Intestinal Fortitude: Adventures in Ancient Medical Treatments

Galen, Method of Medicine 14: 10, 856

“The man was forty years old, as you know. While he was believed to be colic, he not only failed to profit from fomentations, heat treatments, ointments, and enemas—those kinds of things which doctors typically apply—but his condition was exacerbated by most of them. When rue-oil was applied rectally, he got worse; and he was worse still after the application of castor oil. When honey which had been prepared with pepper was inserted, he felt the worst find of pain. And he also suffered when he took the juice of fenugreek finished with honey.* For these reasons, I surmised that the biting fluids had worked themselves into the intestinal walls to begin with and that these were causing infection along with the treatments that had been inserted through his rectum, with the additional complication of the substances that had been ingested orally.

I gave him some food that would not cause problems. Then when I saw him in more pain, I realized that it was critical to purse the kakokhumia [bad-bile]. Although the medicine which is best for this sort of bile-issue is mad from aloe which people now call bitter, I did not date have this man purged right away because he was in pain and without proper nutrition for two months. Once I purged him in stages and moderately over a period of fifteen days I healed him and did not have to provide any other treatment. This man was at that time not afflicted for the first time, and he no longer had stomach pains.”

ὁ μέν γε τεσσαρακοντούτης ἦν, ὡς οἶσθα, | κωλικὸς εἶναι νομιζόμενος, οὐ μόνον οὐδὲν ὀνινάμενος ὑπὸ καταντλήσεων καὶ πυρίας καὶ καταπλασμάτων καὶ κλυσμάτων, οἷς συνήθως εἰώθασιν ἐπὶ τῶν τοιούτων χρῆσθαι διαθέσεων, ἀλλὰ καὶ παροξυνόμενος ὑπὸ τῶν πλείστων. ἐπὶ γοῦν ἐλαίῳ πηγανίνῳ διὰ τῆς ἕδρας ἐνεθέντι χείρων ἐγένετο καὶ αὖθις ἐπὶ καστορίῳ· καὶ μέντοι καὶ μέλι ποτὲ προσενεγκάμενος ἑφθὸν ἔχον πέπερι ἐσχάτως ὠδυνήθη· καὶ τὸν χυλὸν δὲ τῆς ἑφθῆς τήλεως ἅμα μέλιτι λαβὼν ἱκανῶς παρωξύνθη. στοχασάμενος οὖν ἐγὼ χυμοὺς δακνώδεις ἐν αὐτοῖς τοῖς χιτῶσι τῶν ἐντέρων ἀναπεπόσθαι, συνδιαφθείροντας ἑαυτοῖς τά τε κάτωθεν ἐνιέμενα καὶ τὰ διὰ τοῦ στόματος λαμβανόμενα, δύσφθαρτον αὐτῷ τροφὴν δούς.

εἶτ᾿ ἰδὼν ὀδυνώμενον ἔγνων χρῆναι τὴν κακοχυμίαν ἐκκαθαίρειν. ὄντος δ᾿ ἀρίστου πρὸς τὰς τοιαύτας κακοχυμίας φαρμάκου τοῦ διὰ τῆς ἀλόης, ὃ καλοῦσιν ἤδη συνήθως πικράν, ἀθρόως μὲν οὐκ ἐτόλμησα καθαίρειν αὐτὸν τὸν ἄνθρωπον, ὑπό τε τῆς ὀδύνης καὶ τῆς ἐνδείας καθῃρημένον ἤδη που δυοῖν μηνῶν. ἐκ διαστημάτων δέ τινων σύμμετρον | τοῦτ᾿ ἐργαζόμενος ἡμέρας ὡς οἶσθά που πεντεκαίδεκα τελέως ἰασάμην αὐτὸν οὐδὲν οὐκέτι αὐτῷ προσαγαγὼν ἄλλο βοήθημα. οὗτος μὲν οὖν ἐν ἐκείνῳ τῷ χρόνῳ πρῶτον οὕτως ἠνωχλεῖτο, μηδέπω πρότερον ἀλγήσας ἔντερα.

*In case the reader is uncertain, it does in fact seem that all of these substances were applied to the intestines rectally. 

Medieval depiction of an enema being performed
This image is from Pinterest

2 thoughts on “Intestinal Fortitude: Adventures in Ancient Medical Treatments

  1. “Medicine, n. A stone flung down the Bowery to kill a dog in Broadway.” (Ambrose Bierce)
    In Galen’s time it seems that the rock was smaller and the dog was farther away. Does Galen provide observations on the rectal effluent after these treatments? That may rule out an internal hemorrhoid in favour of a problematic colon polyp or mechanical defect such as torsion. Many of the herbal preparations are severely alkaline and the mucosal lining of the colon becomes irritated beyond recovery, much like a Drano enema.

Leave a Reply