1. INFLAMMATION and swelling of the lungs, and along with them a sense of suffocation, which does not long endure, constitute a very acute and fatal ailment. The remedies opposed to it, therefore, ought to be of equal power and speedily applied. We are to open instantly the veins at the elbow, and both together, on the right and on the left side, rather than abstract blood from one larger orifice, so that revulsion of the humours may take place from either side of the lungs: but we must not carry it to the extent of deliquium animi for the deliquium cooperates with the suffocation. But when even a small respite has been obtained, we must suppress the flow and abstraet more afterwards; for, if the exciting causes be from blood, the venesection carries them away; and if phlegm, or froth, or any other of the humours be the agent, the evacuations of the veins widen the compass of the lungs for the passage of the breath. We must expel the fluids and flatus downwards, by anointing the anus after the venesection with natron, honey, rue, and the liquid resin from turpentine. Instead of the venesection,—provided there be a greater impediment,—we must give a clyster of acrid juice, namely, of salts, in addition to the natron, and turpentine resin with the honey; and rue boiled in the oil, and hyssop boiled in the water; and the fleshy parts of the wild cucumber, boiled with water, are very excellent. Dry-cupping applied to the back, the shoulder, and the hypochondria, is altogether beneficial. And if the chest be fleshy, so that the cupping-instrument may not by its pressure bruise the skin about the bones, it is to be also applied there; for if the humours be attracted from all parts of the body, and the spirit (pneuma) be determined outwardly, in those cases in which the lungs are, as it were, choked, there will be respite from the mischief; for peripneumonia is to be attacked in every possible way. But, likewise, neither are we to neglect any of the medicines which prove useful when swallowed by the mouth, for the lungs attract fluids whether they be in health or diseased. We must, therefore, give such medicines as attenuate the fluids so as to promote their perspiration, and such as will lubricate and render them adapted for expectoration. For speedy relief, then, natron is to be drunk with the decoction of hyssop, or brine with vinegar and honey; or mustard moistened with honeyed-water; and we may confidently sprinkle on each some of the root of iris and pepper. But also these things, having been sifted, are to be given in a powder along with honey. But if the patients get no sleep during the day, and remain sleepless also during all the night, it is to be feared lest they become delirious, and there will be need of various soporific medicines unless the disease give way, so that the seasonable administration of these medicines may lull the suffering, for these things are usually soporific. But if you give a medicine at the acme of the suffocation, or when death is at hand, you may be blamed for the patient’s death by the vulgar. The food also must be suitable, acrid, light, solvent of thick matters, detergent: of pot-herbs, the leek, or the cress, or the nettle, or the cabbage boiled in vinegar; of austere things (frumentacea?) the juice of ptisan, taking also of marjoram, or of hyssop, and of pepper, and more natron instead of the salts. Also spelt in grains well boiled with honeyed-water: in the course of the boiling, they should all be deprived of their flatulence, for flatulent things are hurtful to persons in peripneumonia. If they are free from fever, wine is to be given for drink, but not such as is possessed of much astringency, for astringency condenses bodies; but in these the parts are rather to be relaxed. We must also promote the expulsion of the sputa. On the whole the drink should be scanty, for drenching is prejudicial to the lungs, because the lungs attract from the stomach and belly. Let the chest be covered up in wool, with oil, natron, and salts. The best ointment is that prepared of the lemnestis, and dried mustard with liquid cerate; and, on the whole, we are to determine outwardly the fluids, the heat, and the spirit (pneuma). And smelling to acrid things is beneficial, also anointings, and ligatures of the extremities. When these things are done, if the disease do not yield, the patient is in a hopeless condition.
1. κάτοξυ καὶ ἐπίκαιρον κακὸν φλεγμασίη καὶ πρῆσις τοῦ πνεύμονος, ἐφʼ οἷσι πνὶξ ὀλιγοχρονίη. χρὴ ὦν ἀντίξοα ἠδὲ ὠκέα ἔμμεναι τὰ ἀλεξήμα τα· τάμνειν αὐτίκα τὰς ἐπʼ ἀγκῶνι φλέβας· ἠδʼ ἄμφω ἅμα ἐπὶ δεξιὰ καὶ ἀριστερὰ μᾶλλον, ἢ ἐκ μιῆς μέζονος, — ὡς ἀφʼ ἑκατέρης τῆς χώρης τοῦ πνεύμονος ἡ ἀντίσπασις τῶν ὑγρῶν ἔῃ· μὴ μέσφι λειποθυμίης· προστιμωρέει γὰρ τῇ πνιγὶ ἡ λειποψυχίη. ἀλλὰ κἢν σμικρὸν ἀναπνεύσωσι, ἐπισχόντα χρὴ τὴν Ῥοὴν αὖθις ἀφαιρέειν. ἢν γὰρ ἐξ αἵματος αἱ προφάσιες ἔωσι, αὐτὴν τὴν αἰτίην ἡ φλεβοτομίη ἄγει· ἤν τε φλέγμα, ἢ ἀφρὸς, ἤ τι ἄλλο τῶν ὑγρῶν πρήσσῃ, αἱ τῶν φλεβῶν κενώσιες εὐρυτέρην τὴν τοῦ πνεύμονος ποιέουσι χώρην ἐς δίοδον τῆς ἀναπνοῆς. χρὴ δὲ καὶ κάτω ἄγειν ὑγρὰ καὶ φύσας, ἐπὶ μὲν φλεβοτομίης διαχρίοντα τὴν ἕδρην λίτρῳ, μέλιτι, πηγάνῳ, Ῥητίνῃ τῇ ἀπὸ τῆς τερμίνθου τῇ ὑγρῇ. ἀντὶ δὲ τῆς φλεβοτομίης, εἰ μέζων ἡ κώλυσις ἔοι, ὑποκλύζειν χυλῷ δριμέϊ, ἁλσὶ μὲν πρὸς τῷ λίτρῳ, ἡ Ῥητίνη δὲ τῆς τερμίνθου ξὺν τῷ μέλιτι· πήγανον δὲ ἐν τῷ ἐλαίῳ καὶ ὕσσωπον ἐν τῷ ὕδατι ἑψηθέντα. καὶ κολοκύντης δὲ τῆς ἀγρίης αἱ σάρκες, αἱ εἴσω, ἑψηθεῖσαι ξὺν ὕδατι, ἄρισται. Σίκυαι κοῦφαι ἐς τὰ μετάφρενα καὶ τὸν νῶτον καὶ τὰ ὑποχόνδρια πάντη ξύμφοροι. ἢν δέ πως ὁ θώρηξ εὔσαρκος ἔῃ, ὅκως μὴ ἀμφὶ τοῖσι ὀστέοισι τὸ δέρμα ἡ σικύη ἀμφιθλάσῃ ἐρείδουσα, καὶ τῷδε προσβάλλειν· ἢν γὰρ πάντη τοῦ σώματος τά τε ὑγρὰ ἐφέλκηται καὶ τὸ πνεῦμα ἔξω τιταίνηται, οἷσί περ ὁ πνεύμων πνίγεται, ἀνάπνευσις ἂν γίγνοιτο τοῦ κακοῦ. πάντη γὰρ πολιορκέειν χρὴ τὴν περιπνευμονίην. ἀτὰρ μηδὲ τῶν διὰ στόματος ὠφελούν των φαρμάκων ὑπερορῆν μηδέν. ἕλκει γὰρ ὁ πνεύμων καὶ ἐν ὑγείῃ ὑγρὸν, καὶ ἢν νοσῇ. φαρμάκων διδόναι ὦν ὁκόσα λεπτύνει τὰ ὑγρὰ ἐς διαπνοὴν, ἠδὲ ὀλισθηρὰ καὶ εὔροα ἐς ἀναγωγὴν τεύξει· πίνειν μὲν ἐς τάχος τῆς ὠφελείης λίτρον ξὺν ὑσσώπου ἑψήματι, ἢ ἅλμην ξὺν ὄξεϊ καὶ μέλιτι, ἢ σίνηπι ὑγρὸν ξὺν μελικρή τῳ. ἐμπάσσειν δὲ ἑκάστῳ καὶ τῆς ἴριδος τῆς Ῥίζης καὶ πεπέριος εὔτολμον· ἀτὰρ καὶ τάδε ξηρὰ σήσαντα ξὺν μέλιτι διδόναι. ἢν δὲ ἄϋπνοι ἔωσι διʼ ἡμέρης, ἠδὲ ἐγρηγορῶσι πάννυχοι, δέος μὴ ὁ ἄνθρωπος μανῇ, καὶ ποικίλων φαρμάκων ὑπνωτικῶν χρέος, ἢν μή τι ἐνδιδῷ ἡ νοῦσος, ὅκως καὶ τὴν ταλαιπωρίην ὁ τῶν φαρμάκων καιρὸς εὐνάσῃ. τὰ πολλὰ γὰρ γίγνεται καρώδεα. ἢν δὲ ἐν ἀκμῇ τῆς πνιγὸς καὶ ὑπὸ τῷ ὀλέθρῳ φάρμακον διδῷς, θανάτου ἂν εἴης παρὰ τοῖσι δημότῃσι αἴτιος. χρὴ δὲ καὶ τὰ σιτία ἴκελα ἔμμεναι, δριμέα, λεπτὰ, διαλυτικὰ παχέος, σμηγματώδεα· λαχάνων, πράσον, ἢ κορωνόπους, ἢ κνίδη, ἢ κράμβη ἐν ὄξεϊ ἑψηθεῖσα. αὐστηρῶν δὲ, πτισάνης ὁ χυλὸς, τῆς ὀριγάνου ἢ ὑσσώπου προσλαβὼν, ἠδὲ πεπέριος καὶ λίτρου πλεῖον ἀντὶ τῶν ἁλῶν· χόνδροι ξὺν μέλικρήτῳ κάθεφθοι. ἄφυσα δὲ πάντα ἐν τῇ ἑψήσι ἔστω. κακὸν γὰρ περιπνευμονικοῖσι φῦσαι. οἶνος ποτὸν, ἢν ἄπυροι ἔωσι, μὴ πολλόν τι τῆς στύψιος ἔχων. πυκνωτικὸν γὰρ σωμάτων ἡ στῦψις. χρὴ δὲ τουτέοισι ἀραιοῦν μὲν τὰ μέρεα μᾶλλον. πολλὸν δὲ ἄγειν τὰ πτύελα· τὸ ξύμπαν δὲ, ὀλίγον ἔστω ποτόν πνεύμονι γὰρ τέγξις κακὸν, οὕνεκεν πνεύμων ἀπὸ στομάχου ἕλκει καὶ κοιλίης. θώρηξ δὲ ἐσκεπάσθω εἰρίοισι ξὺν λίπαϊ, καὶ λίτρῳ, ἢ ἁλσί. ἄριστον δὲ χρῖσμα τὸ διὰ τῆς λιμνήστιδος, σίνηπι ξηρὸν ξὺν κηρωτῇ ὑγρῇ. καὶ τὸ ξύμπαν ἔξω ἄγειν καὶ ὑγρὰ καὶ θερμασίην καὶ πνεῦμα. ἀρήγει καὶ ὄσφρησις δριμέων, χρίσιες, ἄκρων δεσμός. τάδε μέντοι ποιέοντι ἢν μὴ εἴκῃ ἡ νοῦσος, ἀνέλπιστος ὁ ἄνθρωπος.
2. ALL the forms of the bringing up of blood are of an unmild character, not only as to mode, whether the flow proceed from rupture, erosion, or even rarefaction; and whether it come from the chest, the lungs, the stomach, or the liver, which are the most dangerous cases; but also from the head, although it occasions less mischief. For the flow is of blood; and blood is the food of all parts, the heat of all parts, and the colour of all parts. It is dreadful to see it flowing from the mouth in any way; but bad indeed if it proceed from an important viscus, and still worse if it proceed from rupture and erosion.
2. πᾶσαι δὲ ἰδίαι ἀναγωγῆς αἵματος οὐκ εὐήθεες, οὐ τοῦ τρόπου μοῦνον, ἢν ἐκ Ῥήξιος, ἢ διαβρώσιος, ἀλλὰ κἢν ἀραίωσις φέρῃ· οὐδʼ ἢν ἀπὸ θώρηκος, ἢ πνεύμονος, ἢ στομάχου, ἢ ἥπατος, τῶν κινδυνωδέων· ἀλλὰ κἢν ἀπὸ κεφαλῆς ἡ ἀσινεστέρη. αἵματος γὰρ ἡ φορή· αἷμα δὲ πάντων τροφὴ, πάντων δὲ θέρμη, πάντων δὲ χροιή· καὶ φοβερὸν μὲν ἰδεῖν διὰ στόματος ὁκωσοῦν Ῥέον· κακὸν δὲ, ἤν γε ἀπὸ σπλάγχνου καιρίου· κάκιον δὲ ἢν ἐκ Ῥήξιος καὶ διαβρώσιος.
It is necessary, therefore, that the physician should make the more haste in bringing assistance to this affection; and, in the first place, the patient must get coldish air to breathe, a chamber on the ground, and a couch firmly fixed, so that he may not be shaken (for all shaking is stimulant); the bed should be solid, not very yielding, nor deep, nor heated; his position erect; rest from speaking and hearing; tranquillity of mind, cheerfulness, since depression of spirits especially accompanies these cases; for who is there that does not dread death when vomiting blood?
χρὴ ὦν τὸν ἰητρὸν τοῦ πάθεος ξυνεπείγειν μᾶλλον ἀρήγοντα. καὶ πρῶτον μὲν ψυχρότερον αἱρέεσθαι ἠέρα ἐς ἀναπνοὴν, σηκὸν ἐπίπεδον, κλίνην ἑδραίην, ὅκως μηδὲν σείηται — ἐρεθιστικὸν γὰρ αἱ σείσιες — κοίτη δὲ στερεὴ, μὴ κάρτα εἴκουσα μηδὲ βαθείη, ἄθερμος· ὄρθιον δὲ τὸ σχῆμα· ἡσυχίη λαλιῆς, ἠδὲ ἀκουσμά των. ψυχῆς ἀταραξίη, εὐθυμίη. πάγχυ δὲ τοῖσι τουτέοισι ξυνομαρτέει δυσελπιστίη. τίς γὰρ ἐμέων αἷμα θάνατον οὐκ ὀρρωδέει; ἢν ὦν πολύαιμοι καὶ ἐπίφλεβοι ἔωσι, ἐπὶ πάσῃ ἰδέῃ ἀναγωγῆς τάμνειν φλέβα·
If, therefore, the patient be full of blood, and have large veins, in every form of rejection we must open a vein; whether it proceed from rupture, or erosion, venesection is very suitable; and even, if from rarefaction, there is danger, lest the fulness of blood burst forth. And we are to open the hollow vein at the elbow (for the blood flows readily from it, and it is easily opened, and the orifice can be safely kept open for several days). In a word, then, in all the diseases of all the vital organs, this is the outlet of the blood. For the one higher up and this are both branches of the humeral, so that the one above can have no more remedial power than the mesal. They are ignorant of these divisions who have connected the upper vein with the stomach and liver. But if the flow proceed from the spleen, they direct us to open the vein of the left hand, which runs between the little finger and the one next the middle; for certain physicians held it to terminate in the spleen; but it is a branch of the vein below those at the elbow. Why, then, should we rather open the vein at the fingers than the one at the elbow? for there it is larger, and the blood flows readily from it. Altogether, then, we are to stop before coming to deliquium animi. Yet neither, also, is much blood to be abstracted; for the hemorrhage itself is calculated to enfeeble the patient; but, after abstracting a small quantity, repeat the bleeding the same day, the next, and the day following. But if the patient be thin, and scantily supplied with blood, we must not open a vein. So much respecting the abstraction of blood.
ἤν τε γὰρ ἐκ Ῥήξιος ἢ διαβρώσιος, εὐάρμοστος φλεβοτομίη· ἤν τε ἐπʼ ἀραιώσι, δέος μὴ ἀπορρήξῃ τὸ πλῆθος· τάμνειν δὲ τὴν ἐπʼ ἀγκῶνι κοίλην· εὔροόν τε γὰρ τὸ αἷμα τῆσδε καὶ κατασχά ζεσθαι Ῥηϊδίη, καὶ ἐς πλεῦνας ἡμέρας Ῥέειν ἀσινέως εὔστομος. ἐπὶ πᾶσι δὲ πάντων, ὡς ἔπος εἰπεῖν, τῶν καιρίων σπλάγχνων ὁδὸς ἥδε αἵματος. ἡ δὲ ἀνωτέρη τῆσδε, καὶ ἥδε, ἀποσχίδες ἔασι, μιῆς τῆς ἀπὸ τοῦ βραχίονος, ἄμφω. ὥστε οὐδὲν μέζον ἡ ἀνωτέρω τῆς μέζης ἐς ὄνησιν ἴσχει. ἀΐδριες γὰρ τῶν ἀποσχισίων, ὅσοι στομάχῳ καὶ ἥπατι ξυνῆψαν τὴν ἄνω. ἢν δὲ ἀπὸ σπληνὸς Ῥὲῃ, ταμνεν τῆς ἀριστερῆς χειρὸς τήν μέσην δακτύλων μικροῦτε καὶ παραμέσου. τήνδε γὰρ τῶν ἰητρῶν μετεξέτεροι δοκέουσι ἐπὶ σπλῆνα κραίνειν· ἀτὰρ καὶ ἥδε τῶν ἐπʼ ἀγκῶνι τῆς κάτω ἐστὶ ἡ ἀπόσχισις. τί ὦν πλέον εἰ πρὸς τοῖσι δακτύλοις, καὶ μὴ ἐπʼ ἀγκῶνι τάμνοι τις αὐτέην; μείζων γὰρ τῇδε καὶ εὔροος. τὸ ξύμπαν μὲν ὦν πρόσω λειποθυμίης ἐπισχεῖν· ἀτὰρ μηδὲ πολλὸν ἀφαιρέειν. ἱκανὴ γὰρ καὶ ἡ αἱμορραγίη γυιῶσαι τὸν ἄνθρωπον. ξυνεχὲς δὲ καὶ ἀπὸ σμικρῆς ἀφαιρέσιος ἐπαφαιρέειν, καὶ αὐτῆμαρ, καὶ τῆς ὑστεραίης, καὶ ἐπὶ τῆς ἄλλης ὑστέρης. ἢν δὲ ὁ ἀσθενέων ἰσχνὸς καὶ λείφαιμος ἔῃ, μὴ τάμνειν φλέβα. τάδε μὲν ὦν ἀμφὶ ἀφαιρέσιος αἵματος.
We are also to assist by means of ligatures to the extremities. Above the feet to the ankles and knees, and above the hands to the wrists and arms, a broad band is to be used, so that the constriction may be strong, and yet not produce pain. To the regions, also, from which the blood flows, we are to apply unwashed wool from the sheep; but moisten it with a liquid, such as austere wine, and the oils of roses and of myrtles. But if the hemorrhage be of an urgent nature, instead of the wool we are to use sponges, and vinegar instead of the wine, and let the part be anointed with myrtle oil; and we are to dust upon the sponges some of the dry inspissated juices, such as that of acacia, or of hypocistis, or else of aloes. The juice of the unripe grape, dissolved in vinegar, is also a very excellent thing. But if the liquid application be troublesome or disagreeable, we are to use plasters; for these stretch the skin around, and press it, as it were, with the hand, and they are possessed of very strong powers as astringents and desiccants. In addition to these, there are very many others of tried efficacy; but the best are those which contain vinegar, and the expressed juice of ivy leaves, and asphaltos, and verdigris, alum, frankincense, myrrh, calcined copper, the squama æris, and such of the plasters as resemble these; or unscoured wool, or sponges damped in a small quantity of vinegar. But if the patients cannot bear the distension of the plasters, we are to make these things into an epitheme: fat dates, damped in dark austere wine, are pounded into a cake; then we are to sprinkle on it acacia in a soft state, and the rinds of pomegranate; these things having been all rubbed upon a rag, are applied to the chest. Barley-meal, moistened in wine or vinegar, or the fine flour of the dried lentil, sifted in a sieve, and made up with cerate or rose ointment, is to be applied; we are also to mix some of the root of the comfrey sifted. Another: Boil the roots of the wild prunes in vinegar, and having pounded into a cake, mix a little of sumach, and of gum, and of myrtle. These are to be mixed with one another differently, according as the strength of the medicines, mildness, or smell thereof is wanted. For we must also gratify the sick. These are the external remedies.
ἀρήγειν δὲ καὶ δεσμοῖσι ἄκροις· ποδῶν μὲν, ὑπὲρ σφυρὰ καὶ γούνατα· χειρῶν δὲ, ὑπὲρ καρπὸν καὶ βραχίονα· ταινίη πλατείη, ὅκως ἡ διάσφιγξις κραταιὴ μὲν ᾖ, ἄλγος δὲ μὴ φέρῃ· τοῖσι δὲ αἱμορραγέουσι χωρίοισι ἐπιβάλλειν χρὴ ἔρια μὲν πινόεντα οἰσύπῳ ἀπὸ τῆς ὀΐος· τέγγειν δὲ χυμῷ, οἴνῳ αὐστηρῷ, καὶ Ῥοδίνῳ, ἢ μυρσίνῳ λίπαϊ. ἢν δὲ ξυνεπείγῃ ἡ αἱμορραγίη, ἀντὶ μὲν τῶν ἐρίων σπόγγοισι χρέεσθαι· ὄξεϊ δὲ, ἀντὶ τοῦ οἴνου. ὑπαλειφέσθω δὲ μυρσίνῳ τὸ χωρίον· ἐπιπάσσειν δὲ τοῖσι σπόγγοισι τῆς ἀκακίης, ἢ ὑποκιστίδος ξηρῶν τῶν χυλῶν, ἢ καὶ ἀλόης. ἄριστον δὲ καὶ τὸ ὀμφάκιον ὄξεϊ λυθέν. ἢν δὲ ἡ τέγξις ἄσηρον ᾖ καὶ δύσφορον, ἐμπλάστροισι χρέεσθαι. καὶ γὰρ τὸ δέρμα περιτείνουσι, καὶ οἷον τῇ χειρὶ κρατέουσι. ἀτὰρ καὶ αἱ δυνάμεις αὐτέων στῦψαι καὶ ξηρῆναι δυνατώταται. μυρίαι δὲ καὶ ἄλλοισι ἄλλαι πείρῃ ἔασι πισταί· ἄρισται δὲ ὁκόσαι ὄξος ἴσχουσι καὶ ἰτέης φύλλων χυλὸν, ἠδὲ καὶ ἄσφαλτον, καὶ ἰὸν, καὶ στυπτηρίην, καὶ λιβανωτὸν, καὶ σμύρνην, καὶ χαλκὸν κεκαυμένον καὶ λεπίδα, καὶ ὁκόσαι τοιαῖδε ἐπὶ τοῖσι ἐμπλάστροισι· ἢ ἔρια τὰ πινόεντα, ἢ οἱ σπόγγοι ἐν βραχέϊ δευθέντες ὄξεϊ· ἢν δὲ τὴν τάνυσιν τῶν ἐμπλάστρων μὴ φέρωσι, ἐπίθεμα ποιέειν· φοίνικες οἱ πίονες ἐν οἴνῳ μέλανι αὐστηρῷ δευθέντες ἐς μᾶζαν τρίβονται· ἔπειτα ἀκακίη ἐμπάσσεται λείη καὶ σίδια· ἐγχρισθέντα δὲ ἐς τρύχιον κατὰ τοῦ θώρηκος τίθεται. ἄλφιτα οἴνῳ, ἢ ὄξεϊ δευθέντα, ἠδε φακῆς ἄλητον λεπτὸν, κρησέρῃ σεσησμένον, κηρωτῇ ἢ Ῥοδίνῳ μύρῳ ἀναλαμβάνοντα τιθέναι. μίσγειν δὲ καὶ συμφύτου τῆς Ῥίζης σεσησμένης. ἄλλο· βραβύλων ἀγρίων Ῥίζας ἑψεῖν ἐν ὄξεϊ καὶ τρίψαντα ἐς μᾶζαν, παραμίσγειν Ῥοὸς, καὶ κόμμιος, καὶ μυρσίνης βραχύ. τῶνδε μέντοι γε ἄλλα ἄλλοισι ξυμμίσγειν, ὅκως ἂν ἰσχύος τῆς τῶν φαρμάκων καὶ προσηνείης καὶ ὀσμήσιος δέηται. χρὴ γὰρ καὶ τοῖσι κάμνουσι χαρίσασθαι.
But a more important part of the treatment lies in things drunk and swallowed, since these remedies come nearest the injured parts. Of these there are three distinct kinds: either they are calculated by the contraction or compression of the vessels to bind the passages of the flux; or to incrassate and coagulate the fluid, so that it may not flow, even if the passages were in a state to convey it; or to dry up the outlets, by retaining the blood in its pristine state, so that the parts may not thus remain emptied by the flux, but may regurgitate where the effusion is. For rarefaction of the veins, astringency is sufficient, for it runs through the pores like a fluid when poured into a water-cask newly wetted. And also in the division of vessels stypticity is the remedy, by producing contraction of the lips; but for this purpose we must use the greater and more powerful medicines. But if the form of hemorrhage be that from erosion, and if the lips of the ulcer do not coalesce by the action of the astringents, but the wound gapes, and cannot be brought together by compression, we must produce congelation of the blood, and also of the heat; for the flow is stopped by the immobility and coagulation of these. To the rare parts, then, oxycrate is sufficient for producing astriction; for the fluid is not pure blood, but the sanies thereof from small orifices; and even of this medicine, there is no necessity of much being given, or frequently; and in certain cases, the external treatment is sufficient. So, likewise, the decoction of dates and of edible carobs, when drunk, has by itself proved sufficient. Let the vinegar be from wines of an astringent nature, and if not by pharmaceutical preparation, at all events let it be such as by time has become acrid and astringent. But in dilatations of the wounds, in addition to the oxycrate, let there be given the simple medicines at first, such as the juice of plantain, of knot-grass, or of endive; of each an equal part with the oxycrate. But if the flow increase, sprinkle on it one dram of the dried hypocistis, or of acacia, on three cupfuls of the oxycrate. The juice, also, of the wild grape is very excellent. But if the ailment prevail over this, sprinkle on it triturated gall, and the dried root of the bramble, and the sea stone, the coral, triturated and dried. But the root of rhubarb is more powerful than these to cool, to dry, to astringe; in short, for every purpose. But it is used with the oxycrate alone; or, if more powerful things are required, as a remedy. To the juices of endive with plantain we add some of the root, namely, three oboli of it to three or four cyathi of the fluid. But in crosions, we must produce astringency even in it, so as to induce coagulation of the blood that flows, and also for the sake of the containing vessels, so that the veins which have sustained a large wound may shut their mouths. But the medicines which are drunk should be strong, and capable of inducing coagulation. Wherefore, give the juice of coriander with vinegar, and the rennet of a hare, or of a hind, or of a kid, but not in great quantity (for certain of these have proved fatal in a large dose); but of the juice of the coriander give not less than half a cyathus to three of the oxycrate, and of the rennet three oboli, or at most four. For such modes of the flow, the Samian earth is very excellent, and the very white Aster, and the Eretrian, and the Sinopic, and the Lemnian seal: of these, at least, one dram weight, and at most three, with some of the decoctions, as of dates, or of edible carobs, or of the roots of brambles. But if there be roughness of the windpipe, and cough along with it, we must sprinkle these things on Cretic rob. Starch, dissolved in these, is a most excellent thing for lubricating the windpipe; for along with its power of lubricating, it also possesses that of agglutinating. If, therefore, the flow of blood be not urgent, it must be given once a day, before the administration of food; but if it be urgent, also a second and third time in the evening. And from the medicines are to be made draughts of the dried substances with honey, boiled to the proper consistence; galls pulverised: and a very good thing is sumach for the condiments, also grape-stones, and the fruit of the sharp dock, either each by itself, or all together. These things, moreover, are good to be kept below the tongue during the whole time of melting; but likewise common gum with the plant, (?) and the gum tragacanth. The compound medicines of tried efficacy are infinite; and various are the usages of trochisks—of that from Egyptian thorn, of another from amber, and another named from saffron, of which the composition has been described separately.
τάδε μὲν ἐκτὸς θετὰ ἄκη. Ἡ δὲ τῶνδε καιριωτ έρη ἴησις ἐν τοῖσι ποτοῖσι καὶ καταπότοισι κέεται, ὡς ἄγχιστα τῶν τετρωμένων ἔῃ τὰ φάρμακα. τρισσὴ δὲ τουτέων ἡ ἰδέη· ἢ τοὺς ὀχετοὺς τοῦ Ῥοοῦ δῆσαι, ξυναγωγ ῇ καὶ πιέσι τῶν ἀγγείων, ἢ τὸ Ῥέον παχῦναί τε καὶ πῆξαι ὡς μὴ διαρρέῃ, κἢν παραπέμπωσι οἱ ὀχετοί· ἢ ξηρῆναι τὰς ἐφόδους πρὸς ἕδρην τὴν ἀρχαίην τὸ αἷμα στήσαντα, ὅκως μὴ τῇ ἐπιρροῇ κενεόμενοι οἱ χῶροι προσμενέωσι, πλημμυρῶσι δὲ ἔνθα ἡ ξύνδοσις. ἐπὶ μὲν τῆς ἀραιώσιος τῶν φλεβῶν ἡ στῦψις ἀρκέει. διαρρέει γὰρ, ὡς ὑδρεῖον νέον δευθὲν, τῇσι ἀραιώσεσι. ἀτὰρ ἠδὲ ἐπὶ τῇσι διαιρέσεσι στῦψις μὲν ἰητρείη ἐς τὴν ξυναγωγὴν τῶν χειλέων· μέζοσι δὲ καὶ δυνατωτέροισι τοῖσι φαρμάκοις χρέεσθαι. ἢν δὲ ὁ τῆς διαβρώσιος ἔῃ τρόπος, καὶ μὴ ξυνάγηται ὑπὸ τῆς στύψιος τοῦ ἕλκεος τὰ χείλεα, σεσήρῃ δὲ τὸ τρῶμα, ἀξύμβατον ἐκ τῆς διαθλίψιος ἐὸν, πάγον χρὴ τοῦ αἵματος, ἀτὰρ ᾐδὲ τῆς θέρμης ποιέειν. ἀκινησίῃ γὰρ τῶνδε καὶ πήξι ἵσταται ὁ Ῥόος. ὀξύκρητον μὲν ὦν τοῖσι ἀραιοῖσι ἱκανὸν ἐς στῦψιν. οὐδὲ γὰρ οὐδὲ αἷμα ἄκρητόν ἐστι τὸ Ῥέον, ἀλλὰ τοῦδε ἰχὼρ διὰ σμικρῶν τῶν στομίων· καὶ τοῦδε οὐ πολλοῦ οὐδὲ πολλάκις χρέος· μετεξετέροισι δὲ καὶ ἡ ἔξωθεν ἰητρείη· ἀτὰρ καὶ φοινίκων ἢ κεράτιων ἐδωδίμων ἕψημα ποθὲν, μοῦνον ἤρκεσε. ἔστω δὲ τὸ ὄξος οἴνων μὲν τῶν στυφόντων τῷ γένεϊ, εἰ μὴ φαρμακείῃ δὲ, ἀλλὰ τῷ χρόνῳ δριμύτε καὶ στῦφον. ἐπὶ δὲ τῇσι διαστάσεσι τῶν τρωμάτων πρὸς τῷ ὀξυκρήτῳ ἔστω φάρμακα ἁπλᾶ τὴν πρώτην, ἀρνογλώσσου χυλὸς, ἢ πολυγόνου, ἢ σέριδος, ἑκάστου μοίρη πρὸς τῷ ὀξυκρήτῳ· ἢν δʼ ἐπὶ μᾶλλον Ῥέῃ, ὑποκιστίδος, ἢ ἀκακίης ξηρῶν ἐμπάσσειν, ἐς γ′ κυάθους τοῦ ὀξυκρήτου, ὁλκῆς τῶνδε δραχμὴν μίην. ἄριστος δὲ καὶ χυλὸς ὄμφακος. ἢν δὲ κρέσσων ἡ ξυμφορὴ τῷδε γίγνηται, κηκίδα λείην καὶ βάτου Ῥίζην ξηρὴν, καὶ λίθον τὴν ἐξ ἁλὸς κουράλλιον λείην ξηρὴν ἐμπάσσειν. δυνατωτέρη δὲ τῶνδε τοῦ Ῥήου ἡ Ῥίζα, ἐμψῦξαι, ξηρῆναι, στῦψαι, τὰ πάντα ποιῆσαι· ἀτὰρ καὶ ἥδε ξὺν τῷ ὀξυκρήτῳ μούνῳ· ἢν δὲ μεζόνων ἀρήγειν χρέος, τοῖσι χυλοῖσι σέριδος, ξὺν ἀρνογλώσσῳ, τῆς Ῥίζης ἐμπάσσειν ὁλκῆς τριώβολον, ἐς κυάθους τοῦ ὑγροῦ τρεῖς ἢ τέσσαρας. ἐπὶ δὲ τῇσι διαβρώσεσι τότε ὅλως ἐν ἐκείνῃ στῦψιν ἐμποιέειν ἐς πάγον τοῦ διαρρέοντος αἵματος· καὶ τοῖσι δεχομένοισι ὅκως ἀπὸ πολλοῦ τοῦ τρώματος μύωσιν αἱ φλέβες· ἀλλὰ καὶ τὰ πινόμενα ἔστω κραταιὰ, δυνατὰ ποιῆσαι πάγον. χυλὸν ὦν κοριάνου ξὺν ὄξεϊ, ἠδὲ λαγοῦ ταμισὸς, ἢ νεβροῦ, ἢ ἐρίφου, μὴ πολλὸν δὲ διδόναι. ἔκτεινε γάρ κοτε τουτέων τι τῷ πλήθεϊ· ἀλλὰ τοῦ μὲν χυλοῦ τοῦ κοριάνου μὴ μεῖον μὲν ἡμικυάθου ἐς τρεῖς τοῦ ὀξυκρήτου, τῆς δὲ ταμισοῦ ὀβολοὶ μὲν τρεῖς, τὸ δὲ πλεῖστον ὀβολοὶ δʼ. ἐς δὲ τὰ τοιάδε εἴδεα τῆς φορῆς, καὶ γῆ ἀρίστη Σαμία, καὶ ἀστὴρ κάρτα λευκὸς, καὶ Ἐρετριὰς, καὶ Σινῶπις, καὶ σφραγὶς ἡ Λημνίη. τουτέων δὲ ὁλκὴ σταθμοῦ, τὸ μεῖον, ά. τρεῖς δὲ τὸ πλεῖστον· ξύν τινι τῶν ἑψημάτων, φοινίκων, ἢ κερατίων ἐδωδίμων, ἢ Ῥιζῶν βάτων· ἢν δὲ τρηχύνηται ἡ ἀρτηρίη καὶ ἐπὶ τῷδε βήσσῃ, σιραίῳ τῷ Κρητικῷ ἐμπάσσειν τάδε. ἄριστον ἐς λείωσιν ἀρτηρίης καὶ ἄμυλος ξὺν τοῖσι δευθείς· ξὺν γὰρ τῷ λείῳ καὶ τὸ παγερὸν ἴσχει. ἢν μὲν ὦν μὴ ξυνεπείγῃ ἡ φορὴ, ἅπαξ τῆς ἡμέρης πρὸ τῆς προσάρσιος δοτέον· ἢν δὲ, καὶ δὶς καὶ τρίτον ἐς τὴν ἑσπέρην. ἐκ δὲ τῶν φαρμάκων καὶ κατάποτα ποιέειν ξηρῶν ἐν μέλιτι ἑφθῷ ἐς σύστασιν· κηκὶς λείη· ἄριστον δὲ καὶ Ῥόος ἐς τὰ ὄψα, γίγαρτα, καὶ ὁ ὀξυλαπάθου καρπὸς, καὶ ἰδίῃ ἑκάστου, καὶ ξυνῇ. τάδε μέντοι καὶ ὑπὸ τῇ γλώσσῃ ἔχειν ἐς τὸ διηνεκὲς τῆς συντήξιος. ἀτὰρ καὶ κόμμι ξὺν τῷ φυτῷ καὶ τράγου τῆς ἀκάνθης τὸ δάκρυον· ποικίλων δὲ φαρμάκων μυρίη μὲν ἡ πείρη, ποικίλαι δὲ καὶ χρήσιες, τροχίσκων, τοῦ διὰ τῆς Αἰγυπτίας ἀκάνθης, καὶ ἑτέρου διʼ ἠλέκτρου, καὶ ἄλλου τοῦ κροκώδεος, ὧν ἡ σκευασίη ἰδίῃ λέλεκται.
In the absence of fevers, everything is to be attempted in regard to medicines, giving them copiously and frequently. But if fever come on—and most frequently fever takes place, along with inflammations of the wounds—we must not stop the flow suddenly, nor give medicines during the paroxysms, for many die sooner of the fevers than of the flow of blood.
ἄνευ μὲν ὦν πυρετῶν ἅπαντα τολμέειν ἐπὶ τοῖσι φαρμάκοισι, καὶ πολλὰ καὶ πολλάκις διδόντα· ἢν δὲ ἐπιπυρεταίνωσι, — τὰ πολλὰ καὶ ἐπὶ τῇσι φλεγμασίῃσι τῶν τρωμάτων γίγνονται πυρετοὶ, — μήτε ἀθρόον ἴσχειν τὴν φορὴν, μήτε ἐν τοῖσι παροξυσμοῖσι φάρμακα πιπίσκειν.
The articles of food are various in kind like the medicines, but also “the medicines are in the food;” for neither would it be easy to find all the good properties of food in any one article, nor even if a solitary thing were sufficient for the cure, should one only be used, as one would thus readily produce satiety; but we must grant variety if the disease should prove prolonged. Let the food, then, be astringent and refrigerant in properties, as also to the touch, for heat encourages bleeding. Washed alica; rice added to oxycrate; but if the vinegar excite coughing, the decoction of dates; baked bread which has been dried and pounded down to meal, and sifted. Of all these things a draught is to be made with oil; savory seasoned with salts, and sumach to be sprinkled upon it. And if you wish to gratify the patient’s palate, let coriander be added, for this purpose, whenever it is agreeable, or any of the diuretic and diffusible seeds. Lentil, then, with the juice of plantain, if the hemorrhage be urgent, but if not, we should spare the juice, for neither is it of easy digestion, nor pleasant to the taste; for in these cases we must not give indigestible things. But if you apprehend death from the hemorrhage, you must also give what is unpalatable and indigestible; nay, let even harsh things be given if they will preserve life; wherefore, let galls, dried and pulverised, be sprinkled when dry, and cold lentil: eggs thick from boiling, with the seeds of pomegranate or galls, for the food necessarily consists in the medicines. The drink altogether should be scanty, since liquids are incompatible with a dry diet. These are the proper things, provided you wish to astringe and cool. But if you wish also to thicken the blood and spirit (pneuma), milk along with starch and granulated spelt (chondrus), the milk being sometimes given with the starch, and sometimes with the chondrus; they should be boiled to such a consistence as that the draught may not be liquid. But if you wish to incrassate and astringe still more, let the chondrus be boiled with dates, and for the sake of giving consistence, let there be starch and milk; and the Tuscan far is a very excellent thing, being thick, viscid, and glutinous when given along with the milk; the rennet of the kid is to be added to the liquid decoctions for the sake of coagulation, so that with the milk, it attains the consistency of new cheese: still thicker than these is millet boiled with milk like the far, having gall and pomegranate rind sprinkled on it as a powder. But we must look to the proportions of the desiccants and incrassants, for all these things provoke coughing, and in certain cases, from excess of desiccant powers, they have burst the veins. But if things turn out well, and the blood is stopped, we must gradually change to the opposite plan of treatment, “and nothing in excess,” for these cases are apt to relapse, and are of a bad character. We must also strive to put flesh and fat on the patient by means of gestation, gentle frictions, exercise on foot, recreation, varied and suitable food.
πολλοὶ γὰρ ὑπὸ πυρετῶν θᾶσσον ὄλλυνται ἢ ὑπὸ τῆς τοῦ αἵματος φορῆς. τροφαὶ ποικίλαι καὶ τὴν ἰδέην ὁκοῖα τὰ φάρμακα. ἀτὰρ καὶ τὰ φάρμακα ἐν τροφῇ. οὔτε γὰρ ἐπὶ μιῇ μούνῃ ἅπαντα εὑρεῖν τὰ τροφῆς ἀγαθὰ εὔπορον, οὔτε, ἢν μὲν οὖν μούνη ἐς ἰητρείην ἀρκέῃ, μιῇ μούνῃ χρέεσθαι, διὰ τὸν κόρον Ῥηίδιον. καὶ γὰρ τὰ ποικίλα εἴκειν, εἰ δὴ ἀπὸ χρόνιον γίγνεται. ἔστω ὦν στύφουσα καὶ ἐς δύναμιν ψύχουσα· ἀτὰρ ἠδὲ ἐς θίξιν· θέρμη γὰρ αἵματος πρόκλησις. χόνδροι πλυτοί· ὄρυζα ἐς ὀξύκρητον· ἢν δὲ τὸ ὄξος βῆχας ἐμποιέῃ, φοινίκων ἕψημα, ἄρτος ὀπτὸς, κατάξηρος, κοπεὶς, ἠδὲ καὶ ἐς ἄλητον σεσησμένος. ἁπάντων ὦν Ῥόφημα ξὺν λίπαϊ· θύμβρη ἁλσὶ ἡδυνθεῖσα, Ῥοὸς ἐπίπασμα. ἢν δὲ καὶ χαρίσασθαί τι κάμνοντι ἐθέλῃς, κορίανον ἔστω ἐς ἡδονὴν ὅτῳ φίλον, ἤ τι τῶν οὐρητικῶν ἠδὲ εὐπνόων σπερμάτων. φακὸς, ἢν μὲν ἡ αἱμορραγίη ἐπείγῃ, ξὺν ἀρνογλώσσου χυλῷ· ἢν δὲ μὴ, τοῦ χυλοῦ ἔστω φειδώ. οὐ γὰρ εὔπεπτον οὐδὲ προσηνὲς ἐς γεῦσιν. χρὴ δὲ τουτέοισι ἥκιστα πάντων δύσπεπτα διδόναι. ἢν δὲ ἐξ αἱμορραγίης θάνατον ὀρρωδέῃς, καὶ ἀτερπὲς καὶ δύσπεπτον· ἠδὲ ἀπηνέα ἔστω τὰ σώζοντα. κηκὶς ὦν ξηρὴ, λείη, προσεπιπασσέσθω φακῷ τῷ ξηρῷ καὶ ψυχρῷ· ὠὰ ἑψήσι παχέα, ξὺν Ῥοιῆς σιδίοισι, ἢ κηκῖδι. ἥδε ἐστὶ ὑπʼ ἀνάγκης ἐν φαρμάκῳ τροφή· ποτὸν δὲ τὸ ξύμπαν ὀλίγον ἔστω· ξηρῇ γὰρ διαίτῃ ὑγρὸν ἀξύμφορον. τοιάδε μὲν, στῦψαι καὶ ψῦξαι εἰ ἐθέλεις· ἢν δὲ παχῦναι καὶ αἷμα καὶ πνεῦμα, γάλα καὶ ἄμυλος καὶ χόνδροι, ἄλλοτε μὲν ξὺν ἀμύλῳ, ἄλλοτε δὲ ξὺν χόνδρῳ γάλα· ἐς πῆξιν δὲ ἡ σύστασις ὡς μὴ Ῥόφημα ὑγρὸν ᾖ. ἢν δὲ ἐπὶ μᾶλλον παχῦναι καὶ στῦψαι ἐθέλῃς, οἱ χόνδροι μὲν ξὺν φοίνιξι ἑψείσθωσαν· ἐς δὲ τὴν σύστασιν, ἄμυλος ἔστω, καὶ γάλα, ἄριστον καὶ φὰρ τὸ Τυρρηνικὸν, παχὺ ἐὸν καὶ γλίσχρον, καὶ κολλῶδες ξὺν τῷ γάλακτι· ταμισοῦ δὲ τοῦ ἐρίφου ὑγροῖσι τοῖσι ἑψήμασι προσεγχέειν ἐς πῆξιν, ὅκως ἐπὶ γάλακτι ἐς νέου τυροῦ ξύστασιν ἴσχει· παχύτερον δὲ τουτέων, κέγχρος ἑφθὸς ξὺν γάλακτι ὡς τὸ φὰρ, καὶ τὸ ἐπίπαστον ἡ κηκὶς καὶ τὰ σίδια. τεκμαίρεσθαι δὲ τὰς ξυμμετρίας τῶν ξηραινόντων ἢ παχυνόντων· καὶ γὰρ βηχώδεα ταῦτα, ὑπερβολῇ τε ξηρότητος μετεξετέροισι προσέρρηξε τὰς φλέβας. ἢν δὲ εὖ πρήσσηται μὲν, ἴσχηται δὲ τὸ αἷμα, ἐς τἀναντία ἐκ προσαγωγῆς ἡ μεταβολή· καὶ μηδὲν ἄγαν. φιλόστροφα γὰρ τάδε καὶ κακοήθεα. χρὴ δὲ σαρκοῦν ἤδη τὸν ἄνθρωπον καὶ τὰς ὠτειλὰς ἐς τὸ πιηρὸν ἄγειν, αἰώρῃς, ἢ τρίψεσι μαλθακῇσι, περιόδοισι, θυμηδίῃσι, τροφῇ ποικίλῃ καὶ ξυνήθεϊ.
These are the means to be used if, after the flow of blood, the wound adhere and the part heal properly. But if the ulcer remain and become purulent, another plan of treatment is needed, for a discharge of different matters succeeds. This, however, will be treated of among the chronic diseases.
τάδε μὲν ὦν, ἢν ἐκ τῆς φορῆς τοῦ αἵματος τὸ τρῶμα ξυμπεσῃ, καὶ ὁ χῶρος ὑγιασθῇ εὐακέως· ἢν δ͵ ἐγκαταλείπηται ἕλκος, καὶ διάπυον γίγνηται, ἑτέρης μελέτης χρέος· καὶ γὰρ καὶ ἑτέρων διαδέχεται ἡ φορή. περὶ τῆσδε μέντοι ἐν τοῖσι χρονίοισι λελέξεται.
3. IN Syncope, it is necessary that the physician should exercise fore-knowledge; for, if you foresee its approach, and if things present co-operate strongly with you, you may avert it before its arrival. When it is come on, patients do not readily escape from it, for I have said that syncope is the dissolution of nature; and nature when dissolved cannot be restored. We must try to prevent it then, when still impending, or if not, at the commencement. We must form our prognosis from the circumstances stated by us among the acute diseases, where we have described the cause and also the symptoms. The fever Causus, then, is the commencement of the attack, and with Causus the worst of symptoms, dryness, insomnolency, heat of the viscera, as if from fire, but the external parts cold; the extremities, that is to say, the hands and feet, very cold; breathing slowly drawn; for the patients desiderate cold air, because they expire fire: pulse small, very dense, and trembling. Judging from these and the other things stated by me among the symptoms, you will immediately give assistance at the commencement.
3. ἐν συγκοπῇ μάλα χρὴ τὸν ἰητρὸν πρόνοιαν ἐπιτηδεύειν· μέλλουσαν μὲν γὰρ ἢν προγιγνώσκῃς, τά τε παρεόντα ἐπεσσυμένως συνεργοῖένσοι, ἀτὰρ ἠδὲ ἐξελάοις ἂν αὐτέην πρὶν ἥκειν. παρεοῦσαν δὲ οὐ Ῥηϊδίως διδρήσκουσι οἱ νοσεῦντες. λύσιν γὰρ τῆς φύσιος τὴν συγκοπὴν ἔλεξα· οὐ παλίσσυτος δὲ φύσις λυθεῖσα. τήνδε ὦν μάλιστα μὲν μέλλουσαν κωλύειν· ἢν δὲ μὴ, ἄρτι ἀρχομένην. προγιγνώσκειν δὲ χρὴ τοῖσι ἐν τοῖσι ἀμφὶ τῶν ὀξεῶν νούσων λελεγμένοισι, εὖτε τὴν αἰτίην, ἀτὰρ ἠδὲ καὶ τὰ σημήϊα ἐφραζόμεθα. καῦσος μὲν γὰρ ὁ πυρετὸς ἀρχή. ἐπὶ δὲ τῷ καύσῳ κάκιστα σημήϊα, ξηρότης, ἀγρυπνίη, θερμασίη τῶν σπλάγχνων, ὅκως ἀπὸ πυρὸς, ψυχρὰ δὲ τὰ ἔξω· χεῖρες καὶ πόδες ἄκροι ψυχρότατοι· ἀναπνοὴ ἐς ὁλκὴν μακρή· ποθέουσι γὰρ ψυχρὸν ἠέρα, οὕνεκεν ἐκπνέουσι πῦρ. σφυγμοὶ μικροὶ, πυκνότατοι, τρομώδεες. ἐκ τῶνδε ὦν τεκμαιρόμενος ἠδʼ ὁκόσα μοι ἐν τοῖσι σημηΐοισι λέλεκται, αὐτίκʼ ἐξ ἀρχῆς ἀρήγειν.
Unless, then, when everything is against it, the habit, the age, the season, the timidity of the patient, we must open a vein, and even if many symptoms contra-indicate it, but an especial one require it, such as the tongue rough, dry, and black (for it is indicative of all the internal parts). And in all cases we must form an estimate of the strength, whether or not it has failed owing to the pains of the disease and the regimen; for the loss of strength takes place, not only from deficiency, but also from smothering; and if the syncope arise from redundancy, and if inflammation of the hypochondria, or of the liver strongly indicate, there is no necessity for deferring the bleeding. We are to open the hollow vein at the elbow, and abstract the blood by a small orifice, that it may not have a marked effect on the strength; for sudden depletion tries the natural strength: and we must take away much less than if from any other cause; for in syncope, even a slight mistake readily sends a man to the regions below. We must, therefore, immediately give food for the restoration of the strength; for Nature delights in the removal of the old, and in the supply of new things.
ἢν ὦν μὴ πάντα κωλύῃ, ἕξις, ἡλικίη, ὥρη, ἀψυχίη τοῦ ἀνθρώπου, τάμνειν φλέβα· κἢν πολλὰ κωλύῃ, εἷς δέ τις ἀριθμὸς ἐπίκαιρος ᾖ, ὁκοῖον γλῶσσα τρηχείη καὶ ξηρὴ καὶ μἕλαινα· ἥδε τοι γὰρ τὰ εἴσω πάντα σημαίνει· ξυντεκμ αίρεσθαι δὲ ἐπὶ πᾶσι τὴν δύναμιν, εἰ μὴ προαπηύδηκε ἐκ τῆς νούσου πόνων τε καὶ διαίτης. οὐδὲ γὰρ οὐδὲ ἐνδείῃ μοῦνον, ἀλλὰ καὶ πνιγί. ἢν δʼ ὑπὸ πλήθεος γίγνηται συγκοπὴ, καὶ φλεγμασίη τις ὑποχονδρίου, ἢ ἥπατος, μέγα διασημαίνῃ, οὐδὲ ἀμβολῆς χρέος. τάμνειν δὲ τὴν ἐπʼ ἀγκῶνι τὴν κοίλην· ἀτὰρ ἠδὲ διὰ σμικρῆς τῆς σχάσιος ἀφαιρέειν, ὡς μὴ σφόδρα τῇ δυνάμει ἐπίδηλονᾖ. ἐλέγχει γὰρ τὴν φύσιν τὸ ἀθρόον· καὶ πολλόν τι μεῖον ἢ διʼ ἄλλας προφάσιας ἀφαιρέειν. ἢν γὰρ ἐπὶ συγκοπῇ καὶ σμικρὸν ἁμαρτῴη, Ῥηϊδίως εἰς ᾄδου τρέπει. αὐτίκα ὦν διδόναι τροφὴν ἐς νεόχμωσιν τῆς δυνάμιος· γάνυται γὰρ ἡ φύσις καὶ τῇ τῶν παλαιῶν ἀπαλλαγῇ, καὶ τῇ τῶν ποταινίων προσθήκῃ.
But if the strength reject venesection, and inflammations be present, we must apply the cupping-instrument to the seat thereof a considerable time previous to the crisis of the disease; for the crisis takes place at the critical periods; since at the same periods Nature brings on a favourable crisis, and diseases prove fatal. And if the patient should come to such a state as to require wine, it is not very safe to take wine in inflammations; for, wine to persons labouring under inflammation is an increase of the pains, but to those free from inflammation it is an increase of the natural strength. A day or two before the cupping there is need of cataplasms, both in order to produce relaxation of the parts and to procure a flow of blood; and in certain cases, after the cupping, we are to apply a cataplasm on the next day. In this, too, let there be moderation; for there is the same danger from the abstraction of too much blood by cupping. Use clysters only for removing scybala which have long lodged in the bowels; but spare the strength.
ἢν δὲ φλεβοτομίην μὲν ἡ δύναμις ἀποτρέπῃ, φλεγμασίαι δὲ ἔωσι, σικύην τῇδε προσβάλλειν πολὺ πρόσθεν τῆς κρίσιος τοῦ νοσήματος. ἐν κρισίμοισι γὰρ ἡ συγκοπή· ἐπεὶ τῇσι αὐτέῃσι περιόδοισι αἵ τε φύσιες κρίνουσι, αἵ τε νοῦσοι κτείνουσι. κἢν γὰρ ἐς ἀνάγκην οἰνοποσίης ἥκῃ ὁ ἄνθρωπος, οὐ κάρτα ἀσφαλὲς ἐπὶ φλεγμον ῇσι οἰνοποτέειν. οἶνος γὰρ φλεγμαίνουσι μὲν πόνων ἐπίδοσις, ἀφλεγμάντοισι δὲ φύσιος αὔξησις. ἐπίπροσθεν δὲ τῆς σικύης, πρὸ μιῆς ἢ δευτέρης, ἐπιπλάσιος χρέος, ἔς τε ἄνεσιν τῶν μερέων, ἀτὰρ ἠδὲ ἐς εὐροὴν τοῦ αἵματος· μετεξετέροισι δὲ καὶ ἐπὶ τῇ σικύῃ ἐς τὴν δευτέρην ἐπιπλάσσειν. ἔστω δὲ καὶ τῇδε φειδώ· κίνδυνος γὰρ ωὐτὸς τοῦ αἵματος τῆς ἀμετρίης καὶ ἐπὶ τῇ σικύῃ. κλυσμοῖσι δὲ ἐπὶ σκυβάλοισι παλαοῖσι μοῦνον χρέο· τῆς δυνάμιος δὲ φείδεο.
Cold lotions to the head, such as have been directed by me under Phrenitis, but somewhat more liberally. Pure air, rather cooler than otherwise, for respiration. The delight of the sight is to be studied as to plants, painting, waters, so that everything may be regarded with pleasure. The conversation of attendants cheerful; silence and cheerfulness on the part of the patient. Smells fragrant, not calculated to prove heavy to the senses in the head. And let the articles of food also possess a fragrant smell, such as flour moistened with water or vinegar; bread hot, and newly baked. The mouth not to be very often rinsed with wine, nor is it to be altogether rejected.
τέγξιες κεφαλῆς ψυχραὶ, ὁκόσαι μοι ἐπὶ φρενιτι κοῖσι λελέχαται, ὅκως εὐμετρίης ὀλίγῳ μέζω. καθαρὸς ἠὴρ, ψυχρότερος, ἐς ἀνάπνευσιν. ὄψιος τερπωλὴ, φυτῶν, γραφῆς, ὑδάτων, ὡς ὁρῆσθαι τὰ πάντα ἡδέως. λαλιὴ τῶν παρεόντων φιλομει δής· ἡσυχίη, θυμηδίη τοῦ νοσέοντος. ὀσμαὶ εὐώδεες, ἀβαρέες ἐς κεφαλῆς αἴσθησιν. ἀτὰρ καὶ τῶν τρεφόντων ἔστωσαν ὀσμαὶ, ἀλφίτων ξὺν ὕδατι δευθέντων, ἢ ὄξεϊ· ἄρτων θερμῶν νεοπέπτων· οἴνῳ δὲ μὴ κάρτα κλύζειν στόμα, μηδὲ ἅμα εἴργειν. ποτὸν θᾶσσον καὶ συνεχέστερον ἢ τοῖσι ἄλλοισι· τροφὴ ἀνὰ πᾶσαν ἡμέρην κούφη, εὔπεπτος, τὰ πολλὰ σιτώδης ἠδὲ καὶ ἡδεῖα, κἢν μικρὸν χείρων ἔῃ.
Drink to be given more frequently and more copiously than in other complaints. Food every day, light, digestible, mostly from grain, and that which is pleasant, even if somewhat less suitable. For, in these cases, rather than in any other, the palate is to be gratified, since not unusually the disease is generated in the stomach, so as to occasion resolution thereof. Abstinence or famine by no means; for the disease is sufficient to devour up all. But if the period be already come to a crisis, if there be a dew on the clavicle and forehead, the extremities cold; the pulse very small and very frequent, as if creeping, and feeble in tone, the patient must take a little food, and partake of wine effectually. The head, too, is to be strengthened by lotions, as also the bladder. These remedies have been described by me under Phrenitis. We are to give wine, not copiously nor to satiety, for certain patients by unseasonable repletion have died of anorexia, and inability to eat and drink; and to many patients having a good appetite, when the natural powers were dissolved, the abundant supply of food was of no avail; the food descending, indeed, into the stomach, but not ascending from the belly to recruit the strength. Let the food, therefore, be diversified, for the most part from grain, so as that it may be supped rather than masticated; or if solid, let it be made easy to swallow. Eggs, not quite consistent nor roasted whole, but deprived of their solid portion; two or three pieces of bread soaked in wine, at first hot; but, after these, everything cold, unless there be latent inflammations. The wine is to be fragrant, and not very astringent; but by no means thick. Of the Greek wines, the Chian or Lesbian, and such other of the insular wines as are thin; of the Italian, the Surrentine, or Fundan, or Falernian, or Signine, unless it be very astringent; but of these we must reject such as are very old or very young. It is to be given at first hot, to the amount of not less than four cyathi, before the crisis, nor more than a hemina even if the patient be accustomed to drink. But after these things, having given food, if the symptoms of inflammation be past, we are again to give it cold as if for a remedy of the thirst; but this from necessity, and not by itself, but along with the food. We must also take care that the wine do not affect the brain; and after this, abstain. And if after an interval, he wish to sleep, quiet is to be enforced. But if much sweat flow, the pulse come to a stop, the voice become sharp, and the breast lose its heat, we are to give as much wine as the patient can drink. For those who are cold, wine is the only hope of life. Wine, therefore, if the patient be accustomed to it, is sometimes to be taken in drink, and sometimes food is to be eaten with the wine, after an interval, as a respite from the fatigue induced by the disease and the food, for when the strength is small, they are much fatigued, even by the act of taking food. Wherefore the patient must be stout-hearted and courageous, and the physician must encourage him with words to be of good cheer, and assist with diversified food and drink.
τοῖσίδε γὰρ τῶν ἄλλων μᾶλλον χαριστέον. οὐχ ἥκιστα γὰρ τῷ στομάχῳ ἐς ἔκλυσιν ἡ νοῦσος ἐμφύνει. ἀσιτία δὲ, ἢ λιμὸς, οὐδαμᾶ. ἱκανὴ γὰρ ἡ νοῦσος τὰ πάντα λαφύξαι. ἢν δὲ ἥκῃ μὲν ἤδη ἡ περίοδος ἐς κρίσιν, νοτὶς δὲ κληϊδα καὶ μέτωπον ἱζάνῃ, καὶ ἄκρεα ψυχρὰ, σφυγμὸς δὲ σμικρότατος ἠδὲ πυκνότατος, ὁκοῖον ἕρπων, ἀμυδρὸς τὸν τόνον, μικρόν τι ἄρα λαβεῖν χρὴ σίτων, καὶ οἶνου ἐνεργῶς ἅπτεσθαι. χρὴ δὲ κεφαλὴν προησφαλίσθαι τέγξεσι, ἠδὲ τὴν κύστιν. λέλεκται δέ μοι τάδε τὰ ἄκεα ἐπὶ τοῖσι φρενιτι κοῖσι. διδόναι δὲ οἴνου μὴ χανδὸν, μηδὲ ἄδην. μετεξέτεροι δὲ πλησμονῆς ἀκαιρίῃ, ἀνορεξίῃτε, καὶ ἀδρανίῃ τοῦ φαγεῖν τε καὶ πιεῖν, ἀπώλοντο· πολλοῖσι δὲ, καὶ εὐσίτοισι ἐοῦσι, λελυμένης ἤδη τῆς φύσιος, οὐδὲν τὸ πλῆθος ἐς τὸ μὴ θανεῖν ἤρκεσε, ἐς μὲν τὴν γαστέρα κατιόντων τῶν σιτίων, οὐκ ἀνιόντων δὲ ἐς τὴν δύναμιν ἀπὸ τῆς κοιλίης. ἔστω ὦν σιτία μὲν ποικίλα, τὰ πολλὰ σιτώδεα, ὡς Ῥυμφάνειν μᾶλλον ἢ μασᾶσθαι· κἢν στερεὰ ἔῃ, ὀλισθηρὰ γιγνέσθω. ὠὰ μὴ κάρτα ξυνεστῶτα, μηδʼ ὀπτὰ ὅλα, τοῦ στερεοῦ γυμνά· ψωμοὶ διάβροχοι οἴνῳ, τὰ πρῶτα θερμῷ, δύο ἢ τρεῖς· ἐπὶ δὲ τοῖσι τὰ πάντα ψυχρὰ, ἢν μὴ ὑποικουρέωσι φλεγμοναί· οἶνος εὐώδης, μὴ κάρτα στύφων, παχὺς δὲ ὡς ἥκιστα. Ἑλληνικοὶ μὲν Χῖος, ἢ Λέσβιος, ὁκόσοι τε ἄλλοι νησιῶται λεπτοί· Ἰταλῶν δὲ, Σουρεντῖνος, ἢ Φουνδανὸς, ἢ Φαλερῖνος, ἢ Σιγνῖνος, ἢν μὴ σφόδρα στύφῃ· παραιτέεσθαι δὲ τῶνδε τὸν κάρτα παλαιὸν, ἢ νεώτερον. διδόναι ὦν, τὰ πρῶτα, θερμὸν, μὴ μεῖον κυάθων τεσσάρων, πρὸ τὴς κρίσιος, μηδὲ κοτύλης πλεῖον, κἢν εὔποτος ἔῃ· ἐπὶ δὲ τῶνδε σιτίον διδόντα, εἰ τὰ τῆς φλεγμασίης παρήκοι, αὖθις ψυχρὸν ὀρέγειν, ὅκως ἐς ἄκος δίψεος. πρὸς ἀνάγκην δὲ, μὴ μόνον μὲν, ξὺν σιτίῳ δέ· προυπερηρεῖσθαι δὲ χρὴ, ὡς μὴ ἅψιν φρενῶν ὁ οἶνος ποιέηται. καὶ ἐπὶ τοῖσι δὲ συνανέχειν· κἢν ἐκ διαστάσιος εὕδειν θέλῃ, ἡσυχίη προσακτέη. ἢν δὲ πουλὺς μὲν ἱδρὼς ἐκρέῃ, σφυγμοὶ δὲ πρὸς ἀκινησίην, ὀξεῖα δὲ φωνὴ, ἄθερμα δὲ καὶ τὰ στήθεα, διδόναι τοῦ οἴνου ὁκόσον ἂν δύνηται πιεῖν. μοῦνος γὰρ οἶνος ἐλπὶς ἐς ζωὴν ψυχροῖς. καὶ οἶνος ὦν ξυνήθης εἰ εἴη, ἄλλοτε μὲν πιεῖν, ἄλλοτε δὲ αὖ σιτίον ξὺν οἴνῳ φαγεῖν. ἐκ διαστήσιος μὲν ἐς ἀνάπαυλαν τοῦ καμάτου, τοῦ ἔκ τε τῆς νούσου καὶ τῆς τροφῆς. ἐν γὰρ σμικρῇ τῇ ἰσχύϊ μογέουσι κάρτα καὶ ἐπὶ τῇ ἐδωδῇ. χρὴ ὦν αὐτόν τε ἀλκήεντα καὶ εὔθυμον ἔμμεναι, καὶ τὸν ἰητρὸν ἔπεσι μὲν παραφάσθαι ἐς εὐελπιστίην ἔμμεναι, ὡς δὲ ἀρήγειν ποικίλῃ τροφῇ τε καὶ οἴνῳ.
The other treatment is also to be applied energetically for restraining the sweats, and for resuscitating the spark of life. Let, therefore, an epitheme be applied to the chest on the left mamma,—dates triturated in wine along with aloes and mastich,—and let these things be mixed up with a cerate composed of nard. And if this become disagreeable, we may apply another epitheme, made by taking the seed, and whatever is hard out of the apples, and having bruised them down, mix up with some fragrant meal; then we are to mix together some of the hair of wormwood, and of myrtle, and of acacia, and of the manna of frankincense, all sifted; which being all rubbed up together, are to be added to the cerate of wild vine. But if the sweat be not thereby restrained, the juice of the wild grape is to be added to the mixture, and acacia, and gum, and the edible part of sumach, and alum, and dates, and the scented juice of roses. All these things along with nard and oil of wild vine are to be applied to the chest; for this at the same time cools and is astringent. Let him lie in cool air, and in a house having a northern exposure; and if the cool breeze of Boreas breathe upon him, “it will refresh his soul sadly gasping for breath.” The prospect should be to-wards meadows, fountains, and babbling streams, for the sweet exhalations from them, and the delightful view, warm the soul and refresh nature. And, moreover, it is also an incentive to eat and to drink. But if from want one is not fortunate enough to possess these things, we must make an imitation of the cool breeze, by fanning with the branches of fragrant boughs, and, if the season of spring, by strewing the ground with such leaves and flowers as are at hand. The coverlet should be light and old, so as to admit the air, and permit the exhalation of the heat of the chest; the best kind is an old linen sheet. We are to sprinkle the neck, the region of the clavicle and chest with flour, so that it may nourish by its fragrance, and restrain by its dryness; and the spongy parts of the body are to be dusted with meal, but the face with the Samian earth, which is to be passed through a sieve; and having been bound into a spongy cloth, it is to be dusted on the part, so that the finer particles may pass through the pores to the forehead and cheeks. And slaked lime and roasted gypsum, sifted in a small sieve, are to be applied to the moist parts. A sponge out of cold water applied to the face has sometimes stopped the sweats, by occasioning congelation of the running fluids, and by condensation of the pores. The anus is to be anointed, so that the flatus arising from the cold and food may be discharged. And we are to recall the heat of the extremities by gleucinum, or Sicyonian oil, along with pepper, castor, natron, and cachry, melting into them a little wax, so that the liniment may stick. And we are to resuscitate the heat by means of the ointment of lemnestis, and of euphorbium, and of the fruit of the bay. The small red onions raw, along with pepper, and the powdered lees of vinegar, make an excellent cataplasm to the feet; but it is to be constantly raised from the place every hour, for there is danger of ulceration and blisters. From these things there is hope that the patient may thus escape.
χρὴ δὲ καὶ τῇ ἄλλῃ ἰητρείῃ ἐνεργῷ χρέεσθαι, ἔς τε τὴν τῶν ἱδρώτων κάθεξιν, καὶ τῆς δυνάμιος ἀνάστασιν ἐς τὸ ζώπυρον· ἔστω ὦν ἐπίθημα τῷ θώρηκι ἐς τὸν ἀριστερὸν μαστὸν, φοίνικες ἐν οἴνῳ λεῖοι, ξὺν ἀλόῃ καὶ μαστίχῃ, κηρωτῇ δὲ ξὺν νάρδῳ πεποιημένῃ ἀνειλήφθω τάδε· καὶ ἢν τόδε ἀσηρὸν γίγνηται, ἄλλο ἐπιτιθέναι ἐπίθημα, μήλων ἐξελόντα τὸ σπέρμα καὶ ὅτι περ ἂν σκληρὸν ᾖ, θλάσαντα, ξυμμίσγειν ἀλφίτοισι εὐώδεσι. ἔπειτα ἀψινθίου κόμην, καὶ μυρσίνης, ἠδʼ ἀκακίης, καὶ μάννης σεσησμένων, ξυμμίσγειν· ὁμοῦ δὲ τὰ πάντα φυράσαντα, κηρωτῇ ἀναλαμβάνειν οἰνανθίνῃ· ἢν δὲ ὑπὸ τῶνδε μὴ ἴσχηται ὁ ἱδρὼς, ὄμφακος χυλὸς εἰς φύρησιν ξυντεθεὶς, καὶ ἀκακίη, καὶ κόμμι, ἠδὲ Ῥοὸς τὸ ἐδώδιμον, καὶ στυπτηρίη, καὶ φοίνικες, καὶ Ῥόδων χυλὸς εὔπνοος· ἅμα πάντα νάρδῳ τε καὶ οἰνάνθης τῷ λίπαϊ, ἐς τὸν θώρηκα τιθέναι· καὶ γὰρ τόδε ἐμψύχει τε καὶ στύφει. κατακεέ σθω δὲ ἐν ἠέρι ψυχρῷ, εἴτε καὶ πρὸς ἄρκτον ὁ οἶκος· εἰ δὲ καὶ εἴη αὔρη βορέου ψυχρὴ ἐπιπνείουσα, ζωγρήσει κακῶς κεκαφηότα θυμόν. ἔστω δὲ καὶ εἰς λειμῶνας καὶ πηγὰς καὶ κελαρύζποντας ὀχετούς· καὶ γὰρ καὶ τὸ εὔπνοον τῶνδε καὶ ἡ θυμηδίη καὶ τὴν ψυχὴν θάλπει καὶ τὴν φύσιν ζωγρεῖ. ἀτὰρ καὶ πρόκλησις τοῦ φαγεῖν τε καὶ πιεῖν· ἢν δὲ ὑπʼ ἀπορίης μὴ τάδε τις εὐτυχῇ, μιμέεσθαι χρὴ καὶ αὔρην ψυχρὴν, πτόρθων εὐωδέων ἡδονῆς Ῥιπίσι, καὶ ὥρην εἰαρὸς φύλλοισι ἠδʼ ἄνθεσι τοῖσι παρεοῦσι στορέσαντα τὴν γῆν. ἀτὰρ καὶ ἐπίβλημα ἔστω κοῦφον, παλαιὸν, ὡς δέχηται μὲν τὸν ἠέρα, διαπνέῃ δὲ τοῦ θώρηκος τὴν θέρμην. ἄριστον δὲ ὀθόνη παλαιή. πάσσειν δὲ αὐχένας καὶ κληῗδας ἀλφίτοισι, καὶ θώρηκα· τρέφειν μὲν τῷ εὐόσμῳ, τῷ δὲ αὐχμηρῷ ξυνέχειν. καὶ παιπάλῃ δὲ τοῦ σώματος τὸ ἀραιὸν ἐμπάσσειν. ἀτὰρ καὶ τὰ πρόσωπα τῇ γῇ τῇ Σαμίῃ, τῇ κρησέρῃ σεσησμένῃ ἐς ὀθόνην ἀραιὴν ἐνδήσαν τα, καταπάσσειν, ὡς διασήθηται ἐς τὰ μέτωπα καὶ τὰ μῆλα ἡ ἄχνη· καὶ τίτανον ἐσβεσμένην, καὶ γύψον ὀπτὴν, σησθέντα ἐν κρησέρῃ μικρῇ, ἐμβάλλειν ἐπὶ τοῖσι ἰκμαλέοισι· ἔστησέτε κοτὲ ἱδρῶτας καὶ σπογγίη ψυχροῦ ἐς τὰ πρόσωπα προσβληθεῖσα, πήξι μὲν τῶν διαρρεόντων ὑγρῶν, πυκνότητι δὲ τῆς ἀραιώσιος. διαχρίειν δὲ τὴν ἕδρην, ὅκως ἡ τοῦ ψυχροῦ φῦσα καὶ τῆς τροφῆς ἐκχέηται. ἠδὲ ἀνακαλέσασθαι τῶν ἄκρων τὴν θέρμην γλευκίνῳ ἢ σικυωνίῳ λίπαϊ ξὺν πεπέρεϊ, καὶ τῷ καστορίῳ, καὶ νίτρῳ, καὶ κάχρυ, κηροῦ σμικρὸν ἐντήκοντα, ὡς ποθίζῃ τὸ χρῖσμα· καὶ διὰ τῆς λιμνήστιδος, ἠδʼ εὐφορβίου, καὶ δάφνης τοῦ καρποῦ ἀλείμματι, ἐπανάκλη σι ν θέρμης ποιέεσθα ι. ἀτὰρ καὶ βολβοὶ ὠμοὶ οἱ σμικροί τε καὶ ἐρυθροὶ ξὺν πεπέρεϊ καὶ ὄξους τρυγίῃ λείῃ ἄριστον ἐπίπλασμα τῶν ποδῶν, καθʼ ὥρην ξυνεχέστατα ἀείροντα· κίνδυνος γὰρ ἑλκέων ἠδὲ φλυκται νώσιος. ἐπὶ τοῖσι ἐλπὶς τὸν ὧδε νοσέοντα διαδρῆναι τὸν ὄλεθρον.
And if the physician should do everything properly, and if everything turn out well, along with the syncope the inflammations that supervene are resolved; and sweat, indeed, is nowhere, but a restoration of the heat everywhere, even at the extremities of the feet and the nose; but the face is of a good colour; pulse enlarged in magnitude, not tremulous, strong; voice the same as customary, loud, and in every respect lively. Lassitude not out of place, but the patient is also seen sleeping: and, if sleep seize him, he digests his food, recovers his senses, and sprouts out into a new nature; and if roused from sleep, the breathing is free, he is light and vigorous; and here calls to his memory the circumstances of the disease like a dream.
κἢν πάντα μὲν τὰ κατὰ λόγον ἰητρὸς ἔρδῃ, εὖ δὲ πάντα χωρέῃ, ξὺν τῇ ξυγκοπῇ καὶ εἰ φλεγμασίαι ἐπιέασι, ἐκλύονται· καὶ ἱδρὼς μὲν οὐδαμᾶ, θέρμης δὲ ἀνάκλησις πάντη, ἀτὰρ καὶ ἐς ἄκρους πόδας καὶ ἀνὰ Ῥῖνα· τὸ δὲ πρόσωπον εὔχροον· σφυγμοὶ ἐς μέγεθος ἠρμένοι, ἄτρομοι, σφοδροί· φωνὴ δὲ ξυνήθης, εὔφωνος, καὶ τὰ πάντα ζωώδης· κάματος οὐκ ἀγεννὴς, ἀτὰρ ἠδʼ εὕδων ὁρᾶται· καὶ ἢν ἕλῃ μιν ὕπνος, ἐξέπεψε μὲν τὰ σιτία, ἐξένηψε δὲ τὴν αἴσθησιν, ἀτὰρ ἠδʼ ἐξεβλάστησε τὴν φυήν. κἢν ἐξ ὕπνου ἔγρηται, εὔπνοος, εὐσταλὴς, εὔτονος, ἀναπεμπάζεται δὲ, ὅκως περ ὄναρ, τὴν νοῦσον.
But in other cases obscure fevers are left behind, and sometimes slight inflammations, and a dry tongue: they are parched, have rigors, are enfeebled, and relaxed, in which cases there is a conversion to marasmus; when we must not waste time with rest and a slender diet, but have recourse to motions, by gestation, and to friction and baths, so that the embers of life may be roused and mended. We are to give milk, especially that of a woman who has just borne a child, and that a male child; for such persons require nursing like new-born children. Or if it cannot be obtained, we must give the milk of an ass which has had a foal not long before, for such milk is particularly thin; and by these means the patient is to be brought back to convalescence and his accustomed habits.
μετεξετέροισι δὲ πυρετοὶ ἀμαυροὶ ἐγκαταλείπονται, καί πη καὶ φλεγμασίαι σμικραὶ, καὶ γλῶσσα ξηρή· ἄνικμοι, Ῥιγώδεες, νωθροὶ, διαλελυμένοι, οἷσι ἐς μαρασμὸν ἡ περιτροπή. εὖτε οὐ καταβλακεύειν χρὴ ἠρεμίῃ καὶ λεπτῇ διαίτῃ· ἀλλʼ ἐς κινήσιας ἄγειν, αἰώρης καὶ τρίψιος, καὶ λουτρῶν, ὅκως ἐκ τοῦ νεκρώδεος ἐνταθέῃ καὶ ἀνατραφέῃ τὸ ζώπυρον. διδόναι δὲ καὶ γάλα, μάλιστα μὲν γυναικὸς νεοτόκου καὶ κουροτρόφου. καὶ γὰρ οἵδε ἀνατροφῆς, ὅκως ἀρτίτοκοι παῖδες, δέονται. ἢν δὲ μὴ, ὄνου μὴ παλαιοτόκου· ἐξίτηλον γὰρ τὸ τοιόνδε γάλα. καὶ ἐπὶ τοῖσδε ἐς ἀνάληψιν ἄγειν καὶ τὰ συνήθεα.
4. IN Cholera, the suppression of the discharges is a bad thing, for they are undigested matters. We must, therefore, readily permit them to go on, if spontaneous, or if not, promote them by giving some tepid water to swallow, frequently indeed, but in small quantity, so that there may be no spasmodic retchings excited in the stomach. But if there also be tormina and coldness of the feet, we are to rub the abdomen with hot oil, boiled with rue and cumin, to dispel the flatulence; and we are to apply wool. And, having anointed the feet, they are to be gently rubbed, stroking them rather than pinching them. And these things are to be done up to the knees for the restoration of the heat; and the same is to be practised until the fæces pass downwards, and the bilious matters ascend upwards. But if all the remains of the food have been discharged downwards, and if bile be evacuated, and if there still be bilious vomiting, retchings, and nausea, uneasiness and loss of strength, we must give two or three cupfuls (cyathi) of cold water, as an astringent of the belly, to stop the reflux, and in order to cool the burning stomach; and this is to be repeatedly done when what even has been drunk is vomited. The cold water, indeed, readily gets warm in the stomach, and then the stomach rejects it, annoyed as it is both by hot and cold: but it constantly desiderates cold drink. But, if the pulse also fall to a low state, and become exceedingly rapid and hurried, if there be sweat about the forehead and region of the clavicles, if it run in large drops from all parts of the body, and the discharge from the bowels is not restrained, and the stomach still vomits, with retchings and deliquium animi, we must add to the cold water a small quantity of wine, which is fragrant and astringent, that it may refresh the senses by its bouquet, contribute to the strength of the stomach by its spirit, and to the restoration of the body by its nutritious powers. For wine is swiftly distributed upwards over the system, so as to restrain the reflux; and is subtil, so that when poured into the frame it strengthens the habit, and it is strong so as to restrain the dissolving powers. We are also to sprinkle on the body some fresh and fragrant meal. But if the bad symptoms become urgent, with sweating, and strainings, not only of the stomach, but also of the nerves, and if there be hiccups; and if the feet are contracted, if there be copious discharges from the bowels, and if the patient become dark-eoloured, and the pulse is coming to a stop, we must try to anticipate this condition beforehand; but if it be come on, we must give much cold water and wine, not indeed wine slightly diluted, for fear of intoxication, and of hurting the nerves, and along with food, namely, pieces of bread soaked in it. We are likewise to give of other kinds of food, such as have been described by me under syncope, autumnal fruit of an astringent nature, services, medlars, quinces, or the grape. But if everything be vomited, and the stomach can contain nothing, we must return again to hot drink and food, for in certain cases the change stops the complaint; the hot things, moreover, must be intensely so. But if none of these things avail, we are to apply the cupping-instrument between the shoulder-blades, and turn it below the umbilicus; but we are to shift the cupping-instrument constantly, for it is painful when it remains on a place, and exposes to the risk of blistering. The motion of gestation is beneficial by its ventilation, so as to recreate the spirit (pneuma), stay the food in the bowels, and make the patient’s respiration and pulse natural. But if these symptoms increase, we must apply epithemes over the stomach and chest; and these are to be similar to those for syncope—dates soaked in wine, acacia, hypocistis, mixed up with rose cerate, and spread upon a linen cloth, are to be applied over the stomach; and to the chest we are to apply mastich, aloe, the pulverised hair of wormwood, with the cerate of nard, or of wild vine, as a cataplasm to the whole chest; but if the feet and muscles be spasmodically distended, rub into them Sicyonian oil, that of must, or old oil with a little wax; and also add in powder some castor. And if the feet also be cold, we are to rub them with the ointment containing lemnestis and euphorbium, wrap them in wool, and rectify by rubbing with the hands. The spine also, the tendons, and muscles of the jaws are to be anointed with the same. If, therefore, by these means the sweat and discharges from the bowels are stopped, and the stomach receives the food without vomiting it again, the pulse becomes large and strong, and the straining ceases; if the heat prevails everywhere, and reaches the extremities, and sleep concocts all matters, on the second or third day the patient is to be bathed, and remitted to his usual course of living. But if he vomit up everything, if the sweat flow incessant, if the patient become cold and livid, if his pulse be almost stopped and his strength exhausted, it will be well in these circumstances to try to make one’s escape with credit.
4. ἐν χολέρῃ ἡ τῶν φερομέν ων ἐπίσχεσις κακόν· ἄπεπτα γὰρ. χρὴ ὦν ἡμᾶς Ῥηϊδίως αὐτόματα δέχεσθαι· ἢν δὲ μὴ, ὀτρύνειν, διδόντας ὕδατος εὐκρήτου Ῥυμφαίνειν, ξυνεχές γε μὴν, ὀλίγον δὲ, ὅκως μὴ ἐντάσιες ἔωσι κεναὶ στομάχῳ, σπασμώδεες· ἢν δὲ καὶ στρόφοι ἔωσι, καὶ ποδῶν ψύξιες, τέγγειν μὲν τὴν κοιλίην λίπαϊ θερμῷ ξὺν πηγάνῳ καὶ κυμίνῳ ἑψηθέντι, ἐς τὰς τῶν φυσέων διακρίσιας, καὶ ἐπιτιθέναι εἴριον. καὶ τὼ πόδε λιπαίνον τα ἡσυχῇ τρίβειν, ἀμφαφόωντα μᾶλλον ἢ πιέζοντα. ἀτὰρ καὶ μέχρι τῶν γουνάτων γιγνέσθω τάδε, ἐς ἀνάκλησιν θέρμης. καὶ μέσφι μὲν κόπρια κάτωθεν διαχωρέει, ἄνωθεν δὲ χωρέει χολώδεα, τάδε χρὴ ποιέειν. ἢν δὲ ὑπεληλύθῃ μὲν ὁ πᾶς παλαιὸς σῖτος, χολαὶ δὲ διΐωσι, καὶ χολώδης ἔμετος καὶ διάτασις ἔῃ, ἠδὲ καὶ ἄση, καὶ ἀπορίη, καὶ ἀδυναμίη, ψυχροῦ ὕδατος κυάθους δύο, ἢ τρεῖς, διδόναι, ἔς τε τὴν τῆς κοιλίης στῦψιν, ὅκως ἐπίσχῃ τὴν παλίρροιαν, ἠδὲ τὸν στόμαχον αἰθόμενον ἐμψύξῃ. ξυνεχέως δὲ τόδε, ἐπὴν τὸ ποθὲν ἐμέσῃ, πρήσσειν. Ῥηϊδίως μὲν τὸ ψυχρὸν ἐν τῇ κοιλίῃ θάλπεται· ἀτὰρ ἠδὲ ἐξεμεῖ ὁ στόμαχος, ἀχθηδόνι τοῦ θερμοῦ καὶ ψυχροῦ· ξυνεχέως δὲ ποθέει ψυχρὸν ποτόν. ἢν δὲ καὶ σφυγμοὶ μὲν ἐς τὸ μικρὸν ξυμπέσωσι, ἠδὲ ἐς τὸ ξυνεχὲς καὶ πυκνὸν διώκωνται, ἱδρὼς δὲ περὶ μέτωπα καὶ κληϊδας, καὶ πάντη τοῦ σώματος στάγδην Ῥέῃ, καὶ γαστὴρ μὴ ἐπίσχηται, καὶ ὁ στόμαχος ἐμέῃ ἔτι ξὺν τάσι καὶ λειποψυχίῃ, καὶ οἴνου βραχὺ ἐπιστάζειν τῷ ὕδατι τῷ ψυχρῷ, εὐώδεος, στύφοντος, ἔς τε τὴν τῆς αἰσθήσιος ἀνάκλησιν ὑπὸ τῆς ὀσμῆς καὶ ἐς τὴν τούτου Ῥῶσιν ὑπὸ τῆς δυνάμιος, καὶ ἐς τὴν τοῦ σώματος πρόσθεσιν ὑπὸ τῆς θρέψιος. οἶνος γὰρ ὠκὺς μὲν ἐς τὴν ἄνω ἴξιν ὡς τὴν παλιρροίην σχέθειν· λεπτὸς δὲ, ὡς Ῥηϊδίως χυθεὶς τῇ φύσι τὴν ἕξιν ἐρρῶσθαι. κραταιὸς δὲ, ὡς δύναμιν στῆσαι Ῥέουσαν. ἐπιπάσσειν δὲ καὶ ἀλφίτων κοτὲ, νέων, εὐπνόων. ἢν δὲ ξυνεπείγῃ πάντα, ἱδρὼς καὶ ἔντασις, οὐ τοῦ στομάχου μοῦνον, ἀλλὰ καὶ νεύρων, λὺγξ κενεὴ, καὶ πόδες ξυντιταίνωνται, καὶ κοιλίη ὑποφέρῃ πολλὰ, καὶ ἀχλυώδης ὥνθρωπος, σφυγμοὶ δὲ πρὸς ἀκινησίην ἔωσι, τότε χρὴ φθάνειν τήνδε τὴν κατάστασιν· εἰ δὲ καὶ παρῇ, ψυχροῦ καὶ οἴνου πολλόν τι διδόναι, μὴ ἀκρητεστέρου δὲ, διὰ τὴν μέθην καὶ τὰ νεῦρα, ξὺν σιτίῳ ψωμοῖσι διαβρόχοισι· διδόναι δὲ καὶ τῆς ἄλλης τροφῆς, ὁκοῖα ἐν συγκοπῇ μοι λέλεκται, ὀπώρην στύφουσαν, οὖα, μέσπιλα, μῆλα κυδώνια, σταφυλήν. ἢν δὲ τὰ πάντα ἐμέῃ, καὶ ὁ στόμαχος μηδὲν ἴσχῃ, ἐς τὰ θερμὰ καὶ ποτὰ καὶ βρώματα παλινδρομέειν· μετεξετέροισι γὰρ ἔστησεν ἡ μεταβολή· τὰ θερμὰ δὲ ἔστω θερμότατα· ἢν δὲ μηδέν τι τούτων ἀρήγῃ, σικύην ἐς τὸ μεσηγὺ τῶν ὠμοπλατέων προσβάλλειν, καὶ κάτωθεν ὀμφαλοῦ τρέπειν· συνεχῶς δὲ τὰς σικύας μεθιζάνειν. ὀδυνηρὸν γὰρ τὸ ἐπίμονον καὶ κίνδυνον φέρον φλυκταινώσιος. ὤνησέ κοτε κίνησις αἰώρης εὔπνοος ὡς καὶ τὸ πνεῦμα ζωγρῆσαι, καὶ τὴν τροφὴν ἐν τῇ κοιλίῃ σχέθειν, καὶ εὔπνοον καὶ εὔσφυκτον τὸν νοσέοντα θέμεναι. ἢν δὲ ἐπὶ μέζω γίγνηται τάδε, ἐπὶ τῆς κοιλίης καὶ τοῦ θώρηκος τιθέναι· καὶ τάδε ἔστω ὁκοῖα ἐς συγκοπὴν, φοίνικες ἐν οἴνῳ δεδευμένοι, ἀκακίη, ὑποκιστίς. τάδε ξὺν Ῥοδίνῃ κηρωτῇ ἀναλαβόντα, ἐγχρίσαντα δὲ ἐς ὀθόνην, ἐπὶ τὴν κοιλίην τιθέναι. ἐς δὲ τὸν θώρηκα, μαστίχην, ἀλόην, ἀψινθίου κόμην λείαν ξὺν κηρωτῇ ναρδίνῳ ἢ οἰνάνθης, ἐπιπλάσαι ὅλῳ τῷ θώρηκι· ἐς δὲ τοὺς πόδας καὶ τοὺς μύας, ἢν τιταίνωνται, σικυώνιον, γλεύκινον, ἢ παλαιὸν ἄλειφα, ξὺν κηρῷ σμικρῷ χρίειν· ἐπιπάσσειν δὲ καὶ τοῦ κάστορος· ἢν δὲ καὶ ψυχροὶ ἔωσι οἱ πόδες, καὶ τῷ διὰ τῆς λιμνήστιδος καὶ εὐφορβίου χρίειν ἀλείμματι, καὶ ἐρίοισι ἀμφελίσσειν, καὶ ψηλαφίῃ χειρῶν ἀπιθύνειν· ἀλλὰ καὶ τὴν Ῥάχιν, καὶ τοὺς τένοντα ς καὶ τοὺς μύας τῶν τε σιηγόνων, τοῖσι αὐτέοισι χρίειν. κἢν μὲν ἐπὶ τοῖσι ἴσχηται μὲν ὁ ἱδρὼς καὶ ἡ γαστὴρ, ὅ τε στόμαχος δέχηται τὰ σιτία καὶ μὴ ἐμέῃ, σφυγμοὶ δὲ μεγάλοι τε καὶ εὔτονοι ἔωσι, καὶ ἡ ξύντασις ἀπολείπῃ, θέρμη δὲ καὶ πάντα ἀναίρῃ καὶ ἐς τὰ ἄκρα ἀφίκῃ, ὕπνος δὲ πάντα πέσσῃ, δευτέρῃ ἡμέρῃ ἢ τρίτῃ λούσαντα, τρέπειν ἐς τὰ ξυνήθεα· ἢν δὲ πάντα μὲν ἀπεμέῃ, ἱδρὼς δὲ ἄσχετος Ῥέῃ, ψυχρὸς δὲ καὶ πελιὸς γίγνηται ὥνθρωπος, σφυγμοὶ δὲ πρὸς ἀπόσβεσιν ἔωσι, καὶ ἀπηυδήκῃ, ἀγαθὸν ἐν τοῖσι τουτέοισι εὐπρεπέα εὑρέσθαι φυγήν.