8. THERE are two forms of quinsey. The one is attended with heat, and great inflammation of the tonsils, and swelling outwardly; moreover, the tongue, uvula, and all the parts there, are raised up into a swelling. The other is a collapse of these parts, and compression inwardly, with greater sense of suffocation, so that the inflammation appears to be determined to the heart. In it, then, particularly, we must make haste to apply our remedies, for it quickly proves fatal. If, then, it proceed from taking too much food and wine, we must inject the bowels on the day of the attack, and that with two clysters: the one a common clyster, so as to bring off the feculent matters; and the other for the purpose of producing revulsion of the humours from the tonsils and chest. It will therefore be, but not undiluted....... and the decoctions of centaury and hyssop; for these medicines also bring off phlegm. And if the patient has been on a restricted diet, we open the vein at the elbow, and make a larger incision than usual, that the blood may flow with impetuosity and in large quantity; for such a flow is sufficient to mitigate the heat most speedily, is able to relieve the strangulation, and reduce all the bad symptoms. It is no bad practice, likewise, to bring the patient almost to fainting, and yet not so as that he should faint altogether, for some from the shock have died of the fainting........ or binding them with ligatures above the ankles and knees. It is a very good thing, likewise, to apply ligatures to the forearms above the wrists, and above the forearms to the arms. And if deglutition be easy, we are to give elaterium with honeyed-water, and the whey of milk, as much as will be sufficient to purge the patient. In these cases, elaterium is preferable to all other cathartics; but cneoros and mustard are also suitable, for both these purge the bowels. If the inflammations do not yield to these means, having bent the tongue back to the roof of the mouth, we open the veins in it; and if the blood flow freely and copiously, it proves more effectual than all other means. Liquid applications to the inflamed parts, at first of an astringent nature, so as to dispel the morbid matters: unwashed wool, then, with hyssop, moistened in wine, and the ointment from the unripe olive. But the cataplasms are similar to the liquid applications,—dates soaked in wine, and levigated with rose-leaves. But in order that the cataplasm may be rendered glutinous and soft, let flour or linseed, and honey and oil be added, to produce the admixture of all the ingredients. But if it turn to a suppuration, we are to use hot things, such as those used in the other form of synanche. Let fenugreek be the powder, and manna and resin the substances which are melted; and let the hair of poley be sprinkled on it, and a hot fomentation be made with sponges of the decoction of the fruit of the bay and of hyssop. And the powdered dung of pigeons or of dogs, sifted in a sieve, is most efficacious in producing suppuration, when sprinkled on the cataplasm. As gargles, honeyed-water, with the decoction of dried lentil, or of hyssop, or of roses, or of dates, or of all together. We are also to smear the whole mouth, as far as the internal fauces, either with Simples, such as the juice of mulberries, or the water of pounded pomegranates, or the decoction of dates; or with Compound preparations, such as that from mulberries, or that from besasa, or that from the juice of pomegranates, and that from swallows. But if the ulcers proceed from eschars, these gargles, and washes for the mouth, the decoction of hyssop in honeyed-water, or of fat figs in water, and along with them starch dissolved in honeyed-water, or the juice of ptisan, or of tragus (spelt?). But in the species of synanche attended with collapse, we are to make a general determination from within outwardly, of the fluids, of the warmth, and of all the flesh, so that the whole may swell out. Let the liquid applications then be of a hot nature, with rue and dill, natron being sprinkled upon them; and along with them the cataplasms formerly mentioned. It is a good thing also to apply a cerate with natron and mustard for inducing heat; for heat determined outwardly is the cure of such complaints; and thus swelling takes place in the neck, and an external swelling rescues from peripneumonia; but in cases of synanche, the evil when inwardly is of a fatal nature. But those who, in order to guard against suffocation in quinsey, make an incision in the trachea for the breathing, do not appear to me to have proved the practicability of the thing by actual experiment; for the heat of the inflammation is increased by the wound, and thus contributes to the suffocation and cough. And, moreover, if by any means they should escape the danger, the lips of the wound do not coalesce; for they are both cartilaginous, and not of a nature to unite. * * * * * * * * * * * * * * * * * * * * * * * * * * OF the affections which form about the columella, some require to be treated by excision; but the surgical treatment of such cases does not come within the design of this work.
8. δοιαὶ συνάγχης ἔασι ἰδέαι. ἡ μὲν σὺν θερμασίῃ καὶ μεγάλῃ πρήσιτῶν παρισθμίων, καὶ ἐξογκώσι ἔξω· ἀτὰρ καὶ ἡ γλῶσσα, καὶ ὁ γαργαρεὼν, καὶ πάντα τὰ τῇδε μέρεα ἐς ὄγκον ἀείρεται· ἡ δὲ ἑτέρη ξύμπτωσίς ἐστι τουτέων ἠδὲ ἐς τὸ ἔσω πίεσις, ξὺν ἀγχόνῃ μέζονι, ὡς δοκέειν τὴν φλεγμασίην εἴσω μέσφι τῆς κραδίης ἐρηρεῖσθαι. τῇδε χρὴ μάλιστα ὠκέως ἀρήγειν· τῇδε γὰρ καὶ ὠκέως θνήσκουσι. ἢν μὲν ὦν ἀπὸ κραιπάλης καὶ οἰνοφλυγίης ἔωσι, ὑποκλύζειν αὐτῆμαρ. ἀλλὰ καὶ δισσοῖς κλύσμασι, τῷ μὲν ξυνήθεϊ, ὡς ἄγειν κοπρώδεα· τῷ δὲ ὡς ἀποσπᾶσθαί τι τῶν χυμῶν ἀπὸ τῶν παρισθμίων τε καὶ θώρηκος. ἔσται ὦν, ἀλλὰ μήτε ἀκρητεστέρη, … καὶ κενταυρίου καὶ ὑσσώπου ἑψήματα. τάδε γὰρ καὶ φλεγμάτων ἀγωγά. κἢν δὲ ἀπὸ λεπτῆς διαίτης ἔωσι, τάμνειν φλέβατὴν ἐπʼ ἀγκῶνι. μέζονα δὲ τὴν τομὴν σχάζειν, ὅκως Ῥοιζηδὸν ἠδὲ ἀθρόον Ῥέῃ τὸ αἷμα. ὅδε γὰρ ὁ Ῥόος ἱκανὸς μὲν ὡς ὤκιστα θερμασίην πρηϋναι, δυνατὸς δέ ἀγχόνην λῦσαι καὶ πάντα μειῶσαι. οὐκ ἀγεννὲς δὲ καὶ μέχρι λειποθυμίη ς ἄγειν, μὴ μέντοι λειποθυμέειν. μετεξέτεροι γὰρ ξὺν τῇ πληγῇ ἐξέθανον ἐπὶ τῇ λειποψυχίῃ … ἢ δεσμοῖσι σφίγγοντες ὑπὲρ σφυρὰ καὶ γούνατα· ἄριστον δὲ καὶ ὑπὲρ καρποὺς ἐς πήχεας καὶ ὑπὲρ πήχεας ἐς βραχίονα· ἢν δὲ καταπίνειν Ῥήϊστον ᾖ, ἐλατήριον διδόναι ξὺν μελικρήτῳ καὶ ὀρρῷ γάλακτος, ὁκόσον ἂν καθῆραι ἱκανὸν ᾖ τὸν ἄνθρωπον. ἐλατήριον δὲ τοῖσδε τῶν ἄλλων καθαρτηρίων κρέσσον· ξύμφορον δὲ καὶ κνέωρον καὶ νᾶπυ. τώδε γὰρ ἄμφω τὰς κοιλίας καθαίρει· ἐπὶ δὲ τοῖσι ἢν μὴ ἐνδίδωσι αἱ πρήσιες, πρὸς τὸν οὐρανὸν ἀνακλάσαντα τὴν γλῶσσαν τάμνειν τὰς ἐν αὐτέῃ φλέβας. κἢν εὐρόως καὶ πολλὸν Ῥυῇ τὸ αἷμα, τῶν ἄλλων μᾶλλον ἂν ὤνησε. τέγξιες ἐπὶ τοῖσι φλεγμαίνουσι, τὰ πρῶτα μὲν στύφουσαι, ὅκως ἐς παλίρροιαν ἴωσιν αἱ ὗλαι· ἔριά τʼ ὦν πιναρὰ ξὺν οἰσύπῳ, δευθέντα οἴνῳ καὶ ἀλείφατι τῷ ἀπὸ τῆς ἐλαίης τῆς ὄμφακος. ἀτὰρ καὶ τὰ ἐπιπλάσματα ἴκελα τῇ τέγξι, φοίνικες ἐν οἴνῳ δεδευμένοι, λεῖοι ξὺν Ῥοδίοισι πετάλοισι. ὡς δὲ γλίσχρον τε καὶ μαλακὸν ἔῃ τὸ ἐπίπλασμα, καὶ ἄλητον ἔστω, ἢ λίνου σπέρμα, καὶ μέλι, καὶ ἔλαιον, ἐς τὴν ἁπάντων μίξιν. ἢν δὲ ἐς πύησιν τρέπηται, τοῖσι θερμοῖσι χρέεσθαι, οἷσπερ καὶ ἐπὶ τῆς ἑτέρης συνάγχης. τῆλις ὦν ἔστω τὸ ἄλητον, καὶ μάννα, καὶ Ῥητίνη τὰ τηκτά· καὶ πολίου κόμη ἐμπασσέσθω. καὶ πυρίη θερμὴ σπόγγοισι δάφνης τοῦ καρποῦ καὶ ὑσσώπου ἑψήματι. ἐς δὲ ἐμπύησιν δυνατώτατον, πελιάδων ἢ κυνῶν κόπρον προσεπιπάσσειν λεπτὴν ἀπὸ κρησέρης· διακλύσματα δὲ, μελίκρητον ξὺν φακῆς ἢ ὑσσώπου ἑψήματι, ἢ Ῥόδων, ἢ φοινίκων, ἢ ὁμοὺ πάντων. ἐγχρίειν δὲ τὸ στόμα πᾶν μέχρι τῆς ἔσω φάρυγγος, ἁπλοῖσι μὲν, — χυλῷ μόρων, Ῥοιῶν ὕδατι λεανθέντων, ἢ φοινίκων ἑψήματι· φαρμάκοισι δὲ τῇ διὰ τῶν μόρων, ἢ καὶ τῇ βησασᾷ, καὶ χυλῷ Ῥοὸς, καὶ τῇ διὰ τῶν χελιδόνων. ἢν δὲ ἕλκεα ἐσχάρων ἔωσι, διακλύσματα τάδε καὶ ἀνακογχυλισμοὶ, ὑσσώπου ἀφεψήματι ἐν μελικρήτῳ, ἢ σύκων τῶν πιόνων ἐν ὕδατι καὶ ἐπὶ τοῖσδε ἄμυλος διεθεὶς ἐν μελικρή τῳ, ἢ πτισάνης χυλῷ, ἢ τράγου. ἐπὶ δὲ τῆς μετὰ ξυμπτώσιος συνάγχης, ἔσωθεν ἔξω ἄγειν πάντα, καὶ ὕγρὰ, καὶ θέρμην, καὶ σάρκα πᾶσαν, ὡς ἐξογκέῃ ἔξω τὸ πᾶν. ἔστωσαν ὦν θερμαὶ αἱ τέγξιες ξὺν πηγάνῳ καὶ ἀνήθῳ, ἐμπασσομ έν ου νίτρου· καὶ ἐπιπλάσμα τα ξὺν τουτέοισι τὰ πρόσθεν. ἀγαθὸν δὲ κηρωτὴν σὺν νίτρῳ καὶ σινήπι τιθέναι ἐς θερμασίην. θερμασίη δὲ ἡ ἐς τὰ ἔξω τὰ τοιάδε ἰῆται. ἀτὰρ ἠδὲ ἐξογκέει ἐς τὸν αὐχένα· ὄγκος δὲ περιπνευμονίης Ῥύεται ἐπαιωρεύμενος ἔξω· εἴσω δὲ τοῖσι συναγχι κοῖσι ὀλέθριον κακόν· ὁκόσοι δὲ ὑπʼ εὐλαβίης τῆς ἐπὶ τῆς συνάγχης πνιγὸς τὴν ἀρτηρίην ἔταμον ἐς ἄναπνοὴν, οὔ μοι δοκέουσι πείρῃ τὸ πρῆγμα πιστώσασθαι· ἥ τε γὰρ θερμασίη τῆς φλεγμασίης μέζων ἐκ τοῦ τρώματος γίγνεται καὶ προστιμωρέει τῇ πνιγὶ, καὶ βήσσουσι· ἢν δὲ καὶ ἄλλως ἐκφύγωσι τόνδε τὸν κίνδυνον, οὐ ξυνάγεται τοῦ τρώματος τὰ χείλεα. ἄμφω γὰρ χονδρώδεα καὶ ἀξύμφυτα.
9. Some are to be treated as acute affections; for some of them readily prove fatal by suffocation and dyspnœa. These are the diseases which we call uva and columella; for both are attended with inflammation and increase in thickness and length, so that the parts hang down, and come into the arteria aspera. The columna is of equal thickness from the base to the extremity in the palate: the uva is of unequal thickness; for its base at the palate is slender, whereas at its extremity it is rounded and thick, with redness and lividity, whence it gets the appellation of uva. These, then, must be speedily relieved; for the death from suffocation is very speedy. If, then, the patients be young, we must open the vein at the elbow, and evacuate copiously by a larger incision than usual; for such an abstraction frees one from suffocation, as it were, from strangulation. It is necessary, also, to inject with a mild clyster, but afterwards with an acrid one, again and again, until one has drawn from the parts above by revulsion; and let ligatures be applied to the extremities above the ankles and knees, and above the wrists and forearms to the arms. But if the suffocation be urgent, we must apply a cupping-instrument to the occiput and to the thorax, with some scarifications, and also do everything described by me under synanche; for the mode of death is the same in both. We must also use the same medicines to the mouth, both astringents and emollients, with fomentation of the external parts, cataplasms, and liniments to the mouth. For the forms named columella and uva, as an astringent medicine take the juice of pomegranate, acacia dissolved in honey or water, hypocistis, Samian, Lemnian, or Sinopic earth, and the inspissated juice of sour grapes. But if the diseased part be ulcerated, gum and starch moistened in the decoction of roses or of dates, and the juice of ptisan or of spelt (tragus). But in columella let there be more of the stronger medicines, from myrrh, costus, and cyperus; for the columella endures these acrid substances. But should the part suppurate, in certain cases even the bones of the palate have become diseased, and the patients have died, wasted by a protracted consumption. The remedies of these will be described elsewhere.
9. τῶν παθέων ὁκόσα ἀμφὶ τὴν κιονίδα γίγνεται, τὰ μὲν ὑποτάμνειν χρὴ, ἀλλʼ οὐ τοῦ παρεόντος λόγου ἡ τῶνδε χειρουργίη· τὰ δὲ ὡς ὀξέα ἰῆσθαι. Ῥηϊδίως γὰρ πνίγει καὶ δυσπνοίῃ τινὰ τουτέων κτείνει. τοιάδε μέντοι ἐστὶ, ἣν καλέομεν σταφυλήν τε καὶ κιονίδα. ἄμφω γὰρ ξὺν φλεγμασίῃ καὶ πάχεϊ καὶ μήκεϊ ξυνίσταντα ι, ὡς ἐς τὴν ἀρτηρίην ἐκκρεμέα γίγνεσθαι· ἴσῳ μὲν πάχεϊ ἀπὸ τῆς βάσιος μέσφι ἄκρου τοῦ οὐρανοῦ ὁ κίων· ἀνίσῳ δὲ ἡ σταφυλή. τῆσδε γὰρ ἰσχνὴ μὲν ἡ ἀπὸ τοῦ οὐρανοῦ βάσις· ἐς δὲ τὸ ἄκρον στρογγύλη καὶ παχεῖα, ξὺν ἐρυθήμα τι, ἢ πελιδνώσι· τῇδε καὶ σταφυλὴν ἐπίκλησιν ἔσχηκε τὸ πάθος. τοῖσι ὦν χρὴ ὠκέως ἀρήγειν. ὤκιστος γὰρ ὁ ἀπὸ πνιγὸς ὄλεθρος. ἢν μὲν ὦν νεηνίαι οἱ πεπονθότες ἔωσι, τάμνειν τὴν ἐπʼ ἀγκῶνι φλέβα, ἠδʼ ἀθρόον κενοῦν μέζονι τῇ τομῇ. ὡς γὰρ ἀπʼ ἀγχόνης ἀπέλυσε τῆς πνιγὸς ἡ τοιήδε ἀφαίρεσις· δεῖ δὲ ὑποκλύζειν κλυσμῷ πρηέϊ, ἔπειτα δὲ δριμέϊ ἄλλοτε καὶ ἄλλοτε, ἔς τʼ ἂν ἑλκύσῃ τι ἄνωθεν ἐς μετάστασιν. περικεέσθωσαν δὲ καὶ δεσμοὶ σφίγγοντες ἄκροισι τοῖσι σκέλεσι ὑπὲρ σφυρὰ καὶ γούνατα καὶ ὕπερθεν καρπῶν καὶ πήχεων ἐς βραχίον ας. εἰ δέ τι ἡ πνὶξ ἐπισπέρχοι, σικύην ἐπὶ τὸ ἰνίον, ἠδὲ ἐς τὸν θώρηκα προσβάλλειν, καὶ τουτέων ἐντάμνειν τινὰ· πρήσσειν τε ἅπαντα, ὁκόσα μοι ἐν τῇ συνάγχῃ λέλεκται. ωὐτὸς γὰρ ἀμφοῖν ὀλέθρου τρόπος· ἀλλὰ καὶ τοῖσι ἐς τὸ στόμα φαρμάκοισι τοῖσι αὐτέοισι χρέεσθαι καὶ στύψεσι καὶ μαλθακτηρίοις, καὶ πυρίῃ τῇ ἔξωθεν, καὶ ἐπιπλάσμασι, καὶ ἐς τὸ στόμα ἐγχρίσμασι· περὶ δὲ τὸν κίονα ἢ τὴν σταφυλὴν ἔστω στῦμμα, Ῥοὸς χυλὸς, μέλιτι ἢ ὕδατι λυθεῖσα ἀκακία, ὑποκιστὶς, γῆ Σαμίη, ἢ Λημνίη, ἢ Σινῶπις, ἠδὲ ὀμφάκιον· ἢν δὲ ἑλκώδης ἔῃ, κόμμι καὶ ἄμυλον δευθέντα Ῥόδων ἢ φοινίκων ἀφεψήματι, καὶ πτισάνης, ἢ τράγου χυλός· ἐπὶ δὲ τοῦ κίονος ἔστω πλέον τι τῶν εὐτονωτέρων, διὰ σμύρνης τε καὶ κόστου, καὶ κυπέρου. ἀνέχεται γὰρ τῶνδε τῶν δριμέων ὁ κίων. ἢν δὲ ἔμπυος ὅδε ὁ χῶρος γένηται, μετεξετέροισι ἠδὲ τὰ τῆς ὑπερώης ὀστέα ἐφθάρη, καὶ ἐς μακρὸν φθίνοντες τὸν βίον ἐτελεύτησαν. τῶνδε μέντοι τὰ ἄκεα ἑτέρωθι λελέξεται.
10. IN some respects, the treatment of these is the same as that of the other affections in the tonsils, and in some peculiar. In inflammation and suffocation, the remedies are clysters, venesection, liquid applications, cataplasms, fomentation, ligatures, cupping; and all these are applicable here. But anointing with more potent medicines is proper; for the ulcers do not stop, nor do eschars form on the surface. But if a sanies from them run inwardly, the parts, even if before in a healthy state, very soon become ulcerated, and very soon the ulcers spread inwardly, and prove fatal. It might be beneficial to burn the affection with fire, but it is unsuitable owing to the isthmus. But we must use medicines resembling fire to stop the spreading and also for the falling off of the eschars: these are alum, gall, the flowers of the wild pomegranate, either in a dried state or with honeyed-water. And the same medicines may be blown in by means of a reed, or quill, or a thick and long tube, so that the medicines may touch the sores. The best of these medicines is calcined chalcitis, with cadmia triturated in vinegar. Let there be a double proportion of the cadmia, and of the root of rhubarb, with some fluid. It is necessary, however, to guard against their pressure, for the ulcers thus get moist and spread farther. We must, therefore, sprinkle them in a dry state with a quill. But the liquid medicines, having been much diluted, are to be injected upon the columella. But if the eschars be already loosened, and the ulcers become red, there is then most danger of convulsion; for generally the ulcers are dried up, and thereby tonic contractions of the nerves are induced. It is necessary then to soften and moisten by means of milk, with starch, and the juice of ptisan, or of tragus, or linseed, or the seed of fenugreek. In certain cases also the uvula has been eaten down to the bone of the palate and the tonsils to their base and epiglottis; and in consequence of the sore, the patient could neither swallow anything solid nor liquid; but the drink regurgitating has cut him off by starvation.
10. πῆ μὲν ξυνὴ καὶ τῶνδε πρὸς τἄλλα πάθεα τὰ ἐν τοῖσι παρισθμίοισι ἰητρειη, πῆ δὲ ἰδίη. ἐπὶ φλεγμασίῃ καὶ ἀγχόνῃ, κλυσμοὶ, φλεβοτομίη, τέγξιες, ἐπιπλάσιες, πυρίη, διάδεσμοι, σικύη, πάντα τωὐτά. χρίσιες δὲ φαρμάκων δυνατωτέρων· οὐ γὰρ ἀτρεμέει τὰ ἕλκεα, οὐδὲ ἐσχάραι γίγνονται ἐπιπολῆς· ἀλλὰ κἢν ἰχὼρ ἀπὸ τουτέων εἴσω στάξῃ, ὤκιστα μὲν ἑλκοῦται τὰ μέρη, κἢν ἀσινέα ᾖ· ὤκιστα δὲ εἰς τὸ εἴσω νέμεται καὶ κτείνει. πυρὶ μὲν ὦν καίειν τὸ πάθος ἀρωγὸν, ἀλλʼ ἀξύνετον διὰ τὸν ἰσθμόν· φαρμάκοισι δὲ πυρὶ ἰκέλοισι χρέεσθαι ἔς τε τὴν ἐπίσχεσι ν τῆς νεμήσιος, ἀτὰρ ἠδὲ ἐς τὴν τῶν ἐσχαρέων ἔκπτωσιν. ἔστι δὲ στυπτηρίη ξὺν μέλιτι, κηκὶς, βαλαύστιον, ξηρὰ, ἢ ξὺν μελικρή τῳ. τοῖσι δὲ αὐτοῖς καὶ ἐμφυσῆν καλάμῳ, ἢ πτίλῳ, ἢ καυλῷ παχέϊ καὶ ἐπιμήκεϊ, ὡς τῶν ἑλκέων θιγγάνειν τὰ φάρμακα. ἄριστον δὲ καὶ χαλκῖτις ὀπτὴ ξὺν καδμίῃ λείῃ ξὺν ὄξεϊ· ἔστω δὲ μοίρης διπλάσιον τῆς καδμίης, καὶ Ῥήου ἡ Ῥίζα ξύν τινι ὑγρῷ. φυλάσσεσθαι δὲ χρὴ τῶνδε τὰς ἐπιθλίψιας· ὑγραίνει γὰρ τὰ ἕλκεα καὶ ἐπὶ μᾶλλον νέμεται. χρὴ ὦν πτερῷ τὰ ξηρὰ καταπάσσειν· τὰ δὲ ὑγρὰ ὑγρότατα ποιέοντα ἐς τὸν γαργαρεῶνα ἐγχέειν. ἢν δὲ αἱ ἐσχάραι ἤδη τε ἀπολύωνται, τὰ δὲ ἕλκεα ἐρυθρὰ γίγνηται, κίνδυνος τότε μάλιστα σπασμοῦ. ἐπιξηραίνε ται γὰρ ὡς ἐπίπαν τὰ ἕλκεα, καὶ τοῖσι δὲ τὰ νεῦρα ξυντείνετα ι. χρὴ ὦν γάλακτι ξὺν ἀμύλῳ καὶ χυλῷ πτισάνης, ἢ τράγου, ἢ λίνου σπέρματι, ἢ τήλιος μαλθάσσειν καὶ ὑγραίνειν. μετεξετέροισι δὲ καὶ ἡ κιονὶς διεβρώθη μέχρις ὀστέου τοῦ τῆς ὑπερώης, καὶ τὰ παρίσθμια ἄχρι βάσιος καὶ ἐπιγλωττίδος, καὶ ἐπὶ τῇ ὠτειλῇ καταπίνειν οὔτε στερεὸν, οὔτε ὑγρὸν ἠδύναντο, ἀλλὰ καὶ τὸ ποτὸν ἀνακοπτόμενον ἀπέπνιγέ κοτε τὸν ἄνθρωπον λιμῷ.
11. IN cases of Pleurisy there is no time for procrastination, nor for putting off the great remedy. For the fever, being very acute, hastens to a fatal termination; the pain also of the succingens hurries on to the worse; and moreover coughs which agitate the chest and head exhaust the powers. Wherefore then, on the selfsame day we must by all means open a vein. But if it be in connection with repletion of food and drink, having kept the patient fasting for one day, we are to abstract blood from the vein in the hollow of the elbow, in a line with the opposite side, (for it is better to take it from a very great distance); but not to the extent of deliquium animi, for there is danger of Peripneumonia supervening if the body, being congealed, should leave the soul; for the fluids rush inward when deprived of their external heat and tension. For the Lungs are of loose texture, hot, and possessed of strong powers of attraction; the lungs also are the neighbours of the ribs, and their associates in suffering; and this succession of disease is not readily recovered from; whereas in Pleuritis from Peripneumonia, recovery readily takes place, this combination being milder. It is necessary, therefore, after a moderate flow of blood, to recruit the patient for a time, and afterwards abstract again; if matters go on well, the same day, provided the remission be long; but if not, on the day following. But if there is no remission of the fever (for generally the fever prevails and increases for one day), we are to abstract blood the third day during the second remission, when also food is to be given—after having anointed the patient freely, having also applied to the side soft oil with the heating ointment of rue, or the decoction of dill. A very soothing fomentation is also to be applied to the side. In certain cases, the pain and inflammation are determined outwardly, so as to make it appear an affection of the parts there; but it is merely an exacerbation of the internal symptoms.
11. οὐκ ἀμβολῆς καιρὸς ἐν πλευριτικοῖσι, οὐδʼ ὑπερθέσιος μεγάλης ἰητρείης· ὅ τε γὰρ πυρετὸς, κάτοξυς ἐὼν, ἐς ὄλεθρον ὁρμᾷ· ἥ τε ὀδύνη τοῦ ὑπεζωκότος ξυνεπείγει ἐπὶ τὸ κάκιον· ἀτὰρ καὶ βῆχες κλονέουσαι τὸν θώρηκα καὶ τὴν κεφαλὴν ὑπολύουσι τὰς δυνάμιας. μάλιστα μὲν ὦν αὐτῆμαρ φλέβα τάμνειν· ἢν δὲ ἀπὸ πλήσιος σίτων καὶ ποτῶν ἔῃ, ἐπʼ ἀσιτίης μίην ἡμέρην φυλάξαντα, ἀφαιρέειν ἀπʼ ἀγκῶνος τῆς ἐν τῷ κοίλῳ φλεβὸς, τοῦ κατʼ ἴξιν τῇσι ἑτέρῃσι πλευρῇσι· κρέσσον γὰρ ἀπωτάτω ἄγειν. τὸ δὲ πλῆθος μὴ μέχρι λειποθυμίης· περιπνευμονίην γὰρ ἐπιφοιτῆσαι κίνδυνος, ἢν τὸ σῶμα ἐπιψυχθὲν τὴν ψυχὴν ἐκλείπῃ. εἴσω γὰρ τὰ ὑγρὰ ξυνθέει, τῆς ἐκτὸς ἀφαιρεθέντα θέρμης τε καὶ τάσιος. πνεύμων δὲ μανός τε καὶ θερμὸς, καὶ ἐς ὁλκὴν δυνατώτατος. πλευρῶν δὲ γειτόνημα, πνεύμων, καὶ κοινωνὸς ἀλγέων· ἀτὰρ καὶ αἱ τοῦδε διαδέξιες οὐ μάλα περιγίγνονται. περιεστηκυῖα δὲ πλευρῖτις ἀπὸ περιπνευμονίης, εὐηθέστερον γάρ. χρὴ ὦν ἐπὶ ξυμμέτρῳ τῇ Ῥοῇ τοῦ αἵματος μεσηγὺ τὸν ἄνθρωπον ξυλλέξαντα αὖθις ἀφαιρέειν· εἰ μὲν εὖ ἔχοι, αὐτῆμαρ, τῆς ἐπανέσιος μακρῆς γιγνομένης· ἢν δὲ μὴ, τῆς ὑστέρης· ἢν δὲ μηδὲ ὁ πυρετὸς ἐνδιδῷ· — τὰ πολλὰ γὰρ μίην ἡμέρην ὁ πυρετὸς ἴσχει τε καὶ αὔξει. — τῇ τρίτῃ ἐν τῇ δευτέρῃ ἐπανέσι ἀφαιρέειν, τῇπερ καὶ τὰ προσάρματα δοτέον, λιπαρῶς μὲν χρίσαντα ὅλον τὸν ἄνθρωπον· ἐπὶ δὲ τῇ πλευρῇ καὶ ἔλαιον θέντα μαλθακὸν ξὺν ἀλείφατι θερμῷ πηγάνου ἢ ἀνήθου ἀφεψήματος· καταιον εῖν δὲ τὸ πλευρὸν εὖ μάλα προσηνέως. μετεξετέροισι δὲ καὶ τὸ ἄλγημα καὶ ἡ φλεγμασίη ἔξω ὤκειλε, ὡς δοκέειν τῶν τῇδε τὸ πάθος εἶναι· τὸ δέ ἐστι τῶν ἔνδον αὔξησις.
Let us now treat of regimen, in order that, respecting all the system of treatment, there may be no mistake. “For in food will consist the medicines, but also the medicines in food.” In kind, then, it is to be hot and humid, smooth and consistent, detergent, solvent, having the power of dissolving and attenuating phlegm. Of all kinds of food, therefore, ptisan is to be preferred; at the commencement, then, strained to its juice, so that the solid part of it may be separated; and made with honey only; and let the usual articles added to it for seasoning and variety be absent (for now the juice alone is sufficient). It will be calculated to moisten and warm, and able to dissolve and clear away phlegm, to evacuate upwards without pain such matters as should be brought up, and also readily evacuate the bowels downwards. For its lubricity is agreeable and adapted to deglutition. Moreover, its glutinous quality soothes heat, purges the membranes, concocts coughs, and softens all the parts. These are the virtues of barley. The next place to it is held by chondrus, being possessed of some of the good qualities of ptisan. For in regard to its glutinous quality, its lubricity, and its appropriateness for deglutition, it is equal to the other, but in other respects inferior. They are to be made plain, with honey alone. The tragus also is excellent. But rice is worse than these, inasmuch as it has the property of drying, roughening, and of stopping the purgation of the sides, rather than of making it more fluid. A very excellent thing is dry bread, broken into pieces, passed through a sieve, gently warmed, well concocted, which with honeyed-water is sufficient nourishment. But if the disease have already progressed, and the patient have given up his food, the ptisan of barley is to be administered in a soft state, and well boiled. Dill and salts are to be the condiments of the ptisan, and oil which is thin, without quality, without viscidity, without asperity; it is better, however, not to boil much of the oil with the ptisan; for thus the draught becomes fatty, and the oil loses its badness, and with much boiling is no longer perceptible, being drunk up by the juice. And let leek with its capillary leaves, and bitter almonds, be boiled with the juice of ptisan; for the draught thus promotes perspiration, and becomes medicinal, and the leeks eaten out of the juice are beneficial and very delicious. Now also is the season for using wholesome eggs; but if the expectoration be fluid and copious, sprinkle on them some native sulphur and natron. But the best thing of all is to give new-laid eggs which have never been subjected to the fire; for the heat of the hen is more humid than fire, and more congenial to the patient, as proceeding from one animal to another.
τροφῆς δὲ νῦν, ὡς ἀμφὶ πάσης ἰητρείης ἔστω λόγος, ὡς μηδὲν ἐς ἁμαρτωλὴν εἴη. ἐν τροφῇ γὰρ κείσεται τὰ φάρμακα, ἀτὰρ καὶ τὰ φάρμακα ἐν τροφῇ. γένεϊ μὲν ὦν θερμὴ καὶ ὑγρὴ, ἠδὲ λείη καὶ ὁμαλὴ, σμηγματώδης, διαλυτικὴ, λῦσαι, λεπτῦναι φλέγμα δυναμένη. σιτίων μὲν ὦν ἁπάντων πτισάνη προκεκρίσθω· ἐν ἀρχῇ μὲν εἰς χυλὸν διηθημένη, ὡς τὸ στερεὸν αὐτέης διακεκρίσθαι, ξὺν μέλιτι πεποιημένη μοῦνον. πτισάνης δὲ τὰ ξυνήθεα ἐς ἡδονὴν καὶ ποικιλίην φάρμακα ἀπέστω, νῦν γὰρ ἀρκεῖ ὁ χυλὸς μοῦνος· ἱκανὴ μὲν ὑγρῆναι καὶ θερμῆνα ι, δυνατὴ δὲ λῦσαι φλέγμα καὶ σμῆξαι· ἄνω δὲ ἀνάγειν μὲν ἀπόνως ὁκόσα ἀνάγεσθαι χρή· ὑπάγειν δὲ Ῥηϊδίως τὴν κοιλίην. προσηνὲς δὲ τὸ λεῖον αὐτῆς καὶ ἐς κατάποσιν εὔκολον. ἀτὰρ καὶ τὸ γλίσχρασμα θερμασίας πρηο̈́νει, ὑμένας καθαίρει, πεπαίνει βῆχας, πάντα μαλθάσσει. αἵδε κριθῆς ἔασι ἀρεταί· δευτέρην δὲ χώρην ἔχουσι οἱ χόνδροι, ὀλίγοισί τισι τῆς πτισάνης ἀγαθοῖσι καὶ αὐτοὶ ἄριστοι ἐόντες. τὸ γλίσχρασμα γὰρ, τὸ λεῖον, τὸ προσηνὲς ἐς κατάποσιν, ξυνόν· τὰ δʼ ἄλλα πάντα μείους· πεποιήσθωσαν δὲ καὶ οἵδε ἁπλοῖ ξὺν μέλιτι μοῦνον. ἀγαθοὶ δὲ καὶ τράγοι. κακίων δὲ ἐπʼ αὐτῶν ὄρυζα ξηρῆναι, τρηχῆνα ι, ἐπίσχεῖν κάθαρσιν πλευρῶν μᾶλλον ἢ οὐρῆσαι· ἄριστος δὲ καὶ ἄρτος ξηρὸς κοπεὶς, κρησέρῃ σεσησμένος, εὔκρητος, εὔπεπτος, ξὺν μελικρήτῳ διαρκὴς τροφή. ἢν δὲ ἤδη μὲν προήκῃ ἡ νοῦσος, πρὸς δὲ τὰ σιτία ἀπηυδήκῃ ὥνθρωπος, πτισάνη μὲν ἐκ κριθῆς διδόσθω λείη, κάθεφθος· ἄνηθον δὲ ἔστω καὶ ἅλες πτισάνης τὰ ὄψα· καὶ ἔλαιον λεπτὸν, ἄποιον, ἄγλισχρον, ἀτρήχυντον· κρέσσον δὲ ξὺν τῇ πτισάνῃ, ὡς μὴ πολλὸν τοῦ ἐλαίου ἑψεῖν. καὶ γὰρ πῖον ἴσχει τὸ Ῥόφημα, καὶ τὴν κακίην τὸ ἔλαιον ὄλλυσι. οὐδὲ γὰρ ἐμφανὲς ἔτι γίγνεται τῇ πολλῇ ἑψήσι εἰς τὸν χυλὸν ἀναποθέν. ἔστω δὲ καὶ πράσον ξὺν τῇ κόμῃ καὶ ἀμύγδαλα πικρὰ ξὺν τῷ χυλῷ ἑψόμενα. εὔπνοόν τε γὰρ καὶ φαρμακῶδες ὑπὸ τῶνδε γίγνεται, καὶ τὰ πράσα βρωθῆναι ὑπὸ τοῦ χυλοῦ, ὀνησιφόρα καὶ ἥδιστα. ἤδη δὲ καὶ ὠῶν καιρὸς εὐχύλων· ἢν δὲ ὑγρὴ καὶ πολλὴ ἀναγωγὴ ἔῃ, θείου τοῦ ἀπύρου ἐμπασσέσθω καὶ νίτρου. ἄριστον δὲ τῶν ἀρτιτόκων ὠῶν δοθῆναι ἐκ πυρὸς ἀπύρων. ἀπὸ γὰρ τῆς μητρὸς ἡ θέρμη, ὑγροτέρη μὲν πυρὸς, οἰκειοτέρη δὲ τῷ νοσέοντι, ὅκως ἐκ ζῴου ζῴῳ. ἢν δὲ φλέγμα κολλῶδες ἔῃ καὶ γλίσχρον,
But if the phlegm be glutinous and viscid, pour oil into the eggs, and sprinkle some of the dried resin of pine—so that the sulphur may be more powerful; melting also with them some of the resin of turpentine; pepper also and all cognate substances are beneficial in eggs, and in all kinds of food; the extremities of animals melted down in soups, pigeons, boiled hens; the brains of swine roasted with the cawl, but without it they are not savoury. If the patient has no râle, we must give him fish from the depth of the sea, or rock fish, the best which the country produces. And that the patient may not transgress in regimen, owing to his appetite, nor become wasted by a spare diet, he is to be gratified with some fruit; such as apples boiled in water, or honeyed-water, or stewed in suet (but we must take off the skin and rough parts within along with the seeds,); and in season we may give some figs. We must give likewise of any other kind of autumn fruit which is not only not hurtful but also beneficial. So much with regard to diet.
ἐς τὰ ὠὰ ἔλαιον ἔγχέειν καὶ Ῥητίνης τῆς ξηρῆς τῆς ἀπὸ πίτυος ἐμπάσσειν, ὅκως τὸ θεῖον κρέσσον ἔῃ, καὶ τῆς ἀπὸ τερμίνθου δὲ τήξαντα· καὶ πέπερι ὀνηϊστὸν καὶ ἐν ὠοῖς καὶ ἐν πτισάνῃ καὶ ἅπασι τοῖσι ἐδέσμασι καὶ ὁκόσα πεπέρεϊ ξυνῳδά· κρεῶν ἀκρόποδες ἐν χυλοῖσι τακεροὶ, πέλειαι, ἀλεκτορίδες ἑφθαί· συῶν ἐγκέφαλοι, ὀπτοὶ μὲν σὺν τῷ ἐπιπλόῳ· ἄνευ δὲ τουτέου ἄκνισοι. ἢν δὲ ἄκερχνος ἔῃ, δοτέον καὶ θαλασσίων, ἢ πετραίων ὅ τι ἂν ἄριστον ἡ χώρη φέρῃ. ὡς δὲ μὴ ἁμαρτάνῃ ἐπιθυμίῃ, μηδὲ σμήχηται ἐν τῇ λεπτῇ διαίτῃ ὁ νοσέων, χαρίζεσθαι ὀπώρης, μήλων ἑφθῶν ἐν ὕδατι ἢ μελικρή τῳ, ἢ στέατι ὀπτῶν — ἀφαιρέειν δὲ χρὴ τοῦ λέπους καὶ τῶν ἐντὸς τρηχέων ξὺν τοῖσι σπέρμασι· — ἐφʼ ὥρης δὲ καὶ σύκων. ἀτὰρ καὶ τῆς ἄλλης δοτέον, ὁκόσον ἂν ᾖ ἀβλαβὴς ἡ ὀπώρη, ἀλλὰ καὶ ὀνηϊστός. ἀμφὶ μὲν ὦν τροφῆς τάδε.
Wool fumigated with sulphur and moistened with oil in which dill and rue have been boiled, is to be laid on the side. Foment the side constantly with these, and, before the administration of food, apply cataplasms, in addition to the usual ingredients containing melilot boiled with honeyed-water, and mixing therewith some of the fleshy part of the poppy in a boiled state, and sprinkling on it the meal of the manna thuris. But if the expectoration be more fluid and copious, we are to mix the flour of darnel, or of hedge mustard, and sprinkle natron on it. But if the disease be prolonged, the pain having become fixed, and the purging liquid, it is to be apprehended that pus is about to form; wherefore mix with the cataplasms mustard and cachrys; and if the patients have a feeling as if the internal parts were cold, some vinegar may be poured into it. The heat of the cataplasms should be of a strong kind, that it may last the longer; for this is better than having the heat kept up by renewal of the cataplasms. Let the fomentations consist of salts and millet in bags, or of warm oil in bladders. Every apparatus used for fomentation should be light, so that the weight may not add to the pain. These things moreover are to be used also after the food, if the pain be urgent. And, in addition to these means, now also should be the time of cupping;
ἐπὶ δὲ τῷ πλευρῷ κέεσθαι χρὴ ἔρια θυμιηθέντα θείῳ, λίπαϊ δεδευμένα, ἔνθα ἄνηθον ἕψηται, ἢ πήγανον. ξυνεχὲς δὲ τουτέοισι τὸ πλευρὸν καταιον εῖν, ἠδὲ ἐπιπλάττε ιν πρὸ τῆς προσάρσιος· πρὸς τοῖσι ξυνήθεσι πλάσμασι, μελίλωτον ἑψηθὲν ξὺν μελικρήτῳ, ξυμμίσγοντα μήκωνος τῆς σαρκὸς ἐνηψημένης, καὶ μάννης ἄλητον ἐμπάσσειν· ἢν δὲ ὑγροτέρη ᾖ ἀναγωγὴ καὶ πολλὴ, αἴρης ἄλητον ἢ ἐρυσίμου ξυμμίσγειν καὶ νίτρον ἐμπάσσειν· ἢν δὲ μῆκος ἤδη τῆς νούσου γίγνηται, καὶ τῆς ὀδύνης ἐγκεομένης, καὶ ὑγρῆς καθάρσιος γιγνομένης, ἔμπυον μὲν ἐλπὶς τὸν ἄνθρωπον ἔσεσθαι· σίνηπι δὲ ξυμμίσγειν καὶ κάγχρυ τοῖσι ἐπιπλάσμασι. ἢν δὲ καὶ ψυχρῶν τῶν τόπων εἴσωθεν τοῖσι κάμνουσι αἴσθησις γίγνηται, ὄξος παραχέειν. χρὴ δὲ ἐνεργὸν ποιέεσθαι, ἐς πολλὸν τὴν θερμασίην τῶν ἐπιπλασμάτων διαρκέειν. κρέσσων γὰρ ἤδη καὶ ἡ θέρμη τῆς τῶν ἐπιπλασμά των νεωχμώσιος ἔστωσαν ὦν θάλψιες ἐν κυρβασίῃσι διὰ ἁλῶν, ἢ κέγχρου, ἢ λίπαος θερμοῦ ἐν κυστεσι. κοῦφον δὲ ἔστω πᾶν μηχάνημα πυρίης, ὡς μὴ τὰ ἄχθεα πρὸς τῷ πόνῳ πόνον ἐνδιδῷ. τοῖσδε μέντοι καὶ ἐπὶ τῇ τροφῇ χρέεσθαι, ἢν ξυνεπείγ ῃ τὸ ἄλγος.
but it is best after the seventh day: before this you should not be urgent with it, for the diseases are not of a favourable character which require cupping before the seventh day. Let the instrument be large, broad every way, and sufficient to comprehend the place which is pained; for the pain does not penetrate inwardly, but spreads in width. There should be plenty of heat below the cupping-instrument, so as not only to attract, but also to warm before the extinction of the fire. And after the extinction, having scarified, we are to abstract as much blood as the strength will permit; much more than if you had to take away blood from the hypochondria for any other cause. For the benefit from cupping is most marked in cases of Pleurisy. But salts or natron are to be sprinkled on the scarifications, a pungent and painful practice indeed, but yet a healthful one. But we must estimate the powers and habits of the patient. For if strong in mind and robust in body, we must sprinkle some of the salts, not indeed so as to come into immediate contact with the wounds themselves, but they are to be sprinkled on a piece of linen-cloth damped with oil, and it is to be spread over the place; for the brine which runs from the melting of the salts is less stimulant than the salts themselves. We must also pour in much of the oil, that by its soothing properties it may obtund the pain occasioned by the acrimony of the other. On the second day it will be a very good rule to apply the cupping-instrument again, so as that a thin sanies may be abstracted from the wounds. This, indeed, is much more effectual than the previous cupping, and much less calculated to impair the strength; for it is not blood, the nutriment of the body, but sanies that runs off. This then you are to do after having made a previous estimate of the strength. On the third day we are to apply cerate with the ointments of privet and of rue. But if the sputa still require purging, we are to melt into the cerates some resin, or mix some native sulphur therewith, and again the part is to have a fomentation. With regard to the form of the cupping-instrument, it should either be an earthen vessel, light, and adapted to the side, and capacious; or, of bronze, flat at the lips, so as to comprehend the parts affected with pain; and we are to place below it much fire along with oil, so that it may keep alive for a considerable time. But we must not apply the lips close to the skin, but allow access to the air, so that the heat may not be extinguished. And we must allow it to burn a long while, for the heat within it, indeed, is a very good fomentation, and a good provocative of perspirations.
ἤδη δὲ ἐπὶ τοῖσδε καὶ σικύης καιρὸς γένοιτο· ἄριστος δὲ ὁ μετὰ ἑβδόμην, πρόσθεν δὲ μὴ ξυνεπειχθείης. οὐ γὰρ εὐήθεες αἱ νοῦσοι, ὁκόσαι πρὸ ἑβδόμης ἁπαιτέου σι σικύην. ἔστω δὲ μεγάλη, εὐρεῖα πάντη, ἀμφισχε ῖν τὸ ἀλγέον χωρίον ἱκανή. οὐ γὰρ εἴσω ἐνδιδοῖ τὸ ἄλγος, ἀλλʼ εἰς εὖρος κέχυται. ἔστω δὲ καὶ ἡ ὑπὸ τῇ σικύῃ φλὸξ πολλὴ, ὡς μὴ μοῦνον ἑλκύσαι, ἀλλὰ καὶ ἀλεῆναι πρὸ τῆς ἀποσβέσι ος τοῦ πυρός· καὶ μετὰ τὴν ἀπόσβεσι ν ἀποσχάσα ντ α ἀφαιρέε ιν αἷμα, ὁκόσον ἂν ἡ δύναμις παρείη. πολλὸν δὲ ἔστω πλέον ἢ εἰ ἀπʼ ἄλλης προφάσιο ς ἀπὸ τῶν ὑποχονδρ ίω ν ἀφαιρέο ις αἷμα. ἐπιδηλοτ άτ η γὰρ ἐπὶ τῶν πλευριτι κῶ ν ἡ ἀπὸ σικύης ὠφελείη· ἅλες δὲ ἢ νίτρον ἐπὶ τοῖσι σχάσεσι, δηκτικὸν μὲν καὶ ἀλγεινὸν, ὑγιεινὸν δέ. ἀλλὰ ξυντεκμαίρεσθαι τὰς δυνάμιας καὶ τοῦ ἀνθρώπου τὸν τρόπον. ἢν γὰρ ἀλκήεις τὴν ψυχὴν καὶ καρτερὸς ἔῃ, ἐμπάσσειν τῶν ἁλῶν, μὴ αὐτοῖσι τοῖσι ἕλκεσι ὡς αὐτέων ψαύειν, τῇ δὲ ὀθόνῃ ἐπιπάσσειν δεδευμέ νῃ τῷ λίπαϊ, ἠδὲ ἐπιπετάζειν τῷ χωρίῳ. οἱ γὰρ ἐκ τῆς συντήξιος ἰχῶρες τῶν ἁλῶν εἰσι ἀδηκτότεροι. πολλὸν δὲ τοῦ λίπαος καταιονεῖν χρὴ, ὅκως τῷ προσηνέϊ τοῦδε ἀμβλύνῃ τὸ ἄλγος τῆς δήξιος. δευτέρῃ δὲ ἡμέρῃ ἄριστον τὴν σικύην προσβάλλειν, ὡς ἐκ τῶν τρωμάτων ἕλκηταί τις λεπτὸς ἰχώρ. τόδε πολλὸν μὲν τῆς ἐπίπροσθεν σικύης ἀνυσιμώτερον, πολλὸν δὲ τῆς δυνάμιος φυλακτικώτερον. οὐ γὰρ αἷμα, ἡ τροφὴ, ἀλλὰ ἰχὼρ ἐκρέει. καὶ τόδε μέντοι προευκρινήσας ἀμφὶ τῆς δυνάμιος πρήσσειν. τῇ τρίτῃ δὲ κηρωτὴν ξὺν τῷ κυπρίνῳ καὶ πηγάνῳ τιθέναι. ἢν δὲ ἔτι καθάρσιος τὰ πτύαλα δέηται, τοῖσι κηρώμασι Ῥητίνης ξυντήκειν, ἢ τοῦ θείου τοῦ ἀπύρου ξυμμίσγειν· καὶ αὖθις πυρίην τὸ χωρίον ἔχειν· ὡς τρόπος δὲ σικύης· ἔχειν ὦν χρὴ κεραμεο ῦν κοῦφον ἁρμόζον τῇ πλευρῇ, εὐρὺ, ἤ τι χάλκεον, πρηνὲς ἐπὶ τὰ χείλεα ἀμφιθεῖ ναι τοῖσι ἀλγέουσι· ὑποτιθέναι δὲ φλόγα μεγάλην ξὺν λίπαϊ, ὅκως ζῶσα ἐς πολλὸν διαρκέῃ χρόνον· μὴ περισφίγγειν δὲ τὰ χείλεα πρὸς τῇ σαρκὶ, ἀλλʼ ἐς διαπνοὴν διαδοχή τις ἔστω ὡς μὴ διασβεσθέῃ τῇ πνιγί· ἐς πολλὸν δὲ ἐξάπτεσθαι ἔνι· ἡ γὰρ ἔνδον ἐκείνου θέρμη, ἄριστον μὲν πυρίημα, ἀγαθὴ δὲ πρόκλησις ἱδρώτων.
And we must not overlook purging downwards, in men injecting oil of rue into the gut, and, in women, also into the womb. And let something be constantly drunk and swallowed; for this purpose, honeyed-water, with rue and juice of ptisan, if there is a constant cough, as being a medicine in the food. But if it is not the season of administering food, let it be one of the compound preparations, such as butter boiled with honey to a proper consistence. Of this, round balls the size of a bean are to be given to hold under the tongue, moving them about hither and thither, so that they may not be swallowed entire, but melted there. The medicine also from poppies with honey and melilot is agreeable, being possessed of soothing and hypnotic properties. This is to be given before the administration of food, after it, and after sleep. To the patient when fasting, the following medicinal substances are to be given: of nettle, of linseed, of starch, and of pine fruit in powder, of each, a cupful (cyathus), and of bitter almonds twenty-five in number, and as many seeds of pepper. These things being toasted and triturated with honey, are to be mixed up into a linctus; of these the dose is one spoonful (cochleare). But if he expectorate thin and unconcocted matters, two drams of myrrh, one of saffron, and fifteen grains of pepper to be mixed with one pound of honey. This medicine should be given also before the administration of food to the amount of half a spoonful. It is good also in chronic cases, when oxymel likewise is to be given if the dyspnœa be urgent.
χρὴ δὲ μηδὲ τὴν κάτω ἰητρείην ὑπερορῆν, ἀνδράσι μὲν ἐς τὸ ἔντερον πηγάνινον ἔλαιον ἐγχέοντα, γυναιξὶ δὲ καὶ ἐς ὑστέρην· διηνεκέα δὲ τὰ πινόμενα καὶ κατάποτα ἔστω, μελίκρη τον ξὺν τῷ πηγάνῳ, καὶ χυλῷ πτισάνης, ἢν ξυνεχὲς βήσσῃ, ὡς ἐν τροφῇ φάρμακον· ἢν δὲ μὴ τροφῆς καιρὸς ἔῃ, ἔστω δή τι καὶ τῶν ποικίλων· πινέριον ξὺν μέλιτι ἑψηθὲν ἐς σύστασιν. τὰς δὲ χρὴ σφαίρας μέγεθος ὅσον κυάμου στρογγύλας οὔσας διδόναι ὑπὸ τὴν γλῶτταν ἔχειν, διαφέροντα τῇδε κἀκεῖσε, ὡς μὴ κατάποτον, ἀλλὰ τηκτὸν ἔῃ· προσηνὲς δὲ καὶ τὸ διὰ τῆς μήκωνος ξὺν μέλιτι καὶ μελιλώτῳ φάρμακον λεῖον καὶ ὑπνικόν. τάδε μέντοι καὶ πρὸ τῆς ἄρσιος, καὶ ἐπʼ αὐτέῃ, καὶ ἐπὶ τῷ ὕπνῳ διδόναι· ἀσίτῳ δὲ τὰ φαρμακώ δεα, κνίδης καὶ λὶνου τοῦ σπέρματος, καὶ ἀμύλου, καὶ κώνου τοῦ κοκκάλου λείου, ἑκάστου κύαθον· καὶ ἀμύγδάλων τῶν πικρῶν πέντε καὶ εἴκοσι τὸν ἀριθμόν· τόσοι δὲ καὶ πεπέριος κόκκοι. φωχθέντα δὲ χρὴ λεῖα μέλιτι ἐς ἂν ἔκλειγμα φυρῆν· τῶν δόσις μυστίλημίη· ἢν δὲ ὑγρὰ καὶ ἄπεπτα ἀνάγῃ, σμύρνης ὁλκῆς͵ δύο, κρόκου μίη, πεπέριος κόκκοι δεκαπέντε, μέλιτος φυρῆναι λίτρᾳ μίῃ. τόδε μέντοι ἤδη τὸ φάρμακον καὶ πρὸ τῆς ἄρσιος δοτέον, μυστίλης ἥμισυ. ἀγαθὸν τόδε ἐπὶ τοῖσι χρονίζουσι, εὖτε καὶ ὀξύμελι διδόναι χρὴ, ἢν δύσπνοια ξυνεπείγῃ.
Such physicians as have given cold water to pleuritics, I cannot comprehend upon what principle they did so, nor can I approve the practice from experience; for if certain patients have escaped the danger from having taken cold water, these would appear to me not to have been pleuritic cases at all. But by the older physicians, a sort of congestion was called pleuritis, being a secretion of bile with pain of the side, attended with either slight fever or no fever at all. This affection, indeed, got the name of pleurisy, but it is not so in reality. But sometimes a spirit (or wind, pneuma) collecting in the side, creates thirst and a bad sort of pain, and gentle heat; and this ignorant persons have called pleurisy. In them, then, cold water might prove a remedy through the good luck of the person using it; for the thirst may have been extinguished, and the bile and wind expelled downwards, while the pain and heat have been dissipated. But in inflammation of the side and swelling of the succingeus, not only cold water but also cold respiration is bad.
ψυχρὸν δὲ ὕδωρ ὁκόσοι τῶν ἰητρῶν τοῖσι πλευριτι κοῖσι ἔδοσαν, οὔτε ὁκοίῳ λόγῳ ξυμβαλέειν ἔχω, οὔτε τῇ πείρῃ πιστώσασθαι. εἰ γάρ τινες ἀπὸ ψυχροῦ διηλλάξαντο τὸν κίνδυνον, οἵδε μοι οὐκ ἐδόκεον εἶναι πλευριτικοὶ, ἀλλὰ καὶ τοῖσι παλαιοτέροισι ἰητροῖσι ἰδέη τις ξυνδρομῆς πλευρῖτις ἐκικλήσκετο, χολῆς ἔκκρισις ἐοῦσα ξὺν πόνῳ πλευροῦ ἐπὶ σμικρῷ πυρετῷ, ἢ καὶ ἄνευ πυρετῶν. τόδε μέντοι τὸ πάθος οὔνομα μὲν πλευρίτιδος, τὸ δὲ πρῆγμα οὐκ ἴσχει· ἀλλὰ καὶ πνεῦμά κοτε, ξυνιστὰν ἐν πλευρῷ, δίψαν ἐνδιδοῖ καὶ ὀδύνην πονηρὴν, μαλθακήν τε θέρμην· καὶ τόδε ἐκάλεσαν ἄνδρες ἀΐδριες πλευρῖτιν. ἐπὶ τῶνδε ὦν ὕδωρ ψυχρὸνἄκος ἂν γίγνοιτο εὐτυχίῃ τοῦ χρεομένου· ἐσβέσθη μὲν ἂν τὸ δίψος, ἡ δὲ χολὴ καὶ τὸ πνεῦμα ὑπηλάθη, καὶ διέπνευσε τὸ ἄλγος καὶ ἡ θέρμη· ἐπὶ δὲ φλεγμασίῃ πλευροῦ, καὶ τοῦ ὑπεζωκότος πρήσι, οὐ μόνον ὕδωρ ψυχρὸν, ἀλλὰ καὶ ἀναπνοὴ ψυχρὴ κακόν.
If, then, owing to the treatment formerly described persons affected with pleurisy survive the attack, but have still a short cough, and now and then are seized with heat, we must hasten to dissipate these symptoms; for the residue of the disease either produces a relapse, or it is converted into a suppuration.
ἦν ὦν ἐκ τῆς πρόσθεν ἰητρείης περιγίγνωνται οἱ πλευριτικοὶ, ἔτι δὲ βραχέα βήσσωσι καὶ θέρμη ἄλλοτε καὶ ἄλλοτε ἴσχῃ, σπεύδειν χρὴ διαλύειν τάδε· ἢ γὰρ ὑποστροφὰς ποιέει τὰ ἐγκαταλιμπ ανόμενα, ἢ ἐς ἐμπύησιν τρέπεται.