ST. LOUIS -- The same illness Carlos Martinez pitched through with relative success earlier this week knocked him out on Friday night and could put his next scheduled outing in jeopardy if the weakness persists.
Still fighting a respiratory illness that has swept through the Cardinals' clubhouse, Martinez ran out of energy in the fourth inning of an eventual 4-2 loss to the Pirates. The cough he hasn't been able to kick for about 10 days persisted, and the lingering effects of significant weight loss caused him to tire.
"I kind of felt the fastball isn't there, and I felt a little dehydrated and stuff like that," said Martinez, using teammate Brayan Pena as a translator. "When the game was going on and on and on, I felt weaker."
Martinez revealed that he did not do his normal weight-room strength training ahead of this start, and he estimated that he's dropped as much as 15 pounds since first getting ill. However, manager Mike Matheny said the club had no reservations sending him to the mound as scheduled, nor did the illness keep Martinez from participating in a local Cinco de Mayo celebration or attending the St. Louis Blues' playoff hockey game with teammates the night before his outing.
"It looked like he was on the mend and things were going in a good direction and he just kind of didn't have it," Matheny said. "He was hydrated, and he passed everybody's test. We didn't see anything that was making us concerned that this might be the case."

Martinez agreed that he could benefit from a few days of rest, but added that he did not think it would be necessary to skip his next start -- scheduled for Thursday. The Cardinals will determine that after reevaluating the right-hander this weekend.
"I really have to go and do what I have to do to get my strength back," Martinez said. "I feel like I'm not going to miss any starts. I have to hydrate even more."
He appeared strong early against the Pirates, allowing one run over his first three innings. His mechanics slowly eroded, though, and by the fourth, Martinez looked out of sorts. Nine of the first 11 pitches he threw in the frame were balls, which drew a mound visit from pitching coach Derek Lilliquist.
Martinez remained in the game and got an infield popup on his first pitch to Jung Ho Kang with the bases full, then threw one pitch to Josh Harrison. Something in Martinez's motion caught the attention of Yadier Molina. The Cardinals catcher went to check on the right-hander and was soon followed by Matheny and athletic trainer Adam Olsen.
"Up until that point, he had a different body language. I think we could all see that early on," Matheny said. "But he was still making pretty good pitches. But that one particular pitch when Yadi went out, it looked like he hesitated. Something just looked odd."
After a short discussion, Martinez headed back to the dugout with Olsen. When he spoke with the media two hours later, Martinez did so with heavy eyelids and a pestering cough.
"I'm not feeling good," he remarked at one point. "I'm not feeling good at all."