SECT. XLII.—ON WATCHFULNESS IN FEVERS.
Those who are much troubled with insomnolency, we are to direct to have their legs and hands bound with ligatures at the time when they were accustomed to go to rest; and make them keep their eyelids open, or wink, until they are sufficiently fatigued; then we suddenly loosen the ligatures, remove the lamp, and order complete stillness to be preserved. But, when the insomnolency is obstinate, we must bathe the forehead during the decline of the paroxysm with the decoction of the heads of the black poppy, and direct the patient to snuff up the dried and powdered husk of the white poppy; or from the root of the mandragora pounded with wine and rose oil in equal quantities, we make an emollient ointment (malagma), and smear the forehead with it. Or we use, during the paroxysms, wild thyme boiled in must with melilot. Or, taking the pounded heads of poppies, we make a cataplasm of it with bread and rose oil, or cerate. And the greatest attention ought to be paid to the food. Let about three spoonfuls of the seeds of the white poppy be added to the patient’s gruels; and let his pot-herbs be prepared by adding to them as many of the leaves of the black poppy, if green, as can be contained within three fingers; or otherwise, three or four dried heads may be boiled with them and taken. If, even by these means, sleep cannot be procured, let him be smeared with the juice of poppy or of mandragora. But the electuary composed from the heads of poppies, and, particularly that which is drunk with sodden wine, to the amount of a spoonful, or a spoonful and a half, often disposes to sleep. Those who are not troubled with fulness of the head may use the following fumigations in the decline: Of Indian leaf, of amomum, of costus, of arnabo, of each ℥ j, of the fruit of the balsam tree lb. j, of storax, of ammoniac perfume, of Scythian bdellium, of the root of the mandragora, and juice of poppy, as much; use as a fumigation with cypress-wood.
Commentary. We are informed by Celsus that Asclepiades trusted almost entirely to gentle friction in such cases. (iii, 18.)
Our author, as usual, copies freely from Oribasius. (See Synops. vi, 31.) Nearly the same directions are given by Aëtius. (v, 116.) Those in the beginning of the Section are from Galen; the remaining part is from Herodotus and Philumenus.
Nonnus gives a correct account of the established rules of treatment in such cases. Thus, he directs us to use ligatures, and apply friction, to the extremities; and, if this treatment have not the desired effect, to have recourse to soporific decoctions, or liniments prepared with poppies, opium, mandragora, &c., or even to give internally an infusion of poppy heads. (Epitome, 145.)
The directions given by Avicenna are so like our author’s that we must suppose them copied from him. He directs us first to try the effect of fatiguing the patient by talking loud to him, placing many candles in his chamber, and applying ligatures to his extremities. When this method does not succeed, he recommends the soporific applications mentioned by our author. When there is nothing to forbid the use of it, he permits the syrup of poppies. (iv, i, 2, 20.) Haly Abbas likewise recommends poppies externally and internally. (Pract. iii, 23.) Averrhoes briefly directs food and applications of a soporific nature. (Collig. vii, 2.) Rhases mentions our author’s plan of treatment, and further seems to approve of liniments made of mandrogora, opium, henbane, and the juice of lettuces. (Cont. xxxi.)
Cælius Aurelianus remarks that the indiscreet use of soporifics may bring on lethargy. According to Prosper Alpinus, the Methodists approved of fomentations, consisting of soporific medicines, such as lettuces, opium, and the like. (Med. Meth. vi, 8.)
The earlier of the modern writers on medicine approve of applying to the nose a sponge soaked in a soporific liniment prepared from opium, henbane, mandrake, cicuta, lettuce, and the like. (See Theodoricus, iii, 8.)