Chapter XVI: Part 16

Although Rhases be the most ancient writer whose account of smallpox and measles has come down to us, he does not pretend to have been the first of his countrymen who had noticed them, but gives extracts from the works of the elder Mesue, the elder Serapion and Aaron, wherein mention is made of them. According to Rhases, the common cause of smallpox is a fermentation in the blood; and hence the disease is most apt to seize children, whose blood is hotter than that of other persons. He was well aware, however, that the disease is capable of being propagated by contagion, for he ranks the pestilential fever or smallpox among the diseases “qui transeunt ab uno ad alios.” The symptoms, as described by him, are, continued fever, pain in the back, itching at the nose, disturbed sleep, and afterwards redness and fulness of the face, pain of the throat, difficulty of breathing, dryness of the mouth, thick spittle, hoarseness, headach, inquietude; and these symptoms are followed by the characteristic eruption of the smallpox or measles; but in the case of the latter there is more anxiety of mind, sick qualms, and heaviness of heart; and in that of the former there is more pain in the back, heat, and inflammation of the whole body, especially in the throat, with a shining redness. He then lays down the rules of treatment. He directs us to bleed from the arm at the commencement, provided the patient be more than fourteen years old, but by a cupping instrument if he be younger. He forbids us, however, to abstract blood after the eruption is come out. He allows light kinds of animal food, with acids; and for drink he recommends water cooled with snow, or cold spring water, or some diluent and acid draught, such as barley-water acidulated with pomegranate juice. Aaron, one of his authorities, forbids, however, the administration of cold water when the eruption is coming out. He directs the chamber to be sprinkled with cold water, and even at a certain stage permits the patient to go into the cold bath. He recommends abstinence from new milk, wine, dates, honey, mutton, beef, shell-fish, and all high-seasoned and heating things. The rest of his general treatment we need not give in detail. Suffice it to say, that the medicines recommended by him are, for the most part, vegetable acids and astringents. Upon the whole, the earlier part of his treatment consists of bleeding, cold drinks, and acid draughts. For hastening the eruption, when that is desirable, he directs us to wrap up the patient closely in clothes; to rub his body all over; to keep him in a room not very cold; to give him some cold water to drink; to put on a double shirt; and to place near him two small basins of very hot water, one before and the other behind him, so that the vapour may be diffused all over his body, except the face; but he prudently directs us not to allow the moisture to cool upon the body, but to get it carefully wiped off. All furnaces and hot baths he condemns, as overheating and weakening. He very much commends figs for promoting the eruption. He afterwards gives very minute directions about the treatment of particular parts, such as the eyes, the throat, and the nose. For the eyes, he recommends various astringent lotions or collyria, such as galls and rose-water, sumach, pomegranate rind, &c. The care of the throat he justly holds to be a very important consideration, and recommends bleeding when there is acute pain, and gargling with cold water, or with astringent decoctions, such as those of acid pomegranates, sumach, and the juice of mulberries. When the pustules on the limbs are large, he directs us to open them; and when there is great pain in the soles, he recommends them to be rubbed with warm oil, or the feet to be put into hot water. When the pustules seem to stand in need of ripening, he directs the body to be fomented with the steam arising from a hot decoction of chamomile, violets, and the like; and, when too humid, the patient is to be laid on pounded roses, rice-meal, or millet seed. For removing the scabs and eschars, he recommends us to rub them with the warm oil of sesame, or oil of pistaches; but the larger are to be cut off carefully without any application of oil. For removing the specks on the eye he recommends many stimulant collyria, containing antimony, verdigris, sal ammoniac, tutty, camphor, &c. For removing cicatrices or marks on other parts of the body, he mentions various applications, containing litharge, bastard spurge, &c. When the belly is loose, either in smallpox or measles, which, as he remarks, is commonly the case on the decline of the fever, he recommends abstinence from all laxative things, and commends barley-gruel, to which the meal of pomegranate seeds may be added; or, if the looseness increase, gum arabic, &c. may be added to the drink. He adds, that it sometimes happens that the bowels require to be opened, and he directs this to be done by means of myrobalans, prunes, and the like. When in measles there is much appearance of vitiated bile, he directs the discharge of it to be promoted. He points out the difference between distinct and confluent smallpox; and remarks that the latter is far more dangerous than the other. He also correctly states that when, in measles or smallpox, the eruption is suddenly determined inwardly, it is a fatal symptom. He all along inculcates that measles and smallpox are nearly allied to each other.

Georgius, one of the authorities quoted in his ‘Continens,’ says that measles arise from blood mixed with much bile, and smallpox from gross blood mixed with much humidity. He states that the danger is proportionate to the pain in the throat and difficulty of breathing. The elder Serapion, as quoted by him in the same work, directs, if it is the winter season, the wood of tamarisk, &c. to be burned beside the patient.

In his work ‘Ad Mansorem,’ he recommends nearly the same treatment as that which we have been detailing from his Tractatus on Smallpox; but does not speak so decidedly in favour of cold drink.

Avicenna’s description of smallpox and measles is very similar to that of Rhases. He confidently pronounces them to be contagious diseases. He states correctly, that when smallpox proves fatal, it is usually from the affection of the throat, or from the bowels becoming ulcerated. Sometimes, he adds, the disease superinduces bloody urine. He agrees with Rhases that measles is a bilious affection, and that it differs from smallpox only in this, that in the former the morbific matter is in smaller quantity, and does not pass the cuticle. His treatment also is little different. At any period during the first four days he approves of venesection, but forbids it afterwards. He recommends cooling and diluent draughts prepared from tamarinds and the like. He prescribes figs to facilitate the eruption of the pustules, and forbids cold drink after they begin to come out. When the pustules are large and fully formed, he approves of letting out their contents with a gold needle. His treatment of the throat, eyes, belly, and hands is nearly the same as that recommended by Rhases. When ulcers are formed after the falling off of the eschars, he directs them to be dressed with the white ointment, composed of ceruse and litharge. (iii, 1, 4.)

Serapion’s account of smallpox and measles, as is remarked by Haly Abbas, is very defective. He treats of them along with apostemes, and his description of the symptoms is far from being accurate.

Avenzoar, in his Treatise on Epidemical Diseases, treats incidentally of measles and smallpox, for the cure of which he recommends principally gentle purgatives, such as tamarinds, with cooling and acid drinks. (iii, 3, 4.)

Alsaharavius also mentions them briefly among the pestilential diseases; but his description of them is not to be compared with that of Rhases.

According to Haly Abbas, variola is produced either by external causes, such as a pestilential state of the atmosphere, or from respiring the air of a place which has been tainted with the effluvia from the pustules of persons affected with the disease; or it may arise from an ebullition of the blood when it is loaded with gross humours which nature endeavours to cast outwards. He then briefly describes several varieties of the disease, differing from one another in degrees of malignity; and among them he ranks rubeola, which is occasioned, he says, by a hot thin blood, and is not of a bad nature. In it, he says, the eruption, when at its height, resembles millet seeds, or is somewhat larger, the colour is red, and the pustules discharge nothing. The precursory symptoms of smallpox are fever, swelling of the face, itching of the nose, inflammation and redness in the face and other members, heaviness of the head, and roughness of the throat. (Theor. viii, 14.) With regard to the treatment of variola and rubeola, he recommends venesection during any of the first three days; or, if the patient be a child, he directs us to apply a cupping instrument to the back. The patient is then to be made to drink barley-water in which jujubes and sebesten plums have been boiled; syrup of poppies is to be added, if the cough be troublesome, or the pain of the throat severe; and spoon-meats prepared with spinage, orach, and the like, are to be given. When the eruption does not come properly out, he recommends a decoction of fennel, lentils, figs, &c. to be taken cold.—By the way, this practice is favorably mentioned by Fracastorius, a writer of the 16th century (De Morb. Cont.) For asperity in the chest he recommends the mucilage of fleawort, linseed, and the like, and forbids all heating things. The patient is to be kept upon a low diet, as in other fevers; and his apartment is to be fumigated with aromatics, such as sandal-wood, myrtles, and roses. When the belly is constipated, he directs barley-water with manna, prunes, and the like; or, if loose, barley-water with myrtle seeds, gum Arabic, Armenian, or Cretan earth (chalk?). He forbids purgatives after the seventh day, especially in rubeola, as there is danger of diarrhœa or dysentery being superinduced; and, if these affections should come on, he directs them to be stopped with astringents. He recommends particular attention to the eyes at the commencement, and with this intention directs them to be bathed with an astringent decoction. No animal food is to be allowed until the eruption and heat are gone.

BOOK THIRD.

SECT. I.—ON AFFECTIONS OF THE HAIR, ALOPECIA, OPHIASIS, AND BALDNESS.

As some plants die from dryness for want of sap, and some from the sap being unsuitable to them, so it happens, in like manner, with the hairs; for baldness is occasioned by want of the natural juices, and alopecia and ophiasis by the badness of them. These complaints differ only in figure; for, in the latter, the affected part has the appearance of a serpent; and alopecia derives its appellation from the circumstance of foxes being frequently subject to the affection. Judging of the prevailing humour, then, from the colour of the skin, we are first to evacuate it by purging, and then to have recourse to local applications. If, therefore, the colour incline to black or white, we purge with the medicine called hiera, which evacuates both phlegm and the melancholic humour; but if it is palish, we give pills of aloes. An account of these medicines will be found in that part of our work which treats of Compound Medicines. After general depletion, we are to use masticatories composed of vinegar, mustard, and honey, and not once only, but frequently. It will be better, too, if marjoram, pennyroyal, thyme, or hyssop be infused in the vinegar. In all the other complaints of the head, the same method is to be observed, first evacuating the prevailing humour, either by purging, or by phlebotomy if there be also a fulness of blood, and then proceeding to the topical treatment.

_On alopecia._ Having first cleansed the part with nitre (_soda_), and scrubbed it with a rough cloth, more particularly a woollen cloth, and continued the friction until it become red, anoint it with vervain pounded with vinegar in the sun. Or, rub in the roughest alcyonium burnt and pounded with lamp-oil. Or, burn the root of the club-rush, or the rind of the bitter almond, and rub them in with oil or bears’ grease. These are moderate remedies. But stronger applications may be prepared from euphorbium, thapsia, and adarce, pounded with oil of bays, or liquid pitch.—_Another_: Having burnt the shells of sea-urchins, mix them with bears’ grease, and anoint with them, having first cleansed the part with nitre.—_Another_: Of pepper, of dried sheep’s dung, of hedge mustard, of rocket seeds, of each dr. iv; of white hellebore, dr. iij; of mouse-dung, dr. j: add to the gall of a bull, of a goat, or of a hog.—_Another tried remedy for alopecia_: Of the root of mandragora, of birthwort, of the root of wake-robin, of wax, of liquid pitch, oz. viij; of swine’s seam not salted, of the heart or inner part of the herb nerium a little: boil the seam and the nerium until the herb be softened; then strain and throw away the herb, and add to the axunge the other ingredients, and boil. Add the wax and the liquid pitch, and use boldly in the sun. When the ulcers are cicatrized, burn the head of a fox, take alcyonium, the leaves of the black alkanet, and, having pounded all together, sprinkle upon the ointment, in order to promote the growth of the hair.—_Another_: Of a mouse’s head burnt, one part; of the shells of the sea-urchin, one part; boil in a pot with swine’s seam, and use. They may also be sprinkled in powder.

_A medicament from Thapsia, for all chronic affections._ Of euphorbium, of thapsia, of bay-berries, of each, oz. j; of native sulphur, oz. ss.; of hellebore, oz. ss; of wax, oz. viij; of oil of bays, or old castor oil, q. s. When stronger applications are required, add of cardamom, oz. j; of burnt alcyonium, oz. j; and it will be applicable not only for alopecia, but for all cases of chronic coldness. But in every case of alopecia have recourse in the first place to the process of cleansing with nitre, then friction, and frequent shaving. I have seen many have their hair reproduced by friction alone, and frequent shaving.

_For baldness, and to promote the growth of the hair, from Crito._ Take the dried stomachs of five hares, roast carefully in an earthen vessel, add to them the third part of myrtle tops, of the fruit of acacia, of the juice of acacia, of sweetbriar, an equal part, of maiden hair, oz. iij; pound all these things together, and sift through a small sieve. Then adding of bears’ grease, lb. iv, of that of a seal the same quantity, pound and preserve in a leaden vessel. At the time of using add to any fragrant ointment.

_Preservatives of the hair._ Of maiden-hair, one part; of ladanum, two parts; add to wine and myrtle oil, and use.—_Another_: Pound the flower of anemone, and rub it in with oil. The same will blacken the hair.—_Another_: Pound the straight vervain dried with its roots, sift through a narrow sieve, and, having mixed with oil, so as to have the thickness of the bath-sordes, lay it up in a copper vessel, and, when softened, use instead of oil in like manner.

_A watery infusion for increasing the growth of the hairs, and for blackening them._ Of rain water, six sextarii; of Alexandrian sumach, three sextarii; of maiden-hair, oz. iv; of savin, oz. iv; of ladanum, oz. j; of dried gourd, oz. j; of myrtle, oz. j; allow to macerate in a glass vessel for twenty days, stirring it twice a day with a pine spatula. On the following day plunge the comb into the infusion, and use once a day. And the seed of marshmallows, when rubbed in while in a bath, preserves the hair and promotes its growth. And, in like manner, oil may be rubbed in that has had the seed of marsh-mallows boiled in it, or added to it.

_For thinning the hair._ Of the leaves of the fig-tree, of the rind of the white wild vine, of pumice-stone, of the shells of buccinæ, of Cimolian earth, of each one mina. Put them into a new crude pot, and having covered it with clay, burn in a furnace, and pound, adding of aphronitrum half a mina, of the galls called omphacitæ thirty in number, pulverize and use.—_Another_: Of aphronitrum, half a mina; of roasted pumice-stone, four minæ; of fissile alum (_alumen scissile_), of dried iris, of the black wild myrtle, of gum, of the root of bryony, of each dr. iv; of unripe lupines pounded, the fourth part of a gallon; use without tallow.

_For falling out of the hair._ Rub in aloes, with black austere wine; or, the cover of the purpura boiled with oil; or, myrrh and ladanum, with wine and myrtle oil; or, pound burnt sheep’s dung on a shell, and rub it in with oil, having first shaved the head.

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COMMENTARY. See Galen (de Med. sec. Loc. i, Parat. Facil., and Meth. Med. xiv, 18); Celsus (vi, 4); Aëtius (vi, 65); Alexander (1); Pliny (H. N. xxviii, 46); Octavius Horatianus (i, 7); Marcellus (de Med.); Isidorus (Orig. iv, 8); Oribasius (Synops. viii, 22, and Meth. Med. iv, 5); Nonnus (8); Heliodorus (ap. Nicetam); Incertus auctor. (Frag. ap. Moschionem in Gynæc. 21); Pollux (Onomast.); Myrepsus (38); Actuarius (Meth. Med. ii, 5); Psellus (op. Med.); Serapion (i, 1); Mesue (ii, 1); Avicenna (iv, 7, 1); Avenzoar (i, 1, 3); Haly Abbas (Theor. viii, 8, Pract. iv, 12); Alsaharavius (Pract. i, 2); Rhases (ad Mansor. vi, 1, Contin. xxxvi.) See also Callimachus (Hymn. ad Dianam, l. 79); with the learned Notes of Tytler and Spanheim.

Our author copies closely from Galen, who explains at considerable length his principles of treatment; which consists of purging with warm cathartics, shaving the part frequently, rubbing it, and using calefacient applications. He says that the disease is occasioned either by the deficiency or depravity of the nutritive juices. Drs. Willan and Bateman describe this complaint by the name of porrigo decalvans. Bateman justly remarks, that, “all that can be prescribed respecting the treatment of this affection has been expressed by Celsus with his usual terseness: “Quidam hæc genera arearum scalpello exasperant; quidam illinunt adurentia ex oleo, maximèque chartam combustam; quidam resinam terebinthinam cum thapsia inducunt. Sed nihil melius est quam novaculâ quotidie radere, quia, cum paulatim summa pellicula excisa est, adaperiuntur pilorum radiculæ. Neque ante oportet desistere, quam frequentem pilum nasci apparuerit. Id autem quod subinde raditur, illini atramento sutorio satis est.”

The modes of treatment recommended by the other authorities are in principle the same as our author’s and that of Celsus. Octavius Horatianus, after directing pills containing colocynth, aloes, scammony, and wormwood, recommends nearly the same external treatment as Celsus: “Omnes confectiones quæ mediocriter calefacere possunt, mediocribus et delicatioribus corporibus adhibendæ sunt. Prius ergo loca linteolo usque ad ruborem ante curam confricentur mediocriter, ne vulnerentur. Quæ si vulnerabuntur, oleo roseo, vel adipibus anserinis recuranda sunt.”

Dioscorides recommends tar-water and other preparations of pitch for alopecia.

In a Fragment of an anonymous author, published along with ‘Moschion’ in the ‘Gynæcia,’ very sensible rules of treatment are given; namely, to shave the part frequently, to rub it with compositions containing mustard, adarce, wormwood, alcyonium, &c., and to purge with aloes, scammony, colocynth, and the like. Similar directions are given by Heliodorus. Even Alexander, who in general controverts freely the opinions of Galen, does not differ from him at all in this case. He lays down the treatment of baldness very systematically, according as the falling off of the hairs arises from preternatural dryness of the part, or from contraction or expansion of the pores, or whether it proceed from the purging of the system from depraved humours. In the first of these cases he recommends baths, and a moistening diet, but forbids the use of astringent applications. For preternatural openness or relaxation of the pores he recommends applications of an astringent and bracing nature, and strongly nourishing food. For preternatural contraction of the pores he advises the opposite class of remedies. When the hairs fall out owing to the cleansing of the system from depraved humours, as happens after diseases, he cautions against a too meddlesome interference with the process of nature. Aëtius and Oribasius are the servile copyists of Galen. Marcellus gives a long list of compound medicines for the cure of alopecia. Pliny recommends bull’s gall with Egyptian nitre. The ancients were in the practice of using nitre for cleaning linen, as is remarked by Bernard (ad Nonnum, u. s.) On the ancient practice of scrubbing the head with nitre or soda, see Salmasius (ad Tertull. de Pallio, 432.)

The Pseudo-Dioscorides recommends shaving, rubbing with nitre, and stimulant applications containing arsenic. (Euporist.)

The Arabians treat the disease exactly as the Greeks. Avenzoar recommends purging, a regulated diet, and friction with oil of nuts and cherva. Haly Abbas approves of general evacuants, friction, and stimulant applications containing cantharides, nitre, &c. Alsaharavius recommends emetics after food, purging with hiera picra, friction with compositions containing mustard, euphorbium, pellitory, nettle-seed, with oil of sesame, or with liquid pitch. Ophiasis, he says, is to be treated upon the same principles. Among the ingredients of Mesue’s compositions, we remark cantharides, musk, and amber. Serapion, like Galen and some of the others, makes mention of red arsenic as an ingredient in these applications. Rhases, in his ‘Continens,’ collects the opinions of all preceding authorities on the nature and treatment of these diseases. Most of the local applications recommended by them are stimulants and rubefacients, such as mastich, euphorbium, cantharides, ladanum, St. John’s-wort, &c. which are to be rubbed in with oil or pitch. He mentions that the celebrated Antyllus recommended scarifications, cupping, and leeching. Servitor directs a depilatory, prepared by mixing two parts of quicklime with one of arsenic in a crucible or mortar, and adding a little water to them. Pliny, Samonicus, Marcellus Empericus, and other ancient authorities speak highly of bear’s grease for the cure of baldness.

For the cure of ophiasis the earlier modern surgeons recommended depilatories containing arsenic, quicklime, vitriol, hellebore, and the like. One described by Rolandus consists of quicklime and arsenic boiled in water. (i, 14.) A similar one is described by Plempius.

SECT. II.—FOR MAKING THE HAIR CURLED, AND FOR DYEING IT. FROM CLEOPATRA.

Having first scrubbed the head, anoint the hair with the root of cow-parsnip in undiluted wine.—_Another_: Having shaved the head, and scrubbed it, take a young pine kernel, and burn it until it be reduced to ashes, put it into a mortar and pulverize it, adding myrtle ointment, until it be of the thickness of honey, and thus anoint the head with it.—_Another_: Rub in equal parts of myrtles and beet, with oil.—_Another_: Twenty galls; of maiden-hair, oz. ij; pound with sea-water until they attain the thickness of honey. Having rubbed the hair with urine, or lixivial ashes, and cleaned it with warm water, anoint it with this medicine for two days, then stopping, on the third day clean it, and, having shaved, anoint with myrtle oil. This will render the hair smooth, and curled, and black; but it will be more curled if you shave before using it.

_Preservatives of hoary hairs, and other compositions for dyeing them black._ Of the oil of unripe olives, three sextarii; of spikenard, dr. j; of unguis aromaticus (sweet-hoof?), dr. iv; of schænanth, dr. iv. Boil with oil, and separately pound and dissolve carefully one ounce of the juice of acacia in wine. When only a third part of the oil remains, strain it, and mixing with the acacia, lay it up in a vessel, and anoint with it every day.—_Another_: Of the bark of green walnuts, oz. iij; of the root of the ilex, oz. iij; of dark-coloured wine, three sextarii; boil to a third part, and, having strained, pound the remainder with one sextarius of myrtle oil. To be used every day.

_An infusion for dyeing the hair black._ Of galls, one sextarius, of elm-leaved sumach (_rhus coriaria_), two sextarii; of the leaves of privet, an equal quantity; of black myrtle leaves, the same; of cinnaris a handful; of poppy-heads the same; of lake water, twelve sextarii. Macerate for many days, boil to a third, then rub and anoint the head. When the hairs are dry anoint with an acetabulum of Cimolian earth, and an equal quantity of quicklime. Dissolving these things in the juice of boiled beet, anoint with it, and then, for the sake of protection, put over it the leaves of beet, and, when they adhere properly, wash in the bath with it.

_For dyeing tawny hairs, and making them of a bright yellow colour._ Take of myrrh, one part; of the flower of salt, one part; pulverize carefully, and, having made it of the thickness of the sordes of a bath, scrub the head, anoint it with the ointment, and allow it to remain a night and a day, and then order it to be wiped off.—_Another_: Rub in unripe lupines with water.—_Another_: Of litharge, dr. j; of Cretan earth, dr. iv; of quicklime, dr. j; with water make to the thickness of bath sordes, and anoint. Apply the leaves of beet for two or three days, and then clean.

_For making black hairs yellow._ Add the lees of wine to the sordes of a bath, and, having made it to the consistence of cerate, use it when you are going to sleep, and in the morning the hairs will be yellow.—_Another_: Macerate the leaves of privet in the juice of Fuller’s herb (_struthium_), and use the infusion.

_A gold-coloured dye._ Of alum, dr. vj; of red arsenic, dr. vj; of saffron, dr. ij; of the thapsus used by dyers, called _herba rubia_ by the Romans, dr. viij; of the lixivial ashes used by the bonnet-makers, four sextarii; boil the ashes and the thapsus pounded together, and, when but one half remains, squeeze out the juice, and dissolve in it the alum, red arsenic, and saffron; put it into a glass vessel, and, at the time of using, first scrub the head, and then anoint with it. When it is all drunk up, clean with the decoction of fenugreek, barley, and cumin, having previously washed them with a sufficiency of tepid water, and add as much soap as is required.—_Another_: Mixing together the burnt lees of wine and the oil used in the baths, anoint the hairs.—_Another_: Scrub with Gallic soap and water at each bath.—_Another very fine_: Of red sumach, one sextarius; of galls, lb. iss; of sheep’s dung, oz. ij; of the golden-coloured herb, called _rubia_ by the Romans, oz. ij; of maiden-hair, two bunches (_fasciculi_); of wormwood, one bunch; of lupines stripped of their outer coat, two cyathi; of water, six sextarii; put all into a glass vessel, and allow to macerate for nine days, stirring it twice a day. At the time of using, strain out what is required, and, soaking a sponge in it, rub the hairs, and when they are moistened allow them to drink it up. When dried, wash with a solution of soap in warm water.

_For making the hairs white._ Burn the flowers of the white petty-mullein, moisten with vinegar, and mix for a detergent ointment.—_Another_: Of the fruit of petty-mullein, dr. j; of alum, dr. j; of the rind of radishes, dr. j; pound, and mix of bull’s glue, dr. iv.

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COMMENTARY. Galen, when about to treat of compositions for the hair, remarks that the application of these does not belong properly to the physician, but that he may sometimes be obliged to furnish them to _royal ladies_, whom, under certain circumstances, he cannot venture to disobey. That the ladies, in ancient times, were in the practice of painting their hair, is evident from Achilles Tatius (ii, 149), and Juvenal (vi, 354.) Eustathius mentions that antimony was very much used for painting the eyebrows black. (Comment. in Iliad, viii, _versus finem_.)

For further information upon this subject, with which we must confess ourselves wholly unacquainted, we refer the reader to the following works: Alexander (i, 3); Oribasius (iv, 7, 8); Aëtius (vi, 58); Nonnus (2, 3); Octavius Horatianus (i, 1); Avicenna (iv, 7, 1); Alsaharavius (Pract. xvii, 7); Rhases (ad Mansor. v, and Contin. xxxvi.) Vegetius, the great authority on Veterinary Surgery, gives prescriptions for dyeing the hair of cattle. (Mulom. ii.)

The thapsus mentioned in this Section occurs in Theocritus (Idyl. ii, 88,) and is said by the scholiast to be a Scythian wood for dyeing the hair. It also occurs in Nicander (Ther. l, 529). His metaphrasist, Eutecnius, says that it grows in Sicily. Lucan, in like manner, calls it _Erycina thapsus_, i. e. Sicilian thapsus. (Pharsal. ix, 916.) It is impossible to determine exactly what tree it was.

The opinions of the philosophers regarding the hair may be learned from Aristotle (H. A. iii), and Pliny (H. N. xi, 94.) Both state that the hair and also the nails grow after death; and Philoponus mentions this circumstance as a well-known fact. See Comment. in Aristot. de Anima, Præfat. It may be proper to mention that Bichat and other modern physiologists have been of the same opinion.

SECT. III.—ON PITYRIASIS.

Pityriasis is an eruption of small furfuraceous substances on the skin of the head, or the rest of the body, without ulceration. It is occasioned, either by depraved humours which have been determined to the head, or by a saltish phlegm, or by bilious or melancholic blood. After the general system has been evacuated, as formerly described, we must use some of the under-mentioned remedies. Having first macerated Cimolian earth in water, mix with the juice of beet, and anoint it, allowing it to remain until dry, then wash it away, and, having pounded frankincense with wine and oil, anoint with them. Next day, rub in stavesacre with oil.—_Another_: Of nitre, of the burnt lees of wine, of ben-nut, of each, lb. j; of stavesacre, lb. iss. Dissolve in wine, and rub the head; or, if the rest of the body be affected with tingling, it may be used dry. When the pityriasis is more humid, wash with brine or the decoction of lupines. Of this remedy I have had ample experience.

_On psydracia and exanthemata of the head._ The psydracia are small protuberances, like blisters, elevated above the skin. The exanthemata are superficial ulcerations, somewhat red and rough. Both are to be cured by the under-mentioned remedies: Of litharge, dr. ij; of ceruse, dr. iv; of alum dr. ij: of the green leaves of rue, dr. ij; pound with vinegar and myrtle-oil, and anoint.—_Another_: Pounding rue and alum with honey, anoint with this the head, after having first shaved it. If the head is excoriated, apply olive leaves boiled with honey.—_Another_: Of litharge and ceruse, of each, dr. xij; of native sulphur, dr. viij; mix with myrtle cerate.

_For the thick and red ulcers of the head, resembling papulæ, or small nipples, from which ichor is discharged._ Having first shaved the head and scrubbed it with water and nitre, use native sulphur livigated with human urine; or anoint with melanteria and vinegar.

_For achores and favi._ The complaint called achor is one of those which affect the skin of the head, corroding the skin by very small perforations, from which a discharge of viscid humour takes place. The complaint called favus is nearly allied to it in appearance, since it consists of larger perforations resembling the combs of bees, containing a honey-like fluid. They are occasioned by a nitrous and saltish phlegm. In such cases, the diet should consist of wholesome food; and everything that is acrid and saltish should be avoided, more particularly if the attack be inflammatory. After the proper evacuation of the prevailing humour, having shaved the hairs, foment twice, thrice, or oftener, with warm water, in which has been boiled myrtle, bramble, or lentil, or bitter lupines, or the root of asparagus. When the ichorous discharge is greater, apply a cataplasm of the leaves of willow, with water, or of lentil. The ointments used should consist of Cimolian, Cretan, or Samian earth, or pompholyx, or spodium, or litharge, or cadmia, or burnt paper, or the powder from pepper. All these are to be applied with vinegar. We may use the following smegma: Of sulphur, of the herb perdicias, and soap, of each equal parts. The following are compound applications: Of litharge, dr. xvj; of the leaves of rue, dr. viij; of the stavesacre, dr. iv; of copperas, dr. ij; with vinegar and myrtle oil; make to the consistence of bath-sordes, and anoint with it.—_Another_: Of sandyx (_calcined ceruse?_), dr. iv; of myrrh, dr. iv; of native sulphur, dr. ij; of manna, dr. iv; rub into the part with old oil.

_For achores._ When they discharge ichor, triturate the dross of silver, or yellow ore of lead (_molybdœna_), and sprinkle upon them.—_Another, for achores and humid psora_: Of the roses of the rhododaphne, oz. iv; of native sulphur, oz. iv; of liquid pitch, oz. iij; of dry pitch, oz. iij; of wax, oz. vj; of myrtle oil, q. s. For children, dissolve in milk, and anoint.

_For fici._ We give the name of fici to ulcerous excrescences which are round, somewhat hard, red, and accompanied with pain. They arise for the most part on the head, but also sometimes on the other parts of the body. The best application for this complaint consists of fissile alum, of the calcined flowers of copper, of taurocolla, of each equal parts, with double the quantity of the flakes of copper; triturate with vinegar, and anoint. A proper application is also prepared from the burnt heads of the cackrel fish, the bulbi boiled, and their ashes mixed with vinegar.

_A dry application for ficose eruptions of the head and chin._ Of misy, dr. iss; of chalcitis, dr. iiss; of squama æris, dr. j; of fissile alum, dr. j. Having washed, apply this powder in a dry state unsparingly, and allow it to remain. Next day, having again washed, wipe the part with a sponge, and apply it again. A thick scab will then fall from the ulcer. Repeat the same application the following days. The cure will be effected in a few days without leaving a cicatrix; but this medicine operates strongly.

_For lice in the head._ Direct the head to be scrubbed with the decoction of lupines; or pound together stavesacre and sandarach, and rub them in along with oil or vinegar; or a small quantity of pepper may be added to old oil, so as not to occasion ulceration; or the juice of ivy with honey may be used; or mustard and vinegar; or the gum vernix, or liquid pitch with alum; or the expressed juice of the bay berries; or oil of radishes. I have always succeeded by pounding stavesacre with vinegar and oil, and anointing with this.

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COMMENTARY. Drs. Willan and Bateman agree with all the best medical writers of antiquity in describing, by the name of _pityriasis_, a disease consisting of slight, scaly, and branny exfoliations without ulceration. See Galen (Sec. Loc. i); Alexander (i, 3); Oribasius (Synops. vi, 25); Aëtius (vi, 66); Actuarius (de Sig. Morb. ii, 5); Nonnus (4.) Actuarius, who gives a very distinct account of the disease, states in strong terms the danger of repressing the cutaneous eruption. (l. c.)

It is the _porrigo sicca_ of Celsus (vi, 2), who recommends for it shaving the head, and using slightly repressing applications, “quale est nitrum cum aceto, vel ladanum cum myrteo et vino, vel myrobalanum cum vino.” Marcellus distinguishes the pityriasis from porrigo. (De Med. 4.)

The Arabians, especially Serapion, direct very active general treatment, such as venesection, masticatories, cathartics, and the like. (i, 4.) It is described under the name of _furfures capitis_ by the translator of Haly Abbas. (Theor. viii, 18.) Like the Greeks, he represents it as consisting of small furfuraceous scales without ulceration. Alsaharavius uses the same name, and recommends bleeding, cupping, purging, and external applications of a detergent nature, such as flour of vetches, with vinegar and the like. Avenzoar recommends pills of drastic purgatives, and the ordinary lotions. (i, 1, 10.) See also Avicenna (iv, 7, 1, 24); and Rhases (ad Mansor. v, 1; Contin. xxxvi.) In the ‘Continens,’ the disease is described by the names of furfures and impetigo, for which Rhases recommends liniments containing nitre, sulphur, hellebore, vinegar, &c.

Willan and Bateman describe the _psydracia_ as being small pustules irregularly circumscribed and terminating in a laminated scab. Most of the above-mentioned writers treat of them in the same terms as our author. They seem to be the _balchie_ of Avicenna (iv, 7, 6, 1) who calls them a malignant species of achor. See Galen (l. c.)

Galen, Alexander, Aëtius, and our author describe the _exanthemata_ as being small superficial ulcerations. Drs. Willan and Bateman use it as a generic term for rashes. The exanthemata seem to be the _alraba_ or _pustulæ dulces_ of Alsaharavius (i, 10.) See Book First, Sect. VI, and Book Fourth, Sect. VIII, of this Work.

Willan and Bateman apply the terms _achor_ and _favus_ in the same sense as Paulus and the other ancient authors. Octavius Horatianus uses the terms acora and cerio. He says, “Acoræ et ceriones distant, quod ceriones plures cavernas egestionis habent et humorem multo pinguiorem emittunt; acora autem unam cavernam habet, et humorem egerit aquatiorem.” (i, 5.) Galen has treated of these complaints very fully, and his applications are similar to those of our author. See also most of the authorities on pityriasis. The favus is the first species of _tinea_ described by Haly Abbas. It consists, he says, of cells, and discharges a fluid-like honey. The achor is his _amada_, or third species of _tinea_, consisting of smaller cells than the former. Alsaharavius describes the favus by the name of _alsahara_. It contains, he says, a viscid fluid like honey. He recommends for it purgatives, and detergent applications containing nitre, lees of wine, &c. (Pract. i, 9.) The achor is called _alsahafa_ by him. The description which Actuarius gives of papulæ, favus, and ficus is sufficiently distinct, but not different from our author’s. (De Diagnos. ii, 5.)

The other authorities gives the same account of _ficus_ as Paulus. It is Haly Abbas’ second species of _tinea_, and is described by him as consisting of hard round protuberances. Haly’s fourth species of _tinea_ consists of small ulcers of a mammiform appearance. They are mentioned by our author. Fabricius ab Aquapendente defines the ficus thus: “Tumeur qui est rouge, ronde, quelque peu dure, et de laquelle (etant ulcérée et pressée) sort une matière sanieuse, semblable aux grains de figues.” (Œuv. Chir. i, 1, 13.) He says that Hippocrates and Galen give a different account of it from our author’s; but we can see very little difference between them. Most of the ancient authors recommend the same remedies for ficus as Paulus. The most active of these are stavesacre, and sandarach or red sulphuret of arsenic. They do not appear to have apprehended danger from the free use of arsenic in this way. Galen recommends equal parts of white hellebore, stavesacre, and nitre with oil. (De Med. Sec. Loc. i.) Octavius Horatianus mentions equal parts of pellitory and galls. The same medicines are recommended by Serapion, (i, 5.) See also Oribasius (de Loc. Affect. iv, 11); Celsus (xi, 3); Cælius Aurelianus (de Morb. Tard. iv, 2.) Haly’s remedies consist of galls, litharge, mercury _killed_ (sublimed?), sulphur, and so forth. Among those of Rhases we remark squills, assafœtida, quicklime, mercury, &c. However, he prefers excision. (Continens. xxxvi).

For pediculi in the head, the Arabians recommend nearly the same compositions as our author. They contain arsenic, stavesacre, hellebore, nitre, and the like. See Alsaharavius (Pract. i, 16), and Phases (Cont. xxxvi, 6.) Among the ingredients mentioned by the latter, we remark quicksilver, sulphur, red arsenic, mustard, stavesacre, the oil of oleander, vinegar, &c. These medicines form the ingredients in the compositions recommended by modern writers on this complaint. See Plempius (de Morbis Pilorum), and Amatus Lusitanus (Curat. 58.)

SECT. IV.—ON HEADACH.

Headach, which is one of the most serious complaints, is sometimes occasioned by an intemperament solely; sometimes by a redundance of humours, and sometimes by both; and sometimes it is occasioned by a procatarctic cause, such as external heat, or cold, or drunkenness, or a blow. The most vehement pains of the head are excited by the active qualities, particularly heat. Those occasioned by dryness are not equally vehement; but a humid quality excites no pain of itself, unless it happens to be joined to heat, cold, or a fulness of humours. Headachs occurring in a fever having been treated of in the preceding Book on Fevers, we will now treat of the others.

_On headach from heat._ When headach proceeds from exposure to heat, the skin feels hotter and drier than natural at the first application of the hand, and the eyes of such persons are red. They delight in cold affusions and ointments, and are benefited by them. The method of cure will correspond with that described as applicable for cases of headach in fevers. When the pain becomes chronic, we must have recourse to some of the under-mentioned applications. The following applications to the forehead and temples will also be proper, namely, bread soaked in oxycrate and rose-oil, to which may sometimes be joined almonds; or roses either dried or fresh, or mixed with mint and pennyroyal; or bread with the leaves of the peach tree. Benefit may also be derived from basil, pounded with vinegar and rose-oil; or from ivy berries boiled in vinegar, and pounded with rose-oil; or from wheaten flour mixed with the watery decoction of wild thyme; or from cardamom toasted and triturated in vinegar and rose-oil; or from leaven with rose-oil; or from dried iris with vinegar. These applications must be changed frequently; for if allowed to remain long, they have no effect.

_Trochisks for headach connected with a warm intemperament._ Of saffron, dr. v; of copperas, dr. x; of alum, dr. xvj; of myrrh, dr. vij; of the oil of unripe olives, dr. iij; of chalcitis, dr. iij; of gum, dr. iij; of austere wine, _q. s._ Use with oxycrate, and, if watchfulness accompany it, add some of the soporifics.

_On headachs from a cold intemperament._ In cases of headachs from coldness, the symptoms are just the reverse of those proceeding from heat; for the face is pale and not contracted, and the patients do not delight in cold things, nor are benefited by them. The diagnosis will also be confirmed by adverting to their diet, and the like. The ointments applied should contain rue, or the oil of bay, or of iris, or of nard, or the juice of balsam, more particularly if the excrementitious humours be thick and viscid. This must be rubbed into the forehead, and likewise preparations containing pepper and euphorbium. Also give thin wines and recommend exercise, hot baths, and occasionally an emetic from radishes. When the exciting cause is a chronic quality without plethora, use the following application: Of white pepper, dr. ij; of crocomagma, dr. ij; of fresh euphorbium, dr. viiiss; of pigeon’s dung, dr. iss; of the strongest vinegar, _q. s._ Having first rubbed the affected part, anoint with this.

_On headachs from a bilious humour._ The symptoms resemble those occasioned by heat, only there are more gnawing pains at the stomach, paleness of the countenance, and sometimes a bitter taste in the mouth. This affection occurs most frequently in adults who are of a hot temperament, lead an anxious life, and are subject to collections of yellow bile. They must use tepid baths, and mild ointments, with a watery drink; and their whole diet should be moistening, and consist of good juices. The bilious humours must be evacuated with the decoction of wormwood, or with aloes, or the antidote called hiera picra, either alone, or in combination with a little scammony, or the aloetic pills. The forehead is to be rubbed with the saffron trochisk, or with that called trigonos, or the like.

_On headach from sympathy._ If the head be affected sympathetically with the general system, this must be our first care, by attending to the intemperament and the prevailing matter. If it proceed from plethora, more especially a venous one, we will bleed; but, if it be only an offending quality, we will use a purgative medicine. If the head sympathise with some particular part, such as the liver, belly, or stomach, we must apply remedies to these organs. If a hot intemperament accompany, we give bread which has been steeped in a watery wine, or spoon-meats from chondrus. Moderately cooling and tonic applications are likewise to be used externally, as formerly described. But if the headach be occasioned by viscid and thick humours contained in the stomach, these must be dislodged by drinking oxymel, either alone or that preparation called the Julian. We must also use decoctions of hyssop and marjoram, and other things still hotter and more incisive, and likewise the emetic from radishes, hot embrocations, and cataplasms.

_On headach from wine._ If the wine remain undigested, we must procure vomiting, by drinking tepid water; but if the headach remain after digestion, we must use cooling and repellent applications, such as rose-oil alone and with vinegar, or the juice of ivy, or of cabbage. And the leaves of cabbage infused in warm water, and applied to and bound to the head, naturally counteract intoxication. They must also eat boiled cabbage. Dried lentil is also beneficial, particularly to those who have a loose belly. They ought likewise to eat alica, pomegranates, apples and pears, and drink water.

_On headach from a blow._ We must immediately bleed those who have headach from a blow (unless the injury be superficial), and use suitable embrocations to the head; bathe it with sweet oil; cover it with wool; and make the patients abstain from wine and a rich diet, more especially if they have fever; and, upon the whole, we are to accommodate our treatment as for the inflammation of nervous parts, and especially of the membranes of the brain. If there be a wound it must be treated accordingly.

_An emollient application for headach._ Of wax, dr. vij; of almond-oil, oz. iij; of turpentine, dr. viij; of scraped verdigris, of Cimolian earth, and of chalcitis, of each, dr. iv; of pumice-stone, dr. iij; of burnt copper and scales of steel (_squamæ stomomatis_), of each dr. ij; and, if appear to be too hard, soften it with almond-oil.

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COMMENTARY. By cephalalgia, as Aretæus remarks, is to be understood an acute pain of the head, and by cephalæa a chronic one. Our author does little more than abridge the contents of the second book of Galen’s work ‘De Med. sec. Loc.’, where this subject is treated of with unrivalled precision. See also Aretæus (de Morb. Chron. i, 2); Oribasius (de Loc. Affect. iv, 1); Celsus (iv, 2); Cælius Aurelianus (de Morb. Chron. i, 1); Octavius Horatianus, (ii, 1); Alexander (i, 10); Pseudo-Dioscorides (Euporist. i, 6); Actuarius (Meth. Med. vi, 2); Aëtius (vi, 40); Leo (Synops. ii, 1); Nonnus (10); Serapion (i, 6); Avicenna (iii, 1, 2); Avenzoar (i, 3); Mesue (de Ægr. Capitis, ii, 1); Haly Abbas (Theor. ix, 3, Pract. v); Alsaharavius (Pract. i, 2, 1); Rhases (ad Mansor. ix, 1, Contin. i, 21.)

In headach from heat, Galen and Alexander concur in condemning the use of poppies, hemlock, and mandragora, unless when compelled to have recourse to them by the continued watchfulness of the patient. Galen directs the application of snow to the head. Avenzoar recommends the affusion of cold liquids from a height upon the head. Serapion mentions oil cooled with ice. When the pain is obstinate, Rhases approves of opening the temporal artery. When the pain is violent, the author of the ‘Euporista’ recommends us to shave the head and bathe it with a decoction of narcotic vegetables. Galen expresses himself very clearly with regard to the sympathy between the head and the stomach, from nervous communication. (Loc. affect. iii, 9.)

For headachs arising from a hot or cold intemperament, Galen recommends the remedies called metasyncritica by the Methodists, for an account of which see Le Clerc. (Hist. de la Méd. ii, iv, 1, 3.) He says, “Ce que Thessalus appelloit metasyncrise etoit un changement qu’ il prétendoit faire dans tout le corps, ou dans quelque partie seulement.” Such rubefacients as mustard, thapsia, &c. belonged to this class. See also Prosper Alpinus (de Med. Method. iii, 15.) The term signifies “altering the system;” and, therefore, we have generally rendered it “alteratives” in the course of this translation. The treatment followed by Philagrius in the hot and fiery intemperament of the head deserves to be noticed. In a case of this description having used many other cooling remedies in vain, he says he shaved the head and applied snow to it, by which means he extinguished the intemperament. (Theophilus, Sch. in Hipp. t. ii, 457, ed. Dietz.) This practice is borrowed from Galen, as above.

Our author borrows his treatment of bilious headach from Galen and Alexander. To his judicious account of headach from wine or a blow, nothing need be added from any other author. Alexander justly remarks that, when it arises from the latter cause, it is very dangerous. He is fuller than our author in treating of headach from sympathy with the liver, for which he recommends local applications of a cooling nature and a generous diet. Similar treatment, he adds, is to be pursued when it arises from a hot intemperament of the stomach, bowels, or spleen.

According to Avicenna and Actuarius, frothy urine, that is to say, urine having bubbles on the surface, is characteristic of cephalalgia.

The Arabians generally treat of the disease by the name of _soda_.

Headach, says Haly Abbas, is either seated in the head, or arises from sympathy. When seated in the head, it either arises from an intemperament, or organic disease, or flatus, or a blow. One of the most common causes of sympathetic headach is the presence of bilious matters in the stomach, which case is generally relieved by vomiting. Protracted watchfulness induces headach, by occasioning a corruption of the food in the stomach; and protracted sleep in like manner fills the brain with vapours. Excessive evacuation, by producing a dry intemperament, proves a cause of headach. It is in this manner that epistaxis and menorrhagia occasion headach. Haly Abbas, like Galen, mentions as a cause of headach an excessive sensibility of the nerves which connect the brain and stomach. Haly further states that headach will arise from sympathy with the uterus, as after abortions, obstructions of the lochial or menstrual discharge, and the like causes. He remarks that violent headach will sometimes occasion loss of speech, owing to an affection of the nerve which is distributed upon the muscles of speech. His treatment, like our author’s, is varied according to the nature of the exciting causes; and his account of it is so full and judicious, that we regret our limits do not permit us to give a more ample detail of it. His remedies are, general bleeding, cupping the extremities or back part of the neck, anodyne or cold applications to the head, drastic or gentle purgatives, and so forth.

Alsaharavius treats the complaint upon similar principles. When it arises from heat, he recommends the affusion of tepid water over the head, and afterwards applies oils cooled in snow. When connected with bile, he directs the belly to be opened. When it is occasioned by a sanguineous plethora, he recommends general bleeding and the application of cupping-instruments to the nape of the neck.

Rhases, as usual, treats fully of _soda_ and all its varieties. When of an inflammatory nature, he recommends bleeding, purging, and the application of vinegar and rose-oil to the head. When connected with bile, he directs first vomiting by drinking tepid water, and then to take purgatives, and afterwards wormwood. When the disease is protracted, he approves of opening the temporal vessels, and of using sternutatories. When it arises from a blow, he recommends bleeding, and purging with colocynth, &c. He states that Ruffus recommended the affusion of cold water, or of oils congealed in snow, over the head. In obstinate cases, he directs the use of the actual cautery.

SECT. V.—ON CEPHALÆA AND HEMICRANIA.