on regimen in acute diseases-第6部分

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strong　cause；　one　ought　to　open　the　internal　vein　of　the　right　arm；
and　abstract　blood　more　or　less　according　to　the　habit　and　age　of
the　patient。　Such　cases　are　mostly　attended　with　the　following
symptoms：　redness　of　the　face；　eyes　fixed；　hands　distended；　grinding
of　the　teeth；　palpitations；　jaws　fixed；　coldness　of　the　extremities；
retention　of　airs　in　the　veins。
　　5。　When　pains　precede；　and　there　are　influxes　of　black　bile　and　of
acrid　humors；　and　when　by　their　pungency　the　internal　parts　are
pained；　and　the　veins　being　pinched　and　dried　become　distended；　and
getting　inflamed　attract　the　humors　running　into　the　parts；　whence　the
blood　being　vitiated；　and　the　airs　collected　there　not　being　able　to
find　their　natural　passages；　coldness　comes　on　in　consequence　of
this　stasis；　with　vertigo；　loss　of　speech；　heaviness　of　the　head；
and　convulsion；　if　the　disease　fix　on　the　liver；　the　heart；　or　the
great　vein　（vena　cava？）；　whence　they　are　seized　with　epilepsy　or
apoplexy；　if　the　defluxions　fall　upon　the　containing　parts；　and　if
they　are　dried　up　by　airs　which　cannot　make　their　escape；　such　persons
having　been　first　tormented　are　to　be　immediately　bled　at　the
commencement；　while　all　the　peccant　vapors　and　humors　are　buoyant；　for
then　the　cases　more　easily　admit　of　a　cure；　and　then　supporting　the
strength　and　attending　to　the　crisis；　we　may　give　emetics；　unless
the　disease　be　alleviated；　or　if　the　bowels　be　not　moved；　we　may
administer　a　clyster　and　give　the　boiled　milk　of　asses；　to　the
amount　of　not　less　than　twelve　heminae；　or　if　the　strength　permit；
to　more　than　sixteen。
　　6。　Quinsy　takes　place　when　a　copious　and　viscid　defluxion　from　the
head；　in　the　season　of　winter　or　spring；　flows　into　the　jugular　veins；
and　when　from　their　large　size　they　attract　a　greater　defluxion；　and
when　owing　to　the　defluxion　being　of　a　cold　and　viscid　nature　it
becomes　enfarcted；　obstructing　the　passages　of　the　respiration　and
of　the　blood；　coagulates　the　surrounding　blood；　and　renders　it
motionless　and　stationary；　it　being　naturally　cold　and　disposed　to
obstructions。　Hence　they　are　seized　with　convulsive　suffocation；　the
tongue　turning　livid；　assuming　a　rounded　shape；　and　being　vent　owing
to　the　veins　which　are　seated　below　the　tongue　（for　when　an　enlarged
uvula；　which　is　called　uva；　is　cut；　a　large　vein　may　be　observed　on
each　side）。　These　veins；　then；　becoming　filled；　and　their　roots
extending　into　the　tongue；　which　is　of　a　loose　and　spongy　texture；　it；
owing　to　its　dryness　receiving　forcibly　the　juice　from　the　veins；
changes　from　broad　and　becomes　round；　its　natural　color　turns　to
livid；　from　a　soft　consistence　it　grows　hard；　instead　of　being
flexible　it　becomes　inflexible；　so　that　the　patient　would　soon　be
suffocated　unless　speedily　relieved。　Bleeding；　then；　in　the　arm；　and
opening　the　sublingual　veins；　and　purging　with　the　electuaries；　and
giving　warm　gargles；　and　shaving　the　head；　we　must　apply　to　it　and　the
neck　a　cerate；　and　wrap　them　round　with　wool；　and　foment　with　soft
sponges　squeezed　out　of　hot　water；　give　to　drink　water　and　hydromel；
not　cold；　and　administer　the　juice　of　ptisan　when；　having　passed　the
crisis；　the　patient　is　out　of　danger。　When；　in　the　season　of　summer　or
autumn；　there　is　a　hot　and　nitrous　defluxion　from　the　head　（it　is
rendered　hot　and　acrid　by　the　season）；　being　of　such　a　nature　it
corrodes　and　ulcerates；　and　fills　with　air；　and　orthopnoea　attended
with　great　dryness　supervenes；　the　fauces；　when　examined；　do　not
seem　swollen；　the　tendons　on　the　back　part　of　the　neck　are　contracted；
and　have　the　appearance　as　if　it　were　tetanus；　the　voice　is　lost；
the　breathing　is　small；　and　inspiration　becomes　frequent　and
laborious。　In　such　persons　the　trachea　becomes　ulcerated；　and　the
lungs　engorged；　from　the　patient's　not　being　able　to　draw　in　the
external　air。　In　such　cases；　unless　there　be　a　spontaneous
determination　to　the　external　parts　of　the　neck；　the　symptoms　become
still　more　dreadful；　and　the　danger　more　imminent；　partly　owing　to　the
season；　and　the　hot　and　acrid　humors　which　cause　the　disease。
　　7。　When　fever　seizes　a　person　who　has　lately　taken　food；　and　whose
bowels　are　loaded　with　faces　which　have　been　long　retained；　whether　it
be　attended　with　pain　of　the　side　or　not；　he　ought　to　lie　quiet
until　the　food　descend　to　the　lower　region　of　the　bowels；　and　use
oxymel　for　drink；　but　when　the　load　descends　to　the　loins；　a　clyster
should　be　administered；　or　he　should　be　purged　by　medicine；　and　when
purged；　he　should　take　ptisan　for　food　and　hydromel　for　drink；　then　he
may　take　the　cerealia；　and　boiled　fishes；　and　a　watery　wine　in　small
quantity；　at　night；　but　during　the　day；　a　watery　hydromel。　When　the
flatus　is　offensive；　either　a　suppository　or　clyster　is　to　be
administered；　but　otherwise　the　oxymel　is　to　be　discontinued；　until
the　matters　descend　to　the　lower　part　of　the　bowels；　and　then　they　are
to　be　evacuated　by　a　clyster。　But　if　the　ardent　fever　（causus）
supervene　when　the　bowels　are　empty；　should　you　still　judge　it
proper　to　administer　purgative　medicine；　it　ought　not　be　done　during
the　first　three　days；　nor　earlier　than　the　fourth。　When　you　give　the
medicine；　use　the　ptisan；　observing　the　paroxysms　of　the　fevers；　so　as
not　to　give　it　when　the　fever　is　setting　in；　but　when　it　is　ceasing；
or　on　the　decline；　and　as　far　as　possible　from　the　commencement。
When　the　feet　are　cold；　give　neither　drink　nor　ptisan；　nor　anything
else　of　the　kind；　but　reckon　it　an　important　rule　to　refrain　until
they　become　warm；　and　then　you　may　administer　them　with　advantage。　For
the　most　part；　coldness　of　the　feet　is　a　symptom　of　a　paroxysm　of
the　fever　coming　on；　and　if　at　such　a　season　you　apply　those　things；
you　will　commit　the　greatest　possible　mistake；　for　you　will　augment
the　disease　in　no　small　degree。　But　when　the　fever　ceases；　the　feet；
on　the　contrary；　become　hotter　than　the　rest　of　the　body；　for　when　the
heat　leaves　the　feet；　it　is　kindled　up　in　the　breast；　and　sends　its
flame　up　to　the　head。　And　when　all　the　heat　rushes　upwards；　and　is
exhaled　at　the　head；　it　is　not　to　be　wondered　at　that　the　feet
become　cold；　being　devoid　of　flesh；　and　tendinous；　and　besides；　they
contract　cold；　owing　to　their　distance　from　the　hotter　parts　of　the
body；　an　accumulation　of　heat　having　taken　place　in　the　chest：　and
again；　in　like　manner；　when　the　fever　is　resolved　and　dissipated；
the　heat　descends　to　the　feet；　and；　at　the　same　time；　the　head　and
chest　become　cold。　Wherefore　one　should　attend　to　this；　that　when
the　feet　are　cold；　the　bowels　are　necessarily　hot；　and　filled　with
nauseous　matters；　the　hypochondrium　distended：　there　is　jactitation　of
the　body；　owing　to　the　internal　disturbance；　and　aberration　of　the
intellect；　and　pains；　the　patient　is　agitated；　and　wishes　to　vomit；
and　if　he　vomits　bad　matters　he　is　pained；　but　when　the　heat
descends　to　the　feet；　and　the　urine　passes　freely；　he　is　every　way
lightened；　even　although　he　does　not　sweat；　at　this　season；　then；
the　ptisan　ought　to　be　given；　it　would　be　death　to　give　it　before。
　　8。　When　the　bowels　are　loose　during　the　whole　course　of　fevers；　in
this　case　we　are　most　especially　to　warm　the　feet；　and　see　that　they
are　properly　treated　with　cerates；　and　wrapped　in　shawls；　so　that　they
may　not　become　colder　than　the　rest　of　the　body；　but　when　they　are
hot；　no　fomentation　must　be　made　to　them；　but　care　is　to　be　taken　that
they　do　not　become　cold；　and　very　little　drink　is　to　be　used；　either
cold　water　or　hydromel。　In　those　cases　of　fever　where　the　bowels　are
loose；　and　the　mind　is　disordered；　the　greater　number　of　patients　pick
the　wool　from　their　blankets；　scratch　their　noses；　answer　briefly　when
questions　are　put　to　them；　but；　when　left　to　themselves；　utter　nothing
that　is　rational。　Such　attacks　appear　to　me　to　be　connected　with　black
bile。　When　in　these　cases　there　is　a　colliquative　diarrhoea；　I　am　of
opinion　that　we　ought　to　give　the　colder　and　thicker　ptisans；　and　that
the　drinks　ought　to　be　binding；　of　a　vinous　nature；　and　rather
astringent。　In　cases　of　fever　attended　from　the　first　with　vertigo；
throbbing　of　the　head；　and　thin　urine；　you　may　expect　the　fever　to
be　exacerbated　at　the　crisis；　neither　need　it　excite　wonder；
although　there　be　delirium。　When；　at　the　commencement；　the　urine　is
cloudy　or　thick；　it　is　proper　to　purge　gently；　provided　this　be
otherwise　proper；　but　when　the　urine　at　first　is　thin；　do　not　purge
such　patients；　but；　if　thought　necessary；　give　a　clyster；　such
patients　should　be　thus　treated；　they　should　be　kept　in　a　quiet　state；
have　unguents　applied　to　them；　and　be　covered　up　properly　with
clothes；　and　they　should　use　for　drink　a　watery　hydromel；　and　the
juice　of　ptisan　as　a　draught　in　the　evening；　clear　out　the　bowels　at
first　with　a　clyster；　but　give　no　purgative　medicines　to　them；　for；　if
you　move　the　bowels　strongly；　the　urine　is　not　concocted；　but　the
fever　remains　long；　without　sweats　and　without　a　crisis。　Do　not　give
draughts　when　the　time　of　the　crisis　is　at　hand；　if　there　be
agitation；　but　only　when　the　fever　abates　and　is　alleviated。　It　is
proper　to　be　guarded　at　the　crises　of　other　fevers；　and　to　withhold
the　draughts　at　that　season。　Fevers　of　this　description　are　apt　to
be　protracted；　and　to　have　determinations；　if　the　inferior　extremities
be　cold；　about　the　ears　and　neck；　or；　if　these　parts　are　not　cold；
to　have　other　changes；　they　have　epistaxis；　and　disorder　of　the
bowels。　But　in　cases　of　fever　attended　with　nausea；　or　distention　of
the　hypochondria；　when　the　patients　cannot　lie　reclined　in　the　same
position；　and　the　extremities　are　cold；　the　greatest　care　and
precaution　are　necessary；　nothing　should　be　given　to　them；　except
oxymel　diluted　with　water；　no　draught　should　be　administered；　until
the　fever　abate　and　the　urine　be　concocted；　the　patient　should　be　laid
in　a　dark　apartment；　and　recline　upon　the　softest　couch；　and　he　should
be　kept　as　long　as　possible　in　the　same　position；　so　as　not　to　toss
about；　for　this　is　particularly　beneficial　to　him。　Apply　to　the
hypochondrium　linseed　by　inunctions；　taking　care　that　he　do　not
catch　cold　when　the　application　is　made；　let　it　be　in　a　tepid　state；
and　boiled　in　water　and　oil。　One　ma