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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.