<TEI xmlns="http://www.tei-c.org/ns/1.0" xmlns:py="http://codespeak.net/lxml/objectify/pytype" py:pytype="TREE"><text><body><div type="translation" n="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" xml:lang="eng"><div type="textpart" subtype="section" xml:base="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" n="1"><p rend="align(indent)">Those who composed what are called <q rend="double">The Cnidian Sentences</q><note>The Cnidian Sentences in all probability were the results of the observations and theories made in the Temple of Health at Cnidos. We may reasonably conclude from what we know of them, that, like the Coacae Praenotiones at Cos, the Cnidian Sentences at Cnidos were looked up to in the time of Hippocrates as the great guides to medical practice. How much, then, it is to be regretted that they have not come down to us like the other! It is clear, however, from Galen’s commentary, that the work was extant in his time, and from it, as will be seen, we are enabled to draw a few particulars respecting the theoretical and practical views of the Cnidians. Le Clerc considers it likely that Euryphon was the author of the Cnidian Sentences (Hist. Phys., i., 3, 30); but it is evident, from the terms in which Hippocrates refers to them, that they were not the work of a single author. He makes mention, it will be remarked, of more than one person being concerned in remodelling them.</note> 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.<note>By this our author means that the Cnidians neglected Prorrhetics and prognostics. This must be obvious to every person who had entered properly into the spirit of the Hippocratic system of medicine.</note> 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 <pb n="p.61"/> 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 <q rend="double">Sentences</q> 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.</p></div><div type="textpart" subtype="section" xml:base="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" n="2"><p rend="align(indent)">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 <pb n="p.62"/> 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.</p></div><div type="textpart" subtype="section" xml:base="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" n="3"><p rend="align(indent)"> 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.</p></div><pb n="p.63"/><div type="textpart" subtype="section" xml:base="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" n="4"><p rend="align(indent)"> 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,<note>Our author now enters upon the consideration of one of his principal objects in the preent work, namely, to describe the modes of preparing ptisan (<emph rend="italic">or</emph>the decoction of barley), and its uses in acute diseases. He is so full on this subject that the present treatise is quoted by Athenaeus (Deipnos. ii., 16), by the name of the work On the Ptisan. Galen states that, on the principle that diseases are to be cured by their contraries, as the essence of a febrile disease is combined of heat and dryness, the indication of a cure is to use means of a cooling and moistening nature, and that the ptisan fulfils both these objects.</note> 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 <pb n="p.64"/> 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.</p></div><div type="textpart" subtype="section" xml:base="urn:cts:greekLit:tlg0627.tlg004.perseus-eng2" n="5"><p rend="align(indent)"> 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 <pb n="p.65"/> being seized with delirium, and others dying suffocated with orthopnoee and riles. Such persons the ancients thought <emph rend="italic">struck</emph>, 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.</p></div></div></body></text></TEI>