Part 60

Serapion recommends styptic and desiccative applications, such as galls, frankincense, alum, the flowers of vine, myrtles, and the like. (De Antidotis, vi, 20.)

Haly Abbas briefly recommends friction with styptic oils, and to remove the patient to a cool apartment. (Pract. iii, 24.)

Alsaharavius, in like manner, recommends friction with astringent oils, such as those prepared with roses, pomegranates, and the like. (xxxi, 2, 8.)

Avicenna and Rhases adopt the same plan of treatment as our author. The latter directs us to rub the body with rose oil, or myrtle oil, to sprinkle the patient with rose water in the decoction of myrtles, to fan him, and to lay in his chamber the tops of cooling herbs and trees. (Contin. xxxi.)

Prosper Alpinus informs us that the Methodists approved of cool air, of sprinkling the face with cold fluids, of rubbing the body with styptic oils, and of giving astringent wines internally. He also mentions the application of snow over the arteries of the extremities, and pouring cold water over those of the wrist. It is to be regretted, however, that this author too frequently omits to quote his ancient authorities. (See Medic. Method., vi, 18, and vii, 3.)

SECT. XLVIII.—ON COUGH IN FEVERS.

We must endeavour to remove a cough in fevers, more especially in such as come on with rigors, for it exasperates the fever when it is subsiding. We must give lozenges from boiled honey to hold below the tongue, for these melt and remove the substances which obstruct respiration. The time for using them is at the acme of the paroxysm, and a short time before the attack. Well-boiled hydromel must likewise be given. When there is no suspicion of the nerves being affected, in process of time you may give oxymel with confidence, or if not it, the decoction of hyssop, which is a remedy also for rigors. If the fever is not of the ardent kind, you may give castor, which is also of use to the nervous system. Electuaries may be used, made of the kernels of the common and wild pine, iris, linseed, bitter almonds, and nettle-seed. But the most of these may be mixed with the food. Turpentine-rosin should be given in an egg. To the chest and the parts about the trachea, apply a sulphurated woollen cloth, and oil of rue, or of iris, or of dill. Tight ligatures long applied are excellent for stopping cough, I mean to the middle and extremities. Nor will it be unsuitable to use for the cough stavesacre dried, which may be chewed with dried grapes or mastich. The extremities may be rubbed, chafed, and bound with ligatures, and afterwards the retracted parts unbound. But if the cough annoys, owing to the acrid nature of the fever, we must use a gargle of tepid water. Cold water also is often useful; and, in like manner, gargles of oxycrate, or of the decoctions of dates, roses, or liquorice. Moderately cooling things are also to be laid over the bowels and heart.

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COMMENTARY. Galen gives some ingenious remarks on the causes of coughing. He states that when any substance becomes fixed in the trachea, as it is a cartilaginous and hard tube, and incapable of contraction, nature brings on coughing, by which a violent expiration of air is induced. A cough, then, is nothing but a violent expiration by which nature endeavours to expel any body that obstructs the air-passages; and, when she cannot accomplish this at the first effort, she repeats it once and again until she effect her purpose. He goes on to state, that such fluids as are very watery, instead of being brought up, are merely divided or cut asunder by the current of air, while such as are thick and viscid, adhere so closely to the sides of the windpipe that they cannot be removed, and hence violent efforts are necessary to effect the discharge of them. (De Causis Sympt. ii, 4.) He treats fully of compositions for coughs in his work ‘De Comp. Med. sec. Loc.’ (vii.) See the 28th Section of the Third Book.

Avicenna recommends cough pills and lohocks made with poppies, the cold medulla of fruit, starch, and the like. (iv, i, 2.)

The prescriptions of Serapion contain liquorice, sweet almonds, tragacanth, and the like. (De Antidotis, vii, 17.) Those of Haly Abbas are very similar. (Pract. iii, 22.)

A receipt is given by Rhases for cough pills, the principal ingredients of which are tragacanth, sweet almonds, poppy seed, gum Arabic, and Armenian bole. (Divis. i, 52.) Many such receipts are given by Myrepsus.

SECT. XLIX.—ON SNEEZING.

Sneezing frequently occurring in fevers is troublesome, for it determines to the head and weakens the strength, and, in some cases, it produces a discharge of blood. Such are the bad effects of sneezing, which ought therefore, to be contended against. It is restrained by rubbing the nose, forehead, and eyes; by yawning, frequent friction of the roof of the mouth, eructation, stretching of the loins, raising the head, turning to the side, gently chafing the extremities, anointing the masseter muscles, pouring hot oil into the ears, applying a warm cushion under the chin. It is proper to avoid being roused suddenly from sleep, and also smoke, dust, acrid smells, pepper, castor, mustard, and mint. The smell of apples and polenta is proper, for it blunts the desire of sneezing. The empty sea-sponges do the same. When there is a frequent desire of sneezing without the ability, let the lips be composed, let the patient smell to acrid substances, and let the mind be relaxed.

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COMMENTARY. Galen explains that sneezing is a still more violent effort of nature than coughing, and that its intention is to remove irritating matters from the parts about the nose. (De Caus. Sympt. ii, 4.)

Avicenna gives ample directions for the treatment of sneezing; but they are evidently copied from our author. (iv, 1, 2.) The same may be said of Haly Abbas. (Pract. iii, 22.) Rhases recommends us to give warm gruel internally, to pour warm water on the head, and to apply oil of gourd, of roses, and the like, to the nostrils. (Cont. xxxi.)

Cassius Medicus discusses the question why rubbing the nose and eyes stops sneezing. He supposes that it is by occasioning a discharge from these parts, whereby the exciting cause is removed. (Probl. 45.)

SECT. L.—ON LOSS OF APPETITE.

When loss of appetite is occasioned by depraved humours, we must give those kinds of food and drink which will either clear away such humours by vomiting, or downwards by the bowels, or those that by dilution will render them better. You have the materials of these things treated of in the First Book of this work. Should the loss of appetite be occasioned by debility, since all debility is owing to an intemperament of the parts, we must cure the species of intemperament by its contraries. Wherefore we will give a more particular account of loss of appetite in treating of stomach complaints in the Third Book. But in fevers we must straightway endeavour to bring back the appetite with aromatics, more particularly by giving polenta moistened with water, or oxycrate, or diluted wine, or a decoction of some of the fragrant and astringent fruits; by gentle unction and moderate friction of the whole body, by chafing, by bathing the face, and swallowing a small quantity of water; and, by putting the fingers down the throat, the stomach has been roused to bring up the food, more especially if the fluid discharged be bilious or acid. After the first days, cataplasms of dates, of apples, of the wild wine, of wormwood, and of aloes, ought to be applied over the stomach. Let a variety of simple food be prepared, and from grain, having some difference from the common articles, but not very different from those used in fevers; and among them those fruits which do not readily turn acid, nor are very sweet, but are ripe; however, they are not to be eaten to satiety, but only so as to whet the appetite for other food. While they are eating, the most delicious articles ought to be present, which may have the power to provoke and incite the desire. After the fever is gone, should the want of appetite continue during the recovery, yellow parsnip boiled with oxymel, and lettuces, and pickled olives, and capers, and pickles, the bulbi, and every other stomachic should be thought of; and, in particular, those things should be recollected in which the patient delighted most when in good health. Walking, gestation, vociferation, calefacient plasters, frictions, and exercises ought to be had recourse to. And drinking the propoma from wormwood, or from aloes, or swallowing the vinegar of squills to the amount of a mystrum, have proved excellent remedies.

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COMMENTARY. Galen’s explanation of the philosophy of the sense of appetite is very interesting. He remarks that the appetite is a refined species of touch, the seat of which is the mouth of the stomach, which, therefore, is supplied with nerves direct from the brain. He goes on to remark, that the earth is to plants what the stomach is to animals, supplying them with abundance of food as long as it is moistened by seasonable rains; but, when it becomes parched with drought, the plants in like manner are dried up for want of nutriment. (This comparison is borrowed without acknowledgment from Aristotle.) To animals, then, as not being fixed to the earth (with a few exceptions), nature bestowed a stomach which is to them a repository of food, such as the earth is to plants, and she further gave them a sense of want by which they have the desire of being filled with food and drink in due season. This desire of being filled is called the appetite, which arises from a sense of want, when the veins of the stomach absorb, and, as it were, suck from it, whereby a painful feeling is excited, the proper cure of which is a supply of food. The sensation then of sucking constitutes hunger. The loss of appetite may arise either from the sense of the sucking being lost, or from the process of sucking (absorption?) not taking place, or from the body not being evacuated. (De Causis Sympt. i, 7.) He treats of stomach affections very fully in his work ‘De Med. sec. Locos.’ (viii.)

Treatment similar to our author’s is recommended by Alexander (vii, 7), and by Oribasius (Synops. vi, 35.)

Avicenna evidently takes his plan of treatment from our author, for he recommends emetics, and afterwards fragrant things, with a plaster composed of fruits laid over the stomach, and wormwood, aloes, &c., internally. (iv, 1, 2, 26.) Among the causes of loss of appetite mentioned by him in another place are general disorder of the constitution in fevers, severe thirst, repletion with depraved humours, and insensibility of the mouth of the stomach, so that it does not perceive the suction of the veins. (iii, 13, 2, 7.)

Haly’s treatment is nearly the same. He recommends fragrant food and fragrant wine after the acme of the fever, gentle laxatives, and such modes of exercise as he can bear. (Pract. iii, 21.)

SECT. LI.—ON BULIMOS OR INORDINATE HUNGER.

If want of appetite should pass into the opposite state, I mean an excessive atrophy, called bulimos, we must resuscitate such persons with roasted pork, or kids, and other savoury things; and, in a word, with every strong-scented thing, if the acute stage of the fever be past. We must bind the extremities, and rouse, by pinching the cheeks, and pulling the hair and ears. When recovered, we must give bread that has been dipped in diluted wine, or any other diffusible thing.

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