Aphorisms — First Draft Translation

APHORISMS. SECTION ONE. 1.1 Life is short, the art long, the right moment fleeting, experience treacherous, judgment difficult. One must attend not only to doing what is needful oneself, but also the patient, those present, and external circumstances must cooperate. In disturbances of the belly and vomitings that arise spontaneously: if what is purged is of the kind that ought to be purged, it is beneficial and they bear it with ease; if not, the contrary. 1.2 So too with emptying of the vessels: if what occurs is of the kind that ought to occur, it is beneficial and they bear it with ease; if not, the contrary. One must therefore look to the region, the season, the age, and the diseases, in which it is or is not appropriate. In athletic conditioning, peak conditions of good bodily tone are precarious when they stand at the extreme; for they cannot remain in the same state, nor stay still; and since they do not stay still, they can no longer advance toward the better—what remains is movement toward the worse. For these reasons it is beneficial to dissolve the good condition promptly, so that the body may take a fresh start of restoration; and equally one must not drive depletions to the extreme—that is precarious—but rather bring them to the point that the nature of the person who is to endure it can sustain. 1.3 Likewise, evacuations that are carried to the extreme are precarious; and again, restorations that stand at the extreme are precarious. Spare and strict regimens are precarious both in prolonged sufferings and in acute ones where the patient cannot tolerate them. 1.4 And again, regimens that have reached the extreme of spareness are difficult; for repletion at the extreme is also difficult. Patients on spare regimens commit errors, and so are harmed more; for every error that occurs becomes greater than it would be on a somewhat more ample regimen. For this reason also, very spare, fixed, and strict regimens are precarious for healthy persons, because they bear errors less well. 1.5 For this reason, spare and strict regimens are precarious in most cases compared with those slightly more ample. But for extreme diseases, extreme treatments carried to exactness are best. 1.7 Where the disease is very acute, it involves the most extreme distress at once, and it is necessary to use the most extremely spare regimen; where this is not so, but the patient can be nourished more amply, one should step down proportionally, by as much as the disease is milder than the extremes. When the disease is at its height (akmē), then it is necessary to use the most spare regimen. 1.9 One must also reckon together whether the patient will hold out with the regimen until the height (akmē) of the disease, and whether he will give up first and not hold out with the regimen, or whether the disease will give up first and will be blunted. For those in whom the height comes at once, feed sparely at once; for those in whom the height comes later, toward that point, and a little before it, reduce; beforehand, nourish more richly, so that the patient may hold out. 1.11 In the paroxysms one must hold back; for adding is harmful. And all that is exacerbated according to cycles, during the paroxysms one must hold back. The paroxysms and the conditions (katastaseis) will be indicated by the diseases themselves, by the seasons of the year, and by the correspondence of the cycles to one another, whether they recur daily, every other day, or at longer intervals. And also by what appears as a sign: for example, in pleuritic cases, if sputum appears early at the onset, it shortens the course; if it appears later, it lengthens it. And urines, stools, sweats—appearing as signs—indicate both cases difficult and easy to judge (krisis), and diseases short and long. 1.13 Old men bear fasting most easily, second those of settled age, least young men, and most of all children, and among these those who are most habitually vigorous. Growing things have the most innate heat; they therefore need the most nourishment; if not, the body is consumed. In old men the heat is small, and therefore they need few things to feed the fire; for it is quenched by many. For this reason also fevers in old men are not similarly acute; for the body is cold. 1.15 The bellies are naturally warmest in winter and spring, and sleep is longest. In these seasons, therefore, more provisions (προσάρματα) should be given; for the innate heat is greatest, and needs more nourishment. Evidence: the young and athletes. Fluid regimens benefit all who are feverish, and most especially children, and others who are accustomed to live in this way. 1.17 Also for those who take food once, or twice, more or less, and in parts—some allowance must be given to habit, to season, to region, and to age. In summer and autumn, people bear food most poorly; in winter, most easily; in spring, second. 1.19 For those whose exacerbations come in cycles, give nothing and do not press them during the paroxysms, but rather withdraw from the additions before the crises (kriseis). Things being resolved in crisis (krinomena) and those just resolved, do not disturb or introduce anything new, neither by purgatives nor by other provocations, but let them be. 1.21 Whatever must be drawn off, draw it in whichever direction it most inclines, through the appropriate passages. Purge and move what is concocted (pepona), not what is raw, and not at the beginnings, unless there is urgency; and for the most part there is no urgency. 1.23 What is being evacuated should not be judged by quantity, but by whether it passes as it ought and is borne easily; and where one must carry it to the point of fainting, do this too, if the patient can hold out. In acute sufferings, use purgatives rarely and at the outset, and do this only after prior careful assessment. 1.25 If what is purged is of the kind that ought to be purged, it is beneficial and they bear it with ease; what is contrary, they bear with difficulty. SECTION TWO. 2.1 In whatever disease sleep causes distress, it is deadly; if sleep is beneficial, not deadly. Where sleep puts an end to delirium, it is a good sign. 2.3 Sleep and wakefulness, both occurring beyond measure, are bad. Neither satiety nor hunger, nor anything else, is good when it exceeds what is natural. 2.5 Spontaneous fatigues indicate diseases. Those who, when some part of the body is laboring, are for the most part unaware of the pains—in these the mind (gnōmē) is sick. 2.7 Bodies wasted over a long time should be restored slowly; those wasted in a short time, quickly. If someone recovering from disease takes nourishment but does not gain strength, it indicates that the body is consuming more nourishment than it is receiving; if this happens when nourishment is not being taken, one must know that evacuation is needed. 2.9 Bodies that one wishes to purge should be made freely flowing. Bodies that are not clean: the more you nourish them, the more you will harm them. 2.11 It is easier to be filled with drink than with food. What is left behind in diseases after the crisis is accustomed to cause relapses. 2.13 In those for whom a crisis (krisis) is coming, the night before the paroxysm is generally difficult to bear, while the following night is more easily borne for the most part. In fluxes of the belly, changes in the stools are beneficial, unless they change to the worse. 2.15 Where the throat is diseased, or growths (phymata) sprout on the body, one should examine the excretions; for if they are bilious, the body is also sick; if they come to resemble those of healthy persons, it is safe to nourish the body. Where there is hunger, one should not labor. 2.17 Whenever an excess of nourishment beyond what is natural enters, this produces disease—and the treatment shows this. Of things that nourish all at once and quickly, the passages through also occur quickly. 2.19 In acute diseases, advance declarations are not altogether safe, neither about death nor about recovery. Those whose bellies are fluid in youth—as they age, these dry up; those whose bellies are dry in youth—as they grow older, these become moist. 2.21 Pre-meal fortification (thorēxis) dissolves hunger. Whatever diseases arise from repletion, evacuation heals; and whatever arise from evacuation, repletion heals; and for the rest, the counter-movement. 2.23 Acute diseases are judged in fourteen days. Of the first seven, the fourth is manifest (epidēlos); the eighth is the beginning of a second week, and the eleventh is to be observed (theōrētē)—for it is the fourth day of the second week; and again the seventeenth is to be observed (theōrētē)—for it is the fourth from the fourteenth and the seventh from the eleventh. 2.25 Summer quartan fevers are for the most part short; autumn ones are long, especially those that run into winter. Fever following a convulsion is better than a convulsion following fever. 2.27 Improvement not in accord with reason should not be trusted, nor should adverse developments occurring against reason be greatly feared; for most such things are unstable and not accustomed to persist or to last long. In those who are not entirely superficially feverish, for the body to persist and yield nothing, or to melt away more than reason would expect, is bad; for the one signifies a long disease, the other, weakness. 2.29 At the beginnings of diseases, if something seems to call for movement, move it; but when they are at their height, it is better to keep still. At beginnings and ends, everything is weakest; at the heights, strongest. 2.31 In one recovering from illness who has a good appetite yet the body advances not at all, this is bad. As a general rule, all who are in poor condition, if at first they have a good appetite yet advance not at all, toward the end lose appetite again; but those who at first have a poor appetite, then later a good one, do better. 2.33 In every disease, for the mind (dianoia) to be sound and well disposed toward what is offered is a good sign; the contrary is bad. In diseases, those are in less danger for whom the disease is more consonant with their nature, their habitual condition (hexis), their age, and their season, than those for whom it is not consonant in any of these respects. 2.35 In all diseases, it is better for the region around the navel and the lower belly to have some fullness; the very lean and wasted state is bad; and such a state is also precarious for downward purgings. Those who are in bodily health, when purged with medicines, are quickly exhausted—as are those who subsist on poor nourishment. 2.37 Those who are in good bodily condition are difficult to purge. A drink or food that is slightly inferior but more agreeable is to be preferred over a better one that is less agreeable. 2.39 Old men fall sick less than young men for the most part; but whatever chronic diseases they do acquire, most often die with them. Hoarseness and running of the nose in the very old do not ripen (pepainontai). 2.41 Those who faint repeatedly and severely without apparent cause die suddenly. To resolve a severe apoplexy is impossible; a mild one, not easy. 2.43 Of those who have been strangled or otherwise brought down but have not yet died—those in whom there is foam about the mouth do not revive. Those who are very stout by nature are more prone to sudden death than the lean. 2.45 In young persons with epileptic conditions, changes of age, place, and way of life (bioi) bring relief most of all. When two pains occur at the same time but not in the same place, the more violent one obscures the other. 2.47 Pains and fevers occur more during the formation of pus than when it has formed. In every motion of the body, when it begins to cause distress, resting immediately prevents exhaustion. 2.49 Those accustomed to bearing their habitual labors, even if they are weak or old, bear them more easily than those who are strong and young but unaccustomed. Long-habituated things, even if they are worse than unfamiliar ones, tend to cause less disturbance; and one must also make transitions to what is unaccustomed. To evacuate, or fill, or heat, or cool, or otherwise move the body by much and suddenly is precarious; and everything excessive is hostile to nature. Little by little is safe, and especially so when one passes from one thing to another. 2.52 When everything is being done according to reason yet the expected results do not occur, do not shift to something else while the original judgment holds. Those whose bellies are fluid—when young they do better than those with dry bellies, but toward old age they do worse; for they dry up for the most part as they grow old. 2.54 In bodily size: to reach the age of nine is fine and not unpleasant; but to reach old age in such a body is inconvenient and worse than in smaller ones. SECTION THREE. 3.1 Changes of seasons give rise to diseases most of all, and within the seasons, great shifts of cold or warmth, and similarly for the rest by the same reasoning. Of constitutions (physiai), some are well or ill disposed toward summer, others toward winter. 3.3 Of diseases, some are well or ill disposed relative to others; and certain ages are well or ill disposed relative to seasons, regions, and regimens (diaita). In the seasons, when on the same day there is at one time heat, at another cold, autumnal diseases are to be expected. 3.5 South winds bring heaviness of hearing, dimness of vision, heaviness of head, sluggishness, and loosening of the body; when this wind prevails, such things are suffered in illnesses. If it is a north wind: coughs, throats, hard bellies, difficult and shivery urination, pains of the sides and chest; when this wind prevails, such things are to be expected in illnesses. When summer comes to resemble spring, many sweats in fevers are to be expected. 3.7 In droughts, acute fevers arise; and if the year is of such a character for an extended time, the diseases that come should for the most part be expected to be of that character. In settled seasons, when each season gives what belongs to it in due course, diseases are stable and easy to judge (eukrineis); in unsettled seasons, they are unsettled and difficult to judge. 3.9 In autumn, diseases are most acute and most deadly in general; spring is most healthful and least deadly. Autumn is bad for those who are wasting away (phthínousi). 3.11 Concerning seasons: if winter is dry and northerly, but spring rainy and southerly, it follows necessarily that in summer there will be acute fevers, eye inflammations (ophthalmiai), and dysenteries, especially in women and in men who are fluid in constitution. If winter is southerly and rainy and mild, and spring dry and northerly, women whose births fall toward spring miscarry on any pretext; and those who do give birth produce children that are feeble and sickly, such that they either perish immediately or live on lean and sickly; for the rest of mankind there will be dysenteries and dry eye inflammations, while old men will be carried off quickly by catarrhs. 3.13 If summer is dry and northerly and autumn rainy and southerly, headaches come with winter, and coughs and hoarseness and running of the nose, and in some phthisis (wasting/consumption). If it is northerly and without rain, it is favorable for those who are fluid in constitution and for women; but for the rest there will be dry eye inflammations, acute fevers, runnings of the nose, and in some melancholia. 3.15 Of the annual conditions (katastasiai) taken as a whole, droughts are healthier than rainy seasons and less deadly. Among the diseases arising in rainy seasons the following occur for the most part: long fevers, fluxes of the belly, putrefactions, epileptic seizures, apoplectic seizures, and quinsies; in droughts: wasting diseases (phthisinades), eye inflammations, joint diseases (arthritides), stranguries, and dysenteries. 3.17 The daily conditions: northerly ones firm up the body and make it well-toned, mobile, well-colored, and sharper of hearing; they dry out the bellies, bite the eyes, and if any chest pain pre-exists, it worsens. Southerly ones dissolve the bodies and moisten them, and produce heaviness of hearing, heaviness of head, and vertigo, and in the eyes and the body difficulty of movement, and they moisten the bellies. According to the seasons: in spring and the height of summer, children and those close to them in age live best and are most healthy; in summer and autumn, old men, up to a point; the remainder of that, and in winter, those of middle age. 3.19 All diseases occur in all seasons, but some arise and are exacerbated more in particular ones. In spring: madness, melancholic conditions, epileptic conditions, blood fluxes, quinsies, runnings of the nose, hoarseness, coughs, lepra, lichens (leichēnes), alphoi (white skin patches), ulcerative eruptions in greatest number, growths (phymata), and joint conditions. 3.21 In summer: some of these also, and continuous fevers, burning fevers (causoi), tertian fevers in greatest number, vomitings, diarrheas, eye inflammations, ear pains, mouth ulcerations, putrefactions of the genitals, and sweat-rashes (hidrōa). In autumn: most of the summer ones, and quartan fevers, wandering fevers, spleen conditions, dropsies, phthisis (wasting/consumption), stranguries, smooth intestine-flux (leienteriai), dysenteries, hip-joint pains (ischiadai), quinsies, breathlessness conditions (asthmata), ileus conditions (eileoí), epilepsies, madness, and melancholia. 3.23 In winter: pleuritis, pneumonia (peripleumonia), runnings of the nose, hoarseness, coughs, pains of the chest, pains of the sides, pains of the loins, headaches, vertigo, apoplectic seizures. According to age, the following occur: in small and newborn children—mouth sores (aphthai), vomiting, cough, sleeplessness, frights, inflammation of the navel, moisture of the ears. 3.25 As they approach teething: itching of the gums, fevers, convulsions, diarrheas, especially when bringing up the canine teeth, and in the chubbiest children and those with hard bellies. In those who have grown somewhat older: inflammations of the tonsils, inward displacement of the vertebra at the back of the neck, breathlessness conditions, stone formations (lithiaseis), round worms (helminths), pin-worms (askarides), warts (akrochordonai), satyriasis (satyriasmoi), swollen lymph nodes (choirades), and other growths, especially those already mentioned. 3.27 In those still older, approaching puberty: many of these same things, and prolonged fevers more so, and blood flows from the nostrils. Most childhood sufferings are judged: some within forty days, some within seven months, some within seven years, some as they approach puberty. Whatever conditions persist in children and are not dissolved around the time of pubescence, or in females around the breaking of the menses, tend to become chronic. 3.29 In young men: spitting of blood, phthisis (wasting/consumption), acute fevers, epilepsies, and other diseases, especially those already mentioned. In those past this age: breathlessness conditions, pleuritis, pneumonia (peripleumonia), lethargy (lēthargoí), phrenitis, burning fevers (causoi), chronic diarrheas, cholera, dysenteries, smooth intestine-flux (leienteriai), hemorrhoids. 3.31 In old men: difficult breathing (dyspnoia), catarrhs with coughing, stranguries, difficult urination, joint pains, kidney conditions (nephritides), vertigo, apoplectic seizures, bad states of the body (kachexiai), itching of the whole body, sleeplessness, moistures of belly, eyes, and nose, dimness of sight (amblyōpiai), cloudiness of the eyes (glaukōsies), heaviness of hearing. SECTION FOUR. 4.1 Pregnant women should be purged—if there is urgency—from four months up to seven months; these should be treated with less boldness. Infants and older persons must be handled with caution. In purgings, draw from the body those things of the same kind as what usefully passes of its own accord; what passes in the contrary direction, check. 4.3 If what is purged is of the kind that ought to be purged, it is beneficial and they bear it with ease; the contrary, with difficulty. Purge upward more in summer, downward in winter. 4.5 At the rising of the Dog Star and just before, purgings are difficult. Lean persons who are easy to keep going upward—purge upward, avoiding winter. 4.7 Those who are hard to keep going and moderately fleshed—purge downward, avoiding summer. Those with wasting tendency (phthīnōdeas)—avoid purging upward. 4.9 Melancholic persons—purge downward more vigorously, by the same reasoning applied in reverse. Purge in very acute cases, if there is urgency, on the same day; for delay in such cases is bad. 4.11 Where there are griping pains, pains around the navel, and loins pains not resolved either by purging or otherwise, the condition settles into dry dropsy. Where the bowels are in a smooth-flux state (leienteriōdees)—to purge upward in winter is bad. 4.13 For hellebore treatment in those not easily purged upward: before the drinking, pre-moisten the bodies with more nourishment and rest. When one has drunk hellebore, promote movement of the body rather than sleep and stillness; sea-voyaging also shows that motion disturbs the bodies. 4.15 When you want the hellebore to work more, set the body in motion; when you want to stop it, induce sleep and do not move it. Hellebore is dangerous in those whose flesh is healthy—for it produces convulsions. 4.17 In a person without fever: loss of appetite, gnawing at the upper stomach (kardiōgmos), darkening of vision with vertigo (skotodinos), and a bitter taste in the mouth indicate that upward purging is needed. Pains above the midriff (phrenes) indicate upward purging; those below, downward. 4.19 Those who do not become thirsty during the drinking of medicines—the purging does not stop before they become thirsty. In those without fever, if there is griping, heaviness of the knees, and pain in the loins, this indicates that downward purging is needed. 4.21 Dark stools like blood, coming spontaneously of their own accord, with or without fever, are very bad; and the more numerous and worse the colors, the worse it is. When they come in response to a purgative medicine, they are better; and even if the colors are numerous, that is not bad. In whatever diseases black bile passes—either upward or downward—at the very beginning, it is deadly. 4.23 In those who have been wasted by acute or long-standing diseases, or by wounds, or otherwise, if black bile or something like black blood passes, they die on the following day. If dysentery begins from black bile, it is deadly. 4.25 Blood passing upward—whatever kind it is—is bad; downward, good; and dark stools passed are also good. If, in someone held by dysentery, what passes resembles pieces of flesh, it is deadly. 4.27 In those in whom bleeding flows abundantly from any part during fevers, in their recovery their bellies become moist. In those whose stools are bilious, when deafness comes on it ceases; and in those who have deafness, when bilious stools come on, it ceases. 4.29 In those in whom chills occur during fevers on the sixth day, the crisis is difficult. In those whose paroxysms come—whatever hour they release, if they seize again at the same hour on the following day—the crisis is difficult. 4.31 In those with exhaustion-pains during fevers, depositions (apostaseis) form most often in the joints and alongside the jaw. In those who have some pain when they rise from diseases, depositions form there. 4.33 Moreover, if some part was already laboring before the onset of the illness, there the disease takes hold. If, in one held by fever, choking suddenly comes on without there being any swelling in the throat, it is deadly. 4.35 If, in one held by fever, the neck is suddenly twisted and he can swallow only with difficulty, without there being any swelling, it is deadly. Sweats occurring in those who are fevering on the third day, and the fifth, and the seventh, and the ninth, and the eleventh, and the fourteenth, and the seventeenth, and the twenty-first, and the twenty-seventh, and the thirty-first, and the thirty-fourth, are favorable; for these sweats bring fevers to a crisis. Those that do not arise in this way signify suffering, length of illness, and relapse. 4.37 Cold sweats occurring alongside a sharp fever signify death; alongside a milder fever, they signify length of illness. And wherever in the body the sweat is, there it points to the disease. 4.39 And wherever in the body there is heat or cold, there is the disease. And wherever throughout the whole body there are changes — whether the body is being chilled, or is being warmed again, or one color follows another — this signifies length of illness. 4.41 Profuse sweat arising from sleep without any apparent cause signifies that the body is using more nourishment than it needs; but if this occurs in one who is not taking nourishment, it signifies that evacuation is needed. Profuse sweat, whether cold or hot, flowing continually — the cold signifies a greater disease, the hot a lesser one. 4.43 Fevers that do not intermit but become stronger every other day are dangerous; but in whatever way they do intermit, it signifies they are not dangerous. Those in whom fevers are prolonged develop either tumors or pains in the joints. 4.45 Those in whom tumors or pains in the joints arise from fevers — these make use of more food. If a rigor falls upon a non-intermitting fever in one who is already weak, it is deadly. 4.47 Expectorations in non-intermitting fevers that are livid, bloody, foul-smelling, or bilious are all bad. Those that come away cleanly are good — and so too with the stools and the urine. But if nothing beneficial is excreted through these channels, it is bad. In non-intermitting fevers, if the outer parts are cold while the inner parts burn and there is thirst, it is deadly. 4.49 In a non-intermitting fever, if a lip, or an eyebrow, or an eye, or the nose is distorted, or if the patient does not see, or does not hear, and the patient is weak — whatever of these occurs, death is near. Wherever in a non-intermitting fever there is difficult breathing and delirium, it is deadly. 4.51 In fevers, abscesses not resolving at the first crises signify length of illness. Those who weep in fevers or in other illnesses of their own accord — this is nothing out of place; those who weep not of their own accord — this is more out of place. 4.53 In those in whom a sticky crust forms on the teeth during fevers, the fevers become more severe. Those who have prolonged dry coughs, causing slight irritation, in burning fevers are not particularly thirsty. 4.55 Fevers associated with swellings in the groin are all bad, except for the daily ones. Sweat coming on in one who is fevering, with the fever not ceasing, is bad; for the illness is prolonged, and it signifies greater moisture. 4.57 In one held by convulsion or tetanus, fever coming on resolves the disease. In one held by a burning fever, the coming on of a rigor brings resolution. 4.59 An exact tertian fever is resolved at the longest in seven circuits. In those whose ears become deaf during fevers, blood flowing from the nostrils, or the bowel being thoroughly disturbed, resolves the disease. 4.61 In a fevering person, if the fever does not release on odd days, it is accustomed to relapse. In those in whom jaundice appears during fevers before the seventh day, it is bad — unless fluid discharges occur from the belly. 4.63 In those in whom rigors occur daily during fevers, the fevers are resolved day by day. In those in whom jaundice appears during fevers on the seventh or the ninth or the eleventh or the fourteenth day, it is good — unless the right hypochondrium is hard; but if it is, it is not good. 4.65 In fevers, intense burning about the belly and heartburn are bad. In acute fevers, convulsions and severe pains about the viscera are bad. 4.67 In fevers, frights or convulsions arising from sleep are bad. In fevers, pneuma (breath) that is labored is bad; for it signifies convulsion. 4.69 In those whose urine is thick, clotted, and scanty — these being persons not without fever — an abundant flow of thin urine following upon this is beneficial; and such favorable thin urine especially appears in those whose urine showed a sediment from the beginning or quickly. In those whose urine during fevers is turbid, like that of a beast of burden, headaches either are present or will be present. 4.71 In those whose illness comes to a crisis on the seventh day, the urine has a reddish cloud on the fourth day, and the rest follows accordingly. Those whose urine is clear and white — this is bad; and it appears especially in those with phrenitis (inflammation of the mind). 4.73 In those whose hypochondria are distended and rumbling, when pain in the lower back comes on, the bellies of these persons become moist — unless winds break through downward, or a quantity of urine comes on; and these things occur in fevers. In those in whom there is hope of an abscess forming at the joints, a copious, very thick, and white urine flowing resolves the abscess — of the kind that in some begins to appear on the fourth day in fatiguing fevers; but if there is also bleeding from the nostrils, it resolves very quickly. 4.75 If one passes blood or pus in the urine, it signifies ulceration of the kidneys or the bladder. In those from whose thick urine small fleshy particles like hairs pass out together, these are secreted from the kidneys. 4.77 In those from whose thick urine bran-like matter passes out with it, the bladder has a scaly condition. Those who spontaneously pass blood in their urine — this signifies a rupture of a small vessel from the kidneys. 4.79 In those whose urine has a sandy sediment, the bladder has stones. If one passes blood and clots in the urine, has straining in urination, and pain strikes into the hypogastrium and the perineum, the parts about the bladder are suffering. 4.81 If one passes blood and pus and scales in the urine and the smell is heavy, it signifies ulceration of the bladder. In those in whom tumors grow in the urethra, when the tumor has suppurated and burst, there is resolution. 4.83 Profuse urination occurring at night signifies a scanty stool. SECTION FIVE. 5.1 Convulsion from hellebore is deadly. Convulsion coming on upon a wound is deadly. 5.3 After great flowing of blood, convulsion or hiccup coming on is bad. After excessive purging, convulsion or hiccup coming on is bad. 5.5 If someone suddenly becomes voiceless while drunk, he dies in convulsion — unless fever takes hold, or, having come to the hour at which drunken states resolve, he speaks. Those seized by tetanus perish within four days; but if they escape these, they recover. 5.7 Epileptic conditions that arise before puberty undergo a change; those that arise at twenty-five years, these for the most part persist until death. Those who become pleuritic and are not purged clear in fourteen days — in these it settles into empyema. 5.9 Phthisis (wasting / consumption) arises most often in the age group from eighteen years up to thirty-five. Those who escape cynanche (throat-strangling) and it turns to the lung — these die within seven days; but if they escape these, they become empyemic. 5.11 In those troubled by phthisis, if the sputum which they cough up smells heavily when poured onto coals, and the hair falls from the head, it is deadly. Those suffering from phthisis whose hair falls from the head — these, when diarrhea comes on, die. 5.13 Those who cough up frothy blood — in these, such bringing-up comes from the lung. Diarrhea coming on in one held by phthisis is deadly. 5.15 Those who become empyemic following pleurisy — if they are purged clear within forty days from the time the rupture occurs, they recover; but if not, it passes into phthisis. Heat used repeatedly causes these harms: softening of the flesh, weakness of sinews, dulling of the mind, hemorrhages, faintings — these are among those that bring death. 5.17 Cold causes convulsions, tetanus, blackenings, and shivering-fevers. Cold is hostile to bones, teeth, sinews, the brain, the spinal marrow; heat is beneficial. 5.19 Whatever parts are chilled, warm them — except where there is bleeding or a likelihood of it. For wounds, cold is biting, hardens the skin around them, makes pain such that suppuration cannot occur, blackens, causes shivering-fevers, convulsions, and tetanus. 5.21 There are cases, however, where in tetanus without a wound in a young, well-fleshed person, in midsummer, a copious pouring of cold water brings back heat; and heat resolves these conditions. Heat promotes suppuration — not in every wound — and is the greatest sign of safety; it softens the skin, reduces it, relieves pain, soothes rigors, convulsions, tetanus; and in head wounds and sores, heat also relieves heaviness of the head; and it makes the greatest difference in fractures of bones, especially in those that are stripped bare, and among these especially in those that have wounds on the head; and in whatever parts die or become ulcerated from cold, and in spreading herpetic sores, and for the rectum, genitals, womb, and bladder — for these, heat is friendly and resolving, cold is hostile and killing. 5.23 In these cases one must use cold: where there is bleeding or likelihood of it — not upon the parts themselves but around them, from where the flow comes; and in inflammations or superficial inflammations tending toward redness and suffusion with fresh blood, apply it to these — since at any rate in old ones it blackens; and in erysipelas that is not ulcerated — since where it is ulcerated it causes harm. Cold things, such as snow and ice, are hostile to the chest, provocative of coughs, liable to cause hemorrhage, liable to cause catarrh. 5.25 Swellings and pains in the joints without a wound, gout, and sprains — for most of these, copious cold water poured on relieves and reduces them and dissolves the pain; moderate numbness dissolves pain. Water that heats quickly and cools quickly is lightest. 5.27 For those who feel a desire to drink at night when intensely thirsty, if they fall asleep upon it, it is good. Fumigation in aromatics promotes the flow of the menses and would in many ways be useful for other things too, were it not that it causes heaviness of the head. 5.29 Purge pregnant women — if there is urgency — from four months, and up to seven months less vigorously; be cautious with the very young and the older. For a pregnant woman to be seized by any of the acute diseases is deadly. 5.31 A pregnant woman who undergoes phlebotomy miscarries, and the more so the larger the embryo. In a woman who is vomiting blood, the breaking forth of the menses brings resolution. 5.33 For a woman in whom the menses have stopped, blood flowing from the nostrils is good. For a pregnant woman, if the belly flows copiously, there is danger of miscarriage. 5.35 For a woman troubled by uterine disturbances, or laboring in childbirth, a sneeze coming on is good. Menses that are discolored and not always the same signify that purging is needed. 5.37 For a pregnant woman, if her breasts suddenly become thin, she miscarries. For a pregnant woman carrying twins, if one breast becomes thin, she miscarries one; and if the right becomes thin, the male; if the left, the female. 5.39 If a woman who is neither pregnant nor has given birth has milk, her menses have ceased. In women in whom blood gathers in the breasts, it signifies madness. 5.41 If you wish to know whether a woman is pregnant, when she is about to sleep, give her honeyed water to drink while fasting; if she has griping about the belly, she is pregnant; if not, she is not. A pregnant woman, if she carries a male, has good color; if a female, bad color. 5.43 If erysipelas develops in the womb of a pregnant woman, it is deadly. Those who are abnormally thin while pregnant miscarry before they gain flesh. 5.45 Those of moderate bodily condition who miscarry in the second and third month without apparent cause — in these the cotyledons are full of mucus and cannot hold the embryo because of its weight, but break away. Those who are abnormally fat and do not conceive — in these the omentum presses upon the mouth of the womb, and until they become thinner they do not conceive. 5.47 If the womb, lodged in the hip, suppurates, it must be packed with a tent. Male embryos are more often on the right side, females on the left. 5.49 For prolapse of the womb, apply a sternutatory and then hold the nostrils and mouth. If you wish to stop the menses in a woman, apply the largest possible cupping vessel to the breasts. 5.51 In those who are pregnant, the mouth of the womb is closed. If in a pregnant woman much milk flows from the breasts, it signifies that the embryo is weak; but if the breasts are firm, it signifies that the embryo is more healthy. 5.53 In those who are about to lose their embryos, the breasts become thin; but if they become hard again, there will be pain either in the breasts, or in the hips, or in the eyes, or in the knees, and they do not lose them. In those women in whom the mouth of the womb is hard, the mouth of the womb must close. 5.55 Those who are pregnant and seized by fevers and greatly wasted without apparent cause either give birth with difficulty and dangerously, or in miscarrying are in danger. If in a woman convulsion and fainting come on together with a flow of the menses, it is bad. 5.57 When the menses occur in excess, diseases follow; and when they do not occur, diseases arise from the womb. In inflammation of the rectum and in inflammation of the womb, straining in urination comes on; and in suppurating kidneys, straining in urination comes on; and in inflammation of the liver, hiccup comes on. 5.59 If a woman does not conceive, and you wish to know whether she will, wrap her in coverings and fumigate from below; and if the smell seems to travel through the body to the nostrils and mouth, know that she is not barren on her own account. If the menses proceed in a pregnant woman, it is impossible for the embryo to be healthy. 5.61 If the menses do not proceed in a woman, and neither shivering nor fever comes on, but nausea keeps coming upon her, reckon that she is pregnant. Those women who have wombs that are cold and dense do not conceive; and those who have their wombs over-moist do not conceive, for the seed is quenched; and those who have them rather dry and burning — the seed perishes from want of nourishment; but those whose wombs have a well-proportioned krasis (blending) of both — such women become fertile. 5.63 Similarly also in males: either owing to the openness of the body the pneuma (breath) is carried outward so as not to convey the seed; or owing to denseness the fluid does not pass out; or owing to coldness it is not kindled so as to be gathered to that place; or owing to heat the same thing happens. Giving milk to those with headache is bad; and bad also for those who are fevering, and for those whose hypochondria are distended and rumbling, and for those who are thirsty; and bad too for those whose stools are bilious while in acute fevers, and for those in whom there has been a copious discharge of blood. It is fitting for those suffering from phthisis who are not fevering very much; and give it also in prolonged, mild fevers when they show disproportionate wasting and none of the foregoing signs is present. 5.65 In those in whom swellings appear on wounds, they do not readily have convulsions, nor do they go mad; but when these swellings disappear suddenly, those who have wounds on the back get convulsions and tetanus, those on the front get madness, sharp pains in the side, or empyema, or dysentery — if the swellings were more red. If, when wounds are severe and dangerous, no swelling appears, it is a great evil. 5.67 The soft, good; the raw-fleshed, bad. For one in pain at the back of the head, cutting the upright vein in the forehead is beneficial. 5.69 Rigors begin, in women more from the lower back and through the back to the head; but also in men more from behind than from the front of the body, as from the forearms and thighs; and they have loose skin, as hair shows. Those seized by quartan fever are not particularly prone to being seized by convulsion; but if they are seized first and then a quartan comes on, the convulsion ceases. 5.71 In those whose skin is stretched, dry, and hard, they die without sweat; in those whose skin is loose and open, they die with sweat. Jaundiced persons are not particularly prone to flatulence. SECTION SIX. 6 title In long-standing smooth-flux of the bowel, acid eructation coming on, not having been present before, is a good sign. 6.2 Those whose noses are by nature more moist, and whose seed is more moist, are sicker in their health; those in the opposite condition are healthier. In long-lasting dysenteries, loss of appetite is bad; and with fever, worse. 6.4 Ulcers that shed the hair around them are of malignant character. Pains in the sides, in the chest, and in other parts — if they differ greatly from each other — must be carefully studied. 6.6 Kidney conditions and those of the bladder are cured with difficulty in old men. Pains occurring in the belly — those that are diffuse are lighter, those that are not diffuse are more intense. 6.8 In those with dropsy, wounds that arise on the body are not easily healed. Broad skin eruptions are not very itchy. 6.10 For one suffering and in great pain in the head, pus or water or blood flowing through the nostrils, or through the mouth, or through the ears resolves the disease. For melancholic and kidney patients, hemorrhoids coming on are good. 6.12 For one cured of long-standing hemorrhoids, if one is not left, there is danger of dropsy or phthisis coming on. In one held by hiccup, sneezes coming on resolve the hiccup. 6.14 In one held by dropsy, water flowing through the vessels into the belly brings resolution. In one held by prolonged diarrhea, vomiting coming on spontaneously resolves the diarrhea. 6.16 In one held by pleurisy or by pneumonia, diarrhea coming on is bad. For one with eye inflammation, being seized by diarrhea is good. 6.18 To have the bladder cut through, or the brain, or the heart, or the diaphragm, or any of the small intestines, or the belly, or the liver — these are deadly. When a bone, or cartilage, or a sinew, or the thin part of the jaw, or the foreskin is cut through, it neither grows nor knits together. 6.20 If blood flows into the belly contrary to nature, it must necessarily suppurate. In those who are mad, when varicosities or hemorrhoids come on, the madness resolves. 6.22 Ruptures descending from the back to the elbows — phlebotomy resolves them. If fear or despondency persists for a long time, such a thing is melancholic. 6.24 If any of the small intestines is cut through, it does not knit together. Erysipelas turning inward from without is not good; from within going outward is good. 6.26 In those in whom tremors arise in burning fevers, delirium resolves it. Those who are empyemic or dropsical and are cut or cauterized — when the pus or water flows out all at once, they all perish. 6.28 Eunuchs do not have gout, nor do they become bald. A woman does not have gout, unless her menses cease. 6.30 A child does not have gout before sexual activity. Pains of the eyes are resolved by drinking unmixed wine, or bathing, or a fomentation, or phlebotomy, or taking a purging draught. 6.32 Those who stammer are most prone to being seized by prolonged diarrhea. Those prone to acid eructation are not very prone to pleurisy. 6.34 Bald persons do not develop large varicosities; but those who become bald and then develop varicosities become hairy again. For those with dropsy, cough coming on is bad. 6.36 Phlebotomy resolves painful urination; cut the inner veins. For one held by cynanche, swellings appearing outside in the throat are good. 6.38 For those in whom hidden cancers arise, it is better not to treat them; for those who are treated perish quickly, while those who are not treated survive for a long time. Convulsions arise either from overfilling or from emptying; and so too does hiccup. 6.40 In those who have pains about the hypochondrium without inflammation, fever coming on resolves the pain. In those in whom something suppurating within the body gives no external sign, it gives no sign because of the thickness of the part. 6.42 In jaundiced conditions, the liver becoming hard is bad. Those with enlarged spleen who are seized by dysentery — in these, when the dysentery becomes prolonged, dropsy or smooth-flux of the bowel comes on, and they perish. 6.44 In those in whom intestinal obstruction arises from straining in urination, they perish within seven days — unless, when fever comes on, the urine flows copiously. Wounds that become year-long or persist for a longer time — necessarily the bone separates and the scars become hollow. 6.46 Those who develop a hump from asthma or cough before puberty perish. Those whom phlebotomy or purging benefits — it is fitting to phlebotomize or purge these in spring. 6.48 For those with enlarged spleen, dysentery coming on is good. All gouty affections of the joints, having resolved their inflammation, clear up within forty days. 6.50 In those in whom the brain is cut through, it is necessary that fever and vomiting of bile come on. In those who are healthy and suddenly have pains in the head, and immediately lie voiceless and snoring, these perish within seven days — unless fever takes hold. 6.52 One must also observe the appearances of the eyes during sleep; for if something appears, the eyelids being drawn together, of the white — when the patient is not in diarrhea or taking a purging draught — the sign is bad and strongly portends death. Delirious states occurring with laughter are safer; those occurring with earnestness are more dangerous. 6.54 In acute conditions accompanied by fever, weeping breathing is bad. Gouty affections of the joints move for the most part in spring and autumn. 6.56 In melancholic diseases the dangerous attacks tend toward the following: they signify either apoplexy (sudden incapacitation) of the body, or convulsion, or madness, or blindness. Apoplexy occurs most often in the age group from forty years to sixty. 6.58 If the omentum prolapses, it must necessarily rot. In those troubled by hip pain in whom the hip is displaced and then falls back, mucous discharges come on. 6.60 In those troubled by long-standing hip pain in whom the hip is displaced, the leg wastes and they go lame — unless they are cauterized. SECTION SEVEN. 7.1 In acute diseases, chilling of the extremities is bad. Over a diseased bone, livid flesh is bad. 7.3 After vomiting, hiccup and red eyes are bad. After sweat, shivering is not good. 7.5 After madness, dysentery, or dropsy, or standing apart from oneself is good. In prolonged illness, loss of appetite and unmixed stools are bad. 7.7 After heavy drinking, rigor and delirium are bad. At the inward rupture of a tumor, faintness, vomiting, and collapse of strength occur. 7.9 After a flow of blood, delirium or convulsion is bad. After intestinal obstruction, vomiting, or hiccup, or convulsion, or delirium is bad. 7.11 After pleurisy, pneumonia is bad. After pneumonia, phrenitis is bad. 7.13 In intense burning fevers, convulsion or tetanus is bad. After a blow to the head, stupor or delirium is bad. 7.15 After spitting of blood, spitting of pus. After spitting of pus, phthisis and a persistent flow; and when the expectoration ceases, they die. 7 17 Following inflammation of the liver, hiccup: bad. Following sleeplessness, convulsion or disordered thinking: bad. 7 18bis Following lethargy, trembling: bad. Following stripping of bone bare, erysipelas. 7 20 Following erysipelas, putrefaction or suppuration. Following strong pulsation in wounds, hemorrhage. 7 22 Following prolonged pain in the region of the belly, suppuration. Following unmixed discharge downward, dysentery. 7 24 Following cutting through of bone, disordered thinking, if it finds an empty space. Convulsion following the drinking of a purgative drug: deadly. 7 26 Following severe pain in the region of the belly, chilling of the extremities: bad. In a woman with child, tenesmus coming on causes miscarriage. 7 28 Whatever bone, cartilage, or sinew is cut away in the body, neither grows again nor knits together. If a strong diarrhea comes upon one held by white phlegm, it resolves the disease. 7 30 In those whose stools are frothy during diarrheas, these drain downward from the head. In those who are feverish, when the sediments in the urine are coarse and granular, they signify a long illness. 7 32 In those whose sediments are bilious but thin at the top, they signify an acute illness. In those whose urines separate into distinct layers, there is a strong agitation within the body. 7 34 In those in whose urines bubbles stand on the surface, they signify kidney disease and that the illness will be long. In those whose surface film is oily and dense, these signify kidney disease and that it will be acute. 7 36 In those who have kidney disease and in whom the aforementioned signs occur, and sharp pains arise in the muscles of the spine: if the pains occur in the outer regions, expect an abscess forming outward; if the pains occur more toward the inner regions, expect the abscess also forming more inward. Those who vomit blood: if without fever, this is a sign of safety; if with fever, bad; treat with cooling and astringent agents. 7 38 Catarrhs into the upper cavity suppurate within twenty days. If one urinates blood and clots, has strangury, and pain falls upon the perineum and the pubic region, this signifies disease of the bladder. 7 40 If the tongue suddenly becomes powerless, or some part of the body suffers apoplexy (sudden incapacitation), such a condition is of the melancholic kind. If, when elderly persons are being strongly purged, hiccup comes on, this is not good. 7 42 If a fever does not proceed from bile, resolution of the fever occurs when much hot water is poured over the head. A woman does not become ambidextrous. 7 44 Those who are suppurating internally and are cauterized or cut: if the pus flows out clean and white, they survive; but if it is blood-tinged, foul-muddy, and foul-smelling, they perish. Those whose liver is suppurating and are cauterized or cut: if the pus flows out clean and white, they survive (for in such cases the pus is enclosed in a membrane); but if it flows like olive-oil lees, they perish. 7 46 For pains of the eyes, after giving undiluted wine to drink and washing with much hot water, perform phlebotomy. A person with dropsy, if cough takes hold, is beyond hope. 7 48 Strangury and difficult urination are resolved by warming with wine and phlebotomy; cut the inner veins. For one held by quinsy, swelling and redness appearing in the chest: good, for the disease turns outward. 7 50 Those in whom the brain mortifies perish within three days; but if they escape these, they recover. Sneezing arises from the head when the brain is being warmed through or when the hollow space in the head becomes moistened; the air within then overflows, and makes a sound because its passage out is through a narrow channel. 7 52 In those who have intense pain in the liver, fever coming on resolves the pain. In those for whom it is beneficial to draw blood from the veins, it is beneficial to perform phlebotomy in spring. 7 54 In those in whom phlegm is shut off between the diaphragm and the stomach and causes pain, having no outlet into either of the cavities, when the phlegm turns through the veins into the bladder, resolution of the disease occurs. In those in whom the liver, filled with water, ruptures into the omentum, the belly fills with water and they die. 7 56 Restlessness, yawning, shivering — wine drunk equal part with equal part resolves these. In those in whom growths form in the urethra, when the growth suppurates and bursts open, the pain is resolved. 7 58 In those whose brain is shaken by some cause, they necessarily become voiceless at once. Bodies that have moist flesh need to have hunger induced in them; for hunger dries out bodies. 7 59 If, in one held by fever, when there is no swelling in the throat, choking suddenly comes on and the person cannot swallow, or only with great difficulty: deadly. If, in one held by fever, the neck is twisted and the person cannot swallow, when there is no swelling in the neck: deadly. 7 61 Wherever there are changes throughout the whole body — the body chilling and then warming again, or the color shifting from one to another — this signifies a lengthy disease. Abundant sweat, hot or cold, flowing constantly, signifies that there is a fullness of fluid; one must therefore remove it upward in the strong, downward in the weak. 7 63 Continuous fevers, if they become stronger every third day, are dangerous; but in whatever manner they have intermissions, this signifies they are without danger. Those with prolonged fevers develop either growths or pains in the joints. 7 65 Those in whom growths or pains in the joints arise out of fevers use more food. If someone gives a feverish person the nourishment one gives a healthy person, what is strength to the healthy person is disease to the sick one. 7 67 One must observe what is excreted through the bladder, whether it resembles what is excreted in healthy persons; whatever is least like what passes in health is most diseased, and what is like that of healthy persons is least diseased. And in those whose stools, if you let them stand without stirring, form a sediment like scrapings — for these it is beneficial to purge the belly downward; but if, without having made it clean, you give them gruel, the more you give, the more you will harm. 7 69 In those in whom raw matter passes downward, it is from black bile — the more raw matter, the more black bile; the less, the less. Expectorations in continuous fevers that are livid, bloody, and foul-smelling are all bad; those that pass off properly are good, whether from the belly or the bladder; and wherever anything that is passing off comes to a halt in one who has not been purged, this is bad. 7 71 Bodies should be made free-flowing wherever one wishes purging to occur; and if you wish to make them free-flowing upward, check the belly; if you wish to make them free-flowing downward, moisten the belly. Sleep, sleeplessness — both occurring beyond the moderate degree: disease. 7 73 In continuous fevers, if the outer parts are cold while the inner parts burn and fever holds: deadly. In a continuous fever, if the lip, or nose, or eye is twisted, if the person does not see, if the person does not hear, already being weak — whatever one of these signs is present: deadly. 7 75 Following white phlegm, dropsy comes on. Following diarrhea, dysentery. 7 77 Following dysentery, smooth-gut flux (leientery). Following mortification (sphacelus), separation of bone. 7 79et80 Following vomiting of blood, wasting (phthora) and upward expectoration of pus follow; following wasting, flux from the head follows; following flux, diarrhea; following diarrhea, stopping of the upward expectoration; following the stopping, death. The same holds for what passes through the bladder and the belly in stools, and in what passes through the flesh, and wherever else the body departs from its nature: if a little, the disease is small; if much, great; if very much, such a thing is deadly. 7 82 Those who become phrenitic past forty years of age do not readily recover; for those run less danger in whom the disease is suited to their nature and age. In those whose eyes weep during illnesses by their own choosing, this is good; in those whose eyes weep without their choosing, bad. 7 84 In those who are on the fourth day of fevers when blood flows from the nostrils: bad. Sweats are dangerous when they do not occur on the critical days; and when they are forceful and rapidly driven out from the forehead like drops and streams; and when they are very cold and abundant; for such sweat must necessarily travel with violence, with excess of distress, and with prolonged pressing out. 7 86 Following a chronic disease of the belly, downward collapse: bad. What drugs do not cure, the knife cures; what the knife does not cure, fire cures; what fire does not cure, these must be held to be incurable.