De Medicina

25 There is, again, another affection which the Greeks call tenesmos, slighter than all those last spoken of. It should be counted neither with acute nor with chronic diseases, since it is readily relieved, and never by itself fatal. As in the case of dysentery, there is equally the frequent desire for stool, and equally the pain when anything is passed. There is a discharge resembling phlegm and mucus; sometimes it is even slightly bloodstained; but mingled with properly formed faeces derived from food. The patient should sit in hot water, and make application frequently to his anus. For this there are several suitable medicaments; butter in rose oil, gum acacia dissolved in vinegar; that wax-salve which the Greeks call tetrapharmacon, made liquid with rose oil; alum wrapped up in wool and so applied; the same clysters as are beneficial in dysentery; the same decoction of vervains to foment the lower parts. He should drink on alternate days water and a thin dry wine

lukewarm or better cold. The diet should be the same as prescribed above 922) for dysentery.

26 Even slighter, while recent, is diarrhoea, in which the stool is liquid and more frequent than ordinary; and sometimes the pain is bearable, at times very severe, when it is a worse affair. But a flux from the bowel for one day is often salutary, and even for several days, provided that fever is absent and it subsides within seven days. For the body is purged, and whatever is about to cause a complaint inside is evacuated with advantage. But persistence is the danger; for it excites at times dysentery and feverishness and exhausts strength. It is sufficient on the first day to rest, and not to check the movement of the bowels. If it stops of itself, the patient should make use of the bath, and take a little food; if it persists, he should abstain, not only from for, but even from drink. If on the day following, in spite of all, the stool is still liquid, he should rest as before and take a little astringent food. On the third day he should go to the bath; be rubbed all over vigorously except the abdomen, sit with his loins and shoulder-blades before a fire; take food of an astringent kind, and a little undiluted wine. If on the fourth day the flux persists, he should eat more but provoke a vomit afterwards, and counter in a general way the diarrhoea by thirst, hunger and vomiting, until it subsides for it is scarcely possible that after so attending to it, the bowel will not be controlled. Another method to suppress the diarrhoea is to dine and then vomit; the next day to rest in bed, in the evening to be anointed, but lightly, then to eat about half a pound of bread soaked in undiluted Aminaean wine; after that something roasted, poultry in par=

ticular, and lastly to drink the same wine mixed with rain-water; and to do so until the fifth day, then vomit again. Now Asclepiades, against the opinion of previous writers, affirmed that the drink should be kept constantly cold, indeed as cold as possible. I myself hold that each should trust in his own experiences, whether hot than cold drink should be made us of. It sometimes happens also that this disorder, having been neglected for several days, is more difficult to relieve. Such a patient should commence with an emetic; then the following day at evening be anointed in a warm room; take food in moderation, and the sourest wine undiluted; a wax-salve with rue should be applied to the abdomen. In this affection neither walking nor rubbing is of benefit; sitting in a carriage and even more riding on horseback is advantageous; for nothing strengthens the intestines more. But if use is to be made of medicaments as well, the most suitable is that made from orchard fruit. At the time of the vintage, pears and crab apples are thrown into a large vessel; and if the latter are not to be had, green Tarentine or Signine pears, Scaudian, or Amerian apples, sweet-scented. To these are added quinces and pomegranates with their rind, service fruit, and those that are called torminalia, which we use by preference, so that these occupy one-third of the jar; then this is next to be fille up with must, and boiled until all the ingredients have become resolved into a uniform mass. It is not unpleasant to the taste, and taken as needed, it controls the bowel gently, without any harm to the stomach. It is enough to take in one day two or three spoonfuls. Another composition is stronger: myrtle berries are gathered, and wine expressed from them is boiled down to one-tenth, of which a cup is sipped. A third can be prepared at any time by scooping out the inside of a pomegranate, removing all the seeds, and returning the pulp into the cavity, than raw eggs are pounded in, and stirred round with a small rod; next the fruit itself is heated over charcoal, for it does not burn so long as the inside is liquid; when the inside begins to dry the pomegranate is taken off the brazier and with a spoon the inside is scooped out and eaten. By certain acrid additions this remedy can be made more active; thus also it may be stirred up in peppered wine and mixed with salt and pepper, and so eaten. Pease porridge, with which a little of an old honeycomb has been boiled, also lentil porridge boiled with pomegranate rind, also a decoction of bramble tops eaten with oil and vinegar, are efficacious, as also draughts of a decoction of dates or quinces or dried service fruits or brambles. Such are the kind I refer to whenever I say an astringent draught should be administered. Also a half-pint of wheat is boiled in dry Aminaean wine, and first the wheat is eaten on a stomach empty both of food and drink, afterwards the wine itself is drunk and can be justly counted amongst the most active remedies. Also there can be given to drink Signian wine, or dry and resinated wine, or any other dry wine. And a pomegranate may be pounded up along with its rind and seeds, and mixed with wine of the above sort; the patient either sips it undiluted, or drinks it mixed with water. But it is superfluous except in bad cases to make use of medicaments.