Aëtius gives nearly the same account as our author, both having evidently borrowed from Galen. He strongly praises vinegar of squills, myrrh, pepper, and the like. In certain cases he advises the application of the actual cautery to the head (see [Book Sixth, Sect. I]) under the impression that the disease is occasioned by a defluxion from it. He also speaks of burning the chest in several places for the purpose of making issues; and further recommends strong rubefacients.
Among the articles recommended by Marcellus, the Empiric, for difficulty of breathing, we remark vinegar of squills, natron (soda), opium, horehound, &c. The first article, it will be perceived, among his remedies for asthma is vinegar of squills. Almost all the ancient authorities praise the virtues of squills in this disease.
Aretæus gives a good description of the symptoms of the disease, which he attributes to a humid, thick, and glutinous matériel in the lungs. He says, the lungs are primarily affected, and through them sympathetically the diaphragm, and parts about the chest which assist in respiration. But if the heart be affected, he adds, the issue is speedily fatal. Among the incipient symptoms he mentions flatulence of the bowels, restlessness, and latent heat by night. As the paroxysm proceeds, the cheeks become red, the nose sharp, the eyes prominent as if from strangulation, there is a râle even when awake, and still more so when asleep; the voice is humid and devoid of resonance, with an insatiable desire of cold air, panting, and orthopnœa. To these symptoms are added, paleness of the countenance, with the exception of the cheeks; profuse sweats about the face and chest; constant and difficult coughing, with little expectoration. His chapter on the treatment is lost.
As Oribasius, Actuarius, and Nonnus follow the principles laid down by Galen, we need not give any account of their opinions.
Octavius Horatianus adopts Galen’s theory, which he thus explains: “Pingui autem et frigido phlegmate pulmonibus adhærente, cavernæ, vel meatus, quibus naturaliter spiritus redditur et accipitur, concluduntur; et ex hoc impedimento suspirium, vel anhelitus molestissimus, nascitur, ut sedendo magis quam jacendo respiret.” He recommends bleeding, if not contra-indicated; but, if that is the case, frequent abstinence. Among his internal remedies we remark oxymel, gum ammoniac, castor, and vinegar of squills. He approves also of emetics. He recommends stimulant applications to the chest, also fomentations and sinapisms. A long journey, he says, is beneficial.
Cælius Aurelianus disapproves of burning the head and of strong purging. He approves of bleeding, if the patient’s strength permit, of clysters, cupping the breast, gestation, friction, vociferation, emetics from radishes, or even from hellebore, and of giving the vinegar of squills. He speaks favorably of the cold bath. His description of humid asthma is very striking, and has been commended by late authorities on the subject. The sounds within the chest are thus described: “stridor, atque sibilatio pectoris, cum vocis debilitate.”
Cassius discusses the question why there is a sibilant murmur in cases of orthopnœa, and decides that it is because the affection is a contraction and falling-in of the cells of the lungs, and the breath rushing through a narrow passage produces this murmur. (Prob. 82.)
Serapion recommends friction, exercise, squills, fumigations with arsenic, &c. Mesue also recommends arsenic in various forms. Avicenna’s account is particularly full and judicious. He properly remarks that asthma is sometimes connected with derangement of the heart, liver, and stomach. Like the others, he approves of arsenic, both in pills and in solution.
Haly Abbas, like Galen, refers asthma to a collection of gross phlegm about the cells of the lungs. His remedies are of an attenuant and incisive nature, and he particularises the vinegar of squills. He cautions asthmatics to beware of indigestion, and, therefore, forbids exercise after food, but recommends it before a meal. After exercise he enjoins hard friction, no doubt with the intention of favouring the cutaneous perspiration. Rhases commends squills and the tepid bath. Like the others, he approves of inhaling the vapours of arsenic.
Vegetius, the veterinary surgeon, recommends squills with wine, assafœtida, and oil, for these complaints in cattle.