De Medicina |
Translator: Walter George Spencer
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| 101 |
Superest ut ad extremas partes corporis ueniam , quae articulis inter se conseruntur . Initium a coxis faciam . Harum ingens dolor esse consueuit , isque hominem saepe debilitat et quosdam non dimittit ; eoque id genus difficillime curatur , quod fere post longos morbos uis pestifera huc se inclinat ; quae ut illas partes liberat , sic hanc , iam ipsam quoque adfectam , prehendit . —Fouendum primum aqua calida est , deinde utendum calidis cataplasmatis . Maxime prodesse uidetur aut cum hordeacea farina aut cum ficu ex aqua decocta mixtus capparis cortex concisus , uel lolii farina ex uino diluto cocta et mixta cum acida faece ; quae qu ia refrigescunt , imponere noctu malagmata commodius est . I nul ae quoque radix contusa et ex uino austero postea cocta et late super coxam imposita inter ualentissima auxilia est . Si ista non soluerunt , sale calido et umido utendum est . Si ne sic quidem finitus dolor est , aut tumor ei accedit , incisa cute admouendae sunt cucurbitulae ; mouenda urina ; aluos , si compressa est , ducenda . Vltimum est et in ueteribus quoque morbis efficacissimum tribus aut quattuor locis super coxam cutem candentibus ferramentis exulcerare . Sed frictione quoque utendum est maxime in sole et eodem die saepius , quo facilius ea , quae coeundo nocuerunt , di gerantur ; eaque , si nulla exulceratio est , etiam ipsis coxis ; si est , ceteris partibus adhibenda est . Cum uero saepe aliquid exulcerandum candenti ferramento sit , ut e o materia inutilis euocetur , illud perpetuum est , non , ut primum fieri potest , huius generis ulcera sanare , sed ea trahere , donec id uitium , cui per haec opitulamur , conquiescat .
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29 It remains for me to come to the extremities of the body which are interconnected by joints. I begin with the hips. In these severe pain is wont to occur, and this often weakens the patient, and some it never leaves: and on this account it is a difficult class to treat, for it is generally after chronic diseases that a pestiferous force directs itself to the hip; which, as it releases other parts, seizes upon this, which now becomes the seat of the disease. The hip is to be first fomented with hot water, after which hot plasters are applied. Those which appear to be especially beneficial are these: caper bark chopped up and mixed either with barley meal or with fig decoction, or darnel meal boiled in diluted wine and mixed with sour wine lees: since these are apt to grow cold, by night it is better to put on emollients. Inula root also pounded and afterwards boiled in dry wine and applied widely of the hip is among the most efficacious of remedies. If these do not resolve the trouble, then hot moist salt is to be employed. If even these measures do not end the pain, and a swelling supervenes, the skin is incised and cups are to be applied; diuretics are given; and the bowels if costive are to be clystered. The ultimate measure and the most efficacious in cases of old standing, is to set up issues in three or four places over the hip by burning the skin with cauteries. But rubbing is also to be employed, particularly in the sun and often each day, in order that the materials of the disease, which have been doing harm by collecting, may be the more readily dispersed; and the rubbing is applied actually over the hips in the absence of ulceration; if there is any, then to other parts. Since now some issue often has to be set up by the hot cautery, in order that matter may be extracted, it is the general rule not to let ulcerations of this kind heal offhand, but to let them drag on until the complaint which we aim to relieve has quieted down. |
| 102 |
Coxis proxima genua sunt ; in quibus ipsis nonnumquam dolor esse consueuit .—In isdem autem cataplasmatis cucurbitulisque praesidium est , sicut etiam cum in umeris aliisue commissuris dolor aliquis exortus est . Equitare ei , cui genua dolent , inimicissimum omnium est . Omnes autem eiusmodi dolores , ubi inueterauerunt , uix citra ustionem finiuntur .
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30 Next to the hips come the knees, in which pain now and again occurs, and these same plasters and cuppings are a safeguard, as also when any pain arises in the shoulder or other joints. Riding on horseback is of all things the most injurious to anyone with painful knees. All such pains, when of long standing, are hardly ever ended except by cauterization. |
| 103 |
In manibus pedibusque articulorum uitia frequentiora longioraque sunt , quae in podagris cheragrisue esse consuerunt . Ea raro uel castratos uel pueros ante feminae coitum uel mulieres , nisi quibus menstrua suppressa sunt , tempta nt.—Vbi sentire coeperunt , sanguis mittendus est : id enim inter initia statim factum saepe annu am, nonnumquam perpetuam ualetudinem tutam praestat . Quidam etiam , cum asinino lacte poto sese eluissent , in perpetuum hoc malum euaserunt : quidam , cum toto anno a uino , mulso , uenere sibi temperassent , securitatem totius uitae consecuti sunt ; idque utique post primum dolorem seruandum est , etiamsi quieuit . Quod si iam consuetudo eius facta est , potest quidem aliquis esse securior is temporibus , quibus dolor se remisit : maiorem uero curam adhibere debet is , quibus id reuertitur ; quod fere uere autumnoue fieri solet . Cum uero dolor urget , mane gestari debet ; deinde ferri in ambulationem ; ibi se dimouere , et , si podagra est , interpositis temporibus exiguis inuicem modo sedere , modo ingredi ; tum , antequam cibum capiat , sine balneo loco calido leuiter perfricari , sudare , perfundi aqua egelida : deinde cibum sumere ex media materia , interpositis rebus urinam mouentibus , quotiensque plenior est , uomere . Vbi dolor uehemens urget , interest sine tumore is sit , an tumor cum calore , an tumores iam etiam obcal luerint . Nam si tumor nullus est , calidis fomentis opus est . Aquam marinam uel muriam duram feruefacere oportet , deinde in peluem coicere , et , cum iam homo pati potest , pedes demittere , superque pallam dare , et uestimento tegere ; paulatim deinde iuxta labrum ipsum ex eadem aqua leuiter infundere , ne calor intus destituat ; ac deinde noctu cataplasmata calfacientia imponere , maximeque ibisci radicem ex uino coctam . Si uero tumor calorque est , utiliora sunt refrigerantia , recteque in aqua quam frigidissima articuli continentur , sed neque cotidie neque diu , ne nerui indurescant . Inponendum uero est cataplasma , quod refrigeret , neque tamen in hoc ipso diu permanendum , sed ad ea transeundum , quae sic reprimunt , ut emolliant . Si maior est dolor , papaueris cortices in uino coquendi miscendique cum cerato sunt , quod ex rosa factum sit ; uel cerae et adipis suillae tantundem una liquandum , deinde his uinum miscendum ; atque ubi quod ex eo impositum est incaluit , detrahendum , et subinde aliud inponendum est . Si uero tumores etiam obcal luerunt et dolent , leuat spongia inposita , quae subinde ex oleo et aceto uel aqua frigida exprimitur , aut pari portione inter se mixta pix , cera , alumen . Sunt etiam plura idonea manibus pedibusque malagmata . Quod si nihil superinponi dolor patitur , id , quod sine tumore est , fouere oportet spongia , quae in aquam calidam demittatur , in qua uel papaueris cortices uel cucumeris siluestris radix decocta sit ; tum inducere articulis crocum cum suco papaueris et ouillo lacte . At si tumor est , foueri quidem debet aqua egelida , in qua lentiscus aliaue uerbena ex reprimentibus decocta sit , induci uero medicamentum ex nucibus amaris cum aceto tritis , aut cerussa , cui contritae herbae muralis sucus sit adiectus . Lapis etiam , [ qui carnem edit , ] quem ΣΑΡΚΟΦΑΓΟΝ Graeci uocant , excisus sic ut pedes capiat , demissos eos , cum dolent , retentosque ibi leuare consueuit . Ex quo in Asia lapidi As sio gratia est . Vbi dolor et inflammatio se remiserunt , quod intra dies quadraginta fit , nisi uitium hominis accessit , modicis exercitationibus , abstinentia , unctionibus lenibus utendum est , sic ut etiam tum acopo uel liquido cerato cyprino articuli perfricentur . Equitare podagricis quoque alienum est . Quibus uero articulorum dolor certis temporibus reuertitur , hos ante et curioso uictu cauere oportet , ne inutilis materia corpori supersit , et crebriore uomitu ; et si quis ex corpore metus , uel alui ductione uti uel lacte purgari . Quod Erasistratus in podagricis expulit , ne in inferiores partes factus cursus pedes repleret , cum euidens sit omni purgatione non superiora tantummodo sed etiam inferiora exinaniri .
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31 Joint troubles in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra. these seldom attack eunuchs or boys before coition with a woman, or women except those in whom the menses have become suppressed. Upon the commencement of pain blood should be let; for when this is carried out at once in the first stages it ensures health, often for a year, sometimes for always. Some also, when they have washed themselves out by drinking asses' milk, evade this disease in perpetuity; some have obtained lifelong security by refraining from wine, mead and venery for a whole year; indeed this course should be adopted especially after the primary attack, even although it has subsided. But if the malady has already become established, it may be possible to act with more freedom in those seasons in which the pain tends to remit; but he should adopt more careful treatment at those times in which it recurs, which is generally in spring or autumn. Now when the pain requires it, in the morning the patient should be rocked; then carried to a promenade; there he should move about, and in the case of podagra he should take short turns at sitting down and walking about: next before taking food and without entering the bath itself, but in a hot room, he should be gently rubbed, sweated, and then douched with lukewarm water: the food following should be of the middle class; diuretics are given with it, and an emetic whenever he is of a fuller habit. When the pain is very severe, it makes a difference whether there is an absence of swelling, or a swelling with heat, or swellings which already hardened. For if there is no swelling, hot foments are needed. Either sea-water, or strong brine should be heated, then poured into a vessel; and as soon as he can bear it, the man puts his feet in, over the vessel is spread a cloak, and over him a blanket; after that hot water is poured over the lip of the vessel, a little at a time, to prevent the contents from losing heat: and then at night heating plasters are applied, especially mallow root boiled in wine. But if there is swelling and heat, refrigerants are more useful, and the joints may be rightly held in very cold water, but not every day, nor for long, lest the sinews become hardened. There is to be applied also a cooling plaster; this, however, is not to be kept on for long, but a change made to those which soothe as well as repress. If pain is greater, rind of poppy-heads is to be boiled in wine, and mixed with wax-salve made up with rose oil; or wax and lard, equal parts, are melted together, and then the wine mixed with these; and as soon as this application becomes hot, it is to be removed and another immediately put on. But if the swellings have grown hard and are painful, the application of a sponge frequently squeezed out of oil and vinegar, or out of cold water, or the application of pitch, wax and alum, equal parts mixed, gives relief. There are also several emollients suitable alike for the hands and feet. But if the pain does not allow of anything being put on, when there is no swelling, the joint should be fomented with a sponge which has been dipped in a warm decoction of poppy-head rind, or of wild cucumber root, next the joints are smeared with saffron, poppy-juice and ewe's milk. But if there is a swelling, this ought to be bathed with a tepid decoction of mastic or some other repressant vervain, and then covered with a medicament composed of bitter almonds pounded up in vinegar, or of white lead, to which has been added the juice of pounded pellitory. The stone, too, which corrodes flesh, which the Greeks call sarcophagos, is carved out so as to admit the feet; when these are painful, they are inserted and held there, and are usually relieved. In Asia Minor Assian limestone is held in esteem for this purpose. When pain and inflammation have subsided, which should happen within forty days, unless the patient is in fault, gentle exercise, spare diet, soothing anoint- ings, are to be employed, provided that also then the joints may be rubbed with an anodyne salve or with a liquid wax-salve of cyprus oil. But riding on horseback is harmful for those with podagra. Those, too, in whom joint-pains tend to recur at certain seasons ought both to take precautions beforehand as to their diet, lest there should be a surfeit of harmful material in the body, and to use an emetic the most frequently; and those in any anxiety as to their body should make use of clystering, or of purgation by milk. This treatment for those with podagra was rejected by Erasistratus, lest a flux directed downwards might fill up the feet, though it is evident that any purgation extracts, not only from the upper parts, but also from the lower as well. |
| 104 |
Ex quocumque autem morbo quis inualescit , si tarde confirmatur , uigilare prima luce debet ; nihilo minus in lecto conquiescere ; circa tertiam horam leuiter unctis manibus corpus permulcere . Deinde delectationis causa , quantum iuuat , ambulare , circumcisa omni negotiosa actione ; tum gestari diu , multa frictione uti , loca , caelum , cibos saepe mutare . Vbi triduo quadriduoue uinum bibit , uno aut etiam altero die interponere aquam . Per haec enim fiet , ne in uitia tabem inferentia incidat et ut mature uires suas recipiat . Cum ex toto uero conualuerit , periculose uitae genus subito mutabit et inordinate aget . Paulatim ergo debebit omissis his legibus eo transire , ut arbitrio suo uiuat .
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32 Now from whatever disease he is recovering, if his convalescence is slow, the patient ought to keep awake from dawn, but nevertheless stay at rest in bed: about nine o'clock he should be gently stroked over with anointed hands, after that by way of amusement, and as long as he pleases, walk, all business being omitted: then he should use conveyances for a good while, be rubbed much, often change his residence, climate and diet. Having taken wine for three or four days, he should for one or two days drink water only. For thus he will ensure that he does not lapse into a complaint which causes wasting, but soon gets back his full strength. When he has, in fact, completely recovered, it will be dangerous for him suddenly to change his way of life and to act without restraint. Therefore he should only little by little leave off what has been prescribed, and pass to a way of life of his own choosing. |