Chapter XVII: Preface (7)

There is also another distemper, which is more mild than any I have been treating of, called by the Greeks tenesmus[DE]. This ought to be ranked neither with the acute nor the chronic disorders, since it may be easily removed, and by itself never proves mortal. In this, as well as in a dysentery, there is a frequent motion to stool; and equal pain, when any thing is excreted. Something like to phlegm and mucus is discharged, sometimes too, slightly tinctured with blood; but with these is sometimes mixed what has been duly concocted from the food.

[DE] τεινεσμὸς.

It is proper to sit down in warm water; to apply something to the anus itself pretty often. For which purpose many medicines are suitable: butter with oil of roses; acacia dissolved in vinegar; that plaister, which the Greeks call tetrapharmacum(29), melted with rose oil; alum wrapped in wool, and thus applied; and the same injections which relieve in the dysentery; the same decoction of vervains to foment the lower parts. Every other day, water and light austere wine are to be drunk alternately. The drink ought to be egelid, and nearer to cold: the diet of the same nature as we have directed for a dysentery.

CHAP. XIX.

OF A SIMPLE PURGING, AND ITS CURE.

A purging, while recent, is still a more gentle distemper, in which the discharge is both liquid, and more frequent than ordinary. In this the pain is sometimes tolerable, at other times very severe; and that shews a greater violence of the disease. But for the belly to be loose for one day is often salutary; and even for several days, provided there be no fever, and it cease in seven days. For thus the body is cleansed; and what would have hurt internally, is advantageously evacuated. But the continuance of it is dangerous; for sometimes it brings on a dysentery, and febriculas, and wastes the strength.

It is sufficient to rest the first day; and not to stop the flux of the belly. If it has ceased spontaneously, to make use of the bath, to take a little food: if it continues, to abstain, not only from food, but from drink also. On the day following, if the belly still be loose, to continue at rest; and take a very little astringent food. On the third day to go into the bath; to rub every part of the body briskly, except the belly; to expose the loins and shoulders to the heat of the fire; to take food, but such as is astringent to the belly; a little wine undiluted. If on the day following the purging shall continue, to eat more, but likewise to vomit. Upon the whole, to struggle against it by thirst, fasting, and vomiting, till it ceases: for it is scarcely possible, that after this care the belly should not be bound.

There is another method, when one has a mind to stop the flux, to take supper, and then to vomit; on the day after, to rest in bed; to be anointed in the evening, but gently; then to eat half a pound of bread in neat Aminaean wine; next, something roasted, and especially a bird; and afterwards to drink the same wine mixed with rain water; and to continue in this course till the fifth day, and vomit again. Asclepiades, contrary to former authors, affirmed, that the drink ought always to be cold, and indeed as cold as possible. My opinion is, that every one may determine by his own experience, whether he should use it hot or cold.

But it sometimes happens, that this disorder, neglected for several days, may be more difficult to cure; it is proper to begin with a vomit; then on the evening of the following day, to be anointed in a tepid place; to eat moderately, and drink wine undiluted and as rough as can be got; to keep rue with cerate applied over the belly. And in this state of the body, neither walking nor friction are proper: riding in a chariot is good, on horseback much better; for nothing strengthens the intestines more.

If medicines are to be made use of, those composed of the apple kind are most suitable. At the time of vintage, pears and crab apples are to be thrown into a large vessel; if these cannot be had, green tarentine pears, or signine, the apples called scandiana or amerina, or pears called myrrhapia(30); and to these quinces must be added, and pomegranates with their bark, service fruit, and, which are more used, the torminalia, and let these take up the third part of the jar; after that it must be filled with must, and boiled till the whole contents being dissolved unite into one mass. This is not unpleasant to the taste; and whenever the case requires it, taken moderately, without any prejudice to the stomach it binds the belly: it is sufficient to take two or three spoonfuls in one day. Another stronger medicine is, to gather myrtle berries, and press the wine from them, to boil it to the tenth part, and sup a cyathus of that. The third, which may be got at any time, is to scoop a pomegranate, and taking out all the seeds, to put in again the membranes, that were betwixt them; then to drop in raw eggs, and mix them up with a small wooden stirrer; then to put the shell over the fire, which does not burn, while there is any moisture within; when it begins to grow dry, it is proper to remove it, and taking out the contents with a spoon, to eat them. This acquires great efficacy by the addition of some other things: therefore it is even put into pepper wine, and mixed with salt, and pepper, and eaten with these: and pulse may be taken also boiled with some old honeycomb. And lentils boiled with pomegranate bark, and bramble tops boiled in water, and eaten with oil and vinegar, are efficacious: as also to drink the decoction either of dates, or quinces, or dry service fruit, or bramble berries; and I mean this kind of liquor, whenever I direct such drink to be given as is astringent. A hemina of wheat also is boiled in austere Aminaean wine; and the wheat is given to a person fasting and thirsty, and after that the wine is supped: this may justly be ranked amongst the most powerful medicines. And the signine wine is given also to drink, or resinated austere, or any other austere kind. And the pomegranate is bruised with its shells and seeds, and is mixed with such wine; and a person either sups this alone, or drinks it mixed. But the use of medicines is needless, unless where the disorder is violent.

CHAP. XX.

OF THE DISEASES OF THE WOMB, AND THEIR CURE.

From the womb in women proceeds a violent distemper; and next to the stomach, this part both suffers most sensibly itself, and most affects the rest of the body. Sometimes it destroys the senses, so as to occasion their falling as in an epilepsy: but with this difference, that the eyes are not turned, nor is there any discharge of froth, nor convulsions: there is only a profound sleep. In some women this distemper returns frequently, and attends them during the whole course of their lives.

When it attacks, if there be sufficient strength, bleeding relieves: if there is not, yet cucurbitals must be applied to both sides of the groin. If the patient lies long in this state, or used to do so, it is proper to hold to the nostrils the extinguished wick of a lamp, or some other of these things I have mentioned of a remarkably bad smell, in order to rouse the woman. The same purpose is obtained by the pouring on of cold water. And rue bruised small with honey is good, or cerate of cyprine oil, or any other hot and moist cataplasm, applied from the pudenda up to the pubes. In the mean time, the hips and hams ought also to be rubbed.

After this, when she returns to herself, she must be forbid wine for a whole year, even although the disorder do not return. Friction must be practised every day over the whole body, but chiefly on the belly and hams. Food of the middle kind must be given: mustard be applied to the lower belly every third or fourth day, till the skin grow red.

If the hardness continue(31), nightshade dipt in milk, and then rubbed small, seems to be a proper emollient, and white wax and deers marrow with iris ointment, or beef suet, or goat’s, mixed with rose oil. In drink must be given either castor, or git, or dill. If she is not in good habit, she may be purged with the cyperus. If the womb is ulcerated, a cerate may be made of rose oil, also fresh hogs lard mixed with whites of eggs may be applied: or the white of an egg mixed with rose oil, with the addition of some powder of roses to help the consistence. But when the womb is pained, it ought to be fumigated with sulphur.

But if an excessive discharge hurts a woman, the remedy is to make an incision in the skin, and apply cucurbitals either to the groin or below the breasts. If the discharge is malignant,(32) restringents must be used. This intention is answered by white olives, black poppies taken with honey, and gum liquified, together with the powdered seed of smallage, and given in a cyathus of passum.

Besides these, in all disorders of the womb, such drink is proper as is made of the aromaticks, that is, spikenard, saffron, cinnamon, cassia, and the like. The mastich tree boiled to a decoction has the same effects. But if the pain be intolerable, and blood is discharged, even bleeding is proper; or at least the application of cucurbitals to the hips, after making an incision in the skin.

[Sidenote: _Of an excessive discharge of urine._]

But when urine is made beyond the measure of what is drunk, and coming away without pain emaciates, and creates danger, if it be limpid, there is a necessity for exercise and friction, especially in the sun, or at the fire. The bath ought to be seldom used, and the stay in it but short; the food astringent; the wine austere and undiluted, in summer cold, in winter egelid, but as little as possible. The belly should be either opened by a clyster, or purged with milk. If the urine is thick, both the exercise and friction ought to be more violent; the stay in the bath longer; the food tender; wine as above directed: in both cases, every thing that provokes urine must be avoided.

CHAP. XXI.

OF AN EXCESSIVE DISCHARGE OF SEMEN, AND ITS CURE.

There is also a distemper about the parts of generation, an excessive profusion of semen, which without venery or dreams, runs off in such quantities, that in time it destroys a man by a consumption.

In this disorder brisk frictions, pouring water over the body, and swimming in water extremely cold are salutary: no food nor drink but what is taken cold. It is proper also to avoid crudities, and every thing flatulent; and to take nothing that seems to generate semen: such are siligo, fine flour of wheat, eggs, alica, starch, all glutinous flesh, pepper, rocket, bulbous roots, pine nuts. And it is not improper to foment the lower parts with a decoction of the astringent vervains, and to apply a cataplasm composed of the same to the lower belly and groin; and especially rue with vinegar(33); and the person should be cautious not to sleep supine.

CHAP. XXII.

OF THE DISEASE OF THE HIPS, AND ITS CURE.

It remains that I come to the extremities, which are connected together by articulations. I shall begin with the hips. In these a violent pain arises, which often weakens, and some people it never leaves: and for this reason that species is most difficult to cure, which after long diseases turns upon this part with a pernicious force: and as it relieves other parts, so it takes a fast hold of this, which it affects.

Fomentations of hot water must be used first; then warm cataplasms. The applications, which appear to be most useful in this case, are the bark of capers cut small and mixed with barley-meal, or with a fig boiled in water; or the meal of darnel boiled with diluted wine, and mixed with dry lees. It is more convenient to apply these malagmas in the night-time, because they are apt to grow cold. The root of elicampane also bruised, and after boiled with austere wine, and spread all over the hip is amongst the most powerful remedies. If these do not discuss the malady, hot and moist salt must be made use of.

If the pain is not removed by this method neither, or a swelling comes on, the skin must be cut and cucurbitals applied; urine must be promoted; and if the belly be bound a clyster must be given. The last remedy, which is also of great efficacy in disorders of the womb, is to make ulcers in the skin with hot irons in three or four places above the hip. To make use of friction too, chiefly in the sun, and several times in one day: that this hurtful collection of humours may be more easily discussed. The hips themselves may be rubbed, if there be no ulcer; if there is, the other parts of the body. Now since an ulcer is frequently to be made with hot iron, that noxious matter may be evacuated, this is always to be observed, that ulcers of this kind be not healed, as soon as may be; but kept open, till the distemper, which we propose to cure by them ceases.

CHAP. XXIII.

OF A PAIN IN THE KNEES, AND ITS CURE.

The knees are next to the hips, in which there sometimes happens to be a pain. The cure consists in the same cataplasms and cupping: which are the remedies also when any pain arises in the shoulders, or the other joints. It is most hurtful of all things for one, whose knees are pained, to ride on horseback. Now all pains of this kind, when they have continued long, are scarcely cured without the use of the actual cautery.

CHAP. XXIV.

OF THE DISEASES IN THE JOINTS OF THE HANDS AND FEET, AND THEIR CURE.

In the hands and feet the diseases of the joints are more frequent, and continue longer. Such as happen to gouty people in these places, seldom disturb either eunuchs, or boys before coition, or women unless their menses be suppressed.

When they begin to feel them, blood must be let. For this done immediately at the beginning often procures good health for a whole year, sometimes for life. Some too by cleansing themselves thoroughly by drinking asses milk, have prevented its ever returning; Others by abstaining from wine, mulse and venery for a year, have rendered themselves secure from it for their whole life. And this method is to be pursued after the first attack of the pain, although it has ceased. But if the fits of it are grown customary, one may indeed be more secure at such times as the pain has remitted: but more care ought to be taken at such seasons, as it returns(34), which happens commonly in the spring or autumn.

Now when the pain is not violent, the patient ought to use gestation in the morning; then to be carried, or to exercise himself by walking gently, and if the gout be in the foot, at small intervals alternately sometimes to sit, sometimes to walk; next before he takes food, without bathing to be rubbed gently in a warm place, to sweat, and have egelid water poured over him; after that to take food of the middle kind, making use at times of diuretics; and whenever he turns plethoric to vomit.

When the pain is very violent, it makes a difference, whether there be no swelling, or a tumour with heat, or a swelling already grown callous. For if there is no tumour, hot fomentations are required. It is proper to heat sea-water, or strong brine, then to pour it into a bason, and when the patient can bear it, to put his feet into it, and spread his gown over them, and cover them beside with cloaths, pouring in gradually at the edge of the vessel some of the same liquor, that the heat within may not decrease; and then in the night-time to apply heating cataplasms, and especially the root of marshmallows boiled in wine. But if there be a swelling and heat, coolers are more proper, and it is fit to keep the joints in the coldest water; but neither every day, nor long at a time, lest the nerves be indurated. And a cooling cataplasm must be applied: nor must even that be continued long; but a change must be made to those things, which are repellent, and at the same time emollient.

If the pain be more severe, the bark of poppies must be boiled in wine, and mixed with cerate made of rose-oil: or equal quantities of wax and hogs lard must be melted together, then wine mixed with them; and whenever an application of this medicine has grown hot, it must be removed, and another put on immediately.

But if the tumours have grown callous, and are painful, they are relieved by the application of a sponge squeezed now and then out of oil, or vinegar, or cold water; or by equal parts of pitch, wax and alum mixed together. There are also several malagmas proper for the hands and feet. But if the pain will allow nothing to be laid on, it is fit to foment the part, which is not swelled, with a sponge dipped in a warm decoction of poppy-bark, or the roots of wild cucumber; then to put over the joints saffron with the juice of poppies and ewes milk.

But if there is a swelling, it ought to be fomented with an egelid decoction of mastic-tree, or any other of the restringent vervains; and be covered with a medicine composed of bitter almonds powdered, and vinegar; or ceruss with an addition of the juice of the wall-herb bruised. The stone also, which eats flesh, by the Greeks called [DF]sarcophagus(35), cut into such a form as to receive the feet, usually relieves their pain, when they are put into it and kept there. Of this they make sepulchres in Assus. And the Asian stone(36) also has its merit for giving ease.

[DF] σαρκοφάγος.

When the pain and inflammation have remitted (which happens within thirty days, unless the patient has been faulty) moderate exercises, abstinence, gentle unctions must be used, the joints being at the same time rubbed with an acopon(37), or liquid cerate of cyprine oil. Riding is hurtful, to those that have the gout in their feet.

Those, who have stated returns of this pain, before them ought both by a strict regimen to take care to prevent the redundancy of hurtful matter in the body, and to use frequent vomiting, and if there is reason to apprehend a present plethora, either clysters, or purging by milk. Which Erasistratus declared against, when the feet were gouty; lest the course of the humours downward should occasion a redundancy in the feet: though it is evident in every purgation, that not only the superior parts, but the inferior also are emptied.

CHAP. XXV.

OF THE TREATMENT OF PATIENTS RECOVERING.

From whatever distemper a person is recovering, if he gathers strength slowly, he ought to awake at day-light, nevertheless to lie still in bed; about the third hour to rub his body gently with his hands anointed. Then to amuse himself by walking as long as he finds it agreeable, laying aside all attention to business; then to use gestation for a long time, much friction; to change often his situation, air, and food. When he has drunk wine for three or four days, for one or even two to interpose water. For by these methods he shall both escape those distempers, that bring on a consumption, and may quickly recover his strength. But when he is entirely recovered, it will be dangerous for him to change his course suddenly, and turn irregular. Therefore he ought by slow degrees to lay aside these restraints, and change to the way of life most agreeable to his humour(38).

A. CORNELIUS CELSUS

OF

MEDICINE.

_BOOK V._