---
title: "On Medicine · De medicina"
author: "Celsus"
translator: "Walter George Spencer"
languages: [la, en]
shelf: "Classical Latin"
url: https://scriptura.si/works/celsus-on-medicine/
cite: "Celsus, tr. Walter George Spencer, On Medicine · De medicina. Scriptura (scriptura.si), https://scriptura.si/works/celsus-on-medicine/"
---

# On Medicine · De medicina

*Celsus, tr. Walter George Spencer*

The best Roman account of medicine: diet, drugs and surgery, from the history of the art to the treatment of fractures.

> Latin: ed. Friedrich Marx, from the Perseus Digital Library (canonical-latinLit, phi0836.phi002, CC BY-SA 4.0).

> English: Walter George Spencer, from the Perseus Digital Library (phi0836.phi002.perseus-eng2). Notes are not included.

> Rows follow the references the two texts share (books, chapters and sections), cut where both reach the end of a sentence.

## Contents

1. [Book I · preface](https://scriptura.si/works/celsus-on-medicine/1.md)
2. [Book I · preface, chapters 1–3](https://scriptura.si/works/celsus-on-medicine/2.md)
3. [Book I · chapters 3–10](https://scriptura.si/works/celsus-on-medicine/3.md)
4. [Book II · preface, chapters 1–7](https://scriptura.si/works/celsus-on-medicine/4.md)
5. [Book II · chapters 7–8](https://scriptura.si/works/celsus-on-medicine/5.md)
6. [Book II · chapters 8–15](https://scriptura.si/works/celsus-on-medicine/6.md)
7. [Book II · chapters 16–33](https://scriptura.si/works/celsus-on-medicine/7.md)
8. [Book III · chapters 1–6](https://scriptura.si/works/celsus-on-medicine/8.md)
9. [Book III · chapters 6–16](https://scriptura.si/works/celsus-on-medicine/9.md)
10. [Book III · chapters 17–21](https://scriptura.si/works/celsus-on-medicine/10.md)
11. [Book III · chapters 21–27](https://scriptura.si/works/celsus-on-medicine/11.md)
12. [Book IV · chapters 1–7](https://scriptura.si/works/celsus-on-medicine/12.md)
13. [Book IV · chapters 8–14](https://scriptura.si/works/celsus-on-medicine/13.md)
14. [Book IV · chapters 15–25](https://scriptura.si/works/celsus-on-medicine/14.md)
15. [Book IV · chapters 26–32](https://scriptura.si/works/celsus-on-medicine/15.md)
16. [Book V · chapters 5–18](https://scriptura.si/works/celsus-on-medicine/16.md)
17. [Book V · chapters 19–24](https://scriptura.si/works/celsus-on-medicine/17.md)
18. [Book V · chapters 25–26](https://scriptura.si/works/celsus-on-medicine/18.md)
19. [Book V · chapters 26–27](https://scriptura.si/works/celsus-on-medicine/19.md)
20. [Book V · chapters 27–28](https://scriptura.si/works/celsus-on-medicine/20.md)
21. [Book V · chapter 28](https://scriptura.si/works/celsus-on-medicine/21.md)
22. [Book VI · chapters 1–6](https://scriptura.si/works/celsus-on-medicine/22.md)
23. [Book VI · chapters 6–7](https://scriptura.si/works/celsus-on-medicine/23.md)
24. [Book VI · chapters 7–14](https://scriptura.si/works/celsus-on-medicine/24.md)
25. [Book VI · chapters 15–19](https://scriptura.si/works/celsus-on-medicine/25.md)
26. [Book VII · preface, chapters 1–7](https://scriptura.si/works/celsus-on-medicine/26.md)
27. [Book VII · chapters 7–10](https://scriptura.si/works/celsus-on-medicine/27.md)
28. [Book VII · chapters 11–19](https://scriptura.si/works/celsus-on-medicine/28.md)
29. [Book VII · chapters 19–26](https://scriptura.si/works/celsus-on-medicine/29.md)
30. [Book VII · chapters 26–33](https://scriptura.si/works/celsus-on-medicine/30.md)
31. [Book VIII · chapters 1–3](https://scriptura.si/works/celsus-on-medicine/31.md)
32. [Book VIII · chapters 4–8](https://scriptura.si/works/celsus-on-medicine/32.md)
33. [Book VIII · chapters 9–10](https://scriptura.si/works/celsus-on-medicine/33.md)
34. [Book VIII · chapters 11–25](https://scriptura.si/works/celsus-on-medicine/34.md)

## 1. Book I · preface

Source: https://scriptura.si/works/celsus-on-medicine/1/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/1/#p-N

[¶0] pr. Just as agriculture promises nourishment to healthy bodies, so does the Art of Medicine promise health to the sick. Nowhere is this Art wanting, for the most uncivilized nations have had knowledge of herbs, and other things to hand for the aiding of wounds and diseases. This Art, however, has been cultivated among the Greeks much more than in other nations — not, however, even among them from their first beginnings, but only for a few generations before ours. Hence Aesculapius is celebrated as the most ancient authority, and because he cultivated this science, as yet rude and vulgar, with a little more than common refinement, he was numbered among the gods. After him his two sons, Podalirius and Machaon, who followed Agamemnon as leader to the Trojan War, gave no inconsiderable help to their comrades. Homer stated, however, not that they gave any aid in the pestilence or in the various sorts of diseases, but only that they relieved wounds by the knife and by medicaments. Hence it appears that by them those parts only of the Art were attempted, and that they were the oldest. From the same authority, indeed, it can be learned that diseases were then ascribed to the anger of the immortal gods, and from them help used to be sought; and it is probable that with no aids against bad health, none the less health was generally good because of good habits, which neither indolence nor luxury had vitiated: since it is these two which have afflicted the bodies of men, first in Greece, and later amongst us; and hence this complex Art of Medicine, not needed in former times, nor among other nations even now, scarcely protracts the lives of a few of us to the verge of old age.

> Latin: pr. Vt alimenta sanis corporibus agricultura, sic sanitatem aegris MEDICINA promittit. Haec nusquam quidem non est, siquidem etiam inperitissimae gentes herbas aliaque promta in auxilium uulnerum morborumque nouerunt. Verum tamen apud Graecos aliquanto magis quam in ceteris nationibus exculta est, ac ne apud hos quidem a prima origine, sed paucis ante nos saeculis. Vt pote cum uetustissimus auctor Aesculapius celebretur, qui quoniam adhuc rudem et uulgarem hanc scientiam paulo subtilius excoluit, in deorum numerum receptus est. Huius deinde duo filii Podalirius et Machaon bello Troiano ducem Agamemnonem secuti non mediocrem opem commilitonibus suis attulerunt; quos tamen Homerus non in pestilentia neque in uariis generibus morborum aliquid adtulisse auxilii, sed uulneribus tantummodo ferro et medicamentis mederi solitos esse proposuit. Ex quo apparet has partes medicinae solas ab is esse te⟨m⟩tatas, easque esse uetustissimas. Eodem uero auctore disci potest morbos tum ad iram deorum inmortalium relatos esse, et ab isdem opem posci solitam uerique simile est inter * nulla auxilia aduersae ualetudinis, plerumque tamen eam bonam contigisse ob bonos mores, quos neque desidia neque luxuria uitiarant; siquidem haec duo corpora prius in Graecia, deinde apud nos adflixerunt ideoque multiplex ista medicina, neque olim neque apud alias gentes necessaria, uix aliquos ex nobis ad senectutis principia perducit.

[¶1] Therefore even after these I have mentioned, no distinguished men practised the Art of Medicine until literary studies began to be pursued with more attention, which more than anything else are a necessity for the spirit, but at the same time are bad for the body. At first the science of healing was held to be part of philosophy, so that treatment of disease and contemplation of the nature of things began through the same authorities; clearly because healing was needed especially by those whose bodily strength had been weakened by restless thinking and night-watching. Hence we find that many who professed philosophy became expert in medicine, the most celebrated being Pythagoras, Empedocles and Democritus. But it was, as some believe, a pupil of the last, Hippocrates of Cos, a man first and foremost worthy to be remembered, notable both for professional skill and for eloquence, who separated this branch of learning from the study of philosophy. After him Diocles of Carystus, next Praxagoras and Chrysippus, then Herophilus and Erasistratus, so practised this art that they made advances even towards various methods of treatment.

> Latin: Ergo etiam post eos, de quibus re⟨t⟩tuli, nulli clari uiri medicinam exercuerunt, donec maiore studio litterarum disciplina agitari coepit; quae ut animo praecipue omnium necessaria, sic corpori inimica est. Primoque medendi scientia sapientiae pars habebatur, ut et morborum curatio et rerum naturae contemplatio sub isdem auctoribus nata sit: scilicet is hanc maxime requirentibus, qui corporum suorum robora quieta cogitatione nocturnaque uigilia minuerant. Ideoque multos ex sapientiae professoribus peritos eius fuisse accipimus, clarissimos uero ex is Pythagoran et Enpedoclen et Democritum. Huius autem, ut quidam crediderunt, discipulus Hippocrates Cous, primus ex omnibus memoria dignus, a studio sapientiae disciplinam hanc separauit, uir et arte et facundia insignis.

[¶2] During the same times the Art of Medicine was divided into three parts: one being that which cures through diet, another through medicaments, and the third by hand. The Greeks termed the first Διαιτητικήν, the second Φαρμακευτικήν, the third Χειρουργίαν. But of that part which cured diseases by diet those who were by far the most famous authorities, endeavouring to go more deeply into things, claimed for themselves also a knowledge of nature, without which it seemed that the Art of Medicine would be stunted and weak. After them first of all Serapion, declaring that this kind of reasoning method was in no way pertinent to Medicine, based it only upon practice and upon experience. To him followed Apollonius and Glaucias, and somewhat later Heraclides of Tarentum, and other men of no small note, who in accordance with what they professed called themselves Empirici (or Experimentalists). Thus this Art of Medicine which treats by diet was also divided into two parts, some claiming an Art based upon speculation, others on practice alone. But after those mentioned above no one troubled about anything except what tradition had handed down to him until Asclepiades changed in large measure the way of curing. Of his successors, Themison, late in life, diverged from Asclepiades in some respects. And it is through these men in particular that this health-giving profession of ours has grown up.

> Latin: Post quem Diocles Carystius, deinde Praxagoras et Chrysippus, tum Herophilus et Erasistratus sic artem hanc exercuerunt, ut etiam in diuersas curandi uias processerint. Isdemque temporibus in tres partes medicina diducta est, ut una esset quae uictu, altera quae medicamentis, tertia quae manu mederetur. Primam ΔΙΑΙΤΗΤΙΚΗΝ secundam ΦΑΡΜΑΚΕΥΤΙΚΗΝ tertiam ΧΕΙΡΟΥΡΓΙΑΝ Graeci nominarunt. Eius autem, quae uictu morbos curat, longe clarissimi auctores etiam altius quaedam agitare conati, rerum quoque naturae sibi cognitionem uindicarunt, tamquam sine ea trunca et debilis medicina esset. Post quos Serapion, primus omnium nihil hanc rationalem disciplinam pertinere ad medicinam professus, in usu tantum et experimentis eam posuit. Quem Apollonius et Glaucias et aliquanto post Heraclides Tarentinus et aliqui non mediocres uiri secuti ex ipsa professione se empiricos appellauerunt. Sic in duas partes ea quoque, quae uictu curat, medicina diuisa est, aliis rationalem artem, aliis usum tantum sibi uindicantibus, nullo uero quicquam post eos, qui supra comprehensi sunt, agitante, nisi quod acceperat, donec Asclepiades medendi rationem ex magna parte mutauit.

[¶3] Since of the divisions of the Art of Medicine, the one which heals diseases, as it is the most difficult, is also the most famous, we must speak about it first. And because there is a primary difference of opinion, so holding that the sole knowledge necessary is derived from experience, others propounding that practice is not efficient enough except after acquiring a reasoned knowledge of human bodies and of nature, I must indicate which are the principal statements on either side, so that I may the more easily interpose my own opinion also.

> Latin: Ex cuius successoribus Themison nuper ipse quoque quaedam in senectute deflexit. Et per hos quidem maxime uiros salutaris ista nobis professio increuit. Quoniam autem ex [tribus] medicinae partibus ut difficillima, sic etiam clarissima est ea, quae morbis medetur, ante omnia de hac dicendum est.

[¶4] They, then, who profess a reasoned theory of medicine propound as requisites, first, a knowledge of hidden causes involving diseases, next, of evident causes, after these of natural actions also, and lastly of the internal parts.

> Latin: Et quia prima in e⟨o⟩ dissensio est, quod alii sibi experimentorum tantummodo notitiam necessariam esse contendunt, alii nisi corporum rerumque ratione comperta non satis potentem usum esse proponunt, indicandum est, quae maxime ex utraque parte dicantur, quo facilius nostra quoque opinio interponi possit.

[¶5] They term hidden, the causes concerning which inquiry is made into the principles composing our bodies, what makes for and what against health. For they believe it impossible for one who is ignorant of the origin of diseases to learn how to treat them suitably. They say that it does not admit of doubt that there is need for differences in treatment, if, as certain of the professors of philosophy have stated, some excess, or some deficiency, among the four elements, creates adverse health; or, if all the fault is in the humours, as was the view of Herophilus; or in the breath, according to Hippocrates; or if blood is transfused into those blood-vessels which are fitted for pneuma, and excites inflammation which the Greeks term φλεγμόνην, and that inflammation effects such a disturbance as there is in fever, which was taught by Erasistratus; or if little bodies by being brought to a standstill in passing through invisible pores block the passage, as Asclepiades contended — his will be the right way of treatment, who has not failed to see the primary origin of the cause. They do not deny that experience is also necessary; but they say it is impossible to arrive at what should be done unless through some course of reasoning. For the older men, they say, did not cram the sick anyhow, but reasoned out what might be especially suitable, and then put to the test of experience what conjecture of a sort had previously led up to. Again they say that it makes no matter whether by now most remedies have been well explored already... if, nevertheless, they started from a reasoned theory; and that in fact this has also been done in many instances. Frequently, too, novel classes of disease occur about which hitherto practice has disclosed nothing, and so it is necessary to consider how such have commenced, without which no one among mortals can possibly find out whether this rather than that remedy should be used; this is the reason why they investigate the occult causes.

> Latin: Igitur ii, qui RATIONALEM medicinam profitentur, haec necessaria esse proponunt: abditarum et morbos continentium causarum notitiam, deinde euidentium; post haec etiam naturalium actionum, nouissime partium interiorum. Abditas causas uocant, in quibus requiritur, ex quibus principiis nostra corpora sint, quid secundam, quid aduersam ualetudinem faciat. Neque enim credunt posse eum scire, quomodo morbos curare conueniat, qui unde sint ignoret; neque esse dubium quin alia curatione opus sit, si ex quattuor principiis uel superans aliquod uel deficiens aduersam ualetudinem creat, ut quidam ex sapientiae professoribus dixerunt: alia, si in umidis omne uitium est, ut Herophilo uisum est; alia, si in spiritu, ut Hippocrati; alia, si sanguis in eas uenas, quae spiritui accommodatae sunt, transfunditur et inflammationem, quam Graeci ΦΛΕΓΜΟΝΗΝ nominant, excitat, eaque inflammatio talem motum efficit, qualis in febre est, ut Erasistrato placuit; alia, si manantia corpuscula per inuisibilia foramina subsistendo iter claudunt, ut Asclepiades contendit: eum uero recte curaturum, quem prima origo causae non fefellerit. Neque uero infitiantur experimenta quoque esse necessaria, sed ne ad haec quidem aditum fieri potuisse nisi ab aliqua ratione contendunt: non enim quidlibet antiquiores uiros aegris inculcasse, sed cogitasse quid maxime conueniret, et id usu explorasse, ad quod ante coniectura aliqua duxisset. Neque interesse, an nunc iam pleraque explorata sint * * *, si a consilio tamen coeperunt. Et id quidem in multis ita se habere.

[¶6] But they call evident those causes, concerning which they inquire, as to whether heat or cold, hunger or surfeit, or such like, has brought about the commencement of the disease; for they say that he will be the one to counter the malady who is not ignorant of its origin.

> Latin: Saepe uero etiam noua incidere genera morborum, in quibus nihil adhuc usus ostenderit et ideo necessarium sit animaduertere, unde ea coeperi⟨n⟩t; sine quo nemo reperire mortalium possit, cur hoc quam illo potius utatur. Et ob haec quidem in obscuro positas causas persecuntur.

[¶7] Further, they term natural actions of the body, those by which we draw in and emit breath, take in and digest food and drink, as also those actions through which food and drink are distributed into every part of the members. Moreover, they also inquire why our blood-vessels now subside, now swell up; what is the explanation of sleep and wakefulness: for without knowledge of these they hold that no one can encounter or remedy the diseases which spring up in connexion with them. Among these natural actions digestion seems of most importance, so they give it their chief attention. Some following Erasistratus hold that in the belly the food is ground up; others, following Plistonicus, a pupil of Praxagoras, that it putrefies; others believe with Hippocrates, that food is cooked up by heat. In addition there are the followers of Asclepiades, who propound that all such notions are vain and superfluous, that there is no concoction at all, but that material is transmitted through the body, crude as swallowed. And on these points there is little agreement indeed among them; but what does follow is that a different food is to be given to patients according as this or that view is true. For if it is ground up inside, that food should be selected which can be ground up the most readily; if it putrefies, that which does so most expeditiously; if heat concocts it, that which most excites heat. But none of these points need be inquired into if there be no concoction but such things be taken which persist most in the state in which they were when swallowed. In the same way, when breathing is laboured, when sleep or wakefulness disturbs, they deem him able to remedy it who had understood beforehand how these same natural actions happen.

> Latin: Euidentes uero has appellant, in quibus quaerunt, initium morbi calor attulerit an frigus, fames an satietas, et quae similia sunt: occursurum enim uitio dicunt eum, qui originem non ignorarit. Naturales uero corporis actiones appellant, per quas spiritum trahimus et emittimus, cibum potionemque et adsumimus et concoquimus, itemque per quas eadem haec in omnes membrorum partes digeruntur. Tum requirunt etiam, quare uenae nostrae modo summittant se, modo attollant; quae ratio somni, quae uigiliae sit; sine quorum notitia neminem putant uel occurrere uel mederi morbis inter haec nascentibus posse. Ex quibus quia maxime pertinere ad rem concoctio uidetur, huic potissimum insistunt; et duce alii Erasistrato teri cibum in uentre contendunt, alii Plistonico Praxagorae discipulo putrescere; alii credunt Hippocrati per calorem cibos concoqui; acceduntque Asclepiadis aemuli, qui omnia ista uana et superuacua esse proponunt: nihil enim concoqui, sed crudam materiam, sicut adsumpta est, in corpus omne diduci. Et haec quidem inter eos parum constant: illud uero conuenit, alium dandum cibum laborantibus, si hoc, alium, si illud uerum est: nam si teritur intus, eum quaerendum esse, qui facillime teri possit; si putrescit, eum, in quo hoc expeditissimum est; si calor concoquit, eum, qui maxime calorem mouet: at nihil ex his esse quaerendum, si nihil concoquitur, ea uero sumenda, quae maxime manent, qualia adsumpta sunt.

[¶8] Moreover, as pains, and also various kinds of diseases, arise in the more internal parts, they hold that no one can apply remedies for these who is ignorant about the parts themselves; hence it becomes necessary to lay open the bodies of the dead and to scrutinize their viscera and intestines. They hold that Herophilus did this in the best way by far, when they laid open men whilst alive — criminals received out of prison from the kings — and while these were still breathing, observed parts which beforehand nature had concealed, their position, colour, shape, size, arrangement, hardness, softness, smoothness, relation, processes and depressions of each, and whether any part is inserted into or is received into another. For when pain occurs internally, neither is it possible for one to learn what hurts the patient, unless he had acquainted himself with the position of each organ or intestine; nor can a diseased portion of the body be treated by one who does not know what that portion is. When a man's viscera are exposed in a wound, he who is ignorant of the colour of a part in health may be unable to recognize which part is intact, and which part damaged; thus he cannot even relieve the damaged part. External remedies too can be applied more aptly by one acquainted with the position, shape and size of the internal organs, and like reasonings hold good in all the instances mentioned above. Nor is it, as most people say, cruel that in the execution of criminals, and but a few of them, we should seek remedies for innocent people of all future ages.

> Latin: Eademque ratione, cum spiritus grauis est, cum somnus aut uigilia urguet, eum mederi posse arbitrantur, qui prius illa ipsa qualiter eueniant perceperit. Praeter haec, cum in interioribus partibus et dolores et morborum uaria genera nascantur, neminem putant his adhibere posse remedia, qui ipsa⟨s⟩ ignoret. Ergo necessarium esse incidere corpora mortuorum, eorumque uiscera atque intestina scrutari; longeque optime fecisse Herophilum et Erasistratum, qui nocentes homines a regibus ex carcere acceptos uiuos inciderint, considerarintque etiamnum spiritu remanente ea, quae natura ante clausisset, eorumque positum, colorem, figuram, magnitudinem, ordinem, duritiem, mollitiem, l⟨e⟩uorem, contactum, processus deinde singulorum et recessus, et siue quid inseritur alteri, siue quid partem alterius in se recipit: neque enim, cum dolor intus incidit, scire quid doleat eum, qui, qua parte quo⟨d⟩que uiscus intestinumue sit, non cognouerit neque curari id, quod aegrum est, posse ab eo, qui quid sit ignoret; et cum per uolnus alicuius uiscera patefacta sunt, eum, qui sanae cuiusque colorem partis ignoret, nescire quid integrum, quid corruptum sit; ita ne succurrere quidem posse corruptis.

[¶9] On the other hand, those who are called "Empirici" because they have experience, do indeed accept evident causes as necessary; but they contend that inquiry about obscure causes and natural actions is superfluous, because nature is not to be comprehended. That nature cannot be comprehended is in fact patent, they say, from the disagreement among those who discuss such matters; for on this question there is no agreement, either among professors of philosophy or among actual medical practitioners. Why, then, should anyone believe rather in Hippocrates than in Herophilus, why in him rather than in Asclepiades? If one wants to be guided by reasoning, they go on, the reasoning of all of them can appear not improbable; if by method of treatment, all of them have restored sick folk to health: therefore one ought not to derogate from anyone's credit, either in argument or in authority. Even philosophers would have become the greatest of medical practitioners, if reasoning from theory could have made them so; as it is, they have words in plenty, and no knowledge of healing at all. They also say that the methods of practice differ according to the nature of localities, and that one method is required in Rome, another in Egypt, another in Gaul; but that if the causes which produce diseases whether everywhere the same, the same remedies should be used everywhere; that often, too, the causes are apparent, as, for example, of ophthalmia, or of wounds, yet such causes do not disclose the treatment: that if the evident cause does not supply the knowledge, much less can a cause which is in doubt yield it. Since, therefore, the cause is as uncertain as it is incomprehensible, protection is to be sought rather from the ascertained and explored, as in all the rest of the Arts, that is, from what experience has taught in the actual course of treatment: for even a farmer, or a pilot, is made not by disputation but by practice. That such speculations are not pertinent to the Art of Medicine may be learned from the fact that men may hold different opinions on these matters, yet conduct their patients to recovery all the same. This has happened, not because they deduced lines of healing from obscure causes, nor from the natural actions, concerning which different opinions were held, but from experiences of what had previously succeeded. Even in its beginnings, they add, the Art of Medicine was not deduced from such questionings, but from experience; for of the sick who were without doctors, some in the first days of illness, longing for food, took it forthwith; others, owing to distaste, abstained; and the illness was more alleviated in those who abstained. Again, some partook of food whilst actually under the fever, some a little before, others after its remission, and it went best with those who did so after the fever had ended; and similarly some at the beginning adopted at once a rather full diet, others a scanty one, and those were made worse who had eaten plentifully. When this and the like happened day after day, careful men noted what generally answered the better, and then began to prescribe the same for their patients. Thus sprang up the Art of Medicine, which, from the frequent recovery of some and the death of others, distinguished between the pernicious and the salutary.

> Latin: Aptiusque extrinsecus inponi remedia conpertis interiorum et sedibus et figuris cognitaque eorum magnitudine; similesque omnia, quae posita ⟨supra⟩ sunt, rationes habere. Neque esse crudele, sicut plerique proponunt, hominum nocentium et horum quoque paucorum suppliciis remedia populis innocentibus saeculorum omnium quaeri. Contra ii, qui se ENPIRICOS ab experientia nominant, euidentes quidem causas ut necessarias amplectuntur: obscurarum uero causarum et naturalium actionum quaestionem ideo superuacuam esse contendunt, quoniam non conprehensibilis natura sit. Non posse uero conprehendi patere ex eorum, qui de his disputarunt, discordia, cum de ista re neque inter sapientiae professores, neque inter ipsos medicos conueniat. Cur enim potius aliquis Hippocrati credat quam Herophilo? cur huic potius quam Asclepiadi? Si rationes sequi uelit, omnium posse uideri non inprobabiles; si curationes, ab omnibus his aegros perductos esse ad sanitatem. Ita neque disputationi neque auctoritati cuiusquam fidem derogari oportuisse. Etiam sapientiae studiosos maximos medicos esse, si ratiocinatio hoc faceret: nunc illis uerba superesse, deesse medendi scientiam. Differre quoque pro natura locorum genera medicinae, et aliud opus esse Romae, aliud in Aegypto, aliud in Gallia. Quod si morbos haec [causae] facerent, quae ubique eadem essent, eadem remedia quoque ubique esse debuisse. Saepe etiam causas apparere, ut puta lippitudinis, uulneris, neque ex his patere medicinam. Quod si scientiam hanc non subiciat euidens causa, multo minus eam posse subicere, quae in dubio est. Cum igitur illa incerta, inconprehensibilis sit, a certis potius et exploratis petendum esse praesidium, id est is, quae experientia in ipsis curationibus docuerit, sicut in ceteris omnibus artibus. Nam ne agricolam quidem aut gubernatorem disputatione sed usu fieri. Ac nihil istas cogitationes ad medicinam pertinere eo quoque disci, quod qui diuersa de his senserint, ad eandem tamen sanitatem homines perduxerint: id enim fecisse, quia non ab obscuris causis neque a naturalibus actionibus, quae apud eos diuersae erant, sed ab experimentis, prout cuique responderant, medendi uias traxerint. Ne inter initia quidem ab istis quaestionibus deductam esse medicinam, sed ab experimentis: aegrorum enim, qui sine medicis erant, alios propter auiditatem primis diebus protinus cibum adsumpsisse, alios propter fastidium abstinuisse; leuatumque magis eorum morbum esse, qui abstinuerant. Itemque alios in ipsa febre aliquid edisse, alios paulo ante eam, alios post remissionem eius; optime deinde iis cessisse, qui post finem febris id fecer⟨a⟩nt;

[¶10] It was afterwards, they proceed, when the remedies had already been discovered, that men began to discuss the reasons for them: the Art of Medicine was not a discovery following upon reasoning, but after the discovery of the remedy, the reason for it was sought out. They ask, too, does reasoning teach the same as experience? If the same, it was needless; if something else, then it was even opposed to it: nevertheless, at first remedies had to be explored with the greatest care; now, however, they have been explored already; there were neither new sorts of diseases to be found out, nor was a novel remedy wanted. For even if there happened nowadays some unknown form of malady, nevertheless the practitioner had not to theorize over obscure matters, but straightway would see to which disease it came nearest, then would make trial of remedies similar to those which have succeeded often in a kindred affection, and so through its similarities find help; that is not to say that a practitioner had no need to take counsel, and that an irrational animal was capable of exhibiting this art, but that these conjectures about concealed matters are of no concern because it does not matter what produces the disease but what relieves it; nor does it matter how digestion takes place, but what is best digested, whether concoction comes about from this cause or that, and whether the process is concoction or merely distribution. We had no need to inquire in what way we breathe, but what relieves laboured breathing; not what may move the blood-vessels, but what the various kinds of movements signify. All this was to be learnt through experiences; and in all theorizing over a subject it is possible to argue on either side, and so cleverness and fluency may get the best of it; it is not, however, by eloquence but by remedies that diseases are treated. A man of few words who learns by practice to discern well, would make an altogether better practitioner than he who, unpractised, over-cultivates his tongue.

> Latin: eademque ratione alios inter principia protinus usos esse cibo pleniore, alios exiguo; grauioresque eos factos, qui se implerant. Haec similiaque cum cottidie inciderent, diligentes homines notasse quae plerumque melius responderent; deinde aegrotantibus ea praecipere coepisse. Sic medicinam ortam, subinde aliorum salute, aliorum interitu perniciosa discernentem a salutaribus. Repertis deinde iam remediis, homines de rationibus eorum disserere coepisse; nec post rationem medicinam esse inuentam, sed post inuentam medicinam rationem esse quaesitam. Requirere etiam s⟨e⟩, ratio idem doceat quod experientia an aliud: si idem, superuacuam esse; si aliud, etiam contrariam. Primo tamen remedia exploranda summa cura fuisse; nunc uero iam explorata esse; neque aut noua genera morborum reperiri, aut nouam desiderari medicinam. Quod si iam incidat mali genus aliquod ignotum, non ideo tamen fore medico de rebus cogitandum obscuris, sed eum protinus uisurum cui morbo id proximum sit, temptaturumque remedia similia illis, quae uicino malo saepe succurrerint, et per eius similitudines opem reperturum. Neque enim se dicere medicum consilio non egere et inrationale animal hanc artem posse praestare; sed has latentium rerum coniecturas ad rem non pertinere, quia non intersit, quid morbum faciat, sed quid tollat; neque ad rem pertineat, quomodo, sed quid optime digeratur, siue hac de causa concoctio incidat siue illa, et siue concoctio sit illa siue tantum digestio. Neque quaerendum esse quomodo spiremus, sed quid grauem et tardum spiritum expediat; neque quid uenas moueat, sed quid quaeque motus genera significent.

[¶11] Now the matters just referred to they deem to be superfluous; but what remains, cruel as well, to cut into the belly and chest of men whilst still alive, and to impose upon the Art which presides over human safety someone's death, and that too in the most atrocious way. Especially is this true when, of things which are sought for with so much violence, some can be learnt not at all, others can be learnt even without a crime. For when the body had been laid open, colour, smoothness, softness, hardness and all similars would not be such as they were when the body was untouched; because bodies, even when uninjured yet often change in appearance, they note, from fear, pain, want of food, indigestion, weariness and a thousand other mediocre affections; it is much more likely that the more internal parts, which are far softer, and to which the very light is something novel, should under the most severe of woundings, in fact mangling, undergo changes. Nor is anything more foolish, they say, than to suppose that whatever the condition of the part of a man's body in life, it will also be the same when he is dying, nay, when he is already dead; for the belly indeed, which is of less importance, can be laid open with the man still breathing; but as soon as the knife really penetrates to the chest, by cutting through the transverse septum, a sort of membrane which divides the upper from the lower parts (the Greeks call it dia/fragma), the man loses his life at once: so it is only when the man is dead that the chest and any of the viscera come into the view of the medical murderer, and they are necessarily those of a dead, not of a living man. It follows, therefore, that the medical man just plays the cut-throat, not that he learns what our viscera are like when we are alive. If, however, there be anything to be observed whilst a man is still breathing, chance often presents it to the view of those treating him. For sometimes a gladiator in the arena, or a soldier in battle, or a traveller who has been set upon by robbers, is so wounded that some or other interior part is exposed in one man or another. Thus, they say, an observant practitioner learns to recognize site, position, arrangement, shape and such like, not when slaughtering, but whilst striving for health; and he learns in the course of a work of mercy, what others would come to know by means of dire cruelty. That for these reasons, since most things are altered in the dead, some hold that even the dissection of the dead is unnecessary; although not cruel, it is none the less nasty; but all that is possible to come to know in the living, the actual treatment exhibits.

> Latin: Haec autem cognosci experimentis. Et in omnibus eiusmodi cogitationibus ⟨in⟩ utramque partem disseri posse; itaque ingenium et facundiam uincere, morbos autem non eloquentia sed remediis curari. Quae si quis elinguis usu discreta bene norit, hunc aliquanto maiorem medicum futurum, quam si sine usu linguam suam excoluerit. Atque ea quidem, de quibus est dictum, superuacua esse tantummodo: id uero, quod restat, etiam crudele, uiuorum hominum aluum atque praecordia incidi, et salutis humanae praesidem artem non solum pestem alicui, sed hanc etiam atrocissimam inferre; cum praesertim ex his, quae tanta violentia quaerantur, alia non possint omnino cognosci, alia possint etiam sine scelere. Nam colorem, l⟨e⟩uorem, mollitiem, duritiem, similiaque omnia non esse talia inciso corpore, qualia integro fuerint, quia, cum corpor⟨a⟩ inuiolata sint, haec tamen metu, dolore, inedia, cruditate, lassitudine, mille aliis mediocribus adfectibus saepe mutentur; multo magis ueri simile esse interiora, quibus maior mollities, lux ipsa noua sit, sub grauissimis uulneribus et ipsa trucidatione mutari. Neque quicquam esse stultius, quam quale quidque uiuo homine est, tale existimare esse moriente, immo iam mortuo. Nam uterum quidem, qui minus ad rem pertineat, spirante homine posse diduci: simul atque uero ferrum ad praecordia accessit et discissum transuersum saeptum est, quod membrana quaedam ⟨est quae⟩ superiores partes ab inferioribus ⟨di⟩ducit (ΔΙΑΦΡΑΓΜΑ Graeci uocant), hominem animam protinus amittere: ita mortui demum praecordia et uiscus omne in conspectum latrocinantis medici dari ut⟨ique⟩ necesse est tale, quale mortui sit, non quale uiui fuit. Itaque consequi medicum, ut hominem crudeliter iugulet, non ut sciat, qualia uiui uiscera habeamus. Si quid tamen sit, quod adhuc spirante homine conspectu subiciatur, id saepe casum offerre curantibus. Interdum enim gladiatorem in harena uel militem in acie uel uiatorem a latronibus exceptum sic uulnerari, ut eius interior aliqua pars aperiatur, et in alio alia;

[¶12] Since all these questions have been discussed often by practitioners, in many volumes and in large and contentious disputations, and the discussion continues, it remains to add such views as may seem nearest the truth. These are neither wholly in accord with one opinion or another, nor exceedingly at variance with both, but hold a sort of intermediate place between divers sentiments, a thing which may be observed in most controversies when men seek impartially for truth, as in the present case. For as regards the causes which either favour health or excite disease, how breath is drawn in or food distributed, not even philosophers attain to full knowledge, but seek it out by conjecture. But where there is no certain knowledge about a thing, mere opinion about it cannot find a certain remedy. And it is true that nothing adds more to a really rational treatment than experience. Although, therefore, many things, which are not strictly pertinent to the Arts as such, are yet helpful by stimulating the minds of those who practise them, so also this contemplation of the nature of things, although it does not make a practitioner, yet renders him more apt and perfected in the Art of Medicine. And it is probable that Hippocrates, Erasistratus and certain others, who were not content to busy themselves over fevers and ulcerations, but also to some extent searched into the nature of things, did not by this become practitioners, but by this became better practitioners. But reasoning is necessary to the Art of Medicine, not only when dealing with obscure causes, or natural actions, but often... for it is an art based on conjecture. However, in many cases not only does conjecture fail, but experience as well; and at times, neither fever, nor appetite, nor sleep follow their customary course. More rarely, yet now and again, a disease itself is new. That this does not happen is manifestly untrue, for in our time a lady, from whose genitals flesh had prolapsed and become gangrenous, died in the course of a few hours, whilst practitioners of the highest standing found out neither the class of malady nor a remedy. I conclude that they attempted nothing because no one was willing to risk a conjecture of his own in the case of a distinguished personage, for fear that he might seem to have killed, if he did not save her; yet it is probable that something might possibly have been thought of, had no such timidity prevailed, and perchance this might have been successful had one but tried it. In this sort of practice similarity is not always of service, and when it does prove serviceable, nevertheless there has been a process of reasoning, in the theorizing over similar classes of diseases and of remedies, as to which is the best remedy to use. When, therefore, such an incident occurs, the practitioner ought to arrive at something which may answer, even if perhaps not always, yet nevertheless more often than not. He will see, however, every novel plan, not from hidden things, for these are dubious and unascertainable, but from those which can be explored, that is, from evident causes. For what matters is this: whether fatigue or thirst, whether heat or cold, whether wakefulness or hunger, whether abundance in food or wine, whether intemperance in venery, has produced the disease. Nor should there be ignorance of the sick man's temperament; whether his body is rather humid or rather dry, whether his sinews are strong or weak, whether he is frequently or rarely ill; and when ill whether so severely or slightly, for a short or long while; the kind of life he has lived, laborious or quiet, accompanied by luxury or frugality. From such and similar data, one may often deduce a novel mode of treatment.

> Latin: ita sedem, positum, ordinem, figuram, similiaque alia cognoscere prudentem medicum, non caedem sed sanitatem molientem, idque per misericordiam discere, quod alii dira crudelitate cognorint. Ob haec ne mortuorum quidem lacerationem necessariam esse (quae etsi non crudelis, tamen foeda sit), cum aliter pleraque in mortuis se habeant; quantum uero in uiuis cognosci potest, ipsa curatio ostendat. Cum haec per multa uolumina perque magnas contentionis [disputationes] a medicis saepe tractata sint atque tractentur, subiciendum est, quae proxima uero uideri possint. Ea neque addicta alterutri opinioni sunt, neque ab utraque nimium abhorrentia, ⟨sed⟩ media quodammodo inter diuersas sententias; quod in plurimis contentionibus deprehendere licet sine ambitione uerum scrutantibus: ut in hac ipsa re. Nam quae demum causae uel secundam ualetudinem praestent, uel morbos excitent, quo modo spiritus aut cibus uel trahatur uel digeratur, ne sapientiae quidem professores scientia conprehendunt, sed coniectura persecuntur. Cuius autem rei non est certa notitia, eius opinio certum reperire remedium non potest. Verumque est ad ipsam curandi rationem nihil plus conferre quam experientiam. Quamquam igitur multa sint ad ipsas artes proprie non pertinentia, tamen eas adiuuant excitando artificis ingenium: itaque ista quoque naturae rerum contemplatio, quamuis non faciat medicum, aptiorem tamen medicinae reddit perfectumque. Veri⟨que⟩ simile est et Hippocraten et Erasistratum, et quicumque alii non contenti [sint] febres et ulcera agitare rerum quoque naturam aliqua parte scrutati sunt, non ideo quidem medicos fuisse, uerum id⟨eo⟩ quoque maiores medicos extitisse. Ratione uero opus est ipsi medicinae, etsi non inter obscuras causas neque inter naturales actiones, tamen saepe * *: est enim haec ars coniecturalis. Neque respondet ei plerumque non solum coniectura sed etiam experientia et interdum non febris, non †cibus, non somnus subsequitur, sicut adsueuit. Rarius sed aliquando morbus quoque ipse nouus est: quem non incidere manifeste falsum est, cum aetate nostra * * * quae ex naturalibus partibus carne prolapsa et arente intra paucas horas exspirauerit, sic ut nobilissimi medici neque genus mali neque remedium inuenerint. Quos ego nihil temptasse iudico, quia nemo in splendida persona periclitari coniectura sua uoluerit, ne occidisse, nisi seruasset, uideretur: ueri tamen simile est potuisse aliquid cogitare, detracta tali uerecundia, et fortasse responsurum fuisse id, quod aliquis esset expertus. Ad quod medicinae genus neque semper similitudo aliquid confert, et si quando confert, tamen id ipsum rationale est, inter similia genera et morborum et remediorum cogitare, quo potissimum medicamento sit utendum. Cum igitur talis res incidit, medicus aliquid oportet inueniat, quod non utique fortasse sed saepius tamen etiam respondeat. Petet autem nouum quodque consilium non ab rebus latentibus (istae enim dubiae et incertae sunt), sed ab iis, quae explorari possunt, id est euidentibus causis.

## 2. Book I · preface, chapters 1–3

Source: https://scriptura.si/works/celsus-on-medicine/2/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/2/#p-N

[¶0] None the less the foregoing statements ought not to be passed by as if they did not admit of controversy. For Erasistratus himself has affirmed that diseases were not produced by such causes, since other persons, and even the same person at different times, were not rendered feverish by them. Further, certain practitioners of our time, following, as they would have it appear, the authority of Themison, contend that there is no cause whatever, the knowledge of which has any bearing on treatment: they hold that it is sufficient to observe certain general characteristics of diseases; that of these there are three classes, one a constriction, another a flux, the third a mixture. For the sick at one time excrete too little, at another time too much; again, from one part too little, from another too much; and these classes of diseases are sometimes acute, sometimes chronic, at times on the increase, at times constant, at times diminishing. Once it has been recognized, then, which it is of these, if the body is constricted, it has to be relaxed; if suffering from a flux, that has to be controlled; if a mixed lesion, the more severe malady must be countered first. Moreover, there must be treatment of one kind for acute diseases, another kind for chronic ones, another for increasing, stationary, or for those already tending to recovery. They hold that the Art of Medicine consists of such observations; which they define as a sort of way, which they name μέθοδοσ, and maintain that medicine should examine those characteristics which diseases have in common. They do not want to be classed with reasoners from theory, nor with those who look to experience only; for in so naming themselves Methodici, they dissent from the former because they are unwilling that the Art should consist in conjecture about hidden things, and from the latter because they think that in the observation of experience there is little of an Art of Medicine.

> Latin: Interest enim fatigatio morbum an sitis, an frigus an calor, an uigilia an fames fecerit, an cibi uinique abundantia, an intemperantia libidinis. Neque ignorare hunc oportet, quae sit aegri natura, umidum magis an magis siccum corpus eius sit, ualidi nerui an infirmi, frequens aduersa ualetudo an rara, eaque, cum est, uehemens esse soleat an leuis, breuis an longa; quod is uitae genus sit secutus, laboriosum an quietum, cum luxu an cum frugalitate: ex his enim similibusque saepe curandi noua ratio ducenda est. Quamuis ne haec quidem sic praeteriri debent, quasi nullam controuersiam recipiant. Nam et Erasistratus non ex illis ⟨causis⟩ fieri morbos dixit, quoniam et alii et idem alias post istas non febricitarent; et quidam medici saeculi nostri sub auctore, ut ipsi uideri uolunt, Themisone contendunt nullius causae notitiam quicquam ad curationes pertinere; satisque esse quaedam communia morborum intueri. Siquidem horum tria genera esse, unum adstrictum, alterum fluens, tertium mixtum. Nam modo parum excernere aegros, modo nimium, modo alia parte parum, alia nimium: haec autem genera morborum modo acuta esse, modo longa, et modo increscere, modo consistere, modo minui. Cognito igitur eo, quod ex his est, si corpus adstrictum est, digerendum esse; si profluuio laborat, continendum; si mixtum uitium habet, occurrendum subinde uehementiori malo. Et aliter acutis morbis medendum, aliter uetustis, aliter increscentibus, aliter subsistentibus, aliter iam ad sanitatem inclinatis. Horum obseruationem medicinam esse;

[¶1] As relates to Erasistratus, in the first place the actual evidence is against his opinion, because seldom does a disease occur unless following upon one of these; secondly, it does not follow that what has done no harm to one patient, or to that same patient upon one occasion, may not harm another patient, or the same one at another time. For it is possible that there are certain underlying conditions in the body, whether related to infirmity, or to an actual affection of some kind, which either are not present in another person, or were not existent in that patient on another occasion, and which of themselves are not enough to constitute a disease, yet they may render the body more liable to other injurious affections. But if Erasistratus had been sufficiently versed in the study of the nature of things, as those practitioners rashly claim themselves to be, he would have known also that nothing is due to one cause alone, but that which is taken to be the cause is that which seems to have had the most influence. Indeed it is possible that when one cause acts alone, it may not disturb, yet when acting in conjunction with other causes it may produce a very great disturbance. Moreover, even Erasistratus himself, who says that fever is produced by blood transfused into the arteries, and that this happens in an over-replete body, failed to discover why, of two equally replete persons, one should lapse into disease, and the other remain free from anything dangerous; and that clearly happens every day. Hence, however true this transfusion, one can learn that it does not occur of itself when there is bodily fullness, but when there is added something else.

> Latin: quam ita finiunt, ut quasi uiam quandam quam ΜΕΘΟΔΟΝ nominant, eorumque, quae in morbis communia sunt, contemplatricem esse contendant. Ac neque rationalibus se neque experimenta tantum spectantibus adnumerari uolunt, cum ab illis eo nomine dissentiant, quod in coniectura rerum latentium nolunt esse medicinam; ab his eo, quod parum artis esse in obseruatione experimentorum credunt. Quod ad Erasistratum pertinet, primum ipsa euidentia eius opinioni repugnat * * quia raro nisi post horum aliquid morbus uenit; deinde non sequitur, ut, quod alium non adficit aut eundem alias, id ne alteri quidem aut eidem tempore alio noceat. Possunt enim quaedam subesse corpori uel ex infirmitate eius uel ex aliquo adfectu, quae uel in alio non sunt, uel in hoc alias non fuerunt eaque per se non tanta, u⟨t⟩ concitent morbum, tamen obnoxium magis aliis iniuriis corpus effici⟨a⟩nt. Quod si contemplationem rerum naturae, quam temere medici ⟨isti⟩ sibi uindicant, satis conprehendisset, etiam illud scisset, nihil omnino ob unam causam fieri, sed id pro causa adprehendi, quod contulisse plurimum uidetur. Potest autem id, dum solum est, non mouere, quod iunctum aliis maxime moueat. Accedit ad haec, quod ne ipse quidem Erasistratus, qui transfuso in arterias sanguine febrem fieri dicit idque nimis repleto corpore incidere, repperit, cur ex duobus aeque repletis alter in morbum incideret, alter omni periculo uacaret;

[¶2] But disciples of Themison, if they hold their precepts to be of constant validity, are reasoners even more than anybody else; for if a man des not hold all the tenets that another reasoner approves, he does not forthwith have to assume a different name for his art, if (and this is the essential point) he does rely not only on written authority, but also upon reasoning from theory. But if, which is nearer to the truth, the Art of Medicine admits of scarcely any universal precepts, reasoners are in the same position as those who depend upon experience alone, all the more because whether the disease has braced or relaxed is what the most uninstructed can see. But if a remedy which loosens a body braced up, or tightens a loosened body, has been deduced by a reasoning from theory, the practitioner is a reasoner; if (as the man who denies himself to be a reasoner must admit) he acts from experience, he is an Empiric. Thus according to Themison, knowledge of a disease is outside the Art, and medicine is confined to practice; nor has there been added anything to what Empirics profess, but something taken away; for reasoners from theory gaze about over a multiplicity of matters, Empirics look to circumstances the most simple, and nothing more than commonplaces. For in like manner those who treat cattle and horses, since it is impossible to learn from dumb animals particulars of their complaints, depend only upon common characteristics; so also do foreigners as they are ignorant of reasoning subtleties look rather to common characteristics of disease. Again, those who take charge of large hospitals, because they cannot pay full attention to individuals, resort to these common characteristics. I vow, the ancients knew all this, but were not content therewith; therefore even the oldest authority, Hippocrates, said that in healing it was necessary to take note both of common and of particular characteristics. Indeed these very Methodici, even within their professed limitations, cannot be consistent; for there are divers kinds of constricting and relaxing diseases, those in which there is a flux being the more easy to observe. For it is one thing to vomit blood, another bile, another food; it is one thing to suffer from diarrhoea, another from dysentery; one thing to be relaxed through sweating, another to be wasted by consumption. Humour may break out into particular parts, such as the eyes or the ears; from a risk of this kind there is no human member free. No one of these occurrences is treated in the same way as another.

> Latin: quod cotidie fieri apparet. Ex quo disci potest, ut uera sit illa transfusio, tamen illam non per se, cum plenum corpus est, fieri, sed cum horum aliquid accesserit. Themisonis uero aemuli, si perpetua quae promittunt habent, magis etiam quam ulli rationales sunt. Neque enim, si quis non omnia tenet, quae rationalis alius probat, protinus alio [nouo] nomine artis indiget, si modo, (quod primum est,) non memoriae soli sed rationi quoque insistit. Si, uero quod propius est, uix ulla perpetua praecepta medicinalis ars recipit, idem sunt quod ii, quos experimenta sola sustinent; eo magis quoniam, conpresserit aliquem morbus an fuderit, quilibet etiam inperitissimus uidet: quid autem conpressum corpus resoluat, quid solutum teneat, si a ratione tractum est, rationalis est medicus; si, ⟨ut⟩ ei, qui se rationalem negat, confiteri necesse est, ab experientia, empericus. Ita apud eum morbi cognitio extra artem, medicina intra usum est; neque adiectum quicquam empericorum professioni, sed demptum est, quoniam illi multa circumspiciunt, hi tantum facillima, et non plus quam uulgaria. Nam et ii, qui pecoribus ac iumentis medentur, cum propria cuiusque ex mutis animalibus nosse non possint, communibus tantummodo insistunt; et exterae gentes, cum suptilem medicinae rationem non nouerint, communia tantum uident; et qui ampla ualetudinaria nutriunt, quia singulis summa cura consulere non sustinent, ad communia ista confugiunt. Neque Hercules istud antiqui medici nescierunt, sed his contenti non fuerunt. Ergo etiam uetustissimus auctor Hippocrates dixit mederi oportere et communia ⟨et⟩ propria intuentem. Ac ne isti quidem ipsi intra suam professionem consistere ullo modo possunt: siquidem et conpressorum et fluentium morborum genera diuersa sunt; faciliusque id in iis, quae fluunt, inspici potest. Aliud est enim sanguinem, aliud bilem, aliud cibum uomere; aliud deiectionibus, aliud torminibus laborare; aliud sudore digeri, aliud tabe consumi.

[¶3] Hence the Art descends straight down from a consideration of the common characteristics of a flux to the particular case. Moreover, because the same remedies do not meet with success in all, even of similar cases, additional knowledge of peculiarities in such a case is often necessary. Although certain things act upon the bowels in most cases, whether as astringents or as laxatives, yet there are to be found some in whom the same thing acts differently than it does in others. In such instances, therefore, investigation of particular characteristics is salutary, that of common characteristics the reverse. Moreover, a reckoning up of the cause often solves the malady. Thus Cassius, the most ingenious practitioner of our generation, recently dead, in a case suffering from fever and great thirst, when he learnt that the man had begun to feel oppressed after intoxication, administered cold water, by which draught, when by the admixture he had broken the force of the wine, he forthwith dispersed the fever by means of a sleep and a sweat. He, as a practitioner, provided an opportune remedy, not out of consideration whether the man's body was constricted or relaxed, but from what had happened beforehand to cause it. Besides, according to these very authorities there are particulars relating to locality and to season. When they are discussing what should be done by men in health, they prescribe the avoidance of cold, heat, surfeit, fatigue, venery, especially in sickly localities and seasons; in such places and seasons rest is to be taken, particularly when one feels a sense of oppression, and neither the stomach is to be disturbed by an emetic, nor the bowels by a purge. Such generalities are indeed true: none the less they descend from them to certain particular characteristics, unless they would persuade us that climate and season are to be taken into consideration by those in health but not by the sick, the very persons in whom all such observance is by so much the more necessary, the more that their weakness is liable to all attacks. Nay, even in the same patient, the particular characteristics of a disease are very various, and those who have been treated for a time in vain by the ordinary remedies have been often restored by contrary ones. And in the giving food too there are many distinctions to be noted; I will content myself with one instance. For hunger is more easily borne by an adult than by a boy, more easily in a dense than in a thin atmosphere, more easily in winter than in summer, more easily by one accustomed to a single meal than by one used in addition to one at midday, more easily when sedentary than when in active exercise; and often it is necessary to hurry on the meal in the case of one who is intolerant of hunger. Hence I conjecture that he who is not acquainted with the peculiar characteristics has merely to consider the general ones; and he who can become acquainted with peculiarities, whilst insistent upon them, ought not to neglect generalities as well; and consequently, presuming their state to be equal, it is more useful to have in the practitioner a friend rather than a stranger.

> Latin: Atque in partes quoque umor erumpit, ut oculos aurisque; quo periculo nullum humanum membrum uacat. Nihil autem horum sic ut aliud curatur. Ita protinus in his a communi fluentis morbi contemplatione ad propriam medicin⟨a⟩ descendit. Atque in hac quoque rursus alia proprietatis notitia saepe necessaria est; quia non eadem omnibus etiam in similibus casibus opitulantur: siquidem certae qu⟨aeda⟩m res sunt, quae in pluribus uentrem aut adstringunt aut resoluunt. Inueniuntur tamen, in quibus aliter atque in ceteris idem eueniat: in his ergo communium inspectio contraria est, propriorum tantum salutaris. Et causae quoque aestimatio saepe morbum soluit. Ergo etiam ingeniosissimus saeculi nostri medicus, quem nuper uidimus, Cassius febricitanti cuidam et magna siti adfecto, cum post ebrietatem eum premi coepisse cognosset, aquam frigidam ingessit; qua ille ⟨e⟩pota cum uini uim miscendo fregisset, protinus febrem somno et sudore discussit. Quod auxilium medicus opportune prouidit non ex eo, quod aut adstrictum corpus erat aut fluebat, sed ex ea causa, quae ante praecesserat. Estque etiam proprium aliquid et loci et temporis istis quoque auctoribus: qui, cum disputant, quemadmodum sanis hominibus agendum sit, praecipiunt, ut grauibus aut locis aut temporibus magis uitetur frigus, aestus, satietas, labor, libido; magisque ut conquiescat isdem locis aut temporibus, si quis grauitatem corporis sensit, ac neque uomitu stomachum neque purgatione aluum sollicitet. Quae uera quidem sunt; a communibus tamen ad quaedam propria descendunt, nisi persuadere nobis uolunt sanis quidem considerandum esse, quod caelum, quod tempus anni sit, aegris uero non esse; quibus tanto magis omnis obseruatio necessaria est, quanto magis obnoxia offensis infirmitas est. Qui⟨n⟩ etiam morborum in isdem hominibus aliae atque aliae proprietates sunt; et qui secundis aliquando frustra curatus est, contrariis saepe restituitur. Plurimaque in dando cibo discrimina reperiuntur, ex quibus contentus uno ero. Nam famem facilius adulescens quam puer, facilius in denso caelo quam in tenui, facilius hieme quam aestate, facilius uno cibo quam prandio quoque adsuetus, facilius inexercitatus quam exercitatus homo sustinet: saepe autem in eo magis necessaria cibi festinatio est, qui minus inediam tolerat. Ob quae conicio eum, qui propria non nouit, communia tantum debere intueri; eumque, qui nosse proprietates potest, non illas quidem oportere neglegere, sed his quoque insistere; ideoque, cum par scientia sit, utiliorem tamen medicum esse amicum quam extraneum.

[¶4] Therefore, to return to what I myself propound, I am of opinion that the Art of Medicine ought to be rational, but to draw instruction from evident causes, all obscure ones being rejected from the practice of the Art, although not from the practitioner's study. But to lay open the bodies of men whilst still alive is as cruel as it is needless; that of the dead is a necessity for the learner, who should know positions and relations, which the dead body exhibits better than does a living and wounded man. As for the remainder, which can only be learnt from the living, actual practice will demonstrate it in the course of treating the wounded in a somewhat slower yet much milder way.

> Latin: Igitur, ut ad propositum meum redeam, rationalem quidem puto medicinam esse debere, instrui uero ab euidentibus causis, obscuris omnibus non ab cogitatione artificis sed ab ipsa arte reiectis. Incidere autem uiuorum corpora et crudele et superuacuum est, mortuorum discentibus necessarium: nam positum et ordinem nosse debent, quae cadauer melius quam uiuus et uulneratus homo repraesenta[n]t. Sed et cetera, quae modo in uiuis cognosci possunt, in ipsis curationibus uulneratorum paulo tardius sed aliquanto mitius usus ipse monstrabit.

[¶5] With these premises I will first speak of how those in health should act (Book I), than I will pass on to what pertains to diseases (Book II, 1‑8), and to their treatments (Book II, 9‑33).

> Latin: His propositis, primum dicam, quemadmodum sanos agere conueniat, tum ad ea transibo, quae ad morbos curationesque eorum pertinebunt.

[¶6] 1. 1 A man in health, who is both vigorous and his own master, should be under no obligatory rules, and have no need, either for a medical attendant, or for a rubber and anointer. His kind of life should afford him variety; he should be now in the country, now in town, and more often about the farm; he should sail, hunt, rest sometimes, but more often take exercise; for whilst inaction weakens the body, work strengthens it; the former brings on premature old age, the latter prolongs youth. It is well also at times to go to the bath, at times to make use of cold waters; to undergo sometimes inunction, sometimes to neglect that same; to avoid no kind of food in common use; to attend at times a banquet, at times to hold aloof; to eat more than sufficient at one time, at another no more; to take food twice rather than once a day, and always as much as one wants provided one digests it. But whilst exercise and food of this sort are necessities, those of the athletes are redundant; for in the one class any break in the routine of exercise, owing to necessities of civil life, affects the body injuriously, and in the other, bodies thus fed up in their fashion age very quickly and become infirm. Concubitus indeed is neither to be desired overmuch, nor overmuch to be feared; seldom used it braces the body, used frequently it relaxes. Since, however, nature and not number should be the standard of frequency, regard being had to age and constitution, concubitus can be recognized as harmless when followed neither by languor nor by pain. The use is worse in the day-time, and safer by night; but care should be taken that by day it be not immediately followed by a meal, and at night not immediately followed by work and watching. Such are the precautions to be observed by the strong, and they should take care that whilst in health their defences against ill-health are not used up.

> Latin: 1. SANVS homo, qui et bene ualet et suae spontis est, nullis obligare se legibus debet, ac neque medico neque iatroalipta egere. Hunc oportet uarium habere uitae genus: modo ruri esse, modo in urbe, saepiusque in agro; nauigare, uenari, quiescere interdum, sed frequentius se exercere; siquidem ignauia corpus hebetat, labor firmat, illa maturam senectutem, hic longam adulescentiam reddit. Prodest etiam interdum balineo, interdum aquis frigidis uti; modo ungui, modo id ipsum neglegere; nullum genus cibi fugere, quo populus utatur; interdum in conuictu esse, interdum ab eo se retrahere; modo plus iusto, modo non amplius adsumere; bis die potius quam semel cibum capere, et semper quam plurimum, dummodo hunc concoquat. Sed ut huius generis exercitationes cibique necessariae sunt, si⟨c⟩ athletici superuacui: nam et intermissus propter ciuiles aliquas necessitates ordo exercitationis corpus adfligit, et ea corpora, quae more eorum repleta sunt, celerrime et senescunt et aegrotant. Concubitus uero neque nimis concupiscendus, neque nimis pertimescendus est. Rarus corpus excitat, frequens soluit. Cum autem frequens non numero sit sed natura * *, ratione aetatis et corporis, scire licet eum non inutilem esse, quem corporis neque languor neque dolor sequitur. Idem interdiu peior est, noctu tutior, ita tamen, si neque illum cibus, neque hunc cum uigilia labor statim sequitur. Haec firmis seruanda sunt, cauendumque ne in secunda ualetudine aduersae praesidia consumantur.

[¶7] 2. 2 The weak, however, among whom are a large portion of townspeople, and almost all those fond of letters, need greater precaution, so that care may re-establish what the character of their constitution or of their residence or of their study detracts. Anyone therefore of these who has digested well may with safety rise early; if too little, he must stay in bed, or if he has been obliged to get up early, must go to sleep again; he who has not digested, should lie up altogether, and neither work nor take exercise nor attend to business. He who without heartburn eructates undigested food should drink cold water at intervals and none the less exercise self-control. He should also reside in a house that is light, airy in summer, sunny in winter; avoid the midday sun, the morning and evening chill, also exhalations from rivers and marshes; and he should not often expose himself when the sky is cloudy to a sun that breaks through..., lest he should be affected alternately by cold and heat — a thing which excites particularly choked nostrils and running colds. Much more indeed are these things to be watched in unhealthy localities, where they even produce pestilence. He can tell that his body is sound, if his morning urine is whitish, later reddish; the former indicates that digestion is going on, the latter that digestion is complete. On waking one should lie still for a while, then, except in winter time, bathe the face freely with cold water; when the days are long the siesta should be taken before the midday meal, when short, after it. In winter, it is best to rest in bed the whole night long; if there must be study by lamp-light, it should not be immediately after taking food, but after digestion. He who has been engaged in the day, whether in domestic or on public affairs, ought to keep some portion of the day for the care of the body. The primary care in this respect is exercise, which should always precede the taking of food; the exercise should be ampler in the case of one who has laboured less and digested less well. Useful exercises are: reading aloud, drill, handball, running, walking; but this is not by any means most useful on the level, since walking up and down hill varies the movement of the body, unless indeed the body is thoroughly weak; but it is better to walk in the open air than under cover; better, when the head allows of it, in the sun than in the shade; better under the shade of a wall or of trees than under a roof; better a straight than a winding walk. But the exercise ought to come to an end with sweating, or at any rate lassitude, which should be well this side of fatigue; and sometimes less, sometimes more, is to be done. But in these matters, as before, the example of athletes should not be followed, with their fixed rules and immoderate labour. The proper sequel to exercise is: at times an anointing, whether in the sun or before a brazier; at times a bath, which should be in a chamber as lofty, well lighted and spacious as possible. However, neither should be made use of invariably, but one of the two the oftener, in accordance with the constitution. There is need of a short rest afterwards. Coming to food, a surfeit is never of service, excessive abstinence is often unserviceable; if any intemperance is committed, it is safer in drinking than in eating. It is better to begin a meal with savouries, salads and such-like; and after that meat is to be eaten, best either when roasted or boiled. All preserved fruits are unserviceable for two reasons, because more is taken owing to their sweetness, and even what is moderate is still digested with some difficulty. Dessert does no harm to a good stomach, in a weak one it turns sour. Whoever then in this respect has too little strength, had better eat dates, apples and such-like at the beginning of the meal. After many drinkings which have somewhat exceeded the demands of thirst, nothing should be eaten; after a surfeit of food there should be no exertion. Anyone who has had his fill digests the more readily if he concludes the meal with a drink of cold water, then after keeping awake for a time has a sound sleep. When a full meal is taken at midday, after it there should be no exposure to cold, heat or fatigue, which do not harm the body so easily when it is empty as when it is full. When from whatever causes there is prospective want of food, everything laborious should be avoided.

> Latin: 2. At INBECILLIS, quo in numero magna pars urbanorum omnesque paene cupidi litterarum sunt, obseruatio maior necessaria est, ut, quod uel corporis uel loci uel studii ratio detrahit, cura restituat. Ex his igitur qui bene concoxit, mane tuto surget; qui parum, quiescere debet, et si mane surgendi necessitas fuit, redormire; qui non concoxit, ex toto conquiescere ac neque labori se neque exercitationi neque negotiis credere. Qui crudum sine praecordiorum dolore ructat, is ex interuallo aquam frigidam bibere, et se nihilo minus continere. Habitare uero aedificio lucido, perflatum aestiuum, hibernum solem habente; cauere meridianum solem, matutinum et uespertinum frigus, itemque auras fluminum atque stagnorum; minimeque nubilo caelo soli aperienti se * * committere, ne modo frigus, modo calor moueat; quae res maxime grauedines destillationesque concitat. Magis uero grauibus locis ista seruanda sunt, in quibus etiam pestilentiam faciunt. Scire autem licet integrum corpus esse, quo die mane urina alba, dein rufa est: illud concoquere, hoc concoxisse significat. Vbi experrectus est aliquis, paulum intermittere; deinde, nisi hiemps est, fouere os multa aqua frigida debet; longis diebus meridiari potius ante cibum; si minus, pos eum. Per hiemem potissimum totis noctibus conquiescere; sin lucubrandum est, non post cibum id facere, sed post concoctionem. Quem interdiu uel domestica uel ciuilia officia tenuerunt, huic tempus aliquod seruandum curationi corporis sui est. Prima autem eius curatio exercitatio est, quae semper antecedere cibum debet, in eo, qui minus laborauit et bene concoxit, amplior; in eo, qui fatigatus est et minus concoxit, remissior. Commode uero exercent clara lectio, arma, pila, cursus, ambulatio, atque haec non utique plana commodior est, siquidem melius ascensus quoque et descensus cum quadam uarietate corpus moueat, nisi tamen id perquam inbecillum est: melior autem est sub diuo quam in porticu; melior, si caput patitur, in sole quam in umbra, ⟨melior in umbra⟩ quam paries aut uiridia efficiunt, quam quae tecto subest; melior recta quam flexuosa. Exercitationis autem plerumque finis esse debet sudor aut certe lassitudo, quae citra fatigationem sit, idque ipsum modo minus, modo magis faciendum est. Ac ne his quidem athletarum exemplo uel certa esse lex uel inmodicus labor debet. Exercitationem recte sequitur modo unctio, uel in sole uel ad ignem; modo balineum, sed conclaui quam maxime et alto et lucido et spatioso. Ex his uero neutrum semper fieri oportet, sed saepius alterutrum pro corporis natura. Post haec paulum conquiescere opus est. Vbi ad cibum uentum est, numquam utilis est nimia satietas, saepe inutilis nimia abstinentia: si qua intemperantia subest, tutior est in potione quam in esca. Cibus a salsamentis, holeribus similibusque rebus melius incipit; tum caro adsumenda est, quae assa optima aut elixa est. Condita omnia duabus causis inutilia sunt, quoniam et plus propter dulcedinem adsumitur, et quod modo par est, tamen aegrius concoquitur. Secunda mensa bono stomacho nihil nocet, in inbecillo coacescit. Si quis itaque hoc parum ualet, palmulas pomaque et similia melius primo cibo adsumit. Post multas potiones, quae aliquantum sitim excesserunt, nihil edendum est, post satietatem nihil agendum. Vbi expletus est aliquis, facilius concoquit, si, quicquid adsumpsit, potione aquae frigidae includit, tum paulisper inuigilat, deinde bene dormit. Si quis interdiu se inpleuit, post cibum neque frigori neque aestui neque labori se debet committere: neque enim tam facile haec inani corpore quam repleto nocent. Si quibus de causis futura inedia est, labor omnis uitandus est.

[¶8] 3. 3 Now the foregoing precepts indeed almost always hold good; but some particular notice requires to be taken of changes of surroundings and varieties of constitution and sex and age and seasons. For it is not safe to remove either from a salubrious to an oppressive locality, or from an oppressive to a salubrious one. It is better to make the move from a salubrious into an oppressive place at the beginning of winter, from an oppressive into a salubrious one in early summer. It is not good indeed to overeat after a long fast, nor to fast after overeating. And he runs a risk who goes contrary to his habit and eats immoderately whether once or twice in the day. Again, neither sudden idleness after excessive labour, nor sudden labour after excessive idleness, is without serious harm. Therefore when a man wishes to make a change, he ought to habituate himself little by little; indeed any work is easier even for a boy or an old man than for an unaccustomed adult. Hence also too idle a life is inexpedient, because there may come up some necessity for labour. But if at any time a man has had to undergo unaccustomed labour, or at any rate much more than he is used to, he should go to bed on an empty stomach, more especially if he has a bitter taste in his mouth, or his eyes are dimmed, or his bowels disturbed; for then he must not only sleep with his stomach empty, but even remain at rest over the next day, unless rest has quickly removed the trouble; in this case he should get up and take slowly a short walk. But even when there has been no necessity for a sleep, because a man has only done more moderate work, still he ought, all the same, to take a little walk. This then should be the rule for everyone after incurring fatigue before taking food: first to walk about a little, then, if no bath is at hand, to undergo anointing and sweating in a warm place whether in the sun or before a fire; when there is a bath, he should first sit in the warm room, then, after resting there a while, go down into the tubs; next, after being anointed freely with oil and gently rubbed down, again descend into the tub; finally he should foment the face, first with warm, then with cold water. A very hot bath does not suit such cases. Therefore if one's excessive fatigue almost amounts to a fever, it is quite sufficient for him to sit in warm water, to which a little oil may be added, up to the groins, in a tepid room; next his whole body, and especially the parts which have been under water, should be rubbed gently with oil to which a little wine and pounded salt have been added. This done, anybody who has undergone fatigue is ready for food, in particular food of a fluid consistency; he should be content with water to drink, or if wine, certainly diluted, of the sort to promote diuresis. Further it should be recognized that after labour accompanied by sweating a cold drink is most pernicious, and even although sweating after a fatiguing journey has passed off, it is unserviceable. After coming out of the bath, too, Asclepiades held it unserviceable; and this is true in the case of those whose bowels are loose at uncertain moments, and who readily shiver; but it is not the universal rule in all cases, since it is more natural that a heated stomach should be cooled, and a cold one warmed by a drink. I grant so much, but I hesitate to give this as a rule, for as a matter of fact a cold drink is bad while sweating. It also happens that after a dinner of many courses and many drinks of diluted wine a vomit is even advantageous; the next day there should be a prolonged rest followed by exercise in moderation. If there is oppression due to a persistence of fatigue, water and wine should be drunk alternately, but the bath seldom used. A change of work, too, relieves lassitude; and when a novel form of customary work has tired a man, that form to which he is accustomed restores him. To one who is fatigued that couch is best which he uses every day; for whether soft or hard, one to which he is unaccustomed wearies him. Certain things are specially applicable to one who is fatigued whilst travelling on foot. To be rubbed often while actually on the way restores him; after the journey he should sit awhile, then undergo anointing; next at the bath foment with hot water his upper rather than his lower parts. But anyone who has become overheated in the sun should go at once to the bath, and there have oil poured over the head and body; next go down to a thoroughly hot tub; then have water poured over his head freely, first hot, next cold. On the other hand, he who has become much chilled should first sit in the calidarium, well wrapped up, until he sweats; next be anointed, afterwards laved, then take food in moderation and after that drinks of undiluted wine. He too who on a voyage is troubled by seasickness, if he has vomited out a quantity of bile, should fast or take very little food. If he has spewed out sour phlegm, he may take food notwithstanding, but lighter than usual; if he has nausea without vomiting, he should either fast, or after food excite a vomit. But he who has spent all day sitting in a carriage or at the games should not after that hurry but walk slowly; also it is of service to linger somewhat in the bath, and then take a small dinner afterwards. When overheated in the bath, taking vinegar and holding it in the mouth restores him; if that is not at hand, cold water may be taken in the same way.

> Latin: 3. Atque haec quidem paene perpetua sunt. Quasdam autem obseruationes desiderant ⟨et⟩ nouae res et corporum genera et sexus et aetates et tempora anni. Nam neque ex salubri loco in grauem, neque ex graui in salubrem transitus satis tutus est. Ex salubri in grauem prima hieme, ex graui in eum, qui salubris est, prima aestate transire melius est. Neque ex multa uero fame nimia satietas neque ex nimia satietate fames idonea est. Periclitaturque et qui semel et qui bis die cibum incontinenter contra consuetudinem adsumit. Item neque ex nimio labore subitum otium neque ex nimio otio subitus labor sine graui noxa est. Ergo cum quis mutare aliquid uolet, paulatim debebit adsuescere. Omnem etiam laborem facilius uel puer uel senex quam insuetus homo sustinet. Atque ideo quoque nimis otiosa uita utilis non est, quia potest incidere laboris necessitas. Si quando tamen insuetus aliquis laborauit, aut si multo plus quam solet etiam si qui adsueuit, huic ieiuno dormiendum est, multo magis etiam si os amarum est uel oculi caligant, aut uenter perturbatur: tum enim non dormiendum tantummodo ieiuno est, sed etiam * in posterum diem permanendum, nisi cito id quies sustulit. Quod si factum est, surgere oportet et lente paulum ambulare. At si somni necessitas non fuit, quia modice magis aliquis laborauit, tamen ingredi aliquid eodem modo debet. Communia deinde omnibus sunt post fatigationem cibum sumpturis: ubi paulum ambulauerunt, si balneum non est, calido loco uel in sole uel ad ignem ungui atque sudare; si est, ante omnia in tepidario sedere, deinde ubi paululum conquierunt, intrare et descendere in solium; tum multo oleo ungui leniterque perfricari, iterum in solium descendere, post haec os aqua calida, deinde frigida fouere. Balineum his feruens idoneum non est. Ergo si nimium alicui fatigato paene febris est, huic abunde est loco tepido demittere se inguinibus tenus in aquam calidam, cui paulum olei sit adiectum, deinde totum quidem corpus, maxime tamen eas partes, quae in aqua fuerunt, leuiter perfricare ex oleo, cui uinum et paulum contriti salis sit adiectum. Post haec omnibus fatigatis aptum est cibum sumere, eoque umido uti, aqua uel certe diluta potione esse contentos, maximeque ea, quae moueat urinam. Illud quoque nosse oportet, quod ex labore sudanti frigida potio perniciosissima est atque etiam, cum sudor se remisit, itinere fatigatis inutilis. A balineo quoque uenientibus Asclepiades inutilem eam iudicauit; quod in iis uerum est, quibus aluus facile nec tuto resoluitur quique facile inhorrescunt; perpetuum in omnibus non est, cum potius naturale sit potione aestuantem stomachum refrigerari, frigentem calefieri. Quod ita praecipio, ut tamen fatear, ne ex hac quidem causa sudanti adhuc frigidum bibendum esse. Solet etiam prodesse post uarium cibum frequentesque dilutas potiones uomitus, et postero die longa quies, deinde modica exercitatio. Si adsidua fatigatio urguet, in uicem modo aquam, modo uinum bibendum est, raro balineo utendum. Leuatque lassitudinem etiam laboris mutatio; eumque, quem nouum genus eiusdem laboris pressit, id quod in consuetudine est, reficit. Fatigato cotidianum cubile tutissimum est: lassat enim quod contra consuetudinem, seu molle seu durum est. Proprie quaedam ad eum pertinent, qui ambulando fatigatur. Hunc reficit in ipso quoque itinere frequens frictio, post iter primum sedile, deinde unctio; tum calida aqua in balineo magis superiores partes quam inferiores foueat. Si quis uero exustus in sole est, huic in balneum protinus eundum perfundendumque oleo corpus et caput; deinde in solium bene calidum descendendum est; tum multa aqua per caput infundenda, prius calida, deinde frigida. At ei, qui perfrixit, opus est in balineo primum inuoluto sedere, donec insudet; tum ungui, deinde lauari; cibum modicum, deinde potiones meracas adsumere. Is uero, qui nauigauit et nausea pressus est, si multam bilem euomuit, uel abstinere a cibo debet uel paulum aliquid adsumere. Si pituitam acidam effudit, utique sumere cibum, sed adsueto leuiorem: si sine uomitu nausea fuerit, uel abstinere uel post cibum uomere. Qui uero toto die uel in uehiculo uel in spectaculis sedit, huic nihil currendum sed lente ambulandum est. Lenta quoque in balineo mora, dein cena exigua prodesse cons⟨u⟩erunt. Si quis in balineo aestuat, reficit hunc ore exceptum et in eo retentum acetum; si id non est, eodem modo frigida aqua sumpta.

## 3. Book I · chapters 3–10

Source: https://scriptura.si/works/celsus-on-medicine/3/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/3/#p-N

[¶0] But above all things everyone should be acquainted with the nature of his own body, for some are spare, others obese; some hot, others more frigid; some moist, others dry; some are costive, in others the bowels are loose. It is seldom but that a man has some part of his body weak. So then a thin man ought to fatten himself up, a stout one to thin himself down; a hot man to cool himself, a cold man to make himself warmer; the moist to dry himself up, the dry to moisten himself; he should render firmer his motions if loose, relax them if costive; treatment is to be always directed to the part which is mostly in trouble.

> Latin: Ante omnia autem norit quisque naturam sui corporis, quoniam alii graciles, alii obessi sunt, alii calidi, alii frigidiores, alii umidi, alii sicci; alios adstricta, alios resoluta aluus exercet. Raro quisquam non aliquam partem corporis inbecillam habet. Tenuis uero homo inplere se debet, plenus extenuare; calidus refrigerare, frigidus calefacere; madens siccare, siccus madefacere; itemque aluum firmare is, cui fusa, soluere is, cui adstricta est: succurrendumque semper parti maxime laboranti est.

[¶1] Now the body is fattened: by moderate exercise, by oftener resting, by anointing, and by the bath if after a meal at midday; by the bowels being confined, by winter cold in moderation, by sleep adequate but not over long, by a soft couch, by a tranquil spirit, by food whether solid or fluid which is sweet and fatty; by meals rather frequent and as large as it is possible to digest. The body is thinned: by hot water if one bathes in it and especially if salt; by the bath on an empty stomach, by a scorching sun, by heat of all kinds, by worry, by late nights; by sleep unduly short or overlong, by a hard bed throughout the summer; by running or much walking or any violent exercise; by a vomit, by purgation, by sour and harsh things consumed; by a single meal a day; by the custom of drinking wine not too cold upon an empty stomach.

> Latin: Implet autem corpus modica exercitatio, frequentior quies, unctio et, si post prandium est, balineum; contracta aluus, modicum frigus hieme, somnus et plenus et non nimis longus, molle cubile, animi securitas, adsumpta per cibos et potiones maxime dulcia et pinguia; cibus et frequentior et quantus plenissimus potest concoqui. Extenuat corpus aqua calida, si quis in ea descendit, magisque si salsa est; ieiuno balineum, inurens sol ut omnis calor, cura, uigilia; somnus nimium uel breuis uel longus, per aestatem durum cubile; cursus, multa ambulatio, omnisque uehemens exercitatio; uomitus, deiectio, acidae res et austerae; et semel die adsumptae epulae;

[¶2] But as I have mentioned a vomit and a purge among thinning measures, there are some things to be said in particular concerning them. I note that a vomit was rejected by Asclepiades in the book written by him, entitled De tuenda sanitate; I do not blame him for being disquieted with the custom of those, who by ejecting every day achieve a capacity for gormandizing. He has even gone somewhat further; for from the same volume he has expelled likewise purgings; which indeed are pernicious when procured by too powerful medicaments. Such measures, however, are not to be dispensed with entirely, because regard for different constitutions and times can make them necessary, provided that they are employed in moderation and only when needed. Hence Asclepiades has himself allowed that what is already corrupted ought to be expelled: so this kind of treatment is not wholly to be condemned. But there may be more than one reason for this too; and so a somewhat closer consideration may be given to the matter.

> Latin: et uini non praefrigidi ieiuno potio in consuetudinem adducta. Cum uero inter extenuantia posuerim uomitum et deiectionem, de his quoque proprie quaedam dicenda sunt. ⟨R⟩eiectum esse ab Asclepiade uomitum in eo uolumine, quod DE TVENDA SANITATE composuit, uideo; neque reprehendo, si offensus eorum est consuetudine, qui cotidie eiciendo uorandi facultatem moliuntur. Paulo etiam longius processit; idem purgationes quoque eodem uolumine expulit: et sunt eae perniciosae, si nimis ualentibus medicamentis fiunt. Sed haec tamen summouenda esse non est perpetuum, quia corporum temporumque ratio potest ea facere necessaria, dum et modo et non nisi cum opus est adhibeantur. Ergo ille quoque ipse, si quid iam corruptum esset, expelli debere confessus est: ita non ex toto res condemnanda est. Sed esse eius etiam plures causae possunt;

[¶3] A vomit is more advantageous in winter than in summer, for then more phlegm and severer stuffiness in the head occur. It is unsuitable for the thin and for those with a weak stomach, but suitable for the plethoric, and all who have become bilious, whether after overeating or imperfect digestion. For if the meal has been larger than can be digested, it is not well to risk its corruption; and if it has already become corrupted, nothing is more to the purpose than to eject it by whatever way its expulsion is first possible. When, therefore, there are bitter eructations, with pain and weight over the heart, recourse should be had at once to a vomit, which is likewise of service to anyone who has heartburn and copious salivation or nausea, or ringing in the ears, or watering of the eyes, or a bitter taste in the mouth; similarly in the case of one who is making a change of climate or locality; as well as in the case of those who become troubled by pain over the heart when they have not vomited for several days. Nor am I unaware that in such cases there is prescribed rest, but that is not always within the reach of those who are obliged to be busy; nor does rest act in the same way with everybody. Accordingly I allow that vomiting should not be practised for the sake of luxury; on account of health I believe from experiment that it is sometimes rightly practised, nevertheless with this reservation, that no one who wants to keep well, and live to old age, should make it a daily habit. He who after a meal wants to vomit, if he does so easily should first take tepid water by itself; when there is more difficulty, a little salt or honey should be added. To cause a vomit on getting up in the morning, he should first drink some honey or hyssop in wine, or eat a radish, and after that drink tepid water as described above. The other emetics prescribed by the ancient practitioners all disturb the stomach. After a vomit, when the stomach is weak, a little suitable food should be taken, and for drink, unless the vomiting has made the throat raw, three cupfuls of cold water. He who has provoked a vomit, if it be early in the day, should after that take a walk, next undergo anointing, then dine; if after dining, he should the next day bathe, or sweat in the baths. After that the following meal had better be a light one, consisting of bread a day old, harsh undiluted wine, roasted meat, all food being of the dryest. Whoever aims to provoke a vomit twice a month, had better arrange to do so on two consecutive days, rather than once a fortnight, unless this longer interval causes heaviness in the chest.

> Latin: estque in ea quaedam paulo subtilior obseruatio adhibenda. Vomitus utilior est hieme quam aestate: nam tunc et pituitae plus et capitis grauitas maior subest. Inutilis est gracilibus et inbecillum stomachum habentibus: utilis plenis, biliosis omnibus, si uel nimium se replerunt, uel parum concoxerunt. Nam siue plus est quam quod concoqui possit, periclitari ne conrumpatur non oportet: siue[ro] corruptum est, nihil commodius est quam id, qua uia primum expelli potest, eicere. Itaque ubi amari ructus cum dolore et grauitate praecordiorum sunt, ad hunc protinus confugiendum est. Item prodest ei, cui pectus aestuat et frequens saliua uel nausea est, aut sonant aures, aut madent oculi, aut os amarum est; similiterque ei, qui uel caelum uel locum mutat; isque, quibus, si per plures dies non uomuerunt, dolor praecordia infestat. Neque ignoro inter haec praecipi quietem, quae non semper contingere potest agendi necessitatem habentibus, nec in omnibus idem facit.—Itaque istud luxuriae causa fieri non oportere confiteor: interdum ualetudinis causa recte fieri experimentis credo cum eo tamen, ne quis, qui ualere et senescere uolet, hoc cottidianum habeat. Qui uomere post cibum uolt, si ex facili facit, aquam tantum tepidam ante debet adsumere; si difficilius, aquae uel salis uel mellis paulum adicere. At qui mane uomiturus est, ante bibere mulsum uel hysopum, aut esse radiculam debet, deinde aquam tepidam, ut supra scriptum est, bibere. Cetera, quae antiqui medici praeceperunt, stomachum omnia infestant. Post uomitum, si stomachus infirmus est, paulum cibi, sed huius idonei, gustandum, et aquae frigidae cyathi tres bibendi sunt, nisi tamen fauces uomitus exasperarint. Qui uomuit, si mane id fecit, ambulare debet, tum ungi, dein cenare; si post cenam, postero die lauari et in balneo sudare. Inde proximus cibus mediocris utilior est isque esse debet cum pane hesterno, uino austero meraco et carne assa cibisque omnibus quam siccissimis. Qui uomere bis in mense uult, melius consulet, si biduo continuarit, quam si post quintum decimum diem uomuerit, nisi haec mora grauitatem pectori faciet.

[¶4] Now defaecation is to be procured also by a medicament, when, the bowels being costive, too little is passed, with the result that there is increase of flatulence, dizziness of vision, headaches, and other disturbances in the upper parts. For what can rest and fasting help in such circumstances which come about so much through them? He who wants to defaecate should in the first place make use of such food and wine as will promote it; then if these have little effect, he should take aloes. But purgatives also, whilst necessary at times, when frequently used entail danger; for the body becomes subject to malnutrition, since a weakened state leaves it exposed to maladies of all sorts.

> Latin: Deiectio autem medicamento quoque petenda est, ubi uenter suppressus parum reddit, ex eoque inflationes, caligines, capitis dolores, aliaque superioris partis mala increscunt. Quid enim inter haec adiuuare possunt quies et inedia * * *, quae per illas maxime eueniunt? Qui deicere uolet, primum cibis uinisque utetur is, qui hoc praestant; dein, si parum illa proficient, aloen sumat. Sed purgationes quoque, ut interdum necessariae sunt, sic, ubi frequentes sunt, periculum adferunt: adsuescit enim non ali corpus, cum omnibus morbis obnoxia maxime infirmitas sit.

[¶5] The body is heated: by anointing, by salt-water affusion and the more so when hot; by all food which is salt, bitter and fleshy; and after meals by the bath and harsh wine. On the contrary it is cooled: by the bath and sleep on an empty stomach, if not too prolonged; by all sour food; by the coldest water to drink, by oil affusion when mixed with water.

> Latin: Calefacit autem unctio, aqua salsa, magisque si calida est, omnia salsa, amara, carnosa; si post cibum est, balneum, uinum austerum. Refrigerant in ieiunio et balneum et somnus, nisi nimis longus est, omnia acida, aqua ⟨quam⟩ frigidissima, oleum, si aqua miscetur.

[¶6] The body is rendered humid: by more than customary exertion, by a frequent bath, by food in increased amount, by copious drinking, followed by walking and late hours; much walking, early and forced, has by itself the same effect, food being taken not immediately after exercise; so also those classes of edibles which come from cold and rainy and irrigated localities. On the contrary the body is dried: by moderate exercise, hunger, anointing without the addition of water, summer heat with moderate exposure to the sun, cold water to drink, food immediately after exercise, and all edibles coming from hot and dry districts.

> Latin: Vmidum autem corpus efficit labor maior quam ex consuetudine, frequens balineum, cibus plenior, multa potio, post hanc ambulatio et uigilia; per se quoque ambulatio multa et matutina et uehemens, exercitationi non protinus cibus adiectus; ea genera escae, quae ueniunt ex locis frigidis et pluuiis et inriguis. Contra siccat modica exercitatio, fames, unctio sine aqua, calor, sol modicus, frigida aqua, cibus exercitationi statim subiectus, et is ipse ex siccis et aestuosis locis ueniens.

[¶7] The bowels are confined by exertion, by sitting still, by besmearing the body with potter's clay, by a scanty diet, and that taken once a day in the case of one accustomed to two meals, by drinking little and that only after the consumption of whatever food is to be taken, also by rest after food. On the contrary they are rendered loose: by increasing the length of the walk, more food and drink; by moving about after the meal; by frequently drinking during the meal. This too should be recognized, that a vomit confines the bowels when relaxed, and relaxes them when costive: again, a vomit immediately after the meal confines the bowels, later it relaxes them.

> Latin: Aluum adstringit labor, sedile, creta figularis corpori inlita, cibus inminutus, et is ipse semel die adsumptus ab eo, qui bis solet; exigua potio neque adhibita, nisi cum cibi quis, quantum adsumpturus est, cepit, post cibum quies. Contra soluit aucta ambulatio atque esca po⟨tusque⟩, motus, qui post cibum est, subinde potiones cibo inmixtae. Illud quoque scire oportet, quod uentrem uomitus solutum conprimit, compressum soluit; itemque conprimit is uomitus, qui statim post cibum est, soluit is, qui tarde superuenit.

[¶8] As to what pertains to age: the middle-aged sustain hunger more easily, less so young people, and least of all children and old people. The less readily one supports it, the more often should food be taken; one who is growing needs it most. Children and the old should bathe in warm water. Wine should be diluted for children; for the old men it should be rather undilute: but at neither age be of a kind to cause flatulence. It matters less for the young what they take and the way they are treated. Those who when young are relaxed, when old are generally costive; those constipated in youth are often relaxed when old. It is better to be rather relaxed when young, rather costive when old.

> Latin: Quod ad aetates uero pertinet, inediam facillime sustinent mediae aetates, minus iuuenes, minime pueri et senectute confecti. Quo minus fert facile quisque, eo saepius debet cibum adsumere, maximeque eo eget, qui increscit. Calida lauatio et pueris et senibus apta est. Vinum dilutius pueris, senibus meracius: neutri aetati, quae inflationes mouent. Iuuenum minus quae adsumant et quomodo curentur, interest. Quibus iuuenibus fluxit aluus, plerumque in senectute contrahitur: quibus in adulescentia fuit adstricta, saepe in senectute soluitur. Melior est autem in iuuene fusior, in sene adstrictior.

[¶9] The season of the year also merits consideration. In winter it is fitting to eat more, and to drink less but of a stronger wine, to use much bread, meat preferably boiled, vegetables sparingly; to take a single meal unless the bowels are too costive. If a meal is taken at midday, it is better that it should be somewhat scanty, and that dry, without meat, and without drinking. At that season everything taken should be hot or heat-promoting. Venery then is not so pernicious. But in spring food should be reduced a little, the drink added to, but, however, of wine more diluted; more meat along with vegetables should be taken, passing gradually from boiled to roast. Venery is safest at this season of the year. But in summer the body requires both food and drink oftener, and so it is proper in addition to take a meal at midday. At that season both meat and vegetables are most appropriate; wine that is much diluted in order that thirst may be relieved without heating the body; laving with cold water, roasted meat, cold food or food which is cooling. But just as food is taken more frequently, so there should be less of it. In autumn owing to changes in the weather there is most danger. Hence it is not good to go out of doors unless well covered, and with thick shoes, especially on the colder days; nor at night to sleep in the open air, or at any rate to be well covered. A little more food may now be taken, the wine less in quantity but stronger. Some think orchard fruit injurious, which is generally the case when eaten immoderately all day, without reducing more substantial food. Hence it is not the fruit but the heaping of all things together which does harm, but in none of them all is there less harm than in the fruit. But it is not fitting to eat of it oftener than other kinds of food, and when eaten, it is necessary to subtract some of the more substantial food. But venery is useful neither in summer nor in autumn; it is more tolerable nevertheless in autumn, in summer it is to be abstained from entirely, if that possibly be done.

> Latin: Tempus quoque anni considerare oportet. Hieme plus esse conuenit, minus sed meracius bibere; multo pane uti, carne potius elixa, modice holeribus; semel ⟨die⟩ cibum capere, nisi si nimis uenter adstrictus est. Si prandet aliquis, utilius est exiguum aliquid, et ipsum siccum sine carne, sine potione sumere. Eo tempore anni calidis omnibus potius utendum est uel calorem mouentibus. Venus tum non aeque perniciosa est. At uere paulum cibo demendum, adiciendum potioni, sed dilutius tamen bibendum est; magis carne utendum, magis holeribus; transeundum paulatim ad assa ab elixis. Venus eo tempore anni tutissima est. Aestate uero et potione et cibo saepius corpus eget; ideo prandere quoque commodum est. Ei tempori aptissima sunt et caro et holus, potio quam dilutissima, ut et sitim tollat nec corpus incendat; frigida lauatio, caro assa, frigidi cibi uel qui refrigerent. Vt saepius autem cibo utendum, sic exiguo est. Per autumnum propter caeli uarietatem periculum maximum est. Itaque neque sine ueste neque sine calciamentis prodire oportet, praecipueque diebus frigidioribus, neque sub diuo nocte dormire, aut certe bene operiri. Cibo uero iam paulo pleniore uti licet, minus sed meracius bibere. Poma nocere quidam putant, quae inmodice toto die plerumque sic adsumuntur, ne quid ex densiore cibo remittatur. Ita non haec sed consummatio omnium nocet; ex quibus in nullo tamen minus quam in his noxae est. Sed his uti non saepius quam alio cibo conuenit. Denique aliquid densiori cibo, cum hic accedit, necessarium est demi. Neque aestate uero neque autumno utilis uenus est, tolerabilior tamen per autumnum: aestate in totum, si fieri potest, abstinendum est.

[¶10] 4. 4 I have next to speak of those who have some parts of the body weak. He whose head is infirm ought, after he has digested well, to rub it gently in the morning with his own hands; never if possible cover it with a wrap; have it shaved to the skin. It is well to avoid moonlight, and especially before the actual conjunction of the moon and sun, and to walk nowhere after dinner. If he has retained his hair, he should comb it every day, walk much, but, if possible, not under cover nor in the sun; everywhere, however, he should avoid the sun's blaze, especially after taking food and wine; undergo anointing rather than affusion, but that never before a flaming fire, on occasion before a brazier. If he goes owing to the bath he should first sweat for a while, in the tepidarium, wrapped up, and then undergo anointing there; next pass into the calidarium; after a further sweat he should not go down into the hot bath, but have himself sluiced freely from the head downwards, first with hot, next with tepid, then with cold water, which should be poured for longer on the head than upon other parts, after which it should be rubbed for a while, lastly wiped dry and anointed. Nothing is so beneficial to the head as cold water, and so he who has a weak head every day throughout the summer hold it for a while under the stream from a large conduit. But even if he undergoes anointing without going into the bath, and cannot bear cooling of the whole body, he should always nevertheless douche his head with cold water; but since he does not want the rest of his body wetted, he bends forward for the water not to run down his neck, and with his hands directs the flow to his face, that his eyes or other parts may not be irritated. He must take food in moderation and such as he can easily digest; and if fasting affects his head, he should take a meal at midday; if it does not so suffer, the single meal is preferable. It is more expedient for him to drink a light wine, well diluted, rather than water, in order that he may have something in reserve when his head begins to become heavier; and to him, on the whole, neither wine nor water is proper always; each constitutes a remedy when taken in its turn. To write, to read, to argue, is not beneficial to him, particularly after dinner; after which, indeed, even cogitation is not sufficiently safe; worst of all, however, is a vomit.

> Latin: 4. Proximum est, ut de iis dicam, qui PARTES aliquas corporis inbecillas habent. Cui caput infirmum est, is si bene concoxit, leniter ⟨per⟩fricare id mane manibus suis debet; numquam id, si fieri potest, ueste uelare; ad cutem tonderi. Vtileque lunam uitare, maximeque ante ipsum lunae solisque concursum; sed nusquam post cibum * *. Si cui capilli sunt, cottidie pectere, multum ambulare, sed, si licet, neque sub tecto neque in sole; ubique autem uitare solis ardorem, maximeque post cibum et uinum; potius ungui quam lauari, numquam ad flammam ungui, interdum ad prunam. Si in balineum uenit, sub ueste primum paulum in tepidario insudare, ibi ungui; tum transire in caldarium; ubi sudauit, in solium non descendere, sed multa calida aqua per caput se totum perfundere, tum tepida, deinde frigida. diutiusque ea caput quam ceteras partes perfundere; deinde id aliquamdiu perfricare, nouissime detergere et unguere. Capiti nihil aeque prodest ⟨atque⟩ aqua frigida: itaque is, cui hoc infirmum est, per aestatem id bene largo canali cotidie debet aliquamdiu subicere. Semper autem, etiamsi sine balineo unctus est neque totum corpus refrigerare sustinet, caput tamen aqua frigida perfundere: sed cum ceteras partes adtingi nolit, demittere id, ne ad ceruices aqua descendat; eamque, ne quid oculis aliisue partibus noceat, defluentem subinde manibus [ad os] regere⟨re⟩. Huic modicus cibus necessarius est, quem facile concoquat; isque, si ieiuno caput laeditur, adsumendus etiam medio die est; si non laeditur, semel potius. Bibere huic adsidue uinum dilutum leue quam aquam magis expedit, ut, cum caput grauius esse coeperit, sit quo confugiat. Eique ex toto neque uinum neque aqua semper utilia sunt: medicamentum utrumque est, cum in uicem adsumitur. Scribere, legere, uoce contendere huic opus non est, utique post cenam; post quam ne cogitatio quidem ei satis tuta est; maxime tamen uomitus alienus est.

[¶11] 5. 5 Nor indeed is it only those who are troubled by a weakness of the head that find the use of cold water beneficial, but also those who suffer with persistent running from the eyes, choked nostrils and running from the nose, and tonsillar maladies. In these cases, not only is the head to be douched every day, but also the face bathed with abundance of cold water; especially should this be carried out by all those benefited by it, whenever the south wind renders the weather more oppressive. And whereas after dinner either wrangling or mental worry is injurious to everybody, it is especially so to those who are disposed to pains in the head or windpipe, or to other forms of oral affections. Choked nostrils and running from the nose can be also avoided, or minimized, if one who is liable to these makes as little change as possible in respect to residence and water; if he protects the head, that it may not be scorched by the sun, or be chilled by a passing cloud; if the head be shaved after digestion and the stomach empty; if there be no reading or writing after a meal.

> Latin: 5. Neque uero iis solis, quos capitis inbecillitas torquet, usus aquae frigidae prodest, sed iis etiam, quos adsiduae lippitudines, grauidines, destillationes tonsillaeque male habent. His autem non caput tantum cottidie perfundendum est, sed os quoque multa frigida aqua fouendum est; praecipueque omnibus, quibus hoc utile auxilium est, eo utendum est, ubi grauius caelum austri reddiderunt. Cumque omnibus inutilis sit post cibum aut contentio aut agitatio animi, tum iis praecipue, qui uel capitis uel arteriae dolores habere consuerunt, uel quoslibet alios oris adfectus. Vitari etiam grauedines destillationesque possunt, si quam minime qui his oportunus est loca aquasque mutet; si caput in sole protegit, ne incendatur, neu subito ex repentino nubilo frigus id moueat; si post concoctionem ieiunus caput radit; si post cibum neque legit neque scribit.

[¶12] 6. 6 But one who is often troubled by an urgent motion should exercise his upper parts at handball and the like; walk on an empty stomach, avoid the sun and continual bathing; undergo anointing even without sweating, not make use of multifarious foods, least of all stews or pulse or greens, and of those things which pass through quickly; in a word, to avoid all things which are digested slowly. Especially advantageous are: venison and hard fish and meat of domestic animals roasted. It is never expedient to drink wine treated with sea-water, nor indeed thin or sweet wine, but that which is dry and fuller-bodied, and not too old. If one desires to use honeyed wine, it should be made from boiled honey. Cold drinks are to be used whenever possible, so long as they do not disturb the bowels. When anything in the dinner is felt to disagree, he should provoke a vomit, repeating it the next day; on the third day should be eaten a small quantity of bread soaked in wine with the addition of grapes preserved in a jar or in must which has been boiled down and such like; then he should return to his accustomed habit; but he must always rest after the meal, there must be no tension of mind, no moving about in a walk however short.

> Latin: 6. Quem uero frequenter cita aluus exercet, huic opus est pila similibusque superiores partes exercere; dum ieiunus est, ambulare; uitare solem, continua balinea; ungi citra sudorem; non uti cibis uariis, minimeque iurulentis, aut leguminibus holeribusque, iisque, quae celeriter descendunt; omnia denique fugere, quae tarde concocuntur. Venatio durique pisces et ex domesticis animalibus assa caro maxime iuuant. Numquam uinum salsum bibere expedit, ne tenue quidem aut dulce, sed austerum et plenius, neque id ipsum peruetus. Si mulso uti uolet, id ex decocto melle faciendum est. Si frigidae potiones uentrem eius non turbant, his utendum potissimum est. Si quid offensae in cena sensit, uomere debet, idque postero quoque die facere; tertio modici ponderis panem ex uino esse, adiecta uua ex olla uel ex defruto similibusque aliis; deinde ad consuetudinem redire. Semper autem post cibum conquiescere, ac neque intendere animum, neque ambulatione quamuis leui dimoueri.

[¶13] 7. 7 When the more lax intestine, which they name colon, tends to be painful, and when it is nothing more than an inflation of a sort, the aim should be to promote digestion; to practise reading aloud and other exercises; to use a hot bath, also hot food and drink, and in short, to avoid all manner of cold, all sweets and pulse, and whatever else tends to flatulence.

> Latin: 7. At si laxius intestinum dolere consueuit, quod colum nominant, cum id nihil nisi genus inflationis sit, id agendum est, ut concoquat aliquis; ut lectione aliisque generibus exerceatur; utatur balineo calido, cibis quoque et potionibus calidis, denique omni modo frigus uitet, item dulcia omnia leguminaque et quicquid inflare consueuit.

[¶14] 8. 8 But if anyone suffers from his stomach, he should read out loud, and after the reading take a walk, then exercise himself at handball and at drill or at anything else which brings the upper part of the body into play; on an empty stomach he should not drink water but hot wine; if he digests readily he should take two meals a day; drink light and dry wine, and after a meal drinks should preferably be cold. Weakness of the stomach is indicated by pallor, wasting, pain over the heart, nausea, and involuntary vomiting, headache when the stomach is empty; where these symptoms are absent, the stomach is sound. Nor must one absolutely trust those of our patients who when very unwell have conceived a longing for wine or cold water, and in backing up their desires, lay the blame on their perfectly innocent stomach. But those who digest slowly, and whose parts below the ribs on that account become inflated, or who on account of heat of some kind become thirsty at night, may drink before going to bed three or four cupfuls of wine through a fine reed. Also, to counter slow digestion, it is well to read aloud, next to take a walk, then to be either anointed or laved, taking care to drink wine cold, a large drink after dinner, but as I have said through a tube, ending all by drinking cold water. He whose food tends to turn sour should beforehand take a draught of tepid water and vomit; but if as a consequence he has frequent motions, he should, whenever possible after each stool, take a draught of cold water.

> Latin: 8. Si quis uero stomacho laborat, legere clare debet et post lectionem ambulare; tum pila et armis alioue quo genere, quo superior pars mouetur, exerceri; non aquam sed uinum calidum bibere ieiunus; cibum bis die adsumere, sic tamen ut facile concoquat; uti uino tenui et austero, et si post cibum, frigidis potius potionibus. Stomachum autem infirmum indicant pallor, macies, praecordiorum dolor, nausea, et nolentium uomitus, ieiuno dolor capitis; quae in quo non sunt, is firmi stomachi est. Neque credendum utique nostris est, qui cum in aduersa ualetudine uinum aut frigidam aquam concupiuerunt, deliciarum patrocinium in accusatione[m] non merentis stomachi habent. At qui tarde concocunt, et quorum ideo praecordia inflantur, quiue propter ardorem aliquem noctu sitire consuerunt, ante quam conquiescant duos tresue cyathos per tenuem fistulam bibant. Prodest etiam aduersus tardam concoctionem clare legere, deinde ambulare, tum uel ungui uel lauari; adsidue uinum frigidum bibere, et post cibum magnam potionem, sed, ut supra dixi, per siphonem; deinde omnes potiones aqua frigida includere. Cui uero cibus acescit, is ante eum bibere aquam egelidam debet et uomere: at si cui ex hoc frequens deiectio incidit, quotiens aluus ei constiterit, frigida potione potissimum utatur.

[¶15] 9. 9 When sinews tend to become painful, as is common in foot or hand ache, the affected part should be exercised as far as possible, even exposing it to work or to cold, unless when pain is increasing. Rest in the open air is best. Venery is always inimical; an in all other bodily affections, digestion is a necessity, for indigestion is most harmful, and whenever the body is attacked, the faulty part feels it most. But just as digestion has to do with all sorts of troubles, so has cold with some, heat with others; each person should be guided by his own bodily habit. Cold is inimical to the aged, and to the thin; to wounds, to the parts below the ribs, intestines, bladder, ears, hips, bladebones, genitals, bones, teeth, sinews, womb, brain. It renders the skin pale, dry, hard, black; from it are developed shiverings and tremors. But cold is beneficial to the young and to stout people; in cold weather, with due precautions, the mind is more vigorous and the digestion better. Cold water affusion is of service, not only to the head, but also to the stomach, and to painful joints not accompanied by ulcerations, also for those who are too rubicund, when pain is absent. But heat benefits all that cold harms, such as dimness of eyesight when there is neither pain nor lacrimation, also contracted sinews, and particularly those ulcerations which are due to cold. It gives the surface of the body a good colour; it promotes diuresis. If excessive it weakens the body, mollifies sinews, relaxes the stomach. Yet cold and heat are both least safe when applied suddenly to persons unaccustomed to them; for cold gives rise to pain in the side and other diseases, cold water excites swelling in the neck. Heat hinders concoction, prevents sleep, exhausts by sweating, renders liable the body to pestilential illnesses.

> Latin: 9. Si cui uero dolere nerui solent, quod in podagra cheragraue esse consueuit, huic, quantum fieri potest, exercendum id est, quod adfectum est, obiciendumque labori et frigori, nisi cum dolor increuit. Sub diuo quies optima est. Venus semper inimica est; concoctio, sicut in omnibus corporis adfectibus, necessaria: cruditas enim id maxime laedit, et quotiens offensum corpus est, uitiosa pars maxime sentit. Vt concoctio autem omnibus uitiis occurrit, sic rursus aliis frigus, aliis calor; quae sequi quisque pro habitu corporis sui debet. Frigus inimicum est seni, tenui, uulneri, praecordiis, intestinis, uesicae, auribus, coxis, scapulis, naturalibus, ossibus, dentibus, neruis, uuluae, cerebro. Idem summam cutem facit pallidam, aridam, duram, nigram; ex hoc horrores tremoresque nascuntur. At prodest iuuenibus et omnibus plenis; erectiorque mens est, et melius concoquitur, ubi frigus quidem est sed cauetur. Aqua uero frigida infusa, praeterquam capiti, etiam stomacho prodest, etiam articulis doloribusque, qui sunt sine ulceribus, item rubicundis nimis hominibus, si dolore uacant. Calor autem adiuuat omnia, quae frigus infestat, item lippientis, si nec dolor nec lacrimae sunt, neruos quoque, qui contrahuntur, praecipueque ea ulcera, quae ex frigore sunt. Idem corporis colorem bonum facit, urinam mouet. Si nimius est, corpus effeminat, neruos emollit, stomachum soluit. Minime uero frigus et calor tuta sunt, ubi subita insuetis sunt: nam frigus lateris dolores aliaque uitia, frigida aqua strumas excitat. Calor concoctionem prohibet, somnum aufert, sudorem digerit, obnoxium morbis pestilentibus corpus efficit.

[¶16] 10. 10 There are also observances necessary for a healthy man to employ during a pestilence, although in spite of them he cannot be secure. At such a time, then, he will do well to go abroad, take a voyage; when this cannot be, to be carried in a litter, walk in the open before the heat of the day, gently, and to be anointed in like manner; further as stated above he should avoid fatigue, indigestion, cold, heat, venery, and keep all the more to rule, should he feel any bodily oppression. At such a time he should not get up early in the morning nor walk about barefoot, and least so after a meal or bath. Neither on an empty stomach nor after a meal should he provoke a vomit, or set up a motion; indeed if the bowels tend to be loose, they are to be restrained. The fuller his habit of body, the more abstinence; he should avoid the bath, sweating, a midday siesta, and in any case if food has been taken previously; at such times, however, it is better then to take only one meal a day, and that a moderate one, lest indigestion be provoked. He should drink, one day water, the next day wine; if he observes these rules, there should be the least possible alteration as to the rest of his accustomed dietary. Such then are the things to be done in pestilence of all sorts, and particularly in one brought by south winds. And the same precautions are needed by those who travel, when they have left home during an unhealthy season, or when entering an unhealthy district. Even when something prevents observance of other rules, yet he ought to keep up the alteration, mentioned above, from wine to water, and from water to wine.

> Latin: 10. Est etiam obseruatio necessaria, qua quis in PESTILENTIA utatur adhuc integer, cum tamen securus esse ⟨non⟩ possit. Tum igitur oportet peregrinari, nauigare, ubi id non licet, gestari, ambulare sub diu ante aestum leniter eodemque modo ungui; et, ut supra conprensum est, uitare fatigationem, cruditatem, frigus, calorem, libidinem, multoque magis ⟨se⟩ continere, si qua grauitas in corpore est. Tum neque mane surgendum neque pedibus nudis ambulandum est, minime post cibum aut balineum; neque ieiuno neque cenato uomendum est, neque mouenda aluus; atque etiam, si per se mota est, conprimenda est. Abstinendum potius, si plenius corpus est, itemque uitandum balneum, sudor, somnus meridianus, utique si cibus quoque antecessit; qui tamen semel die tum commodius adsumitur, insuper etiam modicus, ne cruditatem moueat. Alternis diebus in uicem modo aqua modo uinum bibendum est. Quibus seruatis ex reliqua uictus consuetudine quam minimum mutari debet. Cum uero haec in omni pestilentia facienda sint, tum in ea maxime, quam austri excitarint. Atque etiam peregrinantibus eadem necessaria sunt, ubi graui tempore anni discesserunt ex suis sedibus, uel ubi in graues regiones uenerunt. Ac si cetera res aliqua prohibebit, utique retineri debebit a uino ad aquam, ab hac ad uinum qui supra positus est transitus.

## 4. Book II · preface, chapters 1–7

Source: https://scriptura.si/works/celsus-on-medicine/4/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/4/#p-N

[¶0] pr. Of impending disorders there are many signs, in explaining which I shall not hesitate to make use of the authority of ancient men, and especially of Hippocrates; for although more recent practitioners have made some changes in methods of treatment, they allow none the less that the ancients prognosticated best. Before I note, however, those preceding symptoms which suggest fear of disease, it does not seem unfitting to set out: the seasons of the year (1, 1‑2), the sorts of weather (1, 3‑4), periods of life and temperaments which may be in particular safe or open to risks (1, 5), and what kind of disorders is most to be apprehended in each (1, 6‑23). Not that men may not sicken and die at any season, in any sort of weather, at any age, whatever their temperament, from any kind of disease, but since certain kinds occur less... but some kinds occur more often, so it is of use that everyone should recognize against what, and when, he should be most on his guard.

> Latin: pr. Instantis autem aduersae ualetudinis SIGNA conplura sunt. In quibus explicandis non dubitabo auctoritate antiquorum uirorum uti, maximeque Hippocratis, cum recentiores medici, quamuis quaedam in curationibus mutarint, tamen haec illos optime praesagisse fateantur. Sed antequam dico, quibus praecedentibus morborum timor subsit, non alienum uidetur exponere, quae tempora anni, quae tempestatum genera, quae partes aetatis, qualia corpora maxime tuta uel periculis oportuna sint, quod genus aduersae ualetudinis in quo timeri maxime possit, non quo non omni tempore, in omni tempestatum genere omnis aetatis, omnis habitus homines per omnia genera morborum et aegrotent et moriantur, sed quo minus * * * frequentius tamen quaedam eueniant, ideoque utile sit scire unumquemque, quid et quando maxime caueat.

[¶1] 1. 1 So then spring is the most salubrious, next after it comes winter; summer is rather more dangerous than salubrious, autumn is by far the most dangerous. But as regards weather the best is that which is settled, whether cold or hot, the worst that which is the most changeable, and that is why autumn brings down the greatest number. For generally about midday there is heat, but at night and in the early morning, cold, as also in the evening. Thus the body, relaxed by the preceding summer, and now by the midday heat, is caught by the sudden cold. But while this chiefly occurs at this season, so whenever the like happens harm is done.

> Latin: 1. Igitur saluberrimum uer est, proxime deinde ab hoc hiemps; periculosior quam ⟨salub⟩rior aestas, autumnus longe periculosissimus. Ex tempestatibus uero optimae aequales sunt, siue frigidae siue calidae; pessimae, quae maxime uariant; quo fit, ut autumnus plurimos opprimat. Nam fere meridianis temporibus calor, nocturnis atque matutinis simulque etiam uespertinis frigus est. Corpus ergo, et aestate ⟨et⟩ subinde meridianis caloribus relaxatum, subito frigore excipitur. Sed ut eo tempore id maxime fit, sic, quandocumque euenit, noxium est.

[¶2] In settled weather fine days are the most salubrious, rainy better than foggy or cloudy days; and in winter the best days are those in which there is an entire absence of wind, in summer those in which westerly winds blow. As for the other winds, the northerly are more salubrious than those from the sunrising or south; nevertheless, these vary somewhat according to the character of the district. For almost everywhere wind when coming from inland is salubrious, and injurious when from the sea. And not only is health more assured in settled weather, but pre-existing diseases also, if there have been any, are milder and more quickly terminated. But the worst weather for the sick man is that which has caused his sickness, so much so that a change to weather of a naturally worse sort may be, in his condition, salutary.

> Latin: Vbi aequalitas autem est, tamen saluberrimi sunt sereni dies; meliores pluuii quam tantum nebulosi nubiliue, optimique hieme qui omni uento uacant, aestate quibus fauonii perflant. Si genus aliud uentorum est, salubriores septentrionales quam subsolani uel austri sunt, sic tamen haec, ut interdum regionum sorte mutentur. Nam fere uentus ubique a mediterraneis regionibus ueniens salubris, a mari grauis est. Neque solum in bono tempestatium habitu certior ualetudo est, sed †prior morbi quoque, si qui inciderunt, leuiores sunt ⟨et⟩ promptius finiuntur. Pessimum aegro caelum est, quod aegrum fecit, adeo ut in id quoque genus, quod natura peius est, in hoc statu salubris mutatio sit.

[¶3] The middle period of life is the safest, for it is not disturbed by the heat of youth, nor by the chill of age. Old age is more exposed to chronic diseases, youth to acute ones. The square-built frame, neither thin nor fat, is the fittest; for tallness, as it is graceful in youth, shrinks in the fulness of age; a thin frame is weak, a fat one sluggish.

> Latin: At aetas media tutissima est, quae neque iuuentae calore, neque senectutis frigore infestatur. Longis morbis senectus, acutis adulescentia magis patet. Corpus autem habilissimum quadratum est, neque gracile neque obesum. Nam longa statura, ut in iuuenta decora est, sic matura senectute conficitur, gracile corpus infirmum, obesum hebes est.

[¶4] In spring those diseases are usually to be apprehended which are stirred up anew by movement of humor. Consequently there tend to arise runnings from the eyes, pustules, haemorrhages, congestions in the body, which the Greeks call apostemata, black bile which they call μελανχολίαν, madness, fits, angina, choked nostrils, runnings from the nose. Also those diseases which affect joints and sinews, being at one time troublesome, at another quiescent, then especially both begin and recur.

> Latin: Vere tamen maxime, quae cum umoris motu nouantur, in metu esse consuerunt. Ergo tum lippitudines, pustulae, profusio sanguinis, abscessus corporis, quae apostemata Graeci nominant, bilis atra, quam ΜΕΛΑΝΧΟΛΙΑΝ appellant, insania, morbus comitialis, angina, grauedines, destillationes oriri solent. I quoque morbi, qui in articulis neruisque modo urguent modo quiescunt, tum maxime et inchoantur et repetunt.

[¶5] But summer, while not wholly exempt from most of the foregoing maladies, adds to them fevers whether continued or ardent or tertian, vomitings, diarrhoeas, earaches, oral ulcerations, cankers which occur on other parts but especially upon the pudenda, and whatever exhausts the patient by sweating.

> Latin: At aestas non quidem uacat plerisque his morbis, sed adicit febres uel continuas uel ardentis uel tertianas, uomitus, alui deiectiones, auricularum dolores, ulcera oris, cancros et in ceteris quidem partibus, sed maxime obscenis, et quicquid sudore hominem resoluit.

[¶6] In autumn there is scarcely one of the foregoing which does not happen; but at this season in addition there arise irregular fevers, splenic pain, subcutaneous dropsy, consumption, called by the Greeks phthisis, urinary difficulty, which they call strangury, the small intestine malady which they term ileos, the intestinal lubricity which they call leienteria, hip-pains, fits. Autumn too is a season fatal to those exhausted by chronic diseases and overwhelmed by the heat just past, others it weakens by fresh maladies; and it involves some in very chronic ones, especially quartan fevers, which may last even through the winter. Nor is any other period of the year more exposed to pestilence of whatever sort; although it is harmful in a variety of ways.

> Latin: Vix quicquam ex his in autumnum non incidit: sed oriuntur quoque eo tempore febres incertae, lienis dolor, aqua inter cutem, tabes, quam Graeci ΦΘΙΣΙΝ nominant, urinae difficultas, quam ΣΤΡΑΝΓΟΥΡΙΑΝ appellant, tenuioris intestini morbus quem ileon nominant, leuitas intestinorum, qui lienteria uocatur, coxae dolores, morbi comitiales. Idemque tempus et diutinis malis fatigatos, et ab aestate tantum proxima pressos interemit, et alios nouis morbis conficit; et quosdam longissimis inplicat, maximeque quartanis, quae per hiemem quoque exerceant. Nec aliud magis tempus pestilentiae patet, cuiuscumque ea generis est; quamuis uariis rationibus nocet.

[¶7] Winter provokes headache, coughs, and all the affections which attack the throat, and the sides of the chest and lungs.

> Latin: Hiemps autem capitis dolores, tussim et quicquid in faucibus in lateribus in uisceribus mali contrahitur, inritat.

[¶8] Of the various sorts of weather, the north wind excites cough, irritates the throat, constipates the bowels, suppresses the urine, excites shiverings, as also pain of the lungs and chest. Nevertheless it is bracing to a healthy body, rendering it more mobile and brisk. The south wind dulls hearing, blunts the senses, produces headache, loosens the bowels; the body as a whole is rendered sluggish, humid, languid. The other winds, as they approximate to the north or south wind, produce affections corresponding to the one or other. Moreover, any hot weather inflates the liver and spleen, and dulls the mind; the result is that there are faintings, that there is an outburst of blood. Cold on the other hand brings about: at times tenseness of sinews which the Greeks call spasmos, at times the rigor which they call tetanos, the blackening of ulcerations, shiverings in fevers. In times of drought there arise acute fevers, runnings from the eyes, dysenteries, urinary difficulty, articular pains. In wet weather there occur chronic fevers, diarrhoeas, angina, canker, fits, and the loosening of sinews which the Greeks call paralysis. Not only does the weather of the day but also of the preceding days matter. If a dry winter has been accompanied by north winds, or again a spring by south winds and rain, generally there ensue runnings from the eye, dysenteries, fevers, and most of all in more delicate bodies, hence especially in women. If on the other hand south winds and rain have prevailed during winter, and the spring is cold and dry, pregnant women near their confinement are in danger of miscarrying; those indeed who reach term, give birth only to weaklings hardly alive. Other people are attacked by dry ophthalmia, and if elderly by choked nostrils and runnings from the nose. But when the south wind prevails from the beginning of winter to the end of spring, side pains, also the insanity of those in fever which is called phrenesis, are very rapidly fatal. And when hot weather begins in the spring, and lasts through the summer, severe sweating must ensue in cases of fever. If a summer has been kept dry by northerly winds, but in the autumn there are showers and south winds, there may then arise cough, runnings from the nose, hoarseness, and indeed in some, consumption. But if the autumn is dry owing to a north wind continuing to blow, all those with more delicate bodies, among whom, as I have mentioned, are women, enjoy good health. The harder constitutions, however, may possibly be attacked by dry ophthalmias, and by fevers, some acute, some chronic, also by those maladies which arise from black bile.

> Latin: Ex tempestatibus aquilo tussim mouet, fauces exasperat, uentrem adstringit, urinam sup⟨p⟩rimit, horrores excitat, item dolores lateris et pectoris. Sanum tamen corpus spissat et mobilius atque expeditius reddit. Auster aures hebetat, sensum tardat, capitis dolores mouet, aluum soluit, totum corpus efficit hebes, umidum, languidum. Ceteri uenti, quo uel huic uel illi propiores sunt, eo magis uicinos his illisue affectus faciunt. Denique omnis calor iecur et lienem inflat, mentem hebetat; ut anima deficiat, ut sanguis prorumpat, efficit. Frigus modo neruorum distentionem, modo rigorem infert; illud spasmos, hoc tetanos Graece nominatur; nigritiem in ulceribus, horrores in febribus excitat. In siccitatibus acutae febres, lippitudines, tormina, urinae difficultas, articulorum dolores oriuntur; per imbres longae febres, alui deiectiones, angina, cancri, morbi comitiales, resolutio neruorum (paralysin Graeci nominant). Neque solum interest, quales dies sint, sed etiam, quales ante praecesserint. Si hiemps sicca septentrionales uentos habuit, uer autem austros et pluuias exhibet, fere subeunt lippitudines, tormina, febres, maximeque in mollioribus corporibus, ideoque praecipue in muliebribus. Si uero austri pluuiaeque hiemem occuparunt, uer autem frigidum et siccum est, grauidae quidem feminae, quibus tum adest partus, abortu periclitantur; eae uero, quae gignunt, inbecillos uixque uitales edunt. Ceteros lippitudo arida et, si seniores sunt, grauedines atque destillationes male habent. At si a prima hieme austri ad ultimum uer continuarint, laterum dolores et insania febricitantium, quam ⟨ph⟩renesin appellant, celerrime rapiunt. Vbi uero calor a primo uere orsus aestatem quoque similem exhibet, necesse est multum sudorem in febribus subsequi. At si sicca aestas aquilones habuit, autumno uero imbres austrique sunt, tota hieme, quae proxima est, tussis, destillatio, raucitas, in quibusdam etiam tabes oritur. Sin autem autumnus quoque aeque siccus isdem aquilonibus perflatur, omnibus quidem mollioribus corporibus, inter quae muliebria esse proposui, secunda ualetudo contingit: durioribus uero instare possunt et aridae lippitudines, et febres partim acutae partim longae, et i morbi, qui ex ⟨a⟩tra bile nascuntur.

[¶9] As regards the various times of life, children and adolescents enjoy the best health in spring, and are safest in early summer; old people are at their best during summer and the beginning of autumn; young and middle-aged adults in winter. At these periods should any indisposition arise, it is very probable that infants and children still of tender age should suffer from the creeping ulcerations of the mouth which the Greeks call aphthas, vomiting, insomnia, discharges from the ear, and inflammations about the navel. Especially in those teething there arise ulcerations of the gums, slight fevers, sometimes spasms, diarrhoea; and they suffer as the canine teeth in particular are growing up; the most well-nourished children, and those constipated, are especially in danger. In those somewhat older there occur affections of the tonsils, various spinal curvatures, swelling in the neck, the painful kind of warts which the Greeks call acrochordones, and a number of other swellings. At the commencement of puberty, in addition to many of the above troubles, there occur chronic fevers and also nose-bleedings. Throughout childhood there are special dangers, first about the fortieth day, then in the seventh month, next in the seventh year, and after that about puberty. The sorts of affections which occur in infancy, when not ended by the time of puberty, or of the first coitions, or of the first menstruations in the females, generally become chronic; more often, however, puerile affections, after persisting for a rather long while, come to an end. Adolescence is liable to acute diseases, such as fits, especially to consumption; those who spit blood are generally youths. After that age come on pain in the side and lung, lethargy, cholera, madness, and outpourings of blood from certain mouths of veins which the Greeks call haemorrhoids. In old age there occur breathing and urinary difficulties, choked nostrils, joint and renal pains, paralysis, the bad habit of body which the Greeks call cachexia, insomnias, the more chronic maladies of the ears, eyes, also of the nostrils, and especially looseness of the bowels with its sequences, dysentery, intestinal lubricity, and the other ills due to bowel looseness. In addition thin people are fatigued by consumption, diarrhoea, running from the nose, pain in the lung and side. The obese, many of them, are throttled by acute diseases and difficult breathing; they die often suddenly, which rarely happens in a thinner person.

> Latin: Quod ad aetates uero pertinet, pueri proximique his uere optime ualent, et aestate prima tutissimi sunt, senes aestate et autumni prima parte, iuuenes hieme quique inter iuuentam senectutemque sunt. Inimicior senibus hiemps, aestas adulescentibus est. Tum si qua inbecillitas oritur, proximum est, ut infantes tenerosque adhuc pueros serpentia ulcera oris, quae ΑΦΘΑΣ Graeci nominant, uomitus, nocturnae uigiliae, aurium umor, circa umbilicum infla⟨mma⟩tiones exerceant. Propriae etiam dentientium gingiuarum exulcerationes, febriculae, interdum neruorum distentiones, alui deiectiones; maximeque caninis dentibus orientibus male habent; quae pericula plenissimi cuiusque sunt, et cui maxime uenter adstrictus est. At ubi aetas paulum processit, glandulae, et uertebrarum, quae in spina sunt, aliquae inclinationes, struma, uerrucarum quaedam genera dolentia (ΑΚΡΟΧΟΡΔΟΝΑΣ Graeci appellant) et plura alia tubercula oriuntur. Incipiente uero iam pube, et ex isdem mult⟨a⟩, et longae febres, sanguinis ex naribus cursus. Maximeque omnis pueritia, primum circa quadragesimum diem, deinde septimo mense, tum septimo anno, postea circa pubertatem periclitatur. Si qua etiam genera morborum in infantem inciderunt, ac neque pubertate neque primis coitibus neque in femina primis menstruis finita sunt, fere longa sunt: saepius tamen morbi pueriles, qui diutius manserunt, terminantur. Adulescentia morbis acutis item comitialibus tabique maxime obiecta est; fereque iuuenes sunt, qui sanguinem expuunt. Post hanc aetatem laterum et pulmonis dolores, lethargus, cholera, insania, sanguinis per quaedam uelut ora uenarum (ΑΙΜΟ⟨Ρ⟩ΡΟΙΔΑΣ Graeci appellant) profusio. In senectute spiritus et urinae difficultas, grauedo, articulorum et renum dolores, neruorum resolutiones, malus corporis habitus (†ΚΑΚΕΞΙΑΝ Graeci appellant), nocturnae uigiliae, uitia longiora aurium, oculorum, etiam narium, praecipueque soluta aluus, et quae secuntur hanc, tormina uel leuitas intestinorum ceteraque uentris fusi mala. Praeter haec graciles tabes, deiectiones, destillationes, item uiscerum et laterum dolores fatigant. Obesi plerumque acutis morbis et difficultate spirandi strangulantur, subitoque saepe moriuntur; quod in corpore tenuiore uix euenit.

[¶10] 2. 2 Now antecedent to illness, as I have stated above, certain signs arise, all of which have this in common, that the body becomes altered from its accustomed state, and that not only for the worse, but it may be even for the better. Hence when a man has become fatter and better looking and with a higher colour, he should regard with suspicion these gains of his for, because they can neither remain in the same state nor advance further, as a rule they fall back in a sort of collapse. Still it is a worse sign when anyone, contrary to his habit, becomes thinner, and loses his colour and good looks; for when there is a superfluity of flesh there is something for the disease to draw upon; when there is a deficiency, there is nothing to hold out against the disease itself. Further, there should be apprehension at once: if the limbs become heavier, if frequent ulcerations arise, if the body feels hotter than customary; if heavier sleep oppresses, if there are tumultuous dreams, if anyone wakes up oftener than usual, then falls asleep again; if the body of the sleeper has partial sweats in unaccustomed places, and especially about the chest or neck or legs or knees or hips. Again, if the spirit flags, if he is reluctant to talk or move about, if the body be torpid; if there is pain over the heart or over all the chest, or of the head as happens in most; if the mouth becomes filled with saliva, if there is pain in turning the eyes, if the troops are constricted, when the limbs shiver, if the breathing becomes more laboured; if the blood-vessels of the forehead are distended and throb, if there are frequent yawns; if the knees feel as if fatigued, or the whole body feels weary. Of these signs, many are often, some always, antecedents of fever. The first thing, however, to be considered is, whether any of these signs happen somewhat frequently, yet no bodily trouble has followed it. For there are some peculiarities of persons, without knowledge of which it is not easy for anybody to prognosticate what is going to happen. Consequently anyone may readily be at ease in the case of happenings which he has frequently escaped without harm: the man who ought to be anxious is the one to whom these signs are new, or who has never found them free from danger unless he has taken precautions.

> Latin: 2. Ante aduersam autem ualetudinem, ut supra dixi, quaedam NOTAE oriuntur, quarum omnium commune est aliter se corpus habere atque consueuit, neque in peius tantum sed etiam in melius. Ergo si plenior aliquis et speciosior et coloratior factus est, suspecta habere bona sua debet; quae quia neque in eodem habitu subsistere neque ultra progredi possunt, fere retro quasi ruina quadam reuoluuntur. Peius tamen signum est, ubi aliquis contra consuetudinem emacuit et colorem decoremque amisit, quoniam in is, quae superant, e⟨s⟩t quod morbus demat; in is, quae desunt, non est quod ipsum morbum ferat. Praeter haec protinus timeri debet, si grauiora membra sunt, si crebra ulcera oriuntur, si corpus supra consuetudinem incaluit; si grauior somnus pressit, si tumultuosa somnia fuerunt, si saepius expergiscitur aliquis quam adsuevit, deinde iterum soporatur; si corpus dormientis circa partes aliquas contra consuetudinem insudat, maximeque si circa pectus, aut ceruices, aut crura uel genua uel coxas. Item si marcet animus, si loqui et moueri piget, si corpus torpet; si dolor praecordiorum est aut totius pectoris aut, qui in plurimis ⟨e⟩uenit, capitis; si saliuae plenum os est, si oculi cum dolore uertuntur, si tempora adstricta sunt, si membra inhorrescunt, si spiritus grauior est; si circa frontem intentae uenae mouentur, si frequentes oscitationes; si genua quasi fatigata sunt, totumue corpus lassitudinem sentit. Ex quibus saepe plura, numquam non aliqua febrem antecedunt. In primis tamen illud considerandum est, nu⟨m⟩ cui saepius horum aliquid eueniat neque ideo corporis ulla difficultas subsequatur. Sunt enim quaedam proprietates hominum, sine quarum notitia non facile quicquam in futurum praesagiri potest. Facile itaque securus est in is aliquis, quae saepe sine periculo euasit: ille sollicitari debet, cui haec noua sunt, aut qui ista numquam sine custodia sui tuta habuit.

[¶11] 3. 3 But when fever has actually seized upon a man, it may be known that he is not in danger: if he lies upon his side, whether on his right or left, just as suits him, with his legs a little drawn up, as is generally the way with a healthy person when lying down; if the patient turns readily in bed, if he sleeps through the night, and keeps awake by day; if he breathes easily; if he does not toss about; if the skin around the navel and pubes is plump; if the parts below the ribs on the two sides are uniformly soft, without any sensation of pain; for even although they are somewhat tumid, so long as they yield to pressure by the fingers, and are not tender, this illness, though it will continue for some time, yet will be safe. There is promise of freedom from anxiety when the body in general is uniformly soft and warm, and it sweats uniformly all over, and if with this sweating the touch of fever comes to an end. Among good signs are: sneezing, also a desire for food, whether maintained from the first, or even beginning after a distaste for food. Nor should a fever which ends on the same day cause alarm, nor indeed one which, although longer in disappearing, yet entirely quiets down before the next paroxysm, so that the body is rendered sound, or, as the Greeks call it, eilikrines. But should any vomiting occur, it should be of bile and of phlegm mixed; any sediment in the urine would be white, slimy, and uniform, and so that even if small clouds, as it were, are swimming in it, they sink to the bottom. Again the belly of one who is safe from danger yields soft, formed motions, at much the same time as was customary in health, as well as proportionate to the food taken. A loose motion is worse; but not even this should cause alarm at once, if on the following morning the stool is rather more solid, or if each succeeding motion becomes firmer, reddish, and smelling no worse than that of a man in health. There is no harm in passing off some round worms towards the crisis of the malady. When flatulence causes pain and swelling in the upper part of the abdomen, it is a good sign when intestinal rumbling passes thence downwards towards the lower belly, and the more so, when without difficulty the wind escapes along with the faeces.

> Latin: 3. Vbi uero febris aliquem occupauit, scire licet non periclitari, si in latus aut dextrum aut sinistrum, ut ipsi uisum est, cubat, cruribus paulum reductis, qui fere sani quoque iacentis habitus est; si facile conuertitur, si noctu dormit, interdiu vigilat; si ex facili spirat, si non conflictatur; si circa umbilicum et pubem cutis plena est; si praecordia eius sine ullo sensu doloris aequaliter mollia in utraque parte sunt: quod si paulo tumidiora sunt, sed tamen digitis cedunt et non dolent, haec ualetudo, ut spatium aliquod habebit, sic tuta erit. Corpus quoque, quod aequaliter molle et calidum est, quodque aequaliter totum insudat, et cuius febricula eo sudore finitur, securitatem pollicetur. Sternumentum etiam inter bona indicia est, et cupiditas cibi uel a primo seruata, uel etiam post fastidium orta. Neque terrere debet ea febris, quae eodem die finita est, ac ne ea quidem, quae, quamuis longiore tempore euanuit, tamen ante alteram accessionem ex toto quieuit, sic ut corpus integrum, quod ΕΙΛΙΚΡΙΝΕΣ Graeci uocant, fieret. Si quis autem incidit uomitus, mixtus esse et bile et pituita debet, et in urina subsidere album, leue, aequale, sic ut etiam, si quae quasi nubeculae innatarint, in imum deferantur. At uenter ei, qui a periculo tutus est, reddit mollia, figurata, eodem fere tempore, quo secunda ualetudine adsueuit, modo conuenientia iis, quae adsumuntur. Peior cita aluus est: sed ne haec quidem terrere protinus debet, si matutinis temporibus coacta magis est, aut si procedente tempore paulatim contrahitur et rufa est neque foeditate odoris similem aluum sani hominis excedit. Ac lumbricos quoque aliquos sub finem morbi descendisse nihil nocet. Si infl⟨a⟩tio in superioribus partibus dolorem tumoremque fecit, bonum signum est sonus uentris inde ad inferiores partes euolutus, magisque etiam, si sine difficultate cum stercore excessit.

[¶12] 4. 4 On the contrary there is danger of a severe disease: when the patient lies on his back with his arms and legs outstretched; when at the onset of an acute disease, especially in lung troubles, he wants to sit up; when he is worn down by insomnia even if he gets some sleep in the day-time, in which case to sleep between ten o'clock in the morning and night is worse than from early morning till ten o'clock. The worst, however, is if he gets sleep neither by day nor by night; for this generally cannot happen unless there is continuous pain. It is not a good sign, however, to be oppressed beyond measure by sleep, and it is the worse the more that somnolence continues day and night. It is also evidence of a serious malady: when the breathing is forcible and quick, when the patient begins to have shiverings from the sixth day, to spit up pus, to expectorate it with difficulty, to have continuous pain, to bear up against the disease with difficulty, to toss the arms and legs, to shed tears involuntarily, to have sticky humor adhering to the teeth, the skin about the navel and the pubes wasted; the parts below the ribs inflamed, painful, hard, tumid, tense and this more on the right than on the left side; the greatest danger, however, is if in that region the blood-vessels throb forcibly. It also indicates a serious malady: to become thinner too quickly; to have the head, feet and hands hot, and the belly and sides cold, or to have the extremities cold at the height of an acute disease, or to shiver after sweating; or after vomiting to hiccough or to get red eyes; or to have loss of appetite after eagerness for food or after prolonged fevers; or to sweat profusely, especially a cold sweat, or to have sweats unequally distributed over the body which do not put an end to the fever; and when those fevers which recur every day at the same hour, or which have always equal paroxysms, are not relieved on the third day, but continue; serious also are those fevers which, whilst they increase by paroxysms and are relieved by declining, yet never leave the body free. The worst is when the fever is not even relieved but continues uniformly at its height. It is likewise dangerous for a fever to supervene upon jaundice, especially if the parts below the ribs on the right side remain hard. In these sufferers every acute fever must make us seriously anxious; and never in acute fever or following on sleep is a spasm otherwise than terrifying. To lie in a fright on awaking from sleep is a sign of serious malady; and also when, immediately upon the onset of a fever, there is mental disturbance, or any one of the limbs is paralysed; in which case, although there is a return of vitality, yet generally that limb is weakened. A vomit also is a danger-sign if purely of phlegm or of bile, unmixed, and it is the worse if green or black. It is a bad sign when the urinary sediment is reddish and slimy; worse if it is like flower-petals, thin and white; worst of all if there is an appearance as if of fine clouds composed of bran. Also thin and white urine is faulty, but above all in phrenetics. Again it is bad for the motions to be totally suppressed; it is dangerous also during fevers when fluid stools allow the patient no rest in bed, and especially if the evacuation is quite liquid, whether it be whitish or greenish or frothy. In addition danger is indicated when the motion is scanty, viscid, slimy, white, the same when greenish yellow; or if it is either livid or bilious, or bloody, or if a worse odour when ordinary. It is bad after a prolonged fever when the stool is unmixed.

> Latin: 4. Contra grauis morbi periculum est, ubi supinus aeger iacet porrectis manibus et cruribus; ubi residere uolt in ipso acuti morbi impetu, praecipueque pulmonibus laborantibus; ubi nocturna uigilia premitur, etiamsi interdiu somnus accedit; ex quo tamen peior est, qui inter quartam horam et noctem est, quam qui matutino tempore ad quartam. Pessimum tamen est, si somnus neque noctu neque interdiu accedit: id enim fere sine continuo dolore esse non potest. Neque uero signum bonum est etiam somno ultra debitum urgueri, peiusque, quo magis se sopor interdiu noctuque continuat. Mali etiam morbi testimonium est uehementer et crebro spirare, a sexto die coepisse inhorrescere, pus expuere, uix excreare, dolorem habere continuum, difficulter morbum ferre, iactare bracchia et crura, sine uoluntate lacrimare; habere umorem glutinosum dentibus inhaerentem, cutem circa umbilicum et pubem macram, praecordia inflammata, dolentia, dura, tumida, intenta, magisque si haec dextra parte quam sinistra sunt; periculosissimum tamen est, si uenae quoque ibi uehementer agitantur. Mali etiam morbi signum est nimis celeriter emacrescere; caput et pedes manusque calidas habere uentre et lateribus frigentibus, aut frigidas extremas partes acuto morbo urguente, aut post sudorem inhorrescere; aut post uomitum singultum esse uel rubere oculos; aut post cupiditatem cibi postue longas febres hunc fastidire; aut multum sudare, maximeque frigido sudore, aut habere sudores non per totum corpus aequales, quique febrem non finiant, et febres eas, quae cotidie tempore eodem reuertantur, quaeue semper pares accessiones habeant neque tertio quoque die leuentur quaeque continuent, ut per accessiones increscant, tantum per de⟨c⟩essiones molliantur, neque umquam integrum corpus dimittant. Pessimum est, si ne leuatur quidem febris, sed aeque concitata continuat. Periculosum etiam est post arcuatum morbum febrem oriri, utique si praecordia dextra parte dura manserunt. Ac dolentibus his nulla acuta febris leviter terrere nos debet; neque umquam in acuta febre aut a somno non est terribilis neruorum distentio. Timere etiam ex somno mali morbi est, itemque in prima protinus febre mentem esse turbatam membrumue aliquod esse resolutum; ex quo casu quamuis uita redditur, tamen id fere membrum debilitatur. Vomitus etiam periculosus est si sincer⟨us est nec ei⟩ pituita uel bilis est mixta, peiorque, si uiridis aut niger. At mala urina est, in qua subsidunt subrubra et leuia; deterior, in qua quasi folia quaedam tenuia atque alba; pessima ex his, si tamquam ex furfuribus factas nubeculas repraesentat. Diluta quoque atque alba uitiosa est, sed in ⟨ph⟩reneticis maxime. Aluus autem mala est ex toto suppressa; periculosa etiam, quae inter febres fluens conquiescere hominem in cubili non patitur, utique, si quod descendit est perliquidum aut albidum aut pallidum aut spumans. Praeter haec periculum ostendit id quod excernitur, si est exiguum, glutinosum, leue, album, idemque subpallidum; uel si est aut liuidum aut biliosum aut cruentum aut peioris odoris quam ex consuetudine. Malum est etiam, quod post longas febres sincerum est.

[¶13] 5. 5 After such signs the only thing to pray for is that the disease may be a long one, for so it must be unless it kills. Nor is there any other hope of life in grave illnesses except that the patient may avoid the attack of the disease by protracting it, and that it may be prolonged for sufficient time to afford opportunity for treatment. At the onset, however, there are certain signs from which it is possible to conclude that the disease, even if it be not fatal, nevertheless is going to last rather a long time: when in fevers which are not acute a cold sweat breaks out over the head and neck only, or when there is general sweating without the fever subsiding, or when the patient is at one time cold, at another time hot, or his colour changes from moment to moment, or when in the course of fever there is a congestion in some part, which does not lead the way to recovery, or when the patient wastes a little for a considerable time, again if the urine is at one time clear and limpid, at another time has some sediment which is slimy, white or red, or if there is in the sediment an appearance of bread crumbs, or it sends up bubbles.

> Latin: 5. Post haec indicia uotum est longum morbum fieri: si⟨c⟩ enim necesse est, nisi occidit. Neque uitae alia spes in magnis malis est, quam ut impetum morbi trahendo aliquis effugiat porrigaturque in id tempus, quod curationi locum praestet. Protinus tamen signa quaedam sunt, ex quibus colligere possimus morbum, etsi non interemit, longius tamen tempus habiturum: ubi frigidus sudor inter febres non acutas circa caput tantum aut ceruices oritur, aut ubi febre non quiescente corpus ⟨insudat, aut ubi corpus⟩ modo frigidum modo calidum est et color alius ex alio fit, aut ubi, quod inter febres aliqua parte abscessit, ad sanitatem non peruenit, aut ubi aeger pro spatio parum emacrescit; item si urina modo pura et liquida est, modo habet quaedam subsidentia, ⟨aut si⟩ leuia atque alba rubraue ⟨sunt,⟩ quae in ea subsidunt, aut si quasdam quasi m⟨i⟩culas repraesentat, aut si bull⟨ul⟩as excitat.

[¶14] 6. 6 But among the foregoing signs, though there are indeed grounds for fear, still there is hope left: however, that the last stage has now been reached is indicated by the nose becoming pointed, the temples sunken, the eyes hollowed, the ears cold and flaccid with the tips drooping slightly, the skin of the forehead hard and tight: the aspect is dusky or very pallid, and much more so when there has been no preceding insomnia, nor diarrhoea, nor loss of appetite. From which causes these appearances at times arise, but only last one day: and so when they last longer death is indicated. In the case of long-standing disease, when such signs have lasted for the third day, death is at hand, and the more so if besides this the eyes also shun the light and shed tears, and are reddened where they should be white, and the veins in them are pale, and phlegm floating in them comes to stick to the angles and one eye becomes smaller than the other, and either both are deep-sunken, or more tumid, and the eyelids are not closed in sleep, but some of the white of the eyes appears between them — always provided that this has not been occasioned by fluid motions; the same is the case when the eyelids become pale and a similar pallor renders colourless the lips and nostrils; so also when the lips and nostrils and eyes and eyebrows or any one of them become distorted; and the patient owing to weakness either hears not or sees not. Death is likewise denoted: when the patient lies on his back with his knees bent; when he keeps on slipping down towards the foot of the bed; when he uncovers his arms and legs and tosses them about anyhow, whilst they lack warmth; when he gapes, when he continually falls asleep; when he whose mind is amiss grinds his teeth, which he did not do in health; when an ulceration, whether pre-existing or arising in the course of the illness, has become dry and either pallid or livid. The following are also indications of death: the nails and fingers pallid; the breath cold; or if the patient, in a fever or acute disease, or mad or with pain either in the lung or head, picks with his hands at the flock or pulls at the fringes of the bedclothes, or claws at anything small projecting from the adjacent wall. Pains about the hips and lower parts, which, after starting and spreading to the viscera, then suddenly subside, afford evidence of oncoming death, and the more so if there are other signs in addition. It is impossible for a patient to be saved, who, having fever without any swelling, is suddenly choked, or who cannot swallow his saliva; or who, in the same condition of fever and body, has the neck twisted so that he can swallow nothing whatever; or who has continuous fever and is in the last stage of bodily weakness; or when, without the fever subsiding, the surface of the body becomes cold whilst the interior is so hot as even to produce thirst; or when, likewise without the fever subsiding, he is distressed at once by delirium and difficulty in breathing; or when, after a draught of hellebore, he is seized with spasm; or becoming drunk he loses his speech: for generally he is carried off in a spasm, unless either fever supervenes, or he begins to speak by the time that the intoxication should have passed off. A woman also when pregnant is easily carried of by an acute disease, as also a man in whom sleep aggravates pain, and one in whom, at the very beginning of a fresh disorder, black bile presents itself, whether below or above; or after his body has become attenuated by a long illness and weakened, when such bile gains exit either way. Expectoration of bile or pus, whether they come up separately or mixed, discloses a danger of death. And when either commences about the seventh day, the patient will most likely die about the fourteenth day, unless other signs, better or worse, supervene; and according as these subsequent signs are the slighter or the graver, so they denote a later or earlier death. In an acute fever a cold sweat is noxious, and so is a vomit in any malady when varied in composition and multicoloured, particularly so when malodorous. And to have vomited blood in a fever is also noxious. Now red and thin urine is usual in severe indigestion, and often, before there is time for it to mature, it carries the man off; and so when such urine persists for a rather long while, danger of death is indicated. The worst and especially death-bringing urine, however, is that which is black, thick, malodorous; such urine is most to be dreaded both in men and in women; but in children urine which is thin and diluted. A motion also is noxious: when varied in composition, when it presents shreds, blood, bile, greenish matter, whether at different times, or simultaneously mixed together yet distinguishable. But although it is possible for the patient to bear up awhile against such symptoms, a speedy termination is denoted, when the motion is livid and also when it is either black, or pallid, or fatty, especially if there is added an intensely fetid odour. I know that on this point someone may question me:— if there are such sure signs of approaching death, how is it that patients who have been deserted by their medical attendants sometimes recover? And rumour has spread it about that some have revived whilst being carried out to burial. Democritus, indeed, a man justly renowned, even held that the signs of life having ended, upon which practitioners had relied, were not sufficiently sure; much more did he not admit that there could be any sure signs of approaching death. In answer to these I shall not even assert that some signs, stated as approximately certain, often deceive inexperienced practitioners, but not good ones; for instance Asclepiades, when he met the funeral procession, recognized that a man who was being carried out to burial was alive; and it is not primarily a fault of the art if there is a fault on the part of its professor. But I shall more modestly suggest that the art of medicine is conjectural, and such is the characteristic of a conjecture, that though it answers more frequently, yet it sometimes deceives. A sign therefore is not to be rejected if it is deceptive in scarcely one out of a thousand cases, since it holds good in countless patients. I state this, not merely in connexion with noxious signs, but as to salutary signs as well; seeing that hope is disappointed now and again, and that the patient dies whom the practitioner at first deemed safe; and further that measures proper for curing now and again make a change into something worse. Nor, in the face of such a variety of temperaments, can human frailty avoid this. Nevertheless the medical art is to be relied upon, which more often, and in by far the greater number of patients, benefits the sick. It should not be ignored, however, that it is rather in acute diseases that signs, whether of recovery or of death, may be fallacious.

> Latin: 6. Sed inter haec quidem proposito metu spes tamen superest: ad ultima uero iam uentum esse testantur nares acutae, conlapsa tempora, oculi concaui, frigidae languidaeque aures et imis partibus leuiter ⟨a⟩uersae, cutis circa frontem dura et intenta: color aut niger aut perpallidus, multoque magis, si ita haec sunt, ut neque uigilia praecesserit neque uentris resolutio neque inedia. Ex quibus causis interdum haec spe⟨cie⟩s oritur, sed uno die finitur: itaque diutius durans mortis index est. Si uero in morbo uetere iam triduo talis est, in propinquo mors est, magisque, si praeter haec oculi quoque lumen refugiunt et inlacrimant, quaeque in iis alba esse debent, rubescunt, atque in isdem uenulae pallent, pituitaque in iis innatans nouissime angulis inhaerescit, alterque ex his minor est, iique aut uehementer subsederunt, aut facti tumidiores sunt, perque somnum palpebrae non committuntur, sed inter has ex albo oculorum aliquid apparet, neque id fluens aluus expressit; eaedemque palpebrae pallent, et idem pallor labra et nares decolorat; eademque labra et nares oculique et palpebrae et supercilia aliquaue ex his peruertuntur; isque propter inbecillitatem iam non audit, aut non uidet. Eadem mors denuntiatur, ubi aegri supini cubantis genua contracta sunt; ubi is deorsum ad pedes subinde delabitur; ubi brachia et crura nudat et inaequaliter dispergit, neque iis calor subest; ubi hiat, ubi adsidue dormit; ubi is, qui mentis suae non est, neque id facere sanus solet, dentibus stridet; ubi ulcus, quod aut ante aut in ipso morbo natum est, aridum et aut pallidum aut liuidum factum est. Illa quoque mortis indicia sunt: ungues digitique pallidi, frigidus spiritus; aut si manibus quis in febre et acuto morbo uel insania pulmonisue dolore uel capitis in ueste floccos legit fimbriasue deducit, uel in adiuncto pariete, si qua minuta eminent, ca⟨r⟩pit. Dolores etiam circa coxas et inferiores partes orti, si ad uiscera transierunt, subitoque desierunt, mortem subesse testantur, magisque si alia quoque signa accesserunt. Neque is seruari potest, qui sine ullo tumore febricitans subito strangulatur, aut deuorare saliuam suam non potest; cuiue in eodem febris corporisque habitu ceruix conuertitur sic, ut deuorare aeque nihil possit; aut cui simul et continua febris et ultima corporis infirmitas est; aut cui febre non quiescente exterior pars friget, interior sic calet, ut etiam sitim faciat; aut qui febre ⟨aeque⟩ non quiescente simul et delirio et spirandi difficultate uexatur; aut qui epoto ueratro exceptus distentione neruorum est; aut qui ebrius ommutuit: is enim [febre adiecta] neruorum distentione consumitur, nisi aut febris accessit, aut eo tempore, quo ebrietas solui debet, loqui coepit. Mulier quoque grauida acuto morbo facile consumitur; et is, cui somnus dolorem auget; et cui protinus in recenti morbo bilis atra uel infra uel supra se ostendit; cuiue alterutr⟨o⟩ modo se prompsit, cum iam longo morbo corpus eius esset extenuatum et adfectum. Sputum etiam biliosum et purulentum, siue separatim ista siue mixta proueniunt, interitus periculum ostendunt. Ac si circa septimum diem tale esse coepit, in proximum est, ut is circa quartum decimum diem decedat, nisi alia signa mitiora peioraue accesserint; quae quo leuiora grauioraue subsecuta sunt, eo uel seriorem mortem uel maturiorem denuntiant. Frigidus quoque sudor in acuta febre pestifer est, atque in omni morbo uomitus, qui uarius et multorum colorum est, praecipueque si malus in hoc odor est. Ac sanguinem quoque in febre uomuisse pestiferum est. Vrina uero rubra et tenuis in magna cruditate esse consueuit, et saepe, antequam spatio maturescat, hominem rapit: itaque si talis diutius permanet, periculum mortis ostendit. Pessima tamen est praecipueque mortifera nigra, crassa, mali odoris; atque in uiris quidem et mulieribus talis deterrima est: in pueris uero quae tenuis et diluta est. Aluus quoque uaria pestifera est, quae strigmentum, sanguinem, bilem, uiride aliquid, modo diuersis temporibus, modo simul, et in mixtura quadam, discreta tamen repraesentat. Sed haec quidem potest paulo diutius trahere: in praecipiti uero iam esse denuntiat, quae li[q]uida eademque uel nigra uel pallida uel pinguis est, utique si magna foeditas odoris accessit. Illud interrogari me posse ab aliquo scio: si certa futurae mortis indicia sunt, quomodo interdum deserti a medicis conualescunt? * * quosdamque fama prodiderit in ipsis funeribus reuixisse. Quin etiam uir iure magni nominis Democritus ne finitae quidem uitae satis certas notas esse proposuit, quibus medici credidissent: adeo illud non reliquit, ut certa aliqua signa futurae mortis essent. Aduersus quos ne dicam illud quidem, quod in uicino saepe quaedam notae positae non bonos sed inperitos medicos decipiunt, quod Asclepiades funeri obuius intellexit [quendam] uiuere qui efferebatur; nec protinus crimen artis esse, si quod professoris sit. Illa tamen moderatius subiciam, coniecturalem artem esse medicinam, rationemque coniecturae talem esse, ut, cum saepius aliquando responderit, interdum tamen fallat. Non si quid itaque uix in millensimo corpore aliquando decipit, id notam non habet, cum per innumerabiles homines respondeat. Idque non in is tantum, quae pestifera sunt, dico, sed in is quoque, quae salutaria; siquidem etiam spes interdum frustratur, et moritur aliquis, de quo medicus securus primo fuit: quaeque medendi causa reperta sunt, nonnumquam in peius aliquid conuertunt. Neque id euitare humana inbecillitas in tanta uarietate corporum potest. Sed tamen medicinae fides est, quae multo saepius perque multo plures aegros prodest. Neque tamen ignorare oportet in acutis morbis fallaces magis notas esse et salutis et mortis.

[¶15] 7. 7 Now that I have set out the signs which are of general occurrence in any case of illness, I pass on to indicate signs which may be presented in particular sorts of diseases. There are, moreover, certain signs, some preceding, some in the course of fevers, which show what is, or what is about to become, the state of the internal parts. Before fever, if the head is heavy, or the eyes dimmed after sleep, or there are frequent sneezings, some attack of phlegm about the head is to be apprehended. If a man is full blooded or very hot, it is likely that there will be haemorrhage from some part. If a man without cause becomes thin, there is fear that his body may lapse into a dangerous state. If there is pain below the ribs or severe flatulence, or if for a whole day undigested urine is passed, there is clearly indigestion present. Persons whose colour is bad when they are not jaundiced are either sufferers from pains in the head or are earth eaters. Those who for a long time have a pale or puffy face are sufferers from head, bowel or stomach trouble. If in the case of a child with constant fever no motion is passed, the colour is altered, and sleeplessness persists and constant crying, there is danger of spasms. Again running from the nose recurring often in a slender and tall man is a sign that consumption is to be apprehended. When for several days no motion passes, it shows that a sudden motion or a touch of fever is impending. Dropsy is impending, when with prolonged diarrhoea the feet swell; when there is pain in the lower belly and hips; but this class of disease is wont to arise from the flanks. There is danger, the same as just stated, to those in whom, when there is a desire for stool, the bowels yield nothing unless a forced hard motion; also in whom there is swelling in the feet, and a swelling in turn in the right and then the left half of the abdomen which rises and subsides: but this disease appears to begin from the liver. It is a sign of the same disease, when intestines in the umbilical region undergo twisting (the Greeks call it strophos), when pains in the hips persist, which are not dispersed either by time or by medicaments. But when heat of joints, whether in the feet, hands, or any other part, is such that at that spot the sinews are contracted, or if that same limb, fatigued by a slight cause, is disturbed by heat and by cold alike, it denotes that there is about to set in pain in feet or hands, or disease of that joint in which heat is felt. Children in whom there has been nose-bleeding, which then has ceased, are sure to be troubled by pains in the head, or they get some severe joint-ulcerations, or they also become debilitated by disease of some kind. Women in whom the menstrua are not forthcoming are sure to have the most acute pains in the head, or some part or other becomes subject to disease. There are similarly dangers for those in whom joint-disorders, pains and swellings, arise and subside without pain in the feet and such like diseases, especially if they have often pain in the temples and night sweats. Running from the eyes is to be apprehended when the forehead itches. If after childbirth a woman has severe pains, yet without other bad signs, about the twentieth day either blood will burst out from the nose, or there will be some congestion in the lower parts. Indeed anyone getting great pain in the temples or forehead may be rid of it in one of these two ways, by haemorrhage especially if young, if older by suppuration. Fever, moreover, which suddenly, unaccountably and without good signs comes to an end, generally recurs. He will be found to have ulceration either in the nose or in the throat, whose throat, whether in the day-time, or by night, fills with blood, when this has been preceded neither by pains in the head, nor by pain over the heart, nor by coughing, nor by vomiting, nor by slight fever. In a woman, if without apparent cause an inguinal swelling has arisen with slight fever, there is ulceration in the womb. Again thick urine, the sediment from which is white, indicates that pain and disease are to be apprehended in the region of joints or viscera. Similar urine, when greenish, is a sign that there will be either visceral pain and swelling with some danger, or certainly that the patient is not free from fever. But if there is blood or pus in the urine, either the bladder or the kidneys have become ulcerated. The kidneys at any rate are the seat of disorder: if the urine is thick and contains bits of flesh like hairs; if it froths and is malodorous; if at one time it presents something like sand, at another time like blood; when the hips are painful, as also the parts intermediate and above the pubes, and there are frequent eructations, now and again bilious vomiting, and the extremities become cold; when there is frequent desire to urinate but great urinary difficulty, and when what is passed is like water, reddish or pallid, yet is followed by little relief, and much wind too is passed with a motion. But the bladder is the actual seat of the disorder: when urine is passed drop by drop, or when blood is emitted with it, and in the blood are some clots which are passed with difficulty, and when the lower parts in the region of the pubes are painful. Cases of stone in the bladder are recognized by the following signs: urine is passed with difficulty and slowly, now and again even involuntarily, drop by drop, the urine being sandy; at times blood, or something blood-stained or purulent, is excreted with the urine; this some pass more readily standing, some whilst lying on the back and especially those with large calculi, some even pass urine bending forwards whilst they relieve the pain by drawing out the penis. There is in that part also a feeling of weight, increased by running, or by any kind of movement. Some also when in great pain interlock their feet, crossing alternately the one over the other. Women again are forced to put their hands to their vulvar orifice and scratch; at times they feel the stone when they put a finger to the place where it is pressing upon the neck of the bladder. But there is a lung disease in those who spit up frothy blood. In a pregnant woman immoderate looseness of the bowels can drive out the foetus; in the same condition, what she is carrying is a weakling, if milk escapes from her breasts; firm breasts testify that it is healthy. It signifies that the liver is inflamed when there is hiccough both frequent and continuing longer than usual. When swellings which have supervened upon ulcerations subside suddenly, if situated in the back, either spasm or rigor may be apprehended; but if this happens in front, either acute pleural pain or madness is to be expected: at times also in such a case, diarrhoea follows, which is the safest thing. If a customary bleeding from haemorrhoids is suddenly suppressed, dropsy or phthisis follows. Phthisis likewise supervenes if, after beginning with pain in the side, suppuration cannot be cleared off within forty days. And the black bile disease supervenes upon prolonged despondency with prolonged fear and sleeplessness. Those who often have bleeding from the nose, have swelling of the spleen, or pains in the head, and as a consequence some observe phantoms before their eyes. But those in whom the spleens are enlarged, in these the gums are diseased, the mouth foul, or blood bursts out from some part. When none of these things happen, of necessity bad ulcers will be produced on the legs, and from these black scars. In those who, with a cause for pain, do not feel it, the mind is disordered. If blood flows into the abdomen it is there turned into pus. There is danger of suppuration in the chest when pain spreads there from the hips and lower parts, even although no other bad sign is added. When, without any fever, there is pain or itching in some part, with redness and heat, some suppuration is taking place there. Also urine which is not limpid enough for a man in health denotes that some parotid suppuration is about to set in.

> Latin: 7. Sed cum proposuerim signa, quae in omni aduersa ualetudine communia esse consuerunt, eo quoque transibo, ut, quas aliquis in singulis morborum generibus habere possit notas, indicem. Quaedam autem sunt quae ante febres, quaedam quae inter eas, quid aut intus sit aut uenturum sit, ostendunt. Ante febres, si caput graue est, aut ex somno oculi caligant, aut frequentia sternumenta sunt, circa caput aliquis pituitae impetus timeri potest. Si sanguis aut calor abundat, proxumum est, ut aliqua parte profluuium sanguinis fiat. Si sine causa quis emacrescit, ne in malum habitum corpus eius recidat, metus est. Si praecordia dolent, aut inflatio grauis est, aut toto die non concocta fertur urina, cruditatem esse manifestum est. Quibus diu color sine morbo regio malus est, ii uel capitis doloribus conflictantur, uel terram edunt. Qui diu habent faciem pallidam et tumidam, aut capite aut uisceribus aut aluo laborant. Si in continua febre puero uenter nihil reddidit, mutaturque ei color, neque somnus accedit, ploratque is adsidue, metuenda neruorum distentio est. Frequens autem destillatio in corpore tenui longoque tabem timendam esse testatur. Vbi pluribus diebus non descendit aluus, docet aut subitam deiectionem aut febriculam instare. Vbi pedes turgent, longae deiectio⟨nes sunt;⟩ ubi dolor in imo uentre et coxis est, aqua inter cutem instat: sed hoc morbi genus ab ilibus oriri solet. Idem propositum periculum est iis, quibus uoluntas desidendi est, uenter nihil reddit nisi et aegre et durum, tumor in pedibus est, idemque modo dextra modo sinistra parte uentris inuicem oritur atque finitur: sed a iocinere id malum proficisci uidetur. Eiusdem morbi nota est, ubi circa umbilicum intestina torquentur (ΣΤΡΟΦΟΥΣ Graeci nominant), coxaeque dolores manent, eaque neque tempore neque remediis soluuntur. Calor autem articulorum prout in pedibus manibusue aut alia qualibet parte sic est ut eo loco nerui contrahantur, aut si id membrum ex leui causa fatigatum aeque frigido calidoque offenditur, podagram cheragramue, uel eius articuli, in quo id sentitur, morbum futurum esse denuntiat. Quibus in pueritia sanguis ex naribus fluxit, deinde fluere desiit, uel capitis doloribus conflictentur necesse est, uel in articulis aliquas exulcerationes grauis habeant, uel aliquo morbo etiam debilitentur. Quibus feminis menstrua non proueniunt, necesse est capitis acerbissimi dolores sint, uel quaelibet alia pars morbo infestetur. Eademque iis pericula sunt, quibus articulorum uitia, dolores tumoresque, sine podagra similibusque morbis, oriuntur et desinunt, utique, si saepe tempora isdem dolent noctuque corpora insudant. Si fros prurit, lippitudinis metus est. Si mulier a partu uehementes dolores habet, neque alia praeterea signa mala sunt, circa uicensimum diem aut sanguis per nares erumpet, aut in inferioribus partibus aliquid abscedet. Quicumque etiam dolorem ingentem circa tempora et frontem habebit, is alterutra ratione eum finiet, magisque si iuuenis erit, per sanguinis profusionem, si senior, per suppurationem. Febris autem, quae subito sine ratione, sine bonis signis finita est, fere reuertitur. Cui sanguine fauces et interdiu et noctu replentur, sic ut neque capitis dolores neque praecordiorum neque tussis neque uomitus neque febricula praecesserit, huius aut in naribus aut in faucibus ulcus reperietur. Si mulieri inguen et febricula orta est, neque causa apparet, ulcus in uulua est. Urina autem crassa, ex qua quod desidet album est, significat circa articulos aut circa viscera dolorem metumque morbi esse. Eadem uiridis aut uiscerum dolorem tumoremque cum aliquo periculo subesse, aut certe corpus integrum non esse testatur. At si sanguis aut pus in urina est, uel uesica uel renes exulcerati sunt. Si haec crassa carunculas quasdam exiguas quasi capillos habet, aut si bullat et male olet, et interdum quasi harenam, interdum quasi sanguinem trahit, dolent autem coxae et quae inter has superque pubem sunt, et accedunt frequentes ructus, interdum uomitus biliosus, extremaeque partes frigescunt, urinae crebra cupiditas sed magna difficultas est, et quod inde excretum est, aquae simile uel rufum uel pallidum est, paulum tamen in eo leuamenti est, aluus uero cum multo spiritu redditur, utique in renibus uitium est. ⟨A⟩t si paulatim destillat, uel si sanguis per hanc editur, et in eo quaedam cruenta concreta sunt, idque ipsum cum difficultate redditur, et circa pubem inferiores partes delent, in eadem uesica uitium est. Calculosi uero his indiciis cognoscuntur: difficulter urina redditur paulatimque; interdum etiam sine uoluntate destillat; eadem harenosa est; nonnumquam sanguis aut cruentum aut purulentum aliquid cum ea excernitur; eamque quidam promptius recti, quidam resupinati, maximeque ii, qui grandes calculos habent, quidam etiam inclinati reddunt, colemque extendendo dolorem leuant. Grauitatis quoque cuiusdam in ea parte sensus est; atque ea cursu omnique motu augentur. Quidam etiam, cum torquentur, pedes inter se, subinde mutatis uicibus, inplicant. Feminae uero oras naturalium suorum manibus admotis scabere coguntur: nonnumquam, si digitum admouerunt, ubi uesicae ceruicem is urguet, calculum sentiunt. At qui spumantem sanguinem excreant, iis in pulmone uitium est. Mulieri grauidae sine modo fusa aluus excutere partum potest. Eidem si lac ex mammis profluit, inbecillum est quod intus gerit: durae mammae sanum illud esse testantur. Frequens singultus et praeter consuetudinem continuus iecur inflammatum esse significat. Si tumores super ulcera subito esse desierunt, idque a tergo incidit, uel distentio neruorum uel rigor timeri potest: at si a priore parte id euenit, uel lateris acutus dolor uel insania expectanda est: interdum etiam eiusmodi casum, quae tutissima inter haec est, profusio alui sequitur. Si ora uenarum, sanguinem solita fundere, subito suppressa sunt, aut aqua inter cutem aut tabes sequitur. Eadem tabes subit, si in lateris dolore orta suppuratio intra quadraginta dies purgari non potuit. At si longa tristitia cum longo timore et uigilia est, atrae bilis morbus subest. Quibus saepe ex naribus fluit sanguis, iis aut lienis tumet, aut capitis dolores sunt, quos sequitur, ut quaedam ante oculos tamquam imagines obuersentur. At quibus magni lienes sunt, iis gingiuae malae sunt, et os olet, aut sanguis aliqua parte prorumpit; quorum si nihil euenit, necesse est in cruribus mala ulcera, et ex his nigrae cicatrices fiant. Quibus causa doloris neque sensus eius est, his mens labat. Si in uentrem sanguis confluxit, ibi in pus uertitur. Si a coxis et inferioribus partibus dolor in pectus transit, neque ullum signum malum accessit, suppurationis eo loco periculum est. Quibus sine febre aliqua [ex] parte dolor aut prurigo cum rubore et calore est, ibi aliquid suppurat. Vrina quoque, quae in homine sano parum liquida est, circa aures futuram aliquam suppurationem esse denuntiat.

## 5. Book II · chapters 7–8

Source: https://scriptura.si/works/celsus-on-medicine/5/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/5/#p-N

[¶0] Now these signs, though even in the absence of fever, they afford indications of latent or oncoming affections, do so with much more certainty when there is fever in addition; and then signs of other diseases besides may develop. Thus madness is to be apprehended immediately: when a patient speaks more hurriedly than he did when well, and of a sudden becomes loquacious, and that with more audacity than was his wont; or when he breathes slowly and forcibly, and has dilated blood-vessels, while the parts below the ribs are hard and swollen. Further signs of madness are: frequent movement of the eyes, and, in cases of headache, shadows passing before the eyes; or loss of sleep in the absence of pain, the wakefulness persisting night and day; or lying on the belly contrary to habit without being obliged to do so by abdominal pain; or, while the body is still vigorous, an unaccustomed grinding of the teeth. If also there has been congestion which has subsided without the formation of pus, whilst fever persists, there is brought about danger first of delirium, then of death. Acute pain in ear with continuous severe fever also often disturbs the mind; from which affection younger patients die at times within seven days; older ones later, for they experience neither such high fever, nor are equally delirious, hence they hold out until this condition is converted into pus. The breasts of a woman, when they become suffused with blood, also indicate that delirium is about to supervene. But in those in whom fevers are prolonged, there will be an abscess somewhere or pains in the joints. When during fever the breathing in the throat becomes impeded, spasms are impending. If angina subsides suddenly, the malady has passed into the lung; and it is then often fatal within seven days. If that does not happen, it follows that somewhere there is suppuration. Again after a prolonged looseness of the bowels there arise dysenteries, and after these intestinal lubricity; phthisis after excessive runnings from the nose; lung diseases after pain in the side; and from these madness; after ardent fevers rigor or spasm of sinews; after a head wound, delirium; when wakefulness tortures, spasms of sinews; when in wounds blood-vessels throb violently, haemorrhage. But suppuration is induced by many diseases; for if fever continues for a long while without pain and without evident cause, suppuration is developing in some part — in younger patients, however; for generally in the elderly from a self-same malady a quartan fever is developed. Suppuration is likewise being produced if the parts below the ribs are hard and painful, and have not carried off the patient by the twentieth day, or nose-bleeding has not occurred, and this chiefly in the case of adolescents, especially if from the commencement there has been dimness of vision, or headache; but in these cases something is abscessing in the lower parts of the abdomen. Or if the parts below the ribs present a soft swelling which persists and does not subside within sixty days, and fever holds all that time; but in these cases an abscess is being produced in the upper parts of the abdomen. And if it is not produced in the actual viscera, it breaks out around the ears. Whilst every swelling of long standing is generally an expectant abscess, it tends more to this in the region in front of the heart, than in the abdomen, and in the abdomen rather above than below the navel. Something is abscessing, either in the jaws or in the joints, if there is with the fever also a feeling of lassitude. At times too the urine remains thin and unconcocted for so long that other signs are salutary, and from this condition an abscess often occurs below the transverse membrane which the Greeks call diaphragma. Pain in the lung again, when not terminated by expectoration or by blood-letting, or by regulation of the diet, may excite some abscesses in it about the twentieth, thirtieth, fortieth, occasionally sixtieth day. But we will count from the day when there is first fever or shivering or sense of weight in that part. These abscesses originate sometimes from the lung, sometimes from the opposite side. Whichever side is affected the suppuration gives rise to pain in inflammation; it is hotter there, and if the patient lies on the sound side he seems to oppress it by some weight. Further, any suppuration, not yet evident to the eye, can be detected as follows: if the fever does not remit, but whilst diminishing by day, increases at night, there is profuse sweating, a desire to cough, yet hardly anything is expectorated in coughing; the eyes are sunken, the cheeks flushed, the veins under the tongue pale; the finger nails become curved, the fingers hot, especially at their tips; there are swellings in the feet; there is greater difficulty in breathing, and distaste for food; pustules spring up all over the body. But if there was pain from the commencement with cough and difficult breathing, the abscess will burst before or about the twentieth day; if these signs happen later they necessarily have to develop, but the less quickly they come to a head, the later the relief. In a grave disease the feet, toes and nails also tend to blacken; and when death does not follow, and the rest of the body recovers, nevertheless the feet fall off.

> Latin: Haec uero, cum sine febre quoque uel latentium uel futurarum rerum notas habeant, multo certiora sunt, ubi febris accessit, atque etiam aliorum morborum tum signa nascuntur. Ergo protinus insania timenda est, ubi expeditior alicuius, quam sani fuit, sermo subitaque loquacitas orta est, et haec ipsa solito audacior; aut ubi raro quis et uehementer spirat, uenasque concitatas habet praecordiis duris et tumentibus. Oculorum quoque frequens motus, et in capitis dolore offusae oculis tenebrae, uel nullo dolore substante somnus ereptus, continuataque nocte et die uigilia, uel prostratum contra consuetudinem corpus in uentrem, sic ut ipsius alui dolor id non coegerit, item robusto adhuc corpore insolitus dentium stridor insaniae signa sunt. Si quid etiam abscessit, et antequam suppuraret manente adhuc febre subsedit, periculum adfert primum furoris, deinde interitus. Auris quoque dolor acutus cum febre continua uehementique saepe mentem turbat; ex eo casu iuueniores interdum intra septimum diem moriuntur, seniores tardius, quoniam neque aeque magnas febres experiuntur, neque aeque insaniunt: ita sustinent, dum is adfectus in ⟨p⟩us uer⟨t⟩atur. Suffusae quoque sanguine mulieris mammae furorem uenturum esse testantur. Quibus autem longae febres sunt, iis aut abscessus aliqui aut articulorum dolores erunt. Quorum faucibus in febre inliditur spiritus, instat his neruorum distentio. Si angina subito finita est, in pulmone⟨m⟩ id malum transit; idque saepe intra septimum diem occidit. Quod nisi incidat, sequitur, ut aliqua parte suppuret. Deinde post alui longam resolutionem tormina, post haec intestinorum leuitas oritur; post nimias destillationes tabes, post lateris dolorem uitia pulmonum, post haec insania; post magnos feruores corporis neruorum rigor aut distentio; ubi caput uulneratum est, delirium; ubi uigilia torsit, neruorum distentio; ubi uehementer uenae super ulcera mouentur, sanguinis profluuium. Suppuratio uero pluribus morbis excitatur: nam si longae febres sine dolore, sine manifesta causa remanent, in aliquam partem id malum incumbit, in iuuenioribus tamen: nam senioribus ex eiusmodi morbo quartana fere nascitur. Eadem suppuratio fit, si praecordia dura, dolentia ante uicensimum diem hominem non sustulerunt, neque sanguis ex naribus fluxit, maximeque in adulescentibus, utique si inter principia aut oculorum caligo aut capitis dolores fuerunt: sed tum ⟨in⟩ inferioribus partibus aliquid abscedit. Aut si praecordia tumorem mollem habent, neque habere intra sexaginta dies desinunt, haeretque per omne id tempus febris; sed tum in superioribus partibus fit abscessus; ac si inter ipsa uiscera non f⟨i⟩t, circa aures erumpit. Quo⟨m⟩que omnis longus tumor ad suppurationem fere spectet, magis eo tendit is, qui in praecordiis quam is, qui in uentre est; is, qui supra umbilicum quam is, qui infra est. Si lassitudinis etiam sensus in febre est, uel in maxillis uel in articulis aliquid abscedit. Interdum quoque urina tenuis et cruda sic diu fertur, ut alia salutaria signa sint, exque eo casu plerumque infra transuersum septum, quod ΔΙΑΦΡΑΓΜΑ Graeci uocant, fit abcessus. Dolor etiam pulmonis, si neque etiam per sputa neque per sanguinis detractionem neque per uictus rationem finitus est, uomicas aliquas intus excitat aut circa uicesimum diem ⟨aut circa tricesimum⟩ aut circa quadragesimum, nonnumquam etiam circa sexagensimum. Numerabimus autem ab eo die, quo primum febricitauit aliquis aut inhorruit aut grauitatem eius partis sensit. Sed hae uomicae modo a pulmone modo a contraria parte nascuntur. Quod suppurat, ab ea parte, quam adficit, dolorem inflammationemque concitat: ipsum calidius est ⟨et,⟩ si in partem sanam aliquis decubuit, onerare eam ex pondere aliquo uidetur. Omnis etiam suppuratio, quae nondum oculis patet, sic deprehendi potest: si febris non dimittit, eaque interdiu leuior est, noctu increscit, multus sudor oritur, cupiditas tussiendi est, et paene nihil in tussi excreatur, oculi caui sunt, malae rubent, uenae sub lingua inalbescunt, in manibus fiunt adunci ungues, digiti maximeque summi ⟨ca⟩lent, in pedibus tumores sunt, spiritus difficilius trahitur, cibi fastidium est, pustulae toto corpore oriuntur. Quod si protinus initio dolor et tussis fuit et spiritus difficultas, uomica uel ante uel circa uicesimum diem erumpet: si serius ista coeperint, necesse est quidem increscant, sed quo minus cito adfecerint, eo tardius soluentur. Solent etiam in graui morbo pedes cum digitis unguibusque nigrescere: quod si non est mors consecuta et reliquum corpus inualuit, pedes tamen decidunt.

[¶1] 8. 8 It follows now that I have to explain the special signs which in any particular affection indicate either hope or danger.

> Latin: 8. Sequitur, ut in quoque morbi genere proprias notas explicem, quae uel spem uel periculum ostendant.

[¶2] When there is pain in the bladder, if purulent urine is discharged which has in it a sediment slimy and white, it allays apprehension.

> Latin: Ex uesica dolenti si purulenta urina processit, inque ea leue et album subsedit, metum detrahit.

[¶3] In pulmonary disease a patient may possibly regain health, if expectoration, although purulent, relieves pain, so long as he breathes and expectorates freely, and bears the disease without difficulty. Nor is there cause for alarm at an early stage, if the expectoration is mixed with something reddish and with blood, so long as it is expectorated at once.

> Latin: In pulmonis morbo si sputo ipso leuatur dolor, quamuis id purulentum est tamen aeger facile spirat, facile excreat, morbum ipsum non difficulter fert, potest ei secunda ualetudo contingere. Neque inter initia terreri conuenit, si protinus sputum mixtum est rufo quodam et sanguine, dummodo statim edatur.

[¶4] Pain in the side ends if the suppuration which has arisen is cleared off within forty days.

> Latin: Laterum dolores suppuratione facta, deinde intra quadragesimum diem purgata, finiuntur.

[¶5] If there is an abscess in the liver, and the pus let out is uniform and white, in that case recovery is easy, because the mischief is enclosed in a capsule.

> Latin: Si in iocinere uomica est, et ex ea fertur pus purum et album, salus facilis est: id enim malum in tunica est.

[¶6] Among suppurations too those are tolerable which point and discharge outwards. And of those which move inwards, those are the most favourable which do not affect the overlying skin, but leave it free from pain, and of the same colour as the surroundings. Pus indeed causes no fear, wherever it breaks out, when slimy and uniformly white, and if the fever subsides at once upon its discharge, and distaste for food and thirst cease to be troublesome. Also whenever suppuration descends into the legs, and the patient's expectoration from being reddish becomes purulent, there is less danger. But in phthisis, he that is to recover should have his expectoration white, uniform in consistency and colour, unmixed with phlegm;

> Latin: Ex suppurationibus uero eae tolerabiles sunt, quae in exteriorem partem feruntur et acuuntur. At ex iis, quae intus procedunt, eae leuiores, quae contra se cutem non adficiunt, eamque et sine dolore esse et eiusdem coloris, cuius reliquae partes sunt, sinunt esse. Pus quoque, quacumque parte erumpit, si est leue, album, unius coloris, sine ullo metu est, et quo effuso febris protinus conquieuit desieruntque urguere cibi fastidium et potionis desiderium. Si quando etiam suppuratio descendit in crura, sputumque eiusdem factum pro rufo purulentum est, periculi minus est.

[¶7] and that which drips into the nose from the head should have similar characters. It is the best by far for there to be no fever; second best when the fever is so slight as not to impair the appetite or cause frequent thirst. In this affection the patient's state is favourable: when the bowels are moved once a day, the motions being formed and in amount corresponding to the food consumed; the body least attenuated, the chest most broad and hairy; its cartilages small, and covered with flesh. If supervening on phthisis, a woman's menses also become suppressed and pain is continuous over her chest and shoulders, a sudden eruption of blood customarily relieves the disease; for the cough becomes less, and the thirst and slight fever subside. But generally in these cases, unless the haemorrhage recurs, an abscess bursts, and the more blood comes from it the better. Dropsy is the least alarming when it has commenced without being preceded by any disease;

> Latin: At in tabe eius, qui saluus futurus est, sputum esse debet album, aequale totum, eiusdemque coloris, sine pituita; eique etiam simile esse oportet, si quid in nares a capite destillat. Longe optimum est febrem omnino non esse; secundum est tantulam esse, ut neque cibum inpediat neque crebram sitim faciat. Aluus in hac ualetudine ea tuta est, quae cotidie, quae coacta, quae conuenientia iis, quae adsumuntur, reddit; corpus id, quod minime tenue maximeque lati pectoris atque saetosi est, cuiusque cartilago exigua et carnosa est. Super tabem si mulieri suppressa quoque menstrua fuerunt, et circa pectus atque scapulas dolor mansit subitoque sanguis erupit, leuari morbus solet: nam et tussis minuitur, et sitis atque febricula desinunt. Sed isdem fere, nisi redit sanguis, uomica erumpit; quae quo cruentior, eo melior est.

[¶8] next when it has supervened upon a long illness, certainly if the viscera are sound, if the breathing is easy, if there is no pain, if the body is not hot, and the extremities are wasted uniformly, if the abdomen is soft, if there is no cough, no thirst, if the tongue is not much parched even after sleep; if there is desire for food, if the bowels are moved by medicaments, if the motions when spontaneous are soft and formed, if the size of the abdomen are reduced; if the urine is altered both by a change of the wine and of certain medicinal draughts; if there is no lassitude and the disorder is easily borne: a patient who presents all these signs is thoroughly safe, and that case is hopeful which exhibits the greater number of them.

> Latin: Aqua autem inter cutem minime terribilis est, quae nullo antecedente morbo coepit; deinde, quae longo morbo superuenit, utique si firma uiscera sunt, si spiritus facilis, si nullus dolor, si sine calore corpus est, aequaliterque in extremis partibus macrum est, si mollis uenter, si nulla tussis, nulla sitis, si lingua ne ⟨su⟩per somnum quidem inarescit; si cibi cupiditas est, si uenter medicamentis mouetur, si per se excernit mollia et figurata, si extenuatur; si urina et uini mutatione et epotis aliquibus medicamentis mutatur; si corpus sine lassitudine est et morbum facile sustinet: siquidem in quo omnia haec sunt, is ex toto tutus est; in quo plura ex his sunt, is in bona spe est.

[¶9] Joint-disorders, too, such as foot and hand aches, if they attack young people and have not induced callosities, can be resolved; for the most part they are removed by dysenteries and fluid motions, whatever the sort.

> Latin: Articulorum uero uitia, ut podagrae cheragraeque, si iuuenes temptarunt neque callum induxerunt, solui possunt; maximeque torminibus leniuntur et quocumque modo uenter fluit.

[¶10] Epileptic fits again are not difficult to bring to an end, when they have commenced before puberty, and whenever the sensation of the coming fit begins in some one part of the body. It is best for it to begin from the hands or feet, next from the flanks, worst of all from the head.

> Latin: Item morbus comitialis ante pubertatem ortus non aegre finitur; et in quo ab una parte corporis uenientis accessionis sensus incipit, optimum est a manibus pedibusue initium fieri, deinde a lateribus; pessimum inter haec ⟨a⟩ capite.

[¶11] In such patients, also, the most favourable signs are when the disease can be discharged in the stools. Diarrhoea is itself harmless, when there is no fever, if it is quickly over, if on touching the abdomen no movements are to be felt, if wind follows the last of the motion.

> Latin: Atque in his quoque ea maxime prosunt, quae per deiectiones excernuntur. Ipsa autem deiectio sine ulla noxa est, quae sine febre est, si celeriter desinit, si cont⟨a⟩cto uentre nullus motus eius sentitur, si extremam aluum spiritus sequitur.

[¶12] Even dysenteries are not a danger although blood or shreds are passed, as long as fever and other accessories of this malady are absent, so that even a pregnant woman can not only be preserved herself, but the foetus preserved also. It is helpful in this malady if the patient's age is already mature. Intestinal lubricity on the other hand is more easy got rid of in childhood, certainly if urine begins to be passed and the body to be nourished by the food.

> Latin: Ac ne tormina quidem periculosa sunt, si sanguis et strigmenta descendunt, dum febris ceteraeque accessiones huius morbi absint, adeo ut etiam grauida mulier non solum reseruari possit, sed etiam partum reseruare; prodestque in hoc morbo, si iam aetate aliquis processit.

[¶13] The same age has the advantage in cases both of hip and shoulder pains, and of all forms of para-lysis;

> Latin: Contra intestinorum leuitas facilius a teneris aetatibus depellitur, utique si ferri urina et ali cibo corpus incipit.

[¶14] in such the hip may be cured easily and early, if it is not numbed, if slightly cool, even though the pains are severe, and a paralysed limb can be restored if its nutrition is not at all impaired. Paralysis of the face may be even ended by a quick motion; and any purging benefits runnings of the eyes. But madness is relieved rather by the formation of varicose veins or by a sudden effusion of blood from haemorrhoids or by dysentery. Shoulder pains spreading to the shoulder-blades or hands are relieved by a vomit of black bile;

> Latin: Eadem aetas prodest ⟨et⟩ in coxae dolore et umerorum et omni resolutione neruorum; ex quibus coxa, si sine torpore est, si leuiter friget, quamuis magnos dolores habet, tamen et facile et mature sanatur, resolutumque membrum, si nihilo minus alit⟨ur⟩, fieri sanum potest. Oris resolutio etiam aluo cita finitur; omnisque deiectio lippienti prodest. At uarix ortus uel per ora uenarum subita profusio sanguinis uel tormina insaniam tollunt.

[¶15] and pain of any kind which moves downwards is the more curable. Sneezing puts an end to hiccough.

> Latin: Vmerorum dolores, qui ad scapulas uel manus tendunt, uomitu atrae bilis soluuntur; et quisquis dolor deorsum tendit, sanabilior est.

[¶16] Prolonged diarrhoeas are suppressed by vomiting.

> Latin: Singultus sternumento finitur.

[¶17] In a woman a vomiting of blood is relieved by menstruation;

> Latin: Longas deiectiones supprimit uomitus.

[¶18] when not cleared up by menstruation, nose-bleeding removes all danger. A woman in trouble with her womb or labour difficulty is relieved by sneezing. Quartan fever in summer is mostly short. In a case of ardent fever with a tremor, delirium is salutary.

> Latin: Mulier sanguinem uomens profusis menstruis liberatur. Quae menstruis non purgatur, si sanguinem ex naribus fudit, omni periculo uacat. Quae locis laborat aut difficulter partum edit, sternumento leuatur.

[¶19] For enlargement of the spleen dysenteries are good. Then again fever itself is in the end often a protection, which may appear very strange.

> Latin: Aestiua quartana fere breuis est. Cui calor et tremor est, saluti delirium est. Lienosis bono tormina sunt.

[¶20] For it brings to an end pains over the heart if there is no inflammation; and it also relieves a painful liver; and if it begins after spasm and rigor, it gives entire relief; and it removes the disease of the small intestine arising from urinary difficulty, if by its heat it promotes urination.

> Latin: Denique ipsa febris, quod maxime mirum uideri potest, saepe praesidio est. Nam et praecordiorum dolores, si sine inflammatione sunt, finit; et iocineris dolori succurrit; et neruorum distentionem rigoremque, si postea coepit, ex toto tollit; et ex difficultate urinae morbum tenuioris intestini ortum, si urinam per calorem mouet, leuat.

[¶21] Now pains in the head, accompanied by dimness of vision and redness of the eyes, along with some itching of the forehead, may be relieved by a haemorrhage, whether fortuitous or procured. Pains in the head and forehead due to wind or to cold or to heat are terminated by running from the nose and sneezings. The ardent fever, however, which the Greeks call causodes, is got rid of by a sudden shivering.

> Latin: At dolores capitis, quibus oculorum caligo et rubor cum quadam frontis prurigine accedunt, sanguinis profusione uel fortuita uel etiam petita summouentur. Si capitis ac frontis dolores ex uento uel frigore aut aestu sunt, grauedine et sternumentis finiuntur.

[¶22] During a fever, if the ears have become dulled, that trouble is entirely removed by a flux of blood from the nose, or by loose motions from the bowel. Against deafness nothing can be more efficacious than a bilious stool. Those who have begun to suffer from the smaller kinds of abscesses in the urethra which they call phumata, get well when pus has come away from that part.... and since they mostly arise of themselves, we may know that even where the resources of art are applied, nature can do the most.

> Latin: Febrem autem ardentem, quam Graeci causoden uocant, subitus horror exsoluit. Si in febre aures obtunsae sunt, si sanguis naribus fluxit, aut uenter resolutus est, illud malum desinit ex toto. Nihil plus aduersus surditatem quam biliosa aluus potest. Quibus in fistula urinae ⟨uel⟩uti minutiores abscessus, quos ΦΥΜΑΤΑ uocant, esse coeperunt, is, ubi pus ea parte profluxit, sanitas redditur.

[¶23] On the other hand, pain in the bladder with persistent fever, when nothing is passed by the bowel, is a fatal evil;

> Latin: * * * Ex quibus cum pleraque per se proueniant, scire licet inter ea quoque, quae ars adhibet, naturam plurimum posse.

[¶24] the danger is greatest in boys from the seventh to the fourteenth year. In pulmonary disease, if there was no expectoration during the first days, if it then begins from the seventh day and persists beyond a further seven days, it is dangerous.

> Latin: Contra si ue⟨si⟩ca ⟨cum⟩ febre continenti dolet, neque ⟨uenter⟩ quicquam reddit, malum atque mortiferum est; maximeque id periculum est pueris a septimo anno ad quartum decimum.

[¶25] And the more the sputum has an undistinguishable admixture of colours, the worse it is. But nevertheless nothing is worse than for the expectoration emitted to be homogeneous, whether reddish, or clotted, or white, or glutinous, or pallid, or frothy; worst of all, however, is the black. In this same disease the following are signs of danger: cough, catarrh, and even sneezing, which in other maladies is held salutary; and a sudden diarrhoea following upon the above is a most dangerous sign. Generally too the same signs hold good for pain in the side as for that in the lung, both the more favourable as well as the graver signs.

> Latin: In pulmonis morbo, si sputum primis diebus non fuit, deinde a septimo die coepit et ultra septimum mansit, periculosum est; quantoque magis mixtos neque inter se diductos colores habet, tanto deterius. Et tamen nihil peius est quam sincerum id edi, siue rufum est siue cruentum siue album siue glutinosum siue pallidum siue spumans; nigrum tamen pessimum est. In eodem morbo periculosa sunt tussis, destillatio, etiam quod alias salutare habetur, sternumentum; periculosissimumque est, si haec secuta subita deiectio est.

[¶26] If the pus discharged from the liver is bloody, it is a deadly sign.

> Latin: Fere uero quae in pulmonis, eadem in lateris dolore et mitiora signa et asperiora esse consuerunt.
Ex iocinere si pus cruentum exit, mortiferum est.

[¶27] Now of suppurations the worst are those which tend inwards, whilst also discolouring the overlying skin: of those again which burst externally, the worst are those which are largest and most widespread. But even after the abscess has ruptured, or the pus has been let outwards, there is danger for certain if the fever does not subside, or although it subsides, nevertheless recurs; or further if there is thirst, if distaste for food, if liquid motions, if the pus is livid and pallid, if the patient expectorates nothing but frothy phlegm. And of such suppurations, old people die mostly of those excited by lung diseases; younger people of other kinds.

> Latin: At ex suppurationibus eae pessimae sunt, quae intus tendunt, sic ut exteriorem quoque cutem decolorent: ex is deinde, quae in exteriorem partem prorumpunt, eae pessimae, quae maximae quaeque planissimae sunt. Quod si, ne rupta quidem uomica uel pure extrinsecus emisso, febris quieuit, aut quamuis quierit, tamen repetit, item si sitis est, si cibi fastidium, si uenter liquidus, si pus est liuidum et pallidum, si nihil aeger excreat nisi pituitam spumantem, periculum certum est. Atque ex is quidem suppurationibus, quas pulmonum morbi concitarunt, fere senes moriuntur: ex ceteris iuniores.

[¶28] But that in phthisis danger threatens a thin man is signified as follows: the expectoration is purulent with admixtures, a persistent fever robs him of his appetite at meal-times and afflicts him with thirst. Death is at hand if, after the patient has dragged on for a long while, the hair falls out, the urine exhibits sediment like cobwebs and has a foul odour, and most of all when upon the above diarrhoea supervenes; especially if it is the autumn season, when patients who have lasted through the rest of the year are generally undone. Moreover, in this disease, after pus has been expectorated, it is fatal for there to be an entire cessation of spitting. In the course of phthisis, even in adolescents, abscesses followed by fistulae arise in the lung; and unless numerous signs of convalescence follow, they do not readily heal. But as regards others, the least easily cured are girls, or those women in whom suppression of menses has supervened upon the phthisis. When again in a man who has been healthy there arises suddenly pain in the head, next he is so overcome by sleep that he snores and cannot be awaked, he will die by the seventh day; the more so, if a loose motion has not preceded, if the eyelids of the sleeper are unclosed and the whites of the eyes show. And in these cases death follows except if the malady has been dispersed by fever.

> Latin: At in tabe sputum mixtum, purulentum, febris adsidua, quae et cibi tempora eripit et siti adfligit, in corpore tenui subesse periculum testantur. Si quis etiam in eo morbo diutius traxit, ubi capilli fluunt, ubi urina quaedam araneis similia subsidentia ostendit, atque in iis odor foedus est, maximeque ubi post haec orta deiectio est, protinus moritur, utique si tempus autumni est, quo fere qui cetera parte anni traxerunt, resoluuntur. Item pus expuisse in hoc morbo, deinde ex toto spuere desisse mortiferum est. Solent etiam in adulescentibus ex eo morbo uomicae fistulaeque oriri; quae non facile sanescunt, nisi si multa signa bonae ualetudinis subsecuta sunt. Ex reliquis uero minime facile sanantur uirgines aut eae mulieres, quibus super tabem menstrua suppressa sunt. Cui uero sano subitus dolor capitis ortus est, dein somnus oppressit, sic ut stertat neque expergiscatur, intra septimum diem pereundum est; magis si eum aluus cita non antecesserit, si palpebrae dormientis non coeunt, si album oculorum apparet. Quos tamen ita mors sequitur, si id malum non est febre discussum.

[¶29] Again dropsy, if caused by an acute disease, is seldom conducted to a cure, at any rate when signs supervene the reverse of those noted above. Likewise too in this disease a cough takes away hope as is also the case if there is an outburst of blood whether upwards or downwards and water fills the middle of the body. In some also in this disease swellings arise, then subside, and again recur: such patients are in a somewhat safer state than those mentioned above, if they give attention; but generally they are undone by over-confidence in their health. Here we may wonder with good reason why there should be occurrences which cause our bodies harm, and yet at the same time in a measure are beneficial: for whether it is dropsical fluid which has filled a patient up, or whether it is a quantity of pus which has collected in a large abscess, evacuation all at once is as fatal to him, as if a healthy man loses blood by a wound.

> Latin: At aqua inter cutem, si ex acuto morbo coepit, ad sanitatem raro perducitur, utique si contraria iis, quae supra posita sunt, subsecuntur. Aeque in ea quoque tussis spem tollit, item, si sanguis sursum deorsumque erupit et aqua medium corpus inplevit. Quibusdam etiam in hoc morbo tumores oriuntur, deinde desinunt, deinde rursus adsurgunt: hi tutiores quidem sunt, quam qui supra conprehensi sunt, si adtendun⟨t⟩; sed fere fiducia secundae ualetudinis opprimuntur. Illud iure aliquis mirabitur, quomodo quaedam simul et adfligant nostra corpora, et parte aliqua tueantur: nam siue aqua inter cutem quem impleuit, siue in magno abscessu multum puris coit, simul id omne effudisse aeque mortiferum est, ac si quis sani corporis uulnere factus exsanguis est.

[¶30] Those too who suffer in their joints, so that growths of hard stuff are formed upon them, are never relieved entirely: all these damages, whether they have begun in old age, or have lasted from youth up to old age, although there is a possibility of some alleviation, are never entirely cured.

> Latin: Articulis uero qui sic dolent, ut super eos ex callo quaedam tubercula innata sint, numquam liberantur: quaeque eorum uitia uel in senectute coeperunt, uel ad senectutem ab adulescentia pervenerunt, ut aliquando leniri possunt, sic numquam ex toto finiuntur.

[¶31] Also fits which have arisen after the twenty-fifth year are hard to relieve, much harder when they begin after the fortieth; hence at this age, whilst there may be some hope from nature, there is scarcely any from the Art of Medicine. In this affection, if the whole body is affected all together, and there has not been beforehand in any part some feeling of an oncoming ill, but the patient falls down unexpectedly, he scarcely ever gets well, be his age what it may: further, if either the mind is diseased, or paralysis has been set up, there is no opportunity for the Art of Medicine.

> Latin: Morbus quoque comitialis post annum XXV ortus aegre curatur, multoque aegrius is, qui post XL annum coepit, adeo ut in ea aetate aliquid in natu⟨ra⟩ spei, uix quicquam in medicina sit. In eodem morbo si simul totum corpus adficitur, neque ante in partibus aliquis uenientis mali sensus est, sed homo inprouiso concidit, cuiuscumque is aetatis est, uix sanescit: si uero aut mens laesa est, aut neruorum facta resolutio, medicinae locus non est.

[¶32] Again in cases of diarrhoea, danger of death is at hand: if there is fever in addition, if there is inflammation of the liver or of the parts over the heart or of the stomach, if excessive thirst, if the affection is prolonged; if the stools are varied and passed with pain, and especially if with these signs true dysenteries set in; and this disease carries off mostly children up to the age of ten; other ages bear it more easily. Also a pregnant woman can be swept away by such an event, and even if she herself recovers, yet she loses the child. Dysenteries are fatal, moreover, when originated by black bile, or if a black motion suddenly issues from a body already wasted by dysentery.

> Latin: Deiectionibus quoque si febris accessit, si inflammatio iocineris aut praecordiorum aut uentris, si inmodica sitis, si longius tempus, si aluus uaria, si cum dolore est, etiam periculum mortis subest, maximeque si inter haec tormina ue⟨r⟩a esse coeperunt; isque morbus maxime pueros absumit usque ad annum decimum: ceterae aetates facilius sustinent. Mulier quoque gravida eiusmodi casu rapi potest; atque, etiamsi ipsa conualuit, tamen partum perdit. Quin etiam tormina ab atra bile orsa mortifera sunt, aut si sub his extenuato iam corpore subito nigra aluus profluxit.

[¶33] Now intestinal lubricity is the more dangerous, if there is a frequent motion, if there is a flux from the bowel at all hours, with or without noise, if the same condition continues by night and in the day-time, if what is passed is either undigested or black, and besides that also slimy and foul; if there is urgent thirst, if urine is not passed after a drink (which happens because then all fluid passes down, not into the bladder, but into the intestine); if the mouth becomes ulcerated, the face reddened and marked as if by kinds of spots of all colours; if the belly is as though in a state of fermentation, fatty and wrinkled, also if there is no desire for food...; while death is imminent in these circumstances, it is much more imminent if also this disease has already lasted a long while, especially if it be in an old patient.

> Latin: At intestinorum leuitas periculosior est, si frequens deiectio est, si uenter omnibus horis et cum so⟨n⟩o et sine hoc profluit; si similiter noctu et interdiu, si, quod excernitur, aut crudum est aut nigrum et praeter id etiam leue et mali odoris; si sitis urget, si post potionem urina non redditur (quod euenit, quia tunc liquor omnis non in uesicam sed intestina descendit); si os exulceratur, rubet facies et quasi maculis quibusdam colorum omnium distinguitur; si uenter est quasi fermentatus, pinguis atque rugosus, si cibi et * * cupiditas non est; inter quae cum euidens mors sit, multo euidentior est, si iam longum quoque id uitium est, id maxime etiam, si in corpore senili est.

[¶34] If again there is disease in the smaller intestine, vomiting, hiccough, spasm, delirium are bad signs.

> Latin: Si uero in tenuiore intestino morbus est, uomitus, singultus, neruorum distentio, delirium mala sunt.

[¶35] In jaundice again it is most pernicious for the liver to become hard.

> Latin: At in morbo arquato durum fieri iecur perniciosissimum est.

[¶36] If dysentery has seized upon those with disease of the spleen which has then turned into dropsy or into leientery, scarcely any medical treatment can save them from danger.

> Latin: Quos lienis male habet, si tormina prenderunt, deinde inuersa sunt uel in aquam inter cutem uel intestinorum leuitatem, uix ulla medicina periculo subtrahit.

## 6. Book II · chapters 8–15

Source: https://scriptura.si/works/celsus-on-medicine/6/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/6/#p-N

[¶0] The disease of the smaller intestine, unless resolved, kills within seven days.

> Latin: Morbus intestini tenuioris * * nisi resolutus est, intra septimum diem occidit.

[¶1] A woman after childbirth is in danger of death, if also oppressed by violent and persistent pain in the head along with fever.

> Latin: Mulier ex partu si cum febre uehementibus etiam et adsiduis capitis doloribus premitur, in periculo mortis est.

[¶2] To breathe rapidly is a bad sign if there is pain and inflammation in those parts which contain viscera.

> Latin: Si dolor atque inflammatio est in iis partibus, quibus uiscera continentur, frequenter spirare signum malum est.

[¶3] A prolonged pain in the head, if without cause it shifts to the neck and shoulders, and again returns to the head, or if it spreads from the head to reach the neck and shoulders, is most pernicious, unless it induces some abscess so that pus is coughed up, or unless there is an outburst of blood from some part, or unless there is upon the head an eruption of much scurf or of pimples all over the body. Equally severe is this malady when a numbness or an itching wanders, now all over the head, now over part of it, or there is felt there a sensation as of something cold, and when these symptoms extend to the tip of the tongue. And since the abscesses described above are beneficial, recovery is more difficult, in proportion as they supervene less often upon such maladies.

> Latin: Si sine causa longus dolor capitis est, et in ceruices ac scapulas transit, rursusque in caput reuertitur, aut a capite ad ceruices scapulasque peruenit, perniciosus est, nisi uomicam aliquam excitauit, sic ut pus extussiretur, aut nisi sanguis aliqua parte prorupit, aut nisi in capite multa porrigo totoue corpore pustulae ortae sunt. Aeque magnum malum est, ubi torpor atque prurigo peruagantur, modo per totum caput, modo in parte, aut sensus alicuius ibi quasi frigoris est, eaque ad summam quoque linguam perueniunt. Et cum in isdem abscessibus auxilium sit, eo difficilior sanitas est, quo minus saepe sub his malis illi subsecuntur.

[¶4] When there are pains in the hips, if there is great numbness, and both the leg and hip become cold, if there is no movement of the bowel except forced, and the stool passed is mucous, and if the patient is already over forty, there will be a very prolonged illness, lasting at least a year, nor will it possibly come to an end except either in spring or in autumn.

> Latin: In coxae uero doloribus si uehemens torpor est, frigescitque crus et coxa, aluus nisi coacta non reddit, idque quod excernitur muccosum est, iamque aetas eius hominis XL annum excessit, is morbus erit longissimus minimeque ann⟨u⟩us, neque finiri poterit nisi aut uere aut autumno.

[¶5] Treatment is likewise difficult at that age when pain in the shoulders either spreads to the hands or extending to the shoulder-blades gives rise to numbness and pain there, which is not relieved by a vomit of bile.

> Latin: Difficilis aeque curatio est in eadem aetate, ubi umerorum dolor uel ad manus peruenit uel ad scapulas tendit torporemque et dolorem creat, neque bilis uomitu leuatur.

[¶6] Whatever too the part of the body, any limb which becomes paralysed if it is not moved and wastes, will not be restored to its former state, and the less so the longer the paralysis has been, and the older the patient. And for the cure of all cases of paralysis, winter and autumn are not favourable seasons; there is possibly hope in spring and summer; even when mild this disease is scarcely curable, a severe attack cannot be cured. All pain also becomes less amenable to treatment as it spreads upwards.

> Latin: Quacumque uero corporis parte membrum aliquod resolutum est, si neque mouetur et emacrescit, in pristinum habitum non reuertitur, eoque minus, quo uetustius id uitium est, et quo magis in corpore senili est. Omnique resolutioni neruorum ad medicinam non idonea tempora sunt hiemps et autumnus: aliquid sperari potest uere et aestate; is morbus mediocris uix sanatur, uehemens sanari non potest.
Omnis etiam dolor minus medicinae patet, qui sursum procedit.

[¶7] In a pregnant woman, if the breasts suddenly shrivel up, there is danger of abortion. A woman has a defective menstruation who has milk in her breasts, not having just borne a child, or being pregnant.

> Latin: Mulieri grauidae si subito mammae emacuerunt, abortus periculum est. Quae neque peperit neque grauida est, si lac habet, a menstruis defecta est.

[¶8] Quartan fever, whilst brief in summer, is generally prolonged in autumn, and especially so when beginning at the approach of winter. There is danger of death if haemorrhage is followed by dementia and by spasm; the same is the case when, after purgation by medicaments, and, with the bowel still empty, there is an attack of spasm, as also if with great pain in the bowel the extremities become cold.

> Latin: Quartana ⟨aestiua breuis,⟩ autumnalis fere longa est maximeque quae coepit hieme adpropinquante. Si sanguis profluit, dein secuta est dementia cum distentione neruorum, periculum mortis est, itemque si medicamentis purgatum et adhuc inanem neruorum distentio oppressit, ⟨item⟩ si in magno ⟨alui⟩ dolore extremae partes frigent.

[¶9] He does not return to life who has been taken down from hanging with foam around the mouth.

> Latin: Neque is ad uitam redit, qui ex suspendio spumante ore detractus est.

[¶10] A black stool resembling black blood, passed suddenly, whether accompanied by fever, or even without fever, is dangerous.

> Latin: Aluus nigra, sanguini atro similis, repentina, siue cum febre siue etiam sine hac est, perniciosa est.

[¶11] 9. 9 Having recognized the indications which either console us with hope, or terrify us with fear, we must pass to the methods of treating Diseases. Of these some are general aids, some special. General Aids are those which are beneficial in most diseases, Special Aids in particular ones. I shall speak first of the general, some of which, however, sustain not alone the sick but also those in health; some are applied against illness only. Now every corporeal aid either diminishes substance or adds to it, either draws it out or represses it, either cools or warms, either hardens or softens; some act, not merely in one way, but even in two ways, not contrary the one to the other. Substance is withdrawn by blood-letting, cupping, purging, vomiting, rubbing, rocking, and by bodily exercises of all kinds, by abstinence, by sweating; of these I shall now speak.

> Latin: 9. Cognitis indiciis, quae nos uel spe consolentur uel metu terreant, ad CVRATIONES morborum transeundum est. Ex his quaedam communes sunt, quaedam propriae. Communes, quae pluribus opitulantur morbis; propriae, quae singulis. Ante DE COMMVNIBVS dicam: ex quibus tamen quaedam non aegros solum sed sanos quoque sustinent, quaedam in aduersa tantum ualetudine adhibentur. Omne uero auxilium corporis aut demit aliquam materiam aut adicit, aut ⟨e⟩uocat aut reprimit, aut refrigerat aut calefacit, simulque aut durat aut mollit: quaedam non uno modo tantum sed etiam duobus inter se non contrariis adiuuant. DEMITVR MATERIA sanguinis detractione, cucurbitula, deiectione, uomitu, frictione, gestatione omnique exercitatione corporis, abstinentia, sudore; de quibus protinus dicam.

[¶12] 10. 10 To let blood by incising a vein is no novelty; what is novel is that there should be scarcely any malady in which blood may not be let. Again, to let blood in young women who are not pregnant is an old practice; but it is not an old practice for the same to be tried in children and in the elderly and also in pregnant women: for indeed the ancients were of opinion that the first and last years could not sustain this kind of treatment, and they were persuaded that a pregnant woman, so treated, would abort. Practice subsequently showed indeed that in these matters there is no unvarying rule, and that other observations are rather to be made, to which the consideration of the practitioner ought to be directed. For it matters not what is the age, nor whether there is pregnancy, but what may be the patient's strength. So, then, if a youth is weakly, or a woman, although not pregnant, has little strength, it is bad to let blood; for any remaining strength dies out if it is thus stripped away. But a strong child, or a robust old man, or a pregnant woman in good health, may be so treated with safety. It is mostly, however, in such cases that an inexperienced practitioner can be deceived, because at the above ages there is usually a less degree of strength; and a pregnant woman has need also, after the blood-letting, of forces to sustain, not merely herself, but also her unborn child. Not that we should be in a hurry to do anything that demands anxious attention and care; for in that very point lies the art of medicine, which does not count years, or regard only the pregnancy, but calculates the strength of the patient, and infers from that whether possibly or no there is a superfluity, enough to sustain either a child or an old man or simultaneously two beings within one woman. There is a difference between a strong and an obese body, between a thin and an infirm one: thinner bodies have more blood, those of fuller habit more flesh. The more easily, therefore, do the former sustain this sort of depletion; and the more quickly is he who is over-fat distressed by it; hence it is that the body's strength may be estimated better by its blood-vessels than by its actual appearance. And the foregoing are not the sole considerations, but there is also the kind of disease, whether a superabundance or a deficiency of bodily material has done the harm, whether the body is corrupted or sound. For if the material of the body is either deficient, or is sound, blood-letting in unsuitable; but if the harm is its copiousness, or the material has become corrupted, there is no better remedy. Therefore severe fever, when the bodily surface is reddened, and the blood-vessels full and swollen, requires withdrawal of blood; so too diseases of the viscera, also paralysis and rigor and spasm of sinews, in fact whatever strangulates the throat by causing difficulty of breathing, whatever suppresses the voice suddenly, whenever there is intolerable pain, and whenever there is from any cause rupture and contusion of internal organs; so also a bad habit of body and all acute diseases, provided, as I have stated above, they are doing harm, not by weakness, but by overloading. But it may happen that some disease demands blood-letting, although the body seems scarcely able to bear it; if, however, there appears to be no other remedy, and if the patient is likely to die unless he be helped even at some risk — that being the position, it is the part of a good practitioner to show that without the withdrawal of blood there is no hope, and to confess how much fear there may be in that step, and then at length, if the attempt is demanded, to let blood. In such a case there should be no hesitation about it; for it is better to try a double-edged remedy than none at all; and in particular it should be done: when there are paralyses; when a man becomes speechless suddenly; when angina causes choking; when the preceding paroxysm of a fever has been almost fatal, and it is very probable that a like paroxysm is about to set in which it seems impossible for the patient's strength to sustain. Further although it is least proper to let blood whilst food is undigested, yet that is not an invariable precept; for the case will not always wait for digestion. Thus if a man falls from a height, if there is contusion, or something else happening suddenly has caused vomiting of blood, although food may have been taken but a short while before, yet at once the bodily material should be depleted, lest, if it forms a congestion, it should harm the body; and the same rule will hold good also in other sudden accidents which cause suffocation. But if the character of the affection permits, it should be done then only when there remains no suspicion of undigested food; and therefore the second or third day of the illness may seem the most fitting for the procedure. But whilst there is sometimes a necessity for blood-letting even on the first day, it is never of service after the fourth day, for within that interval the material itself has both been sucked up and corrupted the body, so that then depletion can make it weak but cannot make it sound. But if there is the oppression of a vehement fever, to let blood during the actual paroxysm is to cut the man's throat; the remission is therefore to be awaited: if the fever does not decrease, but merely stops increasing, and there is no hope of remission, then also the opportunity, bad as it is, as it is the only one, should not be missed. When the measure is necessary it should generally be divided between two days; on the first it is better to relieve, and later to deplete the patient, rather than perchance to precipitate his end by dissipating his strength all at once. But if this answers in the case of pus, or of the water in dropsy, all the more necessarily should it answer in the letting out of blood. If the cause affects the body as a whole, blood should be let from the arm; if some part, then actually from that part, or at any rate from a spot as near as may be, for it is not possible to let blood from everywhere, but only from the temples, arms and near the ankles. Nor am I ignorant that some say blood should be let from a place the furthest away from the damaged part, for that thus the course of the material of the disease is diverted, but that otherwise it is drawn into the very part which is damaged. Yet this is erroneous, for blood-letting draws blood out of the nearest place first, and thereupon blood from more distant parts follows so long as the letting out of blood is continued; when put a stop to, no more blood comes to the part diseased, because it is no longer drawn to the opened vein. Practice itself, however, seems to have taught that for a broken head blood should be let preferably from the arm; when the pain is situated in one upper limb, then from the arm opposite; I believe because, if anything goes wrong, those parts are more liable to take harm which are already in a bad state. Blood is also at times diverted when, having burst out at one place, it is let out at another. For bleeding from a place where it is not desired ceases after something is applied to stop it there, when the blood is given another exit. Now blood-letting, whilst it may be very speedily done by one practised in it, yet for one without experience is very difficult, for to the vein is joined an artery, and to both sinews. Hence should the scalpel strike a sinew, spasm follows, and this makes a cruel end to the patient. Again, when an artery is cut into, it neither coalesces nor heals; it even sometimes happens that a violent outburst of blood results. As to the actual vein, when completely divided by a forceful cut, its two ends are pressed together, and do not let out the blood. Yet if the scalpel is entered timidly, it lacerates the skin but does not enter the vein; at times, indeed, the vein is concealed and not readily found. Thus many things make difficult to one who is unskilled what to one experienced is very easy. The vein ought to be cut half through. As the blood streams out its colour and character should be noted. For when the blood is thick and black, it is vitiated, and therefore shed with advantage, if red and translucent it is sound, and that blood-letting, so far from being beneficial, is even harmful; and the blood should be stopped at once. But this cannot happen under that practitioner who knows from what sort of body blood should be let. It more often happens that the flow of blood continues as black as on the first day; although this be so, nevertheless, if enough has flowed out, blood-letting should be stopped, and always an end should be put to it before the patient faints, and the arm should be bandaged after superimposing a pad squeezed out of cold water, and the next day the vein is to be flicked open by the tip of the middle finger so that, its recent coalescence being undone, it may again let out blood. Whether it be on the first or on the second day that the blood, which has at first flowed out thick and black, begins to become red and translucent, a sufficient quantity has been withdrawn, and the rest of the blood is pure; and so at once the arm should be bandaged and kept so until the little scar is strong, and this, in a vein, becomes firm very quickly.

> Latin: 10. Sanguinem incisa uena mitti nouum non est: sed nullum paene esse morbum, in quo non mittatur, nouum est. Item mitti iunioribus feminis uterum non gerentibus uetus est: in pueris uero idem experiri et in senioribus et in grauidis quoque mulieribus uetus non est: siquidem antiqui primam ultimamque aetatem sustinere non posse hoc auxilii genus iudicabant, persuaserantque sibi mulierem grauidam, quae ita curata esset, abortum esse facturam. Postea uero usus ostendit nihil in his esse perpetuum, aliasque potius obseruationes adhibendas esse, ad quas derigi curantis consilium debeat. Interest enim, non quae aetas sit, neque quid in corpore intus geratur, sed quae uires sint. Ergo si iuuenis inbecillus est, aut si mulier, quae grauida non est, parum ualet, male sanguis emittitur: emoritur enim uis, si qua supererat, hoc modo erepta. At firmus puer et robustus senex et grauida mulier ualens tuto curatur. Maxime tamen in his medicus inperitus falli potest, quia fere minus roboris illis aetatibus subest; mulierique praegnati, post curationem quoque, uiribus opus est, non tantum ad se, sed etiam ad partum sustinendum. Non quicquid autem intentionem animi et prudentiam exigit protinus faciendum est, cum praecipua in hoc ars sit, quae non annos numeret, neque conceptionem solam uideat, sed uires aestimet, et eo colligat, possit necne superesse, quod uel puerum uel senem uel in una muliere duo corpora simul sustineat. Interest etiam inter ualens corpus et obesum, inter tenue et infirmum: tenuioribus magis sanguis, plenioribus magis caro abundat. Facilius itaque illi detractionem eiusmodi sustinent: celeriusque ea, si nimium est pinguis, aliquis adfligitur; ideoque uis corporis melius ex uenis quam ex ipsa specie aestimatur. Neque solum haec consideranda sunt, sed etiam morbi genus quod sit, utrum superans an deficiens materia laeserit, corruptum corpus sit an integrum. Nam si materia uel deest uel integra est, istud alienum est: at si uel copia sui male habet, uel corrupta est, nullo modo melius succurritur. Ergo uehemens febris, ubi rubet corpus, uenaeque plenae tument, sanguinis detractionem requirit; item uiscerum morbi, neruorum et resolutio et rigor et distentio, quicquid denique fauces difficultate spiritus strangulat, quicquid supprimit subito uocem, quisquis intolerabilis dolor est, et quacumque de causa ruptum aliquid intus atque collisum est; item malus corporis habitus omnesque acuti morbi, qui modo, ut supra dixi, non infirmitate sed onere nocent. Fieri tamen potest, ut morbus quidem id desideret, corpus autem uix pati posse uideatur: sed ⟨si⟩ nullum tamen appare⟨a⟩t aliud auxilium, periturusque sit qui laborat, nisi temeraria quoque uia fuerit adiutus, in hoc statu boni medici est ostendere, quam nulla spes sit sine sanguinis detractione, faterique, quantus in hac ipsa metus sit, et tum demum, si exigetur, sanguinem mittere. De quo dubitari in eiusmodi re non oportet: satius est enim anceps auxilium experiri quam nullum; idque maxime fieri debet, ubi nerui resoluti sunt; ubi subito aliquis ommutuit; ubi angina strangulatur; ubi prioris febris accessio paene confecit, paremque subsequi uerisimile est neque eam uidentur sustinere aegri uires posse. Cum sit autem minime crudo sanguis mittendus, tamen ne id quidem perpetuum est: neque enim semper concoctionem res expectat. Ergo si ex superiore parte aliquis decidit, si contusus est, si ex aliquo subito casu sanguinem uomit, quamuis paulo ante sumpsit cibum, tamen protinus ei demenda materia est, ne, si subsederit, corpus adfligat; idemque etiam in aliis casibus repentinis, qui strangulabunt, dictum erit. At si morbi ratio patietur, tum demum nulla cruditatis suspicione remanente id fiet; ideoque ei rei uidetur aptissimus aduersae ualetudinis dies secundus aut tertius. Sed ut aliquando etiam primo die sanguinem mittere necesse est, sic numquam utile post diem quartum est, cum iam spatio ipsa materia et exhausta est et corpus conr⟨u⟩pit, ut detractio inbecillum id facere possit, non possit integrum. Quod si uehemens febris urget, in ipso impetu eius sanguinem mittere hominem iugulare est; expectanda ergo remissio est: si non decrescit, sed crescere desiit, neque speratur remissio, tum quoque, quamuis peior, sola tamen occasio non omittenda est. Fere etiam ista medicina, ubi necessaria est, in biduum diuidenda est: satius est enim in primo leuare aegrum, deinde perpurgare, quam simul omni ⟨ui⟩ effusa fortasse praecipitare. Quod si in pure quoque aquaque, quae inter cutem est, ita respondet, quanto magis necesse est in sanguine respondeat. Mitti uero is debet, si totius corporis causa fit, ex brachio; si partis alicuius, ex ea ipsa parte aut certe quam proxima, quia non ubique mitti potest, sed in temporibus, in brachiis, iuxta talos. Neque ignoro quosdam dicere quam longissime sanguinem inde, ubi laedit, esse mittendum: sic enim auerti materiae cursum: at illo modo in id ipsum, quod grauat, euocari. Sed id falsum est: proximum enim locum primum exhaurit, ex ulterioribus autem eatenus sanguis sequitur, quatenus emittitur; ubi is suppressus est, quia non trahitur, ne uenit quidem. Videtur tamen usus ipse docuisse, si caput fractum est, ex brachio potius sanguinem esse mittendum; si quod in umero uitium est, ex altero brachio: credo quia, si quid parum cesserit, opportuniores hic eae partes iniuriae sunt, quae iam male habent. Auertitur quoque interdum sanguis, ubi alia parte prorumpens alia emittitur. Desinit enim fluere qua nolumus, inde obiectis quae prohibeant, alia dato itinere. Mittere autem sanguinem cum sit expeditissimum usum habenti, tum ignaro difficillimum est: iuncta enim est uenae arteria, his nerui. Ita, si neruum scalpellus attingit, sequitur neruorum distentio, eaque hominem crudeliter consumit. At arteria incisa neque coit neque sanescit; interdum etiam, ut sanguis uehementer erumpat, efficit. Ipsius quoque uenae, si forte praecisa est, capita comprimuntur, neque sanguinem emittunt. At si timide scalpellus demittitur, summam cutem lacerat neque uenam incidit: nonnumquam ⟨etiam⟩ ea latet neque facile reperitur. Ita multae res id difficile inscio faciunt, quod perito facillimum est. Incidenda ad medium uena est. Ex qua cum sanguis erumpit, colorem eius habitumque oportet attendere. Nam si is crassus et niger est, uitiosus est, ideoque utiliter effunditur: si rubet et perlucet, integer est; eaque missio sanguinis adeo non prodest, ut etiam noceat; protinusque is supprimendus est. Sed id euenire non potest sub eo medico, qui scit, ex quali corpore sanguis mittendus sit. Illud magis fieri solet, ut aeque niger adsidue ac primo die profluat; quod quamuis ita est, tamen si iam satis fluxit, supprimendus est, semperque ante finis faciendus est, quam anima deficiat, deligandumque brachium superinposito expresso ex aqua frigida penicillo, et postero die auerso medio digito uena ferienda, ut recens coitus eius resoluatur iterumque sanguinem fundat. Siue autem primo siue secundo die sanguis, qui crassus et niger initio fluxerat, et rubere et perlucere coepit, satis materiae detractum est, atque quod superest sincerum est; ideoque protinus brachium deligandum habendumque ita est, donec ualens cicatricula sit; quae celerrime in uena confirmatur.

[¶13] 11. 11 Now there are two kinds of cups, one made of bronze, the other of horn. The bronze cup is open at one end, closed at the other; the horn one, likewise at one end open, has at the other a small hole. Into the bronze cup is put burning lint, and in this state the mouth is applied and pressed to the body until it adheres. The horn cup is applied as it is to the body, and when the air is withdrawn by the mouth through the small hole at the end, and after the hole has been closed by applying wax over it, the horn cup likewise adheres. Either form of cup may be made, not only of the above materials, but also of anything else suitable; when others are lacking, a small drinking-cup or porridge bowl with a narrowish mouth may be adapted conveniently for the purpose. If the skin upon which the cup is to be stuck is cut beforehand with a scalpel, the cup extracts blood; when the skin is intact, wind. Therefore when it is some matter inside which is doing the harm, the former method of cupping should be employed, when it is flatulency, then the latter. Now the use of a cup is the rule for a disease, not of the body as a whole, but of some part, the sucking out of which suffices for the re-establishment of health. And this same fact is a proof that with a scalpel, when a part is being relieved, blood must be let from that very part where the injury already exists; since unless it be to divert haemorrhage in that direction, nobody applies a cup to a part distant from the disease, but to that which is actually affected and has to be relieved. Further there may be need for cupping in chronic maladies, although already of somewhat long duration, if there is corrupted material or an unhealthy condition of wind; in certain acute cases also, if the body ought to be depleted and at the same time the patient's strength does not admit of cutting a vein; and cupping, as it is a less severe remedy, so it is a safer one; nor is it ever dangerous, even if adopted in the midst of the attack of a fever, or even with food undigested. Therefore, when blood-letting is needed, if cutting a vein is an instant danger, or if the mischief is still localised, recourse is to be had rather to cupping, not forgetting that whilst we recognize the absence of danger, its efficacy is thus the less, and it is impossible to remedy a severe malady unless by a remedy likewise severe.

> Latin: 11. Cucurbitularum duo uero genera sunt, aeneum et corneum. Aenea altera parte patet, altera clausa est: altera cornea parte aeque patens altera foramen habet exiguum. In aeneam linamentum ardens coicitur, ac sic os eius corpori aptatur inprimiturque, donec inhaereat. Cornea corpori per se inponitur, deinde, ubi ea parte, qua exiguum foramen est, ore spiritus adductus est, superque cera cauum id clausum est, aeque inhaerescit. Vtraque non ex his tantum materiae generibus, sed etiam ex quolibet alio recte fit: ac si cetera defecerunt, caliculus quoque aut pultarius oris compressioris ei rei commode aptatur. Vbi inhaesit, si concisa ante scalpello cutis est, sanguinem extrahit, si integra est, spiritum. Ergo ubi materia, quae intus est, laedit, illo modo, ubi inflatio, hoc inponi solet. Vsus autem cucurbitulae praecipuus est, ubi non in toto corpore sed in parte aliqua uitium est, quam exhauriri ad confirmandam ualetudinem satis est. Idque ipsum testimonium est etiam scalpello sanguinem, ubi membro succurritur, ab ea potissimum parte, quae iam laesa est, esse mittendum, quod nemo cucurbitulam diuersae parti inponit, nisi cum profusionem sanguinis eo auertit, sed ei ipsi, quae dolet quaeque liberanda est. Opus etiam esse cucurbit⟨ul⟩a potest in morbis longis, quamuis iam ⟨e⟩is spatium aliquod accessit, siue corrupta materia siue spiritu male habente: in acutis quoque quibusdam, si et leuari corpus debet et ex uena sanguinem mitti uires non patiuntur; idque auxilium ut minus uehemens, ita magis tutum neque umquam periculosum est, etiamsi in medio febris impetu, etiamsi in cruditate adhibetur. Ideoque ubi sanguinem mitti opus est, si incisa uena praeceps periculum est, aut si in parte corporis etiam⟨num⟩ uitium est, huc potius confugiendum est, cum eo tamen, ut sciamus hic ut nullum periculum, ita leuius praesidium esse, nec posse uehementi malo nisi aeque uehemens auxilium succurrere.

[¶14] 12. 12 Now purging was promoted by the ancients in almost all diseases by various medicaments, and by frequent clysters; they administered either black hellebore root, or polypody fern root, or the copper scales which the Greeks call lepida chalkou, or the milky juice of seaside spurge, of which one drop on bread purges freely, or milk, whether from an ass or cow, or goat, to which a little salt was added, which they boiled, and having removed the solidified skin, they obliged their patients to drink the whey-like remainder. But medicaments generally irritate the stomach; a motion when excessively liquid, or a clyster often repeated, weakens the patient. Never, therefore, in illness is a medicament which causes such a motion rightly given, unless when that malady is without fever, as when black hellebore root is given either to those with black bile and to those suffering from insanity with melancholy, or to those who have their sinews in some part paralysed. But in the presence of fevers, it suffices for the purpose of a purge to take such food and drink as both nourish and at the same time soften the belly; and there are sorts of illness in which purgation by milk is suitable. Still, for the most part the bowel preferably is to be clystered; the practice was limited by Asclepiades though still kept, but I see that in our time it is usually neglected. But the limitation which he seems to have adopted is most fitting: that this remedy should not be tried often, and yet we should not omit to use it once, or at most twice: if the head is heavy; if the eyes are dim; if the disease is in the larger intestine, which the Greeks call colon; if there are pains in the lower belly or in the hips; if bilious fluid collects in the stomach, or even phlegm or other water-like humor forms there; if wind is passed with undue difficulty; if there is no spontaneous motion, and especially if the faeces remain inside although close to the anus, or if the patient who fails to pass anything perceives a foul odour in his breath, or if the motions have become corrupted; or if abstinence does not at once get rid of the fever; or if the patient's strength does not allow of blood-letting when it is needed, or the time for that measure has passed; or if previous to the malady the patient has been drinking freely; or if a patient who has been purged repeatedly, whether that has been intentional or casual, has suddenly a suppression of motions. However, the following rules are to be observed: that the clyster is not to be administered before the third day, nor whilst there is any undigested food; nor in a case of weakness due to exhaustion by a long illness; nor to a patient who has daily a sufficient motion, nor to one whose stools are liquid; nor during the acme of the paroxysm of a fever, for what is then injected is retained in the bowel and mounting up into the head brings about a much graver danger. On the day too before the clyster the patient ought to fast, in order to fit himself for such a treatment, and on the actual day, some hours beforehand, he should drink warm water to moisten his upper parts; there should then be introduced into the bowel simply water when we are content with a gentle remedy, or hydromel as one a little stronger; or as a soothing enema a decoction of fenugreek, or of pearl barley, or of mallow, or as an astringent clyster a decoction of vervains, but a drastic one is sea-water or ordinary water with salt added; and the better in both instances for boiling. A clyster is made more drastic by the addition of olive oil, or soda, or honey: the more drastic the clyster, the more it extracts, but the less easily it is borne. The fluid injected should be neither cold nor hot, lest either way it should do harm. Following upon the injection the patient ought to keep in bed as long as he can, and not give way to his first desire to defaecate; then go to stool only when he must. In this way generally when the material is extracted, and the upper parts relieved, the disease itself is mollified. But when the patient has become exhausted owing to forced calls to stool, he ought for a while to keep quiet; and lest his strength fail, he should certainly take food that day, but whether it should be abundant or scanty, should be regulated according to the strength of the paroxysm anticipated, or the absence of such apprehension.

> Latin: 12. Deiectionem autem antiqui uariis medicamentis crebraque alui ductione in omnibus paene morbis moliebantur; dabantque aut nigrum ueratrum aut filiculam aut squamam aeris, quam ΛΕΠΙΔΑ ΧΑΛΚΟΥ Graeci uocant, aut lactucae marinae lac, cuius gutta pani adiecta abunde purgat, aut lac uel asininum aut bubulum, uel caprinum, eique salis paulum adiciebant, decoquebantque id et sublatis is, quae coierant, quod quasi serum supererat, bibere cogebant. Sed medicamenta stomachum fere laedunt: aluus si uehementius fluit aut saepius ducitur, hominem infirmat. Ergo numquam in aduersa ualetudine medicamentum eius rei causa recte datur, nisi ubi is morbus sine febre est, ut cum ueratrum nigrum aut atra bile uexatis aut cum tristitia insanientibus aut iis, quorum nerui parte aliqua resoluti sunt, datur. At ⟨ubi⟩ febres sunt, satius est eius rei causa cibos potionesque adsumere, qui simul et alant et uentrem molliant; suntque ualetudinis genera, quibus ex lacte purgatio conuenit. Plerumque uero aluus potius ducenda est; quod ab Asclepiade quoque sic temperatum, ut tamen seruatum sit, uideo plerumque saeculo nostro praeteriri. Est autem ea moderatio, quam is secutus uidetur, aptissima, ut neque saepe ea medicina temptetur, et tamen semel, summum uel bis non omittatur: si caput graue est; si oculi caligant; si morbus maioris intestini est, quod Graeci colum nominant; si in imo uentre aut si in coxa dolores sunt; si in stomachum quaedam biliosa concurrunt, uel etiam pituita eo s⟨e⟩ umorue aliquis aquae similis confert; si spiritus difficilius redditur; si nihil per se uenter excernit, utique si iuxta quoque stercus est et intus remanet, aut si stercoris odorem nihil deiciens aeger ex spiritu suo sentit, aut si corruptum est quod excernitur; aut si prima inedia febrem non sustulit; aut si sanguinem mitti, cum opus sit, uires non patiuntur tempusue eius rei praeterit, aut si multum ante morbum aliquis potauit; aut si is, qui saepe uel sponte uel casu purgatus est, subito habet aluum suppressam. Seruanda uero illa sunt, ne ante tertium diem ducatur; ne ulla cruditate substante; ⟨ne⟩ in corpore infirmo diuque in aduersa ualetudine exhausto, neue in eo, cui satis aluus cottidie reddit quiue eam liquidam habebit; ne in ipso accessionis impetu, quia quod tum infusum est, aluo continetur, regestumque in caput multo grauius periculum efficit. Pridie uero abstineri debet aeger, ut aptus tali curationi sit, eodem die ante aliquot horas aquam calidam bibere, ut superiores eius partes madescant; tum inmittenda in aluum est, si leui medicina contenti sumus, pura aqua, si paulo ualentiore, mulsa; si leni, ea, in qua faenum Graecum uel tisana uel malua decocta sit, [si reprimendi causa, ex uerbenis] acris autem est marina aqua uel alia sale adiecto; atque utraque decocta commodior est. Acrior fit adiecto uel oleo uel nitro uel melle: quoque acrior est, eo plus extrahit, sed minus facile sustinetur. Idque, quod infunditur, neque frigidum esse oportet neque calidum, ne alterutro modo laedat. Cum infusum est, quantum fieri potest, continere se in lecticulo debet aeger, nec primae cupiditati deiectionis protinus cedere: ubi necesse est, tum demum desidere. Fereque eo modo dempta materia, superioribus partibus leuatis, morbum ipsum mollit. Cum uero, quotiens res coegit, desidendo aliquis se exhausit, paulisper debet conquiescere; et ne uires deficiant, utique eo die cibum adsumere; qui plenior an exiguus sit, ex ratione eius accessionis, quae expectabitur aut in metu non erit, aestimari oportebit.

[¶15] 13. 13 Again, a vomit, as it is often quite a necessity for one who in health is bilious, so is it also in those diseases which bile has occasioned. It is the more necessary, therefore, for all who are troubled by shivering and trembling before fevers, for all suffering from cholera, even for all suffering from insanity accompanied by a kind of hilarity, and also for those afflicted by epilepsy. But if the disease is an acute one, as in the case of cholera, if there is fever, during the shivering fits, then the sharper medicaments are out of place, as mentioned above in relation to purgations, and for the purpose of a vomit it is sufficient to take the emetics which I have prescribed to be taken by those in health. But when there are chronic and violent diseases without fever, such as epilepsy and insanity, white hellebore root should also be used. But it is not right to give it either in winter or in summer; the spring is the best time, and autumn tolerably good. Whoever is going to administer it ought to take care beforehand that the body of the prospective recipient is rendered more humid. This should be recognized, that all such medicaments given as a drink do not always benefit the sick, and are always harmful to those in health.

> Latin: 13. At uomitus ut in secunda quoque ualetudine saepe necessarius biliosis est, sic etiam in is morbis, quos bilis concitauit. Ergo omnibus, qui ante febres horrore et tremore uexantur, omnibus, qui cholera laborant, omnibus etiam cum quadam hilaritate insanientibus, et comitiali quoque morbo oppressis necessarius est. Sed si acutus morbus est, sicut in cholera, si febris est, ut inter horrores, asperioribus medicamentis opus non est, sicut in deiectionibus quoque supra dictum est; satisque est ea uomitus causa sumi, quae sanis quoque sumenda esse proposui. At ubi longi ualentesque morbi sine febre sunt, ut comitialis, ut insania, ueratro quoque albo utendum est. Id neque hieme ⟨neque⟩ aestate recte datur, optime uere, tolerabiliter autumno. Quisquis daturus erit, id agere ante debebit, ut accepturi corpus umidius sit. Illud scire oportet, omne eiusmodi medicamentum, quod potui datur, non semper aegris prodesse, semper sanis nocere.

[¶16] 14. 14 Now concerning rubbing, Asclepiades as if he were the inventor of the practice has treated it in his volume, entitled "Common aids," at such great length, that, though making mention only of three such aids, namely, Rubbing, Water-drinking, and Rocking, yet he has taken up the greatest part with the first-named subject. Now on such matters recent writers ought to have credit where they have made discoveries, or where they have rightly followed others; yet we must not omit to attribute to their true authors teaching found among the more ancient writers. And it cannot be disputed that Asclepiades has taught when and how rubbing should be practised, with a wider application, and in a clearer way, although he has discovered nothing which had not been comprised in a few words by that most ancient writer Hippocrates, who said that rubbing, if strenuous, hardens the body, if gentle, relaxes; if much, it diminishes, if moderate, fills out. It follows, therefore, that in the following cases rubbing should be employed, when either a feeble body has to be toned up, or one indurated has to be softened, or a harmful superfluity is to be dispersed, or a thin and infirm body has to be nourished. Yet when examined with attention (although this no longer concerns the medical man) the various species of rubbing may be easily recognized as all dependent on causing one thing, depletion. For an object is toned up when that is removed, which, by its presence was the cause of the laxness; and is softened when that which has been producing induration is abstracted; and it is filled up, not by the rubbing itself, but by the nutriment, which subsequently penetrates by some sort of dispersal to the very skin itself after it has become relaxed. The cause of the different results lies in the degree. Now there is a great difference between anointing and rubbing. For it is desirable that even in acute and recent diseases the body should be anointed and then gently stroked, but only during remissions and before food. But prolonged rubbing is unsuitable in acute and increasing troubles, unless it be in madness to procure sleep. Yet a prolonged illness and one declining from its primary vehemence loves this aid. I am quite aware that some say that the need for any aid is during the increase of diseases, not when diseases are tending to end of themselves. But this is not the case. For a disorder, even although it will end of itself, may be expelled yet more speedily by adopting the aid. An aid is necessary on two accounts, both that health may be regained at the earliest possible moment, and that what remains of the disease may not again become exacerbated from however slight a cause. Possibly the disease may have become less grave than it had been, yet is not completely got rid of, but some remnants of it persist, which the application of a remedy disperses. But while rubbing is rightly applied after a disorder has been lessened, yet it should never be applied whilst a fever is increasing: but if possible after the fever has entirely left the body, or if not, at least when it has remitted. Sometimes, moreover, rubbing should be applied to the body all over, as when a thin man ought to put on flesh; sometimes to a part only, either because weakness of the limb actually rubbed demands it, or that of some other part. For both prolonged headaches are relieved by rubbing of the head, although not at the height of the pain, and any partially paralysed limb is strengthened by itself being rubbed. Much more often, however, some other part is to be rubbed than that which is the seat of the pain; and especially when we want to withdraw material from the head or trunk, and therefore rub the arms and legs. Neither should we listen to those who would fix numerically how many times a patient is to be stroked; for that is to be regulated by his strength; and if he is very infirm fifty strokes may possibly be enough, if more robust possibly two hundred may be made; then an intermediate number according to his strength. Hence it is that the hand is to be passed even fewer times over a woman than over a man, fewer over a child or old man, than over a young adult. Finally, if particular limbs are rubbed, many strokes are re-quired and forcible rubbing; both because the body cannot be as a whole quickly rendered weak through a part, and it is necessary that as much as possible of the diseased matter should be dispersed, whether our aim is to relieve the limb actually rubbed, or through it another limb. When, however, general bodily weakness requires that the rubbing should be applied all over, it should be shorter and more gentle, just to the extent of softening the skin, so that the body may be more easily capable of forming new material from food recently consumed. As I have stated above (II.6.7), a patient is already in a bad way, when the exterior of the body is cold, whilst his interior is hot and there is thirst. But even then rubbing is the only remedy; if it draws the heat outwards into the skin, it makes possible an opportunity for other treatment.

> Latin: 14. De frictione uero adeo multa Asclepiades tamquam inuentor eius posuit in eo uolumine, quod COMMVNIVM AVXILIORVM inscripsit, ⟨ut,⟩ cum trium faceret tantum mentionem, huius et aquae et gestationis, tamen maximam partem in hac consumpserit. Oportet autem neque recentiores uiros in is fraudare, quae uel reppererunt uel recte secuti sunt, et tamen ea, quae apud antiquiores aliquos posita sunt, auctoribus suis reddere. Neque dubitari potest, quin latius quidem et dilucidius, ubi et quomodo frictione utendum esse⟨t,⟩ Asclepiades praeceperit, nihil tamen reppererit, quod ⟨non⟩ a uetustissimo auctore Hippocrate paucis uerbis comprehensum sit, qui dixit frictione, si uehemens sit, durari corpus, si lenis, molliri: si multa, minui, si modica, inpleri. Sequitur ergo, ut tum utendum sit, cum ⟨aut⟩ adstringendum corpus sit, quod hebes est, aut molliendum, quod induruit, aut digerendum in eo, quod copia nocet, aut alendum id, quod tenue et infirmum est. Quas tamen species si quis curios⟨i⟩us aestimet (quod iam ad medicum non pertinet), facile intelleget omnes ex una causa pendere, quae demit. Nam et adstringitur aliquid eo dempto, quod interpositum, ut id laxaretur, effecerat, ⟨et⟩ mollitur eo detracto, quod duritiem creabat, et inpletur non ipsa frictione sed eo cibo, qui postea usque ad cutem digestione quadam relaxatam penetrat. Diuersarum uero rerum in modo causa est. Inter unctionem autem et frictionem multum interest. Vngui enim leuiterque pertractari corpus etiam in acutis et recentibus morbis oportet, in remissione tamen et ante cibum. Longa uero frictione uti ⟨ne⟩que in acutis morbis neque increscentibus conuenit, praeterquam cum phreneticis somnus ea quaeritur. Amat autem hoc auxilium ualetudo longa et iam a primo inpetu inclinata. Neque ignoro quosdam dicere omne auxilium necessarium esse increscentibus morbis, non cum iam per se finiuntur. Quod non ita se habet. Potest enim morbus, etiam qui per se finem habiturus est, celerius tamen adhibito auxilio pelli. Quod duabus de causis necessarium est, et ut quam primum bona ualetudo contingat, et ne morbus, qui remanet, iterum, quamuis leui de causa, exasperetur. Potest morbus minus grauis esse quam fuerit, neque ideo tamen solui, sed reliquiis quibusdam inhaerere, quas admotum aliquod auxilium discutit. Sed ut leuata quoque aduersa ualetudine recte frictio adhibetur, sic numquam adhibenda est fe⟨b⟩re increscente: uerum, si fieri potest, cum ex toto corpus ea uacabit; si minus, certe cum ea remiserit. Eadem autem modo in totis corporibus esse debet, ut cum infirmus aliquis implendus est, modo in partibus, aut quia ipsius eius membri inbecillitas id requirit aut quia alterius. Nam et capitis longos dolores ipsius frictio leuat, non in inpetu tamen doloris, et membrum aliquod resolutum ipsius frictione confirmatur. Longe tamen saepius aliud perfricandum est, cum aliud dolet; maximeque cum a summis aut a mediis partibus corporis euocare materiam uolumus, ideoque extremas partes perfricamus. Neque audiendi sunt qui numero finiunt, quotiens aliquis perfricandus sit: id enim ex uiribus hominis colligendum est; et si is perinfirmus est, potest satis esse quinquagies, si robustior, potest ducenties esse faciendum; inter utrum⟨que⟩ deinde, prout uires sunt. Quo fit, ut etiam minus saepe in muliere quam in uiro, minus saepe in puero uel sene quam iuuene manus dimouendae sint. Denique si certa membra perfricantur, multa ualentique frictione opus est: nam neque totum corpus infirmari cito per partem potest, et opus est quam plurimum materiae digeri, siue id ipsum membrum siue per id aliud leuamus. At ubi totius corporis inbecillitas hanc curationem per totum id exigit, breuior esse debet et lenior, ut tantummodo summam cutem emolliat, quo facilius capax ex recenti ⟨ci⟩bo nouae materiae fiat. In malis iam aegrum esse, ubi exterior pars corporis friget, interior cum siti calet, [ut] supra posui. Sed tunc quoque unicum in frictione praesidium est; quae si calorem in cutem euocauit, potest alicui medicinae locum facere.

[¶17] 15. 15 Rocking also is very suitable for chronic maladies which are already abating; it is also of service both for those who are now entirely free from fever, but cannot as yet themselves take exercise, and also for those in whom persist sluggish remnants of maladies, not otherwise to be got rid of. Asclepiades has stated that use is to be made of rocking even for dispersal of a recent and severe fever, especially an ardent fever. But that gives rise to danger; an attack of that sort is better sustained by keeping quiet. If anyone, however, wants to give it a trial, let him try it when the tongue is not furred, when there is no swelling, no induration, no pain, either in the viscera or head or about the heart. And on the whole a body in pain should never be rocked, whether the pain be general or local, except, however, when sinews alone are in pain, and never during the rise of a fever, but only during its remission. But there are many sorts of rocking, and they are to be regulated both by the patient's strength and by his resources, lest either a weak patient undergo overmuch depletion, or a poor man come short. The gentlest rocking is that on board ship either in harbour or in a river, more severe is that aboard ship on the high seas, or in a litter, even severer still in a carriage: but each of these can either be intensified or mitigated. Failing any of the above, the bed should be so slung as to be swayed; if not even that, at any rate a rocker should be put under its foot so that the bed may be moved from side to side by hand. And this sort of exercise of the lighter kinds suits the infirm, the stronger kinds again those who have already become free from fever for several days, or those who, whilst feeling the commencement of grave disorders, as yet are free from fever (which happens in the case both of phthisis and of stomach disease, and of dropsy, also, at times, of jaundice), or when certain diseases such as epilepsy and madness persist without fever, for however long. In which affections also those kinds of exercises are necessary, which we have included in the passage where we prescribed what healthy, yet not strong, men should carry out.

> Latin: 15. Gestatio quoque longis et iam inclinatis morbis aptissima est; utilisque est et iis corporibus, quae iam ex toto febre carent sed adhuc exerceri per se non possunt, et iis, quibus lentae morborum reliquiae remanent neque aliter eliduntur. Asclepiades etiam in recenti uehementique praecipueque ardente febre ad discutiendam eam gestatione dixit utendum. Sed id periculose fit, meliusque quiete eiusmodi impetus sustinetur. Si quis tamen experiri uolet, sic experiatur: si lingua non erit aspera, si nullus tumor, nulla durities, nullus dolor uisceribus aut capiti aut praecordiis suberit. Et ex toto numquam gestari corpus dolens debet, siue id in toto siue in parte est, nisi tamen solis neruis dolentibus, neque umquam increscente febre sed in remissione eius. Genera autem gestationis plura sunt adhibendaque sunt et pro uiribus cuiusque et pro opibus, ⟨ne⟩ aut inbecillum hominem nimis digerant, aut humili desint. Lenissima est naui uel in portu uel in flumine, uehementior uel in alto mari naui uel lectica, etiamnum acrior uehiculo: atque haec ipsa et intendi et leniri possunt. Si nihil eorum est, suspendi lectus debet et moueri: si ne id quidemst, at certe uni pedi subiciendum fulmentum est, atque ita lectus huc et illuc manu inpellendus. Et leuia quidem genera exercitationis infirmis conueniunt, ualentiora uero iis, qui iam pluribus diebus febre liberati sunt, aut iis, qui grauium morborum initia sic sentiunt, ut adhuc febre uacent (quod et in tabe et in stomachi uitiis, et cum aqua cutem subit, et interdum in regio fit), aut ubi quidam morbi, qualis comitialis, qualis insania est, sine febre quamuis diu manent. In quibus adfectibus ea quoque genera exercitationum necessaria sunt, quae conprehendimus eo loco, quo, quemadmodum sani neque firmi homines se gererent, praecepimus.

## 7. Book II · chapters 16–33

Source: https://scriptura.si/works/celsus-on-medicine/7/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/7/#p-N

[¶0] 16. 16 Now Abstinence is of two kinds, in one of which the patient takes nothing at all, in the other only what he must. The beginnings of diseases require at first hunger and thirst, the actual diseases then moderation, so that nothing but what is expedient, and not too much of that, may be consumed; for it is not at all proper to have surfeit at once after a fast. But if this be not good even in healthy bodies, when some necessity has imposed fasting, how much worse it is in a sick body! To a sufferer nothing is more advantageous than a timely abstinence. Among us intemperate men with regard to their food themselves... the times are left to the doctors; again others make a present of the times to their medical men, but reserve to themselves as to quantity. They think that they are generous, when they leave them to decide as to all else, and keep free as to the kind of food; as if it were a question of what may be yielded to the doctor, not what may be good for the patient, who suffers grievous harm, as often as he transgresses in what he consumes, whether as to the time of the meal, its quantity or its quality.

> Latin: 16. Abstinentiae uero duo genera sunt, alterum ubi nihil adsumit aeger, alterum ubi non nisi quod oportet. Initia morborum primum famem sitimque desiderant, ipsi deinde morbi moderationem, ut neque aliud quam expedit neque eius ipsius nimium sumatur: neque enim conuenit iuxta inediam protinus satietatem esse. Quod si sanis quoque corporibus inutile est, ubi aliqua necessitas famem fecit, quanto inutilius est etiam in corpore aegro? Neque ulla res magis adiuuat laborantem quam tempestiua abstinentia. Intemperantes homines apud nos ipsi cibi * * * tempora curantibus dantur: rursus alii tempora medicis pro dono remittunt, sibi ipsis modum uindicant. Liberaliter agere se credunt, qui cetera illorum arbitrio relinquant, in genere cibi liberi sunt: quasi quaeratur quid medico liceat, non quid aegro salutare sit, cui uehementer nocet, quotiens in eius, quod adsumitur, uel tempore uel modo uel genere peccatur.

[¶1] 17. 17 Sweating also is elicited in two ways, either by dry heat, or by the bath. The dry is the heat of hot sand, of the Laconian sweating-room, and of the dry oven, and of some natural sweating places, where hot vapour exhaling from the ground is confined within a building, as we have it in the myrtle groves above Baiae. Besides these it is also derived from the sun and through exercise. These treatments are useful whenever humor is doing harm inside, and has to be dispersed. And also some diseases of sinews are best treated thus. But the other treatments may suit the infirm: sun and exercise only the more robust, who must, however, be free from fever, whether only at the com-mencement of a disease, or when actually in the grasp of a grave malady. But care must be taken that none of the above are tried either during fever or with food undigested. Now the bath is of double service; for at one time after fevers have been dissipated, it forms for a convalescent the preliminary to a fuller diet and stronger wine; at another time it actually takes off the fever; and it is generally adopted, when it is expedient to relax the skin and draw out corrupt humor and change the bodily habit. The ancients used it rather timidly, Asclepiades more boldly. There is indeed nothing to be apprehended from its use, if it be timely; before the proper time it does harm. A patient who has become free from fever can safely be bathed, as soon as there has been no paroxysm for one whole day, on the next day after the time for a paroxysm. But where the fever has a regular periodicity so that it recurs every third or fourth day, when there has not been a recurrence, the bath is safe. Even whilst fevers are persisting, if they are slow and mild, and have lasted a long while, this treatment may properly be tried, so long as the parts below the ribs are neither indurated nor swollen, the tongue not furred, there is no pain in the trunk or head, and the fever is not then on the increase. And in those fevers which have a definite periodicity, there are two opportunities for the bath, one before the shivering, the other after the fever has ended: but in the case of those who have been the subjects for a long while of slow and slight fever, the time for the bath is when the paroxysm has wholly remitted, or if that does not occur, at any rate when it has mitigated, and the patient's body has already become as sound as it possibly can in this sort of complaint. A weakly patient who is about to go to the bath should avoid exposing himself to cold beforehand. On arriving at the bath, he should sit for a while to try whether his temples become tightened, and whether any sweat arises: if the former happens without the latter, for that day the bath is unsuitable, and he should be anointed lightly and carried home, and cold is to be avoided in every possible way and abstinence practised. But if the temples are unaffected, and sweating starts there first, and then elsewhere, his face is to be fomented with hot water; then he should go down into the hot bath, where it is to be noted whether there is shrivelling of the skin at the first touch of hot water, which can hardly happen when the indications noted above have been attended to properly: it is, however, a sure sign of the bath being injurious. Whether he should be anointed before entering, or after the hot bath, should be decided from the degree of his convalescence. Generally, however, unless it has been definitely prescribed that it is to be done afterwards, when the sweating begins the body should be slightly anointed, and then he is to get into the hot water. And whilst in it also regard should be had to his strength; he ought not to be kept in the bath until he faints from the heat, but be taken out earlier and carefully wrapped up so that no cold reaches him, and so that he may sweat there also before taking anything. There are hot foments: millet, salt, or sand, any of which is heated, and put into a linen cloth: when less heat is required the linen cloth may be used alone, but if greater heat, firebrands are extinguished, wrapped up in rags, and so put round him. Further, leathern bottles are to be filled with hot oil, or hot water is poured into earthenware vessels, called from their shape "lentils"; and salt is put into a linen bag, and dipped into very hot water, then laid upon the limb to be fomented.... and two broad-ended cautery irons are heated near the fire, and one of them is dipped into that salt, and water is lightly sprinkled upon the iron held over the part. When the iron begins to cool, it is put back into the fire, and the second iron made use of in the same way as the first, turn and turn about: during the procedure a hot brine drips down, which is beneficial for sinews contracted by disease of any kind. The common effect of all these measures is to disperse whatever is oppressing the parts over the heart, or strangling the throat, or harming some limb. It will be stated under particular maladies when use is to be made of each (III, IV).

> Latin: 17. Sudor etiam duobus modis elicitur, aut sicco calore aut balneo. Siccus calor est et harenae calidae et Laconici et clibani et quarundam naturalium sudationum, ubi terra profusus calidus uapor aedificio includitur, sicut super Baias in murtetis habemus. Praeter haec sole quoque et exercitatione mouetur. Vtiliaque haec genera sunt, quotiens umor intus nocet, isque digerendus est. Ac neruorum quoque quaedam uitia sic optime curantur. Sed cetera infirmis possunt conuenire: sol et exercitatio tantum robustioribus, qui tamen sine febre uel inter initia morborum uel etiam grauibus morbis tenentur. Cauendum autem est, ne quid horum uel in febre uel in cruditate temptetur. At balnei duplex usus est: nam modo discussis febribus initium cibi plenioris uinique firmioris [ualetudinis] facit, modo ipsam febrem tollit; fereque adhibetur, ubi summam cutem relaxari euocarique corruptum umorem et habitum corporis mutari expedit. Antiqui timidius eo utebantur, Asclepiades audacius. Neque terrere autem ea res, si tempestiua est, debet: ante tempus nocet. Quisquis febre liberatus est, simulatque ea uno die non accessit, eo, qui proximus est post tempus accessionis, tuto lauari potest. At si circumitum habere ea febris solita est, sic ut tertio quartoue die reuertatur, quandocumque non accessit, balneum tutum est. Manentibus uero adhuc febribus, si eae sunt quae lentae lenesque iam diu male habent, recte medicina ista temptatur, cum eo tamen, ne praecordia dura sint neue ea tumeant, neue lingua aspera sit, neue aut in medio corpore aut in capite dolor ullus sit, neue tum febris increscat. Atque in iis quidem febribus, quae certum circuitum habent, duo balnei tempora sunt, alterum ante horrorem, alterum febre finita: in is uero, qui lentis febriculis diu detinentur, cum aut ex toto recessit accessio, aut si id non solet, certe lenita est, iamque corpus tam integrum est, quam maxime esse in eo genere ualetudinis solet. Inbecillus homo iturus in balneum uitare debet, ne ante frigus aliquod experiatur. Vbi in balneum uenit, paulisper resistere experirique, num tempora adstringantur, et an sudor aliqui oriatur: si illud incidit, hoc non secutum est, inutile est eo die balineum perunguendusque is leniter et auferendus est, uitandumque omni modo frigus, et abstinentia utendum. At si temporibus integris primum ibi, deinde alibi sudor incipit, fouendum os aqua calida; tum in solio descendendum est, atque ibi quoque uidendum est, num sub primo contactu aquae calidae summa cutis inhorrescat, quod uix fieri potest, si priora recte cesserunt: certum autem signum inutilis balinei est. Ante uero an postea quam in aquam calidam se demittat aliquis perungui debeat, ex ratione ualetudinis suae cognoscat. Fere tamen, nisi ubi nominatim ut postea fiat praecipietur, moto sudore leuiter corpus perunguendum, deinde in aquam calidam demittendum est. Atque hic quoque habenda uirium ratio est; neque committendum, ut per aestum anima deficiat; sed maturius is auferendus curioseque uestimentis inuoluendus est, ut neque ad eum frigus adspiret, et ibi quoque, antequam aliquid adsumat, insudet. Fomenta quoque calida sunt milium, sal, harena, quidlibet eorum calfactum et in linteum coniectum: si minore ui opus est, etiam solum linteum, at si maiore, exstincti ti⟨ti⟩ones inuolutique panniculis et sic circumdati. Quin etiam calido oleo replentur utriculi, et in uasa fictilia, [similitudine] quas lenticulas uocant, aqua coicitur; et sal sacco linteo excipitur, demittiturque in aquam bene calidam, tum super id membrum, quod fouendum est, conlocatur * * * iuxtaque ignem ferramenta duo sunt, capitibus paulo latioribus, alterumque ex iis demittitur in eum salem, et super aqua leuiter aspergitur: ubi frigere coepit, ad ignem refertur, et idem in altero fit, deinde inuicem in utroque: inter quae descendit salsus et calidus sucus, qui contractis aliquo morbo neruis opitulatur. His omnibus commune est digerere id, quod uel praecordia onerat, uel fauces strangulat, uel in aliquo membro nocet. Quando autem quoque utendum sit, in ipsis morborum generibus dicetur.

[¶2] 18. 18 After having spoken of those things which benefit by depleting, we come to those which nourish, namely food and drink. Now these are of general assistance not only in diseases of all kinds but in preserving health as well; and an acquaintance with the properties of all is of importance, in the first place that those in health may know how to make use of them, then, as we follow on to the treatment of diseases (III, IV), we can state the species of aliments to be consumed, without the necessity every time of naming them singly. So then it should be known that all pulses, and all bread-stuffs made from grain, form the strongest kind of food (I call strongest that which has most nourishment). To the same class of further belong: all domesticated quadruped animals; all large game such as the wild she-goat, deer, wild boar, wild ass; all large birds, such as the goose and peacock and crane; all sea monsters, among which is the whale and such like; also honey and cheese. Hence it is not wonderful that pastry made of grain, lard, honey and cheese is very strong food. Among food materials of the middle class ought to be reckoned: of pot-herbs, those of which the roots or bulbs are eaten; of quadrupeds, the hare; birds of all kinds from the smallest up to the flamingo; likewise all fish which do not bear salting or are salted whole. The weakest of food materials are: all vegetable stalks and whatever forms on a stalk, such as the gourd and cucumber and caper, all orchard fruits, olives, snails, and likewise shellfish. But although these are so divided, nevertheless even those of the same species admit of great differentiation, one thing being stronger or weaker than another: whilst there is more nutriment in bread than in anything else, wheat is a stronger food than millet, and that again than barley; and of wheat the strongest is siligo, next simila, then the meal from which nothing is extracted, which the Greeks call autopuros; weaker is bread made from pollen, weakest the common grey bread. Among pulses, bean and lentils are stronger food than peas. Of vegetables the turnip and navew and all bulbs, among which I include the onion also and garlic, are stronger than the parsnip, or that which is specially called a root. Also cabbage and beet and leek are stronger than lettuce or gourd or asparagus. But of fruit growing on twigs, grapes, figs, nuts, dates are stronger than orchard fruit properly so‑called; and of these last, the juicy are stronger than the mealy. Likewise of those birds, which belong to the middle class, those which rely more on their feet are stronger food than those which rely more on their wings; and of those birds which depend on flight, the larger birds yield stronger food than the smaller, such as the fig-eater and thrush. And those also which pass their time in the water yield a weaker food than those which have no knowledge of swimming. Among food from domesticated quadrupeds pork is the weakest, beef the strongest. And so also of game, the larger the animal the stronger the food it yields. The fish most in use belong to the middle class; the strongest are, however, those from which salted preparations can be made, such as the mackerel; next come those which, although more tender, are nevertheless firm, such as the gilthead, gurnard, sea bream, eyefish, then the flat fish, and after these still softer, the bass and mullets, and after these all rock fish. Not only is there differentiation in the classes of nutriments, but also as much in the actual species of nutriment; which is due both to age and part of the animal and to soil and to climate and to habit. For every four-footed animal yields less nutriment while it is a suckling, likewise a chicken in a coop, the more tender it is; also a half-grown fish, which has not filled out to its full size. Then likewise in the same pig, trotters, chaps, ears or brain, in a lamb or kid the whole head, also the pettitoes, are somewhat less nutritious than other parts, and so can be placed in the middle class. In birds, the neck and wings are rightly counted as weak nutriment. As regards soil, grain is also more nutritious grown in hilly than in flat districts; fish living among rocks are less nutritious than those in sand, and these again less than those in mud. Hence it is that the same classes of fish from a pond or lake or river are heavier, and those which live in deep water are lighter food than those which live in shallows. Every wild animal is a lighter food than the same species domesticated, and the product of a damp climate is lighter than that of a dry one. Again, all kinds of fat meat have more nutriment than lean, fresh meat than salted, recently killed than stale. Then the same meat is more nourishing stewed than roasted, more so roasted than boiled. A hard-boiled egg is a very substantial material, a soft cooker or raw egg very light. And while all bread-stuffs are among the most solid, yet some kinds of grain after being soaked, such as spelt, rice, pearl barley, or the gruel or porridge made out of these, and also bread soaked in water, can be reckoned among the weakest of food. Of drinks too the strongest class are: whatever can be made from grain, likewise milk, mead, must boiled down, raisin wine, wine either sweet or heady or still fermenting or of great age. But vinegar, and that wine which is a few years old, whether dry or rich, are intermediate in quality; and therefore to weak patients nothing of the other class should be given. Water is of all the weakest; and drink from grain is the more nutritious, according as the grain itself is nutritious; wine coming from a good soil is more nutritious than from a poor one, that from a temperate climate more nutritious than from an extreme one, whether too wet or too dry, whether excessively cold or hot. Mead, the more honey it contains, must the more it is boiled down, raisin wine the drier the grapes - are the stronger. Rain water is the lightest, then spring water, next water from a river, than from a well, after that from snow or ice; heavier still is water from a lake, the heaviest from a marsh. The recognition of water is as easy as it is necessary for those who want to know its nature. For by weighing, the lightness of water becomes evident, and of water of equal weight, that is the better, which most quickly heats or cools, also in which pulse is most quickly cooked. It is generally the case too that the more substantial the material, the less readily it is digested, but once digested it nourishes the more. Thus the quality of the food administered should be in accordance with the patient's strength, and the quantity in accordance with its quality. For weak patients, therefore, there is needed the lightest food; food of the middle class best sustains those moderately strong, and for the robust the strongest is the fittest. Finally, of the lightest foods more can be taken; it is rather with the strongest food that moderation should be observed.

> Latin: 18. Cum de iis dictum sit, quae detrahendo iuuant, ad ea ueniendum est, quae alunt, id est, CIBVM ET POTIONEM. Haec autem non omnium tantum morborum sed etiam secundae ualetudinis communia praesidia sunt; pertinetque ad rem omnium proprietates nosse, primum ut sani sciant, quomodo his utantur, deinde ut exsequentibus nobis morborum curationes liceat species rerum, quae adsumendae erunt, subicere, neque necesse sit subinde singulas eas nominare. Scire igitur oportet omnia legumina, quaeque ex frumentis panificia sunt, generis ualentissimi esse (ualentissimum uoco, in quo plurimum alimenti est); item omne animal quadrupes domi natum; omnem grandem feram, quales sunt caprea, ceruus, aper, onager; omnem grandem auem, quales sunt anser et pauo et grus; omnes beluas marinas, ex quibus cetus est quaeque his pares sunt; item mel et caseum. Quo minus mirum est opus pistorium ualentissimum esse, quod ex frumento, adipe, melle, caseo constat. In media uero materia numerari ex holeribus debere ea, quorum radices uel bulbos adsumimus; ex quadrupedibus leporem; aves omnes a minimis ad phoenicopterum; item pisces omnes, qui salem non patiuntur solidiue saliuntur. Inbecillissimam uero materiam esse omnem caulem holeris et quicquid in caule nascitur, qualis est cucurbita et cucumis et capparis, omnia poma, oleas, cochleas, itemque conculia. Sed quamuis haec ita discreta sunt, tamen etiam quae sub eadem specie sunt, magna discrimina recipiunt, aliaque res alia uel ualentior est uel infirmior: siquidem plus alimenti est in pane quam in ullo alio, firmius est triticum quam milium, id ipsum quam hordeum; et ex tritico firmissima siligo, deinde simila, deinde cui nihil demptum est, qu⟨em⟩ ΑΥΤΟΠΥΡΟΝ Graeci uocant: infirmior est ex polline, infirmissimus cibarius panis. Ex leguminibus uero ualentior faba uel lenticula quam pisum. Ex holeribus ualentior rapa napique et omnes bulbi, in quibus cepam quoque et alium numero, quam pastinaca uel ⟨quae⟩ specialiter radicula appellatur. Item firmior brassica et beta et porrum quam lactuca uel cucurbita uel asparagus. At ex fructibus surculorum ualentiores uuae, ficus, nuces, palmulae quam quae poma proprie nominantur; atque ex his ipsis firmiora quae sucosa quam quae fragilia sunt. Item⟨que⟩ ex is auibus, quae in media specie sunt, ualentior ea, quae pedibus quam quae uolatu magis nititur: et ex is, ⟨quae⟩ uolatu fidunt, firmiores quae grandiores aues quam quae minutae sunt, ut ficedula et turdus. Atque eae quoque, quae in aqua degunt, leuiorem cibum praestant, quam quae natandi scientiam non habent. Inter domesticas uero quadrupedes leuissima suilla est, grauissima bubula. Itemque ex feris, quo maius quodque animal, eo robustior ex eo cibus est. Pisciumque eorum, qui ex media materia sunt, quibus maxime utimur, tamen grauissimi sunt, ex quibus salsamenta quoque fieri possunt, qualis lacertus est; deinde ii qui, quamuis teneriores, tamen duri sunt, ut aurata, coruus, sparus, oculata, tunc plani, post quos etiamnum leuiores lupi mullique, et post hos omnes saxatiles. Neque uero in generibus rerum tantummodo discrimen est, sed etiam in ipsis; quod et aetate fit et membro et solo et caelo et habitu. Nam quadrupes omne animal, si lactens est, minus alimenti praestat, itemque quo tenerior pullus cohortalis est; in piscibus quoque media aetas, quae non summam magnitudinem inpleuit. Deinde ex eodem sue ungulae, rostrum, aures, cerebellum, ex agno haedoue cum petiolis totum caput aliquanto quam cetera membra leuiora sunt, adeo ut in media materia poni possint. Ex auibus colla alaeue recte infirmis adnumerantur. Quod ad solum uero pertinet, frumentum quoque ualentius est collinum quam campestre; leuior piscis inter saxa editus quam in harena, leuior in harena quam in limo. Quo fit, ut e⟨x⟩ stagno uel lacu uel flumine eadem genera grauiora sint, leuiorque qui in alto quam qui in uado uixit. Omne etiam ferum animal domestico leuius, et quodcumque umido caelo quam quod sicco natum est. Deinde etiam omnia pinguia quam macra, recentia quam salsa, noua quam uetusta plus alimenti habent. Tum res eadem magis alit iurulenta quam assa, magis assa quam elixa. Ouum durum ualentissimae materiae est, molle uel sorbile inbecillissimae. Cumque panificia omnia firmissima sint, elota tamen quaedam genera frumenti, ut halica, oryza, tisana, uel ex isdem facta sorbitio aut pulticula, et aqua quoque madens panis inbecillissimis adnumerari potest. Ex potionibus uero quaecumque ex frumento facta est, itemque lac, mulsum, defrutum, passum, uinum aut dulce aut uehemens aut mustum aut magnae uetustatis ualentissimi generis est. ⟨At⟩ acetum et ⟨id⟩ uinum, quod paucorum annorum uel austerum uel pingue est, in media materia est; ideoque infirmis numquam generis alterius dari debet. Aqua omnium inbecillissima est; firmiorque ex frumento potio est, quo firmius est ipsum frumentum; firmior ex eo uino, quod bono solo quam quod tenui, quodque temperato caelo quam quod nimis aut umido aut nimis sicco nimiumque aut frigido aut calido natum est. Mulsum, quo plus mellis habet, defrutum, quo magis incoctum est, passum, ex quo sicciore uua est, eo ualentius est. Aqua leuissima pluuialis est, deinde fontana, tum ex flumine, tum ex puteo, post haec ex niue aut glacie: grauior his ex lacu, grauissima ex palude. Facilis etiam et necessaria cognitio est naturam eius requirentibus. Nam leuis pondere apparet, et ex is, quae pondere pares sunt, eo melior quaeque est, quo celerius et calfit et frigescit, quoque celerius in ea legumina percoquuntur. Fere uero sequitur, ut, quo ualentior quaeque materia est, eo minus facile concoquatur, sed, si concocta est, plus alat. Itaque utendum est materiae genere pro uiribus, modusque omnium pro genere sumendus. Ergo inbecillis hominibus rebus infirmissimis opus est: mediocriter firmos media materia optime sustinet, et robustis apta ualidissima est. Plus deinde aliquis adsumere ex leuioribus potest: magis in iis, quae ualentissima sunt, temperare sibi debet.

[¶3] 19. 19 The foregoing are not the only differentiations; but as well some materials have good juices, others bad, what the Greeks call euchylous and kakochylous; some are bland, others acrid; some render our phlegm thicker, others thinner; some agree with the stomach, others are alien; also some cause flatulence, others are free from that; some warm, others cool; some readily turn sour in the stomach, others do not readily decompose inside; some move the bowels, others check motions; some excite urination, others retard it; some promote sleep, others excite the senses. All these, then, should be known because one suits one body or constitution, one another.

> Latin: 19. Neque haec sola discrimina sunt; sed etiam aliae res boni suci sunt, aliae mali, quas ΕΥΧΥΛΟΥΣ uel ΚΑΚΟΧΥΛΟΥΣ Graeci uocant; aliae lenes, aliae acres; aliae crassiorem pituitam in nobis faciunt, aliae tenuiorem; aliae idoneae stomacho, aliae alienae sunt; itemque aliae inflant, aliae ab hoc absunt; aliae calfaciunt, aliae refrigerant; aliae facile in stomacho acescunt, aliae ⟨non⟩ facile intus corrumpuntur; aliae mouent aluum, aliae supprimunt; aliae citant urinam, aliae tardant; quaedam somnum mouent, quaedam sensum excitant. Quae omnia ideo noscenda sunt, quoniam aliud alii uel corpori uel ualetudini conuenit.

[¶4] 20. 20 Of good juice are: wheat, siligo, spelt, rice, starch, frumenty, pearl barley gruel, milk, soft cheese, all sorts of game, all birds of the middle class, also the larger birds named above; fish intermediate between the soft and hard, such as mullet and bass; spring lettuce, nettle-tops, mallow, gourd, raw egg, purslane, snails, dates; orchard fruit which is neither bitter nor sour; wine sweet or mild, raisin wine, must boiled down; olives preserved either in wine or must; sow's womb, pig's chaps and trotters, all fatty or glutinous meat, and the liver of all animals.

> Latin: 20. Boni suci sunt triticum, siligo, halica, oryza, amulum, tragum, tisana, lac, caseus mollis, omnis uenatio, omnes aues, quae ex media materia sunt, ex maioribus quoque eae, quas supra nominaui; medii inter teneros durosque pisces, ut mullus, ut lupus; uerna lactuca, urtica, malua, [cucumis,] cucurbita, ⟨ouum sorbile,⟩ portulaca, cocleae, palmulae; ex pomis quodcumque neque acerbum neque acidum est; uinum dulce uel lene, passum, defrutum; oleae, quae ex his duobus in altero utro seruatae sunt; uuluae, rostra, trunculique suum, omnis pinguis caro, omnis glutinosa, omne iecur.

[¶5] 21. 21 Of bad juice are: millet, panic, barley, pulse; very lean meat from domesticated animals and all salted meat; all pickled fish, fish sauce, old cheese; skirret, radish, turnip, navew, bulbs; cabbage and even more its sprouts, asparagus, beet, cucumber, leek, rocket, cress, thyme, catmint, savory, hyssop, rue, dill, fennel, cummin, anise, sorrel, mustard, garlic, onion; spleens, kidneys, chitterlings; orchard fruit when sour or bitter; vinegar, everything acrid, sour, bitter, oily; also rock fish, and all fish of the very soft kind, or on the other hand those which are very hard and strong-flavoured, mostly such as live in ponds, lakes and muddy rivers, and which have become excessively large.

> Latin: 21. Mali uero suci sunt milium, panicium, hordeum, legumina; caro domestica permacra omnisque caro salsa, omne salsamentum, garum, uetus caseus; siser, radicula, rapa, napi, bulbi; brassica magisque etiam cyma eius, asparagus, beta, cucumis, porrus, eruca, nasturcium, thymum, nepeta, satureia, hysopum, ruta, anetum, feniculum, cuminum, anesum, lapatium, sinapi, alium, cepe; lienes, renes, intestina; pomum quodcumque acidum uel acerbum est; acetum, omnia acria, acida, acerba, oleum; pisces quoque saxatiles, omnesque, qui ex tenerrimo genere sunt, aut qui rursus nimium duri uir⟨o⟩sique sunt, ut fere quos stagna, lacus limosique riui ferunt, quique in nimiam magnitudinem excesserunt.

[¶6] 22. 22 The following are bland materials: broth, porridge, pancake, starch, pearl barley gruel, fat and glutinous meat, generally all that belong to domesticated animals, particularly, however, the trotters and titbits of pigs, the pettitoes and heads of kids, calves, and lambs, and the brains of all animals; likewise all bulbs properly so‑called, milk, must boiled down, raisin wine and pine kernels. The following are acrid: everything especially harsh, everything sour, everything salt, and even honey, and the better it is the more it is so. Likewise garlic, onion, rocket, rue, cress, cucumber, beet, cabbage, asparagus, mustard, radish, endive, basil, lettuce and most pot-herbs.

> Latin: 22. Lenes autem sunt sorbitio, pulticula, laganus, amilum, tisana, pinguis caro et quaecumque glutinosa est; quod fere quidem in omni domestica fit, praecipue tamen in ungulis trunculisque suum, in pe⟨t⟩iolis capitulisque haedorum et uitulorum et agnorum, omnibusque cerebellis; item qui proprie bulbi nominantur, lac, defrutum, passum, nuclei pinei. Acria sunt omnia nimis austera, omnia acida, omnia salsa, et mel quidem, quo melius est, eo magis. Item alium, cepa, eruca, ruta, nasturcium, cucumis, beta, brassica, asparagus, sinapi, radicula, intubus, ocimum, lactuca, maximaque holerum pars.

[¶7] 23. 23 Now the following make phlegm thicker: raw eggs, spelt, rice, starch, pearl barley gruel, milk, bulbs, and generally all glutinous substances. Phlegm is rendered thinner by: all salted and acrid and acid materials.

> Latin: 23. Crassiorem autem pituitam faciunt oua sorbilia, halica, oriza, amulum, tisana, lac, bulbi, omniaque fere glutinosa. Extenuant eandem omnia salsa, atque acria atque acida.

[¶8] 24. 24 But best suited to the stomach are: whatever is harsh, even what is sour, and that which has been sprinkled moderately with salt; so also unleavened bread, and spelt or rice or pearl barley which has been soaked; birds and game of all kinds, and both of these whether roasted or boiled; among domesticated animals, beef; of other meat the lean rather than the fat; the trotters, chaps, ears, and the sterile womb of a pig; among pot-herbs, endive, lettuce, parsnip, cooked gourd, skirret; among orchard fruit, the cherry, mulberry, service fruit, the mealy pear from Crustumeria, or the Mevian; also keeping-pears, Tarentine or Signian, the round or Scandian apple or that of Ameria or the quince or pomegranate, raisins preserved in jars; soft egg, dates, pine kernels, white olives preserved in strong brine, or the same steeped in vinegar, or black olives which have been well ripened on the tree, or which have been preserved in raisin wine, or in boiled-down must; dry wine is allowable even although it may have become harsh, also that doctored with resin; hard-fibred fish of the intermediate class, oysters, scallops, the shellfish murex and purpura, snails; food and drink either very cold or very hot; wormwood.

> Latin: 24. Stomacho autem aptissima sunt, quaecumque austera sunt; etiam quae acida sunt, quaeque contacta sale modice sunt; item panis sine fermento, et elota halica, uel oriza uel tisana; omnis auis, omnis uenatio; atque utraque uel assa uel elixa: ex domesticis animalibus bubula: si quid ex ceteris sumitur, macrum potius quam pingue; ex sue ungulae, rostra, aures, uoluae sterilesque; ex holeribus intubus, lactuca, pastinaca, cucurbita elixa, siser; ex pomis cerasium, morum, sorbum, pirum fragile, quale Crustuminum uel Meuianum est; item pira, quae reponuntur, Tarentina atque Signina, malum orbiculatum aut Scaudianum uel Amerinum uel Cotoneum uel Punicum, uuae ex olla; molle ouum, palmulae, nuclei pinei, oleae albae ex dura muria, eaedem aceto intinctae, uel nigrae, quae in arbore bene permaturuerunt, uel quae in passo defrutoue seruatae sunt; uinum austerum, licet etiam asperum sit, item resinatum; duri ex media materia pisces, ostrea, pectines, murices, purpurae, cocleae, cibi potionesque uel frigidae uel feruentes, apsinthium.

[¶9] 25. 25 But on the other hand materials alien to the stomach are: all things tepid, all things salted, all things stewed, all things over-sweetened, all things fatty, broth, leavened bread, and likewise that made from either millet or barley, pot-herb roots, and pot-herbs eaten with oil or fish sauce, honey, mead, must boiled down, raisin wine, milk, cheese of all kinds, fresh grapes, figs both green and dry, pulse of all sorts, and whatever causes flatulence; likewise thyme, catmint, savory, hyssop, cress, sorrel, charlock, walnuts. But it can be understood from the above that what has good juice does not necessarily agree with the stomach, and that whatever agrees with the stomach has not necessarily good juice.

> Latin: 25. Aliena uero stomacho sunt omnia tepida, omnia salsa, omnia iurulenta, omnia praedulcia, omnia pinguia, sorbitio, panis fermentatus, itemque uel ex milio uel ex hordeo, radices holerum, et quodcumque holus ex oleo garoue estur, mel, mulsum, defrutum, passum, lac, omnis caseus, uua recens, ficus et uirides et aridae, legumina omnia, quaeque inflare consuerunt; item thymum, nepeta, satureia, hysopum, nasturcium, lapatium, lapsanum, iuglandes. Ex his autem intellegi potest non, quicquid boni suci est, protinus stomacho conuenire, neque, ⟨quic⟩quid stomacho conuenit, protinus boni suci esse.

[¶10] 26. 26 Now flatulence is produced by: almost all food which is leguminous, fatty, sweet, everything stewed, must, and also that wine was has not as yet matured; among pot-herbs, garlic, onion, cabbage, and all roots except skirret and parsnip; bulbs, figs even when dried but especially when green, fresh grapes, all nuts except pine kernels, milk, cheese of all kinds; lastly anything eaten half-cooked. The least flatulence comes from what is got by hunting and birding, from fish, orchard fruit, olives, or shellfish, from eggs whether cooked soft or raw, from old wine. Fennel and anise in particular even relieve flatulence.

> Latin: 26. Inflant autem omnia fere legumina, omnia pinguia, omnia dulcia, omnia iurulenta, mustum, atque etiam id uinum, cui nihil adhuc aetatis accessit; ex holeribus alium, cepa, brassica, omnesque radices, excepto sisere et pastinaca; bulbi, ficus etiam aridae sed magis uirides, uuae recentes, nuces omnes, exceptis nucleis pineis, lac, omnisque caseus; quicquid deinde subcrudum aliquis adsumpsit. Minima inflatio fit ex uenatione, aucupio, piscibus, pomis, oleis, conchyliisue, ouis uel mollibus uel sorbilibus, uino uetere. Feniculum uero et anetum inflationes etiam leuant.

[¶11] 27. 27 Again the heating foods are: pepper, salt, all stewed meat, garlic, onion, dried figs, pickled fish, wine, and the stronger this is, the more heating it is. Cooling foods are: pot-herbs the stalks of which are eaten uncooked, such as endive and lettuce, and also coriander, cucumber, cooked gourds, beet, mulberries, cherries, sour apples, mealy pears, boiled meat, and in particular vinegar, whether taken with food or as a drink.

> Latin: 27. At calfaciunt piper, sal, caro omnis iurulenta, alium, cepa, ficus aridae, salsamentum, uinum, et quo meracius est, eo magis. Refrigerant holera, quorum crudi caules adsumuntur, ut intubus et lactuca, et item coriandrum, cucumis, elixa cucurbita, beta, mora, cerasia, mala austera, pira fragilia, caro elixa, praecipueque acetum, siue cibus ex eo siue potio adsumitur.

[¶12] 28. 28 Foods that readily decompose inside are: leavened bread, and any sort other than that made of wheat, flour, milk, honey, and therefore also all things made with milk and all pastry, soft fish, oysters, vegetables, cheese both new and old, meat fat or tender, sweet wine, mead, must boiled down, raisin wine; finally everything stewed or over-sweetened or over-thin. But the following decompose the least within: unleavened bread, birds, especially those with harder flesh, hard fish, not only for instance the gilthead or the sea bream, but also the squid, lobster and octopus; likewise beef and hard meat of all kinds; and the same is better if lean or salted; all pickled fish, snails, the shellfish, murex purpura; and wine which is harsh or resinated.

> Latin: 28. Facile autem intus corrumpuntur panis fermentatus, et quisquis alius quam ex tritico est, lac, mel; ideoque etiam lactentia atque omne pistorium opus, teneri pisces, ostrea, holera, caseus et recens et uetus, crassa uel tenera caro, uinum dulce, mulsum, defrutum, passum; quicquid deinde uel iurulentum est uel nimis dulce uel nimis tenue. At minime intus uitiantur panis sine fermento, aues et eae potius duriores, duri pisces: neque solum aurata tuta aut sparus sed etiam lolligo, lucusta, polypus; item bubula omnisque dura caro; eademque aptior est, si macra, si salsa est; omniaque salsamenta, cocleae, murices, purpurae; uinum austerum uel resinatum.

[¶13] 29. 29 Again, the bowels are moved by: leavened bread, and especially if it is the grey wheaten or barley bread, cabbage if lightly cooked, lettuce, dill, cress, basil, nettle-tops, purslane, radish, caper, garlic, onion, mallow, sorrel, beet, asparagus, gourds, cherries, mulberries, raisins preserved in jars, all ripe fruit, a fig even dried, but especially a green one, fresh grapes; fat small birds, snails, fish sauce, pickled fish, oysters, giant mussels, sea-urchins, sea-mussels, almost all shellfish, especially the soup made from them, rock fish and all soft fish, cuttlefish ink; any meat eaten when fat, either stewed or boiled, waterfowl, uncooked honey, milk, all things made with milk, mead, wine sweet or salted, soft water; all food sweetened, tepid, fatty, boiled, stewed, salted or watery.

> Latin: 29. At aluum mouent panis fermentatus, magisque si cibarius uel hordiacius est, brassica, si subcruda est, lactuca, anetum, nasturcium, ocimum, urtica, portulaca, radicula, capparis, alium, cepa, malua, lapatium, beta, asparagus, cucurbita, cerasia, mora, uua ⟨ex olla⟩, omnia mitia, ficus etiam arida, sed magis uiridis, uuae recentes; pingues minutae aues, cocleae, garum, salsamentum, ostrea, pelorides, echini, musculi, et omnes fere conchulae, maximeque ius earum, saxatiles et omnes teneri pisces, sepiarum atramentum; si qua caro adsumitur, pinguis, eadem uel iurulenta uel elixa, aues quae natant, mel crudum, lac, lact⟨e⟩ntia omnia, mulsum, uinum dulce uel salsum, aqua tenera; omnia dulcia, tepida, pinguia, elixa, iurulenta, salsa uel diluta.

[¶14] 30. 30 On the contrary the bowels are confined: by bread made from siligo or simila flour, especially when unleavened, and particularly so when toasted, and this property is even increased by baking twice, porridge either from spelt or panic or millet, as well as gruel from the same, and especially if these have been parched beforehand; lentil porridge to which beet or endive or chicory or plantain has been added, and especially when these have been previously toasted, or endive by itself, or roasted with plantain, or chicory, the smaller pot-herbs, cabbage twice boiled; eggs rendered hard, especially by poaching; small birds, the blackbird and wood-pigeons especially when cooked in diluted vinegar, cranes, all birds which run rather than fly; the hare, wild she-goat, the liver of animals which yield suet, particularly the ox, and suet itself; cheese which has become rather strong in taste, either from age or because of that change which we note in cheese from across the sea, or, if it is new, after it has been cooked in honey or mead; also cooked honey, unripe pears, service fruit, especially those called torminalia, quinces and pomegranates, olives either white or over-ripe, myrtleberries, dates, the purpura and murex, wine resinated or harsh, and that undiluted, vinegar, mead which has been heated, also must boiled down, raisin wine, water tepid or very cold, hard water (that is, which decomposes late), hence principally rain water; everything hard, harsh, rough, grilled, and in the case of the same meat the flesh roasted rather than boiled.

> Latin: 30. Contra astringunt panis ex siligine uel ex simila, magis si sine fermento est, magis etiam si ustus est, intenditurque uis eius etiam, si bis coquitur, pulticula uel ex halica uel ex panicio uel ex milio, itemque ex isdem sorbitio, et magis si haec ante fricta sunt; lenticula, cui uel beta uel intubus uel ambubeia uel plantago adiecta est, magisque etiam si illa ante fricta est, per se etiam intubus uel ex plantagine uel ambubeia f⟨ri⟩cta, minuta holera, brassica bis decocta; dura oua, magisque si assa sunt; minutae aues, merula, palumbus, magisque in posca si decoctus est, grues, omnes aues, quae magis currunt quam uolant; lepus, caprea, iecur ex eis, quae sebum habent, maximeque bubulum, ac sebum ipsum; caseus, qui uehementior uetustate fit uel ea mutatione, quam in eo transmarino uidemus, aut si recens est, ex melle mulsoue decoctus; item mel coctum, pira inmatura, sorua, magisque ea, quae torminalia nominantur, mala Cotonea et Punica, oleae uel albae uel permaturae, murta, palmulae, purpurae, murices, uinum resinatum uel asperum, item meracum, acetum, mulsum quod inferuuit, item defrutum, passum, aqua uel tepida uel praefrigida, dura, id est ea, quae tarde put⟨r⟩escit, ideoque pluuia potissimum; omnia dura, macra, austera, aspera, tosta, ⟨et in eadem⟩ carne assa potius quam elixa.

[¶15] 31. 31 The following increase the urine: garden herbs of good odour, as parsley, rue, dill, basil, mint, hyssop, anise, coriander, cress, rocket, fennel; and besides these asparagus, capers, catmint, thyme, savory, charlock, parsnip, especially growing wild, radish, skirret, onion; of game especially the hare; thin wine, pepper both round and long, mustard, wormwood, pine kernels.

> Latin: 31. Vrinam autem mouent quaecumque in horto nascentia boni odoris sunt, ut apium, ruta, anetum, ocimum, menta, hysopum, anesum, coriandrum, nasturcium, eruca, feniculum; praeter haec asparagus, capparis, nepeta, thymum, satureia, lapsanum, pastinaca, magisque agrestis, radicula, siser, cepa; ex uenatione maxime lepus; uinum tenue, piper et rotundum et longum, sinapi, absinthium, nuclei pinei.

[¶16] 32. 32 For producing sleep the following are good: poppy, lettuce, and mostly the summer kinds in which the stalk is very milky, the mulberry, the leek. For exciting the senses: catmint, thyme, savory, hyssop, and especially pennyroyal, rue and onion.

> Latin: 32. Somno uero aptum est papauer, lactuca, maximeque aestiua, cuius coliculus iam lacte repletus est, morum, porrus. Sensus excitat nepeta, thymum, satureia, hysopum, praecipueque puleium, ruta et cepe.

[¶17] 33. 33 For drawing out the material of the disease certainly many things can be used, but as they are mostly composed of foreign medicaments and are more useful in other affections than in those relieved by the dietetic regimen, I will defer their consideration for the present (V. Proem., 1, 2): but I will mention here those which are at hand, and are suitable to the diseases of which I am about to speak (III, IV), since they blister the body and thus extract from it the material of disease. Now those which have this faculty are the seeds of rocket, cress, radish, and most of all mustard. The same faculty exists in salt and figs. Those which gently both repress and mollify at the same time are greasy wool to which has been added oil with vinegar or wine, crushed dates, bran boiled in salt water or vinegar. But those which simultaneously repress and cool are pellitory, which the Greeks call parthenion or perdeikion, thyme, pennyroyal, basil, the blood-herb which the Greeks call polygonon, purslane, poppy-leaf, vine-tendril, coriander, hyocyamus-leaves, moss, skirret, parsley, solanum, which the Greeks call strychnos, cabbage-leaves, endive, plantain, fennel-seed; crushed pears and apples and especially quinces, lentils; cold water, especially rain water, wine and vinegar, and everything soaked in these, whether bread or meal or sponge or ashes, or greasy wool or even lint; Cimolian chalk, gypsum; oil perfumed with quince, myrtle, rose; unripe olive oil; vervains, the leaves crushed along with their young twigs, of which sort are the olive, cypress, myrtle, mastic, tamarisk, privet, rose, bramble, laurel, ivy, and pomegranate. Those which repress without cooling are cooked quinces, pomegranate rind, hot water in which the vervains enumerated above have been boiled, powdered wine lees or myrtle leaves, bitter almonds. But those which are heating are poultices made of meal, whether of wheat or spelt or barley or bitter vetches or darnel or millet or panic or lentil or bean or lupin or linseed or fenugreek, when one of these has been boiled and applied hot. All forms of meal poultices, however, are rendered more efficacious by cooking in mead instead of in water. Besides there are: cyprus or iris oil, marrow, cat's fat, olive oil, especially if it is old, and there has been added to the oil salt, soda, black cummin, pepper, cinquefoil. Generally those which are powerful to repress inflammation, and cool, harden the tissues; those which are heating, disperse inflammation and soften, and this last property belongs especially to plasters of linseed or fenugreek seeds. But as regards all these medicaments, whether used as simples or in mixtures, their uses by medical men vary, so that it is clear that each man follows his own ideas rather than what he has found to be true by actual fact.

> Latin: 33. EVOCARE uero materiam multa admodum possunt, sed ea cum ex peregrinis medicamentis maxime constent, aliisque magis, quam quibus ratione uictus succurritur, opitulentur, in praesentia differam: ponam uero ea, quae prompta et is morbis, de quibus protinus dicturus sum, apta corpus erodunt, et sic eo quod mali est extrahunt. Habent autem hanc facultatem semen erucae, nasturcii, radiculae, praecipue tamen omnium sinapi. Salis quoque et fici eadem uis est. Leniter uero simul et REPRIMVNT et molliunt lana sucida quo cum aceto uel uino oleum adiectum est, contritae palmulae, furfures in salsa aqua uel aceto decoctae. At simul et reprimunt et refrigerant herba muralis (ΠΑΡΘΕΝΙΟΝ uel ΠΕΡΔΕΙΚΙΟΝ appellant), serpullum, puleium, ocimum, herba sanguinalis, quam Graeci ΠΟΛΥΓΟΝΟΝ uocant, portulaca, papaueris folium, capriolique uitium, coriandrum, folia hyoscyamu, muscus, siser, apium, solanum (quam strychnon Graeci uocant), brassicae folia, intubus, plantago, feniculi semen; contrita pira uel mala, praecipueque Cotonea, lenticula; aqua frigida, maximeque pluuialis, uinum, acetum, et horum aliquo madens uel panis uel farina uel spongia uel cinis uel lana sucida uel etiam linteolum; creta Cimolia, gypsum; melinum, murteum, rosa, acerbum oleum; uerbenarum contusa cum teneris colibus folia; cuius generis sunt olea, cupressus, myrtus, lentiscus, tamarix, ligustrum, rosa, rubus, laurus, hedera, Punicum malum. Sine frigore autem reprimunt cocta mala Cotonea, malicorium, aqua calda, in qua uerbenae coctae sunt, quas supra posui, puluis uel ex faece uini uel ex murti foliis, amarae nuces. CALFACIT uero ex qualibet farina cataplasma siue ex tritici siue farris siue hordei siue erui siue lolii siue milii uel panicii uel lenticulae uel fabae uel lupini ⟨uel lini⟩ uel feni Graeci, ubi ea defer⟨u⟩uit calidaque inposita est. Valentior tamen ad id omnis farina est ex mulso quam ex aqua cocta. Praeterea cyprinum, irinum, medulla, adeps ex fele, oleum, magisque si uetus est, iunctaque oleo sal, nitrum, git, piper, quinquefolium. Fereque quae uehementer reprimunt et refrigerant, durant: quae calfaciunt, digerunt et emolliunt, praecipueque ad emolliendum potest cataplasma ex lini uel feni Graeci semine. His autem omnibus, et simplicibus et permixtis, uarie medici utuntur, ut magis quid quisque persuaserit sibi appareat, quam quid euidenter compererit.

## 8. Book III · chapters 1–6

Source: https://scriptura.si/works/celsus-on-medicine/8/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/8/#p-N

[¶0] 1. 1 Having dealt with all that pertains to whole classes of diseases taken together, I come to the treatment of diseases one by one. Now the Greeks divided these into two species, terming some acute, others chronic. But because maladies did not always respond in the same way to treatment, some of the Greek writers have placed among the acute what others have placed among the chronic; from this it is clear that there are more than two classes. For some diseases are certainly of short duration, which carry off the patient quickly, or themselves come quickly to an end; some are chronic, in which neither recovery is near at hand nor death; and there is a third class, at one time acute, at another time chronic, and that occurs not only in fevers, where it is most frequent, but in other affections also. And besides the above there is a fourth class which cannot be said to be acute, because it is not fatal, nor really chronic, because if treated it is readily cured. When I come myself to speak of diseases singly, I will point out to which class each belongs. But I shall divide all diseases into those which appear to have their seat in the body as a whole, and into those which originate in particular parts. I shall begin with the former, after a few words of preface concerning all. Whatever the malady luck no less than the art can claim influence for itself; seeing that with nature in opposition the art of medicine avails nothing. There is, however, for a practitioner who is unsuccessful, more excuse in acute than in chronic diseases: for acute diseases are of short duration, within which the patient is snuffed out, if not benefited by the treatment: chronic diseases give time for deliberation, and for change of remedies, so that when the practitioner is in attendance from the commencement, it is seldom that a docile patient should perish unless by the practitioner's default. A chronic disease, nevertheless, when it has become deep-seated, is no less difficult to deal with than an acute one. And indeed the older an acute malady, the more recent a chronic one, the more easily it is treated. There is another point which should be borne in mind, that the same remedies do not suit all patients. Hence it is that the highest authorities proclaim as if they were the only remedies, now some, now others, each in accordance with what he has found successful. It is well, then, when any one remedy fails, to look not so much to the authority as to the patient, and to make trial, now of one, now of another remedy, taking care, however, that in acute diseases what is doing no good is changed quickly; in chronic diseases which it takes time to produce as well as to remove, if a remedy does not succeed at once, it should not be condemned at once, much less should it be discontinued if it is beneficial, though only to a small extent, because the progress is completed by time.

> Latin: 1. Prouisis omnibus, quae pertinent ad uniuersa genera morborum, ad singulorum curationes ueniam. Hos autem in duas species Graeci diuiserunt, aliosque ex his acutos, alios longos esse dixerunt. Ide⟨m⟩que quoniam non semper eodem modo respondebant, eosdem alii inter acutos, alii inter longos rettulerunt; ex quo plura eorum genera esse manifestum est. Quidam enim breues utique sunt, qui cito uel tollunt hominem, uel ipsi cito finiuntur; quidam longi, sub quibus neque sanitas in propinquo neque exitium est; tertiumque genus eorum est, qui modo acuti, modo longi sunt, idque non in febribus tantummodo, in quibus frequentissimum est, sed in aliis quoque fit. Atque etiam praeter hos quartum est, quod neque acutum dici potest, quia non peremit, neque utique longum, quia, si occurritur, facile sanatur. Ego cum de singulis dicam, cuius quisque generis sit indicabo. Diuidam autem omnes in eos, qui IN TOTIS CORPORIBVS consistere uidentur, et eos, qui oriuntur in partibus. Incipiam a prioribus, pauca de omnibus praefatus. In nullo quidem morbo minus fortuna sibi uindicare quam ars potest: ut pote qu⟨o⟩m repugnante natura nihil medicina proficiat. Magis tamen ignoscendum medico est parum proficienti in acutis morbis quam in longis: hic enim breue spatium est, intra quod, si auxilium non profuit, aeger extinguitur: ibi et deliberationi et mutationi remediorum tempus patet, adeo ut raro, si inter initia medicus accessit, obsequens aeger sine illius uitio pereat. Longus tamen morbus cum penitus insedit, quod ad difficultatem pertinet, acuto par est. Et acutus quidem quo uetustior est, longus autem quo recentior, eo facilius curatur. Alterum illud ignorari non oportet, quod non omnibus aegris eadem auxilia conueniunt. Ex quo incidit, ut alia atque alia summi auctores quasi sola uindicarint, prout cuique cesserat. Oportet itaque, ubi aliquid non respondet, non tanti putare auctorem quanti aegrum, et experiri aliud atque aliud, sic tamen ut in acutis morbis cito mutetur quod nihil prodest in longis, quos tempus ut facit sic etiam soluit, non statim condemnetur, si quid non statim profuit, minus uero remoueatur, si quid paulum saltem iuuat, quia profectus tempore expletur.

[¶1] 2. 2 Now at their commencements, it is easy to recognize at once what is an acute disease, and what a chronic one, not only as regards those which take a uniform course, but also when the course is variable. For when severe paroxysms and pains are causing distress without intermission, the disease is acute: it becomes evident that the future course will be prolonged when there are but slight pains and fever, and when there are long intervals between the paroxysms, and there are in addition the signs which have been described in the preceding book. It is also to be noted whether the disease is increasing, or stationary, or lessening, because some remedies are suitable for increasing, more for declining maladies; and when an acute fever is increasing in urgency, remedies which are suitable in decreasing affections are to be tried rather during the remissions. A disease is increasing in urgency when pains and paroxysms occur with more severity, and when they both recur at shorter intervals, and desist later than before. And, in chronic diseases too, even if they do not present such characteristic signs, it may be recognized that the affection is increasing: if sleep is irregular; if digestion deteriorates; if the stools become more foul; the sense duller; the mind more sluggish; if a feeling of cold, or of heat, runs through the body, if the body becomes more pale. But opposite signs mark a decline in the disease.... In acute diseases, moreover, the patient is to be given food after more delay, and not until the paroxysm is already declining so that its force may be broken primarily by the withholding of nutriment; in chronic diseases, earlier, so that it may support the patient for the duration of his coming illness. But if sometimes, not the whole body, but a part only, is affected, still the support of the strength of the whole body rather than the curing by itself of the part diseased is of more importance. It makes a great difference also whether from the commencement the patient has been treated correctly or incorrectly, because treatment has less advantage in those cases in which a course has been persisted in without effort. If a patient lives through indiscreet treatment with his strength unimpaired, an appropriate treatment may restore him forthwith. But as I commenced (II.2) with those symptoms which show some signs of impending illness, I shall make a beginning as to treatment by noticing the same period. If, therefore, any of the signs then referred to occur, the best treatment is rest and abstinence; if anything at all is to be drunk, let it be water, and it is sufficient for this to be continued sometimes for one day, sometimes, when alarming signs persist, for two days; on the day following the fast, food should be taken sparingly, and water drunk; the next day even wine, and then in turn, on alternate days, water and wine, until all anxiety is at an end. For often in this way a severe disease is dispersed while it is impending. And many deceive themselves with the hope of getting rid of the languor straightaway on the first day, either by exercise, or by a bath, or by a purge, or by an emetic, or by sweating, or by drinking wine: not but that such a procedure may succeed or not disappoint, but more often it fails, and abstinence by itself is a remedy without any risk; especially since it also admits of being modified in accordance with the degree of apprehension, and if the indications are of the slighter kind, it is enough to abstain from wine alone, its withdrawal being more advantageous than if something were subtracted from the food; if they are of somewhat greater severity, it is easy to limit the drink to water, and at the same time to withdraw meat from the diet, sometimes also to use less bread than usual, and to be content with moist food, especially pot-herbs; and it is sufficient to abstain entirely from food and wine, and from all bodily movement, only when serious symptoms have given rise to alarm. Nor is there a doubt that scarcely anyone falls ill who has hidden nothing but has countered disease in good time by these measures.

> Latin: 2. Protinus autem inter initia scire facile est, quis acutus morbus quis longus sit, non in is solis, in quibus semper ita se habet, sed in is quoque, in quibus uariat. Nam ubi sine intermissionibus accessiones et dolores graues urgent, acutus est morbus: ubi lenti dolores lentaeue febres sunt et spatia inter accessiones porrigunt, acceduntque ea signa, quae priore uolumine exposita sunt, longum hunc futurum esse manifestum est. Videndum etiam est, morbus an increscat, an consistat, an minuatur, quia quaedam remedia increscentibus morbis, plura inclinatis conueniunt; eaque, quae decrescentibus apta sunt, ubi acutus increscens urget, in remissionibus potius experienda sunt. Increscit autem morbus, dum grauiores dolores accessionesque ueniunt, eaeque et ante, quam proximae, reuertuntur et postea desinunt. Atque in longis quoque morbis etiam tales notas non habentibus scire licet increscere, si somnus incertus est, si deterior concoctio, si foediores deiectiones, si tardior sensus, si pigrior mens, si percurrit corpus frigus aut calor, si id magis pallet. Ea uero, quae contraria his sunt, decedentis eius notae sunt. * * Praeter haec in acutis morbis serius aeger alendus est, nec nisi iam is inclinatis, ut primo dempta materia impetum frangat, in longis maturius, ut sustinere spatium adfecturi mali possit. Ac si quando is non in toto corpore sed in parte est, magis tamen ad rem pertinet uim totius corporis moliri quam proprie partis aegrae sanitatem. Multum etiam interest, ab initio quis recte curatus sit an perperam, quia curatio minus is prodest, in quibus adsidue frustra fuit. Si qui temere habitus adhuc integris uiribus uiuit, admota curatione momento restituitur. Sed cum ab is coeperim, quae notas quasdam futurae aduersae ualetudinis exhibent, curationum quoque principium ab animaduersione eiusdem temporis faciam. Igitur si quid ex is, quae proposita sunt, incidit, omnium optima sunt quies et abstinentia: si quid bibendum est, aqua, idque interdum uno die fieri satis est, interdum, si terrentia manent, biduo; proximeque abstinentiam sumendus est cibus exiguus, bibenda aqua, postero die etiam vinum, deinde inuicem alternis diebus modo aqua modo uinum, donec omnis [causae] metus finiatur. Per haec enim saepe instans grauis morbus discutitur. Plurimique falluntur, dum se primo die protinus sublaturos languorem aut exercitatione aut balneo aut coacta deiectione aut uomitu aut sudationibus aut uino sperant; non quo non interdum incidat aut non dec⟨e⟩per⟨i⟩t sed quo saepius fallat, solaque abstinentia sine ullo periculo medeatur: cum praesertim etiam pro modo terroris moderari liceat, et, si leuiora indicia fuerunt, satis sit a uino tantum abstinere, quod subtractum plus, quam si cibo quid dematur, adiuuat; si paulo grauiora, facile sit non aquam tantum bibere sed etiam cibo carnem subtrahere, interdum panis quoque minus quam pro consuetudine adsumere, umidoque cibo esse contentos et holere potissimum, satisque sit tum ex toto a cibo, a uino, ab omni motu corporis abstinere, cum uehementes notae terruerunt. Neque dubium est, quin uix quisquam, qui non dissimulauit sed per haec mature morbo occurrit, aegrotet.

[¶2] 3. 3 These then are the things to be done by those, who, being in health, have cause merely to be apprehensive. Now there follows the treatment of fevers, a class of disease which both affects the body as a whole, and is exceedingly common. Of fevers, one is quotidian, another tertian, a third quartan. At times certain fevers recur in even longer cycles, but that is seldom. In the former varieties both the diseases and their medicines are of various kinds. Now quartan fevers have the simpler characteristics. Nearly always they begin with shivering, then heat breaks out, and the fever having ended, there are two days free; this on the fourth day it recurs. But of tertian fevers there are two classes. The one, beginning and desisting in the same way as a quartan, has merely this distinction, that it affords one day free, and recurs on the third day. The other is far more pernicious; and it does indeed recur on the third day, yet out of forty-eight hours, about thirty-six, sometimes less, sometimes more, are in fact occupied by the paroxysm, nor does the fever entirely cease in the remission, but it only becomes less violent. This class most practitioners term hemitritaion. Quotidian fevers, however, vary and have many forms. For some begin straightaway with a feeling of heat, others of chill, others with shivering. I call it a chill when the extremities become cold, shivering when the whole body shakes. Again, some desist so that complete freedom follows, others so that there is some diminution of the fever, yet none the less some remnants persist until the onset of the next paroxysm; and others often run together so that there is little or no remission, but the attacks are continuous. Again, some have a vehement hot stage, others a bearable one; some are every day equal, others unequal, and the paroxysm in turn slighter one day, more severe another: some recur at the same time the day following, some either earlier or later; some take up a day and a night with the paroxysm and the remission, some less, others more; some set up sweating as they remit, others do not; and in some, freedom is arrived at through sweating, in others the body is only made the weaker. But the paroxysms also occur sometimes once on any one day, sometimes twice or more often. Hence it often comes about that daily there are several paroxysms and remissions, yet so that each corresponds to one which has preceded it. But at times the paroxysms also become so confused together, that neither their durations nor intermissions can be observed. It is not true, as some say, that no fever is irregular unless as the outcome either of an abscess or of inflammation or of ulceration; for if this were true, the treatment always would be the easier, but what evident causes bring about, hidden ones can bring about also. And men are not arguing about facts but about words if, when during the same illness fevers come on in different ways, they say that these are not irregular returns of the same fever, but other different ones arising in succession; even though it were true, it would have nothing to do with the mode of treatment. The duration of remissions also is at times considerable, at other times scarcely of any length.

> Latin: 3. Atque haec quidem sanis facienda sunt tantum cum causa metuentibus. Sequitur uero CVRATIO FEBRIVM quod et in toto corpore et uulgare maxime morbi genus est. Ex his una cotidiana, altera tertiana, altera quartana est. Interdum etiam longiore circuitu quaedam redeunt, sed id raro fit. In prioribus et morbi * sunt et medicina. Et quartanae quidem simpliciores sunt. Incipiunt fere ab horrore, deinde calor erumpit, finitaque febre biduum integrum est: ita quarto die reuertitur. Tertianarum uero duo genera sunt. Alterum eodem modo, quo quartana, et incipiens et desinens, illo tantum interposito discrimine, quod unum diem praestat integrum, tertio redit. Alterum longe perniciosius, quod tertio quidem die reuertitur, ex quadraginta autem et octo horis fere triginta et sex per accessionem occupat (interdum etiam uel minus uel plus), neque ex toto in remissione desistit, sed tantum leuius est. Id genus plerique medici ΗΜΙΤΡΙΤΑΙΟΝ appellant. Cottidianae uero uariae sunt et multiplices. Aliae enim protinus a calore incipiunt, aliae a frigore, aliae ab horrore. Frigus uoco, ubi extremae partes membrorum inalgescunt, horrorem, ubi corpus totum intremit. Rursus aliae sic desinunt, ut ex toto sequatur integritas; aliae sic, ut aliquantum quidem minuatur ex febre, nihilo minus tamen quaedam reliquiae remaneant, donec altera accessio accedat; ac saepe aliae * * uix quicquam aut nihil remittant sed continuent. Deinde aliae feruorem ingentem habent, aliae tolerabilem: aliae cotidie pares sunt, aliae inpares, atque inuicem altero die lenior, altero uehementior *: aliae tempore eodem postridie reuertuntur, aliae uel serius uel celerius: aliae diem noctemque accessione et decessione implent, aliae minus, aliae plus: aliae cum decedunt, sudorem mouent, aliae non mouent; atque alias per sudorem ad integritatem uenitur, alias tantum corpus inbecillius redditur. At accessiones etiam modo singulae singulis diebus fiunt, modo binae pluresue concurrunt. Ex quo saepe euenit, ut cotidie plures accessiones remissionesque sint, sic tamen, ut unaquaeque alicui priori respondeat. Interdum uero accessiones quoque confunduntur, sic ut notari neque tempora earum neque spatia possint. Neque uerum est, quod dicitur a quibusdam, nullam febrem inordinatam esse, nisi aut ex uomica aut ex inflammatione aut ex ulcere: facilior enim semper curatio foret, si hoc uerum esset: sed quod euidentes causae faciunt, facere etiam abditae possunt. Neque de re sed de uerbo controuersiam mouent, qui, cum aliter aliterque in eodem morbo febres accedunt, non easdem inordinate redire, sed alias aliasque subinde oriri dicunt; quod tamen ad curandi rationem nihil pertineret, etiamsi uere diceretur. Tempora quoque remissionum modo liberalia, modo uix ulla sunt.

[¶3] 4. 4 Such for the most part is the account of fevers; but there are different sorts of treatment in accordance with what is held by the several authorities. Asclepiades said that it is the office of the practitioner to treat safely, speedily, and pleasantly. That is our aspiration, but there is generally danger both in too much haste and too much pleasure. But what moderation must be shown, in order that as far as possible all those blessings may be attained, the patient's safety being always kept first, will be considered among the actual details of the treatment.

> Latin: 4. Et febrium quidem ratio maxime talis est: curationum uero diuersa genera sunt, prout auctores aliquos habent. Asclepiades officium esse medici dicit, ut tuto, ut celeriter, ut iucunde curet. Id uotum est, sed fere periculosa esse nimia et festinatio et uoluptas solet. Qua uero moderatione utendum sit, ut, quantum fieri potest, omnia ista contingant prima semper habita salute, in ipsis partibus curationum considerandum erit.

[¶4] Before everything is the question as to what regimen the patient should keep to during the first days. The ancients tried to ensure assimilation by administering certain medicaments, because they dreaded indigestion most of all; next by the repetition of clysters they extracted the matter which appeared to be doing harm. Asclepiades did away with medicaments; he did not clyster the bowel with such frequency but still he generally did this in every disease; but the actual fever, he professed to use as a remedy against itself: for he deemed that the patient's forces ought to be reduced by daylight, by keeping awake, by extreme thirst, so that during the first days he would not allow even the mouth to be swilled out. Therefore those are quite wrong who believe that his regimen was a pleasant one in all respects; for in the later days he allowed even luxuries to his patient, but in the first days of the fever he played the part of torturer. Now in my opinion medicinal draughts and clysters should only be administered occasionally; and I consider that they should not be used as to pull to pieces the patient's strength, since the greatest danger is from weakness. There ought to be, therefore, only such a diminution of superfluous matter as is dispersed by natural processes when nothing is being added afresh. Hence for the first days there is to be abstinence from food; the patient is to keep in the light during the day unless weak, for this also clears the body; and so he ought to lie up in a room as... as possible. As regards indeed thirst and sleep, it should be so managed that he keeps awake during the day; at night as far as possible he should be at rest; and he should neither drink much nor be too much distressed by thirst; his mouth also can be swilled out when dry, if he has a bad taste in it, even though that is not the time suitable for a drink. And Erasistratus said appropriately that often whilst the inside does not require fluid, the mouth and throat require it, and it does not help to keep the patient in suffering. And for the first days, such ought to be the regimen.

> Latin: Et ante omnia quaeritur, primis diebus aeger qua ratione continendus sit. Antiqui medicamentis quibusdam datis concoctionem moliebantur, eo quod cruditatem maxime horrebant: deinde eam materiem, quae laedere uidebatur, ducendo saepius aluum subtrahebant. Asclepiades medicamenta sustulit; aluum non totiens sed fere tamen in omni morbo subduxit; febre uero ipsa praecipue se ad remedium eius uti professus est: conuellendas enim uires aegri putauit luce, uigilia, siti ingenti, sic ut ne os quidem primis diebus elui sineret. Quo magis falluntur, qui per omnia iucundam eius disciplinam esse concipiunt: is enim ulterioribus quidem diebus cubantis etiam luxuriae subscripsit, primis uero tortoris uicem exhibuit. Ego autem medicamentorum dari potiones et aluum duci non nisi raro debere concedo: non ideo tamen id agendum, ut aegri uires conuellantur, existimo, quoniam ex inbecillitate summum periculum est. Minui ergo tantum materiam superantem oportet, quae naturaliter digeritur, ubi nihil noui accedit. Itaque abstinendus a cibo primis diebus est; in luce habendus aeger, nisi infirmus, interdiu est, quoniam corpus ista quoque digerit, isque cubare quam maxime * * conclaui debet. Quod ad sitim uero somnumque pertinet, moderandum est, ut uigilet interdiu. Noctu, si fieri potest, conquiescat: ac neque potet, neque nimium siti crucietur; os etiam eius elui potest, ubi et siccum est, et ipsi faetet, quamuis id tempus potioni aptum non est. Commodeque Erasistratus dixit saepe in⟨t⟩eriore parte umorem non requirente os et fauces requirere, neque ad rem male haberi aegrum pertinere. Ac primo quidem sic tenendus est. Optimum uero medicamentum eius est oportune cibus datus;

[¶5] But his best medicament is food opportunely given; the question is when it should first be garden. Most of the ancients gave it late, often on the fifth, often on the sixth day of illness, which the climate of Asia or of Egypt may perchance permit. Asclepiades, after he had for three days harassed the patient in every way, destined the fourth day for food. But Themison, recently, took into account not when the fever began, but when it ceased, or at any rate was alleviated; and awaiting the third day from that time, if there was no return of the fever, gave food at once; if fever recurred, he gave food when it ceased, or if it obstinately persisted, he certainly gave it if the fever abated. But on none of these matters is there actually an invariable precept. For it may be that the first food should be given on the first day, it may be on the second, it may be on the third, it may be not until the fourth or fifth day; it may be after one paroxysm, it may be after two, it may be after several. For it all depends upon the kind of disease, the patient's body, the climate, his age, and the time of year; where circumstances differ so greatly, there cannot be an invariable rule of time by any means. In the case of a disease which takes away more of the patient's strength, food is to be given earlier, and the same in a climate in which he uses up more. Hence in Africa it seems right that a patient should never fast over a day. Food should also be given sooner to a child than to an adolescent, sooner in summer than in winter. There is one thing that should be observed, always, and everywhere, that the patient's strength should be continually under the eye of the attending practitioner; and so long as there is a superfluity, he should counter it by abstinence; if he begins to fear weakness, he should assist with food. For it is his business to see that the patient is neither burdened by superfluous material nor rendered weak by hunger. And this I find also in the writings of Erasistratus; who although he did not direct when the bowels should be emptied, or when the body in general, nevertheless, by saying that such things should be seen to, and food given when it was needed by the body, showed sufficiently that food should not be given while the strength was in excess, but that care should be taken not to let it become deficient. Hence it can be understood that it is not possible for many patients to be cared for by one practitioner, and provided that he is skilled in the art, he is a suitable one who does not much absent himself from the patient. But they who are slaves to gain, since more is to be got out of a crowd, are glad to adopt those precepts which do not exact a sedulous attendance, as in this very instance. For even those who see the patient but seldom find it easy to count days or paroxysms; a physician must always be at hand, if he is to see the one thing that matters, the point when the patient is about to become too weak unless he gets food. The fourth day, however, is generally the most suitable date for beginning to give food.

> Latin: qui quando primum dari debeat, quaeritur. Plerique ex antiquis tarde dabant, saepe quinto die, saepe sexto; et id fortasse uel in Asia uel in Aegypto caeli ratio patitur. Asclepiades ubi aegrum triduo per omnia fatigarat, quartum diem cibo destinabat. At Themison nuper, non quando coepisset febris, sed quando desisset, aut certe leuata esse⟨t⟩, considerabat; et ab illo tempore expectato die tertio, si non accesserit febris, statim; si accesserat, ubi ea uel desierat, uel si adsidue inhaerebat, certe si se inclinauerat, cibum dabat. Nihil autem horum utique perpetuum est. Nam potest primo die primus cibus dandus esse, potest secundo, potest tertio, potest non nisi quarto aut quinto, potest post unam accessionem, potest post duas, potest post plures. Refert enim qualis morbus sit, quale corpus, quale caelum, quae aetas, quod tempus anni; minimeque in rebus inter se multum differentibus perpetuum esse praeceptum temporis potest. Ex morbo, qui plus uirium aufert, celerius cibus dandus est, itemque eo caelo, quo magis digerit. Ob quam causam in Africa nulla die aeger abstineri recte uidetur. Maturius etiam puero quam iuueni, aestate quam hieme dari debet. Vnum illud est, quod semper, quod ubique seruandum est, ut aegri uires subinde adsidens medicus inspiciat; et quamdiu supererunt, abstinentia pugnet; si inbecillitatem uereri coeperit, cibo subueniat. Id enim eius officium est, ut aegrum neque superuacua materia oneret, neque inbecillitatem fame prodat. Idque apud Erasistratum quoque inuenio; qui quamuis parum docuit, quando uenter, quando corpus ipsum exinaniretur, dicendo tamen haec esse uisenda et tum cibum dandum, cum corpori deberetur, satis ostendit, dum uires superessent, dari non oportere: ne deficerent, consulendum esse. Ex his autem intellegi potest ab uno medico multos non posse curari, eumque, si artifex sit, idoneum esse, qui non multum ab aegro recedit. Sed qui quaestui seruiunt, quoniam ⟨is⟩ maior ex populo est, libenter amplectuntur ea praecepta, quae sedulitatem non exigunt, ut in hac ipsa re. Facile est enim dies uel accessiones numerare is quoque, qui aegrum raro uident: ille adsid⟨e⟩at necesse est, qui quod solum opus est uisurus est, quando nimis inbecillus futurus sit, nisi cibum acceperit. In pluribus tamen ad initium cibi dies quartus aptissimus esse consueuit.

[¶6] But there is another uncertainty which concerns even the days themselves, since the ancients chiefly preferred the odd days and termed them critical, as though then the fate of the sick man was decided. These were the third, fifth, seventh, ninth, eleventh, fourteenth and twenty-first days, the most importance being attached to the seventh, next to the fourteenth and then to the twenty-first. Therefore they administered food to their patients as follows: they awaited paroxysms on odd days, and after that they gave food, as though slighter paroxysms were impending, insomuch that Hippocrates, when the fever desisted on any other than an odd day, was accustomed to fear a recurrence. Asclepiades has justly repudiated this as false, and he said that no day was more or less dangerous to patients for being even or odd. For sometimes even days are the worse, and it is more suitable to give food after paroxysms on these days. Sometimes even in the course of the same fever the daily order changes, and that day becomes graver which had wont to have more of a remission; and besides, the fourteenth day itself, which the ancients confessed to be of great importance, is an even day. Since they held that the eighth day had the character of the first day, because from it began the second numbering of seven, they contradicted themselves in not giving more importance to the eighth, tenth and twelfth days, for they gave more to the ninth and eleventh. After doing this without any rational probability, they went on from the eleventh, not to the thirteenth, but to the fourteenth day. There is even in Hippocrates this statement, that the fourth day is the gravest in the case of those whom the seventh day is to liberate. So according to that very authority, there may be on an even day both a graver fever and a certain sign of what will happen. In another passage the same authority regarded each fourth day, namely, the fourth, seventh, eleventh, fourteenth, and seventeenth, as the most effective in both respects. Thus he passed from an odd system of reckoning to an even one, yet did not, even then, keep to his proposition; for the eleventh is not the fourth day after the seventh, but the fifth. It is clear enough that by whatever reasoning we view this numbering, there is to be found nothing rational in that authority at least. But in these matters indeed the Pythagorean numbers, then quite famous, deceived the ancients, since here also the practitioner ought not to count days, but observe the actual paroxysms, and from these infer when food should be given.

> Latin: Est autem alia etiam de diebus ipsis dubitatio, quoniam antiqui potissimum impares sequebantur, eosque, tamquam tum de aegris iudicaretur, ΚΡΙΣΙΜΟΥΣ nominabant. Hi erant dies tertius, quintus, septimus, nonus, undecimus, quartus decimus, unus et uicesimus, ita ut summa potentia septimo, deinde quarto decimo, deinde uni et uicensimo daretur. Igitur sic aegros nutri⟨e⟩bant, ut dierum inparium accessiones expectarent, deinde postea cibum quasi leuioribus accessionibus instantibus darent, adeo ut Hippocrates, si alio die febris desisset, recidiuam timere sit solitus. Id Asclepiades iure ut uanum repudiauit, atque in nullo die, qua par inparue esset, is uel maius uel minus periculum esse dixit. Interdum enim peiores dies pares fiunt, et oportun⟨i⟩us post eorum accessiones cibus datur. Nonnumquam etiam in ipso morbo dierum ratio mutatur, fitque grauior, qui remissior esse consuerat; atque ipse quartus decimus par est, in quo magnam uim esse antiqui fatebantur. Qui cum octauum primi die naturam habere contenderent, ut ab eo secundus septenarius numerus inciperet, ipsi sibi repugnabant non octauum, neque decimum, neque duodecimum diem sumendo quasi potentiorem: plus enim tribuebant nono et undecimo. Quod cum fecissent sine ulla probabili ratione, ab undecimo non ad tertium decimum sed ad quartum decimum transibant. Est etiam apud Hippocrate⟨n⟩ eis, qu⟨os⟩ septimus dies liberaturus sit, quartum esse grauissimum. Ita illo quoque auctore in die pari et grauior febris esse potest et certa futuri nota. Atque idem alio loco quartum quemque diem ut in utrumque efficacissimum adprehendit, id est quartum, septimum, undecimum, quartum decimum, septimum decimum. In quo et ab inparis ad paris numeri rationem transit et ne hoc quidem propositum conseruauit, cum a septimo die undecimus non quartus sed quintus sit. Adeo apparet, quacumque ratione ad numerum respeximus, nihil rationis sub illo quidem auctore reperiri. Verum in his quidem antiquos tum celebres admodum Pythagorici numeri fefellerunt, cum hic quoque medicus non numerare dies debeat, sed ipsas accessiones intueri, et ex his coniectare, quando dandus cibus sit.

[¶7] But it is much more pertinent to this subject to know whether food should be given when the pulse has well quieted down, or while remnants of the fever still persist. For the ancients proffered food when the bodies were as far as possible from fever: Asclepiades did so when the fever was beginning to abate although present. In this he followed false reasoning; not that food may not be given earlier sometimes, if another paroxysm is feared soon, but it certainly ought to be given when the patient is at his soundest: for food is less corrupted when introduced into a body free from fever. Nor however, is that true, which Themison held, that if the patient was likely to be free from fever for a couple of hours, it was better to give food then, in order that the food might be distributed when the body was as far as possible fever-free. For if it were possible for it to be distributed so quickly, that would be the best plan; but since that short time does not allow of it, it is better that the first food should be received by a declining fever, rather than that remnants of food should be received by a recommencing fever. In this case, if the favourable time is longer, it should be given when the body is as free as possible; if short, even before it becomes quite free. But what also holds good for a full freedom does so also for a remission, which can occur, especially in the course of a continuous fever.

> Latin: Illud autem magis ad rem pertinet scire, tum oporteat dari, cum iam bene uenae conquieuerunt, an etiamnum manentibus reliquiis febris. Antiqui enim quam integerrimis corporibus alimentum offerebant: Asclepiades inclinata quidem febre sed etiamnu⟨m⟩ tamen inhaerente. In quo uanam rationem secutus est, non quo non sit interdum maturius cibus dandus, si mature timetur altera accessio, sed quo scilicet quam sanissimo dari debeat: minus enim conrumpitur quod integro corpori infertur. Neque tamen uerum est, quod Themisoni uidebatur, si duabus horis integer futurus esset aeger, satius esse tum dare, ut ab integro potissimum corpore diduceretur. Nam si diduci tam celeriter posset, id esset optimum: sed cum id breue tempus non praestet, satius est principia cibi a decedente febre quam reliquias ab incipiente excipi. Ita si longius tempus secundum est, quam integerrimo dandum est; si breue, etiam antequam ex toto integer fiat. Quo loco uero integritas est, eodem est remissio, quae maxime in febre continua potest esse.

[¶8] And there is the further question, whether it is necessary to wait for the same number of hours as the fever lasted, or if it is sufficient to suffer the first part of them to elapse so that the food may settle down more comfortably for the patient, if sometimes there is no intermission. It is safest, however, first to let pass the period of the whole preceding paroxysm, although in the case of a prolonged fever the patient may be indulged earlier, provided that half at least of that time has first passed. And this is to be observed not only in the fever just mentioned but in all.

> Latin: Atque hoc quoque quaeritur, utrum tot horae expectandae sint, quot febrem habuerunt, an satis sit primam partem earum praeteriri, quo[d] aegris iucundius insidat †si interdum non uacat. Tutissimum est autem ante totius accessionis tempus praeterire, quamuis, ubi longa febris fuit, potest indulgeri aegro maturius, dum tamen ante minime pars dimidia praeterea⟨tur⟩. Idque non in ea sola febre, de qua proxime dictum est, sed in omnibus ita seruandum est.

[¶9] 5. 5 The foregoing rules are rather of general application to fevers of all sorts: now I pass to their particular kinds. If, therefore, there has been only one paroxysm, then an intermission, and the fever arises either from the groin, or from fatigue, or from hot weather, or some other similar thing, and so that it gives no apprehension of a more internal cause, then on the day following, when the time for the recurrence of a paroxysm has elapsed without any disturbance, food can be given. But when there supervenes a deeply seated heat and a sense of weight, whether in the head or in the parts below the ribs, and it is not evident what is disturbing the system, even although freedom follows upon a single paroxysm, nevertheless the third day is to be awaited because a tertian is to be apprehended; and when the time for such a paroxysm has passed, food is to be given, but in small amount, because a quartan may yet be apprehended; and not until the fourth day, if the body is still free, may it be used with confidence. But if on the second, or third, or fourth day fever has recurred, the disease can be recognized. But tertian and quartan fever in which there is both a definite cycle ending in freedom from fever, and ample periods of quiet, are most quickly dealt with, and of these I will speak in their proper place (III.14, 15). Now, however, I will explain the treatment of those fevers which cause trouble every day. Food, therefore, is more suitably given to the patient upon alternate days, in order one day to diminish the fever, the other to recruit his strength. But if it be that sort of quotidian fever in which there is a complete intermission, food should be given immediately upon the body becoming fever-free: if, although there are no paroxysms, the fever is nevertheless continuous and daily increasing, but with remissions that are not complete, food should be given when the system is in that state that no major remission is expected; if the paroxysm on one day is more severe, on the next day milder, food is to be given after the more severe paroxysm. But if the fever continues without ever becoming milder, and it is necessary to give food, there is a great controversy as to the time when it should be given. Some, because patients generally have more of a remission early in the morning, think that food should be given then. But if this answers, the reason for giving food is not the fact that it is morning, but the fact that the patient has more of a remission. But if the patient has no relief even in the morning, it becomes all the worse time for food, just because, although by itself that time should be better, owing to the fault of the disease it is not so; and at the same time, it is followed by midday, after which generally patients become worse, and so it may be feared that the patient may become more distressed than usual. To such a patient, therefore, others give food in the evening: but since at that time those who are ill are generally at their worst, there is fear that any action we may then take may exasperate the fever somewhat. For these reasons I delay until midnight, that is, when one critical time is over, and the next furthest off, whilst the hours which follow before dawn are those during which all patients generally sleep the most; after that comes early morning, naturally a period of greatest relief. If, however, fevers are erratic, since there is apprehension that paroxysms may immediately follow food, whenever a patient begins to have relief after a paroxysm, then food ought to be taken. But if several paroxysms occur on the same day, it should be noted whether they are equal in all respects, which can scarcely ever be the case, or unequal. If they are equal in all respects, food should be given rather after any paroxysm which does not desist between midday and evening. If they are unequal, it is to be considered in what way they differ; for if one is more severe and another slighter, food should be given after the more severe; if one lasts longer, another a shorter time, after the longer; if one is more severe, another more prolonged, it is to be observed which of thetwo causes more distress, the former by its severity, or the latter by its length, and food must be given after the one which causes the most distress. But what matters almost more than anything is, how long and of what kind are the remissions between them: for if after one paroxysm shivering persists, after another the body is free from this, the more suitable time for food is when the body is free. If a slight feverishness persists all the time, but a longer period of remission occurs at one time than at another, that is the time to be selected; so that, when paroxysms are continuous, straightway, when the first one has begun to pass off, food may be given. For it is the general rule to which every pan of treatment should be directed, to give food always as long as possible before the next ensuing paroxysm, and while keeping this rule, to give the food when the body is most free from fever. This should be observed not merely with two paroxysms but also with several. But although it is most proper to give food on alternate days, yet if the system is weak, it should be given every day; and far more so if the fevers continue without remissions, inasmuch as they distress the patient more; or when two or more paroxysms occur on the same day. This occurrence renders it necessary that immediately from the first day, food must be administered daily if the pulse has immediately become weak, and several times on the same day, if in the course of several paroxysms there is progressive diminution of the bodily strength. However, in these cases we must keep to this rule, that less food is to be given after paroxysms of such a kind that no food at all would be given after them if the bodily condition allowed it. When, however, a fever threatens, begins, increases, continues stationary, declines, then persists at a low level, or terminates, it should be recognized that the best time for food is after the fever has terminated; next, when it is continuing at a diminished level; and thirdly, if need be, whenever there is a decline; all other times are dangerous. If, however, there is urgent necessity on account of weakness, it is better to give some food when the increase in the fever has become stationary, rather than whilst it is increasing, better whilst the paroxysm is as yet imminent, rather than after it has commenced, nevertheless with this proviso, that there is no time at which a patient who is failing should not be supported. Most emphatically, it is not enough for the practitioner to pay attention merely to the actual fevers, but also he must look to the habit of the body as a whole, and direct treatment to that, whether patients have superabundance or deficiency of strength, or whether there are other intervening affections. While, however, it is always of advantage for patients to be free from care, so that they may suffer in body alone, and not also in spirit, it is so especially after food has been taken. Therefore if there are any things which might exasperate their emotions, it is best to withhold these from notice whilst they are ill: if this cannot be done, nevertheless to keep all back after food, until the time of sleep, and to tell them when they wake up.

> Latin: 5. Haec magis per omnia febrium genera perpetua sunt: nunc ad singulas earum species descendam. Igitur si semel tantum accessit, deinde desiit, eaque uel ex inguine uel ex lassitudine uel ex aestu aliaue re simili fuit, sic ut interior nulla causa metum fecerit, postero die, cum tempus accessionis ita transiit, ut nihil mouer⟨i⟩t, cibus dari potest. At si ex alto calor uenit et grauitas uel capitis uel praecordiorum secuta est neque apparet quid corpus confuderit, quamuis unam accessionem secuta integritas est, tamen quia tertiana timeri potest, expectandus est dies tertius; et ubi accessionis tempus praeteriit, cibus dandus est, sed exiguus, quia quartana quoque timeri potest; et die quarto demum, si corpus integrum est, eo cum fiducia utendum. Si uero postero tertioue aut quarto die secuta febris est, scire licet morbum esse. Sed tertianarum uel quartanarum, ⟨quarum⟩ et certus circumitus est et finis in integritate et liberaliter quieta tempora sunt, expeditior ratio est; de quibus suo loco dicam. Nunc uero eas explicabo, quae cotidie urgent. Igitur tertio quoque die cibus aegro commodissime datur, ut alter febrem minuat, alter uiribus subueniat. Sed is dari debet, si cotidiana febris est, quae ex toto desinat, simul atque corpus integrum factum est: si quamuis non accessiones, febres tamen iunguntur et cotidie quidem increscunt sed sine integritate tamen remittunt, cum corpus ita se habet, ut maior remissio non expectetur; si altero die grauior, ⟨altero leuior⟩ accessio est, post grauiorem. Fere uero grauiorem accessionem leuior nox sequitur; quo fit, ut grauiorem accessionem nox quoque tristior antecedat. At si continuatur febris neque leuior umquam fit et dari cibum necesse est, quando dari debeat, magna dissensio est. Quidam, quia fere remissius matutinum tempus aegris est, tum putant dandum. Quod si respondet, non quia mane est, sed quia remissior aeger est, dari debet. Si uero ne tum quidem ulla requies aegris est, hoc ipso peius id tempus est, quod, cum sua natura melius esse debeat, morbi uitio non est; simulque insequitur tempus meridianum, a quo cum omnis aeger fere peior fiat, timeri potest, ne ille magis etiam quam ex consuetudine urgeatur. Igitur alii uespere tali aegro cibum dant: sed cum eo tempore fere pessimi sint qui aegrotant, uerendum est, ne, si quid tunc mouerimus, fiat aliquid asperius. Ob haec ad mediam noctem decurro, id est, finito iam grauissimo tempore eodemque longissime distante, secuturis uero antelucanis horis, quibus omnes fere maxime dormiunt, deinde matutino tempore, quod natura sua leuissimum est. Si uero febres uagae sunt, quia uerendum est, ne cibum statim subsequantur, quandocumque quis ex accessione leuatus est, tunc debet adsumere. At si plures accessiones eo⟨dem⟩ die ueniunt, considerare oportet, paresne per omnia sint, quod uix fieri potest, an inpares. Si per omnia pares sunt, post eam potius accessionem cibus dari debet, quae non inter meridiem et uesperum desinit. Si inpares sunt, considerandum est, quo distent: nam si grauior altera, altera leuior est, post grauiorem dari debet; si altera longior, altera breuior, post longiorem: si altera grauior, altera longior est, considerandum est, utra magis adfligat, illa ui, an haec tempore, et post eam dandum. Sed paene plurimum interest, quantae qualesque inter eas remissiones sint: nam si post alteram febrem motio manet, post alteram integrum corpus est, integro corpore cibo tempus aptius est. Si semper febricula manet, sed alterum tamen longius tempus remissionis est, id potius eligendum est, adeo ut, ubi accessiones continuantur, protinus inclinata priore dandus cibus sit. Etenim perpetuum est, ad quod omne consilium derigi potest, cibum quam maxime semper ab accessione futura reducere, et hoc saluo, dare quam integerrimo corpore. Quod non inter duas tantum sed etiam inter plures accessiones seruabitur. Sed cum sit aptissimum tertio quoque die cibum dare, tamen si corpus infirmum est, cotidie dandus est; multoque magis, si continentes febres sine remissione sunt, quanto magis corpus adfligunt; aut si duae pluresue accessiones eodem die ueniunt. Quae res efficit, ut et a primo die protinus cibus dari cotidie debeat, si protinus uenae conciderunt; et saepius eodem die, si inter plures accessiones subinde uis corpori deest. Illud tamen in his seruandum est, ut post eas febres minus cibi detur, post quas, si per corpus liceret, omnino non daretur. Cum uero febris instet, incipiat, augeatur, consistat, decedat, deinde in decessione consistat aut finiatur, scire licet optimum cibo tempus esse febre finita; deinde, cum decessio eius consistit; tertium, si necesse est, quandocumque decedit: cetera omnia periculosa esse. Si tamen propter infirmitatem necessitas urget, satius esse consistente iam incremento febris aliquid offerre quam increscente, satius esse instante quam incipiente, cum eo tamen, ut nullo tempore is, qui deficit, non sit sustinendus. Neque Hercules satis est ipsas tantum febres medicum intueri, sed etiam totius corporis habitum et ad eum d⟨e⟩rigere curationem, siue supersunt uires seu desunt seu quidam alii affectus interueniunt. Cum uero semper aegros securos agere conueniat, ut corpore tantum, non etiam animo laborent, tum praecipue, ubi cibum sumpserunt. Itaque si qua sunt, quae exasperatura eorum animos sunt, optimum est ea, dum aegrotant, eorum notitiae subtrahere: si id fieri non potest, sustinere tamen post cibum usque somni tempus, et cum experrecti sunt, tum exponere.

[¶10] 6. 6 But the rationing of patients' food is the easier because often the stomach spues it back, although the appetite is eager for it; over drink, however, there is a mighty battle, the more so the greater the fever. For fever inflames thirst, and then most demands water when it is most dangerous. But the patient is to be taught that when the fever quiets down, thirst also will become quiet at once, and that the paroxysm will be prolonged if any sustenance is given to it: thus he who does not drink will the sooner cease to be thirsty. It is necessary, however, seeing that even in health hunger is more easily borne than thirst, to indulge patients more as to drink than food. But on the first day, at any rate, no fluid at all should be given, unless the pulse sinks so suddenly that food as well ought to be given: on the second day too and even on later days upon which food is not given, yet if great thirst oppresses, drink should be given. And indeed that dictum of Heraclides of tarentum was not wanting in reason: whenever either bile or indigestion disorders the patient, it is also expedient by draughts in moderation to mingle fresh material with the decomposing. We must see that, just as times are appointed for food, so they are appointed also for drink when given apart from food,... or when we want the patient to get the sleep which thirst usually prevents. But there is sufficient agreement that for all who are feverish an excess of fluid is unsuitable, and especially for women who have lapsed into fever after childbirth.

> Latin: 6. Sed de cibo quidem facilior cum aegris ratio est, quorum saepe stomachus hunc respuit, etiamsi mens concupiscit: de potione uero ingens pugna est, eoque magis, quo maior febris est. Haec enim sitim accendit, et tum maxime aquam exigit, cum illa periculosissima est. Sed docendus aeger est, ubi febris quierit, protinus sitim quoque quieturam, longioremque accessionem fore, si quod ei datum fuerit alimentum: ita celerius eum desinere sitire, qui non bibit. Necesse est tamen, quanto facilius etiam sani famem quam sitim sustinent, tanto magis aegris in potione quam in cibo indulgere. Sed primo quidem die nullus umor dari debet, nisi subito sic uenae ceciderunt, ut cibus quoque dari debeat, secundo uero ceterisque etiam, quibus cibus non dabitur, tamen si magna sitis urgebit, potio dari debet. Ac ne illud quidem ab Heraclida Tarentino dictum ratione caret: ubi aut bilis aegrum aut cruditas male habet, expedire quoque per modicas potiones misceri noua⟨m⟩ materia⟨m⟩ corrupta⟨e⟩. Illud uidendum est, ut qualia tempora cibo leguntur, talia potioni quoque, ubi sine illo datur, deligantur * * *, aut cum aegrum dormire cupiemus, quod fere sitis prohibet. Satis autem conuenit, cum omnibus febricitantibus nimius umor alienus sit, tum praecipue esse feminis, quae ex partu in febres inciderunt.

## 9. Book III · chapters 6–16

Source: https://scriptura.si/works/celsus-on-medicine/9/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/9/#p-N

[¶0] But although the character of the fever, and of its remission, fixes the time for giving food and drink, yet it is not very easy to know when the patient has fever, when he is better, when he is becoming worse: without which food and drink cannot be administered. For the pulse upon which we mostly rely (III.4, 16) is a very deceptive thing, because often it is rendered slower or faster by age and by sex and by constitution. And very frequently when the body is fairly healthy, if the stomach is weak, also at times when a fever is beginning, the pulse is low and quiescent, so that possibly a patient may seem weak who will yet easily support the impending severe paroxysm. On the contrary, the bath and exercise and fear and anger and any other feeling of the mind is often apt to excite the pulse; so that when the practitioner makes his first visit, the solicitude of the patient who is in doubt as to what the practitioner may think of his state, may disturb the pulse. On this account a practitioner of experience does not seize the patient's forearm with his hand, as soon as he comes, but first sits down and with a cheerful countenance asks how the patient finds himself; and if the patient has any fear, he calms him with entertaining talk, and only after that moves his hand to touch the patient. If now the sight of the practitioner makes the pulse beat, how easily may a thousand things disturb it! Another thing which we put faith in, a sensation of heat, is equally fallacious: for it may be excited by hot weather, by work, by sleep, by fear, by anxiety. Such things also should be noted indeed, but not altogether relied on. And we know at once that he is not feverish, whose pulse is of natural regularity, and his warmth such as is customary in health: we must not, however, at once assume fever if there is heat and high pulse, but under the following conditions: if also the surface of the skin is dry in patches; if both the forehead feels hot, and it feels hot deep under the heart; if the breath streams out of the nostrils with burning heat; if there is a change of colour whether to unusual redness or to pallor; if the eyes are heavy and either very dry or somewhat moist; if sweat, when there is any, comes in patches; if the pulse is irregular. On this account the practitioner should not take his seat in a dark part of the room, nor at the patient's head, but he should face the patient in a good light, so that he may note all the signs from his face as he lies in bed. Now when there has been fever and it has decreased, one should observe whether the temples or other parts of the body are becoming a little moist, which is evidence that sweating is about to set in; and if there is any sign of it, then and not before hot water should be given to drink, of which the effect is salutary if it causes a general sweating all over the body. Now to promote this the patient should keep his hands well covered under the bed-clothes, and do the same with his legs and feet. But it is a mistake to torment patients with bed-clothes, as many do, at the very paroxysm of the fever, worst of all when it is an ardent fever. If the body begins to sweat, a linen towel should be warmed, and each part gradually wiped over. But when the sweating has quite ended, or if none has come, when the patient seems in the most fit state for food, he should be anointed lightly under the bedclothes, next wiped over, and then given food. For patients in fever, liquid food is best, or whatever approximates to fluid, and that of the lightest possible kind, barley gruel in particular; and if there have been high fevers, that should be of the thinnest. Honey also which has been freed from the comb may be correctly added to give the body more nutriment; not if it upsets the stomach this is unnecessary, as also is the gruel itself. But in its place can be given either crumbled bread or washed spelt groats in hot water; in hydromel if the stomach is firm and the bowels tight, or in vinegar and water if the former is weak and the latter loose. And indeed this will suffice for food on the first day; then on the next day some addition can be made, yet from the same class of food, either pot-herbs or shell-fish or orchard fruit. And whilst fevers are on the actual increase, this is the only suitable food; but when the fevers have subsided or abated, a beginning indeed is to be made always with something of the lightest kind, then something to be added of the middle class, regard being had throughout both to the patient's strength and to his disease. A variety of food may be placed before the patient as Asclepiades prescribed, only when he is troubled by loss of appetite, and insufficiency of strength, in order that by tasting a little of each he may avoid starvation. But if there is no lack of strength nor loss of appetite, the patient should not be tempted by a variety of food, lest he take more than he can digest. And there is no truth in what Asclepiades said, that a variety of food is more easily digested; for it is eaten more readily, but digestion depends upon what the food is, and how much. Nor is it safe for the patient to be filled up with food whilst there are great pains, nor during an increase of the malady, but only after his illness has turned towards improvement.

> Latin: Sed cum tempora cibo potionique febris et remissionis ratio det, non est expeditissimum scire, quando aeger febricitet, quando melior sit, quando deficiat; sine quibus dispensari illa non possunt. Venis enim maxime credimus, fallacissimae rei, quia saepe istae leniores celerioresue sunt et aetate et sexu et corporum natura. Et plerumque satis sano corpore, ⟨si⟩ stomachus infirmus est, nonnumquam etiam incipiente febr⟨e⟩, subeunt et quiescunt, ut inbecillus is uideri possit, cui facile laturo grauis instat accessio. Contra saepe eas concitare solet balneum et exercitatio et metus et ira et quilibet alius animi adfectus, adeo ut, cum primum medicus uenit, sollicitudo aegri dubitantis, quomodo illi se habere uideatur, eas moueat. Ob quam causam periti medici est non protinus ut uenit adprehendere manu brachium, sed primum desidere hilari uultu percontarique, quemadmodum se habeat, et si quis eius metus est, eum probabili sermone lenire, tum deinde eius corpori manum admouere. Quas uenas autem conspectus medici mouet, quam facile mille res turbant. Altera res est, cui credimus, calor, aeque fallax: nam hic quoque excitatur aestu, labore, somno, metu, sollicitudine. Intueri quidem etiam ista oportet, sed ⟨e⟩is non omnia credere. Ac protinus quidem scire est, non febricitare eum, cuius uenae naturaliter ordinatae sunt, teporque talis est, qualis esse sani solet: non protinus autem sub calore motuque febrem esse concipere, sed ita: si summa quoque arida inaequaliter cutis est; si calor et in fronte est et ex imis praecordiis oritur; si spiritus ex naribus cum feruore prorumpit; si color aut rubore aut pallore nouo mutatus est; si oculi graues et aut persicci aut subumidi sunt; si sudor, cum sit, inaequalis est; si uenae non aequalibus interuallis mouentur. Ob quam causam medicus neque in tenebris neque a capite aegri debet residere, sed inlustri loco aduersus, ut omnes notas ex uoltu quoque cubantis percipiat. Vbi uero febris fuit ac decreuit, expectare oportet, num tempora partesue corporis aliae paulum madescant, quae sudorem uenturum esse testentur; ac si qua nota est, tum demum dare potui aquam calidam, cuius salubris effectus est, si sudorem per omnia membra diffundit. Huius autem rei causa continere aeger sub ueste satis multa manus debet, eademque crura pedesque contegere; qua male plerique aegros in ipso febris impetu, pessimeque, ubi ardens ea est, male habent. Si sudare corpus coepit, linteum tepefacere oportet paulatimque singula membra dete⟨r⟩gere. At ubi sudor omnis finitus est, aut si is non uenit, ubi quam maxime potuit idoneus esse cibo aeger uidetur, leuiter sub ueste ungendus est, tum detergendus, deinde ei cibus dandus. Cibus autem febricitantibus umidus est aptissimus aut umori certe quam proximus, utique ex materia quam leuissima maximeque sorbitio; eaque, si magnae febres fuerint, quam tenuissima esse debet. Mel quoque despumatum huic recte adicitur, quo corpus magis nutriatur: sed id si stomachum offendit, superuacuum est, sicut ipsa quoque sorbitio. Dari uero in uicem eius potest uel intrita ex aqua calida uel halica ⟨e⟩lota; si firmus est stomachus et compressa aluus, ex aqua mulsa; si uel ille languet uel haec profluit, ex posca. Et primo quidem cibo id satis est: secundo uero aliquid adici potest, ex eodem tamen genere materiae, uel holus uel conchylium uel pomum. Et dum febres quidem increscunt, hic solus cibus idoneus est: ubi uero aut desinunt aut leuantur, semper quidem incipiendum est ab aliquo ex materia leuissima, adiciendum uero aliquid ex media, ratione habita subinde et uirium hominis et morbi. Ponendi uero aegro uarii cibi, sicut Asclepiades praecepit, tum demum sunt, ubi fastidio urgetur neque satis uires sufficiunt, ut paulum ex singulis degustando famem uitet. At si neque uis neque cupiditas deest, nulla uarietate sollicitandus aeger est, ne plus adsumat quam concoquat. Neque uerum est, quod ab eo dicitur, facilius concoqui cibos uarios: eduntur enim facilius, ad concoctionem autem materiae genus et modus pertinent. Neque inter magnos dolores neque increscente morbo tutum est aegrum cibo impleri, sed ubi inclinata iam in melius ualetudo est. Sunt aliae quoque in febribus obseruationes necessariae.

[¶1] In fevers there are also other things that have to be observed. And this also must be noted, which some give as their sole precept, whether the body is constricted or relaxes; the first condition chokes it, the second wastes it away.

> Latin: Atque id quoque uidendum est, quod quidam solum praecipiunt, adstrictum corpus sit an profluat; quorum alterum strangulat, alterum digerit.

[¶2] For if there is constriction, the bowels are to be moved by a clyster, urination promoted, and sweating elicited in every way. In this class of maladies it is beneficial to let blood, to shake up the body by vigorous rocking, to keep the patient in the light, to impose hunger and thirst and wakefulness. It is also useful to take the patient to the bath, putting him first into the solium, next to anoint him, then to return him to the solium again and foment his groins with plenty of water; at times also oil may be mixed with the water in the solium; food is to be used later and not too often: it is to be thin, plain, soft, hot, scanty, consisting mainly of pot-herbs, such as sorrel, nettle-tops, mallow, and also of soup made from shell-fish, mussels or spiny lobsters. No meat should be given unless boiled. But as to drink, there should be more freedom, both before and after and along with food, beyond what thirst demands. Again, after the bath wine of fuller body and sweeter can also be given; once or twice Greek salted wine can be used.

> Latin: Nam si adstrictum est, ducenda aluus est, mouenda urina, eliciendus omni modo sudor. In hoc genere morborum emisisse sanguinem, concussisse uehementi⟨b⟩us gestationibus corpus, in lumine habuisse, imperasse famem, sitim, uigiliam prodest. Vtile est etiam ducere in balneum, prius demittere in solium, tum ungere, iterum ad solium redire multaque aqua fouere inguina; interdum etiam oleum in solio cum aqua calida miscere; uti cibo serius et rarius, tenui, simplici, molli, calido, exiguo, maximeque holeribus, qualia sunt lapatium, urtica, malua, uel iure etiam concharum musculorumue aut lucustarum: neque danda caro nisi elixa est. At potio esse debet magis liberalis, et ante cibum et post hunc et cum hoc ultra quam sitis coget. Poteritque a balineo etiam pinguius aut dulcius dari uinum; poterit semel aut bis interponi Graecum salsum.

[¶3] On the contrary, however, if the system is relaxed, sweating is to be suppressed, rest in a dark room resorted to, and sleep allowed at will; the body is to be rocked only in the lightest fashion, and helped as may suit the illness. For if the patient has loose motions, or if the stomach does not retain its contents, when the fever has subsided he should be given a large drink of tepid water, and be induced to vomit, unless the throat or the chest or the side is painful, or the disease is of long standing. But if sweating is troublesome, the skin should be hardened by nitre or salt, mixed with oil; and if the sweating is rather slight, the body is to be anointed with olive oil: if more profuse, with rose, quince, or myrtle oil, to which a dry wine should be added. But any patient with loose motions, when he reaches the bath, should be first anointed, then put into the solium. When there is anything wrong with the skin, it is better to use cold rather than hot water. Coming to the food, this should be nutritious, cold, dry, plain, with the least possible tendency to decomposition, bread toasted, meat roasted, wine dry or at any rate somewhat dry; if the bowels are loose, the wine should be hot, but cold when there is trouble from sweating or vomiting.

> Latin: Contra uero si corpus profluit, sudor coercendus, requies habenda erit, tenebris somnoque, quandoque uolet, utendum, non nisi leni gestatione corpus agitandum, et pro genere mali subueniendum. Nam si uenter fluit, aut si stomachus non continet, ubi febris decreuit, liberaliter oportet aquam tepidam potui dare, et uomere cogere, nisi aut fauces aut praecordia aut latus dolet, aut uetus morbus e⟨s⟩t. Si uero sudor exercet, duranda cutis est nitro uel sale, quae cum oleo miscentur; ac si leuius id uitium est, oleo corpus ungendum; si uehementius, rosa uel melino uel murteo, cui uinum austerum sit adiectum. Quisquis autem fluore aeger est, cum uenit in balineum, prius ungendus, deinde in solium d⟨e⟩mittendus est. Si in cute uitium est, frigida quoque quam calida aqua melius utetur. Vbi ad cibum uentum est, dari debet is ualens, frigidus, siccus, simplex, qui quam minime corrumpi possit, panis tostus, caro assa, uinum austerum uel certe subausterum; si uenter profluit, calidum, si sudores nocent uomitusue sunt, frigidum.

[¶4] 7. 7 Among fevers the case of pestilence demands special consideration. In this it is practically useless to prescribe fasting or medicine or clysters. If strength permits of it, blood-letting is best, and especially if there is fever with pain: but if that is hardly safe, after the fever has either declined or remitted, the chest is cleared by an emetic. But in such cases the patient requires to be taken to the bath earlier than in other affections, to be given hot and undiluted wine, and all food glutinous, including that sort of meat. For the more quickly such violent disorders seize hold, the earlier are remedies to be taken in hand, even with some temerity. But if a child is the sufferer, and not robust enough for lo-letting to be possible, thirst is to be used in his case, the bowels are to be moved by a clyster whether of water or of pearl-barley gruel; then and not before he is to be sustained by light food. Indeed in general children ought not to be treated like adults. Therefore, as in any other sort of disease, we must set to work with more caution in these cases; not let blood readily, not readily clyster, not torment by wakefulness and by hunger or excess of thirst, nor is a wine treatment very suitable. After the remission of the fever a vomit is to be elicited, then food of the lightest nature is given, after which let the child sleep; next day, if the fever persists, let the child be kept without food, and on the third day return to food as above. Our aim should be, as far as possible to sustain the child, by food when suitable, with abstinence in between when suitable, omitting all else. But if an ardent fever is parching up the patient, no medicinal draught is to be given, but during the paroxysms he is to be cooled by oil and water, mixed by the hand until they turn white. He should be kept in a room where he can inhale plenty of pure air; he is not to be stifled by a quantity of bed-clothes, but merely covered by light ones. Vine leaves also which have been dipped in cold water can be laid over the stomach. He is not even to be distressed by too much thirst; he should get food fairly soon, namely from the third day, and after being anointed beforehand. If phlegm collects in the stomach, when the paroxysm has already declined he is to be made to vomit; then to be given cold salads, or orchard fruit agreeable to the stomach. If the stomach remains dry, there should be given to begin with either pearl barley or spelt or rice gruel with which fresh lard has been boiled. Whilst the fever is at its height, certainly not before the fourth day, and if there is already great thirst, cold water is to be administered copiously so that the patient may drink even beyond satiety. As soon as the stomach and chest have become replete beyond measure and sufficiently cooled, he should vomit. Some do not even insist on the vomit, but use the cold water by itself, given up to satiety, as the medicament. When either of the above has been done, the patient is to be well wrapped up and put to bed so that he may sleep; and generally, after prolonged thirst and wakefulness, after full sating with water, after making a break in the heat, there comes abundant sleep: which brings on a profuse sweat, and this is an immediate relief, but only to those who have no pains accompanying the ardent fever, no swelling of the parts below the ribs, nothing prohibitory either in the chest or in the lung or in the throat, no ulcerations, no diarrhoea, no flux from the bowel. But if in fever of this sort the patient coughs readily, he is not to be distressed by severe thirst, nor ought he to drink water cold, but he is to be treated in the way prescribed for other fevers.

> Latin: 7. Desiderat quoque propriam animaduorsionem in febribus pestilentiae casus. In hac utile minime est aut fame aut medicamentis uti, aut ducere aluum. Si uires sinunt, sanguinem mittere optimum est, praecipueque si cum dolore febris est: si id parum tutum est, ubi febris aut tenuata est aut leuata est, uomitu pectus purgare. Sed in hoc maturius quam in aliis morbis ducere in balineum opus est, uinum calidum et meracius dare, et omnia glutinosa; inter quae carnem quoque generis eiusdem. Nam quo celerius eiusmodi tempestates corpiunt, eo maturius auxilia etiam cum quadam temeritate rapienda sunt. Quod si puer est qui laborat, neque tantum robur eius est, ut ei sanguis mitti possit, siti ei utendum est, ducenda aluus uel aqua uel tisanae cremore, tum denique is leuibus cibis nutriendus. Et ex toto non sic pueri ut uiri curari debent. Ergo, ⟨ut⟩ in alio quoque genere morborum, parcius in his agendum est: non facile sanguinem mittere, non facile ducere aluum, non cruciare uigilia fameque aut nimia siti, non uino curare satis conuenit. Vomitus post febrem eliciendus est, deinde dandus cibus ex leuissimis, tum is dormiat; posteroque die, si febris manet, abstineatur; tertio ad similem cibum redeat. Dandaque opera est, quantum fieri potest, ut inter oportunam abstinentiam cibosque oportunos, omissis ceteris, nutriatur. Si uero febris ardens extorret, nulla medicamenti danda potio est, sed in ipsis accessionibus oleo et aqua refrigerandus est; quae miscenda manu sunt, donec albescant. Eo conclaui tenendus, quo multum et purum aerem trahere possit; neque multis uestimentis strangulandus, sed admodum leuibus tantum uelandus est. Possunt etiam super stomachum inponi folia uitis in aqua frigida tincta. Ac ne siti quidem nimia uexandus est. Alendus maturius est, id est a tertio die, et ante cibum idem perungendus. Si pituita in stomachum coit, inclinata iam accessione uomere cogendus est; tum dandum frigidum holus, aut pomum ex is, quae stomacho conueniunt. Si siccus manet stomachus, protinus uel tisanae uel halicae uel orizae cremor dandus est, cum quo recens adeps cocta sit. Cum uero in summo incremento morbus est, utique non ante quartum diem, magna siti antecedente, frigida aqua copiose praestanda est, ut bibat etiam ultra satietatem. Cum iam uenter et praecordia ultra modum repleta satisque refrigerata sunt, uomere debet. Quidam ne uomitum quidem exigunt, sed ipsa aqua frigida tantum ad satietatem data pro medicamento utuntur. Vbi utrumlibet factum est, multa ueste operiendus est, et collocandus ut dormiat; fereque post longam sitim et uigiliam, post multam satietatem, post infractum calorem plenus somnus uenit; per quem ingens sudor effunditur, idque praesentissimum auxilium est, sed in is tamen, in quibus praeter ardorem nulli dolores, nullus praecordiorum tumor, nihil prohibens uel in thorace uel in pulmone uel in faucibus, non ulcera, non deiectio, non profluuium alui fuit. Si quis autem in huiusmodi febre leuiter tussit, is neque uehementi siti conflictatur, neque bibere aquam frigidam debet, sed eo modo curandus est, quo in ceteris febribus praecipitur.

[¶5] 8. 8 But when the fever is that kind of tertian which the physicians call hemitritaion, great care is required to avoid a mistake, for it has a number of frequently recurring paroxysms and remissions, so that it can appear to be some other class of disease and the fever may last from twenty-four to thirty-six hours, so that what is really the same paroxysm may not seem to be the same. And it is then exceedingly important not to give food except in that remission which is a real one, and when that does come, to give it at once. Many die suddenly from error one way or the other on the part of the practitioner. And unless something strongly prohibits, blood should be let at the onset, then food is to be given, which, without exciting the fever, should yet sustain a long course of it.

> Latin: 8. At ubi id genus tertianae est, quod emitritaeon medici appellant, magna cura opus est, ne id fallat: habet enim plerumque frequentes accessiones decessionesque, ut aliud genus morbi uideri possit porrigique febris inter horas XXIIII et XXXVI, ut quod idem est, non idem esse uideatur. Et magnopere necessarium est neque dari cibum nisi in ea remissione, quae uera est, et ubi ea uenit, protinus dari. Plurimique sub alterutro curantis errore subito moriuntur. Ac nisi magnopere res aliqua prohibet, inter initia sanguis mitti debet, tum dari cibus, qui neque incitet febrem, et tamen longum eius spatium sustineat.

[¶6] 9. 9 Sometimes also slow fevers hold the body without any remission, and give no place for either food or any medicament. In that case it should be the aim of the practitioner to change the disease, for perhaps that will make it more amenable to treatment.. For this object cold water, to which oil has been added, should be sprinkled at frequent intervals over the patient's body, for it thus comes about now and again that a shivering follows, and some beginning of a fresh pulse motion, and after this when, after the body has become hotter, there may even follow a remission. Rubbing with oil and salt appears also to benefit such cases. But if for a long while there is a chill, and a numbness and a tossing of the body, it is not unfitting to administer three or four cups of honeyed wine even while the fever is present, or food along with wine well diluted. For often in this way the fever is augmented, and the increased heat which arises simultaneously both relieves the pre-existing disorders and offers hope of a remission, and through that of treatment. Assuredly that treatment is no novelty by which some nowadays at times cure by contrary remedies patients who have been handed over to them, after dragging on under more cautious practitioners. Even among the ancients, before Herophilus and Erasistratus, but especially after Hippocrates. There was a certain Petron, who on taking over a patient with fever, covered him with a quantity of clothes in order simultaneously to excite great heat and thirst. Then when the fever began to remit somewhat, he gave cold water to drink; and if this raised a sweat, he declared that the patient was recovering; if it did not, he administered even more cold water and then forced him to vomit. If by either of the above ways he had rendered the patient free from fever, he at once gave him roast pork and wine; if he had not so freed him, he boiled water with salt, and obliged the patient to drink it, in order that by moving the bowels he might cleanse the stomach. And the above formed the whole of this man's practice; and it pleased those whom successors of Hippocrates had failed to cure, no less than in our time it pleases those, who, after they have dragged on for a long while under disciples of Herophilus and Erasistratus, have not been benefited. Yet it is harsh treatment none the less, for if it is adopted forthwith at the commencement, it kills many patients. Since, however, it is impossible for the same remedies to suit everybody, rashness helps those whom the usual regimen has not made well; hence it is that practitioners of this class manage other people's patients better than their own. Yet it is the part also of a circumspect man at times to renew and increase a disease and to inflame fevers, for when the existing condition does not answer to a treatment, that which is to come may do so.

> Latin: 9. Nonnumquam etiam lentae febres sine ulla remissione corpus tenent, ac neque ⟨cibo neque⟩ ulli remedio locus est. In hoc casu medici cura esse debet, ut morbum mutet: fortasse enim curationi oportunior fiet. Saepe igitur ex aqua frigida, cui oleum sit adiectum, corpus eius pertractandum est, quoniam interdum sic euenit, ut horror oriatur et fiat initium quoddam noui motus exque eo, cum magis corpus incaluit, sequatur etiam remissio. In his frictio quoque ex oleo et sale salubris uidetur. At si diu frigus est et torpor et iactatio corporis, non alienum est in ipsa febre mulsi dare tres aut quattuor cyathos, uel cum cibo uinum bene dilutum. Intenditur enim saepe ex eo febris, et maior ortus calor simul et priora mala tollit et spem remissionis inque ea curationis ostendit. Neque Hercules ista curatio noua est, qua nunc quidem traditos sibi aegros, qui sub cautioribus medicis trahebantur, interdum contrariis remediis sanant. Siquidem apud antiquos quoque ante Herophilum et Erasistratum maximeque post Hippocratem fuit * * Petro quidam, qui febricitantem hominem ubi acceperat, multis uestimentis operiebat, ut simul calorem ingentem sitimque excitaret. Deinde ubi paulum remitti coeperat febris, aquam frigidam potui dabat, ac si mouerat sudorem, explicuisse se aegrum iudicabat; si non mouerat, plus etiam aquae frigidae ingerebat et tum uomere cogebat. Si alterutro modo febre liberauerat, protinus suillam assam et uinum homini dabat; si non liberauerat, decoquebat aquam sale adiecto eamque bibere cogebat, ut mouendo uentrem purgaret. Et intra haec omnis eius medicina erat: eaque non minus grata fuit is, quos Hippocratis successores non refecerant, quam nunc est is, quos Herophili uel Erasistrati aemuli diu tractos non adiuuerunt. Neque ideo tamen non est temeraria ista medicina, quia, si plures protinus a principiis excepit, interemit. Sed, cum eadem omnibus conuenire non possint, fere quos ratio non restituit, temeritas adiuuat; ideoque eiusmodi medici melius alienos aegros quam suos nutriunt. Sed est circumspecti quoque hominis et nouare interdum et augere morbum et febres accendere, quia curatio⟨nem⟩ ubi id quod est non recipit, potest recipere id quod futurum est.

[¶7] 10. 10 We must also take into consideration whether fevers exist alone, or whether there are additional troubles, namely whether the head aches, whether the tongue is roughened, whether the chest is tight. If there is headache, rose oil should be mixed with vinegar and poured over the head; next two strips of linen are taken, each corresponding in length and breadth to the forehead, of which in turn one is placed in the rose oil and vinegar, the other on the forehead; or unscoured wool is soaked in the same and applied. If the vinegar hurts, the rose oil alone is to be used; if rose oil itself irritates, then bitter olive oil. If there is little relief from the above, we may pound up either dried orris root, or bitter almonds, or some other from among refrigerant herbs; any one of these applied with vinegar lessens pain, one more in one case, another in another. There is benefit from the application of bread soaked in poppy head decoction, or in rose oil containing cerussa or litharge. Also it is not unsuitable to snuff up thyme or dill. But first there is inflammation and pain in the chest, the first thing is to apply to it repressing plasters, lest more diseased matter should gather there, if hotter ones were applied; next, when the primary inflammation has subsided, and not before, we must go on to hot and moist plasters, in order to disperse what remains of the matter. Now the signs of an inflammation are four: redness and swelling with heat and pain. Over this Erasistratus greatly erred, when he said that no fever occurred apart from inflammation. Therefore if there is pain without inflammation, nothing is to be put on: for the actual fever at once will dissolve the pain. But if there is neither inflammation nor fever, but just pain in the chest, it is allowable to use hot and dry foments from the first. Again if the tongue is dry and scabrous, it is to be wiped over first with a pledget of wool dipped in hot water, then to be smeared with a mixture of rose oil and honey. Honey cleans, rose oil represses and at the same time does not allow the tongue to dry. But if the tongue is not scabrous, only dry, after being wiped over with the pledget of wool, it should be smeared with rose oil to which a little wax has been added.

> Latin: 10. Considerandum est etiam, febresne solae sint, an alia quoque his mala accedant, id est, num caput doleat, num lingua aspera, num praecordia intenta sint. Si capitis dolores sint, rosam cum aceto miscere oportet et in id ingerere; deinde habere duo pittacia, quae frontis latitudinem longitudinemque aequent, ex his inuicem alterum in aceto et rosa habere, alterum in fronte; aut intinctam isdem lanam sucidam inponere. Si acetum offendit, pura rosa utendum est; si rosa ipsa laedit, oleo acerbo. Si ista parum iuuant, teri potest uel iris arida uel nuces amarae uel quaelibet herba ex refrigerantibus; quorum quidlibet ex aceto inpositum dolorem minuit, sed magis aliud in alio. Iuuat etiam panis cum papauere iniectus, uel cum rosa, cerussa spumaue argenti. Olfacere quoque uel serpullum uel anethum non alienum est. At si in praecordiis inflammatio et dolor est, primo superimponenda sunt cataplasmata reprimentia, ne, si calidiora fuerint, plus eo materiae concurrat; deinde si prima inflammatio se remisit, tum demum ad calida et umida ueniendum est, ut ea, quae remanserunt, discutiant. Notae uero inflammationis sunt quattuor: rubor et tumor cum calore et dolore. Quo magis errauit Erasistratus, cum febrem nullam esse sine hac dixit. Ergo si sine inflammatione dolor est, nihil imponendum est: hunc enim statim ipsa febris soluet. At si neque inflammatio neque febris sed tantum praecordiorum dolor est, protinus calidis et siccis fomentis uti licet. Si uero lingua sicca et scabra est, detergenda primum penicillo est ex aqua calida, deinde unguenda mixtis inter se rosa et melle. Mel purgat, rosa reprimit simulque siccescere non sinit. At si scabra non est sed arida, ubi penicillo detersa est, ungi rosa debet, cui cerae paulum sit adiectum.

[¶8] 11. 11 Generally also preceding fevers there is a chill, and that is a most troublesome class of malady. When it is expected, the patient is to be prohibited from drinking anything: for this, given a little while beforehand, adds much to the illness. Likewise he is to be covered up quite soon with a quantity of bed-clothes; to the parts about which we feel concern there are to be applied such dry and hot foments as will not immediately set up a very vehement heat, but gradually increase it. The said parts are also to be rubbed by hands anointed with cold olive oil, to which has been added one of the heating agents. And some practitioners are satisfied with one rubbing of any kind of oil. During remissions of these fevers, some give three or four cupfuls of barley water even although some fever still persists; then, the fever having definitely ended, they reinvigorate the stomach with cold and light food. This, I think, should be tried only when there has been little benefit from food given once and at the end of the paroxysm. It must be carefully looked to, however, that the time of the remission is not deceptive; for often in this class of illness the fever seems to diminish, and then again becomes intense. Some degree of trust must be placed in that remission which is prolonged, and diminishes restlessness and the foulness of the mouth which the Greeks term ozaena. This is pretty generally agreed, that if the daily paroxysms are equal, a little food should be given every day: if the paroxysms are unequal, food should be given after the more severe, after the slighter ones hydromel.

> Latin: 11. Solet etiam ante febres esse frigus idque uel molestissimum morbi genus est. Vbi id expectatur, omni potione prohibendus est aeger: haec enim paulo ante data multum malo adicit. Item maturius ueste multa tegendus est; admouenda partibus is, pro quibus metuimus, sicca et calida fomenta sic, ne statim uehementissimi calores incipiant, sed paulatim increscant. Perfricandae quoque eae partes manibus unctis ex uetere oleo sunt eique adiciendum aliquid ex calefacientibus. Contentique medici quidam una frictione etiam ex quolibet oleo sunt. In harum febrium remissionibus nonnulli tres aut quattuor cyathos sorbitionis etiamnu⟨m⟩ manente febre dant, deinde ea bene finita reficiunt stomachum cibo frigido et leui. Tum hoc ego puto temptandum, quo⟨m⟩ parum cibus semel et post febrem datus prodest. Sed curiose prospiciendum, ne tempus remissionis decipiat: saepe enim ⟨in⟩ hoc quoque genere ualetudinis iam minui febris uidetur, et rursus intenditur. Aliqua ei remissioni credendum est, quae etiam moratur et iactationem foetoremque quendam oris, quem ozen⟨am⟩ Graeci uocant, minuit. Illud satis conuenit, si cottidie pares accessiones sunt, cotidie paruum cibum dandum: si inpares, post grauiorem, cibum; post leuiorem, aquam mulsam.

[¶9] 12. 12 Now shivering usually precedes those fevers which have a fixed cycle and a complete remission; hence they are the most safe, and specially admit of treatment. For when periodicity is uncertain, neither clyster nor bath, nor wine nor other medicament, is administered at the right moment: for it is uncertain when the fever will supervene, so that if it comes on suddenly, it may happen that there is the greatest harm in what is intended to serve as an aid. And there is nothing else that can be one, except for the patient to abstain strictly for the first days, then, upon the decline of that paroxysm which is the severest, to take food. When, however, there is an assured cycle, all those remedies are more easily tried, because we are more able to inform ourselves of the alternations between paroxysms and remissions. In those fevers, however, which have become inveterate, starving is not of service; it is only in the first days that the fever is to be thus countered; later the treatment is to be divided, first to disperse the shivering, then the fever. Therefore, as soon as the patient shivers, and after the shivering grows hot, he should be given to drink tepid water with a little salt in it, and so made to vomit: for generally such shivering arises from a bilious sediment in the stomach. Likewise if shivering recurs at the next cycle, the same should be done; for often the fever is thus shaken off, and now we may learn to what class it belongs. And so in view of the possibility of the next paroxysm, the third which may be threatening, the patient should be conducted to the bath, and it should be do arranged that he is already in the solium at the moment for the shivering. If there also he feels chilled, yet none the less he should do the same again in view of a fourth paroxysm, for often in that way the shivering is shaken off. If there is no benefit even from the bath, before the paroxysm let him eat garlic, or drink hot water containing pepper; to see if these when taken excite heat which prevents the shivering. Further in the same way as prescribed for a chill before shivering can come on, the patient should be covered up, and the whole body surrounded with foments — but the stronger ones are to be used at once — and thoroughly encompassed by wraps which enclose hot tiles and cinders. If, notwithstanding, shivering breaks out, let the patient be anointed freely under the wraps with hot oil, to which add one of the heating elements: let rubbing be applied, so far as he can bear it, especially of the arms and legs, while he holds his breath. Nor should it be stopped even if he shivers; for often the pertinacity of the rubber overcomes the body's malady. If he vomits somewhat, tepid water is to be given him, and he is to be forced to vomit again; the same measures must be used until shivering comes to an end. But if the shivering is too slow in subsiding, in addition to the above, a clyster should be given; for that also is of good effect by unloading the body. The last remedies after these are rocking and rubbing. Now in such illness the food to be given is such chiefly as will secure a soft motion, meat glutinous, wine, when any is given, dry.

> Latin: 12. Horror autem eas fere febres antecedit, quae certum habent circuitum et ex toto remittuntur; ideoque tutissimae sunt maximeque curationes admittunt. Nam ubi incerta tempora sunt, neque alui ductio neque balineum neque uinum neque medicamentum aliud recte datur: incertum est enim, quando febris uentura sit: ita fieri potest, ut, si subito uenerit, summa in eo pernicies sit, quod auxilii causa sit inuentum. Nihilque aliud fieri potest, quam ut primis diebus bene abstineatur aeger, deinde sub decessu febris eius, quae grauissima est, cibum sumat. At ubi certus circumitus est, facilius illa omnia temptantur, quia magis proponere nobis accessionum et decessionum uices possumus. In his autem, cum inueterauerunt, utilis fames non est: primis tantummodo diebus ea pugnandum est; deinde diuidenda curatio est, et ante horror, tum febris discutienda. Igitur cum primum aliquis inhorruit, et ⟨ex⟩ horrore incaluit, dare oportet ei potui tepidam aquam subsalsam et uomere eum cogere: nam fere talis horror ab is oritur, quae biliosa in stomacho resederunt. Idem faciendum est, si proximo quoque circuitu aeque accessit: saepe enim sic discutitur, iamque, quod genus febris sit, scire licet. Itaque sub expectatione proximae accessionis, quae instare tertia potest, deducendus in balineum est, dandaque opera, ut per tempus horroris in solio sit. Si ibi quoque * senserit, nihilo minus idem sub expectatione quartae accessionis faciat: siquidem eo quoque modo saepe id discutitur. Si ne balneum quidem profuit, ante accessionem alium edat, aut bibat aquam calidam cum pipere: siquidem ea quoque adsumpta calorem mouent, qui horrorem non admittit. Deinde eodem modo, quo in frigore praeceptum est, antequam inhorrescere possit, operiatur, fomentisque, sed protinus ualidioribus, totum corpus circumdet maximeque inuolutis extinctis testis et titionibus. Si nihilo minus horror perruperit, multo oleo calefacto inter ipsa uestimenta perfundatur, cui aeque ex calfacientibus aliquid sit adiectum; adhibeaturque frictio, quantam is sustinere poterit, maximeque in manibus et cruribus; et spiritum ipse contineat. Neque desistendum est, etiamsi horret: saepe ⟨enim⟩ pertinacia iuuantis malum corporis uincit. Si quid euomuit, danda aqua tepida, iterumque uomere cogendus est; utendumque eisdem est, donec horror finiatur. Sed praeter haec ducenda aluus est, si tardius horror quiescit: siquidem id quoque exonerato corpori prodest. Vltimaque post haec auxilia sunt gestatio et fricatio. Cibus autem in eiusmodi morbis maxime dandus est, qui mollem aluum praestet, caro glutinosa: uinum, cum dabitur, austerum.

[¶10] 13. 13 The foregoing remarks apply to all periodic fevers: but they are to be distinguished, according to the dissimilar characters of each. If it is a daily fever, it is particularly important to abstain for the first three days, then to make use of food upon alternate days: if this fever has become inveterate, the bath and wine are to be tried at the end of the paroxysm, and especially so when the fever persists after the shivering has been removed.

> Latin: 13. Haec ad omnes circuitus febrium pertinent: discernendae tamen singulae sunt, sicut rationem habent dissimilem. Si cottidiana est, triduo primo magnopere abstineri oportet, tum cibis altero quoque die uti: si res inueterauerit, post febrem experiri balneum et uinum, magisque si horrore sublato haec superest.

[¶11] 14. 14 But if it be a tertian, when there are complete intermissions, or a quartan, on the intermediate days the patient should make use of walking and of other exercises and of anointings. In this kind of malady, well before the paroxysm, a certain Cleophantus, one of the ancient physicians, poured over the patient's head quantities of hot water; and then gave wine. Asclepiades, although he followed many of this man's precepts, rejected this one, and rightly, for it is of doubtful effect. In the case of a tertian fever, Asclepiades said that on the third day following the paroxysm, the bowels should be moved by a clyster; on the fifth day after the shivering a vomit should be elicited; then, after the paroxysm, according to the custom of Cleophantus, patients whilst still heated were to be given food and wine, on the sixth day to be kept in bed; for so he hoped to prevent a paroxysm on the seventh day. It is likely that this may often happen. It is safer, however, so that we may use the exact order laid down, to try the three remedies, vomiting, clystering, and wine-drinking, on three several days, that is, on the third, fifth and seventh days, with this proviso that on the seventh day wine is not to be drunk until after the time for the paroxysm. But if a tertian fever is not dispersed within the first days, but is becoming chronic on the day that the paroxysm is expected, the patient should keep his bed; after the paroxysm he should be rubbed, then, having taken food, drink water; on the day following, which is free from fever, the patient should keep quiet, avoid exercise and anointing, and be content with water only. And that indeed is the best procedure; but if there is urgent weakness, he may both take wine after the paroxysm and a little food on the intermediate day.

> Latin: 14. Si uero tertiana, quae ex toto intermittit, aut quartana est, mediis diebus et ambulationibus uti oportet aliisque exercitationibus et unctionibus. Quidam ex antiquis medicis Cleophantus in hoc genere morborum multo ante accessionem per caput aegrum multa calida aqua perfundebat, deinde uinum dabat. Quod, quamuis pleraque praecepta eius uiri secutus est Asclepiades, recte tamen praeteriit: est enim anceps. Ipse, si tertiana febris est, tertio die post accessionem dicit aluum duci oportere, quinto post horrorem uomitum elicere, deinde post febrem, sicut illi mos erat, adhuc calidis dari cibum et uinum, sexto die in lectulo detineri: sic enim fore, ne septimo die febris accedat. Id saepe posse fieri uerisimile est. Tutius tamen est, ut hoc ipso ordine utamur, tria remedia, uomitus, alui ductionis, uini per triduum, id est tertio die et quinto et septimo temptare, ne uinum nisi post accessionem die septimi bibat. Si uero primis diebus discussus morbus non est, inciditque in uetustatem, quo die febris expectabitur, in lectulo se contineat, post febrem confricetur, tum cibo adsumpto bibat aquam; postero die, qui uacat, ab exercitatione unctioneque aqua tantum contentus conquiescat. Et id quidem optimum est: si uero inbecillitas urgebit, et post febrem uinum ⟨et⟩ medio die paulum cibi debebit adsumere.

[¶12] 15. 15 In a quartan fever the same should be done. But seeing that unless it has been shaken off within the first days, it is a long while in terminating, we must be more careful from the very first to lay down what should be done in it. Therefore if a paroxysm has set in with shivering and has remitted, the patient ought to observe a regimen on the same day and on the following and on the third day; on the first day after the paroxysm he should take only hot water; on the next two days abstain if possible even from that;; on the fourth day, if the fever recurs with shivering, he should vomit, as was prescribed before; then after the paroxysm he should take a limited quantity of food and of wine four ounces. On the next two days he should fast, taking only hot water if thirsty. On the seventh day the cold stage should be anticipated by the bath; if a paroxysm recurs, the bowels should be moved by a clyster; having settled down after the clyster, the patient should be anointed and rubbed vigorously; then take food and wine as above; on the next two days abstain, and undergo rubbing. On the tenth day trial is again made of the bath; and if after that a paroxysm follows, he should in the same way be rubbed, and drink wine more freely. And it is likely that so many days of fasting, along with the other measures prescribed, will get rid of the fever. But if the quartan fever persists notwithstanding, a totally different line of treatment is to be pursued, the aim being that the body may easily bear what has to be borne for a long while. Therefore we cannot approve the practice of Heraclides of Tarentum, who said that in the first days the bowel was to be clystered and then there was to be abstinence until the seventh day. Even supposing a man could endure this, yet if he does become freed from fever, he will have scarcely strength enough to recover; they themselves if there be more frequent recurrences of the fever he will sink. If, therefore, the disease shall remain on the thirteenth day, the bath should not be tried, either before or after the paroxysm, except occasionally when the shivering has been thrown off. The actual shivering is to be driven off by the measures above prescribed; then after the paroxysm it will be proper that the patient be anointed, and rubbed vigorously, and take food both nourishing and abundant, with as much wine as he likes; on the day following, when sufficiently rested, he is to walk, to take exercise, to be anointed and vigorously rubbed, then to take food without wine, and on the third day to abstain. On the day that a recurrence of the paroxysm is expected, he should get up beforehand, and so arrange the performance of the exercises that the time for the onset of the fever concurs with that of the exercise; for often in this way the paroxysm is thrown off. But if attacked during the exercise, he should thereupon return home to bed. In this kind of sickness the remedies are: anointing, rubbing, exercise, food, wine. If constipated, the bowels are to be clystered. But whilst the stronger patients can easily carry out the above, if weakness has supervened, rocking should replace exercise; if even that cannot be borne, nevertheless rubbing should be applied. If this also, when vigorous, is trying to the patient, treatment should be restricted to rest and anointing and food; care being taken that indigestion does not convert the quartan into a quotidian fever. For a quartan kills no one, but when a quotidian is made out of it, the patient is in a bad way; this, however, does not happen unless through the fault either of the patient or of the practitioner.

> Latin: 15. Eadem in quartana facienda sunt. Sed cum haec tarde admodum finiatur nisi primis diebus discussa est, diligentius ab initio praecipiendum est, quid in ea fieri debeat. Igitur si cui cum horrore febris accessit eaque desiit, eodem die et postero tertioque continere se debebit, et aquam tantummodo calidam primo die post febrem sumere; biduo proximo, quantum fieri potest, ne hanc quidem: si quarto die cum horrore febris reuertitur, uomere, sicut ante praeceptum est; deinde post febrem modicum cibum sumere, uini quadrantem. Postero tertioque die abstineri, aqua tantummodo calida, si sitiet, adsumpta. Septimo die balineo frigus praeuenire; si febris redierit, ducere aluum; ubi ex eo corpus conquieuerit, in unctione uehementer perfricari; eodem modo sumere cibum et uinum; biduo proximo se abstinere, frictione seruata. Decimo die rursus balneum experiri; et si postea febris accessit, aeque perfricari, uinum copiosius bibere. Ac proximum est, tot dierum ut abstinentia cum ceteris, quae praecipiuntur, febrem tollant. Si uero nihilo minus remanet, aliud ex toto sequendum est curationis genus, idque agendum, ut id, quod diu sustinendum est, corpus facile sustineat. Quo minus etiam probari curatio Heraclidis Tarentini debet, qui primis diebus ducendam aluum, deinde abstinendum in septimum diem dixit. Quod ut sustinere aliquis possit, tamen etiam febre liberatus uix refectioni ualebit: adeo, si febris saepius accesserit, concidet. Igitur, si tertio decimo die morbus manebit, balineum neque ante febrem neque postea temptandum erit, nisi interdum iam horrore discusso. Horror ipse per ea, quae supra scripta sunt, expugnandus; deinde post febrem oportebit ungui et uehementer perfricari, cibum et ualidum et fortiter adsumere, uino uti quantum libebit; postero die, cum satis quieuerit, ambulare, exerceri, ungui, perfricari fortiter, cibum capere sine uino, tertio die abstinere. Quo die uero febrem expectabit, ante surgere, exerceri dareque operam, ut in ipsa exercitatione febris tempus incurrat: sic enim saepe illa discutitur. At si in opere occupauit, tum demum se recipere. In eiusmodi ualetudine medicamenta sunt oleum, frictio, exercitatio, cibus, uinum. Si uenter adstrictus est, soluendus est. Sed haec facile ualidiores faciunt: si inbecillitas occupauit, pro exercitatione gestatio est; si ne hanc quidem sustinet, adhibenda tamen frictio est. Si haec quoque [uehemens] onerat, intra quietem et unctionem et cibum sistendum est; dandaque opera est, ne qua cruditas in cotidianam id malum uertat. Nam quartana neminem iugulat: sed si ex ea cotidiana facta est, in malis aeger est; quod tamen nisi culpa uel aegri uel curantis numquam fit.

[¶13] 16. 16 But if there is a double quartan fever, and those exercises which I have mentioned cannot be adopted, either the patient should rest entirely, or if that is difficult walk quietly, then sit with his feet and head carefully wrapped up; as often as a paroxysm has recurred and has remitted, he should take food in moderation and wine; for the remainder of the remission, unless there is urgent weakness, he should fast. But if two paroxysms are almost continuous, he should take food after both are over; then in the intermission he should move about a little, and after being anointed take food. Now since an inveterate quartan is seldom got rid of except in the spring, it is at that season especially that attention is to be given, lest something occur to hinder recovery. And it is of advantage in an old quartan to later now and then the class of diet, and change from wine to water, from bland food to acrid, from acrid to bland; to eat radish, then to vomit; to move the bowels by shell-fish or chicken broth; to add heating agents to the oil for rubbing; before the paroxysm to sip two cups of vinegar, or one cup of mustard in three of Greek salted wine, or pepper, castoreum, laser and myrrh in equal proportions in water. For by these and such-like remedies the system is to be stirred up in order that it may be moved from the state in which it is being held. When the fever has quieted down, for a long while it is well to keep in mind the day on which it occurred, and on that day to avoid cold, heat, indigestion, fatigue: for fever readily recurs unless even a convalescent patient fears that day for some time to come.

> Latin: 16. At si duae quartanae sunt, neque eae, quas proposui, exercitationes adhiberi possunt, aut ex toto quiescere opus est, aut, si id difficile est, leuiter ambulare, considere diligenter inuolutis pedibus et capite; quotiens febris accessit et desiit, cibum modicum sumere et uinum, reliquo tempore, nisi inbecillitas urguet, abstinere. ⟨A⟩t si duae febres paene iunguntur, post utramque cibum sumere, deinde uacuo tempore et moueri aliquid et post unctionem cibo uti. Cum uero uetus quartana raro nisi uere soluatur, utique eo tempore attendendum est, ne quid fiat, quod ualetudinem impediat. Prodestque in uetere quartana subinde mutare uictus genus, a uino ad aquam, ab aqua ad uinum, a lenibus cibis ad acres, ab acribus ad lenes transire; esse radicem, deinde uomere; iure uel * * pulli gallinacei uentrem resoluere; oleo ad frictiones adicere calfacientia; ante accessionem sorbere uel aceti cyathos duos, uel unum sinapis cum tribus Graeci uini [salsi], uel mixta paribus portionibus et in aqua diluta piper, castoreum, laser, murram. Per haec enim similiaque corpus agitandum est, ut moueatur ex eo statu, quo detinetur. Si febris quieuit, diu meminisse eius diei conuenit, eoque uitare frigus, calorem, cruditatem, lassitudinem: facile enim reuertitur, nisi a sano quoque aliquamdiu timetur.

## 10. Book III · chapters 17–21

Source: https://scriptura.si/works/celsus-on-medicine/10/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/10/#p-N

[¶0] 17. 17 But if a quotidian has been made out of a quartan fever, since this may have happened from mismanagement, the patient ought to fast for two days, make use of rubbing, and be given only a drink of water in the evening: it often happens that on the third day there is no paroxysm. But whether or not, food should be given after the time for the paroxysm. But if this fever persists, a two days' fast should be enjoined so far as the system can bear it, and rubbing used every day.

> Latin: 17. At si ex quartana facta cotidiana est, cum id uitio inciderit, per biduum abstinere oportet, et frictione uti, uespere tantummodo aquam potui dare: tertio die saepe fit, ne febris accedat. Sed siue fuit siue non fuit, cibus post accessionis tempus est dandus. At si manet, per biduum abstinentia, quanta maxime imperari corpori potest, frictione cotidie utendum est.

[¶1] 18. 18 The regimen of fevers has now been expounded; there are, however, other affections of the body which follow upon this, among which I subjoin in the first place those which cannot be assigned to any definite part.

> Latin: 18. Et febrium quidem ratio exposita est. Supersunt uero alii corporis adfectus, qui huic superueniunt, ex quibus eos, qvi certis partibvs adsignari non possvnt, protinus iungam.

[¶2] I shall begin with insanity, and first that form of it which is both acute and found in fever. The Greeks call it phrenesis. Before all things it should be recognized, that at times, during the paroxysm of a fever, patients are delirious and talk nonsense. This is indeed no light matter, and it cannot occur unless in the case of a severe fever; it is not, however, always equally dangerous; for commonly it is of short duration, and when the onslaught of the paroxysm is relieved, at once the mind comes back. This form of the malady does not require other remedy than that prescribed for the curing of the fever. But insanity is really there when a continuous dementia begins, when the patient, although up till then in his sanity in his senses, yet entertains certain vain imaginings; the insanity becomes established when the mind becomes at the mercy of such imaginings. But there are several sorts of insanity; for some among insane persons are sad, others hilarious; some are more readily controlled and rave in words only, others are rebellious and act with violence; and of these latter, some only do harm by impulse, others are artful too, and show the most complete appearance of sanity while seizing occasion for mischief, but they are detected by the result of their acts. Now that those who merely ave in their talk, or who make but trifling misuse of their hands, should be coerced with the severer forms of constraint is superfluous; but those who conduct themselves more violently it is expedient to fetter, lest they should do harm either to themselves or to others. Anyone so fettered, although he talks rationally and pitifully when he wants his fetters removed, is not to be trusted, for that is a madman's trick. The ancients generally kept such patients in darkness, for they held that it was against their good to be frightened, and that the very darkness confers something towards the quieting of the spirit. But Asclepiades said that they should be kept in the light, since the very darkness was terrifying. Yet neither rule is invariable: for light disturbs one more, darkness another; and some are met with in whom no difference can be observed, either one way or the other. It is best, therefore, to make trial of both, and to keep that patient in the light who is frightened by darkness, and him in darkness who is frightened by light. And when there is no such difference, the patient if strong should be kept in a light room, if not strong he should be kept in a dim one. Now it is useless to adopt remedies when the delirium is at its height; for simultaneously fever is also increasing. So then there is nothing else to do than to restrain the patient, but when circumstances permit, relief must be given with haste. Asclepiades said that in such cases to let blood is to commit murder; following the line of reasoning, that there was no insanity unless with high fever, and that properly blood was let only during the stage of remission. But he himself in these cases sought to bring on sleep by prolonged rubbing, though it is the intensity of the fever which hinders sleep, and it is only during the remission that rubbing is of service. Hence he ought to have passed over this remedy also. What then is there to do? Many things may be rightly done in imminent danger, which otherwise ought to be omitted. And fever also, when continuous, has times during which, although it does not remit, yet it does not increase, and this time, although not the best, yet is the second best time for remedies; and at this time blood ought to be let, if the patient's strength allow it. There can be less question as to whether a motion should be induced. Next, after a day's interval, the head should be shaved bare and then fomented with water in which vervains or other repressive herbs have been boiled; alternatively it is proper first to foment, then to shave, and again to foment; and lastly to pour rose oil over the head and into the nostrils; also to hold to the nose rue pounded up in vinegar, and to excite sneezing by drugs efficacious for the purpose. Such things, however, should be done only in the case of those who are not lacking in strength; but if there is weakness, the head is merely moistened by rose oil to which thyme or something similar has been added. Whatever the patient's strength, the two herbs, bitter-sweet and pellitory, are beneficial, if the head is wetted with the juice expressed from both simultaneously. When the fever has remitted, recourse should be had to rubbing, more sparingly, however, in those who are over-cheerful, than in those who are too gloomy. But in dealing with the spirits of all patients suffering from this type of insanity, it is necessary to proceed according to the nature of each case. Some need to have empty fears relieved, as was done for a wealthy man in dread of starvation, to whom pretend legacies were from time to time announced. Others need to have their violence restrained as is done in the case of those who are controlled even by flogging. In some also untimely laughter has to be put a stop to by reproof and threats; in others, melancholy thoughts are to be dissipated, for which purpose music, cymbals, and noises are of use. More often, however, the patient is to be agreed with rather than opposed, and his mind slowly and imperceptibly is to be turned from the irrational talk to something better. At times also his interest should be awakened; as may be done in the case of men fond of literature, to whom a book may be read, correctly when they are pleased by it, or incorrectly if that very thing annoys them; for by making corrections they begin to divert their mind. Moreover, they should be pressed to recite anything they can remember. Some who did not want to eat were induced to do so, by be placed on couches between other diners. But certainly for all so affected sleep is both difficult and especially necessary; for under it many get well. Beneficial for this, as also for composing the mind itself, is saffron ointment with orris applied to the head. If in spite of this the patients are wakeful, some endeavour to induce sleep by draughts of decoction of poppy or hyoscyamus; others put mandrake apples under the pillow; others smear the forehead with cardamomum balsam or sycamine tears. This name I find used by practitioners, but there are no tears on the mulberry, although the Greeks call the mulberry sycaminon. What in fact is meant are the tears of a tree growing in Egypt, which they call in that country sycamoros. Many foment the face and head at intervals with a sponge dipped in a decoction of poppy heads. Asclepiades said that these things were of no benefit, because they often produced a change into lethargy (III.20); but he prescribed for the patient that during the first day he should keep from food, drink and sleep, in the evening water should be given him to drink, after which he should be rubbed with gentleness, but the rubber must not press hard even with the hand (II.14); during the day following the same was to be done, then in the evening gruel and water should be given and rubbing again applied: for by this he said we should succeed in bringing on sleep. This does happen sometimes, and to such a degree that Asclepiades allowed that excess of rubbing may even cause danger of lethargy. But if sleep does not thus occur, then at length it is to be procured by the above medicaments, having regard, of course, to the same moderation, which is necessary here also, for fear we may afterwards not be able to wake up the patient whom we wish to put to sleep. Sleep is also assisted by the sound of falling water near by, also rocking after food and at night, and especially the motion of a slung hammock (II.15). If blood has not been let before, and the patient's mind is unstable and sleep does not occur, it is not unfitting to apply a cup over an incision into the occiput, which can produce sleep because it relieves the disease. Now moderation in food is also to be observed: for the patient ought not to be surfeited lest it madden him, and he should certainly not be tormented by fasting lest he collapse through debility. The food should be light, in particular gruel, and hydromel for drink, of which three cups are enough, given twice a day in winter, and four times in summer.

> Latin: Incipiam ab insania, primamque huius ipsius partem adgrediar, quae et acuta et in febre est: ΦΡΕΝΗΣΙΝ Graeci appellant. Illud ante omnia scire oportet, interdum in accessione aegros desipere et loqui aliena. Quod non quidem leue est neque incidere potest nisi in febre uehementi; non tamen aeque pestiferum est: nam plerumque breue esse consueuit leuatoque accessionis impetu protinus mens redit. Neque id genus morbi remedium aliud desiderat, quam quod in curanda febre praeceptum est. Phrenesis uero tum demum est, cum continua dementia esse incipit, cum aeger, quamuis adhuc sapiat, tamen quasdam uanas imagines accipit: perfecta est, ubi mens illis imaginibus addicta est. Eius autem plura genera sunt: siquidem ex phreneticis alii tristes sunt; alii hilares; alii facilius continentur et intra uerba desipiunt; alii consurgunt et uiolenter quaedam manu faciunt; atque ex his ipsis alii nihil nisi impetu peccant, alii etiam artes adhibent summamque speciem sanitatis in captandis malorum operum occasionibus praebent, sed exitu deprenduntur. —Ex his autem eos, qui intra uerba desipiunt, aut leuiter etiam manu peccant, onerare asperioribus coercitionibus superuacuum est: eos, qui uiolentius ⟨s⟩e gerunt, uincire conuenit, ne uel sibi uel alteri noceant. Neque credendum est, si uinctus aliqui, dum leuari uinculis cupit, quamuis prudenter et miserabiliter loquitur, quoniam is dolus insanientis est. Fere uero antiqui tales aegros in tenebris habebant, eo quod is contrarium esset exterreri, et ad quietem animi tenebras ipsas conferre aliquid iudicabant. At Asclepiades, tamquam tenebris ipsis terrentibus, in lumine habendos eos dixit. Neutrum autem perpetuum est: alium enim lux, alium tenebrae magis turbant; reperiunturque, in quibus nullum discrimen deprehendi uel hoc uel illo modo possit. Optimum itaque est utrumque experiri, et habere eum, qui tenebras horret, in luce, eum qui lucem, in tenebris. At ubi nullum tale discrimen est, aeger, si uires habet, loco lucido; si non habet, obscuro continendus est. Remedia uero adhibere, ubi maxime furor urget, superuacuum est: simul enim febris quoque increscit. Itaque tum nihil nisi continendus aeger est: ubi uero res patitur, festinanter subueniendum est. Asclepiades perinde esse dixit his sanguinem mitti ac si trucidentur: rationem hanc secutus, quod neque insania esset, nisi febre intenta, neque sanguis nisi in remissione eius recte mitteretur. Sed ipse in his somnum ⟨multa frictione quaesiuit, cum et intentio febris somnum⟩ impediat et frictio non nisi in remissione eius utilis sit. Itaque hoc quoque auxilium debuit praeterire. Quid igitur est? Multa in praecipiti periculo recte fiunt alias omittenda. Et continuata quoque febris habet tempora, quibus, etsi non remittit, non tamen crescit, estque hoc ut non optimum, sic tamen secundum remediis tempus, quo, si uires aegri patiuntur, sanguis quoque mitti debet. Minus deliberari potest, an aluus ducenda sit. Tum interposito die conuenit caput ad cutem tondere, aqua deinde fouere, in qua uerbenae aliquae decoctae sint [uel ex reprimentibus]; aut prius fouere, deinde radere, et iterum fouere; ac nouissime rosa caput naresque implere, offerre etiam naribus rutam ex aceto contritam, mouere sternumenta medicamentis in id efficacibus. Quae tamen facienda sunt in is, quibus uires non desunt: si uero inbecillitas est, rosa tantum caput adiecto serpullo similique aliquo ⟨m⟩adefaciendum est. Vtiles etiam in quibuscumque uiribus duae herbae sunt, solanum et muralis, ⟨si⟩ simul ex utraque suco expresso caput impletur. Cum febris remisit, frictione utendum est, parcius tamen in is, qui nimis hilares quam in is, qui nimis tristes sunt. Aduersus autem omnium sic insanientium animos gerere se pro cuiusque natura necessarium est. Quorundam enim uani metus leuandi sunt, sicut in homine praediuite famem timente incidit, cui subinde falsae hereditates nuntiabantur. Quorundam audacia coercenda est, sicut in is fit, in quibus continendis plagae quoque adhibentur. Quorundam etiam intempestiuus risus obiurgatione et minis finiendus: quorundam discutiendae tristes cogitationes; ad quod symphoniae et cymbala strepitusque proficiunt. Saepius tamen adsentiendum quam repugnandum et paulatim et non euidenter ab iis, quae stulte dicentur, ad meliora mens eius adducenda. Interdum etiam elicienda ipsius intentio; ut fit in hominibus studiosis litterarum, quibus liber legitur ⟨a⟩ut recte, si delectantur, aut perperam, si id ipsum eos offendit: emendando enim conuertere animum incipiunt. Quin etiam recitare, si qua meminerunt, cogendi sunt. Ad cibum quoque quosdam non desiderantes reduxerunt i, qui inter epulantes eos conlocarunt. Omnibus uero sic adfectis somnus et difficilis et praecipue necessarius est: sub hoc enim plerique sanescunt. Prodest ad id atque etiam ad mentem ipsam conponendam crocinum unguentum cum irino in caput additum. Si nihilo minus uigila⟨n⟩t, quidam somnum moliuntur potui dando aquam, in qua papauer aut hyoscyamos decocta si⟨n⟩t, alii mandragorae mala puluino subiciunt, alii uel amomum uel sycamini lacrimam fronti inducunt. Hoc nomen apud medicos reperio. Sed cum Graeci morum sycaminon appellant, mori nulla lacrima est. Sic uero significatur lacrima arboris in Aegypto nascentis, quam ibi sycomoron appellant. Plurimi, decoctis papaueris corticibus, ex ea aqua spongia os et caput subinde fouent. Asclepiades ea superuacua esse dixit, quoniam in lethargum saepe conuerterent: praecepit autem, ut primo die a cibo, potione, somno abstineretur, uespere ei daretur potui aqua, tum frictio admoueretur lenis, ut ne manum quidem qui perfricaret uehementer inprimeret; postero deinde die isdem omnibus factis uespere ei daretur sorbitio et aqua, rursusque frictio adhiberetur: per hanc enim nos consecuturos, ut somnus accedat. Id interdum fit, et quidem adeo, ut illo confitente nimia frictio etiam lethargi periculum adferat. Sed si sic somnus non accessit, tum demum illis medicamentis arcessendus est, habita scilicet eadem moderatione, quae hic quoque necessaria est, ne, quem obdormire uolumus, excitare postea non possimus. Confert etiam aliquid ad somnum silanus iuxta cadens, uel gestatio post cibum et noctu, maximeque suspensi lecti motus. Neque alienum est, si neque sanguis ante missus est, neque mens constat, neque somnus accedit, occipitio inciso cucurbitulam admouere; quae quia leuat morbum, potest etiam somnum facere. Moderatio autem in cibo quoque adhibenda est: nam neque aeger implendus est, ne insaniat, neque ieiunio utique uexandus, ne inbecillitate in cardiacum incidat.

[¶3] There is another sort of insanity, of longer duration because it generally begins without a fever, but later excites a slight feverishness. It consists in depression which seems caused by black bile. Blood-letting is here of service; but if anything prohibit this, then comes firstly abstinence, secondly a clearance by white hellebore and a vomit. After either, rubbing twice a day is to be adopted; if the patient is strong, frequent exercise as well: vomiting on an empty stomach. Food of the middle class should be given without wine; but as often as I indicate this class of food, it should be understood that some of the weakest class of food also may be given, provided that this is not used alone; and that it is only the strongest class of food which is excluded. In addition to the above: the motions are to be kept very soft, causes of fright excluded, good hope rather put forward; entertainment sought by story-telling, and by games, especially by those with which the patient was wont to be attracted when sane; work of his, if there is any, should be praised, and set out before his eyes; his depression should be gently reproved as being without cause; he should have it pointed out to him now and again how in the very things which trouble him there may be a cause of rejoicing rather than of solicitude. When there is fever besides, it is to be treated like other fevers.

> Latin: Opus est cibo infirmo maximeque sorbitione, potione aquae mulsae, cuius ternos cyathos bis hieme, quater aestate dedisse satis est. Alterum insaniae genus est, quod spatium longius recipit, quia fere sine febre incipit, leues deinde febriculas excitat. Consistit in tristitia, quam uidetur bilis atra contrahere.—In hac utilis detractio sanguinis est: si quid hanc ⟨poterit⟩ prohibere, prima est abstinentia, secunda per album ueratrum uomitumque purgatio, post utrumlibet adhibenda bis die frictio est; si magis ualet, frequens etiam exercitatio: in ieiuno uomitus. Cibus sine uino dandus ex media materia est; quam quotiens posuero, scire licebit etiam ex infirmissima dari posse, dum ne ⟨illa sol⟩a quis utatur: ualentissima tantummodo esse remouenda. Praeter haec seruanda aluus est quam tenerrima, remouendi terrores, et potius bona spes offerenda; quaerenda delectatio ex fabulis ludisque, maxime quibus capi sanus adsuerat; laudanda, si qua sunt, ipsius opera et ante oculos eius ponenda; leuiter obiurganda uana tristitia; subinde admonendus, in is ipsis rebus, quae sollicitant, cur potius laetitiae quam sollicitudinis causa sit.

[¶4] The third kind of insanity is of all the most prolonged whilst it does not shorten life, for usually the patient is robust. Now of this sort there are two species: some are duped not by their mind, but by phantoms, such as the poets say Ajax saw when mad or Orestes; some become foolish in spirit.

> Latin: Si febris quoque accessit, sicut aliae febres curanda est. Tertium genus insaniae ⟨est⟩ ex his longissimum, adeo ut uitam ipsam non impediat; quod robusti corporis esse consueuit.

[¶5] If phantoms mislead, we must note in the first place whether the patients are depressed or hilarious. For depression black hellebore should be given as a purge, for hilarity white hellebore as an emetic; and if the patient will not take the hellebore in a draught, it should be put into his bread to deceive him the more easily; for if he has well purged himself, he will in great measure relieve himself of his malady. Therefore even if one does of the hellebore has little effect, after an interval another should be given. It should be known that a madman's illness is less serious when accompanied by laughter than by gravity. This also is an invariable precept in all disease, that when a patient is to be purged downwards, his belly is to be loosened beforehand, but confined when he is to be purged upwards.

> Latin: Huius autem ipsius species duae sunt: nam quidam imaginibus, non mente falluntur, quales insanientem Aiacem uel Orestem percepisse poetae ferunt: quidam animo desipiunt. Si imagines fallunt, ante omnia uidendum est, tristes an hilares sint. In tristitia nigrum ueratrum deiectionis causa, in hilaritate album ad uomitum excitandum dari debet; idque si in potione non accepit, in pane adiciendum est, quo facilius fallat: nam si bene se purgauerit, ex magna parte morbum leuabit. Ergo etiamsi semel datum ueratrum parum profecerit, interposito tempore iterum dari debet. Neque ignorare oportet leuiorem esse morbum cum risu quam cum serio insanientium.

[¶6] If, however, it is the mind that deceives the madman, he is best treated by certain tortures. When he says or does anything wrong, he is to be coerced by starvation, fetters and flogging. He is to be forced both to fix his attention and to learn something and to memorize it; for thus it will be brought about that little by little he will be forced by fear to consider what he is doing. To be terrified suddenly and to be thoroughly frightened is beneficial in this illness and so, in general, is anything which strongly agitates the spirit. For it is possible that some change may be effected when the mind has been withdrawn from its previous state. It also makes a difference, whether from time to time without cause the patient laughs, or is sad and dejected: for the hilarity of madness is better treated by those terrors I have mentioned above. If there is excessive depression light and prolonged rubbing twice a day is beneficial, as well as cold water poured over the head, and immersion of the body in water and oil. The following are general rules: the insane should be put to fatiguing exercise, and submitted to prolonged rubbing, and given neither fat meat nor wine: after the clearance the lightest food of the middle class is to be used; they should not be left alone or among those they do not know, or among those whom either they despise or disregard; they ought to have a change of scene, and if the mind returns, they should undergo the tossing incident to travel (II.15), once a year.

> Latin: Illud quoque perpetuum est in omnibus morbis, ubi ab inferiore parte purgandus aliquis est, uentrem eius ante soluendum esse; ubi a superiore, comprimendum. Si uero consilium insanientem fallit, tormentis quibusdam optime curatur. Vbi perperam aliquid dixit aut fecit, fame, uinculis, plagis coercendus est. Cogendus est et attendere et ediscere aliquid et meminisse: sic enim fiet, ut paulatim metu cogatur considerare quid faciat. Subito etiam terreri et expauescere in hoc morbo prodest, et fere quicquid animum uehementer turbat. Potest enim quaedam fieri mutatio, cum ab eo statu mens, in quo fuerat, abducta est. Interest etiam, ipse sine causa subinde rideat, an maestus demissusque sit: nam demens hilaritas terroribus iis, de quibus supra dixi, melius curatur. Si nimia tristitia, prodest lenis sed multa bis die frictio, item per caput aqua frigida infusa, demissumque corpus in aquam et oleum. Illa communia sunt, insanientes uehementer exerceri debere, multa frictione uti, neque pinguem carnem neque uinum adsumere; cibis uti post purgationem ex media materia quam leuissimis; non oportere esse uel solos uel inter ignotos, uel inter eos, quos aut contemnant aut neglegant; mutare debere regiones et, si mens redit, annua peregrinatione esse iactandos.

[¶7] Rarely, yet now and then, however, delirium is the produce of fright; this class of insanity, has similar sub-divisions, and is to be treated by the same species of dietetic regimen, except that, in this form of insaneness alone, wine is properly given.

> Latin: Raro sed aliquando tamen ex metu delirium nascitur. Quod genus insanientium specie * * * similique uictus genere curandum est, praeterquam quod in hoc insaniae genere solo recte uinum datur.

[¶8] 19. 19 That kind of affection which the Greeks call cardiac is a complete contrast to the foregoing diseases, although insane persons often pass over into it; in those the mind gives way, in this it holds firm. Indeed the illness is nothing other than excessive weakness of the body, which, while the stomach is languid, wastes away through immoderate sweating. And it may be recognized at once by the exiguous and weak pulsation of the blood vessels, while sweat, at once unaccustomed and excessive and untimely, breaks out all over the chest and neck, and even over the head, the feet and legs remaining more dry and cold; and it is a form of acute disease. The primary treatment is the application over the chest of repressant plasters; the secondary, to stop sweating. The latter is accomplished by bitter olive oil, or rose or quince or myrtle oil, with any of which the body is to be lightly anointed, then a salve made up of any of them is to be applied. If the sweating wins, the patient is to be smeared over with gypsum or litharge or cimolian chalk, or even powdered over with the same at intervals. A powder consisting of the pounded leaves of dried myrtle or of blackberry, or of the dried lees of dry and good wine, attains the same end; there are many simple materials, and if these are not at hand, it is useful enough to scatter on any dust from the road. In addition to this, moreover, in order that he may sweat less, the patient should be lightly covered and lie in a cool room, with the windows open, so that some breeze reaches him. A third aid is to help his weakness whilst in bed by food and wine. The food, whilst not much in quantity, should be given often, as well by night as by day, so as to nourish without becoming onerous. It should consist of the weakest class of materials and should be suitable to the stomach. Unless there is necessity, it is not well to hurry on to wine. But when fainting is apprehended, then there is given both bread crumbled into the wine and wine by itself dry indeed yet thin, undiluted, lukewarm, at intervals liberally, and if the patient is taking but little food, polenta may be scattered into the wine; and that wine should not be lacking in strength, yet not over-strong the patient may properly drink three quarters of a litre, and even more if of large build, in the course of a day and night: if he does not take his food, the patient should be anointed, should have cold water poured over him, and after that be given food. But if the stomach has become relaxed and retains but little, let the patient vomit as he will, whether before or after food, and after vomiting take food again. If even after that food is not retained, he should sip a cupful of wine, and another after the interval of an hour. If the stomach returns this wine also, he should be rubbed all over with pounded onions, which as they dry cause the stomach to retain the wine, and as a result, cause heat to return throughout the body, and a forceful pulsation to the blood vessels. The last resource is the introduction into the bowel from below of barley or spelt gruel, since that too supports the patient's strength. Should he feel hot, it is not inappropriate to hold to his nostrils a restorative such as rose oil in wine; if he has cold extremities, they should be rubbed by hands anointed and warmed. If we can by these measures obtain a diminution in the severity of the sweating, and a prolongation of life, time itself now begins to come to our aid. When the patient appears to have reached safety, rapid release into the same state of weakness is still to be feared; hence along with a gradual withdrawal of wine, the patient ought each day to take stronger food, until a sufficiency of bodily strength is gained.

> Latin: 19. His morbis praecipue contrarium est id genus, quod cardiacum a Graecis nominatur, quamuis saepe ad eum phrenetici transeunt: siquidem mens in illis labat, in hoc constat. Id autem nihil aliud est quam nimia inbecillitas corporis, quod stomacho languente inmodico sudore digeritur. Licetque protinus scire id esse, ubi uenarum exigui inbecillique pulsus sunt, sudor autem et supra consuetudinem et modo * et tempore ex toto thorace et ceruicibus atque etiam capite prorumpit, pedibus tantummodo et cruribus siccioribus atque frigentibus; acutique id morbi genus est. Curatio prima est supra praecordia imponere quae reprimant cataplasmata, secunda sudorem prohibere. Id praestat acerbum oleum uel rosa uel melinum aut myrteum, quorum aliquo corpus leuiter perunguendum, ceratumque ex aliquo horum tum inponendum est. Si sudor uincit, delinendus homo est uel gypso uel spuma argentea uel Cimolia creta, uel etiam subinde horum puluere respergendus. Idem praestat puluis ex contritis aridi myrti uel rubi foliis, aut ex austeris et boni uini arida faece; pluraque similia sunt, quae si desunt, satis utilis est quilibet ex uia puluis iniectus. Super haec uero, quo minus corpus insudet, leui ueste debet esse contectus, loco non calido, fenestris patentibus, sic ut perflatus quoque aliquis accedat. Tertium auxilium est inbecillitati iacentis cibo uinoque succurrere. Cibus non multus quidem, sed saepe tamen nocte ac die dandus est, ut nutriat, neque oneret. Is esse debet ex infirmissima materia et stomacho aptus. Nisi si necesse est, ad uinum festinare non oportet. Si uerendum est, ne deficiat, tum et intrita ex hoc, et hoc ipsum austerum quidem, sed tamen tenue, meraculum, egelidum subinde et liberaliter dandum est, adiecta polenta, si modo is aeger parum cibi adsumit; idque uinum esse debet neque nullarum uirium, neque ingentium: recteque toto die ac nocte uel tres heminas aeger bibet; si uastius corpus est, plus etiam: si cibum non accipit, perunctum perfundere aqua frigida ante conueniet, et tunc dare. Quod si stomachus resolutus parum continet, et ante cibum et post eum sponte uomere oportet, rususque post uomitum cibum sumere. Si ne id quidem manserit, sorbere uini cyathum, interpositaque hora sumere alterum. Si id quoque stomachus reddiderit, totum corpus bulbis contritis superinlinendum est; qui ubi inaruerunt, efficiunt, ut uinum in stomacho contineatur, exque eo toti corpori calor, uenisque uis redeat. Vltimum auxilium est in aluum tisanae uel halicae cremorem ex inferioribus partibus indere, siquidem id quoque uires tuetur. Neque alienum est naribus quoque aestuantis admouere quod reficiat [id est rosa et uinum]: si qua in extremis partibus frigent, unctis et calidis manibus fouere. Per quae si consequi potuimus, ut et sudoris impetus minuatur, et uita prorogetur, incipit iam tempus ipsum esse praesidio. Vbi esse in tuto uidetur, uerendum tamen, ne in eandem infirmitatem cito recidat; itaque uino tantummodo remoto cotidie ualidiorem cibum debet adsumere, donec satis uirium corpori redeat.

[¶9] 20. 20 There is also another disease, a contrast in a different way to the phrenetic. In the latter sleep is got with great difficulty, and the mind is disposed to any foolhardiness; in this disease there is a pining away, and an almost insurmountable need of sleep. The Greeks name it lethargy. And it also is an acute sort, and unless remedied, quickly kills. Some strive to excite these patients by applying at intervals medicaments to promote sneezing, and those which stimulate by their offensive odour, such as burning pitch, unscoured wool, pepper, hellebore, castoreum, vinegar, garlic, onion. Moreover, they burn near them galbanum, hair or hartshorn, or when that is not at hand, some other kind of horn, for these when burnt give out an offensive odour. One Tharrias said, indeed, that this affection is a sort of feverish paroxysm, and that the patient is relieved when that remits, hence those without keep on irritating such patients do harm uselessly. But the important point is whether the patient wakes up with the remission; or whether the fever is either not relieved, or else it is relieved and yet sleep still oppresses him. For if the patient wakes up, it is needless to treat him as if in a stupor; for he is not made better by keep in him awake, but if he is better he keeps awake of himself. If the sleepiness in us interrupted the patient must certainly be aroused, but only at those times when the fever is of the slightest, in order that he may both make a natural evacuation and take food. Now a most powerful excitant is cold water poured suddenly over him; therefore when the fever has remitted, and he has been anointed freely, he should have three or four jarfuls poured over his head. But this measure should be employed only when the patient's breathing is regular, and the parts below the ribs soft: otherwise those are to be preferred which have been mentioned above. Such is the most suitable procedure, so far as concerns sleeplessness. But in order to cure, the head is to be shaved, and then fomented with vinegar and water in which laurel or rue leaves have been boiled. On the following day castoreum may be applied, or rue pounded up in vinegar, or laurel berries or ivy with rose oil and vinegar; mustard put to the nostrils is particularly efficacious both for arousing the patient, and when put on the head or forehead for driving out the disease itself. Rocking is also advantageous in this malady; and most of all food given opportunely, that is in the greatest degree of remission that can be found. Now gruel is most fitting until the disease begins to decrease; so if there is a severe paroxysm every day, it is given daily; if every other day, after a more severe paroxysm, gruel, and after a slighter paroxysm, hydromel. Wine is also of no mean service, when given at the proper time all with suitable food. But if this kind of torpor attacks the body after prolonged fevers, all the other measures are to be carried out, in the same way, and in addition three or four hours before the paroxysm castoreum is administered, mixed with scammony if the bowels are costive, if not, then by itself in water. If the parts below the ribs are soft, food should be given more freely; if hard, the patient must subsist on the gruel mentioned above, whilst something is to be applied to the parts below the ribs to repress and mollify at the same time.

> Latin: 20. Alter quoque morbus est aliter phrenetico contrarius. In eo difficilior somnus, prompta ad omnem audaciam mens est: in hoc marcor et inexpugnabilis paene dormiendi necessitas. Lethargum Graeci nominarunt. Atque id quoque genus acutum est, et nisi succurritur, celeriter iugulat.—Hos aegros quidam subinde excitare nituntur admotis is, per quae sternu[ta]menta euocentur, et is, quae odore foedo mouent, qualis est pix cruda, lana sucida, piper, ueratrum, castoreum, acetum, ⟨alium, cepa. Iuxta etiam⟩ galbanum incendunt, aut pilos aut cornu ceruinum; si id non est, quodlibet aliud: haec enim cum conburuntur, odorem foedum mouent. Tharrias uero quidam accessionis id malum esse dixit, leuarique, cum ea decessit; itaque eos, qui subinde excitant, sine usu male habere. Interest autem, in decessione expergiscatur aeger, an aut febris non leuetur aut leuata quoque ea somnus urgue⟨a⟩t. Nam si expergiscitur, adhibere †eum sopito superuacuum est: neque enim uigilando melior fit, sed per se, si melior est, uigilat. Si uero continens ei somnus est, utique excitandus est, sed iis temporibus, quibus febris leuissima est, ut et excernat aliquid et sumat. Excitat autem ualidissime repente aqua frigida infusa. Post remissionem itaque perunctum multo oleo corpus tribus aut quattuor amphoris totum per caput perfundendum est. Sed hoc utemur, si aequalis aegro spiritus erit, si mollia praecordia: sin aliter haec erunt, ea potiora, quae supra comprehensa sunt. Et quod ad somnum quidem pertinet, commodissima haec ratio est. Medendi autem causa caput radendum, deinde posca fouendum est, in qua laurus aut ruta decocta sit. Altero die inponendum castoreum, aut ruta ex aceto contrita aut lauri bacae aut hedera cum rosa et aceto; praecipueque proficit ⟨et⟩ ad excitandum hominem naribus admotum et ad morbum ipsum depellendum capiti frontiue inpositum sinapi. Gestatio etiam in hoc morbo prodest, maximeque oportune cibus datus, id est in remissione, quanta maxime inueniri poterit. Aptissima autem sorbitio est, donec morbus decrescere incipiat, sic ut, si cotidie grauis accessio est, haec cotidie detur; si alternis, post grauiorem sorbitio, post leuiorem mulsa aqua. Vinum quoque cum tempestiuo cibo datum non mediocriter adiuuat. Quod si post longas febres eiusmodi torpor ⟨corpori⟩ accessit, cetera eadem seruanda sunt: ante accessionem autem tribus quattuorue horis castoreum, si uenter adstrictus est, mixtum cum scamonea; si non est, per se ipsum cum aqua dandum est. Si praecordia mollia sunt, cibis utendum plenioribus; si dura, in isdem sorbitionibus subsistendum, inponendumque praecordiis quod simul et reprimat et molliat.

[¶10] 21. 21 Now the foregoing is indeed an acute disease. But a chronic malady may develop in those patients who suffer from a collection of water under the skin, unless this is dispersed within the first days. The Greeks call this hydrops. And of this there are three species: sometimes the belly being very tense, there is within a frequent noise from the movement of wind; sometimes the body is rendered uneven by swellings rising up here and there all over; sometimes the water is drawn all together within, and is moved with the movement of the body, so that its movement can be observed. The Greeks call the first tympanites, the second leukophlegmasia or hyposarka, the third ascites. The characteristic common to all three species is an excessive abundance of humour, owing to which in these patients ulcerations even do not readily heal. This is a malady which often begins of itself, often it supervenes upon a disease of long standing, upon quartan fever especially (III.15, 16). It is relieved more easily in slaves than in freemen, for since it demands hunger, thirst, and a thousand other troublesome treatments and prolonged endurance, it is easier to help those who are easily constrained than those who have an unserviceable freedom. But even those who are in subjection, if they cannot exercise complete self-control, are not brought back to health. Hence a not undistinguished physician, a pupil of Chrysippus, at the court of King Antigonus, held that a certain friend of the king, noted for intemperance, could not be cured, although but moderately affected by that malady; and when another physician, Philip of Epirus, promised that he would cure him, the pupil of Chrysippus replied that Philip was regarding the disease, he the patient's spirit. Nor was he mistaken. For although the patient was watched with the greatest diligence, not only by his physician but by the king as well, by devouring his poultices and by drinking his own urine, he hurried himself headlong to his end. At the beginning, however, cure is not difficult, if there is imposed upon the body thirst, rest, and abstinence; but if the malady has become of long standing, it is not dispersed except with great trouble. They say, however, that Metrodorus, a pupil of Epicurus, when afflicted with this disease, and unable to bear with equanimity necessary thirst, after abstaining for a long while, was accustomed to drink and then to vomit. Now if what has been drunk is then returned, distress is much reduced; but if retained in the stomach, it increases the disorder; and so it must not be tried in every case. But if there is also fever, this is first of all to be overcome by the methods which have been prescribed concerning possible relief in such cases (III.4‑17). If the patient has become free from fever, then at length we must go on to those measures by which the disorder itself is usually treated. And here, whatever the species, so long as the disease has not taken too firm a hold, the same remedies are required. The patient should walk much, run a little, and his upper parts in particular are to be rubbed while he holds his breath. Sweating is also to be procured, not only by exercise, but also by heated sand, or in the Laconicum, or with a clibanus and such-like; especially serviceable are the natural and dry sweating places, such as we have in the myrtle groves above Baiae. The bath and moisture of every kind is wrong. Pills composed of wormwood two parts, myrrh one part, are given on an empty stomach. Food should be of the middle class indeed, but, of the harder kind; no more of drink is to be given than to sustain life, and the best is that which stimulates urine. But that, however, is better brought about by diet than by medicament. If, nevertheless, the matter is urgent, one of those drugs which are efficacious is to be made into a decoction, and that given as a draught. Now this faculty seems to belong to iris root, spikenard, saffron, cinnamon, cassia, myrrh, balsam, galbanum, ladanum, oenanthe, opopanax, cardamomum, ebony, cypress seeds, the Taminian berry which the Greeks call staphis agria, southernwood, rose leaves, sweet flag root, bitter almonds, goat's marjoram, styrax, costmary, seeds of rush, square and round (the Greeks call the former cyperon, the latter schoinon): whenever I use these terms I refer, not to native plants, but to such as are imported among spices. The mildest of these, however, are to be tried first, such as rose leaves or spikenard. A dry wine is beneficial, but it must be very thin. It is good besides to measure every day with string the circumference of the abdomen, and to put a mark where it surrounds the belly, then the day following to see whether the body is fuller or thinner, for the thinning shows a yielding to the treatment. Nor is it unserviceable to take the measure of his drink, and of his urine; for if more humour is evacuated than taken in, then at least there is hope of recovery. Asclepiades has put it on record that for a patient who had lapsed from a quartan into dropsy, he employed for two days abstinence and rubbing, on the third day, the patient having all become freed from both the fever and the water, he gave food and wine.

> Latin: 21. Sed hic quidem acutus est morbus. Longus uero fieri potest eorum, quos aqua inter cutem male habet, nisi primis diebus discussus est: hydropa Graeci uocant. Atque eius tres species sunt. Nam modo uentre uehementer intento creber intus ex motu spiritus sonus est; modo corpus inaequale est tumoribus ⟨aliter⟩ aliterque per totum id orientibus; modo intus in unum aqua contrahitur et moto corpore ita mouetur, ut impetus eius conspici possit. Primum ΤΥΜΠΑΝΕΙΤΗΝ, secundum ΛΕΥΚΟΦΛΕΓΜΑΤΙΑΝ uel ΥΠΟ ΣΑΡΚΑ, tertium ΑΣΚΕΙΤΗΝ Graeci nominarunt. Communis tamen omnium est umoris nimia abundantia, ob quam ne ulcera quidem in his aegris facile sanescunt. Saepe uero hoc malum per se incipit, saepe alteri uetusto morbo maximeque quartanae superuenit. Facilius in seruis quam in liberis tollitur, quia, cum desideret famem, sitim, mille alia taedia longamque patientiam, promptius is succurritur, qui facile coguntur, quam quibus inutilis libertas est. Sed ⟨ne⟩ i quidem, qui sub alio sunt, si ex toto sibi temperare non possunt, ad salutem perducuntur. Ideoque * non ignobilis medicus, Chrysippi discipulus, apud Antigonum regem, amicum quendam eius, notae intemperantiae, mediocriter eo morbo inplicitum, negauit posse sanari; cumque alter medicus Epirotes Philippus se sanaturum polliceretur, respondit illum ad morbum aegri respicere, se ad animum. Neque eum res fefellit. Ille enim cum summa diligentia non medici tantummodo, sed etiam regis custodiretur, tamen malagmata sua deuorando bibendoque suam urinam in exitium se praecipitauit. Inter initia tamen non difficilis curatio est, si inperata ⟨sunt⟩ corpori sitis, requies, inedia: at si malum inueterauit, non nisi magna mole discutitur. Metrodorum tamen Epicuri discipulum ferunt, cum hoc morbo temptaretur, nec aequo animo necessariam sitim sustineret, ubi diu abstinuerat, bibere solitum, deinde euomere. Quod si redditur quicquid receptum est, multum taedio demit; si a stomacho retentum est, morbum auget; ideoque in quolibet temptandum non est. Sed si febris quoque est, haec in primis summouenda est per eas rationes, per quas huic succurri posse propositum est. Si sine febre aeger est, tum demum ad ea ueniendum est, quae ipsi morbo mederi solent. Atque hic quoque, quaecumque species e⟨s⟩t, si nondum nimis occupauit, isdem auxiliis opus est. Multum ambulandum, currendum aliquid est, superiores maxime partes sic perfricandae, ut spiritum ipse contineat. Euocandus est sudor non per exercitationem tantum, sed etiam in harena calida uel Laconico uel clibano similibusque aliis; maximeque utiles naturales et siccae sudationes sunt, quales super Baiias in murtetis habemus. Balineum atque omnis umor alienus est. Ieiuno recte catapotia dantur, facta ex apsinthi duabus, murrae tertia parte. Cibus esse debet ex media quidem materia, sed tamen generis durioris: potio non ultra danda est quam ut uitam sustineat, optimaque est, quae urinam mouet. Sed id ipsum tamen moliri cibo quam medicamento melius est. Si tamen res coget, ex is aliquid, quae id praestant, erit decoquendum, eaque aqua potui danda. Videntur autem hanc facultatem habere iris, nardum, crocum, cinnamomum, casia, murra, balsamum, galbanum, ladanum, oenanthe, panaces, cardamomum, hebenus, cupressi semen, uua t⟨a⟩minia quam ΣΤΑΦΙΔΑ ΑΓΡΙΑΝ Graeci nominant, habrot⟨o⟩num, rosae folia, acorum, amarae nuces, tragoriganum, styrax, costum, iunci quadrati et rotundi semen: illud cyperon, hoc ΣΧΟΙΝΟΝ Graeci uocant; quae quotiens posuero, non quae hic nascuntur, sed quae inter aromata adferuntur, significabo. Primo tamen quae leuissima ex his sunt id est rosae folia uel nardi spica temptanda est. Vinum quoque utile est austerum, sed quam tenuissimum. Commodum est etiam lino cotidie uentrem metiri et, qua conprehendit aluum, notam imponere, posteroque die uidere, plenius corpus sit an extenuetur: id enim, quod extenuatur, medicinam sentit. Neque alienum est metiri et potionem eius et urinam: nam si plus umoris excernitur quam insumitur, ita demum secundae ualetudinis spes est. Asclepiades in eo, qui ex quartana in hydropa deciderat, se abstinentia bidui et frictione usum, tertio die iam et febre et aqua liberato cibum et uinum dedisse memoriae prodidit.

[¶11] So far the prescription can be common to all the species; if the disease is more severe, the method of treatment must be different. For instance, if there is flatulence and owing to that pain is frequent, a vomit is beneficial, either daily or on alternate days, after food; hot and dry foments are to be applied. If the pain is not ended by these, dry cuppings are needed, but if the torment is not relieved even by these, skin incisions are made and then the cups applied. If cupping does no good, the last resource is to infuse hot water copiously into the rectum and draw it out again. Nay even vigorous rubbing with oil and any one of the heating agents should be carried out three or four times a day, but in this rubbing the abdomen is to be left out; but to this mustard should be applied repeatedly until the skin is excoriated; and ulcerations are to be set up in many places upon the abdominal wall by means of the red hot cautery, and the ulcers to be kept open for some time. It is useful also to suck a boiled squill bulb; but for a long while after such attacks of flatulence the patient should abstain from everything that causes it.

> Latin: Hactenus communiter de omni specie ⟨prae⟩cipi potest: si uehementius malum est, diducenda ratio curandi est. Ergo si inflatio et ex ea dolor creber est, utilis cotidianus aut altero quoque die post cibum uomitus est; fomentis siccis calidisque utendum est. Si per haec dolor non finitur, necessariae sunt sine ferro cucurbitulae: si ne per has quidem tormentum tollitur, incidenda cutis est; tum his utendum est. Vltimum auxilium est, si cucurbitulae nihil profuerunt, per aluum infundere copiosam aquam calidam eamque recipere. Quin etiam cotidie ter quaterque opus est uti frictione uehementi, cum oleo et quibusdam calefacientibus. Sed in hac frictione a uentre abstinendum est: inponendum uero in eum crebrius sinapi, donec cutem erodat; ferramentisque candentibus pluribus locis uenter exulcerandus est; seruanda ulcera diutius. Vtiliter etiam scilla cocta delinguitur; sed diu post has infl⟨a⟩tiones abstinendum est ab omnibus inflantibus.

## 11. Book III · chapters 21–27

Source: https://scriptura.si/works/celsus-on-medicine/11/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/11/#p-N

[¶0] But if the affection is that named leukophlegmasia, the swollen parts should be exposed to the sun, but not too much lest feverishness ensue. If the sun is over-strong, the head is to be covered, and rubbing is to be used with hands just moistened with water to which salt and soda and a little oil is added, taking care that the hands of children or of women are employed, for theirs is a softer touch; and this ought to be done, should the patient's strength allow of it, for a whole hour before noon, or for half an hour after noon. Repressing poultices are of benefit, especially for the more delicate. Also an incision should be made our fingers' breadth above the ankle on the inner side through which humour may discharge freely for some days, and the actual swellings ought to be incised by deep cuts; the body also is to be shaken up by much rocking (II.15); then after the incisions have formed a scab, both exercises and food must be increased, until the patient is restored to his former state of health. The food should be nutritious and glutinous, mostly meat. The wine, when the stomach permits of it, should be rather sweet, but should be drunk alternately with water every two or three days. The seeds of the wolf's-milk plant, which grows to a large size on the seacoast, may be advantageously administered in a draught with water. If the patient is strong enough, he should suck a boiled squill bulb as noted above. There are many authorities who would have the swelling beaten with inflated ox-bladders.

> Latin: At si id uitium est, cui ΛΕΥΚΟΦΛΕΓΜΑΤΙΑ nomen est, eas partes, quae tument, subicere soli oportet, sed non nimium, ne febricula incidat. Si is uehementior est, caput uelandum est, utendumque frictione, madefactis tantum manibus aqua, cui sal et nitrum et olei paululum sit adiectum, sic ut aut pueriles aut muliebres manus adhibeantur, quo mollior earum tactus sit; idque, si uires patiuntur, ante meridiem tota hora, post meridiem semihora fieri oportet. Vtilia etiam sunt cataplasmata, quae reprimunt, maximeque si corpora teneriora sunt. Incidendum quoque super talum quattuor fere digitis ex parte interiore, qua per aliquot dies frequens umor feratur, atque ipsos tumores incidere altis plagis oportet; concutiendumque multa gestatione corpus est; atque ubi inductae uulneribus cicatrices sunt, adiciendum et exercitationibus et cibis, donec corpus ad pristinum statum reuertatur. Cibus ualens esse debet et glutinosus, maximeque caro. Vinum, si per stomachum licet, dulcius, sed ita ut inuicem biduo triduoue modo aqua, modo id bibatur. Prodest etiam lactucae marinae, quae grandis iuxta maria nascitur, semen cum aqua potui datum. Si ualens est qui id accipit, et scilla cocta, sicut supra dixi, delinguitur.

[¶1] But if the form of the affection is that in which much water is drawn into the belly, the patient should take walks, but with much more moderation, and have applied a dispersive poultice, covered with three folds of linen, bandaged on not too tightly; a practice begun by Tharrias, which I see many have followed. If the liver or spleen is plainly affected, a fatty fig bruised with honey should be put on over it: if the belly is not dried up by such remedies, and in spite of them the humour is in large amount, aid must be given in a quicker way, by giving issue to it through the belly itself (VII.15). I am quite aware that such a way of treatment was disapproved of by Erasistratus, for he deemed the disease to be one of the liver, that therefore it was the liver which had to be rendered sound, and that it was of no use to let out water which, if that organ is diseased, will continually be reproduced. But firstly, the disease is not primarily one of that organ alone; for it occurs when the spleen is affected, and there is a general diseased condition of the body; further, granted that it begins from the liver, the water unnaturally collected there, unless evacuated, injures both the liver and all the rest of the internal organs. And it is agreed, nevertheless, that the body generally has to be treated; for the mere evacuation of the humour does not restore health, but it affords an opportunity for medicaments which the accumulation within impedes. And indeed it is not in dispute that not everybody with this affection can be so treated, but only the young and robust, in whom fever is wholly absent, or who have sufficiently long intermissions. For those are unfitted for this treatment whose stomach is corrupted, or who have lapsed into the malady owing to black bile, or who have a diseased condition of body. But food on the day the humour is first let out is not needed unless strength fails. On the days following, both food and wine, undiluted indeed, but not overmuch in quantity, should be given; little by little the patient should be submitted to exercise, rubbing, sun-heat, sweating, a sea voyage, along with a suitable diet, until he has completely recovered. Such a case requires a bath seldom, more often an emetic on an empty stomach; in summer a swim in the sea is beneficial. For a long while after his recovery, however, the practice of venery is unsuitable.

> Latin: Auctoresque multi sunt inflatis uesicis pulsandos tumores esse. Si uero id genus morbi est, quo in uterum multa aqua contrahitur, ambulare, sed magis modice, oportet, malagma quod digerat inpositum habere, idque ipsum superimposito triplici panno fascia, non nimium tamen uehementer, adstringere; quod a Tharria profectum esse seruatum a pluribus uideo. Si iecur aut lienem adfectum esse manifestum est, ficum pinguem contusam adiecto melle superponere: si per talia auxilia uenter non siccatur, sed umor nihilo minus abundat, celeriore uia succurrere, ut is per uentrem ipsum emittatur. Neque ignoro displicuisse Erasistrato hanc curandi uiam: morbum enim hunc iocineris putauit: ita illud esse sanandum, frustraque aquam emitti, quae uitiato illo subinde nascatur. Sed primum non huius uisceris unius hoc uitium est: nam et liene adfecto et in totius corporis malo habitu fit; deinde ⟨ut inde⟩ coeperit, tamen aqua, nisi emittitur, quae contra naturam ibi substitit, et iocineri et ceteris partibus interioribus nocet. Conuenitque corpus nihilo minus esse curandum: neque enim sanat emissus umor, sed medicinae locum facit, quam intus inclusus impedit. Ac ne illud quidem in controuersiam uenit, quin non omnes in hoc morbo sic curari possint, sed iuuenes robusti, qui uel ex toto carent febre, uel certe satis liberales intermissiones habent. Nam quorum stomachus corruptus est, quiue ex atra bile in hoc deciderunt, quiue malum corporis habitum habent, idonei huic curationi non sunt. Cibus autem, quo die primum umor emissus est, superuacuus est, nisi ⟨si⟩ uires desunt. Insequentibus diebus et is et uinum meracius quidem, sed non ita multum dari debet; paulatimque euocandus aeger est ad exercitationes, frictiones, solem, sudationes, nauigationes et idoneos cibos, donec ex toto conualescat. Balneum rarum res amat, frequentiorem in ieiunio uomitum. Si aestas est, in mari natare commodum est. Vbi conualuit aliquis, diu tamen alienus ei ueneris usus est.

[¶2] 22. 22 Longer and more dangerous is the illness which follows when wasting disease attacks a patient. This also has several species. There is one in which the body is not nourished enough, and as there is some natural loss going on all the time without replacement, extreme emaciation ensues, which unless countered, kills. The Greeks call it atrophia. It proceeds commonly from two causes: for either from excessive dread the patient consumes less, or from excessive greed more, than he ought: thus either the deficiency weakens, or the superfluity undergoes decomposition. There is another species which the Greeks call cachexia, in which owing to bad habit of body all the aliments undergo decomposition. This occurs generally in those whose bodies have become vitiated by prolonged disease, and even if they have rid themselves of this, yet they do not regain health; or when the system has become affected by bad medicaments; or for a long while necessaries of life have been deficient; or unusual or unserviceable food has been consumed; or something similar has happened. In this case besides the wasting, it not unfrequently occurs that the skin surface undergoes irritation by persistent pustulation or ulceration, or else some parts of the body become swollen. The third species, which the Greeks call phthisis, is the most dangerous by far. The malady usually arises in the head, thence it drips into the lung; there ulceration supervenes, from this a slight feverishness is produced, which even after it has become quiescent nevertheless returns; there is frequent cough, pus is expectorated, sometimes blood-stained. When the sputum is thrown upon a fire, there is a bad odour, hence those who are in doubt as to the disease employ this as a test.

> Latin: 22. Diutius saepe et periculosius tabes eos male habet, quos inuasit. Atque huius quoque plures species sunt. Vna est, qua corpus non alitur, et naturaliter semper aliquis decedentibus, nullis uero in eorum locum subeuntibus, summa macies oritur, et nisi occurritur, tollit: ΑΤΡΟΦΙΑΝ Graeci uocant. Ea duabus fere de causis incidere consueuit: aut enim nimio timore aliquis minus, aut auiditate nimia plus quam debet adsumit: ita quod uel deest infirmat, uel quod superat corrumpitur. Altera species est quam Graeci †ΚΑΚΕΞΙΑΝ appellant, ubi malus corporis habitus est, ideoque omnia alimenta corrumpuntur. Quod fere fit, quom longo morbo uitiata corpora, etiamsi illo uacant, refectionem tamen non accipiunt; aut cum malis medicamentis corpus adfectum est; aut cum diu necessaria defuerunt; aut cum inusitatos aut inutiles cibos aliquis adsumpsit, aliquidue simile incidit. Hic praeter tabem illud quoque nonnumquam accidere solet, ut per adsiduas pusulas aut ulcera summa cutis exasperetur, uel aliquae corporis partes intumescant. Tertia est longeque periculosissima species, quam Graeci ⟨pthisin⟩ nominarunt. Oritur fere a capite, inde in pulmonem destillat; huic exulceratio accedit; ex hac febricula leuis fit, quae etiam cum quieuit, tamen repetit; frequens tussis est, pus excreatur, interdum cruentum aliquid. Quicquid excreatum est, si in ignem impositum est, mali odoris est. Itaque qui de morbo dubitant, hac nota utuntur.

[¶3] As these are the species of wasting, the first consideration should be, which the patient is suffering from: next, if it is only that the body is not being sufficiently nourished, we must look to the cause of this, and if the patient has been consuming less food than he ought, addition is to be made, but only a little at a time, lest if the system becomes overloaded suddenly by an unaccustomed quantity, it may hinder digestion. On the other hand, if the patient has been consuming more than he ought, he should first fast for a day, then begin with a scanty amount of food, increasing daily until he reaches the proper amount. Further, he should walk in places as little cold as possible, whilst avoiding the sun; he should also use the hand exercises; if he is weaker, he should be rocked, anointed and then rubbed, doing as much as possible of this himself, several times each day, before and after meals, until he sweats — sometimes adding heating agents to the oil. It is advantageous on an empty stomach to pinch up and pull on the skin in a number of places, in order to relax it, or to do the same by applying a pitch plaster and at once pulling it off. The bath also is sometimes beneficial, but only after a scanty meal. And whilst actually in the solium, some food may properly be taken, also immediately after a rubbing, when applied without the bath. The food too should be of the kinds easily digested, which are most nutritious. Hence also the use of wine is necessary, but it should be dry; urination is to be stimulated.

> Latin: Cum haec genera tabis sint, animaduertere primum oportet, quid sit, qui laboretur; deinde, si tantum non ali corpus apparet, causam eius attendere, et si cibi minus aliquis quam debet adsumpsit, adicere, sed paulatim, ne, si corpus insuetum subita multitudine onerauerit, concoctionem impediat. Si uero plus iusto qui adsumere solitus est, abstinere uno die, deinde ab exiguo cibo incipere, cotidie adicere, donec ad iustum modum perueniat. Praeter haec conuenit ambulare locis quam minime frigidis, sole uitato; per manus quoque exerceri: si infirmior est, gestari, ungui, perfricari, si potest, maxime per se ipsum, saepius eodem die, et ante cibum et post eum, sic ut interdum oleo quaedam adiciantur calfacientia, donec insudet. Prodestque in ieiuno prendere per multas partes cutem et adtrahere, ut relaxetur; aut inposita resina et abducta subinde idem facere. Vtile est etiam interdum balneum, sed post cibum exiguum. Atque in ipso solio recte cibi aliquid adsumitur, aut si sine hoc frictio fuit, post eam protinus. Cibi uero esse debent ex iis, quae facile concoquantur: qui maxime alunt. Ergo uini quoque, sed austeri, necessarius usus est; mouenda urina.

[¶4] But if there is a bad habit of body, the patient should abstain at first, next have the bowels moved by a clyster, then take food a little at a time, with exercise, anointing and rubbing. A frequent bath is useful for these cases, but on an empty stomach, prolonged till there is sweating. Abundant and varied and succulent food is necessary, such as will less readily decompose, and dry wine. If there is no relief from anything else, blood should be let, but only a little each day for several days; with this proviso, that the other remedies also should be employed as described.

> Latin: At si malus corporis habitus est, primum abstinendum est, deinde aluus ducenda, tum paulatim cibi dandi, adiectis exercitationibus, ⟨unctionibus, frictionibus⟩. Vtilius his frequens balineum est, sed ieiunis, ⟨etiam⟩ usque sudorem. Cibis uero opus est copiosis, uariis, boni suci, quique etiam [si] minus facile corrumpantur, uino austero. Si nihil reliqua proficiunt, sanguis mittendus est, sed paulatim cotidieque pluribus diebus, cum eo ut cetera quoque eodem modo seruentur.

[¶5] But if there is more serious illness and a true phthisis, it is necessary to counter it forthwith at the very commencement; for when of long standing it is not readily overcome. If the strength allows of it a long sea voyage is requisite with a change of air, of such a kind that a denser climate should be sought than that which the patient quits; hence the most suitable is the voyage to Alexandria from Italy. And the body ought generally to be able to bear this in the early stages, since this disease arises especially during the most stable part of life, namely between eighteen and thirty-five years of age. If the patient's weak state does not allow of the above, the best thing for him is to be rocked in a ship without going far away. If anything prevents a sea voyage, the body is to be rocked in a litter, or in some other way. Further, the patient should keep away from business, and everything disturbing to his spirit; he should indulge in sleep; he is to be warned against catarrh, lest that should make worse what the treatment is relieving; indigestion should be avoided, also the sun and cold; the mouth should be covered, the neck wrapped up, any cough put a stop to by its appropriate remedies; and whenever there is an intercurrent fever, it is countered, sometimes by abstinence, sometimes by timely meals, at which water is to be drunk. Milk also, which in headaches, in acute fevers and for the excessive thirst they occasion, also when the chest swells, or there is bilious urine, or a flux of blood, is as bad as a poison, can nevertheless be given appropriately in phthisis, as also in all prolonged feverishness. But if there has either been no intercurrent fever yet, or if it has already remitted, recourse should be had to moderate exercise, walking in particular, also to gentle rubbing. The bath is unsuitable. The food should at first be acrid, such as garlic and leeks, also this latter or endive, basil or lettuce after soaking in vinegar; later the food should be bland, such as a gruel made with pearl barley, or spelt flour, or starch to which milk is added. Rice also, and if there is nothing else, parched groats of spelt answer. Subsequently use is to be made of the above foods in turn, with some additions from food of the middle class, especially grilled brains, small fish and such like. Flour mixed with mutton- or goat-fat and then boiled serves for a medicament. The wine taken ought to be light and dry. So far there is no great difficulty in countering the disease. But if it is more severe, and the body is evidently wasting, stronger remedies are required. Ulceration is to be set up by cautery, at one spot under the chin, at another on the neck, two upon each breast, and the same below the shoulder-blades which the Greeks call omoplatae. The ulcerations are not to be allowed to heal until the cough has stopped, and for this there must clearly be a special treatment also. Then three or four times a day the extremities should be rubbed vigorously, the chest being merely stroked with the hands; an hour after food both legs and arms are to be rubbed. At intervals of ten days the patient should be immersed in the solium contain in oil with the hot water. On other days he should drink first water, then wine; if there is no cough, the drink should be cold, if there is cough lukewarm. It is also of advantage to give food every day during the remission; rubbing and rocking should be employed likewise. On the fourth or fifth day he should take the above mentioned acrid food, now and then polygonum or plantain juice in vinegar. A further remedy is either plantain juice by itself, or horehound juice cooked with honey; of the former a cupful may be sipped, of the latter a spoonful, a little at a time, put upon the tongue, or one half part of turpentine resin, and another part of butter and honey may be mixed together and cooked. But of all these measures the principal ones are the diet, rocking in a litter or on a ship, and the gruel. Loose motions must be especially obviated. Frequent vomiting in this affection is a sign of danger, especially when blood is vomited. A patient who is beginning to improve a little should resume exercises, rubbing, and increase of food, next rub himself while holding his breath, but for a long while abstain from wine, the bath and venery.

> Latin: Quod si mali plus est et uera pt⟨h⟩isis est, inter initia protinus occurrere necessarium est: neque enim facile is morbus, cum inueterauit, euincitur. Opus est, si uires patiuntur, longa nauigatione, caeli mutatione, sic ut densius quam id est, ex quo discedit aeger, petatur: ideoque aptissime Alexandriam ex Italia itur. Fereque id posse inter principia corpus pati debet, cum hic morbus aetate firmissima maxime oriatur, id est ab anno XIIX ad annum XXXV. Si id inbecillitas non sinit, naue tamen non longe gestari commodissimum est. Si nauigationem aliqua res prohibet, lectica uel alio modo corpus mouendum est; tum a negotiis abstinendum est omnibusque rebus, quae sollicitare animum possunt; somno indulgendum; cauendae destillationes, ne, si quid cura leuarit, exasperent; et deuitanda cruditas, simulque et sol et frigus; os obtegendum; fauces uelandae; tussicula suis remediis finienda; et quamdiu quidem febricula incursat, huic interdum abstinentia, interdum etiam tempestiuis cibis medendum; eoque tempore bibenda aqua. Lac quoque, quod in capitis doloribus et in acutis febribus et per eas facta nimia siti, ac, siue praecordia tument, siue biliosa urina est, siue sanguis fluxit, pro ueneno est, in pt⟨h⟩isi tamen, sicut in omnibus longis difficilibusque febriculis recte dari potest. Quod si febris aut nondum incursat, aut iam remisit, decurrendum est ad modicas exercitationes, maximeque ambulationes, item lenes frictiones. Balineum alienum est. Cibus esse debet primo acer, ut alium, porrum, idque ipsum ex aceto, uel ex eodem intubus, ocimum, lactuca, dein lenis, ut sorbitio ex tisana uel ex halica uel ex amulo, lacte adiecto. Idem oriza quoque et, si nihil aliud est, far praestat. Tum in uicem modo his cibis, modo illis utendum est; adiciendaque quaedam ex media materia, praecipueque uel ex pruna cerebellum uel pisciculus et his similia. Farina etiam cum sebo ouillo caprinoue mixta, deinde incocta pro medicamento est. Vinum adsumi debet leue, austerum. Hactenus non magna mole pugnatur. Si uehementior noxa est, ac neque febricula neque tussis quiescit, tenuarique corpus apparet, ualidioribus auxiliis opus est. Exulcerandum est ferro candenti, uno loco sub mento, altero in gutture, duobus ad mammam utramque, item sub imis ossibus scapularum, quas ΩΜΟΠΛΑΤΑΣ Graeci uocant, sic, ne sanescere ulcera sinas nisi tussi finita; cui per se quoque medendum esse manifestum est. Tum ter quaterue die uehementer extremae partes perfricandae; thorax leui manu pertractandus; post cibum intermittenda hora, et perfricanda crura brachiaque. Interpositis denis diebus demittendus aeger in solium, in quo sit aqua calida et oleum. Ceteris diebus bibenda aqua; tum uinum; si tussis non est, potui frigidum dandum; si est, egelidum. Vtile est etiam cibos in remissionibus cotidie dari, frictiones gestationesque similiter adhibere, eadem acri⟨a⟩ quarto aut quinto die adsumere, interdum herbam sanguinalem ex aceto uel plantaginem esse. Medicamentum etiam est uel plantaginis sucus per se, uel marrubii cum melle incoctus, ita ut illius cyathus sorbi⟨l⟩o sumatur huius cocleare plenum paulatim delingatur, uel inter se mixta et incocta resinae terebenthinae pars dimidia, buturi et mellis pars altera. Praecipua tamen ex his omnibus sunt uictus, uehiculum et nauis, et sorbitio. Aluus cita utique uitanda est. Vomitus in hoc morbo frequens perniciosus est, maximeque sanguinis. Qui meliusculus esse coepit, adicere debet exercitationes, frictiones, cibos, deinde ipse se suppresso spiritu perfricare, diu abstinere a uino, balneo, uenere.

[¶6] 23. 23 That malady which is called comitialis, or the greater, is one of the best known. The man suddenly falls down and foam issues out of his mouth; after an interval he returns to himself, and actually gets up by himself. This kind affects men oftener than women. And usually it persists even until the day of death without danger to life; nevertheless occasionally, whilst still recent, it is fatal to the man. And often if remedies have been ineffectual, in boys the commencement of puberty, in girls of menstruation, has removed it. Now sometimes there is a spasm of the sinews when the man falls down, sometimes there is none. Some try to rouse the patients as is done in the case of those affected by lethargy; which is quite useless, both because not even the lethargic patient is cured by this method, and because, though it may be impossible to waken him and he may thus die of starvation, the epileptic, on the other hand, returns to himself. If a man falls in a fit without the addition of spasms, certainly he should not be bled; if there are spasms, at any rate he should not be bled unless there are other indications for the bleeding. But it is necessary to move the bowels by a clyster, or by a purge of black hellebore, or by both if the strength allows of it. Next the head should be shaved and oil and vinegar poured over it, the patient should be given food on the third day, as soon as the hour has passed at which he had a fit. But neither gruels, nor other soft and easily digested food, nor meat, least of all pork, are suitable for such patients, but food materials of the middle class: for there is need to give strength and indigestion is to be avoided; in addition he should avoid sunshine, the bath, a fire, all heating agents; also cold, wine, venery, overlooking a precipice, and everything terrifying, vomiting, fatigue, anxiety, and all business. When food has been given upon the third day, it should be omitted on the fourth, and then on alternate days, observing the same hour for the meal, until fourteen days have elapsed. When the malady lasts beyond this period, it loses its acute character, and if it persists, it is now to be treated as chronic. But if the practitioner has not been in attendance from the day of the first fit, but a patient who is liable to fits has been handed over to of him, the class of diet given above should straightway be adhered to, and the day awaited upon which the patient may have a fit; than there is to be used either blood-letting, or clystering, or purgation by black hellebore, as prescribed above. Next on the following days the patient is to be supported by those foods I have mentioned, avoiding everything which I have said must be avoided. If the malady has not been brought to an end by these measures recourse should be had to white hellebore, administering it three or four times, without many days between, never, however, repeating it unless he has had a fit. Moreover, on intermediate days his strength must be supported by additions to what has been prescribed above. On awakening in the morning, his body should be lightly rubbed with old oil, including the head, but excluding the stomach; he should then walk as straight and as far as he can; after the walk he should be rubbed vigorously for a long while in a warm place, and with not less than two hundred hand-strokings, unless he is weak (II.14); next plenty of cold water should be poured over his head; he should take a little food; rest; again before night take a walk; and once more be vigorously rubbed, yet without touching either his stomach or his head; after this he may have dinner, and at intervals of three or four days he should eat for a day or two acrid foods. If not freed by these measures, his head should be shaved; anointed with old oil, to which vinegar and nitre have been added; have salt water poured over it; next upon an empty stomach he should take castoreum in water; no water should be used for drinking unless it has been boiled. Some have freed themselves from such a disease by drinking the hot blood from the cut throat of a gladiator: a miserable aid made tolerable by a malady still most miserable. But as to what is really the concern of the practitioner, the last resources are: to let a left blood from both legs near the ankle, to incise the back of the scalp and apply cups, to burn in two places with a cautery, at the back of the scalp and just below where the highest vertebra joins the head, in order that pernicious humour may exude through the burns. If the disease has not been brought to an end by the foregoing measures, it is probable that it will be lifelong. To mitigate it to some extent all you can do is to use exercise, plenty of rubbing, and the food which has been mentioned above, particularly avoiding what we have declared to be harmful.

> Latin: 23. Inter notissimos morbos est etiam is, qui comitialis uel maior nominatur. Homo subito concidit, ex ore spumae mouentur, deinde interposito tempore ad se redit, et per se ipse consurgit. Id genus saepius uiros quam feminas occupat. Ac solet quidem etiam longum esse usque mortis diem et uitae non periculosum: interdum tamen cum recens est, hominem consumit. Et saepe eum, si remedia non sustulerunt, in pueris ueneris, in puellis menstruorum initium tollit. Modo cum distentione autem neruorum prolabitur aliquis, modo sine illa. Quidam hos quoque isdem quibus lethargicos excitare conantur; quod admodum superuacuum est, et quia ne letharg⟨ic⟩us quidem his sanatur, et quia, cum possit ille numquam expergisci atque ita fame interire, hic ad se utique reuertitur. Vbi concidit aliquis, si nulla neruorum distentio accessit, utique sanguis mitti non debet: si accessit, non utique mittendus est, nisi alia quoque hortantur. Necessarium autem est ducere aluum, uel nigro ueratro purgare, uel utrumque facere, si uires patiuntur; tunc caput tondere oleoque et aceto perunguere; cibum post diem tertium, simul transit hora, qua concidit, dare. Neque sorbitiones autem his aliique molles et faciles cibi neque caro, minimeque suilla, conuenit, sed media materia: nam et uiribus opus est et cruditates cauendae sunt; cum quibus fugere oportet solem, balneum, ignem omniaque calfacientia; item frigus, uinum, uenerem, loci praecipitis conspectum omniumque terrentium, uomitum, lassitudines, sollicitudines, negotia omnia. Vbi tertio die cibus datus est, intermittere quartum et inuicem alterum quemque, eadem hora cibi seruata, donec quattuordecim dies transeant. Quos ubi morbus excessit, acuti uim deposuit; a⟨t⟩ si manet, curandus iam ut longus est. Quod si non, quo die primum incidit, medicus accessit, sed is, qui cadere consueuit, ei traditus est, protinus eo genere uictus ⟨adhi⟩bito, qui supra conprehensus est, expectandus est dies, quo prolabatur; utendumque tum uel sanguinis missione uel ductione alui uel nigro ueratro, sicut praeceptum est. Insequentibus deinde diebus per eos cibos, quos proposui, uitatis omnibus, quae cauenda dixi, nutriendus. Si per haec morbus finitus non fuerit, confugiendum erit ad album ueratrum, ac ter quoque aut quater eo utendum non ita multis interpositis diebus, sic tamen ne iterum umquam sumat, nisi conciderit. Mediis autem diebus uires eius erunt nutriendae, quibusdam praeter ea, quae supra scripta sunt, adiectis. Vbi mane experrectus est, corpus eius leuiter ex oleo ⟨uetere⟩, cum capite, excepto uentre, permulceatur; tum ambulatione quam maxime recta et longa utatur; post ambulationem loco tepido uehementer et diu, ac non minus ducenties, nisi infirmus erit, perfricetur; deinde per caput multa aqua frigida perfundatur; paulum cibi adsumat; conquiescat; rursus ante noctem ambulatione utatur; iterum uehementer perfricetur, sic ut neque uenter neque caput contingatur; post haec cenet, interpositisque tribus aut quattuor diebus uno aut altero acria adsumat. Si ne per haec quidem fuerit liberatus, caput radat; unguatur oleo ueteri, adiecto aceto et nitro; perfundatur aqua salsa; bibat ieiunus ex aqua castoreum; nulla aqua nisi decocta potionis causa utatur. Quidam iugulati gladiatoris calido sanguine epoto tali morbo se liberarunt; apud quos miserum auxilium tolerabile miserius malum fecit. Quod ad medicum uero pertinet, ultimum est iuxta talum ex utroque crure paulum sanguinis mittere, occipitium incidere et cucurbitulas admouere, ferro candenti in occipitio quoque et infra, qua summa uertebra cum capite committitur, adurere duobus locis, ut per ea perniciosus umor euadat. Quibus si finitum malum non fuerit, prope est, ut perpetuum sit. Ad leuandum id tantummodo utendum erit exercitatione, multa frictione, cibisque, qui supra conprehensi sunt, praecipueque uitanda omnia, quae ne fierent excepimus.

[¶7] 24. 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.

> Latin: 24. Aeque notus est morbus, quem interdum arquatum, interdum regium nominant. Quem Hippocrates ait, si post septimum diem febricitante aegro superuenit, tutum esse, mollibus tantummodo praecordiis substantibus: Diocles ex toto, si post febrem oritur, etiam prodesse; si post hunc febris, occidere. Color autem eum morbum detegit, maxime oculorum, in quibus quod album esse debet, fit luteum. Soletque accedere et sitis et dolor capitis et frequens singultus et praecordiorum dextra parte durities et, ubi corporis uehemens motus est, spirit⟨us difficult⟩as membrorumque resolutio; atque ubi diutius manet morbus, totum corpus cum pallore quodam inalbescit. Primo die abstinere aegrum oportet, secundo ducere aluum, tum, si febris est, eam uictus genere discutere; si non est, scamoniam potui dare, uel cum aqua betam albam contritam, uel cum aqua mulsa nuces amaras, absinthium, anesum, sic ut pars huius minima sit. Asclepiades aquam quoque salsam, et quidem per biduum, purgationis causa bibere cogebat, iis quae urinam mouent reiectis. Quidam superioribus omissis per haec et per eos cibos, qui extenuant, idem se consequi dicunt. Ego ubique, si satis uirium est, ualidiora; si parum, inbecilliora auxilia praefero. Si purgatio fit, post eam triduo primo modice cibum oportet adsumere ex media materia, et uinum bibere Graecum salsum, ut resolutio uentris maneat; tum altero triduo ualidiores cibos, et carnis quoque aliquid esse, intra aquam manere; deinde ad superius genus uictus reuerti, cum eo ut magis satietur; omisso Graeco uino bibere integrum austerum; atque ita per haec variare, ut interdum ⟨acres quoque cibos interponat, interdum⟩ ad salsum uinum redeat. Per omne uero tempus utendum est exercitatione, fricatione, si hiemps est, balneo; si aestas, frigidis natationibus; lecto etiam et conclaui cultiore, lusu, i⟨o⟩co, ludis, lasciuia, per quae mens exhilaretur; ob quae regius morbus dictus uidetur. Malagma quoque, quod digerat, super praecordia datum, prodest, uel arida ibi ficus superimposita, si iecur aut lienis est adfectus.

[¶8] 25. 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.

> Latin: 25. Ignotus autem paene in Italia, frequentissimus in quibusdam regionibus is morbus est, quem ΕΛΕΦΑΝΤΙΑΣΙΝ Graeci uocant; isque longis adnumeratur: quo totum corpus adficitur, ita ut ossa quoque uitiari dicantur. Summa pars corporis crebras maculas crebrosque tumores habet; rubor harum paulatim in atrum colorem conuertitur. Summa cutis inaequaliter crassa, tenuis, dura mollisque, quasi squamis quibusdam exasperatur; corpus emacrescit; os, surae, pedes intumescunt. Vbi uetus morbus e⟨s⟩t, digiti in manibus pedibusque sub tumore conduntur; febricula oritur, quae facile tot malis obrutum hominem consumit.—Protinus ergo inter initia sanguis per biduum mitti debet, aut nigro ueratro uenter solui. Adhibenda tum, quanta sustineri potest, inedia; paulum deinde uires reficiendae et ducenda aluus; post haec ubi corpus leuatum est, utendum exercitatione praecipueque cursu; sudor primum labore ipsius corporis, deinde etiam siccis sudationibus euocandus; frictio adhibenda, moderandumque inter haec, ut uires conseruentur. Balneum rarum esse debet; cibus sine pinguibus, sine glutinosis, sine inflantibus; uinum praeterquam primis diebus recte datur. Corpus contrita plantago et inlita optime tueri uidetur.

[¶9] 26. 26 We also see occasionally some who have been stunned, in whom the body and the mind are stupefied. This is produced sometimes by lightning stroke, sometimes by disease; the Greeks call this latter apoplexia. In these cases, blood is to be let, and either white hellebore (II.13.2) or a clyster administered; then rubbings are applied, and food of the middle class given, and that the least fatty; also some which is acrid; there is to be abstinence from wine.

> Latin: 26. Attonitos quoque raro uidemus, quorum et corpus et mens stupet. Fit interdum ictu fulminis, interdum morbo: ΑΠΟΠΛΗΞΙΑΝ hunc Graeci appellant.—His sanguis mittendus est; ueratro quoque albo, uel alui ductione utendum; tunc adhibendae frictiones, et ex media materia minime pingues cibi, quidam etiam acres: a uino abstinendum.

[¶10] 27. 27 Relaxing of the sinews, on the other hand, is a frequent disease everywhere. It attacks at times the whole body, at times part of it. Ancient writers named the former apoplexy, the latter paralysis: I see that now both are called paralysis. Those who are gravely paralyzed in all their limbs are as a rule quickly carried off, but if not so carried off, some may live a long while, yet rarely however regain health. Mostly they drag out a miserable existence, their memory lost also. The disease, when partial only, is never acute, often prolonged, generally remediable. If all the limbs are gravely paralyzed withdrawal of blood either kills or cures. Any other kind of treatment scarcely ever restores health, it often merely postpones death, and meanwhile makes life a burden. If after blood-letting, neither movement nor the mind is recovered, there is no hope left; if they do return, health also is in prospect. But when a particular part is paralyzed, in accordance with the force of the disease, and the strength of the body, either blood is to be let, or the bowel clystered. The rest that has to be done is the same in both conditions: in particular cold should be avoided; and the patient should return to exercise a little at a time, in such a way that he should begin to walk at once, if he can. If the weakness of the legs prevent this, he should be carried about in a litter or rocked in his bed, then, if possible, his defective limb should be moved by himself, failing that by someone else, and by a form of compulsion, it should be restored to is customary state. It is also beneficial to stimulate the skin of the torpid limb, either by whipping with nettles, or by applying mustard plasters, these latter being removed as soon as the skin becomes red. Appropriate applications also are crushed squills, and onions pounded up with frankincense. Nor is it amiss to pluck on the skin for some time by the aid of a pitch plaster every third day (III.22.6) and sometimes to apply dry cups in several places. Again for anointing, old olive oil is most suitable, or soda mixed with oil and vinegar. Further, it is also highly necessary to foment with warm sea water, or failing that with salt and water. And if there are at hand swimming baths, whether natural or artificial, they should be used as much as possible; especially the defective limb should be moved in them; if there are none such the ordinary bath is of service. The food should be of the middle class, particularly game, the drink hot water without wine. If, however, the disease is of long standing, every fourth or fifth day Greek salted wine may be given, in order to purge. An emetic after supper is of use. At times also there occurs pain in the sinews. In that case it is not expedient to excite vomiting nor urination as some prescribe, nor indeed sweating other than through exercise; water should be drunk; twice a day in bed the body should be rubbed gently and for some time, and then whilst holding the breath, the limbs, preferably the upper, are to be moved in the course of exercise. The bath should be seldom used; from time to time there should be a change of air by travel. If there is pain, the part should be wetted with water containing soda, but not oil, then wrapped up, and under it should be placed a brazier containing some glowing charcoal with sulphur, so that it may be fumigated for a while; this should be repeated from time to time, but only on an empty stomach and after digestion is completed. Cups also may be applied at frequent intervals to the painful part, and this place lightly beaten with inflated ox bladders. It is also of service to mix fat with pounded henbane and nettle seeds, equal parts of each, and put this on, also to foment with a decoction of sulphur. Further, it is a good plan to apply leather bottles filled with hot water, or bitumen mixed with barley meal. And for the actual pain the best remedy is forceful rocking; which in other kinds of pain is the worst. Tremor of sinews again is like with made worse by an emetic, and by medicaments causing urination. Inimical also are baths and dry sweatings. Water is to be drunk; the patient should there are a smart walk and be anointed and rubbed as well, especially by himself; the upper limbs are to be exercised by ball games and the like; he may think what food he likes provided that he studies his digestion. He should avoid worry after meals; make the rarest use of venery. If at any time he has given way to it, then he ought to be rubbed, with oil, gently and for some time, whilst in bed, by the hands of boys rather than men. Now suppurations which arise in some interior part, when they become noticeable, first should be acted upon by those poultices which repress, less there is produced a harmful collection of the material of disease; next if these remedies are unsuccessful, the suppurations may be dissipated by dispersive poultices. If we are not successful in that, it follows that the suppuration should be drawn outwards, next that it should mature. The ending of every abscess is to rupture; the indication is pus discharged either from the bowels or mouth. But nothing ought to be done to diminish the discharge of the pus. Broth and hot water are chiefly to be given. When pus ceases to be discharged, then there should be a transition to digestible yet nutritious food consumed cold, also cold water for drink, commencing, however, with lukewarm. To begin with, things such as pine kernels, or almonds, or hazel nuts, may be eaten along with honey; afterwards these make way for whatever can make the scar form earlier. At this stage as a medicament for the ulceration there is to be taken either leek or horehound juice, and whatever the food, leeks should be added. Rubbing is required also for parts unaffected, so also gentle walks; to be avoided are wrestling and running and other things tending to irritate healing ulcerations, for in this malady the vomiting of blood is most pernicious and to be guarded against in every way.

> Latin: 27. At resolutio neruorum frequens ubique morbus est: interdum ⟨tota corpora, interdum⟩ partes infestat. Veteres auctores illud ΑΠΟΠΛΗΞΙΑΝ, hoc ΠΑΡΑΛΥΣΙΝ nominarunt: nunc utrumque ΠΑΡΑΛΥΣΙΝ appellari uideo. Solent autem qui per omnia membra ⟨uehementer⟩ resoluti sunt, celeriter rapi; ac si correpti non sunt, diutius quidem uiuunt, sed raro tamen ad sanitatem perueniunt; plerumque miserum spiritum trahunt, memoria quoque amissa. In partibus uero numquam acutus, saepe longus, fere sanabilis morbus e⟨s⟩t. Si omnia membra uehementer resoluta sunt, sanguinis detractio uel occidit uel liberat. Aliud curationis genus uix umquam sanitatem restituit, saepe mortem tantum differt, uitam interim infestat. Post sanguinis missionem si non redit et motus et mens, nihil spei superest; si redit, sanitas quoque prospicitur. At ubi pars resoluta est, pro ui et mali et corporis uel sanguis mittendus uel aluus ducenda est. Cetera eadem in utroque casu facienda sunt, siquidem uitare praecipue conuenit frigus; paulatimque ad exercitationes reuertendum est, sic ut ingrediatur ipse protinus, si potest. Si id crurum inbecillitas prohibet, uel gestetur, uel motu lecti concutiatur; tum id membrum, quod defici⟨t⟩, si potest, per se, si minus, per alium moueatur, et ui quadam ad consuetudinem suam redeat. Prodest etiam torpentibus membris summam cutem exasperare uel urticis caesam uel inposito sinapi, sic ut, ubi rubere coeperit corpus, haec remouea⟨n⟩tur. Scilla quoque contrita bulbique contriti cum ture recte inponuntur. Neque alienum est resina cutem tertio quoque die diutius uellere; pluribus etiam locis aliquando sine ferro cucurbitulas admouere. Vnctioni uero aptissimum est uetus oleum uel nitrum aceto et oleo mixtum. Quin etiam fouere aqua calida marina, uel si ea non est, tamen salsa magnopere necessarium est. Ac si quo loco uel naturales uel etiam manu factae tales natationes sunt, is potissimum utendum est; praecipueque in is agitanda membra, quae maxime deficiunt; si id non est, balneum tamen prodest. Cibus esse debet ex materia media, maximeque ex uenatione: potio sine uino aquae calidae. Si tamen uetus morbus est, interponi quarto uel quinto die purgationis causa uinum Graecum salsum potest. Post cenam utilis uomitus est. Interdum uero etiam neruorum dolor oriri solet. In hoc casu non uomere, non urinam medicamentis mouere, non sine exercitatione sudorem, ut quidam praecipiunt, expedit: bibenda aqua est, bis die in lectulo leniter satis diu corpus perfricandum est, deinde retento spiritu ab ipsa exercitatione potius superiores partes mouendae; balneo raro utendum; mutandum subinde peregrinationibus caelum. Si dolor est, ea ipsa pars sine oleo nitro ex aqua perunguenda ⟨est, deinde inuoluenda,⟩ et subicienda pruna lenis et sulpur, atque ita diu subfumigandum; idque aliquandiu faciendum, sed ieiuno, cum bene iam concoxerit. Cucurbitulae quoque saepe dolenti parti admouendae sunt, pulsandusque leuiter inflatis uesicis bubulis ⟨is⟩ locus est. Vtile est etiam sebum miscere cum hyoscyami et urticae contritis seminibus, sic ut omnium par modus sit, idque inponere; fouere aqua, in qua sulpur decoctum sit. Vtriculi quoque recte inponuntur aqua calida repleti, aut bitumen cum hordeacia farina †iactum. Atque in ipso potissimum dolore utendum gestatione uehementi est; quod in aliis doloribus pessimum est. Tremor autem neruorum aeque uomitu medicamentisque urinam mouentibus intenditur. Inimica etiam habet balinea assasque sudationes. Bibenda aqua est; acri ambulatione utendum, itemque unctionibus frictionibusque, maxime per se ipsum; pila similibusque superiores partes dimouendae; cibo quolibet utendum, dum concoctioni utique studeatur. Secundum cibum curis abstinendum; rarissima uenere utendum est. Si quando quis in eam prolapsus est, tum oleo leuiter diuque in lectulo perfricari manibus puerilibus quam uirilibus debet. Suppurationes autem, quae in aliqua interiore parte oriuntur, ubi notae fuerint, primum id agere oportet per ea cataplasmata, quae reprimunt, ne coitus inutilis materiae fiat; deinde, si haec uicta sunt, per ea malagmata, quae digerunt, dissipentur. Quod si consecuti non sumus, sequitur ut euocetur, deinde, ut maturescat. Omnis tum uomicae finis est, ut rumpatur; indiciumque est pus uel aluo uel ore redditum. Sed nihil facere oportet, quo minus, quicquid est puris, excedat. Vtendum maxime sorbitione est, et aqua calida. Vbi pus ferri desiit, transeundum ad faciles quidem sed tamen ualidiores et frigidos cibos frigidamque aquam, sic ut ab egelidis tamen initium fiat. Primoque cum melle quaedam edenda, ut nuclei pinei uel Graecae nuces uel Abellanae; postea summouendum id ipsum, quo maturius induci cicatrix possit. Medicamentum eo tempore ulceri est sucus adsumptus uel porri uel marrubii, et omni cibo porrum ipsum adiectum. Oportebit autem ut⟨i⟩ in is partibus, quae non adficientur, frictionibus, item ambulationibus lenibus; uitandumque erit, ne uel luctando uel currendo uel alia ratione sanescentia ulcera exasperentur: in hoc enim morbo perniciosus ideoque omni modo cauendus sanguinis uomitus est.

## 12. Book IV · chapters 1–7

Source: https://scriptura.si/works/celsus-on-medicine/12/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/12/#p-N

[¶0] 1. 1 Thus far I have dealt with those classes of diseases which so affect bodies as a whole, that fixed situations cannot be assigned to them: I will now speak of diseases in particular parts. Diseases of all the internal parts and their treatment, however, will come under view more readily if I first describe briefly their institutions. The head, then, and the structures within the mouth are not only bounded by the tongue and palate, but also by whatever is visible to our eyes. On the right and left sides around the throat, great blood-vessels named sphagatides, also arteries called carotids, run upwards in their course beyond the ears. But actually within the neck are placed glands, which at times become painfully swollen. From that point two passages begin: one named the windpipe, the more superficial, leads to the lung; the deeper, the gullet, to the sm; the former takes in the breath, the latter food. Though their courses diverge, where they are joined, there is a little tongue in the windpipe, just below the fauces, which is raised when we breathe, and, when we swallow food and drink, closes the windpipe. Now the actual windpipe is rigid and gristly; in the throat it is prominent, in the remaining parts it is depressed. It consists of certain little rings, arranged after the likeness of those vertebrae which are in the spine, but in such a way that whilst rough on the outer surface, the inside is smooth like the gullet; descending to the praecordia, it makes a junction with the lung. The lung is spongy, and so can take in the breath, and at the back it is joined to the spine itself, and it is divided like the hoof of an ox into two lobes. To the lung is attached the heart, which, muscular in nature, is placed under the left breast, and has two small stomach-like pockets. Now, under the heart and lung is a transverse partition of strong membrane, which separates the belly from the praecordia; it is sinewy, and many blood-vessels also take their course through it; it separates from the parts above not only the intestines but also the liver and the spleen. These organs are placed against it but under it, on the right and left sides respectively. The liver, which starts from the actual partition under the praecordia on the right side, is concave within, convex without; its projecting part rest lightly on the stomach, and it is divided into four lobes. Outside its lower part the gall-bladder adheres to it: but the spleen to the left is not connected to the same partition, but to the intestine; in texture it is soft and loose, moderately long and thick; and it hardly projects at all from beneath the ribs into the belly, but is hidden under them for the most part. Now the foregoing are joined together. The kidneys on the other hand are different; they adhere to the loins above the hips, being concave on one surface, on the other convex; they are both vascular, have ventricles, and are covered by coats. These then are the situations of the viscera. Now the gullet, which is the commencement of the intestines, is sinewy; beginning at the seventh spinal vertebra, it makes a junction in the region of the praecordia with the stomach. And the stomach, which is the receptacle of the food, consists of two coats; and it is placed between the spleen and the liver, both overlapping it a little. There are also fine membranes by which these three are interconnected, and they are joined to that partition, which I have described above as transverse. Thence the lowest part of the stomach, after being directed a little to the right, is narrowed into the top of the intestine. This juncture the Greeks call pylorus, because, like a gateway, it lets thru into the parts below whatever we are to excrete. From this point begins the fasting intestine, not so much infolded; it has this name because it does not hold what it has received, but forthwith passes it on into the parts below. Beyond is the thinner intestine, infolded into many loops, its several coils being connected with the more internal parts by fine membranes; these coils are directed rather to the right side, to end in the region of the right hip; however, they occupy mostly the upper parts. After that spot this intestine makes a junction crosswise with another, the thicker intestine; which, beginning on the right side, is long and pervious towards the left, but not towards the right, which is therefore called the blind intestine. But that one which is pervious being widespread and winding, and less sinewy than the upper intestines, has a flexure on both sides, right and left, especially on the left side and in the lower parts and touches the liver and stomach, next it is joined to some fine membranes coming from the left kidney, and thence bending backwards and to the right, it is directed straight downwards to the place where it excretes; and so it is there named the straight intestine. The omentum too, which overlies all these, is at its lower part smooth and compact, softer at its upper part; fat also is produced in it, which like the brain and marrow is without feeling. Again from the kidneys, two veins, white in colour, lead to the bladder; the Greeks call them ureters, because they believe that through them the urine descending drops into the bladder. Now the bladder, sinewy and in two layers at its bag, is at its neck bulky and fleshy; it is connected by blood-vessels with the intestine, and with that bone which underlies the pubes. The bladder itself is loose and rather free, and situated differently in men and women: for in men it is close to the straight intestine, being inclined rather to the left side; in women it is situated over the genitals, and whilst free above, is supported actually by the womb. Again, in males, a longer and narrower urinary passage descends from the neck of the bladder into the penis; in women, a shorter and wider one presents itself over the neck of the womb. Now the womb in virgins is indeed quite small; in women, unless they are pregnant, it is not really much larger than a handful. Beginning over against the middle of the rectum by a straight narrow neck, which they call canalis, it is then turned a little towards the right hip joint; next, as it rises above the right intestine, its sides are fastened into the woman's ilia. Again, these ilia are situated between the hip joints and the pubes at the bottom of the abdomen. From them and from the pubes the abdominal wall extends upwards to the praecordia; it is covered visibly upon the outside by skin, inside by a smooth membrane which makes a junction with the omentum; and it is named by the Greeks peritoneal membrane.

> Latin: 1. Hactenus reperiuntur ea genera morborum, quae in totis corporibus ita sunt, ut is certae sedes adsignari non possint: nunc de is dicam, quae sunt IN PARTIBVS. Facilius autem omnium interiorum morbi curationesque in notitiam uenient, si prius eorum sedes breuiter ostendero. Caput igitur, eaque, quae in ore sunt, non lingua tantummodo palatoque ⟨terminantur,⟩ sed etiam quatenus oculis nostris exposita sunt. In dextra sinistraque circa guttur uenae grandes, quae sph⟨a⟩gitides nominantur, itemque arteriae, quas carotidas uocant, sursum procedentes ultra aures feruntur. At in ipsis ceruicibus glandulae positae sunt, quae interdum cum dolore intumescunt. Deinde duo itinera incipiunt: alterum asperam arteriam nominant, alterum stomachum. Arteria exterior ad pulmonem, stomachus interior ad uentriculum fertur; illa spiritum, hic cibum recipit. Quibus cum diuersae uiae sint, qua coeunt exigua in arteria sub ipsis faucibus lingua est; quae, cum spiramus, attollitur, cum cibum potionemque adsumimus, arteriam claudit. Ipsa autem arteria, dura et cartilaginosa, in gutture adsurgit, ceteris partibus residit. Constat ex circulis quibusdam, compositis ad imaginem earum uertebrarum, quae in spina sunt, ita tamen ut ex parte exteriore aspera, ex interiore stomachi modo leuis sit; eaque descendens ad praecordia cum pulmone committitur. Is spongiosus, ideoque spiritus capax, et a tergo spinae ipsi iunctus, in duas fibras ungulae bubulae modo diuiditur. Huic cor adnexum est, natura musculosum, in pectore sub sinistriore mamma situm; duosque quasi uentriculos habet. At sub corde atque pulmone trauersum ex ualida membrana saeptum est, quod praecordiis uterum diducit; idque neruosum, multis etiam uenis per id discurrentibus; a superiore parte non solum intestina, sed iecur quoque lienemque discernit. Haec uiscera proxuma sed infra tamen posita dextra sinistraque sunt. Iecur a dextra parte sub praecordiis ab ipso saepto orsum, intrinsecus cauum, extrinsecus gibbum; quod prominens leuiter uentriculo insidet, et in quattuor fibras diuiditur. Ex inferiore uero parte ⟨ei fel⟩ inhaeret: at lienis sinistra non eidem saepto sed intestino innexus est; natura mollis et rarus, longitudinis crassitudinisque modicae; isque paulum costarum regione in uterum excedens ex maxima parte sub his conditur. Atque haec quidem iuncta sunt. Renes uero diuersi; qui lumbis summis coxis inhaerent, a parte earum resimi, ab altera rotundi; qui et uenosi sunt, et uentriculos habent, et tunicis super conteguntur. Ac uiscerum quidem hae sedes sunt. Stomachus uero, qui intestinorum principium est, neruosus: a septima spinae uertebra incipit, circa praecordia cum uentriculo committitur. Ventriculus autem, qui receptaculum cibi est, constat ex duobus tergoribus; isque inter lienem et iecur positus est, utroque ex his paulum super eum ingrediente. Suntque etiam membranulae tenues, per quas inter se tria ista conectuntur, iungunturque ei saepto, quod transuersum esse supra posui. Inde ima uentriculi pars paulum in dexteriorem partem conuersa, in summum intestinum coartatur. Hanc iuncturam ΠΥΛΩΡΟΝ Graeci uocant, quoniam portae modo in inferiores partes ea, quae excreturi sumus, emittit. Ab ea ieiunum intestinum incipit, non ita inplicitum; cui tale uocabulum est, quia numquam quod accepit, continet, sed protinus in inferiores partes transmittit. Inde tenuius intestinum est, in sinus uehementer inplicitum: orbes uero eius per membranulas singuli cum in⟨t⟩erioribus conectuntur; qui in dexteriorem partem conuersi et e regione dexterioris coxae finiti, superiores tamen partes magis complent. Deinde id intestinum cum crassiore altero transuerso committitur; quod a dextra parte incipiens, in sinisteriorem peruium et longum est, in dexteriorem non est, ideoque caecum nominatur. At id, quod peruium est, late fusum atque sinuatum, minusque quam superiora intestina neruosum, ab utraque parte huc atque illuc uolutum, magis tamen ⟨in⟩ sinisteriores inferioresque partes, contingit iecur atque uentriculum; deinde cum quibusdam membranulis a sinistro rene uenientibus iungitur, atque hinc dextra recuruatum in imo derigitur, qua excernit; ideoque id ibi rectum intestinum nominatur. Contegit uero uniuersa haec omentum, ex in⟨f⟩eriore parte leue et strictum, ex superiore mollius; cui adeps quoque innascitur, quae sensu, sicut cerebrum quoque et medulla, caret. At a renibus singulae uenae, colore albae, ad uesicam feruntur: ureteras Graeci uocant, quod per eas inde descendentem urinam in uesicam destillare concipiunt. Vesica autem in ipso sinu neruosa et duplex, ceruice plena atque carnosa, iungitur per uenas cum intestino eoque osse, quod pubi subest. Ipsa soluta atque liberior est, aliter in uiris atque in feminis posita: nam in uiris iuxta rectum intestinum est, potius in sinistram partem inclinata: in feminis super genitale earum sita est, supraque elapsa ab ipsa uulua sustinetur. Tum in masculis iter urinae spatiosius et conpressius a ceruice huius descendit ad colem: in feminis breuius et plenius super uuluae ceruicem se ostendit. Volua autem in uirginibus quidem admodum exigua est; in mulieribus uero, nisi ubi grauidae sunt, non multo maior, quam ut manu conprehendatur. Ea, recta tenuataque ceruice, quem canalem uocant, contra mediam aluum orsa, inde paulum ad dexteriorem coxam conuertitur; deinde super rectum intestinum progressa, iliis feminae latera sua innectit. Ipsa autem ilia inter coxas et pubem imo uentre posita sunt. A quibus ac pube abdomen susum uersus ad praecordia peruenit: ab exteriore parte euidenti cute, ab interiore leui membrana inclusum, quae omento iungitur; peritonaeos autem a Graecis nominatur.

[¶1] 2. 2 Having made a sort of survey as it were of these organs, so far as it is necessary for a practitioner to know them, I shall follow out the remedies for the several parts when diseased, starting with the head; under that term I now mean that part which is covered with hair; for pain in the eyes, ears and teeth and the like will be elsewhere explained (VI.6‑9, VII.7‑12). In the head, then, there is at times an acute and dangerous disease, which the Greeks call cephalaia; the signs of which are hot shivering, paralysis of sinews, blurred vision, alienation of the mind, vomiting, so that the voice is suppressed, or bleeding from the nose, so that the body becomes cold, vitality fails. In addition there is intolerable pain, especially in the region of the temples and back of the head. Again, there is sometimes a chronic weakness in the head, which, although neither severe nor dangerous, lasts through life; sometimes there is more severe pain, but of short duration, and not fatal, which is brought about by wine or indigestion or cold or heat or the sun. And all these pains occur, sometimes with fever, sometimes without fever; sometimes they affect the whole head, sometimes a part only; at times so as to cause excruciating pain also in the adjacent part of the face. Besides the foregoing there is a class which may become chronic, in which a humour inflates the scalp, so that it swells up and yields to the pressure of the fingers. The Greeks call it hydrocephalus. Of these forms, that mentioned second, while it is slight, is to be treated by the regimen I have stated when I was describing what healthy men should do in the case of weakness of any part (I.4). For pain in the head accompanied by fever the remedies have been detailed when describing the treatment of fevers in general (III.3‑17). Now to speak of the rest. Of these the case that is acute, also that which surpasses ordinary limits, and that which is of sudden causation and although not deadly, is yet violent, has its primary remedy in blood-letting. But this measure is unnecessary, unless the pain is intolerable, and it is better to abstain from food; also from drink, when possible; if not possible, then to drink water. If, on the day following, pain persists, the bowels should be clystered, sneezing provoked, and nothing but water taken. For often, in this way, all the pain is dispersed within one or two days, especially if it has originated from wine of indigestion. But if there is little benefit from the above, the head should be shaved down to the scalp; then it should be considered what cause excited the pain. If the cause was hot weather, it is well to pour cold water freely over the head, to put on the head a concave sponge now and again wrung out of cold water; to anoint the head with rose oil and vinegar, or better to put on unscoured wool saturated with the same, or else other refrigerant plasters. But if cold has done the harm, the head should be bathed with warm sea-water, or at any rate salt and water, or with a laurel-leaf decoction, after which the head should be rubbed smartly, have warm oil poured on it, and then be covered up. Some even bandage up the head, some load it with neck-wraps and mufflers, and so get relief; warm plasters give help in other cases. Hence, even when the cause is unknown, it should be observed whether cooling or heating methods afford the more relief, and to make use of those which experience has approved. But if the cause is not known, the head should be bathed, first in warm water as noted above, or in salt and water, or in the laurel decoction, next in cold vinegar and water. For all long-standing pain in the head, the following are the general measures: to provoke sneezing; to rub the legs smartly; to gargle things which provoke salivation; to apply cups to the temples and occiput; to draw blood from the nostrils; to pluck upon the skin of the temples frequently by the aid of pitch plasters; to apply mustard in order to cause ulcers over the site of the pain, after having put a layer of linen over the skin to prevent violent erosion; to excite ulcerations by cautery, applied over the seat of the pain; to take food in great moderation, with water; after the pain has been relieved, to go to the bath, and there to have much water poured over the head, first hot, then cold; if the pain has been quite dispersed, the patient may even return to wine, but should always before anything else drink some water. The class in which humour collects upon the head is different. In that case it is necessary to shave the head to the scalp; then to apply mustard until it causes ulcers; if this is of little avail, recourse must be had to the scalpel. The following measures are the same as for dropsical patients: exercise, sweating, smart rubbing, and such food and drink as will specially promote urination.

> Latin: 2. His uelut in conspectum quendam, quatenus scire curanti necessarium est, adductis, remedia singularum laborantium partium exsequar, orsus a capite; sub quo nomine nunc significo eam partem, quae capillis tegitur: nam oculorum, aurium, dentium dolor, et si qui similis est, alias erit explicandus. In capite autem interdum acutus et pestifer morbus est, quem ΚΕΦΑΛΑΙΑΝ Graeci uocant; cuius notae sunt horror calidus, neruorum resolutio, oculorum caligo, mentis alienatio, uomitus, sic ut uox supprimatur, uel sanguinis ex naribus cursus, sic ut corpus frigescat, anima deficiat. Praeter haec dolor intolerabilis, maxime circa tempora uel occipitium. Interdum autem in capite longa inbecillitas, sed neque grauis neque periculosa, per hominis aetatem est: interdum grauior dolor sed breuis, neque tamen mortiferus, qui uel uino uel cruditate uel frigore uel igne aut sole contrahitur. Hique omnes dolores modo in febre, modo sine hac sunt; modo in toto capite, modo in parte, interdum sic ut oris quoque proximam partem excrucient. Praeter haec etiam⟨num⟩ inuenitur genus, quod potest longum esse; ubi umor cutem inflat, eaque intumescit et prementi digito cedit: ΥΔΡΟΚΕΦΑΛΟΝ Graeci appellant. Ex his id, quod secundo loco positum est, dum leue est, qua si⟨t⟩ ratione curandum, dixi, cum persequerer ea, quae sani homines ⟨in⟩ inbecillitate partis alicuius facere deberent. Quae uero auxilia sunt capitis, ubi cum febre dolor est, eo loco explicitum est, quo febrium curatio exposita est. Nunc de ceteris dicendum est. Ex quibus id, quod acutum est, idque, quod supra consuetudinem intenditur, idque, quod ex subita causa etsi non pestiferum tamen uehemens est, primam curationem habet, qua sanguis mittatur. Sed id, nisi intolerabilis dolor est, superuacuum est, satiusque est abstinere a cibo; si fieri potest, etiam potione; si non potest, aquam bibere. Si postero die dolor remanet, aluum ducere, sternumenta euocare, nihil adsumere nisi aquam. Saepe enim dies unus aut alter totum dolorem hac ratione discutit, utique si ex uino uel cruditate origo est. Si uero in his auxilii parum est, tonderi oportet ad cutem; dein considerandum est, quae causa dolorem excitarit. Si calor, aqua frigida multa perfundere caput expedit, spongiam concauam inponere subinde in aqua frigida expressam; unguere rosa et aceto, uel potius his tinctam lanam sucidam imponere aliaue refrigerantia cataplasmata. At si frigus nocuit, caput oportet perfundere aqua calida marina uel certe salsa, aut in qua laurus decocta sit; tum caput uehementer perfricare; deinde calido oleo implere, ueste uelare. Quidam id etiam deuinciunt; alii ceruicalibus uestimentisque onerant, et sic leuantur; alios calida cataplasmata adiuuant. Ergo etiam ubi causa incognita est, uidere oportet, refrigerantia magis an calfacientia leniant, et is uti, quae experimentum adprobarit. At si parum causa discernitur, perfundere caput, primum calida aqua, sicut supra praeceptum est, uel salsa, uel ex lauro decocta, tum frigida posca. Illa in omni uetusto capitis dolore communia sunt: sternumenta excitare, inferiores partes uehementer perfricare; gargarizare iis, quae saliuam mouent; cucurbitulas temporibus et occipitio admouere; sanguinem ex naribus extrahere; resina subinde tempora reuellere, et imposito sinapi exulcerare ea, quae male habent ante linteolo subiecto, ne uehementer adrodat; candentibus ferramentis, ubi dolor est, ulcera excitare; cibum permodicum cum aqua sumere; ubi leuatus est dolor, in balineum ire, ibi multa aqua, prius calida, deinde frigida per caput perfundi: si discussus ex toto dolor est, etiam ad uinum reuerti, sed postea semper antequam quicquam aliud aquam bibere. Dissimile est id genus, quod umorem in caput contrahit. In hoc tonderi ad cutem necessarium est; deinde inponere sinapi sic ut exulceret; si id parum profuit, scalpello utendum est. Illa cum hydropicis communia sunt: exerceatur, insudet, uehementer perfricetur, cibis potionibusque utatur urinam praecipue mouentibus.

[¶2] 3. 3 Again, about the face there originates an affection which the Greeks call "dog spasm." And it begins along with acute fever; the mouth is drawn to one side by a peculiar movement, and so it is nothing else than a distortion of the mouth. In addition there is frequent change of colour in the face as well as over all the body, also an inclination to sleep. In this case blood-letting is the best thing; if that does not end the disorder, the bowels are moved with a clyster; when not even thus dispersed, vomiting is provoked by white hellebore. It is necessary besides to avoid the sun, fatigue and wine. If it is not dispersed by these measures, use running, rubbing of the affected part gently and repeatedly, also rub other parts for less time, but smartly. It is also useful to provoke sneezing; to shave the head, to pour over it hot sea water, or at any rate salt and water, provided that sulphur is also added; after this affusion the patient should again be rubbed; should chew mustard, applying at the same time to the parts of the mouth affected a wax salve, likewise to the unaffected parts mustard until it produces erosion. Food of the middle class is most suitable.

> Latin: 3. Circa faciem uero morbus innascitur, quem Graeci ΚΥΝΙΚΟΝ ΣΠΑΣΜΟΝ nominant. Isque cum acuta fere febre oritur; os cum motu quodam peruertitur [ideoque nihil aliud est quam distentio oris]. Accedit crebra coloris in facie totoque in corpore mutatio; somnus in promptu est.—In hoc sanguinem mittere optimum est: si finitum eo malum non est, ducere aluum: si ne sic quidem discussum est, albo ueratro uomitum mouere. Praeter haec necessarium est uitare solem, lassitudinem, uinum. Si discussum his non est, utendum est cursu, frictione in eo, quod laesum est, leni et multa; in reliquis partibus breuiore sed uehementi. Prodest etiam mouere sternumenta; caput radere, idque perfundere aqua calida uel marina uel certe salsa, sic ut ei sulpur quoque adiciatur; post perfusionem iterum perfricare; sinapi manducare, eodemque tempore adfectis oris partibus ceratum, integris idem sinapi, donec adrodat, imponere. Cibus aptissimus ex media materia est.

[¶3] 4. 4 But if there is paralysis of the tongue, which sometimes occurs of itself, sometimes is produced by some disease, so that the man's speech is not distinct, he should gargle a decoction of thyme, hyssop or mint; drink only water; have the head, face, the parts under the chin and the neck smartly rubbed; the tongue itself smeared with laser; chew very acrid materials, mustard, onion, garlic, and strive with all his force to pronounce words; hold his breath at exercise; frequently pour cold water over his head; on occasion eat a quantity of radish and then vomit.

> Latin: 4. At si lingua resoluta est, quod interdum per se, interdum ex morbo aliquo fit, sic ut sermo hominis non explicetur, oportet gargarizare ex aqua, in qua uel thymum uel hysopum uel nepeta decocta sit; aquam bibere; caput et os et ea, quae sub mento sunt, et ceruicem uehementer perfricare; lasere linguam ipsam lin⟨e⟩re; manducare quae sunt acerrima, id est in sinapi alium, cepam; magna ui luctari, ut uerba exprimantur; exerceri retento spiritu; caput saepe aqua frigida perfundere; nonnumquam multam esse radiculam, deinde uomere.

[¶4] 5. 5 Again there is dripping from the head sometimes into the nose, which is a mild affair; sometimes into the throat, which is worse, sometimes into the lung, which is worst of all. When the drip is into the nostrils, a thin phlegm is discharged from them; there is slight pain, and a feeling of weight in the head, with frequent sneezing; if the drip is into the throat, it irritates and excites a slight cough; if the drip is into the lung, besides the sneezing, cough and even weight in the head, there is lassitude, thirst, a feeling of heat, and bilious urine. Another although not very different affection is gravedo. This closes up the nostrils, renders the voice hoarse, excites a dry cough; in it the saliva is salt, there is ringing in the ears, the blood-vessels in the head throb, the urine is turbid. Hippocrates named all the above coryza; I note that now the Greeks reserve this term for gravedo, the dripping they call catastagmus. These affections are commonly of short duration, but if neglected may last a long while. None is fatal, except that which causes ulcers in the lung. Whenever we feel anything of the sort, we should forthwith keep out of the sun, and abstain from the bath, wine and coition; but the use meanwhile of anointing and of customary food is allowable. The patient should walk, but only briskly and under cover; after that the head and face should be rubbed for more than fifty strokes. This complaint is generally relieved, provided that we take care of ourselves for a couple of days, or for three at the most. When the disease has been relieved so that the drip of phlegm becomes thick, or the gravedo so that the nostrils are more open, the bath may be resumed, much water, at first hot, then lukewarm, being used to foment the face and head; next, along with more food, wine may be taken. But if on the fourth day the phlegm is still thin, or the nostrils still stuffed up, the patient should take dry Aminaean wine, then for a couple of days water; after which he can return to the bath and his usual habits. Nevertheless, even during those days, when some things are to be avoided, it is not expedient to treat the patients as sick men, but they are to do everything as in health, unless these symptoms have been liable to cause more prolonged and severe trouble; for then a somewhat more careful attention is needed. Therefore in such a case if there is a drip into the nose or into the throat, besides the treatment described above, the patient from the start should walk a good deal during the first days: have the lower limbs smartly rubbed, together with more gentle rubbing of the chest, face and head; his accustomed food should be reduced by one-half; he may take eggs, also starchy and such-like foods, which thicken phlegm; thirst should be resisted as far as he can bear it. When by these measures a patient has been prepared for the bath, and has used it, there may be added to the diet small fish or meat, provided that at first he should not take the full quantity of food; undiluted wine should be taken more freely. But if the drip is into the lung also, there is even more need for walking and rubbing and the same regimen as to diet, and if that diet is not effective, more acrid food is to be employed; he should allow himself more sleep, and abstain from all business; but the bath should be tried at a somewhat later stage. In the case of gravedo, he should lie in bed on the first day, neither eat nor drink, cover the head, and wrap wool around the throat; on the next day he should get up, and still abstain from drink, or, if he must have some, take not more than one tumbler-full of water; on the third day he may eat the crumb of bread, but not much, with some small fish, or light meat, and water for drink. Should the patient be unable to restrain himself from using a fuller diet, he is to provoke a vomit; when he gets to the bath, he should foment freely his head and face with hot water until he sweats, and then have recourse to wine. After the above measures it is scarcely possible for the same discomfort to persist; but if it does so, use cold, dry, light food with the least possible fluid, whilst continuing the rubbings and the exercises, such as are needed in all such sorts of illness.

> Latin: 5. Destillat autem de capite interdum in nares, quod leue est; interdum in fauces, quod peius est; interdum etiam in pulmonem, quod pessimum est. Si in nares destillauit, tenuis per has pituita profluit; caput leuiter dolet, grauitas eius sentitur, frequentia sternumenta sunt; si in fauces, has exasperat, tussiculam mouet; si in pulmonem, praeter sternumenta et tussim est etiam capitis grauitas, lassitudo, sitis, aestus, biliosa urina. Aliud autem quamuis non multum distans malum grauedo est. Haec nares claudit, uocem obtundit, tussim siccam mouet; sub eadem salsa est saliua, sonant aures, uenae mouentur in capite, turbida urina est. Haec omnia ΚΟΡΥΖΑΣ Hippocrates nominat: nunc uideo apud Graecos in grauedine hoc nomen seruari, destillationem ΚΑΤΑΣΤΑΓΜΟΝ appellari. Haec autem et breuia et, si neglecta sunt, longa esse consuerunt. Nihil pestiferum est, nisi quod pulmonem exulcerauit. Vbi aliquid eiusmodi sensimus, protinus abstinere a sole, balneo, uino, uenere debemus; inter quae unctione et adsueto cibo nihilo minus uti licet. Ambulatione tantum acri sed tecta utendum est; post eam caput atque os supra quinquagiens perfricandum. Raroque fit ut, si biduo uel certe triduo nobis temperauimus, id uitium non leuetur. Quo leuato, ⟨si⟩ in destillatione crassa facta pituita est, uel in grauedine nares magis patent, balneo utendum est, multaque aqua prius calida, post egelida fouendum os caputque; deinde cum cibo pleniore uinum bibendum. At si aeque tenuis quarto die pituita est, uel nares aeque clausae uidentur, adsumendum est uinum Aminaeum austerum, dein rursus biduo aqua; post quae ad balneum et ad consuetudinem reuertendum est. Neque tamen illis ipsis diebus, quibus aliqua omittenda sunt, expedit tamquam aegros agere, sed cetera omnia quasi sani⟨s⟩ facienda sunt, praeterquam si diutius aliquid et uehementius ista sollicitare consuerunt: huic enim quaedam curiosior obseruatio necessaria est. Igitur huic, si in nares uel in fauces destillauit, praeter ea, quae supra rettuli, protinus primis diebus multum ambulandum est; perfricandae uehementer inferiores partes, leuior frictio adhibenda thoraci ori capiti; demenda adsueto cibo pars dimidia; sumenda oua, amylum similiaque, quae pituitam faciunt crassiorem: siti quanta maxime sustineri potest, pugnandum. Vbi per haec idoneus aliquis balneo factus eoque usus est, adiciendus est cibo pisciculus aut caro, sic tamen ne protinus iustus modus cibi sumatur; uino meraco copiosius utendum est. At si in pulmonem quoque destillat, multo magis et ambulatione et fricatione opus est eademque adhibita ratione in cibis, si non satis illi proficiunt, acrioribus utendum est; magis somno indulgendum, abstinendumque a negotiis omnibus; aliquando sed serius balineum temptandum. In grauedine autem primo die quiescere, neque esse neque bibere, caput uelare, fauces lana circumdare; postero die surgere, abstinere a potione, aut si res coegerit, non ultra heminam aquae adsumere; tertio die panis non tam multum ex parte interiore qum pisciculo uel leui carne sumere; aquam bibere. Si quis sibi temperare non potuerit quominus pleniore uictu utatur, uomere; ubi in balneum uentum est, multa calida aqua caput et os fouere usque ad sudorem; tum ad uinum redire. Post quae uix fieri potest, ut idem incommodum maneat; sed si manserit, utendum erit cibis frigidis, aridis, leuibus, umore quam minimo, seruatis frictionibus exercitationibusque, quae in omni tali genere ualetudinis necessariae sunt.

[¶5] 6. 6 From the head we pass to the neck, which is liable to harm from diseases of considerable gravity. There is, however, no disease more distressing, and more acute, than that which by a sort of rigor of the sinews, now draws down the head to the shoulder-blades, now the chin to the chest, now stretches out the neck straight and immobile. The Greeks call the first opisthotonus, the next emprosthotonus, and the last tetanus, although some with less exactitude use these terms indiscriminately. These diseases are often often fatal within four days. If the patients survive this period, they are no longer in danger. They are all treated by the same method and this is agreed upon, but Asclepiades in particular believed in blood-letting, which some said should be particularly avoided, because the body was then especially in need of that heat which was in the blood. But this is false; for it is not in the nature of the blood to be especially hot, but of all that composes man, the blood most quickly turns, now hot, now cold. Still, whether or no it ought to be let, can be learnt from the instructions concerning blood-letting (II.10, 11). But anyhow it is right to give castory, and with it pepper or laser; further, a warm and moist fomentation is needed. For this purpose most pour hot water freely at intervals over the neck. This affords temporary relief, but renders the sinews more susceptible to cold, a thing certainly to be avoided. It is, therefore, more beneficial, first to anoint the neck with a liquid wax-salve, then to apply ox-bladders or leathern bottles filled with hot oil, or else a hot meal plaster, or a pod of round pepper crushed up in a fig. The best thing, however, is to foment with moistened salt according to the method already described (II.17.9, 10; 33.1). Whatever meanwhile is being done, the patient should be brought near a fire, or into the sun in hot weather, and old oil in particular should be rubbed into his neck, shoulder-blades and spine; or if that is not at hand, Syriac oil, or if not even that, oldest lard. Rubbing applied to the whole length of the vertebrae is beneficial, but especially so to those of the neck. Therefore, with certain intervals however, this procedure should be carried out both by day and by night. During such intervals some kind of an emollient composed of heating substances should be put on. Cold is especially to be guarded against; and so there ought to be a fire kept burning constantly in the room in which the patient is lying, especially during the hours before dawn, when the cold is particularly intense. It is not unserviceable to keep the head closely clipped, moistened with hot iris or cyprus oil, and covered by putting on a cap; sometimes even to submerge the patient either in hot oil, or in hot water in which fenugreek has been boiled and a third part of oil added. If the bowels also have been moved by a clyster, this often relaxes the upper parts. Should the pain grow even still more severe, cups should be applied to the neck after the skin has been incised; or the same spot is to be burnt either with the cautery, or by mustard. When the pain has been relieved and the neck begins to be moved, it can be recognized that the disease is yielding to treatment. But for a long while food which has to be chewed should be avoided; sops and eggs, raw or soft boiled, are to be used; any kind of soup may be taken. But if the patient has done well, and the neck appears to be all right, then will be the time to begin with pulse porridge, or well-moistened crumbled bread. He is to chew bread, however, earlier than to drink wine, because the use of wine is particularly risky, and so ought to be deferred for a longer time.

> Latin: 6. A capite transitus ad ceruicem est, quae grauibus admodum morbis obnoxia est. Neque tamen alius inportunior acutiorque morbus est, quam is, qui quodam rigore neruorum modo caput scapulis, modo mentum pectori adnectit, modo rectam et inmobilem ceruicem intendit. Primum Graeci ΟΠΙΣΘΟΤΟΝΟΝ, ⟨in⟩sequentem ΕΜΠΡΟΣΘΟΤΟΝΟΝ, ultimum ΤΕΤΑΝΟΝ appellant, quamuis minus subtiliter quidam indiscretis his nominibus utuntur. Ea saepe intra quartum diem tollunt: si hunc euaserunt, sine periculo sunt.—Eadem omnia ratione curantur idque conuenit * * * Sed Asclepiades utique emittendum sanguinem credidit; ⟨quod⟩ quidam utique uitandum esse dixerunt, eo quod maxime tum corpus calore egeret, isque esset in sanguine. Verum hoc quidem falsum est: neque enim natura sanguinis est, ⟨ut⟩ utique caleat, sed ex is, quae in homine sunt, hic celerrime uel calescit uel refrigescit. Mitti uero necne debeat, ex is intellegi potest, quae de sanguinis missione praecepta sunt. Vtique autem recte datur castoreum, et cum hoc piper uel laser; deinde opus est fomento umido et calido. Itaque plerique aqua calida multa ceruices subinde perfundunt. Id in praesentia leuat, sed oportuniores neruos frigori reddit, quod utique uitandum est. Vtilius igitur est cerato primum liquido ceruicem perunguere; deinde admouere uesicas bubulas uel utriculos oleo calido repletos, uel ex farina calidum cataplasma, uel piper rotundum cum ficu contusum. Vtilissimum tamen est umido sale fouere; quod quomodo fieret iam ostendi. Vbi eo aliquid factum est, admouere ad ignem; uel si aestas est, in sole⟨m⟩ aegrum oportet; maximeque oleo ueteri, si id non est, Syriaco; si ne id quidem est, adipe quam uetustissima ceruicem et scapulas et spinam perfricare. Frictio cum omnibus in homine uertebris utilis sit, tum is praecipue, quae in collo sunt. Ergo die nocteque, interpositis tamen quibusdam temporibus, hoc remedio utendum est. Dum intermittitur, imponendum malagma aliquod ex calfacientibus. Cauendum uero praecipue frigus; ideoque in eo conclaui, quo cubabit aeger, ignis continuus esse debebit, maximusque tempore antelucano, quo praecipue frigus intenditur. Neque inutile erit caput adtonsum habere idque irino uel cyprino calido madefacere et superinposito pilleo uelare; nonnumquam etiam ⟨in⟩ calidum oleum totum descendere, uel in aquam calidam, in qua faenum Graecum decoctum sit et adiecta olei pars tertia. Aluus quoque ducta saepe superiores partes resoluit. Si uero etiam uehementius dolor creuit, admouendae ceruicibus cucurbitulae sunt, sic ut cutis incidatur; eadem aut ferramentis aut sinapi adurenda. Vbi leuatus est dolor mouerique ceruix coepit, scire licet cedere remediis morbum. Sed diu uitandus cibus, quisquis mandendus est: sorbitionibus utendum itemque ouis sorbilibus aut apalis [mollibus]; ius aliquod adsumendum. At si bene processerit iamque ex toto recte se habere ceruices uidebuntur, incipiendum erit a pulticula uel intrita bene madida. Celerius tamen etiam panis mandendus quam uinum gustandum, siquidem huius usus praecipue periculosus ideoque in longius tempus differendus est.

[¶6] 7. 7 Whilst this kind of disease involves the region of the neck as a whole, another equally fatal and acute has its seat in the throat. We call it angina; the Greeks have names according to its species. For sometimes no redness or swelling is apparent, but the skin is dry, the breath drawn with difficulty, the limbs relaxed; this they call synanche. Sometimes the tongue and throat are red and swollen, the voice becomes indistinct, the eyes are deviated, the face is pallid, there is hiccough; that they call cynanche: the signs in common are, that the patient cannot swallow food nor drink, and his breathing is obstructed. It is a slighter case when there is merely redness and swelling, not followed by the other symptoms; this they call parasynanche. Whichever form occurs blood must be let if strength permits; if there is no surplus strength, then move the bowels by a clyster. Cups also may be applied with benefit under the chin, also outside the throat, so as to draw out the matter which is suffocating. Next, moist foments are needed, for dry ones hinder the breath. Consequently sponges, dipped into hot oil at intervals, should be put on; that is better than hot water; but most efficacious here too is hot moistened salt. Moreover, it is useful: to make a decoction with hydromel of hyssop, catmint, thyme, wormwood, or even of bran, and dried figs, and to gargle with it; afterwards to smear the palate with ox-gall, or with the medicament made of mulberries. It is also appropriate for a cough to dust the palate with pounded pepper. If there is little effect from these remedies, the last resource is to make sufficiently deep incisions into the upper part of the neck under the lower jaw, or into the palate in front of the uvula, or into the veins under the tongue, in order that the disease may discharge through the incisions. If the patient is not benefited by all this, it must be recognized that he has been overcome by the disease. But if these measures have relieved the disease, and the throat again admits both food and breath, a return to health is easy. And sometimes nature also assists when the disease moves from a more restricted to a more widespread seat; so when redness and swelling have arisen over the praecordia, it may be recognized that the throat is becoming free. But whatever has relieved it, the patient should begin with fluids, especially with the hydromel decoction; next soft and unacrid food should be taken until the throat has returned to its original condition. I hear it commonly said that if a man eat a nestling swallow, for a whole year he is not in danger from angina; and that when the disease attacks anyone it is also beneficial to burn a nestling which has been preserved in salt and to crumble the powdered ash into hydromel which is administered as a draught. Since this remedy has considerable popular authority, and cannot possibly be a danger, although I have not read of it in medical authorities, yet I thought that it should be inserted here in my work.

> Latin: 7. Vt hoc autem morbi genus circa totam ceruicem, sic alterum aeque pestiferum acutumque in faucibus esse consueuit. Nostri anginam uocant: apud Graecos nomen, prout species est. Interdum enim neque rubor neque tumor ullus apparet, sed corpus aridum est, uix spiritus trahitur, membra soluuntur: id ΣΥΝΑΓΧΗΝ uocant. Interdum lingua faucesque cum rubore intumescunt, uox nihil significat, oculi uertuntur, facies pallet, singultus est: id ΚΥΝΑΓΧΗΝ uocant. Illa communia sunt: aeger non cibum deuorare, non potionem potest, spiritus eius in⟨ter⟩cluditur. Leuius est, ubi tumor tantummodo ruborque est, cetera non secuntur: id ΠΑΡΑΣΥΝΑΓΧΗΝ appellant.—Quicquid est, si uires patiuntur, sanguis mittendus est; si non abundat, secundum est ducere aluum. Cucurbitula quoque recte sub mento et circa fauces admouetur, ut id, quod strangulat, euocet. Opus est deinde fomentis umidis: nam sicca spiritum elidunt. Ergo admouere spongias oportet, quae melius in calidum oleum quam in calidam aquam subinde ⟨d⟩emittuntur; efficacissimumque est hic quoque salis calidus sucus. Tum commodum est hysopum uel nepetam uel thumum uel apsinthium uel etiam furfures aut ficus aridas aut mulsam aquam decoquere, eaque gargarizare; post haec palatum unguere uel felle taurino uel eo medicamento, quod ex moris est. Polline etiam †si piperis id recte respergitur. Si per haec parum proficitur, ultimum est incidere satis altis plagis sub ipsis maxillis supra collum, uel in palato citra uuam, uel eas uenas, quae sub lingua sunt, ut per ea uulnera morbus erumpat. Quibus si non fuerit aeger adiutus, scire licet malo uictum esse. Si uero his morbus leuatus est, iamque fauces et cibum et spiritum capiunt, facilis ad bonam ualetudinem recursus est. Atque interdum natura quoque adiuuat, si ex angustiore sede uitium transit in latiorem; itaque rubore et tumore in praecordiis orto scire licet fauces liberari. Quicquid autem eas leuauit, incipiendum est ab umidis, maximeque aqua mulsa decocta: deinde adsumendi molles et non acres cibi sunt, donec fauces ad pristinum habitum reuertantur. Vulgo audio, si quis pullum hirundininum ederit, angina toto anno non periclitari; seruatumque eum ex sale, cum is morbus urget, comburi, carbonemque eius contritum in aquam mulsam, quae potui datur, infriari et prodesse. Id cum idoneos auctores ex populo habeat, neque habere quicquam periculi possit, quamuis in monumentis medicorum non legerim, tamen inserendum huic operi meo credidi.

## 13. Book IV · chapters 8–14

Source: https://scriptura.si/works/celsus-on-medicine/13/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/13/#p-N

[¶0] 8. 8 There is also in the region of the throat a malady which amongst the Greeks has different names according to its intensity. It consists altogether in a difficulty of breathing; when moderate and without any choking, it is called dyspnoea; when most severe, so that the patient cannot breathe without making a noise and gasping, asthma; but when in addition the patient can hardly draw in his breath unless with the neck outstretched, orthopnoea. Of these, the first can last a long while, the two following are as a rule acute. The signs common to them are: on account of the narrow passage by which the breath escapes, it comes out with a whistle; there is pain in the chest and praecordia, at times even in the shoulder-blades, sometimes subsiding, then returning; to these there is added a slight cough. Blood-letting is the remedy unless anything prohibits it. Nor is that enough, but also the bowels are to be relaxed by milk, the stool being rendered liquid, at times even a clyster is given; as the body becomes depleted by these measures the patient begins to draw his breath more readily. Moreover, even in bed the head is to be kept raised; the chest movement assisted by hot foments and plasters, dry or even moist, and later either emollients are to be applied or at any rate a wax-salve made with cyprus, or iris ointment. Next, on an empty stomach the patient should take a draught of hydromel, in which either hyssop or crushed caper root has been boiled. It is also of use to suck either soda or white nasturtium seed, parched, crushed and then mixed with honey; and for the same purpose, galbanum and turpentine resin are boiled together to a coherent mass, and a bit of this, the size of a bean, is sucked every day, or unfused sulphur 1 gram and 0·66 gram of southernwood are pounded up in a cupful of wine and sipped lukewarm. It is also not a foolish idea that the liver of a fox should be dried, pounded and the mash sprinkled into the above, or that the lung of that animal, as fresh as possible, roasted without touching iron in the cooking, should be eaten. In addition to the above, gruels and light food are to be used, at intervals also a light dry wine, occasionally an emetic. Some kind of diuretic is also beneficial, but there is nothing better than a walk until almost fatigued, also frequent rubbings, especially of the lower extremities, either in the sun, or before a fire, done by the patient himself or others, until he sweats.

> Latin: 8. Est etiam circa fauces malum, quod apud Graecos aliud aliudque nomen habet, prout se intendit. Omne in difficultate spirandi consistit; sed haec dum modica est neque ex toto strangulat. ΔΥΣΠΝΟΙΑ appellatur; cum uehementior est, ut spirare aeger sine sono et anhelatione non possit, ΑΣΘΜΑ: ⟨at⟩ cum accessit id quoque, ⟨quod aegre⟩ nisi recta ceruice spiritus trahitur, ΟΡΘΟΠΝΟΙΑ. Ex quibus id, quod primum est, potest diu trahi: duo insequentia acuta esse consuerunt. His communia sunt, quod propter angustias, per quas spiritus euadit, sibilum exit; dolor in pectore praecordiisque est, interdum etiam scapulis, isque modo ⟨decedit, modo⟩ reuertitur; ad haec tussicula accedit.—Auxilium est, nisi aliquid prohibet, in sanguinis detractione. Neque id satis est, sed lacte uenter quoque soluendus est, liquanda aluus, interdum etiam ducenda; quibus extenuatum corpus incipit spiritum trahere commodius. Caput autem etiam in lecto sublime habendum est; thorax fomentis cataplasmatisque calidis aut siccis aut etiam umidis adiuuandus est, et postea uel malagma superimponendum, uel certe ceratum ex cyprino uel irino unguento. Sumenda deinde ieiuno potui mulsa aqua, ⟨cum qua⟩ uel hysopus cocta uel contrita capparis radix sit. Deli⟨n⟩gitur etiam utiliter aut nitrum aut nasturcium album frictum, deinde contritum et cum melle mixtum; simulque coquntur mel, galbanum, resina terebenthina, et ubi coierunt, ex his quod fabae magnitudinem habet cotidie sub lingua liquatur: aut sulpuris ignem non experti P. #1108 #1109 #1110 ⟨h⟩abrotoni P. #1108 #1109 in uini cyatho teruntur, idque tepefactum sorbetur. Est etiam non uana opinio uulpinum iecur, ubi siccum est et aridum factum, contundi oportere polentamque ex eo potioni aspergi; uel eiusdem pulmonem quam recentissimum assum, sed sine ferro coctum, edendum esse. Praeter haec sorbitionibus et lenibus cibis utendum est, interdum uino tenui, austero, nonnumquam uomitu. Prosunt etiam quaecumque urinam augent, sed nihil magis quam ambulatio lenta paene usque ad lassitudinem; frictio multa praecipue inferiorum partium, uel in sole uel ad ignem, et per se ipsum et per alios usque ad sudorem.

[¶1] 9. 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 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.

> Latin: 9. In interiore uero faucium parte interdum exulceratio esse consueuit. In hac plerique extrinsecus cataplasmatis calidis fomentisque umidis utuntur: uolunt etiam uaporem calidum ore recipi. Per quae molliores alii partes eas fieri dicunt oportunioresque uitio iam haerenti. Sed si bene uitari frigus potest, tuta illa praesidia; si metus eius est, superuacua sunt. Vtique autem perfricare fauces periculosum est: exulcerat enim. Neque utilia sunt quae urinae mouendae sunt, quia possunt, dum transeunt, ibi quoque pituitam extenuare [quam supprimi melius est]. Asclepiades multarum rerum, quas ipsi quoque secuti sumus, auctor bonus, acetum ait quam acerrimum esse sorbendum: hoc enim sine ulla noxa comprimi ulcera. Sed id supprimere sanguinem, ulcera ipsa sanare non potest. Melius huic rei Lycium est, quod idem quoque ⟨aeque⟩ probat, uel porri uel marrubii sucus, uel nuces Graecae cum tracanto contritae ⟨et cum passo mixtae⟩, uel lini semen contritum et cum dulci uino mixtum. Exercitatio quoque ambulandi currendique necessaria est, frictio a pectore uehemens toti inferiori parti adhibenda. Cibi uero esse debent neque nimium acres neque asperi, mel, lenticula, tragum, lac, tisana, pinguis caro, praecipueque porrum et quicquid cum hoc mixtum est. Potionis quam minimum esse conuenit; aqua dari potest uel pura, uel in qua malum Cotoneum palmulaeue decoctae sint. Gargarizationes quoque lenes, sin hae parum proficiunt, reprimentes, utiles sunt. Hoc genus neque acutum est et potest esse non longum: curationem tamen maturam, ⟨ne⟩ uehementer et diu laedat, desiderat.

[¶2] 10. 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 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.

> Latin: 10. Tussis uero fere propter faucium exulcerationem est. Quae multis modis contrahitur: itaque illis restitutis ipsa finitur. Solet tamen interdum per se quoque male habere, et uix, cum uetus facta est, eliditur. Et modo arida est, modo pituitam citat.—Oportet hysopum altero quoque die bibere; spiritu retento currere, sed minime in puluere; ac lectione uti uehementi, quae primo impedita tussi, post eam uincit; tum ambulare; deinde per manus quoque exerceri, et pectus diu perfricari; post haec quam pinguissimae ficus uncias tres super prunam incoctas esse. Praeter haec, si umida est, prosunt frictiones ualidae cum quibusdam calfacientibus, sic ut caput quoque siccum uehementer perfricetur; item cucurbitulae pectori admotae; sinapi ex parte exteriore faucibus inpositum, donec leuiter exulceret; potio ex menta nucibusque Graecis et amylo; primoque adsumptus panis aridus, deinde aliquis cibus lenis. At si sicca tussis est, cum uehementissime urget, adiuuat uini austeri cyathus adsumptus, dum ne amplius id interposito tempore aliquo quam ter aut quater fiat; item laseris quam optimi paulum deuorare opus est; porri uel marrubii sucum adsumere; scillam delingere, acetum ex ea uel certe acre sorbere; aut cum spica alii contriti duos uini cyathos. Vtilis etiam in omni tussi est peregrinatio, nauigatio longa, loca maritima, natationes; cibus interdum mollis, ut malua, ut urtica, interdum acer; lac cum alio coctum; sorbitiones, quibus laser sit adiectum, aut in quibus porrum incoctum tabuerit; ouum sorbile sulpure adiecto; potui primum aqua calida, deinde in uicem aliis diebus haec, aliis uinum.

[¶3] 11. 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 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 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 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.

> Latin: 11. Magis terreri potest aliquis, cum sanguinem expuit: sed id modo minus, modo plus periculi habet. Exit modo ex gingiuis, modo ex ore et quidem ex hoc interdum etiam copiose, sed sine tussi, sine ulcere, sine gingiuarum ullo uitio, ita ut nihil excreetur. Verum ut ex naribus aliquando, sic ex ore prorumpit. Atque interdum sanguis profluit, interdum simile aquae quiddam, in qua caro recens lota est. Nonnumquam autem is a summis faucibus fertur, modo exulcerata ea parte, modo non exulcerata, sed aut ore uenae alicuius adaperto, aut tuberculis quibusdam natis, exq⟨ue⟩ his sanguine erumpente. Quod ubi incidit, neque laedit potio aut cibus neque quicquam ut ex ulcere excreatur. Aliquando uero gutture et arteriis exulceratis frequens tussis sanguinem quoque extundit: interdum etiam fieri solet, ut aut ex pulmone aut ex pectore aut ex latere aut ex iocinere feratur. Saepe feminae, quibus sanguis per menstrua non respondit, hunc expuunt. Auctoresque medici sunt uel exe⟨s⟩a parte aliqua sanguinem exire, uel rupta, uel ore alicuius uenae patefacto: primam ΔΙΑΒΡΩΣΙΝ, secundam ΡΗΞΙΝ[ΣΧΑΣΜΟΝ], tertiam ΑΝΑΣΤΟΜΩΣΙΝ appellant. Vltima minime nocet, prima grauissime. Ac saepe quidem euenit, uti sanguinem pus sequatur. Interdum autem qui sanguinem ipsum suppressit, satis ad ualetudinem profuit: sed si secuta ulcera sunt, si pus, si tussis est, prout sedes ipsa est, ita uaria et periculosa genera morborum sunt. Si uero sanguis tantum fluit, expeditius et remedium et finis est. Neque ignorari oportet eis, quibus fluere sanguis solet aut quibus dolet spina coxaeue aut post cursum uehementem uel ambulationem, dum febris absit, non esse inutile sanguinis mediocre profluuium, idque per urinam redditum quoque ipsam lassitudinem soluere; ac ne in eo quidem terribile esse, qui ex superiore loco decidit, si tamen in eius urina nihil nouauit; neque uomitum huius adferre periculum, etiam cum repetit, si ante confirmare et implere corpus licuit et ex toto nullum nocere, qui in corpore robusto neque nimius est neque tussim aut calorem mouet. Haec pertinent ad uniuersum: nunc ad ea loca, quae praeposui, ueniam. Si ex gingiuis exit, portulacam manducasse satis est; si ex ore, continuisse eo merum uinum; si parum id proficit, acetum. Si inter haec quoque grauiter erumpit, quia consumere hominem potest, commodissimum est impetum eius admota occipitio cucurbitula, sic ut cutis quoque incidatur, auertere: si id mulieri, cui menstrua non feruntur, euenit, eandem cucurbitulam incisis inguinibus eius admouere. At si ex faucibus interioribusue partibus processit, et metus maior est et cura maior adhibenda. Sanguis mittendus est, et si nihilo minus ex ore processit, iterum tertioque, et cotidie paulum aliquid. Protinus autem debet sorbere uel acetum uel cum ture plantaginis aut porri sucum, imponendaque extrinsecus supra id, quod dolet, lana sucida ex aceto est, et id spongia subinde refrigerandum. Erasistratus horum crura quoque et femora brachiaque pluribus locis deligabat. Id Asclepiades adeo non prodesse, etiam inimicum esse proposuit. Sed id saepe commode respondere experimenta testantur. Neque tamen pluribus locis deligari necesse est, sed satis est infra inguina et super talos, summosque umeros, etiam brachia. Tum si febris urget, danda est sorbitio, et potui aqua, in qua aliquid ex is, quae aluum adstringunt, decoctum sit. At si abest febris, uel elota halica uel panis ex aqua frigida et molle quoque ouum dari potest, potui uel idem, quod supra scriptum est, uel uinum dulce uel aqua frigida: sed sic bibendum erit, ut sciamus huic morbo sitim prodesse. Praeter haec necessaria sunt quies, securitas, silentium. Caput huius quoque cubantis sublime esse debet, recteque tondetur; facies saepe aqua frigida fouenda est. At inimica sunt uinum, balneum, uenus, in cibo oleum, acria omnia, item calida fomenta, conclaue calidum et inclusum, multa uestimenta corpori iniecta. Etiam frictiones * * ubi bene etiam sanguis conquieuit. Tum uero incipiendum est a brachiis cruribusque, a thorace abstinendum. In hoc casu per hiemem locis maritumis, per aestatem * mediterraneis opus est.

[¶4] 12. 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, 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 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, 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, 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).

> Latin: 12. Faucibus subest stomachus; in quo plura longa uitia incidere consuerunt. Nam modo ingens calor, modo inflatio hunc, modo inflammatio, modo exulceratio adficit: interdum ⟨pituita, interdum⟩ bilis oritur; frequentissimumque eius malum est, quo resoluitur, neque ulla re magis aut adficitur aut corpus adficit. Diuersa autem ut uitia eius, sic etiam remedia sunt. Vbi exaestuat, aceto cum rosa extrinsecus subinde fouendus inponendusque puluis cum oleo et ea cataplasmata, quae simul et reprimunt et emolliunt. Potui, nisi quid obstat, egelida aqua praestanda. Si inflatio est, prosunt admotae cucurbitulae neque incidere cutem necesse est: prosunt sicca et calida fomenta, sed non uehementissima. Interponenda abstinentia est; utilis in ieiunio potio est apsinthi uel hysopi uel rutae. Exercitatio primo leuis, deinde maior adhibenda est, maximeque quae superiores partes moueat; quod genus in omnibus stomachi uitiis aptissimum est. Post exercitationem opus est unctione, frictione; balneo quoque nonnumquam, sed rarius; interdum alui ductione; cibis deinde calidis neque inflantibus, eodemque modo calidis potionibus, primo aquae, post, ubi resedit inflatio, uini austeri. Illud quoque in omnibus stomachi uitiis praecipiendum est, [ut] quo modo se quisque aeger refecerit, eo ut sanus utatur: nam redit huic inbecillitas sua, nisi eisdem defenditur bona ualetudo, quibus reddita est. At si inflammatio aliqua est, quam fere tumor et dolor sequitur, prima sunt quies, abstinentia, lana sulpurata circumdata, in ieiuno absinth⟨i⟩um. Si ardor stomachum urget, aceto cum rosa subinde fouendus est: deinde cibis quidem utendum modicis; inponenda uero extrinsecus quae simul et reprimunt et emolliunt: ⟨post⟩ea deinde his detractis utendum calidis ex farina cataplasmatis, quae reliquias digerant; interdum aluus ducenda, adhibenda exercitatio et cibus plenior. At si ulcera stomachum infestant, eadem fere facienda sunt, quae in faucibus exulceratis praecepta sunt. Exercitatio, frictio inferiorum partium adhibenda; adhibendi lenes et glutinosi cibi, sed citra satietatem: omnia acria atque acida remouenda. Vino, si febris non est, dulci, aut si id infla⟨t⟩, certe leni utendum: sed neque praefrigido neque nimis calido. Si uero pituita stomachus impletur, necessarius modo in ieiuno, modo post cibum uomitus est: utilis exercitatio, gestatio, nauigatio, frictio. Nihil edendum bibendumque nisi calidum uitatis tantum is, quae pituitam contrahere consuerunt. Molestius est, si stomachus bile uitiosus est. Solent autem i, qui sic temptantur, interpositis quibusdam diebus hanc, et quidem, quod pessimum est, atram uomere.—His recte aluus ducitur, potiones ⟨ex⟩ absinthio dantur: necessaria gestatio, nauigatio est; si fieri potest, ex nausia uomitus *, uitanda cruditas, sumendi cibi faciles et stomacho non alieni, uinum austerum. Vulgatissimum uero pessimumque stomachi uitium est [resolutio est], cum cibi non tenax est, soletque desinere ali corpus ac sic tabe consumi.—Huic generi inutilissimum balineum est: lectiones exercitationesque superioris partis necessariae, item unctiones frictionesque; his perfundi frigida atque in eadem natare, canalibus eiusdem subicere et stomachum ipsum et magis etiam a scapulis id, quod contra stomachum est, consistere in frigidis medi⟨cat⟩isque fontibus, quales Cutiliarum Sumbruinarumque sunt, salutare est. Cibi quoque adsumendi sunt frigidi, qui potius difficulter coquntur, quam facile uitiantur. Ergo plerique, qui nihil aliud concoquere possunt, bubulam coqunt. Ex quo colligi potest neque auem neque uenationem neque piscem dari debere nisi generis durioris. Potui quidem aptissimum est uinum frigidum, uel certe bene calidum meracum, potissimum Raeticum uel Allobrogicum aliudue, quod et austerum et resina conditum est: si id non est, quam asperrimum maximeque Signinum. Si cibus non continetur, danda aqua et eliciendus plenior uomitus est, iterumque dandus cibus; et tum admouendae duobus in⟨f⟩ra stomachum digitis cucurbitulae ibique duabus aut tribus horis continendae sunt. Si simul et uomitus et dolor est, imponenda supra stomachum est lana sucida uel spongia ex aceto uel cataplasma, quod refrigeret. Perfricanda uero non diu sed uehementer brachia et crura et calfacienda. Si plus doloris est, in⟨fra⟩ praecordia quattuor digitis cucurbitula utendum est, et protinus dandus panis ex posca frigida: si non continuit, post uomitum lene aliquid ex is, quae non aliena stomacho sint: si ne id quidem tenuit, singuli cyathi uini singulis interpositis horis, donec stomachus consistat. Valens etiam medicamentum est radiculae sucus, ualentius acidi Punici mali c⟨u⟩m pari modo suci, qui ex dulci Punico malo est, adiecto etiam intubi suco et mentae, sed huius minima parte; quibus tantundem, quantum in his omnibus est, aquae frigidae quam optime miscetur: id enim plus quam uinum ad conprimendum stomachum potest. Supprimendus autem uomitus est, qui per se uenit. S⟨ed⟩ si nausia est aut si coacuit intus cibus aut computruit, quorum utrumlibet ructus ostendit, eiciendus est; protinusque, cibis adsumptis isdem, quos proxime posui, stomachus restituendus. Vbi sublatus est praesens metus, ad ea redeundum est, quae supra praecepta sunt.

[¶5] 13. 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, 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, 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.

> Latin: 13. Stomachus lateribus cingitur, atque in his quoque uehementes dolores esse consuerunt. Et initium uel ex frigore uel ex ictu uel ex nimio cursu uel ex morbo est. Sed interdum ⟨om⟩ne malum intra dolorem est isque modo tarde, modo celeriter soluitur: interdum ad perniciem quoque procedit oriturque acutus morbus, qui pleur⟨i⟩ticus a Graecis nominatur. Huic dolori lateris febris et tussis accedit; et per hanc excreatur, si tolerabilis morbus est, pituita; si grauis, sanguis. Interdum etiam sicca tussis est, quae nihil emo⟨l⟩itur, idque primo uitio grauius, secundo tolerabilius est.—Remedium uero est magni et recentis doloris sanguis missus: at siue leuior siue uetustior casus est, uel superuacuum uel serum id auxili est; confugiendumque ad cucurbitas est, ante summa cute incisa. Recte etiam sinapi ex aceto super pectus inponitur, donec ulcera pusulasque excitet, et tum medicamentum, quod umorem illuc citet. Praeter haec circumdare primum oportet latus abso lanae sulpuratae; deinde, cum paululum inflammatio se remisit, siccis et calidis fomentis uti. Ab his transitus ad malagmata est. Si uetustior dolor remanet, nouissime resina inposita discutitur. Vtendum cibis potionibusque calidis, uitandum frigus. Inter haec tamen non alienum e⟨s⟩t extremas partes oleo et sulpure perfricare; si leuata tussis est, leni lectione uti, iamque et acres cibos et uinum meracius adsumere. Quae ita a medicis praecipiuntur, ut tamen sine his rusticos nostros epota ex aqua herba trixa⟨g⟩o satis adiuuet. Haec in omni lateris dolore communia sunt: plus negotii est, si acutus quoque morbus is factus est. In hoc praeter ea, quae supra posita sunt, haec animaduertenda sunt; ut cibus sit quam maxime tenuis et lenis, praecipueque sorbitio eaque ex tisana potissimum, aut ius, in quo porrus cum pullo gallinaceo coctus sit, idque non nisi tertio quoque die detur, si tamen per uires licebit: potui uero aqua mulsa, in qua hysopum aut ruta decocta sit. Quae quibus temporibus danda sint, ex ratione uel adiectae uel leuatae febris apparebit, sic ut in remissione quam maxima dentur, cum eo tamen, ut sciamus non esse eius generis tussi aridas fauces committendas: nam saepe, ubi nihil est, quod excreetur, continuatur et strangulat. Ob quam causam dixi etiam peius id genus esse tussis, quod nihil quam quod pituitam moueret. Sed hic uinum sorbere, ut supra praecepimus, morbus ipse non patitur: in uicem eius cremor tisanae sumendus est. Vt his autem in ipso morbi feruore sustinendus aeger est, sic, ubi paululum is se remisit, alimenta pleniora et uini quoque aliquid dari potest, dum nihil detur, quod aut refrigeret corpus aut fauces asperet. Si in refectione quoque manserit tussis, intermittere oportebit uno die, posteroque cum cibo uini paulo plus adsumere. Atque incipiente quoque tussi, tum non erit alienum, ut supra quoque positum est, uini cyathos sorbere, sed id in hoc genere ualetudinis dulce uel certe lene commodius est. Si malum inueterauit, athletico uictu corpus firmandum est.

[¶6] 14. 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 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, 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.

> Latin: 14. A compagine corporis ad VISCERA transeundum est, et inprimis ad pulmonem ueniendum; ex quo uehemens et acutus morbus oritur, quem peripleumoniac⟨o⟩n Graeci uocant. Eius haec condicio est: pulmo totus adficitur; hunc casum eius subsequitur tussis bilem uel pus trahens, praecordiorum totiusque pectoris grauitas, spiritus difficultas, magnae febres, continua uigilia, cibi fastidium, tabes. Id genus morbi plus periculi quam doloris habet.—Oportet, si satis ualidae uires sunt, sanguinem mittere; si minores, cucurbitulas sine ferro praecordiis admouere. Tum si satis ualet, gestando aegrum digerere; si parum, intra domum tamen dimouere: potionem autem hysopi * cum quo ficus arida sit incocta, aut aquam mulsam, in qua uel hysopum uel ruta decocta sit: frictione uti diutissime in scapulis, proxime ab his in brachiis et pedibus et cruribus, leuiter contra pulmonem, idque bis cottidie facere. Quod ad cibum uero pertinet, huic nec salsis opus est neque acribus neque amaris neque aluum adstringentibus, sed paullo lenioribus. Ergo primis diebus danda est sorbitio tisanae uel halicae uel oryzae, cum qua recens adeps cocta sit: cum hac sorbile ouum, nuclei pinei ex melle, panis uel elota halica ex aqua mulsa; potui deinde non solum pura aqua sed etiam mulsa egelida, aut si aestas est, etiam frigida, nisi quid obstat. Haec autem altero quoque die increscente morbo dare satis est. Vbi increment⟨um⟩ constitit, quantum res patitur, ab omnibus abstinendum est, praeterquam aqua egelida. Si uires desunt, adiuuandae sunt aqua mulsa. Prosuntque aduersus dolores imposita calida fomenta uel ea, quae simul et reprimunt et emolliunt. Prodest impositus super pectus sal bene contritus cum cerato mixtus, quia leuiter cutem erodit, eoque impetum materiae, quo pulmo uexatur, euocat. Vtile etiam aliquod malagma est ex is, quae materiam trahunt. Neque alienum est, dum premit morbus, clausis fenestris aegrum continere: ubi paullum leuatus est, ter aut quater die fenestris aliquis apertis paruum aerem recipere. Deinde in refectione pluribus diebus a uino abstinere; gestatione, frictione uti, sorbitionibus; et prioribus cibis adicere ex holeribus porrum, ex carne ungulas et summa trunculorum, atque pisciculos, sic ut diu nihil ⟨nisi⟩ molle et lene sumatur.

## 14. Book IV · chapters 15–25

Source: https://scriptura.si/works/celsus-on-medicine/14/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/14/#p-N

[¶0] 15. 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 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.

> Latin: 15. Alterius quoque uisceris morbus, iocineris, aeque modo longus, modo acutus esse consueuit: ΗΠΑΤΙΚΟΝ Graeci uocant. Dextra parte sub praecordiis uehemens dolor est, idemque ad latus dextrum et ad iugulum umerumque partis eiusdem peruenit: nonnumquam manus quoque dextra torquetur, horror calidus est. Vbi male est, bilis euomitur; interdum singultus prope strangulat. Et haec quidem acuti morbi sunt: longioris uero, ubi suppuratio in iocinere est, dolorque modo finitur, modo intenditur, dextra parte praecordia dura sunt et tument; post cibum maior spiritus difficultas est; accedit maxillarum quaedam resolutio. Vbi inueterauit malum, uenter et crura pedesque intumescunt, pectus atque umeri circaque iugulum utrumque extenuatur.—Initio sanguinem mittere optimum est: tum uenter soluendus est, si non potest aliter, per nigrum ueratrum. Inponenda extrinsecus cataplasmata, primum quae reprimant, deinde calida quae diducant, quibus recte iris uel apsinthium adicitur; post haec malagma. Dandae uero sorbitiones sunt, omnesque cibi et calidi et qui non multum alant, ei fere qui pulmonis quoque dolori conueniunt, praeterque eos, qui urinam mouent, potionesque ad id efficaces. Vtilia in hoc morbo sunt thymum, satureia, hysopum, nepeta, amulum, sesamum, lauri bacae, pini flos, herba sanguinalis, menta, ex malo Cotoneo medium, columbae iecur recens et crudum. Ex quibus quaedam per se esse, quaedam adicere uel sorbitioni uel potioni licet, sic tamen, ut parce adsumantur. Neque alienum est absinthium contritum ex melle et pipere, eiusque catapotium cotidie deuorare. Abstinendum utique est ab omnibus frigidis: neque enim res ulla magis iecur laedit. Frictionibus utendum in extremis partibus: uitandus omnis labor, omnis uehementior motus; ne spiritus quidem diutius continendus est. Ira, trepidatio, pondus, ictus, cursus inimica sunt. Perfusio corporis multa prodest ex aqua, si hiemps est, calida, si aestas, tepida; item liberalis unctio et in balneo sudor. Si uero iecur uomica laborat, eadem facienda sunt, quae in ceteris interioribus suppurationibus. Quidam etiam contra id scalpello aperiunt et ipsam uomicam adurunt.

[¶1] 16. 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 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 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.

> Latin: 16. At lienis, ubi adfectus est, intumescit, simulque cum eo pars sinistra; eaque dura est et prementi renititur: uenter intentus est; aliquis etiam cruribus tumor est. Vlcera aut omnino non sanescunt, aut certe cicatricem uix recipiunt: in intenta ambulatione cursuque dolor et quaedam difficultas est.—Hoc uitium quies auget: itaque exercitatione et labore opus est, habita tamen ratione, ne febrem i⟨s⟩ta, si nimium processeri⟨n⟩t, excitent. Vnctiones frictionesque et sudores necessarii sunt. Dulcia omnia inimica sunt, item lac et caseus: acida autem maxime conueniunt. Ergo acetum acre per se sorbere, et magis etiam quod scilla conditum est, expedit. Edenda sunt salsamenta uel oleae ex muria dura, tinctae in aceto lactucae, intubique ex eodem, betae ex sinapi, asparagus, armoracia, pastinaca, ungulae, rostra, aues macrae, eiusdem generis uenatio. Potui uero ieiuno dari debet apsinthium incoctum: at post cibum aqua a ferrario fabro, in qua candens ferrum subinde tinctum sit: haec enim uel praecipue lienem coercet. Quod animaduersum est in is animalibus, quae aput hos fabros educata exiguos lienes habent. Potest etiam dari uinum tenue, austerum; omniaque in cibis et potionibus, quae urina⟨e⟩ mouendae sunt. Praecipueque ad id ualet uel trifolii semen uel cuminum uel apium uel serpullum uel cytisus uel portulaca uel nepeta uel thymum uel hysopum uel satureia: haec enim inde commodissime uidentur umorem deducere. Lienis quoque bubulus utiliter esui datur; praecipueque eruca et nasturcium lienem extenuant. Inponenda quoque extrinsecus sunt quae leuent. [Fit ex unguento et palmulis, quod myrobalanon Graeci uocant; fit ex lini et nasturci semine, quo uinum et oleum adicitur; fit ex cupresso uiridi et arida ficu; fit ex sinapi, cui sebi hirquini a renibus quarta pars ponderis adicitur, teriturque in s⟨o⟩le et protinus imponitur.] Multisque modis huic rei cappari aptum est: nam et ipsum cum cibo adsumere et muriam eius cum aceto sorbere commodum est. Quin etiam extrinsecus radicem contritam uel corticem eius cum furfuribus aut ipsum cappari cum melle contritum imponere expedit. Malagmata quoque huic rei aptantur.

[¶2] 17. 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.

> Latin: 17. At renes ubi adfecti sunt, diu male habent. Peius est, si frequens biliosus uomitus accedit.—Oportet conquiescere, cubare molliter, soluere aluum, si aliter non respondet, etiam ducere; saepe desidere in aqua calida; neque cibum neque potionem frigidam adsumere; abstinere ab omnibus salsis, acidis, acribus, pomis; bibere liberaliter; ⟨a⟩dicere modo cibo modo potioni piper, porrum, ferulam, album papauer; quae maxime inde urinam mouere consuerunt. Auxilio quoque his exulceratis sunt, si adhuc ulcera purganda sunt, cucumeris semina detractis corticibus sexaginta, nuclei ex pinu siluestri XII, anesi quod tribus digitis sumi possit, croci paulum, contrita et in duas mulsi potiones diuisa: si uero dolor tantum leuandus est, eiusdem cucumeris semina XXX, idem nuclei XX, nuces Graecae V, croci paululum, contrita e⟨t⟩ cum lacte potui data. A⟨c⟩ super quoque recte quaedam malagmata iniciuntur, maximeque ea, quae umori extrahendo sunt.

[¶3] 18. 18 From the viscera we proceed to the intestines, which are subject to diseases, both acute and chronic. 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 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.

> Latin: 18. A uisceribus ad INTESTINA ueniendum est, quae sunt et acutis et longis morbis obnoxia. Primo⟨que⟩ facienda mentio est choler⟨ae⟩, quia commune id stomachi atque intestinorum uitium uideri potest: nam simul et deiectio et uomitus est, praeterque haec inflatio est. Intestina torquentur, bilis supra infraque erumpit, primum aquae similis, deinde ut in ea recens caro lota esse uideatur, interdum alba, nonnumquam nigra uel uaria. Ergo eo nomine morbum hunc cholera⟨m⟩ Graeci nominarunt. Praeter ea uero, quae supra conprehensa sunt, saepe etiam crura manusque contrahuntur, urget sitis, anima deficit; quibus concurrentibus non mirum est, si subito quis moritur: neque tamen ulli morbo minor⟨e⟩ momento succurritur.—Protinus ergo, ubi ista coeperunt, aquae tepidae quam plurimum bibere oportet et uomere. Vix umquam fi⟨t⟩ ne uomitus sequatur: sed etiamsi incidit, miscuisse tamen nouam materiam corruptae prodest; parsque sanitatis est uomitum esse subpressum. Si id incidit, protinus ab omni potione abstinendum est: si uero tormina sunt, oportet frigidis et umidis fomentis stomachum fouere, uel si uenter dolet, isdem egelidis, sic ut uenter ipse mediocriter calentibus iuuetur. Quod si uehementer et uomitus et deiectio et sitis uexant, et adhuc subcruda sunt, quae uomuntur, nondum uino maturum tempus est: aqua, neque ea ipsa frigida, sed potius egelida danda est; admouendumque naribus est puleium ex aceto, uel polenta uino adsparsa, uel menta * secundum naturam est. ⟨A⟩t cum discussa cruditas est, tum magis uerendum est, ne anima deficiat. Ergo tum confugiendum est ad uinum. Id esse oportet tenue, odoratum, cum aqua frigida mixtum, uel polenta adiecta uel infracto pane, quem ipsum quoque adsumere expedit quotiensque aliquid aut stomachus aut uenter effudit, totiens per haec uires restituere. Erasistratus primo tribus uini guttis aut quinis aspergendam potionem esse dixit, deinde paulatim merum adiciendum. Is si et ab initio uinum dedit et metum cruditatis secutus est, non sine causa fecit: si uehementem infirmitatem adiuuari posse tribus guttis putauit, errauit. At si inanis est homo, et crura eius contrahuntur, interponenda potio apsinthi est. Si extremae partes corporis frigent, unguendae sunt calido oleo, cui cerae paulum sit adiectum, calidisque fomentis nutriendae. Si ne sub his quidem quies facta est, extrinsecus contra uentriculum ipsum cucurbitula admouenda est, aut sinapi superinponendum. Vbi is constitit, dormire oportet; postero die utique a potione abstinere, die tertio in balneum ire; paulatim se cibo reficere. Somno quisquis facile adquiescit * * * itemque lassitudine et frigore. Si post suppressam choleram febricula manet, aluum duci necessarium est, tum cibis uinoque utendum est.

[¶4] 19. 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, 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.

> Latin: 19. Sed hic quidem morbus et acutus est, et inter intestina stomachumque uersatur sic, ut cuius potissimum partis sit, non facile dici possit. In ipsius uero uentriculi porta consistit is, qui * * et longus esse consueuit: coeliacus a Graecis nominatur. Sub hoc uenter indurescit, dolorque eius est; aluus nihil reddit, ac ne spiritum quidem transmittit; extremae partes frigescunt; difficulter spiritus redditur. —Commodissimum est inter initia calida * et cataplasmata toto uentri imponere, ut dolorem leniant, post cibum uomere, atque ita uentrem exinanire; proxumis deinde diebus cucurbitulas sine ferro uentri et coxis admouere; uentrem ipsum liquare, dato lacte et uino salso frigido; si tempus anni patitur, etiam uiridibus ficis, sic tamen, ne quis aut cibus aut umor uniuersus detur sed paulatim. Ergo per interualla temporis sat est cyathos binos ternosue sumere, et cibum pro portione huius; commodeque facit cyatho lactis cyathus aquae mixtus et sic datus; cibique inflantes et acres utiliores sunt, adeo ut lacti quoque recte contritum alium adiciatur. Procedente uero tempore opus est gestari, maximeque nauigare; perfricari ter aut quater die, sic ut nitrum oleo adiciatur; perfundi aqua calida post cibum; deinde sinapi imponere per omnia membra, excepto capite, donec adrodatur et rubeat maximeque si corpus durum et uirile est. Paulatim deinde faciendus est transitus ad ea, quae uentrem conprimunt. Assa caro danda ualens, et quae non facile corrumpatur: potui uero pluuialis aqua decocta, sed quae per binos ternosue cyathos bibatur. Si uetus uitium est, oportet laser quam optimum ad piperis magnitudinem deuorare, altero quoque die uinum uel aquam bibere, interdum interposito cibo singulos uini cyathos sorbere: ex inferiore parte infundere pluuia[ti]lem egelidam aquam, maximeque si dolor in imis partibus remanet.

[¶5] 20. 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 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.

> Latin: 20. Int⟨ra⟩ ipsa uero intestina consistunt duo morbi, quorum alter in tenuiore, alter in pleniore est. Prior acutus est, insequens esse longus potest. Diocles Carystius tenuioris intestini morbum ΧΟΡΔΑΨΟΝ, plenioris ΕΙΛΕΟΝ nominauit: a plerisque uideo nunc illum priorem ΕΙΛΕΟΝ, hunc ΚΟΛΙΚΟΝ nominari. Sed prior ⟨modo supra umbilicum⟩, modo sub umbilico dolorem mouet. Fit alterutro ⟨loco⟩ inflammatio; nec aluus nec spiritus infra transmittitur. ⟨Si⟩ superior pars adfecta est, cibus, si inferior, stercus per os redditur, si utrumlibet, uetus est. Adicit periculo uomitus biliosus, mali odoris, aut uarius aut niger.—Remedium est sanguinem mittere aut cucurbitulas pluribus locis admouere, non ubique cute incisa: id enim duobus aut tribus locis satis est: ex ceteris spiritum euocare abunde est. Tum animaduertere oportet quo loco malum sit: solet enim contra id tumere. Et si supra umbilicum est, alui ductio utilis non est: si infra est, aluum ducere, ut Erasistrato placuit, optimum est, et saepe id auxilii satis est. Ducitur autem percolato tisanae cremore cum oleo et melle, sic ut praeterea nihil adiciatur. ⟨Si nihil⟩ tumet, duas manus imponere oportet supra summum uentrem, paulatimque deducere: inuenietur enim mali locus, qui necesse est renitatur; et ex eo d⟨e⟩liberari poterit, ducenda necne aluus sit. Illa communia sunt; calida cataplasmata admouere, eaque imponere a mammis usque ad inguina et spinam ac saepe mutare; brachia cruraque perfricare, demittere totum hominem in calido oleo: si dolor non quiescit, etiam in aluum ex parte inferiore tres aut quattuor cyathos calidi olei dare. Vbi per haec consecuti sumus, ut iam ex inferiore parte spiritus transmittatur, offerre potui mulsum tepidum non multum: nam ante magna cura uitandum est, ne quid bibat. Si id commode cessit, adicere sorbitionem. Vbi dolor et febricula quierunt, tum demum uti cibo pleniore, sed neque inflante neque duro neque ualido, ne intestina adhuc imbecilla laedantur: potui uero nihil * praeterquam puram aquam. Nam siue quid uinulentum siue acidum est, id huic morbo alienum est. Ac postea quoque uitare oportet balneum, ambulationem, gestationem, ceterosque corporis motus: nam facile id malum redire consueuit, et, siue cum frigus subit siue aliqua iactatio, nisi bene iam confirmatis intestinis reuertitur.

[¶6] 21. 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.

> Latin: 21. Is autem morbus, qui ⟨in⟩ intestino pleniore est, in ea maxime parte est, quam ⟨caec⟩am esse proposui. Vehemens fit inflatio, uehementes dolores, dextra magis parte; intestinum, quod uerti uidetur * * prope spiritum elidit. In plerisque post frigora cruditatesque oritur, deinde quiescit, et per aetatem saepe repetens sic cruciat, ut uitae spatio nihil demat.—Vbi is dolor coepit, admouere sicca et calida fomenta oportet, sed primo len⟨i⟩a, deinde ualidiora, simulque friction⟨e⟩ ad extremas partes [id est crura brachiaque] materiam reuocare: si discussu⟨s⟩ non est, qua dolet, cucurbitulas sine ferro defigere. Est etiam medicamentum eius rei causa comparatum, quod colicon nominatur: id se repperisse Cassius gloriabatur. Magis prodest potui datum, sed impositum quoque extrinsecus digerendo spiritum dolorem leuat. Nisi finito uero tormento recte neque cibus neque potio adsumitur. Quo uictu sit utendum, qui hoc genere temptantur, iam mihi dictum est. [Confectio medicamenti, quod colicon nominatur: ex his constat: costi, anesi, castorei, singul⟨orum⟩ P#1111 #1108 III, petroselini P#1111 de〈n〉 III, piperis longi et rotundi, singul⟨orum⟩ P#1111 #1108 II, papaueris lacrimae, iunci rotundi, myrrae, nardi, singul⟨orum⟩ P#1111 #1108 VI; quae melle excipiuntur. Id autem et deuorari potest et ex aqua calida sumi.]

[¶7] 22. 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.

> Latin: 22. Proxima his inter intestinorum mala tormina esse consueuerunt: dys⟨e⟩nteria Graece uocatur. Intus intestina exulcerantur; ex his cruor manat isque modo cum stercore aliquo semper liquido, modo cum quibusdam quasi muccosis excernitur, interdum simul quaedam carnosa descendunt; frequens deiciendi cupiditas dolorque in ano est. Cum eodem dolore exiguum aliquid emittitur atque eo quoque tormentum intenditur; idque post tempus aliquod leuatur exiguaque requies est; somnus interpellatur; febricula oritur; longoque tempore id malum cum inueterau[er]it, aut tollit hominem, aut, etiamsi finitur, excruciat. —Oportet inprimis conquiescere, siquidem omnis agitatio exulcerat; deinde ieiunum sorbere uini cyathum, cui contrita radix quinquefolii sit adiecta; imponere cataplasmata super uentrem, quae reprimunt, quod in superioribus uentris morbis non expedit; quotiensque desidit, subluere aqua calida, in qua decoctae uerbenae sint; port⟨u⟩lacam uel coctam uel ex dura muria ⟨e⟩sse; cibos potionesque eas, quae adstringunt aluum … Si uetustior morbus est, ex inferioribus partibus tepidum infundere uel tisanae cremorem uel lac uel adipem liquatam uel medullam ceruinam uel oleum uel cum rosa butyrum uel cum eadem album crudum ex ouis uel aquam, in qua lini semen decoctum sit, uel si somnus non accedit, uitellos cum aqua, in qua rosae floris folia cocta sint: leuant enim dolorem haec et mitiora ulcera efficiunt, maximeque utilia sunt, si cibi quoque secutum fastidium est. Themison muria dura quam asperrima ⟨h⟩ic utendum memoriae prodidit. Cibi uero esse debent, qui leniter uentrem ⟨ad⟩stringant. ⟨A⟩t ea, quae urinam mouent, si ea consecuta sunt, in aliam partem umorem auertendo prosunt: si non sunt consecuta, noxam augent; itaque nisi in quibus prompte id facere consuerunt, non sunt adhibenda. Potui, si febricula est, aqua pura calida uel ea, quae ipsa quoque adstringat, dari debet: si non est, uinum leue, austerum. Si pluribus diebus nihil remedia alia iuuerunt uetusque iam uitium est, aquae bene frigidae potio adsumpta ulcera adstringit et initium secundae ualetudinis facit. Sed ubi uenter suppressus est, protinus ad calidam potionem reuertendum est. Solet autem interdum etiam putris sanies pessimique odoris descendere, solet purus sanguis profluere. Si superius uitium est, aluus aqua mulsa duci debet, tunc deinde eadem infundi, quae supra comprehensa sunt. [Valensque est etiam aduersus cancerem intestinorum minii gleba cum salis hemina contrita, si mixta his aqua in aluum datur.] A⟨t⟩ si sanguis profluit, cibi potionesque esse debent, quae adstringant.

[¶8] 23. 23 From dysentery there proceeds sometimes leienteria, when the intestines cannot retain anything, and whatever is swallowed is straightway excreted imperfectly digested. Sometimes in the patients this drags on, sometimes it hurries them off. In this affection especially astringents should be put on the chest, and when the skin becomes ulcerated, then an emollient to draw out humour; and the patient should sit in a decoction of vervains; take both food and drink which control the bowel: and have cold water poured over him. Nevertheless, care should be taken lest with all these remedies there be an opposite trouble set up by excessive flatulence. Consequently, little by little, the intestines should be strengthened by some additions daily. As in the case of any abdominal flux, so in this, it is particularly necessary that the patient should go to stool, not as often as inclined, but as often as compelled, so that by such delay the intestines may be got into the habit of holding up their contents. There is another thing which, whilst applicable equally to all similar affections, is to be specially observed in this, that as many beneficial medicaments are disagreeable to the taste, such as the mixture containing plantain and blackberries and any mixture containing pomegranate rind, that shall be chosen which the patient likes most. Moreover, if he loathes all of them, something to excite his appetite should be interposed, less useful, perhaps, but most pleasant. Exercise and rubbing are needed in this disease also, as well as heat, whether of the sun, or a fire, and baths; and according to Hippocrates, a vomit even by white hellebore, when other measures prove of little avail.

> Latin: 23. Ex torminibus interdum intestinorum leuitas oritur, quae * * continere nihil possunt, et, quicquid adsumptum est, imperfectum protinus reddunt. Id interdum aegros trahit, interdum praecipitat.—In hoc utique adhibere oportet comprimentia, quo facilius tenendi aliquid intestinis uis sit. Ergo et super pectus ponetur sinapi, exulcerataque cute malagma, quod umorem euocet; et ex uerbenis decoct⟨a in⟩ aqua desidat; et cibos potionesque adsumat, quae aluum adstringunt; et frigidis utetur perfusionibus. Oport⟨et⟩ tamen prospicere, ne simul his omnibus admotis uitium contrarium per immodicas inflationes oriatur. Paulatim ergo firmari intestina debebunt aliquibus ⟨c⟩otidie adiectis. Et cum in omni fluore uentris, tum in hoc praecipue necessarium est, non quotiens libet desidere, sed quotiens necesse est, ut haec ipsa mora in consuetudinem ferendi oneris intestina deducat. Alterum quoque, quod aeque ad omnes similes adfectus pertinet, in hoc maxime seruandum est, ut, cum pleraque utilia insuauia sint, qualis est plantago et rubi et quicquid malicorio mixtum est, ea potissimum ex his dentur, quae maxime aeger uolet. Deinde, si omnia ista fastid⟨i⟩t, ad excitandam cibi cupiditatem interponatur aliquid minus utile, sed magis gratum. Exercitationes, frictiones huic quoque morbo necessariae sunt, et cum his sol, ig⟨n⟩is, balneum; uomitus, ut Hippocrati uisum est, etiam albo ueratro, si cetera parum proficient, euocatus.

[¶9] 24. 24 Again, worms also occasionally take possession of the bowel, and these are discharged at one time from the lower bowel, at another more nastily from the mouth: and we observe them sometimes to be flattened, which are the worse, at times to be rounded. For the flat worms there should be given as draughts, a decoction of lupins, of or of mulberry bark, to which may be added, after pounding, either hyssop or a vinegar cupful of pepper, or a little scammony. Alternatively on one day let him eat a quantity of garlic and vomit, then on the next day take a handful of fine pomegranate roots, crush them and boil them in a litre and a half of water down to one-third, to this add a little soda, and drink it on an empty stomach. At three hours' interval, let him take two further draughts; but with the addition of half a pint of sea water or strong brine; then on going to stool, sit over a basin of hot water. Again, for the round worms which especially trouble children, both the same remedies may be given and some milder ones, such as pounded-up seeds of nettles or of cabbage or of cummin in water, or mint in the same or a decoction of wormwood or hyssop in hydromel or cress seeds pounded up in vinegar. It is also of service either to eat lupin or garlic, or administer into the lower bowel a clyster of olive oil.

> Latin: 24. Nonnumquam autem lumbrici quoque occupant aluum, hique modo ex inferioribus partibus, modo foedius ore redduntur; atque interdum latos eos, qui peiores sunt, interdum teretes uidemus.—Si lati sunt, aqua potui dari debet, in qua lupinum aut cortex mori decoctus sit, aut cui adiectum sit contritum uel hysopum uel piperis acetabulum uel scamoniae paulum. Vel etiam pridie, cum multum a⟨l⟩ium ⟨ed⟩erit, uomat, posteroque die mali Punici tenues radiculas colligat, quantum manu comprehendet; eas contusas in aquae tribus sextariis decoquat, donec tertia pars supersit; huc adiciat nitri paulum, et ieiunus bibat. Interpositis deinde tribus horis duas potiones sumat; at aquae * * * uel muriae durae sit adiecta; tum desidat subiecta calida aqua in pelue. Si uero teretes sunt, qui pueros maxime exercent, et eadem dari possunt et quaedam leuiora, ut contritum semen urticae aut brassicae aut cumini cum aqua, uel menta cum eadem uel absinthium decoctum uel hysopum ex aqua mulsa uel nasturcii semen cum aceto contritum. Edisse etiam et lupinum et a⟨l⟩ium prodest, uel ⟨in⟩ aluum oleum subter dedisse.

[¶10] 25. 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.

> Latin: 25. Est autem aliud leuius omnibus proximis, de quibus supra dictum est, quod ⟨t⟩enesmon Graeci uocant. Id neque acutis neque longis morbis adnumerari debet, cum et facile tollatur neque umquam per se iugulet. In hoc aeque atque in torminibus frequens desidendi cupiditas est, aeque dolor, ubi aliquid excernitur. Descendunt autem pituitae muccisque similia, interdum etiam le⟨u⟩iter subcruenta: sed his interponuntur nonnumquam ex cibo quoque recte coacta. —Desidere oportet in aqua calida saepiusque ipsum ⟨a⟩nu⟨m⟩ nutrire. Cui plura medicamenta idonea sunt: butyrum cum rosa; a⟨c⟩acia ex aceto liquata; e⟨m⟩plastrum id, quod ΤΕΤΡΑΦΑΡΜΑΚΟΝ Graeci uocant, rosa liquatum; alumen lana circumdatum et ita adpositum, eademque ex inferiore parte indita, quae torminum auxilia sunt; eadem * * uerbenae decoctae, ut inferiores partes foueantur. Alternis uero diebus aqua, alternis leue et austerum uinum bibendum est. Potio esse debet egelida et frigida⟨e⟩ pro⟨p⟩ior; ratio uictus talis, qualem in tormin⟨ibus⟩ supra praecepimus.

## 15. Book IV · chapters 26–32

Source: https://scriptura.si/works/celsus-on-medicine/15/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/15/#p-N

[¶0] 26. 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.

> Latin: 26. Leuior etiam, dum recens, deiectio est, ubi et liquida aluus et saepius quam ex consuetudine fertur; atque interdum tolerabilis dolor est, interdum grauissimus, idque peius est. Sed uno die fluere aluum saepe pro ualetudine est, atque etiam pluribus, dum febris absit et intra septimum diem id conquiescat. Purgatur enim corpus, et quod intus laesurum erat, utiliter effunditur. Verum spatium periculosum est: interdum enim tormina ac febriculas excitat uiresque consumit. —Primo die quiescere satis est, neque impetum uentris prohibere. Si per se desiit, balneo uti, paulum cibi capere; si mansit, abstinere non solum a cibo sed etiam a potione. Postero die si nihilo minus liquida aluus est, aeque conquiescere, paulum astringentis cibi sumere. Tertio die in balneum ire; uehementer omnia praeter uentrem perfricare, ad ignem lumbos scapulasque admouere; cibis uti, sed uentrem contrahentibus, uino non multo mera⟨c⟩o. Si postero quoque die fluet, plus e[di]sse, sed uomere et, ex toto donec conquiescat, contra siti, fame, uomitu niti: uix enim fieri potest, ut post hanc animaduersionem aluus non contrahatur. Alia uia est, ubi uelis subprimere, cenare, deinde uomere; postero die in lecto conquiescere, uespere ungi, sed leniter; deinde panis circa selibram ex uino Aminaeo mero sumere; tum assum aliquid, maximeque auem, et postea uinum idem bibere aqua pluuiali mixtum, idque usque quintum diem facere, iterumque uomere. Frigidam autem adsidue potionem esse debere contra priores auctores Asclepiades affirmauit, et quidem quam frigidissimam. E⟨go⟩ experimentis quemque in se credere debere existimo, calida potius an frigida utatur. Interdum autem euenit, ut id pluribus diebus neglectum curari difficilius possit. A uomitu oportet incipere; deinde postero die uespere tepido loco ungi; cibum modicum adsumere, uinum mera⟨c⟩um quam asperrimum; impositam super uentrem habere cum cerato rutam. In hoc autem affectu corporis neque ambulatione neque frictione opus est: uehiculo sedisse uel magis etiam equo prodest: neque enim ulla res magis intestina confirmat. Si uero etiam medicamentis utendum, aptissimum est id, quod ex pomis fit. Vindemiae tempore in grande uas coicienda sunt pira atque mala siluestria: si ea non sunt, pira Tarentina uiridia uel Signina, mala Scaudiana uel Amerina, myrapia; hisque adicienda sunt Cotonea, et cum ipsis corticibus suis Punica, sorba, et, quibus magis utimur, [et] torminalia, sic ut haec tertiam ollae partem teneant; tum deinde ea musto implenda est, coquendumque id, donec omnia, quae indita sunt, liquata ⟨in⟩ unitatem quandam coeant. Id gust⟨u⟩ non insuaue est, et, quandocumque opus est, adsumptum, leniter sine ulla stomachi noxa uentrem tenet. Duo aut tria coclearia uno die sumpsisse sat⟨is⟩ est. Alterum ualentius genus est: murtae bacas legere, ex his uinum exprimere, id decoquere, ut decima pars remaneat, eiusque cyathum sorbere. Tertium, quod quandocumque fieri potest: malum Punicum excauare, exemptisque omnibus seminibus, membranas, quae inter ea fuerunt, iterum * * coicere; tum infundere cruda oua, ⟨r⟩udiculaque miscere; dein malum ipsum super prunam imponere, quod, dum umor intus est, non aduritur: ubi siccum esse coepit, remouere oportet, extractumque cocleari quod intus est e⟨ss⟩e. Aliquibus * adiectis maius momentum habet; itaque etiam in piperatum coicitur misceturque cum sale et pipere †Est quid ex his edendum est. Pulticula etiam, cum qua paulum ex fauo uetere cocti sit, et lenticula cum malicorio cocta, rubique cacumina in aqua decocta, et ex oleo atque aceto adsumpta, efficacia sunt, atque ea aqua, in qua uel palmulae uel malum Cotoneum uel arida sorba uel rubi decocti sunt, potata. Quod genus significo, quotiens potionem dandam esse dico, quae astringat. Tritici quoque hemina in uino Aminaeo austero decoquitur, idque triticum ieiuno ac sitienti datur, superque id uinum id sorbetur; quod iure ualentissimis medicamentis adnumerari potest. Atque etiam potui datur uinum Signinum uel resinatum austerum uel quodlibet austerum. Contunditurque cum corticibus seminibusque suis Punicum malum uinoque tali miscetur; idque uel merum sorbet aliquis uel bibit mixtum. Sed medicamentis uti nisi in uehementibus malis superuacuum est.

[¶1] 27. 27 From the womb of a woman, also, there arises a violent malady; and next to the stomach this organ is affected the most by the body, and has the most influence upon it. At times it makes the woman so insensible that it prostrates her as if by epilepsy. The case, however, differs from epilepsy, in that the eyes are not turned nor is there foaming at the mouth nor spasm of sinews; there is merely stupor. In some women this attack recurs at frequent intervals and lasts throughout life. When this happens, if there is sufficient strength, blood-letting is beneficial; if too little, yet cups should be applied to the groins. If she lies prostrate for a long while, or if she has done so at other times, hold to her nostrils an extinguished lamp wick, or some other of these materials which I have referred to as having a specially foetid odour (III.20, 1), to arouse the woman. For the same end, affusion with cold water is also effectual. And there is benefit from rue pounded up with honey, or from a wax-salve made up with cyprus oil or from hot moist plasters of some sort applied to the external genitals as far as the pubes. At the same time also the hips and the backs of the knees should be rubbed. Then when she has come to herself, she should be cut off from wine for a whole year, even if a similar attack does not recur. Friction should be applied daily to the whole body, but particularly to the abdomen and behind the knees.

> Latin: 27. Ex uulua quoque feminis uehemens malum nascitur proximeque a[b] stomacho uel adficitur haec uel corpus adficit. Interdum etiam sic exanimat, ut tamquam comitiali morbo prosternat. Distat tamen hic casus eo, quod neque oculi uertuntur nec spumae profluunt nec nerui distenduntur: sopor tantum est. Idque quibusdam feminis crebro reuertens perpetuum est.—Vbi incidit, si satis uirium est, sanguis missus adiuuat; si parum est, cucurbitulae tamen defigendae sunt in inguinibus. Si diutius aut iacet aut alioqui iacere consueuit, admouere oportet naribus extinctum ex lucerna li⟨n⟩amentum, uel aliud ex is, quae foedioris odoris esse rettuli, quod mulierem excitet. Idemque aquae quoque frigidae perfusio efficit. Adiuuatque ruta contrita cum melle, uel ex cyprino ceratum, uel quodlibet calidum et umidum cataplasma naturalibus pube tenus impositum. Inter haec etiam perfricare coxas et poplites oportet. Deinde ubi ad se redit, circumcidendum uinum est in totum annum, etiamsi casus idem non reuertitur. Frictione cottidie utendum totius quidem corporis, praecipue uero uentris et poplitum. Cibus ex media materia dandus; sinap⟨i⟩ super imum uentrem tertio quoque aut quarto die imponendum, donec corpus rubeat. Si durities manet, mollire commode uidetur solanum in lac demissum, deinde contritum, et cera alba atque medulla ceruina cum irino, aut sebum taurinum uel caprinum cum rosa mixtum. Dandum etiam potui uel castoreum est uel git uel anetum. Si parum pura est, purgatur iunco quadrato. Si uero uulua exulcerata est, ceratum ex rosa fiet, e⟨i⟩ recens suilla adeps et ex ouis album misceatur, idque adponatur; uel album ex ouo cum rosa mixtum, adiecto, quo facilius consistat, contritae rosae puluere. Dolens uero ea sulpure suffumigari debet. At si purgatio nimia mulieri nocet, remedio sunt cucurbitulae cute incisa inguinibus uel etiam sub mammis admotae. si maligna purgatio est, subicienda sunt medicamenta quae euocent, ut costus, pule⟨i⟩um, albae uiolae flos, nepeta, sat[i]ureia, hysopum: ex quibus, quae cibo apta sunt, etiam cum illo assumpta proficiunt et praetuta porrum, ruta, omne acre ⟨h⟩olus. Si sanguis, qui infra erumpere debuit, per nares erumpit, incisis inguinibus admovendae cucurbitulae sunt idque per tres aut quattuor menses tricesimo quoque die repetitum huic quoque uitio medetur. Si nusquam sanguis se ostendit, ideoque graves capitis dolores urgent, e⟨x⟩ brachio ille mittendus est.

[¶2] Food of the middle class should be given: every third or fourth day mustard is to be applied over the hypogastrium until the skin is reddened. If induration persists, a convenient emollient appears to be bitter sweet steeped in milk, then pounded and mixed with white wax and deer marrow in iris oil, or suet of beef or goat mixed with rose oil.

> Latin: Vesica autem uariis et interdum acutis, interdum longis morbis obnoxia est. Communis omnium est urinae difficultas. Discrimina tamen in hac ipsa non sunt mediocria. Vnum genus est quo subinde urinae desiderium est, ⟨sed⟩ paulum eius emittitur. Totius tamen diei noctisque spatio plus quam sat est redditur. Id cum inueterauerit, tabe quadam hominem consumit. Huic accedit ipsius naturalis dolor maximeque urina et incipiente desinente. Nonnumquam uero idem dolor etiam uentrem imum coxasque etiam latera complectitur. Solent enim uesicae uitiis affici renes sicut illorum magis haec quoque afficitur.

[¶3] Also there should be given in draught either castory, or git, or dill. If the womb is not healthy, it is cleaned with square rushes; but if it is actually ulcerated a wax-salve is made with rose oil, with pounded rose-leaves added to give it consistence. When painful the womb should be fumigated from below with sulphur.

> Latin: Alius morbus est tormento crudelior, ubi urina uix et non nisi magna ui exprimitur. Sed hoc ipso cruciat quod ⟨urina⟩ continetur. Accedit calor quidam ruborque et circa pubem cum dolore tumor atque durities; nonnumquam uomitus. Interdum etia⟨m⟩ tenuis urina in ipsa crura destillat. Saepe quod descendit purulentum est. Quae omnia quibusdam ulceribus natis oriri uidentur. Interdum autem aeque ulceribus ceterisque isdem obstantibus, urina tenuis est et aut nigra aut pallida aut cruenta simulque quaedam concreta prorumpunt.

[¶4] But if excessive menstruation is doing harm to the woman, the remedy is to scarify and cup the groins, or even to apply cups under the breasts.

> Latin: Ac si scabies uesicam occupauit, multa et mali odoris urina est, eaque bullat et quaedam muccis furfuribusue similia ostendit. Subestque ut in prioribus, iunctarum quoque partium dolor simulque naturalis ipsius maxime dum urina descendit.

[¶5] If the menstrual discharge is bad, the following medicaments are to be applied to evoke blood: costmary, pennyroyal, white violet, parsley, catmint and savory and hyssop.

> Latin: Praeter haec, calculi quoque in uesica nascuntur, urinae difficultate et magno dolore aeque accedentibus. Rursus ubi etiam sine dolore praeter modum urina descendit, contrario modo tabes hominem consumit. Atque ex ea quoque modo tenuis profluit, modo turbida et crassa. Et haec quidem fere in hac parte incidere consuerunt.

[¶6] Let her include what is suitable in her diet: leeks, rue, cummin, onion, mustard, or any other acrid vegetable.

> Latin: Commune uero ad urinae difficultatem remedium est his cibis uti: qui boni suci sunt, acria salsa, uinum uetus austerum uitare, leni ambulatione uti. Item leni frictione citra sudorem.

[¶7] If blood bursts out from the nose at a time when it should do so from the genitals, the groins are to be scarified and cupped, repeating this every thirtieth day for three or four months, then you may be sure that this affection has been cured. But if there is no show of blood, you may be sure that there are pains coming in the head. Then blood is to be let from the arms, and you have given relief at once.... constricting remedies. White olives also produce the same effect, also black poppy seeds, taken with honey, and liquid gum, mixed with pounded celery seeds, and given in a cupful of raisin wine. Besides the above, draughts suited for all bladder pains are made from aromatics, such as spikenard, saffron, cinnamon, cassia, and such like, also decoction of mastic does good.

> Latin: Rursus alia diuersorum malorum diuersa remedia sunt. Ergo quibus et multa et nimis crebra inter dolores urina destillat, eos oportet in balneum ire. Ibi multa aqua calida fouere inguina, calida omnia adsumere, deinde uomere. Postero die ratio est lauari eadem, deinde dimidio minus quam consuetudine cibi capere atque inuicem altero die hoc, altero, illo modo se curare. Si longius malum factum est, fouere inferiores cotidie partes aqua calida in qua lini semen decoctum sit, in eadem residere umbilico tenus. Ceratum ex oleo uetere facere eoque pubem proximasque partes circumdare. Abstinere ab omnibus quibus urinae mouendae sunt, potionem quoque qua⟨m⟩ parcissime adsumere, cibos capere ex media materia uel etiam imbellicissima, saepe sorbitiones quoque, at nihil frigidi neque edere neque bibere. Vomitus interponere, aluum, si⟨aliter⟩ non respondet, uel ducere uel aliquo medicamento mouere. Si uero ulcera uel scabies uesicam occupauit, lacte uenter soluendus est. Demittendus homo in aquam calidam oleo mixtam, potui danda aqua quae comprimat. Mel quoque et dulcia omnia uidentur utilia. Imponendum super ceratum est ex irino uel cyprino factum.

[¶8] If in spite of these pain becomes intolerable and there is blood in the urine, venesection is proper, or at any rate wet cupping over the hips. But when the urine exceeds in quantity the fluid taken, even if it is passed without pain, it gives rise to wasting and danger of consumption; if it is thin, there is need for exercise and rubbing, particularly in the sun and before a fire. The baths should be taken but seldom, and the patient should not stay in it for long;

> Latin: Longe pericul⟨os⟩issima in calculis res est. Calculi modo integra, modo scabra uesica nascuntur. Integra nati aut semper in ea mouentur—quos ab innatando πλωτοῦσ Graeci uocant—, aut in ipsa uesicae ceruice orti ubi primo, conquiescunt. Postea, magnitudine adsumpta, pondere in uesicam prolabuntur. Hi uero qui ulceribus innati sunt, primum his quasi crestae inhaerent; deinde, quia i⟨n⟩natuerunt, non continentur; inde quoque pondere decidunt. Vtrique ex immobilibus mobiles fiunt. Solutique calculi qui prius ulceri inhaeserat, signum est contra morem sanguis profusus et eo plus quo is asperior est. Carunculaeque tenues subalbidae cartilagini similes secutae in quibusdam etiam plenior. Omnis autem calculus qui uel a principio uagus natus uel postea factus est modo uesicae ceruicem urget, modo ab ea recedit. Initium est eo delapsi, dolor auctus et urina difficilior. Ac nisi inde retro redit et tortus exstet, febriculas excitat.

[¶9] the food should be astringent, the wine dry and undiluted, cold in summer, lukewarm in winter, and in quantity the monument required to allay thirst. The bowels also are to be moved by a clyster or by taking milk. If the urine is thick, exercise and rubbing should be more though, and the patient should stay longer in the bath; food and wine should be of the lighter kind. In both affections, everything that promotes urine should be avoided. 28 There is also a complaint about the genitals, an excessive outflow of semen;

> Latin: Igitur ubi prima esse nota calculi coepit, experienda sunt remedia quae nonnumquam citra scalpelli curationem, ⟨si⟩ maxime coneris, is uitium discutiunt ieiunoque cotidie paulum quod deuoret resinae terebinthinae dandum est. Id enim et calculos discutit et quaedam arenosa coeuntia.
Idem faciunt etiam albae oliuae, et nigrum papauer cum melle adsumptum, et cummis cum contrito semine apii liquatum et cum cyatho passi datum. Praeter haec in omnibus uesicae doloribus idoneae potiones sunt, quae ex odoribus fiunt, id est spica nardi, croco, cinnamo, casia, similibusque. Idemque etiam decocta lentiscus praestat. Si tamen intolerabilis dolor est et sanguis profluit, etiam sanguinis detractio apta est, aut certe coxis admotae cucurbitulae cute incisa.

[¶10] which is produced without coition, without nocturnal apparitions, so that in course of time the man is consumed by wasting. Salutary remedies in this affection are: vigorous rubbings, affusions, swimming in quite cold water; no food and drink taken unless cold. He should, moreover, avoid everything indigestible, everything flatulent; nothing should be taken of those things which appear to collect the semen, such things are siligo, simila, eggs, spelt, starch, all glutinous flesh, pepper, colewort, bulbs, pine kernels. It is not inexpedient to bathe the lower extremities in a decoction of astringent vervains, to cover the hypogastrium and groins with plasters prepared from the same decoction, and in particular from rue preserved in vinegar: also the patient should avoid sleeping on his back.

> Latin: At cum urina super potionum modum etiam sine dolore profluens maciem et periculum * facit, si tenuis est, opus est exercitatione et frictione, maximeque in sole uel ad ignem. Balneum rarum esse debet, neque longa in eo mora, cibus conprimens, uinum austerum meracum, per aestatem frigidum, per hiemem egelidum, sed tantum, quantum minimum siti⟨m⟩ fini⟨at⟩. Aluus quoque uel ducenda uel lacte purganda est. Si crassa urina est, uehementior esse debet et exercitatio et frictio, longior i⟨n⟩ balneo mora; cibis opus est teneri⟨ori⟩bus, uin⟨o⟩ eodem. In utroque morbo uitanda omnia sunt, quae urinam mouere consuerunt. Est etiam circa naturalia uitium, nimia profusio seminis; quod sine uenere, sine nocturnis imaginibus sic fertur, ut interposito spatio tabe hominem consumat.—In hoc adfectu salutares sunt uehementes frictiones, perfusiones natationesque quam frigidissimae, neque cibi nec potio nisi frigida adsumpta. Vitare autem oportet cruditates, omnia infla⟨ntia⟩; nihil ex is adsumere, quae contrahere semen uidentur, qualia sunt siligo, simila, oua, halica, ⟨a⟩mylum, omnis caro glutinosa, piper, eruca, bulbi, nuclei pinei. Neque alienum est fouere inferiores partes aqua decocta ex uerbenis comprimentibus, ex isdem aliqua cataplasmata imo uentri inguinibusque circumdare, praecipueque ex aceto rutam; uitare et⟨iam⟩, ne supinus obdormiat.

[¶11] 29. 29 It remains for me to come to the extremities of the body which are interconnected by joints. I begin with the hips. In these severe pain is wont to occur, and this often weakens the patient, and some it never leaves: and on this account it is a difficult class to treat, for it is generally after chronic diseases that a pestiferous force directs itself to the hip; which, as it releases other parts, seizes upon this, which now becomes the seat of the disease. The hip is to be first fomented with hot water, after which hot plasters are applied. Those which appear to be especially beneficial are these: caper bark chopped up and mixed either with barley meal or with fig decoction, or darnel meal boiled in diluted wine and mixed with sour wine lees: since these are apt to grow cold, by night it is better to put on emollients. Inula root also pounded and afterwards boiled in dry wine and applied widely of the hip is among the most efficacious of remedies. If these do not resolve the trouble, then hot moist salt is to be employed. If even these measures do not end the pain, and a swelling supervenes, the skin is incised and cups are to be applied; diuretics are given; and the bowels if costive are to be clystered. The ultimate measure and the most efficacious in cases of old standing, is to set up issues in three or four places over the hip by burning the skin with cauteries. But rubbing is also to be employed, particularly in the sun and often each day, in order that the materials of the disease, which have been doing harm by collecting, may be the more readily dispersed; and the rubbing is applied actually over the hips in the absence of ulceration; if there is any, then to other parts. Since now some issue often has to be set up by the hot cautery, in order that matter may be extracted, it is the general rule not to let ulcerations of this kind heal offhand, but to let them drag on until the complaint which we aim to relieve has quieted down.

> Latin: 29. Superest ut ad extremas partes corporis ueniam, quae articulis inter se conseruntur. Initium a coxis faciam. Harum ingens dolor esse consueuit, isque hominem saepe debilitat et quosdam non dimittit; eoque id genus difficillime curatur, quod fere post longos morbos uis pestifera huc se inclinat; quae ut illas partes liberat, sic hanc, iam ipsam quoque adfectam, prehendit. —Fouendum primum aqua calida est, deinde utendum calidis cataplasmati[bu]s. Maxime prodesse uidetur aut cum hordeacea farina aut cum ficu ex aqua decocta mixtus capparis cortex concisus, uel lolii farina ex uino diluto cocta et mixta cum acida faece; quae qu⟨i⟩a refrigescunt, imponere noctu malagmata commodius est. I⟨n⟩ul⟨ae⟩ quoque radix contusa et ex uino austero postea cocta et late super coxam imposita inter ualentissima auxilia est. Si ista non soluerunt, sale calido et umido utendum est. Si ne sic quidem finitus dolor est, aut tumor ei accedit, incisa cute admouendae sunt cucurbitulae; mouenda urina; aluos, si compressa est, ducenda. Vltimum est et in ueteribus quoque morbis efficacissimum tribus aut quattuor locis super coxam cutem candentibus ferramentis exulcerare. Sed frictione quoque utendum est maxime in sole et eodem die saepius, quo facilius ea, quae coeundo nocuerunt, di⟨ger⟩antur; eaque, ⟨si⟩ nulla exulceratio est, etiam ipsis coxis; si est, ceteris partibus adhibenda est. Cum uero saepe aliquid exulcerandum candenti ferramento sit, ut e⟨o⟩ materia inutilis euocetur, illud perpetuum est, non, ut primum fieri potest, huius generis ulcera sanare, sed ea trahere, donec id uitium, cui per haec opitulamur, conquiescat.

[¶12] 30. 30 Next to the hips come the knees, in which pain now and again occurs, and these same plasters and cuppings are a safeguard, as also when any pain arises in the shoulder or other joints. Riding on horseback is of all things the most injurious to anyone with painful knees. All such pains, when of long standing, are hardly ever ended except by cauterization.

> Latin: 30. Coxis proxima genua sunt; in quibus ipsis ⟨non⟩numquam dolor esse consueuit.—In isdem autem cataplasmatis cucurbitulisque praesidium est, sicut etiam cum in umeris aliisue commissuris dolor aliquis exortus est. Equitare ei, cui genua dolent, inimicissimum omnium est. Omnes autem eiusmodi dolores, ubi inueterauerunt, uix citra ustionem finiuntur.

[¶13] 31. 31 Joint troubles in the hands and feet are very frequent and persistent, such as occur in cases of podagra and cheiragra. these seldom attack eunuchs or boys before coition with a woman, or women except those in whom the menses have become suppressed. Upon the commencement of pain blood should be let; for when this is carried out at once in the first stages it ensures health, often for a year, sometimes for always. Some also, when they have washed themselves out by drinking asses' milk, evade this disease in perpetuity; some have obtained lifelong security by refraining from wine, mead and venery for a whole year; indeed this course should be adopted especially after the primary attack, even although it has subsided. But if the malady has already become established, it may be possible to act with more freedom in those seasons in which the pain tends to remit; but he should adopt more careful treatment at those times in which it recurs, which is generally in spring or autumn. Now when the pain requires it, in the morning the patient should be rocked; then carried to a promenade; there he should move about, and in the case of podagra he should take short turns at sitting down and walking about: next before taking food and without entering the bath itself, but in a hot room, he should be gently rubbed, sweated, and then douched with lukewarm water: the food following should be of the middle class; diuretics are given with it, and an emetic whenever he is of a fuller habit. When the pain is very severe, it makes a difference whether there is an absence of swelling, or a swelling with heat, or swellings which already hardened. For if there is no swelling, hot foments are needed. Either sea-water, or strong brine should be heated, then poured into a vessel; and as soon as he can bear it, the man puts his feet in, over the vessel is spread a cloak, and over him a blanket; after that hot water is poured over the lip of the vessel, a little at a time, to prevent the contents from losing heat: and then at night heating plasters are applied, especially mallow root boiled in wine. But if there is swelling and heat, refrigerants are more useful, and the joints may be rightly held in very cold water, but not every day, nor for long, lest the sinews become hardened. There is to be applied also a cooling plaster; this, however, is not to be kept on for long, but a change made to those which soothe as well as repress. If pain is greater, rind of poppy-heads is to be boiled in wine, and mixed with wax-salve made up with rose oil; or wax and lard, equal parts, are melted together, and then the wine mixed with these; and as soon as this application becomes hot, it is to be removed and another immediately put on. But if the swellings have grown hard and are painful, the application of a sponge frequently squeezed out of oil and vinegar, or out of cold water, or the application of pitch, wax and alum, equal parts mixed, gives relief. There are also several emollients suitable alike for the hands and feet. But if the pain does not allow of anything being put on, when there is no swelling, the joint should be fomented with a sponge which has been dipped in a warm decoction of poppy-head rind, or of wild cucumber root, next the joints are smeared with saffron, poppy-juice and ewe's milk. But if there is a swelling, this ought to be bathed with a tepid decoction of mastic or some other repressant vervain, and then covered with a medicament composed of bitter almonds pounded up in vinegar, or of white lead, to which has been added the juice of pounded pellitory. The stone, too, which corrodes flesh, which the Greeks call sarcophagos, is carved out so as to admit the feet; when these are painful, they are inserted and held there, and are usually relieved. In Asia Minor Assian limestone is held in esteem for this purpose. When pain and inflammation have subsided, which should happen within forty days, unless the patient is in fault, gentle exercise, spare diet, soothing anoint-ings, are to be employed, provided that also then the joints may be rubbed with an anodyne salve or with a liquid wax-salve of cyprus oil. But riding on horseback is harmful for those with podagra. Those, too, in whom joint-pains tend to recur at certain seasons ought both to take precautions beforehand as to their diet, lest there should be a surfeit of harmful material in the body, and to use an emetic the most frequently; and those in any anxiety as to their body should make use of clystering, or of purgation by milk. This treatment for those with podagra was rejected by Erasistratus, lest a flux directed downwards might fill up the feet, though it is evident that any purgation extracts, not only from the upper parts, but also from the lower as well.

> Latin: 31. In manibus pedibusque articulorum uitia frequentiora longioraque sunt, quae in podagris cheragrisue esse consuerunt. Ea raro uel castratos uel pueros ante feminae coitum uel mulieres, nisi quibus menstrua suppressa sunt, tempta⟨n⟩t.—Vbi sentire coeperunt, sanguis mittendus est: id enim inter initia statim factum saepe annu⟨a⟩m, nonnumquam perpetuam ualetudinem ⟨tutam⟩ praestat. Quidam etiam, cum asinino lacte poto sese eluissent, in perpetuum hoc malum euaserunt: quidam, cum toto anno a uino, mulso, uenere sibi temperassent, securitatem totius uitae consecuti sunt; idque utique post primum dolorem seruandum est, etiamsi quieuit. Quod si iam consuetudo eius facta est, potest quidem aliquis esse securior is temporibus, quibus dolor se remisit: maiorem uero curam adhibere debet ⟨is⟩, quibus id reuertitur; quod fere uere autumnoue fieri solet. Cum uero dolor urget, mane gestari debet; deinde ferri in ambulationem; ibi se dimouere, et, si podagra est, interpositis temporibus exiguis inuicem modo sedere, modo ingredi; tum, antequam cibum capiat, sine balneo loco calido leuiter perfricari, sudare, perfundi aqua egelida: deinde cibum sumere ex media materia, interpositis rebus urinam mouentibus, quotiensque plenior est, uomere. Vbi dolor uehemens urget, interest sine tumore is sit, an tumor cum calore, an tumores iam etiam obcal⟨l⟩uerint. Nam si tumor nullus est, calidis fomentis opus est. Aquam marinam uel muriam duram feruefacere oportet, deinde in peluem coicere, et, cum iam homo pati potest, pedes demittere, superque pallam dare, et uestimento tegere; paulatim deinde iuxta labrum ipsum ex eadem aqua leuiter infundere, ne calor intus destituat; ac deinde noctu cataplasmata calfacientia imponere, maximeque ibisci radicem ex uino coctam. Si uero tumor calorque est, utiliora sunt refrigerantia, recteque in aqua quam frigidissima articuli continentur, sed neque cotidie neque diu, ne nerui indurescant. Inponendum uero est cataplasma, quod refrigeret, neque tamen in hoc ipso diu permanendum, sed ad ea transeundum, quae sic reprimunt, ut emolliant. Si maior est dolor, papaueris cortices in uino coquendi miscendique cum cerato sunt, quod ex rosa factum sit; uel cerae et adipis suillae tantundem una liquandum, deinde his uinum miscendum; atque ubi quod ex eo impositum est incaluit, detrahendum, et subinde aliud inponendum est. Si uero tumores etiam obcal⟨l⟩uerunt et dolent, leuat spongia inposita, quae subinde ex oleo et aceto uel aqua frigida exprimitur, aut pari portione inter se mixta pix, cera, alumen. Sunt etiam plura idonea manibus pedibusque malagmata. Quod si nihil superinponi dolor patitur, id, quod sine tumore est, fouere oportet spongia, quae in aquam calidam demittatur, in qua uel papaueris cortices uel cucumeris siluestris radix decocta sit; tum inducere articulis crocum cum suco papaueris et ouillo lacte. At si tumor est, foueri quidem debet aqua egelida, in qua lentiscus aliaue uerbena ex reprimentibus decocta sit, induci uero medicamentum ex nucibus amaris cum aceto tritis, aut cerussa, cui contritae herbae muralis sucus sit adiectus. Lapis etiam, [qui carnem edit,] quem ΣΑΡΚΟΦΑΓΟΝ Graeci uocant, excisus sic ut pedes capiat, demissos eos, cum dolent, retentosque ibi leuare consueuit. Ex quo in Asia lapidi As⟨s⟩io gratia est. Vbi dolor et inflammatio se remiserunt, quod intra dies quadraginta fit, nisi uitium hominis accessit, modicis exercitationibus, ⟨abstinentia, unctionibus⟩ lenibus utendum est, sic ut etiam ⟨t⟩um acopo uel liquido cerato cyprino articuli perfricentur. Equitare podagricis quoque alienum est. Quibus uero articulorum dolor certis temporibus reuertitur, hos ante et curioso uictu cauere oportet, ne inutilis materia corpori supersit, et crebriore uomitu; et si quis ex corpore metus, uel alui ductione uti uel lacte purgari. Quod Erasistratus in podagricis expulit, ne in inferiores partes factus cursus pedes repleret, cum euidens sit omni purgatione non superiora tantummodo sed etiam inferiora exinaniri.

[¶14] 32. 32 Now from whatever disease he is recovering, if his convalescence is slow, the patient ought to keep awake from dawn, but nevertheless stay at rest in bed: about nine o'clock he should be gently stroked over with anointed hands, after that by way of amusement, and as long as he pleases, walk, all business being omitted: then he should use conveyances for a good while, be rubbed much, often change his residence, climate and diet. Having taken wine for three or four days, he should for one or two days drink water only. For thus he will ensure that he does not lapse into a complaint which causes wasting, but soon gets back his full strength. When he has, in fact, completely recovered, it will be dangerous for him suddenly to change his way of life and to act without restraint. Therefore he should only little by little leave off what has been prescribed, and pass to a way of life of his own choosing.

> Latin: 32. Ex quocumque autem morbo quis inualescit, si tarde confirmatur, uigilare prima luce debet; nihilo minus in lecto conquiescere; circa tertiam horam leuiter unctis manibus corpus permulcere. Deinde delectationis causa, quantum iuuat, ambulare, circumcisa omni negotiosa actione; tum gestari diu, multa frictione uti, loca, caelum, cibos saepe mutare. Vbi triduo quadriduoue uinum bibit, uno aut etiam altero die interponere aquam. Per haec enim fiet, ne in uitia tabem inferentia incidat et ut mature uires suas recipiat. Cum ex toto uero conualuerit, periculose uitae genus subito mutabit et inordinate aget. Paulatim ergo debebit omissis his legibus eo transire, ut arbitrio suo uiuat.

## 16. Book V · chapters 5–18

Source: https://scriptura.si/works/celsus-on-medicine/16/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/16/#p-N

[¶0] 5. I have spoken of those maladies of the body in which the regulation of the diet is most helpful: now I pass on to that part of medicine which combats rather by medicaments. These were held of high value by ancient writers, both by Erasistratus and those who styled themselves Empirics, especially how by Herophilus and his school, insomuch that they treated no kind of disease without them. A great deal has also been recorded concerning the powers of medicaments, as in the works of Zeno or of Andreas or of Apollonius, surnamed Mys. On the other hand, Asclepiades dispense with the use of these for the most part, not without reason; and since nearly all medicaments harm the stomach and content bad juices, he transferred all his treatment rather to the management of the actual diet. But while in most diseases that is the more useful method, yet very many illnesses attack our bodies which cannot be cured without medicaments. This before all things it is well to recognize, together, that it is impossible to separate off any one part completely, but each gets its name from the treatment which it uses most. Therefore, both that which treats by dieting has recourse at times to medicaments, and that which combats disease mainly by medicaments ought also to regulate diet, which produces a good deal of effect in all maladies of the body. But since all medicaments have special powers, and afford relief, often when simple, often when mixed, it does not seem amiss beforehand to state both their names and their virtues and how to compound them, that there may be less delay when we are describing the treatment itself.

> Latin: 5. Dixi de is malis corporis, quibus uictus ratio maxime subuenit: nunc transeundum est ad eam medicinae partem, quae magis MEDICAMENTIS pugnat. His multum antiqui auctores tribuerunt, et Erasistratus et ii, qui se empiricos nominarunt, praecipue tamen Herophilus deductique ab illo uiro, adeo ut nullum morbi genus sine his curarent. Multaque etiam de facultatibus medicamentorum memoriae ⟨prodiderunt⟩, qualia sunt uel Zenonis uel Andriae uel Apolloni, qui Mys cognominatus est. Horum autem usum ex magna parte Asclepiades non sine causa sustulit; et cum omnia fere medicamenta stomachum laedant malique suci sint, ad ipsius uictus rationem potius omnem curam suam transtulit. Verum ut illud in plerisque morbis utilius est, sic multa admodum corporibus nostris incidere consuerunt, quae sine medicamentis ad sanitatem peruenire non possunt. Illud ante omnia scire conuenit, quod omnes medicinae partes ita innexae sunt, ut ex toto separari non possint sed ab eo nomen trahant, a quo plurimum petunt. Ergo et illa, quae uictu curat, aliquando medicamentum adhibet, et illa, quae praecipue medicamentis pugnat, adhibere etiam rationem uictus debet, quae multum admodum in omnibus corporis malis proficit. Sed cum omnia medicamenta proprias facultates habeant, ac simplicia saepe opitulentur, saepe mixta, non alienum uidetur ante proponere et nomina et uires et mixturas eorum, qui minor ips⟨as nobis⟩ curationes exsequentibus mora sit.

[¶1] 1. 1 The following suppress bleeding: Blacking with the Greeks call chalcanthon, copper ore, acacia, and lycium with water, frankincense, lign-aloe, gums, lead sulphide, leek, polygonum; Cimolian chalk or potter's clay, antimony sulphide; cold water, wine, vinegar; alum from Melos, iron and copper scales and of this last there are two kinds, one from ordinary copper, the other from red copper.

> Latin: 1. Sanguinem supprimunt atramentum sutorium, quod Graeci chalcanthon appellant, chalcitis, acacia, et ex aqua Lycium, tus, aloe, cummi, plumbum combustum, porrum, herba sanguinalis; creta uel Cimolia uel figularis, misy; frigida aqua, uinum, acetum; alumen Melinum, squama et ferri et aeris [atque huius quoque duae species sunt, alia tantum aeris, alia rubri aeris].

[¶2] 2. 2 The following agglutinate a wound: myrrh, frankincense, gums, especially gum arabic; fleawort, tragacanth, cardamon, bulbs, linseed, nasturtium; white of egg, glue, isinglass; white vine, snails pounded with their shells, cooked honey, a sponge squeezed out of cold water or out of wine or out of vinegar; unscoured wool squeezed out of the same; if the wound is slight, even cobwebs. The following subdue inflammation: alum, both split alum called schiston, and alum brine; quince oil, orpiment, verdigris, copper ore, blacking.

> Latin: 2. Glutinant uulnus murra, tus, cummi, praecipueque acanthinum; psylleum, tragacantha, cardamomon, bulbi, lini semen, nasturcium; oui album, gluten, icthyocolla; uitis alba, contusae cum testis suis cocleae, mel coctum; spongia uel ex aqua frigida uel ex uino uel ex aceto expressa; ex isdem lana sucida; si leuis plaga est, etiam aranea. Reprimunt alumen et scissile, quod ΣΧΙΣΤΟΝ uocatur, et liquidum; Melinum, auripigmentum, aerugo, chalcitis, atramentum sutorium.

[¶3] 3. 3 The following mature abscessions and promote suppuration: nard, myrrh, costmary, balsam, galbanum, propolis, storax, frankincense, both the soot and the bark, bitumen, pitch, sulphur, resin, suet, fat, oil.

> Latin: 3. Concoqunt et mouent pus nardum, murra, costus, balsamum, galbanum, propolis, st⟨u⟩rax, turis et fuligo et cortex, bitumen, pix, sulpur, resina, sebum, adeps, oleum.

[¶4] 4. 4 The following open, as it were, mouths in our bodies, called in Greek stomou=n: cinnamon, balsam, all-heal; rush-root, pennyroyal, white violet flowers, bdellium, galbanum, turpentine and pine-resin, propolis, old olive-oil; pepper, pyrethrum, ground pine thistle, black bryony berries, sulphur, alum, rue seed.

> Latin: 4. Aperiunt tamquam ora in corporibus, quod stom⟨un⟩ Graece dicitur, cinnamomum, balsamum, panaces; iuncus quadratus, puleium et flos albae uiolae, bdella, galbanum, resina terebenthina et pinea, propolis, oleum uetus; piper, pyrethrum, chamaepitys, uua t⟨a⟩minia; sulpur, alumen, rutae semen.

[¶5] 5. 5 The following have a cleaning effect: verdigris, orpiment, called by the Greeks arsenicon now this has the same property as sandarach, but copper scales are stronger, pumice; orris root, balsam, storax, frankincense, frankincense bark, pine-resin and liquid turpentine, vine-flowers; lizard dung, blood of pigeon and wood pigeon and swallow; ammoniacum, bdellium which has the same virtue as ammoniacum, but southernwood is more powerful, dry fig, Cnidian berry, powdered ivory, omphacium, radish; rennet, especially of the hare which has the same faculty as other rennet but is far more active, ox-bile, uncooked yolk of e.g., burnt stagshorn, ox-glue, raw honey, antimony sulphide, copper ore; saffron, black bryony berries, southernwood, litharge, oak-gall, haematite, minium, costmary, sulphur, crude pitch, suet, fat, oil, rue, leek, lentil, bitter vetch.

> Latin: 5. Purgant aerugo, auripigmentum, quod arsenicon a Graecis nominatur [huic autem et sandaracae in omnia eadem uis, sed ualidior est squama aeris], pumex; iris, balsamum, st⟨u⟩rax, tus, turis cortex, resina et pinea et terebenthina liquida, oenanthe; lacerti stercus, sanguis columbae et palumbi et hirundinis; Hammoniacum, bdellium [quod in omnia idem quod Hammoniacum potest, sed ualentius est habrot⟨o⟩num], ficus arida, coccum Cnidium, scobis eboris, omphacium, radicula; coagulum, sed maxime leporinum [cui eadem quae ceteris coagulis facultas, sed ubique ualidior est], fel, uitellus crudus, cornu ceruinum, gluten taurinum, mel crudum; misy, chalcitis; crocum, uua t⟨a⟩minia; habrotonum, spuma argenti, galla, squama aeris, lapis haematites, minium, costum, sulpur, pix cruda; sebum, adeps, oleum; ruta, porrum, lenticula, eruum.

[¶6] 6. 6 The following are erodents: alum brine, especially when made from round alum, verdigris, copper ore, antimony sulphide, copper scales, especially from red copper, calcined copper, sandarach, minium from Sinope; oak-galls, balsam, myrrh, frankincense, frankincense bark, galbanum, liquid turpentine, pepper of both kinds but especially the round, cardamon; orpiment, lime, soda and its scum; parsley seed, narcissus root, omphacium, coral, oil of bitter almonds, garlic, uncooked honey, wine, mastich, iron scales, ox-bile, scammony, black bryony berries, cinnamon, storax, hemlock seed, omphacium, parsley seed, resin, narcissus seed, bitter almonds and their oil, blacking, chrysocolla, hellebore, ash.

> Latin: 6. Rodunt alumen liquidum, sed magis rotundum, aerugo, chalcitis, misy, squama aeris, sed magis rubri, aes combustum, sandaraca, minium Sinopicum; galla, balsamum, murra, tus, turis cortex, galbanum, resina terebenthina umida, piper utrumque, sed rotundum magis, cardamomum; auripigmentum, calx, nitrum et spuma eius; [apii semen], narcissi radix, [omphacium], alcyonium, [oleum ex amaris nucibus], alium, mel crudum, uinum, lentiscus, squama ferri, fel taurinum, scamonia, uua t⟨a⟩minia, cinnamomum, styrax, cicutae semen, omphacium, apii semen, resina, narcissi semen, fel, nuces amarae oleumque earum, atramentum sutorium, chrysocolla, ueratrum, cinis.

[¶7] 7. 7 The following are exedents: acacia juice, ebony, verdigris, copper scales, chrysocolla, ash, cyprus ash, soda, cadmia, litharge, hypocistis, slag, salt, orpiment, sulphur, hemlock, sandarach, salamander-ash, coral, flowers of copper, copper ore, blacking, ochre, lime, vinegar, oak-gall, alum, milk of the wild fig, or of sea spurge which the Greeks call tithymallos, coral, bile, frankincense, spode, lentil, honey, olive leaves, horehound, haematite stone, Phrygian, Assian and ironschist, antimony sulphide, wine, vinegar.

> Latin: 7. Exedunt corpus acaciae sucus, hebenus, aerugo, squama aeris, chrysocolla, cinis, cinis Cyprius, nitrum, cadmia, spuma argenti, hypocistis, diphryges, sal, auripigmentum, sulpur, cicuta, sandaraca, salamandra, [alcyoneum], aeris flos, chalcitis, atramentum sutorium, ochra, calx, [acetum], galla, alumen, lac caprifici uel lactucae marinae, quae tithymallos a Graecis appellatur, alcyoneum, fel, turis fuligo, spodium, lenticula, mel, oleae folia, marrubium, lapis haematites et Phrygius et As⟨s⟩ius et scissilis, misy, uinum, acetum.

[¶8] 8. 8 The following are caustics: orpiment, blacking, copper ore, antimony sulphide, verdigris, lime, burnt papyrus-ash, salt, copper scales, burnt wine-lees, myrrh, dung of lizard and pigeon and wood pigeon and swallow, pepper, Cnidian berry, garlic, slag, both the milks mentioned in the previous chapter, hellebore both white and black, cantharides, coral, pyrethrum, frankincense, salamander-ash, rocket, sandarach, black bryony berries, chrysocolla, ochre, split alum, sheep's dung, vine-flower buds.

> Latin: 8. Adurunt auripigmentum, atramentum sutorium, chalcitis, misy, aerugo, calx, charta combusta, sal, squama aeris, faex combusta, murra, stercus et lacerti et columbae et palumbi et hirundinis, piper, coccum ⟨C⟩nidium, alium, diphryges, lac utrumque, quod proxime [capite supra] comprehensum est, ueratrum et album et nigrum, cantharides, corallium, pyrethrum, ⟨tus,⟩ salamandra, eruca, sandaraca, uua t⟨a⟩minia, chrysocolla, ochra, alumen scissile, ouillum stercus, oenanthe.

[¶9] 9. 9 The foregoing generally induce scabs on ulcerations almost as when burnt by a cautery, but most of all copper ore — especially after being heated — copper flowers, verdigris, orpiment, antimony sulphide, and that also more after being heated.

> Latin: 9. Eadem fere crustas ulceribus tamquam igne adustis inducunt, sed praecipue chalcitis, utique si cocta est, flos aeris, aerugo, auripigmentum, misy, et id quo⟨que⟩ magis coctum.

[¶10] 10. 10 But such scabs are loosened by wheat flour with rue or leek or lentils, to which some honey has been added.

> Latin: 10. Crustas uero has resoluit farina triticea cum ruta uel porro, aut lenticula, cui mellis aliquid adiectum est.

[¶11] 11. 11 The following, again, are most powerful to disperse whatever has collected in any part of the cody: southernwood, elecampane, marjoram, white violet, honey, lily, Cyprian marjoram, milk, melilot, thyme, oil of cypress, cedar-oil, iris, purple violet, narcissus, rose, saffron, raisin wine, angular rush, nard, cinnamon, casia, ammoniacum, wax, resin, black bryony berries, litharge, storax, dry fig, goat's marjoram, linseed, narcissus seed, bitumen, sordes from the gymnasium, pyrites or millstone, raw yolk of egg, bitter almonds, sulphur.

> Latin: 11. Ad discutienda uero ea, quae in corporis parte aliqua coierunt, maxime possunt habrot⟨o⟩num, helenium, amaracus, alba uiola, mel, lirium, sampsychus Cyprius, lac, sertula Campana, serpullum, cupressus, cedrus, iris, uiola purpurea, narcissus, rosa, crocum, passum, iuncus quadratus, nardum, cinnamomum, casia, Hammoniacum, cera, resina, uua t⟨a⟩minia, spuma argenti, styrax, ficus arida, tragoriganus, lini et narcissi semen, bitumen, sordes ex gymnasio, pyrites lapis aut molaris, crudus uitellus, amarae nuces, sulpur.

[¶12] 12. 12 The following are epispastics: ladanum, round alum, ebony, linseed, omphacium, ox-bile, copper ore, bdellium, turpentine and pine resin, propolis, dried fig cooked, pigeons' dung, pumice, darnel meal, unripe figs cooked in water, elaterium, laurel berries, soda, salt.

> Latin: 12. Euocat et educit ladanum, alumen rotundum, hebenus, lini semen, omphacium, fel, chalcitis, bdellium, resina terebenthina et pinea, propolis, ficus arida decocta, stercus columbae, pumex, farina lolii, grossi in aqua cocti, elaterium, lauri bacae, nitrum, sal.

[¶13] 13. 13 The following relieve any irritated part: oxide of zinc, ebony, gum, white of egg, milk, tragacanth.

> Latin: 13. Leuat id, quod exasperatum est, spodium, hebenus, cummi, oui album, lac, tragacanthum.

[¶14] 14. 14 The following make the flesh grow, and fill in ulcerations: pine-resin, ochre from Attica or Scyros, wax, butter.

> Latin: 14. Carnem alit et ulcus implet resina pinea, ochra Attice uel ⟨Sc⟩yrice, cera, buturum.

[¶15] 15. 15 The following are emollients: calcined copper, Eretrian earth, soda, poppy-tears, ammoniacum, bdellium, wax, suet, soft fat, oil, dried fig, sesamum, melilot, narcissus root and seed, rose-leaves, curd, raw yolk of egg, bitter almonds, marrow of any kind, antimony sulphide, pitch, snails boiled, hemlock seed, lead-slag which the Greeks call skwri/a molu/bdou, all-heal, cardamon, galbanum, resin, black bryony berries, storax, iris, balsam, gymnasium sordes, sulphur, butter, rue.

> Latin: 15. Molliunt aes combustum, terra Eretria, nitrum, papaueris lacrima, Hammoniacum, bdellion, cera, sebum, adeps, oleum, ficus arida, sesamum, sertula Campana, narcissi et radix et semen, rosae folia, coagulum, uitellus crudus, amarae nuces, medullae omnes, sti⟨b⟩i, ⟨pi⟩x, ⟨coclea⟩ cocta, cicutae semen, plumbi recrementum (ΣΚΩΡΙΑΝ ΜΟΛΥΒΔΟΥ Graeci uocant), panaces, cardamomum, galbanum, resina, uua t⟨a⟩minia, styrax, iris, balsamum, sordes ex gymnasio, sulpur, buturum, ruta.

[¶16] 16. 16 The following cleanses the skin: honey, but better if mixed with galls or bitter vetch or lentil or horehound or iris or rue or soda or verdigris.

> Latin: 16. Cutem purgat mel, sed magis si est cum galla uel eruo uel lenticula uel marrubio uel iride uel ruta uel nitro uel aerugine.

[¶17] 17. 17 The powers of medicaments when unmixed having been set out, we have to say how how they may be mixed together, and what are the compositions so made. Now they are mixed in various ways and there is no limit to this, since some simples may be omitted, others added, and when the same ingredients are used the proportion of their weights may be changed. Hence though there are not so very many substances having medicinal powers, there are innumerable kinds of mixtures; and, even if all of them could be included, yet this would be needless. For the same effects are produced by but a few compositions, and to vary these is easy to anyone who knows their powers. Therefore I shall content myself with those I have heard of as the best known. Now in this book I will set forth those compositions which may have been required in the previous treatments or which pertain to those treatment with which I am going shortly to mention here, so that I may bring together at the same time compositions which are more generally used: those that are applicable to a particular disease, or even to a few, I shall mention in their appropriate places. But I wish to make clear in advance that our uncia has the weight of seven denarii, next that I divide one denarius by weight into six parts, namely, sextantes; so that I have in the sextans of a denarius the same weight as the Greeks have in what they call an obolus. That being reduced to our weight, takes the obolus a little more than half a scripulus. Now emollients and plasters and pastils which the Greeks call trochiscoi, whilst they have much in common, differ in this, that emollients are made chiefly from essences of flowers and even from their shoots, plasters and pastils rather from certain metallic materials: again, the emollients if crushed become quite soft enough; for they are applied over intact skin; the materials out of which plasters and pastils are made are rubbed together laboriously in order that they may not irritate wounds when they are applied to them. But between a plaster and a pastil there is this difference: a plaster must contain some liquefied ingredient, in a pastil only dry materials are used, combined together by a little fluid. Then a plaster is made in this way: dry medicaments are rubbed down separately, then when they have been mixed, either vinegar is dropped in or any other liquid free from fat that is at hand, and these ingredients are rubbed together again. The materials capable of being liquefied are melted all together over the fire, and if there is to be any admixing of oil, it is then poured in. A dry ingredient is even sometimes boiled in oil beforehand: when what should be done separately has been accomplished, all are mixed together. But the making of pastils, on the other hand, is this: dry medicaments which have been rubbed together are mixed by the aid of a liquid free from fat, such as wine or vinegar and the mixture is dried again, and when required for use, dissolved in a liquid of the same kind. Further, a plaster is laid on, a pastil is smeared on, or is mixed with something softer such as a cerate.

> Latin: 17. Expositis simplicibus facultatibus dicendum est, quemadmodum misceantur, quaeque ex his fiant. Miscentur autem uarie, neque huius ullus modus est, cum ex simplicibus alia demantur, alia adiciantur, isdemque servatis ponderum ratio mutetur. Itaque cum facultatium materia non ita multiplex sit, innumerabilia mixturarum genera sunt: quae conprehendi si possent, tamen esset superuacuum. Nam et idem effectus intra paucas compositiones sunt, et mutare eas cuilibet cognitis facultatibus facile est. Itaque contentus is ero, quas accepi uelut nobilissimas. In hoc autem uolumine eas explicabo, quae uel desiderari in prioribus potuerunt, uel ad eas curationes pertinent, quas protinus hic comprehendam, sic ut tamen quae magis communia sunt, simul iungam: si qua singulis uel etiam paruis adcommodata sunt, in ipsorum locum differam. Sed et ante sciri uolo, in uncia pondus denarium septem esse, unius deinde denarii pondus diuidi a me in sex partes, id est sex⟨tantes⟩, ut idem in ⟨sextante⟩ denarii habeam, quod Graeci habent in eo, quem obolon appellant. Id ad nostra pondera relatum paulo plus dimidio scripulo facit. Malagmata uero atque emplastra pastil⟨l⟩ique, quos trochiscos Graeci uocant, cum plurima eadem habeant, differunt eo, quod malagmata maxime ex odoribus eorumque etiam surculis, emplastra pastillique magis ex quibusdam metallicis fiunt; deinde malagmata contusa abunde mollescunt: nam super integram cutem iniciuntur: laboriose uero conteruntur ea, ex quibus emplastra pastillique fiunt, ne laedant uulnera, cum inposita sunt. Inter emplastrum autem et pastillum hoc interest, quod emplastrum utique liquati aliquid accipit, in pastillo tantum arida medicamenta aliquo umore iunguntur. Tum emplastrum hoc modo fit: arida medicamenta per se teruntur, deinde mixtis ⟨i⟩is instillatur aut acetum aut si quis alius ⟨non⟩ pinguis umor accessurus est, et ea rursus ex eo teruntur. Ea uero, quae liquari possunt, ad ignem simul liquantur, et si quid olei misceri debet, tum infunditur. Interdum etiam aridum aliquod ex oleo prius coquitur: ubi facta sunt, quae separatim fieri debuerunt, in unum omnia miscentur. At pastilli haec ratio est: arida medicamenta contrita umore non pingui, ut uino uel aceto, co⟨g⟩untur, et rursus coacta inarescunt, atque ubi utendum est, eiusdem generis umore diluuntur. Tum emplastrum imponitur, pastillus inlinitur, aut alicui molliori, ut cerato, miscetur.

[¶18] 18. 18 Premising the above, I will speak first of emollients, almost all of which were invented, not for the purpose of cooling but for heating. There is, however, one kind which can cool, being suitable for hot podagras. It is a cupful of oak-galls, unripe or otherwise, coriander seed, hemlock, dried poppy-tears, and gum, of each 63 cc.; of washed cerate called by the Greeks πεπλυμένον, 168 grams.

> Latin: 18. His cognitis, primum MALAGMATA subiciam, quae fere non sunt refrigerandi sed calfaciendi causa reperta. Est tamen, quod refrigerare possit, ad calidas podagras aptum. Habet gallae et immaturae et alterius, coriandri seminis, cicutae, lacrimae aridae, cummis, singulorum plenum acetabulum; cerati eloti, quod ΠΕΠΛΥΜΕΝΟΝ Graeci uocant, selibram. Reliqua fere calefaciunt.

[¶19] Almost all the rest are heating. But some disperse the diseased matter, some extract it and are called epispastic; most are designed rather for particular parts of the body.

> Latin: Sed quaedam digerunt materiam, quaedam extrahunt, quae ΕΠΙΣΠΑΣΤΙΚΑ uocantur; pleraque certis magis partibus membrorum adcommodata sunt.

[¶20] If diseased matter has to be extracted, as in the case of a dropsy, pleurisy, incipient abscession, also in cases of moderate suppuration, the following emollient is suitable which contains: dried resin, soda, ammoniacum, galbanum, 336 grams, each, wax 336 grams. Or that one which contains: scrapings of verdigris and frankincense, each 8 grams, ammoniac salt 24 grams, copper scales, wax, each 32 grams, dried resin 48 grams, 42 cc of vinegar. Cumin meal with soap-wort and honey serves the same purpose.

> Latin: Si materia extrahenda est, ut in hydropico, in lateris dolore, in incipiente abscessu, in suppuratione quoque mediocri, aptum est id, quod habet resinae aridae, nitri, Hammoniaci, galbani, singulorum pondo; cerae pondo. Aut in quo haec sunt: aeruginis rasae, turis, singulorum P. #1108 II; Hammoniaci salis P. #1108 VI; squamae aeris, cerae, singulorum P. #1108 VIII; resinae aridae P. #1108 XII; aceti cyathus. Idem praestat cumini farina cum struthio et melle. Si iecur dolet, id in quo est balsami lacrimae P.

[¶21] If there is pain in the liver apply the emollient which consists of balsam tears 48 grams, costmary, cinnamon, casia bark, myrrh, saffron, round rush, balsam seeds, Illyrian iris, cardamon, amomum, nard, each 64 grams. To these is added nard ointment until the consistency is that of a cerate. And this is for use whilst fresh; but if it is to be kept, turpentine resin 64 grams, and wax 40 grams, are pounded up together in mild wine, and then mixed with the above.

> Latin: #1108 XII; costi, cinnamomi, casiae corticis, murrae, croci, iunci rotundi, balsami seminis, iridis Illyricae, cardamomi, amomi, nardi, singulorum P. #1108 XVI. Quibus adicitur nardum [unguentum], donec cerati crassitudo sit. Et huius quidem recentis usus est: si uero seruandum est, resinae terebenthinae P. #1108 XVI, cerae P. #1108 X ex uino leni contunduntur, tum eo miscentur.

[¶22] But if there is acute pain of the spleen the rind of the nut, called by the Greeks βάλανοσ μυρεψικήν, and soda are pounded together in equal proportions and sprinkled with sharpest vinegar; when of the consistency of a cerate this is spread on lint previously moistened in cold water, and so applied, with barley-meal dusted over it; but it should not be kept on longer than six hours, lest it consume the spleen; it is better to apply it two or three times.

> Latin: At si lienis torquet, glandis, quam balanon ΜΥΡΕΨΙΚΗΝ Graeci uocant, cortex et nitrum paribus portionibus contunduntur, respergunturque aceto quam acerrimo. Vbi cerati crassitudinem habet, linteo ante in aqua frigida madefacto inlinitur et sic inponitur, supraque farina hordeacea inicitur: sed manere ibi non amplius sex horis debet, ne lienem consumat; satiusque est id bis aut ter fieri.

[¶23] Lysias compounded an emollient equally useful the liver and spleen and for abscesses and scrofulous tumours, for parotid swellings and joints, for heels suppurating or otherwise painful, even for promoting digestion, from the following: opopanax, storax, galbanum, resin, each 8 grams, ammoniacum, bdellium, wax, beef suet, dried iris, each 16 grams, cachry, 63 cc, and 40 peppercorns, all pounded with iris ointment to the right consistency.

> Latin: Commune autem et iocineri et lieni et abscessibus et strumae, parotidibus, articulis, calcibus quoque suppurantibus aut aliter dolentibus, etiam concoctioni uentris Lysias composuit ex his: opopanacis, styracis, galbani, resinae, singulorum P. #1108 II; Hammoniaci, bdelli, cerae, sebi taurini, iridis aridae P. #1108 IIII; cac⟨h⟩ryos acetabulo, piperis granis XL; quae contrita irino unguento temperantur. Ad laterum autem dolores compositio est Apollophanis, in qua sunt resinae terebenthinae, turis fuliginis, singulorum P.

[¶24] Again, for pains in the sides there is the composition of Apollophanes: turpentine-resin and frankincense root, each 16 grams, bdellium, ammoniacum, iris, calf's or goat's kidney-suet, mistletoe juice, each 16 grams. This composition relieves pain of all kinds, softens indurations, and is moderately heating.

> Latin: #1108 IIII; bdelli, Hammoniaci, iridis, sebi uitulini aut caprini a renibus, ⟨uis⟩ci, singulorum P. #1108 IIII. Haec autem eadem omnem dolorem leuant, dura emolliunt, mediocriter calfaciunt.

[¶25] The emollient of Andreas is for like use; and it also relaxes, draws out humour, matures pus, and when it is matured ruptures the skin, and brings a scar over. It is applied with advantage to abscesses, both small and large, likewise to joints and so both to the hips and feet when painful; further, it repairs any part of the body that is contused; also softens the praecordia when hard and swollen; draws outwards splinters of bone — in short, is of service in all cases which heat can benefit. It is composed of wax 4 grams, mistletoe juice, and tears of sycaminus, also called sycomorus, 4 grams each, round and long pepper, ammoniacum for fumigation, bdellium, Illyrian iris, cardamon, amomum balsam wood, male frankincense, myrrh, dried resin, 0 grams each, pyrethrum, Cnidian berries, scum of soda, ammoniac salt, Cretan aristolochia, wild cucumber root, liquid turpentine and resin, 80 grams each, to which is added a sufficiency of iris ointment to give it proper consistency.

> Latin: Ad idem [latus] Andreae quoque malagma est, quod etiam resoluit, educit umorem, pus maturat, ubi id maturum est, cutem rumpit, ad cicatricem perducit. Prodest impositum minutis maioribusque abscessibus, item articulis ideoque et coxis et pedibus dolentibus: item, si quid in corpore conlisum est, reficit; praecordia quoque dura et inflata emollit, ossa extrahit, ad omnia denique ualet, quae adiuuare calor potest. Id habet cerae P. #1108 I; uisci, sycamini, quam alias sycomorum uocant, lacrimae, singulorum P. #1108 I; piperis et rotundi et longi, Hammoniaci thymiamatis, bdelli, iridis Illyricae, cardamomi, amomi, xylobalsami, turis masculi, murrae, resinae aridae, singulorum P. #1108 X; pyrethri, cocci Cnidi, spumae nitri, salis Hammoniaci, aristolo⟨c⟩iae Creticae, radicis ex cucumere agresti, resinae terebenthinae liquidae, singulorum P. #1108 XX. Quibus adicitur unguenti irini, quantum satis est ad ea mollienda atque cogenda.

[¶26] A special emollient for relaxing parts constricted, for softening parts indurated, and for dispersing any collection is ascribed to Polyarchus. It contains square rush, cardamon, frankincense soot, amomum, wax and liquid resin in equal quantities.

> Latin: Praecipuum uero est ad resoluenda, quae astricta sunt, mollienda, quae dura sunt, digerenda, quae coeunt, id, quod ad Polyarchum auctorem refertur. Habet iunci quadrati, cardamomi, turis fuliginis, amomi, cerae, resinae liquidae pares portiones.

[¶27] Another emollient for the same purpose is that of Nileus: crocomagma, which is as it were saffron-lees, 16 grams, ammoniacum for fumigating, and wax, 80 grams each. Of these the first two are rubbed up in vinegar, the wax is liquefied by melting in rose-oil, and then all are mixed together.

> Latin: Aliud ad eadem Nilei: croci magmatis, quod quasi recrementum eius est, P. #1108 IIII; Hammoniaci thymiamatis, cerae, singulorum P. #1108 XX. Ex quibus duo priora ex aceto teruntur, cera cum rosa liquatur, et tum omnia iunguntur. Proprie etiam dura emollit id, quod Moschi esse dicitur.

[¶28] Especially useful for softening induration is an emollient said to have been invented by Moschus. It contains galbanum 28 grams, frankincense soot 56 grams, wax and ammoniacum for fumigation, 112 grams each, dried pitch 672 grams, vinegar 750 cc.

> Latin: Habet galbani unciam; turis fuliginis P. #1109; cerae, Hammoniaci thymiamatis trientes; picis aridae P. II; aceti heminas tres. Fertur etiam ad digerenda, quae coeunt, sub auctore Medio, quod habet cerae P. #1109; panacis P. S.;

[¶29] We have also one ascribed to medius for dispersing collections of matter. It contains wax 56 grams, panax 168 grams, copper scales, round alum, split alum, 336 grams each, calcined lead 504 grams.

> Latin: squama⟨e⟩ aeris, aluminis rotundi, item scissilis, singulorum P. I; plumbi combusti P. I S. Ad eadem Pantaenus utebatur calcis P. S.; sinapis contriti, item faeni Graeci, aluminis, singulorum P.

[¶30] Pantaenus used for the same purpose, quicklime 168 grams, pounded mustard, also fenugreek and alum, 336 grams each, ox-suet 840 grams.

> Latin: I; sebi bubuli P. II S. Ad strumam multa malagmata inuenio.

[¶31] For scrofulous tumour I find many emollients. Now I think that the worse this disease, and the less easy its dispersal, the most have been the remedies tried, with results varying according to the several patients. Andrias invented the following: nettle-seed 4 grams, round pepper, bdellium, galbanum, ammoniacum for fumigation, dried resin, 16 grams each, with equal parts of liquid resin, wax, pyrethrum, long pepper, seed of sea spurge, unheated sulphur, which is called apyron. Nicon's emollient contains dried vinegar lees, soda-scum, ammoniac salt, mustard, cardamon, wild cucumber root, resin, 32 grams each. These are pounded up together in mild wine.

> Latin: Credo autem, quo peius id malum est minusque facile discutitur, eo plura esse temptata, quae in personis uarie responderunt. —Andrias auctor est, ut haec misceantur: urticae seminis P. #1108 I; piperis rotundi, bdelli, galbani, Hammoniaci thymiamatis, resinae aridae, singulorum P. #1108 IIII; resinae liquidae, cerae, pyrethri, piperis longi, lactucae marinae seminis, sulpuris ignem non experti, quod apyron uocatur, pares portiones. Hoc autem quod Niconis est: faecis aridae aceti, spumae nitri, salis Hammoniaci, sinapis, cardamomi, radicis ex cucumere siluestri, resinae, singulorum P. #1108 VIII; quae ex leni uino contunduntur.

[¶32] A more active emollient for the same purpose contains mistletoe juice, ape's dung, resin, untreated sulphur, equal parts; another emollient contains sulphur 4 grams, the stone called pyrites 16 grams, and 63 cc of cumin. In another are pyrites one part, sulphur two parts, turpentine resin three parts.

> Latin: Expeditius ad idem fit, quod habet uisci, simini stercoris, resinae, sulpuris ignem non experti pares portiones; et in quo est sulpuris P. #1108 I, lapidis quem pyriten uocant P. #1108 IIII, cumini acetabulum. Item in quo est lapidis eiusdem pars una, sulpuris duae partes, resinae terebenthinae partes tres.

[¶33] An emollient, the invention of a certain Arab, serves to disperse scrofulous swelling, and the sprouting small tumours which are called phymata. It contains myrrh, ammoniac salt, incense, resin both liquid and dried, crocomagma, was, 4 grams each, the stone called pyrites 16 grams, to which some add sulphur 672 grams.

> Latin: Arabis autem cuiusdam est ad strumam et orientia tubercula, quae phymata uocantur, quod haec digerit. Habet murrae, salis Hammoniaci, turis, resinae et liquidae et aridae, croci magmatis, cerae, singulorum P. #1108 I; lapidis eius quem pyriten uocant P. #1108 IIII; quibus quidam adiciunt sulpuris P. II.

[¶34] There is also an emollient efficacious for scrofulous swellings, and for those boils which are slow to come to a head, also for those which are called carcinoid. It contains sulphur 8 grams, soda 16 grams, myrrh 24 grams, frankincense soot 3.3 grams, ammoniac salt 56 grams, wax 336 grams.

> Latin: Est etiam proficiens in struma et in is tuberibus, quae difficiliter concocuntur, et in is, quae carcinode uocantur, quod ex his constat: sulpuris P. #1108 II; nitri P. #1108 IIII, murrae P. #1108 VI, fuliginis turis P. #1113., salis Hammoniaci P. #1109, cerae P. I.

[¶35] Protarchus, for parotid swellings, and for those small tumours which are named melicerides favi or phymata, and bad ulcerations, mixed together: pumice, liquid pine-resin, frankincense soot, soda-scum, iris, each 32 grams, along with wax 36 grams, to which are added 63 cc. of oil.

> Latin: Protarchus autem ad parotidas eaque tubercula, quae melicer⟨ides⟩ [favi] uel phymata nominantur, item mala ulcera pumicis, resinae pineae liquidae, turis fuliginis, spumae nitri, iridis, singulorum P. #1108 VIII cum cerae P. #1108 VIIII miscebat, hisque olei cyathum et dimidium adiciebat.

[¶36] But against panus at any stage and when incipient, the condition called by the Greeks phygetron, and against any small tumour called phyma, the ochre named Attic is mixed with equal parts of wheat flour, and whilst these are being stirred together, honey is dropped in until the consistency is that of an emollient.

> Latin: At aduersus panum, * * tum primum orientem, quod phygetron Graeci uocant, et omne tuberculum, quod phyma nominatur, miscetur ocra quae Attice nominatur cum duabus partibus similae, hisque cum tunduntur subinde mel instillatur, donec malagmatis crassitudo sit.

[¶37] Also all the small tumours called phymata are dispersed by an emollient containing quicklime, soda-scum, round pepper, each 4 grams, galbanum 8 grams, salt 16 grams, which are taken up in a cerate made of rose oil.

> Latin: Discutit etiam omne tuberculum, quod phyma uocatur, id quod habet calcis, nitri spumae, piperis rotundi, singulorum P. #1108 I; galbani P. #1108 II; salis P. #1108 IIII, quae excipiuntur cerato ex rosa facto.

[¶38] Any abscession is suppressed by galbanum and crushed beans, each 4 grams, myrrh, frankincense, caper root bark, each 16 grams. And calcined murex well pounded, with vinegar gradually added, is sufficient to disperse an abscession when forming.

> Latin: Supprimitque omne quod abscedit id, in quo est galbani, fabae fresae, singulorum P. #1108 I; murrae, turis, ex radice capparis corticis, singulorum P. #1108 IIII. Satisque omnia abscedentia digerit murex combustus et bene contritus, aceto subinde adiecto.

[¶39] But if sufficient blood comes up, it is right to apply a remedy which is also useful against phymata. It consists of the following ingredients: bdellium, storax, ammoniacum, galbanum, pine-resin liquid and dried, also lentiscus-resin, frankincense, iris, 8 grams each.

> Latin: At si satis sanguis subit, recte imponitur quod aduersus phymata quoque potest. Constat ex his: bdelli, styracis, Hammoniaci, galbani, resinae aridae et liquidae pineae, item ex lentisco, turis, iridis, singulorum P. #1108 II.

[¶40] But the phymata called carcinoid are relieved by the following: galbanum, mistletoe juice, ammoniacum, turpentine-resin, 4 grams each, beef suet 168 grams, of burnt wine-lees as large an amount as can be added without making the mass too dry for an emollient.

> Latin: Carcinode uero phymata commode his leniuntur: galbani, uisci, Hammoniaci, resinae terebenthinae, †in, singulorum P. #1108 I; sebi taurini P. S.; faecis combustae quam maxima portione, dum id siccius non faciat quam esse malagma oportet.

[¶41] But after a blow on the face there is discolouration and bruising, the following prescription applied night and takes it away: aristolochia and thapsia, each 8 grams, bdellium, storax, ammoniacum for fumigation, galbanum, dried resin, liquid from lentiscus-resin, male frankincense, Illyrian iris wax, each 16 grams. The application of bean-meal also has the same effect.

> Latin: Quod si facie contusa liuor subcruentus est, haec compositio nocte et die imposita tollit: aristolochiae, thapsiae, singulorum P. #1108 II; bdelli, styracis, Hammoniaci thymiamatis, galbani, resinae aridae et ex lentisco liquidae, turis masculi, iridis Illuricae, cerae, singulorum P. #1108 IIII. Idem faba quoque imposita proficit.

[¶42] There are certain emollients called by the Greeks anastomotica, because they have the property of opening the pores. Of these one contains long pepper and soda-scum, each 8 grams, hedge mustard 16 grams, these are mixed together with honey. They are also suitable for scrofulous tumours. Of this class is... a yet more powerful one of this kind is that which consists of lime 16 grams, 6 peppercorns; soda and wax, each 48 grams, honey 56 grams, and 250 cc. of oil.

> Latin: Sunt etiam quaedam malagmata, quae an⟨a⟩stom⟨o⟩tica Graeci uocant, quoniam aperiendi uim habent. Quale est, quod ex his constat: piperis longi, spumae nitri, singulorum P. #1108 II; erysimi P. #1108 IIII, quae cum melle miscentur. Idoneaque etiam strumae aperiendae sunt. Eius generis est * * uehementiusque ex his est id, quod habet calcis P. #1108 IIII; piperis grana VI; nitri, cerae, singulorum P. #1108 XII; mellis P. #1109; olei heminam.

[¶43] There is also a prescription of Nicon which relaxes, opens and cleans. It contains coral, sulphur, soda, and pumice, equal parts, to which pitch and wax are added to the consistency of a cerate.

> Latin: Niconis quoque est quod resoluit, aperit, purgat. Habet alcyoneum, sulpur, nitrum, pumicem paribus portionibus, quibus tantum picis et cerae adicitur, ut fiat cerati crassitudo.

[¶44] Again, for the hard parts there is the emollient of Aristogenes made from the following: sulphur 4 grams, turpentine-resin, soda-scum, the inner part of a quill-bulb, washed lead, 8 grams each, frankincense soot 32 grams, the ripest figs and beef-suet, 32 grams each, wax 48 grams, Macedonian iris 24 grams, parched sesame 63 cc.

> Latin: Ad spissa autem Aristogenis fit ex his: sulpuris P. #1108 I; resinae terebenthinae, nitri spumae, et ex scilla partis interioris, plumbi eloti, singulorum P. #1108 II; turis fuliginis P. #1108 VIII; ficus aridae quam pinguissimae, sebi taurini, singulorum P. #1108 VIII; cerae P. #1108 XII; iridis Macedonicae P. #1108 VI;

[¶45] And most of all is an emollient suitable for sinews and joints. Thus still that of Euthycleus, suitable for joints and for any kind of pain, including that of the bladder, and for joints contracted by recent scarring which the Greeks call ancylae: it consists of frankincense soot 63 cc., of resin the same, galbanum without stalks 42 grams, ammoniacum and bdellium, of each 12 grams.... of each 56 grams, wax 168 grams. Another for similar pain in the fingers contains ammoniacum, galbanum, and soda, each 56 grams, liquid resin 24 grams, wax 64 grams.

> Latin: sesami fricti acetabulum. Maximeque neruis et articulis malagma conuenit. Igitur Euthyclei est ad articulos, et ad omnem dolorem et ad uesicae, et ad recenti cicatrice contractos articulos, quas ancylas Graeci nominant, quod habet: fuliginis turis acetabulum; resinae tantundem; galbani sine surculis sescunciam; Hammoniaci, bdelli * P. #1108 III. * * * singulorum P. #1109; cerae P. S. Ad eosdem digitos iridis, Hammoniaci, galbani, nitri, singulorum P. #1108 XIIII; resinae liquidae P. #1108 VI; cerae P.

[¶46] The emollient of Sosagoras for pain in joints contains calcined lead, poppy tears, hyoscyamus bark, storax, sulphurwort, suet, resin and wax, equal parts.

> Latin: #1108 XVI. Ad dolores articulorum Sosagorae: plumbi combusti, papaueris lacrimae, corticis hyoscyami, styracis, peucedani, sebi, resinae, cerae pares portiones.

[¶47] That of Chrysippus contains liquid resin, sandarach, 48 grams each, to which a little wax is added.

> Latin: Chrysippi: resinae liquidae, sandaracae, piperis, singulorum P. #1108 XII;

[¶48] That of Clesiphon consists of Cretan wax, turpentine resin, the reddest soda, 168 grams each, and 126 cc. of oil. But this soda is pounded up beforehand over a period of three days, water being added drop by drop, and then boiled in half a litre of water until all fluid has gone. This composition too can be applied to parotid swellings, phymata, scrofulous tumours, and to soften any collection of humour.

> Latin: quibus cerae paululum adicitur. Clesip⟨h⟩ontis: cerae Creticae, resinae terebenthinae, nitri quam ruberrumi, singulorum P. S., olei cyathi tres. Sed id nitrum ante per triduum instillata aqua teritur, et cum sextario eius incoquitur, donec omnis umor consumatur. Potest uero ea compositio etiam ad parotidas, phymata, strumam omnemque coitum umoris emolliendum.

[¶49] Some apply to joints with good effect part of a dried fig mixed with catmint; or black bryony berries without the seeds, with pennyroyal.

> Latin: Ad articulos fici quoque aridi partem nepetae mixtam uel uuam t⟨a⟩miniam sine seminibus cum puleio recte aliquis imponit. Eadem podagrae praesidi⟨o⟩ sunt.

[¶50] The same are good for podagra. But for this there is also Ariston's emollient which consists of nard, cinnamon, casia, chameleon, angular rush, 32 grams each, goat's suet in liquid iris oil 80 grams, iris which should have been steeped in the sharpest vinegar for 20 days, 4 grams: this emollient also disperses recent phymata and pain of all sorts.

> Latin: Sed ad eam fit Aristonis quoque, quod habet: nardi, cinnamomi, casiae, chamaeleontis, iunci rotundi, singulorum P. #1108 VIII; sebi caprini ex irino liquati P. #1108 XX; iridis P. #1108 I, quae in aceto quam acerrimo iacere per XX dies debet. Idem autem etiam recentia phymata doloresque omnes discutit.

[¶51] But Theoxenus for pain in the feet mixed one part of kidney-suet with two parts of salt and applied a thin membrane smeared with these, then poured over it ammoniacum for fumigation dissolved in vinegar.

> Latin: At Theoxenus ad pedum dolores sebi a renibus partem tertiam, salis partes duas miscebat, hisque membranulam inlitam imponebat, tum superiniciebat Hammoniacum thymiama in aceto liquatum.

[¶52] But Numenius used to soften podagra and all cases of indurated joints with an emollient consisting of southernwood, dried rose-leaves and poppy-tears, 12 grams each, turpentine-resin 16 grams, frankincense and soda-scum, 32 grams each, iris and aristolochia, 48 grams each, wax 1 kilogram, to which is added of cedar-oil 42 cc., of laurel-oil 126 cc., of bitter olive-oil 500 cc.

> Latin: At Numenius podagram ceterosque articulos induratos hoc molliebat: habrotoni, rosae aridae, papaueris lacrimae, singulorum P. #1108 III; resinae terebenthinae P. #1108 IIII; turis, spumae nitri, singulorum P. #1108 VIII; iridis, aristolochiae, singulorum P. #1108 XII; cerae P. III; quibus adicitur cedri cyathus I, olei laurei cyathi III, olei acerbi sextarius.

[¶53] If at any time callus has formed in joints, Dexius advised an application of lime 16 grams, white lead 32 grams, pine-resin 80 grams, 30 peppercorns, wax 56 grams. While these are being pounded together 250 cc. of mild wine is dropped in.

> Latin: Si quando autem in articulis callus increuit, Dexius docuit inponere calcis P. #1108 IIII; cerussae P. #1108 VIII; resinae pineae P. #1108 XX; piperis grana XXX; cerae P. #1109; quibus, dum contunduntur, hemina uini lenis instillatur.

## 17. Book V · chapters 19–24

Source: https://scriptura.si/works/celsus-on-medicine/17/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/17/#p-N

[¶0] 19. 19 Among the plasters none render greater service than those for immediate application to bleeding wounds, which the Greeks call enhaema. For these repress inflammation, unless a severe cause excites it, and even then they lessen its attack; further, they agglutinate wounds which allow of it, and induce a scar in them. But as the plasters consist of medicaments which are not greasy, they are named alipe.

> Latin: 19. Ex EMPLASTRIS autem nulla maiorem usum praestant, quam quae cruentis protinus uulneribus iniciuntur: enhaema Graeci uocant. Haec enim reprimunt inflammationem, nisi magna uis eam con⟨c⟩it⟨at⟩, atque illius quoque impetum minuunt; tum glutinant uulnera, quae id patiuntur, cicatricem isdem inducunt. Constant autem ex medicamentis non pinguibus, ideoque alipe[ne] nominantur. Optimum ex his est quod barbarum uocatur.

[¶1] The best of these is the plaster called barbarum. It contains scraped verdigris 48 grams, litharge 80 grams, alum, dried pitch, dried pine-resin, 4 grams each, to which is added oil and vinegar 250 cc. each.

> Latin: Habet aeruginis rasae P. #1108 XII; spumae argenti P. #1108 XX; aluminis, picis aridae, resinae pineae aridae, singulorum P. #1108 I; quibus adiciuntur olei et aceti singulae heminae.

[¶2] Another one called Coacon, used for the same purpose, consists of litharge 400 grams, dried resin the same, but the litharge should be first boiled in three-quarters of a litre of oil. In these two plasters the colour is black, which is the colour generally produced by the pitch-resin, but the blackest is from bitumen, green from verdigris or copper scales, red from minium, white from white-lead.

> Latin: Alterum ad idem, quod Coacon uocant, habet spumae argenti P. #1108 C; resinae aridae tantundem: sed spuma prius ex tribus olei heminis coquitur. His duobus emplastris color niger est, qui fere talis fit ex pice atque resina: at ex bitumine nigerrimus, ex aerugine aut aeris squama uiridis, ex minio ruber, ex cerussa albus. Paucae admodum compositiones sunt, in quibus aliquid mixturae uarietas nouat.

[¶3] There are very few compositions in which diversity of ingredients makes any change. Hence that plaster which is called basilicon is also black. It consists of all-heal 4 grams, galbanum 8 grams, pitch and resin, 40 grams each, oil 20 cc.

> Latin: Ergo id quoque nigrum est, quod basilicon nominatur. Habet panacis P. #1108 I; galbani P. #1108 II; picis et resinae, singulorum P. #1108 X; olei dimidium cyathum. At, quia peruiride est, zmaragdinum appellatur in quo sunt: resinae pineae P.

[¶4] But, because it is bright green, a plaster is called emerald-like which contains pine-resin 12 grams, wax 4 grams, verdigris 168 grams, frankincense soot 56 grams, oil the same, and vinegar enough to combine into one the soot and the verdigris.

> Latin: #1108 III; cerae P. #1108 I; aeruginis P. s.; turis fuliginis P. #1109; olei tantundem; aceti, quo fuligo et aerugo in unum cogantur. Est etiam coloris fere rufi, quod celeriter ad cicatricem uulnera perducere uidetur. Habet turis P.

[¶5] There is also one, almost red in colour, which is found to bring wounds rapidly to a scar. It contains incense 4 grams, resin 8 grams, copper scales 16 grams, litharge 80 grams, wax 400 grams, oil 250 cc.

> Latin: #1108 I; resinae P. #1108 II; squamae aeris P. #1108 IIII; spumae argenti P. #1108 XX; cerae P. #1108 C, olei heminam. Praeterea est quam ΡΑΠΤΟΥΣΑΝ a glutinando uocant. Constat ex his: bituminis, aluminis scissilis P.

[¶6] As well, there is one called rhaptousa, because it agglutinates, consisting of bitumen and split alum 16 grams, litharge 160 grams, and 250 cc. of old oil.

> Latin: #1108 IIII; spumae argenti P. #1108 XL; olei ueteris hemin⟨a⟩. Praeterea sunt quaedam generis eiusdem, quae, quia capitibus fractis maxime conueniunt, cephalica a Graecis nominantur.

[¶7] There are also some plasters of the same class, called by the Greeks cephalica, because they are especially suitable for broken heads. That of Philotas has the following composition: Eretrian earth and chalcitis, 16 grams each, myrrh and calcined copper 40 grams each, isinglass 24 gram each, scraped verdigris, round alum, crude antimony sulphide and aristolochia, 32 grams each, copper scales 40 grams, male frankincense 8 grams, wax 336 grams, rose-oil and bitter olive-oil, 125 cc. each, and sufficient vinegar to rub up the ingredients while keeping them dry.

> Latin: Philotae compositio habet: terrae Eretriae, chalcitidis, singulorum P. #1108 IIII; murrae, aeris combusti, ⟨singulorum⟩ P. #1108 X; icthyocollae [singulorum] P. #1108 VI; aeruginis rasae, aluminis rotundi, misy crudi, aristolochiae, singulorum P. #1108 VIII; squamae aeris P. #1108 X; turis masculi P. #1108 II; cerae P. I; rosae et olei acerbi ternos cyathos; aceti quantum satis est, dum arida ex eo conteruntur. Aliud ad idem uiride: aeris combusti, squamae aeris, murrae, icthyocollae, singulorum P.

[¶8] A green plaster for the same purpose consists of calcined copper, copper scales, myrrh and isinglass 24 grams each, crude antimony sulphide, scraped verdigris, aristolochia and alum, 32 grams each, wax 4 grams, oil 250 cc., and as much vinegar as is required.

> Latin: #1108 VI; misy crudi, aeruginis rasae, aristolochiae, aluminis rotundi, singulorum P. #1108 VIII; cerae P. #1108 I, olei hemina, aceti quod satis sit. Puri autem mouendo non aliud melius quam quod expeditissimum est: tetrapharmacon a Graecis nominatur.

[¶9] But for promoting suppuration there is nothing better than the plaster called by the Greeks tetrapharmacon, which acts very quickly. It contains wax, pitch, resin and bull's suet, or, if that is not at hand, veal-suet, in equal proportions.

> Latin: Habet pares portiones cerae, picis, resinae, sebi taurini, si id non est, uitulini. Alterum ad idem enneapharmacum nominatur, quod magis purgat. Constat ex nouem rebus: cera, melle, sebo, resina, murra, rosa, medulla uel ceruina uel uitulina uel bubula, ⟨oe⟩s⟨y⟩po, buturo.

[¶10] Another for the same purpose is named enneapharmacum, which is more for cleaning wounds. It has nine ingredients: wax, honey, suet, resin, myrrh, rose-oil, deer or calf or ox marrow, oesypum, butter; equal weights of which are mixed together.

> Latin: Quorum ipsorum quoque pondera paria miscentur. Sunt autem quaedam emplastra, quibus utriusque rei facultas est, quae si * * * singula habenda sunt, meliora sunt: sed in copia reicienda sunt, is potius adhibitis, quae proprie id, quod eo tempore opus est, consecuntur.

[¶11] Now there are certain plasters which produce both effects which if... they are to be applied for both purposes are better; but if there is a choice these are to be rejected, and those plasters rather are to be selected which especially effect what is needed at the time. I will mention two as examples.

> Latin: Exempli causa duo proponam. Est igitur ad uulnera Attal⟨i⟩um, quod habet: squamae aeris P. #1108 XVI; ⟨turis⟩ fuliginis P. #1108 XV; Hammoniaci tantundem; resinae terebenthinae liquidae P. #1108 XXV; sebi taurini tantundem;

[¶12] There is the plaster of Attalus for wounds, which contains copper scales 64 grams, frankincense soot 60 grams, ammoniacum the same; liquid turpentine 100 grams, bull-suet this amount; vinegar three-quarters of a litre, oil half a litre.

> Latin: aceti heminas tres, olei sextarium. At inter ea, quae fracto capiti accommodantur, habent quidam id, quod ad auctorem Iudaeum refertur. Constat ex his: salis P. #1108 IIII; squamae aeris rubri, aeris combusti, singulorum P. #1108 XII;

[¶13] But among those suitable for broken heads, some include the one which is ascribed to Iudaeus. It is composed of salt 16 grams, red copper scales and calcined copper, 48 grams each, ammoniacum for fumigation, frankincense soot and dried resin, 64 grams each, Colophon resin, wax and prepared calf's suet, 80 grams each, vinegar 65 cc., less than 40 cc. of oil. The Greeks call tetherapeumena, what we call prepared, when, for instance, from suet all membranous particles are carefully removed, and so in the case of other medicaments.

> Latin: Hammoniaci thymiamatis, turis fuliginis, resinae aridae, singulorum P. #1108 XVI; resinae Colophoniacae, cerae, sebi uitulini curati, singulorum P. #1108 XX; aceti sesquicyath⟨o⟩, olei minus cyath⟨o⟩. ⟨ΤΕ⟩ΘΕΡΑΠΕ⟨Υ⟩ΜΕΝΑ Graeci appellant, quae curata uocant, cum ex sebo puta omnes membranulae diligenter exemptae sunt [ex alio medicamento]. Sunt etiam quaedam emplastra nobilia ad extrahendum. Quae ipsa quoque ΕΠΙΣΠΑΣΤΙΚΑ nominantur; quale est quod, quia lauri bacas habet, dia daphnidon appellatur. In eo est resinae terebenthinae P.

[¶14] There are besides certain plasters noteworthy for extracting, and these too are named epispastic; for instance, that called dia daphnidon, because it contains laurel berries. In it there are terebinth-resin 40 grams, soda, wax, dried pitch, laurel-berries, 80 grams each, with a little oil. But whenever I mention a berry or nut or the like, it should be understood that the outer husk is seem to be removed before weighing.

> Latin: #1108 X; nitri, cerae, picis aridae, bacarum lauri, singulorum P. #1108 XX; olei paulum. Quotiens aut⟨em⟩ bacam aut nucem aut simile aliquid posuero, scire oportebit, antequam expendatur, ei summam pelliculam esse demendam. Aliud eodem nomine, quod puri quoque mouendo est: sebi uitulini, Hammoniaci thymiamatis, picis, cerae, nitri, bacarum lauri, resinae aridae, aristolochiae, pyrethri pares portiones.

[¶15] Another of the same name which also promotes suppuration, contains calf-suet, ammoniacum for fumigation, pitch, wax, soda, laurel-berries, dried resin, aristolochia and pellitory, equal parts.

> Latin: Praeter has est Philocratis, quod habet: salis Hammoniaci P. #1108 VII; aristolochiae P. #1108 VIII; cerae, resinae terebenthinae, fuliginis turis, singulorum P. #1108 XV; spumae argenti P.

[¶16] There is also that of Philocrates, which consists of ammoniac salt 28 grams, aristolochia 32 grams, wax, turpentine resin, frankincense soot, 60 grams each, litharge 128 grams, to which is added, in order to promote suppuration, iris 16 grams, and galbanum 24 grams.

> Latin: #1108 XXXII, quibus, ut pus quoque moueant, iridis P. #1108 IIII et galbani P. #1108 VI adiciuntur. Optimum tamen ad extrahendum est id, quod a similitudine sordium rhypodes Graeci appellant.

[¶17] The best as an extractive, however, is that called by the Greeks rhypodes, from its resemblance to dirt. It contains myrrh, crocus, iris, propolis, bdellium, pomegranate heads, alum both split and round, antimony sulphide, copper ore, boiled blacking, all-heal, ammoniacum salt, mistletoe juice, 16 grams each, aristolochia 32 grams, copper scales 56 grams, turpentine resin 300 gams, wax and ox or he-goat's suet, 400 grams each.

> Latin: Habet murrae, croci, iridis, propolis, bdelli, capitulorum Punici mali, aluminis et scissilis et rotundi, misy, chalcitis, atramenti sutorii cocti, panacis, salis Hammoniaci, uisci, singulorum P. #1108 IIII; aristolochiae P. #1108 VIII; squamae aeris P. #1108 XVI; resinae terebenthinae P. #1108 LXXV; cerae et sebi uel taurini uel hircini, singulorum P. #1108 C. Hecatae⟨o⟩ quoque auctore emplastrum generis eiusdem fit ex his: galbani P. #1108 II; fuliginis turis P. #1108 IIII; picis P. #1108 VI;

[¶18] The plaster invented by Hecataeus is of the same class, and is composed of galbanum 8 grams, frankincense soot 16 grams, pitch 24 grams, wax and turpentine-resin, 32 grams each, with which is mixed a little iris ointment.

> Latin: cerae et resinae terebenthinae singulorum P. #1108 VIII; quibus paululum irini unguenti miscetur. Valensque ad idem emplastrum uiride Alexandrinum est. Habet aluminis scissilis P. #1108 VIII; salis Hammoniaci P. #1108 VIII #1109;

[¶19] Efficacious for the same purpose is the green Alexandrian plaster. It consists of split alum 32 grams, ammoniac salt 32·66 grams, copper scales 64 grams, myrrh and frankincense 72 grams, wax 600 grams, Colophon or pine resin 800 grams, oil 250 cc., vinegar half a litre.

> Latin: squamae aeris P. #1108 XVI; murrae, turis, singulorum P. #1108 XVIII; cerae P. #1108 CL; resinae Colophoniacae aut pineae P. #1108 CC; olei heminam, aceti sextarium. Quaedam autem sunt emplastra exedentia, quae septa Graeci uocant;

[¶20] Some plasters, called by the Greeks septa, eat away flesh; one such contains turpentine-resin and frankincense soot, each 56 grams, copper scales 4 grams, ladanum 8 grams, alum the same amount, litharge 16 grams.

> Latin: quale est id, quod habet resinae terebenthinae, fuliginis turis, singulorum P. #1109; squamae aeris P. #1108 I; ladani P. #1108 II; aluminis tantundem; spumae argenti [singulorum] P. #1108 IIII.

[¶21] The following prescription is even violent in its action on soft tissue, and also causes exfoliation of bone and keeps down fungating flesh: litharge and copper scales 28 grams each, unheated soda, Assos stone, aristolochia, 56 grams each, wax, turpentine resin, incense and old oil, blacking and ammoniac salt, 168 grams each, scraped verdigris 224 grams, vinegar of squills 250 cc., Aminaean wine the same amount.

> Latin: Exest etiam uehementer corpus atque ossa quoque resoluit et supercrescentem carnem coercet id, quod habet spumae argenti, squamae aeris uncias singulas; nitri ignem non experti, lapidis As⟨s⟩ii, aristolochiae P. sextantes; cerae, resinae terebenthinae, turis, olei ueteris, atramenti sutorii, salis Hammoniaci P. S.; aeruginis rasae P. bessem; aceti scilliti heminam; uini Aminaei tantundem.

[¶22] There are also some suitable for bites; one of these is the black paste of Diogenes, which contains bitumen, wax, dried pine-resin, each 80 grams, litharge 400 grams, oil half a litre. Another consists of copper scales 16 grams, white-lead and scraped verdigris, each 32 grams, ammoniacum 48 grams, wax and pine resin, each 100 gams, litharge 400 grams, oil half a litre. Or there is that in which there are copper scales 56 grams, galbanum 24 grams, white-lead and scraped verdigris, a 32 grams, ammoniacum 48 grams, wax and pine-resin, each 140 grams cooked with litharge.

> Latin: Sunt etiam aduersus morsus quaedam adcommodata, quale est Dioge⟨ni⟩ nigrum, quod habet: bituminis, cerae, resinae pineae aridae, singulorum P. #1108 XX; spuma⟨e⟩ argenti P. #1108 C; olei sextarium. Aut in quo sunt squamae aeris P. #1108 IIII; cerussae et aeruginis ⟨r⟩assae, singulorum P. #1108 VIII; Hammoniaci P. #1108 XII; cerae, resinae pineae, singulorum P. #1108 XXV; spumae argenti P. #1108 C; olei sextarium. Aut in quo sunt squamae aeris P. #1108 XIIII; galbani P. #1108 VI; cerussae et aeruginis rasae, singulorum P. #1108 VIII; Hammoniaci P. #1108 XII; cerae, resinae pineae, singulorum P. #1108 XXXV * * * spuma argenti concoquitur.

[¶23] The red plaster called Ephesian is likewise suited for this purpose. It contains turpentine-resin 8 grams, galbanum 16 grams, minium for Sinope 24 grams, frankincense soot 24 grams, wax 32 grams, litharge 144 grams, old olive-oil 250 cc.

> Latin: Rubrum quoque emplastrum, quod E⟨p⟩hesium uocatur, huc aptum est. Habet resinae terebenthinae P. #1108 II; galbani P. #1108 IIII; minii Sinopici P. #1108 VI; turis fuliginis P. #1108 VI; cerae P. #1108 VIII; spumae argenti P.

[¶24] There is another similar one which consists of copper scales and frankincense soot, each 16 grams, galbanum 24 grams, ammoniac salt 48·66 grams, wax 100 grams, olive-oil 750 cc. These plasters, however, may be also usefully applied to more erect wounds.

> Latin: #1108 XXXVI; olei ueteris heminam. Item id, quod ex his constat; squamae aeris, turis fuliginis, singulorum P. #1108 IIII; galbani P. #1108 VI; salis Hammoniaci P. #1108 XII #1109; cerae P. #1108 XXV; olei tribus heminis.

[¶25] There are also soothing white plasters, called by the Greeks leuca, fitted in general for wounds which are not severe, especially in old people. Such is that containing white-lead 128 grams, prepared calf's suet, and wax, each 192 grams, olive-oil 750 cc., with which the white-lead is boiled.

> Latin: Haec autem aliis quoque recentioribus uulneribus recte imponuntur. Sunt etiam alba lenia (leuca Graeci uocant) fere non grauibus uulneribus accommodata, praecipueque senilibus. Quale est quod habet: cerussae P. #1108 XXXII; sebi uitulini curati et cerae, singulorum P. #1108 XLVIII; olei heminas tres;

[¶26] Another consists of white-lead 80 grams, wax 140 grams, olive-oil 250 cc., water half a litre. Whatever these liquids are added to white lead or litharge, it is understood that those drugs are to be boiled up in the liquids. But the above composition being of a glistening white appearance is called ivory plaster.

> Latin: ex quibus ea cerussa coquitur. Aliud quod habet cerussa⟨e⟩ P. #1108 XX; cerae P. #1108 XXXV, olei heminam, aquae sextarium. Quae quotiens adiciuntur cerussae uel spumae argenti, scire licet illa ex his coquenda esse. Est autem ea percandida compositio quae supra posita est, ideoque elephantine nominatur.

[¶27] There are also some soothing plasters, commonly called liparae by the Greeks, such as that containing minium 16 grams, litharge 100 grams, wax and lard, each 148 grams, with the yolk of 4 eggs.

> Latin: Lenia quoque quaedam emplastra sunt, quas liparas fere Graeci nominant; ut id, quod habet mini P. #1108 IIII; spumae argenti P. #1108 XXV; cerae et adipis suillae, singulorum P. #1108 XXXVII; uitellos quattuor.

[¶28] Another composition of the same sort contains wax and turpentine-resin, each 24 grams, white-lead 32 grams, litharge and lead-slag, called by the Greeks σκωρία μολύβδου, each 80 grams, castor-oil and myrtle-oil, a 250 cc.

> Latin: Alia compositio generis eiusdem: cerae, resinae terebenthinae, singulorum P. #1108 VI; cerussae P. #1108 VIII; spumae argenti, plumbi recrementi (ΣΚΩΡΙΑΝ ΜΟΛΥΒΔΟΥ Graeci uocant), singulorum P. #1108 XX;

[¶29] A third, said to have been invented by Archagathus, contains boiled antimony sulphide and calcined copper, each 16 grams, boiled white-lead 32 grams, turpentine-resin 40 grams, litharge 24 grams.

> Latin: cicini olei et murt⟨e⟩i singulorum heminae. Tertia, quae ad auctorem Arcagathum refertur: misy cocti, aeris combusti, singulorum P. #1108 IIII; cerussae coctae P. #1108 VIII; resinae terebenthinae P.

[¶30] Yet another of the same class consists of litharge, wax and lard, each 108 grams, yolk of 4 eggs boiled, rose-oil 250 cc. Another consists of a cerate made with myrtle-oil three parts, lard a fourth part, and a small quantity of lead-slag. Alternatively: litharge 168 grams, olive-oil 250 cc., and an equal quantity of sea water, boiled, to which, when off the boil, a little wax may be added. Or: wax, suet, antimony sulphide, litharge and white-lead, equal parts.

> Latin: #1108 X; spumae argenti P. #1108 VI. Etiamnum generis eiusdem: spumae argenti, cerae, adipis suillae, singulorum P. #1108 XXVII; uitelli cocti IIII; rosae hemina. Aut: cerati ex oleo myrteo facti partes tres; adipis suillae pars quarta; paulum ex plumbi recremento. Aut: spumae argenti selibra, ex olei hemina et aquae marinae altera cocta, donec bullire desierit, cui paulum cerae sit adiectum. Aut: pares portiones cerae, sebi, stibis, spumae argenti, cerussae.

[¶31] 20. 20 Pastils have also dives faculties. For some are suitable for agglutinating and making the scar upon recent wounds: such as that containing copper ore, antimony sulphide, soda-scum, flowers of copper, oak-galls, split alum moderately boiled, each 4 grams, calcined copper and pomegranate-heads, each 12 grams. It should be dissolved with vinegar, and so smeared on for agglutinating a would. But if the part wounded involves sinews or muscles, it is better to mix the pastil with a cerate, eight parts of the former to nine of the latter. Another for the same purpose is composed of bitumen and split alum, each 4 grams, calcined copper 16 grams, litharge 44 grams, oil half a litre. But the pastil of Polyides called the "seal" is by far the most celebrated. It contains split alum 4·66 grams, blacking 8 grams, myrrh 20 grams, ling aloes the same, pomegranate heads and ox-bile, 24 grams each; these are rubbed together and taken up in dry wine. For foul ulcerations and gangrene in the ears, nostrils and genitals, and their inflammatory complications, take chrysocolla 4 grams, blacking and split alum 8 grams each, winter cherry bark 16 grams, minium 24 grams, litharge 48 grams, white lead 64 grams; these are both compounded with vinegar and dissolved for use with the same. The pastil of Andron is for inflammation of the uvula, and for the genitals when foul, and even when affected by canker. It contains oak-galls, blacking, and myrrh, 4 grams each, aristolochia and split alum, 8 grams each, pomegranate-heads 100 grams, compounded with raisin wine, and when required for use dissolved in vinegar or wine, according as the disease to be treated is more severe or milder. But the following is appropriate for anal fissures, for bleeding piles, or for canker, verdigris 8 grams, myrrh 16 grams, gum 32 grams, frankincense 48 grams, antimony sulphide, poppy tears and acacia, 64 grams each. These are both pounded up in wine and for actual use are dissolved in the same. The following present is efficacious to expel stones from the bladder along with the urine; casia, crocus, myrrh, costmary, nard, cinnamon, liquorice root, balsamum and hypericum juice, equal parts; these are rubbed together, then mild wine is poured on, and pastils are made, each weighing 0·66 gram; one of them is given every morning on an empty stomach.

> Latin: 20. Pastilli quoque facultates diuersas habent. Sunt enim ad recentia uulnera glutinanda sanandaque apti; qualis est qui habet chalcitis, misy, spumae nitri, floris aeris, gallae, aluminis scissilis modice cocti, singulorum P. #1108 I; aeris combusti, capitulorum mali Punici, singulorum P. #1108 III. Hunc oportet diluere aceto, ⟨ac⟩ sic, ubi uulnus glutinandum est, inlin⟨e⟩re. At si neruosus aut muscolosus is locus est, commodius est cerato miscere, sic ut illius VIII partes, nona huius sit. Alius ad idem constat ex his: bituminis, aluminis scissilis, singulorum P. #1108 I; aeris combusti P. #1108 IIII; spumae argenti P. #1108 XI; olei sextari⟨o⟩. Sed longe Poly⟨i⟩di celeberrimus est, sphragis autem nominatur; qui habet aluminis scissilis P. #1108 I #1109; atramenti sutorii P. #1108 II; murrae P. #1108 V; aloes tantundem; capitulorum Punici mali, fellis taurini, singulorum P. #1108 VI; quae contrita uino austero excipiuntur. Ad ulcera sordida et nigritiem in auribus, naribus, obscenis partibus, inflammationesque eorum: chrysocollae P. #1108 I; atramenti sutori, aluminis scissilis, singulorum P. #1108 II; halicaccabi corticis P. #1108 IIII; mini P. #1108 VI; spumae argenti P. #1108 XII; cerussae P. #1108 XVI; quae ex aceto et coguntur et, ubi utendum est, diluuntur. Andronis uero est ad uuam inflammatam, ad naturalia sordida, etiam cancro laborantia: gallae, atramenti sutorii, murrae, singulorum P. #1108 I; aristolochiae, aluminis scissilis, singulorum P. #1108 II; capitul⟨orum⟩ Punici mali P. #1108 XXV; ex passo coacta, et cum usus exigit, aceto uel uino diluta, prout ualentius aut lenius uitium est, cui medendum est. Proprie autem ad ani fissa, uel ora uenarum fundentia sanguinem, uel cancrum: aeruginis P. #1108 II; murrae P. #1108 IIII; cummis P. #1108 VIII; turis P. #1108 XII; stibis, lacrimae papaveris, acaciae, singulorum P. #1108 XVI. Quae ex uino et teruntur et in ipso usu deliquantur. Expellere autem ex uesica cum urina calculum uidetur haec compositio: ca⟨s⟩iae, croci, murrae, costi, nardi, cinnamomi, dulcis radicis, balsami, hyperici pares portiones conteruntur, deinde uinum lene instillatur, et pastilli fiunt, qui singuli habeant P. #1108 #1109, hique singuli cotidie mane ieiuno dantur.

[¶32] 21. 21 These three classes of compositions —emollients, pastils and plasters — have very wide and varied uses. But there are other useful compositions, such as those which are introduced into women from below: the Greeks call them pessoi. Their characteristic is that the component medicaments are taken up in soft wool, and this wool is inserted into the genitals. A pessary for inducing menstruation contains soda 2·65 grams, added to two Caunean figs; or garlic seeds are pounded, a little myrrh added, and these are mixed with Susine lily ointment; or the pulp of a wild cucumber is diluted in woman's milk. To mollify the womb a yolk of egg, fenugreek, rose-oil and saffron are mixed together. Or elaterium 0·66 gram, the same quantity of salt, and black bryony berries 24 grams are taken up with honey. The pessary invented by Boethus consists of saffron and turpentine resin, 16 grams each, myrrh 1·33 grams, rose-oil 4 grams, calf's suet 4·66 grams, wax 8 grams, mixed together. But against inflammations of the womb, the composition of Numenius is the best; it consists of saffron 1 gram, wax 4 grams, butter 32 grams, goose-fat 48 grams, 2 yolks of egg boiled, and of rose-oil less than 40 cc. If the foetus is dead, to render its expulsion more easy, pomegranate rind should be rubbed up in water and so used. If a woman is liable to fits owing to genital disease, snails are to be burnt with their shells, and pounded up together; then honey added to them. If a woman does not conceive, lion's fat is to be softened by rose-oil.

> Latin: 21. Haec tria compositionum genera [id est, quae in malagmatibus, pastillis emplastrisque sunt] maximum praecipueque uarium usum praestant. Sed alia quoque utilia sunt, ut ea, quae feminis subiciuntur: PESSOS Graeci uocant. Eorum haec proprietas est: medicamenta composita molli lana excipiuntur, eaque lana naturalibus conditur. Ad sanguinem autem euocandum Cauneis duabus adicitur nitri P. #1108 S #1109; aut alii semen conteritur, adicitur murrae paululum, et unguento susino miscetur; aut cucumeris siluestris pars interior ex lacte muliebri diluitur. Ad uuluam molliendam oui uitellus et foenum Graecum et rosa et crocum temperantur. Aut elateri P. #1108 #1109; salis tantundem; uuae t⟨a⟩miniae P. #1108 VI melle excipiuntur. Aut Boetho auctore croci, resinae terebenthinae, singulorum P. #1108 IIII; murrae P. #1108 #1109 #1109; rosae P. #1108 I; sebi uitulini P. #1108 I #1109; cerae P. #1108 II miscentur. Optuma autem aduersus inflammationes uuluae Numenii compositio est, quae habet: croci P. #1108 #1109 #1110; cerae P. #1108 I; buturi P. #1108 VIII; adipis anserini P. #1108 XII; uitellos coctos duos, rosae minus cyatho. Si uero infans intus decessit, quo facilius eiciatur, mal⟨i⟩corium ex aqua terendum eoque utendum est. Si concidere uitio locorum mulier solet, cocleae cum testis suis comburendae conterendaeque, deinde his mel adiciendum est. Si non comprehendit, adeps leonina ex rosa mollienda est.

[¶33] 22. 22 Now, some mixtures of medicaments are used dry, without being combined, so that they are dusted or smeared on after some liquid has been mixed with them. Such is the present to eat away fungous flesh, which contains copper scales and frankincense soot, 4 grams each, verdigris 8 grams. But when combined with honey this compound cleans ulcers, when with wax it fills them up. Also antimony sulphide and oak-galls, if they are mixed in equal proportions, corrode flesh. We may either sprinkle this mixture on dry or take it up in cadmian ointment and smear it on. Honey mixed with lentils or with horehound or with olive leaves previously boiled in wine holds in check putrid flesh, prevents its further spread, and is a mild corrosive. The same is the action of melilot, boiled in honey wine, then pounded up; or lime with cerate; or bitter almonds with garlic in the proportion of three to one, with the addition of a little saffron. Or the composition containing litharge 24 grams, burnt ox-horn 48 grams, myrtle-oil and wine, 125 cc. of each. Or that mixture which consists of pomegranate flowers, blacking and lign-aloes, 8 grams each, split alum and frankincense 16 grams, oak-galls 32 grams, aristolochia 40 grams. Stronger as a corrosive is that compounded by calcining orpiment with copper ore, and with either soda or lime or burnt papyrus; salt with vinegar is similar. Or that composition which contains copper ore, pomegranate heads, lign-aloes, 8 grams each, split alum and frankincense, 16 grams each, oak-galls 32 grams, aristolochia 40 grams, with sufficient honey to combine them. An alternative is the composition containing cantharides 4 grams, sulphur 4 grams, darnel 12 grams, to which is added enough liquid pitch to combine them. Or also that composed of copper ore mixed with resin and rue; or slag similarly with resin; or black bryony berries with liquid pitch. The same property too belongs both to burnt wine-lees and lime and soda, equal parts, or to split alum, 1·33 grams, frankincense, sandarach and soda, 4 grams each, oak-galls 32 grams, aristolochia 40 grams, and as much honey as is required. There is also the compound of Heras which contains myrrh and copper ore, 8 grams each, lign-aloes, frankincense, split alum, 16 grams, aristolochia and immature oak-galls, 32 grams each, pomegranate rind pounded 40 grams. The compound of Iudaeus contains lime two parts; the reddest soda one part, mixed with the urine of a young boy to the consistency of strigil scrapings. But the place on which it is smeared should from time to time be moistened. Then the compound of Iollas consists of burnt papyrus and of sandarach, 4 grams each, lime 8 grams, mixed with the same quantity of orpiment. But if there is haemorrhage from the membrane covering the brain, a yolk of egg which has been charred and then pounded should be scattered on; for haemorrhage elsewhere orpiment and copper scales, 4 grams each, sandarach 8 grams, calcined marble 16 grams, should be dusted on. The same also checks canker. To induce scarifying, copper scales and frankincense soot, 8 grams each, lime 16 grams. The same also counters fungous flesh. Also Timaeus used the following for ignis sacer and for canker: myrrh 8 grams, frankincense and blacking, 12 grams each, sandarach, orpiment, copper scales, 16 grams each, oak-galls 24 grams, burnt white-lead 32 grams. This is either scattered on dry or has the same effect when taken up in honey. Sneezing too is excited by putting up the nose either white veratrum or soapwort; or the following mixture: pepper and white veratrum, 0·66 gram each, castoreum 1 gram, soda-scum 4 grams, soapwort 16 grams. Now gargles are used as emollients or as repres-sives or to draw out humour. As emollients, milk, pearl-barley or bran gruel; as repressants, a decoction of lentils or rose-leaves or blackberries or quinces or of dates. Mustard and pepper draw out humour.

> Latin: 22. Quaedam autem mixturae medicamentorum sunt, quibus ARIDIS neque coactis utimur, sic ut inspergamus, aut cum aliquo liquido mixta inlinamus. Quale est ad carnem supercrescentem exedendam, quod habet: squamae aeris, fuliginis turis, singulorum P. #1108 I; aeruginis P. #1108 II. Haec autem eadem cum melle purgant ulcera, cum cera inplent. Misy quoque et galla, si paribus portionibus misceantur, corpus consumunt; eaque uel arida inspergere licet uel excepta cadmia inlin⟨e⟩re. Putrem uero carnem continet neque ultra serpere patitur et leniter exest mel uel cum lenticula uel cum marrubio uel cum oleae foliis ante ex uino decoctis. Item sertula Campana in mulso cocta, deinde contrita; aut calx cum cerato; aut amarae nuces cum alio, sic ut huius pars tertia sit, paulumque his croci adiciatur. Aut quod habet spumae argenti P. #1108 VI; cornu bubuli combusti P. #1108 XII; olei murtei et uini cyathos ternos. Aut quod ex his constat: floris Punici mali, atramenti sutorii, aloes, singulorum P. #1108 II; aluminis scissilis, turis, singulorum P. #1108 IIII; gallae P. #1108 VIII; aristolochiae P. #1108 X. Vehementius idem facit etiam adurendo auripigmentum cum chalcitide et aut nitro aut calce aut charta combusta: item sal cum aceto. Vel ea compositio, quae habet: chalcitidis, capitulorum Punici mali, aloes, singulorum P. #1108 II; aluminis scissilis, turis, singulorum P. #1108 IIII; gallae P. #1108 VIII; aristolochiae P. #1108 X; mellis quantum satis sit ad ea cogenda. Vel cantharid⟨um P.⟩ #1108 I; sulpuris P. #1108 I; lolii P. #1108 III; quibus adicitur picis liquidae quantum satis est ad iungendum. Vel chalcitis quoque cum resina et ruta mixta; aut cum eadem resina diphryges; aut uua t⟨a⟩minia cum pice liquida. Idem uero possunt et faec⟨i⟩s uini combustae et calcis et nitri pares portiones; uel aluminis scissilis P. #1108 #1109 #1109; turis, sandaracae, nitri, singulorum P. #1108 I; gallae P. #1108 VIII; aristolochiae P. #1108 X; mellis quantum satis sit. Est etiam H⟨e⟩rae compositio, quae habet murrae, chalcitidis, singulorum P. #1108 II; aloe⟨s⟩, turis, aluminis scissilis, singulorum P. #1108 IIII; aristolochiae, gallae inmaturae, singulorum P. #1108 VIII; malicori contriti P. #1108 X. Est Iudaei, in qua sunt calcis partes duae; nitri quam ruberrumi pars tertia, quae urina inpuberis pueri coguntur, donec strigmenti crassitudo sit. Sed subinde is locus, cui id inlinitur, madefaciendus est. At Iollas chartae combustae, sandaracae, singulorum P. #1108 I; calcis P. #1108 II; auripigmenti tantundem miscebat. Si uero ex membrana, quae super cerebrum est, profluit sanguis, uitellus combustus et contritus inspergi debet: si alio loco sanguinis profluuium est, auripigmenti, squamae aeris, singulorum P. #1108 I; sandaracae P. ⟨#1108⟩ II; marmoris cocti P. #1108 IIII inspergi debet. Eadem cancro quoque obsistunt. Ad inducendam cicatricem: squamae aeris, turis fuliginis, singulorum P. #1108 II; calcis P. ⟨#1108⟩ IIII. Eadem increscentem quoque carnem coercent. Timaeus autem ad ignem sacrum, ad cancrum his utebatur: murrae P. #1108 II; turis, atramenti sutori, singulorum P. #1108 III; sandaracae, auripigmenti, squamae aeris, singulorum P. #1108 IIII; gallae P. #1108 VI; cerussae combustae P. #1108 VIII. Ea uel arida inspersa uel melle excepta idem praestant. Sternumenta uero uel albo ueratro uel struthio coiecto in nares excitantur, uel his mixtis: piperis, ueratri albi, singulorum P. #1108 #1109; castorei P. #1108 #1112; spumae nitri P. #1108 I; struthi P. ⟨#1108⟩ IIII. Gargarizationes autem aut leuandi causa fiunt aut reprimendi aut euocandi. Leuant lac, cremor uel tisanae uel furfurum: reprimit aqua, in qua uel lenticula uel rosa uel rubus uel Cotoneum malum uel palmulae decoctae sunt. Euocant sinapi, piper.

[¶34] 23. 23 Antidotes are seldom needed, but are at times important because they bring aid to the gravest cases. They are appropriately administered for bodily contusions, either from blows or in cases of a fall from a height, or for pain in the viscera, sides, fauces, or internal parts. But they are chiefly necessary against poisons introduced into our bodies through bites or food or drink. One consists of poppy-tears 0·66 gram, sweet flag and malabathrum, 20 grams each, Illyrian iris and gum, 8 grams each, anise 12 grams, Gallic nard, dried rose-leaves and cardamons, 16 grams each, parsley 16·66 grams (or trifolium 20 grams), black casia, seseli, bdellium, balsam seed, white pepper, 20·66 grams each, storax 20·66 grams, myrrh, opopanax, Syrian nard, male frankincense and hypocistis juice, 24 grams each, castoreum 24 grams, costmary, white pepper, galbanum, turpentine resin, crocus, flowers of round rush 25 grams, liquorice root 33 grams, which are taken up in honey or in raisin wine. Alternatively there is that which Zopyrus is said to have compose for a King Ptolemy, and to have called it ambrosia, consisting of the following: costmary and male frankincense, 1·33 grams each, white pepper 1 gram, flowers of round rush 8 grams, cinnamon 12 grams, black casia 16 grams, Cilician saffron 17 grams, myrrh called stacte 20 grams, Indian nard 21 grams. Each ingredient is ground up separately, and they are taken up in boiled honey; then at the time of using, a quantity the size of an Egyptian bean is dissolved in a draught of wine. But the most famous antidote is that of Mithridates, which that king is said to have taken daily and by it to have rendered his body safe against danger from poison. It contains costmary 1·66 grams, sweet flag 20 grams, hypericum, gum, sagapenum, acacia juice, Illyrian iris, cardamon, 8 grams each, anise 12 grams, Gallic nard, gentian root and dried rose-leaves, 16 grams each, poppy-tears and parsley, 17 grams each, casia, saxifrage, darnel, long pepper, 20·66 grams each, storax 21 grams, castoreum, frankincense, hypocistis juice, myrrh and opopanax, 24 grams each, malabathrum leaves 24 grams, flower of round rush, turpentine-resin, galbanum, Cretan carrot seeds, 24·66 grams each, nard and opobalsam, 25 grams each, shepherd's purse 25 grams, rhubarb root 28 grams, saffron, ginger, cinnamon, 29 grams each. These are pounded and taken up in honey. Against poisoning, a piece the size of an almond is given in wine. In other affections an amount corresponding in size to an Egyptian bean is sufficient.

> Latin: 23. ANTIDOTA raro sed praecipue interdum necessaria sunt, quia grauissimis casibus opitulantur. Ea recte quidem dantur conlisis corporibus, uel per ictus, uel ubi ex alto deciderunt, uel in uiscerum, laterum, faucium, interiorumque partium doloribus. Maxime autem desideranda sunt aduersus uenena, uel per morsus uel per cibos aut potiones nostris corporibus inserta. Unum est, quod habet lacrimae papaueris P. #1108 #1109; acori, malobathri P. #1108 V; iridis Illyricae, cummi, singulorum P. #1108 II; anesi P. #1108 III; nardi Gallici, foliorum rosae aridorum, cardamomi, singulorum P. #1108 IIII; petroselini P. ⟨#1108⟩ IIII #1109 (uel folii P. ⟨#1108⟩ V); casiae nigrae, silis, bdelli, balsami seminis, piperis albi, singulorum P. ⟨#1108⟩ V #1109; styracis P. ⟨#1108⟩ V #1109; murrae, opopanacis, nardi Syri, turis masculi, hypocistidis suci, singulorum P. #1108 VI; castorei ⟨P.⟩ #1108 VI; costi, piperis albi, galbani, resinae terebenthinae, croci, floris iunci rotundi, singulorum P. ⟨#1108⟩ VI #1109 #1110; dulcis radicis P. ⟨#1108⟩ VIII #1109 #1110; quae uel melle uel passo excipiuntur. Alterum, quod Zopyrus regi Ptolemaeo dicitur composuisse atque ambrosian nominasse, ex his constat: costi, turis masculi, singulorum P. ⟨#1108⟩ #1109 #1109; piperis albi P. ⟨#1108⟩ #1109 #1110; floris iunci rotundi P. ⟨#1108⟩ II; cinnamomi P. ⟨#1108⟩ III; casiae nigrae P. ⟨#1108⟩ IIII; croci Cilici P. ⟨#1108⟩ IIII #1109 #1110; murrae, quam stacten nomina⟨n⟩t, P. ⟨#1108⟩ V; nardi Indici P. ⟨#1108⟩ V #1109 #1110. Quae singula contrita melle cocto excipiuntur; deinde ubi utendum est, id quod Aegyptiae fabae magnitudinem impleat, in potione uini diluitur. Nobilissimum autem est Mithridatis, quod cottidie sumendo rex ille dicitur aduersus uenenorum pericula tutum corpus suum reddidisse. In quo haec sunt: costi P. ⟨#1108⟩ #1109 #1109 #1110; acori P. ⟨#1108⟩ V; hyperici, cummi, sagapeni, acaciae suci, iridis Illyricae, cardamomi, singulorum P. ⟨#1108⟩ II; anesi P. ⟨#1108⟩ III; nardi Gallici, gentianae radicis, aridorum rosae foliorum, singulorum P. ⟨#1108⟩ IIII; papaueris lacrimae, petroselini, singulorum P. ⟨#1108⟩ IIII #1109 #1110; casiae, silis, lolii, piperis longi, singulorum P. #1108 V #1109; styracis P. ⟨#1108⟩ V #1109 #1110; castorei, turis, hypocistidis suci, murrae, opopanacis, singulorum P. ⟨#1108⟩ VI; malobathri folii ⟨P.⟩ #1108 VI; floris iunci rotundi, resinae terebenthinae, galbani, dauci Cretici seminis, singulorum P. ⟨#1108⟩ VI #1109; nardi, opobalsami, singulorum P. ⟨#1108⟩ VI #1109 #1110; th⟨l⟩aspis P. #1108 VI #1109 #1110; radicis Ponticae P. ⟨#1108⟩ VII; croci, zingiberis, cinnamomi, singulorum P. #1108 VII #1109 #1110. Haec contrita melle excipiuntur, et aduersus uenenum, quod magnitudinem nucis Graecae impleat, ex uino datur. In ceteris autem adfectibus corporis pro modo eorum uel quod Aegyptiae fabae uel quod erui magnitudinem impleat, satis est.

[¶35] 24. 24 Acopa again are useful for neuralgia. Of these there is one which consists of the flower of the round rush, 9·33 grams each, costmary, square rush, laurel berries, ammoniacum, cardamons, 17 grams each, myrrh and calcined copper 28 grams, Illyrian iris and wax 56 grams, Alexandrian flag, round rush, aspalathus and balsam wood, 112 grams each, suet 4 grams, iris ointment 42 cc. Another called euodes is prepared as follows: wax 84 grams, oil this quantity, and turpentine-resin, the size of a walnut, are boiled together, then pounded in a mortar, and into this is gradually dropped 63 cc. of the best honey, and then iris ointment and rose-oil, 125 cc. of each. Now enchrista is the Greek name for liquid applications. Of these one is used for cleaning and filling up ulcers, especially about sinews. It is composed of a mixture of each parts of butter, calf's marrow, calf's suet, goose-fat, wax, honey, turpentine-resin, rose-oil and castor-oil. This are all liquefied separately, then the liquids are mixed and stirred up together. And the above is more for cleaning up wounds; it is more of an emollient if instead of the rose-oil, cyprus-oil is poured in. And for ignis sacer litharge 24 grams, burnt ox-horn 48 grams, are rubbed together, adding by turns wine, especially that which is called sil, and myrtle-oil until 125 cc. of each is mixed in.

> Latin: 24. Acopa quoque utilia neruis sunt. Quale est, quod habet floris iunci rotundi P. ⟨#1108⟩ II #1109 #1109; costi, iunci quadrati, lauri bacarum, Hammoniaci, cardamomi, singulorum P. ⟨#1108⟩ IIII #1109 #1110; murrae, aeris combusti, singulorum P. ⟨#1108⟩ VII; iridis Illyricae, cerae, singulorum P. ⟨#1108⟩ XIIII; Alexandrini calami, iunci rotundi, aspal⟨a⟩thi, xylobalsami, singulorum P. #1108 XXVIII; sebi P. ⟨#1108⟩ I; unguenti irini cyathum. Alterum, quod euodes uocant, hoc modo fit: cerae P. #1109 #1110; olei tantundem; resinae terebenthinae ad nucis iuglandis magnitudinem simul incocuntur; deinde ⟨infusa⟩ in mortario teruntur, instillaturque subinde quam optumi mellis acetabulum, tum irini unguenti et rosae terni cyathi. Enchrista autem Graeci uocant liquida, quae inlinuntur. Quale est, quod fit ad ulcera purganda et inplenda, maxime inter neruos, paribus portionibus inter se mixtis: buturi, medullae ⟨uitulinae,⟩ sebi uitulini, adipis anserinae, cerae, mellis, resinae terebenthinae, rosae, olei cicini. Quae separatim omnia liquantur, deinde liquida miscentur, et tum simul teruntur. Et hoc quidem magis purgat: magis uero emollit, si pro rosa cyprus infunditur. ⟨Et⟩ ad sacrum ignem: spumae argenti P. #1108 VI; corn⟨u⟩ bubuli combusti P. #1108 XII conteruntur, adiciturque inuicem uinum et id quod specialiter sil uocatur, et murteum, donec utriusque terni cyathi coiciantur.

## 18. Book V · chapters 25–26

Source: https://scriptura.si/works/celsus-on-medicine/18/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/18/#p-N

[¶0] 25. 25 Pills are also numerous, and are made for various purposes. Those which relieve pain through sleep are called anodynes; unless there is overwhelming necessity, it is improper to use them; for they are composed of medicaments which are very active and alien to the stomach. There is one, however, which actually promotes digestion; it is composed of poppy-tears and galbanum, 4 grams each, myrrh, castory, and pepper, 8 grams each. Of this it is enough to swallow an amount the size of a vetch. Another, worse for the stomach, but more soporific, consists of mandragora 1 gram, celery-seed and hyoscyamus seed, 16 grams each, which are rubbed up after soaking in wine. One of the same size mentioned above is quite enough to take. But whether there is headache or ulceration or ophthalmia or toothache or difficulty in breathing or intestinal gripings or inflammation of the womb or pain in the hips of liver or spleen or ribs, or, whether owing to genital trouble, a woman collapses speechless, a pillar of the following kind counteracts pain by producing sleep: saxifrage, sweet flag, wild rue seed, 4 grams each, castory and cinnamon 8 grams, poppy-tears, panax root, dried mandrake apples, flowers of the round rush, 9 grams each, and 56 peppercorns. These are first pounded separately, then rubbed up all together, whilst gradually adding raisin wine until the mixture is either swallowed or dissolved in water and taken as a draught. Or take a good handful of wild poppy-heads when just ripe for collecting the juice and put into a vessel and boil with water sufficient to cover it. When this handful has been well boiled there, after being squeezed out it is thrown away; and with its juice is mixed an equal quantity of raisin wine, and heated until to consistency of sordes. When the mixture has cooled, pills are formed, the size of our beans; they are used in many ways. For they procure sleep whether taken as they are or in water; they relieve earache when a little rue-juice and raisin wine are added; when dissolved in wine they relieve gripings, and when mixed with cerate of rose-oil with the addition of a little saffron they relieve inflammation of the womb; also when smeared upon the forehead mixed with water they check the flow of phlegm into the eyes. Again if inflammation of the womb prevents sleep take saffron 1·33 grams, anise and myrrh, 4 grams each, poppy-tears 12 grams, hemlock seed 32 grams. These are mixed together, and taken up in old wine, and a pill the size of a lupin is dissolved in 125 cc. of water. It is dangerous, however, to give it when there is fever. For the relief of pain in the liver soda 1 gram, saffron, myrrh, Gallic nard, 4 grams each, are taken up in honey, and a pill the size of an Egyptian bean administered. A pill to stop pain in the side is made of pepper, aristolochia, nard, and myrrh in equal parts. A pill for pain in the chest is made from nard 4 grams, frankincense and casia, 12 grams each, myrrh and cinnamon, 24 grams each, saffron 32 grams, turpentine-resin 1 gram, honey three-quarters of a litre. The pill of Athenion for cough contains myrrh and pepper, 0·66 gram each, castory and poppy-tears, 4 grams each; these are rubbed down separately, then together, and two pills, the size of our bean, are given in the morning and two at bed-time. If cough prevents sleep the pill of Heracleides of Tarentum relieves both; it contains saffron 0·66 gram, myrrh, long pepper, costmary, galbanum, 1 gram each, cinnamon, castor and poppy-tears, 4 grams each. But if ulcers of the throat causing cough are to be cleaned, panax, myrrh and turpentine-resin, 28 grams each, galbanum 0·66 gram, hyssop 1 gram are rubbed together, and 250 cc. of honey added to them and as much swallowed as can be taken up on the finger. The pill of Cassius for colic contains saffron, anise, castory, 12 grams each, parsley 16 grams, pepper both long and round, 20 grams each, poppy-tears, round rush, myrrh, nard, 24 grams each; these are taken up in honey. It may be either swallowed as it is or dissolved in hot water. A draught for the expulsion of a dead foetus or placenta consists of ammoniac salt 4 grams, or of Cretan dittany 4 grams in water. In difficult labour hedge mustard in tepid wine should be administered on an empty stomach. The voice is strengthened by frankincense 4 grams in two cups of wine. For difficult micturition long pepper, castory, myrrh, galbanum, poppy-tears, saffron, costmary, 28 grams each; storax and turpentine-resin, 56 grams each, honey with absinth 42 cc. Of this an amount the size of an Egyptian bean should be taken in the morning and after dinner. A medicine for the windpipe is prepared as follows: casia, iris, cinnamon, nard, myrrh, frankincense, 4 grams each; saffron 1 gram; and 30 peppercorns boiled in a litre and a half of raisin wine until of the consistency of honey. Or, saffron, myrrh, frankincense, 4 grams each, similarly boiled in raisin wine to the same consistency. Or 750 cc. of raisin wine are boiled until a drop, if taken out, solidifies; thereupon pounded casia 4 grams is added.

> Latin: 25. CATAPOTIA quoque multa sunt, uariisque de causis fiunt. Anodyna uocant, quae somno dolorem leuant; quibus uti, nisi nimia necessitas urget, alienum est: sunt enim ex uehementibus medicamentis et stomacho alienis. Potest tamen etiam ad concoquendum, quod habet papaueris lacrimae, galbani, singulorum P. #1108 I; murrae, castorei, piperis, singulorum P. #1108 II. Ex quibus, quod erui magnitudinem habet, satis est deuorasse. Alterum stomacho peius, ad somnum ualentius, ex his fit: mandragorae P. #1108 #1109 #1110; apii seminis, item hyoscyami seminis, singulorum P. #1108 IIII; quae ex uino teruntur. Vnum autem eiusdem magnitudinis, quae supra posita est, abunde est sumpsisse. Siue autem capitis dolores siue ulcera siue lippitudo siue dentes * * siue spiritus difficultas siue intestinorum tormenta siue inflammatio uuluae est, siue coxa siue iecur aut lienis aut latus torquet, siue uitio locorum aliqua prolabitur et ommutescit, occurrit dolori per quietem eiusmodi catapotium: silis, acori, rutae siluestris seminis, singulorum P. #1108 I; castorei, cinnamomi, ⟨singulorum P.⟩ #1108 II; papaueris lacrimae, panacis radicis, mandragorae, malorum aridorum, iunci rotundi floris, singulorum P. #1108 II #1109 #1110; piperis grana LVI. Haec per se contrita, rursus instillato subinde passo, simul omnia teruntur, donec crassitudo sordium fiat. Ex eo paululum aut deuoratur, aut aqua diluitur et potui datur. Quin etiam siluestris papaueris, cum iam ad excipiendam lacrimam maturum est, manipellus qui manu conprehendi potest, in uas demittitur, et superinfunditur aqua, quae id contegat, atque ita coquitur. Vbi iam bene manipellus is coctus est ibidem * * * expressus proicitur; et cum eo umore passi pa⟨r⟩ mensura miscetur, inferue⟨fi⟩tque, donec crassitudinem sordium habeat. Cum infrixit, catapotia ex eo fiunt ad nostrae fabae magnitudinem, habentque usum multiplicem. Nam et somnum faciunt uel per se adsumpta uel ex aqua data, et aurium dolores leuant, adiectis exiguo modo rutae suci ac passi, et tormina supprimunt ex uino liquata, et inflammationem uuluae coercent mixta cerato ex rosa facto, cum paulum his croci quoque accessit; et ex aqua fronti inducta pituitam in oculos decurrentem tenent. Item si uulua dolens somnum prohibet, croci P. #1108 #1109 #1109; anesi, murrae, singulorum P. #1108 I; papaueris lacrimae P. #1108 III; cicutae seminis P. #1108 VIII miscentur excipiunturque uino uetere, et quod lupini magnitudinem habet in tribus cyathis aquae diluitur. Id tamen in febre periculose datur. Ad iecur sanandum nitri P. #1108 #1109 #1110; croci, murrae, nardi Gallici, singulorum P. #1108 I melle excipiuntur, daturque quod Aegyptiae fabae magnitudinem habeat. Ad lateris dolores finiendos piperis, aristolochiae, nardi, murrae pares portiones. Ad thoracis nardi P. #1108 I; turis, casiae, singulorum P. #1108 III; murrae, cinnamomi, singulorum P. #1108 VI; croci P. #1108 VIII; resinae terebenthinae P. ⟨#1108⟩ #1109 #1110; mellis heminae tres. Ad tussim Athenionis: murrae, piperis, singulorum P. #1108 #1109; castorei, papaueris lacrimae, singulorum P. #1108 I. Quae separatim contusa postea iunguntur, et ad magnitudinem fabae nostrae bina catapotia mane, bina noctu dormituro dantur. Si tussis somnum prohibet, ad utrumque Heraclidis Tarentini: croci P. #1108 #1109; murrae, piperis longi, costi, galbani, singulorum P. #1108 #1109 #1110; cinnamomi, castorei, papaueris lacrimae, singulorum P. #1108 I. Quod si purganda ulcera in faucibus tussientibus sunt, panacis, murrae, resinae terebenthinae, singulorum P. uncia; galbani P. #1108 #1109; hysopi P. #1108 #1109 #1110 conterenda sunt, hisque hemina mellis adicienda, et quod digito excipi potest, deuorandum est. Colice uero Cassi ex his constat: croci, anesi, castorei, singulorum P. #1108 III; petroselini P. #1108 IIII; piperis et longi et rotundi, ⟨singulorum⟩ P. #1108 V; papaueris lacrimae, iunci rotundi, murrae, nardi, singulorum P. #1108 VI; quae melle excipiuntur. Id autem et deuorari potest et ex aqua calida sumi. Infantem uero mortuum aut secundas expellit aquae potio, cui salis Hammoniaci P. #1108 I, aut cui dictamni Cretici ⟨P.⟩ #1108 I adiectum est. Ex partu laboranti erysimum ex uino tepido ieiunae dari debet. Vocem adiuuat turis P. #1108 I in duobus cyathis uini datum. Aduersus urinae difficultatem piperis longi, castorei, murrae, galbani, papaueris lacrimae, croci, costi unciae singulae; styracis, resinae terebenthinae pondo sextantes, melabsinthi cyathus. Ex quibus ad magnitudinem fabae Aegyptiae et mane et cenato dari debet. Arteriace uero hoc modo fit: casiae, iridis, cinnamomi, nardi, murrae, turis, singulorum P. #1108 I; croci P. #1108 I #1109 #1110; piperis grana XXX ex passi tribus sextariis decocuntur, donec mellis crassitudo his fiat. Aut croci, murrae, turis, singulorum P. #1108 I coiciuntur in passi eundem modum, eodemque modo decocuntur. Aut eiusdem passi heminae tres usque eo coquuntur, donec extracta inde gutta indurescat; eo adicitur tritae casiae P. #1108 I.

[¶1] 26. 26 Now that I have set out the properties of the medicaments, I will explain the classes of lesions harmful to the body: there are five; when something from without causes the lesion, as in the case of wounds; when some internal part has become corrupted, as in the case of canker; when some new formation has occurred, such as a stone in the bladder; when something has grown bigger, as when a vein swells up and is converted into a varix; when there is some defect, as when some part has been mutilated.

> Latin: 26. Cum facultates medicamentorum proposuerim, genera, in quibus noxa corpori est, proponam. Ea quinque sunt: cum quid extrinsecus laesit, ut in uulneribus; cum quid intra se ipsum corruptum est, ut in cancro; cum quid innatum est, ut in uesica calculus; cum quid increuit, ut uena, quae intumescens in uaricem conuertitur; cum quid deest, ut cum curta pars aliqua est. Ex his alia sunt, in quibus plus medicamenta, alia, in quibus plus manus proficit.

[¶2] In some of these medicaments are more effectual, in others surgery. Postponing those conditions which demand in particular the scalpel and surgical treatment, I will speak now of those which chiefly require medicaments. As I have done before, I shall divide this part of treatment, and speak first of those lesions which may occur in any part of the body, then of those which attack particular parts. I shall begin with wounds.

> Latin: Ego dilatis iis, quae praecipue scalpellum et manum postulant, nunc de is dicam, quae maxime medicamentis egent. Diuidam autem hanc quoque curandi partem sicut priorem et ante dicam ⟨de is,⟩ quae in QVAMLIBET PARTEM corporis incidunt, tum de is, quae certas partes infestant. Incipiam a uulneribus.

[¶3] In this connexion, however, a practitioner should know above all which wounds are incurable, which may be cured with difficulty, and which more readily. For it is the part of a prudent man first not to touch a case he cannot save, and to the risk the appearance of having killed one whose lot is but to die; next, when there is grave fear without, however, absolute despair, to point out to the patient's relatives that hope is surrounded by difficulty, for then if the art is overcome by the malady, he may not seem to have been ignorant or mistaken. But while such steps become a prudent practitioner, it is like a mountebank to exaggerate a small matter in order to enhance his own achievement. It is right to commit himself to a statement that a case is simple in order that he may examine it with even more care for fear a case slight in itself may become worse by negligence on the doctor's part.

> Latin: In his autem ante omnia scire medicus debet, quae insanabilia sint, quae difficilem curationem habeant, quae promptiorem. Est enim prudentis hominis primum eum, qui seruari non potest, non adtingere, nec subire speciem * * * eius, ut occisi, quem sors ipsius interemit; deinde ubi grauis metus sine certa tamen desperatione est, indicare necessariis periclitantis in difficili spem esse, ne, si uicta ars malo fuerit, uel ignorasse uel fefellisse uideatur. Sed ut haec prudenti uiro conueniunt, sic rursus histrionis est paruam rem adtollere, quo plus praestitisse uideatur. Obligarique aecum est confessione promptae rei, quo curiosius etiam circumspiciat, ne, quod per se exiguum est, maius curantis neglegentia fiat.

[¶4] It is impossible to save a patient when the base of the brain, the heart, the gullet, the porta of the liver, or the spinal marrow has been pierced; when the middle of the lung, or the jejunum, or the small intestine, or the stomach, or kidneys have been wounded; or when the large blood-vessels and arteries in the region of the throat have been cut.

> Latin: Seruari non potest, cui basis cerebri, cui cor, cui stomachus, cui iocineris portae, cui in spina medulla percussa est, cuique aut pulmo medius aut ieiunum aut tenuius intestinum aut uentriculus aut renes uulnerati sunt; cuiue circa fauces grandes uenae uel arteriae praecisae sunt.

[¶5] Again, there is hardly ever recovery when either the lung or the thick part of the liver or the membrane enclosing the brain, or the spleen, womb, bladder, any of the intestines or diaphragm has been wounded in any part. There is also grave danger when the point of a weapon has gone down to the large blood-vessels deeply seated in the armpits or hams. Also wounds are dangerous wherever the blood-vessels are larger, because they may exhaust the patient by profuse bleeding. This occurs not only in the armpits and hams, but also in those blood-vessels which go to the anus and testicles. Moreover, a wound is a bad one whenever it is in the armpits or in the thighs or in hollow places or in joints or between the fingers; also whenever a muscle or sinew or artery or membrane or bone or cartilage is injured. The safest of all is a wound in the flesh.

> Latin: Vix autem ad sanitatem perueniunt, quibus ulla parte aut pulmo aut iocineris crassum aut membrana, quae continet cerebrum, aut lienis aut uulua aut uesica aut ullum intestinum aut saeptum transuersum uulneratum est. Ii quoque in praecipiti sunt, in quibus usque ad grandes intusque conditas uenas in alis uel poplitibus mucro desedit. Periculosa etiam uulnera sunt, ubicumque uenae maiores sunt, quoniam exhaurire hominem profusione sanguinis possunt. Idque euenit non in alis tantum atque poplitibus, sed etiam in is uenis, quae ad anum testiculosque perueniunt. Praeter haec malum uulnus est, quodcumque in alis uel feminibus uel inanibus locis uel in articulis uel inter digitos est; item quodcumque musculum aut neruum aut arteriam aut membranam aut os aut cartilaginem laesit.

[¶6] The above wounds are severer or slighter according to their situations. Still, whenever it is large, a wound makes for danger.

> Latin: Tutissimum omnium, quod in carne est. Et haec quidem loco uel peiora uel mitiora sunt.

[¶7] The class of wound and its shape are also important. For a contused would is worse than one simply incised, hence it is better to be wounded by a sharp weapon than by a blunt one. A wound is worse also if a piece is cut out, or if the flesh is cut away in one part and hanging free in another. A curved wound is worst, a straight linear one safest; hence a wound is more or less serious, according as it approximates to the former or to the latter shape.

> Latin: Modo uero periculum facit, quodcumque magnum est. Aliquid etiam in uulneris genere figuraque est. Nam peius est, quod etiam conlisum quam quod tantum discissum est, adeo ut acuto quoque quam retunso telo uulnerari commodius sit. Peius etiam uulnus est, ex quo aliquid excisum est, exue quo caro alia parte abscisa alia dependet. Pessimaque plaga curua est: tutissima quae lineae modo recta est;

[¶8] Again, both age and constitution and mode of life and the season have also some influence; for a boy or young adult heals more readily than does an old man; one who is strong than a weak man; a man who is not too thin or too fat than one who is either of these; one of sound habit than of unsound; one who takes exercise than a sluggard; one who is sober and temperate than one addicted to wine and venery. And the most opportune time for healing is the spring, or at any rate when the weather is neither cold nor hot, for wounds are harmed by excessive heat and excessive cold, but most of all by variations of these; hence autumn is the most pernicious season.

> Latin: quo deinde propius huic illiue figurae uulnus est, eo uel deterius uel tolerabilius est. Quin etiam confert aliquid et aetas et corpus et uitae propositum et anni tempus; quia facilius sanescit puer uel adulescens quam senior, ualens quam infirmus; neque nimis tenuis neque nimis plenus, quam si alterum ex his est; integri habitus quam corrupti, exercitatus quam iners, sobrius et temperans quam uino uenerique deditus. Oportunissimumque curationi tempus uernum est, aut certe neque feruens neque frigidum, siquidem uulnera et nimius calor et nimium frigus infestant, maxime tamen horum uarietas;

[¶9] Now most wounds are open to view; some are inferred from their situation, which we have pointed out elsewhere when indicating the positions of the internal parts. Since, however, some of these wounds are near at hand, and it is of importance whether the wound is superficial or has penetrated inwards, it is necessary to state the signs by which it is possible to recognize what has happened inside, and from which follow either hope or despair.

> Latin: ideoque perniciosissimus autumnus est. Sed pleraque ex uulneribus oculis subiecta sunt; quorundam ipsae sedes indices sunt, quas alio loco demonstrauimus, cum positus interiorum partium ostendimus.

[¶10] Now when the heart is penetrated, much blood issues, the pulse fades away, the colour is extremely pallid, cold and malodorous sweats burst out as if the body had been wetted by dew, the extremities become cold and death quickly follows.

> Latin: Verum tamen quia quaedam uicina sunt, interestque uulnus in summa parte sit an penitus penetrauerit, necessarium est notas subicere, per quas, quid intus actum sit, scire possimus, et ex quibus uel spes uel desperatio oriatur.

[¶11] But when the lung is pierced there is difficulty in breathing; frothy blood escapes from the mouth, red blood from the wound; and at the same time breath is drawn with a noise; to lie upon the wound affords relief; some stand up without any reason. Many speak if they have been laid upon the wound; if upon the opposite side they become speechless.

> Latin: Igitur corde percusso sanguis multus fertur, uenae ⟨e⟩languescunt, color pallidissimus, sudores frigidi malique odoris tamquam inrorato corpore oriuntur, extremisque partibus frigidis matura mors sequitur. Pulmone uero icto spirandi difficultas est; sanguis ex ore spumans, ex plaga ruber; simulque etiam spiritus cum sono fertur; in uulnus inclinari iuuat;

[¶12] Symptoms that the liver should have been wounded are that considerable haemorrhage occurs from under the right part of the hypochondria; the hypochondria are retracted towards the spine; the patient is eased by lying on his belly; stabbing pains spread upwards as high as the clavicle and its junction with the scapula; to which, not infrequently, also bilious vomiting is added.

> Latin: quidam sine ratione consurgunt. Multi si in ipsum uulnus inclinati sunt, loquntur, si in aliam partem, obmutescunt. Iocineris autem uulnerati notae sunt multus sub dextra parte praecordiorum profusus sanguis; ad spinam reducta praecordia; in uentrem cubandi dulcedo; punctiones doloresque usque ad iugulum iunctumque ei latu⟨m⟩ scapularum os intenti;

[¶13] When the kidneys have been penetrated, pain spreads down to the groin and testicles; urine is passed with difficulty, and it is either bloodstained or actual blood clot is passed.

> Latin: quibus nonnumquam etiam bilis uomitus accedit. Renibus uero percussis dolor ad inguina testiculosque descendit;

[¶14] But when the spleen has been pierced, black blood flows out from the left side; the hypochondria on that side together with the stomach become hard; great thirst comes on; pain extends to the clavicle as when the liver has been wounded.

> Latin: difficulter urina redditur, eaque aut haec cruenta aut cruor fertur. At liene icto sanguis niger a sinistra parte prorumpit; praecordia cum uentriculo ab eadem parte indurescunt; sitis ingens oritur;

[¶15] But when the womb has been penetrated, there is pain in the groins and hips and thighs; blood passes downwards in part through the wound, in part by the vagina; bilious vomiting follows. Some become speechless, some are mentally disturbed, others whilst composed in mind complain of pain in their sinews and eyeballs, and when dying they suffer like those wounded in the heart.

> Latin: dolor ad iugulum sicut iocinere uulnerato uenit. At cum uulua percussa est, dolor inguinibus et coxis et feminibus est; sanguinis pars per uulnus, pars per naturale descendit; uomitus bilis insequitur. Quaedam obmutescunt, quaedam mente labuntur, quaedam sui conpotes neruorum oculorumque dolore urgeri se confitentur, morientesque eadem, quae corde uulnerato, patiuntur.

[¶16] When the brain or its membrane has been wounded, blood escape through the nostrils, in some also through the ears; and generally bilious vomiting follows. Some lose their senses and take no notice when spoken to; some have a wild look; in some the eyes move from side to side as if they were out of control; generally on the third or fifth day delirium supervenes; many have also spasm of sinews. Again, before death many tear off the bandages with which their head has been bound up, and expose the bared wound to cold.

> Latin: Sin cerebrum membranaue eius uulnus accepit, sanguis per nares, quibusdam etiam per aures exit; fereque bilis uomitus insequitur. Quorundam sensus optunduntur, appellatique ignorant; quorundam trux uultus est; quorundam oculi quasi resoluti huc atque illuc mouentur; fereque tertio uel quinto die delirium accedit; multorum etiam nerui distenduntur.

[¶17] But when the gullet has been penetrated, hiccough and bilious vomiting follow; if any food or drink is swallowed, it is returned at once; pulsation of the blood-vessels fades away; thin sweat breaks out, following which the extremities become cold.

> Latin: Ante mortem autem plerique fascias, quibus caput deligatum est, lacerant ac nudum uulnus frigori obiciunt. Vbi stomachus autem percussus est, singultus et bilis uomitus insequitur; si quid cibi uel potionis adsumptum est, ea redditur cito.

[¶18] The signs when the small intestine and the stomach have been wounded are the same; for food and drink come out through the wound; the hypochondria become hard, sometimes bile is regurgitated through the mouth. Only in the case of the intestine the situation of the wound is lower down. All other intestinal wounds cause the emission of faeces or a faecal odour.

> Latin: Venarum motus elanguescunt, sudores tenues oriuntur, per quos extremae partes frigescunt. Communes uero ieiuni intestini et uentriculi uulnerati notae sunt: nam cibus et potio per uulnus exeunt; praecordia indurescunt; nonnumquam bilis per os redditur. Intestino tantum sedes inferior est.

[¶19] When the marrow which is within the spine has been crushed, there is either paralysis or spasm of sinews; sensation is interrupted; after some time there is involuntary evacuation from the parts below of either semen or urine of even faeces.

> Latin: Cetera intestina icta uel stercus uel odorem eius exhibent. Medulla uero, quae in spina est, discussa nerui resoluuntur aut distenduntur; sensus intercidit;

[¶20] But if the diaphragm has been penetrated, the praecordia are contracted upwards; the spine is painful; breathing is laboured; frothy blood escapes.

> Latin: interposito tempore aliquo sine uoluntate inferiores partes uel semen uel urinam uel etiam stercus excernunt. At si saeptum transuersum percussum est, praecordia susum contrahuntur;

[¶21] When the bladder has been wounded, the groins are painful; the hypogastrium becomes tense; blood is passed, instead of urine, the urine being discharged from the actual wound. The gullet is affected, and so the patients either vomit bile or hiccough. Coldness and after that death follows.

> Latin: spina dolet; spiritus rarus est; sanguis spumans fertur. Vesica uero uulnerata dolent inguina: quod super pubem est, intenditur; pro urina sanguis, at ex ipso uulnere urina descendit. Stomachus adficitur: itaque aut bilem uomunt, aut singultiunt;

[¶22] Even when these facts are known, there are still some other things to be learnt about wounds and ulcerations in general, of which we will now speak. From wounds, then, there comes out blood, or sanies, or pus. Blood everybody knows; sanies is thinner than blood, varying both in thickness and stickiness and colour. Pus is the thickest and whitest, more sticky than either sanies or blood. Now blood comes out from a fresh wound or from one which is already healing, sanies between these two periods, pus from an ulceration already beginning to heal. Again, the Greeks distinguish by name different kinds of sanies and pus. For there is a kind of sanies which is named either hidros or melitera; there is pus which is called alaeodes. Hidros is thin, whitish, and comes from a bad ulceration, especially when inflammation has followed upon a wound of a sinew. Melitera is thicker, stickier and whitish, something like honey. It is likewise discharged from bad ulcerations, when sinews near to joints have been wounded, and among such places especially from the knees. Elaeodes is thin, whitish, fatty, in colour and fattiness not unlike olive-oil; it appears in large ulcerations when they are healing. Blood is bad when it is too thin or too thick, livid or black in colour, or mixed with phlegm or variable; it is best when hot, red, moderately thick, and not sticky. Consequently from the first the treatment is more expeditious in the case of a wound from which good blood has flowed. Also later there is more hope in the case of wounds from which all the discharges are of the better kind. Thus sanies is bad when profuse, too thin, livid, or pallid or black or sticky or malodorous or when it erodes either the ulceration itself or the skin adjoining it; it is better when not profuse, moderately thick, reddish or whitish. But hidros is worse when it is profuse, thick, somewhat livid or pallid, stick, black, hot, malodorous; it is less serious when whitish, and when all the rest of its characteristics are the opposite of the foregoing. Melitera again is bad when profuse and very thick; better for being thinner and less copious. Amongst these discharges pus is the best; but it is likewise worse when profuse, thin, watery, and the more so if it is such from the beginning; and also if it is in colour like whey, if pallid, or livid, or like wine-lees; if, besides, it is malodorous, unless, however, it is the part which causes this odour. It is better, the smaller the quantity, the thicker and whiter; also if it is bland, odourless, uniform; none the less it should correspond in quantity with the size and age of the wound. For naturally there is more discharge, the larger the wound, si more when inflammation has not yet subsided. Elaeodes also is worse when large in quantity and but little fatty, the less in quantity and the more fatty the better.

> Latin: frigus et ex eo mors sequitur. His cognitis etiamnum quaedam alia noscenda ad omnia uulnera ulceraque, de quibus dicturi sumus, pertinentia. Ex his autem exit sanguis, sanies, pus. Sanguis omnibus notus est: sanies est tenuior hoc, uarie crassa et glutinosa et colorata. Pus crassissimum albidissimumque, glutinosius et sanguine et sanie. Exit autem sanguis ex uulnere recenti aut iam sanescente, sanies [est] inter utrumque tempus, ⟨pus⟩ ex ulcere iam ad sanitatem spectante. Rursus et sanies et pus quasdam species Graecis nominibus distinctas habent. Est enim quaedam sanies, quae uel hidros uel melitera nominatur; est pus, quod elaeodes appellatur. Hidros tenuis, subalbidus ex malo ulcere exit, maximeque ubi neruo laeso inflammatio secuta est. Melitera crassior et glutinosior, subalbida, mellique albo subsimilis. Fertur haec quoque ex malis ulceribus, ubi nerui circa articulos laesi sunt, et inter haec loca maxime ex genibus. Elaeodes tenue, subalbidum, quasi unctum, colore atque pinguitudine oleo albo non dissimile; apparet in magnis ulceribus sanescentibus. Malus autem est sanguis nimium aut tenuis aut crassus, colore uel liuidus uel niger, aut pituita mixtus aut uarius: optimus calidus, ruber, modice crassus, non glutinosus. Itaque protinus eius uulneris expedita magis curatio est, ex quo sanguis bonus fluxit. Itemque postea spes in is maior est, ex quibus melioris generis quaeque proueniunt. Sanies igitur mala est multa, nimis tenuis, liuida aut pallida aut nigra aut glutinosa aut mali odoris, aut quae ipsum ulcus et iunctam ei cutem erodit: melior est non multa, modice crassa, subrubicunda aut subalbida. Hidros autem peior est multus, crassus, subliuidus aut subpallidus, glutinosus, ater, calidus, mali odoris: tolerabilior est subalbidus, qui cetera omnia contraria prioribus habet. Melitera autem mala est multa et percrassa: melior, quae tenuior et minus copiosa est. Pus inter haec optimum est; sed id quoque peius est multum, tenue, dilutum, magisque si ab initio tale est; itemque si colore sero simile, si pallidum, si liuidum, si faeculentum est; praeter haec, si male olet, nisi tamen locus hunc odorem excitat. Melius est, quo minus est, quo crassius, quo albidius; itemque si leue est, si nihil olet, si aequale est: modo tamen conuenire et magnitudini uulneris et tempori debet. Nam plus ex maiore, plus nondum solutis inflammationibus naturaliter fertur.

[¶23] After these matters have been investigated, when a man has been wounded who can be saved, there are in the first place two things to be kept in mind: that he should die from haemorrhage or inflammation. If we are afraid of haemorrhage which can be judged both from the position and size of the wound and from the force of the flowing blood, the wound is to be filled with dry lint, and over that a sponge applied, squeezed out of cold water, and pressed down by the hand. If the bleeding is not checked thus, the lint must be changed several times, and if it is not effective when dry, it is to be soaked in vinegar. Vinegar is powerful in suppressing a flow of blood; and some, therefore, pour it into wounds. But then there is an underlying fear of another kind, that if too much diseased matter is forcibly retained in the wound it will afterwards cause great inflammation. It is on this account that no use is made, either of corrosives or of caustics, owing to the crust they induce, although most of these medicaments suppress bleeding; but if for once recourse is had to them, choose those which have a milder action. But if even these are powerless against the profuse bleeding, the blood-vessels which are pouring out blood are to be seized, and round the wounded spot they are to be tied in two places and cut across between so that the two ends coalesce each on itself and yet have their orifices closed. When circumstances do not even admit of this, the blood-vessels can be burnt with a red-hot iron. But even when there has been a considerable bleeding from a place where there is neither sinew nor muscle, such as the forehead or top of the head, it is perhaps best to apply a cup to a distant part, in order to divert thither the course of the blood.

> Latin: Elaeodes quoque peius est multum, et parum pingue: quo minus eius, quoque id ipsum pinguius, eo melius est. Quibus exploratis, ubi aliquis ictus est qui seruari potest, protinus prospicienda duo sunt: ne sanguinis profusio neue inflammatio interemat. Si profusionem timemus, quod ex sede uulneris et ex magnitudine eius et ex impetu ruentis sanguinis intellegi potest, siccis lin⟨a⟩mentis uulnus inplendum est, supraque imponenda spongia ex aqua frigida expressa ac manu super conprimenda. Si parum sic sanguis conquiescit, saepius linamenta mutanda sunt, et si sicca parum ualent, aceto madefacienda sunt. Id uehemens ad sanguinem subprimendum est; ideoque quidam id uolneri infundunt. Sed alius rusus metus subest, ne nimis ualenter ibi retenta materia magnam inflammationem postea moueat. Quae res efficit, ut neque rodentibus medicamentis neque adurentibus et ob id ipsum inducentibus crustam sit utendum, quamuis pleraque ex his sanguinem supprimunt; sed, si semel ad ea decurritur, is potius, quae mitius idem efficiunt. Quod si illa quoque profluuio uincuntur, uenae quae sanguinem fundunt adprehendendae, circaque id quod ictum est duobus locis deligandae intercidendaeque sunt, ut et in se ipsae coea⟨n⟩t, et nihilo minus ora praeclusa habeant. Vbi ne id quidem res patitur, possunt ferro candenti aduri.

[¶24] Against bleeding there is help in the foregoing measures, but against inflammation it lies simply in the bleeding itself. Inflammation is to be feared when a bone is injured or sinew or cartilage or muscle, or whenever there is little outflow of blood compared to the wound. Therefore, in such cases, it will not be desirable to suppress the bleeding early, but to let blood flow as long as it is safe; so that if there seems too little bleeding, blood should be let from the arm as well, at any rate when the patient is young and robust and used to exercise, and much more so when a drinking bout has preceded the wound. But if a muscle is seen to be wounded, it will be best to cut it right through; for when stabbed it causes death, when cut through it admits of cure.

> Latin: Sed etiam satis multo sanguine effuso ex eo loco, quo neque neruus neque musculus est, ut puta in fronte uel superiore capitis parte, commodissimum tamen est cucurbitulam admouere a diuersa parte, ut illuc sanguinis cursus reuocetur. Et aduersus profusionem quidem in his auxilium est: aduersus inflammationem autem in ipso sanguinis cursu. Ea timeri potest, ubi laesum est uel os uel neruus uel cartilago uel musculus, aut ubi parum sanguinis pro modo uulneris fluxit. Ergo quotiens quid tale erit, sanguinem mature subprimere non oportebit, sed pati fluere, dum tutum erit; adeo ut, si parum fluxisse uidebitur, mitti quoque ex brachio debeat; utique si corpus iuuenile et robustum et exercitatum est, multoque magis si id uulnus ebrietas praecessit.

[¶25] Now, when bleeding has been suppressed if excessive, or encouraged when not enough has escaped of itself, then by far the best thing is for the wound to become agglutinated. But this is possible for a wound in the skin, or even in the flesh, if nothing else has occurred to do it harm. Agglutination is possible if the flesh is hanging free at one part, whilst attached at another, provided, however, that the flesh is still sound, and has a connexion with the body to feed it. But with wounds which are being agglutinated, there are two treatments. For if the wound is in a soft part, it will be stitched up, and particularly when the cut is in the tip of the ear or the point of the nose or forehead or cheek or eyelid or lip or the skin over the throat or abdomen. But if the wound is in the flesh, and gapes, and its margins are not easily drawn together, then stitching in unsuitable; fibulae (the Greeks call them ancteres) are then to be inserted, which draw together the margins to some extent and so render the subsequent scar less broad. Now from the above it can be gathered also whether flesh which is hanging free at one part and attached at another, if it is still capable of juncture, demands suture or fibula. But neither of these should be inserted until the interior of the wound has been cleansed, lest some blood-clot be left in it. For blood clot turns into pus, and excites inflammation, and prevents agglutination of the wound. Not even lint which has been inserted to arrest bleeding should be left in, for this also inflames the wound. The suture or fibula should take up, not only skin but also some of the underlying flesh, where there is any, that it may hold more firmly, and not tear through the skin. And both are best used with a strand of a soft wool not too closely twisted that it may cause less irritation to the body, and both should be inserted at intervals not too distant or too close. For if the intervals are too distant, the wound is not held together; if too close, it is very hurtful, for the more often the needle this fixes the tissues, and the more places are wounded by the inserted stitches, the worse is the inflammation set up, especially in summer. Neither procedure needs any force, but is useful just so far as the skin follows that which draws it as if of its own accord. Generally, however, fibulae leave the wound wider open, a suture joins the margins together, but these should not be brought actually into contact throughout the whole length of the wound, in order that there may be an outlet for any humour collecting within. If any wound admits of neither of these, it should none the less be cleaned. Hence, upon every wound there is to be applied, first a sponge squeezed out of vinegar; or out of wine if the patient cannot bear the strength of vinegar. A slight wound is even benefited if a sponge is applied wrung out of cold water. But in whatever way it is put on, it is only of service while moist; and so it must not be allowed to become dry. And a wound can be treated without foreign and far-fetched and complicated medicaments. But if any one has not confidence in this treatment, a medicament should be put on, which has no suet in its composition, chosen from those which I have stated to be suitable for bleeding wounds: and especially, if it is a flesh wound, the composition called barbarum; if a wound of sinews or of cartilage or of some projecting part, such as the ears or lips, the seal of Polyides: the green composition called Alexandrian is also suitable for sinews; and that which the Greeks call rhaptousa for parts which project. When the body is bruised it is usual also for the skin to be broken to a small extent. When this occurs, it is not improper to lay it open more widely with a scalpel, unless there are muscles and sinews near, as it is inexpedient to cut into these. When it has been sufficiently opened, a medicament is seem to be put on. But if the skin over the contusion, although broken too little, yet must not be laid open more widely on account of sinews or muscles, then such applications should be made as gently extract humour, especially that which I have said is called rhypodes. It is also not inappropriate, when the wound is severe, after putting on what is beneficial, to lay on over this, wool saturated with vinegar and oil; or a poultice, gently repressant if to a soft part; or emollient to a part where there are sinews or muscles.

> Latin: Quod si musculus laesus uidebitur, praecidendus erit: nam percussus mortiferus est, praecisus sanitatem recipit. Sanguine autem uel subpresso, si nimius erumpit, uel exhausto, si per se parum fluxit, longe optimum est uulnus glutinari. Potest autem id, quod uel in cute uel etiam in carne est, si nihil ei praeterea mali accedit. Potest caro alia parte dependens, alia inhaerens, si tamen etiamnum integra est et coniunctione corporis fouetur. In is uero, quae glutinantur, duplex curatio est. Nam si plaga in molli parte est, sui debet, maximeque si discissa auris ima est uel imus nasus uel frons uel bucca uel palpebra uel labrum uel circa guttur cutis uel uenter. Si uero in carne uulnus est hiatque neque in unum orae facile adtrahuntur, sutura quidem aliena est: inponendae uero fibulae sunt (ancteras Graeci nominant), quae oras, paululum tamen, contrahunt, quo minus lata postea cicatrix sit. Ex his autem colligi potest, id quoque, quod alia parte dependens alia inhaerebit, si alienatum adhuc non est, suturam an fibulam postulet. Ex quibus neutra ante debet imponi, quam intus uolnus purgatum est, ne quid ibi concreti sanguinis relinquatur. Id enim et in pus uertitur, et inflammationem mouet, et glutinari uolnus prohibet. Ne lin⟨a⟩mentum quidem, quod subprimendi sanguinis causa inditum est, ibi relinquendum est: nam id quoque inflammat. Conprehendi uero sutura uel fibula non cutem tantum sed etiam aliquid ex carne, ubi suberit haec, oportebit, quo ualentius haereat neque cutem abrumpat. Vtraque optima est ex acia molli non nimis torta, quo mitius corpori insidat, utraque neque nimis rara neque nimis crebra inicienda est. Si nimis rara est, non continet; si nimis crebra est, uehementer adficit, quia quo saepius acus corpus transuit quoque plura loca iniectum uinculum mordet, eo maiores inflammationes oriuntur magisque aestate. Neutra etiam uim ullam desiderat, sed eatenus utilis est, qua cutis ducentem quasi sua sponte subsequitur. Fere tamen fibulae latius uulnus esse patiuntur, sutura oras iungit, quae ne ipsae quidem inter se contingere ex toto debent, ut, si quid intus umoris concreuerit, sit qua emanet. Si quod uulnus neutrum horum recipit, id tamen purgari debet. Deinde omni uulneri primo inponenda est spongia ex aceto expressa: si sustinere aliquis aceti uim non potest, uino utendum est. Leuis plaga iuuatur etiam, si ex aqua frigida expressa spongia inponitur. Sed ea quocumque modo inposita est, dum madet, prodest; itaque ut inarescat, non est committendum. Licetque sine peregrinis et conquisitis et compositis medicamentis uulnus curare. Sed si quis huic parum confidit, imponere medicamentum debet, quod sine sebo compositum sit ex is, quae cruentis uulneribus apta esse proposui: maximeque, si caro est, barbarum; si nerui uel cartilago uel aliquid ex eminentibus, quales aures uel labra sunt, Poly⟨id⟩i s⟨ph⟩ragidem: Alexandrinum quoque uiride neruis idoneum est; eminentibusque partibus ea, quam Graeci rhaptusam uocant. Solet etiam colliso corpore exigua parte findi cutis. Quod ubi incidit, non alienum est scalpello latius aperire, nisi musculi neruique iuxta sunt; quos incidi non expedit. Vbi satis d⟨i⟩ductum est, medicamentum imponendum est. At si id, quod collisum est, quamuis parum d⟨i⟩ductum est, latius tamen aperiri propter neruos aut musculos non licet, adhibenda sunt ea, quae umorem leniter extrahant, praecipueque ex his id, quod rhypodes uocari proposui. Non alienum est etiam, ubicumque uulnus graue est, imposito quo id iuuetur, insuper circumdare lanam sucidam ex aceto et oleo; uel cataplasma, si mollis is locus est, quod leniter reprimat; si neruosus aut musculosus, quod emolliat.

## 19. Book V · chapters 26–27

Source: https://scriptura.si/works/celsus-on-medicine/19/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/19/#p-N

[¶0] The bandage too for binding up a wound is best made of linen, and it should be so wide as to cover it in a single turn, not the wound alone but somewhat of its edges on either side. If the flesh has receded more from one edge, the traction is better made from that side. If equally from both, the bandage, put crosswise, should press the margins together; or if the character of the wound does not admit of that, the middle of the bandage is to be applied first, so that it may then be drawn to either side. Moreover, the wound is to be bandaged so that it is held together, yet not constricted. When it is not so held, it gapes; if it is constricted too much, there is a risk of canker. In winter there should be more turns of the bandage, in summer just those necessary; finally, the end of the bandage is to be stitched by means of a needle to the deeper turns; for a knot hurts the wound, unless, indeed, it is at a distance from it.

> Latin: Fascia uero ad uulnus deligandum lintea aptissima est eaque lata esse debet, ut semel iniecta non uulnus tantum sed paululum utrimque etiam oras eius conprehendat. Si ab altera parte caro magis recessit, ab ea melius adtrahitur; si aeque ab utraque, transuersa conprehendere oras debet; aut si id uulneris ratio non patitur, media primum inicienda est, ut tum in utramque partem ducatur. Sic autem deliganda est, ut et contineat neque adstringat. Quod non continetur, elabitur: quod nimis adstrictum est, cancro periclitabitur. Hieme saepius fascia circumire debet, aestate quotiens necesse est; tum extrema pars eius inferioribus acu adsuenda est: nam nodus ulcus laedit, nisi tamen longe est. Illo neminem decipi decet, ut propriam uiscerum curationem requirat: de quibus supra posui.

[¶1] On the following point no practitioner should be ignorant so that he has to enquire as to the special treatment required for the internal organs, which I have spoken of above. For whilst an external wound is to be treated either by suture, or by some sort of medicine; in the case of the internal organs, nothing is to be moved, unless it be to cut away some bit of liver or spleen or lung which hangs outside. Otherwise internal wounds will be cured by the regulation of diet, and by those medicaments which I have stated in the preceding book to suit each individual organ.

> Latin: Nam plaga ipsa curanda extrinsecus uel sutura uel alio medicinae genere est: in uisceribus nihil mouendum est, nisi ut, si quid ex iocinere aut liene aut pulmone dumtaxat extremo dependet, praecidatur. Alioqui uolnus interius ea uictus ratio eaque medicamenta sanabunt, quae cuique uisceri conuenire superiore libro posui. His ita primo die ordinatis, homo lecto conlocandus est; isque, si graue uulnus est, abstinere, quantum uires patiuntur, ante inflammationem cibo debet: bibere, donec sitim finiat, aquam calidam;

[¶2] So then, after this has been done on the first day, the patient is to be put to bed; if the wound is severe, before inflammation sets in, he should abstain from food, as far as his strength permits; he should drink warm water until his thirst is quenched; or, if it is summer and he has neither fever nor pain, even cold water. There is, however, in this no standing order, for always account has to be taken of the bodily strength, since weakness may render it necessary for him to take food even from the first, light of course and scanty, just enough to sustain him; and many who are actually fainting from loss of blood must, before any treatment, be resuscitated by wine, which in other cases is most inimical to a wound.

> Latin: uel, si aestas est ac neque febris neque dolor est, etiam frigidam. Adeo tamen nihil perpetuum est, sed semper pro ui corporis aestimandum, ut inbecillitas etiam cibum protinus facere necessarium possit, tenuem scilicet ⟨et⟩ exiguum, qui tantum sustineat; multique etiam ex profluuio sanguinis intermorientes ante ullam curationem uino reficiendi sunt, quod alioqui inimicissimum uulneri est. Nimis uero intumescere uulnus periculosum; nihil intumescere periculosissimum est: illud indicium est magnae inflammationis, hoc emortui corporis. Protinusque, si mens homini consistit, si nulla febris accessit, scire licet mature uulnus sanum fore.

[¶3] It is dangerous when a wound swells overmuch; no swelling at all is the worst danger: the former is an indication of severe inflammation; the latter that the part is dead. And from the first if the patient retains his senses, if no fever follows, we may recognize that the wound will soon heal. And even fever should not cause alarm in the case of a large wound, if it persists while there is inflammation. That fever is harmful which either supervenes upon a slight wound, or lasts beyond the inflammatory period, or excites delirium; or which does not put an end to the rigor or spasm of sinews which has originated from the wound. Also involuntary bilious vomiting either immediately after the injury, or during the inflammatory period, is a bad sign only when sinews or even the neighbourhood of sinews have been wounded. The induction of a vomit, however, is not inappropriate, especially in those habituated to it; provided that this is not done immediately after food, or just when the inflammation has arisen, or when the wound is situated in the upper part of the body.

> Latin: Ac ne febris quidem terrere debet, si in magno uulnere, dum inflammatio est, permanet. Illa perniciosa est, quae uel leui uulneri superuenit, uel ultra tempus inflammationis durat, uel delirium mouet; uel, si neruorum rigor aut distentio, quae ex uulnere orta est, eam non finit. Vomitus quoque bilis non uoluntarius, uel protinus ut percussus est aliquis, uel dum inflammatio manet, malum signum est in is dumtaxat, quorum uel nerui, uel etiam neruosi loci uulnerati sunt. Sponte tamen uomere non alienum est, praecipue is, quibus in consuetudine fuit: sed neque protinus post cibum, neque iam inflammatione orta, neque cum in superioribus partibus plaga est. Biduo sic uulnere habito, tertio die id aperiundum, ⟨de⟩tergendaque sanies ex aqua frigida est, eademque rursus inicienda. Quinto iam die, quanta inflammatio futura est, se ostendit.

[¶4] When the wound has been so treated for two days, on the third it should be uncovered, sanies washed away with cold water, and then the same dressing applied again. By the fifth day the extent of inflammation in prospect is apparent. And on that day, when the wound has been uncovered again, its colour must be considered. If it is livid or pallid or patchy or dusky, it can be recognized that the wound is a bad one, and whenever this is observed, it should alarm us. It is best for the wound to be white or rubicund; also if the skin is hardened, thickened, or painful, danger is indication. Good signs are for the skin to be thin and soft without pain. But if the wound is agglutinating or swollen slightly, the same dressings as at first are to be applied; if there is severe inflammation and no hope of agglutination, then such applications are to be made as promote suppuration. And now the use of hot water as well is a necessity, in order to disperse diseased matter and to soften hardening and bring out pus. The temperature of the water must be pleasant to the hand when put into it, and the affusion is to be continued until the swelling is seen to have diminished and a more natural colour to have returned to the wound. After this fomentation, if the wound is not gaping widely, a plaster should be put on at once, particularly that tetrapharmacum if it is a large wound; in the case of wounds of joints, fingers, cartilaginous places, the plaster rhypodes; if the wound gapes more widely, that same plaster should be liquefied by iris unguent, and lint smeared with this laid all over the wound; upon this put the plaster, and above that greasy wool. The bandages are to be even less tight than at first.

> Latin: Quo die rursus detecto uulnere considerandus color est. Qui si liuidus aut pallidus aut uarius aut niger est, scire licet malum uulnus esse; idque quandocumque animaduersum est, terrere nos potest. Album aut rubicundum esse ulcus commodissimum est: item cutis dura, crassa, dolens periculum ostendit. Bona signa sunt, ubi haec sine dolore tenuis et mollis est. Sed si glutinatur uulnus aut leuiter intumuit, eadem sunt inponenda, quae primo fuerunt: si grauis inflammatio est neque glutinandi spes est, ea, quae pus moueant. Iamque aquae quoque calidae necessarius usus est, ⟨ut⟩ et materiam digerat et duritiam emolliat et pus citet. Ea sic temperanda est, ut manu contingenti iucunda sit, usque adeo adhibenda, donec aliquid ex tumore minuisse coloremque ulceri magis naturalem reddidisse uideatur. Post id fomentum, si lat⟨e⟩ plaga non patet, inponi protinus emplastrum debet,
maximeque si grande uulnus est, tetrapharmacum; si in articulis, digitis, locis cartilaginosis, rhypodes: et si latius hiat, idem illud emplastrum liquari ex irino unguento oportet eoque inlita li⟨n⟩amenta disponi per plagam; deinde emplastrum supra dari, et super id sucidam lanam. Minusque etiam quam primo fasciae adstringendae sunt. Proprie quaedam in articulis uisenda sunt, in quibus, si praecisi nerui sunt, qui continebant, debilitas eius partis sequitur. Si id dubium est, et ex acuto telo plaga est, ea transuersa commodior est;

[¶5] As to joints, there are certain special points to be noticed as, if the controlling sinews have been divided, weakness of the part concerned follows. If this is in doubt, and the wound has been made by a sharp weapon, a transverse wound is the more favourable; if by a blunt and heavy weapon, the shape of the wound makes no difference. But it is to be observed whether pus is being formed above the joint or beneath. If it is produced underneath, and thick and white discharge continues for some time, it is probable that a sinew has been cut, and the more so the greater the pains and inflammation, and the earlier these occur. But even though no sinew is divided, yet, if a hard swelling persists for a long while round about, the wound will last a long time and even after healing a swelling will persists; and in future that limb will be bent or stretched out slowly. There is, however, more delay in extending a limb which has been kept bent while treated, than in bending a limb which has been kept straight. Also there should be a definite rule as to position for a limb which has been wounded. If the wound is seem to be agglutinated, the limb is kept raised; it must not be bent either way if there is still inflammation; if pus is already being discharged it should be hanging down. The best medicament too is rest; movement and walking before healing are adverse. The danger, however, from movement is less for wounds of the head and arms than for the lower limbs. Walking about is least of all suited to an injured thigh or leg or foot. The patient's room should be kept warm. Bathing, too, while the wound is not yet clean, is one of the worst things to do; for this makes the wound both wet and dirty, and then there is a tendency for gangrene to occur. It is advantageous to apply light rubbing, but in those parts which are rather far away from the wound.

> Latin: si retuso et graui, nullum in figura discrimen est. Sed uidendum est, pus supra articulum an infra nascatur. Si sub eo nascitur albumque et crassum diu fertur, neruum praecisum credibile est, magisque quo maiores dolores inflammationesque et quo maturius excitatae sunt. Quamuis autem non abscisus neruus est, tamen si circa tumor durus diu permanet, necesse est et diuturnum ulcus esse et sano quoque eo tumorem permanere; futurumque est ut tarde membrum id uel extendatur uel contrahatur. Maior tamen in extendendo mora est, ubi recuruato curatio adhibita est, quam in recuruando eo, quod rectum continuerimus. Conlocari quoque membrum quod ictum est ratione certa debet. Si glutinandum est, ut superius sit: si in inflammationibus est, ut in neutram partem inclinatum sit: si iam pus profluit, ut deuexum sit. Optimum etiam medicamentum quies est: moueri, ambulare nisi sanis alienum est. Minus tamen is periculosum, qui in capite uel brachiis quam qui in inferioribus partibus uulnerati sunt. Minimeque ambulatio conuenit femine aut crure aut pede laborante. Locus, in quo cubabit, tepidus esse debebit. Balneum quoque, dum parum uulnus purum est, inter res infestissimas est: nam id et umidum et sordidum reddit, ex quibus ad cancrum transitus esse consueuit. Leuis frictio recte adhibetur, sed is partibus, quae longius absunt a uulnere. Inflammatione finita uulnus purgandum est. Et id optime faciunt tincta in melle li⟨n⟩amenta, supraque idem emplastrum uel enneapharmacum dandum est. Tum demum uero purum ulcus est, cum rubet, ac nimium neque siccum neque umidum est.

[¶6] When the inflammation has ended, the wound must be cleaned. And that is best done by putting on lint soaked in honey, and over it the plaster called tetrapharmacum or that called enneapharmacum. Then at length the wound is really clean when it is red, and neither too dry nor too moist. But a wound is not clean when it lacks sensation, when there is sensation which is not natural, when it is either too dry or too wet, when it is either whitish or pallid or livid or blackish.

> Latin: At quodcumque sensu caret, quod non naturaliter sen⟨t⟩it, quod nimium aut aridum aut umidum est, quod aut albidum aut pallidum aut liuidum aut nigrum est, id purum non est. Purgato, sequitur ut impleatur; iamque calida aqua eatenus necessaria est, ut sanies remoueatur. Lanae sucidae superuacuus usus est: lota melius circumdatur.

[¶7] When the wound is clean, there follows the growth of new flesh; and now warm water is necessary in order to remove sanies. The use of unscoured wool is superfluous; scoured wool is the better wrapping. But for filling up a wound certain medicaments also are useful; therefore it is not inappropriate to make use of such things as butter with rose-oil and a little honey; or the tetrapharmacum with the said rose-oil, or lint soaked in rose-oil. More beneficial, however, is an occasional bath, a nourishing diet, while avoiding everything acrid, but now somewhat fuller, for both poultry and venison and boiled pork can be given. In all cases, while fever and inflammation are present, wine is inappropriate; also, until the scar is formed, if either sinews or muscles have been wounded; or even if there is a deep flesh wound. But when the wound is of the safer kind, only skin deep, wine if not too old, given in moderation, can even aid the growth of flesh. If any part is to be softened, which is necessary in the region of sinews and muscles, cerate also is to be used upon the wound. But if flesh fungates, dry lint is a moderate repressant, copper scales a more active one. If more fungation needs to be removed the still more active corrosives are to be employed. After all such applications, lycium dissolved in raisin wine or in milk, or even only an application of dry lint, is useful in inducing a scar.

> Latin: Ad implendum autem uulnus proficiunt quidem etiam medicamenta aliqua: itaque ea adhiberi non alienum est, ut buturum cum rosa et exigua mellis parte; aut cum eadem rosa tetrapharmacum; aut ex rosa li⟨n⟩amenta. Plus tamen proficit balneum rarum, cibi boni suci, uitatis omnibus acribus, sed iam pleniores: nam et auis et uenatio et suilla elixa dari potest. Vinum omnibus, dum febris, inflammatio inest, alienum est: itemque usque cicatricem, si nerui musculiue uulnerati sunt; etiam, si alte caro. At si plaga in summa cute generis tutioris est, potest non peruetus, modice tamen datum, ad implendum quoque proficere. Si quid molliendum est, quod in neruosis locis musculosisque necessarium est, cerato quoque super uulnus utendum est. At si caro supercreuit, modice reprimit siccum lin⟨a⟩mentum, uehementius squama aeris. Si plus est, quod tolli opus est, adhibenda sunt etiamnum uehementiora, quae corpus exedunt. Cicatricem post omnia haec commode inducit Lycium ex passo aut lacte dilutum, uel etiam per se impositum siccum lin⟨a⟩mentum. Hic ordo felicis curationis est. Sed quaedam tamen periculosa incidere consuerunt: interdum enim uetustas ulcus occupat, induciturque ei callus, et circum orae crassae liuent;

[¶8] Such is the procedure of a successful treatment; dangerous complications, however, are wont to occur. Sometimes the wound becomes the seat of chronic ulceration, and it becomes hardened, and the thickened margins are a livid colour; after which whatever medicament is applied is of little service; and this commonly occurs when the wound has been carelessly treated. At times, whether owing to excess of inflammation, or to unusually hot weather, or to excessively cold weather, of because the wound has been bandaged too tightly, or on account of old age, or of a bad habit of body, canker sets in. The Greeks divided this genus into species for which there are no terms in our language.

> Latin: post quae quicquid medicamentorum ingeritur, parum proficit; quod fere neglegenter ⟨curato ulceri superuenit. Inter⟩dum uel ex nimia inflammatione, uel ob aestus inmodicos, uel ob nimia frigora, uel quia nimis uulnus adstrictum est, uel quia corpus aut senile aut mali habitus est, cancer occupat. Id genus a Graecis diductum in species est, nostris uocabulis non est. Omnis autem cancer non solum id corrumpit, quod occupauit, sed etiam serpit; deinde aliis aliisque signis discernitur. Nam modo super inflammationem rubor ulcus ambit, isque cum dolore procedit (erysipelas Graeci nominant);

[¶9] Now canker, whatever its species, corrupts not only the part it attacks, but it also spreads; next it is distinguished by differing signs. For sometimes a redness, over and above the inflammation, surrounds the wound, and this spreads with pain (the Greeks term it erysipelas); at times the wound is black because its flesh has become corrupted, and this is still more intensified by putrefaction when the wound is moist, and from the black wound is discharged a pallid humour, which has a foul odour, and the granulations break down: at times also sinews and membranes undergo dissolution, and when a probe is introduced it passes to the side or downwards, and this lesion not infrequently affects the bone too; sometimes there arises what the Greeks call gangrene. The former varieties occur in any part of the body; gangrene in the extremities, that is, in the nails, armpits or groins, and generally in aged people or in those of a bad habit of body. The flesh in the wound becomes either black or livid, but dry and shrivelled; the skin near it is for the most part occupied by dusky pustules; then the skin around these becomes either pallid or livid, and usually wrinkled, deficient in sensation: farther away from the wound the skin is inflamed. All these things spread simultaneously, the ulceration into the pustules, the pustules into the pallid or livid part, that into the inflamed part, and that again into the sound flesh. Now together with the above an acute fever arises and great thirst: in some also delirium: others, although in their right minds, nevertheless stammer so that they can scarcely explain their feelings; the stomach begins to be affected: even the breath gets a foul odour. This disorder at its commencement admits of treatment; but when thoroughly established it is incurable, and most patients die in a cold sweat.

> Latin: modo ulcus nigrum est, quia caro eius corrupta est, idque uehementius etiam put⟨r⟩escendo intenditur ubi uulnus umidum est et ex nigro ulcere umor pallidus fertur malique odoris [est] carunculaeque corruptae: interdum etiam nerui ac membranae resoluuntur, specillumque demissum descendit aut in latus aut deorsum, eoque uitio nonnumquam os quoque adficitur; modo oritur ea, quam Graeci gangrenam appellant. Priora in qualibet parte corporis fiunt: hoc in prominentibus membris, id est, inter ungues et alas uel inguina, fereque in senibus uel in is, quorum corpus mali habitus est. Caro in ulcere uel nigra uel liuida est, sed sicca et arida; proxumaque cutis plerumque subnigris pustulis impletur; deinde ei proxima uel pallida uel liuida, fereque rugosa, sine sensu est; ulterior ⟨in⟩ inflammatione est. Omniaque ea simul serpunt; ulcus in locum pus⟨t⟩ulosum, pus⟨t⟩ulae in eum, qui pallet aut liuet, pallor aut liuor in id, quod inflammatum est, inflammatio in id, quod integrum est, transit. Inter haec deinde febris acuta oritur ingensque sitis: quibusdam etiam delirium: alii, quamuis mentis suae compotes sunt, balbutiendo tamen uix sensus suos explicant; incipit adfici stomachus; fit foedi spiritus ipse odoris. Atque initium quidem eius mali recipit curationem; ubi uero penitus insedit, insanabile est; plurimique sub frigido sudore moriuntur. Ac pericula quidem uulnerum haec sunt. Vetus autem ulcus scalpello concidendum est, excidendaeque eius orae, et, quicquid super eas liuet, aeque incidendum.

[¶10] And such are the dangers following upon wounds. Now a wound when of long standing should be cut with a scalpel, its margins excised, and incisions made at the same time into any livid area surrounding the margins. If there is a small varix inside the wound which hinders healing, it also is to be excised. Then when the blood has been let out and the wound made like a new one, the same treatment is to be adopted as that described for recent wounds. If any one does not want to use the scalpel, healing may be secured by using the plaster made up with ladanum, and, when that has eaten away the ulcer, by the one which induces a scar.

> Latin: Si uaricula intus est, quae id sanari prohibet, ea quoque excidenda. Deinde, ubi sanguis emissus nouatumque uulnus est, eadem curatio adhibenda, quae in recentibus uulneribus exposita est. Si scalpello aliquis uti non uult, potest sanare id emplastrum, quod ex ladano fit, et cum ulcus sub eo exesum est, id, quo cicatrix inducitur. Id autem, quod erysipelas uocari dixi, non solum uulneri superuenire sed sine hoc quoque oriri consueuit, atque interdum periculum maius adfert, utique si circa ceruices aut caput constitit.— Oportet, si uires patiuntur, sanguinem mittere;

[¶11] But what I have said is called erysipelas, not only follows upon a would, but is wont also to arise without a wound, and sometimes brings with it some danger, especially when it sets in about the neck or head. If strength permits, blood should be let; then repressives and refrigerants applied together, particularly white-lead with nightshade juice, or Cimolian chalk with rain-water as an excipient; or flour made into a paste with the same, with cyprus shoots added, or lentil meal if the skin is more delicate. Whatever is put on is to be covered over with beet leaves, and over that with lint wetted with cold water. If refrigerants by themselves have little effect, they are to be combined with the following: sulphur 4 grams, white-lead and saffron, 50 grams each; and these are pounded up with wine and the place smeared with them: or when the skin is more hardened, nightshade leaves are pounded, mixed with lard, and applied spread on lint.

> Latin: deinde imponere simul reprimentia et refrigerantia, maximeque cerussam solani suco, aut Cimoliam cretam aqua pluuiali exceptam; aut ex eadem aqua subactam farinam cupresso adiecta aut, si tenerius corpus est, lenticulam. Quicquid inpositum est, betae folio contegendum et super linteolum frigida aqua madens inponendum. Si per se refrigerantia parum proderunt, miscenda erunt hoc modo: sulpuris P. #1108 I; cerussae, croci singulorum P. #1108 X⟨II S.⟩; eaque cum uino conterenda sunt, et id his inlinendum: aut si durior locus est, solani folia contrita suillae adipi miscenda sunt et inlita linteolo superinicienda. At si nigrities est nequedum serpit, imponenda sunt, quae carnem putrem lenius edunt, repurgatumque ulcus sic ut cetera nutriendum est.

[¶12] But if there is a blackening which is not yet spreading, the milder corrosives of putrid flesh are to be put on, and the wound having been thus cleaned out, is cared for like other wounds. If there is more corruption, and it is already spreading, stronger corrosives are needed. If even these are not effective, the place should be burnt by a cautery until no more humour escapes from it; for sound flesh is dry when it is burnt. After the cauterizing of a putrid wound, such drugs are to be applied as will loosen from the living flesh the crusts which the Greeks call eschara. When these have fallen off, the wound is to be cleaned by honey and resin in particular; but it can also be cleaned by the other materials with which suppurating wounds are treated and in the same way brought to healing.

> Latin: Si magis putre est, iamque procedit ⟨ac serpit,⟩ opus est uehementius erodentibus. Si ne haec quidem euincunt, aduri locus debet, donec ex eo nullus umor feratur: nam quod sanum est, siccum est, cum aduritur. Post ustionem putris ulceris superponenda sunt, quae crustas a uiuo resoluant: eas escharas Graeci nominant. Vbi eae exciderunt, purgandum ulcus maxime melle et resina est: sed aliis quoque purgari potest, quibus purulenta curantur; eodemque modo ad sanitatem perducendum est. Gangrenam uero, si nondum plane tenet, sed adhuc incipit, curare non difficillimum est, utique in corpore iuuenili;

[¶13] But gangrene, when not yet widespread, but only beginning, is not very difficult to cure, at any rate in a young subject; and even more so if muscles are intact, sinews uninjured or but slightly affected, and no large joint opened, or if there is little flesh in the part, and so not much to putrefy, and if the lesion is limited to one place; and this mostly happens in a finger. In such a case the first thing to be done, when strength permits, is to let blood; then whatever has become dry, and by stretching out, as it were, in injuring also what is next to it, is cut away up to this point the sound tissue. Whilst the gangrene is spreading, medicaments which tend to promote suppuration are not to be applied; and therefore not even hot water. Weighty dressings also, although repressant, are unsuitable; but the lightest are needed; and over the parts which are inflamed refrigerants are to be used. If the malady is still not checked, the part between what is sound and diseased ought to be cauterized; and in such a case especially assistance is to be sought, not only from medicaments, but also from a system of diet; for this malady only occurs in a corrupt and diseased body. Therefore at first, unless weakness prohibits it, the patient should fast; after that he should be given light food and drink to tone up the bowels, and so also the body in general. Later if the lesion has been checked, the same things should be put on the wound which were prescribed for putrid ulceration. And it is now also permissible to make use of a fuller diet — foods of the middle class, but only such as dry up the bowels and the body generally; and cold rain-water to drink. The bath is harmful until it is quite certain that soundness has returned; for a wound, if softened in the bath, is quickly again affected by the same malady. But it still happens sometimes that none of these remedies is effectual, and in spite of everything this canker spreads. In such circumstances there is one sad by solitary remedy to secure the safety of the rest of the body, that is to cut away the limb which is gradually dying.

> Latin: et magis etiam si musculi integri sunt, si nerui uel laesi non sunt uel leuiter adfecti sunt, neque ullus magnus articulus nudatus est, aut carnis in eo loco paulum est, ideoque non multum, quod putresceret, fuit, consistitque eo loco uitium; quod maxime fieri in digito potest.—In eiusmodi casu primum est, si uires patiuntur, sanguinem mittere; deinde quicquid aridum est et intentione quadam proximum quoque locum male habet, usque eo [sanum corpus] concidere. Medicamenta uero, dum malum serpit, adhibenda nulla sunt, quae pus mouere consuerunt; ideoque ne aqua quidem calida. Grauia quoque, quamuis reprimentia, aliena sunt; sed his quam leuissimis opus est; superque ea, quae inflammata sunt, utendum est refrigerantibus. Si nihilo magis malum constitit, uri, quod est inter integrum ac uitiatum locum, debet: praecipueque in hoc casu petendum non a medicamentis solum sed etiam a uictus ratione praesidium est: neque enim id malum nisi corrupti uitiosique corporis est. Ergo primo, nisi inbecillitas prohibet, abstinentia utendum; deinde danda quae per cibum potionemque aluum ideoque etiam corpus adstringant, sed ea leuia. Postea si uitium constitit, inponi super uulnus eadem debent, quae in putri ulcere praescripta sunt. Ac tum quoque ut plenioribus cibis uti licebit ex media materia, sic tamen non nisi aluum corpusque siccantibus; aqua uero pluuia[ti]li frigida. Balneum, nisi iam certa fiducia redditae sanitatis est, alienum est: siquidem emollitum in eo uulnus cito rursus eodem malo adficitur. Solent uero nonnumquam nihil omnia auxilia proficere ac nihilo minus serpere is cancer. Inter quae, miserum sed unicum auxilium est, ut cetera pars corporis tuta sit, membrum, quod paulatim emoritur, abscidere. Hae grauissimorum uulnerum curationes sunt. Sed ne illa quidem neglegenda, ubi integra cute interior pars conlisa est;

[¶14] Such are the treatments of the gravest wounds. But there should be no neglect of those in which the skin is intact, but some inner part has been contused; or where something has been scraped or rubbed off: or what a splinter has become fixed in the body, or where the wound is small but deep.

> Latin: ⟨aut ubi derasum adtritumue aliquid est;⟩ aut ubi surculus corpori infixus est; aut ubi tenue sed altum uulnus insedit.

[¶15] In the first case the best thing is to cook the rind of a pomegranate in wine, and pound up its interior and mix with rose-oil cerate, and so apply it: next, when the skin has been actually abraded, to lay on a soothing medicament such as lipara.

> Latin: In primo casu commodissimum est malicorium ex uino coquere, interioremque eius partem conterere et cerato miscere ex rosa facto, idque superponere: deinde, ubi cutis ipsa exasperata est, inducere lene medicamentum, quale lipara est. Dera⟨s⟩so uero detritoque imponendum est emplastrum tetrapharmacum, minuendusque cibus et uinum subtrahendum.

[¶16] When the skin has been scraped and rubbed off, the plaster tetrapharmacum is to be applied, the food reduced and wine withdrawn. Such wounds are not to be disregarded because deeper structures are uninjured; for often from injuries of this kind canker develops. But if the hurt is trifling, and of small extent, we may be content with the same soothing application.

> Latin: Neque id, quia non habebit altiores ictus, contemnendum erit: siquidem ex eiusmodi casibus saepe cancri fiunt. Quod si leuius id erit et in parte exigua, contenti esse poterimus eodem leni medicamento. Surculum uero, si fieri potest, oportet uel manu uel etiam ferramento eicere.

[¶17] A splinter too, whenever possible, should be extracted either by the hand or even by the help of an instrument. But if the splinter has been broken off or has penetrated too deeply for this to be done, it must be drawn towards the surface by a medicament. The best thing to draw it out is an application of pole-reed root pound up straight away if soft, but if already rather hard, boiled first in honey wine; to which honey should always be added, or birthwort also with honey. Of splinters the pole-reed is the worst because it is rough; there is the same harmfulness in fern. But by experience it has been learnt that either, when pounded up and applied, serves as a medicament against the other. Any medicament which has an extractive property has the same effect on splinters of all kinds.

> Latin: Si uel praefractus est uel altius descendit, quam ut id ita fieri possit, medicamento euocandus est. Optume autem educit superinposita harundinis radix, si tenera est, protinus contrita; si iam durior, ante in mulso decocta; cui semper mel adiciendum est aut aristolochia cum eodem melle. Pessima ex surculis harundo est, quia aspera est: eademque offensa etiam in f⟨i⟩lice est. Sed usu cognitum est utramque aduersus alteram medicamentum esse, si contrita superinposita est. Facit autem idem in omnibus surculis, quodcumque medicamentum extrahendi uim habet. Idem altis tenuibusque uulneribus aptissimum est.

[¶18] The same treatment is best for deep and narrow wounds. The plaster of Philocrates is especially good for the former, that of Hecataeus for the latter.

> Latin: Priori rei Philocratis, huic Hecataei emplastrum maxime conuenit.

[¶19] Whatever the kind of wound, when the time has come for inducing the scar, which must be after the wound has cleaned and filled with new flesh, first lint is applied, wetted by cold water while the flesh is being nourished; afterwards, when it has to be checked, dry lint must be applied until the scar is induced. Then plumbum album should be bandaged on in order to keep down the scar, and to give it a colour as much as possible like sound skin. Wild cucumber root has the same property, so has the present contain in: elaterium 4 grams, litharge 8 grams, unguent 16 grams. These are taken up in turpentine until the whole is of the consistency of a plaster. Further, equal parts of verdigris and washed lead mixed together with rose-oil gently clean black scars; either the scar may be anointed, as can be done on the face; or the above may be applied as a plaster, which is more convenient for other parts of the body. But if the scar is either elevated or depressed, it is foolish, just for the sake of appearance, to submit to pain and medicinal applications. Else both conditions can be remedied, since either scar can be made into a wound by the use of a scalpel. Or if a medicament is preferred, corrosive compositions have the same effect. After the skin has been wounded, to an elevated cicatrix corrosives are applied, to a depressed one medicaments which make flesh, until the wound, in each case, is on a level with the sound skin; and then the scar is induced.

> Latin: Vbi uero in quolibet uulnere uentum ad inducendam cicatricem est, quod perpurgatis iam repletisque ulceribus necessarium est, primum ex aqua frigida lin⟨a⟩mentum, dum caro alitur; deinde iam, cum continenda est, ⟨siccum imponendum est,⟩ donec cicatrix inducatur. Tum deligari super album plumbum oportet quo et reprimitur cicatrix et colorem maxime corpori sano similem accipit. Idem radix siluestris cucumeris praestat, idem compositio, quae habet: elateri P. #1108 I; spumae argenti P. #1108 II; unguenti pondo #1108 IIII. Quae excipiuntur resina terebenthina, donec emplastri crassitudo ex omnibus fiat. Ac nigras quoque cicatrices leniter purgant paribus portionibus mixta aerugo, plumbum elotum, eademque rosa coacta; siue unguitur cicatrix, quod in facie fieri potest; siue id ut emplastrum inponitur, quod in aliis partibus commodius est. At si uel excreuit cicatrix uel concaua est, stultum est decoris causa rursus et dolorem et medicinam sustinere. Alioqui res utrique succurri patitur, siquidem utraque cicatrix exulcerari scalpello potest. Si medicamentum aliquis mauult, idem efficiunt compositiones eae, quae corpus exedunt. Cute exulcerata super eminentem carnem exedentia medicamenta coicienda sunt, super concauam implentia, donec utrumque ulcus sanae cuti aequetur; et tum cicatrix inducatur.

[¶20] 27. 27 I have spoken of those wounds which are mostly inflicted by weapons. My next task is to speak of those which are caused by the bite, at times of a man, at times of an ape, often of a dog, not infrequently of wild animals or of snakes. For almost every bite has in it poison of some sort. Therefore if the wound is severe, a cup should be applied straightway of it; if slighter a plaster, especially that of Diogenes. If that is not at hand, then one of the others I have recommended against bites; failing such, the green plaster called Alexandrian; if not even that is to be had, then any one which suits recent wounds, so long as it is not greasy. Salt is also a remedy for bites, especially dog-bite, if a hand is then placed over the bite and struck by two fingers of the other hand; for this brings out sanies; and brine-pickle may also be appropriately bandaged upon such a wound.

> Latin: 27. Dixi de is uulneribus, quae maxime per tela inferuntur. Sequitur, ut de is dicam, quae morsu fiunt, interdum hominis, interdum simiae, saepe canis, nonnumquam ferorum animalium aut serpentium. Omnis autem fere morsus habet quoddam uirus: itaque si uehemens uulnus est, cucurbitula admouenda est; si leuius, protinus emplastrum iniciendum, praecipueque Diogen⟨i⟩. Si id non est, quodlibet ex is, quae aduersus morsus proposui: si ea non sunt, uiride Alexandrinum: si ne id quidem est, quodlibet non pingue ex is, quae recentibus uulneribus accommodantur. Sal quoque his, praecipueque ei, quod canis fecit, medicamentum est, si manus uulneri inponitur superque id duobus digitis uerberatur: exaniat enim; ac salsamentum quoque recte super id uulnus deligatur.

[¶21] But especially if the dog was mad, the poison must be drawn out by a cup; next, if the wound is not among sinews and muscles, it must be cauterized; if it cannot be cauterized, it is not amiss to bleed the man. After cauterizing, applications are to be put on as for other burns; if the wound is not cauterized, such medicaments as are powerful corrosives. After this the wound should be filled in and brought to healing, not by any new method, but as already described above. After the bite of a mad dog some send the patients at once to the bath, and there let them sweat as much as their bodily strength allows, the wound being kept open in order that the poison may drop out freely from it; then follows the administration of much wine, undiluted, which is an antidote to all poisons. And when this has been carried out for three days, the patient is deemed to be out of danger.

> Latin: Vtique autem si rabiosus canis fuit, cucurbitula uirus eius extrahendum est; deinde si locus neque neruosus neque musculosus est, uulnus id adurendum est: si uri non potest, sanguinem homini mitti non alienum est. Tum usto quidem uulneri superimponenda quae ceteris ustis sunt: ei uero, quod expertum ignem non est, ea medicamenta, quae uehementer exedunt. Post quae nullo nouo magisterio, sed iam supra posito ulcus erit implendum et ad sanitatem perducendum. Quidam post rabiosi canis morsum protinus in balineum mittunt ibique patiuntur desudare, dum uires corporis sinunt, ulcere adaperto, quo magis ex eo quoque uirus destillet; deinde multo mera⟨c⟩oque uino accipiunt, quod omnibus uenenis contrarium est. Idque cum ita per triduum factum est, tutus esse homo a periculo uidetur.

[¶22] But when too little has been done for such a wound, it usually gives rise to a fear of water which the hands call hydrophobia, a most distressing disease, in which the patient is tortured simultaneously by thirst and by dread of water. In these cases there is very little help for the sufferer. But still there is just one remedy, to throw the patient unawares into a water tank which he has not seen beforehand. If he cannot swim, let him sink under and drink, then lift him out; if he can swim, push him under at intervals so that he drinks his fill of water even against his will; for so his thirst and dread of water are removed at the same time. Yet this procedure incurs a good danger, that a spasm of sinews, provoked by the cold water, may carry off a weakened body. Lest this should happen, he must be taken straight from the tank and plunged into a bath of hot oil. But as an antidote we should give especially the one which I put first, when that is not at hand, another; it is to be given in a draught of water, if the patient does not dread water yet; and if the bitterness is objected to, honey is to be added; if dread of water has already seized him, the antidote can be swallowed as a pill.

> Latin: Solet autem ex eo uulnere, ubi parum occursum est, aquae timor nasci (hydrophobas Graeci appellant), miserrimum genus morbi, in quo simul aeger et siti et aquae metu cruciatur; quo oppressis in angusto spes est. Sed unicum tamen remedium est, neque opinantem in piscinam non ante ei prouisam proicere. Et si natandi scientiam non habet, modo mersum bibere pati, modo attollere: si habet, interdum deprimere, ut inuitus quoque aqua satietur: sic enim simul et sitis et aquae metus tollitur. Sed aliud periculum excipit, ne infirmum corpus in aqua frigida uexatum neruorum distentio absumat. Id ne incidat, a piscina protinus in oleum calidum demittendus est. Antidotum autem praecipue id, quod primo loco posui, ubi id non est, aliud, si nondum aeger aquam horret, potui ex aqua dandum est; et si amaritudine offendit, mel adiciendum est: si iam is morbus occupauit, per catapotia sumi potest.

[¶23] Serpents' bites again need a not very different treatment, although in this the ancients had very various methods so that for each kind of snake some prescribed one special kind of remedy, some another; but in all it is the same measures which are the most efficacious. Therefore first the limb is to be constricted above this kind of wound, but not too tightly, lest it become numbed; next, the poison is to be drawn out. A cup does this best. But it is not amiss beforehand to according to incisions with a scalpel around the wound, in order that more of the vitiated blood may be extracted. If there is no cup at hand, although this can hardly happen, use any similar vessel which can do what you want; if there is not even this, a man must be got to suck the wound. I declare there is no particular science in those people who are called Psylli, but a boldness confirmed by experience. For serpent's poison, like certain hunter's poisons, such as the Gauls in particular use, does no harm when swallowed, but only in a wound. Hence the snake itself may be safely eaten, whilst its stroke kills; and if one is stupefied, which mountebanks effect by certain medicaments, and if anyone puts his finger into its mouth and is not bitten, its saliva is harmless. Anyone, therefore, who follows the example of the Psylli and sucks out the wound, will himself be safe, and will promote the safety of the patient. He must see to it, however, beforehand that he has no sore place on his gums or palate or other parts of the mouth. After the suction, the patient should be put into a warm room, in such a position that the part bitten is inclined downwards. If there is no one at hand to suck out the wound, or to cup it, the patient should sip goose or mutton or veal broth and provoke a vomit; further a live chicken should be cut through the middle, and whilst warm applied forthwith over the wound so that its inner part is in contact with the patient's body. It will also do to slaughter a kid or lamb, and immediately to put the hot flesh upon the wound. The plasters also should be applied which have been mentioned above; the most suitable is the Ephesian plaster, or that noted next after it. There is ready help in on of the antidotes; if none is at hand, it is necessary to take in sips a draught of strong wine with pepper, or anything else which will stir up heat, to prevent humour from coagulating internally; for most poisons cause death by cold. All diuretics also are useful, because they dilute the diseased matter.

> Latin: Serpentium quoque morsus non nimium distantem curationem desiderant, quamuis in ea multum antiqui uariarunt, ut in singula anguium genera singula medendi genera praeciperent aliique alia: sed in omnibus eadem maxime proficiunt.—Igitur in primis super uulnus id membrum deligandum est, non tamen nimium uehementer, ne torpeat; deinde uenenum extrahendum est. Id cucurbitula optume facit. Neque alienum est ante scalpello circa uulnus incidere, quo plus uitiati iam sanguinis extrahatur. Si cucurbitula non est, quod tamen uix incidere potest, tum quodlibet simile uas, ⟨quod⟩ idem possit; ⟨si ne id quidem est,⟩ homo adhibendus est, qui id uulnus exsugat. Neque Hercules scientiam praecipuam habent ii, qui Psylli nominantur, sed audaciam usu ipso confirmatam. Nam uenenum serpentis, ut quaedam etiam uenatoria uenena, quibus Galli praecipue utuntur, non gustu, sed in uulnere nocent. Ideoque colubra ipsa tuto estur, ictus eius occidit; et si stupente ea, quod per quaedam medicamenta circulatores faciunt, in os digitum quis indidit neque percussus est, nulla in ea saliua noxa est. Ergo quisquis exemplum Psylli secutus id uulnus exsuxerit, et ipse tutus erit et tutum hominem praestabit. Illud [ne intereat] ante debebit adtendere, ne quod in gingiuis palatoue aliaue parte oris ulcus habeat. Post haec is homo loco calido conlocandus est, sic ut id quod percussum erit, in inferiorem partem inclinetur. Si neque qui exsugat neque cucurbitula est, sorbere oportet ius anserinum uel ouillum uel uitulinum et uomere, uiuum autem gallinaceum pullum per medium diuidere et protinus calidum super uolnus imponere, sic ut pars interior corpori iungatur. Facit id etiam haedus agnusue discissus, et calida eius caro statim super uolnus imposita. Emplastra quoque si qua * * supra conprehensa sunt; aptissimumque est uel Ephesium uel id, quod ei subiectum est. Praesensque in aliquo antidoto praesidium est: si id non est, necessarium est exsorbere potionem meri uini cum pipere, uel quidlibet aliud quod calori mouendo est, ne umorem intus coire patiatur: nam maxima pars uenenorum frigore interemit. Omnia etiam urinam mouentia, quia materiam extenuant, utilia sunt. Haec aduersus omnes ictus communia sunt. Vsus tamen ipse docuit eum, quem aspis percussit, acetum potius bibere ⟨debere⟩.

## 20. Book V · chapters 27–28

Source: https://scriptura.si/works/celsus-on-medicine/20/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/20/#p-N

[¶0] Such are the general remedies against bites of any kind. Experience has taught, however, that anyone bitten by an asp should in particular drink vinegar. The case of a certain boy is said to demonstrate this, for having been thus bitten, partly on account of the bite, and partly owing to excessively hot weather, he was tormented by thirst, and being in a dry place found no other fluid, so he drank the vinegar he chanced to have with him, and was saved. I believe this happened because although vinegar is a refrigerant, it has also the faculty of dissipating. Hence it is that earth sprinkled with it froths. Therefore it is likely that by the same faculty humour which is condensing inside a patient is dissipated by it, and so health is restored.

> Latin: Quod demonstrasse dicitur casus cuiusdam pueri, qui cum ab hac ictus esset et partim ob ipsum uolnus partim ob inmodicos aestus siti premeretur ac locis siccis alium umorem non reperiret, acetum, quod forte secum habebat, ebibit et liberatus est, credo, quoniam id, quamuis refrigerandi uim habet, tamen ⟨habet etiam⟩ dissupandi; quo fit, ut terra respersa eo spumet. Eadem ergo ui uerisimile est spissescentem quoque intus umorem hominis ab eo discuti et sic dari sanitatem. In quibusdam etiam aliis serpentibus quaedam auxilia certa satis nota sunt. Nam scorpio sibi ipse pulcherrimum medicamentum est.

[¶1] There are also against certain other reptiles remedies which are well enough known. For the scorpion is itself the best remedy against itself. Some pound up a scorpion and swallow it in wine; some pound it up in the same way and put it upon the wound; some put it upon a brazier and fumigate the wound with it, putting a cloth all round to prevent the escape of the fumes, afterwards they bandage its ash upon the wound. The patient should also drink wine in which have been steeped the seeds, or at any rate the leaves, of the herba solaris, which the Greeks call heliotropion. It is good also to apply to the wound bran soaked in vinegar, or wild rue, or roasted salt with honey. I have known, however, practitioners who merely let blood from the arm of those stung by a scorpion, that and nothing more.

> Latin: Quidam contritum cum uino bibunt: quidam eodem modo contritum super uolnus imponunt: quidam super prunam eo imposito uolnus suffumigant, undique ueste circumdata, ne is fumus dilabatur; tum carbonem eius super uolnus deligant. Bibere autem oportet herbae solaris, quam heliotropion Graeci uocant, semen uel certe folia ex uino. Super uolnus uero etiam furfures ex aceto uel ruta siluatica recte imponitur uel cum melle sal tostus. Cognoui tamen medicos, qui a scorpione ictis nihil aliud quam ex bracchio sanguinem miserunt. Et ad scorpionis autem et aranei ictum alium cum ruta recte miscentur, ex oleoque contritum superinponitur.

[¶2] For the sting of a scorpion also, or for that of a spider, it is good to put on garlic mixed with rue and pounded up with oil.

> Latin: At si cerastes aut dipsas aut haemorrhois percussit, ⟨p⟩oli quod Aegyptiae fabae magnitudinem aequet, arfactum ut in duas potiones diuidendum est, sic ut ei rutae paulum adiciatur.

[¶3] But when cerastes, or dipsas, or haemorrhois has bitten a man, poley-germander roasted, equal in amount to an Egyptian bean, is divided into two draughts, a little rue being added. Trefoil also and wild mint and allheal-juice, with vinegar, are equally efficacious. Costmary, casia, and cinnamon may appropriately be taken in draughts.

> Latin: Trifolium quoque et mentastrum et cum aceto panaces aeque proficiunt. Costumque et casia et cinnamomum recte per potionem adsumuntur. Aduersus chelydri uero ictum panaces aut laser, quod sit scrip. III S. [#1108 I], uel porri sucus cum hemina uini sumendus ⟨est⟩, et edenda multa satureia.

[¶4] For the bite of a chelydrus, allheal-juice or laser 4 grams, or leek-juice in 250 cc. of wine, may be taken, and a quantity of savory eaten. Over the bite either goat's dung, or barley-meal boiled with vinegar should be applied, or rue, or catnip pounded with salt, with honey added. This last is equally efficacious for the bite of a cerastes.

> Latin: Imponendum autem super uulnus stercus caprinum ex aceto coctum, aut ex eodem hordiacia farina, aut ruta uel nepeta cum sale contrita melle adiecto. Quod in eo quoque uulnere, quod cerastes fecit, aeque ualet. Vbi uero phalangium nocuit, praeter eam curationem, quae manu redditur, saepe homo demittendus in solium est;

[¶5] But when a venomous spider has done the harm, in addition to the surgical treatment, the patient should be plunged often into the hot bath; and take equal quantities of myrrh and bryony berries in 250 cc. of raisin wine; or radish seeds or darnel root in wine; bran boiled in vinegar is to be put on the wound, and the patient is kept in bed.

> Latin: dandusque ei murrae et uuae t⟨a⟩miniae par modus ex passi hemina; uel radiculae semen aut lolii radix ex uino; et super uulnus furfures ex aceto coctae; imperandumque, ⟨ut is conquiescat.⟩

[¶6] But the foregoing classes of reptiles belong to foreign countries, and are especially poisonous, and they are mostly generated in hot countries. Italy and colder countries are healthier in this respect too, for the reptiles they produce are less dangerous. Against them sufficient remedies are betony or convolvulus or centaury or agrimony or germander or burdock or sea parsnip; any one or two of these is pounded up and taken in wine... and applied to the bite. It must be remembered that all snake-bites are more harmful when either the reptile or the man is hungry. Hence snakes are most injurious when brooding, and it is of the greatest importance when there is danger from snakes not to go out before taking some food.

> Latin: ⟨Verum haec genera serpentium⟩ et peregrina et aliquanto magis pestifera sunt, maximeque aestuosis locis gignuntur. Italia frigidioresque regiones hac quoque parte salubritatem habent, quod minus terribiles angues edunt. Aduersus quos satis proficit herba Vettonica uel Cantabrica uel centaurios uel argimonia uel trixago uel personina uel marinae pastinacae, uel singulae binaeue tritae et cum uino potui datae * * * sunt et super uulnus impositae. Illud ignorari non oportet, omnis serpentis ictum et ieiuni et ieiuno magis nocere; ideoque perniciosissimae sunt cum incubant, utilissimumque est, ubi ex anguibus metus est, non ante procedi quam quis aliquid adsumpsit.

[¶7] It is not so easy to render assistance when poison has been taken in food or drink, first because patients do not perceive it at once as when bitten by a snake; and so are unable to afford themselves any help immediately. Moreover, the mischief starts, not from the skin, but from within. But the best thing, as soon as any one has perceived it, is to swallow a quantity of oil at once and vomit; then, when the praecordia have been emptied, to drink an antidote; or failing that undiluted wine.

> Latin: Non tam ex facil⟨i⟩ is opitulari est, qui uenenum uel in cibo uel in potione sumpserunt, primum quia non protinus sentiunt, ut ab angue icti; ita ne succurrere quidem statim sibi possunt; deinde quia noxa non a cute sed ab interioribus partibus incipit. Commodissimum est tamen, ubi primum sensit aliquis, protinus oleo multo epoto uomere; deinde ubi praecordia exhausit, bibere antidotum: si id non est, uel merum uinum.

[¶8] There are, nevertheless, certain remedies proper for particular poisons, especially for the milder ones. If a potion of cantharides has been swallowed, all-heal pounded in milk should be given or galbanum with the addition of wine, or milk by itself.

> Latin: Sunt tamen quaedam remedia propria aduersus quaedam uenena, maximeque leuiora. Nam si cantharidas aliquis ebibit, panaces cum * * contusa uel galban⟨um⟩ uino adiecto dari, uel lac per se debet.

[¶9] If it be hemlock, hot undiluted wine with rue should be taken in a large quantity, then the patient should be made to vomit; and after that laser is given in wine; and if free from fever he should be put into a hot bath; if not free, he should be anointed with heating remedies. After this, rest is necessary.

> Latin: Si cicutam, uinum merum calidum cum ruta quam plurimum ingerendum est; deinde is uomere cogendus; posteaque laser ex uino dandum: isque, si febre uacat, in calidum balneum mittendus; si non uacat, unguendus ex calfacientibus est. Post quae quies ei necessaria est.

[¶10] If it be hyoscyamus, honey wine should be drunk hot, or milk of any kind, especially asses' milk.

> Latin: Si hyoscyamum, feruens mulsum bibendum est, aut quodlibet lac, maxime tamen asininum.

[¶11] If it be white-lead, mallow or walnut juice rubbed up in wine is best.

> Latin: @@Si cerussam, ius maluae uel ius glandis ex uino contritae maxime prosunt.

[¶12] If a leech has been swallowed, vinegar with salt is to be drunk. When milk has curdled inside, either raisin wine or rennet or laser with vinegar.

> Latin: Si sanguisuga epota est, acetum cum sale bibendum est. Si lac intus coiit, aut passum aut coagulum aut cum aceto laser.

[¶13] If any one has eaten fungi that are not used, a radish or purslane is to be eaten alone or with a draught of salt and vinegar. Such fungi may be distinguished from the sorts in use by their appearance, and may be rendered safe by suitable cooking; for when boiled in oil, or along with a pear-tree twig, they lose all their noxious property.

> Latin: Si fungos inutiles quis adsumpsit, radicula aut †pota aut cum sale et aceto edenda est. Ipsi uero hi et specie quidem discerni possunt ab utilibus et cocturae genere idonei fieri. Nam siue ex oleo inferuerunt, siue piri surculus cum his inferuuit, omni noxa uacant.

[¶14] Burns are likewise the product of external violence, and so it seems to follow that I should speak of them here. Now they are best treated by leaves either of lily or of hound's tongue or of beet, boiled in old wine and oil; any one of the above applied at once brings healing. But the treatment can also be divided into: first, a stage of moderately exedent and repressant applications both to check blisters and to roughen the skin; next, a stage of soothing applications for healing. Among the former is lentil meal with honey, or myrrh with wine, or Cimolian chalk pounded up with frankincense bark and mixed with water, and when it has to be used, diluted with vinegar. Subsequent applications include anything that is greasy; but the most suitable is that containing lead slag or yolk of egg. There is also another treatment of burns, namely, while the inflammation lasts, to keep lentil meal and honey on the wound; next, when the inflammation has subsided, flour with rue or with leek or with horehound, until the crusts fall off; then vetch meal with honey, or iris ointment or turpentine-resin, until the ulceration is clean, and finally dry lint.

> Latin: Adustis quoque locis extrinsecus uis infertur: itaque sequi uidetur, ut de his dicam. Haec autem optime curantur folio aut lilii aut linguae caninae aut betae in uetere uino oleoque decoctis; quorum quidlibet protinus impositum ad sanitatem perducit. Sed diuidi quoque curatio potest in ea, quae mediocriter exedentia reprimentiaque primo et pusulas prohibeant et summam pel⟨l⟩iculam exasperent; deinde ea, quae lenia ad sanitatem perducant. Ex prioribus est lenticulae cum melle farina uel myrra cum uino ⟨uel⟩ creta Cimolia cum turis cortice contrita et aqua coacta atque, ubi usus necessitas incidit, aceto diluta. Ex insequentibus quaelibet lipara: sed idonea maxime est, quae uel plumbi recrementum uel uitellos habet. Est etiam illa adustorum curatio, dum inflammatio est, impositam habere cum melle lenticulam: ubi ea declinauit, farina⟨m⟩ cum ruta uel porro uel marrubio, donec crustae cadant; tum eruum cum melle aut irim aut resinam terebinthinam, donec ulcus purum sit; nouissime siccum lin⟨a⟩mentum.

[¶15] 28. 28 From those lesions which are due to something from without we come to those which originate from within, when some bodily part has become corrupted. Of these none are worse than carbuncles, the signs of which are: redness, with a few pustules projecting a little, mostly black, sometimes livid or pallid; their contents seems to be sanies; the colour underneath is black; the actual tissue is dry, and harder than it should be naturally; and round them there is a sort of crust, and outside that an inflammatory ring; and there the skin cannot be pinched up, but is as it were fixed in the underlying flesh. The patient is somnolent; sometimes there is shivering or fever or both. And this lesion spreads, sometimes quickly, sometimes slowly, pushing out a sort of root underneath; on the surface too as it spreads the skin gets paler, then becomes livid, and a ring of small pustules arises; and if this occurs in the region of the gullet or fauces, often it suddenly stops the patient's breathing. The best thing is to apply a cautery at once; this is not a severe procedure, because the patient does not feel it, since the flesh is dead; and the cauterizing is topped when pain is felt all over the lesion. After that the wound is to be treated like other burns; for under erodent medicaments it follows that the crust becomes separated on all sides from the liv gate flesh, and takes off with it whatever has become corrupted; and the cavity when clean can be dressed with some preparation to make flesh. But when the lesion is on the surface of the skin, it is possible to cure it simply by exedents or at any rate by caustics. The strength of the remedy adopted is to be proportionate to the lesion. But whatever the medicament is, if it is sufficiently effectual, it forthwith detaches the corrupted part from the living; we may be confident that wherever the application works, the diseased flesh everywhere sloughs off. If the medicament is being mastered by the disease, certainly there must be no delay in applying the cautery. But in such a case there should be abstinence from food and from wine; it is a good thing to drink water freely. And this should be done all the more when there is feverishness as well.

> Latin: 28. Ab his, quae extrinsecus incidunt, ad ea ueniendum est, quae interius corrupta aliqua corporum parte nascuntur. Ex quibus non aliud carbunculo peius est. Eius ha⟨e⟩ notae sunt: rubor est, superque eum non nimium pusulae eminent, maxime nigrae, interdum subliuidae aut pallidae: in his sanies esse uidetur. Infra color niger est: ipsum corpus aridum et durius quam naturaliter oportet; circaque quasi crusta est, eaque inflammatione cingitur: neque in eo loco leuari cutis potest, sed inferiori carni quasi adfixa est. Somnus urguet, nonnunquam horror aut febris oritur, aut utrunque. Idque uitium subteractis quasi quibusdam radicibus serpit, interdum celerius, interdum tardius: supra quoque procedens inalbescit, dein liuidum fit, circumque exiguae pustulae oriuntur; et si circa stomachum faucesue incidit, subito spiritum saepe elidit.—Nihil melius est quam protinus adurere; neque id graue est: nam non sentit, quoniam ea caro mortua est; finisque adurendi est, dum ex omni parte sensus doloris est. Tum deinde uulnus sicut cetera adusta curandum est: sequitur enim sub medicamentis erodentibus crusta undique a uiua carne d⟨i⟩ducta, quae trahit secum quicquid corruptum erat; purusque iam sinus curari potest implentibus. At si in summa cute uitium est, possunt succurrere quaedam uel exedentia tantum uel etiam adurentia. Vis pro magnitudine adhibenda est. Quodcunque uero medicamentum ⟨im⟩positum est, si satis proficiet, protinus a uiuo corruptam partem resoluit; certaque esse fiducia potest f⟨o⟩re, ut undique uitiosa caro exc⟨i⟩dat, qua [huiusce rei medicamen] exest. Si [id non fit] medicamentum malo uincitur, utique ad ustionem properandum est. Sed in eiusmodi casu abstinendum a cibo, a uino est: aquam liberaliter bibere expedit. Magisque ea seruanda sunt, si febricula quoque accessit. Non idem periculum carcinoma adfert, nisi imprudentia curantis agitatum est.

[¶16] A carcinoma does not give rise to the same danger unless it is irritated by imprudent treatment. This disease occurs mostly in the upper parts of the body, in the region of the face, nose, ears, lips, and in the breasts of women, but it may also arise in an ulceration, or in the spleen. Around the spot is felt a sort of pricking; there is a fixed, irregular swelling, sometimes there is also numbness. Around it are dilated tortuous veins, pallid or livid in hue; sometimes in certain cases they are even hidden from view; and in some the part is painful to the touch, in others there is no feeling. And at times the part becomes harder or softer than natural, yet without ulcerating; and sometimes ulceration supervenes on all the above signs. The ulceration at times has no special characteristic; at times it resembles what the Greeks call condylomata, both in a sort of roughness and in size; its colour is either red or like that of lentils. It is not safe to give it a blow; for either paralysis or spasm of the sinews follows at once. Often from a blow on it a man loses speech and faints; in some also, if the place is pressed, the parts around become tense and swollen. Then it is the worst kind. And generally the first stage is what the Greeks call cacoethes; then from that follows a carcinoma without ulceration; then ulceration, and from that a kind of wart. It is only the cacoethes which can be removed; the other stages are irritated by treatment; and the more so the more vigorous it is. Some have used caustic medicaments, some the cautery, some excision with a scalpel; but no medicament has ever given relief; the parts cauterized are excited immediately to an increase until they cause death. After excision, even when a scar has formed, none the less the disease has returned, and caused death; while at the same time the majority of the patients, though no violent measures are applied in the attempt to remove the tumour, but only mild applications in order to soothe it, attain to a ripe old age in spite of it. No one, however, except by time and experiment, can have the skill to distinguish a cacoethes which admits of being treated from a carcinoma which does not. Therefore, as soon as the lesion is first noted, caustic medicaments should be applied. If the disease is relieved, if tis indications are lessened, the treatment can be advanced to the use of the knife and of the cautery. If it is irritated at once, we may recognize that it is already a carcinoma, and that all acrid and severe remedies are to be avoided. But if the place is hardened without ulceration, it is enough to put on a fig of the fattest sort or the plaster called rhypodes. If there is an ulceration level with the skin, the rose cerate is to be applied, to which must be added powder from a crusted earthenware pot, into which a blacksmith has been accustomed to dip red-hot iron. If there is a considerable growth upon it, copper scales, which are the mildest of the caustics, are to be tried, until they check the tendency to growth; but only so if it is in no wise made worse: when the growth is less prominent we ought to rest content with the rose cerate.

> Latin: Id uitium fit maxime in superioribus partibus, circa faciem, nares, aures, labra, mammas feminarum: †et in ulcere autem aut splene hoc nascitur. Circa locum aliqu⟨a⟩ quasi puncta sentiuntur; isque immobilis, inaequalis tumet, interdum etiam torpet. Circa eum inflatae uenae quasi recuruantur, haeque pallent aut liuent, nonnunquam etiam in quibusdam delitescunt; tactusque is locus aliis dolorem adfert, in aliis ⟨sens⟩um non habet. Et non⟨n⟩unquam sine ulcere durior aut mollior est quam esse naturaliter debet: nonnunquam isdem omnibus ulcus accedit. Interdumque nullam habet proprietatem, interdum simile is est, quae uocant Graeci condyl⟨o⟩mata aspr⟨itu⟩dine quadam et magnitudine; colorque eius ruber est aut lenticulae similis. Neque tuto fer⟨i⟩tur: nam protinus aut resolutio neruorum aut distentio insequitur. Saepe homo ictus ommutescit, atque eius anima deficit: quibusdam etiam, si id ipsum pressum est, quae circa sunt, intenduntur et intumescunt. Ob quae pessimum id genus est. Fereque primum id fit, quod cacoethes a Graecis nominatur; deinde ex eo id carcinoma, quod sine ulcere est; deinde ulcus, ex eo thymium. Tolli nihil nisi cacoethes potest: reliqua curationibus inritantur; et quo maior uis adhibita est, eo magis. Quidam usi sunt medicamentis adurentibus, quidam ferro adusserunt, quidam scalpello exciderunt: neque ulla unquam medicina prof⟨e⟩cit, sed adusta protinus concitata sunt et increuerunt, donec occiderent. Excisa, etiam post inductam cicatricem, tamen reuerterunt et causam mortis adtulerunt: cum interim plerique nullam uim adhibendo, qua tollere id malum temptent, sed imponendo tantum lenia medicamenta, quae quasi blandiantur, quominus ad ultimam senectutem perueniant, non prohibentur. Discernere autem cacoethes, quod curationem recipit, a carcinomate, quod non recipit, nemo scire * potest sed tempore et experimento. —Ergo ubi primum id uitium notatum est, imponi debent medicamenta adurentia. Si leuatur malum, minuuntur eius indicia, procedere curatio potest et ad scalpellum et ad ustionem. Si protinus inritatum est, scire licet iam carcinoma esse, remouendaque sunt omnia acria, omnia uehementia. Sed si sine ulcere is locus durus est, imponi ficum quam pinguissimam aut rypodes emplastrum satis est. Si ulcus aequale est, ceratum ex rosa iniciendum est, adiciendusque ei puluis ex contrita testa, ex qua faber ferrarius tinguere candens ferrum solitus est. Si id nimium supercreuit, temptanda squama aeris est, quae lenissima ex adurentibus est, eatenus ne quid eminere patiatur; sed ita, si nihil exacerbauit: si minus, eodem cerato contenti esse debebimus. Est etiam ulcus, quod ΘΗΡΙΩΜΑ Graeci uocant. Id et per se nascitur et interdum ulceri ex alia causa facto superuenit. Color est uel liuidus uel niger, odor foedus, multus et muc⟨c⟩i⟨s⟩ similis umor.

[¶17] There is also an ulceration which the Greeks call therioma. This may arise spontaneously, and at times it may supervene upon ulceration from another cause. It has either a livid or black colour, a foul odour, and an abundant mucus-like discharge. The ulcer itself is insensitive to touch and applications; there is just disturbance by itching. But around there is pain and inflammation; sometimes even fever is set up, occasionally blood is discharged from the ulceration. This also is a spreading disease. And all these signs often extend, and there results from them an ulcer which the Greeks call phagedaena, because it spreads rapidly and penetrates down to the bones and so devours the flesh. This ulceration is uneven, bog-like; there is a large amount of glutinous discharge; the stench is intolerable, and the inflammation is greater than accords with the extent of the ulceration. Both therioma and phagedaena, like all canker, occur for the most part in the aged or those of a bad habit of body. Both are treated in the same way, but treatment is more necessary in the severer form. Firstly, a regimen must be enforced, so that the patient rests in bed, abstains from food for the first days, drinks very freely of water; also has the bowels moved by a clyster; then, on the subsidence of the inflammation, takes digestible food, avoiding everything acrid; drinks as much as he likes, but for the time being contents himself with water, except that at dinner he may drink a little dry wine. But fasting is not to be used for patients with phagedaena to the same extent as for those with therioma. Over the ulceration too should be dusted dry lign-aloes pounded up or vine-flower, and if this does no good, copper ore; and if by erosion of flesh a sinew has become exposed, it must first be covered by lint, to prevent the medicament from burning it. If still stronger remedies are required, then recourse must be had to more active caustics. But whatever the medicament to be sprinkled on, it ought to be applied by means of the flat end of a probe. Over this should be put either lint soaked in honey or olive-leaves boiled in wine or horehound; and this is to be covered over by lint well wrung out of cold water; the inflammatory swelling around is to be covered with repressant poultices. If there is no benefit from these measures, the place should be burnt with the cautery, exposed sinews being first carefully covered over. The tissue burnt, whether by caustic or by the cautery, is first to be cleaned, then to be filled up with new flesh, as is clear to anyone from what has been stated before.

> Latin: Ipsum ulcus neque tactum neque medicamentum sentit: prurigine tantum mouetur. At circa dolor est et inflammatio; interdum etiam febris oritur, nonnunquam ex ulcere sanguis erumpit. Atque id quoque malum serpit. Quae omnia saepe intenduntur fitque ex his ulcus, quod phagedainam Graeci uocant, quia celeriter serpendo penetrandoque usque ossa corpus uorat. Id ulcus inaequale est, caeno simile; inestque multus umor glutinosus; odor intolerabilis, maiorque quam pro modo ulceris inflammatio. Vtrunque, sicut omnis cancer, fit maxime in senibus uel is, quorum corpora mali habitus sunt.—Curatio utriusque eadem est, sed in maiore malo magis necessaria. Ac primum a uictus ratione ordinandus est, ut quiescat in lectulo, ut primis diebus a cibo abstineat, aquam quam plurimam adsumat; aluus quoque ei ducatur; dein post inflammationem cibum boni suci capiat, uitatis omnibus acribus; potionis quantum uolet, sic ut interdiu quidem aqua contentus sit, in cena uero etiam uini austeri aliquid bibat. Non aeque tamen fame in is, quos ΦΑΓΕΔ⟨Α⟩ΙΝΑ urgebit, atque is, qui therioma adhuc habebunt, utendum erit. Et uictus quidem talis necessarius est. Super ulcus uero inspergenda arida al⟨oe⟩ * oenanthe est, et, si parum proficiet, chalcitis. Ac si quis neruus exesa carne nudatus est, contegendus ante linteolo est, ne sub eo medicamento aduratur. Si ualidioribus etiamnum remediis opus est, ad eas compositiones ueniendum est, quae uehementius adurunt. Quicquid autem inspergitur, auerso specillo infundi debet. Superdanda cum melle sunt uel lin⟨a⟩menta uel oleae folia ex uino decocta uel marrubium; eaque linteolo contegenda in aqua frigida madefacto dein bene expresso; circaque, qua tumor ex inflammatione est, imponenda quae reprimant cataplasmata. Si sub his nihil proficitur, ferro locus aduri debet, diligenter neruis, si qui apparent, ante contectis. Adustum uel medicamentis uel ferro corpus primum purgandum, deinde implendum esse apparere cuilibet ex prioribus potest. Sacer quoque ignis malis ulceribus adnumerari debet. Eius duae species sunt: alterum est subrubicundum aut mixtum rubore atque pallore exasperatumque per pusulas continuas, quarum nulla †alteri maior est, sed plurimae perexiguae: in his semper fere pus et saepe rubor cum calore est.

[¶18] Ignis sacer should be counted also among the bad ulcerations. Of this there are two kinds; one is reddish or partly red, partly pale and roughened by a chronic pustulation, the pustules all of about equal size, but mostly very small: in them there is nearly always pus and often there is redness with heat. And sometimes the disease spreads while the first part attacked is healing; sometimes even after this is ulcerated, when the pustules have ruptured and the ulcer continues and a humour is discharged which appears to be continuing between sanies and pus. It attacks chiefly the chest or flanks or extremities, particularly the soles of the feet. The second form, again, consists of a superficial ulceration, not going deep, but wide, somewhat livid, yet patchy; while it heals at the centre, it extends at the margins. And often the part which apparently had healed again ulcerates. But the skin around, which is about to be invaded by the disease, becomes more swollen and harder and of a dusky red colour. And it is the aged who are mostly afflicted by this malady too or those with a bad habit of body, but chiefly in the legs. Now all cases of erysipelas, although the least dangerous of the ulcerations which spread, are the most difficult to relieve. A chance remedy for it is a one-day fever which carries off noxious humour. The thicker and the whiter the pus, the less the danger. It is also beneficial to make incisions below the opneings of the sores, to let a larger amount of pus escape, and to extract it because the body there is corrupt. If, however, slight fever supervenes, abstinence, rest in bed and a clyster are needed. In erysipelas of all kinds, neither mild and glutinous nor salted and acrid foods should be used, but material of the middle class, such as unleavened bread, fish, kid, poultry and all kinds of game, except wild boar's meat. When there is no feverishness, both rocking and walking are of service, and dry wine and the bath. And in this class of cases drink should be taken more freely than food. gut if the ulceration spreads slowly it should be fomented with hot water; if rapidly, with hot wine; then whatever pustules there are must be opened with a needle; afterwards applications are to be made which corrodeputrid flesh. When the inflammation is relieved and the ulcer cleaned, soothing ointment should be applied. But in the former kind, quinces, boiled in wine and pounded, may prove beneficial, as also a plaster, either that of Heras or the tetrapharmacum, with a fifth part of frankincense added, or black ivy boiled in dry wine; and if the disease is spreading rapidly there is nothing better. When the ulceration has been cleaned, the same soothing remedies which I prescribed above for the superficial variety are sufficient to induce healing.

> Latin: Serpitque id nonnunquam sanescente eo, quod primum uitiatum est, nonnunquam etiam exulcerato, ubi ruptis pusulis ulcus continuatur umorque exit, qui esse inter saniem et pus uideri potest. Fit maxime in pectore aut lateribus aut eminentibus partibus, praecipueque in plantis. Alterum autem est in summae cutis exulceratione, sed sine altitudine, latum, subliuidum, inaequaliter tamen; mediumque sanescit extremis procedentibus. Ac saepe id, quod iam sanum uidebatur, iterum exulceratur. At circa proxima cutis, quae uitium receptura est, tumidior et durior est coloremque habet ex rubro subnigrum. Atque hoc quoque malo fere corpora seniora temptantur aut quae mali habitus sunt, sed in cruribus maxime. —Omnis autem sacer ignis, ut minimum periculum habet ex is, quae serpunt, sic prope difficillime tollitur. Medicamentum eius fortuitum est uno die febris, quae umorem noxium absumat. ⟨P⟩us quo crassius et albidius est, eo periculi minus est. Prodest etiam infra os uulnerum * laedi, qu⟨o⟩ plus puris exeat et id, quod ibi corruptum corpus ⟨est, ex⟩traha⟨tur⟩. Sed tamen si febricula accessit, abstinentia, lectulo, alui ductione opus est. In omni uero sacro igni neque lenibus et glutinosis [cibis], neque salsis et acribus utendum est, sed is, quae inter utrunque sunt, qualis est panis sine fermento, piscis, haedus, aues, exceptoque apro omnis fere uenatio. Si non est febricula, et gestatio utilis est et ambulatio et uinum austere et balneum. Atque in hoc quoque genere potio magis liberalis esse quam cibus debet. Ipsa autem ulcera si mediocriter serpunt, aqua calida, si uehementius, uino calido fouenda sunt; deinde acu pusulae, quaecunque sunt, aperiendae; tum imponenda ea, quae putrem carnem exedunt. Vbi inflammatio sublata ulcusque purgatum est, imponi lene medicamentum debet. In altero autem genere possunt proficere mala Coton⟨e⟩a in uino cocta atque contrita, potest emplastrum uel H⟨e⟩rae uel tetr⟨a⟩pharmacum, cui quinta pars turis adiecta sit, potest nigra hedera ex uino austero cocta; ac, si celeriter malum serpit, non aliud magis proficit. Purgato ulcere, quod in summa cute esse proposui, satis ad sanitatem eadem lenia medicamenta proficient. Chironeum autem ulcus appellatur, quod et magnum est et habet oras duras, callosas, tumentes. Exit sanies non multa sed tenuis. Odor malus neque in ulcere neque in eius umore est; nulla inflammatio, dolor modicus est;

[¶19] Again, the ulcer called chironean is large and has hard, callous, swollen margins. A sanies exudes, which is not copious, but thin. There is no bad odour, either in the ulcer or in its discharge; no inflammation; pain is moderate; it does not spread, so it brings no design, but it does not heal rapidly. At times a thin scab is produced, then in turn it is broken down and the ulceration is renewed. It occurs chiefly on the feet and legs. On it should be applied something which is at once soothing, and active and repressant, such as the following: copper scales, washed lead calcined, 16 grams each, cadmia and wax, 32 grams each, along enough rose-oil to give the wax together with the other materials a soft consistence.

> Latin: nihil serpit, ideoque nullum periculum affert, sed non facile sanescit. Interdum tenuis cicatrix inducitur, deinde iterum rumpitur ulcusque renouatur. Fit maxime in pedibus et cruribus. Super id imponi debet, quod et lene aliquid et uehemens et reprimens habeat. Quale eius rei causa fit ex his: squamae aeris, plumbi eloti combusti, singulorum P. #1108 IIII; ca⟨d⟩miae, cerae, ⟨singulorum⟩ P. #1108 VIII; rosae quantum satis est ad ceram simul cum eis molliendam. Fiunt etiam ex frigore ulcera hiberna, maxime in pueris, et praecipue pedibus digitisque eorum, nonnunquam etiam in manibus.

[¶20] Ulcers are also produced in winter by the cold, mostly in children, and particularly on their feet and toes, sometimes also on the hands. There is redness with moderate inflammation; some pustules arise followed by ulceration; the pain is moderate. The itching is greater; at times humour exudes, but not much; it seems to resemble either pus or sanies. In the first place, the ulcers are to be fomented freely with a hot decoction of turnips, or, if these are not to be had, some kind of repressant vervain. If there is not yet an open ulcer, copper scales as hot as can be borne are to be applied. If there is already an ulceration, then apply equal parts of alum and frankincense pounded together with the addition of wine, or pomegranate-rind boiled in water and then pounded. If the skin has become detached, in that case also soothing medicaments do good.

> Latin: Rubor cum inflammatione mediocri est; interdum pusulae oriuntur, deinde exulceratio: dolor autem modicus. Prurigo maior est: nonnunquam umor exit, sed non multus, qui referre uel pus uel saniem uidetur.—In primis multa calida aqua fouendum est, in qua rapa decocta, aut si ea non sunt, aliquae uerbenae ex reprimentibus. Si n⟨on⟩dum adapertum ulcus, aes, quam maxime calidum quis pati potest, admouendum est. Si iam exulceratio est, imponi debet alumen aequa portione cum ture contritum uino adiecto, aut malicorium in aqua coctum deinde contrit⟨um⟩. Si summa detracta pellicula est, hic quoque melius lenia medicamenta proficiunt. Struma quoque est tumor, in quo subter concreta quaedam ex pure et sanguine quasi glandulae oriuntur;

[¶21] Struma, again, is a swelling, in which there occur underneath certain concretions of pus and blood like little glands; they are specially embarrassing to medical men, for they set up fever and yet do not quickly come to a head; and whether they are treated by incision or by medicaments, they are generally prone to recur in the neighbourhood of their scars, and this happens much more often after the application of medicaments; and in addition to all this, they are of long duration. These swellings arise particularly in the neck, but also in the armpits and groins and in the flanks. The surgeon Meges stated that he had met with them also in the breasts of women.

> Latin: quae uel praecipue fatigare medicos solent, quoniam et febres mouent nec unquam facile maturescunt; et siue ferro siue medicamentis curantur, plerumque iterum iuxta cicatrices ipsas resurgunt multoque post medicamenta saepius; quibus id quoque adcedit, quod longo spatio detinent. Nascuntur maxime in ceruice, sed etiam in alis et inguinibus * lateribus: in mammis quoque feminarum se reperisse [chirurgicus] Meges auctor est. —Propter haec et album ueratrum recte datur, atque etiam saepius, donec ea digerantur, et medicamenta imponuntur, quae umorem uel educant uel dissipent, quorum supra mentio facta est.

[¶22] For these white hellebore is an appropriate remedy, and this must be taken frequently until they are dispersed; and also the medicaments which have been mentioned above are applied in order to draw out or disperse the humour. Some also use caustics which eat away, and by forming a scab harden the place; after which they dress it like an ulceration. Whatever the mode of treatment, however, after the ulcer has cleaned, the patient is to have exercise and nourishment until the scar is formed. Although these are the doctrines of the physicians; it has been found out by the experience of some country folk, that anyone with a bad struma may be freed from it by eating a snake.

> Latin: Adurentibus quoque quidam utuntur, quae exedunt crustaque eum locum astringant; tunc uero ut ulcus curant. Quaecunque autem ratio curandi est, corpus puro ulcere exercendum atque alendum est, donec ad cicatricem perueniat. Quae cum medici doceant, quorundam rusticorum experimento cognitum, quem struma male habet, si [eum] anguem edit, liberari. Furunculus uero est tuberculum acutum cum infla⟨mma⟩tione et dolore, maximeque ubi iam in pus uertit. Qui ubi adapertus est, et exit ⟨pus⟩, apparet pars carnis in ⟨p⟩us uersa, pars corrupta subalbida, subrubra, quem uentriculum quidam furunculi nominant.

[¶23] The boil, again, is a pointed swelling attended by inflammation and pain, and especially so when it is being converted into pus. When it has opened and the pus gone out, it is seen that part of the flesh has been turned into pus, part into a greyish-reddish core which some call the sac of the boil. There is no danger in it, even although no treatment is adopted; for it ripens of itself, and bursts; but the pain renders treatment preferable in order to afford earlier relief. The special medicine for this is galbanum; but there are others also which have been mentioned above. If none of these are available a plaster that is not greasy should first be applied to disperse it; next, if this is not effective, something adapted to promote suppuration; if even that is not to be had, either raisin wine or yeast. When the pus has been squeezed out, no further treatment is needed.

> Latin: In eo nullum periculum est, etiam ut nulla curatio adhibeatur: maturescit enim per se atque erumpit: sed dolor efficit, ut potior medicina sit, quae maturius liberet.—Proprium eius medicamentum galbanum est: sed alia quoque ⟨quae⟩ supra comprehensa sunt. Si cetera desunt, imponi debe⟨t⟩ primum non pingue emplastrum, ut id reprimat; deinde, si non repressit, quodlibet puri mouendo accommodatum; si ne id quidem est, uel resina uel fermentum. Expresso pure nulla ultra curatio necessaria est. Phyma uero nominatur tuberculum furunculo simile, sed rotundius et planius, saepe etiam maius. Nam furunculus oui dimi⟨dii⟩ magnitudinem raro explet, nunquam excedit: phyma etiam latius patere consueuit, sed inflammatio dolorque sub eo minores sunt.

[¶24] A phyma is a swelling which resembles a boil, but is rounder and flatter, often also larger. For a boil rarely reaches the size of half an egg, and never exceeds it; a phyma commonly extends even over a wider area, but the pain and the inflammation in it are less. When it has been opened, pus appears in the same way; no core is found as in a boil, in fact all the corrupted flesh is turned into pus. Now in children this occurs more often and is more readily relieved; in young adults it is more rare and more difficult to treat. Where age has hardened the body, the disease does not even occur. By what medicaments it should be dispersed has been stated above.

> Latin: Vbi diuisum est, pus eodem modo apparet; uentriculus, ut in furunculo, non inuenitur, uerum omnis corrupta caro in pus uertitur. Id autem in pueris et saepius nascitur et facilius tollitur: in iuuenibus rarius ori⟨tur⟩ et difficilius curatur. Vbi aetas indurauit, ne nascitur quidem. Quibus uero medicamentis discuteretur, supra propositum est. Phyget⟨r⟩on autem est tumor non altus, latus, in quo quiddam pusulae simile est. Dolor distentioque uehemens est, et maior quam pro magnitudine tumoris, interdum etiam febricula. Idque tarde maturescit neque magnopere in pus conuertitur.

[¶25] Phygetron, again, is a wide swelling, not much raised up, in which there is a certain resemblance to a pustule. The pain and tension is severe, and more than would be expected from the size of the swelling; at times there is also feverishness. The ripening takes place slowly, and not much pus is formed. It occurs particularly on the top of the head, or in the armpits or groins. Our people call it panus, from its spindle-shape. And I have pointed out above by what medicament this should be relieved.

> Latin: Fit maxime aut in uertice aut in alis aut inguinibus. Pan⟨u⟩m a similitudin⟨e⟩ figurae nostri uocant. Atque id ipsum quo medicamento tolleretur, supra demonstraui. Sed cum omnes hi nihil nisi minuti abscessus sint, generale nomen trahit latius uitium ad suppurationem spectans; idque fere fit aut post febres aut post dolores partis alicuius maximeque eos, qui uentrem infestarunt.

[¶26] But although all these diseases are really only minute abscesses, that name implies in general a more extensive lesion, tending to suppuration; and it occurs usually either after fevers or after pains in some part, and particularly after those which have attacked the abdomen. And generally it is visible, since there is some rather widespread swelling, like that which I have previously described as called phyma, and it grows red and hot and shortly afterwards hard as well, and becomes more painful as it increases and occasions both thirst and insomnia: sometimes, however, there may be none of these signs to note in the skin, and especially when pus is forming more deeply; but along with the thirst and insomnia some stabbing pains are felt internally. And it is more favourable when it does not become harder on a sudden, and although it does not redden, nevertheless changes somewhat in colour. Such are the signs which arise when pus is already forming; the swelling and redness begin long before. But if the place is soft, the gathering of the diseased matter is to be diverted by poultices which are at the same time repressant and cooling; such as I have mentioned elsewhere, and just above under erysipelas: if it has become already hard, recourse must be had to poultices for dispersing and resolving; such as a dried and crushed fig, or wine-lees mixed with cerate, made up with hog's lard, or cucumber-root to which has been added twice the weight of flour, previously boiled in honey wine. Again, we may mix equal part by weight of ammoniacum, galbanum, propolis, mistletoe-juice, and of myrrh half as much by weight as of the other ingredients. And the plasters and emollients which I have described above have the same effect. A swelling which has not been dispersed by such measures must needs mature; that it may do so more quickly, barley-meal should be put on boiled in water with which also some herb should be mixed. The same applications are appropriate also for the smaller abscesses, the names and peculiarities of which I have referred to above; treatment is the same for all, only differing in degree.

> Latin: Saepiusque oculis expositum est, siquidem latius aliquid intumescit ad similitudinem eius, quod phyma uocari proposui, rubetque cum calore et paulo post etiam cum duritia, magisque †innocenter indolescit et sitim uigiliamque exprimit: interdum tamen nihil horum in cute deprehendi potest, maximeque ubi altius pus mouetur, sed cum siti uigiliaque sentiuntur intus aliquae punctiones. Et quod desubito durius non est, mollius est et quamuis non rubet, coloris tamen aliter mutati est. Quae signa iam pure oriente nascuntur: tumor ruborque multo ante incipiunt. Sed si locus mollis est, auertendus is materiae ⟨a⟩ditus est per cataplasmata, quae simul et reprimunt et refrigerant; qualia et alias et paulo ante in erysipelate proposui: si iam durior est, ad ea ueniendum est, quae digerant et resoluant; qualis est ficus arida contusa, aut faex mixta cum cerato, quod ex adipe suilla coactum sit, aut cucumeris radix, cui ex farina duae partes adiectae sint ante ex mulso decoctae. Licet etiam miscere aequis portionibus Hammoniacum, galbanum, propolim, uiscum, pondusque adicere myrrae dimidio minus quam in prioribus singulis erit. Atque emplastra quoque et malagmata idem efficiunt, quae supra explicui. Quod per haec discussum non est, necesse est maturescat; idque quo celerius fiat, imponenda est farina hordeacia ex aqua cocta * * * recte miscetur. Eadem autem haec in minoribus quoque abscessibus, quorum nomina proprietatesque supra reddidi, recte fiunt; eademque omnium curatio, tantum modo distat. Crudum est autem, in quo magis quasi * uenarum motus est, et grauitas et ardor et distentio et dolor et rubor et durities et, si maior abscessus est, horror aut etiam febricula permanet; penitusque condita suppurati⟨o est⟩, si pro his, quae alibi cutis ostendit, punctiones sunt. Vbi ista se remiserunt, iamque is locus prurit et aut subliuidus aut subalbidus est, matura suppuratio est;

## 21. Book V · chapter 28

Source: https://scriptura.si/works/celsus-on-medicine/21/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/21/#p-N

[¶0] Now a swelling is immature when the blood-vessels throb more as if they were bubbling and there is weight and heat and tension and pain and redness and hardening and, if the abscess is larger, shivering or even persistent feverishness; and a suppuration is completely concealed, if, instead of the signs presented by the skin in other cases, there are stabbing pains. When these signs subside, and the place begins to itch, and is either bluish or greyish, the suppuration has matured; and when it has been opened by means of these medicaments or even by the knife, the pus must be let out. Then if there are any abscesses in the armpits or groins, they must be dressed without inserting lint. In other parts also, if there is one small opening, if there has been moderate suppuration, if it has not penetrated deeply, if there is no fever, if the patient is strong, lint is equally superfluous. In other cases lint should be applied, but sparingly, and only if the opening is large. It is beneficial, whether lint is used or not, to apply lentil meal with honey, or pomegranate rind boiled in wine; these are suitable alone or mixed together. If the parts are hard, they should be softened by applying either pounded mallow or fenugreek or flax seed boiled in raisin wine. Whatever dressing is afterwards applied should not be tight but bandaged on lightly. No one should be misled into applying a cerate in this sort of case. All the other directions for cleaning the ulceration, forming flesh, and inducing a scar have been described in treating of wounds.

> Latin: eaque ubi uel per ipsa medicamenta uel etiam ferro aperta est, pus debet emitti. Tum si qua in alis uel inguinibus sunt, sine lin⟨a⟩mento nutrienda sunt. In ceteris quoque partibus, si una plaga exigua est, si mediocris suppuratio fuit, si non alte penetrauit, si febris non est, si ualet corpus, aeque lin⟨a⟩menta superuacua sunt. In reliquis, parce tamen, nec nisi * plaga est, imponi debent. Commode uero uel super lin⟨a⟩menta uel sine his imponitur lenticula ex melle aut malicorium ex uino coctum; quae et per se et mixta idonea sunt. Si qua circa duriora sunt, ad ea mollienda uel malua contrita uel faeni Graeci liniue semen ex passo coctum superdandum est. Quicquid deinde impositum est, non astringi sed modice deligari debet. Illo neminem decipi decet, ut in hoc genere cerato utatur. Cetera quae pertinent ad purgandum ulcus, ad implendum, ad cicatricem inducendam, conueniuntque, in uulneribus exposita sunt. Nonnunquam autem et ex eiusmodi abscessibus et ex aliis ulcerum generibus fistulae oriuntur. Id nomen est ulceri alto, angusto, calloso. Fit in omni fere parte corporis, habetque quaedam in singulis locis propria. Prius de communibus dicam. Genera igitur plura fistularum sunt, siquidem aliae breues sunt, aliae altius penetrant; aliae rectae intus feruntur, aliae multoque plures transuersae;

[¶1] Sometimes, again, fistulae arise, both from abscesses of this kind and from other sorts of ulceration. A fistula occurs in almost any part of the body, but in each place it has some peculiarities. I shall speak first of its general characteristics. There are many kinds of fistulae, then, and whilst some are short, others penetrate deeper; some run straight inwards, others, and by far the most numerous, crosswise; some are simple, others beginning by one opening form two or three branches inside or even divide into several passages; some go straight, others are curved and tortuous. Some end in the flesh, others penetrate to bone or to cartilage, or, when neither of these is underneath, reach to the inner parts; some, therefore, are treated easily, others with difficulty; and some are even found to be incurable. The treatment is speedy when the fistula is simple, recent and only involving the flesh, and the body itself helps, when it is youthful and sound: contrary conditions are inimical; also if the fistula has damaged bone or cartilage or sinew or muscles; if it has involved a joint; or if it has penetrated either to the bladder of lung or womb or to large veins or arteries or to hollow regions, which as the throat, gullet or thorax. When too the fistula goes towards the intestines it is always dangerous, often deadly. When the body is either sick or aged or in bad condition, the case is much worse. First of all, however, it is prisoner to pass a probe into the fistula, that we may learn both its direction and depth, and at the same time whether it is moist or rather dry. This is known when the probe is withdrawn. But if there is bone in the neighbourhood, we can also learn whether the fistula has reached and penetrated the bone or not, and how far the damage has gone. For if what is touched by the end of the probe is soft, the disease is still limited to the flesh; if it meets with more resistance, the fistula has reached bone. But when the probe slides smoothly, there is not yet decay; if it does not so slide, but meets with an even surface, there is some decay although still slight; if what underlies is uneven also and rough, the bone has become more seriously eaten away. But the position of the fistula shows where there is underlying cartilage, and resistance to the probe shows when this has been reached. And from these signs we may gather the situation, extent and harmfulness of fistulae; whether too they are simple, or have several branches, can be estimated from the amount of pus; for it there is more than one opening will account for, it is clear that there are several branches; and since generally flesh and sinew and sinewy tissue such as sheaths and membranes are near the fistula, the character of the pus also will show whether the several branches have eaten into other parts of the body. For pus derived from flesh is smooth, white and fairly plentiful; from sinewy structures it is of the same colour but thinner and less in quantity; from sinews it is fatty and not unlike oil. Further also, the bending of the body indicates whether the fistulae have penetrated in several directions, because often when a patient has changed his recumbent posture, or held a limb in a different position, pus which had previously ceased, begins to discharge again; and it then becomes evident, not only that there is another branch from which pus is being discharged, but also that it is tending into another part of the body. But if the fistula is in the flesh, and is recent and simple, and is not tortuous or in a cavity or joint, but in a part which remains still unless moved with the body generally, a sufficiently effective application is a plaster such as is applied to recent wounds, so long as it is composed of either salt or of alum or of copper scales or of verdigris or some other metallic substances; and from this a tent should be made, thinner at one end, a little thicker at the other. This should be passed into the fistula with the pointed end forwards, and be kept until pure blood shows itself. Such are the general rules for the use of all tents for fistulae. Next, the same plaster spread on lint is put over the place, and over that is applied a sponge dipped in vinegar; it is sufficient to change the dressing on the fifth day. The class of food to be used is that which I have prescribed for making flesh. And if the fistula is at some distance from the praecordia, the patient should eat radishes at intervals on an empty stomach, and then vomit. A fistula of long standing becomes callous. Now no one can mistake callus, for it is hard and either white or pallid. But there is then need for stronger medicines: such as that which has of poppy tears 4 grams, gum 12·66 grams, cadmia 16 grams, blacking 32 grams, worked up water to form a tent. Or else there is the composition containing galls 1 gram, verdigris, sandarach, Egyptian alum, 1·16 gram each, roasted blacking 2·32 grams. Or that which is compose of copper ore and limestone, with half as much orpiment as of each of the other two; and these are taken up in boiled honey. But the quickest remedy is that prescribed by meges; rub up verdigris scrapings 8 grams, then dissolve ammoniacum for incense 1·16 gram in vinegar, and work the verdigris into this infusion; and this is one of the best remedies. But whilst the above remedies are the most efficacious, when they are not at hand it is easy to eat away the callus with any of the caustic medicaments; it is enough to smear one of them on rolled papyrus, or upon a pledget of wool twisted into the shape of a tent. Squills boiled and mixed with quicklime also eat away callus. If, however, the fistula is longer but runs crosswise, it is best to insert a probe and to cut down upon its end; then a tent is passed into each opening. But if we deem the fistula to be double or multiple, yet only short and confined to flesh, we should not make use of a tent, because it treats one part and omits the rest; but the same medicaments, dry, are put into a writing-quill, and that having been placed against the orifice of the fistula is to be blown through, in order that these medicaments may be forced in; or the same materials dissolved in wine, or, if the fistula is more foul, in honey wine, or, if more callous, in vinegar, are to be poured in. Whatever is introduced, refrigerants and repressants must be put on over the wound; for generally the parts surrounding the fistula are somewhat inflamed. It is not inappropriate, when changing the dressing and again before inserting fresh medicaments, to wash out the fistula, using an ear syringe; with wine if there is much pus; with vinegar if there is hard callus; if it is already clean, with honey wine or a decoction of vetch, to which also a little honey should be added. Thus it generally happens that that covering which is between the opening and the sound flesh is destroyed by the medicaments and comes quite away, and underneath is a clean ulceration; when this has occurred, agglutinants are applied, especially a sponge steeped in boiled honey. I am not unaware that many favour the insertion of lint formed into a tent and dipped in honey; but this agglutinates more quickly than flesh is formed. There need be no fear that clean flesh in contact with clean flesh will fail to unite: we see that there is often no need to add medicaments as well to effect this, since often when there is ulceration of the fingers, unless we have taken careful precautions, they become joined together whilst healing.

> Latin: aliae simplices sunt, aliae duplices triplicesue ab uno ore intus orsae quae fiunt; aut etiam in plures sinus diuiduntur; aliae rectae, aliae flexae et tortuosae sunt. Aliae intra carnem desinunt, aliae ad ossa aut cartilaginem penetrant aut, ubi neutrum horum subest, ad interiora perueniunt; aliae deinde facile, aliae cum difficultate curantur; atque etiam quaedam insanabiles reperiuntur.—Expedita curatio in fistula simplici recenti intra carnem, adiuuatque ipsum corpus, si iuuenile, si firmum est: inimica contraria his sunt; itemque si fistula os uel cartilaginem uel neruum uel musculos laesit; si articulum occupauit; si uel ad uessicam uel ad pulmonem uel ad uuluam uel ad grandes uenas arteriasue uel ad inania, ut guttur, stomachum, thoracem, penetrauit. Ad intestina quoque eam tendere semper periculosum, saepe pestiferum est. Quibus multum mali accedit, si corpus uel aegrum uel senile ⟨uel⟩ mali habitus est. Ante omnia autem demitti specillum in fistulam conuenit, ut quo tendat et quam alte perueniat, scire possimus, simul etiam protinus umida an siccior sit; quod extracto specillo patet. Si uero os in uicino est, id quoque disci potest, iam necne eo fistula peruenerit; * * penetrauit, quatenus nocuerit. Nam si molle est, quod ultimo specillo contingitur, intra carnem adhuc uitium est: si magis id renititur, ad os uentum est. Ibi deinde si labitur specillum, nondum caries est: si non labitur, sed aequali innititur, caries quidem, uerum adhuc leuis est: si inaequale quoque et asperum subest, uehementius os exessum est. At cartilago ubi subsit, ipsa sedes docet peruentumque esse ad eam ex renisu patet. Et ex his quidem colliguntur fistularum sedes, spatia, noxae: simplices uero eae sint, an in plures partes diducantur, cognosci potest ex modo puris; cuius si plus fertur quam quod simplici spatio conuenit, plures sinus esse manifestum est; cumque fere iuxta sint caro et neruos et aliqua neruosa, quales fere tunicae membranaeque sunt, genus quoque puris docebit, num plures sinus intus diuersa corporis genera perroserint. Siquidem in carne pus leue, album, copiosius fertur; at ex neruoso loco coloris quidem eiusdem, sed tenuius et minus; ex neruo pingue et oleo non dissimile. Denique etiam corporis inclinatio docet, num in plures partes fistulae penetrarint, quia saepe cum quis aliter decubuit aliterue membrum conlocauit, pus ferri quod iam desierat iterum incipit; testaturque non solum alium sinum esse ex quo descendat, sed etiam in aliam corporis partem eum tendere. Sed si ⟨et⟩ in carne et recens et simplex est, ac neque rugosa neque caua sede neque in articulo, sed in eo membro, quod per se inmobile non nisi cum toto corpore mouetur, satis proficiet emplastrum, quod recentibus uulneribus inponitur, dum habeat uel sale uel alumen uel squamam aeris uel aeruginem uel ex metallicis aliquid; exque eo collyrium fieri debet altera parte tenuius, altera parte paulo plenius; idque ea parte, qua tenuius est, antecedente demitti oportet in fistulam, donec purus sanguis se ostendat. Quae in omnibus collyris fistularum perpetua sint. Idem deinde emplastrum in linteolo superinponendum, supraque inicienda spongia est in acetum ante demissa; soluique quinto die satis est. Genusque uictus adhibendum est, quo carnem ali docui. Ac si longius a praecordis fistula est, ex interuallo ieiunum radiculas esse, deinde uomere necessarium est. Vetustate callosa fit fistula. Callus autem neminem fallit, quia durus est et aut albus aut pallidus. Sed tum ualidioribus medicamentis opus est; quale est, quod habet: papaueris lacrimae P. #1108 I; cummis P. #1108 III #1109; cadmiae P. #1108 IIII; atramenti sutori P. #1108 VIII; ex quibus aqua coactis collyrium fit. Aut in quo sunt: gallae P. #1108 #1109 #1110; aeruginis, sandaracae, aluminis Aegypti, singulorum P. #1114 I; atramenti sutori conbusti P. #1114 II. Aut quod constat ex chalcitide et saxo calcis, quibus auripigmenti dimidio minus quam in singulis prioribus est adicitur; eaque melle cocto excipiuntur. Expeditissimum autem est ex praecepto Megetis aeruginis rasae P. #1108 II conterere, deinde Hammoniaci thymiamatis P. #1114 I aceto liquare, eoque infuso aeruginem c⟨o⟩gere; idque ex primis medicamentis est. Sed ut haec maximi effectus sunt, sic, cui i⟨s⟩ta non adsunt, facile tamen est callum quibuslibet adurentibus medicamentis erodere: satisque est uel papyrum intortum uel aliquid ex penicillo in modum collyri adstrictum eo inlini. Scilla quoque cocta et mixta cum calce callum exest. Si quando uero longior sed transuersa fistula est, demisso specillo contra principium huius incidi commodissimum est, et collyrium utrinque demitti. At si duplicem esse fistulam aut multiplicem existimamus, sic tamen ut breuis intraque carnem sit, collyrio uti non debemus, quod unam partem curet, reliquas omittat; sed eadem medicamenta arida in calamum scriptorium coicienda sunt, isque ori fistulae aptandus, inspirandumque, ut ea medicamenta intus conpellantur: aut eadem ex uino liquanda, uel, si sordidior fistula est, ex mulso, si callosior, ex aceto sunt idque intus infundendum. Quicquid inditum est, superponenda sunt, quae refrigerent et reprimant: nam fere quae circa fistulam sunt, habent aliquid inflammationis. Neque alienum est, ubi qui soluerit, antequam rursus alia medicamenta coiciat, per oricularium clysterem fistulam eluere; si plus puris fertur, uino; si callus durior est, aceto; si iam purgatur, mulso uel aqua, in qua eruum coctum sit, sic ut huic quoque mellis paulum adiciatur. Fere uero fit, ut ea tunica, quae inter f⟨o⟩r⟨a⟩men et integram carnem est, uicta medicamentis tota exeat, infraque ulcus purum sit; quod ubi contigit, imponenda glutinantia sunt, praecipueque spongia melle cocto inlita. Neque ignoro multis placuisse lin⟨a⟩mentum in modum collyri compositum tinctum melle demitti; sed celerius id glutinat quam impletur. Neque uerendum est, ne purum corpus puro corpori iunctum non coeat: adiectis quoque medicamentis ad id efficacibus * * * cum saepe exulceratio digitorum, nisi magna cura prospeximus, sanescendo in unum eos iungat. Est etiam ulceris genus, quod a faui similitudine ΚΗΡΙΟΝ a Graecis nominatur, idque duas species habet. Alterum est subalbidum, furunculo simile, sed maius et cum dolore maiore. Quod ubi maturescit, habet foramina, per quae fertur umor glutinosus et purulentus; neque tamen ad iustam maturitatem peruenit. Si diuisum est, multo plus intus corrupti quam in furunculo apparet altiusque descendit. Raro fit nisi in scapulis.

[¶2] There is besides a class of ulceration which the Greeks call κηρίον from its resemblance to honeycomb, and of this there are two kinds. One is greyish, like a boil, but larger and more painful. As it is maturing, holes appear through which is discharged a glutinous and purulent humour; yet it does not properly mature. If it is cut into, there appears much more corruption than in a boil, and it penetrates deeper. It is rare except in the scapular region. The other kind is found only in the head; it projects less above the surface, is hard, broad, greenish or greyish-green in colour, more ulcerated; there are holes at the root of each hair, through which is discharged a glutinous greenish-white humour, in consistency like honey or mistletoe-juice, or at times like olive-oil. If it is cut into, the flesh within appears green. The pain also and inflammation are so severe that they generally cause acute fever. On a case which is only irritated by a few openings, suitable applications are a dry fig and linseed boiled in honey wine or plasters or emollients which draw out diseased matter, or the medicaments noted above for such purposes. For the other form of this, the same medicaments are good, also flour boiled in honey wine mixed with half its quantity of turpentine-resin; also a fig boiled in honey wine, to which a little pounded hyssop may be added; also black bryony berries, added to a fig, one part to three. If in either case medicaments are of little service, the whole ulceration ought to be cut away down to the sound flesh. When the ulceration is removed, medicaments are put on the wound, first to promote suppuration, next to clean it, and then to make flesh. There are also certain wart-like ulcerations, different in name and in their ill-effects. They call one acrochordon, when some material which is rather hard and at times somewhat rough, collects under the skin: its colour is that of the skin; it is thin underneath, broadening nearer the skin; of moderate size, as it is seldom larger than a bean. It is rare to find one alone, but generally there are several, and they are mostly found in children; and sometimes they go suddenly, sometimes they cause slight inflammation, and under this they even turn into pus. But that which is named thymion projects above the surface like a little wart, narrow near the skin, wider above, hardish and at the top very rough. The top in colour is like flowers of thyme, whence its name, and there it is readily split and made to bleed; at times the bleeding is considerable; it is generally about the size of an Egyptian bean, rarely larger, sometimes quite small. Sometimes one is alone, generally several grow together, either on the palms or soles of the feet. The worst, however, are situated upon the genitals, and there they bleed the most. But those called myrmecia are less prominent and harder than the thymion, their roots are more deeply fixed and they are more painful: they are broad underneath but thin above, they bleed less, and they scarcely ever exceed the size of a lupin. These also grow either on the palms or soles of the feet. The clavus, again, though occasionally found elsewhere, occurs mostly on the feet, and especially after contusions, although sometimes from other causes; it causes pain when walking, though not at other times.

> Latin: Alterum * * * est minus super corpus eminens, durum, latum, subuiride, subpallidum, magis exulceratum: siquidem ad singulorum pilorum radices foramina sunt, per quae fertur umor glutinosus, subpallidus, crassitudinem mellis aut uisci referens, interdum olei. Si inciditur, uiridis intus caro apparet. Dolor autem ⟨et⟩ inflammatio ingens est, adeo ut acutam quoque febrem mouere consuerint.—Super id, quod minus crebris foraminibus exasperatum est, recte inponitur et ficus arida et lini semen in mulso coctum et emplastra ac malagmata materiam educentia, aut quae proprie huc pertinentia supra posui. Super alterum et eadem medicamenta, et farina ex mulso cocta, sic ut ⟨e⟩i dimidium resinae terebenthinae misceatur; et ficus in mulso decocta, cui paulum hysopi contriti sit adiectum; et uuae t⟨a⟩miniae pars quarta fico adiecta. Quod si parum in utrolibet genere medicamenta proficiunt, totum ulcus usque ad sanam carnem excidi oportebit. Vlcere ablato super plagam medicamenta danda sunt, primum quae pus citent, deinde quae purgent, tum quae impleant. Sunt uero quaedam uerrucis similia, quorum diuersa nomina ut uitia sunt. ACROCHORDONA uocant, ubi sub cute coit aliquid durius, et interdum paulo asperius, coloris eiusdem, infra tenue, ad cutem latius; idque modicum est, quia raro fabae magnitudinem excedit. Vix unum tantum eodem tempore nascitur, sed ⟨fere⟩ plura, maximeque in pueris; eaque nonnumquam subito desinunt, nonnumquam mediocrem inflammationem excitant; sub qua etiam in pus conuertuntur. At THYMION nominatur, quod super corpus quasi uerrucula eminet, ad cutem tenue, supra latius, subdurum et in summo perasperum. Idque summum colorem floris thymi repraesentat, unde ei nomen est, ibique facile finditur et cruentatur; nonnumquam aliquantum sanguinis fundit, fere⟨que⟩ circa magnitudinem fabae Aegyptiae est, raro maius, interdum perexiguum. Modo unum autem, modo plura nascuntur, uel in palmis uel inferioribus pedum partibus. Pessima tamen in obscenis sunt maximeque ibi sanguinem fundunt. MYRMECIA autem uocantur humili⟨o⟩ra thym⟨i⟩o durioraque, quae radices altius exigunt maioremque dolorem mouent: infra lata, super autem tenuia, minus sanguinis mittunt; magnitudine uix umquam lupini modum excedunt. Nascuntur ea quoque aut in palmis, aut inferioribus pedum partibus. CLAVVS autem nonnumquam quidem alibi, sed in pedibus tamen maxime nascitur, praecipue ex contuso, quamuis interdum aliter; dolorem, etiamsi non alias, tamen ingredienti mouet. Ex his acrochordon et thymium saepe etiam per se finiuntur, et quo minora sunt, eo magis. Myrmecia et claui sine curatione uix umquam desinunt. Acrochordon, si excissa est, nullam radiculam reli⟨n⟩quit, ideoque ne renascitur quidem. Thymio clauoque excissis, sub⟨ter⟩ rotunda radicula nascitur, quae penitus descendit ad carnem, eaque relicta idem rursus exigit. Myrmecia latissimis radicibus inhaerent, ideoque ne excidi quidem sine exulceratione magna possunt.

[¶3] Of these the acrochordon and thymion often end of themselves, and the more so the smaller they are. The myrmecia and corns scarcely ever subside without treatment. The acrochordon, if cut off, leaves no trace of a root behind, and so does not sprout again. When the thymion and clavus have been cut off, a small rounded root is formed underneath, which penetrates right down into the flesh, and if this is left behind it sprouts up again. The myrmecia are held by very broad roots, and so cannot be excised without causing a large wound. A corn is best scraped down from time to time; for thus, without any violence, it softens, and if also a little blood is let out, it often dies away. It is also removed if we clean the part round it and then put on resin mixed with a little powdered millstone. All the other varieties are to be burnt away by medicaments: for some the ash of wine-lees is best; for myrmecia the application made of alum and sandarach. But the skin all round should be covered with leaves that it also may not become ulcerated; afterwards lentil meal is put on. Even a fig in boiled water removes a thymium.

> Latin: Clauum subinde radere commodissimum est: nam sine ulla ui sic mollescit; ac si sanguinis quoque aliquid emissum est, saepe emoritur. Tollitur etiam, si quis eum circumpurgat, deinde inponit resinam, cui miscuit pulueris paulum, quem ex lapide molari contrito fecit. Cetera uero genera medicamentis adurenda sunt; aliisque id, quod ex faece uini; myrmecis id, quod ex alumine et sandaraca est, aptissimum. Sed ea, quae circa sunt, foliis contegi debent, ne ipsa quoque exulcerentur; deinde postea lenticula imponi. Tollit thym⟨i⟩um etiam ficus in aqua cocta. At pusulae maxime uernis temporibus oriuntur. Earum plura genera sunt. Nam modo circa totum corpus partemue aspritudo quaedam fit, similis iis pusulis, quae ex urtica uel sudore nascuntur: exanthemata Graeci uocant; eaque modo rubent, modo colorem cutis non excedunt. Nonnumquam plures similes uaris oriuntur, nonnumquam maiores pusulae liuidae aut pallidae aut nigrae, aut aliter naturali colore mutato;

[¶4] Pustules arise chiefly in the spring; there are many kinds. For at times a sort of roughness comes all over the body, or a part of it, resembling the pustules which are set up by nettles or by sweating; exanthemata the Greeks call them. At times they are red, at times no redder than the colour of the skin; sometimes a number occur resembling pimples, sometimes the pustules are larger, livid or pallid or black or otherwise changed from the natural colour; and there is humour underneath them. When these have burst the flesh below looks as if it were ulcerated; in Greek these are called phlyctaenae. They are produced either by cold or by heat or by medicaments. A phylacion is a somewhat harder pustule, whitish and pointed, from which moisture is squeezed out. But after pustules at times small ulcerations arise, either dry or moist, sometimes attended only by itching, sometimes also by inflammation and pain; the discharge is either pus or sanies or both; this generally occurs in children, selected on the trunk, often on the extremities. The worst kind of pustule is that called epinyctis; its colour is usually livid or black or white. And there is severe inflammation round it; and when laid open a mucous ulceration is found within, of a colour like its own humour. It gives greater pain than its size would suggest; for it is no larger than a bean. And this too grows on the extremities, and generally by night, whence also the name applied to it by the Greeks. Now in all kinds of pustules, the treatment first is much walking and exercise; and if anything prevents these, then rockings. Next food must be diminished, all things acrid and thinning avoided; and the same treatment should be applied to nursing women, if the sucking baby is so affected. Moreover, the patient who is robust, if the pustules are small, ought to go to the bath and sweat, and at the same time to dust the pustules with soda and to mix wine with oil and anoint himself, after which he goes down into the hot bath. If this does no good, or if the pustules are of the larger kind, lentil meal should be applied, and after the upper skin has been detached, we must pass on to soothing medicaments. The epinyctis, after lentil meal application, is appropriately treated by means of polygonum or green coriander. Ulcerations caused by the pustules are relieved by litharge mixed with fenugreek seeds, rose-oil and endive juice being added in turn until the mixture becomes of the consistency of honey. For the pustules which affect infants apply: pyrite stone 9·3 grams, mixed with fifty bitter almonds, and 125 cc. of oil added. But first the pustules should be anointed with white-lead, then smeared with the above.

> Latin: subestque his umor. Vbi eae ruptae sunt, infra quasi exulcerata caro apparet: phlyctaenae Graece nominantur. Fiunt uel ex frigore uel ex igne uel ex medicamentis. Ph⟨l⟩yzacion autem paulo durior pusula est, subalbida, acuta, ex qua ipsa quod exprimitur umidum est. At ⟨ex⟩ pusulis uero nonnumquam etiam ulcuscula ⟨fi⟩unt aut aridiora aut umidiora; et modo tantum cum prurigine, modo etiam cum inflammatione aut dolore; exitque aut pus aut sanies aut utrumque; maximeque id euenit in aetate puerili, raro in medio corpore, saepe in eminentibus partibus. Pessima pusula est, quae epinyctis uocatur: ea colore uel subliuida uel nigra uel alba esse consueuit. Circa hanc autem uehemens inflammatio est; et cum adaperta est, reperitur intus exulceratio muccosa, colore umori suo similis. Dolor ex ea supra magnitudinem eius est: neque enim ea faba maior est. Atque haec quoque oritur in eminentibus ⟨partibus⟩ et fere noctu; unde nomen quoque a Graecis ei inpositum est. —In omnium uero pusularum curatione primum est multum ambulare atque exerceri; si quid ista prohibet, gestari. Secundum est cibum minuere, abstinere ab omnibus acribus et extenuantibus; eademque nutrices facere oportet, si lactens puer ita adfectus est. Praeter haec is, qui iam robustus est, si pusulae minutae sunt, desudare in balneo debet, simulque super eas nitrum inspergere oleoque uinum miscere et sic ungui; tum descendere in solium. Si nihil sic proficitur, aut si maius pusularum genus occupauit, imponenda lenticula est, detractaque summa pellicula ad medicamenta lenia transeundum est. Epinyctis post lenticulam recte herba quoque sanguinali uel uiridi coriandro curatur. Vlcera ex pusulis facta tollit spuma argenti cum semine feni Graeci mixta, sic ut his inuicem rosa atque intubi sucus adiciatur, donec mellis crassitudo ei fiat. Proprie ad eas pusulas, quae infantes male habent, lapidis, quem pyriten uocant, P. #1114 VIII cum quinquaginta amaris nucibus miscetur, adiciunturque olei cyathi tres. Sed prius ungui ex cerussa pusulae debent, tum hoc inlini. Scabies uero durior: cutis rubicunda, ex qua pusulae oriuntur, quaedam umidiores, quaedam sicciores. Exit ex quibusdam sanies, fitque ex his continuata exulceratio pruriens; serpitque in quibusdam cito. Atque in aliis quidem ex toto desinit, in aliis uero certo tempore anni reuertitur.

[¶5] But scabies is harder: the skin is ruddy, from which the pustules grow up, some moist, some dry. From some of these sanies escapes; and from them comes a persistent itching ulceration, which in some cases rapidly spreads. And whilst in some persons it vanishes completely, in others it returns at a definite time of the year. The rougher the skin, and the more the itching, the more difficult is its relief. Hence the Greeks call such scabies, agria that is, savage. In this case also the same regimen as that given above is necessary; at the beginning a suitable application is that composed of sublimed zinc oxide, saffron, verdigris 1· 16 grams each; white pepper and omphacium 4 grams; zinc oxide ore 9· 3 grams. But when ulceration already exists that com-posed of sulphur 1·16 gram, wax 4·65 grams, liquid pitch 250 cc., oil one litre; these are heated together until they are of the consistency of honey. There is also the composition ascribed to Protarchus. It consists of half a litre of lupin meal, 190 cc. of soda, 250 cc. of liquid pitch, liquid resin 168 grams, and 125 cc. of vinegar. Also a suitable mixture is saffron, lycium, verdigris, myrrh, and charcoal in equal proportions boiled in raisin wine; this checks everywhere all discharge of phlegm. And when there is nothing else at hand, lees of olive-oil boiled down to one-third, or sulphur mixed with liquid pitch, as I have suggested for cattle is also of service for men suffering from scabies.

> Latin: Quo asperior est quoque prurit magis, eo difficilius tollitur: itaque eam, quae talis est, agrian [id est feram] Graeci appellant. —In hoc quoque uictus ratio eadem quae supra necessaria est: medicamentum autem ad incipientem hanc idoneum est, quod fit ex spodi, croci, aeruginis, singulorum P. #1114 ⟨I⟩; piperis albi, omphaci, singulorum P. #1108 I; cadmiae P. #1114 VIII. At ubi iam exulceratio est, id, quod fit ex sulpuris P. #1114 I; cerae P. #1114 IIII; picis liquidae hemina; olei sextaris duobus; quae simul incocuntur, dum crassitudo mellis sit. Est etiam quod ad Protarchum auctorem refertur. Habet farinae lupinorum S. I.; nitri cyathos IIII S.; picis liquidae heminam; resinae umidae selibram; aceti cyathos tres. Crocum quoque, Lycium, aerugo, murra, cinis aequis portionibus recte miscentur, ⟨et⟩ ex passo cocuntur; idque omnem pituitam ubique sustinet. Ac si nihil aliud est, amurca ⟨ad⟩ tertiam partem decocta uel sulpur pici liquidae mixtum, sicut in pecoribus proposui, hominibus quoque scabie laborantibus opitulantur. Inpetiginis uero species sunt quattuor. Minime mala est, quae similitudinem scabie repraesentat: nam et rubet ⟨et⟩ durior est et exulcerata est et roditur.

[¶6] Impetigo, again, has four species. The least bad is that which presents a semblance to scabies; for there is redness and some hardness and ulceration and erosion. But it is distinguished from scabies because there is more ulceration and there are pustules like pimples, and in it is seen an appearance as of small bubbles from which after a time little scales are detached; and this recurs at fixed seasons. The second kind is worse, almost like a pimple, but rougher and redder; it has various shapes; small scales are detached from the skin surface; there is more erosion; it spreads more rapidly and widely, and both comes and goes at fixed seasons even more markedly than the previous sort; it is called rubrica. The third kind is worse still; for it is thicker, harder and there is more swelling; there are cracks in the skin and more active erosion. This form also is scaly, but the scales are black. It spreads widely and not slowly. It varies less in the times at which it increases or subsides, and is never quite got rid of: its name is black impetigo. The fourth kind, which is quite incurable, differs in colour, for it is whitish and like a recent scar, and has small pallid or whitish scales; some are like lentils, and when these are removed there is sometimes bleeding. Otherwise its humour is white, the skin hard and chapped; it spreads widely. Now all these kinds occur generally on the hands and feet; they also attack the nails. There is no more efficacious remedy than that which I have mentioned above as prescribed by Protarchus for scabies. But Serapion used soda 2·32 grams, and sulphur 4·64 grams, taken up with plenty of resin.

> Latin: Distat autem ab ea, quod magis exulcerata est et uaris similis pusulas habet; uidenturque esse in ea quasi bullulae quaedam, ex quibus interposito tempore squamulae resoluuntur; certioribus⟨que⟩ hoc temporibus reuertitur. Alterum genus peius est, simile papulae fere, sed asperius rubicundiusque; figuras uarias habet; squamulae ex summa cute discedunt; ros⟨i⟩o maior est; celerius et latius procedit certioribusque etiamnum quam prior temporibus et fit et desinit: rubrica cognominat⟨ur⟩. Tertia etiannum deterior est: nam et crassior est et durior et magis tumet; in summa cute finditur et uehementius roditur. Ipsa quoque squamosa sed nigra; proceditque et late nec tarde; et minus errat in temporibus, quibus aut oritur aut desinit neque ex toto tollitur: nigrae cognomen est. Quartum genus est, quod curationem omnino non recipit, distans colore: nam subalbidum est et recenti cicatrici simile; squamulasque habet ⟨pallidas, quasdam subalbidas⟩, quasdam lenticulae similes, quibus dempti⟨s⟩ nonnumquam profluit sanguis. Alioqui uero umor eius albidus est, cutis dura atque fissa est; proceditque latius. Haec uero omnia genera maxime oriuntur in pedibus et manibus; atque ungues quoque infestant. Medicamentum non aliud ualentius est quam quod ad scabiem quoque pertinere sub auctore Protarcho retuli. Sarapion autem nitri P. #1114 II, sulpuris P. #1114 IIII excipiebat resina copiosa, eaque utebatur. Papularum uero duo genera sunt.

[¶7] Of papules again there are two kinds. There is one in which the skin is roughened by very small pustules, and is reddened and slightly erodes; in the middle it is a little smoother; it spreads slowly. This disease generally has a round shape at its beginning, and in the same fashion it spreads in a circle. But the other variety is that which the Greeks call agria that is, savage; and in this there is a similar but greater roughness of the skin with ulceration, more severe erosion, and redness; sometimes it even loosens the hair. It is less round in shape, heals with more difficulty, and unless it is got rid of, turns into an impetigo. But in fact a slight papule heals if it is rubbed daily with spittle before eating; a more severe one is got rid of best by an application of pounded pellitory. But turning to compound medicaments, that same one of Protarchus is efficacious in these cases, when the disorder is less severe. An alterna-tive for the same affection is the composition of Myron containing red soda and frankincense, 4 grams each, purified cantharides 8 grams, sulphur unheated, the same amount, and turpentine resin 80 grams, darnel meal a litre and a half, cumin 145 cc., and half a litre of raw pitch.

> Latin: Alterum est in quo per minimas pusulas cutis exasperatur et rubet leuiterque roditur: medium habet pauxillo leuius, tarde serpit. Idque uitium maxime rotundum incipit, eademque ratione in orbem procedit. Altera autem est, quam agrian [id est feram] Graeci appellant; in qua similiter quidem sed magis cutis exasperatur exulceraturque, ac uehementius et roditur et rubet et interdum etiam pilos remittit. Minus rotunda est, difficilius sanescit: nisi sublata est, in inpetiginem uertitur. Sed leuis papula etiam, si ieiuna saliua cotidie defricatur, sanescit: maior commodissime murali herba tollitur, si sub ea detrita est. Vt uero ad composita medicamenta ueniamus, idem illud Protarchi tanto ualentius in his est, quanto minus in his uiti est. Alterum ad idem Myronis: nitri rubri, turis, singulorum P. #1108 I; cantharidum purgatarum P. #1108 II; sulpuris ignem non experti tantundem; resinae terebenthinae liquidae P. #1108 XX; farinae loli S. III; gitti cyathos III S.; picis crudae S. I. Vitligo quoque quamuis per se nullum periculum adfert, tamen et foeda est et ex malo corporis habitu fit.

[¶8] Vitiligo also, though not dangerous in itself, is still ugly and is due to a bad habit of body. There are three species. It is called alphos when it is white in colour, generally rather rough, and not continuous, so that it looks as if drops of some sort had been sprinkled about. Sometimes also it spreads still more widely with certain gaps. That called melas differs from it in being of a black colour and like a shadow; otherwise it is similar. Leuce is somewhat like alphos, but is whiter and extends deeper; there are hairs on it, white, and like down. All these spread, but more quickly in some people than in others. The alphos and melas come and go at various seasons; the leuce, once established, is not easily got rid of. The two former are not difficult to treat, the latter is scarcely ever cured, for even if the discoloration is mitigated, the colour of health does not right altogether. But whether any one of these is curable or not is easily learnt by this test. The skin should be cut into or pricked with a needle: if blood escapes, which it usually does in the first two species, there is place for a remedy; if a whitish humour, cure is impossible, and then we should even refrain from treating it. But to the species which admits of treatment we should apply lentil meal, mixed with sulphur and frankincense, pounded up together in vinegar. Another application for the same purpose, ascribed to Irenaeus, is composed of coral, soda, cumin and dried fig-leaves, in equal quantities, pounded up with vinegar added. The vitiligo is smeared with this in the sun, then it is soon washed off, lest it corrode too much. Some find it useful to anoint the species which I have said is called alphos with the following prescription ascribed to Myron: they mix sulphur 1 gram, split alum 0·66 gram, soda 1·33 grams with a cupful of dried myrtle leaves; then at the bath they dust bean-meal over the vitiligo and afterwards apply the above remedy. That which I said was termed melas is treated by pounding up together coral, frankincense, barley and bean-meal; and these are sprinkled on, using no oil in the bath before the patient sweats; then this kind of vitiligo is rubbed off.

> Latin: Eius tres species sunt. Alphos uocatur, ubi color albus est, fere subasper, et non continuus, ut quaedam quasi guttae dispersae esse uideantur. Interdum etiam latius et cum quibusdam intermissionibus serpit. Melas colore ab hoc differt, quia niger est et umbrae similis: cetera eadem sunt. Leuce habet quiddam simile alpho, sed magis albida est, et altius descendit, in eaque albi pili sunt et lanugini similes. Omnia haec serpunt, sed in aliis celerius, in aliis tardius. Alphos et melas in quibusdam uariis temporibus et oriuntur et desinunt: leuce quem occupauit, non facile dimittit. Priora curationem non difficillimam recipiunt, ultimum uix umquam sanescit; ac si quid ei uitio demptum est, tamen non ex toto sanus color redditur. Vtrum autem aliquod horum sanabile sit, an non sit, experimento facile colligitur. Incidi enim cutis debet aut acu pungi: si sanguis exit, quod fere fit in duobus prioribus, remedio locus est; si umor albidus, sanari non potest; itaque ab hoc quidem abstinendum est. Super id uero, quod curationem recipit, inponenda lenticula mixta cum sulpure et ture, sic ut ea contrita ex aceto sint. Aliud ad idem, quod ad Irenaeum auctorem refertur: alcyonium, nitrum, ⟨cuminum,⟩ fici folia arida paribus portionibus contunduntur adiecto aceto. His in sole uitligo perunguitur, deinde non ita multo post, ⟨ne⟩ nimis erodatur, eluitur. Proprie quidam Myrone auctore eos, quos alphos uocari dixi, hoc medicamento perungunt: sulpuris P. #1108 #1109 #1110; aluminis scissilis P. ⟨#1108⟩ #1109; nitri P. ⟨#1108⟩ #1109 #1109; murti aridae contrita⟨e⟩ acetabulum miscent; deinde in balneo super uitliginem inspergunt farina⟨m⟩ ex faba, tum haec inducunt. Ii uero, quos melanas uocari dixi, curantur, cum simul contrita sunt alcyoneum, tus, hordeum, faba; eaque sine oleo in balineo ante sudorem insperguntur; tum genus id uitliginis defricatur.

## 22. Book VI · chapters 1–6

Source: https://scriptura.si/works/celsus-on-medicine/22/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/22/#p-N

[¶0] 1. 1 I have spoken of those lesions which affect the whole body and require the aid of medicaments; now I come to those which customarily occur only in particular parts, beginning with the head. In the head, then, when the hair falls out, the principal remedy is frequent shaving. Ladanum mixed with oil, however, is some help in preserving it. I am now referring to the falling out of hair after illness; for no kind of remedy can be given to stop the head of some people from becoming bald through age.

> Latin: 1. Dixi de is uitiis, quae per totum corpus orientia medicamentorum auxilia desiderant: nunc ad ea ueniam, quae non nisi in SINGVLIS PARTIBVS incidere consuerunt, orsus a capite. In hoc igitur capillis fluentibus maxime quidem saepe radendo succurritur. Adicit autem uim quandam ad continendum ladanum cum oleo mixtum. Nunc de is capillis loquor, qui post morbum fere fluunt: nam quominus caput quibusdam aetate nudetur, succurri nullo modo potest.

[¶1] 2. 2 But the condition is called porrigo, when between the hairs something like small scales rise up and become detached from the scalp: and at times they are moist, much more often dry. Sometimes this happens without ulceration, sometimes there is a localized ulceration, and from this comes sometimes a foul odour, sometimes none. This generally occurs on the scalp, more seldom on the beard, occasionally even on the eyebrow. It does not arise only there is some general bodily lesion, so that it is not entirely without its use; for it does not exude from a thoroughly sound head. When there is present some lesion in the head, it is not disadvantageous for the surface of the scalp to become here and there corrupted, rather than for the harmful material to be diverted thence to another part of more importance. Hence it is more beneficial from time to time to clear the scalp by combing, than to repress the disorder altogether. But if this condition is too troublesome, which may happen when a discharge of humour has set in, and especially if this is malodorous, the head is to be shaved often, after which one of the mild repressants is applied, such as soda in vinegar, or ladanum in myrtle oil and wine, or bennut oil with wine. If there is little benefit from these measures it is permissible to use stronger ones, whilst bearing in mind that, at any rate when the disease is of recent origin, this is not a good thing.

> Latin: 2. Porrigo autem est, ubi inter pilos quaedam quasi squamulae surgunt haeque a cute resoluuntur: et interdum madent, multo saepius siccae sunt. Idque euenit modo sine ulcere, modo exulcerato loco, huic quoque modo malo odore, modo nullo accedente. Fereque id in capillo fit, rarius in barba, aliquando etiam in supercilio. Ac neque sine aliquo uitio corporis nascitur neque ex toto inutile est: nam bene integro capite non exit.—Vbi aliquod in eo uitium est, non incommodum est summam cutem potius subinde corrumpi quam id quod nocet in aliam partem magis necessariam uerti. Commodius est ergo subinde pectendo repurgare quam id ex toto prohibere. Si tamen ea res nimium offendit, quod umore sequente fieri potest, magisque si is etiam mali odoris est, caput saepe radendum est, dein id super adiuuandum aliquis ex leuiter reprimentibus, quale est nitrum cum aceto, uel ladanum cum murteo et uino, uel myrobalanum cum uino. Si parum per haec proficitur, uehementioribus uti licet, cum eo ut sciamus utique in recenti uitio id inutile esse.

[¶2] 3. 3 There is also an ulceration, called sycosis by the Greeks from is resemblance to a fig; a sprouting up of flesh occurs. That is the general description: but there are two subordinate species; in one the ulceration is indurated and circular, in the other moist and irregular in outline. From the hard species there is a somewhat scanty and glutinous discharge; from the moist the discharge is abundant and malodorous. Both occur in those parts which are covered by hair; but the callous and circular ulceration mostly on the beard, the moist form, on the other hand, chiefly on the scalp. In both it is good to apply elaterium, or pounded linseed worked up in water, or a fig boiled in water, or the plaster tetrapharmacum moistened with vinegar; also Eretrian earth dissolved in vinegar is suitable for smearing on.

> Latin: 3. Est etiam ulcus, quod a fici similitudine sycosis a Graecis nominatur: caro excrescit. Et id quidem generale est: sub eo uero duae species sunt: alterum ulcus durum et rotundum est, alterum umidum et inaequale. Ex duro exiguum quiddam et glutinosum exit, ex umido †sumplus et mali odoris. Fit utrumque in is partibus, quae pilis conteguntur: sed id quidem, quod callosum et rotundum est, maxime in barba, id uero, quod umidum, praecipue in capillo.—Super utrumque oportet inponere elaterium aut lini semen contritum et aqua coactum aut ficum in aqua decoctam aut emplastrum tetrapharmacum ex aceto subactum; terra quoque Eretria ex aceto liquata recte inlinitur.

[¶3] 4. 4 Bald spots also are of two kinds. In both, owing to the dying of the surface pellicle, hairs are at first rendered thin, and then they fall out; and when the place is cut into, the blood which flows is thin and malodorous. Both kinds spread, in some quickly, in others slowly; the worse kind is that in which the skin has become thick, somewhat fatty, and quite smooth. But that which is named alopecia spreads without defined configuration. It occurs in the hairy scalp or in the beard. That again which is called from its shape ophis, commences at the back of the head, and without exceeding two fingers in breadth, creeps forward to the ears with two heads, in some even to the forehead, until the two heads join one another in front. The former affection occurs at any age, the latter generally in young children. The former scarcely ever terminates, such under treatment, the latter often by itself. Some scarify these bald patches with a scalpel; some smear on caustics mixed with oil, and especially burnt papyrus; some apply turpentine-resin with fennel. But there is nothing better than to shave the part daily with a razor, because as the surface skin is gradually removed, the hair roots become exposed; and the treatment should continue until a number of hairs are seen to be growing up. Following upon the shaving it is sufficient to smear on Indian ink.

> Latin: 4. Arearum quoque duo genera sunt. Commune utrique est, quod emortua summa pellicula pili primum extenuantur, deinde excidunt; ac si ictus is locus est, sanguis exit liquidus et mali odoris. Increscitque utrumque in aliis celeriter, in aliis tarde; peius est i⟨d⟩ quod densam cutem et subpinguem ⟨et⟩ ex toto glabram fecit. Sed ea, quae alopecia nominatur, sub qualibet figura dilatatur. Est et in capillo et in barba. Id uero, quod a similitudine ophis appellatur, incipit ab occipitio; duorum digitorum latitudinem non excedit; ad aures duobus capitibus serpit, quibusdam etiam ad frontem, donec se duo capita in priore parte committant. Illud uitium in qualibet aetate e⟨s⟩t, hoc fere in infantibus.—Illud uix umquam sine curatione, hoc per se saepe finitur. Quidam haec genera arearum scalpello exasperant: quidam inlinunt adurentia ex oleo, maximeque chartam conbustam: quidam resinam terebenthinam cum thabsia inducunt. Sed nihil melius est quam nouacula cottidie radere, quia, cum paulatim summa pellicula excisa est, adaperiuntur pilorum radiculae; neque ante oportet desistere, quam frequentem pilum nasci apparuerit. Id autem, quod subinde raditur, inlini atramento scriptorio satis est.

[¶4] 5. 5 To treat pimples and spots and freckles is almost a waste of time, yet women cannot be torn away from caring from their looks. But of these just mentioned, pimples and spots are commonly known, although that species of spot is more rare which is called by the Greeks semion, since it is rather red and irregular. Freckles are, in fact, ignored by most; they are nothing more than a roughened and indurated discoloration. Whilst the others occur only on the face, a spot sometimes also appears on other parts of the body; of that by itself I do not think it worth while to write elsewhere. But pimples are best removed by the application of resin to which not less than the same amount of split alum and a little honey has been added. A spot is removed by equal quantities of galbanum and soda pounded in vinegar to the consistency of honey. With this the part is to be smeared, and after the lapse of several hours, the next morning, it is washed off, and the place anointed lightly with oil. Freckles are removed by resin to which a third part of rock-salt and a little honey has been added. For all the above and also for colouring scars that composition is useful which is said to have been invented by Trypho the father. In this are equal parts of the dregs of bennut oil, bluish Cimolian chalk, bitter almonds, barley and vetch meal, along with white soapwort and mellilot seeds. These are all rubbed up together with very bitter honey, smeared on at night and washed away in the morning.

> Latin: 5. Paene ineptiae sunt curare uaros et lenticulas et ephelidas, sed eripi tamen feminis cura cultus sui non potest. Ex his autem, quas supra posui, uari lenticulaeque uulgo notae sunt; quamuis rarior ea species est, quam semion Graeci uocant, cum sit ea lenticula rubicundior et inaequalior. Ephelis uero a plerisque ignoratur, quae nihil est nisi asperitas quaedam et durities mali coloris. Cetera non nisi in facie, lenticula etiam in alia parte nonnumquam nasci solet; de qua per se scribere alio loco uisum operae pretium non est.—Sed uar⟨i⟩ commodissime tolluntur inposita resina, cui ⟨non⟩ minus quam ipsa est aluminis scissilis, et paulum mellis adiectum est. Lenticulam tollunt galbanum et nitrum, cum pares portiones habent contritaque ex aceto sunt, donec ad mellis crassitudinem uenerint. His corpus inlinendum et interpositis pluribus horis [mane] eluendum est oleoque leuiter unguendum. Ephelidem tollit resina, cui tertia pars salis fossilis et paulum mellis adiectum est. Ad omnia ista uero atque etiam ad colorandas cicatrices potest ea compositio, quae ad Tryphonem patrem auctorem refertur. In ea pares portiones ⟨sunt⟩ myrobalani magmatis, cretae Cimoliae subcaeruleae, nucum amararum, farinae hordei atque erui, struthi albi, sertulae Campanae seminis. Quae omnia contrita melle quam amarissimo coguntur, inlitumque ⟨id⟩ uespere mane ⟨eluitur.⟩

[¶5] 6. 6 Now the foregoing are subjects of minor importance. But there are grave and varied mishaps to which our eyes are exposed; and as these have so large a part both in the service and the amenity of life, they are to be looked after with the greatest care. Now directly ophthalmia sets in, there are certain signs by which it is possible to foretell the course of the disease. For if lacrima-tion swelling of the eyelids and a thick rheum appear all at once; if that rheum is mixed with tears, if the tears are not hot, but the rheum is white and bland, and the swelling is not hard, there is then no apprehension of a prolonged illness. But if lacrimation is profuse and hot, rheum scanty, swelling moderate, and that in one eye only, the case will be a prolonged one, but without danger. And that kind of ophthalmia is the least painful, but is seldom relieved before the twentieth day, and at times lasts two months. As it subsides, the rheum begins to be white and bland, mixed with tears. But if both eyes are attacked simultaneously, the duration may possibly be shorter, but there is danger of ulceration. Now rheum, when it is dry and sticky, gives rise to some pain, but subsides sooner unless ulceration is set up. If there is great swelling without pain and dryness, there is no danger; if there is dryness, accompanied by pain, there is generally ulceration, and at times the result is that the eyelid sticks to the eyeball. There is danger of similar ulceration in the eyelids or in the pupils when, in addition to great pain, the tears are salt and hot; or if, even after the swelling has subsided, there continues for some time a flow of tears mixed with rheum. The case is worse still when the rheum is pallid or livid, the tears hot and profuse, the head hot, and pain shoots from the temples to the eyes, causing wakefulness at night; in these circumstances generally the eyeball ruptures, and we must pray that there may be ulceration only. When the eyeball has ruptured inwards a touch of fever is beneficial. If the eyeball protrudes after rupturing outwards, there is no remedy. If something white has developed from the dark part of the eye, it persists for a long while; but if it is rough and thick, some vestige remains even after treatment. According to Hippocrates, the oldest authority, the treatment of the eyes includes bloodletting, medicaments, the bath and wine; but he gave little explanation of the proper times and reasons for these remedies, things of the highest importance in the art of medicine. There is no less help, often, in abstinence and clysters. Now at times inflammation seizes the eyes, and there is pain in them together with swelling, and there follows a flow of rheum, sometimes rather profuse or acrid, sometimes in both respects rather moderate. In such a case, rest in bed and abstinence are the chief remedies. From the first day, therefore, the patient should lie in bed in a dark room, and at the same time he should refrain even from talking; take no food at all, and if feasible not even water, or at any rate the least possible amount. If the pains are severe, it is better that he should be bled on the second day, but when urgent this may be done even on the first day, at any rate if the veins on the forehead are swollen, and if there is superfluity of matter in a robust patient. But if the attack is less violent, it requires less drastic treatment: the bowel should be clystered, but only on the second or third day. But moderate inflammation requires neither blood-letting nor clystering, it is sufficient for the patient to stay in bed and fast. A prolonged abstinence, however, is not necessary in patients with ophthalmia, for it may render the rheum thinner, and more acrid; hence some of the lightest kind of food should be given on the second day, such as seems likely to render the rheum thicker; for instance, raw eggs; in a less severe case, porridge also or bread soaked in milk. On the following days, according as the inflammation subsides, additional food may be taken, but of the same class; certainly nothing salted, or acrid, or likely to make the rheum thinner should be consumed, and nothing but water drunk. Such a dietetic regimen is exceedingly necessary. But from the first day, saffron 4 grams and the finest wheat flour 8 grams should be made up with white of egg to the consistency of honey, then spread on lint and stuck on the forehead, in order that by compressing the veins the flow of rheum may be checked. If saffron is not at hand, frankincense has the same effect. Whether it is spread on linen, or on wool, makes no difference. There should be smeared over the eyeball, of saffron as much as can be taken up in three fingers, of myrrh in amount the size of a bean, of poppy-tears the size of a lentil: these are pounded up in raisin wine, and applied on a probe to the eyeball. Another composition having the same efficacy is made up of: myrrh 0.33 grams, mandragora juice 4 grams; poppy-tears 8 grams; rose-leaves and hemlock seeds 12 grams each; acacia 16 grams; gum 32 grams. These applications are made by day; at night, in order better to assure sleep, it is not inappropriate to apply above the eye, the crumb of white bread soaked in wine; for this at once represses rheum, and absorbs any flow of tears, and prevents the eye from becoming glued up. If this application, owing to the great pain in the eye, seems oppressive and hard, eggs, both the white and the yolk, are poured into a vessel, a little honey-wine added, and the mixture stirred with the finger. When thoroughly mixed, soft well-combed wool is soaked in it and the wool then applied over the eyes. This is both a light application and one which by cooling checks rheum, yet does not quite dry it up, and so the eye is not allowed to become glued up. Boiled barley-meal, mixed with boiled quinces, is also a suitable application; nor is it inconsistent with the treatment, even to put on a pad of wool wrung as hard as possible out of water, if the attack is a lighter one, or out of vinegar and water, if it is more severe. The former applications are to be bandaged on, so that they do not fall off during sleep; the latter it suffices to lay one because it can be changed readily by the patient himself, and when it becomes dry, it must be wetted again. If the affection is so severe as to prevent sleep, for a time one of the remedies which the Greeks call anodyna should be administered, an amount the size of a vetch to a child, that of a bean to a man. For the eyeball itself there is no appropriate application on the first day, unless the inflammation is only moderate, for by such the flow of rheum is often stimulated rather than lessened. From the second day, even when the disease is severe, the direct application of medicaments is proper, when blood has been let or clystering applied, or after it has become evident that neither is needed.

> Latin: 6. Sed haec quidem mediocria sunt. Ingentibus uero et uariis casibus OCVLI nostri patent; qui cum magnam partem ad uitae simul et usum et dulcedinem conferant, summa cura tuendi sunt. Protinus autem orta lippitudine quaedam notae sunt, ex quibus quid euenturum sit colligere possumus. Nam si simul et lacrima et tumor et crassa pituita ⟨coeperint, si ea pituita⟩ lacrimae mixta est, si ea lacrima calida ⟨non⟩ est, pituita uero alba et mollis, tumor non durus, longae ualetudinis metus non est. At si lacrima multa et calida, pituitae paulum, tumor modicus est, idque in uno oculo est, longum id, sed sine periculo futurum est. Idque lippitudinis genus minime cum dolore est, sed uix ante uicensimum diem tollitur, nonnumquam per duos menses durat. Quandoque finitur, pituita alba et mollis incipit esse, lacrimaeque miscetur. At si simul ea utrumque oculum inuaserunt, potest esse breuior, sed periculum ulcerum est. Pituita autem sicca et arida dolorem quidem mouet, sed maturius desinit, nisi quid exulcerauit. Tumor magnus ⟨si⟩ sine dolore est et siccus, sine ullo periculo est: si siccus quidem, sed cum dolore est, fere exulcerat, et nonnumquam ex eo casu fit, ut palpebra cum oculo glutinetur. Eiusdem exulcerationis timor in palpebris pupillisue est, ubi super magnum dolorem lacrimae salsae calidaeque eunt, aut etiam, si tumore [in] finito diu lacrima cum pituita profluit. Peius etiamnum est, ubi pituita ⟨pal⟩lida aut liuida est, lacrima calida et multa profluit, caput calet, a temporibus ad oculos dolor peruenit, nocturna uigilia urget, siquidem sub his oculus plerumque rumpitur, uotumque est, ut tantum exulceretur. Intus ruptum oculum febricula iuuat. Si foras iam ruptus procedit, sine auxilio est. Si de nigro aliquid albidum factum est, diu manet: at si asperum et crassum est, etiam post curationem uestigium aliquod relinquit. —Curari uero oculos sanguinis detractione, medicamento, balneo, uino uetustissimus auctor Hippocrates memoriae prodidit: sed eorum tempora et causas parum explicuit, in quibus medicinae summa est. Neque minus in abstinentia et alui ductione saepe auxilii est. Hos igitur interdum inflammatio occupat, ubi cum tumore in his dolor est, sequiturque pituitae cursus nonnumquam copiosior uel acrior, nonnumquam utraque parte moderatior. In eiusmodi casu prima omnium sunt quies et abstinentia. Ergo primo die loco obscuro cubare debet, sic ut a sermone quoque abstineat; nullum cibum adsumere, si fieri potest, ne aquam quidem; si[n] minus, certe quam minimum eius. Quod si graues dolores sunt, commodius secundo die; si tamen res urget, etiam primo sanguis mittendus est, utique, si in fronte uenae tument, si firmo corpore materia superest. Si uero minor impetus, minus acrem curationem requirit; aluum, sed non nisi secundo tertioue die, duci oportet. ⟨At⟩ modica inflammatio neutrum ex his auxilium desiderat, satisque est uti quiete et abstinentia. Neque tamen lippientibus longum ieiunium necessarium est, ne pituita tenuior atque acrior fiat: sed secundo die dari debet id, quod leuissimum uideri potest ex is, quae pituitam faciunt crassiorem; qualia sunt oua sorbilia: si minor uis urget, pulticula quoque aut panis ex lacte. Insequentibusque diebus quantum inflammationi detrahetur, tantum adici cibis poterit, sed generis eiusdem; utique ut nihil salsum, nihil acre, nihil ex is, quae extenuant, sumatur, nihil potui praeter aquam. Et uictus quidem ratio talis maxime necessaria est. Protinus autem primo die croci P. #1108 I, et farinae candidae quantum tenuissimae P. ⟨#1108 II,⟩ excipere oportet oui albo, donec mellis crassitudinem habeat, idque in linteolum inlin⟨e⟩re, et fronti adglutinare, ut conpressis uenis pituitae impetum cohibeat. Si crocum non est, tus idem facit. Linteolo an lana excipiatur, nihil interest. Superinungui uero oculi debent, sic ut croci quantum tribus digitis conprehendi potest, sumatur; murrae ad fabae, papaueris lacrimae ad lenticulae magnitudinem; eaque cum passo conterantur, et specillo super oculum inducantur. Aliud ad idem: murrae P. #1108 #1110; mandragorae suci P. #1108 I; papaueris lacrimae P. #1108 II; foliorum rosae, cicutae seminis, singulorum P. #1108 III; acaciae P. #1108 IIII; cummis P. #1108 VIII. Et haec quidem interdiu: nocte uero, quo commodior quies ueniat, non alienum est superinponere candidi panis interiorem partem ex uino subactam: nam et pituitam reprimit, et, si quid lacrimae processit, absorbet, et oculum glutinari non patitur. Si graue id et durum propter magnum oculorum dolorem uidetur, oui et album et uitellus in uas defundendum est, adiciendumque eo mulsi paulum, idque digito permiscendum. Vbi facta unitas est, demitti debet lana mollis bene carpta, quae id excipiat, superque oculos inponi. Ea res et leuis est et refrigerando pituitam coercet, et non exarescit, et glutinari oculum non patitur. Farina quoque hordeacia cocta, et cum malo Cotoneo cocto mixta commode inponitur; neque a ratione abhorret etiam penicillo potissimum uti expresso, si leuior impetus est, ex aqua, si maior, ex posca. Priora fascia deliganda sunt, ne per somnum cadant: at hoc superinponi satis est, quia et reponi ab ipso commode potest, et, cum inaruit, iterum madefaciendum est. Si tantum mali est, ut somnum diu prohibeat, eorum aliquod dandum est, quae anodyna Graeci appellant; satisque puero quod erui, uiro quod fabae magnitudinem impleat. In ipsum uero oculum primo die, nisi modica inflammatio est, nihil recte coicitur: saepe enim potius concitatur eo pituita quam minuitur. A secundo die graui quoque lippitudini per indita medicamenta recte succurritur, ubi uel iam sanguis missus uel aluus ducta est, aut neutrum necessarium esse manifestum est. Multa autem multorumque auctorum collyria ad id apta sunt, nouisque etiam nunc mixturis temperari possunt, cum lenia medicamenta et modice reprimentia facile et uarie misceantur. Ego nobilissima exequar. Est igitur Philonis, quod habet cerussae elotae, spodii, cummis, singulorum P. #1108 I; papaueris lacrimae conbustae P. #1108 I⟨I⟩.

[¶6] Now for this disease there are many salves devised by many inventors, and these can be blended even now in novel mixtures, for mild medicaments and moderate repressants may be readily and variously mingled. I will mention the most famous.

> Latin: Illud scire oportet, hic quoque omnia medicamenta singula primum per se teri, deinde mixta iterum adiecta paulatim uel aqua uel alio umore: cummi cum quasdam alias facultates habeat, hoc maxime praestare, ut, ubi collyria facta inaruerunt, glutinata sint neque frientur.

[¶7] There is then the salve of Philo, which contains: washed cerussa, spode and gum 4 grams each; poppy-tears toasted 8 grams. It is important to know that each of these ingredients should be pounded separately, than mixed together, gradually adding water, or some other fluid. Gum, amongst other properties, has this particular advantage, that when salves made of it have become dry, they stick together and do not break up.

> Latin: Dionysi uero collyrium est: papaueris lacrimae combustae, donec tenerescat, P. #1108 I #1109; turis combusti, cummis, singulorum P. #1108 S; spodii P. #1108 IIII. Cleonis nobile admodum: papaueris lacrimae frictae P. #1108 I; croci P. #1108 #1109; cummis P. #1108 I; quibus cum teruntur adicitur rosae sucus. Aliud eiusdem ualentius: squamae aeris, quod stomoma appellant, P. #1108 I; croci P.

[¶8] The salve of Dionysius consists of: poppy-tears toasted until they soften 4.66 grams, toasted frankincense and gum 2 grams each, and zinc oxide 16 grams.

> Latin: #1108 II; spodii P. #1108 IIII; plumbi eloti et combusti P. #1108 ⟨V⟩I; cummis tantundem. Attalium quoque ad idem est, maxime ubi multa pituita profluit: castorei P.

[¶9] The salve of Cleon is quite famous: poppy-tears toasted 4 grams, saffron 0.66 grams, gum 4 grams, to which after being pounded is added rose juice. The same man prescribed another more active salve: scales of the copper which is called stomoma 4 grams; saffron 8 grams; zinc oxide 16 grams; lead washed and roasted 24 grams; with a like quantity of gum. There is also for the same complaint the salve of Attalus especially when the rheum is profuse: castoreum 0.33 grams; lign-aloes 0.66 grams; saffron 4 grams; myrrh 8 grams; lycium 12 grams; prepared zinc oxide 32 grams; a like quantity of antimony sulphide and acacia juice 48 grams. And when no gum is added it is preserved liquid in a small receptacle. Theodotus added to the above mixture: poppy-tears toasted 0.33 grams; copper scales roasted and washed 8 grams; toasted date kernels 40 grams; gum 48 grams.

> Latin: #1108 #1110; aloes P. #1108 #1109; croci P. #1108 I; murrae P. #1108 II; Lyci P. #1108 III; cadmiae curatae P. #1108 VIII; stibis tantundem, acaciae suci P. #1108 XII. Quod ⟨cum⟩ cummis ⟨q⟩uid hoc non habet, liquidum in puxidicula seruatur. Theodotus uero huic compositioni adiecit papaueris lacrimae combustae P. #1108 #1110; aeris combusti et eloti P. #1108 II; nucleos palmularum combustos P. #1108 X; cummis P. #1108 XII. At ipsius Theodoti, quod a quibusdam acharistum nominatur, eiusmodi est: castorei, nardi Indici, singulorum P. #1108 I; Lyci P. ⟨#1108⟩ #1109; papaueris lacrimae tantundem; murrae P. #1108 II; croci, cerussae elotae, aloes, singulorum P. #1108 III; cadmiae botruitidis elotae, aeris conbusti, singulorum P.

[¶10] The salve of Theodotus himself, which by some is called achariston, is composed of: castoreum and Indian nard 4 grams each; lycium 0.66 gram; an equal amount of poppy-tears; myrrh 8 grams; saffron, washed white lead and lign-aloes 12 grams of each; cluster-shaped oxide of zinc, washed and roasted copper scales 32 grams each; gum 72 grams; acacia juice 80 grams; the same amount of antimony sulphide, to which is added rain-water.

> Latin: #1108 VIII; cummis P. #1108 XVIII; acaciae suci P. #1108 XX; stibis tantundem; quibus aqua pluuia[ti]lis adicitur. Praeter haec ex frequentissimis collyriis est id, quod quidam cyc⟨n⟩on, quidam a cinereo colore tephron appellant: amuli, tra⟨c⟩antae, acaciae suci, cummis, singulorum P. #1108 I; papaueris lacrimae P. #1108 II; cerussae elotae P. #1108 IIII; spumae elotae P.

[¶11] Besides the above, among the most commonly used salves is that which some call cycnon, others from its ashen colour tephron, which contains: starch, tragacanth, acacia juice, gum 4 grams each; poppy-tears 8 grams; washed cerussa 16 grams; washed litharge 32 grams. These ingredients likewise are compounded with rain-water.

> Latin: ⟨#1108⟩ VIII, quae aeque ex aqua pluuia[ti]li conteruntur. Euelpides autem, qui aetate nostra maximus fuit ocularius medicus, utebatur eo, quod ipse conposuerat: trygodes nominabat: castorei P. #1108 #1109 #1109; Lyci, nardi, papaueris lacrimae, singulorum P. #1108 I;

[¶12] Euelpides, the most famous oculist of our time, used a salve of his own composition called trygodes: castoreum 1.33 grams; lycium, nard and poppy-tears 4 grams each; saffron, myrrh and lign-aloes 16 grams each; roasted copper scales 36 grams; oxide of zinc and antimony sulphide 48 grams; acacia juice 144 grams; the same amount of gum.

> Latin: croci, murrae, aloes, singulorum P. #1108 IIII; aeris combusti P. #1108 VIIII; cadmiae et stibis, singulorum P. #1108 XII; acaciae suci P. #1108 XXXVI; cummis tantundem. Quo grauior uero quaeque inflammatio est, eo magis leniri medicamentum debet adiecto uel albo oui uel muliebri lacte.

[¶13] The more severe the inflammation, the milder should the application be made, by adding to it white of egg or woman's milk. But if neither doctor nor medicine is at hand, either of the above, dropped into the eye with a little screw of lint prepared for the purpose, often relieves the trouble. But when the patient has been relieved and the discharge of rheum is already checked, any slight symptoms which remain may be got rid of by making use of the bath and of wine. Therefore when at the bath the patient should be first rubbed over gently with oil, especially over the legs and thighs, and he should bathe his eyes freely with hot water, next hot water should be poured over his head, followed by tepid water; after the bath he must take care that he is not harmed by cold or draught: subsequently he should use a diet rather fuller than had been customary for those days, whilst avoiding everything which may render the rheum thinner. He should drink mild wine, not too dry, and moderately old, taking it neither too freely nor too sparingly, so that, without causing indigestion, it may nevertheless induce sleep, and mollify the internal latent acrid humour. If at the bath the patient feels the trouble in the eyes becoming worse than before he entered, which often happens to those who have hurried on to this course of treatment whilst there is still a discharge of rheum, he ought immediately to leave the bath, take no wine that day, and less food even than on the previous day. Afterwards, as soon as the flow of rheum has subsided sufficiently, he may return again to the use of the bath. Nevertheless, from the fault of the weather, or of the patient's constitution, if on happens that for many days neither the pain nor inflammation is checked, and least of all the discharge of rheum. When this occurs and the affection is now established by reason of its long standing, recourse must be had to these same remedies that is, the bath and wine. For whilst they unsuitable early in the complaints because they can then irritate and stir up inflammation, yet in inveterate cases which have not yielded to other remedies, they are quite effectual, that is to say, in this as in other instances, when ordinary remedies have proved useless, contrary ones are beneficial. But beforehand the patient should be shaved down to the scalp, then in the bath he should foment both his head and eyes with plenty of hot water, next clean both with a little roll of lint, and anoint the head with iris ointment: and he should keep to his bed until all the heat so produced has ended, and the sweat which of necessity has collected in the head has passed off. He is then to take food and wine of the same sort as above, drinking the wine undiluted; and he must rest with the head wrapped up. For often after these measures a sound sleep, or a sweat, or a clearance of the bowel, terminates the discharge of rheum. If, as more often happens, the malady is in some measure relieved, the same regimen is pursued for a number of days until recovery is completed. If, meanwhile, the bowels do not act, clysters are given to relieve the upper parts of the body. But occasionally a violent inflammation breaks out with so much force as to push forwards the eyes out of their place: the Greeks call this proptosis, because the eyes drop forwards. In this cases especially, if the strength allows of it, blood is to be let; if that is impracticable, then a clyster and prolonged abstinence should be prescribed. The blandest medicaments are required; hence some use that salve of Cleon's which has been noted above, as consisting of two ingredients, poppy-tears and gum, but the best is the salve of Nileus, and this point is agreed on by all authorities.

> Latin: At si neque medicus neque medicamentum praesto est, saepius utrumlibet horum ⟨in⟩ oculos penicillo ad id ipsum facto infusum id malum lenit. Vbi uero aliquis releuatus est, iamque cursus pituitae constitit, reliquias fortasse leniores futuras discutiunt balneum et uinum. Igitur lauari debet leuiter ante oleo perfricatus diutiusque in cruribus et feminibus, multaque calida aqua fouere oculos; deinde per caput prius calida, deinde egelida perfundi: ⟨a⟩ balineo cauere ne quo frigore afflatuue laedatur; post haec cibo paulo pleniore quam ex eorum dierum consuetudine uti uitatis tamen omnibus pituitam extenuantibus. Vinum bibere ⟨lene,⟩ subausterum, modice uetus, neque effuse neque timide, ut neque cruditas ex eo et tamen somnus fiat lenianturque intus latentia acria. Si quis in balineo sensit maiorem oculorum perturbationem quam attulerat, quod incidere is solet, qui manente adhuc pituitae cursu festinarunt, quam primum discedere debet, nihil eo die uini adsumere, cibi minus etiam quam pridie. Deinde cum primum satis pituita substitit, iterum ad usum balinei redire. Solet tamen euenire nonnumquam siue tempestatium uitio siue corporis, ut pluribus diebus neque dolor neque inflammatio et minime pituitae cursus finiatur. Quod ubi incidit iamque ipsa uetustate res matura est, ab his isdem auxilium petendum est [id est balineo et uino]. Haec enim ut in recentibus malis aliena sunt, quia concitare ea possunt et accendere, sic in ueteribus, quae nullis aliis auxiliis cesserunt, admodum efficacia esse consuerunt, uidelicet hic quoque ut alibi, cum secunda uana fuerunt, contrariis adiuuantibus. Sed ante tonderi ad cutem conuenit, deinde in balineo aqua calida quam plurima caput atque oculos fouere, tum utrumque penicillo detergere, et ungere caput irino unguento; continereque in lectulo se, donec omnis calor, qui conceptus est, finiatur desinatque sudor, qui necessario in capite collectus est. Tum ad idem cibi uinique genus ueniendum, sic ut potiones meracae sint; obtegendumque caput et quiescendum. Saepe enim post haec grauis somnus, saepe sudor, saepe alui deiectio pituitae cursum finit. Si leuatum malum est, quod aliquanto saepius fit, per plures dies idem fieri oportet, donec ex toto sanitas restituatur. Si diebus isdem aluus nihil reddit, ducenda est, quo magis superiores partes leuentur. Nonnumquam autem ingens ⟨in⟩flammatio tanto impetu erumpit, ut oculos sua sede propellat: proptosin id, quoniam oculi procidunt, Graeci appellant. His utique, si uires patiuntur, sanguinem mitti; si id fieri non potest, aluum duci, longioremque inediam indici necessarium est. Opus autem lenissimis medicamentis est, ideoque Cleonis collyrio quidam, quod ex duobus ante positum est, utuntur: sed optumum ⟨est⟩ Nilei, neque de ullo magis inter omnes auctores conuenit. Id habet nardi Indici, papaueris lacrimae, singulorum P. #1108 #1110; cummis P. #1108 I; croci P. #1108 II; foliorum rosae recentium P. #1108 IIII; quae uel aqua pluuia[ti]li, uel uino leni, subaustero coguntur. Neque alienum est malicorium uel sertulam Campanam ex uino coquere, deinde conterere; aut murram nigram cum rosae foliis miscere; aut hyoscyami ⟨folia⟩ cum oui uitello cocti aut farinam cum acaciae suco uel passo aut mulso; quibus si folia quoque papaueris adiciuntur, aliquanto ualentiora sunt.

[¶14] This salves consists of Indian nard and poppy-tears 0.33 gram each; gum 4 grams; saffron 8 grams; fresh rose leaves 16 grams, which are mixed up in rain-water or in a rather mild wine. And it is not out of place to boil pomegranate rind or melilot in wine and then pound it; or to mix black myrrh with rose leaves, or hyoscyamus leaves with the yolk of a boiled egg, or flour with acacia juice and raisin wine or honeyed wine; if poppy-tears too be added to these, they are rendered somewhat more active. Having prepared one of the above, the eyes should be swabbed with a small screw of lint, wrung out in a hot decoction of myrtle or rose leaves and then one of the salves placed in them. Furthermore, after incising the skin of the occiput, a cup is to be applied there. But if the eye is not restored into position by the above remedies, but remains pushed forward as before, it should be recognized that its sight is lost; and that the eyeball will harden or will be converted into pus. If suppuration shows itself in the corner nearest the temple, the eyeball should be cut into, in order that by letting out the pus, both inflammation and pain may be ended, and the coats of the eyeball may recede, so that the patient's looks afterwards may be less disfigured. There should then be applied either one of the above salves with milk or egg, or saffron, either by itself or mixed with white of egg. But if the eyeball has grown hard and is dead, but not converted into pus, so much of it is to be cut out as projects in an ugly fashion; for this purpose the sclerotic coat is seized with a hook, and the scalpel cuts under it; then the same medicaments are to be inserted until all pain has stopped. Use is to be made of the same medicaments for an eye which has first prolapsed, and then has split open in several places.

> Latin: Horum aliquo praeparato penicillo fouere oculos oportet ex aqua calida expresso, in qua ante uel murti uel rosae folia decocta sint; deinde ex illis aliquid inponi. Praeter haec ab occipitio incisa cute cucurbitula adhibenda est. Quod si per haec restitutus oculus in sedem suam non est eodemque modo prolapsus permanet, scire oportet lumen esse amissum; deinde futurum ut aut indurescat is aut in pus uertatur. Si suppuratio se ostendit ab eo angulo, qui tempori propior est, incidi oculus debet, ut effuso pure et inflammatio ac dolor finiatur, et intus tunicae residant, quo minus foeda postea facies sit. Vtendum deinde uel his collyriis est ex lacte aut ouo, uel croco * * * uel cui album oui misceatur. At si induruit et sic emortuus est, ne in pus uerteretur, quatenus foede prominebit, excidendum erit, sic ut hamo summa tunica adprehendatur, infra id scalpellus incidat; tum eadem medicamenta erunt coicienda, donec omnis dolor finiatur. Isdem medicamentis in eo quoque oculo utendum est, qui prius procidit, dein per plura loca fissus est. Solent etiam carbunculi ex inflammatione nasci, nonnumquam in ipsis oculis, nonnumquam in palpebris, et in his ipsis modo ab interiore modo ab exteriore.—In hoc casu aluus ducenda est, cibus minuendus, lac potui dandum, ut acria quae laeserunt leniantur. Quod ad cataplasmata et medicamenta pertinet, is utendum, quae aduersum inflammationem proposita sunt. Atque hic quoque Nilei collyrium optimum est: si tamen carbunculus in exteriore palpebrae parte est, ad cataplasmata aptissimum est lini semen ex mulso coctum; aut si id non est, tritici farina eodem modo cocta.

[¶15] It is also customary for inflammation to give rise to carbuncles, sometimes upon the actual eyeballs, sometimes upon the eyelids, either on the inner or on the outer surface of these. When this occurs, the patient should be clystered, the food diminished, and milk given as a drink, in order to mollify the acrid matter which is doing harm. As regards poultices and medicaments, what has been prescribed for inflammation must be used. And here again the salve of Nileus is best: but when the carbuncle is on the outer surface of the eyelid, the most suitable poultice is one of linseed boiled in honeyed wine, or, if that is not at hand, flour boiled in the same.

> Latin: Pusulae quoque ex inflammatione interdum oriuntur. Quod si inter initia protinus incidit, magis etiam seruanda sunt, quae de sanguine et quiete supra proposui: sin serius quam ut sanguis mitti possit, aluus tamen ducenda est; si id quoque aliqua res inhibet, utique uictus ratio seruanda est. Medicamentis autem h⟨u⟩c quoque lenibus opus est, quale Nilei, quale Cleonis est. Id quoque, quod Philalethus uocatur, h⟨u⟩c aptum est: murrae, papaueris lacrimae, singulorum P. #1108 I; plumbi eloti, terrae Samiae, quae aster uocatur, tracanti, singulorum P. #1108 IIII; stibis cocti, amuli, singulorum P.

[¶16] Pustules are also an occasional consequence of inflammation. If this happens early during the first stage, the blood-letting and rest prescribed above should be even more strictly enforced; if later than the stage when blood-letting is possible, the bowels, nevertheless, should be clystered; and if anything should prevent this also, at any rate the regimen as to diet should be followed. For this condition also soothing medicaments are necessary, such as those of Nileus and Cleon.

> Latin: #1108 VI; spodi eloti, cerussae elotae, singulorum P. #1108 VIII. Quae aqua pluuia[ti]li excipiuntur. Vsus collyrii uel ex ouo uel ex lacte est. Ex pusulis ulcera interdum fiunt; ea recentia aeque lenibus medicamentis nutrienda sunt, et isdem fere, quae supra in pusulis posui.—Fit quoque proprie ad haec quod dia libanu uocatur. Habet aeris combusti et eloti, papaueris lacrimae frictae, singulorum P. #1108 I;

[¶17] Also the salve named after Philalethus is suitable, consisting of: myrrh and poppy-tears 4 grams each; washed lead, Samian earth called aster, and tragacanth 16 grams each; boiled antimony sulphide and starch 24 grams each; washed oxide of zinc and washed cerussa 32 grams each. These are made up with rain-water. The salve is used either with white of egg or milk.

> Latin: spodi eloti, turis, stibis combusti et eloti, murrae, cummis, singulorum P. #1108 II. Euenit etiam, ut oculi uel ambo uel singuli minores fiant quam esse naturaliter debeant; idque et acer pituitae cursus in lippitudine efficit et continuati fletus et ictus parum bene curati.—In his quoque isdem lenibus medicamentis ex muliebri lacte utendum est;

[¶18] From pustules ulcerations sometimes arise. These when recent are likewise to be treated by mild applications, generally by the same as I have prescribed above for pustules. That which is called 'dia libanu' is specially prepared for the above condition. It is composed of roasted and washed copper, and parched poppy-tears 4 grams each; washed zinc oxide, frankincense, roasted and washed, antimony sulphide, myrrh, and gum 8 grams each.

> Latin: cibis uero is, qui maxime corpus alere et inplere consuerunt; uitandaque omni modo causa, quae lacrimas excitet, curaque domesticorum; quorum etiam, si quid tale incidit, [eius] notitiae subtrahendum. Atque acria quoque medicamenta et acres cibi non alio magis nomine his nocent, quam quod lacrimas moue⟨n⟩t.

## 23. Book VI · chapters 6–7

Source: https://scriptura.si/works/celsus-on-medicine/23/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/23/#p-N

[¶0] It happens too that the eyeballs, either both or one, become smaller than naturally they ought to be. An acrid discharge of rheum in the course of ophthalmia causes this, also continuous weeping, and an injury improperly treated. In these cases the same mild applications mixed with woman's milk should also be used, and for food, that which is most nourishing and body-building. In every way any cause which may excite tears must be avoided, and anxiety about home affairs also, knowledge of which, if anything of that sort has arisen, must be kept from the patient. And acrid medicaments and sour food do harm in these cases, chiefly because of the tears which they excite.

> Latin: Genus quoque uiti est, qu⟨om⟩ inter pilos palpebrarum peduculi nascuntur: pthiriasi⟨n⟩ Graeci nominant. Quod cum ex malo corporis habitu fiat, raro non ultra procedit. Sed fere tempore interposito pituitae cursus acerrimus sequitur, exulceratisque uehementer oculis aciem quoque ipsam corrumpit.—His aluus ducenda est, caput ad cutem tondendum, diuque cotidie ieiunis perfricandum; his ambulationibus aliisque exercitationibus diligenter utendum; gargarizandum ex mulso, in quo nepeta et pinguis ficus decocta sit; saepe in balineo multa aqua calida fouendum caput; uitandi acres cibi, lacte uinoque pingui utendum, bibendumque liberalius quam edendum est.

[¶1] There is also a kind of disorder in which lice are born between the eyelashes; the Greeks call it phthiriasis. Since this comes from a bad state of health it seldom fails to get worse; but usually in time a very acrid discharge of rheum follows, and if the eyeballs become severely ulcerated, it even destroys their vision. In these cases the bowel should be clystered, the head shaved to the scalp, and rubbed for a good while daily whilst the patient fasts; walking and other exercises should be diligently practised; he should gargle honey wine in which mint and ripe figs have been boiled; at the bath the head should often be freely fomented with hot water, acrid food avoided, milk and sweet wine should be taken, with more drink than food. Medicaments administered internally should be bland lest they stimulate the acridity of the rheum; other medicaments too are put upon the lice themselves in order to kill them and prevent any more from being born. For this purpose soda-scum 0.33 gram, sandarach 0.33 gram and black bryony berries 4 grams are pounded up together, with equal proportions of old oil and vinegar, until of the consistency of honey.

> Latin: Medicamenta uero intus quidem lenia danda sunt, ne quid acrioris pituitae concitent, super ipsos uero peduculos alia, quae necare eos, et prohibere, ne similes nascantur, possint. Ad id ipsum spumae nitri P. #1108 #1110; sandaracae P. #1108 #1110; uuae t⟨a⟩miniae P. #1108 I simul teruntur, adiciturque uetus oleum pari portione atque acetum, donec mellis ei crassitudo sit. Hactenus oculorum morbi * * * lenibus medicamentis nutriuntur. Genera deinde alia sunt, quae diuersam curationem desiderant, fereque ex inflammationibus nata, sed finitis quoque his manentia. Atque in primis in quibusdam perseuerat tenuis pituitae cursus; quibus aluus ⟨ab⟩ inferiore parte euocanda est, demendum aliquid ex cibo. Neque alienum est inlini frontem conpositione Andriae, quae habet cummis P. #1108 I; cerussae, stibis, singulorum P. #1108 II; spumae argenti coctae et elotae P. #1108 IIII. Sed ea spuma ex aqua pluuia[ti]li coquitur, et arida haec medicamenta ex suco murti conteruntur.

[¶2] The preceding diseases of the eyes are treated with bland applications. Next come other classes which require a different treatment, and they usually originate from inflammation, but also persist after the inflammation has subsided. And first in some cases there is a thin discharge of rheum which persists; in these the bowel is to be clystered, and the amount of food somewhat reduced. And it is not inappropriate to smear the forehead with the composition of Andrias; this consists of gum 4 grams, cerussa and antimony sulphide 8 grams each, litharge heated and washed 16 grams. But the litharge must be boiled in rain-water, and the dry ingredients pounded up in myrtle juice. When the forehead has been smeared with this, a poultice is put on of flour mad eio a paste with cold water, to which is added acacia juice or cypress oil. It is also useful to apply a cup to the top of the head after making an incision, or blood may be let from the temples. The following ointment should be used: copper scales and poppy-tears 4 grams each; stag's horn calcined and washed, washed lead, and gum, 16 grams each; frankincense, 48 grams. This slave, because it contains horn, is called dia tu keratos. Whenever I do not name the kind of fluid to be added, I would have water to be understood.

> Latin: His inlita fronte cataplasma quoque superiniciendum est ex farina, quae frigida aqua coacta sit, cuique aut acaciae sucus aut cupressus adiecta sit. Cucurbitula quoque inciso uertice recte a⟨d⟩commodatur aut ex temporibus sanguis emittitur. Inungui uero eo debet, quod habet: squamae aeris, papaueris lacrimae, singulorum P. #1108 ⟨I⟩; ceruini cornus conbusti et eloti, plumbi eloti, cummis, singulorum P. #1108 IIII; turis P. #1108 XII. Hoc collyrium, quia cornu habet, dia tu ceratos nominatur. Quotienscumque non adicio, quod genus umoris adiciendum sit, aquam intellegi uolo. Ad idem Euelpidis, quod memigmenon nominabat. In eo papaueris lacrimae ⟨et albi piperis⟩ singulae unciae sunt; cummis libra ⟨P.⟩; aeris combusti P. ⟨#1108⟩ I S. Inter has autem curationes post intermissiones aliqua prosunt balineum et uinum. Cumque omnibus lippientibus uitandi cibi qui extenuant, tum praecipue, quibus tenuis umor diu fertur. Quod si iam fastidium est eorum, quae pituitam crassiorem reddunt (sicut in hoc genere materiae maxime promptum est), confugiendum est ad ea, quae, quia uentrem, corpus quoque adstringunt.

[¶3] For the same purpose there is the salve of Euelpides, which he called memigmenon, containing poppy-tears and white peppercorns 28 grams each; gum 336 grams; roasted copper 6 grams. However, in the course of the treatment, after a subsidence of the disease, the bath and wine are of some service. In all cases of ophthalmia food that makes thin should be avoided, but especially in those who have had for long a discharge of thin humour. But if food which renders the rheum thicker comes to be disliked, which very readily happens with this kind of diet, recourse should be had to those foods which, in bracing up the bowels, do the same to the body in general.

> Latin: At ulcera, si cum inflammatione finita * ⟨non⟩ sunt, aut supercrescentia aut sordida aut caua aut certe uetera esse consuerunt. Ex his supercrescentia collyrio, quod memigmenon uocatur, optime reprimuntur: sordida purgantur et eodem et eo, quod zmilion nominatur. Habet aeruginis P. #1108 IIII; cummis tantundem; Hammoniaci, mini Sinopici, singulorum P. #1108 XVI; quae quidam ex aqua, quidam, quo uehementiora sint, ex aceto terunt. Id quoque Euelpidis, quod pyrron[a] appellabat, huc utile est: croci P. #1108 I; papaueris lacrimae, cummis, singulorum P. #1108 II; aeris combusti et eloti, murrae, singulorum P. #1108 IIII;

[¶4] Again, ulcerations which do not heal after inflammation has ended, tend to become fungous or foul or excavated, or at any rate chronic. Such as are fungous are best repressed by the salve called menigmenon; those which are foul are cleaned both by the same and by that called zmilion. This contains: verdigris 16 grams; gum the same; ammoniacum and Sinopic minium 64 grams; some pound up these with water, others with vinegar, in order to make it more active.

> Latin: piperis albi P. #1108 VI. Sed ante leni, tum hoc inunguendum est. Id quoque eiusdem, quod sp⟨h⟩aerion nominabat, eodem ualet: lapidis haematitis eloti P. #1108 I #1109; piperis grana sex; cadmiae elotae, murrae, papaueris lacrimae, singulorum P. #1108 II; croci P. #1108 IIII; cummis P. #1108 VIII. Quae cum uino Aminaeo conterantur. Liquidum autem medicamentum ad idem conponebat, in quo era⟨n⟩t haec: aeruginis P.

[¶5] The salve of Euelpides also which he called pyrron is of use for this: saffron 4 grams; poppy-tears and gum 8 grams; roasted and washed copper and myrrh 16 grams each; white pepper 24 grams. But the eyes are first smeared with a mild ointment, then with the above.

> Latin: #1108 #1109; misy conbusti, atramenti sutori, cinnamomi, singulorum P. #1108 I; croci, nardi, papaueris lacrimae, singulorum P. #1108 I #1109; murrae P. #1108 II; aeris combusti P. #1108 III; cineris ex odoribus P.

[¶6] That salve of his which he named sphaerion has the same effect: washed haematite stone 4.66 grams; 6 peppercorns; washed zinc oxide, myrrh and poppy-tears 8 grams; saffron 16 grams; gum 32 grams; these are pounded up in Aminean wine.

> Latin: #1108 IIII; piperis grana XV. Haec ex uino austero teruntur, deinde cum passi tribus heminis decocuntur, donec corpus unum sit; idque medicamentum uetustate efficacius fit.

[¶7] For the same purpose he prepared a liquid salve, containing verdigris 0.66 gram; roasted antimony sulphide, shoemakers-blacking, and cinnamon 4 grams each; saffron, nard and poppy-tears 4.66 grams each; myrrh 8 grams; roast copper 12 grams; ash of aromatic herbs 16 grams; 15 peppercorns. These are pounded up in dry wine, then boiled in 750 cc. of raisin wine until of uniform consistency. This is rendered more efficacious by age.

> Latin: Caua uero ulcera commodissime implent ex is, quae supra posita sunt, sphaerion et id, quod Philalethus uocatur. Idem sp⟨h⟩aerion uetustis ulceribus et uix ad cicatrices uenientibus optime succurrit. Est etiam collyrium, quod, cum ad plura ualeat, plurimum tamen proficere in ulceribus uidetur. ⟨Refertur⟩ ad Hermone⟨m⟩ auctorem. Habet piperis longi P. #1108 I #1109; albi P. #1108 #1110; cinnamomi, costi, singulorum P.

[¶8] Excavated ulcerations, too, are most readily replenished with flesh by the compositions mentioned above, sphaerion, and that called Philalethus. Sphaerion is the best remedy for old-standing ulcerations, and those that are difficult to heal.

> Latin: #1108 I; atramenti sutori, nardi, casiae, castorei, singulorum P. #1108 II; gallae P. #1108 V; murrae, croci, turis, Lyci, cerussae, singulorum P. #1108 VIII; papaueris lacrimae P. #1108 XII;

[¶9] There is also a salve, which whilst efficacious in many ways seems to be specially so in the case of ulcerations. It is said to have been invented by Hermon. It contains: long pepper 4.66 grams; white pepper 0.33 gram; cinnamon and costmary 4 grams each; shoemaker's blacking, nard, casia and castoreum 8 grams each; gall 20 grams; myrrh, saffron, frankincense, lycium and cerussa, 32 grams each; poppy-tears 48 grams; lign-aloes, roasted copper and oxide of zinc 64 grams each; acacia, antimony sulphide and gum 100 grams each.

> Latin: aloes, aeris combusti, cadmiae, singulorum P. #1108 XVI; acaciae, stibis, cummis, singulorum P. #1108 XXV. Factae uero ex ulceribus cicatrices duobus uitiis periclitantur, ne aut cauae aut crassae sint. Si cauae sunt, potest eas implere id, quod ⟨s⟩phaerion uocari dixi, uel id, quod Asclepios nominatur. Habet papaueris lacrimae P. #1108 II; sagapeni, opopanacis, singulorum P. #1108 III; aeruginis P. #1108 IIII; cummis P. #1108 VIII; ⟨piperis P. #1108 XII;⟩

[¶10] Scars resulting from ulcerations are liable to two defects, they are either depressed or thick. If depressed, new flesh may be grown by applying that salve called sphaerion, or that named Asclepios, which contains: poppy-tears 8 grams; sagapenum and all-heal 12 grams each; verdigris 16 grams; gum 32 grams; pepper 48 grams; washed oxide of zinc and cerussa 64 grams each. But thick scars are thinned either by the smilion, or by the salve of Canopus which contains: cinnamon and acacia 4 grams each; washed oxide of zinc, saffron, myrrh, poppy-tears and gum 8 grams each; white pepper and frankincense 12 grams each; roasted copper 32 grams. Or the pyxinum of Euelpides, which consists of: rock-salt 16 grams; ammoniacum used for incense, 32 grams; poppy-tears 48 grams; cerussa 60 grams; white pepper and Sicilian saffron 128 grams each; gum 52 grams; washed zinc oxide 36 grams. However, the best for elevating a scar seems to be: gum 0.66 gram; verdigris 4 grams; dregs of saffron 16 grams.

> Latin: cadmiae elotae, cerussae, singulorum P. #1108 XVI. At si crassae cicatrices sunt, extenuat uel ⟨z⟩milion uel Canopitae collyrium, quod habet: cinnamomi, acaciae, singulorum P. #1108 I; cadmiae elotae, croci, murrae ⟨papaueris lacrimae,⟩ cummis, singulorum P. #1108 II; piperis albi, turis, singulorum P. #1108 III; aeris combusti P. #1108 VIII. Vel Euelpidis pyxinum, quod ex his constat: salis fossilis P. #1108 IIII; Hammoniaci thymiamatis P. #1108 VIII; papaueris lacrimae P. #1108 XII; cerussae P. #1108 XV; piperis albi, croci ⟨Siculi,⟩ singulorum P. #1108 XXXII; cummis P. #1108 XIII; cadmiae elotae P. #1108 VIIII. Maxime tamen tollere cicatricem uidetur id, quod habet: cummis P. #1108 #1109; aeruginis P. #1108 I; croci magmatis P. #1108 IIII. Est etiam genus inflammationis, in qua, si cui tument ac distenduntur cum dolore oculi, sanguinem ex fronte ⟨e⟩mitti necessarium est, multaque aqua calida caput atque oculos fouere;

[¶11] There is also a class of inflammation in which, if the eyes swell and become tense with pain, it is necessary to let blood from the forehead, and to foment the head and eyes frequently with hot water; also to gargle, using a decoction of lentils, or the cream of figs; to apply as an ointment acrid medicaments, such as have been noted above, especially that named sphaerion, and that containing haematite stone. There are also other salves of use for softening trachoma of which I am just going to speak.

> Latin: gargarizare ex lenticula uel fici cremore; inungui acribus medicamentis, quae supra conprehensa sunt, maximeque eo, quod sphaerion nominatur, quod lapidem haematitem habet. Atque alia quoque utilia sunt, quae ad extenuandam aspritudinem fiunt, de qua protinus dicam. Haec autem inflammationem oculorum fere sequitur, interdum maior, interdum leuior.

[¶12] Now this condition generally follows inflammation of the eyes; sometimes it is more serious, sometimes less so. Often too, as the result of trachoma, inflammation is set up, which in its turn increases the trachoma, and sometimes lasts a short time, sometimes long, and then it is scarcely ever terminated. In this class of affection, some scrape the thick and indurated eyelids with a fig-leaf and a rasp and sometimes with a scalpel, and every day rub medicaments into the under surface of the eyelid; such things should only be done when there is marked and inveterate hardness, and not often; for the same result is better attained by dieting and proper medicaments. Therefore we shall make use of exercise and frequent baths, and foment the eye-lids freely with hot water, and the food we give will be acrid and attenuating, and the medicine the salve called caesarianum. This contains: shoemaker's blacking 1.33 grams; antimony sulphide 1.66 grams; white pepper 1.33 grams; poppy-tears and gum 8 grams each; washed oxide of zinc 16 grams; antimony sulphide 24 grams. And this preparation will do for all kinds of eye-inflammations, except such as are relieved by bland remedies.

> Latin: Nonnumquam etiam ex aspritudine lippitudo fit, ipsam deinde aspritudinem auget, fitque ea ⟨alias⟩ breuis, in aliis longa et quae uix umquam finiatur.—In hoc genere ualetudinis quidam crassas durasque palpebras et ficulneo folio et asperato specillo et interdum scalpello eradunt, uersasque cotidie medicamentis suffricant; quae neque nisi in magna uetustaque aspritudine neque saepe facienda sunt: nam melius eodem ratione uictus et idoneis medicamentis peruenitur. Ergo exercitationibus utemur et balneo frequentiore, multaque * oculorum aqua calida fouebimus; cibos autem sumemus acres et extenuantis, medicamentum id, quod Caesarianum uocatur. Habet atramenti sutori P. #1108 I #1110; misy P. #1108 I #1109; piperis albi P. #1108 #1109 #1109; papaueris lacrimae, cummis, singulorum P. #1108 II; cadmiae elotae P. #1108 IIII; stibis P. #1108 VI; satisque constat hoc collyrium aduersus omne genus oculorum ualetudinis idoneum esse, exceptis is, quae lenibus nutriuntur. Id quoque, quod Hieracis nominatur, ad aspritudinem potest. Habet murrae P. #1108 I; Hammoniaci thymiamatis P.

[¶13] That called after Hierax is also efficacious for trachoma. It contains: myrrh 4 grams; ammoniacum used for incense 8 grams; copper filings 16 grams. For the same purpose there are also those called respectively Canopite, smilion, pyxinum, and sphaerion. But when none of these made up medicaments is at hand, then goat's bile or honey of the best is suitable enough for the treatment of trachoma.

> Latin: #1108 II; aeruginis rasae P. #1108 IIII. Ad idem idoneum est etiam id, quod Canopitae est et, quod zmilion uocatur, et id, quod pyxinum et id, quod sphaerion. Si conposita medicamenta non adsunt, felle caprino uel quam optimo melle satis commode aspritudo curatur. Est etiam genus aridae lippitudinis: xeropthalmia⟨n⟩ Graeci appellant.

[¶14] There is a kind of dry inflammation of the eyes called by the Greeks xerophthalmia. The eyes neither swell nor run, but are none the less red and heavy and painful, and at night the lids get stuck together by very troublesome rheum; the less violent the onset of this kind of trouble is, the less readily it is terminated. In this lesion there is need for much walking, much exercise, frequent bathing, sitting in the bath and sweating, and much rubbing. The food should not be too flesh-making, neither is acrid food suitable, but a mean between the two. In the morning, when it is plain that all food has been digested, it is not inappropriate to gargle with mustard, then next to rub the head and face for a considerable time.

> Latin: Neque tument neque fluunt oculi, sed rubent tamen et cum dolore quodam grauescunt et noctu praegraui pituita inhaerescunt; quantoque minor generi⟨s⟩ huius impetus, tanto finis minus expeditus est.—In hoc uitio multum ambulare, multum exerceri, lauari saepe, * * * ibique desudare, multaque frictione uti necessarium est. Cibi neque ii qui implent, neque nimium acres apti sunt, sed inter hos medi. Mane, ubi concoxisse manifestum est, non est alienum ex sinapi gargarizare, tum deinde caput atque os diutius defricare. Collyrium uero aptissimum est, quod rinion uocatur. Habet murrae P. #1108 #1109; papaueris lacrimae, acaciae suci, piperis, cummis, singulorum P.

[¶15] Again, a most suitable salve is that called rhinion. It contains: myrrh 0.66 gram; poppy-tears, acacia juice, pepper and gum 4 grams each; haematite stone, Phrygian and Lycian stone, and split stone, 8 grams each; roasted copper 16 grams. The salve pyxinum is also fitting for this same purpose.

> Latin: #1108 I; lapidis haematitis, lapidis Phrygii, Lucii, lapidis scissilis, singulorum P. #1108 II; aeris combusti P. #1108 IIII. Ac pyxinum quoque eodem accommodatum est. Si uero scabri oculi sunt, quod maxime in angulis esse consueuit, potest prodesse rinion, id quod supra positum est;

[¶16] When the eyes are scabrous, which mostly occurs at their angles, the rhinion slave noted above may do good; that one may also serve which contains: copper filings, long pepper and poppy-tears 8 grams each; white pepper and gum 16 grams each; washed oxide of zinc and cerussa 64 grams each. Nothing, however, is better than that named by Euelpides basilicon. It contains: poppy-tears cerussa and Assos stone, 8 grams each; gum 12 grams; white pepper 16 grams; saffron 24 grams; psoricum 42 grams. Now there is no drug called psoricum, but some copper ore and a little more than half as much oxide of zinc are pounded up together in vinegar, and this is placed in an earthenware jar and covered over with fig-leaves and is buried underground; after twenty days it is taken up, and again pounded, when it is given this name. It is generally agreed that the salve basilicum is suitable for all affections of the eyes which are not treated by bland medicaments. But when such compositions are not at hand, honey and wine relieve the scabrous angles of the eyes; in this and in dry ophthalmia relief is afforded by soaking bread in wine, and applying it over the eyes. For since there is generally some humour which is irritating either the eyeball itself, or the eyelids, by this application any humour on the surface is drawn out and any near at hand driven back.

> Latin: potest militare: id, quod habet aeruginis rasae, piperis longi, papaueris lacrimae, singulorum P. #1108 II; piperis albi, cummis, singulorum P. #1108 IIII; cadmiae elotae, cerussae, singulorum P. #1108 XVI. Nullum tamen melius est quam Euelpidis, quod basilicon nominabat. Habet papaueris lacrimae, cerussae, lapidis As⟨s⟩ii, singulorum P. #1108 II; cummis P. ⟨#1108⟩ ⟨III; piperis albi P. #1108⟩ IIII, croci P. #1108 VI; psorici P. #1108 XIII. Nulla autem per se materia est, quae psoricum nominetur, sed chalcitidis aliquid et cadmiae dimidio plus ex aceto simul conteruntur, idque in uas fictile additum et contectum ficulneis foliis sub terra reponitur, sublatum⟨qu⟩e post dies uiginti rursus teritur, et sic †appellatur. Verum in basilico quoque collyrio conuenit ad omnes affectus oculorum id esse idoneum, qui non lenibus medicamentis curantur. Vbi non sunt autem medicamenta composita, scabros angulos leuant et mel et uinum; succurritque et his et aridae lippitudini, si quis pane⟨m⟩ ex uino subactum super oculum inponit. Nam cum fere sit umor aliquis, qui modo ipsum oculum, modo angulos aut palpebras exasperat, sic et, si quid prodit umoris, extrahitur, et, si quid iuxta est, repellitur.

[¶17] Again the eyes tend at times to become dim from ophthalmia, but also apart from that, on account of old age, or other weakness. If the disorder is owing to the remnants of an ophthalmia, the salve called Asclepios is of service and that which is composed of saffron dregs.

> Latin: Caligare uero oculi nonnumquam ex lippitudine, nonnumquam etiam sine hac propter senectutem inbecillitatemue aliam consuerunt. Si ex reliquis lippitudinis id uitium est, adiuuat collyrium, quod Asclepios nominatur, adiuuat id, quod ex croci magmate fit.

[¶18] Also there is a special preparation for this purpose called dia crocu. It contains pepper 4 grams; Cilician saffron, poppy-tears and cerussa 8 grams each; psoricum and gum 16 grams each.

> Latin: Proprie etiam ad id componitur, quod dia crocu uocant. Habet piperis P. #1108 I;

[¶19] But if the eyes are dim from old age or other weakness, it is good to anoint with best honey, cyprus oil, and old olive oil. The most suitable unguent, however, is made of balsam one part, and old olive or cyprus oil two parts, and three parts of the sharpest honey. Here too those applications are suitable which were noted just above for dim vision and previously for thinning scars. If anyone finds his eyes becoming dim he must walk and exercise a great deal; also bathe frequently, and in the bath he is to be rubbed all over, especially, however, on his head, with iris unguent, until he sweats; and he should then be wrapped up, and not uncover, until after reaching home the sweating and heat have passed off. Then he should take acrid foods which will make him thin and some days afterwards gargle with mustard.

> Latin: croci Cilici, papaueris lacrimae, cerussae, singulorum P. #1108 II; psorici, cummis, singulorum P. #1108 IIII. At si ex senectute aliaue inbecillitate id est, recte inungui potest et melle quam optumo et cypr⟨o⟩ et oleo uetere. Commodissimum tamen est balsami partem unam et olei ueteris aut cypri partes duas, mellis quam acerrimi partes tres miscere. Vtilia huc quoque medicamenta sunt, quaeque ⟨ad caliginem proxime quaeque⟩ ad extenuandas cicatrices supra comprehensa sunt. Cuicumque uero oculi caligabunt, huic opus erit multa ambulatione ⟨atque exercitatione,⟩ frequenti balneo, ubi totum quidem corpus perfricandum est, praecipue tamen caput, et quidem irino, donec insudet, uelandumque postea nec detegendum antequam sudor et calor domi conquierint.

[¶20] Cataract also, which the Greeks call hypochysis, sometimes interferes with the vision of the eye. When it has become long established it is to be treated surgically. In its earliest stages it may be dispersed occasionally by certain measures: it is useful to let blood from the forehead or nostrils, to cauterize the temporal blood vessels, to bring out phlegm by gargling, to inhale smoke, to anoint the eyes with acrid medicaments. That regimen is best which makes phlegm thin.

> Latin: Tum cibis utendum acribus et extenuantibus, interpositisque aliquibus diebus ex sinapi gargarizandum. Suffusio quoque, quam Graeci hypochysin nominant, interdum oculi potentiae, qua cernit, se opponit. Quod si inueterauit, manu curandum est. Inter initia nonnumquam certis obseruationibus discutietur. Sanguinem ex fronte uel naribus mittere, in temporibus uenas adurere, gargarizando pituitam euocare, subfumigare, oculos acribus medicamentis inunguere expedit.

[¶21] Again, even the relaxation of the eyes which the Greeks call paralysis is not to be treated by any different regimen or by any different medicaments. It is sufficient to explain just the kind of lesion it is. It happens then sometimes in the case of one eye, sometimes of both, from some blow, or from epilepsy, or from a spasm, by which the eyeball itself is violently shaken, that it cannot be directed at any object, or be held at all steady, but with no reason it turns now this way, now that, and so does not even afford a view of objects.

> Latin: Victus optimus est, qui pituitam extenuat. Ac ne resolutio quidem oculorum, quam paralysin Graeci nominant, alio uictus modo uel aliis medicamentis curanda est. Exposuisse tantum genus uitii satis est. Igitur interdum euenit, modo in altero oculo, modo in utroque, aut ex ictu aliquo aut ex morbo comitiali, aut ex distentione neruorum, qua uehementer ipse oculus concussus est, ut is neque quoquam intendi possit, neque omnino consistat, sed huc illucue sine ratione moueatur;

[¶22] The malady the Greeks call mydriasis is not very different from the above. The pupil spreads out and is dilated, and its vision becomes dimmed and almost lost. This kind of weakness is most difficult to relieve. Both of these paralysis and mydriasis are to be countered by all the same prescriptions as mistiness of the eyes, but with a few alterations such as the addition sometimes of vinegar, sometimes of soda, to the iris unguent for the head; while honey is sufficient for the eye inunctions. In the case of mydriasis, some patients have been relieved by the use of hot water, some without any obvious cause have suddenly become blind. Some of these after seeing nothing for some time have suddenly regained vision following a profuse stool. Hence it seems not inappropriate, whether in a recent case or in one of some standing, by the use of medicaments to force stools in order to drive downwards all noxious matter.

> Latin: ideoque ne conspectum quidem rerum praestat. Non multum ab hoc malo distat id, quod mydriasin Graeci uocant. Pupilla funditur et dilatatur, aciesque eius hebetescit ac paene * *.—Difficillime genus id inbecillitatis eliditur. In utraque parte uero [id est et paralysi et mydriasi] pugnandum est per eadem omnia, quae in caligine oculorum praecepta sunt, paucis tantum mutatis, siquidem ad caput irino interdum acetum, interdum nitrum adiciendum est, melle inungui satis est. Quidam in posteriore uitio calidis aquis usi releuatique: quidam sine ulla manifesta causa subito obcaecati sunt. Ex quibus nonnulli cum aliquamdiu nihil uidissent, repentina profusione alui lumen receperunt;

[¶23] There is besides a weakness of the eyes, owing to which people see well enough indeed in the daytime but not at all at night; in women whose menstruation is regular this does not happen. But success sufferers should anoint their eyeballs with the stuff dripping from a liver whilst roasting, preferably of a he-goat, or failing that of a she-goat; and as well they should eat some of the liver itself. But, we may also use with advantage the same remedies which dry up scars and trachoma. Some add honey to pounded purslane seed until the mixture no longer drops from the end of a probe, and with it anoint the eyeballs. The same exercises, baths, rubbings, and gargles are also to be used for these patients.

> Latin: quo minus alienum uidetur e⟨t⟩ recenti re et interposito tempore medicamentis quoque moliri deiectiones, quae ⟨om⟩nem noxiam materiam ⟨in⟩ inferiora depellant. Praeter haec inbecillitas oculorum est, ex qua quidem interdiu satis, noctu nihil cernunt; quod in feminam bene respondentibus menstruis non cadit.—Sed sic laborantes inungui oportet sani⟨e⟩ iocineris maxime hirquini, si minus, caprini, ubi id assum coquitur, excepta; atque edi quoque ipsum iecur debet. Licet tamen etiam isdem medicamentis non ⟨in⟩utiliter uti, quae uel cicatrices uel aspritudinem extenuant: quidam contrito semin⟨i⟩ portlacae mel adiciunt, eatenus ne id ex specillo destillet, eoque inungunt.

[¶24] All the foregoing disorders arise within the body; but a blow from without at times so inures the eye that it is suffused with blood. Nothing is then better than to anoint the eyeball with the blood of a pigeon, dove, or swallow. There is some reason for this, because the vision of these birds, when indicate from without, returns after an interval to its original state, most speedily in the case of the swallow. This also has given rise to the fable that the old birds restore the vision by a herb, when it really returns spontaneously. Hence the blood of these birds most properly protects our eyes too after an external injury, and in the following order: swallows' blood is best, next that of the pigeon, and the dove's is the least efficacious, both as regards the birds themselves and us. In order to relieve inflammation, it is not unfitting to apply a poultice over the injured eye. The best salt from Ammon, or some other salt, is pounded, and oil gradually added until it is of the consistency of strigil scrapings. Then this is mixed with barley-meal which has been boiled in honey wine. But it is easy, after looking through all that medical practitioners have written, for anyone to see that there is scarcely any one of the eye disorders among those included above which it may not be possible to clear up by simple and readily procured remedies.

> Latin: Exercitationibus, balneo, frictionibus, gargarizationibus isdem his quoque utendum est. Et haec quidem in ipsis corporibus oriuntur. Extrinsecus uero interdum sic ictus oculum laedit, ut sanguis in eo suffundatur. —Nihil commodius est quam sanguine uel columbae uel palumbi uel hirundinis inunguere. Neque id sine causa fit, cum horum acies extrinsecus laesa interposito tempore in anticum statum redeat, cel⟨err⟩ime hirundinis. Vnde etiam fabulae locus factus est, per parentes id herba restitui, quod per se sanescit. Eorumque ergo sanguis nostros quoque oculos ab externo casu commodissime tuetur, hoc ordine, ut sit hirundinis optimus, deinde palumbi, minime efficax columbae et illi ipsi et nobis. Supra percussum uero oculum ad inflammationem leniendam non est alienum inponere etiam cataplasma. ⟨Sal⟩ Hammoniacus uel quilibet alius quam optimus teri debet, sic ut ei paulatim oleum adiciatur, donec crassitudo strigmenti fiat. Id deinde miscendum est cum hordeacia farina, quae ex mulso decocta sit. Facile autem recognitis omnibus, quae medici prodiderunt, apparere cuilibet potest, uix ullum ex is, quae supra conprehensa sunt, oculi uitium esse, quod non simplicibus quoque et promptis remediis summoueri possit.

[¶25] 7. 7 So much, then, for those classes of eye disease, for which medicaments are most successful; and now we pass to the ears, the use of which comes next to eye-sight as Nature's gift to us. But in the case of the ears still a somewhat greater danger; for whereas lesions of the eyes keep the mischief to themselves, inflammations and pains in the ears sometimes even serve to drive the patient to madness and death. The makes it more desirable to apply treatment at the very beginning, that there may be no opening for the greater discovering. As soon, therefore, as the pain is first felt, the patient should fast and keep quiet; the next day, if the pain is still severe, the head should be shaved, and after it has been anointed with hot iris unguent, covered up. But great pain with fever and sleeplessness require also that blood should be let; if anything prevents this, the bowels are to be moved. Hot poultices also, frequently changed, are of service, whether composed of fenugreek or linseed or other meal boiled in honey wine, and sponges also wrung out of hot water, applied at intervals, are appropriate. Then, when the pain is relieved, iris or cyprus unguent should be spread around the ears; in some cases, however, the rose unguent is more advantageous. If severe inflammation entirely prevents sleep, there should be added to the poultice half its quantity of toasted and pounded poppy-head rind, and this should be boiled down with the rest in diluted raisin wine. It is desirable also to pour some medicament into the ear, and this should always be made lukewarm beforehand; and is best dropped in from a strigil. When the ear is full, soft wool is applied over it to keep in the fluid. And these are the medicaments generally used for this purpose: but also there is rose oil and arundo-root juice and oil in which worms have been boiled, juice expressed from bitter almonds or from peach-kernels. But the compositions for relieving inflammation and pain generally employed are: castoreum and poppy-tears in equal amounts, pounded together; then to these there is added raisin wine. Or poppy-tears, saffron and myrrh in equal quantities pounded, while rose oil and raisin wine are dropped in by turns. Or the bitter part of the Egyptian bean pounded up with rose oil added; with these some mix a little myrrh or poppy-tears, or frankincense in woman's milk, or the juice of bitter almonds with rose oil. Or castoreum, myrrh and poppy-tears, equal parts, with raisin wine. Or saffron 1 gram; myrrh and shredded alum 0.66 gram of each;; whilst this is being pounded there is slowly added to it 125 cc. of raisin wine, of honey rather less than 40 cc., and this is one of the best remedies. Or poppy-tears in vinegar. Themison's compound may also be used; it contains: castoreum, opopanax and poppy-tears 8 grams each, buckthorn scum 16 grams. These are pounded and made up in raisin wine, until they have the consistency of a wax salve and are so preserved. When required for use, this composition is again stirred with a probe whilst adding raisin wine. The rule is general, that when a composition has become too thick to be dropped into the ear, some of the fluid with which it was made up is added until it become sufficiently liquid.

> Latin: 7. Hactenus in oculis ea * * reperiuntur, in quibus medicamenta plurimum possint: ideoque ad aures transeundum est, quarum usum proximum a luminibus natura nobis dedit. Sed in his aliquanto maius periculum est: nam uitia oculorum intra ipsos nocent, aurium inflammationes doloresque interdum etiam ad dementiam mortemque praecipitant. Quo magis inter initia protinus succurrendum est, ne maiori periculo locus sit. —Ergo ubi primum dolorem aliquis sensit, abstinere et continere se debet; postero die, si uehementius malum est, caput tondere, idque irino unguento calido perunguere et operire. At magnus cum febre uigilia⟨que⟩ dolor exigit, ut sanguis quoque mittatur; si id aliquae causae prohibent, aluus soluenda est. Cataplasmata quoque calida subinde mutata proficiunt, siue feni Graeci siue lini siue alia farina ex mulso decocta e⟨t⟩ recte etiam subinde admouentur spongiae ex aqua calida expressae. Tum leuato dolore ceratum circumdari debet ex irino aut cyprino factum: in quibusdam tamen melius quod ex rosa est proficit. Si uehemens inflammatio somnum ex toto prohibet, adici cataplasmati debent papaueris cortices fricti atque contriti, sic ut ex his pars dimidia sit, eaque tum simul ex passo mixto decoquatur. In aurem uero infundere aliquod medicamentum oportet, quod semper ante tepefieri conuenit, commodissimeque per striglem instillatur. Vbi auris repleta est, super lana mollis addenda est, quae umorem intus contineat. Et haec quidem communia sunt medicamenta: uerum est et rosa et radicum harundinis sucus, et oleum, in quo lumbrici cocti sunt, et umor ex amaris nucibus aut ex nucleo mali Persici expressus. Conposita uero ad inflammationem doloremque leniendum haec fere sunt: castorei, papaueris lacrimae pares portiones conteruntur; deinde adicitur his passum. ⟨Vel⟩ papaueris lacrimae, croci, murrae par modus sic teritur, ut inuicem modo rosa modo passum ⟨in⟩stilletur. Vel id, quod amarum in Aegyptia faba est, conteritur rosa adiecta; quibus murrae quoque paulum a quibusdam miscetur uel papaueris lacrimae aut tus cum muliebri lacte uel amararum nucum cum rosa sucus. Vel castorei, murrae, papaueris lacrimae pares portiones cum passo. Vel croci P. #1108 #1109 #1110; murrae, aluminis scissilis, ⟨singulorum⟩ P. #1108 #1109; quibus dum teruntur paulatim miscentur passi cyathi tres, mellis minus cyatho, idque ex primis medicamentis est. Vel papaueris lacrima[e] ex aceto. Licet etiam compositione uti Themisonis, quae habet castorei, opopanacis, papaueris lacrimae, singulorum P. #1108 II; spumae Lyci P. #1108 IIII. Quae contrita passo excipiuntur, donec ⟨c⟩erati crassitudinem habeant, atque ita reponuntur. Vbi usus requiritur, rursus id medicamentum adiecto passo specillo teritur. Illud perpetuum est, quotienscumque crassius medicamentum est quam ut in aurem instillari possit, adiciendum eum esse umorem, ex quo id componi debet, donec satis liquidum sit.

[¶26] If again the ears have pus in them as well, it is proper to pour in boxthorn juice by itself, or iris unguent or leek juice or the juice of a sweet pomegranate warmed in its rind, to which a little myrrh is added. It is useful to mix together myrrh of the sort called stacte 4 grams; the same amount of saffron; 25 bitter almonds; of honey 250 cc.; these are pounded together, and when they are to be used, are warmed in a pomegranate rind. The medicaments which are compounded for ulcerations of the mouth are equally healing for ulcerations of the ear. If the disease is of longer standing, and much matter is discharged, the composition said to have been invented by Erasistratus is suitable: pepper 0.66 gram; saffron 0.66 gram; myrrh and cooked antimony sulphide 4 grams each; roasted copper 8 grams. These are pounded up in wine, and when the mixture has become dry, 750 cc. of raisin wine are added, and are boiled up with it. When it is to be used, wine and honey are added to these ingredients. There is also the medicament of the surgeon Ptolemaeus, which contains: mastich 0.66 gram, oak galls 0.66 gram, omphacium 4 grams; and pomegranate juice. There is the very active remedy of Menophilus, which consists of: long pepper 4 grams; castoreum 8 grams; myrrh, saffron, poppy-tears, Syrian nard, frankincense, pomegranate rind, the embryo of an Egyptian bean, bitter almonds, and the best honey 16 grams each. These are pounded together with the addition of very sour vinegar until of the consistency of raisin wine. The prescription of Craton is the following: cinnamon and casia 0.66 grams, boxthorn juice, nard and myrrh 4 grams each, lign-aloes 8 grams, honey 125 cc., wine half a litre. The lycium is first boiled in the wine, and the rest added. But when there is much pus, and the odour bad, verdigris scrapings and frankincense 8 grams each, honey 85 cc.; vinegar 170 cc. are boiled together. For use, it is mixed with sweet wine. Or equal weights of shredded alum, poppy-tears and acacia juice are mixed together, and to these is added of hyoscyamus juice less than half the quantity of each one of the above; and these are pounded together and diluted with wine. Also hyoscyamus juice is sufficiently beneficial by itself.

> Latin: Si uero pus quoque aures habent, recte Lycium per se infunditur, aut irinum unguentum aut porri sucus cum melle aut centauri sucus cum passo aut dulcis mali Punici sucus in ipsius cortice tepefactus, adiecta murrae exigua parte. Recte etiam miscentur murrae, quam stacten cognominant, P. #1108 I; croci tantundem; nuces amarae XXV; mellis sex cyath⟨i⟩; quae contrita, cum utendum est, in cortice mali Punici tepefiunt. Ea quoque medicamenta, quae oris exulcerati causa componuntur, aeque ulcera aurium sanant. Quae si uetustiora sunt et multa sanies fluit, apta compositio est, quae ad auctorem Erasistratum refertur: piperis P. #1108 #1109; croci P. #1108 #1109; murrae, ⟨mi⟩sy cocti, singulorum P. #1108 I; aeris combusti P. #1108 II. Haec ex uino teruntur: deinde ubi inaruerunt, adiciuntur passi heminae tres et simul incocuntur. Cum utendum est, adicitur his mel et uinum. Est etiam Ptolemaei chirurgi medicamentum, quod habet: lentisci P. #1108 #1109; gallae P. ⟨#1108⟩ #1109; omphaci P. #1108 I; sucum Punici mali. Est Menophili ualidum admodum, quod ex his constat: piperis longi P. #1108 I; castorei P. #1108 II; murrae, croci, papaueris lacrimae, nardi Suriaci, turis, malicori, ex Aegyptia faba partis interioris, nucum amararum, mellis quam optumi, singulorum P. #1108 IIII; quibus cum teruntur adicitur acetum quam acerrimum, donec crassitudo in his passi fiat. Est Cratonis: cinnamomi, casiae, singulorum P. #1108 #1109; Lyci, nardi, murrae, singulorum P. #1108 I; aloes P. #1108 II; mellis cyathi tres; uini sextarius; ex quibus Lycium cum uino decoquitur, deinde his alia miscentur. At si multum puris malusque odor est, aeruginis rasae, turis, singulorum P. #1108 II; mellis cyathi duo; aceti quattuor simul incocuntur. Vbi utendum est, dulce uinum miscetur.

[¶27] A general remedy for all ear cases, and one approved by experience, was composed by Asclepiades. This contains: cinnamon and casia 4 grams each; flowers of round cyperus, castoreum, white pepper, long pepper, cardamomum and bennut, 8 grams each; male frankincense, Syrian nard, fatty myrrh, saffron, soda-scum, 12 grams each. These are pounded separately, then mixed with vinegar and again pounded, and so preserved; when for use they are diluted with vinegar. In the same way a general remedy for all ear disorders is the tablet of Polyidus, dissolved in sweet wine, the prescription for which is given in the last book. But if there is both a discharge of matter and a swelling, it is not unfitting to ash out the ear with diluted wine through an ear syringe, and then pour in dry wine mixed with rose oil, to which a little oxide of zinc has been added, or boxthorn juice with milk, or polygonum juice with rose oil, or pomegranate juice with a very little myrrh.

> Latin: Aut aluminis scissilis, papaueris lacrimae, acaciae suci par pondus miscetur, hisque adicitur hyoscyami suci dimidio minor quam unius ex superioribus portio, eaque trita ex uino diluuntur. Per se quoque hyoscyami sucus satis proficit. Commune uero auxilium aduersus omnes aurium casus iamque usu conprobatum Asclepiades conposuit. In eo sunt cinnamomi, casiae, singulorum P. #1108 I; floris iunci rotundi, castorei, albi piperis, longi, amomi, myrobalani, singulorum P. #1108 II; turis masculi, nardi Syriaci, murrae pinguis, croci, spumae nitri, singulorum P. #1108 III. Quae separatim contrita, rursus mixta ex aceto conteruntur, atque ita condita, ubi utendum est, aceto diluuntur. Eodem modo commune auxilium auribus laborantibus est Poly⟨id⟩i sphragis ex dulci uino liquata, quae conpositio priore libro continetur.

## 24. Book VI · chapters 7–14

Source: https://scriptura.si/works/celsus-on-medicine/24/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/24/#p-N

[¶0] If there is also foul ulceration, it is better to wash out with honey wine, and then pour in some one of the compositions described above which contain honey. If there is a great discharge of pus the head is to be shaved, and hot water poured freely over it, also the patient should gargle with the same, walk until tired, and take food sparingly. If there is bleeding from the ulcerations, boxthorn juice should be poured in mixed with milk, or with water in which rose leaves have been boiled, with polygonum juice or that of acacia added. If flesh has formed over the ulcerations and there is a malodorous discharge, the ear should be washed out with tepid water, then that composition poured in which contains frankincense, verdigris, vinegar and honey; or honey boiled with verdigris. Copper scales also pounded up with sandarach may be instilled through a tube with advantage.

> Latin: Quod si et sanies profluit et tumor est, non alienum est mixto uino per oricularium clysterem eluere, et tum infundere uinum austerum cum rosa mixtum, cui spodi paulum sit adiectum, aut Lucium cum lacte aut herbae sanguinalis sucum cum rosa aut mali Punici sucum cum exigua murrae parte. ⟨Si⟩ sordida quoque ulcera sunt, melius mulso eluuntur, et tum aliquid ex is, quae supra scripta sunt, quod mel habeat, infunditur. Si magis pus profluit, et caput utique tondendum est et multa calida aqua perfundendum, ⟨et gargarizandum,⟩ et usque ad lassitudinem ambulandum, et cibo modico utendum est. Si cruor quoque ex ulceribus apparuit, Lycium cum lacte debet infundi, uel aqua, in qua rosa decocta sit, suco aut herbae sanguinalis aut acaciae adiecto. Quod si super ulcera caro increuit, eaque mali odoris saniem fundit, aqua tepida elui debet, tum infundi id, quod ex ture et aerugine et ⟨aceto et⟩ melle fit, aut mel cum aerugine incoctum.

[¶1] When maggots have appeared, if they are near the surface, they must be extracted by an ear scoop; if further in they must be killed by medicaments, and afterwards care taken that they do not breed. White veratrum pounded up in vinegar serves for both these purposes. The ear should also be washed out with a decoction of horehound in wine. By this procedure dead maggots will be driven forwards into the outer part of the ear, whence they can be readily withdrawn.

> Latin: Squama quoque aeris cum sandaraca contrita per fistulam recte instillatur. Vbi uero uermes orti sunt, si iuxta sunt, protrahendi oriculario specillo sunt; si longius, medicamentis enecandi, cauendumque ne postea nascantur. Ad utrumque proficit album ueratrum cum aceto contritum. Elui quoque aurem oportet uino, in quo marrubium decoctum sit.

[¶2] But if the ear-passage has been narrowed and thick matter collects within, honey of the best ought to be introduced. If this does not help, there must be added to 65 cc. of honey 8 grams of verdigris scrapings; they must be boiled together and so used. Iris root with honey has the same efficacy. So also has galbanum 8 grams, myrrh and ox bile 1.33 grams each, and of wine a sufficient quantity to dissolve the myrrh.

> Latin: Emortu⟨i su⟩b his uermes in primam partem auris prouocabuntur, unde educi facillime possunt. Sin foramen auris conpressum est, et intus crassa sanies subest, mel quam optimum addendum est. Si id parum proficit, mellis cyatho et dimidio aeruginis rasae P. #1108 II adiciendum est incoquendumque, et eo utendum. Iris quoque cum melle idem proficit.

[¶3] When a man is becoming dull of hearing, which happens most often after prolonged headaches, in the first place, the ear itself should be inspected: for there will be found either a crust such as comes upon the surface of ulcerations, or concretions of wax. If a crust, hot oil is poured in, or verdigris mixed with honey or leek juice or a little soda in honey wine. And when the crust has been separated from the ulceration, the ear is irrigated with tepid water, to make it easier for the crusts now disengaged to be withdrawn by the ear scoop. If it be wax, and if it be soft, it can be extracted in the same way by the ear scoop; but if hard, vinegar containing a little soda is introduced; and when the wax has softened, the ear is washed out and cleared as above. When the heaviness of the head persists it should be shaved; the head rubbed over gently and for some time with castoreum to which either iris or laurel oil has been added with either of which a little vinegar has been mixed; then the patient must take a long walk, and after the rubbing his head is to be fomented with hot water. And the food should be of the lightest and of the middle class, and the drinks especially diluted; he should occasionally gargle. Further, the ear should be syringed with castoreum mixed with vinegar and laurel oil and the juice of young radish rind, or with cucumber juice, mixed with crushed rose leaves. The dropping in of the juice of unripe grapes mixed with rose oil is also fairly efficacious against deafness.

> Latin: Item galbani P. #1108 II, murrae et fellis taurini, singulorum P. #1108 #1109 #1109, uini quantum satis est ad murram diluendam. Vbi uero grauius aliquis audire coepit, quod maxime post longos capitis dolores euenire consueuit, in primis aurem ipsam considerare oportet: apparebit enim aut crusta, qualis super ulcera innascitur, aut sordium coitus. Si crusta est, infundendum est oleum calidum, aut cum melle aerugo uel porri sucus, aut cum mulso nitri paulum. Atque ubi crusta a corpore iam recedit, eluenda auris aqua tepida est, quo facilius ea per se diducta oriculario specillo protrahatur. Si sordes ⟨h⟩aeque molles sunt, eodem specillo eximendae sunt: at si durae sunt, acetum et cum eo nitri paulum coiciendum est; cumque emollitae sunt, eodem modo elui aurem purgarique oportet. Quod si capitis grauitas manet, attondendum; idem leniter * sed diu perfricandum est, adiecto uel irino uel laureo oleo, sic ⟨ut⟩ utrilibet paulum aceti misceatur; tum diu ambulandum, leniterque post unctionem aqua calida caput fouendum. Cibisque utendum ex inbecillissima et media materia, magisque adsumendae dilutae potiones; nonnumquam gargarizandum est. Infundendum autem in aurem ⟨castoreum⟩ cum aceto et laureo oleo ⟨et⟩ suco radic⟨ul⟩ae corticis, aut cucumeris agrestis sucus additis contritis rosae foliis.

[¶4] Another class of lesion is that in which the ears produce a ringing noise within themselves: and this also prevents them from perceiving sounds from without. This is least serious when due to cold in the head; worse when occasioned by diseases or prolonged pains of the head; worst of all when it precedes the onset of serious maladies, and especially epilepsy.

> Latin: Inmaturae quoque uuae sucus cum rosa instillatus aduersus surditatem satis proficit. Aliud uiti genus est, ubi aures intra se ipsas sonant; atque hoc quoque fit, ne externum sonum accipiant. Leuissimum est, ubi id ex grauidine est; peius, ubi ex morbis capitisue longis doloribus incidit;

[¶5] If it is due to a cold, the ear should be cleaned and the breath held until some humour froths out from it. If it arises from disease and pain in the head, the prescriptions as to exercise, rubbing, affusion and gargling should be carried out. Only foods that make thin are to be used. Into the ear radish juice should be dropped with oil of roses or with the juice of wild cucumber root; or castoreum with vinegar and laurel oil. Also veratrum is pounded up for this purpose in vinegar, then mixed with boiled honey, and a slave made of it and introduced into the ear.

> Latin: pessimum, ubi magnis morbis uenientibus maximeque comitiali praeuenit. Si ex grauidine est, purgare aurem oportet et spiritum continere, donec inde umor aliquis ex⟨spu⟩met. Si ex morbo uel capitis dolore, quod ad exercitationem, frictionem, perfusionem gargarizationemque pertinet, eadem facienda sunt. Cibis non utendum nisi extenuantibus. In aurem dandus radiculae sucus cum rosa uel cum suco radicis ex cucumere agresti; uel castoreum cum aceto et laureo oleo;

[¶6] If the noise begins without these reasons and so causes dread of some new danger, there should be inserted into the ear castoreum in vinegar or with either iris oil or laurel oil; or castoreum is mixed with this together with the juice of bitter almonds; or myrrh and soda with rose oil and vinegar But in this case also, there is more benefit from regulation of the diet, and the same is to be done as was prescribed above, with even greater care. And, besides, until the noise has ceased the patient must abstain from wine. But if there is at the same time both ringing and inflammation, laurel oil should be freely inserted, or the oil expressed from bitter almonds with which some mix myrrh or castoreum.

> Latin: ueratrum quoque ⟨ad⟩ id ex aceto conteritur, deinde melle cocto excipitur, et inde collyrium factum in aurem demittitur. Si sine his coepit ideoque nouo metu terret, in aurem dare⟨i⟩ debet castoreum cum aceto uel irino aut laureo oleo; aut huic mixtum castoreum cum suco nucum amararum; aut murra et nitrum cum rosa et aceto. Plus tamen in hoc quoque proficit uictus ratio, eademque facienda sunt, quae supra conprehendi, cum maiore quoque diligentia; et praeterea, donec is sonus finiatur, a uino abstinendum. Quod si simul et sonus est et inflammatio, laureum oleum coniecisse abunde est, aut id, quod ex amaris nucibus exprimitur, quibus ⟨qui⟩dam uel castoreum uel murram miscent.

[¶7] It happens also occasionally that something slips into the ear, such as a small stone, or some living thing. If a flea has got in, a little wool is introduced in which it becomes engaged and so is extracted. If it does not come out, or if it is some other creature, a probe is wrapped round with a little wool, soaked in very sticky resin, especially turpentine resin, which after being passed in the ear is there twisted round; for that will certainly catch it. If it is some inanimate object, it is to be withdrawn by an ear scoop or by a small blunt hook slightly bent. If these are ineffectual it is possible to extract it by means of resin as above. Also if a sneezing fit is induced, this easily moves it away or a forcible injection of water through an ear syringe. Again, a plank may be arranged, having its middle supported and the ends unsupported. Upon this the patient is tied down, with the affected ear downwards, so that the ear projects beyond the end of the plank. Then the end of the plank at the patient's feet is struck with a mallet, and the ear being so jarred what is within drops out.

> Latin: Solet etiam interdum in aurem aliquid incidere, ut calculus aliquodue animal. Si pulex intus est, conpellendum eo lanae paulum est, quo ipse is subit et simul extrahitur. Si non est secutus aliudue animal est, specillum lana inuolutum in resina quam glutinosissim⟨a⟩ maximeque terebenthina demittendum, idque in aurem coiciendum ibique uertendum est: utique enim conprehendit [eximet]. Sin aliquid exanime est, specillo oriculario protrahendum est aut hamulo retuso paulum recuruato. Si ista nihil proficiunt, potest eodem modo resina protrahi. Sternumenta quoque admota id commode elidunt, aut oriculario clystere aqua uehementer intus conpulsa. Tabula quoque conlocatur, media inhaerens, capitibus utr⟨im⟩que pendentibus; superque eam homo deligatur in id latus uersus, cuius auris eo modo laborat, sic ut extra tabulam emineat. Tum malleo caput tabulae, quod a pedibus est, feritur; atque ita concussa aure id quod inest excidit.

[¶8] 8. 8 Now ulcerated nostrils should be fomented with steam from hot water; that is done either by applying a sponge after squeezing it ou, or by holding the nose over a narrow-mouthed vessel filled with hot water. After this fomentation the ulcerations should be smeared with lead slag, white lad or litharge; with any of these a kind of poultice is compounded, and to this, while it is being pounded up, wine and myrtle oil are added alternately, until it becomes of the consistency of honey. But if these ulcerations involve bone, and have numerous crusts with a foul odour, which kind the Greeks call ozaena, it ought to be understood that it is scarcely possible to afford relief in that disease. The following measures, none the less, can be tried: the head may be shaved to the scalp, rubbed frequently and vigorously, and sluiced with quantities of hot water; then the patient is to take a great deal of exercise, and a moderate amount of food, neither sour nor very nutritious. Further, into the nostril itself may be inserted honey to which a very small quantity of turpentine resin has been added (this is done on a probe wrapped round with wool), and this juice is drawn inwards by the breath until it can be tasted in the mouth. For in this way the crusts are loosened, and they should then be blown out by sneezing. The ulcerations having been cleaned are steamed over hot water; then there should be applied either boxthorn-juice diluted with wine or wine lees or omphacium or the juice of mint or horehound or blacking made glowing hot and then pounded, or the interior part of a squill crushed; provided that to any of these honey is added. The honey should be a very small part in all these mixtures, except with the blacking, when there should be just enough to make the mixture liquid, whilst with the squill certainly the honey should form the larger part; a probe should be wrapped round with wool, and dipped into this medicament, and with it the ulcers are filled. And further, a strip of linen is folded into a long roll, smeared with the same medicament, and inserted into the nostril, and is lightly bandaged on below. This should be done in winter and spring twice a day, in summer and autumn three times a day. Again, inside the nostrils there are sometimes formed little lumps like women's nipples, and these are fixed by their deepest and most fleshy parts. These should be treated by caustics, under which they are completely eaten away. A polypus, in fact, is a lump of this sort, sometimes white, sometimes reddish, which is attached to the bone of the nose, and fills the nostril, being directed sometimes towards the lips, sometimes backwards through that passage by which the breath goes from the nose to the throat. In this direction it may grow until it can be seen behind the uvula; it chokes the patient, especially when the south or east wind blows; generally it is soft, rarely hard, and the latter sort hinders breathing more and dilates the nose; it is then generally cancerous, and so should not be touched. But the other kind can generally be removed by the knife; sometimes, however, it dries up, if the following composition is inserted into the nostril on lint or on a feather: minium from Sinope, copper ore, lime, and sandarach 4 grams each, blacking 4 grams.

> Latin: 8. Nares uero exculceratas fouere oportet uapore aquae calidae. Id et spongia expressa atque admota fit et subiecto uase oris angusti calida aqua repleto. Post id fomentum inlinenda ulcera sunt ⟨a⟩ut plumbi recremento aut cerussa aut argenti spuma: cum quolibet horum * * aliquod conteri[t,] eique, dum teritur, in uicem uinum et oleum murteum adici[t,] donec †mellis crassitudinem fecerit. Sin autem ea ulcera circa os sunt pluresque crustas et odorem foedum habent, quod genus Graeci ozenam appellant, sciri quidem debet uix ei malo posse succurri. Nihilo minus tamen haec temptari possunt, ut caput ad cutem tondeatur adsidueque uehementer perfricetur, multa calida aqua perfundatur, multa ⟨dein⟩ ambulatio sit, cibus modicus, neque acer neque ualentissimus. Tum in narem ipsam mel cum exiguo modo resinae terebenthinae coiciatur (quod specillo quoque inuoluto lana fit) adtrahaturque spiritu ⟨i⟩s sucus, donec in ore gustus eius sentiatur. Sub his enim crustae resoluuntur, quae tum per sternumenta elidi debent. Puris ulceribus uapor aquae calidae subiciendus est; ⟨deinde adhibendum⟩ aut Lycium ex uino dilutum, aut amurca aut omphacium aut mentae aut marrubii sucus aut atramentum sutorium, ⟨quod⟩ concand⟨e⟩factum, deinde contritum sit; aut interior scillae pars contrita, sic ut horum cuilibet mel adiciatur. Cuius in ceteris admodum exigua pars esse debet; in atramento sutorio tanta, ut ea mixtura liquida fiat; cum scilla utique pars maior; inuoluendumque lana specillum est, et in eo medicamento tinguendum, eoque ulcera inplenda sunt. Rursusque lin⟨a⟩mentum inuolutum et oblongum eodem medicamento inlinendum demittendumque in narem est et ab inferiore parte leniter deligandum. Idque per hiemem et uer ⟨b⟩is die, per aestatem ⟨et⟩ autumnum ter die fieri debet. Interdum uero in naribus etiam carunculae quaedam similes muliebribus mammis nascuntur, eaeque imis partibus, quae carnosissimae sunt, inhaerent. Has curare oportet medicamentis adurentibus, sub quibus ex toto consumuntur. Polypus uero est caruncula, modo alba ⟨modo⟩ subrubra, quae narium ossi inhaeret, ac modo ad labra tendens narem implet, modo retro per id foramen, quo spiritus a naribus ad fauces descendit, adeo increscit, uti post uuam conspici possit; strangulatque hominem, maxime austro aut euro flante; fereque mollis est, raro dura, eaque magis spiritum impedit et nares dilatat; quae fere carcinodes est; itaque attingi non debet. Illud aliud genus fere quidem ferro curatur, interdum tamen inarescit, si addita in narem per lin⟨a⟩mentum aut penicillum ea compositio est, quae habet: mini Sinopici, chalcitidis, calcis, sandaracae, singulorum P. #1108 I; atramenti sutori P. #1108 II.

[¶9] 9. 9 Now in the case of pain in the teeth, which by itself also can be counted among the greatest of torments, wine must be entirely cut off. At first the patient must fast, then take sparingly of soft food, so as not to irritate the teeth when masticating; then externally steam from hot water is to be applied by a sponge, and an ointment put on made from cyprus or iris oil, with a woollen bandage over it, and the head must be wrapped up. For more severe pain a clyster is useful, with a hot poultice upon the cheeks, and hot water containing certain medicaments held in the mouth and frequently changed. For this purpose cinquefoil root may be boiled in diluted wine, and hyoscyamus root either in vinegar and water, or in wine, with the addition of a little salt, also poppy-head skins not too dry and mandragora root in the same condition. But with these three remedies, the patient should carefully avoid swallowing the fluid in the mouth. The bark of white poplar roots boiled in diluted wine may be appropriately used for the same purpose, and stag's horn shavings boiled in vinegar, and catmint together with a torch rich in resin and a fig equally rich boiled either in honey wine or in vinegar and honey. When the fig has been boiled down with these, this fluid is strained. Also a prove wrapped round with wool is dipped in hot oil, and the tooth itself fomented with this. Moreover, some applications, like poultices, are smeared on the tooth itself, and for this purpose the inside rind of an unripe dry pomegranate is pounded up with equal parts of oak-galls and pine bark, with which minium is mixed; and these when pounded together are made up with rain-water. Or equal quantities of all-heal, poppy-tears, sulphur wort, and black bryony berries without the seeds are pounded together. Or three parts of galbanum to one of poppy juice. Whatever is applied to the teeth directly, none the less the ointment mentioned above must also be put on the jaws and covered over with wool. Some rub up together myrrh and cardamoms, 4 grams each; saffron chamomile figs and broom 16 grams each; and mustard 32 grams; spread it on lint and apply to the shoulder on the side of the painful tooth; over the shoulder-blade, if it is an upper tooth; on the chest if a lower one; and this relieves the pain, and as soon as it has relieved it, must be at once taken off. When a tooth decays, there is no hurry to extract it, unless it cannot be helped, but rather to the various applications described above, we must add more active compositions for the relief of pain, such as that of heras. This has poppy juice 4 grams; pepper 8 grams; sory 40 grams, pounded, taken up in galbanum, and applied round the tooth; or that of Menemachus, especially for molar teeth, containing saffron 0.66 gram, cardamons, frankincense root, figs, broom and pellitory 16 grams each; mustard 32 grams. Again, some mix chamomile, pepper, elaterium and broom 4 grams each; shredded alum, poppy juice, black bryony berries, crude sulphur, bitumen, laurel berries and mustard 8 grams each. But if pain compels its removal, a peppercorn without the tegument, or an ivy berry without the tegument is inserted into the cavity of the tooth, which it splits, and the tooth falls out in bits. Also the tail spine of the flat fish which we call pastinaca, and the Greeks trygon, is roasted, pounded and taken up in resin, and this, when applied around the tooth, loosens it. Also shredded alum and... put into the cavity loosens the tooth. However, it is better to insert this wrapped up in a flake of wool, for it thus relieves the pain whilst preserving the tooth. These are the remedies recognized by medical practitioners, but country people have found out by experience that if a tooth aches, catmint should be pulled up with its roots, and put into a pot, and water poured over it, and placed beside the patient as he sits all covered by clothes; then red-hot stones are thrown in so as to be covered by the water; the patient inhales the steam with his mouth open, whilst, as stated above, he is completely covered over. For profuse sweating follows, and also a steady stream of phlegm flows from the mouth, and this ensures good health always for a year, and often for longer.

> Latin: 9. In dentium autem dolore, qui ipse quoque maximis tormentis adnumerari potest, uinum ex toto circumcidendum est. Cibo quoque primo abstinendum, deinde eo modico mollique utendum, ne mandentis dentes inritet; tum extrinsecus admouendus per spongiam uapor aquae calidae, inponendumque ceratum ex cyprino ex⟨ue⟩ irino factum, lanaque id conprehendendum, caputque uelandum est. Quod si grauior dolor est, utiliter et aluus ducitur, et calida cataplasmata super maxillas inponuntur, et ore umor calidus cum medicamentis aliquibus continetur, saepiusque mutatur. Cuius rei causa et quinquefolii radix in uino mixto coquitur, et hyoscyami radix uel in posca uel in uino, sic ut paulum his salis adiciatur et papaueris non nimium aridi cortices et mandragorae radix eodem modo. Sed in his tribus utique uitandum est, ne, quod haustum erit, deuoretur. Ex populo quoque alba cortex radicis in hunc ⟨u⟩sum in uino mixto recte coquitur, et in aceto cornus ceruini ramentum, et nepeta cum taeda pingui ac ficu item pingui uel in mulso uel in aceto et melle; ex quibus cum ficus decocta est, is umor percolatur. Specillum quoque lana inuolutum in calidum oleum demittitur, eoque ipse dens fouetur. Quin etiam quaedam quasi cataplasmata in dentem ipsum inlinuntur; ad quem usum ex malo Punico acido arido mal⟨i⟩corii pars interior cum pari portione et gallae et pinei corticis conteritur, misceturque his minium; eaque contrita aqua pluuia[ti]li coguntur. Aut panacis, papaueris lacrimae, peucedani, uuae t⟨a⟩miniae sine seminibus pares portiones conteruntur. Aut galbani partes tres, papaueris lacrimae pars quarta. Quicquid dentibus admotum est, nihilo minus supra maxillas ceratum, quale supra posui, ⟨e⟩sse debet lana optentum. Quidam etiam murrae, cardamomi, singulorum P. #1108 I; croci, pyrethri, ficorum, ⟨s⟩partes, singulorum P. #1108 IIII; sinapis P. #1108 VIII contrita linteolo inlinunt, inponuntque in umero partis eius, qua dens dolet: si is superior est, a scapulis; si inferior, a pectore; idque dolorem leuat, et cum leuauit, protinus summouendum est. Si uero exesus est dens, festinare ad eximendum eum, nisi res coegit, non est necesse: sed ⟨t⟩um omnibus fomentis, quae supra posita sunt, adiciendae quaedam ualentiores conpositiones sunt quae dolorem leuant; qualis Herae est. Habet autem papaueris lacrimae P. #1108 I; piperis P. #1108 II; soreos P. #1108 X; quae contrita galbano excipiuntur, idque circumdatur; aut Menemachi, maxime ad maxillares dentes, in qua sunt croci P. #1108 #1109; cardamomi, turis fuliginis, ficorum, ⟨s⟩partes, pyrethri, singulorum P. #1108 IIII; sinapis P. #1108 VIII. Quidam autem miscent pyrethri, piperis, elateri, ⟨s⟩partes, singulorum P. #1108 I; aluminis scissilis, papaueris lacrimae, uuae t⟨a⟩miniae, sulpuris ignem non experti, bituminis, lauri bacarum, sinapis, ⟨singulorum P.⟩ #1108 II. Quod si dolor eximi eum cogit, et piperis semen cortice liberatum, et eodem modo baca hederae coniecta in [id] foramen dentem findit, isque per testas excidet. Et plani piscis, quam pastinacam nostri, trygona Graeci uocant, aculeus torretur, deinde conteritur resinaque excipitur, quae denti circumdata hunc soluit. Et alumen scissile et * * in foramen coniectum dentem citat. Sed id tamen inuolutum in lanula demitti commodius est, quia sic dente seruato dolorem leuat. Haec medicis accepta sunt. Sed agrestium experimento cognitum est, cum dens dolet, herbam mentastrum cum suis radicibus euelli debere, et in peluem coici, supraque aquam infundi, collocarique iuxta sedentem hominem undique ueste contectum; tum in peluem candentes silices d⟨e⟩mitti, sic ut aqua tegantur; hominemque eum hiante ore uaporem excipere, ut supra dictum est, undique inclusum. Nam et sudor plurimus sequitur, et per os continens pituita defluit, idque saepe longiorem, semper annuam ualetudinem bonam praestat.

[¶10] 10. 10 Again, if the tonsils owing to the inflammation are swollen but not ulcerated, the head is to be kept covered; externally the painful part should be fomented by steam; the patient is to take walking exercise freely; when in bed his head should be raised repressive gargles should be used. Also that root which they call sweet, crushed and boiled in raisin wine or honey wine, has the same beneficial effect. It is useful to anoint them gently with certain medicaments prepared as follows: the juice is squeezed out of sweet pomegranates, and of this half a litre is boiled over a slow fire until of the consistency of honey; then saffron, myrrh, and shredded alum 8 grams each are pounded together, and to this is added a little at a time 85 cc. of mild wine and 42 cc. of honey; next these latter are mixed with the pomegranate juice aforesaid, and all gently boiled again. Or half a litre of the pomegranate juice is boiled in the same way, and the following after being pounded in like manner are added: nard 0.33 gram; omphacium 4 grams; cinnamon, myrrh and casia 0.33 gram each; these same compositions are also appropriate both for purulent ears and nostrils. Food too in this affection should be bland that it may not irritate. If the inflammation is so severe that breathing is hindered, the patient should keep in bed, abstaining from food, and take nothing else except hot water; the bowels should be moved by a clyster, and the gargle of fig and honey wine used; the tonsils are to be smeared with honey and omphacium; internally steam is to be inhaled somewhat longer until the tonsils suppurate and spontaneously open. If after pus has formed these swellings do not burst, they are to be cut into; then the patient must gargle with warm honeyed wine. But if with only moderate swelling there is ulceration as well, the throat is to be gargled with bran gruel to which a little honey should be added; and the ulcers smeared with the following composition: 750 cc. of the sweetest raisin wine are boiled down to one-third, then are added: frankincense 4 grams; garlic 4 grams; saffron and myrrh 0.66 gram each; and all are then gently heated together. When the ulcers have cleaned, the throat is gargled with bran gruel or milk. And here also bland food is necessary, and in addition sweet wine can be taken.

> Latin: 10. Si uero tonsillae sine exulceratione per inflammationem intumuerunt, caput uelandum est; extrinsecus is locus uapore calido fouendus; multa ambulatione utendum; caput in lecto sublime habendum; gargarizandumque reprimentibus. Radix quoque ea, quam dulcem appellant, contusa et in passo mulsoue decocta idem praestat. Leniterque quibusdam medicamentis eas inlini non alienum est, quae hoc modo fiunt: ex malo Punico dulci sucus exprimitur, et eius sextarius in leni igne coquitur, donec ei mellis crassitudo est; tum croci, murrae, aluminis scissilis, ⟨singulorum⟩ P. #1108 II per se conteruntur, paulatimque his adiciuntur uini lenis cyathi duo, mellis unus; deinde priori suco ista miscentur, et rursus leniter incocuntur. Aut eiusdem suci sextarius eodem modo coquitur, atque eadem ratione trita haec adiciuntur: nardi P. #1108 #1110; omphaci P. #1108 I; cinnamomi, murrae, casiae, singulorum P. #1108 #1110; eadem autem haec et auribus et naribus purulentis adcommodata sunt. Cibus in hac quoque ualetudine lenis esse debet, ne exasperet. Quod si tanta inflammatio est, ut spiritum impediat, in lecto conquiescendum, cibo abstinendum, neque adsumendum quicquam praeter aquam calidam est; aluus quoque ducenda est; gargarizandum ex fico et mulso; inlinendum mel cum omphacio; intrinsecus admouendus sed aliquanto diutius uapor calidus, donec ea suppurent et per se aperiantur. Si pure substante non rumpuntur hi tumores, incidendi sunt; deinde ex mulso calido gargarizandum. At si modicus quidem tumor ⟨sed⟩ exulceratio est, furfurum cremori ad gargarizandum paulum mellis adiciendum est; inlinendaque ulcera hoc medicamento: passi quam dulcissimi tres heminae ad unam cocuntur; tum adicitur t⟨u⟩ris P. #1108 I; ⟨ali P. #1108 I;⟩ croci, murrae, singulorum P. #1108 #1109; leuiterque omnia rursus feruescunt. Vbi pura ulcera sunt, eodem furfurum cremore uel lacte gargarizandum est. Atque hic quoque cibis lenibus opus est, quibus adici dulce uinum potest.

[¶11] 11. 11 Now ulcerations of the mouth if accompanied by inflammation, and if they are foul and reddish, are best treated by the medicaments made from pomegranates mentioned above. And, as a repressant, pearl barley gruel to which a little honey has been added is to be often held in the mouth; the patient must walk and not take acrid food. As soon as the ulcerations begin to clean, a bland liquid, at times even the purest water, is held in the mouth. It is then beneficial to eat a pear of the softer sort, and more food along with sharp vinegar; then the ulcers should be dusted over with split alum, to which about half as much again of unripe oak-galls has been added. If the ulcers are alar encrusted, as happens after cauterization, those compositions are to be applied which the Greeks call antherae: equal portions of galingale, myrrh, sandarach, and alum. Or saffron and myrrh 4 grams each; iris, split alum and sandarach 16 grams each; galingale 32 grams. Or oak-galls and myrrh 4 grams each; split alum 8 grams; rose leaves 16 grams. But some mix saffron 0.66 gram; split alum and myrrh 4 grams each; sandarach 8 grams; galingale 16 grams. The first compositions are dried and then dusted on; the last one is smeared on with honey added, and used not only for ulcerations of the mouth, but also of the tonsils. But by far the most dangerous are those ulcers which the Greeks call aphtae, certainly in children; in them they often cause death, but there is not the same danger for men and women. These ulcers begin from the gums: next they invade the palate and the whole mouth; then they pass downwards to the uvula and throat, and if these are involved, it is not easy for the child to recover. But the disease is even worse in a suckling, for there is then less possibility of its conquest by any remedy. But it is most important that the nurse should be made to take exercise both by walking and by doing work which moves her arms; she should be sent to the bath, and ordered when there to have hot water poured over her breasts; moreover, she should have bland, easily digestible food; and for drink, if the infant is feverish, water; if free from fever, diluted wine. And if the nurse is constipated, her bowels are to be moved by a clyster. If there is clotted phlegm in her mouth, she must vomit. Then the child's ulcers are to be anointed with honey, to which is added sumach, which they call Syrian, or bitter almonds; or a mixture of dried rose leaves, pinecone seeds, mint, young stalks, and honey, or that medicament which is made of mulberries, the juice of which is concentrated in the same way as pomegranate juice to the consistency of honey; similarly too there is mixed with it saffron, myrrh, alum, wine and honey; nothing should be given which can provoke spittle. If it is an older child he should generally gargle as described above. If the milder medicaments do little good, the caustic materials which induce crusts upon the ulcers should be applied, such as split alum or copper ore or blacking. Even hunger is beneficial and the greatest possible abstinence is to be ordered. The food ought to be bland; for cleansing the ulcers, however, sometimes cheese with honey is appropriately given.

> Latin: 11. Vlcera autem oris si cum inflammatione sunt et parum pura ac rubicunda sunt, optume is medicamentis curantur, quae [supra posita] ex malis Punicis fiunt. Continendusque saepe ore reprimens cremor est, cui paulum mellis sit adiectum: utendum ambulationibus et non acri cibo. Simul atque uero pura ulcera esse coeperunt, lenis umor, interdum etiam quam optima aqua ore continenda est. Prodestque adsumptum pirum mitiu⟨s⟩ pleniorque cibus cum acri acet⟨o⟩ inspergique ulcera debent alumine scissili, cui dimidio plus gallae inmaturae sit adiectum. Si iam crustas habent, quales in adustis esse consuerunt, adhibendae sunt hae conpositiones, quas Graeci antheras nominant: iunci quadrati, murrae, sandaracae, aluminis pares portiones. Aut croci, murrae, singulorum P. #1108 I; ⟨i⟩ridis, aluminis scissilis, sandaracae, singulorum P. ⟨#1108⟩ IIII; iunci quadrati P. #1108 VIII. Aut gallae, murrae, singulorum P. #1108 I; aluminis scissilis P. #1108 II; rosae foliorum P. #1108 IIII. Quidam autem croci P. #1108 #1109; aluminis scissilis, murrae, singulorum P. ⟨#1108⟩ I; sandaracae P. #1108 II; iunci quadrati P. #1108 IIII miscent. Priora arida insperguntur: hoc cum melle inlinitur, neque ulceribus tantum sed etiam tonsillis. Verum ea longe periculosissima sunt ulcera, quas apthas Graeci appellant, sed in pueris: hos enim saepe consumunt, in uiris et mulieribus idem periculum non est. Haec ulcera a gingiuis incipiunt; deinde palatum totumque os occupant; tum ad uuam faucesque descendunt, quibus obsessis non facile fit, ut puer conualescat. Ac miserius etiam est, si lact⟨e⟩ns adhuc infans est, quo minus imperari remedium aliquod potest. Sed inprimis nutrix cogenda est exerceri et ambulationibus et is operibus, quae superiores partes mouent; mittenda in balineum iubendaque ibi calida aqua mammas perfundere; tum alenda cibis lenibus et is, qui non facile corrumpuntur: potione, si febricitat puer, aquae; si sine febre est, uini diluti. Ac si aluus nutricis substitit, ducenda est. Si pituita eius in os coit, uomere debet. Tum ipsa ulcera perunguenda sunt melle, cui rhus, quem Syriacum uocant, aut amarae nuces adiectae sunt; uel mixtis inter se rosae foliis ⟨aridis,⟩ pineis nucleis, menta, coliculo, melle, uel eo medicamento, quod ex moris fit, quorum sucus eodem modo quo Punici mali ad mellis crassitudinem coquitur; eademque ratione ei crocum, murra, alumen, uinum, mel, miscetur: neque quicquam dandum, a qu⟨o⟩ umor euocari possit. Si uero iam firmior puer est, gargarizare debet is fere, quae supra conprehensa sunt. Ac si lenia medicamenta in eo parum proficiunt, adhibenda sunt ea, quae adurendo crustas ulceribus inducant. Quale est scissile alumen uel chalcitis uel atramentum sutorium. Prodest etiam fames et abstinentia quanta maxime inperari potest. Cibus esse debet lenis: ad purganda tamen ulcera interdum caseus ex melle recte datur.

[¶12] 12. 12 Ulcerations of the tongue need no other treatment than that noted in the first part of the previous chapter. But those which arise at the side of the tongue last the longest; and it should be looked to, whether some tooth opposite the ulcer is too pointed, which often keeps an ulceration in that position from healing, in which case the tooth must be smoothed down.

> Latin: 12. Linguae quoque ulcera non aliis medicamentis egent, quam quae prima parte superioris capitis exposita sunt. Sed quae in latere eius nascuntur, diutissime durant; uidendumque est, num contra dens aliquis acutior sit, qui sanescere saepe ulcus eo loco non sinit, ideoque leuandus est.

[¶13] 13. 13 There often occur on the gums adjacent to the teeth certain painful swellings: the Greeks call them parulides. These at first should be gently rubbed over with powdered slat; or with a mixture of powdered rock-salt, cyprus oil and catmint; then the mouth is washed out with lentil gruel, and the mouth is held open at intervals until there has been a sufficient flow of phlegm. When there is still more severe inflammation, the same medicaments are to be used as noted above for ulcerations of the mouth: and between the tooth and gum should be inserted a little roll of soft lint soaked in one of the compositions which I said are called antherae. If the hardness of the gum prevents this, then hot steam by means of a sponge is to be applied outside, followed by a cerate. If suppuration shows itself, the steaming is continued longer, and hot honey wine in which a fig has been boiled down is held in the mouth; and before the abscess is quite mature it should be cut into, for fear that the bone may suffer if the pus should be retained longer. But if there is greater swelling, it is better to cut all away so as to free the tooth on both sides. When the pus is let out, if the incision is small it will suffice to hold hot water in the mouth and to foment externally with its steam; if it is larger, lentil gruel should be used, and the same medicaments as for the treatment of ulcerations of the mouth in general. There are also other ulcerations, mostly arising in the gums, for which the same remedies are beneficial; in particular, however, privet should be chewed and the juice held in the mouth. It happens now and then, whether following a gumboil or not, that a discharge of pus persists from an ulcer on the gum; this is due to either a decayed tooth or to bone that is broken or injured and diseased in some other way, and it most commonly occurs through a fissure in the bone. When this is the case, the place must be laid open, the tooth extracted; any projecting scale of bone is to be removed; and any carious bone scraped away. What ought to be done after this has been included in the treatment of other ulcerations. If the gums have retracted from the teeth, the same antherae are of service. It is also useful to chew pears and apples which are not too ripe, and to hold their juice in the mouth. Vinegar that is not too sharp can also be held in the mouth with similar advantage.

> Latin: 13. Solent etiam interdum iuxta dentes in gingiuis tubercula quaedam oriri dolentia: parulidas Graeci appellant. Haec initio leniter sale contrito perfricare oportet; aut inter se mixtis sale fossili combusto, cupresso, nepeta; deinde eluere os cremore lenticulae, inter haec hiare, donec pituita satis profluat. In maiore uero inflammatione isdem medicamentis utendum est, quae ad ulcera oris supra posita sunt: et mollis lin⟨amenti⟩ paulum inuoluendum ex is aliqua compositione, quas antheras uocari dixi, demittendumque id inter dentem et gingiuam. Quod si †duriore id prohibebit, extrinsecus admouendus erit spongia uapor calidus, inponendumque ceratum. Si suppuratio se ostendet, diutius eo uapore utendum erit, et continendum ore calidum mulsum, in quo ficus decocta sit; idque subcrudum incidendum, ne, si diutius ibi pus remanserit, os laedat. Quod si maior is tumor est, commodius totum exciditur, sic ut ex utraque parte dens liberetur. Pure exempto si leuis plaga est, satis est ore calidam aquam continere, extrinsecus fouere eodem uapore; si maior est, lenticulae cremore uti isdemque medicamentis, quibus cetera ulcera oris curantur. Alia quoque ulcera in gingiuis plerumque oriuntur, quibus eadem quae in reliquo ore succurrunt; maxime tamen mandere ligustrum oportet, sucumque eum ore continere. Fit etiam interdum, ut gingiuae ulcere, siue parulis fuit siue non fuit, diutius pus feratur; quod aut dente corrupto, aut fracto uel * * aliterque uitiato osse; maximeque id per fissum ⟨e⟩uenire consueuit. Vbi incidit, locus aperiendus, dens eximendus; testa ossis, si qua excessit, recipienda est; si quid uitiosi est, radendum. Post quae quid fieri debeat, supra in aliorum ulcerum curatione conprehensum est. Si uero a dentibus gingiuae recedunt, eaedem antherae succurrunt. Vtile est etiam pira aut mala non permatura mandere, et ore eum umorem continere. Idemque praestare non acre acetum in ore retentum potest.

[¶14] 14. 14 Inflammation of the uvula should also cause anxiety when severe. In this case, as before, abstinence is necessary, and it is right to let blood; and if anything prevents this, it is useful to clyster the bowel; and also the head must be kept covered and raised; and the patient must gargle with a decoction of blackberries and lentils. But the uvula its is to be smeared either with omphacium or oak-galls or split alum to any one of which honey has been added; it is also good to smear the uvula with chelidonium juice by means of a spoon, and especially with honey. For this purpose also the composition called Andronium is suitable; it consists of: split alum, red copper scales, blacking, oak-galls, myrrh and antimony sulphide; these are pounded separately and again pounded when mixed together, a dry wine being gradually added till the ingredients have the consistency of honey. After the uvula has been smeared with one of these compounds there is, as a rule, a free flow of phlegm; when this has subsided, hot wine should be gargled. But if there is less severe inflammation, it is sufficient to pound up assafoetida and add cold water to it, and to put the fluid into a spoon and apply it under the uvula itself. When there is only moderate swelling, even cold water held in the same way under the uvula subdues it. Also the same cold water is to be used as a gargle which, with or without the addition of assafoetida, has been applied in this manner to the uvula.

> Latin: 14. Vuae uehemens inflammatio terrere quoque debet. Itaque in hac et abstinentia necessaria est, et sanguis recte mittitur; et si id aliqua res prohibet, aluus utiliter ducitur; caputque super haec uelandum et sublimius habendum est: tum aqua gargarizandum, in qua simul rubus et lenticula decocta sit. Inlinenda autem ipsa uua uel omphacio uel galla uel alumine scissili, sic ut cuilibet eorum mel adiciatur; ⟨chelidoniae quoque suco per coclear inlita uua maximeque * * prodest.⟩ Est etiam medicamentum hu⟨c⟩ aptum, quod Andronium appellatur. Constat ex his: alumine scissili, squama aeris rubri, atramento sutorio, galla, murra, misy; quae per se contrita mixtaque rursus paulatim adiecto uino austero teruntur, donec his mellis crassitudo sit. Vbi horum aliquo inlita uua est, fere multa pituita decurrit; cumque ea quieuit, ex uino calido gargarizandum est. Quod si minor ea inflammatio est, laser terere, eique adicere frigidam aquam satis est, eam⟨que⟩ aquam cocleario exceptam ipsi uuae subicere. Ac mediocriter eam tumentem aqua quoque frigida eodem modo subiecta reprimit. Ex eadem autem aqua gargarizandum quoque est, quae uel cum lasere uel sine eo hac ratione uuae subiecta est.

## 25. Book VI · chapters 15–19

Source: https://scriptura.si/works/celsus-on-medicine/25/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/25/#p-N

[¶0] 15. 15 If at any time gangrene has attacked ulcers of the mouth, the first thing to consider is whether the general health is bad, and if so to obviate it; next the actual ulcers are to be treated. But if the disease is superficial, it is sufficient to use a powdered anthera to dust on the ulcer if moist; if the ulcer is rather dry, to smear it on mixed with a little honey: for somewhat deeper ulcerations, apply burnt papyrus two parts, and orpiment one part; if the mischief penetrates very deeply, burnt papyrus three parts, orpiment one part, or equal parts of rock salt and roasted iris, or copper ore, quick-lime and orpiment, likewise equal parts. But in order that neighbouring spots may not be injured, it is necessary to apply lint dipped in rose oil over these caustic medicaments. Some also put the roasted salt into 250 cc. of strong vinegar until it ceases to dissolve; then the vinegar is boiled to dryness, and the salt pounded up and dusted on. But whenever this medicament is applied, the mouth should be washed out both before and after, either with lentil gruel, or with a decoction of vetches or of olives or of vervains, to any one of which a little honey is added. Also vinegar of squills held sufficiently long in the mouth is beneficial for such ulceration, so too the salt after evaporation as described above dissolved again in vinegar. But whilst the affection continues to be severe it is necessary both to hold one or other of the remedies in the mouth for some time and to use them two or three times a day, If it is a child who is attacked, a probe wrapped round with wool is dipped in the medicament and held to the ulcer, lest by accident he should swallow the caustic. If it is the gums which are involved, and some teeth are loose, they should be extracted, for they greatly hinder treatment. If these medicaments do no good, the ulcers are to be cauterized. But this procedure is not necessary for any ulcer on the lips since excision is more convenient. Indeed such an ulcer, except by adopting surgical measures, whether cauterizing or excising, cannot be replenished with new flesh. But the bones of the bums, which are inert, continue bare after the cauterization; for no flesh grows up afterwards. A lentil dressing, however, is to be applied to the parts cauterized until it is rendered as healthy as possible.

> Latin: 15. Si quando autem ulcera oris cancer inuasit, primum considerandum est, num malus corporis habitus sit, eique occurrendum; deinde ipsa ulcera curanda. Quod si in summa parte id uitium est, satis proficit anthera umido ulceri arida inspersa; sicciori cum exigua parte mellis inlita: si paulo altius, chartae conbustae partes duae, auripigmenti pars una: si penitus malum descendit, chartae conbustae partes tres, auripigmenti pars quarta, aut pares portiones salis fricti et iridis frictae, aut item pares portiones chalcitidis, calcis, auripigmenti. Necessarium autem est lin⟨a⟩mentum in rosa tinguere, et super adurentia medicamenta inponere, ne uicinum et sanum locum laedant. Quidam etiam in acris aceti heminam frictum salem coiciunt, donec tabescere desinat; deinde id acetum coqunt, donec exsiccetur; eumque salem contritum inspergunt. Quotiens autem medicamentum inicitur, et ante ⟨et⟩ post os diluendum est uel cremore lenticulae uel aqua, in qua aut eruum aut oleae uerbenae⟨ue⟩ decoctae sint, sic ut cuilibet eorum paulum mellis misceatur. Acetum quoque ex scilla retentum ore satis aduersus haec ulcera proficit, ⟨item⟩ ex aceto cocto sali, sicut supra demonstratum est, rursus mixtum acetum. Sed et diu continere utrumlibet, et id bis aut ter die facere, prout uehemens malum est, necessarium est. Quod si puer est, cui id incidit, specillum lana inuolutum in medicamentum demittendum est, et super ulcus tenendum, ne per inprudentiam adurentia deuoret. Si in gingiuis est, mouenturque aliqui dentes, refi⟨g⟩i eos oportet: nam curationes uehementer inpediunt. Si nihil medicamenta proficient, ulcera erunt adurenda. Quod tamen in labris ideo non est necessarium, quoniam excidere commodius est. Et id quidem, aeque adustum atque excisum, sine ea curatione, quae corpori manu adhibetur, inpleri non potest. Gingiuarum uero ossa, quae hebetia sunt, in perpetuum ustione nudantur: neque enim postea caro increscit. Inponenda tamen adustis lenticula est, donec sanitatem, qualis esse potest, recipiant.

[¶1] 16. 16 Such are the disorders in the head which generally require medicaments. But just below the ears parotid swellings are inclined to occur, sometimes during health when inflammation occurs there, some after prolonged fevers when the force of the disease has been turned in that direction. It is of the nature of an abscession; and so no novel treatment is called for, only what follows must be attended to: if there is swelling without previous disease, repressants are to be tried first; if there has been illness, repressives are objectionable, and it is more convenient that the abscess should mature and be opened as soon as may be.

> Latin: 16. Haec in capite fere medicamentis egent. Sub ipsis uero auribus oriri parotides solent, modo in secunda ualetudine ibi inflammatione orta, modo post longas febres illuc inpetu morbi conuerso. Id abscessus genus est: itaque nullam nouam curationem desiderat, animaduersionem tantummodo hanc habet necessariam: [quia,] si sine morbo id intumuit, primum reprimentium ⟨faciendum⟩ experimentum est; si aduersa ualetudine, illud inimicum est maturarique et quam primum aperiri commodius est.

[¶2] 17. 17 For prominent navels, in order that surgical measures need not be used, abstinence should first be tried, a clyster to induce a motion, and the following applications to the umbilicus: hemlock and soot 4 grams each; washed white lead 24 grams; washed lead 32 grams; 2 eggs; to these nightshade juice also is added. This ought to be kept on for a long time, the patient meanwhile lying up, and taking food in such moderation that all flatulence is avoided.

> Latin: 17. Ad umbilicos uero prominentes, ne manu ferroque utendum sit, ante temptandum est, ut abstineat⟨ur⟩, aluus his ducatur, inponatur super umbilicum id, quod ex his constat: cicutae et fuliginis, singulorum P. #1108 I; cerussae elotae P. #1108 VI; plumbi eloti P. #1108 VIII; ouis duobus, quibus etiam solani sucus adicitur. Hoc etiam diutius inpositum esse oportet: sed interim conquiescere hominem, cibo modico ⟨uti, sic⟩ ut uitentur omnia inflantia.

[¶3] 18. 18 Next come subjects relating to the privy parts, for which the terms employed by the Greeks are the most tolerable, and are now accepted for use, since they are met with in almost every medical book and discourse. Not even the common use has commended our coarser words for those who would speak with modesty. Hence it is more difficult to set forth these matters and at the same time to observe both propriety and the precepts of the art. Nevertheless, this ought not to deter me from writing, firstly in order that I may include everything which I have heard of as salutary, secondly because their treatment ought above all things to be generally understood, since every one is most unwilling to show such a complaint to another person.

> Latin: 18. Proxima sunt ea, quae ad partes obscenas pertinent, quarum apud Graecos uocabula et tolerabilius se habent et accepta iam usu sunt, cum in omni fere medicorum uolumine atque sermone iactentur: apud nos foediora uerba ne consuetudine quidem aliqua uerecundius loquentium commendata sunt, ut difficilior haec explanatio sit simul et pudorem et artis praecepta seruantibus. Neque tamen ea res a scribendo me deterrere debuit: primum, ut omnia quae salutaria accepi, conprehendere⟨m⟩; dein, quia in uolgus eorum curatio etiam praecipue cognoscenda est, quae inuitissimus quisque alteri ostendit.

[¶4] So then when the penis swells up owing to inflammation, and the foreskin cannot be drawn back, or conversely drawn forwards, the place should be fomented freely with hot water. But when the glans is covered up, hot water should be injected, between it and the foreskin, by means of an ear syringe. If the foreskin is thus softened and rendered thinner, and yields when drawn upon, the rest of the treatment is more speedy. If the swelling goes on, either lentil meal or horehound or olive leaves, boiled in wine, is to be laid on, to each of which, whilst being pounded up, a little honey is to be added; and the penis is to be bandaged upwards to the belly. That is required in the treatment of all its disorders; and the patient ought to keep quiet and abstain from food, and drink water just so much as is justified by thirst. On the next day fomentations with water must again be applied in the same way, and even force should be tried as to whether the foreskin will yield; if it does not give way, the foreskin is to be notched at its margin with a scalpel. For when sanies has flowed out this part will become thinner, and the foreskin the more easily drawn upon. But whether the foreskin is made to yield by this procedure, or whether it has at no time proved resistant, ulcerations will be found, either in the ulterior part of the foreskin, or in the glans, or behind this in the penis, and these ulcerations must of necessity be either clean or dry or moist and purulent. If they are dry, they must in the first place be fomented with hot water; then apply either buckthorn in wine, or olive lees in the same, or butter with rose oil. If there is a thin humour, the ulcerations should be bathed with wine, and then to butter and rose oil a little honey and a fourth part of turpentine resin is to be added and this dressing put on. But when pus runs from the ulcers, first they are to be bathed with hot honey wine; than there is put on: pepper 4 grams; myrrh 0.66 gram; saffron and boiled antimony sulphide 8 grams each; these are heated in dry wine to the consistency of honey. Moreover, the same composition is suitable for the tonsils, a dripping uvula, and ulcerations of the mouth and nostrils. Another for the same purpose consists of pepper and myrrh 0.66 gram each; saffron 1.33 gram; cooked antimony sulphide 4 grams; roasted copper 8 grams; these are first pounded together in dry wine, then, when they are dry, are again pounded up in 125 cc. of raisin wine and heated to the consistency of birdlime. Verdigris too mixed with boiled honey, also those compositions noted above for ulcerations of the mouth, or the compositions of Erasistratus or of Craton are suitable for applying to suppurating genitals. Also... olive leaves are boiled in 375 cc. of wine, to which is added split alum 16 grams, lycium 32 grams; and 250 cc. of honey; and if there is more pus, this medicament is made up with honey; if less, with wine. After treatment, the general procedure, so lon as the inflammation persists, is to apply a poultice such as was mentioned above, and to dress the ulcers daily in the same way. If a free discharge of foul pus begins, the ulcers should be bathed with lentil gruel to c a little honey has been added. Or a decoction is made of olive or of mastich leaves, or of horehound, and the liquid used with honey in the same way; and the same remedies are to be laid on of even omphacium with honey, or that prescription used for the ears containing verdigris and honey, or Andron's composition, or an anthera, as long as a little honey is added to it. Some treat all ulcerations of the kind here spoken of with lycium and wine. If the ulceration spreads more widely and deeply, it should be bathed in the same way, and then there should be applied either verdigris or omphacium with honey or Andron's composition or that containing horehound, myrrh or saffron, split alum boiled, dried rose leaves and oak-galls, 4 grams each; Sinopic minium 8 grams. These are pounded up first separately, then together again, with honey added, until of the consistency of a liquid cerate; then gently heated in a bronze pot but not allowed to boil over. When drops from it begin to solidify, the pot is taken off the fire; and this composition when it is to be used is dissolved in honey or wine. But the same by itself is also good for fistulae. The ulceration at times even penetrates to fibrous tissues; there is a running discharge, then sanies, thin and foul, coloured or like water in which fresh meat has been soaked; and the place is painful and has a pricking sensation. This kind, although purulent, is none the less to be treated by bland applications, such as the tetrapharmacum plaster dissolved in rose oil with the addition of a little frankincense; or the composition made of butter, rose oil, resin and honey noted by me above. In particular this ulcer should be fomented freely with hot water, and should be kept covered, not exposed to cold. Sometimes through such an ulceration the penis is so eaten away underneath the foreskin that the glans falls off; in which case the foreskin itself must be cut away all round. It is the rule, whenever the glans of any part of the penis has fallen off, or has been cut away, that the foreskin should not be preserved, lest it come into contact, and adhere to the ulceration, so that afterwards it cannot be drawn back, and further perhaps may choke the urethra. Again, little tumours, which the Greeks call phymata, spring up around the glans; they are burnt away by caustic or the cautery; when the crusts fall off, copper scales are dusted that no more may grow there.

> Latin: Igitur si ex inflammatione coles intumuit, reducique summa cutis aut rursus induci non potest, multa calida aqua fouendus locus e⟨s⟩t. Vbi ⟨uero⟩ glans contecta est, oriculario quoque clystere ⟨inter⟩ eam cutemque aqua calida inserenda est. Si mollita sic et extenuata cutis ducenti paruit, expeditior reliqua curatio est. Si tumor uicit, inponenda est uel lenticula uel marrubium uel oleae folia ex uino cocta, sic ut cuilibet eorum, dum teritur, mellis paululum adiciatur; sursumque coles ad uentrem deligandus est. Quod in omni curatione eius necessarium est; isque homo continere se et abstinere a cibo debet, et potione aquae tantum a siti uindicari. Postero die rursum adhibendum isdem rationibus aquae fomentum est, et cum ui quoque experiendum, an cutis sequatur; eaque si non parebit, leuiter summa scalpello concidenda erit. Nam cum sanies profluxerit, extenuabitur is locus, et facilius cutis ducetur. Siue autem hoc modo uicta erit, siue numquam repugnauerit, ulcera uel in cutis ulteriore parte uel in glande ultraue eam in cole reperientur; quae necesse est aut pura siccaue sint aut umida et purulenta. Si sicca sunt, primum aqua calida fouenda sunt; deinde inponendum Lycium ex uino aut amurca cocta cum eodem aut cum rosa buturum. Si leuis is umor inest, uino eluenda sunt, tum buturo et rosae mellis paulum, et resinae terebenthinae pars quarta adicienda est; eoque utendum. At si pus ex is profluit, ante omnia elui mulso calido debent; tum inponi piperis P. #1108 I; murrae P. #1108 #1109; croci, misyos cocti, singulorum P. #1108 II; quae ex uino austero cocuntur, donec mellis crassitudinem habeant. Eadem autem conpositio tonsillis, uuae madenti, oris nariumque ulceribus accommodata est. Aliud ad eadem: piperis P. #1108 #1109; murrae P. #1108 #1109; croci P. #1108 #1109 #1109; misy cocti P. #1108 I; aeris combusti P. #1108 II; quae primum ex uino austero conteruntur, deinde ubi inaruerunt, iterum teruntur ex passi tribus cyathis et incocuntur, donec uisci crassitudinem habeant. Aerugo quoque ⟨cum⟩ cocto melle eaque quae ad oris ulcera supra conprensa sunt [curant] aut Erasistrati conpositio aut Cratonis recte super purulenta naturalia inponitur. Foli⟨orum⟩ quoque oleae P. ⟨#1108⟩ * ex nouem cyathis uini cocuntur; his adicitur aluminis scissilis P. #1108 IIII; Lyci P. #1108 VIII; mellis sex cyath⟨i⟩: ac si plus puris est, id medicamentum ex melle; si minus, ex uino diluitur. Illud perpetuum est, post curationem, dum ⟨in⟩flammatio manet, quale supra positum est, cataplasma super dare, et cotidie ulcera eadem ratione curare. Quod si pus et multum et cum malo odore coepit profluere, elui cremore lenticulae debet, sic ut ei mellis paulum adiciatur. Aut oleae uel lentisci folia uel marrubium decoquendum est, eoque umore eodem modo cum melle utendum; inponendaque eadem aut etiam omphacium cum melle aut id, quod ex aerugine et melle ad aures fit; aut conpositio Andronis aut anthera, sic ut ei paulum mellis adiciatur. Quidam omnia ulcera, de quibus adhuc dictum est, Lycio ex uino curant. Si uero ulcus latius atque altius serpit, eodem modo elui debet, inponi uero aut aerugo aut omphacium cum melle aut Andronis compositio aut marrubii, murrae aut croci, aluminis scissilis cocti, rosae foliorum aridorum, gallae, singulorum P. #1108 I; mini Sinopici P. #1108 II. Quae per se singula primum teruntur, deinde iuncta iterum melle adiecto, donec liquidi cerati crassitudinem habeant; tum in aeneo uaso leniter cocuntur, ne superfluant. Cum iam guttae indurescunt, uas ab igni remouetur; idque medicamentum, prout opus est, aut ex melle aut ex uino liquatur. Idem autem per se etiam ad fistulas utile est. Solet etiam interdum ad neruos ulcus descendere, profluitque pituita multa, sanies tenuis malique odoris non †cocta aut aquae similis, in qua caro recens lota est; doloresque is locus et punctiones habet. Id genus quamuis inter purulenta est, tamen lenibus medicamentis curandum est, quale est emplastrum tetrapharmacum ex rosa liquatum, sic ut turis quoque paulum ei misceatur; aut id, quod ex buturo, rosa, resina, melle fit, supra uero a me positum est; praecipueque id ulcus multa calida aqua fouendum est, uelandumque neque frigori committendum. Interdum autem per ipsa ulcera coles sub cute exest⟨ur⟩ sic ut glans excidat; sub quo casu cutis ipsa circumcidenda est. Perpet⟨u⟩umque est, quotiens glans aut ex cole aliquid uel excidit uel absciditur, hanc non esse seruandam, ne considat ulcerique adglutinetur, ac neque reduci possit postea, et fortasse fistulam quoque urinae claudat. Tubercula etiam, quae phumata Graeci uocant, circa glandem oriuntur, quae uel medicamentis uel ferro aduruntur; et cum crustae exciderunt, squama aeris inspergitur, ne quid ibi rursus increscat. Haec citra cancrum sunt;

[¶5] The foregoing ulcerations stop short of canker, which in other parts, but here the more especially, attacks ulcerations. It begins in a black patch. If it invades the foreskin, at once a probe should be passed underneath, upon which the foreskin is to be incised and the margins seized with forceps; then what is corrupted is cut away, a little of the sound tissue being also removed; this is followed by cauterization. Whenever there is any cauterization, it follows too that here lentil meal is to be applied; next when the crusts have separated the ulcers are treated like others. But if the canker invades the penis itself, some one of the caustics is dusted on, and especially that composed of quick-lime, copper ore and orpiment. If medicaments fail, in this case also whatever is corrupted should be cut away with a scalpel, so far that some sound tissue is also removed. It is likewise the rule here that after the canker has been cut out, the wound is to be cauterized. But if hard scabs form, whether after caustics or the cautery, there is a great danger that haemorrhage from the penis will follow upon their separation. Therefore there is need for prolonged rest with the body almost immobile until the scabs gently separate from the penis. But if the patient, either purposely or accidentally, from moving about too soon, has detached the scabs and haemorrhage has occurred, cold water should be applied. If this has little effect, recourse must be had to medicaments which suppress haemorrhage. If these do not succeed either, the spot should be carefully and cautiously cauterized, and no opportunity afterwards given for the same risk by any sort of movement.

> Latin: qui cum in reliquis partibus tum in his quoque uel praecipue ulcera infestat. Incipit a nigritie. Quae si cutem occupauit, protinus specillum subiciendum, eaque incidenda est; deinde orae uulsella prendendae; tum quicquid corruptum est excidendum, sic ut ex integro quoque paulum dematur; idque adurendum. Quotiens quid ustum est, hic quoque sequitur, ut inponenda lenticula sit; deinde ubi crustae exciderunt, ulcera sicut alia curentur. Ac si cancer ipsum colem occupauit, inspergenda aliqua sunt ex adurentibus, maximeque id, quod ex calce, chalcitide, auripigmento componitur. Si medicamenta uincuntur, hic quoque scalpello quicquid corruptum est, sic ut aliquid etiam integri trahat, praecidi debet. Illud quoque aeque perpetuum est, exciso cancro uulnus esse adurendum. Sed siue ex medicamentis siue ex ferro crustae occa⟨l⟩luerunt, magnum periculum est, ne his decidentibus ex cole profusio sanguinis insequatur. Ergo longa quiete et inmobili paene corpore opus est, donec ex ipso crustae leniter resoluantur. Ac si uel uolens aliquis uel inprudens, dum ingreditur inmature, crustas diduxit, et fluuit sanguis, frigida aqua adhibenda est. Si haec parum ualet, decurrendum est ad medicamenta, quae sanguinem supprimunt. Si ne haec quidem succurrunt, aduri diligenter et timide debet, neque ullo postea motu dandus eidem periculo locus est. Nonnumquam etiam id genus ibi cancri, quod phagedaena a Graecis nominatur, oriri solet.

[¶6] Occasionally on this part there arises that kind of canker which the Greeks call phagedaena. In such a case there must be no delay whatever: the treatment is immediate cauterization, whether with medicaments as above, or, if these have little effect, with the cautery. There is also a sort of blackness, which is insensitive, but spreads and, if we leave it alone, extends even to the bladder, after which nothing can avail If it is situated at the lip of the glans around the urethra, a fine probe should be inserted into the urethra first that it may not be closed up; then the black patch burnt with the cautery. If it has gone deep, whatever is involved is to be cut away. The rest of the treatment is the same as for other kinds of canker.

> Latin: In quo minime differendum sed protinus isdem medicamentis et, si parum ualent, ferro adurendum. Quaedam etiam nigrities ⟨est,⟩ quae non sentitur, sed serpit ac, si sustinuimus, usque ad uesicam tendit, neque succurri postea potest. Si id in summa glande circa fistulam urinae est, prius in eam ⟨tenue⟩ specillum demittendum est, ne claudatur; deinde id ferro adurendum. Si uero alte penetrauit, quicquid occupatum est, praecidendum est. Cetera eadem, quae in aliis cancris, facienda sunt. Occallescit etiam in cole interdum aliquid, idque omne paene sensu caret; quod ipsum quoque excidi debet.

[¶7] Again, now and then a callosity forms in the penis; and it is almost entirely without feeling; this also should be excised. But if a carbuncle occurs here, it is first to be irrigated with water through an ear syringe; next the growth is to be cauterized with medicaments, especially copper ore with honey or verdigris with boiled honey, or fried sheep's dung pounded up similarly with honey. When the carbuncle falls off, use the fluid medicaments prepared for ulcers of the mouth.

> Latin: Carbunculus autem ibi natus primum a⟨qu⟩a per oricularium clystere⟨m⟩ eluendus est; deinde ipse quoque medicamentis urendus, maximeque chalcitide cum melle aut aerugine cum cocto melle, aut ouillo stercore fricto et contrito cum eodem melle. Vbi is excidit, liquidis medicamentis utendum est, quae ad or⟨is⟩ ulcer⟨a⟩ conponuntur. In testiculis uero si qua inflammatio sine ictu orta est, sanguis a talo mittendus est; a cibo abstinendum;

[¶8] But if any inflammation occurs in the testicles, not due to injury, blood is to be let from the ankle; there must be abstinence from food and bean meal boiled in honey wine must be applied, always cumin rubbed up in boiled honey; of pounded cumin with the rose oil cerate; or parched linseed, pounded up and boiled in honey wine; or wheat flour in honey wine boiled with cyprus shoots; or pounded lily root. If the testicles have become indurated, apply linseed or fenugreek seed boiled in honey wine; or the cyprus oil cerate; or fine wheat flour pounded up in wine to which a little saffron has been added. If the induration is already of long standing, the most efficacious something is wild cucumber root boiled in honey wine, then pounded up. If the testicles swell as the result of an injury, it is necessary to let blood, especially if they are livid as well. Then one of the compositions containing cumin mentioned above should be put on; or the composition which contains: fused soda 4 grams; pine resin and cumin, 8 grams each; black bryony berries without the seeds 16 grams; along with sufficient honey to combine them. If, as the result of an injury, the testicle lacks nutrition, generally pus develops; then the only thing to be done is of cut into the scrotum, and let out the pus, and to excise the testicle itself.

> Latin: inponenda ex faba farina eo ex mulso cocta cum cumino contrito et ex melle cocto; aut contritum cuminum cum cerato ex rosa facto; aut lini semen frictum, contritum et in mulso ⟨coctum; aut tritici farina ex mulso⟩ cocta cum cupresso; aut lilii radix contrita. At si idem induruerunt, inponi debet lini uel faeni Graeci semen ex mulso coctum; aut ex cyprino ceratum; aut simila ex uino contrita, cui paulum croci sit adiectum. Si uetustior iam durities est, maxime proficit cucumeris agrestis radix in mulso cocta, deinde contrita. Si ex ictu tument, sanguinem mitti necessarium est, magisque si etiam liuent. Inponendum uero utrumlibet ex iis, quae cum cumino conponuntur supraque posita sunt; aut ea conpositio, quae habet: nitri cocti P. #1108 I; resinae pineae, cumini, singulorum P. #1108 II; uuae t⟨a⟩miniae sine seminibus P. #1108 IIII; mellis quantum satis sit ad ea cogenda. Quod si ex ictu testiculus al⟨i⟩ desit, fere pus quoque increscit, neque aliter succurri potest quam si inciso scroto et pus emissum et ipse testiculus excisus est. Anus quoque multa taediique plena mala recipit, neque inter se multum abhorrentes curationes habet.

[¶9] The anus also is subject to many most tedious maladies, which do not require much variation in their treatment. In the first place, the skin of the anus is often fissured at several places; the Greeks call these ragadia. If this is recent, the patient should keep quiet and sit in hot water. Further, pigeon's eggs are to be boiled until hard, shelled, and then one should be covered completely in very hot water, the other is applied hot to the place, the eggs being used thus turn and turn about. Then the tetrapharmacum or the rhypodes is to be diluted for use with rose oil; or fresh wool-grease is mixed with the liquid cerate made up with rose oil; or washed lead with the same cerate; or a little myrrh to turpentine resin; or old oil to litharge; with any one of which the anus is smeared. If the lesion is external, not hidden inside, lint may be soaked in the same medicament and applied; whatever is put on is to be covered by a cerate. In such a case also neither acrid nor coarse food is to be taken nor such as constipates; dry food is not satisfactory unless in very small amount; liquid, mild, fatty and glutinous nutriment is better. There is nothing to prevent the use of mild wine.

> Latin: A⟨c⟩ primum in eo saepe, et quidem pluribus locis, cutis scinditur: ragadia Graeci uocant. Id si recens est, quiescere homo debet, ⟨et⟩ in aqua calida desidere. Columbina quoque oua coquenda sunt, et, ubi induruerunt, purganda; deinde alterum deponefacere in aqua bene calida debet, alterum calidum loco subicere, sic ut inuicem utroque aliquis utatur. Tum tetrapharmacum ⟨au⟩t rhypodes ad hoc rosa diluendum est, aut ⟨oesy⟩pum recens miscendum cum cerato liquido ex rosa facto aut eidem cerato plumbum elotum: aut adiciendum aut resinae terebenthinae murrae ⟨paulum,⟩ aut spumae argenti uetus oleum, et qu⟨o⟩libet ex his id perunguendum. Si, quicquid laesum est, extra est neque intus reconditum, eodem medicamento tinctum ⟨linamentum⟩ superdandum est et, quicquid ante adhibuimus, cerato contegendum. ⟨In hoc autem casu⟩ neque acribus ⟨cibis utendum est⟩ neque asperis neque aluum conprimentibus, ne aridum quidem quicquam satis utile est nisi admodum paulum: liquida, lenia, pinguia, glutinosa meliora sunt.

[¶10] A condyloma is a small tumour due to inflammation of some kind. When it appears the same prescriptions apply regarding rest, food and drink as have just been set out. Also the tumour itself may be properly treated by fomenting similarly with eggs. But the patient should first sit in a repressant decoction of vervains. Then we may properly apply lentil meal with a little honey, also mellilot boiled in wine, bramble leaves pounded up with the rose oil cerate or a quince, or the inner rind of a pomegranate boiled in wine, pounded up in the same cerate; or copper ore boiled and pounded, then taken up in wool-grease and rose oil; and the composition containing: frankincense 4 grams, split alum 8 grams, white lead 12 grams, litharge 20 grams, into which whilst it is being pounded up rose oil and wine are dropped by turns. But the binder for this part is a square of linen or woollen cloth, which has a loop at each of two adjacent angles and a tape at each of the two opposite ones. The square having been applied underneath with the two loops upon the abdominal wall, the pes are brought round from behind and passed through the loop on its corresponding side. Each tape being drawn tight, that on the right side is carried round the back to the left, and the left tape back and round to the right side. Finally, the ends of the tapes are tied together in front of the abdomen. But if a long-standing condyloma is already indurated and does not yield to the foregoing measures, it can be burnt with a caustic consisting of: verdigris 4 grams; myrrh 16 grams; cumin 32 grams; frankincense 48 grams; antimony sulphide, poppy juice, and acacia juice, 64 grams each, and by this medicament some also produce a fresh surface on the ulcers, which I have described above. If this has little effect upon the condyloma it is possible to apply strong caustics. When the tumour has been eaten away, a change is made to mild medicaments.

> Latin: Vino leni uti nihil prohibet. Condyloma autem est tuberculum, quod ex quadam inflammatione nasci ⟨solet. Id ubi ortum est, quod ad quietem, ci⟩bos ⟨potionesque⟩ pertinet, eadem seruari debe⟨n⟩t, quae proxime scripta sunt: isdem etiam ouis recte tuberculum id fouetur. Sed desidere ante homo in aqua debet, in qua uerbenae decoctae sunt ex reprimentibus. Tum recte inponitur et lenticula cum exigua parte mellis et sertula Campana ex uino cocta; et rubi folia contrita cum cerato ex rosa facto; et cum eodem cerato contritum uel Cotonium malum, uel malicori ex uino cocti pars interior; et chalcitis cocta atque contrita, deinde ⟨oesy⟩po ac rosa excepta; et ex ea conpositione, quae habet: turis P. #1108 I; aluminis scissilis P. #1108 II; cerussae P. #1108 III; spumae argenti P. #1108 V; quibus, dum teruntur, inuicem rosa et uinum instillatur. Vinculum autem ei loco linteolum aut panniculus quadratus est, qu⟨i⟩ ad duo capita duas ansas, ad latera duo totidem fascias habet; cumque subiectus est, ansis ad uentrem datis, posteriore parte in ea⟨s⟩ adductae fasciae coiciuntur, atque ubi artatae sunt, dexterior sinistra, sinisterior dextra procedit, circumdataeque circa aluum inter se nouissime deligantur. Sed si uetus condyloma iam induruit, neque sub his curationibus desidit, aduri medicamento potest, quod ex his constat: aeruginis P. #1108 I; murrae P. #1108 IIII; cummis P. #1108 VIII; turis P. #1108 XII; stibis, papaueris lacrimae, acaciae, singulorum P. #1108 XVI, quo medicamento quidam etiam ulcera, de ⟨quibus proxime dixi⟩, renouant. Si hoc parum in condylomate proficit, adhiberi possunt etiam uehementer adurentia.

[¶11] There is also a third lesion, in which vein mouths rise up as from little heads, which at frequent intervals pour out blood: the Greeks call them haemorrhoids. In women they may even appear at the vulvar orifice. There are some in whom it is hardly safe to suppress such a flux of blood, those who are not the weaker for it; for to these it is a purgation, not a disease. Hence some, after being cured, since the blood had no way out, and diseased matter was diverted towards the praecordia and viscera, have been carried off by sudden diseases of the gravest kind. But if the bleeding is doing harm to anyone, he should sit in a decoction of vervains, and the best thing to apply is pomegranate rind pounded up with dried rose leaves, or anything else that stops bleeding. But inflammation especially tends to occur when first a rather violent evacuation of the bowels has ruptured the epidermis, and later a hard stool has injured this spot. Then the patient should sit in soft water and foment with eggs; yolk of egg which has been stirred up with rose leaves and boiled in raisin wine is to be applied; if the haemorrhoids are internal, by the finger, if external, spread upon linen. The medicaments described above for recent fissures are suitable here also. In this case the diet should be the same as in the preceding one. But if the above treatment has little effect, it is usual to apply caustics to destroy these small heads. If they are already of long standing, then, on the authority of Dionysius, sandarach should be dusted on, and after that the composition should be applied containing copper scales and orpiment 20 grams, limestone 32 grams; the next day the haemorrhoids are to be punctured with a needle. The small heads having been cauterized, a scab is produced which prevents blood from running out. But whenever haemorrhage is thus suppressed, the diseased matter is to be dispersed by free exercise that no danger may ensue. And besides, in men and in women who are not menstruating, blood should be let from the arm now and then.

> Latin: Vbi consumptus est ⟨t⟩umor, ad medicamenta lenia transeundum est. Tertium autem uitium ora uenarum tamquam ex capitulis quibusdam surgentia, quae saepe sanguinem fundunt: haemorroidas Graeci uocant; idque etiam in ore uoluae feminarum incidere consueuit. Atque in quibusdam parum tuto supprimitur, qui sanguinis profluuio inbecilliores non fiunt: habent enim purgationem hanc, non morbum. Ideoque curati quidam, cum sanguis exitum non haberet, inclinata ad praecordia et ad uiscera mat⟨er⟩ia, subitis et grauissimis morbis correpti sunt. —Si cui uero id nocet, is desidere in aqua ex uerbenis debet, inponere maxime malicorium cum aridis rosae foliis contritum, aut ex is aliquid, quae sanguinem supprimunt. Solet autem oriri inflammatio maxime ubi maior * * * dura aluus eum locum laesit. Tum in aqua dulci desidendum est, et fouendum ouis; inponendi uitelli cum rosae foliis ex passo subactis; idque si intus est, digito inlinendum; si extra, superinlitum panniculo ⟨im⟩ponendum est. Ea quoque medicamenta, quae recentibus scissuris posita sunt, h⟨u⟩c idonea sunt. Cibis uero in hoc casu isdem quibus in prioribus utendum est. Si ista parum iuuant, solent inposita medicamenta adurentia ea capitula absumere. Ac si iam uetustiora sunt, sub auctore Dionysio ⟨in⟩sp⟨e⟩rgenda sandraca est, deinde inponendum id quod ex his constat: squamae aeris, auripigmenti, singulorum P. #1108 V; saxi calcis P. #1108 VIII; postero die acu conpungendum. Adustis capitulis fit cicatrix, quae sanguinem fundi prohibet. Sed quotiens is suppressus est, ne quid periculi adferat, multa exercitatione digerenda materia est. Praetereaque uiris et feminis, quibus menstrua non proueniunt, interdum ex brachio sanguis mittendus est.

[¶12] If the anus itself, or, as sometimes happens, the mouth of the womb, prolapses, examination should be made to see whether what is protruding is clean, or is covered with a mucous humour. If it is clean, the patient should sit in water; either in salt water or in water boiled with vervains or pomegranate rind. If it is moist, it should be bathed with dry wine and smeared with roasted wine lees. After being treated in one of these ways, it is to be replaced, and pounded plantain or willow leaves boiled in vinegar applied, next lint, and wool over it: and these must be bandaged on, whilst the legs are kept tied together.

> Latin: At si anus ipse uel os uuluae procidit (nam id quoque interdum fit), considerari debet, purumne id sit, quod prouolutum est, an umore muccoso circumdatum. Si purum est, in aqua desidere homo debet; aut salsa aut cum uerbenis uel malicorio incocta. Si umidum, uino austero subluendum est inlinendumque faece uini conbusta. Vbi utrolibet modo curatum est, intus reponendum est, inponendaque plantago contrita uel folia salicis in aceto cocta, tum linteolum, et super lana; eaque deliganda sunt cruribus inter se deuinctis.

[¶13] In the same place an ulceration like a fungus may arise, which must be bathed with lukewarm water in winter, at other seasons in cold water; then copper scales are dusted on, and over that is applied a cerate made with myrtle oil to which has been added a little of copper scales, soot, and lime. If this treatment gives no relief, it is to be cauterized, either with more active medicaments or with the cautery.

> Latin: Fungo quoque simile ulcus in eadem sede nasci solet: id, si hiemps est, egelida; si aliud tempus, frigida aqua fouendum est, dein squama aeris inspergenda, supraque ceratum ex murteo factum, cui paulum squamae, fuliginis, calcis sit adiectum. Si hac ratione non tollitur, uel medicamentis uehementioribus uel ferro adurendum est.

[¶14] 19. 19 Old-standing ulcerations of the fingers are most suitably treated by buckthorn juice, or by boiled olive lees, in either case with the addition of wine. In the same parts a small piece of flesh sometimes grows out from the nail, causing great pain; the Greeks call it pterygium. Round alum from Melos should be dissolved in water to the consistency of honey; the same quantity of honey as there was of dry alum is then poured in, and the mixture is stirred with a rod until it is of a saffron colour, and then smeared on. Some prefer to boil up the same ingredients together for the same purpose after mixing equal quantities of dry alum and honey. If the whitlow is not removed by this treatment, it should be cut away; next the finger is bathed in a decoction of vervains, and over it is then put the following composition: copper ore, pomegranate rind, and copper scales, mixed with ripe figs, lightly boiled in honey; or burnt papyrus, orpiment, and crude sulphur in equal parts may be mixed with a cerate containing myrtle oil; or scraped verdigris 4 grams, copper scales 8 grams, mixed together in 42 cc. of honey; or equal parts of limestone, copper ore and orpiment are mixed together. Whichever of these is applied, it is covered over by linen wetted with water. On the third day the finger is dressed again, any dried part is removed, and similar treatment continued. When this does not succeed, the whitlow is cleaned by means of a scalpel, and the place burnt with a fine cautery, followed by the dressing usual after cauterization. And when nails are scabrous, they must be loosened all round, where they are in contact with the flesh; next some of the following composition is put on them: sandarach and sulphur 8 grams each; soda and orpiment 16 grams each; liquid resin 32 grams. The finger is dressed again on the third day. Under this medicament, diseased nails fall off and in their stead better ones grow.

> Latin: 19. Digitorum autem uetera ulcera commodissime curantur aut Lycio aut amurca cocta, cum utrilibet uinum adiectum est. In isdem recedere ab ungue caruncula cum magno dolore consueuit: pterygion Graeci appellant.—Oportet alumen Melinum rotundum in aqua liquare, donec mellis crassitudinem habeat; tum quantum eius aridi fuit, tantundem mellis infundere, et rudicula miscere, donec similis croco color ef⟨f⟩iat, eoque inlinere. Quidam * ad eundem usum decoquere simul malunt, cum paria pondera aluminis aridi et mellis miscuerunt. Si hac ratione ea non exciderunt, excidenda sunt; deinde digiti fouendi aqua ex uerbenis, inponendumque super medicamentum ita factum: chalcitis, mal⟨i⟩corium, squama aeris excipiuntur fico pingui leniter cocta ex melle; aut chartae combustae, auripigmenti, sulpuris ignem non experti par modus cerato miscetur ex murteo facto; aut aeruginis rasae P. #1108 I, squamae P. #1108 II mellis cyatho coguntur; aut pares portiones miscentur saxi calcis, chalcitidis, auripigmenti. Quicquid horum impositum est, tegendum linteolo aqua madefacto est. Tertio die digitus resoluendus, et si quid aridi est, iterum excidendum, similisque adhibenda curatio est. Si non uincitur, purgandum est scalpello tenuibusque ferramentis adurendum e⟨t⟩ sicut reliqua usta curandum est. @@At ubi scabri ungues sunt, circum aperiri debent, corpus qua contingunt; tum super eos ex hac compositione aeque inponi: sandracae, sulpuris, singulorum P. #1108 II; nitri, auripigmenti, singulorum P. #1108 IIII; resinae liquidae P. #1108 VIII; tertioque id die resoluendum est. Sub quo medicamento uitiosi ungues cadunt, et in eorum locum meliores renascuntur.

## 26. Book VII · preface, chapters 1–7

Source: https://scriptura.si/works/celsus-on-medicine/26/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/26/#p-N

[¶0] pr. The third part of the Art of Medicine is that which cures by the hand, as I have already said, and indeed it is common knowledge. It does not omit medicaments and regulated diets, but does most by hand. The effects of this treatment are more obvious than any other kind; inasmuch as in diseases since luck helps much, and the same things are often salutary, often of no use at all, it may be doubted whether recovery has been due to medicine or a sound body or good luck. Besides, in cases where we depend chiefly upon medicaments, although an improvement is clear enough, yet it is often clear that recovery is sought in vain with them and gained without them: this can be seen for instance in treating the eyes, which after being worried by doctors for a long time sometimes get well without them. But in that part of medicine which cures by hand, it is obvious that all improvement comes chiefly from this, even if it be assisted somewhat in other ways. This branch, although very ancient, was more practised by Hippocrates, the father of all medical art, than by his forerunners. Later it was separated from the rest of medicine, and began to have its own professors; in Egypt it grew especially by the influence of Philoxenus, who wrote a careful and comprehensive work on it in several volumes. Gorgias also and Sostratus and Heron and the two Apollonii and Ammonius, the Alexandrians, and many other celebrated men, each found out something. In Rome also there have been professors of no mean standing, especially the late Tryphon the father and Euelpistus, and Meges, the most learned of them all, as can be understood from his writings; these have made certain changes for the better, and added considerably to this branch of learning. Now a surgeon should be youthful or at any rate nearer youth than age; with a strong and steady hand which never trembles, and ready to use the left hand as well as the right; with vision sharp and clear, and spirit undaunted; filled with pity, so that he wishes to cure his patient, yet is not moved by his cries, to go too fast, or cut less than is necessary; but he does everything just as if the cries of pain cause him no emotion. But it can be asked what is the proper province of this part of my work because surgeons claim for themselves the treatment of wounds as well, and of many of the ulcerations which I have described elsewhere. I for my part deem one and the same man able to undertake all of these; and when divisions are made, I praise him who has undertaken the most. I have myself kept for this part cases in which the practitioner does not find wounds but makes them, and in which I believe wounds and ulcerations to be benefited more by surgery than by medicine; as well as all that which concerns the bones. These cases I shall proceed to discuss in turn, and leaving to another volume the subject of bones I shall deal with the rest in this one; beginning with cases which occur anywhere in the body I shall pass on to those which occur in special situations.

> Latin: pr. Tertiam esse medicinae partem, quae MANV curet, et uulgo notum et a me propositum est. Ea non quidem medicamenta atque uictus rationem omittit, sed manu tamen plurimum praestat, estque eius effectus inter omnes medicinae partes euidentissimus. Siquidem in morbis, cum multum fortuna conferat, eademque saepe salutaria, saepe uana sint, potest dubitari, secunda ualetudo medicinae an corporis an * beneficio contigerit. In is quoque, in quibus medicamentis maxime nitimur, quamuis profectus euidentior est, tamen sanitatem et per haec frustra quaeri et sine his reddi saepe manifestum est: sicut in oculis quoque deprehendi potest, qui a medicis diu uexati sine his interdum sanescunt. At in ea parte, quae manu curat, euidens omnem profectum, ut aliquid ab aliis adiuuetur, hinc tamen plurimum trahere. Haec autem pars cum sit uetustissima, magis tamen ab illo parente omnis medicinae Hippocrate quam a prioribus exculta est. Deinde posteaquam diducta ab aliis habere professores suos coepit, in Aegypto quoque Philoxeno maxime increuit auctore, qui pluribus uoluminibus hanc partem diligentissime conprehendit. Gorgias quoque et Sostratus et Heron et Apollonii duo et Hammonius Alexandrini multique alii celebres uiri singuli quaedam reperierunt. ⟨Ac⟩ Romae quoque non mediocres professores, maximeque nuper T⟨r⟩yphon pater et Euelpistus et, ut scriptis eius intellegi potest, horum eruditissimus Meges quibusdam in melius mutatis aliquantum ei disciplinae adiecerunt. Esse autem chirurgus debet adulescens aut certe adulescentiae propior; manu strenua, stabili, nec umquam intremescente, eaque non minus sinistra quam dextra promptus; acie oculorum acri claraque; animo intrepidus; misericors sic, ut sanari uelit eum, quem accepit, non ut clamore eius motus uel magis quam res desiderat properet, uel minus quam necesse est secet; sed perinde faciat omnia, ac si nullus ex uagitibus alterius adfectus oriatur. Potest autem requiri, quid huic parti proprie uindicandum sit, quia uulnerum quoque ulcerumque multorum curationes, quas alibi executus sum, chirurgi sibi uindicant. Ego eundem quidem hominem posse omnia ista praestare concipio; atque ubi se diuiserunt, eum laudo qui quam plurimum percepit. ⟨Ip⟩se autem huic parti ea reliqui, in quibus uulnus facit medicus, non accipit, et in quibus uulneribus ulceribusque plus profici manu quam medicamento credo; tum quicquid ad ossa pertinet. Quae deinceps exequi adgrediar, dilatisque in aliud uolumen ossibus, in hoc cetera explicabo; praepositisque is, quae IN QVALIBET CORPORIS PARTE fiunt, ad ea, quae prop⟨r⟩ias sedes habent, transibo.

[¶1] 1. 1 First then the displacements, in whatever part of the body they are, ought to be immediately treated, so that the skin is several times incised with a sharp scalpel where the pain is, and the blood as it issues wiped off with the back of the knife. But if relief is rather slow in coming and there is now redness as well, and if, where the redness is, there is swelling in addition, wherever there is swelling this treatment is best. Repressants are then to be applied, in particular unscoured wool soaked in vinegar and oil. In a slighter case the same applications may afford relief even without the scalpel; and if there is nothing else at hand, wood-ash, preferably of vine twigs, or failing that any other kind, stirred to a paste in vinegar, or even in water.

> Latin: 1. Luxata igitur, in quacumque parte corporis sunt, quam primum sic curari debent, ut, qua dolor est, ea scalpello cutis crebro incidatur, detergeaturque eodem auerso profluens sanguis. Quod si paulo tardius subuenitur iamque etiam rubor est, qua rubet corpus si tumor quoque accessit, quacumque is est, id optimum auxilium est. Tum superdanda reprimentia sunt, maximeque lana sucida ex aceto et oleo. Quod si leuior is casus est, possunt etiam sine scalpello inposita eadem mederi; et si nihil aliud est, cinis quoque maxime ex sarmentis (si is non est, quilibet alius) ex aceto uel etiam ex aqua coactus.

[¶2] 2. 2 There is prompt relief in such cases; but there is more trouble where a lesion has arisen internally of itself which causes swellings and tends to suppuration. I have described elsewhere the various classes of abscession, and I have pointed out the suitable medicaments; it now remains to speak of those which should be treated by surgery. Before the abscession becomes hardened, the overlying skin should be scarified and a cup put on, in order to draw outwards whatever bad and corrupted matter has collected; and it is right to repeat this every third day until every indication of inflammation has gone. It may be, however, that the cupping has no effect; for at times, although seldom, it happens that the abscess is enclosed in a covering of its own, which the ancients named a coat. Meges, because every such coat is sinew-like, said that no sinew could be produced under a lesion by which flesh is eaten away; but that when pus has been there for a long time, a callus forms round it. This has no bearing upon the mode of treatment, for the same thing ought to be done, whether it be a coat, or a callus. There is nothing to prevent a callus being called a coat, since it covers. Moreover at times the coat has formed after the pus has become more matured; so that what is under it cannot be drawn out by cupping. But this is readily recognized when the application of a cup causes no change. Therefore when that happens, or there is already hardening, there is no help from cupping, but as I have said elsewhere it is whilst matter is collecting that it has to be diverted or dispersed, or else matured. In the two former contingencies no further treatment is needed. When pus has matured, if in the armpits or groins it will not often have to be cut into. The same is true when the abscess is of moderate extent, so also when it is in the skin, or even in the flesh, unless the patient's weakness forces us to hurry; it is sufficient to poultice in order to make the pus come out of its own accord. For the place which has not felt the knife may generally escape without a scar. But if the abscess is more deeply seated, we must consider whether the part has sinews or not. For if it is free from sinews, it should be laid open with a red-hot cautery-knife; which has this advantage, that a small wound continues open longer for the withdrawal of the pus, and the resulting scar is small. But if there are sinews near by, the cautery is unsuitable, lest spasm of the sinews ensues or paralysis of the limb; then the scalpel becomes necessary. But although abscesses elsewhere can be opened even whilst immature, where there are sinews, we must wait for them to be fully matured, since the skin then becomes thin, and the pus joins it, and so is nearer to get at. Most abscesses require a linear incision; but in that termed panus, because it generally thins out the skin extremely, all the skin overlying the pus is to be cut away. But when the scalpel is used, care should always be taken that the incisions made are as few and as small as possible, but enough in number and extent to afford the necessary relief. For the larger cavities may at times have to be cut into rather widely even by two or three incisions, and cuts must be so made that the deepest part of the cavity gets a vent, lest any fluid should be left there to eat its way gradually into adjoining tissue, which was previously sound. Also it is natural that the skin should have to be cut away rather widely. For when the whole bodily habit has become vitiated in the course of a prolonged disease and the abscess cavity has extended widely and the skin over it has already become pallid, then we can recognize that the skin is already dead and of no further use; and therefore the excision of overlying skin is better, especially if the suppuration is round about the larger joints, and if the patient, confined to bed, has been exhausted by diarrhoea, and gained nothing from his food. But the skin should be so cut out as to leave a myrtle leaf shaped wound, in order that it may heal more readily: and this should be the constant rule, whenever, or for whatever reason, the practitioner cuts out skin. Where the pus has been let out, for the armpit or groin lint plugging is unsuitable, but a sponge squeezed out of wine must be put on. In other parts, if likewise a lint plug is unnecessary, a little honey will be infused into the cavity to clean it, then agglutinants put on: if lint plugs are needed, over them also should be placed sponges similarly squeezed out of wine. But it has been said elsewhere when plugging is, and is not requisite. In all other ways the same procedure is to be followed after an abscess has been opened by incision, which I have described for one which has ruptured under medicaments.

> Latin: 2. Verum hoc quidem promptum est: in is autem negotium maius est, quae per se uitio intus orto intumescunt et ad suppurationem spectant. Ea omnia genera abscessum esse alias proposui, medicamentaque his idonea executus sum: nunc superest, ut dicam in isdem quae manu fieri debeant. Ergo priusquam indurescant, cutem incidere et cucurbit⟨ul⟩am adcommodare oportet, quae quicquid illuc malae corruptaeque materiae coiit, extrahat; idque iterum tertio die recte fit, donec omne indicium inflammationis excedat. Neque tamen fas non est nihil cucurbitulam agere: interdum enim fit, sed raro, ut, quicquid abscedit, uelamento suo includatur: id antiqui tunicam nominabant. Meges, quia tunica omnis neruosa est, dixit non nasci sub eo uitio neruum, quo caro consumeretur; sed subiecto iam uetustiore pure callum circumdari. Quod ad curationis rationem nullo loco pertinet, quia ⟨quic⟩quid, si tunica est, idem, si callus est, fieri debet. Neque ulla res prohibet, etiamsi callus est, tamen quia cingit, tunicam nominari. Tum pure quoque maturiore haec interdum esse consueuit; ideoque quod sub ea est, extrahi per cucurbitulam non potest. Sed facile ⟨id⟩ intellegitur, ubi nihil admota illa mutauit. Ergo siue id incidit siue iam durities est, in hac auxilii nihil est, ⟨sed⟩, ut alias scripsi, uel auertenda concurrens eo materia uel digerenda uel ad maturitatem perducenda est. Si priora contigerunt, nihil praeterea necessarium est. Si pus maturuit, in alis quidem et inguinibus raro secandum est, item ubicumque mediocris abscessus est, item quotiens in summa cute uel etiam carne uitium est, nisi festinare cu⟨b⟩antis inbecillitas cogit; satisque est cataplasmatis efficere, ut per se pus aperiatur. Nam fere sine cicatrice potest esse is locus, qui expertus ferrum non est. Si autem altius malum est, considerari debet neruosusne is locus sit an non sit. Nam si sine neruis est, candenti ferramento aperiri debet; cuius haec gratia est, quod exigua plaga diutius ad pus euocandum patet, paruaque postea cicatrix fit. At si nerui iuxta sunt, ignis alienus est, ne uel distendantur, uel membrum debilitent: necessaria uero opera scalpelli est. Sed cetera etiam subcruda aperiri possunt: inter neruos ultima expectanda maturitas est, quae cutem extenuet eique pus iungat, quo propius reperiatur. Iamque alia rectam plagam desiderant: in pan⟨o⟩, quia fere vehementer cutem extenuat, tota ea super pus excidenda est. Semper autem ubi scalpellus admouetur, id agendum est, ut et quam minimae et paucissimae plagae sint, cum eo tamen ut necessitati succurramus et in modo et in numero. Nam maiores sinus latius interdum etiam duabus aut tribus lineis incidendi sunt, dandaque opera, ut imus sinus exitum habeat, ne quis umor intus subsidat, qui proxima et adhuc sana ⟨e⟩rodendo sinuet. Est etiam in rerum natura, ut cutis latius excidenda sit. Nam ubi post longis morbis totus corporis habitus uitiatus est lateque se sinus suffudit et in eo iam cutis pallet, scire licet eam iam emortuam esse et inutilem futuram; ideoque excidere commodius est, maxime si circa articulos maiores id euenerit, cubantemque aegrum fluens aluus exhaurit neque per alimenta quicquam corpori accedit. Sed excidi ita debet, ut plaga ad similitudinem myrtei folii fiat, quo facilius sanescat: idque perpetuum est, ubicumque medicus et quacumque causa cutem excidit. Pure effuso, in alis uel inguinibus, linamento opus non est ⟨s⟩ed spongia ex uino inponenda est. In ceteris partibus, si aeque linamenta superuacua sunt, purgationis causa paulum mellis infundendum, deinde glutinantia super danda: si illa necessaria sunt, super ea quoque similiter dari spongia eodem modo ex uino expressa debet. Quando autem linamentis opus sit, quando non sit, alias dictum est. Cetera eadem incisa suppuratione facienda sunt, quae, ubi per medicamenta rupta est, facienda esse proposui.

[¶3] 3. 3 Now how the treatment is succeeding, how much is to be either hoped or feared, can be learnt straightaway from signs which on the whole are the same as have been mentioned already for wounds. Good signs are: ready sleep, easy breathing, no harassing thirst, no aversion to food; for any feverishness to pass off; and for the pus to be white and uniform, not foul. Bad signs are: wakefulness, laboured breathing, thirst, aversion to food, fever, the pus dark or like wine lees, and foul. Again, bad signs in the course of the treatment are: haemorrhage, or if the margins become fleshy before the sinus has been filled up by flesh, and this flesh is insensitive and not firm. But the worst sign of all is a faint, whether during the dressing, or after it. Again there is some reason for anxiety when the illness suddenly subsides, and then suppuration breaks out; or if the illness persists after the pus has been let out. And one cause for anxiety is if the wound is insensible to corrosives. But while it is chance that makes the signs point now one way, now another, it is the practitioner's part to strive to bring about healing. Therefore whenever it is dressed, the abscess cavity should be washed out, with wine mixed with rain water or with a decoction of lentils, when the discharge seems to need checking; with honey wine when cleaning is required; after which it is dressed as before. When the discharge appears to be checked, and the cavity clean, then is the time to help the growth of flesh, both by irrigating with equal parts of wine and honey, and by laying on a sponge soaked in wine and rose oil. Although the growth of flesh is helped by these medicaments, this is better attained, as I have said elsewhere, by a careful regimen; this consists, after the cessation of the fever and a return of appetite, in an occasional bath, gentle rocking daily, food and drink suitable for making flesh. These prescriptions all apply to abscesses which have burst under medicaments; but they have been held over to this place because it is scarcely possible to cure a large abscess without using the knife.

> Latin: 3. Protinus autem quantum curatio efficiat, quantumque aut sperari aut timeri debeat, ex quibusdam signis intellegi potest, fereque isdem, quae ⟨in⟩ uolneribus ⟨exposita sunt⟩. Nam bona signa sunt somnum capere, facile spirare, siti non confici, cibum non fastidire: si febricula fuit, ea uacare; itemque habere pus album, leue, non foedi odoris. Mala sunt uigilia, spiritus grauitas, sitis, cibi fastidium, febris, pus nigrum aut faeculentum et foedi odoris. Item procedente curatione eruptio sanguinis, aut si, antequam sinus carne impleatur, orae carnosae fiunt, illa quoque ipsa carne hebete nec firma. Deficere tamen animam uel ipsa curatione uel postea pessimum omnium est. Quin etiam morbus ipse siue subito solutus est, deinde suppuratio exorta est, siue effuso pure permanet, non iniuste terret. Estque inter causas timoris, si sensus in uulnere rodentium non est. Sed ut haec ipsa fortuna huc illucue discernit, sic medici partium est eniti ad reperiendam sanitatem. Ergo quotiens ulcus resoluerit, eluere id, si reprimendus umor uidebitur, uino ex aqua pluuia[ti]li mixto uel aqua, in qua lenticula cocta sit, debebit; si purgandum erit, mulso; rursusque inponere eadem. Vbi iam repressus uidebitur umor, ulcusque puru⟨m⟩ erit, produci carnem conueniet, et foueri uulnus pari portione uini ac mellis, superque inponi spongiam ex uino et rosa tinctam. Per quae cum caro producatur, plus tamen (ut alias quoque dixi) uictus ratio eo confert; id est solutis iam febribus et cibi cupiditate reddita balneum rarum, cotidiana sed lenis gestatio, cibi potionesque corpori faciundo aptae. Quae omnia per medicamenta quoque suppuratione rupta secuntur: sed quia magno malo uix sine ferro mederi licet, in hunc locum reseruata sunt.

[¶4] 4. 4 Again, for fistulae which penetrate so deeply that a medicated bougie cannot be passed down to the ends, or those which are tortuous or multiple, surgery has the advantage over medicine; and there is less trouble if the fistula runs horizontally under the skin, than when it tends directly inwards. Therefore if it lies horizontally under the skin, a probe should be introduced and cut down upon. When there are bends, these are followed up in the same way with the probe and knife; so also when they present multiple branchings. When the end of the fistula is reached, all the callus should be cut out, then pins are inserted through the skin margin, and agglutinating medicaments spread over all. But if it runs straight inwards, after its chief direction has been explored by means of the probe, that cavity ought to be excised, then a pin is to be inserted through the skin opening, and agglutinating medicaments applied as above; or if there is more corrupt ulceration, which is at time the case when there is disease of bone, after the bone has been treated, suppuratives are put on. Now it is common for fistulae to have their exit between ribs; when this is the case the rib must be cut across on either side at that spot, and the segment removed lest anything diseased be left within. Fistulae which have passed between the ribs often involve the transverse septum separating the viscera above from the intestine. This can be recognized by the position of the fistula and the severity of the pain, and because at times, air with frothy humour escapes from the fistula, especially when the patient has held his breath. In that case there is no opportunity for the medical art. But in the case of other fistulae near the ribs which are curable, greasy medicaments are objectionable but anything else which suits wounds may be used; the best, however, is lint put on dry, or after soaking in honey if anything has to be cleaned. There is no bone in the abdomen, but all the same fistulae there are so dangerous that Sostratus thought them incurable. Experience, however, shows that this is not always the case. Indeed — and this may seem very remarkable — a fistula which forms over the liver, spleen, or stomach, is safer than one right over the intestine, not because a fistula there is more harmful, but because it opens the way to another danger. Some writers who have had experience of this have shown little perception of the true facts. For often the abdomen is actually penetrated by a weapon, and sutures bring the margins of the wound together and how this is done I will presently point out. Therefore also when a fine fistula breaks through the abdominal wall, it is possible to cut it out, and to join its margins by suture. But if such a fistula widens out inside, this excision necessarily leaves a wide gap which cannot be sutured without applying great force especially in the deeper part where the abdomen is enclosed by a kind of membrane which the Greeks call peritoneum. Therefore, when the patient begins to get up and move about, the sutures break, and intestines prolapse; which causes his death. But these cases are not altogether desperate, and so for the finer fistulae, treatment is to be adopted. Special consideration is required in the case of those in the anus. In these, where a probe has been passed up to its end, the skin should be cut through, next through this new orifice the probe is to be drawn out, followed by a linen thread which has been passed through the eye made for the purpose in the other end of the probe. Then the two ends of the linen thread are taken and knotted together so as to grip loosely the skin overlying the fistula. The linen thread should be made up of two or three strands of raw flax, twisted up so as to make one. Meanwhile the patient can do his business, walk, bathe, and take food as if in the best of health. Only this thread is to be moved twice a day, but without undoing the knot, the part of the thread outside being drawn within the fistula, and the thread must not be left until it becomes foul, but every third day the knot is to be undone, and to one end that of another fresh thread is tied, and the old thread being withdrawn the new one is to be left in the fistula after being similarly knotted. For thus the thread cuts through the skin overlying the fistula slowly, and whilst the skin released from the thread undergoes healing, that which is still gripped is being cut through. This method of treatment is lengthy but causes no pain. Those in a hurry should constrict the skin with the thread, so that they may continue through more quickly; and at night they should insert into the fistula some fine pledglets of wool, in order that its overlying skin, being put on the stretch, may be thinned out; but these measures cause pain. More speed may be added, but more pain as well, if both the thread and the pledglets are smeared with some one of the medicaments, which I have noted for the eating away of callus. Even here, however, the knife must be used, if the fistula extends inwards, of is multiple. In these kinds of fistulae, therefore, when the probe has been inserted, the skin is to be cut through along two lines so that between them a very fine strip of skin may be taken out, in order that the margins may not unite at once, and that there may be room for the smallest possible quantity of lint to be inserted; all the rest is done in the way described for abscesses. If, however, from one orifice several sinuses lead off, the straight part of the fistula is to be laid open with the scalpel, and the others branching from it, which are now exposed, are to be gripped by a thread. Should any fistula extend so far inwards that it cannot be safely laid open by the knife, a medicated bougie is to be put in. But in all such cases, whether treated surgically or by medicaments, the food should be moist, the drink abundant, and for a while water: when flesh begins to grow up, then at length the patient is to make use of the bath occasionally, and of flesh-making food.

> Latin: 4. Aduersus fistulas quoque, si altius penetrant, ut ad ultimas demitti collyrium non possit, si tortuosae sunt, si multiplices, maius in manu quam in medicamentis praesidium est; minusque operae est, si sub cute transuersa⟨e⟩ feruntur, quam si rectae intus tendunt.—Igitur si sub cute transuersa fistula est, demitti specillum debet, supraque ea incidi. Si flexus reperientur, hi quoque simul specillo et ferro persequendi; itemque faciendum, si plures se quasi ramuli ostendunt. Vbi ad finis fistulae uentum est, excidendus ex ea totus callus est, superque fibulae dandae et medicamentum quo glutinetur. At si recta subter tendit, ubi, quo maxime ferat, specillo exploratum est, excidi ⟨is⟩ sinus debet; dein fibula oris cutis inicienda est; et aeque glutinantia medicamenta superdanda sunt aut, si corruptius ulcus est, quod interdum osse uitiato fit, ubi id quoque curatum est, pus mouent⟨ia.⟩ Solent autem inter costas fistulae subter exire; quod ubi incidit, eo loco costa ab utraque parte praecidenda et eximenda est, ne quid intus corruptum relinquatur. Solent, ubi costas transierunt, saeptum id, quod transuer⟨s⟩um a superioribus uisceribus intestina discernit, uiolare. Quod intellegi loco et magnitudine doloris potest. Qui * * * nonnumquam spiritus ea cum umore quasi bullante prorumpit, maximeque si hunc ore ille continuit. In eo medicinae locus nullus est. In ceteris uero, quae circa costas sanabilia sunt, pinguia medicamenta inimica sunt; ceteris, quae ad uulnera adcommodantur, uti licet: optime tamen sicca lin⟨a⟩menta uel, si purgandum aliquid uidetur, in melle tincta inponuntur. Ventri nullum os subest, sed ibi perniciosae admodum fistulae fiunt, adeo ut Sostratus insanabiles esse crediderit. Id non ex toto ita se habere usus ostendit. Et quidem, quod maxime mirum uideri potest, tutior fistula est contra iecur et lienem et uentriculum quam contra intestina, non quo perniciosior ibi sit, sed quo alteri periculo locum faciat. Cuius experimen⟨to mo⟩ti quidam auctores parum modum rei cognouerunt. Nam uenter saepe etiam telo perforatur, prolapsaque intestina conduntur, et oras uulneris suturae conprehendunt; quod quemadmodum fiat, mox indicabo. Itaque etiam ubi tenuis fistula abdomen perrumpit, excidere ea⟨m⟩ licet suturaque oras coniungere. Si uero ea fistula intus patuit, excissa necesse est latius foramen relinquat, quod nisi magna ui, utique ab interiore parte, sui non potest; qua quasi membrana quaedam finit abdomen, quam periton⟨a⟩eon Graeci uocant. Ergo ubi aliquis ingredi ac moueri coepit, rumpitur illa sutura, atque intestina soluuntur; quo fit, ut pereundum homini sit. Sed ⟨non⟩ omni modo res ea desperationem habet, ideoque tenuioribus fistulis adhibenda curatio est. Propriam etiam⟨num⟩ animaduersionem desiderant ea⟨e⟩, quae in ano sunt. In has demisso specillo ad ultimum eius caput incidi cutis debet, dein nouo foramine specillum educi lino sequente, quod in aliam eius partem ob id ipsum perforatam coniectum sit. Ibi linum prehendendum uinciendumque cum altero capite est, ut laxe cutem, quae super fistulam est, teneat; idque linum debet esse crudum et duplex triplexue, sic tortum, ut unitas facta sit. Interim autem licet negotia gerere, ambulare, lauari, cibum capere ⟨per⟩inde atque sanissimo. Tantummodo ⟨i⟩d linum bis die saluo nodo ducendum est, sic ut subeat fistulam pars quae superior fuit. Neque committendum est, ut id linum putrescat, sed tertio quoque die nodus resoluendus est, et ad caput alterum recens linum alligandum est eductoque uetere id in fistula cum simili nodo relinquendum. Sic enim id paulatim cutem, quae supra fistulam est, incidit; simulque et id sanescit, quod a lino relictum est et id, quod ab eo mordetur, inciditur. Haec ratio curationis longa ⟨sed⟩ sine dolore est. Qui festinant, adstringere cutem lino debent, quo celerius secent, noctuque ex penicillo tenuia quaedam intus demittere, ut cutis hoc ⟨ipso⟩ extenuetur quo extenditur; sed haec dolorem mouent. Adicitur celeritati sicut tormento quoque, si et linum et id, quod ex penicillo est, aliquo medicamento inlinitur ex is, quibus callum exedi posui. Potest tamen fieri, ut ad scalpelli adcurationem etiam illo loci ueniendum sit, si intus fistula fert, si multiplex est. Igitur in haec genera demisso specillo duabus lineis incidenda cutis est, ut media inter eas habenula tenuis admodum eiciatur; ne protinus orae coeant, sitque locus aliquis lin⟨a⟩mentis, quae quam paucissima superinicienda sunt; omniaque eodem modo facienda, quae in abscessibus posita sunt. Si uero ab uno ore plures sinus erunt, recta fistula scalpello erit incidenda; ab eo ceterae, quae iam patebunt, lino excipiendae. Si intus aliqua procedet, quo ferrum tuto peruenire non poterit, collyrium demittendum erit. Cibus autem in eiusmodi omnibus casibus, siue manu siue medicamentis agetur, dari debet umidus, potio liberalis, diuque aqua: ubi iam caro increscit, tum demum et balineis raris utendum erit et cibis corpus inplentibus.

[¶5] 5. 5 Missiles too, which have entered the body and become fixed within, are often very troublesome to extract. And some of the difficulties arise from their shape, some owing to the positions to which they have penetrated. Whatever the missile may be, it is extracted, either by the wound of entry, or through the spot towards which it is pointing. In the former case, the missile has already made a way for its withdrawal; in the latter the way out is made with the scalpel; for the flesh is cut through upon its point. But if the missile is not deeply seated, and lies in superficial tissue, or if it is certain that it has not crossed the line of large blood vessels or sinews, there is nothing better than to pull it out by the way it entered. But if the distance it has to be withdrawn is greater than that which remains to be forced through, or if it has crossed the line of blood vessels and sinews, it is more convenient to lay open the rest of its course and so draw it out. For it will be more easily got at and more safely pulled out. And in the case of one of the larger limbs, if the point has passed beyond the middle, a through and through wound heals more easily because it can be dressed with a medicament at both ends. But if the missile is to be drawn back, the wound should be enlarged with a scalpel, for then the missile comes away more easily, also less inflammation is caused; for this becomes more severe if the missile itself lacerates the tissues while being withdrawn. So also when a counter opening is made, this ought to be too wide for the missile to fill as it is passing out. In either case, the greatest care should be taken that no vein, nor one of the larger sinews, nor an artery, is cut. When any one of these is observed, it is to be caught by a blunt hook and held away from the scalpel. Than the incision has been made large enough, the missile is to be drawn out, proceeding in the same way, and taking the same care, lest that which is being extracted should injure one of those structures which I have said are to be protected. The foregoing are general rules; there are some rules which apply to special missiles, and these I will at once set out. Nothing penetrates so easy into the body as an arrow, and it also becomes very deeply fixed. And this happens both because it is propelled with great force and because it is sharply pointed. Hence it is more often to be extracted through a counter opening than through the wound of entry, and especially so because it is generally furnished with barbs which lacerate more when drawn backwards than if pushed through a counter opening. When a passage out has been laid open, the flesh ought to be stretched apart by an instrument like a Greek letter; next when the point has come into view, if the shaft is still attached, it is to be pushed on until the point can be seized from the counter opening and drawn out: if the shaft has already become detached, and only the arrowhead is within, the point should be seized by the fingers or by forceps, and so drawn out. Nor is the method of extraction different when it is preferred to withdraw the arrow by the wound of entry; the wound having been enlarged, either the shaft, if it is still attached, or, if not, the arrowhead itself, is pulled upon. When the barbs come into view, if they are short and fine, they should be nipped off on the spot by forceps, and the missile drawn out without them. If the barbs are too large and resistant for this, they must be covered by reed pens which have been split, and thus pulled out carefully so as not to tear the flesh. This is what is to be done in the case of arrows. But if it is a broad weapon which has been embedded, it is not expedient to extract it through a counter opening, lest we add a second large wound to one already large. It is therefore to be pulled out by the aid of some such instrument as that which the Greeks call the Dioclean cyathiscus, because invented by Diocles, whom I have said already to have been among the greatest of the ancient medical men. The instrument consists of two iron or even copper blades, one blade has at each angle of its end a hook, turned downwards; the other blade has its sides turned up so that it forms a groove, also its end is turned up somewhat, and perforated by a hole. The latter blade is first passed up to the weapon, and then underneath it, until the point is reached, the blade is then rotated somewhat until the point becomes engaged in the perforation. After the point has entered the perforation, the hooks of the first mentioned blade are fitted by the aid of the fingers over the upturned end of the blade already passed, after which simultaneously the cyathiscus and the weapon are withdrawn. There is a third kind of missile which at times has to be extracted such as a lead ball, or a pebble, or such like, which has penetrated the skin and become fixed within unbroken. In all such cases the wound should be laid open freely, and the retained object pulled out by forceps the way it entered. But some difficulty is added in the case of any injury in which a missile has become fixed in bone, or in a joint between the ends of two bones. When in a bone, the missile is swayed until the place which grips the point yields, after which it is extracted by the hand, or by forceps; this is the method also used in extracting teeth. In this way the missile nearly always comes out, but if it resists, it can be dislodged by striking it with some instrument. The last resort when it cannot be pulled out, is to bore into the bone with a trepan close by the missile, and from that hole to cut away the bone in the shape of the letter V, so that the lines of the letter which diverge to either side face the missile; after that it is necessarily loosened and easily removed. If the missile has forced its way actually into a joint between the ends of two bones, the limbs above and below are encircled by bandages or straps, by means of which they are pulled in opposite directions, so that the sinews are put on the stretch; the space between the ends of the bone is widened by these extensions, so that the missile is without difficulty withdrawn. In doing this care must be taken, as mentioned elsewhere, to avoid injury to a sinew, vein or artery while the weapon is being extracted by the same method which was described above. But if the missile is also poisoned, after doing all the same things, even more promptly, if possible, in addition that treatment is to be applied which is given for one who has drunk poison, or has been bitten by a snake. The care of the wound itself after the extraction of the missile does not differ from that of a wound in which nothing has lodged and on which I have said enough elsewhere.

> Latin: 5. Tela quoque, quae inlata corporibus intus haeserunt, magno negotio saepe eiciuntur. Suntque quaedam difficultates ex generibus eorum: quaedam ex is sedibus, in quas illa penetrarunt. Omne autem telum extrahitur aut ab ea parte, qua uenit, aut ab ea, in quam ⟨te⟩tendit. Illic uiam, qua redeat, ipsum sibi fecit, hic a scalpello accipit: nam contra mucronem caro inciditur. Sed si non alte telum insedit, et in summa carne est, aut certe magnas uenas et loca neruosa non transit, nihil melius quam qua uenit id euellere. Si uero plus est, per quod telo reuertendum quam quod perrumpendum est, iamque uenas neruosaque id transit, commodius est aperire quod superest, eaque extrahere: nam et propius petitur, ⟨et tutius euellitur;⟩ et in maiore membro, si medius mucro transit, facilius sanescit quod peruium est, quia utrimque medicamento fouetur. Sed si retro telum recipiendum, amplianda scalpello plaga est, quo facilius id sequatur, quoque minor oriatur inflammatio; quae maior fit, si ab illo ipso telo, dum redit, corpus laniatur. Item si ex alia parte uulnus aperiatur, laxius esse debet, quam ut telo postea transeunte amplietur. Summa autem utraque parte habenda cura est, ne uena, ne maior neruos, ne arteria incidatur. Quorum ubi aliquid detectum est, excipiendum hamo retuso est, abducendumque a scalpello. Vbi autem satis incisum est, telum eximendum est, tum quoque eodem modo et eadem cura habita, ne sub eo, quod eximitur, aliquod eorum laedatur, quae tuenda esse proposui. Haec communia. Sunt propria quaedam in singulis telorum generibus, quae protinus subiciam. Nihil tam facile in corpus quam sagitta conditur, eademque altissime ins⟨i⟩dit. Haec autem eueniunt, et quia magna ui fertur illa, et quia ipsa in angusto est. Saepius itaque ab altera parte, quam ex qua uenit, recipienda et praecipue quia fere spiculis cingitur, quae magis laniant, si retrorsus quam si contra eximatur. Sed inde aperta uia, caro diduci debet ferramento ad similitudinem facto Graecae litterae *: deinde, ubi apparuit, si mucro⟨n⟩i harundo inhaeret, propellenda est, donec ab altera adprehendi et extrahi possit; si iam illa decidit solumque intus ferrum est, mucro uel digitis adprehendi uel forfice atque ita educi debet. Neque alia ratio extrahendi est, ubi ab ea parte, qua uenit, euelli magis placuit: nam ampliato magis uulnere, aut harundo, si inest, euellenda est, aut si ea non est, ferrum ipsum. Quod si spicula apparuerunt eaque breuia et tenuia sunt, forfice ibi comminui debent, uacuumque ab his telum educi: si ea maiora ualentioraque sunt, fissis scriptoris calamis contegenda, ac ne quid lacerent, sic euellenda sunt. In sagittis quidem haec obseruatio est. Latum uero telum si conditum est, ab altera parte educi non expedit, ne ingenti uulneri ipsi quoque ingens uulnus adiciamus. Euellendum est ergo genere quodam ferramenti, quod Diocleum cyathiscum Graeci uocant, quoniam auctorem Dioclen habet; quem inter priscos maximosque medicos fuisse iam posui. Lammina uel ferrea uel aenea etiam ab altero capite duo utrimque deorsum conuersos uncos habet; ab altero duplicata lateribus, leuiterque extrema in eam partem inclinata, qua sinuata est, insuper ibi etiam perforata est. Haec iuxta telum transuersa demittitur; deinde ubi ad ⟨imum⟩ mucronem uentum est, paulum torquetur, ut telum foramine suo excipiat. Cum in cauo mucro est, ilico digiti subiecti partis alterius uncis simul et ferramentum id extrahunt et telum. Tertium genus telorum est, quod interdum euelli debet; plumbea glas aut lapis aut simile aliquid, quod perrupta cute integrum intus insedit.—In omnibus his latius uulnus aperiundum, idque quod inest, ea, qua uenit, forfice extrahendum est. Accedit uero aliquid difficultatis sub omni ictu, si telum uel ossi inhaesit uel in articulo se inter duo ossa demersit. In osse usque eo mouendum est, donec laxetur is locus, qui mucronem momordit; et tunc uel manu uel forfice telum extrahendum est; quae ratio in dentibus quoque eiciendis est. Vix umquam ita telum non sequitur: sed si morabitur, excuti quoque ictum aliquo ferramento poterit. Vltimum est, ubi non euellitur, terebra iuxta forare, ab eoque foramine ad speciem litterae †uel contra telum os excidere sic, ut lin⟨e⟩ae, quae diducuntur, ad telum spectent; eo facto id necesse est labet et facile auferatur. Inter duo uero ossa si per ipsum articulum perr⟨u⟩perit, circa uolnus duo membra fascis habenisue deliganda et per has in diuersas partes diducenda sunt, ut neruos distendant; quibus extentis laxius inter ossa spatium est, ut sine difficultate telum recipiatur. Illud uidendum est, sicut in aliis locis posui, ne quis neruus aut uena aut arteria a telo laedatur, dum id extrahit⟨ur,⟩ eadem scilicet ratione, quae supra posita est. At si uenenato quoque telo quis ictus est, i⟨s⟩dem omnibus, si fieri potest, etiam festinantius actis, adicienda curatio est, quae uel epoto ueneno, uel a serpente ictis adhibetur. Vulneris autem ipsius extracto telo medicina non alia est, quam quae esset, si corpore icto nihil inhaesisset; de qua satis alio loco dictum est.

[¶6] 6. 6 Such are lesions which can arise in any part of the body; the remainder occur in special situations, of these I am going to speak, beginning with the head. On the head many kinds of small tumours occur; besides those called ganglia, melicerides and atheromata, different authorities distinguish certain sorts by different names, and to these I myself will add one, steatoma. Although these tend to occur both in the neck and in the armpits and flanks, yet I have not dealt with them separately for there is little difference among them and none of them are dangerous and all are treated in the same way. Now all the above start from a very small beginning and grow slowly for a long time and have a coat of their own to enclose them. Some of them are hard and resistant, some soft and yielding; some become partially bald, others continue to be covered by their proper hair; generally they are painless. What they contain can be surmised, but cannot be fully known until the contents have been turned out. Generally, however, in those which are resistant, we find something like little stones, or balls of compressed hair; and in those which are yielding either some material similar to honey or thin porridge or something like grazed cartilage or bruised and bloody flesh, and the contents generally vary in colour. Ganglia are mostly resistant; atheromata have porridge-like contents; meliceris has a more fluid humour, and so it fluctuates when pressed upon; a steatoma contains a kind of fat. This last spreads most widely and loosens all the skin over it so that it is flaccid, although in the others the skin is more tense. All parts covered by hair should be shaved first and the incision made across the middle; but the coat of a steatoma is also to be cut into in order to let out whatever has collected within, because it is not easy to separate the coat from the skin and underlying flesh; in the other kinds the coating is to be preserved entire. Then as soon as the white and tight coat is seen, it is to be separated from the skin and flesh by the handle of the scalpel, and turned out together with its contents. But if muscle adheres to the deeper part of the tunic, lest it should be injured, only the superficial part of the tunic is to be cut away, and the deeper part left in position. When the whole has been removed the margins of the incision are to be brought together, a pin passed through them and, over this, an agglutinating medicament applied. When the whole, or any part of the coat has been left, suppuratives must be applied.

> Latin: 6. Haec ⟨e⟩uenire in qualibet parte corporis possunt: reliqua CERTAS SEDES habent, de quibus dicam orsus a capite. In hoc multa uariaque tubercula oriuntur: gang⟨lia⟩, meliceridas, atheromata nominant aliisque etiamnum uocabulis quaedam alii discernunt, quibus ego steatomata quoque adiciam. Quae quamuis et in ceruice et in alis et in lateribus oriri solent, per se tamen non posui, cum omnia ista mediocres differentias habeant, ac neque periculo terreant neque diuerso genere curentur. Omnia uero ista et ex paruulo incipiunt et diu paulatimque increscunt, et tunica sua includuntur. Quaedam ex his dura ac renitentia, quaedam mollia cedentiaque sunt; quaedam spatio nudantur, quaedam tecta capillo suo permanent; fereque sine dolore sunt. Quid intus habeant, ut coniectura praesagiri potest, sic ex toto cognosci, nisi cum eiecta sunt, non potest. Maxime tamen in is, quae renituntur, aut lapillis quaedam similia aut concreti confersique pili reperiuntur: in is uero, quae cedunt, aut melli simile aliquid aut tenui pulticulae aut quasi rassae cartilagini aut carni hebeti et cruentae, quibus ⟨ali⟩ alique colores esse consuerunt. Fereque ganglia renituntur: atheromati subest quasi tenuis pulticula: meliceridi liquidior umor, ideoque pressu⟨s⟩ circumfluit: steatomati pingue quiddam. Idque latissime patere consueuit, resoluitque totam cutem superpositam sic, ut e⟨a⟩ labet, cum in ceteris sit adstrictior. Omnia derassa ante si capillis conteguntur, per medium oportet incidi: sed steatomatis tunica quoque secanda est, ut effundatur quicquid intus coit, quia non facile a cute et subiecta carne ea separ⟨a⟩tur: in ceteris ipsa tunica inuiolata seruanda est. Protinus autem ⟨ut⟩ alba et intenta se ostendit, tum scalpelli manubriolo deducenda a cute ⟨et⟩ carne est, eiciendaque cum eo, quod intus tenet. Si quando tamen ab inferiore parte tunicae musculus inhaesit, ne is laedatur, superior pars illius decidenda; at im⟨a⟩ ibi relinquenda est. Vbi tota exempta est, committendae orae, fibulaque his inicienda, et super medicamentum glutinans dandum est. Vbi uel tota tunica uel aliquid ex ea relictum est, pus mouentia adhibenda sunt.

[¶7] 7. 7 But whilst the preceding kinds of lesion do not differ much among themselves or in the mode of treatment, those in the eyes which demand surgical measures are different from each other and differently treated. For instance in the upper eyelid cysts are apt to be formed, fatty and weighty, which hardly allow the eyes to be raised, and they set up a slight but persistent discharge of rheum from the eyes; and these generally occur in children. When the eyeball has been pressed with two fingers so as to render the skin of the upper eyelid tense, a transverse linear incision is to be made with a scalpel, with so light a touch that the cyst itself is not cut into; when the way is opened it protrudes of itself. It should then be seized with the fingers and taken out, for it comes away easily. One of the ointments, with which running eyes are anointed, is then smeared on, and in a very few days a fine scar is induced. There is more trouble when the cyst has been cut into, for it lets out a humour, and afterwards, because it is very thin, it cannot be laid hold of. Should this chance to happen, something to promote suppuration should be applied.

> Latin: 7. Sed ut haec neque genere uiti neque ratione curationis inter se multum distant, sic in oculis, quae manum postulant, et ipsa diuersa sunt et aliter aliterque curantur. Igitur in superioribus palpebris uesicae nasci solent pingues graues⟨que,⟩ quae uix attollere oculos sinunt, leuesque pituitae cursus sed adsiduos in oculis mouent: fere uero in pueris nascuntur. —Oportet conpresso digitis duobus oculo atque ita cute intenta scalpello transuersam lineam incidere, suspensa leuiter manu, ne uesica ipsa uulneretur; u⟨b⟩i locus ei patefactus est, ipsa prorumpit. Tum digitis ea⟨m⟩ adprehendere oportet et euellere; facile autem sequitur. Dein superinungui collyrio debet ex is aliquo, quo lippientes oculi superinunguntur; paucissimisque diebus cicatricula inducitur. Molestius est, ubi incisa uesica est: effundit enim umorem, neque postea, quia tenuis admodum est, potest colligi. Si forte id incidit, eorum aliquid inponendum est, quae puri mouendo sunt.

[¶8] A very small tumour forms in the same upper eyelid, above the line of the eyelashes, which from its resemblance to a barleycorn is termed by the Greeks crithê. Its contents are slow to come to a head and contained within a coat; it should be fomented with hot bread or with wax gently heated, but not so hot that it cannot easily be borne by that part; for under this treatment it is often dispersed, but at times it matures. When pus shows itself, it should be cut across with a scalpel and any humour inside squeezed out; then the eyelid is afterwards also to be fomented as above by steam, and ointment applied until it heals.

> Latin: In eadem palpebra supra pilorum locum tuberculum paruulum nascitur, quod a similitudine hordei a Graecis crit⟨h⟩e nominatur. Tunica ⟨quidda⟩m, quod difficulter maturescit, conprehensum ⟨est; id⟩ uel calido pane uel cera subinde calfacta foueri oportet sic, ne nimius is calor sit sed facile ea parte sustineatur: hac enim ratione saepe discutitur, interdum concoquitur. Si pus se ostendit, scalpello diuidi debet, et quicquid intus umoris est, exprimi;

[¶9] Other tumours also, not unlike these, form on the eyelids; but they are not quite the same shape and are mobile, so that they can be pushed about with the finger; and so the Greeks call them chalazia. They should be cut down upon, from the outside if under the skin, from the inside if under the cartilage, than separated from the sound tissue by the handle of the scalpel. If the cut is on the inner surface, first mild, then more acrid ointment is to be applied; if on the outer, an agglutinating plaster is put on.

> Latin: eodem deinde uapore postea quoque foueri et superinungui, donec ad sanitatem perueniat. Alia quoque quaedam in palpebris ⟨huic⟩ non dissimilia ⟨ori⟩untur: sed neque utique figura⟨e⟩ eiusdem, et mobilia, simul atque digito uel huc uel illuc inpelluntur; ideoque ea chalazia Graeci uocant.— Haec incidi debent, si sub cute sunt, ab exteriore parte; si sub cartilagine, ab interiore; deinde scalpelli manubriolo deducenda ab integris partibus sunt.

[¶10] An unguis too, called pterygium in Greek, is a little fibrous membrane, springing from the angle of the eye which sometimes even spreads so as to block the pupil. Most often it arises from the side of the nose, but sometimes from the temporal angle. When recent it is not difficult to disperse by the medicaments which thin away corneal opacities; if it is of long standing, and thick, it should be excised. After fasting for a day, the patient is either seated facing the surgeon, or turned away, so that he lies on his back, his head in the surgeon's lap. Some want him facing if the disease is in the left eye and lying down if in the right. Now one eyelid must be held open by the assistant, the other by the surgeon; but he holds the lower lid when seated opposite the patient, and the upper when the patient is on his back. Thereupon the surgeon passes a sharp hook, the point of which has been a little incurved, under the edge of the pterygium and fixes the hook in it; next, leaving that eyelid also to the assistant, he draws the hook towards himself thus lifting up the pterygium, and passes through it a needle carrying a thread; then having detached the needle, he takes hold of the two ends of the thread, and raises up the pterygium by means of the thread; he now separates any part of it which adheres to the eyeball by the handle of the scalpel until the angle is reached; next by alternately pulling and slackening the thread, he is able to discover the beginning of the pterygium and the end of the angle. For there is double danger, that either some of the pterygium is left behind and if this ulcerates, it is hardly ever amenable to treatment; or that with it part of the flesh is cut away from the angle; and if the pterygium is pulled too strongly, the flesh follows unnoticed, and when it is cut away a hole is left through which there is afterwards a persistent flow of rheum; the Greeks name it rhyas. Therefore the true edge of the angle must certainly be observed; and when this has been clearly determined, after the pterygium has been drawn forward just enough, the scalpel is to be used, then that little membrane is to be cut away as not to injure the angle in any way. After that, lint soaked in honey is to be put on, and over that a piece of linen, and either a sponge or unscoured wool. And for the next few days the eye must be opened daily to prevent the eyelids uniting by a scar for if that happens a third danger is added; and the lint is to be put on again, and last of all one of the salves applied which help wounds to heal. But this treatment ought to be in the spring, or certainly before winter; this warning applies to many cases, and it will be enough to give it here once for all. For there are two classes of treatment: one in which we cannot choose the time but must make the best of things, as in the case of wounds; the other in which there is no urgency and it is safest to wait, for example when the affection progresses slowly and the patient is not racked by pain. Then we should wait for spring, or if there is more urgency, autumn is better than either summer or winter, and especially mid-autumn when the hot weather has broken and the cold not yet begun. The more essential the part to be treated, the greater the danger; and often the larger the wound to be made, the more regard should thus be paid to the season.

> Latin: Ac, si intus plaga est, inunguendum primum lenibus, deinde acrioribus; si extra, superdandum emplastrum, quo id glutinetur. Vnguis uero, quod pterygion Graeci uocant, est membranula neruosa oriens ab angulo, quae nonnumquam ad pupillam quoque peruenit, eique officit; saepius a narium, interdum etiam a temporum parte nascitur. Hunc recentem non difficile est discutere medicamentis, quibus cicatrices in oculis extenuantur: si inueterauit iamque ei crassitudo quoque accessit, excidi debet. Post abstinentiam uero unius diei uel aduersus in sedili contra medicum is homo collocandus est, uel sic auersus, ut in gremium eius caput resupinus effundat. Quidam, si in sinistro oculo uitium est, aduersum; si in dextro, resupinum collocari uolunt. Alteram autem palpebram a ministro deduci oportet, alteram a medico: sed ab hoc, si ille aduersus est, inferiorem; si supinus, superiorem. Tum idem medicus hamulum acutum, paululum mucrone intus recuruato, subicere extremo ungui debet, eumque infigere, atque eam quoque palpebram tradere alteri; ipse hamulo adprehenso leuare unguem, eumque acu traicere linum trahente; deinde acum ponere, lini duo capita adprehendere, et per ea erecto ungue, si qua parte oculo inhaeret, manubriolo scalpelli deducere, donec ad angulum ueniat; deinde inuicem modo remittere, modo adtrahere, ut sic et initium eius et finis anguli reperiatur. Duplex enim periculum est, ne uel ex ungue aliquid relinquat⟨ur,⟩ quod exulceratum uix ullam recipiat curationem; uel ex angulo quoque caruncula abscidatur; quae, si uehementius unguis ducitur, sequitur ideoque decipit: abscisa patefit foramen, per quod postea semper umor descendit: rhy⟨a⟩da Graeci uocant. Verus ergo anguli finis utique noscendus est; qui ubi satis constitit, non nimium adducto ungue scalpellus adhibendus est, deinde excidenda ea membranula, ne quid ex angulo ⟨l⟩aedatur. Eodem inde ex melle lin⟨a⟩mentum super⟨d⟩andum est supraque linteolum, et aut spongia aut lana sucida; proximisque diebus deducendus cotidie oculus est, ne cicatrice inter se palpebrae glutinentur, siquidem id quoque tertium periculum accedit; eodemque modo lin⟨a⟩mentum inponendum, ac nouissime inunguendum collyrio, quo ulcera ad cicatricem perducuntur. Sed ea curatio uere esse debet aut certe ante hiemem; de qua re ad p⟨l⟩ura loca pertinente semel dixisse satis erit. Nam duo genera curationum sunt. Alia, in quibus eligere tempus non licet, sed utendum est eo, quod incidit, sicut in uulneribus [in fistulis]; alia, in quibus nullus dies urguet, et expectare tutissimum [facile] est, sicut euenit in is, quae et tarde crescunt et dolore non cruciant. In his uer expectandum est, aut si quid magis pressit, melior tamen autumnus est quam aestas aut hiemps, atque is ipse medius, iam fractis aestibus, nondum ortis frigoribus.

## 27. Book VII · chapters 7–10

Source: https://scriptura.si/works/celsus-on-medicine/27/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/27/#p-N

[¶0] In the course of treating pterygium, lesions arise, as I have just said, which are also apt to arise from other causes. Sometimes when the pterygium has not been quite cut away or from some other cause, a small tumour, called by the Greeks encanthis, forms at the angle and this does not allow the eyelids to be completely drawn down. It should be caught up with a hook and cut around, but with so delicate a touch that nothing is cut away from the angle itself. A bit of lint is then besprinkled with oxide of zinc or blacking, and inserted into that angle after separating the lids, and over this the dressing as above is bandaged on. Upon the following days, the eye is dressed in the same way, after having been fomented with tepid, or even with cold water.

> Latin: Quo magis autem necessaria pars erit, quae tractabitur, hoc quoque maiori periculo subiecta est; et saepe, quo maior plaga facienda, eo magis haec temporis ratio seruabitur. Ex curatione uero unguis, ut dixi, uitia nascuntur, quae ipsa aliis quoque de causis oriri solent. Interdum enim fit in angulo, parum ungue exciso uel aliter, tuberculum, quod palpebras parum deduci patitur: enca⟨nth⟩is Graece nominatur. Exci⟨p⟩i hamulo et circumcidi debet, hic quoque diligenter temperata manu, ne quod ex ipso angulo abscidat.

[¶1] At times the eyelids adhere together, and the eye cannot be opened. When this happens, the eyelids commonly adhere to the white of the eye, that is to say, when an ulceration upon either has been carelessly treated; for in the course of healing what could and should have been kept apart has been allowed to stick: the Greeks give the name of ancyloblepharus to one who suffers from both lesions. When the eyelids only stick together they are separated without difficulty, but sometimes this is useless for they stick together again. Separation should be tried, however, because it is generally a success. The reverse end of a probe is to be inserted and the eyelids separated by this, then small pledglets of wool are put in until ulceration of the part has ceased. But when an eyelid adheres to the white of the eye itself, Heraclides of Tarentum invented the method of cutting underneath the eyelid with the knife held, but very carefully, so that nothing is cut away, either from the eyeball, or from the eyelid, and if something must be, rather from the eyelid. The eyeball should afterwards be anointed with the medicaments with which trachoma is treated; and the eyelid turned up every day, not only that the medicament may be applied to the ulceration, but also lest the eyelid should adhere again; moreover the patient himself should be told to raise his eyelid frequently with two fingers. I for my part do not remember anyone to have been cured by this method. Meges also has recorded that he tried many times, but was never successful, for the eyelid has always again become adherent to the eyeball.

> Latin: Tum exiguum lin⟨a⟩mentum respergendum est uel cadmia uel atramento sutorio, inque eum angulum deductis palpebris inserendum, supraque eodem modo deligandum, proximisque diebus similiter nutriendum, tantum ut primis aqua egelida uel etiam frigida foueatur. Interdum inter se palpebrae coalescunt aperirique non potest oculus. Cui malo solet etiam illud accedere, ut palpebrae cum albo oculi cohaeresca⟨nt, s⟩cilicet cum ⟨in⟩ utroque fuit ulcus neclegenter curatum: sanescendo enim, quod diduci potuit et debuit, glutinauit: ancyloblepharus †sub utroque uitio Graeci uocant. Palpebrae tantum inter se cohaerentes non difficulter diducuntur, sed interdum frustra: nam rursus glutinantur. Experiri tamen oportet, quia bene res saepius cedit. Igitur auersum specillum inserendum, ⟨di⟩ducendaeque ⟨eo⟩ palpebrae sunt; deinde exigua penicilla interponenda, donec exulceratio eius loci finiatur. At ubi albo ipsius oculi palpebra inhaesit, Heraclides Tarentinus auctor est aduerso scalpello subsecare cum magna moderatione, ut neque ex oculo neque ex palpebra quicquam abscidatur; ac si necesse est, ex palpebra potius. Post haec inunguatur oculus medicamentis, quibus aspritudo curatur; cottidieque palpebra uert⟨a⟩tur, non solum ut ulceri medicamentum inducatur, sed etiam ⟨ne rursus inhaereat; ipsique etiam⟩ praecipiatur, ut saepe eam digitis duobus attollat. Ego sic restitutum esse neminem memini.

[¶2] Again, at the angle next to the nostrils, there opens a sort of small fistula, due to some lesion, through which rheum persistently drips; the Greeks call it aigilops. This causes a persistent eye trouble; sometimes it even eats away the bone, and penetrates to the nostril. And at time it has the character of a carcinoma when the veins become distended and look jaundiced, the skin livid, hard and irritable to the slightest touch, and it gives rise to inflammation in the parts near to it. Of these affections it is dangerous to treat those which resemble carcinoma, for that even hastens death. Again, it is useless to treat those which penetrate to the nostrils for they never heal. But when limited to the angle, treatment is possible so long as we do not forget that it is difficult. The nearer the opening to the angle, the greater the deficiency, on account of the very narrow space for handling the lesion. When the trouble is fresh, however, cure is easier. Now the margin of the opening is to be caught up by a hook, then as I have described for fistula in general the whole channel down to the bone is to be excised; and the eye and adjacent parts having been well covered over, the bone is to be cauterized; and more thoroughly when there is already decay, in order that a thicker scale may separate. Some apply caustics, such as cobbler's blacking or bronze or copper filings, which act more slowly, and do not have the same effect. After cauterization of the bone, the same treatment is followed as in other burns.

> Latin: Meges se quoque multa temptasse, neque umquam profuisse, quia semper iterum oculo palpebra inhaeserit, memoriae prodidit. Etiamnum in angulo, qui naribus pro⟨p⟩ior est, ex aliquo uitio quasi parua fistula aperitur, per quam pituita adsidue destillat: aegilopa Graeci uocant. Idque adsidue male habet oculum; nonnumquam etiam exesso osse usque nares penetrat. Atque interdum naturam carcinomatis habet, ubi intentae uenae et a⟨r⟩quatae sunt, color pallet, cutis dura est et leui tactu inritatur, inflammationemque in eas partes, ⟨quae⟩ coniunctae sunt, euocat. —Ex his eos, qui quasi car⟨ci⟩noma habent, curare periculosum est: nam mortem quoque ea res maturat; eos uero, quibus ad nares tendit, superuacuum: neque enim sanescunt. A⟨t⟩ quibus ⟨id⟩ in angulo e⟨s⟩t, potest adhiberi curatio, cum eo ne ignotum sit esse difficilem: quantoque angulo propius id foramen est, tanto difficilior est, quoniam perangustum est, in quo uersari manus possit. Recenti tamen re mederi facilius est. Sed hamulo summum eius foraminis excipiendum; deinde totum id cauum, sicut in fistulis dixi, usque ad os excidendum; oculoque et ceteris iunctis partibus bene obtectis, os ferramento adurendum est; uehementiusque si iam carie uexatum est, quo crassior squama a⟨bs⟩cedat.

[¶3] The eyelashes also may irritate the eye from two causes: one is that the skin on the outer surface of the eyelid becomes relaxed and slips downwards, causing its eyelashes to be turned inwards against the eyeball because the cartilage does not simultaneously give way; in the other case, beyond the natural row of eyelashes another row sprouts out, which is directed straight inwards against the eyeball. The following are the modes of treatment. If eyelashes have grown where they ought not, a fine iron needle flattened like a spear point is put into the fire; then when the eyelid is turned up, so that the offending eyelashes can be seen by the operator, the red hot needle is passed along their roots, from the angle, for a third of the length of the eyelid, then for a second and for a third time, until the opposite angle is reached; this causes all the roots of the eyelashes so cauterized to die. A medicament is then applied to check inflammation, and when the crusts have become detached, cicatrization is to be induced. This kind of trouble is very easily cured. Some say that a needle carrying a doubled-up hair from a woman's head should be passed through the eyelid from within outwards close to the eyelashes, and where the needle has passed through, an eyelash is to be inserted into the loop of the said hair where doubled, and the eyelash drawn by the loop through to the outer surface of the eyelid; there it is to be glued down; and a medicament is then applied to agglutinate the puncture; thus it comes about that afterwards that eyelash is directed outwards. But in the first place this cannot be done unless the eyelash is rather long, and in this situation they are generally short; further, when numerous eyelashes are affected, the passing of a needle so many times is necessarily a prolonged torture, and it may set up severe inflammation. Lastly, when there is any rheum subsisting there, and the eye has been irritated previously by the eyelashes, and now by the perforation through the eyelid, it is scarcely possible that the glue binding down the eyelash should not be dissolved; and so it comes to pass that the eyelash returns to the position from which it was forcibly removed. But there is no doubt about the following treatment of too lax an eyelid, which is commonly practised by everybody. It is necessary to close the eye and from the middle, either of the upper or the lower eyelid, to seize a fold of skin between a finger and thumb, and so to raise it; then consider how much must be removed the lid to be in a natural position for the future. In this too there are two dangers; that if too much has been excised the eyeball cannot be covered, if too little nothing has been gained, and a patient has been cut to no purpose. Next where it is seen that incision is to be made, a mark must be made by two lines of ink, but in such a way that between the margin holding the eyelashes, and the marked line adjacent, there remains skin enough for a needle afterwards to take up. When everything is ready the scalpel is to be applied; and the incision nearer the eyelashes themselves is to be made first in the case of the upper lid, but second for the lower one; in the case of the left eye, the incision is made from the outer angle; of the right eye from the inner one; then the skin between the two incisions is to be excised. Next the edges of the wound are to be brought into opposition by one stitch, and the eye is to be closed and if the eyelid descends too little the suture is slackened, if too much, either the suture is tightened, or even an additional fine strip may be excised from the margin furthest from the eyelashes. Where the eyelid has been cut other sutures may be put in but not more than three. Further, in the case of the upper lid, a linear incision is to be made under the row of eyelashes itself, so that these having been drawn away from under are directed upwards, and when there is but a slight drooping of the upper lid, this alone may suffice; the lower lid does not need the additional incision. When these things have been done, a sponge squeezed out of cold water is bandaged on. The next day an agglutinating plaster is applied; on the fourth day the sutures are taken out, and a salve for repressing inflammation smeared on.

> Latin: Quidam adurentia inponunt, ⟨ut⟩ atramentum sutorium uel chalcitidem uel aeruginem rasam; quod et tardius et non idem facit. Osse adusto curatio sequitur eadem, quae in ceteris ustis. Pili uero, qui in palpebris sunt, duabus de causis oculum inritare consuerunt: nam modo palpebrae [superioris] summa cutis relaxatur et procidit; quo fit, ut eius pili ad ipsum oculum conuertantur, quia non simul cartilago quoque se remisit; modo sub ordine naturali pilorum alius ordo subcrescit, qui protinus intus ad oculum tendit.— Curationes hae sunt. Si ⟨pili nati sunt,⟩ qui non debuerunt, tenuis acus ferrea ad similitudinem hastae lata in ignem coicienda est; deinde candens, sublata palpebra sic, ut eius perniciosi pili in conspectum curantis ueniant, sub ipsis pilorum radicibus ab angulo inmittenda est, ut ea tertiam partem palpebrae trans⟨u⟩at; deinde iterum tertioque usque ad alterum angulum; quo fit, ut omnes pilorum radices adustae ⟨e⟩moriantur. Tum superinponendum medicamentum est, quod inflammationem prohibeat, ⟨at⟩que ubi crustae exciderunt, ad cicatricem perducendum. Facillime autem id genus sanescit. Quidam aiunt acu transui iuxta pilos in exteriorem partem palpebrae oportere eamque transmitti duplicem capillum muliebrem ducentem; atque ubi acus transit, in ipsius capilli sinum, qua duplicatur, pilum esse coiciendum et per eum in superiorem palpebrae partem adtrahendum; ibique corpori adglutinandum; et inponendum medicamentum, quo foramen glutinetur: sic enim fore, ut is pilus in exteriorem partem postea spectet. Id primum fieri non potest, nisi in pilo longiore, cum fere breues eo loco nascantur; deinde si plures pili sunt, necesse est longum tormentum totiens acus traiecta magnamque inflammationem moueat. Nouissime cum umor aliquis ibi subsit, oculo ⟨et⟩ ante per pilos et tum per palpebrae foramina adfecto uix fieri potest, ut gluten, quo uinctus est pilus, non resoluatur; eoque fit, ut is eo, unde ui abductus est, redeat. Ea uero curatio, quae [palpebrae laxioris] ab omnibus frequentatur, nihil habet dubii: siquidem oportet contecto oculo mediam palpebrae cutem, siue ea superior siue inferior est, adprehendere digitis ac sic leuare; tum considerare, quantulo detracto futurum sit, ut naturaliter se habeat. Siquidem hic quoque duo pericula circumstant: si nimium fuerit excisum, ne contegi oculus non possit; si parum, ne nihil actum sit, et frustra sectus aliquis sit. Qua deinde incidendum uidebitur, per duas lineas atramento notandum est sic, ut inter oram, quae pilos continet, et pro⟨p⟩iorem ei lineam aliquid relinquatur, quod adprehendere acus postea possit. His constitutis scalpellus adhibendus est; et si superior palpebra, ante; si inferior, postea propius ipsis pilis incidendum; initiumque faciendum in sinistro oculo ab eo angulo, qui tempori; in dextro ab eo, qui naribus propior est; idque, quod inter duas lineas est, excidendum. Deinde orae uulneris inter se simplici sutura committendae, operiendusque oculus et si parum palpebra descendet, laxanda sut⟨ura⟩; si nimium, aut adstringenda, aut etiam rursus tenuis habenula e⟨st⟩ ab ulteriore ora excidenda. Vbi secta est, aliae suturae adiciendae, quae supra tres esse non debent. Praeter haec in superiore palpebra sub pilis ipsis incidenda linea est, ut⟨i⟩ ab inferiore parte deducti pili susum spectent; idque, si leuis inclinatio est, etiam solum satis tuetur; inferior palpebra eo non eget. His factis, spongia ex aqua frigida expressa super deliganda est.

[¶4] But in the course of the above treatment it sometimes happens that when too much skin has been excised, the eyeball is not covered; and occasionally this also occurs from some other cause: the Greeks call the condition lagophthalmus. If too much of the eyelid is lost, no treatment can restore it; if a small loss it may be remedied. Just below the eyebrow the skin is to be incised in the figure of a crescent with the horns pointing downwards. The incision should reach as far as the cartilage without injuring it; for should the cartilage be cut into, the eyelid will droop, and cannot afterwards be raised. Therefore if the skin is merely drawn apart, it follows that the bottom of the eyelid droops slightly because of the gap made by the cut above; into this gap lint is to be inserted, both to prevent the separated edges from reuniting, and to help the growth of the flesh between, so that the eyeball comes to be properly covered when the gap has filled up.

> Latin: Postero die glutinans emplastrum iniciendum, quarto suturae tollendae, et collyrio, quod inflammationes reprimit, superinunguendum. Nonnumquam autem nimium sub hac curatione excisa cute euenit, ut oculus non tegatur; idque interdum etiam alia de causa fit: lagopt⟨h⟩almus Graeci appellant. In quo si nimium palpebra⟨e⟩ deest, nulla id restituere curatio potest; si exiguum, mederi licet.— Paulum infra supercilium cutis incidenda est lunata figura cornibus eius deorsum spectantibus. Altitudo esse plagae usque ad cartilaginem debet ipsa illa nihil laesa: nam si ea incisa est, palpebra concidi⟨t⟩, neque attolli postea potest. Cute igitur tantum diducta fit, ut paulum ⟨in⟩ ima oculi ora descendat hiante scilicet super plag⟨a⟩; in qua⟨m⟩ linamentum coiciendum est, quod et coniungi diductam cutem prohibeat et in medio carunculam citet;

[¶5] Whilst a defect in the upper eyelid is that it descends too little and so does not cover the eyeball, sometimes the lower lid is not raised enough but hangs down and gapes open, and cannot reach the upper lid. And this, too, happens sometimes from the defective treatment described above, sometimes from old age: the Greeks call it ectropion. If this is due to bad treatment, the same procedure as that noted above is employed, but the horns of the incision are to be directed now towards the jaws, not towards the eyeball: if from old age, all that extrudes is burnt away with a fine cautery, then honey smeared on; from the fourth day the eye is steamed, and anointed with medicaments to induce a scar.

> Latin: quae ubi eum locum inpleuit, postea recte oculus operitur. Vt superioris autem palpebrae uitium est, quo parum descendit ideoque oculum non contegit, sic inferioris, quo parum susum attollitur, sed pendet et hiat, neque potest cum superiore committi. Atque id quoque euenit interdum ex simili uitio curationis, interdum etiam senectute: ectropion Graeci nominant.—Si ex mala curatione est, eadem ratio medicinae est, quae supra posita est;

[¶6] Such as a rule are the lesions which are apt to occur around the eyeball in the angles or eyelids. But in the eyeball itself the outer tunic is sometimes raised, by the rupture or by the relaxation of certain membranes inside, and its shape becomes like a grape: the Greeks therefore call the lesion staphyloma. There are two modes of treatment. In one a needle carrying two threads is passed through the middle of its base, and first the two ends of the upper thread, and then those of the lower, are knotted, and these gradually cut through and so excise the staphyloma. In the other method, a piece about the size of a lentil is cut off from its tip, then oxide or carbonate of zinc is dusted on. After either method, wool soaked in white of egg is applied; subsequently the eye is steamed, and then anointed with soothing medicaments.

> Latin: plagae tantum cornua ad maxillas, non ad oculum conuertenda sunt: si ex senectute est, tenui ferramento id totum extrinsecus adurendum est, deinde melle inunguendum: a quarto die uapore aquae calidae fouendum, inunguendumque medicamentis ad cicatricem perducentibus. Haec fere circa oculum in angulis palpebrisque incidere consuerunt. In ipso autem oculo nonnumquam summa attollitur tunica, siue ruptis intus membranis aliquibus siue laxatis, et similis figura acino fit: unde id staphyloma Graeci uocant.—Curatio duplex est: altera: ad ipsas radices per medium transuere acu duo lina ducente; deinde alterius lini duo capita ex superiore parte, alterius ex inferiore astringere inter se; quae paulatim secando id excidunt. Altera: in summa parte eius ad lenticulae magnitudinem excidere;

[¶7] Again, small hard tumours in the white of the eyeball are called clavi, from a resemblance in shape to nailheads. These it is best to transfix with a needle at their base, and to cut away underneath the needle; then to anoint with soothing medicaments.

> Latin: deinde spodium aut cadmiam infriare. Vtrolibet autem facto, album oui lana excipiendum et inponendum; posteaque uapore aquae calidae fouendus oculus et lenibus medicamentis inunguendus est.

[¶8] I have already made mention elsewhere of cataract, because when of recent origin it is also often dispersed by medicaments: when it is more chronic it requires treatment by surgery, and this is one of the most delicate operations. Before I speak of this, the nature of the eyeball itself has to be briefly explained. A knowledge of this is often useful, but especially here. The eyeball, then, has two external tunics, of which the outer is called by the Greeks ceratoides. In that part of the eye which is white it is fairly thick; over the region of the pupil it is thin. To this tunic the under one is joined; in the middle where the pupil is, it is pierced by a small hole: around this it is thin, further out it too is thicker and is called by the Greeks chorioides. These two tunics whilst enclosing the contents of the eyeball, coalesce again behind it, and after becoming thinned out and fused into one, go through the space between the bones, and adhere to the membrane of the brain. Under these two tunics, at the spot where the pupil is, there is an empty space; then underneath again is the thinnest tunic, which Herophilus named arachnoides. At its middle the arachnoides is cupped, and contained in that hollow is what, from its resemblance to glass, the Greeks call hyaloides; it is humour, neither fluid nor thick, but as it were curdled, and upon its colour is dependent the colour of the pupil, whether black or steel-blue, since the outer tunic is quite white: but this humour is enclosed by that thin membrane which comes over it from the interior. In front of these is a drop of humour like white of egg, from which comes the faculty of seeing; it is named by the Greeks crystalloides.

> Latin: Claui autem uocantur callosa in ⟨albo⟩ oculi tubercula, quibus nomen a figurae similitudine est. Hos ad imam radicem perforare acu commodissimum est, infraque eam excidere; deinde lenibus medicamentis inunguere. Suffusionis iam alias feci mentionem, quia cum recens incidit, medicamentis quoque saepe discutitur: sed ubi uetustior facta est, manus curationem desiderat, quae inter subtilissimas haberi potest. ⟨De⟩ qua antequam dico, paucis ante ipsius oculi natura indicanda est. Cuius cognitio cum ad plura loca pertineat, tum uel praecipue ad hunc pertinet. Is igitur summas habet duas tunicas, ex quibus superior a Graecis ceratoides uocatur. Ea, qua parte alba est, satis crassa; pupillae loco extenuatur. Huic inferior adiuncta est, media parte, qua pupilla est, modico foramine concaua; circa tenuis, ulterioribus partibus ipsa quoque plenior, quae chor⟨i⟩oides a Graecis nominatur. Hae duae tunicae, cum interiora oculi cingant, rursus sub his coeunt, extenuataeque et in unum coactae ⟨per⟩ foramen, quod inter ossa est, ad membranam cerebri perueniunt eique inhaerescunt. Sub his autem, qua parte pupilla est, locus uacuus est; deinde infra rursus tenuissima tunica, quam Herophilus arachnoidem nominauit. Ea media subsidit * * * eoque cauo continet quiddam, quod a uitri similitudine hyaloides Graeci uocant.

[¶9] Now either from disease or from a blow, a humour forms underneath the two tunics in what I have stated to be an empty space; and this as it gradually hardens is an obstacle to the visual power within. And there are several species of this lesion; some curable, some which do not admit of treatment. For there is hope if the cataract is small, and immobile, if it has also the colour of sea water or of glistening steel, and if at the side there persists some sensation to a flash of light. If large, if the black part of the eye has lost its natural configuration and is changed to another form, if the colour of the suffusion is sky blue or golden, if it shakes and moves this way and that, then it is scarcely ever to be remedied. Generally too the case is worse when the cataract has arisen from a severe disease, from severe pains in the head or from a blow of a violent kind. Old age is not favourable for treatment, since apart from this lesion, sharpness of vision is naturally dulled; neither is childhood favourable, but rather intermediate ages. Neither a small nor a sunken eye is satisfactory for treatment. And in the cataract itself, there is a certain development. Therefore we must wait until it is no longer fluid, but appears to have coalesced to some sort of hardness. Before treatment the patient should eat in moderation and for three days beforehand drink water, for the day before abstain from everything. Then he is to be seated opposite the surgeon in a light room, facing the light, while the surgeon sits on a slightly higher seat; the assistant from behind holds the head so that the patient does not move: for vision can be destroyed permanently by a slight movement. In order also that the eye to be treated may be held more still, wool is put over the opposite eye and bandaged on: further the left eye should be operated on with the right hand, and the right eye with the left hand. Thereupon a needle is to be taken pointed enough to penetrate, yet not too fine; and this is to be inserted straight through the two outer tunics at a point intermediate between the pupil of the eye and the angle adjacent to the temple, away from the middle of the cataract, in such a way that no vein is wounded. The needle should not be, however, entered timidly, for it passes into the empty space; and when this is reached even a man of moderate experience cannot be mistaken, for there is then no resistance to pressure. When the spot is reached, the needle is to be sloped against the suffusion itself and should gently rotate there and little by little guide it below the region of the pupil; when the cataract has passed below the pupil it is pressed upon most firmly in order that it may settle below. If it sticks there the cure is accomplished; if it returns to some extent, it is to be cut up with the same needle and separated into several pieces, which can be the more easily stowed away singly, and form smaller obstacles to vision. After this the needle is drawn straight out; and soft wool soaked in white of egg is to be put on, and above this something to check inflammation; and then bandages. Subsequently the patient must have rest, abstinence, and inunction with soothing medicaments; the day following will be soon enough for food, which at first should be liquid to avoid the use of the jaws; then, when the inflammation is over, such as has been prescribed for wounds, and in addition to these directions it is necessary that water should for some time be the only drink.

> Latin: Id neque ⟨liquidum neque⟩ aridum est, sed quasi concretus umor, ex cuius colore pupillae color uel niger est uel caesius, cum summa tunica tota alba sit: id autem superueniens ab interiore parte membranula * includit. Su⟨per⟩ his gutta umoris est, oui albo similis, a qua uidendi facultas proficiscitur: crystalloides a Graecis nominatur. Igitur uel ex morbo uel ex ictu concrescit umor sub duabus tunicis, qua locum esse uacuum proposui; isque paulatim indurescens interiori * potentiae se opponit. Vitiique eius plures species sunt; quaedam sanabiles, quae⟨dam quae⟩ curationem ⟨non⟩ admittunt. Nam si exigua suffusio est, si immobilis, colorem uero habet marinae aquae uel ferri nitentis et a latere sensum aliquem fulgoris relinquit, spes superest. Si magna est, si nigra pars oculi, amissa naturali figura, in aliam uertit, si suffusioni color caeruleus est aut auri similis, si labat et hac atque illac mouetur, uix umquam succurritur. Fere uero peior est, quo⟨m⟩ ex grauiore morbo, maioribus capitis doloribus uel ictu uehementiore orta est. Neque idonea curation⟨i⟩ senilis aetas est, quae sine ⟨e⟩o uitio tamen aciem ⟨hebetem⟩ habet: at ne puerilis quidem, sed inter haec media. Oculus quoque curationi neque ⟨exiguus neque⟩ concauus satis oportunus est. Atque ipsius suffusionis quaedam maturitas est: expectandum igitur est, donec iam non fluere sed duritie qu⟨a⟩dam concreuisse uideatur. Ante curationem autem modico uti cibo, bibere aquam triduo debet, pridie ab omnibus abstinere. Post haec in aduorso collocandus est, loco lucido, lumine a⟨d⟩uerso, sic ut contra medicus paulo altius; a posteriore parte caput eius, qui curabitur, minister contineat, ut inmobile id praestet: nam leui motu eripi acies in perpetuum potest. Quin etiam ipse oculus, qui curabitur, inmobilior faciendus est, super alterum lana inposita [deligata]: curari uero sinister oculus dextra manu, dexter sinistra debet. Tum acus admouenda est, sic ⟨ac⟩uta, ut foret, non nimium tenuis; eaque demittenda sed recta est per summas duas tunicas medio loco inter oculi nigrum et angulum tempori propiorem, e regione mediae suffusionis sic, ne qua uena laedatur. Neque tamen ⟨timide⟩ d⟨e⟩mittenda est, quia inani loco excipitur; ad quem cum uentum est, ne mediocriter quidem peritus falli potest, quia prementi nihil renititur. Vbi eo uentum est, inclinanda acus ad ipsam suffusionem leuiterque ibi uerti et paulatim eam deducere infra regionem pupillae debet; ubi deinde eam transit, uehementius inprimi, ut inferiori parti insidat. Si haesit, curatio expleta est: si subinde redit, eadem acu concidenda et in plures partes dissipanda est, quae singulae et facilius conduntur et minus late officiunt. Postea educenda recta acus est; inponendumque lana molli exceptum oui album, et supra, quod inflammationem coerceat; atque ita deuinciendum. Post haec opus est quiete, abstinentia, lenium medicamentorum inunctionibus;

[¶10] Also with regard to the discharge of a thin rheum which troubles the eyes, I have already explained what is to be done by means of medicaments. I come now to cases which demand surgical treatment. But we have remarked that in some the eyes never dry up, but are always moistened by a thin rheum; this keeps up trachoma, and upon slight provocation excites inflammations and ophthalmia, so troubling the patient all his life; and sometimes this cannot be remedied at all, but sometimes it is curable. This is the first thing to be decided, that in the latter case the patient may be relieved, in the former no surgical treatment may be applied. And in the first place, the treatment is useless in those who have had the disorder from infancy, of necessity it will continue to their dying day; again, it is not necessary in those cases where the discharge is scanty, though acrid, since they will derive no benefit from surgery; by medicaments and by the regulation of diet which renders the rheum thicker, they come back to health. Further, broad heads are hardly ever adapted to the treatment. Then it makes a difference whether the rheum comes from blood vessels between the skull and the scalp, or from those between the membrane of the brain and the skull. Generally those above the skull irrigate the eyes by way of the temples, those under it by way of membranes connecting the eyes with the brain. Now it is possible to apply a remedy to those blood vessels which lie above the bone — to those below it is not. Neither can patients be relieved in whom rheum is flowing down both ways, because although relieved in one direction, none the less trouble continues by the other. How the matter stands is to be learnt as follows. The head having been first shaved, those medicaments by which the rheum is checked in ophthalmia are smeared on from the eyebrow to the crown of the head. If the eyes begin to dry, it is clear that the moisture comes from those blood vessels which are beneath the scalp; if in spite of the application, they continue moist, it is manifest that the downflow of rheum is from under the skull. If there is humour but in less amount, the lesion is double. In the majority of patients, however, it is found that the superficial blood vessels are involved, and so also the majority can be relieved. This is well known, not in Greece only, but among other races too, so that no portion of the Art of Medicine has become more widespread among the nations of the earth. Some Greek practitioners made nine linear incisions into the scalp, two vertical ones in the occipital region, a transverse one above them; then two above the ears, with a cross-cut uniting them, three vertical ones between the crown and the forehead. Others were found who drew those lines directly from the vertex to the temples and having ascertained where the muscles began from the movements of the jaws, cut through the scalp over them with a light hand, and after the margins of the incisions had been retracted by blunt hooks, inserted lint, in order that the former edges of the skin should not unite, and that flesh should grow up in between so as to constrict the veins carrying humour to the eyes. Some even marked out with ink two lines, from the middle of one ear to the middle of the other, and from the nose to the crown. Then, where the two lines meet, they cut with a scalpel, and after blood has flowed out, they cauterized the bone there. But further, both on the temples and also between the forehead and crown, they likewise applied the red hot cautery to prominent blood vessels. A treatment frequently used is to cauterize the blood vessels on the temples, which indeed in this malady are usually rather swollen, but in order that they may be more distended and show up better, the neck is first bandaged moderately tight and the blood vessels then burnt with fine blunt cautery points until the flow of rheum to the eyes ceases. For that is a sign of the blocking up as it were of the channels by which humor was being carried. There is a more effectual means, however, when the blood vessels are thin and deep-seated, and so cannot be picked out, whereby the neck is bandaged as before, and the patient holds his breath, so as to make the vessels more prominent, and then those on the temples and between the fore-head and vertex are marked out with ink; upon this the neck is released, the blood vessels are cut into where marked and blood let flow; when enough has been let out, the vessels are burnt with fine cauteries; over the temples this is done cautiously lest the underlying muscles controlling the jaws feel it; between the forehead and the crown the cautery is applied firmly in order that a scale may become detached from the skull. Even more efficacious is the African method; they burn the crown of the scalp through down to the bone so that it may cast off a scale. But there is nothing better than the practice in transalpine Gaul; there they pick out blood vessels in the temples and crown of the head. Now I have already explained the treatment after cautery. I here add that there should be no haste, either in detaching crust, or in letting the ulceration heal after cauterization of blood vessels, lest haemorrhage burst out, or pus be too quickly suppressed, for whilst it is the object by the ulceration to dry up these parts, it is not the object to drain them out by bleeding; but if there is bleeding, such medicaments should be sprinkled on as suppress bleeding, but do not cauterize. With regard to the selection of blood vessels, and what is to be done when they are picked out, I will speak when I come to varicose veins in the leg.

> Latin: cibo, qui postero die satis mature datur, primum liquido, ne maxillae laborent; deinde inflammatione finita, tali, qualis in uulneribus propositus est; quibus, ut aqua diutius bibatur, necessario accedit. De pituitae quoque tenuis cursu, qui oculos infestat, quatenus medicamentis agendum e⟨s⟩t, iam explicui. Nunc ad ea ueniam, quae curationem manu postulant. Animaduertimus autem quibusdam numquam siccescere oculos, ⟨sed⟩ semper umore tenui madere; quae res aspritudinem continuat, ex leuibus momentis inflammationes et lippitudines excita⟨t,⟩ totam denique uitam hominis infestat; idque in quibusdam nulla ope adiuuari potest, in quibusdam sanabile est: quod primum [discrimen est] nosse oportet, ut alteris succurratur, alteris manus non iniciatur. Ac primum superuacua curatio est in is, qui ab infantibus id uitium habent, quia necessario mansurum est usque mortis diem; deinde non necessaria etiam in is, quibus non multa, ⟨sed⟩ acris pituita est, siquidem manu nihil adiuuantur: medicamentis et uictus ratione, quae crassiorem pituitam reddit, ad sanitatem perueniunt. Lata etiam capita uix medicinae patent. Tum interest uenae pituitam mittant quae inter caluariam et cutem sunt, an quae inter membrana⟨m⟩ cerebri et caluariam. Superiores fere per tempora oculos rigant; inferiores per eas membranas, quae ab oculis ad cerebrum tendunt. Potest autem adhiberi remedium is, quae supra os fluunt; non potest is, quae sub osse. Ac ne is quidem succurritur, quibus pituita utrimque descendit, quia leuata altera parte nihilo minus altera infestat. Quid sit autem, hac ratione cognoscitur. Raso capite an⟨te⟩ ea medicamenta, quibus in lippitudine pituita suspenditur, a superciliis usque ad uerticem inlini debent. Si sicci oculi esse coeperunt, apparet per eas uenas, quae sub cute sunt, inrigari: si nihilo minus madent, manifestum est sub osse descendere: si est umor, sed leuior, duplex uitium est. Plurimi tamen ex laborantibus reperiuntur, quos superiores uenae exerceant; ideoque pluribus etiam opitulari licet. Idque non in Graecia tantummodo, sed in aliis quoque gentibus celebre est, adeo ut nulla medicinae pars magis per nationes quoque exposita sit. Reperti in Graecia sunt, qui nouem lineis cutem capitis inciderent; duabus in occipitio rectis, una super eas transuersa; deinde ⟨duabus⟩ super aures, una inter eas item transuersa; tribus inter uerticem et frontem rectis. Reperti sunt, qui a capite recte eas lineas ad tempora deducerent, cognitisque ex motu maxillarum musculorum initiis leuiter super eos cutem inciderent, ⟨di⟩ductisque per retusos hamos oris insererent linamenta, ut neque inter se cutis antiqui fines committerentur, et in medio caro incresceret; quae uenas, ex quibus umor ad oculos transiret, adstringeret. Quidam etiam atramento duas lineas duxerunt a media aure ad mediam alteram aurem; deinde a naribus ad uerticem. Tum ubi lineae committebantur, scalpello inciderunt, et post sanguinem effusum ⟨o⟩s ibidem ad⟨us⟩serunt. Nihilo minus autem et in temporibus et inter frontem atque caluariam eminentibus uenis idem candens ferrum admouerunt. Frequens curatio est uenas in temporibus adurere, quae fere quidem in eiusmodi malo tument: sed tamen, ut inflentur magisque se ostendant, ceruix ante modice deliganda est, tenuibusque ferramentis et retussis uenae adurendae, donec in oculis pituitae cursus conquiescat. Id enim signum est quasi excaecatorum itinerum, per quae umor ferebatur. Valentior tamen medicina est, ubi tenues conditaeque uenae sunt, ideoque legi non possunt, eodem modo ceruice deligata retentoque ab ipso spiritu quo magis uenae prodeant, atramento notare eas contra tempora et inter uerticem ac frontem; deinde ceruice resoluta, qua notae sunt uenae, incidere, et sanguinem mittere; ubi satis fluxit, tenuibus ferramentis adurere: contra tempora quidem timide, ne subiecti musculi qui maxillas tenent sentiant; inter frontem uero et uerticem uehementer, ut squama ab osse secedat. Efficacior tamen etiamnum est Afrorum curatio, qui uerticem usque ad os adurunt sic, ut squamam remittat. Sed nihil melius est quam quod in Gallia est comata: qui ibi uenas in temporibus et in superiore capitis parte legunt. Adusta quomodo curanda sint, iam explicui. Nunc illud adicio: neque ut crustae decidant, neque ut ulcus inpleatur, adustis uenis esse properandum, ne uel sanguis erumpat uel cito pus subprimatur, cum per hoc siccescere eas partes opus sit, per illud exhauriri opus non sit: si quando tamen sanguis eruperit, infricanda medicamenta esse, quae sic sanguinem supprimant, ne adurant. Quemadmodum autem ⟨uenae⟩ delegendae sunt, quidque lectis is faciendum sit, cum uenero ad crurum uarices, dicam.

[¶11] 8. 8 Whilst the eyes demand many kinds of surgical treatment, there are but few affections of the ears which are dealt with by this branch of medicine. It does happen, however, whether from birth, or later when there has been ulceration and the ear becomes filled up by scarring, that there is no passage in the ear and so it cannot hear. When this is the case, we must try with a probe whether the part is filled up deeply, or whether there is merely a superficial agglutination. For if deeply, there is no yielding to pressure made on the probe; if superficial, the probe enters freely. The former should not be touched, lest, where there is no hope of success, a spasm may be set up, and from that may follow danger of death. The latter is easily treated. For where the passage should be, either one of the caustic medicaments is to be applied, or an opening made with the cautery, or the place may even be cut through with a scalpel. After it has been laid open, and the ulceration has been cleaned, a quill is to be inserted, smeared with a medicament to induce a scar, and the same medicament applied around, until the skin has healed round the quill; by this means when the quill has been removed, the faculty of hearing follows. But where the ears, in a man for instance, have been pierced and have become offensive, it is enough to pass a red hot needle quickly though the hole in order to blister its margins superficially or even to produce the same effect by a caustic; then afterwards to put on applications to clean the place and later what will make the flesh grow there and induce a scar. But if the hole is enlarged, as is usually the case with those who have worn heavy ear-rings, the rest of the lobule should be cut through; then the edges above made raw with a scalpel, and the wound sutured, and agglutinating medicaments put on. A third method, where there has been some mutilation, is to patch, and since this can be done in the case of the lips and nostrils as well, and the procedure is the same, the description too should be given at the same time.

> Latin: 8. Verum ut oculi multiplicem curationem etiam manus exigunt, sic in auribus admodum pauca sunt, quae in hac medicinae parte tractentur. Solet tamen euenire, uel a primo die protinus, uel postea facta exulceratione, dein per cicatricem aure repleta, ut foramen in ea nullum sit, ideoque audiendi usu careat. Quod ubi incidit, specillo temptandum est, altene id repletum, an in summo tantum glutinatum sit. Nam si alte est, prementi non cedit; si in summo, specillum protinus recipit. Illud attingi non oportet, ne ⟨sine⟩ effectus spe distentio oriatur neruorum, et ex ea mortis periculum sit: hoc facile curatur. Nam qua cauom esse debet, uel medicamentum aliquod inponendum est ex adurentibus, uel candenti ferro aperiendum, uel etiam scalpello incidendum. Cumque id patefactum et iam ulcus purum est, coicienda eo pinna est, inlita medicamento cicatricem inducente, circaque id⟨em⟩ medicamentum dandum, ut cutis circa pinnam sanescat; quo fit, ut ea remota postea facultas audiendi sit. At ubi aures, in uiro puta, perforatae sunt et offendunt, traicere id cauum celeriter candente acu ⟨sa⟩tis est, ut leuiter eius orae ulcerentur; aut etiam adurente medicamento idem exulcerare, postea deinde inponere id, quod purget, tum quod eo loc⟨o⟩ repleat et cicatricem inducat. Quod si magnum id foramen est, sicut solet esse in is, qui maiora pondera auribus gesserunt, incidere quod superest ad extremum oportet; supra deinde oras scalpello exulcerare, et postea suere, ac medicamentum, qu⟨o⟩ glutinetur, inponere. Tertium est, si quid ibi curti est, sarcire. Quae res cum in labris quoque et naribus fieri possit, eandem etiam rationem habeat, simul explicanda est.

[¶12] 9. 9 Mutilations then occur in these three parts and can be treated if they are small; if they are large, either they are not susceptible of treatment, or else may be so deformed by it as to be more unsightly than before. And indeed in the ear and nostrils the deformity is the only trouble; but in the case of the lips, if these have become too much contracted, there is also loss of a necessary function, because it becomes less easy both to take food and to speak plainly. Now new substance is not produced at the place itself, but it is drawn from the neighbourhood; and when the change is small this hardly robs any other part and may pass unnoticed, but when large, it cannot do so. And again, this procedure in unsuited to the aged, to those in bad bodily condition, and to those whose wounds heal with difficulty; because there are no cases in which canker sets in more quickly, or is more difficult to get rid of. The method of treatment is as follows: the mutilation is enclosed in a square; from the inner angles of this incisions are made across, so that the part on one side of the quadrilateral is completely separated from that on the opposite side. Then the two flaps, which we have freed, are brought together. If they cannot be sufficiently brought together, at each end beyond the original incisions semilunar cuts which only divide the skin are made with the horns pointing towards the incisions. This enables the edges to be brought together more easily. No force should be used, but the traction should be such that the edges easily approximate and, when left free, do not recoil much. At times, however, if the skin has been drawn across from one side to a considerable extent, or even at all, it makes the part which it has left unsightly. In a case of that sort, leaving that side untouched, an incision should be made only on the other side. For instance we should not attempt to make traction upon the lobules of the ears, the bridge of the nose, the margins of the nostrils, or the corners of the lips. But we shall try traction from either side if anything is required for the upper part of the ears, the tip of the nose, the bridge of the nose, the skin between the nostrils, and the middle of the lips. At times the mutilation is in two places, but the method of treatment is the same. Cartilage if it projects into the incision is to be cut away; for it does not agglutinate nor is it safely transfixed by a needle. But it should not be much cut away lest pus collect on each side between the two margins of loose skin. Then the margins after being brought together are to be sutured by taking up from each skin only, and the earlier incisions are also to be sutured. In dry parts such as the nostrils, it is sufficient to spread on litharge. But into the more distance semilunar wounds lint is to be placed in order that flesh may grow and fill the wound; and it is clear that the greatest attention should be paid to what is thus sutured, from what I mentioned above about canker. Consequently every third day the part should be steamed, then dressed as before; and generally the wound has adhered by the seventh day. Then the sutures should be removed, and the wound allowed to heal.

> Latin: 9. Curta igitur in his tribus * * ac si qua parua sunt, curari possunt; ⟨si qua maiora sunt, aut⟩ non recipiunt curationem, aut ita per hanc ⟨ipsam⟩ deformantur, ut minus indecora ante fuerint. Atque in aure quidem et naribus deformitas sola timeri potest: in labris uero, si nimium contracta sunt, usui quoque necessario iactura fit, quia minus facile et cibus adsumitur et sermo explicatur. Neque enim creatur ibi corpus, sed ex uicino adducitur; quod in leui mutatione et nihil †eripere et fallere oculum potest, in magna non potest. Neque senile autem corpus, neque quod mali habitus est, neque in quo difficulter ulcera sanescunt, huic medicinae idoneum est, quia nusquam celerius cancer occupat aut difficilius tollitur. Ratio curationis eiusmodi est: id, quod cu⟨rt⟩um est, in quadratum derigere; ab interioribus eius angulis lineas transuersas incidere, quae citeriorem partem ab ulteriore ex toto deducant; deinde ea, quae sic resoluimus, in unum adducere. Si non satis iunguntur, ultra lineas, quas ante fecimus, alias duas lunatas et ad plagas conuersas immittere, quibus summa tantum cutis diducatur: sic enim fit, ut facilius quod adducitur sequi possit; quod non est cogendum, sed ita ⟨ad⟩ducendum, ut ex facili subsequatur et dimissum non multum recedat. Interdum tamen ab altera parte cutis * aut omnino adducta deformem, quem reliquit, locum reddit. Eiusmodi loci altera pars incidenda, altera intacta habenda est. Ergo neque ex imis auribus neque ex medio naso imisue narum partibus neque ex angulis labrorum quicquam adtrahere temptabimus: utri⟨m⟩que autem petemus, si quid summis auribus, si quid imis, si quid aut medio naso aut mediis naribus aut mediis labris deerit. Quae tamen inter⟨dum⟩ etiam duobus locis cu⟨rt⟩a esse consuerunt: sed eadem ratio curandi est. Si cartilago in eo, quod incisum est, eminet, excidenda est: neque enim aut glutinatur aut acu tuto traicitur. Neque longe tamen excidi debet, ne inter duas oras liberae cutis utrimque coitus puris fieri possit. Tum iunctae orae inter se suendae sunt utrimque cute adprehensa, et qua priores lineae sunt, ea quoque suturae iniciendae sunt. Siccis locis ut in naribus inlita spuma argenti satis proficit. In ulteriores uero lunatasque plagas li⟨n⟩amentum dandum est, ut caro increscens uulnus impleat; summaque cura quod ita sutum est, tuendum esse apparere ex eo potest, quod de cancro supra posui. Ergo ⟨etiam⟩ tertio quoque die fouendum erit uapore aquae calidae, rursusque idem medicamentum iniciendum; fereque septimo die glutinatum est. Tum suturae eximi, et ulcus ad sanitatem perduci debet.

[¶13] 10. 10 As for the polypus which grows in the nostrils, I have already laid down elsewhere that the best treatment is with the knife. Therefore this too should be loosened from the bone by a sharp instrument, shaped like a spear head, care being taken not to injure the cartilage under it, which is difficult to treat. When detached it is to be extracted by an iron hook; then the nostril is gently filled with lint folded or in a roll, soaked in something to stop the bleeding; when the bleeding has stopped, the ulceration is to be cleaned with a lint plug. When it is clean, insert a quill (as described above in the case of the ear), smeared with the medicament which causes a scar to form until healing is completed.

> Latin: 10. Polypum uero, qui in naribus nascitur, ferro praecipue curari iam alias posui. Ergo ⟨etiam⟩ hunc ferramento acuto in modum spathae facto resoluere ab osse oportet, adhibita diligentia, ne infra cartilago laedatur, in qua difficilis curatio est. Vbi abscis⟨s⟩us est, unco ferramento extrahendus est; tum inplicitum linamentum uel aliquid ex penicillo respergendum est medicamento, quo sanguis supprimitur, eoque naris leuiter inplenda. Sanguine suppresso linamento ulcus purgandum est. Vbi purum est, eo pinna, eodem modo quo in aure supra positum est, medicamento inlita, quo cicatrix inducitur, intus demittenda, donec in tot⟨um⟩ id sanescat.

## 28. Book VII · chapters 11–19

Source: https://scriptura.si/works/celsus-on-medicine/28/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/28/#p-N

[¶0] 11. 11 Now as to the lesion called by the Greeks ozaena, I have found nothing in the writings of great surgeons about surgical treatment if it did not yield to medicaments. I believe this is because it seldom heals quite completely, though the treatment its involves considerable pain. Some, however, lay down that either an earthenware tube, or a smooth quill, is to be inserted into the nostril until it reaches the bone, and then a fine cautery point is passed down that tube right to the bone. The cauterized spot is afterwards dressed with verdigris and honey, and when clean is healed by applying lycium. Or the nostril may be laid open from its base as far as the bone, so that the place can be seen, and the cautery more easily applied; then the nostril must be sewn up, and the cauterized ulceration treated as above; the fine suture is dressed with litharge or other agglutinant.

> Latin: 11. Id autem uitium, quod ozena Graece uocatur, si medicamentis non cederet, quemadmodum manu curandum esset, apud magnos chirurgos non rep⟨p⟩eri. Credo quia res raro ad sanitatem satis proficit, cum aliquid in ipsa curatione torment⟨i⟩ habeat. Apud quosdam tamen positum est uel fictilem fistulam uel enodem scriptorium calamum in narem esse coiciendum, donec susum ad os perueniat; tum per id tenue ferramentum candens dandum esse ad ipsum os; deinde adustum locum purgandum esse aerugine et melle: ubi purus est, Lycio ad sanitatem perducendum. Vel narem incidendam esse ab ima parte ad os, ut et conspici locus possit, et facilius candens ferramentum admoueri; tum sui narem debere, et adustum quidem ulcus eadem ratione curari: suturam uero inlini uel spuma argenti uel alio glutinante.

[¶1] 12. 12 In the mouth too some conditions are treated by surgery. In the first place, teeth sometimes become loose, either from weakness of the roots, or from disease drying up the gums. In either case the cautery should be applied so as to touch the gums lightly without pressure. The gums so cauterized are smeared with honey, and swilled with honey wine. When the ulcerations have begun to clean, dry medicaments, acting as repressants, are dusted on. But if a tooth gives pain and it is decided to extract it because medicaments afford no relief, the tooth should be scraped round in order that the gum may become separated from it; then the tooth is to be shaken. And this is to be done until it is quite moveable: for it is very dangerous to extract a tooth that is tight, and sometimes the jaw is dislocated. With the upper teeth there is even greater danger, for the temples or eyes may be concussed. Then the tooth is to be extracted, by hand, if possible, failing that with the forceps. But if the tooth is decayed, the cavity should be neatly filled first, whether with lint or with lead, so that the tooth does not break in pieces under the forceps. The forceps is to be pulled straight upwards, lest if the roots are bent, the thin bone to which the tooth is attached should break at some part. And this procedure is not altogether free from danger, especially in the case of the short teeth, which generally have shorter roots, for often when the forceps cannot grip the tooth, or does not do so properly, it grips and breaks the bone under the gum. But as soon as there is a large flow of blood it is clear that something has been broken off the bone. It is necessary therefore to search with a probe for the scale of bone which has been separated, and to extract it with a small forceps. If this does not succeed the gum must be cut into until the loose scale is found. And if this has been done at once, the jaw outside the tooth hardens, so that the patient cannot open his mouth. But a hot poultice made of flour and a fig is then to be put on until pus is formed there: then the gum should be cut into. A free flow of pus also indicates a fragment of bone; so then too it is proper to extract the fragment; sometimes also when the bone is injured a fistula is formed which has to be scraped out. But a rough tooth is to be scraped in the part which has co black, and smeared with crushed rose-petals to which a fourth part of ox-galls and the same amount of myrrh has been added; and at frequent intervals undiluted wine is to be held in the mouth; and in this case the head is to be wrapped up, and the patient should have much walking exercise, massage of his head and food which is not too bitter. But if teeth become loosened by a blow, or any other accident, they are to be tied by gold wire to firmly fixed teeth, and repressants must be held in the mouth, such as wine in which some pomegranate rind has been cooked, or into which burning oak galls have been thrown. In children too if a second tooth is growing up before the first one has fallen out, the tooth which ought to come out must be freed all round and extracted; the tooth which has grown up in place of the former one is to be pressed upwards with a finger every day until it has reached its proper height. And whenever, after extraction, a root has been left behind, this too must be at once removed by the forceps made for the purpose which the Greeks call rhizagra. Now tonsils which have become hardened after inflammation (they are called by the Greeks antiades) since they are enclosed in a thin tunic, should be scratched round with a finger and drawn out. But if they cannot be so detached they should be seized with a hook and excised with a scalpel; and the hollow then swilled out with vinegar and the wound smeared with something to check the blood. If the uvula, owing to inflammation is elongated downwards, and is painful and dusky red in colour, it cannot be cut away without danger; for usually much blood flows: and so it is better to employ the treatment described elsewhere. But if, though there is no inflammation, it has become drawn so far downwards owing to phlegm, and is thin, pointed and white, it should be cut away; so also when the tip is bluish black and thick, but the base thin. There is no better way than to seize it with a small forceps and below this to cut off as much as we wish. And there is no danger of cutting off too much or too little since we can leave below the forceps only that part which is clearly useless; and cut away what is in excess of the natural length of the uvula. After the operation the same treatment should be carried out as I have just described for the tonsils. Again the tongue in some persons is tied down from birth to the part underlying it, and on this account they cannot even speak. In such cases the extremity of the tongue is to be seized with a forceps, and the membrane under it incised, great care being taken lest the blood vessels close by are injured and bleeding causes harm. The treatment of the wound afterwards has been described above. And indeed many when the wound has healed have spoken; I have, however, known a case when, though the tongue has been undercut so that it could be protruded well beyond the teeth, nevertheless the power of speech has not followed. So it is that in the Art of Medicine even where there is a rule as to what ought to be done, yet there is no rule as to what result ensues. Sometimes also under the tongue an abscess occurs which is generally enclosed in a coat and causes much pain. If it is small, one cut is enough; if large, the skin over it is to be excised down to the coating; then the two margins are laid hold of with hooks, and the coating is to be freed from what it surrounds and completely extracted, taking great care throughout the operation that no large blood vessel is cut into. The lips often split, and this not only is painful but has the inconvenience that speech is hindered; as this is apt to enlarge the cracks painfully and so causes them to bleed. If the cracks are superficial they are better treated by the medicaments used for ulcerations of the mouth. But if the fissures have penetrated deeper, it is necessary to burn them with a fine cautery, spearhead shaped, which should as it were skim over them without being pressed down. Afterwards the same is to be done as for cauterization of the ears.

> Latin: 12. In ore quoque quaedam manu curantur. Vbi in primis dentes nonnumquam mouentur, modo propter radicum inbecillitatem, modo propter gingiuarum arescentium uitium.—Oportet in utrolibet candens ferramentum gingiuis admoueri, ut attingat leuiter, non insidat. Adustae gingiuae melle inlinendae ⟨et mulso eluendae⟩ sunt. Vt pura ulcera esse coeperunt, arida medicamenta inf⟨ri⟩anda sunt ex is, quae reprimunt. Si uero dens dolores mouet eximique eum, quia medicamenta nihil adiuuant, placuerit, circumradi debet, ut gingiuae ab eo resoluantur; tum is concutiendus est. Eaque facienda, donec bene moueatur: nam dens haerens cum summo periculo euellitur, ac nonnumquam maxilla loco mouetur; idque etiam maiore periculo in superioribus dentibus fit, quia potest tempora oculosue concutere. Tum, si fieri potest, manu; si minus, forfice, dens excipiendus est. Ac si ex⟨e⟩ssus est, ante [id foramen] uel linamento uel bene adcommodato plumbo replendus est, ne sub forfice confringatur. Recta uero forfex ⟨d⟩ucenda est, ne inflexis radicibus os rarum, cui dens inhaeret, parte aliqua frangat. Neque ideo nullum eius rei periculum est utique in dentibus breuibus, qui fere longiores radices non habent: saepe enim forfex cum dentem conprehendere non possit aut frustra conprehendat, os gingiuae prehendit et frangit. Protinus autem ubi plus sangu⟨in⟩is profluit, sci⟨re⟩ licet, aliquid ex osse fractum esse. Ergo specillo conquirenda est ⟨test⟩a, quae recessit, et uolsella protrahenda est. ⟨Si⟩ non sequitur, incidi gingiua debet, donec labans ossis testa recipiatur. Quod si factum statim non est, indurescit extrinsecus maxilla, ut is hiare non possit. ⟨Sed⟩ inponendum ⟨calidum⟩ ex farina et fico cataplasma est, donec ibi pus moueatur; tum incidi gingiua debet. Pus quoque multum profluens ossis fracti nota est: itaque etiam tum id extrahi convenit; nonnumquam etiam eo laeso fistula fit, quae eradi debet. Dens autem scaber, qua parte niger, radendus inlinendusque rosae flore contrito, cui gallae quarta pars et altera murrae sit adiecta; continendumque ore crebro uinum meracum; atque in eo casu uelandum caput, ambulatione multa, frictione capitis, cibo non acri utendum. At si ex ictu uel alio casu aliquid labant dentes, auro cum is, qui bene haerent, uinciendi sunt; continendaque ore reprimentia, ut uinum, in quo malicorium decoctum, ⟨aut⟩ in quo galla candens coniecta sit. Si quando etiam in pueris ante alter dens nascitur quam prior excidat, is qui cadere debuit circumpurgandus et euellendus est: is qui natus est in locum prioris cotidie digito adur⟨g⟩endus, donec ad iustam magnitudinem perueniat. Quotienscumque dente exempto radix relicta est, protinus ea quoque ad id facta forfice, quam riza⟨gran⟩ Graeci uocant, eximenda est. Tonsillas autem, quae post inflammationes indu⟨ru⟩erunt, antiades autem a Graecis appellantur, cum sub leui tunica sint, oportet digito circumradere et euellere: si ne si⟨c⟩ quidem resoluuntur, hamulo excipere ⟨et⟩ scalpello excidere; tum ulcus aceto eluere et inlin⟨e⟩re uulnus medicamento, quo sanguis supprimitur. Vua si cum inflammatione descendit, dolorique est et subrubicundi coloris, praecidi sine periculo non potest: solet enim multum sanguinem effundere: ita⟨que⟩ melius est is uti, quae alias proposita sunt. Si uero inflammatio quidem nulla est, nihilo minus autem ultra iustum modum a pituita deducta sit, et est tenuis, acuta, alba, praecidi debet; itemque si ima liuida et crassa, summa tenuis est. Neque quicquam commodius est quam uolsella prehendere, sub e⟨a⟩que quod uolumus excidere. Neque enim ullum periculum est, ⟨ne⟩ plus minusue praecidatur, cum liceat tantum infra uolsella⟨m⟩ relinque⟨re,⟩ quantum [in]utile esse manifestum est; idque praecidere, quo longior uua est quam esse naturaliter debet. Post curationem eadem facienda sunt, quae in tonsilla his proxime posui. Lingua uero quibusdam cum subiecta parte a primo [natali] die uincta est, qui ob id ⟨n⟩e loqui quidem possunt.—Horum extrema lingua uolsella prehendenda est, sub eaque membrana incidenda, magna cura habita, ne uenae quae iuxta sunt uiolent⟨ur⟩ et profusio[ne] sanguinis noceat. Reliqua curatio uulneris in prioribus posita est. Et plerique quidem ubi consanuerunt, locuntur: ego autem cognoui, qui succisa lingua cum abunde super dentes eam promeret, non tamen loquendi facultatem consecutus est. Adeo in medicina, etiam ubi perpetuum est, quod fieri debet, non tamen perpetuum est id, quod sequi conuenit. Sub lingua quoque interdum aliquid abscedit, quod fere consistit in tunica doloresque magnos mouet.—Quo, si exiguum est, incidi semel satis est; si maius, summa cutis usque ad tunicam excidenda est; deinde utrimque orae hamulis excipienda⟨e⟩ et tunica undique circumdato liberanda * * * est, magna diligentia per omnem curationem habita, ne qua maior uena incidatur. Labra autem saepe finduntur eaque res habet cum dolore etiam hanc molestiam, quod sermo prohibetur; qui subinde eas rimas cum dolore diducendo sanguinem citat. Sed has, ⟨si⟩ in summo sunt, medicamentis curare commodius est, quae ad ulcera oris fiunt. Si uero altius descenderunt, necessarium est tenui ferramento adurere; quod spathae simile quasi transcurrere, non inprimi debet. Postea facienda eadem sunt, quae in auribus adustis exposita sunt.

[¶2] 13. 13 Now in the neck between the skin and the trachea, a tumour occurs which the Greeks call bronchocele, it contains now soft flesh, now a humour somewhat like honey or water, sometimes also hairs mixed up with minute bones; whatever the contents, they are enclosed in a coat. Treatment is possible by caustics which eat away the skin together with the underlying tunic. When this has been done, if there is humour inside, it flows out; if anything solid, it is turned out with the finger; the wound then heals under lint dressings. But treatment by the knife is shorter. A linear incision is made over the middle of the tumour down to the tunic; then the morbid pouch is separated by the finger from the sound tissue, and the whole is removed along with its covering. Next the wound is washed out with vinegar to which either salt or soda has been added, and the margins brought together by one suture; the rest of the applications are the same as in other cases of sutured wounds and after that it is lightly bandaged so as not to trouble the throat by pressure. But if it is impossible to take out the tunic, caustics are to be dusted into its interior, and it is then dressed with lint and other suppuratives.

> Latin: 13. At in ceruice inter cutem et asperam arteriam tumor increscit: bronchocelen Graeci uocant; quo modo caro hebes, modo umor aliquis melli aquaeue similis includitur, interdum etiam minutis ossibus pili inmixti. Ex quibus quicquid est, tunica continetur.—Potest autem adurentibus medicamentis curari, quibus summa cutis cum subiecta tunica exestur. Quo facto, siue umor est, profluit; siue quid densius, digitis educitur; tum ulcus sub lin⟨a⟩mentis sanescit. Sed scalpelli curatio brevior est. Medio tumore una linea inciditur usque ad tunicam; deinde uitiosus sinus ab integro corpore separatur digito, totusque cum uelamento suo eximitur. Tum aceto, cui uel salem uel nitrum aliquis adiecit, * eluitur, oraeque una sutura iunguntur; ceteraque eadem quae in aliis suturis superiniciuntur leuiterque inde, ⟨ne⟩ fauces * * urgeatque, deligatur. Si quando autem tunica eximi non potu⟨er⟩it, intus inspergenda adurentia; lin⟨a⟩mentisque id curandum est et ceteris pus mouentibus.

[¶3] 14. 14 There are also around the navel many lesions about which, owing to their rarity, there is little agreement among authorities. But it is probable that each has passed over what was unknown to himself; while no one has depicted what he had not seen. Common to all cases is an ugly prominence of the umbilicus, and the causes are sought for. Meges gave three; rupture into it of the intestine, of the omentum, or of humour. Sostratus said nothing about the omentum; in addition to the other two he said that at times there was increase of flesh in that part, sometimes sound, sometimes cancerous. Gorgias himself also omitted mention of the omentum; but he gave the same number of causes, three, and said that occasionally wind also ruptured into it. Heron having given all these four causes, made mention of both the omentum and of that form which was caused simultaneously by the omentum and intestine. But which of these causes it is, may be recognized by the following indications. When intestine has prolapsed the swelling is neither hard nor soft; it is reduced by anything cold; and it increases not only under heat of all kinds but also when the breath is held. At intervals it rumbles, and if the patient lies down on his back the swelling subsides, as the intestine has slipped back. But when it is the omentum, whilst other signs are similar, the swelling is softer, broad at its base, thinned out towards its apex; if any one grasps it, it slips away. When both intestine and omentum have prolapsed, the signs are mingled, and the softness is intermediate between the two; but the flesh is harder, and even when the patient lies on his back there is always swelling, and it does not yield to pressure, to which the preceding forms yield readily. If it is malignant the signs are the same as I have stated for cancer. Humour fluctuates when pressed upon; wind, on the other hand yields under pressure, but returns at once, also the swelling retains the same shape when the patient lies down on his back. Of these varieties, the disorder due to wind does not admit of treatment; also cancerous flesh is dangerous to treat, so should be left alone. Sound flesh ought to be cut away and the wound dressed with lint. Some let out humour, either by perforating with a needle, or by cutting into the apex of the tumour, and then similarly dressing the wound with lint. As to the rest of the treatment opinions vary. Of course the patient must be laid on his back, in order that the swelling, whether it be intestine or omentum, may slip back into the abdomen. But when the navel sac was then empty, some caught it between two little rods, and fastened the ends of the rods tightly together, so that it mortified there; some passed a needle doubly threaded through the base of the sac, then knotted the two ends of each thread on opposite sides, as is done also in staphyloma of the eye; from in this way that part beyond the ligatures mortifies. Some, in addition, before tying the ends also cut into the protrusion along a marked line and excised it: in order that they might more easily insert a finger and push back whatever had ruptured into the sac; then at length they tied the ligatures. But it is quite enough to order the patient to hold his breath so that the tumour shows itself at its largest; then to mark its base with ink; next with the patient on his back, to compress the tumour with the fingers, so that whatever has not slipped back of itself is forced back by the hand. After this the umbilicus is drawn forwards, and tightly constricted with flaxen thread along the marks of the ink; next the part beyond the ligature is either burnt with caustics or with the cautery, until it mortifies, after which the wound is dressed like other burns. This method answers best, not only when it is intestine or omentum or both, but even when it is humour. But first precautions must be taken against any danger from the ligature. For neither an infant nor a robust adult nor an old man is suited to this treatment, but a child between seven and fourteen years of age. Secondly a suitable body for it is one that is sound, but where there is general ill-health, or pustules or eruptions, and such like, it is not suitable. The smaller tumours also are readily curable, but there is danger in the treatment of those which are excessively large. Moreover the autumn and winter seasons should be avoided, the spring is the best season, early summer is not unfavourable. The patient should also fast on the day before the operation, and that is not enough, but the bowels also are to be moved by a clyster, in order that all that has extruded may more readily return into the abdomen.

> Latin: 14. Sunt etiam circa umbilicum plura uitia, de quibus propter raritatem inter auctores parum constet. Verisimile est autem id a quoque praetermissum, quod ipse non cognouerat; a nullo id, quod non uiderat, fictum. Commune omnibus est umbilicum indecore prominere: causae requiruntur. Meges tres has posuit: modo intestinum eo inrumpere; modo omentum; modo umorem. Sostratus nihil de omento dixit: duobus isdem adiecit carnem ibi interdum increscere, eamque modo integram esse, modo carcinomati similem. Gorgias ipse quoque omenti mentionem omisit: sed eadem tria causatus, spiritus quoque interdum eo dixit inrumpere. Heron omnibus his quattuor positis, et omenti mentionem habuit et eius, quod * * simul et omentum et intestinum habuerit. Quid autem horum sit, his indiciis cognoscitur. Vbi intestinum prolapsum est, tumor neque durus neque mollis est, omni frigore minuitur: non solum sub omni calore sed etiam retento spiritu crescit. Sonat interdum, atque ubi resupinatus est aliquis, delapso intestino ipse desidit. Vbi uero omentum est, cetera similia sunt; tumor mollior et, ab ima parte latus, extenuatus in uertice est; si quis adprehendit, elabitur. Vbi utrumque est, indicia quoque mixta sunt, et inter utrumque mollities: at caro durior est, semperque etiam resupinato corpore tumet, prementique non cedit, prioribus facile cedentibus. Si uitiosa est, easdem notas habet, quas in carcinomate exposui. Vmor autem si premitur, circumfluit: at spiritus pressus cedit, sed protinus redit, resupinato quoque corpore tumorem in eadem figura tenet. Ex his id, quod ex spiritu uitium est, medicinam non admittit; caro quoque carcinomati similis cum periculo tractatur; itaque omittenda est. Sana excidi debet idque uulnus lin⟨a⟩mentis curari. Vmorem quidem * * uel inciso summo tumore effundunt, et uulnus isdem linamentis curant. In reliquis uariae sententiae sunt. Ac resupinandum quidem corpus esse res ipsa testatur, ut in uterum, siue intestinum siue omentum est, delabatur. Sinus uero umbilici tum uacus ⟨a⟩ quibusdam duabus regulis exceptus est, uehementerque earum capitibus deligatis ibi emortus: a quibusdam, ad imum acu traiecta duo lina ducente, deinde utriusque lini duobus capitibus diuersae partes adstrictae; quod in uua quoque oculi fit: nam sic id, quod supra uinculum est, moritur. Adiecerunt quidam, ut antequam uincirent, summum una linea inciderent exciderentque: quo facilius digito demisso quod illuc inrupisset depellerent; tum deinde uinxerunt. Sed abunde est iubere spiritum continere, ut tumor quantus maximus esse potest, se ostendat; tum imam basem eius atramento notare, resupinatoque homine digitis tumorem eum premere, ut, si quid delapsum non est, manu cogatur. Post haec umbilicum adtrahere, et qua nota atramenti est, lino uehementer adstringere; deinde partem superiorem aut medicamentis aut ferro adurere, donec emoriatur, atque ut cetera usta ulcus nutrire. Idque non solum ubi intestinum uel omentum uel utrumque est, sed etiam ubi umor est, optime proficit. Sed ante quaedam uisenda sunt, ne quod ex uinculo periculum sit. Nam curationi neque infans neque aut robustus annis aut senex aptus est, sed * a septimo fere anno ad quartum decimum. Deinde ei corpus idoneum est id, quod integrum est: at quod mali habitus est, quo⟨d⟩ue papulas, inpetigine⟨m⟩, similiaque habet, idoneum non est. Leuibus quoque tumoribus facile subuenitur: at in eorum, qui nimis magni sunt, curatione periculum est. Tempus autem anni autumnale et hibernum uitandum; uer est idoneum maxime ac prima ae⟨s⟩tas non aliena est. Praeter haec abstinere pridie debet; neque id satis est, sed aluus quoque ei ducenda est, quo facilius omnia, quae excesserunt, intra uterum considant.

[¶4] 15. 15 I have said elsewhere that in those who are dropsical the water ought to be let out: here I must describe how this should be done. Now some make the perforation about four fingers breadth below the navel, and to the left; some make it by perforating the navel itself; some first burn through the skin and then cut into the abdominal cavity, because flesh which has been divided by cautery heals less quickly. Now when entering the knife great care should be taken that no blood vessel is cut into. The knife must be such that its point should be about the third of a finger's breadth, and it should be so entered as to penetrate the membrane separating the flesh from the interior; then a lead or bronze tube should be inserted, either with lips curved back at its outer end, or with a collar round the middle so that the whole of it cannot slip inside. The part of the tube within the abdominal cavity should be a little longer than the part outside, in order that it may project inwards beyond the deeper membrane. Through this tube the humour is let out; and when the greater part has escaped, the tube is to be closed by a lint plug, and left in the wound if it was not burnt with a cautery; then on each of the following days about one hemina is let out, until there appears no trace of fluid. Some, however, even when the skin has not been cauterized, take out the tube forthwith, and then bandage on the wound a squeezed-out sponge; then on the next day they pass in a tube again (which the recent wound admits if it is slightly stretched) in order that any remaining fluid may be let out. They are satisfied when this has been done twice in this manner.

> Latin: 15. Aquam is, qui hydropici sunt, emitti oportere alias dixi: nunc quemadmodum fiat, dicendum est. Quidam autem sub umbilico, fere quattuor interpositis digitis, in sinistra parte; quidam ipso umbilico perforato id facere consuerunt: quidam cute primum adusta, deinde interiore abdomine inciso, quia, quod per ignem diuisum est, minus celeriter coit. Ferramentum autem d⟨e⟩mittitur, magna cura habita, ne qua uena incidatur. Id tale esse debet, ut fere tertiam digiti partem latitudo mucronis impleat; demittendumque ita est, ut membranam quoque transeat, qua caro ab interiore parte finitur; eo tum plumbea aut aenea fistula coicienda est, uel recuruatis in exteriorem partem labris, uel in media circumsurgente quadam mora, ne tota intus delabi possit. Huius ea pars, quae intrat, paulo longior esse debet quam ⟨quae extra,⟩ ut ultra ulteriorem membranam procedat. Per hanc effundendus umor est; atque ubi maior pars eius euocata est, cludenda demisso linteolo fistula est, et in uulnere, si ustum non est, relinquenda; deinde per insequentes dies circa singulas heminas emittendum, donec nullum aquae uestigium appareat. Quidam tamen etiam non usta cute protinus fistulam recipiunt, et super uulnus spongiam expressam deligant; deinde postero die rursus fistulam demittunt (quod recens uulnus paulum diductum patitur), ut, si quid umoris superest, emittatur; idque bis ita fecisse contenti sunt.

[¶5] 16. 16 Sometimes the abdomen is penetrated by a stab of some sort, and it follows that intestines roll out. When this happens we must first examine whether they are uninjured, and then whether their proper colour persists. If the smaller intestine has been penetrated, no good can be done, as I have already said. The larger intestine can be sutured, not with any certain assurance, but because a doubtful hope is preferable to certain despair; for occasionally it heals up. Then if either intestine is livid or pallid or black, in which case there is necessarily no sensation, all medical aid is vain. But if intestines have still their proper colour, aid should be given with all speed, for they undergo change from moment to moment when exposed to the external air, to which they are unaccustomed. The patient is to be laid on his back with his hips raised; and if the wound is too narrow for the intestines to be easily replaced, it is to be cut until sufficiently wide. If the intestines have already become too dry, they are to be bathed with water to which a small quantity of oil has been added. Next the assistant should gently separate the margins of the wound by means of his hands, or even by two hooks inserted into the inner membrane: the surgeon always returns first the intestines which have prolapsed the later, in such a way as to preserve the order of the several coils. When all have been returned, the patient is to be shaken gently: so that of their own accord the various coils are brought into their proper places and settle there. This done, the omentum too must be examined, and any part that is black dead is to be cut away with shears; what is sound is returned gently into place in front of the intestines. Now stitching of the surface skin only or of the inner membrane only is not enough, but both must be stitched. And there must be two rows of stitches, set closer together than in other places, partly because they can be broken here more easily by the abdominal movement, partly because that part of the body is not specially liable to severe inflammations. Therefore two needles are to be threaded and one is to be held in each hand; and the stitches are to be inserted, first through the inner membrane, so that the surgeon's left hand pushes the needle from within outwards through the right margin of the wound, and his right hand through the left margin, beginning from one end of the wound. The result is that it is the blunt end of the needle which is always being pushed away from the intestines. When each margin has been once traversed, the hands interchange needles, so that into the right hand comes the needles which was in the left, and into the left the needle which was in the right; and again, after the same method they are to be passed through the margins; and when for the third and fourth time, the needles have changed hands the wound is to be closed. Afterwards the same thread and the same needles are now transferred to the skin, and stitches are to be inserted by a like method into this as well, always directing the needles from within outwards, and with the same change, between the hands. It is too obvious to need constantly repeating that agglutinants are then to be put on with the addition either of a sponge or of greasy wool, squeezed out of vinegar. Over this application the abdomen should be lightly bandaged.

> Latin: 16. Nonnumquam autem uenter ictu aliquo perforatur, sequiturque ut intestina euoluantur. Quod ubi incidit, protinus considerandum est, an ea integra sint, deinde an is color suus maneat. Si ten⟨ui⟩us intestinum perforatum est, nihil profici posse iam rettuli. Latius intestinum sui po⟨te⟩st, non quo certa fiducia sit, sed quo[d] dubia spe⟨s⟩ certa desperatione sit potior: interdum enim glutinatur. Tum si utrumlibet intestinum liuidum aut pallidum aut nigrum est, quibus illud quoque necessario accedit, ut sensu careat, medicina omnis inanis est. Si uero adhuc ea sui coloris sunt, cum magna festinatione succurrendum est: momento enim alienantur, externo et insueto spiritu circumdato. Resupinandus autem homo est coxis erectioribus; et si angustius uulnus est, quam ut intestina commode refundantur, incidendum est, donec satis pateat. Ac si iam sicciora sunt intestina, perluenda aqua sunt, cui paulum admodum olei sit adiectum. Tum minister oras ulceris leuiter diducere manibus suis uel etiam duobus hamis interiori membranae iniectis debet: medicus priora semper intestina, quae posteriora prolapsa sunt, condere sic, ut orbium singulorum locum seruet. Repositis omnibus, leuiter homo concutiendus est; quo fit, ut per se singula intestina in suas sedes deducantur et in his considant. His conditis, omentum quoque considerandum est, ex quo, si quid iam nigri [emortui] est, forfice excidi debet; si quid integrum est, leuiter super intestina deduci. Sutura autem neque summae cutis neque interioris membranae per se satis proficit, sed utri⟨us⟩que. E⟨t⟩ quidem duobus linis inicienda est, spissior quam alibi, quia et rumpi facilius motu uentris potest, et non aeque magnis inflammationibus ⟨pars ea⟩ exposita est. Igitur in duas acus fila coicienda, ⟨e⟩aeque duabus manibus tenendae; et prius interiori membranae sutura inicienda est sic, ut sinistra manus in dexteriore ora, in sinisteriore dextra a principio uulneris orsa ab interiore parte in exteriorem acum mittat. Quo fit, ut ab intestinis ea qu⟨idem⟩ pars semper acuum ⟨sit,⟩ quae retusa est. ⟨Se⟩mel utraque parte traiecta, permutandae acus inter manus sunt, ut ea sit in dextra, quae f⟨u⟩it in sinistra; ea ueniat in sinistram, quam dextra continuit; iterumque eodem modo per oras immittenda⟨e⟩ sunt; atque ita tertio et quarto deincepsque permutatis inter manus acubus, plaga includenda. Post haec eadem fila, eaedemque acus ad cutem transferendae, similique ratione ei quoque parti sutura inicienda, semper ab interiore parte acubus uenientibus, semper inter manus traiectis. Dein glutinantia inicienda, quibus aut spongia⟨m⟩ aut sucidam lanam ex aceto expressam accedere debere manifestius est, quam ut semper dicendum sit. Inpositis his, leuiter deligari uenter debet.

[¶6] 17. 17 Sometimes, however, whether from some blow, or from holding the breath too long, or from carrying a heavy weight, the inner membrane of the abdomen is ruptured, whilst the skin over it is entire. This often occurs too in the case of women from childbearing, and it particularly takes place in the iliac regions. But it follows since the overlying flesh is soft, that it does not hold the intestines properly in place and that the skin is stretched by them and forms an ugly swelling. And this too is treated differently by different surgeons. For some pass two threads through the base by means of a needle, and then tie on each side, as has been described for the navel and for staphyloma, in order that what is beyond the ligature may mortify; some excise the middle of the swelling by a myrtle-leaf shaped incision, which as I said is the method which should always be adopted, and then they unite the edges by stitching. But the best way is with the patient on the back, to try with the hand in which part the swelling is most yielding, for of necessity it is at that part that the inner membrane is ruptured, and where it is entire the swelling is more resistant. Where the rupture is seen to be, two linear incisions are made with a scalpel, so that when what lies between has been excised, the inner membrane has a wound freshly made on each side, because stitching will not unite a lesion of long standing. When on exposure any part of the membrane presents not a recent but an old rupture, a thin strip is to be pared away, which only just makes the margins raw. All the directions for stitching and further treatment have been given above. Besides the above there are sometimes varicose veins upon the abdominal wall, and because there is no other treatment for these than what is usual for the legs since I shall treat of that part later, I will defer this too till then.

> Latin: 17. Interdum tamen uel ex ictu aliquo uel retento diutius spiritu uel sub graui fasce interior abdominis membrana superiore cute integra rumpitur. Quo⟨d⟩ feminis quoque ex utero saepe euenire consueuit; fitque praecipue circa ilia. Sequitur autem, cum superior caro mollis sit, ut non satis intestina contineat, isque intenta cutis indecore intumescat.—Atque id quoque aliter ab aliis curatur. Quidam enim per acum duobus linis ad imam basem inmissis sic utrimque deuinciunt, quemadmodum et ⟨in⟩ umbilico et in uua positum est, ut quicquid super uinculum est emoriatur: quidam medium tumorem excidunt ad similitudinem myrtei foli, quod semper eodem modo seruandum esse iam posui, et tum oras sutura iungunt. Commodissimum est autem resupinato corpore experiri manu, qua parte ⟨is⟩ tumor maxime cedat, quia necesse est ea parte ⟨rupta⟩ membrana sit; quaque integra est, ea magis obnitatur; tum qua rupta uidebitur, immittendae scalpello duae lineae sunt, ut excisso medio interior membrana utrimque recente⟨m⟩ plagam habeat, quia quod uetus est, sutura non coit. Loco patefacto, si qua parte membrana non nouam plagam sed ueterem habet, tenuis excidenda habena est, quae tantum ora⟨s⟩ eius exulceret. Cetera, quae ad suturam reliquamque curationem pertineant, supra conprehensa sunt. Praeter haec euenit, ut in quorundam uentribus uarices sint; quarum quia nulla alia curatio est, quam quae in cruribus esse consueuit, †tum eam partem explanaturus, hanc quoque eo differo.

[¶7] 18. 18 Now I come to those lesions which are apt to arise in the genital parts around the testicles; and to explain them more easily, the nature of the said region must briefly be described first. The testicles then are somewhat like marrow, for they do not bleed and they lack all feeling; but the coverings by which they are enclosed give pain both when injured and inflamed. Now the testicles hang from the groins, each by a cord which the Greeks call the cremaster with each of which descend a pair of veins and a pair of arteries. And these are ensheathed in a tunic, thin, fibrous, bloodless, white, which is called by the Greeks elytroides. Outside this is stronger tunic, which at its lowest part is closely adherent to the inner one; the Greeks call it dartos. Further, many fine membranes hold together the veins, and the arteries, and the cords aforesaid, and also in between the two tunics there are some fine and very small membranes, descending from the parts above. Thus far the coverings and supports belong to each testicle separately; next common to both and to all within is the pouch which is now visible to us; the Greeks call it oscheon, we the scrotum; and at its lowest part this is slightly connected with the middle coverings, higher up it is only surrounded by them. Now, underneath the scrotal covering many lesions are apt to occur, sometimes after the rupture of the coverings which, as I have said, begin from the groins, sometimes when they are uninjured. Since at times either owing to disease there is first inflammation, then afterwards a rupture from the weight; or after some blow there, there is a direct rupture of the covering which ought to separate the intestines from the parts below; then either omentum, or it may be intestine, rolls down by its own weight; this having found a way gradually from the groins into the parts below as well, there separates by its pressure the coverings which are fibrous and therefore give way. The Greeks call the condition enterocele and epiplocele, with us the ugly but usual name for it is hernia. Now if omentum has come down, the tumour in the scrotum never disappears, either if the patient fasts, or if his body is turned from side to side, or lies in some special position; again, if the breath is held, it does not increase to any extent; to the touch it seems uneven and soft and slippery. But if intestine has also come down this tumour is with-out inflammation, sometimes it diminishes, sometimes increases, and it is generally painless and soft. When the patient is quiescent or lying down, it disappears, at times altogether; sometimes it becomes divided so that very small remnants stay in the scrotum. But after shouting or over-eating, or if the patient has been strained by a weight of any sort, it increases; under all kinds of cold it shrinks, under heat it enlarges; then the scrotum becomes globular and smooth to the touch; and within the scrotum the intestine slips about, when pressed upon it reverts towards the groin, when released it rolls down again with a sort of murmur. That is what happens in slight cases; but at times, when faeces have been taken in, it swells more largely, it cannot be forced back, and it then brings on pain both in the scrotum and in groins and abdomen. At times the stomach also becomes affected, and there is an issue from the mouth, first of red, then of green, and even in some of black bile. At times too, whilst the membranes remain entire, fluid distends the scrotum. There are two forms of this affection: for the fluid collects either between the coverings or in the membranes surrounding the veins and arteries, and then these membranes become thickened and weighted down. And even if the fluid lies between the membranes it is not confined to one place; it may lie between the superficial and middle membrane, or between the middle and inner membranes. The Greeks have one general name, they call it hydrocele, whichever kind it is; our people, not knowing enough perchance to make distinctions, call it by the same name as the preceding disorder. Now there are signs, some common to all cases, some particular: the common one is the existence of the fluid; the particular, the situation of it. We learn that there is fluid underneath, if the swelling never disappears entirely although it is at times less, whether from fasting or feverishness, and especially in boys; the tumour is soft when the fluid contained is only small in amount; but if it increases to a great extent, the tumour becomes tense like a wineskin which has been filled and tightly tied. Also veins in the wall of the scrotum are distended; and upon pressure with the finger the fluid recedes, and as it flows round raises up the part where there is no pressure and is seen through the scrotal wall as if it were contained in a glass or horn vessel; and however much is there is no pain. But the situation of the fluid is recognized as follows: if it is between the scrotal wall and the middle membrane, when we press with two fingers, the humour gradually comes up, returning as the fingers are withdrawn; the scrotal wall is whiter than natural; if it is drawn upon, it stretches either not at all, or very little; the testicle on that side cannot be seen or felt. But if it is under the middle membrane, the scrotum is stretched and more raised up, so that the root of the penis is concealed under the swelling. Besides the above a varicose affection which the Greeks call cirsocele occurs, in which also the membranes are intact. The veins become swollen, and when twisted, and massed together at the upper part, they distend the scrotum generally, or the middle or the inner covering; sometimes they grow even beneath the inner covering around the actual testicle and its cord. Of these the veins in the scrotal wall can be seen; but those situated in the middle or inner coverings, being more deeply placed, are not indeed equally visible but even these can be seen, especially because there is a certain amount of swelling in proportion to the size and form of the veins, and this is more resistant to pressure, and also is rendered irregular owing to the bulgings of the veins, whilst the testicle on that side hangs lower down than it ought. But when the disease has spread also over the testicle and its cord, the testicle sinks a little lower, and becomes smaller than its fellow, in as much as its nutrition has become defective. Sometimes, though rarely, flesh also grows between the tunics; the Greeks call this sarcocele. At times also the testicle itself swells owing to inflammation and this causes fever as well. And unless this inflammation quickly subsides, pain spreads to the inguinal and iliac regions, and these parts swell; the cord from which the testicle hangs becomes fuller, and at the same time it hardens. Besides this it happens sometimes that the groin is occupied by a rupture; they call it bubonocele.

> Latin: 18. Venio autem ad ea, quae in naturalibus partibus circa testiculos oriri solent; quae quo facilius explicem, prius ipsius loci natura paucis proponenda est. Igitur testiculi simile quiddam medullis habent: ⟨nam⟩ sanguinem non emittunt et omni sensu carent: dolent autem in ictibus et inflammationibus tunicae, quibus i continentur. Dependent uero ab inguinibus per singulos neruos, quos cremasteras Graeci uocant, cum quorum utroque binae descendunt et uenae et arteriae. Haec autem tunica conteguntur tenui, neruosa, sine sanguine, alba, quae ely⟨t⟩roides a Graecis nominatur. Super ea ualentior tunica est, quae interiori uehementer ima parte inhaeret: darton Graeci uocant. Multae deinde membranulae uenas et arterias eosque neruos conprehendunt; atque inter duas quoque tunicas a superioribus partibus leues paruulaeque sunt. Hactenus propria utrique testiculo uelamenta et auxilia sunt: communis deinde utrique omnibusque interioribus sinus est, qui iam conspicitur a nobis: ⟨os⟩cheon Graeci, scrotum nostri uocant; isque ab ima parte mediis tunicis leuiter innexus est, a superiore tantum circumdatus. Sub hoc igitur plura uitia esse consuerunt; quae modo ruptis tunicis, quas ab inguinibus incipere proposui, modo his integris fiunt. Siquidem interdum uel ex morbo primum inflammatur, deinde postea pondere abrumpitur; uel ex ictu aliquo protinus rumpitur tunica, quae diducere ab inferioribus partibus intestina debuit; tum pondere eo deuoluitur aut omentum aut etiam intestinum; idque ibi reperta uia paulatim ab inguinibus in inferiores quoque partes nissum subinde neruosas tunicas et ob id eius rei patientes diducit: enterocelen et epiplocelen Graeci uocant: apud nos indecorum sed commune his hirneae nomen est. Deinde, si descendit omentum, numquam in scroto tumor tollitur, siue inedia fuit, si⟨ue⟩ corpus huc illucue conuersum aut aliquo modo conlocatum est; itemque, si ⟨re⟩tentus est spiritus, non magnopere increscit; tactu uero inaequalis est et mollis et lubricus. At si intestinum quoque descendit, tumor is sine ⟨in⟩flammatione modo minuitur, modo increscit estque fere sine dolore et cum mollitie. ⟨Cum⟩ quiescit aliquis aut iacet, interdum ex toto desidit; interdum sic diuiditur, ut in scroto exiguae reliquiae maneant. At clamore et satietate, et si sub aliquo pondere is homo nisus est, crescit: frigore omni contrahitur, calore diffunditur; estque tum scrotum et rotundum et tactu leue: idque, quod subest, lubricum est; si pressum est, ad inguina reuertitur, dimissumque iterum cum quodam quasi murmure deuoluitur. Et id quidem in leuioribus malis euenit: nonnumquam autem stercore accepto uastius tumet, retroque compelli non potest, adfertque tum dolorem et scroto et inguinibus et abdomini. Nonnumquam stomachus quoque adfectus primum rufam bilem per os reddit, deinde uiridem, quibusdam etiam nigram. Integris uero membranis interdum eam partem umor distringit. Atque eius quoque species duae sunt: nam uel inter tunicas ⟨is⟩ increscit uel in membranis, quae ibi circa uenas et arteria⟨s⟩ sunt, ubi eae grauatae occal⟨l⟩uerunt. Ac ne ei quidem umori, qui inter tunicas est, una sed⟨es⟩ est: nam modo inter summam et mediam, modo inter mediam et imam consistit. Graeci ⟨communi⟩ nomine, quicquid est, hydrocelen appellant: nostri, ut scilicet nullis discriminibus satis cognitis, haec quoque sub eodem nomine quo priora habent. Signa autem quaedam communia sunt, quaedam propria: communia, quibus umor deprehenditur; propria, quibus loc⟨u⟩s. Vmorem subesse discimus, si tumor est numquam ex toto se remittens, sed interdum leuior aut propter famem aut propter febriculam, maximeque in pueris; isque mollis est, si non nimius umor subest: at si is uehementer increuit, renititur sicut uter repletus et arte adstrictus. Venae quoque in scroto inflantur, est, si digito pressimus, cedit umor circumfluens⟨que⟩ id, quod non premitur, attollit et tamquam in uitro cornuue per scrotum apparet, estque, quantum in ipso est, sine dolore. Sedes autem eius sic deprehenditur. Si inter summam mediamque tunicam est, cum digitis duobus pressimus, paulatim umor inter eos * reuertens subit; scrotum †ipsius albidius: si ducitur, aut nihil aut paruulum intenditur; testiculus ea parte neque uisu neque tactu sentitur. At si sub media tunica est, intentum scrotum magis se attollit, adeo ut superior coles sub tumore eo delitescat. Praeter haec aeque integris tunicis ramex innascitur: cirso⟨ce⟩len Graeci appellant. Venae intumescunt, ⟨e⟩aeque intortae conglomerataeque a superiore parte uel ipsum scrotum inplent uel mediam tunicam uel imam: interdum etiam sub ima tunica circa ipsum testiculum neruumque eius increscunt. Ex his ea⟨e⟩, quae in ipso scroto sunt, oculis patent: eae uero, quae mediae imaeue tunicae insident, ut magis conditae non aeque quidem cernuntur, sed tamen etiam uisui subiectae sunt, praeterquam quod et tumoris aliquid est pro uenarum magnitudine ac modo, et id prementi magis renititur ac per ipsos uenarum toros inaequale est et, qua parte id est, testiculus magis iusto dependet. Cum uero etiam super ipsum testiculum neruumque eius id malum increuit, aliquanto long⟨i⟩us testiculus ipse descendit, minorque altero fit, ut pote alimento amisso. Raro sed aliquando caro quoque inter tunicas increscit: sarcocelen Graeci uocant. Interdum etiam ex inflammatione tumet ipse testiculus, ac febres quoque adfert; et nisi celeriter ea inflammatio conquieuit, dolor ad inguina atque ilia peruenit, partesque eae intumescunt; neruus, ex quo testiculus dependet, plenior fit simulque indurescit. Super haec inguen quoque nonnumquam †uarice inplicetur: bubonocelen appellant.

[¶8] 19. 19 When these lesions have been recognized their treatment must be discussed; in this some methods are common to all, some peculiar to particular kinds. I shall discuss first what is common to all. But I shall now speak of those cases demanding the knife: for those which are incurable, or should be cared for otherwise, will be mentioned as I come to the separate kinds. Now sometimes the inguinal region has to be cut into, sometimes the scrotum. In either case the man for three days before should drink water, and for the day before abstain also from food: on the day itself he must lie on his back; next if the groin has to be cut into, and if the pubes is already covered by hair, this is to be shaved off beforehand: and then after stretching the scrotum, so that the skin of the groin is rendered tense, the cut is made below the abdominal cavity, where the membranes below are continuous with the abdominal wall. Now the laying open is to be done boldly, until the outer tunic, that of the scrotum itself, is cut through, and the middle tunic reached. When an incision has been made, an opening presents leading deeper. Into this the index finger of the right hand is introduced, in order that by the separation of the intervening little membranes the hernial sac may be freed. Next the assistant grasping the scrotum with his left hand should stretch it upwards, and draw it away as far as possible from the groins, at first including the testicle itself until the surgeon cuts away with the scalpel all the fine membranes which are above the middle tunic if he is unable to separate it with his finger; then the testicle is let go in order that it may slip downwards, and show in the wound and then be pushed out by the surgeon's finger, and laid along with its two tunics upon the abdominal wall. There whatever is diseased is cut round and away, in the course of which many blood vessels are met with; the smaller ones can be summarily divided; but larger ones, to avoid dangerous bleeding, must be first tied with rather long flax thread. If the middle tunic be affected, or the disease has grown beneath it, it will have to be cut away even as high as the actual groin. Lower down, however, not all is to be removed: for at the base of the testicle there is an intimate connexion with the inner tunic, where excision is not possible without extreme danger; and so there it is to be left. The same is to be done if the inner tunic is the seat of the disease. But the cutting away cannot be done quite completely at the inguinal end of the wound, but only somewhat lower down, lest the abdominal membrane be injured and set up inflammation. On the other hand too much of its upper part should not be left behind, lest subsequently there forms a pouch which continues to be the seat of the same malady. The testicle having been thus cleared is to be gently returned through the incision, along with the veins and arteries and its cord; and it must be seen that blood does not drop down into the scrotum, or a clot remain anywhere. This will be accomplished if the surgeon takes the precaution of tying the blood vessels; the threads with which the ends of these are tied should hang out of the wound; following upon suppuration they will fall off painlessly. Through the margins of the wound itself two pins are then passed, and over this an agglutinating dressing. But it becomes necessary sometimes to cut away a little from one or other of the edges of the skin-incisions in order to make a broader and thicker scar. When this occurs the lint dressing must not be pressed on but must be applied lightly, and over it such things as repel inflammation, unscoured wool or sponge soaked in vinegar; all the other treatment is the same as when suppuratives have to be applied.

> Latin: 19. His cognitis, de curatione dicendum est, in qua quaedam communia omnium sunt, quaedam propria singulorum. Prius de communibus dicam. Loquar autem nunc de is, quae scalpellum desiderant: nam uel quae sanari non possunt, uel aliter nutriri debeant, dicendum erit, simul ad species singulas uenero. Inciditur autem interdum inguen, interdum scrotum. In utraque curatione homo ante triduum bibere aquam, pridie abstinere etiam a cibo debet: ipso autem die collocari supinus; deinde si inguen incidendum est, idque iam pube contegitur, ante radendum est; et tunc extenso ⟨s⟩croto, ut cutis inguinis intenta sit, id incidendum sub imo uentre, qua cum abdomine tunicae inferiores committuntur. Aperiendum autem audacter est, donec summa tunica, quae ipsius ⟨s⟩croti est, incidatur, perueniaturque ad eam, quae media. Plaga facta foramen deorsum uersus subest. In id demittendus est sinistrae manus digitus index, ut deductis interuenientibus membranulis sinum laxet. Minister autem sinistra manu conprehendens scrotu⟨m⟩ susum uersum [eum] debet extendere, et quam maxime ab inguinibus abducere, primum cum ipso testiculo, dum medicus omnes membranulas, quae supra mediam tunicam sunt, si digito deducere non potest, scalpello abscidat; deinde sine eo, ut is delapsus ipsi plagae iungatur digitoque inde promatur, et super uentrem cum duabus suis tunicis collocetur. Inde si qua uitiosa sunt, ⟨circumcidenda sunt;⟩ in quibus cum multae uenae discurrant, tenuiores quidem protinus praecidi possunt; maiores uero ante longiore lino deligandae sunt, ne periculose sanguinem fundant. Si media tunica uexata erit aut sub ea malum increuerit, excidenda erit sic, ut alte ad ipsum inguen praecidatur. Infra tamen non tota demenda est: nam quod ad basin testiculi uehementer cum ima tunica conexu⟨m⟩ est, excidi sine summo periculo non potest; itaque ibi relinquendum est. Idem in ima quoque tunica, si laesa est, faciendum est. Sed non a summa inguinis plaga uerum infra paulum ea abscidenda, ne laesa abdominis membrana inflammationes moueat. Neque tamen nimium ex ea susum relinquendum est, ne postea sinuetur et sedem eidem malo praestet. Purgatus ita testiculus per ipsam plagam cum uenis et arteriis et neruo suo leuiter demittendus est, uidendumque, ne sanguis in scrotum descendat neue concretus aliquo loco maneat. Quae ita fient, si uenis uinciendo medicus prospexerit: lina, quibus capita earum continebuntur, extra plagam dependere debebunt; quae pure orto sine ullo dolore excident. Ipsi autem plagae iniciendae duae fibulae sunt, et insuper medicamentum, quo glutinetur. Solet autem interdum ab altera ora necessarium esse aliquid excidi, ut cicatrix maior et latior fiat. Quod ubi incidit, lin⟨a⟩menta super ⟨non⟩ fulcienda sed leuiter tantum ponenda sunt, supraque ea, quae inflammationem repellant, id est ex aceto uel lana sucida uel spongia: cetera eadem, quae, ubi pus moueri debet, adhibenda sunt. At cum infra incidi oportet, resupinato homine subicienda sub scroto sinistra manus est; deinde id uehementer adprehendendum et incidendum.

## 29. Book VII · chapters 19–26

Source: https://scriptura.si/works/celsus-on-medicine/29/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/29/#p-N

[¶0] But when an incision is required lower down, then with the man on his back, the left hand is to be passed under the scrotum; next this must be grasped firmly and the incision made. If the disease is small in extent, the incision is limited, so as to leave intact the lower third of the scrotum in order to support the testicle; if more extensive, the incision is prolonged so that just a little is left at the bottom to support the testicle. But the scalpel at first should be held in a very light hand, with its edge vertical to the skin, until the wall of the scrotum has been divided; then the edge is sloped sideways so as to cut across the membranes between the scrotal wall and the middle tunic. And if the disease is in the wall of the scrotum there is no need to touch the middle tunic; if it also lies under the middle tunic, this too has to be cut through, and the inner tunic as well if that covers the lesion. Now wherever the disease is found to be, the assistant should press the scrotum gently upwards; the surgeon either with his finger, or with the handle of the scalpel, separates the middle tunic from its connexion with the scrotal wall, and brings it forwards; then with a knife, called from its shape 'the raven,' he lays it open so that his index and middle finger can enter. With these fingers so introduced the remainder of the tunic should be brought forwards, and the knife inserted in between the two fingers, and any diseased matter taken away or let out. If one of the tunics has been injured it also should be cut away; the middle one, as stated above, as far up as the groin; the inner one to a little below the groin. But before they are cut away, the blood vessels above too should be ligatured with flax thread, the ends of which are to be left hanging out of the wound, as in the case of other blood vessels that have had to be tied. This done, the testicle is to be replaced inside, and the scrotal margins united by stitches, not too few lest the edges fail to unite and the treatment is prolonged, and not too many lest they augment the inflammation. Here also it must be seen to that no blood remains in the scrotum. Then agglutinants are put on. But if at any time blood trickles down into the scrotum, or any clot collects in it, an incision should be made below, and after clearing out the blood, a sponge soaked in strong vinegar is put on. Further, all such wounds made for the above reasons, after having been bandaged up, when there is no pain, should not be dressed until the fifth day, but the wool or sponge is to be saturated sufficiently with vinegar twice a day; if there is pain, and when pins have been inserted they are then to be taken out; when lint has been used it must be changed and the fresh lint wetted with rose oil and wine. Should inflammation increase, to the previously mentioned applications add a plaster of lentils and honey or of pomegranate rind boiled in dry wine, or of the two combined. If the inflammation does not subside under these applications, after the fifth day the wound is to be fomented freely with hot water, until the scrotum itself both shrinks and becomes wrinkled; then apply a wheat flour plaster with pine resin added; which, for a robust patient has been boiled in vinegar, and for a delicate one in honey. Whatever the application used, there is no doubt that if there is much inflammation, suppuratives must be applied. But if pus collects in the scrotum itself, it must be let out through a small incision; and enough lint must be put on to cover the opening. When the inflammation is at an end, for the sake of the cords first the plaster and then a cerate is to be used. Such is the proper treatment of wounds of this sort. For the rest as regards both treatment and diet, these should conform to what has been prescribed for other sorts of wounds.

> Latin: Si paruolum est, quod nocet, modice, ut tertia pars integra ad sustinendum testiculum infra relinquatur; si maius est, etiam amplius, ut paulum tantummodo ad imum, cui testiculus insidere possit, integrum maneat. Sed primo rectus scalpellus quam leuissima manu teneri debet, donec scrotum ipsum diducat; tum inclinandus mucro est, ut trans⟨uersa membrana⟩ secet, quae infra summam mediamque tunicam sunt. Ac si uitium in proximo est, mediam tunicam attingi non oportet: si sub illa quoque conditur, etiam illa incidenda est, sicut tertia quoque, si illa uitium tegit. Vbicumque autem repertum est malum, ministrum ab inferiore parte exprimere moderate scrotum oportet; medicum digito manubriolou⟨e⟩ scalpelli deductam inferior⟨e⟩ ⟨parte⟩ tunicam extra conlocare; deinde eam ferramento, quod a similitudine coruom uocant, incidere sic, ut intrare duo digiti, index et medius, possint. His deinde * coniectis, excipienda reliqua pars tunicae, et inter digitos scalpellus inmittendus est, eximendumque aut effundendum ⟨quic⟩quid est noxium. Qua⟨m⟩cumque autem tunicam quis uiolauit, illam quoque debet excidere; ac mediam quidem, ut supra dixi, quam altissime ab inguine; imam autem paulum infra. Ceterum antequam excidantur, eae quoque uinciri lino summae debent et eius lini capita extra plagam relinquenda sunt, sicut in aliis quoque [uenis,] quae id requisierint. Eo facto, testiculus intus reponendus est, oraeque scroti suturi⟨s⟩ inter se committendae, neque paucis, ne parum glutinentur et longior fiat curatio; neque multis, ne inflammationem augeant. Atque ⟨hic⟩ quoque uidendum est, ne quid in scroto sanguinis maneat. Tum inponenda glutinantia sunt. Si quando autem in scrotum sanguis deflu⟨x⟩it aliquidue concretum ex eo de⟨s⟩ce⟨n⟩dit, incidi subter id debet, purgatoque eo spongia acri aceto madens circumdari. Deligatum autem uulnus omne, quod ex his causis factum est, si dolor nullus est, quinque primis diebus non est resoluendum, sed bis die tantum aceto inroranda lana uel spongia: si dolor est, tertia die resoluendum, et ubi fibulae sunt, eae incidendae; ubi linamentum, id inmutandum est rosaque et uino madefaciendum id, quod inponitur. Si inflammatio increscit, adiciendum prioribus cataplasma ex lenticula et melle uel malicorio, quod in austeri uino coctum sit, uel ex his mixtis. Si sub his inflammatio non conquieuerit, post diem quintum multa calida aqua uulnus fouendum, donec scrotum ipsum et extenuetur et rugosius fiat; tunc inponendum cataplasma ex triticea farina, cui resina pinea adiecta sit; quae ipsa, si robustus cubat, ex aceto; si tener, ex melle coquenda sunt. Neque dubium est, quodcumque in⟨d⟩itum est, si magna inflammatio est, quin ea, quae pus mouent, inponenda sint. Quod si pus in ipso scroto ortum est, paulum id incidi debet, ut exitus detur; lin⟨a⟩mentumque eatenus ponendum est, ut foramen tegat. Inflammatione finita, propter neruos priore cataplasmate, dein cerato utendum. Haec proprie ad eiusmodi uulnera pertinent. Cetera et in curatione et in uictu similia is esse debent, quae in alio quoque uulnerum genere praecepimus.

[¶1] 20. 20 After this introduction, we come to particular conditions. And if in a young child intestine prolapses, bandaging should be tried before the knife. For this a strip of linen is taken, to one end of which is stitched a ball of rags which is placed on the prolapse itself so as to push back the intestines: then the rest of the strip of bandage is firmly tied all round; under this the intestines are often forced inside and the tunics become agglutinated together. Again, if the patient is older, and the large size of the swelling shows that much of the intestines has come down, and if in addition there is pain and vomiting, which generally happens because faeces from undigested food have slipped down, then it is clearly impossible to employ the knife except harmfully; the trouble can only be mitigated, and must be drawn out by other measures. Blood should be let from the arm, then if the patient's strength permits, fasting for three days should be prescribed, or else at least for as long as the strength allows. Meanwhile a plaster of linseed first boiled in honey wine is to be kept on over the hernia. Later one of barley meal with resin is to be applied, and the patient immersed in a bath of hot water to which olive oil also has been added; after which some light warm food is to be given. Some also employ a clyster; but that can only bring down something into the scrotum, and cannot evacuate anything from it. When by the measures just described, the disease has been mitigated, if at any time pain recurs, the same measures will have to be repeated which we have just found to be beneficial. If without causing any pain, a large amount of intestine has prolapsed, it is useless to operate; not that it is impossible to push back the intestines out of the scrotum, unless inflammation prevents it, but because as they are forced back they may become impacted in the groins and give rise to a swelling, so that the trouble is not ended but only changed in position. But in a case which is suitable for treatment by the knife, as soon as the incision made in the groin reaches the middle tunic, this must be seized near the margins by a couple of hooks, when, after drawing down all the fine membranes the surgeon sets it free. Nor is there any danger in wounding what has to be cut out, since the intestine must lie underneath it. When the middle tunic has been thus drawn down, it is slit open from the groin to the testicle, but so as not to injure the latter; then it is cut away. Generally, however, this treatment is only admissible in boyhood and when the trouble is limited. For a robust man with a more extensive disorder the testicle should not be turned out, but kept in position. The procedure is as follows. The groin is laid open as before down to the middle tunic, and this tunic is seized as described above with two hooks, whilst the assistant keeps the testicle in its place, so that it does not come out of the wound; then the middle tunic is cut into with a scalpel towards its lower part, and through the opening the index finger of the left hand is passed beneath the testicle which is forced up into the wound; then the thumb and forefinger of the right hand separate the vein, the artery and the cord, and their tunic from the one above them. Any little membranes in the way are divided with a scalpel until now the entire tunic comes into view. After cutting away what has to be excised, and replacing the testicle, a rather broad strip is to be pared off from the edges of the wound in the groin, so that by making the wound broader it may form more flesh.

> Latin: 20. His propositis ad singulas species ueniendum est. Ac si cui paulo puero intestinum descendit, ante scalpellum experienda uinctura est. Fascia eius rei causa fit, cui ⟨im⟩o loco pila adsuta est ex panniculis facta, quae ad repellendum intestinum ipsi illi subicitur; deinde reliqua fasciae pars arte circumdatur; sub quo saepe et intus conpellitur intestinum et inter se tunicae glutinantur. Rursus si aetas processit, multumque intestini descendisse ex tumore magno patet, adiciunturque dolor et uomitus, quae ⟨s⟩tercore ex cruditate eo delapso fere accidunt, scalpellum adhiberi sine pernicie non posse manifestum est: leuandum tantummodo malum et per alias curationes extrahendum est. Sanguis mitti ex brachio debet; deinde, si uires patiuntur, inperanda tridui abstinentia est; si minus, certe pro ui corporis quam longissima. Eo uero tempore superhabendum cataplasma ex lini semine, quod ante aliquis ex mulso decoxerit. Post haec et farina hordiacia cum resina inicienda, et is demittendus in solium aquae calidae, cui oleum quoque adiectum sit; dandumque aliquid cibi lenis calidi. Quidam etiam aluum ducunt; id deducere aliquid in scrotum potest, educere ex eo non potest. Per ea uero, quae supra scripta sunt, leuato malo, si quando alias dolor reuerterit, eadem mod⟨o⟩ ualere q⟨uae⟩ n⟨oui⟩m⟨us⟩ erunt facienda. Si⟨n⟩e dolore quoque si multa intestina prolapsa sunt, secari superuacuum est, non quo non excludi a scroto possint, nisi tamen inflammatio prohibuit, sed quo repulsa inguinibus inmorentur ibique tumorem excitent, atque ita fiat mali non finis sed mutatio. ⟨At⟩ in eo, quem scalpello curari oportebit, simul atque ad mediam tunicam uulnus in inguine factum peruenerit, du⟨o⟩bus hamulis ea iuxta ipsas oras adprehendi debebit, cum deductis omnibus membranulis medicus eam liberet. Neque enim cum periculo laeditur, quae excidenda est, cum intestinum esse nisi sub ea non possit. Vbi deducta autem erit, ab inguine usque ad testiculum incidi debebit sic, ne is ipse laedatur; tum excidi. Fere tamen hanc curationem puerilis aetas et modicum malum recipit. Si uir robustus est maiusque id uitium est, extrahi testiculus non debet, sed in sua sede permanere. Id hoc modo fit. Inguen eadem ratione usque ad mediam tunicam scalpello aperitur, eaque tunica eodem modo duobus hamis excipitur sic, ut a ministro testiculus eatenus contineatur, ne per uulnus exeat; tum ea tunica deorsum uersus scalpello inciditur, sub ea index digitus sinistrae manus ad imum testiculum d⟨e⟩mittitur, eumque ad plagam conpellit; deinde dextrae manus duo digiti, pollex atque index, uenam et arteriam et neruum tunicamque eorum a superiore tunica deducunt. Quod si aliquae membranulae prohibent, scalpello resoluuntur, donec ante oculos tota iam tunica sit. Excisis, quae excidenda sunt, repositoque testiculo, ab ora quoque eius uulneris, quod ⟨in⟩ inguine est, demenda habenula paulo latior est, quo maior plaga sit et plus creare carni⟨s⟩ possit.

[¶2] 21. 21 But if omentum comes down, the groin is to be cut into as described above, and the tunics drawn down. Then it must be considered whether the mass is rather large or only small. For when quite small the omentum may be pushed back beyond the groin into the abdominal cavity, either with the finger, or with the opposite end of a probe; if the mass is larger what has prolapsed from the belly should be left hanging out of the wound, and smeared with caustic medicaments until it mortifies and falls off. In this condition too some transfix the tumour with a doubly threaded needle, and tie the two ends of each thread on opposite sides, under which treatment it mortifies, but more slowly. This may, however, be hastened by smearing the omentum beyond the ligature with medicaments which eat it away but do not erode; the Greeks call them septa. Some have cut away the omentum with shears. If it is quite small, this is unnecessary; if larger, bleeding may follow, because the omentum itself is connected with blood vessels, some rather large. And although in the case of an abdominal wound, prolapsed omentum is cut away with shears after it has mortified and there is no other safe way of removing it, no precedent can be drawn from that for this case. As to the treatment of the wound when the omentum has been replaced, it should be stitched; if the quantity was large, and has been left outside to mortify, the margins should be pared as described above. But if a hydrocele occurs, in boys an incision is to be made in the groin, unless in their case too the large quantity of liquid prevents it; in men, and when there is a large amount of fluid, a scrotal incision is made. So then if the incision is in the groin, when the tunics have been drawn forwards the humour must then be evacuated there; if in the scrotum, and if the trouble is immediately beneath, there is nothing to do but to let out the fluid and cut away any membranes which are keeping it in; then the incision is washed with water to which salt or nitre has been added. If the fluid is under the middle tunic, or under the inner one, these tunics have to be brought out of the scrotal wound, and cut away.

> Latin: 21. At si omentum descendit, eodem quidem modo quo supra scriptum est, aperiendum inguen, deducendaeque tunicae sunt. Considerandum autem, maiorne is modus an exiguus sit. Nam quod paruulum est, super inguen in aluum uel digito uel auerso specillo repellendum est; si plus est, sinere oportet dependere, quantum ex utero prolapsum est, idque adurentibus medicamentis inlin⟨e⟩re, donec emoriatur et excidat. Quidam hic quoque duo lina acu tra⟨i⟩ciunt, binisque singulorum capitibus diuersas partes adstringunt, sub quo aeque sed tardius emoriatur. Adicitur tamen hic quoque celeritati, s⟨i⟩ omentum super uinculum linitur medicamentis, quae sic exedunt, ne erodant: septa Graeci uocant. Fuerunt etiam qui omentum forfice praeciderent, quod in paruolo non est necessarium; si maius est, potest profusione⟨m⟩ sanguinis facere, siquidem omentum quoque uenis quibusdam etiam maioribus inligatum est. Neque uero si discusso uentre id prolapsum forfice praeciditur, cum et emortuum sit et aliter tutius auelli non possit, inde huc exemplum ⟨transferendum⟩ est. Vulnus autem curari, si reiectum omentum est, sutura debet; si amplius fuit et extra emortum est, excisis oris, sicut supra positum est. Si uero umor intus est, incidendum est in pueris quidem inguen, nisi in his quoque id liquoris eius maior modus prohibet; in uiris uero et ubicumque multus umor subest, scrotum. Deinde si inguen incisum est, ea protractis tunicis umor effundi debet; si scrotum ⟨et⟩ sub hoc protinus uitium est, nihil aliud quam umor effundendus abscidendaeque membranae sunt, si quae eum continuerunt; deinde eluendum id ex aqua, quae uel salem adiectum uel nitrum habeat; si sub media imaue tunica, totae eae extra scrotum conlocandae excidendaeque sunt.

[¶3] 22. 22 Now a varix, when in the scrotal skin, must be burnt with finely pointed cauteries, which penetrate into the veins themselves, but so that nothing deeper than the veins is burnt; the cautery is to be applied especially where the veins form a twisted mass. Then flour which has been steeped in cold water is put on and over this the bandage I have described as suitable after anal operations. On the third day lentil meal with honey is applied: after the crusts have separated the ulcers are to be cleaned with honey, filled with rose oil, and cicatrized with dry lint. But when the veins overlying the middle tunic swell, the groin is to be incised and the tunic pressed out into the wound; from it the veins are separated by a finger or the handle of the scalpel. But at the part where they are still attached, the veins are to be tied with linen thread both above and below that part; then cut away just beyond the ligatures and the testicle replaced. But when the varix is situated upon the inner tunic, it is necessary to cut through the middle tunic; then, if but two or three veins are swollen and some part only is involved, so that most of it is still free of the disease, the same is to be done as described above, so that the veins after being ligatured on the side of the groin and testicle respectively are cut away, after which the testicle is replaced. But if the varix involves the whole of one testis, the index finger is to be passed into the wound and under the veins, so as to draw them gradually forward, and they must be brought up until the testicle of that side is level with the opposite one. Then pins are passed through the edges so that at the same time they take up the veins as well. It is done in this way: the pin perforates from without through one edge of the wound, then it is passed not through an actual vein but through its membrane, and is pushed out through this to the opposite margin of the incision. There is always a membrane between these veins, and no danger is involved, and when the pin has been fixed by a thread it holds the veins fast enough. Then whatever veins have been drawn forwards should be pushed back within the inguinal wound by the reverse end of the probe. The time to take out the pins is when the inflammation has ceased and the wound has cleaned, so that one and the same scar may bind together simultaneously both the margins of the incision and the veins. But if a varix has developed between the inner tunic and the testicle itself and its cord, there is but one method of treatment, to excise the testicle entirely. For it is now useless for generation, and always hangs down in an ugly way, while it is sometimes painful as well. But in this case also the groin is to be cut into, the middle tunic pressed out and cut away, and the inner tunic likewise. Then the cord by which the testicle is suspended is to be cut through. After this the veins and arteries towards the groin are to be ligatured with linen thread, and cut away below the ligature.

> Latin: 22. Ramex autem, si super ipsum scrotum est, adurendus est tenuibus et acutis ferramentis, quae ipsis uenis infigantur, cum eo ne amplius quam has urant; maximeque, ubi inter se implicatae glomerantur, eo ferrum id admouendum est. Tum super farina ex aqua frigida subacta inicienda est, utendumque eo uinculo, quod idoneum esse ani curationibus posui. Tertio die lenticula cum melle inponenda est; post eiectis crustis ulcera melle purganda, rosa inplenda, ad cicatricem aridis lin⟨a⟩mentis perducenda sunt. Quibus uero super mediam tunicam uenae tument, incidendum inguen est, atque tunica promenda; ab ea uenae digito uel manubriolo scalpelli separandae. Qua parte uero inhaerebunt, et a⟨b⟩ superiore ⟨et⟩ ab inferiore parte lino uinciendae; tunc sub ipsis uinculis praecidendae, reponendusque testiculus est. At ubi supra tertiam tunicam ramex insedit, mediam excidi necesse est; deinde, si duae tresue uenae tument, et ita pars aliqua obsidetur, ut maior eo uitio uacet, idem faciendum, quod supra scriptum est, ut et ab inguine et ab testiculo deligatae uenae praecidantur, isque condatur. Sin totum id ramex obsederit, per plagam demittendus digitus index erit, subiciendusque uenis sic, ut paulatim eas protrahat, eaeque adducendae, donec is testiculus par alteri fiat. Tum fibulae oris sic iniciendae, ut simul eas quoque uenas conprehenda⟨n⟩t. Id hoc modo fit: acus ab exteriore parte ora⟨m⟩ uulneris perforat; tum non per ipsam uenam sed per membranam eius emittitur per eamque in alteram oram conpellitur. Vena uulnerari non debet, ne sanguinem fundat. Membrana semper inter has uenas est, ac neque periculum adfert, et filo conprehensa illas abunde tenet. Itaque etiam satis est duas fibulas esse. Tum uenae, quaecumque protractae sunt, in ipsum inguen auerso specillo conpelli debent. Soluendi fibulas tempus inflammatione finita et purgato uulnere est, ut una simul et oras et uenas cicatrix deuinciat. Vbi uero inter imam tunicam et ipsum testiculum neruumque eius ramex est ortus, una curatio est, quae ⟨to⟩tum testiculum abscidit. Nam neque ad generationem quicquam is confert, et omnibus indecore, quibusdam etiam cum dolore dependet. Sed tum quoque inguen incidendum, media tunica promenda atque excidenda est; idem imae faciundum; neruus, ex quo testiculus dependet, praecidendus. Post id uenae et arteriae ad inguen lino deligandae et infra uinculum abscidendae sunt.

[¶4] 23. 23 Flesh also, if it ever grows between the tunics, must certainly be cut out; but it is better to make an incision through the scrotum itself. But if the cord has become indurated, the condition cannot be cured either by surgery, or by medicaments. For burning fevers and green or black vomit oppress the patients, and besides these great thirst and roughness of the tongue; and generally from the third day frothy bile is passed in a smarting motion. But the patient cannot readily either take food, or retain it; not long after the extremities grow cold, tremor arises, the hands are outstretched involuntarily; then a cold sweating on the forehead is followed by death.

> Latin: 23. Caro quoque, si quando inter tunicas concreuit, nihil dubi est, quin eximenda sit; sed id ipso scroto inciso fieri commodius est. At si neruus in⟨du⟩ruit, curari res neque ⟨manu neque⟩ medicamento potest. Vrguent enim febres ardentes et aut uirides aut nigri uomitus; praeter haec ingens sitis et linguae aspritudo; fereque a die tertio spuma⟨ns⟩ bilis aluo cum rosione redditur. At neque adsumi facile cibus neque contineri potest, neque multo post extremae partes frigescunt, tremor oritur, manus sine ratione extenduntur; deinde in fronte frigidus sudor, eumque mors sequitur.

[¶5] 24. 24 But when there is a varix actually situated in the inguinal region, if it forms a moderate swelling, a linear incision is made, if larger two incisions, and the included skin excised. Then without drawing out the testicle, as I directed to be done for cases of prolapse of the intestines, the veins are to be taken up, and ligatured where they are attached to the tunics, then cut away below the ligature knots. The treatment of the wound presents nothing novel.

> Latin: 24. Vbi uero in ipso inguine ramex est, si tumor modicus est, semel incidi, si maior, duabus lineis debet, ut medium excidatur; deinde non extracto testiculo, sicut intestinis quoque prolapsis interdum fieri docui, colligendae uenae uinciendaeque, ubi tunicis inhaerebunt, et sub his praecidendae sunt. Neque quicquam noui curatio uulneris eius requirit.

[¶6] 25. 25 From the above we pass to operations on the penis itself. And, if the glans is bare and the man wishes for the look of the thing to have it covered, that can be done; but more easily in a boy than in a man; in one in whom the defect is natural, than in one who after the custom of certain races has been circumcised; and in one who has the glans small and the adjacent skin rather ample, while the penis itself is shorter, rather than in one in whom the conditions are contrary. Now the treatment for those in whom the defect is natural is as follows. The prepuce around the glans is seized, stretched out until it actually covers the glans, and there tied. Next the skin covering the penis just in front of the pubes is cut through in a circle until the penis is bared, but great care is taken not to cut into the urethra, nor into the blood vessels there. This done the prepuce slides forwards towards the tie, and a sort of small ring is laid bare in front of the pubes, to which lint is applied in order that flesh may grow and fill it up. It is seen that a large enough part of the penis has been bared, if the skin is distended little or not at all, and if the breadth of the wound above supplies sufficient covering. But until the scar has formed it must remain tied, only a small passage being left in the middle for the urine. But in one who has been circumcised the prepuce is to be raised from the underlying penis around the circumference of the glans by means of a scalpel. This is not so very painful, for once the margin has been freed, it can be stripped up by hand as far back as the pubes, nor in so doing is there any bleeding. The prepuce thus freed is again stretched forwards beyond the glans; next cold water affusions are freely used, and a plaster is applied round to repress severe inflammation. And for the following days the patient is to fast until nearly overcome by hunger lest satiety excite that part. When the inflammation has ceased, the penis should be bandaged from the pubes to the corona; over the glans the plaster is applied with the other end of the probe. This is done in order that the lower part may agglutinate, whilst the upper part heals without adhering. On the other hand, if the glans has become so covered that it cannot be bared, a lesion which the Greeks call phimosis, it must be opened out, which is done as follows: underneath the foreskin is to be divided from its free margin in a straight line back as far as the frenum, and thus the skin above is relaxed and can be retracted. But if this is not successful, either on account of constriction or of hardness of the skin, a triangular piece of the foreskin is cut out from underneath, having its apex at the frenum, and its base at the edge of the prepuce. Then lint dressing and other medicaments to induce healing are put on. But it is necessary that the patient should lie up until the wound heals, for walking rubs the wound and makes it foul. Some have been accustomed to pin up the prepuce in adolescents either for the sake of the voice, or for health's sake. This is the method: the foreskin covering the glans is stretched forwards and the point for perforation marked on each side with ink. Then the foreskin is let go. If the marks are drawn back over the glans too much has been included, and the marks should be placed further forward. If the glans is clear of them, their position is suitable for the pinning. Then the foreskin is transfixed at the marks by a threaded needle, and the ends so this thread are knotted together. Each day the thread is moved until the edges of the perforations have cicatrized. When this is assured the thread is withdrawn and a fibula inserted, and the lighter this is the better. But this operation is more often superfluous than necessary.

> Latin: 25. Ab his ad ea transeundum est, quae in cole ipso fiunt. In quo si glans nuda est, uultque aliquis eam decoris causa tegere, fieri potest; sed expeditius in puero quam in uiro; in eo, cui id naturale est, quam in eo, qui quarundam gentium more circumcisus est; in eo, cui glans parua, iuxtaque eam cutis spatiosior, ⟨breuior⟩ uero ipse coles est, quam in quo contraria his sunt. Curatio autem eorum, quibus id naturale est, eiusmodi est. Cutis circa glandem prehenditur et extenditur, donec illam ipsam condat, ibique deligatur. Deinde iuxta pubem in orbe⟨m⟩ tergus inciditur, donec coles nudetur, magnaque cura cauetur, ne uel urinae iter uel uenae, quae ibi sunt, incidantur. Eo facto, cutis ad uinculum inclinatur, nudaturque circa pubem uelut circulus; eoque linamenta dantur, ut caro increscat et id impleat. * * * satisque uelamenti supra latitudo plagae praestat. Sed donec cicatrix sit, uinctum esse debet, in medio tantum relicto exiguo urinae itinere. At in eo, qui circumcisus est, sub circulo glandis scalpello deducenda cutis ab interiore colest. Non ita ⟨dolet,⟩ quia summo soluto deduci deorsum usque ad pubem manu potest; neque ideo sanguis profluet. Resoluta autem cutis rursus extenditur ultra glandem; tum multa frigida aqua fouetur, emplastrumque circa datur, quod ualentem inflammationem reprimat. Proximisque diebus e⟨i⟩ prope a fame uictus ⟨sit⟩, ne forte eam partem satietas excitet. Vbi iam si⟨ne⟩ inflammatione est, deligari debet a pube usque circulum; super glandem autem auerso * emplastro inposito induci. Sic enim fit, ut inferior pars glutinetur, superior ita sanescat, ne inhaereat. Contra si glans ita contecta est, ut nudari non possit, quod uitium Graeci phimosin ap⟨p⟩ellant, aperienda est; quod hoc modo fit: subter a summa ora cutis inciditur recta linea usque ad frenum, atque ita superius tergus relaxatum cedere retro potest. Quod si parum sic profectum est, aut propter angustias aut propter duritiem tergoris, protinus triangula forma cutis ab inferiore parte excidenda est sic, ut uertex eius ad frenum, basis in tergo⟨re⟩ extremo sit. Tum superdanda lin⟨a⟩menta sunt aliaque medicamenta, quae ad sanitatem perducant. Necessarium autem est, donec cicatrix sit, conquiescere: nam ambulatio adterendo ulcus sordidum reddit. Infibulare quoque adulescentulos, interdum uocis, interdum ualetudinis causa, quidam consueuerunt; eius haec ratio est: cutis, quae super glandem est, extenditur, notaturque utrimque a l⟨a⟩teribus atramento qua perforetur; deinde remittitur. Si super glandem notae reuertuntur, nimis adprehensum est et ultra notari debet; si glans ab is libera est, is locus idoneus fibulae est. Tum qua notae sunt, cutis acu filum ducente transuitur, eiusque fili capita inter se deligantur, cotidieque id mouetur, donec circa foramina cicatriculae fiant. Vbi eae confirmatae sunt, exempto filo fibula additur; quae quo leuior, eo melior est. Sed hoc quidem saepius inter superuacua quam inter necessaria est.

[¶7] 26. 26 Sometimes we are compelled to draw off the urine by hand when it is not passed naturally; either because in an old man the passage has collapsed, or because a stone, or a blood-clot of some sort has formed an obstruction within it; but even a slight inflammation often prevents natural evacuation; and this treatment is needed not only for men but sometimes also for women. For this purpose bronze tubes are made, and the surgeon must have three ready for males and two for females, in order that they may be suitable for every body, large and small: those for males should be the longest, fifteen finger-breadths in length, the medium twelve, the shortest nine; females, the longer nine, the shorter six. They ought to be a little curved, but more so for men, and they should be very smooth and neither too large nor too small. Then the man must be placed on his back, in the way described for anal treatment, on a low seat or couch; while the practitioner stands on his right side, and taking the penis of the male patient in his left hand, with his right hand passes the pipe into the urethra; and when it has reached the neck of the bladder, the pipe together with the penis is inclined and pushed on right into the bladder; and when the urine has been evacuated, it is taken out again. The woman's urethra is both shorter and straighter, like a nipple placed between the inner labia over the vagina, and this requires assistance no less often though it is attended by somewhat less difficulty. Sometimes too a stone slips into the urethra itself, and lodges not far from its orifice, because this becomes narrower further down. The stone should if possible be extracted either by an earscoop or by the instrument with which a stone is drawn out in the course of lithotomy. If this cannot be done, the foreskin is drawn as far forwards as possible over the glans and tied there by a thread. Then to one side of the penis a longitudinal incision is to be made and the stone taken out, after which the prepuce is released. This is done in this way so that an intact portion of skin covers the incision into the penis, and urine flows out naturally.

> Latin: 26. Res uero interdum cogit emoliri manu urinam, cum illa non redditur, aut quia senectute iter eius conlapsum est, aut quia calculus uel concretum aliquid ex sanguine intus se opposuit; a⟨t⟩ mediocris quoque inflammatio saepe eam reddi naturaliter prohibet: idque non in uiris tantummodo sed in feminis quoque interdum necessarium est. Ergo aeneae fistulae fiunt, quae ut omni corpori, amplior⟨i⟩ minorique, sufficiant, ad mares tres, ad feminas duae medico habendae sunt: ex uirilibus maxima decem et quinque est digitorum, media duodecim, minima nouem: ex mulie⟨b⟩ribus maior nouem, minor sex. Incuruas uero esse eas paulum, sed magis uiriles oportet, leuisque admodum ac neque nimis plenas ⟨ne⟩que nimis tenues. Homo tum resupinus eo modo, quo in curatione ani figuratur, super subsellium aut lectum conlocandus est. Medicus autem a dextro latere ⟨s⟩inistra quidem manu colem masculi continere, dextra uero fistulam demittere in ⟨i⟩ter urinae debet; atque ubi ad ceruicem uesicae uentum est, simul cum cole fistulam inclinatam in ipsam uesicam conpellere, eamque urina reddita recipere. Femina breuius urinae ⟨i⟩ter et rectius habet, quod mammulae simile inter imas oras super naturale positum non minus saepe auxilio eget, aliquanto minus difficultatis exhi⟨bet⟩. Nonnumquam etiam prolapsus in ipsam fistulam calculus, quia subinde ea extenuatur, non longe ab exitu inhaerescit. Eum, si fieri potest, oportet euellere uel oriculario specillo uel eo ferramento, quo in sectione calculus protrahitur. Si id fieri non potuit, cutis extrema quam plurimum adtrahenda et condita glande lino uinc⟨i⟩enda est; deinde a latere recta plaga col⟨e⟩s incidendus, et calculus eximendus est, tum cutis remittenda.

[¶8] Now that mention has been made of the bladder and of stone, this seems the proper place to describe what treatment is to be adopted in cases of calculus, when it is impossible otherwise to afford relief; but it is most inadvisable to undertake it hastily, since it is very dangerous. This operation is not suitable for every season or at any age or for every lesion, but it must be used in the spring alone, in a boy who is not less than nine years of age and not more than fourteen, and if the disease is so bad that it cannot be relieved by medicaments, or endured by the patient without shortly bringing his life to a close. Sometimes even a rash line of treatment is successful, but it generally disappoints, especially in this sort of case, where the types and seasons of danger are very numerous, and these I will describe along with the treatment itself. Therefore when it has been decided to make trial of this last resource, for some days beforehand the patient's body is to be prepared by dieting, so that he takes a moderate amount of food which is wholesome, and not glutinous, and drinks water. Meanwhile he should also take walking-exercise to encourage the stone to descend to the neck of the bladder. Whether this has happened is recognized by the insertion of the finger, as I shall point out in the course of the treatment. When that is assured and the boy has been kept fasting from the previous day, then the operation is carried out in a warm room, and in the following manner. A strong and well-trained man, seated on a high stool, seizes the boy from behind and draws him backwards until his buttocks rest on the man's knees. When the boys' legs have been drawn up, the man orders him to put his hands behind his knees, and to pull upon them as much as he can, and at the same time the man keeps them in this position. But if a stronger person is to be treated, two strong men are seated on stools, side by side, and both the stools and the adjacent legs of the men are lashed together, so that they cannot be separated. Then the patient is seated in the same way as above upon the knees of the two men; and according to their position, one man takes hold of the patient's left leg, the other of the right, whilst at the same time the patient pulls upon his own hams. Whether one or two men hold the patient, they press downwards with their chests upon the patient's shoulders. Hence it results that the hollow between the iliac regions above the pubes is outstretched without any folds, and as the bladder is crammed into a narrow space the calculus can easily be seized hold of. In addition, moreover, two strong men should be put to stand at the sides, and they by standing there prevent the man or men who holding the boy from slipping. Then the surgeon having carefully pared his nails and anointed his left hand, gently introduces two fingers, the index and the middle, first one and then the other, into the anus; next he places the fingers of his right hand upon the hypogastrium, but lightly, lest if the two sets of fingers should press around the calculus with any force, the bladder may be injured. And in this procedure we must not act with haste, as in most cases, but so that safety is the first consideration; for an injury to the bladder causes spasm with danger of death. And the stone is first sought for about the neck of the bladder; when found there it is expelled with less trouble. And this is why I said there should be no operation except when the stone has been recognized by its special signs. But if the stone is not found at the neck of the bladder, or if it has slipped backwards, the fingers are placed against the base of the bladder, while the surgeon's right hand too is placed above the stone and gradually follows it downwards. When the stone has been found, and it must fall between his hands, it is guided downwards with special care the smaller and the smoother it is, lest it escape. This is that the bladder may not be too often disturbed. Therefore the right hand of the surgeon is always kept above the stone whilst the fingers of the left press it downwards until it arrives at the neck of the bladder: and it must be pressed towards this so that if oblong, it comes out end on; if flat it lies crossways; if cubical, it rests on two of its angles; if any part is larger, the smaller part comes out first. In the case of a spherical stone, it is clear that the shape makes no difference, except that if any part is the smoother this should be in front. When the stone has now got there, then the skin over the neck of the bladder next the anus should be incised by a semilunar cut, the horns of which point towards the hips; then a little lower down in that part of the incision which is concave, a second cut is to be made under the skin, at a right angle to the first, to open up the neck of the bladder until the urinary passage is opened so that the wound is a little larger than the stone. For those who make a small opening for fear of a fistula, which in this situation the Greeks call rhyas, incur this same danger to a greater degree, because the stone, when it is pressed down with force, makes a way out for itself unless it is given one. And this is even more harmful if the shape of the stone or its roughness has caused any additional trouble. As a consequence bleeding and spasm may be set up. And even if the patient survives he will have, nevertheless, a much wider fistula if the neck of the bladder has been torn, than he would have had if it had been cut. Now when the urethra has been laid open, the stone comes into view; its colour is of no importance. If it is small, it can be pushed outwards with the fingers on one side, and extracted by those on the other. If large, we must put over the upper part of it the scoop made for the purpose. This is thin at the end, beaten out into a semicircular shape, smooth on the outer side, where it comes into contact with the body, rough on the inner where it touches the stone. The scoop must be rather long, for a short one has not the strength to extract. When the scoop has been put in, it should be moved to each side to see whether the stone is held, because if it has been well grasped, it is moved with the scoop. This is required lest when the scoop begins to be drawn forward, the stone should slip inwards and the scoop cut into and lacerate the wound opening, and I have noted above how dangerous this is. When it is certain that the stone is sufficiently held, almost simultaneously a triple movement is to be made; first towards each side, then outwards, this in such a way that the movement is gentle and the stone is at first drawn outwards but little; this done the one end is to be raised so that the scoop may stay further in, and more easily draw out the stone. But if at any time the stone cannot be properly caught from above, it will have to be taken hold of from one side. This is the simplest method of operation. But various contingencies call for some further observations. There are some stones which are not merely rough but also spinous, which if they have come down to the neck of the bladder of their own accord may be extracted without any danger. But it is not safe to search for these within the bladder and draw them out, for when they have wounded the bladder they cause a speedy death from spasm, and much more so if a spinous stone sticks to the bladder, and when being drawn down has folded it over. Now it may be inferred that the stone is at the neck of the bladder, when the patient has difficulty in passing water: or that the stone is spinous, when he passes bloody urine in drops. And it is most important that the calculus should be felt under the fingers, and that the operation should not be proceeded with unless this is assured. And then too the fingers must be applied gently, lest they wound by pressing forcibly: the incision is then made. Many use a scalpel here also. Since this is rather weak, and may meet some projecting part of the stone, and while cutting the flesh over the projection fail to divide what is in the hollow beneath, but leave something which necessitates a second operation. Meges made a straight blade, with a wide border on its upper part, semicircular and sharp below. This knife, with its handle grasped between the two fingers, index and middle, and the thumb put into the back of the blade, was so pressed down that any projection upon the stone might be cut through along with the flesh. By this means it followed that he made one opening of a sufficient size. But in whatever way the neck of the bladder is laid open, any rough stone should be extracted gently, and no force used to hasten matters.

> Latin: Sic enim fit, ut incisum colem integra pars cutis contegat, et urina naturaliter profluat. Cum uesicae uero calculique facta mentio sit, locus ipse exigere uidetur, ut subiciam, quae curatio calculosis, cum aliter succurri non potest, adhibeatur: ad quam festinare cum praeceps sit, nullo modo conuenit. Ac neque omni tempore neque in omni aetate neque in omni uitio id experiundum est, sed solo uere, in eo corpore, quod iam nouem annos, nondum quattuordecim excessit, et si tantum mali est, ut neque medicamentis uinci possit, neque ⟨i⟩am trahi posse uideatur, quo minus interposito aliquo spatio interemat. Non quo non interdum etiam temeraria medicina proficiat, sed quo saepius utique in hoc fallat, in quo plura et genera et tempora periculi sunt; quae simul cum ipsa curatione proponam. Igitur, ubi ultima experiri statutum est, ante aliquot diebus uictu corpus praeparandum est, ut modicos, ut salubres cibos, ut minime glutinosos adsumat; ut aquam bibat. Ambula⟨ndi uero inter haec exercita⟩tione utatur, quo magis calculus ad uesicae ceruicem descendat. Quod an inciderit, digitis quoque, sicut in curatione docebo, demissis cognoscitur. Vbi eius rei fides est, pridie is puer ⟨in ieiunio continendus, et⟩ tum loco calido curatio adhibenda; quae hoc modo ordinatur: homo praeualens et peritus in sedili alto considit; supinumque eum et auersum, super genua sua coxis eius conlocatis, conprehendit; reductisque eius cruribus ipsum quoque iubet, manibus ad suos poplites datis, eos quam maxime possit adtrahere, simulque ipse sic eos continet. Quod si robustius corpus eius est, qui curatur, duobus sedilibus iunctis duo ualentes insidunt, quorum et sedilia et interiora crura inter se deligantur, ne diduci possint. Tum is super duorum genua eodem modo collocatur; atque alter, prout consedit, sinistrum crus eius, alter dextrum, simulque ipse poplites suos adtrahit. Siue autem unus, siue duo continent, super umeros eius suis pectoribus incumbunt. Ex quibus euenit, ut inter ilia sinus super pubem sine ullis rugis sit extentus et in angustum conpulsa uesica e⟨x⟩ fac⟨ili⟩ calculus capi possit. Praeter haec etiamnum a l⟨a⟩teribus duo ualentes obiciantur, qui circumstantes lab⟨a⟩re uel unum uel duos, qui puerum contine⟨n⟩t, non sinunt. Medi⟨c⟩us deinde, diligenter unguibus circumcisis, un⟨c⟩ta⟨q⟩ue sinistra manu duos eius digitos, indicem et medium, leniter prius unum, deinde alterum in anum eius demittit; dextraeque digitos super imum abdomen leuiter inponit, ne, si utrimque digiti circa calculum uehementer concurrerint, uesicam laedant. Neque uero festinanter in hac re, ut in plerisque, agendum est, sed ita, ut quam maxime id tuto fiat: nam laesa uesica neruorum distentiones cum periculo mortis excitat. A⟨c⟩ primum circa ceruicem quaeritur calculus, ubi repertus minore negotio expellitur. Et ideo dixi ne curandum quidem, nisi cum hoc indiciis suis cognitum est. Si uero aut ibi non fuit aut recessit retro, digiti ad ultimam uesicam dantur, paulatimque dextra quoque manus eius ultra translata subsequitur. Atque ubi repertus calculus, qui necesse est in manus incidat, eo curiosius deducitur, quo minor leuiorque est, ne effugiat. [id est ne saepius agitanda uesica sit.] Ergo ultra calculum dextra semper manus eius ⟨se⟩ opponit, sinistrae digiti deorsum eum conpellunt, donec ad ceruicem peruenitur: in quam, si oblongus est, si⟨c⟩ compellendus est, ut pronus exeat; si planus, sic ut transuersus sit; si quadratus, ut duobus angulis sedeat; si altera parte plenior, sic ut prius ea, qua tenuior sit, euadat. In rotundo nihil interesse ex ipsa figura patet, nisi si le⟨u⟩ior altera parte est, ut ea antecedat. Cum iam eo uenit, t⟨um⟩ incidi super uesicae ceruicem iuxta anum cutis plaga lunata usque ad ceruicem uesicae debet, cornibus ad coxas spectantibus: paulum deinde ⟨infra⟩ ea parte, qua resima plaga est, etiamnum sub cute altera transuersa plaga facienda est, qua ceruix aperi⟨a⟩tur, donec urinae iter pateat sic, ut plaga paulo maior quam calculus sit. Nam qui metu fistulae, quam illo loco ⟨r⟩hyada Graeci uocant, parum patefaciunt, maiore eodem periculo reuoluuntur, quia calculus iter, cum ui promitur, facit, nisi accipit; idque etiam perniciosius est, si figura quoque calculi uel aspritudo aliquid eo contulit. Ex quo et sanguinis profusio et distentio neruorum fieri potest. Quae si quis euasit, multo tamen patentiorem fistulam habiturus est rupta ceruice, quam habuisset incisa. Cum uero ea patefacta est, in conspectu⟨m⟩ calculus uenit; in cuius colore nullum discrimen est. Ipse si exiguus est, digitis ab altera parte propelli, ab altera protrahi potest. Si maior, iniciendus a superiore ⟨ei⟩ parte uncus est eius rei causa factus. Is est ad extremum tenuis, in semicirculi specie⟨m⟩ retusae latitudinis, ab exteriore parte leuis, qua corpori iungitur, ab interiore asper, qua calculum adtingit isque longior potius esse debet: nam breuis extrahendi uim non habet. Vbi iniectus est, in utrumque latus inclinandus est, ut appareat calculus ⟨si⟩ teneatur; quia, si adprehensus est, ille simul inclinatur. Idque eo nomine opus est, ne, cum adduci uncus coeperit, calculus intus effugiat, hic in oram uulneris incidat eamque conuulneret: in qua re quo⟨d⟩ periculum esse⟨t⟩, iam supra posui. Vbi satis teneri calculum patet, eodem paene momento triplex motus adhibendus est: in utrumque latus, deinde extra, sic tamen id leniter ut fiat paulumque primo calculus adtrahatur. Quo facto, attollendus un⟨c⟩us extremus est, uti intus magis maneat faciliusque illum producat. Quod si quando a superiore parte calculus parum commode conprehendetur, a latere erit adprehendendus. Haec est simpli⟨ci⟩ssima curatio. Sed uarietas rerum quasdam etiamnum animaduersiones desiderat. Sunt enim quidam non asperi tantummodo sed spi⟨no⟩ssi quoque calculi, qui per se quidem delapsi in ceruicem sine ullo periculo eximuntur. In uesica uero non tuto uel hi conquiruntur uel adtrahuntur, quoniam ubi illam conuulnerarunt, ex distentione neruorum mortem maturant; multoque magis, si spina aliqua uesicae inhaeret eamque, cum duceretur, duplicauit. Colligitur autem eo, quod difficilius urina red⟨d⟩itur, in ceruice calculum esse; eo, quod cruenta destillat, eum esse spinosum; maximeque sub his digitis quoque experiundum est, neque adhibenda manus, nisi id constitit. Ac tum quoque leniter ⟨intus digiti obiciendi, ne ualenter⟩ promouend⟨o⟩ conuolnerent; tum incidendum. Multi hic quoque scalpello usi sunt. Meges quoniam is infirmior est potestque in aliqua prominentia incidere, inciso[q]ue super illa corpore qua cauum subest, non secare, sed relinquere quod iterum incidi necesse sit, ferramentum fecit rectum, in summa parte labrosum, in ima semicirculatum acutumque. Id receptum inter duos digitos, indicem ac medium, super pollice inposito, sic deprimebat, ⟨ut⟩ simul cum carne, si quid ex calculo prominebat, incidere⟨t⟩. Quo consequebatur, ut semel quantum ⟨satis⟩ esset, aperiret. Quocumque autem modo ceruix pa⟨t⟩efacta est, leniter extrahi quod asperum est debet, nulla propter festinationem ui admota.

## 30. Book VII · chapters 26–33

Source: https://scriptura.si/works/celsus-on-medicine/30/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/30/#p-N

[¶0] A sandy stone is made evident before the operation by the sandy urine which is passed, and in the course of it, since it does not present a uniform resistance to the fingers in the rectum, and in addition it breaks up. Again soft stones and those composed of numerous small ones which only lightly adhere together, are indicated when the urine shows scalelike particles. All these should be brought out gently by changing as before the position of the fingers in turn, without injury to the bladder, yet so as not to leave behind in it any scattered remnants which will render the after-treatment difficult. When anything of this kind comes into view it is to be extracted by the fingers or scoop. And if there are several stones they are to be extracted one by one, but if a very small stone remains over it had better be left. For it is difficult to find it in the bladder, or when found it easily escapes again. In such a prolonged search the bladder is injured and fatal inflammations set up; so that some who have not been operated on have died after the bladder has been for a long while and in vain pushed about by the fingers. There is the additional reason that a small stone is later moved forward with the urine into the wound and so removed. If, however, at any time the stone appears too large to extract without tearing the neck of the bladder, it is to be split up; hence Ammonius the inventor of this process was surnamed lithotomus. This is done as follows: the scoop is passed over the stone, so that it easily keeps hold of the stone, even when it is struck; next an instrument is used of moderate thickness, its front end tapering yet blunt, and when this is put against the calculus, and its other end struck, it splits up the stone, great care being taken that the instrument does not come into contact with the bladder itself, and that no fragment from the broken calculus cuts into it.

> Latin: At calculus harenosus et ante manifestus est, quoniam e⟨o⟩ urina quoque redditur harenosa, et in ipsa curatione, quoniam inter subiectos digitos neque aeque renititur et insuper dila⟨bi⟩tur. Item molles calculos et ex pluribus minutisque sed inter se parum adstrictis compositos indicat urina trahens quasdam quasi squamula⟨s⟩. Hos omnes leniter permutatis subinde digitorum uicibus sic oportet adducere, ne uesicam laedant neue intus aliquae dissipatae reliquiae maneant, quae postmodo curationi difficultatem faciant. ⟨Quic⟩quid autem ex his in conspectum uenit, uel digitis uel unco eximendum est. Ac si plures calculi sunt, singuli protrahi debent, sic tamen ⟨ut,⟩ si quis exiguus supererit, potius relinquatur. Siquidem in uesica difficulter inuenitur, inuentusque celeriter effugit. Ita longa inquisitione uesica laeditur, excitatque inflammationes mortiferas, adeo ut quidam non secti, cum diu frustraque per digitos uesica esset agitata, decesserint. Quibus accedit etiam, quod exiguus calculus ad plagam urina postea promouetur et excidit. Si quando autem is [maior] non uidetur nisi rupta ceruice extrahi posse, findendus est: cui⟨u⟩s repertor Hammonius ob id litho⟨to⟩mos cognominatus est. Id hoc modo fit: uncus inicitur calculo sic, ut facile eum concussum quoque tene⟨a⟩t, ne is retro reuoluatur; tum ferramentum adhibetur crassitudinis modicae, prima parte tenu⟨i⟩ sed retus⟨a⟩; quod admo⟨t⟩um calculo ex altera parte ictu eum findit, magna cura habita, ne aut ad ipsam uesicam ferramentum perueniat, aut calculi fractura ne quid incidat.

[¶1] Now these operations are similar in females too, yet there are some particulars to be mentioned about them. Since in women when the stone is small, the use of the knife is unnecessary because the stone is forced by the urine into the neck of the bladder which is shorter and more yielding in females than in males. Therefore the stone often escapes of itself, and if it sticks in the first part, which is narrower, yet it may be extracted by the scoop described above without any harm. But for larger stones the treatment is the same. Except that in the case of a virgin the fingers are passed as in males, in the case of a woman into the vagina. Then the incision is to be made in a virgin just under the left labium, in a woman between the urethra and pubic bone, and in both instances by a transverse wound. There is no need to be frightened if there is freer bleeding from a woman.

> Latin: Hae uero curationes in feminis quoque similes sunt, de quibus tamen [parum] proprie quaedam dicenda sunt. Siquidem in his, ubi paruolus calculus est, scalpellus superuacuus est, quia is urina ⟨in⟩ ceruicem compellitur, quae et †in breuior quam in maribus et laxior est. Ergo ⟨et⟩ per se saepe excidit, et si in primo, quod est angustius, inhaeret, eodem tamen unco sine ulla noxa educitur. At in maioribus calculis necessaria eadem ⟨cu⟩ratio est. Sed uirgini subire digiti qua masculo, mulieri per naturale eius debent. Tum uirgini quidem sub ima sinisteri⟨ore⟩ ora, mulieri uero inter urinae iter et os pubis incidendum est sic, ut utroque loco plaga ⟨i⟩st⟨a⟩ transuersa sit; neque terreri conuenit, si plus ex muliebri corpore sanguinis profluit.

[¶2] When the stone has been extracted, if the patient is strong and has not suffered excessively, it is well to let the bleeding go on, so that less inflammation may follow. Besides it is not unfitting for him to move about a little, in order that any blood clot still inside may drop out. But if again the bleeding does not cease of its own accord, it must be stopped lest all his strength be used up; and in weaker patients this is to be done immediately after the operation; since just as there is the risk of spasm from pushing about the bladder, so there is a second danger that in the absence of medicaments so much blood may be lost as to prove fatal. To prevent this the patient should be seated in a bath of strong vinegar to which a little salt has been added; under this treatment the bleeding generally stops, and it also has an astringent effect on the bladder so that the inflammation there is lessened. But if this is not successful, cups are to be applied on groins and hips and above the pubes. As soon as sufficient blood has been drawn away or the bleeding checked, the patient should be so placed on his back that his head is low, his hips a little raised; and two or three layers of linen soaked in vinegar are to be applied over the wound. Then after two hours he should be put into a hip bath and lean back in the hot water, so that the water covers him from his knees to his navel, while the rest of his body is wrapped up, except that his hands and feet are exposed, in order that he may be less exhausted and remain in the bath longer: the usual result is free sweating. And his mouth and face must be wiped with a sponge from time to time, and an end put to this hot bath whenever it becomes harmful by weakening the patient. Afterwards the patient is freely rubbed with oil, and a dressing of soft wool applied, soaked in warm oil, covering the pubes and hips and groins as well as the wound itself, which had previously been covered with a similar dressing, but of lint. From time to time this dressing is to be saturated with the warm oil in order that cold may not reach the bladder, and that the sinews may be gently softened. Some make use of heating plasters; these do more harm by their weight pressing upon the bladder, and by irritating the wound, than they do good by their heating. For the same reason not even a bandage is required. On the next day if there is difficulty in breathing, if urine is not passed, if the region about the pubes swells prematurely it may be recognized that a blood clot has collected in the bladder; for this the fingers are introduced into the rectum as before and the bladder stroked gently so as to break up clots; thus they subsequently escape by the wound. It is not inappropriate to inject vinegar mixed with soda into the bladder through the wound by means of an ear syringe, for in this way also clotted blood is broken up; and it is proper to do this even on the first day if we are afraid that there is a clot inside, especially when weakness prevents the patient from moving about to eliminate it. The treatment afterwards is the same, sitting in a hot bath, a pad and wool prepared as before as dressings. But a boy should not be put so often into the hot water nor kept in so long as an adolescent; a weak patient as a robust one; one with a slight inflammation as one severely inflamed; a patient with a relaxed body as one in good tone. Meanwhile, if the patient sleeps and breathes regularly and his tongue is moist and there is only moderate thirst and the hypogastrium is flat, if there is not much pain and but moderate fever, we may assume that the treatment is doing well. In such cases the inflammation generally ends on the fifth or seventh day; when it has passed off, the hip bath becomes unnecessary; whilst the patient is on his back the wound is just to be fomented enough with hot water to wash away any urine that irritates. Now the medicaments to be applied should be suppuratives, and if the wound seems to need cleaning, it is to be smeared with honey, or if that irritates it can be tempered with rose oil. The nine-drug plaster seems the most suitable at this stage of the treatment for it contains both suet as a suppurative, and honey to clean the wound, also marrow, best from a calf; its contents are particularly efficient in preventing the establishment of a fistula. But lint at this period is not to be applied directly to the wound, but it may be properly put on over medicaments to keep them in place. When, however, the wound is clean, it is to be healed by applying plain lint. During this period, however, when the course of the treatment has not gone well, various dangers arise. These may be expected: if there is persistent insomnia, laboured breathing, a dry tongue, great thirst, a distended hypogastrium; if the wound gapes; if the urine as it escapes does not irritate the wound; if there is some livid discharge by night and day alike before the third day; if the patient does not answer or replies slowly; if there are severe pains; if after the fifth day high fever oppresses the patient and a distaste for food persists; if he finds more ease by lying on his stomach. But the worst complication is spasm of the sinews and bilious vomiting before the ninth day. But when there is danger of inflammation the best treatment is by abstinence, food in small quantities and at stated intervals, and at the same time fomentations and the other things described above.

> Latin: Calculo euolso, si ualens corpus est neque magnopere uexatum, sinere oportet sanguinem fluere, quo minor inflammatio oriatur. Atque ingredi quoque eum paulum non alienum est, ut excidat, si quid intus concreti sanguinis mansit. Quod si per se non destitit, rursus, ne uis omnis intereat, subprimi debet; idque protinus ⟨in⟩ inbecillioribus ab ipsa curatione faciendum est: siquidem, ut distentione neruorum periclitatur aliquis, dum uesica eius agitatur, sic alter metus excipi⟨t⟩, [⟨re⟩motis medicaminibus] ne tantum sanguinis profluat, ut occidat. Quod ne incidat, desidere is debet in acre acetum, cui aliquantum salis sit adiectum; sub quo et sanguis fere conquiescit, et adstringitur uesica, ideoque minus inflammatur. Quod si parum proficit, adglutinanda cucurbitula est et inguinibus et coxis et super pubem. Vbi iam satis uel euocatus est sanguis uel prohibitus, ⟨r⟩esupinus ⟨is⟩ collocandus est sic, ut caput humile sit, coxae paulum excitentur; ac super ulcus inponendum est duplex aut triplex linteolum aceto madens. Deinde interpositis duabus horis in solium is aquae calidae resupinus d⟨e⟩mittendus est sic, ut a genibus ad umbilicum aqua teneat, cetera uestimentis circumdata sint, manibus tantummodo pedibusque nudatis, ut et minus digeratur et ibi diutius maneat: ex quo multus sudor oriri solet. ⟨At⟩qu⟨e⟩ os spongia subinde ⟨et⟩ facie⟨m⟩ detergendum est, finisque eius fomenti est, donec infirmando offendat. Tum multo is oleo perunguendus, inducendusque absus lanae mollis tepido oleo repletus, qui pubem et coxas et inguina et plagam ipsam—contectam †eodem ante sed linteolo—protegat; isque subinde oleo tepido madefaciendus est, ut neque frigus ad uesicam admittat et neruos leniter molliat. Quidam cataplasmatis calfacientibus utuntur; ea plus pondere nocent, quo uesicam urguendo uulnus inritant, quam c⟨a⟩lore proficiunt. Ergo ne uinculum quidem ullum necessarium est. Proximo die, si spiritus difficilius redditur, si urina non excedit, si locus circa pubem mature intumuit, scire licet in uesica sanguinem concretum remansisse: igitur, demissis eodem modo digitis, leuiter pertractanda uesica est, et discutienda, si qua coierunt; quo fit, ut per uulnus postea procedant. Non alienum est etiam oriculario clystere acetum nitro mixtum per plagam in uesicam conpellere: nam sic quoque discutiuntur, si qua cruenta coierunt; eaque facere etiam primo die conuenit, si timemus, ne quid intus sit, maximeque ubi ambulando id elicere inbecillitas prohibuit. Cetera eadem facienda sunt, ut demittatur in solio, ut eodem modo panniculus, e⟨o⟩dem ⟨ulceri⟩ lana superiniciatur. Sed neque saepe neque tam diu in aqua calida puer habendus quam adulescens est, infirmus quam ualens, leui quam grauiore inflammatione adfectus, is cuius corpus diger⟨i⟩tur quam is cuius astrictum est. Inter haec uero, si somnus est et aequalis spiritus et madens lingua et sitis modica et uenter imus ⟨sedet⟩, si mediocris est cum febre modica dolor, scire licet recte curationem procedere. Atque in his inflammatio fere quinto uel septimo die finitur; qua leuata solium superuacuum est. Supini tantummodo uulnus aqua calida fouendum est, ut, si quid urinae rodit, eluatur. Inponenda autem medicamenta sunt pus mouentia, et si purgandum ulcus uidebitur, melle inlinendum: id si rodet, rosa temperabitur. Huic curationi aptissimum uidebitur enneapharmacum emplastrum: nam et sebum habet ad pus mouendum et mel ad ulcus repurgandum, medulla⟨m⟩ etiam maximeque uitulina⟨m⟩; quod in id, ne fistula relinquatur, praecipue proficit. Linamenta uero tum super ulcus non sunt necessaria: super medicamentum ad id continendum recte inponuntur. At ubi ulcus purgatum est, puro linamento ad cicatricem perducendum est. Quibus temporibus tamen, si felix curatio non fuit, uaria pericula oriuntur. Quae praesagire protinus licet: si continua uigilia est, si spiritus difficultas; si lingua arida est, si sitis uehemens; si uenter imus tumet; si uulnus hiat, ⟨si⟩ transfluens urina id non rodit, * * * similiter ⟨ante⟩ tertium diem quaedam liuida excedunt; si is aut nihil aut tarde respondet; si uehementes dolores, si post diem quintum magnae febres urguent et fastidium cibi permanet, ⟨si⟩ cuba⟨re⟩ in uentrem iucundius est. Nihil tamen peius est distentione neruorum et ante diem nonum uomitu bilis. Sed cum inflammation⟨is⟩ sit metus, succurri abstinentia, modicis et tempestiuis cibis, inter haec fomentis, et quibus supra scripsimus, oportet.

[¶3] 27. 27 The nearest danger is canker. This is recognized if the discharge, whether from the wound, or through the penis, is a malodorous sanies, also something of the nature of blood-clot, and thin bits of flesh like flocks of wool; and in addition to this if the margins of the wound become dry; if there is pain in the groins; if the fever does not subside and it increases at night, if there are irregular shivering-fits as well. We must examine in what direction the canker is spreading. If to the penis, that part becomes hard and red and is painful to the touch, and the testicles swell; if into the bladder itself, anal pain follows, the hips harden, the legs cannot be easily stretched. But if to either side, this fact is clear to the eyes, and the gangrene shows the same marks on both sides, but smaller on that less affected.— But first it is important that the patient shall lie properly, that is, that the same part should always be uppermost and that that should be the part where the disease is spreading. Thus if the direction is into the penis, the patient is laid on his back; if into the bladder, on his belly; if into one side, then he lies on the more sound one. Coming to the treatment, the man should be placed in a bath containing a decoction of horehound or of cyprus or of myrtle; and the same fluid boiled is injected into the wound with a syringe; then is put on a plaster of lentils with pomegranate rind, both of which have been boiled in wine, or a similar decoction of blackberry, or of olive leaves, or of other material which I have set out as suitable for arresting and cleaning wounds affected by canker. Dry medicaments of this sort may be blown in through a quill. When the gangrene begins to come to a standstill, the wound is washed with honey wine, but at this stage a cerate should be avoided, for by softening the tissues it predisposes to that very malady: we must rather smear on washed lead with wine, over that the same spread on linen. By such measures it is possible to effect a cure, but we must not ignore the fact that when canker has once started, the stomach is often affected, since the bladder is closely associated with it; hence, it happens that food is not kept down, or when it is retained, not digested, nor is the body nourished; and thus the wound cannot clean, nor gain flesh: and these facts necessarily hasten death. But while it is in no way possible to save such cases as these, yet a method of treatment should be observed from the very first for a long while, in which of course due regard must be had to food and drink. For at first only fluid food should be given; when the wound has cleaned food of the middle class; greens and salted fish are always unsuitable. The amount of drink should be moderate, for if too little is drunk, the wound becomes inflamed, the patient suffers from insomnia and gets weaker; if too much is drunk, the bladder fills frequently and so is irritated. It is too obvious to need repetition that nothing except water is to be drunk. Now it generally happens under such a diet that the bowels do not act. They are to be moved by a clyster containing either fenugreek or mallow. The same decoction mixed with rose oil is to be injected into the wound itself through an ear syringe whenever the urine causes irritation and stops the wound from cleaning. General all the urine escapes at first through the wound; then in the course of healing it divides, and part begins to pass through the penis until the wound has completely closed; and this occurs at times in the third month, at times not before the sixth month, and occasionally not for a year. And we need not despair of the firm healing of the wound, unless the neck of the bladder has been roughly ruptured, or when owing to gangrene many large portions of the flesh have sloughed away and some fibrous tissue too. But the greatest care must be taken that no fistula, or only a very small one, is left there. With this object as the wound tends to form a scar, the patient should lie with his thighs and legs stretched out, except only when the stones have been soft and sandy: for then the bladder is slower in cleaning itself: and so it is necessary to keep the wound open longer, and only when there is nothing more to come out of the bladder is the wound allowed to heal. If the margins of the wound stick together, before the bladder has been cleaned, and pain and inflammation recur, the wound should be reopened, either by the finger, or by the reversed end of a probe, in order that what is causing the pain may be let out; and after such evacuation, when for some time clear urine has passed, then at length cicatrizing applications are put on; and as prescribed above, the legs are kept extended with the feet close together as much as possible. But if there seems to be danger of a fistula, from the causes mentioned above, a leaden tube should be put into the anus to make the closing of the fistula easier, or at any rate to narrow it, whilst the legs are kept extended and the thighs and ankles tied together until the scar has assumed its final form.

> Latin: 27. Proximus cancri metus est. Is cognoscitur, si et per uulnus et per ipsum colem fluit sanies mali odoris, cumque eo quaedam ⟨a⟩ concreto sanguine non abhorrentia tenu⟨e⟩sque carunculae lanulis similes; praeter haec, si orae uulneris aridae sunt, si dolent inguina; si febris non def⟨i⟩t, eaque in noctem augetur, si inordinati horrores accedunt. Considerandum autem est, in quam partem cancer is tendat. Si ad colem, indurescit is locus et rubet et tactu dolorem excitat, testiculique intumescunt: si in ipsam uesicam, ani dolor sequitur, coxae durant, non facile crura extendi possunt. A⟨t⟩ si in alterutrum latus, oculis id expositum est, paresque utrimque easdem notas sed minores habet.—Primum autem ad rem pertinet corpus recte iacere, ut superior pars eadem semper sit * * in quam uitium fertur. Ita si ad colem it, supinus is collocari debet; si ad uesicam, in uentrem; si in latus, in id, quod integrius est. Deinde ubi uentum fuerit ad curationem, homo in aquam demittetur, in qua marrubium decoctum sit aut cupressus aut myrtus; idemque umor * clystere intus a⟨g⟩etur; tum superponetur lenticula cum malicorio mixta, quae utraque ex uino decocta sint; uel rubus aut oleae folia eodem modo decocta, aliaue medicamenta, quae ad cohibendos purgandosque cancros proposuimus. Ex quibus si qua erunt ⟨arida,⟩ per scriptorium calamum inspirabuntur. Vbi stare coeperit cancer, mulso u⟨o⟩lnus eluetur, uitabiturque eo tempore ceratum, quod ad recipiendum id malum corpus emollit: potius plumbum elotum cum uino inunguetur, superque idem linteolo inlitum inponetur. Sub quibus perueniri ad sanitatem potest, cum eo tamen quod non ignoremus orto cancro saepe adfici stomachum, cui cum uesica quaedam consortio est; exque eo fieri, ut neque retineatur cibus neque, si quis retentus est, coquatur, neque corpus alatur, ideoque ⟨ne⟩ uulnus quidem aut purgari aut ali possit; quae necessario mortem maturant. Sed ut his succurri nullo modo potest, sic a primo tamen diu tenenda ratio ⟨curatio⟩nis est; in qua quaedam obseruatio ad cibum quoque potionemque pertinens necessaria est. Nam cibus inter principia non nisi umidus dari debet: ubi ulcus purgatum est, ex media materia: holera et salsamenta semper aliena sunt. Potione opus est modica: nam si parum bibitur, accenditur uulnus, et uigilia urguet et uis corporis minuitur: si plus aequo adsumitur, subinde uesica impletur eo⟨que⟩ inritatur. Non nisi aqua⟨m autem bibendam esse manifestius est, quam⟩ ut subinde dicendum sit. Solet uero sub eiusmodi uictu euenire, ut al⟨u⟩os non reddatur. Haec aqua ducenda est, in qua uel faenum Graecum uel malua decocta sit. Idem umor rosa mixtus in ipsum uulnus oriculario clystere agendus est, ubi id rodit urina neque purgari patitur. Fere uero primo per uulnus exit hae⟨c⟩; deinde eo sanescente diuiditur, et pars per colem descendere incipit, donec ex toto plaga claudatur; quod interdum tertio mense, interdum non ante sextum, nonnumquam exacto quoque anno fit. ⟨Neque⟩ desperari debet solida glutinatio uulneris, nisi ubi aut uehementer rupta ceruix est, aut ex cancro multae magnaeque carunculae simulque neruosa aliqua exciderunt. Sed ut uel nulla ibi fistula uel exigua admodum relinquatur, summa cura prouidendum est. Ergo cum iam ad cicatricem uulnus intendit, extentis iacere feminibus et cruribus oportet, nisi tamen molles harenosiue calculi fuerunt: sub his enim tardius uesica purgatur; ideoque diutius plagam patere necessarium est ⟨et⟩ tum demum, ubi iam nihil tale extra ⟨fertur, ad cicatricem⟩ perduci. Quod si antequam uesica purgata est, orae se glutinarunt, dolorque et inflammatio ⟨re⟩dierunt, uulnus digitis uel auerso specillo diducendum est, ut torquentibus detur exitus; iisque effusis cum diutius pura urina descendat, tum demum quae cicatricem inducant ponenda sunt; extend⟨end⟩ique, ut supra posui, pedes quam maxime iuncti. Quod si fistulae metus ex is causis, quas proposui, subesse uidebitur, quo facilius cludatur ea u⟨el c⟩erte coangustetur, in anum quoque danda plumbea fistula est; extentisque cruribus femina talique inter se deligandi sunt, donec, qualis futura est, cicatrix sit.

[¶4] 28. 28 And whilst the foregoing can occur both in males and females, there are also some troubles which are peculiar to females, especially that occasionally their genitals do not allow of coitus, the orifices having coalesced. And this sometimes happens even in the mother's womb; sometimes when ulceration has occurred in those parts, and through bad treatment there the margins have become united during healing. If the condition is congenital a membrane obstructs the vulvar orifice; if due to ulceration flesh has filled the same. The membrane should be incised along two lines crossing one another like the letter X, great care being taken that the urethra is not injured; then the membrane is to be cut away all round. But if flesh has grown there, it must be laid open with a single straight cut; next when the margin has been seized either with a forceps or hook, a fine strip must be cut away from it, after which there is inserted wool rolled lengthwise (the Greeks call it lemniscus), dipped in vinegar, and over this is bandaged on greasy wool wetted with vinegar: this is changed on the third day and the wound treated like other wounds; and as soon as it begins to heal, a lead tube smeared with a cicatrizing ointment is passed in, and over this the same application applied until the cut surface has cicatrized.

> Latin: 28. Et hoc quidem commune esse et maribus et feminis potest: proprie uero quaedam ad feminas pertinent, ut in primis quod earum naturalia nonnumquam inter se glutinatis oris concubitum non ⟨ad⟩mittunt. Idque interdum euenit protinus in utero matris; interdum exulceratione in his partibus facta, et per malam curationem hi⟨c⟩ oris sanescendo iunctis. ⟨Si⟩ ex utero est, membrana ori uoluae opposita est; si ex ulcere, caro ide⟨m⟩ repleuit.—Oportet autem membranam duabus lineis inter se transuersis incidere ad similitudinem litterae X, magna cura habita, ne urinae iter uioletur, deinde undique eam membranam excidere. A⟨t⟩ si caro increuit, necessarium est recta linea patefacere; tum ab ora uel uolsella uel hamo adprensa tamquam habenulam exc⟨i⟩dere, ⟨et intus implicitum in⟩ longitudinem lin⟨a⟩mentum (lemniscum Graeci uocant) in aceto tinctum d⟨e⟩mittere, supraque sucidam lanam aceto madentem deligare; tertio die soluere ulcus et sicut alia ulcera curare; cumque iam ad sanitatem tendet, plumbeam fistulam medicamento cicatricem inducent⟨e⟩ inlin⟨e⟩re eamque intus dare, supraque idem medicamentum inicere, donec ad cicatricem plaga perueniat.

[¶5] 29. 29 Again when a woman has conceived, if the foetus, already nearly at term, dies inside and cannot get out of itself, an operation must be done, which may be counted among the most difficult; for it requires both extreme caution and neatness, and entails very great risk. But this shows, and not this only, how marvellous beyond all else is the womb. To begin with then the woman should be placed on her back across the bed, so that the iliac regions are compressed by her own thighs; by this means both her hypogastrium is in full view of the surgeon and the foetus is forced towards the mouth of the womb. This, after the death of the foetus contracts, but later on usually dilates a little. The surgeon making use of this opportunity should first insert the index finger of his greased hand, and keep it there until the mouth is opened again, and then he should insert a second finger, and the other fingers on the like opportunity, until the whole hand can be put in. To allow of this, much depends both on the size of the vagina, and the resistance of its sinewy tissues, and the patient's constitution, and also her strength of mind, especially since on occasion even both hands have to be passed in. It is also important that the hypogastrium and extremities should be kept very warm, that inflammation should not have begun, but that the treatment should be adopted without delay. For if the abdomen is already distended, the hand cannot be inserted nor can the foetus be extracted without the greatest suffering, and fatal spasm of the sinews often follows, accompanied by vomiting and tremor. But when the hand has reached the dead foetus its position is immediately felt. For it lies head on or feet foremost, or crosswise; generally, however, so that there is either a hand or foot within reach. It is the object now of the surgeon to direct it with his hand either into a head or even into a foot presentation, if it happens to be presenting otherwise: and if there is no other course, when a hand or foot is grasped, the trunk is straightened: for grasping a hand converts the presentation into a head one, grasping a foot into a foot presentation. Then if the head is nearest, a hook must be inserted which is completely smooth, with a short point, and this it is right to fix into an eye or ear or the mouth, even at times into the forehead, then this is pulled upon and extracts the foetus. But not every moment is proper for the extraction; for should this be attempted when the mouth of the womb is contracted, as there is no way out, the foetus is torn away from the hook, and its point then slips into the mouth of the womb itself; and there follows spasm of the sinews and great risk of death. Therefore whilst the mouth is contracted we should wait, and draw gently on the hook when it dilates, and so at these opportunities gradually extract the foetus. Now the right hand should pull the hook whilst the left is inserted within and pulls the foetus, and at the same time guides it. It also often happens that such a foetus is distended by fluid, and from it a foul sanies discharges. If so, the abdomen of the foetus is bored into by the index finger, when by escape of the fluid, the foetus is made smaller; then it is gently to be delivered by the hands alone. For if a hook is inserted it readily slips out of the soft little body, when the danger noted above is incurred. If the foetus has been turned to present by the feet it is also not difficult to extract; for the feet are grasped by the doctor's hands, and it is readily drawn out. But if the foetus is lying crosswise and cannot be turned straight, the hook is to be inserted into an armpit and traction slowly made; during this the neck is usually bent back, and the head turned backwards to the rest of the foetus. The remedy then is to cut through the neck, in order that the two parts may be extracted separately. This is done with a hook which resembles the one mentioned above, but has all its inner edge sharp. Then we must proceed to extract the head first, then the rest, for if the larger portion be extracted first, the head slips back into the cavity of the womb, and cannot be extracted without the greatest risk. Should this, however, happen, a folded pad is placed upon the woman's hypogastrium, and then a man strong, but not untrained, must stand on her left side, and place his two hands over the hypogastrium and press one over the other so that the head is forced to the mouth of the womb, when it must be extracted by the hook as described above. But if one foot presents whilst the other remains behind with the trunk, anything which has been drawn out must be cut away piecemeal; and if the buttocks begin to engage in the mouth of the womb they are to be pushed back and the foot of the foetus found and then drawn forwards. There are also other difficulties, which make it necessary to cut up and extract a foetus which does not come out whole. Now as soon as the foetus has been extracted it should be handed to the assistant to hold on his upturned hands, and the surgeon with his left hand must draw gently upon the navel cord, so as not to rupture it, whilst he passes his right hand along it up to what they called the secundines, which was the envelope of the foetus within the womb. When his hand has grasped the secundines including the whole of the blood vessels and membranes he brings them down from the womb in the same manner, and extracts the whole together with any retained blood clot. Then when the thighs have been tied together the woman is put to bed in a moderately warm room, which is free from draughts. Over the hypogastrium is placed greasy wool dipped in vinegar and rose oil. The rest of the treatment followed is the same as for inflammation and for wounds which are in the sinews.

> Latin: 29. Vbi conc⟨e⟩pit autem aliqua, si iam prope maturus partus intus emortus est neque excidere per se potest, adhibenda curatio est, quae numerari inter difficillima potest: nam et summam prudentiam moderationemque desiderat, et maximum periculum adfert. Sed ante omnia uuluae natura mirabilis cum in multis aliis tum in hac ⟨re⟩ quoque facile cognoscitur.—Oportet autem ante omnia resupinam mulierem transuerso lecto sic collocare, ut feminibus eius ipsius ilia conprimantur; quo fit, ut et imus uenter in conspectu medici sit ⟨et⟩ infans ad os uoluae conpellatur. Quae emortuo partu id conprimit, ex interuallo uero paulum dehiscere †ut. Hac occasione usus medicus unctae manus indicem digitum primum debet inserere atque ibi continere, donec iterum ad [os] aperiatur, rursusque alterum digitum demittere debebit, et per easdem occasiones alios, donec tota esse intus manus possit. ⟨Ad⟩ cuius rei facultate⟨m⟩ multum confert et magnitudo uoluae et uis neruorum eius et corporis totius habitus et mentis etiam robur, cum praesertim intus nonnumquam etiam duae manus dari debeant. Pertinet etiam ad rem quam caldissimum esse imum uentrem et extrema corporis, nequedum inflammatione⟨m⟩ coepis⟨se⟩, sed recenti re protinus adhiberi medicinam. Nam si corpus iam intumuit, neque demitti manus neque educi infans nisi aegerrime potest sequiturque saepe cum uomitu, cum tremore mortifera neruorum ⟨distentio. Verum⟩ intus emortuo corpori manus iniecta protinus habitum eius sentit. Nam aut in caput aut in pedes conuersum est, aut transuersum iacet; fere tamen sic, ut uel manus eius uel pes in propinquo sit. Medici uero propositum est, ut eum manu derigat uel in caput uel etiam in pedes, si forte aliter conpositus est: ac si nihil aliud est, manus uel pes adprehensus corpus rectius reddit: nam manus in caput, pes in pedes eum conuertet. Tum si caput proximum est, demitti debet uncus undique leuis, acuminis breuis, qui uel oculo uel auri uel ori, interdum etiam fronti recte inicitur; deinde adtractus infantem educit. Neque tamen quolibet is tempore extrahi debet: nam si conpresso uoluae ore id temptatum est, non emittente eo infans abrumpitur, et unci acumen in ipsum os uoluae delabitur; sequiturque neruorum distentio et ingens periculum [mortis]. Igitur conpressa uolua conquiescere, hiante leniter trahere ⟨oportet, et per has occasiones paulatim eum educere. Trahere⟩ autem dextra manus uncum, sinistra intus posita infantem ipsum, simulque eum derigere debet. Solet etiam euenire, ut is infans umore distendatur, exque eo profluat foedi odoris sanies. Quod si tale est, indice digito corpus ⟨illud forandum est, ut effuso umore extenuetur; tum id leniter per ipsas manus recipiendum est. Nam uncus iniectus facile hebeti corpusculo⟩ labitur; in quo quid periculi sit, supra positum est. In pedes quoque conuersus infans non difficulter extrahitur; quibus adprehensis per ipsas manus commode educitur. Si uero transuersus est neque derigi potuit, uncus alae iniciendus, paulumque adtrahendus est; sub quo fere ceruix replicatur, retroque caput a⟨d⟩ relicum corpus spectat. Remedio est ceruix praecisa, ut separatim utraque pars auferatur. Id unco fit, qui prioris similis in interiorem tantum partem per totam aciem exacuitur. Tum id agendum est, ut ante caput, deinde reliqua pars auferatur, quia fere maiore parte extracta caput in uacuam uoluam prolabitur, extrahique sine summo periculo non potest. Si tamen id incidit, super uentrem mulieris duplici panniculo iniecto, ualens homo non inperitus a sinistro latere eius debet adsistere et super imum uentrem eius duas manus inponere alteraque alteram premere; quo fit, ut illud caput ad os uoluae conpellatur; idque eadem ratione, quae supra posita est, unco extrahere *. At si pes alter iuxta repertus est, alter retro cum corpore est, quicquid protractum, paulatim abscidendum est: ⟨et⟩ si clunes os uuluae urguere coeperunt, iterum retro repellendae sunt, conquisitusque pes eius adducendus. Aliaeque etiamnum difficultates faciunt, ut, qui solidus non exit, concisus eximi debeat. Quotiens autem infans protractus est, tradendus ministro est, ut is eum supinis manibus sustine⟨at⟩; medicus deinde sinistra manu leniter trahere umbilicum debet ita ne abrumpat; dextra eum sequi usque ad eas, quas secundas uocant (quod uelamentum infantis intus fuit), isque ultimis adprehensis uenulas membranulasque omnes eadem ratione manu deducere a uolua, totumque illud extrahere et si quid intus praeterea concreti sanguinis remanet. Tum conpressis in unum feminibus, illa conclaui collocanda est modicum calorem sine ullo perflat⟨u⟩ habente. Super imum uentrem eius inponenda ⟨lana sucida⟩ in aceto et rosa tincta. Reliqua curatio talis esse debet, qualis ⟨in⟩ inflammationibus et in is uulneribus, quae in neruosis locis sunt, adhibetur.

[¶6] 30. 30 Lesions of the anus also, when they do not yield to medicaments, require the aid of surgery. If, therefore, any fissure has persisted so long that it has become hard and callous, it is best to move the bowels by a clyster, then apply a hot sponge to soften the fissures and cause them to protrude. When brought into view each is excised and made into a fresh wound; then soft lint is put on and over this a pad smeared with honey, and all is covered with soft wool, fixed by a bandage; on the next and following days all the other emollient medicaments are to be used, which I said above, were required by such lesions when recent, and for the first few days at any rate the patient must live on fluids; then some food is gradually added, but of the class prescribed in the same passage. If however any pus arises in these fissures as the result of inflammation, as soon as it becomes evident, it is to be cut into, lest the anus itself suppurate. But this must not be done hastily, for if cut before it matures the inflammation is very much increased, and pus is somewhat more freely formed. Here too a light diet and emollient dressings are necessary. The tumours, which are called condylomata, when hardened are treated by the following method. First of all the bowel is clystered; then the tumour is seized with a forceps close to its roots and cut away. After this, the same course of treatment is followed as that described above; only if there is any excrescence it is repressed by copper scales. The mouths of veins which discharge blood are removed as follows. When any patient is losing blood, fasting is indicated, and a rather severe clystering of the bowel, to make the openings more prominent, and thus what may be called the little heads of the veins all come into view. Then if a head is very small and has a thin base it must be tied by a flax thread, a little above where it joins the anus. A sponge squeezed out of hot water is next to be applied until it becomes livid, then with a finger-nail or scalpel it is to be scratched off above the knot. Unless this is done great pain follows, and sometimes even difficulty in urinating. If the head is larger and the base broader, it is seized by one or two hooks, and an incision made a little above the base; in doing this nothing of the head should be left nor anything taken away from the anus. This is accomplished by not drawing upon the hooks either too much or too little. When the incision has been made, a pin should be passed through, and under the pin the head is tied round with a linen thread. If there are two or three, the lowest must be dealt with first; if more, they are not all treated at once, to avoid having tender scars in several places at once. If there is bleeding, it is taken up in a sponge; then lint is put on, the thighs and groins anointed, as well as the parts near the wound; over it is applied a cerate and a poultice of barley meal, and this part must be filled up with soft wool and then bandaged. The next day, the patient should sit in hot water and after that have the same poultice applied. Twice a day, before and after the operation, the necks and thighs are to be anointed with a liquid cerate; and the patient must be kept in a warm room. After five or six days, the bits of linen are removed by the aid of an earscoop. If the little heads do not come away at the same time, they are to be removed by the finger; then by the same soothing medicaments which I have described above, the wounds are healed up. After the trouble has been ended I have already noted elsewhere what must be done.

> Latin: 30. Ani quoque uitia, ubi medicamentis non uincuntur, manus auxilium desiderant. Ergo si qua scissa in eo uetustate induruerunt iamque callum habent, commodissimum est ducere aluum; tum spongiam calidam admouere, ut relaxentur illa et foras prodeant. Vbi in conspectu sunt, scalpello singula excidere et ulcera renouare; deinde inponere lin⟨a⟩mentum ⟨molle,⟩ et supra linteolum inlitum melle; locumque eum molli lana inplere et ita uincire; altero die deincepsque ceteris lenibus medicamentis uti, quae ad recentia eadem uitia necessaria esse alias proposui; et utique per primos dies sorbitionibus eum sustinere; paulatim deinde cibis adicere aliquid, generis tamen eius, qu⟨o⟩ius eodem loco praeceptum est. Si quando autem ex inflammatione pu⟨r⟩is ⟨quid⟩ in his oritur, ubi primum apparuit, incidendum est, ne anus ipse suppuret. Neque tamen ante properandum est: nam si crudum incisum est, inflammationis multum accedit, et puris aliquanto amplius concitatur. ⟨In⟩ his quoque uulneribus lenibus cibis isdemque medicamentis opus est. At tubercula, quae condylomata appellantur, ubi ⟨induruerunt,⟩ hac ratione curantur. Aluos ante omnia ducitur; tum uulsella tuberculum adprehensum iuxta radices praeciditur. Quod ubi factum est, eadem sequntur, quae supra post curationem adhibenda proposui: tantummodo, si quid increscit, squama aeris coercendum est. Ora etiam uenarum fundentia sanguinem sic tolluntur. Vbi sanguis ⟨c⟩ui fluit, fames ⟨in⟩dicitur, aluus acrius ducitur, quo magis or⟨a⟩ promoueantur; eoque fit, ut omnia ue⟨narum⟩ quasi capitula conspicua sint. Tum si capitulum exiguum est basimque tenuem habet, adstringendum lino paulum supra est, quam ubi cum ano committitur. Inponenda * * aqua calida spongia est, donec id liueat; deinde aut ungue aut scalpello supra nodum id exulcerandum est. Quod nisi factum est, magni dolores subsequuntur, interdum etiam urinae difficultas. Si id maius est et basis latior, hamulo uno aut altero excipiendum est paulumque supra basim incidendum; neque relinquendum quicquam ⟨ex eo capitulo neque quicquam⟩ ex ano demendum est. ⟨Quod⟩ consequitur is, qui neque nimium neque parum ⟨hamos⟩ ducit. Qua incisum est, acus debet inmitti infraque eam lino id capitulum alligari. Si duo triaue sunt, imum quo⟨d⟩que primum curandum est; si plura, non omnia simul, ne tempore eodem undique tenerae cicatrices sint. Si sanguis profluit, excipiendum est spongia; deinde linamentum inponendum; unguenda femina et inguina et quicquid iuxta ulcus est; ceratumque superdandum et farina hordiacia calida, inplendusque is locus est * * sic deligandus est. Postero die is desidere in aquam caldam debet eodemque cataplasmate foueri. Ac bis die, et ante curationem et post eam, ceruices ac femina liquido cerato perunguenda sunt; tepidoque is loco continendus. Interpositis quinque aut sex diebus oriculario specillo linamenta educenda. Si capitula simul non exciderunt, digito promouenda; tum lenibus medicamentis isdem, quae alia⟨s⟩ posui, ulcera ad sanitatem perducenda. Finito uitio, quemadmodum agendum esset, iam alias [superius] exposui.

[¶7] 31. 31 We next pass from the foregoing subjects to the legs, and if varicose veins occur there, they are removed by a procedure which is not difficult. To this place I have put off also the treatment of the small veins which cause trouble in the head, also of varicose veins on the abdomen, because it is all the same. Any vein therefore which is troublesome may be shrivelled up by cauterizing or cut out by surgery. If a vein is straight, or though crooked is yet not twisted, and if of moderate size, it is better cauterized. This is the method of cauterization: the overlying skin is incised, then the exposed vein is pressed upon moderately with a fine, blunt, hot cautery iron, avoiding a burn of the margins of the incision, which can easily be done by retracting them with hooks. This step is repeated throughout the length of the vein, generally at intervals of four fingers' breadth, after which a dressing is put on to heal up the burns. But excision is done in the following way: the skin is similarly incised over the vein, and the margins held apart by hooks; with a scalpel the vein is separated from surrounding tissue, avoiding a cut into the vein itself; underneath the vein is passed a blunt hook; the same procedure is repeated at the intervals noted above throughout the course of the vein which is easily traced by pulling on the hook. When the same thing has been done wherever there are swellings, at one place the vein is drawn forward by the hook and cut away; then, where the next hook is, the vein is drawn forwards and again cut away. After the leg has thus been freed throughout from the swellings the margins of the incisions are brought together and an agglutinating plaster put on over them.

> Latin: 31. Ab his ad crura proximus transitus est, in quibus orti uarices non difficili ratione tolluntur. H⟨u⟩c autem et earum uen⟨ul⟩arum, quae in capite nocent, et eorum uaricum, qui in uent⟨r⟩e sunt, curationem distuli, quoniam ubi⟨que⟩ eadem est.—Igitur uena omnis, quae noxia est, aut adusta tabescit aut manu eximitur. Si recta est, si quamuis transuersa tamen simplex, si modica est, e⟨a⟩ melius aduritur. Si curua est et uelut in orbes quosdam inplicatur pluresque inter se inuoluuntur, utilius eximere est. Adurendi ratio haec est: cutis superinciditur; tum patefacta uena tenui et retuso ferramento candente modice premitur, uitaturque, ne plagae ipsius orae adurantur, quas reducere hamulis facile est. ⟨Id⟩ interpositis fere quaternis digitis per totum uaricem fit; et tum superinponitur medicamentum, quo adusta sanantur. At exciditur hoc modo: cute eadem ratione super uenam incisa, hamulo orae excipiuntur; scalpelloque undique corpore uena ⟨d⟩educitur; caueturque, ⟨[ne] inter haec ne ipsa laedatur; eique retusus hamulus subicitur;⟩ interpositoque eodem fere spatio, quod supra positum est, in eadem uena idem fit; quae quo tendat, facile hamulo extento cognoscitur. Vbi iam idem, quacumque uarices sunt, factum est, uno loco adducta per hamulum uena praeciditur, deinde qua proximus hamus est, adtrahitur [euellitur] ibique rursus absciditur. Ac sic undique uaricibus crure liberato plagarum orae committuntur et super emplastrum glutinans in⟨ic⟩itur.

[¶8] 32. 32 But if the fingers, either before birth or later on account of ulceration of their adjacent surfaces, adhere together, they are separated by the knife; after that each finger is separately enclosed in a plaster without grease, and so each heals separately. If after ulceration of a finger, a badly formed scar has made it crooked, in the first place a poultice is tried, and if this is of no avail, which is generally the case with old scars and tendon injuries, we must see whether the trouble is in the tendon, or in the skin only. If it is in the tendon, it should not be touched, for the condition is incurable; if in the skin, the whole scar should be cut out, which had generally become hard and so did not allow the finger to be extended. When it had been thus straightened a new scar must be allowed to form there.

> Latin: 32. At si digiti uel in utero protinus, uel propter communem exulcerationem postea cohaeserunt, scalpello d⟨i⟩ducuntur; dein separatim uterque non pingui emplastro circumdatur atque ita per se uterque sanescit. Si uero fuit ulcus in digito posteaque male inducta cicatrix curuum eum red⟨di⟩dit, primum malagma temptandum est; deinde, si id nihil prodest (quod et in ueteri cicatrice et ubi nerui laessi sunt euenire consueuit) uidere oportet, neruine id uitium an cutis sit. Si nerui est, attingi non debet: neque enim sanabile est: si cutis, tota cicatrix excidenda, quae fere callosa extendi digitum minus patiebatur; tum rectus sic ad nouam cicatricem perducendus est.

[¶9] 33. 33 When gangrene has developed between the nails and in the armpits or groins, and if medicaments have failed to cure it, the limb, as I have stated elsewhere, must be amputated. But even that involves very great risk; for patients often die under the operation, either from loss of blood or syncope. It does not matter, however, whether the remedy is safe enough, since it is the only one. Therefore, between the sound and the diseased part, the flesh is to be cut through with a scalpel down to the bone, but this must not be done actually over a joint, and it is better that some of the sound part should be cut away than that any of the diseased part should be left behind. When the bone is reached, the sound flesh is drawn back from the bone and undercut from around it, so that in that part also some bone is bared; the bone is next to be cut through with a small saw as near as possible to the sound flesh which still adheres to it; next the face of the bone, which the saw has roughened, is smoothed down, and the skin drawn over it; this must be sufficiently loosened in an operation of this sort to cover the bone all over as completely as possible. The part where the skin has not been brought over is to be covered with lint; and over that a sponge soaked in vinegar is to be bandaged on. The remaining treatment is that prescribed for wounds in which suppuration is to be brought about.

> Latin: 33. Gangrena⟨m⟩ inter ungues alasque aut inguina nasci, et si quando medicamenta uincantur, membrum praecidi oportere alio loco mihi dictum est. Sed id quoque cum periculo summo fit: nam saepe in ipso opere uel profusione sanguinis uel animae defectione moriuntur. Verum hic quoque nihil interest, an satis tutum praesidium sit, quod unicum est. Igitur inter sanam uitiatamque partem incidenda scalpello caro usque ad os est sic, ut neque contra ipsum articulum id fiat, et potius ex sana parte aliquid excidatur quam ex aegra relinquatur. Vbi ad os uentum est, reducenda ab eo sana caro ⟨et⟩ circa os subsecanda est, ut ea quoque parte aliquid os nudetur; deinde id serrula praecidendum est quam proxime sanae carni etiam inhaerenti; ac tum frons ossis, quem serrula exasperauit, leuandus est, supraque inducenda cutis, quae sub eiusmodi curatione laxanda est, ut quam maxime undique os contegat. Quo cutis inducta non fuerit, id lin⟨a⟩mentis erit contegendum, et super id spongia ex aceto deliganda. Cetera postea sic facienda, ut in uulneribus, in quibus pus moueri debet, praeceptum est.

## 31. Book VIII · chapters 1–3

Source: https://scriptura.si/works/celsus-on-medicine/31/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/31/#p-N

[¶0] 1. 1 The remaining part of my work relates to the bones; and to make this more easily understood, I will begin by pointing out their positions and shapes.

> Latin: 1. Superest ea pars, quae ad OSSA pertinet; quae quo facilius accipi possit, prius positus figurasque eorum indicabo.

[¶1] First then comes the skull, concave internally, convex externally, on both aspects smooth, where it covers the cerebral membrane as well as where it is covered by the skin bearing hair; and it is in one layer from the back of the head to the temples, in two layers from the forehead to the vertex. Its bones are hard externally, but the inner parts which connect them together are softer, and between these run large blood-vessels which probably supply their nutrition. It is rare for the skull to be solid without sutures; in hot countries, however, this is more easily found; and that kind of head is the firmest and safest from headaches. As for the rest, the fewer the sutures, the better for the heads; and there is no certainty as to the number, or even as to the position of the sutures. Generally, however, there are two above the ears separating the temples from the upper part of the head: a third stretches to the ears across the vertex and separates the occiput from the top of the head. A fourth runs likewise from the vertex over the middle of the head to the forehead, sometimes ending at the hairy margin, sometimes dividing the forehead itself and ending between the eyebrows. Most of these are dovetailed, but those which cross over above the ears are bevelled off a little all along their margin so that the lower bones smoothly overlap the upper. Now the thickest bone in the head is behind the ear, where hair does not grow, probably on that very account. Under the muscles covering the temples is situated the middle bone which slopes outwards. But the face has the largest suture; it begins at one temple, passes across the middle of the orbits and nose to the other temple. From this suture two short sutures are directed downwards from the inner corners of the eyes; and the cheeks at their upper parts also have transverse sutures. From the middle of the nostrils or of the gums of the upper teeth, one suture runs back through the middle of the palate, another cuts the same palate transversely. These are the sutures found in most skulls.

> Latin: Igitur caluaria incipit, ex interiore parte concaua, extrinsecus gibba, utrimque leuis, et qua cerebri membranam contegit et qua cute capillum gignente contegitur; eaque simplex ab occipitio et temporibus, duplex usque in uerticem a fronte. Ossaque eius ab exterioribus partibus dura, ab interioribus, quibus inter se conectuntur, molliora sunt; interque ea uenae discurrunt, quas his alimentum subministrare credibile est. Rara autem caluaria solida sine suturis est; locis tamen aestuosis facilius inuenitur; et id caput firmissimum atque a dolore tutissimum est. Ex ceteris, quo suturae pauciores sunt, eo capitis ualetudo commodior est: neque enim certus earum numerus est, sicut ne locus quidem. Fere tamen duae ⟨in⟩super aures tempora a superiore capitis parte discernunt; tertia ad aures per uerticem tendens occipitium a summo capite diducit. Quarta ab eodem uertice per medium caput ad frontem procedit; eaque modo sub imo capillo desinit, modo frontem ipsam secans inter supercilia finit * * * Ex his ceterae quidem suturae in unguem committuntur: eae uero, quae super aures trauersae sunt, totis oris paulatim extenua⟨n⟩tur atque ita inferiora ossa superioribus leniter insidunt. Crassissimum uero in capite os post aurem est, qua capillus, ut ⟨u⟩erisimile est, ob id ipsum non gignitur. Sub is [quo]que musculis, qui tempora conectunt, os medium in exteriorem partem inclinatum positum est. At facies suturam habet maximam, quae a tempore incipiens per medios oculos naresque transuersa peruenit ad alterum tempus. A qua breue⟨s⟩ duae sub interioribus angulis deorsum spectant; et malae quoque in summa parte singulas transuersas suturas habent.

[¶2] Now the largest passages leading into the head are those of the eyes, next the nostrils, then those of the ears. Those of the eyes lead direct and without branching into the brain. The two nasal passages are separated by an intermediate bone. These begin at the eyebrows and eye-corners, and their structure is for almost a third part bony, then changes into cartilage, and the nearer they get to the mouth the more soft and fleshy their structure becomes. Now these passages are single between the highest and lowest part of the nostrils, but there they each break up into two branches, one set from the nostrils to the throat for expiration and inspiration, the other leading to the brain and split up in its last part into numerous small channels through which we get our sense of smell. In the ear the passage is also at first straight and single, but as it goes further becomes tortuous. And close to the brain this too is divided into numerous fine passages which give the faculty of hearing. Adjacent to the passages there are two little pits, as it were, above which ends the bones which stretches across from the cheek, supported by deeper-seated bones: it may be called the yoke, from the same resemblance which led the Greeks to call it zygodes. But the lower jaw is a soft bone and a single one, of which the chin forms the middle and lowest portion, whence it is continued on the two sides to the temples; and it alone is movable, for the cheek-bones with all that bone which produces the upper teeth are immobile. Now the ends of the lower jaw itself form, as it were, two horns. One process broader below tapers to its tip, and as it passes higher, goes under the zygoma, and is fastened to the temporal muscles above it. The other is shorter and more rounded off, and in that pit which is adjacent to the auditory passages, it is set in a sort of hinge, and as it bends there forwards backwards supplies the power of movement to the lower jaw.

> Latin: A mediisque naribus ⟨aut⟩ superiorum dentium gingiuis per medium palatum una procedit, aliaque transuersa idem palatum secat. Et suturae quidem in plurimis hae sunt. Foramina autem intra caput maxima oculorum sunt, ⟨deinde narium, tum quae in auribus habemus. Ex his quae oculorum sunt,⟩ recta simplicia ad cerebrum tendunt. Narium duo foramina osse medio discernuntur: siquidem ha⟨e⟩ primum ⟨a⟩ superciliis angulisque oculorum osse inchoantur ad tertiam fere partem; deinde in cartilaginem uersae, quo propius ori descendunt, eo magis caruncula quoque molliuntur. Sed ea foramina, quae a summis ad imas nares simplicia sunt, ibi rursum in bina itinera diuiduntur; aliaque ex his ad fauces peruia spiritum et reddunt et accipiunt, alia ad cerebrum tendenti⟨a⟩ ultima parte in multa et tenu⟨i⟩a foramina dissipantur, per quae sensus odoris nobis datur. In aure quoque primum rectum et simplex iter; procedendo flexuosum ⟨fit. Quod ipsum⟩ iuxta cerebrum in multa et tenuia foramina diducitur, per quae facultas audiendi est. Iu⟨xt⟩aque ea duo paruuli quasi sinus sunt; superque eos finitur os, quod transuersum a genis tendens ab inferioribus ossibus sustinetur: iugale appellari potest, ab eadem similitudine, a qua id Graeci zygodes appellant. Maxilla uero est molle os; eaque una est, cuius eadem et media et ima pars mentum est, a quo utrimque procedit ad tempora; solaque ea mouetur: nam malae cum toto osse, quod superiores dentes exigit, immobiles sunt. Verum ipsius maxillae partes extremae quasi bicornes sunt. Alter processus in⟨f⟩ra latior uertice ipso tenuatur, longiusque procedens sub osse iugali subit, et ⟨super⟩ id temporum musculis inligatur.

[¶3] The teeth are harder than bone, some are fixed in the lower jaw, some in the cheek-bones. Of the teeth, the four in front are named by the Greeks tomis because they cut. These are flanked at each side by four canine teeth. Behind these on either side is generally a set of four molars, except in those who have five one tooth on each side coming through later. There are some in whom the four last, which generally come through late, do not make their appearance. Of these teeth the front ones are fixed by single roots, the molars at least by two, sometimes even by three or four; and generally the longer root produces the shorter teeth; the straight tooth has a straight root; a crooked tooth a crooked root. From the same root in children a new tooth grows which general pushes out the former one, but sometimes shows itself behind or in front of it.

> Latin: Alter breuior et rotundior et in eo sinu, qui iuxta foramina auris est, cardinis modo †fit; ibique huc et illuc se inclinans maxillae facultatem motus praestat. Duriores osse dentes sunt, quorum pars maxillae, pars superior⟨i⟩ ossi malarum haeret. Ex his quaterni primi, quia secant, tomis a Graecis nominantur; hi deinde quattuor caninis dentibus ex omni parte cinguntur; ultra quos utrimque fere maxillares quaterni sunt, praeterquam in is * * Sunt, quibus ⟨IV⟩ ultimi, qui sero gigni solent, non increuerunt. Ex his priores singulis radicibus, maxillares utique binis, quidam etiam ternis quaternisue nituntur; fereque longior radix breuiorem dentem edit;

[¶4] Now the spine is the support of the head. It is composed of twenty-four vertebrae, seven in the neck, twelve belonging to the ribs; the remaining five are below the ribs. The vertebrae are bones rounded off and short; from each side they thrust out a transverse process; they are perforated in the middle where the spinal marrow which is connected with the brain passes downwards, and at the sides also through the two transverse processes they are traversed by fine channels, through which little membranes pass down resembling the cerebral membrane; with the exception of the three highest all the vertebrae have slight depressions in their articular processes on the upper side, on the lower side other articular processes grow downwards. The highest vertebra is therefore the immediate support of the head, receiving its small processes into two depressions, and this enables the head to move up and down. The second vertebra is made irregular by a protuberance and is attached to the lower side of the one above. To secure the rotation of the head the top of it ends in a narrower round process, so that the first vertebra encircling the top of this allows the head to turn sideways as well. After the same fashion the third vertebra supports the second, hence there is easy movement in the neck. And the neck could not even hold up the head were it not supported on each side by straight and powerful sinews which the Greeks call te/nontej; since whenever the head bends one of the sinews is always tense, and does not allow what is above to slip too far over. From the third vertebra in turn grow little protuberances which are inserted into the vertebra below; the remaining vertebrae are fastened into the ones below them by processes directed downwards and support the ones above them in the depression which they have on either side, and they are held together by many ligaments and cartilages. Thus by bending once in the required direction and avoiding moving in other directions man stands upright, or bends somewhat, to do anything that is required.

> Latin: rectique dentis recta etiam radix, curui flexa est. Exque eadem radice in pueris nouus dens subit, qui multo saepius priorem expelli⟨t⟩, interdum tamen supra infraue eum se ostendit. Caput autem spina excipit. Ea constat ex uertebri⟨s⟩ quattuor et uiginti: septem in ceruice sunt, duodecim ad costas, reliquae quinque sunt proximae costis. Eae teretes breuesque; ab utroque latere processus duos exigunt; mediae perforatae, qua spinae medulla cerebro commissa descendit, circa quoque per duos processus tenuibus cauis peruiae, per quae membrana cerebri similes membranulae deducuntur; omnesque uertebrae exceptis tribus summis a superiore parte in ipsis processibus paulum desidentis sinus habent; ab inferiore alios deorsum uersus processus exigunt. Summa igitur protinus caput sustinet, per duos sinus receptis exiguis eius processibus; quo fit, ut caput susum deorsum uersum * Tuber⟨i⟩ exasperatur secunda, superiori parte * inferiore. Quod ad circuitum pertinet, pars summa angustiore orbe finitur; ita superior ei summae circumdata in latera quoque caput moueri sinit. Tertia eodem modo secundam excipit; ex quo facilis ceruici mobilitas est. Ac ne sustineri quidem caput posset, nisi utrimque rect⟨i⟩ ualentesque nerui collum continerent, quos ΤΕΝΟΝΤΑΣ Graeci appellant; siquidem horum inter omnes flexus alter semper intentus ultra prolabi superiora non patitur. Iamque uertebra tertia tubercula, quae inferiori inserantur, exigit: ceterae process⟨ib⟩us deorsum spectantibus in inferiores ⟨in⟩sinuantur, ac per sinus, quos utrimque habent, superiores accipiunt, multisque neruis et multa cartilagine continentur. Ac sic, uno flexu modico in promptum dato, ceteris negatis, homo e⟨t⟩ rectus insistit, et aliquid ad necessaria opera curuatur.

[¶5] Below the neck the highest rib is placed on a level with the shoulders; after that there are six lower ribs, reaching as far as the bottom of the thorax; the ribs, which in their first part are rounded and end in small heads, as it were, are lightly fixed to the transverse processes of the vertebrae, which themselves have slight depressions; then the ribs flatten out and after curving outwards gradually degenerate into cartilage, and here, after again bending slightly inwards, they become united to the breast-bone. This, a strong and hard bone, begins below the throat, is lunated on each side, and, when it becomes itself softened into cartilage, is bounded by the praecordia. Below the upper ribs, there are five called by the Greeks nothae; they are short, thinner, and after changing gradually into cartilage, they are embedded in the highest part of the abdomen. The lowest of these consists for the most part only of cartilage. Again, from the neck two wide bones extend to the shoulders on each side; we call them scutula operta, the Greeks omoplatae. These bones are curved at their highest point, and below these they are triangular, and become gradually wider as they approach the spine. As they become wider, they become blunter. And they too at the lowest part soften into cartilage at the back and float, as it were, since they are unconnected with any other bone except at the top, but there they held in place by very strong muscles and sinews. Now at the level of the first rib, and a little behind its middle, a bone grows out which at first is slight but as it comes nearer the broad bone of the shoulder-blades becomes thicker and broader, and curves slightly outwards; and this at its other upper end is enlarged somewhat to support the root of the neck. But this bone itself is curved, and must not be reckoned among the hardest or most solid, and it lies with one head fixed as just stated, the other in a small depression of the breast-bone; it moves a little with the movement of the arm, and is connected with the flat bone of the shoulder-blades by sinews and cartilage.

> Latin: Infra ceruicem uero summa costa contra umerum sita est; inde ⟨VI⟩ inferiores usque ad imum pectus perueniunt; ea⟨e⟩que primis partibus rotundae et leniter quasi capitulatae uertebrarum transuerseis processibus et i⟨ps⟩i⟨s⟩ quoque paulum sinuatis inhaerent; inde ⟨l⟩atescunt et in exteriorem partem recuruatae paulatim in cartilaginem degenerant; eaque parte rursus ⟨in⟩ interiora leniter flexa⟨e⟩ committuntur cum osse pectoris. Quod ualens et durum a faucibus incipit, ab utroque latere lunatum et a praecordiis iam ipsum quoque cartilagine mollitum terminatur; sub costis uero prioribus, quinque, quas ΝΟ⟨Θ⟩ΑΣ Graeci nominant, breues tenuioresque atque ipsae quoque paulatim in cartilaginem uersae extremis abdominis partibus inhaerescunt; imaque ex his maiore iam parte nihil nisi cartilago est. Rursus a ceruice duo lata ossa utrimque ad scapulas tendunt: nostri scutula operta, omoplatas Graeci nominant. Ea summis uerticibus sinuata, ab his triangula, paulatimque latescentia ad spinam tendunt; et quo latiora qu⟨a⟩que parte sunt, hoc hebetiora. Atque ipsa quoque in imo cartilag⟨in⟩osa posteriore parte uelut innatant, quoniam nisi †uel in summo nulli ossi inhaerescunt, ibi uero ualidis musculis neruisque constricta sunt. At a summa costa paulo interius quam ubi ⟨ea⟩ media est os excrescit, ibi quidem tenue, procedens uero, quo propius lato scapularum ossi fit, eo plenius latiusque et paulum in exteriora curuatum; quod altera uerticis parte modice intumescens sustinet iugulum. Id autem ipsum recuruum ac neque inter * * * durissima ossa numerandum, altero capite in eo, quod posui, altero in exiguo sinu pectoralis ossis insidit, paulumque motu bracchi mouetur, et cum lato osse scapularum infra caput eius neruis et cartilagin⟨e⟩ conectitur.

[¶6] From this point begins the humerus, which at both ends is swollen out, and is there soft, without marrow and cartilaginous; in the middle cylindrical, hard, contain in marrow; and slightly curved both forwards and outwards. Now its front part is that on the side of the chest, its back, that on the side of the shoulder-blades; its inner part that which faces the side, its outer away from the side. It will be clear in later chapters that this applies to all joints. Now the upper head of the humerus is more rounded than any other bone hitherto described and is inserted by a small excrescence into the top of the wide bone of the shoulder-blades, and the greater part of it is held fast by sinews outside its socket.

> Latin: Hinc umerus incipit, extremis utrimque capitibus tumidus, mollis, sine medulla, cartilaginosus: medius teres, durus, medullosus; leniter gibbus et in priorem et in exteriorem partem. Prior autem pars e⟨s⟩t, quae a pectore est, posterior, quae a scapulis; ⟨interior, quae ad latus⟩ tendit, exterior, quae ab eo recedit; quod ad omnes articulos pertinere in ulterioribus patebit. Superius autem umeri caput rotundius quam cetera ossa, de quibus adhuc dixi, paruo excessu uertici lati scapularum ossis inseritur, ac maiore parte extra situm neruis deligatur.

[¶7] The humerus at its lower end has two processes, between which the bone is hollowed out even more than at its extremities. This furnishes a seat for the forearm, which consists of two bones. The radius, which the Greeks call cercis, is the uppermost and shorter; at its beginning it is thinner, with a round and slightly hollowed head which receives a small protuberance of the humerus; and it is kept in place there by sinews and cartilage. The ulna is further back and longer and at first larger, and at its upper extremity is inserted by two outstanding prominences into the hollow of the humerus, which, as I said above, is between the two processes. At their upper ends the two bones of the forearm are bound together, then they gradually separate, to come together again at the wrist, but with an alteration in size; since there the radius is the larger whilst the ulna is quite small. Further, the radius as it enlarges into its cartilaginous extremity is hollowed out at its tip. The ulna is rounded at the extremity, and projects a little at one part. And, to avoid repetition, it should not be overlooked that most bones turn into cartilage at their ends, and that all joints are bounded by it, for movement would be impossible unless apposition were smooth, nor could they be united with flesh and sinews unless some such intermediary material formed the connection.

> Latin: At inferius duos processus habet, inter quos quod medium est magis etiam extremis partibus sinuatur. Quae res sedem brachio praestat, quod constat ex ossibus duobus. Radius, quam cercida Graeci appellant, superior breuiorque, et primo tenuior, rotundo et leniter cauo capite exiguum umeri tuberculum recipit, atque ibi neruis et cartilagine continetur. Cubitus inferior longiorque et primo plenior, in summo capite duobus quasi uerticibus extantibus in sinum umeri, quem inter duos processus eius esse proposui, se inserit. Primo uero du⟨o⟩ brachii ossa uincta paulatim dirimuntur, rursusque ad manum coeunt modo crassitudinum mutato, siquidem ibi radius plenior, cubitus admodum tenuis est. Dein radius in caput cartilaginosum consurgens in uertice eius sinuatur. Cubitus rotundus in extremo parte altera paulum procedit. Ac ne saepius dicendum sit, illud ignorari non oportet, plurima ossa in cartilaginem desinere, nullum articulum non sic finiri: neque enim aut moueri posset, nisi leui inniteretur, aut cum carne neruisque coniungi, nisi ea media ⟨quaedam⟩ materia committeret.

[¶8] Turning to the hand, the first part of the palm consists of many minute bones of which the number is uncertain, but all are oblong and triangular, and are connected together on some plan since the upper angle of one alternates with the base of another; therefore they appear like one bone which is slightly concave. Now two small bones project from the hand and are fitted into the hollow of the radius; and at the other end five straight bones directed towards the fingers complete the palm; from these spring the fingers themselves, each composed of three bones; and all are similarly formed. A lower bone is hollowed out at its top to admit a small protuberance from an upper bone, and sinews keep them in place; from them grow nails which become hard, and thus these adhere by their roots to flesh rather than to bone.

> Latin: In manu uero prima palmae pars ex multis minutisque ossibus constat, quorum numerus incertus est, sed oblonga omnia et triangula, structura quadam inter se conectuntur, cum inuicem superior alterius angulus, alterius planities sit; eoque fit ex his unius ossis paulum in interiora concaui species. Verum ex manu duo exigui processus in sinus radi coiciuntur; tum ex altera parte recta quinque ossa ad digitos tendentia palmam explent; a quibus ipsi digiti oriuntur, qui ex ossibus ternis constant; omniumque eadem ratio est. Interius ⟨os⟩ in uertic⟨e⟩ sinuatur, recipitque exterioris exiguum tuberculum, neruique ea continent; a quibus orti ungues indurescunt, ideoque non ossi sed carni magis radicibus suis inhaerent.

[¶9] And such are the arrangements for the upper limbs. Now the bottom of the spine is fixed between the bone of the hips, which lies crosswise and is very strong and so protects the womb, bladder and rectum; and the bone bulges out externally, is bent up towards the spin, and on the sides that is, the hips proper, it has rounded hollows; and from these start the bone they call the comb, situated crosswise above the intestines below the pubes, and this supports the belly; in men the bone is straight, in women more curved outwards so as not to hinder parturition.

> Latin: Ac superiores quidem partes sic ordinatae sunt. Ima uero spina in coxarum osse desidit, quod transuersum longeque ualentissimum uoluam, uesicam, rectum intestinum tuetur; idque ab exteriore parte gibbum, ad spinam resupinatum, a lateribus [id est ipsis coxis] sinus rotundos habet; a quibus oritur os, quod pectinem uocant, idque super intestina sub pube transuersum uentrem firmat;

[¶10] Next in order are the thigh-bones, the heads of which are even more globular than those of the arm-bones, although those are the most globular of the other bones; below there are two processes, one directed forward, the other backward; after this the bones are hard and marrowy and convex on the outer side, and they are again enlarged at their lower ends also. The upper ends are inserted into hollows of the hip-bones, as the arm-bones into the shoulder-bones; then these tend gently downwards and inwards in order that they may support the upper parts of the body more evenly. But the heads at the lower end have a hollow in between, that the leg-bones may be more easily fixed into them. Their juncture is covered by a small, soft, cartilaginous bone, called the knee-cap. This bone, which floats freely and is not attached to any other bone, but held in place by flesh and sinews, is turned slightly towards the thigh-bone and protects the joint in all movements of the legs.

> Latin: rectius in uiris, recuruatum magis in exteriora in feminis, ne partum prohibeat. Inde femina ordiuntur, quorum capita rotundiora etiam quam umerorum sunt, cum illa ex ceteris rotundissima sint: infra uero duos processus a priore et a posteriore parte habent; dein dura et medullossa et ab exteriore parte gibba, rursus inferioribus quoque capitibus intumescunt. Superiora in sinus coxae, sicut umeri in ea ossa, quae scapularum sunt, coiciuntur; tum infra introrsum leniter intendunt, quo aequalius superiora membra sustineant. At inferiora capita media sinuantur; quo facilius excipi cruribus possint. Quae commissura osse paruo, molli, cartilaginoso tegitur: patellam uocant. Haec super innatans, neque ulli ossi inhaerens, sed carne et neruis deligata, pauloque magis ad femoris os tendens inter omnes crurum flexus iuncturam tuetur.

[¶11] The leg itself is made up of two bones; for as the thigh-bone is throughout similar to the humerus, so is the leg like the forearm, hence the form and appearance of the one can be learnt from the other: and what holds good for the bones holds also for the soft parts. One bone lies outside, and this too itself is called the calf. It is the shorter, and is smaller in its upper part, but swells out just at the ankles. The other is placed more in front and is named tibia; it is the longer, and is larger at the upper end, and it alone joins with the lower head of the thigh-bone, as the ulna does with the humerus. These two bones, moreover, are joined together at the lower and upper ends, but in the middle as in the forearm they are separated. The leg below is received by the transverse bone of the ankles, which itself is set upon the heel-bone; the heel-bone is hollowed out in one part, and has excrescences at another part, so that it receives the excrescences of the ankle and is received itself into the hollow of the ankle. The heel-bone is without marrow, is hard, and projects somewhat backwards where it presents a rounded outline. The other bones of feet are constructed in a similar way to the bones of the hand; the sole corresponds to the palm, digits to digits, nails to nails.

> Latin: Ipsum autem crus est ex ossibus duobus: etenim per omnia femur umero, crus ⟨uero⟩ brachio simile est, adeo ut habitus quoque et decor alterius ex altero cognoscatur: quod ab ossibus incipiens etiam in carne respondet. Verum alterum os ab exteriore parte [id est supra] positum est, quod ipsum quoque su⟨r⟩a nominatur. Id breuius supraque tenuius ad ipsos talos intumescit. Alterum a priore parte positum, cui tibiae nomen est, longius et in superiore parte plenius, solum cum femoris inferiore capite committitur, sicut ⟨cum umero cubitus. Atque ea quoque⟩ ossa, infra supraque coniuncta, media ut in bracchio dehiscunt. Excipitur autem crus infra osse transuerso talorum; idque ipsum super os calcis situm est, quod quadam parte sinuatur, quadam excessus habet, et procedentia ex talo recipit et in sinum eius inseritur. Idque sine medulla durum magisque in posteriorem partem proiectum teretem ibi figuram repraesentat. Cetera pedis ossa ad eorum, quae in manu sunt, similitudinem structa sunt: plant⟨a⟩ palmae, digiti digitis, ungues unguibus respondent.

[¶12] 2. 2 Now when any bone has been injured, it either becomes diseased or splits or is broken or perforated or crushed or displaced. A diseased bone generally first becomes fatty, next either blackened or rotten; and this occurs in cases of severe ulceration or fistula, when these have become chronic or even gangrenous. And it is necessary in the first place to expose the diseased bone by cutting out the ulcer, and if the bone disease extends beyond the margins of the ulcer to cut away the flesh until sound bone is exposed all round. Then if the diseased bone appears merely fatty, it is enough to apply a cautery once or twice until a scale of Boeotian comes away; or to scrape it away until there is bleeding, which is a sign of sound bone; for diseased bone is necessarily dry. The same is also to be done for diseased cartilage; it too must be scraped away with a scalpel until what remains is sound. Then, whether bone or cartilage has been scraped, finely powdered soda must be dusted on; and nothing different is to be done when the surface of the bone is black or carious, except that the treatment by cautery or scraping must be continued for a longer time. In these cases if the surgeon scrapes he should press boldly upon the instrument that he may effect more and finish sooner. The end is when white or hard bone is reached. White bone instead of black, or hard bone instead of carious clearly indicates the end of the diseased part. I have already stated that sound bone also bleeds to some extent. But if in either case it is doubtful how deep the disease has reached, in the case of carious bone, this is readily ascertained. A fine probe is introduced into the hole, and according as it enters to a less or greater extent, it shows either that the caries is superficial or that it has penetrated more deeply, With black bone it is possible to form some opinion also from the pain and fever; when these are moderate in degree, the disease cannot have penetrated deeply. This becomes more obvious, however, when a trepan is used; for the limit of disease is reached when the bone dust ceases to be black. Therefore, if caries has penetrated deeply, by means of the trepan holes are bored in the bone at frequent intervals, equal in depth to the extent of the disease; next cautery points are passed into these holes, until the bone becomes entirely dry. For after such applications, simultaneously the diseased part separates off from the bone underneath, and the cavity will make flesh, and no humour or very little will be subsequently discharged. If on the other hand the disease, whether blackness or caries, has extended to the other side of the bone as well, excision is required; and the same can be done when caries has penetrated right through a bone. But whatever is wholly diseased is to be wholly removed; if the lower part is sound, only that which is corrupt should be excised. Further, if there is caries of the skull or breast-bone or rib, the cautery is useless, and excision is necessary. Nor are we to listen to those who await the third day after the bone has been laid bare before excising; for all cases are treated more safely before the inflammatory reaction. Therefore, whenever possible at the same sitting, the skin is to be incised, and the bone exposed, and freed from a that is diseased. And much the most dangerous case is in the breast-bone, for even if the operation has been successful, complete healing scarcely ever results.

> Latin: 2. Omne autem os, ubi iniuria accessit, aut uitiatur aut finditur aut frangitur aut foratur aut conliditur aut loco mouetur. Id quod VITIATVM est, primo fere pingue fit, deinde uel nigrum uel cariosum; quae supernatis grauibus ulceribus aut fistulis, hisque uel longa uetustate uel etiam cancro occupatis, eueniunt.—Oportet autem ante omnia os nudare ulcere exciso, et, si latius est eius uitium quam ulcus fuit, carnem subsecare, donec undique os integrum pateat; tum id, quod pingue est, semel iterumue satis est admoto ferramento adurere, ut ex eo ⟨squama⟩ secedat; aut radere, donec iam aliquid cruoris ostendatur, quae integri ossis nota est: nam necessum est aridum sit id, quod uitiatum est. Idem in cartilagine quoque laesa faciendum est: siquidem ea quoque scalpello radenda est, donec integrum id sit, quod relinquatur; deinde si⟨ue os siue⟩ cartilago rasa est, nitro bene trito respergendum est: neque alia facienda sunt, ubi caries nigritiesue in summo osse est: siquidem id uel paulo diutius eodem ferramento adurendum, uel radendum est. Qui radit haec, audacter inprimere ferramentum debet, ut et agat aliquid et maturius desinat. Finis est, cum ⟨uel⟩ ad album os uel ad solidum uentum est. Albo finiri ex nigritie ⟨uitium⟩, soliditate quadam ex carie manifestum est; accedere etiam cruoris aliquid integro supra dictum est. Si quando autem an altius descenderit utrumlibet, dubium est, in carie quidem expedita cognitio est. Specillum tenue in foramina demittitur, quod magis minusue intrando uel in summo cariem esse uel altius descendisse testatur. Nigrities colligi quidem potest etiam ex dolore et ex febre; quae ubi mediocria sunt, illa alte descendisse non potest. Manifestior tamen adacta terebra fit: nam finis uitii est, ubi scobis nigra esse desit. Igitur si caries alte descendit, per terebram ⟨os p⟩ung⟨e⟩nd⟨u⟩m creb⟨r⟩is foraminibus est, quae altitudine uitium aequent; tum in ea foramina demittenda candentia ferramenta sunt, donec i⟨d⟩ siccum os ex toto fiat. Simul enim post haec et soluetur ab inferiore osse, quodcumque uitiatum est, et is sinus carne replebitur, et umor aut nullus postea feretur aut mediocris. Sin autem nigrities [est] aut si caries ad alteram quoque partem ossis transit, oportet excidi; atque idem in †carie quoque ad alteram partem ossis penetrante fieri potest. Sed quod totum ⟨uitiatum est, totum⟩ eximendum est: si inferior pars integra est, eatenus, quod corruptum est, excidi debet. Item, siue capitis siue ⟨pectoris os siue⟩ costa cariosa e⟨s⟩t, inutilis u⟨s⟩tio est, et excidendi necessitas est. Neque audiendi sunt qui osse nudato diem tertium expectant, ut tum excidant: ante inflammationem enim tutius ⟨omnia⟩ tractantur. Itaque, quantum fieri potest, eodem momento et cutis incidenda est, et os detegendum et omni uitio liberandum est. Longeque pernici⟨oss⟩issimum est, quod in osse pectoris est, quia uix, etiam si recte cessit curatio, ueram sanitatem reddit.

[¶13] 3. 3 Now bone is excised in two ways; if the damaged part is very small, with the modiolus, which the Greeks call xoineiki/j; if more extensive by means of trepans. I will describe the use of both. The modiolus is a hollow cylindrical iron instrument with its lower edges serrated; in the middle of which is fixed a pin which is itself surrounded by an inner disc. The trepans are of two kinds; one like that used by smiths, the other longer in the blade, which begins in a sharp point, suddenly becomes larger, and again towards the other end becomes even smaller than just above the point. When the disease is so limited that the modiolus can include it, this is more serviceable; and if the bone is carious, the central pin is inserted into the hole; if there is black bone, a small pit is made with the angle of a chisel for the reception of the pin, so that, the pin being fixed, the modiolus when rotated cannot slip; it is then rotated like a trepan by means of a strap. The pressure must be such that it both bores and rotates; for if pressed lightly it makes little advance, if heavily it does not rotate. It is a good plan to drop in a little rose oil or milk, so that it may rotate more smoothly; but if too much is used the keenness of the instrument is blunted. When a way has been cut by the modiolus, the central pin is taken out, and the modiolus worked by itself; then, when the bone dust shows that underlying bone is sound, the modiolus is laid aside. But if disease is too extensive for the modiolus to cover, the operation must be carried out by the trepan. With this a hole is made exactly at the margin of the diseased and sound bone, then not very far off a second, and a third, until the whole area to be excised is ringed round by these holes; and here also the bone dust shows how deep the trepan is to go. Next the excising chisel is driven through from one hole to the other by striking it with a mallet, and cuts out the intervening bone, and so a ring is made like the smaller one cut by the modiolus. And in whichever way the circle has been made, the same excising chisel should cut away from the corrupted bone every scale-like layer until sound bone is left. Black bone hardly ever penetrates the whole thickness of the bone, but caries sometimes does so, and especially when the cranium is diseased. A test of this is also made by means of the probe, which when inserted into a cavity which has solid bone underneath finds some resistance because of this and is wet when it comes up. If it finds a clear way, as it goes deeper between bone and membrane, it encounters no resistance and comes up dry; not because there is no harmful sanies within, but because this is spread over a wider area. If bone is diseased right through, whether it be black bone exposed by the trepan, or caries discovered by a probe, the use of the modiolus is generally out of place, because what goes down so deep must be more widely opened up. Then the trepan which I described second is to be used; and in order that it may not get too hot, it should be dipped repeatedly in cold water. But particular care must be taken when we have bored half through a bone consisting of a single layer, or through the upper layer of a bone of two layers; in the former the actual distance bored, in the latter the appearance of blood is the indication. Therefore the strap is then worked more gently and the left hand held up and moved away more often, and the depth of the borehole is to be examined in order that we may perceive just when the bone is being broken through anywhere, and not run the risk of injuring the cerebral membrane by the point; which causes severe inflammation with danger of death. When boreholes have been made, the intervening partitions are to be excised in the same way but much more carefully, lest the corner of the chisel injure the aforesaid membrane; until a sufficient opening has been made to insert a guard of the membrane which the Greeks call meningophylax. This consists of a plate of bronze, its end slightly concave, smooth on the outer side; this is so inserted that the smooth side is next the brain, and is gradually pushed in under the part where the bone is being cut through by the chisel; and if it is knocked by the corner of the chisel it stops the chisel going further in; and so the surgeon goes on striking the chisel with the mallet more boldly and more safely, until the bone, having been divided all round, is lifted by the same plate, and can be removed without any injury to the brain. When all this bone has been removed, the margins of the opening must be filed down smooth, and if any bone dust is sticking to the membrane it is to be removed. When the outer table has been removed, and the inner table left, it is not only the margins but also all the bone which is to be smoothed down, in order that skin may grow over it subsequently without harm; for when it grows over rough bone there is never sound healing, but it causes new pains. What is to be done when the bain is exposed, I will describe when I come to fractures. If some of the inner table has been preserved, medicaments which are not greasy, such as are fitted for recent wounds, are to be applied, and over that, unscoured wool soaked in oil and vinegar. In course of time flesh grows up from the bone and fills up the hollow made by the surgery. Also if any bone has been cauterized it separates from the healthy part, and between the sound and dead bone granulations form to throw off what has separated; and this is usually a thin and small splinter, which the Greeks call a scale. It may possibly even happen as the result of an injury, that bone, although neither fissured nor fractured, yet has its surface indented and roughened; when this happens scraping and smoothing suffice. These conditions, although mostly occurring in the head, are found also in the other bones, so that whenever the same thing happens the same procedure is to be followed. But for bones which are fractured, fissured, perforated or crushed, some special treatment is required, suited for particular cases, and some general measures which apply to the majority; of these I will proceed to treat, beginning with the said cranium.

> Latin: 3. Exciditur uero os duobus modis: si paruulum est, quod laesum est, modiolo, quam ΧΟΙΝΕΙΚΙΔΑ Graeci uocant; si spatios⟨i⟩us, terebris. Vtriusque rationem proponam. Modiolus ferramentum concauum, teres est, imis oris serratum, per quod medium clauus ipse quoque interiore orbe cinctus demittitur. Terebrarum autem duo genera sunt: alterum simile ei, quo fabri utuntur, alterum capituli ⟨longioris; quod ab⟩ acuto mucrone incipit, dein subito latius fit, atque iterum ab alio principio paulo minus quam aequaliter sursum procedit. Si uitium in angusto est, quod conprehendere modiolus possit, ille potius aptatur; et, si caries subest, medius clauus in foramen demittitur; si nigrities, angulo scalpri sinus exiguus fit, qui clauom recipiat, ut eo insistente circumactus modiolus delabi non possit; deinde is habena quasi terebra conuertitur. Estque quidam premendi modus, ut et foretur ⟨et circ⟩umagatur; quia si leuiter inprimitur, parum proficit; si grauiter, non mouet⟨ur⟩. Neque alienum est instillare paulum rosae uel lactis, quo magis lubrico circumagatur; quod ipsum tamen, si copiosius est, aciem ferramenti hebetat. Vbi iam iter modiolo pressum est, medius clauus educitur, et ille per se agitur; dein cum sanitas inferioris partis scobe cognita est, modiolus remouetur. At si latius uitium est quam ut illo conprehendatur, terebra res agenda est. Ea foramen fit in ipso fine uitiosi ossis atque integri; deinde alterum non ita longe, tertiumque; donec totus is locus, qui excidendus est, his cauis cinctu⟨s sit⟩; atque ibi quoque quatenus terebra agenda sit, scobis significat. Tum excissorius scalper ab altero foramine ad alterum malleolo adactus id, quod inter utrumque medium est, excidit; ac sic ambitus similis ei fit, qui in angustiore⟨m⟩ orbe⟨m⟩ modio⟨lo⟩ inprimitur. Vtr⟨o⟩ modo uero id circumductum est, idem excissorius scalper in osse corrupto planissumam quamque testam †laesit, donec integrum os relinquatur. Vix umquam nigrities, inte⟨rd⟩um caries per totum os perrumpit, maximeque ubi uitiata caluaria est. Id quoque signi specillo significatur, qu⟨od⟩ depressu⟨m⟩ in id foramen, quod infra solidam sedem habet, [et] ob id re⟨nit⟩ens aliquid inuenit, et madens exit. Si peruium inuenit, altius descendens inter os et membranam nihil oppositum inuenit, educiturque siccu⟨m⟩: non quo non subsit aliqua uitiosa sanies, sed quo[niam] ibi ut in latiore sede diffusa sit. Siue autem nigrities, quam terebra detexit, siue caries, quam specillum ostendit, os transit, modioli quidem usus fere superuacuus est, quia latius pateat necesse est, quod ⟨t⟩am alte processit. Terebra uero ea, quam secundo loco posui, utendum; eaque ne nimis incalescat, subinde in aquam frigidam demittenda est. Sed tum maiore cura agendum est, cum iam aut simplex os dimidium perforatum est, aut in duplici superius: illud spatium ipsum, hoc sanguis significat. Ergo tum lentius ducenda habena suspendendaque manus sinistra est et saepius attollenda, et foraminis altitudo consideranda, ut, quandoque qui perrumpatur, sentiamus, neque periclitemur, ne mucrone cerebri membrana laedatur; ex quo graues inflammationes cum periculo mortis oriuntur. Facti⟨s⟩ foraminibus, eodem modo media ⟨saepta⟩, sed multo circumspectius, excidenda sunt, ne forte angulus scalpri eandem membranam uiolet; donec fiat aditus, per quem membranae custos inmittatur: menin⟨go⟩phylaca Graeci uocant. Lammina aenea est, prima paulum resima, ab exteriore parte leuis; quae demissa sic, ut exterior pars ⟨eius⟩ cerebro propior sit, subinde ei subicitur quod scalpro discutiendum est; ac, si excipit eius angulum, ultra transire non patitur; eoque et audacius et tutius scalprum malleolo medicus subinde ferit, donec undique excisum os eadem lammina leuatur, tollique sine ulla noxa cerebri potest. Vbi totum os eiectum est, circumradendae leuandaeque orae sunt, et, si quid scobis membranae insedit, colligendum. Vbi superiore parte sublata relicta inferior est, non orae tantum sed os quoque totum leuandum est, ut sine noxa postea cutis increscat, quae aspero osse nascens protinus non sanitatem, sed nouos dolores mouet. Patefacto cerebro qua ratione agendum sit, dicam, cum ad fracta ossa uenero. Si bas⟨s⟩is aliqua seruata est, superinponenda sunt medicamenta non pinguia, quae recentibus uulneribus ac⟨c⟩ommodantur; supraque inponenda lana sucida oleo atque aceto madens. Vbi tempus processit, ab ipso o⟨ss⟩e caro increscit, eaque factum manu sinum complet. Si quod etiam ⟨os⟩ adustum est, a parte sana recedit, subi⟨t⟩que inter integram atque ⟨e⟩mortuam partem caruncula, quae quod apscessit expellat; eaque fere, quia testa tenuis et angusta est, squama [id est lepis] a Graecis nominatur. Potest etiam euenire, ut ex ictu neque findatur os neque perfringatur, sed summum tamen collidatur exaspereturque; quod ubi incidit, radi et leuari satis est. Haec quamuis maxime fiunt in capite, tamen ceteris quoque ossibus communia sunt, ut ubicumque idem incidit, eodem remedio sit utendum. At quae FRACTA, fissa, forata, collisa sunt, quasdam proprias in singulis generibus, quas⟨dam⟩ communes in pluribus curationes requirunt; de quibus protinus dicam, initio ab eadem caluaria accepto.

## 32. Book VIII · chapters 4–8

Source: https://scriptura.si/works/celsus-on-medicine/32/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/32/#p-N

[¶0] 4. 4 Therefore after a blow on the head first we must enquire whether the patient has had bilious vomiting, whether there has been obscurity of vision, whether he has become speechless, whether he has had bleeding from the nose or ears, whether he fell to the ground, whether he has lain senseless as if asleep; for such signs do not occur unless with fractured bone; and when they are present, we must recognize that treatment is necessary but difficult. If in addition there is also stupor, if the mind wanders, if either paralysis or spasm has followed, it is probable that the cerebral membrane has also been lacerated; and then there is little hope. But if none of these signs follows the injury, it is not even certain whether the bone is broken: and the first thing then to consider is whether he was struck by a stone or club or sword or other such weapon, and whether such a weapon was blunt or pointed, medium or heavy, used with much or little force; for the lighter the blow, the more easily we may conclude that the bone has resisted it. But the best plan is to make certain by exploration. Accordingly a probe should be introduced into the wound; it should be neither very fine nor pointed, lest it enter one of the natural sutures and give rise to a false belief in a fracture of bone; neither should it be too thick lest small fissures be missed. When the probe comes into contact with the bone, if nothing but what is smooth and slippery is met with, it can be seen that the bone is intact; if any roughness is met with, at least where there are no sutures, it is a sign that the bone is fractured. Hippocrates, with great men's love of truth in great matters, has described how he had been deceived by sutures. For shallow minds, because they have nothing, never belittle themselves; such a sincere confession of the truth befits a great mind which will still have many titles to greatness, and especially in performing the task of handing down knowledge for the advantage of posterity, that no one else may be deceived again by what has deceived him. But my regard for the memory of a great teacher has somehow led me into this digression. Now a suture may possibly deceive just because it is rough too; so that although there is really a fissure, yet we may take it to be a suture, where it is likely that there is one. Therefore we must not be deceived just by this; the safest way is to lay bare the bone. For as I have stated above, sutures are not always in the same position, and a natural union of bone and a fissure from injury may coincide, or the fissure may be close by. Therefore sometimes when the blow was severe, although nothing is detected by the probe, it is still best to open the place up. And if even then no fissure is visible, ink is to be applied over the bone, then it is to be scraped with a chisel; for a fissure will retain the blackness. It may even happen that the blow may have been upon one part of the head, and fracture at another. Thus if anyone has been heavily struck and bad signs have followed, and no fissure has been found in the part where the scalp has been wounded, it is worth while to examine whether some other part is softer and swollen, and to lay it open; then perhaps fissured bone may be found there. Even if it be uselessly incised, the scalp heals without much trouble. A fractured bone unless it is treated causes severe inflammations, and is treated afterwards with greater difficulty. Rarely, but now and then, it happens, however, that whilst the bone remains whole and sound, yet within the skull a blood-vessel in the cerebral membrane has been ruptured by the blow and some blood has escaped, and this having formed a clot, causes great pains, or sometimes obscures vision. But generally the pain is directly over the clot, and when the scalp at that point is incised, the bone is found to be pallid; if so, that bone also is to be cut out.

> Latin: 4. Igitur ubi ea percussa, protinus requirendum est, num bilem homo is uomuerit, num oculi eius occaecati sint, num obmutuerit, num per nares auresue sanguis ei fluxerit, num conciderit, num sine sensu quasi dormiens iacuerit: haec enim non nisi osse fracto eueniunt; atque ubi inciderunt, scire licet necessariam sed difficilem curationem esse. Si uero etiam torpor accessit, si mens non constat, si neruorum uel resolutio uel distentio secuta est, uerisimile est etiam cerebri membranam esse uiolatam; eoque in angusto magis spes est. At si nihil horum secutum est, potest etiam dubitari, an os fractum sit; et protinus considerandum est, lapide an ligno an ferro an alio telo percussus sit, et hoc ipso le⟨u⟩i an aspero, mediocri an uastiore, uehementer an leuiter, quia quo mitior ictus f⟨u⟩it, eo facilius os ei restitisse credibile est. Sed nihil tamen melius est quam certiore id nota explorare. Ergo qua plaga est, demitti specillum oportet, neque nimis tenue neque acutum, ne, cum in quosdam naturales sinus inciderit, opinionem fracti ossis frustra faciat; neque nimis plenum, ne paruolae rim⟨ul⟩ae fallant. Vbi specillum ad os uenit, si nihil nisi leue et lubricum occurrit, integrum id uideri potest; si quid asperi est utique qua suturae non sunt, fractum os esse testatur. A suturis se deceptum esse Hippocrates memoriae prodidit, more scilicet magnorum uirorum et fiducia⟨m⟩ magnar⟨um⟩ rer⟨um⟩ habentium. Nam leuia ingenia, quia nihil habent, nihil sibi detrahunt: magno ingenio, multaque nihilo minus habituro, conuenit etiam simplex ueri [erroris] confessio praecipueque in eo ministerio, quod utilitatis causa posteris traditur, ne qui decipiantur eadem ratione, qua quis ante deceptus est. Sed haec quidem alioqui memoria magni professoris ut interponeremus effecit. Potest autem sutura eo nomine fallere, qu⟨ia⟩ aeque aspera est; ut aliquis hanc esse, etiamsi rima est, existimet eo loco, quo subesse hanc verisimile est. Ergo eo nomine decipi non oportet, sed os deoperire tutissimum. Nam neque utique certa sedes, ut supra posui, suturarum est, et potest idem et naturaliter commissum et ictu fissum esse iuxtaue aliquid fissum habere. Quin aliqu⟨ando⟩ etiam, ubi ictus fuit uehementior, quamuis specillo nihil inuenitur, tamen aperire commodius est. Ac si ne tum quidem rima manifesta est, inducendum super os atramentum scriptorium est, deinde scalpro id deradendum: nigritiem enim continet, si quid fissum est. Solet etiam euenire, ut altera parte fuerit ictus, et os altera fiderit. Itaque si grauiter aliquis percussus est, si mala indicia subsecuta sunt, neque ea parte, qua cutis discussa est, rima reperitur, non incommodum est parte altera considerare, num qui locus mollior sit et tumeat, eumque aperire, siquidem ibi fissum os reperietur. Nec tamen magno negotio cutis sanescit, etiamsi frustra secta est. Os fractum, nisi si succursum est, grauibus inflammationibus adficit, difficiliusque postea tractatur. Raro sed aliquando tamen euenit, ut os quidem totum integrum maneat, intus uero ex ictu uena aliqua in cerebri membrana rupta aliquid sanguinis mittat, isque ibi concretus magnos dolores moueat, * oculos quibus⟨dam⟩ obcaecet. Sed fere contra id dolor est et eo loco cute incisa pallidum os reperitur; ideoque id quoque os excidendum est.

[¶1] But for whatever cause this treatment is necessary, if the scalp has not been laid open sufficiently, it must be incised more widely until the injury is well in view. In doing so we must see that none of the fine inner membrane covering the skull, under the scalp, remains over the bone; for whenever this is lacerated by the chisel or trepan it causes severe fevers with inflammations, and so it is better to raise it wholly off the bone. If there is a cut as part of the wound we must take it as it is; if we have to make it, the best incision is generally that which is formed by two lines in the shape of the letter X; next the scalp is raised by cutting under each of the little tongues. When doing this if bleeding takes place it must be checked by the application of a sponge saturated with vinegar from time to time, also it must be absorbed by swabs of dry lint and the head must be raised higher. There need be no anxiety unless it comes from among the muscles covering the temples; but there also this is the safest method of dealing with it.

> Latin: Quacumque autem de causa ⟨cu⟩ratio haec necessaria est, si nondum satis cutis patefacta est, latius aperienda est, donec quicquid laesum est in conspectu sit. In quo ipso uidendum est, ne qui⟨d⟩ ex ima membranula, quae sub cute caluariam cingit, super os relinquatur, siquidem ea scalpro terebrisue lacerata uehementes febres cum inflammationibus excitat; itaque eam commodius est ex toto ab osse deduci. Plagam, si ex uulnere est, talem necesse est habeamus, qualem acceperimus: si manu facienda est, ea fere commodissima est, quae duabus transuersis lineis litterae X figuram accipit; tum deinde a singulis procedentibus lingulis cutis subsecatur. Inter quae si sanguis fertur, spongia subinde in aceto tincta cohibendus est, occupandusque est obiectis linamentis et caput altius excitandum. Neque id ullum metum, nisi inter musculos qui tempora continent, adfert: sed ibi quoque nihil tutius fit.

[¶2] In every case of a fissured or fractured bone, the older practitioners resorted at once to the instruments for cutting out the fragments. But it is much better first to try the plasters which are prepared for the cranium. One of these dissolved in vinegar is to be put upon the fissured or fractured bone by itself; next over this, a little overlapping the wound, lint steeped in the same, and over this unscoured wool sprinkled with vinegar; then the wound is bandaged and the dressing changed daily, and so treated up to the fifth day; on the sixth day also the wound is steamed by means of a sponge, then dressed as before. And if granulation begins, and the feverishness either subsides or lessens, and appetite returns, and there is sufficient sleep, we should persevere with the same applications. Next as time goes on, the plaster is to be softened by the addition of the cerate made with rose oil that it may cause the flesh to grow more readily; for by itself it has a repressant action. Under this treatment fissures are often filled up by some callus which forms a sort of scab in the bone; and if the fragments are more widely separated, any that are not in contact also become fastened together by the same callus, and this is a better covering for the brain than the flesh which grows up after the bone has been excised. But if under this first treatment fever becomes intensified and sleep short and disturbed by dreams, while the wound discharges and does not heal, and the glands in the neck on each side swell, and there is great pain, and in addition a growing aversion to food, then at length we must resort to surgery with the chisel.

> Latin: In omni uero fisso fractoue osse protinus antiquiores medici ad ferramenta ueniebant, quibus id exciderent: sed multo melius est ante emplastra experiri, quae caluariae causa conponuntur. Eorumque aliquod oportet ex aceto mollitum per se super fissum fractumue os inponere; deinde super id aliquanto latius quam uulnus est eodem medicamento inlitum linteolum, et praeterea sucidam lanam aceto tinctam; tum uulnus deligare et cotidie resoluere, similiterque ⟨curare usque⟩ ad diem quintum, a sexto die etiam uapore aquae calidae per spongiam fouere, cetera [ex] eadem facere. Quod si caruncula increscere coeperit et febricula aut soluta erit aut breuior et cupiditas cibi reuerterit, satisque ⟨s⟩omni accedet, in eodem medicamento erit perseuerandum. Procedente deinde tempore, emolliendum id emplastrum adiecto cerato ex rosa facto, quo facilius carnem producat: nam per se reprimendi uim habet. Hac ratione saepe rimae callo quodam inplentur estque ea ossis uelut cicatrix; et latius f⟨r⟩acta ossa, si qua inter se non cohaerebant, eodem callo glutinantur estque id aliquanto melius uelamentum cerebro quam caro, quae exciso osse increscit. Si uero sub prima curatione febris intenditur breuesque somni et idem per somnia tumultuosi sunt, ulcus madet neque alitur, et in ceruicibus glandulae oriuntur, magni dolores sunt, cibique super haec fastidium increscit, tum demum ad manum scalprumque ueniendum est. Duo uero sub ictu caluariae pericula sunt, ne uel findat⟨ur⟩ ⟨os⟩ uel medium desidat.

[¶3] A blow on the cranium involves two dangers; either a split bone or a depressed fracture. If the bone is split, the edges may remain in close contact, either because one margin overrides the other, or because they have become closely interlocked again. Hence it follows that humour collects on to the cerebral membrane but has no means of exit, and so irritates it, exciting severe inflammation. But when there is a depressed fracture, the bone presses on the cerebral membrane and sometimes also sharp points like needles from the fractured bone cause irritation. Cases like this require assistance, with as little loss of bone as possible. Therefore if one edge overlies the other, it is sufficient to cut away the overlying edge with a flat chisel; when this is removed a gap is left wide enough for treatment. But when the fractured edges have become interlocked, a hole should be made with a trepan at a finger's breadth to one side; and from this two cuts should be made with the chisel to the fissure, in the form of the letter V, with the apex at the hole and the base at the fissure; but if the fissure is a lone one, similar curs should be made from a second hole. And thus there is no concealed cavity in that bone, and a way out is given freely to all harmful material within. Even when the fractured bone is depressed, it need not all be excised. But whether completely broken off and separated from the rest, or still attached by a small portion to the skull around, the fragment should be separated by the chisel from the sound bone. Next, in the depressed fragment, close to the groove which we have just made, holes are to be bored as well; two when the damage is of small extent, three when larger, and the intervening partitions must be cut through. Next the chisel is to be so used on each side of the said groove, that a crescent-shaped gap is made with its convexity on the side of the fragment, and its horns directed towards the intact bone. Then if there are any detached fragments which can be easily removed, they are to be seized with forceps made for the purpose and particularly the pointed fragments which are irritating the membrane. If this cannot be done easily, the plate which I have suggested as a guard of this membrane is to be passed underneath in order that all pointed fragments which project inwards may be cut away over the plate, and any depressed bone is to be raised by means of the same plate. This method of treatment ensures that fragments still attached become consolidated; and detached fragments come away in course of time under the dressing without any pain; and by that treatment there is left a gap in the skull large enough for the extraction of matter; and the brain is better protected by leaving the bone than if it had been excised. After this, that membrane should be sprinkled with strong vinegar, in order that any bleeding from it may be checked, or any collection of clot which remains inside may be broken up. Then the same plaster, softened as described above, should be put on the membrane itself; and the rest of the dressing as before, ointment on the lint, and unscoured wool; the patient should be kept in a warm room; the wound dressed daily, even twice a day in summer.

> Latin: Si fissum est, possunt ⟨o⟩rae esse conpressae, uel quia altera super alteram excessit, uel etiam quia uehementer se rursus commiserunt. Ex quo euenit, ut umor ad membranam quidem descendat, exitum uero non habeat ac si⟨c⟩ eam inritet et graues inflammationes moueat. A⟨t⟩ ubi medium desedit, eandem cerebri membranam os urget interdum etiam ex fractura quibusdam uelut aculeis pungentibus. His ita succurrendum est, ut tamen quam minimum ex osse dematur. Ergo si ora alteri insed⟨it, satis est id quod eminet⟩, plano scalpro excidere; quo sublato ⟨iam⟩ rima hiat quantum curationi satis est. At si orae inter se conprimuntur, a latere eius interposito digiti spatio terebra foramen faciendum est; ab eoque scalper duabus lineis ad rimam agendus ad similitudinem †c litterae sic, ut ue⟨r⟩tex ⟨eius⟩ a foramine, basis a rima sit: quod si rima longius patet, ab altero foramine rursus similis sinus fieri debebit. Et ita †nihil latens in eo osse cauum est abundeque exitus datur intus laedentibus. Ne si fractum quidem os desedit, totum excidi necesse est. Sed siue totum perfractum est et ab alio ex toto recessit siue circumpositae caluariae inhaeret exigua parte, ab eo, quod naturaliter se habet, scalpro diuidendum est. Deinde in eo, quod desedit, iuxta rimam, quam fecimus, foramina addenda sunt; si in angusto noxa est, duo; si latius patet, tria; saeptaque eorum excidenda; et tum scalper utrimque ad rimam agendus sic, ut lunatum sinum faciat imaque pars eius intus ad fracturam, cornua ad os integrum spectent. Dein, si qua labant ⟨et⟩ ex facili remoueri possunt, forfice ad id facta colligenda sunt, maximeque ea, quae acut⟨a⟩ membranam infestent. Si id ex facili fieri non potest, subicienda lammina est, quam custodem eius membranae esse proposui; ut super, quicquid spinosum est et intus eminet, excidatur; eademque lammina, quicquid deorsum insedit, attollendum. Hoc genus curationis efficit, ut qua parte fracta ossa tamen inhaerent, solidentur; qua parte abrupta sunt, sine ullo tormento sub medicamento tempore excidant; spatiumque inter haec satis illa magnum ad extrahendam saniem relinquatur; plusque in osse propugnaculi cerebrum habeat, quam habiturum fuit eo exciso. His factis, ea membrana acri aceto respergenda est, ut, siue aliquid sanguinis ex ea profluit, cohibeatur, siue intus concretus cruor remanet, discutiatur. Tum idem medicamentum eodem modo, qui supra positus est, mollitum ipsi membranae inponendum est; ceteraque eodem modo facienda sunt, quae ad linteolum inlitum et lanam sucidam pertinent; conlocandusque is loco [in] tepido; curandum cotidie uulnus, bis etiam aestate. Quod si membrana per inflammationem intumuerit, infundenda erit rosa tepida;

[¶4] But if the membrane swells up through inflammation, it is to be bathed with tepid rose oil; if it swells so as to project even above the level of the skull, well-ground lentils or crushed vine leaves, mixed either with fresh butter or goose-grease, will control it; and the neck should be anointed with liquid cerate containing iris oil. But if it shall ap-pear that the membrane is not clean, equal parts of its special medicament and of honey are to be mixed together and poured on, and to keep this in place one or two pads of lint must be put on, and over all linen upon which some of the medicament has been smeared. When the membrane is clean, a cerate to form flesh is to be added to the medicament and similarly applied.

> Latin: si usque eo tumebit, ut super ossa quoque emineat, coercebit eam bene trita lenticula uel folia uitis contrita, et cum recenti uel buturo uel adipe anserina mixta; cerui⟨x⟩que molliri debebit liquido cerato ex irino facto. At si parum pura membrana uidebitur, par modus eius emplastro et melli miscendus erit, idque super infundendum; eiusque continendi causa unum aut alterum linamentum iniciendum, et super linteolo, cui emplastrum inlitum sit, contegendum. Vbi ⟨[plus] pura⟩ membrana est, eadem ratione adiciendum emplastro ceratum, ut carnem producat. Quod ad abstinentiam uero et primos ulterioresque cibos potionesque pertinet, eadem, quae in uulneribus praecepi, seruanda sunt, eo magis, quo periculosius haec pars adficitur.

[¶5] As regards abstinence and the food and drink at first and later, the same course is to be adopted as I prescribed for wounds, and all the more because the danger is greater when this part is affected. And even when the time has come not only to sustain but also to build up the patient, still anything requiring mastication should be avoided; and also smoke and anything which provokes sneezing. But there is good hope when the membrane is movable and of normal colour, when the flesh growing up is a brit red, and when the jaw and neck move with ease. Bad signs are: the membrane immobile, black or livid or any other unwholesome colour; delirium, acrid vomiting, paralysis or spasm livid flesh, rigor of jaw and neck. As for other signs — sleep, appetite, fever, colour of the pus — the indications as to recovery or death are the same as in the case of other wounds. When things are going well, flesh grows up from the ma itself and from the bone as well if it is in two layers, so that the space between the bones becomes filled up; sometimes it even grows out above the skull. If this occurs copper scales are to be dusted on in order to repress and control it. Also applications to induce a scar must be laid on the flesh. And this is readily brought about everywhere except on the forehead a little above the eye-brows; for there it is almost impossible to avoid a lifelong wound which has to be kept covered by medicated lint. It should be the rule for all cases in which the skull has been fractured, that until the scar is firm, the patient should avoid sun, wind, frequent baths, and the free use of wine.

> Latin: Quin etiam, cum iam non solum sustineri sed ali is quoque ⟨oportebit⟩, tamen erunt uitanda, quaecumque mandenda sunt; item fumus et quicquid excitat sternumentum. Spem uero certam faciunt membrana mobilis ac sui coloris, caro increscens rubicunda, facilis motus maxillae atque ceruicis. Mala signa sunt membrana inmobilis, nigra uel liuida uel aliter coloris corrupti; dementia, acris uomitus, neruorum uel ⟨re⟩solutio uel distentio; caro liuida, maxillarum rigor atque ceruicis. Cetera, quae ad somnum, cibi desiderium, febrem, puris colorem attinent, eadem, quae in ceteris uulneribus, uel salutaria uel mortifera sunt. Vbi bene res cedit, incipit ab ipsa membrana uel si os eo loco duplex est inde quoque caro increscere; eaque ⟨id, quod⟩ inter ossa uacum est, replet: nonnumquam etiam super caluariam excrescit. Quod si incidet, inspergenda squama aeris est, ut id reprimat cohibeatque. Ea carni superdanda, quae ad cicatricem perducant. Omnibusque ea locis commode inducitur excepta frontis ea parte, quae paulum super id ⟨est,⟩ quod inter supercilia est: ibi enim ui⟨x⟩ fieri potest, ut non per omnem aetatem sit exulceratio; quae linteolo medicamentum habente contegendas⟨t⟩. Illa utique capite fracto seruanda sunt, ut, donec iam ualida cicatrix ⟨sit,⟩ uitentur sol, uen⟨t⟩us, frequens balineum, maior uini modus.

[¶6] 5. 5 In the nostrils again either the bony or cartilaginous part may be broken, and that either in front, or to one side. If both are broken across, or one of them, the nose sinks in and the breath is drawn through with difficulty; if bone on one side is broken, there is a depression; if cartilage, the nose is bent to the opposite side. Whatever occurs in the case of the cartilage, it must be gently raised either by passing a probe under it or by compressing with a finger on each side; then a roll of folded linen with thin leather sewn on over it is introduced; or some sort of dry pad similarly shaped; or a large quill smeared with gum or joiner's glue, and wrapped round with soft thin leather, which will prevent the cartilage from sinking in again. But if broken across, both nostrils are to be filled equally; if on one side, the nostril on the side to which the nose is bent should be filled with a thicker roll, the other nostril with a thinner one. Outside also a strap of soft leather, the middle smeared with a mixture of fine flour and incense soot, is applied, and it must be carried back behind the ears and fastened to the forehead by its two ends. The flour and incense when dried sticks to the skin like glue and keeps the nose in place. If what has been inserted causes irritation, as happens mostly when the septal cartilage inside is fractured, the nostrils are to be raised and kept in place by the strip of leather alone; then this too is removed at the end of a fortnight after loosening with warm water, and afterwards every day the nose should be fomented with the same. But if the bone is broken, this also is put back into position by the finger; and when the injury is in front, both nostrils are plugged; when on one side, the nostril on the side towards which the bone has been displaced. Cerate is to be applied, and the part bound fairly tightly, because in this position callus grows not only sufficiently to cause union, but even into a tumour. From the third day the nose is to be fomented with hot water, more especially as it begins to unite. Even if there are several fragments, each is to be forced into place by the fingers applied outside, and the strip in the same way is to be put on outside, and a cerate over it, and no additional bandage. But if any fragment has become completely separated and will not unite with the rest, this will be recognized by the fluid which is discharged freely from the lesion; then the fragment should be extracted by means of a forceps; when the inflammatory reaction is at an end, some medicament from among the mild repressants is applied. The case is worse when there is an external wound as well as a fracture, whether of bone or cartilage. This only occurs rarely. If it does happen, the fragments are to be replaced into position in the same way, while the skin is dressed with one of the plasters suitable for recent wounds; but no bandage must be put over it.

> Latin: 5. In naribus uero et os et cartilago frangi solet, ⟨et⟩ quidem modo aduersa, modo a latere. Si aduersa ⟨a⟩m⟨b⟩o fracta sunt alterumue ex is, nare⟨s⟩ desidunt, difficulter spiritus trahitur: si a latere os fractum est, is locus cauus ⟨est⟩; si cartilago, in alteram partem nares declinantur. Quicquid in cartilagine incidit, excitand⟨a⟩ ea leniter est aut subiecto specillo aut duobus digitis utrimque conpressis; deinde in longitudinem inplicata l⟨i⟩namenta et molli pellicula cincta circumsutaque intus adigenda sunt; aut eodem modo compositum aliquid ex arido penicillo; aut grandis pinna cummi uel fabrili glutine inlita et molli pellicula circumdata, quae desidere cartilaginem non sinat. Sed si aduersa ea fracta est, aequaliter utraque naris inplenda est: si a latere, crassius esse debet ab ea parte, in quam nasus iacet, ab altera tenu⟨iu⟩s id quod inseritur. Extrinsecus autem circumdanda habena est mollis, media inlita mixtis inter se simil⟨a⟩ et turis fuligine; eaque ultra aures ducenda et fronti duobus capitibus adglutinanda est: id enim corpori quasi gluten inhaerescit et, cum induruit, nares commode continet. Sin quod intus inditum est laedit, sicut maxime fit, ubi interior cartilago perfracta est, excitatae nares eadem tantummodo habena continendae sunt; deinde post quattuordecim dies id ipsum demendum est. Resoluitur autem aqua calida, eaque tum is locus cotidie ⟨f⟩ouendus. ⟨S⟩in ⟨os⟩ fractum est, id quo⟨que⟩ digitis in suam sedem reponendum est; atque ubi aduersum id ictum est, utraque naris inplenda est; ubi a latere, ea, in quam os inpulsum est; inponendumque ceratum, et paulo uehementius deligandum est, quia callus eo loco non ad sanitatem tantummodo, sed etiam ad tumorem increscit. A tertio die fouendum id aqua calida est, tantoque magis, quanto propius esse sanitati debet. Quod si plura erunt fragmenta, nihilo minus extrinsecus singula in suas sedes digitis erunt conpellenda; inponendaque extrinsecus eadem habena, et super eam ceratum; neque ultra fascia adhibenda est. ⟨At si⟩ quod fragmentum undique resolutum cum ceteris non glutinabitur, intellegetur quidem ex umore, qui multus ex uulnere feretur, uolsella uero extrahetur; finitisque inflammationibus, inponetur aliquod medicamentum ex is, quae leniter reprimunt. Peius est, ubi aut ossi aut cartilagini fractae cutis quoque uulnus accessit. Id admodum raro fit. Si incidit, illa quidem nihilo minus eadem ratione in suas sedes excitanda sunt: cuti uero superinponendum emplastrum aliquod ex is, quae recentibus uulneribus accommodata sunt: sed insuper nullo uinculo ⟨de⟩ligandum est.

[¶7] 6. 6 In the ear also the cartilage is sometimes ruptured. If this happens, before suppuration has supervened, an agglutinating medicament should be put on; for this often prevents suppuration, and cures the ear. As in the case of the nose, it must not be overlooked that the cartilage itself does not agglutinate, but flesh grows round it and so the place becomes consolidated. Hence, if the skin is torn along with rupture of the cartilage, the skin on both sides is to be stitched. But I speak now of a case where the cartilage is broken, but the skin intact. Now in that case if suppuration supervenes, the skin on the other side is to be laid open and a crescent-shaped piece of cartilage cut out beneath; then a mild styptic such as lycium dissolved in water is put on until bleeding ceases; next lint smeared with a plaster without any grease is applied and soft wool to fill the space between the ear and the head; then the ear is lightly bandaged, and from the third day the ear is steamed as in the case of the nose (5.4). In these kinds of injuries also fasting is necessary at first until inflammation has ceased.

> Latin: 6. In aure quoque interdum rumpitur cartilago. Quod si incidit, antequam pus oriatur, inponendum glutinans medicamentum est: saepe enim suppurationem prohibet ⟨et⟩ aurem confirmat. Illud et in hac et in naribus ignorari non oportet, ⟨non⟩ quidem cartilaginem ipsam glutinari, circa tamen carnem increscere solidarique eum locum. —Itaque si cum cute cartilago rupta est, cutis utrimque suitur. Nunc autem de ea dico, quae cute integra frangitur. In ea uero si iam pus natum est, aperienda altera parte cutis et ipsa cartilago contra lunata plaga excidenda est; deinde utendum est medicamento leniter supprimente, quale Lycium est aqua dilutum, donec sanguis fluere desinat; tum inponendum linteolum cum emplastro sic, ut pingue omne u⟨i⟩tetur, et a parte posteriore lana mollis auri subicienda est, quae quod est inter hanc et caput compleat; tum ea leniter deliganda est, et a tertio die uapore, ut in naribus posui fouenda. Atque in his quoque generibus abstinentia primi temporis necessaria est, donec inflammatio finiatur.

[¶8] 7. 7 As I am going to pass on from the above to the lower jaw I think I ought to point out certain matters pertaining to fractures so as not to have to say the same things too often. Any bone, then, may be split, either in a straight line as a log of wood is cleft lengthwise, or across, sometimes obliquely; and in the latter case, the fractured ends are sometimes blunted, sometimes pointed. The last is the worst because two ends are not brought together easily when they have nothing blunt to rest against, and they lacerate the flesh, sometimes also sinews and muscles; indeed sometimes there are several fragments. Now in other bones one fragment often separates from another completely; but in the case of the jaw the pieces of bone even when injured are always in contact with one another at some point. Begin then by applying pressure with the two thumbs in the mouth and two fingers on the skin outside, and force all the fragments into position; next, if the lower jaw has been broken across, in which case generally one tooth stands higher than its neighbour, when it has been put back into position tie together with horsehair the two adjacent teeth, or if these are loose, teeth further away. In other varieties of this fracture, the binding is superfluous, but what follows is the same for all: a double fold of linen soaked in wine and oil is to be put on, smeared with fine flour and incense as before; then over this a bandage or strip of soft leather has a slit made in the middle to enclose the chin on each side and thence the ends are carried to the top of the head and tied there. What follows applies to fractures in general: fasting is a necessity at first; then from the third day a fluid diet, and when the inflammation has subsided a somewhat fuller diet to build up the strength; wine is wrong throughout; then on the third day the bandage is removed, and the part fomented with steam by means of a sponge, and the bandage reapplied as before; the same thing is to be done again on the fifth day and so on until the inflammation has ceased, which is generally by the ninth or the seventh day. The inflammation gone, the bones must be examined again, and if the fractured ends are not in place, they are reset; after which the bandaging should not be dispensed with until two-thirds of the time has elapsed which such bones take to unite. Bones generally reunite as follows: between the fourteenth and twenty-first days the lower jaw, cheek-bones, clavicle, sternum, blade-bones, ribs, spine, hip-bone, astragalus, heel-bone, and the bones of the hands and feet; between the twentieth and thirtieth days the bones of the leg and forearm; between the twenty-seventh and fortieth days the upper arm and thigh. But in the case of the lower jaw, there is this addition, that fluid food has to be taken for a longer period. And even after time has elapsed the patient must continue to eat pancakes and such-like, and must not eat anything hard until the formation of callus has rendered the lower jaw quite firm; also, at any rate for the first days, the patient should not speak.

> Latin: 7. Ab his ad maxillam uenturus indicanda quaedam puto communiter ad omnia ossa pertinentia, ne saepius eadem dicenda sint. Omne igitur os modo rectum ut li⟨g⟩num in longitudine⟨m⟩ finditur, modo frangitur transuorsum, interdum oblicum; atque id ipsum nonnumquam retusa habet capita, nonnumquam acuta. Quod genus pessimum est, quia neque facile committuntur, quae nulli retuso innituntur, et carnem uulnerant, interdum neruum quoque aut musculum: quin etiam aliquando plura fragmenta fiunt. Sed in aliis quidem ossibus ex toto saepe fragmentum a fragmento recedit: maxillae uero semper aliqua parte etiam uexata ossa inter se cohaerent. Igitur inprimis digitis duobus utrimque prementibus et ab ore et ab cute omnia ossa in suam sedem compellenda sunt; deinde, si transuersa maxilla fracta est (sub qu⟨o⟩ casu fere dens super proximum dentem excedit), ubi ea in suam sedem conlocata est, duo proximi dentes aut, si hi labant, ulteriores inter se seta deligandi sunt. ⟨Id in alio genere fracturae superuacuum est, cetera eadem facienda sunt:⟩ nam linteolum duplex madens uino et oleo superiniciendum cum eadem simil⟨a⟩ et eadem ⟨turis⟩ fuligine est; deinde aut fascea aut mollis habena media in longitudinem incisa, ut utrimque mentum conplectatur et inde capita eius supra caput adducta ibi deligentur. Illud quoque ad omnia ossa pertinens dictum erit, famem primum esse necessariam; deinde a die tertio umidum cibum, ⟨sub⟩lata inflammatione paulo pleniorem, eumque qui carnem alat: uinum per omne tempus esse alienum; deinde tertio die resolui debere, foueri per spongia⟨m⟩ uapore aquae calidae, eademque quae primo fuerunt superdari: idem die quinto fieri et donec inflammatio finiatur, quae uel nono die uel septumo fere soluitur. Ea sublata, rursus ossa esse tractanda, ut, si quid fractum loco suo non est, reponatur: neque id esse soluendum, nisi duae partes eius temporis, intra quod quaeque ossa conferu⟨e⟩nt, transi⟨erint⟩. Fere uero int⟨er⟩ quartum decimum et unum et uicensimum diem sanescunt maxilla, malae, iugulum, pectus, latum os scapularum, costae, spina, coxarum os, ta⟨li,⟩ calx, manus, planta: inter uicensimum et tricensimum diem crura, bracchiaque: inter septimum et uicensimum et quadragensimum umeri et femina. Sed in maxilla illud quoque adiciendum est, quod umidus cibus diu adsumendus est. Atque etiam cum tempus processit, in lagano similibusque aliis perseuerandum est neque quicquam edendum ⟨duri,⟩ donec ex toto maxillam callus firmarit; itemque utique primis diebus habendum silentium.

[¶9] 8. 8 Now if the clavicle has been broken across, it sometimes unites correctly by itself, and unless moved can be cured without being bandaged; but sometimes, and especially when it has been moved, it slips out of place. And generally the fragment on the side of the breast is bent forwards, that on the side of the shoulder backwards. The reason is that the bone has no independent movement, but moves with the shoulder, while the part attached to the breast is immovable; therefore while this remains stationary, the shoulder-fragment is displaced below it by the movement of the shoulder. But so seldom does the clavicle incline forwards that great teachers have recorded that they have never seen it. However, the authority of Hippocrates is ample on this matter. But as the two cases are different, so they require different treatment. When the clavicle points towards the blade-bones, the shoulder is to be forced backwards with the palm of the right hand, and simultaneously the clavicle must be brought forwards. When the clavicle has been turned towards the chest it must be directed backwards, and the shoulder is to be drawn forwards, and if the shoulder is lower, the breast-fragment is not to be pressed down, for it is immobile, but the shoulder must be raised. And if the shoulder is higher the breast-fragment is to be covered with wool, and the arm bandaged to the chest. If the fragments have pointed ends, the skin over them should be incised, and the splinter which are injuring the flesh cut off from the bones, after which the blunted ends are to be brought together. If any part of the clavicle projects it should be covered with three layers of linen soaked in wine and oil. If the fragments are numerous, they must be fixed with a gutter-splint made of cane smeared on its inner side with cerate so that it does not slip under the bandage. The turns of the bandage when the clavicle is fixed should be many, rather than tight, and this should be the rule in the case of other fractured bones. If the right clavicle is fractured, the bandage must be carried from it to the left armpit, if the left clavicle, to the right armpit, then back under the armpit of the fractured side. After this, if the clavicle is inclined towards the shoulder-blade, the forearm is bandaged to the side; if it points forwards, the forearm is bandaged to the neck and the patient kept on his back. All the rest of the treatment is the same that was described above. But there are several bones almost immobile whether hard or cartilaginous, which cn be either fractured or bored into or crushed or split; such are the cheek-bones, breast-bone, shoulder-blade, ribs, spine, hip, ankle-bones, heel-bone, bones of the palm and sole. All these are treated in a similar way. If there is a wound over the fracture, it is to be dressed with the appropriate medicaments; as the wound heals callus also fills fissures in the bone or any perforation. If the skin is intact and we gather from the pain that the bone is injured, there is nothing else to do but to rest, apply a cerate and a light bandage until the pain is ended by the healing of the bone.

> Latin: 8. Iugulum uero si transuersum fractum est, ⟨non⟩numquam per se rursus recte coit et, nisi mouetur, sanari sine ⟨u⟩inctura potest: nonnumquam uero, maxime⟨que⟩ ubi motum ⟨est,⟩ elabitur. Fereque id, quod a pectore est, * * * id, quod ab umero est, in posteriorem partem inclinatur. Cuius ea ratio est, quod per se non mouetur, sed cum umeri motu consentit * * * itaque eo subsistente sub i⟨d⟩ umer⟨o⟩ agitatur. Raro uero admodum in priorem partem iugulum inclinatur, adeo ut magni professores numquam se uidisse memoriae mandarint. Sed locuples tamen eius rei auctor Hippocrates est. Verum ut dissimilis uterque casus est, sic quaedam dissimilia requirit. Vbi ad scapulas iugulum tendit, simul dextra manu plana propellendus in posteriorem partem umerus ⟨est,⟩ et illud in priore⟨m⟩ adtrahendum. Vbi ad pectus conuersum est, ipsum quidem retro dandum, umerus autem in priorem partem adducendus ac si is inferior est, non id, quod a pectore est, deprimendum est, quia immobile est, sed umerus ipse adtollendus ⟨erit:⟩ a⟨t⟩ s⟨i⟩ superior est, id, quod a pectore est, inplendum lana et umerus ad pectus deligandus est. Si acuta fragmenta sunt, incidi contra cutis debet: ex ossibus ea, quae carnem uulnerant, praecidenda, tum retussa ossa committenda sunt. Si quod ab aliqua parte eminet, opponendum ei triplex linteolum est in uino et oleo tinctum. Si plura fragmenta sunt, excipienda sunt e⟨a⟩ ex ferula facto ca⟨nal⟩iculo eodemque intus incerato, ne fascea diducatur; quae iugulo composito circumdanda est saepius potius quam ualentius; quod ipsum quoque in omnibus ⟨ossibus⟩ fractis perpetuum est. A dextro ⟨uero⟩ iugulo, si id fractum est, ⟨ad⟩ alam sinistram, a sinistro ad dextram †rursusque sub ala sua fasciari debet. Post haec si iugulum ad scapulas inclinatum est, brachium ad latus; si in partem priorem, ad ceruicem deligandu⟨m⟩ est ⟨supinusque homo conlocandus.⟩ Cetera eadem facienda, quae supra conprehensa sunt. Sunt uero plura ossa fere inmobilia uel dura uel cartilaginosa, quae uel franguntur uel forantur uel conliduntur uel finduntur, ut malae, pectus, latum os scapularum, costae, spina, co⟨x⟩arum os, tali, calx, manus, planta. Horum omnium eadem curatio est. Si supra uulnus est, id suis medicamentis nutriendum est; quo sanescente, rimas quoque ossis, aut si quod f⟨ora⟩men ⟨est,⟩ callus implet. Si cutis integra est et os laesum esse ex dolore colligimus, nihil aliud quam quiescendum, inponendumque ceratum est et leniter deligandum, donec sanitate ossis dolor finiatur.

## 33. Book VIII · chapters 9–10

Source: https://scriptura.si/works/celsus-on-medicine/33/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/33/#p-N

[¶0] 9. 9 There is, however, something special to be said of the rib, because it is near the viscera, and that region is exposed to greater danger. A rib then is sometimes split so as not to injured the upper bone, but only the thin structure on its inner side; sometimes it is completely broken across. If the fracture is incomplete, blood is not expectorated, and fever does not follow, nor is there suppuration except very rarely, nor great pain; nevertheless there is some tenderness to touch, but it is quite enough to do what has been described above, and to begin the bandaging from the middle of the bandage that it may not displace the skin to either side. Then after twenty-one days, by which time the bone other formed a firm union, a fuller diet is to be administered in order to fatten the body as much as possible, so as to cover the bone better, for the bone there whilst still tender is liable to injury owing to the thinness of the skin. But during the whole course of recovery the patient muting or even straining the voice, noise, anger, violent bodily movements, smoke, dust, and anything that causes a cough or sneeze; it is not even advisable to hold the breath for long. But if a rib has been broken right across the case is more severe; for grave inflammations follow and fever and suppuration and often danger to life: and blood is expectorated. If therefore the strength allows, blood should be let from the arm on the side of the injury; if strength does not allow of this the trouble is, however, to be countered by a clyster that will not irritate, and by a low diet for a long while. Bread is not allowed before the seventh day, but only broth; and locally a cerate is to be applied made of linseed, to which boiled resin is added; or the poultice of Polyarchus, or cloths soaked in wine, rose oil and olive oil; and over that oft undressed wool then two bandages beginning from the middle and loosely bound on. But it is more important to avoid all the things mentioned above, so much so that even breathing should not be hurried. If cough is persistent, a draught of germander or rue or French lavender or of cumin and pepper should be taken. But if more severe pain comes on a plaster of darnel or of barley meal is also to be applied, to which is added a third of a ripe first and this will lie upon the place by day; but at night, as the plaster may become displaced, use the same cerate or poultice or cloths as above. Therefore too the dressing must be taken off every day until we find the cerate or poultice suffi-cient. And for ten days the patient may be thinned down by hunger, from the eleventh day he may begin nourishing food; and with that the bandages may be applied round even more loosely than at first; and generally this treatment will continue till the fortieth day. But if there is danger of suppuration, the poultice will be more likely to disperse it than the cerate. If the suppuration gains way, and the treatment above described fails to disperse it, there must be no delay lest the bone underneath become diseased; but where there is most swelling, the red-hot cautery is to be applied until it reaches pus; and that is to be let out. When no pointing of the swelling is evident, we may learn where the pus is chiefly deposited as follows. We smear the whole region with pipe-clay and allow it to dry; the spot where it remains moist the longest marks the neighbourhood of the pus, and there the cautery should be applied. If the suppuration is widely spread, two or three places must be perforated by the cautery. We should then introduce a strip of linen, or some kind of tent bound round with a thread so that it can be easily withdrawn. The rest of the treatment is as in other cauterizations. When the ulceration has cleaned, then the patient should be well fed, lest this disease be followed by what may become fatal wasting. Sometimes even when the bone has been only slightly affected but neglected at first, not pus but a humour somewhat like mucus collects within, and there is a softening under the skin; here also the cauter is to be used. About the spine there is also something special to note. For if a spinal process has in any way been fractured, there is a depression at that spot, also pricking pains are felt in it, because such fragments are necessarily spiky; this consequently makes the patient lean forwards. These are the signs of the condition; but the same medicaments are required as have been mentioned in the early part of this chapter.

> Latin: 9. ⟨Proprie⟩ quaedam tamen de costa dicenda sunt; quia iuxta uiscera est, grauioribusque periculis is locus expositus est. Haec quoque igitur interdum sic finditur, ut ne summum quidem os sed interior pars eius, quae rara est, laedatur, interdum sic, ut eam tota⟨m⟩ is casu⟨s⟩ perruperit. Si tota fracta non est, nec sanguis expuitur nec febricula sequitur, nec quicquam suppurat, nisi admodum raro, nec dolor magnus est: tactu tamen is locus leniter indolescit. Sed abunde est eadem, quae supra scripta sunt, facere, et a media fascea incipere deligare, ne in alterutram partem haec cutem inclinet. Ab uno uero et uicensimo die, quo utique os esse debet glutinatum, id agendum cibis uberioribus est, ut corpus quam plenissimum fiat, quo melius os uestiat, quod illo loco tenerum adhuc iniuriae sub tenui cute expositum est. Per omne autem tempus curationis uitandus clamor, strictior quoque *, tumultus, ira, motus uehementior corporis, fumus, puluis, et quicquid uel tussim uel sternumentum mouet; ne spiritum quidem magnopere continere expedit. At si tota costa perfracta est, casus asperior est: nam et graues inflammationes et febris et suppuratio et saepe uitae periculum sequitur: et sanguis spuitur. Ergo, si uires patiuntur, ab eo bracchio, quod super eam costam est, sanguis mittendus est: si non patiuntur, aluus tamen sine ullo acri ducenda est, diutiusque inedia pugnandum. Panis uero ante septimum diem non adsumendus, sed una sorbitione uiuendum; inponendumque ei loco ceratum ex lino factum, cui cocta quoque resina adiecta sit; aut Polyarchi malagma, aut ⟨p⟩anni ex uino et rosa et oleo; superque inponenda lana sucida mollis et duae fasceae a mediis orsae minimeque adstrictae. Mult⟨o⟩ uero magis omnia uitanda, quae supra posui, adeo ut ne spiritus quidem saepius mouendus sit. Quod si tussis infestabit, potio sumenda erit uel ex trixsagine uel ex ruta uel ex [herba] sto⟨e⟩chade uel ex cumino et pipere. Grauioribus uero doloribus urguentibus cataplasma inponi quoque conueniet uel ex lolio uel ex hordeo, cui pinguis fici tertia pars sit adiecta; et id quidem interdiu superiacebit: noctu uero idem aut ceratum aut malagma aut panni, quia potest cataplasma decidere. Ergo cottidie quoque resoluetur, donec iam cerato aut malagmate possumus esse contenti. Et decem quidem diebus extenuabitur fame corpus, ab undecimo uero ali incipiet; ideoque etiam laxior quam primo fascea circumligabitur; fereque ea curatio ad quadragesimum diem perueniet. Qu⟨od⟩ si me⟨tus⟩ erit suppurationis, plus malagma quam ceratum ad digerendum proficiet. Si suppuratio uicerit, neque per quae supra scripta sunt discuti potuerit, omnis mora uitanda erit, ne os infra uitietur: sed qua parte maxime tumebit, demittendum erit candens ferramentum, donec ad pus perueniat; idque effundendum. Si nusquam caput se ostendet, ubi maxime pus sub⟨s⟩it, sic intellegimus: creta Cimolia totum locum inlinemus et siccari patiemur: quo loco maxime umor in ea perseuerabit, ibi ⟨p⟩us proximum erit eaque uri debebit. Si latius aliquid abscedet, duobus aut tribus locis erit perforandum. Demittendum erit lin⟨a⟩mentum aut aliquid ex penicillo, quod summum lino sit deuinctum, ut facile educatur. Reliqua eadem, quae in ceteris adustis, facienda sunt. Vbi purum erit ulcus, ali corpus debebit, ne tabes perniciosa futura id malum subsequatur. Nonnumquam etiam leuius ipso osse adfecto et inter initia neclecto, non ⟨p⟩us sed umor quidam muccis similis intus coit, mollescitque contra cutis; in qua simili ustione utendum est. In spina quoque est quod proprie notemus. Nam si id, quod ex uertebra excedit, aliquo modo fractum est, locus quidem concauus fit, ⟨p⟩unctiones autem in eo sentiuntur, quia necesse est ea fragmenta spinosa esse; quo fit, ut homo in interiorem partem subinde nitatur. Haec noscendae rei [causa] sunt: medicamentis uero isdem opus est, quae ⟨p⟩rima parte huius capitis exposita sunt.

[¶1] 10. 10 Similar again in great part are accidents to the upper arm and thigh and their treatment; there are also some points common to the arms, forearms, thighs, legs and digits, since there is least danger when the middle of the bone is fractured. The nearer the fracture is to either the upper or the lower end the worse it is; for they are at once more painful and more difficult to treat. The least troublesome is the simple transverse fracture; the multiple and the oblique are worse; the worst are those where the fragments are pointed. Now sometimes the fractured bones in these cases remain in their places; but much more often they slip out and overlap each other; this is the first question to be decided, and the signs are unmistakable. If the fragments are in contact, they make a sound when moved and produce a stabbing sensation; they are not level to the touch. But if they are in touch not directly but obliquely, which happens when the fragments are not in their place, that limb will be shorter than the other, and its muscles swell up. Therefore if this has been noted, the limb ought to be stretched at once; for the sinews and muscles which the bones keep on the stretch are contracted, and do not come into their proper place unless someone forces them into position. Moreover if this is not done at first, inflammation sets in; during which it is both difficult and dangerous to employ force to the sinews; for either spasm or gangrene follows, or, even if the case goes very favourably, suppuration. Therefore if the fragments have not been replaced before the inflammation, this must be done after. Now a finger or any other limb that is still supple can be stretched by one man alone, when he takes one end with his right, the other with his left hand: a stronger limb requires two men to pull in op directions. If the sinews are more resistant, as in powerful men, especially in their thighs and legs, leather straps or linen bands are to be put round each end of the joints, and pulled in opposite directions by several persons. When by force the limb has been made a little longer than it should be, then at length the bones must be pushed back into their place by the hands. A sign of the replacement is that the pain disappears, and the limb becomes equal to the other. Then cloths folded over two or three times and dipped in both wine and oil are wrapped round the part, and it is best for these to be of linen. Generally six bandages are needed. The first, a very short one, is to make three turns over the fracture in the form of a spiral carried upwards; three such turns are sufficient. The second bandage, half as long again, should begin over any projection if there is one; if the bone is quite smooth, it may begin anywhere over the fracture, in an opposite direction to the first bandage, and go downwards, then back over the fracture to end above the first bandage. Over these two bandages is spread a cerate on a broader layer of lint in order to hold the bandages in place; and if at any point bone projects, a triple layer of wool, soaked in wine and oil, is put over it. The foregoing are surrounded by a third bandage, and then by a fourth, the turns always following a direction the reverse of the bandage underneath. The third bandage ends below, the other three above the fracture. It is better to make the turns of the bandage numerous rather than tight, for a part which is constricted is damaged and disposed to gangrene; now a joint should be bandaged as little as possible, but this is necessary if the bone is fractured close to it. The limb should be kept bandaged until the third day: and it ought to be so bandaged that on the first day, whilst it does not hurt, yet it should not seem to be slack; on the second day it should be slacker, and on the third almost loose. Then the limb must be bandaged again, and a fifth bandage added to the others; on the fifth day the bandaging should be undone, and the limb wrapped in six bandages, put on so that the third and fifth bandages finish below, the others ending above. And, whenever the limb is uncovered, it is to be fomented with hot water. But if the fracture is near a joint, from time to time wine with the addition of a little oil is to be dropped into it, and the same treatment is continued until the inflammation has subsided or the limb has become even a little smaller than ordinary. This occurs by the seventh, or certainly by the ninth day; then the bones are easily manipulated. Therefore if not yet in place, they should be put back; if any fragments project, they must be pushed back into position; then the limb is to be bandaged as before, and over the fracture splints are arranged above so as to hold the fragments firmly in position; and the broader and stronger split is put on the side to which the fractured ends tend to deviate. All these splints should all be bent opposite to a joint so as not to injure it, and they should not press more than is requisite to hold the fragments in place; and since after a while they become loose, every third day the straps keeping them in place are tightened; if there is no itching, or pain, they are kept on for two-thirds of the time which it takes for such a fractured bone to unite; after that the part is fomented lightly with hot water, for the diseased matter must be first dissolved, than extracted. For this reason there should also be gentle inunction with liquid cerate, and superficial rubbing; and the bandaging should be looser. Every third day this bandage is removed, and omitting the hot fomentations, the same treatment is carried out, such that at each change there is one bandage less. The foregoing treatment is general, the following applies to particular fractures.

> Latin: 10. Similes rursus ex magna parte casus curationesque sunt umer⟨i⟩ et femoris: communia etiam quaedam umeris, bracchiis, feminibus, cruribus, digitis: siquidem e⟨a⟩ minime periculose media franguntur. Quo propior fractura capiti uel superiori uel inferiori est, eo peior est: nam et maiores dolores adfert et difficilius curatur. Ea maxime tolerabilis est simplex transuersa; peior, ubi multa fragmenta atque ubi obliqua; pessimum, ubi eadem acuta sunt. Nonnumquam autem fracta in his ossa in suis sedibus remanent; multo saepius excidunt aliudque super aliud effertur; idque ante omnia considerari debet et sunt notae certae. Si suis sedibus sunt, mota res⟨o⟩nan⟨t⟩, punctionisque sensum repraesentant; tactu inaequalia sunt. Si uero non aduersa sed obliqua iunguntur, quod fit ubi loco suo non sunt, membrum id altero ⟨iam erit⟩ breuius ⟨et⟩ musculi eius tument.—Ergo si hoc depre⟨n⟩sum est, protinus id membrum oportet extendere: nam nerui musculique intenti per ossa contrahuntur neque in suum locum ueniunt, nisi illos per uim aliquis intendit. Rursus, si primis diebus id omissum est, inflammatio oritur; sub qua et difficile et periculose uis neruis adhibetur: nam distentio neruorum uel cancer sequitur, uel cert⟨e⟩, ut mitissime a⟨g⟩atur, pus. Itaque si antea reposita ossa non sunt, postea reponenda sunt. Intendere autem digitum uel aliud quo⟨d⟩que membrum, si adhuc tenerum est, etiam unus homo potest, cum alteram partem dextr⟨a⟩, alteram sinistr⟨a⟩ prendit: ualentius membr⟨um⟩ duobus eget, qui in diuersa contendant. Si firmiores nerui sunt, ut in uiris robustis maximeque eorum feminibus et cruribus euenit, habenis quoque uel linteis fasceis utrimque capita articulorum deliganda, et per plures in diuersa ducenda sunt. Vbi paulo longius quam naturaliter esse debet membrum uis fecit, tum demum ossa manibus in suam sedem compellenda sunt, indiciumque ossi⟨s⟩ repositi est dolor sublatus et membrum alteri [parti] aequatum. * inuoluendum duplicibus triplici⟨busue⟩ panni⟨s⟩ et in uino et oleo tinctis, quos linteos esse commodius est. Fere uero ⟨fasce⟩is sex opus est. Prima breuissima adhibenda, quae circa fractura⟨m⟩ ter uoluta, sursum uersum feratur et quasi in coclea⟨m⟩ serpat; satisque est eam ter hoc quoque modo circuire. Altera dimidio longio⟨r⟩, eaque, ⟨si⟩ qua parte os eminet, ab ea; si totum aequale est, undelibet super fracturam debet incipere priori aduersa deorsumque tendere, atque iterum de fractura reuer⟨s⟩a in superiore parte ultra priorem fasciam desinere. Super has iniciendum latiore linteo ceratum est, quod eas contineat; ac si qua parte os eminet, triplex ea pannus obiciendus eodem uino et oleo madens. Haec tertia fascia comprehendenda sunt, quartaque sic, ut semper insequens priori aduersa sit, et tertia tantum inferiore parte, tres in superiore f⟨in⟩iant⟨ur⟩. ⟨At⟩qu⟨e⟩ satius est saepius circuire quam adstringi: siquidem id, quod adstrictum est, alienatur et cancro oportunum est: articulum autem quam minime uincire opus est, sed si iuxta hunc os fractum est, necesse est. Deligatum uero membrum in diem tertium continendum est; eaque uinctura talis esse debet, ut primo die nihil offenderit, non tamen laxa uisa sit, secundo laxior, tertio iam paene resoluta. Ergo tum rursum id membrum deligandum, adiciendaque prioribus quinta fascia est; iterumque quinto die resoluendum est, et sex fasceis inuoluendum sic, ut tertia et quinta infra, ceterae supra finiantur. Quotienscumque autem soluitur membrum, calida aqua fouendum. Sed si iuxta articulum fractura est, †die instillandum uinum est, exigua parte olei adiecta, eademque omnia facienda, donec adeo inflammatio soluatur uel ⟨ten⟩uius quoque quam ex consuetudine id membrum fiat. Quod si septimus dies non dedit, certe nonus exhibet; tum facillime ossa tractantur. Rursus ergo si parum commissa sunt, committi debent: si qua fragmenta eminent, in suas sedes reponenda sunt; deinde eodem modo membrum deligandum, ferulaeque super adcommodandae sunt, quae fi⟨x⟩ae circumpositaeque ossa in sua sede contineant; et in quam partem fractura inclinat, ab ea latior ualentiorque ferula inponenda est. Easque omnes c⟨on⟩tra articulum esse oportet resimas, ne hunc laedant, nec ultra astringi quam ut ossa contineant; et cum spatio laxentur, tertio quoque ⟨die⟩ paulum habenis suis coartari; ac si nulla prurigo, nullus dolor est, sic manere, donec duae partes eius temporis, qu⟨o⟩ quo⟨d⟩que os conferuet, compleantur: postea leuius aqua calida fouere, quia primo digeri materiam opus est, tum euocari. Ergo cerato quoque liquido id ⟨l⟩eniter est unguendum, perfricandaque summa cutis est; laxiusque id deligandum est. Tertio quoque die soluendum sic, ut remota calida aqua cetera eadem fiant: tantummodo singulae fasciae, quotiens resolutae fuerint, subtrahantur.

[¶2] If the upper arm is fractured, extension is not made as in other limbs, but the patient is seated on a high stool, whilst the surgeon faces him on a lower one. One bandage about the patient's neck is to serve as a sling to support the forearm; another is looped under the armpit and is knotted over the head; a third surrounding the lower end of the humerus is carried down and has its ends tied together below. Then an assistant behind the patient stretches out his right forearm through the second loop, if it is the patient's right humerus which is to be extended, his left if it is the left, and grasps a stick placed upright between the patient's thighs. At the same time the surgeon puts his right foot in the third loop I have described, if the left arm is being treated, his left foot if the right. And at the same time the assistant lifts one loop up while the surgeon presses the other down, the result being that the humerus is gently extended. Now the bandages, if the middle or lower part of the bone is broken, are shorter, but longer for the upper part, so that they may stretch thence under the opposite armpit too, over the chest and blade-bones. And they... But from the first the forearm during the bandaging must be flexed thus, and, since it must be put so even before the bandaging, this ensures that it cannot later, when in the sling, bend the upper arm from the position in which it was while being bandaged. And when the forearm is in a sling, the upper arm too is to be loosely bandaged to the side; this causes is to be moved as little as possible, and so the bones keep in the position in which they have been set. When it is the time for applying the splints, the longest should be placed externally, shorter ones over the biceps in front, the shortest under the armpit. And when the fracture is near the elbow joint, the bandage must be taken off more frequently, or the sinews will become fixed, and the forearm rendered useless. Whenever the bandages are removed, the site of the fracture should be held by the hand, the elbow fomented with warm water, and rubbed with liquid cerate. The splints should not be applied at all over the bony points of the elbow, or should be somewhat shorter. And if the forearm is fractured, the first thing to consider is whether one or both bones are broken;

> Latin: Haec communia sunt, illa propria: siquidem umerus fractus non sic ut membrum aliud intenditur, sed homo conlocatur alto sedili, medicus autem humiliore aduersus. Vna fascia bracchium amplexa e⟨x⟩ ceruice ipsius, qui laesus est, id sustineat; altera ab †altera parte super caput data ibi accipit nodum; tertia uincto imo umero deorsum demittitur, ibi quoque capitibus eius inter se uinctis. Deinde ab occipitio ipsius minister sub ea fascea, quam secundo loco posui, ⟨p⟩orrecto, si dexter umerus ducendus est dextro, si sinister ⟨sinistro⟩ brachio demissum inter femina eius, qui curatur, baculum tenet: medicus super eam fasceam, de qua tertio loco dixi, plantam inicit dextra⟨m⟩ si sinister, sinistram si dexter umerus ⟨c⟩uratur; simulque alteram fasciam minister attollit, alteram premit medicus; quo fit ut leniter umerus extendatur. Fasceis uero, si medium aut imum os fractum est, breuioribus opus est; si summum, longioribus, ut ab eo sub altera quoque ala per pectus et scapulas porrigantur. Quae * * * Protinus uero bracchium, cum deligatur, sic inclinandum est idque efficit, cu⟨m⟩ ante fascias quoque sic figurandum sit, ne postea suspens⟨u⟩m aliter ⟨atque⟩ cum deligabatur, umerum inclinet. Bracchioque suspenso ipse quoque umerus ad latus leniter deligandus est; per quae fit, ut minime moueatur ideoque ossa sic se habe⟨a⟩nt, ut aliquis composuit. Cum ad ferulas uentum est, extrinsecus esse earum longissimae debent, a lacerto breuiore⟨s⟩, sub ala breuissimae. Saepiusque eae resoluendae sunt, ubi in uicinia cubiti umerus fractus est, ne ibi nerui rigescant et inutile bracchium efficiant. Quotiens solutae sunt, fractura manu continenda, cubitus aqua calida fouendus est ⟨et⟩ molli cerato perfricandus; ferulaeque uel omnino non inponendae contra eminentia cubiti, uel aliquanto breuiores sunt.

[¶3] not that a different treatment is to be adopted, but first in order that there should be more forcible extension if both bones are fractured, because the tendons necessarily contract less when one bone is unbroken and keeps them on the stretch, secondly that greater care may be taken in setting the bones when the fellow bone affords no aid; for when one bone is intact, it is of more assistance to the other which is fractured than are bandages and splints. Now when applying the bandage to the forearm the thumb should be turned somewhat towards the chest, for this is the most natural position for the forearm; and after applying the bandage to the forearm it is most comfortable placed in a sling, the broader part of which encloses the forearm, whilst its tapering ends are knotted around the neck. And thus the forearm is comfortably slung from the neck, and it should hang a little above the level of the opposite elbow....

> Latin: Ac si bracchium fractum est, in primis considerandum est, alterum os an utrumque comminutum sit; non quo alia in eiusmodi casu curatio admouenda ⟨sit⟩, sed primum, ut ualentius extendatur, si utrumque os fractum est, quia necesse est minus neruos contrahi altero osse integro eosque intendente; deinde, ut curiosius omnia in continendis ossibus fia⟨n⟩t, si neutrum alteri auxilio est: nam ubi alterum integrum est, plus opis in eo quam in fasciis ferulisque est. Deligari autem bracchium debet paulum pollice ad pectus inclinato, siquidem is maxime bracchii naturalis habitus: [sit] idque inuolutum mitella commodissime excipitur, quae latitudine ipsi bracchio, perangustis capitibus collo inicitur. Atque ita commode bracchium ex ceruice suspensum est, idque paulum supra cubiti alterius regionem pendere oportet.

[¶4] But if there is any fracture at the top of the ulna, fixation by a bandage is wrong, for it renders the forearm immobile. And if nothing is done except for the relief of pain, the limb will become as useful as before. In the case of the leg it is equally important that one bone at least should be sound.

> Latin: … Quod si ex summo cubito ⟨qu⟩id f⟨r⟩actum sit, glutinare id uinciendo alienum est: fit enim bracchium inmobile. Ac si nihil aliud quam dolori occursum est, idem qui fuit eius ⟨u⟩sus est.

[¶5] One thing is common to fractures of leg and thigh, that after being bandaged the limb is laid in a gutter-splint. This splint should have two holes near the lower end, by which any fluid that has formed may run off; and there should be a stay for the sole of the foot both to support it and stop it from slipping backwards; and at the sides are slots so that when straps are passed through these, a kind of stay holds the leg and thigh as they have been set. If the leg is fractured, the splint should start from the sole; if the thigh, from about the ham up to the hip; if the fracture is near the head of the thigh, the hip should be included as well. It must not be overlooked, however, that if the thigh-bone is fractured it becomes shorter, for it never returns to its former state, and that afterwards the patient treads on the tips of the toes of that leg; but the disablement is much uglier when neglect is added to misfortune.

> Latin: In c⟨r⟩ure aeque ad rem pertinet alterum saltem os integrum manere. Commune uero ei femorique est quod, ubi deligatum est, in canalem coniciendum est. Is canalis et inferiore parte f⟨ora⟩mina ⟨II⟩ habere debet, per quae, si quis umor excesserit, descendat; et a planta moram, quae simul et sustineat eam et delabi non patiatur; et a lateribus caua, per quae loris datis morae quaedam crus femurque, ut collocatum est, detinea⟨n⟩t. Esse etiam is debet a planta, si crus fractum est; circa poplitem, si femur, usque ad coxam; si iuxta superius caput femoris, sic, ut ipsa quoque e⟨i⟩ coxa ⟨ins⟩it. Neque tamen ignorari oportet, si femur fractum est, fieri breuius, quia numquam in anti⟨c⟩um statum reuertitur, summisque digitis postea cruris eius insisti: sed multo tamen f⟨oed⟩ior debilitas est, ubi fortunae neglegentia quoque accessit.

[¶6] For a finger, it is enough to bandage it to a single strip of wood when the inflammation is over.

> Latin: Digitum satis est ad unum surculum post inflammationem deligari.

[¶7] While these instructions are for individual bones, the following are general for all. For the first days fasting; next a more liberal diet as soon as the callus should be forming; abstinence from wine for a long time; free fomentation with hot water while there is inflammation; more sparing when it has subsided, then long continued but gentle inunction with liquid cerate, for the extremities of the fractured limb. And the limb should not be exercised too soon but brought back to its former use gradually.

> Latin: His proprie ad singula membra pertinentibus, rursus illa communia sunt: primis diebus fames; deinde tum, cum iam increscere callum oportet, liberalius alimentum; longa a uino abstinentia; fomentum aquae calidae, dum inflammatio est, libera⟨l⟩e; ⟨ubi⟩ ea desit, modicum; tum etiam longior ulterioribus e⟨x⟩ liquido cerato membris et mollis tamen unctio. Neque protinus exercendum id membrum, sed * ad antiquos usus reducendum est.

[¶8] The case is rather more grave, when there is a flesh wound as well as a fracture, and especially when muscles of the thigh and upper arm are involved: for they are liable to more severe inflammations and also have a greater tendency to gangrene. And in the case of the thigh-bone, if the fragments have separated from one another, amputation is generally necessary. The upper arm also is liable to this danger, but is more easily preserved. And these dangers are greater if the fracture is co to joints. We must therefore act with greater caution, and the muscle crossing the wound should be cut through. If there has been little haemorrhage, blood should be let; the patient must be made thin by a low diet. In all other limbs there must be gradual extension and a rather gentle replacement of the bones in position; but in these it is inexpedient to stretch the sinews; nor should the bones be handled; and the patient is to be allowed the posture he finds least painful. Now upon all wounds of this kind there is to be applied first lint soaked in wine to which a little rose oil has been added; the other remedies are as before. The bandages should be somewhat wider than the wound, slacker perhaps than if there is no wound; the more easily a wound can be harmed, and attacked by gangrene, the less tightly it should be bandaged. Rather by having a number of bandages we must arrange that, although loose, they afford equal support. This will be the treatment for the thigh-bone or upper arm if the fragments are in good line; but if they are not so, the bandaging is applied only so far as to keep the medicaments in place. The rest of the treatment is the same as described before except that no cane nor gutter-splints are put on, under which it is impossible for a wound to heal, but only plenty of wide bandages, which likewise are kept well soaked with warm oil and wine, especially in the first inflammation. And the diet at first must be low; wine is improper; the wound is to be fomented with hot water, and chill avoided in every way; and we should pass on to medicaments which induce suppuration, the treatment being directed rather to the wound than to the fracture; consequently the bandage must be removed every day and the wound dressed. In this treatment when a small fragment of bone projects, if it is blunt, it is pushed back into place; if it is pointed, the projection, if long, is cut off before replacing it; if short, it is filed off; and in either case it is smoothed down with a chisel, and then pushed back. And if this cannot be done with the hand, pinchers, such as smiths use, must be applied on the concave side to the end of the bone which is in a correct position in order that the convex side may force the projecting bone into place. If the projecting fragment is larger, and covered with small membranes, it is best to leave these to be loosened by medicaments, and then to cut off the bone as soon as it is laid bare; of course this is to be done soon. By this method the bones may join and the wound also may heal, the former in due time, the latter as circumstances permit. It happens also occasionally in the case of a large wound that some fragments die, so to speak, and fail to unite with the rest of the bone;

> Latin: Grauius aliquanto est, cum ossis fracturae carnis quoque uulnus accessit, maxumeque si id musculi femoris aut ⟨ume⟩ri senserunt: nam et inflammationes multo grauiores et promptiores cancr⟨o⟩s habent. Ac femur quidem, si ossa inter se ⟨re⟩cesserunt, fere praecidi necesse est. Vmerus uero quoque in periculum uenit, s⟨ed⟩ facilius conseruatur. Quibus periculis etiam magis id expositum, quod iuxta ipsos articulos ictum est. Curiosius igitur agendum est, et musculus quidem, per mediam plagam transuersus praecidendus; sanguis uero, si parum fluxit, mittendus; corpus inedia extenuandum. Ac reliqua quidem membra lentius intendenda, et lenius in is ossa in suam sedem reponenda sunt: ⟨in⟩ his uero neque intendi neruos neque ossa tractari satis expedit; ipsique homini permittendum est, ut sic ea collocata habeat, quemadmodum minime laedunt. Omnibus autem his uulneribus inponendum primo linamentum est uino madens, cui rosae paulum admodum adiectum sit, cetera eadem. Deligandaque fas⟨c⟩is sunt aliquanto quam uulnus latioribus, laxius scilicet quam si ea plaga non esset: quanto facilius et alienari et occupari cancro uulnus potest * * * numero potius fasciarum id agendum est, ut laxae quoque aeque contineant. Quod in femore umeroque sic fiet, si ossa forte recte concurrerint: sin aliter se habebunt, eatenus circumdari fascia debebit, ut inpositum medicamentum contineat. Cetera eadem, quae supra scripsi, facienda sunt, praeterquam quod neque ferulis neque canalibus, inter quae uulnus sanescere non potest, sed pluribus tantummodo et latioribus fasceis opus est: ingerendumque subinde in eas est calidum oleum et uinum, magisque in * * * primo fame utendu⟨m⟩; * e⟨s⟩t alien⟨um⟩; uulnus calida aqua fouendum, frigusque omni ratione uitandum; et transeundum ad medicamenta, quae puri mouend⟨o⟩ sunt; maiorque uulneri quam ossi cura agenda: ergo cottidie soluendum nutriendumque est. Inter quae si qu⟨od⟩ paruulum fragmentum ossis eminet, id si retusum est, in suam sedem dandum; si acutum, ante acumen eius, ⟨si⟩ longius est, praecidendum; si breuius, limandum et utrumque scalpro l⟨eu⟩andum; tum ipsum recondendum est. Ac si id manus facere non potest, uulsella, quali fabri utuntur, inicienda est recte se haben⟨t⟩i capiti ab ea parte, qua sima est, ut ea parte, qua ⟨g⟩ib⟨b⟩a est, eminens os in suam sedem compellat. Si id maius est membranulisque cing⟨itur⟩, sinere oportet ea⟨s⟩ sub medicamentis resolui, idque os, ubi iam nudatum est, abscidere; quod maturius scilicet faciendum est. Potestque ea ratione et os coire et uulnus sanescere, illud suo tempore, hoc prout se habet.

[¶9] this as usual can be learnt from the character of the discharge. It is then particularly necessary to loosen the bandage and dress the wound more often. It generally happens that after some days such bone comes away by itself. Although the condition of the wound is bad before, nevertheless surgery can sometimes cure it. But if in wounds of this kind pain and inflammation occur, the limb must be bathed in cold water, and you will have to do this for some time. For often the sound skin is broken by a fragment of bone, and at once irritation and pain occur. When this happens the wound must be unbandaged at once, and fomented in summer with cold water, in winter with lukewarm water, then the myrtle cerate must be put on. But at times the fracture irritates the flesh by projections like needle-points: as soon as this is known by the itching and pricking, the surgeon is obliged to expose and cut off these points. The rest of the treatment is in either case the same as when a blow cause the wound in the first instance.

> Latin: Nonnumquam etiam in magno uulnere euenit, ut fragmenta quaedam uelut emoriantur neque cum ceteris coeant; quod hic quoque ex modo fluentis umor⟨is⟩ colligitur. Quo magis necessarium est saepius ulcus resoluere atque nutrire. Sequitur uero, ut id os per se post aliquot dies excidat. Cum ⟨i⟩am misera antea condicio uulneris sit, tamen id interdum manus * * * diutiusque facies. Saepe enim integra cutis osse abrumpitur, protinusque prurigo et dolor oritur. Quae soluere, si accidit, maturius oportet, et fouere aqua per aestatem frigida, per hiemem egelida; deinde ceratum myrteum inpon⟨en⟩dum. At interdum fractur⟨a⟩ quibusdam uelut aculeis carnem uexat: qu⟨o⟩ [a] prurigin⟨e⟩ et p⟨un⟩ctionibus cognit⟨o⟩, aperire id medicus e⟨o⟩sque aculeos praecidere necesse habet. Reliqua uero curatio in utroque hoc casu eade⟨m⟩ est, quae ubi ictus protinus * intulit.

[¶10] When the wound is clean in these cases too food must be given that makes the flesh grow. If the limb is still too short, and the bones are not in place, a thin wedge, as smooth as possible, should be inserted between the fractured ends, so that the head of the wedge projects a little out of the wound; every day it is driven inwards a little until by this means the limb becomes like the other; then the wedge is taken out and the wound left to heal; to encourage it to heal the limb is fomented with a cold decoction of myrtle, ivy or similar vervains; a desiccating medicament is smeared on; and special care must be taken to keep the limb at rest until there is firm union.

> Latin: Puro iam ulcere cibis hic quoque utendum est carnem producentibus. Si breui⟨us⟩ adhuc membrum est et ossa loco suo non sunt, e⟨o⟩ paxillus tenuis quam leuissimi generis inter ea demitti debet sic, ut capite paululum supra ulcus emineat; ⟨i⟩sque cottidie plenior adigendus est, donec par id membrum alteri fiat; tum paxillus remouendus; uulnus sanandum est; cicatrix inducta fouenda frigida aqua est, in qua myrtus, hedera, aliaeue similes uerbenae ⟨decoctae⟩ sint; inlinendumque medicamentum est quod siccet; et magis etiam hic qu⟨ies⟩cundum, donec id membrum confirmetur.

[¶11] But if at any time the bones have not united, because they have often been unbandaged and moved about, then the treatment is obvious; keep them still and they may unite. If the fracture is of long standing, the limb is stretched in order to reproduce et injury to some extent; the fractured ends must be separated by manipulation, so that when allowed to come into contact they rub one another; thus any fatty tissue is rubbed of, and the whole thing is like a fresh fracture; great care, however, must be taken that sinews and muscles are not injured. Then the limb is to be fomented with a decoction of pomegranate rind and wine; and this, mixed with white of egg, is used as a dressing; it is changed on the third day, and the limb fomented with the decoction of vervains mentioned above; on the fifth day this is repeated and splints placed round it.

> Latin: Si quando uero ossa non conferuuerunt, qu⟨ia⟩ saepe solut⟨um⟩, saepe motu⟨m⟩, in apert⟨o⟩ deinde curatio est: possunt enim coire * * Si uetustas occupauit, membrum extendendum est, ut aliquid laedatur: ossa inter se manu diuidenda, ut concurrendo exasperentur, ut, si quid pingue est, eradatur totumque id quasi recens fiat, magna tamen cura habita, ⟨ne⟩ nerui musculiue laed⟨a⟩ntur. Tum uino fouendum est, in quo malicorium de⟨coc⟩tum sit; i⟨n⟩ponendumque id ipsum [corium] oui albo mixtum: tertio die resoluendum fouendumque aqua, in qua uerbenae, ⟨de⟩ quibus supra dixi, decoctae sint: quinto die idem faciendum, ferulaeque circumdandae. Cetera et ante et post eadem facienda, quae supra scripsi.

[¶12] The rest of the treatment before and after this is the same as described above. But sometimes the bones unite with one another sideways, and the limb is then shorter and misshapen; and if the ends are at all pointed, sharp prickings are felt. On this account the bones should be re-fractured and put straight. It is done in this way; the limb is fomented freely with hot water, smeared with a liquid cerate, then stretched. And meanwhile the surgeon handles the bones, and as the callus is still soft, separates the ends, and forces the projecting piece into place; and if he is not strong enough to do this, he puts a ruler wrapped in wool over the projecting bone; and by bandaging it like this forces the bone back to its original place. But occasionally, though the fragments are in correct apposition, too much callus develops and there is a swelling over the fracture. When this happens the limb should be gently rubbed for a long while with oil containing salt and soda, and then fomented freely with hot water and salt; and a poultice should be applied as a dispersive, besides firmer bandages; use a diet of green vegetables, and an emetic besides, which reduces the callus together with the flesh. And it is of advantage in this condition to apply mustard mixed with a fig to the corresponding limb until it causes irritation and draws away the diseased matter. When by this means the swelling has been reduced, return is made to the ordinary course of life.

> Latin: Solent tamen interdum transuersa inter se ossa conferuere, eoque et breuius membrum et indecorum fit; et si capita acutiora sunt, adsiduae ⟨p⟩unctiones sentiuntur. Ob quam causam frangi rursus ossa et derigi debent. Id hoc modo fit. Calida aqua multa membrum id fouetur, et ex cerato liquido perfricatur intenditurque. Et inter haec medicus pertractans ossa, ut adhuc tenero callo, manibus ea d⟨i⟩ducit, compelli⟨t⟩que id, quod eminet, ⟨in⟩ suam sedem; et, s⟨i⟩ parum ualuit, ab ea parte, in qua⟨m⟩ os se inclinat, e⟨i⟩ inuolutam lana regulam obicit; atque ita deligando adsuescere iterum uetustae sedi cogit. Nonnumquam autem recte quidem ossa co⟨i⟩erunt, superincreuit uero nimius callus, ide⟨o⟩que locus ⟨is⟩ intumuit. Quod ubi incidit, diu leuiterque id membrum perfricandum est ex oleo et sale et nitro, multumque aqua calida salsa fouendum; et inponendum malagma quod digerat, adstrictiusque alligandum; holeribusque et praeterea uomitu utendum, per quae cum carne callus quoque extenuatur. Confertque aliquid e⟨o⟩ sinapi quod cum ficu in alterum par membrum inpositum * donec id paulum erodat eoque euocet materiam. Vbi his tumor extenuatus est, rursus ad ordinem uitae reuertendum est.

## 34. Book VIII · chapters 11–25

Source: https://scriptura.si/works/celsus-on-medicine/34/ · cite a paragraph as https://scriptura.si/works/celsus-on-medicine/34/#p-N

[¶0] 11. 11 So much for the discussion of fractured bones. Turning to dislocations, these are of two kinds: for at times bones which are conjoined gape asunder, as when the shoulder-bone recedes from the clavicle, and, in the forearm, the radius from the ulna, or in the leg the tibia from the fibula; sometimes after a jump the heel-bone from the ankle, though this is rare; at times joints slip out of position. I will speak of the former first. Now when anything of this sort happens, there is a depression at once on the spot, and when the finger is put into this a gap is felt; after this severe inflammation arises, particularly at the ankle; indeed this is often a cause of fevers also and gangrene and spasms of the sinews or rigors, which bend back the head to the shoulder-blade. To avoid these things the same is to be done as was laid down for bone injuries in general, so that pain and swelling may be thereby relieved. For bones so separated never again unite, and even if the appearance of the limb is somewhat impaired its usefulness is not. Since all joints, including the jawbone and vertebrae, are held in place by strong sinews, they are displaced either by force or after some accident which has ruptured or weakened the sinews, and this occurs more readily in boys and youths, than in the more robust. And these joints slip out forwards, backwards, inwards, outwards, some in all directions, some in certain only. And there are some signs which are common to all, some special to each; there is always a swelling in the part into which the bone has ruptured, and a hollow whence the bone has receded. These signs are found in all, but others only in some cases; these I will describe when speaking of each separately. But while it is possible for all joints to slip out, yet not all can be replaced. For the head is never forced back into position, nor is a spinal vertebra, nor a jawbone which has been dislocated forwards on both sides, and has become inflamed before it has been replaced. Again, any joints which have slipped owing to a lesion of their sinews, even when forced back into position slip out again. Also when joints have been dislocated in childhood, and have not been replaced, there is less growth than elsewhere. The flesh of all which are out of place wastes, and in the near more than in the distant part of the limb; for instance, if the upper arm-bone is not in its place, the wasting is more here than in the forearm, more in the forearm than in the hand. Again, according to the site and character of the accidents, more or less use of the limb is retained; and the more use is retained, the less does it waste. Now every dislocation ought to be replaced before there is inflammation; but if this has set in already, the limb is not to be disturbed until after it subsides; only when it has ended should replacement be attempted in the limbs which allow of it. But for this much depends upon the general constitution of the patient and his sinews. For if his body is slender, and humid, if sinews are weak, the bone is readily replaced; but just as the bones slips out more easily in the first instance, so the replacement is less secure. With an opposite type of constitution the replacement is more lasting but there is more difficulty in restoring that which has been put out of position. The inflammation should be relieved by applying greasy wool saturated with vinegar: there should be abstinence from food, in the case of the stronger joints, for three days, some he said for five; warm water is drunk, enough to relieve thirst; this regimen must be followed more strictly after dislocation of bones which are held in place by strong and large muscles; far more strictly indeed if fever supervenes; then after the fifth day there should be hot-water fomentation; when the wool is removed, a cerate must be applied made with cyprus oil with the addition of soda, until all inflammation has ended. Then the limb is to be rubbed, good food given and wine in moderation; and now also the natural use of the limb is to be encouraged; because though movement when it gives pain is harmful, it is otherwise most beneficial to the body. After these generalities, I will now speak of particular cases.

> Latin: 11. Ac de fractis quidem ossibus hactenus dictum sit. MOVENTVR autem ea sedibus suis duobus modis: nam modo quae iuncta sunt inter se ⟨de⟩hiscunt, ut cum latum scapularum os ab umero recedit, et in brachio radius a cubito, et in crure tibia a sura; interdum [a saltu] calcis os a talo, quod raro tamen fit: modo articuli suis sedibus excidunt. Ante de prioribus dicam. Quorum ⟨ubi aliquid incidit, protinus is locus⟩ cau⟨us⟩ est, depressusque digitus sinum inuenit; deinde grauis inflammatio oritur, atque in talis praecipu⟨e⟩: siquidem febres quoque et cancros et neruorum uel distentiones uel rigores, qui caput scapulis adnectunt, mouere consueuit. Quorum uitandorum causa facienda ea⟨dem⟩ sunt, quae in ossibus ⟨omn⟩ibus laesis [aliquid ubi incidit, protinus is locus] proposita sunt, ut dolor tumorque per ea tollantur. Nam diducta ossa numquam ⟨rursus⟩ inter se iunguntur, et ut aliquid decoris eo loco, sic nihil usus amittitur. Maxilla uero et uertebra omnesque articuli, cum ualidis neruis conprendantur, excidunt ⟨aut⟩ ui expulsi, aut aliquo casu neruis uel ruptis ⟨uel⟩ infirm⟨a⟩tis, faciliusque in pueris et adulescentulis quam in robustioribus. Hique elabuntur in priorem * * * in exteriorem partem, quidam omnibus modis, quidam certi⟨s⟩. Sunt⟨que⟩ quaedam communia omnium signa, quaedam propria sunt ⟨cuiusque⟩: siquidem semper ea parte est tumor, in qua⟨m⟩ os prorumpit; ea sinus, ⟨a⟩ qua recessit. Et haec quidem in omnibus deprenduntur, alia uero in singulis; quae, simul atque de quoque dicam, proponenda erunt. Sed ut excidere omnes articuli [non] possunt, sic non omnes reponuntur. Caput enim numquam * * compellitur, neque in spina uertebra, neque ea maxilla, quae, utraque parte prolapsa, antequam reponer⟨e⟩tur, inflammationem mouit. Rursus ⟨si⟩ qui neruorum uitio prolapsi sunt, conpulsi quoque in suas sedes iterum excidunt. A⟨c⟩ quibus in pueritia exciderunt neque repositi sunt, minus quam ceteri crescunt. Omniumque, quae loco suo non sunt, caro e⟨ma⟩cres⟨cit,⟩ magi⟨s⟩que in proximo membro quam ulteriore, ut puta, si umerus loco suo non est, maior in eo ipso fit quam in brachio, maior in hoc quam in manu ⟨m⟩acies. Tum pro sedibus et pro casibus, qui inciderunt, aut maior aut minor usus ⟨eius⟩ membri relinquitur; quoque in e⟨o⟩ plus usus superest, eo minus id extenuatur. Quicquid autem loco suo motum est, ante inflammationem reponendum est: ⟨si⟩ illa occupauit, dum conquiescat, n⟨on⟩ lacessendum: ubi finitast, temptandum in is membris, quae id patiuntur. Multum autem eo confert et corporis et neruorum habitus. Nam si corpus tenue, si umidum est, si nerui infirmi, expeditius os reponitur: sed ut primo facilius excidit, ⟨i⟩t⟨a⟩ postea minus fideliter continetur. Quae contraria his sunt, melius continent: sed id, quod expulsum est, difficulter admittunt.—Oportet autem ipsam inflammationem leuare super sucida lana ex aceto inposita: a cibo, si ualentioris articuli casus est, triduo, interdum etiam quinque diebus abstinere; bibere aquam calidam, dum sitim finiat; curiossiusque haec facere is ossibus motis, quae ualidis plenisque musculis continentur: si uero etiam febris accessit, multo magis; deinde ex die quinto ⟨fouere⟩ aqua calida; remotaque ⟨l⟩ana ceratum inponere ex cyprino factum, nitro quoque adiecto, donec omnis inflammatio finiatur. Tunc [in]frictionem ei membro adhibere; cibis uti bonis; uti uino modice; iamque ad usus quoque suos id membrum promouere, quia motus ut in dolore pestifer, sic alias saluberrimus corpor⟨i⟩ est. Haec communia sunt, nunc de singulis dicam.

[¶1] 12. 12 The lower jaw is displaced forwards, sometimes on one side, sometimes on both. If on one side, it inclines with the chin to the opposite side, the teeth do not correspond with their fellows, but the canine are under the incisors. But if on both sides, the whole chin is moved forwards, and the lower teeth stick out beyond the upper ones; and the muscles above appear tense. As soon as possible the patient is to be seated on a stool, with an assistant behind holding his head, or with his back against a wall and a hard leather cushion between the wall and the back of his head, against which his head is firmly pushed by the assistant, to keep it from moving. Then the surgeon's thumbs, which have been wrapped round with strips of linen or bandages so that they may not slip, are inserted into the mouth whilst the fingers are applied outside. When the jaw has been grasped firmly, if it has slipped forwards to one side, the chin is to be pressed down towards the throat with a jerk. Then simultaneously the head is firmly held, and the chin being raised the jaw is forced back to its place, and the mouth is closed so that all this is done almost with one movement. If it has been dislocated on both sides all the same movements are to be done except that the jaw is forced straight backwards. When the bone is in its place, if the accident has been attended with pain in the eyes and neck, blood is to be let from the arm. For all patients with dislocated bones, a more liquid diet is proper at first, but especially in this case, since even talking, as it causes constant movement of the mouth by means of the sinews, is harmful.

> Latin: 12. Maxilla in priorem partem propellitur, sed modo altera parte, modo utraque. Si alter⟨a⟩, in contrariam partem ipsa mentum⟨que⟩ inclinatur; dentes paribus non respondent, sed sub is, qui secant, canini sunt. A⟨t⟩ si utraque, totum mentum in exteriorem partem promouetur; inferioresque dentes longius quam superiores excedunt; intentique super musculi apparent. —Primo quoque tempore autem homo in sedili conlocandus est sic, ut minister a posteriore parte caput eius contineat, uel sic, ut iuxta parietem is sedeat, subiecto inter parietem et caput eius scorteo puluino ⟨duro,⟩ eoque caput e⟨ius⟩ per ministrum urgeatur, quo sit immobili⟨u⟩s. Tum medici digiti pollices linteolis uel fasceis, ne delabantur, inuoluti in os eius coiciendi, ceteri extrinsecus admouendi sunt. Vbi uehementer maxilla adprehensa est, ⟨si un⟩a parte procidit, concutiendum mentum ⟨et⟩ ad guttur adducendum est. Tum simul et caput adprehendendum, et excitato mento maxilla in suam sedem conpellenda, et os eius conprimendum est sic, ut omnia paene uno ⟨mo⟩mento fiant. Si⟨n⟩ utraque parte prolapsa est, eadem omnia eadem facienda, sed aequaliter retro maxilla agenda est. Reposito osse, si cum dolore oculorum et ceruic⟨i⟩s ist⟨e⟩ casus incidit, ex brachio sanguis mittendus est. Cum omnibus uero, quo⟨rum⟩ ossa mota sunt, primo liquidior cibus conueniat, tum his praecipue, adeo ut sermo quoque frequenti motu oris per neruos laedat.

[¶2] 13. 13 As I stated in the first part, the head is held by two processes, inserted into two cups in the highest vertebra. These processes sometimes slip out backwards; with the result that the sinews under the occiput are stretched, and the chin fixed to the chest; the man cannot drink or speak, and sometimes has involuntary emission of semen; upon these symptoms death very quickly supervenes. Now I thought this condition should be described, not that there is any treatment for it, but that it may be recognized by these indications, and that those who have lost someone in this way may not deem the medical man to have been at fault.

> Latin: 13. Caput duobus processibus in duos sinus summae uertebrae demissis super ceruicem contineri in prima parte proposui. Hi processus interdum in posteriorem partem excidunt; quo fit, ut, ⟨qui⟩ nerui s⟨unt⟩ sub occipitio, extendantur, mentum pectori adglutinetur, neque bibere is, neque lo⟨qui⟩ possit, interdum sine uoluntate semen emittat; quibus celerrime mors superuenit. Ponendum autem hoc esse credi⟨di,⟩ non ⟨quo⟩ curatio eius rei ulla sit, sed ut res indiciis cognosc⟨er⟩etur et non putarent sibi medicum defuisse, ⟨si qui⟩ sic aliquem perdidisse⟨n⟩t.

[¶3] 14. 14 The same fate awaits those whose spinal vertebrae have been dislocated; for this cannot happen without rupture of the marrow in the middle of them, and of the two little membranes which pass oust between the two processes at the side, and of the sinews which hold them together. But the vertebrae may slip pout both backwards and forwards, above the diaphragm or below it. The direction of the displacement is indicated either by a swelling or by a hollow at the back. If it happens above the diaphragm, there is paralysis of the arms, and vomiting or spasm follow, breathing is difficult, pain is severe, and hearing blunted. If below the diaphragm, the lower limbs are paralysed, the urine is suppressed, or sometimes is passed involuntarily. From such accidents the man dies more slowly than when the head is displaced, yet within three days. As for what Hippocrates said, that when a vertebra has been displaced backwards, the man is to be laid out on his face, and stretched out, while an assistant presses his heel upon the displaced bone and pushes it inwards, that procedure is only to be adopted when the bone has slipped out a little, not if there is a total displacement. For occasionally weakness of the sinews causes a vertebra, although not displaced, to project a little, either backwards or forwards. This is not a fatal accident, but we cannot press upon a vertebra from within; it cannot even be touched; and if it is pressed upon from outside, it generally slips back again, unless, as very rarely happens, the strength of the sinews is renewed.

> Latin: 14. Idem casus manet ⟨e⟩os, quorum in spina uertebrae excide⟨ru⟩nt: id enim non potest fieri, nisi et medulla, quae per medium, et duabus membranulis, quae per duos a lateribus processus feruntur, et neruis, qui contine⟨n⟩t, ruptis. Excidunt autem et in posteriorem partem et in priorem et supra saeptum transuersum et infra. In utram[que] partem excideri⟨n⟩t, a posteriore parte uel tumor uel sinus †donec. Si super saeptum id incidit, manus resoluuntur, uomitus aut neruorum distentio insequitur, spiritus difficulter mouetur, dolor urguet et aures obtusae sunt. Si sub sae⟨pt⟩o, femina resoluuntur, urina subprimitur, interdum etiam sine uoluntate prorumpit. Ex eiusmodi casibus, ut tardius qua⟨m⟩ ex capitis, sic tamen intra triduum homo moritur. Nam quod Hippocrates dixit, uertebra in exteriorem partem prolapsa pronum hominem collocandum esse et extendendum, tum calce aliquem super ipsum ⟨os⟩ debere consistere, ⟨et⟩ ⟨id⟩ intus inpellere, in is accipiendum, quae paulum excesserunt, non is, quae toto loco mota sunt. Nonnumquam enim neruorum inbecillitas efficit, ut, quamuis non exciderit uertebra, tantum paruum tamen aut * * * in priorem partem promineat. Id non iugulat: sed ab interiore parte ne contingit quidem †posse: ab exteriore si propulsum est, plerumque iterum redit, nisi, quod admodum rarum est, uis neruis restituta est.

[¶4] 15. 15 Passing to the humerus, it is sometimes put out into the armpit, sometimes forwards. If it is dislocated into the armpit, the elbow stands out from the side; again, this elbow, together with the upper arm, cannot be raised to the level of the ear on the same side, and that forearm is longer than the other. But if forwards, the upper forearm can be stretched out, but not to its full extent; and it is more difficult to stretch out the elbow forwards than backwards. So if the upper bone has slipped out into the armpit and the patient is still young or supple, at any rate if the sinews are not very powerful, it is sufficient to have him held on a stool; one of the two assistants is directed to press gently upon the head of the blade-bone, while the other stretches the forearm; then the surgeon seated behind thrusts one hand into the point's armpit, presses the bone up with this hand, and with the other presses the elbow to the side. But for a more powerful patient, with stronger sinews, a wooden board is required, two fingers thick, and lon enough to reach from the armpit to the fingers; the upper end is rounded and slightly hollowed to admit a small part of the head of the humerus. In three places in this, with a space between, are two slots through which soft straps are passed. And this board, covered with bandage to avoid injury by contact, is so applied from the forearm to the armpit, that its upper end is put under the armpit: it is then tied to the limb by its straps, one just below the head of the humerus, the second a little above the elbow, the third short of the wrist, to which purpose the two spaces between the six holes are adapted. The limb so fixed is passed over a rung of a poultry ladder at such a height that the patient himself cannot stand firmly; and whilst his body is allowed to sink down to one side, the limb is stretched on the other side; and thus it comes about that the top of the humerus is forced upwards into place by the top of the board, sometimes with, sometimes without a sound. It is easy to learn that there are many other methods by reading Hippocrates alone, but no other has met with more approval in practice. But if the humerus is put out forwards, the man is laid on his back and a bandage or a leather strap passed under his armpit, the ends of which are handed to one assistant behind the man's head and his forearm to another assistant; and it must be arranged that the former pulls the strap, the latter the forearm. Then the surgeon should thrust back the man's head with his left hand, whilst with his right he raises the elbow together with the upper arm and forces the bone back into place; and reduction is easier in this case than in the previous one. When the bone has been replaced, the armpit is filled with wool; if the bone had moved backwards, to prevent it from slipping back; if forwards, to make the bandaging more effective. Then the bandage must first pass under the armpit and control the head of the bone, then stretch across the chest under the opposite armpit, next over the shoulder-blades and again back to the head of the same arm-bone, and it is to be carried round several times in the same way until bone is well held. The bone when bandaged in this way is held in place more comfortably if it is also bandaged close to the side.

> Latin: 15. Vmerus autem modo in alam excidit, modo in partem priorem. Si in alam delapsus e⟨s⟩t, cubitus recedit ⟨a⟩ latere; rursum iuxta eiusdem partis aurem cum umero porrigi non potest, longius⟨que⟩ altero id brachium est. ⟨At si⟩ in priorem partem, summ⟨u⟩m quidem brachium extenditur, minus tamen quam naturaliter; difficiliusque in priorem partem quam in posteriorem cubitus porrigitur. Igitur si in alam umerus excidit, et uel puerile adhuc est corpus uel molle, certe inbecillius neruis intentum est, satis est conlocare id in sedili; et ex duobus ministris alteri imperare, ut caput lati scapularum oss⟨is⟩ leniter redducat, alteri ut brachium extendat: ipsum posteriore parte residentem †renum sub ala eius †coire; simulque et ill⟨a⟩ os * et altera manu brachium eius ad latus impellere. At si uastius corpus neruiue robustiores sunt, necessaria est spatula lignea, et quae crassitudinem duorum digitorum habet, longitudin⟨e⟩ ab ala usque ad digitos peruenit; in qua summa capitulum est rotundum, leniter cauum, ut recipere particulam aliquam ex capite umeri possit. In ea bina foramina tribus locis sunt inter se spatio distantibus, in quae lora mollia coiciuntur. Eaque spata fascia inuoluta, quo minus tactu laedat, ad alam brachio derigitur sic, ut caput eius summae alae subiciatur; deinde loris suis ad brachium deligatur, uno loco paulum ⟨infra umeri caput, altero paulum⟩ supra cubitum, tertio citra manu⟨m;⟩ cu⟨i⟩ rei protinus interualla ⟨II VI⟩ quoque foraminum aptata sunt. Sic brachium deligatum super scalae gallinariae gradum traicitur, ita altae, ut consistere homo ipse non possit; simulque in alteram partem corpus demittitur, in alteram brachium intenditur; eoque fit, ut capite ligni caput umeri inpulsum in suam sedem modo cum sono, modo sine hoc compellatur. Multas alias esse rationes scire facile est uno Hippocrate lecto, sed non alia magis usu conprobata est. At si in partem priorem umerus excidit, supinus homo collocandus est; fasciaque aut habena media ala circumdanda est, capitaque eius post caput hominis ministro tradenda, brachium alteri; praecipiendumque, ut il⟨l⟩e habenam, hic brachium extendat. Deinde medicus caput quidem hominis sinistr⟨a⟩ debet repellere; dextra uero cubitum cum umero attollere et os in suam sedem compellere; faciliusque id in hoc casu quam in priore reuertitur. Reposito umero lana alae subicienda est; si interiore parte os fuit, ut ei opponatur; si in priore, ut tamen commodius deligetur. Tum fascia primum sub ala obuoluta caput eius debet conprehendere; deinde per ⟨p⟩ectus ad alteram alam, ab eaque ad scapulas, russusque ad eiusdem umeri caput tendere; saepiusque eadem ratione circumagi, donec bene id teneat. Vinctus hac ratione umerus ⟨commodius⟩ continetur, si adductus ad latus si⟨c⟩ quoque fascia deligatur.

[¶5] 16. 16 From what was said at the beginning of this book, it can be understood how the three bones, humerus, radius and ulna, meet together at the elbow. If the ulna which is connected to the upper arm slips away from it, the radius which is joined to the ulna is sometimes dragged with it, sometimes remains in position. The ulna can slip out in all four directions: but if it is dislocated forwards, the forearm is extended and cannot be flexed; if backwards, the forearm is flexed and cannot be extended, and it is shorter than on the opposite side; sometimes this causes fever and bilious vomiting. If the ulna has been dislocated outwards or inwards, the forearm is stretched but a little bent towards the part from which the bone has receded. Whatever has happened, there is one method of treatment which holds good not only for the ulna but also for all long bones which are connected at their articulation by a long head. Each limb is to be pulled in opposite directions until there is a gap between the bones. Then the bone which has fallen out of place is forced into the opposite direction from the position into which it has slipped. The methods of extension, however, are various according to the strength of the sinews, and the direction in which the bones have given way. And sometimes only the hands are used, sometimes other means have to be applied. Thus if the ulna has slipped for-wards, extension by two hands, at times aided by straps, is sufficient; then some round object is to be put in front of the biceps and the ulna suddenly flexed over it towards the upper arm. But in other forms of displacement, it is best to stretch the forearm as described above for fracture of the elbow and then to replace the bones. The rest of the treatment is the same as in all other cases; only the dressing must be taken off more quickly and more often and there must be more plentiful fomentations with hot water, and more prolonged rubbing with oil, nitre and salt. For whether the elbow remains out of place or is put back again, callus forms more quickly round it than round any other joint, and if this callus has grown through resting the joint it prevents flexion afterwards.

> Latin: 16. In cubito autem tria co⟨i⟩re ossa umeri ⟨et⟩ radii et cubiti ipsius, ex is, quae prima parte huius uoluminis posita sunt, intellegi potuit. S⟨i⟩ cubitus, qui adnexus umero est, ab hoc excidit, radius, qui adiunctus est, interdum trahitur, interdum subsistit. In omnes uero quattuor partes excidere cubitus potest: sed si in priorem prolapsus est, extentum brachium est neque recur⟨u⟩atur; si in posteriorem, brachium curuum est neque extenditur, breuiusque altero est; interdum febrem uomitum⟨que⟩ bilis mouet; si in exteriorem ⟨interiorem⟩ue, brachium porrectum est, ⟨sed⟩ paulum in ea⟨m⟩ parte⟨m,⟩ a qua os recessit, recuruatum.—Quicquid incidit, reponendi ratio una est; neque in cubito tantum sed in omnibus quoque membris longis, ⟨quae⟩ per articulum * longa testa ⟨iungun⟩tur: utrumque membrum in diuersas partes extendere, donec spatium inter ossa liberum sit; tum id os, ⟨quod⟩ excidit, ab ea parte, in quam prolapsum est, in contrariam impellere. Extendendi tamen alia atque alia genera sunt, prout aut nerui ualent, aut ossa ⟨huc illucue se dederunt.⟩ Ac modo manibus solis utendum est, modo quaedam alia adhibenda. Ergo si in priorem partem cubitus prolapsus est, extendi per duos manibus, interdum etiam habenis adiectis, satis est; deinde rotundum aliquid a lacerti parte ponendum est, et super ⟨id repente⟩ cubitus ad umerum inpellendus est. At in aliis casibus commodissimum est eadem ratione brachium extendere, quae fracto cubito supra posita ⟨est⟩, et tum ossa reponere. Reliqua eadem curatio est, quae in omnibus: celerius tantum ⟨et⟩ saepius id resoluendum est, multa magis aqua calida fouendum, diutius ex oleo et nitro ac sale perfricandum. In cubito enim celerius quam in ullo alio articulo, siue ⟨extra remansit siue⟩ intus reuertit, callus circumdatur; isque si per quietem increuit, flexus illius postea prohibet.

[¶6] 17. 17 The hand also may be dislocated in all four directions. If it has slipped out backwards, the fingers cannot be stretched out; if forwards, they do not bend; if to either side, the hand is turned in the opposite direction either towards the thumb or towards the little finger. It can be replaced without difficulty. The hand, supported on a hard and resistant object, must be stretched one way, the forearm the other, in such a way that the hand is palm downwards if the bone has slipped out backwards, palm upwards if forwards; if the displacement is inwards or outwards, upon the side. When the sinews are sufficiently stretched, the surgeon's hands push back the bone, in the opposite direction to the side to which it has slipped. Where the dislocation is forwards or backwards, some hard object is placed upon the hand, and pressed on the projecting bone, and by this additional force the bone is more readily pushed back into place.

> Latin: 17. Manus quoque in omnes quattuor partes prolabitur. Si in posteriorem partem excidit, porrigi digiti non possunt; si in priorem, non inclinantur; si in alterutrum latus, manus in contrarium [id est aut ad pollicem aut ad minimum digitum] conuertitur. Reponi non difficillime potest. Super durum locum et renitentem ex altera parte intendi manus, altera brachium debet sic, ut prona sit, si in posteriorem partem os excidit; supina, si in priorem; ⟨si in interiorem⟩ exterioremue, in latus. Vbi ⟨satis⟩ nerui diducti sunt, ⟨o⟩s, qu⟨od⟩ in alterutrum latus procidit, manibus in contrarium repellendum est. At is, quae in priorem ⟨posteriorem⟩ue partem lapsa sunt, super inponendum durum aliquid, idque supra prominens os manu urguendum est, per quod uis adiecta facilius ⟨id⟩ in suam sedem compellit.

[¶7] 18. 18 In the palm also bones are sometimes moved from their places, either forwards or backwards; for they cannot move sideways because of the bones on either side. There is but one sign, and that common to all, a swelling over the displacement, a hollow at the spot from which the bone has receded. But without extension the bone is returned into its place imply by firm pressure with a finger.

> Latin: 18. In palma qu⟨o⟩que ossa interdum suis sedibus pro⟨mo⟩uentur, modo in priorem partem, modo in posteriorem: in latus enim moueri paribus ossibus oppositis non possunt. Signum id solum est omniumque commune: tumo⟨r⟩ ea parte, in quam os uenit; ab ea sinu⟨s⟩, a qua recessit. Sed sine intentione digito tantummodo bene pressum os in suam sedem reuertitur.

[¶8] 19. 19 Now the fingers can be dislocated in almost as many ways as the hand and the signs are the same. But in stretching these less force is required, for the joints are shorter and the sinews less strong. They only need to be stretched out on a table, when the dislocation is forwards or backwards; then reduction is made with the palm of the hand; but when the displacement is to one side, by means of the surgeon's fingers.

> Latin: 19. At in digitis totidem fere casus eademque signa sunt, quae in manibus. Sed in his extendendis no⟨n⟩ aeque ui opus est, quo⟨m⟩ et articuli breuiores et nerui minus ualidi sint. Super mensam ⟨tan⟩tummodo intendi debent, qui uel in priorem ⟨uel in posteriorem⟩ partem exciderunt; tum i⟨ma⟩ palma conpelli: at id, quod in latus elapsum est, digitis restitui.

[¶9] 20. 20 Since I have described the above, I can be held also to have described displacements in the legs: for in this kind of accident also there is some similarity between the thigh and upper arm, between the tibia and ulna, between the foot and the hand. But there are also some special points to note about the legs. The thigh-bone may be moved out of place in all four directions, oftenest inwards, next outwards, very rarely forwards or backwards. If it has been dislocated inwards, the leg is longer than the other, and is bowed; for the point of the foot looks outwards; if outwards, the leg becomes shorter and knock-need, and the foot is inclined inwards; the heel in walking does not touch the ground, but only the extreme end of the sole; the leg in this case supports the rest of the body better and more uprightly than in the other and there is less need for a stick. If forwards, the leg is extended and cannot be bent; as far as the heel the injured leg is the length of the other one, but the extremity of the sole is less bent forward; and in this case there is marked pain, and very often the urine is suppressed. When the inflammation and pain have subsided, the patients walk fairly and the whole of their foot touches the ground. If backwards, the leg cannot be stretched out, and is shorter; when the patient is standing the heel in these cases too cannot touch the ground. But the great danger with regard to the thigh is that it is difficult to replace, or, after replacement, slips again out of position. Some hold that it always does so; but such renowned authorities as Hippocrates and Diocles and Phylotimus and Nileus and Heracles of Tarentum have related that they had completely restored such cases; nor would Hippocrates, Andreas, Nileus, Nymphodorus, Protarchus, Heraclides, and a certain smith as well, have invented so many sorts of instruments for making extension on the thigh after this accident, if it had been all of no use. But although that opinion is a false one, there is this truth in it: since the ligaments and muscles there are very strong, if they retain their strength they scarcely allow of replacement; if not, they do not keep in place afterwards. Replacement, then, is to be attempted; and if the limb is weak it is sufficient to stretch it by straps, one from the groin, another from the knee; if stronger, the assistants will have more purchase if they have knotted the straps around long poles; and if after pressing the lower ends of the poles against firm supports, they have drawn the upper ends towards themselves with both hands. Even more forcible pressure can be exerted by stretching the limb over a bench, at either end of which is a windlass to which the straps are attached; when these are rotated as in a winepress, it is possible, by continuing to do this, even to rupture the ligaments and muscles, and not merely to stretch them. Now the patient is to be laid upon this bench, on his face or back or side, so that that part is always the higher into which the bone has slipped, and that from which it has receded the lower. When the sinews have been stretched, if the bone comes forwards, some round object is placed over the groin and the patient's knee must be pulled back over it with a jerk, in the same way and for the same reason for which this was done in the case of the forearm; as soon as the thigh can be bent up, the bone is in place. In the other cases, when the bones under extension have receded a little from each other, the surgeon should force the projecting part back, whilst an assistant presses the hip in the opposite direction. When the bone is replaced nothing further need be done, but the patient must be kept in bed for a rather long time or the thigh may become displaced again on moving while the sinews are still relaxed.

> Latin: 20. Cum de his dixerim, de is quoque, quae in cruribus sunt, uideri possum dixisse: siquidem etiam in hoc casu quaedam similitudo est femori et umero, tibiae et cubito, pedi et manui. Quaedam tamen separatim quoque de his dicenda sunt. Femur in omnes quattuor partes promouetur, saepissime in interiorem, deinde in exteriorem, raro admodum in priorem aut posteriorem. Si ⟨in⟩ interiorem partem prolapsum est, crus longius altero et ua⟨ti⟩um est: extra enim pes ultimus spectat; si in ⟨ex⟩teriorem, breuius uarumque fit, et ⟨pes⟩ intus inclinatur; calx ingressu terram non contingi⟨t,⟩ sed planta i⟨ma⟩; melius⟨que⟩ id crus superiusque corpus quam in priore casu fert, minusque baculo eget. Si in priorem, crus extensum est, in⟨c⟩li⟨n⟩arique non potest; alteri cruri ad calcem par est: sed ima planta minus in priorem partem inclinatur; dolorque in hoc casu praecipuus est, et maxime urina supprimitur. Vbi cum dolore inflammatio quieuit, commode ingrediuntur, totusque eorum pes ⟨inc⟩ed⟨i⟩t. Si in posteriorem, extendi non potest crus, breuiusque ⟨est⟩; ubi constitit, calx ⟨his⟩ quoque terram non contingit. Magnum autem femori periculum est, ne ⟨uel⟩ difficulter reponatur, uel repositum rursu⟨s⟩ excidat. Quidam iterum semper excidere contendunt: sed Hippocrates et Diocles et Ph⟨y⟩lotimus et Nileus et Heraclides Tarentinus, clari admodum auctores, ex toto se restituisse memoriae prodiderunt: neque tot genera machinamentorum quoque ad extendendum in hoc casu femur Hippocrates, Andreas, Nileus, Nymphodorus, Protarchus, Heraclides, quidam quoque faber repperissent, si id frustra esset. Sed ut haec falsa opinio est, sic illud uerum est: cum ibi ualentissimi nerui musculique sint, si suum robur habent, uix admittere; si non habent, postea non continer⟨e⟩. Temptandum igitur est: et si tenerum membrum est, satis est haben⟨a⟩ alter⟨a⟩ ab inguine, alter⟨a⟩ a genu intendi; ⟨si⟩ ualidius, melius adducent, qui easdem ⟨habenas⟩ ad ⟨b⟩acula ualida deligarint; cumque eorum fustium imas partes oppositae morae obiecerint, superiores ad se utraque manu traxerint. Etiamnum ualentius intenditur membrum super scamnum, cui ab utraque parte axes sunt, ad quos habenae illae deligantur; qui, ut in torcularibus conuersi, rumpere quoque, si quis perseuerauerit, non solum extendere neruos et musculos possunt. Collocandus autem homo super id scamnum est aut pronus aut supinus aut in latus sic, ut semper ea pars superior sit, in quam os prolapsum est, et ⟨ea⟩ inferior, a qua recessit. Neruis extensis, si in priorem partem os uenit, rotundum aliquid super inguen ponendum, subitoque super id genu adducendum est eodem modo eademque de causa, qua idem in brachio fit: protinusque, si conplicari femur potest, intus est. In ceteris uero casibus, ubi ossa ⟨per uim⟩ paulum inter se recesserunt, medicus debet id, quod eminet, retro cogere; minister contra inde coxam propellere. ⟨Re⟩posito osse, nihil aliud [noui] curatio requirit, quam ut diutius is in lecto detineatur, ne, si motum adhuc neruis laxioribus femur fu⟨er⟩it, rursus erumpat.

[¶10] 21. 21 It is very well known that the knee is put out externally and internally and backwards. Many have written that it does not slip out forwards; and this may be very near the truth, for the knee-cap is there right in front and holds the head of the tibia in place. Meges, however, has recorded a case in which he replaced a knee which had slipped forwards. In cases affecting the knee-joint the sinews can be extended by the same means as I have described for the thigh. And when it has slipped out backwards, as described above, a round ball of some kind is placed on the ham, and when the leg is bent up over it, the knee slips back again. In the other cases it is to be replaced by the surgeon's hands while the bones are being drawn apart in opposite directions.

> Latin: 21. Genu uero et in exteriorem ⟨et interiorem⟩ et in posteriorem partem excidere notissimum est. In priorem non prolabi plerique scripserunt; potestque ⟨id⟩ uero proximum esse, cum inde opposita patella ipsa quoque caput tibiae contineat. M⟨e⟩g⟨e⟩s tamen eum, cui in priorem partem excidi⟨sset⟩, a se curatum esse memoriae prodidit. —In his casibus intendi nerui rationibus isdem, quas in femore rettuli, possunt. Et id quidem, quod in posteriorem partem excidit, eodem modo, rotundo aliquo super poplitem inposito adductoque eo crure, reconditur. Cetera uero manibus simul, dum ossa in diuersas partes * * * conpellentur.

[¶11] 22. 22 The ankle can be dislocated in all fought directions. When it slips inwards, the sole of the foot is turned outwards; when outwards, the contrary sign is exhibited. If the ankle is dislocated forwards, the broad sinew behind is hard and tense, and in those cases manipulation is required; if backwards, the heel is almost hidden and the sole is elongated. But this is also replaced by manipulation, the foot and leg first being stretched in opposite directions. And after this kind of accident also, the patient should stay for a long while in because, lest the ankle, which sustains the whole weight of the body, should give way and again be displaced if the sinews have not gained strength enough for bearing the weight. At first low shoes should be worn, so that the ankle may not be injured by tight lacing.

> Latin: 22. Talus in omnes partes prolabitur. Vbi in interiorem partem excidit, ⟨i⟩ma pars pedis in exteriorem partem conuertitur; ubi huic contrarius casus, contrarium etiam signum extat. Si in priorem partem erumpit, a posteriore latus neruos durus et insanus est: m⟨a⟩n⟨u⟩que his opus est: si in posteriorem, ⟨cal⟩x paene conditur, pla⟨nt⟩a maior fit. Reponitur autem is quoque per manus, prius in diuersa pede et crure d⟨i⟩ductis. Et in hoc quoque casu diutius in lectulo perseuerandum est, ne is talus, qui totum corpus sustinet, parum confirmatis neruis ferendo oneri, cedat rursusque prorumpat. Calciamentis quoque humilioribus primo tempore utendum, ne uinctura talum ipsum laedat.

[¶12] 23. 23 The bones of the sole of the foot may come out like those of the hand, and are set after the same fashion. Only the bandage should also include the heel, in case, when the middle and front part of the sole have to be bandaged, if the ankle is left unbandaged, too much matter should accumulate there, and lead to suppuration.

> Latin: 23. Plantae ossa isdem modis quibus in manu prodeunt, isdemque conduntur. Fascia tantummodo calcem quoque debet comprehendere, ne, cum mediam plantam imumque eius uinciri necesse est, liber ⟨t⟩al⟨us⟩ in medio relictus materiam pleniorem recipiat ideoque suppuret.

[¶13] 24. 24 For the toes the same treatment is required as was laid down for the fingers. But the middle or end joint when replaced may be fixed in some kind of gutter splint.

> Latin: 24. In digitis nihil ultra fieri debet quam quod in is, ⟨qui⟩ sunt in manu, positum est. Potest tamen conditus articulus medius aut summus canaliculo aliquo contineri.

[¶14] 25. 25 This is the treatment for those cases in which no wound accompanies the dislocation.... In these cases too there is not only great danger but it is more serious, the larger the limb, and the more powerful the sinews and muscles controlling it. Hence in the case of the shoulder and hip joints there is risk of death: and if the bones are set, there is no hope at all; if not, there is still some danger, and in either case the nearer the wound is to the joint the greater the cause for anxiety. Hippocrates said that no such dislocation could be replaced safely except those of fingers and toes, and feet and hands, and even in these cases it was best not to be in a hurry. Some have also replaced elbows and knees; and have then let blood at the elbow, lest gangrene and spasm should arise, after which generally in such cases an early death follows. Even a finger, in which the damage and therefore the damage is least, ought not to be reset whilst there is inflammation, or indeed at a later stage when the condition is of long standing. Moreover, when after replacement the sinews become tense, the bone should at once be put out again. Where there is a dislocation and a wound as well, the limb which has not been seet should lie in the position easiest to the patient; only it must not be moved or hang downwards. In every disorder of this kind there is great advantage in prolonged abstinence, and then in the treatment described above for fractured bones when there is also a wound. If bare bone projects, it will always be troublesome; hence the projection is to be sawn away and dry lint and medicaments without lard put on, until what is possible in the way of healing for such a case is arrived at; for weakness of the limb follows and the scar that forms is thin, and this of necessity is afterwards readily subject to injury.

> Latin: 25. Haec facienda sunt in is casibus, ubi sine uulnere ossa exciderunt. * * * Hic quoque et ingens periculum est, et eo grauius, quo maius membrum est, quoue ualidioribus neruis aut musculis continetur. Ideoque ⟨in⟩ umeris femoribusque metus mortis est: ac, si reposita e⟨i⟩s ossa sunt, spes nulla est; ⟨si⟩ non reposita, tamen nonnullum periculum est; eoque maior in utroque timor est, quo propius uulnus articulo est. Hippocrates nihil t⟨u⟩to reponi posse praeter digitos et plantas et manuus dixit, atque in his quoque diligenter esse agendum, ne praecipitarent. Quidam brachia quoque et crura reposuerunt; et ne cancri distentionesque neruorum orirentur, sub quibus ⟨in⟩ eiusmodi casu f⟨e⟩re mors matura e⟨s⟩t, sanguinem ex brachio miserunt. Verum ne digitus quidem, in quo minimum ut malum, sic etiam periculum est, reponi debet, aut in inflammatione aut postea, cum iam uetus res est. Sic quoque reposito osse nerui ⟨ubi⟩ distenduntur, rursus id protinus expellendum est. Omne autem membrum, quod cum uulnere loco motum neque repositum est, sic iacere conuenit, ut maxime cubantem iuuat; tantum ne moueatur neue dependeat. In omnique tali mo⟨rb⟩o magnum ex longa fame praesidium est, deinde ex curatione eadem, quae proposita est, ubi ossibus fractis uulnus accessit. Si nudum os eminet, impedimento semper futurum est: id⟨eo⟩ quod excedit abscidendum est, inponendaque super arida linamenta sunt et medicamenta non pinguia, donec quae sola esse in eiusmodi re sanitas potest, ueniat: nam et debilitas sequitur et tenuis cicatrix inducitur, quae necesse est facile noxae postea pateat.