Chapter IX: Part 9

He who has taken the subject of health into consideration ought also to be acquainted with the powers of wine. Wine in general is nutritious, but that which is red and thick is more particularly so; but its juices are not good. The sweet also is nutritious, but not stomachic. The astringent is stomachic, but is distributed with difficulty to the parts of the body, and nourishes less. The white nourishes less still. Wine of a yellow colour is the best of all. That which is old is more heating and desiccant than the new. Such, in the main, are the properties of wine. But wine in general resuscitates the natural heat within us, and therefore it improves digestion, and forms good blood. And being of a penetrating nature, it diffuses the nourishment all over the body, and therefore it recruits those who are emaciated by disease, for it gives them an appetite for food. It attenuates phlegm, clears away the bile by urine, and imparts a good colour. To the soul also it communicates gladness and pleasure, and improves the strength. Such are the good effects of the moderate use of wine. But its immoderate use produces just the reverse; wherefore, those who are drunk become changed, are delirious, and disposed to heavy sleep. On that account, such an immoderate use of wine ought to be avoided; but at greater intervals it may be drank liberally, for it promotes the discharges by urine and perspiration. But it is better in such cases to vomit, by taking, beforehand, of honied water, so that one may not be injured by it. When one has drunk largely, it is not proper to take much of any other food; but while drinking, one should eat boiled cabbage, and taste some sweetmeat, particularly almonds. These things relieve headach, and are not difficult to vomit. It is also very proper to take the infusion of wormwood before drinking, for of all things it is the best preservative from surfeit. If one experience any painful effects from wine, one should drink cold water, and the next day again the infusion of wormwood; and by using exercise, friction, the bath, and restricted food, in this way get restored to health.

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COMMENTARY. The opinions of the ancients on this interesting subject may be best learned by consulting Hippocrates (de Diæta, ii, 22, et alibi); Celsus (ii); Pliny (H. N. xiv and xxxiii, 22, 26); Dioscorides (v); Galen (de Sanit. tuend. v, 5, and de Alim. Facult. iii); Oribasius (Med. Col. v, and Euporist. i, 12); Aëtius (i); Athenæus (Deipnos. i); Macrobius (Saturnal.); Actuarius (de Diæta, 8); Simeon Seth (de Alimentis); Serapion (de Simplicibus, &c.); Haly Abbas (Theor. 30, and Pract. i, 8); Avicenna (i, 3, 2); Rhases (ad Mansor. iii, 5, and Continen. xxxvii); Alsaharavius (Theor. xiii, 2.) Stobæus gives an interesting collection of the opinions of the philosophers and poets. (Sermo xviii.)

For an ample account of the ancient and modern wines, the reader is particularly referred to the late ingenious and classical publication of Dr. Henderson. See also Barry (on Ancient Wines), and Canonherius (de Admirandis Vini Virtutibus.)

From the works of Moses and Homer, we learn that the art of converting the innocent juice of the grape into wine must have been a very early invention. Eustathius informs us that, in very ancient times, the wines were all of a dark colour; and hence Homer applies to the sea the epithet of _wine-coloured_, ὄινοπα πόντον. (Comment, in Iliad. I.) Achilles Tatius makes the same remark regarding the ancient wine, (ii, 67, ed. Salmasius.) However, in the time of Hippocrates, they had wines of all colours, as well as characters. He thus describes their general properties: Black and austere wines are of a drying nature, and are not laxative, nor diuretic, nor sialogogue. It is their heat that renders them desiccative, by consuming the humidity of the body. The soft dark wines are of a more moistening nature, and are more flatulent and laxative. The sweet dark wines are of a more moistening nature, but they are heating and flatulent by imparting humidity. The white austere wines are heating, but are rather diuretic than laxative. The new are more laxative than the old, as being a nearer approach to the fresh juice of the grape, and they are nutritious; and the fragrant wines than those of the same age which have no _bouquet_, because they are better concocted; and the thick than the thin. But thin sweet wines are more diuretic, laxative, and moistening, and form weak blood.

Celsus ranks the “vinum dulce vel lene” among the “res boni succi.” Sharp austere wine he places among the things which are most suitable for the stomach.

Dioscorides delivers very judiciously the different characters of wines. He concludes with remarking that, although habitual intoxication be prejudicial to the health, a moderate indulgence in wine for some days, especially after drinking water, is beneficial, by proving an alterative to the system, purging the secretions, and promoting the insensible perspiration.

From Pliny’s excellent statement of the medicinal and dietetical properties of wine, we select the following remarks: “Vino aluntur vires, sanguis, colorque hominum. Vino modico nervi juvantur, copiosiore læduntur, sic et oculi. Stomachus recreatur; appetentia ciborum invitatur; tristitia et cura hebetatur; urina et algor expellitur; somnus conciliatur. Præterea vomitiones sistit. Vetus coposiore aqua miscetur, magisque urinam expellit; minus siti resistit. Dulce minus inebriat sed stomacho innatat; austerum facilius concoquitur. Stomacho minus utile est pingue, nigrum, sed corpora magis alit. Tenue et austerum minus alit, magis stomachum nutrit.”

The information supplied by Galen on this subject is most ample, but in too diffuse a shape to suit our narrow limits. Upon the whole, he states, thin wines are diuretic, but supply little nourishment, whereas the thick are proportionally nutritious. He says that the Falernian, especially the sweeter kind, is one of the most wholesome wines. Athenæus gives an interesting account of the Falernian, upon the authority of Galen. He says it is fit to be drank after it is ten years old, and from fifteen to twenty; but that, when older, it occasions headach and affects the nerves. He describes two kinds of it, the sweet and the austere. The latter, he adds, is of a tawny colour, that is to say, a colour intermediate between the white and black. Dr. Henderson concludes, that the modern Madeira is a near approach to the ancient Falernian. Brasavolus and C. Avantius compare it to a wine known in modern Rome by the name of _greco di soma_. Galen gives very minute directions for forcing this wine, or giving it premature age by heat. (De Antid. i, and de Simpl. iv.) Vitruvius, for this purpose, gives directions for building the wine-cellar close to the kitchen. (vi.) Athenæus says, that wine digests the food, and, being of a subtle nature, promotes the distribution of it. We learn from him that the ancients sometimes used their wines cooled with ice. (Deipnos. iii, 99.) He thus describes the different characters of the wines used in his time; that is to say, about the middle of the second century, P. C. Of wines, some are white, some tawny, and some dark coloured. The white is in nature the thinnest, diuretic, and heating, and being digestible it inflames the head, for it is a wine that has a tendency upwards. A dark-coloured wine, which is not of a sweet nature, is very nutritious and astringent. Sweet wines, whether of a white or tawny colour, are very nutritious; for they lubricate the passage, and thickening the humours, prove less troublesome to the head. The nature of sweet wines is to remain for a time in the præcordia, and to prove expectorant, as Diocles and Praxagoras tell. Mnesitheus the Athenian says dark-coloured wine is very nutritious, the white very diuretic and very subtle, and the tawny dry, and of all wines the one that most promotes the digestion of food. Wines carefully prepared with salt water are not of an intoxicating nature, they loosen the belly, occasion pains of the stomach, and produce flatulence, but promote digestion. Such are the Myndian and the Halicarnassian. The Coan is well prepared with salt water; the Rhodian has a less proportion of it; the Cnidian engenders blood, is nutritious, and laxative, but when drunk in large quantities it upsets the stomach; the Lesbian has less astringency and is more diuretic; the Chian is a most delicious wine, and especially the kind called Ariusian; but there are three varieties of it, the austere, the sweet, and the intermediate.—Of the Italian wines, the most delicious are the Alban and the Falernian. The Adrian is a diffusible, diaphoretic, and safe wine. (i, 25.) According to Galen, the cæcuban, so frequently mentioned by Horace, was not any one sort of wine, but a general name applied to all generous and old wines. (De Succ. bon. 2.) Old wine was much sought after: Galen says everything is impaired by age but wine. (De Antidot.) The Falernian was reckoned best from ten to twenty: the Surrentine was not thought good until twenty-five. (Athen. i.)

According to Actuarius, the thick wines are most nourishing and form the thickest blood, but are apt to occasion visceral obstructions; while, on the other hand, the thin wines are more stomachic and less nourishing. The sweet are the contrary; but the white are less hot than the others; the gold-coloured are more hot; and then the red.

Wine, says Simeon Seth, is not only nutritious, but promotes in a great degree the distribution of the food over the body, rousing, and at the same time increasing the vital heat, and with it the urinary and other secretions. It suits best, he says, with persons of a cold and dry temperament; and, therefore, it is most proper for old men. He adds that the immoderate use of wine dissolves the vital tone, depresses the natural heat, and occasions apoplexy, epilepsy, and tumours of the body. Macrobius attempts to trace a resemblance between the effects of habitual intoxication and those resulting from exposure to extreme cold. “Quæcunque nimium algentibus, eadem contingunt ebriis. Fiunt enim tremuli, pallidi, graves; et saltu tumultuantis spiritus artus suos et membra quatiuntur. Idem corporis torpor ambobus, eadem linguæ titubatio. Multis etiam morbus ille quem παράλυσιν Græci vocant sic nimio vino, et multo algore contingit.” In like manner, a modern writer, Andreas Baccius, maintains that some wines are of a cold nature.

Haly Abbas gives nearly the same characters of wine as Seth. His account of all the wines, natural and artificial, used in his time, is most ample.

Alsaharavius forbids wine to be taken when the stomach is quite empty, or after a full meal. When taken seasonably, he says it improves the appetite, increases the vital heat, nourishes the body, and clears the senses.

Avicenna, with his usual judgment and industry, collects all the information of preceding authors, to which he adds his own opinions. He remarks that the immoderate use of wine induces disease of the liver and brain, and debilitates the nerves.

Wine, says Rhases, warms the stomach and liver, and dispels flatulence, promotes digestion, provokes the urinary and alvine discharges, and gladdens the mind.

Serapion copies mostly from Galen in delivering the general characters of wine. He disapproves of wine made with salt water. For an account of it, see Pliny and Athenæus, (l. c.)

The ancients were scarcely more agreed respecting the intoxicating properties of wine than they were as to the powers of the cabbage in counteracting them. Old Cato the Censor, who was in the practice “of warming his virtue with wine,” describes the following method of cooling it: “Si voles in convivio multum bibere cænareque, ante cæenam esto crudam brassicam quantum voles ex aceto, et item ubi cænaveris comesto aliqua V. folia, reddent te quasi nihil ederis, biberisque, bibesque quantum voles.” (De R. R. 156.) See a long dissertation on this property of the cabbage in Athenæus (Deipnos. i, _ad finem_); also Pliny (Hist. Nat. xx, 34); Pseudo-Dioscorides (Euporist. i, 24); Nonnius (14); Simeon Seth (in voce Brassica); Geopon. (xii, 17); Avicenna, Rhases, and Serapion give the same character of it. Plutarch affirms that almonds also are a preservative from intoxication. (Quæst. vi.)

Before quitting this subject, we must notice certain peculiar modes of preparing wine. The _mustum_ was wine newly made, or the fresh juice of the grape. The _protropum_ was the juice which runs from grapes without pressing. The _mulsum_ was a preparation of wine and honey. Dioscorides recommends two parts of wine to one of honey; but there does not appear to have been any fixed proportion. The _sapa_, called by the Greeks _hepsema_ and _siræum_, according to Pliny, is must boiled to a third; and the _defrutum_ the same reduced to a half. They are now called robs, a term borrowed from the Arabians. The _carenum_, according to Isidorus, is must reduced to two thirds. The _passum_ was a sweet wine prepared from grapes which had been much dried in the sun. The _passum creticum_, which is much praised by Pliny and Athenæus, and is often mentioned by our author, the learned Andreas Baccius and Nonnius believe to have resembled the modern malmsey. We have already mentioned a peculiar species of wine prepared with salt water. The ancients also gave artificial qualities to wine by adding rosin, pitch, and other substances to the casks in which it was deposited. See ‘Geoponica’ (vii.) Dioscorides gives receipts for preparing a great variety of vinous tinctures. These were used only for medicinal purposes. (Mat. Med. v.)

It is scarcely necessary for us to remark that the ancients generally drank their wines diluted either with hot or cold water. Hence the poet Juvenal says: “Quando vocatus adest calidæ gelidæque minister.” (Sat. v, 63.) According to Pliny, Staphylus first introduced this practice (H. N. viii, 56); but Athenæus refers it to Melampus (ii.) It would appear, however, from some passages in the ‘Ecclesiazusæ’ of Aristophanes, and from Eustathius’s Commentary on Homer (Iliad, ix, 203), that the ancients often drank their wines undiluted. It was customary, during the time of dinner, to drink off a cup of pure wine to “the good deity.” See Athenæus (xv, 17), with the learned note of Schweighäuser. The wine and water were commonly mixed together according to certain fixed proportions, such as one part of wine and two of water, or two of wine and three of water, or equal parts of both. (Eustathius in Odyss. vii.) In winter it was the rule to drink equal parts of wine and hot water; but in summer two parts of water were added to one of wine. (Anonymus de Diæta ap. Phys. et Med. Min. ed. Ideler, p. 197.) It would appear that it was a common practice to drink wine with other hot things in the morning during the cold months of winter. (Hierophilus de Nutr. Meth. ed. Ideler.)

SECT. XCVI.—ON HONEY AND HYDROMEL OR HONIED WATER.

Boiled honey is rather nutritious than laxative; but when unboiled the contrary. It agrees with cold and humid temperaments, but in the warm it is converted into bile. Honied water does not agree well with those who are affected with bitter bile, being converted into bile. In such constitutions the honied water ought to be very weak; but it is not proper for those whose bowels are easily affected. The honied water may be prepared by adding eight parts of water to the honey, and thus boiling it until it cease from frothing. It is expedient also to clear away the scum as soon as formed.

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COMMENTARY. Honey, says Hippocrates, when eaten with other food, is nutritious, and improves the colour; but, when taken alone, it rather attenuates than recruits. Actuarius says that scummed honey, when taken with other food, is nutritious and laxative. Democritus said, that health was best promoted by lubricating the inside with honey, and the outside with oil. Honey and bread formed the favorite food of the Pythagoreans. Athenæus (Deipnos. ii, 7.) See also Oribasius (Synops. iv, 38); Haly Abbas (v, 27); Simeon Seth (in voce Mel.)

Galen gives the following account of the phenomenon of a _honey shower_: “I have sometimes known in the season of summer a great quantity of honey to be found upon the leaves of trees, shrubs, and certain herbs, so that the country people said, jesting, ‘Jupiter has rained honey.’ A cold night, as for summer, had preceded (for it happened in summer); but the temperature of the former day had been hot and dry. It was thought, therefore, by those who were skilled in nature, that an exhalation from the earth and waters, finely attenuated and concocted by the heat of the sun, had been condensed and collected by the cold of the succeeding night. This phenomenon occurs rarely with us; but it takes place frequently in Mount Lebanon every summer.” (De Alim. Facult.) See also Fragmentum Theophrasti (de Melle, ed. Heinsius.) Ernestus Faber states that the honey here described is the manna of cedars. (De Manna Ebræorum, 12.)

A wine prepared from honey and aromatics is much commended by an intelligent writer on dietetics as possessing more heat and dryness than any other species of wine, and improving the appetite and colour. (Anonym. Tract. de Cibis ap. Ermerins Anecdota Græca, p. 237.)

Our author has given one method of preparing the hydromel, or honied water. Different modes are described by other authors. Thus, Mesue recommends seven parts of water to one of honey. It appears from Hippocrates, however, that it was taken more or less diluted. Pliny and Dioscorides make mention of hydromel prepared by mixing two parts of water with one of honey. This seems to have been the strongest hydromel. A species of hydromel carefully prepared, and kept for a considerable time, was esteemed a delicious beverage. Ludovicus Nonnius compares it to the mead used by certain nations of the north. They prepare it with hops and yeast, so that it is made to emulate the nature of wine. The Greeks and Romans did not make use either of hops or yeast.

In imitation of Galen, who, under the head of honey (de Simpl.), treats also of _sugar_, we shall give a brief account of the latter in this place. The _saccharum_, then, which is mentioned by Theophrastus (Frag. l. c.), Dioscorides (ii, 104), Galen (l. c.), Strabo (Geogr. xv), Pliny (H. N. xii, 17), and other ancient authors, was a natural concretion forming on various reeds, but more especially upon the bamboo cane (_bambusa arundinacea_.) The bamboo is noticed by Herodotus (Hist. iii, 98), and by Ctesias (Photii Lex.) Moses Chorenensis, a writer of the fifth century (Geogr. Armen.), is the first who makes mention of sugar procured from the cane by boiling.

SECT. XCVII.—ON SLEEP.

It remains, after having treated of everything connected with diet, to say something of sleep, which is generally taken after every other thing. Sleep, then, may be briefly defined to be a relaxation of the vital powers, occasioned by a suitable moisture irrigating the brain. When properly taken it may produce many good effects. It digests the food, concocts the humours, soothes pain, alleviates lassitude, and relaxes that which is contracted. It is also calculated to produce oblivion of mental sufferings, and to rectify the distracted powers of reason. The most suitable season for sleep is after a meal. But that during the day does not agree with all, because the time spent in sleep is not sufficient for the complete digestion of the food; and, when the digestion is interrupted unseasonably, those who rise from sleep at noon are often troubled with acidity and flatulence, and sometimes even with a gurgling noise in their bowels, unless from habit or sufficient rest these bad effects be obviated. The best season for sleep is the night, for the humidity and drowsy stillness of night contribute to perfect digestion. Wherefore after these nocturnal slumbers we feel the most desire for evacuation. The proper limit to sleep should be the complete digestion of the food, as may be ascertained by the eructations, and by tapping over the stomach; after which it may be not unuseful to awake in order to evacuate the excrementitious remains of the digestion.

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COMMENTARY. The philosophy of sleep is ingeniously treated of by Hippocrates (de Insomniis), and by Aristotle (in his treatise de Somno et Vigilia.) Aristotle states that digestion goes on best during sleep. Pliny’s definition of sleep seems to be taken from Hippocrates: “Est autem somnus nihil aliud quam animi in medium sese recessus.” (H. N. x, 97.) Alexander Aphrodisiensis, in like manner, says, “Know that, during the day, the natural principle is less occupied with its own peculiar operations, I mean the digestion of the food, the changes of the chyle, sanguification, distribution, assimilation, and the like, the mind being engaged in its other energies, namely, the five senses, fantasy, reasoning, and memory; but during night, on the other hand, nature operates more, and the mind less.” (Problem i, 118.) See also particularly Oribasius (Med. Coll. vi, 4); Actuarius (de Diæta, 11); Avicenna (i, 3, 3); Rhases (ad Mansor. iv, 3); Haly Abbas (Theor. v, 35); Alsaharavius (Theor. xi, 3); Averrhoes (Collect. i, 21.) Averrhoes defines sleep to be the recession of the sensorial powers from their organs to the internal parts; and hence, he remarks, those who sleep with their eyes open do not perceive the objects nearest to them. The vital heat being then collected internally, he adds, the powers of the digestive faculty are increased. Rhases agrees with Galen that moderate sleep forms good blood; but that too much corrupts the juices, that is to say, impairs digestion. Haly Abbas remarks that, during sleep, the animal powers are suspended, while the vital and natural continue unaffected; and, therefore, the mind or principle of life being then disengaged, as it were, from one of its offices, is the abler to perform the others aright. Hence, he adds, digestion is best performed during sleep. Alsaharavius approves of taking rest after a meal, but recommends an hour to elapse before going to sleep.

The reader will find in Stentzel’s little treatise, entitled ‘Διατριβὴ περι τοῦ ὕπνου,’ an interesting exposition of the opinions of the ancient philosophers and physicians on this subject. There is an ingenious disquisition on the nature of sleep in the commentary of Stephanus on the Prognostics of Hippocrates. In reference to Aristotle’s division of causes, he decides that the efficient cause of sleep is the rest of the particular senses, and of the general sensorium: the material, a humidity which is carried to the roots of the nerves, and prevents the exit of the vital spirit; the formal or organic, the brain, in which the humidity is collected; and the final, or end which sleep serves, the recreation of the powers. (Dietz, T. i, 142.)

SECT. XCVIII.—ON WATCHFULNESS.

The cure of watchfulness in disease, whether proceeding from pain, fever, or some acute symptom, will be treated of under the head of Fevers. But we shall now treat of the watchfulness of those in health. If their watchfulness proceed from sorrow, care, or any mental emotions, we must endeavour if possible to remove the offending cause, and then to divert the attention by agreeable sounds. For this purpose, some seek after the gentle noise of waters, by which they are soothed and lulled to rest. After proper digestion, they should use baths, especially in the evening, and a moistening diet, such as lettuces and the like. They may also mix the green leaves of the black poppy with condiments, and eat fish of easy digestion. They should also use plenty of wine which is light and not old. When about to go to bed, their heads should be anointed with rose oil, or with oil in which the heads of poppies or mandrake have been boiled. And the oil of dill not too old is soporific. I have known rest succeeding suddenly to fatigue produce this effect. Moderate coition will sometimes do the same. Others easily procure rest by having their head and feet cooled. But if their watchfulness be occasioned by their stomachs being oppressed by the quantity or bad quality of the food (and I have known this happen, in like manner as in others it arises from an unseasonable abstinence or diminution of their accustomed food), this ought to be inquired into and the cause removed.

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COMMENTARY. We have mentioned, in the 74th Section, that Galen cured himself of watchfulness by eating freely of lettuces. See further Oribasius (Med. Collect, vi); Averrhoes (Collectan. ii, 5); Alsaharavius (Theor. xi, 3); Rhases (Contin. xxxi, Aphorism, iii.) Indigestion, as regards both food and drink, is stated by Hippocrates as one of the common effects of protracted insomnolency. (De Diæt. in Morb. Acut. 13.) According to Damascius, the commentator on Hippocrates, the causes of insomnolency are, heat of the brain, an intemperament alone, or the prevalence of a bilious humour. (Ed. Dietz. T. ii, 298.)

Rhases recommends lettuces, the tepid bath, the affusion of tepid water on the head, and diluted wine. He also recommends mandragora and opium, which, he says, Galen states will produce soporific effects, not only when taken internally, but when rubbed on the forehead, and applied to the nostrils. He particularly approves of the following liniment: Pound the bark of mandragora, the seed of black henbane, and opium, with the juice of lettuce, and rub into the temples. He further mentions, that having fallen into a state of insomnolency from too much application to study, he cured himself by eating lettuces and using the oil of the water lily externally. (Aph. u. s.)

SECT. XCIX.—ON SOMNOLENCY.

If, on the other hand, the sleep be profound and heavy, we must abstain from frequent baths and cooling unguents; we must use masticatories, and upon the whole change the regimen for one of a hotter, drier, and less nutritive character, because the affection is occasioned by a cold and humid matter irrigating the brain.

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COMMENTARY. See the Commentary on the Sections on Lethargy and Carus in Book Third.

SECT. C.—THE EPISTLE OF DIOCLES ON THE PRESERVATION OF HEALTH.—DIOCLES TO KING ANTIGONUS.

Since of all kings you are the most skilled in the arts, and have lived very long, and are skilled in all philosophy, and have attained the highest rank in mathematics, I, supposing that the science which treats of all things that relate to health is a branch of philosophy becoming a king and befitting to you, have written you this account of the origin of diseases, of the symptoms which precede them, and of the modes by which they may be alleviated. For neither does a storm gather in the heavens but it is preceded by certain signs which seamen and men of much skill attend to, nor does any disease attack the human frame without having some precursory symptom. If, then, you will only be persuaded by what we say regarding them, you may attain a correct acquaintance with these things. We divide the human body into four parts: the head, the chest, the belly, and the bladder.—When a disease is about to fix in the head, it is usually announced beforehand by vertigo, pain in the head, heaviness in the eyebrows, noise in the ears, and throbbing of the temples; the eyes water in the morning, attended with dimness of sight; the sense of smell is lost, and the gums become swelled. When any such symptoms occur, the head ought to be purged, not indeed with any strong medicine, but taking the tops of hyssop and sweet marjoram, pound them and boil them in a pot with half a hemina of must or rob, rinse the mouth with this in the morning before eating, and evacuate the humours by gargling. There is no gentler remedy than this for affections of the head. Mustard in warm honied water also answers the purpose very well. Take a mouthful of this in the morning before eating, gargle and evacuate the humours. The head also should be warmed by covering it in such a manner as that the phlegm may be readily discharged. Those who neglect these symptoms are apt to be seized with the following disorders: Inflammations of the eyes, cataracts, pain of the ears as if from a fracture, strumous affections of the neck, sphacelus of the brain, catarrh, quinsy, running ulcers called achores, caries, enlargement of the uvula, defluxion of the hairs, ulceration of the head, pain in the teeth.—When some disease is about to fall upon the chest, it is usually announced by some of the following symptoms: There are profuse sweats over the whole body, and particularly about the chest, the tongue is rough, expectoration saltish, bitter, or bilious, pains suddenly seizing the sides or shoulder-blades, frequent yawning, watchfulness, oppressed respiration, thirst after sleep, despondency of mind, coldness of the breast and arms, trembling of the hands. These symptoms may be relieved in the following manner: Procure vomiting after a moderate meal without medicine. Vomiting also when the stomach is empty will answer well; to produce which first swallow some small radishes, cresses, rocket, mustard, and purslain, and then by drinking warm water procure vomiting. Upon those who neglect these symptoms the following diseases are apt to supervene: Pleurisy, peripneumony, melancholy, acute fevers, frensy, lethargy, ardent fever attended with hiccough.—When any disease is about to attack the bowels, some of the following symptoms announce its approach: In the first place, the belly is griped and disordered, the food and drink seem bitter, heaviness of the knees, inability to bend the loins, pains over the whole body unexpectedly occurring, numbness of the legs, slight fever; when any of these occur, it will be proper to loosen the belly by a suitable diet without medicine. There are many articles of this description which one may use with safety, such as beets boiled in honied water, boiled garlic, mallows, dock, the herb mercury, honied cakes; for all these things are laxative of the bowels. Or, if any of these symptoms increase, mix bastard saffron with all these decoctions, for thereby they will be rendered sweeter and less dangerous. The smooth cabbage boiled in a large quantity of water is also beneficial; this decoction with honey and salt may be drank to the amount of about four heminæ, or the water of chick-peas or tares boiled may be drank in the same manner. Those who neglect the afore-mentioned symptoms are apt to be seized with the following affections: Diarrhœa, dysentery, lientery, ileus, ischiatic disease, tertian fever, gout, apoplexy, hemorrhoids, rheumatism.—When any disease is about to seize the bladder, the following symptoms are its usual precursors: A sense of repletion after taking even a small quantity of food, flatulence, eructation, paleness of the whole body, deep sleep, urine pale and passed with difficulty, swellings about the privy parts. When any of these symptoms appear, their safest cure will be by aromatic diuretics. Thus the roots of fennel and parsley may be infused in white fragrant wine, and drunk every day when the stomach is empty in the morning to the amount of two cyathi, with water in which carrot, myrtle, or elecampane has been macerated (you may use any of these you please, for all are useful); and the infusion of chick-peas in water may be drank in like manner. On those who neglect these symptoms the following diseases are apt to supervene: Dropsy, enlargement of the spleen, pain of the liver, calculus, inflammation of the kidneys, strangury, distension of the belly. Regarding all these symptoms it may be remarked that children ought to be treated with gentler remedies, and adults with more active.—I have now to give you an account of the seasons of the year in which each of these complaints occur, and what things ought to be taken and avoided. I begin with the winter solstice.—_Of the winter solstice_: This season disposes men to catarrhs and defluxions, until the vernal equinox. It will be proper then to take such things as are of a heating nature, drink wine little diluted, or drink pure wine, or of the decoction of marjoram, and indulge in venery. From the winter solstice to the vernal equinox are ninety days.—_Of the vernal equinox_: This season increases phlegm in men, and the sweetish humours in the blood until the rising of the pleiades. Use therefore juicy and acrid things, take labour, and indulge in venery. To the rising of the pleiades are forty-six days.—_Of the rising of the pleiades_: This season increases the bitter bile, and bitter humours in men, until the summer solstice. Use therefore all sweet things, laxatives of the belly, and indulge but sparingly in venery. To the summer solstice are forty-five days.—_Of the summer solstice_: This season increases the formation of black bile in men, until the autumnal equinox. Use therefore cold water, and everything that is fragrant; and do not indulge in venery, or do so more sparingly than is generally directed regarding these matters. To the autumnal equinox are ninety-three days.—_Of the autumnal equinox_: This season increases phlegm and thin rheums in men until the setting of the pleiades. Use therefore remedies for removing rheums, have recourse to acrid and succulent things, take no vomits, and abstain from labour and venery. To the setting of the pleiades are forty-five days.—_Of the setting of the pleiades_: This season increases phlegm in men until the winter solstice. Take therefore all sour things, drink as much as is agreeable of a weak wine, use fat things, and labour strenuously. To the winter solstice are forty-five days.

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COMMENTARY. This Diocles was an ancient physician of great eminence. Galen often mentions him along with his idol, Hippocrates, as the greatest of medical authorities. Cælius Aurelianus frequently quotes his opinions in respectful terms, although belonging to a different sect from his own. Pliny says that he was next to Hippocrates in fame as in time. Octavius Horatianus calls him the younger Hippocrates. Athenæus mentions a work of his on Poisons, and another on Cookery.

Le Clerc questions the authenticity of this epistle, but seems to have had no other grounds for his scepticism than the general suspicion which has attached to all the Epistolæ Græcanicæ since the memorable controversy between the Honorable Mr. Boyle and Dr. Bentley on the authenticity of the Epistles of Phalaris. It is published in the ‘Bibliotheca Græca’ of Albertus Fabricius, who appears to have been satisfied as to its genuineness. Mr. Moir, the author of ‘Outlines of the Ancient History of Medicine,’ condemns it as apocryphal, upon the authority of Schulze. (p. 76.) All we shall say on this point is, that the evidence against the authority of this Epistle appears to us to be very inconclusive.

BOOK SECOND.

SECT. I.—ON FEVERS, FROM THE WORKS OF GALEN AND SEVERAL OTHERS.

After having treated of those things which relate to the preservation of health, we now come to the treatment of persons already in disease, and shall begin with homogeneous disorders as being the most simple. These are what are called Fevers. Wherefore, using again principally Oribasius’ Epitome of the Works of Galen and several others on this subject, we shall add a very few things omitted by them.

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COMMENTARY. The following ancient authorities may be consulted on the subject of fever: Hippocrates (Epidem. et alibi); Galen (Comment. in Hippocr. Epidem., de Differentiis Febrium, Meth. Med. viii, Therap. ad Glauc. i, De Typis, de Crisibus et alibi); Celsus (iii); Pseudo-Dioscorides (Euporist. ii); Oribasius (Synop. vi, Euporist.); Aretæus (Morb. Acut. ii, 4); Aëtius (v); C. Aurelianus (Pass. Acut. ii, 10); Alexander Trallian (xii); Alexander Aphrodisiensis (Probl. i, 84, de Febribus); Actuarius (Meth. Med. iii); Pliny (Hist. Nat. xxviii, 66, xxx, 30); Palladius (de Febribus); Michael Psellus (Opus Medicum); Synesius (de Febribus); Leo (ap. Ermerins Anecdota Græca); Stephanus (Comment. in Prognost. Hippocrat. ed. Dietz); Constantinus Africanus (de Febribus); Serenus Samonicus; Vindicianus (Epistola ap. Fabricii Bibl. Græc. tom. xiii); Avicenna (iv, i); Syrasis, Avicennæ Expositor; Haly Abbas (Theor. viii, Pract. viii); Alsaharavius (Theor. vi, Pract. xxxii); Serapion (tr. vi); Avenzoar (iii, 7); Averrhoes (Collig. vii); Rhases (ad Mans. x, Contin. xxx.)

All the ancient authorities held that a fever consists of a preternatural increase of the Innate, or, as it is now called, Animal heat, which they considered as the instrument by which the soul performs all the functions of the body. See Alexander Aphrod. (de Feb.) Thus, Palladius defines a fever to be “a preternatural heat, which begins in the heart, and is diffused by the arteries over the whole body, sensibly injuring the actions of the body.” Hippocrates, Galen, Aëtius, Alexander Trallian, Psellus, Leo, and Actuarius give similar definitions. Cælius Aurelianus says of Asclepiades: “Febrium ponit signum calorem plurimum.” (Morb. Acut. i, 14.) Isidorus defines a fever thus: “Febris a fervore dicta est; est enim abundantia caloris.” (Orig.) Hippocrates, however, the great opponent of hypothesis in medicine, insists that there is more in a fever than a simple excess of pure heat; or, in other words, that the essence of fever is heat mixed up with noxious qualities. (De Vet. Med. § 17.) The celebrated Erasistratus maintained an opinion, lately revived by Clutterbuck and Broussais, that fevers and inflammations are identical. See Milligan’s Celsus (p. 13 and 112); and Cælius Aurelianus (de Acut. Morb. ii, 3.) He further taught that in fevers the blood of the veins is thrown into the arteries. (Plutarch de Placit. Philos. v, 29.)

The Arabians adopt the opinions of Hippocrates, Alexander, and Galen. Thus, for example, Haly Abbas defines fever to be a preternatural heat proceeding from the heart, and diffused by the arteries over all parts of the body. According to him there are three kinds of fevers. The first, are seated in the spirits, and affect only the heat of the body: these are called ephemeral fevers. The second, originate in a vitiated state of the fluids, which impart a preternatural degree of heat to the heart, whence it is diffused over all the body. The third arise in the vital organs and solid parts, from which heat is transmitted to the heart. (Pract. viii, 2.) See also, in particular, Rhases (Cont. xxx.)

SECT. II.—OF THE PRINCIPAL CONSIDERATIONS TO BE INQUIRED INTO WITH REGARD TO FEBRILE AFFECTIONS.

The first thing to be considered is, whether the disease will prove fatal or not; then, if it is not to prove fatal, whether it will be acute or chronic (these considerations apply to other great disorders); and, third, whether it will come to a crisis all at once (which is peculiar to fevers), or be resolved gradually.

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COMMENTARY. This Section, and great part of the contents of this book are taken from Galen (Therap. ad Glauc. i,) or from Oribasius (Synops. vi.)

SECT. III.—FROM GALEN, WHAT TO CALL THE COMMENCEMENT OF THE DISEASE.

As headach is not the same complaint as fever, so neither are insomnolency, loss of appetite, heaviness of the whole body, and a sense of lassitude; and yet each of these symptoms, although different from fever, announces its approach. A fever setting in, and more especially in an acute manner, cannot escape our notice, nor even that of a person unacquainted with these matters. Or, if we should suppose that it might escape us, I should wonder if the patient himself could be ignorant of it for more than an hour. Wherefore I call that time the commencement of the disorder, when those who are beginning clearly to be affected with the fever betake themselves to bed.

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COMMENTARY. The whole of this Section is taken from Galen (de Diebus criticis), where the question is fully discussed. Aëtius, like our author, defines the commencement of a fever to be the time when the strength of the patient being overcome by the complaint, he is obliged to take to bed. On this point the Arabians venture to differ from the Greeks. Thus, Rhases and Avicenna reckon the commencement from the time when the patient first feels a departure from health.

The disagreement among the authorities upon this point is to be regretted, as it tends to obscure the doctrine of the critical days.

SECT. IV.—HOW TO KNOW WHETHER THE DISEASE WILL PROVE FATAL OR NOT.

These are fatal symptoms: A deathlike countenance, sharp nose, hollow eyes, and the other symptoms described by Hippocrates, when they do not proceed from watchfulness, or evacuation, or want of food; also, intolerance of the light, shedding tears from no external cause, there being no particular affection of the eyes; or the one eye appearing less than the other; or the white of the eyes becoming red, or livid, or black, or having a muddiness in them; and the white of the eyes appearing during sleep, the eyelids not being closed, unless this symptom proceed from a great evacuation, or from habit. Likewise grinding the teeth, a state of delirium, picking at flocks of wool, or bits of chaff, are not favorable. Attention should also be paid to the patient’s mode of lying. To lie on one’s back, as it were, in a relaxed state, and to sink downwards in bed, are indications of extreme debility. It is still worse to have a cold respiration at the mouth and nostrils; and a pulse obscure, dense, and intermitting, and profuse sweatings with syncope are most mortal symptoms. If all the symptoms we have mentioned, or even more appear, or if they be fewer in number but strong, and if they be without any of the favorable ones, death is inevitable. The breathing free, pulse natural, soundness of intellect, being well disposed to take whatever is offered, the appearance of countenance and mode of reclining like those of persons in health,—all these symptoms are favorable and prognosticate recovery; and, in general, whatever symptom is contrary to the natural state indicates an unfavorable, whereas, what is correspondent, indicates a favorable termination. Concerning the prognosis from the urine, alvine discharges, and sputa, we will speak soon.

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COMMENTARY. The great master of prognostics is Hippocrates, whose system of medicine was entirely based on the observation of the favorable and unfavorable symptoms of disease. It would appear that the first advances in this art were made in the temples of the gods, and especially of Æsculapius, which the sick were in the practice of resorting to in order to ascertain the issue of their maladies. See a very ingenious and learned disquisition, ‘de Hippocratis Doctrina a Prognostice oriunda,’ by F. Z. Ermerins, M.D. The works of Hippocrates, especially the ‘Prorrhetica and Coacæ,’ contain a rich treasure of observations which cannot be too much explored by the student of medicine. His prognostics are founded upon the appearances of the face, eyes, tongue, the voice, hearing, the state of the hypochondriac region, the abdomen, the general system, sleep, respiration, and the excretions. We can do little more, in this place, than express our high sense of the value of the ‘Hippocratic Treatises on Prognostics,’ and recommend the study of them to all members of the profession who would wish to learn the true inductive system of cultivating medicine. We shall give as a specimen of Hippocrates’ and Galen’s labours, in this department, a few of Galen’s remarks on the causes of the symptoms, as described by Hippocrates. It is one of the prognostics of Hippocrates, that profuse perspiration in acute fevers is unfavorable; and, in explanation of this, Galen states that a critical sweat may indeed be favorable; but that such as are profuse and continued indicate a complete prostration of the vital powers. A fixedness of the eyes is said by Hippocrates to be a fatal symptom; the reason of which, according to Galen, is, that it proceeds from paralysis, or insensibility of the muscles of the eye. Hippocrates mentions it as an unfavorable symptom when the patient lies with his mouth open; and Galen attributes this symptom to the origin of the nerves, that is to say, the brain, undergoing pressure. Hippocrates states, that involuntary discharges from the bowels are an unfavorable symptom; and Galen justly remarks that they indicate great insensibility.

The Prognostics and Aphorisms of Hippocrates are further illustrated by the learned and interesting Commentaries of Stephanus Sophista, Theophilus, and Damascius, which were published a few years ago by Dietz. From the nature of their works, it is impossible to give any satisfactory outline of their contents within our narrow limits. We shall merely give one specimen of them. It is stated in one of the Aphorisms of Hippocrates, that dyspnœa and delirium occurring together in fever, indicate a fatal termination. Upon which Theophilus and Damascius remark, that the one symptom implies disease of the heart and the other of the brain. (Ed. Dietz. T. H., p. 415.)

Celsus gives an elegant translation of this part of the works of Hippocrates. The following is his version of the description of the Facies Hippocratica: “Ad ultima jam ventum esse testantur, nares acutæ, collapsa tempora, concavi oculi, frigidæ languidæque aures et imis partibus leniter versæ, cutis circa frontem dura et intenta, color aut niger aut perpallidus.” Other unfavorable symptoms are also strikingly portrayed: “Mali morbi testimonium est vehementer et crebro spirare: a sexto die cepisse inhorrescere; pus expuere; vix excreare; dolorem habere continuum; difficulter ferre morbum; jactare brachia et crura; sine voluntate lachrimare; habere humorem glutinosum dentibus inhærentem; cutem circa umbilicum et pubem macram, præcordia inflammata, dolentia, dura, tumida, intenta, magisque si hæc dextra parte, quam sinistra est; periculosissimum tamen est, si venæ quoque ibi vehementer agituntur.”

Aëtius and Oribasius, like our author, borrow almost every thing from Hippocrates and Galen.

Rhases and Avicenna, particularly the latter, treat of the prognostics in fever very fully. Avicenna, like Hippocrates, sets down deafness as an unfavorable symptom. Hippocrates had stated, that jaundice coming on before the seventh day is unfavorable; but Averrhoes affirms, that all the Indian and Persian physicians reckoned it a favorable symptom. Rhases considers yellowness of the skin an unfavorable symptom, unless the fever be of a bilious nature. Alsaharavius says it is an unfavorable complication when it does not prove critical. It is proper to mention here that Hippocrates modifies the above prognostic by stating in one of his aphorisms, that jaundice coming on on the 7th, 9th, 11th, or 14th day is favorable. (iv. 64.) Alsaharavius states it as a dangerous symptom, when the patient lies on his back with his legs drawn up. This agrees with the prognostic of Celsus “Mors denuntiatur ubi æger supinus cubat, eique genua contracta sunt.” Avicenna and Averrhoes state it as a fatal symptom when the patient sinks down in bed and exposes his hands and feet. (Averrhoes, Comment. in Cant. Avicennæ.)

According to Rhases it is a bad symptom when the patient has lost his modesty, so as to expose freely those parts of the body that should be covered. He holds also that it is a bad symptom when the vomitings resemble verdigris. (Ad Mansor. x, 21.)

Prosper Alpinus gives an admirable account of the prognostics in diseases. See his work, ‘De Præsagiendâ Morte et Vitâ ægrotantium,’ _passim_. He agrees with the ancients, that deafness is an unfavorable symptom, unless it occur at the time of a crisis. Like the ancients, he considers the absence of thirst an unfavorable symptom in ardent diseases, as indicating that the system is insensible of its wants.

SECT. V.—HOW TO KNOW IF THE DISEASE WILL BE OF LONG DURATION.

The duration of the disease may be ascertained from four things: from the movement of the disease itself, from the habit of the patient, from the pulse, and from the species of the fever. From the movement of the disease thus: if the four periods of a particular paroxysm have passed over quickly and in the least possible time, the disease will be an acute one, the furthest bound of which will be the seventh day, and generally it will come to a crisis on the fourth. If the periods of the first paroxysm occupy more time than this, but do not exceed twelve hours, the disease will still be an acute one, which will terminate within the fourteenth day. If it extend longer, so that the commencement and augmentation of the paroxysm alone occupy a longer period than a day or a night, such a disease will prove a long one. If the disease have no particular paroxysms, but consist of one continued paroxysm, as it were, from beginning to end, as in synochous fevers, even in this case you may call the disease an acute one. It may be judged of from the habit of the patient; for if the face and the rest of the body are already considerably wasted, an acute disease is indicated; but if nowise reduced, a chronic one; for a great collection of offending matter is indicated, which will require a length of time for its concoction. It may be judged of from the pulse: thus, a great, strong, quick, and dense pulse, is indicative of an acute disease, but the contrary of a chronic. From the species of the fever, inasmuch as hot and ardent fevers indicate an acute, whereas gentler, and, as it were, smothered fevers indicate a chronic one.

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COMMENTARY. Celsus thus states the prognostics of a protracted fever: “Signa quædam sunt, ex quibus colligere possumus, morbum, etsi non interemerit, longius tamen tempus habiturum: ubi frigidus sudor inter febres non acutas circa caput tantum, et cervices oritur: aut ubi, febre non quiescente, corpus insudat: aut ubi corpus modo frigidum, modo calidum est, et color alius ex alio fit: aut ubi, quod inter febres aliqua parte abscessit, ad sanitatem non pervenit: aut ubi æger pro spatio parum emacrescit: item si urina modo liquida et pura est, modo habet quædam subsidentia; si lævia atque alba rubraque sunt, quæ in eâ subsidunt; aut si quasdam quasi miculas repræsentet; aut si bullulas excitat.”

Galen has given a full exposition of these symptoms in his Commentary on the Prognostics of Hippocrates, from which Aëtius, Oribasius, and our author have borrowed largely. Rhases, Avicenna, but most especially Haly Abbas, treat at great length of this subject. See also Averrhoes (Commentaries on the Cantica of Avicenna.)

SECT. VI.—HOW TO KNOW IF THE DISEASE WILL TERMINATE BY A CRISIS, OR BY RESOLUTION.

This may be ascertained from what has been already said, namely, the species of the fever and its duration, and perhaps from the species of the fever alone. For hot and ardent fevers are of short duration, and usually terminate with some critical evacuation; whereas the gentler kinds prove more chronic, and have a tendency to abscess. From what has been said, it appears that we may prognosticate not only when the disease will come to a crisis, but also how it will terminate; for acute diseases generally terminate by critical evacuation, and the chronic by abscess.

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COMMENTARY. A similar statement is made by Aëtius (v, 22.) See also Averrhoes (Comment. in Cantica Avicennæ.)

SECT. VII.—ON CRITICAL DAYS.