The account given by Celsus is very similar, and highly interesting. He approves of bleeding, the internal and external use of vinegar, and cold water to drink. Part of his treatment deserves to be given in his own inimitable language: “Præter hæc necessaria sunt quies, securitas, silentium. Caput cujus quoque cubantis sublime esse debet, rectèque tondetur. Facies sæpe aquâ frigidâ fovenda est. At inimica sunt vinum, balneum, venus, in cibo oleum, acria omnia, item calida fomenta, conclave calidum et inclusum, multa vestimenta corpori injecta, etiam frictiones. In hoc casu per hiemem, locis maritimis; per æstatem, mediterraneis opus est.”
Scribonius Largus, among other remedies, mentions sponging the chest with vinegar.
Pliny the elder recommends the juice of henbane in hemoptysis. (H. N. xxvi, 15.) See also Marcel. Empir. (17); Plin. Valerian. (iv, 69.)
The account given by Aëtius is full and judicious, but mostly borrowed from Galen. He approves of the internal use of vinegar, and of applying to the chest wool soaked in the same.
Oribasius, Actuarius, and Nonnus recommend internal remedies like those of our author.
Alexander’s observations are exceedingly judicious; but we can only afford room to state his opinion of external applications. He approves of embrocations by means of wool soaked in rose-oil, or the like, with some vinegar or austere wine not very old; but recommends us to change the application frequently, as by allowing it to remain it will only irritate and provoke the flow of blood. With such precautions Octavius Horatianus, in like manner, approves of sponging the chest with sour wine and water, or vinegar. Alexander properly forbids us to give anything warm, and cautions against violent exercise, anger, venery, and saltish food.
Galen expounds the pathology and principles of treatment so fully, that we cannot even venture to give an abridgment of his account, but will venture to recommend it to the serious attention of the medical reader. We must not omit, however, what he says respecting the use of cold and astringent applications to the chest: “I do not, like most physicians, approve of applying externally astringents, or things which are of a cooling nature without astringency, in cases of hemorrhage; for it appears to me that they have sometimes a contrary effect from what they are intended to produce, as they occasion a determination inwardly, and congestion in the deep-seated veins. I have therefore known cases of persons affected with spitting of blood who were evidently hurt by the application of cold to the chest. Wherefore, in cases of hemorrhage, I do not approve of the indiscriminate use of cold applications.” (Meth. Med. v, 6.) See also de Const. Artis Med. (16.) Galen mentions that blood may run down from the fauces into the windpipe, and thereby occasion groundless apprehensions of hemoptysis.
It deserves to be remarked that Dioscorides, Pliny, Galen, Alexander, and Paulus agree in recommending the hæmatite, or bloodstone for hemoptysis. It is a native oxyde of iron.
To the long and accurate account given by Cælius Aurelianus it is impossible to do justice in a short abstract. Passing over entirely his description of the symptoms, and explanation of the sources from which the blood is discharged, we shall merely dwell upon a few points of his practice. He insists with proper earnestness on the necessity of complete rest, coolness, and abstinence from everything of a stimulant nature; and recommends the practice already often mentioned of applying to the part affected sponges or compresses soaked in cold water, or in water and vinegar, or in some astringent decoction. He also approves of the application of ointments or plasters composed of galls, alum, the rind of the pomegranate, and the like. From among his many internal medicines we would point out the composition consisting of gum acacia, alum, and the decoction of poppies. When the discharge does not stop before the third day, he recommends venesection. But if pain, difficulty of breathing, or a dry cough should come on, he approves of bleeding at an earlier period of the disease. He then directs us to give emollient epithemes, electuaries containing frankincense and opium, and the like. When the pain is protracted, he recommends us to apply cupping-instruments or leeches to the part affected. Food of a middle quality, milk, and the like are to be given. From his strictures upon the practice of the others, it appears that some of the medical sects had condemned venesection, but it is satisfactory to know that most of the authorities were agreed about the propriety of it. The Methodist forbids it when there are no symptoms of inflammation present. It seems there were disputes also about the propriety of ligatures to the extremities, but Cælius pronounces in favour of this practice. He informs us further that some questioned the propriety of giving vinegar, but he decidedly approves of it. When there is any inflammation, he disapproves entirely of astringents. He also condemns sudorifics and diuretics. He allows exercise only when the complaint has abated.