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27 Relaxing of the sinews, on the other hand, is a frequent disease everywhere. It attacks at times the whole body, at times part of it. Ancient writers named the former apoplexy, the latter paralysis: I see that now both are called paralysis. Those who are gravely paralyzed in all their limbs are as a rule quickly carried off, but if not so carried off, some may live a long while, yet rarely however regain health. Mostly they drag out a miserable existence, their memory lost also. The disease, when partial only, is never acute, often prolonged, generally remediable. If all the limbs are gravely paralyzed withdrawal of blood either kills or cures. Any other kind of treatment scarcely ever restores health, it often merely postpones death, and meanwhile makes life a burden. If after blood-letting, neither movement nor the mind is recovered, there is no hope left; if they do return, health also is in prospect. But when a particular part is paralyzed, in accordance with the force of the disease, and the strength of the body, either blood is to be let, or the bowel[p. 347] clystered. The rest that has to be done is the same in both conditions: in particular cold should be avoided; and the patient should return to exercise a little at a time, in such a way that he should begin to walk at once, if he can. If the weakness of the legs prevent this, he should be carried about in a litter or rocked in his bed, then, if possible, his defective limb should be moved by himself, failing that by someone else, and by a form of compulsion, it should be restored to is customary state. It is also beneficial to stimulate the skin of the torpid limb, either by whipping with nettles, or by applying mustard plasters, these latter being removed as soon as the skin becomes red. Appropriate applications also are crushed squills, and onions pounded up with frankincense. Nor is it amiss to pluck on the skin for some time by the aid of a pitch plaster every third day (III.22.6) and sometimes to apply dry cups in several places. Again for anointing, old olive oil is most suitable, or soda mixed with oil and vinegar. Further, it is also highly necessary to foment with warm sea water, or failing that with salt and water. And if there are at hand swimming baths, whether natural or artificial, they should be used as much as possible; especially the defective limb should be moved in them; if there are none such the ordinary bath is of service. The food should be of the middle class, particularly game, the drink hot water without wine. If, however, the disease is of long standing, every fourth or fifth day Greek salted wine may be given, in order to purge. An emetic after supper is of use. At times also there occurs pain in the sinews. In that case it is not expedient to excite vomiting nor urination as some prescribe, nor indeed sweating[p. 349] other than through exercise; water should be drunk; twice a day in bed the body should be rubbed gently and for some time, and then whilst holding the breath, the limbs, preferably the upper, are to be moved in the course of exercise. The bath should be seldom used; from time to time there should be a change of air by travel. If there is pain, the part should be wetted with water containing soda, but not oil, then wrapped up, and under it should be placed a brazier containing some glowing charcoal with sulphur, so that it may be fumigated for a while; this should be repeated from time to time, but only on an empty stomach and after digestion is completed. Cups also may be applied at frequent intervals to the painful part, and this place lightly beaten with inflated ox bladders. It is also of service to mix fat with pounded henbane and nettle seeds, equal parts of each, and put this on, also to foment with a decoction of sulphur. Further, it is a good plan to apply leather bottles filled with hot water, or bitumen mixed with barley meal. And for the actual pain the best remedy is forceful rocking; which in other kinds of pain is the worst. Tremor of sinews again is like with made worse by an emetic, and by medicaments causing urination. Inimical also are baths and dry sweatings. Water is to be drunk; the patient should there are a smart walk and be anointed and rubbed as well, especially by himself; the upper limbs are to be exercised by ball games and the like; he may think what food he likes provided that he studies his digestion. He should avoid worry after meals; make the rarest use of venery. If at any time he has given way to it, then[p. 351] he ought to be rubbed, with oil, gently and for some time, whilst in bed, by the hands of boys rather than men. Now suppurations which arise in some interior part, when they become noticeable, first should be acted upon by those poultices which repress, less there is produced a harmful collection of the material of disease; next if these remedies are unsuccessful, the suppurations may be dissipated by dispersive poultices. If we are not successful in that, it follows that the suppuration should be drawn outwards, next that it should mature. The ending of every abscess is to rupture; the indication is pus discharged either from the bowels or mouth. But nothing ought to be done to diminish the discharge of the pus. Broth and hot water are chiefly to be given. When pus ceases to be discharged, then there should be a transition to digestible yet nutritious food consumed cold, also cold water for drink, commencing, however, with lukewarm. To begin with, things such as pine kernels, or almonds, or hazel nuts, may be eaten along with honey; afterwards these make way for whatever can make the scar form earlier. At this stage as a medicament for the ulceration there is to be taken either leek or horehound juice, and whatever the food, leeks should be added. Rubbing is required also for parts unaffected, so also gentle walks; to be avoided are wrestling and running and other things tending to irritate healing ulcerations, for in this malady the vomiting of blood is most pernicious and to be guarded against in every way.
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