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400 BC
ON REGIMEN IN ACUTE DISEASES
by Hippocrates
Translated by Francis Adams
THOSE who composed what are called 〃The Cnidian Sentences〃 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。 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 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 〃Sentences〃 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。
2。 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 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。
3。 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。
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