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LETHARGICS are to be laid in the light, and exposed to the rays of the sun (for the disease is gloom); and in a rather warm place, for the cause is a congelation of the innate heat. A soft couch, paintings on the wall, bed-clothes of various colours, and all things which will provoke the sense of sight; conversation, friction along with squeezing of the feet, pulling, tickling. If deep sleep prevail, shouting aloud, angry reproach,

threats regarding those matters which he is accustomed to dread, announcement of those things which he desires and expects. Everything to prevent sleep--the reverse of that which is proper for phrenitics.

With regard to the depletion of lethargics this should be known:--If the obliviousness be the sequela of another disease, such as phrenitis, we must not open a vein, nor make a great evacuation of blood in any way, but inject the belly, not solely for the evacuation of its contents, but in order to produce revulsion from above, and to determine from the head: there should be a good deal of salts and natron in it, and it answers very well if you add a sprinkling of castor to the clyster; for in lethargics the lower intestine is cold, and dead, as it were, to evacuation. But, if the lethargy is not the consequence of another disease, but is the original affection, and if the patient appear to be plethoric, provided it be with blood, we must open a vein at the elbow; but, if with a watery phlegm, or other humours, we must purge by means of cneoros1 with the ptisan, or by black hellebore with honeyed-water, in the beginning, if you wish to do so moderately; but if to a greater extent, you must give to the patient when fasting of the medicine called Hiera, to the extent of two drams with three cupfuls of honeyed-water; and, having waited until it purges, then give food, if it be the proper season; but otherwise nourishment is to be given the next day. It will be seasonable then to give in the evening a dram of the hiera, dissolved either in two cupfuls of water or of honeyed-water.

Total abstinence from food is bad, as is also much food. It is proper, then, to administer a little food every day, but not to withdraw food altogether; for the stomach to be reminded of its duties and fomented, as it were, during the whole day. Also the food must be attenuant and laxative, rather in the form of soups than roasted, such as hens or shell-fish; and the

herb mercury is to be boiled with it, and some vinegar added. And we may add to the juices, if it be proper to use the juice of ptisan, something to promote exhalation and the discharge of urine, such as fennel, parsley--the pot-herbs themselves, or their fruits. Horehound, also, by its acrid qualities, does good; and likewise colewort with oil, and the brine of fish (garum). The sweet cumin is a most excellent medicine for the flatulence and urine; for the stomach and bladder are to be stimulated during the whole time of the disease.

The moist applications to the head the same as in the case of phrenitics; for in both the senses are filled with vapours, which must either be expelled by refrigerants and astringents, such as the oil of roses or the juice of ivy, or dissipated into exhalation by attenuants, such as wild thyme in vinegar, with the rose-oil. But if there be pain of the nerves, and coldness of the whole body, but more especially of the extremities, we must besmear and bathe the head and neck with castor and oil of dill, and anoint the spine with the same along with Sicyonian oil, the oil of must, or old oil; at the same time, we must rub both the arms from the shoulders and both the legs from the groins. With these, moreover, the bladder is to be soothed, which suffers, as being of a nervous nature, and is stressed as being the passage for the urine; and also is irritated by the acrimony of the humours, for the urine is bilious. But if the trembling increase, and there be danger of a convulsion, we must necessarily use Sicyonian oil to the head, but use it in small quantity. But if there be inflammation of the hypochondria, and fulness thereof, flatulence, and tension of the skin, or if there be a hollow there from retraction inwards of the hypochondria, we must apply the embrocations and cataplasms, described by us under Phrenitics.

The cupping-instrument is by no means to be used if the disease be the consequence of phrenitis, but this may be done more boldly if it be the original disease. If the tongue be

black, and a swelling point in the hypochondria, the cupping-instrument must necessarily be used. When in the course of time the senses have been evacuated, and the patient is otherwise more tolerant of the disease, we may apply the cupping-instrument to the top of the head, since we can evacuate from it without injury to the strength.

Flatulence is to be expelled both upwards and downwards; for lethargy produces collections of flatus both in the cavities and in the whole frame, from inactivity, torpor, and want of spirit, which motion and watchfulness dissipate; wherefore, having rubbed up green rue with honey and natron, we anoint therewith; it will expel the wind more effectually if one part of the resin of turpentine be added to these things. A fomentation also will expel flatus, either with hot unwashed wool, or with rough old rags, or a sponge with water in which hyssop, marjoram, penny-royal, or rue, have been boiled. The potions2 also which are taken before food expel flatus, and these also bring away phlegm and bile in the stomach and bowels; such are hyssop, boiled mulse, Cretan dictamny, or marjoram: maiden-hair and agrostis3 are acrid, but possessed of expulsive qualities, for indeed they evacuate flatus and urine.

If there be trembling of the hands and head, he may take a draught, consisting of castor with three cupfuls of honeyed-water, for some days; or if he will not drink this, we may melt down the castor in a sufficient quantity of oil, wherein rue has been boiled, to the amount of three cupfuls; and a double amount of this is to be injected into the lower bowel, and is to be repeated for several days; and after the benefit derived from it (for it brings off flatus upwards and downwards, and, in certain cases, urine and fæces), if it should

be diffused over the whole system in any way, the nerves recover from their tremblings and become strong, and it changes the habit of body to the hot and dry, and alters the constitutions of diseases. It is also a very excellent thing to blow it into the nostrils, for in this way it expels flatulence by sneezing; for as the bladder secretes urine, so does the nose mucus. It effects these things by its gentle heat, in which respect it is superior to the other sternutatories, pepper, hellebore, soap-wort, and euphorbium; for these things, both at their first and last impression are harsh, and disorder the head and the sense, whereas castor gradually creates a gentle heat. To the head it is also otherwise suitable, because the nerves everywhere derive their origin from it; and castor is a remedy for the diseases of the nerves; but to mix it with some one or more of the medicines described will not be disagreeable, for if it be mixed, it will not immediately disorder the head, even in a moderate degree, but after a time it will stir up the heat.

The nose is to be moistened by tickling; by odours acrid indeed to the sense, but possessed of heating powers, such as the castor itself, or savory, or penny-royal, or thyme, either in a green state, or in a dried, moistened well with vinegar.

Anointing with acrid medicines is proper to the feet and knees. The materiel thereof should be heating and pungent by degrees; for there is need of both in cases of lethargy to induce warmth and watchfulness. In the first place, it is proper to whip the limbs with the nettles, for the down thereof sticking to the skin does not endure long, but imparts no disagreeable tingling and pain; it also moderately stimulates, induces swelling, and provokes heat. But if you desire to have these effects produced more powerfully, rub in equal parts of lemnestis4 and euphorbium, with oil of must. It is

also a very good thing to rub with raw squill pulverised; but it is necessary to rub off the oily matter of the limb (for everything acrid loses its stimulant properties with oil) -- unless it be medicinal -- either the oil of privet, or that of must, or the Sicyonian. But if after these things a deep coma prevail, it will be proper, having pounded the wild cucumber with vinegar, and mixed it with an equal quantity of a cake of mustard, to apply this as an acrid cataplasm, and one which will speedily occasion redness, and will also quickly produce swelling. But if there be danger of blistering and of wounds, it will be proper to raise the cataplasm frequently, and see that none of these effects be produced. These things, therefore, are to be done to relieve the torpor and insensibility of the parts at all seasons, except at the commencement of the paroxysms.

But if the patient have already recovered his sensibility, but there is still some heaviness of the head, noise, or ringing thereof, it will be proper to evacuate phlegm by the mouth, first by giving mastich to chew, so that he may constantly spit, then again stavesacre, the granum cnidium,5 but more especially mustard, because it is a common article, and also because it is more of a phlegmagogue than the others. And if the patient drink it willingly, it will be sufficient to dissolve the matters in the stomach, it will also be able to moisten the stomach and expel flatulence; for this once fortunately happened to myself in the case of a man who drank it by my directions; for experience is a good teacher, one ought, then, to try experiments, for too much caution is ignorance.

The head, then, after the hair has been clipped to the skin, if much good is not thereby accomplished, is to be shaven to procure insensible perspiration, and also to allow the anointing with acrid medicines, such as that from lemnestis (or adarce),

or thapsia,6 or mustard moistened with water; these things, with double the quantity of bread, are to be rubbed on an old piece of skin, and applied to the head, taking good care at the expiry of an hour to foment the parts with hot sponges.

It will also not be devoid of utility, when all, or most at least, of the fatal symptoms of the disease are gone, but the languor remains, to bathe; and then also gestation, friction, and all gentle motion will be beneficial.

1 Daphne Cneorum L.

2 Propomata, or whets. See Paulus Ægineta, vol. iii. p. 544. They correspond to the Liqueurs of the present day, but were taken at the beginning of a feast. Comp. Horat. Sat. ii. 4, ll. 24--27.

3 Probably the Triticum repens.

4 An efflorescence collecting about reeds in salt lakes. The same as ἀδάρκη, for which see the Appendix to Dunbar's Greek Lexicon.

5 Probably the fruit of the Daphne cnidium.

6 Thapsia Garganica L., a species of deadly carrot.

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