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.
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.
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.
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.
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.
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.
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.
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.
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.
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;
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.
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.⟩
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.
⟨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.
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.
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.
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.
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.
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.
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.
If it be hyoscyamus, honey wine should be drunk hot, or milk of any kind, especially asses' milk.
Si hyoscyamum, feruens mulsum bibendum est, aut quodlibet lac, maxime tamen asininum.
If it be white-lead, mallow or walnut juice rubbed up in wine is best.
@@Si cerussam, ius maluae uel ius glandis ex uino contritae maxime prosunt.
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.
Si sanguisuga epota est, acetum cum sale bibendum est. Si lac intus coiit, aut passum aut coagulum aut cum aceto laser.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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;
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.
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.
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.
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;
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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;