The next disorders we are to treat of, are those of the private parts. The names of which amongst the Greeks are both more tolerable, and already established by custom; since they are of common use in almost every book and discourse of physicians: with us the terms are more indecent, and have had no sanction from the conversation of modest men to qualify their coarseness. This makes it difficult to treat of them so, as at once to preserve a delicacy of expression, and deliver plainly the precepts of the art. Nevertheless this circumstance ought not to deter me from writing. In the first place, because it is my intention to comprehend every thing, that I have learned to be useful; in the next place, because every body should know how to cure those disorders, which we are so unwilling to expose to another.

Therefore, if the penis be swelled from an inflammation, and the prepuce cannot either be drawn back, or brought forward again, the part must be fomented plentifully with warm water. And when the glans is covered, warm water must also be injected by a syringe, betwixt it and the skin. If the skin, mollified and extenuated by this means, can be drawn back, the subsequent part of the cure is more easy; if the swelling prevails against this remedy, lentils, or horehound, or olive leaves boiled in wine must be applied, and to any of these, while it is rubbed, a little honey is added; and the penis is to be tied up to the belly; which is necessary in the cure of all its disorders; and the patient ought to confine himself to a strict regimen, and abstain from eating, and relieve his thirst by nothing but water. The day following, the fomentation of water must be applied in the same way, and trial made, even with some degree of violence, to pull back the prepuce; if it will not give way, the surface of it must be slightly cut with a knife. For when the sanies is discharged, the part will be extenuated, and the prepuce more easily drawn back.

Whether it has yielded to the latter method, or has never resisted, ulcers will be found, either in the inner part(15) of the prepuce, or in the glans, or in the penis beyond that; which must, of necessity, be either clean and dry, or humid and purulent. If they be dry, they must be first fomented with hot water; then lycium, with wine applied, or oil lees boiled with the same, or rose oil with butter. If there is a thin humour in them, they must be washed with wine; then a little honey and oil of roses with butter, and a fourth part of turpentine resin must be used. But if pus is discharged from them, first of all they ought to be washed with warm mulse; after which is applied of pepper p. i. *. myrrh p. ii. *. saffron, calcined milsy, each p. ii. *. which are boiled with a rough wine, to the consistence of honey. The same composition is also proper for the tonsils, a moist uvula, and ulcers of the nostrils and mouth. Another for the same purpose: of pepper p. i. *. myrrh p. i. *. saffron p. ii *. milsy p. i. *. calcined copper p. ii. *. which are first rubbed down with a rough wine, then when they have grown dry, they are again rubbed with three cyathi of passum, and boiled to the consistence of viscum. Verdigrease too, with boiled honey, and those compositions, which were mentioned before, for ulcers of the mouth, cure these. But the composition of Erasistratus, or Crato, is a proper application for purulent ulcers of the parts of generation. Olive leaves also are boiled in nine cyathi of wine(16), and to these are added of scissile allum p. iv. *. lycium p. viii. *. honey a cyathus and half; and if the quantity of pus be pretty great, this medicine is diluted with honey; if small, with wine. This is a constant rule; after dressing, while the inflammation continues, to apply over it such a cataplasm, as before directed, and to dress the ulcers every day in the same manner. But if pus begins to be discharged in a great quantity, and is fetid, the ulcer ought to be washed with cream of lentils, with the addition of a little honey, or a decoction of olive, or mastich leaves; or a decoction of horehound used in the like manner with honey. And the same dressings must be applied; or else omphacium with honey; or that composition for the ears, which is made of verdigrease and honey; or the composition of Andron; or an anthera, with the addition of a little honey. Some dress all the ulcers, which we have yet mentioned, with lycium and wine.

If the ulcer increases in breadth and deepness, it ought to be washed in the same manner; and either verdigrease, or omphacium with honey, applied; or Andron’s composition; or of horehound, myrrh, saffron, scissile alum calcined, dry rose leaves, galls, each p. i. *. Sinopian minium, p. ii. *. which are first powdered separately; then mixed and rubbed together in honey, till they acquire the consistence of liquid cerate; after which they are boiled in a copper vessel, gently, so as not to boil over; when the drops of it grow hard, the vessel is taken off the fire; and this medicine, as occasion requires, is softened, either with honey or wine. The same composition, by itself, is also good for fistulas.

Sometimes too, the ulcer penetrates to the nerves; and there is a plentiful discharge of humour, and thin sanies and fetid, of no consistence, but like water, in which recent flesh has been washed; there are pains and prickings in the parts. Although this be of the purulent kind, yet it must be cured by mild medicines; such as the tetrapharmacum plaister, liquified with rose oil, and mixed with a little frankincense; or that, which is made of butter, rose oil, resin, and honey, already mentioned. Above all, this ulcer is to be fomented with abundance of warm water, and covered, and not exposed to the cold.

Sometimes also, by these ulcers, the penis under the skin is so consumed, that the glans falls off. In which case, the prepuce itself must be taken off by circumcision. And it is a general rule, whenever the glans, or any part of the penis falls off, or is cut off, that the skin be kept from falling in contact and uniting with the ulcer(17), so that it cannot be drawn back afterwards, and perhaps may even obstruct the urinary passage.

Tubercles likewise, which the Greeks call phymata, arise about the glans; which are cauterized either by medicines, or the actual cautery; and when the sloughs cast off, copper scales are sprinkled upon them, to prevent any thing growing there again.

In what we have hitherto described there is still no gangrene; to which, as in the other parts, so more especially here, ulcers are liable. It begins with a blackness. If this seizes the prepuce, a probe must be immediately put under it, and an incision made; then the extremities are to be laid hold of with a vulsella(18), and whatever is corrupted must be cut away, and even some of the sound part taken off, and the place cauterized. Whenever any part is burned, the next step is to apply lentils; afterwards, when the sloughs have cast off, the cure is the same with that of common ulcers.

But if a gangrene has seized the penis itself, some of the escharotic medicines must be sprinkled upon it, chiefly that, which is composed of lime, chalcitis, and orpiment. If medicines fail of success, here also whatever is corrupted is to be cut out with a knife, in such a manner as that some of the sound part be taken with it. This rule is as universal as the former, when a gangrened part is cut away, that the wound must be cauterized. But if either by means of medicines, or the actual cautery, the sloughs have grown callous, there is great danger, that when they cast off, a profusion of blood from the penis may follow. Therefore long rest is necessary, and keeping the body almost immoveable, till the sloughs be gently loosened from it in proper time. But if a person either wittingly, or inadvertently, by walking too soon has separated the sloughs, and there ensues a hæmorrhage, cold water must be applied. If that does not prevail, recourse must be had to those medicines, which stop blood. If even these do not relieve, the part must be cauterized carefully and cautiously; and not afterwards exposed to the same danger by any motion whatsoever.

Sometimes also in the same place there happens that kind of gangrene, which the Greeks call phagedæna[ GL ]. In which no time is to be lost, but the same remedies must be immediately applied; and if these are not successful, it must be burnt by the actual cautery. There is likewise a certain blackness, which gives no pain, but spreads, and if we do not resist it, it makes its way to the bladder; and cannot be cured afterwards. But if it be at the end of the glans near the urinary pipe, a small probe should be introduced into that first, to prevent its closing; and then the actual cautery must be applied to the ulcer. But if it has penetrated deep, whatever is tainted must be cut off. For the rest, it must have the same treatment with other gangrenes.

There is likewise sometimes a callous excrescence from the penis, which is almost void of all sensation, and ought to be cut out. A carbuncle, as soon as it appears there, must be washed by means of a syringe; then it must be cauterized too with medicines, particularly chalcitis with honey, or verdigrease with boiled honey, or sheep’s dung toasted and powdered with honey. When it falls off, liquid medicines must be used, which are composed for the lips of ulcers.

If any inflammation begins in the testicles without a blow, blood must be taken from the ancle; the patient must abstain from eating; that composition must be applied, which consists of bean meal boiled in mulse, then mixed with powdered cummin, and worked up to a consistence with honey; or powdered cummin with cerate made of rose oil; or lintseed toasted, powdered, and boiled in mulse; or wheat meal boiled in mulse with cypress; or lily root bruised. But if the testicles are grown hard, lint or fenugreek seed, boiled in mulse, should be applied; or cerate made of cyprine oil; or fine flour rubbed with wine and the addition of a little saffron. If the hardness be already of pretty long standing, the root of wild cucumber boiled in mulse and then bruised does a great deal of service.

If they are swelled from a blow, it is necessary to let blood, and more so if they are livid besides; and either of these compositions made with cummin above mentioned must be applied; or that composition, which contains of nitre calcined p. i. *. pine resin, cummin, each p. ii. *. stavesacre without the seeds p. iv. *. honey, a sufficient quantity to bring them to a consistence. But if from the blow the testicle ceases to receive nourishment, there is generally a collection of pus at the same time, and there is no other remedy for it, than by making an incision in the scrotum, to discharge the pus, and extirpate the testicle itself.

The anus too is liable to many and very tedious disorders; and these are cured by methods not very different from one another. In the first place it is a common ailment here, that the skin is chopped, and that in several places: the Greeks call it rhagadia[ GM ]. When this is recent, the patient ought to rest, and sit down in hot water. Pigeons eggs are also to be boiled, and when they are hard, the shells taken off, after that one of them ought to lie in water well heated, while the part is fomented with the other warm; and thus each of them must be used alternately for some time. Then the tetrapharmacum or the rhypodes must be softened with rose oil; or recent œsypum mixed with liquid cerate made of rose oil; or to the same liquid cerate must be added washed lead; or myrrh to turpentine resin; or old oil to litharge: and the part anointed with any of these. If the part affected be external, and not concealed within, a piece of lint dipped in the same medicine ought to be applied to it, and whatever is laid first on, must be covered with cerate. In this case neither acrid food, nor austere, nor binding must be used; nothing even dried is good, unless the quantity be very small. Liquid, mild, fat and glutinous food is better. There is no reason to refrain from the use of mild wine.

A condyloma is a tubercle, which commonly proceeds from some inflammation. When it appears, the directions must be observed, which were just now given, with regard to rest, meat, and drink. It is proper to foment this tubercle with eggs, as in the other case. But the patient should first sit down in a decoction of repellent vervains in water; then it is fit to apply lentils with a small proportion of honey, mellilot boiled with wine, and bramble leaves bruised with cerate made of rose oil; and with the same cerate either a quince bruised, or the inner part of pomegranate bark boiled in wine; and chalcitis burnt, and powdered, then mixed with œsypum and rose oil; and some of that composition, which contains of frankincense p. i. *. scissile alum p. ii. *. ceruss p. iii. *. litharge p. v. *. to these, while they are powdered, is instilled alternately oil of roses and wine. The bandage for that part is a square piece of linen or woollen cloth, which at two of its corners has two loops, and at the other as many fillets; and when it is put under the patient, the loops being turned toward the belly, the two fillets from behind are put through them, and when drawn tight, the right one must be extended to the left, and that on the left to the right, and lastly both being brought round are tied in a knot over the belly. But if the condyloma be inveterate, and is grown hard, and does not give way to these methods, it may be cauterized by a medicine, which consists of the following ingredients; of verdigrease p. ii. *. myrrh p. iv. *. gum p. viii. *. frankincense p. xii. *. antimony, poppy tears, acacia, each p. xvi. *. with which medicine some chuse to renew those ulcers of which I was lately treating. If this has no effect upon the condyloma, even stronger caustics may be used. When the tumour is consumed, we must change to the mild applications.

The third disease of the anus is when the orifices of the hemorrhoidal veins grow turgid, and shoot out something like small heads, which often discharge blood; the Greeks call them the hæmorrhoides[ GN ]. And this frequently happens to women in the mouth of the womb. And it is not safe to stop it in some people, who are not weakened by the discharge of blood: for this serves for a drain, and is not a disease. And therefore some that have been cured, as the blood had no exit, have been seized with sudden and very dangerous distempers, from the matter settling upon the præcordia and bowels. But a man that feels bad effects from this discharge, ought to sit down in a decoction of vervains; and to apply principally pomegranate bark powdered, with dry rose leaves; and some of those things, which stop blood. An inflammation sometimes comes on, especially when hard excrements hurt the part. Then the patient must sit down in pure water, and foment the part with eggs, and apply the yolks with rose leaves beat up with passum; and if the disorder be within, this must be put to it with the finger; if without, it must be applied spread upon a cloth. Those medicines too, which are calculated for recent fissures, are suitable here. And the same diet must be used in this, as in the former cases. If these methods give but little relief, it is usual by the application of caustic medicines to consume these small heads. But if they be inveterate, by the direction of Dionysius, sandarach is to be sprinkled upon them; after that the following composition must be applied: of copper scales, orpiment, each p. v. *. stone lime p. viii. *. the next day, they must be punctured with a needle. By cauterizing these small heads a cicatrix is formed(19), which prevents the effusion of blood. But whenever this is stopped, to avoid any dangerous consequence from the suppression, the matter must be dissipated by much exercise; and besides both men, and such women, whose menstrual discharge is stopped, ought sometimes to be bled in the arm.

But if the anus itself, or the mouth of the womb fall down (for that sometimes happens) it ought to be considered whether the part, which is protruded, be clean, or covered with a mucous humour. If it be clean, the patient ought to sit down in salt water, or a decoction of vervains or of pomegranate bark in water: but if moist, it must be washed with a rough wine, and rubbed with burnt lees of wine. When it has been treated in either way, it must be replaced; and an application made of bruised plantain, or willow leaves boiled in vinegar; over that, linen and wool: these must be tied on, and the legs bound close together.

There sometimes appears an ulcer in the same part resembling a mushroom. This, if it be the winter-time, must be fomented with water just warm; if any other season, with cold; afterwards it must be sprinkled on copper scales, and over that cerate applied made of myrtle oil, with the addition of a little scales, soot, and lime. If it is not removed in this method, it must be consumed either by stronger medicines(20) or the actual cautery.