Of Medicine, in Eight Books

by Aulus Cornelius Celsus

Of a catarrh and gravedo.

A humour distils from the head sometimes into the nose, which is a slight disorder; sometimes upon the fauces, which is worse; sometimes even upon the lungs, which is worst of all. If it have fallen upon the nose, a thin rheum flows from the nostrils, the head is slightly pained, a weight is felt in it, and there are frequent sneezings. If upon the fauces, it irritates them, and raises a slight cough. If upon the lungs, beside the sneezings and cough, there is also a weight in the head, lassitude, thirst, heat, and bilious urine.

Another (though not very different) disorder is a gravedo. This obstructs the nostrils, blunts the voice, raises a dry cough: at the same time the saliva is salt, there is a sounding in the ears, the veins of the head move, and the urine is turbid. All these disorders Hippocrates calls coryzæ[ CF ]. I observe that this is now by the Greeks appropriated to the gravedo: and catarrhs are called by them catastagmi[ CG ]. These are common, and of short continuance; but if they be neglected, are usually lasting. None of them is dangerous, but such as ulcerate the lungs.

When we perceive any such symptoms, we ought immediately to avoid the heat of the sun, the bath, and venery[(6)]. And at the same time nevertheless unction may be used, and the ordinary diet. The patient should take a straight, but not too quick walk; and after it the head and face must be rubbed above fifty times. And it seldom happens, if we have restricted ourselves for two days or three at most, that the disorder is not mitigated. When it is abated, if in the catarrh the phlegm turns thicker, or in a gravedo, if the nostrils are more open[(7)], the bath is to be used, and the face and head fomented plentifully first with hot water, and then with egelid; after that, the patient may eat heartily and drink wine. But if on the fourth day the phlegm is equally thin, or the nostrils appear equally obstructed, austere Arminæan wine[(8)] is to be taken; then again for two days successively water; after which the person may return to the bath, and his usual way of living.

Neither even on these days, in which some things are to be refrained, is it proper to live like sick people; but in all other respects the same liberties may be taken as in health, except by one, who uses to be long and severely afflicted with these disorders; for such a person requires a management somewhat nicer. Therefore if the defluxion be upon his nose or fauces, besides what I mentioned before, he ought immediately in the first days of his indisposition to walk much, to rub the inferior parts briskly, the friction must be more gentle upon the thorax, and gentler still upon the head, the ordinary diet must be diminished to half the quantity, eggs must be used, starch, and such like things, which generate a thicker phlegm; thirst, as much as he can bear, must be one part of the cure. When by these means one has been rendered fit for the bath, and has used it, a small fish, or flesh is to be added to his diet; with this caution however, that he do not immediately take his ordinary quantity of victuals. Pure wine must be used pretty plentifully.

But if it distils also upon the lungs, there is a much greater necessity for walking and friction, still observing the same rules in diet. If these have not the desired effect, he must use the more acrid kinds, indulge sleep more, and abstain from all business, sometimes try the bath, but not soon.

In a gravedo it is necessary for the first day to rest, neither to eat nor drink, to cover the head, and put wool round the throat; the day following to rise, to abstain long from drinking, or if he is obliged to do it, not to take above a hemina of water; on the third day to take a little soft bread with a small fish or some light flesh, and to drink water. If a person should not be able to forbear eating heartily, he must vomit: when he comes into the bath, he is to foment his head and face plentifully with warm water, till he sweat, then return to the use of wine. After which it can scarcely happen, that the same indisposition will continue. But if it remain, use must be made of cold, dry, and light food, as little moisture as possible, friction and exercise being still continued, which are necessary in every indisposition of this nature.

CHAP. III. OF THE DISEASES OF THE NECK, AND THEIR CURE.

From the head we proceed to the neck, which is liable to very severe diseases. Nor is there a more troublesome or more acute distemper than that, which by a kind of spasm of the nerves draws sometimes the head to the shoulders, sometimes the chin to the breast, sometimes stretches the neck and holds it straight and immoveable. The first the Greeks call opisthotonus[ CH ], the second emprosthotonus[ CI ], and the last tetanus[ CJ ], although some with less accuracy make use of these names indiscriminately. They often kill within four days: if the patients have escaped that time, they are out of danger.

All these are cured by the same method; so far physicians agree. But Asclepiades believed, that blood should be let: some again affirmed that ought by all means to be avoided: for this reason, that the body then stood most in need of heat; and that this resides in the blood of the veins. This indeed is false. For it is not the nature of the blood to be peculiarly hot; but amongst the several things, which compose the human body, it most quickly grows either hot or cold. Whether or no it be proper to make this discharge, may be understood from the general directions, which were given about bleeding. But it is evidently proper to give castor, and with it pepper or laser. Then a moist and hot fomentation is needful. Therefore most physicians pour warm water frequently upon the neck. That relieves for the present; but renders the nerves more liable to cold, which is to be particularly avoided.