on regimen in acute diseases-第3章

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in　the　bowels；　but　rather　when　one　learned　what　trouble；　swelling；
flatulence；　and　tormina　the　cake　（maza）　will　raise　in　the　belly　when
eaten　by　a　person　not　accustomed　to　it；　and　how　much　weight　and
distention　of　the　bowels　bread　will　create　to　a　person　accustomed　to
live　upon　the　maza；　and　what　thirst　and　sudden　fullness　will　be
occasioned　by　eating　hot　bread；　owing　to　its　desiccant　and
indigestible　properties；　and　what　different　effects　are　produced　by
fine　and　coarse　bread　when　eaten　contrary　to　usage；　or　by　the　cake
when　usually　dry；　moist；　or　viscid；　and　what　different　effects　polenta
produces　upon　those　who　are　accustomed　and　those　who　are
unaccustomed　to　the　use　of　it；　or　drinking　of　wine　or　drinking　of
water；　when　either　custom　is　suddenly　exchanged　for　the　other；　or
when；　contrary　to　usage；　diluted　wine　or　undiluted　has　been　suddenly
drunk；　for　the　one　will　create　water…brash　in　the　upper　part　of　the
intestinal　canal　and　flatulence　in　the　lower；　while　the　other　will
give　rise　to　throbbing　of　the　arteries；　heaviness　of　the　head；　and
thirst；　and　white　and　dark…colored　wine；　although　both　strong　wines；
if　exchanged　contrary　to　usage；　will　produce　very　different　effects
upon　the　body；　so　that　one　need　the　less　wonder　that　a　sweet　and
strong　wine；　if　suddenly　exchanged；　should　have　by　no　means　the　same
effect。
　　11。　Let　us　here　briefly　advert　to　what　may　be　said　on　the　opposite
side；　namely；　that　a　change　of　diet　has　occurred　in　these　cases；
without　any　change　in　their　body；　either　as　to　strength；　so　as　to
require　an　increase　of　food；　or　as　to　weakness；　so　as　to　require　a
diminution。　But　the　strength　of　the　patient　is　to　be　taken　into
consideration；　and　the　manner　of　the　disease；　and　of　the
constitution　of　the　man；　and　the　habitual　regimen　of　the　patient；
not　only　as　regards　food　but　also　drink。　Yet　one　must　much　less　resort
to　augmentation；　since　it　is　often　beneficial　to　have　recourse　to
abstraction；　when　the　patient　can　bear　it；　until　the　disease　having
reached　its　acme　and　has　become　concocted。　But　in　what　cases　this　must
be　done　will　be　afterwards　described。　One　might　write　many　other
things　akin　to　those　which　have　been　now　said；　but　there　is　a　better
proof；　for　it　is　not　akin　to　the　matter　on　which　my　discourse　has
principally　turned；　but　the　subject…matter　itself　is　a　most　seasonable
proof。　For　some　at　the　commencement　of　acute　diseases　have　taken
food　on　the　same　day；　some　on　the　next　day；　some　have　swallowed
whatever　has　come　in　their　way；　and　some　have　taken　cyceon。　Now　all
these　things　are　worse　than　if　one　had　observed　a　different　regimen；
and　yet　these　mistakes；　committed　at　that　time；　do　much　less　injury
than　if　one　were　to　abstain　entirely　from　food　for　the　first　two　or
three　days；　and　on　the　fourth　or　fifth　day　were　to　take　such　food；　and
it　would　be　still　worse；　if　one　were　to　observe　total　abstinence　for
all　these　days；　and　on　the　following　days　were　to　take　such　a　diet；
before　the　disease　is　concocted；　for　in　this　way　death　would　be　the
consequence　to　most　people；　unless　the　disease　were　of　a　very　mild
nature。　But　the　mistakes　committed　at　first　were　not　so　irremediable
as　these；　but　could　be　much　more　easily　repaired。　This；　therefore；　I
think　a　strong　proof　that　such　or　such　a　draught　need　not　be
prescribed　on　the　first　days　to　those　who　will　use　the　same　draughts
afterwards。　At　the　bottom；　therefore；　they　do　not　know；　neither
those　using　unstrained　ptisans；　that　they　are　hurt　by　them；　when
they　begin　to　swallow　them；　if　they　abstain　entirely　from　food　for
two；　three；　or　more　days；　nor　do　those　using　the　juice　know　that
they　are　injured　in　swallowing　them；　when　they　do　not　commence　with
the　draught　seasonably。　But　this　they　guard　against；　and　know　that
it　does　much　mischief；　if；　before　the　disease　be　concocted；　the
patient　swallow　unstrained　ptisan；　when　accustomed　to　use　strained。
All　these　things　are　strong　proofs　that　physicians　do　not　conduct
the　regimen　of　patients　properly；　but　that　in　those　diseases　in
which　total　abstinence　from　food　should　not　be　enforced　on　patients
that　will　be　put　on　the　use　of　ptisans；　they　do　enforce　total
abstinence；　that　in　those　cases　in　which　there　should　be　no　change
made　from　total　abstinence　to　ptisans；　they　do　make　the　change；　and
that；　for　the　most　part；　they　change　from　abstinence　to　ptisans；
exactly　at　the　time　when　it　is　often　beneficial　to　proceed　from
ptisans　almost　to　total　abstinence；　if　the　disease　happen　to　be　in　the
state　of　exacerbation。　And　sometimes　crude　matters　are　attracted
from　the　head；　and　bilious　from　the　region　near　the　chest；　and　the
patients　are　attacked　with　insomnolency；　so　that　the　disease　is　not
concocted；　they　become　sorrowful；　peevish；　and　delirious；　there　are
flashes　of　light　in　their　eyes；　and　noises　in　their　ears；　their
extremities　are　cold；　their　urine　unconcocted；　the　sputa　thin；
saltish；　tinged　with　an　intense　color　and　smell；　sweats　about　the
neck；　and　anxiety；　respiration；　interrupted　in　the　expulsion　of　the
air；　frequent　and　very　large；　expression　of　the　eyelids　dreadful；
dangerous　deliquia；　tossing　of　the　bed…clothes　from　the　breast；　the
hands　trembling；　and　sometimes　the　lower　lip　agitated。　These　symptoms；
appearing　at　the　commencement；　are　indicative　of　strong　delirium；
and　patients　so　affected　generally　die；　or　if　they　escape；　it　is
with　a　deposit；　hemorrhage　from　the　nose；　or　the　expectoration　of
thick　matter；　and　not　otherwise。　Neither　do　I　perceive　that　physicians
are　skilled　in　such　things　as　these；　how　they　ought　to　know　such
diseases　as　are　connected　with　debility；　and　which　are　further
weakened　by　abstinence　from　food；　and　those　aggravated　by　some　other
irritation；　those　by　pain；　and　from　the　acute　nature　of　the　disease；
and　what　affections　and　various　forms　thereof　our　constitution　and
habit　engender；　although　the　knowledge　or　ignorance　of　such　things
brings　safety　or　death　to　the　patient。　For　it　is　a　great　mischief　if
to　a　patient　debilitated　by　pain；　and　the　acute　nature　of　the　disease；
one　administer　drink；　or　more　ptisan；　or　food；　supposing　that　the
debility　proceeds　from　inanition。　It　is　also　disgraceful　not　to
recognize　a　patient　whose　debility　is　connected　with　inanition；　and　to
pinch　him　in　his　diet；　this　mistake；　indeed；　is　attended　with　some
danger；　but　much　less　than　the　other；　and　yet　it　is　likely　to　expose
one　to　much　greater　derision；　for　if　another　physician；　or　a　private
person；　coming　in　and　knowing　what　has　happened；　should　give　to　eat　or
drink　those　things　which　the　other　had　forbidden；　the　benefit　thus
done　to　the　patient　would　be　manifest。　Such　mistakes　of
practitioners　are　particularly　ridiculed　by　mankind；　for　the　physician
or　nonprofessional　man　thus　coming　in；　seems　as　it　were　to　resuscitate
the　dead。　On　this　subject　I　will　describe　elsewhere　the　symptoms　by
which　each　of　them　may　be　recognized。
　　12。　And　the　following　observations　are　similar　to　those　now　made
respecting　the　bowels。　If　the　whole　body　rest　long；　contrary　to　usage；
it　does　not　immediately　recover　its　strength；　but　if；　after　a
protracted　repose；　it　proceed　to　labor；　it　will　clearly　expose　its
weakness。　So　it　is　with　every　one　part　of　the　body；　for　the　feet
will　make　a　similar　display；　and　any　other　of　the　joints；　if；　being
unaccustomed　to　labor；　they　be　suddenly　brought　into　action；　after　a
time。　The　teeth　and　the　eyes　will　suffer　in　like　manner；　and　also
every　other　part　whatever。　A　couch；　also；　that　is　either　softer　or
harder　than　one　has　been　accustomed　to　will　create　uneasiness；　and
sleeping　in　the　open　air；　contrary　to　usage；　hardens　the　body。　But
it　is　sufficient　merely　to　state　examples　of　all　these　cases。　If　a
person　having　received　a　wound　in　the　leg；　neither　very　serious　nor
very　trifling；　and　he　being　neither　in　a　condition　very　favorable　to
its　healing　nor　the　contrary；　at　first　betakes　himself　to　bed；　in
order　to　promote　the　cure；　and　never　raises　his　leg；　it　will　thus　be
much　less　disposed　to　inflammation；　and　be　much　sooner　well；　than　it
would　have　been　if　he　had　strolled　about　during　the　process　of
healing；　but　if　upon　the　fifth　or　sixth　day；　or　even　earlier；　he
should　get　up　and　attempt　to　walk；　he　will　suffer　much　more　then
than　if　he　had　walked　about　from　the　commencement　of　the　cure；　and
if　he　should　suddenly　make　many　laborious　exertions；　he　will　suffer
much　more　than　if；　when　the　treatment　was　conducted　otherwise；　he
had　made　the　same　exertions　on　the　same　days。　In　fine；　all　these
things　concur　in　proving　that　all　great　changes；　either　one　way　or
another；　are　hurtful。　Wherefore　much　mischief　takes　place　in　the
bowels；　if　from　a　state　of　great　inanition　more　food　than　is
moderate　be　administered　（and　also　in　the　rest　of　the　body；　if　from
a　state　of　great　rest　it　be　hastily　brought　to　greater　exertion；　it
will　be　much　more　injured）；　or　if　from　the　use　of　much　food　it　be
changed　to　complete　abstinence；　and　therefore　the　body　in　such　cases
requires　protracted　repose；　and　if；　from　a　state　of　laborious
exertion；　the　body　suddenly　falls　into　a　state　of　ease　and
indolence；　in　these　cases　also　the　bowels　would　require　continued
repose　from　abundance　of　food；　for　otherwise　it　will　induce　pain　and
heaviness　in　the　whole　body。
　　13。　The　greater　part　of　my　discourse　has　related　to　changes；　this
way　or　that。　For　all　purposes　it　is　profitable　to　know　these　things；
and　more　especially　respecting　the　subject　under　consideration；…
that　in　acute　diseases；　in　which　a　change　is　made　to　ptisans　from　a
state　of　inanition；　it　should　be　made　as　I　direct；　and　then　that
ptisans　should　not　be　used　until　the　disease　be　concocted；　or　some
other　symptom；　whether　of　evacuation　or　of　irritation；　appear　in　the
intestines；　or　in　the　hypochondria；　such　as　will　be　described。
Obstinate　insomnolency　impairs　the　digestion　of　the　food　and　drink；
and　in　other　respects　changes　and　relaxes　the　body；　and　occasions　a
heated　state；　and　heaviness　of　the　head。
　　14。　One　must　determine　by　such　marks　as　these；　when　sweet；　strong；
and　dark　wine；　hydromel；　water　and　oxymel；　should　be　given　in　acute
diseases。　Wherefore　the　sweet　affects　the　head　less　than　the　strong；
attacks　the　brain　less；　evacuates　the　bowels　more　than　the　other；
but　induces　swelling　of　the　spleen　and　liver；　it　does　not　agree　with
bilious　persons；　for　it　causes　them　to　thirst；　it　creates　flatulence
in　the　upper　part　of　the　intestinal　canal；　but　does　not　disagree
with　the　lower　part；　as　far　as　regards　flatulence；　and　yet
flatulence　engendered　by　sweet　wine　is　not　of　a　transient　nature；
but　rests　for　a　long　time　in　the　hypochondria。　And　therefore　it　in
general　is　less　diuretic　than　wine　which　is　strong　and　thin；　but　sweet
wine　is　more　expectorant　than　the　other。　But　when　it　creates　thirst；
it　is　less　expectorant　in　such　cases　than　the　other　wine；　but　if　it　do
not　create　thirst；　it　promotes　expectoration　better　than　the　other。
The　good　and　bad　effects　of　a　white；　strong　wine；　have　been　already
frequently　and　fully　stated　in　the　disquisition　on　sweet　wine；　it　is
determined　to　the　bladder　more　than　the　other；　is　diuretic　and
laxative；　and　should　be　very　useful　in　such　complaints；　for　if　in
other　respects　it　be　less　suitable　than　the　other；　the　c