Part 7

"If his eyes are deeply situated in his head, we say that he is crafty and a deceiver."

"If his eyes are prominent, we say that he is immodest, loquacious and stupid."

"He whose eyes are mobile and sharp is a deceiver, crafty and a thief."

"He whose eyes are large and tremulous is lazy and a braggart (spaciosus?), and fond of women."

and so forth for an entire page of the Compendium.

Actual diseases of the eye are discussed in chapters on pain in the eyes, ophthalmia, pannus (including ungula, egilops and cataract), tumors of the conjunctiva, itching of the eyes, lachrymation, cancer, diseases of the cornea and uvea, diseases of the eyelids, lachrymal fistula and entropion. The treatment consists generally in ointments and collyria in abundance, but in fistula lachrymalis incision and tents of alder-pith, mandragora (malum terrae), briony, gentian, etc., are recommended, and entropion is referred directly to the surgeon.

The Latin term cataracta (also catarracta and catarractes) is applied to a disease of the eyes by Gregory of Tours (Hist. Franc., v. 6) as early as A.D. 650, and again by Constantine Africanus, of the school of Salernum, in 1075 (De Chirurg., cap. XXX). Singularly the word is not found in the "Chirurgia" of Roger of Parma, from whom Gilbert seems to have borrowed most of his surgical knowledge. Nor is it employed by Roland, Roger's pupil and editor. It recurs, however, in the Glossulae Quatuor Magistrorum (about 1270). But in all these writers cataracta seems to be included under the general term pannus, meaning opacities of every kind. Indeed Gilbert says, "Ungula, egilops, cataracta and macula are species of pannus, all arising from the same causes and cured by the same treatment." A few lines later, however, in distinguishing these various species, he adds: "Cataract arises from a humor collected between the tunics of the eye": and again it is said to be blood filling the veins of the eyes, and especially those of the conjunctiva, and derives its name a caracteribus (?). The truth is none of these writers seem to have any very definite knowledge of the distinction between the various opacities of the media of the eye, all of which were included under the general term pannus. But, what is more remarkable, Roger, Roland and The Four Masters make no mention of the possibility of surgical interference in these cases, but content themselves with elaborate collyria and ointments, or simply with internal treatment. Gilbert, on the other hand, while recommending these collyria and ointments, and even the internal remedies, adds the following:

"Interior autem macula, quae tela vocatur, subcornea situata, si vl'e (?) purgatione precendente et colliriis et pulveribus non removetur, acu torta immissa per caprinum angulum extrahatur aut inferius replicetur" (f. 137a).

And again (f. 141d):

"In uvea sunt largitas et constrictio et aqua sive cataracta.... Aqua quandoque per medium pupille descendit, inferius stans, subuvea apparens, quae perfecte curatur secundum quosdam immisso acus aculeo per pupillam, ut extra fluat aqua."

Chapters on the physiology of hearing, smelling and the sensation of touch are followed by a discussion of the symptoms and treatment of earache, abscess of the ear, discharges (bloody and sanious) from the ear, worms and other foreign bodies in the ear, tinnitus aurium, deafness, coryza, epistaxis, nasal polypi, ozaena, cancer of the nose, fissures and ulcers of the lips, foul breath, diseases of the tongue, toothache, etc.

Physiognomy, a favorite theme with our author, appears again in a considerable chapter on the physiognomy of the nose, mouth, face and the teeth.

"He who laughs frequently is kind and genial in all things and is not worried over trifles."

"He who laughs rarely is contrary and critical."

"He who has large ears is stolid and long-lived."

"He who has a large mouth is gluttonous and daring."

"He whose teeth are defective and small is weak in his whole body."

"He whose canine teeth are long and straight is a glutton and a rascal."

The department of genito-urinary diseases is introduced by a long chapter entitled "De approximeron," a formidable Latin word defined by Gilbert as sexual impotence. An elaborate discussion of the physiology of generation and the phenomena of impotence is followed by a collection of remedies for the condition, of which the best that can be said is that they are probably no less effective than most of the modern drugs recommended for the same purpose. Concerning a function over which so many fond superstitions still linger in the public mind we may, perhaps, charitably forgive Gilbert for the introduction of an empirical remedy for sterility, which, he assures us, he has often tried and with invariable success, and which enjoys the double advantage of applicability to either sex.

"Let a man, twenty years of age or more, before the third hour of the vigil of St. John the Baptist, pull up by the roots a specimen of consolida major (comfrey) and another of consolida minor (healall), repeating thrice the Lord's prayer (oratio dominica). Let him speak to no one while either going or returning, say nothing whatever, but in deep silence let him extract the juice from the herbs and with this juice write on as many cards as may be required the following charm:

"Dixit dominus crescite. [symbol: dagger]. Uthihoth. [symbol: dagger]. multiplicamini. [symbol: dagger]. thahechay. [symbol: dagger]. et replete terram. [symbol: dagger]. amath.

"If a man wears about his neck a card inscribed with these identical words written in this juice, he will beget a male. Conversely, if a woman, she will conceive a female" (f. 287b).

Gilbert, however, cautions the bearer of this potent charm of the possible dangers of satyriasis incurred thereby, and offers suitable remedies for so alarming a condition.

Chapters on satyriasis, gomorrhea (gonorrhea in its etymological sense, seminal emissions), with a third entitled "De pustulis et *apostematibus virgae" complete this department of medical art. The last chapter recognizes the venereal origin of the pustules and ulcers discussed, but furnishes no direct evidence of Gilbert's belief in the existence of a specific venereal poison.

While Gilbert is very scrupulous in his examination of the gross appearances of the urine in most diseases, his discussion of the diseases of the kidneys and bladder includes only pain in the kidneys, abscess of the kidneys, renal and vesical calculus, hematuria, incontinence of urine, dysuria and strangury.

The chapter on hematuria presents a very curious specimen of medieval pathology. Gilbert says: "The escape of blood in the urine is due sometimes to the liver, sometimes to the bile, sometimes to the kidneys and loins, sometimes to the bladder. If the blood is pure and clear, in large quantity, mixed perfectly with the urine and accompanied by pain in the right hypochondrium, it comes from the liver. Such urine presents scarcely any sediment. If the blood comes from the lrili vein, it is also rather pure, but less pure than in the former case, nor is the quantity so great, while pain is felt over the region of the seventh vertebra, counting from below. If it comes from the kidneys, it is scanty and pure as it leaves the bladder, but soon coagulates and forms a dark deposit in the vessel, while pain is felt in the pubes and peritoneum.... If pus, blood and epithelium (squamae) are passed, and the odor is strong, it signifies ulceration of the bladder" (f. 275b).

Diabetes is defined as "An immoderate passage or attraction of urine from the liver to the kidneys and its passage through the kidneys, as the result of a warm or dry distemperature of these organs." The idea of some association of the liver and kidneys in the production of diabetes is at least as old as the eleventh century, and Gilbert's definition of the disease is undoubtedly borrowed from the "Practica" of John Platearius (A.D. 1075), of the school of Salernum. The symptoms, continual thirst, dryness of the mouth, emaciation, in spite of an inordinate appetite, frequent and profuse urination, are correctly given, but no knowledge of the presence of sugar in the urine is indicated.

Dyampnes (involuntary micturition) claims a page or more of explanation and treatment, and its frequent occurrence in old men and children is noticed.