on regimen in acute diseases-第2章

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from　being　evacuated。　These　symptoms　supervene；　not　only　if　ptisan
be　administered　unseasonably；　but　still　more　if　any　other　food　or
drink　worse　than　ptisan　be　given。
　　6。　For　the　most　part；　then；　the　results　are　the　same；　whether　the
patient　have　used　the　unstrained　ptisan　or　have　used　the　juice
alone；　or　even　only　drink；　and　sometimes　it　is　necessary　to　proceed
quite　differently。　In　general；　one　should　do　thus：　if　fever
commences　shortly　after　taking　food；　and　before　the　bowels　have　been
evacuated；　whether　with　or　without　pain；　the　physician　ought　to
withhold　the　draught　until　he　thinks　that　the　food　has　descended　to
the　lower　part　of　the　belly；　and　if　any　pain　be　present；　the　patient
should　use　oxymel；　hot　if　it　is　winter；　and　cold　if　it　is　summer；　and；
if　there　be　much　thirst；　he　should　take　hydromel　and　water。　Then；　if
any　pain　be　present；　or　any　dangerous　symptoms　make　their
appearance；　it　will　be　proper　to　give　the　draught　neither　in　large
quantity　nor　thick；　but　after　the　seventh　day；　if　the　patient　be
strong。　But　if　the　earlier…taken　food　has　not　descended；　in　the　case
of　a　person　who　has　recently　swallowed　food；　and　if　he　be　strong　and
in　the　vigor　of　life；　a　clyster　should　be　given；　or　if　he　be　weaker；　a
suppository　is　to　be　administered；　unless　the　bowels　open　properly
of　themselves。　The　time　for　administering　the　draught　is　to　be
particularly　observed　at　the　commencement　and　during　the　whole
illness；　when；　then；　the　feet　are　cold；　one　should　refrain　from　giving
the　ptisan；　and　more　especially　abstain　from　drink；　but　when　the
heat　has　descended　to　the　feet；　one　may　then　give　it；　and　one　should
look　upon　this　season　as　of　great　consequence　in　all　diseases；　and　not
least　in　acute　diseases；　especially　those　of　a　febrile　character；
and　those　of　a　very　dangerous　nature。　One　may　first　use　the　juice；　and
then　the　ptisan；　attending　accurately　to　the　rules　formerly　laid　down。
　　7。　When　pain　seizes　the　side；　either　at　the　commencement　or　at　a
later　stage；　it　will　not　be　improper　to　try　to　dissolve　the　pain　by
hot　applications。　Of　hot　applications　the　most　powerful　is　hot　water
in　a　bottle；　or　bladder；　or　in　a　brazen　vessel；　or　in　an　earthen
one；　but　one　must　first　apply　something　soft　to　the　side；　to　prevent
pain。　A　soft　large　sponge；　squeezed　out　of　hot　water　and　applied；
forms　a　good　application；　but　it　should　be　covered　up　above；　for
thus　the　heat　will　remain　the　longer；　and　at　the　same　time　the　vapor
will　be　prevented　from　being　carried　up　to　the　patient's　breath；
unless　when　this　is　thought　of　use；　for　sometimes　it　is　the　case。
And　further；　barley　or　tares　may　be　infused　and　boiled　in　diluted
vinegar；　stronger　than　that　it　could　be　drunk；　and　may　then　be　sewed
into　bladders　and　applied；　and　one　may　bran　in　like　manner。　Salts　or
toasted　millet　in　woolen　bags　are　excellent　for　forming　a　dry
fomentation；　for　the　millet　is　light　and　soothing。　A　soft
fomentation　like　this　soothes　pains；　even　such　as　shoot　to　the
clavicle。　Venesection；　however；　does　not　alleviate　the　pain　unless
when　it　extends　to　the　clavicle。　But　if　the　pain　be　not　dissolved　by
the　fomentations；　one　ought　not　to　foment　for　a　length　of　time；　for
this　dries　the　lungs　and　promotes　suppuration；　but　if　the　pain　point
to　the　clavicle；　or　if　there　be　a　heaviness　in　the　arm；　or　about　the
breast；　or　above　the　diaphragm；　one　should　open　the　inner　vein　at
the　elbow；　and　not　hesitate　to　abstract　a　large　quantity；　until　it
become　much　redder；　or　instead　of　being　pure　red；　it　turns　livid；
for　both　these　states　occur。　But　if　the　pain　be　below　the　diaphragm；
and　do　not　point　to　the　clavicle；　we　must　open　the　belly　either　with
black　hellebore　or　peplium；　mixing　the　black　hellebore　with　carrot
or　seseli；　or　cumin；　or　anise；　or　any　other　of　the　fragrant　herbs；　and
with　the　peplium　the　juice　of　sulphium　（asafoetida）；　for　these
substances；　when　mixed　up　together；　are　of　a　similar　nature。　The　black
hellebore　acts　more　pleasantly　and　effectually　than　the　peplium；
while；　on　the　other　hand；　the　peplium　expels　wind　much　more
effectually　than　the　black　hellebore；　and　both　these　stop　the　pain；
and　many　other　of　the　laxatives　also　stop　it；　but　these　two　are　the
most　efficacious　that　I　am　acquainted　with。　And　the　laxatives　given　in
draughts　are　beneficial；　when　not　very　unpalatable　owing　to
bitterness；　or　any　other　disagreeable　taste；　or　from　quantity；
color；　or　any　apprehension。　When　the　patient　has　drunk　the　medicine；
one　ought　to　give　him　to　swallow　but　little　less　of　the　ptisan　than
what　he　had　been　accustomed　to；　but　it　is　according　to　rule　not　to
according　to　rule　not　to　give　any　draughts　while　the　medicine　is　under
operation；　but　when　the　purging　is　stopped　then　he　should　take　a
smaller　draught　than　what　he　had　been　accustomed　to；　and　afterwards　go
on　increasing　it　progressively；　until　the　pain　cease；　provided　nothing
else　contra…indicate。　This　is　my　rule；　also；　if　one　would　use　the
juice　of　ptisan　（for　I　hold　that　it　is　better；　on　the　whole；　to
begin　with　taking　the　decoction　at　once；　rather　than　by　first　emptying
the　veins　before　doing　so；　or　on　the　third；　fourth；　fifth；　sixth；　or
seventh　day；　provided　the　disease　has　not　previously　come　to　a
crisis　in　the　course　of　this　time）；　and　similar　preparations　to
those　formerly　described　are　to　be　made　in　those　cases。
　　8。　Such　are　the　opinions　which　I　entertain　respecting　the
administering　of　the　ptisan；　and；　as　regards　drinks；　whichsoever　of
those　about　to　be　described　may　be　administered；　the　same　directions
are　generally　applicable。　And　here　I　know　that　physicians　are　in　the
practice　of　doing　the　very　reverse　of　what　is　proper；　for　they　all
wish；　at　the　commencement　of　diseases；　to　starve　their　patients　for
two；　three；　or　more　days；　and　then　to　administer　the　ptisans　and
drinks；　and　perhaps　it　appears　to　them　reasonable　that；　as　a　great
change　has　taken　place　in　the　body；　it　should　be　counteracted　by
another　great　change。　Now；　indeed；　to　produce　a　change　is　no　small
matter；　but　the　change　must　be　effected　well　and　cautiously；　and　after
the　change　the　administration　of　food　must　be　conducted　still　more　so。
Those　persons；　then；　would　be　most　injured　if　the　change　is　not
properly　managed；　who　used　unstrained　ptisans；　they　also　would
suffer　who　made　use　of　the　juice　alone；　and　so　also　they　would
suffer　who　took　merely　drink；　but　these　least　of　all。
　　9。　One　may　derive　information　from　the　regimen　of　persons　in　good
health　what　things　are　proper；　for　if　it　appear　that　there　is　a
great　difference　whether　the　diet　be　so　and　so；　in　other　respects；　but
more　especially　in　the　changes；　how　can　it　be　otherwise　in　diseases；
and　more　especially　in　the　most　acute？　But　it　is　well　ascertained　that
even　a　faulty　diet　of　food　and　drink　steadily　persevered　in；　is
safer　in　the　main　as　regards　health　than　if　one　suddenly　change　it
to　another。　Wherefore；　in　the　case　of　persons　who　take　two　meals　in
the　day；　or　of　those　who　take　a　single　meal；　sudden　changes　induce
suffering　and　weakness；　and　thus　persons　who　have　not　been
accustomed　to　dine；　if　they　shall　take　dinner；　immediately　become
weak；　have　heaviness　over　their　whole　body；　and　become　feeble　and
languid；　and　if；　in　addition；　they　take　supper；　they　will　have　acid
eructations；　and　some　will　have　diarrhoea　whose　bowels　were　previously
dry；　and　not　having　been　accustomed　to　be　twice　swelled　out　with
food　and　to　digest　it　twice　a　day；　have　been　loaded　beyond　their　wont。
It　is　beneficial；　in　such　cases；　to　counterbalance　this　change；　for
one　should　sleep　after　dinner；　as　if　passing　the　night；　and　guard
against　cold　in　winter　and　heat　in　summer；　or；　if　the　person　cannot
sleep；　he　may　stroll　about　slowly；　but　without　making　stops；　for　a
good　while；　take　no　supper；　or；　at　all　events；　eat　little；　and　only
things　that　are　not　unwholesome；　and　still　more　avoid　drink；　and
especially　water。　Such　a　person　will　suffer　still　more　if　he　take
three　full　meals　in　the　day；　and　more　still　if　he　take　more　meals；　and
yet　there　are　many　persons　who　readily　bear　to　take　three　full　meals
in　the　day；　provided　they　are　so　accustomed。　And；　moreover；　those
who　have　been　in　the　habit　of　eating　twice　a　day；　if　they　omit　dinner；
become　feeble　and　powerless；　averse　to　all　work；　and　have　heartburn；
their　bowels　seem；　as　it　were；　to　hang　loose；　their　urine　is　hot　and
green；　and　the　excrement　is　parched；　in　some　the　mouth　is　bitter；
the　eyes　are　hollow；　the　temples　throb；　and　the　extremities　are
cold；　and　the　most　of　those　who　have　thus　missed　their　dinner　cannot
eat　supper；　or；　if　they　do　sup；　they　load　their　stomach；　and　pass　a
much　worse　night　than　if　they　had　previously　taken　dinner。　Since；
then；　an　unwonted　change　of　diet　for　half　a　day　produces　such
effects　upon　persons　in　health；　it　appears　not　to　be　a　good　thing
either　to　add　or　take　from。　If；　then；　he　who　was　restricted　to　a
single　meal；　contrary　to　usage；　having　his　veins　thus　left　empty
during　a　whole　day；　when　he　supped　according　to　custom　felt　heavy；
it　is　probable　that　if；　because　he　was　uneasy　and　weak　from　the　want
of　dinner；　he　took　a　larger　supper　than　wont；　he　would　be　still　more
oppressed；　or　if；　wanting　food　for　a　still　greater　interval；　he
suddenly　took　a　meal　after　supper；　he　will　feel　still　greater
oppression。　He；　then；　who；　contrary　to　usage；　has　had　his　veins　kept
empty　by　want　of　food；　will　find　it　beneficial　to　counteract　the　bad
effects　during　that　day　as　follows：　let　him　avoid　cold；　heat；　and
exertion；　for　he　could　bear　all　these　ill；　let　him　make　his　supper
considerably　less　than　usual；　and　not　of　dry　food；　but　rather
liquid；　and　let　him　take　some　drink；　not　of　a　watery　character；　nor　in
smaller　quantity　than　is　proportionate　to　the　food；　and　on　the　next
day　he　should　take　a　small　dinner；　so　that；　by　degrees；　he　may
return　to　his　former　practice。　Persons　who　are　bilious　in　the
stomach　bear　these　changes　worst；　while　those　who　are　pituitous；
upon　the　whole；　bear　the　want　of　food　best；　so　that　they　suffer　the
least　from　being　restricted　to　one　meal　in　the　day；　contrary　to　usage。
This；　then；　is　a　sufficient　proof　that　the　greatest　changes　as　to
those　things　which　regard　our　constitutions　and　habits　are　most
especially　concerned　in　the　production　of　diseases；　for　it　is
impossible　to　produce　unseasonably　a　great　emptying　of　the　vessels
by　abstinence；　or　to　administer　food　while　diseases　are　at　their　acme；
or　when　inflammation　prevails；　nor；　on　the　on　the　whole；　to　make　a
great　change　either　one　way　or　another　with　impunity。
　　10。　One　might　mention　many　things　akin　to　these　respecting　the
stomach　and　bowels；　to　show　how　people　readily　bear　such　food　as
they　are　accustomed　to；　even　if　it　is　not　naturally　good；　and　drink　in
like　manner；　and　how　they　bear　unpleasantly　such　food　as　they　are
not　accustomed　to；　even　although　not　bad；　and　so　in　like　manner　with
drink；　and　as　to　the　effects　of　eating　much　flesh；　contrary　to
usage；　or　garlic；　or　asafoetida；　or　the　stem　of　the　plant　which
produces　it；　or　things　of　a　similar　kind　possessed　of　strong
properties；　one　would　be　less　surprised　if　such　things　produce　pains
in　the　bowels；　but　rather　when　one　learned　what　trouble；　swelling；
flatulence；　and　tormina　the　cake　（maza）　will