As the practice of the other authorities is conducted upon similar principles, we shall mention them very succinctly. For the depraved appetite which longs for earth, Serapion recommends aromatic spices, such as cardamon, cubebs, and the like. For the continued vomiting, Alsaharavius directs plasters, containing the oil of spikenard, mastich, quinces, wormwood, and the like, or a vessel filled with hot water, to be applied over the stomach, pomegranate seeds to be held in the mouth; and that the patient should take gentle exercise, and abstain from all sweet things.
Alexander Aphrodisiensis accounts for the disease in much the same way as Galen and Aëtius. He says that, when the menstrual fluid is suppressed, a determination of it takes place to the stomach, until the fœtus becomes as large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the œdematous swellings of the feet and legs, most of the other authorities concur with our author in recommending astringent applications. The anthyllis, mentioned by him, is supposed by Sprengel to have been the cressa cretica. (R. H. Hist. p. 164.)
We shall conclude our commentary on this Section with an outline of the directions given by Aspasia for the management of pregnant women. Women who have conceived are to be guarded from frights, sorrow, and all violent mental perturbation. They are to avoid gestation in carriages, severe exercise, inordinate breathing and blows about the loins; also the lifting of heavy loads, dancing, and sitting on hard seats. Likewise all acrid and flatulent food, strong clysters, and too much or too little food and drink are to be avoided. All discharges of blood, whether from the nose or hemorrhoids, are dangerous in the pregnant state. Moderate and wholesome food, gestation in a sedan, gentle walking, soft friction, and the exercise of spinning are proper. About the eighth month, which is the most critical period of pregnancy, the diet is to be more contracted, and the exercise increased. If the bowels are constipated owing to compression of the rectum, by the enlarged uterus, laxative food is to be given, such as ptisan and mallows. In the ninth month the regimen is to be of a relaxing nature, and for this purpose the tepid bath is to be frequently taken, for it has a great effect in rendering parturition easy. (Apud Aëtium, xvi, 12.)
Our author borrows part of this chapter from Oribasius, and abridges the rest from Galen and Aëtius.
SECT. II.—ON THE NURSE.
A nurse is to be chosen who is free from every complaint, and is neither very old nor very young. She ought not to be less than twenty-five nor more than thirty-five. Her chest should be large, as also her breasts, and her nipples neither contracted nor turned aside. The rest of her body should be neither very fat nor very spare. It is of great consequence to the child that his nurse should have brought forth but a short time before, and that her child had been a male rather than otherwise. She ought to avoid everything of a very desiccative nature, and likewise such as are saltish, acrid, sour, acid, bitter, very heating, or of an offensive smell: also, such as are strongly fragrant, condiments, and such like acrid substances. Let the nurse also abstain from venery. Let her work with her hands and shoulders, let her labour at the mill and the loom, and carry about the child in her arms. This may be done for three or four months.
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COMMENTARY. This Section is taken from Oribasius. (Synops. v, 2.)
Aëtius gives somewhat fuller directions. He says, the nurse ought not to be younger than twenty, nor older than forty; should be free from disease, and have breasts neither too small nor too large; for when the breasts are too large, they contain more milk than the child can manage: and part being retained spoils, and proves injurious to the child, and even affects the health of the nurse; when too small, on the other hand, they do not contain a sufficient supply of milk. Large nipples, he remarks, hurt the gums, and impede deglutition; whereas, when too small, they cannot be got hold of. The nurse, he says, should be chaste, sober, cleanly, and cheerful. (iv, 4.)
The directions given by the other authorities, are very similar to our author’s. See, in particular, Rhases (ad Mansor. iv, 30); Avicenna (Cantic.); Averrhoes (in Cant. p. ii, tr. 1.) Avicenna says, the nurse ought to be from twenty-five to thirty-five years old. Averrhoes says, from twenty to thirty.
It appears to have been a general practice among the Romans, after they became luxurious and effeminate, for the ladies of noblemen to consign the care of their infants to wet nurses. Tacitus, in his elegant dialogue ‘de Oratoribus,’ inveighs against this practice. See also a spirited declamation on this subject, by the philosopher, Phavorinus, in the ‘Noctes Atticæ’ of Aulus Gellius. (xii, 1.)
SECT. III.—ON THE MILK OF THE NURSE.
The best milk is that which is moderate in thickness, quantity, colour, smell, and taste. It is a proper way to try the quality of the milk, by pouring a little of it upon the nail of the thumb and observing it in the sun; for, when upon turning the nail, it neither runs off too slowly nor too quickly, it is good milk. You may also try it thus: by pouring some milk into a glass vessel, and putting some runnet into it, then squeezing them together with your fingers, allow it to coagulate, and observe whether the cheesy part be less than the serous; for such milk is unsuitable, and also the opposite kind is of difficult digestion. The best kind is that which has a moderate proportion of each.
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COMMENTARY. This Section is taken from Oribasius (Synops. v, 3), and Aëtius (iv, 3.)
The method of trying the quality of the milk here recommended is mentioned by Aëtius, Barytus (ap. Geopon. xviii, 20), Dioscorides, Avicenna, Haly Abbas, and Alsaharavius. According to Avicenna, a child ought not to be allowed to take suck oftener than twice or thrice in the day. See, in particular, Haly Abbas (Pract. i, 21), and Alsaharavius (Pract. xxx, 3.)
SECT. IV.—HOW TO CORRECT THE BAD QUALITIES OF MILK.
The bad qualities of milk may be thus corrected. If it be too thick, the phlegm ought to be evacuated by vomits, the most proper of which are those of vinegar and honey. It is also proper to extenuate by labour before meals. Also the following substances are proper, namely: wild marjoram, hyssop, savoury, shepherd’s needle, thyme, the small radish, and old pickle with vinegar and honey. But if it be more acrid and thinner than natural, the nurse ought to be relieved from much labour, to be fed upon strong soups, and the flesh of swine, and to be allowed sodden must and sweet wine. If it be in too small quantity, she ought to get soups and a generous diet, with sweet wine for drink; and her breast and nipples should be rubbed. The cupping instrument, if applied, will also be of service. That medicines for the formation of milk, are possessed of some efficacy, I am well aware, and yet I do not recommend them in all cases, for they greatly waste the body. They are, the root and fruit of the fennel boiled in ptisan, the leaves of the cytisus in dark-coloured wine or ptisan, the sweet gith (melanthium), dill, the root and fruit of the carrot. They are to be first soaked with warm water, and then given. But when the milk is bad, whether it be thick, acrid, or of a strong smell, it is first to be sucked out and then the child is to be applied. For that which is acrid ought, on no account, to be given to the infant when hungry; but that which has an offensive smell may be corrected by fragrant wine and sweet food. Of coagulated milk in the breasts, we will treat in the Third Book.
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COMMENTARY. Aristotle forbids wet nurses to drink wine. It is the same thing, he adds, whether the nurse or the child drink it. (De Somno.)
Oribasius, Aëtius, and Avicenna give similar directions to our author’s. They all permit nurses to take a moderate allowance of animal food and wine. When the nurse has too little milk, Aëtius recommends her to drink ale (Zythus.) He also approves of sweet wine, gruels prepared with fennel, or green dill boiled with ptisan. When the milk is thin, he directs her to abstain from baths, and to take food of a nutritive quality, such as fine bread, the legs of swine, tender birds, the flesh of kids, and sweet wine. When the milk is thick, he recommends frequent baths, and an attenuant diet. When it is excessive, he directs her to diminish the quantity of the food, and to take what is less nutritive, and to make discutient applications to the breasts, such as a linen cloth dipped in vinegar, and to wash them frequently with warm salt water, or the decoction of myrtle.
Hippocrates forbids the nurse to take things of an acrid, saltish, acid, or crude nature. He recommends fennel, cytisus, parsley, and the hot bath as a general regimen to nurses. (De Mulieb.)
Haly Abbas gives similar directions. He properly recommends the nurse to abstain from taking things of a pungent, sour, and bitter nature. When the nurse’s milk is deficient, he recommends that she should get the milk of cows and goats, fennel, lettuce, parsley, and the like. (Pract. i, 21.)
SECT. V.—ON THE MANAGEMENT OF THE INFANT.
The first food given to a new-born child should be honey, and afterwards milk, twice, or at most three times a day. When it appears disposed for it, and seems able to digest it, it may get some food, care being taken not to stuff it. If this should happen to be the case, it will become more sleepy and inactive, there will be swelling of the belly and flatulence, and its urine will be more watery than natural. When this is observed, it ought to get no more food until what it has got be consumed. The child may be brought up upon milk until it be two years old, after which, its diet may be changed to food from grain.
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