Transcriber’s notes:

This e-book has an unusual structure, being a compilation of eight smaller books accompanied by eight related sets of numbered explanatory notes provided by the author. It also contains several hundred footnotes scattered throughout the text (many being Greek spellings of words in the text). These have been given alphabetic labels and are now grouped together as endnotes. All notes have been hyperlinked to facilitate access. Hyperlinks have also been added to index items and to the table of contents.

Numerous asterisks are present in parts of the text; these represent uncertain quantities, not footnotes, as explained in [notes] on p. xxxii. The text also contains archaic characters that may not display correctly with all viewing devices or fonts. For best viewing, the device’s character encoding should be set to Unicode (UTF-8), and one of the following fonts selected: Arial Unicode MS, DejaVu, Segoe UI Symbol or FreeSerif.

The text has been preserved as in the original, including inconsistent punctu­ation, capitalis­ation and hyphen­ation. Archaic and inconsistent spellings have been retained except where obviously misspelled in the original. A [list] of these and other corrections has been appended at the end.

The cover image of the book was created by the transcriber and is placed in the public domain.

A. CORN. CELSUS OF MEDICINE IN EIGHT BOOKS.

TRANSLATED

WITH NOTES CRITICAL AND EXPLANATORY

BY

JAMES GREIVE, M.D.

A NEW EDITION.

EDINBURGH:

Printed at the University Press;

FOR DICKINSON AND COMPANY, INFIRMARY-STREET.

TO
MR SHARP,
SURGEON TO GUY’S HOSPITAL,
FELLOW OF THE ROYAL SOCIETY,
AND
MEMBER OF THE ROYAL ACADEMY OF SURGERY
AT PARIS.

SIR,

The favourable opinion you have been pleased to express of the following translation, and the trouble you have taken to revise the chirurgical part, are obligations, which I embrace this opportunity of acknowledging with the highest pleasure.

And though I had not received such marks of your friendship, yet there is no person, to whom a translation of Celsus can be more properly addressed; since no writer in this age appears to have a more just esteem for this excellent author, or to have imitated his conciseness and elegance, with so much success.

I am,
with great esteem,
Sir,
your most obedient,
humble servant,
James Greive.

London,
January 26th, 1756.

PREFACE.

It has been a question much debated, whether, and how far the writings of the ancient physicians are of service to direct our practice in the cure of diseases; but without repeating what has been already said on this point, I imagine their usefulness may be inferred from this single consideration, that the mechanism of the human body being always and every where the same, a faithful history of diseases must necessarily be one of the surest guides to the application of proper remedies. Moreover, if the diagnostics and prognostics be of the greatest moment in physic, and are only to be collected from long and accurate observation, then the records left us by the ancients, who were so assiduous in their observations, so clear and exact in their descriptions, must be allowed to contain a valuable treasure of medical knowledge.

We have seen, in the present age, many learned physicians, who, though they readily admit the improvements of the moderns, nevertheless apply themselves with great industry to the study of the ancients; and indeed, to say nothing of the superiority of some of the ancients in stile and composition, as a matter of taste, I think it can hardly be denied, that a man, capable of making proper allowances for the variations in respect of climate and manner of living, may receive great benefit from the materials left us by these ingenious writers of antiquity, and find many hints, which, pursued with diligence, and applied with caution, may both correct and enlarge his practice.

Celsus is justly esteemed one of the most valuable amongst the ancients. He is so often quoted, with approbation, by our best writers in physic, and so much admired by the learned world for propriety, ease, and elegance, that it is a needless attempt in these days to draw his character. However, he is so little mentioned by the ancients, that our curiosity cannot be gratified with any particulars of his life; nor can we even determine what was his profession, if it does not appear from his writings.

Quintilian often mentions a treatise of his upon rhetoric, which though he hardly ever quotes, but where he differs from him, he allows to be composed with accuracy. But whatever he thought of his oratory, he gives an honourable testimony to the extent of his learning. For to persuade his student of eloquence to make himself master of all the sciences, after mentioning the greatest geniuses that ever appeared in Greece or Rome, as Homer, Plato, Aristotle, Cato the censor, Varro, and Cicero, he adds, “Why should I name any more instances? when even Cornelius Celsus, a man of a moderate share of genius, has not only composed treatises on all these arts, but has also left precepts of the military art, agriculture, and medicine. The bare attempt requires us to believe he understood all these subjects: but to give perfection to so great a work is a difficult task, to which no man was ever found equal[ A ].”

Some have complained of the partiality, or jealousy of the rhetorician, who allows Celsus only a moderate share of genius. Others esteem it no diminution to be placed in a rank below the writers above named. Without doubt, this would do him very great honour: but if we even take the character literally, still we are to consider Quintilian as having every where in view the perfection of oratory. Now this, it should appear, Celsus hardly affected, by his confining the orator to questions in dispute[ B ]; which in great measure excludes the descriptive and moving parts of the art: therefore Quintilian’s man of middling genius may be a perfect writer in the instructive manner, though he want the qualifications for the bar or the forum. But to do Celsus some farther honour, may it not be supposed, that had Quintilian been as competent a judge of his medical, as of his rhetorical writings, he would not have stiled him, Vir mediocri ingenio. I have made bold to hazard this observation from an opinion, that none but a physician can form a just idea of the excellence of this work; much less could any but a physician be the author of it. Celsus the physician might very well write on agriculture, &c. but it by no means follows, that Celsus, not versed in the practice of physic, could have written accurately on diseases. If then this notion be just, it may reasonably be concluded, that his medical writings were the most perfect, as being the fruit of his principal and particular studies.

Columella (De re rustica) often quotes him with great deference to his authority; he equals him to the most learned writers on husbandry; and when he is correcting a vulgar error, expresses his surprise that Cornelius Celsus could be misled, “who was not only skilled in agriculture, but took in the whole compass of natural knowledge[C].” I shall not recite all the passages, where he mentions Celsus, but cannot help transcribing one, it is so expressive of our author’s manner. It is on the article of bees, “concerning which (says he) it is impossible to surpass the diligence of Hyginus, the profusion of ornaments in Virgil, and the elegance of Celsus. Hyginus has with great industry collected the precepts, which lay scattered in the ancients; Virgil has adorned the subject with poetic flowers; and in Celsus we find a judicious mixture of both these manners[ D ].”

From Columella’s mentioning Celsus as a contemporary, but not as a living writer[ E ], and our author’s speaking of Themison in the same manner[ F ], Le Clerc infers, with great probability, that Celsus wrote towards the latter end of the reign of Augustus, or at latest, in the beginning of Tiberius; in which last period he is placed by Fabricius[ G ]. And that he cannot have been later, appears not only from these authorities, but almost undeniably from the purity and elegance of his style, more nearly allied to the Augustan, than any of the succeeding ages.

Both Columella and Quintilian seem to speak of him as a Roman, and indeed our author himself, when he is giving the Greek name for any distemper, and is to add the Roman, frequently uses this phrase, nostri vocant, our countrymen call it, or some other expression of the same nature[ H ].

We have seen by the above quotations, how many treatises were composed by Celsus, which have all perished in the barbarous ages, except this work on medicine; which from the manner of its beginning, Ut alimenta sanis corporibus agricultura, sic medicina ægris sanitatem promittit, seems to have immediately followed his book on husbandry: for this easy transition is very common with our author in connecting different subjects. What confirms this is, that H. Stephens, upon the authority of an ancient manuscript, has prefixed as the title, Aurelii Cornelii Celsi de re medica libri octo; operis ab eo scripti de artibus pars sexta. It would be still more evident, if we could depend upon the manuscript in the library of Alex. Paduan: in which, at the end of the fourth book is written, Artium Cornelii Celsi liber nonus, idem medicinæ liber quartus explicit feliciter[ I ]. For his agriculture contained five books[ J ], with which the first four of this work make up the nine.

Every trifling circumstance relating to our author has employed the industry of his learned commentators. The English reader will therefore forgive me for observing, that in most of the manuscripts, his name is written A. Cornelius Celsus. And Rubeus informs us, the ancient manuscript in the Vatican library has this title, Auli Cornelii Celsi liber sextus, idemque medicinæ primus. As Aurelius was the name of a Roman family, it is not probable that this would be his praenomen; on the contrary, Aulus is found to be a common praenomen in the Cornelian family[ K ]. For these reasons, I read his name A. that is Aulus, &c. instead of Aurelius, as most of the printed copies have it.

From our author’s admirable abstract of the history of physic, it is easy to see he had studied and thoroughly digested the writings of the preceding physicians, and been attentive to the practice, as well as to the arguments of the several sects. We have no reason to doubt he made the best use of them; for we see that he confined himself to no one party, but selected from each what he judged to be most salutary. Though he has quoted many authors, sometimes with a view to recommend their practice in particular cases, at other times to shew the impropriety of it; yet through the whole, Hippocrates and Asclepiades seem to have been highest in his esteem; but he does not give up his judgment implicitly to these for he often leaves both, and advances very good reasons for differing from them. He ingenuously owns[ L ], that he has borrowed the prognostics from Hippocrates, “because,” says he, “though the moderns have made alterations in the method of curing, nevertheless they allow, that he has left the best prognostics.” With regard to the critical days, he entirely condemns his doctrine, and follows Asclepiades in rejecting the notion as idle and chimerical[ M ]. But from both these authors he dissents in his rules about bleeding.

It would be superfluous for me to prefix to this translation a general view of Celsus’s practice in the various diseases; for besides that this is already done by the learned Le Clerc[ N ], our author’s method is so clear and concise, that the reader will acquire, with ease, the most perfect idea from the book itself.

Whenever he differs in opinion from writers, whose authority he otherwise reveres, we find his reasoning modest, concise, close, and admirably well adapted to the subject in dispute; but the delicacy of his expression, when he condemns others, and the caution with which he avoids speaking of himself, have led some to believe he was not a practitioner: though the strongest argument against his having practised physic is drawn from the silence of Pliny, who names Celsus, in several books, among the authors from whom he took his materials, and never ranks him in the list of physicians, whom he separates from the others. But I am surprised it has escaped the observation of the critics, that these catalogues of physicians consist only of foreigners, whom Pliny distinguishes from other foreigners, who were not physicians; whereas Celsus stands always amongst the Romans. Now Pliny, in his list of Roman writers, has not noted their several professions: for in most of the places, where we read the name of Celsus, we also find that of Antonius Castor, without any mention of his profession, though Pliny himself in another place tells us[ O ], he was a physician of great reputation, whom he saw living in retirement, and cultivating a kind of physic-garden, when he was above an hundred years old. Thus, the name of Antonius Castor would have been lost with his writings, notwithstanding the figure he made among his contemporaries, had he not happened to be mentioned by Pliny. And hence it appears, that nothing can be inferred from the silence of Pliny and the other ancients, in regard to the profession of Celsus; though he should not be Cornelius the physician, mentioned by Galen, as Le Clerc thinks it probable he is.

I might have urged many passages in this book to prove that he was a physician, if I had not reason to think the present age is already satisfied in that point. There are two, however, so remarkable, that they ought not to be omitted. When our author is considering the proper time for allowing nourishment, after saying that some gave their patients food in the evening, he gives reasons against that method, and then adds, “Ob haec ad mediam noctem decurro, i. e. For these reasons I defer it till midnight.” Thus most of the older copies read, and also Morgagni’s manuscript; so that Linden is not easily to be forgiven for making alterations in so material a place[ P ]. In the other passages there is no variation in the reading. In that species of the ancyloblepharon, where the eye-lid unites with the white of the eye, our author, after describing the method of cure, immediately adds, “Ego sic restitutum neminem memini. Meges se quoque multa, &c. i. e. I do not remember an instance of any person cured in this way. Meges also has told us that he has tried many methods, and never was successful, because the eye-lid always united again to the eye[ Q ].” The form of expression here used by our author, in a manner peculiar to a practitioner, would come very improperly from a mere compiler. The connection of these two sentences by quoque seems to put our author’s own observation upon the same footing with that of Meges, whom he quotes on several occasions as a most accomplished surgeon[ R ].

It may not be amiss, however, to take notice of a distinction Celsus makes between two kinds of professors of physic. When he is shewing the necessity of circumspection in the physician, he adds, “From[ S ] these things it may be inferred, that many people cannot be attended by one physician; and that the man to be trusted is he, who knows his profession, and is not much absent from the patient. But they, who practice from views of gain, because their profits rise in proportion to the number of patients, readily fall in with such rules, as do not require a close attendance, as in this very case. For it is easy for such as seldom see the patient, to count the days and the paroxysms: but it is necessary for him to sit by his patient, who would form a true judgment of what is alone fit to be done, when he will be too weak, unless he get food.” As his censure is so severe upon a practice, which he thought too extensive, it is natural to suppose, that his was confined to his acquaintance, and that his fortune and generosity rendered him superior to the view of living by the profession.

To all the later copies of Celsus is prefixed an index of the several editions, which makes it needless for me to give an account of them. All the older ones, printed in the fifteenth and sixteenth centuries, abound with numberless gross errors, that in many places utterly destroy the construction. These, Vander Linden undertook to correct, and the authorities he used for that purpose are contained in a catalogue annexed to his preface, in which he tells us he has made very few changes from his own conjecture, and none of these, but where the subject evidently required them. In the dedication he says, “Who would imagine, that after the diligent labours of so many illustrious men, as Egnatius, Cæsarius, Constantine, Stephens, Pantinus, Ronsseus, and Rubeus, I should have corrections to make in more than two thousand places?”

As it was proper I should translate from one particular edition, I chose for that purpose Linden’s; or Almeloveen’s, who has followed him almost in every letter; as these are generally esteemed by far the most correct: though it must be owned, that Linden has made many alterations without necessity, and sometimes for the worse. Where the sense was either obscure or inconsistent with the context, I have often been assisted by the more ancient editions. On such occasions I have given my authority and reasons in the notes. In passages where I found a reading in the old copies much preferable to Linden’s, but not altogether necessary upon account of the sense, I have marked it in a note, without adopting it into the next.

There are very few places, where I have ventured to alter the reading on my own conjecture, and these are all noted in the margin, where I have assigned my reasons, which, I hope, will convince the learned reader. My notes will shew in how many instances I have been obliged to the excellent epistles of Morgagni. This learned and ingenious author has, in my opinion, entered more into the spirit and true meaning of Celsus, than any of the preceding commentators[ T ].

Had there been so correct an edition of Celsus, as I think may be made, with proper judgment, from the editions and manuscripts extant, it would have shortened my labour.

That Celsus divided his books into chapters, appears from several passages: whereas no person, as far as I can find, pretends, that the marginal contents came from the author himself. The editions differ in these; but as it is of small importance, I have not troubled the reader with any remarks on that article. Where I found those of Linden evidently wrong, I have endeavoured to supply the defect.

With regard to the materia medica, the notes are drawn chiefly from Pliny and Dioscorides, whom I esteemed the best authors on that article. When I have given English names to any of the simples, I follow the most judicious moderns; though it must be remembered, that many of them cannot be determined with absolute certainty.

Through most of the compositions the text is miserably corrupted; and what is worse, I do not find, that by comparing the various editions this part can be restored. I had once some thoughts of labouring this point particularly, but as it would have been expected I should support every alteration with proper reasons, and as I despaired of executing it so, as to meet with universal approbation, and after all it would have been more a matter of curiosity than of real use, I omitted that part of my design; besides, this must have considerably increased the number of my notes, which I have endeavoured should be as few as the nature of the undertaking would admit of. For these reasons I have closely adhered to the text of Linden, without even departing from it, where the nature of the whole composition will evidently demonstrate the proportions of several ingredients to be highly incongruous.

It has been my principal care to convey the precise meaning of my author, and also to preserve the genius of his style, where the English idiom would allow. I have likewise been careful not to wrest any expression of Celsus, in order to deceive the reader into a greater opinion of his knowledge, than he really deserves. His merit is sufficiently great without pretending to find in him any discoveries, the honour of which is due to the moderns. Every man of learning, who is acquainted with the state of physic among the ancients, and knows how far it differs from the modern, must be sensible of the difficulty of translating an author so elegant and concise, with the strictness necessary in a work of this nature. Such judges, I hope, will censure the faults, which cannot escape their observation, with the candour inseparable from true criticism.

It only remains, that I return thanks to my ingenious and learned friends of the faculty, who have favoured me with their opinions on several passages, particularly to Dr. Maghie of Guy’s hospital.

CONTENTS.

Roman measures of capacity for things liquid, reduced to english wine measure, the wine pint holding 287/8 solid inches.

No. I.

Possibly No. I. may be better understood in the following form.

No. II.

Roman measures of capacity for things dry, reduced to english corn measure, the english corn pint holding 33 3/5 inches.

No. III.

The same table in another form.

No. IV.

Note, The tables, No. I. and No. III. are exactly copied from Dr Arbuthnot, No. XII. and XIII. I have here gone no higher than the sextarius, as that is the greatest measure mentioned by Celsus; it has its name from making the sixth part of the Roman congius.

I would have taken the table of weights from Dr Arbuthnot also, if he had given one accommodated to Celsus; but as he has not, I have composed the following, No. VI. according to the division of Celsus himself, who tells us[ U ], that he divides the uncia, or ounce, into seven denarii, and the denarius into six sextantes.

Besides these, in several compositions our author uses semuncia and sescuncia, that is half an ounce and ounce and half; and to save the reader the trouble of reduction, I have given them also a place in the table.

The accurate Mr Greaves[ V ], from repeated experiments, concluded the Roman denarius to contain 62 grains English Troy weight, from which the proportions of the other weights are determined.

No. V.

Celsus’s weights compared with apothecaries’ weights.

No. VI.

Note 1st. The Romans divided all integers, as they did their as, into twelve equal parts called unciæ. Thus the sextans was the sixth part of the as, containing two of these unciæ, quadrans one fourth, or three unciæ, triens the third part, or four unciæ, semis one half, or six unciæ, bes or bessis two-thirds, or eight unciæ, dodrans three-fourths being nine unciæ. The weight of these then differs, as the integer is the libra, the uncia, or denarius, which the attentive reader will easily reduce, if he is disposed to calculate the quantities, observing that they are not to be taken for aliquot parts of the denarius, but when they follow the mark of the denarius. The integer preceding, and the nature of the composition will be the best explication.

Note 2. The denarius mark was X or 𐆖

, as containing originally ten small asses. This by the copiers has been often confounded with X, denoting the number of ten denarii; so that after all the pains of critics and commentators, the proportions of the ingredients in several compositions seem to be irrecoverably lost. For this reason, I suppose the later editors have thought fit to change it for the common asterisk.

Note 3. The characters for quantities are variously marked in different authors, and the same note has several values. There is one of this uncertainty in Celsus, that is Z, which we are told expresses the libra, the sescuncia, the sextans of a pound, the denarius and the sextans of a denarius[ W ]. Which of these different values it bears in any particular place must be determined by the connection. When it follows the mark of the denarius, it can mean no more than the sextans of a denarius.

Note 4. p. stands for pondo, which is an indeclinable word, and when joined with numbers, signifies libra or a pound; when with other weights, it stands for no more than pondus or weight in general.

For an example of the reduction of Celsus’s weights to ours, the following may serve.

Lib. v. cap. 19. no. 7. Philotas’s plaister contains,

ERRATA,
IN THE TEXT.

A. CORNELIUS CELSUS

OF

MEDICINE.

BOOK I.

PREFACE.

As agriculture promises food to the healthy, so medicine promises health to the sick. There is no place in the world, where this art is not found: for even the most barbarous nations are acquainted with herbs, and other easy remedies for wounds and diseases. However it has been more improved by the Greeks than any other people: though not from the infancy of that nation, but only a few ages before our own times; as appears by their celebrating Æsculapius as its most ancient author; who, because he cultivated this science with somewhat more accuracy, which, before him, was rude and of low esteem, was received into the number of their gods.[(1)] After him his two sons, Podalirius and Machaon, following Agamemnon to the Trojan war, were not a little useful to their fellow soldiers. But even these, according to Homer’s account, did not undertake the plague, nor the other various kinds of diseases, but only cured wounds by incisions, and medicines: from which it appears, that they entirely confined themselves to the chirurgical part of medicine, and that this was the most antient branch. From the same author we may also learn, that diseases were then believed to arise from the anger of the immortal gods,[(2)] and that relief used to be sought from them. It is also probable, that though there were few remedies for distempers known, men nevertheless generally enjoyed good health from the sobriety of their lives, yet untainted by sloth and luxury. For these two vices, first in Greece, and then among us, rendered men liable to many diseases. And hence that variety of remedies now used, which was neither necessary in ancient times, nor is yet in other nations, scarcely protracts the lives of a few of us to the verge of old age. For the same reason, after those, whom I have mentioned, no men of eminence practised medicine, till learning began to be pursued with greater application; which, as it is of all things most necessary to the mind, so it is no less hurtful to the body. And at first the science of healing was accounted a branch of philosophy; so that the cure of diseases, and the study of nature, owed their rise to the same persons: and for this very good reason, because they, who had impaired their bodies by anxious thought, and nightly watchings, stood most in need of its assistance. And thus we find, that many amongst the philosophers were skilled in this science; of whom the most celebrated were Pythagoras, Empedocles, and Democritus. Hippocrates of Cos, who, according to some authors, was the disciple of the last mentioned of these, and is so justly admired both for his knowledge in this profession, and for his eloquence, was the first worthy of notice, who separated medicine from the study of philosophy. After him, Diocles the Carystian, then Praxagoras and Chrysippus; after these, Herophilus and Erasistratus applied themselves to this art, and differed widely from each other in their methods of cure.

(1) For references 1, 2, 3, &c. see Notes at the end.

During this period, physick was divided into three parts: the first cured by diet, the second by medicines, the third by manual operations: the first they termed, in Greek, Diætetice,[ X ] the second Pharmaceutice,[ Y ] and the third Chirurgice.[ Z ] The most illustrious professors of that branch, which treats diseases by diet, endeavoured to extend their views farther, and took in the assistance of natural philosophy; being persuaded that, without it, medicine would be a weak and imperfect science. After these came Serapion, who first of all maintained, that the rational method of study was foreign to the art of medicine, and confined it to practice and experience. In his steps followed Appollonius and Glaucias, and some time after Heraclides of Tarentum, and others of no small note; who, from the doctrine they asserted, stiled themselves Empiricks[ AA ]. And thus the Dietetick branch was also divided into two parts, one set of physicians pursuing theory, the other following experience alone. However, after these we have enumerated above, no one attempted any thing new, till Asclepiades, who greatly changed the art of medicine. And Themison, one of his successors, has also lately, in his old age, departed from him in some things. And these are the men, to whom we are chiefly indebted for the improvements made in this salutary profession.

As that branch of medicine, which respects the cure of diseases, is the noblest, as well as the most difficult of the three, we shall first treat of that part. And because in this the chief dispute is, that some alledge an acquaintance with experiments to be only requisite, while others affirm experience alone to be insufficient, without a thorough knowledge of the constitution of bodies, and what naturally happens to them; it will be proper to recite the principal arguments on both sides, that we may the more easily deliver our own opinion upon the question.

Those then, who declare for a theory in medicine, look upon the following things as necessary: the knowledge of the occult and constituent causes of distempers; next, of the evident ones; then, of the natural actions; and, lastly, of the internal parts. They call these causes occult, in which we inquire of what principles our bodies are composed, what constitutes health, and what sickness. For they hold it impossible that any one should know how to cure diseases, if he be ignorant of the causes, whence they proceed; and that it is not to be doubted, but one method of cure is required, if the redundancy or deficiency in any of the four principles[(3)] be the cause of diseases, as some philosophers have affirmed; another, if the fault lie wholly in the humours, as Herophilus thought; another, if in the inspired air, as Hippocrates believed; another, if the blood be transfused into those vessels[(4)], which are designed only for air, and occasion an inflammation, which the Greeks call phlegmone[ AB ], and that inflammation cause such a commotion as we observe in a fever, which was the opinion of Erasistratus; another, if the corpuscles passing through the invisible pores should stop, and obstruct the passage, as Asclepiades maintained: that he will proceed in the proper method of curing a disease, who is not deceived in its original cause. Nor do they deny experience to be necessary, but affirm, it cannot be obtained without some theory; for that the more ancient practitioners did not prescribe any thing, at hazard, for the sick, but considered what was most suitable, and examined that by experience, to which they had before been led by some conjecture. That it is of no moment in this argument, whether most remedies were discovered by experiment, provided they were at first applied with some rational view: and that this holds in many cases; but new kinds of distempers often occur, in which practice has hitherto given no light; so that it is necessary to observe whence they arose; without which no mortal can find out, why he should make use of one thing, rather than another. And for these reasons they investigate the occult causes. They term those causes evident, in which they inquire, whether the beginning of the distemper was occasioned by heat or cold, fasting or surfeit, and the like. For they say, he will be able to oppose the first appearances, who is not ignorant of their rise. Those actions of the body which they call natural, are inspiration and exspiration, the reception and concoction of our meat and drink, as also the distribution[(5)] of the same into the several parts of the body. They also inquire how it happens, that our arteries rise and fall; from what causes proceed sleep and watching; without the knowledge of which, they conceive it impossible for any person either to oppose the beginnings of diseases, that depend on these particulars, or cure them when formed. As of all these things they look upon concoction to be of the greatest importance, they insist chiefly upon it; and some of them following the opinion of Erasistratus, affirm that the food is concocted in the stomach by attrition; others, after Plistonicus, the disciple of Praxagoras, by putrefaction; others, upon the credit of Hippocrates, believe concoction is effected by heat. After them follow the disciples of Asclepiades, who hold all these hypotheses to be vain and idle; for that there is no concoction at all, but the matter, crude as it is received, is distributed through the whole body. And in these things they are by no means agreed: however, it is not disputed, that according to the different hypotheses, a different regimen of diet is to be observed by sick people. For if it be performed by attrition, such food is to be chosen, as will most easily be broken to pieces; if by putrefaction, such as most quickly undergoes that change; if heat be the cause of concoction, then such as most effectually cherishes heat. But if there be no concoction at all, then none of these kinds of aliment are to be chosen: but such are to be taken, as are least liable to change from the state in which they are received. And, by the same way of reasoning, when there is a difficulty of breathing, when sleep or watchings oppress, they are of opinion, that the man, who has first learned in what manner these happen, will be capable of curing them. Besides, as pains, and various other disorders, attack the internal parts, they believe no person can apply proper remedies to those parts, which he is ignorant of; and therefore, that it is necessary to dissect dead bodies, and examine their viscera and intestines; and that Herophilus and Erasistratus had taken far the best method for attaining that knowledge, who procured criminals out of prison, by royal permission, and dissecting them alive, contemplated, while they were even breathing, the parts, which nature had before concealed; considering their position, colour, figure, size, order, hardness, softness, smoothness, and asperity[(6)]; also the processes and depressions of each, or what is inserted into, or received by another part; for, say they, when there happens any inward pain, a person cannot discover the seat of that pain, if he have not learned where every viscus or intestine is situated; nor can the part, which suffers, be cured by one, who does not know what part it is; and that when the viscera happen to be exposed by a wound, if one is ignorant of the natural colour of each part, he cannot know what is sound and what corrupted; and for that reason is not qualified to cure the corrupted parts; besides they maintain, that external remedies are applied with much more judgment, when we are acquainted with the situation, figure, and size of the internal parts; and that the same reasoning holds in all the other instances above mentioned. And that it is by no means cruel, as most people represent it, by the tortures of a few guilty, to search after remedies for the whole innocent race of mankind in all ages.

On the other hand, those, who from experience, stile themselves empiricks, admit indeed the evident causes as necessary; but affirm the inquiry after the occult causes and natural actions to be fruitless, because nature is incomprehensible. And that these things cannot be comprehended, appears from the controversies among those, who have treated concerning them, there being no agreement found here either amongst the philosophers or the physicians themselves: for, why should one believe Hippocrates rather than Herophilus? or, why him more than Asclepiades? that if a man inclines to determine his judgment by reasons assigned, the reasons of each of them seem not improbable; if by cures, all of them have restored the diseased to health; and therefore we should not deny credit either to the arguments or authority of any of them. That even the philosophers must be allowed to be the greatest physicians, if reasoning could make them so; whereas it appears, that they have abundance of words, and very little skill in the art of healing. They say also that the methods of practice differ according to the nature of places; thus one method is necessary at Rome, another in Egypt, and another in Gaul. That if the causes of distempers were the same in all places, the same remedies ought also to be used every where. That often too the causes are evident; as for instance in a lippitude[(7)], or a wound, and nevertheless the method of cure does not appear from them: that if the evident cause does not suggest this knowledge, much less can the other, which is itself obscure. Seeing then this last is uncertain and incomprehensible, it is much better to seek relief from things certain and tried; that is, from such remedies as experience in the method of curing has taught us, as is done in all other arts; for that neither a husbandman nor a pilot is qualified for his business by reasoning, but by practice: and that these disquisitions have no connection with medicine, may be inferred from this plain fact, that physicians, whose opinions in those matters have been directly opposite to one another, have notwithstanding equally restored their patients to health: that their success was to be ascribed to their having derived their methods of cure, not from the occult causes, or the natural actions, about which they were divided, but from experiments, according as they had succeeded in the course of their practice. That medicine, even in its infancy, was not deduced from these inquiries, but from experiments: for of the sick, who had no physicians, some from a keen appetite, had immediately taken food in the first days of their illness, while others feeling a nausea, had abstained from it; and that the disorder of those, who had abstained, was more alleviated; also, some in the paroxysm of a fever had taken food, others a little before it came on, and others after its remission; and that it succeeded best with those who had done it after the removal of the fever: in the same manner some used a full diet in the beginning of a disease; others were abstemious; and that those grew worse, who had eaten plentifully. These and the like instances daily occurring, that diligent men observed attentively, what method generally answered best, and afterwards began to prescribe the same to the sick. That this was the rise of the art of medicine, which by the frequent recovery of some, and the death of others, distinguishes what is pernicious from what is salutary; and that when the remedies were found, men began to discourse about the reasons of them: that medicine was not invented in consequence of their reasoning, but the theory was sought for after the discovery of medicine. They ask too, whether reason prescribes the same as experience, or something different; if the same, they infer it to be needless, if different, mischievous. That at first, however, there was a necessity for examining remedies with the greatest accuracy, but now they are sufficiently ascertained; and that we neither meet with any new kind of disease, nor want any new method of cure. That if some unknown distemper should occur, the physician would not therefore be obliged to have recourse to the occult things; but he would presently see to what distemper it is most nearly allied, and make trial of remedies like to those, which have often been successful in a similar malady, and by the resemblance between them would find some proper cure. For they do not affirm, that judgment is not necessary to a physician, and that an irrational animal is capable of practising this art; but that those conjectures, which relate to the occult things, are of no use; because it is no matter what causes, but what removes a distemper: nor is it of any importance in what manner the distribution is performed, but what is most easily distributed; whether concoction fails from this cause or that; or whether it be properly a concoction, or only a distribution: nor are we to inquire how we breathe, but what relieves a difficult and slow breathing; nor what is the cause of motion in the arteries, but what each kind of motion indicates. That these things are known by experience: that in all disputes of this kind, a good deal may be said on both sides; and therefore genius and eloquence obtain the victory in the dispute; but diseases are cured not by eloquence, but by remedies; so that if a person, without any eloquence, be well acquainted with those remedies, that have been discovered by practice, he will be a much greater physician than one who has cultivated his talent in speaking without experience. That these things, however, which have been mentioned, are only idle: but what remains is also cruel, to cut open the abdomen and præcordia of living men, and make that art, which presides over the health of mankind, the instrument, not only of inflicting death, but of doing it in the most horrid manner; especially if it be considered, that some of those things, which are sought after with so much barbarity, cannot be known at all, and others may be known without any cruelty; for that the colour, smoothness, softness, hardness, and such like, are not the same in a wounded body, as they were in a sound; and further, because these qualities, even in bodies that have suffered no external violence, are often changed by fear, grief, hunger, indigestion, fatigue, and a thousand other inconsiderable disorders; which makes it much more probable, that the internal parts, which are far more tender, and never exposed to the light itself, are changed by the severest wounds and mangling. And that nothing can be more ridiculous than to imagine any thing to be the same in a dying man, nay one already dead, as it is in a living person: for that the abdomen[(8)] indeed may be opened[(9)], while a man breathes; but as soon as the knife has reached the præcordia[(10)], and the transverse septum is cut, which by a kind of membrane divides the upper from the lower parts, (and by the Greeks is called the Diaphragm[ AC ]) the man immediately expires; and thus the præcordia, and all the viscera never come into the view of the butchering physician, till the man is dead; and they must necessarily appear as those of a dead person, and not as they were while he lived; and thus the physician gains only the opportunity of murdering a man cruelly, and not of observing, what are the appearances of the viscera in a living person: if, however, there be any thing which can be observed in a person, that yet breathes, chance often throws it in the way of such as practise the healing art; for that sometimes a gladiator on the stage, a soldier in the field, or a traveller beset by robbers, is so wounded, that some internal part, different in different people, may be exposed to view; and thus a prudent physician finds their situation, position, order, figure, and the other particulars he wants to know, not perpetrating murder, but attempting to give health; and learns that, by compassion, which others had discovered by horrid cruelty. That for these reasons it is not necessary to lacerate even dead bodies; which, though not cruel, yet may be shocking to the sight, since most things are different in dead bodies; and even the dressing of wounds shows all that can be discovered in the living.

Since these points have often been, and still continue to be disputed with great warmth by physicians in large volumes, ’tis proper to add some reflections, that may seem to come the nearest to the truth, and which neither slavishly follow either of these opinions, nor are too remote from both, but lie, as it were, in the middle, betwixt these opposite extremes; which those, that inquire after truth without partiality, may find to be the surest method for directing the judgment in most warm controversies, as well as in this now before us. For, with regard to the causes of health or diseases, in what manner the air, or food, is either conveyed or distributed, the philosophers themselves do not attain to an absolute certainty; they only make probable conjectures. Now, when there is no certain knowledge of a thing, a mere opinion about it cannot discover a sure remedy. And it must be owned, that nothing is of greater use, even to the rational method of curing, than experience. Altho’ then many things are taken into the study of arts, which do not, properly speaking, belong to the arts themselves, yet they may greatly improve them by quickening the genius of the artist; wherefore the contemplation of nature, though it cannot make a man a physician, yet may render him fitter for the practice of medicine. Indeed, it is very probable, that both Hippocrates and Erasistratus, and all the others, who were not content with treating fevers and ulcers, but examined in some measure into the nature of things, tho’ they did not by such study become physicians, yet became more able physicians by that means. And medicine itself requires the help of reason, if not always amongst the occult causes, or the natural actions, yet often; for it is a conjectural art; and not only conjecture in many cases, but even experience is found not consistent with its rules. And sometimes neither fever, nor appetite, nor sleep, follow their usual antecedents in the regular course. A new distemper sometimes, though very seldom, appears; that such a case never happens is manifestly false; for, in our own time, a certain lady, from a quantity of flesh[(11)] falling down from her private parts, and growing dry, expired in a few hours; so that the most celebrated physicians neither found out the genus of the distemper, nor any remedy for it. I suppose the reason they forbore to attempt any thing was, that none of them was willing to run a risk upon his own conjecture only in a person of her quality, for fear he should be thought to have killed, if he did not save her; yet it is probable that some one, without that regard to the opinion of the world, might have contrived something, which upon trial would have succeeded. Nor is a similitude always serviceable in this kind of practice; and where it is, this properly belongs to the rational part, to consider amidst a number of similar kinds, both of diseases and remedies, what particular medicine ought to be preferred. When such an incident occurs, the physician ought to invent something, which though perhaps it does not always answer, yet most commonly may: and he shall draw his new method, not from the occult things (for they are dubious and uncertain) but from those, that can be fully known, that is, from the evident causes. For it makes a considerable difference, whether the distemper was occasioned by fatigue, or thirst, or cold, or heat, or watching, or hunger; or whether it arose from too much food and wine, or excess of venery. And he ought not to be ignorant of the constitution of his patient, whether his body be too moist, or too dry: whether his nerves[(12)] be strong or weak; whether he be frequently or seldom ailing; and whether his illnesses are severe or slight, of long continuance or short; what way of life he has pursued, laborious or sedentary, luxurious or frugal; for from these, and such like circumstances, he must often draw a new method of cure.

Nevertheless even these things ought not to be so passed over, as if they were uncontroverted; for Erasistratus has affirmed, that distempers were not occasioned by them, because other people, and even the same person at different times, would not fall into a fever upon them. And some of the Methodists of our own age, from the authority of Themison (as they would have it thought) assert, that the knowledge of no cause whatever bears the least relation to the method of cure; and that it is sufficient to observe some general symptoms of distempers; and that there are three kinds of diseases, one bound, another loose[(13)], and the third a mixture of these. For that sometimes the excretions of sick people are too small, sometimes too large; and sometimes one particular excretion is deficient, while another is excessive. That these kinds of distempers are sometimes acute, and sometimes chronic; sometimes increasing, sometimes at a stand[(14)], and sometimes abating. As soon then as it is known, to which of these classes a distemper belongs if the body be bound, it must be opened; if it labours under a flux, it must be restrained; if the distemper be complicated, then the most urgent malady must be first opposed. And that one kind of treatment is required in acute, another in inveterate distempers; another, when diseases are increasing; another, when at a stand; and another, when inclining to health. That the observation of these things constitutes the art of medicine, which they define as a certain way of proceeding, which the Greeks call Method[ AD ], and affirm it to be employed in considering those things, that are in common to the same distempers: nor are they willing to have themselves classed either with the rationalists, or with those, who regard only experiments; for they dissent from the first sect, in that they will not allow medicine to consist in forming conjectures about the occult things; and also from the other in this, that they hold the observation of experiments to be a very small part of the art.

As to what Erasistratus maintains; in the first place, plain fact contradicts his opinion; because a distemper very seldom happens, unless after some of these occurrences, that have been mentioned. And then it does not follow, that what does not affect one person, may not hurt another; nor what does not affect the same person at one time, may not hurt him at another; for there may be some latent circumstances in a body, either in respect of weakness, or some disorder, which either are not in another, nor were in the same body at a different time; and these, though of themselves not considerable enough to cause a distemper, yet may render a body more liable to other injuries: but if he had been sufficiently skilled in the contemplation of the works of nature (which the physicians with very good reason endeavour to attain) he must have known this also, that nothing happens from one single cause; but that is to be taken for the cause, which seems to have contributed most to the effect. Now it is possible, that what does not move at all while alone, may in conjunction with other things excite a great commotion. Besides, Erasistratus himself, who says, that a fever arises from a transfusion of the blood into the arteries, and that this happens in a plethoric body, can assign no reason, why of two persons equally plethoric, the one should fall into a distemper, and the other be free from all danger, which manifestly happens every day. From hence it appears, that supposing this transfusion to be real, nevertheless, when there is a plethora, it does not happen of itself, but when some one of the conditions above-mentioned goes along with it.

But the followers of Themison, if they assert their maxims to hold universally, are still more rationalists than those, that pass under that name; for though one rationalist does not maintain all that another approves, there is no necessity to invent a new appellation for him; provided, which is the principal thing, he does not proceed upon memory alone, but takes in reason too. But if, which is nearer to the truth, the art of medicine hardly admits of any universal precepts, then they are in the same class with those, who depend upon experiments alone: and the more so, because any unskilful person can discover, whether a distemper has bound up a man, or rendered him lax. Now if what relaxes a constringed body, or restrains a loose, be drawn from reason, such a practitioner is a rational physician: but if from experience, as he must confess, who will not allow himself to be a rationalist, then he is an empirick. And so, according to him, the knowledge of the distemper is foreign to the art, but the remedy lies within the bounds of experience. Nor is any improvement made by them upon the profession of the empiricks, but on the contrary, something is taken from it; the empiricks attending with great circumspection to many circumstances; whereas these regard only the easiest, and no more than the common things. For in like manner those, who are employed in curing cattle, since it is impossible for them to be informed by the dumb animals, what is peculiar in the case of each, regard only what is common to them all: and foreign nations, as they are not acquainted with any subtile theory of medicine, take notice only of the common symptoms: those also, who take under their care a great number of patients, because they are not able to consult the distinct necessities of each with the utmost attention, have respect only to those generals. Nor indeed were the ancient physicians ignorant of this method, but they were not content with it; for even the most ancient writer Hippocrates said, that in practice it is necessary to regard both the general and peculiar circumstances. Nor is it possible even for them to confine themselves within the narrow limits of their own profession; for there are different kinds both of the bound, and lax disorders; which is more easily observed in the lax, for it is one thing to vomit blood, another to vomit bile, and another to vomit the food: and there is also a difference betwixt labouring under a simple purging, and a dysentery; between being weakened by sweats, and wasted by a consumption. A humour also breaks out upon particular parts, as the eyes, for instance, and the ears; and no member of the human body is free from that danger. Now not one of these disorders is cured exactly in the same manner as another; so that in these, medicine descends from the general observation of the lax kind, to the peculiar. And in this again another kind of knowledge of peculiarity is often necessary; because the same thing will not relieve all, that labour under similar distempers. For though there are certain things, which either bind the belly, or open it in most people; yet some are to be met with, in whom the same intention is gained by means contrary to the common. So that in such, the general observation is hurtful, and the peculiar only salutary. And a right apprehension of the cause often removes a distemper. Upon this account it was, that the most ingenious physician of our age, the late Cassius, being called to one in a fever distressed with violent thirst, when he found, that his complaints began after hard drinking, ordered him to drink plentifully of cold water. When his patient had drank this, and by the mixture had weakened the force of the wine, he was presently freed from the fever by a sleep, and a sweat. Which remedy the physician very judiciously adapted to the case, not from the consideration of his body being either bound or loose, but from the cause that had preceded. There is also another peculiarity to be regarded, which is that of place and season, according to these authors themselves; who, when they are giving directions for the management of the healthy, order them more carefully to avoid cold, heat, satiety, labour, and venery, in sickly places or seasons; and to take more rest in such seasons or places, if they have any sense of weight hanging upon their body; and in such circumstances neither to disturb the stomach by vomiting, nor the belly by purging. These things indeed are certain; yet they descend from generals to some things that are particular: unless they would have us believe, that healthy men should observe the temper of the air, and the season of the year, and that sick people don’t need to take that care, to whom all precaution is so much the more necessary, by how much an infirm state of health is more liable to receive injury. Besides, there are very different properties of distempers in the same person. And one, who has been sometimes unsuccessfully tried by medicines, which seemed proper for his disorder, is often recovered by the contrary. There are also many distinctions to be observed in the giving of food, of which I shall only name one instance. A youth bears hunger more easily than a boy; better in a thick, than a clear air; more easily in winter than summer; with more ease, one, that is accustomed to a single meal, than another, who eats a dinner also[(15)]; a sedentary person more easily, than one that takes exercise. Now generally food ought to be prescribed so much the sooner, as the person is less able to bear the want of it in health. For these reasons I am apt to think, that he, who is not acquainted with the peculiarities, ought only to consider the general: and that he, who can find out the peculiar, ought not to neglect, but take them in too for the direction of his practice. And therefore, where the knowledge is equal, yet a friend is a more useful physician, than a stranger. To return to my point then, my opinion is, that medicine ought to be rational, but to draw its methods from the evident causes, all the obscure being removed, not from the attention of the artist, but from the practice of the art. Again, to dissect the bodies of living men is both cruel and superfluous. But the dissection of dead subjects is necessary for learners: for they ought to know the position and order of the parts, which dead bodies will show better, than a living and wounded man. But as for the other things, which can only be observed in living bodies, practice itself will discover them in the cure of the wounded, somewhat more slowly, but with more tenderness. Having delivered my sentiments upon these points, I shall lay down the proper rules for the management of people in health, and then proceed to what relates to diseases and their cure.

CHAP. I. RULES FOR THE HEALTHY.

A sound man, who is both in health, and his own master, ought to confine himself to no rules; and neither call for the assistance of a physician nor an iatroalipta[(16)]. ’Tis good for him to diversify his way of life; to be sometimes in the country, sometimes in the city, and frequently in the fields; to sail, to hunt; sometimes to rest, but exercise himself frequently: for indolence enervates the body, labour strengthens it: the first brings on a quick old age, the other makes a long youth. ’Tis also proper to make use sometimes of the warm bath[(17)], and sometimes of the cold; to anoint sometimes, and at other times to neglect it; to avoid no kind of food, that may be in common use; sometimes to eat in company, at other times to retire from it; sometimes to eat more than is sufficient, and at other times no more; to take food rather twice in the day than once; and always as much as he can, provided he concoct it. But as exercise and food of this kind are necessary, so the exercise and diet of wrestlers are inconvenient: both because the order of exercise being interrupted by some necessary business of life, hurts the body; and because those bodies, which are very high fed, like their’s, soonest decay, and are most liable to diseases.

Of Coition.

Coition is neither to be too much desired, nor too much feared. Seldom used, it excites the body; frequent, relaxes. But as the frequency is to be judged of, not by the number of repetitions, but by nature, regard being had to the age and constitution, we may know it not to be useless, when it is neither followed by a languor of the body, nor pain. It is worse in the day-time, but safer in the night; but the general rule will hold for both, if neither meat be taken after the first, nor the other be followed by wakefulness and labour. These things are to be observed by strong people; and care must be taken, that the reliefs of sickness be not wasted in good health.

CHAP. II. RULES FOR VALETUDINARY PEOPLE.

But greater precaution is necessary for the valetudinary; amongst whom are the greatest number of those that live in cities, and almost all that are fond of study: that care may rectify the disorders which arise from their constitution, situation, or study. Any of these then, who has concocted well, will rise in the morning safely; he that finds the concoction not completed, ought to lie still; and if he be under a necessity of rising, to go to sleep afterwards. He that has not concocted at all, should be entirely at rest, and neither venture upon labour, nor exercise, nor business. He that is troubled with crude belching, without pain of the præcordia, ought now and then to drink cold water, and withal to confine himself to certain rules; to live in a house well lighted, that enjoys the summer’s breeze and the winter’s sun; to avoid the meridian sun, the morning and evening cold, as also the air of rivers and lakes; and by no means to expose himself to the sun breaking out in a cloudy sky, lest he be sometimes affected with heat, and sometimes with cold, which very often occasions gravedoes[(18)] and catarrhs. These inconveniences are to be guarded against with greater diligence in sickly places, in which they even cause a pestilence. We may know a body to be in health, when every day in the morning the urine is first white, and then of a light red colour: the first shows that the concoction is going on, and the other, that it is compleated. When any person awakes, he ought to wait a little, and then, unless it be the winter time, to wash his mouth plentifully with cold water; in long days, to take the air in the middle of the day, before meat; or, if he cannot do that conveniently, after it. In winter especially, to rest the whole night; but, if he is obliged to study in the night, to do it not immediately after eating, but after concoction. He, that in the day-time has been employed either in domestic or civil business, ought to set apart some time for the refreshment of his body; the principal part of which is exercise, which ought always to go before meat: in one that has laboured little[(19)], and has concocted well, it should be stronger; in one who has been fatigued, and has not concocted well, it may be more gentle. Proper exercises are, reading aloud, handling of arms, the ball, running, and walking; which last is better not upon plain ground: for an ascent and descent agitates the body with some variety, unless it be very weak. And it is better in the open air, than in a portico; better in the sun, if the head can bear it, than in a shade; better in a shade formed by walls, or parks, than under a roof; a straight walk is better than a winding. In most cases a beginning sweat should put an end to exercise, or at least lassitude, that does not amount to fatigue; and that sometimes in a less, sometimes in a greater degree. In all these exercises, there should neither be, as among wrestlers, an inviolable rule, nor too violent labour. Exercise is rightly followed, sometimes by unction, either in the sun, or before a fire, at other times by the bath, which is best in a room as high, light, and spacious as may be. Neither of these should be always done; but either one of them oftner than the other, as agrees best with the constitution. After these, it is necessary to take some rest. When food is to be taken, it is never proper to overload: but too great abstinence is often hurtful: if there be any small excess committed, it is often safer in drinking than eating. It is best to begin with salt fish[(20)], greens, and such like. After these flesh, which is best roasted, or boiled. All preserves, upon a double account, are hurtful, both because people are tempted by their agreeable taste to exceed in quantity, and though the quantity be moderate, they are of difficult concoction. A desert is not hurtful to a good stomach, but turns sour upon a weak. And therefore one, that is less firm in that part, will do better to use dates, apples, and such fruit for that purpose. After drinking somewhat more than thirst requires, no more should be eaten. With a full stomach a man should set about no action. When one has eat plentifully, the concoction is more easy, if he concludes the meal with a drink of cold water, then continues awake for a little while, and afterwards has a sound sleep. If a person has made a hearty meal in the day-time, he ought not to expose himself after it, either to cold, heat, or labour; for these do not so readily hurt with an empty as a full body. If upon any occasion one is to want food for a time, all labour is to be avoided.

CHAP. III. SOME OBSERVATIONS SUITED TO NEW INCIDENTS, AND THE DIFFERENT CONSTITUTIONS, SEXES, AND AGES, AND THE SEASONS OF THE YEAR.

What we have delivered above, is nearly of universal extent: but some precautions are necessary for new incidents, and for the constitutions, sexes[(21)], and ages, and the seasons of the year. For it is neither very safe to remove from a healthy place into a sickly; nor from a sickly into a healthy. It is best to remove from a healthy place to a sickly, in the beginning of winter; from a sickly to a healthy, in the beginning of summer. It is neither fit to overload with food after much fasting, nor is fasting good after too full eating. And those persons endanger themselves, who, contrary to their custom, either once or twice a day eat immoderately. Again, sudden ease is very hurtful after great labour, and sudden labour after too great inactivity. For this reason, when one has a mind to make any change in his way of living, he must accustom himself to it gradually. All kinds of labour are more easily endured even by a boy or an old man, than by a man that is not used to it. And upon this account too, a life over inactive is not good; because there may happen to be a necessity for labour. But if at any time a person altogether unused has occasionally laboured, or even one, that is accustomed to it, has laboured much harder than ordinary, he ought to sleep with an empty stomach; and so much the rather, if he have a bitter taste in his mouth, or a dimness in his eyes, or his belly be disordered, For then he must not only sleep with an empty stomach, but even continue to fast the following day, unless rest has quickly carried off the disorder. And if that be the case, he should get up, and walk a little at a slow pace. But if a person has been at more moderate labour, so that he was not obliged to go to sleep, nevertheless he ought to walk in the same manner.

What follows is to be generally observed by those, that after fatigue are to eat: when they have walked a little, if they have not an opportunity of bathing, they ought to be anointed in a warm place, either in the sun, or before a fire, and then to sweat. But if they have that conveniency, they should first of all sit down in the tepidarium; next, after they have rested a little, go down into the warm bath; then anoint with a good deal of oil, and rub gently, and again go into the bath; this done wash the mouth with warm water, and then with cold. A very hot bath is not fit for such people. And therefore if any one is so much over fatigued as to be feverish, it is sufficient for him, in a tepid room, to dip himself up to the groin in warm water, with a small mixture of oil: after that, to rub over the whole body, but principally those parts, that have been in the water, with oil, in which there is an addition of wine and a little powdered salt. Afterwards it is proper for all people, that are fatigued, to take food, and that of a moist nature; to be content either with water, or at most a diluted drink, especially such as is diuretic. It is fit also to know this, that drinking cold water is very pernicious to one, that is sweating by labour; and hurtful to those, that are fatigued by a journey, even when the sweat has abated. Asclepiades believed it to be bad for those too, that had immediately come from the bath. This holds true in those, who are easily purged, but not with safety, and are liable to shudderings, but is not universal; because it is most agreeable to nature, that a hot stomach should be cooled by drinking, and a cold one heated. Which rule when I lay down, I own at the same time, that cold water should not be given to one, that is in a sweat, though occasioned by bathing. It is common also after various food, and frequent diluted drinks, for a vomit to be serviceable, and the following day a long rest, and then gentle exercise. If one be troubled with frequent yawning[(22)], he should drink wine and water by turns, and seldom make use of the bath. A change of labour also relieves from fatigue; and when any person is distressed by some unusual kind of labour, that which he is accustomed to, refreshes him. It is very safe for a person, who is fatigued, to rest upon a couch, if he has before made it a daily practice; on the contrary, it wearies one, that is not used to it. For whatever is contrary to custom proves hurtful, whether it be indulgence or severity.

There are some methods peculiarly adapted to the case of a man fatigued by walking. Frequent friction, even upon the journey, relieves him; at the end of the journey first sitting down, and then unction; afterwards he may foment with warm water, or use the warm bath, rather to his lower, than his upper parts. But if any one has been scorched in the sun, he must immediately go to the bagnio, and rub over his body and head with oil, and then go down into the bath, warmed to a good degree; after that, first warm water must be poured over the head, and then cold. But he, that has been chilled with cold, must wrap himself up, and sit down in the laconicum, till he sweat; then anoint, and afterwards bathe; eat moderately, and drink wine unmixed.

He that has been upon sea, and is troubled with a nausea, if he has vomited much bile, ought to abstain from food wholly, or take very little: if he has brought up acid phlegm, he may notwithstanding take food, but lighter than ordinary: if he has had a nausea without vomiting, he should abstain from food, or take a vomit after meat. He that has sat the whole day, either in a chariot or in the theatre, should by no means run, but walk slowly. It has been frequently serviceable to stay a long while in the bath, and then to sup slightly. If one grows hot in the bath, it will refresh him to take vinegar, and hold it in his mouth: if that is not at hand, cold water may be used in the same manner. Above all things it is proper to know the constitution of the body: because some are slender, others fat; some hot, others cold; some moist, others dry; some costive, and others lax. There are very few instances of men, who have not a weakness in some part or other of their body. A person of a slender habit should take methods to gain flesh, one of a plethoric should diminish his bulk; one of a hot temperament ought to cool himself, the cold to warm him; one of a humid should dry, and one of a dry should moisten; he that is loose in the belly should harden it, and he that is bound should relax; and in general, means must always be used to help that part which is most liable to disorders.

The means of fattening the body.

The body is fattened by gentle exercise, frequent rest, unction, and the warm bath, if it be after dinner; a costive belly, moderate cold in the winter, a full sleep, but not over long, a soft couch, tranquillity of mind, the eating and drinking of sweet and fat things, frequent meals, and as much food as it is possible to digest.

Of extenuat­ing the body.

The body is extenuated by going into warm water[(23)], and especially if it be salt, the bath with an empty stomach, a scorching sun, and all heat, care, watching, either too short or too long sleep; lying upon the ground in the summer time, and upon a hard couch in the winter; running, much walking, and all violent exercise, vomiting, purging, acid and austere things, and a single meal in the day, also a custom of drinking wine, that’s not very cold, upon an empty stomach.

Since I have classed vomiting and purging amongst the methods for extenuating, I must say something in particular about them. I observe, that vomiting is rejected by Asclepiades in that book, which he composed upon the preservation of health; nor do I blame him, if he was offended with the custom of those, who by such daily evacuation endeavour to procure a voracious appetite. But he has gone something farther. He has also in the same book forbid purging. And indeed this is hurtful, if it be procured by too strong medicines. It can be no universal maxim however, that these should be laid aside entirely; because it is possible, that the nature of constitutions and particular junctures may make them necessary, provided they be used with moderation, and not without necessity; and even he himself has granted, that if any thing be corrupted, it ought to be expelled. So that this method is not to be altogether condemned, but there may be many occasions for it, and it requires a more particular and nice observation.

Of vomits.

A vomit is more useful in the winter than summer, because in that season there is more phlegm, and a greater heaviness in the head. It does no good to those, that are slender, and have a weak stomach; but it is useful to those, that are of a full habit, and all bilious people, if they have either overloaded themselves, or their concoction has been impaired: for if they have taken a greater quantity than can be concocted, they ought not to run the risk of its corrupting; or if it is already corrupted, nothing is more proper than to have it expelled in the most expeditious way possible. For this reason, whenever they are attacked with bitter eructations, attended with pain and weight of the præcordia, they must immediately have recourse to this remedy. It is likewise proper for one, who has a scorching heat in the breast, and a frequent spitting or a nausea, or for one who has noise in his ears, or a humour in the eyes, or a bitterness in the mouth; as also for one, who changes either his air or situation, and to those, who are troubled with a pain of the præcordia, if they have not vomited for several days. I am sensible, that in these cases rest is prescribed, which cannot always be had by those, who are under a necessity of stirring about; nor indeed has it the same effect in every body. I grant then, that vomits should not be taken with a view of indulging the luxurious appetite: that they are sometimes useful remedies, I believe upon the credit of experience; but I would advise any, who wishes to be healthy, and live to old age, not to make a daily practice of it. When one chuses to vomit after meat, if he does it easily, he should first drink only warm water; if with difficulty, let him add a little salt or honey to the water; but he, that intends to vomit in the morning, should first drink mulse[(24)], or eat hyssop[(25)], or radish, and then drink warm water, as has been directed already. All the other things which the ancient physicians prescribed, are hurtful to the stomach. If it is weak after the vomit, a little food is to be taken, but of a proper kind; and if the fauces have been much irritated, three cyathi of cold water may be drunk. He, that has vomited, if it was in the morning, ought to take a walk, then anoint, afterwards sup; but if after supper, on the following day he should bathe, and sweat in the bagnio; he will do well to make the next meal slight, and the bread he uses at it should be stale, wine austere and unmixed, the flesh roasted, and all the food of the driest kind. He that chuses to vomit twice in the month, will find it answer the purpose better, if he do it for two days successively, than if he were to repeat it on the fifteenth day, unless such an intermission should cause a weight at his breast.

Of purging.

When the belly is costive, so as to evacuate very sparingly, and from that cause flatulencies, dimness of sight, pains of the head, and other disorders of the superior parts, grow troublesome, then ’tis fit to take a purge: for what assistance can rest or abstinence afford in these disorders, of which they are the principal causes? He that wants to be lax, let him first use such food and wine as produce that effect: and if they don’t succeed, let him take aloes. But purging, though it be sometimes necessary, yet, when it is frequent, becomes dangerous; for thus the body will be habitually deprived of its nourishment, and by that means become valetudinary, for a body in a weak state is the most liable to all kinds of distempers.

What heats and cools the body.

The body is heated by unction, salt water, and more so if it be warm; all salt provisions, and austere wine. On the contrary, it is cooled by bitter and fleshy substances, taken with an empty stomach; the bath after meals, and sleep, unless it be too long, and all acids; the coldest water; oil, if it be mixed with water; and lotus[(26)].

What mois­tens and dries the body.

The body is rendered humid[(27)] by less exercise than ordinary, frequent bathing, a full diet, much drink, a walk after it, and continuing awake. Walking long, and briskly, has of itself the same tendency; and morning exercise, if one does not eat presently after it; and those kinds of food, which come from cold climates, or rainy, or otherwise damp. On the contrary, dryness is caused by immoderate exercise, hunger, unction, heat without moisture, immoderate use of salt, cold water, and the taking of food immediately after exercise, and such particularly as comes from dry and hot climates.

What binds and relaxes the belly.

The belly is bound by labour, sitting still, rubbing potter’s chalk upon the body, and by diminishing the usual quantity of food, as also if it be taken but once a day by one who is accustomed to it twice; by drinking little, and not till one has eat as much, as he designs for the time; rest after meat. On the other hand, the belly is relaxed by an increase of walking and food, motion after meat, and drinking frequently in the time of meals. ’Tis necessary also to know this that a loose belly is bound by a vomit, and a costive one is loosened by the same: and a vomit immediately after meat binds it; but one that comes some time after, renders it lax.

Of the dif­fer­ent ages.

As to the different ages, people in middle life bear want of food most easily; young men not so well; least of all boys, and very old men. The more uneasiness one finds from it, he ought to take victuals the oftener; and that frequency is more especially necessary for one, that is growing. Warm bathing is fit both for boys and old men. Wine should be given to boys more diluted, to old men less; but such as occasions flatulencies, to neither of them. It is of less consequence what victuals young men eat, and how dressed. Those that are loose in the belly while young, for the most part are costive when they grow old; such as are costive, in their youth, are often loose in old age. It is best for a young man to have a lax belly, and for an old man to be bound.

Of the sea­sons.
Winter.

It is necessary also to consider the seasons of the year. It is proper to eat more in the winter; to take a smaller quantity of drink, but less diluted; to make much use of bread, and flesh rather boiled than roasted, and greens sparingly; to take food once a day, unless the belly be too much bound. If one dines, it is better to take some trifling thing, and that dry, without flesh, and without drink. In that season of the year, all warm things, or such as promote heat, are best. Nor is venery altogether so hurtful then, as at some other times.

Spring.

But in the spring the quantity of food is to be lessened, and the drink increased, but more diluted; more use is to be made of flesh and greens, and there must be a gradual change from boiled to roast flesh. Venery is most safe in that season of the year.

Summer.

But in summer the body requires meat and drink more frequently; therefore it is convenient to take a dinner. Flesh and greens are most proper in that season; drink very much diluted, that it may at once remove thirst, and not inflame the body; bathing in cold water; roast flesh, cold food, or such as is cooling. As food must be often taken, so it must be in small quantities.

Autumn.

Now in autumn there is the greatest danger, upon account of the frequent changes of the air. And for this reason one should never go abroad, especially in the colder days, without warm cloaths and shoes, nor sleep in the air in the night-time, or at least be well covered. At this time the diet may be something more full, the drink less, but stronger. Some imagine apples[(28)] to be hurtful, which for the most part are eaten immoderately through the whole day, while no abatement is made from the more substantial food. Thus the mischief does not proceed from them, but from the aggregate of all that is taken; for none of them contribute less to it than these. But it is not fit to use them oftener than the other kinds. Lastly, it is necessary when an addition is made in this article, to lessen the quantity of the stronger food. Venery is neither good in the summer, nor in autumn; but is less hurtful in autumn; in summer, if possible, there ought to be a total abstinence from it.

CHAP. IV. RULES FOR THOSE THAT HAVE A WEAKNESS IN THE HEAD.

Our next business is to consider the cases of those, who have a weakness in any particular part of the body. He, that has a weakness in his head, if he has concocted well, ought to rub it gently with his hands in the morning; and never, if he can avoid it, put any covering upon it, or clip the hair close to the skin; it is proper for him to avoid exposing it to the moon, and more especially before her conjunction with the sun, but never to go out after meat: if he have his hair, to comb it every day; to walk much, but if he can, neither under a roof, nor in the sun; and also to avoid the scorching heat of the sun, particularly after meat or wine. He should rather anoint than bathe, and the unction should be performed, never before a flame, sometimes at a glowing red fire. If he come to the bath, he ought first to wrap himself up, and sweat a little in the tepidarium, anoint there, and then go into the calidarium; when he has sweat, not to go into the bath, but to pour hot water over his head, so that it may run over all his body, then tepid water in the same manner, and lastly cold; and the last longer upon his head than the other parts; after which to rub it for some time; lastly, to dry and anoint. Nothing is so beneficial to the head as cold water; for this reason, he that has a weak head, should every day in the summer hold it for some time under a pretty strong stream. And though he has anointed without going into the bath, and is not able to bear dipping in cold water, nevertheless he should always pour cold water upon his head. But when he is unwilling to have the other parts of his body touched, he must bend his head forward, so that the water may not fall down into his neck; and that it may not offend his eyes, or any other part, he is to throw it back now and then with his hands, as it runs down. It is necessary for him to use a spare diet, which is easily concocted; and if he finds his head uneasy, when his stomach is empty, he must eat in the middle of the day; if fasting does not injure it, once a day is more eligible. Mild diluted wine is more proper for his common drink than water, that when his head grows worse, he may have some refuge left; and it is neither fit for him to drink wine always, nor water; each of them is a remedy, when used alternately. He must neither write nor read, nor speak with vehemence, especially after supper; at which time neither is thinking very safe for him; but above all things a vomit is hurtful.

CHAP. V. DIRECTIONS FOR THOSE THAT LABOUR UNDER A LIPPITUDE, GRAVEDO, CATARRH, AND DISORDERS OF THE TONSILS.

Nor is the use of cold water beneficial to those only, who are distressed with a weakness in their head; but also to such as are troubled with constant lippitudes, or gravedoes, catarrhs, and disorders in their tonsils. Such people must not only pour cold water upon their head every day, but also wash their mouth with a large quantity of it; and all, that find relief from this practice, must especially make use of it, when the air has been rendered unwholesome by southerly winds. And as all strong attention or fatigue of mind after meat is hurtful to every body, so it is more particularly to those, who are liable to pains in their head, or windpipe, or any other disorders in their mouth. A person subject to gravedoes and catarrhs, may avoid these disorders by changing his air, place, or water, as little as possible; and by covering his head in the sun, so as it may neither be overheated, nor suffer by cold from the sudden intervention of a cloud; by shaving his head with an empty stomach after concoction, and neither reading nor writing after meat.

CHAP. VI. THE PROPER REGIMEN FOR PEOPLE LIABLE TO A PURGING.

He, that is frequently troubled with a purging, ought to exercise his upper parts by the ball, and such like motions; to walk, while his stomach is empty; to avoid too great heat from the sun, and constant bathing; to anoint without sweating. He should not use a variety of food, and by no means meat stewed into broth, or vegetables of the leguminous kind, or those greens that pass quickly through the body; in fine, to take all such things as are slowly concocted. Venison, hard fish, and the roasted flesh of tame animals, are very proper. It is never fit to drink salt wine[(29)], nor even the weak, nor sweet wine, but the austere, of a strong body, and not over old. If he chuses mulse, it must be prepared with boiled honey. If cold drinks don’t disturb his belly, he must use them principally. If any thing has disagreed with him at supper, he ought to vomit, and to repeat it the day following; on the third day to eat a small quantity of bread dipped in wine, or eggs fried in oil, or in defrutum[(30)], and things of a like nature: after that to return to his usual diet. After meat always to rest, and neither apply his thoughts to any subject closely, nor give himself a shock by walking however gently.

CHAP. VII. RULES FOR THOSE THAT ARE LIABLE TO A PAIN OF THE COLON.

But if the large intestine, which is called colon[ AE ], is often pained, since that disorder is nothing else but a kind of flatulence, the intention to be pursued is, that concoction may be duly performed; the patient must practise reading, and other exercises, make use of the hot bath, and take his food and drink hot; lastly, let him avoid cold by all means, every thing that is sweet, and leguminous vegetables, and whatever generally causes flatulencies.

CHAP. VIII. RULES FOR ONE THAT HAS A WEAK STOMACH.

A man, whose stomach is infirm, ought to read aloud, after reading to walk, then to exercise himself with the ball or arms, or any other kind, which agitates the superior parts; upon an empty stomach, not to drink water, but hot wine; to take food twice a day, but in such quantity, as he can easily concoct; to make use of small and austere wine, and to take his drink after meat rather cold. The indications of a weak stomach are paleness, leanness, pain in the præcordia, nausea, involuntary vomiting, a pain of the head, when the stomach is empty: where these signs are not found, the stomach is strong. And we are not to believe our countrymen, who, when they are indisposed, and have a strong inclination for wine or cold water, defend their luxury by pretending the stomach does not do its office. But those that concoct slowly, and whose præcordia on that account are inflated, or who, by reason of any heat, are accustomed to be thirsty in the night-time, before going to rest may drink two or three cyathi of wine through a small pipe. It is good also against a slow concoction to read aloud, then to walk, afterwards to anoint or bathe, to drink always cold wine, and after meat to drink largely, but in the way I mentioned already by a siphon: lastly, to conclude all the drinks with cold water. He, whose food grows sour in his stomach, before he eats, should drink egelid water, and vomit. But if the use of this should occasion a looseness, whenever he is relieved of that complaint, he should by all means make use of cold drinks.

CHAP. IX. DIRECTIONS FOR THOSE THAT ARE LIABLE TO PAINS OF THE NERVES.

He that is subject to pains in the nerves, as is common in the gout of the hands or feet, ought as much as possible to exercise the part affected, and expose it to labour and cold; unless the pain has become violent, in which case rest is best. Venery is always hurtful. Concoction is necessary, as well in this, as in all disorders of the body: for crudity injures it more than any thing; and whenever the body is out of order, the diseased part feels it most sensibly. As concoction is an adversary to all diseases, so some again are relieved by cold, and others by heat. Either of which every one ought to procure, according to the habit of his body. Cold is hurtful to an old or slender man, to a wound, to the præcordia, intestines, bladder, ears, hips, shoulders, private parts, teeth, bones, nerves, womb, and brain. It also renders the surface of the skin pale, dry, hard, and black. From this proceed shudderings and tremours. But it is beneficial to young people, and all that are of a full habit. The mind also is more brisk, and the concoction goes on better, when ’tis cold, if due care is taken to guard against it. Cold water poured on, besides being useful to the head, does good to the stomach. It is likewise of service to the joints, and pains, which are not attended with ulcers; also to persons, that are too ruddy, if they be free from pain. Heat helps whatever cold hurts; and those too that have blear eyes, if they have neither pain nor an effusion of tears; also contracted nerves, and especially those ulcers which arise from cold. It causes a good colour in the body, and promotes the excretion of urine. In too great a degree, it enervates the body, softens the nerves, and relaxes the stomach. But neither cold nor heat is by any means safe, coming suddenly upon persons unaccustomed to it; for cold occasions pains in the sides, and other disorders, and cold water causes scrophulous swellings; heat hinders concoction, prevents sleep, wastes by sweat, and renders the body obnoxious to pestilential distempers.

CHAP. X. DIRECTIONS IN A PESTILENCE.

There are some rules necessary to be observed in a pestilence by a man, who continues in good health, but cannot however be secure. At that time it is proper to take journies and to sail. When that can’t be done, to use gestation, gentle walking in the open air before the heat of the day, and unction with the same moderation; and as has been directed above, to avoid fatigue, crudity, cold, heat, and venery, and confine himself to a strict regimen. If he feel any heaviness hanging about his body, then he is neither to rise in the morning, nor walk barefooted at any time, much less after meat or the bath; nor to vomit either with an empty stomach, or after supper: neither should the belly be purged; and if it grow loose of itself, it must be restrained. Abstinence should rather be observed, if the body is plethoric. Also it is proper to avoid the bath, sweating, sleeping in the middle of the day, especially after meat; which by the way, it is more convenient to take once a day, and that sparingly, lest it should occasion crudity: every other day to drink alternately water and wine. These rules being carefully observed, as little alteration as possible should be made in the usual course of life. And as they are to be practised in every pestilence, so principally in that, which is occasioned by southerly winds. And the very same precautions are necessary for those that take journies, when they have set out from home in a sickly season of the year, or have come into sickly countries. But if the nature of any engagements should prevent the observance of the other rules, yet it will be necessary to live abstemiously; and thus to change from wine to water, and from that to wine again, in the manner that has been prescribed above.

A. CORNELIUS CELSUS

OF

MEDICINE.

BOOK II.

PREFACE.

Of the approach of a disorder there are many signs. In the explication of which, I shall, without hesitation, make use of the authority of the ancients, and more especially that of Hippocrates; as even the more modern physicians, although they have made alterations in the method of curing, nevertheless confess, that he has delivered the best prognostics from these signs. But before I speak of those antecedents, which give cause to apprehend distempers ensuing; it seems not improper to explain, what seasons of the year, what kinds of weather, what times of life, what constitutions are most safe from, or most obnoxious to dangers, and what kinds of disorders are most to be feared in each of these. Not but in any weather[(1)], men of all ages and all habits, fall into all kinds of distempers, and die of them too; but because some events are more frequent than others. And therefore it is useful for every person to know, against what, and when, he should be most upon his guard.

CHAP. I. OF THE DIFFERENT SEASONS, WEATHER, AGES, CONSTITUTIONS, AND THE DISEASES PECULIAR TO EACH.

The most healthful season then is the spring, next to that the winter, the summer is more dangerous than either, the autumn by far the most dangerous of all. With regard to the weather, that is best, which is equal, whether it be cold or hot: that, which varies most, is the worst. For this reason it is, that the autumn destroys the greatest number. For generally in the middle of the day it is hot, the nights, mornings, and evenings too, are cold: thus the body relaxed by the preceding summer, and by the frequent meridian heats of autumn, is exposed to sudden cold. But as this is most common in this season, so it is hurtful, whenever it happens. When the weather is equal, serene days are most healthful: rainy are better than those that are only misty or cloudy: and in winter those days are best, that have no wind at all; in summer, that have the westerly breezes. If the winds blow from any of the other quarters, the northerly are more salutary than the easterly or southerly. Nevertheless these sometimes differ according to the situation of countries. For generally in every place a wind, that comes from the inland parts, is healthful; one from the sea is sickly. And not only health is more certain in a good temperature of the weather, but even the more malignant distempers, which happen to come on then, are more mild and sooner removed. That air is the worst for a sick person, which has occasioned his distemper; insomuch that in such a case, a change for weather in it’s own nature worse is favourable.

The middle age is safest, because it is neither endangered by the heat of youth, nor the coldness of old age. Old age is more liable to chronical diseases, and youth to acute ones. The body most promising for health is the square, neither over slender, nor over fat. For a tall stature, as it is comely in youth, so it quickly wears out by age. A slender body is weak, a corpulent heavy.

Whatever disorders arise from the motion of the humours, are generally to be most apprehended in the spring[(2)]; so that, at this season, lippitudes, pimples, hæmorrhages, abscesses of the body, which the Greeks call apostemata[ AF ], atrabilis, which they name melancholia[ AG ], madness, epilepsy, angina, gravedoes, and catarrhs, usually occur. Also those distempers in the joints and nerves, which sometimes are troublesome, and sometimes easy, at this time of the year are the most apt both to begin and return. Neither is the summer altogether free from most of the above-mentioned distempers; but adds moreover fevers, either ardent, or tertian, vomitings, purgings, ear-achs, ulcers of the mouth, gangrenes, both in the other parts of the body, and chiefly in the private parts; and all these disorders that waste a man by sweat. There is hardly any of these, that is not found in the autumn; but there arise then, besides irregular fevers, pain of the spleen, dropsical disorders[(3)], consumption, which the Greeks call phthisis[ AH ]; difficulty of urine, which they term stranguria[ AI ]; the distemper of the smaller intestine which they name ileos[ AJ ], there happens also what the Greeks call lienteria[ AK ]; pains of the hips, epileptic disorders. And the same season is mortal to those that are worn out with long diseases, and such, as have been oppressed by the preceding summer; and it dispatches some by new distempers, and involves others in very tedious ones, especially quartan agues, which may even continue through the winter. Nor is any season more liable to the plague, of whatever kind it be, however various in its manner of hurting. The winter provokes pains of the head, the cough, and whatever disorder is contracted in the fauces, sides, or bowels.

With regard to the varieties of weather, the north wind raises a cough, exasperates the fauces, binds the belly, suppresses urine, excites shudderings, also pain of the side and breast; yet it braces a sound body[(4)], and renders it more mobile and brisk. The south wind causes dulness of hearing, blunts the senses, raises a pain of the head, opens the belly, and renders the whole body heavy, moist, and languid. The other winds, by how much they approach more nearly to either of these, produce effects the more similar to each of them. All heat inflames the liver and spleen, enervates the mind, and occasions faintings, and hæmorrhages. Cold causes sometimes convulsions, and sometimes a tetanus, the Greek name for the first is spasmos[ AL ], and for the other tetanos[ AM ]: it produces blackness in ulcers, and a shuddering in fevers. In dry weather we meet with acute fevers, lippitudes, dysenteries, stranguries, pains of the joints; in rainy, tedious fevers, diarrhœas, angina, gangrenes, epilepsies, palsy, which the Greeks call paralysis[ AN ]. Nor is the present weather only to be considered, but also what has been its course for some time. If a dry winter has been attended with northerly winds, and the spring with southerly, and rains, there most commonly ensue lippitudes, dysenteries, fevers, and these chiefly in more delicate bodies, particularly women. But if southerly winds and rains have prevailed in the winter, and the spring be cold and dry, then indeed pregnant women, whose time is near, are in danger of a miscarriage; and those, that go their full time, bring forth weakly children, not likely to live. Other people are attacked with dry lippitudes, and if they are old, with bad gravedoes and catarrhs. But if the southerly winds have continued from the beginning of winter to the end of spring, people are very quickly taken off by pleurisies, and fevers attended with a delirium, which is called phrenitis[ AO ]. But when the heat begins with the spring, and continues through the summer, profuse sweating in fevers necessarily follows. But if a dry summer has been attended with northerly winds, and the autumn with rains, and southerly, all the following winter we find coughs, catarrhs, hoarseness, and in some a consumption. But if the autumn too is equally dry, and the same northerly winds blow, all the more delicate bodies, amongst which I placed women, enjoy a good state of health: and for the more robust, they may possibly be attacked with dry lippitudes, and fevers either acute, or tedious, and atrabiliary disorders.

As to the different ages, children, and those a little more advanced, have their health best in the spring, and are most safe in the beginning of summer; old men in the summer, and beginning of autumn; young and middle aged men in the winter. The winter is more hurtful to old men, and the summer to youths. For the peculiar weaknesses, that appear at different times of life, first of all infants and young children will be troubled with spreading ulcers of the mouth, which the Greeks call aphthæ[ AP ], vomitings, nightly watching, humour in the ears, and inflammations about the navel. The peculiar complaints of such as are teething, are exulcerations in the gums, convulsions, slight fevers, purgings, and these are chiefly troublesome about the cutting of the canine teeth. Infants of the fullest habit, and whose bellies are very much bound, are most liable to these dangers. But when they have grown up a little, there appear disorders of the glands, and different inclinations of the vertebræ, which compose the spine, scrophulous swellings, some painful kinds of warts, by the Greeks called acrochordones[ AQ ], and many other tubercles. In the beginning of puberty, many of the above-named, and long fevers, and hæmorrhages from the nose. And generally all children are most in danger first about the fortieth day, then the seventh month, then the seventh year, after these at the time of puberty. Moreover any distempers, which commence in infancy, and are terminated neither by puberty, nor in men by their first commerce with women, nor in women by the appearance of their menses, commonly continue long: yet more frequently these puerile disorders of long standing are removed by these means. Youth is most subject to acute disorders, and epileptic, and to a consumption: and they are commonly young men, who spit blood. After this age, come on pleurisies and peripneumonies, lethargy, cholera, madness, and discharges of blood from certain mouths, as it were, of the veins, by the Greeks called hæmorrhoides[ AR ]. In old age, difficulty of breathing, and making urine, gravedo, pains of the joints and kidneys, palsies, bad habit of body, which the Greeks call cachexia[ AS ], nightly watchings, tedious disorders of the ears, of the eyes, and nose, and especially a loose belly, and its consequences a dysentery, or lientery, and other indispositions incident to that habit. Besides these the slender are distressed with consumptions, purgings, catarrhs, and pains of the bowels, and sides. The corpulent generally are oppressed with acute diseases, and difficulty of breathing, and often die suddenly, which seldom happens in a more slender body.

CHAP. II. OF THE SIGNS OF AN APPROACHING ILLNESS.

Before an illness, as I mentioned above, there appear some signs of its approach. All of them have this in common, that the body alters from its ordinary state; and not only for the worse, but even for the better. For this reason, if one has become more plump, and looks better, and of a more florid complexion than usual, he ought to hold these advantages suspected. For because these things can neither continue at a stay, nor admit further improvement, they generally run backward very fast, like some heavy body tumbling down. But it is a worse sign, when one is emaciated contrary to his natural habit, and has lost his colour and comeliness: because bodies redundant can allow something to be carried off by a distemper; the deficient have not wherewithal to bear the force of the distemper itself. Besides there is cause to be presently alarmed, if the limbs are heavy; if frequent ulcers break out; if the body has grown hotter than common; if sleep be too heavy; if the dreams are tumultuous; if one awakes oftner than usual, and then falls asleep again; if the body of a person asleep sweats in some parts contrary to custom, especially if that be about the breast, or neck, or legs, or knees, or hips; also if the mind is languid; if there is a reluctance to speaking and motion; if the body be indisposed to action; if the præcordia are pained, or the whole breast, or which happens in most people, the head; if the mouth is filled with saliva; if the eyes feel pain in turning; if the temples be strait bound[(5)]: if the limbs have shudderings; if the breathing is difficult; if the arteries in the forehead are dilated and beat strong; if there be frequent yawnings; if the knees feel tired, or the whole body be afflicted with a lassitude. Several of these things often, some of them always, precede a fever. This, however, ought to be first considered, whether any of these happen frequently to a person without any consequent uneasiness. For there are some peculiarities in the constitutions of particular persons, without the knowledge of which, it is not easy to prognosticate what is to happen. With reason therefore a man is free from apprehensions about those things, which he has often escaped without danger: he only is justly uneasy, to whom these appearances are new, or who has never been secured from their bad effects without proper precautions.

CHAP. III. GOOD SYMPTOMS IN SICK PEOPLE.

When any person is seized with a fever, it is certain he is not in danger, if he lies either upon his right or left side, as may have been usual with him, with his legs a little drawn up, which by the way is commonly the lying posture of a person in health; if he turns himself with ease; if he sleeps in the night-time, and keeps awake in the day; if he breathes easily; if he does not struggle; if the skin about the navel and pubes be full[(6)]; if his præcordia be equally soft on both sides, without any sense of pain; or although they are a little swelled, yet yield to the impression of the fingers, and are not pained. This illness, though it will continue some time, yet will be safe. The body also, which is every where soft, and in the same degree of heat, and which sweats all over equally, and whose fever is removed by that sweat, is in a fair way of doing well. When the body is recovering its health, sneezing also is amongst the good signs, and an appetite, either continued from the beginning, or even coming after a nausea. Nor should that fever alarm, which terminates in one day; nor indeed that, which though it has prevailed for a longer time, yet has totally intermitted betwixt paroxysms, so as the body became free from all complaint, which the Greeks call eilicrines[ AT ]. If any thing happens to be discharged by vomiting, it ought to be a mixture of bile and phlegm: and the sediment of the urine white, smooth, equal; so that, if there is any thing like small clouds swimming in it, that subsides to the bottom. And the stools in one, who is safe from danger, are soft, figured, and evacuated at nearly the same intervals, as was usual in health, and in quantity duly proportioned to the nourishment, that is taken. A loose belly is worse: but even this should not immediately be esteemed dangerous, if the discharge be of a harder consistence in the morning, or gradually turn less liquid, and the excrements be reddish, and their offensive smell don’t exceed that of the like discharge of a healthy man. And there is nothing bad in voiding some worms at the end of the distemper[(7)]. If a flatulency has occasioned a pain and swelling in the upper parts without an inflammation, a rumbling of the belly from thence to the lower parts is a good sign; and more so, if it has found an easy passage with the excrements.

CHAP. IV. BAD SYMPTOMS IN SICK PEOPLE.

On the other hand there is hazard of a dangerous distemper, when the patient lies supine, with his arms and legs extended: when he inclines to sit up during the greatest violence of an acute distemper, especially in a peripneumony: when he is distressed with wakefulness in the night, even although he sleep in the day time. Now sleep, which happens betwixt the fourth hour[(8)] and night, is worse than that, which is betwixt morning and the same hour. But it is worst of all, if he neither sleep in the night, nor the day time: for that cannot well happen without a constant delirium. Neither is it a good sign to be oppressed with sleep beyond measure: and the worse, the nearer the sleep comes to being continued day and night. It is also a sign of a dangerous distemper to breathe quickly, and with vehemence; for shudderings to have come on after the sixth day; to spit matter; to expectorate with difficulty; to have constant pain; to be much distressed with the distemper; to toss the arms and legs about; to weep involuntarily; to have a glutinous humour sticking to the teeth; for the skin about the navel and pubes to be emaciated; for the praecordia to be inflamed, painful, hard, swelled, tense: the case is worse, if these appearances be more on the right side than on the left: but the danger is still greatly increased, if at the same time the pulsation of the arteries there be violent. Again, it indicates a bad distemper to be too quickly emaciated; to have the head, feet, and hands cold, with the belly and sides hot; or for the extremities to be cold during the violence of an acute distemper; or to shudder after sweating; or after vomiting to have the hiccough, or the eyes to be red; or after having an appetite for food, or at the end of long fevers, to loath it; to sweat much, and especially a cold sweat; or to have sweats not equally diffused over the whole body, and such as do not terminate the fever. They are also bad fevers, which return every day at the same time; or those, that always have paroxysms equally violent, and which do not remit every third day; or those, that continue so as to increase in their paroxysms, and only remit in their intervals, but never leave the body quite free from disorder. It is worst of all, if the fever does not at all remit, but continues with equal violence. It is dangerous too for a fever to come after a jaundice, especially if the praecordia have continued hard on the right side; or on the left, if attended with pain there. Every acute fever ought to give us no small apprehensions: and always in such a fever, or after sleep, convulsions are terrible. It is also a sign of a bad distemper to wake with a fright, and likewise in the beginning of a fever for the mind to be presently disordered, or any limb to become paralytic. In that case, though the patient escape with life, yet for the most part that limb is debilitated. A vomiting also of pure phlegm or bile is dangerous; and if it be green, or black, it is worse. Urine is bad, where the sediment is reddish or livid; and worse, in which there is a kind of small and white threads: and worst of all, that, which bears the resemblance of small clouds, composed as it were of particles of bran. Thin and white urine is bad, but especially in phrenitic patients. It is bad to have the belly entirely bound. And a purging too in fevers is dangerous, where it will not allow a man to rest in his bed; especially if the discharge be very liquid, or whitish, or pale, or frothy. Besides these it portends danger, if the excretion be small in quantity, glutinous, smooth, white, and at the same time of a palish colour; or if it is either livid, or bilious, or bloody, or of a more offensive smell than common. An unmixed discharge also, which comes after long fevers, is bad.

CHAP. V. SIGNS OF LONG SICKNESS.

After the foregoing symptoms have appeared, ’tis known, that a distemper will become tedious: for it must necessarily be so, unless it be mortal. And there is no other hope in violent diseases, than that the patient may escape by eluding the first shock of the distemper, that there may be room for the application of proper methods of cure. But some signs appear in the beginning of a distemper, from which we may gather, that although it does not prove mortal, yet it will last for a considerable time. In fevers not violent, when a cold sweat comes on only about the head or neck; or when the body sweats without the fever intermitting; or when the body is sometimes cold, and sometimes hot, and the colour changes; or when in fevers an abscess, which has been formed in some part, does not prove salutary; or when the patient, considering the time of his illness, is but little emaciated. Also, if the urine at some times is thin and limpid, and at other times has some sediment; and if what subsides be smooth, and white, or red; or if it have the appearance of motes; or if it send up air bubbles.

CHAP. VI. THE SYMPTOMS OF DEATH.

But though in such circumstances there is reason to fear, yet there remains some hope. But we are sure a person is come to the last stage, when the nose is sharp, the temples shrivelled, the eyes hollow, the ears cold, and languid, and slightly inverted at their extremities, the skin about the forehead hard and tense, the colour either black or very pale; and much more so, if these things happen without any preceding wakefulness, or purging, or fasting: from which causes this appearance sometimes arises, but then it vanishes in one day. So that if it continues longer, it is a forerunner of death. And if it remains the same for three days in a tedious distemper, death is very near: and more especially if besides the eyes can’t bear the light and shed tears; and the white part of them grows red; and their small vessels are pale; and humour floating in them at last sticks to the angles; and one eye is less than the other; and they are either very much sunk, or much swelled; and when the eye-lids in sleep are not closed, but betwixt them there appears some part of the white of the eye; provided it be not occasioned by a flux; when the eye-lids also are pale, and the same paleness discolours the lips and nose; and also when the lips, and nose, and eyes, and eye-lids, and eye-brows, or some of these, are distorted, and the patient from pure weakness loses his hearing, or sight.

Death is also to be expected, when the patient lies supine, and his knees are contracted; when he slides downward now and then towards his feet; when he lays bare his arms and legs, and tosses them about irregularly, and there is no heat in them; when he gapes with his mouth; when he sleeps constantly; when being insensible, he grinds his teeth, and had not that custom in health; when an ulcer, which broke out either before, or in the time of his sickness, has grown dry, and turned either pale or livid, The following symptoms are also deadly; pale-coloured nails, and fingers; a cold breath; or if one in a fever, and acute disease, or madness, or peripneumony, or pain of the head, gathers the wool off the cloaths with his hands, or draws out and smooths their edges, or catches at any small prominences in an adjoining wall. Pains also, that have begun in the hips and lower parts, if they have been translated to the bowels, and suddenly ceased, are sure prognostics of approaching death; and more so, if any of the other symptoms have also concurred. And it is impossible to save that person, who labouring under a fever without any tumour, is suddenly, as it were, strangled, or cannot swallow his spittle; or one, whose neck, while the fever and habit of body remain the same, is turned aside, so that it is equally impossible for him to swallow any thing; or him, who at the same time has a continued fever, and extreme weakness of body; or when, without an abatement of the fever, the external surface of his body is cold, and the internal parts so hot as to produce thirst; or one, who, the fever continuing as in the former case, is distressed at once with a delirium and difficulty of breathing; or one, who, after drinking hellebore, has been seized with convulsions; or one, that has lost his speech after being intoxicated with liquor, for he is commonly carried off by convulsions, unless either a fever has supervened, or he has begun to speak at the time, when the effects of the liquor shall be over. A pregnant woman is also easily destroyed by an acute distemper. And likewise any person, whose disorder is increased by sleep; and one, who in the beginning of a recent disorder, vomits, or voids by stool, atrabilis; and the event is the same, where this has been discharged in either of these ways, when the body has been already extenuated, and wasted by a long illness. A bilious spitting, and purulent, whether they come up separately, or mixed, shew that there is danger of death. And if this appearance has commenced about the seventh day of a disease, the consequence is, that the patient will die about the fourteenth, unless some other symptoms more benign, or malignant, come on: and these after symptoms, the more gentle or violent they are, signify that death will happen so much the later, or sooner. A cold sweat likewise in an acute fever is mortal; and in every disease, a vomiting variegated with different colours; and especially if it be fetid. And it is also extremely bad to vomit blood in a fever. The urine is commonly of a bright yellow colour and thin in great crudity; and often before it has time to concoct, kills the patient. Upon this account, if it continue so for any time, it prognosticates danger of death. But the worst of all and most deadly is the black, thick, and fetid. And such as this is the worst in men and women; but in children that, which is thin and watery. A variegated discharge also by the belly is very bad; and such as contains strigments[(9)], blood, bile, and something green, and these either at different times, or all together in a kind of mixture, but so as each of them appear distinctly. Yet ’tis possible for one to endure this somewhat longer. But a speedy death is denoted, when the discharge is liquid, and withal either black, or pale, or fat; especially if besides it have an intolerable stench.

I am sensible I may be asked, how it happens, if the signs of future death are infallible, that some, who are entirely given over by physicians, should recover, and that some are reported to have come to life again, even when they were carried out to be buried? Nay, the justly famed Democritus maintained, that even the marks that life was gone, which physicians had trusted, were not certain: so far was he from allowing, that there could be any certain prognostics of death. In answer to which I shall not insist, that some marks, which bear a great resemblance to each other, often deceive not the able, but the unskilful physicians, (which Asclepiades knowing, when he met a funeral, cried out, that the person, whom they were about to bury, was alive) and that the art is not to be charged with the faults of any of its professors. But I will answer with more moderation; that medicine is a conjectural art, and that the nature of conjecture is such, that although it answers for the most part, yet sometimes it fails. And if a prognostic may deceive a person, perhaps in one of a thousand instances, it must not therefore be denied credit, since it answers in innumerable others. And this I say not only with regard to the mortal, but also to the salutary symptoms. For hope too is sometimes disappointed, and one dies, whom at first the physician thought in no danger. And those things, which have been contrived for curing, sometimes occasion a change for the worse. Nor is it possible for human weakness to avoid this, in so great a variety of constitutions. But medicine however deserves credit, which most frequently, and in the greatest number of sick people by far, is of service. Nevertheless we ought not to be ignorant, that the prognostics both of recovery and death are more fallacious in acute distempers.

CHAP. VII. OF THE SIGNS IN PARTICULAR DISEASES.

Having then mentioned those signs, which belong to diseases in general, I shall now proceed to point out those marks, which may attend the particular kinds of them. Now there are some of these, which happen before, and others in the time of fevers, which discover either the state of the internal parts, or what is likely to follow. Before fevers, if the head be heavy, or there be a dimness in the eyes after sleep, or there be frequent sneezings, some disorder from phlegm about the head may be feared. If a person abound with blood, or be very hot, the consequence is, that there may be an hæmorrhage from some part. If any person is emaciated without an evident cause, he is in danger of falling into a bad habit of body. If the præcordia are pained, or there is a troublesome flatulency, or if the urine is discharged the whole day unconcocted, ’tis plain there is a crudity. Such as have a bad colour for a long time without a jaundice, are either distressed with pains of the head, or labour under a malacia. Those, whose faces long continue pale and swelled, have disorders either of the head, or bowels, or belly. If a boy in a continued fever has no passage in his belly, and his colour is changed and he is deprived of sleep, and is constantly bemoaning, himself, convulsions are to be apprehended. A frequent catarrh in a slender body and tall, gives ground to fear a consumption. When for several days there is no stool, it portends either a sudden purging, or a slight fever. When the feet swell, and there is a long continued purging, or pain in the bottom of the belly and hips, a dropsical disorder is impending: but this kind of distemper commonly arises from the ilia. Those also are exposed to the same danger, whose belly, discharges nothing, when they have a stimulus, unless with difficulty, and the excrements hard. When there is a swelling in the feet, and when the like tumour, sometimes in the right, sometimes in the left side of the belly alternately rises and falls, that disorder seems to arise from the liver. It is a mark of the same distemper, when the intestines about the navel are pained, which the Greeks call strophos[ AU ], and pains of the hip continue without being relieved either by time or remedies. If a pain of the joints, for instance in the feet or hands, or in any other part, be attended with a contraction of the nerves there; or if any limb fatigued by slight exercise, is equally distressed by heat and cold, we may expect the gout either in the feet or hands, or that there will be a disease in that joint, where the pain is felt. Such as have had hæmorrhages from the nose, while they were children, which afterwards ceased, must either be afflicted with pains of the head, or have some troublesome exulcerations in their joints, or fall into some languishing distemper. Women, whose menses are suppressed, will be subject to excruciating pains of the head, or a disorder in some other part. And those are liable to the same dangers, who have complaints in their joints, such as pains and swellings coming and going, without the gout, and such-like distempers. Particularly if their temples are often pained, and their body sweats in the night-time, and their forehead itches, there is fear of a lippitude. If a woman after delivery has violent pains, with no other bad symptoms, about the twentieth day there will either be an eruption of blood from the nose, or some abscess in the lower parts. And in general in any person, a violent pain about the temples and forehead, will be removed in one of these two ways: more probably by an hæmorrhage, if the person be young; if somewhat more advanced, by a suppuration. A fever, which goes off suddenly without any apparent reason, without good signs, commonly returns. A person, whose fauces are filled with blood, both in the day-time, and in the night, will be found to have an ulcer there, if neither pains of the head, nor of the præcordia, nor a cough, nor vomiting, nor slight fever have preceded. If a woman is attacked with a slight fever from a disorder in the groin, and the cause does not appear, there is an ulcer in the womb. Thick urine, in which there is a white sediment, implies that there is a pain about the joints, or the bowels, and fear of some impending distemper. When it is green, it shows, that the bowels will be pained, or that there will be a swelling attended with some danger; or at least, that the body is not sound. But if there is blood or pus in the urine, either the bladder or kidneys are ulcerated. If it be thick, and contain in it some small caruncles, or something like hairs; or if it be frothy, or fetid; or sometimes bring off something like sand, and sometimes like blood; and the hips be pained, and those parts, which lie between them, and above the pubes; and besides these if there be frequent eructations, sometimes a bilious vomiting, and the extremities be cold, and there is a frequent inclination to make water, but great difficulty in it, and what comes away be limpid, or reddish, or pale, and gives some small relief, and the belly be discharged with much wind; in such circumstances the distemper lies in the kidneys. But if the urine drops away slowly, or if blood is discharged with it, and in that some bloody concretions, and it is made with difficulty, and the internal parts about the pubes are pained, the fault is in the bladder. Those, that have calculous concretions, are known by these symptoms. The urine is made with difficulty, and comes away slowly, and by drops, and sometimes involuntarily, is sandy; sometimes blood, or bloody concretions, or something purulent is discharged with it. Some make it more readily standing upright, others lying upon their back: especially those, that have large stones; some even in an inclined posture, and these by drawing out the penis, alleviate their pain. There is also a sensation of weight in that part, which is increased by running, and every kind of motion. Some also in the paroxysm of the pain, cross their feet over one another, often changing them. But women are often obliged to rub the external orifice of their pudenda with their hands: sometimes applying their finger to that part, when it presses upon the neck of the bladder, they feel the stone. But where any expectorate frothy blood, their disorder is in the lungs. A pregnant woman, whose belly is very loose, may possibly miscarry. If the milk flows from her breast, the fœtus is weak. Hard breasts shew the child to be sound. A frequent hiccough, and of longer continuance than ordinary, is a sign of an inflammation of the liver. If tumours upon ulcers have suddenly disappeared, and this has happened in the back, we may be apprehensive either of convulsions, or a tetanus: but if in the fore part of the body, either a pleurisy or madness is to be expected. Sometimes also a purging, which is the safest of them all, follows such an accident. If the hæmorrhoidal veins, in one used to a discharge of blood from them, suddenly stop, either a dropsical disorder or a consumption ensues. A consumption also comes on, if suppurated matter derived from a pleurisy cannot be carried off within forty days. But where there is a long continued grief attended with long fear and watching, the atrabiliary distemper is the consequence. Those, who have frequent hæmorrhages from the nose, labour under a swelling of the spleen, or pains of the head: and they commonly see imaginary objects floating before their eyes. But those, whose spleens are large, have their gums diseased and a stinking mouth, or an hæmorrhage in some part. If none of these happen, bad ulcers will be formed in their legs, and black cicatrices from them. Where there is a cause of pain and no sense of it, the mind is disordered. If blood has been collected in the abdomen, it is there converted into pus. If a pain removes from the hips and the lower parts into the breast, and no bad symptom has supervened, there is danger of a suppuration in that place. Those, that without a fever have a pain, or itching, with redness and heat, in any part, will have a suppuration there. Limpid urine also in a valetudinary person portends some suppuration about the ears.

Now as these appearances, even without a fever, contain indications of what is latent or future, they are much more certain when accompanied with a fever; and then symptoms of other disorders also shew themselves. Wherefore when a person speaks more quickly than he used to do in health, and of a sudden talks much, and that with greater confidence than ordinary; or when one breathes slow, and with great force, and the pulse beats high, with hard and swelled præcordia, then there is a fear of approaching madness. Frequent motion of the eyes also, and a darkness arising before them, together with head-ach; or loss of sleep without any pain, and a continual watching day and night; or lying upon the belly contrary to custom, if that is not occasioned by a pain of the belly itself; also an unusual grinding of the teeth, while the body continues strong, are signs of madness. If an abscess has been formed, and subsides before a discharge by spitting comes on, the usual fever still continuing, there will be danger first of madness, and then of death. An acute pain also of the ear, with a continued and strong fever, often disorders the mind: and of this malady younger people sometimes die in seven days; those that are older hold out something longer: because their fevers are not equally violent, nor their distraction so great; so that they last till the distemper is resolved into pus. A suffusion of blood in the breasts of a woman betokens approaching madness. Those, that have long fevers, will either have an abscess formed somewhere, or pains of the joints. Those, whose breath is greatly straitened in passing through the fauces in fevers, will soon fall into convulsions. If an angina suddenly disappears, the distemper is removing into the lungs; and that is often fatal before the seventh day: and if that does not happen, the consequence is a suppuration in some part. Lastly, after long purgings come dysenteries; after these a lientery; after violent catarrhs a consumption; after pleurisies diseases of the lungs; after which madness; after great heats of the body a tetanus or convulsion; after a wound of the head a delirium; after great torment for want of sleep, convulsions; when the blood vessels above ulcers are in strong motion, there will be an hæmorrhage.

A suppuration is produced many ways[(10)]; for if fevers unattended with pain continue long without any manifest cause, the disorder is transferred upon some particular part: but this happens only in younger people; for in the elderly, a quartan ague is the common consequence of such a disease. A suppuration also happens, if the præcordia being hard and pained have neither carried off the patient before the twentieth day, nor an hæmorrhage from the nose has ensued; and this holds chiefly in youths, especially if in the beginning of the distemper they had dimness of the eyes, or pains of the head: but then the abscess forms in the lower parts of the body. But if there be a soft tumour in the præcordia, and it has not ceased within sixty days, and the fever continues all that time, then the abscess forms in the superior parts: and if there is not a discharge of blood from the nose[(11)] in the beginning, it breaks out about the ears. And as every tumour of long standing generally tends to suppuration, so one, that is seated in the præcordia is more likely to have that issue, than one that is in the belly: and one, that is above the navel, than one, that is below it. Also if there is a sense of lassitude in a fever, an abscess is formed either in the jaws, or the joints. Sometimes too the urine continues long and thin, and crude, and the other symptoms are good: in this case for the most part an abscess is formed below the transverse septum (which the Greeks call diaphragma). If a peripneumony is removed neither by expectoration, nor by cupping, nor bleeding, nor a proper regimen, it sometimes gives rise to some vomicæ, either about the twentieth day, or thirtieth, or fortieth, and even sometimes about the sixtieth. Now we must date our reckoning from that day, in which the person was first taken with the fever, or seized with a horror, or felt a weight in the part. But these vomicæ are generated sometimes in the lungs, sometimes about the ribs. Where the suppuration is seated, it raises a pain and inflammation, and there is a greater heat there: and if one has lain down upon the sound side, he imagines it loaded with some weight. And every suppuration, that is not yet visible, may be known by the following signs: the fever does not wholly intermit, but is more mild in the day-time, and increases at night, there is plentiful sweating, an inclination to cough, and hardly any thing brought up by it, the eyes are hollow, cheeks red, the veins under the tongue white, the nails of the hands crooked, the fingers, especially their extremities, hot; there are swellings in the feet, difficulty in breathing, loathing of food, pimples breaking out over the whole body. But if the pain, cough, and difficulty of breathing have come on immediately at the beginning, the vomica will break before, or about the twentieth day. If these have begun later, they must of course increase; but the less quickly they have appeared, the more slowly will they be removed. It is common also in a severe distemper for the feet, hands, and nails to turn black: and if death has not followed, and the other parts of the body are restored, yet the feet fall off.

CHAP. VIII. WHAT SYMPTOMS ARE DANGEROUS, OR HOPEFUL IN PARTICULAR DISEASES.

Our next business is to explain the particular marks in every kind of distemper, which either afford hope, or indicate danger. If the bladder be pained, and there be a discharge of purulent urine, and also a smooth and white sediment in it, there is no danger. In a peripneumony, if the pain is mitigated by the spitting, although that be purulent, yet if the patient breathes easily, expectorates freely, and is not much distressed with the distemper, he may possibly recover his health. Nor need we immediately give way to fears, if the spittle is mixed with some reddish blood, provided that presently ceases. Pleurisies, that suppurate, when the matter is carried off within forty days, are thereby terminated. If there is a vomica in the liver, and the matter discharged from it be unmixed and white, the patient easily recovers, for that disorder is seated in the membrane. Now these kinds of suppurated tumours are tolerable, which are directed towards the external parts, and rise to a point. But of those, which point inward, the more mild are such, as while close, don’t affect the skin, and suffer it to remain without pain, and of the same colour with the other parts. Also pus from whatever part it is discharged, if it be smooth, white, and uniform, is not at all dangerous; and if after the evacuation of it the fever has presently abated, and the nausea and thirst have ceased to be troublesome. If at any time also a suppuration falls into the legs, and the patient’s discharge by spitting becomes purulent instead of reddish, the danger is less. But in a consumption, he that is to recover, will have his spitting white, uniform, and of the same colour, with out phlegm: and whatever falls down from the head by the nostrils, should be of a like nature. ’Tis far best to be altogether free from a fever: next to this, that it be so gentle, as neither to prevent the taking of food, nor occasion a frequent thirst. In this distemper that state of the belly is safe, in which every day consistent excrements are evacuated, in quantity proportioned to the food; and so is that body, which is least slender, and has the broadest and most hairy chest, and whose cartilage is small and fleshy. In a consumption too, if a woman has had her menses suppressed, and while the pain still remains about her breast, and shoulders, and the blood has of a sudden made its way, the distemper is commonly mitigated: for both the cough is lessened, and the thirst and febricula cease. But in the same patients, if their menses do not return, for the most part the vomica breaks: and the more bloody the discharge from it is, so much the better. A dropsical disorder is the least to be feared, which has begun without any preceding distemper. Of the next favourable sort is that, which succeeds a long distemper, if at the same time the bowels be firm; if the breathing be easy; if there is no pain; if the body is not hot; and is equally lean in its extremities; if the belly is soft; if there be no cough, no thirst; if the tongue even in sleep does grow dry; if there is an appetite for meat; if the belly yields to purging medicines; if spontaneously it discharges excrements soft and figured; if it grows less[(12)]; if the urine is altered by the change of wine, and by drinking certain medicinal potions; if the body is free from lassitude, and easily bears motion: for where one has all these symptoms, he is altogether safe; where most of them appear, the patient is in a hopeful way. Diseases of the joints, as the gout in the feet or hands, if they have attacked the patients young, and have not brought on a callus, may be removed; and they are most of all allayed by a dysentery, and when by any means the belly becomes loose. Also an epilepsy, that begins before puberty, is easily removed; and where a person sensibly feels the approaching fit first affecting some part of the body. It is best, that it begin at the hands or feet; next to them, at the sides; but worst of all, when it begins at the head. And in these patients also, excretions by the belly are of the greatest service. Now a purging is not in the least hurtful, which is without a fever, if it quickly, ceases; if upon feeling the belly, there is no motion perceived; if wind is discharged at the end of a stool. Nay even a dysentery is not dangerous, if blood and strigments are discharged, provided the patient is without a fever, and the other concomitants of this distemper: insomuch, that a pregnant woman may not only be cured, but her fœtus also preserved. And it is an advantage in this disorder, if the patient has come to some age. On the contrary, a lientery is more easily cured in tender age: especially if the urine begins to be excreted, and the body to be nourished with food. The same age is most favourable in pains of the hip, and arms, and in every paralytic disorder. Amongst these, the hip, if it be without numbness, if its coldness be slight, although it be greatly pained, yet it is easily and quickly cured; and a paralytic limb, if it continue to be nourished, may be recovered. A palsy of the mouth also is cured by a loose belly. And all purging does good to one labouring under a lippitude. Madness is removed by the appearance of a varicous swelling, or sudden eruption of blood from the hæmorrhoidal veins, or a dysentery. Pains of the arms, which are propagated either to the shoulders, or hands, are cured by vomiting of atrabilis. And whatever pain moves downward, is more easily cured. A hiccough is cured by sneezing. A vomiting stops long purgings. A woman, that vomits blood, is relieved by the flux of her menses. She, whose menses are deficient, if there has been an hæmorrhage from the nose, is free from all danger. And one, that is hysteric[(13)] or has a difficult labour, is relieved by sneezing. To one, that has a heat and tremour, a delirium is salutary. Dysenteries are of service to splenetic people. Lastly, a fever itself, which may seem very wonderful, is often a remedy for other distempers. For it both cures pains of the præcordia, that are not attended with inflammation, and relieves in a pain of the liver; and entirely removes convulsions, and a tetanus, if it comes after them; and where the distemper of the smaller intestine has been occasioned by a difficulty in making urine, if by the heat it promotes urine, it gives ease. Pains of the head attended with dimness of the eyes and redness with an itching in the forehead, are removed by a discharge of blood, either spontaneous or procured. If pains of the head and forehead arise from being exposed to the wind, or cold, or heat, they are cured by a gravedo, and sneezing. A sudden shuddering puts an end to an ardent fever, which the Greeks call causodes[ AV ]. When in a fever, there is a deafness, if blood is discharged from the nose, or the belly turns loose, that disorder is entirely removed. Nothing is more prevalent against deafness, than bilious stools. Those, that have small abscesses, which the Greeks call phymata[ AW ], formed in the urethra, are cured, when pus is discharged from thence. Now as most of these favourable turns happen of themselves, we may conclude, that nature has very great power in these very helps, which are applied by art.

On the contrary, when there is a pain in the head in a continued fever, and it does not at all remit, it is a bad and mortal symptom: and boys from the seventh to the fourteenth year are most liable to this danger. In a peripneumony, if the spitting did not come on in the beginning, but after the seventh day, and has continued above other seven days, it is dangerous: and the more mixed and less distinct the colours are, so much the worse. And yet nothing is worse, than for it to be excreted entirely homogeneous, whether it be reddish, or bloody, or white, or glutinous, or pale, or frothy: but the worst of all colours is black. A cough and catarrh are dangerous in the same disease; also a sneezing, which in other cases is reckoned salutary; and there is the greatest danger of all, if these things have been followed by a sudden purging. Now generally the symptoms, which are either good or bad in peripneumonies, are so in pleurisies too. A discharge of bloody pus from the liver is mortal. These are the worst kinds of suppurations, which tend inward, and discolour the external skin at the same time. Of that kind, that breaks outward[(14)], the worst are those, that are largest and flattest. But if the fever has not gone off, when the vomica is broke, or the pus evacuated, or after its ceasing returns again; also if there be a thirst, or a nausea, or a loose belly, or livid and pale pus, if the patient expectorates nothing but frothy phlegm; then there is certain danger. And of these kinds of suppurations, which have been produced by diseases of the lungs, old men commonly die: but those; those that are younger, by the other kinds. But in a consumption, a mixed and purulent spitting, a continued fever, which also destroys the appetite, and torments with thirst, in a slender body are sure prognosticks of immediate danger. If one has lasted under this distemper even for a considerable time, when the hairs first fall off, when the urine has something floating upon it like cobwebs, and the spittle has a fetid smell, and particularly when after these a purging has appeared, he will die soon: and more especially if it be autumn: in which season commonly those, that have got over the other part of the year, come to the close of their life. It is also mortal in this distemper to have expectorated pus, and afterwards for that to have entirely disappeared. It is likewise common for this disease in young people to arise from a vomica or fistula; and they do not readily recover, unless many salutary symptoms have ensued. With regard to others, virgins are the hardest to cure, or those women, that fall into a consumption from a suppression of the menses. A healthy person who has been taken with a sudden pain of his head, and then fallen into a deep sleep, so as to snore, and does not awake, will die before seven days are expired: and more especially if, when a looseness has not preceded, his eyelids are not closed in sleep, but the white of his eyes appears. Death however is not the certain consequence, if a fever comes on, which may remove the distemper. A dropsical disorder occasioned by an acute distemper, is seldom cured: especially if followed by the opposite symptoms to those above-mentioned. A cough likewise is equally destructive of hope in this distemper: also an hæmorrhage either upward or downward, and a collection of water in the middle of the body[(15)]. Some people too in this disease have swellings, which afterwards subside, and then appear again. Such indeed are more safe than those mentioned before, if they take the proper care: but they commonly perish from a persuasion of their being well. Some people with good reason will wonder, how any thing can at once both be hurtful to our bodies, and in part conduce to their preservation. For whether a dropsy has filled one with water, or a great quantity of pus has been collected in a large abscess, for the whole to be discharged at once is equally mortal, as for a sound person to lose all his blood by a wound. If the joints of any person are pained, so that some tubercles from a callus grow upon them, they are never cured: and the disorders of those parts, which have either begun in old age, or have continued from youth to that time of life, though they may be sometimes mitigated, yet are never entirely removed. An epilepsy also, that begins after the twenty-fifth year, is difficult to cure: and much more so that, which has begun after the fortieth; so that, although there may be some hope from nature, scarce any thing is to be expected from medicine at that age. In the same disease if the whole body is affected at once, and the patient is not sensible of the fit beginning in any part, but falls down suddenly, whatever his age be, he rarely gets free of the distemper: but if his intellects be injured, or a palsy has come on, there is no room for medicine. In purgings too, if attended with a fever; if with an inflammation of the liver, or præcordia, or belly; if with an intolerable thirst; if the disease has continued long; if the discharge of the belly is variegated; if it is expelled with pain, there is danger even of death: and more especially if with these symptoms a dysentery has grown inveterate. And this distemper sweeps off children chiefly to their tenth year: at other times of life, it is more easily endured. A pregnant woman also may be carried off by such a case: and although she herself recovers, yet she loses her child. Moreover a dysentery occasioned by atrabilis is mortal: or a sudden and black discharge from the belly, when the body is already wasted by that distemper. But a lientery is more dangerous, if the purging be frequent; if the belly is discharged at all hours, both with a rumbling, and without it; if it continues with equal violence both night and day; if what is excreted, is either crude, or black, and besides smooth and fetid; if thirst is troublesome; if urine is not made after drinking (the cause of which is, that all the liquor at that time descends, not into the bladder, but into the intestines) if the mouth is ulcerated; if the face is red, and marked with certain spots of all colours; if the belly is puffed up as it were by fermentation[(16)], fat and full of wrinkles; and if there is no appetite for food. And as in these circumstances death is the plain consequence; it is much more evidently so, if the disease is already of long standing; especially if withal the patient be old. In the distemper of the smaller intestine, a vomiting, hiccough, convulsion, and delirium, are bad symptoms. In the jaundice it is the most pernicious symptom for the liver to be indurated. Those, that have disorders in the spleen, if they be seized with a dysentery, which afterwards turns to a dropsy or a lientery, it is scarce in the power of medicine to save. The distemper of the smaller intestine arising from a difficulty of urine, unless it be removed by a fever, kills within seven days. If a woman after delivery is seized with a fever, and violent and constant pains of the head, she is in danger of dying. If there is a pain and inflammation in those parts, which contain the bowels, it is a bad sign to fetch the breath often. If a pain of the head continues long without a perceptible cause, and removes into the neck and shoulders, and again returns into the head; or comes from the head to the neck and shoulders, it is dangerous: unless it produce some vomica, so that the pus may be expectorated; or unless there is an hæmorrhage from some part; or scurf break out plentifully in the head, or pustules over the whole body. It is an equally formidable distemper when a numbness and itching wander about; sometimes over the whole head, sometimes in a part of it; or when there is something like a sensation of cold in the part, and these reach even to the end of the tongue. And though in these cases abscesses are beneficial, yet there is less hope of a recovery by their means, as they are seldom formed after such disorders begin. In pains of the hip, if there is a great numbness, and the leg and hip are cold, and the belly has no passage, but when assisted, and the excrements are slimy, and the age of the person exceed forty, the distemper will be very tedious, and at least of a year’s continuance; neither will it be possible to remove it, unless it be either in the spring or autumn. At the same time of life, the cure is equally difficult, when a pain of the arms removes into the hands, or reaches to the shoulders, and produces a torpor and pain, and is not relieved by a bilious vomiting. A paralytic limb in any part of the body, if it has no motion, and pines away, will not recover its former state; and the more inveterate the distemper, and the more advanced in years the patient is, so much the less probable is the cure. And in every paralytic disorder, the winter and autumn are improper seasons for medicine: some benefit may possibly be hoped for in the spring and summer. And this distemper, when moderate, is cured with difficulty; when violent, it cannot be cured at all. Every pain also, which moves upward, yields less to medicine. If the breasts of a pregnant woman have shrunk suddenly, there is danger of a miscarriage. In a woman that has milk, and has neither had a child, nor is pregnant, the menses are suppressed. A quartan ague in the summer is short, but in the autumn commonly long; especially that, which has come on, when the winter was approaching. If there has been an hæmorrhage followed with madness and convulsions, there is danger of death. Also if a convulsion has seized a person purged by medicines and still empty; or if the extremities are cold in the time of great pain. Nor does a person return to life, who has been hanged, and taken down with a frothing mouth. A black and sudden discharge of the belly, like black blood, whether it be attended with a fever or not, is pernicious.

CHAP. IX. OF THE CURE OF DISEASES.

Having considered those signs, which may give us hope or fear, we must proceed to the methods of curing diseases. Now these are divided into the general and particular: the general, which relieve several distempers, the particular, which are confined to single disorders. I shall first treat of the general. But there are some of those, that not only support the sick, but conduce to the preservation of the healthy, others are made use of in sickness only.

Now every thing that assists the body, either evacuates somewhat, or adds, or draws, or restrains, or cools, or heats, and at the same time either hardens, or mollifies. Some things also are useful not in one way only, but even in two, that are not contrary to each other. An evacuation is made by bleeding, cupping, purging, vomiting, friction, gestation, and all exercise of the body, abstinence and sweat. Of these I shall now treat.

CHAP. X. OF BLEEDING.

To let blood by the incision of a vein is not new: but to practise this in almost every distemper is new. Again, to bleed younger people, and women, that are not pregnant, is of ancient use. But to attempt the same in children and old people, and in pregnant women, is not an old practice. For indeed the ancients judged, that the first and last stages of life were not able to bear this kind of remedy; and they were persuaded, that a pregnant woman, who had been thus treated, would miscarry. But afterwards experience proved, that none of these rules were universal, and that some other circumstances were rather to be regarded, by which the intention of the physician was to be directed. For the material point is not, what the age may be, or what is contained within the body, but what degree of strength there is. Upon this account if a young man is valetudinary, or a woman not with child be weak, bleeding is bad: for the remaining strength, is by this evacuation destroyed. Whereas to a stout boy, and a robust old man, and a strong pregnant woman, it may be used with safety. ’Tis true an unskilful physician may be greatly deceived in such patients: because there is commonly less strength at these times of life. And a pregnant woman stands in need of strength after her cure, to support not only herself, but her fœtus also. But whatever requires either attention of mind, or prudence, is not to be immediately rejected: since the excellency of the art here consists, not in numbering the years, nor in regarding conception alone, but in considering the strength, and collecting from thence, whether there will be left sufficient to support either a boy, or an old man, or two bodies at once in one woman. There is a difference also between bodies strong, and corpulent: and those, that are slender, and infirm. In the slender, blood more abounds, but in those of a fuller habit, flesh. Wherefore the first bear this evacuation more easily: and he, that is over fat, is soonest distressed by it. For this reason the strength of the body is to be estimated rather by the state of the vessels, than from its appearance.

Nor are these the only particulars to be considered, but also what kind of distemper it is: whether a redundancy, or deficiency of matter has been hurtful; whether the body be corrupted or sound. For if there be a deficiency, or the humours be sound, this method is prejudicial. But if either the quantity of matter is hurtful, or it is corrupted, no other remedy is more successful; for this reason a violent fever, when the skin is red, and the veins are full and turgid, requires bleeding: likewise diseases of the bowels, and palsies, and the tetanus, and convulsions; in fine, whatever strangulates the fauces, so as to cause a difficulty in breathing; whatever suddenly stops the speech; any pain, that is intolerable; and any internal rupture, or bruise, from whatever cause; also a bad habit of body; and all acute distempers; provided, as I observed above, they hurt not by weakness, but by redundancy.

But it may possibly happen, that a distemper may indeed require this method, and at the same time the body may seem hardly able to bear it: but yet if there appears no other remedy, and the patient must perish, unless he shall be relieved even by a rash attempt; in this case, it is the part of a good physician to shew, that there is no hope without bleeding; and to confess what bad consequences may be apprehended even from that remedy; and after that, to bleed if desired. It is by no means proper to hesitate about it in such a situation as this: for it is better to try a doubtful remedy, than none at all. And this ought especially to be practised, when there is a palsy; when one has lost his speech suddenly; when an angina suffocates; when the preceding paroxysm of a fever has almost killed a person, and another equally severe is likely to follow, and the strength of the patient seems unable to bear it.

Though bleeding ought not to be performed in a state of crudity, yet even that does not hold always. For the circumstances will not at all times wait for concoction. So that if any person has fallen front a height, or has received a contusion, or vomits blood from some sudden accident, although he has taken food a little before, yet that evacuation is proper, lest if the matter settle, it distress the body. The same rule will hold in other sudden cases too, where there is a danger of suffocation. But if the nature of the distemper will allow a delay, it must not be done, till all remaining suspicion of crudity is removed. Upon this account, the second or third day of an illness seems most proper for this operation. But as sometimes it is necessary to bleed even on the first day, so it is never good after the fourth, when by time alone, the matter is either dissipated, or has corrupted the body; so that the evacuation may weaken, but cannot make it sound. But when a vehement fever prevails, to bleed in the time of its violence is killing the patient. Therefore an intermission[(17)] is to be awaited for: if it does not intermit, when it has ceased to increase: if there be no hopes even of a remission, in that case the only opportunity offered, though less favourable, is not to be neglected.

Further this remedy, where it is necessary, generally were best to be divided into two days; for it is better at the first to lighten the patient, and after that to cleanse him thoroughly, than to run any risk of his life by dissipating all his strength at once. And if this method be found to answer in the cure of a dropsy, how much more must it of necessity answer with regard to the blood?

If the disorder be in the whole body, the evacuation ought to be made from the arm: if in any particular place, from the part affected, or at least as near to it as may be; because it cannot be performed every where, but only in the temples, and in the arms, and near the ancles. I am not ignorant, that it is the opinion of some, that blood should be let at the greatest distance from the part where it does harm; for that thus the course of the matter is diverted; but in the other way it is drawn into that very place, which is distressed. But this is altogether false. For it first empties the part nearest: and the blood flows from the more remote, as long as the evacuation is continued: when this is stopt, because there is no more attraction, it then ceases to come. Yet experience itself seems to have shewn, that in a fracture of the skull blood is to be let rather from the arm: and if the disorder is in one arm, it must be performed in the other: I suppose for this reason, because if any miscarriage should happen, those parts, which are already hurt[(18)], are more exposed to injuries. Sometimes also an hæmorrhage breaking out in one part, is stopt by bleeding in another. For it ceases to flow, where we would not have it, when we apply what will stop its course there, and open another passage for it.

Altho’ bleeding is very easy to one, who has experience; yet it is very difficult to one, that is ignorant. For the vein lies close to the arteries; and to these the nerves. So that if the lancet has touched a nerve, a convulsion will follow, which destroys a man miserably. And then a wounded artery neither unites again, nor heals; and sometimes it occasions a violent hæmorrhage. If also the vein itself happens to be cut quite through, the two ends are compressed, and discharge no blood. Again, if the lancet is entered with fear, it lacerates the surface of the skin, and does not open the vein. Sometimes too the vein lies concealed, and is not easily found. Thus many circumstances make that difficult to an ignorant person, which is very easy to the skilful.

The vein is to be cut at the middle. And when the blood flows from it, its colour and consistence ought to be observed. For if it be thick and black, it is bad; and therefore the discharge is useful: if red and pellucid, it is sound; and that evacuation is so far from being beneficial, that it may even hurt, and is immediately to be stopt. But such an accident cannot happen to the physician, who knows in what case bleeding is to be used. It more commonly happens, that it flows on the first day equally black thro’ the operation. And altho’ it be so, yet if the discharge is sufficient, it must be stopt: and an end must always be put to it, before the person faints.

Then the arm is to be bound up, putting upon it a penecillum[(19)] dipt in cold water, and squeezed; and on the following day, the vein must be rubbed with the middle finger, that its recent union may be resolved, and it may again discharge blood. Whether it happens on the first or second day, that the blood, which at first flowed thick, and black, has begun to appear red and pellucid, there is then a sufficient quantity taken away, and what remains is pure: so that the arm is to be immediately bound up, and kept so, till the cicatrice is firm; which firmness it very soon acquires in a vein.

CHAP. XI. OF CUPPING.

There are two sorts of cucurbitals: the one of copper, the other of horn. That of copper is open at the one end, and close at the other; that of horn is likewise open at one end, and at the other has a small hole. Into the copper one burning linen is put, and its mouth is clapt close to the body, and is prest down, till it adhere to it. The horn kind is only applied to the body, and after that, when a person has sucked out the air by the small hole, and that is closed with wax, it sticks, as well as the other. Both of these are made not only of these two materials, but of any thing else. Where no better can be got, a small cup with a narrow mouth is fit enough for the purpose. When it adheres, if the skin has been cut before with a scalpel, it will bring out blood: if the skin is whole, air. Wherefore when the offence is from matter contained within, the first method is to be pursued: when it is only a flatulency, the other is commonly used.

Now the principal use of a cucurbital is, when a disorder is not in the whole body, but only in a part, the emptying of which is sufficient to render it sound. And this very thing is a proof, that in the cure of any member, bleeding by a lancet too is to be performed rather in the part which is already hurt: because no body puts the cucurbital upon a different part, unless to divert the flux of blood thither, but on that, which is diseased, and which is to be relieved.

There may possibly be a necessity for using the cucurbital in chronic distempers (although they be already of some standing) if there be either corrupted matter, or a flatulency. Likewise in some acute distempers, if at the same time the body requires to be lightened, and the strength will not admit of bleeding from a vein. And this remedy, as it is less violent, so it is more safe; and is never dangerous, though it be made use of in the greatest violence of a fever, or even in the time of crudity. For this reason, when there is a necessity for bleeding, if the opening of a vein is very dangerous, or the disorder is fix’d in a noble part of the body, we must also have recourse to this instrument. We must be sensible however, that as it is attended with no danger, so it gives a feebler aid; and that is not possible to relieve a violent distemper, but by an equally violent remedy.

CHAP. XII. OF PURGING.

In almost every distemper the ancients endeavoured to purge by various medicines and frequent clysters: and they gave either black hellebore, or polypody of the oak, or scales of copper[(20)], or the milk of sea-spurge[(21)], a drop of which taken upon bread purges plentifully; or asses, or cow’s, or goat’s milk, with the addition of a little salt; and this they boiled, and taking away what had been curdled, they obliged the patient to drink what remained like whey.

But generally purging medicines injure the stomach. Wherefore aloes is to be mixed with all cathartics. If the purging be severe, or frequent clysters be administered, it weakens a man. For that reason it is never proper in an illness to give medicines with that view, unless there be no fever concomitant: as when black hellebore is given to those that labour under atrabilis, or a melancholy madness, or any paralytic disorder. But where there are fevers, it is better to take such food and drink for that purpose, as may at once both nourish, and prove laxative. And there are some kinds of disorders, with which purging by milk agrees.

Of clysters.

But for the most part the belly is to be opened by clysters. Which method, somewhat censured, though not entirely laid aside by Asclepiades, I observe to be generally neglected in our own age. That moderation, which he seems to have followed, is most proper, that neither this remedy should be often tried, nor be entirely omitted, but used once, or at most twice, if the head is heavy, or the eyes dim; if there is a disorder of the large intestine, which the Greeks call colon; if there are pains of the lower belly, or in the hips; if any thing bilious be accumulated in the stomach, or even any flux of phlegm or a humour like water thither; if the breathing is difficult; if there is no natural discharge from the belly; especially if the excrements are near the anus, and still remain within; or if the patient, while he has no passage, nevertheless perceives the smell of excrements in his breath; or if the stools appear corrupted; or if an early abstinence has not removed a fever; or when a case may require bleeding, and the strength will not allow of it, and the time for that operation is past; or if one has drank much before an illness; or if a person, who was frequently loose, either naturally or by some accident, is suddenly bound in the belly. But the following rules are to be observed, that it be not used before the third day; nor while any crudity remains; nor in a body weak and exhausted by long sickness; nor to a person, whose belly discharges sufficiently every day, or one that is loose; nor during the paroxysm of a fever; because what is injected at this time, is retained within the belly, and being thrown upon the head, greatly increases the danger. On the day before, the patient ought to fast, that he may be prepared for this remedy. On the day of the operation to drink, some hours before, hot water, that his superior parts may be moistened; then the injection is to be performed with pure water, if we be content with a gentle medicine; if somewhat more powerful is required, hydromel[(22)]; if a lenient, a decoction of fœnugreek, or ptisan[(23)], or mallows, in water: if it be intended to restringe, a decoction of vervains[(24)]. Sea-water, or any other water with the addition of salt, is acrid: but both of these are better boiled. A greater degree of acrimony is given by adding either oil, or nitre, or honey also. The more acrid it is, it evacuates the more; but it is not so easy to bear. The injection ought neither to be cold, nor hot; lest it hurt either way. When it is injected, the patient ought to confine himself as much as possible in bed, and not yield immediately to the first stimulus he finds to go to stool; and not till necessity obliges him. And commonly this evacuation by lightning the superior parts mitigates the distemper itself. When a person has fatigued himself by going to stool, as often as he was obliged, he ought to take rest for a little time; and lest he grow faint, even on the same day to take food. The quantity of which ought to be determined by considering the nature of the paroxysm that is expected; or whether there is no danger of any.

CHAP. XIII. OF VOMITING.

As a vomit even in health is often necessary to persons of a bilious habit; it is likewise so in those distempers, which are occasioned by bile. Upon this account it is necessary to those, that before fevers are distressed with horrors and tremors; to all those, that labour under a cholera; and all, that are attacked with madness, and a concomitant mirth; and those also, who are oppressed with an epilepsy. But if the distemper be acute, as the cholera; if it be a fever, while there are tetani, the rougher medicines are improper, as has been observed above in the article of purging; and it is sufficient to take such a vomit, as I prescribed for people in health. But when distempers are of long standing, and stubborn, without any fever, as an epilepsy or madness, we must use even white hellebore. Which it is not proper to administer in the winter, or summer; it is best in the spring: in the autumn it does tolerably well. Whoever prescribes it, ought first to take care, that the body of his patient be moist. It is necessary to know, that every medicine of this kind, which is given by way of potion, is not always beneficial to sick people, to healthy always hurtful.

CHAP. XIV. OF FRICTION.

Concerning friction[(25)], Asclepiades looking upon himself as the inventor of it, has said so much in that book, which he entitled ‘of general remedies,’ that tho’ he mentions only three things, that, and wine, and gestation, yet he has taken up the greatest part of his treatise upon the first. Now as it is not fit to defraud the moderns of the merit either of their new discoveries or judicious imitations, so it is but just at the same time to assign those things, which were practised among some of the ancients, to their true authors. It cannot indeed be doubted, that Asclepiades has been both fuller and clearer in his directions, when and how friction ought to be used; but he has discovered nothing, which was not comprized in a few words by the most ancient author Hippocrates; who said, that friction, if violent, hardens the body; if gentle, softens it; if plentiful, extenuates; if moderate, increases its bulk: from whence it follows, that it is to be made use of, when a lax body requires to be braced; or to soften one, that is indurated; or to dissipate where the fulness is hurtful; or to nourish that, which is slender and infirm.

Nevertheless, if a person examine more curiously into these different species (which is not here the province of a physician) he will easily understand that the effects of them all proceed from one cause; that is, the carrying off of something. For a part will be bound, when that thing is taken away, the intervention of which had caused it to be lax; and another is softened by removing that, which occasioned the hardness; and the body is filled, not by the friction itself, but by that food, which afterwards makes its way to the skin, relaxed by a kind of digestion[(26)]. And the degree of it is the cause of these effects so widely different.

But there is a great deal of difference betwixt unction, and friction. For it is necessary for the body to be anointed, and gently rubbed even in acute and recent distempers; but this must be done in the time of their remission, and before taking food. But to make use of long friction is not proper, either in acute or increasing disorders; except when the intention of it is to procure sleep in phrenitic patients. This remedy is very agreeable to inveterate distempers, and where they have abated somewhat of their first violence. I am not ignorant that some maintain, that every remedy is necessary for distempers, while they are increasing, not when they are going off spontaneously. But this is not just; for a distemper, though it would come to a period of itself, may notwithstanding be sooner terminated by the application of remedies. The use of which is necessary upon a double account, both that the health may be restored as soon as possible; and that the disorder, which remains, be not irritated again by any slight cause: for a distemper may be less violent, than it has been, and yet not entirely removed; but there may be some remains of it, which the use of remedies may dissipate.

But though friction may be used in the decline of an illness, yet it is never to be practised in the increase of a fever; but if possible, when the body is entirely free of it; if that can’t be done, at least when there is a remission. It ought also to be performed sometimes over the whole body, as when we would have an infirm person take on flesh; sometimes in particular parts, either because the weakness of that part itself, or of some other, requires it. For both inveterate pains of the head are mitigated by the friction of it (yet not during their violence) and any paralytic limb is strengthened by rubbing it: but much more commonly, when one part is pained, a different one is to be rubbed; and particularly, when we want to make a derivation from the upper or middle parts of the body; and with this intention we rub the extremities. And these people are not to be regarded, who prescribe to a certain number, how often a person is to be rubbed: for that is to be estimated from his strength. Thus if one is very weak, fifty times may be sufficient: if of a more robust habit, it may be done two hundred times. And then in different proportions betwixt these two according to the strength. Whence it also happens, that the motion of the hands in friction must be less frequent in a woman than a man; less frequent in a boy or an old man, than a young man. Lastly, if particular parts are rubbed, they require much and strong friction. For the whole body cannot be quickly weakened by a part, and there is a necessity for dissipating as much of the matter as we can, whether the intention be to relieve the part we brush, or another by means of it. But where a weakness of the whole body requires this treatment all over, it ought to be shorter and more mild; so as only to soften the surface of the skin, to render it more apt to receive new matter from fresh nourishment. A patient is known to be in a bad situation, when the surface of his body is cold, and the internal part is hot with a concomitant thirst, as I observed above. But even in this case friction is the only remedy, which, if it have brought out the heat, may make way for the use of some medicine.

CHAP. XV. OF GESTATION.

Gestation is most proper for chronic distempers, and those that are already upon the decline. And it is useful both to those, who are quite free of a fever, but yet are not able to exercise themselves; and those, that have the slow relicks of distempers, which are not otherwise expelled. Asclepiades said, that gestation was to be used even in a recent and violent, and especially an ardent fever, in order to discuss it. But that is dangerous; and the violence of such a distemper is sustained better by remaining quiet. Yet if any person will make trial of it, he may do it under these circumstances, if his tongue is not rough, if there be no tumour, no hardness, no pain in his bowels, nor head, nor præcordia. And gestation ought never to be used at all in a body that is pained, whether in the whole, or in any part, unless the pain be in the nerves alone; and never in the increase of a fever, but upon its remission.

There are many kinds of gestation: in the use of which the strength and circumstances of the patient are to be considered; that they may neither dissipate too much a weak man, nor be out of the reach of one of small fortune. The most mild kind of gestation is in a ship, either in a port, or a river; or in a litter, or a chair; more brisk in a chariot; more violent in a ship on the ocean. And each of them may be rendered both more sharp, and more mild. If none of them can be done, the bed must be suspended and moved to and fro. If even that can’t be accomplished, at least a prop is to be put under one foot[(27)] of the bed, and thus the bed moved back and forward by the hand. And indeed the mild kinds of exercise agree with the weakest; the stronger with those, who have been for several days free from the fever; or those, who feel the beginnings of severe distempers, but are yet without a fever (which is the case in a consumption, and indispositions of the stomach, and a dropsical disorder, and sometimes in a jaundice) or when some distempers, such as an epilepsy or madness, continue, though for a considerable time, without any concomitant fever. In which disorders, these kinds of exercises also are necessary, which were mentioned in that place, where we prescribed rules for the conduct of sound, but weakly men.

CHAP. XVI. OF ABSTINENCE.

There are two kinds of abstinence. One, when the patient takes no food at all: the other, when he takes only what is proper. The beginnings of diseases call for fasting and thirst: after that in the distempers themselves moderation is required, so that nothing but what is proper be taken, and not too much of that; for it is not fit after fasting, to enter immediately upon a full diet. And if this be hurtful even to sound bodies, that have been under the necessity of wanting food for some time, how much more is it so to a weak, not to say a diseased one? And there is nothing which more relieves an indisposed person, than a seasonable abstinence. Intemperate men amongst us chuse for themselves the seasons of eating, and leave the quantity of their food to the physicians. Others again compliment the physicians with the times, but reserve the quantity to their own determination. Those fancy themselves to behave very genteelly, who leave every thing else to the judgment of the physicians, but insist upon the liberty of chusing the kind of their food; as if the question was, what the physician has a right to do, not what may be salutary to the patient; who is greatly hurt as often as he transgresses either in the time, measure, or quality of his food.

CHAP. XVII. OF SWEATING.

A sweat is procured in two ways; either by a dry heat, or a bath. A dry heat is raised by hot sand, the laconicum, and clibanum[(28)], and some natural sweating places, where a hot vapour exhaling out of the earth is inclosed by a building, as there is at Baiæ amongst the myrtle groves. Besides these, it is solicited by the sun and exercise. These kinds are useful, wherever an internal humour offends, and is to be dissipated. Also some diseases of the nerves are best cured by this method. And the others may be proper for weak people: the heat of the sun and exercise agree only with the more robust; when they are falling into a disorder, or even during the time of distempers not violent, provided they be free of a fever. But care must be taken, that none of these be attempted either in a fever[(29)], or in the time of crudity.

But the use of the bath is twofold. For sometimes after the removal of fevers, it is a proper introduction to a fuller diet and stronger wine for the recovery of health: sometimes it removes the fever itself. And it is generally used, when it is expedient to relax the surface of the skin, and solicit the evacuation of the corrupted humour, and to change the habit of the body. The ancients used it with greater caution: Asclepiades more boldly. And there is no reason to be afraid of it, if it be seasonable: before the proper time, it does harm. Whoever has been freed of a fever, as soon as he has escaped the fit for one day, on the day following, after the usual time of its coming on, may safely bathe. And if the fever used to be periodical, so as to return upon the third or fourth day, whenever it has missed, the bath is safe. And even during the continuance of fevers, if they be of the slow kind, and the patients have splenetic disorders of long standing, it is proper to make trial of this remedy: on this condition however, that the præcordia be not hard nor swelled, nor the tongue rough, and there be no pain either in the trunk of the body or in the head, and the fever be not then increasing. And in these fevers indeed, which have a certain period, there are two opportunities for bathing; the one, before the shuddering; the other, after the fit is ended. In those again, who are long distressed with slow febriculas, either when the fit is entirely off; or if that does not happen, at least when it has remitted, and the body is as sound, as it generally is in that kind of illness.

A valetudinary man, that is going into the bath, ought to be careful not to expose himself to any cold before. When he has come to the bagnio, he is to stand still a little, and try whether his temples are bound, and if any sweat breaks out: if the first has happened, and the other not followed, the bath will be improper that day: he must be anointed slightly, and carried back, and by all means avoid cold, and be abstemious. But if his temples are not affected, and a sweat begins, first there, and then elsewhere, he must wash his mouth with plenty of warm water, then go into the bath; and there he must observe, whether at the first touch of the warm water he feels a shuddering upon the surface of his skin; which can scarcely happen, if the circumstances above-mentioned were as they should be: however, this is a certain sign of the bath’s being hurtful.

One from the state of his health may know, before he go into the warm water, whether it be proper to anoint himself after it. However for the most part (except in cases where it shall be expressly ordered to be done after) upon the beginning of a sweat the body is to be anointed gently, and then to be dipped in the warm water. And in this case also regard must be had to his strength; and he must not be allowed to faint by the heat, but must be speedily removed, and carefully wrapped up in cloaths, lest any cold get to him; and there also he must sweat, before he take any food.

Warm fomentations are millet-seed, salt, sand: any of these heated, and put into a linen cloth: even linen alone, if there be less heat required; but if greater, extinguished coals, wrapt up in cloths, and applied round a person. Moreover bottles[(30)] are filled with hot oil: and water is poured into earthen vessels, which from their resemblance in shape are called lenticulæ[(31)]: and salt is put into a linen bag, and dipt into water well heated, then set upon the limb that is to be fomented. And at the fire are placed two ignited pieces of iron, with pretty broad heads: one of these is put into dry salt, and water is sprinkled lightly upon it; when it begins to grow cold, it is carried back to the fire: the other is made use of in the same manner; so each of them alternately: and in the mean time, the hot and salt liquor drops down through the cloth, which relieves the nerves contracted by any disease. All of them have this property in common of dissipating that, which either loads the præcordia, or suffocates the fauces, or is hurtful in any limb. When each of these sorts of fomentations is to be used, shall be directed under the particular kinds of distempers.

CHAP. XVIII. OF THE DIFFERENT KINDS OF FOOD AND DRINK.

Since we have treated of those things, which relieve by evacuation, we must now proceed to those, which nourish us, that is, our food and drink. Now these are not only the common supports in all distempers, but even of health too. And it is of importance to be acquainted with the properties of them all: first, that the healthy may know, in what manner they are to make use of them: secondly, that in treating of the method of curing diseases, it may suffice to mention in general the species of what is to be taken, without being under the necessity of naming each particular upon every occasion.

It is fit to know then, that all leguminous vegetables, and those grains, which are made into bread, are of the strongest kind of food (I call that the strongest, in which there is the most nourishment) also every quadruped, that is tame, all large wild beasts, such as the wild goat, deer, wild boar, wild ass; every great bird, such as the goose, peacock, and crane; all large fishes, the cetus[(32)], and others of a like size; also honey, and cheese. So that it is no wonder that particular kind of bread[(33)] should be very strong, which is made of corn, fat, honey, and cheese. Of a middle nature ought to be reckoned those pot-herbs, whose roots or bulbusses we use for food; amongst quadrupeds the hare; all birds, from the least upwards to the phœnicopter[(34)]; also all fish, that will not bear salt, or such, as are salted whole. Of the weakest kind are all potherbs, and whatever grows on a stalk, such as the gourd, and cucumber, and caper, and all the apple kind, olives, snails[(35)], and also conchylia[(36)].

But although these are thus distinguished, yet there are great differences between things even of the same class; and one is either more substantial, or weaker than another. For instance, there is more nourishment in bread, than in any thing else. Wheat is more firm than millet: and that again than barley: and the strongest kind of wheat is the siligo[(37)]; after that the finest flour; next, that which has nothing taken from it, which the Greeks call autopyron[ AX ]: still weaker than these is the second flour: the weakest is grey bread. Amongst the leguminous vegetables the bean or lentil is more substantial than pease. Amongst the potherbs, turnep and navew gentle, and all the bulbous kind (in which I rank the onion also, and garlick) are more substantial than the parsnip, or that which is particularly called radicula (garden radish.) Also cabbage, and betes, and leeks, are stronger than lettuce, or gourd, or asparagus. But amongst the fruits of the surculous tribe, grapes, figs, nuts, dates, apples properly so called, are of the firmer kind. And amongst these the juicy are stronger than the mealy[(38)] fruits. Also of these birds, which are of the middle kind, those are stronger, which make more use of their feet, than their wings: and of those, that trust more to flying, the larger birds are stronger than the small ones, as the beccaficos, and thrush[(39)]. And those also, which live in the water, afford a lighter food than those, which cannot swim. Amongst the tame animals pork is lightest; beef heaviest. Also of the wild, the larger any animal is, so much the stronger food it is. And of those fishes also, which are of the middle kind, the heaviest, though we make most use of them, are first all those, that are made salsamenta[(40)], such as the lacertus[(41)]; next such, as though more tender than the other, yet are in themselves hard, as the aurata, corvus, sparus, oculata; in the next rank are the plani fish, after which lighter still are lupi and mulli: and then all rock fish.

And there is not only a difference in the classes of things, but also in the things themselves; which arises from their age, the different parts of their body, the soil, air, and the case they are in. For every four footed animal[(42)], that is sucking, affords less nourishment; also a dunghill fowl, the younger it is. In fish too, the middle age, before they have reached their greatest bulk. For the parts, the heels, cheeks, ears, and brain of a hog; of a lamb or kid, the whole head with the petty toes, are a good deal lighter than the other parts; so that they may be ranked in the middle class. In birds, the necks or wings are properly numbered with the weakest. As to the soil, the corn, that grows upon hilly parts, is stronger than what grows upon a plain. Fish got in the midst of rocks, is lighter than those in the sand; those in the sand, than those in the mud. Whence it happens, that the same kinds either from a pond, or lake, or river, are heavier: and that, which lives in the deep, is lighter than one in shoal water. Every wild animal also is lighter than a tame one: and whatever is produced in a moist air, than another in a dry. In the next place, all the same foods afford more nourishment, fat than lean; fresh more than salt; new than stale. Again, the same thing nourishes more, when it is stewed into broth, than roasted, more roasted than fried. A hard egg is of the strongest kind; soft, or sorbile[(43)] of the weakest. And though all grains, made into bread, are most firm, yet some kinds washed, as alica[(44)], rice, ptisan, or gruel made of the same, or pulse[(45)], and bread moistened with water, may be reckoned with the weakest.

With regard to drinks, whatever is prepared from grain, also milk, mulse, defrutum, passum[(46)], wine either sweet or strong, or must, or very old wine, are of the strongest kind. But vinegar, and wine a few years old, or austere, or oily, is of the middle kind. And therefore none of these should be given to weak people. Water is weakest of all. And the drink, that is made of grain, is stronger in proportion to the hardness of the grain itself: and that wine, which is produced in a good soil, more so than in a poor soil; or in a temperate air, than one, which is either over moist or too dry, and either over cold or too hot. Mulse, the more honey it contains, defrutum, the more it is evaporated in boiling, and passum, the drier the grape is from which it is prepared, are so much the stronger. Rain water is lightest; next spring water, then river water, then that of a well; after these snow, or ice; water of lakes is heavier than these; and that of fens heaviest of all. The trial is both easy and necessary to those, that want to know its nature. For the lightness appears from weighing it; and amongst those, that are of equal weight, the sooner any of them grows hot or cold, and the more quickly herbs are boiled in it, the better it is.

It is a general rule, that the stronger each kind is, so much the less easily it is concocted; but when once concocted, it nourishes more. Wherefore the nature of the food must be determined by the degree of one’s strength; and the quantity proportioned to the kind. Upon this account weak men must make use of the weakest things; a middle kind best supports those, that are moderately strong; and the most substantial is fittest for the robust. Lastly, A person may take a greater quantity of what is lighter: but in what is most substantial, he ought to moderate his appetite.

CHAP. XIX. GENERAL PROPERTIES OF DIFFERENT FOODS.

And these above-mentioned are not the only distinctions; but some things afford good juices, others bad, which two kinds the Greeks term euchyma and cacochyma[ AY ]; some are mild, others acrid; some generate in us a thicker phlegm, others a more fluid; some agree with the stomach, others not; likewise some produce flatulencies, others have not that property; some heat, others cool; some readily turn sour in the stomach, others are not easily corrupted there; some open the belly, others bind it; some promote urine, others retard it; some are soporiferous, others excite the senses. Now all these must be known for this reason, that different things are proper in different constitutions or states of health.

CHAP. XX. OF THINGS CONTAINING GOOD JUICES.

Good juices are afforded by wheat, siligo, alica, rice, starch[(47)], tragum[(48)], milk, soft cheese, all venison, all birds of the middle class; of the larger kind also, those that we mentioned above; the middle kind betwixt tender and hard fishes, as the mullus, and lupus; pot-herbs, lettuce, nettle, mallows, cucumber, gourd, purslane, snails, dates; any of the apple kind, that are neither bitter, nor acid; wine sweet or mild, passum, defrutum, olives, or any of this fruit preserved in either of the two last mentioned liquors; the wombs[(49)], cheeks, and legs of hogs, all fat flesh, and glutinous, all livers, and a sorbile egg.

CHAP. XXI. OF FOODS CONTAINING BAD JUICES.

Of bad juices are millet, panick, barley, leguminous vegetables, the flesh of tame animals very lean, and all salt meat, all salt fish and garum[(50)], old cheese, skirret, radish, turneps, navew gentle, bulbusses[(51)], cabbage, and more especially its sprouts, asparagus, betes, cucumber, leek, rocket, cresses, thyme, catmint, savory, hyssop, rue, dill, fennel, cumin, anise, dock, mustard, garlick, onion, spleens, kidneys, intestines, every kind of apple, that is acid or bitter, vinegar, every thing, that is acrid, acid, or bitter, oil, also rock-fish, and those, that are of the tenderest kind, or those again, which are either too hard and strong tasted, as those found in ponds, lakes, or muddy rivers generally are, or those, that have grown to an excessive bulk.

CHAP. XXII. OF MILD AND ACRID THINGS.

The following are mild; gruel, pulse, pancake[(52)], starch, ptisan, fat flesh, and all glutinous flesh, such as we have in all tame animals, but especially in the heels, and legs of swine, the petty-toes, and heads of kids, calves, and lambs, and the brains of them all. Also milk, and what are properly called sweets, defrutum, passum, pine-nuts.

Things acrid are, whatever is too austere, all acids, all salt provisions; and even honey, which is the more so, the better it is: likewise garlick, onion, rocket, rue, cresses, cucumber, bete, cabbage, asparagus, mustard, radish, endive, basil, lettuce, and the greatest part of pot-herbs.

CHAP. XXIII. OF THOSE THINGS WHICH GENERATE A THICK AND A FLUID PHLEGM.

A thick phlegm is generated by sorbile eggs, alica, rice, starch, ptisan, milk, bulbous roots, and almost every thing that is glutinous.

The contrary effect is produced by all salted, and acrid, and acid substances.

CHAP. XXIV. OF WHAT AGREES WITH THE STOMACH.

Whatever is austere or acid, or whatever is moderately sprinkled with salt, is agreeable to the stomach: also un-leavened bread, and washed alica, or rice, or ptisan; and all birds, and all venison; and both of these either roasted or boiled: amongst the tame animals, beef; if any of the rest is made use of, rather lean than fat; in a swine the heels, cheeks, ears, and barren wombs; amongst pot-herbs endive, lettuce, parsnip, boiled gourd, skirret; of the apple kind, the cherry, mulberry, service fruit, mealy pears, such as are either those called crustumina[(53)] or næviana, also those called tarentina, or signina; the round apples, or scandiana, or amerina, or quinces, or pomegranates, wormwood[(54)], jar raisins, soft eggs, dates, pine-nuts, white olives preserved in strong brine or tinctured with vinegar, or the black kind, which have grown thoroughly ripe upon the tree, or been kept in passum or defrutum; austere wine, although it be grown rough, also resinated[(55)]; hard fish of the middle class, oysters, pectines[(56)], murex and purpura[(57)], periwinkles; food and drink either cold or hot.

CHAP. XXV. OF THINGS HURTFUL TO THE STOMACH.

The stomach is offended by every thing tepid, all salt provisions, all meat stewed into broth, every thing too sweet, all fat substances, gruel, leavened bread, and the same made either from millet or barley, oil, roots of pot-herbs, and whatever greens are eaten with oil or garum, honey, mulse, defrutum, passum, milk, all cheese, fresh grapes, figs both green and dry, all leguminous vegetables, and things, that usually prove flatulent; also thyme, catmint, savory, hyssop, cresses, dock, nipplewort, and walnuts. From this account it may be inferred, that it is no rule that what affords a good juice, agrees with the stomach; nor that what agrees with the stomach, is for that reason of good juice.

CHAP. XXVI. OF THOSE THINGS, WHICH OCCASION FLATULENCIES, AND THE CONTRARY.

Flatulencies are generated by almost all the leguminous vegetables, every thing fat, or over sweet, all stewed meat; must, and even any wine, that has not got age: amongst pot-herbs, garlick, onion, cabbage, and all roots (except skirret and parsnip) bulbusses, dry figs too, but more especially the green, fresh grapes, all nuts, except pine-nuts, milk, and all cheese, and lastly, whatever is too crude.

Little or no flatulency is occasioned by venison, wild fowl, fish, apples, olives, conchylia, eggs either soft or sorbile, old wine. But fennel and dill even relieve flatulencies.

CHAP. XXVII. OF THOSE THINGS WHICH HEAT AND COOL.

Heat is excited by pepper, salt, all flesh stewed into soup, garlick, onion, dry figs, salt fish, wine which is the more heating, the stronger it is.

Those greens are cooling, whose stalks are eaten without boiling, as endive, and lettuce: likewise coriander, cucumber, boiled gourd, bete, mulberries, cherries, austere apples, mealy pears, boiled flesh, and especially vinegar mixed either with meat or drink.

CHAP. XXVIII. OF WHAT IS EASILY CORRUPTED IN THE STOMACH, AND THE CONTRARY.

The following kinds easily corrupt in the stomach, leavened bread, and such as is made of any other grain than wheat, and all kinds of the sweet bread mentioned before[(58)], milk, honey, also sucking animals, and tender fish, oysters, greens, cheese both new and old, coarse or tender flesh, sweet wine, mulse, defrutum passum; lastly, whatever is either juicy, or too sweet, or over thin.

But unleavened bread, birds, especially the harder, hard fish, and not only the aurata for instance, or scarus[(59)], but even the lolligo, locusta, polypus, do not easily corrupt; also beef and all hard flesh: the same is preferable if it be lean, and salted; and all salt fish; periwinkles, the murex and purpura, austere wine, or resinated.

CHAP. XXIX. OF WHAT OPENS THE BELLY.

The belly is opened by leavened bread, and the more so if it be coarse, or made of barley; cabbage if it be not well boiled, lettuce, dill, cresses, basil, nettle, purslane, radishes, capers, garlick, onion, mallows, dock, bete, asparagus, gourd, cherries, mulberries, all mild apples, figs even dry, but more especially green, fresh grapes, fat small birds, periwinkles, salt fish and garum, oysters, pelorides[(60)], sea-urchins, muscles, and almost all shell fish, and chiefly the liquor of them, rock fish, and all tender fish, blood of the cuttle fish; and any fat meat, and the same stewed, or boiled; birds that swim; crude honey, milk, all sucking animals, mulse, sweet or salt wine, soft water[(61)], every thing tepid, sweet, fat, boiled, stewed, salt, or diluted.

CHAP. XXX. OF WHAT BINDS THE BELLY.

On the contrary the belly is bound by bread made of the siligo, or flour of wheat; especially if it be unleavened; and more so if it be also toasted: and this virtue is even increased, if it be twice baked: pulse made either from alica, or panick, or millet; also gruel prepared from the same; and more so, if these have been toasted first. Lentils with the addition of betes, or endive, or cichory, or plantain, and more so, if these have been toasted before: endive also by itself or cichory toasted, with plantain; small greens, cabbage twice boiled; hard eggs, and more so if roasted; small birds, black bird, ring-dove, especially boiled in vinegar and water, crane and all birds that run, more than they fly; hare, wild goat; the liver of those animals, that have suet, especially that of beef, and the suet itself; cheese, which is grown strong by age, or by that change, which we observe in the foreign kind; or if it be new, boiled with honey or mulse; also boiled honey, unripe pears, fruit of the service-tree, more especially those that they call torminalia[(62)], quinces and pomegranates, olives either white or early ripe, myrtle-berries, dates, the purpura and murex, wine either resinated or rough, and wine undiluted, vinegar, mulse, that has been boiled, also rough defrutum, passum, water either tepid or very cold, and hard, that is, such as keeps long without stinking, therefore particularly rain water, every thing hard, lean, austere, rough, and scorched, and the same flesh rather roasted, than boiled.

CHAP. XXXI. OF DIURETIC MEATS AND DRINKS.

The urine is promoted by whatever grows in the garden of a good smell, as smallage, rue, dill, basil, mint, hyssop, anise, coriander, cresses, rocket, fennel. Besides these, asparagus, caper, catmint, thyme, savory, nipplewort, parsnip, especially the wild kind, radish, skirret, onion; of venison principally the hare; small wine, pepper both round and long, mustard, wormwood, pine-nuts.

CHAP. XXXII. OF SOPORIFEROUS AND EXCITING THINGS.

Sleep is procured by the poppy, lettuce, especially the summer kind, when its stalk is replete with milk, mulberries, and leeks.

The senses are excited by catmint, thyme, savory, hyssop, particularly pennyroyal, rue and onion.

CHAP. XXXIII. OF THOSE THINGS, WHICH DRAW, REPEL, OR COOL, OR HEAT, OR HARDEN, OR SOFTEN.

Many things are powerful in drawing out matter: but as these consist principally of foreign medicines, and not so much adapted to the cases of those who are to be relieved by diet, I shall postpone the mention of them for the present: and shall only name those things, which are commonly at hand, and are fit for corroding, and thus extracting whatever is hurtful in those distempers, concerning which I am presently to treat. This virtue resides in the seeds of rocket, cresses, radish; but most of all mustard. The same power is also found in salt, and figs.

Sordid wool[(63)] dipt either in vinegar, or wine, with an addition of oil; bruised dates, bran boiled in salt water or vinegar, are all at the same time both restringent and emollient.

But the following things both restringe and cool, the wall herb (which they call parthenium or perdicium, feverfew) serpyllum, pennyroyal, basil, the blood herb (which the Greeks call polygonon[ AZ ],) purslane, poppy-leaves, and clippings of vines, coriander-leaves, henbane, moss, skirret, smallage, nightshade (which the Greeks call struchnos)[ BA ], cabbage-leaves, endive, plantain, fenel-seed, mashed pears or apples, chiefly quinces, lentils; cold water, especially rain water, wine, vinegar; and bread, or meal, or sponge, or pieces of cloth, or sordid wool, or even linen, moistened in any of these liquors; Cimolian chalk[(64)], tarras[(65)], oil of quinces[(66)], or myrtles[(67)], or of roses[(68)], bitter oil[(69)], leaves of vervains bruised with their tender stalks; of this kind are olive, cypress, myrtle, mastich-tree, tamarisk, privet, rose, bramble, laurel, ivy, pomegranate.

Boiled quinces, pomegranate bark, a hot decoction of vervains, which I mentioned before, powder from the lees of wine, or myrtle-leaves, bitter almonds, all restringe without cooling.

A cataplasm made from any meal is heating, whether it be of wheat, or of far[(70)], or barley, or bitter vetch, or darnel, or millet, or panick, or lentil, or beans, or lupines, or lint, or fenugreek; the meal after being boiled is laid on hot. But every kind of meal boiled in mulse is more effectual for this purpose, than the same prepared with water. Besides these, Cyprine oil[(71)], or iris[(72)], marrow, fat of a cat, mixed with oil, especially if it be old, salt, nitre[(73)], git, pepper, cinquefoil.

And we may observe in general, that those things, which both restringe violently and cool, are hardening: and those which heat and dissipate, are softening: but the most powerful cataplasm for softening is made from the seeds of lint or fenugreek.

Now physicians make use of all these things variously, both by themselves, and mixed; so that we rather see what each of them was strongly persuaded of, than what upon certain trial he found to be useful.

A. CORNELIUS CELSUS

OF