《on regimen in acute diseases》

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on regimen in acute diseases- 第7部分


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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 you give the
medicine; use the ptisan; observing the paroxysms of the fevers; so as
not to give it when the fever is setting in; but when it is ceasing;
or on the decline; and as far as possible from the commencement。
When the feet are cold; give neither drink nor ptisan; nor anything
else of the kind; but reckon it an important rule to refrain until
they become warm; and then you may administer them with advantage。 For
the most part; coldness of the feet is a symptom of a paroxysm of
the fever coming on; and if at such a season you apply those things;
you will commit the greatest possible mistake; for you will augment
the disease in no small degree。 But when the fever ceases; the feet;
on the contrary; become hotter than the rest of the body; for when the
heat leaves the feet; it is kindled up in the breast; and sends its
flame up to the head。 And when all the heat rushes upwards; and is
exhaled at the head; it is not to be wondered at that the feet
become cold; being devoid of flesh; and tendinous; and besides; they
contract cold; owing to their distance from the hotter parts of the
body; an accumulation of heat having taken place in the chest: and
again; in like manner; when the fever is resolved and dissipated;
the heat descends to the feet; and; at the same time; the head and
chest become cold。 Wherefore one should attend to this; that when
the feet are cold; the bowels are necessarily hot; and filled with
nauseous matters; the hypochondrium distended: there is jactitation of
the body; owing to the internal disturbance; and aberration of the
intellect; and pains; the patient is agitated; and wishes to vomit;
and if he vomits bad matters he is pained; but when the heat
descends to the feet; and the urine passes freely; he is every way
lightened; even although he does not sweat; at this season; then;
the ptisan ought to be given; it would be death to give it before。
  8。 When the bowels are loose during the whole course of fevers; in
this case we are most especially to warm the feet; and see that they
are properly treated with cerates; and wrapped in shawls; so that they
may not become colder than the rest of the body; but when they are
hot; no fomentation must be made to them; but care is to be taken that
they do not become cold; and very little drink is to be used; either
cold water or hydromel。 In those cases of fever where the bowels are
loose; and the mind is disordered; the greater number of patients pick
the wool from their blankets; scratch their noses; answer briefly when
questions are put to them; but; when left to themselves; utter nothing
that is rational。 Such attacks appear to me to be connected with black
bile。 When in these cases there is a colliquative diarrhoea; I am of
opinion that we ought to give the colder and thicker ptisans; and that
the drinks ought to be binding; of a vinous nature; and rather
astringent。 In cases of fever attended from the first with vertigo;
throbbing of the head; and thin urine; you may expect the fever to
be exacerbated at the crisis; neither need it excite wonder;
although there be delirium。 When; at the commencement; the urine is
cloudy or thick; it is proper to purge gently; provided this be
otherwise proper; but when the urine at first is thin; do not purge
such patients; but; if thought necessary; give a clyster; such
patients should be thus treated; they should be kept in a quiet state;
have unguents applied to them; and be covered up properly with
clothes; and they should use for drink a watery hydromel; and the
juice of ptisan as a draught in the evening; clear out the bowels at
first with a clyster; but give no purgative medicines to them; for; if
you move the bowels strongly; the urine is not concocted; but the
fever remains long; without sweats and without a crisis。 Do not give
draughts when the time of the crisis is at hand; if there be
agitation; but only when the fever abates and is alleviated。 It is
proper to be guarded at the crises of other fevers; and to withhold
the draughts at that season。 Fevers of this description are apt to
be protracted; and to have determinations; if the inferior extremities
be cold; about the ears and neck; or; if these parts are not cold;
to have other changes; they have epistaxis; and disorder of the
bowels。 But in cases of fever attended with nausea; or distention of
the hypochondria; when the patients cannot lie reclined in the same
position; and the extremities are cold; the greatest care and
precaution are necessary; nothing should be given to them; except
oxymel diluted with water; no draught should be administered; until
the fever abate and the urine be concocted; the patient should be laid
in a dark apartment; and recline upon the softest couch; and he should
be kept as long as possible in the same position; so as not to toss
about; for this is particularly beneficial to him。 Apply to the
hypochondrium linseed by inunctions; taking care that he do not
catch cold when the application is made; let it be in a tepid state;
and boiled in water and oil。 One may judge from the urine what is to
take place; for if the urine be thicker; and more yellowish; so much
the better; but if it be thinner; and blacker; so much the worse;
but if it undergo changes; it indicates a prolongation of the disease;
and the patient; in like manner; must experience a change to the worse
and the better。 Irregular fevers should be let alone until they become
settled; and; when they do settle; they are to be treated by a
suitable diet and medicine; attending to the constitution of the
patient。
  9。 The aspects of the sick are various; wherefore the physician
should pay attention; that he may not miss observing the exciting
causes; as far as they can be ascertained by reasoning; nor such
symptoms as should appear on an even or odd day; but he ought to; be
particularly guarded in observing the odd days; as it is in them; more
especially; that changes take place in patients。 He should mark;
particularly; the first day on which the patient became ill;
considering when and whence the disease commenced; for this is of
primary importance to know。 When you examine the patient; inquire into
all particulars; first how the head is; and if there be no headache;
nor heaviness in it; then examine if the and sides be free of pain;
for if the hypochondrium be painful; swelled; and unequal; with a
sense of satiety; or if there be pain in the side; and; along with the
pain; either cough; tormina; or belly…ache; if any of these symptoms
be present in the hypochondrium; the bowels should be opened with
clysters; and the patient should drink boiled hydromel in a hot state。
The physician should ascertain whether the patient be apt to faint
when he is raised up; and whether his breathing be free; and examine
the discharges from the bowels; whether they be very black; or of a
proper color; like those of persons in good health; and ascertain
whether the fever has a paroxysm every third day; and look well to
such persons on those days。 And should the fourth day prove like the
third; the patient is in a dangerous state。 With regard to the
symptoms; black stools prognosticate death; but if they resemble the
discharges of a healthy person; and if such is their appearance
every day; it is a favorable symptom; but when the bowels do not yield
to a suppository; and when; though the respiration be natural; the
patient when raised to the night table; or even in bed; be seized with
deliquium; you may expect that the patient; man or woman; who
experiences these symptoms; is about to fall to fall into a state of
delirium。 Attention also should be paid to the hands; for if they
tremble; you may expect epistaxis; and observe the nostrils; whether
the breath be drawn in equally by both; and if expiration by the
nostrils be large; a convulsion is apt to take place; and should a
convulsion occur to such a person; death may be anticipated; and it is
well to announce it beforehand。
  10。 If; in a winter fever; the tongue be rough; and if there be
swoonings; it is likely 
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