Pliny Natural History, Vol. VI (Loeb Latin-English)

"...without making a noise and gasping, it is asthma; but when, in addition, the patient can hardly draw in his breath unless the neck is outstretched, it is orthopnoea." — IV. 8, 1.

(c) "While this kind of disease involves the region of the neck as a whole, another equally fatal and acute has its seat in the throat. We call it angina; the Greeks have names according to its species. Sometimes no redness or swelling is apparent, but the skin is dry, breath is drawn with difficulty, and the limbs are relaxed; this they call synanche. Sometimes the tongue and throat are red and swollen, the voice becomes indistinct, the eyes are deviated, the face is pallid, and there is hiccough; this they call cynanche. The signs in common are that the patient cannot swallow or drink, and his breathing is obstructed." — IV. 7, 1.

According to Jan's Index, opisthotonus occurs in Pliny 24 times, tetanus 9 times, and emprosthotonus not at all. According to the same Index, dyspnoea is mentioned 4 times, asthma twice, *orthopnoea 28 times, and suspiriosi (not apparently in Celsus) 34 times.

The first reaction of a reader is to infer that Pliny was lax in his use of these terms, as Celsus says some people were in their use of terms for the various forms of tetanus. But Pliny is not an original authority; he is merely a note-taker, borrowing his technical terms from other writers, whether Greek or Roman. The laxity (if laxity there is) is not Pliny's, but that of his sources. It is possible that suspiriosus is a word that was in general use, and not a technical term of the physicians. With the Latin text before his eyes, the reader should not be...