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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
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。
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 tim