Of the complaints which befal women in a pregnant state, the most troublesome are a redundance of crudities, continued vomiting, salivation, heartburn, and loathing of food; it will therefore be proper to give directions regarding them. The most suitable remedies are, exercise on foot, food not too sweet, wines which are yellow, fragrant, and about five years old, and moderate drink. All these things are proper for the cure of crudities and vomiting. For medicines, you may give the plant of knot-grass, boiled in water, for drink; and likewise dill, and the Pontic-root, called Rha, in the dialect of its native country. These things may be taken at a meal, or before it. Externally, the flowers of the wild vine, those of the wild or domestic pomegranate, the leaves of the alsanders (smyrnium), and the seed of the fennel, may be mixed together according to pleasure, along with dates and old wine, and applied to the præcordium in the form of a cataplasm. Heartburn may be alleviated by drinking warm water, by gentle exercise on foot, and by covering the hypochondrium with soft wool. In the case of those who have an aversion to food, whet their appetite with a variety of articles of a savory nature, and also give dry starch. This last is particularly serviceable to those who long to eat earth, as is the case in the complaint called Pica, which occurs most frequently about the third month after conception; because the fœtus being then weak, cannot consume all the aliment which is brought to the uterus, and hence various superfluities are collected in the stomach; and therefore they have a desire for complicated and improper articles, such as extinguished coals, Cimolian earth, and many more such things. On that account, the affection has got its appellation, either from the variety of colours which the bird Pica possesses, or from its being subject to this complaint. Labour and long journeys will also contribute to restore a desire for wholesome food. But she who has accustomed herself to live in an indolent manner, will not be able, when she proves with child, to bear exercise all at once. To those who loathe food, it may be of service to take acrid substances, and particularly mustard. For swellings of the feet, it may be proper to bind over them the herb anthyllis, soaked in vinegar; or to lay the leaves of a cabbage over them, and to anoint them with Cimolian earth mixed with vinegar, or with alum and vinegar. It is likewise of use to sprinkle the feet with a decoction of the Median apples, called citrons.
Commentary. We shall commence by giving a short account of ancient opinions on a curious subject not touched upon by our author,—we mean, on the influence of the imagination in pregnant women on the fœtus.
Hippocrates says, that when pregnant women long to eat coals and earth, the likeness of these things appears on the head of the child. (De Superfœt. c. 8.) Galen likewise believed in the influence of the imagination of pregnant women on the fœtus in utero. (Ad Pison.) Soranus also was a firm believer, and gives instances in women and in the inferior animals of the force of imagination at the time of impregnation. (lib. vii.) This belief was very ancient, for it appears to be countenanced by the Jewish historian. (See Genesis, xxx, 37-9.) Traces of this opinion may be found in Hesiod; and distinct allusion to it is made in the ‘Cynegetics’ of Oppian. (i, 327.) The story in the ‘Æthiopics’ of Heliodorus respecting Chariclea, the white daughter of the black king and queen of the Æthiopians, bespeaks the prevalence of the belief at the time when this celebrated romance was written. Andreas Laurentius gives an interesting statement of ancient and modern opinions on this subject. (De Mirab. Strum. Sanit.)
The bird pica is mentioned by name (κίττα) in the ‘Aves’ of Aristophanes. (See also Schol. in Aristoph. in Pac. 496, and Vesp. 348; Aristotle, Hist. An. vii, 4; and Pliny, Hist. Nat. x, 41.) Harduin concludes, from Pliny’s account of it, that it was the magpie. But we are rather inclined to follow Schneider in referring it to the jay, or corvus glandarius.
On the disease, see Galen (Hyg.; de Causis Sympt. i, 7); Aëtius (xvi, 10); Theophanes Nonnus (c. 213); Moschion (de Morb. Mulier. c. 27); Eros (apud Gynæcia), Alexander Aphrodisiensis (Problem. ii, 73); Pseudo-Dioscorides (Euporist. ii, 16); Soranus (viii); Leo (vi, 14); Rhases (Contin. xi); Avicenna (iii, 21, 2); Haly Abbas (Theor. vi, 17); Serapion (Tr. iii, 22); Alsaharavius (Pract. xxv, 2, 8.) It appears to be the malacia of Pliny (Hist. Nat. xxiii, 56, ed. Hard.)
Moschion defines the Pica to be an appetite for unusual food, which happens to pregnant women at some irregular period; being attended with a collection of depraved humours and nausea. It occurs, he says, most commonly in the second month, but sometimes earlier, and sometimes later. He recommends a restricted diet at first, then wine, dry astringent food, cataplasms of a repellent nature, and bodily motion.
Soranus treats of Pica in very similar terms to those of Moschion.
But the account of the disease given by Galen and Aëtius is the fullest. They derive the name either from the bird, as mentioned above, or from ivy (κίττος), because, as ivy entwines itself about various plants, so does this appetite in pregnant women fasten upon a variety of improper articles of food. It is attended with languor of the stomach, nausea, and loathing of food, bringing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All these symptoms arise, they say, from a sanguineous plethora, brought on by a suppression of the menstrual discharge. They, therefore, recommend a restricted diet, and moderate exercise when the woman was accustomed to it. When the humour which infests the stomach is of an acid, acrid, or saltish nature, they direct draughts of tepid water, to encourage vomiting; they forbid all sweet things; and recommend an old sub-astringent wine. When there is a loathing of food, they advise us to tempt the appetite with a variety of savory things. To those who have a desire for eating earth, they particularly recommend starch. When the fluid which is vomited is of a thick and viscid nature, they recommend pickles, radishes, and oxymel, for an emetic. They also particularly direct astringent cataplasms and plasters to be applied to the præcordia.
As the practice of the other authorities is conducted upon similar principles, we shall mention them very succinctly. For the depraved appetite which longs for earth, Serapion recommends aromatic spices, such as cardamon, cubebs, and the like. For the continued vomiting, Alsaharavius directs plasters, containing the oil of spikenard, mastich, quinces, wormwood, and the like, or a vessel filled with hot water, to be applied over the stomach, pomegranate seeds to be held in the mouth; and that the patient should take gentle exercise, and abstain from all sweet things.
Alexander Aphrodisiensis accounts for the disease in much the same way as Galen and Aëtius. He says that, when the menstrual fluid is suppressed, a determination of it takes place to the stomach, until the fœtus becomes as large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the œdematous swellings of the feet and legs, most of the other authorities concur with our author in recommending astringent applications. The anthyllis, mentioned by him, is supposed by Sprengel to have been the cressa cretica. (R. H. Hist. p. 164.)
We shall conclude our commentary on this Section with an outline of the directions given by Aspasia for the management of pregnant women. Women who have conceived are to be guarded from frights, sorrow, and all violent mental perturbation. They are to avoid gestation in carriages, severe exercise, inordinate breathing and blows about the loins; also the lifting of heavy loads, dancing, and sitting on hard seats. Likewise all acrid and flatulent food, strong clysters, and too much or too little food and drink are to be avoided. All discharges of blood, whether from the nose or hemorrhoids, are dangerous in the pregnant state. Moderate and wholesome food, gestation in a sedan, gentle walking, soft friction, and the exercise of spinning are proper. About the eighth month, which is the most critical period of pregnancy, the diet is to be more contracted, and the exercise increased. If the bowels are constipated owing to compression of the rectum, by the enlarged uterus, laxative food is to be given, such as ptisan and mallows. In the ninth month the regimen is to be of a relaxing nature, and for this purpose the tepid bath is to be frequently taken, for it has a great effect in rendering parturition easy. (Apud Aëtium, xvi, 12.)
Our author borrows part of this chapter from Oribasius, and abridges the rest from Galen and Aëtius.
A nurse is to be chosen who is free from every complaint, and is neither very old nor very young. She ought not to be less than twenty-five nor more than thirty-five. Her chest should be large, as also her breasts, and her nipples neither contracted nor turned aside. The rest of her body should be neither very fat nor very spare. It is of great consequence to the child that his nurse should have brought forth but a short time before, and that her child had been a male rather than otherwise. She ought to avoid everything of a very desiccative nature, and likewise such as are saltish, acrid, sour, acid, bitter, very heating, or of an offensive smell: also, such as are strongly fragrant, condiments, and such like acrid substances. Let the nurse also abstain from venery. Let her work with her hands and shoulders, let her labour at the mill and the loom, and carry about the child in her arms. This may be done for three or four months.
Commentary. This Section is taken from Oribasius. (Synops. v, 2.)
Aëtius gives somewhat fuller directions. He says, the nurse ought not to be younger than twenty, nor older than forty; should be free from disease, and have breasts neither too small nor too large; for when the breasts are too large, they contain more milk than the child can manage: and part being retained spoils, and proves injurious to the child, and even affects the health of the nurse; when too small, on the other hand, they do not contain a sufficient supply of milk. Large nipples, he remarks, hurt the gums, and impede deglutition; whereas, when too small, they cannot be got hold of. The nurse, he says, should be chaste, sober, cleanly, and cheerful. (iv, 4.)
The directions given by the other authorities, are very similar to our author’s. See, in particular, Rhases (ad Mansor. iv, 30); Avicenna (Cantic.); Averrhoes (in Cant. p. ii, tr. 1.) Avicenna says, the nurse ought to be from twenty-five to thirty-five years old. Averrhoes says, from twenty to thirty.
It appears to have been a general practice among the Romans, after they became luxurious and effeminate, for the ladies of noblemen to consign the care of their infants to wet nurses. Tacitus, in his elegant dialogue ‘de Oratoribus,’ inveighs against this practice. See also a spirited declamation on this subject, by the philosopher, Phavorinus, in the ‘Noctes Atticæ’ of Aulus Gellius. (xii, 1.)
The best milk is that which is moderate in thickness, quantity, colour, smell, and taste. It is a proper way to try the quality of the milk, by pouring a little of it upon the nail of the thumb and observing it in the sun; for, when upon turning the nail, it neither runs off too slowly nor too quickly, it is good milk. You may also try it thus: by pouring some milk into a glass vessel, and putting some runnet into it, then squeezing them together with your fingers, allow it to coagulate, and observe whether the cheesy part be less than the serous; for such milk is unsuitable, and also the opposite kind is of difficult digestion. The best kind is that which has a moderate proportion of each.
Commentary. This Section is taken from Oribasius (Synops. v, 3), and Aëtius (iv, 3.)
The method of trying the quality of the milk here recommended is mentioned by Aëtius, Barytus (ap. Geopon. xviii, 20), Dioscorides, Avicenna, Haly Abbas, and Alsaharavius. According to Avicenna, a child ought not to be allowed to take suck oftener than twice or thrice in the day. See, in particular, Haly Abbas (Pract. i, 21), and Alsaharavius (Pract. xxx, 3.)
The bad qualities of milk may be thus corrected. If it be too thick, the phlegm ought to be evacuated by vomits, the most proper of which are those of vinegar and honey. It is also proper to extenuate by labour before meals. Also the following substances are proper, namely: wild marjoram, hyssop, savoury, shepherd’s needle, thyme, the small radish, and old pickle with vinegar and honey. But if it be more acrid and thinner than natural, the nurse ought to be relieved from much labour, to be fed upon strong soups, and the flesh of swine, and to be allowed sodden must and sweet wine. If it be in too small quantity, she ought to get soups and a generous diet, with sweet wine for drink; and her breast and nipples should be rubbed. The cupping instrument, if applied, will also be of service. That medicines for the formation of milk, are possessed of some efficacy, I am well aware, and yet I do not recommend them in all cases, for they greatly waste the body. They are, the root and fruit of the fennel boiled in ptisan, the leaves of the cytisus in dark-coloured wine or ptisan, the sweet gith (melanthium), dill, the root and fruit of the carrot. They are to be first soaked with warm water, and then given. But when the milk is bad, whether it be thick, acrid, or of a strong smell, it is first to be sucked out and then the child is to be applied. For that which is acrid ought, on no account, to be given to the infant when hungry; but that which has an offensive smell may be corrected by fragrant wine and sweet food. Of coagulated milk in the breasts, we will treat in the Third Book.
Commentary. Aristotle forbids wet nurses to drink wine. It is the same thing, he adds, whether the nurse or the child drink it. (De Somno.)
Oribasius, Aëtius, and Avicenna give similar directions to our author’s. They all permit nurses to take a moderate allowance of animal food and wine. When the nurse has too little milk, Aëtius recommends her to drink ale (Zythus.) He also approves of sweet wine, gruels prepared with fennel, or green dill boiled with ptisan. When the milk is thin, he directs her to abstain from baths, and to take food of a nutritive quality, such as fine bread, the legs of swine, tender birds, the flesh of kids, and sweet wine. When the milk is thick, he recommends frequent baths, and an attenuant diet. When it is excessive, he directs her to diminish the quantity of the food, and to take what is less nutritive, and to make discutient applications to the breasts, such as a linen cloth dipped in vinegar, and to wash them frequently with warm salt water, or the decoction of myrtle.
Hippocrates forbids the nurse to take things of an acrid, saltish, acid, or crude nature. He recommends fennel, cytisus, parsley, and the hot bath as a general regimen to nurses. (De Mulieb.)
Haly Abbas gives similar directions. He properly recommends the nurse to abstain from taking things of a pungent, sour, and bitter nature. When the nurse’s milk is deficient, he recommends that she should get the milk of cows and goats, fennel, lettuce, parsley, and the like. (Pract. i, 21.)
The first food given to a new-born child should be honey, and afterwards milk, twice, or at most three times a day. When it appears disposed for it, and seems able to digest it, it may get some food, care being taken not to stuff it. If this should happen to be the case, it will become more sleepy and inactive, there will be swelling of the belly and flatulence, and its urine will be more watery than natural. When this is observed, it ought to get no more food until what it has got be consumed. The child may be brought up upon milk until it be two years old, after which, its diet may be changed to food from grain.
Commentary. This Section is taken from Oribasius. (Synops. v, 5.)
Galen, in like manner, approves of the honey. He directs the body of a new-born child to be sprinkled with salt; and afterwards rubbed every day with oil. After the milk-diet is given up, the first food to be administered, he says, should be bread, and afterwards pulse and flesh. He forbids the use of wine, because the temperament of a child is hot and humid. He approves of the hot bath, but condemns the use of the cold for young children. (Hyg. pluries.)
Aëtius recommends the child to be brought up upon milk for twenty months. Moschion says, from eighteen months to two years will be sufficient. Avicenna, like our author, mentions two years. It is stated by Selden, that the Hebrew women gave suck to their children for two years. This practice is enjoined in the Koran. Aëtius is not so strict in regard to regimen as Galen; he allows us to vary the milk-diet, by giving occasionally soft eggs, mead, or sweet wine diluted with water. (iv, 28.)
Moschion, Averrhoes, and Avicenna approve of exercising the child in a cradle, and of lulling him with music. When the cord falls off, Avicenna advises that the part should be sprinkled with the powder of burnt lead.
Averrhoes disapproves of sprinkling the child’s body with salt, as recommended by Galen. (Collig. ii, 6.) He agrees with Galen, however, in condemning the use of wine. He directs exercise for the child every day; after exercise, friction, and after friction, the bath. He forbids the use of the cold bath, however, because it retards the growth. When the child does not sleep, Avicenna and Averrhoes recommend poppy in his food. (Cant. ii, 1.)
Haly Abbas directs us, when there is any malformation of the head, to reduce it to its proper shape, and bind it firm. Like Galen, he recommends that the body of a new-born child should be sprinkled with salt and powdered roses, to harden the skin. He directs us to give the child, for the first two days, sugar, triturated with the oil of sesame. He recommends the frequent use of the tepid bath. He properly directs the nurse not to expose the child’s eyes to the strong light of day, nor to allow him to sleep in a strong sun, for fear of injuring his eyes. When a child cries, it is the duty of the nurse, he says, to find out the cause, as a child never cries except when something hurts it. The most common causes, he adds, are, heat or cold, fleas or gnats, hunger or thirst, retention of urine or of the fæces. For retention of the urine, he recommends melon-seed with julep both to the child and the nurse; and when the child’s bowels are constipated, he directs the nurse to take laxative herbs, oil of olives, prunes, and so forth. It is clear, therefore, that he was aware that a child may be operated upon by medicines given to the nurse. (Pract. i, 20.)
The directions given by Alsaharavius are very similar. He remarks that violent crying may occasion a descent of the bowels.
Syrasis, one of the commentators on Avicenna, recommends the tepid bath for young children, and food after it. He directs the nurse to exercise the child before putting him into the bath.
From what we have stated, it will be seen that the ancient physicians did not approve of the cold regimen, absurdly proposed by certain modern philosophers as the most proper for infants.
According to Athenæus, the sons of Roman freemen were prohibited from drinking wine until they were thirty years old. (Deipnos, x, 23.) Plato enjoins complete abstinence from wine until the age of eighteen, and great moderation until thirty. (Leg. ii.)
Whatever eruptions appear upon the skin of a child, are to be encouraged, in the first place; but when the eruption is properly come out, it may be cured by putting the child into baths of myrtle, or lentisk, or roses, and then anointing with the oil of roses or lentisk, or with a cerate containing ceruse. And its body may be gently rubbed with nitre; but it will not bear hard friction. But a very good plan is for the nurse to be fed upon sweetish things. And the child’s diet ought to be attended to, so that it be neither too full nor too spare. If the child’s belly be constipated, a little honey may be put into its food; and if even then it do not obey, turpentine, to the size of a chick-pea, may be added. When the bowels are loose, millet, in particular, ought to be administered.
Commentary. This Section is taken from Oribasius (Synops. v, 6.) See also Aëtius (iv, 21.) The Exanthemata here referred to would appear, properly speaking, to be the strophuli of Dr. Willan, but the ancients used the term rather vaguely for several eruptive diseases. (See Book Fourth.) The Exanthemata are the “pustulæ parvæ” of Eros (apud Gynæcia, p. 59.) For the Arabians, see in particular Haly Abbas (Pract. i, 20); Avicenna (i, 3, 1); Alsaharavius (Tr. xxvi, 7 and 8.) Alsaharavius describes two cutaneous complaints of infancy by the names of Alseafa and Alkaba. The former he describes as consisting of pustules, which affect the heads of infants, and sometimes the face. They are attended, he says, with a constant itching, and occasion erosion. His treatment is to shave the head, and to apply to it first a leaf of blite (bletæ vel betæ?) and afterwards an ointment composed of spuma argenti, ceruse, and lye, with rose-oil and wax. The Alkaba is said to be of the same nature, only that the fluid which runs from the pustules resembles honey. This, therefore, must be the porrigo favosa. His remedies are, to wash the head frequently with a lotion made from marjoram, mint, or centaury; and then to apply an ointment composed of spuma argenti, ceruse, Armenian bole, sulphur, almonds, and quicksilver; and also liniments of rose-oil and vinegar, with the free use of the bath. As Dr. Willan remarks, he has described the strophuli by the name of pustulæ, (bothor.) (Tr. xxvi, 25.) He says of them: “Aliæ sunt albæ, aliæ rubeæ, aliæ nigræ, aliæ magnæ, aliæ parvæ et multæ et paucæ, aliæ fortis et acuti doloris, et mortiferæ,” &c. It appears, therefore, that he applies the term in a very lax signification.
Rhases describes the Exanthemata by the name of vesicæ. He prescribes, at the commencement, medicines for expelling the morbific superfluity from the inner parts, such as the decoction of dates or figs, with fennel water. When the eruption is fairly come out, he recommends baths medicated with roses, myrtles, and the like; after which, the child is to be rubbed with the oil of roses or of violets. (De Morbis Infant, c. 19.) We may mention that Lanfrancus, and the other medical authorities of that age, describe them by the name of saphati.
When the child is seized with cough or defluxion, recourse is to be had to a linctus of honey. It is first to be bathed copiously with warm water, even to its head, and plenty of honey given: then press its tongue gently with your finger, and it will vomit up much phlegm.
Commentary. See Oribasius (Synops. v, 7), and Aëtius (iv, 18.) Aëtius recommends various lohochs or linctus. One of them consists of pine-nuts, almonds, linseed, liquorice-juice, and honey.
Emetics and demulcents, such as gum arabic and liquorice, are the remedies recommended by Avicenna, (i, 3, 1.)
Haly Abbas approves of lohochs, containing almonds, honey, &c. (Pract. i, 20.) Alsaharavius recommends various demulcents, and an electuary containing poppy-seed, tragacanth, and the seeds of citrons, to be taken in a decoction of Sebesten plums. He also directs us to produce vomiting, by making the patient swallow copious draughts of honied water. (Tr. xxvi, 24.)
Rhases recommends nearly the same remedies. (De Morbis Infant, c. 18.)
This would appear to be the most proper place for giving from Aëtius some account of two affections of infancy, which our author has omitted to describe. He says, when children have been fed on improper food, or when, from any other cause, their stomachs become loaded with phlegm, they are troubled with snorting; and in that case he recommends a linctus of linseed, honey, &c.; or if the affection be obstinate, to make them vomit by pressing down the tongue with a finger smeared with oil. (iv, 7.)
When an infant has lost its voice, which, he says, arises commonly from constipation, he recommends the juice of cabbage, either by the mouth or in a lavement; or a suppository into the anus. (iv, 8.)
If the child be troubled with pruritus, use fomentations, and anoint with plenty of refined oil, in which a little wax has been melted.
Commentary. See Galen (Hyg. v); Oribasius (Synops. v, 8); Avicenna (i, 3, 1); Haly Abbas (Pract. i, 20); Rhases (de Morb. Infant, c. 19); Alsaharavius (Pract. xxvi, 25.)
The account given by Oribasius is similar to our author’s. (Synops. v, 8.)
Alsaharavius properly recommends attention to correct the acrimony of the nurse’s milk; to wash the child with decoctions of roses, myrtle leaves, and the like; if the pustules are of a dry nature, to rub them with oil of sesame or of violets; and, if humid, with an ointment made of wax, litharge, and rose-oil.
Rhases directs the nurse to abstain from sweet and salt things, as they inflame the blood; and to put the child into a bath medicated with mallows, pearl-barley, fenugreek, gourds, &c.
Avicenna and Haly Abbas treat the complaint upon similar principles.
Dentition commences about the seventh month. At that time inflammations of the gums, cheeks, and tendons are apt to occur; and sometimes convulsions. The child must then get nothing which requires mastication; and his gums should be rubbed frequently when in the bath with the finger, or soothed with the fat of fowls or the brain of a hare. When the teeth are just coming through, the neck, jaws, and head should be wrapped in soft wool, or they may be anointed with warm sweet oil, some of which ought to be poured into the pores of the ears. The child ought then to have a more generous quality of food, and be bathed in warm water. If he have diarrhœa, it is proper to bind his belly by epithemes, namely, such as are of an astringent nature, as cumin, dill, or parsley, sprinkled upon wool. It is proper to mix the seeds of roses, and, in short, to use hot desiccants. If the bowels are constipated, they may be gently roused to action by means of a suppository of honey, or the belly may be anointed with mint pounded in honey. But the best remedy for the convulsions of children, apparently, is to bathe them in water wherein turnsol (heliotropium) has been boiled. It will be of consequence also to use the oil of privet, of the iris, and the Sicyonian oil; and, in short, everything which is of a calefacient nature. But when the teeth have come through so as to bite the fingers, it may be proper that he keep in his mouth the root of the iris, shaven down and not quite dried. This also is of use to ulcers. Butter likewise rubbed in with honey will be of service. The flesh of an old pickle relieves pruritus of the gums.
Commentary. See, in particular, Oribasius (Synops. v, 9), and Aëtius (iv, 9.) Hippocrates and Aëtius recommend a jasper amulet. Hippocrates remarks that fevers, pruritus, looseness of the bowels, and convulsions are apt to come on at the time of dentition, if the child be plethoric, and his bowels constipated. (Aphoris, cum Comment. Galeni.) Aretæus makes the same statement. (Morb. acut. i, 6.)
Moschion directs the gums of the child to be rubbed, after the fifth month, with sweet oil, the fresh grease of a hen, the brain of a hare, and lastly with boiled honey. When inflammation supervenes afterwards, he recommends fumigations and cataplasms, and directs the food and drink of the nurse to be restricted. (c. 119.)
The directions given by Avicenna are similar to those of Moschion. (i, 3, 1.) Alsaharavius properly states that the best way to avoid difficult dentition is to guard against corruption of the food and drink, and to abstain from emetics, acids, figs, &c. To remove the painful symptoms attendant on dentition, he directs us to rub the gums with olive oil, honey in which aloes and gum arabic have been boiled, and the like; to wrap the head in soft wool, and to pour tepid water upon it. (Pract. xxxvi, 19.)
The treatment recommended by the other authorities is very similar. See, in particular, Rhases (Ad Mans. iii, 13.)
The only ancient authors who make mention of scarification of the gums as a remedy for painful dentition are, Marcellus Sideta (Medicina, ex Piscibus,) and Pliny (Hist. Nat. xxxii, 26.) Both direct it to be done with the sting of the Pastinaca Marina.
Infants are liable to an ulcer of the mouth called aphtha. It is either whitish, reddish, or black, like an eschar. That which is black is of the worst kind and most fatal. The iris mixed with honey is of use, or you may blow in the dry powder if you please; also, the pounded leaves of roses, or the flowers of roses, and crocus—a small quantity of myrrh, galls, frankincense, or the bark of the frankincense tree: all these together, or separately, may be mixed with honey; and, in addition to these, may be joined honied water and the juice of the sweet pomegranate.
Commentary. Hippocrates mentions aphthæ among the diseases of dentition. (De Dent.) Theophilus, the commentator on Hippocrates, says, that aphthæ are occasioned by the tenderness of the parts, which cannot bear the bad qualities of the milk. According to Aretæus, the land of Egypt is particularly prolific of these ulcers, which are engendered by the impurities of the water and the quality of the vegetables that grow there. (Morb. Acut. i, 9.) The aphthæ appear to be the oscedo of Isidorus. (Orig. iv, 8.)
Our author copies from Oribasius. (Synops. v, 10.) See also Aëtius, (viii, 39.) Aëtius borrows his account from Galen, who is very full upon the treatment of aphthæ. He remarks that recent superficial ulcers are easily cured, but that such as spread and are of a gangrenous nature are very dangerous. He gives, at great length, directions for the composition of applications, suited to every modification of the complaint. When the pustules are red, he prescribes washes of a moderately astringent and cooling nature; if yellowish, the same, but somewhat more refrigerant; if whitish and pituitous, detergents are to be used; and, if black, the most powerful discutients. For simple cases of the aphthæ infantium, he merely recommends the flowers of roses with honied water. Most of his remedies are astringents. (De Med. sec. Loc. lib. vi.) In another work, he says that aphthæ are occasioned by the acrimony of the milk, and are to be cured by astringents. (Comment. in III Epidem.)
Pliny mentions that the lapis melititis was used as an application in cases of ulceration of the fauces. (Hist. Nat., xxxvi.) There is reason to believe that it was Borax, or borate of soda.
Avicenna recommends at first washes prepared from the vegetable acids, and afterwards astringents, such as galls, sumach, balaustine, &c. (i, 3, 1.) See also Haly Abbas (Pract. i, 20.)
Alsaharavius states that aphthæ commonly arise from the sharpness of the milk. His general treatment consists in regulating the diet of the nurse, and using washes principally of an astringent nature for the child’s mouth. When they are very painful, he adds to the washes the juice of lettuce, endive, and the like. When they are whitish, he recommends a powder consisting of myrtle, saffron, and sugar. (Tr. xxvi, 20.) Rhases’ treatment is quite similar. (De Morbis Infantium, c. 14.)
The author of the following work, which has been falsely ascribed to Dioscorides, recommends certain applications of a strongly escharotic nature, such as this: Of arsenic, p. i; of burnt paper, p. iii; or this, of sandarach and rose-oil equal parts. (Euporist. i, 82.)
Psellus enumerates two kinds of aphthæ, namely, the white and the red; the former, he says, is mild, the latter very dangerous. (Poëma Medicum.)
Excoriations of the thighs may be sprinkled with dried myrtle, cyperus, and roses.
Commentary. See, in particular, Oribasius (Synops. v, 11); Aëtius (iv, 24); and Avicenna (i, 3, 1.) All recommend nearly the same astringent applications for the intertrigo of infants.
Watery discharges from the ears may be dried up by applying to them wool with alum, or with wine and honey, or by an injection of old wine either alone or mixed with saffron.
Commentary. Oribasius, Aëtius, Avicenna, and Haly Abbas recommend the same treatment, which would seem to be very proper. Alsaharavius recommends wool soaked in a solution of alum, and injections, consisting of solutions of nitre (soda) in vinegar. Rhases makes mention of nearly the same applications. (De Morb. Infant. c. 9.)
Siriasis is an inflammation of the parts about the brain and its membranes. A hollowness of the open of the head and eyes attend it, with paleness and dryness of the body. It is relieved by an application of the red of an egg with oil of roses to the open of the head, in the form of a compress, and frequently changed.
Another application for Siriasis. Place upon the open of the head, the leaves of that species of heliotropium called scorpiurus, the parings of a gourd, the membrane which envelopes the fleshy part of a ripe cucumber, the juice of the garden nightshade, with oil of roses.
Commentary. See Oribasius (Synops. v, 13); Aëtius (iv, 13); Avicenna (i, 3, 1); Haly Abbas (Pract. i, 20); Alsaharavius (Pract. xxvi, 9); Rhases (de Morb. Infant. c. 5); Pseudo-Dioscorides (Euporist. i, 9); Alexander Aphrodisiensis (Problem i, 98); Pliny (Hist. Nat. xxxii, 48.)
Aëtius and Avicenna agree in describing it as an inflammation and swelling of the brain and its membranes, so as to occasion a hollow at the bregma, and as being attended with ardent fever. The account given by the others is very similar. All recommend cooling and astringent applications to the part. According to Alexander Aphrodisiensis, children are most subject to this affection, especially in the summer season; for which he attempts to assign the reason. He describes it as an inflammation of the membranes of the brain. The author of the ‘Euporista’ recommends the juices of various cooling herbs, as local applications. Pliny represents the heat of it as excessive. He says, “Siriasesque infantium spongia frigida crebro liumefectata, rana inversa adalligata efficacissime sanet, quam aridam inveniri affirmant.” (l. c.)
Although somewhat out of place, we shall venture to introduce here some account of two diseases of infancy which are omitted by our author, but are briefly described by Aëtius and Rhases.
For prolapsus ani, Aëtius recommends various applications in the form of powder and fomentation; but states, that what he himself constantly made use of was tepid brine or salt water. (iv, 19.) See Rhases (de Morb. Inf. c. 21.)
Umbilical hernia, he says, may be occasioned by crying, a blow, or a fall. For this he recommends various astringent preparations from alum, galls, &c., applied on a linen compress to the navel. (iv, 20.) Rhases recommends similar applications, and also a compress with the gluten of hides to be bound over the navel. (De Morb. Infant. c. 22.) As far as we can recollect, Hippocrates and his commentators are the only ancient authorities that make mention of inflammation of the navel after the cord has dropped off. (Aphor. c. Comment. ed. Dietz, p. 374.)
Infants and children when weaned from milk, are to be allowed to live merrily and without restraint; their food ought to be light, and their exercise gentle. After six or seven years of age, both boys and girls are to be consigned over to schoolmasters of a mild and benevolent disposition; as such persons will impart instruction to them in a cheerful manner, and without constraint; for relaxation of the mind contributes much to the growth of the body. Boys twelve years of age should go to teachers of grammar and geometry, and get their bodies hardened by gymnastic exercises. From fourteen to twenty-one, their proper employment will be the study of mathematics and initiation in philosophy. At the same time, however, it will be proper to use more exercise for strengthening the body, so that, exercising both mind and body, they may be prevented from indulging their carnal desires. They ought likewise to be restricted as to wine. To adults the fullest supply of nourishment, both as to body and mind, ought to be allowed; wherefore, they should use all kinds of gymnastic exercises, particularly such as each has been accustomed to, and food which is sufficient and nutritious. In the decline of life, both the bodily and mental supply ought to be abridged; and the gymnastic exercises diminished in proportion. The food also is to be gradually lessened as the habit begins to contract the frigidity of age.
Commentary. These simple but judicious directions respecting the regimen of the different periods of life are taken from Oribasius (Synops. v, 14); or from Aëtius (iv, 29.) Many of them are borrowed originally from Galen. (Hyg. i.)
Similar directions are given at great length by Haly Abbas. He positively prohibits children from taking wine. He insists that wine not only proves prejudicial to health, but also deteriorates the morals. (Pract. i, 22.) Alsaharavius agrees with him in proscribing wine to children. (Theor. xiii, 2.)
Avicenna makes very judicious observations on this subject, but the greater part of them are taken from Galen. He insists, with becoming earnestness, on the propriety of attending to the regulation of the passions of the child, as being conducive to his health as well as to his morals. As soon as the boy is roused from sleep he is to be bathed; then he is to be allowed to play for an hour; afterwards, he is to have something to eat, and then is to be allowed more play. Afterwards he is to be bathed; then he is to take food; and, if possible, he is to be prevented from drinking water immediately after a meal, as it has a tendency to make unconcocted chyle be distributed over the body. When six years old, he is to be consigned to the care of a teacher, but he is not to be compelled to remain constantly in school. Avicenna goes on to state that, at the age he has then reached, he is to be more sparingly bathed, and that his exercise is to be multiplied before eating. Like most of the ancient authorities, he forbids wine to a child. Thus, he adds, is the regimen of the child to be regulated until he reach the age of fourteen. (I, i, 4.)
Averrhoes gives very sensible directions on this subject. He forbids the use of wine and ales until manhood. (Collig. vi, 6.)
Before gymnastic exercises, the body ought to be rubbed moderately first with towels, and then with oil in the hollows of the naked hands, until it be properly warmed and softened, and its surface have contracted a florid blush, and become distended.
Commentary. A more circumstantial account of the mode of preparing the body for gymnastic exercises is given by Oribasius. (Med. Collect. vi, 13.) It is taken, however, from Galen’s second book of ‘Hygiene.’ See a similar account in Aëtius (iii, 1), and Avicenna (i, 3, 2.) The object of it, according to Alexander Aphrodisiensis, was to soften the parts so that they might not be ruptured. (Prob. i, 119.) To rub the body with oil was a general practice of the ancients before strong exercises of every kind. Hence Horace characterizes an inactive person by his dread of oil, “Cur olivum Sanguine viperino cautius vitat?”—that is to say, as his commentator Acron explains it, “Cur vitat olivum, id est oleum, quo unctus tutius natet et luctetur?” The poet alludes to the practice in another place: “Ter uncti Transnanto Tiberim.” It appears from Martial that a composition of oil and wax, called ceroma, was sometimes used for this purpose:
According to Thucydides, the Lacedemonians were the first who rubbed their bodies with oil before wrestling. (i, 1.) Pliny mentions the use of oil before the gymnastic exercises as a luxury introduced by the Greeks. It appears from him that cheap aromatics were sometimes added to the oil. He further relates that some barbarous nations used butter instead of oil. (Hist. Nat. xi, 41.)
Athenæus mentions that Antiochus Epiphanes supplied the wrestlers at Daphne with oil of saffron, of marjoram, and the like. (Deipn. v.)
Lucian makes Solon say to Anacharsis, that oil produces the same effect upon the living body as upon leather, softening it, and rendering it stronger and less apt to break. (Anacharsis.)
The poets describe Venus as preparing herself for exercise by being rubbed with fragrant ointments, whereas Minerva disdained to use anything but common oil. See Callimachus (Lav. Pall.) and Sophocles (ap. Athen. Deipnos. xv, 35.)
The Roman emperors, and other luxurious persons, often made use of perfumed ointments instead of oil. See Suetonius (in Vita Caligulæ), Lampridius (in Vita Heliogabali.) It would appear that under the empire the people of Rome were supplied gratuitously with oil in their public baths. (Lamp. c. 24, and Burman, de V. R. c. iii.)
Exercise is a violent motion. The limit to its violence should be a hurried respiration. Exercise renders the organs of the body hardy and fit for their functional actions. It makes the absorption of food stronger, and expedites its assimilation; and it improves nutrition by increasing heat. It also clears the pores of the skin, and evacuates superfluities by the strong movement of the lungs. Since, therefore, it contributes to distribution, care ought to be taken that neither the stomach nor bowels be loaded with crude and indigestible food or liquids; for there is a danger lest they should be carried to all parts of the body before they are properly digested. It is clear then that exercise ought to be taken before eating. The colour of the urine will point out the proper time for exercise. When it is watery, it indicates that the chyme absorbed from the stomach is still undigested. When it is of a deep yellow colour, and bilious, it shows that digestion had been long ago accomplished. When it is moderately pale, it indicates that digestion has just taken place; and this is the proper time for exercise, after having evacuated whatever excrementitious matters are collected in the bladder and bowels.
Commentary. The remarks of our author on the effects of exercise are exceedingly pertinent and comprehensive. See, in like manner, Aëtius (iii, 2), and Oribasius (Med. Collect. vi, 11.) But Galen is the great authority on this subject, which he treats of very fully and philosophically, in the second book of his ‘Hygiene.’ He agrees entirely with Hippocrates, that the proper time for exercise is before a meal, because, the excrementitious superfluities being thereby evacuated, the body is in a fit condition for receiving a new supply. He explains, however, afterwards, that it is after the digestion and distribution of a preceding meal have been accomplished that exercise will be most proper.
According to Haly Abbas, exercise is useful for three purposes: 1. For rousing the innate or natural heat, whereby the processes of digestion and distribution are accelerated. 2. For opening the pores of the body, and evacuating its superfluities. 3. For strengthening and rousing the animal actions, by the friction it occasions. (Theor. v, 2.) Avicenna gives nearly the same statement of the good effects of exercise. Haly Abbas forbids exercise immediately after dinner. He adds, that exercise taken immediately after a meal makes the food descend to the intestines, where it is absorbed by the veins before it is properly concocted, and thereby the liver becomes loaded with crudities. (Pract. i, 3.)
Alsaharavius recommends exercise before a meal, but advises it not to be continued after one feels fatigued and languid. (Theor. ii, 2.) The same rule is distinctly laid down by Rhases. (Contin. xxxiii.)
It appears that, instead of taking exercise after food, the ancients were in the practice of indulging in a short sleep after their dinner or mid-day meal. See Plautus (Mostell. ac. iii, sc. 2, 1. 8), and the note of Meursius (Ed. Gronov.) Homer says that it is beneficial to old men to indulge in sleep after the bath and taking food. (Galen. Hyg. 1.)
Plutarch mentions that Cicero was cured of debility of the stomach by taking moderate exercises. (In vita Cicer.)
It was one of the extravagant opinions of Erasistratus, that exercise is not at all necessary for the health of the animal frame.
The common effect of all kinds of exercise is to produce an increase of the natural heat of animals. But each species has something peculiar to it. Strong, that is to say, violent exercise gives vigour to the muscles and nerves: such are digging, and lifting a very heavy burden, while one remains in the same spot, or moves about; or lifting small weights and walking about as much as one can. Of this kind, is the exercise of scaling a rope, and many others of a like kind. The swift kinds of exercise are such as do not require strength and violence, namely, running, fighting with one’s shadow, wrestling with the extremities of the hands, the exercise with the leather bag, and that with the small Ball. This last is compounded of intension and velocity; and such exercises as are intense may become violent by adding velocity to them. Besides, some kinds of exercise bring the loins into action, and some the hands or legs; others the spine or the chest alone, or the lungs. And exercise ought to be carried on until the body becomes distended, and the skin of a florid hue; and until then, the motions ought to be strong, equable, and spirited, upon which you may see warm sweat, mixed with vapour, break out. It will then be time for you to stop, when any of the symptoms which I have mentioned have undergone a change, namely, when the bulk of the body becomes contracted, or when the florid colour of the skin declines. And, should any of the motions remit, it will then be time to stop immediately; or, if there should be any change in the quantity or quality of the perspiration; for if it should become smaller in quantity, or colder, we must desist, and, besmearing the body with oil, endeavour to restore it. It will then be proper to use the Restorative friction, as the masters of gymnastics are wont to practise.
Commentary. We shall now give a brief account of the ancient exercises, some of which are altogether omitted by our author.
The σκιομαχία is thus explained by Cornarius: “Porro σκιομαχίαν accipio umbratilem pugnam, quâ quis privatim domi aut sub umbra, non in propatulo se exercet, ac veluti præparat ad justam pugnam publicè faciendam.” (Notæ in Paul. Ægin. h. 1.) This account, however, does not agree with that of Oribasius, who describes it as a mock encounter at boxing and jumping with one’s own shadow. (Med. Collect. vi, 29.) It is thus described in the Latin translation of Avicenna: “Et ex eis est, insequi umbram suam, ut ipsam percutiat in capite, et manus ad invicem percutere.” (i, 3, 2, 2.) It is mentioned in this sense by Plato (de Legibus, vii), by Plutarch (Probl. Conviv. vii), and by Achilles Tatius (p. 115.) Juvenal probably alludes to this sport. (Sat. vi, 246.) We have therefore translated it, “fighting with one’s own shadow.”
The ἀκροχειρισμὸς is thus described by Scaliger: “Est autem ἀκροχειρίζειν luctæ pars, cum primoribus tantum digitis insertis roboris faciunt periculum.” (Poet. i, 22.) Suidas explains it thus: “A man taking hold of his antagonist’s fingers, strove to break them, and did not give over until he compelled him to yield.” The term occurs in Aristotle. (Eth. Nicom. iii, 1.) See also, Athenæus. (Deipnos. iv, 13.) It is called ἀκροχέιρισις by Hippocrates (De Diæta. ii, 42), who says it reduces the body.
The exercise with the κώρυκος, or leather bag, is described by Oribasius in the following manner: A bag filled with flour or sand was suspended from the top of the house, on a level with the navel; it was then pushed forwards with the hands to the extremity of the rope, and, as it recoiled, the person performing the exercise retreated backwards, so as to escape from it. (Med. Collect. vi, 33.) This exercise is mentioned by Hippocrates. (De Diæta, ii.) Cornarius and the translator of Hippocrates confound it with the follis of the Romans; but Mercurialis clearly shows that they were quite different. The follis was a leather ball, inflated with air; such is the description of it by Cælius Aurelianus: “Follis erat pila magna ex aluta confecta, soloque vento repleta.” Martial represents it as a becoming exercise for boys or old men: