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1 1 I have spoken of those lesions which affect the whole body and require the aid of medicaments;1 now I come to those which customarily occur only in particular parts, beginning with the head.
In the head, then, when the hair falls out, the principal remedy is frequent shaving. Ladanum mixed with oil, however, is some help in preserving it. I am now referring to the falling out of hair after illness; for no kind of remedy can be given to stop the head of some people from becoming bald through age.
2 1 But the condition is called porrigo,2 when between the hairs something like small scales rise up and become detached from the scalp: and at times they are moist, much more often dry. Sometimes this happens without ulceration, sometimes there is a localized ulceration, and from this comes sometimes a foul odour, sometimes none. This generally occurs on the scalp, more seldom on the beard, occasionally even on the eyebrow. It does not arise unless there is some general bodily lesion, so that it is not entirely without its use; for it does not exude from a thoroughly sound head. When there is present some lesion in the head, it is not disadvantageous for the surface of the scalp to become here p181 and there corrupted, rather than for the harmful material to be diverted thence to another part of more importance. 2 Hence it is more beneficial from time to time to clear the scalp by combing, than to repress the disorder altogether. But if this condition is too troublesome, which may happen when a discharge of humour has set in, and especially if this is malodorous, the head is to be shaved often, after which one of the mild repressants is applied, such as soda in vinegar, or ladanum in myrtle oil and wine, or bennut oil with wine. If there is little benefit from these measures it is permissible to use stronger ones, whilst bearing in mind that, at any rate when the disease is of recent origin, this is not a good thing.
3 1 There is also an ulceration, called sycosis3 by the Greeks from is resemblance to a fig; a sprouting up of flesh occurs. That is the general description: but there are two subordinate species; in one the ulceration is indurated and circular, in the other moist and irregular in outline. 2 From the hard species there is a somewhat scanty and glutinous discharge; from the moist the discharge is abundant and malodorous. Both occur in those parts which are covered by hair; but the callous and circular ulceration mostly on the beard, the moist form, on the other hand, chiefly on the scalp. In both it is good to apply elaterium, or pounded linseed worked up in water, or a fig boiled in water, or the plaster tetrapharmacum4 moistened with vinegar; also Eretrian earth dissolved in vinegar is suitable for smearing on.
4 1 Bald spots5 also are of two kinds. In both, p183 owing to the dying of the surface pellicle, hairs are at first rendered thin, and then they fall out; and when the place is cut into, the blood which flows is thin and malodorous. Both kinds spread, in some quickly, in others slowly; the worse kind is that in which the skin has become thick, somewhat fatty, and quite smooth. 2 But that which is named alopecia6 spreads without defined configuration. It occurs in the hairy scalp or in the beard. That again which is called from its shape ophis,7 commences at the back of the head, and without exceeding two fingers in breadth, creeps forward to the ears with two heads, in some even to the forehead, until the two heads join one another in front. The former affection occurs at any age, the latter generally in young children. The former scarcely ever terminates, such under treatment, the latter often by itself. 3 Some scarify these bald patches with a scalpel; some smear on caustics mixed with oil, and especially burnt papyrus; some apply turpentine-resin with fennel. But there is nothing better than to shave the part daily with a razor, because as the surface skin is gradually removed, the hair roots become exposed; and the treatment should continue until a number of hairs are seen to be growing up. Following upon the shaving it is sufficient to smear on Indian ink.
5 1 To treat pimples and spots and freckles is almost a waste of time, yet women cannot be torn away from caring from their looks. But of these just mentioned, pimples and spots are commonly known, although that species of spot is more rare which is called by the Greeks semion,8 since it is p185 rather red and irregular. Freckles are, in fact, ignored by most; they are nothing more than a roughened and indurated discoloration. 2 Whilst the others occur only on the face, a spot sometimes also appears on other parts of the body; of that by itself I do not think it worth while to write elsewhere. But pimples are best removed by the application of resin to which not less than the same amount of split alum and a little honey has been added. A spot is removed by equal quantities of galbanum and soda pounded in vinegar to the consistency of honey. With this the part is to be smeared, and after the lapse of several hours, the next morning, it is washed off, and the place anointed lightly with oil. 3 Freckles are removed by resin to which a third part of rock-salt and a little honey has been added. For all the above and also for colouring scars that composition is useful which is said to have been invented by Trypho the father. In this are equal parts of the dregs of bennut oil, bluish Cimolian chalk, bitter almonds, barley and vetch meal, along with white soapwort and mellilot seeds. These are all rubbed up together with very bitter honey, smeared on at night and washed away in the morning.
6 1 Now the foregoing are subjects of minor importance. But there are grave and varied mishaps to which our eyes are exposed; and as these have so large a part both in the service and the amenity of life, they are to be looked after with the greatest care. Now directly ophthalmia9 sets in, there are certain signs by which it is possible to foretell the course of the disease. For if lacrimation swelling of the eyelids and a thick rheum appear all at once; if that rheum is mixed with tears, if the tears are not hot, but the rheum is white and bland, and the swelling is not hard, there is then no apprehension of a prolonged illness. bBut if lacrimation is profuse and hot, rheum scanty, swelling moderate, and that in one eye only, the case will be a prolonged one, but without danger. And that kind of ophthalmia is the least painful, but is seldom relieved before the twentieth day, and at times lasts two months. As it subsides, the rheum begins to be white and bland, mixed with tears. But if both eyes are attacked simultaneously, the duration may possibly be shorter, but there is danger of ulceration. Now rheum, when it is dry and sticky, gives rise to some pain, but subsides sooner unless ulceration is set up. cIf there is great swelling without pain and dryness, there is no danger; if there is dryness, accompanied by pain, there is generally ulceration, and at times the result is that the eyelid sticks to the eyeball. There is danger of similar ulceration in the eyelids or in the pupils when, in addition to great pain, the tears are salt and hot; or if, even after the swelling has subsided, there continues for some time a flow of tears mixed with rheum. dThe case is worse still when the rheum is pallid or livid, the tears hot and profuse, the head hot, and pain shoots from the temples to the eyes, causing wakefulness at night; in these circumstances generally the eyeball ruptures, and we must pray that there may be ulceration only. When the eyeball has ruptured inwards a touch of fever is beneficial. If the eyeball protrudes after rupturing outwards, there is no remedy. If something white p189 has developed from the dark part of the eye, it persists for a long while; but if it is rough and thick, some vestige remains even after treatment. eAccording to Hippocrates, the oldest authority, the treatment of the eyes includes bloodletting, medicaments, the bath and wine; but he gave little explanation of the proper times and reasons for these remedies, things of the highest importance in the art of medicine. There is no less help, often, in abstinence and clysters. Now at times inflammation seizes the eyes, and there is pain in them together with swelling, and there follows a flow of rheum, sometimes rather profuse or acrid, sometimes in both respects rather moderate. In such a case, rest in bed and abstinence are the chief remedies. fFrom the first day, therefore, the patient should lie in bed in a dark room, and at the same time he should refrain even from talking; take no food at all, and if feasible not even water, or at any rate the least possible amount. If the pains are severe, it is better that he should be bled on the second day, but when urgent this may be done even on the first day, at any rate if the veins on the forehead are swollen, and if there is superfluity of matter in a robust patient. But if the attack is less violent, it requires less drastic treatment: the bowel should be clystered, but only on the second or third day. gBut moderate inflammation requires neither blood-letting nor clystering, it is sufficient for the patient to stay in bed and fast. A prolonged abstinence, however, is not necessary in patients with ophthalmia, for it may render the rheum thinner, and more acrid; hence some of the lightest kind of food should be given on the second day, such as seems likely to p191 render the rheum thicker; for instance, raw eggs; in a less severe case, porridge also or bread soaked in milk. On the following days, according as the inflammation subsides, additional food may be taken, but of the same class; certainly nothing salted, or acrid, or likely to make the rheum thinner should be consumed, and nothing but water drunk. hSuch a dietetic regimen is exceedingly necessary. But from the first day, saffron 4 grams and the finest wheat flour 8 grams should be made up with white of egg to the consistency of honey, then spread on lint and stuck on the forehead, in order that by compressing the veins the flow of rheum may be checked. If saffron is not at hand, frankincense has the same effect. Whether it is spread on linen, or on wool, makes no difference. iThere should be smeared over the eyeball, of saffron as much as can be taken up in three fingers, of myrrh in amount the size of a bean, of poppy-tears the size of a lentil: these are pounded up in raisin wine, and applied on a probe to the eyeball. Another composition having the same efficacy is made up of: myrrh 0.33 grams, mandragora juice 4 grams; poppy-tears 8 grams; rose-leaves and hemlock seeds 12 grams each; acacia10 16 grams; gum 32 grams. kThese applications are made by day; at night, in order better to assure sleep, it is not inappropriate to apply above the eye, the crumb of white bread soaked in wine; for this at once represses rheum, and absorbs any flow of tears, and prevents the eye from becoming glued up. If this application, owing to the great pain in the eye, seems oppressive and hard, p193 eggs, both the white and the yolk, are poured into a vessel, a little honey-wine added, and the mixture stirred with the finger. When thoroughly mixed, soft well-combed wool is soaked in it and the wool then applied over the eyes. lThis is both a light application and one which by cooling checks rheum, yet does not quite dry it up, and so the eye is not allowed to become glued up. Boiled barley-meal, mixed with boiled quinces, is also a suitable application; nor is it inconsistent with the treatment, even to put on a pad of wool wrung as hard as possible out of water, if the attack is a lighter one, or out of vinegar and water, if it is more severe. The former applications are to be bandaged on, so that they do not fall off during sleep; the latter it suffices to lay one because it can be changed readily by the patient himself, and when it becomes dry, it must be wetted again. mIf the affection is so severe as to prevent sleep, for a time one of the remedies which the Greeks call anodyna11 should be administered, an amount the size of a vetch to a child, that of a bean to a man. For the eyeball itself there is no appropriate application on the first day, unless the inflammation is only moderate, for by such the flow of rheum is often stimulated rather than lessened. From the second day, even when the disease is severe, the direct application of medicaments is proper, when blood has been let or clystering applied, or after it has become evident that neither is needed.
2 Now for this disease there are many salves12 devised by many inventors, and these can be blended even now in novel mixtures, for mild medicaments and moderate repressants may be readily and variously mingled. I will mention the most famous.
p195 3 There is then the salve of Philo, which contains: washed cerussa, spode and gum 4 grams each; poppy-tears toasted 8 grams. It is important to know that each of these ingredients should be pounded separately, than mixed together, gradually adding water, or some other fluid. Gum, amongst other properties, has this particular advantage, that when salves made of it have become dry, they stick together and do not break up.
4 The salve of Dionysius consists of: poppy-tears toasted until they soften 4.66 grams, toasted frankincense and gum 2 grams each, and zinc oxide 16 grams.
5 The salve of Cleon is quite famous: poppy-tears toasted 4 grams, saffron 0.66 grams, gum 4 grams, to which after being pounded is added rose juice. The same man prescribed another more active salve: scales of the copper which is called stomoma13 4 grams; saffron 8 grams; zinc oxide 16 grams; lead washed and roasted 24 grams; with a like quantity of gum. bThere is also for the same complaint the salve of Attalus especially when the rheum is profuse: castoreum 0.33 grams; lign-aloes 0.66 grams; saffron 4 grams; myrrh 8 grams; lycium 12 grams; prepared zinc oxide 32 grams; a like quantity of antimony sulphide and acacia juice 48 grams. And when no gum is added it is preserved liquid in a small receptacle. Theodotus added to the above mixture: poppy-tears toasted 0.33 grams; copper scales roasted and washed 8 grams; toasted date kernels 40 grams; gum 48 grams.
6 The salve of Theodotus himself, which by some is called achariston,14 is composed of: castoreum and Indian nard 4 grams each; lycium 0.66 gram; an equal amount of poppy-tears; myrrh 8 grams; saffron, p197 washed white lead and lign-aloes 12 grams of each; cluster-shaped oxide of zinc, washed and roasted copper scales 32 grams each; gum 72 grams; acacia juice 80 grams; the same amount of antimony sulphide, to which is added rain-water.
7 Besides the above, among the most commonly used salves is that which some call cycnon,15 others from its ashen colour tephron, which contains: starch, tragacanth, acacia juice, gum 4 grams each; poppy-tears 8 grams; washed cerussa 16 grams; washed litharge 32 grams. These ingredients likewise are compounded with rain-water.
8 Euelpides, the most famous oculist of our time, used a salve of his own composition called trygodes:16 castoreum 1.33 grams; lycium, nard and poppy-tears 4 grams each; saffron, myrrh and lign-aloes 16 grams each; roasted copper scales 36 grams; oxide of zinc and antimony sulphide 48 grams; acacia juice 144 grams; the same amount of gum.
bThe more severe the inflammation, the milder should the application be made, by adding to it white of egg or woman's milk. But if neither doctor nor medicine is at hand, either of the above, dropped into the eye with a little screw of lint prepared for the purpose, often relieves the trouble. But when the patient has been relieved and the discharge of rheum is already checked, any slight symptoms which remain may be got rid of by making use of the bath and of wine. cTherefore when at the bath the patient should be first rubbed over gently with oil, especially over the legs and thighs, and he should bathe his eyes freely with hot water, next hot water should be poured over his head, followed p199 by tepid water; after the bath he must take care that he is not harmed by cold or draught: subsequently he should use a diet rather fuller than had been customary for those days,17 whilst avoiding everything which may render the rheum thinner. He should drink mild wine, not too dry, and moderately old, taking it neither too freely nor too sparingly, so that, without causing indigestion, it may nevertheless induce sleep, and mollify the internal latent acrid humour. dIf at the bath the patient feels the trouble in the eyes becoming worse than before he entered, which often happens to those who have hurried on to this course of treatment whilst there is still a discharge of rheum, he ought immediately to leave the bath, take no wine that day, and less food even than on the previous day. Afterwards, as soon as the flow of rheum has subsided sufficiently, he may return again to the use of the bath. Nevertheless, from the fault of the weather, or of the patient's constitution, if on happens that for many days neither the pain nor inflammation is checked, and least of all the discharge of rheum. When this occurs and the affection is now established by reason of its long standing, recourse must be had to these same remedies that is, the bath and wine. eFor whilst they unsuitable early in the complaints because they can then irritate and stir up inflammation, yet in inveterate cases which have not yielded to other remedies, they are quite effectual, that is to say, in this as in other instances, when ordinary remedies18 have proved useless, contrary ones are beneficial. But beforehand the patient should be shaved down to the scalp, then in the bath he should foment both his head and eyes with plenty of hot water, next p201 clean both with a little roll of lint, and anoint the head with iris ointment: and he should keep to his bed until all the heat so produced has ended, and the sweat which of necessity has collected in the head has passed off. fHe is then to take food and wine of the same sort as above, drinking the wine undiluted; and he must rest with the head wrapped up. For often after these measures a sound sleep, or a sweat, or a clearance of the bowel, terminates the discharge of rheum. If, as more often happens, the malady is in some measure relieved, the same regimen is pursued for a number of days until recovery is completed. If, meanwhile, the bowels do not act, clysters are given to relieve the upper parts of the body. gBut occasionally a violent inflammation breaks out with so much force as to push forwards the eyes out of their place: the Greeks call this proptosis,19 because the eyes drop forwards. In this cases especially, if the strength allows of it, blood is to be let; if that is impracticable, then a clyster and prolonged abstinence should be prescribed. The blandest medicaments are required; hence some use that salve of Cleon's20 which has been noted above, as consisting of two ingredients, poppy-tears and gum, but the best is the salve of Nileus,21 and this point is agreed on by all authorities.
9 This salves consists of Indian nard and poppy-tears 0.33 gram each; gum 4 grams; saffron 8 grams; fresh rose leaves 16 grams, which are mixed up in rain-water or in a rather mild wine. And it is not out of place to boil pomegranate rind or melilot in wine and then pound it; or to mix black myrrh with rose leaves, p203 or hyoscyamus leaves with the yolk of a boiled egg, or flour with acacia juice and raisin wine or honeyed wine; if poppy-tears too be added to these, they are rendered somewhat more active. bHaving prepared one of the above, the eyes should be swabbed with a small screw of lint, wrung out in a hot decoction of myrtle or rose leaves and then one of the salves placed in them. Furthermore, after incising the skin of the occiput, a cup is to be applied there. But if the eye is not restored into position by the above remedies, but remains pushed forward as before, it should be recognized that its sight is lost; and that the eyeball will harden or will be converted into pus. If suppuration shows itself in the corner nearest the temple, the eyeball should be cut into, in order that by letting out the pus, both inflammation and pain may be ended, and the coats of the eyeball may recede, so that the patient's looks afterwards may be less disfigured. cThere should then be applied either one of the above salves with milk or egg, or saffron, either by itself or mixed with white of egg. But if the eyeball has grown hard and is dead, but not converted into pus, so much of it is to be cut out as projects in an ugly fashion; for this purpose the sclerotic coat is seized with a hook, and the scalpel cuts under it; then the same medicaments are to be inserted until all pain has stopped. Use is to be made of the same medicaments for an eye which has first prolapsed, and then has split open in several places.
10 It is also customary for inflammation to give rise to carbuncles, sometimes upon the actual eyeballs, sometimes upon the eyelids, either on the inner or on the outer surface of these. When this occurs, the p205 patient should be clystered, the food diminished, and milk given as a drink, in order to mollify the acrid matter which is doing harm. As regards poultices and medicaments, what has been prescribed for inflammation must be used. And here again the salve of Nileus22 is best: but when the carbuncle is on the outer surface of the eyelid, the most suitable poultice is one of linseed boiled in honeyed wine, or, if that is not at hand, flour boiled in the same.
11 Pustules are also an occasional consequence of inflammation. If this happens early during the first stage, the blood-letting and rest prescribed above should be even more strictly enforced; if later than the stage when blood-letting is possible, the bowels, nevertheless, should be clystered; and if anything should prevent this also, at any rate the regimen as to diet should be followed. For this condition also soothing medicaments are necessary, such as those of Nileus and Cleon.
12 Also the salve23 named after Philalethus is suitable, consisting of: myrrh and poppy-tears 4 grams each; washed lead, Samian earth called aster,24 and tragacanth 16 grams each; boiled antimony sulphide and starch 24 grams each; washed oxide of zinc and washed cerussa 32 grams each. These are made up with rain-water. The salve is used either with white of egg or milk.
13 From pustules ulcerations sometimes arise. These when recent are likewise to be treated by mild applications, generally by the same as I have prescribed above for pustules.25 That which is called 'dia libanu'26 is specially prepared for the above condition. It is composed of roasted and washed copper, and parched poppy-tears 4 grams p207 each; washed zinc oxide, frankincense, roasted and washed, antimony sulphide, myrrh, and gum 8 grams each.
14 It happens too that the eyeballs, either both or one, become smaller than naturally they ought to be. An acrid discharge of rheum in the course of ophthalmia causes this, also continuous weeping, and an injury improperly treated. In these cases the same mild applications mixed with woman's milk should also be used, and for food, that which is most nourishing and body-building. In every way any cause which may excite tears must be avoided, and anxiety about home affairs also, knowledge of which, if anything of that sort has arisen,27 must be kept from the patient. And acrid medicaments and sour food do harm in these cases, chiefly because of the tears which they excite.
15 There is also a kind of disorder in which lice are born between the eyelashes; the Greeks call it phthiriasis. Since this comes from a bad state of health it seldom fails to get worse; but usually in time a very acrid discharge of rheum follows, and if the eyeballs become severely ulcerated, it even destroys their vision. In these cases the bowel should be clystered, the head shaved to the scalp, and rubbed for a good while daily whilst the patient fasts; walking and other exercises should be diligently practised; he should gargle honey wine in which mint and ripe figs have been boiled; bat the bath the head should often be freely fomented with hot water, acrid food avoided, milk and sweet wine should be taken, with more drink than food. Medicaments administered internally should be bland lest they stimulate the acridity of the rheum; p209 other medicaments too are put upon the lice themselves in order to kill them and prevent any more from being born. For this purpose soda-scum 0.33 gram, sandarach 0.33 gram and black bryony berries 4 grams are pounded up together, with equal proportions of old oil and vinegar, until of the consistency of honey.
16 The preceding diseases of the eyes are treated with bland applications. Next come other classes which require a different treatment, and they usually originate from inflammation, but also persist after the inflammation has subsided. And first in some cases there is a thin discharge of rheum which persists; in these the bowel is to be clystered, and the amount of food somewhat reduced. And it is not inappropriate to smear the forehead with the composition of Andrias; this consists of gum 4 grams, cerussa and antimony sulphide 8 grams each, litharge heated and washed 16 grams. bBut the litharge must be boiled in rain-water, and the dry ingredients pounded up in myrtle juice. When the forehead has been smeared with this, a poultice is put on of flour made into a paste with cold water, to which is added acacia juice or cypress oil. It is also useful to apply a cup to the top of the head after making an incision, or blood may be let from the temples. The following ointment should be used: ccopper scales and poppy-tears 4 grams each; stag's horn calcined and washed, washed lead, and gum, 16 grams each; frankincense, 48 grams. This salve, because it contains horn, is called dia tu keratos.28 Whenever p211 I do not name the kind of fluid to be added, I would have water to be understood.
17 For the same purpose there is the salve of Euelpides, which he called memigmenon,29 containing poppy-tears and white peppercorns 28 grams each; gum 336 grams; roasted copper 6 grams. However, in the course of the treatment, after a subsidence of the disease, the bath and wine are of some service. In all cases of ophthalmia food that makes thin should be avoided, but especially in those who have had for long a discharge of thin humour. But if food which renders the rheum thicker comes to be disliked, which very readily happens with this kind of diet, recourse should be had to those foods which, in bracing up the bowels, do the same to the body in general.
18 Again, ulcerations which do not heal after inflammation has ended, tend to become fungous or foul or excavated, or at any rate chronic. Such as are fungous are best repressed by the salve called memigmenon; those which are foul are cleaned both by the same and by that called zmilion.30 19 This contains: verdigris 16 grams; gum the same; ammoniacum and Sinopic minium 64 grams; some pound up these with water, others with vinegar, in order to make it more active.
20 The salve of Euelpides also which he called pyrron31 is of use for this: saffron 4 grams; poppy-tears and gum 8 grams; roasted and washed copper and myrrh 16 grams each; white pepper 24 grams. But the eyes are first smeared with a mild ointment, then with the above.
p213 21 That salve of his which he named sphaerion32 has the same effect: washed haematite stone 4.66 grams; 6 peppercorns; washed zinc oxide, myrrh and poppy-tears 8 grams; saffron 16 grams; gum 32 grams; these are pounded up in Aminean wine.
22 For the same purpose he prepared a liquid salve, containing verdigris 0.66 gram; roasted antimony sulphide, shoemakers-blacking, and cinnamon 4 grams each; saffron, nard and poppy-tears 4.66 grams each; myrrh 8 grams; roast copper 12 grams; ash of aromatic herbs 16 grams; 15 peppercorns. These are pounded up in dry wine, then boiled in 750 cc. of raisin wine until of uniform consistency. This is rendered more efficacious by age.
23 Excavated ulcerations, too, are most readily replenished with flesh by the compositions mentioned above, sphaerion, and that called Philalethus.33 Sphaerion is the best remedy for old-standing ulcerations, and those that are difficult to heal.
24 There is also a salve, which whilst efficacious in many ways seems to be specially so in the case of ulcerations. It is said to have been invented by Hermon. It contains: long pepper 4.66 grams; white pepper 0.33 gram; cinnamon and costmary 4 grams each; shoemaker's blacking, nard, casia and castoreum 8 grams each; gall 20 grams; myrrh, saffron, frankincense, lycium and cerussa, 32 grams each; poppy-tears 48 grams; lign-aloes, roasted copper and oxide of zinc 64 grams each; acacia, antimony sulphide and gum 100 grams each.
25 Scars resulting from ulcerations are liable to two defects, they are either depressed or thick. If p215 depressed, new flesh may be grown by applying that salve called sphaerion, or that named Asclepios, which contains: poppy-tears 8 grams; sagapenum and all-heal 12 grams each; verdigris 16 grams; gum 32 grams; pepper 48 grams; washed oxide of zinc and cerussa 64 grams each. bBut thick scars are thinned either by the smilion, or by the salve of Canopus34 which contains: cinnamon and acacia 4 grams each; washed oxide of zinc, saffron, myrrh, poppy-tears and gum 8 grams each; white pepper and frankincense 12 grams each; roasted copper 32 grams. cOr the pyxinum35 of Euelpides, which consists of: rock-salt 16 grams; ammoniacum used for incense, 32 grams; poppy-tears 48 grams; cerussa 60 grams; white pepper and Sicilian saffron 128 grams each; gum 52 grams; washed zinc oxide 36 grams. However, the best for elevating a scar seems to be: gum 0.66 gram; verdigris 4 grams; dregs of saffron 16 grams.
26 There is also a class of inflammation in which, if the eyes swell and become tense with pain, it is necessary to let blood from the forehead, and to foment the head and eyes frequently with hot water; also to gargle, using a decoction of lentils, or the cream of figs; to apply as an ointment acrid medicaments, such as have been noted above, especially that named sphaerion, and that containing haematite stone. There are also other salves of use for softening trachoma36 of which I am just going to speak.
27 Now this condition generally follows inflammation p217 of the eyes; sometimes it is more serious, sometimes less so. Often too, as the result of trachoma, inflammation37 is set up, which in its turn increases the trachoma, and sometimes lasts a short time, sometimes long, and then it is scarcely ever terminated. In this class of affection, some scrape the thick and indurated eyelids with a fig-leaf and a rasp and sometimes with a scalpel, and every day rub medicaments into the under surface of the eyelid; such things should only be done when there is marked and inveterate hardness, and not often; for the same result is better attained by dieting and proper medicaments. bTherefore we shall make use of exercise and frequent baths, and foment the eye-lids freely with hot water, and the food we give will be acrid and attenuating, and the medicine the salve called caesarianum. This contains: shoemaker's blacking 1.33 grams; antimony sulphide 1.66 grams; white pepper 1.33 grams; poppy-tears and gum 8 grams each; washed oxide of zinc 16 grams; antimony sulphide 24 grams.a And this preparation will do for all kinds of eye-inflammations, except such as are relieved by bland remedies.
28 That called after Hierax is also efficacious for trachoma. It contains: myrrh 4 grams; ammoniacum used for incense 8 grams; copper filingsb 16 grams. For the same purpose there are also those called respectively Canopite, smilion, pyxinum, and sphaerion. But when none of these made up medicaments is at hand, then goat's bile or honey of the best is suitable enough for the treatment of trachoma.
29 There is a kind of dry inflammation of the eyes called by the Greeks xerophthalmia. The eyes neither swell nor run, but are none the less red p219 and heavy and painful, and at night the lids get stuck together by very troublesome rheum; the less violent the onset of this kind of trouble is, the less readily it is terminated. In this lesion there is need for much walking, much exercise, frequent bathing, sitting in the bath and sweating, and much rubbing. The food should not be too flesh-making, neither is acrid food suitable, but a mean between the two. In the morning, when it is plain that all food has been digested, it is not inappropriate to gargle with mustard, then next to rub the head and face for a considerable time.
30 Again, a most suitable salve is that called rhinion.38 It contains: myrrh 0.66 gram; poppy-tears, acacia juice, pepper and gum 4 grams each; haematite stone, Phrygian and Lycian stone, and split stone,39 8 grams each; roasted copper 16 grams. The salve pyxinum is also fitting for this same purpose.
31 When the eyes are scabrous,40 which mostly occurs at their angles, the rhinion salve noted above may do good; that one may also serve which contains: copper filings, long pepper and poppy-tears 8 grams each; white pepper and gum 16 grams each; washed oxide of zinc and cerussa 64 grams each. Nothing, however, is better than that named by Euelpides basilicon. It contains: poppy-tears cerussa and Assos stone, 8 grams each; gum 12 grams; white pepper 16 grams; saffron 24 grams; psoricum1 42 grams. bNow there is no drug called psoricum, but some copper ore and a little more than half as much oxide of zinc are pounded up together in vinegar, p221 and this is placed in an earthenware jar and covered over with fig-leaves and is buried underground; after twenty days it is taken up, and again pounded, when it is given this name. It is generally agreed that the salve basilicum is suitable for all affections of the eyes which are not treated by bland medicaments. cBut when such compositions are not at hand, honey and wine relieve the scabrous angles of the eyes; in this and in dry ophthalmia relief is afforded by soaking bread in wine, and applying it over the eyes. For since there is generally some humour which is irritating either the eyeball itself, or the eyelids, by this application any humour on the surface is drawn out and any near at hand driven back.
32 Again the eyes tend at times to become dim from ophthalmia, but also apart from that, on account of old age, or other weakness. If the disorder is owing to the remnants of an ophthalmia, the salve called Asclepios is of service and that which is composed of saffron dregs.
33 Also there is a special preparation for this purpose called dia crocu.42 It contains pepper 4 grams; Cilicianº saffron, poppy-tears and cerussa 8 grams each; psoricum and gum 16 grams each.
34 But if the eyes are dim from old age or other weakness, it is good to anoint with best honey, cyprus oil, and old olive oil. The most suitable unguent, however, is made of balsam one part, and old olive or cyprus oil two parts, and three parts of the sharpest honey. Here too those applications are suitable which were noted just above p223 for dim vision and previously for thinning43 scars. bIf anyone finds his eyes becoming dim he must walk and exercise a great deal; also bathe frequently, and in the bath he is to be rubbed all over, especially, however, on his head, with iris unguent, until he sweats; and he should then be wrapped up, and not uncover, until after reaching home the sweating and heat have passed off. Then he should take acrid foods which will make him thin and some days afterwards gargle with mustard.
35 Cataract44 also, which the Greeks call hypochysis, sometimes interferes with the vision of the eye. When it has become long established it is to be treated surgically. In its earliest stages it may be dispersed occasionally by certain measures: it is useful to let blood from the forehead or nostrils, to cauterize the temporal blood vessels, to bring out phlegm by gargling, to inhale smoke, to anoint the eyes with acrid medicaments. That regimen is best which makes phlegm thin.
36 Again, even the relaxation of the eyes which the Greeks call paralysis45 is not to be treated by any different regimen or by any different medicaments. It is sufficient to explain just the kind of lesion it is. It happens then sometimes in the case of one eye, sometimes of both, from some blow, or from epilepsy, or from a spasm, by which the eyeball itself is violently shaken, that it cannot be directed at any object, or be held at all steady, but with no reason it turns now this way, now that, and so does not even afford a view of objects.
p225 37 The malady the Greeks call mydriasis46 is not very different from the above. The pupil spreads out and is dilated, and its vision becomes dimmed and almost lost. This kind of weakness is most difficult to relieve. Both of these paralysis and mydriasis are to be countered by all the same prescriptions as mistiness of the eyes, but with a few alterations such as the addition sometimes of vinegar, sometimes of soda, to the iris unguent for the head; while honey is sufficient for the eye inunctions. bIn the case of mydriasis, some patients have been relieved by the use of hot water, some without any obvious cause have suddenly become blind. Some of these after seeing nothing for some time have suddenly regained vision following a profuse stool. Hence it seems not inappropriate, whether in a recent case or in one of some standing, by the use of medicaments to force stools in order to drive downwards all noxious matter.
38 There is besides a weakness of the eyes, owing to which people see well enough indeed in the daytime but not at all at night;47 in women whose menstruation is regular this does not happen. But success sufferers should anoint their eyeballs with the stuff dripping from a liver whilst roasting, preferably of a he-goat, or failing that of a she-goat; and as well they should eat some of the liver itself. But, we may also use with advantage the same remedies which dry up scars and trachoma. Some add honey to pounded purslane seed until the mixture no longer drops from the end of a probe, and with it anoint the p227 eyeballs. The same exercises, baths, rubbings, and gargles are also to be used for these patients.
39 All the foregoing disorders arise within the body; but a blow from without at times so inures the eye that it is suffused with blood. Nothing is then better than to anoint the eyeball with the blood of a pigeon, dove, or swallow. There is some reason for this, because the vision of these birds, when injured from without, returns after an interval to its original state, most speedily in the case of the swallow. bThis also has given rise to the fable that the old birds restore the vision by a herb,48 when it really returns spontaneously. Hence the blood of these birds most properly protects our eyes too after an external injury, and in the following order: swallows' blood is best, next that of the pigeon, and the dove's is the least efficacious, both as regards the birds themselves and us. In order to relieve inflammation, it is not unfitting to apply a poultice over the injured eye. cThe best salt from Ammon, or some other salt, is pounded, and oil gradually added until it is of the consistency of strigil scrapings. Then this is mixed with barley-meal which has been boiled in honey wine. But it is easy, after looking through all that medical practitioners have written, for anyone to see that there is scarcely any one of the eye disorders among those included above which it may not be possible to clear up by simple and readily procured remedies.
7 1 So much, then, for those classes of eye disease, for which medicaments are most successful; and now we pass to the ears, the use of which comes next to eyesight p229 as Nature's gift to us. But in the case of the ears still a somewhat greater danger; for whereas lesions of the eyes keep the mischief to themselves, inflammations and pains in the ears sometimes even serve to drive the patient to madness and death.49 The makes it more desirable to apply treatment at the very beginning, that there may be no opening for the greater discovering. bAs soon, therefore, as the pain is first felt, the patient should fast and keep quiet; the next day, if the pain is still severe, the head should be shaved, and after it has been anointed with hot iris unguent, covered up. But great pain with fever and sleeplessness require also that blood should be let; if anything prevents this, the bowels are to be moved. Hot poultices also, frequently changed, are of service, whether composed of fenugreek or linseed or other meal boiled in honey wine, and sponges also wrung out of hot water, applied at intervals, are appropriate. cThen, when the pain is relieved, iris or cyprus unguent should be spread around the ears; in some cases, however, the rose unguent is more advantageous. If severe inflammation entirely prevents sleep, there should be added to the poultice half its quantity of toasted and pounded poppy-head rind, and this should be boiled down with the rest in diluted raisin wine. It is desirable also to pour some medicament into the ear, and this should always be made lukewarm beforehand; and is best dropped in from a strigil.50 When the ear is full, soft wool is applied over it to keep in the fluid. dAnd these are the medicaments generally used for this purpose: but also there is rose oil and arundo-root juice and oil in which worms have been boiled, juice expressed from bitter almonds or p231 from peach-kernels. But the compositions for relieving inflammation and pain generally employed are: castoreum and poppy-tears in equal amounts, pounded together; then to these there is added raisin wine. Or poppy-tears, saffron and myrrh in equal quantities pounded, while rose oil and raisin wine are dropped in by turns. eOr the bitter part of the Egyptian bean pounded up with rose oil added; with these some mix a little myrrh or poppy-tears, or frankincense in woman's milk, or the juice of bitter almonds with rose oil. Or castoreum, myrrh and poppy-tears, equal parts, with raisin wine. Or saffron 1 gram; myrrh and shredded alum 0.66 gram of each; whilst this is being pounded there is slowly added to it 125 cc. of raisin wine, of honey rather less than 40 cc., and this is one of the best remedies. Or poppy-tears in vinegar. fThemison's compound may also be used; it contains: castoreum, opopanax and poppy-tears 8 grams each, buckthorn scum 16 grams. These are pounded and made up in raisin wine, until they have the consistency of a wax salve and are so preserved. When required for use, this composition is again stirred with a probe whilst adding raisin wine. The rule is general, that when a composition has become too thick to be dropped into the ear, some of the fluid with which it was made up is added until it become sufficiently liquid.
2 If again the ears have pus in them as well, it is proper to pour in boxthorn juice by itself, or iris unguent or leek juice or the juice of a sweet pomegranate warmed in its rind, to which a little myrrh is added. It is useful to mix together myrrh of the sort called p233 stacte 4 grams; the same amount of saffron; 25 bitter almonds; of honey 250 cc.; these are pounded together, and when they are to be used, are warmed in a pomegranate rind. The medicaments which are compounded for ulcerations of the mouth are equally healing for ulcerations of the ear.51 bIf the disease is of longer standing, and much matter is discharged, the composition said to have been invented by Erasistratus is suitable: pepper 0.66 gram; saffron 0.66 gram; myrrh and cooked antimony sulphide 4 grams each; roasted copper 8 grams. These are pounded up in wine, and when the mixture has become dry, 750 cc. of raisin wine are added, and are boiled up with it. When it is to be used, wine and honey are added to these ingredients. There is also the medicament of the surgeon Ptolemaeus, which contains: mastich 0.66 gram, oak galls 0.66 gram, omphacium 4 grams; and pomegranate juice. cThere is the very active remedy of Menophilus, which consists of: long pepper 4 grams; castoreum 8 grams; myrrh, saffron, poppy-tears, Syrian nard, frankincense, pomegranate rind, the embryo of an Egyptian bean, bitter almonds, and the best honey 16 grams each. These are pounded together with the addition of very sour vinegar until of the consistency of raisin wine. The prescription of Craton is the following: cinnamon and casia 0.66 grams, boxthorn juice, nard and myrrh 4 grams each, lign-aloes 8 grams, honey 125 cc., wine half a litre. The lycium is first boiled in the wine, and the rest added. dBut when there is much pus, and the odour bad, verdigris scrapings and frankincense 8 grams each, honey 85 cc.; vinegar 170 cc. are boiled together. For use, it is mixed with sweet p235 wine. Or equal weights of shredded alum, poppy-tears and acacia juice are mixed together, and to these is added of hyoscyamusº juice less than half the quantity of each one of the above; and these are pounded together and diluted with wine. Also hyoscyamusº juice is sufficiently beneficial by itself.
3 A general remedy for all ear cases, and one approved by experience, was composed by Asclepiades. This contains: cinnamon and casia 4 grams each; flowers of round cyperus, castoreum, white pepper, long pepper, cardamomum and bennut, 8 grams each; male frankincense, Syrian nard, fatty myrrh, saffron, soda-scum, 12 grams each. These are pounded separately, then mixed with vinegar and again pounded, and so preserved; when for use they are diluted with vinegar. bIn the same way a general remedy for all ear disorders is the tablet of Polyidus, dissolved in sweet wine, the prescription for which is given in the last book.52 But if there is both a discharge of matter and a swelling, it is not unfitting to ash out the ear with diluted wine through an ear syringe, and then pour in dry wine mixed with rose oil, to which a little oxide of zinc has been added, or boxthorn juice with milk, or polygonum juice with rose oil, or pomegranate juice with a very little myrrh.
4 If there is also foul ulceration, it is better to wash out with honey wine, and then pour in some one of the compositions described above which contain honey. If there is a great discharge of pus the head is to be shaved, and hot water poured freely over it, also the patient should gargle with the same, walk until tired, and take food sparingly. If there is bleeding from the ulcerations, boxthorn p237 juice should be poured in mixed with milk, or with water in which rose leaves have been boiled, with polygonum juice or that of acacia added. bIf flesh has formed over the ulcerations and there is a malodorous discharge, the ear should be washed out with tepid water, then that composition poured in which contains frankincense, verdigris, vinegar and honey; or honey boiled with verdigris. Copper scales also pounded up with sandarach may be instilled through a tube with advantage.
5 When maggots have appeared, if they are near the surface, they must be extracted by an ear scoop; if further in they must be killed by medicaments, and afterwards care taken that they do not breed. White veratrum pounded up in vinegar serves for both these purposes. The ear should also be washed out with a decoction of horehound in wine. By this procedure dead maggots will be driven forwards into the outer part of the ear, whence they can be readily withdrawn.
6 But if the ear-passage has been narrowed and thick matter collects within, honey of the best ought to be introduced. If this does not help, there must be added to 65 cc. of honey 8 grams of verdigris scrapings; they must be boiled together and so used. Iris root with honey has the same efficacy. So also has galbanum 8 grams, myrrh and ox bile 1.33 grams each, and of wine a sufficient quantity to dissolve the myrrh.
7 When a man is becoming dull of hearing, which happens most often after prolonged headaches, in the first place, the ear itself should be inspected: for there will be found either a crust such as comes upon the surface of ulcerations, or concretions of wax. p239 If a crust, hot oil is poured in, or verdigris mixed with honey or leek juice or a little soda in honey wine. And when the crust has been separated from the ulceration, the ear is irrigated with tepid water, to make it easier for the crusts now disengaged to be withdrawn by the ear scoop. bIf it be wax, and if it be soft, it can be extracted in the same way by the ear scoop; but if hard, vinegar containing a little soda is introduced; and when the wax has softened, the ear is washed out and cleared as above. When the heaviness of the head persists it should be shaved; the head rubbed over gently and for some time with castoreum to which either iris or laurel oil has been added with either of which a little vinegar has been mixed; then the patient must take a long walk, and after the rubbing his head is to be fomented with hot water. cAnd the food should be of the lightest and of the middle class, and the drinks especially diluted; he should occasionally gargle. Further, the ear should be syringed with castoreum mixed with vinegar and laurel oil and the juice of young radish rind, or with cucumber juice, mixed with crushed rose leaves. The dropping in of the juice of unripe grapes mixed with rose oil is also fairly efficacious against deafness.
8 Another class of lesion is that in which the ears produce a ringing noise within themselves: and this also prevents them from perceiving sounds from without. This is least serious when due to cold in the head; worse when occasioned by diseases or prolonged pains of the head; worst of all when it precedes the onset of serious maladies, and especially epilepsy.
bIf it is due to a cold,53 the ear should be cleaned p241 and the breath held until some humour froths out from it. If it arises from disease and pain in the head, the prescriptions as to exercise, rubbing, affusion and gargling should be carried out. Only foods that make thin are to be used. Into the ear radish juice should be dropped with oil of roses or with the juice of wild cucumber root; or castoreum with vinegar and laurel oil. Also veratrum is pounded up for this purpose in vinegar, then mixed with boiled honey, and a slave made of it and introduced into the ear.
cIf the noise begins without these reasons and so causes dread of some new danger, there should be inserted into the ear castoreum in vinegar or with either iris oil or laurel oil; or castoreum is mixed with this together with the juice of bitter almonds; or myrrh and soda with rose oil and vinegar But in this case also, there is more benefit from regulation of the diet, and the same is to be done as was prescribed above,54 with even greater care. And, besides, until the noise has ceased the patient must abstain from wine. dBut if there is at the same time both ringing and inflammation, laurel oil should be freely inserted, or the oil expressed from bitter almonds with which some mix myrrh or castoreum.
9 It happens also occasionally that something slips into the ear, such as a small stone, or some living thing. If a flea has got in, a little wool is introduced in which it becomes engaged and so is extracted. If it does not come out, or if it is some other creature, a probe is wrapped round with a little wool, soaked in very sticky resin, especially turpentine resin, which after being passed in the ear is there twisted p243 round; for that will certainly catch it. If it is some inanimate object, it is to be withdrawn by an ear scoop or by a small blunt hook slightly bent. bIf these are ineffectual it is possible to extract it by means of resin as above. Also if a sneezing fit is induced, this easily moves it away or a forcible injection of water through an ear syringe. Again, a plank may be arranged, having its middle supported and the ends unsupported. Upon this the patient is tied down, with the affected ear downwards, so that the ear projects beyond the end of the plank. Then the end of the plank at the patient's feet is struck with a mallet, and the ear being so jarred what is within drops out.
8 1 Now ulcerated nostrils should be fomented with steam from hot water; that is done either by applying a sponge after squeezing it out, or by holding the nose over a narrow-mouthed vessel filled with hot water. After this fomentation the ulcerations should be smeared with lead slag, white lad or litharge; with any of these a kind of poultice is compounded, and to this, while it is being pounded up, wine and myrtle oil are added alternately, until it becomes of the consistency of honey. But if these ulcerations involve bone, and have numerous crusts with a foul odour, which kind the Greeks call ozaena,55 it ought to be understood that it is scarcely possible to afford relief in that disease. The following measures, none the less, can be tried: the head may be shaved to the scalp, rubbed frequently and vigorously, and sluiced with quantities of hot water; then the patient is to take a great deal of p245 exercise, and a moderate amount of food, neither sour nor very nutritious. Further, into the nostril itself may be inserted honey to which a very small quantity of turpentine resin has been added (this is done on a probe wrapped round with wool), and this juice is drawn inwards by the breath until it can be tasted in the mouth. cFor in this way the crusts are loosened, and they should then be blown out by sneezing. The ulcerations having been cleaned are steamed over hot water; then there should be applied either boxthorn-juice diluted with wine or wine lees or omphacium or the juice of mint or horehound or blacking made glowing hot and then pounded, or the interior part of a squill crushed; provided that to any of these honey is added. dThe honey should be a very small part in all these mixtures, except with the blacking, when there should be just enough to make the mixture liquid, whilst with the squill certainly the honey should form the larger part; a probe should be wrapped round with wool, and dipped into this medicament, and with it the ulcers are filled. And further, a strip of linen is folded into a long roll, smeared with the same medicament, and inserted into the nostril, and is lightly bandaged on below. This should be done in winter and spring twice a day, in summer and autumn three times a day.
2 Again, inside the nostrils there are sometimes formed little lumps like women's nipples, and these are fixed by their deepest and most fleshy parts. These should be treated by caustics, under which they are completely eaten away. A polypus, in fact, is a lump of this sort, sometimes white, sometimes reddish, which is attached to the bone of the nose, and fills the nostril, being directed p247 sometimes towards the lips, sometimes backwards through that passage by which the breath goes from the nose to the throat. In this direction it may grow until it can be seen behind the uvula; bit chokes the patient, especially when the south or east wind blows; generally it is soft, rarely hard, and the latter sort hinders breathing more and dilates the nose; it is then generally cancerous, and so should not be touched. But the other kind can generally be removed by the knife;56 sometimes, however, it dries up, if the following composition is inserted into the nostril on lint or on a feather: minium from Sinope, copper ore, lime, and sandarach 4 grams each, blacking 4 grams.
9 1 Now in the case of pain in the teeth, which by itself also can be counted among the greatest of torments, wine must be entirely cut off. At first the patient must fast, then take sparingly of soft food, so as not to irritate the teeth when masticating; then externally steam from hot water is to be applied by a sponge, and an ointment put on made from cyprus or iris oil, with a woollen bandage over it, and the head must be wrapped up. For more severe pain a clyster is useful, with a hot poultice upon the cheeks, and hot water containing certain medicaments held in the mouth and frequently changed. 2 For this purpose cinquefoil root may be boiled in diluted wine, and hyoscyamus root either in vinegar and water, or in wine, with the addition of a little salt, also poppy-head skins not too dry and mandragora root in the same condition. But with these three remedies, the patient should carefully avoid swallowing the fluid in the mouth. The bark of white poplar roots boiled in diluted wine may be p249 appropriately used for the same purpose, and stag's horn shavings boiled in vinegar, and catmint together with a torch rich in resin and a fig equally rich boiled either in honey wine or in vinegar and honey. When the fig has been boiled down with these, this fluid is strained. 3 Also a probe wrapped round with wool is dipped in hot oil, and the tooth itself fomented with this. Moreover, some applications, like poultices, are smeared on the tooth itself, and for this purpose the inside rind of an unripe dry pomegranate is pounded up with equal parts of oak-galls and pine bark, with which minium is mixed; and these when pounded together are made up with rain-water. Or equal quantities of all-heal, poppy-tears, sulphur wort, and black bryony berries without the seeds are pounded together. Or three parts of galbanum to one of poppy juice. Whatever is applied to the teeth directly, none the less the ointment mentioned above must also be put on the jaws and covered over with wool. 4 Some rub up together myrrh and cardamoms, 4 grams each; saffron chamomile figs and broom 16 grams each; and mustard 32 grams; spread it on lint and apply to the shoulder on the side of the painful tooth; over the shoulder-blade, if it is an upper tooth; on the chest if a lower one; and this relieves the pain, and as soon as it has relieved it, must be at once taken off. 5 When a tooth decays, there is no hurry to extract it, unless it cannot be helped, but rather to the various applications described above, we must add more active compositions for the relief of pain, such as that of Heras. This has poppy juice 4 grams; pepper 8 grams; sory 40 grams, pounded, taken up in galbanum, and p251 applied round the tooth; or that of Menemachus, especially for molar teeth, containing saffron 0.66 gram, cardamons, frankincense root, figs, broom and pellitory 16 grams each; mustard 32 grams. Again, some mix chamomile, pepper, elaterium and broom 4 grams each; shredded alum, poppy juice, black bryony berries, crude sulphur, bitumen, laurel berries and mustard 8 grams each. 6 But if pain compels its removal, a peppercorn without the tegument, or an ivy berry without the tegument is inserted into the cavity of the tooth, which it splits, and the tooth falls out in bits. Also the tail spine of the flat fish which we call pastinaca, and the Greeks trygon,57 is roasted, pounded and taken up in resin, and this, when applied around the tooth, loosens it. Also shredded alum and . . . put into the cavity loosens the tooth. However, it is better to insert this wrapped up in a flake of wool, for it thus relieves the pain whilst preserving the tooth. 7 These are the remedies recognized by medical practitioners, but country people have found out by experience that if a tooth aches, catmint should be pulled up with its roots, and put into a pot, and water poured over it, and placed beside the patient as he sits all covered by clothes; then red-hot stones are thrown in so as to be covered by the water; the patient inhales the steam with his mouth open, whilst, as stated above, he is completely covered over. For profuse sweating follows, and also a steady stream of phlegm flows from the mouth, and this ensures good health always for a year, and often for longer.
10 1 Again, if the tonsils58 owing to the inflammation p253 are swollen but not ulcerated, the head is to be kept covered; externally the painful part should be fomented by steam; the patient is to take walking exercise freely; when in bed his head should be raised repressive gargles should be used. Also that root which they call sweet,59 crushed and boiled in raisin wine or honey wine, has the same beneficial effect. It is useful to anoint them gently with certain medicaments prepared as follows: 2 the juice is squeezed out of sweet pomegranates, and of this half a litre is boiled over a slow fire until of the consistency of honey; then saffron, myrrh, and shredded alum 8 grams each are pounded together, and to this is added a little at a time 85 cc. of mild wine and 42 cc. of honey; next these latter are mixed with the pomegranate juice aforesaid, and all gently boiled again. Or half a litre of the pomegranate juice is boiled in the same way, and the following after being pounded in like manner are added: nard 0.33 gram; omphacium 4 grams; cinnamon, myrrh and casia 0.33 gram each; these same compositions are also appropriate both for purulent ears and nostrils. 3 Food too in this affection should be bland that it may not irritate. If the inflammation is so severe that breathing is hindered, the patient should keep in bed, abstaining from food, and take nothing else except hot water; the bowels should be moved by a clyster, and the gargle of fig and honey wine used; the tonsils are to be smeared with honey and omphacium; internally steam is to be inhaled somewhat longer60 until the tonsils suppurate and spontaneously open. If after pus has formed these swellings do not burst, they are to be cut into;61 then the patient must gargle with warm honeyed wine. p255 But if with only moderate swelling there is ulceration as well, the throat is to be gargled with bran gruel to which a little honey should be added; and the ulcers smeared with the following composition: 750 cc. of the sweetest raisin wine are boiled down to one-third, then are added: frankincense 4 grams; garlic 4 grams; saffron and myrrh 0.66 gram each; and all are then gently heated together. When the ulcers have cleaned, the throat is gargled with bran gruel or milk. And here also bland food is necessary, and in addition sweet wine can be taken.
11 Now ulcerations of the mouth if accompanied by inflammation, and if they are foul and reddish, are best treated by the medicaments made from pomegranates mentioned above.62 And, as a repressant, pearl barley gruel to which a little honey has been added is to be often held in the mouth; the patient must walk and not take acrid food. As soon as the ulcerations begin to clean, a bland liquid, at times even the purest water, is held in the mouth. It is then beneficial to eat a pear of the softer sort, and more food along with sharp vinegar; then the ulcers should be dusted over with split alum, to which about half as much again of unripe oak-galls has been added. 2 If the ulcers are already encrusted, as happens after cauterization, those compositions are to be applied which the Greeks call antherae:63 equal portions of galingale, myrrh, sandarach, and alum. Or saffron and myrrh 4 grams each; iris, split alum and sandarach 16 grams each; galingale 32 grams. Or oak-galls and myrrh 4 grams each; split alum 8 grams; rose leaves 16 grams. But some mix saffron 0.66 gram; split alum and myrrh 4 grams each; sandarach 8 grams; galingale 16 grams. p257 The first compositions are dried and then dusted on; the last one is smeared on with honey added, and used not only for ulcerations of the mouth, but also of the tonsils.
3 But by far the most dangerous are those ulcers which the Greeks call aphtae,64 certainly in children; in them they often cause death, but there is not the same danger for men and women. These ulcers begin from the gums: next they invade the palate and the whole mouth; then they pass downwards to the uvula and throat, and if these are involved, it is not easy for the child to recover. But the disease is even worse in a suckling, for there is then less possibility of its conquest by any remedy. 4 But it is most important that the nurse should be made to take exercise both by walking and by doing work which moves her arms; she should be sent to the bath, and ordered when there to have hot water poured over her breasts; moreover, she should have bland, easily digestible food; and for drink, if the infant is feverish, water; if free from fever, diluted wine. And if the nurse is constipated, her bowels are to be moved by a clyster. 5 If there is clotted phlegm in her mouth, she must vomit. Then the child's ulcers are to be anointed with honey, to which is added sumach, which they call Syrian, or bitter almonds; or a mixture of dried rose leaves, pinecone seeds, mint, young stalks, and honey, or that medicament which is made of mulberries, the juice of which is concentrated in the same way as pomegranate juice to the consistency of honey; similarly too there is mixed with it saffron, myrrh, alum, wine and honey; nothing should be given which can provoke spittle. 6 If it is an older child he should p259 generally gargle as described above. If the milder medicaments do little good, the caustic materials which induce crusts upon the ulcers should be applied, such as split alum or copper ore or blacking. Even hunger is beneficial and the greatest possible abstinence is to be ordered. The food ought to be bland; for cleansing the ulcers, however, sometimes cheese with honey is appropriately given.
12 1 Ulcerations of the tongue need no other treatment than that noted in the first part of the previous chapter. But those which arise at the side of the tongue last the longest; and it should be looked to, whether some tooth opposite the ulcer is too pointed, which often keeps an ulceration in that position from healing, in which case the tooth must be smoothed down.
13 1 There often occur on the gums adjacent to the teeth certain painful swellings: the Greeks call them parulides.65 These at first should be gently rubbed over with powdered slat; or with a mixture of powdered rock-salt, cyprus oil and catmint; then the mouth is washed out with lentil gruel, and the mouth is held open at intervals until there has been a sufficient flow of phlegm.
2 When there is still more severe inflammation, the same medicaments are to be used as noted above for ulcerations of the mouth: and between the tooth and gum should be inserted a little roll of soft lint soaked in one of the compositions which I said are called antherae.66 If the hardness of the gum prevents this, then hot steam by means of a sponge p261 is to be applied outside, followed by a cerate. If suppuration shows itself, the steaming is continued longer, and hot honey wine in which a fig has been boiled down is held in the mouth; and before the abscess is quite mature it should be cut into, for fear that the bone may suffer if the pus should be retained longer. 3 But if there is greater swelling, it is better to cut all away so as to free the tooth on both sides. When the pus is let out, if the incision is small it will suffice to hold hot water in the mouth and to foment externally with its steam; if it is larger, lentil gruel should be used, and the same medicaments as for the treatment of ulcerations of the mouth in general. There are also other ulcerations, mostly arising in the gums, for which the same remedies are beneficial; in particular, however, privet should be chewed and the juice held in the mouth. 4 It happens now and then, whether following a gumboil or not, that a discharge of pus persists from an ulcer on the gum; this is due to either a decayed tooth or to bone that is broken or injured and diseased in some other way, and it most commonly occurs through a fissure in the bone. When this is the case, the place must be laid open, the tooth extracted; any projecting scale of bone is to be removed; and any carious bone scraped away. What ought to be done after this has been included in the treatment of other ulcerations. If the gums have retracted from the teeth, the same antherae are of service. It is also useful to chew pears and apples which are not too ripe, and to hold their juice in the mouth. Vinegar that is not too sharp can also be held in the mouth with similar advantage.
p263 14 1 Inflammation of the uvula should also cause anxiety when severe. In this case, as before, abstinence is necessary, and it is right to let blood; and if anything prevents this, it is useful to clyster the bowel; and also the head must be kept covered and raised; and the patient must gargle with a decoction of blackberries and lentils. But the uvula is to be smeared either with omphacium or oak-galls or split alum to any one of which honey has been added; it is also good to smear the uvula with chelidonium juice by means of a spoon, and especially with honey. For this purpose also the composition called Andronium is suitable; it consists of: split alum, red copper scales, blacking, oak-galls, myrrh and antimony sulphide; these are pounded separately and again pounded when mixed together, a dry wine being gradually added till the ingredients have the consistency of honey. 2 After the uvula has been smeared with one of these compounds there is, as a rule, a free flow of phlegm; when this has subsided, hot wine should be gargled. But if there is less severe inflammation, it is sufficient to pound up assafoetida and add cold water to it, and to put the fluid into a spoon and apply it under the uvula itself. When there is only moderate swelling, even cold water held in the same way under the uvula subdues it. Also the same cold water is to be used as a gargle which, with or without the addition of assafoetida, has been applied in this manner to the uvula.
15 1 If at any time gangrene has attacked ulcers of the mouth, the first thing to consider is whether the general health is bad, and if so to obviate it; next the actual ulcers are to be treated. But if the p265 disease is superficial, it is sufficient to use a powdered anthera to dust on the ulcer if moist; if the ulcer is rather dry, to smear it on mixed with a little honey: for somewhat deeper ulcerations, apply burnt papyrus two parts, and orpiment one part; if the mischief penetrates very deeply, burnt papyrus three parts, orpiment one part, or equal parts of rock salt and roasted iris, or copper ore, quick-lime and orpiment, likewise equal parts. 2 But in order that neighbouring spots may not be injured, it is necessary to apply lint dipped in rose oil over these caustic medicaments. Some also put the roasted salt into 250 cc. of strong vinegar until it ceases to dissolve; then the vinegar is boiled to dryness, and the salt pounded up and dusted on. But whenever this medicament is applied, the mouth should be washed out both before and after, either with lentil gruel, or with a decoction of vetches or of olives or of vervains, to any one of which a little honey is added.
3 Also vinegar of squills held sufficiently long in the mouth is beneficial for such ulceration, so too the salt after evaporation as described above dissolved again in vinegar. But whilst the affection continues to be severe it is necessary both to hold one or other of the remedies in the mouth for some time and to use them two or three times a day, If it is a child who is attacked, a probe wrapped round with wool is dipped in the medicament and held to the ulcer, lest by accident he should swallow the caustic. If it is the gums which are involved, and some teeth are loose, they should be extracted, for they greatly hinder treatment. 4 If these medicaments do no good, the ulcers are to be cauterized. But this procedure is not necessary for any ulcer on p267 the lips since excision is more convenient. Indeed such an ulcer, except by adopting surgical measures, whether cauterizing or excising, cannot be replenished with new flesh. But the bones of the bums, which are inert, continue bare after the cauterization; for no flesh grows up afterwards. A lentil dressing,67 however, is to be applied to the parts cauterized until it is rendered as healthy as possible.
16 1 Such are the disorders in the head which generally require medicaments. But just below the ears parotid swellings68 are inclined to occur, sometimes during health when inflammation occurs there, some after prolonged fevers when the force of the disease has been turned in that direction. It is of the nature of an abscession; and so no novel treatment is called for, only what follows must be attended to: if there is swelling without previous disease, repressants are to be tried first; if there has been illness, repressives are objectionable, and it is more convenient that the abscess should mature and be opened as soon as may be.
17 1 For prominent navels, in order that surgical measures need not be used,69 abstinence should first be tried, a clyster to induce a motion, and the following applications to the umbilicus: hemlock and soot 4 grams each; washed white lead 24 grams; washed lead 32 grams; 2 eggs; to these nightshade juice also is added. This ought to be kept on for a long time, the patient meanwhile lying up, and taking food in such moderation that all flatulence is avoided.
p269 18 1 Next come subjects relating to the privy parts, for which the terms employed by the Greeks are the most tolerable, and are now accepted for use, since they are met with in almost every medical book and discourse. Not even the common use has commended our coarser words for those who would speak with modesty. Hence it is more difficult to set forth these matters and at the same time to observe both propriety and the precepts of the art. Nevertheless, this ought not to deter me from writing, firstly in order that I may include everything which I have heard of as salutary, secondly because their treatment ought above all things to be generally understood, since every one is most unwilling to show such a complaint to another person.
2 So then when the penis swells up owing to inflammation, and the foreskin cannot be drawn back, or conversely drawn forwards, the place should be fomented freely with hot water. But when the glans is covered up,70 hot water should be injected, between it and the foreskin, by means of an ear syringe. If the foreskin is thus softened and rendered thinner, and yields when drawn upon, the rest of the treatment is more speedy. If the swelling goes on, either lentil meal or horehound or olive leaves, boiled in wine, is to be laid on, to each of which, whilst being pounded up, a little honey is to be added; and the penis is to be bandaged upwards to the belly. bThat is required in the treatment of all its disorders; and the patient ought to keep quiet and abstain from food, and drink water just so much as is justified by thirst. On the next day fomentations with water must again be applied in the same way, and even force should be tried as to p271 whether the foreskin will yield; if it does not give way, the foreskin is to be notched at its margin with a scalpel. For when sanies has flowed out this part will become thinner, and the foreskin the more easily drawn upon. cBut whether the foreskin is made to yield by this procedure, or whether it has at no time proved resistant, ulcerations will be found, either in the ulterior part of the foreskin, or in the glans, or behind this in the penis, and these ulcerations must of necessity be either clean or dry or moist and purulent. If they are dry, they must in the first place be fomented with hot water; then apply either buckthorn in wine, or olive lees in the same, or butter with rose oil. If there is a thin humour, the ulcerations should be bathed with wine, and then to butter and rose oil a little honey and a fourth part of turpentine resin is to be added and this dressing put on. dBut when pus runs from the ulcers, first they are to be bathed with hot honey wine; than there is put on: pepper 4 grams; myrrh 0.66 gram; saffron and boiled antimony sulphide 8 grams each; these are heated in dry wine to the consistency of honey. Moreover, the same composition is suitable for the tonsils, a dripping uvula, and ulcerations of the mouth and nostrils. Another for the same purpose consists of pepper and myrrh 0.66 gram each; saffron 1.33 gram; cooked antimony sulphide 4 grams; roasted copper 8 grams; these are first pounded together in dry wine, then, when they are dry, are again pounded up in 125 cc. of raisin wine and heated to the consistency of birdlime. eVerdigris too mixed with boiled honey, also those compositions noted above for ulcerations of the mouth,71 or the compositions of Erasistratus or of p273 Craton72 are suitable for applying to suppurating genitals. Also . . . olive leaves73 are boiled in 375 cc. of wine, to which is added split alum 16 grams, lycium 32 grams; and 250 cc. of honey; and if there is more pus, this medicament is made up with honey; if less, with wine. After treatment, the general procedure, so long as the inflammation persists, is to apply a poultice such as was mentioned above, and to dress the ulcers daily in the same way. fIf a free discharge of foul pus begins, the ulcers should be bathed with lentil gruel to which a little honey has been added. Or a decoction is made of olive or of mastich leaves, or of horehound, and the liquid used with honey in the same way; and the same remedies are to be laid on of even omphacium with honey, or that prescription used for the ears containing verdigris and honey,74 or Andron's composition,75 or an anthera,76 as long as a little honey is added to it. gSome treat all ulcerations of the kind here spoken of with lycium and wine. If the ulceration spreads more widely and deeply, it should be bathed in the same way, and then there should be applied either verdigris or omphacium with honey or Andron's composition or that containing horehound, myrrh or saffron, split alum boiled, dried rose leaves and oak-galls, 4 grams each; Sinopic minium 8 grams. These are pounded up first separately, then together again, with honey added, until of the consistency of a liquid cerate; then gently heated in a bronze pot but not allowed to boil over. hWhen drops from it begin to solidify, the pot is taken off the fire; and this composition when it is to be p275 used is dissolved in honey or wine. But the same by itself is also good for fistulae. The ulceration at times even penetrates to fibrous tissues; there is a running discharge, then sanies, thin and foul, coloured or like water in which fresh meat has been soaked; and the place is painful and has a pricking sensation. iThis kind, although purulent, is none the less to be treated by bland applications, such as the tetrapharmacum plaster77 dissolved in rose oil with the addition of a little frankincense; or the composition made of butter, rose oil, resin and honey noted by me above.78 In particular this ulcer should be fomented freely with hot water, and should be kept covered, not exposed to cold. Sometimes through such an ulceration the penis is so eaten away underneath the foreskin that the glans falls off; in which case the foreskin itself must be cut away all round. kIt is the rule, whenever the glans of any part of the penis has fallen off, or has been cut away, that the foreskin should not be preserved, lest it come into contact, and adhere to the ulceration, so that afterwards it cannot be drawn back, and further perhaps may choke the urethra. Again, little tumours, which the Greeks call phymata,79 spring up around the glans; they are burnt away by caustic or the cautery; when the crusts fall off, copper scales are dusted that no more may grow there.
3 The foregoing ulcerations stop short of canker,80 which in other parts, but here the more especially, attacks ulcerations. It begins in a black patch. If it invades the foreskin, at once a probe should be passed underneath, upon which the foreskin is to be incised and the margins seized with forceps; then p277 what is corrupted is cut away, a little of the sound tissue being also removed; this is followed by cauterization. Whenever there is any cauterization, it follows too that here lentil meal is to be applied; next when the crusts have separated the ulcers are treated like others. bBut if the canker invades the penis itself, some one of the caustics is dusted on, and especially that composed of quick-lime, copper ore and orpiment. If medicaments fail, in this case also whatever is corrupted should be cut away with a scalpel, so far that some sound tissue is also removed. It is likewise the rule here that after the canker has been cut out, the wound is to be cauterized. But if hard scabs form, whether after caustics or the cautery, there is a great danger that haemorrhage from the penis will follow upon their separation. cTherefore there is need for prolonged rest with the body almost immobile until the scabs gently separate from the penis. But if the patient, either purposely or accidentally, from moving about too soon, has detached the scabs and haemorrhage has occurred, cold water should be applied. If this has little effect, recourse must be had to medicaments which suppress haemorrhage. If these do not succeed either, the spot should be carefully and cautiously cauterized, and no opportunity afterwards given for the same risk by any sort of movement.
4 Occasionally on this part there arises that kind of canker which the Greeks call phagedaena.81 In such a case there must be no delay whatever: the treatment is immediate cauterization, whether with medicaments as above, or, if these have little effect, with the cautery. There is also a sort of blackness, which is insensitive, but spreads and, if we leave it p279 alone, extends even to the bladder, after which nothing can avail If it is situated at the lip of the glans around the urethra, a fine probe should be inserted into the urethra first that it may not be closed up; then the black patch burnt with the cautery. If it has gone deep, whatever is involved is to be cut away. The rest of the treatment is the same as for other kinds of canker.
5 Again, now and then a callosity forms in the penis; and it is almost entirely without feeling; this also should be excised. But if a carbuncle82 occurs here, it is first to be irrigated with water through an ear syringe; next the growth is to be cauterized with medicaments, especially copper ore with honey or verdigris with boiled honey, or fried sheep's dung83 pounded up similarly with honey. When the carbuncle falls off, use the fluid medicaments prepared for ulcers of the mouth.
6 But if any inflammation occurs in the testicles, not due to injury, blood is to be let from the ankle;84 there must be abstinence from food and bean meal boiled in honey wine must be applied, always cumin rubbed up in boiled honey; of pounded cumin with the rose oil cerate; or parched linseed, pounded up and boiled in honey wine; or wheat flour in honey wine boiled with cyprus shoots; or pounded lily root. If the testicles have become indurated, apply linseed or fenugreek seed boiled in honey wine; or the cyprus oil cerate; or fine wheat flour pounded up in wine to which a little saffron has been added. If the induration is already of long standing, the most efficacious something is wild cucumber root boiled in honey wine, then pounded up. bIf the testicles swell as the result of an injury, it is necessary p281 to let blood, especially if they are livid as well. Then one of the compositions containing cumin mentioned above should be put on; or the composition which contains: fused soda 4 grams; pine resin and cumin, 8 grams each; black bryony berries without the seeds 16 grams; along with sufficient honey to combine them. If, as the result of an injury, the testicle lacks nutrition, generally pus develops; then the only thing to be done is of cut into the scrotum, and let out the pus, and to excise the testicle itself.
7 The anus also is subject to many most tedious maladies, which do not require much variation in their treatment. In the first place, the skin of the anus is often fissured at several places; the Greeks call these ragadia.85 If this is recent, the patient should keep quiet and sit in hot water. Further, pigeon's eggs are to be boiled until hard, shelled, and then one should be covered completely in very hot water, the other is applied hot to the place, the eggs being used thus turn and turn about. Then the tetrapharmacum86 or the rhypodes87 is to be diluted for use with rose oil; or fresh wool-grease is mixed with the liquid cerate made up with rose oil; or washed lead with the same cerate; bor a little myrrh to turpentine resin; or old oil to litharge; with any one of which the anus is smeared. If the lesion is external, not hidden inside, lint may be soaked in the same medicament and applied; whatever is put on is to be covered by a cerate. In such a case also neither acrid nor coarse food is to be taken nor such as constipates; dry food is not satisfactory p283 unless in very small amount; liquid, mild, fatty and glutinous nutriment is better. There is nothing to prevent the use of mild wine.
8 A condyloma88 is a small tumour due to inflammation of some kind. When it appears the same prescriptions apply regarding rest, food and drink as have just been set out. Also the tumour itself may be properly treated by fomenting similarly with eggs. But the patient should first sit in a repressant decoction of vervains. Then we may properly apply lentil meal with a little honey, also mellilot boiled in wine, bramble leaves pounded up with the rose oil cerate or a quince, or the inner rind of a pomegranate boiled in wine, pounded up in the same cerate; or copper ore boiled and pounded, then taken up in wool-grease and rose oil; and the composition containing: bfrankincense 4 grams, split alum 8 grams, white lead 12 grams, litharge 20 grams, into which whilst it is being pounded up rose oil and wine are dropped by turns. But the binder for this part is a square of linen or woollen cloth, which has a loop at each of two adjacent angles and a tape at each of the two opposite ones. The square having been applied underneath with the two loops upon the abdominal wall, the tapes are brought round from behind and passed through the loop on its corresponding side. Each tape being drawn tight, that on the right side is carried round the back to the left, and the left tape back and round to the right side. Finally, the ends of the tapes are tied together in front of the abdomen. cBut if a long-standing condyloma is already indurated and does not yield to the foregoing measures, it can be burnt with a caustic consisting of: verdigris 4 p285 grams; myrrh 16 grams; cumin 32 grams; frankincense 48 grams; antimony sulphide, poppy juice, and acacia juice, 64 grams each, and by this medicament some also produce a fresh surface on the ulcers, which I have described above.89 If this has little effect upon the condyloma it is possible to apply strong caustics. When the tumour has been eaten away, a change is made to mild medicaments.90
9 There is also a third lesion, in which vein mouths rise up as from little heads,91 which at frequent intervals pour out blood: the Greeks call them haemorrhoids. In women they may even appear at the vulvar orifice. There are some in whom it is hardly safe to suppress such a flux of blood, those who are not the weaker for it; for to these it is a purgation, not a disease. Hence some, after being cured, since the blood had no way out, and diseased matter was diverted towards the praecordia and viscera, have been carried off by sudden diseases of the gravest kind. bBut if the bleeding is doing harm to anyone, he should sit in a decoction of vervains, and the best thing to apply is pomegranate rind pounded up with dried rose leaves, or anything else that stops bleeding. But inflammation especially tends to occur when first a rather violent evacuation of the bowels has ruptured the epidermis, and later a hard stool has injured this spot.92 Then the patient should sit in soft water and foment with eggs; yolk of egg which has been stirred up with rose leaves and boiled in raisin wine is to be applied; if the haemorrhoids are internal, by the finger, if external, spread upon linen. The medicaments93 described above for recent fissures are suitable here also. In this case the diet p287 should be the same as in the preceding one. But if the above treatment has little effect, it is usual to apply caustics to destroy these small heads. If they are already of long standing, then, on the authority of Dionysius, sandarach should be dusted on, and after that the composition should be applied containing copper scales and orpiment 20 grams, limestone 32 grams; the next day the haemorrhoids are to be punctured with a needle. The small heads having been cauterized, a scab is produced which prevents blood from running out. But whenever haemorrhage is thus suppressed, the diseased matter is to be dispersed by free exercise that no danger may ensue. And besides, in men and in women who are not menstruating, blood should be let from the arm now and then.
10 If the anus itself, or, as sometimes happens, the mouth of the womb, prolapses, examination should be made to see whether what is protruding is clean, or is covered with a mucous humour. If it is clean, the patient should sit in water; either in salt water or in water boiled with vervains or pomegranate rind. If it is moist, it should be bathed with dry wine and smeared with roasted wine lees. After being treated in one of these ways, it is to be replaced, and pounded plantain or willow leaves boiled in vinegar applied, next lint, and wool over it: and these must be bandaged on, whilst the legs are kept tied together.
11 In the same place an ulceration like a fungus may arise, which must be bathed with lukewarm water in winter, at other seasons in cold water; then copper scales are dusted on, and over that is applied a cerate made with myrtle oil to which has been p289 added a little of copper scales, soot, and lime. If this treatment gives no relief, it is to be cauterized, either with more active medicaments or with the cautery.
19 1 Old-standing ulcerations of the fingers are most suitably treated by buckthorn juice, or by boiled olive lees, in either case with the addition of wine. In the same parts a small piece of flesh sometimes grows out from the nail, causing great pain; the Greeks call it pterygium.94 Round alum from Melos should be dissolved in water to the consistency of honey; the same quantity of honey as there was of dry alum is then poured in, and the mixture is stirred with a rod until it is of a saffron colour, and then smeared on. Some prefer to boil up the same ingredients together for the same purpose after mixing equal quantities of dry alum and honey. 2 If the whitlow is not removed by this treatment, it should be cut away; next the finger is bathed in a decoction of vervains, and over it is then put the following composition: copper ore, pomegranate rind, and copper scales, mixed with ripe figs, lightly boiled in honey; or burnt papyrus, orpiment, and crude sulphur in equal parts may be mixed with a cerate containing myrtle oil; or scraped verdigris 4 grams, copper scales 8 grams, mixed together in 42 cc. of honey; or equal parts of limestone, copper ore and orpiment are mixed together. Whichever of these is applied, it is covered over by linen wetted with water. 3 On the third day the finger is dressed again, any dried part is p291 removed, and similar treatment continued. When this does not succeed, the whitlow is cleaned by means of a scalpel, and the place burnt with a fine cautery, followed by the dressing usual after cauterization.
And when nails are scabrous, they must be loosened all round, where they are in contact with the flesh; next some of the following composition is put on them: sandarach and sulphur 8 grams each; soda and orpiment 16 grams each; liquid resin 32 grams. The finger is dressed again on the third day. Under this medicament, diseased nails fall off and in their stead better ones grow.
1 V.26, 27, 28.
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2 Porrigo means scurf or dandruff, and the name was given to conditions, such as seborrhoea or eczema capitis, where there was excessive detachment of such scales from the scalp. The word, according to Pursue, N. H. XX.9.29 = furfur, bran, and the corresponding Greek name for the condition, (p179)πιτυρίασις, had the same derivation (πίτυρα, bran), and is still used.
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3 σύκωσις was so named by Heraclides of Tarentum because the diseased area resembled the interior of a ripe fig. When the disease occurred on the beard it was known as chin disease, mentagra. It was by Pliny (N. H. XXVI.1.2, 3) to have been recently imported from Asia and to be contagious.
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4 See V.19.9.
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5 To these the term "areae Celsi" has often been applied in medical works in reference to this description.
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6 ἀλωπεκία = mange in a fox (ἀλώπεξ).
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7 From its resemblance to the track of a serpent (ὄφις). Sabouraud described the occurrence of this disease in 19 Paris school children (Monatschrift f. prakt. Dermatol. 1898, 27.439, 3).
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8 σημεῖον, a birth mark, naevus.
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9 Celsus used lippitudo to translate the ὀφθαλμία of Hippocrates = running or bleary eyes (ὀφθαλμοὶ λημῶντες); pituita for λήμη, rheum; aspritudo for τράχωμα, which was used to denote chronic conjunctivitis, ophthalmia and trachoma, the p185 eye diseases general among eastern races. For the whole chapter cf. Hippocrates (Prorrhetica II.18) Littré IX.44.
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10 Cf. V.1, p4, which includes acacia and cummis among medicaments which suppress haemorrhage. Acacia must mean (p191)the gum prepared from the acacia shrub and cummis some other gum — possibly mecca balsam.
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11 V.25.1‑3.
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12 For the meaning of collyrium see p154, note a.
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13 Hardened in the fire.
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14 "Ungrateful": relieving so quickly that the patient felt no gratitude for his cure (Galen, II.749).
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15 The κυνάριον κολλύριον was stamped with the likeness of a swan; it is mentioned also by Galen, Alexander of Tralles and Aetius. It was also known as the ashen (τέφριον) salve, from its colour due to the litharge (black oxide of lead and silver) which it contained.
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16 So called from its resemblance to τρύξ (Latin faex), wine lees.
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17 i.e. the period of his illness.
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18 Secunda remedia were the ordinary remedies, those which followed the rule laid down in the text-books of the time, and were contrasted with contraria remedia (vol. I, p38).
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19 πρόπτωσις is not found in any extant works of earlier authors as a description of the eye condition to which the name is still applied, though this passage of Celsus shows that it was so used in Greek writers on medicine.
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20
VI.6.5A.
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21
Mentioned also by Galen, De Comp. Med., sec. loc. IV., XII.765
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22
V.6.8G, 9A.
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24
Potter's clay from Samos; it was stamped with a star.
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25
V.28.15E.
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26
διὰ λιβάνου so called because it contained frankincense.
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27
i.e. any worry likely to cause tears.
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28
διὰ τοῦ κέρατος: boiled stag's horn yielded a glutinous mucus and is mentioned by Galen as a bland application;
(p209)it is to be distinguished from cornu cervinum ustum, incinerated stag's horn yielding calcium oxide, quicklime, which was used for cleaning wounds, V.5.2
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29 μεμιγμένον κολλύριον — mixed salve.
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30 Zmilion (σμιλίον, the little scalpel) was sharp as a knife in its effect.
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31 From its red (πυρρός) colour: it contained red oxide of copper.
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32 From its shape which was that of a ball (σφαῖρα): see also V.6.23, 25, 26, 28.
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34 A salve named after the town of Canopus in Egypt.
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35 Collyrium pyxinum, a salve kept in a box-wood case; such receptacles, specially labelled, have been unearthed from apothecae or drug shops excavated in Pompei and elsewhere.
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36 For trachoma see p184 note a; the disease continues unaltered to this day among eastern races; in Egypt especially it is general among the populace in various degrees of severity.
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37 i.e. chronic conjunctivitis.
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38 Cf. Paulus Aegineta, 3.22 ῥινάριον.
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39 Split alum, cf. V.2.
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40 Inflammation of the eyelid (Blepharitis marginalis or angularis).
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41 Psoricum (ψωρικὸν φάρμακον) was a remedy for itch, ψώρα. The composition was noted by Dioscorides and Pliny; oxides of copper and zinc were the active ingredients.
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42 διὰ κρόκου, containing saffron from Corycus (now Khorgos) in Cilicia.
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44 Suffusio (ὑπόχυσις) is a collection of humour behind the pupil. The name cataracta (καταρράκτης) was first used by Constantinus about 1070 in a translation from the Arabic. See also VII.7.13.
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45 Paralysis and resolutio nervorum are used alternatively. The description is rather of a functional disorder than of a muscular paralysis.
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46 Mydriasis (μυδρίασις). The reflex effect of most light entering through the dilated pupil is to cause the eyelids to close (μύειν).
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47 Celsus here describes a particular functional disorder caecitas crepuscularis, inability to see at dusk, and at night; p225 cats and other animals have better vision than man in this respect. The term nyctalopia (night blindness) is meaningless and so has led to endless confusion.
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48 Chelidonium majus, the greater celandine, which blooms when the swallow (χελιδών) is arriving on the swallow wind p227 (Theophrastus, Enquiry into Plants, VII.15.1, Loeb translation, II.136). Its juice yields a narcotic alkaloid.
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49 The truth of this statement, unique in ancient medical literature, only came to be appreciated after the middle of the 19th century.
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50 The strigil, commonly made of horn, had a groove like our shoehorn, into which liquid medicaments were poured, and from which fluid could be poured in drops.
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52 V.20.2.
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53 Vol. I p370.
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54 8B.
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55 Celsus is the first to use the word ozaena (Greek ὄζαινα, bad-smelling breath, cf. Dioscorides IV.140) of the ulcers, which are one of the causes of this condition: Galen (Med.,19, XIV.785) describes the relief of ὄζαινα by the removal of polypi.
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56 VII.10.
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57 The sting ray (Pliny, N. H. IX.155); the spine calcined would produce calcium oxide, quick-lime.
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58 See III.370, note b, where an operation for their removal is described.
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59 Radix dulcis (γλυκύρριζα), liquorice, yielded a peculiar sugar, an important alternative to honey in the days before the introduction of cane sugar.
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60 i.e. for a longer time than was necessary for the external treatment described in sect. 1.
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61 For the operation see VI.12.2.3.
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63 For these medicaments from flower blossoms, cf. VI.13.2, 4; 15.1; 18.2, and see Galen (XIII.839).
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64 I.195 note; Appendix I, p591.
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65 Parulis (παρουλίς, Galen, XIV.785), a gumboil; not mentioned elsewhere by Celsus.
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66 p254, note b.
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67 Lenticula may be a lentil poultice to cleanse the wound, or dried and powdered lentils applied as an exedent. Some commentators think a cutting chisel or gouge is referred to, with a lentil shaped button on the point (scalper lenticularis, cf. VIII.3.4; 4.14) which was to be used to scrape the bone.
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68 The parotid swellings that occurred "during health" were perhaps mumps (cf. Hippocrates I.146, Epidemics I.1): "After prolonged fevers," dryness and foulness of the mouth might produce an infection which spread up the ducts to the (p267)parotid glands, while the "abscess" resulted from some general septic infection, especially an abdominal one.
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69 VII.14.
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70 Cf. VII.25.2, where the condition is called phimosis (φιμός, dicebox); the first known use of the special term for this condition.
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71 VI.11.1, 2; also prescriptions in chaps. 8 to 15.
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73 The quantity is doubtful, see critical note.
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75 V.20.4.
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77 V.19.4.
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78 Par. 2C.
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79 For these and their treatment see V.18.16 ff. and 28.9.
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80 See Appendix, p589.
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81 V.28.3B.
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82 V.28.1. Cf. Scribonius Largus, 25, carbunculos quos ἄνθρακας dicunt. For Carbunculus oculi, VI.6.10.
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83 V.8.
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84 Vol. I p162 notes. (II.10.12.)
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85 For these, cf. Galen XIII.516 and 715. The surgical treatment of anal fissure is described in Book VII.30.1 ff.
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86 V.19.9.
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87 V.19.15.
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88 Cf. V.28.2B.
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89 p271.
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90 Cf. VII.30.2 for the surgical treatment of condylomata.
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91 Cf. VII.30.2 for the surgical treatment of haemorrhoids.
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92 An inflamed pile is the result.
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94 A paronychia or whitlow. Hippocrates (Epidemics II.27; Littré V.139) calls it παρωνυξία. The Latin name (not used by Celsus) was reduvia, and πτερύγιον, which he (p289)gives as the Greek, is seldom found in this sense in any extant writings, though pterygium is often found in Latin writers. For another meaning of pterygium see III.328, note b.
a antimony sulphide 1.66 grams . . . antimony sulphide 24 grams: So reads Spencer's translation. This is not a one-time proofreading error in the Loeb edition, but the result of his having systematically translated two different Latin words, misy and stibis, by antimony sulphide. I'm still inputting the texts; this note is for now a placeholder, and I'll come back to it. In the meantime, beware of "antimony sulphide" whenever you read it here.
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b So the Loeb; but this is a mistranslation: "copper" should be "verdigris". The mistake is all the more puzzling that elsewhere in this same Book (7.2d, 7.6), the same translator renders aeruginis rasae correctly. (I owe this note not to any astuteness of my own, but to the sharp eyes and kind communicativeness of reader Paul Keyser at the IBM T. J. Watson Research Center.)
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