Part 62

Cælius Aurelianus directs the tongue to be cleaned with a sponge squeezed out of hot water. Avicenna recommends for this purpose an instrument called chaizaran, and also directs us to use sugar, or a sponge with a small quantity of salt and rose oil. He likewise makes mention of the salt brought from India, possessing the colour of salt and the taste of honey. (iv, 1, 2, 22.) The Pseudo-Dioscorides recommends mint triturated with honey, red sumach, and rose oil with honey, or by itself. (Euporist. ii, 18.)

Prosper Alpinus held that the Indian salt, mentioned by our author and Avicenna, was the same as our sugar. But this opinion was controverted by Carolus Arantius, (Baptista Fieræ Cœna.) Sprengel, accordingly, maintains that the Greeks and Romans were utterly unacquainted with our sugar. (Rei Herb. Hist., and Notæ in Dioscoridem, ii, 104.) The mel arundinum appears, in fact, to have been a natural concretion, and it was most probably the same as the Indian salt. See Dr. Milward’s Letter to Sir Hans Sloane. The cane from which the ancient sugar was procured is now called by botanists the bambusa arundinacea, or bamboo cane. See Book First, 96.

SECT. LV.—ON NAUSEA.

When nausea comes on without being produced artificially, it is a clear inference that noxious humours are vexing the stomach. Some feel uneasy, but vomit nothing, the humour being retained in the coats. When the humours are pituitous, we must get them concocted by rest, spare diet, and sleep. But the thinner may be ejected by vomiting, produced either with the juice of ptisan, or with honied water. But those which are viscid and thick, stand in need of attenuant remedies, such as oxymel, and the like. But, when a noxious fluid is detained in the coats, the powder from aloes, called picra, is beneficial, but astringents are pernicious; whereas, if there be much fluid, but not of a noxious kind, astringents will be beneficial, but the aloetic medicine will bring on marasmus. When cold is joined to humidity, we must mix calefacients with astringents. The symptom of the affection being of a cold nature is that there is no thirst, nor sensation of heat.

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COMMENTARY. Oribasius recommends the same treatment. (Synops. vi, 40.) Our author appears to have condensed the lengthy account given by Galen and Aëtius. (ix, v.)

Alexander also treats of the subject at great length, but we can only afford room for a few extracts. When the nausea arises from plethora, he directs bleeding; and when the plethora is connected with vitiated humours, he recommends both bleeding and purging. When bilious or melancholic humours occasion the nausea, he recommends dilution at first by giving tepid water or the like, and then evacuations of them by purging or emetics. When the humour is an acrid or sweet phlegm, he recommends oxymel, radishes, and the like. When a serous and thin humour is impacted in the stomach, he evacuates it by procuring vomiting with tepid water or ptisan. (vii, 13.)

Serapion appears to have copied from our author. (iii, 5.) See Avicenna (iii, xiii, 5, 8.) Rhases applies over the stomach a cold plaster with snow. When the nausea is oppressive, he promotes vomiting with tepid water. (Cont. xi.)

SECT. LVI.—ON VOMITING OF BILE.

To those who vomit bile, a cataplasm must be applied, made of dates, the rind of pomegranate, and gall, boiled in wine or oxycrate, along with pounded bread. And acacia, hypocystis, and the flowers of the wild pomegranate and sumach, ought to be added to the cataplasm. A cupping-instrument also, when applied with a strong heat, is of great service. Food ought to be given frequently in small quantities. To those who vomit black bile and have the stomach inflated, apply sponges soaked in hot vinegar of the most acrid qualities, or a cataplasm of the leaves of the ivy boiled in wine.

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COMMENTARY. This is taken from Oribasius (Synops. vi, 41.)

Alexander states that the proper remedies for vomiting occasioned by a redundance of bile are diluents and refrigerants. He recommends internally ptisan, lettuces with a small quantity of vinegar, &c. For drink, he particularly approves of cold water, but forbids much to be given at a time. When the strength fails, he permits a small proportion of hydromel, wine, or the like, to be added to the water. In certain cases, when the patient is troubled with insomnolency, he directs us to add the heads of poppies to his drink. He also recommends external applications possessed of tonic, cooling, and repellent properties. (vii, 17.)

Serapion recommends us not to interfere with a critical vomiting. When it is continued, he directs us to give clysters and gentle purgatives at first, and afterwards vegetable acids and astringents. When these remedies fail, he directs us, if the strength be good, to bleed from the arm. He also makes mention of external applications, possessed of astringent and refrigerant properties. (iii, 15.) Haly Abbas, in like manner, cautions against stopping a critical vomiting. (iii, 24.) Alsaharavius prescribes draughts of tepid water at first, and afterwards the infusion of wormwood or of aloes. He also recommends external applications of a strengthening nature. (Pract. xvi, 20.) Avicenna’s plan of treatment appears to have been copied from our author’s. (iv, i, 2.) Rhases recommends acid drinks, such as the decoction of pomegranates and the like. (Cont. xi.)

According to Prosper Alpinus, the treatment of the Methodists consisted in administering sub-acid fruits, the juice of wormwood or of mint in wine, and in applying externally tonic epithemes, containing sumach, galls, mastich, and the like. (Med. Meth. xii, 11.)

SECT. LVII.—ON HICCOUGH.

Singultus is occasioned either by fulness, or emptiness; or by the presence of acrid and pungent humours in the stomach, and when they are vomited, it ceases. And many, if they only take the medicine composed of the three kinds of pepper, and drink wine immediately after, have hiccough. And it is well known that many people hiccup when the food spoils on the stomach. Many also hiccup from rigors. We will find an emetic a proper remedy in cases which are occasioned by fulness or pungency, and warmth in those from cold; and, when the complaint is occasioned by a plethora of humours, there is need of strong evacuation. This may be accomplished by sneezing, but when emptiness is the cause, sneezing will not cure it; for in such cases, we must give rue with wine, or nitre in honied water, or hartwort, or carrot, or cumin, or ginger, or calamint, or Celtic nard. These are the remedies for such cases as are occasioned by corruption of the food, cold, or plethora. When a redundance of cold and viscid humours is the cause, give castor to the amount of three oboli to drink in oxycrate, and the same thing will be of use when applied externally to the skin, along with old Sicyonian oil. The vinegar of squills or oxymel may also be drunk with advantage. Retaining the breath is likewise of great use.

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COMMENTARY. This Section is copied from Oribasius (Synops. vi, 42.)

According to Galen’s explanation, hiccough is occasioned by any exciting cause which rouses the stomach to violent emotions. He states that sneezing proves a cure to it. (De Caus. Sym. iii, 6.) Celsus says, in like manner, ‘Singultus sternutamento finitur.’ He states that frequent and unusual hiccuping is symptomatic of an inflamed liver. (ii, 7.) Aëtius, in like manner, says that singultus in fevers often arises from inflammation of the stomach and neighbouring parts. He treats of the complaint at great length. When it arises from pungent humours, he gives first emetics, and afterwards narcotics, such as opium, &c. He also applies a cupping instrument with great heat to the breast, stomach, and back, in certain cases. (ix, 5.)

Alexander gives an interesting account of this affection, for which he recommends various remedies. When connected with inflammation of the stomach or liver, he begins with bleeding. When it is occasioned by thick and viscid humours, he recommends an oxymel of squills, the composition of which he minutely describes. He also speaks favorably of emetics. When the humours are of a pungent nature he approves of diluents and the drinking of tepid water. Sometimes, he adds, he has known a draught of cold water prove effectual. (vii, 15.)

When singultus is connected with a cold cause, the author of the ‘Euporista,’ ascribed to Dioscorides, recommends us to put the feet into hot water, to take tepid draughts, and apply hot fomentations to the stomach. (ii, 4.)

Though there is perhaps nothing original in the views of the Arabians, they treat of hiccough very fully and accurately. Among the causes of it, mentioned by Alsaharavius, is inflammation of the stomach and liver, in which case he recommends venesection. When connected with excessive heat of these parts, he approves of cold air, cold drink, and refrigerant draughts, containing prunes, tamarinds, camphor, &c. (xvi, 18.) The causes of hiccough, according to Serapion, are evacuation, repletion, pungent and cold humours. His remedies are emetics, calefacients, and attenuants, which are to be directed according to the nature of the exciting cause. (iii, 17.) See also Avicenna (iii, 13, v, 25); Rhases (Divis. 62, ad Mansor. ix, 65, Cont. xi.) Rhases recommends calefacients, such as cumin, pepper, rue, and the like, in vinegar. He also approves of emetics and laxatives.

Prosper Alpinus says that the ancient Methodists approved of oily emetics. (Meth. Med. vi, 8.) It will be remarked, that our author states that many persons are seized with hiccough if they take peppers with wine. Prosper Alpinus mentions that they had this effect on him (de Præs. V. et M. ægr. iii, 9); and I have further to state the same of myself.

Rogerius, probably copying from Rhases (for the practice of the earlier modern physicians is mostly borrowed from the Arabians), recommends principally calefacient, attenuant, and carminative medicines, mixed with gentle laxatives, such as prunes. (iii, 21.)

SECT. LVIII.—ON CONSTIPATION AND LOOSENESS OF THE BOWELS IN FEVERS.

Those things which remedy a dry state of the bowels are treated of in the First Book sufficiently. But since a humid or loose state of the bowels may prevail in fevers, this also must be treated of; for many are cut off not by the fever itself, but by this symptom alone. In the commencement, we must not interfere with the discharge when it proceeds from corruption of the food and indigestion; but when the evacuation becomes immoderate, it must be restrained. If the discharges are of an acrid nature, that which is given should consist of good juices, and be otherwise thick, such as spoon-meats from pearl-spelt (chondrus) and ptisan. Baths are also befitting after the complaint has become concocted. But when the discharges consist of phlegm and are watery, on the other hand, the food ought to be of a more dry and heating nature, as far as the fever will permit. Of this kind, are those things which are prepared from heating condiments. But they must abstain from baths, unless otherwise required. When the digestive faculty is in an atonic state, we must give food and applications of an astringent nature; the food consisting of things in particular, to which pomegranates, apples, pears, or medlars have been added, or these fruits themselves, and thin fragrant wine of an astringent quality; and the applications are to be cataplasms made of polenta, and dates, and wormwood, roses, myrtles, and such like things. It must be considered also, to what part these cataplasms are to be applied, I mean the region of the stomach, the lower belly, or perhaps the loins. Bloody discharges are restrained and dried up by remedies containing fine flour of polenta, with frankincense, or manna mixed with wine, or oxycrate. When the watery discharge is acrid, it must be sweetened by a lavement either with water alone, or the juice of ptisan, or of chondrus, or rice, or tragum, not once, but often; and afterwards there are to be added dried roses, or myrtles, and sometimes galls; and an egg with rose oil, and a thin astringent wine, or the decoction of roses, may be injected or applied to the anus, which will blunt the desire of going to stool. But when the calls are frequent, a clew formed of warm threads may be applied to the anus.

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