When singultus is connected with a cold cause, the author of the ‘Euporista,’ ascribed to Dioscorides, recommends us to put the feet into hot water, to take tepid draughts, and apply hot fomentations to the stomach. (ii, 4.)
Though there is perhaps nothing original in the views of the Arabians, they treat of hiccough very fully and accurately. Among the causes of it, mentioned by Alsaharavius, is inflammation of the stomach and liver, in which case he recommends venesection. When connected with excessive heat of these parts, he approves of cold air, cold drink, and refrigerant draughts, containing prunes, tamarinds, camphor, &c. (xvi, 18.) The causes of hiccough, according to Serapion, are evacuation, repletion, pungent and cold humours. His remedies are emetics, calefacients, and attenuants, which are to be directed according to the nature of the exciting cause. (iii, 17.) See also Avicenna (iii, 13, v, 25); Rhases (Divis. 62, ad Mansor. ix, 65, Cont. xi.) Rhases recommends calefacients, such as cumin, pepper, rue, and the like, in vinegar. He also approves of emetics and laxatives.
Prosper Alpinus says that the ancient Methodists approved of oily emetics. (Meth. Med. vi, 8.) It will be remarked, that our author states that many persons are seized with hiccough if they take peppers with wine. Prosper Alpinus mentions that they had this effect on him (de Præs. V. et M. ægr. iii, 9); and I have further to state the same of myself.
Rogerius, probably copying from Rhases (for the practice of the earlier modern physicians is mostly borrowed from the Arabians), recommends principally calefacient, attenuant, and carminative medicines, mixed with gentle laxatives, such as prunes. (iii, 21.)
SECT. LVIII.—ON CONSTIPATION AND LOOSENESS OF THE BOWELS IN FEVERS.
Those things which remedy a dry state of the bowels are treated of in the [First Book] sufficiently. But since a humid or loose state of the bowels may prevail in fevers, this also must be treated of; for many are cut off not by the fever itself, but by this symptom alone. In the commencement, we must not interfere with the discharge when it proceeds from corruption of the food and indigestion; but when the evacuation becomes immoderate, it must be restrained. If the discharges are of an acrid nature, that which is given should consist of good juices, and be otherwise thick, such as spoon-meats from pearl-spelt (chondrus) and ptisan. Baths are also befitting after the complaint has become concocted. But when the discharges consist of phlegm and are watery, on the other hand, the food ought to be of a more dry and heating nature, as far as the fever will permit. Of this kind, are those things which are prepared from heating condiments. But they must abstain from baths, unless otherwise required. When the digestive faculty is in an atonic state, we must give food and applications of an astringent nature; the food consisting of things in particular, to which pomegranates, apples, pears, or medlars have been added, or these fruits themselves, and thin fragrant wine of an astringent quality; and the applications are to be cataplasms made of polenta, and dates, and wormwood, roses, myrtles, and such like things. It must be considered also, to what part these cataplasms are to be applied, I mean the region of the stomach, the lower belly, or perhaps the loins. Bloody discharges are restrained and dried up by remedies containing fine flour of polenta, with frankincense, or manna mixed with wine, or oxycrate. When the watery discharge is acrid, it must be sweetened by a lavement either with water alone, or the juice of ptisan, or of chondrus, or rice, or tragum, not once, but often; and afterwards there are to be added dried roses, or myrtles, and sometimes galls; and an egg with rose oil, and a thin astringent wine, or the decoction of roses, may be injected or applied to the anus, which will blunt the desire of going to stool. But when the calls are frequent, a clew formed of warm threads may be applied to the anus.
Commentary. Galen forbids venesection when the fever is complicated with diarrhœa. (Therap. ad Glauc. i.)
When the body is constipated, Celsus recommends laxatives, diuretics, and sudorifics. He adds, it may also be proper to let blood, practise gestation, enjoin abstinence from food and drink, and keep the patient from sleeping. He likewise recommends the bath, both of tepid water and of oil. When the bowels are loose he enjoins rest and sleep, gives medicines to restrain sweating, and forbids all exercise except gentle gestation. He also directs us to excite vomiting by copious draughts of tepid water, unless the complaint be of long standing, or there be pain of the throat, præcordia, or side. (iii, 6.)
Alexander forbids narcotics, unless in cases of extreme urgency. Avicenna joins him in laying down this injunction, and otherwise directs us to treat the diarrhœa febrilis upon general principles. (iii, 16, 1, 4.) Haly Abbas treats fever, when complicated with constipation, by giving gentle laxatives, such as prunes and tamarinds, or, if these prove injurious to the stomach, by administering clysters. When the diarrhœa is complicated with a discharge of blood, he approves of adding to the other medicines Armenian earth, purslain, sumach, or such like astringents. (Pract. iii, 24.) See Serapion (iii, 17); Rhases (Divis. 67.)
According to Prosper Alpinus, the ancient Methodists approved of astringent applications and astringent clysters for febrile diarrhœa. (Med. Meth. vi, 10.) Sydenham and Van Swieten agree with Alexander and Avicenna in forbidding to stop diarrhœa in fevers by means of opiates, unless in extreme cases.