Of Medicine, in Eight Books

by Aulus Cornelius Celsus

When they begin to feel them, blood must be let. For this done immediately at the beginning often procures good health for a whole year, sometimes for life. Some too by cleansing themselves thoroughly by drinking asses milk, have prevented its ever returning; Others by abstaining from wine, mulse and venery for a year, have rendered themselves secure from it for their whole life. And this method is to be pursued after the first attack of the pain, although it has ceased. But if the fits of it are grown customary, one may indeed be more secure at such times as the pain has remitted: but more care ought to be taken at such seasons, as it returns[(34)], which happens commonly in the spring or autumn.

Now when the pain is not violent, the patient ought to use gestation in the morning; then to be carried, or to exercise himself by walking gently, and if the gout be in the foot, at small intervals alternately sometimes to sit, sometimes to walk; next before he takes food, without bathing to be rubbed gently in a warm place, to sweat, and have egelid water poured over him; after that to take food of the middle kind, making use at times of diuretics; and whenever he turns plethoric to vomit.

When the pain is very violent, it makes a difference, whether there be no swelling, or a tumour with heat, or a swelling already grown callous. For if there is no tumour, hot fomentations are required. It is proper to heat sea-water, or strong brine, then to pour it into a bason, and when the patient can bear it, to put his feet into it, and spread his gown over them, and cover them beside with cloaths, pouring in gradually at the edge of the vessel some of the same liquor, that the heat within may not decrease; and then in the night-time to apply heating cataplasms, and especially the root of marshmallows boiled in wine. But if there be a swelling and heat, coolers are more proper, and it is fit to keep the joints in the coldest water; but neither every day, nor long at a time, lest the nerves be indurated. And a cooling cataplasm must be applied: nor must even that be continued long; but a change must be made to those things, which are repellent, and at the same time emollient.

If the pain be more severe, the bark of poppies must be boiled in wine, and mixed with cerate made of rose-oil: or equal quantities of wax and hogs lard must be melted together, then wine mixed with them; and whenever an application of this medicine has grown hot, it must be removed, and another put on immediately.

But if the tumours have grown callous, and are painful, they are relieved by the application of a sponge squeezed now and then out of oil, or vinegar, or cold water; or by equal parts of pitch, wax and alum mixed together. There are also several malagmas proper for the hands and feet. But if the pain will allow nothing to be laid on, it is fit to foment the part, which is not swelled, with a sponge dipped in a warm decoction of poppy-bark, or the roots of wild cucumber; then to put over the joints saffron with the juice of poppies and ewes milk.

But if there is a swelling, it ought to be fomented with an egelid decoction of mastic-tree, or any other of the restringent vervains; and be covered with a medicine composed of bitter almonds powdered, and vinegar; or ceruss with an addition of the juice of the wall-herb bruised. The stone also, which eats flesh, by the Greeks called [ DF ]sarcophagus[(35)], cut into such a form as to receive the feet, usually relieves their pain, when they are put into it and kept there. Of this they make sepulchres in Assus. And the Asian stone[(36)] also has its merit for giving ease.

When the pain and inflammation have remitted (which happens within thirty days, unless the patient has been faulty) moderate exercises, abstinence, gentle unctions must be used, the joints being at the same time rubbed with an acopon[(37)], or liquid cerate of cyprine oil. Riding is hurtful, to those that have the gout in their feet.

Those, who have stated returns of this pain, before them ought both by a strict regimen to take care to prevent the redundancy of hurtful matter in the body, and to use frequent vomiting, and if there is reason to apprehend a present plethora, either clysters, or purging by milk. Which Erasistratus declared against, when the feet were gouty; lest the course of the humours downward should occasion a redundancy in the feet: though it is evident in every purgation, that not only the superior parts, but the inferior also are emptied.

CHAP. XXV. OF THE TREATMENT OF PATIENTS RECOVERING.

From whatever distemper a person is recovering, if he gathers strength slowly, he ought to awake at day-light, nevertheless to lie still in bed; about the third hour to rub his body gently with his hands anointed. Then to amuse himself by walking as long as he finds it agreeable, laying aside all attention to business; then to use gestation for a long time, much friction; to change often his situation, air, and food. When he has drunk wine for three or four days, for one or even two to interpose water. For by these methods he shall both escape those distempers, that bring on a consumption, and may quickly recover his strength. But when he is entirely recovered, it will be dangerous for him to change his course suddenly, and turn irregular. Therefore he ought by slow degrees to lay aside these restraints, and change to the way of life most agreeable to his humour[(38)].