第2章

2。Bleedintheacuteaffections,ifthediseaseappearstrong,andthepatientsbeinthevigoroflife,andiftheyhavestrength。

Ifitbequinsyoranyotherofthepleuriticaffections,purgewithelectuaries;butifthepatientbeweaker,orifyouabstractmoreblood,youmayadministeraclystereverythirdday,untilhebeoutofdanger,andenjointotalabstinenceifnecessary。

3。Hypochondriainflamednotfromretentionofflatus,tensionofthediaphragm,checkedrespiration,withdryorthopnoea,whennopusisformed,butwhenthesecomplaintsareconnectedwithobstructedrespiration;butmoreespeciallystrongpainsoftheliver,heavinessofthespleen,andotherphlegmasiaeandintensepainsabovethediaphragm,diseasesconnectedwithcollectionsofhumors,-allthesediseasesdonotadmitofresolution,iftreatedatfirstbymedicine,butvenesectionholdsthefirstplaceinconductingthetreatment;thenwemayhaverecoursetoaclyster,unlessthediseasebegreatandstrong;butifso,purgingalsomaybenecessary;

butbleedingandpurgingtogetherrequirecautionandmoderation。

Thosewhoattempttoresolveinflammatorydiseasesatthecommencementbytheadministrationofpurgativemedicines,removenoneofthemorbifichumorswhichproducetheinflammationandtension;forthediseaseswhileunconcoctedcouldnotyield,buttheymeltdownthosepartswhicharehealthyandresistthedisease;sowhenthebodyisdebilitatedthemaladyobtainsthemastery;andwhenthediseasehastheupperhandofthebody,itdoesnotadmitofacure。

4。Whenapersonsuddenlyloseshisspeech,inconnectionwithobstructionoftheveins,-ifthishappenwithoutwarningoranyotherstrongcause,oneoughttoopentheinternalveinoftherightarm,andabstractbloodmoreorlessaccordingtothehabitandageofthepatient。Suchcasesaremostlyattendedwiththefollowingsymptoms:rednessoftheface,eyesfixed,handsdistended,grindingoftheteeth,palpitations,jawsfixed,coldnessoftheextremities,retentionofairsintheveins。

5。Whenpainsprecede,andthereareinfluxesofblackbileandofacridhumors,andwhenbytheirpungencytheinternalpartsarepained,andtheveinsbeingpinchedanddriedbecomedistended,andgettinginflamedattractthehumorsrunningintotheparts,whencethebloodbeingvitiated,andtheairscollectedtherenotbeingabletofindtheirnaturalpassages,coldnesscomesoninconsequenceofthisstasis,withvertigo,lossofspeech,heavinessofthehead,andconvulsion,ifthediseasefixontheliver,theheart,orthegreatvein(venacava?);whencetheyareseizedwithepilepsyorapoplexy,ifthedefluxionsfalluponthecontainingparts,andiftheyaredriedupbyairswhichcannotmaketheirescape;suchpersonshavingbeenfirsttormentedaretobeimmediatelybledatthecommencement,whileallthepeccantvaporsandhumorsarebuoyant,forthenthecasesmoreeasilyadmitofacure;andthensupportingthestrengthandattendingtothecrisis,wemaygiveemetics,unlessthediseasebealleviated;orifthebowelsbenotmoved,wemayadministeraclysterandgivetheboiledmilkofasses,totheamountofnotlessthantwelveheminae,orifthestrengthpermit,tomorethansixteen。

6。Quinsytakesplacewhenacopiousandvisciddefluxionfromthehead,intheseasonofwinterorspring,flowsintothejugularveins,andwhenfromtheirlargesizetheyattractagreaterdefluxion;andwhenowingtothedefluxionbeingofacoldandviscidnatureitbecomesenfarcted,obstructingthepassagesoftherespirationandoftheblood,coagulatesthesurroundingblood,andrendersitmotionlessandstationary,itbeingnaturallycoldanddisposedtoobstructions。Hencetheyareseizedwithconvulsivesuffocation,thetongueturninglivid,assumingaroundedshape,andbeingventowingtotheveinswhichareseatedbelowthetongue(forwhenanenlargeduvula,whichiscalleduva,iscut,alargeveinmaybeobservedoneachside)。Theseveins,then,becomingfilled,andtheirrootsextendingintothetongue,whichisofalooseandspongytexture,it,owingtoitsdrynessreceivingforciblythejuicefromtheveins,changesfrombroadandbecomesround,itsnaturalcolorturnstolivid,fromasoftconsistenceitgrowshard,insteadofbeingflexibleitbecomesinflexible,sothatthepatientwouldsoonbesuffocatedunlessspeedilyrelieved。Bleeding,then,inthearm,andopeningthesublingualveins,andpurgingwiththeelectuaries,andgivingwarmgargles,andshavingthehead,wemustapplytoitandtheneckacerate,andwrapthemroundwithwool,andfomentwithsoftspongessqueezedoutofhotwater;givetodrinkwaterandhydromel,notcold;andadministerthejuiceofptisanwhen,havingpassedthecrisis,thepatientisoutofdanger。When,intheseasonofsummerorautumn,thereisahotandnitrousdefluxionfromthehead(itisrenderedhotandacridbytheseason),beingofsuchanatureitcorrodesandulcerates,andfillswithair,andorthopnoeaattendedwithgreatdrynesssupervenes;thefauces,whenexamined,donotseemswollen;thetendonsonthebackpartoftheneckarecontracted,andhavetheappearanceasifitweretetanus;thevoiceislost,thebreathingissmall,andinspirationbecomesfrequentandlaborious。Insuchpersonsthetracheabecomesulcerated,andthelungsengorged,fromthepatient’snotbeingabletodrawintheexternalair。Insuchcases,unlesstherebeaspontaneousdeterminationtotheexternalpartsoftheneck,thesymptomsbecomestillmoredreadful,andthedangermoreimminent,partlyowingtotheseason,andthehotandacridhumorswhichcausethedisease。

7。Whenfeverseizesapersonwhohaslatelytakenfood,andwhosebowelsareloadedwithfaceswhichhavebeenlongretained,whetheritbeattendedwithpainofthesideornot,heoughttoliequietuntilthefooddescendtothelowerregionofthebowels,anduseoxymelfordrink;butwhentheloaddescendstotheloins,aclystershouldbeadministered,orheshouldbepurgedbymedicine;andwhenpurged,heshouldtakeptisanforfoodandhydromelfordrink;thenhemaytakethecerealia,andboiledfishes,andawaterywineinsmallquantity,atnight,butduringtheday,awateryhydromel。Whentheflatusisoffensive,eitherasuppositoryorclysteristobeadministered;butotherwisetheoxymelistobediscontinued,untilthemattersdescendtothelowerpartofthebowels,andthentheyaretobeevacuatedbyaclyster。Butiftheardentfever(causus)

supervenewhenthebowelsareempty,shouldyoustilljudgeitpropertoadministerpurgativemedicine,itoughtnotbedoneduringthefirstthreedays,norearlierthanthefourth。Whenyougivethemedicine,usetheptisan,observingtheparoxysmsofthefevers,soasnottogiveitwhenthefeverissettingin,butwhenitisceasing,oronthedecline,andasfaraspossiblefromthecommencement。

Whenthefeetarecold,giveneitherdrinknorptisan,noranythingelseofthekind,butreckonitanimportantruletorefrainuntiltheybecomewarm,andthenyoumayadministerthemwithadvantage。Forthemostpart,coldnessofthefeetisasymptomofaparoxysmofthefevercomingon;andifatsuchaseasonyouapplythosethings,youwillcommitthegreatestpossiblemistake,foryouwillaugmentthediseaseinnosmalldegree。Butwhenthefeverceases,thefeet,onthecontrary,becomehotterthantherestofthebody;forwhentheheatleavesthefeet,itiskindledupinthebreast,andsendsitsflameuptothehead。Andwhenalltheheatrushesupwards,andisexhaledatthehead,itisnottobewonderedatthatthefeetbecomecold,beingdevoidofflesh,andtendinous;andbesides,theycontractcold,owingtotheirdistancefromthehotterpartsofthebody,anaccumulationofheathavingtakenplaceinthechest:andagain,inlikemanner,whenthefeverisresolvedanddissipated,theheatdescendstothefeet,and,atthesametime,theheadandchestbecomecold。Whereforeoneshouldattendtothis;thatwhenthefeetarecold,thebowelsarenecessarilyhot,andfilledwithnauseousmatters;thehypochondriumdistended:thereisjactitationofthebody,owingtotheinternaldisturbance;andaberrationoftheintellect,andpains;thepatientisagitated,andwishestovomit,andifhevomitsbadmattersheispained;butwhentheheatdescendstothefeet,andtheurinepassesfreely,heiseverywaylightened,evenalthoughhedoesnotsweat;atthisseason,then,theptisanoughttobegiven;itwouldbedeathtogiveitbefore。

8。Whenthebowelsarelooseduringthewholecourseoffevers,inthiscasewearemostespeciallytowarmthefeet,andseethattheyareproperlytreatedwithcerates,andwrappedinshawls,sothattheymaynotbecomecolderthantherestofthebody;butwhentheyarehot,nofomentationmustbemadetothem,butcareistobetakenthattheydonotbecomecold;andverylittledrinkistobeused,eithercoldwaterorhydromel。Inthosecasesoffeverwherethebowelsareloose,andthemindisdisordered,thegreaternumberofpatientspickthewoolfromtheirblankets,scratchtheirnoses,answerbrieflywhenquestionsareputtothem,but,whenlefttothemselves,utternothingthatisrational。Suchattacksappeartometobeconnectedwithblackbile。Wheninthesecasesthereisacolliquativediarrhoea,Iamofopinionthatweoughttogivethecolderandthickerptisans,andthatthedrinksoughttobebinding,ofavinousnature,andratherastringent。Incasesoffeverattendedfromthefirstwithvertigo,throbbingofthehead,andthinurine,youmayexpectthefevertobeexacerbatedatthecrisis;neitherneeditexcitewonder,althoughtherebedelirium。When,atthecommencement,theurineiscloudyorthick,itispropertopurgegently,providedthisbeotherwiseproper;butwhentheurineatfirstisthin,donotpurgesuchpatients,but,ifthoughtnecessary,giveaclyster;suchpatientsshouldbethustreated;theyshouldbekeptinaquietstate,haveunguentsappliedtothem,andbecoveredupproperlywithclothes,andtheyshouldusefordrinkawateryhydromel,andthejuiceofptisanasadraughtintheevening;clearoutthebowelsatfirstwithaclyster,butgivenopurgativemedicinestothem,for,ifyoumovethebowelsstrongly,theurineisnotconcocted,butthefeverremainslong,withoutsweatsandwithoutacrisis。Donotgivedraughtswhenthetimeofthecrisisisathand,iftherebeagitation,butonlywhenthefeverabatesandisalleviated。Itispropertobeguardedatthecrisesofotherfevers,andtowithholdthedraughtsatthatseason。Feversofthisdescriptionareapttobeprotracted,andtohavedeterminations,iftheinferiorextremitiesbecold,abouttheearsandneck,or,ifthesepartsarenotcold,tohaveotherchanges;theyhaveepistaxis,anddisorderofthebowels。Butincasesoffeverattendedwithnausea,ordistentionofthehypochondria,whenthepatientscannotliereclinedinthesameposition,andtheextremitiesarecold,thegreatestcareandprecautionarenecessary;nothingshouldbegiventothem,exceptoxymeldilutedwithwater;nodraughtshouldbeadministered,untilthefeverabateandtheurinebeconcocted;thepatientshouldbelaidinadarkapartment,andreclineuponthesoftestcouch,andheshouldbekeptaslongaspossibleinthesameposition,soasnottotossabout,forthisisparticularlybeneficialtohim。Applytothehypochondriumlinseedbyinunctions,takingcarethathedonotcatchcoldwhentheapplicationismade;letitbeinatepidstate,andboiledinwaterandoil。Onemayjudgefromtheurinewhatistotakeplace,foriftheurinebethicker,andmoreyellowish,somuchthebetter;butifitbethinner,andblacker,somuchtheworse;

butifitundergochanges,itindicatesaprolongationofthedisease,andthepatient,inlikemanner,mustexperienceachangetotheworseandthebetter。Irregularfeversshouldbeletaloneuntiltheybecomesettled,and,whentheydosettle,theyaretobetreatedbyasuitabledietandmedicine,attendingtotheconstitutionofthepatient。

9。Theaspectsofthesickarevarious;whereforethephysicianshouldpayattention,thathemaynotmissobservingtheexcitingcauses,asfarastheycanbeascertainedbyreasoning,norsuchsymptomsasshouldappearonanevenoroddday,butheoughtto,beparticularlyguardedinobservingtheodddays,asitisinthem,moreespecially,thatchangestakeplaceinpatients。Heshouldmark,particularly,thefirstdayonwhichthepatientbecameill,consideringwhenandwhencethediseasecommenced,forthisisofprimaryimportancetoknow。Whenyouexaminethepatient,inquireintoallparticulars;firsthowtheheadis,andiftherebenoheadache,norheavinessinit;thenexamineiftheandsidesbefreeofpain;

forifthehypochondriumbepainful,swelled,andunequal,withasenseofsatiety,oriftherebepainintheside,and,alongwiththepain,eithercough,tormina,orbelly-ache,ifanyofthesesymptomsbepresentinthehypochondrium,thebowelsshouldbeopenedwithclysters,andthepatientshoulddrinkboiledhydromelinahotstate。

Thephysicianshouldascertainwhetherthepatientbeapttofaintwhenheisraisedup,andwhetherhisbreathingbefree;andexaminethedischargesfromthebowels,whethertheybeveryblack,orofapropercolor,likethoseofpersonsingoodhealth,andascertainwhetherthefeverhasaparoxysmeverythirdday,andlookwelltosuchpersonsonthosedays。Andshouldthefourthdayprovelikethethird,thepatientisinadangerousstate。Withregardtothesymptoms,blackstoolsprognosticatedeath;butiftheyresemblethedischargesofahealthyperson,andifsuchistheirappearanceeveryday,itisafavorablesymptom;butwhenthebowelsdonotyieldtoasuppository,andwhen,thoughtherespirationbenatural,thepatientwhenraisedtothenighttable,oreveninbed,beseizedwithdeliquium,youmayexpectthatthepatient,manorwoman,whoexperiencesthesesymptoms,isabouttofalltofallintoastateofdelirium。Attentionalsoshouldbepaidtothehands,foriftheytremble,youmayexpectepistaxis;andobservethenostrils,whetherthebreathbedrawninequallybyboth;andifexpirationbythenostrilsbelarge,aconvulsionisapttotakeplace;andshouldaconvulsionoccurtosuchaperson,deathmaybeanticipated,anditiswelltoannounceitbeforehand。

10。If,inawinterfever,thetongueberough,andiftherebeswoonings,itislikelytobetheremissionofthefever。Neverthelesssuchapersonistobekeptuponarestricteddiet,withwaterfordrink,andhydromel,andthestrainedjuices,nottrustingtotheremissionofthefevers,aspersonshavingthesesymptomsareindangerofdying;when,therefore,youperceivethesesymptoms,announcethisprognostic,ifyoushalljudgeproper,aftermakingthesuitableobservations。When,infevers,anydangeroussymptomappearsonthefifthday,whenwaterydischargessuddenlytakeplacefromthebowels,whendeliquiumanimioccurs,orthepatientisattackedwithlossofspeech,convulsions,orhiccup,undersuchcircumstancesheislikelytobeaffectedwithnausea,andsweatsbreakoutunderthenoseandforehead,oronthebackpartoftheneckandhead,andpatientswithsuchsymptomsshortlydie,fromstoppageoftherespiration。When,infevers,abscessesformaboutthelegs,and,gettingintoachronicstate,arenotconcoctedwhilethefeverpersists,andifoneisseizedwithasenseofsuffocationinthethroat,whilethefaucesarenotswelled,andifitdonotcometomaturation,butisrepressed,insuchacasethereisapttobeaflowofbloodfromthenose;ifthis,then,becopious,itindicatesaresolutionofthedisease,butifnot,aprolongationofthecomplaint;andthelessthedischarge,somuchworsethesymptoms,andthemoreprotractedthedisease;butiftheothersymptomsareveryfavorable,expectinsuchacasethatpainswillfalluponthefeet;

ifthentheyattackthefeet,andifthesecontinuelonginaverypainful,andinflamedstate,andiftherebenoresolution,thepainswillextendbydegreestotheneck,totheclavicle,shoulder,breast,ortosomearticulation,inwhichaninflammatorytumorwillnecessarilyform。Whenthesearereduced,ifthehandsarecontracted,andbecometrembling,convulsionanddeliriumseizesuchaperson;butblistersbreakoutontheeyebrow,erythematakesplace,theoneeyelidbeingtumefiedovertopstheother,ahardinflammationsetsin,theeyebecomestronglyswelled,andthedeliriumincreasesmuch,butmakesitsattacksratheratnightthanbyday。Thesesymptomsmorefrequentlyoccuronoddthanonevendays,but,whetherontheoneortheother,theyareofafatalcharacter。Shouldyoudeterminetogivepurgativemedicinesinsuchcases,atthecommencement,youshoulddosobeforethefifthday,iftherebeborborygmiinthebowels,or,ifnot,youshouldomitthemedicinesaltogether。Iftherebeborborygmi,withbiliousstools,purgemoderatelywithscammony;

butwithregardtothetreatmentotherwise,administerasfewdrinksanddraughtsasuntiltherebesomeamendment,andthediseaseispastthefourteenthday。Whenlossofspeechseizesaperson,onthefourteenthdayofafever,thereisnotusuallyaspeedyresolution,noranyremovalofthedisease,forthissymptomindicatesaprotracteddisease;andwhenitappearsonthatday,itwillbestillmoreprolonged。When,onthefourthdayofafever,thetonguearticulatesconfusedly,andwhentherearewateryandbiliousdischargesfromthebowels,suchapatientisapttofallintoastateofdelirium;thephysicianought,therefore,towatchhim,andattendtowhateversymptomsmayturnup。Intheseasonofsummerandautumnanepistaxis,suddenlyoccurringinacutediseases,indicatesvehemenceoftheattack,andinflammationinthecourseoftheveins,andonthedayfollowing,thedischargeofthinurine;andifthepatientbeintheprimeoflife,andifhisbodybestrongfromexercise,andbrawny,orofamelancholictemperament,oriffromdrinkinghastremblinghands,itmaybewelltoannouncebeforehandeitherdeliriumorconvulsion;andifthesesymptomsoccuronevendays,somuchthebetter;butoncriticaldays,theyareofadeadlycharacter。If,then,acopiousdischargeofbloodprocureanissuetothefullnessthereofaboutthenose,orwhatiscollectedabouttheanus,therewillbeanabscess,orpainsinthehypochondrium,ortesticles,orinthelimbs;andwhentheseareresolved,therewillbeadischargeofthicksputa,andofsmooth,thinurine。Infeverattendedwithsingultus,giveasafoetida,oxymel,andcarrot,trituratedtogether,inadraught;orgalbanuminhoney,andcumininalinctus,orthejuiceofptisan。Suchapersoncannotescape,unlesscriticalsweatsandgentlesleepsupervene,andthickandacridurinebepassed,orthediseaseterminateinanabscess:givepine-fruitandmyrrhinalinctus,andfurthergiveaverylittleoxymeltodrink;butiftheyareverythirsty,somebarley-water。

11。Peripneumonia,andpleuriticaffections,aretobethusobserved:Ifthefeverbeacute,andiftherebepainsoneitherside,orinboth,andifexpirationbeifcoughbepresent,andthesputaexpectoratedbeofablondorlividcolor,orlikewisethin,frothy,andflorid,orhavinganyothercharacterdifferentfromthecommon,insuchacase,thephysicianshouldproceedthus:ifthepainpassupwardtotheclavicle,orthebreast,orthearm,theinnerveininthearmshouldbeopenedonthesideaffected,andbloodabstractedaccordingtothehabit,age,andcolorofthepatient,andtheseasonoftheyear,andthatlargelyandboldly,ifthepainbeacute,soastobringondeliquiumanimi,andafterwardsaclysteristobegiven。Butifthepainbebelowthechest,andifveryintense,purgethebowelsgentlyinsuchanattackofpleurisy,andduringtheactofpurginggivenothing;butafterthepurginggiveoxymel。

Themedicineistobeadministeredonthefourthday;onthefirstthreedaysafterthecommencement,aclystershouldbegiven,andifitdoesnotrelievethepatient,heshouldthenbegentlypurged,butheistobewatcheduntilthefevergoesoff,andtilltheseventhday;thenifheappeartobefreefromdanger,givehimsomeunstrainedptisan,insmallquantity,andthinatfirst,mixingitwithhoney。Iftheexpectorationbeeasy,andthebreathingfree,ifhissidesbefreeofpain,andifthefeverbegone,hemaytaketheptisanthicker,andinlargerquantity,twiceaday。Butifhedonotprogressfavorably,hemustgetlessofthedrink,andofthedraught,whichshouldbethin,andonlygivenonceaday,atwhateverisjudgedtobethemostfavorablehour;thisyouwillascertainfromtheurine。Thedraughtisnottobegiventopersonsafterfever,untilyouseethattheurineandsputaareconcocted(if,indeed,aftertheadministrationofthemedicinehebepurgedfrequently,itmaybenecessarytogiveit,butitshouldbegiveninsmallerquantitiesandthinnerthanusual,forfrominanitionhewillbeunabletosleep,ordigestproperly,orwaitthecrisis);

butwhenthemeltingdownofcrudemattershastakenplace,andhissystemhascastoffwhatisoffensive,therewillthenbenoobjection。Thesputaareconcoctedwhentheyresemblepus,andtheurinewhenithasreddishsedimentsliketares。Butthereisnothingtopreventfomentationsandceratesbeingappliedfortheotherpainsofthesides;andthelegsandloinsmayberubbedwithhotoil,oranointedwithfat;linseed,too,intheformofacataplasm,maybeappliedtothehypochondriumandasfarupasthebreasts。Whenpneumoniaisatitsheight,thecaseisbeyondremedyifheisnotpurged,anditisbadifhehasdyspnoea,andurinethatisthinandacrid,andifsweatscomeoutabouttheneckandhead,forsuchsweatsarebad,asproceedingfromthesuffocation,rales,andtheviolenceofthediseasewhichisobtainingtheupperhand,unlesstherebeacopiousevacuationofthickurine,andthesputabeconcocted;wheneitherofthesecomeonspontaneously,thatwillcarryoffthedisease。Alinctusforpneumonia:Galbanumandpine-fruitinAttichoney;andsouthernwoodinoxymel;makeadecoctionofpepperandblackhellebore,andgiveitincasesofpleurisyattendedwithviolentpainatthecommencement。Itisalsoagoodthingtoboilopoponaxinoxymel,and,havingstrainedit,togiveittodrink;itanswerswell,also,indiseasesoftheliver,andinseverepainsproceedingfromthediaphragm,andinallcasesinwhichitisbeneficialtodeterminetothebowelsorurinaryorgans,whengiveninwineandhoney;whengiventoactuponthebowels,itshouldbedrunkinlargerquantity,alongwithawateryhydromel。

12。Adysentery,whenstopped,willgiverisetoanaposteme,ortumor,ifitdonotterminateinfeverswithsweats,orwiththickandwhiteurine,orinatertianfever,orthepainfixuponavarix,orthetesticles,oronthehip-joints。

13。Inabiliousfever,jaundicecomingonwithrigorbeforetheseventhdaycarriesoffthefever,butifitoccurwithoutthefever,andnotatthepropertime,itisafatalsymptom。

14。Whentheloinsareinatetanicstate,andthespiritsintheveinsareobstructedbymelancholichumors,venesectionwillaffordrelief。Butwhen,ontheotherhand,theanteriortendonsarestronglycontracted,andiftherebesweatsabouttheneckandface,extortedbytheviolentpainoftheparchedanddriedtendonsofthesacralextremity(theseareverythick,sustainingthespine,andgivingrisetoverygreatligaments,whichterminateinthefeet,)insuchacase,unlessfeverandsleepcomeon,followedbyconcoctedurineandcriticalsweats,givetodrinkastrongCretanwine,andboiledbarley-mealforfood;anointandrubwithointmentscontainingwax;

bathethelegsandfeetinhotwater,andthencoverthemup;andsoinlikemannerthearms,asfarasthehands,andthespine,fromthenecktothesacrum,aretobewrappedinaskinsmearedwithwax;thismustextendtothepartsbeyond,andintervalsaretobeleftforapplyingfomentations,bymeansofleatherbottlesfilledwithhotwater,then,wrappinghimupinalinencloth,layhimdowninbed。Donotopenthebowels,unlessbymeansofasuppository,whentheyhavebeenlongofbeingmoved。Iftherebeanyremissionofthedisease,sofarwell,butotherwise,poundoftherootofbryoniainfragrantwine,andthatofthecarrot,andgivetothepatientfastingearlyinthemorning,beforeusingtheaffusion,andimmediatelyafterwardslethimeatboiledbarley-mealinatepidstate,andasmuchashecantake,andinadditionlethimdrink,ifhewill,winewelldiluted。Ifthediseaseyieldtothesemeans,somuchthebetter,but,ifotherwise,youmustprognosticateaccordingly。

15。Alldiseasesareresolvedeitherbythemouth,thebowels,thebladder,orsomeothersuchorgan。Sweatisacommonformofresolutioninallthesecases。

16。Youshouldputpersonsonacourseofhelleborewhoaretroubledwithadefluxionfromthehead。Butdonotadministerhelleboretosuchpersonsasarelaboringunderempyemaconnectedwithabscesses,haemoptysis,andintemperament,oranyotherstrongcause,foritwilldonogood;andifanythingunpleasantoccurthehelleborewillgettheblameofit。Butifthebodyhavesuddenlylostitspowers,oriftherebepaininthehead,orobstructionoftheearsandnose,orptyalism,orheavinessofthelimbs,oranextraordinaryswellingofthebody,youmayadministerthehellebore,providedthesesymptomsbenotconnectedwithdrinking,norwithimmoderatevenery;norwithsorrow,vexation,norinsomnolency,for,ifanyofthesecausesexist,thetreatmentmusthaverespecttoit。

17。Fromwalkingarisepainsofthesides,oftheback,oftheloins,andofthehip-joint,anddisorderoftherespirationhasoftenbeenfromthesamecause,for,afterexcessesofwineandflatulentfood,painsshoottotheloinsandhips,accompaniedwithdysuria。

Walkingisthecauseofsuchcomplaints,andalsoofcoryzaandhoarseness。

18。Disordersconnectedwithregimen,forthemostpart,maketheirattackaccordinglyasanyonehaschangedhishabitualmodeofdiet。Forpersonswhodinecontrarytocustomexperiencemuchswellingofthestomach,drowsiness,andfullness;andiftheytakesupperoverandabove,theirbellyisdisordered;suchpersonswillbebenefitedbysleepingaftertakingthebath,andbywalkingslowlyforaconsiderabletimeaftersleep;if,then,thebowelsbemoved,hemaydineanddrinkasmallquantityofwinenotmuchdiluted;butifthebowelsarenotopened,heshouldgethisbodyrubbedwithhotoil,and,ifthirsty,drinkofsomeweakandwhitewine,orasweetwine,andtakerepose;ifhedoesnotsleepheshouldreposethelonger。

Inotherrespectsheshouldobservetheregimenlaiddownforthosewhohavetakenadebauch。Withregardtothebadeffectsofdrinks,suchasareofawaterynaturepassmoreslowlythroughthebody,theyregurgitate,asitwere,andfloataboutthehypochondria,anddonotflowreadilybyurine;whenfilledupwithsuchadrink,heshouldnotattemptanyviolentexertion,requiringeitherstrengthorswiftness,butshouldrestasmuchaspossibleuntilthedrinkhasbeendigestedalongwiththefood;butsuchdrinksasarestrongerormoreaustere,occasionpalpitationinthebodyandthrobbinginthehead,andinthiscasethepersonaffectedwilldowelltosleep,andtakesomehotdraughtforwhichhefeelsdisposed;forabstinenceisbadinheadacheandtheeffectsofasurfeit。Thosewho,contrarytousage,restrictthemselvestoonemeal,feelemptyandfeeble,andpasshoturineinconsequenceoftheemptinessoftheirvessels;theyhaveasaltandbittertasteinthemouth;theytrembleatanyworktheyattempt;theirtemplesthrob;andtheycannotdigesttheirsuppersowellasiftheyhadpreviouslytakentheirdinner。Suchpersonsshouldtakelesssupperthantheyarewont,andapuddingofbarley-mealmoremoistthanusualinsteadofbread,andofpotherbsthedock,ormallow,andptisan,orbeets,andalongwiththefoodtheyshouldtakewineinmoderation,anddilutedwithwater;aftersuppertheyshouldtakeashortwalk,untiltheurinedescendandbepassed;andtheymayuseboiledfish。

Articlesoffoodhavegenerallysucheffectsasthefollowing:

Garlicoccasionsflatulenceandheataboutthechest,heavinessofthehead,andnausea,andanyotherhabitualpainisapttobeexasperatedbyit;itisdiuretic,which,insofar,isagoodpropertywhichitpossesses;buttoeatitwhenonemeanstodrinktoexcess,orwhenintoxicated。Cheeseproducesflatulenceandconstipation,andheatstheotherarticlesoffood;anditgivesrisetocruditiesandindigestion,butitisworstofalltoeatitalongwithdrinkafterafullmeal。Pulseofallkindsareflatulent,whetherraw,boiled,orfried;leastsowhenmaceratedinwater,orinagreenstate;theyshouldnotbeusedexceptalongwithfoodpreparedfromthecerealia。Eachofthesearticles,articles,however,hasbadeffectspeculiartoitself。Thevetch,whetherraworboiled,createsflatulenceandpain。Thelentilisastringent,anddisordersthestomachiftakenwithitshull。Thelupinehasthefewestbadeffectsofallthesethings。Thestalkandthejuiceofsilphium(asafoetida),passthroughsomepeople’sbowelsveryreadily,butinothers,notaccustomedtothem,theyengenderwhatiscalleddrycholera;thiscomplaintismoreespeciallyproducedbyitifmixedwithmuchcheese,oreatenalongwithbeef。Melancholicdiseasesaremostparticularlyexacerbatedbybeef,foritisofanunmanageablenature,andrequiresnoordinarypowersofstomachtodigestit;itwillagreebestwiththosewhouseitwellboiledandprettylongkept。Goat’sfleshhasallthebadpropertiesofbeef;itisanindigestible,moreflatulentandengendersacideructationsandcholera;suchashasafragrantsmell,isfirm,andsweettothetaste,isthebest,whenwellbakedandcooled;butthosekindswhicharedisagreeabletothetaste,haveabadsmell,andarehard,suchareparticularlybad,andespeciallyifveryfresh;itisbestinsummerandworstinautumn。Thefleshofyoungpigsisbad,eitherwhenitistooraworwhenitisover-roasted,foritengendersbileanddisordersthebowels。Ofallkindsofflesh,porkisthebest;

itisbestwhenneitherveryfat,nor,ontheotherhand,verylean,andtheanimalhadnotattainedtheageofwhatisreckonedanoldvictim;itshouldbeeatenwithouttheskin,andinacoldishstate。

19。Indrycholerathebellyisdistendedwithwind,thereisrumblinginthebowels,paininthesidesandloins,nodejections,but,onthecontrary,thebowelsareconstipated。Insuchacaseyoushouldguardagainstvomiting,butendeavortogetthebowelsopened。Asquicklyaspossiblegiveaclysterofhotwaterwithplentyofoilinit,andhavingrubbedthepatientfreelywithunguents;

puthimintohotwater,layinghimdowninthebasin,andpouringthehotwateruponhimbydegrees;andif,whenheatedinthebath,thebowelsbemoved,hewillbefreedfromthecomplaint。Toapersoninsuchacomplaintitwilldogoodifhesleep,anddrinkathin,old,andstrongwine;andyoushouldgivehimoil,sothathemaysettle,andhavehisbowelsmoved,whenhewillberelieved。Hemustabstainfromallotherkindsoffood;butwhenthepainremits,givehimassesmilktodrinkuntilheispurged。Butifthebowelsareloose,withbiliousdischarges,tormina,vomitings,afeelingofsuffocation,andgnawingpains,itisbesttoenjoinrepose,andtodrinkhydromel,andavoidvomiting。

20。Therearetwokindsofdropsy,theoneanasarca,which,whenformed,isincurable;theotherisaccompaniedwithemphysema(tympanites?)andrequiresmuchgoodfortunetoenableonetotriumphoverit。Laboriousexertion,fomentation,andabstinence(aretobeenjoined)。Thepatientshouldeatdryandacridthings,forthuswillhepassthemorewater,andhisstrengthbekeptup。Ifhelaborsunderdifficultyofbreathing,ifitisthesummerseason,andifheisintheprimeoflife,andisstrong,bloodshouldbeabstractedfromthearm,andthenheshouldeathotpiecesofbread,dippedindarkwineandoil,drinkverylittle,andlabormuch,andliveonwell-fedpork,boiledwithvinegar,sothathemaybeabletoendurehardexercises。

21。Thosewhohavetheinferiorintestineshot,andwhopassacridandirregularstoolsofacolliquativenature,iftheycanbearit,shouldprocurerevulsionbyvomitingwithhellebore;butifnot,shouldgetathickdecoctionofsummerwheatinacoldstate,lentilsoup,breadcookedwithcinders,andfish,whichshouldbetakenboilediftheyhavefever,butroastedifnotfeverish;andalsodark-coloredwineiffreeoffever;butotherwisetheyshouldtakethewaterfrommedlars,myrtles,apples,services,dates,orwildvine。Iftherebenofever,andiftherebetormina,thepatientshoulddrinkhotasses’milkinsmallquantityatfirst,andgraduallyincreaseit,andlinseed,andwheatenflour,andhavingremovedthebitterpartofEgyptianbeans,andgroundthem,sprinkleonthemilkanddrink;

andlethimeateggshalf-roasted,andfineflour,andmillet,andperl-spelt(chondrus)boiledinmilk;-allthesethingsshouldbeeatencold,andsimilararticlesoffoodanddrinkshouldbeadministered。

22。Themostimportantpointofregimentoobserveandbeguardedaboutinprotracteddiseases,istopayattentiontotheexacerbationsandremissionsoffevers,soastoavoidthetimeswhenfoodshouldnotbegiven,andtoknowwhenitmaybeadministeredwithoutdanger;thislastseasonisatthegreatestpossibledistancefromtheexacerbation。

23。Oneshouldbeabletorecognizethosewhohaveheadachefromgymnasticexercises,orrunning,orwalkingorhunting,oranyotherunseasonablelabor,orfromimmoderatevenery;alsothosewhoareofapalecolor,ortroubledwithhoarseness;thosewhohaveenlargedspleen,thosewhoareinastateofanaemia,thosewhoaresufferingfromtympanites,thosehavingdrycoughandthirst,thosewhoareflatulent,andhavethecourseofthebloodintheirveinsintercepted;thosepersonswhosehypochondria,sides,andbackaredistended:thosehavingtorpor;thoselaboringunderamaurosis,orhavingnoisesintheirears;thosesufferingfromincontinenceofurineorjaundice,orwhosefoodispassedundigested;thosewhohavedischargesofbloodfromthenoseoranus,orwhohaveflatulenceandintensepain,andwhocannotretainthewind。Inthesecasesyoumaydomischief,butcannotpossiblydoanygoodbypurging,butmayinterruptthespontaneousremissionsandcrisesofthecomplaints。

24。Ifyouthinkitexpedienttoletblood,seethatthebowelsbepreviouslysettled,andthenbleed;enjoinabstinence,andforbidtheuseofwine;andcompletethecurebymeansofasuitableregimen,andwetfomentations。Butifthebowelsappeartobeconstipated,administerasoothingclyster。

25。Ifyouthinkitnecessarytogivemedicines,youmaysafelypurgeupwardsbyhellebore,butnoneofthoseshouldbepurgeddownwards。Themosteffectualmodeoftreatmentisbytheurine,sweats,andexercise;andusegentlefrictionsoasnottohardentheconstitution;andifhebeconfinedtobedletothersrubhim。

Whenthepainisseatedabovethediaphragm,placehimerectforthemostpart,andlethimbeaslittlereclinedaspossible;andwhenheisraiseduplethimberubbedforaconsiderabletimewithplentyofhotoil。Butifthepainsbeinthelowerbellybelowthediaphragm,itwillbeusefultoliereclinedandmakenomotion,andtosuchapersonnothingshouldbeadministeredexceptthefriction。

Thosepainswhicharedissolvedbydischargesfromthebowels,byurine,ormoderatesweats,ceasespontaneously,iftheyareslight,butifstrongtheyprovetroublesome;forpersonssoaffectedeitherdie,oratleastdonotrecoverwithoutfurthermischief,fortheyterminateinabscesses。

26。Adraughtforadropsicalperson。Takethreecantharides,andremovingtheirhead,feet,andwings,trituratetheirbodiesinthreecupfuls(cyathi)ofwater,andwhenthepersonwhohasdrunkthedraughtcomplainsofpain,lethimhavehotfomentationsapplied。

Thepatientshouldbefirstanointedwithoil,shouldtakethedraughtfasting,andeathotbreadwithoil。

27。Astyptic。Applythejuiceofthefiginwardlytothevein;orhavingmouldedbiestingsintoatent,introduceupthenostril,orpushupsomechalcitiswiththefinger,andpressthecartilagesofthenostrilstogether;andopenthebowelswiththeboiledmilkofasses:orhavingshavedtheheadapplycoldthingstoitifinthesummerseason。

28。Thesesamoidespurgesupwardswhenpoundedinoxymeltotheamountofadrachmandahalf,anddrunk;itiscombinedwiththehellebores,totheamountofthethirdpart,andthusitislessapttoproducesuffocation。

29。Trichiasis。Havingintroducedathreadintotheeyeofaneedlepushitthroughtheupperpartofthedistendedeyelid,anddothesameatthebaseofit;havingstretchedthethreadstieaknotonthem,andbindupuntiltheydropout:and,ifthisbesufficient,sofarwell;butifotherwise,youmustdothesamethingagain。Andhemorrhoids,inlikemanner,youmaytreatbytransfixingthemwithaneedleandtyingthemwithaverythickandlargewoolenthread;forthusthecurewillbemorecertain。Whenyouhavesecuredthem,useasepticapplication,anddonotfomentuntiltheydropoff,andalwaysleaveonebehind;andwhenthepatientrecovers,lethimbeputuponacourseofhellebore。Thenlethimbeexercisedandsweated;thefrictionofthegymnasiumandwrestlinginthemorningwillbeproper;buthemustabstainfromrunning,drinking,andallacridsubstances,exceptmarjoram;lethimtakeanemeticeverysevendays,orthreetimesinamonth;forthuswillheenjoythebestbodilyhealth。Lethimtakestraw-colored,austere,andwaterywine,anduselittledrink。

30。Forpersonsaffectedwithempyema。Havingcutsomebulbsorsquill,boilinwater,andwhenwellboiled,throwthisaway,andhavingpouredinmorewater,boiluntilitappeartothetouchsoftandwell-boiled;thentrituratefinelyandmixroastedcumin,andwhitesesames,andyoungalmondspoundedinhoney,formintoanelectuaryandgive;andafterwardssweetwine。Indraughts,havingpoundedaboutasmallacetabulumofthewhitepoppy,moistenitwithwaterinwhichsummerwheathasbeenwashed,addhoney,andboil。

Lethimtakethisfrequentlyduringtheday。Andthentakingintoaccountwhatistohappen,givehimsupper。

31。Fordysentery。Afourthpartofapoundofcleanedbeans,andtwelveshootsofmadderhavingbeentriturated,aretobemixedtogetherandboiled,andgivenasalinctuswithsomefattysubstance。

32。Fordiseasesoftheeyes。Washedspodium(tutty?)mixedwithgrease,andnotofathinnerconsistencethandough,istobecarefullytriturated,andmoistenedwiththejuiceofunriperaisins;andhavingdriedinthesun,moistenuntilitisoftheconsistenceofanointment。Whenitbecomesagaindry,letitbefinelylevigated,anointtheeyeswithit,anddustitupontheanglesoftheeyes。

33。Forwateryeyes。Takeonedrachmofebenyandnineoboliofburntcopper,rubthemuponawhetstone,addthreeoboliofsaffron;

triturateallthesethingsreducedtoafinepowder,pourinanAtticheminaofsweetwine,andthenplaceinthesunandcoverup;

whensufficientlydigested,useit。

34。Forviolentpainsoftheeyes。Takeofchalcitis,andofraisin,ofeach1dr。,whendigestedfortwodays,strain;andpoundingmyrrhandsaffron,andhavingmixedmust,withthesethings,digestinthesun;andwiththisanointtheeyeswheninastateofseverepain。

Letitbekeptinacoppervessel。

35。Modeofdistinguishingpersonsinanhystericalfit。Pinchthemwithyourfingers,andiftheyfeel,itishysterical;butifnot,itisaconvulsion。

36。Topersonsincoma,(dropsy?)givetodrinkmeconium(euphorbiapeplus?)totheamountofaroundAtticleciskion(smallacetabulum)。

37。Ofsquamaaeris,asmuchasthreespecillacancontain,withtheglutenofsummerwheat:levigate,pound,formintopills,andgive;itpurgeswaterdownwards。

38。Amedicineforopeningthebowels。Pouruponfigsthejuiceofspurge,intheproportionofseventoone:thenputintoanewvesselandlaypastwhenproperlymixed。Givebeforefood。

39。Poundingmeconium,pouringonitwater,andstraining,andmixingflour,andbakingintoacake,withtheadditionofboiledhoney,giveinaffectionsoftheanusandindropsy;andaftereatingofit,letthepatientdrinkofasweetwaterywine,anddilutedhydromelpreparedfromwax:orcollectingmeconium,layitupformedicinalpurposes。