9 But in the interior parts of the throat there is sometimes ulceration. For this most employ plasters and hot foments externally; they also order hot steam to be inhaled by the mouth. Others say that by these measures the parts are rendered more soft and more liable to the complaint already existing there. But these applications are salutary if cold can be completely avoided; if cold is to be apprehended, they are useless. But anyhow to rub the throat is dangerous; for it provokes ulceration. Nor are diuretics useful, because in the course of being swallowed they can also make thin the phlegm there, which is better suppressed. Asclepiades, who wisely advises many things, which we
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also ourselves practise, said that very sour vinegar should be sipped; for by this the ulcers are constricted without doing harm. But whilst vinegar can suppress bleeding, it cannot heal the actual ulcerations. For that purpose lycium is better, and Asclepiades approved equally of it, or leek or horehound juice, or almonds pounded up with tragacanth and mixed with raisin wine, or linseed pounded and mixed with sweet wine. Exercise also by walking and by running is necessary, and smart rubbing from the chest downwards should be applied to the whole of the lower part of the body. The food too should be neither very acrid nor rough, honey, lentils, wheat porridge, milk, pearl barley gruel, fat meat and especially a leek decoction and anything mixed with it. Of drink the least possible is proper; water can be given either by itself, or when quince or dates have been boiled in it. Bland gargles are of service also, or when ineffectual then repressants. This sort of affection is not acute, and cannot last long; nevertheless, it requires timely treatment, lest it should become a severe and chronic complaint.
10 Cough again is generally owing to ulceration of the throat. This is incurred in many ways: and so when the throat has healed the cough is ended. Nevertheless, at times cough is a trouble by itself, and when it has become chronic, is difficult to get rid of. Sometimes the cough is dry, sometimes it excites phlegm. Hyssop should be taken every other day; the patient should run whilst holding the breath, but not where there is dust; he should practise reading loudly, which may at first be impeded by the cough, but later overcomes it; next walking; then manual exercises also, and the chest should
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be rubbed for a long while. After such exercises he should eat three ounces of very juicy figs, cooked over charcoal. Besides the above, when the cough is moist, smart rubbings with some kind of heating substance are good, provided that the head too is briskly rubbed when dry; in addition, cups are applied to the chest; mustard put on outside over the throat until there is slight excoriation; and a draught taken, composed of mint, almonds, and starch; first of all dry bread should be eaten, then any kind of bland food. But if the cough is dry and very troublesome, it is relieved by taking a cup of dry wine, provided that this is done only three or four times at rather long intervals; further, there is need to swallow a little of the best laser, to take juice of leeks or horehound; to suck a squill, to sip vinegar of squills, or at any rate sharp vinegar; or two cupfuls of wine with a bruised clove of garlic. In every case of cough it is of use to travel, take a long sea voyage, live at the seaside, swim, sometimes to take bland food, such as mallows, or nettle-tops, sometimes acrid; milk cooked with garlic; gruels to which laser has been added, or in which leeks have been boiled to pieces; a raw egg to which sulphur has been added; at first warm water to drink, than, in turn, one day water, the next day wine.
11 When blood is spat up there is more cause for alarm, although that presents at one time less, at another more of danger. Blood sometimes comes from the gums, sometimes from the mouth, and that at times copiously, yet without cough, without ulceration, without any disease of the gums, so that there is no expectoration. But just as there is on occasion bleeding from the nostrils, so also does it
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burst out from the mouth. And sometimes it is blood which flows, sometimes something resembling water in which fresh meat has been washed. On the other hand, blood may come from the uppermost part of the throat, at one time when there is ulceration in that part, at another without ulceration, but either the mouth of some blood-vessel has opened, or the blood breaks out of certain tubercles which have originated there. When this happens, neither food nor drink does harm, nor is there any expectoration as from an ulcer. When, however, the throat and air tubes are ulcerated, the frequent cough also forces out blood; at times it is even brought up out of the lung or out of the chest or out of the sides or out of the liver. Often women, in whom the blood is not being given out through the menses, expectorate blood.
According to medical authorities blood gains exit either from some part eroded, or ruptured, or from the opened mouth of some blood-vessel; the first they call diabrosis, the second rhexis, the third anastomosis. The last is the least harmful, the first, the worst. And often indeed it happens that pus follows the blood. Now at times to stop the bleeding suffices to promote recovery; but if there follow ulcerations, or pus, or a cough, according to the situation there arise various and dangerous classes of diseases. But if only blood flows out, both the remedy and the ending are the quicker. Nor ought we to ignore that in those who are in the habit of bleeding or in whom the back or hips ache whether after hard running or walking, a limited flow of blood is not disadvantageous as long as fever is absent, and when blood is passed by the
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urine it even relieves this very lassitude; nor indeed, in the case of a fall from a height, is there anything alarming if blood comes with the urine, so long as there is nothing else unusual in the urine; nor does vomiting of blood bring about danger, even when repeated, if before it recurs the body is allowed to regain strength and fill up; and it does no harm at all in a robust man, if not excessive, and when it excites neither cough nor fever.
The foregoing are general remarks: now I come to the particular points mentioned above. If blood escapes from the gums, it suffices to chew purslane; if from the mouth, undiluted wine should be held in it; if this does no good, then vinegar. If in spite of these remedies there is a severe outburst, since this may be the death of the patient, its attack is best diverted by applying a cup to the occipital region, after first incising the skin; when this happens in a woman whose menses are not forthcoming, a cup is applied to each groin, likewise after making incisions. But if the bleeding comes from the throat, or from more internal parts, there is more to fear, and a more active treatment is to be adopted. Blood should be let, and if the flow from the mouth is not lessened, the venesection should be repeated a second or a third time, and every day a little. From the first also the patient should sip either vinegar or plantain or leek juice with frankincense, and outside over the seat of pain there is to be applied unscoured wool soaked in vinegar, cooled at intervals by means of a sponge. Erasistratus used also to bind up the legs and thighs and the forearms of such patients in several places. This constricting Asclepiades declared far from being beneficial, to be even harmful. But that it often
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answers well experience bears witness. Yet there is no necessity to bind the patient in many places; it is enough to do it below the groins and above the ankles and at the upper part of the arms, also the forearms. Further, if fever is troublesome, gruel must be given, and for drink water in which has been boiled any one of the intestinal astringents. But if fever is absent, there may be given: either washed spelt or bread soaked in cold water and also soft eggs, and for drink either that mentioned above, or sweet wine or cold water; but drink must be given with the knowledge that in this disease thirst is an advantage. Besides these, there are needed rest, freedom from care, and silence. The head also of the patient whilst in bed should be kept raised, and well shaved; the face is often to be bathed with cold water. On the other hand, there is danger in wine, the bath, coition, oil in the food, all acrid food; the same applies to hot foments, a hot close room, much bedclothes piled on the patient. Rubbings also are useful after the bleeding has quite stopped. Then indeed a beginning can be made on the arms and legs, avoiding the chest. A patient in this case should live through the winter by the sea, during the summer inland.
12 Below the throat is placed the stomach, in which there tend to occur many chronic complaints. For sometimes great heat affects it, sometimes flatulence, sometimes inflammation, sometimes ulceration; at times phlegm collects, at times bile; but the most frequent malady is that in which it undergoes paralysis, nor does anything else so affect it, or,
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through it, the whole body. As diverse as are its complaints, so are the remedies.
When heated, it should be bathed externally at intervals with vinegar and rose oil, and road dust applied with oil, and those plasters which simultaneously repress and soothe. For drink, unless there is anything against it, lukewarm water is the best.
If there is flatulence, it is beneficial to apply cups, but there is no need to incise the skin; dry and hot foments do good, but not the strongest kind. At intervals there should be enjoyed abstinence from food; a draught of wormwood or hyssop or of rue on an empty stomach is useful. Exercise at first should be light, then more is to be taken, especially such as moves the upper limbs; the kind most appropriate in all complaints of the stomach. After exercise there is need of anointing, rubbing, occasionally also the bath, yet less often than usual; now and then a clyster; later, food which is hot but not flatulent, and similarly hot drinks, first water and after the flatulence has subsided, dry wine. In all complaints of the stomach this also is to be prescribed, that each should adopt in health that regimen which has cured him; for his weakness will recur unless his health is protected by the same measures as those by which it was restored.
But if there is inflammation of any kind, which is generally followed by swelling and pain, the primary remedies are rest, abstinence, a belt of sulphurated wool, and the wormwood draught upon an empty stomach. If a burning heat troubles the stomach, it should be fomented at intervals with vinegar and
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rose oil; next food should be given in moderation, external applications are also to be made which simultaneously both repress and soothe; next after that, when these are taken off, hot meal plasters are put on to disperse the remnants of the disease: now and again a clyster must be given, exercise must be taken, and a fuller diet.
But if ulcers attack the stomach, generally the same treatment should be applied as has been prescribed in the case of an ulcerated throat (IV.9). Exercise, also rubbing of the lower extremities, is to be practised; bland and glutinous foods taken short of satiety; and all pungent and sharp food withdrawn. Sweet wine is to be used if there is no fever, or if that causes flatulence at any rate light wine, but neither very cold nor too hot.
If the stomach becomes filled with phlegm an emetic is needed, sometimes on an empty stomach, sometimes after food: there is benefit in exercise, rocking, a sea-voyage, rubbing. Nothing should be eaten or drunk unless hot, whilst such things must be avoided as have tended to collect phlegm.
There is worse trouble when the stomach is vitiated by bile. Patients who are troubled with this, vomit up bile at intervals of some days, and worst of all, vomit black bile. For such a clyster is appropriate, and draughts of wormwood should be given; rocking and a sea-voyage are necessary; vomiting when possible is induced by sea-sickness; indigestion must be avoided, the food should be such as is readily swallowed, and not repugnant to the stomach, the wine must be dry.
But the commonest and worst complaint of the stomach is paralysis, when it does not retain food,
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and the nutrition of the body is wont to cease, and so it is consumed by wasting. In this sort of disease the bath is most harmful; reading aloud and exercise of the upper limbs are needed, as also anointing and rubbings; it is good for the patient to have cold water poured over him, and to swim in cold water, also to submit his stomach to jets of it, especially at the back of the stomach from the shoulder-blades downwards, to bathe in cold medicinal springs, such as those at Cutilia and Simbruvium. Food should be also taken cold, rather that which is digested with difficulty than that which readily decomposes. Hence many who can digest nothing else, digest beef, and therefore it may be inferred that neither poultry no venison, nor fish except the harder kinds, should be given. The most suitable drink is wine cold, or else undiluted and well heated, particularly Rhaetic or Allobrogic wine, or any other which is both dry and seasoned with resin; if there is none of the above at hand, then the harshest possible, especially Signine wine. If food is not retained, water must be given and a more copious vomit elicited, after which food is to be given again, and then cups are to be applied two fingers' breadth below the stomach, and they are to be kept on two or three hours. If simultaneously there is both vomiting and pain, there should be placed over the stomach unscoured wool or sponge soaked in vinegar, or a refrigerant plaster. The arms and legs too are to be rubbed sharply, but not for long, and to be kept warm. If pain is more severe, a cup is to be put on four fingers' breadth below the praecordia, and following that bread in cold vinegar and water is to be given; should this not be retained, after the vomiting,
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anything light or not unsuitable for the stomach can be given; if even that is not retained, give a cupful of wine every hour until the stomach settles down. Radish juice also is an active remedy; more active still is a mixture of the juice of sour and sweet pomegranates in equal parts, with the addition of endive and mint juice, the least quantity of the last; the whole of the above may be mixed thoroughly well with an equal quantity of cold water, which is better than wine for tightening up the stomach. Now, vomiting when spontaneous should be arrested; but if there is nausea, or if food turns acid inside, or decomposes, both of which are manifested by eructations, the food should be evacuated, and the stomach forthwith replenished by the taking of food of the kind just noted (§ 9). When immediate apprehension has been removed a return should be made to the prescriptions given above (§ 7).
13 The stomach is girt about by the ribs, and in these also severe pains occur. And the commencement either is from a chill, or from a blow, or from excessive running, or from disease. But at times pain is all there is the matter, and this is recovered from be it slowly or quickly; at times it goes on until it is dangerous, and the acute disease arises which the Greeks call pleurisy. To the aforesaid pain in the side is added fever and cough; and by means of the cough, phlegm is expectorated when the disease is less serious, but blood when it is grave. At times also there is a dry cough without expectoration, which is worse than the former condition, and better than the latter. The aparo remedy for severe and recent pain is blood-letting; but if the case is either of a slighter or of a more chronic kind,
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then this remedy becomes either unnecessary or belated; and recourse is to be had to cupping after incising the skin. It is also appropriate to apply vinegar and mustard upon the chest until this raises ulcerations and pustulations, and then a medicament to draw out the humour that way. Besides the above the side should be first surrounded with a sheet of sulphurated wool; next, after the inflammation has subsided somewhat, have dry and hot foments applied to it. From these transition is made to emollients. If the pain persists for a longer time, it may finally be dispersed by resin plaster. Food and drink should be taken hot, avoiding cold. Along with the above treatment, however, it is not unfitting to rub the lower limbs with oil and sulphur. If the cough has been relieved, the patient should read a little out loud, and now take both sharp food and undiluted wine. Though such are what medical practitioners prescribe, yet our country people, lacking these remedies, find help enough in a draught of germander. The foregoing are the remedies common to all cases of pain in the side: there is more to do if this affection has also become acute. In such cases, besides what has been described above, attention must be given to the following: that the food be as thin and bland as possible, and gruel is most suitable, especially that made with pearl barley, or soup made by boiling a chicken with leeks, and this may be given, but only every third day, if the patient's strength permits of this; the drink should be hydromel in which hyssop or rue has been boiled. The times at which these should be given will become apparent from the way the fever increases or diminishes, so that it should be given when there is least fever, not forgetting,
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however, that a dry throat must not be combined with that kind of cough; for often when there is no expectoration, the cough is incessant and chokes the patient. On this account I stated above that a cough which brings up nothing is of a worse kind than that causing phlegm to be expectorated. But here the disease does not allow of wine being sipped as prescribed above (10.3); pearl barley gruel is to be taken instead. As these have to sustain the patient during the hot stage of the disease, as soon as there is a little remission, the diet can be increased and also some wine given, as long as nothing is given that will either chill the body or irritate the throat. If the cough persists in convalescence, it will be well on one day to omit the wine, and on the next to take a little extra wine with the food. And also at the beginning of a cough, as stated above, it is not amiss to sip cupfuls of wine; but sweet or at any rate light wine, is the more suitable in this kind of illness. If the malady has become inveterate the body must be strengthened by food fit for an athlete.
14 Passing from the framework of the body to the viscera, we come first to the lung, where a grave and acute disease arises, which the Greeks name peripleumoniacon. The conditions are these: the lung is attacked as a whole; this is followed by a cough which draws up bile or pus; there is a feeling of weight over the praecordia and all the chest; there is difficult breathing, high fever, persistent insomnia, loss of appetite, wasting. This sort of disease has in it more of danger than of pain. Blood should be let if there is strength enough; if not, dry cups should be applied over the praecordia. Then if the patient is strong enough he should be rocked to disperse the
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disease; if not, he should yet be moved about in the house: his drink should then be a decoction of hyssop with a dried fig, or hydromel in which hyssop or rue has been boiled; he should be rubbed twice daily, longest between the shoulder-blades, then the arms, feet and legs, but lightly over the lung. As regards food too, in this instance it should be neither salted nor acrid nor bitter nor constipating, but of the rather blander kinds. Therefore on the first days pearl barley or spelt or rice gruel in which fresh lard has been boiled are to be given; with this raw eggs, pine kernels in honey, bread or washed groats of spelt in hydromel; then he may drink not only water by itself but also lukewarm hydromel, or even this cold in summer, unless there is some objection. But whilst the disease is on the increase, it is enough to give these every other day. When the increase has come to a stand, he should abstain, so far as is practicable, from everything except lukewarm water. If the strength begins to fail, hydromel is to be added. For the relief of pain it is helpful to apply foments hot, or those which both repress and soothe. The application to the chest of salt, well rubbed up and mixed with wax-salve, is beneficial because it slightly erodes the skin, and thereby draws out that flood of the matter by which the lung is being oppressed. Useful also is any one of the emollients which draw out the matter. During the pressure of the disease it is not wrong to keep the patient with the windows shut: when he is somewhat better, some windows should be opened three or four times a day to let in a little air. Next during recovery he should for several days abstain from wine, use rocking, rubbing and gruels; to the previous foods add: of vegetables,
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leeks, of meat, trotters and tit-bits, also small fish, so long as for a while nothing but what is soft and bland is consumed.
15 Further a disease of another of the viscera, the liver, is also sometimes chronic, sometimes acute: the Greeks call it hepaticon. There is severe pain in the right part under the praecordia, which spreads to the right side, to the clavicle and arm of that side; at times there is also pain in the right hand, there is hot shivering. In a grave case there is vomiting of bile; sometimes the patient is nearly choked by hiccough. Such are the signs when acute; but in a more chronic case, where there is suppuration within the liver, the praecordia on the right side become hard and swollen; after a meal there is greater difficulty in breathing; then supervenes a sort of paralysis of the lower jaws. When the disease has become inveterate, the abdomen and legs and feet swell; there is wasting of the chest and arms and about the clavicle on both sides. It is best to begin by letting blood; then the bowel is to be moved, if nothing else takes effect, by black hellebore. Externally plasters are to be applied, first repressants, then hot ones to disperse; appropriate additions are iris or wormwood unguents; after these emollients. Gruels, moreover are to be given, all food hot and not too nourishing, generally that kind which is also suitable to pleurisy (IV.13, 4), and in addition such food and drink as promote urination. Beneficial in this disease are: thyme, savory, hyssop, catmint, starch, sesamum
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seeds, laurel berries, young pine-cone tips, knotgrass, mint, quince pulp, the fresh raw liver of a pigeon. Some of the above may be eaten alone, some can be added to the gruel or draughts, so long as they are taken sparingly. There is no objection to wormwood rubbed up in honey and pepper, of which a dose is taken daily. All cold things must be especially avoided; for nothing is more harmful to the liver. Rubbings of the extremities should be employed; all manual work should be avoided, and all more active movement; the patient should never even hold his breath for long together. Anger, hurry, weight-lifting, boxing, running are harmful. A copious affusion of the body with water, hot in winter, tepid in summer, is beneficial, also free anointing and sweating at the bath. But if the liver suffers from an abscess, the same is to be done as in other internal suppurations. Some even with a scalpel make an incision over the liver, and burn through into the actual abscess with the cautery.
16 Now the spleen when affected swells, and with it simultaneously the left side; and this becomes hard and resists pressure. The abdomen is tense: there is even some swelling of the legs. Ulcerations either do not heal at all, or at any rate form a scar with difficulty: there is also pain and some difficulty in walking fast or running. Rest increases this complaint, and so there is need for exercise and work; nevertheless, care must be taken lest if carried too far fever be excited. Anointings and rubbings and
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sweatings are necessary. All sweet things are hurtful, also milk and cheese; but sour things are the most suitable. Therefore sharp vinegar may be sipped by itself, vinegar of squills is even better. Such patients should eat salt fish or olives preserved in strong brine, lettuce dipped in vinegar, also endive in the same, beet with mustard, asparagus, horse-radish, parsnip, trotters, chaps, poultry not fatted, and similar game. The drink too, when taken on an empty stomach, should be wormwood decoction; after food, water in which a blacksmith has from time to time dipped his red-hot irons; since this water especially reduces the spleen. For it has been observed that animals reared by our blacksmiths, have small spleens. Dry thin wine can also be given: and everything, whether food or drink, which causes urination. Of particular value in this respect are: trefoil seeds or cummin or celery or creeping thyme or broom tops or purslane or catmint or thyme or hyssop or savory: for these seem best adapted to draw out humour from the spleen. Ox-spleen may be usefully given to eat; rocket and nasturtium in particular render the spleen smaller. Palliatives must also be applied externally: there is one made of ointment and dates which the Greeks call myrobalanon, or that made of linseed and nasturtium seeds, to which wine and oil have been added; or that made of green cypress and a dried fig; or that made with mustard to which is added a fourth part by weight of he-goat's kidney fat, and which is rubbed up in the sun and applied forthwith. Moreover, capers may be employed in several ways; for they may be both
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taken with the food, and the brine and vinegar in which they have been soaked may be sipped. They may be even applied externally, the root or bark having been rubbed up with bran or the capers themselves with honey. There are also emollients suitable for this affection.
17 As regards the kidneys, these when they have become affected, continue diseased for a long while. It is worse if bilious vomiting is added. The patient should rest, sleep on a soft bed, keep the bowels loose even using a clyster when they do not act otherwise; he should sit frequently in a hot bath; take neither food nor drink cold, abstain from everything salted, acid, acrid, and from orchard fruit; drink freely; add whether to the food or to the drink pepper, leeks, fennel, white poppy; which are the most active in causing a discharge of urine. As an additional remedy when there is ulceration of the kidneys, if the ulcerations are still in need of being cleaned, sixty cucumber seeds stript of the husk, twelve pine kernels, of aniseed as much as can be taken up by three fingers, and a little crocus, are rubbed up together, and divided between two draughts of honey wine: but if it is merely pain was has to be relieved, thirty of the cucumber seeds, twenty pine kernels, five almonds, and a little crocus are rubbed up together and given in milk. And besides it is right to apply certain emollients, and especially such as extract humour.
18 From the viscera we proceed to the intestines, which are subject to diseases, both acute and chronic.
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And in the first place mention is to be made of cholera, because it appears to be a complaint common to the stomach and intestines: for there occur simultaneously diarrhoea and vomiting, and in addition flatulence. The intestines are griped, bile bursts upwards and downwards; first it is watery, then like water in which fresh meat has been washed; at times it is white in colour, at other times black or variously coloured. Hence the Greeks term this affection by the name of cholera. Besides those symptoms which are mentioned above, often the legs and arms are also contracted, there is urgent thirst, and fainting; when such things occur together, it is not to be wondered at if the patient dies suddenly, and yet in no other disease is there less time for affording relief. Therefore immediately upon the commencement of the above signs, the patient should drink as much as he can of tepid water, and vomit. Vomiting hardly ever fails to follow; but even if it does not occur, nevertheless it is advantageous to have mixed fresh material with that which is decomposed; the cessation of vomiting is a step towards recovery. If this happens, the patient should abstain forthwith from all drink; if there are still gripings, the stomach should be treated with cold and moist foments, or if there is pain in the belly, these should be lukewarm, so that the belly itself is relieved by moderately warm applications. But if vomiting, diarrhoea and thirst give rise to severe distress, and the vomit still contains undigested food, it is not yet a fitting time for wine: water should be given, not cold but rather lukewarm: pennyroyal
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in vinegar should be applied to the nostrils, or wine sprinkled with polenta, or mint in its natural state. But when the indigestion has been relieved, there is then greater apprehension of fainting. Recourse therefore should then be had to wine. The wine taken should be thin, aromatic, mixed with cold water, adding either polenta or crumbled bread, and bread by itself ought also to be taken, and as often as either the stomach or intestines discharge their contents, so often should the patient recruit his strength by these means. Erasistratus said that a draught should have mixed with it at first three or five drops of wine, subsequently gradual additions of undiluted wine. If Erasistratus both gave wine at the beginning and was influenced by fear of causing indigestion, he acted not without reason; if he thought that severe weakness could be relieved by three drops of wine, he erred. But if the patient is empty and his legs are contracted, a draught of wormwood should be given at intervals. If the extremities become cold, they should be anointed with hot oil to which a little wax has been added, and stimulated by hot foments. If there is no relief even from the above remedies, outside over the actual stomach cups should be applied, or mustard laid upon it. When he has settled down, he should go to sleep. On the next day he should be sure to abstain from drinking, on the third day he should go to the bath, gradually recruit himself with food. Whoever easily gets to sleep is quickly restored; the trouble is brought back by indigestion and also by fatigue and cold. If, after the suppression of the cholera, slight fever persists, there is need for a clyster, and then to take food and wine.
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19 Now the disorder just described is both acute and has its seat between the intestines and stomach, so that it is not easy to say to which part it most belongs. That which the Greeks term coeliacus has its seat at the gateway of the stomach and is usually both acute and chronic. Under this affection the belly becomes hard and painful; the bowels void nothing, not even wind; the extremities become cold; the breath is passed with difficulty. To begin with it is best to apply hot foments and plasters all over the belly to relieve pain, after food to induce a vomit and thus to empty the belly; next on the following days to apply dry cups to the abdomen and hips; to loosen the bowels, by giving milk and cold salted wine; also if in season green figs, provided that neither drink nor food is given all at once but a little at a time. It is enough, therefore, to take two or three cupfuls at intervals, and food in the same proportion; a cup of milk, mixed with one of water, and so administered, is suitable; flatulent and pungent foods are more useful, hence it is well to add pounded garlic to the milk. And as time goes on there is need for: rocking, especially a sea-voyage; rubbing three or four times a day, soda being added to the oil; hot-water affusions after food; then mustard should be put upon all the extremities, omitting the head, until there is irritation and redness, especially if the body is robust and virile. Gradual transition should next be made to remedies which confine the bowels. Roast meat, such as is nutritious and does not readily decompose, is to be given; and for drink,
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boiled rainwater, of which two or three cupfuls should be drunk at a time. If the disorder is of longer standing the proper thing is to swallow a bit of the best laser the size of a peppercorn, to drink wine and water on alternate days, between meals at times to sip a cupful of wine; to administer a clyster of tepid rain-water, especially if pain persists in the lower bowel.
20 In the intestines proper two diseases have their seat, one in the small, the other in the large. The mr is acute, the latter may become chronic. Diocles of Carystus named the disease of the small intestines chordapsos, of the large eileos. I note that by many the former is now termed eileos, the latter colicos. The former excites pain, at times above, at times below the navel. At one or the other of these places there is inflammation; neither motion nor wind is passed downwards. If the upper part is affected, food, if the lower, faeces is returned by the mouth; if either happens the disease is chronic. Additional signs of danger are if the vomit is bilious, malodorous, either varying in colour of black. The remedy is blood-letting or cupping in several places, the skin not being incised at all; for it is sufficient to do so in two or three places; in the others it is quite enough to extract wind. Next attention should be turned to the seat of disease: for there is commonly a swelling over it. And if this is situated above the navel, there is no
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use in the clyster; if below, to clyster the bowels as Erasistratus advised is the best remedy and often that is all the treatment required. Now the clyster should consist of strained pearl barley gruel, together with oil and honey, nothing else being added. If there is no swelling, the two hands should be placed upon the upper part of the belly, and little by little drawn downwards; for the seat of the trouble may be thus discovered, owing to its being necessarily resistent; and from this one can form an opinion whether the bowels should be clystered or not. The treatments common to both forms are: the application of hot plasters, put on from the breasts to the groins, and back to the spine, and often changed; rubbing of the arms and legs; immersing the patient all over in hot oil. If the pain is not relieved, there is injected into the bowels from below three or four cupfuls of hot oil. When we have brought it about by these measures that wind is now passed down and out, tepid honeyed wine, not much, is given to drink; for before that every care should be taken that nothing at all is drunk. If the honeyed wine is kept down, then give gruel. When pain and feverishness have subsided, then at length a fuller diet is adopted, but nothing flatulent nor solid nor rich, lest the intestines, whilst still weak, take harm; but for drink nothing is better than plain water, for in this disease vinous and acid drinks are objectionable. Subsequently the patient should avoid the bath, walking, rocking and other bodily movements; for this disorder is very liable to recur, and, unless the intestines have already returned to a sound state, either cold or shaking of any kind may cause a return of the trouble.