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.

12 Ulcerations of the tongue need no other treatment than that noted in the first part of the previous chapter. But those which arise at the side of the tongue last the longest; and it should be looked to, whether some tooth opposite the ulcer is too pointed, which often keeps an ulceration in that position from healing, in which case the tooth must be smoothed down.

13 There often occur on the gums adjacent to the teeth certain painful swellings: the Greeks call them parulides. These at first should be gently rubbed over with powdered slat; or with a mixture of powdered rock-salt, cyprus oil and catmint; then the mouth is washed out with lentil gruel, and the mouth is held open at intervals until there has been a sufficient flow of phlegm.

When there is still more severe inflammation, the same medicaments are to be used as noted above for ulcerations of the mouth: and between the tooth and gum should be inserted a little roll of soft lint soaked in one of the compositions which I said are called antherae. If the hardness of the gum prevents this, then hot steam by means of a sponge

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is to be applied outside, followed by a cerate. If suppuration shows itself, the steaming is continued longer, and hot honey wine in which a fig has been boiled down is held in the mouth; and before the abscess is quite mature it should be cut into, for fear that the bone may suffer if the pus should be retained longer. But if there is greater swelling, it is better to cut all away so as to free the tooth on both sides. When the pus is let out, if the incision is small it will suffice to hold hot water in the mouth and to foment externally with its steam; if it is larger, lentil gruel should be used, and the same medicaments as for the treatment of ulcerations of the mouth in general. There are also other ulcerations, mostly arising in the gums, for which the same remedies are beneficial; in particular, however, privet should be chewed and the juice held in the mouth. It happens now and then, whether following a gumboil or not, that a discharge of pus persists from an ulcer on the gum; this is due to either a decayed tooth or to bone that is broken or injured and diseased in some other way, and it most commonly occurs through a fissure in the bone. When this is the case, the place must be laid open, the tooth extracted; any projecting scale of bone is to be removed; and any carious bone scraped away. What ought to be done after this has been included in the treatment of other ulcerations. If the gums have retracted from the teeth, the same antherae are of service. It is also useful to chew pears and apples which are not too ripe, and to hold their juice in the mouth. Vinegar that is not too sharp can also be held in the mouth with similar advantage.

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14 Inflammation of the uvula should also cause anxiety when severe. In this case, as before, abstinence is necessary, and it is right to let blood; and if anything prevents this, it is useful to clyster the bowel; and also the head must be kept covered and raised; and the patient must gargle with a decoction of blackberries and lentils. But the uvula its is to be smeared either with omphacium or oak-galls or split alum to any one of which honey has been added; it is also good to smear the uvula with chelidonium juice by means of a spoon, and especially with honey. For this purpose also the composition called Andronium is suitable; it consists of: split alum, red copper scales, blacking, oak-galls, myrrh and antimony sulphide; these are pounded separately and again pounded when mixed together, a dry wine being gradually added till the ingredients have the consistency of honey. After the uvula has been smeared with one of these compounds there is, as a rule, a free flow of phlegm; when this has subsided, hot wine should be gargled. But if there is less severe inflammation, it is sufficient to pound up assafoetida and add cold water to it, and to put the fluid into a spoon and apply it under the uvula itself. When there is only moderate swelling, even cold water held in the same way under the uvula subdues it. Also the same cold water is to be used as a gargle which, with or without the addition of assafoetida, has been applied in this manner to the uvula.

15 If at any time gangrene has attacked ulcers of the mouth, the first thing to consider is whether the general health is bad, and if so to obviate it; next the actual ulcers are to be treated. But if the

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disease is superficial, it is sufficient to use a powdered anthera to dust on the ulcer if moist; if the ulcer is rather dry, to smear it on mixed with a little honey: for somewhat deeper ulcerations, apply burnt papyrus two parts, and orpiment one part; if the mischief penetrates very deeply, burnt papyrus three parts, orpiment one part, or equal parts of rock salt and roasted iris, or copper ore, quick-lime and orpiment, likewise equal parts. But in order that neighbouring spots may not be injured, it is necessary to apply lint dipped in rose oil over these caustic medicaments. Some also put the roasted salt into 250 cc. of strong vinegar until it ceases to dissolve; then the vinegar is boiled to dryness, and the salt pounded up and dusted on. But whenever this medicament is applied, the mouth should be washed out both before and after, either with lentil gruel, or with a decoction of vetches or of olives or of vervains, to any one of which a little honey is added.

Also vinegar of squills held sufficiently long in the mouth is beneficial for such ulceration, so too the salt after evaporation as described above dissolved again in vinegar. But whilst the affection continues to be severe it is necessary both to hold one or other of the remedies in the mouth for some time and to use them two or three times a day, If it is a child who is attacked, a probe wrapped round with wool is dipped in the medicament and held to the ulcer, lest by accident he should swallow the caustic. If it is the gums which are involved, and some teeth are loose, they should be extracted, for they greatly hinder treatment. If these medicaments do no good, the ulcers are to be cauterized. But this procedure is not necessary for any ulcer on

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the lips since excision is more convenient. Indeed such an ulcer, except by adopting surgical measures, whether cauterizing or excising, cannot be replenished with new flesh. But the bones of the bums, which are inert, continue bare after the cauterization; for no flesh grows up afterwards. A lentil dressing, however, is to be applied to the parts cauterized until it is rendered as healthy as possible.