Ascites historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Historical Perspective

• About 25 BC, Aulus Cornelius Celsus (A.D. 30), a Roman encyclopedist explained in his book "De Medicina" three different types of fluid accumulation under the skin; which was called hydrops by Greeks. Celsus postulated that ascites is mostly secondary to quartan fever (malaria) in Rome.
  • Very tense belly with frequent noise of the wind movement sound - called tympanites
  • Uneven swelling and rising up in the body - called leukophlegmasia or hyposarca
  • The fluid gathering all together in the belly with visible movement along with the movements of body - called ascites
• In 25 BC, Philip of Epirus, promised to cure the certain friend of king Antigonus with ascites. Philip cured the patient with devouring poultices and drinking his own urine. The basis of his treatment was thirst, rest, and abstinence.

Landmark Events in the Development of Treatment Strategies

• About 25 BC, Aulus Cornelius Celsus (A.D. 30), a Roman encyclopedist explained in his book "De Medicina" mentioned that ascites was relieved in slaves more easily than freemen. Because slaves can endure thirst, hunger, and other troublesome more than unserviceable freedom.
• The principles of treatment for ascites were explained as thirst, rest, and abstinence. Drinking less fluid and sweating more, not with exercise, but with heated sand, or in the sweating-room, or with a dry oven and such- like were the other alternative therapies.
• Pills composed of wormwood two parts and myrrh one part were given on an empty stomach to treat refractory types of ascites.
• Various remedies for ascites were postulated as:
  • Iris root
  • Spikenard
  • Saffron
  • Cinnamon
  • Cassia
  • Myrrh
  • Balsam,
  • Galbanum
  • Ladanum
  • Oenanthe
  • Opopanax
  • Cardamon
  • Ebony
  • Cypress seeds
  • Taminian grape which the Greeks call staphisagra
  • Southern wood
  • Rose leaves
  • Sweet flag root
  • Bitter almonds
  • Goat’s marjoram
  • Styrax
• The quantity of fluid input and output had to be measured and recorded daily.
• Abdomen circumference was also measured on a daily basis.

 Celsus De Medicina. With an English translation by W. G. Spencer. Cambridge, Harvard Univer- sity Press; London, Wm. Heinemann, 1335-1938, 3 ~01s. See Book III, chap. 21 (vol. 1, pp. 313 ff.). Prrmission for publication is gratefully ac- knowledgrd.