De Medicina |
Translator: Walter George Spencer
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| 77 |
Destillat autem de capite interdum in nares , quod leue est ; interdum in fauces , quod peius est ; interdum etiam in pulmonem , quod pessimum est . Si in nares destillauit , tenuis per has pituita profluit ; caput leuiter dolet , grauitas eius sentitur , frequentia sternumenta sunt ; si in fauces , has exasperat , tussiculam mouet ; si in pulmonem , praeter sternumenta et tussim est etiam capitis grauitas , lassitudo , sitis , aestus , biliosa urina . Aliud autem quamuis non multum distans malum grauedo est . Haec nares claudit , uocem obtundit , tussim siccam mouet ; sub eadem salsa est saliua , sonant aures , uenae mouentur in capite , turbida urina est . Haec omnia ΚΟΡΥΖΑΣ Hippocrates nominat : nunc uideo apud Graecos in grauedine hoc nomen seruari , destillationem ΚΑΤΑΣΤΑΓΜΟΝ appellari . Haec autem et breuia et , si neglecta sunt , longa esse consuerunt . Nihil pestiferum est , nisi quod pulmonem exulcerauit . Vbi aliquid eiusmodi sensimus , protinus abstinere a sole , balneo , uino , uenere debemus ; inter quae unctione et adsueto cibo nihilo minus uti licet . Ambulatione tantum acri sed tecta utendum est ; post eam caput atque os supra quinquagiens perfricandum . Raroque fit ut , si biduo uel certe triduo nobis temperauimus , id uitium non leuetur . Quo leuato , si in destillatione crassa facta pituita est , uel in grauedine nares magis patent , balneo utendum est , multaque aqua prius calida , post egelida fouendum os caputque ; deinde cum cibo pleniore uinum bibendum . At si aeque tenuis quarto die pituita est , uel nares aeque clausae uidentur , adsumendum est uinum Aminaeum austerum , dein rursus biduo aqua ; post quae ad balneum et ad consuetudinem reuertendum est . Neque tamen illis ipsis diebus , quibus aliqua omittenda sunt , expedit tamquam aegros agere , sed cetera omnia quasi sani s facienda sunt , praeterquam si diutius aliquid et uehementius ista sollicitare consuerunt : huic enim quaedam curiosior obseruatio necessaria est . Igitur huic , si in nares uel in fauces destillauit , praeter ea , quae supra rettuli , protinus primis diebus multum ambulandum est ; perfricandae uehementer inferiores partes , leuior frictio adhibenda thoraci ori capiti ; demenda adsueto cibo pars dimidia ; sumenda oua , amylum similiaque , quae pituitam faciunt crassiorem : siti quanta maxime sustineri potest , pugnandum . Vbi per haec idoneus aliquis balneo factus eoque usus est , adiciendus est cibo pisciculus aut caro , sic tamen ne protinus iustus modus cibi sumatur ; uino meraco copiosius utendum est . At si in pulmonem quoque destillat , multo magis et ambulatione et fricatione opus est eademque adhibita ratione in cibis , si non satis illi proficiunt , acrioribus utendum est ; magis somno indulgendum , abstinendumque a negotiis omnibus ; aliquando sed serius balineum temptandum . In grauedine autem primo die quiescere , neque esse neque bibere , caput uelare , fauces lana circumdare ; postero die surgere , abstinere a potione , aut si res coegerit , non ultra heminam aquae adsumere ; tertio die panis non tam multum ex parte interiore qum pisciculo uel leui carne sumere ; aquam bibere . Si quis sibi temperare non potuerit quominus pleniore uictu utatur , uomere ; ubi in balneum uentum est , multa calida aqua caput et os fouere usque ad sudorem ; tum ad uinum redire . Post quae uix fieri potest , ut idem incommodum maneat ; sed si manserit , utendum erit cibis frigidis , aridis , leuibus , umore quam minimo , seruatis frictionibus exercitationibusque , quae in omni tali genere ualetudinis necessariae sunt .
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5 Again there is dripping from the head sometimes into the nose, which is a mild affair; sometimes into the throat, which is worse, sometimes into the lung, which is worst of all. When the drip is into the nostrils, a thin phlegm is discharged from them; there is slight pain, and a feeling of weight in the head, with frequent sneezing; if the drip is into the throat, it irritates and excites a slight cough; if the drip is into the lung, besides the sneezing, cough and even weight in the head, there is lassitude, thirst, a feeling of heat, and bilious urine. Another although not very different affection is gravedo. This closes up the nostrils, renders the voice hoarse, excites a dry cough; in it the saliva is salt, there is ringing in the ears, the blood-vessels in the head throb, the urine is turbid. Hippocrates named all the above coryza; I note that now the Greeks reserve this term for gravedo, the dripping they call catastagmus. These affections are commonly of short duration, but if neglected may last a long while. None is fatal, except that which causes ulcers in the lung. Whenever we feel anything of the sort, we should forthwith keep out of the sun, and abstain from the bath, wine and coition; but the use meanwhile of anointing and of customary food is allowable. The patient should walk, but only briskly and under cover; after that the head and face should be rubbed for more than fifty strokes. This complaint is generally relieved, provided that we take care of ourselves for a couple of days, or for three at the most. When the disease has been relieved so that the drip of phlegm becomes thick, or the gravedo so that the nostrils are more open, the bath may be resumed, much water, at first hot, then lukewarm, being used to foment the face and head; next, along with more food, wine may be taken. But if on the fourth day the phlegm is still thin, or the nostrils still stuffed up, the patient should take dry Aminaean wine, then for a couple of days water; after which he can return to the bath and his usual habits. Nevertheless, even during those days, when some things are to be avoided, it is not expedient to treat the patients as sick men, but they are to do everything as in health, unless these symptoms have been liable to cause more prolonged and severe trouble; for then a somewhat more careful attention is needed. Therefore in such a case if there is a drip into the nose or into the throat, besides the treatment described above, the patient from the start should walk a good deal during the first days: have the lower limbs smartly rubbed, together with more gentle rubbing of the chest, face and head; his accustomed food should be reduced by one-half; he may take eggs, also starchy and such-like foods, which thicken phlegm; thirst should be resisted as far as he can bear it. When by these measures a patient has been prepared for the bath, and has used it, there may be added to the diet small fish or meat, provided that at first he should not take the full quantity of food; undiluted wine should be taken more freely. But if the drip is into the lung also, there is even more need for walking and rubbing and the same regimen as to diet, and if that diet is not effective, more acrid food is to be employed; he should allow himself more sleep, and abstain from all business; but the bath should be tried at a somewhat later stage. In the case of gravedo, he should lie in bed on the first day, neither eat nor drink, cover the head, and wrap wool around the throat; on the next day he should get up, and still abstain from drink, or, if he must have some, take not more than one tumbler-full of water; on the third day he may eat the crumb of bread, but not much, with some small fish, or light meat, and water for drink. Should the patient be unable to restrain himself from using a fuller diet, he is to provoke a vomit; when he gets to the bath, he should foment freely his head and face with hot water until he sweats, and then have recourse to wine. After the above measures it is scarcely possible for the same discomfort to persist; but if it does so, use cold, dry, light food with the least possible fluid, whilst continuing the rubbings and the exercises, such as are needed in all such sorts of illness. |
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A capite transitus ad ceruicem est , quae grauibus admodum morbis obnoxia est . Neque tamen alius inportunior acutiorque morbus est , quam is , qui quodam rigore neruorum modo caput scapulis , modo mentum pectori adnectit , modo rectam et inmobilem ceruicem intendit . Primum Graeci ΟΠΙΣΘΟΤΟΝΟΝ , insequentem ΕΜΠΡΟΣΘΟΤΟΝΟΝ , ultimum ΤΕΤΑΝΟΝ appellant , quamuis minus subtiliter quidam indiscretis his nominibus utuntur . Ea saepe intra quartum diem tollunt : si hunc euaserunt , sine periculo sunt .—Eadem omnia ratione curantur idque conuenit * * * Sed Asclepiades utique emittendum sanguinem credidit ; quod quidam utique uitandum esse dixerunt , eo quod maxime tum corpus calore egeret , isque esset in sanguine . Verum hoc quidem falsum est : neque enim natura sanguinis est , ut utique caleat , sed ex is , quae in homine sunt , hic celerrime uel calescit uel refrigescit . Mitti uero necne debeat , ex is intellegi potest , quae de sanguinis missione praecepta sunt . Vtique autem recte datur castoreum , et cum hoc piper uel laser ; deinde opus est fomento umido et calido . Itaque plerique aqua calida multa ceruices subinde perfundunt . Id in praesentia leuat , sed oportuniores neruos frigori reddit , quod utique uitandum est . Vtilius igitur est cerato primum liquido ceruicem perunguere ; deinde admouere uesicas bubulas uel utriculos oleo calido repletos , uel ex farina calidum cataplasma , uel piper rotundum cum ficu contusum . Vtilissimum tamen est umido sale fouere ; quod quomodo fieret iam ostendi . Vbi eo aliquid factum est , admouere ad ignem ; uel si aestas est , in sole m aegrum oportet ; maximeque oleo ueteri , si id non est , Syriaco ; si ne id quidem est , adipe quam uetustissima ceruicem et scapulas et spinam perfricare . Frictio cum omnibus in homine uertebris utilis sit , tum is praecipue , quae in collo sunt . Ergo die nocteque , interpositis tamen quibusdam temporibus , hoc remedio utendum est . Dum intermittitur , imponendum malagma aliquod ex calfacientibus . Cauendum uero praecipue frigus ; ideoque in eo conclaui , quo cubabit aeger , ignis continuus esse debebit , maximusque tempore antelucano , quo praecipue frigus intenditur . Neque inutile erit caput adtonsum habere idque irino uel cyprino calido madefacere et superinposito pilleo uelare ; nonnumquam etiam in calidum oleum totum descendere , uel in aquam calidam , in qua faenum Graecum decoctum sit et adiecta olei pars tertia . Aluus quoque ducta saepe superiores partes resoluit . Si uero etiam uehementius dolor creuit , admouendae ceruicibus cucurbitulae sunt , sic ut cutis incidatur ; eadem aut ferramentis aut sinapi adurenda . Vbi leuatus est dolor mouerique ceruix coepit , scire licet cedere remediis morbum . Sed diu uitandus cibus , quisquis mandendus est : sorbitionibus utendum itemque ouis sorbilibus aut apalis ; ius aliquod adsumendum . At si bene processerit iamque ex toto recte se habere ceruices uidebuntur , incipiendum erit a pulticula uel intrita bene madida . Celerius tamen etiam panis mandendus quam uinum gustandum , siquidem huius usus praecipue periculosus ideoque in longius tempus differendus est .
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6 From the head we pass to the neck, which is liable to harm from diseases of considerable gravity. There is, however, no disease more distressing, and more acute, than that which by a sort of rigor of the sinews, now draws down the head to the shoulder-blades, now the chin to the chest, now stretches out the neck straight and immobile. The Greeks call the first opisthotonus, the next emprosthotonus, and the last tetanus, although some with less exactitude use these terms indiscriminately. These diseases are often often fatal within four days. If the patients survive this period, they are no longer in danger. They are all treated by the same method and this is agreed upon, but Asclepiades in particular believed in blood-letting, which some said should be particularly avoided, because the body was then especially in need of that heat which was in the blood. But this is false; for it is not in the nature of the blood to be especially hot, but of all that composes man, the blood most quickly turns, now hot, now cold. Still, whether or no it ought to be let, can be learnt from the instructions concerning blood-letting (II.10, 11). But anyhow it is right to give castory, and with it pepper or laser; further, a warm and moist fomentation is needed. For this purpose most pour hot water freely at intervals over the neck. This affords temporary relief, but renders the sinews more susceptible to cold, a thing certainly to be avoided. It is, therefore, more beneficial, first to anoint the neck with a liquid wax-salve, then to apply ox-bladders or leathern bottles filled with hot oil, or else a hot meal plaster, or a pod of round pepper crushed up in a fig. The best thing, however, is to foment with moistened salt according to the method already described (II.17.9, 10; 33.1). Whatever meanwhile is being done, the patient should be brought near a fire, or into the sun in hot weather, and old oil in particular should be rubbed into his neck, shoulder-blades and spine; or if that is not at hand, Syriac oil, or if not even that, oldest lard. Rubbing applied to the whole length of the vertebrae is beneficial, but especially so to those of the neck. Therefore, with certain intervals however, this procedure should be carried out both by day and by night. During such intervals some kind of an emollient composed of heating substances should be put on. Cold is especially to be guarded against; and so there ought to be a fire kept burning constantly in the room in which the patient is lying, especially during the hours before dawn, when the cold is particularly intense. It is not unserviceable to keep the head closely clipped, moistened with hot iris or cyprus oil, and covered by putting on a cap; sometimes even to submerge the patient either in hot oil, or in hot water in which fenugreek has been boiled and a third part of oil added. If the bowels also have been moved by a clyster, this often relaxes the upper parts. Should the pain grow even still more severe, cups should be applied to the neck after the skin has been incised; or the same spot is to be burnt either with the cautery, or by mustard. When the pain has been relieved and the neck begins to be moved, it can be recognized that the disease is yielding to treatment. But for a long while food which has to be chewed should be avoided; sops and eggs, raw or soft boiled, are to be used; any kind of soup may be taken. But if the patient has done well, and the neck appears to be all right, then will be the time to begin with pulse porridge, or well-moistened crumbled bread. He is to chew bread, however, earlier than to drink wine, because the use of wine is particularly risky, and so ought to be deferred for a longer time. |
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Vt hoc autem morbi genus circa totam ceruicem , sic alterum aeque pestiferum acutumque in faucibus esse consueuit . Nostri anginam uocant : apud Graecos nomen , prout species est . Interdum enim neque rubor neque tumor ullus apparet , sed corpus aridum est , uix spiritus trahitur , membra soluuntur : id ΣΥΝΑΓΧΗΝ uocant . Interdum lingua faucesque cum rubore intumescunt , uox nihil significat , oculi uertuntur , facies pallet , singultus est : id ΚΥΝΑΓΧΗΝ uocant . Illa communia sunt : aeger non cibum deuorare , non potionem potest , spiritus eius in tercluditur . Leuius est , ubi tumor tantummodo ruborque est , cetera non secuntur : id ΠΑΡΑΣΥΝΑΓΧΗΝ appellant .—Quicquid est , si uires patiuntur , sanguis mittendus est ; si non abundat , secundum est ducere aluum . Cucurbitula quoque recte sub mento et circa fauces admouetur , ut id , quod strangulat , euocet . Opus est deinde fomentis umidis : nam sicca spiritum elidunt . Ergo admouere spongias oportet , quae melius in calidum oleum quam in calidam aquam subinde demittuntur ; efficacissimumque est hic quoque salis calidus sucus . Tum commodum est hysopum uel nepetam uel thumum uel apsinthium uel etiam furfures aut ficus aridas aut mulsam aquam decoquere , eaque gargarizare ; post haec palatum unguere uel felle taurino uel eo medicamento , quod ex moris est . Polline etiam †si piperis id recte respergitur . Si per haec parum proficitur , ultimum est incidere satis altis plagis sub ipsis maxillis supra collum , uel in palato citra uuam , uel eas uenas , quae sub lingua sunt , ut per ea uulnera morbus erumpat . Quibus si non fuerit aeger adiutus , scire licet malo uictum esse . Si uero his morbus leuatus est , iamque fauces et cibum et spiritum capiunt , facilis ad bonam ualetudinem recursus est . Atque interdum natura quoque adiuuat , si ex angustiore sede uitium transit in latiorem ; itaque rubore et tumore in praecordiis orto scire licet fauces liberari . Quicquid autem eas leuauit , incipiendum est ab umidis , maximeque aqua mulsa decocta : deinde adsumendi molles et non acres cibi sunt , donec fauces ad pristinum habitum reuertantur . Vulgo audio , si quis pullum hirundininum ederit , angina toto anno non periclitari ; seruatumque eum ex sale , cum is morbus urget , comburi , carbonemque eius contritum in aquam mulsam , quae potui datur , infriari et prodesse . Id cum idoneos auctores ex populo habeat , neque habere quicquam periculi possit , quamuis in monumentis medicorum non legerim , tamen inserendum huic operi meo credidi .
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7 Whilst this kind of disease involves the region of the neck as a whole, another equally fatal and acute has its seat in the throat. We call it angina; the Greeks have names according to its species. For sometimes no redness or swelling is apparent, but the skin is dry, the breath drawn with difficulty, the limbs relaxed; this they call synanche. Sometimes the tongue and throat are red and swollen, the voice becomes indistinct, the eyes are deviated, the face is pallid, there is hiccough; that they call cynanche: the signs in common are, that the patient cannot swallow food nor drink, and his breathing is obstructed. It is a slighter case when there is merely redness and swelling, not followed by the other symptoms; this they call parasynanche. Whichever form occurs blood must be let if strength permits; if there is no surplus strength, then move the bowels by a clyster. Cups also may be applied with benefit under the chin, also outside the throat, so as to draw out the matter which is suffocating. Next, moist foments are needed, for dry ones hinder the breath. Consequently sponges, dipped into hot oil at intervals, should be put on; that is better than hot water; but most efficacious here too is hot moistened salt. Moreover, it is useful: to make a decoction with hydromel of hyssop, catmint, thyme, wormwood, or even of bran, and dried figs, and to gargle with it; afterwards to smear the palate with ox-gall, or with the medicament made of mulberries. It is also appropriate for a cough to dust the palate with pounded pepper. If there is little effect from these remedies, the last resource is to make sufficiently deep incisions into the upper part of the neck under the lower jaw, or into the palate in front of the uvula, or into the veins under the tongue, in order that the disease may discharge through the incisions. If the patient is not benefited by all this, it must be recognized that he has been overcome by the disease. But if these measures have relieved the disease, and the throat again admits both food and breath, a return to health is easy. And sometimes nature also assists when the disease moves from a more restricted to a more widespread seat; so when redness and swelling have arisen over the praecordia, it may be recognized that the throat is becoming free. But whatever has relieved it, the patient should begin with fluids, especially with the hydromel decoction; next soft and unacrid food should be taken until the throat has returned to its original condition. I hear it commonly said that if a man eat a nestling swallow, for a whole year he is not in danger from angina; and that when the disease attacks anyone it is also beneficial to burn a nestling which has been preserved in salt and to crumble the powdered ash into hydromel which is administered as a draught. Since this remedy has considerable popular authority, and cannot possibly be a danger, although I have not read of it in medical authorities, yet I thought that it should be inserted here in my work. |
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Est etiam circa fauces malum , quod apud Graecos aliud aliudque nomen habet , prout se intendit . Omne in difficultate spirandi consistit ; sed haec dum modica est neque ex toto strangulat . ΔΥΣΠΝΟΙΑ appellatur ; cum uehementior est , ut spirare aeger sine sono et anhelatione non possit , ΑΣΘΜΑ : at cum accessit id quoque , quod aegre nisi recta ceruice spiritus trahitur , ΟΡΘΟΠΝΟΙΑ . Ex quibus id , quod primum est , potest diu trahi : duo insequentia acuta esse consuerunt . His communia sunt , quod propter angustias , per quas spiritus euadit , sibilum exit ; dolor in pectore praecordiisque est , interdum etiam scapulis , isque modo decedit , modo reuertitur ; ad haec tussicula accedit .—Auxilium est , nisi aliquid prohibet , in sanguinis detractione . Neque id satis est , sed lacte uenter quoque soluendus est , liquanda aluus , interdum etiam ducenda ; quibus extenuatum corpus incipit spiritum trahere commodius . Caput autem etiam in lecto sublime habendum est ; thorax fomentis cataplasmatisque calidis aut siccis aut etiam umidis adiuuandus est , et postea uel malagma superimponendum , uel certe ceratum ex cyprino uel irino unguento . Sumenda deinde ieiuno potui mulsa aqua , cum qua uel hysopus cocta uel contrita capparis radix sit . Deli ngitur etiam utiliter aut nitrum aut nasturcium album frictum , deinde contritum et cum melle mixtum ; simulque coquntur mel , galbanum , resina terebenthina , et ubi coierunt , ex his quod fabae magnitudinem habet cotidie sub lingua liquatur : aut sulpuris ignem non experti P . #1108 #1109 #1110 habrotoni P . #1108 #1109 in uini cyatho teruntur , idque tepefactum sorbetur . Est etiam non uana opinio uulpinum iecur , ubi siccum est et aridum factum , contundi oportere polentamque ex eo potioni aspergi ; uel eiusdem pulmonem quam recentissimum assum , sed sine ferro coctum , edendum esse . Praeter haec sorbitionibus et lenibus cibis utendum est , interdum uino tenui , austero , nonnumquam uomitu . Prosunt etiam quaecumque urinam augent , sed nihil magis quam ambulatio lenta paene usque ad lassitudinem ; frictio multa praecipue inferiorum partium , uel in sole uel ad ignem , et per se ipsum et per alios usque ad sudorem .
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8 There is also in the region of the throat a malady which amongst the Greeks has different names according to its intensity. It consists altogether in a difficulty of breathing; when moderate and without any choking, it is called dyspnoea; when most severe, so that the patient cannot breathe without making a noise and gasping, asthma; but when in addition the patient can hardly draw in his breath unless with the neck outstretched, orthopnoea. Of these, the first can last a long while, the two following are as a rule acute. The signs common to them are: on account of the narrow passage by which the breath escapes, it comes out with a whistle; there is pain in the chest and praecordia, at times even in the shoulder-blades, sometimes subsiding, then returning; to these there is added a slight cough. Blood-letting is the remedy unless anything prohibits it. Nor is that enough, but also the bowels are to be relaxed by milk, the stool being rendered liquid, at times even a clyster is given; as the body becomes depleted by these measures the patient begins to draw his breath more readily. Moreover, even in bed the head is to be kept raised; the chest movement assisted by hot foments and plasters, dry or even moist, and later either emollients are to be applied or at any rate a wax-salve made with cyprus, or iris ointment. Next, on an empty stomach the patient should take a draught of hydromel, in which either hyssop or crushed caper root has been boiled. It is also of use to suck either soda or white nasturtium seed, parched, crushed and then mixed with honey; and for the same purpose, galbanum and turpentine resin are boiled together to a coherent mass, and a bit of this, the size of a bean, is sucked every day, or unfused sulphur 1 gram and 0·66 gram of southernwood are pounded up in a cupful of wine and sipped lukewarm. It is also not a foolish idea that the liver of a fox should be dried, pounded and the mash sprinkled into the above, or that the lung of that animal, as fresh as possible, roasted without touching iron in the cooking, should be eaten. In addition to the above, gruels and light food are to be used, at intervals also a light dry wine, occasionally an emetic. Some kind of diuretic is also beneficial, but there is nothing better than a walk until almost fatigued, also frequent rubbings, especially of the lower extremities, either in the sun, or before a fire, done by the patient himself or others, until he sweats. |