on regimen in acute diseases-第5章

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ptisan　as　a　drink　immediately　after　the　bath。　Much　will　depend　upon
whether　the　patient；　when　in　good　health；　was　very　fond　of　the　bath；
and　in　the　custom　of　taking　it：　for　such　persons；　especially；　feel　the
want　of　it；　and　are　benefited　if　they　are　bathed；　and　injured　if
they　are　not。　In　general　it　suits　better　with　cases　of　pneumonia
than　in　ardent　fevers；　for　the　bath　soothes　the　pain　in　the　side；
chest；　and　back；　concocts　the　sputa；　promotes　expectoration；
improves　the　respiration；　and　allays　lassitude；　for　it　soothes　the
joints　and　outer　skin；　and　is　diuretic；　removes　heaviness　of　the　head；
and　moistens　the　nose。　Such　are　the　benefits　to　be　derived　from　the
bath；　if　all　the　proper　requisites　be　present；　but　if　one　or　more　of
these　be　wanting；　the　bath；　instead　of　doing　good；　may　rather　prove
injurious；　for　every　one　of　them　may　do　harm　if　not　prepared　not
prepared　by　the　attendants　in　the　proper　manner。　It　is　by　no　means　a
suitable　thing　in　these　diseases　to　persons　whose　bowels　are　too
loose；　or　when　they　are　unusually　confined；　and　there　has　been　no
previous　evacuation；　neither　must　we　bathe　those　who　are
debilitated；　nor　such　as　have　nausea　or　vomiting；　or　bilious
eructations；　nor　such　as　have　hemorrhage　from　the　nose；　unless　it　be
less　than　required　at　that　stage　of　the　disease　（with　those　stages　you
are　acquainted）；　but　if　the　discharge　be　less　than　proper；　one
should　use　the　bath；　whether　in　order　to　benefit　the　whole　body　or　the
head　alone。　If　then　the　proper　requisites　be　at　hand；　and　the
patient　be　well　disposed　to　the　bath；　it　may　be　administered　once
every　day；　or　if　the　patient　be　fond　of　the　bath　there　will　be　no
harm；　though　he　should　take　it　twice　in　the　day。　The　use　of　the　bath
is　much　more　appropriate　to　those　who　take　unstrained　ptisan；　than
to　those　who　take　only　the　juice　of　it；　although　even　in　their　case　it
may　be　proper；　but　least　of　all　does　it　suit　with　those　who　use　only
plain　drink；　although；　in　their　case　too　it　may　be　suitable；　but　one
must　form　a　judgment　from　the　rules　laid　down　before；　in　which　of
these　modes　of　regimen　the　bath　will　be　beneficial；　and　in　which
not。　Such　as　want　some　of　the　requisites　for　a　proper　bath；　but　have
those　symptoms　which　would　be　benefited　by　it；　should　be　bathed；
whereas　those　who　want　none　of　the　proper　requisites；　but　have　certain
symptoms　which　contraindicate　the　bath；　are　not　to　be　bathed。
APPENDIX
　　　　　　　　　　　　　　　　　　　　　　　　APPENDIX

　　Ardent　fever　（causus）　takes　place　when　the　veins；　being　dried　up
in　the　summer　season；　attract　acrid　and　bilious　humors　to
themselves；　and　strong　fever　seizes　the　whole　body；　which
experiences　aches　of　the　bones；　and　is　in　a　state　of　lassitude　and
pain。　It　takes　place　most　commonly　from　a　long　walk　and　protracted
thirst；　when　the　veins　being　dried　up　attract　acrid　and　hot　defluxions
to　themselves。　The　tongue　becomes　rough；　dry；　and　very　black；　there
are　gnawing　pains　about　the　bowels；　the　alvine　discharges　are　watery
and　yellow；　there　is　intense　thirst；　insomnolency；　and　sometimes
wandering　of　the　mind。　To　a　person　in　such　a　state　give　to　drink　water
and　as　much　boiled　hydromel　of　a　watery　consistence　as　he　will　take；
and　if　the　mouth　be　bitter；　it　may　be　advantageous　to　administer　an
emetic　and　clyster；　and　if　these　things　do　not　loosen　the　bowels；
purge　with　the　boiled　milk　of　asses。　Give　nothing　saltish　nor　acrid；
for　they　will　not　be　borne；　and　give　no　draughts　of　ptisan　until　the
crisis　be　past。　And　the　affection　is　resolved　if　there　be　an
epistaxis；　or　if　true　critical　sweats　supervene　with　urine　having
white；　thick；　and　smooth　sediments；　or　if　a　deposit　take　place
anywhere；　but　if　it　be　resolved　without　these；　there　will　be　a　relapse
of　the　complaint；　or　pain　in　the　hips　and　legs　will　ensue；　with
thick　sputa；　provided　the　patient　be　convalescent。　Another　species
of　ardent　fever：　belly　loose；　much　thirst；　tongue　rough；　dry；　and
saltish；　retention　of　urine；　insomnolency；　extremities　cold。　In　such　a
case；　unless　there　be　a　flow　of　blood　from　the　nose；　or　an　abscess
form　about　the　neck；　or　pain　in　the　limbs；　or　the　patient
expectorate　thick　sputa　（these　occur　when　the　belly　is　constipated）；
or　pain　of　the　hips；　or　lividity　of　the　genital　organs；　there　is　no
crisis；　tension　of　the　testicle　is　also　a　critical　symptom。　Give
attractive　draughts。
　　2。　Bleed　in　the　acute　affections；　if　the　disease　appear　strong；
and　the　patients　be　in　the　vigor　of　life；　and　if　they　have　strength。
If　it　be　quinsy　or　any　other　of　the　pleuritic　affections；　purge　with
electuaries；　but　if　the　patient　be　weaker；　or　if　you　abstract　more
blood；　you　may　administer　a　clyster　every　third　day；　until　he　be　out
of　danger；　and　enjoin　total　abstinence　if　necessary。
　　3。　Hypochondria　inflamed　not　from　retention　of　flatus；　tension　of
the　diaphragm；　checked　respiration；　with　dry　orthopnoea；　when　no　pus
is　formed；　but　when　these　complaints　are　connected　with　obstructed
respiration；　but　more　especially　strong　pains　of　the　liver；
heaviness　of　the　spleen；　and　other　phlegmasiae　and　intense　pains　above
the　diaphragm；　diseases　connected　with　collections　of　humors；…　all
these　diseases　do　not　admit　of　resolution；　if　treated　at　first　by
medicine；　but　venesection　holds　the　first　place　in　conducting　the
treatment；　then　we　may　have　recourse　to　a　clyster；　unless　the
disease　be　great　and　strong；　but　if　so；　purging　also　may　be　necessary；
but　bleeding　and　purging　together　require　caution　and　moderation。
Those　who　attempt　to　resolve　inflammatory　diseases　at　the　commencement
by　the　administration　of　purgative　medicines；　remove　none　of　the
morbific　humors　which　produce　the　inflammation　and　tension；　for　the
diseases　while　unconcocted　could　not　yield；　but　they　melt　down　those
parts　which　are　healthy　and　resist　the　disease；　so　when　the　body　is
debilitated　the　malady　obtains　the　mastery；　and　when　the　disease　has
the　upper　hand　of　the　body；　it　does　not　admit　of　a　cure。
　　4。　When　a　person　suddenly　loses　his　speech；　in　connection　with
obstruction　of　the　veins；…　if　this　happen　without　warning　or　any　other
strong　cause；　one　ought　to　open　the　internal　vein　of　the　right　arm；
and　abstract　blood　more　or　less　according　to　the　habit　and　age　of
the　patient。　Such　cases　are　mostly　attended　with　the　following
symptoms：　redness　of　the　face；　eyes　fixed；　hands　distended；　grinding
of　the　teeth；　palpitations；　jaws　fixed；　coldness　of　the　extremities；
retention　of　airs　in　the　veins。
　　5。　When　pains　precede；　and　there　are　influxes　of　black　bile　and　of
acrid　humors；　and　when　by　their　pungency　the　internal　parts　are
pained；　and　the　veins　being　pinched　and　dried　become　distended；　and
getting　inflamed　attract　the　humors　running　into　the　parts；　whence　the
blood　being　vitiated；　and　the　airs　collected　there　not　being　able　to
find　their　natural　passages；　coldness　comes　on　in　consequence　of
this　stasis；　with　vertigo；　loss　of　speech；　heaviness　of　the　head；
and　convulsion；　if　the　disease　fix　on　the　liver；　the　heart；　or　the
great　vein　（vena　cava？）；　whence　they　are　seized　with　epilepsy　or
apoplexy；　if　the　defluxions　fall　upon　the　containing　parts；　and　if
they　are　dried　up　by　airs　which　cannot　make　their　escape；　such　persons
having　been　first　tormented　are　to　be　immediately　bled　at　the
commencement；　while　all　the　peccant　vapors　and　humors　are　buoyant；　for
then　the　cases　more　easily　admit　of　a　cure；　and　then　supporting　the
strength　and　attending　to　the　crisis；　we　may　give　emetics；　unless
the　disease　be　alleviated；　or　if　the　bowels　be　not　moved；　we　may
administer　a　clyster　and　give　the　boiled　milk　of　asses；　to　the
amount　of　not　less　than　twelve　heminae；　or　if　the　strength　permit；
to　more　than　sixteen。
　　6。　Quinsy　takes　place　when　a　copious　and　viscid　defluxion　from　the
head；　in　the　season　of　winter　or　spring；　flows　into　the　jugular　veins；
and　when　from　their　large　size　they　attract　a　greater　defluxion；　and
when　owing　to　the　defluxion　being　of　a　cold　and　viscid　nature　it
becomes　enfarcted；　obstructing　the　passages　of　the　respiration　and
of　the　blood；　coagulates　the　surrounding　blood；　and　renders　it
motionless　and　stationary；　it　being　naturally　cold　and　disposed　to
obstructions。　Hence　they　are　seized　with　convulsive　suffocation；　the
tongue　turning　livid；　assuming　a　rounded　shape；　and　being　vent　owing
to　the　veins　which　are　seated　below　the　tongue　（for　when　an　enlarged
uvula；　which　is　called　uva；　is　cut；　a　large　vein　may　be　observed　on
each　side）。　These　veins；　then；　becoming　filled；　and　their　roots
extending　into　the　tongue；　which　is　of　a　loose　and　spongy　texture；　it；
owing　to　its　dryness　receiving　forcibly　the　juice　from　the　veins；
changes　from　broad　and　becomes　round；　its　natural　color　turns　to
livid；　from　a　soft　consistence　it　grows　hard；　instead　of　being
flexible　it　becomes　inflexible；　so　that　the　patient　would　soon　be
suffocated　unless　speedily　relieved。　Bleeding；　then；　in　the　arm；　and
opening　the　sublingual　veins；　and　purging　with　the　electuaries；　and
giving　warm　gargles；　and　shaving　the　head；　we　must　apply　to　it　and　the
neck　a　cerate；　and　wrap　them　round　with　wool；　and　foment　with　soft
sponges　squeezed　out　of　hot　water；　give　to　drink　water　and　hydromel；
not　cold；　and　administer　the　juice　of　ptisan　when；　having　passed　the
crisis；　the　patient　is　out　of　danger。　When；　in　the　season　of　summer　or
autumn；　there　is　a　hot　and　nitrous　defluxion　from　the　head　（it　is
rendered　hot　and　acrid　by　the　season）；　being　of　such　a　nature　it
corrodes　and　ulcerates；　and　fills　with　air；　and　orthopnoea　attended
with　great　dryness　supervenes；　the　fauces；　when　examined；　do　not
seem　swollen；　the　tendons　on　the　back　part　of　the　neck　are　contracted；
and　have　the　appearance　as　if　it　were　tetanus；　the　voice　is　lost；
the　breathing　is　small；　and　inspiration　becomes　frequent　and
laborious。　In　such　persons　the　trachea　becomes　ulcerated；　and　the
lungs　engorged；　from　the　patient's　not　being　able　to　draw　in　the
external　air。　In　such　cases；　unless　there　be　a　spontaneous
determination　to　the　external　parts　of　the　neck；　the　symptoms　become
still　more　dreadful；　and　the　danger　more　imminent；　partly　owing　to　the
season；　and　the　hot　and　acrid　humors　which　cause　the　disease。
　　7。　When　fever　seizes　a　person　who　has　lately　taken　food；　and　whose
bowels　are　loaded　with　faces　which　have　been　long　retained；　whether　it
be　attended　with　pain　of　the　side　or　not；　he　ought　to　lie　quiet
until　the　food　descend　to　the　lower　region　of　the　bowels；　and　use
oxymel　for　drink；　but　when　the　load　descends　to　the　loins；　a　clyster
should　be　administered；　or　he　should　be　purged　by　medicine；　and　when
purged；　he　should　take　ptisan　for　food　and　hydromel　for　drink；　then　he
may　take　the　cerealia；　and　boiled　fishes；　and　a　watery　wine　in　small
quantity；　at　night；　but　during　the　day；　a　watery　hydromel。　When　the
flatus　is　offensive；　either　a　suppository　or　clyster　is　to　be
administered；　but　otherwise　the　oxymel　is　to　be　discontinued；　until
the　matters　descend　to　the　lower　part　of　the　bowels；　and　then　they　are
to　be　evacuated　by　a　clyster。　But　if　the　ardent　fever　（causus）
supervene　when　the　bowels　are　empty；　should　you　still　judge　it
proper　to　administer　purgative　medicine；　it　ought　not　be　done　during
the　first　three　days；　nor　earlier　than　the　fourth。　When