On Purgatives, Remedies — First Draft Translation

[45] From Hippocrates' sixth book on remedies. The matters concerning remedies are not what they are commonly thought to be. For with the same remedy some are purged and some are not; sometimes it purges different things than what it is accustomed to purge; sometimes it has purged excessively; and sometimes it has done what was needed. So it is not possible to give remedies carelessly, trusting in them blindly. For one must consider that the foods which nourish us are themselves remedies, though weaker than those others; for people, when they eat rightly, are healthy, when not rightly, they fall ill, and when to excess, they are purged just as if by pure remedies. It is clear, then, that these too are remedies, though weaker and slower than pure remedies. Yet these, slower as they are and familiar to us, entering the body each day, when given carelessly and without attention, disturb people and produce disease in some way. And pure and sharp remedies too, if one gives them without feeling and without forethought, will not accomplish anything beneficial. One must therefore give, first of all, to bilious persons that which purges bile, to phlegmatic persons that which purges phlegm, to dropsical persons that which purges the excess moisture, and to melancholic persons that which purges black bile. If you purge outside of these, you do not purge what needs purging, and you will empty out what does not need emptying, so that you err in both respects. Whenever you are about to give someone a remedy, whether downward or upward, you must ask him whether he has at any time drunk a remedy, and whether his belly is quick and responsive to downward-acting remedies or hard. And if he says it is quick and loose, it requires softer and smaller doses of remedies; if it is hard, it requires stronger ones. (50) [95] The same way applies also for upward-acting remedies. If he says he has never been purged either upward or downward, nor drunk any remedies, one must find out whether, in his healthy state with respect to what he takes in, his belly is loose downward or prone to vomiting upward, and whether, on reaching some state of fullness, diarrhoea comes upon him — all these things must be inquired into, so that you may be able to make the right plan. For it is a shameful misfortune to give a man a remedy and kill him. Those who are seized by strong fevers — one must not give these people purgative remedies until the fever lets up; if it does not let up, then at least wait fourteen days before giving purgatives. For their flesh being hot, and their bellies, they absorb the remedy and are not purged at all, and the fever becomes greater and the color turns and they become jaundiced; for the bile having been stirred and not purged, the patient is willing neither to take gruel nor to drink, but loathes everything, and for the most part perishes. If the remedy is retained in the belly, nothing is purged before midday, but when it is purged from midday onward, he becomes faint and perishes. If he survives that day and together with the purging the fever lets up, he recovers; but if the fever seizes him again, he perishes. One must not therefore apply purgative remedies in strong fevers, but if one must do something, one should give an enema, as many times as one wishes — for this is less dangerous. For the same reason, in the summer season, for fifty days from the rising of the Dog Star, one must take care not to give a remedy but to use enemas. (100) [105] For the danger is the same.