Of Medicine, in Eight Books

by Aulus Cornelius Celsus

It is more easily cured in slaves, than in free people; because as it requires fasting, enduring of thirst, and a thousand other hardships, and long patience, such are more readily relieved, that are easily commanded, than those, whose liberty is hurtful to them. But even those, that are under the authority of another, if they cannot entirely command themselves, are not to be recovered. And upon this account no inconsiderable physician, a disciple of Chrysippus, residing with king Antigonus, declared that a certain friend of that prince, of known intemperance, though not very ill of this disease, could not possibly be cured: and when another physician, Philip of Epirus, undertook to cure him, he answered, that the other considered only the distemper of the patient; he, his dispositions. And he was not deceived; for though he was watched with the greatest diligence not only by the physician, but even by the king too, yet by devouring his malagmas[(24)], and drinking his own urine, he quickly killed himself.

However at the beginning the cure is not very difficult, if rest, thirst, and fasting be strictly enjoined. But if the disease has continued long, it is not removed without great trouble. Yet they tell us, that Metrodorus, a disciple of Epicurus, when he was afflicted with this distemper, and could not patiently endure the necessary thirst, after refraining long, used to drink, and then vomit it again. Now if whatever has been taken, be brought up again, it lessens the uneasiness considerably: if it is retained in the stomach, it increases the disorder; therefore it must not be attempted in every one.

But if it be attended with a fever, that in the first place must be removed by such means as have been prescribed for the cure of that distemper. When the patient is free of a fever, then we may apply the usual remedies of the dropsy. And with regard to this, whatever species it is, if it has not got too deep root, the very same remedies are necessary. The person must walk much, run sometimes, and his superior parts especially must be rubbed, so as to bring a warmth into the skin. In the mean time he must keep in his breath. Sweat is likewise to be procured, not by exercise only, but also by hot sand, or the laconicum, or clibanum, and such like means: and natural and dry sweating places are very beneficial: such as we have at Bajæ amongst the groves of myrtles. The bath and all moisture is hurtful. Catapotia[(25)], composed of two parts of wormwood and one of myrrh, are properly given to the patient fasting.

The food ought to be of a middle nature, but of the harder kind of it. No more drink given than to support life: and that is best, which provokes urine. It is better to attempt that by diet[(26)], than medicine. However, if there is a necessity, some of the things, which have that effect, must be boiled, and the decoction of them given to drink. This faculty seems to be possessed by the iris, nard[(27)], saffron, cinnamon, cassia, myrrh, balsam[(28)], galbanum, labdanum, flower of the wild vine, panaces[(29)], cardamom[(30)], ebony, cypress seed, stavesacre, which the Greeks call staphis agria[ BN ], southernwood, rose-leaves, acorum[(31)], bitter almonds, goat’s marjoram, storax, costus, the flower of long and round cyperus[(32)]; the first of these the Greeks call cyperus[ BO ], and the other schœnus[ BP ]. Whenever I mention these, I intend not such as grow here, but those that are imported amongst the spices. However the mildest of these must be tried first, that is the rose-leaves, or spikenard. Austere wine also, but very weak, is good.

It is convenient likewise to measure the belly every day with a thread, and to put a mark upon this, where it meets: and each succeeding day to observe, whether the bulk be enlarged or diminished; for that which lessens, feels the effect of the medicine. And it is not improper to measure the patient’s drink, and his urine; for if more moisture is excreted, than is taken, in such a case there is hope of recovery. Asclepiades tells us in his writings, that to a person, who had fallen into a dropsy after a quartan, he prescribed abstinence for two days, and friction; on the third he gave him food and wine, finding him free both of the fever and dropsy. Thus far general rules may be laid down for all the species of the distemper: if the malady rises to a greater height, different methods of cure are required in each.

Wherefore if there is a flatulency, and from that frequent pain, a vomit after meat every day, or every other day, is of service. After that dry and warm fomentations must be used. If the pain is not removed by these means, cupping without scarification is necessary. If the pain does not even yield to that, the skin must be cut, and the cucurbitals applied again. The last remedy, if the cupping has done no service, is to inject into the belly plenty of warm water, and to take it back again. Moreover it is necessary to make use of friction three or four times a day, with oil and some heating medicines. But in this friction the belly must be avoided; mustard must be applied to it frequently, till it corrode the skin; and several ulcers must be made in the belly with hot irons, and these kept open for some time. Boiled squils also bound upon the skin[(33)] are good. But for a long time after these flatulencies all windy food must be avoided.

But if the distemper be what is called leucophlegmatia, it is fit to expose the swelled parts to the sun; but not too much, lest it inflame the fever. If the sun is too powerful, the head must be covered, and friction made use of, the hands being only moistened with water mixed with salt, and nitre, and a little oil; and that by the hands either of a child or a woman, as their touch is softer: and if the strength will allow, it may be continued a whole hour in the forenoon; in the afternoon for half an hour. Restringent cataplasms also are good; especially if the body be pretty tender. An incision must likewise be made on the inside of the leg, about four fingers breadth above the ancle; from which for some days a good quantity of water may be discharged, and it is proper also to make deep gashes in the tumours: and the body must be well agitated by frequent gestation; and when the wounds are cicatrized, the exercise and food must be increased, till the body return to its former habit. The food ought to be strong and glutinous, and chiefly flesh. The wine pretty sweet, if the stomach will bear it; but in this course, that alternately for two or three days together, sometimes water and sometimes wine be drunk. It is proper also to give the seed of sea spurge, which grows large near the sea, to drink with water. If the person be strong, boiled squills may be tied upon his belly at the same time. And many authors advise, that the tumours be beat with inflated bladders.

But if the disease be of that kind, in which there is a large collection of water within the abdomen, it is fit to walk, but more moderately; to keep a discutient malagma applied to the part, with a triple cloth above it, and to bind it on with a roller, though not too tight. Which practice, introduced by Tharrias, I observe is still continued by the greatest number of physicians. If it is evident, that the liver or spleen is affected, it is proper to apply over it a mellow fig bruised, with the addition of honey. If by such remedies the belly is not dried, but the water notwithstanding abounds, a more speedy method must be taken to relieve, that is, to discharge it by the belly itself. Nor am I ignorant, that Erasistratus disapproved of this method of cure: for he imagined this to be a distemper of the liver; and therefore that means should be used to restore that part to a sound state, and that it was to no purpose to draw off the water, which, while that bowel is distempered, Would be presently collected again. But in the first place, this bowel is not only the seat of this disease: for it arises both in the case of an affected spleen, and a bad habit of the whole body. And secondly, supposing it to have begun thence, yet unless the water be discharged, which stagnates there preternaturally, it hurts both the liver and the other internal parts. And it is granted, that care should be taken nevertheless to cure the whole body. For discharging of the water does not work a cure, but makes room for the operation of medicine, which that obstructs, while it remains there. Neither does this admit of any dispute, that all in this disease are not to be thus treated: but robust young men may, who are either entirely free of a fever, or at least have pretty long intermissions: for those, who have a vitiated stomach, or have fallen into this disorder from the atrabilis, or those, who are in a bad habit of body, are not fit subjects for this treatment. On the day, that the water is first discharged, giving of food is improper, unless the patient feels a want of strength. In the following days indeed wine not much diluted ought to be given, but not in a large quantity, and the patient must be again gradually accustomed to exercises, frictions, the heat of the sun, sweatings, fatigues, and proper food, till he be entirely well. The case requires seldom bathing, and frequent vomits when fasting. If it be the summer-time, it is proper to swim in the sea. For a long time after his recovery venery is hurtful.

CHAP. XXII. OF THE SEVERAL KINDS OF CONSUMPTION AND THEIR CURE.

A consumption is a distemper often of longer continuance, and attended with greater danger. And of this also there are several species. One of them is, where the body is not nourished, and as something is naturally always flying off, and nothing comes in to supply its place, the person becomes extremely emaciated, and unless it be removed, it proves mortal. This the Greeks call atrophia[ BQ ]. It commonly proceeds from one of two causes: for one man through excessive fear takes less, another from too great voraciousness takes more food, than he ought to do: so that either the defect of aliment weakens, or what is redundant is corrupted.