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THE
SYDENHAM SOCIETY

INSTITUTED
MDCCCXLIII

SYDENHAM

LONDON
MDCCCXLIV.

THE
SEVEN BOOKS
OF
PAULUS ÆGINETA.

TRANSLATED FROM THE GREEK.

WITH
A COMMENTARY
EMBRACING A COMPLETE VIEW OF THE KNOWLEDGE
POSSESSED BY THE
GREEKS, ROMANS, AND ARABIANS
ON
ALL SUBJECTS CONNECTED WITH MEDICINE AND SURGERY.

BY FRANCIS ADAMS.

IN THREE VOLUMES.
VOL. I.

LONDON
PRINTED FOR THE SYDENHAM SOCIETY
MDCCCXLIV.

“MULTUM EGERUNT QUI ANTE NOS FUERUNT, SED NON PEREGERUNT. SUSPICIENDI TAMEN SUNT, ET RITU DEORUM COLENDI.”

(SENECA, EPIST. LXIV.)

PRINTED BY C. AND J. ADLARD,
BARTHOLOMEW CLOSE.

ADVERTISEMENT.

Although in the Preface which immediately follows, and which is reprinted with slight alterations from the former edition, I have entered, at some length, upon the subject of the following translation, I felt it necessary, in the circumstances under which my work now appears, to premise a few additional remarks.

It is now many years since I undertook and completed a translation of the whole works of Paulus Ægineta. In the year 1834 I published the first three books, with a commentary, having for its object to embody the most important opinions of the Greek, Roman, and Arabian writers, on all subjects treated of by the original author. Notwithstanding the very favorable reception which that volume obtained from many of the most eminent members of the medical profession, as well as from scholars both at home and abroad, I was under the necessity—from circumstances which I need not here detail—of deviating from my original intention of completing the publication of the work in the same form and at my own risk. After an interval of ten years the proposition was made to me by the Council of the Sydenham Society to prepare a new edition of the volume already published, and to complete the remaining two on the same general plan. This proposition was too gratifying to my feelings not to be immediately assented to; and it is with unfeigned satisfaction that I have now the honour to submit the first volume of the work to the members of so distinguished and important a Society.

In preparing this volume for the press, knowing that it will now be subjected to the criticisms of a very numerous and intelligent body of my professional brethren, I have been anxious to render it worthy of their approbation as far as lay in my power. At the request of the Council I have made considerable omissions in my commentary as formerly printed, more especially in regard to modern authorities; it being thought advisable not to bring the annotations further down than the period of the Arabian writers. I have also made not a few additions and alterations which I hope will be considered as improvements. In performing this part of my task I have greatly profited by the aid and valuable criticisms of two esteemed friends, Sir William Hamilton of Edinburgh, and Dr. Greenhill of Oxford.

I am sensible that it is to the growing conviction in the profession, of the value of the ancient authorities, that I owe the very flattering distinction which my work has now obtained; and I shall have great satisfaction in reverting to the labours of former years if they should now prove instrumental in increasing the desire of becoming acquainted with the views and practice of our forefathers. That the ancient literature of medicine has been too much neglected in this country is not disputed by any competent judge; and it would appear from the remarks of M. Hecker, in his address to the physicians of Germany, given in his admirable work on Epidemics,[1] that the profession on the Continent is not much in advance of us in this respect.

[1] Dr. Babington’s Translation; Sydenham edition, p. xv.

The time, however, it is to be hoped, is not far distant when the medical profession will everywhere be impressed with the importance of becoming properly acquainted with the views of the animal economy and of its derangements, entertained by three of the most intellectual nations of mankind; and when every newly-broached hypothesis will be tested by a comparison with doctrines of a similar nature advanced in former days, and every newly-proposed remedy will be subjected to a like ordeal. Surely every age ought to endeavour to benefit by the experiments, whether successful or otherwise, of all preceding ones; instead of every generation commencing a new series of trials, and wandering over the same ground in search of truths which had been long ago discovered; or in stumbling through the mazes of error without regarding the beacons set up by their forefathers to direct the footsteps of their descendants. If the wisdom of antiquity be entitled to high reverence in any case, it surely is so in medicine, founded as this art especially is on general observation and experience.

What renders ancient medical literature of the more importance at the present day, is the circumstance that it is almost our only source of information with regard to the diseases prevalent in several extensive countries bordering upon the Mediterranean Sea. It is well known that the inhabitants of Greece, of Asia Minor, and of the north coast of Africa have been long sunk into such a state of intellectual decrepitude as renders them incapable of making and recording original observation; consequently, for information in regard to the phenomena of disease, as manifested in these regions, we are almost entirely thrown back upon the literature of their ancestors.

I take the present opportunity of adverting to one or two circumstances which I omitted to notice in my original preface.

An objection, I am well aware, will be made by some scholars to the manner in which I have executed one part of my task. It is this:—that the references to ancient authors are often so vague, as to make it a matter of considerable difficulty to find the passages in the originals. It must be admitted that there are grounds for this objection; and if I had the work to do over again, I should most probably take pains to obviate it, in some degree, at least. But to remedy the omission, after the work was completed on its present plan, would have been a task of immense labour to me, without bringing a correspondent advantage to my readers. Moreover, I am convinced that, even as they stand, the references will, in general, be found sufficient to guide those who have an acquaintance with the originals to the places indicated; and to those who are unacquainted with them, this strict system of quotation would be of no use, further than to inspire them with a greater degree of confidence in the accuracy and pains-taking research of the Editor. It may be proper for me, then, to state that I have made it an invariable rule never to quote at second-hand, nor to make any reference to the opinions of an author whose works I have not myself carefully examined.

Many readers, I fear, will find considerable difficulty with the names of the Compound Medicines which occur throughout this volume; and may be disposed to think it was the duty of the Commentator to explain them as they occur. In answer to this objection, I beg to state, that these compositions will be fully described in the third and last volume, which treats of the Materia Medica and Pharmacy; and on this account I thought it unnecessary to notice them elsewhere. The General Index, which will be given at the end of the work, will also facilitate reference in such cases.

F. A.

Banchory, August 17th, 1844.

EDITOR’S PREFACE
TO THE FIRST EDITION OF VOL. I.

Notwithstanding the additions which have been made of late years to the history of medical literature, it must still be admitted that there is not, in the English language, any work which contains a full and accurate account of the theoretical and practical knowledge possessed by the Greeks, Romans, and Arabians, on matters connected with medicine and surgery. Nor, as far as I can learn, is the case very different with the continental languages. For, although the German and French have lately acquired several histories of medicine distinguished for their ability and research, the object of these works would appear to be confined to a general exposition of the leading discoveries and revolutions in doctrine which marked each particular age or epoch in the profession; and I will venture to affirm that no person will be able to acquire from a perusal of them anything like a competent acquaintance with the minute details of ancient practice. The design of the present publication is to supply the deficiency, now adverted to, by giving a complete Manual of the Surgery and Medicine of the Ancients, with a brief but comprehensive outline of the sciences intimately connected with them, especially Physiology, the Materia Medica, and Pharmacy. At first it was my intention to accomplish this purpose in the form of an original work, but, being perplexed what plan to choose in arranging the multifarious matters which I had to treat of, I at last resolved upon taking for my text-book the celebrated synopsis of Paulus Ægineta, whereby I was at once supplied with a convenient arrangement of my subject, and at the same time, by giving a close translation of it into English, I saw that I would be enabled to enrich our medical literature with one of the most valuable relics of ancient science. By following this correct and faithful guide, by supplying his omissions and enlarging his plan, when necessary, from the more copious works of his predecessors, and by adding, in all cases, the improvements of subsequent ages, down to the latest date of ancient literature, I am in hopes that I have been able to present the reader with a work from which he may, at one view, become acquainted with the prevailing opinions upon all the most important matters connected with medical practice during a period of more than fifteen centuries. Impressed with a sense of the arduous nature of the task which I had undertaken, and sensible that its value consists entirely in its completeness on all points, I have endeavoured to discharge this duty faithfully and to the best of my ability. I trust then it will be found that not only have I overlooked no treatise connected with the medical art which has come down to us from antiquity, but that I have turned to good account my acquaintance with the learned labours of modern commentators, especially in the department of the Materia Medica, in order to adopt the nomenclature of the ancients on these subjects to the terminology of Botany, Chemistry, and Mineralogy, in the present time.

And here may I be permitted to express my conviction that it is not altogether the blindness of partiality contracted towards intellectual pursuits upon which my mind has been so long engaged, that leads me to think that the original authors from whose stores I have drawn so liberally, will yet be found and acknowledged to have been well entitled to the confidence and reputation which they once enjoyed, and to which it is my wish that the present publication should, in some degree, restore them? It appears to me that, at certain periods of ancient times, the standard of professional excellence was such as would not easily be attained at the present day, with all our vaunted improvements in knowledge; and that many of those early masters of our art were distinguished for varied stores of erudition, an ardent love of truth, and an aptitude to detect the fallacies of error, such as few of us even now can lay claim to. The Father of Medicine held that, to become an eminent physician, it was necessary not only to be well acquainted with the structure of the human frame, but also to be skilled in logic, astronomy, and other sciences (De Aer. Aq., &c.); and of him it may be truly asserted, that he cultivated the art of medicine upon the strict principles of the inductive philosophy more than two thousand years before the world gave Lord Bacon the credit of introducing this method of philosophising. His devoted admirer and follower, Galen, was evidently the very beau ideal of an accomplished physician; skilled in all the sciences of the day, in logic, mathematics, rhetoric, and the first philosophy; to all these ornamental branches of knowledge he added a minute acquaintance with anatomy and physiology; a practical experience with the phenomena of diseases as diversified by climate, situation, and the varied modes of life; a singular perseverance in collecting facts; and an extraordinary ability for generalizing them. The contemporaries of Celsus regarded him not only as well acquainted with medical literature, but also as being minutely skilled in every elegant and useful science which was known and cultivated at that remarkable period. And Rhases, the Arabian, requires of him who aspires to eminence in the medical profession, that, instead of wasting his earlier years in frequenting musical and drinking parties, he should have spent them in conning over the valuable records of ancient wisdom. “But the Sciolist,” says he, “who gives himself out for a proficient in the art, while he has scarcely even a smattering of learning, will never be deserving of much confidence, nor ever attain any great eminence in his profession. For it can never be that any individual, to whatever age he may reach, should be able to comprehend in his mind a subject so vast and diffuse, except by treading upon the footsteps of the ancients; since the boundaries of the science far exceed the narrow limits of the life of man, as is the case with most of the liberal arts as well as with medicine. The number of authors is not small by whose labours the art has attained its present growth; and yet one may hope to master the monuments of their industry within the space of a few years. Let us suppose that, in the course of a thousand years, a thousand authors had made improvements in the profession; and then a person who has diligently studied their works may improve his mind as much in knowledge as if he had devoted a thousand years to the study of medicine. But, when an acquaintance with former authors is despised, what need be expected from the efforts of a single person? For, however much he may surpass others in abilities, how is it to be supposed that his private stock of knowledge should be at all worthy to compare with the accumulated treasures of antiquity? In a word, he who has never turned over the pages of the ancient physicians, nor has formed to his mind a distinct conception of the nature of diseases before he enters the chambers of the sick, will find that, from ignorance and misapprehension, he will confound one complaint with another, for this obvious reason, that he has come to his task unprepared and uninstructed.”

And here I would beg to call the attention of my readers to the fact that there is no legitimate mode of cultivating medical knowledge which was not followed by some one or other of the three great sects into which the profession was divided in ancient times. The Empirics held that observation, experiment, and the application of known remedies in one case to others presumed to be of a similar nature, constitute the whole art of cultivating medicine. Though their views were narrow, and their information scanty, when compared with some of the chiefs of the other sects; and although they rejected, as useless and unattainable, all knowledge of the causes and recondite nature of diseases, it is undeniable that, besides personal experience, they freely availed themselves of historical detail, and of a strict analogy founded upon observation and the resemblance of phenomena. To this class we may refer Scribonius Largus, Marcellus, Plinius Valerianus, and a few others, frequently quoted by us. The sect called the Rational, Logical, or Dogmatical, holding that there is a certain alliance and connexion among all the useful and ornamental arts, maintained that it is the duty of the physician not to neglect any collateral science or subject. They therefore inquired sedulously into the remote and proximate causes of diseases, and into the effects of airs, waters, places, pursuits, food, diet, and seasons, in altering the state of the human body, and in rendering it more or less susceptible of morbid changes. Looking upon general rules as not being of universal application, they held that the treatment ought to be modified according to the many incidental circumstances under which their patients might be placed. They freely and fully availed themselves of whatever aid they could derive from experience, analogy, and reasoning. Hippocrates, Galen, Aëtius, Oribasius, Paulus Ægineta, Actuarius, and all the Arabian authorities, may be looked upon as belonging to this sect. The Pneumatic sect, to which Aretæus probably belonged, was nearly allied to the Dogmatical. The sect of the Methodists, rejecting altogether the consideration of remote causes, which they held to be of no importance to the cure, and giving themselves up to too bold a classification of diseases, according to certain hypothetical states of the body in which they were supposed to originate, fettered themselves too much with a few general rules, which they held to be so universally applicable, that they would scarcely allow of their being modified by incidental circumstances in any possible contingency. Notwithstanding this defect, it is undeniable that their speculations as to the nature of diseases are generally very acute, and their modes of treatment frequently very rational. Upon the whole, the general outline of their system would appear to have borne a striking resemblance to that of the sect which started up in Edinburgh towards the end of the last century, called the Brunonian, from the name of its ingenious but fanciful founder, Dr. Brown. The only perfect model of ancient Methodism that has come down to us is Cælius Aurelianus, an author so truly eminent that some of his admirers in modern times have not scrupled to maintain that his works are even better worth being attentively studied than those of Hippocrates and Galen. Moschion and Theodore Priscian (otherwise known by the name of Octavius Horatianus) belonged to this sect; Alexander of Tralles also had a considerable leaning to its principles; and some would even refer the illustrious Celsus to the same class, but probably without good reason, for he would rather seem to have imbibed the genuine spirit of Eclecticism, and like his distinguished correspondent Horace, to have been

“Nullius addictus jurare in verba magistri.”

Before concluding these prefatory remarks, it will be naturally expected that I should say something of the author whose work I have bestowed so much pains in translating and commenting upon. Here, however, I must regret that the information which I have to supply is exceedingly scanty and unsatisfactory. So little is known of him that it is not even ascertained in what century he flourished. Vossius is wholly undecided; Moreau and Le Clerc place him in the fourth century; Vander Linden and Conringius, in the fifth; but Freind, Albertus Fabricius, Hutcheson, Sprengel, and most of the late writers of the Ancient History of Medicine, bring him down as low as the seventh century, upon the authority of Abulfaragius; but every person who is at all acquainted with his works will agree with me that any opinion of his on chronological matters is entitled to very little consideration indeed.

What confidence does a writer deserve who states, for example, that Andromachus, the physician who added the flesh of vipers to the celebrated electuary of Mithridates, lived in the time of Alexander the Great!—that Dioscorides, of Ain Zarba, flourished in the reign of Ptolemy Physcon, namely, about one hundred and twenty years before Christ, whereas it can scarcely admit of a doubt that the celebrated author of the Greek Materia Medica did not live earlier than the end of the first century of the Christian era!—and that Ruffus was contemporary with Plato, when we have the authority of Suidas that he lived in the reign of Trajan! Dr. Milward, in his epistle to Sir Hans Sloane, endeavours to settle the age of our author from the following train of inferences: In the first place, then, since Paulus quotes Alexander Trallian and Alexander Aëtius, it is quite certain that our author was posterior to both these writers. Now the age of Aëtius may be made out from the following circumstances: Aëtius mentions St. Cyril, Archbishop of Alexandria, whose death is ascertained from ecclesiastical history to have happened as late as the middle of the fifth century. Nay, he also takes notice of a medicine much recommended by Petrus Archiater, chief physician to Theodoric, who was posterior to St. Cyril. We cannot possibly suppose it likely, then, that Aëtius flourished earlier than the end of the fifth century. But what brings him still further down, is the circumstance that his predecessor, Alexander, is mentioned by Agathias, the historian, about the middle of the sixth century. (Hist. v, 6.) It would seem almost certain, therefore, taking all these things into consideration, that our Author cannot have lived at an earlier period than in the end of the sixth or the beginning of the seventh century.

But, whatever may have been the period at which he lived, there can be no doubt that he attained great eminence in his profession, and continued to be looked up to as one of the highest authorities in Medicine and Surgery during a long succession of ages. His countryman Nonnus, although he does not mention him by name, gives a brief compendium of a considerable portion of his work; and Psellus does the same in politic verses of some elegance. All the medical authors, in a word, of the distinguished Arabian period, quote his opinions in almost every page of their works, and never fail to recognize him as one of the most eminent of their Grecian masters. At the revival of literature in modern times, the Latin translations of the Arabians continued for a time to be the ordinary guides to practice; but when the superior merit of their Greek originals came to be properly appreciated, our Author rose again into high consideration. As a proof of this, I may mention that the surgery of Fabricius ab Aquapendente is made up almost entirely from his works. Portal, therefore, had no good occasion for representing him as “one of those unfortunate writers to whom posterity had not done justice.” I admit, indeed, that for some time past, since professional research and the study of ancient models have been superseded by a restless desire of novelty in theory and in practice, he has not enjoyed that consideration to which he is justly entitled; but, in this respect, he has only shared the fate of other names, equally eminent for their contributions to medical science, who have now been suffered to fall into neglect.

Of the Latin translations, which are very numerous, the most celebrated is that of Cornarius, published by Henry Stephens in his ‘Medicæ Artis Principes;’ which, however, after a careful examination, I have not found to be so trustworthy as I expected to find it. There once existed an Arabic edition by Honain, or Joannitius, (see Choulant, Handb. der Bücherkunde für die Aeltere Medicin,) but of it I know nothing. The only part which has been translated into any modern language is the Sixth Book, a French translation of which was published at Lyons, A. D. 1539. Of the original there are two editions, namely, the Aldine of 1528 and the Basle of 1538, in neither of which is the text so accurate as could be wished.

F. A.

Banchory-Ternan; Nov. 12th, 1833.

THE AUTHOR’S PREFACE.

It is not because the more ancient writers had omitted anything relative to the Art that I have composed this work, but in order to give a compendious course of instruction; for, on the contrary, everything is handled by them properly, and without any omissions, whereas the moderns have not only in the first place neglected the study of them, but have also blamed them for prolixity. Wherefore, I have undertaken the following Treatise, which, it is like, will serve as a commentary to those who may choose to consult it, whilst it will prove an exercise to me. For it appears strange that lawyers should be possessed of compendious and, as they call them, popular legal synopses, in which are contained the heads of all the laws, to serve for immediate use, whilst we neglect these things, although they have it generally in their power to put off the investigation of any point not only for little but even for a considerable time, whereas we can seldom or very rarely do so; for, in many cases, necessity requires that we act promptly, and hence Hippocrates has properly said, “the season is brief.” (Aph. 1, i.) For their business is generally conducted in the midst of cities, where there is an abundant supply of books, whereas physicians have to act not only in cities, in the fields, and in desert places, but also at sea in ships, where such diseases sometimes suddenly break out as, in the event of procrastination, would occasion death, or at least incur the most imminent danger. But to remember all the rules of the healing art, and all the particular substances connected with it, is exceedingly difficult if not altogether impossible. On this account I have compiled this brief collection from the works of the ancients, and have set down little of my own, except a few things which I have seen and tried in the practice of the art. For being conversant with the most distinguished writers in the profession, and in particular with Oribasius, who, in one work, has given a select view of everything relating to health (he being posterior to Galen, and one of the still more recent authors), I have collected what was best in them, and have endeavoured, if possible, not to pass by any one distemper. For the work of Oribasius, comprehending seventy books, contains indeed an exposition of the whole art, but it is not easily to be procured by people at large on account of its bulk, whilst the epitome of it, inscribed to his son Eustathius, is deficient in some diseases altogether, and gives but an imperfect description of others, sometimes the causes and diagnosis being omitted, and sometimes the proper plan of treatment being forgotten, as well as other things which have occurred to my recollection. Wherefore the present work will contain the description, causes, and cure of all diseases, whether situated in parts of uniform texture, in particular organs, or consisting of solutions of continuity, and that not merely in a summary way, but at as great length as possible.

In the [First Book], you will find everything that relates to Hygiene, and to the preservation from, and correction of, distempers peculiar to the various ages, seasons, temperaments, and so forth; also, the powers and uses of the different articles of food, as is set forth in the chapter of contents.

In the [Second] is explained the whole doctrine of Fevers, an account of certain matters relating to them being premised, such as excrementitious discharges, critical days, and other appearances, and concluding with certain symptoms which are the concomitants of fever.

The [Third Book] relates to Topical affections, beginning from the crown of the head and descending down to the nails of the feet.

The [Fourth Book] treats of those complaints which are external and exposed to view, and are not limited to one part of the body but affect various parts. Also, of Intestinal Worms and Dracunculi.

The [Fifth] treats of the Wounds and Bites of Venomous Animals; also of the distemper called Hydrophobia, and of persons bitten by dogs which are mad, and by those which are not mad; and also of persons bitten by men. Afterwards it treats of deleterious substances, and the preservatives from them.

In the [Sixth Book] is contained everything relating to Surgery, both what relates to the fleshy parts, such as the extraction of weapons; and to the bones, which comprehends Fractures and Dislocations.

In the [Seventh] is contained an account of the Properties of all Medicines, first of the Simple, then of the Compound; particularly of those which I had mentioned in the preceding Six Books, and more especially the greater and, as it were, celebrated preparations. For I did not think it proper to treat of all these articles promiscuously, lest it should occasion confusion, but so that any person looking for one or more of the distinguished preparations might easily find it. Towards the end are certain things connected with the Composition of Medicines, and of those articles which may be substituted for one another: the whole concluding with an account of Weights and Measures.

CONTENTS
OF
THE FIRST VOLUME.

PAGE
Advertisement[v]
Translator’s Preface[ix]
Author’s Preface[xvii]
[FIRST BOOK.]
SECT.
1.On the Complaints of Pregnant Women, and their Diet[1]
2.On the Nurse[5]
3.On the Milk of the Nurse[6]
4.How to correct the bad qualities of Milk[7]
5.On the Management of the Infant[8]
6.On the Eruptions of Children[10]
7.On the Cough and Defluxion of Infants[11]
8.On Pruritus[12]
9.On Dentition[13]
10.On Aphthæ[14]
11.On Excoriations of the Thighs[16]
12.On Discharges from the Ears[ib.]
13.On Siriasis[ib.]
14.The Regimen of Infancy, and of the succeeding ages, until manhood[18]
15.On the Preparatory Friction[19]
16.On Exercises[20]
17.On the kinds of Exercise[22]
18.On the kinds of Friction[28]
19.On Vociferation, or the exercise of the voice[29]
20.On Lassitude from Exercises[30]
21.On Constriction of the Skin[33]
22.On Spontaneous Lassitude[ib.]
23.On the Regimen of old persons[36]
24.For a wrinkled state of the Body[37]
25.To make the Perspiration fragrant[38]
26.To warm the habit[ib.]
27.For Paleness[39]
28.On Lividity[ib.]
29.Preservatives of the Teeth[ib.]
30.For Dulness of Hearing[40]
31.On Dimness of Sight[ib.]
32.On Repletion[41]
33.On Intoxication[43]
34.On wrong Digestion of the Food[44]
35.On Venery[ib.]
36.On Impotence[46]
37.On Inordinate Venery[47]
38.On Redundance of Semen[48]
39.On persons injured by Cold[49]
40.For persons scorched by the Sun[51]
41.On collections of Phlegm in the Stomach[ib.]
42.How to produce easy Vomiting[52]
43.On Laxatives and Diuretics to those in Health[54]
44.On Clysters[57]
45.On Suppositories[58]
46.On Medicines which evacuate Phlegm from the Head—Masticatories, Errhines, and Liniments to the Nose[59]
47.On Emmenagogues[60]
48.On Sudorifics[61]
49.On Airs[63]
50.On Waters[64]
51.On Baths[67]
52.On the Natural Baths[71]
53.On the Regimen fitting to the different Seasons[73]
54.On the Regimen of Persons actively employed[75]
55.On the Regimen of Travellers[76]
56.On the Regimen of Persons on board Ship[79]
57.On the means of diminishing Obesity[80]
58.How to recruit those who are emaciated[82]
59.How to remedy emaciated parts of the Body[84]
60.Diagnosis of the best Temperament[ib.]
61.Diagnosis of the Intemperaments of the Body[85]
62.On the Form of the Head[87]
63.The marks of the Temperaments of the Brain[87]
64.The marks of the Temperaments of the Stomach[90]
65.Diagnosis of the Temperaments of the Lungs[93]
66.The marks of the Temperaments of the Heart[94]
67.On the Temperaments of the Liver[98]
68.Diagnosis of the Temperaments of the Testicles[100]
69.On the parts that are omitted[101]
70.The Correction of Hot Intemperaments of the Body[ib.]
71.The Correction of the Cold Intemperaments of the Body[102]
72.The Cure of the Dry Intemperaments, of the Stomach for example; then of the other Intemperaments[103]
73.On the Powers of the Articles of Food[106]
74.On Pot-herbs[110]
75.On Asparagi, or young Shoots[115]
76.On things having esculent Roots[116]
77.On Truffles and Mushrooms[119]
78.On the frumentaceous articles of Food[120]
79.On Pulse[124]
80.On the Summer Fruits[127]
81.On the Fruit of Trees[129]
82.On Animals; and, first, of Fowls[138]
83.On Eggs[143]
84.On Beasts[145]
85.On the parts of Animals[149]
86.On Milk[151]
87.On the Drinking of Milk[154]
88.Curds and Whey[155]
89.On Cheese[156]
90.On Fishes[157]
91.On the Testacea, or Shellfish[166]
92.On the Mollusca[169]
93.On the Cartilaginous Fishes[ib.]
94.On the Cetacea or large Fishes[170]
95.On the Properties of Wine[172]
96.On Honey, and Hydromel or Honied Water[178]
97.On Sleep[180]
98.On Watchfulness[181]
99.On Somnolency[183]
100.The Epistle of Diocles on the Preservation of Health—Diocles to King Antigonus[ib.]
[SECOND BOOK.]
1.On Fevers, from the works of Galen and several others[187]
2.Of the principal considerations to be inquired into with regard to febrile affections[188]
3.From Galen, what to call the commencement of the Disease[189]
4.How to know whether the Disease will prove fatal or not[ib.]
5.How to know if the Disease will be of long duration[193]
6.How to know if the Disease will terminate by a Crisis or by Resolution[194]
7.On Critical Days[ib.]
8.That Critical Symptoms appearing at the commencement are unfavorable[198]
9.How to judge beforehand of a future Crisis[ib.]
10.How to recognize a present Crisis[199]
11.How to determine whether a past Crisis be favorable[201]
12.On the Pulse, from the works of Galen[202]
13.On the Alvine Discharges[222]
14.On the Indications from the Urine[224]
15.On the Indications from the Sputa[228]
16.The Diagnosis and Cure of Ephemeral Fevers[229]
17.Diagnosis of Fevers from Putrefaction[235]
18.The Cure of Putrid Fevers[237]
19.The Diagnosis of Tertian Fevers[239]
20.The Cure of Tertian Fevers[241]
21.The Cure of Spurious Tertians[243]
22.The Diagnosis of Quartans[245]
23.The Cure of Quartans[246]
24.The Diagnosis of the Quotidian[249]
25.The Cure of Quotidians[250]
26.On the Fever Hepialus, and the Rigor without Heat[251]
27.On the Continual Fevers[253]
28.The Diagnosis and Cure of Synochous Fevers[256]
29.On the Diagnosis of Ardent Fevers[260]
30.The Cure of Ardent Fevers[262]
31.Diagnosis and Cure of Fevers connected with an Erysipelatous affection[264]
32.Diagnosis of Hectic Fevers[266]
33.The Cure of Hectic Fevers[268]
34.On Semi-tertians[271]
35.On Epidemic Diseases[273]
36.On the Plague, from the works of Ruffus[277]
37.On the Treatment of those who are seized with Syncope from crude humours[288]
38.Of those who have fallen into Syncope from thin humours[291]
39.On the other Causes which occasion Syncope[292]
40.On Pain[296]
41.On colliquative Diarrhœa, or Melting[297]
42.On Watchfulness in Fevers[299]
43.The Cure of Cataphora, or Somnolency[301]
44.The Cure of Headach in Fevers[ib.]
45.On the Cure of Stomach affections[303]
46.On inordinate Chills and Rigors in Fevers[305]
47.On Sweats[306]
48.On Cough in Fevers[309]
49.On Sneezing[310]
50.On Loss of Appetite[311]
51.On Bulimos, or inordinate Appetite[313]
52.On the canine Appetite[314]
53.On Thirst[316]
54.On Roughness of the Tongue[318]
55.On Nausea[319]
56.On Vomiting of Bile[320]
57.On Hiccough[321]
58.On Constipation and Looseness of the Bowels in Fevers[323]
59.On trickling of blood and Hemorrhage from the Nose[325]
60.On deliquium animi or Swooning[327]
61.On the treatment of Ulceration upon the Os Sacrum[329]
Appendix to the Commentary on Book Second: On Smallpox and Measles[330]
[THIRD BOOK.]
1.On affections of the Hair, Alopecia, Ophiasis, and Baldness[337]
2.For making the Hair curled, and for dyeing it[342]
3.On Pityriasis[345]
4.On Headach[350]
5.On Cephalæa and Hemicrania[355]
6.On Phrenitis[359]
7.On Phlegmon of the Brain[365]
8.On Erysipelas of the Brain[ib.]
9.On Lethargy[366]
10.On Catochus, or Coma Vigil[369]
11.On the Loss of Memory and of Reason; on Carus and Fatuity[372]
12.On Vertigo[374]
13.On Epilepsy[376]
14.On Melancholia, Mania, and Demoniacs[383]
15.On Incubus, or Nightmare[388]
16.On Lycaon, or Lycanthropia[389]
17.On Love-sick Persons[391]
18.On Apoplexy and Hemiplegia, or Paralysis[392]
19.On Convulsions, or Spasms[401]
20.On Tetanus and its varieties[403]
21.On Tremblings[407]
22.On Diseases of the Eye[409]
23.On Diseases of the Ear[437]
24.On Affections of the Nose, and of the Sense of Smell[446]
25.On Affections of the Face[452]
26.On Affections of the Mouth[454]
27.On Angina, or Quinsey, and Complaints allied to it, in which the subject of those who have been strangled, or otherwise suffocated, is treated of[464]
28.On Coryza, Catarrh, Affections of the Trachea, and Cough[469]
29.On Orthopnœa, Asthma, and Dyspnœa[475]
30.On Peripneumonia[480]
31.On Spitting of Blood[483]
32.On Empyema and Phthisis[491]
33.On Pleurisy[496]
34.On Affections of the Heart[501]
35.On Affections of the Breasts[504]
36.Fetid Smell and Sweating at the Armpits[506]
37.On Affections of the Stomach, of the Hypochondria, and of the Belly[507]
38.On Inflation of the Stomach[514]
39.On Cholera[515]
40.On Lientery and Cæliac Affection[520]
41.On Tenesmus[523]
42.On Dysentery[525]
43.On Colic Affection[531]
44.On Ileus[538]
45.On Affections of the Kidneys and Bladder[541]
46.On Affections of the Liver[560]
47.On Cachexia[568]
48.On Dropsy[569]
49.On the Spleen[577]
50.On Jaundice[580]
51.On Prolapsus of the Navel[587]
52.How to make the Chin and Pubes continue long free of Hairs; on the Preservation of the Genital Organs; and among other things Depilatories[588]
53.On Bubonocele, Enterocele, and Hydrocele[589]
54.On Inflammation of the Testicle and Scrotum, and on the other diseases of these parts[591]
55.On Gonorrhœa and Libidinous Dreams[593]
56.On Satyriasis[596]
57.On Priapism[597]
58.On Impotence of the parts[599]
59.On matters relating to the Genital Organs and Anus[600]
60.On Affections of the Uterus; and, first, of the Menstrual Discharge[608]
61.On Retention of the Menses[609]
62.On Immoderate Menstruation and Uterine Hemorrhage[615]
63.On the Female Flux[617]
64.On Inflammation of the Uterus and Change of its Position[620]
65.On Abscess of the Uterus[623]
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.

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.

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.

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.

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].

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.

Commentary. This Section is taken from Oribasius. (Synops. v, 5.)

Galen, in like manner, approves of the honey. He directs the body of a new-born child to be sprinkled with salt; and afterwards rubbed every day with oil. After the milk-diet is given up, the first food to be administered, he says, should be bread, and afterwards pulse and flesh. He forbids the use of wine, because the temperament of a child is hot and humid. He approves of the hot bath, but condemns the use of the cold for young children. (Hyg. pluries.)

Aëtius recommends the child to be brought up upon milk for twenty months. Moschion says, from eighteen months to two years will be sufficient. Avicenna, like our author, mentions two years. It is stated by Selden, that the Hebrew women gave suck to their children for two years. This practice is enjoined in the Koran. Aëtius is not so strict in regard to regimen as Galen; he allows us to vary the milk-diet, by giving occasionally soft eggs, mead, or sweet wine diluted with water. (iv, 28.)

Moschion, Averrhoes, and Avicenna approve of exercising the child in a cradle, and of lulling him with music. When the cord falls off, Avicenna advises that the part should be sprinkled with the powder of burnt lead.

Averrhoes disapproves of sprinkling the child’s body with salt, as recommended by Galen. (Collig. ii, 6.) He agrees with Galen, however, in condemning the use of wine. He directs exercise for the child every day; after exercise, friction, and after friction, the bath. He forbids the use of the cold bath, however, because it retards the growth. When the child does not sleep, Avicenna and Averrhoes recommend poppy in his food. (Cant. ii, 1.)

Haly Abbas directs us, when there is any malformation of the head, to reduce it to its proper shape, and bind it firm. Like Galen, he recommends that the body of a new-born child should be sprinkled with salt and powdered roses, to harden the skin. He directs us to give the child, for the first two days, sugar, triturated with the oil of sesame. He recommends the frequent use of the tepid bath. He properly directs the nurse not to expose the child’s eyes to the strong light of day, nor to allow him to sleep in a strong sun, for fear of injuring his eyes. When a child cries, it is the duty of the nurse, he says, to find out the cause, as a child never cries except when something hurts it. The most common causes, he adds, are, heat or cold, fleas or gnats, hunger or thirst, retention of urine or of the fæces. For retention of the urine, he recommends melon-seed with julep both to the child and the nurse; and when the child’s bowels are constipated, he directs the nurse to take laxative herbs, oil of olives, prunes, and so forth. It is clear, therefore, that he was aware that a child may be operated upon by medicines given to the nurse. (Pract. i, 20.)

The directions given by Alsaharavius are very similar. He remarks that violent crying may occasion a descent of the bowels.

Syrasis, one of the commentators on Avicenna, recommends the tepid bath for young children, and food after it. He directs the nurse to exercise the child before putting him into the bath.

From what we have stated, it will be seen that the ancient physicians did not approve of the cold regimen, absurdly proposed by certain modern philosophers as the most proper for infants.

According to Athenæus, the sons of Roman freemen were prohibited from drinking wine until they were thirty years old. (Deipnos, x, 23.) Plato enjoins complete abstinence from wine until the age of eighteen, and great moderation until thirty. (Leg. ii.)

SECT. VI.—ON THE ERUPTIONS WHICH HAPPEN TO CHILDREN.

Whatever eruptions appear upon the skin of a child, are to be encouraged, in the first place; but when the eruption is properly come out, it may be cured by putting the child into baths of myrtle, or lentisk, or roses, and then anointing with the oil of roses or lentisk, or with a cerate containing ceruse. And its body may be gently rubbed with nitre; but it will not bear hard friction. But a very good plan is for the nurse to be fed upon sweetish things. And the child’s diet ought to be attended to, so that it be neither too full nor too spare. If the child’s belly be constipated, a little honey may be put into its food; and if even then it do not obey, turpentine, to the size of a chick-pea, may be added. When the bowels are loose, millet, in particular, ought to be administered.

Commentary. This Section is taken from Oribasius (Synops. v, 6.) See also Aëtius (iv, 21.) The Exanthemata here referred to would appear, properly speaking, to be the strophuli of Dr. Willan, but the ancients used the term rather vaguely for several eruptive diseases. (See [Book Fourth.]) The Exanthemata are the “pustulæ parvæ” of Eros (apud Gynæcia, p. 59.) For the Arabians, see in particular Haly Abbas (Pract. i, 20); Avicenna (i, 3, 1); Alsaharavius (Tr. xxvi, 7 and 8.) Alsaharavius describes two cutaneous complaints of infancy by the names of Alseafa and Alkaba. The former he describes as consisting of pustules, which affect the heads of infants, and sometimes the face. They are attended, he says, with a constant itching, and occasion erosion. His treatment is to shave the head, and to apply to it first a leaf of blite (bletæ vel betæ?) and afterwards an ointment composed of spuma argenti, ceruse, and lye, with rose-oil and wax. The Alkaba is said to be of the same nature, only that the fluid which runs from the pustules resembles honey. This, therefore, must be the porrigo favosa. His remedies are, to wash the head frequently with a lotion made from marjoram, mint, or centaury; and then to apply an ointment composed of spuma argenti, ceruse, Armenian bole, sulphur, almonds, and quicksilver; and also liniments of rose-oil and vinegar, with the free use of the bath. As Dr. Willan remarks, he has described the strophuli by the name of pustulæ, (bothor.) (Tr. xxvi, 25.) He says of them: “Aliæ sunt albæ, aliæ rubeæ, aliæ nigræ, aliæ magnæ, aliæ parvæ et multæ et paucæ, aliæ fortis et acuti doloris, et mortiferæ,” &c. It appears, therefore, that he applies the term in a very lax signification.

Rhases describes the Exanthemata by the name of vesicæ. He prescribes, at the commencement, medicines for expelling the morbific superfluity from the inner parts, such as the decoction of dates or figs, with fennel water. When the eruption is fairly come out, he recommends baths medicated with roses, myrtles, and the like; after which, the child is to be rubbed with the oil of roses or of violets. (De Morbis Infant, c. 19.) We may mention that Lanfrancus, and the other medical authorities of that age, describe them by the name of saphati.

SECT. VII.—ON THE COUGH AND DEFLUXION OF INFANTS.

When the child is seized with cough or defluxion, recourse is to be had to a linctus of honey. It is first to be bathed copiously with warm water, even to its head, and plenty of honey given: then press its tongue gently with your finger, and it will vomit up much phlegm.

Commentary. See Oribasius (Synops. v, 7), and Aëtius (iv, 18.) Aëtius recommends various lohochs or linctus. One of them consists of pine-nuts, almonds, linseed, liquorice-juice, and honey.

Emetics and demulcents, such as gum arabic and liquorice, are the remedies recommended by Avicenna, (i, 3, 1.)

Haly Abbas approves of lohochs, containing almonds, honey, &c. (Pract. i, 20.) Alsaharavius recommends various demulcents, and an electuary containing poppy-seed, tragacanth, and the seeds of citrons, to be taken in a decoction of Sebesten plums. He also directs us to produce vomiting, by making the patient swallow copious draughts of honied water. (Tr. xxvi, 24.)

Rhases recommends nearly the same remedies. (De Morbis Infant, c. 18.)

This would appear to be the most proper place for giving from Aëtius some account of two affections of infancy, which our author has omitted to describe. He says, when children have been fed on improper food, or when, from any other cause, their stomachs become loaded with phlegm, they are troubled with snorting; and in that case he recommends a linctus of linseed, honey, &c.; or if the affection be obstinate, to make them vomit by pressing down the tongue with a finger smeared with oil. (iv, 7.)

When an infant has lost its voice, which, he says, arises commonly from constipation, he recommends the juice of cabbage, either by the mouth or in a lavement; or a suppository into the anus. (iv, 8.)

SECT. VIII.—ON PRURITUS.

If the child be troubled with pruritus, use fomentations, and anoint with plenty of refined oil, in which a little wax has been melted.

Commentary. See Galen (Hyg. v); Oribasius (Synops. v, 8); Avicenna (i, 3, 1); Haly Abbas (Pract. i, 20); Rhases (de Morb. Infant, c. 19); Alsaharavius (Pract. xxvi, 25.)

The account given by Oribasius is similar to our author’s. (Synops. v, 8.)

Alsaharavius properly recommends attention to correct the acrimony of the nurse’s milk; to wash the child with decoctions of roses, myrtle leaves, and the like; if the pustules are of a dry nature, to rub them with oil of sesame or of violets; and, if humid, with an ointment made of wax, litharge, and rose-oil.

Rhases directs the nurse to abstain from sweet and salt things, as they inflame the blood; and to put the child into a bath medicated with mallows, pearl-barley, fenugreek, gourds, &c.

Avicenna and Haly Abbas treat the complaint upon similar principles.

SECT. IX.—ON DENTITION.

Dentition commences about the seventh month. At that time inflammations of the gums, cheeks, and tendons are apt to occur; and sometimes convulsions. The child must then get nothing which requires mastication; and his gums should be rubbed frequently when in the bath with the finger, or soothed with the fat of fowls or the brain of a hare. When the teeth are just coming through, the neck, jaws, and head should be wrapped in soft wool, or they may be anointed with warm sweet oil, some of which ought to be poured into the pores of the ears. The child ought then to have a more generous quality of food, and be bathed in warm water. If he have diarrhœa, it is proper to bind his belly by epithemes, namely, such as are of an astringent nature, as cumin, dill, or parsley, sprinkled upon wool. It is proper to mix the seeds of roses, and, in short, to use hot desiccants. If the bowels are constipated, they may be gently roused to action by means of a suppository of honey, or the belly may be anointed with mint pounded in honey. But the best remedy for the convulsions of children, apparently, is to bathe them in water wherein turnsol (heliotropium) has been boiled. It will be of consequence also to use the oil of privet, of the iris, and the Sicyonian oil; and, in short, everything which is of a calefacient nature. But when the teeth have come through so as to bite the fingers, it may be proper that he keep in his mouth the root of the iris, shaven down and not quite dried. This also is of use to ulcers. Butter likewise rubbed in with honey will be of service. The flesh of an old pickle relieves pruritus of the gums.

Commentary. See, in particular, Oribasius (Synops. v, 9), and Aëtius (iv, 9.) Hippocrates and Aëtius recommend a jasper amulet. Hippocrates remarks that fevers, pruritus, looseness of the bowels, and convulsions are apt to come on at the time of dentition, if the child be plethoric, and his bowels constipated. (Aphoris, cum Comment. Galeni.) Aretæus makes the same statement. (Morb. acut. i, 6.)

Moschion directs the gums of the child to be rubbed, after the fifth month, with sweet oil, the fresh grease of a hen, the brain of a hare, and lastly with boiled honey. When inflammation supervenes afterwards, he recommends fumigations and cataplasms, and directs the food and drink of the nurse to be restricted. (c. 119.)

The directions given by Avicenna are similar to those of Moschion. (i, 3, 1.) Alsaharavius properly states that the best way to avoid difficult dentition is to guard against corruption of the food and drink, and to abstain from emetics, acids, figs, &c. To remove the painful symptoms attendant on dentition, he directs us to rub the gums with olive oil, honey in which aloes and gum arabic have been boiled, and the like; to wrap the head in soft wool, and to pour tepid water upon it. (Pract. xxxvi, 19.)

The treatment recommended by the other authorities is very similar. See, in particular, Rhases (Ad Mans. iii, 13.)

The only ancient authors who make mention of scarification of the gums as a remedy for painful dentition are, Marcellus Sideta (Medicina, ex Piscibus,) and Pliny (Hist. Nat. xxxii, 26.) Both direct it to be done with the sting of the Pastinaca Marina.

SECT. X.—ON APHTHÆ.

Infants are liable to an ulcer of the mouth called aphtha. It is either whitish, reddish, or black, like an eschar. That which is black is of the worst kind and most fatal. The iris mixed with honey is of use, or you may blow in the dry powder if you please; also, the pounded leaves of roses, or the flowers of roses, and crocus—a small quantity of myrrh, galls, frankincense, or the bark of the frankincense tree: all these together, or separately, may be mixed with honey; and, in addition to these, may be joined honied water and the juice of the sweet pomegranate.

Commentary. Hippocrates mentions aphthæ among the diseases of dentition. (De Dent.) Theophilus, the commentator on Hippocrates, says, that aphthæ are occasioned by the tenderness of the parts, which cannot bear the bad qualities of the milk. According to Aretæus, the land of Egypt is particularly prolific of these ulcers, which are engendered by the impurities of the water and the quality of the vegetables that grow there. (Morb. Acut. i, 9.) The aphthæ appear to be the oscedo of Isidorus. (Orig. iv, 8.)

Our author copies from Oribasius. (Synops. v, 10.) See also Aëtius, (viii, 39.) Aëtius borrows his account from Galen, who is very full upon the treatment of aphthæ. He remarks that recent superficial ulcers are easily cured, but that such as spread and are of a gangrenous nature are very dangerous. He gives, at great length, directions for the composition of applications, suited to every modification of the complaint. When the pustules are red, he prescribes washes of a moderately astringent and cooling nature; if yellowish, the same, but somewhat more refrigerant; if whitish and pituitous, detergents are to be used; and, if black, the most powerful discutients. For simple cases of the aphthæ infantium, he merely recommends the flowers of roses with honied water. Most of his remedies are astringents. (De Med. sec. Loc. lib. vi.) In another work, he says that aphthæ are occasioned by the acrimony of the milk, and are to be cured by astringents. (Comment. in III Epidem.)

Pliny mentions that the lapis melititis was used as an application in cases of ulceration of the fauces. (Hist. Nat., xxxvi.) There is reason to believe that it was Borax, or borate of soda.

Avicenna recommends at first washes prepared from the vegetable acids, and afterwards astringents, such as galls, sumach, balaustine, &c. (i, 3, 1.) See also Haly Abbas (Pract. i, 20.)

Alsaharavius states that aphthæ commonly arise from the sharpness of the milk. His general treatment consists in regulating the diet of the nurse, and using washes principally of an astringent nature for the child’s mouth. When they are very painful, he adds to the washes the juice of lettuce, endive, and the like. When they are whitish, he recommends a powder consisting of myrtle, saffron, and sugar. (Tr. xxvi, 20.) Rhases’ treatment is quite similar. (De Morbis Infantium, c. 14.)

The author of the following work, which has been falsely ascribed to Dioscorides, recommends certain applications of a strongly escharotic nature, such as this: Of arsenic, p. i; of burnt paper, p. iii; or this, of sandarach and rose-oil equal parts. (Euporist. i, 82.)

Psellus enumerates two kinds of aphthæ, namely, the white and the red; the former, he says, is mild, the latter very dangerous. (Poëma Medicum.)

SECT. XI.—ON EXCORIATIONS OF THE THIGHS.

Excoriations of the thighs may be sprinkled with dried myrtle, cyperus, and roses.

Commentary. See, in particular, Oribasius (Synops. v, 11); Aëtius (iv, 24); and Avicenna (i, 3, 1.) All recommend nearly the same astringent applications for the intertrigo of infants.

SECT. XII.—ON WATERY DISCHARGES FROM THE EARS.

Watery discharges from the ears may be dried up by applying to them wool with alum, or with wine and honey, or by an injection of old wine either alone or mixed with saffron.

Commentary. Oribasius, Aëtius, Avicenna, and Haly Abbas recommend the same treatment, which would seem to be very proper. Alsaharavius recommends wool soaked in a solution of alum, and injections, consisting of solutions of nitre (soda) in vinegar. Rhases makes mention of nearly the same applications. (De Morb. Infant. c. 9.)

SECT. XIII.—ON SIRIASIS.

Siriasis is an inflammation of the parts about the brain and its membranes. A hollowness of the open of the head and eyes attend it, with paleness and dryness of the body. It is relieved by an application of the red of an egg with oil of roses to the open of the head, in the form of a compress, and frequently changed.

Another application for Siriasis. Place upon the open of the head, the leaves of that species of heliotropium called scorpiurus, the parings of a gourd, the membrane which envelopes the fleshy part of a ripe cucumber, the juice of the garden nightshade, with oil of roses.

Commentary. See Oribasius (Synops. v, 13); Aëtius (iv, 13); Avicenna (i, 3, 1); Haly Abbas (Pract. i, 20); Alsaharavius (Pract. xxvi, 9); Rhases (de Morb. Infant. c. 5); Pseudo-Dioscorides (Euporist. i, 9); Alexander Aphrodisiensis (Problem i, 98); Pliny (Hist. Nat. xxxii, 48.)

Aëtius and Avicenna agree in describing it as an inflammation and swelling of the brain and its membranes, so as to occasion a hollow at the bregma, and as being attended with ardent fever. The account given by the others is very similar. All recommend cooling and astringent applications to the part. According to Alexander Aphrodisiensis, children are most subject to this affection, especially in the summer season; for which he attempts to assign the reason. He describes it as an inflammation of the membranes of the brain. The author of the ‘Euporista’ recommends the juices of various cooling herbs, as local applications. Pliny represents the heat of it as excessive. He says, “Siriasesque infantium spongia frigida crebro liumefectata, rana inversa adalligata efficacissime sanet, quam aridam inveniri affirmant.” (l. c.)

Although somewhat out of place, we shall venture to introduce here some account of two diseases of infancy which are omitted by our author, but are briefly described by Aëtius and Rhases.

For prolapsus ani, Aëtius recommends various applications in the form of powder and fomentation; but states, that what he himself constantly made use of was tepid brine or salt water. (iv, 19.) See Rhases (de Morb. Inf. c. 21.)

Umbilical hernia, he says, may be occasioned by crying, a blow, or a fall. For this he recommends various astringent preparations from alum, galls, &c., applied on a linen compress to the navel. (iv, 20.) Rhases recommends similar applications, and also a compress with the gluten of hides to be bound over the navel. (De Morb. Infant. c. 22.) As far as we can recollect, Hippocrates and his commentators are the only ancient authorities that make mention of inflammation of the navel after the cord has dropped off. (Aphor. c. Comment. ed. Dietz, p. 374.)

SECT. XIV.—THE REGIMEN OF INFANCY, AND OF THE SUCCEEDING AGES UNTIL MANHOOD.

Infants and children when weaned from milk, are to be allowed to live merrily and without restraint; their food ought to be light, and their exercise gentle. After six or seven years of age, both boys and girls are to be consigned over to schoolmasters of a mild and benevolent disposition; as such persons will impart instruction to them in a cheerful manner, and without constraint; for relaxation of the mind contributes much to the growth of the body. Boys twelve years of age should go to teachers of grammar and geometry, and get their bodies hardened by gymnastic exercises. From fourteen to twenty-one, their proper employment will be the study of mathematics and initiation in philosophy. At the same time, however, it will be proper to use more exercise for strengthening the body, so that, exercising both mind and body, they may be prevented from indulging their carnal desires. They ought likewise to be restricted as to wine. To adults the fullest supply of nourishment, both as to body and mind, ought to be allowed; wherefore, they should use all kinds of gymnastic exercises, particularly such as each has been accustomed to, and food which is sufficient and nutritious. In the decline of life, both the bodily and mental supply ought to be abridged; and the gymnastic exercises diminished in proportion. The food also is to be gradually lessened as the habit begins to contract the frigidity of age.

Commentary. These simple but judicious directions respecting the regimen of the different periods of life are taken from Oribasius (Synops. v, 14); or from Aëtius (iv, 29.) Many of them are borrowed originally from Galen. (Hyg. i.)

Similar directions are given at great length by Haly Abbas. He positively prohibits children from taking wine. He insists that wine not only proves prejudicial to health, but also deteriorates the morals. (Pract. i, 22.) Alsaharavius agrees with him in proscribing wine to children. (Theor. xiii, 2.)

Avicenna makes very judicious observations on this subject, but the greater part of them are taken from Galen. He insists, with becoming earnestness, on the propriety of attending to the regulation of the passions of the child, as being conducive to his health as well as to his morals. As soon as the boy is roused from sleep he is to be bathed; then he is to be allowed to play for an hour; afterwards, he is to have something to eat, and then is to be allowed more play. Afterwards he is to be bathed; then he is to take food; and, if possible, he is to be prevented from drinking water immediately after a meal, as it has a tendency to make unconcocted chyle be distributed over the body. When six years old, he is to be consigned to the care of a teacher, but he is not to be compelled to remain constantly in school. Avicenna goes on to state that, at the age he has then reached, he is to be more sparingly bathed, and that his exercise is to be multiplied before eating. Like most of the ancient authorities, he forbids wine to a child. Thus, he adds, is the regimen of the child to be regulated until he reach the age of fourteen. (I, i, 4.)

Averrhoes gives very sensible directions on this subject. He forbids the use of wine and ales until manhood. (Collig. vi, 6.)

SECT. XV.—ON THE PREPARATORY FRICTION.

Before gymnastic exercises, the body ought to be rubbed moderately first with towels, and then with oil in the hollows of the naked hands, until it be properly warmed and softened, and its surface have contracted a florid blush, and become distended.

Commentary. A more circumstantial account of the mode of preparing the body for gymnastic exercises is given by Oribasius. (Med. Collect. vi, 13.) It is taken, however, from Galen’s second book of ‘Hygiene.’ See a similar account in Aëtius (iii, 1), and Avicenna (i, 3, 2.) The object of it, according to Alexander Aphrodisiensis, was to soften the parts so that they might not be ruptured. (Prob. i, 119.) To rub the body with oil was a general practice of the ancients before strong exercises of every kind. Hence Horace characterizes an inactive person by his dread of oil, “Cur olivum Sanguine viperino cautius vitat?”—that is to say, as his commentator Acron explains it, “Cur vitat olivum, id est oleum, quo unctus tutius natet et luctetur?” The poet alludes to the practice in another place: “Ter uncti Transnanto Tiberim.” It appears from Martial that a composition of oil and wax, called ceroma, was sometimes used for this purpose:

“Vara nec injecto ceromate brachia tendis.”

(Epigr. vii, 32.)

According to Thucydides, the Lacedemonians were the first who rubbed their bodies with oil before wrestling. (i, 1.) Pliny mentions the use of oil before the gymnastic exercises as a luxury introduced by the Greeks. It appears from him that cheap aromatics were sometimes added to the oil. He further relates that some barbarous nations used butter instead of oil. (Hist. Nat. xi, 41.)

Athenæus mentions that Antiochus Epiphanes supplied the wrestlers at Daphne with oil of saffron, of marjoram, and the like. (Deipn. v.)

Lucian makes Solon say to Anacharsis, that oil produces the same effect upon the living body as upon leather, softening it, and rendering it stronger and less apt to break. (Anacharsis.)

The poets describe Venus as preparing herself for exercise by being rubbed with fragrant ointments, whereas Minerva disdained to use anything but common oil. See Callimachus (Lav. Pall.) and Sophocles (ap. Athen. Deipnos. xv, 35.)

The Roman emperors, and other luxurious persons, often made use of perfumed ointments instead of oil. See Suetonius (in Vita Caligulæ), Lampridius (in Vita Heliogabali.) It would appear that under the empire the people of Rome were supplied gratuitously with oil in their public baths. (Lamp. c. 24, and Burman, de V. R. c. iii.)

SECT. XVI.—ON EXERCISES.

Exercise is a violent motion. The limit to its violence should be a hurried respiration. Exercise renders the organs of the body hardy and fit for their functional actions. It makes the absorption of food stronger, and expedites its assimilation; and it improves nutrition by increasing heat. It also clears the pores of the skin, and evacuates superfluities by the strong movement of the lungs. Since, therefore, it contributes to distribution, care ought to be taken that neither the stomach nor bowels be loaded with crude and indigestible food or liquids; for there is a danger lest they should be carried to all parts of the body before they are properly digested. It is clear then that exercise ought to be taken before eating. The colour of the urine will point out the proper time for exercise. When it is watery, it indicates that the chyme absorbed from the stomach is still undigested. When it is of a deep yellow colour, and bilious, it shows that digestion had been long ago accomplished. When it is moderately pale, it indicates that digestion has just taken place; and this is the proper time for exercise, after having evacuated whatever excrementitious matters are collected in the bladder and bowels.

Commentary. The remarks of our author on the effects of exercise are exceedingly pertinent and comprehensive. See, in like manner, Aëtius (iii, 2), and Oribasius (Med. Collect. vi, 11.) But Galen is the great authority on this subject, which he treats of very fully and philosophically, in the second book of his ‘Hygiene.’ He agrees entirely with Hippocrates, that the proper time for exercise is before a meal, because, the excrementitious superfluities being thereby evacuated, the body is in a fit condition for receiving a new supply. He explains, however, afterwards, that it is after the digestion and distribution of a preceding meal have been accomplished that exercise will be most proper.

According to Haly Abbas, exercise is useful for three purposes: 1. For rousing the innate or natural heat, whereby the processes of digestion and distribution are accelerated. 2. For opening the pores of the body, and evacuating its superfluities. 3. For strengthening and rousing the animal actions, by the friction it occasions. (Theor. v, 2.) Avicenna gives nearly the same statement of the good effects of exercise. Haly Abbas forbids exercise immediately after dinner. He adds, that exercise taken immediately after a meal makes the food descend to the intestines, where it is absorbed by the veins before it is properly concocted, and thereby the liver becomes loaded with crudities. (Pract. i, 3.)

Alsaharavius recommends exercise before a meal, but advises it not to be continued after one feels fatigued and languid. (Theor. ii, 2.) The same rule is distinctly laid down by Rhases. (Contin. xxxiii.)

It appears that, instead of taking exercise after food, the ancients were in the practice of indulging in a short sleep after their dinner or mid-day meal. See Plautus (Mostell. ac. iii, sc. 2, 1. 8), and the note of Meursius (Ed. Gronov.) Homer says that it is beneficial to old men to indulge in sleep after the bath and taking food. (Galen. Hyg. 1.)

Plutarch mentions that Cicero was cured of debility of the stomach by taking moderate exercises. (In vita Cicer.)

It was one of the extravagant opinions of Erasistratus, that exercise is not at all necessary for the health of the animal frame.

SECT. XVII.—ON THE KINDS OF EXERCISE.

The common effect of all kinds of exercise is to produce an increase of the natural heat of animals. But each species has something peculiar to it. Strong, that is to say, violent exercise gives vigour to the muscles and nerves: such are digging, and lifting a very heavy burden, while one remains in the same spot, or moves about; or lifting small weights and walking about as much as one can. Of this kind, is the exercise of scaling a rope, and many others of a like kind. The swift kinds of exercise are such as do not require strength and violence, namely, running, fighting with one’s shadow, wrestling with the extremities of the hands, the exercise with the leather bag, and that with the small Ball. This last is compounded of intension and velocity; and such exercises as are intense may become violent by adding velocity to them. Besides, some kinds of exercise bring the loins into action, and some the hands or legs; others the spine or the chest alone, or the lungs. And exercise ought to be carried on until the body becomes distended, and the skin of a florid hue; and until then, the motions ought to be strong, equable, and spirited, upon which you may see warm sweat, mixed with vapour, break out. It will then be time for you to stop, when any of the symptoms which I have mentioned have undergone a change, namely, when the bulk of the body becomes contracted, or when the florid colour of the skin declines. And, should any of the motions remit, it will then be time to stop immediately; or, if there should be any change in the quantity or quality of the perspiration; for if it should become smaller in quantity, or colder, we must desist, and, besmearing the body with oil, endeavour to restore it. It will then be proper to use the Restorative friction, as the masters of gymnastics are wont to practise.

Commentary. We shall now give a brief account of the ancient exercises, some of which are altogether omitted by our author.

The σκιομαχία is thus explained by Cornarius: “Porro σκιομαχίαν accipio umbratilem pugnam, quâ quis privatim domi aut sub umbra, non in propatulo se exercet, ac veluti præparat ad justam pugnam publicè faciendam.” (Notæ in Paul. Ægin. h. 1.) This account, however, does not agree with that of Oribasius, who describes it as a mock encounter at boxing and jumping with one’s own shadow. (Med. Collect. vi, 29.) It is thus described in the Latin translation of Avicenna: “Et ex eis est, insequi umbram suam, ut ipsam percutiat in capite, et manus ad invicem percutere.” (i, 3, 2, 2.) It is mentioned in this sense by Plato (de Legibus, vii), by Plutarch (Probl. Conviv. vii), and by Achilles Tatius (p. 115.) Juvenal probably alludes to this sport. (Sat. vi, 246.) We have therefore translated it, “fighting with one’s own shadow.”

The ἀκροχειρισμὸς is thus described by Scaliger: “Est autem ἀκροχειρίζειν luctæ pars, cum primoribus tantum digitis insertis roboris faciunt periculum.” (Poet. i, 22.) Suidas explains it thus: “A man taking hold of his antagonist’s fingers, strove to break them, and did not give over until he compelled him to yield.” The term occurs in Aristotle. (Eth. Nicom. iii, 1.) See also, Athenæus. (Deipnos. iv, 13.) It is called ἀκροχέιρισις by Hippocrates (De Diæta. ii, 42), who says it reduces the body.

The exercise with the κώρυκος, or leather bag, is described by Oribasius in the following manner: A bag filled with flour or sand was suspended from the top of the house, on a level with the navel; it was then pushed forwards with the hands to the extremity of the rope, and, as it recoiled, the person performing the exercise retreated backwards, so as to escape from it. (Med. Collect. vi, 33.) This exercise is mentioned by Hippocrates. (De Diæta, ii.) Cornarius and the translator of Hippocrates confound it with the follis of the Romans; but Mercurialis clearly shows that they were quite different. The follis was a leather ball, inflated with air; such is the description of it by Cælius Aurelianus: “Follis erat pila magna ex aluta confecta, soloque vento repleta.” Martial represents it as a becoming exercise for boys or old men:

“Ite procul juvenes, mitis mihi convenit ætas,

Folle decet pueros ludere, folle senes.”

(Epigr. xiv, 45.)

They were different from the pila magna and parva; that is to say, the large and small ball. These balls were of different sizes, and were played with in various ways. They are minutely described by Oribasius. (Med. Collect. vi, 32.) See also Horace (Sat. ii, 2), and Martial (Epigr. iv, 15.) See a most learned and accurate account of all these sports in Mercurialis. (De Arte Gymnastica, ii, 4.) Galen has written a treatise on the exercise of the parva pila. To this class of exercises we may refer the pitching of a stone, which is mentioned by Avicenna.

Our author has neglected to make mention of the halteres in this place, but recommends the exercise for the cure of elephantiasis. (iv, 1.) It is described by Galen, who says, it can be made to exercise the spine transversely. (De Sanit. tuend. ii, 11.) The exercise with them is thus described by Potter: “The exercise of leaping they sometimes performed with weights upon their heads or shoulders, sometimes carrying them in their hands; these were called ἁλτῆρες, which, though now and then of different figures, yet, as Pausanias reports, were usually of an oval form, and made with holes, or else covered with thongs, through which the contenders put their fingers.” (Antiquities of Greece, c. 20.) Mercurialis describes them as masses or weights of different materials, and of such a size as that they could be held in the hands. Ropes, too, he adds, were often fastened to them, to hold with. (De Arte Gymnast. ii, 12.) The Pythagoreans were fond of this exercise. (Iamblichus de Vita Pythagoræ, c. 21.)

The funambulatio consisted merely in scaling ropes, which, as we may suppose, was done in various ways. See Mercurialis (iii, 5), and Baccius (de Thermis, viii, 7.)

The ἐκπλεθρίζειν, as Galen and Avicenna explain, consisted in running round the plethrum, or sixth part of the stadium, and always contracting the circle of one’s course, until one stopt in the middle. The πιτυλίζειν, as the same authors explain, consisted in walking upon one’s toes, and tossing one’s hands backwards and forwards.

The cricilasia appears to have been a large hoop, or circle, which was rolled on the ground. Even Mercurialis admits the obscurity of Oribasius’s description of it. (Med. Collect. vi, 26.)

The petaurum was a seat suspended by ropes, in which seat the person taking the exercise sat, and was tossed about by assistants. It is mentioned by Juvenal (Sat. xiv), and Martial (Epigr. xi, 22.)

Antyllus thus describes the effects of equitation on the human frame: “It strengthens the body, especially the stomach, more than any other mode of exercise; it clears the organs of the senses, and renders them more acute; but it is most inimical to the thorax.” Oribasius (Med. Collect. vi, 24), Pliny (Hist. Nat. xxviii, 4), and Aëtius agree with Antyllus as to the good effects of equitation on the stomach. Hippocrates and Cælius Aurelianus state that equitation is hurtful in disease of the hip-joint. All agree that riding on horseback is hurtful in diseases of the chest.

Of ἀιώρα, or gestation, there were various modes. That in a carriage was very ancient, and is often mentioned by the medical authors. It appears from Pliny (Hist. Nat. xvi, 42), that carriages were generally made of fir, and that the axles were of ilex, mountain ash, or elm. Sometimes, however, the whole chariot was adorned with gold and silver. (Pliny, Hist. Nat. xxiv, 17.) They appear to have been often covered in with skins. (Plutarch, Prob. Roman.) They were generally drawn by horses or mules, sometimes by oxen, and occasionally by slaves. They were so constructed that a person could either sit or lie, according to pleasure. (Galen, Hyg.) At first, according to Pliny, they had only two wheels; the Phrygians, he says, added two more; and Hippocrates mentions that the Scythians introduced the use of six-wheeled carriages. The sedan and chair are often mentioned by the Latin poets, as well as by the medical writers. It is sufficient for our purpose to state that they were so constructed, that one could either sit or lie in them. They sometimes had windows, formed from the lapis specularis. (Juvenal, Sat. iv, 21.) Navigation, or sailing in ships and boats, is often mentioned by ancient authors as a remedial measure. It was practised on the sea or in rivers. According to Aëtius, gestation in general ventilates the natural heat, produces excitement, dispels collected humours, strengthens the frame, and rouses the actions when in an indolent state. (iii, 6.) Celsus has an interesting chapter on gestation. The following rule for the application of it is very judicious: “Gestatio quoque longis et jam inclinatis morbis aptissima est; utilisque est et iis corporibus quæ jam ex toto febre carent, sed adhuc exerceri per se non possunt; et iis quibus lentæ morborum reliquiæ remanent, neque aliter eliduntur.” Upon the whole, he holds it to be a doubtful practice in ardent fever, although sanctioned by the authority of Asclepiades Bithynus: at all events, he insists that gestation is improper when there is any local pain or swelling. After characterizing the different modes of gestation, he remarks respecting them: “Levia quidem genera exercitationis infirmis conveniunt: valentiora vero iis qui jam pluribus diebus febre liberati sunt; aut iis, qui gravium morborum initia sic sentiunt, ut adhuc febre vacent, quod et in tabe, et in stomachi vitiis, et cum aqua cutem subiit, et interdum in regio morbo fit; aut ubi quidam morbi, qualis comitialis, qualis insania est, sine febre, quamvis diu, manent.” (ii, 15.)

Galen eulogises hunting as being an excellent exercise to the body, and an agreeable recreation to the mind. He says, that by the mental excitement which it produces, many have been cured of dangerous diseases. (De parva Pila.) Rhases mentions, that during the prevalence of a certain pestilential epidemic, it was observed, that huntsmen were the only class of people who escaped its contagion. (Contin. iii.) The ancients have transmitted to us many elegant treatises, both in prose and in verse, on this delightful recreation. Those of Xenophon, Oppian, Gratius, and Nemesianus will be found particularly interesting. The younger Pliny attributes his recovery from a certain complaint, to the exercise of hunting. (Epist. v, 6.)

The occupation of fishing, according to Plato, produces neither mental nor bodily excitement. (In Sophista.) Galen and Avicenna briefly mention it as an exercise which may tend to the preservation of health; but neither of them appears to have attached much importance to it. The poet Oppian, however, in his ‘Halieutica’ has celebrated the pleasures and dangers of fishing, with all the enthusiasm of an Isaac Walton, or a Washington Irving.

Oribasius states that swimming tends to warm, strengthen, and attenuate the body. He says that swimming in the sea is particularly applicable in cases of dropsy, eruptive diseases of the skin, and elephantiasis. It is apt, however, he adds, to prove injurious to the head, and also to the nerves when too long continued. We have mentioned in [the fifteenth Section], that the ancients got their bodies rubbed with oil before going into the water. Celsus gives nearly the same account of it, as a remedy for the cure of diseases, as Oribasius. Swimming may be said to have been the national exercise of the ancient Romans. Horace in particular makes frequent allusions to it as an invigorating and manly exercise. The Romans had artificial lakes or ponds connected with their baths, for the purpose of swimming. (Pliny, Epist. v, 6.)

Jumping and dancing, according to Oribasius, occasion a determination downwards, and hence, they may prove useful in cases of amenorrhœa. (Med. Collect. vi, 31.) It appears from a case related in a work attributed to Hippocrates, that jumping was had recourse to, to procure abortion. (De nat. Pueri.) The most eloquent encomiast of dancing is Lucian, who has written an ingenious treatise in praise of it. He contends that it is an excellent training, not only to the body, but also to the mind! He refers to Socrates and other sage philosophers who practised dancing. (De Saltatione.) The Pyrrhic dance of the ancients was particularly celebrated. It was performed by armed men. See Vossius (de Nat. Art. i,) and Athenæus (Deipn. xiv, 19, ed. Schweigh.)

On the Apotherapia or Restorative process, see Galen (Hyg. iii); Oribasius (Med. Collect. vi, 16); and Avicenna (i, 3, 2.) It consisted simply in rubbing the body softly and moderately with oil. According to Galen, the object of it was to relieve the feelings of lassitude, and prevent any bad effects from the exercise. Mercurialis states that, when applied after the bath, it was with the intention of preventing the humidity from being dissipated. Odoriferous ointments and powders were sometimes used instead of the oil. (De Arte gymnast. i; also Baccius de Thermis, 10.)

SECT. XVIII.—ON THE KINDS OF FRICTION.

Hard friction contracts, and soft relaxes; so that those persons that are relaxed should be rubbed hard, and those that are immoderately constricted, softly; and when, neither in the one state nor the other, it is clear that neither the one mode of friction nor the other should be had recourse to, but as much as possible either extreme ought to be avoided. For much and hard friction diminishes the bulk of the body, whilst, on the other hand, little and soft distends it. If the three different kinds of frictions as to quantity be joined to the same number as to quality, they will produce nine combinations, as is stated below. For one of the kinds, as to quantity, for example much, being complicated with the three differences as to quality, I mean the hard, the soft, and the moderate as to hardness, will produce three combinations; and, again, the little being joined to the other three will produce three more; and the moderate as to quality being complicated with the same three, will produce three more, as is shown below:

QUANTITY.QUALITY.
Much}and{Hard.
Much}{Soft.
Much}{Moderate.
Little}and{Hard.
Little}{Soft.
Little}{Moderate.
Moderate}and{Hard.
Moderate}{Soft.
Moderate}{Moderate.

Commentary. The brief but comprehensive rules of Hippocrates for the application of friction, are thus given in the language of Celsus: “Hippocrates dixit, frictione, si vehemens sit, durari corpus; si lenis, molliri; si multa, minui; si modica, impleri.” Celsus adds, that, according to circumstances, the body may be braced by it, if relaxed; may be softened, if indurated; may have its superfluities expelled, if loaded with plethora; and have nourishment attracted to it, if emaciated. He remarks, that it is mostly applicable in the decline of a disease. His other directions for the application of it are very apposite, (ii, 14.)

Pliny delivers the rules of Hippocrates in nearly the same words as Celsus. (Hist. Nat. xxviii, 14.)

Our author’s account of friction is taken from Oribasius (Med. Collect. vi), or from Aëtius (iii.) All, however, are indebted to Galen, who handles the subject most scientifically. (Hyg. ii.)

Similar directions are given by Avicenna (i, 3, 2), and by Haly Abbas (Theor. v, 12.) Averrhoes gives the sum of the directions laid down by Galen and the other authorities. Strong friction, he says, braces and hardens the body; weak, rarifies and softens; moderate, operates in an intermediate degree. Besides, he adds, hard friction diminishes obesity; moderate, on the other hand, tends to remove emaciation. (Collect. ii, 3.)

It was a general practice of the ancients to have recourse to friction in the morning and evening. Oribasius has many excellent observations on this practice. (l. c.)

SECT. XIX.—ON VOCIFERATION, OR THE EXERCISE OF THE VOICE.

In the exercise of the voice, regular and gentle modulation can contribute nothing to health, but the utterance of louder tones is beneficial, and is therefore to be practised. For, much air being inhaled thus by respiration expands the chest and stomach, and dilates and extends all the pores of the body. Wherefore, even in reading, it promotes the excretion of redundant humours, to those who read in a high tone, by inducing sweats; while in those who read with a moderate tone it promotes the insensible perspiration over the whole frame. For by attenuating the excrementitious matters which are hawked up, the saliva, mucus, and phlegm are discharged and consumed. And to those who stand in need of warming, on account of their frigidity, what mode of relief can be more proper than the action of respiration? Such persons ought therefore to read frequently, and, relaxing the whole body, so as to distend the windpipe and all the other passages of air, endeavour to utter the loudest sounds. And yet we must not have recourse to the exercise of the voice rashly, and without consideration, nor when the system is filled with depraved humours, or the stomach loaded with crudities, lest noxious vapours be thereby distributed over the whole body.

Commentary. These remarks of our author are very pertinent; But Oribasius has given a more comprehensive view of the subject, from the works of Antyllus. He thus describes the mode of performing vociferation: The bowels being evacuated, the person’s body is to be first rubbed, and then the inferior parts and the face are to be sponged with water. He is to begin talking, at first, in a moderate tone, while at the same time he walks about, and afterwards, straining his voice to a louder tone, he is to repeat certain verses. (Med. Collect. vi.)

Plutarch gives nearly the same account of it. He commends vociferation as giving strength to the internal parts, increasing the vital heat, purifying the veins, attenuating the blood, and dispelling the humours. He cautions, however, not to strain the voice to too great a pitch, lest it occasion rupture of any of the vessels. (De Sanit. tuendâ.)

Vociferation, according to Aëtius, is an exercise of the chest and the organs of speech, improving the vital heat; attenuating and strengthening the solid parts of the body. He recommends it for the cure of asthma, orthopnœa, phthisical and chronic pains of the chest, or apostemes when they burst; also, in tertian intermittents, and affections of the stomach attended with vomiting. It is unsuitable, he says, in complaints of the head. (iii, 5.)

Celsus recommends loud reading for curing weakness of the stomach. (i, 8.)

Galen scarcely takes any notice of vociferation, except that, in one place, he states that it exercises the chest and lungs. (De Sanit. tuendâ, ii, 11.)

Avicenna, in giving an account of vociferation, follows Aëtius. He says, that it exercises the parts about the mouth and chest; and hence, that it improves the complexion. He likewise cautions us not to prolong loud enunciation, lest it occasion a rupture of the vessels. He directs us to begin moderate, and then strain the voice gradually, and afterwards to allow it to sink by degrees, (i, 3, 2.)

SECT. XX.—ON LASSITUDE FROM EXERCISES.

That species of lassitude called the Ulcerose is occasioned by a collection of thin and pungent superfluities in the body. In the Tensive there is scarcely any superfluity in the system, but the state of the muscles and nerves is such that they appear to be stretched. The Inflammative, in which we feel as if the parts of the body were bruised or inflamed, happens when, being much heated, the muscles attract the surrounding superfluities. There is a fourth species, occasioned by an unnatural dryness of the muscles, in which the body, when stripped naked, appears squalid and constricted, and is averse to motion. The cure of the ulcerose species consists in dispelling the superfluities by much and soft friction with plenty of oil devoid of astringency. The indication of cure in the second or tensive species is relaxation, which may be accomplished by means of little and soft friction with oil heated in the sun; by quietude and rest, by tepid baths, and remaining for a considerable time in the warm water; for, if you repeat the bath two or three times in succession, you will confer so much the greater benefit. In the third species, or the inflammative, there are three indications of cure: the discharge of the superfluity, the relaxing of the constriction, and the cooling of the inflammatory state. Plenty of tepid oil, the softest friction, and remaining long in a bath of a moderate temperature, remove lassitudes of this description. Long-continued quietude is also proper, and repeated inunction. The treatment of the fourth differs in no respect, for the first day, from that of the third, except that the water ought to be hotter, so as to contract gently; and on the second, the restorative kind of exercise must be had recourse to; and when in the bath, let the person straightway leap into the cistern of cold water. All those affected with lassitude stand in need of wholesome food.

Commentary. There is a short treatise on this subject, among the minor works of Theophrastus. He states that, as the excess of motion in this case has produced a preternatural dryness of the body, the indication of cure is to humectate, that is to say, to dilute, by baths and drinks. The work contains many ingenious observations; but our limits do not admit of our giving a proper outline of it.

Our author copies from Oribasius (Synops. v, 15); see, also, Aëtius (iv, 55 et seq.) They all, however, are indebted to Galen. (De Sanit. tuend. iii, 7.) The ulcerose lassitude, he says, arises from a collection of excrementitious superfluities, which are produced by the melting of fat and muscle. In the second species, called the tensive, there is no collection of humours, but the muscular fibres are excessively stretched. The third species, or the inflammative, is characterized by a sensation, as if the parts affected were bruised or inflamed, and happens when the muscles, being excessively heated, attract the superfluities from the surrounding parts. From the pain being deep seated, it has been called ostalgia. He adds a fourth species, being a case somewhat different from all those we have been describing. It is the contrary state to that of the inflammative, the body appearing squalid and contracted. The first case, as it is connected with redundance of humours, is to be cured by discutients; and hence the proper remedy for it is much friction, with emollient oils wholly devoid of astringency. He also approves of the gentle exercise called the restorative. The second species, or the tensive, is to be cured by gentle friction, with emollient oils heated in the sun; by complete quietude, and the frequent repetition of the tepid bath. In particular, unction with oil is proper. The third species, as it is occasioned by violent motions, and is attended with excruciating pains, is to be cured by the gentlest friction, with the most emollient oils; by the most perfect rest, and the tepid bath. The fourth species, characterized by squalor and constriction of the skin, is to be treated by the hot bath, to warm and invigorate the skin, then by soft and slow motions and friction; and then again by the hot bath. But, he adds, the patient must straightway leave the cistern of the hot bath, and plunge into that of the cold, but not remain long in it. The diet, in all these cases, is to be restricted and cooling, especially in the Inflammative.

As all the subsequent authorities, whether Greek or Arabian, adopt the views of Galen, we need not enter into the detail of their plans of treatment. See Psellus (Opus Medicum); Avicenna (i, 3, 2); Rhases (Contin. xxxi); Alsaharavius (Pract. xxxi, 11); Averrhoes (Collig. vi, 8; Collect. ii, 15.) The bath, emollient friction, diluent food, and quietude are the remedies generally recommended by all the ancient authorities; and they are directed with a nice discrimination that cannot be too much admired. Syrasis, one of Avicenna’s expositors, gives the rules of treatment with great judgment.

Prosper Alpinus gives a fair account of the ancient doctrines on this subject. (Meth. Med. iv, 16, and de Præsag. Vita et Morte, ii, 21.)

SECT. XXI.—ON CONSTRICTION OF THE SKIN.

Constriction is occasioned either by obstruction or contraction of the pores. Obstruction is produced either by the quantity or thickness of crude and indigested humours, and contraction by such things as are cold or astringent, or desiccative. Upon stripping the body, the affection is at once recognized by the paleness, hardness, and contraction of the skin, and by the body’s being heated with difficulty during exercise. Calefacient remedies are the proper cure for this state of body, and therefore we must have recourse to the strongest exercise and the hottest baths, and the time of remaining in the cold bath must not be long, nor must the water be very cold. And when about to put on their clothes, let their bodies be anointed with a sweet and thin oil, of a moderately heating quality. Obstructions of the skin are also properly cured by the oil of dill, (more particularly if the dill had been green,) and by the oil of black poplars.

Commentary. This Section is taken from Oribasius. (Synops. v, 16.) But a somewhat fuller account is given by Galen. (Hyg. iii, 10.) Like our author, he states, that this affection is occasioned, either by a collection of thick viscid humours in the body, or by contraction, that is to say, spasm of the cutaneous pores. It is generally brought on, he says, by exposure to cold, or going into an astringent bath. He gives very minute directions about the treatment, recommending hot baths, and friction with oils of a calefacient and attenuant nature. See also Aëtius (iv, 46); and Actuarius (Meth. Med. iii, 16.)

Avicenna treats of it in the same terms as Galen. (i, 3, 3, 15.)

SECT. XXII.—ON SPONTANEOUS LASSITUDE.

Since the Ulcerose lassitude is occasioned by the ill digestion of acrid superfluities, if the cacochymy be small, the restorative exercise will be sufficient; but if it be greater and deeper-seated, we must not permit such a one either to exercise or to take any motion whatever, but he must for one day remain without food, in a state of quietude and sleep; and then in the evening, when he has been rubbed with emollient unguents, and bathed in tepid water, we must give him wholesome food and some soup. And we must also not restrict him from wine, for nothing contributes so much to the digestion of half-digested humours as wine. Should the symptoms be removed by means of the aforesaid treatment, we may allow the man to return to his usual employments; but if on the following day they should still remain, we must bethink ourselves of a more potent remedy. If his strength be good, we must have recourse either to phlebotomy or purging, having first determined which of these remedies we shall try. If he be weak, we must not bleed, but may purge him moderately. If there be many crude humours in the system, we must neither bleed, nor purge, nor exercise, nor move at all, nor try the bath; but we must keep him in a state of perfect quietude, and give him food, drink, and medicines of attenuating and incisive qualities, without being of a manifestly heating nature. We may give vinegar and honey, and occasionally some ptisan or honied water. And since, in such persons, the lower belly is apt to become swelled and distended with wind, and whatever food is taken to be converted into flatulence, it will be better to give some pepper along with the food. It will be better, too, to use the composition called Diospoliticus, and that simple medicine which consists of three kinds of peppers. Oxymel is also most proper. Let them likewise use a drink made from honey, particularly when it begins to become acid; and such wines as are gently acid, and such articles of food as are attenuant without being heating, as capers, if taken with vinegar and honey, or vinegar and oil. When the Tensive species of lassitude takes place without exercise, it indicates that a plethora distends the solid parts of the body. If the fulness be occasioned by blood, it will be best to open a vein, or scarify the ankles. If the Inflammative lassitude be spontaneous, it will not endure a delay of a few hours, much less of two or three days, for it straightway induces a strong fever, unless one anticipate by letting blood. It will be best, if possible, to abstract blood twice in one day; for if care be taken that the first bleeding do not occasion swooning, it will be of less consequence whether or not it occur after the next. Those who are not bled will be fortunate indeed if they escape with the life.

Commentary. These judicious observations are taken from Oribasius (Synops. v, 21.) See also Galen (de Sanit. tuendâ, iv); Aëtius (iv, 41); Avicenna (i, 3, 3, 16); Alsaharavius (Pract. xxxi, 2, 11); Rhases (Contin. xxxi); Averrhoes (Collig. vi, 14.)

All the authorities recommend nearly the same methods of treatment. Galen’s account of the subject is full, complete, and satisfactory, but so lengthy, that we cannot venture even upon an abstract of it. He gives proper directions for the physician to endeavour to find out the cause of the lassitude, and to remedy it accordingly. It is often connected, he says, with retention of the menstrual or hemorrhoidal evacuation, or the stoppage of some customary discharge. When attended with inflammatory symptoms, he is very urgent in recommending immediate venesection, without which, as he remarks, the patient cannot escape with his life, unless he is saved by a critical evacuation, such as bleeding from the nose, or profuse sweating.

When, in the inflammative lassitude, the head is affected, Aëtius directs us to open the cephalic vein; when the chest or back, the basilic; and when the whole body equally, the median. He recommends also cooling herbs, such as beet, mallows, lettuce, and the like, with ptisan and tepid water. He forbids the use of cold water. After the third day, if the patient is convalescent, he allows a thin weak wine, much diluted.

Averrhoes approves very much of Galen’s directions respecting the treatment, except that the peppers recommended by him had not been found to answer in his climate (Cordova). Instead of them, he directs cinnamon, amber, cassia lignea, and similar aromatics to be given.

Avicenna joins Galen in cautioning the physician to be guarded in allowing his patient to take much food, as the veins being emptied by the remedies applied for removing the lassitude, greedily absorb the chyle before it is properly concocted.

SECT. XXIII.—ON THE REGIMEN OF OLD PERSONS.

Old age is dry and cold; and its correctives are calefacients and diluents compounded with them. Friction is to be applied to the aged, but so as not to occasion lassitude. To such as are weak, some such course of diet as the following is to be prescribed: about the third hour, a small bit of bread with Attic honey; and afterwards, about the seventh hour, after having undergone friction, and taken exercise and baths suitable to old men, they must first get such things as are of a laxative nature, and afterwards fish or fowls; and then for supper, such things as are wholesome, and not apt to spoil in the stomach. I also do not forbid them to use wines prepared with honey, particularly such persons as are suspected of being threatened with the stone or gout, and in that case, a little parsley may be added. If phlegm be gendered in the stomach, we must of necessity apply such remedies as will remove it, and return immediately to a diluent diet: we must give them ripe figs in preference to every other kind of food, and if during the winter, dried figs, unless they complain of unpleasant symptoms in the right hypochondrium. When serous and pituitous recrements collect in the bodies of old men, we must promote the discharge of urine every day, and soften the belly, principally by giving oil before a diet. It is obvious, that all pot-herbs ought to be eaten before all other food, with oil, pickles, or olives and damascenes seasoned with salt. When the belly is bound, the herb mercury and the bastard saffron will relieve it. Turpentine also is proper in such cases. It may be given sometimes to the bulk of a Pontic walnut, and sometimes of two or three. Oil also in a clyster is most useful to those who are constipated.

Commentary. This Section is copied from Oribasius. (Synops. v, 18.) See also Aëtius. (iv, 30.) These directions are all borrowed from Galen (Hyg. v), who has treated of the subject with his characteristic elegance and good sense. The following is a brief exposition of his views of practice in such cases: “Old age is cold and dry, and is to be corrected by diluents and calefacients, such as hot baths of sweet waters, drinking wine, and taking such food as is moistening and calefacient.” He strenuously defends the practice of allowing old persons to take wine, and gives a circumstantial account of the Greek and Roman wines best adapted to them. In the case of old persons he approves of three meals in the day. He recommends the bath to be taken before dinner, which should consist of sea fish. He properly expresses his disapprobation of giving them aloetic pills to remove constipation of the bowels, and advises rather that they should be kept open with laxative herbs and oily clysters, in the manner stated by our author. Aëtius remarks, in like manner, that old men are much hurt by strong purgatives, which only increase the disposition to costiveness. All that is required in such cases, he remarks, is to lubricate the rectum with an injection of oil. The Arabians follow closely in the same strain. Alsaharavius recommends old persons to drink strong diuretic wines. He also approves of the tepid bath, and friction with emollient oils. He disapproves of much exercise and of taking aloetic pills, instead of which he directs oily clysters and laxative herbs. (Pract. xxvii, 10.) See more particularly Averrhoes’ Commentary on the Cantica of Avicenna (tr. i.) They agree that if an old man had been accustomed to be frequently bled, the practice is not to be wholly laid aside. Avicenna particularly approves of a milk-diet. He recommends old red wines, but forbids such as are new and sweet. (i, 3, 3.) Even Plato, the philosopher, permits old men to take a liberal allowance of wine, which he pronounces to be the restorative of youth, and the corrective of the austerity and despondency of old age. (leg. ii.) See also Athen. (Deip. x, 54, ed. Schweigh.)

According to Hippocrates, old men bear abstinence better than those of any other period of life. (Aphorism.) The reason of this assigned by his Commentators, Theophilus and Damascius, is, that their innate heat is lower than at any other age, and consequently requires less pabulum to support it. (Ed. Dietz. t. iv, 277.)

SECT. XXIV.—FOR A WRINKLED STATE OF THE BODY.

A wrinkled state of the body may be removed by the farina of bitter tares, mixed with white vine.

Another abstergent composition (smegma), to be frequently rubbed into the skin: fat figs bruised with bryony, and the burned powder of tares, the shells of the cuttle-fish (sepia), mixed with a small quantity of honey.

Commentary. This Section is taken from Oribasius. (Synops. v, 20.)

SECT. XXV.—TO MAKE THE PERSPIRATION FRAGRANT.

The perspiration may be rendered fragrant by mixing the leaves of the cypress, pounded dry, and the bark of the pine in the same ointment. One ought also to remember in the morning, immediately after being dressed, to taste a small quantity of cassia or savin.

Commentary. This is copied from Oribasius. (Synops. v, 21.) See also Rhases (ad Mansor. v, 53.) Rhases recommends the heads of cardui for food, and the seeds of juniper or cassia lignea in the drink. His advice further is to rub the body with pastils of roses, and to drink aromatic wine.

SECT. XXVI.—TO WARM THE HABIT.

Since even the habit must be warmed, it will be proper to use a preparation of a heating nature when in the bath. Let it contain calamint, marjoram (sampsuchum), hyssop, bay berries, rosemary, the stone pyrites, salts, the burnt lees of wine, nitre, pumice-stone, each in proper proportion; also a small quantity of mustard, stavesacre, and the seeds of the thymelæa (granum cnidium). After the bath, use a warm restorative (Acopum), and drink a yellow old wine, having taken a sweet drink (propoma) from wine and honey, pepper, rue, and the like.

Commentary. All this Section is taken from Oribasius, excepting the part relating to the draught or Propoma. The nature of the Propoma will be explained in the [Seventh Book]. We may just mention that it was a sort of liqueur.

SECT. XXVII.—FOR PALENESS.

Paleness of the body is diminished by a merry course of life, and grateful food, by mixing together radishes, leeks, and the green chick-pea. The juice of the sweet pomegranate taken internally, restores the complexion. Oil, in which the root of the white vine (bryonia) has been long boiled, is likewise proper. This gives tone to the body. For detergent applications, form pastils of detergents, as farina, the bulb of the narcissus, and the root of the bryony. The root also of the bitter almond, if taken in abundance, will improve the colour, and likewise the fruit boiled in water and used for a bath.

Commentary. This Section is taken from Oribasius. (Syn. v, 23.)

SECT. XXVIII.—ON LIVIDITY.

Livid spots are prevented from forming on old men, by rendering their skin thick and hardy, and by warming the habit. In order to dispel them, the black places should be rubbed in the bath with salts, and fomented with sponges steeped in a decoction of radish or wormwood.

Commentary. This is taken from Oribasius. (Synops. v, 24.)

SECT. XXIX.—PRESERVATIVES OF THE TEETH.

The teeth will not decay if the following things be attended to: in the first place, to avoid indigestion, and frequent repetitions of emetics. Guard against such food as is hurtful to the teeth, as dried figs, honey boiled, so as to become very hard, dates which are difficult to rub down, and all glutinous substances; likewise such things as are difficult to break, and may thereby loosen the teeth; in like manner also, such substances as set the teeth on edge, and everything which is cold and putrid. The teeth also ought to be cleaned after supper.

Commentary. This Section is mostly taken from Oribasius. (Synops. v, 25.)

Rhases gives similar directions. He forbids emetics, and recommends attention to keeping the teeth clean. He praises the following dentifrice: Of hartshorn, of the seeds of tamarisk, of cyperus, of spikenard, of each ℥j, of the salt of gem ʒij, to be pulverised, and the teeth rubbed with it. (Ad Mansor. iv, 21.)

SECT. XXX.—FOR DULNESS OF HEARING.

Dulness of hearing may be prevented by clearing away the sordes from the meatus, and by occasionally introducing into the ear a piece of linen dipped in a calefacient ointment (dropax), pressing it down, and then drawing it out; for this completely clears the opening, and at the same time, stimulates the sense of hearing. Afterwards, the meatus is to be plugged up with a piece of wool of the size of a tare for a day; and, when it is taken out, the meatus is to be anointed with the oil of almonds, of spikenard, or of chamomile, with the fat of geese, or a small quantity of ox gall. Again, after a time, rubbing mustard and figs together, introduce the collyrium thus prepared, for two hours; and then take it out and pour in oil heated in the hollow of the root of the asphodel.

Commentary. This is taken from Oribasius. (Synops. v, 23.)

Rhases particularly directs great care to avoid indigestion, which, without doubt, is occasionally the cause of indistinct hearing. He recommends some almond oil to be introduced into the meatus, and cautions against exposure to cold wind. (Ad Mansor. iii, 23.)

SECT. XXXI.—ON DIMNESS OF SIGHT.

In order to avoid dimness of sight, when they plunge into cold water, people ought to open their eyes wide, for thereby the strength of their eyes will be much improved. They ought also to be careful not to hurt them by reading. Let them also avoid wine that is thick and sweet, such articles of food as ascend upwards, whatever is of difficult digestion, and engenders crude and thick humours, the herb rocket, leeks, and everything whose pungency ascends upwards. Let them also avoid reclining long in a supine position, cold, winds blowing direct in the face, smoke and dust; and pour daily into the eyes an infusion prepared thus: for a month and a day, put green fennels into an earthen vessel smeared with pitch on the outside, and pour in rain water, and then taking out the fennels, keep the water laid up for use.

Commentary. This is copied from Oribasius. (Synops. v, 27.)

Rhases gives very copious and sensible directions on this subject, but many of them are the same as those given by our author. He forbids all gross and diffusible articles of food, and also thick wines. Although he cautions against reading books written in small characters, he recommends exercising the eyes by looking at large letters or pictures. He also recommends various collyria, containing antimony, tutty, calamine, camphor, and the like. (Ad Mansor. iv, 22.)

SECT. XXXII.—ON REPLETION.

Excess in diet is a very great error; for, even if the stomach should digest it properly, the veins, being over-filled, become affected, are distended and burst; they are obstructed, or filled up with vapours, and become much oppressed. In diseases nothing is worse than plethora of the veins; for, in fulness of the stomach, the offending matters may be evacuated either upwards or downwards, so that it is less pernicious than the other, and yet it is by no means desirable. But if there be too much food in the stomach, it must be immediately evacuated by vomiting, for there is a danger lest being digested it fill up the veins, more particularly if the person who is guilty of the excess be not attentive to the necessary evacuations. Let him vomit, then, before the food become spoiled; or, if there be any objection to vomiting, it will be of great consequence to bring about frequent discharges from the bowels; or otherwise, he should indulge much in sleep, and drink often of tepid water. When he has digested properly, and more especially if he has had evacuations by the bowels, let him have baths and fomentations, and let him drink moderately of watery draughts, and eat some pickle. But should he neither have alvine evacuations, nor digest readily, and if his whole body be heavy, averse to motion, and sleepy, and if his mind be oppressed with unusual sluggishness, these symptoms indicate plethora of the veins; and, when lassitude supervenes to these, it will be proper to enjoin quietude until digestion in the stomach be accomplished, and then to evacuate by labour.

Commentary. Our author, as usual, copies from Oribasius. (Synops. v, 28.)

Hippocrates describes accurately the bad effects of plethora, but at so great length that we cannot venture to give an outline of his practice. We may mention, however, that purging with hellebore, emetics, the warm bath, and venesection are his most powerful remedies. (De Diæta, iii, 16 et seq.)

Galen has also a treatise of considerable length on the same subject. Among the causes of plethora enumerated by him, we remark that he mentions the use of the warm bath after meals, whereby he holds that the system is overloaded with imperfectly concocted chyle. (De Plenitudine, and Meth. Med. ix, 5.) See also Rhases (ad Mansor. ii); Haly Abbas (Pract. i, 12); Alsaharavius (Pract. v, 4); Averrhoes (Comment. in Cant. Avicennæ); Avicenna (i, 2, 3.)

Alsaharavius says that plethora is marked by ruddiness of the body, heaviness, torpor, large veins, somnolency, a large face, and brawny limbs. It is usually accompanied, he adds, by impairment of the understanding, forgetfulness, heaviness of the head, weakness of sight, great pulsation of the arteries, and a disposition to epistaxis. He recommends a restricted diet, consisting of articles not very nutritious, exercise, the bath, along with friction, and medicines calculated to evacuate the prevailing humour, whether blood, phlegm, or bile.

Haly’s account is very like our author’s.

Rhases gives a good description of repletion, which, he says, is generally brought on by excess in eating and drinking, along with too much indulgence in sleep. Avicenna’s description is similar.

SECT. XXXIII.—ON INTOXICATION.

To those who are intoxicated, vomiting is an immediate relief. It will be proper that they drink freely of water and honied water, so that they may vomit freely, and remove the uneasy feelings. After vomiting, let them use the bath, along with plenteous unction, and afterwards rest for some time, well covered up, until they have slept off their debauch.

Commentary. These simple directions are extracted from Oribasius. (Synops. v, 33.) Hippocrates recommends an emetic after intoxication. (De Diæta, iii, 4.)

For the cure of intoxication Haly Abbas recommends the tepid bath, affusion of tepid water, and friction with oil. If headach prevail he directs cold rose oil to be poured on the head; or, if it is summer, cold water. After this the person is to be rubbed, and to take things of a cooling nature, such as prunes, tamarinds, and the like. (Pract. i, 8.)

Rhases recommends vinegar and water, or the like, for drink; the application of vinegar and oil of roses to the head, and camphor and water to the nose. He also approves of emetics, and of putting the person’s hands and feet into cold water. He says one ought to sleep long before going into the bath. (Ad Mansor. v, 71 and 77.)

The practice of taking an emetic after a debauch is often alluded to in the works of the classical authors. Thus it is mentioned by Aristophanes in his ‘Acharnenses.’ Suetonius, in the lives of Vitellius and Claudius, states that these Emperors were in the practice of procuring vomiting, in order to relieve themselves from the effects of excessive eating and drinking. See also Pliny (Hist. Nat. xiv, 28.) Athenæus, upon the authority of Mnestheus, the Athenian physician, recommends that a person who has drunk wine freely should not go to rest until he has vomited more or less. He advises afterwards either the affusion, or bath of hot water. (Deip. xi, 67.) It appears, from Pliny, that the celebrated Asclepiades of Bithynia condemned the use of emetics, which were so common in his time. (Hist. Nat. xxvi, 7.) See also Celsus. (i, 3.)

SECT. XXXIV.—ON WRONG DIGESTION OF THE FOOD.

It contributes much to the health of those whose food spoils in their stomachs, that the offending matters be discharged downwards; and when they are not so discharged naturally, this operation ought to be promoted by gentle laxatives. Persons may, with advantage, take, before eating, an emetic from the drinking of wine, or must. They ought also to be counselled not to take food of a strong or offensive smell, nor such as easily becomes spoiled; but, on the contrary, such as is wholesome. To such persons, evacuations of the bowels at proper intervals, by means of gentle laxatives, are highly expedient.

Commentary. See Oribasius (Euporist. i, 3, and Synops. v, 30.) This subject will be more fully treated of in the [Third Book].

SECT. XXXV.—ON VENERY.

From sexual enjoyments, the following advantages may be derived: they relieve plethora, render the body lighter, promote its growth, and make it more masculine; they free the mind from the cares which beset it, and relieve it from ungovernable anger. Wherefore, the best possible remedy for melancholy is coition. Those also who are otherwise affected with mania it will restore to reason. It is also a powerful remedy for phlegmatic disorders, will restore the appetite to those who have lost it, and dispel continued libidinous dreams. The temperaments which are most adapted for venery are the hot and humid, and these bear it best. A dry and cooling diet, old age, and the season of autumn unfit for it. The diet, therefore, ought to be moistening and heating; and moderation as to labour and food ought to be observed. And as other kinds of labour are useful so also are the venereal, when taken in moderation; for they incite to the act, and, by the habit, procure some alleviation. But nothing is so much required as abundance of food, which also ought to be of a nutritious nature. Of fishes, the best are polypi, (which are otherwise supposed to incite,) and all the class called mollusca; of pot-herbs, the all-good (horminum), hedge-mustard (erysimum), rocket (irio), and turnip. And the following are as medicines: of pulse, beans, chick-peas, Sicilian peas, kidney-beans and peas, which fill the body with vapours and abundance of food. Rue, as it concocts and dispels flatulence, blunts the venereal appetite. But I greatly approve of grapes, which supply the body with moisture, and fill the blood with flatus, which rouses to venery. He who is about to proceed to the act ought to guard against repletion, indigestion, lassitude, precursory vomits and purges, and, in like manner, an acute diarrhœa; for a chronic one is dried up by venery. And strong desires I do not approve of, but think that they ought to be contended against, especially by those who have any distemper. The most proper season for enjoyment is after gymnastic exercises, baths, and a moderate repast; for food contributes to the strength, and diminishes the chills which succeed it. The proper time, as I said before, is after eating, and before sleep, for the lassitude is relieved by sleep. This too is the fittest time for procreation on many accounts, and because that the woman falling asleep is the more likely to retain the semen.