1. THE remedies of acute diseases are connected with the form of the symptoms, certain of which have been described by me in the preceding works. Whatever, therefore, relates to the cure of fevers, according to their differences, the form of the diseases, and the varieties in them, the greater part of these will be treated of in my discourses on fevers. But acute affections which are accompanied with fevers, such as Phrenitis, or those without fevers, as Apoplexy, of these alone will I now write; and that I may not commit blunders, or become diffuse by treating of the same matters in different places, the beginning and end correspond to the same in the work on the affections.
1. ὀξεῶν νούσων ἄκεα ξυναφέα τῇσι σημηΐων ἰδέῃσι, ἀμφὶ ὧν τοῖς ξυγγράμμασι, ἄσσα μοι πρόσθεν γεγράφαται. ὁκόσα μὲν ὦν ἐν πυρετῶν θεραπείῃ γίγνεται κατά τε τὴν τούτων διαφορὴν, καὶ κατὰ τὴν τῶν νοσημάτων ἰδέην, καὶ τὴν ἐν αὐτοῖς ποικιλίην, τουτέων τὰ πλείω ἐν τοῖσι ἀμφὶ πυρετῶν λόγοισι λελέξεται· ὁκόσα δὲ ξὺν πυρετοῖσι ὀξέα γίγνεται πάθεα, ὁκοῖον ἡ φρενῖτις, ἢ ἄνευθε πυρετῶν, ὁκοῖον ἀποπληξίη, ἀμφὶ τῶνδε μοῦνον τὰ ἄκεα φράσω· ὡς δὲ μὴ διαμαρτάνειν, μηδὲ μακρηγορέειν, ἕτερα ἐν ἑτέροισι γράφοντα, ἀρχὴ ἡ ωὐτὴ ἣ καὶ ἀμφὶ τῶν παθέων, καὶ τελευτὴ ἡ ωὐτή.
2. THE patient ought to be laid in a house of moderate size, and mild temperature—in a warm situation, if winter, and in one that is cool and humid, if summer; in spring and autumn, to be regulated according to the season. Then the patient himself, and all those in the house, are to be ordered to preserve quiet; for persons in phrensy are sharp of hearing, are sensitive to noise, and easily become delirious. The walls should be smooth, level, without projections, not adorned with frieze or paintings; for painting on a wall is an excitant. And, moreover, they catch at certain false appearances before their eyes, and grope about things which are not projecting, as if they were so; and any unreal occasion may be a cause sufficient to make them raise their hands. Length and breadth of the couch moderate, so that the patient may neither toss about in a broad one, nor fall out of a narrow bed. In plain bed clothes, so that there may be no inducement to pick at their nap. But on a soft bed, for a hard one is offensive to the nerves; as in phrenitics, above all others, the nerves especially suffer, for they are subject to convulsions. Access of their dearest friends is to be permitted; stories and conversation not of an exciting character; for they ought to be gratified in everything, especially in cases where the delirium tends to anger. Whether they are to be laid in darkness or in light must be determined by the nature of the attack; for if they are exasperated by the light, and see things which exist not, and represent to themselves things not present, or confound one thing with another, or if strange images obtrude themselves upon them; and, in a word, if they are frightened at the light, and the things in the light, darkness must be chosen; but if not, the opposite state. It is a good symptom, too, when they become of a sound mind, and their delirium abates, on exposure to the light. Abstinence from food should not be prolonged; food should be rather liquid, scanty, and frequently administered, for food soothes the soul: the proper time for giving it is during the remissions, both of the fever and of the delirium. But if they have become delirious from want of food, and if the fever do not remit, we are to give food that does not do much harm in fever. It is a favourable circumstance, when the fever and the delirium agree both as to the paroxysms and intermissions.
2. Κατακεκ λίσθαι χρὴ τὸν νοσέοντα ἐν οἴκῳ εὐμέτρῳ, εὐκρήτῳ, χειμῶνος μὲν ἐν ἀλέῃ, θέρεος δὲ ἐν ψύχεϊ νοτερῷ· ἔαρος δὲ καὶ φθινοπώρου πρὸς τὰς ὥρας τεκμαίρεσθαι. ἔπειτα ἡσυχίην ἄγειν κελεύειν καὶ αὐτὸν νοσέοντα καὶ τοὺς ἐπὶ τῆς οἰκίης ἅπαντας· ὀξυήκοοι γὰρ ἠδὲ ψόφου καθαπτόμενοι φρενιτι κοί· ἀτὰρ ὑπὸ τῶνδε μαίνονται. τοῖχοιλεῖοι, ὁμαλοὶ, μηδʼ ὑπερίσχοντες, μηδὲ ἄχναις μηδὲ γραφῇσι εὔκοσμοι· ἐρεθιστικὸν γὰρ τοιχογραφίη. καὶ γὰρ πρὸ τῶν ὀφθαλμῶν ἀμφαιρέουσί τινα ψευδέα ἰνδάλματα, καὶ τὰ μὴ ἐξίσχοντα ἀμφαφόωσι ὡς ὑπερίσχοντα· καὶ πᾶσα πρόφασις ἀναιτίη πρόκλησις χειρῶν φορῆς. κλίνης μῆκος καὶ πλάτος σύμμετρον, ὡς μήτε βληστρίζεσθαι ἐν τῇ πλατείῃ, μήτε ἀπὸ τῆς στενῆς ἐκπίπτειν κοίτης. ἐν ψιλοῖσι τοῖσι τοῖσι στρώμασι, ὡς μὴ κροκυδίζειν ὑπόμνησις ἔοι. ἀτὰρ ἠδὲ ἐν μαλθακοῖσι, ἀστεργὴς γὰρ τοῖσι νεύροισι ἡ σκληρὴ κοίτη. οὐχ ἥκιστα δὲ τῶν ἄλλων τοῖσι φρενιτι κοῖσι τὰ νεῦρα πονέει, μάλα γάρ τοι σπῶνται φρενιτι κοί. εἴσοδοι τῶν φιλτάτων· μῦθοι καὶ λαλιὴ μὴ θυμοδακεῖς· πάντα γὰρ εὐθυμέεσθαι χρὴ, μάλιστα τοῖσι ἐς ὀργὴν ἡ παραφορή· κατάκλισις ἢ ἐν ζόφῳ, ἢ ἐν φωτὶ πρὸς τὸ νόσημα τεκμαρτέη. ἢν γὰρ πρὸς τὴν αὐγὴν ἀγριαίνωσι, καὶ ὁρέωσι τὰ μὴ ὄντα, καὶ τὰ μὴ ὑπεόντα φαντάζωνται, ἢ ἀνθʼ ἑτέρων ἕτερα γιγνώσκωσι, ἢ ξένα ἰνδάλμα τα προβάλλωνται, καὶ τὸ ξύνολον τὴν αὐγὴν ἢ τὰ ἐν αὐγῇ δεδίττωνται, ζόφον αἱρέεσθαι χρή· ἢν δὲ μὴ, τοὐναντίον. ἀγαθὸν δὲ πρὸς αὐγὴν σωφρονέειν τε καὶ πρηο̈́νεσθαι τὴν παραφορήν. ἀσιτίη μὴ μακρή· σιτία δὲ ὑγρότερα καὶ βραχύτερα καὶ συνεχῆ. μειλίγματα γὰρ θυμοῦ σιτία· εὐκαιρίη δὲ ἐν τῇσι ἐπανέσεσι ἀμφοῖν, καὶ πυρετοῦ καὶ παραφορῆς. ἢν δὲ ὑπʼ ἀσιτίης ἐκμαίνωνται, καὶ ἢν μὴ παρήκῃ ὁ πυρετὸς, διδόναι μὴ μεγάλα ἐπὶ πυρετῷ βλάπτοντα. ἀγαθὸν δὲ ξυμφωνέειν καὶ τὸν πυρετὸν, καὶ τὴν παραφορὴν, ἔς τε τοὺς παροξυσμοὺς καὶ τὰς ἐπανέσιας. ἢν ὦν ἥκῃ ὁ καιρὸς ἐς θρέψιν, πρώτιστα σκεπτέον εἰ χρὴ ἀφαιρέειν αἷμα.
If, therefore, the time for the administering of food be come, in the first place, it must be enquired whether it be necessary to abstract blood. If, then, the delirium have come on with fever at the commencement, in the first or second day, it will be proper to open a vein at the elbow, especially the middle. But if the delirium supervene on the third or fourth day, we are to open a vein up to the first period of critical days. But if it was past the proper time for bleeding, on the sixth or seventh day, it will be proper to evacuate considerably before the crises in acute diseases, either by giving purgative medicines, or by using other stimulants. But when opening a vein you must not abstract much, even if you open the vein at the commencement; for phrenitis is an ailment easily convertible into syncope. But if the patient be plethoric and youthful, and if the ailment be connected with fulness in eating and drinking, those indications have nothing to do with the phrenitis; for even without the delirium, it would be proper to abstract much blood in such circumstances; but much less is to be abstracted, if such persons labour under phrenitis. But we may open a vein the more boldly in these cases, if the disease proceed from the præcordia, and not from the head; for there (in the præcordia) is the origin of life. But the head is the seat of sensation, and of the origin of the nerves; and it attracts more blood from the heart than it imparts to the others. If it therefore suffer, it is not proper to open the vein at the elbow; for these affections are such that it is no small injury to evacuate in them. And if the strength be sufficient to withstand the evacuation, we must abstract only once, lest during the interval between the acts of evacuation, the proper season for food be lost. The fevers, in cases of phrenitis, are of a continual type, neither have they long intermissions, but experience short and ill-marked remissions. But if the patient give way before a sufficient quantity has been abstracted, it must be put off until another remission, unless it occur at a distant period; but, if not, having resuscitated the patient by odours, stroking the face, and pricking the feet, we are immediately to abstract blood. The measure of sufficiency is the strength.
ἢν μὲν ὦν ἡ παραφορὴ ξὺν πυρετῷ ἀρχῆθεν εἰσβάλλῃ τῆς πρώτης ἢ δευτέρης ἡμέρης, τάμνειν φλέβα τὴν ἐπʼ ἀγκῶνι, μάλιστα τὴν μέσην· ἀτὰρ καὶ ἢν ἐς τρίτην ἢ τετάρτην ἡμέρην ἡ παραφορὴ ἥκῃ, μέσφι τῆς πρώτης τῶν κρισίμων περιόδου τάμνειν· εἰ δὲ προσωτέρω τοῦ δέοντος χρόνου ἑκταίῳ ἐόντι ἢ ἑβδομαίῳ, ἐῆν, πολλὸν πρὸ τῶν κρισίων ἐν τοῖσι ὀξέσι κενοῦν χρὴ, ἢ φαρμακεύειν, ἢ τοῖσι ἄλλοισι ἐρεθισμοῖσι χρέεσθαι. ἀτὰρ καὶ φλέβα τάμνων μὴ πολλὸν ἀφαιρέειν, κἢν ἐν ἀρχῇ τάμνῃς. φρενῖτις γὰρ εὔτρεπτον ἐς συγκοπὴν κακόν· ἢν δὲ πολυπληθὴς ὁ νοσέων ἔῃ, καὶ νεηνίης, καὶ ἐξ ἀδηφαγίης καὶ οἰνοφλυγίης, — οἵδε οὐ τῆς φρενίτιδος ἔασι οἱ λογισμοὶ, — ἀλλὰ καὶ ἄνευ παραφορῆς πολλὸν τουτέων ἀφαιρέειν αἷμα· πολλὸν δὲ μεῖον ἀφαιρέειν, ἢν οἵδε ἔωσι οἱ φρενιτικοί· τάμνειν δὲ φλέβα τουτέων εὐτολμότερον, ἢν ἐξ ὑποχονδρίων καὶ μὴ ἀπὸ κεφαλῆς ἡ νοῦσος ᾖ. ἐνθάδε γὰρ τῆς ζωῆς ἐστι ἡ ἀρχή· κεφαλὴ δὲ χῶρος μὲν αἰσθήσιος καὶ νεύρων ἀφέσιος· αἷμα δὲ παρὰ καρδίης ἕλκει μᾶλλον ἢ ἄλλοισι διδοῖ. ἢν ὦν πεπόνθῃ ἥδε, οὐ χρὴ τὴν ἐπʼ ἀγκῶνι τάμνειν φλέβα. τάδε γὰρ πάθεα κενεαγγέειν ἐφʼ οἷσι ἡ βλάβη οὐ σμικρή. κἢν μὲν ἡ δύναμις ἀντέχῃ εἰς τὸ ἱκανὸν τῆς κενώσιος, ἅπαξ ἀφαιρέειν, ὅκως μὴ ἐν τῇ διαστάσι τῆς ἐπαφαιρέσιος διολλύηται τῆς τροφῆς ἡ ἐγκαιρίη. ξυνεχέες γὰρ τοῖσι φρενιτι κοῖσι οἱ πυρετοὶ, καὶ οὐδὲ ἐπανέσιας μακρὰς, ἀλλὰ βραχείας καὶ ἀσήμους κουφισμοὺς ποιεύμενοι. ἢν δὲ πρὸ τῆς ξυμμετρίης ἀπαυδήσῃ ὁ νοσέων, ἐς δευτέρην ἐπάνεσιν ὑπερβάλλεσθαι, ἢν μὴ ἐς μακρὸν ἐκπίπτῃ· εἰ δὲ μὴ, ἀνακαλεσάμενον ὀσμῇσι, καὶ ψαύσεσι προσώπου, καὶ πιέσι ποδῶν αὐτίκα ἀφαιρέειν· γνῶμα δὲ τῆς αὐταρκίης ἡ δύναμις. τροφὴ ὑγρὴ πᾶσι μὲν τοῖσι πυρεταίνουσι, οὐκ ἥκιστα δὲ φρενιτι κοῖσι· ἐπιξηρότεροι γὰρ πυρετῶν μούνων. τὸ δὲ μελίκρητον, ἢν μὴ χολώδεες ἔωσι· ἄπεπτον γὰρ τοῖσι πικροχόλοισι. χόνδροι πλυτοὶ ξὺν ὕδατι, ἢ μελικρήτῳ.
Liquid food is proper in all febrile diseases, but especially in phrenitic cases, for these are more arid than mere fevers. The mulse is to be given, unless they are bilious, for it is indigestible in patients who are subject to bitter bile. Alica washed with water, or mulse, is a good thing; also it is good to give pottages of a plain kind, such as decoctions of savory, of parsley, or of dill, for these are beneficial to the respiration, and are diuretic, and a free discharge of urine is beneficial in phrenetics. All kinds of pot-herbs, especially melons, for their gluten is good for lubricating the tongue, the trachea, and for the alvine evacuations; but the best of all are beet, blite, cress, gourd in season, and whatever else is best in its own season. The juice of ptisan in a very liquid state, and containing little nourishment, is most proper at first, being made always thicker as the disease progresses. But the quantity of nourishment is to be diminished at the crises, and a little before them. And, if the disease be protracted, the customary food must not be abstracted, but we must give nourishing articles from the cereals, in order to support the patient; and when there is need, of the flesh of the extremities of beasts and fowls, mostly dissolved in the soups: these ought to be completely dissolved during the process of boiling. The rock fishes are preferable to all others; but on the whole we must choose the best in the country, for countries are believed to differ as to the kinds of fish which are best in them. Fruit containing wine must be given restrictedly, for it is apt to affect the head and præcordia; but if required by the state of the strength and of the stomach, we must give such articles as apples boiled in mulse or roasted in suet. Of other things, each is to be diluted with hot water, if you give it solely for the refreshment of the stomach; but if it is wanted also for strength, you must not dilute the vinous part much. In a word, the food must be such as I have described.
ἀγαθὸν δὲ καὶ ἐκ τῶνδε Ῥοφήματα διδόναι ἁπλᾶ, ὁποῖα θύμβρης, ἢ σελίνου, ἢ ἀνήθου ἐνηψημένων· εὔπνοα γὰρ τάδε καὶ διουρητικά. σύμφορον δὲ φρενιτι κοῖσι οὔρησις· λαχάνων πάντων μὲν, μάλιστα δὲ μαλάχης. ἀγαθὸν γὰρ τὸ γλίσχρασμα καὶ ἐς λειότητ αγλώσσης καὶ ἀρτηρίης, καὶ ἐς τὴν τῶν κοπρίων διέξοδον· ἄριστον δὲ καὶ τεῦτλον, καὶ βλίτον, καὶ κορωνόπους, καὶ κολοκύνται καθʼ ὥρην, καὶ ὅ τι ἂν ἐφʼ ἑκάστης ὥρης ἄριστονᾖ. πτισάνης δὲ χυλὸς ὑγρότατος μὲν ἐν πρώτοισι, ὡς ἀτροφώτερος ἔοι· ἐπὶ δὲ μᾶλλον παχύτερος, ὁκόσον ἂν ἡ νοῦσος προήκοι χρόνον. ὑποστέλλεσθαι δὲ ἐν τῇσι κρίσεσι, καὶ μικρόν τι πρὸ τῶν κρισίων. ἢν δὲ ἐς μῆκος ἡ νοῦσος ἴῃ, μὴ ἀφαιρέειν τῶν προσθεσίων, ἀλλὰ σιτώδεα διδόναι, ὡς ἐξαρκέσῃ ὁ νοσέων· εὖτε καὶ κρεῶν ἀκρέων καὶ πετεινῶν χρέος, τὰ πολλὰ τοῖσι χυλοῖσι ἐντηκομένων· κάρτα γὰρ χρὴ τάδε ἐν τῇ ἑψήσι λύεσθαι· ἰχθύων οἱ πετραῖοι τῶν ἄλλων κρέσσον ές εἰσι. ἐπίπαν δὲ τοὺς ἐν τῇ χώρᾳ ἀρίστους αἱρετέον· ἄλλη γὰρ ἄλλας φέρειν ἰχθύων ἰδέας πεπίστευται χώρη. ὀπώρας οἰνώδεος ὑποστέλλεσθαι, κεφαλῆς γὰρ καὶ φρενῶν ἅψιν ποιέει· ἢν δὲ ἀνάγκη ἔῃ, τῆς δυνάμιος, ἢ τοῦ στομάχου βιαζομένων, ἑφθὰ ἐν μελικρήτῳ, ἢ ὀπτὰ ἐν στέατι, ὁκοῖον μῆλα, δοτέον. τῶν ἄλλων θερμῷ ὕδατι ἕκαστον ἐκλύειν, ἢν ἐς μούνην τὴν τοῦ στομάχου παραμυθίην διδῷς· ἢν δὲ καὶ ἐς δύναμιν δέῃ, μὴ κάρτα τὸ οἰνῶδες ἐκλύειν. τροφὴ μὲν ὦν, ὡς ἔπος εἰπεῖν, τοιήδε. τέγγειν δὲ τὴν κεφαλὴν ἐς ἔμψυξιν, λίπαϊ ἐλαίης ὄμφακος τετριμμένης. ἀλεαίνεσθαι γὰρ ἡ κεφαλὴ οὐ φιλέει φρενιτι κοῖσι· ἢν δὲ καὶ ἀγρυπνίη καὶ φαντασίη ἔωσι, Ῥοδίνου μίσγειν ἶσον ἴσῳ τὰ πρῶτα·
For the sake of refrigeration, the head is to be damped with the oil of the unripe olive pounded; for in phrenitics the head is not fond of being kept warm. But if restlessness and false visions be present, we must mix equal parts of rose-oil at first; and the rose-oil is to be increased for the astringing and cooling of the head. But if they become disordered in understanding, and their voice change, the hair (capillary leaves?) of the wild thyme must be boiled in oils, or the juice of ivy or of knot-grass is also to be infused. But if the delirium get more violent, hog’s-fennel and cow-parsnip are to be boiled in the oils, and some vinegar poured in; for these things dissipate the vapours and heat, and are solvents of the thick humours which contribute to the delirium. But care must be taken that the moist application do not extend to the neck and the tendons, for it is prejudicial to tendons and nerves. Every season is suitable for the damp application, except the commencement of a paroxysm; it should be used more rarely during the increase, but most frequently at the acme; and whenever they are delirious, then, in particular, it will be proper to use a cold application, made still more cold in the season of summer, but in winter tepid. To soothe the delirium it is well to foment the forehead with oxycrate, or the decoction of fleabane, by means of a sponge, and then to anoint with the oil of wild vine or of saffron, and also to anoint the nose and ears with them.
ἔτι δὲ μᾶλλον τὸ Ῥόδινον ἔστω πλέον ἐς στῦψιν καὶ ἔμψυξιν τῆς κεφαλῆς. ἢν δὲ καὶ τὴν γνώμην παρακινέωνται, καὶ τὴν φθέγξιν ἐξαλλάσσωνται, ἑρπύλου κόμης ἐνεψητέον ἐν τοῖσι ἐλαίοισι, ἢ κισσοῦ χυλὸν, ἢ πολυγόνου παραχυτέον· ἢν δʼ ἐπὶ μᾶλλον ἡ παραφορὴ ἐξάπτηται, καὶ πευκέδανον καὶ σπονδύλιον τοῖσι ἐλαίοισι ἐνεψεῖν, καὶ ὄξους παραχεῖν. ἀτμῶν γὰρ τάδε καὶ θέρμης διαπνευστικὰ, καὶ παχέων χυμῶν διαλυτικὰ, ἃ τῆς παραφορῆς ξυναίτια. πεφυλάχθαι δὲ χρὴ τάδε, ὡς μὴ ἐς τὸν αὐχένα καὶ τοὺς τένοντας ἡ τέγξις ἥκῃ. πολεμίη γὰρ τένουσι καὶ νευροῖσι. καιρὸς δὲ πᾶς τέγξιος, πλὴν τῆς ἐσβολῆς τοῦ παροξυσμοῦ· ἀραιοτέρη δὲ ἐν τῇ ἀναβάσι· πάντων δὲ μάλιστα ἐν ἀκμῇ· ᾗ δʼ ἂν ἐκμαίνωνται, τῇδε μάλιστα τέγγειν ψυχρῷ, καὶ ψυχομέν ῳ ἐπὶ μᾶλλον θέρεος ὥρῃ· χειμῶνος δὲ χλιαρῷ. εἰς δὲ τὸ πρηο̈́νειν τὴν παραφορὴν, ὀξυκρήτῳ, ἢ κονύζης ἑψήματι, καὶ σπογγιῇ τὰ πρόσωπα πυριῆν· ἔπειτα χρίειν οἰνανθίνῳ, ἢ κροκίνῳ λίπαϊ, καὶ τὰς Ῥῖνας καὶ τὰ ὦτα τοισίδε διαχρίειν. τάδε μέντοι καὶ ὕπνου ἀγωγά. ἢν γὰρ πάννυχοι μὲν ἐγρήσσωσι, μηδὲ διʼ ἡμέρης εὕδωσι, ἀτενέες δὲ τὸ ξύμπαν ὀφθαλμοὶ, ὁκοῖόντι κέρας ἑστήκωσι, βληστρίζωνται δὲ καὶ ἐξανιστῶνται, ὕπνον αὐτέοισι καὶ ἠρεμίην μηχανέεσθαι, πρώτιστα μὲν διὰ τῶν τῆς κεφαλῆς τεγξίων, Ῥοδίνου ἀκρήτου, ἢ ἀμαρακίνου ξὺν χυλῷ κισσοῦ, ἢ ἑρπύλου, ἢ καὶ μελιλώτου ἐναφεψή ματι.
These things, moreover, also induce sleep. For if they lay awake all night, nor sleep during the day, and the eyes stand quite fixed like horns, and the patients toss about and start up, we must contrive to procure sleep and rest for them; first, by fomentations to the head, with unmixed rose-oil, or oil of marjoram with the juice of ivy, or the decoction of wild thyme or of melilot. But poppy boiled in oil is particularly soporific when applied to the fontenelle of the head, or with a sponge to the forehead. But the poppies, if recently plucked and green, may be applied whole under the pillows; for they thicken and humectate the spirit (pneuma), which is dry and attenuated, and diffuse over the senses fumes which prove the commencement of sleep. But if greater applications are needed, we may rub in the meconium (expressed juice of poppy) itself on the forehead with water, and also anoint the nostrils with the same, and pour it into the ears. Gentle rubbing of the feet with oil, patting of the head, and particularly stroking of the temples and ears is an effectual means; for by the stroking of their ears and temples wild beasts are overcome, so as to cease from their anger and fury. But whatever is familiar to any one is to him a provocative of sleep. Thus, to the sailor, repose in a boat, and being carried about on the sea, the sound of the beach, the murmur of the waves, the boom of the winds, and the scent of the sea and of the ship. But to the musician the accustomed notes of his flute in stillness; or playing on the harp or lyre, or the exercise of musical children with song. To a teacher, intercourse with the tattle of children. Different persons are soothed to sleep by different means.
ἐπὶ μᾶλλον δὲ ὑπνωτικὸν μήκων ἀφεψηθεῖσα ἐν λίπαϊ, ἔς τε τὸ τῆς κεφαλῆς βρέγμα, ἢ ὕδατι ἐς τὸ πρόσωπον ξὺν σπογγιῇ· ὑποτιθέναι δὲ χρὴ καὶ αὐτὰς ὅλας, εἰ εἶεν νεοδρεπεῖς, χλωρὰς τοῖσι ὑποκεφαλαίοισι. παχύνει γὰρ καὶ ὑγραίνει τὸ πνεῦμα ξηρόν τε καὶ λεπτὸν ἐὸν, και ὀμίχλην τῇσι αἰσθήσεσι παρέχει· βαρὺ δὲ καὶ νωθὲς ὀμίχλη, ἥπερ ὕπνου ἀρχή· ἢν δὲ μεζόνων δέωνται, καὶ αὐτὸ τὸ μηκώνειον ἐς τὰ μέτωπα ξὺν ὕδατι χρίειν· ἠδὲ ὑπαλείφειν τὰς Ῥῖνας καὶ ἐς τὰ ὦτα ἐγχέειν· ψηλαφίη ποδῶν εὐαφὴς ξὺν λίπαϊ, ψαῦσις τῆς κεφαλῆς, ἀνυτικὸν δὲ καὶ κνῆσις μάλιστα κροτάφων τε καὶ ὤτων. καὶ γὰρ καὶ τὰ θηρία ἐς ἀνάπαυλαν ὀργῆς τε καὶ θυμοῦ κνήσι ὤτων τε καὶ κροτάφων δαμνῶνται. ὕπνου δὲ ἀγωγὰ ἑκάστου καὶ τὰ ξυνήθεα· ναυτίλῳ μὲν, ἡ ἐν ἀκάτῳ κατάκλισις, καὶ ἐν θαλάσσῃ περιφορὴ, καὶ αἰγιαλῶν ἦχος, καὶ κυμάτων κτύπος, ἀνέμων τε βόμβος, καὶ θαλάσσης καὶ νηὸς ὀδμή· μουσικῷ δὲ ἔτι, ἐθισμὸς αὐλῶν ἐφʼ ἡσυχίῃ, ἢ ψαλμὸς λύρης, ἢ πηκτίδος, ἢ μελέτη παίδων σὺν ᾠδῇ· διδασκάλῳ δὲ, νηπιάχων μύθων προσομιλίη. ἄλλοισι δʼ ἄλλα ὕπνου θελκτήρια. τοῖσι δὲ ὑποχονδρίοισι καὶ τῇ κοιλίῃ ἐμβρέγματα, καὶ ἐπιπλάσματα, ἢν φλεγμονῇ καὶ σκληρίῃ ἐπαίρηται καὶ φύσῃ, ἔλαιον δρυπετοῦς ἐλαίης ἐμβάλλειν. παχὺ γὰρ καὶ γλίσχρον καὶ ἀλεαῖνον.
To the hypochondria and region of the stomach, if distended by inflammation, hardness, and flatulence, embrocations and cataplasms are to be applied, with the addition of the oil of the over-ripe olive, for it is thick, viscid, and calefacient; it therefore is required in inflammation: let dill or flea-bane be boiled in it, and it is a good thing to mix all together; but if flatulence be present also, the fruits of cumin and parsley, and whatever other things are diuretic and carminative, along with sifted natron, are to be sprinkled on the application. But if the liver experience suffering and pain, apply unwashed wool just taken from the ewe, oil from the unripe olive, or rose-oil; but we must mix also Hellenic or Cretan rob, and boil in it melilot, and mixing all these things into one juice, foment the liver therewith. To the spleen the oil must be mixed with vinegar; or if it should appear to be enlarged in bulk, oxycrate, and instead of the wool a soft sponge; for the spleen delights in and is relieved by such things. But if the hypochondria be collapsed and retracted upwards, and the skin be stretched, it will be best instead of the oil, or along with it, to use thick butter in equal quantity, and let fleabane and rosemary be boiled in the decoction, and dill is not unsuitable.
τόδε ὦν χρέος ἐν φλεγμασίῃ. ἐνηψήσθω δὲ ἐν αὐτῇ ἄνηθον, κόνυζα· ἀγαθὸν δὲ ὁμοῦ τὰ πάντα· ἢν δὲ καὶ φύση ἐνῇ, κυμίνου καὶ σελίνου τῶν καρπῶν ἠδὲ ὁκόσα οὔρων καὶ φυσέων ἀγωγά· καὶ νίτρον ἐνσείσαντα ἐμπάσσειν. ἢν δὲ τὸ ἧπαρ τὴν πεῖσιν καὶ τὴν ὀδύνην ἴσχῃ, ἔρια μὲν ἔστω οἰσύπῳ πιναρὰ ἀπὸ τῆς ὄϊος· ἔλαιον δὲ τὸ ἀπὸ τῆς ὄμφακος, ἢ Ῥόδινον· μίσγειν δὲ χρὴ σίραιον Ἑλληνικὸν, ἢ Κρῆτα, καὶ ἐνεψεῖν μελίλωτον, μίξαντά τε ἐς ἕνα χυλὸν τὰ πάντα καταιονεῖν τὸ ἧπαρ· σπληνὶ δὲ τὸ ἔλαιον σὺν ὄξεϊ ἔστω, ἢ εἰ μέζων ἢ πρὶν δοκέοι, ὀξύκρητον, καὶ ἀντὶ ἐρίων σπογγιὴ ἁπαλή. μάλα γὰρ τοῖσδε ὁ σπλὴν χαίρει τε καὶ πρηο̈́νεται. ἢν δὲ τὰ ὑποχόνδρια εἴσω ᾖ, ἠδὲ ἄνω εἰρύηται, καὶ τὸ δέρμα περιτείνηται, ἄριστον μὲν ἀντὶ τοῦ λίπαος, ἢ ξὺν αὐτέῳ, παχὺ πικέριον ἶσον. κόνυζα δὲ ἔστω καὶ λιβανωτὶς τὰ ἐνεψήμα τα· καὶ ἄνηθον οὐκ ἀτερπές. ἢν δὲ ἐπιπλάσσειν εὐκαιρίη ἔῃ, τοῖσι μὲν ἐλαίοισι τοῖσι αὐτέοισι χρέεσθαι ἐπὶ τοῖσι ὁμοίοισι· ὕλη δὲ λίνου σπέρμα, καὶ τῆλις, καὶ ἄλητον κριθῆς λεπτόν· ἀγαθὸν δὲ καὶ κύαμος, καὶ ὄροβος, ἢν ἐξοιδαίνῃ ἡ γαστήρ.
But if it be the proper time for cataplasms, we may use the same oils to the same places, the ingredients of the cataplasms being linseed, fenugreek, or fine barley-meal; beans and vetches, also, are proper if the abdomen be swelled. Roasted millet, also, in bags, makes a light and soft fomentation; when ground it makes, along with honey, oil, and linseed, an excellent cataplasm for the hypochondria. Also let the same flowers, herbs, and seeds which I have described among the embrocations be used for the cataplasms. Honey, also, is useful along with these things, to give consistency to the dry things, and for the mixing of the toasted things, and for the preservation of the heat; it is a good thing, likewise, by itself; also a cataplasm half-boiled, and an embrocation dissolved in some of the liquids, is effectual as an emollient, calefacient, carminative, and diuretic, and to moderate the inflammations. These effects are produced also by mulse when drunk, and even more and greater effects when conveyed internally to the trachea, the lungs, the thorax, and the stomach.
κέγχρος δὲ φωχθεῖσα ἐν μαρσύποισι πυρίημα κοῦφον καὶ μαλθακόν· ἀληλεσμένη δὲ καὶ ξὺν μέλιτι, καὶ ἐλαίῳ, καὶ λίνου σπέρματι ὑποχονδρίοισι ἐπίπλασμα ἀγαθόν. ἄνθη δὲ καὶ βοτάναι καὶ σπέρματα, ἅσσα μοι ἐν τοῖσι ἐμβρέγμασι λέλεκται, καὶ ἐν τοῖσι ἐπιπλάσμασι ἔστω τὰ ωὐτά· μέλι δὲ καὶ σὺν αὐτέοισι μὲν ἀγαθὸν ἐς σύστασιν τῶν ξηρῶν, καὶ ἐς μῖξιν τῶν αὐχμηρῶν, καὶ ὡς ἡ θέρμη ἐς πολλὸν διαρκέῃ· ἀγαθὸν δὲ καὶ αὐτὸ μοῦνον, καὶ ἐπίπλασμα ἡμίεφθον, καὶ ἔμβρεγμα ξύν τινι τῶν ὑγρῶν λυθὲν, μαλθάξαι, ἀλεῆναι, φυσέων καὶ οὔρων ἀγωγὸν, πρηῦναι πρήσιας· τάδε γὰρ καὶ μελίκρη τον ποιέεει ποθὲν, καὶ τουτέων πλέονα καὶ κρέσσονα, εἴσω παρελθὸν ἀρτηρίῃ, καὶ πνεύμονι, καὶ θώρηκι, καὶ κοιλίῃ. ξυνεχέως δὲ τὴν κοιλίην ἐρεθίζειν βαλάνοισι, ἢ διαχρίστοισι, (ἐπιξηραίνονται γὰρ πολλὰ), ἔς τε τὴν ὁλκὴν τῶν ἀπὸ τῆς κεφαλῆς, ἀτὰρ ἠδὲ ἐς διαπνοὴν τῶν ἐν τῷ θώρηκι ἀτμῶν, καὶ ἔκκρισιν τῶν ἐν τῇ κοιλίῃ.
The bowels, also, are to be frequently stimulated by suppositories or liniments (for they are generally constipated), in order to act as derivatives from the head, and also for the evaporation of the vapours in the chest, and for the evacuation of the matters in the belly; but, if the belly be confined for several days, it must be opened by a clyster of mulse, oil, and natron.
ἢν δὲ καὶ πολλῶν ἡμερῶν ἡ γαστὴρ ἐπίσχηται, κλύζειν χρὴ μελικρή τῳ, καὶ ἐλαίῳ, καὶ νίτρῳ. ἢν δὲ μὴ ἀξίως ὑποκαταστῶσι αἱ τῆς φλεγμονῆς πρηδόνες, σικύην θέντα, ἐντάμνειν, ἔνθα ἂν ἡ φλεγμονὴ κραίνῃ καὶ μέζων ἔῃ·
But if the distension of the inflammation do not properly subside, we must apply a cupping-instrument with scarificators where the inflammation points and is greatest, on the first or second day, according as the inflamed parts may indicate, and the strength direct; and from those the amount of the evacuation of the blood must be determined, for excess occasions syncope. During the first and second day the fomentation should be the same; but, on the third, cerate with some of the oils used in the embrocations is to be applied: then, if they be still in a state of inflammation, epithemes, consisting of hyssop, fenugreek boiled in mulse, the resin of the turpentine plant, and wax; the oils the same for these places. If by these means the delirium do not at all abate, it will be necessary to have recourse to cropping of the head, provided the hairs be very long, to the extent of one half; but, if shorter, down to the skin: then, in the meantime having recruited the strength, to apply a cupping-instrument to the vertex, and abstract blood. But dry-cupping is first to be applied to the back.
μίην δὲ ἢ δευτέρην, ὅκως ἂν τά τε φλεγμαίνοντα σημαίνῃ καὶ ἡ δύναμις κελεύῃ, ἀτὰρ καὶ τὸ πλῆθος τοῦ αἵματος τοισίδε τεκμαρτέον· ἀμετρίη γὰρ συγκοπῆς αἰτίη. ἐς μὲν ὦν ἡμέρην μίην ἢ δευτέρην τέγξις ἡ ωὐτὴ, ἐς δὲ τὴν τρίτην κηρωτὴ σύν τινι λίπαϊ τῶν ἐμβρεγμάτων. ἔπειτα ἐπιθήματα, ἐν φλεγμασίῃ μὲν ἢν ἐπεῶσι, ὕσσωπος, τῆλις ἑφθὴ ἐν μελικρήτῳ, τερμίνθου τοῦ φυτοῦ Ῥητίνη, κηρός· τὰ δὲ ἔλαια ἐπὶ τοῖσι αὐτέοισι τὰ ωὐτά. ἢν δὲ μὴ τουτέοισι ἐπανίῃ μηδὲν ἡ παραφορὴ, κουρῆς τῆς κεφαλῆς χρέος, ἢν μὲν μήκισται εἶεν αἱ κόμαι, τὰ πρώτιστα ἐς ἥμισυ· εἰ δὲ βραχύτεραι, ἐν χρῷ· ἔπειτα μεσηγὺ ἀναλαβόντα τὴν δύναμιν, σικύην κατὰ τῆς κορυφῆς προσβάλλει ν ἠδὲ ἀφαιρέειν αἷμα· κούφη δὲ προτέρη ἐς τὰ μετάφρενα κεκολλήσθω. ἐπεὶ δὲ καὶ θώρηκα ἐν πάσῃσι τῇσι ὀξείῃσι νούσοισι ἀκέεσθαι χρὴ, τὸν πάντη κάμνοντα, ξὺν καρδίῃ, καὶ πνεύμονι, πρώτιστα μὲν ὑπʼ ἀνάγκης τῆς ἀναπνοῆς ἄλλοτε μὲν θερμῆς, ἄλλοτε δὲ ψυχρῆς·
But since in all the acute diseases the chest must be remedied, this part generally suffering with the heart and lungs, more especially from the difficulty of the respiration, which is sometimes hot, at other times cold; and, moreover, from ardent fever, cough, badness of the humours, and sympathy of the nerves, and complaint of the stomach, and illness of the pleura and of the diaphragm (for the heart, if it suffer from any dreadful illness, never recovers),—in cases of phrenitis these parts in particular must be soothed. For, indeed, the delirium in certain cases arises from some of the parts in the chest; respiration hot and dry; thirst acrid; febrile heat not easily endured, as being determined from all parts to the chest; and illness from the perversion of its native heat, but greater and more intolerable the communication of the same from the other parts to the chest: for the extremities are cold—the head, the feet, and the hands; but, above these last, the chest. It is to be remedied, then, by humectation and refrigeration. For bathing, oil boiled with camomile or nard; in summer, also, Hellenic rob. But if it be necessary also to apply epithemes, dates moistened with austere wine, then levigated and pounded into a mass with nard, barley meal, and flower of the wild vine, form a soothing cataplasm for the chest: a cooling one is formed of apples bruised with mastich and melilot; all these things, however, are to be mixed up with wax and nard. But if the stomach be affected with torpor and loathing of food, the juice or hair of worm-wood are mixed up with them; and the hypochondriac region is to be fomented with this boiled up in oil. The infusion or the juice of it may be drunk before food to the amount of two cupfuls of the infusion, or one cupful of the bitter juice with two cupfuls of water. But if the stomach be affected with heartburn, not from the constitution of the disease, but of itself from acrid and saltish humours, or from being pinched with bile, or from being parched with thirst, we must give in the food milk mixed with water to the amount of half a hemina of milk in one cupful of water; the patient should swallow the most of it, but he may take a small portion of it with bread.
ἔτι δὲ ὑπὸ πυρετοῦ καυσώδεος, καὶ βηχὸς, καὶ ὑγρῶν πονηρίης, καὶ νεύρων κοινωνίης, καὶ στομάχου συμφορῆς, καὶ ὑπεζωκότος τε καὶ διαφράγματος κακίης· (καρδίη γὰρ ἢν πάθῃ μέζον τι δεινὸν οὔποτε ἀκέεται)· ἐπὶ δὲ τοῖσι φρενιτι κοῖσι καὶ μάλα χρὴ τάδε μειλίσσειν. παραφορὴ μὲν γὰρ μετεξετέροισι ἔκ τινος τῶν ἐν τῷ θώρηκι· ἀναπνοὴ θερμή τε καὶ ξηρή· δίψος δριμὺ, οὐκ εὔφορον πῦρ, τῷ πάντη ἐς θώρηκα ξυρρέειν. καὶ κακίη μὲν ἀπὸ τοῦ οἰκείου θάλπεος τετραμμένου· μέζων τε καὶ δυσφορωτέρη ἡ ἀπὸ τῶν ἄλλων ἐς θώρηκα ξύνδοσις. ἄκρεα γὰρ ψυχρὰ, κεφαλὴ, πόδες τε, καὶ χεῖρες· ὕπερθεν δὲ τῶνδε ὁ θώρηξ. καὶ δέεται ὦν ἀρήγειν ὑγρασίῃ καὶ ψύξι. τέγξις μὲν ὦν ἔλαιον ξὺν χαμαιμήλῳ ἑψηθὲν ἢ νάρδῳ· θέρεος δὲ καὶ σίραιος Ἑλληνικός· ἢν δὲ καὶ ἐπιθέτοισι δέῃ χρέεσθαι, φοίνικες ἐν οἴνῳ αὐστηρῷ δευθέντες· ἔπειτα λεῖοι ἐς μᾶζαν τετριμμένοι ξὺν νάρδῳ, ἀλφίτοισι, οἰνάνθῃ, προσηνὲς θώρηκι ἐπίπλασμα· ψυκτικὸν δὲ καὶ μῆλα θλασθέντα ξὺν μαστίχῃ καὶ μελιλώτῳ. πάντα δὲ κηρῷ καὶ νάρδῳ ἀναλαμβάνειν· ἢν δὲ καὶ τὸν στόμαχον ἔχῃ νάρκη καὶ ἀποσιτίη, ἀψινθίο υχυλὸν ἢ κόμην τοισίδε ξυλλεαίνειν· καὶ τῷδε ἑψηθέντι ξὺν λίπαϊ καταιονεῖν τὸ ὑποχόνδριον. πιπίσκειν δὲ καὶ τὸ ἀπόβρεγμα ἢ χυλὸν αὐτέου πρὸ τῆς τροφῆς, ὁκόσον κυάθους δύο τοῦ ἀποβρέγματος, ἢ κύαθον πικροῦ τοῦ χυλοῦ ξὺν ὕδατος κυάθοις δύο. ἢν δὲ καὶ καῦσος ἔχῃ τὸν στόμαχον, οὐκ ἀπὸ τῆς καταστάσεως τῆς νούσου, ἀλλʼ αὐτοῦ μούνου ἀπὸ χυμῶν δριμέων καὶ ἁλμυρῶν, ἢ ὑπὸ χολῆς δακνομένου, καὶ δίψεϊ αὐαινομένου, ὑδρομιγὲς γάλα δοτέον ἐν τροφῇ, ὅσον ἡμικοτύλιον τοῦ γάλακτος ἐν ὕδατος κυάθῳ ἑνί· Ῥυμφάνειν δὲ αὐτέου τὸ πλεῖστον. βραχὺ δέ τι καὶ σὺν ἄρτῳ ἀναλίσκειν. ἢν δὲ καὶ καῦσος ἔχῃ τὸν ἄνθρωπον, καὶ δίψος, καὶ ἀπορίη, καὶ μανίη, καὶ ἐπιθυμίη ψυχροῦ ὕδατος, διδόναι μεῖον μὲν ἢ ὁκόσον ἐν καύσου νούσῳ ἄνευ φρενίτιδος.
But if the patient be also affected with Causus, and there be thirst, restlessness, mania, and a desire of cold water, we must give less of it than in a case of Causus without phrenitis, for we must take care lest we injure the nerves; we are to give them as much as will prove a remedy for the stomach, and a little is sufficient, for phrenitics are spare drinkers.
τῶνδε γὰρ ἀμφὶ τῶν νεύρων ὀρρωδέειν χρή. διδόναι ὦν ὁκόσον ἐς στομάχου ἄκος· ὀλίγον δὲ ἀπαρκέει· βραχυπότ αι γὰρ οἱ φρενιτι κοί. ἢν δὲ καὶ εἰς συγκοπὴν τράπωνται, γίγνεται γὰρ καὶ τόδε·
But if converted into syncope, and this also happens (the powers of life being loosened, the patient being melted in sweat, and all the humours being determined outwardly, the strength and spirit (pneuma) being also dissolved), we must disregard the delirium, and be upon our guard lest the patient be resolved into vapours and humidity. Then the only support is wine, to nourish quickly by its substance, and to penetrate everywhere, even to the extremities; to add tone to tone, to rouse the torpid spirit (pneuma), warm that which is cold, brace what is relaxed, restrain those portions which are flowing and running outwards, wine being sweet to the senses of smell so as to impart pleasure; powerful to confirm the strength for life; and most excellent to soothe the mind in delirium. Wine, when drunk, accomplishes all these good purposes; for they become composed by the soothing of their minds, are spontaneously nourished to strength, and are inspired with pleasure.
τῆς μὲν δυνάμιος λυομένης, ἱδρῶτι δὲ χεομένου τοῦ ἀνθρώπου, πάντων δὲ εἰς τὸ ἐκτὸς τὴν φορὴν ποιευμένων τῶν ὑγρῶν, καὶ τοῦ τόνου λυομένου καὶ τοῦ πνεύματος, ἔς τε ἀκηδίην μὲν τῆς παραφορῆς, δέος δὲ εἰς ἀτμὸν λυθῆναι καὶ ὑγρασίην τὸν ἄνθρωπον· ἄλκαρ μοῦνόν ἐστι οἶνος, θρέψαι μὲν ὠκέως κατʼ οὐσίην, καὶ πάντη μέχρι περάτων μολεῖν· τόνῳ δὲ προσθεῖναι τόνον, καὶ πνεῦμα νεναρκωμένον ἐγεῖραι, ψῦξιν ἀλεῆναι, στῦψαι πλάδον, φερομένων ἔξω καὶ Ῥεόντων κρατῆσαι, ἡδὺς μὲν ὀσφραίνεσθαι ἐς ἡδονὴν, κραταιὸς δὲ στηρίξαι δύναμιν ἐς ζωήν· ἄριστος δὲ μειλίξαι θυμὸν ἐν παραφορῇ· τάδε μέντοι ποθεὶς ἅμα πάντα πρήσσει. θυμόν τε γὰρ πρηο̈́νονται μαλθάξι φρενῶν, καὶ ἐξ ἑωυτέων ἐς δύναμιν τρέφονται· ἀτὰρ ἠδὲ ἑωυτέοισι ἐμπνέουσι ἐς ἡδονήν. ὅταν πρόσω μὲν ἤδη πολλὸν ἥκῃ χρόνου, ὅ τε πυρετὸς νωθὴς ἔῃ, ἀτὰρ ἠδὲ ἡ παραφορὴ ἐς μώρωσιν τρέπηται·
But when the fever has become protracted and feeble, and the delirium is converted into fatuity, but the hypochondrium is not much injured by swelling, flatulence, or hardness, and the head is the part principally affected, we must boldly wash the head, and practise copious affusions on it; for thus will the habit of body be moistened, the respiration of the head and exhalation over the whole body will be restored; and thus will that which is dry become diluted, and the sense purified of its mist, while the understanding remains sound and firm. These, indeed, are the indications of the removal of the disease.
τὸ δὲ ὑποχόνδριον μὴ πολλόν τι προσβλάπτηται ἢ ὄγκῳ, ἢ φυσήσι, ἢ σκληρίῃ, κεφαλὴ δὲ τὸ πλέον ἔχῃ τῆς αἰτίης, χρὴ τολμέον τα λούειν ἠδὲ καταιον εῖν πολλόν τι τὴν κεφαλήν. ἥ τε γὰρ ἕξις ὑγρανθήσεται, καὶ ἡ κεφαλὴ διαπνευσθήσεται, καὶ τὸ ξύμπαν σκῆνος διατμισθήσεται. ὧδε γὰρ τὸ μὲν ξηρὸν ἀμβλύνεται, καὶ καθαρεύεται δὲ τῆς ὀμίχλης ἡ αἴσθησις· ἡ δὲ γνώμη εὐσταθὴς ἠδὲ ἔμπεδος μίμνει. τάδε μέντοι τῆς λύσιος τῆς νούσου γνώματα.
3. LETHARGICS are to be laid in the light, and exposed to the rays of the sun (for the disease is gloom); and in a rather warm place, for the cause is a congelation of the innate heat. A soft couch, paintings on the wall, bed-clothes of various colours, and all things which will provoke the sense of sight; conversation, friction along with squeezing of the feet, pulling, tickling. If deep sleep prevail, shouting aloud, angry reproach, threats regarding those matters which he is accustomed to dread, announcement of those things which he desires and expects. Everything to prevent sleep—the reverse of that which is proper for phrenitics.
3. Ληθαργικοῖσι κατάκλισις ἐν φωτὶ καὶ πρὸς αὐγήν· ζόφος γὰρ ἡ νοῦσος· ἠδὲ ἐν ἀλέῃ μᾶλλον· ψῦξις γὰρ ἔμφυτος ἡ αἰτίη. κοίτη εὐαφὴς, τοιχογραφίη, στρώματα ποικίλα, πάντα ὁκόσα περ ἐρεθιστικὰ ὄψιος, λαλιὴ, ψηλαφίη ξὺν πιέσι ποδῶν· τιλμοί· κνησμοί. ἢν βαθὺ κῶμα ἴσχῃ, ἐμβόησις, νουθεσίη ὀργίλη, δεῖμα, ἐφʼ οἷσι δειμαίνει. προσαγγελίη τῶν ὁκόσα ἐπόθεε καὶ προσεδόκεε. πάντα ἐς ἐγρήγορσιν ἐναντίως τοῖσι φρενιτι κοῖσι. ἀμφὶ δὲ καὶ κενώσιος ληθαργι κῶν τάδε χρὴ γινώσκειν.
With regard to the depletion of lethargics this should be known:—If the obliviousness be the sequela of another disease, such as phrenitis, we must not open a vein, nor make a great evacuation of blood in any way, but inject the belly, not solely for the evacuation of its contents, but in order to produce revulsion from above, and to determine from the head: there should be a good deal of salts and natron in it, and it answers very well if you add a sprinkling of castor to the clyster; for in lethargics the lower intestine is cold, and dead, as it were, to evacuation. But, if the lethargy is not the consequence of another disease, but is the original affection, and if the patient appear to be plethoric, provided it be with blood, we must open a vein at the elbow; but, if with a watery phlegm, or other humours, we must purge by means of cneoros with the ptisan, or by black hellebore with honeyed-water, in the beginning, if you wish to do so moderately; but if to a greater extent, you must give to the patient when fasting of the medicine called Hiera, to the extent of two drams with three cupfuls of honeyed-water; and, having waited until it purges, then give food, if it be the proper season; but otherwise nourishment is to be given the next day. It will be seasonable then to give in the evening a dram of the hiera, dissolved either in two cupfuls of water or of honeyed-water.
ἢν μὲν ἐξ ἑτέρης νούσου, ὁκοῖόν τι φρενίτιδος, διαδέξηται ἡ λήθη, φλέβα μὲν μὴ τάμνειν, μηδὲ ἀθρόον ποθὲν κενοῦν αἷμα. ὑποκλύζειν δὲ τὴν κοιλίην, μὴ τοῦ κοπρώδεος εἵνεκε μοῦνον, ἀλλʼ ὅκως τι καὶ ἄνωθεν ἀντισπασθῇ, καὶ ἀπὸ τῆς κεφαλῆς ὀχετευθῇ. πλέον οὖν ἔστω ἁλῶν τε καὶ νίτρου. ἄριστον δὲ τῷ κλύσματι εἰ καστόριον ἐμπάσσοις· ψυχρὸν γὰρ τὸ κάτω ἔντερον ληθαργι κοῖσι καὶ πρὸς ἔκκρισιν νεκρῶδες. ἢν δὲ μὴ ἐκ διαδέξιος νούσου, ἀλλʼ ἑωυτέου ἄρχηται ὁ λήθαργος, καὶ δοκέῃ πεπλῆσθαι ὁ νουσέων, ἢν μὲν αἵματος, φλέβα τὴν ἐπʼ ἀγκῶνι τάμνειν· ἢν δὲ φλέγματος ὑδατώδεος εἴτε ἄλλων χυμῶν, καθαίρειν χρὴ κνεώρῳ σὺν τῇ πτισάνῃ, ἢ ἐλλεβόρῳ μέλανι ξὺν μελικρή τῳ, πρὸς τῇσι ἀρχῇσι, ἢν μετρίως βούλῃ· ἢν δὲ μεζόνως, τοῦ φαρμάκου τῆς ἱερῆς καλευμένης νήστι διδόναι ὁλκῆσβʼ, ξὺν μελικρήτου κυάθοις τρισὶ, καὶ περιμείναν τα καθήρασθαι, τότε διδόναι σιτία, ἢν καιρὸς ᾖ· ἢν δὲ μὴ, εἰς τὴν ἐπιοῦσαν ἡμέρην ἡ τροφή· εὐκαιρίη δέ κοτε καὶ ἐν ἑσπέρῃ γίγνεται τῆς ἱερῆς ὁλκῆς ͵α′ ὕδατι ἢ μελικρή τῳ λυομένης, κυάθοις δύο. ἀτροφίη κακὸν, κακὸν δὲ καὶ πολυτροφίη.
Total abstinence from food is bad, as is also much food. It is proper, then, to administer a little food every day, but not to withdraw food altogether; for the stomach to be reminded of its duties and fomented, as it were, during the whole day. Also the food must be attenuant and laxative, rather in the form of soups than roasted, such as hens or shell-fish; and the herb mercury is to be boiled with it, and some vinegar added. And we may add to the juices, if it be proper to use the juice of ptisan, something to promote exhalation and the discharge of urine, such as fennel, parsley—the pot-herbs themselves, or their fruits. Horehound, also, by its acrid qualities, does good; and likewise colewort with oil, and the brine of fish (garum). The sweet cumin is a most excellent medicine for the flatulence and urine; for the stomach and bladder are to be stimulated during the whole time of the disease.
χρὴ ὦν ὀλιγοσιτίῃ χρέεσθαι ἐς ἑκάστην ἡμέρην· ἀθρόον δὲ μὴ ἀσιτεῖν· ὑπομνήσιός τε γὰρ ἠδʼ ἀλέης τῷ στομάχῳ χρέος ἀνὰ πᾶσαν τὴν ἡμέρην. ἀτὰρ καὶ ἡ τροφὴ ἔστω λεπτύνουσα καὶ διαχωρητικὴ ἐν ζωμοῖσι μᾶλλον ἢ ὀπτοῖσι ἀλεκτορίδι, κεγχρίδι. λινόζωστις δὲ ξυνεψείσθω καὶ ὄξος παραχεέσθω. καὶ τοῖσι δὲ χυλοῖσι ἐμβάλλειν, εἴ ποι δέοι χυλῷ χρέεσθαι πτισάνης, εὔπνοον ἠδὲ οὔρων ἀγωγὸν, μάραθρον, σέλινον, τὰ λάχανα, ἢ τουτέων τοὺς καρπούς. ἀγαθὸν δὲ καὶ πράσον τῇ δριμύτητι, καὶ κράμβη ξὺν ἐλαίῳ καὶ γάρῳ· ἄριστον δὲ καὶ κύμινον γλυκὺ, ξὺν κράμβῃ, φυσέων ἠδὲ οὔρων· ἐρεθιστέα γὰρ ἡ κύστις, ἠδὲ γαστὴρ, ἐν πάσῃ τῇ νούσῳ. τέγξιες τῆς κεφαλῆς, αἵπερ καὶ τοῖσι φρενιτι κοῖσι.
The moist applications to the head the same as in the case of phrenitics; for in both the senses are filled with vapours, which must either be expelled by refrigerants and astringents, such as the oil of roses or the juice of ivy, or dissipated into exhalation by attenuants, such as wild thyme in vinegar, with the rose-oil. But if there be pain of the nerves, and coldness of the whole body, but more especially of the extremities, we must besmear and bathe the head and neck with castor and oil of dill, and anoint the spine with the same along with Sicyonian oil, the oil of must, or old oil; at the same time, we must rub both the arms from the shoulders and both the legs from the groins. With these, moreover, the bladder is to be soothed, which suffers, as being of a nervous nature, and is stressed as being the passage for the urine; and also is irritated by the acrimony of the humours, for the urine is bilious. But if the trembling increase, and there be danger of a convulsion, we must necessarily use Sicyonian oil to the head, but use it in small quantity. But if there be inflammation of the hypochondria, and fulness thereof, flatulence, and tension of the skin, or if there be a hollow there from retraction inwards of the hypochondria, we must apply the embrocations and cataplasms, described by us under Phrenitics.
ἀμφοῖν γὰρ αἱ αἰσθήσιες πλέαι γίγνονται ἀτμῶν, ἃς ἀπελαύνειν. χρὴ ψύξεϊ καὶ στύψι, Ῥοδίνῳ, καὶ κισσοῦ χυλῷ· ἢ ἐξατμίζειν ἐς διαπνοὴν τοῖσι λεπτύνουσι, οἷον ἑρπύλῳ ἐν ὄξεϊ σὺν τῷ Ῥοδίνῳ· ἢν δὲ νεύρων πόνος ἔῃ καὶ ψῦξις ὅλου, πολλῷ δὲ μᾶλλον ἀκρέων, τῷ καστορίῳ ξὺν ἀνηθίνῳ λιπαίνειν, ἠδὲ τέγγειν τὴν κεφαλὴν καὶ τὸν αὐχένα, καὶ τὴν Ῥάχιν χριειν τῷ αὐτῷ ξὺν λίπαϊ, σικυωνίῳ, ἢ γλευκίνῳ, ἢ παλαιῷ· ξυγχρίειν δὲ καὶ τὼ χεῖρε ἀπὸ τῶν ὤμων, καὶ τὼ πόδε ἀπὸ τῶν βουβώνων. τοισίδε μέντοι καὶ τὴν κύστιν καταιονεῖν, καὶ ὡς νεῦρον πάσχουσαν, καὶ ὡς οὔρων ὁδὸν κάμνουσαν, ἀτὰρ καὶ τῇ δριμύτητι τῶν χυμῶν ἀχθομένην· χολώδεα γὰρ τὰ οὖρα. ἢν δὲ μέζων ὁ τρόμος ἔῃ, καὶ κίνδυνος σπασμοῦ, καὶ σικυωνίῳ εἰς τὴν κεφαλὴν ὑπʼ ἀνάγκης χρέεσθαι· ὀλίγη δὲ ἤτω ἡ χρῖσις· ἢν δὲ καὶ φλεγμασίαι τῶν ὑποχονδρίων ἔωσι, καὶ πρήσιες καὶ φῦσαι, καὶ περιτάσιες τοῦ δέρματος, ἢ κοῖλον γίγνηται, εἴσω εἰρυομένου τοῦ ὑποχονδρίου, ἐμβρέγματα καὶ ἐπιπλάσματα, ὁκόσα μοι ἐν φρενιτι κοῖσι λέλεκται. σικύῃ ἥκιστα χρέεσθαι ἢν ἀπὸ φρενίτιδος ἔωσι.
The cupping-instrument is by no means to be used if the disease be the consequence of phrenitis, but this may be done more boldly if it be the original disease. If the tongue be black, and a swelling point in the hypochondria, the cupping-instrument must necessarily be used. When in the course of time the senses have been evacuated, and the patient is otherwise more tolerant of the disease, we may apply the cupping-instrument to the top of the head, since we can evacuate from it without injury to the strength.
εὐτολμότερον δὲ ἢν ἀρχῆθεν ἡ νοῦσος εἰσβάλλῃ. ἢν δὲ γλῶσσα μελαίνηται καὶ ὄγκος ἐν τοῖσι ὑποχονδρίοισι σημαίνῃ, ὑπʼ ἀνάγκης τῇ σικύῃ χρέεσθαι· ἐπὴν δὲ πρὸς τῷ μήκεϊ τοῦ χρόνου κενωθήσεται τῇσι αἰσθήσεσι, τἄλλα δʼ εὐπετέστερον φέρῃ, τῇ κορυφῇ τῆς κεφαλῆς προσβάλλειν· ἄλυπον γὰρ τῇ δυνάμι τὸ ἐντεῦθεν κενοῦν. ἄγειν τε καὶ φύσας ἄνω τε καὶ κάτω.
Flatulence is to be expelled both upwards and downwards; for lethargy produces collections of flatus both in the cavities and in the whole frame, from inactivity, torpor, and want of spirit, which motion and watchfulness dissipate; wherefore, having rubbed up green rue with honey and natron, we anoint therewith; it will expel the wind more effectually if one part of the resin of turpentine be added to these things. A fomentation also will expel flatus, either with hot unwashed wool, or with rough old rags, or a sponge with water in which hyssop, marjoram, penny-royal, or rue, have been boiled. The potions also which are taken before food expel flatus, and these also bring away phlegm and bile in the stomach and bowels; such are hyssop, boiled mulse, Cretan dictamny, or marjoram: maiden-hair and agrostis are acrid, but possessed of expulsive qualities, for indeed they evacuate flatus and urine.
φυσέων γὰρ συναγωγὸν λήθαργος καὶ ἐν τῇσι κοιλίῃς ι καὶ ἐν τῷ ὅλῳ σκήνεϊ ἀργίῃ καὶ νωθίῃ καὶ ἀψυχίῃ· διαπνευστι κὸν δὲ κίνησις ἠδὲ ἐγρήγορσις. διαχρίειν οὖν πήγανον χλωρὸν τρίβοντα ξὺν μέλιτι καὶ νίτρῳ· ἀγωγόν τέ ἐστι μᾶλλον φυσέων ξὺν τουτέοισι καὶ τερμίνθου Ῥητίνης μέρος ἕν· καὶ πυρίη προκλητικὴ φυσέων, ἢ πιναροῖσι θερμοῖσι ἐρίοις, τρηχέσι παλαιοῖς Ῥάκεσι, ἢ σπογγιῇ ξὺν ὕδατι, ἔνθʼ ὕσσωπον, ἢ ὀρίγανον, ἢ γλήχων, ἢ Ῥυτὴ ἕψηται· ἄγοι δʼ ἂν φύσας, ἠδὲ ὁκόσα πρὸ τῶν σιτίων πίνεται, τάπερ καὶ φλέγμα καὶ χολὴν ἐν τοῖσι ἐντέροισι καὶ στομάχῳ ἄγει, ὕσσωπον ἐν μελικρή τῳ ἑψηθὲν, δίκταμνον τὸ Κρητικὸν, ὀρίγανον· δριμέα μὲν, ἀγωγὰ δὲ ἀδίαντον, ἄγρωστις· τάδε μέντοι καὶ φυσέων καὶ οὔρων καταρρηκτικά.