Chapter I: Part 1

THE
SYDENHAM SOCIETY

INSTITUTED
MDCCCXLIII

LONDON
MDCCCXLIV.

THE
SEVEN BOOKS
OF
PAULUS ÆGINETA.

TRANSLATED FROM THE GREEK.

WITH
A COMMENTARY
EMBRACING A COMPLETE VIEW OF THE KNOWLEDGE
POSSESSED BY THE
GREEKS, ROMANS, AND ARABIANS
ON
ALL SUBJECTS CONNECTED WITH MEDICINE AND SURGERY.

BY FRANCIS ADAMS.

IN THREE VOLUMES.
VOL. I.

LONDON
PRINTED FOR THE SYDENHAM SOCIETY
MDCCCXLIV.

“MULTUM EGERUNT QUI ANTE NOS FUERUNT, SED NON PEREGERUNT.
SUSPICIENDI TAMEN SUNT, ET RITU DEORUM COLENDI.”
(SENECA, EPIST. LXIV.)

PRINTED BY C. AND J. ADLARD,
BARTHOLOMEW CLOSE.

ADVERTISEMENT.

Although in the Preface which immediately follows, and which is reprinted with slight alterations from the former edition, I have entered, at some length, upon the subject of the following translation, I felt it necessary, in the circumstances under which my work now appears, to premise a few additional remarks.

It is now many years since I undertook and completed a translation of the whole works of Paulus Ægineta. In the year 1834 I published the first three books, with a commentary, having for its object to embody the most important opinions of the Greek, Roman, and Arabian writers, on all subjects treated of by the original author. Notwithstanding the very favorable reception which that volume obtained from many of the most eminent members of the medical profession, as well as from scholars both at home and abroad, I was under the necessity—from circumstances which I need not here detail—of deviating from my original intention of completing the publication of the work in the same form and at my own risk. After an interval of ten years the proposition was made to me by the Council of the SYDENHAM SOCIETY to prepare a new edition of the volume already published, and to complete the remaining two on the same general plan. This proposition was too gratifying to my feelings not to be immediately assented to; and it is with unfeigned satisfaction that I have now the honour to submit the first volume of the work to the members of so distinguished and important a Society.

In preparing this volume for the press, knowing that it will now be subjected to the criticisms of a very numerous and intelligent body of my professional brethren, I have been anxious to render it worthy of their approbation as far as lay in my power. At the request of the Council I have made considerable omissions in my commentary as formerly printed, more especially in regard to modern authorities; it being thought advisable not to bring the annotations further down than the period of the Arabian writers. I have also made not a few additions and alterations which I hope will be considered as improvements. In performing this part of my task I have greatly profited by the aid and valuable criticisms of two esteemed friends, Sir William Hamilton of Edinburgh, and Dr. Greenhill of Oxford.

I am sensible that it is to the growing conviction in the profession, of the value of the ancient authorities, that I owe the very flattering distinction which my work has now obtained; and I shall have great satisfaction in reverting to the labours of former years if they should now prove instrumental in increasing the desire of becoming acquainted with the views and practice of our forefathers. That the ancient literature of medicine has been too much neglected in this country is not disputed by any competent judge; and it would appear from the remarks of M. Hecker, in his address to the physicians of Germany, given in his admirable work on Epidemics,[1] that the profession on the Continent is not much in advance of us in this respect.

[1] Dr. Babington’s Translation; Sydenham edition, p. xv.

The time, however, it is to be hoped, is not far distant when the medical profession will everywhere be impressed with the importance of becoming properly acquainted with the views of the animal economy and of its derangements, entertained by three of the most intellectual nations of mankind; and when every newly-broached hypothesis will be tested by a comparison with doctrines of a similar nature advanced in former days, and every newly-proposed remedy will be subjected to a like ordeal. Surely every age ought to endeavour to benefit by the experiments, whether successful or otherwise, of all preceding ones; instead of every generation commencing a new series of trials, and wandering over the same ground in search of truths which had been long ago discovered; or in stumbling through the mazes of error without regarding the beacons set up by their forefathers to direct the footsteps of their descendants. If the wisdom of antiquity be entitled to high reverence in any case, it surely is so in medicine, founded as this art especially is on general observation and experience.

What renders ancient medical literature of the more importance at the present day, is the circumstance that it is almost our only source of information with regard to the diseases prevalent in several extensive countries bordering upon the Mediterranean Sea. It is well known that the inhabitants of Greece, of Asia Minor, and of the north coast of Africa have been long sunk into such a state of intellectual decrepitude as renders them incapable of making and recording original observation; consequently, for information in regard to the phenomena of disease, as manifested in these regions, we are almost entirely thrown back upon the literature of their ancestors.

I take the present opportunity of adverting to one or two circumstances which I omitted to notice in my original preface.

An objection, I am well aware, will be made by some scholars to the manner in which I have executed one part of my task. It is this:—that the references to ancient authors are often so vague, as to make it a matter of considerable difficulty to find the passages in the originals. It must be admitted that there are grounds for this objection; and if I had the work to do over again, I should most probably take pains to obviate it, in some degree, at least. But to remedy the omission, after the work was completed on its present plan, would have been a task of immense labour to me, without bringing a correspondent advantage to my readers. Moreover, I am convinced that, even as they stand, the references will, in general, be found sufficient to guide those who have an acquaintance with the originals to the places indicated; and to those who are unacquainted with them, this strict system of quotation would be of no use, further than to inspire them with a greater degree of confidence in the accuracy and pains-taking research of the Editor. It may be proper for me, then, to state that I have made it an invariable rule never to quote at second-hand, nor to make any reference to the opinions of an author whose works I have not myself carefully examined.

Many readers, I fear, will find considerable difficulty with the names of the Compound Medicines which occur throughout this volume; and may be disposed to think it was the duty of the Commentator to explain them as they occur. In answer to this objection, I beg to state, that these compositions will be fully described in the third and last volume, which treats of the Materia Medica and Pharmacy; and on this account I thought it unnecessary to notice them elsewhere. The GENERAL INDEX, which will be given at the end of the work, will also facilitate reference in such cases.

F. A.

BANCHORY, _August 17th, 1844_.

EDITOR’S PREFACE TO THE FIRST EDITION OF VOL. I.

Notwithstanding the additions which have been made of late years to the history of medical literature, it must still be admitted that there is not, in the English language, any work which contains a full and accurate account of the theoretical and practical knowledge possessed by the Greeks, Romans, and Arabians, on matters connected with medicine and surgery. Nor, as far as I can learn, is the case very different with the continental languages. For, although the German and French have lately acquired several histories of medicine distinguished for their ability and research, the object of these works would appear to be confined to a general exposition of the leading discoveries and revolutions in doctrine which marked each particular age or epoch in the profession; and I will venture to affirm that no person will be able to acquire from a perusal of them anything like a competent acquaintance with the minute details of ancient practice. The design of the present publication is to supply the deficiency, now adverted to, by giving a complete Manual of the Surgery and Medicine of the Ancients, with a brief but comprehensive outline of the sciences intimately connected with them, especially Physiology, the Materia Medica, and Pharmacy. At first it was my intention to accomplish this purpose in the form of an original work, but, being perplexed what plan to choose in arranging the multifarious matters which I had to treat of, I at last resolved upon taking for my text-book the celebrated synopsis of PAULUS ÆGINETA, whereby I was at once supplied with a convenient arrangement of my subject, and at the same time, by giving a close translation of it into English, I saw that I would be enabled to enrich our medical literature with one of the most valuable relics of ancient science. By following this correct and faithful guide, by supplying his omissions and enlarging his plan, when necessary, from the more copious works of his predecessors, and by adding, in all cases, the improvements of subsequent ages, down to the latest date of ancient literature, I am in hopes that I have been able to present the reader with a work from which he may, at one view, become acquainted with the prevailing opinions upon all the most important matters connected with medical practice during a period of more than fifteen centuries. Impressed with a sense of the arduous nature of the task which I had undertaken, and sensible that its value consists entirely in its completeness on all points, I have endeavoured to discharge this duty faithfully and to the best of my ability. I trust then it will be found that not only have I overlooked no treatise connected with the medical art which has come down to us from antiquity, but that I have turned to good account my acquaintance with the learned labours of modern commentators, especially in the department of the Materia Medica, in order to adopt the nomenclature of the ancients on these subjects to the terminology of Botany, Chemistry, and Mineralogy, in the present time.

And here may I be permitted to express my conviction that it is not altogether the blindness of partiality contracted towards intellectual pursuits upon which my mind has been so long engaged, that leads me to think that the original authors from whose stores I have drawn so liberally, will yet be found and acknowledged to have been well entitled to the confidence and reputation which they once enjoyed, and to which it is my wish that the present publication should, in some degree, restore them? It appears to me that, at certain periods of ancient times, the standard of professional excellence was such as would not easily be attained at the present day, with all our vaunted improvements in knowledge; and that many of those early masters of our art were distinguished for varied stores of erudition, an ardent love of truth, and an aptitude to detect the fallacies of error, such as few of us even now can lay claim to. The Father of Medicine held that, to become an eminent physician, it was necessary not only to be well acquainted with the structure of the human frame, but also to be skilled in logic, astronomy, and other sciences (De Aer. Aq., &c.); and of him it may be truly asserted, that he cultivated the art of medicine upon the strict principles of the inductive philosophy more than two thousand years before the world gave Lord Bacon the credit of introducing this method of philosophising. His devoted admirer and follower, Galen, was evidently the very _beau ideal_ of an accomplished physician; skilled in all the sciences of the day, in logic, mathematics, rhetoric, and the first philosophy; to all these ornamental branches of knowledge he added a minute acquaintance with anatomy and physiology; a practical experience with the phenomena of diseases as diversified by climate, situation, and the varied modes of life; a singular perseverance in collecting facts; and an extraordinary ability for generalizing them. The contemporaries of Celsus regarded him not only as well acquainted with medical literature, but also as being minutely skilled in every elegant and useful science which was known and cultivated at that remarkable period. And Rhases, the Arabian, requires of him who aspires to eminence in the medical profession, that, instead of wasting his earlier years in frequenting musical and drinking parties, he should have spent them in conning over the valuable records of ancient wisdom. “But the Sciolist,” says he, “who gives himself out for a proficient in the art, while he has scarcely even a smattering of learning, will never be deserving of much confidence, nor ever attain any great eminence in his profession. For it can never be that any individual, to whatever age he may reach, should be able to comprehend in his mind a subject so vast and diffuse, except by treading upon the footsteps of the ancients; since the boundaries of the science far exceed the narrow limits of the life of man, as is the case with most of the liberal arts as well as with medicine. The number of authors is not small by whose labours the art has attained its present growth; and yet one may hope to master the monuments of their industry within the space of a few years. Let us suppose that, in the course of a thousand years, a thousand authors had made improvements in the profession; and then a person who has diligently studied their works may improve his mind as much in knowledge as if he had devoted a thousand years to the study of medicine. But, when an acquaintance with former authors is despised, what need be expected from the efforts of a single person? For, however much he may surpass others in abilities, how is it to be supposed that his private stock of knowledge should be at all worthy to compare with the accumulated treasures of antiquity? In a word, he who has never turned over the pages of the ancient physicians, nor has formed to his mind a distinct conception of the nature of diseases before he enters the chambers of the sick, will find that, from ignorance and misapprehension, he will confound one complaint with another, for this obvious reason, that he has come to his task unprepared and uninstructed.”

And here I would beg to call the attention of my readers to the fact that there is no legitimate mode of cultivating medical knowledge which was not followed by some one or other of the three great sects into which the profession was divided in ancient times. The Empirics held that observation, experiment, and the application of known remedies in one case to others presumed to be of a similar nature, constitute the whole art of cultivating medicine. Though their views were narrow, and their information scanty, when compared with some of the chiefs of the other sects; and although they rejected, as useless and unattainable, all knowledge of the causes and recondite nature of diseases, it is undeniable that, besides personal experience, they freely availed themselves of historical detail, and of a strict analogy founded upon observation and the resemblance of phenomena. To this class we may refer Scribonius Largus, Marcellus, Plinius Valerianus, and a few others, frequently quoted by us. The sect called the Rational, Logical, or Dogmatical, holding that there is a certain alliance and connexion among all the useful and ornamental arts, maintained that it is the duty of the physician not to neglect any collateral science or subject. They therefore inquired sedulously into the remote and proximate causes of diseases, and into the effects of airs, waters, places, pursuits, food, diet, and seasons, in altering the state of the human body, and in rendering it more or less susceptible of morbid changes. Looking upon general rules as not being of universal application, they held that the treatment ought to be modified according to the many incidental circumstances under which their patients might be placed. They freely and fully availed themselves of whatever aid they could derive from experience, analogy, and reasoning. Hippocrates, Galen, Aëtius, Oribasius, Paulus Ægineta, Actuarius, and all the Arabian authorities, may be looked upon as belonging to this sect. The Pneumatic sect, to which Aretæus probably belonged, was nearly allied to the Dogmatical. The sect of the Methodists, rejecting altogether the consideration of remote causes, which they held to be of no importance to the cure, and giving themselves up to too bold a classification of diseases, according to certain hypothetical states of the body in which they were supposed to originate, fettered themselves too much with a few general rules, which they held to be so universally applicable, that they would scarcely allow of their being modified by incidental circumstances in any possible contingency. Notwithstanding this defect, it is undeniable that their speculations as to the nature of diseases are generally very acute, and their modes of treatment frequently very rational. Upon the whole, the general outline of their system would appear to have borne a striking resemblance to that of the sect which started up in Edinburgh towards the end of the last century, called the Brunonian, from the name of its ingenious but fanciful founder, Dr. Brown. The only perfect model of ancient Methodism that has come down to us is Cælius Aurelianus, an author so truly eminent that some of his admirers in modern times have not scrupled to maintain that his works are even better worth being attentively studied than those of Hippocrates and Galen. Moschion and Theodore Priscian (otherwise known by the name of Octavius Horatianus) belonged to this sect; Alexander of Tralles also had a considerable leaning to its principles; and some would even refer the illustrious Celsus to the same class, but probably without good reason, for he would rather seem to have imbibed the genuine spirit of Eclecticism, and like his distinguished correspondent Horace, to have been

“Nullius addictus jurare in verba magistri.”

Before concluding these prefatory remarks, it will be naturally expected that I should say something of the author whose work I have bestowed so much pains in translating and commenting upon. Here, however, I must regret that the information which I have to supply is exceedingly scanty and unsatisfactory. So little is known of him that it is not even ascertained in what century he flourished. Vossius is wholly undecided; Moreau and Le Clerc place him in the fourth century; Vander Linden and Conringius, in the fifth; but Freind, Albertus Fabricius, Hutcheson, Sprengel, and most of the late writers of the Ancient History of Medicine, bring him down as low as the seventh century, upon the authority of Abulfaragius; but every person who is at all acquainted with his works will agree with me that any opinion of his on chronological matters is entitled to very little consideration indeed.

What confidence does a writer deserve who states, for example, that Andromachus, the physician who added the flesh of vipers to the celebrated electuary of Mithridates, lived in the time of Alexander the Great!—that Dioscorides, of Ain Zarba, flourished in the reign of Ptolemy Physcon, namely, about one hundred and twenty years before Christ, whereas it can scarcely admit of a doubt that the celebrated author of the Greek Materia Medica did not live earlier than the end of the first century of the Christian era!—and that Ruffus was contemporary with Plato, when we have the authority of Suidas that he lived in the reign of Trajan! Dr. Milward, in his epistle to Sir Hans Sloane, endeavours to settle the age of our author from the following train of inferences: In the first place, then, since Paulus quotes Alexander Trallian and Alexander Aëtius, it is quite certain that our author was posterior to both these writers. Now the age of Aëtius may be made out from the following circumstances: Aëtius mentions St. Cyril, Archbishop of Alexandria, whose death is ascertained from ecclesiastical history to have happened as late as the middle of the fifth century. Nay, he also takes notice of a medicine much recommended by Petrus Archiater, chief physician to Theodoric, who was posterior to St. Cyril. We cannot possibly suppose it likely, then, that Aëtius flourished earlier than the end of the fifth century. But what brings him still further down, is the circumstance that his predecessor, Alexander, is mentioned by Agathias, the historian, about the middle of the sixth century. (Hist. v, 6.) It would seem almost certain, therefore, taking all these things into consideration, that our Author cannot have lived at an earlier period than in the end of the sixth or the beginning of the seventh century.

But, whatever may have been the period at which he lived, there can be no doubt that he attained great eminence in his profession, and continued to be looked up to as one of the highest authorities in Medicine and Surgery during a long succession of ages. His countryman Nonnus, although he does not mention him by name, gives a brief compendium of a considerable portion of his work; and Psellus does the same in politic verses of some elegance. All the medical authors, in a word, of the distinguished Arabian period, quote his opinions in almost every page of their works, and never fail to recognize him as one of the most eminent of their Grecian masters. At the revival of literature in modern times, the Latin translations of the Arabians continued for a time to be the ordinary guides to practice; but when the superior merit of their Greek originals came to be properly appreciated, our Author rose again into high consideration. As a proof of this, I may mention that the surgery of Fabricius ab Aquapendente is made up almost entirely from his works. Portal, therefore, had no good occasion for representing him as “one of those unfortunate writers to whom posterity had not done justice.” I admit, indeed, that for some time past, since professional research and the study of ancient models have been superseded by a restless desire of novelty in theory and in practice, he has not enjoyed that consideration to which he is justly entitled; but, in this respect, he has only shared the fate of other names, equally eminent for their contributions to medical science, who have now been suffered to fall into neglect.

Of the Latin translations, which are very numerous, the most celebrated is that of Cornarius, published by Henry Stephens in his ‘Medicæ Artis Principes;’ which, however, after a careful examination, I have not found to be so trustworthy as I expected to find it. There once existed an Arabic edition by Honain, or Joannitius, (see Choulant, Handb. der Bücherkunde für die Aeltere Medicin,) but of it I know nothing. The only part which has been translated into any modern language is the Sixth Book, a French translation of which was published at Lyons, A. D. 1539. Of the original there are two editions, namely, the Aldine of 1528 and the Basle of 1538, in neither of which is the text so accurate as could be wished.

F. A.

BANCHORY-TERNAN; _Nov. 12th, 1833_.

THE AUTHOR’S PREFACE.

It is not because the more ancient writers had omitted anything relative to the Art that I have composed this work, but in order to give a compendious course of instruction; for, on the contrary, everything is handled by them properly, and without any omissions, whereas the moderns have not only in the first place neglected the study of them, but have also blamed them for prolixity. Wherefore, I have undertaken the following Treatise, which, it is like, will serve as a commentary to those who may choose to consult it, whilst it will prove an exercise to me. For it appears strange that lawyers should be possessed of compendious and, as they call them, popular legal synopses, in which are contained the heads of all the laws, to serve for immediate use, whilst we neglect these things, although they have it generally in their power to put off the investigation of any point not only for little but even for a considerable time, whereas we can seldom or very rarely do so; for, in many cases, necessity requires that we act promptly, and hence Hippocrates has properly said, “the season is brief.” (Aph. 1, i.) For their business is generally conducted in the midst of cities, where there is an abundant supply of books, whereas physicians have to act not only in cities, in the fields, and in desert places, but also at sea in ships, where such diseases sometimes suddenly break out as, in the event of procrastination, would occasion death, or at least incur the most imminent danger. But to remember all the rules of the healing art, and all the particular substances connected with it, is exceedingly difficult if not altogether impossible. On this account I have compiled this brief collection from the works of the ancients, and have set down little of my own, except a few things which I have seen and tried in the practice of the art. For being conversant with the most distinguished writers in the profession, and in particular with Oribasius, who, in one work, has given a select view of everything relating to health (he being posterior to Galen, and one of the still more recent authors), I have collected what was best in them, and have endeavoured, if possible, not to pass by any one distemper. For the work of Oribasius, comprehending seventy books, contains indeed an exposition of the whole art, but it is not easily to be procured by people at large on account of its bulk, whilst the epitome of it, inscribed to his son Eustathius, is deficient in some diseases altogether, and gives but an imperfect description of others, sometimes the causes and diagnosis being omitted, and sometimes the proper plan of treatment being forgotten, as well as other things which have occurred to my recollection. Wherefore the present work will contain the description, causes, and cure of all diseases, whether situated in parts of uniform texture, in particular organs, or consisting of solutions of continuity, and that not merely in a summary way, but at as great length as possible.

In the First Book, you will find everything that relates to Hygiene, and to the preservation from, and correction of, distempers peculiar to the various ages, seasons, temperaments, and so forth; also, the powers and uses of the different articles of food, as is set forth in the chapter of contents.

In the Second is explained the whole doctrine of Fevers, an account of certain matters relating to them being premised, such as excrementitious discharges, critical days, and other appearances, and concluding with certain symptoms which are the concomitants of fever.

The Third Book relates to Topical affections, beginning from the crown of the head and descending down to the nails of the feet.

The Fourth Book treats of those complaints which are external and exposed to view, and are not limited to one part of the body but affect various parts. Also, of Intestinal Worms and Dracunculi.

The Fifth treats of the Wounds and Bites of Venomous Animals; also of the distemper called Hydrophobia, and of persons bitten by dogs which are mad, and by those which are not mad; and also of persons bitten by men. Afterwards it treats of deleterious substances, and the preservatives from them.

In the Sixth Book is contained everything relating to Surgery, both what relates to the fleshy parts, such as the extraction of weapons; and to the bones, which comprehends Fractures and Dislocations.

In the Seventh is contained an account of the Properties of all Medicines, first of the Simple, then of the Compound; particularly of those which I had mentioned in the preceding Six Books, and more especially the greater and, as it were, celebrated preparations. For I did not think it proper to treat of all these articles promiscuously, lest it should occasion confusion, but so that any person looking for one or more of the distinguished preparations might easily find it. Towards the end are certain things connected with the Composition of Medicines, and of those articles which may be substituted for one another: the whole concluding with an account of Weights and Measures.

CONTENTS OF THE FIRST VOLUME.

PAGE

Advertisement v

Translator’s Preface ix

Author’s Preface xvii

FIRST BOOK.

SECT.

1. On the Complaints of Pregnant Women, and their Diet 1

2. On the Nurse 5

3. On the Milk of the Nurse 6

4. How to correct the bad qualities of Milk 7

5. On the Management of the Infant 8

6. On the Eruptions of Children 10

7. On the Cough and Defluxion of Infants 11

8. On Pruritus 12

9. On Dentition 13

10. On Aphthæ 14

11. On Excoriations of the Thighs 16

12. On Discharges from the Ears ib.

13. On Siriasis ib.

14. The Regimen of Infancy, and of the succeeding ages, until
manhood 18

15. On the Preparatory Friction 19

16. On Exercises 20

17. On the kinds of Exercise 22

18. On the kinds of Friction 28

19. On Vociferation, or the exercise of the voice 29

20. On Lassitude from Exercises 30

21. On Constriction of the Skin 33

22. On Spontaneous Lassitude ib.

23. On the Regimen of old persons 36

24. For a wrinkled state of the Body 37

25. To make the Perspiration fragrant 38

26. To warm the habit ib.

27. For Paleness 39

28. On Lividity ib.

29. Preservatives of the Teeth ib.

30. For Dulness of Hearing 40

31. On Dimness of Sight ib.

32. On Repletion 41

33. On Intoxication 43

34. On wrong Digestion of the Food 44

35. On Venery ib.

36. On Impotence 46

37. On Inordinate Venery 47

38. On Redundance of Semen 48

39. On persons injured by Cold 49

40. For persons scorched by the Sun 51

41. On collections of Phlegm in the Stomach ib.

42. How to produce easy Vomiting 52

43. On Laxatives and Diuretics to those in Health 54

44. On Clysters 57

45. On Suppositories 58

46. On Medicines which evacuate Phlegm from the Head—Masticatories,
Errhines, and Liniments to the Nose 59

47. On Emmenagogues 60

48. On Sudorifics 61

49. On Airs 63

50. On Waters 64

51. On Baths 67

52. On the Natural Baths 71

53. On the Regimen fitting to the different Seasons 73

54. On the Regimen of Persons actively employed 75

55. On the Regimen of Travellers 76

56. On the Regimen of Persons on board Ship 79

57. On the means of diminishing Obesity 80

58. How to recruit those who are emaciated 82

59. How to remedy emaciated parts of the Body 84

60. Diagnosis of the best Temperament ib.

61. Diagnosis of the Intemperaments of the Body 85

62. On the Form of the Head 87

63. The marks of the Temperaments of the Brain 87

64. The marks of the Temperaments of the Stomach 90

65. Diagnosis of the Temperaments of the Lungs 93

66. The marks of the Temperaments of the Heart 94

67. On the Temperaments of the Liver 98

68. Diagnosis of the Temperaments of the Testicles 100

69. On the parts that are omitted 101

70. The Correction of Hot Intemperaments of the Body ib.

71. The Correction of the Cold Intemperaments of the Body 102

72. The Cure of the Dry Intemperaments, of the Stomach for
example; then of the other Intemperaments 103

73. On the Powers of the Articles of Food 106

74. On Pot-herbs 110

75. On Asparagi, or young Shoots 115

76. On things having esculent Roots 116

77. On Truffles and Mushrooms 119

78. On the frumentaceous articles of Food 120

79. On Pulse 124

80. On the Summer Fruits 127

81. On the Fruit of Trees 129

82. On Animals; and, first, of Fowls 138

83. On Eggs 143

84. On Beasts 145

85. On the parts of Animals 149

86. On Milk 151

87. On the Drinking of Milk 154

88. Curds and Whey 155

89. On Cheese 156

90. On Fishes 157

91. On the Testacea, or Shellfish 166

92. On the Mollusca 169

93. On the Cartilaginous Fishes ib.

94. On the Cetacea or large Fishes 170

95. On the Properties of Wine 172

96. On Honey, and Hydromel or Honied Water 178

97. On Sleep 180

98. On Watchfulness 181

99. On Somnolency 183

100. The Epistle of Diocles on the Preservation of Health—Diocles
to King Antigonus ib.

SECOND BOOK.

1. On Fevers, from the works of Galen and several others 187

2. Of the principal considerations to be inquired into with
regard to febrile affections 188

3. From Galen, what to call the commencement of the Disease 189

4. How to know whether the Disease will prove fatal or not ib.

5. How to know if the Disease will be of long duration 193

6. How to know if the Disease will terminate by a Crisis or
by Resolution 194

7. On Critical Days ib.

8. That Critical Symptoms appearing at the commencement are
unfavorable 198

9. How to judge beforehand of a future Crisis ib.

10. How to recognize a present Crisis 199

11. How to determine whether a past Crisis be favorable 201

12. On the Pulse, from the works of Galen 202

13. On the Alvine Discharges 222

14. On the Indications from the Urine 224

15. On the Indications from the Sputa 228

16. The Diagnosis and Cure of Ephemeral Fevers 229

17. Diagnosis of Fevers from Putrefaction 235

18. The Cure of Putrid Fevers 237

19. The Diagnosis of Tertian Fevers 239

20. The Cure of Tertian Fevers 241

21. The Cure of Spurious Tertians 243

22. The Diagnosis of Quartans 245

23. The Cure of Quartans 246

24. The Diagnosis of the Quotidian 249

25. The Cure of Quotidians 250

26. On the Fever Hepialus, and the Rigor without Heat 251

27. On the Continual Fevers 253

28. The Diagnosis and Cure of Synochous Fevers 256

29. On the Diagnosis of Ardent Fevers 260

30. The Cure of Ardent Fevers 262

31. Diagnosis and Cure of Fevers connected with an Erysipelatous
affection 264

32. Diagnosis of Hectic Fevers 266

33. The Cure of Hectic Fevers 268

34. On Semi-tertians 271

35. On Epidemic Diseases 273

36. On the Plague, from the works of Ruffus 277

37. On the Treatment of those who are seized with Syncope
from crude humours 288

38. Of those who have fallen into Syncope from thin humours 291

39. On the other Causes which occasion Syncope 292

40. On Pain 296

41. On colliquative Diarrhœa, or Melting 297

42. On Watchfulness in Fevers 299

43. The Cure of Cataphora, or Somnolency 301

44. The Cure of Headach in Fevers ib.

45. On the Cure of Stomach affections 303

46. On inordinate Chills and Rigors in Fevers 305

47. On Sweats 306

48. On Cough in Fevers 309

49. On Sneezing 310

50. On Loss of Appetite 311

51. On Bulimos, or inordinate Appetite 313

52. On the canine Appetite 314

53. On Thirst 316

54. On Roughness of the Tongue 318

55. On Nausea 319

56. On Vomiting of Bile 320

57. On Hiccough 321

58. On Constipation and Looseness of the Bowels in Fevers 323

59. On trickling of blood and Hemorrhage from the Nose 325

60. On deliquium animi or Swooning 327

61. On the treatment of Ulceration upon the Os Sacrum 329

Appendix to the Commentary on Book Second: On Smallpox
and Measles 330

THIRD BOOK.

1. On affections of the Hair, Alopecia, Ophiasis, and Baldness 337

2. For making the Hair curled, and for dyeing it 342

3. On Pityriasis 345

4. On Headach 350

5. On Cephalæa and Hemicrania 355

6. On Phrenitis 359

7. On Phlegmon of the Brain 365

8. On Erysipelas of the Brain ib.

9. On Lethargy 366

10. On Catochus, or Coma Vigil 369

11. On the Loss of Memory and of Reason; on Carus and Fatuity 372

12. On Vertigo 374

13. On Epilepsy 376

14. On Melancholia, Mania, and Demoniacs 383

15. On Incubus, or Nightmare 388

16. On Lycaon, or Lycanthropia 389

17. On Love-sick Persons 391

18. On Apoplexy and Hemiplegia, or Paralysis 392

19. On Convulsions, or Spasms 401

20. On Tetanus and its varieties 403

21. On Tremblings 407

22. On Diseases of the Eye 409

23. On Diseases of the Ear 437

24. On Affections of the Nose, and of the Sense of Smell 446

25. On Affections of the Face 452

26. On Affections of the Mouth 454

27. On Angina, or Quinsey, and Complaints allied to it, in
which the subject of those who have been strangled,
or otherwise suffocated, is treated of 464

28. On Coryza, Catarrh, Affections of the Trachea, and Cough 469

29. On Orthopnœa, Asthma, and Dyspnœa 475

30. On Peripneumonia 480

31. On Spitting of Blood 483

32. On Empyema and Phthisis 491

33. On Pleurisy 496

34. On Affections of the Heart 501

35. On Affections of the Breasts 504

36. Fetid Smell and Sweating at the Armpits 506

37. On Affections of the Stomach, of the Hypochondria, and
of the Belly 507

38. On Inflation of the Stomach 514

39. On Cholera 515

40. On Lientery and Cæliac Affection 520

41. On Tenesmus 523

42. On Dysentery 525

43. On Colic Affection 531

44. On Ileus 538

45. On Affections of the Kidneys and Bladder 541

46. On Affections of the Liver 560

47. On Cachexia 568

48. On Dropsy 569

49. On the Spleen 577

50. On Jaundice 580

51. On Prolapsus of the Navel 587

52. How to make the Chin and Pubes continue long free of
Hairs; on the Preservation of the Genital Organs;
and among other things Depilatories 588

53. On Bubonocele, Enterocele, and Hydrocele 589

54. On Inflammation of the Testicle and Scrotum, and on the
other diseases of these parts 591

55. On Gonorrhœa and Libidinous Dreams 593

56. On Satyriasis 596

57. On Priapism 597

58. On Impotence of the parts 599

59. On matters relating to the Genital Organs and Anus 600

60. On Affections of the Uterus; and, first, of the Menstrual
Discharge 608

61. On Retention of the Menses 609

62. On Immoderate Menstruation and Uterine Hemorrhage 615

63. On the Female Flux 617

64. On Inflammation of the Uterus and Change of its Position 620

65. On Abscess of the Uterus 623

66. On Ulceration of the Womb 624

67. On Cancer 627

68. On Scirrhus and Scleroma 629

69. On the Mole 630

70. On Inflation of the Uterus 632

71. On Uterine Suffocation, or the Hysterical Convulsion 633

72. On Prolapsus Uteri 638

73. On Phimus in the Uterus 640

74. The Cure of Sterility 641

75. On Fissures, Condylomata, and Hemorrhoids of the Uterus 645

76. On Difficult Labour 646

77. On Ischiatic Disease 652

78. On Gout and Arthritis 657

79. On Chilblains, and Affections of the Feet and Hands 676

80. For Corns and Callus 678

81. On Complaints about the Nails 679

PAULUS ÆGINETA.

BOOK FIRST.

SECT. I.—ON THE COMPLAINTS OF PREGNANT WOMEN, AND THEIR DIET.

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.

SECT. II.—ON THE NURSE.

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.)

SECT. III.—ON THE MILK OF THE NURSE.

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.)

SECT. IV.—HOW TO CORRECT THE BAD QUALITIES OF MILK.