Test Bank Reading Understanding and Applying Nursing Research 4th Edition Fain

Test Bank Reading Understanding and Applying Nursing Research

4th Edition Fain
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Introduction to Nursing Research

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. Quantitative research uses the following methods of data collection except:
A. surveys.
B. questionnaires.
C. participant observation.
D. psychosocial instruments.
____ 2. Knowledge is information acquired in a variety of different ways. Methods used to acquire this knowledge are
referred to as:
A. scientific integrity.
B. scientific rigor.
C. triangulation.
D. ways of knowing.
____ 3. When a researcher uses a qualitative and quantitative approach to collecting data, this is referred to as:
A. scientific integrity.
B. scientific rigor.
C. triangulation.
D. ways of knowing.
____ 4. A type of research method emphasizing the meaning of an experience is termed:
A. qualitative.
B. quantitative.
C. scientific integrity.
D. scientific method.
____ 5. A group of individuals who collaborate on a research project from beginning to dissemination of findings are
referred to as a:
A. research consumer.
B. research team.
C. principal investigator.
D. consultant.
____ 6. An example of a specialty journal is:
A. Nursing Research.
B. Research in Nursing and Health.
C. Oncology Nursing Forum.
D. Western Journal of Nursing Research.

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____ 7. Research that is done to examine findings of another researcher using the same variables but different subjects
is referred to as:
A. exploration.
B. replication.
C. empiricism.
D. rigor.
____ 8. The development of a solid foundation of reliable knowledge typically is built from which type of research?
A. basic research
B. action research
C. evaluation research
D. qualitative research
____ 9. Which of the following is not a basic assumption of science?
A. Science cannot provide answers to all questions.
B. It is possible to distinguish between more and less plausible claims.
C. Researchers should follow certain agreed upon norms and practices.
D. Science is best at solving value conflicts.
____ 10. Who is the current Director of the National Institutes of Nursing Research (NINR)?
A. Dr. Rebecca Patton
B. Dr. Julie Gerberding
C. Dr. Patricia Grady
D. Dr. Elias Zerhouni
Introduction to Nursing Research
Answer Section

MULTIPLE CHOICE

1. ANS: C PTS: 1
2. ANS: D PTS: 1
3. ANS: C PTS: 1
4. ANS: A PTS: 1
5. ANS: B PTS: 1
6. ANS: C PTS: 1
7. ANS: B PTS: 1
8. ANS: A PTS: 1
9. ANS: D PTS: 1
10. ANS: C PTS: 1
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 For a full account of the pickled fishes of the ancients, we refer to the
Fragment of Xenocrates, and the third book of Athenæus. We shall give the
general character of them as delivered by the latter, upon the authority of
the Siphnian Diphilus. He says that the pickles prepared from sea, lake, and
river fishes afford little nourishment, contain few juices, are of a heating
nature, are good for the belly, and whet the appetite. The old, he adds, are
better and more acrid. Of all the pickled fishes, the most celebrated was the
one brought from the Pontus, called saperda. According to Athenæus, it
was prepared from the umber (sciæna umbra L.) See also Galen (de Alim.
Facult. iii, 41.) Hippocrates says they are desiccant, attenuant, and for the
most part laxative. (De Diæta.) Diphilus says they are whetters and
laxatives; and hence Galen directs them to be taken at the commencement
of a meal, and particularly recommends them for old men. Rhases speaks
more unfavorably of them.
It may be proper in this place to give some account of the isitia, or isicia
of the ancients. With regard to the etymology of the word, then, it is derived
by Macrobius ab insectione. They consisted of minced meat, either flesh or
fish, boiled or roasted, and seasoned with pepper, cumin, lovage, and the
like. Apicius gives receipts for preparing several dishes of this kind, from
the loligo, sepia, locusta, and swine’s liver. The last mentioned was inclosed
in the omentum, or cowl, and must therefore have resembled the dish now
called a haggis. Lampridius says that the emperor Heliogabalus was the first
who prepared isicia from fishes, oysters, lobsters, squillæ, and the like. If
this statement be true, the works of Apicius which we possess cannot be
genuine. Isicia from shell-fish, the sepia, loligo, &c. are very favorably
spoken of by Alexander Trallian (xi.) On the Isicia, see further Ludovicus
Nonnius (de Piscium Esu, xxxviii), and Lambecius (ad Apic.)

SECT. XCV.—ON THE PROPERTIES OF WINE.

He who has taken the subject of health into consideration ought also to be
acquainted with the powers of wine. Wine in general is nutritious, but that
which is red and thick is more particularly so; but its juices are not good.
The sweet also is nutritious, but not stomachic. The astringent is stomachic,
but is distributed with difficulty to the parts of the body, and nourishes less.
The white nourishes less still. Wine of a yellow colour is the best of all.
That which is old is more heating and desiccant than the new. Such, in the
main, are the properties of wine. But wine in general resuscitates the natural
heat within us, and therefore it improves digestion, and forms good blood.
And being of a penetrating nature, it diffuses the nourishment all over the
body, and therefore it recruits those who are emaciated by disease, for it
gives them an appetite for food. It attenuates phlegm, clears away the bile
by urine, and imparts a good colour. To the soul also it communicates
gladness and pleasure, and improves the strength. Such are the good effects
of the moderate use of wine. But its immoderate use produces just the
reverse; wherefore, those who are drunk become changed, are delirious, and
disposed to heavy sleep. On that account, such an immoderate use of wine
ought to be avoided; but at greater intervals it may be drank liberally, for it
promotes the discharges by urine and perspiration. But it is better in such
cases to vomit, by taking, beforehand, of honied water, so that one may not
be injured by it. When one has drunk largely, it is not proper to take much
of any other food; but while drinking, one should eat boiled cabbage, and
taste some sweetmeat, particularly almonds. These things relieve headach,
and are not difficult to vomit. It is also very proper to take the infusion of
wormwood before drinking, for of all things it is the best preservative from
surfeit. If one experience any painful effects from wine, one should drink
cold water, and the next day again the infusion of wormwood; and by using
exercise, friction, the bath, and restricted food, in this way get restored to
health.

C . The opinions of the ancients on this interesting subject

may be best learned by consulting Hippocrates (de Diæta, ii, 22, et alibi);
Celsus (ii); Pliny (H. N. xiv and xxxiii, 22, 26); Dioscorides (v); Galen (de
Sanit. tuend. v, 5, and de Alim. Facult. iii); Oribasius (Med. Col. v, and
Euporist. i, 12); Aëtius (i); Athenæus (Deipnos. i); Macrobius (Saturnal.);
Actuarius (de Diæta, 8); Simeon Seth (de Alimentis); Serapion (de
Simplicibus, &c.); Haly Abbas (Theor. 30, and Pract. i, 8); Avicenna (i, 3,
2); Rhases (ad Mansor. iii, 5, and Continen. xxxvii); Alsaharavius (Theor.
xiii, 2.) Stobæus gives an interesting collection of the opinions of the
philosophers and poets. (Sermo xviii.)
 For an ample account of the ancient and modern wines, the reader is
particularly referred to the late ingenious and classical publication of Dr.
Henderson. See also Barry (on Ancient Wines), and Canonherius (de
Admirandis Vini Virtutibus.)
From the works of Moses and Homer, we learn that the art of converting
the innocent juice of the grape into wine must have been a very early
invention. Eustathius informs us that, in very ancient times, the wines were
all of a dark colour; and hence Homer applies to the sea the epithet of wine-
coloured, ὄινοπα πόντον. (Comment, in Iliad. I.) Achilles Tatius makes the
same remark regarding the ancient wine, (ii, 67, ed. Salmasius.) However,
in the time of Hippocrates, they had wines of all colours, as well as
characters. He thus describes their general properties: Black and austere
wines are of a drying nature, and are not laxative, nor diuretic, nor
sialogogue. It is their heat that renders them desiccative, by consuming the
humidity of the body. The soft dark wines are of a more moistening nature,
and are more flatulent and laxative. The sweet dark wines are of a more
moistening nature, but they are heating and flatulent by imparting humidity.
The white austere wines are heating, but are rather diuretic than laxative.
The new are more laxative than the old, as being a nearer approach to the
fresh juice of the grape, and they are nutritious; and the fragrant wines than
those of the same age which have no bouquet, because they are better
concocted; and the thick than the thin. But thin sweet wines are more
diuretic, laxative, and moistening, and form weak blood.
Celsus ranks the “vinum dulce vel lene” among the “res boni succi.”
Sharp austere wine he places among the things which are most suitable for
the stomach.
Dioscorides delivers very judiciously the different characters of wines.
He concludes with remarking that, although habitual intoxication be
prejudicial to the health, a moderate indulgence in wine for some days,
especially after drinking water, is beneficial, by proving an alterative to the
system, purging the secretions, and promoting the insensible perspiration.
From Pliny’s excellent statement of the medicinal and dietetical
properties of wine, we select the following remarks: “Vino aluntur vires,
sanguis, colorque hominum. Vino modico nervi juvantur, copiosiore
læduntur, sic et oculi. Stomachus recreatur; appetentia ciborum invitatur;
tristitia et cura hebetatur; urina et algor expellitur; somnus conciliatur.
Præterea vomitiones sistit. Vetus coposiore aqua miscetur, magisque urinam
expellit; minus siti resistit. Dulce minus inebriat sed stomacho innatat;
austerum facilius concoquitur. Stomacho minus utile est pingue, nigrum,
sed corpora magis alit. Tenue et austerum minus alit, magis stomachum
nutrit.”
The information supplied by Galen on this subject is most ample, but in
too diffuse a shape to suit our narrow limits. Upon the whole, he states, thin
wines are diuretic, but supply little nourishment, whereas the thick are
proportionally nutritious. He says that the Falernian, especially the sweeter
kind, is one of the most wholesome wines. Athenæus gives an interesting
account of the Falernian, upon the authority of Galen. He says it is fit to be
drank after it is ten years old, and from fifteen to twenty; but that, when
older, it occasions headach and affects the nerves. He describes two kinds
of it, the sweet and the austere. The latter, he adds, is of a tawny colour, that
is to say, a colour intermediate between the white and black. Dr. Henderson
concludes, that the modern Madeira is a near approach to the ancient
Falernian. Brasavolus and C. Avantius compare it to a wine known in
modern Rome by the name of greco di soma. Galen gives very minute
directions for forcing this wine, or giving it premature age by heat. (De
Antid. i, and de Simpl. iv.) Vitruvius, for this purpose, gives directions for
building the wine-cellar close to the kitchen. (vi.) Athenæus says, that wine
digests the food, and, being of a subtle nature, promotes the distribution of
it. We learn from him that the ancients sometimes used their wines cooled
with ice. (Deipnos. iii, 99.) He thus describes the different characters of the
wines used in his time; that is to say, about the middle of the second
century, P. C. Of wines, some are white, some tawny, and some dark
coloured. The white is in nature the thinnest, diuretic, and heating, and
being digestible it inflames the head, for it is a wine that has a tendency
upwards. A dark-coloured wine, which is not of a sweet nature, is very
nutritious and astringent. Sweet wines, whether of a white or tawny colour,
are very nutritious; for they lubricate the passage, and thickening the
humours, prove less troublesome to the head. The nature of sweet wines is
to remain for a time in the præcordia, and to prove expectorant, as Diocles
and Praxagoras tell. Mnesitheus the Athenian says dark-coloured wine is
very nutritious, the white very diuretic and very subtle, and the tawny dry,
and of all wines the one that most promotes the digestion of food. Wines
carefully prepared with salt water are not of an intoxicating nature, they
loosen the belly, occasion pains of the stomach, and produce flatulence, but
promote digestion. Such are the Myndian and the Halicarnassian. The Coan
is well prepared with salt water; the Rhodian has a less proportion of it; the
Cnidian engenders blood, is nutritious, and laxative, but when drunk in
large quantities it upsets the stomach; the Lesbian has less astringency and
is more diuretic; the Chian is a most delicious wine, and especially the kind
called Ariusian; but there are three varieties of it, the austere, the sweet, and
the intermediate.—Of the Italian wines, the most delicious are the Alban
and the Falernian. The Adrian is a diffusible, diaphoretic, and safe wine. (i,
25.) According to Galen, the cæcuban, so frequently mentioned by Horace,
was not any one sort of wine, but a general name applied to all generous
and old wines. (De Succ. bon. 2.) Old wine was much sought after: Galen
says everything is impaired by age but wine. (De Antidot.) The Falernian
was reckoned best from ten to twenty: the Surrentine was not thought good
until twenty-five. (Athen. i.)
According to Actuarius, the thick wines are most nourishing and form the
thickest blood, but are apt to occasion visceral obstructions; while, on the
other hand, the thin wines are more stomachic and less nourishing. The
sweet are the contrary; but the white are less hot than the others; the gold-
coloured are more hot; and then the red.
Wine, says Simeon Seth, is not only nutritious, but promotes in a great
degree the distribution of the food over the body, rousing, and at the same
time increasing the vital heat, and with it the urinary and other secretions. It
suits best, he says, with persons of a cold and dry temperament; and,
therefore, it is most proper for old men. He adds that the immoderate use of
wine dissolves the vital tone, depresses the natural heat, and occasions
apoplexy, epilepsy, and tumours of the body. Macrobius attempts to trace a
resemblance between the effects of habitual intoxication and those resulting
from exposure to extreme cold. “Quæcunque nimium algentibus, eadem
contingunt ebriis. Fiunt enim tremuli, pallidi, graves; et saltu tumultuantis
spiritus artus suos et membra quatiuntur. Idem corporis torpor ambobus,
eadem linguæ titubatio. Multis etiam morbus ille quem παράλυσιν Græci
vocant sic nimio vino, et multo algore contingit.” In like manner, a modern
writer, Andreas Baccius, maintains that some wines are of a cold nature.
 Haly Abbas gives nearly the same characters of wine as Seth. His
account of all the wines, natural and artificial, used in his time, is most
ample.
Alsaharavius forbids wine to be taken when the stomach is quite empty,
or after a full meal. When taken seasonably, he says it improves the
appetite, increases the vital heat, nourishes the body, and clears the senses.
Avicenna, with his usual judgment and industry, collects all the
information of preceding authors, to which he adds his own opinions. He
remarks that the immoderate use of wine induces disease of the liver and
brain, and debilitates the nerves.
Wine, says Rhases, warms the stomach and liver, and dispels flatulence,
promotes digestion, provokes the urinary and alvine discharges, and
gladdens the mind.
Serapion copies mostly from Galen in delivering the general characters
of wine. He disapproves of wine made with salt water. For an account of it,
see Pliny and Athenæus, (l. c.)
The ancients were scarcely more agreed respecting the intoxicating
properties of wine than they were as to the powers of the cabbage in
counteracting them. Old Cato the Censor, who was in the practice “of
warming his virtue with wine,” describes the following method of cooling
it: “Si voles in convivio multum bibere cænareque, ante cæenam esto
crudam brassicam quantum voles ex aceto, et item ubi cænaveris comesto
aliqua V. folia, reddent te quasi nihil ederis, biberisque, bibesque quantum
voles.” (De R. R. 156.) See a long dissertation on this property of the
cabbage in Athenæus (Deipnos. i, ad finem); also Pliny (Hist. Nat. xx, 34);
Pseudo-Dioscorides (Euporist. i, 24); Nonnius (14); Simeon Seth (in voce
Brassica); Geopon. (xii, 17); Avicenna, Rhases, and Serapion give the same
character of it. Plutarch affirms that almonds also are a preservative from
intoxication. (Quæst. vi.)
Before quitting this subject, we must notice certain peculiar modes of
preparing wine. The mustum was wine newly made, or the fresh juice of the
grape. The protropum was the juice which runs from grapes without
pressing. The mulsum was a preparation of wine and honey. Dioscorides
recommends two parts of wine to one of honey; but there does not appear to
have been any fixed proportion. The sapa, called by the Greeks hepsema
and siræum, according to Pliny, is must boiled to a third; and the defrutum
the same reduced to a half. They are now called robs, a term borrowed from
the Arabians. The carenum, according to Isidorus, is must reduced to two
thirds. The passum was a sweet wine prepared from grapes which had been
much dried in the sun. The passum creticum, which is much praised by
Pliny and Athenæus, and is often mentioned by our author, the learned
Andreas Baccius and Nonnius believe to have resembled the modern
malmsey. We have already mentioned a peculiar species of wine prepared
with salt water. The ancients also gave artificial qualities to wine by adding
rosin, pitch, and other substances to the casks in which it was deposited.
See ‘Geoponica’ (vii.) Dioscorides gives receipts for preparing a great
variety of vinous tinctures. These were used only for medicinal purposes.
(Mat. Med. v.)
It is scarcely necessary for us to remark that the ancients generally drank
their wines diluted either with hot or cold water. Hence the poet Juvenal
says: “Quando vocatus adest calidæ gelidæque minister.” (Sat. v, 63.)
According to Pliny, Staphylus first introduced this practice (H. N. viii, 56);
but Athenæus refers it to Melampus (ii.) It would appear, however, from
some passages in the ‘Ecclesiazusæ’ of Aristophanes, and from Eustathius’s
Commentary on Homer (Iliad, ix, 203), that the ancients often drank their
wines undiluted. It was customary, during the time of dinner, to drink off a
cup of pure wine to “the good deity.” See Athenæus (xv, 17), with the
learned note of Schweighäuser. The wine and water were commonly mixed
together according to certain fixed proportions, such as one part of wine and
two of water, or two of wine and three of water, or equal parts of both.
(Eustathius in Odyss. vii.) In winter it was the rule to drink equal parts of
wine and hot water; but in summer two parts of water were added to one of
wine. (Anonymus de Diæta ap. Phys. et Med. Min. ed. Ideler, p. 197.) It
would appear that it was a common practice to drink wine with other hot
things in the morning during the cold months of winter. (Hierophilus de
Nutr. Meth. ed. Ideler.)
SECT. XCVI.—ON HONEY AND HYDROMEL OR HONIED
WATER.

Boiled honey is rather nutritious than laxative; but when unboiled the
contrary. It agrees with cold and humid temperaments, but in the warm it is
converted into bile. Honied water does not agree well with those who are
affected with bitter bile, being converted into bile. In such constitutions the
honied water ought to be very weak; but it is not proper for those whose
bowels are easily affected. The honied water may be prepared by adding
eight parts of water to the honey, and thus boiling it until it cease from
frothing. It is expedient also to clear away the scum as soon as formed.

C . Honey, says Hippocrates, when eaten with other food, is

nutritious, and improves the colour; but, when taken alone, it rather
attenuates than recruits. Actuarius says that scummed honey, when taken
with other food, is nutritious and laxative. Democritus said, that health was
best promoted by lubricating the inside with honey, and the outside with oil.
Honey and bread formed the favorite food of the Pythagoreans. Athenæus
(Deipnos. ii, 7.) See also Oribasius (Synops. iv, 38); Haly Abbas (v, 27);
Simeon Seth (in voce Mel.)
Galen gives the following account of the phenomenon of a honey shower:
“I have sometimes known in the season of summer a great quantity of
honey to be found upon the leaves of trees, shrubs, and certain herbs, so that
the country people said, jesting, ‘Jupiter has rained honey.’ A cold night, as
for summer, had preceded (for it happened in summer); but the temperature
of the former day had been hot and dry. It was thought, therefore, by those
who were skilled in nature, that an exhalation from the earth and waters,
finely attenuated and concocted by the heat of the sun, had been condensed
and collected by the cold of the succeeding night. This phenomenon occurs
rarely with us; but it takes place frequently in Mount Lebanon every
summer.” (De Alim. Facult.) See also Fragmentum Theophrasti (de Melle,
ed. Heinsius.) Ernestus Faber states that the honey here described is the
manna of cedars. (De Manna Ebræorum, 12.)
A wine prepared from honey and aromatics is much commended by an
intelligent writer on dietetics as possessing more heat and dryness than any
other species of wine, and improving the appetite and colour. (Anonym.
Tract. de Cibis ap. Ermerins Anecdota Græca, p. 237.)
Our author has given one method of preparing the hydromel, or honied
water. Different modes are described by other authors. Thus, Mesue
recommends seven parts of water to one of honey. It appears from
Hippocrates, however, that it was taken more or less diluted. Pliny and
Dioscorides make mention of hydromel prepared by mixing two parts of
water with one of honey. This seems to have been the strongest hydromel.
A species of hydromel carefully prepared, and kept for a considerable time,
was esteemed a delicious beverage. Ludovicus Nonnius compares it to the
mead used by certain nations of the north. They prepare it with hops and
yeast, so that it is made to emulate the nature of wine. The Greeks and
Romans did not make use either of hops or yeast.
In imitation of Galen, who, under the head of honey (de Simpl.), treats
also of sugar, we shall give a brief account of the latter in this place. The
saccharum, then, which is mentioned by Theophrastus (Frag. l. c.),
Dioscorides (ii, 104), Galen (l. c.), Strabo (Geogr. xv), Pliny (H. N. xii, 17),
and other ancient authors, was a natural concretion forming on various
reeds, but more especially upon the bamboo cane (bambusa arundinacea.)
The bamboo is noticed by Herodotus (Hist. iii, 98), and by Ctesias (Photii
Lex.) Moses Chorenensis, a writer of the fifth century (Geogr. Armen.), is
the first who makes mention of sugar procured from the cane by boiling.

SECT. XCVII.—ON SLEEP.

It remains, after having treated of everything connected with diet, to say

something of sleep, which is generally taken after every other thing. Sleep,
then, may be briefly defined to be a relaxation of the vital powers,
occasioned by a suitable moisture irrigating the brain. When properly taken
it may produce many good effects. It digests the food, concocts the
humours, soothes pain, alleviates lassitude, and relaxes that which is
contracted. It is also calculated to produce oblivion of mental sufferings,
and to rectify the distracted powers of reason. The most suitable season for
sleep is after a meal. But that during the day does not agree with all,
because the time spent in sleep is not sufficient for the complete digestion
of the food; and, when the digestion is interrupted unseasonably, those who
rise from sleep at noon are often troubled with acidity and flatulence, and
sometimes even with a gurgling noise in their bowels, unless from habit or
sufficient rest these bad effects be obviated. The best season for sleep is the
night, for the humidity and drowsy stillness of night contribute to perfect
digestion. Wherefore after these nocturnal slumbers we feel the most desire
for evacuation. The proper limit to sleep should be the complete digestion
of the food, as may be ascertained by the eructations, and by tapping over
the stomach; after which it may be not unuseful to awake in order to
evacuate the excrementitious remains of the digestion.

C . The philosophy of sleep is ingeniously treated of by

Hippocrates (de Insomniis), and by Aristotle (in his treatise de Somno et
Vigilia.) Aristotle states that digestion goes on best during sleep. Pliny’s
definition of sleep seems to be taken from Hippocrates: “Est autem somnus
nihil aliud quam animi in medium sese recessus.” (H. N. x, 97.) Alexander
Aphrodisiensis, in like manner, says, “Know that, during the day, the
natural principle is less occupied with its own peculiar operations, I mean
the digestion of the food, the changes of the chyle, sanguification,
distribution, assimilation, and the like, the mind being engaged in its other
energies, namely, the five senses, fantasy, reasoning, and memory; but
during night, on the other hand, nature operates more, and the mind less.”
(Problem i, 118.) See also particularly Oribasius (Med. Coll. vi, 4);
Actuarius (de Diæta, 11); Avicenna (i, 3, 3); Rhases (ad Mansor. iv, 3); Haly
Abbas (Theor. v, 35); Alsaharavius (Theor. xi, 3); Averrhoes (Collect. i, 21.)
Averrhoes defines sleep to be the recession of the sensorial powers from
their organs to the internal parts; and hence, he remarks, those who sleep
with their eyes open do not perceive the objects nearest to them. The vital
heat being then collected internally, he adds, the powers of the digestive
faculty are increased. Rhases agrees with Galen that moderate sleep forms
good blood; but that too much corrupts the juices, that is to say, impairs
digestion. Haly Abbas remarks that, during sleep, the animal powers are
suspended, while the vital and natural continue unaffected; and, therefore,
the mind or principle of life being then disengaged, as it were, from one of
its offices, is the abler to perform the others aright. Hence, he adds,
digestion is best performed during sleep. Alsaharavius approves of taking
rest after a meal, but recommends an hour to elapse before going to sleep.
The reader will find in Stentzel’s little treatise, entitled ‘Διατριβὴ περι
τοῦ ὕπνου,’ an interesting exposition of the opinions of the ancient
philosophers and physicians on this subject. There is an ingenious
disquisition on the nature of sleep in the commentary of Stephanus on the
Prognostics of Hippocrates. In reference to Aristotle’s division of causes, he
decides that the efficient cause of sleep is the rest of the particular senses,
and of the general sensorium: the material, a humidity which is carried to
the roots of the nerves, and prevents the exit of the vital spirit; the formal or
organic, the brain, in which the humidity is collected; and the final, or end
which sleep serves, the recreation of the powers. (Dietz, T. i, 142.)

SECT. XCVIII.—ON WATCHFULNESS.

The cure of watchfulness in disease, whether proceeding from pain,

fever, or some acute symptom, will be treated of under the head of Fevers.
But we shall now treat of the watchfulness of those in health. If their
watchfulness proceed from sorrow, care, or any mental emotions, we must
endeavour if possible to remove the offending cause, and then to divert the
attention by agreeable sounds. For this purpose, some seek after the gentle
noise of waters, by which they are soothed and lulled to rest. After proper
digestion, they should use baths, especially in the evening, and a moistening
diet, such as lettuces and the like. They may also mix the green leaves of
the black poppy with condiments, and eat fish of easy digestion. They
should also use plenty of wine which is light and not old. When about to go
to bed, their heads should be anointed with rose oil, or with oil in which the
heads of poppies or mandrake have been boiled. And the oil of dill not too
old is soporific. I have known rest succeeding suddenly to fatigue produce
this effect. Moderate coition will sometimes do the same. Others easily
procure rest by having their head and feet cooled. But if their watchfulness
be occasioned by their stomachs being oppressed by the quantity or bad
quality of the food (and I have known this happen, in like manner as in
others it arises from an unseasonable abstinence or diminution of their
accustomed food), this ought to be inquired into and the cause removed.
 C . We have mentioned, in the 74th Section, that Galen cured
himself of watchfulness by eating freely of lettuces. See further Oribasius
(Med. Collect, vi); Averrhoes (Collectan. ii, 5); Alsaharavius (Theor. xi, 3);
Rhases (Contin. xxxi, Aphorism, iii.) Indigestion, as regards both food and
drink, is stated by Hippocrates as one of the common effects of protracted
insomnolency. (De Diæt. in Morb. Acut. 13.) According to Damascius, the
commentator on Hippocrates, the causes of insomnolency are, heat of the
brain, an intemperament alone, or the prevalence of a bilious humour. (Ed.
Dietz. T. ii, 298.)
Rhases recommends lettuces, the tepid bath, the affusion of tepid water
on the head, and diluted wine. He also recommends mandragora and opium,
which, he says, Galen states will produce soporific effects, not only when
taken internally, but when rubbed on the forehead, and applied to the
nostrils. He particularly approves of the following liniment: Pound the bark
of mandragora, the seed of black henbane, and opium, with the juice of
lettuce, and rub into the temples. He further mentions, that having fallen
into a state of insomnolency from too much application to study, he cured
himself by eating lettuces and using the oil of the water lily externally.
(Aph. u. s.)

SECT. XCIX.—ON SOMNOLENCY.

If, on the other hand, the sleep be profound and heavy, we must abstain
from frequent baths and cooling unguents; we must use masticatories, and
upon the whole change the regimen for one of a hotter, drier, and less
nutritive character, because the affection is occasioned by a cold and humid
matter irrigating the brain.

C . See the Commentary on the Sections on Lethargy and

Carus in Book Third.
 SECT. C.—THE EPISTLE OF DIOCLES ON THE
PRESERVATION OF HEALTH.—DIOCLES TO KING
ANTIGONUS.

Since of all kings you are the most skilled in the arts, and have lived very
long, and are skilled in all philosophy, and have attained the highest rank in
mathematics, I, supposing that the science which treats of all things that
relate to health is a branch of philosophy becoming a king and befitting to
you, have written you this account of the origin of diseases, of the
symptoms which precede them, and of the modes by which they may be
alleviated. For neither does a storm gather in the heavens but it is preceded
by certain signs which seamen and men of much skill attend to, nor does
any disease attack the human frame without having some precursory
symptom. If, then, you will only be persuaded by what we say regarding
them, you may attain a correct acquaintance with these things. We divide
the human body into four parts: the head, the chest, the belly, and the
bladder.—When a disease is about to fix in the head, it is usually announced
beforehand by vertigo, pain in the head, heaviness in the eyebrows, noise in
the ears, and throbbing of the temples; the eyes water in the morning,
attended with dimness of sight; the sense of smell is lost, and the gums
become swelled. When any such symptoms occur, the head ought to be
purged, not indeed with any strong medicine, but taking the tops of hyssop
and sweet marjoram, pound them and boil them in a pot with half a hemina
of must or rob, rinse the mouth with this in the morning before eating, and
evacuate the humours by gargling. There is no gentler remedy than this for
affections of the head. Mustard in warm honied water also answers the
purpose very well. Take a mouthful of this in the morning before eating,
gargle and evacuate the humours. The head also should be warmed by
covering it in such a manner as that the phlegm may be readily discharged.
Those who neglect these symptoms are apt to be seized with the following
disorders: Inflammations of the eyes, cataracts, pain of the ears as if from a
fracture, strumous affections of the neck, sphacelus of the brain, catarrh,
quinsy, running ulcers called achores, caries, enlargement of the uvula,
defluxion of the hairs, ulceration of the head, pain in the teeth.—When
some disease is about to fall upon the chest, it is usually announced by
some of the following symptoms: There are profuse sweats over the whole
body, and particularly about the chest, the tongue is rough, expectoration
saltish, bitter, or bilious, pains suddenly seizing the sides or shoulder-
blades, frequent yawning, watchfulness, oppressed respiration, thirst after
sleep, despondency of mind, coldness of the breast and arms, trembling of
the hands. These symptoms may be relieved in the following manner:
Procure vomiting after a moderate meal without medicine. Vomiting also
when the stomach is empty will answer well; to produce which first
swallow some small radishes, cresses, rocket, mustard, and purslain, and
then by drinking warm water procure vomiting. Upon those who neglect
these symptoms the following diseases are apt to supervene: Pleurisy,
peripneumony, melancholy, acute fevers, frensy, lethargy, ardent fever
attended with hiccough.—When any disease is about to attack the bowels,
some of the following symptoms announce its approach: In the first place,
the belly is griped and disordered, the food and drink seem bitter, heaviness
of the knees, inability to bend the loins, pains over the whole body
unexpectedly occurring, numbness of the legs, slight fever; when any of
these occur, it will be proper to loosen the belly by a suitable diet without
medicine. There are many articles of this description which one may use
with safety, such as beets boiled in honied water, boiled garlic, mallows,
dock, the herb mercury, honied cakes; for all these things are laxative of the
bowels. Or, if any of these symptoms increase, mix bastard saffron with all
these decoctions, for thereby they will be rendered sweeter and less
dangerous. The smooth cabbage boiled in a large quantity of water is also
beneficial; this decoction with honey and salt may be drank to the amount
of about four heminæ, or the water of chick-peas or tares boiled may be
drank in the same manner. Those who neglect the afore-mentioned
symptoms are apt to be seized with the following affections: Diarrhœa,
dysentery, lientery, ileus, ischiatic disease, tertian fever, gout, apoplexy,
hemorrhoids, rheumatism.—When any disease is about to seize the bladder,
the following symptoms are its usual precursors: A sense of repletion after
taking even a small quantity of food, flatulence, eructation, paleness of the
whole body, deep sleep, urine pale and passed with difficulty, swellings
about the privy parts. When any of these symptoms appear, their safest cure
will be by aromatic diuretics. Thus the roots of fennel and parsley may be
infused in white fragrant wine, and drunk every day when the stomach is
empty in the morning to the amount of two cyathi, with water in which
carrot, myrtle, or elecampane has been macerated (you may use any of
these you please, for all are useful); and the infusion of chick-peas in water
may be drank in like manner. On those who neglect these symptoms the
following diseases are apt to supervene: Dropsy, enlargement of the spleen,
pain of the liver, calculus, inflammation of the kidneys, strangury,
distension of the belly. Regarding all these symptoms it may be remarked
that children ought to be treated with gentler remedies, and adults with
more active.—I have now to give you an account of the seasons of the year
in which each of these complaints occur, and what things ought to be taken
and avoided. I begin with the winter solstice.—Of the winter solstice: This
season disposes men to catarrhs and defluxions, until the vernal equinox. It
will be proper then to take such things as are of a heating nature, drink wine
little diluted, or drink pure wine, or of the decoction of marjoram, and
indulge in venery. From the winter solstice to the vernal equinox are ninety
days.—Of the vernal equinox: This season increases phlegm in men, and
the sweetish humours in the blood until the rising of the pleiades. Use
therefore juicy and acrid things, take labour, and indulge in venery. To the
rising of the pleiades are forty-six days.—Of the rising of the pleiades: This
season increases the bitter bile, and bitter humours in men, until the summer
solstice. Use therefore all sweet things, laxatives of the belly, and indulge
but sparingly in venery. To the summer solstice are forty-five days.—Of the
summer solstice: This season increases the formation of black bile in men,
until the autumnal equinox. Use therefore cold water, and everything that is
fragrant; and do not indulge in venery, or do so more sparingly than is
generally directed regarding these matters. To the autumnal equinox are
ninety-three days.—Of the autumnal equinox: This season increases phlegm
and thin rheums in men until the setting of the pleiades. Use therefore
remedies for removing rheums, have recourse to acrid and succulent things,
take no vomits, and abstain from labour and venery. To the setting of the
pleiades are forty-five days.—Of the setting of the pleiades: This season
increases phlegm in men until the winter solstice. Take therefore all sour
things, drink as much as is agreeable of a weak wine, use fat things, and
labour strenuously. To the winter solstice are forty-five days.

C . This Diocles was an ancient physician of great eminence.

Galen often mentions him along with his idol, Hippocrates, as the greatest
of medical authorities. Cælius Aurelianus frequently quotes his opinions in
respectful terms, although belonging to a different sect from his own. Pliny
says that he was next to Hippocrates in fame as in time. Octavius
Horatianus calls him the younger Hippocrates. Athenæus mentions a work
of his on Poisons, and another on Cookery.
Le Clerc questions the authenticity of this epistle, but seems to have had
no other grounds for his scepticism than the general suspicion which has
attached to all the Epistolæ Græcanicæ since the memorable controversy
between the Honorable Mr. Boyle and Dr. Bentley on the authenticity of the
Epistles of Phalaris. It is published in the ‘Bibliotheca Græca’ of Albertus
Fabricius, who appears to have been satisfied as to its genuineness. Mr.
Moir, the author of ‘Outlines of the Ancient History of Medicine,’
condemns it as apocryphal, upon the authority of Schulze. (p. 76.) All we
shall say on this point is, that the evidence against the authority of this
Epistle appears to us to be very inconclusive.
 BOOK SECOND.

SECT. I.—ON FEVERS, FROM THE WORKS OF GALEN

AND SEVERAL OTHERS.

After having treated of those things which relate to the preservation of

health, we now come to the treatment of persons already in disease, and
shall begin with homogeneous disorders as being the most simple. These
are what are called Fevers. Wherefore, using again principally Oribasius’
Epitome of the Works of Galen and several others on this subject, we shall
add a very few things omitted by them.

C . The following ancient authorities may be consulted on the

subject of fever: Hippocrates (Epidem. et alibi); Galen (Comment. in
Hippocr. Epidem., de Differentiis Febrium, Meth. Med. viii, Therap. ad
Glauc. i, De Typis, de Crisibus et alibi); Celsus (iii); Pseudo-Dioscorides
(Euporist. ii); Oribasius (Synop. vi, Euporist.); Aretæus (Morb. Acut. ii, 4);
Aëtius (v); C. Aurelianus (Pass. Acut. ii, 10); Alexander Trallian (xii);
Alexander Aphrodisiensis (Probl. i, 84, de Febribus); Actuarius (Meth.
Med. iii); Pliny (Hist. Nat. xxviii, 66, xxx, 30); Palladius (de Febribus);
Michael Psellus (Opus Medicum); Synesius (de Febribus); Leo (ap.
Ermerins Anecdota Græca); Stephanus (Comment. in Prognost. Hippocrat.
ed. Dietz); Constantinus Africanus (de Febribus); Serenus Samonicus;
Vindicianus (Epistola ap. Fabricii Bibl. Græc. tom. xiii); Avicenna (iv, i);
Syrasis, Avicennæ Expositor; Haly Abbas (Theor. viii, Pract. viii);
Alsaharavius (Theor. vi, Pract. xxxii); Serapion (tr. vi); Avenzoar (iii, 7);
Averrhoes (Collig. vii); Rhases (ad Mans. x, Contin. xxx.)
All the ancient authorities held that a fever consists of a preternatural
increase of the Innate, or, as it is now called, Animal heat, which they
considered as the instrument by which the soul performs all the functions of
the body. See Alexander Aphrod. (de Feb.) Thus, Palladius defines a fever
to be “a preternatural heat, which begins in the heart, and is diffused by the
arteries over the whole body, sensibly injuring the actions of the body.”
Hippocrates, Galen, Aëtius, Alexander Trallian, Psellus, Leo, and Actuarius
give similar definitions. Cælius Aurelianus says of Asclepiades: “Febrium
ponit signum calorem plurimum.” (Morb. Acut. i, 14.) Isidorus defines a
fever thus: “Febris a fervore dicta est; est enim abundantia caloris.” (Orig.)
Hippocrates, however, the great opponent of hypothesis in medicine, insists
that there is more in a fever than a simple excess of pure heat; or, in other
words, that the essence of fever is heat mixed up with noxious qualities. (De
Vet. Med. § 17.) The celebrated Erasistratus maintained an opinion, lately
revived by Clutterbuck and Broussais, that fevers and inflammations are
identical. See Milligan’s Celsus (p. 13 and 112); and Cælius Aurelianus (de
Acut. Morb. ii, 3.) He further taught that in fevers the blood of the veins is
thrown into the arteries. (Plutarch de Placit. Philos. v, 29.)
The Arabians adopt the opinions of Hippocrates, Alexander, and Galen.
Thus, for example, Haly Abbas defines fever to be a preternatural heat
proceeding from the heart, and diffused by the arteries over all parts of the
body. According to him there are three kinds of fevers. The first, are seated
in the spirits, and affect only the heat of the body: these are called
ephemeral fevers. The second, originate in a vitiated state of the fluids,
which impart a preternatural degree of heat to the heart, whence it is
diffused over all the body. The third arise in the vital organs and solid parts,
from which heat is transmitted to the heart. (Pract. viii, 2.) See also, in
particular, Rhases (Cont. xxx.)

SECT. II.—OF THE PRINCIPAL CONSIDERATIONS TO BE

INQUIRED INTO WITH REGARD TO FEBRILE
AFFECTIONS.

The first thing to be considered is, whether the disease will prove fatal or
not; then, if it is not to prove fatal, whether it will be acute or chronic (these
considerations apply to other great disorders); and, third, whether it will
come to a crisis all at once (which is peculiar to fevers), or be resolved
gradually.
 C . This Section, and great part of the contents of this book are
taken from Galen (Therap. ad Glauc. i,) or from Oribasius (Synops. vi.)

SECT. III.—FROM GALEN, WHAT TO CALL THE

COMMENCEMENT OF THE DISEASE.

As headach is not the same complaint as fever, so neither are

insomnolency, loss of appetite, heaviness of the whole body, and a sense of
lassitude; and yet each of these symptoms, although different from fever,
announces its approach. A fever setting in, and more especially in an acute
manner, cannot escape our notice, nor even that of a person unacquainted
with these matters. Or, if we should suppose that it might escape us, I
should wonder if the patient himself could be ignorant of it for more than an
hour. Wherefore I call that time the commencement of the disorder, when
those who are beginning clearly to be affected with the fever betake
themselves to bed.

C . The whole of this Section is taken from Galen (de Diebus

criticis), where the question is fully discussed. Aëtius, like our author,
defines the commencement of a fever to be the time when the strength of
the patient being overcome by the complaint, he is obliged to take to bed.
On this point the Arabians venture to differ from the Greeks. Thus, Rhases
and Avicenna reckon the commencement from the time when the patient
first feels a departure from health.
The disagreement among the authorities upon this point is to be regretted,
as it tends to obscure the doctrine of the critical days.

SECT. IV.—HOW TO KNOW WHETHER THE DISEASE

WILL PROVE FATAL OR NOT.
 These are fatal symptoms: A deathlike countenance, sharp nose, hollow
eyes, and the other symptoms described by Hippocrates, when they do not
proceed from watchfulness, or evacuation, or want of food; also, intolerance
of the light, shedding tears from no external cause, there being no particular
affection of the eyes; or the one eye appearing less than the other; or the
white of the eyes becoming red, or livid, or black, or having a muddiness in
them; and the white of the eyes appearing during sleep, the eyelids not
being closed, unless this symptom proceed from a great evacuation, or from
habit. Likewise grinding the teeth, a state of delirium, picking at flocks of
wool, or bits of chaff, are not favorable. Attention should also be paid to the
patient’s mode of lying. To lie on one’s back, as it were, in a relaxed state,
and to sink downwards in bed, are indications of extreme debility. It is still
worse to have a cold respiration at the mouth and nostrils; and a pulse
obscure, dense, and intermitting, and profuse sweatings with syncope are
most mortal symptoms. If all the symptoms we have mentioned, or even
more appear, or if they be fewer in number but strong, and if they be
without any of the favorable ones, death is inevitable. The breathing free,
pulse natural, soundness of intellect, being well disposed to take whatever is
offered, the appearance of countenance and mode of reclining like those of
persons in health,—all these symptoms are favorable and prognosticate
recovery; and, in general, whatever symptom is contrary to the natural state
indicates an unfavorable, whereas, what is correspondent, indicates a
favorable termination. Concerning the prognosis from the urine, alvine
discharges, and sputa, we will speak soon.

C . The great master of prognostics is Hippocrates, whose

system of medicine was entirely based on the observation of the favorable
and unfavorable symptoms of disease. It would appear that the first
advances in this art were made in the temples of the gods, and especially of
Æsculapius, which the sick were in the practice of resorting to in order to
ascertain the issue of their maladies. See a very ingenious and learned
disquisition, ‘de Hippocratis Doctrina a Prognostice oriunda,’ by F. Z.
Ermerins, . . The works of Hippocrates, especially the ‘Prorrhetica and
Coacæ,’ contain a rich treasure of observations which cannot be too much
explored by the student of medicine. His prognostics are founded upon the
appearances of the face, eyes, tongue, the voice, hearing, the state of the