When the fainting is occasioned by cholera, diarrhœa, or other repeated
and copious evacuations, we must sprinkle water upon the patient,
twist his nose, rub over the orifice of the stomach, and encourage
vomiting; and we should also irritate the throat with our fingers or
the introduction of a feather. Several strong ligatures are likewise
to be applied; when the evacuations are downwards, to the arms; and,
when upwards, to the legs. The patients are also to be placed in an
easy, erect posture, and a cupping-instrument applied, so as to produce
revulsion to the opposite part of the body. Wine and water relieves
prostration of strength occasioned by frequent evacuations, provided
there be no inflammation of any visceral part, nor violent headach,
nor delirium, nor ardent fever unconcocted, to contra-indicate it; for
in such cases wine will do much mischief. And if it be summer, and the
patient of a hot temperament, and addicted to drink cold things, we
may give cold drink; but if the contrary, warm. When the deliquium is
occasioned by profuse sweats, we are to constrict the skin, as formerly
said, and allow a free current of cool air. In defluxions on the stomach,
none of these things is fitting, unless the application of strengthening
things to the belly and stomach, and bathing them; for baths are most
beneficial in cases of stomach defluxions, but greatly aggravate
hemorrhages and sweatings. Those who have fainting fits from plethora,
must abstain from wine, and food, and from baths too, if there be fever.
And we must give them honied water having thyme, marjoram, pennyroyal,
or hyssop boiled in it. Oxymel also is beneficial to them. But if the
faintings proceed from depraved humours contained in the stomach, we must
prescribe a vomit with water and oil—at the same time tickling the throat
with the finger or a feather. But if vomiting cannot be thereby procured,
we must give pure oil, which will often evacuate downwards. And wormwood
is applicable in such cases. But if the faintings are occasioned by
weakness of the stomach, we must use tonic medicines, as formerly stated
in the Section which treats of this affection, and rub the extremities.
When they proceed from exposure to immoderate heat, we are to prescribe
the bath; or, when from excessive cold, we must use the medicine
containing the three peppers, and pepper itself. Those who fall into
fainting fits owing to great heat, or insolation, or from remaining long
in the bath, may be cured by being sprinkled with cold water, and exposed
to the wind; by having their stomach rubbed, and getting wine and food.
But if the swooning be occasioned by the greatness of the inflammation,
or bad nature of the fever in the attacks, and if the patient is cold, we
ought to rub his limbs strongly, chafe him, apply ligatures, force him
to keep awake, and abstain from food. And these things are to be done
previous to the paroxysm. But those who have faintings from dryness,
should get for food two or three hours before the paroxysm either the
juice of chondrus, or bread out of water, along with the kernels of the
pomegranate, or apples, or pears. But if great danger be anticipated, we
must also give wine. Those who have sudden attacks of fainting are to
be thus treated. And in all cases we are to find out the cause of the
deliquium, and direct our attention to it. And sometimes the greatest
care must be bestowed upon this symptom, which threatens danger, or death
itself.
* * * * *
COMMENTARY. Nearly the same account of deliquium animi in fevers is given
by Aëtius (v, 101 et seq.), and by Oribasius (de Morb. Curat. iii, 7.)
But all these authors are, in fact, indebted to Galen. (Therap. ad Glauc.
i.) Aëtius thus states the distinction between syncope and deliquium:
“Deliquium makes its attack suddenly, depriving the person of sense and
motion, but is not necessarily accompanied with sweats; but syncope
seizes upon persons both when asleep and when awake, and is necessarily
attended with sweats, called syncoptic.”
Alexander delivers a full account of the subject; but his principles of
treatment scarcely differ in any respect from those of Galen. (xii, 13.)
Haly Abbas directs us, when the deliquium proceeds from a defluxion of
humours upon the stomach, to apply ligatures to the extremities, to
dash water on the face, to fan it, and to give vinegar and pepper. He
recommends us to prevent sleep, which has a tendency to extinguish the
powers of the primary viscera, by occasioning a determination inwardly.
When it proceeds from dryness, he directs us to give wine, the decoction
of quinces, of apples, and the like. If it happen at the commencement,
he recommends a piece of bread soaked in wine to be given. (Pract. iii,
25.)
The Arabians in general do not acknowledge the distinction between
syncope and deliquium. See Averrhoes (Colliget. vii, 16); Serapion (vi,
19); Rhases (ad Mansor. x, 13.)
Avicenna seems to point at the distinction, but it is not perceived by
his translator. Rhases recommends the same treatment as Haly Abbas. He
approves of hot wine, food of easy digestion, sprinkling of the face with
cold water, and the application of ligatures to the extremities. (Contin.
xxxi.)