When headach proves troublesome in fevers, after the accustomed
evacuations, in the decline of the paroxyms, the head ought to be
anointed, first with the common oil from unripe olives, or with rose
oil, to which a very small quantity of vinegar has been added; which,
if it be the summer season, and the fever of the ardent type, may be
used cold; but, in winter, if the fever be not ardent, it must be hot or
tepid. In the oil may be boiled the juice of wild thyme and knot-grass
(_polygonum_); and in summer, the heads of the poppy, or the poppy itself
may be added, as in winter, a moderate quantity of the hogs-fennel may
be substituted in place of it. When the pain continues in the forehead,
if the open of the head be bare, a poultice may be applied to it, made
of old barley-meal and knot-grass; or, in like manner, of bread and
roses, or of some myrtle or wild thyme. Some are rather benefited by an
admixture of pennyroyal, and others, when the affection was of a hot
nature, have rather been remedied, by having flea-wort (_psyllium_) added
to the barley-flour, or even by this substance alone, when boiled to
the consistence of bird-lime. It must be frequently changed. Coriander
with barley-meal may be used in like manner. Aloes with vinegar are also
to be rubbed in, or myrrh and ammoniac in like manner, and crocomagma.
Pulsatory pains are dispelled by rue and mint, with bread, to which a
little rose oil has been added. When the pain does not yield to the
afore-mentioned remedies, we must first cut the hair close by the
skin, and then rub some of the oily embrocations over it all; after
which cupping-instruments are to be applied to the hind-head, and the
extremities to be bound with ligatures, and chafed. Leeches also are a
proper application. But if a catarrh or defluxion raise the pain in the
head, we must apply the remedies which will afterwards be described in
the proper place. But if exhalations from the stomach have been carried
upwards, and hurt the head, we must attend to them, as is stated below.
* * * * *
COMMENTARY. Part of the directions delivered by Celsus for the treatment
of headach deserves to be given in his own language: “Si capitis dolores
sunt, rosam cum aceto miscere oportet, et in id ingerere: deinde habere
duo pittacia, quæ frontis latitudinem longitudinemque æquent: ex his
invicem alterum in aceto et rosâ habere, alterum in fronte: aut intinctam
iisdem lanam succidam imponere. Si acetum offendit purâ rosâ uterdum est,
si rosa ipsa lædit, oleo acerbo.” If this does not succeed, he recommends
other more refrigerant applications prepared with iris, poppies, ceruse,
litharge, &c. (iii, 10, 112.)
When headach occurs towards the beginning of fever, Galen bleeds once
and again, if there be nothing to contra-indicate depletion, and more
especially if the patient be plethoric. He then attends whether it arise
from fumes proceeding from the stomach, or constipation of the bowels,
and corrects these conditions accordingly. If it make its attack after
the seventh day, he first evacuates the bowels by clysters, then cups the
back part of the head or neck, or uses paregoric applications, such as
rose oil, with some vinegar, if in summer; but, if in winter, especially
in persons of a cold temperament, the oil of chamomile, with a fifth part
of vinegar. See further ‘De Med. sec. Locos.’ (ii.)
Alexander recommends attention as to whether the headach be connected
with the crisis, and in that case he cautions against meddlesome
interferences, which may do more harm than good. When any applications
are admissible, he recommends that they be of a cooling and soporific
nature. (i, 10.)
Aëtius likewise recommends bleeding, purging, and vomiting, when not
contra-indicated; and gives very proper directions about the local
applications. He directs us to soak a handful of wool in some cooling
fluid, and, holding it above the head, to squeeze out the fluid, so that
it may fall upon the head from a height. (v, 100.)
Palladius says that headach in fevers is occasioned by repletion and
distension of the veins, owing to fumes arising from the stomach. (De
Febribus, 13.) Nonnus merely abridges our author’s account. (Epit. 147.)
Avicenna’s directions about the local applications are brief, and similar
to those of the Greeks. (iv, i, 2, 19.) Haly Abbas recommends bleeding
and attention to the state of the stomach, for the relief of which he in
certain cases permits the use of wine. (Pract. iii, 20.) Rhases joins
preceding authorities in recommending vinegar and rose oil to be poured
upon the head. They are to be used cold in summer, but hot if in winter.
(Cont. xxx.)
We have seen that Celsus approved of cold and astringent applications
to the head. The Methodists condemned this practice, and recommended
hot water to be poured upon the open of the head. Hippocrates seems to
allude to this practice, when he says: “Much hot water poured upon the
head removes fever.” (Aphor. vii, 42.) Prosper Alpinus gives an excellent
account of the Methodical treatment. (Med. Meth. ii, 6.)