On Regimen In Acute Diseases   

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.
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.
5. Ptisans are to be made of the very best barley, and are to be