SECT. XV.—ON INCUBUS, OR NIGHTMARE.
Some say that this disorder is called ephialtes in Greek, from the name of a man, or from those in it fancying as if one leaped upon them. But Themison, in the tenth book of his Epistles, calls it pnigaleon, from a Greek word signifying suffocation. It attacks persons after a surfeit, and who are labouring under protracted indigestion. Persons suffering an attack experience incapability of motion, a torpid sensation in their sleep, a sense of suffocation, and oppression, as if from one pressing them down, with inability to cry out, or they utter inarticulate sounds. Some imagine often that they even hear the person who is going to press them down, that he offers lustful violence to them, but flies when they attempt to grasp him with their fingers. The evil must be guarded against at the commencement; for when it continues long, and attacks every night, it is the forerunner of some serious disease, such as apoplexy, mania, or epilepsy, when the exciting cause is determined to the head; for such as persons affected with epilepsy are, during the day, those labouring under nightmare are in their sleep. We must evacuate the patient’s general system by opening a vein and administering purgatives. Black hellebore is especially serviceable to such persons when given to the amount of a drachm, if three oboli of scammony, and some of the aromatics, such as anise, wild carrot, and Macedonian parsley, be mixed with it. The composition called hiera, from wild gourd, is also of great service; it is the hiera of Ruffus. The diet should be light, and they ought to avoid everything that is flatulent. They are benefited also by the fruit of peony: fifteen of the black grains of which may be pounded with water and drunk frequently.
Commentary. See Aëtius (vi, 12); Oribasius (Synops. viii, 2); Actuarius (i, 16); Cælius Aurelianus (Tard. Pass. i, 3); Psellus (Opus Medicum); Avicenna (iii, 1, 5, 7); Alsaharavius (Pract. i, 33); Rhases (ad Mansor. ix, 12, Contin. i.)
The other ancient authors treat the complaint, like our author, by evacuants. Bleeding (Rhases recommends this to be done at the ancle), drastic purgatives, and friction of the extremities are the common remedies. Alsaharavius says that, if not cured by bleeding, it is to be treated, as epilepsy, with hiera and the like. Even Cælius in this case nearly agrees with the others, recommending restricted diet, and, if the disorder is great, venesection. He also approves of applying cupping-instruments with scarifications on the side of the throat, and, when the disease is protracted, of emetics, and shaving the head. For the cure of incubus, Mesue and Rhases recommend bleeding and an attenuant diet. Ruffus, as quoted by the latter, recommends vomiting, purging, an attenuant diet, sternutatories, masticatories, and ointments to the head, containing castor and the like.
Psellus gives a very graphic description of incubus. (Op. Med.)