De Medicina |
Translator: Walter George Spencer
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| 53 |
At ubi id genus tertianae est , quod emitritaeon medici appellant , magna cura opus est , ne id fallat : habet enim plerumque frequentes accessiones decessionesque , ut aliud genus morbi uideri possit porrigique febris inter horas XXIIII et XXXVI , ut quod idem est , non idem esse uideatur . Et magnopere necessarium est neque dari cibum nisi in ea remissione , quae uera est , et ubi ea uenit , protinus dari . Plurimique sub alterutro curantis errore subito moriuntur . Ac nisi magnopere res aliqua prohibet , inter initia sanguis mitti debet , tum dari cibus , qui neque incitet febrem , et tamen longum eius spatium sustineat .
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8 But when the fever is that kind of tertian which the physicians call hemitritaion, great care is required to avoid a mistake, for it has a number of frequently recurring paroxysms and remissions, so that it can appear to be some other class of disease and the fever may last from twenty-four to thirty-six hours, so that what is really the same paroxysm may not seem to be the same. And it is then exceedingly important not to give food except in that remission which is a real one, and when that does come, to give it at once. Many die suddenly from error one way or the other on the part of the practitioner. And unless something strongly prohibits, blood should be let at the onset, then food is to be given, which, without exciting the fever, should yet sustain a long course of it. |
| 54 |
Nonnumquam etiam lentae febres sine ulla remissione corpus tenent , ac neque cibo neque ulli remedio locus est . In hoc casu medici cura esse debet , ut morbum mutet : fortasse enim curationi oportunior fiet . Saepe igitur ex aqua frigida , cui oleum sit adiectum , corpus eius pertractandum est , quoniam interdum sic euenit , ut horror oriatur et fiat initium quoddam noui motus exque eo , cum magis corpus incaluit , sequatur etiam remissio . In his frictio quoque ex oleo et sale salubris uidetur . At si diu frigus est et torpor et iactatio corporis , non alienum est in ipsa febre mulsi dare tres aut quattuor cyathos , uel cum cibo uinum bene dilutum . Intenditur enim saepe ex eo febris , et maior ortus calor simul et priora mala tollit et spem remissionis inque ea curationis ostendit . Neque Hercules ista curatio noua est , qua nunc quidem traditos sibi aegros , qui sub cautioribus medicis trahebantur , interdum contrariis remediis sanant . Siquidem apud antiquos quoque ante Herophilum et Erasistratum maximeque post Hippocratem fuit * * Petro quidam , qui febricitantem hominem ubi acceperat , multis uestimentis operiebat , ut simul calorem ingentem sitimque excitaret . Deinde ubi paulum remitti coeperat febris , aquam frigidam potui dabat , ac si mouerat sudorem , explicuisse se aegrum iudicabat ; si non mouerat , plus etiam aquae frigidae ingerebat et tum uomere cogebat . Si alterutro modo febre liberauerat , protinus suillam assam et uinum homini dabat ; si non liberauerat , decoquebat aquam sale adiecto eamque bibere cogebat , ut mouendo uentrem purgaret . Et intra haec omnis eius medicina erat : eaque non minus grata fuit is , quos Hippocratis successores non refecerant , quam nunc est is , quos Herophili uel Erasistrati aemuli diu tractos non adiuuerunt . Neque ideo tamen non est temeraria ista medicina , quia , si plures protinus a principiis excepit , interemit . Sed , cum eadem omnibus conuenire non possint , fere quos ratio non restituit , temeritas adiuuat ; ideoque eiusmodi medici melius alienos aegros quam suos nutriunt . Sed est circumspecti quoque hominis et nouare interdum et augere morbum et febres accendere , quia curatio nem ubi id quod est non recipit , potest recipere id quod futurum est .
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9 Sometimes also slow fevers hold the body without any remission, and give no place for either food or any medicament. In that case it should be the aim of the practitioner to change the disease, for perhaps that will make it more amenable to treatment.. For this object cold water, to which oil has been added, should be sprinkled at frequent intervals over the patient's body, for it thus comes about now and again that a shivering follows, and some beginning of a fresh pulse motion, and after this when, after the body has become hotter, there may even follow a remission. Rubbing with oil and salt appears also to benefit such cases. But if for a long while there is a chill, and a numbness and a tossing of the body, it is not unfitting to administer three or four cups of honeyed wine even while the fever is present, or food along with wine well diluted. For often in this way the fever is augmented, and the increased heat which arises simultaneously both relieves the pre-existing disorders and offers hope of a remission, and through that of treatment. Assuredly that treatment is no novelty by which some nowadays at times cure by contrary remedies patients who have been handed over to them, after dragging on under more cautious practitioners. Even among the ancients, before Herophilus and Erasistratus, but especially after Hippocrates. There was a certain Petron, who on taking over a patient with fever, covered him with a quantity of clothes in order simultaneously to excite great heat and thirst. Then when the fever began to remit somewhat, he gave cold water to drink; and if this raised a sweat, he declared that the patient was recovering; if it did not, he administered even more cold water and then forced him to vomit. If by either of the above ways he had rendered the patient free from fever, he at once gave him roast pork and wine; if he had not so freed him, he boiled water with salt, and obliged the patient to drink it, in order that by moving the bowels he might cleanse the stomach. And the above formed the whole of this man's practice; and it pleased those whom successors of Hippocrates had failed to cure, no less than in our time it pleases those, who, after they have dragged on for a long while under disciples of Herophilus and Erasistratus, have not been benefited. Yet it is harsh treatment none the less, for if it is adopted forthwith at the commencement, it kills many patients. Since, however, it is impossible for the same remedies to suit everybody, rashness helps those whom the usual regimen has not made well; hence it is that practitioners of this class manage other people's patients better than their own. Yet it is the part also of a circumspect man at times to renew and increase a disease and to inflame fevers, for when the existing condition does not answer to a treatment, that which is to come may do so. |
| 55 |
Considerandum est etiam , febresne solae sint , an alia quoque his mala accedant , id est , num caput doleat , num lingua aspera , num praecordia intenta sint . Si capitis dolores sint , rosam cum aceto miscere oportet et in id ingerere ; deinde habere duo pittacia , quae frontis latitudinem longitudinemque aequent , ex his inuicem alterum in aceto et rosa habere , alterum in fronte ; aut intinctam isdem lanam sucidam inponere . Si acetum offendit , pura rosa utendum est ; si rosa ipsa laedit , oleo acerbo . Si ista parum iuuant , teri potest uel iris arida uel nuces amarae uel quaelibet herba ex refrigerantibus ; quorum quidlibet ex aceto inpositum dolorem minuit , sed magis aliud in alio . Iuuat etiam panis cum papauere iniectus , uel cum rosa , cerussa spumaue argenti . Olfacere quoque uel serpullum uel anethum non alienum est . At si in praecordiis inflammatio et dolor est , primo superimponenda sunt cataplasmata reprimentia , ne , si calidiora fuerint , plus eo materiae concurrat ; deinde si prima inflammatio se remisit , tum demum ad calida et umida ueniendum est , ut ea , quae remanserunt , discutiant . Notae uero inflammationis sunt quattuor : rubor et tumor cum calore et dolore . Quo magis errauit Erasistratus , cum febrem nullam esse sine hac dixit . Ergo si sine inflammatione dolor est , nihil imponendum est : hunc enim statim ipsa febris soluet . At si neque inflammatio neque febris sed tantum praecordiorum dolor est , protinus calidis et siccis fomentis uti licet . Si uero lingua sicca et scabra est , detergenda primum penicillo est ex aqua calida , deinde unguenda mixtis inter se rosa et melle . Mel purgat , rosa reprimit simulque siccescere non sinit . At si scabra non est sed arida , ubi penicillo detersa est , ungi rosa debet , cui cerae paulum sit adiectum .
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10 We must also take into consideration whether fevers exist alone, or whether there are additional troubles, namely whether the head aches, whether the tongue is roughened, whether the chest is tight. If there is headache, rose oil should be mixed with vinegar and poured over the head; next two strips of linen are taken, each corresponding in length and breadth to the forehead, of which in turn one is placed in the rose oil and vinegar, the other on the forehead; or unscoured wool is soaked in the same and applied. If the vinegar hurts, the rose oil alone is to be used; if rose oil itself irritates, then bitter olive oil. If there is little relief from the above, we may pound up either dried orris root, or bitter almonds, or some other from among refrigerant herbs; any one of these applied with vinegar lessens pain, one more in one case, another in another. There is benefit from the application of bread soaked in poppy head decoction, or in rose oil containing cerussa or litharge. Also it is not unsuitable to snuff up thyme or dill. But first there is inflammation and pain in the chest, the first thing is to apply to it repressing plasters, lest more diseased matter should gather there, if hotter ones were applied; next, when the primary inflammation has subsided, and not before, we must go on to hot and moist plasters, in order to disperse what remains of the matter. Now the signs of an inflammation are four: redness and swelling with heat and pain. Over this Erasistratus greatly erred, when he said that no fever occurred apart from inflammation. Therefore if there is pain without inflammation, nothing is to be put on: for the actual fever at once will dissolve the pain. But if there is neither inflammation nor fever, but just pain in the chest, it is allowable to use hot and dry foments from the first. Again if the tongue is dry and scabrous, it is to be wiped over first with a pledget of wool dipped in hot water, then to be smeared with a mixture of rose oil and honey. Honey cleans, rose oil represses and at the same time does not allow the tongue to dry. But if the tongue is not scabrous, only dry, after being wiped over with the pledget of wool, it should be smeared with rose oil to which a little wax has been added. |
| 56 |
Solet etiam ante febres esse frigus idque uel molestissimum morbi genus est . Vbi id expectatur , omni potione prohibendus est aeger : haec enim paulo ante data multum malo adicit . Item maturius ueste multa tegendus est ; admouenda partibus is , pro quibus metuimus , sicca et calida fomenta sic , ne statim uehementissimi calores incipiant , sed paulatim increscant . Perfricandae quoque eae partes manibus unctis ex uetere oleo sunt eique adiciendum aliquid ex calefacientibus . Contentique medici quidam una frictione etiam ex quolibet oleo sunt . In harum febrium remissionibus nonnulli tres aut quattuor cyathos sorbitionis etiamnu m manente febre dant , deinde ea bene finita reficiunt stomachum cibo frigido et leui . Tum hoc ego puto temptandum , quo m parum cibus semel et post febrem datus prodest . Sed curiose prospiciendum , ne tempus remissionis decipiat : saepe enim in hoc quoque genere ualetudinis iam minui febris uidetur , et rursus intenditur . Aliqua ei remissioni credendum est , quae etiam moratur et iactationem foetoremque quendam oris , quem ozen am Graeci uocant , minuit . Illud satis conuenit , si cottidie pares accessiones sunt , cotidie paruum cibum dandum : si inpares , post grauiorem , cibum ; post leuiorem , aquam mulsam .
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11 Generally also preceding fevers there is a chill, and that is a most troublesome class of malady. When it is expected, the patient is to be prohibited from drinking anything: for this, given a little while beforehand, adds much to the illness. Likewise he is to be covered up quite soon with a quantity of bed-clothes; to the parts about which we feel concern there are to be applied such dry and hot foments as will not immediately set up a very vehement heat, but gradually increase it. The said parts are also to be rubbed by hands anointed with cold olive oil, to which has been added one of the heating agents. And some practitioners are satisfied with one rubbing of any kind of oil. During remissions of these fevers, some give three or four cupfuls of barley water even although some fever still persists; then, the fever having definitely ended, they reinvigorate the stomach with cold and light food. This, I think, should be tried only when there has been little benefit from food given once and at the end of the paroxysm. It must be carefully looked to, however, that the time of the remission is not deceptive; for often in this class of illness the fever seems to diminish, and then again becomes intense. Some degree of trust must be placed in that remission which is prolonged, and diminishes restlessness and the foulness of the mouth which the Greeks term ozaena. This is pretty generally agreed, that if the daily paroxysms are equal, a little food should be given every day: if the paroxysms are unequal, food should be given after the more severe, after the slighter ones hydromel. |