Of liquid alum, p. ij; of myrrh, p. j; dissolve in wine, and
use.—_Another_: Plunge heated Molybdæna into fragrant wine, triturate
with the wine, adding a little myrrh until it become of the thickness
of the sordes in baths, then use. _Another_: Of litharge, dr. xvj; of
myrrh, dr. ij; of amomum, dr. j; mix with wine.—_Another_: Of liquid
alum, dr. viij; of amomum, of myrrh, and of spikenard, of each, dr. iv;
triturate with wine, and use.
* * * * *
COMMENTARY. See in particular Oribasius (Synops. viii, 36); Nonnus (155);
Geopon. (xii, 26); Alsaharavius (Pract. xv); Rhases (ad Mansor. v, 51,
and Contin. xxxvi.)
All the authorities concur in recommending for the cure of this
complaint, a combination of astringents with aromatics. They therefore
direct us to mix alum with storax, myrrh, and the like. Rhases recommends
tutty with rose-water and camphor, and also various astringent and
odoriferous liniments. The plan of treatment directed by Alsaharavius
is deserving of attention. He recommends purging with the hiera picra.
Alsaharavius further recommends a bath in which mint, marjoram, centaury,
spikenard, and the like have been boiled. The part is afterwards to be
rubbed with an ointment, consisting of litharge or tutty, mixed with
alum, myrrh, &c. in fragrant wine.
The ancients believed that living freely upon figs rendered the
perspiration fetid. Eustathius, the commentator on Homer, makes mention
of two Sophists, called Anchimolus and Mochus, who lived solely upon figs
for food, and water for drink; and he adds that their perspiration was so
fetid, that when in the bath everybody shunned them. (Ad Iliad. xiii, 6.)
SECT. XXXVII.—ON AFFECTIONS OF THE STOMACH, OF THE HYPOCHONDRIA, AND OF
THE BELLY.
Those complaints which occur in fevers, such as loathing of food,
bulimia, the canine appetite, atony of the stomach, deliquium animi,
thirst, hiccough, nausea, and syncope, have been treated of sufficiently
in the Second Book, and it would be out of place to say more about
them. But inflammations of the orifice of the stomach and of the liver
require the admixture of astringents; for, if treated by the relaxant
method alone, it will prove dangerous. It will be necessary, then,
whether oil be affused on the part or a cataplasm be applied, to add
some of the astringents to it, such as wormwood or the nard ointment;
or that of apples, or of quinces may be boiled in it. The following
is a cerate which we frequently use: Of white wax, oz. j, (but if in
summer, dr. vij); of aloes and mastich, of each, dr. j; add of the oil
of unripe olives, or of apples and of nard, when going to use it, as
much as will be sufficient to give it consistence. Or, if the stomach
require greater astringency, as not being able to retain the food, mix
also of oil of unripe olives, dr. j; or of the juice of wormwood an
equal quantity; and, thirdly, of the juice of hypocistis, of wild vine,
and of sumach. We must make the quantity of the cerate proportionate
to the number of the other medicines. When the inflammation becomes
protracted and hard, we must apply more complicated remedies, containing
aromatic, emollient, and discutient ingredients, such as that prepared
from melilot, the philagrianum, and the fragrant. And a necklace of green
jasper appended from the neck, so as to touch the stomach, is of great
use. In hot intemperaments of the stomach, or ardent affections of it
with prostration or deliquium animi, or anorexia from any other cause
than fever, give cold water with the juice of unripe grapes, or the
decoction of quinces, or of vine shoots, or the powdered seed of cucumber
with cold water. Apply to the stomach a bladder filled with cold water,
or the shavings of gourd. And the pills called Adipsa are to be given,
as described when treating of thirst. The following medicine is proper
for cooling and strengthening a watery stomach: Of green rose-leaves, dr.
vj; of liquorice juice, dr. iv, mix with sweet wine, and make into an
electuary, to be allowed to melt under the tongue. When, on account of a
gross phlegm, medicines are required to heat and incise it, the following
one will be useful: Of the rind of fennel-root, oz. ij; of vinegar, a
sextarius and a half; of aloes, oz. iij; of honey, lb. iv; the roots
being boiled in the vinegar, are to be squeezed out and thrown away,
and honey being added, it is to be boiled to a proper consistence, and
then powdered aloes sprinkled upon it. Give three spoonfuls of it with
water. Some prepare it without the aloes. The composition from calamint
is also proper for such cases. When the food turns acid on the stomach,
give in water for drink a drachm of coriander seed sprinkled upon it like
polenta, or one spoonful of mastich, or two spoonfuls of the seed of the
white lettuce. The following is a compound medicine: Of pepper, dr. j;
of the seeds of dill, dr. iij; of cumin, dr. iv; triturate, and give at
bedtime one spoonful in diluted wine. Those who form black bile, and
have the stomach inflated, may, during the exacerbations, apply to it
sponges soaked in the strongest vinegar, after which, if the complaints
continue, alum with pulverized copper may be added to honey, and applied.
Let them drink the juice of endive, or let mint be sprinkled upon the
draught. When the stomach is inflated and distended, mix a moderate
quantity of honey and pepper with the decoction of calamint, and give.
For subversion of the stomach, take of the juice of the kernels of the
unripe pomegranate, p. iij; of the juice of mint, p. j; boil until it
thicken, and give a mystrum (_two spoonfuls?_) of it before a meal.
_For salivation of the stomach._ Rinse the mouth with vinegar of squills,
the sauce of pickled olives, or the decoction of the green leaves. Or a
very small quantity of the same may be swallowed. A still more effectual
remedy is aloes dissolved in water. For those who cannot retain their
food (who were particularly called stomachics by the ancients), mix with
honey the flour of fenugreek and the dried seed of mallows in powder, and
apply. The cerate consisting of wax, the lees of oil of iris, and castor,
is also proper.
_On anorexia._ Anorexia is a loathing of food, either from the prevalence
of an intemperament in the stomach, or a collection of humours. You
may know a hot intemperament by the thirst, by the fetid and feculent
eructations if compelled to take food, and from the circumstance that
cold and intractable substances are most easily digested; and a cold by
the opposite, for they neither have thirst, nor can they endure cold
things, and they have sometimes acid eructations. Of those who have
anorexia from humours, they who suffer from thin and sharp humours,
have gnawing pain at the stomach, and are more affected with nausea
and thirst. When the humours become putrid, they sometimes have fever.
When they suffer from thick and viscid humours, these for the most part
neither occasion acute pain nor thirst, but the common symptom of all
these cases is nausea. Wherefore, if the humours are contained in the
cavity of the stomach, they vomit them up; but, if they are absorbed and
infarcted in its coats, they have nausea only, but do not vomit, unless
it be when they have taken food. Those, therefore, who have anorexia
from a hot intemperament, should take cooling things for diet, more
especially such as are prepared from vinegar. Wherefore give them bread
that has been soaked in oxycrate, or oxycrate itself to drink, and
oxygal (vinegar and milk), and that which is called melca by the Romans
(it is a condiment from milk), endive, lettuces, and sometimes cold
water: all these moderately, according to the degree of the prevailing
intemperament; for the immoderate use of them is not only not beneficial,
but often renders the complaint utterly incurable. When the affection
is connected with coldness, it is to be cured by the opposite remedies;
wherefore give to drink old wine and prepared wine, hydrogarum, and the
decoction of anise, rue, and Macedonian parsley, and pepper, in hot
common water; or the composition from the three peppers, or that from
calamint. You may give also the theriac from vipers, which is also not
inapplicable to those who loathe food from a collection of humours.
Garlic, both as food and as medicine, is applicable to them. When the
anorexia proceeds from a collection of humours, you may evacuate such as
are thin and sharp, either by vomiting or purging downwards, and they
may readily be made to vomit, by drinking beforehand tepid water, or
hydromel diluted with a large quantity of water. But it will be better
to give previously some moistening food, such as the juice of ptisan, or
the yelks of eggs. How to produce easy vomiting has been explained in the
First Book. But if the patient be hard to make vomit, it will be better
to determine the matter downwards, having previously diluted their system
by means of plenty of mild food. The cathartic medicine may either be the
picra from aloes, that from quinces, which also admits of scammony, or
that from rhodomel. If it be possible without the scammony to evacuate by
a large dose of aloes, it will be better, because the scammony is bad for
the stomach. When the anorexia proceeds from thick and viscid humours,
you may cure them by attenuating and incisive remedies, such as oxymel,
and the preparations from it and brine, as capers, olives, mustard, and
the like. The remedies recommended for anorexia from a cold intemperament
are not inapplicable to these, and more particularly after evacuation.
You may evacuate them by the oxymel called Julian. Externally you must
use those unguents and emollient ointments which have power to warm and
strengthen the stomach, such in particular as that from the unripe grape,
that called Marciatum, and all the common ointments; also such epithemes
as the Baium, the fragrant, and the like. They ought particularly to have
recourse to exercises and friction. When dyspepsia and anorexia arise
from a cold and liquid humour, or such an intemperament, the medicines
composed from quinces will be applicable to them, I mean that called
meloplacuntion, that from the juice of apples, and that from the flesh
of them, and that which is prepared from the citron. Also the malagmata
or emollient unguents, such as the Marciatum, that from the juice of the
unripe grape, the Baium, Polyarchium, and such like. When there is an
ulcer in the stomach or bowels, the patient must abstain from all acrid
food and drink, and use remedies of a soothing nature, such as draughts
without oil, and those from starch, Samian earth, Lemnian earth, and
milk, or a small quantity of honey, so as to purge without griping. A
convenient epitheme is prepared from dates, the flour of quinces, and a
cerate from quince-ointment, or rose-oil with ammoniac and frankincense;
and also the epitheme of Nileus, the plaster from willows, and the
Icesian may be used. You may know that an ulcer exists by blood, pus, or
the scabs of a sore being vomited up.
_For those whose stomachs are enervated and in a state of atony, and who,
for that reason, do not digest their food, or vomit it up._ Of aloes,
of masucha, of mastich, of storax, of each, oz. ij; of wormwood, oz.
iv; of the flowers of the wild vine, oz. iij; of Gleucine oil, oz. vj;
of quince-ointment, oz. iij; of wine, q. s. Some also add of cyphi and
roses, of each, oz. ij. These things, being powdered, are received upon
purple or wool, and applied to the stomach. But some, by adding of wax,
oz. vj, make an epitheme of it.
_For iliac affections of the stomach, that is, strong and spasmodic
pains._ The trochisk of the Amazonians is the best medicine in this case.
An account of it, and of the ingredients which enter into the composition
of other compound remedies for the stomach, you will find in the last
Book, where Compound Medicines are treated of.
* * * * *
COMMENTARY. See Aretæus (Morb. Chron. ii, 8); Cælius Aurelianus (Pass.
Tard. iii, 2); Celsus (iv, 5); Galen (de Med. sec. loc. vi); Oribasius
(Synop. ix, 10); Aëtius (ix, 1); Alexander (vii, 5); Actuarius (Meth.
Med. iv, 5); Octavius Horatianus (ii, 16); Marcellus (de Med. 20);
Avicenna (iii, 13, 1, 2, 3); Serapion (i, 1); Avenzoar (i, 15); Averrhoes
(Collig. v, 54); Haly Abbas (Pract. vii, 2, Theor. ix, 24); Alsaharavius
(Pract. 16); Rhases (Divis. 59, Contin. xi.)
To all these authors, almost every one of whom has treated of these
complaints more fully than Paulus, or upon a different plan, it is quite
impossible for us to do justice within the narrow limits to which we
confine ourselves in these annotations. We shall, therefore, direct our
attention principally to Celsus, and merely add a few remarks from the
others. The stomach, he says, is affected by great heat, inflation,
inflammation, and ulceration; by phlegm or bile; and by resolution, which
is a common and fatal complaint. Heat is to be cured by cold external
applications, such as vinegar and roses, along with cold drink. Inflation
we shall see treated of in the next Section. Inflammation which is
attended with pain is to be treated by rest, abstinence, sulphurated
wool, and wormwood, when fasting. If attended with ardor, he prescribes
cold and repellent applications, occasionally exercise, and a fuller
diet. Ulceration is to be cured by exercise, friction of the extremities,
smooth and glutinous food, and avoiding every thing that is acid and
acrid. Redundance of phlegm is to be treated by emetics, exercise,
friction, hot drink, and hot food. When bile prevails he recommends
laxatives, potions of wormwood, gestation, or a sea-voyage; emetics,
if they can be conveniently borne, and suitable food, so as to avoid
indigestion. Resolution, he says, is a severe affection of the stomach,
when it cannot retain the food, and the body wastes. The bath, he says,
is useless, but exercise of the upper parts of the body peculiarly
proper. He recommends pouring cold water on the stomach, swimming in the
same, and living on cold food, rather such as is difficult to digest than
what will readily spoil on the stomach. Hence, he says, some digest beef.
Undiluted austere wine, either cold or very hot, is proper. If there is
vomiting with pain, he directs us to apply over the stomach, wool or
sponge soaked in vinegar, or cold cataplasms; or, if the pain be more
severe, a cupping-instrument; then bread which has been steeped in cold
diluted wine is to be given. If this is not retained, some smooth article
of food not disagreeable to the stomach is to be administered; and, if
this be not retained, a cupful of wine is to be taken every hour until
the stomach becomes settled. He also praises an acid mixture, containing
pomegranate, endive, &c.
Aretæus gives a lively description of the feelings of a dyspeptic. The
student who, heedless of the allurements of the senses and of the ties of
nature, follows his divine pursuits with indiscreet ardour, and neglects
to take proper food and exercise, is said to be particularly liable
to affection of the stomach. The cure, he says, is to be effected by
gestation, vociferation, a suitable diet, and indulgence of the patient’s
caprices as far as possible. Wormwood, ginger, aloes, and mastich are
also proper.
Alexander properly remarks that disorder of the stomach affects
sympathetically the heart and brain. He treats fully of inflammation
of the stomach, for which he directs us to give relaxants and tonics,
such as wormwood and mastich. He further recommends the application of
a plaster, composed of emollient and stimulant ingredients, such as
wax, turpentine, ginger, opopanax, &c. It is singular that he and most
of the ancient authorities have omitted to mention venesection for this
complaint. We therefore entertain some doubts whether they meant by it
the gastritis of modern Nosologists, which, by the by, is of so rare
occurrence, that some late writers of high name are of opinion that it
never occurs spontaneously. (See Christison on Poisons.) Some of the
ancient authors, however, do recommend venesection in this complaint,
as for example, Serapion, Rhases, Avicenna, and Haly Abbas. Horatianus
recommends the same for sudden pains of the stomach. Cælius Aurelianus,
while treating in general terms of stomach complaints, recommends
bleeding, “si in vehementiam passio venerit.” He also prescribes cupping
and leeching. His account of these affections is highly interesting,
but so circumstantial that we dare not venture even upon an abridgment
of it. Haly Abbas speaks of the inflammation ending in suppuration. To
Alsaharavius we particularly invite attention. Rhases gives a copious
statement of the opinions of all preceding authorities on this subject.