Part 11

66. On Ulceration of the Womb 624

67. On Cancer 627

68. On Scirrhus and Scleroma 629

69. On the Mole 630

70. On Inflation of the Uterus 632

71. On Uterine Suffocation, or the Hysterical Convulsion 633

72. On Prolapsus Uteri 638

73. On Phimus in the Uterus 640

74. The Cure of Sterility 641

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

76. On Difficult Labour 646

77. On Ischiatic Disease 652

78. On Gout and Arthritis 657

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

80. For Corns and Callus 678

81. On Complaints about the Nails 679

PAULUS ÆGINETA.

BOOK FIRST.

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

Of the complaints which befal women in a pregnant state, the most troublesome are a redundance of crudities, continued vomiting, salivation, heartburn, and loathing of food; it will therefore be proper to give directions regarding them. The most suitable remedies are, exercise on foot, food not too sweet, wines which are yellow, fragrant, and about five years old, and moderate drink. All these things are proper for the cure of crudities and vomiting. For medicines, you may give the plant of knot-grass, boiled in water, for drink; and likewise dill, and the Pontic-root, called Rha, in the dialect of its native country. These things may be taken at a meal, or before it. Externally, the flowers of the wild vine, those of the wild or domestic pomegranate, the leaves of the alsanders (smyrnium), and the seed of the fennel, may be mixed together according to pleasure, along with dates and old wine, and applied to the præcordium in the form of a cataplasm. Heartburn may be alleviated by drinking warm water, by gentle exercise on foot, and by covering the hypochondrium with soft wool. In the case of those who have an aversion to food, whet their appetite with a variety of articles of a savory nature, and also give dry starch. This last is particularly serviceable to those who long to eat earth, as is the case in the complaint called Pica, which occurs most frequently about the third month after conception; because the fœtus being then weak, cannot consume all the aliment which is brought to the uterus, and hence various superfluities are collected in the stomach; and therefore they have a desire for complicated and improper articles, such as extinguished coals, Cimolian earth, and many more such things. On that account, the affection has got its appellation, either from the variety of colours which the bird Pica possesses, or from its being subject to this complaint. Labour and long journeys will also contribute to restore a desire for wholesome food. But she who has accustomed herself to live in an indolent manner, will not be able, when she proves with child, to bear exercise all at once. To those who loathe food, it may be of service to take acrid substances, and particularly mustard. For swellings of the feet, it may be proper to bind over them the herb anthyllis, soaked in vinegar; or to lay the leaves of a cabbage over them, and to anoint them with Cimolian earth mixed with vinegar, or with alum and vinegar. It is likewise of use to sprinkle the feet with a decoction of the Median apples, called citrons.

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COMMENTARY. We shall commence by giving a short account of ancient opinions on a curious subject not touched upon by our author,—we mean, on the influence of the imagination in pregnant women on the fœtus.

Hippocrates says, that when pregnant women long to eat coals and earth, the likeness of these things appears on the head of the child. (De Superfœt. c. 8.) Galen likewise believed in the influence of the imagination of pregnant women on the fœtus in utero. (Ad Pison.) Soranus also was a firm believer, and gives instances in women and in the inferior animals of the force of imagination at the time of impregnation. (lib. vii.) This belief was very ancient, for it appears to be countenanced by the Jewish historian. (See Genesis, xxx, 37-9.) Traces of this opinion may be found in Hesiod; and distinct allusion to it is made in the ‘Cynegetics’ of Oppian. (i, 327.) The story in the ‘Æthiopics’ of Heliodorus respecting Chariclea, the white daughter of the black king and queen of the Æthiopians, bespeaks the prevalence of the belief at the time when this celebrated romance was written. Andreas Laurentius gives an interesting statement of ancient and modern opinions on this subject. (De Mirab. Strum. Sanit.)

The bird pica is mentioned by name (κίττα) in the ‘Aves’ of Aristophanes. (See also Schol. in Aristoph. in Pac. 496, and Vesp. 348; Aristotle, Hist. An. vii, 4; and Pliny, Hist. Nat. x, 41.) Harduin concludes, from Pliny’s account of it, that it was the magpie. But we are rather inclined to follow Schneider in referring it to the jay, or corvus glandarius.

On the disease, see Galen (Hyg.; de Causis Sympt. i, 7); Aëtius (xvi, 10); Theophanes Nonnus (c. 213); Moschion (de Morb. Mulier. c. 27); Eros (apud Gynæcia), Alexander Aphrodisiensis (Problem. ii, 73); Pseudo-Dioscorides (Euporist. ii, 16); Soranus (viii); Leo (vi, 14); Rhases (Contin. xi); Avicenna (iii, 21, 2); Haly Abbas (Theor. vi, 17); Serapion (Tr. iii, 22); Alsaharavius (Pract. xxv, 2, 8.) It appears to be the malacia of Pliny (Hist. Nat. xxiii, 56, ed. Hard.)

Moschion defines the Pica to be an appetite for unusual food, which happens to pregnant women at some irregular period; being attended with a collection of depraved humours and nausea. It occurs, he says, most commonly in the second month, but sometimes earlier, and sometimes later. He recommends a restricted diet at first, then wine, dry astringent food, cataplasms of a repellent nature, and bodily motion.

Soranus treats of Pica in very similar terms to those of Moschion.

But the account of the disease given by Galen and Aëtius is the fullest. They derive the name either from the bird, as mentioned above, or from ivy (κίττος), because, as ivy entwines itself about various plants, so does this appetite in pregnant women fasten upon a variety of improper articles of food. It is attended with languor of the stomach, nausea, and loathing of food, bringing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All these symptoms arise, they say, from a sanguineous plethora, brought on by a suppression of the menstrual discharge. They, therefore, recommend a restricted diet, and moderate exercise when the woman was accustomed to it. When the humour which infests the stomach is of an acid, acrid, or saltish nature, they direct draughts of tepid water, to encourage vomiting; they forbid all sweet things; and recommend an old sub-astringent wine. When there is a loathing of food, they advise us to tempt the appetite with a variety of savory things. To those who have a desire for eating earth, they particularly recommend starch. When the fluid which is vomited is of a thick and viscid nature, they recommend pickles, radishes, and oxymel, for an emetic. They also particularly direct astringent cataplasms and plasters to be applied to the præcordia.