《on regimen in acute diseases》

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on regimen in acute diseases- 第3部分


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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 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 agita
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