De Medicina (Celsus)

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	De Medicina Author: Celsus	Translator: Walter George Spencer
145	Linguae quoque ulcera non aliis medicamentis egent , quam quae prima parte superioris capitis exposita sunt . Sed quae in latere eius nascuntur , diutissime durant ; uidendumque est , num contra dens aliquis acutior sit , qui sanescere saepe ulcus eo loco non sinit , ideoque leuandus est .	12 Ulcerations of the tongue need no other treatment than that noted in the first part of the previous chapter. But those which arise at the side of the tongue last the longest; and it should be looked to, whether some tooth opposite the ulcer is too pointed, which often keeps an ulceration in that position from healing, in which case the tooth must be smoothed down.
146	Solent etiam interdum iuxta dentes in gingiuis tubercula quaedam oriri dolentia : parulidas Graeci appellant . Haec initio leniter sale contrito perfricare oportet ; aut inter se mixtis sale fossili combusto , cupresso , nepeta ; deinde eluere os cremore lenticulae , inter haec hiare , donec pituita satis profluat . In maiore uero inflammatione isdem medicamentis utendum est , quae ad ulcera oris supra posita sunt : et mollis lin amenti paulum inuoluendum ex is aliqua compositione , quas antheras uocari dixi , demittendumque id inter dentem et gingiuam . Quod si † duriore id prohibebit , extrinsecus admouendus erit spongia uapor calidus , inponendumque ceratum . Si suppuratio se ostendet , diutius eo uapore utendum erit , et continendum ore calidum mulsum , in quo ficus decocta sit ; idque subcrudum incidendum , ne , si diutius ibi pus remanserit , os laedat . Quod si maior is tumor est , commodius totum exciditur , sic ut ex utraque parte dens liberetur . Pure exempto si leuis plaga est , satis est ore calidam aquam continere , extrinsecus fouere eodem uapore ; si maior est , lenticulae cremore uti isdemque medicamentis , quibus cetera ulcera oris curantur . Alia quoque ulcera in gingiuis plerumque oriuntur , quibus eadem quae in reliquo ore succurrunt ; maxime tamen mandere ligustrum oportet , sucumque eum ore continere . Fit etiam interdum , ut gingiuae ulcere , siue parulis fuit siue non fuit , diutius pus feratur ; quod aut dente corrupto , aut fracto uel * * aliterque uitiato osse ; maximeque id per fissum euenire consueuit . Vbi incidit , locus aperiendus , dens eximendus ; testa ossis , si qua excessit , recipienda est ; si quid uitiosi est , radendum . Post quae quid fieri debeat , supra in aliorum ulcerum curatione conprehensum est . Si uero a dentibus gingiuae recedunt , eaedem antherae succurrunt . Vtile est etiam pira aut mala non permatura mandere , et ore eum umorem continere . Idemque praestare non acre acetum in ore retentum potest .	13 There often occur on the gums adjacent to the teeth certain painful swellings: the Greeks call them parulides. These at first should be gently rubbed over with powdered slat; or with a mixture of powdered rock-salt, cyprus oil and catmint; then the mouth is washed out with lentil gruel, and the mouth is held open at intervals until there has been a sufficient flow of phlegm. When there is still more severe inflammation, the same medicaments are to be used as noted above for ulcerations of the mouth: and between the tooth and gum should be inserted a little roll of soft lint soaked in one of the compositions which I said are called antherae. If the hardness of the gum prevents this, then hot steam by means of a sponge is to be applied outside, followed by a cerate. If suppuration shows itself, the steaming is continued longer, and hot honey wine in which a fig has been boiled down is held in the mouth; and before the abscess is quite mature it should be cut into, for fear that the bone may suffer if the pus should be retained longer. But if there is greater swelling, it is better to cut all away so as to free the tooth on both sides. When the pus is let out, if the incision is small it will suffice to hold hot water in the mouth and to foment externally with its steam; if it is larger, lentil gruel should be used, and the same medicaments as for the treatment of ulcerations of the mouth in general. There are also other ulcerations, mostly arising in the gums, for which the same remedies are beneficial; in particular, however, privet should be chewed and the juice held in the mouth. It happens now and then, whether following a gumboil or not, that a discharge of pus persists from an ulcer on the gum; this is due to either a decayed tooth or to bone that is broken or injured and diseased in some other way, and it most commonly occurs through a fissure in the bone. When this is the case, the place must be laid open, the tooth extracted; any projecting scale of bone is to be removed; and any carious bone scraped away. What ought to be done after this has been included in the treatment of other ulcerations. If the gums have retracted from the teeth, the same antherae are of service. It is also useful to chew pears and apples which are not too ripe, and to hold their juice in the mouth. Vinegar that is not too sharp can also be held in the mouth with similar advantage.
147	Vuae uehemens inflammatio terrere quoque debet . Itaque in hac et abstinentia necessaria est , et sanguis recte mittitur ; et si id aliqua res prohibet , aluus utiliter ducitur ; caputque super haec uelandum et sublimius habendum est : tum aqua gargarizandum , in qua simul rubus et lenticula decocta sit . Inlinenda autem ipsa uua uel omphacio uel galla uel alumine scissili , sic ut cuilibet eorum mel adiciatur ; chelidoniae quoque suco per coclear inlita uua maximeque * * prodest . Est etiam medicamentum hu c aptum , quod Andronium appellatur . Constat ex his : alumine scissili , squama aeris rubri , atramento sutorio , galla , murra , misy ; quae per se contrita mixtaque rursus paulatim adiecto uino austero teruntur , donec his mellis crassitudo sit . Vbi horum aliquo inlita uua est , fere multa pituita decurrit ; cumque ea quieuit , ex uino calido gargarizandum est . Quod si minor ea inflammatio est , laser terere , eique adicere frigidam aquam satis est , eam que aquam cocleario exceptam ipsi uuae subicere . Ac mediocriter eam tumentem aqua quoque frigida eodem modo subiecta reprimit . Ex eadem autem aqua gargarizandum quoque est , quae uel cum lasere uel sine eo hac ratione uuae subiecta est .	14 Inflammation of the uvula should also cause anxiety when severe. In this case, as before, abstinence is necessary, and it is right to let blood; and if anything prevents this, it is useful to clyster the bowel; and also the head must be kept covered and raised; and the patient must gargle with a decoction of blackberries and lentils. But the uvula its is to be smeared either with omphacium or oak-galls or split alum to any one of which honey has been added; it is also good to smear the uvula with chelidonium juice by means of a spoon, and especially with honey. For this purpose also the composition called Andronium is suitable; it consists of: split alum, red copper scales, blacking, oak-galls, myrrh and antimony sulphide; these are pounded separately and again pounded when mixed together, a dry wine being gradually added till the ingredients have the consistency of honey. After the uvula has been smeared with one of these compounds there is, as a rule, a free flow of phlegm; when this has subsided, hot wine should be gargled. But if there is less severe inflammation, it is sufficient to pound up assafoetida and add cold water to it, and to put the fluid into a spoon and apply it under the uvula itself. When there is only moderate swelling, even cold water held in the same way under the uvula subdues it. Also the same cold water is to be used as a gargle which, with or without the addition of assafoetida, has been applied in this manner to the uvula.
148	Si quando autem ulcera oris cancer inuasit , primum considerandum est , num malus corporis habitus sit , eique occurrendum ; deinde ipsa ulcera curanda . Quod si in summa parte id uitium est , satis proficit anthera umido ulceri arida inspersa ; sicciori cum exigua parte mellis inlita : si paulo altius , chartae conbustae partes duae , auripigmenti pars una : si penitus malum descendit , chartae conbustae partes tres , auripigmenti pars quarta , aut pares portiones salis fricti et iridis frictae , aut item pares portiones chalcitidis , calcis , auripigmenti . Necessarium autem est lin amentum in rosa tinguere , et super adurentia medicamenta inponere , ne uicinum et sanum locum laedant . Quidam etiam in acris aceti heminam frictum salem coiciunt , donec tabescere desinat ; deinde id acetum coqunt , donec exsiccetur ; eumque salem contritum inspergunt . Quotiens autem medicamentum inicitur , et ante et post os diluendum est uel cremore lenticulae uel aqua , in qua aut eruum aut oleae uerbenae ue decoctae sint , sic ut cuilibet eorum paulum mellis misceatur . Acetum quoque ex scilla retentum ore satis aduersus haec ulcera proficit , item ex aceto cocto sali , sicut supra demonstratum est , rursus mixtum acetum . Sed et diu continere utrumlibet , et id bis aut ter die facere , prout uehemens malum est , necessarium est . Quod si puer est , cui id incidit , specillum lana inuolutum in medicamentum demittendum est , et super ulcus tenendum , ne per inprudentiam adurentia deuoret . Si in gingiuis est , mouenturque aliqui dentes , refi gi eos oportet : nam curationes uehementer inpediunt . Si nihil medicamenta proficient , ulcera erunt adurenda . Quod tamen in labris ideo non est necessarium , quoniam excidere commodius est . Et id quidem , aeque adustum atque excisum , sine ea curatione , quae corpori manu adhibetur , inpleri non potest . Gingiuarum uero ossa , quae hebetia sunt , in perpetuum ustione nudantur : neque enim postea caro increscit . Inponenda tamen adustis lenticula est , donec sanitatem , qualis esse potest , recipiant .	15 If at any time gangrene has attacked ulcers of the mouth, the first thing to consider is whether the general health is bad, and if so to obviate it; next the actual ulcers are to be treated. But if the disease is superficial, it is sufficient to use a powdered anthera to dust on the ulcer if moist; if the ulcer is rather dry, to smear it on mixed with a little honey: for somewhat deeper ulcerations, apply burnt papyrus two parts, and orpiment one part; if the mischief penetrates very deeply, burnt papyrus three parts, orpiment one part, or equal parts of rock salt and roasted iris, or copper ore, quick-lime and orpiment, likewise equal parts. But in order that neighbouring spots may not be injured, it is necessary to apply lint dipped in rose oil over these caustic medicaments. Some also put the roasted salt into 250 cc. of strong vinegar until it ceases to dissolve; then the vinegar is boiled to dryness, and the salt pounded up and dusted on. But whenever this medicament is applied, the mouth should be washed out both before and after, either with lentil gruel, or with a decoction of vetches or of olives or of vervains, to any one of which a little honey is added. Also vinegar of squills held sufficiently long in the mouth is beneficial for such ulceration, so too the salt after evaporation as described above dissolved again in vinegar. But whilst the affection continues to be severe it is necessary both to hold one or other of the remedies in the mouth for some time and to use them two or three times a day, If it is a child who is attacked, a probe wrapped round with wool is dipped in the medicament and held to the ulcer, lest by accident he should swallow the caustic. If it is the gums which are involved, and some teeth are loose, they should be extracted, for they greatly hinder treatment. If these medicaments do no good, the ulcers are to be cauterized. But this procedure is not necessary for any ulcer on the lips since excision is more convenient. Indeed such an ulcer, except by adopting surgical measures, whether cauterizing or excising, cannot be replenished with new flesh. But the bones of the bums, which are inert, continue bare after the cauterization; for no flesh grows up afterwards. A lentil dressing, however, is to be applied to the parts cauterized until it is rendered as healthy as possible.