CHAPTER III. CURE OF VERTIGO.
VERTIGO arises as the successor of cephalæa; but also
springs
up as a primary affection from certain causes, as the suppression
of the hemorrhoidal flux; and if blood which used to flow
from the nose has ceased to flow; or if the body has not
perspired properly, either by sweating, or labour, when it had
been used to labour. If then it arise as the consequence of
cephalæa, we must do for its cure those things which have been
described under cephalæa; and I will afterwards state certain
other more powerful means which must be tried ultimately.
But if the disease happen from the suppression of any of the
humours, we must excite the customary secretion; for the
recurrence of nature promotes recovery. If it be delayed, and
the disease increases, in the other suppressions, those by the
nose or sweats, we are to open the vein at the elbow; but in
plethora of the liver, spleen, or any of the viscera in the
middle of the body, cupping affords relief, but as much blood
as is taken from a vein, so much is to be thus abstracted from
them; for it is the nutriment of the exciting cause, in like
manner as the belly. After this the remedies of the head are
to be applied, opening the straight vein on the forehead, or
those at the canthi on either side of the nose; a cupping-instrument
is to be fastened to the vertex, the (
temporal?）
arteries are to be excised, the head shaven, rubefacients applied
to it, phlegm evacuated from the nostrils by sternutatories, or
from the mouth as I have stated--all these things are to be
done in the order described under cephalæa, except that the
juice of sow-bread or of pimpernel is to be used as an injection
into the nose.
But when you have exhausted all the remedies for cephalæa,
the more violent means which are applicable for vertigo are
to be used; we must use the emetics after supper, and those
from radishes, which is also required as a preparation for the
hellebore; for the stomach is to be trained beforehand to the
more violent emetics. But the phlegm now becomes thinner,
and fit for solution in the hellebore. There are several modes
of giving the hellebore; to the stronger sort of patients it is to
be given to the size of a
sesame,
1 or a little larger; or, in slices,
with washed chondrus or lentil, the dose, about two drams.
In the case of feebler and more slender persons, the decoction
with honey, to the amount of two or three spoonfuls, is to be
given. The manner of preparing it will be described else-where.
In the interval between each remedy, the patient is to
be supported, in order that he may be able to endure what is
to be given in the intermediate periods.
The patient is to be assisted during the paroxysms thus:--The
legs are to be bound above the ankles and knees; and the
wrists, and the arms below the shoulders at the elbows. The
head is to be bathed with rose-oil and vinegar; but in the oil
we must boil wild-thyme, cow-parsnip, ivy, or something such.
Friction of the extremities and face. Smelling to vinegar,
penny-royal, and mint, and these things with vinegar. Separation
of the jaws, for sometimes the jaws are locked together;
the tonsils to be tickled to provoke vomiting; for by the discharge
of phlegm they are sometimes roused from their gloom.
These things, then, are to be done, in order to alleviate the
paroxysm and dispel the gloomy condition.
With regard to the regimen during the whole period of the
treatment and afterwards, I hold as follows:--Much sleep is
bad, and likewise insomnolency; for truly much sleep stupefies
the senses of the head. From a redundance of vapours
there is disinclination to every exertion; and these are also
the cause of the weight in the head, the noises, and the
flashes of light, which are the marks of the disease. Insomnolency
induces dyspepsia, atrophy, and wearies out the body;
the spirits flag, and the understanding is unsettled; and for
these reasons such patients readily pass into mania and melancholy.
Moderate sleep is suitable for the proper digestion of
the food and refreshment from the labours of the day; care
and perseverance in these respects; and particular attention is
to be paid to the evacuation of the bowels, for the belly is the
greater source of the bodily perspiration. Next, friction of
the limbs, by means of rough towels, so as to produce rubefaction;
then, of the back and sides; last, of the head. Afterwards,
exercise in walking, gentle at first and in the end;
carried to running in the middle; rest and tranquillity of the
breathing (
pneuma) after the walking. They are to practise
vociferation, using grave tones, for sharp occasion distension
of the head, palpitation of the temples, pulsatory movements
of the brain, fulness of the eyes, and noises in the ears. Sounds
of medium intensity are beneficial to the head. Then the season
of gestation should be regulated so as to promote the expulsion
of the weight in the head; it should be prolonged, yet not so
as to induce fatigue; neither should gestation be made in
tortuous places, nor where there are frequent bendings of the
road, for these are provocative of vertigo. But let the walks
be straight, long, and smooth. If then the patients have been
in the habit of taking lunch, we must only allow of a little
bread, so as to be no impediment to the exercises; for digestion
should take place previously. The head and the hands,
and the frictions thereof, are to be attended to; in the latter it
is to be gently performed for the restoration of the heat, for
plumpness, and strength. Then the head is to be rubbed while
the patient stands erect below a person of higher stature than
himself. Gymnastics skilfully performed which tend to distension
of the neck, and strong exercise of the hands. It is proper,
also, by raising the head, to exercise the eyes at
chironomy, or
at throwing the quoit, or contending at boxing. The exercise
both with the large and the small ball is bad, for the rolling of
the head and eyes, and the intense fixing of them, occasion
vertigo. Leaping and running are very excellent; for everything
that is keen is beneficial to the limbs, and gives tone to
the general system.
2 The cold bath is better than no bath at
all; no bath at all is better than the hot bath: the cold bath is
very powerful as an astringent, incrassant, and desiccant of the
head, which is the condition of health; while the warm bath
is most powerful to humectate, relax, and create mistiness; for
these are the causes of disease of the head, and such also are
south winds, which occasion dulness of hearing. There should
be rest after exercises, to allay the perturbation. Pinching of
the head, even to the extent of producing excoriation of the
skin.
Whetters made of water, or of wine diluted with water,
should be given before a meal. Lunch should be slight: laxatives
from the capillary leaves of pot-herbs,--of mallow, of beet,
and of blite. A condiment of a stomachic nature, which is pleasant
to the mouth, laxative of the bowels, and not calculated to
induce heaviness of the head, is made of thyme, or of savory,
or of mustard. Eggs, hot in winter, and cold in summer,
stripped of their shell, not roasted; olives, dates, pickled meat
in season. Granulated spelt washed, with some of the sweet
things, so as to give it a relish, is to be chosen; and, with
these, salts. Solitude, rest as regards hearing and speaking.
Promenades in a well-ventilated place, rendered agreeable by
trees or herbs. But if it be come to supper-time, they are
again especially to take the cold bath, having been slightly
anointed with oil; or, otherwise, the limbs only. The supper
should be of frumentaceous articles, such as pastry, or a soup
from chondrus (granulated spelt), or a carminative ptisan,
rendered easy of digestion by boiling. The medicines used
for seasoning of the ptisan, pepper, penny-royal, mint, a small
proportion of onions or of leeks, not so much as to float on
the stomach; the acrid part of vinegar is suitable; of fleshes,
the parts of fat animals which are not fat; of swine, the feet
and head; all winged animals--you must select from the great
variety of them what is suitable; the hare and the other kinds
of venison are proper; the hen is easily procured, and suitable.
All articles of the dessert create headaches, except the date, or
figs in the summer season, or the grape if the patient be free
from flatulence; and of sweetmeats, such as are well seasoned,
without fat, and light. Walking, exhilaration; in solitude,
resignation to sleep.
