De Medicina

24 Equally well-known is the disease which they name sometimes the rainbow-hued, sometimes the royal. Of this Hippocrates said that if it comes on after the patient has been suffering from fever for seven days, the patient is safe, provided that the parts under the ribs remain soft. Diocles stated positively that if it arise after a fever, it is even favourable, but deadly if fever follows it. The colour reveals this malady, particularly of the eyes; they become yellow in the parts which should be

white. And it is usually accompanied by thirst and headache and frequent hiccough and induration under the ribs on the right side, and when a sharp movement of the body is made there is difficulty in breathing and laxness of the limbs; and when the disease persists for a long while, the whole body whitens with a sort of pallor.

On the first day the patient should fast, on the second day have the bowels moved by a clyster, then if there is fever, it is dispersed by appropriate diet; if not, scammony is given in a draught, or white beet pounded up in water, or bitter almonds, wormwood, and a very little aniseed in hydromel. Asclepiades used also to make the patient drink salted water, even for a couple of days, in order to purge, and rejected diuretics. Some, omitting the remedies given above, say they gain the same end through diuretics and those foods which cause thinness. For myself, if there is sufficient strength, I prefer the stronger remedies, the milder if there is but little. After purgation, for the first three days a moderate amount of food of the middle-class should be taken with salted Greek wine to drink, in order to keep the bowels loose; then on the ensuing three days, food of the stronger class with some meat, keeping to water for drink; next there is a return to the middle class of food, but in such a way that he may be more satisfied therewith, and for drink an undiluted dry wine in place of the Greek; and this diet is varied so that sometimes acrid foods are put in, sometimes the salted wine is again given. But throughout the whole time use is to be made of exercise, of rubbing, in winter of the bath, in summer of swimming in cold water, the patient should enjoy

a specially good bed and room, also dicing, jesting, play-acting and jollification, whereby the mind may be exhilarated; on account of this treatment the disease seems to have been termed royal. In addition a dispersive poultice, applied under the ribs, is beneficial, or if the liver or spleen has become affected a dried fig is put on.

25 The disease which the Greeks call elephantiasis, whilst almost unknown in Italy, is of very frequent occurrence in certain regions; it is counted among chronic affections; in this the whole body becomes so affected that even the bones are said to become diseased. The surface of the body presents a multiplicity of spots and of swellings, which, at first red, are gradually changed to be black in colour. The skin is thickened and thinned in an irregular way, hardened and softened, roughened in some places with a kind of scales; the trunk wastes, the face, calves and feet swell. When the disease is of long standing, the fingers and toes are sunk under the swelling: feverishness supervenes, which may easily destroy a patient overwhelmed by such troubles. At once, therefore, at the commencement, he should be bled for two days, or the bowels loosened by black hellebore, then a scanty diet is to be adopted as far as can be borne; after that the strength should be a little reinforced and the bowels clystered; subsequently, when the system has been relieved, exercise and especially running is to be used. Sweating should be induced primarily by the patient's own exertion, afterwards also by dry sweatings, rubbing is to be employed with moderation so that strength is preserved. The bath should be seldom used; neither fatty nor glutinous nor flatulent food; wine

is properly given except on the first days. Plantain crushed and smeared on seems to protect the body best.