SECT. VII.—ON THE TREATMENT OF HYPERCATHARSIS.
In cases of hypercatharsis the body is to be rubbed and bathed in hot water, and before the bath a thin, pale-coloured and yellow wine is to be given (for such is the most speedily distributed), and bread soaked in it, and pomegranates. But if the evacuation continue, the limbs are to be bound with ligatures, extending from above downwards, and tightened so as to intercept the blood and spirits. A moderate quantity of the theriac from the flesh of vipers is also to be given. For it soon passes to the skin, and quickly gives a counter-determination to the defluxion of fluids upon the belly, and blunts the poisonous and deleterious property as it were of the cathartics. When in want of it we may use the theriac trochisks, and also that from seeds, and the antidote called Philonius. Cupping-instruments are also to be applied over the stomach, and cataplasms from polenta, and wine and honey; after which we must use the astringent epithemes. But they will derive the most sensible advantage from frictions of the whole body, and draughts of the aforesaid medicines. They must abstain from very cold and very hot air; for the one occasions a determination from without inwards, and increases the discharge, and the other dissipates and reduces the strength. But if the evacuation is increased by irritation in the bowels, we must apply cataplasms of the afore-mentioned things, and injections of emollients, such as the fat of geese, sweet wine, nard, and the like.
Commentary. Oribasius remarks, that when an overdose of a purgative medicine has been taken, it purges first yellow bile, then black bile, and at last blood. He recommends us, in cases of hypercatharsis, to give a hot draught, to apply tight ligatures and violent friction to the extremities, and cupping-instruments to the hypochondrium and back. When the patient can readily be made to vomit, he directs us to produce this operation by the administration of a copious draught of tepid water, and by putting a feather or the fingers down the throat. This is in accordance with Celsus’s rule of practice: “Longas dejectiones supprimit vomitus.” (ii, 8.)
Hippocrates and Aëtius, in cases of excessive purging from the administration of medicine, recommend the bath and a light-coloured wine before and after it.
Avicenna lays down the rules of treatment with great precision, but they are mostly the same as our author’s. After friction, cupping, tight ligatures, and restorative draughts have been tried, should the excessive purging continue he recommends us to administer narcotics. (i, 4, 7.) See, in like manner, Rhases (Contin. xiii, 1, 2), and Serapion (de Antid.) But Mesue is the author who has treated of all the symptoms connected with hypercatharsis at the greatest length. He recommends us to reserve narcotics as an ultimum remedium, as from the unseasonable administration of them much harm might result. He directs us to add cordials and aromatics to the narcotics. When the tenesmus is severe he directs us to stop it by suitable enemata and suppositories. For the debility and lassitude occasioned by too great purgation he recommends a tepid bath of sweet water, and friction with warm oils. (Canones Universales.)