SECT. XLIV.—THE CURE OF HEADACH IN FEVERS.
When headach proves troublesome in fevers, after the accustomed evacuations, in the decline of the paroxyms, the head ought to be anointed, first with the common oil from unripe olives, or with rose oil, to which a very small quantity of vinegar has been added; which, if it be the summer season, and the fever of the ardent type, may be used cold; but, in winter, if the fever be not ardent, it must be hot or tepid. In the oil may be boiled the juice of wild thyme and knot-grass (polygonum); and in summer, the heads of the poppy, or the poppy itself may be added, as in winter, a moderate quantity of the hogs-fennel may be substituted in place of it. When the pain continues in the forehead, if the open of the head be bare, a poultice may be applied to it, made of old barley-meal and knot-grass; or, in like manner, of bread and roses, or of some myrtle or wild thyme. Some are rather benefited by an admixture of pennyroyal, and others, when the affection was of a hot nature, have rather been remedied, by having flea-wort (psyllium) added to the barley-flour, or even by this substance alone, when boiled to the consistence of bird-lime. It must be frequently changed. Coriander with barley-meal may be used in like manner. Aloes with vinegar are also to be rubbed in, or myrrh and ammoniac in like manner, and crocomagma. Pulsatory pains are dispelled by rue and mint, with bread, to which a little rose oil has been added. When the pain does not yield to the afore-mentioned remedies, we must first cut the hair close by the skin, and then rub some of the oily embrocations over it all; after which cupping-instruments are to be applied to the hind-head, and the extremities to be bound with ligatures, and chafed. Leeches also are a proper application. But if a catarrh or defluxion raise the pain in the head, we must apply the remedies which will afterwards be described in the proper place. But if exhalations from the stomach have been carried upwards, and hurt the head, we must attend to them, as is stated below.
Commentary. Part of the directions delivered by Celsus for the treatment of headach deserves to be given in his own language: “Si capitis dolores sunt, rosam cum aceto miscere oportet, et in id ingerere: deinde habere duo pittacia, quæ frontis latitudinem longitudinemque æquent: ex his invicem alterum in aceto et rosâ habere, alterum in fronte: aut intinctam iisdem lanam succidam imponere. Si acetum offendit purâ rosâ uterdum est, si rosa ipsa lædit, oleo acerbo.” If this does not succeed, he recommends other more refrigerant applications prepared with iris, poppies, ceruse, litharge, &c. (iii, 10, 112.)
When headach occurs towards the beginning of fever, Galen bleeds once and again, if there be nothing to contra-indicate depletion, and more especially if the patient be plethoric. He then attends whether it arise from fumes proceeding from the stomach, or constipation of the bowels, and corrects these conditions accordingly. If it make its attack after the seventh day, he first evacuates the bowels by clysters, then cups the back part of the head or neck, or uses paregoric applications, such as rose oil, with some vinegar, if in summer; but, if in winter, especially in persons of a cold temperament, the oil of chamomile, with a fifth part of vinegar. See further ‘De Med. sec. Locos.’ (ii.)
Alexander recommends attention as to whether the headach be connected with the crisis, and in that case he cautions against meddlesome interferences, which may do more harm than good. When any applications are admissible, he recommends that they be of a cooling and soporific nature. (i, 10.)
Aëtius likewise recommends bleeding, purging, and vomiting, when not contra-indicated; and gives very proper directions about the local applications. He directs us to soak a handful of wool in some cooling fluid, and, holding it above the head, to squeeze out the fluid, so that it may fall upon the head from a height. (v, 100.)
Palladius says that headach in fevers is occasioned by repletion and distension of the veins, owing to fumes arising from the stomach. (De Febribus, 13.) Nonnus merely abridges our author’s account. (Epit. 147.)
Avicenna’s directions about the local applications are brief, and similar to those of the Greeks. (iv, i, 2, 19.) Haly Abbas recommends bleeding and attention to the state of the stomach, for the relief of which he in certain cases permits the use of wine. (Pract. iii, 20.) Rhases joins preceding authorities in recommending vinegar and rose oil to be poured upon the head. They are to be used cold in summer, but hot if in winter. (Cont. xxx.)
We have seen that Celsus approved of cold and astringent applications to the head. The Methodists condemned this practice, and recommended hot water to be poured upon the open of the head. Hippocrates seems to allude to this practice, when he says: “Much hot water poured upon the head removes fever.” (Aphor. vii, 42.) Prosper Alpinus gives an excellent account of the Methodical treatment. (Med. Meth. ii, 6.)