Chapter XXII: Preface (5)

When a person grows dull of hearing, (which most commonly happens after long pains of the head) in the first place, it is proper to inspect the ear itself. For there will appear either a crust, such as grows upon ulcers, or a collection of the cerumen. If there is a crust, either warm oil must be infused, or verdigrease with honey, or juice of leek, or a little nitre with mulse. And when this crust falls forward, it must be washed with tepid water, that after it has fairly disengaged itself it may be the easier pulled out by the specillum oricularium. If there be cerumen, and this is soft, it must be taken out with the same instrument. But if it be hard, vinegar, and a little nitre with it must be injected; and when it is softened, the ear should be washed in the same manner, and cleansed. And if a heaviness of the head remain, the hair must be clipped, and the head gently rubbed, but a long time, with the oil of iris or laurel, and with either of these may be mixed a little vinegar: then the patient must take a long walk, and after anointing, foment the head gently with warm water; and make use of food of the weakest and middle class, and more especially take diluted drinks; sometimes use gargarisms. Into the ear must be infused castor, with vinegar and laurel oil, and the juice of radish rind, or the juice of wild cucumber, with the addition of rose leaves powdered. The juice also of unripe grapes infused with oil of roses, is pretty good against a deafness.

[Sidenote: _Of a noise in the ears._]

The disorder is of a different nature, where there is a noise within the ears themselves: and this prevents them from receiving an external sound. This is slightest, when it proceeds from a gravedo; worse, when it is occasioned by a distemper or inveterate pains of the head; worst of all, when it is the harbinger of some violent disease, and particularly of an epilepsy. If it happens from a gravedo, the ear ought to be cleansed, and the patient hold in his breath, till some frothy moisture issue from it. If, from a distemper, or pain of the head, the same rules _as prescribed in a dulness of hearing_, must be practised with regard to exercise, friction, pouring on of cold water, and the use of gargarisms; no food but such as extenuates must be used; juice of radish, with oil of roses, or with the juice of the root of wild cucumber, must be infused into the ear, or castor with vinegar and laurel oil. Hellebore is also rubbed with vinegar, then incorporated with boiled honey, and being made into a collyrium, is introduced into the ear. If it has begun without these, and therefore gives reason to fear the approach of some terrible disease, castor ought to be infused into the ear with vinegar, or oil, either of iris or laurel; or together with the last, castor and the juice of bitter almonds; or myrrh and nitre with oil of roses and vinegar. But a proper diet is more serviceable in this case too. And the same rules are to be observed, which I prescribed above, even with greater exactness; besides which, the patient must refrain from wine, till the noise cease.

But if, at the same time, there are both a noise and an inflammation, it is sufficient to inject laurel oil, or that, which is expressed from bitter almonds; with which, some mix either castor or myrrh.

[Sidenote: _Of extraneous bodies in the ears._]

It sometimes happens too, that something falls into the ear, as a small stone, or some animal. If a flea has got into it, a little wool must be pressed in; and if it comes upon that, it is drawn out along with it. If it has not followed it, or it be any other animal, a probe wrapt in wool must be dipped in the most adhesive resin, particularly turpentine, and this is to be introduced into the ear, and turned round there: for it will certainly catch hold of it, and bring it away. But if it be any lifeless thing, it must be drawn out by the specillum oricularium, or a blunt hook, but little bent. If these means do not succeed, it may be drawn out by resin, in the same manner as directed in the preceding case. Sternutatories also are very proper to force it out, or water strongly injected by a syringe. _The following method is also practised in this case_; a board is laid down(11), supported in the middle, with both ends hanging over, and the patient is tied upon that, lying on that side, the ear of which is affected, so that he does not reach over the board; then the end of the board, where his feet are, must be struck with a hammer, and thus by shaking the ear, what is within it drops out.

CHAP. VIII.

OF THE DISEASES OF THE NOSE.

Ulcers in the nostrils must be fomented with the steam of hot water. This is done both by applying a squeezed sponge, and putting under the nostrils a narrow-mouthed vessel filled with hot water. After this fomentation, the ulcers are to be anointed either with dross of lead, or ceruss, or litharge. When a person powders any of these, he may add, while they are rubbed, alternately, wine and myrtle oil, till he make it of the consistence of honey. But if these ulcers be near the mouth, and have several crusts, and a fetid smell, which kind the Greeks call ozaena[GG], we may take it for granted, that it is hardly possible to cure that disease. Nevertheless, the following things may be tried; to clip the hair of the head close to the skin, and daily to rub it briskly, and pour plenty of warm water over it; to walk much; to eat sparingly, and such food as is neither acrid nor of the strongest kind. Then to put into the nostril honey, with a very little turpentine resin (which is done by a probe, wrapt up in wool) and let this moisture be drawn in by the breath, till the taste of it be perceived in the mouth. For by these means, the crusts are loosened, which ought then to be discharged by sneezing. The ulcers being thus cleansed must be fumigated with the vapour of hot water; afterwards should be applied, either lycium diluted with wine, or the lees of oil, or omphacium, or juice of mint, or of horehound; or copperas that has been burnt white, and then powdered; or the pulp of a squill bruised; to any of these honey may be added, of which in the other mixtures there ought to be only a very small part; with the copperas so much as to make it liquid; but with the squill a considerable quantity; then the end of a probe must be wrapped in wool, and dipped in the medicine; and by that the ulcers are to be incarned. And further, a piece of lint is to be rolled up in an oblong form, and dipped in the same medicine, which is to be introduced into the nostril, and loosely tied at the lower part. This ought to be done twice a day, in the winter and spring, and thrice in the summer and autumn.

[GG] ὄζαινα.

[Sidenote: _Of fleshy caruncles in the nostrils._]

Sometimes in the nostrils there grow caruncles resembling womens’ nipples, and these adhere to its extremities, where it is cartilaginous. These ought to be treated with escharotic medicines; by which they are certainly consumed. A polypus[GH] is a caruncle sometimes white, sometimes inclining to a red colour, which sticks to the bones of the nostrils; and sometimes spreading towards the lips, it fills the nostril, at other times reaching backward through the opening, by which the breath passes from the nose to the fauces, increases so much, that it may be seen behind the uvula; and almost suffocates the patient, especially when the south or east wind blows. It is generally soft, seldom hard; and the latter obstructs the breath more, dilates the nostrils, and is commonly of the cancerous nature, and therefore ought not to be touched. The other kind is generally cured by cutting; sometimes, however, it withers, if by means of lint or a pencillum, that composition be thrust up into the nose, which contains of Sinopian minium, chalcitis, lime, sandarach, each p. i. *. copperas p. ii. *.

[GH] πολύπους.

CHAP. IX.

OF THE TOOTHACH.

In the toothach, a disorder, that may justly be ranked even amongst the greatest torments, the use of wine must be entirely forbid; and at first a total abstinence from food must be observed; afterwards it may be taken sparingly, but soft, lest the teeth be irritated by chewing. Then externally, by means of a sponge, the steam of hot water is to be applied, and a cerate made of cyprine, or iris oil spread upon wool, and the head must also be covered. But if the pain be more severe, a clyster is useful, with hot cataplasms applied to the cheek, as also some medicinal hot liquor held in the mouth, and frequently changed. For which purpose is used a decoction of cinquefoil root in diluted wine; and henbane root, either in vinegar and water, or diluted wine, with the addition of a little salt to either of them; and poppy heads not over dry, and mandrake root prepared in the same manner. But in these three, care must be taken not to swallow what is in the mouth. The bark of the root of white poplar, boiled in diluted wine, does very well for this purpose; or hartshorn shavings in vinegar, and catmint with teda(12), and a mellow fig; also a mellow fig, either in mulse or in vinegar and honey, and when the fig is dissolved by boiling, the liquor is strained. A probe also wrapt up in wool is dipped into hot oil; and used to touch the tooth itself. Moreover, something like cataplasms are put into the tooth. For which end the inner part of the shell of an acid and dry pomegranate is powdered, with an equal quantity of galls and pine bark, and with these is mixed minium; which being powdered, are brought to a consistence with rain water; or panaces, poppy tears, hog’s fennel, stavesacre without its seeds, powdered in equal proportions; or three parts of galbanum, and a fourth of poppy tears. Whatever is applied to the teeth, a cerate, such as is directed above, ought, nevertheless, to be kept upon the cheek, and covered with wool. Some also bruise and spread upon linen, myrrh, cardamoms, of each p. i. *. saffron, pellitory, figs, pepper, each p. iv. *. mustard p. viii. *. and apply this to the arm of that side, where the painful tooth is; if it be in the upper jaw, in the part next the scapula; if in the lower, on that next the breast; and this relieves the pain; and when it has given ease, it must be immediately taken away.

Now if the tooth be spoilt, we need not be hasty in extracting it, unless there be a necessity for it; but in such a case, to all the fomentations directed before, must be added some stronger compositions to ease the pain. Such as is that, which contains of poppy tears p. i. *. pepper p. ii. *. sory(13) p. x. *. these are powdered and mixed up with galbanum, and put round the affected tooth; or that of Menemachus principally for double teeth, in which are of saffron p. i. *. cardamoms, soot of frankincense, figs, pepper, pellitory, each p. iv. *. mustard p. viii. *. Some mix of pellitory, pepper, elaterium, each p. i. *. scissile allum, poppy tears, stavesacre, crude sulphur, bitumen, bay-berries, mustard, of each p. ii. *. But if the pain make it necessary to take it out, a pepper corn stript of its bark, and in the same manner an ivy berry put into its opening, splits the tooth, so that it comes away in scales. The prickle of the planus fish also (which we call pastinaca, the Greeks trygon) is toasted, then powdered, and mixed with resin, which being put round the tooth loosens it. Scissile alum likewise put into the opening disposes the tooth to come away. But it is more expedient to wrap this in a little wool, and then put it in: because in that way it both preserves the tooth, and eases the pain. These are the prescriptions of physicians; but the experience of our peasants has discovered, that for the toothach the herb horsemint ought to be pulled up by the roots, and put into a bason, and water infused upon it, and that the patient should sit down close by it, covered all over with clothes; and then red hot flints are to be thrown into the bason, so as to be covered with the water, and the patient with his mouth open must receive the vapour, close wrapt up as before directed. For both a plentiful sweat follows, and a continued stream of rheum runs from the mouth, which secures health for a pretty long time, and frequently for a whole year.

CHAP. X.

OF THE DISEASES OF THE TONSILS.

If the tonsils swell from an inflammation without an ulcer, the head must be covered as in the last disorder, and the part fomented externally with the vapour of hot water; the patient must walk much; lie in bed with his head raised; and use gargarisms of the repellent medicines. The liquorice root too bruised, and boiled in passum or mulse, has the same effect. And it is not amiss to touch them gently with some medicines, which are made in this manner: the juice is squeezed from a sweet pomegranate, and a sextarius of this is boiled over a gentle fire to the consistence of honey; then saffron, myrrh, scissile alum, of each p. ii. *. are powdered separately, and to these are added gradually two cyathi of mild wine, of honey one; after that, they are mixed with the first mentioned juice; and again gently boiled; or a sextarius of the same juice is boiled in the same way, and the following things powdered in like manner are added to it; of nard p. *. omphacium p. i. *. cinnamon, myrrh, cassia, each p. i. *. And these same compositions are proper both for purulent ears and nostrils. The food in this disorder also ought to be mild, lest it exasperate the inflammation.

But if the inflammation is so great as to obstruct the breath, the patient must rest in bed, abstain from eating, and take nothing else but warm water: a clyster must also be given, and a gargarism used of figs and mulse; and the part touched with honey and omphacium. Externally the hot vapour must be applied, but for a longer time, till they suppurate and break of themselves. If pus is contained within, and the tumours do not break, they must be cut. Afterwards the patient must gargle with warm mulse.

But if with an inconsiderable swelling there is an ulceration, for a gargarism there must be added to the cream of bran a little honey, and the ulcers are to be anointed with the following medicines: three cyathi of the sweetest passum are boiled into one; then is added of frankincense p. i. *. saffron, myrrh, each p. *. and the whole is set upon the fire again, till it boil. When the ulcers are clean, he must gargle with the same cream of bran, or with milk. And in this case also a mild diet is necessary; to which may be added sweet wine.

CHAP. XI.

OF ULCERS OF THE MOUTH.

Ulcers of the mouth, if they be attended with an inflammation, and are foul and red, are best treated by the medicines prepared from pomegranates mentioned before. And a repellent cream, with the addition of a little honey, is to be held in the mouth often; the patient must walk, and avoid all acrid food. When the ulcers begin to be clean, a mild liquor, and sometimes the best water is to be kept in the mouth: and the use of wine undiluted does service, also a fuller diet, provided it be not at all acrid. The ulcers ought to be sprinkled with scissile allum, and a little more than half its quantity of unripe galls.

If they are already covered with crusts, such as we find in burns, the compositions which the Greeks call antherae[GI] are to be applied. These contain of long cyperus, myrrh, sandarach, allum, equal parts; or, of saffron, myrrh, each p. ii. *. iris, scissile allum, sandarach, each p. iv. *. long cyperus p. viii. *. Or, of galls, myrrh, each p. ii. *. scissile allum p. ii. *. rose leaves, p. iv. *. But some mix together of saffron p. *. scissile allum, myrrh, each p. i. *. sandarach p. ii. *. long cyperus p. iv. *. The former are sprinkled on dry; the last is applied with honey; and not only to these ulcers, but to the tonsils also.

[GI] ἀθηραὶι.

But those ulcers, which the Greek call aphthae, are by far the most dangerous; that is, in children; for they often kill them: in men and women there is not the same danger. They begin at the gums, next possess the palate, and the whole mouth; then descend to the uvula and fauces. When these are affected, it is not easy for the child to recover. And the case is more deplorable, if the infant is yet sucking; because it is more difficult to apply any remedy. But in the first place the nurse must be obliged to exercise by walking and such employments as move the superior parts; she must be sent to the bath, and ordered to pour warm water there over her breasts; next, her food must be mild, and such as is not easily corrupted; and if the child have a fever, she must drink water; if not, diluted wine. And if the nurse is costive, she must have a clyster; if phlegm collects in her mouth, a vomit. Then _for the infant_, the ulcers must be anointed with honey, to which is added that kind of rhus(14), which is called Syrian, or bitter almonds; or with a mixture of dry rose leaves, pine kernels, and mint incorporated with honey; or that medicine may be used, which is made up with mulberries; the juice of which is boiled in the same manner as that of the pomegranate to the consistence of honey; and in the same way, saffron, myrrh, allum, wine and honey are mixed with it. Nor is any thing to be given, which may provoke the discharge of humour. If the child is come to more strength, he ought to gargle with such mixtures, as have been mentioned before. And if the milder medicines do but little service here, such are to be used, as by their caustic quality may cover the ulcers with crusts. The scissile allum is powerful, or chalcitis, or copperas. Fasting too, in as great a degree as the patient can bear, does service. The food ought to be mild; however to cleanse the ulcers, it is proper to give sometimes cheese spread with honey.

CHAP. XII.

OF ULCERS OF THE TONGUE.

Ulcers of the tongue require no other medicines than those, that have been laid down in the former part of the last chapter. But such as arise upon the side of it continue longest. And it is necessary to inspect whether some tooth opposite to it is not too sharp, which often prevents an ulcer in that part from healing, and for that reason must be filed.

CHAP. XIII.

OF PARULIDES AND ULCERS IN THE GUMS.

Some painful tubercles also grow sometimes in the gums, near the teeth; the Greeks call them parulides[GJ]. It is proper at the beginning, to rub these gently with powdered salt, or with a mixture of fossile salt calcined, and cypress and catmint; then to wash the mouth with the cream of lentils, withal holding the mouth open, till the phlegm is sufficiently discharged. In a greater inflammation the same medicines are to be used, as were directed before, for ulcers of the mouth; and a little soft lint is to be rolled up in one of those compositions, which I said were called antherae, and that must be put betwixt the tooth and the gum. But if the tumour be too hard to admit of that, the steam of hot water, by means of a spunge, must be used externally, and cerate applied. If a suppuration appears, the steam must be used longer; and a hot decoction of figs in mulse, must also be held in the mouth. And the tubercle must be cut before it be quite ripe, lest the pus, by continuing there too long hurt the bone. If the tumour be pretty large, it is better to cut it out entirely, so that the tooth may be freed on both sides. When the pus is discharged, if the wound be slight, it is sufficient to hold warm water in the mouth, and to foment externally with the same vapour; if it be larger, to make use of the cream of lentils, and the same medicines, by which other ulcers in the mouth are cured.

[GJ] παρουλίδες.

Other ulcers, likewise, frequently arise in the gums, which are relieved in the same manner, as those in the other parts of the mouth. However, it is highly proper to chew privet, and hold the juice of it in the mouth. It sometimes happens, too, that from an ulcer in the gum, whether it be a parulis or not, pus is discharged for a long time, when a tooth is either rotten, or broke, or the bone otherwise spoilt; and that commonly proceeds from a fistula. When this is the case, the part must be opened, and the tooth extracted; if there be any exfoliation, it must be taken out; if any part of it is spoilt, it must be scraped. After which, the same methods must be taken, as were prescribed before in the cure of other ulcers. But if the gums leave the teeth, the same antherae are helpful. It does good also to chew pears or apples not very ripe, and to keep their juice in the mouth. And mild vinegar held in the mouth may have the same effect.

CHAP. XIV.

OF AN INFLAMMATION OF THE UVULA.

A violent inflammation of the uvula may justly excite our fears. Therefore, in this case, abstinence is necessary, and it is proper to bleed; and if there is any good reason against that, a clyster is serviceable. Besides, the head must be covered, and kept pretty high; next, a decoction of bramble and lentils in water, must be used as a gargarism; and the uvula itself be touched with honey, mixed either with omphacium, or galls, or scissile allum. The medicine also, which is called andronium is suitable to this case. It consists of scissile allum, scales of red copper, copperas, galls, myrrh, and misy; which are powdered separately, and being mixed, they are again rubbed with the addition of rough wine, to the consistence of honey. It does great service also to apply to the uvula the juice of celandine, by means of a spoon. When the uvula is moistened with any of these, a great quantity of phlegm runs out; and when that ceases, the patient must gargle with hot wine.

But if the inflammation be slight, it is sufficient to powder laser, and add to it cold water, and to put this water into a spoon, and hold it below the uvula. And when it is not much swelled, cold water alone, used in the same way, constringes it. The patient must also use a gargarism of water, either with laser, or without it. But the chirurgical cure for a lengthened uvula I shall describe afterwards.

CHAP. XV.

OF A GANGRENE OF THE MOUTH.

If a gangrene seizes ulcers of the mouth, it is to be considered in the first place, whether the body be in a bad habit: if it be, that must be rectified; and then we may proceed to the cure of the ulcers. But if that disorder be on the surface, it does well enough to sprinkle a dry anthera upon the ulcer, if moist: if it be somewhat dry, it must be laid on with a small portion of honey: if a little deeper, two parts of burnt paper, and one of orpiment: if the disorder is of a considerable depth, three parts of burnt paper, and a fourth of orpiment, or equal parts of salt and iris both toasted; or equal parts of chalcitis, lime, and orpiment. But it is necessary to dip lint in rose oil, and apply over that escharotic medicines, to prevent their hurting the sound contiguous part. Some also throw in so much toasted salt into a hemina of strong vinegar, till it will dissolve no more; next, they boil away this vinegar till the remainder be dry; and powder the salt, and sprinkle it on the ulcers. Now, as often as a medicine is applied, both before and after, the mouth must be washed, either with cream of lentils, or a decoction of vetches, or olives, or vervains in water; and with any of these must be mixed a little honey. Vinegar of squills, also held in the mouth, has no small efficacy against these ulcers; and vinegar mixed again with the salt, boiled in vinegar, as before directed. But when either of these is used, it must be kept in the mouth a long time together, and be repeated twice or thrice in a day, as the malady is more or less severe. And if the patient be a child, a probe must be wrapped in wool, and dipped into a medicine, and held upon the ulcer; lest for want of thought, he should swallow the escharotics. But if there be a pain in the gums, and some of the teeth be loosened, they ought to be pulled out: for they very much obstruct the cure. If medicines do no service, the ulcers will require to be cauterized: which, however, is not necessary in the lips, because it is more convenient to cut them out. And both that which is cauterized, and that which is cut out, are equally incapable of being filled up without the manual operation. Now the bones of the gums, which have but little life in them, when once stripped by burning, continue bare ever after: for the flesh never grows again there. Upon the burnt places, however, lentils must be applied, till they recover their soundness, as far as the case will admit.

CHAP. XVI.

OF PAROTID SWELLINGS.

These are the disorders in the head, which generally require the help of medicines, but under the ears, it is common for parotides[GK] to arise; sometimes in health, when an inflammation commences there; sometimes after long fevers, when the violence of the disease settles in that part. This is a kind of abscess: and therefore requires no peculiar method of cure. This one caution, however, is necessary, that if the swelling came without any preceding distemper, repellents should first of all be tried: if the disorder proceeds from any illness, that method is hurtful; and it is more expedient to have it maturated and opened as soon as possible.

[GK] παρωτίδες.

CHAP. XVII.

OF A PROMINENT NAVEL.

In the case of a prominent navel, to prevent the necessity of any chirurgical operation, trial must first be made of abstinence, and a clyster must be given; over the navel may be applied that composition, which consists of hemlock and soot, each p. i. *. ceruss washed, p. iv. *. lead washed p. viii. *. with two eggs; to which is likewise added the juice of night-shade. This ought to lie on for a pretty long time; and, in the mean while, the patient is to be restrained from motion, use a spare diet, and avoid every thing flatulent.

CHAP. XVIII.

OF THE DISEASES OF THE PRIVATE PARTS.

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.

[Sidenote: _Of a gangrene._]

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.

[Sidenote: _Of a phagedaena._]

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.

[GL] φαγέδαινα.

[Sidenote: _A callosity or carbuncle._]

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.

[Sidenote: _Diseases of the testicles._]

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.

[Sidenote: _Diseases of the anus. Rhagadia._]

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.

[GM] ῥαγάδια.

[Sidenote: _Of condylomata._]

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.

[Sidenote: _Of the hemorrhoids._]

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.

[GN] αἱμοῤῥοἱδες.

[Sidenote: _Of a prolapsus of the anus or womb._]

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.

[Sidenote: _Of a fungous ulcer._]

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.

CHAP. XIX.

OF ULCERS IN THE FINGERS.

The best cure for ulcers of long standing in the fingers is either lycium or lees of oil boiled; to either of which wine is added. A caruncle here also sometimes recedes from the nails with great pain; the Greeks call it pterygion[GO]. It is proper to dissolve as much round Melian alum in water, as to make it of the consistence of honey; then to pour into it the same quantity of honey as there was of alum, and to stir it with a spatula, till it becomes of a saffron colour, and rub that over it; some people for the same purpose chuse to mix equal quantities of dry alum and honey, and boil them together to the due consistence. If they are not extirpated by this method, they must be cut off; then the fingers must be fomented with a decoction of vervains, and a medicine applied over them compounded thus; chalcitis, pomegranate bark, and copper scales are incorporated with a mellow fig gently boiled, and honey; or equal quantities of burnt paper, orpiment, and crude sulphur are mixed with cerate made of myrtle oil; or of rasile verdigrease p. i. *. copper scales p. ii. *. are brought to a consistence with a cyathus of honey; or equal parts of stone lime, chalcitis, and orpiment are mixed together. Which ever of these is applied, it must be covered with a linen cloth dipped in water. On the third day, the finger must be opened, and what is dry, must be cut away as before, and the like dressing applied. If it does not yield to this method, it must be cleansed with a knife, and burnt with small irons, and cured like other burns.

[GO] πτερύγιον.

But where the nails are scabrous, they ought to be opened round, where they are joined to the flesh; then some of the following composition must be applied over them; of sandarach, sulphur, each p. ii. *. nitre, orpiment, each p. iv. *. liquid resin p. viii. *. And this is to be taken off on the third day. This medicine causes the spoiled nails to fall off and better to grow in their place.

A. CORNELIUS CELSUS

OF

MEDICINE.

_BOOK VII._