SECT. XXVIII.—ON CORYZA, CATARRH, AFFECTIONS OF THE TRACHEA, AND COUGH.
All these complaints have this in common, that they are occasioned by the defluxion of a redundant humour from the head to the parts below. When, therefore, it seats in the nostrils, the disease is called coryza; when in the pharynx and roof of the mouth, simply catarrh; but when it attacks the larynx and arteria trachea, so as to occasion a roughness of the membrane which lines them, the voice becomes hoarse, and the disease is called branchus, or morbus arteriacus: these terms being applicable not only to the inflammatory roughness occasioned by a defluxion from the head, but also to that arising from vociferation and inhaling cold air. When the complaint is protracted, and the defluxion is carried down to the chest and lungs, it gives rise to bad coughs. And a cough often arises from an intemperament; sometimes a hot one, as in fevers, and sometimes a cold, as in northerly states of the weather, which is rather a dry one. Cough is also sometimes symptomatic of some other disease, such as pleurisy, hepatitis, phthisis, or peripneumonia. Wherefore Galen relates that, in certain chronic cases of cough, chalazia (hail-stones) have been brought up from the chest. But Alexander relates that a certain heavy stone, like that which forms in the urinary organs, was brought up in a chronic cough, upon which the cough ceased. We ourselves have seen a discharge of stones with vomiting of blood, as we will describe more accurately when we come to that part. Those who have coryza and catarrh from exposure to heat have a sensation of heat about the parts, and a running of acrid and thin humours from the nostrils and mouth, and there is redness about the face and nose. When they are occasioned by cold, there is distension about the head and forehead, and obstruction of the ethmoid pores, so that the voice does not resound through the nose; and when they are protracted, cough supervenes, and expectoration of phlegm, which is sometimes unconcocted and fluid, and sometimes green. In some cases fever comes on, which does not alleviate the complaint when it proceeds from heat, but when from cold it promotes concoction.
The cure of catarrh and of coryza. When a hot intemperament prevails, those remedies will apply which suit with headachs from the same cause. They must have recourse to baths, and have a large quantity of hot water poured upon the head. The food most befitting are spoon-meats and eggs in a state to be supped, starch, sweet cake, sesame, rice, almonds, the fruit of the cones of pine, and all confections from milk. The wines which are drunk should be sweet and not old. The lohoch from poppy-heads, called diacodium, and other compound medicines for these complaints, are to be taken. When a cold intemperament prevails, and the disease is difficult to remove, a restricted diet is to be observed, and the head anointed with some heating and attenuating ointment, such as that of nard or rue. But the ointment of iris is not only to be rubbed in, but is also to be injected into the nostrils; and, internally, they are to be rubbed with frankincense and myrrh, with oil; and this more especially when the coryza arises from cold. But these are remedied by odoriferous substances with burnt linen, or by gith and cumin burnt and bound up in a linen rag. Let them also smell to the cyphi seleniacum, and let it be rubbed into the forehead; and to it let there be added one of the antiphlogistic plasters, such as the Icesian, the Oxera, the Barbarum, and the Athena. For catarrh from cold it will be expedient to drink of cyphi, and to rub into the chest the juice of balsam by means of unwashed wool; or to apply calefacients to it, along with storax, the ointment of iris, or that of dill. Let them also use hot and concocting food. But when the matter is already concocted, a masticatory will answer well with them, and detergent ointments (smegmata) to the head, such as the soap of Constantine, and the like.
The cure of affections of the trachea, or hoarseness. For the complaint called arteriacus and branchus, those things already mentioned will apply; but, in particular, when an inflammatory affection of the trachea and larynx prevails, we must, at the commencement, use the emplastic remedies, until the inflammation become more moderate; such as those from Cretan sweet wine, tragacanth, gum, and starch, and a decoction of the fatty dates and that of liquorice, with rob, until it become of the consistency of honey. And we must use that class of electuaries called hypoglottides. But, above all things, the patient at this period must abstain from drinking wine; but when the inflammation becomes moderate, he may take some sweet wine. And let him use those spoon-meats which are made from honey and milk, with starch, and bread of fine flour, and almond emulsions; and let him take butter. When a humour remains fixed in the parts, he must have recourse to detergent remedies, such as the porridge of beans, and those things which are prepared from honey, cabbage, and well-boiled leeks. He may also take the hotter medicines, and those used for the cough, in the rob of dried figs, of frankincense, iris, turpentine, storax, galbanum, pepper, cinnamon, cassia, and the like.
On cough. Coughs are to be cured by the same method, attending only to this, whether they be occasioned by sympathy with other parts, such as a defluxion from the uvula or head, and whether they be symptomatic of other diseases; in which case, they are to be disposed of in the manner already mentioned, or as will be described afterwards. An exposition of the compound remedies follows.
Pills for catarrh and cough. Of storax, of myrrh, of opium, of galbanum, equal parts; mix with must, or pound by themselves in a mortar, and make into pills the size of a tare. Give three, four, or five at bedtime, and swallow with some must. These things are for an acrid and thin rheum.—Another: Of the seed of henbane, dr. xij; of pine-nuts, dr. vj; of saffron, dr. ij. Mix with rob or with must, and use.
An electuary. Of honey, oz. j; of butter, oz. ss. Boil together and give; and let the decoction of hyssop, of figs, of pine-nuts, and of iris, be swallowed.
Pills for more inveterate coughs. Of storax, dr. vj; of myrrh, dr. iiss; of turpentine, of galbanum, of opopanax, and of iris, of each, dr. ij; of white pepper, of nitre, of henbane-seeds, of the juice of poppy, of each, dr. j. Beat in a mortar without any liquid, form into pills, and use as formerly directed.
For roughness of the windpipe, cough, and bloody expectoration. Of bitter almonds whitened, xxv in number; of toasted linseed, dr. iv; of tragacanth, dr. ij; of pine nuts, xxx grains; the yelk of an egg roasted in dough. The tragacanth is macerated with water, and the whole mixed with must. If the sound of the voice be broken, mix honey instead of the must, more particularly when there is anything to expectorate.
An arteriac to be kept below the tongue for those who have lost the voice, for hoarseness, and bloody expectoration. Of tragacanth, dr. vj; of gum, dr. vj; of myrrh, dr. iss; of white pepper, xx grains; of saffron, dr. j; of liquorice-juice, dr. vj; the flesh of three dates; of Cretan sweet wine, q. s. The juice of the tragacanth alone placed under the tongue answers very well. Instead of the juice of liquorice, its decoction boiled down to the proper consistence may be substituted in quadruple quantity.
An arteriac for loss of voice, suiting also for strengthening the voice. Boil six leeks to a third part; throw them away, but with the decoction mix the juice of alica and honey; boil with them the yelks of three eggs previously boiled, stirring with a branch of dill.
For coughs. Of pennyroyal, oz. ij; of pine-nuts, of bastard saffron, of linseed, of each, oz. j; of white pepper, oz. iv; mix with boiled honey.—Another: Of hyssop, of pennyroyal, of pepper, of each, oz. j; of Macedonian parsley, oz. ss; of honey, a hemina.
For concocting an inveterate cough. Of honey, dr. xvj; of turpentine, dr. ij; of galbanum, dr. xiv. Having boiled them together, and having formed to the size of beans or of walnuts, let them be sucked.—Another: A dry cough is cured by the arteriacs, and also by the drinking of hot water; for, not being able to expectorate, owing to the thickness of the phlegm, they are assisted in so far by diluents. A decoction from hyssop, and iris, and pine-nuts, also answers with them.
A trochisk to be inhaled for a continued cough. Of storax, of pepper, of mastich, of Macedonian parsley, of each, oz. j; of sandarach, scr. vj; two bay-berries; mix with honey; and fumigate by throwing them upon coals, so that the person affected with the cough may inhale the vapour through a funnel. It answers also with those affected by cold in anywise.
Commentary. All the writers referred to in [the preceding Section] (with the exception of Aretæus) may be consulted here.
Galen, in the seventh book of his work, ‘de Med. sec. loc.’ has treated of these diseases so fully that he may be said to have exhausted the subject. We can only afford room for a few of his general remarks. He states that the arteriacs, or compositions for affections of the arteria trachea, consist of three different kinds of medicines. First, those called by him obstruents, and answering to those now called demulcents, such as Cretan sweet wine, tragacanth, liquorice, and the like, which act by smoothing the asperities of the parts. Second, the acrid, containing cinnamon, turpentine-rosin, and the like. Third, the intermediate, consisting of the juice of ptisan, almonds, and the like. He gives a great number of compositions from Andromachus, Criton, and others, which might deserve attention. Of their ingredients some are expectorants, such as squills, myrrh, &c.; some demulcents, such as liquorice, tragacanth, &c.; and some narcotic, such as opium, mandragora, hyoscyamus, and hemlock. With the medicinal properties of the last-mentioned article (we mean the conium maculatum), which Dr. Paris commends so highly in diseases of the chest, the ancients were sufficiently well acquainted. For humid coughs Galen recommends a composition of alum, opium, galbanum, and storax. He mentions lumbrici in the stomach as a cause of coughs. (Com. in Epid. iii.) Among the remedies mentioned by our author, by Galen, and by most of the ancient authorities, we may remark the inhaling the fumes of certain acrid medicines, such as yellow orpiment and sandarach, or realgar, i. e. red orpiment. Whether the practice be safe or not we shall not pretend to determine; but, unquestionably, it is recommended upon high authority; and therefore it is not true, as has been often stated, that this practice arose from the mistake of confounding the gum juniper, or vernix of the Arabians, also often called sandarach, with the sandarach of the ancients, or realgar. (See Bree on Asthma, p. 231.) We refer to Aëtius (viii, 61); Pseudo-Dioscorides (Euporist. ii, 33); Pliny (H. N. xxxiv, 55); Alexander (v, 4); Myrepsus (xli, 76); Serapion (ii, 19, and 24); and Rhases (Cont. viii.) The ancient veterinary surgeons used arsenic in fumigations for the coughs of cattle. See Vegetius (Mulom. iii, 67.) Platearius, a modern writer of the thirteenth century, recommends arsenic for chronic coughs, both in fumigations and taken into the stomach, and yet he distinguishes quite correctly the sandarach, or red arsenic, from the gum vernix. (De Simplici Medicina.) Some of the earlier writers on the venereal disease recommend fumigations with arsenic for syphilitic ulcers of the throat. (V. Aphrodisiacus, and [Sect. XXIX] of this Book.)
At the commencement of a common catarrh, Celsus advises to abstain “a sole, balneo, vino, venere;” but to use “unctione et assueto cibo.” When the lungs become affected he recommends much friction and exercise on foot. He gives the following account of the origin of these complaints: “Destillat autem humor de capite interdum in nares, quod leve est; interdum in fauces, quod pejus est; interdum etiam in pulmonem, quod pessimum est.” The idea of the disease originating in the head and spreading downwards prevails in all the ancient descriptions of the disease, and, we may mention, is now sanctioned by the authority of the illustrious Laennec. See, in particular, Aëtius, who copies, however, in part from Galen.
Alexander devotes a whole chapter to the consideration of these complaints. He forbids diuretics, because they carry off the thin part of the humours and leave the thick behind. Respecting the chalazia mentioned by Galen, and “the smooth, hard, and firm stone” said to have been expectorated by Alexander’s patient, we have a few remarks to make. The passage in Galen’s work where they are described is at ‘de Loc. Affect.’ iv, near the end. These sputa have been described by recent pathologists. Thus Andral calls them small clots, of a dull white, or inclining a little to yellow, from a small pin’s head to a pea in size. (Clinical Medicine, 464, Engl. ed.) The modern authorities agree that they are indicative of phthisis. Aretæus describes by the name of pneumodes, and as a species of asthma, a diseased state resembling that which we are treating of. The symptoms are dyspnœa, cough, and wasting; pulse small, frequent, and feeble; the sputa, if any, small, white, round, and like hail. The disease proves fatal in the course of a year, and often ends in dropsy and anasarca.
The treatment recommended by the great Methodist Cælius Aurelianus is not much different from the practice of the other sects, only he enjoins a more rigid abstinence from wine and food of a heating nature. He also condemns the practice of inhaling the vapours of red arsenic (sandaracha), and the like. In protracted cases he recommends a change of place.
There is nothing original in the practice of the Arabians. Avicenna prudently forbids preparations of poppies after expectoration has commenced. For coryza Haly Abbas recommends, if the patient’s age and temperament permit, bleeding, a spare diet, abstinence from wine, fumigations with the vapours of camphor, lignum aloes, vinegar, &c.; avoiding to lie on the back, and so forth. He treats at great length of coughs, distinguishing them according as they are seated in the throat, gullet, or lungs, and whether they be sympathetic or not. For hoarseness, he directs gargles from the seed of anise or fennel, or a decoction containing radishes, parsley, fennel, mastich, spikenard, iris, figs, &c. Alsaharavius treats fully of these complaints in much the same terms.