Prorrhetic I — First Draft Translation

PRORRHETIC I 1.1 Those who become comatose at the outset, with pain in the head, loins, hypochondrium, and neck, sleepless — are these not phrenitic? A nostril dripping in such cases is deadly, and especially when it begins on the fourth day. 1.2 A highly reddish flushing of the bowel is bad in all cases, but not least in those just described. Rough and very dry tongues are phrenitic. 1.4 Urines that are colorless, dark, suspended in solution, and accompanied by sweating, occurring with restless sleeplessness — these are phrenitic. Dreams that are vivid in phrenitic cases. 1.6 Frequent hawking, if some other sign is also present, is phrenitic. Burning heat left behind in the hypochondrium after the fever has cooled — bad, and especially if there is sweating. 1.8 Derangements coming after prior debilitation are the worst — as with Thrasyontes. Phrenitic cases that are vigorously tremulous come to a fatal end. 1.10 Verdigris-colored vomits in cases of headache, with deafness, in a sleepless patient — these quickly drive to frenzy. In acute cases, small painful things in the throat, suffocating, gaping open but not easily closing again, in an emaciated patient — these are delirious; from these come phrenitic cases — deadly. 1.12 In phrenitic cases, apparent mildness at the outset, then frequent shifting — this is bad; and excessive salivation is bad. In phrenitic cases, white stool is bad — as with Archekrates; does torpor develop on top of these? A rigor on top of these is worst of all. 1.14 In those who become disordered in a melancholic fashion, when tremors supervene, that is malignant. Those who suddenly become disordered, then develop fever together with sweating, become phrenitic. 1.16 Phrenitic patients drink little, are sensitive to noise, are tremulous. After nauseous vomiting, a clanging voice, eyes with a filmy surface — these are manic, as was the case with the wife of Hermozygos, who went rapidly mad, became speechless, and died. 1.18 In burning fever, when ringing sounds arise together with dimness of sight, and a heaviness comes on in the region of the nostrils, they become disordered in a melancholic fashion. Delirious episodes with a clanging voice, tremulous spasms of the tongue — these, also becoming tremulous, lead to disordered states; hardening in these cases is deadly. 1.20 Tremulous tongues are a sign of an unsettled mind. Foamy froth appearing on the surface of bilious stools — bad, and especially so in one who has had prior pain in the loins and has been mentally carried away. 1.22 Sparse pains along the side in these cases indicate derangement. Loss of voice combined with hiccup — worst of all. 1.24 Loss of voice combined with collapse — worst of all. Pneuma in voicelessness, of the kind that comes readily in those who are being choked, is bad; is this also delirious? Episodes of brief bold derangement are bestial. 1.27 Distress that is phrenitic, occurring with chilling, in one not without fever, sweating in the upper parts — as with Aristagoras — and indeed also deadly. Those things in phrenitis that shift frequently are convulsive. 1.29 Urination that occurs without the patient being reminded of it is deadly; does urination occur in these cases as though the sediment had been stirred up? Do those who are pulsating throughout come to a voiceless end? In phrenitic cases, those with chilling who salivate vomit up dark matter. 1.32 Deafness and urines that are highly red, unstable, suspended in solution — these are delirious; for such patients to become jaundiced is bad; bad also is torpor developing upon jaundice; these patients end up voiceless yet still aware; and I believe the bowels also break loose in them, as happened with Hermippos, and he died. Deafness persisting in acute and disturbed cases is bad. 1.34 Tremulous, indistinct, groping derangements — strongly phrenitic, as with Didymarchos in Kos. Torpor following a rigor — not quite in their right minds. 1.36 Pains around the navel that are pulsating do carry some mental aberration; but around the time of crisis, pneuma passes through abundantly with force in these cases; and pains in the calf in such cases also carry mental aberration. Pains in the thigh in fever carry some delirious quality, and especially if something is suspended in the urine, and all the other delirious signs that come along with it, and such things as are associated with ringing sounds. 1.38 With a loose, weary bowel, in one with headache, thirst, sleeplessness, indistinctness of mind, debility — in those to whom such things happen, there is prospect of mental disorder. Those who sweat especially on the head in acute cases, somewhat distressed — bad, and especially with dark urines; turbid pneuma on top of these — bad. 1.40 Weaknesses that irrationally resemble those from an emptied vessel, where there is no emptying of vessels, are bad. Bowels that have been arrested, but discharge small dark pellet-like stools under compulsion, and a nostril that breaks open bleeding on top of these — bad. 1.42 In those with pain in the loins for a long time together with a nauseating burning heat, sweating in these cases — bad; do tremorous symptoms also develop in these? And does the voice become as in a rigor? Extremities shifting rapidly in both directions — bad; and such a thirst — bad. 1.44 A bold answer coming from one who had been calm — bad. A high-pitched voice — in these cases the hypochondria are drawn inward. 1.46 An eye growing dim is unfavorable; the fixed and clouded eye is bad. Shrilly clanging vocal pitch — bad. 1.48 Grinding of the teeth is deadly in those not accustomed to it even in health; choking in these cases is very bad. A good complexion of the face, and also extreme sullenness — bad. 1.50 Stools ending in foam — unmixed, provocative of paroxysms. Retention of urine following chilling in acute cases — worst of all. 1.52 Deadly signs that ease without showing their meaning indicate death. In acute bilious cases, very pale, foamy, thoroughly bile-soaked stools — bad; and such urines are also bad; is there pain in the liver in these cases? Loss of voice in fevers subsides in convulsive fashion, in silence — deadly. 1.55 Loss of voice following upon pain — hard to die from. Fevers arising from pain in the hypochondrium are malignant. 1.57 Thirst that resolves irrationally in acute cases — bad. Copious sweating occurring simultaneously with acute fevers — unfavorable. 1.59 And ripened urines too — bad; and the red surface-blooms on these, when they persist, and the verdigris-colored ones — bad; and appearing in small amounts, as if dripping. And vomits with varied content are bad, especially when they come on close together. 1.61 Those that chill in cases of restlessness without sweating at critical times — bad; and those that develop shivering on top of these — bad. Vomits that are unmixed and nauseous — bad. 1.63 Is stupor-like heaviness bad everywhere? Unconsciousness coming with a rigor — bad; and amnesia too is bad. 1.65 Chillings following a rigor that do not warm up again — bad. Those who are sweaty following chilling, warming back up — bad; on top of these, a burning pain in the side, and having a fresh rigor — bad. 1.67 Rigors accompanied by burning heat are somewhat deadly, and the flushed face with sweating in these cases is bad; upon these, cooling of the back parts invites convulsion. Those who sweat, are sleepless, and warm back up — bad. 1.69 An upward surge from the loins, a rolling of the eyes — bad. Pain that has settled in the chest together with torpor — bad; in these, when they develop fever, they become burning hot rapidly and die. 1.71 Those vomiting up dark matter, off their food, mentally adrift, with slight pain about the pubic region, eye bold and closed — do not give these purging drugs, for it is deadly; nor those who are swollen, with darkening of vision, who lapse into unconsciousness in their wandering, who are off their food and colorless; nor those who are prostrated in a comatose fever, for it is deadly. Pain in the cardiac region together with a tense hypochondrium and headache is malignant, and there is something asthma-like; do these patients die suddenly, as Lysis did at Odessos? In his case, urines arose with violent fermentation, and there was redness. 1.73 Pain in the neck is bad in every fever, but worst of all in those in whom there is prospect of going mad. Comatose, weary, visually clouded, sleepless, sweating fevers — malignant. 1.75 Frequent shiverings from the back, shifting rapidly, hard to bear — these indicate a painful retention of urine. Patients with nausea, paroxysms without vomiting — bad. 1.77 Chilling combined with hardening — a deadly sign. Thin matter passing from the bowels without the patient being aware of it, in one who is mentally present — bad, as with the patient with liver disease. 1.79 Small bilious vomits — bad, and especially if the patients remain sleepless; a nostril dripping in these cases — deadly. In women after childbirth, when white discharges, then stopping together with fever, deafness, and sharp pain in the side — they become disordered, fatally. 1.81 In burning fevers, with some chilling, with watery-bilious stools coming through frequently, a rolling of the eyes is a bad sign, and especially if they become rigid. Sudden apoplectic attacks in one who has had a prolonged, weakening feverish episode — deadly, as was suffered by the son of Noumenios. 1.83 Upward surges from loins to the cardiac region, feverish, with shivering, vomiting watery and thin things in quantity — when mentally carried away, they become voiceless and die after vomiting dark matter. Closing shut of the eye in acute cases — bad. 1.85 In those with nausea, without vomiting, with pain in the loins, if they become boldly delirious, is there prospect of dark matter passing through? A painful throat, lean, with distress, suffocating — deadly rapidly. 1.87 In those in whom pneuma is being drawn up, and the voice is suffocating, and the vertebra sinks in — in these, toward the end, pneuma becomes as though something were drawing it together. Those with headache who are rigidly delirious, with the bowel arrested, with a bold and staring eye, flushed — they become opisthotonic. 1.89 With distortion of the eyes, feverish, weary — a rigor is deadly; and comatose episodes in these are bad. Pains against the hypochondrium in fevers, which resolve voicelessly with sweating — malignant; upon these, pains going into the hips together with burning fever, and if the bowel breaks loose — deadly. 1.91 Those in whom voices fail together with fevers after a crisis — these die tremulous and comatose. Those in whom the hypochondria are burning hot, stupefied, rigid, shifting in character, and who are distended at the belly, with food arrested, and who sweat — does turbid pneuma in these cases, and semen-like material coming on, indicate hiccup? And the belly passes through foamy bilious matter; flame-like urine passed in these cases is a sign of benefit, yet the belly continues to be disturbed in them. 1.93 In those who become comatose after foamy matter has passed through, fever is sharpened. Losses of voice arising from headache, together with sweating and fever — loosening, with relief, over a longer time; having a fresh rigor on top of these — not bad. 1.95 Hands tremulous, heads aching, neck painful, somewhat deaf, passing dark and rough-textured urines — in those with these symptoms, expect that dark matter will come: deadly. Cases of rigidly voiceless loss of voice following collapse — deadly. 1.97 Pain in the side occurring with bilious spitting, when it vanishes irrationally — they become disordered. With neck pain, in a comatose and sweaty patient, when the belly is bloated, and if something watery loosens under compulsion, and this then passes through flushed out and bile-free — they become disordered; those who are preserved through such episodes fall into a prolonged illness. 1.98 Are bile-free flushings milder, and does the wind-like swelling bring some benefit? Distension of the belly, loosening watery matter under compulsion, quickly swelling again — this has something convulsive about it, as with the son of Aspasios; that it develops shivering on top is deadly; arising from this with convulsions, and filled with wind, having been ill at greater length, a greenish putrefaction appeared at the mouth. 1.100 Chronic pains in the loins, gradually intensifying, extending upward into the hypochondrium, with loss of appetite together with fever — when a tense pain comes to the head in these patients, it kills rapidly in convulsive fashion. Things that develop shivering and are exacerbated more toward night, sleepless, with rambling, sometimes passing urine in bed during sleep — these end in comatose convulsions. 1.102 Those who from the outset sweat, with ripened urines, burning hot, chilling without crisis, quickly turning burning hot again, torpid, comatose, convulsive — deadly. In women prone to attacks, headache and stupor-like heaviness occurring with heaviness — unfavorable; and perhaps these women are also due to suffer something convulsive. 1.104 Pains in a lean throat that are suffocating have something convulsive about them, and especially when they stem from the head, as with the niece of Thrasyontes. Tremulous symptoms, when they become convulsive, show tendency to sweat with a tendency to relapse; for these the crisis comes with shivering; these patients shiver, having been provoked by burning heat about the belly. 1.106 Pain in the loins, together with headache and cardiac pain, with violent hawking — this has something convulsive about it. Something of a suppressed voice together with a rigor at crisis. 1.108 From the bowel, livid, disturbed matter, and urines that are thin and watery — suspicious. A throat that has become somewhat roughened, and a belly gurgling with empty risings, and pains in the forehead — groping, weary, painful in bedclothes and coverings — as these develop they become troublesome; much sleep in such cases is convulsive, and the heavy pains toward the forehead, and difficulty with urination. 1.110 And retention of urine, in those who have rigors following on the convulsive symptoms — as the same woman, having shivered, then sweated. Purgations ending in unmixed matter are provocative of paroxysms in all cases, and in these especially; from such things, swellings behind the ears also arise. 1.112 The most violently startling, disturbed wakings are convulsive, and especially with sweating. And chillings of the neck and back, appearing to involve the whole body, and together with these foamy urinations, combined with fainting and dimming of the eyes — these indicate convulsion is near. 1.114 Pains in the forearms together with neck pain — convulsive; these symptoms also from the face, and in the throat, frequent ringing sounds, salivation — sweating during sleep in these cases is good; is it also not bad to be relieved by sweating in most cases? Pains going downward — easy to bear in these cases. Those sweating in fevers, with headache, with the bowel arrested — convulsive. 1.116 Somewhat crumbly, watery stools, with chilling that is not without fever — unfavorable; rigors on top of these, taking hold of [the bladder and bowel], painful; does the comatose state in these carry something convulsive? I would not be surprised. Things being drawn vomit-fashion in acute cases — unfavorable, and white stools — troublesome; non-sticky matter passing through from these — they become disordered with great burning heat; do comatose, torpid states follow from these? Cases from such conditions fall into a prolonged illness; do these have cough and labored breathing around the time of crisis? Things spreading from the loins upward to the neck and head, having produced paralysis in a stroke-like fashion — convulsive, delirious; do such cases also resolve in convulsion? From such conditions they fall into varied illness, passing through the same things. 1.119 Convulsions in hysteric conditions without fever are manageable, as with Dorkas. The bladder when retained, especially with headache, has something convulsive about it; things resolving numbly in these cases — troublesome, not however deadly; is this also delirious? Do fractures of bone at the temple also invite convulsion? Or being struck while drunk, or a heavy flow at the outset? Convulsive symptoms, with saliva flowing alongside while the patient is feverish and sweating — of mild character; do the bowels become moist over some days in these cases? And I think that an abscess to a joint will come in these. 1.123 Things that are boldly delirious for a short time — melancholic; if they also arise from menstrual disturbance, bestial; these coincide with greater frequency; are these also convulsive? And are losses of voice following stupor also convulsive? As with the shoemaker's daughter; it began while her menstrual flow was present. In those in whom, during convulsive episodes, the eyes gleam with fixed staring, they are not in their right minds and fall into a prolonged illness. 1.125 Hemorrhaging in the wrong direction is bad — such as flowing from the right in the case of an enlarged spleen; and the same in the hypochondrium; in one who sweats, worse. Things cooled with small sweats from the nostrils are malignant. 1.127 After hemorrhage, passage of dark matter — bad; and the reddish ones too are bad; do these cases hemorrhage on the fourth day? Comatose patients from such conditions end in convulsion, with dark matter having passed through beforehand and the belly distended. Hemorrhaging wounds that also sweat — malignant; these patients die while conversing, unawares. 1.129 After a brief hemorrhage and passage of dark stools in acute cases, deafness — bad; passage of blood in these cases is deadly, but it resolves the deafness. With a painful loin, when cardiac symptoms come on — these are signs of hemorrhoid tendency, and I think they also precede. 1.131 Those who hemorrhage at regular intervals, becoming thirsty and pallid, but not hemorrhaging — they end in epilepsy. Cases that are disturbed from the outset, sleepless; with a brief dripping on the sixth day, finding relief through the night, suffering toward the next day, sweating, being overcome, becoming delirious — will hemorrhage copiously; does watery urine indicate something of this kind? In those in whom hemorrhages are more frequent, after time has elapsed the bowels turn bad, unless the urines are ripened. 1.134 In critical chillings, violent hemorrhages are worst. Patients with heaviness of the head, painful at the crown, sleepless — prone to hemorrhage, and especially if there is tension in the neck. 1.136 Those who, after being sleepless, suddenly bleed in restlessness — especially if some flow has already preceded; and those who shiver as well? Rigid, with headache, with neck pain, with red eyes — prone to hemorrhage. 1.138 In those in whom hemorrhage occurs while the bowel is arrested, and who develop shivering afterward — is the bowel in a condition of lienery and some hardness, or are there ascarides, or both? In those in whom there is an upward surge from the loins to the head, with numb hands, cardiac pain, ichor-like discharges — these hemorrhage copiously and the bowel breaks loose; in these, mental confusion is the common state. 1.140 In those in whom, after a copious and frequent hemorrhage with passage of frequent dark matter, when it has stopped they hemorrhage again — these have pain in the bowel but are relieved with the passage of wind; do such patients sweat with much cold sweat? Disturbed urine in these is not bad, nor is a semen-like sediment; but these patients frequently pass watery urines. In those in whom there is only a small drip from the nostrils on top of deafness and torpor, there is something troublesome; vomiting is beneficial for these patients, and disturbance of the bowel. 1.142 In women in whom laborious fevers arise from rigor, the menstrual flow runs down; a painful neck in these cases — prone to hemorrhage. Things that shake the head and ringing symptoms either hemorrhage or bring down menstrual flow, especially if burning heat along the spine accompanies; and perhaps dysentric too. 1.144 Pulsations in the belly, with prolonged tension of the hypochondrium, swollen — prone to hemorrhage; these patients are prone to shivering. Copious nosebleeds forcibly arrested — in some patients these bring on convulsions; phlebotomy resolves them. 1.146 Frequent and small uprisings that are somewhat yellowish, sticky, containing small fecal bits, with pain in the hypochondrium and side — tending toward jaundice; when these stop, do they become pallid? And I think these patients also hemorrhage; for pains in the loins in these cases are signs of hemorrhagic tendency. Tension of the hypochondrium with heaviness of the head and deafness, and what troubles one facing the light — prone to hemorrhage. 1.148 Drippings on the eleventh day — troublesome, especially if they then stop. Things that have sweated at a critical time together with shivering, then on the next day shivered again, irrationally sleepless — I think these will hemorrhage. 1.150 In those in whom copious hemorrhages from the outset, a rigor arrests them. Rigors after hemorrhage — prolonged. 1.152 In those with headaches and neck pains, and a tremulous general weakness of the whole body — hemorrhages resolve these; but these also resolve in time. Urines in cases of swellings beside the ears that ripen quickly and briefly — unfavorable; and such chilling is bad. 1.154 Those with somewhat stupor-like and jaundice-like conditions, not quite perceiving, in whom hiccup appears — the bowel breaks loose; and perhaps when it stops, these patients become pallid; do swellings beside the ears also appear in these? Urines that are retained with a rigor — bad, especially in those who were already in a stupor; is there prospect of parotid swellings in these? From colic conditions, a sediment that is muddy and somewhat livid — bad; does the hypochondrium become painful from such conditions? I think the right one; and are such patients pallid, and do swellings beside the ears appear in them, painful for a short time? When the bowel breaks loose in these — deadly. 1.157 In cases of nausea with sleeplessness, swellings beside the ears especially. In ileus with foul smell, with acute fever, with a raised hypochondrium over a more prolonged period — swellings beside the ears that rise up kill. 1.159 From deafness of moderate character, parotid swellings — especially if something nauseous supervenes; and more so in comatose patients on top of these. Parotid swellings — unfavorable in those with apoplexy-like conditions. 1.161 Things that are exacerbated in convulsive fashion, rigidly, cause parotid swellings to arise. Convulsive tendency, tremulous; nauseous, rigid — causes small parotid swellings to arise. 1.163 Do those who have parotid swellings have headache? And do they also sweat in the upper parts, or have some shivering? Does the bowel also break loose? And are they somewhat comatose? Do watery urines suspended with white matter, and diversely very pale, foul-smelling urines, produce parotid swellings? Do those with such urines have frequent drippings? And do these have a smooth tongue? In those who are bloated with gas, when jaundice and acute fevers supervene together with hard hypochondria, and they have been chilled — large parotid swellings arise. 1.165 Comatose, nauseous, hypochondria painful, tending toward small vomiting — in these, parotid swellings arise; and before this, also swellings about the face. When the bowel has passed dark fecal matter, a coma appearing causes parotid swellings to arise. 1.167 Slight coughing with salivation reduces parotid swellings. From a coma and deafness arising out of headache, something bursts forth beside the ears. 1.169 Tension of the hypochondrium together with nauseous coma and headache raises parotid swellings. Parotid swellings that are painful and have subsided without crisis — unfavorable. PROPHETIC BOOK THE SECOND 2.t Among healers, many, beautiful, and wondrous fortellings are reported — such as I myself have neither made nor heard anyone else make. 2.1 Some of them are of this kind: that a man seemed to be dying — both to the healer attending him and to the others — and then another healer came in and said that the man would not die but would be blind in his eyes; and in another case, going in to a man who appeared to be in a thoroughly bad way, to foretell that the man would recover but would have a lame hand; and in yet another case, to say to one who seemed not likely to survive that he himself would be healthy, but that his toes would blacken and rot away; and other fortellings of this kind are said to fall under such a form. Another kind of foretelling is this: to foretell to those buying and selling deaths for some, madness for others, other diseases for others, and to prophesy about all these things and the earlier times, and to be truthful in all. And yet another form of fortellings is described thus: to know athletes and those who train and toil for the sake of their diseases — if they leave off any portion of their food, or eat something different, or use more drink, or leave off their walking, or do something in the way of sexual acts; none of these escapes notice, not even if the person's disobedience was slight. These are all said to be so precisely refined, these kinds of fortellings. For my own part, I will not divine such things; rather I write down the signs by which one must judge which persons will be healthy and which will die, and those who will be healthy or will die in a short time or in a long time; and I have also written about depositions (critical settlements of disease) — how each is to be examined. But I also think that those who foretold about lamenesses and other such things did so when the disease was already settling, and when it was clear that the deposition would not run backward — if they had good sense, it was far more the case then than before the deposition had begun to form. 2.2 I expect that the other things too can be foretold in a more human fashion than the foretellings regarding buyers and sellers — deaths and diseases and madnesses. These things seem to me to be such, and it does not seem at all difficult for anyone willing to contend in such contests to foretell matters of this kind. For first, who would fail to recognize those with dropsy and those with phthisis (wasting-consumption)? Then again, it is not very hard to miss those who are going to fall into derangement, if one knows in whom this disease is either hereditary or in whom it has previously manifested as madness. For if such people should be heavy wine-drinkers, or should eat much meat, or lie sleepless, or deal thoughtlessly with cold or heat, there is great likelihood that from these habits of regimen they will fall into derangement. And for those who have haemorrhoids, if one were to observe them drinking heavily in winter and having a good complexion, it is possible to foretell concerning them: for there is great likelihood that the blood will burst forth in spring, so that by summer they will be pale and waterlogged. But one must foretell, having studied all these things carefully, whoever desires to contend in such contests; for from what has been written here it is possible to foretell both death and madness and good condition of body. I could mention very many other such things, but I decided to write the most readily recognizable. I advise being as prudent as possible both in the craft generally and in foretellings of this kind, knowing that one who hits the mark with a foretelling will be admired by the patient who understands, while one who misses the mark will, in addition to being hated, risk appearing to have gone mad himself. For these reasons I urge that foretellings and everything else of this kind be made with prudence; though indeed I hear and see that people neither judge correctly what is said and done in the craft nor report it accurately. As for those who exercise and labor under regimens — the precise accuracies said to be achieved, as those who describe them describe them, I neither believe them to be real, nor, if anyone does believe them, do I prevent him from believing: for the underlying suppositions are harmed by no sign, good or bad, that would allow one, by trusting it, to know whether what has been reported is right or not. Otherwise it suits whoever wishes to believe, for I do not stand in the way. 2.3 My view is that if anything true is said — whether among these things concerning those who exercise, or those written earlier — one should first verify this by understanding the signs I describe, and then make the foretelling with reserve and in a human spirit, while at the same time those who report such things tend to describe matters more prodigiously than they actually occurred. Since indeed it is not easy to recognize errors even in illnesses — and yet the patients are lying down and using low-nourishment regimens, so that not many things need to be observed by the attendant in his examination. For some drink only, while others take in addition to drinking either a gruel or a very small amount of food; it is therefore necessary that in such circumstances those who have used more drink will appear to breathe with greater difficulty and to urinate more, while those who have had excess of gruel or food will be more thirsty and more feverish; and if someone uses both drink and foods to excess, in addition to being feverish and breathing with difficulty he will also have the belly stretched and enlarged. It is possible to put all these things and the rest to the finest test by means of the proofs we have and use well in all things. For first, it is easier to recognize by mind and eyes whether a man lying in the same place and following a strict regimen has departed from it, than if he were walking about and eating a great deal; and then, touching the belly and the vessels with the hands, one is less likely to be deceived than without touching. The nostrils give many fine signs in those who are feverish, for the smells differ greatly; but in those who are strong and following a correct regimen I do not know how I would use them, nor in this particular proof. Then, having listened with the ears to the voice and to the breath (pneuma), one can make distinctions, which are not equally evident in those who are strong. But all the same, if the physician has not first learned thoroughly the characters of the diseases and of the patients, he ought not to foretell anything; for the man might become more short of breath while the disease is still wandering, and might run a sharper fever, and the belly might become tense — so that for these reasons it is not safe to foretell before the disease has come to a settled state; but after that time, whatever occurs contrary to expectation must be stated. The harms arising from non-compliance are evident: shortness of breath and the rest of these will have ceased by the next day, if they arose through an error; so if one foresees this turning-point and speaks, one will not miss the mark. I for my part now propose this manner of examination — both concerning those who stay at home, what errors they commit, and concerning those who exercise and all the others. But as for those famed accuracies, I hear of them and laugh at those who report them: when people err in small ways, I do not know how I would expose it; but if the errors are greater, I write how one should make the examination. 2.4 One must first observe the person, in whom one intends to recognize what has been violated, every day in the same place and at the same hour — best of all when the sun is newly shining: for at this time the person would be somewhat emptied out, and is still fasting, and has undergone no exertion except the morning walks, during which he is least likely to violate, if indeed the man, having risen, has settled into his circuit — so that necessarily the man living in a correct regimen will at this hour most consistently have an even condition of color and of the whole body, and on this account the attendant will be most acute of mind and eye at this time. One must also attend to the modes of the person's thinking and the capacity of his body, for different people perform different prescribed tasks with ease or with difficulty. First, then, if one who is being held back by hunger were to eat and drink more, this will be evident from these signs: his body will appear more swollen, more sleek, and of better color, provided his bowel movements have not gone badly; and he will be more cheerful in his exertions. One must also examine whether he belches or is held by wind; for these things properly occur in those so disposed through this fault. If, being compelled to eat frequently and to labor strenuously, he either does not finish the food, or gets drunk, or does not walk off a substantial dinner, examine it this way: if he has eaten the dinner and walked the customary distances, he will be pleasanter to look at, keener and more capable of work in his exercises; and his excrement will be smallest and most compact in this case. But if, having eaten the dinner, he does not walk, he will belch and be flatulent, and his bulk will appear no less, and he will sweat more than before in his exertions, and will be short of breath and heavy; and the passages of the belly will be larger and less sticky in him. If he has consumed neither the food nor walked, he will be more sluggish and more hesitant. If he is drunk, he will sweat more than before, and will be short of breath, and heavier in himself and more moist; he will also be more cheerful, if the head does not trouble him. Having had intercourse with a woman once, he will be keener and more loosened; if he does it many times, he will become harder, with something parched about him, and paler and more prone to exhaustion. Those who are training should pass excrement, for as long as they eat and drink little, that is small and hard, once every day; but if it comes every other day, or every third, or at longer intervals, there is danger of fever or diarrhoea seizing him. Whatever excretions are too moist to retain their shape in the passage, all of these are worse. For those who already eat much and labor greatly, the passage must, while soft, be dry, the quantity proportionate to what is taken in and to the exertion; from equal amounts of food, those who exert themselves least pass the most, and those who exert themselves most pass little, if they are in health and living correctly; other things are to be weighed alongside these. 2.4 (cont.) The more fluid evacuations occurring without fever, and those that come on the seventh day, and those that resolve more quickly, are beneficial — all occurring at one time and not returning; but if the patients should run a fever on top, or the diarrheas should recur, if they become prolonged they are altogether harmful, whether they be bilious or phlegmatic or crude, each kind requiring its own proper regimen and different drug-treatments. Urine must be passed in proportion to the amount drunk, always equal in quantity, as concentrated as possible, and with a sediment slightly thicker than what was drunk. If it should be watery and more than the prescribed drink, it signifies that the person is not complying but is using more drink, or is unable to be nourished up for as long as the urine is doing this. If the urine drips little by little, it signifies either that the person needs drug-treatment, or that he has some disease of the bladder. To urinate blood on few occasions, without fever and without pain, signifies nothing bad but rather brings relief from fatigue; but if he urinates it frequently, or if any of these accompaniments are present, it is grave — but foretell that, whether blood is urinated with pains or with fever, pus will be passed next in the urine, and thus the pains will cease. Thick urine with a white sediment signifies either some pain and swelling about the joints or about the viscera; green sediment indicates either purification of the body or pain and swelling about the viscera. The other sediments in the urine of those who exercise arise entirely from diseases of the bladder; they will make themselves evident, for they will be accompanied by pains and be hard to be rid of. I write these things about these matters, and say other things of a similar kind. Of those whose foretellings are praised for their accuracy, I have met with some of them in person, and have conversed with the sons and students of others, and have obtained the writings of yet others; so that, knowing well what each of them thought, and finding the famed accuracies nowhere, I undertook to write these things. Concerning dropsical patients and those with phthisis (wasting-consumption), and those with podagra (gout), and those seized by what is called the sacred disease, I say the following — in one respect the same thing about all of them: for in whomsoever any of these diseases is hereditary, it is possible to know that they are hard to be rid of; the rest I will write about each separately. 2.6 The person held by dropsy who is going to survive must have sound viscera, and must extend normally and at the same time undergo pepsis (concoction) easily; being of good breath, he must be free of pain, and have the whole body evenly warm and not wasted away at the extremities; it is better to have swellings at the extremities, but best of all to have neither, but the extremities must be soft and lean; and the belly soft to the touch; cough must not be present, nor thirst, nor must the tongue be drying out — both at other times and especially after sleep, though this does happen readily; the foods must be received pleasantly, and eating enough must not be distressing; the belly must respond quickly to drugs, and at other times pass excrement that is soft and retaining its shape; the urine must appear to be passing in proportion to the habits and the changes of wines; the exertion must be borne easily, and there must be no exhaustion. Best of all is it when the person is disposed thus in all things, and he would most safely recover his health; if not, let him have as many of these as possible, for there will be hope of his surviving; but whoever has none of these but their opposites, know him to be without hope; and whoever has few of the things I say are good to be present in the dropsical patient, there is little hope for him. The one who hemorrhages greatly both upward and downward, and in whom fever supervenes, has great likelihood of filling up with water, and of all dropsical patients he is the most short-lived and most inescapable; let another foretell concerning him. Those in whom great swellings arise and then wither, and rise again, these survive more than those who fill up from bursting of blood vessels; but these dropsical conditions deceive the patients, so that they disbelieve their physicians and perish. Concerning those with phthisis (wasting-consumption), regarding the sputum and the cough I say the same things as I wrote concerning those with suppuration. 2.7 For the sputum of the one who is going to recover well must be brought up by coughing with ease, and must be white and uniform and of even color and free of inflammation, while what flows down from the head must turn toward the nostrils; fever must not seize him, or if it does, only so much that it does not prevent his eating dinner, and he must not be thirsty; the belly must pass stool every day, and what is passed must be hard, the quantity proportionate to intake; the person himself must be as little emaciated as possible; the chest is to be praised when it is square and hairy, and its cartilage must be small and strongly fleshed. Whoever has all these things is most likely to survive; whoever has none of them is most surely headed for destruction. All those who become internally suppurating, being young, whether from rupture or fistula or something else of that sort, or from backflow of apostasis (standing-off of disease), do not survive unless a great many of the good signs come upon them. These people die in autumn; and strongly also from other prolonged diseases most people reach their end in that season. Of the others, those least likely to survive are girls and women in whom phthisis (wasting-consumption) arises from suppression of the monthly periods. If a girl or woman is going to survive, many of the other good signs must come upon her, and the monthly periods must appear brightly and cleanly, or there is no hope. Those who develop internal suppuration from bursting of blood vessels, both men and women and girls, survive no less often, but one must, having reckoned up all the signs concerning the suppurating and the phthisic, foretell both who will survive and who will perish. Those who survive most readily from burstings of blood are those in whom there are melancholic pains in the back and chest beforehand, and who become more free of pain after the bursting; for neither do coughs come on with great force, nor do fevers persist for very long, and they bear thirst easily; relapses of the bursting occur most in these patients, if apostases (standings-off of disease) do not supervene; and the bloodiest of the apostases are best. Those in whom there are pains in the chest and who over time grow thin and cough, and in whom shortness of breath occurs, without fevers seizing them or suppuration developing — ask these patients, when they are coughing and short of breath, whether they cough up something twisted and small, with an odor. Concerning those with podagra (gout): all those who are old, or who have callous growths around their joints, or who live in an inactive manner with dry bowels — all of these are incapable of becoming healthy by human craft, as far as I know; they are best treated by dysenteries, if these come on, but other wasting processes that incline toward the lower regions are also quite beneficial. 2.8 But whoever is young and does not yet have callous growths around his joints, and is by nature attentive and hard-working, with bowels that respond well to regimens — such a person, if he encounters a physician who has understanding, might become healthy. Of those seized by the so-called sacred disease, the hardest to be freed from it are those in whom it comes upon them from childhood and grows up alongside them; next are those in whom it arises when the body is in its prime, which would be from twenty-five years to forty-five years; and after these, those in whom the disease arises giving no advance sign of where in the body it begins. 2.9 Those in whom it seems to begin from the head, or from the side, or from the hand, or from the foot, are easier to treat; for even these differ among themselves: those from the head being the most difficult of these, then those from the side; those from the hands and feet being most capable of complete recovery. The physician must attempt treatment in these cases, knowing the manner of healing, if the patients are young and hard-working — except insofar as the mind has some trouble, or someone has been struck by apoplexy (sudden incapacitation); for those melancholic departures from the senses are not beneficial; but all the others that turn downward are all good, and of these too by far the best are the bloodiest. As for those who have begun to be seized in old age, they die most often, and if they do not die they are most quickly relieved spontaneously, but are least benefited by physicians. In those children whose eyes were suddenly twisted, or who suffered some greater harm, or in whom tumors grew under the neck, or who became more thin-voiced, or in whom dry coughs of long standing persist, or in whom, as they grew larger, pain visits the belly and is not stirred out, or who have twistings in the sides or varicose thick veins around the belly, or in whom the omentum descends, or a testicle has grown large, or a hand is thin and powerless, or a foot, or the whole leg has become lame without any other cause — in all these cases one must know that the disease came before all these things, and most of those who raise the children, when questioned, will acknowledge it, while in some cases it escapes notice and they say they know of no such thing occurring. 2.11 Whoever intends to know how each case of wounds will turn out must first be fully versed in the bodily types of people — those better and those worse with respect to wounds; then must know the ages at which each type of wound is hard to be rid of; must have examined the places on the body and how much they differ from one another; and must know what other signs, good and bad, come upon each. For one who knows all these things will also know how each case will turn out; but one who does not know them will not know how the outcomes of the wounds will be. Good bodily types are these: light and well-proportioned, with sound viscera, neither strongly fleshy nor hard; as for color, it may be white, or dark, or red — for all of these are good when unmixed; but if the color is mixed-greenish, or green, or livid, it becomes worse. Whatever bodily types are by nature the opposite of those just described should be known to be worse. As for ages: suppurating tumors and scrofulous ones — children have these most and recover from them most easily; older children and young men develop fewer of them but recover from them with more difficulty. In men, tumors of this kind do not much arise; but honeycomb-like lesions are dangerous, and so are hidden cancers lurking underneath, and the creeping eruptions that arise from night-sores (epinyctides), up to well past sixty years. In the aged, none of these kinds of tumors arise; but hidden cancers and surface-afflictions arise and die with them. Among body-sites, the armpits are harder to treat, and so are the flanks and the thighs; for settlings-in and relapses occur in them. Among those about the joints, the great toes are most dangerous, and especially those of the feet. For those in whom a long-lasting wound arises on the side of the tongue, examine whether any of the teeth next to it is sharp. Wounds most deadly are those into the thick vessels of the neck and the groins, then those into the brain and the liver, then those into the intestine and the bladder. 2 12 All these things, though strongly destructive, are not so unavoidable as they seem; for regions that share the same name differ greatly from one another, and so do the same types. The bodily condition of the same person varies greatly: there are times when even if wounded he would neither develop fever nor become inflamed; and there are times when even without any apparent cause he would have developed fever, and some part of the body would in any case have become inflamed. But when a man who has a wound is not delirious and bears the wound easily, one should proceed with the wound on the assumption that it will turn out in accordance with the principles of treatment and the attending circumstances. People do indeed die from wounds of every kind; for there are many vessels, both fine and thick, which, when they hemorrhage, kill — if they happen to be in a state of engorgement at the moment — the very same vessels which, when cut at another time, benefit the bodies. Many wounds that are in regions that seem benign and appear not at all dangerous have nonetheless caused the blow to inflict such pain that the man cannot draw breath; and others, from the pain of a wound that is nothing dangerous, have managed to draw breath but have become delirious and, having developed fever, have died. For those who have either a body prone to fever or a mind prone to agitation are the ones who suffer such things. But one must neither be astonished at these cases nor be frightened by those, knowing that the psyche and the bodies of human beings differ enormously and possess the greatest force. Those wounds, then, that met with the right moment, or with a body and mind of such a nature, or with a body in such a state of engorgement, or were of such a magnitude that the man could not be brought to submit to treatment while contemptuous of it — in these cases one must stand aside whatever the situation may be, except for those who merely faint for the day; but in all other cases, when the wounds are fresh, one should act, so as to guard against the fevers, the hemorrhages, and the spreadings. One must maintain watch over the most dangerous signs with the greatest exactness and for the longest possible time; for this is also the right thing to do. Of the spreadings, those are the most deadly whose rots are deepest and most black and most dry; bad and dangerous are those that produce a dark ichor; the white and mucous rots kill less often, but relapse more, and become more chronic. 2 13 Herpētes (spreading sores) are the least dangerous of all wounds that spread, but the hardest to be rid of, at least as far as the hidden karkínoi (cancers) are concerned. In all such conditions it is beneficial for a fever to come on for one day, and for the pus to be as white and thick as possible. Mortification of a sinew, or of a bone, or of both, is also of benefit in cases of deep and black rots; for pus flows abundantly in mortifications and dissolves the rots. Of wounds to the head, the most deadly are those reaching the brain, as has already been set out above. Also grave are all of the following: a large bare-stripped bone, a crushed bone, a shattered bone. If the mouth of the wound should be small while the fracture of the bone extends over a wide area, the danger is greater. All these become more dangerous when they are over a suture, and of the regions, always those highest on the head. 2 14 In the case of all wounds worth considering, if the blows are still fresh, one must inquire whether there were projectiles, or whether the man fell, or whether he lost consciousness; for if any of these has occurred, greater watchfulness is required, on the grounds that the brain has received the effect of the wound. If the wound is no longer fresh, look to the other signs and deliberate. Now, it is best that the man who has the wound on his head neither develop fever at all, nor suffer a recurrence of hemorrhage, nor have any inflammation or pain come on; but if any of these should appear, it is safest for them to occur at the beginnings and to persist only a short time. In the pains and inflammations that supervene upon wounds it is beneficial for pus to appear; in hemorrhages, for pus to appear upon the vessels; and in fevers, I say here too that what I wrote as beneficial in the acute diseases is good in these cases, and the opposites are bad. For fever to begin in a head wound on the fourth, seventh, or eleventh day after wounding is very deadly. In most cases, if a wound is four days old when fever begins, the crisis comes on the eleventh day; if the man develops fever when the wound is seven days old, the crisis comes on the fourteenth or seventeenth; if fever begins on the eleventh day, the crisis comes on the twentieth, as has been set out in the section on fevers arising without evident causes. If at the onset of fevers either delirium comes on or apoplexy of some limb, know that the man is being destroyed, unless one of the most favorable signs should come on, or an excellence of the body underlies the condition; [but let the practitioner consider the man's constitution;] for this is still a hope of preservation, though it is unavoidable that the joint against which the apoplexy bore will become lame, should the man survive at all. Wounds in the joints, when they are large and completely sever the sinews that hold things together, will clearly render men lame. 2 15 If there is doubt about the condition of the sinews: if the weapon that made the wound was sharp, a straight wound is better to know of than a transverse one; if the wounding instrument was heavy and blunt, it makes no difference — instead, look to the depth of the blow and the other signs. These are as follows: if pus comes on upon the joint, it must become stiffer; if swelling also persists alongside, this region must remain stiff for a long time, and the swelling, even when the wound is healed, persists; and whatever is being treated when the joint is bent must of necessity flex and extend slowly. In cases where a sinew seems likely to be cast out, it is safer to give advance warning about the lameness, especially if what is being loosened belongs to the lower sinews. You will know in those in whom a sinew is about to be cast out by this: white, thick pus flows out for a long time; pains and inflammations occur around the joint at the outset. The same things also happen when a bone is about to be cast out. Cuts in the elbow joints, especially when in a state of inflammation, come to suppuration and require incisions and cauterizations. If the spinal marrow is diseased, whether from a fall, or from some other cause, or spontaneously, the man loses control of his legs so that he cannot feel them even when touched, and of the belly and the bladder, so that in the first period he passes neither excrement nor urine except under compulsion. 2 16 When the disease has become more long-standing, excrement and urine pass out even without the man's awareness, and he dies not much later after this. In those whose throat fills up with blood many times in each day and night, without prior pain in the head, without cough, without vomiting, without fever taking hold, without pain in either the chest or the back, one should look at the nostrils and the throat; for the man will be found to have either some wound in that region, or a leech. 2 18 Discharging eyes resolve best when the tearing, the discharge, and the swelling begin together. If the tearing is mixed with the discharge and not strongly hot, the discharge is white and soft, and the swelling is light and loose — for if these are in such a condition, the eye will seal shut at night, remaining without pain, and thus it would be least dangerous and of shortest duration. But if copious and hot tearing flows with very little discharge and small swelling, if it is from one eye only, it becomes very chronic but is free from danger; and this pattern is the most free from pain. As for the crisis, look for the first by the twentieth day; if it exceeds that time, expect it by the fortieth; if it does not stop by then either, it resolves in the sixtieth. Throughout this entire time, attend to the discharge: whether it mixes in with the tearing and becomes white and soft, especially around the critical times — for if it is going to stop, it will do these things. If both eyes are affected in this way, there is greater danger of ulceration; but the crisis will be of shorter duration. Dry discharges are very painful, but resolve quickly, provided the eye suffers no wound. If the swelling is large, painless, and dry, it is free from danger; but if it is accompanied by pain, it is bad if dry and dangerous, tending to ulcerate the eye and to cause adhesion; it is also grave when accompanied by both tearing and pain — for if hot and salty tearing flows, there is danger that both the pupil and the eyelids will ulcerate. If the swelling subsides but copious tearing flows for a long time, and there are discharges, one should give advance warning of eversion of the eyelids for men, and for women and children of ulceration and also eversion of the eyelids. If the discharges are greenish-yellow or livid, and the tearing copious and hot, and there is burning in the head, and pains drive through the temple into the eye, and sleeplessness comes on in these cases, an ulcer must necessarily form in the eye; and there is hope that such a case may rupture. A supervening fever is also beneficial, or a pain that settles in the lower back. One must give advance warning of what is to come in these cases, examining the time-course, the discharges from the eye, the severe pains, and the sleeplessness. When it is possible to see the eye directly, if it is found ruptured and the sight protruding through the rupture, it is grave and hard to settle; and if rot is also present in such a case, the eye becomes entirely useless. 2 19 For the other types of wounds, give advance warnings by examining them in relation to their regions, the rots, and the depths; for it is necessary that the scars form according to the severity of the wounds. In those whose eyes rupture and protrude greatly so that the sight is outside its place, there is no possibility of benefiting them — either with time or with skill — toward seeing again; but small displacements of the sight can be settled, provided no further harm comes on and the person is young. Scars from wounds, in cases where no other harm is present, can all be helped both by time and by skill — especially the most recent ones, and those in the youngest bodies. 2 20 Of the regions, the visual faculties suffer the most damage when ulcerated, then the area above the brows, then whatever is closest to these places. Pupils that become glaucous, or silvery-white, or dark-blue are no good at all. Somewhat better than these are those that appear smaller, or wider, or angular — whether they have come to be so from causes, or spontaneously. Hazes, clouds, and veils are smoothed away and disappear, provided no wound comes on in that region, or the man happens to have a scar already in that region, or a pterygion (wing-growth). But if a flash of light comes on and whitens some part of the dark area, and it persists a long time and is rough and thick, it is of a kind to leave a lasting trace. The crises proceed here as I wrote concerning fevers. 2 21 One must learn the signs and then give advance warnings: for the varying forms of eye inflammations, as has been set out for each; for the long-lasting eye inflammations, when the worst of the signs come on; and for the short-lasting ones, when the best signs appear — then give advance warning that they will stop at seven days, or close to that, and otherwise judge that they are safely resolved. Expect relapses in those whose ease came about neither on critical days nor with the appearance of good signs. Above all things in eye conditions one must attend to the state of the urine; for the critical moments are sharp. Dysenteries, if they come on with fever, or with varied stools, or with inflammation of the liver or the hypochondrium or the belly, or such as cause pain, or such as deprive patients of food while causing thirst — all of these are bad; and the one who has the most of these evils will perish the soonest; the one who has the least of such things present has the greatest hope. 2 22 Most deaths from this disease occur among children of five years and older up to ten years; the other age groups less so. Those dysenteries that are beneficial do not produce these evils, but having discharged blood and scrapings, they cease on the seventh, fourteenth, twentieth, or fortieth day, or within these periods. For such discharges also heal diseases already present in the bodies beforehand — older ones over a longer time, while newer ones they can relieve even in a few days. Indeed even women who are pregnant come through these, more so around the time of birth and after birth, and they preserve the fetuses even as blood and scrapings pass for many months — provided no pain is present for them, nor any other of the bad signs I wrote of as being present in dysenteries. But if any of those should appear, it signals destruction for the fetus and danger for the woman carrying it, unless the dysentery stops together with the passing of the fetus and the release of the afterbirth on the same day, or after a short time. Continuous and long-standing leienteries (smooth-gut fluxes) that are thrown into disorder at every hour with and without noise, and that press equally by night and by day, and with stools passing either very raw, or black and smooth and foul-smelling — all of these are bad. 2 23 For they cause thirst, and they do not divert the drink to the bladder so as to be passed as urine, and they ulcerate the mouth, and they produce an elevated redness on the face and freckle-like spots of every color; and they render the bellies at the same time fermented, foul, and wrinkled. Out of such conditions people become unable to eat, to take exercise, and to do the other things of life. This disease is most terrible for the elderly, and it is severe also for men, but much less so for the other age groups. Whoever is not in the age groups I say are badly afflicted by this disease, and has the fewest of the bad signs I have written down, is in the safest condition. This disease requires treatment until the urine passes in proportion to what is drunk, the body increases with the food that enters, and it is freed from the bad colorings. The other diarrheas, those without fevers, are short-lived and benign; for they will cease either by being washed out or spontaneously. One must give advance warning that the discharge will stop when, upon touching the belly with the hand, no movement is felt below and a passage of wind occurs at the end of the stool. The rectum prolapses — in men, those taken by diarrhea who have hemorrhoids; in children, those with bladder stones and those in long and unremitting dysenteries; and in the oldest, those in whom there are adhesions of mucus. As for women — those who are more or less constitutionally able to conceive — examine them as follows: first, the bodily types; for small women are better at conceiving than large, lean than stout, pale than ruddy, dark than livid; those who have visible vessels are better than those in whom they do not show through; to have flesh that puts on weight in an elderly way is bad, but to have full and large breasts is good. 2 24 These things are clear at first sight. One must also inquire about the menstrual periods: whether they appear every month, whether they are sufficient in quantity, whether they are of good color and consistent at each of the times, and on the same days of the months — for it is best that these things occur in this way. The region in which conception takes place, which we call the womb, must be healthy and dry and soft, and must be neither drawn up nor fallen forward, and its mouth must not be turned away or closed up or turned out; for it is impossible for conception to occur if any of these impediments is present. Women who cannot conceive but appear greenish-yellow, with neither fever nor the internal organs being at fault, will say they have pain in the head and that their menses are disordered and irregular for them. And if those in such a condition have little discharge and for a long time, or it is entirely absent, the womb requires purging for them. Women who have good color, much and rich flesh, and hidden small vessels, are without pain, and their menses either do not appear at all or appear little and irregularly — this type is among the most difficult to induce to conceive. If, while the menses are appearing without evident cause, the woman's body is in such a condition and she does not conceive, the region of the womb is the cause, so that offspring cannot be produced; for it is either drawn up or turned out. The other harms that occur here occur together with pains, discolorations, and wasting. Women in whose womb an ulcer has formed — whether from childbirth, from a swelling, or from some other cause — must necessarily have fevers and swellings of the groin and pains in those regions. And if the lochia should also be retained, the pre-existing evils become in every respect more critical and more chronic; and in addition there are pains of the hypochondrium and the head. When an ulcer has formed and healed, that region must of necessity become smoother and harder, and be less able to conceive. If the ulcer should have occurred only on the left side, and the woman should conceive — whether still having the ulcer or now already healed — there is greater hope that she will give birth to a male; if the ulcer occurred on the right side and the woman has conceived, the offspring should be considered more likely to be female. If fevers develop in a woman who is unable to conceive and who is lean, one must ask whether the womb has any ulcer or any other of the harmful things I have written about; for if no underlying harm in that region appears to be the cause of the wasting and the inability to conceive, one must anticipate that the woman will vomit blood; the menses must in such a woman have disappeared; and if the fever is resolved by the rupture of blood, and the menses also appear, she will conceive. But if the stomach should become moist in a harmful way before the blood breaks out, there is danger that the woman will perish before she vomits blood. 2 26 Those women who think they are pregnant but are not, and are deceived for many months with the menses not appearing, and see their bellies growing and stirring — these have pain in the head, the neck, and the hypochondria; and milk does not form in their breasts, except perhaps a little and watery. When the swelling of the belly is dissolved and they become flat, these women will conceive, unless some other impediment arises for them; since this condition is a good thing to bring about a change in the womb, so that after this time one can conceive. But in women who are actually pregnant, these pains do not occur, unless they are habitual, and milk forms in the breasts. Those who are held by long-lasting flows, ask whether they have pain in the head, the lower back, and the lower belly; ask also about teeth-on-edge sensation, dimness of vision, and ringing in the ears. 2 28 Women who, while fasting, vomit bile-tinged matter for many days, neither pregnant nor feverish — inquire whether they also vomit round worms together with it; and if they do not admit to this, give advance warning that it will occur. This disease occurs most commonly in women, then also in maidens, and in other people less so. Those pains that occur without fevers do not produce deaths, but most are long-lasting, involve many shifts of place, and have many relapses. 2 30 [35] The characters of head pains — first, of these: some are straightforward, others much more troublesome. One must examine each kind in the following way. Those who have dim vision and some redness in the eyes, and itching takes hold of the forehead — in these cases blood flowing of its own accord or by compulsion gives relief. This is the simple character. Those in whom pains about the head and forehead arise from strong winds and from cold, when they have been warmed strongly — in these cases, fully developed head catarrh relieves them most, and sneezing also helps, along with mucus forming in the nostrils; rather from its own accord, if not then by compulsion. When head catarrh develops fully, so that coughing also supervenes, and sneezing likewise supervenes — if these do not stop the pains, swellings and loss of color must necessarily supervene in these cases. Those in whom pains arise without evident cause, both long-lasting and throughout the whole head, and who are thin and feeble — for them one must foresee a disease much more troublesome than the preceding. And if the pain descends into the neck and the back, leaving the head, and then runs back again into the head, it becomes still more troublesome. Of all these, the most dreadful is if there is a drawing tension from the head into the neck and the back. For these, one should expect the benefits to come from abscessions — either from coughing up pus, or from hemorrhoids, or from eruptions on the body. A scaly, bran-like condition of the head is also profitable. Numbing and stinging sensations that flash through the head — sometimes through all of it, sometimes through a part — and often something cold seems to them to pass through the head: these patients should be asked whether the stinging also reaches the tip of the tongue. For if it does, the disease becomes complete and harder to be rid of; without this, easy. The ways in which benefit comes, from abscessions, are as written above; abscessions, however, supervene less readily in these cases than in those previous ones. Those whom dark spinning of the head takes hold of along with the pains — this is hard to be rid of and tends to madness; this character arises most in old men. The other diseases about the heads are, without question, strongest and most long-lasting in both men and women; they arise also in young men and girls of marriageable age, and especially around the onset of the monthly courses. In women with head pains, all other things occur that also occur in men; but stinging sensations and the melancholic things are less in women than in men, unless the monthly courses have completely disappeared. Those whose complexion is poor for a long time while they are young, continuously but not in the manner of jaundice — both men and women among these have head pain, eat earth and clay, and have hemorrhoids. 2 31 [5] Those with pale-green coloring that is long-lasting and without strong jaundice — the other things happen to them in the same way, but instead of eating clay and earth, the hypochondria trouble them more than the others. Those who appear pallid for a long time and have swollen faces — one must know that these have pain in the head, or pains about the viscera, or something bad appearing in the seat. 2 32 [5] In most such cases, not just one of these troubles appears, but sometimes many or even all. Those who see in the dark — whom we call nyktalopes — these are seized by the disease when young, either as children or as young men; and they recover of their own accord, some within forty days, others in seven months, while in some it persists for a full year. 2 33 [5] One must form a judgment about the time by looking both at the strength of the disease and at the age of the sick person. Abscessions help these patients when they appear and incline downward, but they do not readily supervene on account of youth. Women are not seized by this disease, nor are girls in whom the monthly courses are present. Those who have long-lasting flows of tears or become nyktalopes — these should be asked whether they had any prior head pain before the onset of these fixed conditions. 2 35 [10] Those who, without having had fever and without being discolored, frequently have pain in the top of the head and the temples — if they do not have some other evident abscession on the face, or speak with a heavy voice, or have pain in the teeth — in these cases one should expect hemorrhage through the nostrils. Those from whose nostrils blood flows, who seem otherwise healthy — in these you will find either an enlarged spleen or pain in the head along with something flickering appearing before the eyes. In most such cases, both what derives from the head in this way and what derives from the spleen appear together in these patients. Diseased gums and foul-smelling mouths go with large spleens. 2 36 Those who have large spleens, in whom neither hemorrhage occurs nor foul-smelling mouth — the shins of these hold bad ulcers and black scars. Those in whom the area beneath the eyes is strongly swollen — you will find these to have large spleens; and if swellings in the feet are also added, they will be found to have water, but one must also inspect the belly and the lower back. 2 38 Distortions in the face, if they do not share in anything else of the body, cease quickly — both of their own accord and under compulsion. Other cases are apoplexy. Those in whom the diseased part of the body wastes away from inability to move — these are unable to return to their former condition. Those in whom wasting does not supervene — these will be healthy. 2 39 [5] Concerning the time when they will recover, one should make a prognosis by looking at the strength of the disease, the time, the age of the person, and the season, knowing that the most long-standing diseases and the worst and those that keep recurring respond most heavily, as do those in the oldest bodies. Autumn and winter are also less favorable than spring and summer for releasing these diseases. Pains arising in the shoulders: those that, descending into the arms, produce numbings and pains — in these cases abscessions do not supervene, but they are cured by vomiting black bile. Those that remain in the shoulders or reach the back — these patients escape by vomiting pus or black bile. 2 40 [5] One must come to understand these cases in the following way: if they breathe easily and are thin, the expectation is rather that they will vomit black bile; but if they breathe more with difficulty, and some color runs over the face that was not there before — either reddish or dark — the expectation is rather that these will spit up pus. One should also examine whether there are swellings in the feet; for this sign agrees with these cases. This disease comes on strongest in men between forty and sixty years of age. This age is especially beset by hip-joint pain (ischias). One must examine the following regarding hip-joint pain: those among older persons in whom the numbings are strongest and the chilling of the lower back and limbs is severe, and who are unable to raise the genitals, and the belly does not pass anything except under compulsion, and much dung-like mucus passes through — in these the disease will be most long-lasting, and one should predict at minimum a year from the time the disease began, and expect benefits in spring and summer. 2 41 [5] In young men, hip-joint pains are no less painful, but shorter; they resolve in forty days; moreover, strong numbings do not supervene, nor chilling of the limbs and the lower back. Those in whom this disease is in the lower back and the leg but does not force them to lie down — one should look for contractures somewhere in the hip joint, and ask whether the pain reaches the groin; for if both these are present, the disease becomes prolonged. One should also ask whether numbings arise in the thigh and reach the hollow of the knee; and if the patient says yes, ask again whether through the shin to the sole of the foot. Those who agree to most of these — tell them that their leg becomes at times warm, at times cold. This disease, in those from whom it leaves the lower back and turns downward — this is reassuring. Those in whom it does not leave the hip joints and the lower back but turns upward — for these one should predict that things are grave. Those in whom pains and swellings about the joints arise and then cease — not in the manner of gout (podagra) — you will find the viscera enlarged and a white sediment in the urine; and the temples, if asked, the patient will say often hurt; and he will say that night sweats occur. 2 42 [5] If neither does this sediment settle in the urine, nor do the sweats occur, there is danger that the joints become lame, or that what they call a honey-cyst (melikēris) forms beneath them. This disease arises in those who, in childhood and youth, habitually had blood flowing from the nostrils but this has now stopped. One should therefore ask about the bursting of blood, whether it occurred in youth; and whether stinging sensations are present in the chest and the back between the shoulder-blades; and those whose bowels cause severe pains without violent disturbance; and those in whom hemorrhoids arise — for this is the starting-point of these diseases. If these persons appear to have poor complexion, one should also ask whether they have head pain — for they will say yes. Of these, those whose bowels are painful on the right side — the pains become stronger, and most especially when the residue of the pain is at the hypochondrium near the liver. Borborygmus arising in the belly gives immediate relief to these pains; and when the pain ceases, they pass urine that is thick and pale-green. This character is in no way deadly, but very long-lasting; and when the disease has already become old, the patients have dim vision from it. But one should ask about the blood, whether it flowed when the patient was young, and about the dim vision, and about the voiding of urine and its pallid-green color, and about the borborygmoi, whether they arise and give relief when they come — for they will affirm all these things. Lichen, lepra (scaly skin), and white patches: those in whom one of these arose while they were young or children — either appearing little by little and growing slowly over a long time — for these the eruption should not be considered an abscession, but a disease. Those in whom one of these arose extensively and suddenly — this would be an abscession. 2 43 [10] White patches arise from the most deadly diseases — for example, the disease called the Phoenician disease. Lepra and lichen arise from melancholic conditions. Among these, the easiest to treat are those that arise in the youngest patients and are themselves newest, and those that grow in the softest and most fleshy parts of the body.