Of Medicine, in Eight Books

by Aulus Cornelius Celsus

When one falls down, if the fit be not attended with a convulsion, blood ought to be let immediately: if it is, that is not to be done, unless other circumstances also encourage it. But it is necessary to give clysters, or to purge with black hellebore, or to do both, if the strength will allow; then to clip the hair of the head close, and anoint it over with oil and vinegar; to give food the third day after, as soon as the hour, at which the patient fell down, is past. Neither are gruels, or victuals otherwise soft and easy of digestion, or flesh, and least of all pork, fit for such persons; but diet of the middle kind: for the case requires strength; and crudities are to be guarded against. At the same time they should avoid the heat of the sun, the bath, fire, and every thing heating; also cold, wine, venery, the sight of a precipice, and every thing that terrifies, vomiting, lassitude, anxieties, all business; and when food has been given on the third day, they should intermit the fourth, and so on every other day; observing the same hour for food for fourteen days. When the distemper has proceeded so far, it has lost the force of an acute one; and if it continues, it must be treated as a chronic.

But if a physician has not been called on the day, that the person first fell, but has a man recommended to his care, who is already used to these falling fits; first of all the regimen above prescribed being followed, the day is to be expected, on which the fit may return: and then either bleeding must be used, or a clyster, or black hellebore, as has been already directed. Then in the following days, he is to be nourished by the food mentioned before, omitting all such as I said were to be avoided.

If the distemper should not be removed by these means, recourse must be had to the white hellebore; and that must be used three or four times, at the distance of a few days betwixt doses; provided however that he never repeat it, unless the fit have recurred. On the intermediate days his strength must be supported by adding some other things to those, which have been mentioned before. When he has waked in the morning, his body may be gently rubbed over with old oil, excepting his head and belly; then let him take a walk, as long and as straight as possible; after the walk let him be rubbed, in a tepid place briskly and long, and not less than two hundred times; unless he be infirm; then let a good quantity of cold water be poured over his head; let him eat a little; and rest; take a walk again before night; be briskly rubbed a second time, without touching either his belly or head; afterwards let him take supper, and with intervals of three or four days, let him for a day or two together make use of a pungent diet.

If the patient should not be cured even by these means, let his head be shaved, anointed with old oil, adding to it vinegar and nitre, and salt water poured upon it; when he is fasting, let him drink castor and water; make use of no water for drink, unless it has been boiled. Some have cured themselves of such a disorder by drinking the warm blood of a gladiator slain. With such people a miserable remedy is rendered tolerable by a more miserable distemper. As to the assistance of medicine, the last remedy is to let a little blood from both legs near the ancle; to make an incision on the back of the head, and apply cucurbitals; with a hot iron also to make an eschar in two places, in the back of the head, and below, where the first vertebra is joined to the head; that by these the noxious humour may be discharged. If by this method the distemper has not been removed, it will probably continue for life. To alleviate it, exercise must only be used, and such food, as has been directed above; and especially every thing avoided, against which we have given cautions.

CHAP. XXIV. OF THE JAUNDICE AND ITS CURE.

The distemper is equally known, which is called sometimes arquatus[(39)], sometimes regius. If this comes on after the seventh day of a fever, Hippocrates pronounces the patient to be safe, provided only the præcordia be soft. Diocles declares without reserve, that if it comes after a fever, it even does good; if a fever follows it, it is mortal. Now this distemper is discovered by the colour, especially of the eyes, in which, what ought to be white, becomes yellow. And it is generally attended by a thirst, pain of the head, frequent hiccough, hardness of the præcordia on the right side; and upon violent motion, a difficulty of breathing, and relaxation of the limbs: and when the distemper continues long, the whole body turns white, with a certain sickly paleness.

For the first day it is proper to enjoin the patient to abstinence; on the second to give a clyster; then if there is a fever, to remove it by proper diet; if there is not, to give scammony to drink, or white betes shred in water, or in hydromel bitter almonds, wormwood, anise, but of the last the smallest quantity. Asclepiades ordered also the drinking of salt water, and that for two days, with an intention to purge, rejecting the use of diuretics. Some omitting the former, by the latter and extenuating diet affirm they obtain the same purpose.

For my part if there be sufficient strength, I prefer the stronger medicines; if but little, the weaker remedies. If the patient has been purged, after that it is fit for the three first days to eat sparingly food of the middle kind, and drink Greek salt wine, that the belly may continue lax; then for other three days to eat more substantial food and some flesh too; and hold to the use of water for drink; then to return to the former diet, only eating more freely of it; and omitting the Greek, to drink black austere wine; and vary this course by using sometimes acrid food, sometimes returning to the salt wine. But through the whole time exercise and friction must be used, and if it be winter, the bath, if summer, swimming in cold water; a bed and room elegant, company, place, diversions, frolicks, and every thing else, that has a tendency to exhilarate the mind: upon which accounts it seems to be called the royal distemper. A discutient malgama also applied to the præcordia has a good effect; or a dry fig laid on there, if the liver or spleen be affected.

CHAP. XXV. OF THE ELEPHANTIASIS, AND ITS CURE.

That distemper, which the Greeks call elephantiasis[ BU ], is almost entirely unknown in Italy, but in some countries is very common, and is ranked amongst the chronic kind. The whole body is affected with it in such a manner, that even the bones are said to be spoilt. Upon the surface of the body are spots and tumours. Their redness by degrees degenerates into a black colour, the skin is unequally thick and thin, hard and soft, and is roughened with something resembling scales, the body wastes, the face, legs, and feet swell. When the distemper is inveterate, the fingers and toes are hid under the swelling; a slight fever comes on, which easily destroys the person sunk under so many maladies.