《on regimen in acute diseases》

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on regimen in acute diseases- 第2部分


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quenching thirst; of very easy digestion; and very weak; all which
qualities are wanted。 If; then; one do not pay proper attention to the
mode of administering the ptisan; much harm may be done; for when
the food is shut up in the bowels; unless one procure some
evacuation speedily; before administering the draught; the pain; if
present; will be exasperated; and; if not present; it will be
immediately created; and the respiration will become more frequent;
which does mischief; for it dries the lungs; fatigues the
hypochondria; the hypogastrium; and diaphragm。 And moreover if;
while the pain of the side persists; and does not yield to warm
fomentations; and the sputa are not brought up; but are viscid and
unconcocted; unless one get the pain resolved; either by loosening the
bowels; or opening a vein; whichever of these may be proper;… if to
persons so circumstanced ptisan be administered; their speedy death
will be the result。 For these reasons; and for others of a similar
kind still more; those who use unstrained ptisan die on the seventh
day; or still earlier; some being seized with delirium; and others
dying suffocated with orthopnoee and riles。 Such persons the
ancients thought struck; for this reason more especially; that when
dead the affected side was livid; like that of a person who had been
struck。 The cause of this is that they die before the pain is
resolved; being seized with difficulty of respiration; and by large
and rapid breathing; as has been already explained; the spittle
becoming thick; acid; and unconcocted; cannot be brought up; but;
being retained in the bronchi of the lungs; produces riles; and;
when it has come to this; death; for the most part; is inevitable; for
the sputa being retained prevent the breath from being drawn in; and
force it speedily out; and thus the two conspire together to aggravate
the sputa being retained renders the respiration frequent; while the
respiration being frequent thickens the sputa; and prevents them
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 additio
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