Chapter XVI: Preface (6)

As the former kind of distemper afflicts the whole neck, so there is another common one equally dangerous and acute, the seat of which is in the fauces. Our authors call it angina: amongst the Greeks the name varies according to the species. For sometimes there appears neither any redness nor tumour; but the body is dry, the breath is fetched with difficulty, the limbs are relaxed. This they call [CK]synanche(11). Sometimes the tongue and fauces are red and swelled, the voice is stopped, the eyes are turned, the face is pale, and there is a hiccough. That is called quasi synanche[CL]. These symptoms are common to both: the patient is not able to swallow either food or drink; his breathing is obstructed. It is more slight, when there is only a swelling and redness, and the rest of the symptoms do not follow. That they call parasynanche[CM].

[CK] συνάγχη.

[CL] ὡς συνάγχη.

[CM] παρασυνάγχη.

Whatever species it be, if the patient’s strength will allow, blood must be let, although there is not a plethora; the next thing is to give a clyster. A cucurbital also is properly applied below the chin, and about the fauces, in order to evacuate the suffocating matter. Then there is a necessity for moist fomentations. For dry ones cut the breath. Therefore it is fit to apply sponges, which are better dipped now and then in warm oil, than in warm water. And it is of great efficacy in this case too, to put on salt in warm bags. Then it is convenient to make a decoction of hyssop, or cat mint, or thyme, or wormwood, or even bran, or dry figs, in hydromel, and use it as a gargarism; after that to touch the palate either with ox-gall, or the medicine, which is composed of mulberries. Fine flour of pepper is also proper to sprinkle upon it.

If from these things there is little benefit, the last remedy is to make pretty deep incisions under the jaws above the neck, and in the palate about the uvula, or to open the veins, that lie under the tongue, that the distemper may be discharged through these wounds. If this method don’t relieve the patient, we may be assured, that the distemper has got the better of him. But if the disorder is mitigated by them, and his throat is capable of admitting meat and drink, health will be easily recovered again. And sometimes nature assists too, if the disorder passes from a more contracted place to a larger. For this reason, when a redness and swelling begins in the præcordia, it is a sign that the malady has begun to leave the throat.

Whatever has relieved it, he must begin with a moist diet, and especially hydromel; then take soft food, and not acrid, till the fauces return to their former soundness. It is a vulgar opinion, that if a person eats a young swallow, he will be in no danger of an angina for the whole year: and that if it be preserved in salt, to burn it, and powder the coal of it, and give it to drink in hydromel, does service in this distemper. And as this is confidently reported by men of good credit among the common people, and the practice can be attended with no danger, although I have not read of it in medical treatises, yet I thought fit to give it a place in this work.

[Sidenote: _Of a difficulty of breathing._]

There is also a disorder about the fauces, which amongst the Greeks has different names, according to its different degrees. The whole consists in a difficulty of breathing: but while it is moderate, and does not wholly suffocate, it is called dyspnœa[CN]; when it is more severe, that the patient cannot breath without a noise, and quick fetches, asthma[CO]; when the difficulty is so great, that respiration cannot be performed, unless the neck be kept erect, orthopnœa[CP]. The first of these may be of long continuance without endangering life: the two following are commonly acute. These symptoms are common to them all, that by the straitness of the passage, through which the breath comes, a wheezing is occasioned; there is a pain in the breast and præcordia, sometimes also in the shoulders, and that goes and comes; besides these there is a slight cough.

[CN] δύσπνοια.

[CO] ̃ἀσθμα.

[CP] ὀρθόπνοια.

Now the remedy, unless there be some contra-indication, is letting of blood. Nor is that sufficient; but goat’s milk must be given warm to the patient fasting, and if he has no fever, his belly must be opened(12); and sometimes purged; and sometimes a clyster must be given, by which means the body being extenuated, the patient begins to breathe more freely. The head also ought to be placed high on the bed, and the thorax assisted with fomentations, and hot cataplasms, either dry or moist; and after that a malagma applied, or a cerate of the cyprine ointment, or that of iris. Then the patient must drink fasting either hydromel, or a decoction of hyssop, or bruised caper-roots in water. It is proper also to give nitre, or cresses, or garlick, toasted, and then ground and mixed with honey: _another medicine is thus prepared_, honey, galbanum, resin, and turpentine are boiled up together: and when they have come to a consistence, the bigness of a bean is put every day in the mouth, and suffered to lie under the tongue, till it be dissolved: or p. *. & a quadrans of crude sulphur, and p. *. of southernwood are powdered, and mixed in a cyathus of wine, and that is supped warm. And it is not an idle opinion, that a fox’s liver dried ought to be beat, and the powder of it sprinkled upon the drink; or that the lungs of the same animal should be eaten roasted as soon as possible after he is killed, but nothing of iron _used in the dressing_. Besides these, gruels and light food must be used, sometimes also small austere wine, and sometimes a vomit taken. Whatever is diuretic, is also good; but nothing more so, than walking slowly almost to lassitude, much friction, especially of the lower parts, either in the sun or at the fire, and both by the patient himself and by others, till he sweat.

[Sidenote: _Of an ulcer in the fauces._]

In the internal part of the fauces there sometimes happens an exulceration. In this case most people make use of hot cataplasms externally, and moist fomentations. They advise also the warm vapour to be received by the mouth: by which, others say these parts are rendered softer, and more fit to afford entertainment to the disorder, that already possesses them. But if the distemper can be prevented by these methods, those remedies are safe: if there is reason to fear _it is already begun_, they are improper. It is undoubtedly dangerous to rub the fauces, for it ulcerates them. Neither are diuretics good: because as they pass, they may possibly attenuate the phlegm of the part affected, which it is better to repel.

Asclepiades, to whom we are indebted for many useful discoveries, in which I have also followed him, recommends the sipping of very strong vinegar, and asserts, that this without any danger suppresses the ulcers. That may possibly prevent a flux of blood, but cannot heal the ulcers. A more proper application is lycium(13), which the same author also equally approves; or the juice of leek, or horehound, or sweet almonds rubbed with tragacanth, and mixed with passum, or lint-seed bruised, and mixed with sweet wine. The exercise also of walking and running is necessary. And smart friction is to be used from the breast downwards to all the inferior parts.

The food ought to be neither too acrid, nor rough: honey, lentils, tragum, milk, ptisan, fat flesh, and especially leeks, and whatever is mixed with the latter. The drink ought to be as little as possible, water may be given, either pure, or boiled to a decoction with a quince or dates. Also mild gargarisms: but if these are not successful, repellent ones are good.

This disease is not acute, and yet may not continue long: but requires a speedy cure, lest it turn very severe and tedious.

[Sidenote: _Of a cough._]

A cough, which is contracted in many different ways, is generally a troublesome concomitant of an exulceration of the fauces; and in this case, when the fauces are cured, the cough ceases. Yet it is sometimes found by itself without any other distemper: and when it becomes inveterate, it is hardly possible to remove it entirely. And sometimes it is dry, sometimes it either generates or discharges phlegm.

In this it is proper to drink hyssop every other day; to keep in the breath and run, but by no means in dusty places; and to read aloud, which at first is obstructed by the cough, but afterwards overcomes it; then to walk; then to use also those exercises that employ the hands, and to rub the breast for a long time: after these to eat three ounces of the mellowest figs stewed over the fire.

Besides if it be moist, strong frictions are good with some heating medicines, the head being briskly rubbed at the same time; also cucurbitals used to the breast, mustard applied to the external part of the fauces, till it be a little ulcerated; the drink may be prepared from mint, and sweet almonds, and starch; and beginning with dry bread he may proceed to any other light food.

But if it be a dry cough, when it is most severe, taking a cyathus of austere wine relieves; provided that be not oftener done than three or four times after proper intervals. It is likewise necessary to swallow a little of the best laser, to take the juice of leeks or horehound, to lick squils, to sup vinegar of squills, or at least sharp vinegar, or two cyathi of wine with a clove of bruised garlick infused in it.

In every cough it does service to take journies, long voyages, and to live near the sea, and to swim. The diet must be sometimes soft, as mallows and nettles; sometimes acrid, as milk boiled with garlick; gruels, to which laser has been added, or such as have had leeks boiled in them, till they have lost all their verdure. A sorbile egg also with an addition of sulphur may be supped; for drink warm water may be taken first, then alternately, some days water, and other days wine.

[Sidenote: _Of a spitting of blood._]

A spitting of blood may strike a greater terror. But that sometimes is less, and sometimes more dangerous. For it issues sometimes from the gums, sometimes from the mouth; and indeed from the latter very plentifully at times, but without a cough, without an ulcer, or any distemper of the gums, and without expectorating any thing; but breaks out from the mouth in the same manner, as from the nose. And sometimes pure blood is discharged, at other times something like water, in which fresh meat has been washed. Sometimes it comes from the upper part of the fauces, which may happen by means of an exulceration in that part; or when it is not ulcerated, either from the mouth of some vein opened, or tubercles rising there, and discharging the blood. When this is the case, neither meat nor drink do harm, nor is any thing expectorated, as from an ulcer. But sometimes, when the throat and wind-pipe are ulcerated, a frequent cough forces out blood too. Neither is it uncommon for it to come either from the lungs, or the breast, or the side, or the liver. Women, whose menses are suppressed, often have these spittings. And medical writers say, that blood is discharged either by the erosion, or the rupture of some part, or the dilatation of the mouth of some vein. The first they call diabrosis[CQ], the second rhegmochasmus[CR], the third anastomosis[CS]. The last does least hurt; the first is most dangerous. And it often happens, that the blood is followed by pus.

[CQ] διάβρωσις.

[CR] ῥηγμοχασμὸς.

[CS] ἀναστόμωσις.

Now sometimes stopping the blood is alone sufficient to effect a cure. But if ulcers have followed, if pus, if there be a cough, diseases are formed, which differ in nature and danger according to the parts they possess. If blood only is discharged, both the remedy is easier, and the termination of the distemper quicker. And we ought not to be ignorant, that a moderate discharge of blood, is not hurtful to those, who are accustomed to hæmorrhages, or such, whose spine or hips are pained, or to any after violent walking or running, provided there be no fever: and that passing off in the urine, it removes even the lassitude. And that it is not terrible in the case of a person, who has fallen from a height, if nothing else appears uncommon in his urine. That neither is a vomiting of blood dangerous, although it return, if opportunity has been allowed to strengthen and fill up the body beforehand: and in general that no such discharge can hurt, when it happens in a strong body, and is neither excessive, nor raises a cough, nor heat. These observations are universal. Now I shall return to those particular places, which I have mentioned.

If it comes from the gums, it is sufficient to chew purslane; if from the mouth, to hold pure wine in it; if that is not effectual, vinegar. If notwithstanding these it breaks out with violence, because it may waste a person, it is most proper to divert its force by applying a cucurbital to the back of the head, and making an incision in the skin; if this happens to a woman, whose menses are stopped, to apply the cucurbital to her groin, with scarification.

But if it has proceeded from the fauces, or the more internal parts, there is more to be feared, and greater care must be taken in the cure. Blood must be let: and if notwithstanding that, it breaks out from the mouth, the operation must be repeated a second, and a third time, and every day a little taken away: the patient ought immediately to sup either vinegar, or the juice of plantain, or leek with frankincense(14): and some sordid wool dipped in vinegar and squeezed, should be applied externally upon the place, which is diseased, and it must be cooled now and then with a sponge. Erasistratus made many ligatures in the legs, and thighs, and arms of such patients. Asclepiades was so far from thinking this useful, that he even judged it hurtful. But a number of experiments gives proof of its often answering very well.

Nevertheless there is not a necessity for making ligatures in many places: but it is sufficient to do it below the groin, and above the ancles, and near the top of the shoulders, and fore arms. Then if the patient have a fever, gruel must be given; and for drink some astringent decoction. But if there is no fever, either washed alica, or bread dipped in cold water, and a soft egg too may be given; and for drink either what was above-mentioned, or sweet wine, or cold water. But in the allowance of drink we must remember, that thirst is serviceable in this disorder.

Besides these, rest, security from apprehensions, and silence are necessary. The patient’s head, when he lies, should also be high, and it is proper to clip it close. The face is to be often bathed with cold water. But wine, the bath, venery, oil amongst meat, all acrid things, warm fomentations, a hot and close room, many cloaths thrown upon the body, are all prejudicial; also frictions, unless when bleedings have entirely ceased. Then indeed he may begin with the arms and legs, but not touch the chest. In this case he should reside near the sea-coast in the winter time, and in the inland places in the summer.

CHAP. V.

OF THE DISORDERS OF THE STOMACH, AND THEIR CURE.

The stomach(15) is below the fauces; to this many tedious disorders are incident. For sometimes a great heat affects it, sometimes a flatulency, or an inflammation, or an exulceration; at other times phlegm or bile attacks it. But the most frequent disease is a relaxation: nor is there any thing from which the stomach either suffers more itself, or more affects the whole frame.

As its disorders are different, so are the remedies. Where it is distressed with heat, it must be embrocated now and then with vinegar and rose oil, and a powder(16) with oil applied, and such cataplasms as at the same time both repel and soften. Cold water may be given to drink, unless there be some particular reason against it.

When there is a flatulency, the application of cucurbitals does service, and there is no necessity for scarification. Dry and warm fomentations, but not very strong, are serviceable. Abstinence must be enjoined at times. To drink wormwood, or hyssop, or rue fasting is good. Exercise must be used, at first gentle, and afterwards stronger; especially such as may move the superior parts, which kind is most proper in all disorders of the stomach. Exercise should be followed by unction and friction; also the bath sometimes, but seldom, and sometimes clysters; after these warm food, and not flatulent; and in the same manner warm drink, first water, afterwards when the inflation has subsided, austere wine. This rule must be laid down in all distempers of the stomach, that by whatever means any patient has been recovered, he must pursue the same method when he is well: for his weakness returns, unless health be preserved by the same regimen, by which it was restored.

But if there be any inflammation, which is commonly followed by a swelling and pain, the chief remedies are, rest, and abstinence, sulphurated wool(17) applied round it, the use of wormwood fasting. If there is a burning heat in the stomach, it must be embrocated now and then with vinegar and rose-oil; and then food must be taken sparingly; and the external applications must be such, as both repel and soften; then withdrawing these, warm cataplasms of meal must be used, to discuss the remains of it; a clyster must be given now and then; exercise must be used, and a fuller diet.

But if the stomach is infested with an ulcer, the same course almost must be pursued, as has been prescribed in ulcerated fauces. Exercise and friction of the lower parts must be practised. Light and glutinous food must be used, but not to satiety. Every thing acrid and acid is to be avoided. If there is no fever, sweet wine may be used, or if that inflates, at least mild; but neither very cold, nor too hot.

If the stomach is loaded with phlegm, a vomit is necessary, sometimes fasting, sometimes after meat. Exercise, gestation, sailing, friction, are good. Nothing is to be eaten or drunk, but what is warm; only avoiding such things, as usually generate phlegm.

It is a more troublesome disorder, where the stomach is vitiated with bile. Those that are thus affected, usually at the interval of some days throw it up, and indeed, which is worst of all, of a black colour. It is proper to give such patients clysters, and potions of wormwood; gestation, and sailing are necessary, and vomiting by sea sickness, if it can be procured; crudity must be avoided; food used easy of concoction, and not ungrateful to the stomach, and austere wine.

The most common and worst disorder of the stomach is a relaxation, that is, when it is not capable of retaining food, and the body ceases to be nourished, and thus is wasted by a consumption. The bath is very hurtful in this species. Reading, and exercising of the superior parts are necessary, also unctions and frictions; then to have cold water poured all over the body, and to swim in cold water, and to lay the stomach itself under canals, and more especially that part below the shoulders, which is opposite to the stomach; to stand in cold and medicinal springs is a salutary practice, such as those of Cutiliæ(18) and Subruinæ; food is also to be used cold, and such rather, as is of difficult concoction than what is easily corrupted: for this reason most people, that can concoct nothing else, concoct beef. Whence we may infer, that neither birds, nor venison, nor fish ought to be given, except the harder kinds. Cold wine indeed is fittest to drink, or at least the strong well warmed, particularly the Rhetic or Allobrogic(19), or any other, which is both austere, and seasoned with resin; if that is not to be had, the roughest possible, and especially Signine(20).

If the food does not stay upon the stomach, water is to be drunk, and a plentiful vomiting procured; and food must be given a second time, and then cucurbitals are to be applied two fingers breadth below the stomach, and kept there for two or three hours. If there is both a vomiting and pain at the same time, sordid wool, or sponge dipped in vinegar, or a cooling cataplasm, must be applied to the stomach. The arms and legs must be rubbed briskly, but not long, and heated.

If the pain is more severe, the cupping must be performed four fingers below the præcordia; bread dipped in cold vinegar and water must be given immediately; if it has not staid, then after the vomiting, some light thing not ungrateful to the stomach; if even that is not retained, a cyathus of wine every hour, till the stomach be settled. The juice of radishes is also a powerful medicine; but a stronger is the juice of the acid pomegranate, with an equal quantity of the juice of the sweet pomegranate, and an addition also of the juice of endive and mint, but the least proportion of this; with which it is very proper to mix as much cold water, as equals the quantity of them all together. For that is more efficacious for composing the stomach than wine. A vomiting, which comes of itself, is to be stopped, although there be a nausea.

But if the food has grown sour or putrid within the stomach, both which accidents are known by the eructations, it must be evacuated; and the stomach must be immediately recruited by taking the same kind of food, that I have just mentioned. When the present danger is removed, we must return to those things which have been prescribed before.

CHAP. VI.

OF PAINS OF THE SIDES, AND THEIR CURE.

The stomach is surrounded by the sides; and in these there happen sometimes violent pains. They arise either from cold, or a blow, or from excessive running, or from a distemper. But sometimes the disorder goes no farther than a pain; which is sometimes slowly, and sometimes quickly removed. At other times it grows extremely dangerous; and there arises an acute distemper, which by the Greeks is called pleuriticus[CT]. To this pain of the side is added a fever and cough: and by the last is expectorated, if the distemper be tolerable phlegm; if severe, blood. Sometimes also the cough is dry, and brings up nothing, and this is worse than the first, but more tolerable than the second.

[CT] πλευριτικὸς. Our author uses here the masculine adjective to
the Latin word _morbus_.

Now the cure of a violent and recent pain is letting of blood. But if the case is more slight or of a longer standing, that remedy in the first is needless, and for the other is too late; and recourse must be had to cupping, first making an incision in the skin. Mustard with vinegar is also proper to apply upon the breast, till it produce ulcuscles and pimples; and after that, a medicine which can derive the humour thither. Besides these it is fit first to put sulphurated wool round the side; and then when the inflammation has a little abated, to make use of dry and warm fomentations. From these a transition is made to malagmas.

If an inveterate pain still continues, in the last place it is discussed by the application of resin. Warm food and drink must be used, and cold avoided. In the mean time, it is not amiss to rub the extremities with oil and sulphur: if the cough has abated to read softly: and by that time to take both acrid food and stronger wine. Such then are the prescriptions of the physicians. But without these it is said, that our peasants find it sufficient for their cure to drink germander in water.

These rules are common in every pain of the side: the cure is more difficult, if the distemper has grown acute. In such a case, besides what has been already directed, these cautions are to be observed: that the food be extremely thin and mild, especially gruel, and particularly that, which is made of ptisan; or chicken broth with leeks, and that is not to be given till the third day, and with this condition then, that the strength will admit of it: and for the drink a decoction of hyssop, or rue in hydromel. Now the seasons for giving these will appear from the consideration of the fevers increasing or abating, so that they be given in the greatest remission. At the same time however we should know, that in a cough of this kind we are not to allow the fauces to be dry. For often, where there is nothing to be expectorated, it continues and suffocates: for which reason I said, that a cough, which evacuates nothing, was still worse than one, which brought up phlegm. But the distemper itself in this case will not allow wine, which we prescribed before: instead of it the cream of ptisan is to be used.

As the patient is to be supported in the violence of the distemper by these things; so when it has abated a little, a fuller diet and also some wine may be allowed; provided nothing be given, which may either refrigerate the body, or irritate the fauces. If the cough remains upon the recovery, it will be proper to intermit for one day, and the day after to take a little more wine with meat. But if the cough still prevails, it will not be amiss, as above directed, to drink some cyathi of wine. But in this kind of disorder sweet wine, or at least mild is more proper. If it grows inveterate, the body must be strengthened by a robust diet.

CHAP. VII.

OF A PERIPNEUMONY, AND ITS CURE.

From the frame of the body we must proceed to the bowels; and first of all to the lungs. Whence a violent and acute distemper arises, which the Greeks call peripneumonia[CU]. The nature of it is this. The whole lungs are affected. And their disorder is followed by a cough bringing up bile, or pus, a weight of the præcordia and the whole breast, difficulty of breathing, violent fevers, continual watching, prostration of appetite, and a consumption. This kind of distemper is attended with more danger than pain.

[CU] περιπνευμονία.

It is fit, if the strength will admit of it, to let blood: if not, to make use of dry cupping to the præcordia; and if the patient can endure it, by gestation to dissipate; if he cannot bear that, to move him gently within the house; to give him in drink hyssop boiled with a dry fig; or a decoction of hyssop or rue in hydromel; to use friction longest upon the shoulders, a little shorter on the arms, and feet, and legs, gentle over the lungs, and to do this twice every day.

As to diet, he ought never to have salt things, nor acrid, nor bitters, nor astringents; but what is of the milder kind. Therefore at the beginning is to be given gruel either of ptisan, or alica, or rice, in which recent fat has been boiled; along with it a sorbile egg, pine-nuts, bread with honey, or washed alica with hydromel. After that, not only pure water must be allowed to drink, but hydromel too egelid; or if it be the summer time, even cold; unless there be some particular reason against it. It is sufficient to give these every other day, when the distemper is increasing.

When it ceases to increase, as much as the circumstances will allow, he must abstain from every thing, except egelid water. If the strength fails, it must be supported by hydromel. And against the pains the application of hot fomentations is good, or such things as both repel and soften. It does good also to lay salt ground fine upon the breast, mixed with cerat; because it corrodes the skin gently, and thus diverts the course of the matter, which oppresses the lungs. Some malagmas too of such things as make a derivation are useful. And it is not improper, during the violence of the distemper, to keep the windows close upon the patient: when it has a little abated, three or four times a day to open them a little and let in fresh air. Then when he begins to recover, for several days to abstain from wine: to use gestation and friction; to add to the gruels and former diet, amongst the pot-herbs leeks; of flesh, the heels, and trotters; and small fish; so that for a long time nothing else be taken, but what is soft and mild.

CHAP. VIII.

OF THE DISEASE OF THE LIVER, AND ITS CURE.

The distemper of another bowel, that is the liver, in like manner happens to be sometimes long and sometimes acute. The Greeks call it hepaticus[CV]. There is a violent pain to the right below the præcordia; and the same reaches to the right side, and to the clavicle, and the shoulder of the same side: sometimes also the right hand is benumbed, and there is a strong shuddering. When it is severe, bile is vomited; sometimes the hiccough almost suffocates. And these are its symptoms, when it is acute. But it is chronical, when there is a suppuration in the liver; and the pain sometimes ceases, at other times increases; on the right side the præcordia are hard and swelled; after eating, the difficulty of breathing is increased. There is also a sort of paralytic relaxation of the jaws. When the disorder has continued long, the belly, and legs, and feet swell; the breast, and arms, and the parts about both clavicles are emaciated.

[CV] ἡπατικὸς the adjective is used here in the same manner, as
pleuriticus before.

In the beginning, the best thing is to let blood: then the belly must be opened; if that cannot be done otherwise, by means of black hellebore. Cataplasms are to be applied externally; first such as may repel, then hot ones, which can discuss; to these it is proper to add iris, or wormwood; after them a malagma. The diet should be gruels, and all the food should be warm, not very nourishing, and generally such as is proper in a peripneumony; and those besides that are diuretic, and such drink as will promote the same end. Thyme is good in this distemper, savory, hyssop, catmint, sweet marjoram, sesamum(21), bay-berries, pine-flowers, blood herb, mint, the pulp of a quince, the fresh and raw liver of a pigeon. Of these some may be eaten alone, and others added to the gruel, or the drinks, but in small quantities; and it is not improper to swallow every day a catapotium composed of powdered wormwood, honey, and pepper. But all cold things must be refrained, for nothing hurts the liver more. The extremities must be rubbed. All labour and violent motion avoided: even the breath must not be long kept in. Anger, flutter, lifting any thing weighty, throwing, running are hurtful. Pouring water plentifully upon the body does good, if it be the winter time, hot; if the summer, tepid; also plentiful unction, and sweating in the bath.

If the liver is oppressed with a vomica, the same method must be followed as in other internal suppurations. Some even make an incision over it(22), and cauterize the vomica itself.

CHAP. IX.

OF THE DISORDER OF THE SPLEEN, AND ITS CURE.

But when the spleen is affected, it swells, and together with it the left side, which is both hard and resists pressure; and the belly is tense: there is some swelling also in the legs. Ulcers either do not heal at all, or at least scarcely cicatrize. In walking briskly or running, there is a pain, and some difficulty.

This malady is increased by rest. Therefore there is a necessity for exercise and labour: care being taken however that these be not carried too far, lest they produce a fever. Unction and friction, and sweatings are necessary. Every thing sweet is hurtful; also milk, and cheese. Acids are most agreeable; therefore it is good to sup sharp vinegar alone, and more especially that, which is tinctured with squills. Salt fish is to be eaten, or olives in hard brine; lettuce in vinegar; endive also, and betes in the same manner; and mustard, wild radish, and parsnips: of animal food the heels, and cheeks, lean birds, and venison of the same kind. A decoction of wormwood in water may be given for drink fasting: but after meat the water, in which a smith has often extinguished hot iron, for this very powerfully contracts the spleen: the discovery of which property we owe to an observation made upon animals bred in the houses of smiths, that they have very small spleens. Small and austere wine may also be given; and every thing in food or drink, which is diuretic: of great efficacy for that purpose is trefoil seed, or cummin, or smallage, or serpyllum, or cytisus(23), or thyme, or hyssop, or savory: for these seem very proper to promote a discharge of the humour from it. It is good also to eat of the spleen of beef: and rocket and cresses are remarkable for attenuating the spleen. There must be some external application to ease the pain. Such is composed from a kind of acorns(24) used by the Unguentarii, which the Greeks call myrobalani[CW]: or the seeds of lint, and cresses mixed with wine and oil: also of green cypress and dry figs: or of mustard and a fourth part of the suet of a goat’s kidneys, and this is rubbed in the sun and applied immediately. And the caper too is fit for this disorder in many forms; for it may both be eaten itself with meat, and its pickle with vinegar supped. Moreover the root powdered or its bark with bran, or the caper itself powdered, and mixed with honey, may be applied externally. There are also malagmas calculated for this purpose.

[CW] μυροβάλανοι.

CHAP. X.

OF THE DISEASES OF THE KIDNEYS, AND THEIR CURE.

But where the kidneys are affected, the disorder continues long. It is worse if attended with a frequent bilious vomiting. It is proper to rest; to lie soft; to open the belly; and even to give a clyster if it will not do without it; to sit down often in warm water; to take neither meat nor drink cold; to abstain from every thing salt, acrimonious, acid, and fruit of the apple kind; to drink freely; to add sometimes to the meat, and sometimes to the drink, pepper, leeks, ferula(25), white poppies, which usually cause a great discharge of urine from the kidneys.

If they be ulcerated, and the ulcers are to be cleansed, the remedy is sixty seeds of cucumber blanched, fifteen kernels of the wild pine, as much anise as can be held betwixt three fingers, a little saffron; all these powdered, and divided into two draughts of mulse.

If the pain only is to be relieved, _the medicine is_ thirty seeds of cucumber, and twenty of the kernels mentioned before, five sweet almonds, a little saffron powdered, and given to drink with milk. And besides these it is proper to apply some malagmas; especially such as are fit for drawing out moisture.

CHAP. XI.

OF THE CHOLERA, AND ITS CURE.

From the bowels we proceed to the intestines, which are obnoxious both to acute and chronic distempers. And first of all we shall make mention of the cholera; because that seems at once to affect equally the stomach and intestines. For at the same time there is both a purging and vomiting: besides these, there are flatulencies, the intestines are racked, bile is forced both upwards and downwards, first resembling water, then as if fresh meat had been washed in it, sometimes white, sometimes black, or variously coloured. Upon this account the Greeks gave this distemper the name of cholera[CX]. And besides what we have taken notice of already, the legs and hands too are often contracted, thirst torments, and there are faintings. Where all these concur, it is not to be wondered, if the patient die suddenly. And nevertheless there is no distemper obviated with less trouble.

[CX] χολέρα.

Wherefore upon the first appearance of these symptoms it is proper to drink plenty of tepid water and to vomit. That scarce ever fails to vomit: but although it miscarries in that, yet it is of use to mix new matter with the corrupted; and it is a step in the recovery, if the vomiting be stopped. If that happens, all drink must immediately be abstained from. But if there be bloody stools, it is fit to bathe the stomach with something cold, or if the belly be pained, with the same egelid, the belly itself being assisted by medicines moderately warm. But if the vomiting, and purging, and thirst, all at once torment greatly, and what is vomited is yet somewhat crude, it is not a proper time to give wine: water must be given, and that not cold, but rather egelid. And penny-royal with vinegar must be applied to the nostrils, or polenta sprinkled with wine, or mint, or what is _comfortable or refreshing_ to nature(26).

But when the crudity is removed, then there is more apprehension of the person fainting. Wherefore at such time recourse must be had to wine: which ought to be small, aromatic, and mixed with cold water, either with the addition of polenta, or a piece of bread, which also it is proper to eat: and as often as the stomach or belly has discharged, so often to recruit the strength by these means. Erasistratus directed to mix at first three or five drops of wine with every draught, and then to add more wine by degrees. He was in the right, if he gave wine from the beginning, and then found reason to fear a crudity: but if he imagined a great weakness could be relieved by three drops of wine, he was mistaken.

But if the patient be empty, and his legs contracted, wormwood must be given to drink now and then. If the extremities be cold, they must be anointed with hot oil, with the addition of a little wax; and cherished with hot fomentations. If even by these relief has not been procured, a cucurbital must be applied externally over the stomach itself, or mustard put upon it. When that is composed, it is proper for him to sleep; and on the day following to abstain from drinking; on the third day to go into the bath; to recruit himself gradually by food; and sleep, if he can rest easily; and to avoid fatigue and colds. If after the suppression of the cholera a feverishness remains, it is necessary to give a clyster, then to take food and wine. Now this distemper is both acute, and so much seated betwixt the intestines and the stomach, that it is hard to say, to which it peculiarly belongs.

CHAP. XII.

OF THE COELIAC DISTEMPER OF THE STOMACH, AND ITS CURE.

At the lower orifice of the stomach is seated a distemper, which is usually long, called cœliacus[CY] by the Greeks. In this the abdomen grows hard, and is pained; there is no passage by stool, and not so much as wind can escape; the extremities grow cold; and there is a difficulty in breathing.

[CY] κοιλιακὸς.

It is most proper in the beginning to apply warm cataplasms over all the belly to ease the pain; after meat to vomit, and thus to empty the belly; then on the following days to apply cucurbitals (without making any incision) to the belly and hips: to loosen the belly itself by giving milk and salt wine cold; green figs also, if it be the season for them; with this caution however, that neither the allowance of food nor drink be given all at once, but gradually. Wherefore at intervals it is sufficient to take two or three cyathi, and food in proportion to this. And a cyathus of milk mixed with an equal quantity of water, and so given, does very well. Warm and acrid food is proper; so that even bruised garlic with milk is no bad mixture.

In a little time the case requires gestation, and especially sailing; to be rubbed three or four times a day with oil and nitre together; to have warm water poured on after meat; then to apply mustard to all the parts of the body, except the head, till they be corroded and grow red; and more especially if the body be firm and strong. Then there must be a gradual change to such things as bind the belly. Strong roasted flesh is to be given, and such as is not easily corrupted: boiled rain water may be given to drink, to the quantity of two or three cyathi at a time.

If the disorder be of long standing, it is proper to swallow the bulk of a pepper-corn of the best laser; and every other day to drink wine or water, at times to sup single cyathi of wine, taking food between; to give a clyster of rain-water egelid; and more especially if the pain continues in the lower parts.

CHAP. XIII.

OF THE DISTEMPER OF THE SMALL GUT, AND ITS CURE.

To the intestines themselves two distempers are peculiar; one of which is in the small, and the other in the large gut. The first is acute: the other may continue long. Diodes the Carystian called the distemper of the small intestine chordapsus[CZ], that of the larger he named ileus[DA]. But I observe, that most people now call the first ileus, and the other colicus[DB]. Now the first occasions a pain, sometimes above, sometimes below the navel. In either place there is an inflammation: neither the excrements nor wind can pass downwards. If the upper part is affected, the food, if the lower, the excrements are returned by the mouth: in either case there is danger; which is increased, if the vomiting be bilious, fetid, or various, or black.

[CZ] χόρδαψος.

[DA] εἰλεὸς.

[DB] κολικὸς.

The cure is letting of blood; or applying cucurbitals in several places, but not to make incisions of the skin every where; for that is sufficient in two or three places: from the rest it suffices to evacuate air. Then it is proper to observe, where the seat of the disorder is; for there is commonly a swelling over it. And if it be above the navel, a clyster signifies nothing: if it is below, it is most proper, in the opinion of Erasistratus, to give clysters sometimes; and this remedy is often of very great service in these parts. The liquor proper for this is strained cream of ptisan, with the addition of oil and honey without any thing else. If there is no swelling, it is most proper to apply the two hands to the top of the belly, and to bring them down gradually; for thus the seat of the disorder will be discovered, as it will necessarily resist the pressure: and from thence it may be determined, whether it is fit to use clysters or not.

The following remedies are general: to apply hot cataplasms from the breasts as far as the groin and spine, and to change them often; to rub the legs and arms; to dip the patient all over in warm oil. If the pain does not abate, to give even a clyster of three or four cyathi of warm oil. When by these means we have procured a passage for the wind downward, to give tepid mulse to drink, but in small quantity, for before great care must be taken that he drink nothing: if that has succeeded well, to add gruel.

When the pain and feverishness have ceased, then we may venture upon a fuller diet; but neither flatulent nor strong, lest the intestines yet weak be hurt. Nothing should be drunk but pure water; for every thing either vinous or acid is prejudicial in this distemper. And even afterwards it is proper to avoid the bath, walking, gestation, and other motions of the body: for the disease is apt to return upon slight occasions; and cold, or any violent motion, before the intestines have fully recovered their strength, brings it back again.

CHAP. XIV.

OF THE DISEASE OF THE LARGE INTESTINE, AND ITS CURE.

That distemper, which is seated in the large intestine, principally affects that part, where I mentioned the cæcum to be situated. There is a violent inflation; vehement pains, especially on the right side: the intestine seems to be inverted, which almost forces out the wind. In most people it comes after colds and crudity, then ceases; and while they live, it often returns, and torments, but does not shorten life.

When this pain has begun, it is proper to apply dry and warm fomentations, but first of all mild, and then stronger; and at the same time by friction to make a derivation of the matter to the extremities, that is, the legs and arms: if it is not removed, to make use of dry cupping, where the pain is. There is also a medicine calculated for this distemper, which is called colicon[DC]. Cassius claimed the glory of this invention. It has the best effect given by way of potion; but even externally applied by dispersing the wind it eases the pain.

Neither food nor drink should be given, till the pain be over. The regimen for such patients I have already mentioned(27). The composition, which is called colicon, consists of the following ingredients: of costus, anise, castor, each p. * iii. parsley, p. * iv. long pepper and round, each p. * v. tears of poppy, round cyperus, myrrh, nard, of each p. * vi. these are incorporated in honey. Now this may be both swallowed alone, and taken with warm water.

CHAP. XV.

OF A DYSENTERY, AND ITS CURE.

The next disorder of the intestines to this is by us called tormina, and by the Greeks dysenteria[DD]. The intestines are ulcerated within; blood flows from them; and together with that either excrements, which are always liquid, or something mucous are discharged; sometimes along with it, something fleshy is excerned. There is a frequent desire of going to stool, and a pain in the anus: with this pain a very small quantity is excreted; and even by that the pain is increased; and after some time it abates, and there is a small interval of ease; sleep is interrupted; a slight fever comes on; and when this distemper grows inveterate, it either kills a man in time, or though it terminates at last, torments him long.

[DC] κολικὸν.

[DD] δυσεντερία.

The first rule to be observed, is to rest; for all kinds of agitation ulcerate: then to sup a cyathus of wine fasting, with the bruised root of cinquefoil; to apply restringent cataplasms over the belly, which is not expedient in the abovementioned disorders of this part; and as often as he has gone to stool, to wash his lower parts with a warm decoction of vervains; to eat purslane, either boiled or preserved in strong brine; to take such food and drink as bind the belly.

If the distemper is of longer standing, it is fit to administer a tepid injection of the cream of ptisan or milk, or melted fat, or deer’s marrow, or oil, or butter with rose oil, or the raw whites of eggs with the same, or a decoction of lintseed; or if there is no sleep, the yolks with a decoction of rose leaves: for these ease the pain, and render the ulcers milder, and are especially useful, if the disorder be also attended with a nausea. Themison asserts, that the roughest brine should be used in the same manner.

The food ought to be such, as is gently astringent to the belly. But diureticks, if they have their natural effect, are useful by making a derivation of the humour: if they do not gain that point, they increase the malady; therefore they must not be administered, but to such, as they usually affect in that way easily. If there be a fever, pure warm water must be given to drink, or such as has an astringent quality: if that is not to be got, light, austere wine. If for several days these remedies have done no good, and the distemper is now inveterate, drinking of water pretty cold binds the ulcers, and begins a recovery. But when the belly is once bound, they must immediately return to warm drink.

Sometimes also there happens to be a discharge of putrid sanies, which has an intolerable stench: and sometimes pure blood comes away. In the first of these cases, the belly should be washed with hydromel; after that the injections above prescribed must be used. And a piece of minium(28) powdered with a hemina of salt, is powerful against a gangrene of the intestines: or they may be mixed with water, and given for a clyster. But if pure blood is evacuated, the food and drink ought to be astringent.

CHAP. XVI.

OF A LIENTERY, AND ITS CURE.

From a dysentery sometimes proceeds a lientery, in which the intestines can retain nothing, and whatever is taken they presently pass unconcocted. This sometimes is tedious, and sometimes carries off people quickly.

Now in this disorder it is proper to administer astringents, to enable the intestines to retain. Wherefore mustard should be applied over the breast; and when the skin is ulcerated, a malagma to discharge the humour: and let the patient sit down in a decoction of the vervains; and take such food and drink as bind the belly, and have cold water poured over him.

Care should be taken, however, that upon the application of all these remedies at once, there do not arise a malady on the contrary extreme by means of immoderate flatulencies. Wherefore the intestines will require to be strengthened gradually by the daily addition of somewhat. And as in every flux of the belly, so in this, it is particularly necessary to go to stool not as often as there is a motion, but as often as there is an absolute necessity, that this very delay may bring the intestines to a habit of bearing their burden.

There is another direction, which belongs equally to all similar disorders, to be principally regarded in this; that since most of the things proper for the disorder are disagreeable to the palate, such as plantain, and bramble berries, and whatever is mixed with pomegranate bark, such of these are to be chosen as the patient prefers. Then if he has an aversion to them all, let something less beneficial, but more grateful, be given at times to excite his appetite. Exercise and friction are necessary also in this distemper: and with these, according to Hippocrates, the heat of the sun, the fire, the bath, and vomiting, even by white hellebore, if the other means for that purpose prove unsuccessful.

CHAP. XVII.

OF WORMS IN THE BELLY, AND THEIR CURE.

Worms too sometimes infest the belly; and they are sometimes discharged downwards, at other times, which is more disagreeable, from the mouth: and sometimes we observe them to be broad, which are the worst kind, and sometimes round.

If they are broad, a decoction of lupines, or mulberry bark in water may be given to drink: or either hyssop, or an acetabulum of pepper powdered, and a scammony with water. Or let the patient on one day, after eating plentifully of garlick, vomit; and the day following take a handful of the small stalks of the pomegranate, and boil these, after bruising them, in three sextarii of water, till a third part remains; let him add to this a little nitre, and drink it fasting: then after the interval of three hours let him take two draughts of this decoction, or the same with the addition of hard brine; then go to stool, having hot water in a vessel below him.

If again they are round, which chiefly molest children, both the same medicines may be given, and something more gentle, as the seed of nettles powdered, or of cabbage, or cummin with water, or mint with the same, or a decoction of wormwood, or hyssop in hydromel, or the seed of cresses powdered with vinegar. It is good also to eat lupines, and garlick, or to have clysters of oil administered.

CHAP. XVIII.

OF A TENESMUS, AND ITS CURE.