Having made some general remarks on the administration of hellebore, to which he was very partial, he proceeds to point out the bad effects resulting from any change in regimen. His views here are very similar to the observations contained in the preceding portion of the work, and in the treatise “On Ancient Medicine.”
The account of dry cholera is confused and vague. By it he would seem to mean flatulent colic, or dry belly-ache. See Opera, ed. Littré, tom. ii., p. 388.
The paragraph on dropsy is interesting, although the views taken of the subject are incomplete. Tympanitis is recognized as a variety of dropsy. Then follow some detached observations on persons whose bowels are heated, and on the regulation of the diet, with some remarks on the different states which counter-indicate purging. At § 23 there are some practical observations on various conditions of the constitution, which it would no doubt be proper for the physician to make himself acquainted with. The contents of all the remaining paragraphs would seem to have nothing to do with the subject of this treatise.
From what is now stated the reader will readily perceive that this treatise abounds in interesting matters, which, even at the present day, may prove suggestive of important views in the theory and practice of medicine. And although the style, in the judgment of Galen, be very different from Hippocrates, and the mode of thought deficient in that precision for which he is so remarkable, the treatise is unquestionably a work of great ability, and contains what we have reason to regard as the results of his experience and meditations on many important subjects. I should have thought it quite unwarrantable, therefore, to have rejected this piece from a volume which professes to give all the genuine remains of our great author. And moreover, at the risk, perhaps, of being set down as an antique devotée, I do not hesitate to declare that in my opinion this and the preceding portion, taken together, contain more original information on the important subject to which they relate than is to be found in any medical work which has been written from the days of our author down to the present time.
I shall conclude the present Argument by giving from Cælius Aurelianus the criticisms of Soranus on the opinions of our author, as delivered in these two treatises. It is to be borne in mind that Soranus was the chief of the ancient sect of physicians called Methodici, which was very inimically disposed towards all the others, and more especially to Hippocrates. Though most of the strictures are evidently overstrained, it cannot fail to be interesting to the reader to have an opportunity of considering them, such as they are.
After giving an elaborate analysis of our author’s views, Cælius Aurelianus proceeds as follows: “His Soranus respondens ait. In calefactionibus acres esse sales, ac necessario tumorem provocare, febremque accendere, poscam etiam constringere et stricturam passionis augere. Item milium frixum graveolens et nidorosum, atque capiti grave, maximè acutè fabricitantium esse perspicimus. Spongiis etiam erat melius quenquam in dimissione patientes partes vaporare, atque oleo calido perfundere. Est præterea improprium, ac sine ratione, tunc uti phlebotomo quoties ad superiora dolor tetenderit; prohibere autem quoties ad inferiora descenderit. Oportet ergo sub hoc argumento neque difficultate tumorum partibus inferioribus impeditos phlebotomare: neque etiam podagricos si quidem inferiora tumere videantur, sed necessariò quoties dolor ad superiora tetenderit, phlebotomiam adhibendam videmus. Siquidem sæpe pejorante ventris fluore, hoc adjutorii genus prohibetur. Neque etiam (ut ait) oportet interiorem venam dividi. Siquidem et exteriori et media divisa corpora releventur. Quippe quum e contrario interiorem prohibeant, propter magnitudinem, ne tumor augeatur. Item sanguinis mutatio iners est detractionis moderationi, sicuti de adjutoriis scribentes demonstrabimus. Sese denique idem Hippocrates impugnat in consequentibus, dicens usque ad animi defectum faciendam detractionem, quod magis vehementer est nocens: siquidem est pericolosa defectio, et neque si sit temporaliter defectionis causa, sensu carens ægrotans, dolore relevatus, videbitur (quum resumptus fuerit) rursum non dolere, quum magis atque magis ejusdem passionis debilia corpora vehementius officiant. Item purgativa medicamina (quæ Græci καθαρτικὰ vocant) acrimoniæ causa, stomachum tumentem, atque hypezocota membranum acuunt in tumorem; et in periculum ventris effusionem provocantia, magnificam passionis ingerunt vehementiam. Nutrire etiam cibo post medicamen non oportebat. Pugnat enim purgationi faciundæ illatum cibi nutrimentum. Quippe quum medicamine corruptum, officii sui careat viribus. Mitto etiam quod ex initio acescere facile ptisanæ succus perspiciatur, confectus quippe ex ordei succo, qui sit digestione difficilis. Dehine ægrotantis corpus non valet tantum sustinere nutrimentum, quantum sanitatis tempore solitum videbatur. Item mulsum ex aceto (quod oxymeli appellavit) sine discretione accipimus. Est etiam immodica usque ad septimum diem cibi abstinentia, quam custodiendam ordinavit.[566] Quippe cum nullus vehementiam passionis sustinere valet, nisi nutrimento quamvis parvo toleratus: et neque in declinatione passionis aliquid humanius cibo largitur, sed in iisdem sorbilibus perseverandum existimat succis. At cum fuerint sputa segniora, tunc ut existimat, erit primo æger nutriendus, quomodo necessariò declinante passione occurrunt intolerato. In cæteris relinquendum temporibus absque nutrimento ægrotantem apertissimè indicavit, quum semper plurimum utilitatis adjutorium cibi, quam cætera possunt adjutoria, largiatur. Omne etiam corpus erit unctione coæquandum, et non ejus particula. Quippe cum totum cibo nutriatur, ipsa quoque unctio non exerta, anxietatem ingerit ægrotanti, quæ latentem difficultatem, atque accessione veniente, corporis provocat incendium.”
APPENDIX TO THE WORK
ON
REGIMEN IN ACUTE DISEASES.
Ardent fever (causus)[567] takes place when the veins, being dried up in the summer season, attract acrid and bilious humors to themselves; and strong fever seizes the whole body, which experiences aches of the bones, and is in a state of lassitude and pain. It takes place most commonly from a long walk and protracted thirst, when the veins being dried up attract acrid and hot defluxions to themselves. The tongue becomes rough, dry, and very black; there are gnawing pains about the bowels; the alvine discharges are watery and yellow; there is intense thirst, insomnolency, and sometimes wandering of the mind. To a person in such a state give to drink water and as much boiled hydromel of a watery consistence as he will take; and if the mouth be bitter, it may be advantageous to administer an emetic and clyster; and if these things do not loosen the bowels, purge with the boiled milk of asses. Give nothing saltish nor acrid, for they will not be borne; and give no draughts of ptisan until the crisis be past. And the affection is resolved if there be an epistaxis, or if true critical sweats supervene with urine having white, thick, and smooth sediments, or if a deposit take place anywhere; but if it be resolved without these, there will be a relapse of the complaint, or pain in the hips and legs will ensue, with thick sputa, provided the patient be convalescent. Another species of ardent fever: belly loose, much thirst, tongue rough, dry, and saltish, retention of urine, insomnolency, extremities cold. In such a case, unless there be a flow of blood from the nose, or an abscess form about the neck, or pain in the limbs, or the patient expectorate thick sputa (these occur when the belly is constipated), or pain of the hips, or lividity of the genital organs, there is no crisis; tension of the testicle is also a critical symptom. Give attractive draughts.[568]
2. Bleed in the acute affections, if the disease appear strong, and the patients be in the vigor of life, and if they have strength.[569] If it be quinsy or any other of the pleuritic affections, purge with electuaries; but if the patient be weaker, or if you abstract more blood, you may administer a clyster every third day, until he be out of danger, and enjoin total abstinence if necessary.
3. Hypochondria inflamed not from retention of flatus, tension of the diaphragm, checked respiration, with dry orthopnœa, when no pus is formed, but when these complaints are connected with obstructed respiration; but more especially strong pains of the liver, heaviness of the spleen, and other phlegmasiæ and intense pains above the diaphragm, diseases connected with collections of humors,—all these diseases do not admit of resolution, if treated at first by medicine, but venesection holds the first place in conducting the treatment; then we may have recourse to a clyster, unless the disease be great and strong; but if so, purging also may be necessary; but bleeding and purging together require caution and moderation. Those who attempt to resolve inflammatory diseases at the commencement by the administration of purgative medicines, remove none of the morbific humors which produce the inflammation and tension: for the diseases while unconcocted could not yield, but they melt down those parts which are healthy and resist the disease; so when the body is debilitated the malady obtains the mastery; and when the disease has the upper hand of the body, it does not admit of a cure.[570]