CHAP. II. OF THE DISORDERS OF THE HEAD, AND THEIR CURE.

Having as it were presented these parts to view, as far as it is necessary for a physician to know them, I shall proceed to the remedies of the disorders of each, beginning with the head: under which name I now intend that part, which is covered with hair: for pains of the eyes, ears, and teeth, and such like, will be treated of elsewhere.

Of pains of the head, and a hydro­ceph­alus.

Now in the head there is sometimes an acute and dangerous distemper, which the Greeks call cephalæa[ CC ]. The marks of which are a strong shuddering, relaxation of the nerves(4), dimness of the eyes, delirium, vomiting, and withal a suppression of the voice; or an hæmorrhage from the nose, and with that a coldness of the body, and fainting; besides these an intolerable pain, especially about the temples, or occiput. Sometimes too there is a long weakness of the head, but neither severe nor dangerous, through the whole life. Sometimes the pain is more violent, but short, yet not fatal; which is contracted either by drinking wine, or crudity, or cold, or heat of a fire or the sun. And all these pains are sometimes accompanied with a fever, and sometimes not: sometimes they afflict the whole head, at other times a part of it; sometimes the pain extends to a contiguous part of the face. Besides these there occurs another disorder, which may continue long: where a humour inflates the skin, and it swells, and yields to the impression of the finger. This the Greeks call hydrocephalus[ CD ].

I have already spoken of the treatment of the second of these kinds, while it is slight, where I laid down rules to be observed by men in health, troubled with a weakness in any part. What remedies also are proper, when the pain is attended with a fever, has been shewn in that place, where the cure of fevers was considered. Now I shall treat of the rest.

That, which is acute, and that, which rises to an unusual height, and that, which proceeds from some sudden cause, and though not mortal, yet is very violent, demands venesection for the first step in the cure. But unless the pain be intolerable, that is needless. And it is better to abstain from food; if possible, from drink too; if not, to drink water. If the pain continues the following day, to give a clyster, to procure sneezings, to take nothing but water: for this discipline often removes it in a day or two, especially if the origin be from wine, or crudity.

But if these methods afford small relief, it is proper to clip the hair close to the skin: then it must be considered, what was the cause of the pain. If heat, it is expedient to pour a great quantity of cold water over the head, to apply a concave sponge frequently dipped in cold water and squeezed, to anoint with rose-oil and vinegar, or rather to apply sordid wool dipped in these, or some other cooling cataplasms. But if cold has brought on the disorder, it is proper to pour upon the head sea water, or at least salt water warm, or a decoction of laurel; then to rub the head briskly; next to embrocate it with warm oil, and to cover it. Some even bind it up; others clap on cervicalia(5) and cloaths, and thus are relieved; others are assisted by hot cataplasms. And therefore, where the cause is not known, it is proper to try, whether cooling things, or heating give most relief, and to use those, which upon experiment shall be found best.

But if the cause cannot be discovered, it is proper to pour over the head first warm water, as has been prescribed, or salt water, or a decoction of laurel, then cold vinegar and water. The following methods are of general use in all inveterate pains of the head: to excite sneezings, to rub the lower parts briskly, to use gargarisms of such things as promote saliva, to apply cucurbitals to the temples and back of the head, to sollicit an hæmorrhage from the nose, to vellicate the temples now and then with resin, and by applying mustard to ulcerate those parts, that are affected, first putting linen below, that it may not corrode too severely, or to make ulcers where the pain is, by hot irons, to eat always moderately, and drink water; when the pain is abated, to go into the bath, there to pour over the head first a great quantity of hot water, and then cold. If the pain is wholly removed, to return even to the use of wine; but ever after to drink water before any thing else.

That kind is different, where a humour is collected within the head. In this it is necessary to clip to the skin; then to apply mustard, so as to ulcerate it; if that does not prove effectual, the knife must be made use of. The management must be so far the same with dropsical cases, that the patient must be exercised, sweated, briskly rubbed, and take such food and drink, as are powerful diureticks.

Of the cyni­cus spas­mus.

There is a distemper incident to the face, which the Greeks call cynicus spasmus[ CE ]. It comes on an acute fever. The mouth is turned aside with a kind of grin, and therefore it is nothing else than a distortion of the mouth. There is also a frequent change of colour in the face and the whole body, and a great propensity to sleep.

It is very proper to let blood in this disorder. If it is not removed by this, to give a clyster. If it does not yield even to that, to vomit by white hellebore. Besides it is necessary to avoid the heat of the sun, fatigue, and wine. But if it is not cured by these methods, running must be used, and gentle and long friction upon that part, which is diseased; in the other parts shorter, but brisk. It does service also to procure sneezings, to shave the head, and to pour upon it hot, either sea water, or at least salt water, with sulphur added to it: after this bathing, to rub again, to chew mustard, and at the same time to apply cerate to the parts of the face that are affected, and to the sound parts mustard, till it corrode them. The most proper diet is of the middle kind.

Of a palsy of the tongue.

But if the tongue be paralytick, which sometimes happens of itself, sometimes is occasioned by distemper, so that the pronunciation is indistinct; it is necessary to use a gargarism of a decoction of thyme, or hyssop, or catmint; to drink water; to rub briskly the head, mouth, and the parts under the chin, and the neck; to rub the tongue itself with laser; to chew the most acrid things, such as mustard, garlick, onion; to make strong efforts to articulate words clearly; to take exercise, keeping in the breath; to pour cold water upon the head often; sometimes to eat plentifully of radishes, and then to vomit.

Of a catarrh and gravedo.

A humour distils from the head sometimes into the nose, which is a slight disorder; sometimes upon the fauces, which is worse; sometimes even upon the lungs, which is worst of all. If it have fallen upon the nose, a thin rheum flows from the nostrils, the head is slightly pained, a weight is felt in it, and there are frequent sneezings. If upon the fauces, it irritates them, and raises a slight cough. If upon the lungs, beside the sneezings and cough, there is also a weight in the head, lassitude, thirst, heat, and bilious urine.

Another (though not very different) disorder is a gravedo. This obstructs the nostrils, blunts the voice, raises a dry cough: at the same time the saliva is salt, there is a sounding in the ears, the veins of the head move, and the urine is turbid. All these disorders Hippocrates calls coryzæ[ CF ]. I observe that this is now by the Greeks appropriated to the gravedo: and catarrhs are called by them catastagmi[ CG ]. These are common, and of short continuance; but if they be neglected, are usually lasting. None of them is dangerous, but such as ulcerate the lungs.

When we perceive any such symptoms, we ought immediately to avoid the heat of the sun, the bath, and venery(6). And at the same time nevertheless unction may be used, and the ordinary diet. The patient should take a straight, but not too quick walk; and after it the head and face must be rubbed above fifty times. And it seldom happens, if we have restricted ourselves for two days or three at most, that the disorder is not mitigated. When it is abated, if in the catarrh the phlegm turns thicker, or in a gravedo, if the nostrils are more open(7), the bath is to be used, and the face and head fomented plentifully first with hot water, and then with egelid; after that, the patient may eat heartily and drink wine. But if on the fourth day the phlegm is equally thin, or the nostrils appear equally obstructed, austere Arminæan wine(8) is to be taken; then again for two days successively water; after which the person may return to the bath, and his usual way of living.

Neither even on these days, in which some things are to be refrained, is it proper to live like sick people; but in all other respects the same liberties may be taken as in health, except by one, who uses to be long and severely afflicted with these disorders; for such a person requires a management somewhat nicer. Therefore if the defluxion be upon his nose or fauces, besides what I mentioned before, he ought immediately in the first days of his indisposition to walk much, to rub the inferior parts briskly, the friction must be more gentle upon the thorax, and gentler still upon the head, the ordinary diet must be diminished to half the quantity, eggs must be used, starch, and such like things, which generate a thicker phlegm; thirst, as much as he can bear, must be one part of the cure. When by these means one has been rendered fit for the bath, and has used it, a small fish, or flesh is to be added to his diet; with this caution however, that he do not immediately take his ordinary quantity of victuals. Pure wine must be used pretty plentifully.

But if it distils also upon the lungs, there is a much greater necessity for walking and friction, still observing the same rules in diet. If these have not the desired effect, he must use the more acrid kinds, indulge sleep more, and abstain from all business, sometimes try the bath, but not soon.

In a gravedo it is necessary for the first day to rest, neither to eat nor drink, to cover the head, and put wool round the throat; the day following to rise, to abstain long from drinking, or if he is obliged to do it, not to take above a hemina of water; on the third day to take a little soft bread with a small fish or some light flesh, and to drink water. If a person should not be able to forbear eating heartily, he must vomit: when he comes into the bath, he is to foment his head and face plentifully with warm water, till he sweat, then return to the use of wine. After which it can scarcely happen, that the same indisposition will continue. But if it remain, use must be made of cold, dry, and light food, as little moisture as possible, friction and exercise being still continued, which are necessary in every indisposition of this nature.