De Medicina |
Translator: Walter George Spencer
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| 69 |
Aeque notus est morbus , quem interdum arquatum , interdum regium nominant . Quem Hippocrates ait , si post septimum diem febricitante aegro superuenit , tutum esse , mollibus tantummodo praecordiis substantibus : Diocles ex toto , si post febrem oritur , etiam prodesse ; si post hunc febris , occidere . Color autem eum morbum detegit , maxime oculorum , in quibus quod album esse debet , fit luteum . Soletque accedere et sitis et dolor capitis et frequens singultus et praecordiorum dextra parte durities et , ubi corporis uehemens motus est , spirit us difficultas membrorumque resolutio ; atque ubi diutius manet morbus , totum corpus cum pallore quodam inalbescit . Primo die abstinere aegrum oportet , secundo ducere aluum , tum , si febris est , eam uictus genere discutere ; si non est , scamoniam potui dare , uel cum aqua betam albam contritam , uel cum aqua mulsa nuces amaras , absinthium , anesum , sic ut pars huius minima sit . Asclepiades aquam quoque salsam , et quidem per biduum , purgationis causa bibere cogebat , iis quae urinam mouent reiectis . Quidam superioribus omissis per haec et per eos cibos , qui extenuant , idem se consequi dicunt . Ego ubique , si satis uirium est , ualidiora ; si parum , inbecilliora auxilia praefero . Si purgatio fit , post eam triduo primo modice cibum oportet adsumere ex media materia , et uinum bibere Graecum salsum , ut resolutio uentris maneat ; tum altero triduo ualidiores cibos , et carnis quoque aliquid esse , intra aquam manere ; deinde ad superius genus uictus reuerti , cum eo ut magis satietur ; omisso Graeco uino bibere integrum austerum ; atque ita per haec variare , ut interdum acres quoque cibos interponat , interdum ad salsum uinum redeat . Per omne uero tempus utendum est exercitatione , fricatione , si hiemps est , balneo ; si aestas , frigidis natationibus ; lecto etiam et conclaui cultiore , lusu , i oco , ludis , lasciuia , per quae mens exhilaretur ; ob quae regius morbus dictus uidetur . Malagma quoque , quod digerat , super praecordia datum , prodest , uel arida ibi ficus superimposita , si iecur aut lienis est adfectus .
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24 Equally well-known is the disease which they name sometimes the rainbow-hued, sometimes the royal. Of this Hippocrates said that if it comes on after the patient has been suffering from fever for seven days, the patient is safe, provided that the parts under the ribs remain soft. Diocles stated positively that if it arise after a fever, it is even favourable, but deadly if fever follows it. The colour reveals this malady, particularly of the eyes; they become yellow in the parts which should be white. And it is usually accompanied by thirst and headache and frequent hiccough and induration under the ribs on the right side, and when a sharp movement of the body is made there is difficulty in breathing and laxness of the limbs; and when the disease persists for a long while, the whole body whitens with a sort of pallor. On the first day the patient should fast, on the second day have the bowels moved by a clyster, then if there is fever, it is dispersed by appropriate diet; if not, scammony is given in a draught, or white beet pounded up in water, or bitter almonds, wormwood, and a very little aniseed in hydromel. Asclepiades used also to make the patient drink salted water, even for a couple of days, in order to purge, and rejected diuretics. Some, omitting the remedies given above, say they gain the same end through diuretics and those foods which cause thinness. For myself, if there is sufficient strength, I prefer the stronger remedies, the milder if there is but little. After purgation, for the first three days a moderate amount of food of the middle-class should be taken with salted Greek wine to drink, in order to keep the bowels loose; then on the ensuing three days, food of the stronger class with some meat, keeping to water for drink; next there is a return to the middle class of food, but in such a way that he may be more satisfied therewith, and for drink an undiluted dry wine in place of the Greek; and this diet is varied so that sometimes acrid foods are put in, sometimes the salted wine is again given. But throughout the whole time use is to be made of exercise, of rubbing, in winter of the bath, in summer of swimming in cold water, the patient should enjoy a specially good bed and room, also dicing, jesting, play-acting and jollification, whereby the mind may be exhilarated; on account of this treatment the disease seems to have been termed royal. In addition a dispersive poultice, applied under the ribs, is beneficial, or if the liver or spleen has become affected a dried fig is put on. |
| 70 |
Ignotus autem paene in Italia , frequentissimus in quibusdam regionibus is morbus est , quem ΕΛΕΦΑΝΤΙΑΣΙΝ Graeci uocant ; isque longis adnumeratur : quo totum corpus adficitur , ita ut ossa quoque uitiari dicantur . Summa pars corporis crebras maculas crebrosque tumores habet ; rubor harum paulatim in atrum colorem conuertitur . Summa cutis inaequaliter crassa , tenuis , dura mollisque , quasi squamis quibusdam exasperatur ; corpus emacrescit ; os , surae , pedes intumescunt . Vbi uetus morbus e st , digiti in manibus pedibusque sub tumore conduntur ; febricula oritur , quae facile tot malis obrutum hominem consumit .—Protinus ergo inter initia sanguis per biduum mitti debet , aut nigro ueratro uenter solui . Adhibenda tum , quanta sustineri potest , inedia ; paulum deinde uires reficiendae et ducenda aluus ; post haec ubi corpus leuatum est , utendum exercitatione praecipueque cursu ; sudor primum labore ipsius corporis , deinde etiam siccis sudationibus euocandus ; frictio adhibenda , moderandumque inter haec , ut uires conseruentur . Balneum rarum esse debet ; cibus sine pinguibus , sine glutinosis , sine inflantibus ; uinum praeterquam primis diebus recte datur . Corpus contrita plantago et inlita optime tueri uidetur .
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25 The disease which the Greeks call elephantiasis, whilst almost unknown in Italy, is of very frequent occurrence in certain regions; it is counted among chronic affections; in this the whole body becomes so affected that even the bones are said to become diseased. The surface of the body presents a multiplicity of spots and of swellings, which, at first red, are gradually changed to be black in colour. The skin is thickened and thinned in an irregular way, hardened and softened, roughened in some places with a kind of scales; the trunk wastes, the face, calves and feet swell. When the disease is of long standing, the fingers and toes are sunk under the swelling: feverishness supervenes, which may easily destroy a patient overwhelmed by such troubles. At once, therefore, at the commencement, he should be bled for two days, or the bowels loosened by black hellebore, then a scanty diet is to be adopted as far as can be borne; after that the strength should be a little reinforced and the bowels clystered; subsequently, when the system has been relieved, exercise and especially running is to be used. Sweating should be induced primarily by the patient's own exertion, afterwards also by dry sweatings, rubbing is to be employed with moderation so that strength is preserved. The bath should be seldom used; neither fatty nor glutinous nor flatulent food; wine is properly given except on the first days. Plantain crushed and smeared on seems to protect the body best. |
| 71 |
Attonitos quoque raro uidemus , quorum et corpus et mens stupet . Fit interdum ictu fulminis , interdum morbo : ΑΠΟΠΛΗΞΙΑΝ hunc Graeci appellant .—His sanguis mittendus est ; ueratro quoque albo , uel alui ductione utendum ; tunc adhibendae frictiones , et ex media materia minime pingues cibi , quidam etiam acres : a uino abstinendum .
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26 We also see occasionally some who have been stunned, in whom the body and the mind are stupefied. This is produced sometimes by lightning stroke, sometimes by disease; the Greeks call this latter apoplexia. In these cases, blood is to be let, and either white hellebore (II.13.2) or a clyster administered; then rubbings are applied, and food of the middle class given, and that the least fatty; also some which is acrid; there is to be abstinence from wine. |
| 72 |
At resolutio neruorum frequens ubique morbus est : interdum tota corpora , interdum partes infestat . Veteres auctores illud ΑΠΟΠΛΗΞΙΑΝ , hoc ΠΑΡΑΛΥΣΙΝ nominarunt : nunc utrumque ΠΑΡΑΛΥΣΙΝ appellari uideo . Solent autem qui per omnia membra uehementer resoluti sunt , celeriter rapi ; ac si correpti non sunt , diutius quidem uiuunt , sed raro tamen ad sanitatem perueniunt ; plerumque miserum spiritum trahunt , memoria quoque amissa . In partibus uero numquam acutus , saepe longus , fere sanabilis morbus e st . Si omnia membra uehementer resoluta sunt , sanguinis detractio uel occidit uel liberat . Aliud curationis genus uix umquam sanitatem restituit , saepe mortem tantum differt , uitam interim infestat . Post sanguinis missionem si non redit et motus et mens , nihil spei superest ; si redit , sanitas quoque prospicitur . At ubi pars resoluta est , pro ui et mali et corporis uel sanguis mittendus uel aluus ducenda est . Cetera eadem in utroque casu facienda sunt , siquidem uitare praecipue conuenit frigus ; paulatimque ad exercitationes reuertendum est , sic ut ingrediatur ipse protinus , si potest . Si id crurum inbecillitas prohibet , uel gestetur , uel motu lecti concutiatur ; tum id membrum , quod defici t , si potest , per se , si minus , per alium moueatur , et ui quadam ad consuetudinem suam redeat . Prodest etiam torpentibus membris summam cutem exasperare uel urticis caesam uel inposito sinapi , sic ut , ubi rubere coeperit corpus , haec remouea ntur. Scilla quoque contrita bulbique contriti cum ture recte inponuntur . Neque alienum est resina cutem tertio quoque die diutius uellere ; pluribus etiam locis aliquando sine ferro cucurbitulas admouere . Vnctioni uero aptissimum est uetus oleum uel nitrum aceto et oleo mixtum . Quin etiam fouere aqua calida marina , uel si ea non est , tamen salsa magnopere necessarium est . Ac si quo loco uel naturales uel etiam manu factae tales natationes sunt , is potissimum utendum est ; praecipueque in is agitanda membra , quae maxime deficiunt ; si id non est , balneum tamen prodest . Cibus esse debet ex materia media , maximeque ex uenatione : potio sine uino aquae calidae . Si tamen uetus morbus est , interponi quarto uel quinto die purgationis causa uinum Graecum salsum potest . Post cenam utilis uomitus est . Interdum uero etiam neruorum dolor oriri solet . In hoc casu non uomere , non urinam medicamentis mouere , non sine exercitatione sudorem , ut quidam praecipiunt , expedit : bibenda aqua est , bis die in lectulo leniter satis diu corpus perfricandum est , deinde retento spiritu ab ipsa exercitatione potius superiores partes mouendae ; balneo raro utendum ; mutandum subinde peregrinationibus caelum . Si dolor est , ea ipsa pars sine oleo nitro ex aqua perunguenda est , deinde inuoluenda , et subicienda pruna lenis et sulpur , atque ita diu subfumigandum ; idque aliquandiu faciendum , sed ieiuno , cum bene iam concoxerit . Cucurbitulae quoque saepe dolenti parti admouendae sunt , pulsandusque leuiter inflatis uesicis bubulis is locus est . Vtile est etiam sebum miscere cum hyoscyami et urticae contritis seminibus , sic ut omnium par modus sit , idque inponere ; fouere aqua , in qua sulpur decoctum sit . Vtriculi quoque recte inponuntur aqua calida repleti , aut bitumen cum hordeacia farina †iactum . Atque in ipso potissimum dolore utendum gestatione uehementi est ; quod in aliis doloribus pessimum est . Tremor autem neruorum aeque uomitu medicamentisque urinam mouentibus intenditur . Inimica etiam habet balinea assasque sudationes . Bibenda aqua est ; acri ambulatione utendum , itemque unctionibus frictionibusque , maxime per se ipsum ; pila similibusque superiores partes dimouendae ; cibo quolibet utendum , dum concoctioni utique studeatur . Secundum cibum curis abstinendum ; rarissima uenere utendum est . Si quando quis in eam prolapsus est , tum oleo leuiter diuque in lectulo perfricari manibus puerilibus quam uirilibus debet . Suppurationes autem , quae in aliqua interiore parte oriuntur , ubi notae fuerint , primum id agere oportet per ea cataplasmata , quae reprimunt , ne coitus inutilis materiae fiat ; deinde , si haec uicta sunt , per ea malagmata , quae digerunt , dissipentur . Quod si consecuti non sumus , sequitur ut euocetur , deinde , ut maturescat . Omnis tum uomicae finis est , ut rumpatur ; indiciumque est pus uel aluo uel ore redditum . Sed nihil facere oportet , quo minus , quicquid est puris , excedat . Vtendum maxime sorbitione est , et aqua calida . Vbi pus ferri desiit , transeundum ad faciles quidem sed tamen ualidiores et frigidos cibos frigidamque aquam , sic ut ab egelidis tamen initium fiat . Primoque cum melle quaedam edenda , ut nuclei pinei uel Graecae nuces uel Abellanae ; postea summouendum id ipsum , quo maturius induci cicatrix possit . Medicamentum eo tempore ulceri est sucus adsumptus uel porri uel marrubii , et omni cibo porrum ipsum adiectum . Oportebit autem ut i in is partibus , quae non adficientur , frictionibus , item ambulationibus lenibus ; uitandumque erit , ne uel luctando uel currendo uel alia ratione sanescentia ulcera exasperentur : in hoc enim morbo perniciosus ideoque omni modo cauendus sanguinis uomitus est .
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27 Relaxing of the sinews, on the other hand, is a frequent disease everywhere. It attacks at times the whole body, at times part of it. Ancient writers named the former apoplexy, the latter paralysis: I see that now both are called paralysis. Those who are gravely paralyzed in all their limbs are as a rule quickly carried off, but if not so carried off, some may live a long while, yet rarely however regain health. Mostly they drag out a miserable existence, their memory lost also. The disease, when partial only, is never acute, often prolonged, generally remediable. If all the limbs are gravely paralyzed withdrawal of blood either kills or cures. Any other kind of treatment scarcely ever restores health, it often merely postpones death, and meanwhile makes life a burden. If after blood-letting, neither movement nor the mind is recovered, there is no hope left; if they do return, health also is in prospect. But when a particular part is paralyzed, in accordance with the force of the disease, and the strength of the body, either blood is to be let, or the bowel clystered. The rest that has to be done is the same in both conditions: in particular cold should be avoided; and the patient should return to exercise a little at a time, in such a way that he should begin to walk at once, if he can. If the weakness of the legs prevent this, he should be carried about in a litter or rocked in his bed, then, if possible, his defective limb should be moved by himself, failing that by someone else, and by a form of compulsion, it should be restored to is customary state. It is also beneficial to stimulate the skin of the torpid limb, either by whipping with nettles, or by applying mustard plasters, these latter being removed as soon as the skin becomes red. Appropriate applications also are crushed squills, and onions pounded up with frankincense. Nor is it amiss to pluck on the skin for some time by the aid of a pitch plaster every third day (III.22.6) and sometimes to apply dry cups in several places. Again for anointing, old olive oil is most suitable, or soda mixed with oil and vinegar. Further, it is also highly necessary to foment with warm sea water, or failing that with salt and water. And if there are at hand swimming baths, whether natural or artificial, they should be used as much as possible; especially the defective limb should be moved in them; if there are none such the ordinary bath is of service. The food should be of the middle class, particularly game, the drink hot water without wine. If, however, the disease is of long standing, every fourth or fifth day Greek salted wine may be given, in order to purge. An emetic after supper is of use. At times also there occurs pain in the sinews. In that case it is not expedient to excite vomiting nor urination as some prescribe, nor indeed sweating other than through exercise; water should be drunk; twice a day in bed the body should be rubbed gently and for some time, and then whilst holding the breath, the limbs, preferably the upper, are to be moved in the course of exercise. The bath should be seldom used; from time to time there should be a change of air by travel. If there is pain, the part should be wetted with water containing soda, but not oil, then wrapped up, and under it should be placed a brazier containing some glowing charcoal with sulphur, so that it may be fumigated for a while; this should be repeated from time to time, but only on an empty stomach and after digestion is completed. Cups also may be applied at frequent intervals to the painful part, and this place lightly beaten with inflated ox bladders. It is also of service to mix fat with pounded henbane and nettle seeds, equal parts of each, and put this on, also to foment with a decoction of sulphur. Further, it is a good plan to apply leather bottles filled with hot water, or bitumen mixed with barley meal. And for the actual pain the best remedy is forceful rocking; which in other kinds of pain is the worst. Tremor of sinews again is like with made worse by an emetic, and by medicaments causing urination. Inimical also are baths and dry sweatings. Water is to be drunk; the patient should there are a smart walk and be anointed and rubbed as well, especially by himself; the upper limbs are to be exercised by ball games and the like; he may think what food he likes provided that he studies his digestion. He should avoid worry after meals; make the rarest use of venery. If at any time he has given way to it, then he ought to be rubbed, with oil, gently and for some time, whilst in bed, by the hands of boys rather than men. Now suppurations which arise in some interior part, when they become noticeable, first should be acted upon by those poultices which repress, less there is produced a harmful collection of the material of disease; next if these remedies are unsuccessful, the suppurations may be dissipated by dispersive poultices. If we are not successful in that, it follows that the suppuration should be drawn outwards, next that it should mature. The ending of every abscess is to rupture; the indication is pus discharged either from the bowels or mouth. But nothing ought to be done to diminish the discharge of the pus. Broth and hot water are chiefly to be given. When pus ceases to be discharged, then there should be a transition to digestible yet nutritious food consumed cold, also cold water for drink, commencing, however, with lukewarm. To begin with, things such as pine kernels, or almonds, or hazel nuts, may be eaten along with honey; afterwards these make way for whatever can make the scar form earlier. At this stage as a medicament for the ulceration there is to be taken either leek or horehound juice, and whatever the food, leeks should be added. Rubbing is required also for parts unaffected, so also gentle walks; to be avoided are wrestling and running and other things tending to irritate healing ulcerations, for in this malady the vomiting of blood is most pernicious and to be guarded against in every way. |