All these complaints have this in common, that they are occasioned by
the defluxion of a redundant humour from the head to the parts below.
When, therefore, it seats in the nostrils, the disease is called coryza;
when in the pharynx and roof of the mouth, simply catarrh; but when it
attacks the larynx and arteria trachea, so as to occasion a roughness of
the membrane which lines them, the voice becomes hoarse, and the disease
is called branchus, or morbus arteriacus: these terms being applicable
not only to the inflammatory roughness occasioned by a defluxion from
the head, but also to that arising from vociferation and inhaling cold
air. When the complaint is protracted, and the defluxion is carried down
to the chest and lungs, it gives rise to bad coughs. And a cough often
arises from an intemperament; sometimes a hot one, as in fevers, and
sometimes a cold, as in northerly states of the weather, which is rather
a dry one. Cough is also sometimes symptomatic of some other disease,
such as pleurisy, hepatitis, phthisis, or peripneumonia. Wherefore Galen
relates that, in certain chronic cases of cough, chalazia (hail-stones)
have been brought up from the chest. But Alexander relates that a certain
heavy stone, like that which forms in the urinary organs, was brought up
in a chronic cough, upon which the cough ceased. We ourselves have seen
a discharge of stones with vomiting of blood, as we will describe more
accurately when we come to that part. Those who have coryza and catarrh
from exposure to heat have a sensation of heat about the parts, and a
running of acrid and thin humours from the nostrils and mouth, and there
is redness about the face and nose. When they are occasioned by cold,
there is distension about the head and forehead, and obstruction of the
ethmoid pores, so that the voice does not resound through the nose; and
when they are protracted, cough supervenes, and expectoration of phlegm,
which is sometimes unconcocted and fluid, and sometimes green. In some
cases fever comes on, which does not alleviate the complaint when it
proceeds from heat, but when from cold it promotes concoction.
_The cure of catarrh and of coryza._ When a hot intemperament prevails,
those remedies will apply which suit with headachs from the same cause.
They must have recourse to baths, and have a large quantity of hot water
poured upon the head. The food most befitting are spoon-meats and eggs
in a state to be supped, starch, sweet cake, sesame, rice, almonds, the
fruit of the cones of pine, and all confections from milk. The wines
which are drunk should be sweet and not old. The lohoch from poppy-heads,
called diacodium, and other compound medicines for these complaints,
are to be taken. When a cold intemperament prevails, and the disease is
difficult to remove, a restricted diet is to be observed, and the head
anointed with some heating and attenuating ointment, such as that of nard
or rue. But the ointment of iris is not only to be rubbed in, but is also
to be injected into the nostrils; and, internally, they are to be rubbed
with frankincense and myrrh, with oil; and this more especially when the
coryza arises from cold. But these are remedied by odoriferous substances
with burnt linen, or by gith and cumin burnt and bound up in a linen rag.
Let them also smell to the cyphi seleniacum, and let it be rubbed into
the forehead; and to it let there be added one of the antiphlogistic
plasters, such as the Icesian, the Oxera, the Barbarum, and the Athena.
For catarrh from cold it will be expedient to drink of cyphi, and to
rub into the chest the juice of balsam by means of unwashed wool; or to
apply calefacients to it, along with storax, the ointment of iris, or
that of dill. Let them also use hot and concocting food. But when the
matter is already concocted, a masticatory will answer well with them,
and detergent ointments (_smegmata_) to the head, such as the soap of
Constantine, and the like.
_The cure of affections of the trachea, or hoarseness._ For the complaint
called arteriacus and branchus, those things already mentioned will
apply; but, in particular, when an inflammatory affection of the trachea
and larynx prevails, we must, at the commencement, use the emplastic
remedies, until the inflammation become more moderate; such as those
from Cretan sweet wine, tragacanth, gum, and starch, and a decoction of
the fatty dates and that of liquorice, with rob, until it become of the
consistency of honey. And we must use that class of electuaries called
hypoglottides. But, above all things, the patient at this period must
abstain from drinking wine; but when the inflammation becomes moderate,
he may take some sweet wine. And let him use those spoon-meats which
are made from honey and milk, with starch, and bread of fine flour, and
almond emulsions; and let him take butter. When a humour remains fixed
in the parts, he must have recourse to detergent remedies, such as the
porridge of beans, and those things which are prepared from honey,
cabbage, and well-boiled leeks. He may also take the hotter medicines,
and those used for the cough, in the rob of dried figs, of frankincense,
iris, turpentine, storax, galbanum, pepper, cinnamon, cassia, and the
like.
_On cough._ Coughs are to be cured by the same method, attending only to
this, whether they be occasioned by sympathy with other parts, such as
a defluxion from the uvula or head, and whether they be symptomatic of
other diseases; in which case, they are to be disposed of in the manner
already mentioned, or as will be described afterwards. An exposition of
the compound remedies follows.
_Pills for catarrh and cough._ Of storax, of myrrh, of opium, of
galbanum, equal parts; mix with must, or pound by themselves in a mortar,
and make into pills the size of a tare. Give three, four, or five at
bedtime, and swallow with some must. These things are for an acrid and
thin rheum.—_Another_: Of the seed of henbane, dr. xij; of pine-nuts, dr.
vj; of saffron, dr. ij. Mix with rob or with must, and use.
_An electuary._ Of honey, oz. j; of butter, oz. ss. Boil together and
give; and let the decoction of hyssop, of figs, of pine-nuts, and of
iris, be swallowed.
_Pills for more inveterate coughs._ Of storax, dr. vj; of myrrh, dr.
iiss; of turpentine, of galbanum, of opopanax, and of iris, of each, dr.
ij; of white pepper, of nitre, of henbane-seeds, of the juice of poppy,
of each, dr. j. Beat in a mortar without any liquid, form into pills, and
use as formerly directed.
_For roughness of the windpipe, cough, and bloody expectoration._ Of
bitter almonds whitened, xxv in number; of toasted linseed, dr. iv; of
tragacanth, dr. ij; of pine nuts, xxx grains; the yelk of an egg roasted
in dough. The tragacanth is macerated with water, and the whole mixed
with must. If the sound of the voice be broken, mix honey instead of the
must, more particularly when there is anything to expectorate.
_An arteriac to be kept below the tongue for those who have lost the
voice, for hoarseness, and bloody expectoration._ Of tragacanth, dr.
vj; of gum, dr. vj; of myrrh, dr. iss; of white pepper, xx grains; of
saffron, dr. j; of liquorice-juice, dr. vj; the flesh of three dates; of
Cretan sweet wine, q. s. The juice of the tragacanth alone placed under
the tongue answers very well. Instead of the juice of liquorice, its
decoction boiled down to the proper consistence may be substituted in
quadruple quantity.
_An arteriac for loss of voice, suiting also for strengthening the
voice._ Boil six leeks to a third part; throw them away, but with the
decoction mix the juice of alica and honey; boil with them the yelks of
three eggs previously boiled, stirring with a branch of dill.
_For coughs._ Of pennyroyal, oz. ij; of pine-nuts, of bastard saffron,
of linseed, of each, oz. j; of white pepper, oz. iv; mix with boiled
honey.—_Another_: Of hyssop, of pennyroyal, of pepper, of each, oz. j; of
Macedonian parsley, oz. ss; of honey, a hemina.
_For concocting an inveterate cough._ Of honey, dr. xvj; of turpentine,
dr. ij; of galbanum, dr. xiv. Having boiled them together, and having
formed to the size of beans or of walnuts, let them be sucked.—_Another_:
A dry cough is cured by the arteriacs, and also by the drinking of hot
water; for, not being able to expectorate, owing to the thickness of the
phlegm, they are assisted in so far by diluents. A decoction from hyssop,
and iris, and pine-nuts, also answers with them.
_A trochisk to be inhaled for a continued cough._ Of storax, of pepper,
of mastich, of Macedonian parsley, of each, oz. j; of sandarach, scr.
vj; two bay-berries; mix with honey; and fumigate by throwing them upon
coals, so that the person affected with the cough may inhale the vapour
through a funnel. It answers also with those affected by cold in anywise.
* * * * *
COMMENTARY. All the writers referred to in the preceding Section (with
the exception of Aretæus) may be consulted here.
Galen, in the seventh book of his work, ‘de Med. sec. loc.’ has treated
of these diseases so fully that he may be said to have exhausted the
subject. We can only afford room for a few of his general remarks. He
states that the arteriacs, or compositions for affections of the arteria
trachea, consist of three different kinds of medicines. First, those
called by him obstruents, and answering to those now called demulcents,
such as Cretan sweet wine, tragacanth, liquorice, and the like, which act
by smoothing the asperities of the parts. Second, the acrid, containing
cinnamon, turpentine-rosin, and the like. Third, the intermediate,
consisting of the juice of ptisan, almonds, and the like. He gives a
great number of compositions from Andromachus, Criton, and others, which
might deserve attention. Of their ingredients some are expectorants, such
as squills, myrrh, &c.; some demulcents, such as liquorice, tragacanth,
&c.; and some narcotic, such as opium, mandragora, hyoscyamus, and
hemlock. With the medicinal properties of the last-mentioned article
(we mean the _conium maculatum_), which Dr. Paris commends so highly in
diseases of the chest, the ancients were sufficiently well acquainted.
For humid coughs Galen recommends a composition of alum, opium,
galbanum, and storax. He mentions lumbrici in the stomach as a cause of
coughs. (Com. in Epid. iii.) Among the remedies mentioned by our author,
by Galen, and by most of the ancient authorities, we may remark the
inhaling the fumes of certain acrid medicines, such as yellow orpiment
and sandarach, or realgar, i. e. red orpiment. Whether the practice be
safe or not we shall not pretend to determine; but, unquestionably, it
is recommended upon high authority; and therefore it is not true, as
has been often stated, that this practice arose from the mistake of
confounding the gum juniper, or vernix of the Arabians, also often called
sandarach, with the sandarach of the ancients, or realgar. (See Bree
on Asthma, p. 231.) We refer to Aëtius (viii, 61); Pseudo-Dioscorides
(Euporist. ii, 33); Pliny (H. N. xxxiv, 55); Alexander (v, 4); Myrepsus
(xli, 76); Serapion (ii, 19, and 24); and Rhases (Cont. viii.) The
ancient veterinary surgeons used arsenic in fumigations for the coughs
of cattle. See Vegetius (Mulom. iii, 67.) Platearius, a modern writer
of the thirteenth century, recommends arsenic for chronic coughs, both
in fumigations and taken into the stomach, and yet he distinguishes
quite correctly the sandarach, or red arsenic, from the gum vernix. (De
Simplici Medicina.) Some of the earlier writers on the venereal disease
recommend fumigations with arsenic for syphilitic ulcers of the throat.
(V. Aphrodisiacus, and Sect. XXIX of this Book.)
At the commencement of a common catarrh, Celsus advises to abstain “a
sole, balneo, vino, venere;” but to use “unctione et assueto cibo.” When
the lungs become affected he recommends much friction and exercise on
foot. He gives the following account of the origin of these complaints:
“Destillat autem humor de capite interdum in nares, quod leve est;
interdum in fauces, quod pejus est; interdum etiam in pulmonem, quod
pessimum est.” The idea of the disease originating in the head and
spreading downwards prevails in all the ancient descriptions of the
disease, and, we may mention, is now sanctioned by the authority of the
illustrious Laennec. See, in particular, Aëtius, who copies, however, in
part from Galen.
Alexander devotes a whole chapter to the consideration of these
complaints. He forbids diuretics, because they carry off the thin part
of the humours and leave the thick behind. Respecting the chalazia
mentioned by Galen, and “the smooth, hard, and firm stone” said to have
been expectorated by Alexander’s patient, we have a few remarks to make.
The passage in Galen’s work where they are described is at ‘de Loc.
Affect.’ iv, near the end. These sputa have been described by recent
pathologists. Thus Andral calls them small clots, of a dull white,
or inclining a little to yellow, from a small pin’s head to a pea in
size. (Clinical Medicine, 464, Engl. ed.) The modern authorities agree
that they are indicative of phthisis. Aretæus describes by the name of
pneumodes, and as a species of asthma, a diseased state resembling that
which we are treating of. The symptoms are dyspnœa, cough, and wasting;
pulse small, frequent, and feeble; the sputa, if any, small, white,
round, and like hail. The disease proves fatal in the course of a year,
and often ends in dropsy and anasarca.
The treatment recommended by the great Methodist Cælius Aurelianus
is not much different from the practice of the other sects, only he
enjoins a more rigid abstinence from wine and food of a heating nature.
He also condemns the practice of inhaling the vapours of red arsenic
(sandaracha), and the like. In protracted cases he recommends a change of
place.
There is nothing original in the practice of the Arabians. Avicenna
prudently forbids preparations of poppies after expectoration has
commenced. For coryza Haly Abbas recommends, if the patient’s age and
temperament permit, bleeding, a spare diet, abstinence from wine,
fumigations with the vapours of camphor, lignum aloes, vinegar, &c.;
avoiding to lie on the back, and so forth. He treats at great length of
coughs, distinguishing them according as they are seated in the throat,
gullet, or lungs, and whether they be sympathetic or not. For hoarseness,
he directs gargles from the seed of anise or fennel, or a decoction
containing radishes, parsley, fennel, mastich, spikenard, iris, figs, &c.
Alsaharavius treats fully of these complaints in much the same terms.