Part 103

For pernio, Aëtius gives a long list of applications, several of which are copied by our author. The ordinary ingredients of them are stimulants and astringents. The following may be pointed out as likely to be useful: Aluminis scissi, dr. x; lithargyri, dr. iv; myrrhæ, dr. j; ovorum albumina duo; vino et oleo myrteo; m. Aëtius also gives a variety of prescriptions for fissures and the other complaints of the feet.

The turnip is mentioned by Pliny as an application to chilblains. See also Galen (de Optima Secta, 16.)

Octavius Horatianus lays down very judicious rules for the treatment of these complaints. His applications, however, are much the same as our author’s. Thus, for chilblains, he recommends fomentations with salt water, or the decoction of beet, containing also alum; after which the part is to be anointed with melted wax. He also mentions, as proper applications, galls pounded with vinegar; a mixture of wax and melted pitch; a cataplasm of boiled lentils; the grease of geese, with wax and oil, applied in a tepid state; and the like. When ulcerated, he directs us to apply an ointment of litharge and axunge. For fissures he particularly recommends liquid pitch; or litharge mixed with ceruse, alum, and wine. When hairs are troublesome, they are to be cleared away with a fine piece of iron.

For fissures Rhases recommends the fat of a cock with galls. Alsaharavius lays down the rules for treating chilblains in all their stages with great precision. If the parts become red or black, he recommends us to make deep scarifications with a scalpel; after which the foot is to be put into hot water and allowed to bleed freely. His dressings are similar to those of the others. Haly’s treatment is like our author’s.

SECT. LXXX.—FOR CORNS AND CALLOUS FLESH.

Having first cleaned the corns, apply one of the septics, either verdigris, red arsenic, the powder for fistulæ, or the collyrium for fistulæ instead of gum mixed with ammoniac. A corn is a white circular body like the head of a nail, forming in all parts of the body, but more especially on the soles of the feet and toes. It may be removed in the course of some time by paring away the prominent part of the corn constantly with a scalpel, or rubbing it down with pumice. The same thing may be done with callus. The ashes of unripe lupines burnt, and mixed with honey, are of use; or misy added to liquid pitch; or gith, with the urine of a boy not come to puberty; or bean-meal boiled with vinegar. And this is an application of approved efficacy for the same purpose: Of cantharides, of copperas, of castor, equal parts; mix with turpentine until it become of the consistence of a plaster, and apply to the corn previously cleaned all around.—Another: Of burnt lees of wine, of quicklime, of mistletoe, equal parts, with strained lye, or the urine of a boy not come to puberty.

* * * * *

COMMENTARY. Aëtius delivers the treatment of corns fully, but his remedies, although similar to those of our author, are not of such ready application.

Celsus says that, by simply paring corns, the part may often be softened. Afterwards rosin mixed with a small quantity of the lapis molaris may be applied.

Avicenna states that, when the disease is not cured, it may end in cancer. Marcellus directs us to pare corns, and apply to them a composition of arsenic and turpentine rosin.

For corns Rhases recommends a composition of red arsenic, quicklime, quicksilver killed, with the ashes of acorns (impure potash?) and oil. He also joins Galen in recommending a composition of cantharides and arsenic. For the callus he recommends the juice of figs and of spurge. (Contin. xxxvi.)

SECT. LXXXI.—ON COMPLAINTS ABOUT THE NAILS; AND, FIRST, OF WHITLOW.

Whitlow is an abscess forming about the root of the nail. When, therefore, the whitlow is small and but commencing, galls with honey repress it, and prevent the formation of an abscess; or the trochisk of Musa, or the Here, in water. When a preternatural growth of flesh has taken place, the object is to consume and break it with things that are not of a corrosive nature. The sordes of the ears and lycium are also good for whitlows. When it suppurates, having opened it and evacuated the fluid, soak a sponge in water, and apply; or apply a cataplasm of lentils pounded with water; or palm-plaster with wine; or green or dried roses macerated in water, and pounded; or dried barley-flour with water. The flour of lupines mixed with honey, or wine and honey is good for whitlow. For ulcerated whitlows: Of verdigris, of litharge, of each, dr. iv; of sarcocolla, dr. iv; sprinkle of it what is sufficient, and apply externally a tent and sponge out of wine. And the flesh must be separated from the nail all around.

On pterygia. Pterygium is fungous flesh covering part of the nail, being caused by whitlow or the like; for which, sprinkle equal parts of arsenic and manna, and apply a tent out of wine and a sponge above it.—Another: Of chalcitis, of the flakes of copper, of pomegranate-rind, equal parts; add to a roasted fig and honey, first bathing the part with the decoction of the thickening matters put into ointments; and clean away the part of the pterygium when dried up.

For pterygia of the toes in a putrid state, and for ulcers of the pudendum. Of frankincense, dr. j; of the scales of copper, dr. j; of scraped verdigris called xyston, dr. iv; of honey, one cyathus; triturate in the sun until it become yellowish, and use upon a compress, having first bathed with wine.

A composition for quickly drying and curing pterygia. Of burnt sori, dr. ij; of frankincense, dr. ij; of verdigris called xyston, dr. j: having triturated with honey, apply to the pterygia. It is useful for the other malignant ulcers, and for lividity, and putridity of these parts.—Another: Add the flakes of copper to the flesh of dates, or of figs, and use.—Another: Having boiled and triturated pigeons’ dung in must with fine polenta, apply warm. And the flakes sprinkled by themselves dry up pterygia. We must always raise and remove with a scalpel the corner of the nail when it increases so as to hurt the pterygium.

For bruised nails. Apply a cataplasm of myrtle and the tender leaves of pomegranate.

For bloody nails. Mix fine flour with pitch, and apply.

To remove diseased nails. Add triturated sulphur to axunge, and apply.

How to remove leprous nails. Of mistletoe of the oak, of red arsenic, of fenugreek, of each, oz. ij; of cantharides, of deadly carrot, of each, oz. j; of vinegar, q. s.—Another: Of bee-glue, of Attic wax, of bitumen, of each, dr. ij; of native sulphur, dr. j. Let only so much oil be added that it may not stain. In using it, warm and apply it to the nails.—Another: Of liquid pitch, of wax, of colophonian rosin, of turpentine, of ammoniac perfume, of native sulphur, of aphronitrum, equal parts; evaporate until it does not stain.—Another, from the works of Ruffus, for leprous nails: Of cantharides, of native sulphur, of copperas, of each, oz. ss; of liquid pitch, oz. ij: having made into a plaster, apply to the nail, removing it every third day.

Another for removing leprous nails without ulceration. Of bitumen, of arsenic, of red arsenic, of native sulphur, of each, dr. iv; add to rosin and use, removing it every seven days.—Another: Mixing the flour of bitter vetches with sheep’s gall, or sheep’s urine, use; or unslacked lime with oil; or Chian mastich with opobalsum; or mixing copperas and native sulphur with mistletoe, spread what is sufficient on a skin, and apply; or triturate stavesacre with vinegar and use; or of turpentine rosin, dr. j; of red arsenic, double the quantity; apply to the root of the nail, and bind carefully. When the nail falls off, apply the myrtle-cerate, containing a small quantity of the composition from rosin.

* * * * *

COMMENTARY. See most of the authorities referred to in Section LXXIX.

Aëtius and Oribasius treat whitlow upon the same plan as our author, namely, by using cooling and astringent applications, such as galls, alum, and pomegranate-rind at the commencement; and after it has burst and fungous flesh has got up, by applying strong caustic and corrosive medicines, such as arsenic, verdigris, quicklime, and the flakes of copper. Neither of these authors, however, say anything about making an early incision of the part affected with whitlow, which must be considered a defect in their method of practice. Octavius Horatianus, however, seems to have had it in view to recommend an early opening, when he says, “Si saniem sanè collegerit, locum pungis.” In fact, it is as soon as the part becomes gorged with blood, and before the matter has had time to be properly formed, that an opening should be made.

Avicenna is exceedingly minute in his directions for treating whitlow. He recommends at first the finger to be put into hot vinegar. Then various astringent and repellent applications are to be used, among other ingredients containing camphor. These are afterwards to be changed for emollient and sedative applications prepared with opium. When matter forms, it is to be let out by a small opening. Haly Abbas recommends at first the seed of fleawort pounded in vinegar or snow, to cool and deaden the sensibility of the part. When these do not answer, he advises suppurative applications; and when the abscess does not open readily, he approves of an incision with the edge of a lancet. When the pain is violent and obstinate, he recommends opium, henbane, and vinegar to be added to the applications. He mentions that Hippocrates recommends an application of galls and vinegar for whitlow. Alsaharavius describes whitlow by the name of alcahas. He recommends us to bleed at the commencement, then to use a plaster of vinegar and opium, or a piece of cloth moistened in snow or cold water, and frequently changed, or to put the finger into hot oil. If these means do not succeed, suppuration is to be encouraged; and as soon as matter forms it is to be let out. Avenzoar describes a species of malignant whitlow, of which we have seen some few cases. He says it spreads up the hand, and occasions corruption of it. He recommends free incision, and relates a case in which very bad effects resulted from neglecting this practice. (iii, 2, 37.) This is perhaps the same disease that is described by Alsaharavius (Pract. xxix, 1, 25), and by Albucasis (Chir. i.)

Rhases says that common people put the finger into hot oil. He also recommends hot vinegar and hot water. (Contin. xxxvi.)

Celsus directs us to make an opening around scabrous nails, and then to apply a composition consisting of red arsenic, nitre, common arsenic, and liquid pitch. Under the use of this application, the diseased nails fall off and healthy ones come in their place. Haly Abbas and Alsaharavius also recommend applications containing arsenic. Alexander Aphrodisiensis mentions that leuce occurs more commonly on the hands than the feet, and in children rather than in adults. This arises, he says, from the feet being more exercised than the hands, and from children eating more voraciously than adults. (Probl. i, 146.) The compositions recommended in the ‘Euporista’ of Dioscorides for leprous nails are arsenic and water, sandarach, quicklime, and burnt lees of wine with pitch, the juice of thapsia and mustard with vinegar, &c. See also M. M. v, 122.

For bruised nails, Aëtius strongly commends a mixture of fossil salt with water and oil. Avenzoar speaks of privet (alcanna) with olive-oil.