On Regimen In Acute Diseases   

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.
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.