De Medicina

Celsus, Aulus Cornelius

Celsus, Aulus Cornelius. De Medicina. Spencer, Walter George, translator. Cambridge, MA: Harvard University; London, England: W. Heinemann Ltd, 1935-1938.

15 Rocking also is very suitable for chronic maladies which are already abating; it is also of service both for those who are now entirely free from fever, but cannot as yet themselves take exercise, and also for those in whom persist sluggish remnants of maladies, not otherwise to be got rid of. Asclepiades has stated that use is to be made of rocking even for dispersal of a recent and severe fever, especially an ardent fever. But that gives rise to danger; an attack of that sort is better sustained by keeping quiet. If anyone, however, wants to give it a trial, let him try it when the tongue is not furred, when there is no swelling, no induration, no pain, either in the viscera or head or about the heart. And on the whole a body in pain should never be rocked, whether the pain be general or local, except, however, when sinews alone are in

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pain, and never during the rise of a fever, but only during its remission. But there are many sorts of rocking, and they are to be regulated both by the patient's strength and by his resources, lest either a weak patient undergo overmuch depletion, or a poor man come short. The gentlest rocking is that on board ship either in harbour or in a river, more severe is that aboard ship on the high seas, or in a litter, even severer still in a carriage: but each of these can either be intensified or mitigated. Failing any of the above, the bed should be so slung as to be swayed; if not even that, at any rate a rocker should be put under its foot so that the bed may be moved from side to side by hand.

And this sort of exercise of the lighter kinds suits the infirm, the stronger kinds again those who have already become free from fever for several days, or those who, whilst feeling the commencement of grave disorders, as yet are free from fever (which happens in the case both of phthisis and of stomach disease, and of dropsy, also, at times, of jaundice), or when certain diseases such as epilepsy and madness persist without fever, for however long. In which affections also those kinds of exercises are necessary, which we have included in the passage where we prescribed what healthy, yet not strong, men should carry out.

16 Now Abstinence is of two kinds, in one of which the patient takes nothing at all, in the other only what he must. The beginnings of diseases require at first hunger and thirst, the actual diseases then moderation, so that nothing but what is expedient, and not too much of that, may be consumed; for it is not at all proper to have surfeit at once after a fast.

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But if this be not good even in healthy bodies, when some necessity has imposed fasting, how much worse it is in a sick body! To a sufferer nothing is more advantageous than a timely abstinence. Among us intemperate men with regard to their food themselves . . . the times are left to the doctors; again others make a present of the times to their medical men, but reserve to themselves as to quantity. They think that they are generous, when they leave them to decide as to all else, and keep free as to the kind of food; as if it were a question of what may be yielded to the doctor, not what may be good for the patient, who suffers grievous harm, as often as he transgresses in what he consumes, whether as to the time of the meal, its quantity or its quality.

17 Sweating also is elicited in two ways, either by dry heat, or by the bath. The dry is the heat of hot sand, of the Laconian sweating-room, and of the dry oven, and of some natural sweating places, where hot vapour exhaling from the ground is confined within a building, as we have it in the myrtle groves above Baiae. Besides these it is also derived from the sun and through exercise. These treatments are useful whenever humor is doing harm inside, and has to be dispersed. And also some diseases of sinews are best treated thus. But the other treatments may suit the infirm: sun and exercise only the more robust, who must, however, be free from fever, whether only at the com-

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mencement of a disease, or when actually in the grasp of a grave malady. But care must be taken that none of the above are tried either during fever or with food undigested. Now the bath is of double service; for at one time after fevers have been dissipated, it forms for a convalescent the preliminary to a fuller diet and stronger wine; at another time it actually takes off the fever; and it is generally adopted, when it is expedient to relax the skin and draw out corrupt humor and change the bodily habit. The ancients used it rather timidly, Asclepiades more boldly. There is indeed nothing to be apprehended from its use, if it be timely; before the proper time it does harm. A patient who has become free from fever can safely be bathed, as soon as there has been no paroxysm for one whole day, on the next day after the time for a paroxysm. But where the fever has a regular periodicity so that it recurs every third or fourth day, when there has not been a recurrence, the bath is safe. Even whilst fevers are persisting, if they are slow and mild, and have lasted a long while, this treatment may properly be tried, so long as the parts below the ribs are neither indurated nor swollen, the tongue not furred, there is no pain in the trunk or head, and the fever is not then on the increase. And in those fevers which have a definite periodicity, there are two opportunities for the bath, one before the shivering, the other after the fever has ended: but in the case of those who have been the subjects for a long while of slow and slight fever, the time for the bath is when the paroxysm has wholly remitted, or if that does not occur, at any rate when it has mitigated, and the

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patient's body has already become as sound as it possibly can in this sort of complaint. A weakly patient who is about to go to the bath should avoid exposing himself to cold beforehand. On arriving at the bath, he should sit for a while to try whether his temples become tightened, and whether any sweat arises: if the former happens without the latter, for that day the bath is unsuitable, and he should be anointed lightly and carried home, and cold is to be avoided in every possible way and abstinence practised. But if the temples are unaffected, and sweating starts there first, and then elsewhere, his face is to be fomented with hot water; then he should go down into the hot bath, where it is to be noted whether there is shrivelling of the skin at the first touch of hot water, which can hardly happen when the indications noted above have been attended to properly: it is, however, a sure sign of the bath being injurious. Whether he should be anointed before entering, or after the hot bath, should be decided from the degree of his convalescence. Generally, however, unless it has been definitely prescribed that it is to be done afterwards, when the sweating begins the body should be slightly anointed, and then he is to get into the hot water. And whilst in it also regard should be had to his strength; he ought not to be kept in the bath until he faints from the heat, but be taken out earlier and carefully wrapped up so that no cold reaches him, and so that he may sweat there also before taking anything. There are hot foments: millet, salt, or sand, any of which is heated, and put into a linen cloth: when less heat is required the linen cloth may be used alone, but

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if greater heat, firebrands are extinguished, wrapped up in rags, and so put round him. Further, leathern bottles are to be filled with hot oil, or hot water is poured into earthenware vessels, called from their shape "lentils"; and salt is put into a linen bag, and dipped into very hot water, then laid upon the limb to be fomented. . . . and two broad-ended cautery irons are heated near the fire, and one of them is dipped into that salt, and water is lightly sprinkled upon the iron held over the part. When the iron begins to cool, it is put back into the fire, and the second iron made use of in the same way as the first, turn and turn about: during the procedure a hot brine drips down, which is beneficial for sinews contracted by disease of any kind. The common effect of all these measures is to disperse whatever is oppressing the parts over the heart, or strangling the throat, or harming some limb. It will be stated under particular maladies when use is to be made of each (III, IV).

18 After having spoken of those things which benefit by depleting, we come to those which nourish, namely food and drink. Now these are of general assistance not only in diseases of all kinds but in preserving health as well; and an acquaintance with the properties of all is of importance, in the first place that those in health may know how to make use of them, then, as we follow on to the treatment of diseases (III, IV), we can state the species of aliments to be consumed, without the necessity every time of naming them singly.

So then it should be known that all pulses, and all bread-stuffs made from grain, form the strongest

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kind of food (I call strongest that which has most nourishment). To the same class of further belong: all domesticated quadruped animals; all large game such as the wild she-goat, deer, wild boar, wild ass; all large birds, such as the goose and peacock and crane; all sea monsters, among which is the whale and such like; also honey and cheese. Hence it is not wonderful that pastry made of grain, lard, honey and cheese is very strong food.

Among food materials of the middle class ought to be reckoned: of pot-herbs, those of which the roots or bulbs are eaten; of quadrupeds, the hare; birds of all kinds from the smallest up to the flamingo; likewise all fish which do not bear salting or are salted whole.

The weakest of food materials are: all vegetable stalks and whatever forms on a stalk, such as the gourd and cucumber and caper, all orchard fruits, olives, snails, and likewise shellfish.

But although these are so divided, nevertheless even those of the same species admit of great differentiation, one thing being stronger or weaker than another: whilst there is more nutriment in bread than in anything else, wheat is a stronger food than millet, and that again than barley; and of wheat the strongest is siligo, next simila, then the meal from which nothing is extracted, which the Greeks call autopuros; weaker is bread made from pollen, weakest the common grey bread.

Among pulses, bean and lentils are stronger food than peas. Of vegetables the turnip and navew and all bulbs, among which I include the onion also and garlic, are stronger than the parsnip, or that which is specially called a root.

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Also cabbage and beet and leek are stronger than lettuce or gourd or asparagus. But of fruit growing on twigs, grapes, figs, nuts, dates are stronger than orchard fruit properly so‑called; and of these last, the juicy are stronger than the mealy.

Likewise of those birds, which belong to the middle class, those which rely more on their feet are stronger food than those which rely more on their wings; and of those birds which depend on flight, the larger birds yield stronger food than the smaller, such as the fig-eater and thrush. And those also which pass their time in the water yield a weaker food than those which have no knowledge of swimming.

Among food from domesticated quadrupeds pork is the weakest, beef the strongest. And so also of game, the larger the animal the stronger the food it yields.

The fish most in use belong to the middle class; the strongest are, however, those from which salted preparations can be made, such as the mackerel; next come those which, although more tender, are nevertheless firm, such as the gilthead, gurnard, sea bream, eyefish, then the flat fish, and after these still softer, the bass and mullets, and after these all rock fish.

Not only is there differentiation in the classes of nutriments, but also as much in the actual species of nutriment; which is due both to age and part of the animal and to soil and to climate and to habit. For every four-footed animal yields less nutriment while it is a suckling, likewise a chicken in a coop, the more tender it is; also a half-grown fish, which has not filled out to its full

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size. Then likewise in the same pig, trotters, chaps, ears or brain, in a lamb or kid the whole head, also the pettitoes, are somewhat less nutritious than other parts, and so can be placed in the middle class. In birds, the neck and wings are rightly counted as weak nutriment. As regards soil, grain is also more nutritious grown in hilly than in flat districts; fish living among rocks are less nutritious than those in sand, and these again less than those in mud. Hence it is that the same classes of fish from a pond or lake or river are heavier, and those which live in deep water are lighter food than those which live in shallows. Every wild animal is a lighter food than the same species domesticated, and the product of a damp climate is lighter than that of a dry one. Again, all kinds of fat meat have more nutriment than lean, fresh meat than salted, recently killed than stale. Then the same meat is more nourishing stewed than roasted, more so roasted than boiled. A hard-boiled egg is a very substantial material, a soft cooker or raw egg very light. And while all bread-stuffs are among the most solid, yet some kinds of grain after being soaked, such as spelt, rice, pearl barley, or the gruel or porridge made out of these, and also bread soaked in water, can be reckoned among the weakest of food.

Of drinks too the strongest class are: whatever can be made from grain, likewise milk, mead, must boiled down, raisin wine, wine either sweet or heady or still fermenting or of great age. But vinegar, and that wine which is a few years old, whether dry or rich, are intermediate in quality; and therefore to weak patients nothing of the other class

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should be given. Water is of all the weakest; and drink from grain is the more nutritious, according as the grain itself is nutritious; wine coming from a good soil is more nutritious than from a poor one, that from a temperate climate more nutritious than from an extreme one, whether too wet or too dry, whether excessively cold or hot. Mead, the more honey it contains, must the more it is boiled down, raisin wine the drier the grapes - are the stronger. Rain water is the lightest, then spring water, next water from a river, than from a well, after that from snow or ice; heavier still is water from a lake, the heaviest from a marsh. The recognition of water is as easy as it is necessary for those who want to know its nature. For by weighing, the lightness of water becomes evident, and of water of equal weight, that is the better, which most quickly heats or cools, also in which pulse is most quickly cooked. It is generally the case too that the more substantial the material, the less readily it is digested, but once digested it nourishes the more. Thus the quality of the food administered should be in accordance with the patient's strength, and the quantity in accordance with its quality. For weak patients, therefore, there is needed the lightest food; food of the middle class best sustains those moderately strong, and for the robust the strongest is the fittest. Finally, of the lightest foods more can be taken; it is rather with the strongest food that moderation should be observed.

19 The foregoing are not the only differentiations; but as well some materials have good juices,

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others bad, what the Greeks call euchylous and kakochylous; some are bland, others acrid; some render our phlegm thicker, others thinner; some agree with the stomach, others are alien; also some cause flatulence, others are free from that; some warm, others cool; some readily turn sour in the stomach, others do not readily decompose inside; some move the bowels, others check motions; some excite urination, others retard it; some promote sleep, others excite the senses. All these, then, should be known because one suits one body or constitution, one another.

20 Of good juice are: wheat, siligo, spelt, rice, starch, frumenty, pearl barley gruel, milk, soft cheese, all sorts of game, all birds of the middle class, also the larger birds named above; fish intermediate between the soft and hard, such as mullet and bass; spring lettuce, nettle-tops, mallow, gourd, raw egg, purslane, snails, dates; orchard fruit which is neither bitter nor sour; wine sweet or mild, raisin wine, must boiled down; olives preserved either in wine or must; sow's womb, pig's chaps and trotters, all fatty or glutinous meat, and the liver of all animals.

21 Of bad juice are: millet, panic, barley, pulse; very lean meat from domesticated animals and all salted meat; all pickled fish, fish sauce, old cheese; skirret, radish, turnip, navew, bulbs; cabbage and even more its sprouts, asparagus, beet, cucumber, leek, rocket, cress, thyme, catmint, savory, hyssop, rue, dill, fennel, cummin, anise, sorrel, mustard,

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garlic, onion; spleens, kidneys, chitterlings; orchard fruit when sour or bitter; vinegar, everything acrid, sour, bitter, oily; also rock fish, and all fish of the very soft kind, or on the other hand those which are very hard and strong-flavoured, mostly such as live in ponds, lakes and muddy rivers, and which have become excessively large.

22 The following are bland materials: broth, porridge, pancake, starch, pearl barley gruel, fat and glutinous meat, generally all that belong to domesticated animals, particularly, however, the trotters and titbits of pigs, the pettitoes and heads of kids, calves, and lambs, and the brains of all animals; likewise all bulbs properly so‑called, milk, must boiled down, raisin wine and pine kernels. The following are acrid: everything especially harsh, everything sour, everything salt, and even honey, and the better it is the more it is so. Likewise garlic, onion, rocket, rue, cress, cucumber, beet, cabbage, asparagus, mustard, radish, endive, basil, lettuce and most pot-herbs.

23 Now the following make phlegm thicker: raw eggs, spelt, rice, starch, pearl barley gruel, milk, bulbs, and generally all glutinous substances. Phlegm is rendered thinner by: all salted and acrid and acid materials.

24 But best suited to the stomach are: whatever is harsh, even what is sour, and that which has been sprinkled moderately with salt; so also unleavened bread, and spelt or rice or pearl barley which has been soaked; birds and game of all kinds, and both of these whether roasted or boiled; among domesticated animals, beef; of other meat the lean rather than the fat; the trotters, chaps,

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ears, and the sterile womb of a pig; among pot-herbs, endive, lettuce, parsnip, cooked gourd, skirret; among orchard fruit, the cherry, mulberry, service fruit, the mealy pear from Crustumeria, or the Mevian; also keeping-pears, Tarentine or Signian, the round or Scandian apple or that of Ameria or the quince or pomegranate, raisins preserved in jars; soft egg, dates, pine kernels, white olives preserved in strong brine, or the same steeped in vinegar, or black olives which have been well ripened on the tree, or which have been preserved in raisin wine, or in boiled-down must; dry wine is allowable even although it may have become harsh, also that doctored with resin; hard-fibred fish of the intermediate class, oysters, scallops, the shellfish murex and purpura, snails; food and drink either very cold or very hot; wormwood.

25 But on the other hand materials alien to the stomach are: all things tepid, all things salted, all things stewed, all things over-sweetened, all things fatty, broth, leavened bread, and likewise that made from either millet or barley, pot-herb roots, and pot-herbs eaten with oil or fish sauce, honey, mead, must boiled down, raisin wine, milk, cheese of all kinds, fresh grapes, figs both green and dry, pulse of all sorts, and whatever causes flatulence; likewise thyme, catmint, savory, hyssop, cress, sorrel, charlock, walnuts. But it can be understood from the above that what has good juice does not necessarily agree with the stomach, and that whatever agrees with the stomach has not necessarily good juice.

26 Now flatulence is produced by: almost all food which is leguminous, fatty, sweet, everything

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stewed, must, and also that wine was has not as yet matured; among pot-herbs, garlic, onion, cabbage, and all roots except skirret and parsnip; bulbs, figs even when dried but especially when green, fresh grapes, all nuts except pine kernels, milk, cheese of all kinds; lastly anything eaten half-cooked. The least flatulence comes from what is got by hunting and birding, from fish, orchard fruit, olives, or shellfish, from eggs whether cooked soft or raw, from old wine. Fennel and anise in particular even relieve flatulence.

27 Again the heating foods are: pepper, salt, all stewed meat, garlic, onion, dried figs, pickled fish, wine, and the stronger this is, the more heating it is. Cooling foods are: pot-herbs the stalks of which are eaten uncooked, such as endive and lettuce, and also coriander, cucumber, cooked gourds, beet, mulberries, cherries, sour apples, mealy pears, boiled meat, and in particular vinegar, whether taken with food or as a drink.

28 Foods that readily decompose inside are: leavened bread, and any sort other than that made of wheat, flour, milk, honey, and therefore also all things made with milk and all pastry, soft fish, oysters, vegetables, cheese both new and old, meat fat or tender, sweet wine, mead, must boiled down, raisin wine; finally everything stewed or over-sweetened or over-thin. But the following decompose the least within: unleavened bread, birds, especially those with harder flesh, hard fish, not only for instance the gilthead or the sea bream, but also the squid, lobster and octopus; likewise beef and hard meat of all kinds; and the same is better if lean or salted; all pickled fish,

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snails, the shellfish, murex purpura; and wine which is harsh or resinated.

29 Again, the bowels are moved by: leavened bread, and especially if it is the grey wheaten or barley bread, cabbage if lightly cooked, lettuce, dill, cress, basil, nettle-tops, purslane, radish, caper, garlic, onion, mallow, sorrel, beet, asparagus, gourds, cherries, mulberries, raisins preserved in jars, all ripe fruit, a fig even dried, but especially a green one, fresh grapes; fat small birds, snails, fish sauce, pickled fish, oysters, giant mussels, sea-urchins, sea-mussels, almost all shellfish, especially the soup made from them, rock fish and all soft fish, cuttlefish ink; any meat eaten when fat, either stewed or boiled, waterfowl, uncooked honey, milk, all things made with milk, mead, wine sweet or salted, soft water; all food sweetened, tepid, fatty, boiled, stewed, salted or watery.

30 On the contrary the bowels are confined: by bread made from siligo or simila flour, especially when unleavened, and particularly so when toasted, and this property is even increased by baking twice, porridge either from spelt or panic or millet, as well as gruel from the same, and especially if these have been parched beforehand; lentil porridge to which beet or endive or chicory or plantain has been added, and especially when these have been previously toasted, or endive by itself, or roasted with plantain, or chicory, the smaller pot-herbs, cabbage twice boiled; eggs rendered hard, especially by poaching; small birds, the blackbird and wood-pigeons especially when cooked in diluted vinegar, cranes, all birds which run rather than fly; the hare, wild she-goat, the liver of animals which yield suet,

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particularly the ox, and suet itself; cheese which has become rather strong in taste, either from age or because of that change which we note in cheese from across the sea, or, if it is new, after it has been cooked in honey or mead; also cooked honey, unripe pears, service fruit, especially those called torminalia, quinces and pomegranates, olives either white or over-ripe, myrtleberries, dates, the purpura and murex, wine resinated or harsh, and that undiluted, vinegar, mead which has been heated, also must boiled down, raisin wine, water tepid or very cold, hard water (that is, which decomposes late), hence principally rain water; everything hard, harsh, rough, grilled, and in the case of the same meat the flesh roasted rather than boiled.

31 The following increase the urine: garden herbs of good odour, as parsley, rue, dill, basil, mint, hyssop, anise, coriander, cress, rocket, fennel; and besides these asparagus, capers, catmint, thyme, savory, charlock, parsnip, especially growing wild, radish, skirret, onion; of game especially the hare; thin wine, pepper both round and long, mustard, wormwood, pine kernels.

32 For producing sleep the following are good: poppy, lettuce, and mostly the summer kinds in which the stalk is very milky, the mulberry, the leek. For exciting the senses: catmint, thyme, savory, hyssop, and especially pennyroyal, rue and onion.

33 For drawing out the material of the disease

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certainly many things can be used, but as they are mostly composed of foreign medicaments and are more useful in other affections than in those relieved by the dietetic regimen, I will defer their consideration for the present (V. Proem., 1, 2): but I will mention here those which are at hand, and are suitable to the diseases of which I am about to speak (III, IV), since they blister the body and thus extract from it the material of disease. Now those which have this faculty are the seeds of rocket, cress, radish, and most of all mustard. The same faculty exists in salt and figs.

Those which gently both repress and mollify at the same time are greasy wool to which has been added oil with vinegar or wine, crushed dates, bran boiled in salt water or vinegar.

But those which simultaneously repress and cool are pellitory, which the Greeks call parthenion or perdeikion, thyme, pennyroyal, basil, the blood-herb which the Greeks call polygonon, purslane, poppy-leaf, vine-tendril, coriander, hyocyamus-leaves, moss, skirret, parsley, solanum, which the Greeks call strychnos, cabbage-leaves, endive, plantain, fennel-seed; crushed pears and apples and especially quinces, lentils; cold water, especially rain water, wine and vinegar, and everything soaked in these, whether bread or meal or sponge or ashes, or greasy wool or even lint; Cimolian chalk, gypsum; oil perfumed with quince, myrtle, rose; unripe olive oil; vervains, the leaves crushed along with their young twigs, of which sort are the olive, cypress, myrtle, mastic, tamarisk, privet, rose, bramble, laurel, ivy, and pomegranate.

Those which repress without cooling are cooked

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quinces, pomegranate rind, hot water in which the vervains enumerated above have been boiled, powdered wine lees or myrtle leaves, bitter almonds.

But those which are heating are poultices made of meal, whether of wheat or spelt or barley or bitter vetches or darnel or millet or panic or lentil or bean or lupin or linseed or fenugreek, when one of these has been boiled and applied hot. All forms of meal poultices, however, are rendered more efficacious by cooking in mead instead of in water. Besides there are: cyprus or iris oil, marrow, cat's fat, olive oil, especially if it is old, and there has been added to the oil salt, soda, black cummin, pepper, cinquefoil.

Generally those which are powerful to repress inflammation, and cool, harden the tissues; those which are heating, disperse inflammation and soften, and this last property belongs especially to plasters of linseed or fenugreek seeds.

But as regards all these medicaments, whether used as simples or in mixtures, their uses by medical men vary, so that it is clear that each man follows his own ideas rather than what he has found to be true by actual fact.

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1 Having dealt with all that pertains to whole classes of diseases taken together, I come to the treatment of diseases one by one. Now the Greeks divided these into two species, terming some acute, others chronic. But because maladies did not always respond in the same way to treatment, some of the Greek writers have placed among the acute what others have placed among the chronic; from this it is clear that there are more than two classes. For some diseases are certainly of short duration, which carry off the patient quickly, or themselves come quickly to an end; some are chronic, in which neither recovery is near at hand nor death; and there is a third class, at one time acute, at another time chronic, and that occurs not only in fevers, where it is most frequent, but in other affections also. And besides the above there is a fourth class which cannot be said to be acute, because it is not fatal, nor really chronic, because if treated it is readily cured. When I come myself to speak of diseases singly, I will point out to which class each belongs. But I shall divide all diseases into those which appear to have their seat in the body as a whole, and into those which originate in particular parts. I shall begin with the former, after a few words of preface concerning all.

Whatever the malady luck no less than the art can claim influence for itself; seeing that with nature

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in opposition the art of medicine avails nothing. There is, however, for a practitioner who is unsuccessful, more excuse in acute than in chronic diseases: for acute diseases are of short duration, within which the patient is snuffed out, if not benefited by the treatment: chronic diseases give time for deliberation, and for change of remedies, so that when the practitioner is in attendance from the commencement, it is seldom that a docile patient should perish unless by the practitioner's default. A chronic disease, nevertheless, when it has become deep-seated, is no less difficult to deal with than an acute one. And indeed the older an acute malady, the more recent a chronic one, the more easily it is treated.

There is another point which should be borne in mind, that the same remedies do not suit all patients. Hence it is that the highest authorities proclaim as if they were the only remedies, now some, now others, each in accordance with what he has found successful. It is well, then, when any one remedy fails, to look not so much to the authority as to the patient, and to make trial, now of one, now of another remedy, taking care, however, that in acute diseases what is doing no good is changed quickly; in chronic diseases which it takes time to produce as well as to remove, if a remedy does not succeed at once, it should not be condemned at once, much less should it be discontinued if it is beneficial, though only to a small extent, because the progress is completed by time.