CHAPTER VI. THE CURE OF TETANUS.
NOW, indeed, a soft, comfortable, smooth, commodious, and
warm bed is required; for the nerves become unyielding, hard,
and distended by the disease; and also the skin, being dry
and rough, is stretched; and the eye-lids, formerly so mobile, can
scarcely wink; the eyes are fixed and turned inwards; and likewise
the joints are contracted, not yielding to extension. Let
the house also be in a tepid condition; but, if in the summer
season, not to the extent of inducing sweats or faintness; for
the disease has a tendency to syncope. We must also not
hesitate in having recourse to the other great remedies; for it
is not a time for procrastination. Whether, then, the tetanus
has come on from refrigeration, without any manifest cause,
or whether from a wound, or from abortion in a woman, we
must open the vein at the elbow, taking especial care with
respect to the binding of the arm, that it be rather loose; and
as to the incision, that it be performed in a gentle and expeditious
manner, as these things provoke spasms; and take away
a moderate quantity at first, yet not so as to induce fainting
and coldness. And the patient must not be kept in a state of
total abstinence from food, for famine is frigid and arid.
Wherefore we must administer thick honeyed-water without
dilution, and strained ptisan with honey. For these things do
not press upon the tonsils, so as to occasion pain; and, moreover,
they are soft to the gullet, and are easily swallowed, are
laxative of the belly, and very much calculated to support
the strength. But the whole body is to be wrapped in wool
soaked in oil of must or of saffron, in which either rosemary,
fleabane, or wormwood has been boiled. All the articles are
to be possessed of heating properties, and hot to the touch.
We must rub with a liniment composed of lemnestis, euphorbium,
natron, and pellitory, and to these a good deal of
castor is to be added. The tendons also are to be well wrapped
in wool, and the parts about the ears and chin rubbed with
liniments; for these parts, in particular, suffer dreadfully, and
are affected with tension. Warm fomentations, also, are to be
used for the tendons and bladder, these being applied in bags
containing toasted millet, or in the bladders of cattle half
filled with warm oil, so that they may lay broad on the
fomented parts. Necessity sometimes compels us to foment
the head, a practice not agreeable to the senses, but good for
the nerves; for, by raising vapours, it fills the senses with
fume, but relaxes the nervous parts. It is proper, then, to use
a mode of fomentation the safest possible, and materials not of
a very heavy smell; and the materials should consist of oil
devoid of smell, boiled in a double vessel,
1 and applied in
bladders; or of fine salts in a bag: for millet and linseed are
pleasant indeed to the touch, but gaseous, and of an offensive
smell. The patient having been laid on his back, the fomentations
are to be spread below the tendons, as far as the vertex;
but we must not advance further to the bregma, for it is the
common seat of all sensation, and of all remedial and noxious
means it is the starting-point. But if it be necessary to apply
cataplasms to the tendons, it must be done below the occiput;
for if placed higher, they will fill the head with the steam of
the linseed and fenugreek. After the cataplasms, it is a good
thing to apply the cupping-instrument to the occiput on both
sides of the spine; but one must be sparing in the use of heat,
for the pressure of the lips of the instrument is thus painful,
and excites contractions. It is better, then, to suck slowly
and softly, rather than suddenly in a short time; for thus the
part in which you wish to make the incision will be swelled
up without pain. Your rule in regard to the proper amount
of blood must be the strength. These are the remedies of
tetanus without wounds.
But if the spasm be connected with a wound, it is dangerous,
and little is to be hoped. We must try to remedy it,
however, for some persons have been saved even in such cases.
In addition to the other remedies, we must also treat the
wounds with the calefacient things formerly described by me,
by fomentations, cataplasms, and such other medicines as excite
gentle heat, and will create much pus: for in tetanus the
sores are dry. Let the application consist of the manna of
frankincense, and of the hair of poley, and of the resins of
turpentine and pine-trees, and of the root of marsh-mallow and
of rue, and of the herb fleabane. These things are to be
mixed up with the cataplasms, melting some of them, sprinkling
the others upon them, and levigating others beforehand
with oil; but the mallow, having been pounded, is to be boiled
beforehand in honeyed-water. We are to sprinkle, also, some
castor on the ulcer, for no little warmth is thereby communicated
to the whole body, because the rigors proceeding from
the sores are of a bad kind. Rub the nostrils with castor
along with oil of saffron; but also give it frequently, in the
form of a draught, to the amount of three oboli. But if the
stomach reject this, give intermediately of the root of silphium
an equal dose to the castor, or of myrrh the half of the silphium:
all these things are to be drunk with honeyed-water.
But if there be a good supply of the juice of the silphium
from Cyrene,
2 wrap it, to the amount of a tare, in boiled
honey,
and give to swallow. It is best given in this way, as it slips
unperceived through the palate; for it is acrid, and occasions
disagreeable eructations, being a substance which has a bad
smell. But if it cannot be swallowed thus, it must be given
dissolved in honeyed-water; for it is the most powerful of all
the medicines given to be swallowed, which are naturally
warming, diluent, and can relax distensions and soothe the
nerves. But if they can swallow nothing, we must inject it
into the anus with the oil of castor; and thus the anus is to be
anointed with oil or honey. With this, also, we must anoint
the fundament, along with oil or honey. But if they will
drink nothing, we must make an injection of some castor with
the oil. With this, also, we are to anoint the fundament,
along with fat or honey; and also foment the bladder; and
use it as an ointment, having melted it with a sufficiency of
wax to bring it to the proper consistence. But if it be the time
for evacuating flatulence and fæces, we are to inject two drams
of the purgative hiera along with honeyed-water and oil, since,
along with the expulsion of these, it warms the lower belly;
for hiera is both a compound and heating medicine.
