Among his internal remedies he mentions broom-seeds, the wine of squills, elder, and hellebore.
Alexander states that a coldness of the liver is the cause of dropsy, in consequence of which it is no longer able to form blood, but converts the fluids into water, phlegm, or air. Hence the distinction of dropsy into ascites, anasarca, and tympanites. In certain cases of anasarca he permits venesection, in order to relieve the depression of the system. He adds afterwards that, if not only the liver, but also the spleen and stomach appear hard, and especially if combined with plethora of blood, venesection is to be had recourse to before all other remedies. But in ascites and tympanites he agrees with Galen in condemning venesection, and trusts principally to purging and friction. Like our author, he commends copper and the leaves of elder. Exercise, he says, is adapted in an especial manner to dropsical complaints, either by sea, on horseback, or in a couch. Horace, by the way, no doubt, alludes to the established practice of taking exercise for the cure of dropsy in the following passage:
Alexander has stated correctly that the disease sometimes derives its origin from disease of the uterus, kidneys, spleen, liver, colon, heart, or other organ of the body. He remarks that dropsy is apt to come on in phthisical cases.
Our author has merely condensed the account given by Aëtius. His list of diuretics contains squills, spikenard, alum, spurge, burnt copper, &c. Like Hippocrates, he approves highly of scarifications at the inner ankle. Upon the authority of Antyllus, he recommends lying in heated salt. In like manner, Galen and some of the other authorities speak favorably of insolation while the patient lies on sand, wheat, or the like. The sand-bath is mentioned as a remedy for dropsy by the earlier modern writers on medicine. See Theodoricus (iii, 33).
Leo, like preceding authorities, refers all dropsies to a coldness of the liver, and says they are mostly incurable. We do not find that Avicenna, Rhases, Avenzoar, and Serapion make any material alteration on the practice of the Greeks. In certain cases of anasarca they permit venesection, but generally condemn it in ascites. They praise mezereon or the chamelæa strongly as a diuretic; and also make mention of colocynth and scammony. Haly Abbas treats separately of anasarca, ascites, tympanites, and dropsy from a hot cause. When anasarca is connected with an obstructed secretion, he approves of bleeding; and, in general, recommends abstinence from drink, exercise in the sun, friction with sand or hard towels, sulphureous baths and diuretics. He concludes with an advice not to persevere too long in the use of any one medicine. In the treatment of ascites, he recommends mezereon, colocynth, &c., but disapproves in general of paracentesis. For tympanitis he prescribes various carminatives, such as parsley, fennel, spikenard, mastich, southernwood, melilot, &c. Alsaharavius expresses himself strongly in favour of venesection for anasarca; and for all kinds of dropsy recommends the sand-bath, sudorifics, and the common remedies mentioned above. The general causes of dropsy upon which Rhases most insists are induration of the liver and debility of the kidneys, so that they no longer attract the aqueous superfluity of the blood. He approves of paracentesis and scarifications of the feet and testicles when they are much swelled. Among his hydragogues, the most powerful are white hellebore, elaterium, scammony, and euphorbium. He mentions that he had known several dropsical cases cured by a spontaneous diarrhœa, and hence he recommends us not to stop one when it comes on. When dropsy is connected with the retention of a natural evacuation, he approves of bleeding. He speaks favorably of the elder as a diuretic.
SECT. XLIX.—ON THE SPLEEN.
The use of the spleen being to attract from the liver the melancholic humour, which is, as it were, the lees of the blood, if its attractive power be weakened, or the passage obstructed by which this was formerly attracted, the black jaundice is formed, blood in an unpurified state being distributed over the whole body; and if there be weight and distension about the spleen, or if there be also pain, obstruction is indicated; but if there be none of these, it is weakness of the attractive power. But vomiting of black bile taking place without fever, or any other symptom of malignity, indicates a weakness of the retentive faculty of the spleen. A weakness of the expulsive faculty will bring on anorexia, the melancholic superfluity being no longer carried to the orifice of the stomach and exciting the appetite. When the melancholic humour is infarcted in the spleen, in the first place inflammation of it occurs, indicated by heat, pain, and tightness, but afterwards it passes into scirrhus, the heat and pain having ceased, while the swelling and hardness remain. Persons thus affected have fetor of the mouth, their gums are corroded, and ulcers in their legs are difficult to heal. When the liver sympathises, dropsy takes place, as formerly mentioned; wherefore intemperaments of it are to be cured like those of the liver. But when inflammation is present, we must bleed from the left arm at the elbow, or at the extremity of the hand, in order that revulsion may take place from as great a distance as possible, and also because of some natural alliance between these parts. Then we are to apply a cataplasm of attenuants which are not manifestly caleficient, intermixing some of the astringents with them. Such is that natural substance called the flower of salt. And this is an admirable cataplasm: Of fenugreek, oz. iv; of barley-flour, of cresses, of each, oz. j; of fat figs, lb. j; of the herb vervain dried, oz. j; macerate the figs in the most acrid vinegar, and boil with the other things already bruised together, and then boil again; or apply goat’s dung boiled with raw barley-meal in oxycrate; and, if you choose, it may receive also some flower of salt. But having first used a fomentation of oil of privet with a little vinegar, use the emollient ointments; and first the more simple, such as this: Of wax, lb. iss; of the fat of bulls, lb. j; of nitre, oz. iij; of turpentine, of the fruit of the chaste-tree, of the bark of the root of capers, of each, oz. v; having boiled the soluble ingredients, sprinkle the powders above. And the malagma of Nileus is an excellent one. If the inflammation is converted into scirrhus, we must use the most powerful applications so as to stimulate the skin, such as the one from goats’ dung, and that from citrons, also that of Macherion, the barber’s, the one from bay-berries, and that from willows. This one I have found to answer upon trial: Of arsenic, oz. ij; of sandarach, oz. ij; of wax, of turpentine, of each, lib. j; of dry pitch, lb. j; of galbanum, oz. j; of opopanax, oz. j; of the bark of the root of capers, of nut ben, of each, oz. iv; of ammoniac perfume, scr. vj; of the oil of nard, and of privet, oz. v. And ammoniac, when rubbed over the spleen with vinegar, is often of great use, and also, when drunk to the amount of three or four scr. with one scr. of castor, while sitting in the hip-bath, having previously chewed dried figs and spit them out. Or of ammoniac, p. j; of castor, p. j; give one drachm of these things, and it will be of great service for scirrhus; and, in like manner, the bark of capers, triturated with vinegar and applied. The same, when drunk with vinegar or oxymel, evacuates thick and viscid humours, and sometimes blood. And the bark of the willow is rubbed in similarly. And the ashes of the brazier’s shop, when applied with raw barley-meal in oxymel, is of use; and the juice of centaury, when applied externally, and when taken in a draught; and the decoction of bitter lupines, when drunk with rue and pepper; and its flour, when applied as a poultice; and the water in which heated iron has been often extinguished, when given to the amount of three cyathi to such as have fever; and to such as are free from fever, to the amount of one cyathus with wine and vinegar; or the root of the wild dock with squills, to the amount of three oboli; or of wall germander, and of wild thyme, an acetabulum; all these may be given with oxymel; or, give two oboli of the juice of the pimpernel having a blue flower (anagallis cærulea?) with oxycrate; or vinegar of squills, or oxymel. These are compound medicines: Of the root of panacea, of ammoniac perfume, of the rind of the root of capers, of fuller’s herb, of the inner part of baked squills, equal parts; give one drachm. It is also of use in asthmatic and dropsical cases.—Another: Of the fruit of tamarisk, dr. iv; of pepper, dr. iv; of spikenard, dr. ij; of ammoniac perfume, dr. ij; triturate with vinegar of squills, and give one drachm in oxymel.
For scirrhus of the spleen. Of sow-bread, dr. xx; of bryony, dr. iij; of dittany, dr. ij; of baked squills, dr. viij; of fuller’s herb, dr. vj; of the root of capers, dr. vj. Give a trochisk to the amount of three oboli in oxymel. And the trochisk from heath is also applicable. The food should be attenuant, acrid, and dry; little drink should be taken; but exercise, friction, and sinapisms should be had recourse to, and sometimes cupping with scarifications.
Commentary. Hippocrates describes several diseases of the spleen in his work, ‘de Internis Affectionibus.’ He states that in scirrhus the spleen is sometimes larger and sometimes smaller than natural. It is an affection which continues long, but is not fatal. Sometimes, he says, it terminates in dropsy, and sometimes in suppuration, when he approves of burning the side. He also recommends diuretics and purging with hellebore. The description which he gives of the symptoms of enlarged spleen, in his work ‘On Airs, &c.,’ is very curious. Dr. Coray considers that it applies to scurvy. (See Notes, &c. 29.)
Aretæus remarks correctly that the spleen is very subject to scirrhus, but little so to suppuration. Scirrhus, he says, is removed with difficulty.
For scirrhous enlargement of the spleen, Celsus recommends unction, friction, and sudorifics. He forbids all sweet things, milk and cheese. He approves of pickled and salted things, acids, the vinegar of squills, a decoction of wormwood, and water in which a red-hot iron has been extinguished. Emollient ointments are to be applied externally.
Cælius Aurelianus says that some had directed the spleen to be cut out when it is much diseased, but he holds the proposal as mere words of course, and believes that the operation had never been performed.
Octavius Horatianus recommends as general remedies for complaints of the spleen, bleeding, purging, and fomentations with wool soaked in equal parts of oil and vinegar. When it becomes indurated he approves of vinegar of squills, friction, gestation, dropaces, salt baths, &c.
Most of our author’s remedies are taken from Galen, who treats fully and scientifically of diseases of the spleen. He states, as a general principle of treatment, that the proper medicines in cases of indurated spleen are such as are of an incisive and attenuant nature. He, therefore, approves of the mixture of bitter with austere things.
Alexander forbids strong purging in the beginning of an inflammation either of the liver or spleen.
The Arabians treat of these affections similarly to the Greeks. Haly Abbas remarks that the spleen can bear much stronger medicines than the liver, and recommends in the indolent diseases of it various bitter and very acid medicines. In inflammation he very properly bleeds. These are his general principles of treatment, the detail of which he explains at great length. Avicenna and Alsaharavius treat of these diseases more minutely than any other of the ancient authorities. Rhases recommends camel’s milk in cases of indurated spleen. He joins Archigenes in directing the application of sinapisms and leeches to the side.
SECT. L.—ON JAUNDICE.
Jaundice is a diffusion of bile over the whole body, sometimes of black, as we stated when treating of diseases of the spleen, and sometimes of yellow. There are many varieties of this complaint, the causes and diagnosis of which are as follows: If jaundice occurring suddenly in a febrile complaint diminish the fever, it is critical, being occasioned by a metastasis of the matter from the deep-seated parts, and, therefore, stands in no need of medicines, but is soon removed by baths and friction. But if it is attended with fever and bilious evacuations from the bowels, and if there be a sense of weight in the right hypochondrium, a hot inflammation of the liver is indicated, by which the blood, being rendered bilious, is conveyed over the whole body. When there is heat in the part without a sense of weight, the affection is occasioned by a hot intemperament alone of the liver. If it is without fever, and the alvine discharges are white, an affection of the gall-bladder, or of its ducts, is indicated. When there is a sense of heaviness in the right hypochondrium, it indicates that the ducts are obstructed; but when without heaviness, weakness of some of its powers is indicated, either of the attractive, by which it attracts the bile from the liver, or of the expulsive, by which it propels the bile to the intestines. For when the blood is not purged of bile, it is diffused over the whole body (as we stated respecting the black jaundice); in which case the urine is voided very much mixed with bile. But jaundice is also occasioned by a hot intemperament of the solid parts, which convert into bile whatever is brought to them in place of food, in like manner as in anasarcous complaints a conversion to a pituitous fluid takes place. This variety of jaundice is recognized by its not occurring at once but by degrees, none of the afore-mentioned symptoms being present. Moreover jaundice is occasioned also by drinking certain deleterious medicines, and by the external application of poison from some venomous animal. The cure of a hot intemperament of the liver, and of inflammation of it, and of weakness of its powers, we have treated of under the head of the affections of it; and what we said there is to be applied here without alteration, that we may not be obliged to repeat the same thing. When both the ducts of the gall-bladder are obstructed, or either of them only, we must let blood from the right arm. But some, both in this case and in jaundice from inflammation of the liver, open the vessel near the middle finger of the right hand. And we must use anti-inflammatory cataplasms, and purge with hiera. But persons affected with jaundice must take the propomata from a decoction of parsley, maiden-hair, or dock, or of wild thyme, reduced to a third part; or sprinkle wormwood on the potion. Two cyathi of the juice of radish, drunk with a cyathus of wine, is also of great use; also two or three cyathi of succory alone, and with wine. In cases of jaundice from inflammation of the liver, give a draught of mulse, or of a decoction of slender birthwort, or of St. John’s wort, or of maiden-hair, or of fuller’s herb, or of madder, in like manner; or a drachm of the shavings of hartshorn with wine, or the decoction of carrot boiled in wine to one third; or they may take a drachm of native sulphur in eggs. These things are of great use also in obstruction. But viij scruples of the seed of orache, with Chrysattic, or any other must, if drunk when in the bath, effect a proper evacuation. But the picra may be properly given in powder, or with oxymel, and the one called Theodoret; likewise the trochisk from bitter almonds. Give also of cinnamon what can be lifted with three fingers in a cyathus of mulse, or in mixed water; or of myrrh, the bulk of a bean, with twenty seeds of pepper, and the same quantity of cinnamon. Those affected with jaundice, owing to a warm intemperament of the solid parts, are to be treated with gentle friction, moderate exercise, unction and baths, with a moistening and moderately cooling diet, the juice of ptisan, intybus, endive, succory, fish, and light watery wine. The treatment of those who are affected with jaundice from drinking some deleterious substance, or from the bite of some venomous animal, will be laid down in the Fifth Book. When bile is lodged in the vessels of the face and eyes, inject elaterium to the size of a vetch, with a woman’s milk, into the nose while in the bath, and then direct the person to descend immediately into it, but not to immerse his head; and after the bath, having given him a recruiting diet, again inject the errhine in the sun. The juices of sow-bread, of horehound, and of gith act in like manner. But let him draw into his nostrils, while seated in the bath, some acrid vinegar, and compress his nostrils for a short time, and it will produce a wonderful discharge.
Commentary. See Hippocrates (de Locis in Homine, 40); Galen (de Med. sec. loc. ix); Aretæus (Morb. Chron. i, 15); Celsus (iii, 24); Cælius Aurelianus (Tard. Pass. iii, 5); Aëtius (x, 18); Oribasius (Cur. Loc. Affect. iv, 99); Actuarius (Meth. Med. i, 11); Nonnus (188); Pliny (H. N. xi, 37; xxvi, 76; xxviii, 64); Ruffus Ephesius (ii); Palladius (de Feb. 6); Alexander Aphrodisiensis (Probl. i, 90); Octavius Horatianus (ii, 14); Scribonius Largus (31); Marcellus (de Med. 22); Serapion (iv, 9); Avicenna (iii, 15, 1); Avenzoar (i, 14, 6); Haly Abbas (Theor. ix, 33; and Pract. vii, 41); Alsaharavius (Pract. xviii, 11); Rhases (Divis. i, 64; Contin. xvi.)
With regard to the etymology of the term icterus: in the first place, Aretæus derives it from the animal ictis, which the Scholiast on Nicander pronounces to be a wild ferret. On the identity of the mustela and ictis, see further Pliny (H. N. xxix, 16.) Schneider determines it to be the mustela furo. (Ad Aristot. H. A. vi, 30.) Isodorus would seem to agree with Aretæus, in his derivation of the term Orig. Suidas, however, derives the word from ἰκτῖνος, a species of kite, and Pliny from some unknown bird of the imaginary name of icterus (H. N. xxx, 11.) We have no hesitation in saying that we are disposed to follow the authority of Aretæus.
Hippocrates directs us to give at first fatty things, and to use the bath for three days; then to abstain from these things, and purge both the belly and the head, and give diuretics. But he forbids cholagogues, which, he says, only increase the disorder of the system. We have stated in the Second Book, Sect. IV, his views regarding jaundice occurring in fever. His commentator Theophilus explains that jaundice arises from obstruction of the ductus choledochus. Hippocrates lays it down as a rule that in cases of jaundice it is a bad symptom when the liver is hard. (Aphor. vi, 42.)
Our author follows closely the views of Galen. He remarks that, when in fever the bile is suddenly determined to the skin, it proves critical, and is easily removed by baths of sweet water, and friction with a discutient or rarefying oil. When the disease proceeds from obstruction of the vessels of the liver, he directs the administration of hot and detergent things, such as gentian, birthwort, and centaury. When occasioned by inflammation of the liver, the remedies suitable to that disease will be proper. When inflammation and obstruction are combined together, they are to be removed by relaxants and detergents. He gives from Andromachus and Archigenes a long list of compositions for jaundice; but we must be content with explaining his general principles without entering upon the detail of his practice. Galen, in another place, remarks that the poisons of certain reptiles occasion jaundice. (De Loc. Affect. vi, 8.) This fact is confirmed by modern observation. See Van Swieten (Comment. 916); Dr. Simson (paper on Jaundice, vol. i of the Medical Essays and Observations); and Rogerius (i, 47.) By the way, the ancients maintained that the primary action of certain poisons is exerted upon the liver. (See Book Fifth, XLII.)
Aretæus insists that jaundice is produced not only by disease of the liver, as generally supposed, but likewise by affections of the spleen, stomach, kidneys, and colon. He further states that jaundice is sometimes engendered by the condition of the general system. He appears to allude to non-elimination of the bile. When the biliary ducts are obstructed, the bile regurgitates from the gall-bladder, and mixes with the blood in the liver, whence it is carried all over the body. In this case the alvine discharges are white, owing to their not being mixed with bile. When the spleen is the seat of the disease, the skin is of a dark yellow colour. He maintains that jaundice likewise arises from affections of the stomach and also of the colon, as digestion is partly performed in the latter viscus. But we must not follow out his description any further, as it is too long for our limits.
Celsus having described the disease, directs us to cure it by abstinence for one day, and then by opening the bowels; if fever is present, the suitable remedies are to be applied, but otherwise scammony or bitters, such as wormwood, are to be given. Some, he says, cured the disease by attenuant food and diuretics, but Asclepiades rejected the latter, and gave salt water as a purgative. Celsus approves of a salt Greek wine, baths, and so forth. During the whole course of the complaint he directs the patient to use friction, and take exercise; and if it is winter to have recourse to the bath, but in summer to swim in the sea. He approves of all kinds of exhilarating sports and amusements, whence the disease, he says, has got the name of regius morbus. Isidorus, in like manner, says of it: “Regium autem morbum inde estimant dictum quod vino bono et regalibus cibis citius curatur.”
Pliny directs us to cure jaundice by producing perspiration with the root of the cyclaminus or sow-bread.
Cælius Aurelianus says that jaundice is brought on by indigestion, or by cathartic medicines which have been taken and have not operated. Sometimes, he says, it is attended with enlargement or scirrhus of the liver, and sometimes, though rarely, the spleen and stomach are affected sympathetically. If the attack is violent, he does not disapprove of venesection; after which the sick are to be restored by soothing treatment, exercise, and food of easy digestion. The accessory symptoms, such as hardness of the liver, spleen, and stomach, are to be attended to; and the bile is to be carried off from the system by administering acrid clysters, and giving infusions of wormwood or wild succory. He also approves of sternutatories such as elaterium; of masticatories given while in the warm bath, and of determining to the skin by sudorifics and medicines which produce pruritus. He also recommends change of air, gestation, swimming in water, frequent vomiting excited by simple means, and acrid food such as capers, squills, &c. He approves likewise of giving a thin wine, and the decoction of hellebore when the disease is protracted; but disapproves of the indiscriminate use of cholagogues, cathartics, and diuretics, such as scammony, and colocynth, with wormwood, birthwort, St. John’s-wort, anise, &c. He thinks mental relaxation and serenity of great consequence to the cure.
Aëtius gives an accurate account of the disease, but his views are very similar to those of Aretæus. He maintains that there are other causes of jaundice besides obstruction of the duct of the gall-bladder. When the affection is not critical, he recommends bleeding and purging. He says that strong purging with colocynth, scammony, and other drastics is required to produce revulsion from the skin. He also approves of deobstruents and diuretics, which are to be given while the patient is in the hot bath. He speaks of sternutatories and sialogogues, like our author. He likewise strongly recommends emetics (iii, 119.)
The treatment recommended by Oribasius, Actuarius, Nonnus, and Octavius, is very little different from our authors. According to Actuarius, the colour of the urine which is characteristic of jaundice is the cærulean, that is to say, the colour of a ripe cherry, or of a dark-coloured wine. (De Urinis, vi, 7.) Theophilus in like manner states that the cærulean-coloured urine indicates jaundice. (De Urin. 6.)
Ruffus the Ephesian describes very correctly the situation and use of the gall-bladder, and remarks, that when its duct is obstructed jaundice is produced, in which case the stools are white and clayey. Aëtius’ recommendation of emetics is upon his authority.
Alexander Aphrodisiensis states that the constipation of the bowels in jaundice is occasioned by the want of the natural bile, which serves as a stimulant to the intestines. For the same reason, he adds, the stools are of a whitish colour.
According to Leo, jaundice arises either from obstruction or from the conversion of the blood into bile by the heat of the system. He also adds that jaundice is sometimes critical.
The poet Lucretius (iv, 333) and the philosopher Aristippus take it for granted that persons in jaundice see every object tinged with yellow. (Sextus Empiricus, adv. Math. vii, 195.)
According to Serapion, a redundance of yellow bile in the body is occasioned either by the system’s not being properly purged of it, or by an over-secretion of it, or by a combination of these causes. Obstruction, he says, may take place either in the liver itself or in the gall-bladder. Sometimes, he remarks, the liver having been inflamed, becomes as hard as a stone, or its ducts are obstructed so that the blood becomes mixed with bile, and in this state is carried over the whole body. He adds, that perhaps the whole gall-bladder is affected, or only one of its ducts, namely, either the superior one, by which it receives bile from the liver, or the inferior, by which the bile passes down to the intestines. In like manner he afterwards states, that sometimes the superior duct losing its tone and becoming obstructed, the bile becomes mixed with the blood; or, the inferior being obstructed, the bile regurgitates to the superior, and becomes intermixed with the blood. And sometimes, he says, the affection arises from the gall-bladder being over-distended in like manner as the urinary bladder sometimes is. When the disease is from obstruction he recommends attenuants, purgatives, emetics, and the other remedies directed by the Greeks. A similar account is given by Avicenna. Like Aëtius, he approves of venesection in certain cases, in opposition to Galen, who, as a general rule, forbids to let blood in jaundice. (De Purg. Virt.) Avicenna also describes the species of jaundice connected with disorder of the general system, described by Aretæus. Avenzoar says that the ducts are obstructed aut verruca aut pustula. The exact signification of these terms cannot easily be determined, but it seems probable that they refer to gall-stones. But the following passage of Haly Abbas puts it beyond a doubt that the ancients were acquainted with hepatic calculi or gall-stones: “Some,” he says, “relate that calculi are formed in the liver, cæcum, and colon.” (Theor. ix, 34.) Haly directs us, when jaundice is connected with inflammation, to bleed, and purge with myrobalans, hepatic aloes, &c. He also makes mention of emetics among his general remedies. When connected with obstruction, particularly of the gall-bladder, he recommends bleeding at the arm, a decoction of wormwood, hiera, scammony, and various remedies of a like nature. To remove the yellow colour of the eye he recommends the tepid bath, and the application to the eyes of the fumes of vinegar. For the cure of jaundice of the spleen, he prescribes the common remedies, and mentions one which he says he learnt from a woman, and found very effectual. It was a draught containing lentils, fennel, and the urine of a boy not come to puberty. Jaundice being a disease which often goes off without any remedies, has been, in all ages, a favourite with empirics. Alsaharavius treats of the disease in much the same terms; recommends bleeding when it is connected with an inflammatory cause, and attenuants, bitters, purgatives, and the hot bath according to circumstances. Rhases, who gives a very full account of jaundice, states that the disease generally arises from obstruction either in the liver or its ducts. He particularly recommends drastic purgatives, such as scammony, along with wormwood, fennel-seed, and the like. When inflammatory symptoms are present he approves of bleeding and the warm bath.
SECT. LI.—ON PROLAPSUS OF THE NAVEL.
The causes and surgical treatment of protrusion of the navel will be treated of in the Surgical part of the work. But, since some restore the parts to their natural state by medicines, we must now mention that method of treatment: Of fissile alum, dr. v; of lees of wine, dr. viij; of rose-oil, dr. x; of unripe gall-nuts, dr. ij; dilute with wine; make to the thickness of honey; and wash with it; and put on externally a sponge soaked in oxycrate, and surround it with a bandage.—Another: Of the outer skin of bruised beans, of galls, of pomegranate flowers, equal parts; boil in water, and when dissolved pound carefully, and wash with it; and apply the sponge, as formerly said.—Another: Of the parings of lead, dr. xvj; of hemlock, of manna, of ceruse, of the juice of hypocistis, of each dr. j; dissolve in wine, and use as above described.
Commentary. See in particular Oribasius (Morb. Curat. iv, 117.) It is not necessary to multiply authorities, as all entertain similar views upon this head. The following is a simple receipt given by Celsus: “Cicutæ et fuliginis, denar. j; cerussæ elotæ, denar. iv; plumbi eloti, denar. viij; ovis duobus; quibus etiam solani succus adjicitur.”
Haly Abbas properly remarks that the umbilical hernia is a protrusion of the omentum or intestine at the navel. He recommends various astringent plasters, containing cypress, galls, alum, &c. (Theor. ix, 36; Pract. vii, 51.)
SECT. LII.—HOW TO MAKE THE CHIN AND PUBES CONTINUE LONG FREE OF HAIRS; ON THE PRESERVATION OF THE GENITAL ORGANS; AND, AMONG OTHER THINGS, OF DEPILATORIES.
Mix equal parts of Cimolian earth and ceruse with the juice of henbane, so as to have the thickness of the bath-sordes; then add of oil of lentisk, q. s.; pound and use.—Another: Pound together the juices of hemlock, of deadly nightshade, of henbane, and of the most tender leaves of lupine, and an equal portion of fleawort, and use, having first scrubbed the part and washed. But for some days previously the patient must drink water.
A depilatory for removing the hairs. Of the slaters which live about houses and roll themselves into balls, dr. ij; of sandarach, dr. iv; of quicklime, dr. viij; of old vinegar, one cyathus; of the lixivial ashes of figs, one cyathus; boil in a pot, and use in the bath.—Another, simple and devoid of smell: Of quicklime, one sextarius; of sandarach, oz. j; boil as aforesaid, and use. But the subject of depilatories is treated of along with the Diseases of the Eye.
Commentary. Depilatories have always been made of similar ingredients to those which enter into our author’s prescriptions, that is to say, arsenic and quicklime have generally entered into the composition of them. The following is one from Baptista Porta: “Constat vivæ calcis partibus quatuor, redactis in pulveris modum, auripigmenti singulari, et decoque.” (Mag. Nat. ix, 4.)
It appears from many passages in the Roman Satirists that the practice of applying depilatories to the obscene parts was common in ancient times. Persius says:
See the learned note of Casaubon; also, Juvenal (Sat. viii, 114), and the note of the Dauphin editor. The Fathers inveigh against this immodest practice. See Tertullianus (de Pallio), and Clemens Alexandrinus (Pædagog. ii, 3.) According to Athenæus, the Tuscans were anciently much given to the use of depilatories. (Deipnos. xii, 14.) See also Apuleius (Metamorph.)
As this subject possesses little interest now, we need not enlarge upon it.
SECT. LIII.—ON BUBONOCELE, ENTEROCELE, AND HYDROCELE.
Protrusions of the bowels occasioned by rupture of the peritonæum are of a very difficult nature, but those from relaxation are of easier cure; for happening commonly to children of a humid temperament, they, for the most part, can be cured without a surgical operation, by the application of remedies and suitable bandages. The under-mentioned remedies are to be applied; but I must mention, in the first place, that these diseases differ in situation only; for, when the intestine remains in the groin, it is called Bubonocele, and when it falls down into the scrotum, it is named Enterocele. Wherefore, take of pomegranate-rind, dr. x; of unripe gall-nuts, dr. v; boil in three cyathi of austere wine; pound and apply, having previously reduced the intestine and bathed the part with cold water. Loose it in ten days; the patient remaining on his couch thirty days, and drinking of the decoction of cypress with wine; or of cypress balls, three oboli, in diluted wine. This medicine is applicable to children.—Another agglutinative application: Of the roots of comfrey, of the juice of horehound, of bitter almonds, of gum, equal parts.—Another: Of turpentine, oz. iss; of wax, of frankincense, of myrrh, of isinglass, of snails with their shells, of each oz. j; macerate the ichthyocolla previously in vinegar for three days.—Another: Of cypress-balls, i. e. spherical fruit, oz. j; of galls, oz. j; of pomegranate-rind, oz. ss; of taurocolla, oz. iij; of manna, of frankincense, oz. ss; of comfrey, oz. ss; of snails with their shells, oz. j; boil the balls and rind in astringent wine for a considerable time; triturate; mix the other ingredients, and when they are added, use.—Another: Of aloes, of pomegranate-rind, of frankincense, of the juice of hypocistis, of artificers’ glue, of pitch, of bitumen, oz. iss; of sweet wine, q. s.—Another more complex application, which will answer also with adults, when the disease is not of long standing: Of chrysocolla, of taurocolla, of sarcocolla, of ichthyocolla, of gagate-stone, of blood-stone, of Syrian sumach, of manna, of acacia, of each, oz. iss; of the stone pyrites, of native sulphur, of the breathing magnet, of fissile alum, of manna, of frankincense, of each, oz. j; of Brutian pitch, oz. v; of snails with their shells, oz. j; of the dross of silver, oz. iv; of galls, oz. j; of squamæ stomomatis (scales of steel?), oz. j; of copper, oz. j; of bitumen, oz. vj; of myrtle-oil, q. s.; mix the dry things with astringent wine, until the preparation is of such a thickness as not to stain, and then use. If they cannot lie in a recumbent posture, bind the application firmly with a triangular bandage of thick materials and sufficient to retain the intestine. Let them abstain from flatulent food, much wine, frequent baths, strong motion, such as running, leaping, loud crying, and the like. For hydrocele, so as to evacuate the fluid: Of pepper, c grains; of bay-berries, lxxx; of nitre, dr. xx; of wax, dr. xl; mix with half a hemina of oil, and use.—Another excellent application: Of the flower of Assian stone, dr. vj; of grapes deprived of their stones, dr. ij; of Ethiopian cumin, dr. viij; of red nitre, dr. viij; having triturated, apply, fomenting with it late and early. Some also add of sulphur, dr. viij.—Another: Mixing unslaked lime with bath-sordes, apply with cerate; and mix some nitre with the unslacked lime.—Another: Having burnt the root of a cabbage, add the ashes to old axunge that has been melted, and remove it every third day. To prevent a collection of water, use the following malagma: Of wax, lb. iiss; of pitch, oz. iv; of ammoniac perfume, oz. iv; of liquid alum, oz. iss. The plaster of the white poplars and the other epispastics are also applicable.
Commentary. As these diseases will be treated of more fully in the Sixth Book, it is unnecessary to say much about them at present.
Our author is most indebted to Aëtius (xiv, 22.) Nonnus recommends astringent applications of a similar nature. (192.) When there is difficulty of reduction, Rhases directs the use of the warm bath perseveringly. Haly Abbas remarks that protrusion of the bowels will sometimes occasion constipation, pain, and death. He says nothing of an operation for relieving the strangulation. Alsaharavius declares that he had found all the applications recommended for the cure of these complaints utterly ineffectual after they are fairly formed. He directs us to return the protruded parts, and secure them by means of a bandage, along with a pad of lead and a plaster of pitch, &c. The Surgical treatment of these complaints is minutely described in the Sixth Book.
SECT. LIV.—ON INFLAMMATION OF THE TESTICLE AND SCROTUM, AND ON THE OTHER DISEASES OF THESE PARTS.
You may recognize inflammation of the scrotum from the pain being felt at the slightest touch of the hand, and from the heat and hardness appearing intense; whereas, when the testicle is inflamed, a slight touch does not give pain, which is only felt when the part is firmly pressed by the fingers, while the redness and hardness appear less at the surface; but, upon grasping it firmly, a deep-seated hardness meets the fingers; and fever is sometimes present. To inflammations of the testicles, in particular, venesection is applicable at the ancle; and to all these, in general, cataplasms and cerates. Cataplasms are to be applied, of the flour of beans boiled in diluted wine, with fat dried grapes deprived of their stones; or, boil the root of cumin or asphodel, and, having pounded, mix with an equal part of the flour of dried barley-meal, and apply as a cataplasm; or, linseed in diluted wine; or, fenugreek in honied water; or, the root in honied water; or, the recent lees of wine, with the flour of barley-meal; or, groundsel and green coriander, with dried grapes deprived of their stones. But if there is much heat, apply a cataplasm of the leaves of henbane with wheat-flour, or that of chick-peas; or, of the leaves of sweet-flag, or of unripe gourd. When the affection is protracted, and attended with hardness, boil the root of wild cucumber in honied water, and, having triturated with the flour of darnel, apply as a cataplasm. And this is an excellent remedy: Of dried grapes deprived of their stones, oz. v; of boiled chick-peas, oz. iss; of cumin, oz. j; of sulphur, oz. ix; of nitre, oz. j; of rosin, oz. iiiss; triturate altogether with honey, and apply as a cataplasm. The following are convenient cerates: Of oil, one cyathus; of Colophonian rosin, oz. vj; of plumbago, of cumin, of dried grapes, of the flour of beans, of each, oz. iv; of wax, oz. ij; boil the plumbago with the oil to a proper consistence, then add the wax and rosin, and, taking it off the fire, pour it half cooled upon the pounded figs and flour.—Another: Of the oil of dill and of roses, of wax, of pine-rosin, of each, oz. v; of cumin, oz. iiss; of asses’ dung, oz. iss; triturate the cumin with the asses’ dung, and when the cerate is cooled mix and levigate; then, placing in a rag, use, applying above it wool out of oil from unripe olives; or, use equal parts of butter and rosin. If from sweats there be ulcers in the scrotum, sprinkle powdered gall or alum upon fat and goats’ gall, and anoint. For testicles affected with aphthæ: Having first anointed with Cimolian earth and water, allow it to dry, and wash with warm water; then, having triturated dried myrtle and a small quantity of alsander, apply as a cataplasm. Excrescences upon the testicles are cured by the application of the lixivial ashes of the vine mixed with wine and water. When there is pruritus of the scrotum, triturate finely nitre, stavesacre, dried figs, and moist alum with vinegar and rose-oil, and anoint with it in the bath; but after the bath, rub in the white of an egg with honey.
Commentary. On diseases of the obscene parts, consult Hippocrates (Epidem. v, 4, et alibi); Galen (Sec. loc. ix; Loc. Affect. vi, 6); Celsus (iv, 21, viii, 18, vi, 18); Aretæus (Morb. Chron. ii, 5); Oribasius (Loc. Affect. iv, 102); Aëtius (xi, 32, xiv, passim); Actuarius (Meth. Med. i, 15, iv, x); Nonnus (192); Alexander (viii, 9, 10); Cælius Aurelianus (Pass. Tard. v, 5); Marcellus (32); Octavius Horatianus (ii, 11); Moschion (de Morbis Mulierum); Scribonius Largus (233); Avicenna (iii, 20, 1, 2); Avenzoar (ii, 3); Haly Abbas (Theor. ix, 37; Pract. viii); Alsaharavius (Pract. xxii); Rhases (Divis. 79; ad Mansor. ix, 101; Contin. xxiv.)
Hippocrates relates a case of prurigo scroti which was removed by hot baths, but the patient afterwards became dropsical and died.
Many of our author’s remedies are taken from Galen, but he has copied most closely from Oribasius and Aëtius.
The treatment of inflammation of the testicles, as laid down by Celsus, is very judicious, namely, bleeding at the ankle, a cataplasm of the flour of beans boiled in mulse with pounded cumin and boiled honey, and other similar applications. When it becomes indurated, linseed or the seed of fenugreek boiled in mulse, or the like, are to be applied. When the testicles swell from a blow, blood must necessarily be extracted from them, more especially if they are livid.
Avicenna is particularly full upon these and all the other diseases of the obscene parts. For pruritus of the testicles and scrotum he recommends bleeding, cupping in the vicinity of these parts, the application of leeches, hot fomentations with acacia, sal ammoniac, &c., and the other remedies mentioned by Paulus. For apostemes he directs us to bleed in the arm and ankle, and to use applications similar to those of our author. Rhases recommends bleeding in the arm and ankle, and at first cold applications, consisting of vinegar and rose-water, which, if the complaint does not abate, are afterwards to be exchanged for suppurative ones. Haly’s treatment is nearly the same. Alsaharavius, like Avicenna, treats inflammation of the testicles by bleeding in the arm and ankle, and using various local applications of a cooling nature. For pruritus he recommends applications containing ceruse, sulphur, nitre, sal ammoniac, and strong vinegar. Rhases mentions that he had an enlargement of the right testicle for which he took an emetic, whereby a manifest reduction of the swelling was produced, and by a repetition of this process the complaint was entirely removed.
SECT. LV.—ON GONORRHŒA AND LIBIDINOUS DREAMS.
Gonorrhœa is an involuntary discharge of semen, taking place frequently without erection of the privy member, owing to weakness of the retentive faculty. In this case it will be proper to keep the patient in a state of rest, covering the loins and pubes with compresses out of wine, oil of apples, or that of the flowers of the wild vine; and cataplasms may be afterwards applied, made of dates, apples, flowers of the wild vine, acacia, hypocistis, sumach, and the like. He may also be made to sit in a hip-bath of the decoctions of lentisk, of bramble, and the like, in wine, or even in water, and use desiccative food. After a little while, he may take gymnastic exercises, by which both the general system and the affected parts will be restored to strength. Redundance of semen has been treated of sufficiently in the First Book, under the head of Hygiene; and there, too, impotence is treated of. A cool couch is beneficial in cases of libidinous dreams; also, laying on the right or left side; all medicines of a cold nature rubbed into the loins, such as coriander, hemlock, ceruse, and purslain, all of which are to be used with vinegar.
Commentary. Celsus recommends strong friction, affusion of cold liquids, swimming in cold water, food and drink of a cooling nature, avoiding everything flatulent and calculated to engender semen, applications such as rue and vinegar to the part, avoiding lying upon the back, and so forth.
Aretæus, in his chapter on Gonorrhœa, makes some very ingenious speculations on the effect which the semen genitale exerts upon the development of the moral character. He remarks that a long-continued draining of the semen sometimes occasions paralysis: he alludes to the tabes dorsalis, a disease well described by Hippocrates. He properly states that gonorrhœa proceeds from relaxation of the genital organs. With regard to the treatment, he recommends at first cooling and astringent applications to stop the flux, but these are afterwards to be exchanged for calefacients and rubefacients. Castor, mint, and the theriac are to be taken internally, along with strong exercise.
Galen defines gonorrhœa to be an involuntary emission of semen, arising from debility of the genital organs, especially of the spermatic vessels.
Aëtius gives a full account of gonorrhœa from Galen, and of oneirogmon from Philagrius, but his treatment is little different from our author’s. For the latter he directs the patient to take such things as are calculated to prevent the formation of semen, as rue, calamint, the chaste-tree, &c.; and further recommends astringent and refrigerant applications, lying on a hard bed, wearing a plate of lead on the loins, and abstaining from the usual provocatives to venery.
The practice of Alexander is exactly the same as that of Aëtius.
Cælius Aurelianus treats oneirogmon upon much the same principles, namely, by cooling applications and injections, the cold bath, astringent food, and so forth. He makes mention of a disease of the genital organs, which we have met with in practice, although we do not recollect to have seen it noticed in any modern author, unless Heberden alludes to it (Comment. 80.) It is an emission of bloody semen in actu venereo. He directs it to be treated by astringent and restorative remedies.
For oneirogmon, the Pseudo-Dioscorides recommends an infusion of the seed of lettuce and purslain, the decoction of nymphæa, &c. (Euporist. ii, 100.) Dioscorides himself recommends hemlock. (Meth. Med. iv, 79.)
Avicenna and Rhases follow the treatment of our author. For the oneirogmon, Haly Abbas recommends various refrigerant and sedative medicines, such as purslain, coriander, lentils, fleawort, poppies, roses, &c. For gonorrhœa he recommends bleeding; emetics if connected with repletion; sleeping in a cold place; various anodyne, astringent, and refrigerant medicines, such as henbane, poppies, roses, lettuce, &c. He also directs a plate of lead to be worn over the loins. Alsaharavius treats minutely of these complaints according to the nature of the exciting cause. His general remedies for gonorrhœa are of a refrigerant and cooling nature, such as citrons, pomegranates, lettuces, henbane, &c. with a plate of lead and other cooling applications. For oneirogmon he recommends liniments of camphor and opium, lying on a hard bed, and refrigerant medicines. Rhases recommends styptic applications, snow, the plate of lead, and the cold bath. He speaks also of rubbing the parts with myrrh, henbane, and opium.
On the pollutio nocturni somni referred to in Deut. xiii, 13, see Isidorus (Comment. in Deut. 20.) Pliny treats of certain herbs which excite, and others which dispel, the “somnia veneris.” Martial, in his epigram addressed to Ponticus, expresses himself in terms of just abhorrence against the detestable vice of manustupration. Galen, however, relates a story of it with disgusting sang froid.
SECT. LVI.—ON SATYRIASIS.
Satyriasis is a palpitation of the genital organ, accompanying some inflammatory affection of the spermatic vessels, with erection; and, if the palpitation do not cease, it is apt to terminate in paralysis of the spermatic vessels, or in spasms. Those affected with convulsion die speedily, having at last inflation of the belly and cold sweats. This complaint sometimes, though rarely, affects women. Wherefore we must open a vein without loss of time, keep the patient upon a spare diet without wine, and purge the belly, not freely but gently, every day. The best articles of food are beet, mallows, a little of the herb mercury, and the soup of the shell-fishes. A simple clyster is no bad remedy. Diuretics must be avoided; and medicines of a cold nature are to applied to the loins, such as the juice of nightshade, of purslain, of henbane, or of hemlock. It may be necessary, also, to rub the penis and the perineum with some soothing and cooling things, such as litharge, Cimolian earth, and ceruse, dissolved in vinegar, water, sweet wine, or rob. It is hurtful to lie on the back. He may drink of the root of water-lily, iris, and maiden-hair. Rue is beneficial both in gonorrhœa and satyriasis. Give, likewise, food from grain in small quantity, and do not gratify the thirst. When the affection is protracted, cupping with scarifications, may be had recourse to; or, if a plethora be present, we may evacuate by leeches. A cataplasm of raw barley-meal may also be applied to the belly.
Commentary. Aretæus has drawn a lively but disgusting picture of a person affected with this complaint, which it is to be hoped that the “march of improvement” in morals has now rendered of rare occurrence. He calls it a most unseemly disease. According to his account, it will even prove fatal occasionally, and that within the space of seven days. He says the natural cure of it is a diarrhœa coming on with bilious discharges. This venereal mania, he says, is to be cured by bleeding from the arm or ankle to deliquium animi, purging with hiera, and wrapping the genital organs and adjoining parts with wool dipped in rose-oil and wine, or in decoctions of such narcotics as hemlock, nightshade, mandrake or poppy; the applications in either case being frequently changed. When these things do not succeed, the neighbouring parts are to be cupped or leeched; and in case of necessity the afore-mentioned refrigerants are to be changed for calefacients, such as the oil of privet, or the Sicyonian oil. This treatment, he remarks, will prove soothing to the nerves. He also recommends castor and a refrigerant diet, from which wine and flesh are to be excluded. It appears, therefore, that our author’s treatment is mostly taken from him.
Oribasius pronounces satyriasis to be a fatal symptom in acute fevers; and Professor Sprengel confirms the justness of this observation. (Hist. de la Méd. t. ii, 188.)
Cælius Aurelianus gives a very circumstantial account of this disease. His treatment differs from that of Aretæus in this respect—that he disapproves entirely of the refrigerant applications, and, instead of them, recommends soothing ones, namely, emollient oils, a hip-bath of oil and water, and the like. He approves also of bleeding, cupping, and leeching.
Octavius Horatianus treats it upon nearly the same principles, that is to say, he recommends fomentations with the vapours of hypocistis or hemlock, hard friction, exercise, and astringent food.
There is nothing original in the treatment of the Arabians. Haly Abbas recommends calefacient and desiccative medicines internally, such as agnus castus, rue, cumin, &c. He also permits the use of narcotics with desiccants, such as coriander, henbane, lettuce, and opium. To the member he directs us to apply a cataplasm containing the oil of roses, lettuce, coriander, and camphor; and when this fails, some opium is to be added. He enjoins hard exercise.
Alsaharavius recommends much the same treatment as our author, namely, bleeding from the arm or foot, diluent and refrigerant draughts, cooling applications containing vinegar, ceruse, &c.; and, if these do not succeed, leeches.
SECT. LVII.—ON PRIAPISM.
Priapism is a permanent enlargement of the penis, which is swelled both in length and circularly, and there is no venereal appetite attending it. The part is swelled by a flatulent spirit engendered from viscid and gross humours by a moderate heat. It is clear, therefore, that the part is not to be heated but cooled moderately, with rose-cerate beat up with water, and with the cerate of chamomile applied to the penis and loins. The diet and medicines should be of an attenuant nature, without being manifestly heating. We must also apply those things which are found, by experience, to be naturally efficacious. We may, therefore, give them also to drink of the water-lily and the seed of the chaste-tree, and mix green rue with their condiments. Yet this must not be given at the commencement, since it is heating, but after the use of other attenuants. If we practise evacuation, it must be by vomiting; for that by the belly often occasions a defluxion to the neighbouring parts. Exercise and friction are to be had recourse to for dispelling the flatus. In none of the cases which we have been mentioning does coition answer, unless when we have reason to suppose that there is a redundance of semen owing to restraint from enjoyment.
Commentary. Many of the ancient authorities make no distinction between satyriasis and priapism, but, according to Cælius Aurelianus, the former is an acute and the latter a chronic disease. Prosper Alpinus, the modern Methodist, says, there is this difference between satyriasis and priapism—that in the former there is violent venereal desire, whereas, in the latter, there is continued erection, but no desire nor emission of semen. It seems, in short, to be a sort of chronic chordee.
Our author, Oribasius, Aëtius, and Actuarius, follow the principles of treatment laid down by Galen. The latter speaks of the anti-aphrodisiacal medicines mentioned by our author.
Alexander forbids the use of such things as are of an intensely cold nature, especially astringents and narcotics. He recommends friction, exercise of the upper parts of the body, and abstinence from flatulent food. All incentives to venery are of course to be avoided.
Avicenna agrees with the Greek authorities respecting the anti-aphrodisiastical properties of rue. Like them, he recommends emetics, but disapproves of drastic purgatives. When the affection is of an inflammatory kind, Haly Abbas recommends general bleeding, cupping, leeches, and applications of a cooling nature, such as vinegar, purslain, solatrum, gourd, &c. Alsaharavius recommends various refrigerant and anodyne remedies, internally and externally.
SECT. LVIII.—ON IMPOTENCE OF THE PARTS.
Those having this complaint have lost their venereal desires, and have become depressed in spirits on that account. The cause of it is a paralysis of the parts, or a defect of semen. Those things which engender semen are treated of under the head of Hygiene in the First Book; and there, too, the incentives to venery of a simple nature are mentioned; and we must now add those which are stronger. Wherefore we must use in general those applications called acopa which are recommended for paralysis; but in particular levigate a burnt swift (stellio), and, adding oil to it, anoint the great toe of the right foot, and then try the venereal act; and when you wish to give over, wash away the ointment from the toe. And the composition from swifts called polymigmaton is a very efficacious application; or propomata from medicines which rouse to erection must be taken, such as this: Of pepper, of pine-nuts, of Macedonian parsley, of the shavings of hartshorn, of turpentine, equal parts; mix with honey.—Another: Of raw chick-peas, of pine-nuts, of each, oz. ij; of rocket, of pepper, of each, oz. j; mix with honey, and give two drachms in wine. And the compound medicine called satyriaca, and such like, will be applicable. But we must also attend to the other causes of the complaint, and apply remedies corresponding to them.
Commentary. This Section is mostly abridged from Aëtius (xi, 35.)
Octavius Horatianus recommends moderate exercise, friction of the extremities, and particularly of the groins, with pepper, euphorbium, and the like; applying plasters (dropaces) of the same to the groins and loins, or making suppositories of them; giving flatulent food, such as rocket, pepper, and the seeds of tares; lying upon a downy bed; having the attendance of females; and indulging in obscene reading.
See a long list of aphrodisiacal medicines in Myrepsus (40); and in Avicenna (iii, 20, 1, 18.) In the latter we remark the nettle, lupine, rocket, asparagus, parsley, cresses, beans, cinnamon, and an animal called dabet alurel, which we conjecture to be the stellio or swift. Haly Abbas treats minutely of this affection, according as it arises from paralysis of the part or defect of semen. In the latter case, as he considers the state of the parts to be connected until a dry and cold intemperament, he recommends juicy flesh, beans, vetches, sweet wine, and so forth. He approves of a hot bath in which violets have been boiled. He also gives calefacients, such as rocket, ginger, asparagus, onions, and the like. Alsaharavius mentions various causes of impotence. One of them is, “excessus delectationis ad illam quam diligit.”
The aphrodisiacal properties of rocket are mentioned by Juvenal (Sat. ix, 134.) See also Pliny (H. N. xix, 6.) Juvenal appears to allude to aphrodisiacal friction. (Sat. vi, 52.)
Athenæus gives a marvellous account of the efficacy of aphrodisiacal medicines. (Deipnos. i, 11.) See the thirty-sixth Section of the First Book of this work.
SECT. LIX.—ON MATTERS RELATING TO THE GENITAL ORGANS AND ANUS.
Ulcers on the pudenda and about the anus, when free from inflammation, require very desiccative applications, such as that from burnt paper, dried burnt dill, and burnt gourd. For humid and recent ulcers, aloes is a good application, when sprinkled on them dry in a fine powder. But the medicine which gives least pain, and is as efficacious as any other, is pompholyx. If the ulcers are more humid, the bark of the pine by itself and bloodstone are proper; but if the ulcers are also deep, manna must be mixed with them; and if the ulcer be spreading, we must apply a cataplasm of dried lentil with pomegranate-rind, and use the plaster called Coracum from oxymel, the trochisk called Bithynus, and that from paper. Fissures in the privy parts and anus are remedied by roasted rosin (colophony?) rubbed with rose-oil, so as to become of the consistence of bath-sordes, and having the yelk of an egg and opium mixed; or the ashes of the dried leaves of ivy burnt, when pounded with rose-oil in a leaden mortar, may be applied. And the trochisk from wine and oil and that from Phrygian stone are excellent applications for fissures and foul ulcers about the corona glandis, more especially when the prepuce cannot be drawn back.—Another simple application, which also blunts acrimony: Of cadmia burnt and washed, oz. ij; of the rose-leaves stripped of their nails (i. e. the white parts of the leaves), oz. vj; sprinkle it dry, having first wiped the part with wine.—The following is an application for condylomata: Of chalcitis, of uncleansed wool, of cerate, of hart’s marrow, of bramble-leaves, equal parts, with cerate; and that from wine and oil in like manner. But if a concealed ulcer is found on the penis within its opening (the urethra), which is discovered from pus or blood being evacuated without urine, it may be cured by first washing it with honey diluted with much water, and then with milk, and then mixing with the milk the collyrium of aster; or the white trochisk, or that from lotus is to be put into a leaden mortar, and the parts anointed, by dipping a feather in it; and then a small twisted tent of scraped linen may be anointed with it and applied. A most excellent application is the one containing of galls, of pompholyx, of starch, and of aloes, equal parts, triturated with rose-oil and the juice of plantain.
For pains of the privy parts. Apply equal parts of butter and of rosin, both properly melted; or apply equal parts of myrrh and of roasted rosin (colophony or fiddlers’ rosin?) triturated with the juice of the plantain.
For swelling of the penis. Of tender vine-leaves, dr. j; of ceruse, dr. v; triturate and apply; bathe with cold sea-water; enjoin rest; and apply bandages to the penis. The lixivial ashes of vine-twigs applied with vinegar cure thymous tumours of the penis, and do not permit them to increase again; and so in like manner the ashes of the burnt bark of willows. In general the thymus, myrmecia, and acrochordon will be eradicated by strongly corrosive applications, and become dead when treated with septics. But, in particular, elaterium when applied with salts is useful, also unripe figs with vinegar, nitre, and flour, and the juice of the fig when rubbed in; the burnt head of an anchovy pickled, verdigris calcined with native sulphur, the juice of tithymallus (spurge?) when rubbed in, the leaves of basil with copperas, or the fruit of the large sunflower applied with wine.
For inflammation of the anus. Of ceruse, oz. iv; of pompholyx, oz. j; or of soft cadmia, of frankincense, oz. j; of the juice of endive, one hemina; mix, adding the juice by degrees until it be all consumed, and then having made a cerate of two ounces of wax, and one pound of rose-oil, mix; and having shaved the part, soften with this strongly. Inject by an instrument for extricating pus, and apply a bandage above. It is of use for inflammatory fissures, and ulcers of the anus attended with heat or pruritus.
For erysipelas about the anus. Of diachylon plaster, lb. j; of rose-oil, q. s; of pure bread, lb. j; of saffron, oz. j; of opium, oz. j. The saffron and opium are macerated in must, and the bread in water; then, when they are pounded, the diachylon and rose-oil are put into them and allowed to soften. It is also applicable to gout attended with the greatest heat.—Another, applicable also to inflammation of the anus: Triturate ceruse with wine and rose-oil in a leaden mortar with a leaden pestle, anoint with it; or, having triturated ceruse, the white of an egg, and rose-oil in the same mortar until it become of the consistence of bath-sordes, anoint with it.
For acute pain of the anus. Of the tender leaves of henbane, of the tender leaves of purslain, of crumbs of bread soaked in wine, of the yelks of roasted eggs, equal parts; of rose-oil, q. s. After fomenting the part with the decoction of roses and melilots, apply this cataplasm.
An excellent application for inflammation of the anus, and, excrescences thereof. Of ceruse, of litharge, of ammoniac perfume, of bdellium, of each, scr. vj; of turpentine, oz. j; of wax, oz. ss; triturate the powders with the juice of nightshade, of henbane, or of purslain; and having mixed the soluble articles, take, and having softened them with rose-oil, use. And the composition called Phicotyche, and that from plumbago, are excellent applications for inflammations of the fundament. And the trochisks from lotus, from winter-cherry, and that from roses are esteemed applications for the anus and privy parts.
For excrescences of the anus. When these excrescences are inflamed, we must use the general applications already mentioned, and in particular the following trochisk: Of ceruse, oz. iij; of pompholyx, oz. j; of litharge, oz. ij; of mastich, scr. iij, add to the juice of henbane. When they are free from inflammation, sprinkle the ashes of burnt cypress balls, having first washed the parts with wine, or the ashes of the burnt peel of dried gourd, or of the bones of dates in like manner, or the ashes of eggshells and of fennel; or having mixed the juice of pomegranate leaves with an equal portion of white wine, wash with it for seven days. For callous excrescences: Triturate quicklime and arsenic with strong vinegar. It will answer well if you anoint with it in the sun.
On hemorrhoids or piles. When piles discharge more than is proper, the consequence is, that the system is reduced to a watery state, and they lose their appetite. There is risk both from the hemorrhage becoming too profuse, and from its being altogether suppressed; and therefore the treatment is attended with difficulty. Wherefore, when the piles are numerous, one ought always to be left for the sake of purging the system. Some also are seated high up and do not make their appearance, which renders them difficult to be cured. Blind piles discharge nothing, but are on that account more painful than the others. On them, therefore, rub the juice of sow-bread, which will open them. For immoderate discharges, take of the Egyptian thorn, of the leaves of the elder, of mugwort, of each, oz. v; boil in eight heminæ of water to one-half, and add of ironwort oz. iv. The herbs are then to be thrown away, and to the decoction the following things are to be added in powder: Of melanteria, of round alum, of each, dr. viij; of litharge, dr. iv; of galls, oz. iij; of misy, dr. ij; of endive, dr. ij. Dissolve this powder in the decoction, and bathe with it seven times in the day; but on the following day bathe with an equal quantity of another preparation of the same kind, and on the third in like manner. If any part of them remain on the fourth day, pierce it with a needle, and if it has any feeling, or bleeds, prepare a decoction like the former, but add only one-half of the powder; but when you have washed until it touch with the powder, that they may be properly burnt. For the inflammation apply a bread-poultice.—Another: Having soaked pure bread in primary sauce, and haring burnt it in a new pot, triturate, and apply it, having first bathed with wine. It is applicable also to excrescences.—Another: Of endive, dr. ij; of chalcitis, dr. j; of misy, dr. j; of copperas, dr. iij; of fissile alum, dr. ix; of burnt copper, dr. j; of melanteria, dr. j; use in a powder. The food for those who have immoderate discharges should be such as forms but little blood, and is not excrementitious, of a desiccant and astringent nature, such as chondrus soaked in oxycrate, rice, and halica, and of pot-herbs, intybus, succory, and purslain, and of wines such as are astringent. For blind piles, food of an opposite description is proper, but particularly the fish called calamary, the cuttle-fish, polypus, the torpedo, and the cartilaginous fishes; for these things raise a tumult in the blood. Emmenagogues are also proper remedies in this case.
For procidentia ani. Of the fruit of heath, of galls, of ceruse, of acacia, of the juice of hypocistis, of pine-bark, of frankincense, of Aminæan myrrh, equal parts; apply in a powder, having first bathed with austere wine.—Another: Of the dross of lead, of Syriac sumach, of each, oz. viij; of the flowers of roses, dr. iv; of Aminæan myrrh, dr. ij; use like the first.—Another: Of pine-bark, of manna, of litharge, of each, dr. viij; of dried cypress balls, of plumbago, of each, dr. ij; use as directed above. Bathing with the patient’s own urine while yet warm is also useful.
Commentary. Consult most of the works referred to in the fifty-fourth Section.
The first part of this Section is almost entirely taken from Galen (sec. loc. ix); the remainder seems to be abridged from Aëtius (xiv.) Galen (Meth. Med. v, 15) insists strongly that diseases of the penis should be treated with desiccative instead of epulotic applications.
No ancient author has treated so fully of diseases of the genital member as Celsus (vi, 18.) His description of the ulcers upon it is very minute. Ulcers, he remarks, are found either upon the prepuce, or on the glans, or beyond it on the member itself. If dry, they are first to be bathed with warm water, and then lycium (catechu?) out of wine, or the lees of oil boiled with the same, or butter with roses is to be applied. If there is a slight discharge, they are to be washed with wine; then honey and a fourth part of turpentine-rosin are to be added to the butter and roses for an application. When there is a purulent discharge it is to be washed away, and the part dressed with an application containing pepper, myrrh, saffron, and misy, boiled in austere wine to the thickness of honey. He mentions various other escharotics containing ærugo, alum, and the like. When at any time inflammation comes on, a cataplasm must be applied. Spreading ulcers are to be treated with applications containing the escharotics we have just mentioned. When a watery sanies runs from the sore it is to be treated with basilicon (tetrapharmacon) melted with roses and some frankincense; and it is to be frequently bathed with hot water and covered up from the cold. The tubercles called phymata are to be burnt down with medicines or a cautery of iron, and when the crust falls off, the squama æris is to be sprinkled on the part. Cancerous sores are to be extirpated by escharotics, as by a composition of quicklime, chalcitis (sulphate of copper?) and arsenic; or they are to be cut out and the part burnt. Phagedænic sores in like manner are to be burnt with medicines or the actual cautery.
Avicenna approves of Galen’s rule of treatment stated above. When sores are recent, he recommends in particular aloes, and when more humid, burnt copper. When an incarnant is required, frankincense is to be mixed. Prurigo is to be cured by venesection, purging, and liniments containing nitre, alum, sal ammoniac, or even stavesacre with vinegar or rose-oil. For prurigo, Alsaharavius recommends lotions of sea-water, decoctions of chamomile, saffron, and camphor pounded with vinegar, and the like applications. For hard pustules he recommends various corrosive applications, some of which contain arsenic. Haly Abbas remarks that ulcers on the genital membranes are attended with the same symptoms as those on other parts.
On diseases of the anus. Celsus has likewise treated very fully of these complaints. For rhagadia or fissures he recommends first the hot bath, and afterwards cooling ointments, such as old oil with litharge, and unwashed wool spread with a composition of liquid cerate and roses. The regimen is thus tersely pointed out: “Liquida, lenia, pinguia, glutinosa, meliora sunt.” The tubercle called condyloma is said to derive its origin from inflammation, and is to be treated at first by making the patient sit in a hip-bath of water having vervain boiled in it; and then lentil with some honey, or a composition containing chalcitis, or alum with ceruse and litharge, or the like, is to be applied. If these do not succeed, the escharotics, such as verdigris, antimony, &c., or even the more powerful caustics are to be used. He treats hemorrhoids upon much the same plan as our author. He begins by inculcating that there is danger in suppressing them suddenly. They are to be treated at first upon the soothing plan, by baths, emollient applications, and those directed for fissures. When these fail, strong caustics are to be applied, such as the composition consisting of arsenic, squama æris, and quicklime. Next day they are to be pierced with a needle. In certain cases he prudently directs bleeding from the arm. Procidentia ani is to be treated in the first place by fomenting the gut with austere wine and the like, and replacing it; and then applying the leaves of willow boiled in vinegar, a linen compress, wool, and a bandage. Fungous ulcers are to be bathed with tepid water, if in winter, or with cold if at any other season; and then sprinkled with squama æris, or dressed with a cerate containing the same with quicklime, &c. If these do not succeed, the parts must be burnt with potential or actual cauteries.