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.)
SECT. XLV.—ON THE CURE OF STOMACH AFFECTIONS.
If the stomach be weak, we must apply strengthening cataplasms to it, such as those made of dates and wine, and of barley-meal and saffron, and of mastich and aloes; and use embrocations from wormwood, the oil of apples, and of mastich, nard, and wine; and if hot, we must add cooling things, such as the juices of gourd, lettuce, purslain, nightshade, endive, and unripe grapes. But if the bowels appear to be inflamed, it will be proper to add to the embrocations some of the relaxing medicines, such as oil of chamomile and of privet, the grease of a cock or goose and bdellium, ammoniac, or the like; and to the cataplasms, the seed of parsley and fenugreek, the flowers of the marshmallows and chamomile; and, in a word, let the application be a compound of relaxing, attenuant, bitter, and astringent properties.