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Bill Thayer

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This webpage reproduces a section of
De Medicina (On Medicine)

A. Cornelius Celsus

published in Vol. II
of the Loeb Classical Library edition, 1938

The text is in the public domain.

This page has been carefully proofread
and I believe it to be free of errors.
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(Vol. II) Celsus
On Medicine

 p. vii  Introduction to Book V

Book V, Chapters 1‑25, contains a list of drugs and prescriptions.​1 Celsus does not classify the ingredients as organic or inorganic, but he first gives a list of substances classified according to their effect on the body (styptics, agglutinants for wounds, substances to repress or mature suppuration, to cleanse wounds, induce healing, relieve irritation and encourage the growth of new flesh, caustics of varying strengths, and emollients), and then passes on to give the prescriptions for poultices, plasters, pastils, pessaries, dusting powders, ointments, gargles, antidotes, anodynes, liniments, draughts and pills.

In his prescriptions Celsus gives quantities, which have been reduced to modern measures,​2 but as we have no means of ascertaining the standard strength of the preparations which he used, it is impossible to dispense his prescriptions or compare them with those in use to‑day.

The internal remedies prescribed by Celsus were chiefly foods or drink (alimenta), and he gives details of their use and effect on the body in Book II,  p. viii chapter 18 ff.,​3 but when the medicamenta proper are described in Book V it is noteworthy that very few are for internal use, and that nearly all are for external application. In the same way in the treatments described in Books I and II, much more attention is given to massage, rocking and remedial exercise​4 than to internal treatment by the purge and vomit, as to the value of which Celsus was very doubtful.5

The preference for external remedies was perhaps due to the limited use of dissection, which resulted in a very imperfect knowledge of anatomy and internal conditions, so that Celsus and his contemporaries inclined to prescribe remedies, the results of which could be seen. While in Egypt the practice of embalming had early made men familiar with internal anatomy and the Alexandrian surgeons used dissection of dead bodies and vivisection for purposes of study and investigation,​6 both methods were strongly condemned by the Empiric school, to whose views Celsus attaches great weight,​7 and evidently became gradually discredited, for when Galen studied at Alexandria in A.D. 152‑157, he had no opportunity of studying human anatomy or morbid conditions by means of dissection. The prejudice against this continued  p. ix during the succeeding centuries and contributed to keep these methods of study in abeyance, and it was not until the renaissance, when they were revived by painters and sculptors eager to retain the standard of Art which had been reached in ancient Greece, that they again became the basis of medical training. The conclusion reached by Celsus himself is that dissection is necessary for the instruction of students​8 and in his treatise he directs attention to what, in his opinion, the Art of medicine could then accomplish. He writes without any real knowledge of internal conditions, he treats the symptoms and not the disease.

In the introduction to his whole work, Celsus had already noted with approval the views of the Empirics that physicians should not be bound by hard and fast rules, and that treatment must vary according to climate and other conditions; though treatment must be based on experience, difference of conditions caused the experience of individual practitioners to vary;​9 he had also noted the division of remedies into secunda and contraria;​10 when the ordinary remedies fail, contrary ones may be employed. An instance was the treatment given to Augustus by the physician Antonius Musa.​11 When the regular treatment with hot poultices failed to relieve a pain in the liver, he applied cold ones. It has been suggested that Augustus was suffering, not from a liver abscess, such as Celsus has described (vol. I, p415), for which such hot applications were given, but from typhoid  p. x fever, and that Antonius Musa applied a cold pack,​12 a treatment still used, a well known instance is that of King Edward VII, who, when Prince of Wales, was in danger from typhoid fever in 1871. The bold originality of the remedies applied by Petron​13 were still remembered by Galen writing a century later.​14 A similar type of "shock" remedy was the treatment of epilepsy by a draught of gladiator's blood​15 and of hydrophobia by throwing the patient into a pond,​16 though the latter may have been more of a homeopathic nature, and would certainly cause the death of a genuine case, though it might be effective in the cases of hysterical symptoms simulating hydrophobia which, as Pasteur observed in his native district, often accompany an outbreak of the disease. But such methods were not always safe, and though they sometimes resulted in spectacular cures, they sometimes killed the patient.17

Turning to the actual ingredients of the prescriptions, the greater part were derived from herbs and vegetables, which, as Celsus himself points out​18 have been used medicinally from the earliest times and by the rudest tribes, but, in addition, many animal organic and inorganic substances were employed. If the herbs used by Celsus are compared with those in a modern materia medica, it will be seen that though many are the same, he often mentions plants which are no longer used, as the drug which they contain can be obtained in a stronger form, or one more satisfactory for use, from some other  p. xi source;​19 in other cases the preparation which he used was evidently much weaker or applied for some other purpose than to‑day,​20 and some of the most important drugs are missing from his list.21

In the same way among the inorganic substances, arsenic, iron and mercury​22 are only used externally.

Internal Remedies

Purgatives are comparatively few and treatment by clystering the bowel was preferred by Asclepiades, whom Celsus is inclined to follow, but he mentions several substances as useful for the purpose: aloes, hellebore, sea-spurge, and others.​23 Castor oil is not included. For inducing a vomit he recommends only  p. xii the simplest means, tepid water with salt, mustard, honey or hyssop, or a radish;​24 pills, pastils and draughts were prescribed for the relief of pain, cough and bladder trouble, and to induce sleep.​25 The "antidotes" were a class of remedy held in high esteem; Celsus said they were not often used, but were important because of the help they gave in the gravest cases. He gave the prescriptions for three; they are mildly stimulant mixtures chiefly characterised by the very large number of their ingredients; it is difficult to see what value they an have had beyond a slightly tonic effect.26

External Remedies

It is noteworthy what great importance Celsus attached to tannin in local applications. This substance, now generally recognised as a useful immediate application for burns and scalds, was the chief effective constituent in many of the substances included in his prescriptions.

In addition to the plasters, poultices and other applications whose use is sufficiently explained in the text itself, one large class of remedies may be grouped under the modern term antiseptics, though no general name is applied to them by Celsus.​27 These substances have the general characteristics of opposing the growth of micro-organisms in wounds and of promoting a free discharge; they include the essential oils, especially rose oil (obtained by steeping the petals in cold water, and keeping them in the cold air till the oil rose to the top and was skimmed off),  p. xiii thyme oil, pitch and turpentine. The phenol or carbolic acid derived from gas tar and used by Lister as an antiseptic was akin to the thymol derived from thyme flowers, though the latter was weaker in action. The antiseptic which largely replaced phenol in surgical practice was mercuric chloride. Celsus frequently recommends orpiment and sandarach, the arsenic sulphides, for cleaning wounds and ulcerations, but as antiseptics these are much weaker than the mercury chloride. Salt solution, so largely used in the great war in the treatment of wounds, was used in ancient medicine for the same purpose, that of prompting a thin discharge, and is often mentioned by Celsus.28

Homoeopathic and Rustic or Popular Remedies

Throughout history a knowledge of herbs and drugs and their medicinal uses has been connected with the early systems of philosophy and occult lore. The "doctrine of signatures" expressed the popular belief that certain plants and minerals bore symbolical marks which indicated the diseases which nature intended them to cure, or that their outward appearance corresponded with the bodily condition of the patient.​29 Traces of this theory and of a belief in sympathetic magic are to be found in many of the remedies, especially the rustic or popular remedies, mentioned by Celsus. A sympathy or "homoeopathy"  p. xiv was believed to exist between the remedy and the disease, and they are "homoeopathic" in a much more fundamental sense than that in which the term is used by those who claim to practise homoeopathy to‑day. Instances of such remedies are the black hellebore (a powerful aperient) supposed to be especially effective in the black bile disease (melancholia),​30 or the white hellebore given to reduce swollen glands in the neck because it tended to produce expectoration of white phlegm.​31 Ox spleen was given as a remedy for enlarged spleen,​32 a poultice of pole reed was applied to a gathering on the hand caused by a splinter, because the commonest source of such splinters was the pole reed;​33 a decoction of worms boiled in oil was poured into suppurating ears where there were maggots.​34 Other well known examples, not mentioned by Celsus, are the application of the roots of the lesser celandine (pilewort) as a remedy for piles, because small excrescences which grew on them resembled the disease, and the use of red light and red cloth in treating smallpox with the idea of bringing out the rash and so evacuating the disease, though here again the treatment has been thought to have a real value as excluding harmful rays from the skin.35

The Editor's Notes:

1 A few additional prescriptions occur in the description of treatment in Books VI and VII; in Books I‑IV, although many foodstuffs or drugs are recommended for use in various diseases, no instructions for compounding are given.

2 See below, pp. lxv‑lxvii.

3 See also vol. I, p483 ff. for a list of alimenta. Alimenta and medicamenta overlapped to some extent and several of the former (e.g. honey, mustard) were ingredients or prescriptions for external use.

4 These formed a very important part of medicine from the earliest times; the use of remedial exercises as a treatment is said to have been introduced by Herodicus, the teacher of Hippocrates.

5 Vol. I, Pro. 28 ff.

6 Celsus relates that the Ptolemies gave Herophilus and Erasistratus the bodies of criminals to vivisect (Pro. 23, 24).

7 Pro. 27 ff. The school was founded by Philinus.

8 Pro. 74.

9 Pro. 30 ff.

10 Pro. 71; see also VI.6.8.E and note b.

11 Suetonius, Augustus, 81.

12 Cf.  Buchan, Augustus, pp161, 162.

13 III.9.2‑4.

14 Galen, I.144, XV.436.

15 III.23.7.

16 V.27.2C.

17 III.9.4.

18 I. Pro. I.

19 The squill provided a substance akin to digitalis (which Celsus does not know) but less satisfactory in use.

20 Opium and castor oil (see list below), papaver and cicinum (sc. oleum).

21 For instance strychnine (prepared from strychnos, nux vomica, a plant from the E. Indies) which was first used in comparatively modern times and aconite (aconitum napellus), still a frequent ingredient of liniments, though seldom prescribed now for internal use. Aconite had been known as a poison from the time of Hippocrates and the staphis agria, identified by Celsus with uva taminia (III.21.7º and list below) is said by Pliny (N. H. XXIII.17) to be a kind of larkspur (delphinium staphisagria). He used it as a vermicide and under the name "stavesacre" it is still so used in the United States.

22 There is no mention of calomel, bismuth, iron or magnesia as internal remedies. The only trace of iron used internally is in the popular remedy for enlarged spleen — water in which a smith's red hot tools have been dipped (IV.16.2);º mercury Celsus only mentions in the form of cinnabar, used externally, see list s.v. minium.

23 I.3.25; II.12; copper chips were also used, see list aes.

24 I.3.22.

25 V.24, 25.

26 V.23.

27 There were many others, see Galen on Antidotes, a work devoted to such medicines (vol. XIV of Kühn's edition).

28 See list s.v. sal. A split fig, which he mentions as a common application on wounds (vol. II, pp159, 161, 289) was used for the same reason, as the sugar in the pulp would promote a thin discharge.

29 For an account of the "doctrine of signatures" cf. T. J. Pettigrew, Superstitions connected with Medicine or Surgery, 1844.

30 II.12.1B.

31 V.28.7B (vol. II, p140 note).

32 IV.16.3. This no doubt originated in the idea that the remedy should resemble the disease; on the other hand the modern treatment of thyroid disease by thyroid extract or liver disease by liver, is at once brought to mind.

33 V.26.35C.

34 VI.7.1.D.

35 For many other instances see Sir J. G. Frazer, The Golden Bough, The Magic Art, vol. I, p78.

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