| [p. 72] which total abstinence
from food should not be enforced on patients that will be put on the
use of ptisans, they do enforce total abstinence; that in those cases
in which there should be no change made from total abstinence to ptisans,
they do make the change; and that, for the most part, they change
from abstinence to ptisans, exactly at the time when it is often beneficial
to proceed from ptisans almost to total abstinence, if the disease
happen to be in the state of exacerbation. And sometimes crude matters
are attracted from the head, and bilious from the region near the
chest, and the patients are attacked with insomnolency, so that the
disease is not concocted; they become sorrowful, peevish, and delirious;
there are flashes of light in their eyes, and noises in their ears;
their extremities are cold, their urine unconcocted; the sputa thin,
saltish, tinged with an intense color and smell; sweats about the
neck, and anxiety; respiration, interrupted in the expulsion of the
air, frequent and very large; expression of the eyelids dreadful;
dangerous deliquia; tossing of the bed-clothes from the breast; the
hands trembling, and sometimes the lower lip agitated. These symptoms,
appearing at the commencement, are indicative of strong delirium,
and patients so affected generally die, or if they escape, it is with
a deposit, hemorrhage from the nose, or the expectoration of thick
matter, and not otherwise. Neither do I perceive that physicians are
skilled in such things as these; how they ought to know such diseases
as are connected with debility, and which are further weakened by
abstinence from food, and those aggravated by some other irritation;
those by pain, and from the acute nature of the disease, and what
affections and various forms thereof our constitution and habit engender,
although the knowledge or ignorance of such things brings safety or
death to the patient. For it is a great mischief if to a patient debilitated
by pain, and the acute nature of the disease, one administer drink,
or more ptisan, or food, supposing that the debility proceeds from
inanition. It is also disgraceful not to recognize a patient whose
debility is connected with inanition, and to pinch him in his diet;
this mistake, indeed, is attended with some danger, but much less
than the other, and yet it is likely to expose one to much greater
derision, for if another physician, or a private
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