Of Medicine, in Eight Books

by Aulus Cornelius Celsus

Moreover every person ought to know, that the viscera, which I mentioned before, require a particular method of cure. For the external wound is to be cured either by a suture, or some other method. In the bowels nothing is to be touched, unless some bit in the extremity of the liver, or spleen, or lungs be hanging out, which may be cut away. Otherwise the internal wound is to be cured by the diet and medicines, which I mentioned in the former book as agreeable to each viscus.

Directions for the patient’s diet.

These steps being taken on the first day, the patient must be put to bed: and if the wound be severe, he ought to abstain from food, as much as his strength will permit, before the inflammation comes on; to satisfy his thirst with warm water, or if it be in summer, and he have neither fever nor pain, the water may be cold. However no rule is so constant, but that a regard must always be had to the strength of the patient; so that his weakness may render it necessary to take food immediately, but such as is thin, and in small quantity, just sufficient to support him. And many sinking under a hæmorrhage, before any thing else be done, are even to be refreshed with wine; which is otherwise very prejudicial to a wound.

Good and bad symptoms in wounds.

It is dangerous for a wound to swell too much: not to swell at all is extremely dangerous. The first is a sign of a violent inflammation; the other of a mortification. If the patient be sensible, and no fever has come on, we may at once conclude, that the wound will be soon healed: and even a fever ought not to alarm us, if in a large wound it continue, while the inflammation subsists; it is bad, when it either supervenes to a slight wound, or lasts longer than the inflammation, or brings on a delirium; or if it does not remove a tetanus, or convulsion, that arose from the wound. Also an involuntary bilious vomiting coming on either immediately after the wound is received, or while the inflammation continues, is a bad symptom in those only, whose nerves, or nervous parts are wounded. However to take a vomit is not hurtful; especially in those, who have been accustomed to it; but neither immediately after meat, nor when the inflammation has begun, nor when the wound is in the superior parts.

Dressings for wounds.

The wound being kept thus for two days, on third it must be opened, and the sanies must be wiped off with cold water, and the same kind of dressings put on. On the fifth day it will be easy to judge to what height the inflammation is to rise. On which day the wound must be uncovered again, and its colour observed. And if it be livid, or pale, or variegated, or black, we may be sure it is a bad wound: and whensoever this appearance is observed, it may alarm us. It is best for a wound to be white, or ruddy. Also a hard, thick, and painful skin denotes danger. It is a good sign, when this is free from pain, thin and soft. But if the wound is closed, or there be a slight swelling, the same application must be used as at first.

If the inflammation is violent, with no hopes of an agglutination, and does not yield, the use of warm water too is necessary, that it may dissipate the matter, and soften the hardness, and promote a suppuration. It must be of such a degree of warmth, as to be agreeable to the hand; and be continued so long, till it appear to have diminished in some measure the swelling, and restored a more natural heat to the ulcer. After this fomentation, if the wound does not gape much, a plaister should be applied immediately, and if it be a large wound, the tetrapharmacum would be best; in the joints, fingers, or cartilaginous parts, the rhypodes. But if it gapes pretty much, that same plaister must be softened with ointment of iris, and lint spread with it must be laid over the wound; then the plaister applied above, and over that sordid wool; and the rollers must be also less tight than at first.

Peculiar directions for wounds in the joints.