previous next


ALL the forms of the bringing up of blood are of an unmild character, not only as to mode, whether the flow proceed from rupture, erosion, or even rarefaction; and whether it come from the chest, the lungs, the stomach, or the liver, which are the most dangerous cases; but also from the head, although it occasions less mischief. For the flow is of blood; and blood is the food of all parts, the heat of all parts, and the colour of all parts. It is dreadful to see it flowing from the mouth in any way; but bad indeed if it proceed from an important viscus, and still worse if it proceed from rupture and erosion.

It is necessary, therefore, that the physician should make the more haste in bringing assistance to this affection; and, in the first place, the patient must get coldish air to breathe, a chamber on the ground, and a couch firmly fixed, so that he may not be shaken (for all shaking is stimulant); the bed should be solid, not very yielding, nor deep, nor heated; his position erect; rest from speaking and hearing; tranquillity of mind, cheerfulness, since depression of spirits especially accompanies these cases; for who is there that does not dread death when vomiting blood?

If, therefore, the patient be full of blood, and have large veins, in every form of rejection we must open a vein; whether it proceed from rupture, or erosion, venesection is very suitable; and even, if from rarefaction, there is danger, lest the fulness of blood burst forth.1 And we are to open the hollow vein at the elbow (for the blood flows readily from it, and it is easily opened, and the orifice can be safely kept open

for several days). In a word, then, in all the diseases of all the vital organs, this is the outlet of the blood. For the one higher up and this are both branches of the humeral, so that the one above can have no more remedial power than the mesal. They are ignorant of these divisions who have connected the upper vein with the stomach and liver. But if the flow proceed from the spleen, they direct us to open the vein of the left hand, which runs between the little finger and the one next the middle; for certain physicians held it to terminate in the spleen; but it is a branch of the vein below those at the elbow. Why, then, should we rather open the vein at the fingers than the one at the elbow? for there it is larger, and the blood flows readily from it. Altogether, then, we are to stop before coming to deliquium animi. Yet neither, also, is much blood to be abstracted; for the hemorrhage itself is calculated to enfeeble the patient; but, after abstracting a small quantity, repeat the bleeding the same day, the next, and the day following. But if the patient be thin, and scantily supplied with blood, we must not open a vein. So much respecting the abstraction of blood.

We are also to assist by means of ligatures to the extremities. Above the feet to the ankles and knees, and above the hands to the wrists and arms, a broad band is to be used, so that the constriction may be strong, and yet not produce pain. To the regions, also, from which the blood flows, we are to apply unwashed wool from the sheep; but moisten it with a liquid, such as austere wine, and the oils of roses and of myrtles. But if the hemorrhage be of an urgent nature, instead of the wool we are to use sponges, and vinegar instead of the wine, and let the part be anointed with myrtle oil; and we are to dust upon the sponges some of the dry inspissated juices, such as that of acacia, or of hypocistis, or else of aloes. The juice of the unripe grape, dissolved in vinegar, is also a very excellent thing. But if the liquid application be troublesome or

disagreeable, we are to use plasters; for these stretch the skin around, and press it, as it were, with the hand, and they are possessed of very strong powers as astringents and desiccants. In addition to these, there are very many others of tried efficacy; but the best are those which contain vinegar, and the expressed juice of ivy leaves, and asphaltos, and verdigris, alum, frankincense, myrrh, calcined copper, the squama æris, and such of the plasters as resemble these; or unscoured wool, or sponges damped in a small quantity of vinegar. But if the patients cannot bear the distension of the plasters, we are to make these things into an epitheme: fat dates, damped in dark austere wine, are pounded into a cake; then we are to sprinkle on it acacia in a soft state, and the rinds of pomegranate; these things having been all rubbed upon a rag, are applied to the chest. Barley-meal, moistened in wine or vinegar, or the fine flour of the dried lentil, sifted in a sieve, and made up with cerate or rose ointment, is to be applied; we are also to mix some of the root of the comfrey sifted. Another: Boil the roots of the wild prunes in vinegar, and having pounded into a cake, mix a little of sumach, and of gum, and of myrtle. These are to be mixed with one another differently, according as the strength of the medicines, mildness, or smell thereof is wanted. For we must also gratify the sick. These are the external remedies.

But a more important part of the treatment lies in things drunk and swallowed, since these remedies come nearest the injured parts. Of these there are three distinct kinds: either they are calculated by the contraction or compression of the vessels to bind the passages of the flux; or to incrassate and coagulate the fluid, so that it may not flow, even if the passages were in a state to convey it; or to dry up the outlets, by retaining the blood in its pristine state, so that the parts may not thus remain emptied by the flux, but may regurgitate where the effusion is. For rarefaction of the veins, astringency

is sufficient, for it runs through the pores like a fluid when poured into a water-cask newly wetted. And also in the division of vessels stypticity is the remedy, by producing contraction of the lips; but for this purpose we must use the greater and more powerful medicines. But if the form of hemorrhage be that from erosion, and if the lips of the ulcer do not coalesce by the action of the astringents, but the wound gapes, and cannot be brought together by compression, we must produce congelation of the blood, and also of the heat; for the flow is stopped by the immobility and coagulation of these. To the rare parts, then, oxycrate is sufficient for producing astriction; for the fluid is not pure blood, but the sanies thereof from small orifices; and even of this medicine, there is no necessity of much being given, or frequently; and in certain cases, the external treatment is sufficient. So, likewise, the decoction of dates and of edible carobs, when drunk, has by itself proved sufficient. Let the vinegar be from wines of an astringent nature, and if not by pharmaceutical preparation, at all events let it be such as by time has become acrid and astringent. But in dilatations of the wounds, in addition to the oxycrate, let there be given the simple medicines at first, such as the juice of plantain, of knot-grass, or of endive; of each an equal part with the oxycrate. But if the flow increase, sprinkle on it one dram of the dried hypocistis, or of acacia, on three cupfuls of the oxycrate. The juice, also, of the wild grape is very excellent. But if the ailment prevail over this, sprinkle on it triturated gall, and the dried root of the bramble, and the sea stone, the coral, triturated and dried. But the root of rhubarb is more powerful than these to cool, to dry, to astringe; in short, for every purpose. But it is used with the oxycrate alone; or, if more powerful things are required, as a remedy. To the juices of endive with plantain we add some of the root, namely, three oboli of it to three or four cyathi of the fluid. But in crosions, we must produce astringency

even in it, so as to induce coagulation of the blood that flows, and also for the sake of the containing vessels, so that the veins which have sustained a large wound may shut their mouths. But the medicines which are drunk should be strong, and capable of inducing coagulation. Wherefore, give the juice of coriander with vinegar, and the rennet of a hare, or of a hind, or of a kid, but not in great quantity (for certain of these have proved fatal in a large dose); but of the juice of the coriander give not less than half a cyathus to three of the oxycrate, and of the rennet three oboli, or at most four. For such modes of the flow, the Samian earth is very excellent, and the very white Aster, and the Eretrian, and the Sinopic, and the Lemnian seal: of these, at least, one dram weight, and at most three, with some of the decoctions, as of dates, or of edible carobs, or of the roots of brambles. But if there be roughness of the windpipe, and cough along with it, we must sprinkle these things on Cretic rob. Starch, dissolved in these, is a most excellent thing for lubricating the windpipe; for along with its power of lubricating, it also possesses that of agglutinating. If, therefore, the flow of blood be not urgent, it must be given once a day, before the administration of food; but if it be urgent, also a second and third time in the evening. And from the medicines are to be made draughts of the dried substances with honey, boiled to the proper consistence; galls pulverised: and a very good thing is sumach for the condiments, also grape-stones, and the fruit of the sharp dock, either each by itself, or all together. These things, moreover, are good to be kept below the tongue during the whole time of melting; but likewise common gum with the plant, (?) and the gum tragacanth. The compound medicines of tried efficacy are infinite; and various are the usages of trochisks--of that from Egyptian thorn, of another from amber, and another named from saffron, of which the composition has been described separately.

In the absence of fevers, everything is to be attempted in regard to medicines, giving them copiously and frequently. But if fever come on--and most frequently fever takes place, along with inflammations of the wounds--we must not stop the flow suddenly, nor give medicines during the paroxysms, for many die sooner of the fevers than of the flow of blood.

The articles of food are various in kind like the medicines, but also "the medicines are in the food;" for neither would it be easy to find all the good properties of food in any one article, nor even if a solitary thing were sufficient for the cure, should one only be used, as one would thus readily produce satiety; but we must grant variety if the disease should prove prolonged. Let the food, then, be astringent and refrigerant in properties, as also to the touch, for heat encourages bleeding. Washed alica; rice added to oxycrate; but if the vinegar excite coughing, the decoction of dates; baked bread which has been dried and pounded down to meal, and sifted. Of all these things a draught is to be made with oil; savory seasoned with salts, and sumach to be sprinkled upon it. And if you wish to gratify the patient's palate, let coriander be added, for this purpose, whenever it is agreeable, or any of the diuretic and diffusible seeds. Lentil, then, with the juice of plantain, if the hemorrhage be urgent, but if not, we should spare the juice, for neither is it of easy digestion, nor pleasant to the taste; for in these cases we must not give indigestible things. But if you apprehend death from the hemorrhage, you must also give what is unpalatable and indigestible; nay, let even harsh things be given if they will preserve life; wherefore, let galls, dried and pulverised, be sprinkled when dry, and cold lentil: eggs thick from boiling, with the seeds of pomegranate or galls, for the food necessarily consists in the medicines. The drink altogether should be scanty, since liquids are incompatible with a dry diet. These are the proper things, provided you wish to astringe and cool. But if

you wish also to thicken the blood and spirit (pneuma), milk along with starch and granulated spelt (chondrus), the milk being sometimes given with the starch, and sometimes with the chondrus; they should be boiled to such a consistence as that the draught may not be liquid. But if you wish to incrassate and astringe still more, let the chondrus be boiled with dates, and for the sake of giving consistence, let there be starch and milk; and the Tuscan far is a very excellent thing, being thick, viscid, and glutinous when given along with the milk; the rennet of the kid is to be added to the liquid decoctions for the sake of coagulation, so that with the milk, it attains the consistency of new cheese: still thicker than these is millet boiled with milk like the far, having gall and pomegranate rind sprinkled on it as a powder. But we must look to the proportions of the desiccants and incrassants, for all these things provoke coughing, and in certain cases, from excess of desiccant powers, they have burst the veins. But if things turn out well, and the blood is stopped, we must gradually change to the opposite plan of treatment, "and nothing in excess," for these cases are apt to relapse, and are of a bad character. We must also strive to put flesh and fat on the patient by means of gestation, gentle frictions, exercise on foot, recreation, varied and suitable food.

These are the means to be used if, after the flow of blood, the wound adhere and the part heal properly. But if the ulcer remain and become purulent, another plan of treatment is needed, for a discharge of different matters succeeds. This, however, will be treated of among the chronic diseases.

1 It is to be understood that by rarefaction our author means exhalation; that is to say, increased action of the exhalants.

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 3.0 United States License.

An XML version of this text is available for download, with the additional restriction that you offer Perseus any modifications you make. Perseus provides credit for all accepted changes, storing new additions in a versioning system.

load focus Greek (Francis Adams LL.D., 1972)
hide Display Preferences
Greek Display:
Arabic Display:
View by Default:
Browse Bar: