De Medicina |
Translator: Walter George Spencer
|
|
| 129 |
Acopa quoque utilia neruis sunt . Quale est , quod habet floris iunci rotundi P . #1108 II #1109 #1109; costi , iunci quadrati , lauri bacarum , Hammoniaci , cardamomi , singulorum P . #1108 IIII #1109 #1110; murrae , aeris combusti , singulorum P . #1108 VII ; iridis Illyricae , cerae , singulorum P . #1108 XIIII ; Alexandrini calami , iunci rotundi , aspal athi, xylobalsami , singulorum P . #1108 XXVIII ; sebi P . #1108 I ; unguenti irini cyathum . Alterum , quod euodes uocant , hoc modo fit : cerae P . #1109 #1110; olei tantundem ; resinae terebenthinae ad nucis iuglandis magnitudinem simul incocuntur ; deinde infusa in mortario teruntur , instillaturque subinde quam optumi mellis acetabulum , tum irini unguenti et rosae terni cyathi . Enchrista autem Graeci uocant liquida , quae inlinuntur . Quale est , quod fit ad ulcera purganda et inplenda , maxime inter neruos , paribus portionibus inter se mixtis : buturi , medullae uitulinae , sebi uitulini , adipis anserinae , cerae , mellis , resinae terebenthinae , rosae , olei cicini . Quae separatim omnia liquantur , deinde liquida miscentur , et tum simul teruntur . Et hoc quidem magis purgat : magis uero emollit , si pro rosa cyprus infunditur . Et ad sacrum ignem : spumae argenti P . #1108 VI ; corn u bubuli combusti P . #1108 XII conteruntur , adiciturque inuicem uinum et id quod specialiter sil uocatur , et murteum , donec utriusque terni cyathi coiciantur .
|
24 Acopa again are useful for neuralgia. Of these there is one which consists of the flower of the round rush, 9·33 grams each, costmary, square rush, laurel berries, ammoniacum, cardamons, 17 grams each, myrrh and calcined copper 28 grams, Illyrian iris and wax 56 grams, Alexandrian flag, round rush, aspalathus and balsam wood, 112 grams each, suet 4 grams, iris ointment 42 cc. Another called euodes is prepared as follows: wax 84 grams, oil this quantity, and turpentine-resin, the size of a walnut, are boiled together, then pounded in a mortar, and into this is gradually dropped 63 cc. of the best honey, and then iris ointment and rose-oil, 125 cc. of each. Now enchrista is the Greek name for liquid applications. Of these one is used for cleaning and filling up ulcers, especially about sinews. It is composed of a mixture of each parts of butter, calf's marrow, calf's suet, goose-fat, wax, honey, turpentine-resin, rose-oil and castor-oil. This are all liquefied separately, then the liquids are mixed and stirred up together. And the above is more for cleaning up wounds; it is more of an emollient if instead of the rose-oil, cyprus-oil is poured in. And for ignis sacer litharge 24 grams, burnt ox-horn 48 grams, are rubbed together, adding by turns wine, especially that which is called sil, and myrtle-oil until 125 cc. of each is mixed in. |
| 130 |
CATAPOTIA quoque multa sunt , uariisque de causis fiunt . Anodyna uocant , quae somno dolorem leuant ; quibus uti , nisi nimia necessitas urget , alienum est : sunt enim ex uehementibus medicamentis et stomacho alienis . Potest tamen etiam ad concoquendum , quod habet papaueris lacrimae , galbani , singulorum P . #1108 I ; murrae , castorei , piperis , singulorum P . #1108 II . Ex quibus , quod erui magnitudinem habet , satis est deuorasse . Alterum stomacho peius , ad somnum ualentius , ex his fit : mandragorae P . #1108 #1109 #1110; apii seminis , item hyoscyami seminis , singulorum P . #1108 IIII ; quae ex uino teruntur . Vnum autem eiusdem magnitudinis , quae supra posita est , abunde est sumpsisse . Siue autem capitis dolores siue ulcera siue lippitudo siue dentes * * siue spiritus difficultas siue intestinorum tormenta siue inflammatio uuluae est , siue coxa siue iecur aut lienis aut latus torquet , siue uitio locorum aliqua prolabitur et ommutescit , occurrit dolori per quietem eiusmodi catapotium : silis , acori , rutae siluestris seminis , singulorum P . #1108 I ; castorei , cinnamomi , singulorum P . #1108 II ; papaueris lacrimae , panacis radicis , mandragorae , malorum aridorum , iunci rotundi floris , singulorum P . #1108 II #1109 #1110; piperis grana LVI . Haec per se contrita , rursus instillato subinde passo , simul omnia teruntur , donec crassitudo sordium fiat . Ex eo paululum aut deuoratur , aut aqua diluitur et potui datur . Quin etiam siluestris papaueris , cum iam ad excipiendam lacrimam maturum est , manipellus qui manu conprehendi potest , in uas demittitur , et superinfunditur aqua , quae id contegat , atque ita coquitur . Vbi iam bene manipellus is coctus est ibidem * * * expressus proicitur ; et cum eo umore passi pa r mensura miscetur , inferue fitque , donec crassitudinem sordium habeat . Cum infrixit , catapotia ex eo fiunt ad nostrae fabae magnitudinem , habentque usum multiplicem . Nam et somnum faciunt uel per se adsumpta uel ex aqua data , et aurium dolores leuant , adiectis exiguo modo rutae suci ac passi , et tormina supprimunt ex uino liquata , et inflammationem uuluae coercent mixta cerato ex rosa facto , cum paulum his croci quoque accessit ; et ex aqua fronti inducta pituitam in oculos decurrentem tenent . Item si uulua dolens somnum prohibet , croci P . #1108 #1109 #1109; anesi , murrae , singulorum P . #1108 I ; papaueris lacrimae P . #1108 III ; cicutae seminis P . #1108 VIII miscentur excipiunturque uino uetere , et quod lupini magnitudinem habet in tribus cyathis aquae diluitur . Id tamen in febre periculose datur . Ad iecur sanandum nitri P . #1108 #1109 #1110; croci , murrae , nardi Gallici , singulorum P . #1108 I melle excipiuntur , daturque quod Aegyptiae fabae magnitudinem habeat . Ad lateris dolores finiendos piperis , aristolochiae , nardi , murrae pares portiones . Ad thoracis nardi P . #1108 I ; turis , casiae , singulorum P . #1108 III ; murrae , cinnamomi , singulorum P . #1108 VI ; croci P . #1108 VIII ; resinae terebenthinae P . #1108 #1109 #1110; mellis heminae tres . Ad tussim Athenionis : murrae , piperis , singulorum P . #1108 #1109; castorei , papaueris lacrimae , singulorum P . #1108 I . Quae separatim contusa postea iunguntur , et ad magnitudinem fabae nostrae bina catapotia mane , bina noctu dormituro dantur . Si tussis somnum prohibet , ad utrumque Heraclidis Tarentini : croci P . #1108 #1109; murrae , piperis longi , costi , galbani , singulorum P . #1108 #1109 #1110; cinnamomi , castorei , papaueris lacrimae , singulorum P . #1108 I . Quod si purganda ulcera in faucibus tussientibus sunt , panacis , murrae , resinae terebenthinae , singulorum P . uncia ; galbani P . #1108 #1109; hysopi P . #1108 #1109 #1110 conterenda sunt , hisque hemina mellis adicienda , et quod digito excipi potest , deuorandum est . Colice uero Cassi ex his constat : croci , anesi , castorei , singulorum P . #1108 III ; petroselini P . #1108 IIII ; piperis et longi et rotundi , singulorum P . #1108 V ; papaueris lacrimae , iunci rotundi , murrae , nardi , singulorum P . #1108 VI ; quae melle excipiuntur . Id autem et deuorari potest et ex aqua calida sumi . Infantem uero mortuum aut secundas expellit aquae potio , cui salis Hammoniaci P . #1108 I , aut cui dictamni Cretici P . #1108 I adiectum est . Ex partu laboranti erysimum ex uino tepido ieiunae dari debet . Vocem adiuuat turis P . #1108 I in duobus cyathis uini datum . Aduersus urinae difficultatem piperis longi , castorei , murrae , galbani , papaueris lacrimae , croci , costi unciae singulae ; styracis , resinae terebenthinae pondo sextantes , melabsinthi cyathus . Ex quibus ad magnitudinem fabae Aegyptiae et mane et cenato dari debet . Arteriace uero hoc modo fit : casiae , iridis , cinnamomi , nardi , murrae , turis , singulorum P . #1108 I ; croci P . #1108 I #1109 #1110; piperis grana XXX ex passi tribus sextariis decocuntur , donec mellis crassitudo his fiat . Aut croci , murrae , turis , singulorum P . #1108 I coiciuntur in passi eundem modum , eodemque modo decocuntur . Aut eiusdem passi heminae tres usque eo coquuntur , donec extracta inde gutta indurescat ; eo adicitur tritae casiae P . #1108 I .
|
25 Pills are also numerous, and are made for various purposes. Those which relieve pain through sleep are called anodynes; unless there is overwhelming necessity, it is improper to use them; for they are composed of medicaments which are very active and alien to the stomach. There is one, however, which actually promotes digestion; it is composed of poppy-tears and galbanum, 4 grams each, myrrh, castory, and pepper, 8 grams each. Of this it is enough to swallow an amount the size of a vetch. Another, worse for the stomach, but more soporific, consists of mandragora 1 gram, celery-seed and hyoscyamus seed, 16 grams each, which are rubbed up after soaking in wine. One of the same size mentioned above is quite enough to take. But whether there is headache or ulceration or ophthalmia or toothache or difficulty in breathing or intestinal gripings or inflammation of the womb or pain in the hips of liver or spleen or ribs, or, whether owing to genital trouble, a woman collapses speechless, a pillar of the following kind counteracts pain by producing sleep: saxifrage, sweet flag, wild rue seed, 4 grams each, castory and cinnamon 8 grams, poppy-tears, panax root, dried mandrake apples, flowers of the round rush, 9 grams each, and 56 peppercorns. These are first pounded separately, then rubbed up all together, whilst gradually adding raisin wine until the mixture is either swallowed or dissolved in water and taken as a draught. Or take a good handful of wild poppy-heads when just ripe for collecting the juice and put into a vessel and boil with water sufficient to cover it. When this handful has been well boiled there, after being squeezed out it is thrown away; and with its juice is mixed an equal quantity of raisin wine, and heated until to consistency of sordes. When the mixture has cooled, pills are formed, the size of our beans; they are used in many ways. For they procure sleep whether taken as they are or in water; they relieve earache when a little rue-juice and raisin wine are added; when dissolved in wine they relieve gripings, and when mixed with cerate of rose-oil with the addition of a little saffron they relieve inflammation of the womb; also when smeared upon the forehead mixed with water they check the flow of phlegm into the eyes. Again if inflammation of the womb prevents sleep take saffron 1·33 grams, anise and myrrh, 4 grams each, poppy-tears 12 grams, hemlock seed 32 grams. These are mixed together, and taken up in old wine, and a pill the size of a lupin is dissolved in 125 cc. of water. It is dangerous, however, to give it when there is fever. For the relief of pain in the liver soda 1 gram, saffron, myrrh, Gallic nard, 4 grams each, are taken up in honey, and a pill the size of an Egyptian bean administered. A pill to stop pain in the side is made of pepper, aristolochia, nard, and myrrh in equal parts. A pill for pain in the chest is made from nard 4 grams, frankincense and casia, 12 grams each, myrrh and cinnamon, 24 grams each, saffron 32 grams, turpentine-resin 1 gram, honey three-quarters of a litre. The pill of Athenion for cough contains myrrh and pepper, 0·66 gram each, castory and poppy-tears, 4 grams each; these are rubbed down separately, then together, and two pills, the size of our bean, are given in the morning and two at bed-time. If cough prevents sleep the pill of Heracleides of Tarentum relieves both; it contains saffron 0·66 gram, myrrh, long pepper, costmary, galbanum, 1 gram each, cinnamon, castor and poppy-tears, 4 grams each. But if ulcers of the throat causing cough are to be cleaned, panax, myrrh and turpentine-resin, 28 grams each, galbanum 0·66 gram, hyssop 1 gram are rubbed together, and 250 cc. of honey added to them and as much swallowed as can be taken up on the finger. The pill of Cassius for colic contains saffron, anise, castory, 12 grams each, parsley 16 grams, pepper both long and round, 20 grams each, poppy-tears, round rush, myrrh, nard, 24 grams each; these are taken up in honey. It may be either swallowed as it is or dissolved in hot water. A draught for the expulsion of a dead foetus or placenta consists of ammoniac salt 4 grams, or of Cretan dittany 4 grams in water. In difficult labour hedge mustard in tepid wine should be administered on an empty stomach. The voice is strengthened by frankincense 4 grams in two cups of wine. For difficult micturition long pepper, castory, myrrh, galbanum, poppy-tears, saffron, costmary, 28 grams each; storax and turpentine-resin, 56 grams each, honey with absinth 42 cc. Of this an amount the size of an Egyptian bean should be taken in the morning and after dinner. A medicine for the windpipe is prepared as follows: casia, iris, cinnamon, nard, myrrh, frankincense, 4 grams each; saffron 1 gram; and 30 peppercorns boiled in a litre and a half of raisin wine until of the consistency of honey. Or, saffron, myrrh, frankincense, 4 grams each, similarly boiled in raisin wine to the same consistency. Or 750 cc. of raisin wine are boiled until a drop, if taken out, solidifies; thereupon pounded casia 4 grams is added. |
| 131 |
Cum facultates medicamentorum proposuerim , genera , in quibus noxa corpori est , proponam . Ea quinque sunt : cum quid extrinsecus laesit , ut in uulneribus ; cum quid intra se ipsum corruptum est , ut in cancro ; cum quid innatum est , ut in uesica calculus ; cum quid increuit , ut uena , quae intumescens in uaricem conuertitur ; cum quid deest , ut cum curta pars aliqua est . Ex his alia sunt , in quibus plus medicamenta , alia , in quibus plus manus proficit . Ego dilatis iis , quae praecipue scalpellum et manum postulant , nunc de is dicam , quae maxime medicamentis egent . Diuidam autem hanc quoque curandi partem sicut priorem et ante dicam de is , quae in QVAMLIBET PARTEM corporis incidunt , tum de is , quae certas partes infestant . Incipiam a uulneribus . In his autem ante omnia scire medicus debet , quae insanabilia sint , quae difficilem curationem habeant , quae promptiorem . Est enim prudentis hominis primum eum , qui seruari non potest , non adtingere , nec subire speciem * * * eius , ut occisi , quem sors ipsius interemit ; deinde ubi grauis metus sine certa tamen desperatione est , indicare necessariis periclitantis in difficili spem esse , ne , si uicta ars malo fuerit , uel ignorasse uel fefellisse uideatur . Sed ut haec prudenti uiro conueniunt , sic rursus histrionis est paruam rem adtollere , quo plus praestitisse uideatur . Obligarique aecum est confessione promptae rei , quo curiosius etiam circumspiciat , ne , quod per se exiguum est , maius curantis neglegentia fiat . Seruari non potest , cui basis cerebri , cui cor , cui stomachus , cui iocineris portae , cui in spina medulla percussa est , cuique aut pulmo medius aut ieiunum aut tenuius intestinum aut uentriculus aut renes uulnerati sunt ; cuiue circa fauces grandes uenae uel arteriae praecisae sunt . Vix autem ad sanitatem perueniunt , quibus ulla parte aut pulmo aut iocineris crassum aut membrana , quae continet cerebrum , aut lienis aut uulua aut uesica aut ullum intestinum aut saeptum transuersum uulneratum est . Ii quoque in praecipiti sunt , in quibus usque ad grandes intusque conditas uenas in alis uel poplitibus mucro desedit . Periculosa etiam uulnera sunt , ubicumque uenae maiores sunt , quoniam exhaurire hominem profusione sanguinis possunt . Idque euenit non in alis tantum atque poplitibus , sed etiam in is uenis , quae ad anum testiculosque perueniunt . Praeter haec malum uulnus est , quodcumque in alis uel feminibus uel inanibus locis uel in articulis uel inter digitos est ; item quodcumque musculum aut neruum aut arteriam aut membranam aut os aut cartilaginem laesit . Tutissimum omnium , quod in carne est . Et haec quidem loco uel peiora uel mitiora sunt . Modo uero periculum facit , quodcumque magnum est . Aliquid etiam in uulneris genere figuraque est . Nam peius est , quod etiam conlisum quam quod tantum discissum est , adeo ut acuto quoque quam retunso telo uulnerari commodius sit . Peius etiam uulnus est , ex quo aliquid excisum est , exue quo caro alia parte abscisa alia dependet . Pessimaque plaga curua est : tutissima quae lineae modo recta est ; quo deinde propius huic illiue figurae uulnus est , eo uel deterius uel tolerabilius est . Quin etiam confert aliquid et aetas et corpus et uitae propositum et anni tempus ; quia facilius sanescit puer uel adulescens quam senior , ualens quam infirmus ; neque nimis tenuis neque nimis plenus , quam si alterum ex his est ; integri habitus quam corrupti , exercitatus quam iners , sobrius et temperans quam uino uenerique deditus . Oportunissimumque curationi tempus uernum est , aut certe neque feruens neque frigidum , siquidem uulnera et nimius calor et nimium frigus infestant , maxime tamen horum uarietas ; ideoque perniciosissimus autumnus est . Sed pleraque ex uulneribus oculis subiecta sunt ; quorundam ipsae sedes indices sunt , quas alio loco demonstrauimus , cum positus interiorum partium ostendimus . Verum tamen quia quaedam uicina sunt , interestque uulnus in summa parte sit an penitus penetrauerit , necessarium est notas subicere , per quas , quid intus actum sit , scire possimus , et ex quibus uel spes uel desperatio oriatur . Igitur corde percusso sanguis multus fertur , uenae elanguescunt , color pallidissimus , sudores frigidi malique odoris tamquam inrorato corpore oriuntur , extremisque partibus frigidis matura mors sequitur . Pulmone uero icto spirandi difficultas est ; sanguis ex ore spumans , ex plaga ruber ; simulque etiam spiritus cum sono fertur ; in uulnus inclinari iuuat ; quidam sine ratione consurgunt . Multi si in ipsum uulnus inclinati sunt , loquntur , si in aliam partem , obmutescunt . Iocineris autem uulnerati notae sunt multus sub dextra parte praecordiorum profusus sanguis ; ad spinam reducta praecordia ; in uentrem cubandi dulcedo ; punctiones doloresque usque ad iugulum iunctumque ei latu m scapularum os intenti ; quibus nonnumquam etiam bilis uomitus accedit . Renibus uero percussis dolor ad inguina testiculosque descendit ; difficulter urina redditur , eaque aut haec cruenta aut cruor fertur . At liene icto sanguis niger a sinistra parte prorumpit ; praecordia cum uentriculo ab eadem parte indurescunt ; sitis ingens oritur ; dolor ad iugulum sicut iocinere uulnerato uenit . At cum uulua percussa est , dolor inguinibus et coxis et feminibus est ; sanguinis pars per uulnus , pars per naturale descendit ; uomitus bilis insequitur . Quaedam obmutescunt , quaedam mente labuntur , quaedam sui conpotes neruorum oculorumque dolore urgeri se confitentur , morientesque eadem , quae corde uulnerato , patiuntur . Sin cerebrum membranaue eius uulnus accepit , sanguis per nares , quibusdam etiam per aures exit ; fereque bilis uomitus insequitur . Quorundam sensus optunduntur , appellatique ignorant ; quorundam trux uultus est ; quorundam oculi quasi resoluti huc atque illuc mouentur ; fereque tertio uel quinto die delirium accedit ; multorum etiam nerui distenduntur . Ante mortem autem plerique fascias , quibus caput deligatum est , lacerant ac nudum uulnus frigori obiciunt . Vbi stomachus autem percussus est , singultus et bilis uomitus insequitur ; si quid cibi uel potionis adsumptum est , ea redditur cito . Venarum motus elanguescunt , sudores tenues oriuntur , per quos extremae partes frigescunt . Communes uero ieiuni intestini et uentriculi uulnerati notae sunt : nam cibus et potio per uulnus exeunt ; praecordia indurescunt ; nonnumquam bilis per os redditur . Intestino tantum sedes inferior est . Cetera intestina icta uel stercus uel odorem eius exhibent . Medulla uero , quae in spina est , discussa nerui resoluuntur aut distenduntur ; sensus intercidit ; interposito tempore aliquo sine uoluntate inferiores partes uel semen uel urinam uel etiam stercus excernunt . At si saeptum transuersum percussum est , praecordia susum contrahuntur ; spina dolet ; spiritus rarus est ; sanguis spumans fertur . Vesica uero uulnerata dolent inguina : quod super pubem est , intenditur ; pro urina sanguis , at ex ipso uulnere urina descendit . Stomachus adficitur : itaque aut bilem uomunt , aut singultiunt ; frigus et ex eo mors sequitur . His cognitis etiamnum quaedam alia noscenda ad omnia uulnera ulceraque , de quibus dicturi sumus , pertinentia . Ex his autem exit sanguis , sanies , pus . Sanguis omnibus notus est : sanies est tenuior hoc , uarie crassa et glutinosa et colorata . Pus crassissimum albidissimumque , glutinosius et sanguine et sanie . Exit autem sanguis ex uulnere recenti aut iam sanescente , sanies inter utrumque tempus , pus ex ulcere iam ad sanitatem spectante . Rursus et sanies et pus quasdam species Graecis nominibus distinctas habent . Est enim quaedam sanies , quae uel hidros uel melitera nominatur ; est pus , quod elaeodes appellatur . Hidros tenuis , subalbidus ex malo ulcere exit , maximeque ubi neruo laeso inflammatio secuta est . Melitera crassior et glutinosior , subalbida , mellique albo subsimilis . Fertur haec quoque ex malis ulceribus , ubi nerui circa articulos laesi sunt , et inter haec loca maxime ex genibus . Elaeodes tenue , subalbidum , quasi unctum , colore atque pinguitudine oleo albo non dissimile ; apparet in magnis ulceribus sanescentibus . Malus autem est sanguis nimium aut tenuis aut crassus , colore uel liuidus uel niger , aut pituita mixtus aut uarius : optimus calidus , ruber , modice crassus , non glutinosus . Itaque protinus eius uulneris expedita magis curatio est , ex quo sanguis bonus fluxit . Itemque postea spes in is maior est , ex quibus melioris generis quaeque proueniunt . Sanies igitur mala est multa , nimis tenuis , liuida aut pallida aut nigra aut glutinosa aut mali odoris , aut quae ipsum ulcus et iunctam ei cutem erodit : melior est non multa , modice crassa , subrubicunda aut subalbida . Hidros autem peior est multus , crassus , subliuidus aut subpallidus , glutinosus , ater , calidus , mali odoris : tolerabilior est subalbidus , qui cetera omnia contraria prioribus habet . Melitera autem mala est multa et percrassa : melior , quae tenuior et minus copiosa est . Pus inter haec optimum est ; sed id quoque peius est multum , tenue , dilutum , magisque si ab initio tale est ; itemque si colore sero simile , si pallidum , si liuidum , si faeculentum est ; praeter haec , si male olet , nisi tamen locus hunc odorem excitat . Melius est , quo minus est , quo crassius , quo albidius ; itemque si leue est , si nihil olet , si aequale est : modo tamen conuenire et magnitudini uulneris et tempori debet . Nam plus ex maiore , plus nondum solutis inflammationibus naturaliter fertur . Elaeodes quoque peius est multum , et parum pingue : quo minus eius , quoque id ipsum pinguius , eo melius est . Quibus exploratis , ubi aliquis ictus est qui seruari potest , protinus prospicienda duo sunt : ne sanguinis profusio neue inflammatio interemat . Si profusionem timemus , quod ex sede uulneris et ex magnitudine eius et ex impetu ruentis sanguinis intellegi potest , siccis lin amentis uulnus inplendum est , supraque imponenda spongia ex aqua frigida expressa ac manu super conprimenda . Si parum sic sanguis conquiescit , saepius linamenta mutanda sunt , et si sicca parum ualent , aceto madefacienda sunt . Id uehemens ad sanguinem subprimendum est ; ideoque quidam id uolneri infundunt . Sed alius rusus metus subest , ne nimis ualenter ibi retenta materia magnam inflammationem postea moueat . Quae res efficit , ut neque rodentibus medicamentis neque adurentibus et ob id ipsum inducentibus crustam sit utendum , quamuis pleraque ex his sanguinem supprimunt ; sed , si semel ad ea decurritur , is potius , quae mitius idem efficiunt . Quod si illa quoque profluuio uincuntur , uenae quae sanguinem fundunt adprehendendae , circaque id quod ictum est duobus locis deligandae intercidendaeque sunt , ut et in se ipsae coea nt, et nihilo minus ora praeclusa habeant . Vbi ne id quidem res patitur , possunt ferro candenti aduri . Sed etiam satis multo sanguine effuso ex eo loco , quo neque neruus neque musculus est , ut puta in fronte uel superiore capitis parte , commodissimum tamen est cucurbitulam admouere a diuersa parte , ut illuc sanguinis cursus reuocetur . Et aduersus profusionem quidem in his auxilium est : aduersus inflammationem autem in ipso sanguinis cursu . Ea timeri potest , ubi laesum est uel os uel neruus uel cartilago uel musculus , aut ubi parum sanguinis pro modo uulneris fluxit . Ergo quotiens quid tale erit , sanguinem mature subprimere non oportebit , sed pati fluere , dum tutum erit ; adeo ut , si parum fluxisse uidebitur , mitti quoque ex brachio debeat ; utique si corpus iuuenile et robustum et exercitatum est , multoque magis si id uulnus ebrietas praecessit . Quod si musculus laesus uidebitur , praecidendus erit : nam percussus mortiferus est , praecisus sanitatem recipit . Sanguine autem uel subpresso , si nimius erumpit , uel exhausto , si per se parum fluxit , longe optimum est uulnus glutinari . Potest autem id , quod uel in cute uel etiam in carne est , si nihil ei praeterea mali accedit . Potest caro alia parte dependens , alia inhaerens , si tamen etiamnum integra est et coniunctione corporis fouetur . In is uero , quae glutinantur , duplex curatio est . Nam si plaga in molli parte est , sui debet , maximeque si discissa auris ima est uel imus nasus uel frons uel bucca uel palpebra uel labrum uel circa guttur cutis uel uenter . Si uero in carne uulnus est hiatque neque in unum orae facile adtrahuntur , sutura quidem aliena est : inponendae uero fibulae sunt ( ancteras Graeci nominant ) , quae oras , paululum tamen , contrahunt , quo minus lata postea cicatrix sit . Ex his autem colligi potest , id quoque , quod alia parte dependens alia inhaerebit , si alienatum adhuc non est , suturam an fibulam postulet . Ex quibus neutra ante debet imponi , quam intus uolnus purgatum est , ne quid ibi concreti sanguinis relinquatur . Id enim et in pus uertitur , et inflammationem mouet , et glutinari uolnus prohibet . Ne lin amentum quidem , quod subprimendi sanguinis causa inditum est , ibi relinquendum est : nam id quoque inflammat . Conprehendi uero sutura uel fibula non cutem tantum sed etiam aliquid ex carne , ubi suberit haec , oportebit , quo ualentius haereat neque cutem abrumpat . Vtraque optima est ex acia molli non nimis torta , quo mitius corpori insidat , utraque neque nimis rara neque nimis crebra inicienda est . Si nimis rara est , non continet ; si nimis crebra est , uehementer adficit , quia quo saepius acus corpus transuit quoque plura loca iniectum uinculum mordet , eo maiores inflammationes oriuntur magisque aestate . Neutra etiam uim ullam desiderat , sed eatenus utilis est , qua cutis ducentem quasi sua sponte subsequitur . Fere tamen fibulae latius uulnus esse patiuntur , sutura oras iungit , quae ne ipsae quidem inter se contingere ex toto debent , ut , si quid intus umoris concreuerit , sit qua emanet . Si quod uulnus neutrum horum recipit , id tamen purgari debet . Deinde omni uulneri primo inponenda est spongia ex aceto expressa : si sustinere aliquis aceti uim non potest , uino utendum est . Leuis plaga iuuatur etiam , si ex aqua frigida expressa spongia inponitur . Sed ea quocumque modo inposita est , dum madet , prodest ; itaque ut inarescat , non est committendum . Licetque sine peregrinis et conquisitis et compositis medicamentis uulnus curare . Sed si quis huic parum confidit , imponere medicamentum debet , quod sine sebo compositum sit ex is , quae cruentis uulneribus apta esse proposui : maximeque , si caro est , barbarum ; si nerui uel cartilago uel aliquid ex eminentibus , quales aures uel labra sunt , Poly idi s phragidem: Alexandrinum quoque uiride neruis idoneum est ; eminentibusque partibus ea , quam Graeci rhaptusam uocant . Solet etiam colliso corpore exigua parte findi cutis . Quod ubi incidit , non alienum est scalpello latius aperire , nisi musculi neruique iuxta sunt ; quos incidi non expedit . Vbi satis d iductum est , medicamentum imponendum est . At si id , quod collisum est , quamuis parum d iductum est , latius tamen aperiri propter neruos aut musculos non licet , adhibenda sunt ea , quae umorem leniter extrahant , praecipueque ex his id , quod rhypodes uocari proposui . Non alienum est etiam , ubicumque uulnus graue est , imposito quo id iuuetur , insuper circumdare lanam sucidam ex aceto et oleo ; uel cataplasma , si mollis is locus est , quod leniter reprimat ; si neruosus aut musculosus , quod emolliat . Fascia uero ad uulnus deligandum lintea aptissima est eaque lata esse debet , ut semel iniecta non uulnus tantum sed paululum utrimque etiam oras eius conprehendat . Si ab altera parte caro magis recessit , ab ea melius adtrahitur ; si aeque ab utraque , transuersa conprehendere oras debet ; aut si id uulneris ratio non patitur , media primum inicienda est , ut tum in utramque partem ducatur . Sic autem deliganda est , ut et contineat neque adstringat . Quod non continetur , elabitur : quod nimis adstrictum est , cancro periclitabitur . Hieme saepius fascia circumire debet , aestate quotiens necesse est ; tum extrema pars eius inferioribus acu adsuenda est : nam nodus ulcus laedit , nisi tamen longe est . Illo neminem decipi decet , ut propriam uiscerum curationem requirat : de quibus supra posui . Nam plaga ipsa curanda extrinsecus uel sutura uel alio medicinae genere est : in uisceribus nihil mouendum est , nisi ut , si quid ex iocinere aut liene aut pulmone dumtaxat extremo dependet , praecidatur . Alioqui uolnus interius ea uictus ratio eaque medicamenta sanabunt , quae cuique uisceri conuenire superiore libro posui . His ita primo die ordinatis , homo lecto conlocandus est ; isque , si graue uulnus est , abstinere , quantum uires patiuntur , ante inflammationem cibo debet : bibere , donec sitim finiat , aquam calidam ; uel , si aestas est ac neque febris neque dolor est , etiam frigidam . Adeo tamen nihil perpetuum est , sed semper pro ui corporis aestimandum , ut inbecillitas etiam cibum protinus facere necessarium possit , tenuem scilicet et exiguum , qui tantum sustineat ; multique etiam ex profluuio sanguinis intermorientes ante ullam curationem uino reficiendi sunt , quod alioqui inimicissimum uulneri est . Nimis uero intumescere uulnus periculosum ; nihil intumescere periculosissimum est : illud indicium est magnae inflammationis , hoc emortui corporis . Protinusque , si mens homini consistit , si nulla febris accessit , scire licet mature uulnus sanum fore . Ac ne febris quidem terrere debet , si in magno uulnere , dum inflammatio est , permanet . Illa perniciosa est , quae uel leui uulneri superuenit , uel ultra tempus inflammationis durat , uel delirium mouet ; uel , si neruorum rigor aut distentio , quae ex uulnere orta est , eam non finit . Vomitus quoque bilis non uoluntarius , uel protinus ut percussus est aliquis , uel dum inflammatio manet , malum signum est in is dumtaxat , quorum uel nerui , uel etiam neruosi loci uulnerati sunt . Sponte tamen uomere non alienum est , praecipue is , quibus in consuetudine fuit : sed neque protinus post cibum , neque iam inflammatione orta , neque cum in superioribus partibus plaga est . Biduo sic uulnere habito , tertio die id aperiundum , detergendaque sanies ex aqua frigida est , eademque rursus inicienda . Quinto iam die , quanta inflammatio futura est , se ostendit . Quo die rursus detecto uulnere considerandus color est . Qui si liuidus aut pallidus aut uarius aut niger est , scire licet malum uulnus esse ; idque quandocumque animaduersum est , terrere nos potest . Album aut rubicundum esse ulcus commodissimum est : item cutis dura , crassa , dolens periculum ostendit . Bona signa sunt , ubi haec sine dolore tenuis et mollis est . Sed si glutinatur uulnus aut leuiter intumuit , eadem sunt inponenda , quae primo fuerunt : si grauis inflammatio est neque glutinandi spes est , ea , quae pus moueant . Iamque aquae quoque calidae necessarius usus est , ut et materiam digerat et duritiam emolliat et pus citet . Ea sic temperanda est , ut manu contingenti iucunda sit , usque adeo adhibenda , donec aliquid ex tumore minuisse coloremque ulceri magis naturalem reddidisse uideatur . Post id fomentum , si lat e plaga non patet , inponi protinus emplastrum debet , maximeque si grande uulnus est , tetrapharmacum ; si in articulis , digitis , locis cartilaginosis , rhypodes : et si latius hiat , idem illud emplastrum liquari ex irino unguento oportet eoque inlita li namenta disponi per plagam ; deinde emplastrum supra dari , et super id sucidam lanam . Minusque etiam quam primo fasciae adstringendae sunt . Proprie quaedam in articulis uisenda sunt , in quibus , si praecisi nerui sunt , qui continebant , debilitas eius partis sequitur . Si id dubium est , et ex acuto telo plaga est , ea transuersa commodior est ; si retuso et graui , nullum in figura discrimen est . Sed uidendum est , pus supra articulum an infra nascatur . Si sub eo nascitur albumque et crassum diu fertur , neruum praecisum credibile est , magisque quo maiores dolores inflammationesque et quo maturius excitatae sunt . Quamuis autem non abscisus neruus est , tamen si circa tumor durus diu permanet , necesse est et diuturnum ulcus esse et sano quoque eo tumorem permanere ; futurumque est ut tarde membrum id uel extendatur uel contrahatur . Maior tamen in extendendo mora est , ubi recuruato curatio adhibita est , quam in recuruando eo , quod rectum continuerimus . Conlocari quoque membrum quod ictum est ratione certa debet . Si glutinandum est , ut superius sit : si in inflammationibus est , ut in neutram partem inclinatum sit : si iam pus profluit , ut deuexum sit . Optimum etiam medicamentum quies est : moueri , ambulare nisi sanis alienum est . Minus tamen is periculosum , qui in capite uel brachiis quam qui in inferioribus partibus uulnerati sunt . Minimeque ambulatio conuenit femine aut crure aut pede laborante . Locus , in quo cubabit , tepidus esse debebit . Balneum quoque , dum parum uulnus purum est , inter res infestissimas est : nam id et umidum et sordidum reddit , ex quibus ad cancrum transitus esse consueuit . Leuis frictio recte adhibetur , sed is partibus , quae longius absunt a uulnere . Inflammatione finita uulnus purgandum est . Et id optime faciunt tincta in melle li namenta , supraque idem emplastrum uel enneapharmacum dandum est . Tum demum uero purum ulcus est , cum rubet , ac nimium neque siccum neque umidum est . At quodcumque sensu caret , quod non naturaliter sen tit, quod nimium aut aridum aut umidum est , quod aut albidum aut pallidum aut liuidum aut nigrum est , id purum non est . Purgato , sequitur ut impleatur ; iamque calida aqua eatenus necessaria est , ut sanies remoueatur . Lanae sucidae superuacuus usus est : lota melius circumdatur . Ad implendum autem uulnus proficiunt quidem etiam medicamenta aliqua : itaque ea adhiberi non alienum est , ut buturum cum rosa et exigua mellis parte ; aut cum eadem rosa tetrapharmacum ; aut ex rosa li namenta . Plus tamen proficit balneum rarum , cibi boni suci , uitatis omnibus acribus , sed iam pleniores : nam et auis et uenatio et suilla elixa dari potest . Vinum omnibus , dum febris , inflammatio inest , alienum est : itemque usque cicatricem , si nerui musculiue uulnerati sunt ; etiam , si alte caro . At si plaga in summa cute generis tutioris est , potest non peruetus , modice tamen datum , ad implendum quoque proficere . Si quid molliendum est , quod in neruosis locis musculosisque necessarium est , cerato quoque super uulnus utendum est . At si caro supercreuit , modice reprimit siccum lin amentum , uehementius squama aeris . Si plus est , quod tolli opus est , adhibenda sunt etiamnum uehementiora , quae corpus exedunt . Cicatricem post omnia haec commode inducit Lycium ex passo aut lacte dilutum , uel etiam per se impositum siccum lin amentum . Hic ordo felicis curationis est . Sed quaedam tamen periculosa incidere consuerunt : interdum enim uetustas ulcus occupat , induciturque ei callus , et circum orae crassae liuent ; post quae quicquid medicamentorum ingeritur , parum proficit ; quod fere neglegenter curato ulceri superuenit . Interdum uel ex nimia inflammatione , uel ob aestus inmodicos , uel ob nimia frigora , uel quia nimis uulnus adstrictum est , uel quia corpus aut senile aut mali habitus est , cancer occupat . Id genus a Graecis diductum in species est , nostris uocabulis non est . Omnis autem cancer non solum id corrumpit , quod occupauit , sed etiam serpit ; deinde aliis aliisque signis discernitur . Nam modo super inflammationem rubor ulcus ambit , isque cum dolore procedit ( erysipelas Graeci nominant ) ; modo ulcus nigrum est , quia caro eius corrupta est , idque uehementius etiam put rescendo intenditur ubi uulnus umidum est et ex nigro ulcere umor pallidus fertur malique odoris carunculaeque corruptae : interdum etiam nerui ac membranae resoluuntur , specillumque demissum descendit aut in latus aut deorsum , eoque uitio nonnumquam os quoque adficitur ; modo oritur ea , quam Graeci gangrenam appellant . Priora in qualibet parte corporis fiunt : hoc in prominentibus membris , id est , inter ungues et alas uel inguina , fereque in senibus uel in is , quorum corpus mali habitus est . Caro in ulcere uel nigra uel liuida est , sed sicca et arida ; proxumaque cutis plerumque subnigris pustulis impletur ; deinde ei proxima uel pallida uel liuida , fereque rugosa , sine sensu est ; ulterior in inflammatione est . Omniaque ea simul serpunt ; ulcus in locum pus tulosum, pus tulae in eum , qui pallet aut liuet , pallor aut liuor in id , quod inflammatum est , inflammatio in id , quod integrum est , transit . Inter haec deinde febris acuta oritur ingensque sitis : quibusdam etiam delirium : alii , quamuis mentis suae compotes sunt , balbutiendo tamen uix sensus suos explicant ; incipit adfici stomachus ; fit foedi spiritus ipse odoris . Atque initium quidem eius mali recipit curationem ; ubi uero penitus insedit , insanabile est ; plurimique sub frigido sudore moriuntur . Ac pericula quidem uulnerum haec sunt . Vetus autem ulcus scalpello concidendum est , excidendaeque eius orae , et , quicquid super eas liuet , aeque incidendum . Si uaricula intus est , quae id sanari prohibet , ea quoque excidenda . Deinde , ubi sanguis emissus nouatumque uulnus est , eadem curatio adhibenda , quae in recentibus uulneribus exposita est . Si scalpello aliquis uti non uult , potest sanare id emplastrum , quod ex ladano fit , et cum ulcus sub eo exesum est , id , quo cicatrix inducitur . Id autem , quod erysipelas uocari dixi , non solum uulneri superuenire sed sine hoc quoque oriri consueuit , atque interdum periculum maius adfert , utique si circa ceruices aut caput constitit .— Oportet , si uires patiuntur , sanguinem mittere ; deinde imponere simul reprimentia et refrigerantia , maximeque cerussam solani suco , aut Cimoliam cretam aqua pluuiali exceptam ; aut ex eadem aqua subactam farinam cupresso adiecta aut , si tenerius corpus est , lenticulam . Quicquid inpositum est , betae folio contegendum et super linteolum frigida aqua madens inponendum . Si per se refrigerantia parum proderunt , miscenda erunt hoc modo : sulpuris P . #1108 I ; cerussae , croci singulorum P . #1108 X II S.; eaque cum uino conterenda sunt , et id his inlinendum : aut si durior locus est , solani folia contrita suillae adipi miscenda sunt et inlita linteolo superinicienda . At si nigrities est nequedum serpit , imponenda sunt , quae carnem putrem lenius edunt , repurgatumque ulcus sic ut cetera nutriendum est . Si magis putre est , iamque procedit ac serpit , opus est uehementius erodentibus . Si ne haec quidem euincunt , aduri locus debet , donec ex eo nullus umor feratur : nam quod sanum est , siccum est , cum aduritur . Post ustionem putris ulceris superponenda sunt , quae crustas a uiuo resoluant : eas escharas Graeci nominant . Vbi eae exciderunt , purgandum ulcus maxime melle et resina est : sed aliis quoque purgari potest , quibus purulenta curantur ; eodemque modo ad sanitatem perducendum est . Gangrenam uero , si nondum plane tenet , sed adhuc incipit , curare non difficillimum est , utique in corpore iuuenili ; et magis etiam si musculi integri sunt , si nerui uel laesi non sunt uel leuiter adfecti sunt , neque ullus magnus articulus nudatus est , aut carnis in eo loco paulum est , ideoque non multum , quod putresceret , fuit , consistitque eo loco uitium ; quod maxime fieri in digito potest .—In eiusmodi casu primum est , si uires patiuntur , sanguinem mittere ; deinde quicquid aridum est et intentione quadam proximum quoque locum male habet , usque eo concidere . Medicamenta uero , dum malum serpit , adhibenda nulla sunt , quae pus mouere consuerunt ; ideoque ne aqua quidem calida . Grauia quoque , quamuis reprimentia , aliena sunt ; sed his quam leuissimis opus est ; superque ea , quae inflammata sunt , utendum est refrigerantibus . Si nihilo magis malum constitit , uri , quod est inter integrum ac uitiatum locum , debet : praecipueque in hoc casu petendum non a medicamentis solum sed etiam a uictus ratione praesidium est : neque enim id malum nisi corrupti uitiosique corporis est . Ergo primo , nisi inbecillitas prohibet , abstinentia utendum ; deinde danda quae per cibum potionemque aluum ideoque etiam corpus adstringant , sed ea leuia . Postea si uitium constitit , inponi super uulnus eadem debent , quae in putri ulcere praescripta sunt . Ac tum quoque ut plenioribus cibis uti licebit ex media materia , sic tamen non nisi aluum corpusque siccantibus ; aqua uero pluuiali frigida . Balneum , nisi iam certa fiducia redditae sanitatis est , alienum est : siquidem emollitum in eo uulnus cito rursus eodem malo adficitur . Solent uero nonnumquam nihil omnia auxilia proficere ac nihilo minus serpere is cancer . Inter quae , miserum sed unicum auxilium est , ut cetera pars corporis tuta sit , membrum , quod paulatim emoritur , abscidere . Hae grauissimorum uulnerum curationes sunt . Sed ne illa quidem neglegenda , ubi integra cute interior pars conlisa est ; aut ubi derasum adtritumue aliquid est ; aut ubi surculus corpori infixus est ; aut ubi tenue sed altum uulnus insedit . In primo casu commodissimum est malicorium ex uino coquere , interioremque eius partem conterere et cerato miscere ex rosa facto , idque superponere : deinde , ubi cutis ipsa exasperata est , inducere lene medicamentum , quale lipara est . Dera sso uero detritoque imponendum est emplastrum tetrapharmacum , minuendusque cibus et uinum subtrahendum . Neque id , quia non habebit altiores ictus , contemnendum erit : siquidem ex eiusmodi casibus saepe cancri fiunt . Quod si leuius id erit et in parte exigua , contenti esse poterimus eodem leni medicamento . Surculum uero , si fieri potest , oportet uel manu uel etiam ferramento eicere . Si uel praefractus est uel altius descendit , quam ut id ita fieri possit , medicamento euocandus est . Optume autem educit superinposita harundinis radix , si tenera est , protinus contrita ; si iam durior , ante in mulso decocta ; cui semper mel adiciendum est aut aristolochia cum eodem melle . Pessima ex surculis harundo est , quia aspera est : eademque offensa etiam in f ilice est . Sed usu cognitum est utramque aduersus alteram medicamentum esse , si contrita superinposita est . Facit autem idem in omnibus surculis , quodcumque medicamentum extrahendi uim habet . Idem altis tenuibusque uulneribus aptissimum est . Priori rei Philocratis , huic Hecataei emplastrum maxime conuenit . Vbi uero in quolibet uulnere uentum ad inducendam cicatricem est , quod perpurgatis iam repletisque ulceribus necessarium est , primum ex aqua frigida lin amentum , dum caro alitur ; deinde iam , cum continenda est , siccum imponendum est , donec cicatrix inducatur . Tum deligari super album plumbum oportet quo et reprimitur cicatrix et colorem maxime corpori sano similem accipit . Idem radix siluestris cucumeris praestat , idem compositio , quae habet : elateri P . #1108 I ; spumae argenti P . #1108 II ; unguenti pondo #1108 IIII . Quae excipiuntur resina terebenthina , donec emplastri crassitudo ex omnibus fiat . Ac nigras quoque cicatrices leniter purgant paribus portionibus mixta aerugo , plumbum elotum , eademque rosa coacta ; siue unguitur cicatrix , quod in facie fieri potest ; siue id ut emplastrum inponitur , quod in aliis partibus commodius est . At si uel excreuit cicatrix uel concaua est , stultum est decoris causa rursus et dolorem et medicinam sustinere . Alioqui res utrique succurri patitur , siquidem utraque cicatrix exulcerari scalpello potest . Si medicamentum aliquis mauult , idem efficiunt compositiones eae , quae corpus exedunt . Cute exulcerata super eminentem carnem exedentia medicamenta coicienda sunt , super concauam implentia , donec utrumque ulcus sanae cuti aequetur ; et tum cicatrix inducatur .
|
26 Now that I have set out the properties of the medicaments, I will explain the classes of lesions harmful to the body: there are five; when something from without causes the lesion, as in the case of wounds; when some internal part has become corrupted, as in the case of canker; when some new formation has occurred, such as a stone in the bladder; when something has grown bigger, as when a vein swells up and is converted into a varix; when there is some defect, as when some part has been mutilated. In some of these medicaments are more effectual, in others surgery. Postponing those conditions which demand in particular the scalpel and surgical treatment, I will speak now of those which chiefly require medicaments. As I have done before, I shall divide this part of treatment, and speak first of those lesions which may occur in any part of the body, then of those which attack particular parts. I shall begin with wounds. In this connexion, however, a practitioner should know above all which wounds are incurable, which may be cured with difficulty, and which more readily. For it is the part of a prudent man first not to touch a case he cannot save, and to the risk the appearance of having killed one whose lot is but to die; next, when there is grave fear without, however, absolute despair, to point out to the patient's relatives that hope is surrounded by difficulty, for then if the art is overcome by the malady, he may not seem to have been ignorant or mistaken. But while such steps become a prudent practitioner, it is like a mountebank to exaggerate a small matter in order to enhance his own achievement. It is right to commit himself to a statement that a case is simple in order that he may examine it with even more care for fear a case slight in itself may become worse by negligence on the doctor's part. It is impossible to save a patient when the base of the brain, the heart, the gullet, the porta of the liver, or the spinal marrow has been pierced; when the middle of the lung, or the jejunum, or the small intestine, or the stomach, or kidneys have been wounded; or when the large blood-vessels and arteries in the region of the throat have been cut. Again, there is hardly ever recovery when either the lung or the thick part of the liver or the membrane enclosing the brain, or the spleen, womb, bladder, any of the intestines or diaphragm has been wounded in any part. There is also grave danger when the point of a weapon has gone down to the large blood-vessels deeply seated in the armpits or hams. Also wounds are dangerous wherever the blood-vessels are larger, because they may exhaust the patient by profuse bleeding. This occurs not only in the armpits and hams, but also in those blood-vessels which go to the anus and testicles. Moreover, a wound is a bad one whenever it is in the armpits or in the thighs or in hollow places or in joints or between the fingers; also whenever a muscle or sinew or artery or membrane or bone or cartilage is injured. The safest of all is a wound in the flesh. The above wounds are severer or slighter according to their situations. Still, whenever it is large, a wound makes for danger. The class of wound and its shape are also important. For a contused would is worse than one simply incised, hence it is better to be wounded by a sharp weapon than by a blunt one. A wound is worse also if a piece is cut out, or if the flesh is cut away in one part and hanging free in another. A curved wound is worst, a straight linear one safest; hence a wound is more or less serious, according as it approximates to the former or to the latter shape. Again, both age and constitution and mode of life and the season have also some influence; for a boy or young adult heals more readily than does an old man; one who is strong than a weak man; a man who is not too thin or too fat than one who is either of these; one of sound habit than of unsound; one who takes exercise than a sluggard; one who is sober and temperate than one addicted to wine and venery. And the most opportune time for healing is the spring, or at any rate when the weather is neither cold nor hot, for wounds are harmed by excessive heat and excessive cold, but most of all by variations of these; hence autumn is the most pernicious season. Now most wounds are open to view; some are inferred from their situation, which we have pointed out elsewhere when indicating the positions of the internal parts. Since, however, some of these wounds are near at hand, and it is of importance whether the wound is superficial or has penetrated inwards, it is necessary to state the signs by which it is possible to recognize what has happened inside, and from which follow either hope or despair. Now when the heart is penetrated, much blood issues, the pulse fades away, the colour is extremely pallid, cold and malodorous sweats burst out as if the body had been wetted by dew, the extremities become cold and death quickly follows. But when the lung is pierced there is difficulty in breathing; frothy blood escapes from the mouth, red blood from the wound; and at the same time breath is drawn with a noise; to lie upon the wound affords relief; some stand up without any reason. Many speak if they have been laid upon the wound; if upon the opposite side they become speechless. Symptoms that the liver should have been wounded are that considerable haemorrhage occurs from under the right part of the hypochondria; the hypochondria are retracted towards the spine; the patient is eased by lying on his belly; stabbing pains spread upwards as high as the clavicle and its junction with the scapula; to which, not infrequently, also bilious vomiting is added. When the kidneys have been penetrated, pain spreads down to the groin and testicles; urine is passed with difficulty, and it is either bloodstained or actual blood clot is passed. But when the spleen has been pierced, black blood flows out from the left side; the hypochondria on that side together with the stomach become hard; great thirst comes on; pain extends to the clavicle as when the liver has been wounded. But when the womb has been penetrated, there is pain in the groins and hips and thighs; blood passes downwards in part through the wound, in part by the vagina; bilious vomiting follows. Some become speechless, some are mentally disturbed, others whilst composed in mind complain of pain in their sinews and eyeballs, and when dying they suffer like those wounded in the heart. When the brain or its membrane has been wounded, blood escape through the nostrils, in some also through the ears; and generally bilious vomiting follows. Some lose their senses and take no notice when spoken to; some have a wild look; in some the eyes move from side to side as if they were out of control; generally on the third or fifth day delirium supervenes; many have also spasm of sinews. Again, before death many tear off the bandages with which their head has been bound up, and expose the bared wound to cold. But when the gullet has been penetrated, hiccough and bilious vomiting follow; if any food or drink is swallowed, it is returned at once; pulsation of the blood-vessels fades away; thin sweat breaks out, following which the extremities become cold. The signs when the small intestine and the stomach have been wounded are the same; for food and drink come out through the wound; the hypochondria become hard, sometimes bile is regurgitated through the mouth. Only in the case of the intestine the situation of the wound is lower down. All other intestinal wounds cause the emission of faeces or a faecal odour. When the marrow which is within the spine has been crushed, there is either paralysis or spasm of sinews; sensation is interrupted; after some time there is involuntary evacuation from the parts below of either semen or urine of even faeces. But if the diaphragm has been penetrated, the praecordia are contracted upwards; the spine is painful; breathing is laboured; frothy blood escapes. When the bladder has been wounded, the groins are painful; the hypogastrium becomes tense; blood is passed, instead of urine, the urine being discharged from the actual wound. The gullet is affected, and so the patients either vomit bile or hiccough. Coldness and after that death follows. Even when these facts are known, there are still some other things to be learnt about wounds and ulcerations in general, of which we will now speak. From wounds, then, there comes out blood, or sanies, or pus. Blood everybody knows; sanies is thinner than blood, varying both in thickness and stickiness and colour. Pus is the thickest and whitest, more sticky than either sanies or blood. Now blood comes out from a fresh wound or from one which is already healing, sanies between these two periods, pus from an ulceration already beginning to heal. Again, the Greeks distinguish by name different kinds of sanies and pus. For there is a kind of sanies which is named either hidros or melitera; there is pus which is called alaeodes. Hidros is thin, whitish, and comes from a bad ulceration, especially when inflammation has followed upon a wound of a sinew. Melitera is thicker, stickier and whitish, something like honey. It is likewise discharged from bad ulcerations, when sinews near to joints have been wounded, and among such places especially from the knees. Elaeodes is thin, whitish, fatty, in colour and fattiness not unlike olive-oil; it appears in large ulcerations when they are healing. Blood is bad when it is too thin or too thick, livid or black in colour, or mixed with phlegm or variable; it is best when hot, red, moderately thick, and not sticky. Consequently from the first the treatment is more expeditious in the case of a wound from which good blood has flowed. Also later there is more hope in the case of wounds from which all the discharges are of the better kind. Thus sanies is bad when profuse, too thin, livid, or pallid or black or sticky or malodorous or when it erodes either the ulceration itself or the skin adjoining it; it is better when not profuse, moderately thick, reddish or whitish. But hidros is worse when it is profuse, thick, somewhat livid or pallid, stick, black, hot, malodorous; it is less serious when whitish, and when all the rest of its characteristics are the opposite of the foregoing. Melitera again is bad when profuse and very thick; better for being thinner and less copious. Amongst these discharges pus is the best; but it is likewise worse when profuse, thin, watery, and the more so if it is such from the beginning; and also if it is in colour like whey, if pallid, or livid, or like wine-lees; if, besides, it is malodorous, unless, however, it is the part which causes this odour. It is better, the smaller the quantity, the thicker and whiter; also if it is bland, odourless, uniform; none the less it should correspond in quantity with the size and age of the wound. For naturally there is more discharge, the larger the wound, si more when inflammation has not yet subsided. Elaeodes also is worse when large in quantity and but little fatty, the less in quantity and the more fatty the better. After these matters have been investigated, when a man has been wounded who can be saved, there are in the first place two things to be kept in mind: that he should die from haemorrhage or inflammation. If we are afraid of haemorrhage which can be judged both from the position and size of the wound and from the force of the flowing blood, the wound is to be filled with dry lint, and over that a sponge applied, squeezed out of cold water, and pressed down by the hand. If the bleeding is not checked thus, the lint must be changed several times, and if it is not effective when dry, it is to be soaked in vinegar. Vinegar is powerful in suppressing a flow of blood; and some, therefore, pour it into wounds. But then there is an underlying fear of another kind, that if too much diseased matter is forcibly retained in the wound it will afterwards cause great inflammation. It is on this account that no use is made, either of corrosives or of caustics, owing to the crust they induce, although most of these medicaments suppress bleeding; but if for once recourse is had to them, choose those which have a milder action. But if even these are powerless against the profuse bleeding, the blood-vessels which are pouring out blood are to be seized, and round the wounded spot they are to be tied in two places and cut across between so that the two ends coalesce each on itself and yet have their orifices closed. When circumstances do not even admit of this, the blood-vessels can be burnt with a red-hot iron. But even when there has been a considerable bleeding from a place where there is neither sinew nor muscle, such as the forehead or top of the head, it is perhaps best to apply a cup to a distant part, in order to divert thither the course of the blood. Against bleeding there is help in the foregoing measures, but against inflammation it lies simply in the bleeding itself. Inflammation is to be feared when a bone is injured or sinew or cartilage or muscle, or whenever there is little outflow of blood compared to the wound. Therefore, in such cases, it will not be desirable to suppress the bleeding early, but to let blood flow as long as it is safe; so that if there seems too little bleeding, blood should be let from the arm as well, at any rate when the patient is young and robust and used to exercise, and much more so when a drinking bout has preceded the wound. But if a muscle is seen to be wounded, it will be best to cut it right through; for when stabbed it causes death, when cut through it admits of cure. Now, when bleeding has been suppressed if excessive, or encouraged when not enough has escaped of itself, then by far the best thing is for the wound to become agglutinated. But this is possible for a wound in the skin, or even in the flesh, if nothing else has occurred to do it harm. Agglutination is possible if the flesh is hanging free at one part, whilst attached at another, provided, however, that the flesh is still sound, and has a connexion with the body to feed it. But with wounds which are being agglutinated, there are two treatments. For if the wound is in a soft part, it will be stitched up, and particularly when the cut is in the tip of the ear or the point of the nose or forehead or cheek or eyelid or lip or the skin over the throat or abdomen. But if the wound is in the flesh, and gapes, and its margins are not easily drawn together, then stitching in unsuitable; fibulae (the Greeks call them ancteres) are then to be inserted, which draw together the margins to some extent and so render the subsequent scar less broad. Now from the above it can be gathered also whether flesh which is hanging free at one part and attached at another, if it is still capable of juncture, demands suture or fibula. But neither of these should be inserted until the interior of the wound has been cleansed, lest some blood-clot be left in it. For blood clot turns into pus, and excites inflammation, and prevents agglutination of the wound. Not even lint which has been inserted to arrest bleeding should be left in, for this also inflames the wound. The suture or fibula should take up, not only skin but also some of the underlying flesh, where there is any, that it may hold more firmly, and not tear through the skin. And both are best used with a strand of a soft wool not too closely twisted that it may cause less irritation to the body, and both should be inserted at intervals not too distant or too close. For if the intervals are too distant, the wound is not held together; if too close, it is very hurtful, for the more often the needle this fixes the tissues, and the more places are wounded by the inserted stitches, the worse is the inflammation set up, especially in summer. Neither procedure needs any force, but is useful just so far as the skin follows that which draws it as if of its own accord. Generally, however, fibulae leave the wound wider open, a suture joins the margins together, but these should not be brought actually into contact throughout the whole length of the wound, in order that there may be an outlet for any humour collecting within. If any wound admits of neither of these, it should none the less be cleaned. Hence, upon every wound there is to be applied, first a sponge squeezed out of vinegar; or out of wine if the patient cannot bear the strength of vinegar. A slight wound is even benefited if a sponge is applied wrung out of cold water. But in whatever way it is put on, it is only of service while moist; and so it must not be allowed to become dry. And a wound can be treated without foreign and far-fetched and complicated medicaments. But if any one has not confidence in this treatment, a medicament should be put on, which has no suet in its composition, chosen from those which I have stated to be suitable for bleeding wounds: and especially, if it is a flesh wound, the composition called barbarum; if a wound of sinews or of cartilage or of some projecting part, such as the ears or lips, the seal of Polyides: the green composition called Alexandrian is also suitable for sinews; and that which the Greeks call rhaptousa for parts which project. When the body is bruised it is usual also for the skin to be broken to a small extent. When this occurs, it is not improper to lay it open more widely with a scalpel, unless there are muscles and sinews near, as it is inexpedient to cut into these. When it has been sufficiently opened, a medicament is seem to be put on. But if the skin over the contusion, although broken too little, yet must not be laid open more widely on account of sinews or muscles, then such applications should be made as gently extract humour, especially that which I have said is called rhypodes. It is also not inappropriate, when the wound is severe, after putting on what is beneficial, to lay on over this, wool saturated with vinegar and oil; or a poultice, gently repressant if to a soft part; or emollient to a part where there are sinews or muscles. The bandage too for binding up a wound is best made of linen, and it should be so wide as to cover it in a single turn, not the wound alone but somewhat of its edges on either side. If the flesh has receded more from one edge, the traction is better made from that side. If equally from both, the bandage, put crosswise, should press the margins together; or if the character of the wound does not admit of that, the middle of the bandage is to be applied first, so that it may then be drawn to either side. Moreover, the wound is to be bandaged so that it is held together, yet not constricted. When it is not so held, it gapes; if it is constricted too much, there is a risk of canker. In winter there should be more turns of the bandage, in summer just those necessary; finally, the end of the bandage is to be stitched by means of a needle to the deeper turns; for a knot hurts the wound, unless, indeed, it is at a distance from it. On the following point no practitioner should be ignorant so that he has to enquire as to the special treatment required for the internal organs, which I have spoken of above. For whilst an external wound is to be treated either by suture, or by some sort of medicine; in the case of the internal organs, nothing is to be moved, unless it be to cut away some bit of liver or spleen or lung which hangs outside. Otherwise internal wounds will be cured by the regulation of diet, and by those medicaments which I have stated in the preceding book to suit each individual organ. So then, after this has been done on the first day, the patient is to be put to bed; if the wound is severe, before inflammation sets in, he should abstain from food, as far as his strength permits; he should drink warm water until his thirst is quenched; or, if it is summer and he has neither fever nor pain, even cold water. There is, however, in this no standing order, for always account has to be taken of the bodily strength, since weakness may render it necessary for him to take food even from the first, light of course and scanty, just enough to sustain him; and many who are actually fainting from loss of blood must, before any treatment, be resuscitated by wine, which in other cases is most inimical to a wound. It is dangerous when a wound swells overmuch; no swelling at all is the worst danger: the former is an indication of severe inflammation; the latter that the part is dead. And from the first if the patient retains his senses, if no fever follows, we may recognize that the wound will soon heal. And even fever should not cause alarm in the case of a large wound, if it persists while there is inflammation. That fever is harmful which either supervenes upon a slight wound, or lasts beyond the inflammatory period, or excites delirium; or which does not put an end to the rigor or spasm of sinews which has originated from the wound. Also involuntary bilious vomiting either immediately after the injury, or during the inflammatory period, is a bad sign only when sinews or even the neighbourhood of sinews have been wounded. The induction of a vomit, however, is not inappropriate, especially in those habituated to it; provided that this is not done immediately after food, or just when the inflammation has arisen, or when the wound is situated in the upper part of the body. When the wound has been so treated for two days, on the third it should be uncovered, sanies washed away with cold water, and then the same dressing applied again. By the fifth day the extent of inflammation in prospect is apparent. And on that day, when the wound has been uncovered again, its colour must be considered. If it is livid or pallid or patchy or dusky, it can be recognized that the wound is a bad one, and whenever this is observed, it should alarm us. It is best for the wound to be white or rubicund; also if the skin is hardened, thickened, or painful, danger is indication. Good signs are for the skin to be thin and soft without pain. But if the wound is agglutinating or swollen slightly, the same dressings as at first are to be applied; if there is severe inflammation and no hope of agglutination, then such applications are to be made as promote suppuration. And now the use of hot water as well is a necessity, in order to disperse diseased matter and to soften hardening and bring out pus. The temperature of the water must be pleasant to the hand when put into it, and the affusion is to be continued until the swelling is seen to have diminished and a more natural colour to have returned to the wound. After this fomentation, if the wound is not gaping widely, a plaster should be put on at once, particularly that tetrapharmacum if it is a large wound; in the case of wounds of joints, fingers, cartilaginous places, the plaster rhypodes; if the wound gapes more widely, that same plaster should be liquefied by iris unguent, and lint smeared with this laid all over the wound; upon this put the plaster, and above that greasy wool. The bandages are to be even less tight than at first. As to joints, there are certain special points to be noticed as, if the controlling sinews have been divided, weakness of the part concerned follows. If this is in doubt, and the wound has been made by a sharp weapon, a transverse wound is the more favourable; if by a blunt and heavy weapon, the shape of the wound makes no difference. But it is to be observed whether pus is being formed above the joint or beneath. If it is produced underneath, and thick and white discharge continues for some time, it is probable that a sinew has been cut, and the more so the greater the pains and inflammation, and the earlier these occur. But even though no sinew is divided, yet, if a hard swelling persists for a long while round about, the wound will last a long time and even after healing a swelling will persists; and in future that limb will be bent or stretched out slowly. There is, however, more delay in extending a limb which has been kept bent while treated, than in bending a limb which has been kept straight. Also there should be a definite rule as to position for a limb which has been wounded. If the wound is seem to be agglutinated, the limb is kept raised; it must not be bent either way if there is still inflammation; if pus is already being discharged it should be hanging down. The best medicament too is rest; movement and walking before healing are adverse. The danger, however, from movement is less for wounds of the head and arms than for the lower limbs. Walking about is least of all suited to an injured thigh or leg or foot. The patient's room should be kept warm. Bathing, too, while the wound is not yet clean, is one of the worst things to do; for this makes the wound both wet and dirty, and then there is a tendency for gangrene to occur. It is advantageous to apply light rubbing, but in those parts which are rather far away from the wound. When the inflammation has ended, the wound must be cleaned. And that is best done by putting on lint soaked in honey, and over it the plaster called tetrapharmacum or that called enneapharmacum. Then at length the wound is really clean when it is red, and neither too dry nor too moist. But a wound is not clean when it lacks sensation, when there is sensation which is not natural, when it is either too dry or too wet, when it is either whitish or pallid or livid or blackish. When the wound is clean, there follows the growth of new flesh; and now warm water is necessary in order to remove sanies. The use of unscoured wool is superfluous; scoured wool is the better wrapping. But for filling up a wound certain medicaments also are useful; therefore it is not inappropriate to make use of such things as butter with rose-oil and a little honey; or the tetrapharmacum with the said rose-oil, or lint soaked in rose-oil. More beneficial, however, is an occasional bath, a nourishing diet, while avoiding everything acrid, but now somewhat fuller, for both poultry and venison and boiled pork can be given. In all cases, while fever and inflammation are present, wine is inappropriate; also, until the scar is formed, if either sinews or muscles have been wounded; or even if there is a deep flesh wound. But when the wound is of the safer kind, only skin deep, wine if not too old, given in moderation, can even aid the growth of flesh. If any part is to be softened, which is necessary in the region of sinews and muscles, cerate also is to be used upon the wound. But if flesh fungates, dry lint is a moderate repressant, copper scales a more active one. If more fungation needs to be removed the still more active corrosives are to be employed. After all such applications, lycium dissolved in raisin wine or in milk, or even only an application of dry lint, is useful in inducing a scar. Such is the procedure of a successful treatment; dangerous complications, however, are wont to occur. Sometimes the wound becomes the seat of chronic ulceration, and it becomes hardened, and the thickened margins are a livid colour; after which whatever medicament is applied is of little service; and this commonly occurs when the wound has been carelessly treated. At times, whether owing to excess of inflammation, or to unusually hot weather, or to excessively cold weather, of because the wound has been bandaged too tightly, or on account of old age, or of a bad habit of body, canker sets in. The Greeks divided this genus into species for which there are no terms in our language. Now canker, whatever its species, corrupts not only the part it attacks, but it also spreads; next it is distinguished by differing signs. For sometimes a redness, over and above the inflammation, surrounds the wound, and this spreads with pain (the Greeks term it erysipelas); at times the wound is black because its flesh has become corrupted, and this is still more intensified by putrefaction when the wound is moist, and from the black wound is discharged a pallid humour, which has a foul odour, and the granulations break down: at times also sinews and membranes undergo dissolution, and when a probe is introduced it passes to the side or downwards, and this lesion not infrequently affects the bone too; sometimes there arises what the Greeks call gangrene. The former varieties occur in any part of the body; gangrene in the extremities, that is, in the nails, armpits or groins, and generally in aged people or in those of a bad habit of body. The flesh in the wound becomes either black or livid, but dry and shrivelled; the skin near it is for the most part occupied by dusky pustules; then the skin around these becomes either pallid or livid, and usually wrinkled, deficient in sensation: farther away from the wound the skin is inflamed. All these things spread simultaneously, the ulceration into the pustules, the pustules into the pallid or livid part, that into the inflamed part, and that again into the sound flesh. Now together with the above an acute fever arises and great thirst: in some also delirium: others, although in their right minds, nevertheless stammer so that they can scarcely explain their feelings; the stomach begins to be affected: even the breath gets a foul odour. This disorder at its commencement admits of treatment; but when thoroughly established it is incurable, and most patients die in a cold sweat. And such are the dangers following upon wounds. Now a wound when of long standing should be cut with a scalpel, its margins excised, and incisions made at the same time into any livid area surrounding the margins. If there is a small varix inside the wound which hinders healing, it also is to be excised. Then when the blood has been let out and the wound made like a new one, the same treatment is to be adopted as that described for recent wounds. If any one does not want to use the scalpel, healing may be secured by using the plaster made up with ladanum, and, when that has eaten away the ulcer, by the one which induces a scar. But what I have said is called erysipelas, not only follows upon a would, but is wont also to arise without a wound, and sometimes brings with it some danger, especially when it sets in about the neck or head. If strength permits, blood should be let; then repressives and refrigerants applied together, particularly white-lead with nightshade juice, or Cimolian chalk with rain-water as an excipient; or flour made into a paste with the same, with cyprus shoots added, or lentil meal if the skin is more delicate. Whatever is put on is to be covered over with beet leaves, and over that with lint wetted with cold water. If refrigerants by themselves have little effect, they are to be combined with the following: sulphur 4 grams, white-lead and saffron, 50 grams each; and these are pounded up with wine and the place smeared with them: or when the skin is more hardened, nightshade leaves are pounded, mixed with lard, and applied spread on lint. But if there is a blackening which is not yet spreading, the milder corrosives of putrid flesh are to be put on, and the wound having been thus cleaned out, is cared for like other wounds. If there is more corruption, and it is already spreading, stronger corrosives are needed. If even these are not effective, the place should be burnt by a cautery until no more humour escapes from it; for sound flesh is dry when it is burnt. After the cauterizing of a putrid wound, such drugs are to be applied as will loosen from the living flesh the crusts which the Greeks call eschara. When these have fallen off, the wound is to be cleaned by honey and resin in particular; but it can also be cleaned by the other materials with which suppurating wounds are treated and in the same way brought to healing. But gangrene, when not yet widespread, but only beginning, is not very difficult to cure, at any rate in a young subject; and even more so if muscles are intact, sinews uninjured or but slightly affected, and no large joint opened, or if there is little flesh in the part, and so not much to putrefy, and if the lesion is limited to one place; and this mostly happens in a finger. In such a case the first thing to be done, when strength permits, is to let blood; then whatever has become dry, and by stretching out, as it were, in injuring also what is next to it, is cut away up to this point the sound tissue. Whilst the gangrene is spreading, medicaments which tend to promote suppuration are not to be applied; and therefore not even hot water. Weighty dressings also, although repressant, are unsuitable; but the lightest are needed; and over the parts which are inflamed refrigerants are to be used. If the malady is still not checked, the part between what is sound and diseased ought to be cauterized; and in such a case especially assistance is to be sought, not only from medicaments, but also from a system of diet; for this malady only occurs in a corrupt and diseased body. Therefore at first, unless weakness prohibits it, the patient should fast; after that he should be given light food and drink to tone up the bowels, and so also the body in general. Later if the lesion has been checked, the same things should be put on the wound which were prescribed for putrid ulceration. And it is now also permissible to make use of a fuller diet — foods of the middle class, but only such as dry up the bowels and the body generally; and cold rain-water to drink. The bath is harmful until it is quite certain that soundness has returned; for a wound, if softened in the bath, is quickly again affected by the same malady. But it still happens sometimes that none of these remedies is effectual, and in spite of everything this canker spreads. In such circumstances there is one sad by solitary remedy to secure the safety of the rest of the body, that is to cut away the limb which is gradually dying. Such are the treatments of the gravest wounds. But there should be no neglect of those in which the skin is intact, but some inner part has been contused; or where something has been scraped or rubbed off: or what a splinter has become fixed in the body, or where the wound is small but deep. In the first case the best thing is to cook the rind of a pomegranate in wine, and pound up its interior and mix with rose-oil cerate, and so apply it: next, when the skin has been actually abraded, to lay on a soothing medicament such as lipara. When the skin has been scraped and rubbed off, the plaster tetrapharmacum is to be applied, the food reduced and wine withdrawn. Such wounds are not to be disregarded because deeper structures are uninjured; for often from injuries of this kind canker develops. But if the hurt is trifling, and of small extent, we may be content with the same soothing application. A splinter too, whenever possible, should be extracted either by the hand or even by the help of an instrument. But if the splinter has been broken off or has penetrated too deeply for this to be done, it must be drawn towards the surface by a medicament. The best thing to draw it out is an application of pole-reed root pound up straight away if soft, but if already rather hard, boiled first in honey wine; to which honey should always be added, or birthwort also with honey. Of splinters the pole-reed is the worst because it is rough; there is the same harmfulness in fern. But by experience it has been learnt that either, when pounded up and applied, serves as a medicament against the other. Any medicament which has an extractive property has the same effect on splinters of all kinds. The same treatment is best for deep and narrow wounds. The plaster of Philocrates is especially good for the former, that of Hecataeus for the latter. Whatever the kind of wound, when the time has come for inducing the scar, which must be after the wound has cleaned and filled with new flesh, first lint is applied, wetted by cold water while the flesh is being nourished; afterwards, when it has to be checked, dry lint must be applied until the scar is induced. Then plumbum album should be bandaged on in order to keep down the scar, and to give it a colour as much as possible like sound skin. Wild cucumber root has the same property, so has the present contain in: elaterium 4 grams, litharge 8 grams, unguent 16 grams. These are taken up in turpentine until the whole is of the consistency of a plaster. Further, equal parts of verdigris and washed lead mixed together with rose-oil gently clean black scars; either the scar may be anointed, as can be done on the face; or the above may be applied as a plaster, which is more convenient for other parts of the body. But if the scar is either elevated or depressed, it is foolish, just for the sake of appearance, to submit to pain and medicinal applications. Else both conditions can be remedied, since either scar can be made into a wound by the use of a scalpel. Or if a medicament is preferred, corrosive compositions have the same effect. After the skin has been wounded, to an elevated cicatrix corrosives are applied, to a depressed one medicaments which make flesh, until the wound, in each case, is on a level with the sound skin; and then the scar is induced. |
| 132 |
Dixi de is uulneribus , quae maxime per tela inferuntur . Sequitur , ut de is dicam , quae morsu fiunt , interdum hominis , interdum simiae , saepe canis , nonnumquam ferorum animalium aut serpentium . Omnis autem fere morsus habet quoddam uirus : itaque si uehemens uulnus est , cucurbitula admouenda est ; si leuius , protinus emplastrum iniciendum , praecipueque Diogen i . Si id non est , quodlibet ex is , quae aduersus morsus proposui : si ea non sunt , uiride Alexandrinum : si ne id quidem est , quodlibet non pingue ex is , quae recentibus uulneribus accommodantur . Sal quoque his , praecipueque ei , quod canis fecit , medicamentum est , si manus uulneri inponitur superque id duobus digitis uerberatur : exaniat enim ; ac salsamentum quoque recte super id uulnus deligatur . Vtique autem si rabiosus canis fuit , cucurbitula uirus eius extrahendum est ; deinde si locus neque neruosus neque musculosus est , uulnus id adurendum est : si uri non potest , sanguinem homini mitti non alienum est . Tum usto quidem uulneri superimponenda quae ceteris ustis sunt : ei uero , quod expertum ignem non est , ea medicamenta , quae uehementer exedunt . Post quae nullo nouo magisterio , sed iam supra posito ulcus erit implendum et ad sanitatem perducendum . Quidam post rabiosi canis morsum protinus in balineum mittunt ibique patiuntur desudare , dum uires corporis sinunt , ulcere adaperto , quo magis ex eo quoque uirus destillet ; deinde multo mera coque uino accipiunt , quod omnibus uenenis contrarium est . Idque cum ita per triduum factum est , tutus esse homo a periculo uidetur . Solet autem ex eo uulnere , ubi parum occursum est , aquae timor nasci ( hydrophobas Graeci appellant ) , miserrimum genus morbi , in quo simul aeger et siti et aquae metu cruciatur ; quo oppressis in angusto spes est . Sed unicum tamen remedium est , neque opinantem in piscinam non ante ei prouisam proicere . Et si natandi scientiam non habet , modo mersum bibere pati , modo attollere : si habet , interdum deprimere , ut inuitus quoque aqua satietur : sic enim simul et sitis et aquae metus tollitur . Sed aliud periculum excipit , ne infirmum corpus in aqua frigida uexatum neruorum distentio absumat . Id ne incidat , a piscina protinus in oleum calidum demittendus est . Antidotum autem praecipue id , quod primo loco posui , ubi id non est , aliud , si nondum aeger aquam horret , potui ex aqua dandum est ; et si amaritudine offendit , mel adiciendum est : si iam is morbus occupauit , per catapotia sumi potest . Serpentium quoque morsus non nimium distantem curationem desiderant , quamuis in ea multum antiqui uariarunt , ut in singula anguium genera singula medendi genera praeciperent aliique alia : sed in omnibus eadem maxime proficiunt .—Igitur in primis super uulnus id membrum deligandum est , non tamen nimium uehementer , ne torpeat ; deinde uenenum extrahendum est . Id cucurbitula optume facit . Neque alienum est ante scalpello circa uulnus incidere , quo plus uitiati iam sanguinis extrahatur . Si cucurbitula non est , quod tamen uix incidere potest , tum quodlibet simile uas , quod idem possit ; si ne id quidem est , homo adhibendus est , qui id uulnus exsugat . Neque Hercules scientiam praecipuam habent ii , qui Psylli nominantur , sed audaciam usu ipso confirmatam . Nam uenenum serpentis , ut quaedam etiam uenatoria uenena , quibus Galli praecipue utuntur , non gustu , sed in uulnere nocent . Ideoque colubra ipsa tuto estur , ictus eius occidit ; et si stupente ea , quod per quaedam medicamenta circulatores faciunt , in os digitum quis indidit neque percussus est , nulla in ea saliua noxa est . Ergo quisquis exemplum Psylli secutus id uulnus exsuxerit , et ipse tutus erit et tutum hominem praestabit . Illud ante debebit adtendere , ne quod in gingiuis palatoue aliaue parte oris ulcus habeat . Post haec is homo loco calido conlocandus est , sic ut id quod percussum erit , in inferiorem partem inclinetur . Si neque qui exsugat neque cucurbitula est , sorbere oportet ius anserinum uel ouillum uel uitulinum et uomere , uiuum autem gallinaceum pullum per medium diuidere et protinus calidum super uolnus imponere , sic ut pars interior corpori iungatur . Facit id etiam haedus agnusue discissus , et calida eius caro statim super uolnus imposita . Emplastra quoque si qua * * supra conprehensa sunt ; aptissimumque est uel Ephesium uel id , quod ei subiectum est . Praesensque in aliquo antidoto praesidium est : si id non est , necessarium est exsorbere potionem meri uini cum pipere , uel quidlibet aliud quod calori mouendo est , ne umorem intus coire patiatur : nam maxima pars uenenorum frigore interemit . Omnia etiam urinam mouentia , quia materiam extenuant , utilia sunt . Haec aduersus omnes ictus communia sunt . Vsus tamen ipse docuit eum , quem aspis percussit , acetum potius bibere debere . Quod demonstrasse dicitur casus cuiusdam pueri , qui cum ab hac ictus esset et partim ob ipsum uolnus partim ob inmodicos aestus siti premeretur ac locis siccis alium umorem non reperiret , acetum , quod forte secum habebat , ebibit et liberatus est , credo , quoniam id , quamuis refrigerandi uim habet , tamen habet etiam dissupandi ; quo fit , ut terra respersa eo spumet . Eadem ergo ui uerisimile est spissescentem quoque intus umorem hominis ab eo discuti et sic dari sanitatem . In quibusdam etiam aliis serpentibus quaedam auxilia certa satis nota sunt . Nam scorpio sibi ipse pulcherrimum medicamentum est . Quidam contritum cum uino bibunt : quidam eodem modo contritum super uolnus imponunt : quidam super prunam eo imposito uolnus suffumigant , undique ueste circumdata , ne is fumus dilabatur ; tum carbonem eius super uolnus deligant . Bibere autem oportet herbae solaris , quam heliotropion Graeci uocant , semen uel certe folia ex uino . Super uolnus uero etiam furfures ex aceto uel ruta siluatica recte imponitur uel cum melle sal tostus . Cognoui tamen medicos , qui a scorpione ictis nihil aliud quam ex bracchio sanguinem miserunt . Et ad scorpionis autem et aranei ictum alium cum ruta recte miscentur , ex oleoque contritum superinponitur . At si cerastes aut dipsas aut haemorrhois percussit , poli quod Aegyptiae fabae magnitudinem aequet , arfactum ut in duas potiones diuidendum est , sic ut ei rutae paulum adiciatur . Trifolium quoque et mentastrum et cum aceto panaces aeque proficiunt . Costumque et casia et cinnamomum recte per potionem adsumuntur . Aduersus chelydri uero ictum panaces aut laser , quod sit scrip . III S. [ #1108 I ] , uel porri sucus cum hemina uini sumendus est , et edenda multa satureia . Imponendum autem super uulnus stercus caprinum ex aceto coctum , aut ex eodem hordiacia farina , aut ruta uel nepeta cum sale contrita melle adiecto . Quod in eo quoque uulnere , quod cerastes fecit , aeque ualet . Vbi uero phalangium nocuit , praeter eam curationem , quae manu redditur , saepe homo demittendus in solium est ; dandusque ei murrae et uuae t aminiae par modus ex passi hemina ; uel radiculae semen aut lolii radix ex uino ; et super uulnus furfures ex aceto coctae ; imperandumque , ut is conquiescat . Verum haec genera serpentium et peregrina et aliquanto magis pestifera sunt , maximeque aestuosis locis gignuntur . Italia frigidioresque regiones hac quoque parte salubritatem habent , quod minus terribiles angues edunt . Aduersus quos satis proficit herba Vettonica uel Cantabrica uel centaurios uel argimonia uel trixago uel personina uel marinae pastinacae , uel singulae binaeue tritae et cum uino potui datae * * * sunt et super uulnus impositae . Illud ignorari non oportet , omnis serpentis ictum et ieiuni et ieiuno magis nocere ; ideoque perniciosissimae sunt cum incubant , utilissimumque est , ubi ex anguibus metus est , non ante procedi quam quis aliquid adsumpsit . Non tam ex facil i is opitulari est , qui uenenum uel in cibo uel in potione sumpserunt , primum quia non protinus sentiunt , ut ab angue icti ; ita ne succurrere quidem statim sibi possunt ; deinde quia noxa non a cute sed ab interioribus partibus incipit . Commodissimum est tamen , ubi primum sensit aliquis , protinus oleo multo epoto uomere ; deinde ubi praecordia exhausit , bibere antidotum : si id non est , uel merum uinum . Sunt tamen quaedam remedia propria aduersus quaedam uenena , maximeque leuiora . Nam si cantharidas aliquis ebibit , panaces cum * * contusa uel galban um uino adiecto dari , uel lac per se debet . Si cicutam , uinum merum calidum cum ruta quam plurimum ingerendum est ; deinde is uomere cogendus ; posteaque laser ex uino dandum : isque , si febre uacat , in calidum balneum mittendus ; si non uacat , unguendus ex calfacientibus est . Post quae quies ei necessaria est . Si hyoscyamum , feruens mulsum bibendum est , aut quodlibet lac , maxime tamen asininum . @@Si cerussam , ius maluae uel ius glandis ex uino contritae maxime prosunt . Si sanguisuga epota est , acetum cum sale bibendum est . Si lac intus coiit , aut passum aut coagulum aut cum aceto laser . Si fungos inutiles quis adsumpsit , radicula aut †pota aut cum sale et aceto edenda est . Ipsi uero hi et specie quidem discerni possunt ab utilibus et cocturae genere idonei fieri . Nam siue ex oleo inferuerunt , siue piri surculus cum his inferuuit , omni noxa uacant . Adustis quoque locis extrinsecus uis infertur : itaque sequi uidetur , ut de his dicam . Haec autem optime curantur folio aut lilii aut linguae caninae aut betae in uetere uino oleoque decoctis ; quorum quidlibet protinus impositum ad sanitatem perducit . Sed diuidi quoque curatio potest in ea , quae mediocriter exedentia reprimentiaque primo et pusulas prohibeant et summam pel liculam exasperent ; deinde ea , quae lenia ad sanitatem perducant . Ex prioribus est lenticulae cum melle farina uel myrra cum uino uel creta Cimolia cum turis cortice contrita et aqua coacta atque , ubi usus necessitas incidit , aceto diluta . Ex insequentibus quaelibet lipara : sed idonea maxime est , quae uel plumbi recrementum uel uitellos habet . Est etiam illa adustorum curatio , dum inflammatio est , impositam habere cum melle lenticulam : ubi ea declinauit , farina m cum ruta uel porro uel marrubio , donec crustae cadant ; tum eruum cum melle aut irim aut resinam terebinthinam , donec ulcus purum sit ; nouissime siccum lin amentum .
|
27 I have spoken of those wounds which are mostly inflicted by weapons. My next task is to speak of those which are caused by the bite, at times of a man, at times of an ape, often of a dog, not infrequently of wild animals or of snakes. For almost every bite has in it poison of some sort. Therefore if the wound is severe, a cup should be applied straightway of it; if slighter a plaster, especially that of Diogenes. If that is not at hand, then one of the others I have recommended against bites; failing such, the green plaster called Alexandrian; if not even that is to be had, then any one which suits recent wounds, so long as it is not greasy. Salt is also a remedy for bites, especially dog-bite, if a hand is then placed over the bite and struck by two fingers of the other hand; for this brings out sanies; and brine-pickle may also be appropriately bandaged upon such a wound. But especially if the dog was mad, the poison must be drawn out by a cup; next, if the wound is not among sinews and muscles, it must be cauterized; if it cannot be cauterized, it is not amiss to bleed the man. After cauterizing, applications are to be put on as for other burns; if the wound is not cauterized, such medicaments as are powerful corrosives. After this the wound should be filled in and brought to healing, not by any new method, but as already described above. After the bite of a mad dog some send the patients at once to the bath, and there let them sweat as much as their bodily strength allows, the wound being kept open in order that the poison may drop out freely from it; then follows the administration of much wine, undiluted, which is an antidote to all poisons. And when this has been carried out for three days, the patient is deemed to be out of danger. But when too little has been done for such a wound, it usually gives rise to a fear of water which the hands call hydrophobia, a most distressing disease, in which the patient is tortured simultaneously by thirst and by dread of water. In these cases there is very little help for the sufferer. But still there is just one remedy, to throw the patient unawares into a water tank which he has not seen beforehand. If he cannot swim, let him sink under and drink, then lift him out; if he can swim, push him under at intervals so that he drinks his fill of water even against his will; for so his thirst and dread of water are removed at the same time. Yet this procedure incurs a good danger, that a spasm of sinews, provoked by the cold water, may carry off a weakened body. Lest this should happen, he must be taken straight from the tank and plunged into a bath of hot oil. But as an antidote we should give especially the one which I put first, when that is not at hand, another; it is to be given in a draught of water, if the patient does not dread water yet; and if the bitterness is objected to, honey is to be added; if dread of water has already seized him, the antidote can be swallowed as a pill. Serpents' bites again need a not very different treatment, although in this the ancients had very various methods so that for each kind of snake some prescribed one special kind of remedy, some another; but in all it is the same measures which are the most efficacious. Therefore first the limb is to be constricted above this kind of wound, but not too tightly, lest it become numbed; next, the poison is to be drawn out. A cup does this best. But it is not amiss beforehand to according to incisions with a scalpel around the wound, in order that more of the vitiated blood may be extracted. If there is no cup at hand, although this can hardly happen, use any similar vessel which can do what you want; if there is not even this, a man must be got to suck the wound. I declare there is no particular science in those people who are called Psylli, but a boldness confirmed by experience. For serpent's poison, like certain hunter's poisons, such as the Gauls in particular use, does no harm when swallowed, but only in a wound. Hence the snake itself may be safely eaten, whilst its stroke kills; and if one is stupefied, which mountebanks effect by certain medicaments, and if anyone puts his finger into its mouth and is not bitten, its saliva is harmless. Anyone, therefore, who follows the example of the Psylli and sucks out the wound, will himself be safe, and will promote the safety of the patient. He must see to it, however, beforehand that he has no sore place on his gums or palate or other parts of the mouth. After the suction, the patient should be put into a warm room, in such a position that the part bitten is inclined downwards. If there is no one at hand to suck out the wound, or to cup it, the patient should sip goose or mutton or veal broth and provoke a vomit; further a live chicken should be cut through the middle, and whilst warm applied forthwith over the wound so that its inner part is in contact with the patient's body. It will also do to slaughter a kid or lamb, and immediately to put the hot flesh upon the wound. The plasters also should be applied which have been mentioned above; the most suitable is the Ephesian plaster, or that noted next after it. There is ready help in on of the antidotes; if none is at hand, it is necessary to take in sips a draught of strong wine with pepper, or anything else which will stir up heat, to prevent humour from coagulating internally; for most poisons cause death by cold. All diuretics also are useful, because they dilute the diseased matter. Such are the general remedies against bites of any kind. Experience has taught, however, that anyone bitten by an asp should in particular drink vinegar. The case of a certain boy is said to demonstrate this, for having been thus bitten, partly on account of the bite, and partly owing to excessively hot weather, he was tormented by thirst, and being in a dry place found no other fluid, so he drank the vinegar he chanced to have with him, and was saved. I believe this happened because although vinegar is a refrigerant, it has also the faculty of dissipating. Hence it is that earth sprinkled with it froths. Therefore it is likely that by the same faculty humour which is condensing inside a patient is dissipated by it, and so health is restored. There are also against certain other reptiles remedies which are well enough known. For the scorpion is itself the best remedy against itself. Some pound up a scorpion and swallow it in wine; some pound it up in the same way and put it upon the wound; some put it upon a brazier and fumigate the wound with it, putting a cloth all round to prevent the escape of the fumes, afterwards they bandage its ash upon the wound. The patient should also drink wine in which have been steeped the seeds, or at any rate the leaves, of the herba solaris, which the Greeks call heliotropion. It is good also to apply to the wound bran soaked in vinegar, or wild rue, or roasted salt with honey. I have known, however, practitioners who merely let blood from the arm of those stung by a scorpion, that and nothing more. For the sting of a scorpion also, or for that of a spider, it is good to put on garlic mixed with rue and pounded up with oil. But when cerastes, or dipsas, or haemorrhois has bitten a man, poley-germander roasted, equal in amount to an Egyptian bean, is divided into two draughts, a little rue being added. Trefoil also and wild mint and allheal-juice, with vinegar, are equally efficacious. Costmary, casia, and cinnamon may appropriately be taken in draughts. For the bite of a chelydrus, allheal-juice or laser 4 grams, or leek-juice in 250 cc. of wine, may be taken, and a quantity of savory eaten. Over the bite either goat's dung, or barley-meal boiled with vinegar should be applied, or rue, or catnip pounded with salt, with honey added. This last is equally efficacious for the bite of a cerastes. But when a venomous spider has done the harm, in addition to the surgical treatment, the patient should be plunged often into the hot bath; and take equal quantities of myrrh and bryony berries in 250 cc. of raisin wine; or radish seeds or darnel root in wine; bran boiled in vinegar is to be put on the wound, and the patient is kept in bed. But the foregoing classes of reptiles belong to foreign countries, and are especially poisonous, and they are mostly generated in hot countries. Italy and colder countries are healthier in this respect too, for the reptiles they produce are less dangerous. Against them sufficient remedies are betony or convolvulus or centaury or agrimony or germander or burdock or sea parsnip; any one or two of these is pounded up and taken in wine . . . and applied to the bite. It must be remembered that all snake-bites are more harmful when either the reptile or the man is hungry. Hence snakes are most injurious when brooding, and it is of the greatest importance when there is danger from snakes not to go out before taking some food. It is not so easy to render assistance when poison has been taken in food or drink, first because patients do not perceive it at once as when bitten by a snake; and so are unable to afford themselves any help immediately. Moreover, the mischief starts, not from the skin, but from within. But the best thing, as soon as any one has perceived it, is to swallow a quantity of oil at once and vomit; then, when the praecordia have been emptied, to drink an antidote; or failing that undiluted wine. There are, nevertheless, certain remedies proper for particular poisons, especially for the milder ones. If a potion of cantharides has been swallowed, all-heal pounded in milk should be given or galbanum with the addition of wine, or milk by itself. If it be hemlock, hot undiluted wine with rue should be taken in a large quantity, then the patient should be made to vomit; and after that laser is given in wine; and if free from fever he should be put into a hot bath; if not free, he should be anointed with heating remedies. After this, rest is necessary. If it be hyoscyamus, honey wine should be drunk hot, or milk of any kind, especially asses' milk. If it be white-lead, mallow or walnut juice rubbed up in wine is best. If a leech has been swallowed, vinegar with salt is to be drunk. When milk has curdled inside, either raisin wine or rennet or laser with vinegar. If any one has eaten fungi that are not used, a radish or purslane is to be eaten alone or with a draught of salt and vinegar. Such fungi may be distinguished from the sorts in use by their appearance, and may be rendered safe by suitable cooking; for when boiled in oil, or along with a pear-tree twig, they lose all their noxious property. Burns are likewise the product of external violence, and so it seems to follow that I should speak of them here. Now they are best treated by leaves either of lily or of hound's tongue or of beet, boiled in old wine and oil; any one of the above applied at once brings healing. But the treatment can also be divided into: first, a stage of moderately exedent and repressant applications both to check blisters and to roughen the skin; next, a stage of soothing applications for healing. Among the former is lentil meal with honey, or myrrh with wine, or Cimolian chalk pounded up with frankincense bark and mixed with water, and when it has to be used, diluted with vinegar. Subsequent applications include anything that is greasy; but the most suitable is that containing lead slag or yolk of egg. There is also another treatment of burns, namely, while the inflammation lasts, to keep lentil meal and honey on the wound; next, when the inflammation has subsided, flour with rue or with leek or with horehound, until the crusts fall off; then vetch meal with honey, or iris ointment or turpentine-resin, until the ulceration is clean, and finally dry lint. |