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.)
SECT. XVI.—ON LYCAON, OR LYCANTHROPIA.
Those labouring under lycanthropia go out during the night imitating wolves in all things, and lingering about sepulchres until morning. You may recognize such persons by these marks: they are pale, their vision feeble, their eyes dry, tongue very dry, and the flow of the saliva stopped; but they are thirsty, and their legs have incurable ulcerations from frequent falls. Such are the marks of the disease. You must know that lycanthropia is a species of melancholy which you may cure at the time of the attack, by opening a vein and abstracting blood to fainting, and giving the patient a diet of wholesome food. Let him use baths of sweet water, and then milk-whey for three days, and purging with the hiera from colocynth twice or thrice. After the purgings, use the theriac of vipers, and administer those things mentioned for the cure of melancholy. When the disease is already formed, use soporific embrocations, and rub the nostrils with opium when going to rest.
Commentary. See Aëtius (vi, 11); Oribasius (Synops. viii, 10); Actuarius (Meth. Med. i, 16); Anonymus (de Lycanth. ap. Phys. et Med. Min.); Psellus (Carm. de Re Med. ibid.); Avicenna (iii, i, 5, 22); Haly Abbas (Theor. ix, 7, Pract. v, 24); Alsaharavius (Pract. i, 2, 28); Rhases (Divis. 10, Cont. i.)
All the other authorities give much the same account of this species of melancholy as Paulus. If we adopt Dr. Mead’s theory respecting the dæmoniacs mentioned in Scripture, we may conclude that the man, whose state is described in Luke (viii, 27), was affected with this disease. Dr. Mead is farther of opinion that Nebuchadnezzar was seized with lycanthropia. The reader will find much curious information on this head in Burton’s ‘Anatomy of Melancholy,’ from which all Mead’s opinions are borrowed.
The Arabian term is cutubut.
Avicenna recommends the application of the actual cautery to the sinciput, when the other remedies fail. Haly Abbas describes the disease by the name of melancholia canina. He says the patient delights to wander among tombs, imitating the cries of dogs; that his colour is pale; his eyes misty (tenebricosi), dry, and hollow; his mouth parched; and that he has marks on his limbs of injuries which he has sustained from falls. He recommends the same treatment as our author: indeed he evidently merely translates this section of Paulus. Alsaharavius seems also to allude to this disease by the name of melancholia canina. Rhases’ account of it is quite similar to our author’s.