---
title: "On Regimen in Acute Diseases · Περὶ διαίτης ὀξέων"
author: "Hippocrates"
translator: "Francis Adams"
languages: [grc, en]
shelf: "Classical Greek"
section: 1 of 2
url: https://scriptura.si/works/hippocrates-regimen-in-acute-diseases/1/
cite: "Hippocrates, tr. Francis Adams, On Regimen in Acute Diseases · Περὶ διαίτης ὀξέων, section 1. Scriptura (scriptura.si), https://scriptura.si/works/hippocrates-regimen-in-acute-diseases/1/"
---

# On Regimen in Acute Diseases · Περὶ διαίτης ὀξέων

*Hippocrates, tr. Francis Adams*

Barley gruel, drinks, baths and how to feed the sick.

> Greek: ed. Émile Littré, from the Perseus Digital Library (canonical-greekLit, tlg0627.tlg004, CC BY-SA 4.0).

> English: Francis Adams, from the Perseus Digital Library (tlg0627.tlg004.perseus-eng2). Notes are not included.

> Rows follow the references the two texts share (chapters and sections), cut where both reach the end of a sentence.

## 1. Sections 1–10

Source: https://scriptura.si/works/hippocrates-regimen-in-acute-diseases/1/ · cite a paragraph as https://scriptura.si/works/hippocrates-regimen-in-acute-diseases/1/#p-N

[¶0] 1. Those who composed what are called “The Cnidian Sentences” have described accurately what symptoms the sick experience in every disease, and how certain of them terminate; and in so far a man, even who is not a physician, might describe them correctly, provided he put the proper inquiries to the sick themselves what their complaints are. But those symptoms which the physician ought to know beforehand without being informed of them by the patient, are, for the most part, omitted, some in one case and some in others, and certain symptoms of vital importance for a conjectural judgment. But when, in addition to the diagnosis, they describe how each complaint should be treated, in these cases I entertain a still greater difference of opinion with them respecting the rules they have laid down; and not only do I not agree with them on this account, but also because the remedies they use are few in number; for, with the exception of acute diseases, the only medicines which they give are drastic purgatives, with whey, and milk at certain times. If, indeed, these remedies had been good and suitable to the complaints in which they are recommended, they would have been still more deserving of recommendation, if, while few in number, they were sufficient; but this is by no means the case. Those, indeed, who have remodeled these “Sentences” have treated of the remedies applicable in each complaint more in a medical fashion. But neither have the ancients written anything worth regimen, although this be a great omission. Some of them, indeed, were not ignorant of the many varieties of each complaint, and their manifold divisions, but when they wish to tell clearly the numbers (species?) of each disease they do not write for their species would be almost innumerable if every symptom experienced by the patients were held to constitute a disease, and receive a different name.

> Greek: 1. 1. οἱ ξυγγράψαντες τὰς Κνιδίας καλεομένας γνώμας, ὁκοῖα μὲν πάσχουσιν οἱ κάμνοντες ἐν ἑκάστοισι τῶν νουσημάτων ὀρθῶς ἔγραψαν, καὶ ὁκοίως ἔνια ἀπέβαινεν αὐτέων· καὶ ἄχρι μὲν τουτέου καὶ μὴ ἰητρὸς δύναιτο τις ἂν ὀρθῶς ξυγγράψαι, εἰ εὖ παρὰ τῶν καμνόντων ἕκαστον πύθοιτο ὁκοῖα πάσχουσιν. ὁκόσα δὲ προκαταμαθεῖν χρὴ τὸν ἰητρὸν, μὴ λέγοντος τοῦ κάμνοντος, τουτέων τὰ πολλὰ παρεῖται, ἄλλα ἐν ἄλλοισι, καὶ ἐπικαιρα ἔνια ἐόντα ἐς τέκμαρσιν. ὁκόταν δὲ ἐς τέκμαρσιν λέγηται ὡς χρὴ ἕκαστα ἰητρεύειν, ἐν τουτέοισι πολλὰ ἑτεροίως γιγνώσκω ἢ ὡς ἐκεῖνοι ἐπεξῄεσαν· καὶ οὐ μοῦνον διὰ τοῦτο οὐκ ἐπαινέω, ἀλλʼ ὅτι καὶ ὀλίγοισι τὸν ἀριθμὸν τοῖσιν ἀκέεσιν ἐχρέοντο· τὰ γὰρ πλεῖστα αὐτέοισιν εἰρέαται πλὴν τῶν ὀξειῶν νούσων, φάρμακα ἐλατήρια διδόναι καὶ ὀῤῥὸν καὶ γάλα ἐς τὴν ὥρην πιπίσκειν. εἰ μὲν οὖν ταῦτα ἀγαθὰ ἦν καὶ ἁρμόζοντα τοῖσι νουσήμασιν, ἐφʼ οἷσι παρῄνεον διδόναι, ἔτι ἂν ἀξιώτερα ἐπαίνου ἦν, ὅτι, ὀλίγα ἐόντα, αὐτάρκεά ἐστιν· νῦν δὲ οὐχ οὕτως ἔχει. οἱ μέν τοι ὕστερον ἐπιδιασκευάσαντες, ἰητρικώτερον δή τι ἐπῆλθον περὶ τῶν προσοιστέων ἑκάστοισιν· ἀτὰρ οὐδὲ περὶ διαίτης οἱ ἀρχαῖοι ξυνέγραψαν οὐδὲν ἄξιον λόγου, καίτοι μέγα τοῦτο παρῆκαν. τὰς μέντοι πολυτροπίας τὰς ἐν ἑκάστῃ τῶν νούσων καὶ τὴν πολυσχιδίην αὐτέων οὐκ ἠγνόεον ἔνιοι· τοὺς δὲ ἀριθμοὺς ἑκάστου τῶν νουσημάτων σάφα φράζειν ἐθέλοντες, οὐκ ὀρθῶς ἔγραψαν· μὴ γὰρ οὐκ εὐαρίθμητον εἴη, εἰ τουτέῳ τις σημανεῖται τὴν τῶν καμνόντων νοῦσον, τῷ ἕτερον ἑτέρου διαφέρειν τι, καὶ, ἢν μὴ τωὐτὸ νούσημα δοκέῃ εἶναι, μὴ τωὐτὸ οὔνομα ἔχειν.

[¶1] 2. For my part, I approve of paying attention to everything relating to the art, and that those things which can be done well or properly should all be done properly; such as can be quickly done should be done quickly; such as can be neatly done should be done neatly; such operations as can be performed without pain should be done with the least possible pain; and that all other things of the like kind should be done better than they could be managed by the attendants. But I would more especially commend the physician who, in acute diseases, by which the bulk of mankind are cut off, conducts the treatment better than others. Acute diseases are those which the ancients named pleurisy, pneumonia, phrenitis, lethargy, causus, and the other diseases allied to these, including the continual fevers. For, unless when some general form of pestilential disease is epidemic, and diseases are sporadic and [not] of a similar character, there are more deaths from these diseases than from all the others taken together. The vulgar, indeed, do not recognize the difference between such physicians and their common attendants, and are rather disposed to commend and censure extraordinary remedies. This, then, is a great proof that the common people are most incompetent, of themselves, to form a judgment how such diseases should be treated: since persons who are not physicians pass for physicians owing most especially to these diseases, for it is an easy matter to learn the names of those things which are applicable to persons laboring under such complaints. For, if one names the juice of ptisan, and such and such a wine, and hydromel, the vulgar fancy that he prescribes exactly the same things as the physicians do, both the good and the bad, but in these matters there is a great difference between them.

> Greek: 2. 2. ἐμοὶ δʼ ἁνδάνει μὲν ἐν πάσῃ τῇ τέχνῃ προσέχειν τὸν νόον· καὶ γὰρ ὁκόσα ἔργα καλῶς ἔχει ἢ ὀρθῶς, καλῶς ἕκαστα χρὴ ποιέειν καὶ ὀρθῶς, καὶ ὁκόσα ταχέως ἔργα, ταχέως, καὶ ὁκόσα καθαρίως, καθαρίως, καὶ ὁκόσα ἀνωδύνως διαχειρίζεσθαι, ὡς ἀνωδυνώτατα ποιέειν, καὶ τἄλλα πάντα τὰ τοιουτότροπα διαφερόντως τῶν πέλας ἐπὶ τὸ βέλτιον ποιέειν χρή. μάλιστα δʼ ἂν ἐπαινέσαιμι ἰητρὸν, ὅστις ἐν τοῖσιν ὀξέσι νουσήμασιν, ἃ τοὺς πλείστους τῶν ἀνθρώπων κτείνει, ἐν τουτέοισι διαφέρων τι τῶν ἄλλων εἴη ἐπὶ τὸ βέλτιον. ἔστι δὲ ταῦτα ὀξέα, ὁκοῖα ὠνόμασαν οἱ ἀρχαῖοι πλευρῖτιν, καὶ περιπλευμονίην, καὶ φρενῖτιν, καὶ λήθαργον, καὶ καῦσον, καὶ τἄλλα νουσήματα ὁκόσα τουτέων ἐχόμενά ἐστιν, ὧν οἱ πυρετοὶ τὸ ἐπίπαν ξυνεχέες. ὅταν γὰρ μὴ λοιμώδεος νούσου τρόπος τις κοινὸς ἐπιδημήσῃ, ἀλλὰ σποράδεες ἔωσιν αἱ νοῦσοι καὶ παραπλήσιοι, ὑπὸ τουτέων τῶν νουσημάτων ἀποθνήσκουσι μᾶλλον ἢ ὑπὸ τῶν ἄλλων τῶν ξυμπάντων. οἱ μὲν οὖν ἰδιῶται οὐ κάρτα γιγνώσκουσι τοὺς ἐς ταῦτα διαφέροντας τῶν πέλας, ἑτεροίων τε μᾶλλον ἰημάτων ἐπαινέται καὶ ψέκται εἰσίν. ἔπειτα μέγα σημεῖον τόδε, ὅτι οἱ δημόται ἀξυνετώτατοι αὐτοὶ ἑωυτῶν περὶ τουτέων τῶν νουσημάτων εἰσὶν ὥς μελετητέα εἶναι· οἱ γὰρ μὴ ἰητροὶ ἰητροὶ δοκέουσιν εἶναι μάλιστα διὰ ταύτας τὰς νούσους· ῤηΐδιον γὰρ τὰ ὀνόματα ἐκμανθάνειν, ὁκοῖα νενόμισται προσφέρεσθαι πρὸς τοὺς τὰ τοιαῦτα κάμνοντας. ἢν γὰρ ὀνομάσῃ τις πτισάνης τε χυλὸν καὶ οἶνον τοῖον ἢ τοῖον καὶ μελίκρητον, ἅπαντα τοῖσι δημότῃσι δοκέουσιν οἱ ἰητροὶ ταῦτα λέγειν, οἵ τε βελτίους καὶ οἱ χείρους· τὰ δὲ οὐχ οὕτως ἔχει, ἀλλʼ ἐν τουτέοισι δὴ καὶ πάνυ μέγα διαφέρουσιν ἕτεροι ἑτέρων.

[¶2] 3. But it appears to me that those things are more especially deserving of being consigned to writing which are undetermined by physicians, notwithstanding that they are of vital importance, and either do much good or much harm. By undetermined I mean such as these, wherefore certain physicians, during their whole lives, are constantly administering unstrained ptisans, and fancy they thus accomplish the cure properly, whereas others take great pains that the patient should not swallow a particle of the barley (thinking it would do much harm), but strain the juice through a cloth before giving it; others, again, will neither give thick ptisan nor the juice, some until the seventh day of the disease, and some until after the crisis. Physicians are not in the practice of mooting such questions; nor, perhaps, if mooted, would a solution of them be found; although the whole art is thereby exposed to much censure from the vulgar, who fancy that there really is no such science as medicine, since, in acute diseases, practitioners differ so much among themselves, that those things which one administers as thinking it the best that can be given, another holds to be bad; and, in this respect, they might say that the art of medicine resembles augury, since augurs hold that the same bird (omen) if seen on the left hand is good, but if on the right bad: and in divination by the inspection of entrails you will find similar differences; but certain diviners hold the very opposite of these opinions. I say, then, that this question is a most excellent one, and allied to very many others, some of the most vital importance in the Art, for that it can contribute much to the recovery of the sick, and to the preservation of health in the case of those who are well; and that it promotes the strength of those who use gymnastic exercises, and is useful to whatever one may wish to apply it.

> Greek: 3. 3. δοκέει δέ μοι ἄξια γραφῆς εἶναι ταῦτα μάλιστα, ὁκόσα τε ἀκαταμάθητά ἐστι τοῖσιν ἰητροῖσιν, ἐπίκαιρα ἐόντα εἰδέναι, καὶ ὁκόσα μεγάλας ὠφελείας φέρει ἢ μεγάλας βλάβας. ἀκαταμάθητα μὲν οὖν τάδε ἐστί· διὰ τί ἄρα ἐν τῇσιν ὀξείῃσι νούσοισιν οἱ μὲν τῶν ἰητρῶν ἅπαντα τὸν αἰῶνα διατελεῦσι πτισάνας διδόντες ἀδιηθήτους, καὶ νομίζουσιν ὀρθῶς ἰητρεύειν, οἱ δέ τινες περὶ παντὸς ποιέονται ὅκως κριθὴν μηδεμίην καταπίῃ ὁ κάμνων (μεγάλην γὰρ βλάβην ἡγεῦνται εἶναι), ἀλλὰ διʼ ὀθονίου διηθεῦντες τὸν χυλὸν διδόασιν· οἱ δʼ αὖ τινες αὐτέων οὔτʼ ἂν πτισάνην παχείην δοῖεν, οὔτε χυλόν· οἱ μὲν μέχρις ἂν ἑβδομαῖος γένηται ὁ κάμνων, οἱ δὲ καὶ διὰ τέλεος ἄχρὶς ἂν κριθῇ ἡ νοῦσος. μάλα μὲν οὖν οὐδὲ προβάλλεσθαι τὰ τοιαῦτα ζητήματα εἰθισμένοι εἰσὶν οἱ ἰητροί· ἴσως δὲ οὐδὲ προβαλλόμενα εὑρίσκεται· καίτοι διαβολήν γε ἔχει ὅλη ἡ τέχνη πρὸς τῶν δημοτέων μεγάλην, ὡς μηδὲ δοκέειν ὅλως ἰητρικὴν εἶναι· ἔν γε τοῖσιν ὀξέσι τῶν νουσημάτων τοσόνδε διοίσουσιν ἀλλήλων οἱ χειρωνάκται, ὥστε ἃ ὁ ἕτερος προσφέρει ἡγεύμενος ἄριστα εἶναι, ταῦτα νομίζειν ἤδη τὸν ἕτερον κακὰ εἶναι· καὶ σχεδὸν ἂν κατά γε τὸ τοιόνδε τὴν τέχνην φαῖεν ὡμοιῶσθαι τῇ μαντικῇ, ὅτι οἱ μάντιες τὸν αὐτὸν ὄρνιθα, εἰ μὲν ἀριστερὸς εἴη, ἀγαθὸν νομίζουσιν εἶναι, εἰ δὲ δεξιὸς, κακόν· καὶ ἐν ἱεροσκοπίῃ τὰ τοιάδε εὕροι τις ἂν ἄλλα ἐπʼ ἄλλοισιν· ἀλλʼ ἔνιοι τῶν μάντιων τἀναντία τουτέων. φημὶ δὴ πάγκαλον εἶναι τοῦτο τὸ σκέμμα καὶ ἠδελφισμένον τοῖσι πλείστοισι τῶν ἐν τῇ τέχνῃ καὶ ἐπικαιροτάτοισιν· καὶ γὰρ τοῖσι νοσέουσι πᾶσιν ἐς ὑγείην μέγα τι δύνασθαι, καὶ τοῖσιν ὑγιαίνουσιν ἐς ἀσφαλείην, καὶ τοῖσιν ἀσκέουσιν ἐς εὐεξίην, καὶ ἐς ὅ τι ἂν ἕκαστος ἐθέλῃ.

[¶3] 4. Ptisan, then, appears to me to be justly preferred before all the other preparations from grain in these diseases, and I commend those who made this choice, for the mucilage of it is smooth, consistent, pleasant, lubricant, moderately diluent, quenches thirst if this be required, and has no astringency; gives no trouble nor swells up in the bowels, for in the boiling it swells up as much as it naturally can. Those, then, who make use of ptisan in such diseases, should never for a day allow their vessels to be empty of it, if I may say so, but should use it and not intermit, unless it be necessary to stop for a time, in order to administer medicine or a clyster. And to those who are accustomed to take two meals in the day it is to be given twice, and to those accustomed to live upon a single meal it is to be given once at first, and then, if the case permit, it is to be increased and given twice to them, if they appear to stand in need of it. At first it will be proper not to give a large quantity nor very thick, but in proportion to the quantity of food which one has been accustomed to take, and so as that the veins may not be much emptied. And, with regard to the augmentation of the dose, if the disease be of a drier nature than one had supposed, one must not give more of it, but should give before the draught of ptisan, either hydromel or wine, in as great quantity as may be proper; and what is proper in each case will be afterward stated by us. But if the mouth and the passages from the lungs be in a proper state as to moisture, the quantity of the draught is to be increased, as a general rule, for an early and abundant state of moisture indicates an early crisis, but a late and deficient moisture indicates a slower crisis. And these things are as I have stated for the most part; but many other things are omitted which are important to the prognosis, as will be explained afterwards. And the more that the patient is troubled with purging, in so much greater quantity is it to be given until the crisis, and moreover until two days beyond the crisis, in such cases as it appears to take place on the fifth, seventh, or ninth day, so as to have respect both for the odd and even day: after this the draught is to be given early in the day, and the other food in place is to be given in the evening. These things are proper, for the most part, to be given to those who, from the first, have used ptisan containing its whole substance; for the pains in pleuritic affections immediately cease of their own accord whenever the patients begin to expectorate anything worth mentioning, and the purgings become much better, and empyema much more seldom takes place, than if the patients used a different regimen, and the crises are more simple, occur earlier, and the cases are less subject to relapses.

> Greek: 4. 4. πτισάνη μὲν οὖν μοι δοκέει ὀρθῶς προκεκρίσθαι τῶν σιτηρῶν γευμάτων ἐν τουτέοισι τοῖσι νουσήμασι, καὶ ἐπαινέω γε τοὺς προκρίναντας. τὸ γὰρ γλίσχρασμα αὐτέης λεῖον καὶ ξυνεχὲς καὶ προσηνές ἐστι καὶ ὀλισθηρὸν καὶ πλαδαρὸν μετρίως καὶ ἄδιψον καὶ εὐέκπλυτον, εἴ τι καὶ τουτέου προσδέοι, καὶ οὔτε στύψιν ἔχον, οὔτε ἄραδον κακὸν, οὔτε ἀνοιδίσκεται ἐν τῇ κοιλίῃ· ἀνῴδηκε γὰρ ἐν τῇ ἑψήσει ὁκόσον πλεῖστον ἐπεφύκει διογκοῦσθαι. ὁκόσοι μὲν οὖν πτισάνῃσι χρέονται, ἐν τουτέοισι τοῖσι νουσήμασιν οὐδεμιῇ ἡμέρῃ κενεαγγητέον, ὡς ἔπος εἰρῆσθαι, ἀλλὰ χρηστέον, καὶ οὐ διαλειπτέον, ἢν μή τι δέῃ ἢ διὰ φαρμακίην ἢ κλύσιν διαλιπεῖν. καὶ τοῖσι μέν γε εἰθισμένοισι δὶς σιτέεσθαι τῆς ἡμέρης, δὶς δοτέον· τοῖσι δὲ μονοσιτέειν εἰθισμένοισιν, ἅπαξ δοτέον τὴν πρώτην, ἐκ προσαγωγῆς δὲ, ἢν ἐνδέχηται, καὶ τουτέοισι δὶς δοτέον, ἤν τι δοκέῃ προσδεῖν. πλῆθος δὲ ἀρκέει κατʼ ἀρχὰς διδόναι μὴ πουλὺ, μηδὲ ὑπέρπαχυ, ἀλλʼ ὁκόσον ἕνεκεν τοῦ ἔθεος ἐσιέναι τι, καὶ κενεαγγίην μὴ γίγνεσθαι πολλήν. περὶ δὲ τῆς ἐπιδόσιος ἐς πλῆθος τοῦ ῤοφήματος, ἢν μὲν ξηρότερον ᾖ τὸ νούσημα ἢ ὡς ἄν τις οἴοιτο, οὐ χρὴ ἐπὶ πλέον διδόναι, ἀλλὰ προπίνειν πρὸ τοῦ ῤοφήματος ἢ μελίκρητον, ἢ οἶνον, ὁκότερον ἂν ἁρμόζῃ· τὸ δʼ ἁρμόζον ἐφʼ ἑκάστοισι τῶν τρόπων εἰρήσεται. ἢν δὲ ὑγραίνηται τὸ στόμα καὶ τὰ ἀπὸ τοῦ πλεύμονος εἴη ὁκοῖα δεῖ, ἐπιδιδόναι χρὴ ἐς πλῆθος τοῦ ῤοφήματος, ὡς ἐν κεφαλαίῳ εἰρῆσθαι· τὰ μὲν γὰρ θᾶσσον καὶ μᾶλλον πλαδῶντα ταχυτῆτα κρίσιος σημαίνει, τὰ δὲ βραδύτερον καὶ ἧσσον βραδυτέρην σημαίνει τὴν κρίσιν. καὶ ταῦτα αὐτὰ μὲν καθʼ ἑωυτὰ τοιάδε τὸ ἐπίπαν ἐστίν· πολλὰ δὲ καὶ ἄλλα ἐπίκαιρα παρεῖται οἷσι προσημαίνεσθαι δεῖ, ἃ εἰρήσεται ὕστερον. καὶ ὁκόσῳ ἂν πλείων ἡ κάθαρσις γίγνηται, τοσῷδε χρὴ πλέον ἐπιδιδόναι ἄχρι κρίσιος· μάλιστα δὲ κρίσιος ὑπερβολῆς δύο ἡμερέων, οἷσί γε ἢ πεμπταίοισιν ἢ ἑβδομαίοισιν ἢ ἐναταίοισι δοκέει κρίνεσθαι, ὡς καὶ τὸ ἄρτιον καὶ τὸ περισσὸν προμηθήσῃ· μετὰ δὲ τοῦτο, τῷ μὲν ῤοφήματι τὸ πρωϊ χρηστέον, ὀψὲ δὲ ἐς σιτία μεταβάλλειν. ξυμφέρει δὲ τὰ τοιάδε ὡς ἐπιτοπουλὺ τοῖσιν ὅλῃσι πτισάνῃσιν αὐτίκα χρεομένοισιν. αἵ τε γὰρ ὀδύναι ἐν τοῖσι πλευριτικοῖσιν αὐτίκα αὐτόματοι παύονται, ὅταν ἄρξωνται πτύειν τι ἄξιον λόγου καὶ ἐκκαθαίρεσθαι, αἵ τε καθάρσιες πολλῷ τελεώτεραί εἰσι, καὶ ἔμπυοι ἧσσον γίγνονται ἢ εἰ ἀλλοίως τις διαιτῴη, καὶ αἱ κρίσιες ἁπλούστεραι καὶ εὐκριτώτεραι καὶ ἧσσον ὑποστροφώδεες.

[¶4] 5. Ptisans are to be made of the very best barley, and are to be well boiled, more especially if you do not intend to use them strained. For, besides the other virtues of ptisan, its lubricant quality prevents the barley that is swallowed from proving injurious, for it does not stick nor remain in the region of the breast; for that which is well boiled is very lubricant, excellent for quenching thirst, of very easy digestion, and very weak, all which qualities are wanted. If, then, one do not pay proper attention to the mode of administering the ptisan, much harm may be done; for when the food is shut up in the bowels, unless one procure some evacuation speedily, before administering the draught, the pain, if present, will be exasperated; and, if not present, it will be immediately created, and the respiration will become more frequent, which does mischief, for it dries the lungs, fatigues the hypochondria, the hypogastrium, and diaphragm. And moreover if, while the pain of the side persists, and does not yield to warm fomentations, and the sputa are not brought up, but are viscid and unconcocted, unless one get the pain resolved, either by loosening the bowels, or opening a vein, whichever of these may be proper;—if to persons so circumstanced ptisan be administered, their speedy death will be the result. For these reasons, and for others of a similar kind still more, those who use unstrained ptisan die on the seventh day, or still earlier, some being seized with delirium, and others dying suffocated with orthopnoee and riles. Such persons the ancients thought struck, for this reason more especially, that when dead the affected side was livid, like that of a person who had been struck. The cause of this is that they die before the pain is resolved, being seized with difficulty of respiration, and by large and rapid breathing, as has been already explained, the spittle becoming thick, acid, and unconcocted, cannot be brought up, but, being retained in the bronchi of the lungs, produces riles; and, when it has come to this, death, for the most part, is inevitable; for the sputa being retained prevent the breath from being drawn in, and force it speedily out, and thus the two conspire together to aggravate the sputa being retained renders the respiration frequent, while the respiration being frequent thickens the sputa, and prevents them from being evacuated. These symptoms supervene, not only if ptisan be administered unseasonably, but still more if any other food or drink worse than ptisan be given.

> Greek: 5. 5. τὰς δὲ πτισάνας χρὴ ἐκ κριθέων τε ὡς βελτίστων εἶναι καὶ κάλλιστα ἡψῆσθαι, καὶ ἄλλως ἢν μὴ τῷ χυλῷ μούνῳ μέλλῃς χρέεσθαι. μετὰ γὰρ τῆς ἄλλης ἀρετῆς τῆς πτισάνης τὸ ὀλισθηρὸν τὴν κριθὴν καταπινομένην ποιέει μὴ βλάπτειν· οὐδαμοῦ γὰρ προσίσχει, οὐδὲ μένει κατὰ τὴν τοῦ θώρηκος ἴξιν. Ὀλισθηροτάτη τε καὶ ἀδιψοτάτη καὶ εὐπεπτοτάτη καὶ ἀσθενεστάτη ἐστὶν ἡ κάλλιστα ἑφθὴ, ὧν πάντων δεῖ. ἢν οὖν μὴ προστιμωρήσῃ τις ὁκόσων δέεται αὐτάρκης εἶναι ὁ τρόπος τῆς τοιαύτης πτισανοῤῥοφίης, πολλαχῆ βεβλάψεται. Ὁκόσοισι γὰρ σῖτος αὐτίκα ἐγκατακέκλεισται, ἢν μή τις ὑποκενώσας τὸ ῤόφημα δώῃ, τὴν ὀδύνην ἐνεοῦσαν προσπαροξύνειεν ἂν, καὶ μὴ ἐνεοῦσαν εὐθὺς ἐμποιήσειεν ἂν, καὶ πνεῦμα πυκνότερον γένοιτʼ ἄν· κακὸν δὲ τοῦτό ἐστιν· ξηραντικὸν γὰρ πλεύμονος, καὶ κοπῶδες ὑποχονδρίων καὶ ἤτρου καὶ φρενῶν. τοῦτο δὲ, ἢν ἔτι τῆς ὀδύνης τοῦ πλευροῦ ξυνεχέος ἐούσης, καὶ πρὸς τὰ θερμάσματα μὴ χαλώσης, καὶ τοῦ πτυέλου μὴ ἀνιόντος, ἀλλὰ καταγλισχραινομένου ἀσαπέως, ἢν μὴ λύσῃ τις τὴν ὀδύνην, ἢ κοιλίην μαλθάξας, ἢ φλέβα ταμὼν, ὁκότερον ἂν τουτέων ξυμφέρῃ, τὰς δὲ πτισάνας ἢν οὕτως ἔχουσι διδῷ, ταχέες οἱ θάνατοὶ τῶν τοιουτέων γίγνονται. διὰ ταύτας οὖν τὰς προφάσιας καὶ ἑτέρας τοιαύτας ἔτι μᾶλλον, οἱ ὅλῃσι τῇσι πτισάνῃσι χρεόμενοι, ἑβδομαῖοι καὶ ὀλιγημερώτεροι θνήσκουσιν· οἱ μέν τοι καὶ τὴν γνώμην βλαβέντες, οἱ δὲ ὑπὸ τῆς ὀρθοπνοίης τε καὶ τοῦ ῤέγχεος ἀποπνιγέντες. μάλα δὲ τοὺς τοιουτέους οἱ ἀρχαῖοι βλητοὺς ἐνόμιζον εἶναι διὰ τόδε μάλιστα· οὐχ ἥκιστα δὲ, ὅτι καὶ ἀποθανόντων αὐτέων ἡ πλευρὴ πελιὴ εὑρίσκεται ἴκελόν τι πληγῇ. αἴτιον δὲ τουτέου τόδε ἐστὶν, ὅτι, πρὶν λυθῆναι τὴν ὀδύνην, θνήσκουσιν· ταχέως γὰρ πνευματίαι γίγνονται· ὑπὸ δὲ τοῦ πολλοῦ καὶ πυκνοῦ πνεύματος, ὡς ἤδη εἴρηται, καταγλισχραινόμενον τὸ πτύελον ἀπέπτως κωλύει τὴν ἐπάνοδον γίγνεσθαι, ἀλλὰ τὴν ῤέγξιν ποιέει ἐνισχόμενον ἐν τοῖσι βρογχίοισι τοῦ πλεύμονος. καὶ ὁκόταν ἐς ταὐτὸ ἔλθῃ, θανατῶδες ἤδη ὡς ἐπιτοπουλὺ ἐστίν· καὶ γὰρ αὐτὸ τὸ πτύελον ἐνισχόμενον κωλύει μὲν τὸ πνεῦμα ἔσω φέρεσθαι, ἀναγκάζει δὲ ταχέως ἔξω φέρεσθαι· καὶ οὕτως ἐς τὸ κακὸν ἀλλήλοισι τιμωρέουσι· τό τε γὰρ πτύελον ἐνισχόμενον πυκνὸν τὸ πνεῦμα ποιέει, τό τε πνεῦμα πυκνὸν ἐὸν ἐπιγλισχραίνει τὸ πτύελον, καὶ κωλύει ἀπολισθαίνειν. καταλαμβάνει δὲ ταῦτα, οὐ μοῦνον ἢν πτισάνῃ ἀκαίρως χρέωνται, ἀλλὰ πουλὺ μᾶλλον ἤν τι ἄλλο φάγωσιν ἢ πίωσι πτισάνης ἀνεπιτηδειότερον.

[¶5] 6. For the most part, then, the results are the same, whether the patient have used the unstrained ptisan or have used the juice alone; or even only drink; and sometimes it is necessary to proceed quite differently. In general, one should do thus: if fever commences shortly after taking food, and before the bowels have been evacuated, whether with or without pain, the physician ought to withhold the draught until he thinks that the food has descended to the lower part of the belly; and if any pain be present, the patient should use oxymel, hot if it is winter, and cold if it is summer; and, if there be much thirst, he should take hydromel and water. Then, if any pain be present, or any dangerous symptoms make their appearance, it will be proper to give the draught neither in large quantity nor thick, but after the seventh day, if the patient be strong. But if the earlier-taken food has not descended, in the case of a person who has recently swallowed food, and if he be strong and in the vigor of life, a clyster should be given, or if he be weaker, a suppository is to be administered, unless the bowels open properly of themselves. The time for administering the draught is to be particularly observed at the commencement and during the whole illness; when, then, the feet are cold, one should refrain from giving the ptisan, and more especially abstain from drink; but when the heat has descended to the feet, one may then give it; and one should look upon this season as of great consequence in all diseases, and not least in acute diseases, especially those of a febrile character, and those of a very dangerous nature. One may first use the juice, and then the ptisan, attending accurately to the rules formerly laid down.

> Greek: 6. 6. μάλα μὲν οὖν τὰ πλεῖστα παραπλήσιαί εἰσιν αἱ τιμωρίαι τοῖσί τε ὅλῃσι τῇσι πτισάνῃσι χρεομένοισι, τοῖσί τε τῷ χυλῷ αὐτέῳ· τοῖσι δὲ μηδετέρῳ τουτέων, ἀλλὰ ποτῷ μοῦνον, ἔστιν ὅπη καὶ διαφερόντως τιμωρητέον. χρὴ δὲ τό γε πάμπαν οὕτω ποιέειν· ἢν νεοβρῶτι ἐόντι αὐτέῳ καὶ κοιλίης μήπω ὑποκεχωρηκυίης ἄρξηται ὁ πυρετὸς, ἤν τε ξὺν ὀδύνῃ, ἤν τε ἄνευ ὀδύνης, ἐπισχεῖν τὴν δόσιν τοῦ ῤοφήματος, ἔστʼ ἂν οἴηται κεχωρηκέναι ἐς τὸ κάτω μέρος τοῦ ἐντέρου τὸ σιτίον. χρέεσθαι δὲ ποτῷ, ἢν μὲν ἄλγημά τι ἔχῃ, ὀξυμέλιτι χειμῶνος μὲν θερμῷ, θέρεος δὲ, ψυχρῷ· ἢν δὲ πολλὴ δίψα ᾖ, μελικρήτῳ καὶ ὕδατι. ἔπειτα, ἢν μὲν ἄλγημά τι ἐνῇ, ἢ τῶν ἐπικινδύνων τι ἐμφαίνηται, διδόναι τὸ ῤόφημα μήτε πουλὺ μήτε παχὺ, μετὰ δὲ τὴν ἑβδόμην, ἢν ἰσχύῃ. ἤν δὲ μὴ ὑπεληλύθῃ ὁ παλαιότερος σῖτος νεοβρῶτι ἐόντι, ἢν μὲν ἰσχύῃ τε καὶ ἀκμάζῃ τῇ ἡλικίῃ, κλύσαι· ἢν δὲ ἀσθενέστερος ᾖ, βαλάνῳ προσχρήσασθαι, ἢν μὴ αὐτόματα διεξίῃ καλῶς. καιρὸν δὲ τῆς δόσιος τοῦ ῤοφήματος τόνδε μάλιστα φυλάσσεσθαι, κατʼ ἀρχὰς καὶ διὰ παντὸς τοῦ νουσήματος· ὅταν μὲν οἱ πόδες ψυχροὶ ἔωσιν, ἐπισχεῖν χρὴ τοῦ ῤοφήματος τὴν δόσιν, μάλιστα δὲ καὶ τοῦ ποτοῦ ἀπέχεσθαι· ὁκόταν δὲ ἡ θέρμη καταβῇ ἐς τοὺς πόδας, τότε διδόναι, καὶ νομίζειν μέγα δύνασθαι τὸν καιρὸν τοῦτον ἐν πάσῃσι τῇσι νούσοισιν· οὐχ ἥκιστα δὲ ἐν τῇσιν ὀξείῃσι, μάλιστα δὲ ἐν τῇσι μᾶλλον πυρετώδεσι καὶ ἐπικινδυνοτάτῃσιν. χρέεσθαι δὲ πρῶτον μάλιστα μὲν χυλῷ, ἔπειτα δὲ πτισάνῃ, κατὰ τὰ τεκμήρια τὰ προγεγραμμένα ἀκριβέως θεωρέων.

[¶6] 7. When pain seizes the side, either at the commencement or at a later stage, it will not be improper to try to dissolve the pain by hot applications. Of hot applications the most powerful is hot water in a bottle, or bladder, or in a brazen vessel, or in an earthen one; but one must first apply something soft to the side, to prevent pain. A soft large sponge, squeezed out of hot water and applied, forms a good application; but it should be covered up above, for thus the heat will remain the longer, and at the same time the vapor will be prevented from being carried up to the patient’s breath, unless when this is thought of use, for sometimes it is the case. And further, barley or tares may be infused and boiled in diluted vinegar, stronger than that it could be drunk, and may then be sewed into bladders and applied; and one may bran in like manner. Salts or toasted millet in woolen bags are excellent for forming a dry fomentation, for the millet is light and soothing. A soft fomentation like this soothes pains, even such as shoot to the clavicle. Venesection, however, does not alleviate the pain unless when it extends to the clavicle. But if the pain be not dissolved by the fomentations, one ought not to foment for a length of time, for this dries the lungs and promotes suppuration; but if the pain point to the clavicle, or if there be a heaviness in the arm, or about the breast, or above the diaphragm, one should open the inner vein at the elbow, and not hesitate to abstract a large quantity, until it become much redder, or instead of being pure red, it turns livid, for both these states occur. But if the pain be below the diaphragm, and do not point to the clavicle, we must open the belly either with black hellebore or peplium, mixing the black hellebore with carrot or seseli, or cumin, or anise, or any other of the fragrant herbs; and with the peplium the juice of sulphium (asafoetida), for these substances, when mixed up together, are of a similar nature. The black hellebore acts more pleasantly and effectually than the peplium, while, on the other hand, the peplium expels wind much more effectually than the black hellebore, and both these stop the pain, and many other of the laxatives also stop it, but these two are the most efficacious that I am acquainted with. And the laxatives given in draughts are beneficial, when not very unpalatable owing to bitterness, or any other disagreeable taste, or from quantity, color, or any apprehension. When the patient has drunk the medicine, one ought to give him to swallow but little less of the ptisan than what he had been accustomed to; but it is according to rule not to give any draughts while the medicine is under operation; but when the purging is stopped then he should take a smaller draught than what he had been accustomed to, and afterwards go on increasing it progressively, until the pain cease, provided nothing else contra-indicate. This is my rule, also, if one would use the juice of ptisan (for I hold that it is better, on the whole, to begin with taking the decoction at once, rather than by first emptying the veins before doing so, or on the third, fourth, fifth, sixth, or seventh day, provided the disease has not previously come to a crisis in the course of this time), and similar preparations to those formerly described are to be made in those cases.

> Greek: 7. 7. ὀδύνη δὲ πλευροῦ ἤν τε κατʼ ἀρχὰς γένηται, ἤν τε ἐς ὕστερον, θερμάσμασι μὲν πρῶτον οὐκ ἀπὸ τρόπου ἐστὶ χρησάμενον πειρηθῆναι διαλῦσαι τὴν ὀδύνην. Θερμασμάτων δὲ κράτιστον μὲν ὕδωρ θερμὸν ἐν ἀσκῷ, ἢ ἐν κύστει, ἢ ἐν χαλκῷ ἀγγείῳ, ἢ ἐν ὀστρακίνῳ· προϋποτιθέναι δὲ χρὴ μαλθακόν τι πρὸς τὴν πλευρὴν, προσηνείης εἵνεκεν. ᾽Αγαθὸν δὲ καὶ σπόγγος μαλθακὸς, μέγας, ἐξ ὕδατος θερμοῦ ἐκπεπιεσμένος προστίθεσθαι· περιστέγειν τε ἄνω τὴν θάλψιν χρή· πλείω τε γὰρ χρόνον διαρκέσει καὶ παραμενεῖ, καὶ ἅμα ὡς μὴ ἡ ἀτμὶς πρὸς τὸ πνεῦμα τοῦ κάμνοντος προσφέρηται, ἢν ἄρα μὴ δοκέῃ καὶ τοῦτο χρήσιμον πρός τι εἶναι· ἔστι γὰρ ὅτε δεῖ πρός τι. ἔτι δὲ καὶ κριθαὶ ἢ ὄροβοι· ἐν ὄξει κεκρημένῳ σμικρῷ ὀξύτερον, ἢ ὡς ἄν τις πίοι, διέντα καὶ ἀναζέσαντα, ἐς μαρσίππια καταῤῥάψαντα προστιθέναι· καὶ πίτυρα τὸν αὐτὸν τρόπον. πυρίη δὲ ξηρὴ, ἅλες, κέγχροι πεφρυγμένοι ἐν εἰρινέοισι μαρσιππίοισιν ἐπιτηδειότατοι· καὶ γὰρ κοῦφον καὶ προσηνὲς ὁ κέγχρος· λύει δὲ μάλθαξις ἡ τοιήδε καὶ τὰς πρὸς κληῗδα περαιούσας ἀλγηδόνας. τομὴ μέντοι γε οὐχ δμοίως λύει ὀδύνην, ἢν μὴ πρὸς τὴν κληῗδα περαίνῃ ἡ ὀδύνη. ἢν δὲ μὴ λύηται πρὸς τὰ θερμάσματα ὁ πόνος, οὐ χρὴ πολὺν χρόνον θερμαίνειν· καὶ γὰρ ξηραντικὸν τοῦ πλεύμονος τοῦτό ἐστι, καὶ ἐμπυητικόν· ἀλλʼ ἢν μὲν σημαίνῃ ἡ ὀδύνη ἐς τὴν κληῗδα ἢ ἐς τὸν βραχίονα βάρος ἢ περὶ μαζὸν ἢ ὑπὲρ τῶν φρενῶν, τάμενιν χρὴ τὴν ἐν τῷ ἀγκῶνι φλέβα τὴν ἔσω, καὶ μὴ ὀκνέεινσυχνὸν ἀφαιρέειν τὸ αἷμα ἕως ἂν ἐρυθρότερον πολλῷ ῤυῇ, ἀντὶ καθαροῦ τε καὶἐρυθροῦ πελιόν· ἀμφότερα γὰρ γίγνεται. ἢν δὲ ὑπὸ τὰς φρένας ᾖ τὸ ἄλγημα, ἐς δὲ τὴν κληῗδα μὴ σημαίνῃ, μαλθάσσειν δεῖ τὴν κοιλίην, ἢ μέλανι ἐλλεβόρῳ ἢ πεπλίῳ, μέλανι μὲν δαῦκον ἢ σέσελι ἢ κύμινον ἢ ἄννησον ἢ ἄλλο τι τῶν εὐωδέων μίσγοντα, πεπλίῳ δὲ ὀπὸν σιλφίου· ἀτὰρ καὶ μισγόμενα ἀλλήλοισιν ὁμοιότροπα ταῦτά ἐστιν. ἄγει δὲ μέλας μὲν καλλίω καὶ κρισιμώτερα πεπλίου, πέπλιον δὲ μέλανος μᾶλλον φυσέων καταῤῥηκτικόν ἐστιν· ἄμφω δὲ ταῦτα ὀδύνην παύει· παύει δὲ καὶ ἄλλα πολλα τῶν ὑπηλάτων· κράτιστα δὲ ταῦτα ὧν ἐγὼ οἶδα ἐστίν. ἐπεὶ καὶ τὰ ἐν τοῖσι ῤοφήμασι διδόμενα ὑπήλατα ἀρήγει, ὁκόσα μὴ ἄγαν ἐστὶν ἀηδέα ἢ διὰ πικρότητα ἢ διʼ ἄλλην τινὰ ἀηδίην, ἢ διὰ πλῆθος ἢ χροιὴν ἢ ὑποψίην τινά. τῆς μὲν πτισάνης, ὁκόταν πίη τὸ φάρμακον, ἐπιῤῥοφῇν αὐτίκα χρὴ διδόναι μηδὲν ἔλασσον ἀξίως λόγου ἢ ὁκόσον εἴθιστο· ἐπεὶ καὶ κατὰ λόγον ἐστὶ μεσηγὺ τῆς καθάρσιος μὴ διδόναι ῤοφῇν· ὁκόταν δὲ λήξῃ ἡ κάθαρσις, τότε ἔλασσον ῤοφεέτω ἢ ὁκόσον εἴθιστο· μετὰ δὲ τοῦτο, ἀναγέτω αἰεὶ ἐπὶ τὸ πλεῖον, ἢν ἥ τε ὀδύνη πεπαυμένη ᾖ, καὶ μηδὲν ἄλλο ἐναντιῶται. ωὑτὸς δέ μοι λόγος ἐστὶ, καὶ ἢν χυλῷ πτισάνης δέῃ χρέεσθαι (φημὶ γὰρ ἄμεινον εἶναι αὐτίκα ἄρξασθαι τοῦ ῤοφῇν τὸ ἐπίπαν μᾶλλον, ἢ προκενεαγγήσαντα ἄρξασθαι τοῦ ῤοφήματος, ἢ τριταῖον, ἢ τεταρταῖον, ἢ πεμπταῖον, ἢ ἑκταῖον, ἢ ἑβδομαῖον, ἤν γε μὴ προκριθῇ ἡ νοῦσος ἐν τουτέῳ τῷ χρόνῳ)· αἱ δὲ προπαρασκευαὶ καὶ ἐπὶ τουτέοισι παραπλήσιοι ποιητέαι, ὁκοῖαι εἴρηνται.

[¶7] 8. Such are the opinions which I entertain respecting the administering of the ptisan; and, as regards drinks, whichsoever of those about to be described may be administered, the same directions are generally applicable. And here I know that physicians are in the practice of doing the very reverse of what is proper, for they all wish, at the commencement of diseases, to starve their patients for two, three, or more days, and then to administer the ptisans and drinks; and perhaps it appears to them reasonable that, as a great change has taken place in the body, it should be counteracted by another great change. Now, indeed, to produce a change is no small matter, but the change must be effected well and cautiously, and after the change the administration of food must be conducted still more so. Those persons, then, would be most injured if the change is not properly managed, who used unstrained ptisans; they also would suffer who made use of the juice alone; and so also they would suffer who took merely drink, but these least of all.

> Greek: 8. 8. περὶ μὲν οὖν ῤοφήματος προσάρσιος οὕτω γιγνώσκω· ἀτὰρ καὶ περὶ ποτοῦ, ὁκοῖον ἄν τις μέλλῃ πίνειν τῶν γραφησομένων, ωὑτός μοι λόγος ὡς ἐπίπαν ἐστίν. οἶδα δὲ τοὺς ἰητροὺς τὰ ἐναντιώτατα ἢ ὡς δεῖ ποιέοντας· βούλονται γὰρ πάντες, ὑπὸ τὰς ἀρχὰς τῶν νούσων προταριχεύσαντες τοὺς ἀνθρώπους ἢ δύο ἢ τρεῖς ἢ καὶ πλείονας ἡμέρας, οὕτω προσφέρειν τὰ ῤοφήματα καὶ τὰ ποτά· καὶ ἴσως τι καὶ εἰκὸς δοκέει αὐτέοισιν εἶναι, μεγάλης μεταβολῆς γενομένης τῷ σώματι, μέγα τι κάρτα καὶ ἀντιμεταβάλλειν. τὸ δὲ μεταβάλλειν μὲν εὖ ἔχει μὴ ὀλίγον· ὀρθῶς μέντοι ποιητέα καὶ βεβαίως ἡ μεταβολὴ, καὶ ἔκ γε τῆς μεταβολῆς ἡ πρόσαρσις τῶν γευμάτων ἔτι μᾶλλον. μάλιστα μὲν οὖν βλάπτοιντο ἂν, εἰ μὴ ὀρθῶς μεταβάλλοιεν, οἱ ὅλῃσι τῇσι πτισάνῃσι χρεόμενοι· βλάπτοιντο δʼ ἂν καὶ οἱ μούνῳ τῷ χυλῷ χρεόμενοι· βλάπτοιντο δʼ ἂν καὶ οἱ μούνῳ τῷ ποτῷ χρεόμενοι, ἥκιστα δʼἂν οὗτοι.

[¶8] 9. One may derive information from the regimen of persons in good health what things are proper; for if it appear that there is a great difference whether the diet be so and so, in other respects, but more especially in the changes, how can it be otherwise in diseases, and more especially in the most acute? But it is well ascertained that even a faulty diet of food and drink steadily persevered in, is safer in the main as regards health than if one suddenly change it to another. Wherefore, in the case of persons who take two meals in the day, or of those who take a single meal, sudden changes induce suffering and weakness; and thus persons who have not been accustomed to dine, if they shall take dinner, immediately become weak, have heaviness over their whole body, and become feeble and languid, and if, in addition, they take supper, they will have acid eructations, and some will have diarrhoea whose bowels were previously dry, and not having been accustomed to be twice swelled out with food and to digest it twice a day, have been loaded beyond their wont. It is beneficial, in such cases, to counterbalance this change, for one should sleep after dinner, as if passing the night, and guard against cold in winter and heat in summer; or, if the person cannot sleep, he may stroll about slowly, but without making stops, for a good while, take no supper, or, at all events, eat little, and only things that are not unwholesome, and still more avoid drink, and especially water. Such a person will suffer still more if he take three full meals in the day, and more still if he take more meals; and yet there are many persons who readily bear to take three full meals in the day, provided they are so accustomed. And, moreover, those who have been in the habit of eating twice a day, if they omit dinner, become feeble and powerless, averse to all work, and have heartburn; their bowels seem, as it were, to hang loose, their urine is hot and green, and the excrement is parched; in some the mouth is bitter, the eyes are hollow, the temples throb, and the extremities are cold, and the most of those who have thus missed their dinner cannot eat supper; or, if they do sup, they load their stomach, and pass a much worse night than if they had previously taken dinner. Since, then, an unwonted change of diet for half a day produces such effects upon persons in health, it appears not to be a good thing either to add or take from. If, then, he who was restricted to a single meal, contrary to usage, having his veins thus left empty during a whole day, when he supped according to custom felt heavy, it is probable that if, because he was uneasy and weak from the want of dinner, he took a larger supper than wont, he would be still more oppressed; or if, wanting food for a still greater interval, he suddenly took a meal after supper, he will feel still greater oppression. He, then, who, contrary to usage, has had his veins kept empty by want of food, will find it beneficial to counteract the bad effects during that day as follows: let him avoid cold, heat, and exertion, for he could bear all these ill; let him make his supper considerably less than usual, and not of dry food, but rather liquid; and let him take some drink, not of a watery character, nor in smaller quantity than is proportionate to the food, and on the next day he should take a small dinner, so that, by degrees, he may return to his former practice. Persons who are bilious in the stomach bear these changes worst, while those who are pituitous, upon the whole, bear the want of food best, so that they suffer the least from being restricted to one meal in the day, contrary to usage. This, then, is a sufficient proof that the greatest changes as to those things which regard our constitutions and habits are most especially concerned in the production of diseases, for it is impossible to produce unseasonably a great emptying of the vessels by abstinence, or to administer food while diseases are at their acme, or when inflammation prevails; nor, on the whole, to make a great change either one way or another with impunity.

> Greek: 9. 9. χρὴ δὲ καὶ τὰ μαθήματα ποιέεσθαι ἐν τῇ διαίτῃ τῶν ἀνθρώπων ἔτι ὑγιαινόντων, οἷα ξυμφέρει· εἰ γὰρ δὴ τοῖσί γε ὑγιαίνουσι φαίνεται διαφέροντα μεγάλα τὰ τοῖα ἢ τοῖα διαιτήματα καὶ ἐν ἄλλῳ τινί που καὶ ἐν τῇσι μεταβολῇσι, πῶς οὐχὶ καὶ ἔν γε τῇσι νούσοισι διαφέρει μεγάλα, καὶ τουτέων ἐν τῇσιν ὀξυτάτῃσι μέγιστα; ἀλλὰ μὴν εὐκαταμάθητόν γε ἐστὶν, ὅτι φαύλη δίαιτα βρώσιος καὶ πόσιος αὐτὴ ἑωυτῇ ἐμφερὴς αἰεὶ, ἀσφαλεστέρη ἐστὶ τὸ ἐπίπαν ἐς ὑγείην, ἢ εἴ τις ἐξαπίνης μέγα μεταβάλλοι ἐς ἄλλο. ἐπεὶ καὶ τοῖσι δὶς σιτεομένοισι τῆς ἡμέρης καὶ τοῖσι μονοσιτέουσιν αἱ ἐξαπιναῖοι μεταβολαὶ βλαβὰς καὶ ἀῤῥωστίην παρέχουσιν. καὶ τοὺς μέν γε μὴ μεμαθηκότας ἀριστᾷν, εἰ ἀριστήσουσιν, εὐθέως ἀῤῥώστους ποιέει, καὶ βαρέας ὅλον τὸ σῶμα, καὶ ἀσθενέας καὶ ὀκνηρούς· ἢν δὲ καὶ ἐπιδειπνήσωσιν, ὀξυρεγμιώδεας· ἐνίοισι δὲ καὶ σπατίλη γένοιτο ἂν, ὅτι παρὰ τὸ ἐωθὸς ἠχθοφόρηκεν ἡ κοιλίη εἰθισμένη ἐπιξηραίνεσθαι, καὶ μὴ δὶς διογκοῦσθαι, μήτε δὶς ἕψειν τὰ σιτία. ἀρήγει οὖν τουτέοισιν ἀνασηκῶσαι τὴν μεταβολήν· ἐγκοιμηθῆναι γὰρ χρὴ, ὥσπερ νυκτα ἀγαγόντα μετὰ τὸ δεῖπνον, τοῦ μὲν χειμῶνος ἀῤῥιγέως, τοῦ δὲ θέρεος ἀθαλπέως· ἢν δὲ μὴ δύνηται καθεύδειν, βραδειην, συχνὴν περίοδον, πλανηθέντα, μὴ στασίμως, δειπνῆσαι μηδὲν, ἢ ὀλίγα καὶ μὴ βλαβερά· ἔτι δὲ ἔλασσον πιεῖν καὶ μὴ ὑδαρές. ἔτι δʼ ἂν μᾶλλον πονήσειεν ὁ τοιοῦτος, εἰ τρὶς σιτέοιτο τῆς ἡμέρης ἐς κόρον· ἔτι δὲ μᾶλλον, εἰ πλεονάκις· καίτοι γε πολλοί εἰσιν, οἳ εὐφόρως φέρουσι τρὶς σιτεόμενοι τῆς ἡμέρης ἐς πλῆθος, οἳ ἂν οὕτως ἐθισθῶσιν. ἀλλὰ μὴν καὶ οἱ μεμαθηκότες δὶς σιτέεσθαι τῆς ἡμέρης, ἢν μὴ ἀριστήσωσιν, ἀσθενέες καὶ ἄῤῥωστοί εἰσι, καὶ δειλοὶ ἐς πᾶν ἔργον, καὶ καρδιαλγέες· κρεμᾶσθαι γὰρ δοκέει τὰ σπλάγχνα αὐτέοισι, καὶ οὐρέουσι θερμὸν καὶ χλωρὸν, καὶ ἡ ἄφοδος ξυγκαίεται· ἔστι δʼ οἷσι καὶ τὸ στόμα πικραίνεται, καὶ οἱ ὀφθαλμοὶ κοιλαίνονται, καὶ οἱ κρόταφοι πάλλονται, καὶ τὰ ἄκρα διαψύχονται· καὶ οἱ μὲν πλεῖστοι τῶν ἀνηριστηκοτων οὐ δύνανται κατεσθίειν τὸ δεῖπνον· δειπνήσαντες δὲ βαρύνουσι τὴν κοιλίην, καὶ δυσκοιτέουσι πουλὺ μᾶλλον ἢ εὶ προηριστήκεσαν. ὁκότε οὖν ταῦτα τοιαῦτα γίγνεται τοῖσιν ὑγιαίνουσιν εἵνεκεν ἡμίσεος ἡμέρης διαίτης μεταβολῆς παρὰ τὸ ἔθος, οὔτε προσθεῖναι λυσιτελέειν φαίνεται, οὔτε ἀφελέειν. εἰ τοίνυν οὗτος ὁ παρὰ τὸ ἔθος μονοσιτήσας, ὅλην ἡμέρην κενεαγγήσας, δειπνήσειεν ὁκόσον εἴθιστο, δειπνήσας δὲ, τότε βαρὺς ἦν, εἰκὸς αὐτὸν, εἰ, ὅτι ἀνάριστος ἐὼν ἐπόνεε καὶ ἠῤῥώστει, δειπνήσειε πλείω ἢ ὁκόσον εἴθιστο, πουλὺ μᾶλλον βαρύνεσθαι· εἰ δέ γε ἐπὶ πλείω χρόνον κενεαγγήσας ἐξαπίνης μεταδειπνήσειν, ἔτι μᾶλλον ἂν βαρύνοιτο. τὸν οὖν παρὰ τὸ ἔθος κενεαγγήσαντα ξυμφέρει ταύτην τὴν ἡμέρην ἀντισηκῶσαι ὧδε· ἀῤῥιγέως καὶ ἀθαλπέως καὶ ἀταλαιπώρως, ταῦτα γὰρ πάντα βαρέως ἂν ἐνέγκοι· τὸ δὲ δεῖπνον συχνῷ ἔλασσον ποιήσασθαι ἢ ὅσον εἴθιστο, καὶ μὴ ξηρὸν, ἀλλὰ τοῦ πλαδαρωτέρου τρόπου· καὶ πιεῖν μὴ ὑδαρὲς, μηδʼ ἔλασσον ἢ κατὰ λόγον βρώματος· καὶ τῇ ὑστεραίῃ ὀλίγα ἀριστῆσαι, ὡς ἐκ προσαγωγῆς ἀφίκηται ἐς τὸ ἔθος. αὐτοὶ μέντοι σφῶν αὐτῶν δυσφορώτερον δὴ τὰ τοιαῦτα φέρουσιν οἱ πικρόχολοι τὰ ἄνω· τὴν δέ γε ἀσιτίην τὴν παρὰ τὸ ἔθος οἱ φλεγματίαι τὰ ἄνω εὐφορώτερον φέρουσι τὸ ἐπίπαν, ὥστε καὶ τὴν μονοσιτίην τὴν παρὰ τὸ ἔθος εὐφορώτερον ἂν οὗτοι ἐνέγκοιεν. ἱκανὸν μὲν οὖν καὶ τοῦτο σημήϊον, ὅτι αἱ μέγισται μεταβολαὶ τῶν περὶ τὰς φύσιας ἡμῶν καὶ τὰς ἕξιας ξυμβαινόντων μάλιστα νοσοποιέουσιν· οὐ δὴ οἷόν τε παρὰ καιρὸν οὔτε σφοδρὰς τὰς κενεαγγείας ποιέειν, οὔτε ἀκμαζόντων τῶν νουσημάτων καὶ ἐν φλεγμασίῃ ἐόντων προσφέρειν, οὔτε ἐξαπίνης οἷόν τε ὅλῳ τῷ πρήγματι μεταβάλλειν οὔτε ἐπὶ τὰ οὔτε ἐπὶ τά.

[¶9] 10. One might mention many things akin to these respecting the stomach and bowels, to show how people readily bear such food as they are accustomed to, even if it is not naturally good, and drink in like manner, and how they bear unpleasantly such food as they are not accustomed to, even although not bad, and so in like manner with drink; and as to the effects of eating much flesh, contrary to usage, or garlic, or asafoetida, or the stem of the plant which produces it, or things of a similar kind possessed of strong properties, one would be less surprised if such things produce pains in the bowels, but rather when one learned what trouble, swelling, flatulence, and tormina the cake (maza) will raise in the belly when eaten by a person not accustomed to it; and how much weight and distention of the bowels bread will create to a person accustomed to live upon the maza; and what thirst and sudden fullness will be occasioned by eating hot bread, owing to its desiccant and indigestible properties; and what different effects are produced by fine and coarse bread when eaten contrary to usage, or by the cake when usually dry, moist, or viscid; and what different effects polenta produces upon those who are accustomed and those who are unaccustomed to the use of it; or drinking of wine or drinking of water, when either custom is suddenly exchanged for the other; or when, contrary to usage, diluted wine or undiluted has been suddenly drunk, for the one will create water-brash in the upper part of the intestinal canal and flatulence in the lower, while the other will give rise to throbbing of the arteries, heaviness of the head, and thirst; and white and dark-colored wine, although both strong wines, if exchanged contrary to usage, will produce very different effects upon the body, so that one need the less wonder that a sweet and strong wine, if suddenly exchanged, should have by no means the same effect.

> Greek: 10. 10. πολλὰ δʼ ἄν τις ἠδελφισμένα τουτέοισι τῶν ἐς κοιλίην καὶ ἄλλα εἴποι, ὡς εὐφόρως μὲν φέρουσι τὰ βρώματα, ἃ εἰθισμένοι εἰσὶν, ἢν καὶ μὴ ἀγαθὰ ᾖ φύσει, ὡσαύτως δὲ καὶ τὰ ποτά· δυσφόρως δὲ φέρουσι τὰ βρωματα, ἃ μὴ εἰθισμένοι εἰσὶν, κἢν μὴ κακὰ ᾖ, ὡσαύτως δὲ καὶ τὰ ποτά. καὶ ὁκόσα μὲν κρεηφαγίη πολλὴ παρὰ τὸ ἔθος βρωθεῖσα ποιέει, ἢ σκόροδα, ἢ σίλφιον ἢ ὀπὸς ἢ καυλὸς, ἢ ἄλλα ὁκόσα τοιουτότροπα μεγάλας δυνάμιας ἔχοντα ἰδίας, ἧσσον ἄν τις θαυμάσειεν, εἰ τὰ τοιαῦτα πόνους ἐμποιέει τῇσι κοιλίῃσι μᾶλλον τῶν ἄλλων· ἀλλʼ εἰ καταμάθοις ὁκόσον μᾶζα ὄχλον καὶ ὄγκον καὶ φῦσαν καὶ στρόφον τῇ κοιλίῃ παρέχει παρὰ τὸ ἔθος βρωθεῖσα τῷ μὴ μαζοφαγέειν εἰθισμένῳ, ἢ ὁκοῖον ἄρτος βάρος καὶ τάσιν κοιλίης τῷ μαζοφαγέειν εἰθισμένῳ· ἢ αὐτός τε ὁ ἄρτος θερμὸς βρωθεὶς οἵην δίψαν παρέχει, καὶ ἐξαπιναίην πληθώρην διὰ τὸ ξηραντικόν τε καὶ βραδύπορον· καὶ οἱ ἄγαν καθαροί τε καὶ ξυγκομιστοὶ παρὰ τὸ ἔθος βρωθέντες οἷα διαφέροντα ἀλλήλων ποιεῦσι· καὶ μᾶζά τε ξηρὴ παρὰ τὸ ἔθος, ἢ ὑγρὴ, ἢ γλίσχρη· καὶ τὰ ἄλφιτα οἷόν τι ποιέει τὰ ποταίνια τοῖσι μὴ εἰωθόσι, καὶ τὰ ἑτεροῖα τοῖσι τὰ ποταίνια εἰωθόσι· καὶ οἰνοποσίη καὶ ὑδροποσίη παρὰ τὸ ἔθος ἐς θάτερα μεταβληθέντα ἐξαπίνης, καὶ ὑδαρής τε οἶνος καὶ ἄκρητος παρὰ τὸ ενος ἐξαπίνης ποθείς· ὁ μὲν γὰρ πλάδον τε ἐν τῇ ἄνω κοιλίῃ ἐμποιήσει καὶ φῦσαν ἐν τῇ κάτω· ὁ δὲ παλμόν τε φλεβῶν καὶ καρηβαρίην καὶ δίψαν· καὶ λευκος τε καὶμέλας οἶνος παρὰ τὸ ἔθος μεταβάλλοντι, εἰ καὶ ἄμφω οἰνώδεες εἶεν, ὅμως πολλὰ ἂν ἑτεροιώσειαν κατὰ τὸ σῶμα, ὡς δὴ γλυκύν τε καὶ οἰνώδεα οἶνον ἧσσον ἄν τις φαίη θαυμαστὸν εἶναι μὴ τωὐτὸ δύνασθαι ἐξαπίνης μεταβληθέντα.