De Medicina |
Translator: Walter George Spencer
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At si duae quartanae sunt , neque eae , quas proposui , exercitationes adhiberi possunt , aut ex toto quiescere opus est , aut , si id difficile est , leuiter ambulare , considere diligenter inuolutis pedibus et capite ; quotiens febris accessit et desiit , cibum modicum sumere et uinum , reliquo tempore , nisi inbecillitas urguet , abstinere . At si duae febres paene iunguntur , post utramque cibum sumere , deinde uacuo tempore et moueri aliquid et post unctionem cibo uti . Cum uero uetus quartana raro nisi uere soluatur , utique eo tempore attendendum est , ne quid fiat , quod ualetudinem impediat . Prodestque in uetere quartana subinde mutare uictus genus , a uino ad aquam , ab aqua ad uinum , a lenibus cibis ad acres , ab acribus ad lenes transire ; esse radicem , deinde uomere ; iure uel * * pulli gallinacei uentrem resoluere ; oleo ad frictiones adicere calfacientia ; ante accessionem sorbere uel aceti cyathos duos , uel unum sinapis cum tribus Graeci uini , uel mixta paribus portionibus et in aqua diluta piper , castoreum , laser , murram . Per haec enim similiaque corpus agitandum est , ut moueatur ex eo statu , quo detinetur . Si febris quieuit , diu meminisse eius diei conuenit , eoque uitare frigus , calorem , cruditatem , lassitudinem : facile enim reuertitur , nisi a sano quoque aliquamdiu timetur .
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16 But if there is a double quartan fever, and those exercises which I have mentioned cannot be adopted, either the patient should rest entirely, or if that is difficult walk quietly, then sit with his feet and head carefully wrapped up; as often as a paroxysm has recurred and has remitted, he should take food in moderation and wine; for the remainder of the remission, unless there is urgent weakness, he should fast. But if two paroxysms are almost continuous, he should take food after both are over; then in the intermission he should move about a little, and after being anointed take food. Now since an inveterate quartan is seldom got rid of except in the spring, it is at that season especially that attention is to be given, lest something occur to hinder recovery. And it is of advantage in an old quartan to later now and then the class of diet, and change from wine to water, from bland food to acrid, from acrid to bland; to eat radish, then to vomit; to move the bowels by shell-fish or chicken broth; to add heating agents to the oil for rubbing; before the paroxysm to sip two cups of vinegar, or one cup of mustard in three of Greek salted wine, or pepper, castoreum, laser and myrrh in equal proportions in water. For by these and such-like remedies the system is to be stirred up in order that it may be moved from the state in which it is being held. When the fever has quieted down, for a long while it is well to keep in mind the day on which it occurred, and on that day to avoid cold, heat, indigestion, fatigue: for fever readily recurs unless even a convalescent patient fears that day for some time to come. |
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At si ex quartana facta cotidiana est , cum id uitio inciderit , per biduum abstinere oportet , et frictione uti , uespere tantummodo aquam potui dare : tertio die saepe fit , ne febris accedat . Sed siue fuit siue non fuit , cibus post accessionis tempus est dandus . At si manet , per biduum abstinentia , quanta maxime imperari corpori potest , frictione cotidie utendum est .
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17 But if a quotidian has been made out of a quartan fever, since this may have happened from mismanagement, the patient ought to fast for two days, make use of rubbing, and be given only a drink of water in the evening: it often happens that on the third day there is no paroxysm. But whether or not, food should be given after the time for the paroxysm. But if this fever persists, a two days' fast should be enjoined so far as the system can bear it, and rubbing used every day. |
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Et febrium quidem ratio exposita est . Supersunt uero alii corporis adfectus , qui huic superueniunt , ex quibus eos , qvi certis partibvs adsignari non possvnt , protinus iungam . Incipiam ab insania , primamque huius ipsius partem adgrediar , quae et acuta et in febre est : ΦΡΕΝΗΣΙΝ Graeci appellant . Illud ante omnia scire oportet , interdum in accessione aegros desipere et loqui aliena . Quod non quidem leue est neque incidere potest nisi in febre uehementi ; non tamen aeque pestiferum est : nam plerumque breue esse consueuit leuatoque accessionis impetu protinus mens redit . Neque id genus morbi remedium aliud desiderat , quam quod in curanda febre praeceptum est . Phrenesis uero tum demum est , cum continua dementia esse incipit , cum aeger , quamuis adhuc sapiat , tamen quasdam uanas imagines accipit : perfecta est , ubi mens illis imaginibus addicta est . Eius autem plura genera sunt : siquidem ex phreneticis alii tristes sunt ; alii hilares ; alii facilius continentur et intra uerba desipiunt ; alii consurgunt et uiolenter quaedam manu faciunt ; atque ex his ipsis alii nihil nisi impetu peccant , alii etiam artes adhibent summamque speciem sanitatis in captandis malorum operum occasionibus praebent , sed exitu deprenduntur . —Ex his autem eos , qui intra uerba desipiunt , aut leuiter etiam manu peccant , onerare asperioribus coercitionibus superuacuum est : eos , qui uiolentius se gerunt , uincire conuenit , ne uel sibi uel alteri noceant . Neque credendum est , si uinctus aliqui , dum leuari uinculis cupit , quamuis prudenter et miserabiliter loquitur , quoniam is dolus insanientis est . Fere uero antiqui tales aegros in tenebris habebant , eo quod is contrarium esset exterreri , et ad quietem animi tenebras ipsas conferre aliquid iudicabant . At Asclepiades , tamquam tenebris ipsis terrentibus , in lumine habendos eos dixit . Neutrum autem perpetuum est : alium enim lux , alium tenebrae magis turbant ; reperiunturque , in quibus nullum discrimen deprehendi uel hoc uel illo modo possit . Optimum itaque est utrumque experiri , et habere eum , qui tenebras horret , in luce , eum qui lucem , in tenebris . At ubi nullum tale discrimen est , aeger , si uires habet , loco lucido ; si non habet , obscuro continendus est . Remedia uero adhibere , ubi maxime furor urget , superuacuum est : simul enim febris quoque increscit . Itaque tum nihil nisi continendus aeger est : ubi uero res patitur , festinanter subueniendum est . Asclepiades perinde esse dixit his sanguinem mitti ac si trucidentur : rationem hanc secutus , quod neque insania esset , nisi febre intenta , neque sanguis nisi in remissione eius recte mitteretur . Sed ipse in his somnum multa frictione quaesiuit , cum et intentio febris somnum impediat et frictio non nisi in remissione eius utilis sit . Itaque hoc quoque auxilium debuit praeterire . Quid igitur est ? Multa in praecipiti periculo recte fiunt alias omittenda . Et continuata quoque febris habet tempora , quibus , etsi non remittit , non tamen crescit , estque hoc ut non optimum , sic tamen secundum remediis tempus , quo , si uires aegri patiuntur , sanguis quoque mitti debet . Minus deliberari potest , an aluus ducenda sit . Tum interposito die conuenit caput ad cutem tondere , aqua deinde fouere , in qua uerbenae aliquae decoctae sint [ uel ex reprimentibus ] ; aut prius fouere , deinde radere , et iterum fouere ; ac nouissime rosa caput naresque implere , offerre etiam naribus rutam ex aceto contritam , mouere sternumenta medicamentis in id efficacibus . Quae tamen facienda sunt in is , quibus uires non desunt : si uero inbecillitas est , rosa tantum caput adiecto serpullo similique aliquo madefaciendum est . Vtiles etiam in quibuscumque uiribus duae herbae sunt , solanum et muralis , si simul ex utraque suco expresso caput impletur . Cum febris remisit , frictione utendum est , parcius tamen in is , qui nimis hilares quam in is , qui nimis tristes sunt . Aduersus autem omnium sic insanientium animos gerere se pro cuiusque natura necessarium est . Quorundam enim uani metus leuandi sunt , sicut in homine praediuite famem timente incidit , cui subinde falsae hereditates nuntiabantur . Quorundam audacia coercenda est , sicut in is fit , in quibus continendis plagae quoque adhibentur . Quorundam etiam intempestiuus risus obiurgatione et minis finiendus : quorundam discutiendae tristes cogitationes ; ad quod symphoniae et cymbala strepitusque proficiunt . Saepius tamen adsentiendum quam repugnandum et paulatim et non euidenter ab iis , quae stulte dicentur , ad meliora mens eius adducenda . Interdum etiam elicienda ipsius intentio ; ut fit in hominibus studiosis litterarum , quibus liber legitur aut recte , si delectantur , aut perperam , si id ipsum eos offendit : emendando enim conuertere animum incipiunt . Quin etiam recitare , si qua meminerunt , cogendi sunt . Ad cibum quoque quosdam non desiderantes reduxerunt i , qui inter epulantes eos conlocarunt . Omnibus uero sic adfectis somnus et difficilis et praecipue necessarius est : sub hoc enim plerique sanescunt . Prodest ad id atque etiam ad mentem ipsam conponendam crocinum unguentum cum irino in caput additum . Si nihilo minus uigila nt, quidam somnum moliuntur potui dando aquam , in qua papauer aut hyoscyamos decocta si nt, alii mandragorae mala puluino subiciunt , alii uel amomum uel sycamini lacrimam fronti inducunt . Hoc nomen apud medicos reperio . Sed cum Graeci morum sycaminon appellant , mori nulla lacrima est . Sic uero significatur lacrima arboris in Aegypto nascentis , quam ibi sycomoron appellant . Plurimi , decoctis papaueris corticibus , ex ea aqua spongia os et caput subinde fouent . Asclepiades ea superuacua esse dixit , quoniam in lethargum saepe conuerterent : praecepit autem , ut primo die a cibo , potione , somno abstineretur , uespere ei daretur potui aqua , tum frictio admoueretur lenis , ut ne manum quidem qui perfricaret uehementer inprimeret ; postero deinde die isdem omnibus factis uespere ei daretur sorbitio et aqua , rursusque frictio adhiberetur : per hanc enim nos consecuturos , ut somnus accedat . Id interdum fit , et quidem adeo , ut illo confitente nimia frictio etiam lethargi periculum adferat . Sed si sic somnus non accessit , tum demum illis medicamentis arcessendus est , habita scilicet eadem moderatione , quae hic quoque necessaria est , ne , quem obdormire uolumus , excitare postea non possimus . Confert etiam aliquid ad somnum silanus iuxta cadens , uel gestatio post cibum et noctu , maximeque suspensi lecti motus . Neque alienum est , si neque sanguis ante missus est , neque mens constat , neque somnus accedit , occipitio inciso cucurbitulam admouere ; quae quia leuat morbum , potest etiam somnum facere . Moderatio autem in cibo quoque adhibenda est : nam neque aeger implendus est , ne insaniat , neque ieiunio utique uexandus , ne inbecillitate in cardiacum incidat . Opus est cibo infirmo maximeque sorbitione , potione aquae mulsae , cuius ternos cyathos bis hieme , quater aestate dedisse satis est . Alterum insaniae genus est , quod spatium longius recipit , quia fere sine febre incipit , leues deinde febriculas excitat . Consistit in tristitia , quam uidetur bilis atra contrahere .—In hac utilis detractio sanguinis est : si quid hanc poterit prohibere , prima est abstinentia , secunda per album ueratrum uomitumque purgatio , post utrumlibet adhibenda bis die frictio est ; si magis ualet , frequens etiam exercitatio : in ieiuno uomitus . Cibus sine uino dandus ex media materia est ; quam quotiens posuero , scire licebit etiam ex infirmissima dari posse , dum ne illa sola quis utatur : ualentissima tantummodo esse remouenda . Praeter haec seruanda aluus est quam tenerrima , remouendi terrores , et potius bona spes offerenda ; quaerenda delectatio ex fabulis ludisque , maxime quibus capi sanus adsuerat ; laudanda , si qua sunt , ipsius opera et ante oculos eius ponenda ; leuiter obiurganda uana tristitia ; subinde admonendus , in is ipsis rebus , quae sollicitant , cur potius laetitiae quam sollicitudinis causa sit . Si febris quoque accessit , sicut aliae febres curanda est . Tertium genus insaniae est ex his longissimum , adeo ut uitam ipsam non impediat ; quod robusti corporis esse consueuit . Huius autem ipsius species duae sunt : nam quidam imaginibus , non mente falluntur , quales insanientem Aiacem uel Orestem percepisse poetae ferunt : quidam animo desipiunt . Si imagines fallunt , ante omnia uidendum est , tristes an hilares sint . In tristitia nigrum ueratrum deiectionis causa , in hilaritate album ad uomitum excitandum dari debet ; idque si in potione non accepit , in pane adiciendum est , quo facilius fallat : nam si bene se purgauerit , ex magna parte morbum leuabit . Ergo etiamsi semel datum ueratrum parum profecerit , interposito tempore iterum dari debet . Neque ignorare oportet leuiorem esse morbum cum risu quam cum serio insanientium . Illud quoque perpetuum est in omnibus morbis , ubi ab inferiore parte purgandus aliquis est , uentrem eius ante soluendum esse ; ubi a superiore , comprimendum . Si uero consilium insanientem fallit , tormentis quibusdam optime curatur . Vbi perperam aliquid dixit aut fecit , fame , uinculis , plagis coercendus est . Cogendus est et attendere et ediscere aliquid et meminisse : sic enim fiet , ut paulatim metu cogatur considerare quid faciat . Subito etiam terreri et expauescere in hoc morbo prodest , et fere quicquid animum uehementer turbat . Potest enim quaedam fieri mutatio , cum ab eo statu mens , in quo fuerat , abducta est . Interest etiam , ipse sine causa subinde rideat , an maestus demissusque sit : nam demens hilaritas terroribus iis , de quibus supra dixi , melius curatur . Si nimia tristitia , prodest lenis sed multa bis die frictio , item per caput aqua frigida infusa , demissumque corpus in aquam et oleum . Illa communia sunt , insanientes uehementer exerceri debere , multa frictione uti , neque pinguem carnem neque uinum adsumere ; cibis uti post purgationem ex media materia quam leuissimis ; non oportere esse uel solos uel inter ignotos , uel inter eos , quos aut contemnant aut neglegant ; mutare debere regiones et , si mens redit , annua peregrinatione esse iactandos . Raro sed aliquando tamen ex metu delirium nascitur . Quod genus insanientium specie * * * similique uictus genere curandum est , praeterquam quod in hoc insaniae genere solo recte uinum datur .
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18 The regimen of fevers has now been expounded; there are, however, other affections of the body which follow upon this, among which I subjoin in the first place those which cannot be assigned to any definite part. I shall begin with insanity, and first that form of it which is both acute and found in fever. The Greeks call it phrenesis. Before all things it should be recognized, that at times, during the paroxysm of a fever, patients are delirious and talk nonsense. This is indeed no light matter, and it cannot occur unless in the case of a severe fever; it is not, however, always equally dangerous; for commonly it is of short duration, and when the onslaught of the paroxysm is relieved, at once the mind comes back. This form of the malady does not require other remedy than that prescribed for the curing of the fever. But insanity is really there when a continuous dementia begins, when the patient, although up till then in his sanity in his senses, yet entertains certain vain imaginings; the insanity becomes established when the mind becomes at the mercy of such imaginings. But there are several sorts of insanity; for some among insane persons are sad, others hilarious; some are more readily controlled and rave in words only, others are rebellious and act with violence; and of these latter, some only do harm by impulse, others are artful too, and show the most complete appearance of sanity while seizing occasion for mischief, but they are detected by the result of their acts. Now that those who merely ave in their talk, or who make but trifling misuse of their hands, should be coerced with the severer forms of constraint is superfluous; but those who conduct themselves more violently it is expedient to fetter, lest they should do harm either to themselves or to others. Anyone so fettered, although he talks rationally and pitifully when he wants his fetters removed, is not to be trusted, for that is a madman's trick. The ancients generally kept such patients in darkness, for they held that it was against their good to be frightened, and that the very darkness confers something towards the quieting of the spirit. But Asclepiades said that they should be kept in the light, since the very darkness was terrifying. Yet neither rule is invariable: for light disturbs one more, darkness another; and some are met with in whom no difference can be observed, either one way or the other. It is best, therefore, to make trial of both, and to keep that patient in the light who is frightened by darkness, and him in darkness who is frightened by light. And when there is no such difference, the patient if strong should be kept in a light room, if not strong he should be kept in a dim one. Now it is useless to adopt remedies when the delirium is at its height; for simultaneously fever is also increasing. So then there is nothing else to do than to restrain the patient, but when circumstances permit, relief must be given with haste. Asclepiades said that in such cases to let blood is to commit murder; following the line of reasoning, that there was no insanity unless with high fever, and that properly blood was let only during the stage of remission. But he himself in these cases sought to bring on sleep by prolonged rubbing, though it is the intensity of the fever which hinders sleep, and it is only during the remission that rubbing is of service. Hence he ought to have passed over this remedy also. What then is there to do? Many things may be rightly done in imminent danger, which otherwise ought to be omitted. And fever also, when continuous, has times during which, although it does not remit, yet it does not increase, and this time, although not the best, yet is the second best time for remedies; and at this time blood ought to be let, if the patient's strength allow it. There can be less question as to whether a motion should be induced. Next, after a day's interval, the head should be shaved bare and then fomented with water in which vervains or other repressive herbs have been boiled; alternatively it is proper first to foment, then to shave, and again to foment; and lastly to pour rose oil over the head and into the nostrils; also to hold to the nose rue pounded up in vinegar, and to excite sneezing by drugs efficacious for the purpose. Such things, however, should be done only in the case of those who are not lacking in strength; but if there is weakness, the head is merely moistened by rose oil to which thyme or something similar has been added. Whatever the patient's strength, the two herbs, bitter-sweet and pellitory, are beneficial, if the head is wetted with the juice expressed from both simultaneously. When the fever has remitted, recourse should be had to rubbing, more sparingly, however, in those who are over-cheerful, than in those who are too gloomy. But in dealing with the spirits of all patients suffering from this type of insanity, it is necessary to proceed according to the nature of each case. Some need to have empty fears relieved, as was done for a wealthy man in dread of starvation, to whom pretend legacies were from time to time announced. Others need to have their violence restrained as is done in the case of those who are controlled even by flogging. In some also untimely laughter has to be put a stop to by reproof and threats; in others, melancholy thoughts are to be dissipated, for which purpose music, cymbals, and noises are of use. More often, however, the patient is to be agreed with rather than opposed, and his mind slowly and imperceptibly is to be turned from the irrational talk to something better. At times also his interest should be awakened; as may be done in the case of men fond of literature, to whom a book may be read, correctly when they are pleased by it, or incorrectly if that very thing annoys them; for by making corrections they begin to divert their mind. Moreover, they should be pressed to recite anything they can remember. Some who did not want to eat were induced to do so, by be placed on couches between other diners. But certainly for all so affected sleep is both difficult and especially necessary; for under it many get well. Beneficial for this, as also for composing the mind itself, is saffron ointment with orris applied to the head. If in spite of this the patients are wakeful, some endeavour to induce sleep by draughts of decoction of poppy or hyoscyamus; others put mandrake apples under the pillow; others smear the forehead with cardamomum balsam or sycamine tears. This name I find used by practitioners, but there are no tears on the mulberry, although the Greeks call the mulberry sycaminon. What in fact is meant are the tears of a tree growing in Egypt, which they call in that country sycamoros. Many foment the face and head at intervals with a sponge dipped in a decoction of poppy heads. Asclepiades said that these things were of no benefit, because they often produced a change into lethargy (III.20); but he prescribed for the patient that during the first day he should keep from food, drink and sleep, in the evening water should be given him to drink, after which he should be rubbed with gentleness, but the rubber must not press hard even with the hand (II.14); during the day following the same was to be done, then in the evening gruel and water should be given and rubbing again applied: for by this he said we should succeed in bringing on sleep. This does happen sometimes, and to such a degree that Asclepiades allowed that excess of rubbing may even cause danger of lethargy. But if sleep does not thus occur, then at length it is to be procured by the above medicaments, having regard, of course, to the same moderation, which is necessary here also, for fear we may afterwards not be able to wake up the patient whom we wish to put to sleep. Sleep is also assisted by the sound of falling water near by, also rocking after food and at night, and especially the motion of a slung hammock (II.15). If blood has not been let before, and the patient's mind is unstable and sleep does not occur, it is not unfitting to apply a cup over an incision into the occiput, which can produce sleep because it relieves the disease. Now moderation in food is also to be observed: for the patient ought not to be surfeited lest it madden him, and he should certainly not be tormented by fasting lest he collapse through debility. The food should be light, in particular gruel, and hydromel for drink, of which three cups are enough, given twice a day in winter, and four times in summer. There is another sort of insanity, of longer duration because it generally begins without a fever, but later excites a slight feverishness. It consists in depression which seems caused by black bile. Blood-letting is here of service; but if anything prohibit this, then comes firstly abstinence, secondly a clearance by white hellebore and a vomit. After either, rubbing twice a day is to be adopted; if the patient is strong, frequent exercise as well: vomiting on an empty stomach. Food of the middle class should be given without wine; but as often as I indicate this class of food, it should be understood that some of the weakest class of food also may be given, provided that this is not used alone; and that it is only the strongest class of food which is excluded. In addition to the above: the motions are to be kept very soft, causes of fright excluded, good hope rather put forward; entertainment sought by story-telling, and by games, especially by those with which the patient was wont to be attracted when sane; work of his, if there is any, should be praised, and set out before his eyes; his depression should be gently reproved as being without cause; he should have it pointed out to him now and again how in the very things which trouble him there may be a cause of rejoicing rather than of solicitude. When there is fever besides, it is to be treated like other fevers. The third kind of insanity is of all the most prolonged whilst it does not shorten life, for usually the patient is robust. Now of this sort there are two species: some are duped not by their mind, but by phantoms, such as the poets say Ajax saw when mad or Orestes; some become foolish in spirit. If phantoms mislead, we must note in the first place whether the patients are depressed or hilarious. For depression black hellebore should be given as a purge, for hilarity white hellebore as an emetic; and if the patient will not take the hellebore in a draught, it should be put into his bread to deceive him the more easily; for if he has well purged himself, he will in great measure relieve himself of his malady. Therefore even if one does of the hellebore has little effect, after an interval another should be given. It should be known that a madman's illness is less serious when accompanied by laughter than by gravity. This also is an invariable precept in all disease, that when a patient is to be purged downwards, his belly is to be loosened beforehand, but confined when he is to be purged upwards. If, however, it is the mind that deceives the madman, he is best treated by certain tortures. When he says or does anything wrong, he is to be coerced by starvation, fetters and flogging. He is to be forced both to fix his attention and to learn something and to memorize it; for thus it will be brought about that little by little he will be forced by fear to consider what he is doing. To be terrified suddenly and to be thoroughly frightened is beneficial in this illness and so, in general, is anything which strongly agitates the spirit. For it is possible that some change may be effected when the mind has been withdrawn from its previous state. It also makes a difference, whether from time to time without cause the patient laughs, or is sad and dejected: for the hilarity of madness is better treated by those terrors I have mentioned above. If there is excessive depression light and prolonged rubbing twice a day is beneficial, as well as cold water poured over the head, and immersion of the body in water and oil. The following are general rules: the insane should be put to fatiguing exercise, and submitted to prolonged rubbing, and given neither fat meat nor wine: after the clearance the lightest food of the middle class is to be used; they should not be left alone or among those they do not know, or among those whom either they despise or disregard; they ought to have a change of scene, and if the mind returns, they should undergo the tossing incident to travel (II.15), once a year. Rarely, yet now and then, however, delirium is the produce of fright; this class of insanity, has similar sub-divisions, and is to be treated by the same species of dietetic regimen, except that, in this form of insaneness alone, wine is properly given. |
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His morbis praecipue contrarium est id genus , quod cardiacum a Graecis nominatur , quamuis saepe ad eum phrenetici transeunt : siquidem mens in illis labat , in hoc constat . Id autem nihil aliud est quam nimia inbecillitas corporis , quod stomacho languente inmodico sudore digeritur . Licetque protinus scire id esse , ubi uenarum exigui inbecillique pulsus sunt , sudor autem et supra consuetudinem et modo * et tempore ex toto thorace et ceruicibus atque etiam capite prorumpit , pedibus tantummodo et cruribus siccioribus atque frigentibus ; acutique id morbi genus est . Curatio prima est supra praecordia imponere quae reprimant cataplasmata , secunda sudorem prohibere . Id praestat acerbum oleum uel rosa uel melinum aut myrteum , quorum aliquo corpus leuiter perunguendum , ceratumque ex aliquo horum tum inponendum est . Si sudor uincit , delinendus homo est uel gypso uel spuma argentea uel Cimolia creta , uel etiam subinde horum puluere respergendus . Idem praestat puluis ex contritis aridi myrti uel rubi foliis , aut ex austeris et boni uini arida faece ; pluraque similia sunt , quae si desunt , satis utilis est quilibet ex uia puluis iniectus . Super haec uero , quo minus corpus insudet , leui ueste debet esse contectus , loco non calido , fenestris patentibus , sic ut perflatus quoque aliquis accedat . Tertium auxilium est inbecillitati iacentis cibo uinoque succurrere . Cibus non multus quidem , sed saepe tamen nocte ac die dandus est , ut nutriat , neque oneret . Is esse debet ex infirmissima materia et stomacho aptus . Nisi si necesse est , ad uinum festinare non oportet . Si uerendum est , ne deficiat , tum et intrita ex hoc , et hoc ipsum austerum quidem , sed tamen tenue , meraculum , egelidum subinde et liberaliter dandum est , adiecta polenta , si modo is aeger parum cibi adsumit ; idque uinum esse debet neque nullarum uirium , neque ingentium : recteque toto die ac nocte uel tres heminas aeger bibet ; si uastius corpus est , plus etiam : si cibum non accipit , perunctum perfundere aqua frigida ante conueniet , et tunc dare . Quod si stomachus resolutus parum continet , et ante cibum et post eum sponte uomere oportet , rususque post uomitum cibum sumere . Si ne id quidem manserit , sorbere uini cyathum , interpositaque hora sumere alterum . Si id quoque stomachus reddiderit , totum corpus bulbis contritis superinlinendum est ; qui ubi inaruerunt , efficiunt , ut uinum in stomacho contineatur , exque eo toti corpori calor , uenisque uis redeat . Vltimum auxilium est in aluum tisanae uel halicae cremorem ex inferioribus partibus indere , siquidem id quoque uires tuetur . Neque alienum est naribus quoque aestuantis admouere quod reficiat : si qua in extremis partibus frigent , unctis et calidis manibus fouere . Per quae si consequi potuimus , ut et sudoris impetus minuatur , et uita prorogetur , incipit iam tempus ipsum esse praesidio . Vbi esse in tuto uidetur , uerendum tamen , ne in eandem infirmitatem cito recidat ; itaque uino tantummodo remoto cotidie ualidiorem cibum debet adsumere , donec satis uirium corpori redeat .
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19 That kind of affection which the Greeks call cardiac is a complete contrast to the foregoing diseases, although insane persons often pass over into it; in those the mind gives way, in this it holds firm. Indeed the illness is nothing other than excessive weakness of the body, which, while the stomach is languid, wastes away through immoderate sweating. And it may be recognized at once by the exiguous and weak pulsation of the blood vessels, while sweat, at once unaccustomed and excessive and untimely, breaks out all over the chest and neck, and even over the head, the feet and legs remaining more dry and cold; and it is a form of acute disease. The primary treatment is the application over the chest of repressant plasters; the secondary, to stop sweating. The latter is accomplished by bitter olive oil, or rose or quince or myrtle oil, with any of which the body is to be lightly anointed, then a salve made up of any of them is to be applied. If the sweating wins, the patient is to be smeared over with gypsum or litharge or cimolian chalk, or even powdered over with the same at intervals. A powder consisting of the pounded leaves of dried myrtle or of blackberry, or of the dried lees of dry and good wine, attains the same end; there are many simple materials, and if these are not at hand, it is useful enough to scatter on any dust from the road. In addition to this, moreover, in order that he may sweat less, the patient should be lightly covered and lie in a cool room, with the windows open, so that some breeze reaches him. A third aid is to help his weakness whilst in bed by food and wine. The food, whilst not much in quantity, should be given often, as well by night as by day, so as to nourish without becoming onerous. It should consist of the weakest class of materials and should be suitable to the stomach. Unless there is necessity, it is not well to hurry on to wine. But when fainting is apprehended, then there is given both bread crumbled into the wine and wine by itself dry indeed yet thin, undiluted, lukewarm, at intervals liberally, and if the patient is taking but little food, polenta may be scattered into the wine; and that wine should not be lacking in strength, yet not over-strong the patient may properly drink three quarters of a litre, and even more if of large build, in the course of a day and night: if he does not take his food, the patient should be anointed, should have cold water poured over him, and after that be given food. But if the stomach has become relaxed and retains but little, let the patient vomit as he will, whether before or after food, and after vomiting take food again. If even after that food is not retained, he should sip a cupful of wine, and another after the interval of an hour. If the stomach returns this wine also, he should be rubbed all over with pounded onions, which as they dry cause the stomach to retain the wine, and as a result, cause heat to return throughout the body, and a forceful pulsation to the blood vessels. The last resource is the introduction into the bowel from below of barley or spelt gruel, since that too supports the patient's strength. Should he feel hot, it is not inappropriate to hold to his nostrils a restorative such as rose oil in wine; if he has cold extremities, they should be rubbed by hands anointed and warmed. If we can by these measures obtain a diminution in the severity of the sweating, and a prolongation of life, time itself now begins to come to our aid. When the patient appears to have reached safety, rapid release into the same state of weakness is still to be feared; hence along with a gradual withdrawal of wine, the patient ought each day to take stronger food, until a sufficiency of bodily strength is gained. |