Book 2

THE affection of diabetes is a species of dropsy, both in cause and in condition, differing only in the place by which the humour runs. For, indeed, in ascites the receptacle is the peritonæum, and it has no outlet, but remains there and accumulates. But in diabetes, the flow of the humour from the affected part and the melting are the same, but the defluxion is determined to the kidneys and bladder; and in dropsical cases this is the outlet when the disease takes a favourable turn; and it is good when it proves a solution of the cause, and not merely a lightening of the burden. In the latter disease the thirst is greater; for the fluid running off dries the body.

But the remedies for the stoppage of the melting are the same as those for dropsy. For the thirst there is need of a powerful remedy, for in kind it is the greatest of all sufferings; and when a fluid is drunk, it stimulates the discharge of urine; and sometimes as it flows off it melts and carries away with it the particles of the body. Medicines, then, which cure thirst are required, for the thirst is great with an insatiable desire of drink, so that no amount of fluid would be sufficient to cure the thirst. We must, therefore, by all means strengthen the stomach, which is the fountain of the thirst. When, therefore, you have purged with the hiera, use as epithemes the nard, mastich, dates, and raw quinces; the juice of these with nard and rose-oil is very good for lotions; their pulp, with mastich and dates, form a cataplasm. And the mixture of these with wax and the nard ointment is good; or the juice of acacia and of hypocistis, both for lotions and cataplasms.

But the water used as drink is to be boiled with autumn fruit. The food is to be milk, and with it the cereals, starch, groats of spelt (alica), gruels. Astringent wines to give tone to the stomach, and these but little diluted, in order to dissipate and clear away the other humours; for thirst is engendered by saltish things. But wine, which is at the same time astringent and cooling, proves beneficial by inducing a change and good temperament; for to impart strength, sweet wine is like blood, which also it forms. The compound medicines are the same, as that from vipers, the Mithridate, that from autumn fruit, and the others which are useful in dropsy. But the whole regimen and course of life is the same.

WHATEVER relates to inflammation, hemorrhage, and such other affections about the kidneys as quickly prove fatal, has been treated of under the Acute Diseases. But regarding ulceration thereof, and the formation of stones, and the many other affections which accompany old persons until death, I am now especially to treat, mostly in order to effect their cure; but, if not, to show how they may be alleviated.

Wherefore, then, it is impossible to eradicate the disposition to form stones. It were easier to render the uterus unfruitful, than to destroy the tendency to engender stones in kidneys wherein it is already formed. We must strive, then, to facilitate the passage of them. If, therefore, the calculi be fixed in a place, I will tell what the remedies are which facilitate their passage; for they are attended with great pain, and sometimes patients die with tormina, volvulus of the colon, and retention of urine; for the kidneys and colon are adjacent to one another. Wherefore if there be a stoppage of the stones, and, along with it, retention of urine and tormina, we are to open the vein at the ankle, on the same side as the kidney affected; for the flow of blood from the kidneys relieves the constriction of the calculi, for inflammation detains them by binding all the parts; and an evacuation of the vessels produces resolution of the inflammation. We are also to bathe the loins where the region of the kidneys is placed. Let the oil which is used either be old, or if recent, let rue be boiled in it. The hair of dill is also diuretic, and rosemary, and marjoram. With these you are to bathe the parts as if with plain water; for mere inunction is a small affair. But you are also to foment with these things, by means of the bladders of cattle filled with the oil of camomile. The materials of the cataplasms along with meal are to be the same. Dry-cupping also has sometimes removed the stoppage of the stones; but in the case of inflammation, it is best to have recourse to scarifications. If, when you have done these things, the calculi still remain fixed, you must place the patient in a bath of oil: for this at once fulfils every indication, it relaxes by its heat, in so far lubricates; while its acrimony stimulates to a desire of making water. These are the means which contribute to the expulsion of calculi. The patient is to take drinks prepared from the roots of certain simple medicines, as valerian, spignel, and asarabacca; and herbs, the prionitis, parsley, and water-parsnip: and of compounds such ointments as contain nard, cassia, myrrh, cinnamon * * * * * * * * * for the cicatrization mustard, and eschars produced by fire, and epithemes as formerly described by me. A regulated diet, unction with oil, sailing and living on the sea,—all these things are remedies for affections of the kidneys. * * * * * * * *

FROM the unseemly nature of the affection, and from the danger attending the colliquative wasting, and in consideration of the want of it for the propagation of the species, we must not be slow to stop a flow of semen, as being the cause of all sorts of evil. In the first place, therefore, we are to treat it like a common defluxion, by astringents applied to the parts about the bladder and the seat of the flux, and with refrigerants to the loins, groin, genital parts, and testicles, so that the semen may not flow copiously; and then again, apply calefacients to the whole system, so as to dry up the passages; this is to be done by styptics and lotions; wool then from the sheep with its sordes, and for oil, the rose ointment, or that from vine flowers, with a light-coloured and fragrant wine; but, gradually warming, by means of common oil, and melilot boiled with it, and marjoram, and rosemary or flea-bane; and a very excellent thing is the hair of dill, and still more, the rue. Use these for the cataplasms, with the meal of barley and vetches, and of hedge-mustard seed, and natron; but honey is to be added, so as to make all combine and mix together. Such also are the cataplasms which redden, and raise pustules, and thereby produce derivation of the flux, and warm the parts. Such is the Green plaster, and that from the fruit of the bay. Frequent draughts too are to be given, prepared from castor and winter cherry, to the amount of one dram, and the decoction of mint; of compounds, that from the two peppers, that of Symphon, that of Philo, the liquid medicine from the wild creature the skink, that of Vestinus, that from the reptiles the vipers. Every attention is to be paid to diet, and he is to be permitted and encouraged to take gymnastics, promenades, and gestation; for these things impart warmth to the constitution, which is needed in this affection. And if the patient be temperate as to venereal matters, and take the cold bath, it may be hoped that he will quickly acquire his virility.

IN the other affections, after the treatment, the diet contributes to the strength and force of the body, by good digestion; but in stomachics alone it is at fault. How it should be, I will now declare. For gestation, promenades, gymnastics, the exercise of the voice, and food of easy digestion, are sufficient to counteract the vitiated appetite of the stomach; but it is impossible that these things could remove protracted indigestion, and convert the emaciated condition of the body to embonpoint. But in these cases, much more than usual, the patients should be indulged, and everything done towards them liberally, the physician gratifying their appetites whenever the objects of them are not very prejudicial; for this is the best course, provided they have no desire of those things which would do them much good. Medicines are to be given in the liquid form—decoctions, as of wormwood; and nard ointment and the Theriac, and the fruit of stone-parsley, and of ginger, and of pepper, and of hartwort; these things are of a digestive nature. And an epitheme is to be applied to the breast for the purpose of astringency, containing nard, mastich, aloe, the acacias, and the juice of quinces, and the pulps of the apples bruised with dates, so as to form an astringent epitheme. Also such other things as have been enumerated by me under diabetes, for the cure of the thirst. For the same causes produce thirst in them, and yet in stomachics the tone of the stomach is not inclined to thirst.

IF the stomach be irretentive of the food, and if it pass through undigested, unchanged and crude, so that nothing ascends into the body, we call such persons cœliacs; being connected with refrigeration of the innate heat which performs digestion, along with atony of the faculty of distribution.

In the first place then, the stomach is to be relieved from its sufferings by rest and abstinence from food, for in this way the natural powers are restored. And if there also be a feeling of fulness in the stomach, we are to administer emetics, in the fasting state, with water or honeyed-water; and the abdomen is to be enveloped and bathed, for the purpose of astringency, with unwashed wool from the sheep, with oily things, as the unguentum rosaceum, œnanthemum, and melinum, or what is best, with that from the lentisk, with hypocistis and the unripe grape. But, along with these, cataplasms, hot to the touch, but astringent in powers. And if there be distension or inflammation anywhere about the liver or mouth of the stomach, we are to apply the cupping-instrument, and scarify; and there are cases in which this alone is sufficient. But when, by means of cerates, the wounds have cicatrised and ended in hardness, we are to apply leeches to it, then digestive epithemes, such as that from seeds, if you possess the root of the chamæleon. The best thing here is the fruit of the bay, and the Malagma by name the Green, and mine—the Mystery. For these soften, irritate, rouse heat, discuss flatulence of the bowels, of which there is need for the sake of astringency. But likewise mustard, lemnestis, euphorbium, and all such prevent refrigeration indeed, and procure resuscitation of the heat. Such medicines also the patient must drink for astringency. In the first place, there is need.......... the juice of plaintain with water made astringent by myrtles or quinces. The stone of an unripe grape is also a very good thing, and wines of a very astringent character. Then the medicines which warm the bowels, namely such potions as are made with ginger, and pepper, and the fruit of the wild parsley which is found among rocks, and the very digestive medicine made from the reptiles the vipers. But if it does not yield at all or slightly to these means, use emetics from radishes; and if you will put into them the root of the white hellebore, for a single night, the purging will thus become very strong, for purging away and removing the cold humours and for kindling up the heat.

And likewise the diet and manner of life should be moderate. Sleep by night, by day walks, vociferation, gestation among myrtles, bays, or thyme; for the exhalation and respiration of such things prove a digestive remedy. Gymnastics, friction, chironomy, exercises of the chest and abdomen by throwing the halteres. Propomata; for bread alone contributes little towards strength. After these, rubefacients, walking * * * * * * * * * * * * * * * * * * * * * * * * *

...... from food and radishes frequently. Then to have recourse to the hellebore. The diet after these the same as in the other affections, and after the diet, anointing with oil and the cold sea-bath. These in an especial manner are the common remedies in all arthritic diseases, for in gouty cases hellebore is the great remedy, yet only in the first attacks of the affection. But if it has subsisted for a long time already, and also if it appear to have been transmitted from the patient’s forefathers, the disease sticks to him until death. But for the paroxysms in the joints, we are to do this: let unscoured wool from the sheep be applied; bathe with rose-oil and wine; and in certain case sponging with oxycrate has done good. Then as a cataplasm, bread with the cooling parts of gourd and pompion, and simple cucumber, and the herb plantain and rose leaves. And the sideritis mitigates pain, along with bread, also lichen, and the root of comfrey, and the herb cinque-foil, and the species of horehound having narrow leaves: of this the decoction makes a fomentation which allays pain, and it forms a cataplasm with crumbs of bread or barley-meal. And the part of citrons which is not fit for food, is excellent with toasted barley-meal. Dried figs and almonds with some of the flours. These form the materiel for refrigeration; and, indeed, this is sometimes beneficial to one, and sometimes to another. In certain cases calefacients are beneficial, and the same is sometimes useful to another. It is said that the following application is powerfully anodyne; let a goat feed on the herb iris, and when it is filled therewith, having waited until the food it has taken be digested in the stomach, let the goat be slaughtered, and bury the feet in fæces within the belly. The medicines for the disease are innumerable; for the calamity renders the patients themselves expert druggists. But the medicines of the physicians will be described in works devoted to these things.

THE remedies ought to be greater than the diseases, for the relief of them. But what method of cure could be able to overcome such a malady as elephas? For the illness does not attack one part or viscus, nor prevail only internally or externally, but inwardly it possesses the whole person, and outwardly, covers the whole surface—a spectacle unseemly and dreadful to behold! for it is the semblance of the wild animal. And, moreover, there is a danger in living or associating with it no less than with the plague, for the infection is thereby communicated by the respiration. Wherefore what sufficient remedy for it shall we find in medicine? But yet it is proper to apply every medicine and method of diet, — even iron and fire, — and these, indeed, if you apply to a recent disease there is hope of a cure. But if fully developed, and if it has firmly established itself in the inward parts, and, moreover, has attacked the face, the patient is in a hopeless condition.

Wherefore we are to open the veins at the elbow, and on both sides; and also those at the ankles, but not the same day, for an interval is better both in order to procure a greater flow of blood, and for the resuscitation of the strength; for it is necessary to evacuate the blood frequently and copiously, as being the nutriment of the disease, but the good portion of it which is the natural nourishment is small. Wherefore while abstracting the vitiated portion, consisting of melted matters, we must form an estimate of the suitable part mixed up with it, until the disease has given way from want of pabulum; for the new part being incorporated with the body, in the course of a long time, obliterates the old. Then we are to give the hiera in a potion not once only, but let everything be done several times after recovery and recurrence. And let the other medicinal purgation by the food be practised; and let the treatment be that which I have described under Ischiatic disease, and let the patient drink undivided milk—and that in great quantity—for opening the bowels. Let it receive the fifth part of water, so that the whole of the milk may pass through. They are quickly to be treated with emetics, at first those given when fasting, next, those after food, then those by radishes. Let all things be done frequently and continuously; administering the hellebore at all seasons, but especially in spring and autumn, giving it every alternate day, and again next year. And if the disease has acquired strength, we must give whatever liquid medicines any one has had experience of; for it is a good thing to administer medicines frequently as a remedy. And I will now describe those with which I am acquainted. Mix one cyathus of cedria and two of brassica, and give. Another: Of the juice of sideritis, of trefoil one cyathus, of wine and honey two cyathi. Another: Of the shavings of an elephant’s tooth one dram with wine, to the amount of two cyathi. But likewise the flesh of the wild reptiles, the vipers, formed into pastils, are taken in a draught. From their heads and tail we must cut off to the extent of four fingers’ breadth, and boil the remainder to the separation of the back-bones; and having formed the flesh into pastils, they are to be cooled in the shade; and these are to be given in a draught in like manner as the squill. The vipers, too, are to be used as a seasoner of food at supper, and are to be prepared as fishes. But if the compound medicine from vipers be at hand, it is to be drunk in preference to all others, for it contains together the virtues of all the others, so to cleanse the body and smooth down its asperities. There are many other medicines...... of the Celts, which are men called Gauls, those alkaline substances made into balls, with which they cleanse their clothes, called soap, with which it is a very excellent thing to cleanse the body in the bath. And purslain and houseleek with vinegar, and also the decoction of the roots of dock with the sulphur vivum proves an excellent detergent. The compound medicine from levigated alcyonium, natron, the burnt lees of wine, alum, sulphur vivum, costus, iris, and pepper, these things are all to be mixed together in each case according to the power, but in proportionate quantities, and this compound is to be sprinkled on the body and rubbed in. For the callous protuberances of the face, we are to rub in the ashes of vine branches, mixed up with the suet of some wild animal, as the lion, the panther, the bear; or if these are not at hand, of the barnacle goose; for like in the unlike, as the ape to man, is most excellent. Also the ammoniac perfume with vinegar and the juice of plantain, or of knot-grass, and hypocistis and lycium. But if the flesh be in a livid state, scarifications are to be previously made for the evacuation of the humours. But if you wish to soothe the parts excoriated by the acrid defluxions, the decoction of fenugreek, or the juice of ptisan, will form an excellent detergent application; also the oil of roses or of lentisk. Continued baths are appropriate for humectating the body, and for dispelling the depraved humours.

The food should be pure, wholesome, of easy digestion, and plain; and the regimen every way well adjusted, as regards sleeping, walking, and places of residence. As to exercises, running, tumbling, and the exercise with the leather-bag; all these with well-regulated intensity, but not so as to induce lassitude. Let vociferation also be produced, as being a seasonable exercise of the breath (pneuma). The clothing should be clean, not only to gratify the sight, but because filthy things irritate the skin. While fasting, the patients are to drink the wine of wormwood. Barley-bread is a very excellent thing, and a sausage in due season, and a little of mallows or cabbage half-boiled, with soup of cumin. For supper, the root of parsnip and granulated spelt (alica), with wine and old honey adapted for the mixing; and such marine articles as loosen the bowels—the soups of limpets, oysters, sea-urchins, and such fishes as inhabit rocky places. And of land animals, such as are wild, as the hare and the boar. Of winged animals, all sorts of partridges, wood-pigeons, domestic-pigeons, and the best which every district produces. Of fruits, those of summer; sweet wines are preferable to such as are strong. The natural hot-baths of a sulphureous nature, a protracted residence in the waters, and a sea-voyage.

Courses of Hellebore: —White hellebore is purgative of the upper intestines, but the black of the lower; and the white is not only emetic, but of all purgatives the most powerful, not from the quantity and variety of the excretion—for this cholera can accomplish—nor from the retching and violence attending the vomitings, for in this respect sea-sickness is preferable; but from a power and quality of no mean description, by which it restores the sick to health, even with little purging and small retching. But also of all chronic diseases when firmly rooted, if all other remedies fail, this is the only cure. For in power the white hellebore resembles fire; and whatever fire accomplishes by burning, still more does hellebore effect by penetrating internally—out of dyspnœa inducing freedom of breathing; out of paleness, good colour; and out of emaciation, plumpness of flesh.