Kitap 1
5
IN cases of melancholy, there is need of consideration in regard to the abstraction of blood, from which the disease arises, but it also springs from cacochymy in no small amount thereof. When, therefore, the disease seizes a person in early life, and during the season of spring we are to open the median vein at the right elbow, so that there may be a seasonable flow from the liver; for this viscus is the fountain of the blood, and the source of the formation of the bile, both which are the pabulum of melancholy. We must open a vein even if the patients be spare and have deficient blood, but abstract little, so that the strength may feel the evacuation but may not be shaken thereby; for even though the blood be thick, bilious, coagulated, and black as the lees of oil, yet still it is the seat and the pabulum of Nature. If, then, you abstract more than enough, Nature, by the loss of nourishment, is ejected from her seat. But if the patient has much blood, for the most part in such cases it is not much vitiated, but still we must open a vein, and not abstract all the blood required the same day, but after an interval, or, if the whole is taken the same day, the strength will indicate the amount. During the interval, the patient is to be allowed a fuller diet than usual, in order to prepare him for enduring the evacuation; for we must assist the stomach, it being in a state of disease, and distress from the black bile lodging there. Wherefore, having kept the patient on a restricted diet for one day previously, we must give black hellebore to the amount of two drams with honeyed-water, for it evacuates black bile. And likewise the capillary leaves of Attic thyme, for it also evacuates black bile. But it is best to mix them together, and give a part of each, to the amount of two drams altogether. After the purging we are to administer the bath, and give a little wine and any other seasoner in the food; for purging fatigues the powers of the stomach. We are, then, to come down to the middle parts, and having first relaxed by cataplasms and bathing, we are to apply a cupping-instrument over the liver and stomach, or the mouth of it; for this evacuation is much more seasonable than venesection. We are also to apply it to the back between the scapulæ, for to this place the stomach is adjacent. Then again we are to recruit; and if the strength be restored by the regimen, we are to shave the head, and afterwards apply the cupping-instrument to it, for the primary and greatest cause of the disease is in the nerves. But neither are the senses free from injury, for hence are their departure and commencement. Wherefore these also are changed, by participating in the affection. Some, likewise, from alienation of the senses have perverted feelings. It is necessary, then, especially to cure the stomach as being disordered of itself, and from black bile being lodged in it. Wherefore we must give to drink continuously of the juice of wormwood from a small amount to a cupful (cyathus), for it prevents the formation of bile. Aloe also is a good thing, for it brings down the bile into the lower gut. If, then, the disease be of recent origin, and the patient be not much changed, he will require no other treatment in these circumstances. There is a necessity, however, for the remaining part of the regimen to the restoration of the habits, and the complete purification of the affection, and the strengthening of the powers, so that the diseases may not relapse. I will explain afterwards the course of life during convalescence.
