ λουτροῦ ἐς ἄνεσιν τῆς κύστιος. ἢν δὲ λίθων ἔμφραξις ἐπίσχῃ τὴν οὔρησιν, τῷ ὀργάνῳ τῷ καθετηρίῳ ὠθεῖν τὸν λίθον ἠδὲ ἄγειν τὸ οὖρον, ἢν μὴ ἔωσι φλεγμοναί. ἐπὶ γὰρ φλεγμονῇσι οὔτε ὁ πόρος δέχεται τὸ ὄργανον, πρὸς δὲ τιτρώσκονται τῷ καθετῆρι. ἢν δὲ ἄπορος μὲν ᾖ ἡ τῶνδε ἰητρείη, θνήσκῃ δὲ ὀδύνῃσι ὥνθρωπος τάμνειν τὴν πλιχάδα καὶ τὸν τῆς κυστίδος τράχηλον, ἔς τε τὴν τῶν λίθων ἔκπτωσιν καὶ τὴν τῶν οὔρων ἔκχυσιν. καὶ μάλιστα μὲν ἀκέσασθαι ἐς ὠτειλὴν ἄγοντα τὸ τρῶμα· ἢν δὲ μὴ, Ῥυάδα γενέσθαι τοῦ οὔρου βέλτιον ἐς τὸν αὖθις τοῦ ἀνθρώπου βίον, ἢ τῇ ὀδύνῃ οἰκτίστως θανεῖν.
10. THE uterus in women has membranes extended on both sides at the flanks, and also is subject to the affections of an animal in smelling; for it follows after fragrant things as if for pleasure, and flees from fetid and disagreeable things as if for dislike. If, therefore, anything annoy it from above, it protrudes even beyond the genital organs. But if any of these things be applied to the os, it retreats backwards and upwards. Sometimes it will go to this side or to that,—to the spleen and liver, while the membranes yield to the distension and contraction like the sails of a ship. It suffers in this way also from inflammation; and it protrudes more than usual in this affection and in the swelling of its neck; for inflammation of the fundus inclines upwards; but if downwards to the feet, it protrudes externally, a troublesome, painful and unseemly complaint, rendering it difficult to walk, to lie on the side or on the back, unless the woman suffer from inflammation of the feet. But if it mount upwards, it very speedily suffocates the woman, and stops the respiration as if with a cord, before she feels pain, or can scream aloud, or can call upon the spectators, for in many cases the respiration is first stopped, and in others the speech. It is proper, then, in these cases, to call the physician quickly before the patient die. Should you fortunately arrive in time and ascertain that it is inflammation, you must open a vein, especially the one at the ankle, and pursue the other means which prove remedial in suffocation without inflammation: ligatures of the hands and feet so tight as to induce torpor; smelling to fetid substances—liquid pitch, hairs and wool burnt, the extinguished flame of a lamp, and castor, since, in addition to its bad smell, it warms the congealed nerves. Old urine greatly rouses the sense of one in a death-like state, and drives the uterus downwards. Wherefore we must apply fragrant things on pessaries to the region of the uterus—any ointment of a mild nature, and not pungent to the touch, nard, or Ægyptian bacchar, or the medicine from the leaves of the malabathrum, the Indian tree, or cinnamon pounded with any of the fragrant oils. These articles are to be rubbed into the female parts. And also an injection of these things is to be thrown into the uterus. The anus is to be rubbed with applications which dispel flatus; and injections of things not acrid, but softening, viscid, and lubricant, are to be given for the expulsion of the fæces solely, so that the region of the uterus may be emptied,—with the juice of marsh-mallow, or of fenugreek, but let melilot or marjoram be boiled along with the oil. But, if the uterus stands in need of support rather than evacuation, the abdomen is to be compressed by the hands of a strong woman, or of an expert man, binding it round also with a roller, when you have replaced the part, so that it may not ascend upwards again. Having produced sneezing, you must compress the nostrils; for by the sneezing and straining, in certain cases, the uterus has returned to its place. We are to blow into the nostrils also some of the root of soapwort, or of pepper, or of castor. We are also to apply the instrument for dry-cupping to the thighs, loins, the ischiatic regions, and groins, in order to attract the uterus. And, moreover, we are to apply it to the spine, and between the scapulæ, in order to relieve the sense of suffocation. But if the feeling of suffocation be connected with inflammation, we may also scarify the vein leading along the pubes, and abstract plenty of blood. Friction of the countenance, plucking of the hair, with bawling aloud, in order to arouse. Should the patient partially recover, she is to be seated in a decoction of aromatics, and fumigated from below with fragrant perfumes. Also before a meal, she is to drink of castor, and a little quantity of the hiera with the castor. And if relieved, she is to bathe, and at the proper season is to return to her accustomed habits; and we must look to the woman that her menstrual discharges flow freely.
10. Ἡ ὑστέρη τῇσι γυναιξὶ ὑμένων ἀποτάσιας ἔνθα καὶ ἔνθα κατὰ λαγόνας ἴσχει, ἀτὰρ ἠδὲ ζῴου πάθη ἐν ὀσφρήσι· ἴεται γὰρ ἐπὶ τοῖσι εὐώδεσι πρὸς ἡδονὴν, καὶ τὰ κάκοσμα καὶ ἀτερπέα ὑπὸ ἀχθηδόνος φεύγει. ἢν μὲν ὦν τῶν ἄνω τι λυπῇ, πρόεισι γυναικηΐων ἔξω. ὧν δὲ κατὰ στόματι ἂν εἴη, ὀπίσω χάζεται ἠδὲ ἄνω· ἴῃ δʼ ἄν ποτε καὶ ἔνθα καὶ ἔνθα ποτὶ σπλῆνα καὶ ἧπαρ· ξυνδιδοῖ δὲ τὰ ὑμένια ἐς ἀπόστασιν καὶ ξυναγωγὴν, ὅκως νηὸς λαίφεα. πάσχει δὲ τάδε καὶ ὑπὸ φλεγμασίης. καὶ γὰρ προπετεστέρη τῷ πάθεϊ καὶ τῷ ὄγκῳ τοῦ αὐχένος γίγνεται· ἡ γὰρ κατὰ πυθμένα φλεγμασίη ἄνω Ῥέπει, ἢν μὲν ἐς πόδας, ἔξω. ἀσηρὸν μὲν ὦν καὶ ἀλεγεινον, καὶ ἀτερπές· δύσχρηστον δὲ καὶ βαδίσαι, καὶ ἐς πλευρὰν κατακέεσθαι, καὶ ὑπτίην, ἢν μὴ τὼ πόδε φλεγμήνῃ ἡ γυνή· ἢν δὲ ἄνω φοιτοίη, ὡς ὀξύτατα μὲν τὴν ἄνθρωπον ἀπέπνιξε, πιέζει δʼ ἀγχόνῃ τῆς ἀναπνοῆς. οὐδὲ γὰρ οὐδὲ φθάνει πονέειν τε καὶ βοᾶν, καὶ τοὺς παρόντας κικλήσκειν ἀρωγούς. τῇσι γὰρ ἀναπνοῆς ἐπίσχεσις θᾶττον πολλῇσι, τῇσι δὲ φωνῆς. εἰκὸς ἂν ὦν τοῖς ἐν τουτέοισι καλέσαι τὸν ἰητρὸν, πρὶν τὴν ἄνθρωπον θανεῖν. ἀλλʼ ἤν κοτε ἐκ συντυχίης ἥκῃς, γνόντα τὴν φλεγμονὴν, σχάσαι φλέβα, μάλιστα μὲν τὴν ἐπὶ τῷ σφυρῷ. ἢν δὲ μὴ εὔροον ἔῃ, τὴν ἐπʼ ἀγκῶνι· ἐπαφαιρέειν δὲ ἀπὸ τοῦ σφυροῦ. πρήσσειν δὲ τὰ ἄλλα, ὁκόσα ἂν καὶ ἄνευ φλεγμασίης ἀρήγῃ πνιγί. δεσμοὶ χειρῶν καὶ ποδῶν, σφίγγοντες ἄχρι ναρκώσιος· ὀσμὴ κακωδέων, πίσσης ὑγρῆς, τριχῶν, εἰρίου κεκαυμένων· λύχνου φλογὸς ἐσβεσμένης, καστορίου, πρὸς τῷ κακώδει καὶ τὰ νεῦρα ψυχθέντα θάλπειν. οὖρον παλαιὸν καὶ τὴν αἴσθησιν ἐξανίστησι κάρτα τοῦ νεκρώδεος, καὶ τὴν ὑστέρην κάτω διώκει. τοιγαρῶν καὶ τοῖσι προσθέτοισι εὐώδεα ἐς τὴν χώρην ἐπιβλητέον τῆς ὑστέρης· μύρον ὁκοῖον ἂν ἔῃ προσηνὲς, ἠδὲ ἄδηκτον τὴν ἁφὴν, νάρδον, ἢ βάκχαρι τὸ Αἰγύπτιον· ἢ τὸ διὰ τῶν φύλλων τοῦ μαλαβάθρου, τοῦ δένδρεος τοῦ Ἰνδικοῦ, ἢ κιννάμωμον κοπὲν ξὺν τῶν εὐόσμων τινὶ λίπαϊ· ἐγχρίειν δὲ τάδε τοῖσι γυναικηΐοισι χώροισι. ἀτὰρ ἠδὲ ἔγχυτον ἐκ τῶνδε ἐγχεῖν τῇ ὑστέρῃ· διαχρίειν δὲ καὶ τὴν ἕδρην φυσέων ἀγωγοῖς· ἠδὲ ὑποκλύζειν μὴ δριμέσι, μαλθακοῖσι, γλίσχροισι, ὀλισθηροῖσι, ἐς τὴν τῶν κοπρίων ἔξοδον μοῦνον, ὅκως ἡ χώρη τῆς ὑστέρης λαπαρὴ γίγνηται· ἀλθαίης χυλῷ, ἢ τήλιος· μελίλωτον δὲ ἢ σάμψυχον ξὺν τῷ λίπαϊ ἑψείσθω· ἢν δὲ βίης ἢ λαπάξιος ἡ ὑστέρη δέηται, χείρεσι μὲν πιέζειν τὸ ὑποχόνδριον γυναικὸς εὐτόνου, ἢ ἀνδρὸς εὐαφοῦς, καὶ διαζῶσαι ταινίαις σφίγγοντα, ὁκόταν διελάσῃ τὸν χῶρον, ὡς μὴ αὖθις ἄνω θέειν· πταρμοὺς ποιέοντα ἐπιλαμβάνειν τὰς Ῥῖνας· τῷ γὰρ πταρμῷ καὶ τῇ ἐντάσι μετεξετέρῃσι ἡ ὑστέρη ἐς χώρηνϊξε· ἐμφυσῆν δὲ ἐς Ῥῖνας οἷά γε στρουθίου Ῥίζης, ἢ πεπέρεος, ἢ τοῦ κάστορος· προσβάλλειν δὲ σικύας κούφας μηροῖσι, λαγόσι, ἰσχίοισι, βουβῶσι, ἕλκοντα τὴν ὑστέρην· προσβάλλειν δὲ καὶ πρὸς Ῥάχιν, ἐς τὸ μεσηγὺ τῶν ὠμοπλατέων, τῇ πνιγὶ ἀρήγοντα· ἢν δὲ ὲπὶ φλεγμονῇ πνίγηται, καὶ διασχάσαι τὴν ἐπὶ τῷ κτενὶ οἰχευμένην φλέβα καὶ ἀφαιρέειν συχνὸν αἷμα. ἀνατρίψιες τοῦ προσώπου, τιλμοὶ τριχῶν, ξὺν ἐμβοήσι ἐς ἀνάκλησιν· ἢν δὲ καὶ μικρὸν ἐπανενέγκωσι, ἐς ἀφέψημα ἀρωμάτων ἐνίζειν, καὶ εὐώδεα θυητὰ ὑποθυμιῆν· πιπίσκειν δὲ πρὸ τῶν σιτίων τοῦ κάστορος, καὶ τῆς ἱερῆς μικρὸν ξὺν τῷ κάστορι· καὶ ἢν ἐπανενέγκῃ, λούειν· καὶ ἐς ὥρην ἐς τὰ ξυνήθεα τρέπειν· μελεδαίνειν δὲ τὴν ἄνθρωπον, ὅκως ἄγηται τὰ ἐπιμήνια εὔροα.
11. INFLAMMATION of the nerves in the genital organs occasions erection of the member with desire and pain in re venerea: there arise spasmodic strainings which at no time abate, since the calamity is not soothed by the coition. They also become maddened in understanding, at first as regards shamelessness in the open performance of the act; for the inability to refrain renders them impudent; but afterwards........ when they have recovered, their understanding becomes quite settled. For all these causes, we must open the vein at the elbow, and also the one at the ankle, and abstract blood in large quantity and frequently, for now it is not unseasonable to induce deliquium animi, so as to bring on torpor of the understanding and remission of the inflammation, and also mitigation of the heat about the member; for it is much blood which strongly enkindles the heat and audacity; it is the pabulum of the inflammation, and the fuel of the disorder of the understanding, and of the confusion. The whole body is to be purged with the medicine, the hiera; for the patients not only require purging, but also a gentle medication, both which objects are accomplished by the hiera. The genital organs, the loins, the perineum and the testicles, are to be wrapped in unwashed wool; but the wool must be moistened with rose-oil and wine, and the parts bathed, so much the more that no heating may be produced by the wool, but that the innate heat may be mitigated by the cooling powers of the fluids. Cataplasms of a like kind are to be applied; bread with the juice of plantain, strychnos, endive, the leaves of the poppy, and the other narcotics and refrigerants. Also the genital organs, perineum, and ischiatic region, are to be rubbed with similar things, such as cicuta with water, or wine, or vinegar; mandragora, and acacia; and sponges are to be used instead of wool. In the interval we are to open the bowels with a decoction of mallows, oil, and honey. But everything acrid...... Cupping-instruments are to be fixed to the ischiatic region, or the abdomen; leeches also are very good for attracting blood from the inner parts, and to their bites a a cataplasm made of crumbs of bread with marsh-mallows. Then the patient is to have a sitz bath medicated with worm-wood, and the decoction of sage, and of flea-bane. But when the affection is protracted for a considerable time without any corresponding intermission, there is danger of a convulsion (for in this affection the patients are liable to convulsions), we must change the system of treatment to calefacients, there is need of oil of must or of Sicyonian oil instead of oil of roses, along with clean wool and warming cataplasms, for such treatment then soothes the inflammations of the nerves,—and we must also give castor with honeyed-water in a draught. Food containing little nourishment, in a cold state, in small quantity, and such as is farinaceous; mostly pot-herbs, the mallow, the blite, the lettuce, boiled gourd, boiled cucumber, ripe pompion. Wine and fleshes to be used sparingly until convalescence have made considerable progress; for wine imparts warmth to the nerves, soothes the soul, recalls pleasure, engenders semen, and provokes to venery. Thus far have I written respecting the cures of acute diseases. One must also be fertile in expedients, and not require to apply his mind entirely to the writings of others. Acute diseases are thus treated of, so that you may avail yourself of what has been written of them, in their order, either singly or all together.
11. τῶν ἐν τοῖς αἰδοίοισι νεύρων ἡ φλεγμασίη ὄρθιον ἀνίσχει τὸ αἰδοῖον, ξὺν ἐπιθυμίῃ καὶ λύπῃ ἀφροδισίων ἔργων πρήξιος. ἐντάσιες δὲ γεννῶνται σπασμώδεες, οὐδαμᾶ πρηϋνόμεναι· ἀλλὰ καὶ ἐπὶ τοῖσι ἀφροδισίοισι ἀμάλθακτος ἡ ξυμφορή. προσεκμαίνονται δὲ καὶ τὴν γνώμην, τὰ πρῶτα μὲν ἐς ἀναισχυντίην, ἐπὶ παρρησίῃ τοῦ πράγματος. θαρσέας γάρ σφεας ποιέει ἡ ἀκυρίη τῆς ξυνουσίης· μετέπειτα δὲ, … ἐπάν ἀναλωφήσωσι, εὖτʼ ἄν σφισι ἡ γνώμη τέλεον μίμνῃ. πάντων ὦν εἵνεκα τάμνειν φλέβα τὴν ἐπʼ ἀγκῶνι, καὶ τὴν ἐπὶ τῷ σφυρῷ. καὶ πολλὸν ἀφαιρέειν καὶ πολλάκις. οὐδὲ γὰρ ἄκαιρον νῦν λειποθυμίην ἐμποιέειν, ἔς τε νάρκην τῆς γνώμης, καὶ ἐς τὰς τῆς φλεγμασίης ξυνδόσιας, καὶ ἐς τὰς τοῦ θερμοῦ τοῦ κατʼ αἰδοῖον πρηο̈́νσιας. αἷμα γὰρ πολλὸν θερμασίης μὲν καὶ τόλμης ἔξαψις καρτερή· φλεγμασίης δὲ τροφὴ, ταράχου δὲ γνώμης καὶ ἀταξίης ἔκκαυμα· καθαίρειν δὲ καὶ τὸ ξύμπαν σκῆνος φαρμάκῳ τῇ ἱερῇ· οὐ γὰρ καθάρσιος δέονται μοῦνον, ἀλλὰ καὶ φαρμακίης προσηνέος. δρῆν μέντοι τάδε ἄμφω ἱερὴ δύναται· κατειλίσσειν δὲ τὰ τε αἰδοῖα καὶ τὰς ἰξύας καὶ τὴν πλιχάδα καὶ τοὺς ὄρχιας ἐρίοισι τοῖσι ἀπὸ ὄϊος Ῥυπῶσι· Ῥοδίνῳ δὲ καὶ οἴνῳ διῆναι χρὴ τὰ ἔρια, καὶ τέγγειν τὰ μέρεα, πολλόντι μᾶλλον τάδε καταιον οῦν τα, ὅκως μήτε θάλψις ἐκ τῶν ἐρίων ἔοι, ἀτὰρ ἡ ἔμφυτος θέρμη ὑπὸ ψυχρῆς δυνάμιος τῶν χυμῶν πρηο̈́νηται. τοιάδε χρὴ καὶ τὰ ἐπιπλάσμα τα τιθέναι· ἄρτον ξὺν ἀρνογλώσσου χυλῷ καὶ στρύχνῳ, καὶ σέριδι, καὶ φύλλοισι μήκωνος καὶ τοῖσι ἄλλοισι, ὅσα νάρκην καὶ ψύξιας ἐμποιέει. ἀτὰρ καταχρίειν τοῖσι ἰκέλοισι τὰ αἰδοῖα καὶ τὴν πλιχάδα καὶ τὰ ἰσχία, κωνείῳ, ξὺν ὕδατι, ἢ οἴνῳ, ἢ ὄξεϊ· μανδραγορίῃ, ἀκακίῃ· καὶ σπόγγοισι ἀντὶ τῶν εἰρίων χρέεσθαι. μεσηγὺ δὲ ὑποκλύζειν μαλάχης ἑψήματι, καὶ ἐλαίῳ, καὶ μέλιτι. δριμὺ δὲ πᾶν … ἀντερείσθωσαν σικύαι κατʼ ἰσχίου, ἢ ἤτρου. ἄρισται δὲ καὶ βδέλλαινέρθεν ἑλκύσαι αἷμα· καὶ ἐπὶ τοῖσι τρώμασι ἐπίπλασμα, αἱ ψίχες ξὺν ἀλθαίῃ· ἔπειτα ἐνίζειν ὕδατι ἀρτεμισίης, ἐλελισφάκου, κονύζης ἑψήματι· καὶ εὖτʼ ἂν προσωτέρω μὲν ἥκῃ χρόνου, μὴ κατὰ λόγον δὲ τὸ πάθος ἐνδιδῷ, δέος δὲ σπασμοῦ· (μάλα γάρ τοι ἐπὶ τῷδε σπῶνται)· μεταβάλλειν χρὴ τὴν θεραπείην τοῖσι θερμαίνουσι· χρέος μὲν γλευκίνου, ἢ σικυωνίου ἀντὶ Ῥοδίνου σὺν εἰρίοισι δὲ καθαροῖσι καὶ ἐπιπλάσμασι ἀλεαίνουσι. ἐμάλαξε γάρ κοτε τῶν νεύρων τὰς πρήσιας ἡ τοιήδε θεραπείη. ἀτὰρ καὶ πιπίσκειν τοῦ κάστορος ξὺν μελικρή τῳ. τροφαὶ ἄτροφοι, ψυχραὶ, βραχέα μὲν τὰ σιτώδη· τὰ πλεῖστα, λάχανα, μαλάχη, βλίτον, θριδακίνη, ἑψητὴ κολοκύν τη, σίκυος ἑφθὸς, πεπέων ὡραῖος· οἴνου δὲ, καὶ κρειῶν, μέσφι πολλῆς ἀναλήψιος, φειδώ. οἶνος γὰρ θάλψις μέν ἐστι νεύρων, μάλθαξις δὲ ψυχῆς, ἐπανάκλησις δὲ ἡδονῆς, γονῆς γένεσις, καὶ πρόκλησις ἀφροδισίων. τάδε μοι ἐς τὰ ὀξέα γεγράφθω ἄκεα. χρὴ δὲ καὶ αὐτόν τινα ξυνευπορέειν, μὴ πάντα ἀλλοτρίῃ ξυγγραφίῃ προσίσχοντα τὸν νόον. οὕτω τὰ ὀξέα πάθεα γίγνεται, ὡς ἐν τάξι τε τοῖσι γεγραμμένοισι, καὶ μούνοισι, ἢ ἅπασι χρέεσθαι.