De Medicina

21 The disease which is in the larger intestine is situated chiefly in that part which I have described as a blind alley (IV.1, 8). There is extreme flatulence, violent pains especially on the right side; the intestine which appears to undergo torsion, . . . almost forces out wind. In most cases it comes on after chills and

fits of indigestion, then subsides, and in course of time often recurs so as to be a cause of suffering but without shortening the length of life. At the commencement of the pain, dry, hot foments should be applied, at first mild, then stronger ones, at the same time rubbing is used to draw off the matter to the extremities, into the legs and arms; if the pain be not so dispersed, dry cups should be applied. There is even a medicament compounded for this very purpose called colicos: Cassius used to boast that he had invented it. It is of more benefit when given as a draught, but when applied externally too it relieves pain by dispersing the wind. Until griping has quite ceased it is not right to take properly either food or drink. I have already stated what kind of food should be used in this kind of disorder (1, 7). The composition of the medicament termed colicos is as follows: costmary, anise, castor, of each 12 grams, of parsley 12 grams, of long and round peppers, a.a. 8 grams, of poppy tears, round rush, myrrh, nard, a.a. 24 grams, all mixed together with honey. This may be either swallowed by itself of the taken in hot water.

22 The most akin to the above among intestinal maladies are gripings, called by the Greeks dysenteria. The insides of the intestines ulcerate; from these blood trickles and at times is excreted with some faeces which are always liquid, at times with a sort of mucus, sometimes at the same time something fleshlike comes down; there is frequent desire to stool and pain in the anus. Along with this

pain a scanty motion is discharged, and by this too the griping pain is intensified: and after a while there is some relief and a short interval of ease; sleep is broken, feverishness comes; when the disorder has continued for a long while, it either carries off the patient, or even, although it come to an end, puts him to torture. Rest must be adopted from the first, since any shaking sets up ulceration; next on an empty stomach he is to sip a cupful of wine to which has been added powdered cinquefoil root; then repressant plasters are put upon the abdomen, which in the case of disorders of the upper abdomen is not expedient; whenever the patient goes to stool, he should bathe the anus with hot water in which vervains have been boiled; purslane should be eaten, whether cooked or pickled in strong brine; also such foods and drink as are astringent to the bowel. If the distemper is of longer standing, there should be injected into the rectum either a tepid cream of pearl barley, or milk, or melted fat, or deer marrow, or olive oil, or rose oil with butter or with raw white of egg, or a decoction of linseed, or if sleep does not occur, yolk of eggs in a decoction no rose-leaves: for such remedies relieve pain and mitigate ulceration, and are of special utility if loss of appetite has ensued. Themison has stated in writing that the strongest brine should be used in these cases. Food too should be of the kind which will act as mild astringents. But diuretics if they take effect are beneficial by directing humour to another part: if they do not take effect, they increase the trouble; so unless for those on whom they act promptly, they should not be used. If there is feverishness, the drink should be hot water, either plain or with some astringent in it; if none, then light dry wine. If for several days other remedies have done no good, and the disease is now of long standing, drinking of very cold water acts as an astringent upon the ulcerations and starts recovery. But as soon as the movement of the bowels is under control, there should forthwith be a return to warm drinks. Sometimes also there is discharged a putrid sanies having a foul odour, sometimes unmixed blood escapes. If the former occurs, a hydromel clyster should be given, and then the other things mentioned above injected. An effective remedy even for intestinal canker is a lump of minium rubbed up with 250 grams of salt, dissolved in water, and administered as a clyster. But if there is a flux of blood, food and drink should be astringent.