Having mentioned the virtues of the simples, we are next to shew in what manner they are to be mixed, and what compositions are made from them. Now they are mixed variously, and there is no certain method for it, since of similar ingredients some are taken away, and others are added; and though the very same simples are all used, the proportion of their weights may be changed. And therefore though the number of medicinal simples be not so very great, there are innumerable kinds of mixtures; which it would be needless to enumerate, though it were possible: both because the same effects are found within the compass of a few compositions; and because it is easy for any person, who is acquainted with their virtues, to change them. I shall therefore confine myself to the most esteemed. Now in this book I shall give an account of those, which may either have been wanted in the preceding, or are employed in the cures, which I am to treat of, only throwing together these compositions, which are of more general use. Such as are accommodated to one particular disorder, or even to a few, I will insert in their proper places.

But before I proceed, I would have it understood, that in an ounce is contained the weight of seven denarii. Next, that I divide each denarius into six parts, that is sextantes, so that I have the same quantity in the sextans of a denarius, that the Greeks have in their obolus[ DM ]. That being reduced to our weights makes a little more than half a scruple.

Now malagmas, and plaisters, and troches, which the Greeks call trochischi[ DN ], though in many things they are the same, differ in this, that malagmas are chiefly made from flowers, and even their stalks, plaisters and troches are more generally composed of some metallic ingredients. Then malagmas being beat up are abundantly soft: for they are applied, where the skin is unbroken: but those things, of which plaisters and troches are made, are carefully powdered; lest they hurt wounds, when they are laid on. Betwixt a plaister and a troche there is this difference, that a plaister admits of something melted: in a troche there are only dry medicines united by some liquid. Again, a plaister is made in this manner: The dry medicines are powdered by themselves: when they are mixed, vinegar is dropped into them, or any other liquor belonging to the composition, that is not greasy; and they are again rubbed with that. Those things, that are capable of being melted, are melted altogether at the fire; and if any oil is to be in the mixture, it is then poured in. Sometimes too, some one of the dry ingredients is first boiled with oil. When these things are finished, which ought to be done separately, the whole is mixed together into one mass. But the way of making troches is this: The dry medicines being powdered are formed into one body with a liquor not greasy, such as wine or vinegar, and again after being brought to a consistence, grow dry: and when they are to be used, are diluted by a liquor of the same kind. There is also a difference in the manner of using these: for a plaister is simply applied, a troche is rubbed on, or else mixed with something softer than itself, or with cerate.

These particulars being premised, I shall first subjoin malagmas, which are commonly contrived not with an intention to cool, but to heat. There is one however, which is cooling, adapted to the hot gout in the feet. It contains of galls both unripe, and otherwise, of coriander-seed, hemlock, poppy-tears, gum, of each an acetabulum, of washed cerate, which the Greeks call peplumenon[ DO ], half a pound.

The other malagmas are mostly heating. But some of them discuss matter, others draw it out, which are called epispastica[ DP ]: most of them are adapted to particular parts of the body.

If matter(35) is to be drawn out, as in a dropsical case, pleurisy, a beginning abscess, and even a moderate suppuration, that is proper, which consists of dry resin, nitre, ammoniacum, galbanum, each p. *. wax, p. *. Or that, which contains rasile verdigrease, frankincense, each p. ii. *. Sal ammoniac p. vi. *. copper scales, wax, each p. viii. *. dry resin p. xii. *. and vinegar a cyathus. The same end is obtained by the meal of cummin-seed with struthium(36) and honey p. ii. *.

If the liver is pained, the proper malagma is that, which contains balsam-tears p. xii. *. costus, cinnamon, cassia bark, myrrh, saffron, round cyperus, balsam-seed, Illyrian iris, cardamom, amomum, nard, of each p. xvi. *. To these is added nard ointment(37), till it be of the consistence of cerate. And this must be used, while it is recent: but if it be to be kept for some time, turpentine resin p. xvi. *. wax p. x. *. must be beat up with mild wine, and mixed with it.

But if the spleen is pained, the bark of that acorn, which the Greeks call myrobalanus, and nitre are beat together in equal quantities, and are sprinkled over with the sharpest vinegar: when it comes to the consistence of cerate, it is spread upon a linen cloth first moistened in cold water, and thus applied, and over it is laid barley meal; but it ought not to lie there above six hours, lest it waste the spleen; and it is better to do it twice or thrice.

Lysias composed a malagma, at once calculated for the liver, and spleen, and for abscesses, and the scrophula, and parotid swellings, and the joints, and heels suppurating, or otherwise painful, likewise to assist the concoction of the stomach, of the following materials: opopanax, galbanum, resin, of each p. ii. *. ammoniacum, bdellium, wax, beef suet, dry iris p. iv. *. with an acetabulum of cachrys(38) and forty grains of pepper: which being powdered are brought to a proper consistence by iris ointment.

The composition of Apollophanes is calculated for pains of the sides. It consists of turpentine resin, soot of frankincense, each p. iv. *. bdellium, ammoniacum, iris, suet from the kidneys either of veal or a goat, viscum(39), each p. iv. *. Now this relieves all pains, mollifies what is hard, and is moderately heating.

The malagma of Andreas also has the same effect; it likewise relaxes, draws out humour, maturates pus, and when that is ripe, it breaks the skin, and brings it to cicatrize. It does good applied either to small or large abscesses; also to pained joints, hips, and feet: it restores too any part, that has been damaged by bruises; softens hard and inflated prÆcordia; extracts bones; and in fine is efficacious in every case, where heat can be of service. It contains wax p. xi. *. viscum, sycaminum (which others call sycamore) tears, each p. i. *. pepper both round and long, ammoniacum thymiama(40), bdellium, Illyrium iris, cardamom, xylobalsam, male frankincense, myrrh, dry resin, each p. x. *. pellitory, gnidian berries, aphronitre, sal ammoniac, root of Cretan birthwort, root of wild cucumber, liquid resin of turpentine, of each p. xx. *. to these is added a sufficient quantity of iris ointment to soften and reduce them to a proper consistence.

The principal composition for relaxing what is bound, softening what is hard, and discussing any collection, is that, which is ascribed to Polyarchus. It contains of long cyperus, cardamom, soot of frankincense, amomum, wax, liquid resin, equal parts.

There is another by Nileus for the same purposes: of crocomagma(41), which is, as it were, the refuse of saffron p. iv. *. ammoniacum thymiama, wax, each p. xxx. *. the two first of these are rubbed down with vinegar, the wax is melted with oil of roses, and then the whole is mixed together.

The malagma, that passes under the name of Moschus, has only the property of softening what is hard. It contains of galbanum one ounce, soot of frankincense p. iii. *. wax, ammoniacum thymiama, each a triens, dry pitch p. ii. *. vinegar three heminae.

Medus’s malagma is used to discuss any collection. This contains wax p. iii. *. panaces 1/2 p. *. copper scales, round alum, scissile alum, of each p. i. *. calcined lead p. i. *. and 1/2.

Panthemus for the same intention made use of lime 1/2 p. *. mustard powdered, fenugreek, alum, each p. i. *. beef suet p. ii. *. and 1/2.

For the scrophula I find many malagmas. I believe indeed, that the more malignant that distemper is, and the more difficult to discuss, the greater number of remedies have been tried; which have succeeded variously in different persons. Andreas is the author of the following mixture: Nettle-seed p. i. *. round pepper, bdellium, galbanum, ammoniacum thymiama, dry resin, of each p. iv. *. liquid resin, wax, pellitory, long pepper, sea spurge-seed, crude sulphur, which is called apyron[ DQ ], equal parts.

Mico’s malagma is this: of dry lees, vinegar, aphronitre, sal ammoniac, mustard, cardamom, wild cucumber-root, resin, each p. iv. *. which are beat up with mild wine.

A more expeditious for the same purpose is that, which contains of viscum, cat’s dung, resin, crude sulphur, equal parts. And another, in which are of sulphur p. i. *. pyrites-stone p. iv. *. of cummin an acetabulum. Likewise that, which consists of one part of pyrites, two of sulphur, and three of turpentine resin.

There is a malagma of a certain Arabian for the scrophula, and rising tubercles, which are called phymata, which discusses them. It contains myrrh, sal ammoniac, frankincense, resin both liquid and dry, crocomagma, wax, of each p. i. *. the pyrites-stone p. iv. *. to which some add sulphur p. ii. *.

There is another of service in the scrophula, and in those tubercles, which are with difficulty brought to maturate; and in those, that are called carcinodea[ DR ], which consists of these things: sulphur p. ii. *. nitre p. iv. *. myrrh p. vi. *. soot frankincense 1/2 p. *. sal ammoniac p. iii. *. wax p. i. *.

Protarchus for parotid swellings, and those tubercles, which are called melicerides[ DS ], that is, honey-combs, or phymata, and for malignant ulcers, made this mixture: of pumice, liquid pine resin, soot of frankincense, aphronitre, iris, each p. viii. *. with wax p. ix. *. and to these he added a cyathus and half of oil.

But against the panus upon its first appearance, which the Greeks call phygethlon[ DT ], and any tubercle, which is called phyma, a mixture is made of attic ochre, with two parts of flour, and to these, while they are beat up, honey is now and then dropped in, till it acquire the consistence of a malagma.

That also discusses all the tubercles, that have the name of phyma, which contains of lime, aphronitre, round pepper, each p. i. *. galbanum p. ii. *. salt p. iv. *. which are incorporated with cerate made of rose-oil.

That malagma suppresses all beginning abscesses, which is composed of galbanum, bruised beans, each p. i. *. myrrh, frankincense, bark of caper-root, each p. iv. *. And the murex burnt, and reduced to a fine powder, dropping in now and then a little vinegar, powerfully discusses all beginning abscesses.

But if in such tumours, too great a quantity of blood is extravasated, it is proper to use an application, which is also efficacious against tubercles. It has the following ingredients: bdellium, storax, ammoniacum, galbanum, pine resin both dry and liquid. Also mastich, frankincense, iris, of each p. ii. *.

Cancers and tubercles are in a good measure eased by this composition: galbanum, viscum, ammoniacum, turpentine resin, each p. i. *. beef suet 1/2 p. *. burned lees as great a proportion as may be, without making it drier than a malagma ought to be.

But if there be a contusion in the face and a livor from an extravasation of blood, the following composition, applied night and day, removes it. Birthwort, thapsia(42), of each p. ii. *. bdellium, storax, ammoniacum thymiama, galbanum, dry resin, and liquid, resin of the mastich-tree, male frankincense, Illyrian iris, wax, of each p. iv. *. The application of a bean also will do good in the same case.

There are also some malagmas, which by the Greeks are called anastomotica[ DU ], because they have the power of opening. Such is that, which is composed of the following things: long pepper, aphronitre, of each p. ii. *. hedge mustard p. iv. *. which are mixed with honey: they are also proper for opening scrophulous tumours. Of the same kind with this, but stronger, is that, which contains lime p. iv. *. pepper six grains, nitre, wax, of each p. x. *. honey p. iii. *. and a hemina of oil.

There is one of Mico’s, which is relaxing, opening, and cleansing. It contains of bastard sponge, sulphur, nitre, pumice, equal parts; to these is added of pitch and wax a sufficient quantity to make it the consistence of cerate.

Aristogenes’s malagma for the bones consists of these ingredients: of sulphur p. i. *. turpentine resin, aphronitre, and the pulp of a squil, washed lead(43), each p. ii. *. soot of frankincense p. viii. *. the mellowest dry figs, beef suet, each p. viii. *. wax p. xii. *. Macedonian iris p. vi. *. sesamum toasted and acetabulum. And this malagma is very agreeable to the nerves and joints.

That, which was invented by Euthycleus, is proper for the joints, and for all pains, particularly in the bladder, and any contraction of the joints from a recent cicatrix, which the Greeks call anchyla[ DV ]. It contains soot of frankincense an acetabulum, the same quantity of resin, galbanum without its stalks an ounce and half, ammoniacum, bdellium, of each p. *. wax 1/2 p. *——There is also another, which consists of iris, ammoniacum, galbanum, nitre, each p. xiv. *. liquid resin p. vi. *. wax p. xvi. *.

Sosagoras’s malagma for pains of the joints: of calcined lead, poppy-tears, bark of henbane, storax, hog’s fennel, suet, resin, and wax, equal parts.

Chrysippus also composed one: of liquid resin, sandarach, pepper, each p. xii. * to these a little wax is added.

Ctesiphon’s: of Cretan wax, turpentine resin, the reddest nitre, each 1/2 p. *. three cyathi of oil. But the nitre is first rubbed for three days with water dropped in upon it, and boiled with a sextarius of it, till all the moisture be consumed.——This composition is also good for parotids, tubercles, and the scrophula, and for softening every collection of humour.

To the joints one may properly apply a part of a dry fig mixed with cat-mint; or staveacre without the seeds, with penny-royal.

The same composition is useful for the gout in the foot. But for that ailment Ariston has also composed one, containing of nard, cinnamon, cassia, chamaeleon, round cyperus, each p. viii. *. goat’s suet melted in iris ointment p. xx. *. iris p. i. *. which ought to lie in the strongest vinegar for twenty days. The same also discusses recent tubercles, and all pains.

But for pains of the feet Theoxenus mixed, of kidney suet a third part, of salt two parts, and applied them spread upon a piece of leather; then put over it ammoniacum thymiama dissolved in vinegar.

But Numenius mollified the gout in the feet, and other indurated joints with the following composition: southernwood, dry roses, poppy-tears, of each p. iii. *. turpentine resin p. iv. *. frankincense, aphronitre, each p. viii. * iris, birthwort, each p. xii. *. wax p. iii. * to these is added one cyathus of cedria(44), three cyathi of laurel oil(45), and a sextarius of bitter oil.

For a callus formed upon the joints, Dexius directed the following application: of lime, p. iv. *. ceruss, p. viii. *. pine resin xx. *. pepper thirty grains, wax p. ii. *. And while these are beat up a hemina of mild wine is poured in.

Of plaisters there are none more useful, than those, which are immediately applied to bloody wounds; the Greeks call them enaima[ DW ]. For these repel an inflammation, unless it be excited by something very violent, and even then they diminish its force, and agglutinate wounds, which are not inflamed, and cicatrize them. They consist of medicines not fat, and therefore by the Greeks are called alipaina[ DX ].

The best of these plaisters is that, which is called barbarum. It contains of rasile verdigrease(46) p. xii. *. litharge p. xx. *. alum, dry pitch, dry pine resin, each p. i. *. to which is added of oil and vinegar each a hemina.

There is another for the same, which is called choacon; it contains of litharge p. x. *. dry resin as much. But the litharge is first boiled in three heminÆ of oil. The colour of both these plaisters is black, which generally results from pitch and resin, as the blackest is from bitumen; from verdigrease, or scales of copper, green; from minium, red; from ceruss, white.

There are a very few compositions, in which the variety of the mixture causes some different appearance; therefore that also is black, which is called basilicon. It contains of opopanax p. i. *. galbanum p. ii. *. pitch and resin, of each p. x. *. half a cyathus of oil.

But that, which is very green, is called smaragdine, in which there are of pine resin. p. iii. *. wax p. i. *. verdigrease 1/2 p. *. flour of frankincense p. ii. *. as much oil and vinegar, with which last the flour and verdigrease are united.

There is also one of a reddish colour, which seems to bring wounds to cicatrize quickly: it consists of frankincense p. i. *. resin p. ii. *. copper scales p. iii. *. litharge p. xx. *. wax p. c. *. of oil a hemina.

Besides, there is another, which from agglutinating is called paracolleticon[ DY ] It contains bitumen, scissile alum, p. iv. *. litharge p. iv. *. and a hemina of old oil.

Besides these there are some of the same kind, which, because they are particularly adapted to fractures of the skull, are by the Greeks called cephalica[ DZ ]. Philotas’s composition contains of Eretrian earth, chalcitis, each p. iv. *. myrrh, calcined copper, each p. x. *. isinglass p. vi. *. rasile verdigrease, round alum, crude misy, birthwort, each p. viii. *. copper scales p. xx. *. male frankincense p. ii. *. wax p. i. *. rose and bitter oil three cyathi, and a sufficient quantity of vinegar for rubbing down all the dry ingredients.

There is another for the same purpose green; which consists of calcined copper, copper scales, myrrh, isinglass, each p. vi. *. crude misy, rasile verdigrease, birthwort, round alum, each p. viii. *. wax p. vi. *. a hemina of oil, and of vinegar a sufficient quantity.

For promoting a suppuration there is nothing better than that, which is very quickly prepared, and by the Greeks is called tetrapharmacum[ EA ]. It contains equal parts of wax, pitch, resin, and beef suet; if the last cannot be had, veal suet.

There is another for the same intention, which is called ennea pharmacum[ EB ], which cleanses more; it consists of nine ingredients, wax, honey, suet, resin, myrrh, rose oil, marrow either of a deer or calf, or beef, or oesypum(47), and butter. These also are mixed in equal quantities.

But there are some plaisters, that answer both these intentions at once; which, unless the case requires distinct applications for each, are preferable; otherwise they are worse, and never to be made use of, but either when both intentions are proposed together, or when, though the plaisters are wanted singly, they are not to be had by themselves. But where there is choice, they are to be rejected, and such only applied as are peculiarly suited to the end to be obtained. For example I will mention two.

There is then the Attalum plaister for wounds: which contains of copper scales p. vii. *. soot of frankincense p. xv. *. ammoniacum as much, liquid turpentine resin p. xxv. *. beef suet the same quantity, three heminÆ of vinegar, a sextarius of oil.

But amongst those, which are proper for a fractured skull, some use that, which is said to be invented by JudÆus. It consists of the following ingredients: salt p. iv. *. red copper scales, calcined copper, each p. xii. *. ammoniacum thymiama, soot of frankincense, dry resin, each p. vi. *. Colophonian resin, wax, veal suet cured, each p. xx. *. a cyathus and half of vinegar is added, and less than a cyathus of oil. What the Greeks call tetherapeumena[ EC ], we call curata, cured; when for instance from the suet all the little membranes are carefully taken away, and so in any other medicine.

There are also some plaisters greatly celebrated for drawing, which are likewise distinguished by the name of epispastica[ ED ]. Such as is that, which because bay-berries are among the ingredients, is called diadaphnidon[ EE ]. In it there is turpentine resin p. x. *. nitre, wax, dry pitch, bay-berries, each p. xx. *. and a little oil. Now as often as I shall mention a berry or a nut, or any thing of that nature, it will be proper to know, that before it be weighed, the exterior, pellicle is to be taken from it.

There is another of the same name, which is also for promoting a suppuration. Of veal suet, ammoniacum thymiama, pitch, wax, nitre, bay-berries, dry resin, birthwort, pellitory, of each equal parts.

Besides these there is one of Philocrates: which contains sal ammoniac p. vii. *. birthwort p. viii. *. wax, turpentine resin, soot of frankincense, each p. xv. *. litharge p. xxxii. *. To these, that it may serve also for promoting a suppuration, are added iris p. iii. *. galbanum p. vi. *.

However that is best for drawing, which from its resemblance to sordes, the Greeks call rhypodes[ EF ]. It contains myrrh, saffron, iris, propolis, bdellium, the heads of pomegranates, scissile and round alum, misy, chalcitis, boiled copperas(48), opopanax, sal ammoniac, viscum, each p. iv. *. birthwort p. viii. *. copper scales p. xvi. *. turpentine resin p. lxxv. *. wax, and suet, either beef or goat’s, each p. c. *.

HecatÆus also is the author of a plaister of the same kind, which is thus composed: galbanum p. ii. *. soot of frankincense p. iv. *. pitch p. v. *. wax and turpentine resin, each p. viii. *. with these a little iris ointment is mixed.

The green Alexandrian drawing plaister is efficacious for the same purpose. It contains scissile alum p. viii. *. sal ammoniac p. vii. *. copper scales p. xvi. *. myrrh, frankincense, each p. xviii. *. wax p. cl. *. colophonian or pine resin p. cxc. *. a hemina of oil, and a sextarius of vinegar.

Some plaisters are eating, which the Greeks call septica[ EG ], such as is that, which contains turpentine resin, soot of frankincense, of each p. ii. *. copper scales p. i. *. labdanum p. ii. * the same quantity of alum, litharge p. iv. *.

This plaister also eats away flesh vehemently, and even dissolves the bones, and keeps down fungous flesh. It contains litharge, copper scales, of each an ounce; nitre that has not felt the fire, Asian stone, birthwort, of each a sextans, wax, turpentine resin, frankincense, old oil, copperas, sal ammoniac, 1/2 p. rasile verdigrease p. bessis, of squill vinegar a hemina, and a like quantity of AminÆan wine.

There are also some calculated against bites; such as the black one of Diogenes: which contains of bitumen, wax, dry pine resin, each p. xx. *. litharge p. c. *. of oil a sextarius. Or that, which consists of copper scales p. iv. *. ceruss and rasile verdigrease each p. viii. *. ammoniacum p. xii. *. wax, pine resin, each p. xxv. *. litharge p. c. *. of oil a sextarius. Or that, which is composed of copper scales p. xiv. *. galbanum p. vi. *. ceruss and rasile verdigrease, each p. viii. *. ammoniacum p. xii. *. wax, pine resin, of each p. lv. *. with these the litharge is boiled.

There is a red plaister of the same virtues, which is called Ephesian. It contains turpentine resin p. ii. *. galbanum p. iv. *. Sinopian minium p, vi. *. soot of frankincense p. vi. *. wax p. viii. *. litharge, p. lvi. *. old oil a hemina.

Likewise that which consists of the following materials; copper scales, soot of frankincense, of each p. iv *. galbanum p. vi. *. sal ammoniac p. xii. z. *. wax p. xxv. *. with three heminÆ of oil. These also are proper applications for other recent wounds.

There are also white lenient plaisters, by the Greeks, from their colour, called leuca[ EH ], generally calculated for slight wounds, and especially those of old men: such as is that, which contains of ceruss p. lii. *. veal suet cured and wax, each p. lviii. *. three heminÆ of oil, with which the ceruss is boiled up.

Another, which consists of ceruss p. xx. *. wax p. lv. *. a hemina of oil, and a sextarius of water. Now as often as these are added, to ceruss or litharge, we may take it for granted, that they are to be boiled with them. This last composition is very white, and therefore it is called elephantine.

There are also some lenient plaisters, which the Greeks commonly call lipara[ EI ], as that which contains minium p. iv.*. litharge, p. xxv. *. wax and hog’s lard, each p. xxxv. *. and the yolks of four eggs.

Another composition of the same kind: wax, turpentine resin, of each p. v. *. ceruss p. viii. *. litharge, dross of lead (scoria molybdi the Greeks call it) each p. x. *. cicine(49) and myrtle oil, each the third part of a hemina.

Another, which is said to be invented by Archagathus: burnt misy, calcined copper, each p. iv. *. burnt(50) ceruss p. viii. *. turpentine resin p. x. *. litharge p. vi. *.

For the same purpose: litharge, wax, hog’s lard, of each p. xxvii. *. boiled yolks of eggs, with a hemina of rose oil. Or this composition: cerate made of myrtle oil three parts, hog’s lard a fourth part, a little lead dross. Or the following composition; of litharge half a pound boiled with a hemina of oil, and a like quantity of sea water, till it cease to bubble, with the addition of a little wax. Or this: equal parts of wax, suet, antimony, litharge, and ceruss.

Troches also have different virtues. For there are some adapted to agglutinate and heal recent wounds: such is that, which contains chalcitis, misy, aphro-nitre, flower of copper, galls, scissile alum moderately burnt, of each p. i. *. calcined copper, the heads of pomegranates, each p. iii. *. This should be diluted with vinegar, and so laid on, when a wound is to be agglutinated. But if it be a nervous or muscular part, it is better to mix it with cerate, so as to have a ninth part of the latter with eight of the other.

Another for the same purpose. It consists of the following materials: bitumen, scissile alum, of each p. i. *. calcined copper p. iv. *. litharge p. xi. *. and a sextarius of oil.

But that of Polybus(51) is by far the most celebrated: it is called sphragis[ EJ ]. Which contains of scissile alum p. iv. *. copperas p. ii. *. myrrh p. v. *. aloes a like quantity; the heads of pomegranates, ox gall, each p. vi. *. which being rubbed together, are incorporated with austere wine.

For foul ulcers, and blackness in the ears, nose, obscene parts, and inflammation in any of these places: of chrysocolla p. i. *. copperas, scissile alum, each p. ii. *. bark of winter cherry p. iv. *. minium p. vi. *. litharge p. xii. *. ceruss p. xvi. *. these are compounded with vinegar, and diluted when used.

Andro’s is for an inflamed uvula, for foulness in the obscene parts, or gangrenes in the same; of galls, copperas, myrrh, each p. i. *. birthwort, scissile alum, each p. ii. *. heads of pomegranates p. xxv. *. compounded with passum, and when they are to be used, diluted with vinegar or wine, according as the disorder, which is to be cured, is more or less violent.

For fissures in the anus, or an effusion of blood from the hÆmorrhoidal veins, or a gangrene, the following is of peculiar efficacy; of verdigrease p. ii. *. myrrh p. iv. *. gum p. viii. *. frankincense p. xii. *. antimony, poppy tears, acacia, each p. xvi. *. which are both rubbed down with wine, and when used, diluted with the same liquor.

This composition seems proper to expel a stone out of the bladder along with the urine: equal parts of cassia, saffron, myrrh, costus, nard, cinnamon, liquorice root, balsam, hypericum are powdered; then mild wine is dropped in, and the troches are formed. Each may contain p. i. *. and one of these may be swallowed every day in the morning fasting.

These three kinds of compositions, that is, malagmas, plaisters, and troches, are extensive and various in their uses. But there are other things also useful: as those, which are applied below to females: the Greeks call them pessi[ EK ]. The manner of them is this: the composition is received in soft wool, and this wool put into the vagina.

For evacuating blood, to two of the small kind of figs called cauneÆ(52) is added nitre p. i. *. Or the seed of garlick is powdered, and a little myrrh added and mixed with susine ointment(53). Or the pulp of a wild cucumber is diluted in woman’s milk.

To soften the womb, the yolk of an egg, and fenugreek, and rose oil, and saffron are mixed together. Or of elaterium p. iii. *. as much salt, and stavesacre p. vi. *. are incorporated with honey.

There is another invented by Boethus, which contains saffron, turpentine resin, each p. iv. *. myrrh p. iii. *. rose oil p. i. *. veal suet p. iii. *. wax p. ii. *. mixed together.

The best composition against an inflammation of the womb, is that of Numenius, which contains saffron p. iii. *. wax p. i. *. butter p. viii. *. goose fat p. xii. *. two boiled yolks of eggs, with less than a cyathus of rose oil.

If a foetus has died within the womb, that it may be the more easily expelled, the bark of pomegranates must be rubbed down with water, and then made use of.

If a woman from an hysterick disorder is subject to fits, snails together with their shells must be burnt and powdered, and then honey added to them.

If a woman does not conceive(54), lions fat must be softened with rose oil.

There are some mixtures of medicines made use of dry without being brought to any consistence, which we sprinkle on, or mix with some liquid, and lay them on. Such as that for eating down fungous flesh, which contains of copper scales, soot of frankincense, each p. i. *. verdigrease p. ii. *. Now this same composition with honey cleanses ulcers; and with wax fills them up. Also, if misy, galls, and cadmia be mixed in equal proportions, they consume the flesh; and these may either be sprinkled on dry(55), or brought to a consistence and spread on.

Honey mixed either with lentils, or with horehound, or with olive leaves first boiled in wine, restrains putrid flesh, and does not suffer it to spread, and is gently corrosive. Also mellilot boiled in mulse, and then rubbed small. Or lime with cerate. Or bitter almonds with a third part of their quantity of garlick, and a little saffron added to them. Or that, which contains litharge p. vi. *. burnt ox horn p. xii. *. myrtle oil and wine, each three cyathi. Or that, which consists of the following things: the flowers of pomegranate, copperas, aloes, of each p. ii. *. scissile allum, frankincense, each p. iv. *. galls p. viii. *. birthwort p. x. *. The following is stronger, and even caustic; orpiment with chalcitis, and either nitre, or lime, or burnt paper. Also salt with vinegar. Or that composition, which contains chalcitis, pomegranate tops, aloes of each p. ii. *. scissile alum, frankincense, each p. iv. *. galls p. viii. *. birthwort p. x. *. and a sufficient quantity of honey to bring them to a proper consistence. Or cantharides, sulphur, of each p. i. *. darnel p. iii. *. with the addition of as much liquid pitch as will keep them together. Or even chalcitis mixed with resin and rue: or diphryges with the same resin; or stavesacre with liquid pitch. There is the same property in burnt lees of wine, and equal parts of lime and nitre. Or scissile alum p. i. *. frankincense, sandarach, nitre, each p. i. *. galls p. viii. *. birthwort p. x. *. and a sufficient quantity of honey.

There is also a composition of Hera’s, which contains myrrh, chalcitis of each p. ii. *. aloes, frankincense, scissile alum, each p. iv. *. birthwort, unripe galls, each p. viii.*. pomegranate bark powdered p. xx. *.

There is likewise one by JudÆus: in which are two parts of lime, and a third of the reddest nitre; which are mixed with the urine of a young boy, till they be of the consistence of strigment. But the part, upon which this is spread, must be moistened now and then.

But Jollas mixed of burnt paper, sandarach, each p. i. *. lime p. ii. *. and the same quantity of orpiment.

But if there is blood discharged from that membrane, which covers the brain, the yolk of an egg ought to be burnt, powdered, and sprinkled upon it. If the hÆmorrhage is from any other part, orpiment, copper scales, of each p. i. *. sandarach p. ii. *. burnt marble(56) p. iv. *. ought to be sprinkled on. The same things also resist a gangrene. To bring on a cicatrix, copper scales, soot of frankincense, of each p. ii. *. lime p. iv. *. p. The same mixture also keeps down fungous flesh.

TimÆus made use of the following composition for the ignis sacer(57) and a gangrene; of myrrh p. ii. *. frankincense, copperas, each p. iii. *. sandarach, orpiment, copper scales, each p. iv. *. galls p. vi. *. burnt ceruss p. viii. *. These have the same effect whether sprinkled on dry, or mixed with honey.

Sneezings are excited by putting into the nose either white hellebore, or struthium. Or this mixture: of pepper, white hellebore each p. iii. *. castor p. i. *. aphronitre p. ii. *. struthium p. iii. *.

Gargarisms are used either to alleviate, or to repel, or to evacuate. Milk cream of ptisan, or bran, are lenients. A decoction either of lentils, or roses, or brambles, or quinces, or dates, are repellent. Mustard and pepper are evacuants.

Antidotes, though seldom wanted, are sometimes extremely necessary, because they relieve in the most dangerous cases. They are properly exhibited, when bodies are bruised either by blows, or by falling from a height, or in pains of the bowels, sides, fauces, and more internal parts. But their principal use is against poisons either injected into our bodies by bites, or received with meat or drink.

There is one, which contains poppy tears p. *. z. acorum, malobathrum(58) p. v. *. Illyrian iris, gum, of each p. ii. *. anise p. iii. *. Gallican nard, dry rose leaves, cardamom, each p. iv. *. parsley p. *. iii. z. trefoil p. v. *. black cassia(59), silis, bdellium, balsam fruit, white poppy seed, each p. *. z. storax p. *. v. z. myrrh, opopanax, Syrian nard, male frankincense, juice of hypocistis, each p. vi. *. castor p. vi. *. costus, white pepper, galbanum, turpentine resin, saffron, flower of round cyperus, each p. vi. *. z. liquorice p. viii. *. z. these are incorporated with honey or passum.

Another antidote, which Zopyrus is said to have compounded for king Ptolemy, and called it ambrosia, consists of the following things: costus, male frankincense, of each p. v. *. white pepper p. *. z. flower of round cyperus p. ii. *. cinnamon p. iii. *. black cassia p. iv. *. Cilician saffron p. *. iv. z. the myrrh called stacte(60) p. v. *. Indian nard p. *. v. z. which being powdered separately, are incorporated with boiled honey: then when it is used, the bigness of an Egyptian bean must be diluted in a draught of wine.

But the most celebrated is that of Mithridates: by taking which every day, this king is said to have rendered his body secure against the danger or poisons. It contains the following things: of costus p. *. z. acorus p. v. *. hystericum, cummin, sagapenum, juice of acacia, Illyrian iris, cardamom, each p. ii. * anise p. iii. * Gallican nard, gentian-root, dry rose leaves, each p. iv. *. poppy tears, parsley, each p. *. iv. z. cassia, siler, darnel, long pepper, each p. vi. *. storax p. *. v. z. castor, frankincense, juice of hypocistis, myrrh, opopanax, each p. vi. *. malobathrum leaves p. vi. *. flower of round cyperus, turpentine resin, galbanum, seed of Cretan carrot, each p. *. v. z. nard, opobalsam, each p. *. vi. z. treacle mustard p. *. vi. pontic root(61) p. vii. *. saffron, ginger, cinnamon, each p. *. viii. These are powdered and mixed with honey, and against poison the bigness of a sweet almond is given in wine. In other disorders of the body, according to their violence, either the bigness of an Egyptian bean, or a vetch, will be sufficient.

Acopa(62) are useful to the nerves. Such is that, which contains flower of round cyperus p. *. ii. z. z. costus, long cyperus, bay berries, ammoniacum, cardamom, each p. *. iv. z. myrrh, calcined copper, each p. vii. *. Illyrian iris, wax, each p. iv. *. Alexandrian reed, round cyperus, calambac wood, xylo-balsam, each p. xviii. *. suet p. i. *. iris ointment a cyathus.

There is another, which they call elÆodes[ EL ]; it is made in this manner: of wax p. *. z. oil a like quantity, and of turpentine resin the bulk of a walnut; these are boiled together: then being poured into a mortar, are rubbed, and an acetabulum of the best honey is gradually dropped into it, then three cyathi of iris ointment and of rose oil.

The Greeks call liquids, that are daubed on, by the name of enchrista[ EM ]. Such as is that for cleansing and incarning ulcers, especially amongst nerves. It consists of a mixture of equal parts of butter, veal marrow, veal suet, goose fat, wax, honey, turpentine resin, rose and cicine oil. These are all melted separately, then mixed while they are liquid, and afterwards rubbed together. And this composition is indeed more cleansing: but it would be more emollient, if instead of the rose oil, that of cyprus be infused.

For the ignis sacer: of litharge p. vi. *. ox-horn burnt p. ii. *. these are beat up together, and there is added alternately wine, and myrtle wine, till three cyathi of each be used.

There are catapotia of various kinds, and composed for different intentions. They call those anodyna[ EN ], which mitigate pain by sleep: which it is not fit to use, unless there be a very great necessity. For they consist of medicines strong and ungrateful to the stomach. Yet that even promotes concoction, which contains poppy tears, galbanum, of each p. i. *. myrrh, castor, pepper, each p. ii. Of these it is sufficient to swallow the bigness of a vetch.

Another, which is more powerful to promote sleep, but worse for the stomach, consists of the following ingredients. Of mandrake p. *. z. seeds of smallage and henbane, each p. iv. *. which are rubbed down with wine. The same quantity of this, as was directed of the other, is a plentiful dose.

If there be pains of the head, or ulcers, or a lippitude, or tooth-ach, or difficulty of breathing, or pains of the intestines, or inflammation of the womb, or the hip, or a pain in the liver, spleen, or side, or if a woman falls into hysterick fits, and loses her speech, a catapotium of the following kind removes the pain by sleep. Sil(63), acorum, seed of wild rue, each p. ii. *. castor, cinnamon, each p. ii. *. poppy-tears, root of panaces, dry mandrake fruit, flower of round cyperus, of each p. ii. *. pepper lvi. grains. These being powdered separately, are again all rubbed together, dropping in now and then passum, till they acquire the consistence of sordes. A little of this is either swallowed, or diluted in water, and given to drink.

Moreover a handful of wild poppy, when it is just ripe for gathering the tear, is put into a vessel, and upon it is infused a sufficient quantity of water to cover it, and thus it is boiled. When this handful has been well boiled, let it be squeezed and thrown away; and with the liquor let an equal quantity of passum be mixed, and let them boil together, till it be as thick as sordes. When it has cooled, it is made into catapotia of the bigness of our bean, which have an extensive use. For they both procure sleep, either taken alone, or given in water, and with the addition of a little juice of rue and passum mitigate ear-aches: and dissolved in wine they stop a dysentery: and mixed with cerate made of rose oil, to which a little saffron is added, they restrain an inflammation of the womb. And spread upon the forehead with water, they stop the flux of gum to the eyes.

Again, if a pain of the womb prevent sleep, a mixture is made of saffron p. ii. *. anise, myrrh, each p. i. *. poppy tears p. iv. *. hemlock seed p. viii. *. and these incorporated with old wine, and the bigness of a lupin is diluted with three cyathi of water. But this is dangerous to give in a fever.

For healing the liver, of nitre p. *. z. saffron, myrrh, Gallican nard, each p. i. *. are mixed with honey, and the bigness of an Egyptian bean serves for a dose.

For removing pains of the sides, equal parts of pepper, birthwort, nard, and myrrh are mixed together.

For pains of the thorax, of nard p. i. *. frankincense, cassia, each p. iii. *. myrrh, cinnamon, each p. vi. *. saffron p. viii. turpentine resin a quadrans, honey three heminÆ.

For a cough is that of Athenio: of myrrh, pepper, each p. i. *. castor, poppy tears, each p. i. *. which are bruised separately, and afterwards mixed, and two catapotia of the bulk of our bean are given in the morning, and two, when the patient is going to sleep at night.

But if a cough prevents sleep, that of Heraclides the Tarentine is calculated for both disorders: of saffron p. i. *. cinnamon, castor, poppy tears, each p. i. *. myrrh, long pepper, costus, galbanum, each p. *. z.

But if ulcers in the fauces of patients labouring under a cough require to be cleansed, of panaces, myrrh, turpentine resin, each p. v. *. galbanum p. *. z. hyssop p. *. z. are to be rubbed together, and to these a hemina of honey is added, and as much as can be taken upon the finger must be swallowed.

The colice of Cassius consists of the following ingredients: of saffron, anise, castor, each p. iii. *. parsley p. iv. *. pepper both long and round, each p. v. *. poppy-tears, round cyperus, myrrh, nard, each p. vi. *. which are incorporated with honey. And this may be both swallowed alone, and taken in warm water.

A draught of water mixed with sal ammoniac p. i. *. or dittany of Crete p. i. *. expels a dead foetus or the secundines.

To women in labour hedge mustard ought to be given in tepid wine, when they are fasting.

The voice is assisted by p. i. *. of frankincense given in two cyathi of wine.

Against a difficulty of urine: of long pepper, castor, myrrh, galbanum, poppy tears, saffron, costus, each one ounce, storax, turpentine resin, of each a sextans, wormwood, honey, a cyathus. Of these the bigness of an Egyptian bean ought to be given in the morning, and after supper.

Arteriace is made in this manner: of cassia, iris, cinnamon, nard, myrrh, frankincense, each p. i. *. saffron, p. i. *. pepper thirty grains, are boiled in three sextarii of passum, till they acquire the consistence of honey. Or saffron, myrrh, frankincense, of each p. i. *. are mixed with the same quantity of passum, and boiled in the same manner. Or three heminÆ of the same passum are boiled, till a drop of it grows hard; and p. i. *. of powdered cassia is added to it.

Having explained the virtues of medicines, I shall next consider five different kinds of disorders, to which the body is incident. When it is hurt externally, as in wounds. When any part is corrupted internally, as in a gangrene. When any thing grows within some part, as the stone in the bladder. When any part is preternaturally enlarged, as a vein, which swelling is called a varix. Lastly, when somewhat is deficient, or maimed. In some of these medicines, in others manual operations are most useful. Deferring the consideration of the disorders, which chiefly require manual operations, I shall now treat of such, as stand mostly in need of medicines. And I shall divide this part of medicine in the same manner as the former, and first speak of those, which may happen in any part of the body; next of these, which attack certain parts. I shall begin with wounds.

Now a physician should above all things know, what are incurable, what difficult to cure, and what more easy. For it is the part of a prudent man first, not to undertake one, whose case is desperate, lest he appear to have killed him, whom his own destiny has destroyed. Next, in a case of great danger, but not quite desperate, to discover to the friends of the patient, that it is a matter of difficulty: that if the malady should prevail against the art, he may neither seem to have been ignorant himself, nor to have deceived them. But as this is the proper conduct for a prudent person, so on the contrary it is the part of a quack to exaggerate a small matter, that he may appear to have performed the greater cure. Where a case is easy, it is reasonable that the physician by a free declaration of its easiness be obliged to the greater diligence and circumspection; that what is in itself small may not by his negligence become more considerable.

A person cannot be preserved, when the basis of the brain, or the heart, or the gullet, or the portÆ of the liver, or the spinal marrow is wounded; or when the middle of the lungs, or the jejunum, or smaller intestine, or stomach, or kidneys are wounded; or when the large veins or arteries about the throat are cut through.

The cure is difficult in such as are wounded either in any part of the lungs, or the thick part of the liver, or the membrane that contains the brain, or in the spleen, or womb, or bladder, or any intestine, or the diaphragm. Such also are in a very dangerous situation, in whom the point of a weapon has penetrated as far as the large blood vessels, that lie deep in the arm-pits and hams. And all wounds are dangerous, wherever there are large blood-vessels, because they may exhaust a person by the profusion of blood. And this happens not only in the arm-pits and hams, but likewise in the veins, which go to the anus and testicles. Besides these, any wound in the arm-pits, or the inside of the thighs, or in any cavity, or between the fingers(15) is bad. Also by which a muscle, or nerve, or artery, or membrane, or bone, or cartilage, is hurt.

A wound in the flesh is safest of all, and these again from their situation are either worse or better. But a wound when large is dangerous from its size.

The nature of the wound also and its figure make some difference; for when a part is both cut and bruised, it is worse than when it is only cut asunder; so that it is better to be wounded by a sharp weapon, than a blunt one. And that wound is worse, out of which any substance is cut, or where the flesh is carried off on one part, and hangs on the other. In general, those wounds are the worst, that are crooked: and those safest that are of a straight direction. And then, the nearer the wound approaches to the first or second of these forms, it is more or less dangerous.

Moreover the age, constitution, the way of life of the patient, and the season of the year, are of some importance: for a boy or a youth recovers more easily than one that is older; the strong than the infirm; one, that is neither too slender nor too plethoric, than one, that is on either of these extremes; one of a sound than one of a corrupt habit; one, that takes exercise, than an indolent person; the sober and temperate than one given to wine and venery. Again, the most convenient season of the year for curing a wound is the spring; or at least when it is neither hot nor cold: for both excessive heat and intense cold are prejudicial to wounds; but most of all an alternate change of these: and for that reason the autumn is very hurtful.

Most wounds are exposed to our view: but there are some, of which we judge from the situation of the parts, which we explained elsewhere, when we demonstrated the position of the internal parts. Nevertheless, because some of these lie superficial, and it makes a difference, whether a wound be in the surface, or has penetrated deeper; it is necessary to mention the appearances, by which we may know what is hurt within; and from which we are either to hope or despair.

When the heart is wounded, there is a great effusion of blood, the pulse is languid, the skin very pale, cold sweats with a bad smell come on, the same as in sickness: the extremities grow cold, and death quickly follows.

When the lungs are wounded, there is a difficulty of breathing; frothy blood is discharged from the mouth, and red blood from the wound; also along with the latter the air issues with a noise; the patient has an inclination to lie upon the wound; some start up without any reason. Many when they are lying upon the wound, are able to speak: if upon another part, they lose that faculty.

The symptoms of a wounded liver are these: there is a great effusion of blood under the right side of the prÆcordia; the prÆcordia are drawn backward towards the spine; there is a pleasure in lying upon the belly; there are prickings and pains reaching as far as the clavicle and the broad bone of the shoulder, that is joined to it; to these there is sometimes added also a bilious vomiting.

When the kidneys are wounded, the pain reaches to the groin and testicles; the urine is made with difficulty; and it is either bloody, or grumous blood is voided.

But when the spleen is wounded, black blood issues out from the left side; the prÆcordia and stomach on the same side grow hard; a great thirst ensues; and a pain strikes up to the clavicle, as when the liver is wounded.

But when the womb is wounded, there is a pain in the groin, and hips, and inside of the thighs; the blood is partly discharged by the wound, partly by the vagina; and a bilious vomiting follows. Some women lose their speech; some are delirious; others sensible, but complain, that they are tormented with a pain of their nerves and eyes: and when dying, have the same symptoms, as attend a wounded heart.

If the brain or its membrane has received a wound, blood is discharged by the nose, in some also by the ears and generally a bilious vomiting follows. The senses of some are impaired, and they do not perceive when they are called upon: the countenance of others is fierce; and their eyes roll different ways, as in a palsy; and commonly on the third or fifth day a delirium comes on. Many are likewise convulsed. Before death most of them tear the bandages, with which their head is bound up, and expose the naked wound to the cold.

When the gullet is wounded, a hiccough and bilious vomiting follow; if any meat or drink has been taken, it is quickly returned; the pulse grows languid; thin sweats come on, in which the extremities grow cold.

The signs of a wound in the jejunum and stomach are the same; for the food and drink pass through the wound: the prÆcordia grow hard; sometimes bile is vomited. Only it must be observed, that the jejunum is situated lower than the stomach. When the other intestines are wounded, they emit either excrement, or its smell.

When the spinal marrow is cut through, there follows either a palsy or convulsions; the patient becomes insensible; and after some time, the lower parts discharge involuntarily either seed, or urine, or excrement.

But if the diaphragm is wounded, the prÆcordia are drawn upward; there is a pain in the spine, an oppression of the breath, and a discharge of frothy blood.

When the bladder is wounded, the groin is pained, there is a tension of the parts immediately above the pubes; instead of urine comes blood; and the urine is discharged at the wound; the stomach is affected, so that the patients either vomit bile, or have a hiccough; a coldness seizes them, and after that death.

These things being known, there still remain some other particulars to be observed relating to the wounds and ulcers, which we are to treat of. From wounds then and ulcers are discharged blood, sanies, and pus. Blood is known to every one. Sanies is thinner than blood, unequally thick, glutinous, and coloured. Pus is very thick and white, also more glutinous than either blood or sanies. Now blood is discharged from a recent wound, or one that is just healing: sanies appears betwixt these times: pus in an ulcer beginning to heal. Further, both sanies and pus are distinguished into several species by Greek names; for there is one kind of sanies, which is called ichor[ EO ], another melicera[ EP ]. There is also a species of pus called elÆodes[ EQ ]. Ichor.Ichor is thin, of a whitish colour, and proceeds from a bad ulcer, and especially where a nerve has been hurt, and an inflammation has followed. Melicera is thicker, more glutinous, whitish,Melicera. and somewhat resembling white honey: this also is discharged from malignant ulcers, where the nerves about the joints are hurt; and amongst the joints principally from the knees. ElÆodes is thin, whitish, somewhatElÆodes. unctuous, in colour and fatness not unlike to white oil; and appears in large ulcers, that are healing. Now blood is bad that is either too thin or too thick, in colour either livid or black; or mixed with phlegm, or of various colours: the best is warm, red, moderately thick, and not glutinous. Therefore from the first the cure of a wound, which has yielded good blood, is more easy and quick: and afterwards there is more hope of those, from which the several discharges have been of the best kind. Sanies then is bad, where it is in great quantity, over thin, livid, or pale, or black, or glutinous, or fetid, or such as corrodes the ulcer itself and the adjacent skin. It is better, when the quantity is small, indifferently thick, of a reddish colour, or inclining to white. Ichor again is the worst, that is plentiful, thick, inclining to a livid or pale colour, glutinous, black, hot, fetid. It is more tolerable, if inclining to white, and when in all other respects it is the reverse of the former. But melicera is bad, when it is in great quantity, and very thick; better, when thinner, and less in quantity. Pus is the best amongst these. But even that too is bad, when it is copious, thin, diluted; and the more so, if it be such from the beginning; also if in colour it resemble serum, if it be pale, or livid, or feculent; moreover if it be fetid; unless the smell arises from the nature of the particular part, where the ulcer is. The less there is of it, and the thicker, and whiter, so much the better; and also if it be smooth, if it have no smell, if it be homogeneous. In quantity, however, it ought to correspond both with the size and age of the wound: for a greater quantity is discharged naturally from a larger one; and more before the inflammation is removed, than afterwards. ElÆodes also when plentiful, and containing but little fat, is bad: but the less there is of it, and the more oily so much the better.

These things being considered, when any person is wounded, that can be cured, two things are immediately to be regarded: that he do not perish either by a hÆmorrhage, or an inflammation. If we are afraid of a hÆmorrhage (which may be known from the situation of the wound and its largeness, and from the force of the stream of blood) the wound is to be filled with dry lint, and over it a sponge squeezed out of cold water must be applied, and pressed down with the hand. If this does not stop the blood, the lint is to be frequently changed: and if it have not strength enough dry, it must be moistened with vinegar. This is very powerful in stopping blood: and therefore some people pour it into the wound. But here again it is to be feared, that the matter being too forcibly retained there, may afterwards raise a great inflammation. Which is the reason why neither corroding medicines, nor such as are caustic, and therefore forming a slough, are to be used, although most of these stop blood: but if recourse is ever had to them, such ought rather to be employed, as are the mildest in their operation. But if even these do not prevail against the hÆmorrhage, the vessels, which discharge the blood are to be taken hold of, and tied in two places about the wounded part, and cut through, that they may both unite together, and nevertheless have their orifices closed. When the circumstances do not even allow of this measure, they may be cauterized with a hot iron. And in this case too, when there is a considerable hÆmorrhage from a part, where there is neither nerve, nor muscle, in the forehead for instance, or upper part of the head, it is very proper to apply a cupping vessel to the opposite part, that the current of blood may be diverted thither.

These then are the remedies against a haemorrhage: but for an inflammation the flux of blood itself is the cure. This may be apprehended, when either a bone has been hurt, or a nerve, or a cartilage, or a muscle, or when the haemorrhage has been too small in proportion to the size of the wound. Therefore when any thing of this kind happens, it will not be proper to stop the blood quickly, but to suffer it to flow as long as it is safe; insomuch that if the discharge has appeared small, it ought also to be taken from the arm; especially if the patient be young and robust, and used to exercise; much more, if he was intoxicated before he received the wound. And if a muscle shall appear to be wounded, it must be cut through: for when it is only divided in part, it is mortal; cut quite through it admits of a cure.

The blood then being either stopped, when the haemorrhage is excessive, or more taken away by phlebotomy when too small, it is far the best method to agglutinate the wound. Now this may be done, either when it is in the skin, or even in the flesh, if nothing else is hurt. It may be done, where the flesh is hanging down in one part, and adhering in another; provided however it be still sound, and nourished by its continuity with the body.

In wounds to be agglutinated there is a double method of cure. For if the wound be in a soft place, it ought to be sewed: and especially, if the extremity of the ear, or the lower part of the nose be cut, or the forehead, or the cheek, or the eye-brow, or the lip, or the skin about the throat, or the belly. But if the wound is in the flesh, and gapes, and its lips cannot be easily brought together, a suture is improper: and in this case fibulÆ(64) are to be put on (the Greeks call them ancteres[ ER ]) to draw the lips a little closer; that the cicatrix may be the less broad after the cure.

Hence now it may be collected, whether a wound, in which the flesh is in one part depending, and in another adhering, if it is not yet corrupted, requires a suture, or a fibula. But neither of them ought to be applied before the wound be cleansed within, lest any concreted blood be left there. For that turns to pus, raises an inflammation, and prevents the wound from being agglutinated. Even the lint, that is put into it to stop the bleeding, must not be left there; for that also inflames.

It will be necessary to take up with the needle, or the fibula, not only the skin, but also some of the flesh below it, that it may adhere the more strongly, and not break away the skin. Both of them are best done with soft thread(65), not too much twisted, that it may be the less uneasy to the part. Neither of them are to be applied at too great distances, nor too frequently: if at too great distances they will not hold; if too frequently they are very hurtful; because the oftener the needle has passed, and the more places are gauled by the fibula, so much the greater will the inflammation be; and especially in the summer-time. Neither of them requires any force; but the operation is only so far useful, as the skin follows the hand as it were of its own accord. Now the fibula commonly allows a wound to be broader: a suture joins its lips, but these should not touch one another in every part; that if any humour be collected within, there may be a passage for it to escape. But if a wound admits of neither of these, it ought nevertheless to be cleansed.

In the next place, upon every wound should be applied first a sponge squeezed out of vinegar: if any patient is not able to bear the strength of vinegar, wine must be made use of: a slight wound is helped by laying on a sponge squeezed even out of cold water. But in whatever way it is put on, it does good no longer than it is moist: therefore it must not be suffered to dry. A wound may be cured without foreign, scarce, and compound medicines. But if one has not confidence in that method, he ought to apply a medicine, that is composed, without suet, of those things, which I mentioned to be proper for bloody wounds; and particularly if it be in the flesh, the barbarum: if it be a nerve, or cartilage, or any of the prominent parts, as the ears, or lips, the sphragis of Polybus. The green Alexandrian also is fit for the nerves; and for the prominent parts that, which the Greeks call rhuptousa[ ES ].

It is common also, where there is a contusion, for the skin to be a little broken. When this happens, it is not improper to make a larger opening with a knife; unless there be muscles and nerves near to it, which it is not fit to cut. When it is sufficiently opened, a medicine must be applied. But if the bruised part cannot admit the opening, though too small, to be enlarged, upon account of nerves or muscles, such applications are to be used, as may draw out the humour gently; and of that kind the fittest for the present purpose is the composition, which I said was called rhypodes. It is not improper also, wherever there is a severe wound, after applying(66) what is agreeable to it; to cover the whole with sordid wool moistened with vinegar and oil; or if the part be soft, a mild restringent cataplasm; if nervous, or muscular, an emollient.

For binding up a wound a linen roller is most convenient: and this ought to be bandages for so broad, that a single application of it may not only cover the wound, but take in a little on each side of it. If the flesh has shrunk away more on one side, it is better to begin the rolling from thence; if equally on both sides, it ought to lay hold of the lips transversely; or if the nature of the wound does not admit of that, the middle of it is first put on, that it may be drawn afterwards both ways. Now it is to be bound on in such a manner, that it may both hold, and not be over tight. When it does not hold, it slides off; and that, which is over tight, hazards a gangrene. In the winter-time the roller ought to be carried round oftener; in the summer, no more than necessity requires. Then the extremity of it is to be sewed to the lower part of the bandage. For a knot hurts a wound, unless it be at a distance from it.

Moreover every person ought to know, that the viscera, which I mentioned before, require a particular method of cure. For the external wound is to be cured either by a suture, or some other method. In the bowels nothing is to be touched, unless some bit in the extremity of the liver, or spleen, or lungs be hanging out, which may be cut away. Otherwise the internal wound is to be cured by the diet and medicines, which I mentioned in the former book as agreeable to each viscus.

These steps being taken on the first day, the patient must be put to bed: and if the wound be severe, he ought to abstain from food, as much as his strength will permit, before the inflammation comes on; to satisfy his thirst with warm water, or if it be in summer, and he have neither fever nor pain, the water may be cold. However no rule is so constant, but that a regard must always be had to the strength of the patient; so that his weakness may render it necessary to take food immediately, but such as is thin, and in small quantity, just sufficient to support him. And many sinking under a hÆmorrhage, before any thing else be done, are even to be refreshed with wine; which is otherwise very prejudicial to a wound.

It is dangerous for a wound to swell too much: not to swell at all is extremely dangerous. The first is a sign of a violent inflammation; the other of a mortification. If the patient be sensible, and no fever has come on, we may at once conclude, that the wound will be soon healed: and even a fever ought not to alarm us, if in a large wound it continue, while the inflammation subsists; it is bad, when it either supervenes to a slight wound, or lasts longer than the inflammation, or brings on a delirium; or if it does not remove a tetanus, or convulsion, that arose from the wound. Also an involuntary bilious vomiting coming on either immediately after the wound is received, or while the inflammation continues, is a bad symptom in those only, whose nerves, or nervous parts are wounded. However to take a vomit is not hurtful; especially in those, who have been accustomed to it; but neither immediately after meat, nor when the inflammation has begun, nor when the wound is in the superior parts.

The wound being kept thus for two days, on third it must be opened, and the sanies must be wiped off with cold water, and the same kind of dressings put on. On the fifth day it will be easy to judge to what height the inflammation is to rise. On which day the wound must be uncovered again, and its colour observed. And if it be livid, or pale, or variegated, or black, we may be sure it is a bad wound: and whensoever this appearance is observed, it may alarm us. It is best for a wound to be white, or ruddy. Also a hard, thick, and painful skin denotes danger. It is a good sign, when this is free from pain, thin and soft. But if the wound is closed, or there be a slight swelling, the same application must be used as at first.

If the inflammation is violent, with no hopes of an agglutination, and does not yield, the use of warm water too is necessary, that it may dissipate the matter, and soften the hardness, and promote a suppuration. It must be of such a degree of warmth, as to be agreeable to the hand; and be continued so long, till it appear to have diminished in some measure the swelling, and restored a more natural heat to the ulcer. After this fomentation, if the wound does not gape much, a plaister should be applied immediately, and if it be a large wound, the tetrapharmacum would be best; in the joints, fingers, or cartilaginous parts, the rhypodes. But if it gapes pretty much, that same plaister must be softened with ointment of iris, and lint spread with it must be laid over the wound; then the plaister applied above, and over that sordid wool; and the rollers must be also less tight than at first.

But there are some peculiarities to be attended to in the joints. If the nerves, which secure them, are cut through, a weakness of that part follows. If that is uncertain, and the wound is from a sharp weapon, and that in a transverse direction, it is more easy to cure: and if it be from a blunt and heavy one, the figure of it makes no difference: but it must be observed whether the pus comes from above or below the joint. If it come from under it, and continue a long time white and thick, it is probable that a nerve is cut through, and the more so, the greater the pains and inflammations are, and the sooner they began. But although the nerve be not cut through, yet if a hard tumour continue round it long, the ulcer of necessity must be tedious, and even when that is healed, the tumour will remain; and it will be a considerable time before that limb recover its power either of extension or contraction. And it is longer before it can be extended, when the cure has been conducted with the joint bent, than it is before one can be bent, which we have kept straight. The limb, that is wounded, ought to be placed also in a certain position: if it is to be agglutinated, it must be laid high; if it is inflamed, so as to incline to neither side; if the pus has begun to flow, it must be kept in a depending posture.

Rest too is an excellent remedy. Motion and walking are prejudicial, except to people in health: however, less dangerous to such as are wounded in the head or arms, than those, that are wounded in the lower parts. And walking is least of all proper, when the hurt is in the thigh, or the leg, or the foot. The place, where the patient lies, ought to be warm. Bathing also, while the wound is not clean, is extremely bad: for that renders it both tumid and foul; from whence the transition to a gangrene is common. Gentle friction is good; but in those parts, that are at a great distance from the wound.

After the inflammation is gone, the wound must be deterged. That end is best obtained by lint dipt in honey; and over that must be applied either the tetrapharmacum plaister, or the enneapharmacum. Now that ulcer is clean, which appears red, and is neither too dry nor too moist. But any ulcer that is deprived of its sensibility, or whose feeling is unnaturally exquisite, or that is either too dry or too moist, or that is either whitish or livid, or black, that ulcer is not clean.

After a wound is deterged, it must next be incarned; and for that purpose warm water is so far necessary, as to remove the sanies. The use of sordid wool is improper; it is better to cover it with such as has been washed. And there are also some medicines, which conduce to the filling up of the wound; therefore it is not amiss to make use of them: such as butter with oil of roses, and a small proportion of honey; or the plaister tetrapharmacum with the same proportion of honey, or with the oil of roses; or lint dipped in oil of roses. But the bath used sparingly is more efficacious; and food of a good juice, avoiding every thing acrid. When they are almost filled up, birds and venison and boiled pork may be given. Wine is always hurtful, while there is a fever or inflammation; and indeed, till it be cicatrized, if either nerves or muscles are wounded; or even the flesh, if it be deep. But if the wound is of the safer kind, and only superficial, wine not very old, given in moderate quantities however, may promote the incarnation. If any thing is to be softened, which is necessary in nervous and muscular parts, cerate must also be laid upon the wound. But if fungous flesh has grown upon it, dry lint restrains it gently; copper scales more powerfully. If the quantity to be taken away be more considerable, things still stronger must be applied to eat down the flesh. After these a cicatrix is very well formed by lycium diluted in passum or milk; or dry lint laid on alone is still more efficacious.

This then is the process of a successful cure. But at times things will happen to take a dangerous turn. For sometimes the ulcer grows ancient, a callosity comes over it, and its lips are thick, and of a livid colour: after which, whatever medicine is applied, does little good; and this generally happens to an ulcer negligently treated.

Sometimes from an excessive inflammation, or violent heats, or excessive cold, or too tight bandages, or the old age or bad habit of the patient, a gangrene seizes upon it. This kind of disorder by the Greeks is divided into several species, for which we have no terms in our language. Now every gangrene not only corrupts that, which it has seized upon, but also spreads. But then the distinction is to be made between the species by different symptoms. For sometimes beyond the inflammation a redness surrounds the ulcer, and spreads with pain; the Greeks call it erysipelas[ ET ].; sometimes the ulcer is black, because the flesh of it is corrupted, and the blackness is greatly increased as the putrefaction goes on, when the wound is moist, and from the black ulcer is discharged a pale fetid liquor, and the flesh within is corrupted(67): sometimes also the nerves and membranes are dissolved, and a probe put in descends either laterally or downwards; sometimes the bone is affected with that disorder: and sometimes there follows what the Greeks call gangrÆna[ EU ].

The former kinds happen in any part of the body: the last mentioned about the extremities, that is, the nails, the armpits, or groin; and generally in old people, or in such as are in a bad habit of body. The flesh of such an ulcer is either black or livid, but dry and withered, and the contiguous skin is for the most part covered with pustules of a dark brown colour; then the next to that is either pale or livid, and commonly of an Æruginous colour, and void of sensation; the skin a little farther off(68) is inflamed. And all these spread at once; the ulcer into the pustulous part; the pustules to the part that is pale or livid; the paleness or livor to that which is inflamed; and the inflammation proceeds to that which is sound. In the mean time an acute fever comes on, and a vehement thirst; some are also delirious; others, though they be sensible, stammer, and with great difficulty can make their meaning understood; the stomach begins to be affected; the breath itself acquires a fetid smell. Now this disorder in the beginning admits of a cure; but when it is thoroughly rooted, it is incurable; and most of them die with a cold sweat.

These are the dangers, to which wounds are liable. But when the ulcer is old, it must be cut round with a knife, and its lips cut off, and whatever beyond them is livid, must likewise be scarified. If there be a small varix within, which prevents its healing, that also must be cut out. Afterwards when blood has been discharged, and a new face thus given to the wound, the same method of cure must be pursued, which has been directed for recent wounds. If any person does not chuse to make use of a knife, the plaister, which is composed of labdanum, may incarn it, and when the ulcer has been eaten down by that, a plaister, which brings on a cicatrix.

Now that, which I said has the name of an erysipelas, is not only consequent upon a wound, but often happens without it, and is sometimes very dangerous; especially if its seat be about the neck or head.

It is proper, if the strength will admit, to bleed; then to apply at once repellents and coolers, and particularly cerus with the juice of nightshade, or cimolian chalk with rain water; or meal made into a paste with the same water, with the addition of cypress, or if it be in a tender part, with lentils. Whatever is applied, must be covered with a beet leaf, and upon that must be laid a linen cloth dipped in cold water. If coolers alone do little service, the following mixture must be made; of sulphur p. i. *. ceruss, saffron, each p. x. *. and these to be rubbed down with wine, and spread over the part: or if the place is not tender, leaves of nightshade powdered must be mixed with hog’s lard, and applied spread upon linen.

But if there be a blackness, which does not yet spread, such applications must be used, as will gently eat away the putrid flesh; and the ulcer being thus cleansed, must be dressed in the same manner as others. If it be more putrid, and already begins to advance and spread, there is a necessity for stronger corrosives. If even these do not overcome it, the part must be cauterized, till no moisture flow from it; for whatever is sound, is dry when it is burnt. After the burning of a putrid ulcer, such applications must be used, as may separate the sloughs from the quick part; the Greeks call them apescharotica[ EV ]. When they have fallen off, the ulcer must be cleansed, particularly with honey and resin; but it may be cleansed also by those things with which purulent ulcers are dressed, and healed up by the like methods.

It is not very difficult to cure a gangrene, if it has not got full possession, but is only beginning, especially in a young person: and easier still, if the muscles are sound; or if the nerves are either untouched, or but slightly affected; and no large joint laid bare; or there be but little flesh in that part, and consequently not much to putrify, and if the disorder is confined to one place, which chiefly happens in a finger. In such a case the first thing to be done, if the strength will allow, is to let blood: after that, to cut through to the sound flesh, whatever is dry, which by a kind of tension is uneasy to the contiguous parts.

While the disorder is spreading, no suppurating medicines are to be applied; and for that reason not so much as warm water. Ponderous medicines also, although they be repellent, are hurtful; but the lightest of that nature are required; and over the parts, which are inflamed, coolers must be applied. If the disease is not stopped by these, so much as is betwixt the sound and corrupted parts, ought to be cauterized.

And in this case particularly help must be sought not from medicines alone, but from a due regimen: for this disease never appears but in a corrupt and vitiated habit. Wherefore in the first place, unless weakness forbid, the patient must live abstemiously: and then for food and drink must be given what will bind the belly, and consequently the body also; but these must be of a light nature. Afterwards if the disorder stop, the same applications must be used as have been prescribed in a putrid ulcer. And then also a fuller diet may be allowed of the middle class: only such however as tends to dry the belly and the whole body; and the drink must be cold rain water. The bath, unless we are confident of a cure, is hurtful; for the ulcer softened by that means is quickly affected again with the same disorder. But sometimes it happens, that all these remedies do no service, and notwithstanding all their force, the gangrene spreads. In which case the miserable but sole remedy is to cut off that limb, which is perishing by degrees, to save the rest of the body.

This then is the method of treating the most severe wounds. But even such are not to be neglected, where the skin is entire, but the flesh within(69) is bruised; or where any thing is razed or rubbed off the surface; or when a splinter is fixed into the flesh; or when a wound, though small, has penetrated deep.

In the first case it is a very proper remedy to boil pomegranate bark in wine, and bruising the inner part of it, to mix it with a cerate of the oil of roses, which is to be laid upon the part; then where the skin is razed, to cover it with a mild medicine, such as the lipara[ EW ].

Upon the part, that has its surface razed and rubbed off, the tetrapharmacum plaister must be applied, and the quantity of food diminished, and wine denied. Nor should such a hurt be looked upon as contemptible, because the wound is not deep: for from such accidents gangrenes often arise. But if it be slight and of small extent, the mild medicine abovementioned may be sufficient for the cure.

A splinter, if possible, must be extracted either by the hand or by an instrument: if it has either broke or penetrated deeper than to admit of this, it must be drawn out by a medicine. Now the best application for that purpose is the root of a reed; which if tender, must be immediately bruised; if grown hard, it may be first boiled in mulse: to this honey must always be added; or birthwort with honey must be applied. The worst splinter is that of a reed, on account of its asperity: the fern is also equally hurtful: but it has been found by experience, that each of these bruised and applied is a cure for the other. Every medicine, that has the faculty of drawing, has the same effect in all splinters. The same kind of medicine is also finest for deep and small wounds: the plaister of Philocrates is best adapted to the former, that of HecatÆus to the latter case.

In any wound, when we are to form the cicatrix (which is necessary after the ulcers are thoroughly cleansed and incarned) in the first place lint dipped in cold water must be applied, while the growth of flesh is encouraged; afterwards when that is to be restrained, it must be put on dry, till a cicatrix be formed; then white lead ought to be bound over it, which both compresses the cicatrix, and gives it a colour resembling the sound part of the body. The root of wild cucumber has the same effect. Also the composition, which contains of elaterium p. i. *. litharge p. ii. *. myrobalans p. iv. *. to which is added turpentine resin, till the whole be brought to the consistence of a plaister. But black cicatrices are gently cleansed by a mixture of equal parts of verdigrease, and washed lead, and the same resin boiled, whether the cicatrix be anointed with this, which may be practised in the face, or it be applied like a plaister, which is more convenient in other parts of the body.

But if the cicatrix is either protuberant or hollow, it is ridiculous, merely in regard to the appearance to submit a second time to the pain and trouble of a cure; otherwise both cases might be remedied. For either of these cicatrices may be converted into a wound by the knife. If one rather chuses a medicine, the same purpose is answered by those compositions, which eat down flesh. When the skin is taken off, upon the prominent one must be applied eating medicines, upon the hollow one such as tend to fill up, till both these kinds of ulcers be brought to the level of the sound skin, and then they may be cicatrized.

I have treated of those wounds, which are most commonly inflicted by weapons. It follows, that I speak concerning those, which are occasioned by the bite, sometimes of a man, sometimes of an ape, often of a dog, sometimes of wild beasts, or other animals, or serpents. Now almost all bites(70) are in some degree venomous.

Therefore if the wound be severe, a cupping vessel must be applied; if slight, a plaister must be immediately put on, particularly that of Diogenes; if that is not to be had, any of those, which I have prescribed against bites; if these are not to be got, the green Alexandrian; if that is not at hand neither, any of those, which are not greasy, that are calculated for recent wounds. Salt is also a remedy for them, and particularly for the bite of a dog, if it be applied dry, and the part be chaffed with two fingers; for it brings out the sanies. It is also of use to bind salt fish over such a wound.

If the dog was mad, it is more especially necessary to extract the poison by cupping. After that, if the part is neither nervous nor muscular, the wound must be cauterized. If it cannot be cauterized, it is proper for the patient to be bled. Then upon the wound, after burning, must be applied what is proper for other cauterized ulcers. Such as have not been cauterized must be treated with those medicines, that powerfully corrode the flesh. After which the wound must be filled up, and healed by no other than the common method already laid down. Some presently after the bite of a mad dog order such a patient into the bath, and allow him to sweat there as long as he is able, with the wound bare, that the poison may the more readily be discharged; then they refresh him with plenty of strong wine, which is an antidote to all poisons. And when this method has been pursued for three days, the patient is thought out of danger.

But it is usual for such a wound, if not effectually treated, to produce a fear of water. The Greeks call it hydrophobia[ EX ]: a most miserable kind of disease, in which the patient is tormented at once with thirst, and a dread of water. When this happens, there is very little hope left. But yet there is one remedy: to throw the patient unawares suddenly into a pond, and if he cannot swim, to suffer him to sink sometimes, and thus drink, and sometimes to lift up his head; if he can swim, to keep him down at times, that even against his will he may be satiated with water: for thus at once both the thirst and dread of water is removed. But this practice is attended with another danger, which is, that a weak body fatigued in cold water, may be destroyed by a convulsion. To prevent which, from the pond he must immediately be put into warm oil. An antidote (particularly that which I mentioned first, or in its stead another) if the patient is not possessed with the horror of water, may be given to drink in water; if he be offended with its bitterness, honey must be added; but if that disease has already come on, it may be taken in the form of catapotia.

The bites of serpents do not require a very different treatment: although in this the ancients varied greatly; in so much that they prescribed as many distinct methods as there were kinds of snakes; in which too they differed widely from each other. But generally the same remedies have the best success in all of them. Wherefore in the first place the limb must be tied above the wound; but not too tight, lest it become torpid. Then the poison must be extracted. This is best done by cupping. Neither is it improper to cut round the wound first with a knife, that the more of the blood already vitiated may be extracted. If a cupping vessel cannot be had (which can scarcely happen) then any other similar vessel will do, which will serve the same purpose. If none such can be got, a person must be employed to suck the wound.

Nor indeed have those, that are called Psylli(71), any peculiar skill, but a boldness confirmed purely by custom. For the poison of a serpent, as also some of those, which hunters make use of, and especially in Gaul(72), are not hurtful, taken in by the mouth, but injected by a wound: and for that reason even a snake itself is safely eaten: its bite is mortal, and when it is in a state of stupidity (which dealers in legerdemain can produce by the force of some drugs) if one puts his finger into its mouth, and is not bit, he receives no hurt from the saliva. Therefore any person that, like a Psyllus, shall suck the wound, will both be safe himself, and save the patient. In the mean time he ought to attend to this first, that he have no ulcer either in his gums, or palate, or any other part of his mouth. Afterwards the patient must be laid in a warm place, in such a posture, that the part, which is wounded, may be in a depending posture.

If no body can be got to suck the wound, nor a cupping vessel is at hand, the patient ought to sup goose or veal broth, till he vomit. A chicken must also be cut through the middle alive, and immediately applied warm over the wound, with the internal part next the body. The same effect is produced by a kid, or a lamb cut up, and the warm flesh immediately laid upon the wound, and by the plaisters, that have been mentioned before: the most proper of which is the Ephesian, or that, which follows it. To take some antidote too immediately, is a powerful protection against the danger. But if that cannot be had, it is necessary to sup a little pure wine with pepper, or any thing else, which serves to excite heat, and does not suffer the humour to coagulate within. For the greatest part of poisons kills by cold. All diuretics too, because they attenuate the humour, are useful.

The former remedies are general, and good against bites: but experience itself has taught us, that a person, who has been bit by an aspis, ought rather to drink vinegar. Which is said to have been discovered by the case of a certain boy, who, when he had been wounded by one, and partly from the wound itself, and partly from the excessive heat of the weather, was tormented with thirst, and the country being dry, could find no other liquor, drank off vinegar, which he chanced to have by him, and was cured. The reason of the effect in my opinion is, that vinegar, though it refrigerate, yet has a faculty of dissipating at the same time. Whence it happens, that earth sprinkled with it rises in a froth. From the same virtue therefore it is very probable, that the fluids of the human body beginning to be coagulated are dissipated by it, and health thereby restored.

Against the poison of some other serpents also peculiar remedies are well known. For the scorpion is a most excellent remedy against itself. Some drink it bruised with wine. Some apply it in the same form to the wound. Others laying it upon live coals fumigate the wound with it, keeping a cloth all round it, that the smoke may not escape; and then bind it on when burnt to a coal. Now it is proper to drink in wine the seed, or at least the leaves of turnsole (which the Greeks call heliotropium[ EY ].) And over the wound it is fit to apply bran with vinegar, or wild rue, or salt toasted with honey. But I have known physicians, who have done nothing else to people stung by a scorpion, but bled them in the arm.

For the sting of a scorpion also, and a spider, garlick mixed with rue, and rubbed down with oil, is a proper application.

For a wound given by a cerastes(73), or dipsas(74), or hÆmorrhois(75), the remedy is dried asphodel, about the bigness of an Egyptian bean, with the addition of a little rue given in drink, and divided into two doses. Trefoil also and horse-mint, and panaces with vinegar are equally good. Also costus, and cassia, and cinnamon are proper to take in drink.

Against the wound of a chersydrus(76), panaces or laser, or each scruples p. ii. *. Or the juice of a leek is to be taken with a hemina of wine, and savory eaten plentifully. And let goat’s dung boiled in vinegar be laid upon the wound; or barley meal in the same manner with vinegar; or rue, or cat-mint, powdered with salt and mixed with honey. And this is equally efficacious against the bite of a cerastes.

When a phalangium(77) has given a wound, beside the chirurgical part of the cure, the patient should be frequently plunged into the warm bath, and an equal quantity of myrrh and stavesacre is to be given in a hemina of passum; or radish-seed, or darnel-root with wine; let there be also applied to the wound bran boiled with vinegar, and he must be ordered to continue quiet.

But the kinds of serpents mentioned hitherto are foreign, and much more dangerous than ours; especially those, which are in very hot countries. Italy and the colder climates, besides that they are more healthful in other respects, have the advantage in this, that they produce snakes less formidable. Their bites are well enough cured by the herb betony, or bindweed, or centory, or agrimony, or germander, or burdock, or pastinaca fish(78), either singly, or any two of them taken together powdered, and thus given to drink in wine, and also applied upon the wound. It is necessary to observe, that the bite of every serpent is more hurtful, when either the animal or the wounded person is fasting, and therefore they are most pernicious when they are hatching; and it is adviseable, when any one is apprehensive of meeting serpents, not to go out, before he has taken some food.

It is not so easy to relieve those, who have swallowed poison, either in their food or drink. In the first place, because they do not perceive it immediately, as those do, who are bit by a snake; and therefore cannot instantly apply the remedy. In the next place, because the hurt does not begin in the skin, but in the internal parts. However it is best, as soon as one discovers it, immediately to drink largely of oil, and to vomit. And then, when he has emptied his praecordia, to take an antidote in his drink; if that is not to be got, pure wine.

Nevertheless there are some peculiar remedies against certain poisons, and chiefly of the milder kind. For if any person has drunk cantharides, he ought to take panaces bruised with milk, or galbanum, with the addition of wine, or milk by itself.

If hemlock, let the patient drink as much hot pure wine with rue as he can; then he must be forced to vomit; after that, laser with wine must be given; and, if he be free of a fever, he must be put into the warm bath; if not, be anointed with warm ingremedies. After these, rest is necessary for him.

If henbane, hot mulse must be drunk, or any kind of milk, but more particularly asses milk.

If ceruss, the juice of mallows, or of a bruised walnut with wine are most serviceable.

If one happens to swallow a leech in drinking, vinegar with salt must be given. If milk has curdled in the stomach, either passum, or laser with vinegar.

If a person has eaten poisonous mushrooms, let him take radish either out of vinegar and water, or salt and vinegar. These may both be distinguished from the good by their form, and also be rendered innocent by the manner of dressing. For they are perfectly freed from all noxious qualities, by boiling them in oil, or with a twig of a pear-tree.

Burns are also to be reckoned amongst the effects of external violence. The plan laid down, therefore, seems to oblige me to speak of them in this place. They are best cured by the leaves either of lilly, or hound’s-tongue, or betes boiled in wine and oil. Any of these presently applied heals them.

But the method of cure may also be divided into those things, which being gently eating and repellent, at first both prevent pustules, and excoriate the part; and those, which being lenient, restore the part to its soundness. Of the former is the meal of lentils with honey, or myrrh with wine; or Cimolian chalk, powdered with the bark of frankincense, and worked up to a paste with water, and when it is to be used, diluted with vinegar. Of the second class any of the lipara. But the most suitable is that, which contains the dross of lead, or yolks of eggs.

Another way also of treating burns is, while the inflammation continues, to apply to them lentils with honey; when that is gone off, meal with rue, or leeks, or horehound, till the crusts fall off, then vetches with honey, or iris, or turpentine resin, till the ulcer be clean; last of all, dry lint.

From external injuries, we proceed to disorders which have an internal origin, when some part of the body is corrupted. Amongst these none is worse than a carbuncle. The marks of it are these. There is a redness, and above that pustules rise, not very high, mostly black, sometimes inclining to a livid colour, or pale. There seems to be sanies in them; below, the colour is black. The flesh is parched, and harder than it ought to be naturally. And about it, there is a sort of crust; which is surrounded with an inflammation. Neither can the skin be lifted up in that place, but is, as it were, bound down to the flesh below. There is a propensity to sleep. Sometimes a shuddering, or fever comes on, or both. And this disease shoots out roots, as it were, below, and spreads, sometimes quickly, sometimes more slowly. At the surface also it spreads and grows white; then becomes livid; and all round it small pustules break out. And if it happen to be near the gullet or fauces, it often stops the breath suddenly.

Nothing is better than to sear it immediately. Neither is that painful, for it has no feeling, because such flesh is mortified. And the burning should be continued, till there is a sense of pain on every side. After this, the ulcer is to be cured in the same manner, as other burns. For by eating medicines is produced an eschar, which being entirely separated from the quick flesh, draws with it whatever was corrupted; and the sinus, by this time clean, may be dressed with incarning medicines. But if the disorder be in the surface of the skin, medicines barely eating, or at most caustic, may be sufficient. The violence of the cure is to be proportioned to the malady. Whatever medicine is applied, if it has the desired effect, will immediately separate the corrupted part from the quick.

And we may generally be confident of success, if the corrupted flesh falls off, wherever such medicine eats down; if that does not happen, and the medicine is overcome by the disease, an immediate recourse must be had to the actual cautery. But in such a case, the patient must abstain from food and wine. It is also proper to drink water plentifully. And these directions are to be observed more strictly, if a febricula be added to the other complaints.

There is not so great danger of a cancer[ EZ ], unless it be irritated by the imprudence of the physician. This disease generally happens in the superior parts, about the face, the nose, ears, lips, and breasts of women. It also rises from the liver, or spleen. About the place there are pricking pains; it is immoveable, and unequally swelled; it is also sometimes insensible. Around it the veins are inflated, and tortuous; and either pale or livid; in some also, they are concealed from view. Touching the part gives pain to some, to others none. Sometimes it is harder, or softer, than it ought naturally to be, without any ulcer; at other times, all other circumstances being as above described, there is likewise an ulcer. Sometimes it has no peculiar characteristic to distinguish it; at other times it resembles those which the Greeks call condylomata[ FA ], but has an asperity and magnitude peculiar to itself. And its colour is red, or resembling that of a lentil. Neither is it safe to cut it; for immediately there follows either a palsy, or a convulsion. Often when a person receives a blow upon it, he loses his speech and faints. In some also if the tumour itself be compressed, the contiguous parts grow tense and swell. Now this is a very bad kind(79). Its general progress is this; first appears what the Greeks call a cacoethes[ FB ], then it becomes a carcinoma, without an ulcer. From that an ulcer; and from an ulcer a thymium.

None of these can be removed but the cacoethes(80); the rest are irritated by every method of cure; and the more violent the operations are, the more angry they grow. Some have made use of caustic medicines; others of the actual cautery; others cut them out with a knife. Nor was any person ever relieved by medicine; but after cauterizing, the tumours have been quickened in their progress, and increased till they proved mortal; when they have been cut out, and cicatrized, they have, notwithstanding, returned, and occasioned death. Whereas, at the same time, most people, by using no violent methods to attempt the extirpation of the disease, but only applying mild medicines, to sooth it, protract their lives, notwithstanding the disorder, to an extreme old age. But no body can pretend to distinguish a cacoethes, which is curable, from a carcinoma, which is not, otherwise than by time and experiments.

Therefore, so soon as this disease is perceived, caustic medicines ought to be applied; if the disorder is alleviated, and its symptoms grow milder, we may proceed both to incision and the actual cautery; if it is immediately irritated, we may conclude, that it is already a carcinoma; and every thing acrid and severe is to be taken away. But if the part is hard, without any ulcer, it is sufficient to apply a very mellow fig, or the plaister called rhypodes. If there is an ulcer, but not rising above the surface of the skin, the cerate of rose oil is to be put on, with the addition of a powdered shell, with smith’s forge water. If it grows fungous, copper scales (which is the gentlest caustic) must be tried, till there is no rising above the other parts; provided still that it does not exasperate; if it does, we ought to be content with the same cerate.

There is also an ulcer, which the Greeks call therioma[ FC ]. This both comes of itself, and sometimes is consequent upon an ulcer produced from another cause. The colour is either livid or black; the smell is bad; it discharges copiously a humour like mucus; it is sensible neither of the touch, nor of medicine; and is only disturbed by itching. About it there is a pain and inflammation. Sometimes also a fever comes on. Sometimes there is a haemorrhage from the ulcer, and this disorder spreads, by which all the symptoms often increase. From these proceeds the ulcer which the Greeks call herpes esthiomenos[ FD ], voracious herpes; because by spreading quickly, and penetrating even to the bones, it devours the body. The surface of this ulcer is unequal, resembling dirt; and there is in it a great quantity of glutinous humour, an intolerable smell, and an inflammation more violent, than is found in an ulcer of that size. Both of them, as indeed all the kinds of gangrenes, happen chiefly to old people, or those, who are in a bad habit of body.

The manner of curing both is the same; but the greater disease requires the sharper remedy. And the regimen must first be regulated; the patient must rest in his bed, for some days abstain from food, drink water very plentifully, and have a clyster given him. Then, when the inflammation is gone, let him take food of a good juice(81), avoiding every thing acrid; he may drink as much as he will, provided he be content in the day-time with water but at supper, he may also drink some rough wine. But the abstinence should not be equally severe in a herpes, and a therioma. This then is the regimen necessary.

Externally upon the ulcer, must be sprinkled powder of dry aloes, and if that does but little service, chalcitis. But if any nerve, by the flesh being destroyed, be laid bare, it must be covered first with linen, lest it be burnt by that medicine. If there is need of remedies still more powerful, we must make use of those compositions, that cauterize more strongly. Now when any medicine is sprinkled on, it ought to be done by the broad end of a probe(82). Over it should be applied either lint with honey, or olive leaves boiled in wine, or horehound: and these must be covered with linen dipped in cold water, and then well squeezed. And all round, where there is a tumour from the inflammation, repellent cataplasms must be applied. If by these methods it grows no better, the place ought to be cauterized with a hot iron; the nerves that are in view being first covered. By what has been said on other occasions, it will be clear enough to any body, that a part, which is burned either by medicines or the actual cautery, must first be cleansed, and then filled up.

The ignis sacer ought also to be numbered amongst bad ulcers. There are two species of it. The one is of a colour inclining to ruddy, or a mixture of red and pale, and the surface is roughened by contiguous pustules, of which no one is bigger than another, but they are very numerous, and exceeding small. In these there is almost always pus, and often a redness attended with heat; and that spreads, sometimes when the part first affected is healing, sometimes when it is ulcerated, in which case, the pustules breaking, one continued ulcer is formed, discharging a humour, which seems to be betwixt sanies and pus. It attacks chiefly the breast, or sides, or extremities, and particularly the soles of the feet. The other kind comes with an ulceration in the surface of the skin, but without going deep, broad, inclining to a livid colour, but unequal; and the middle part of it heals, while the extremities spread; and often that, which seemed to be sound, ulcerates again. But the skin round about it, which is to receive the disease, grows tumid, and hardish, and the colour of it is a blackish red. And this disease too generally attacks old people, or those, that are in a bad habit, but chiefly in their legs.

Now every ignis sacer, though it be the least dangerous of those disorders, which have the disposition to spread, yet is, I had almost said, the hardest to cure of them all. The most effectual remedy is a fever for one day, which consumes the noxious humour. The thicker and whiter the pus is, so much the less is the danger. It does good also to excoriate the part below the ulcer by scourging, that the more pus may be evacuated, and the matter drawn out, which corrupts the flesh there. But notwithstanding if a slight fever comes on, there is a necessity for abstinence, lying a-bed, and clysters. In every ignis sacer, neither mild and glutinous food, nor salt and acrid are proper; but what is betwixt these: such as unleavened bread, fish, kid, birds, and except the wild boar, almost all venison. If there is no febricula, both gestation and walking are serviceable, and rough wine, and the bath; and in this disorder, as well as that mentioned before, the drink ought to be more plentiful than the food.

As for the ulcers themselves, if their progress be moderate, they must be fomented with hot water; if more rapid, with hot wine. Next wherever there are any pustules, they must be opened with a needle. Then such applications used, as may consume the putrid flesh. When the inflammation is removed, and the ulcer cleansed, a lenient medicine ought to be applied. In the second species, quinces boiled in wine and bruised may do good; as likewise the plaister of Hera, or the tetrapharmacum, with the addition of a fifth part of frankincense; likewise black ivy boiled in a rough wine, and if the disorder spread fast, nothing is more efficacious. When the ulcer, which I observed to be in the surface of the skin, is cleansed, the same lenient medicines are sufficient to the cure.

The ulcer named Chironian(83) is large, and has hard, callous, and swelled lips. A sanies is discharged not copious, but thin; the smell is bad. There is no inflammation either in the ulcer or in the tumour about it. The pain is tolerable. It does not spread, and therefore is not dangerous; but it does not easily heal. Sometimes a thin cicatrix comes on, and then breaks again, and the ulcer is renewed. It occurs chiefly in the feet and legs.

The application to it ought to contain both something lenient, and something strong, and repellent. Such as the following composition made for the purpose: of copper scales, calcined lead washed, each p. vi. *. cadmia, wax, each p. viii. *. oil of roses a sufficient quantity to soften the wax with the other ingredients.

There is a kind of ulcer occasioned by the cold of the winter. It is most common in children, chiefly in their feet and toes, sometimes also in their hands. There is a redness with a moderate inflammation. Sometimes pustules break out, which are followed by an ulceration. The pain is not great, the itching greater. Sometimes a humour is discharged, but in small quantity, which seems to resemble either pus or sanies.

In the first place it must be fomented plentifully with a hot decoction of turnips, or if these are not to be had, some of the repellent vervains. If it is not yet ulcerated, copper, as hot as a person is able to bear it, must be applied. When it is already ulcerated, allum, powdered with an equal quantity of frankincense, ought to be put to it, with the addition of wine; or pomegranate bark boiled in water, then beat. If the surface of the skin be excoriated, in that case lenient medicines succeed best.

The scrophula is a tumour, in which there are formed some concretions of pus and blood, resembling small glands. These are extremely troublesome to physicians, because they both generate fevers, and never maturate kindly; and whether they be cured by incision or medicines, for the most part they rise again close to the cicatrices; which they are much more ready to do, after being treated with medicines; and what is more, they are of long continuance. They grow chiefly in the neck; but also in the armpits, the groin and the sides. Meges the surgeon assures us, that he has met with them in the breasts of women too.

For these reasons, it is proper to give internally white hellebore, and that even frequently, till they be discussed; and externally to apply medicines which may either draw out the humour, or discuss it; such as have been mentioned before. Some also make use of caustics, which eat down and constringe the part with an eschar; and then treat it like an ulcer. Whatever method of cure be pursued, when the ulcer is clean, the body must be exercised and nourished, till it come to a cicatrix. These are the methods prescribed by physicians(84): but the experience of some peasants has discovered, that eating a snake cures a scrophulous patient.

A furuncle is an acute tubercle, attended with inflammation and pain; and especially when it is just turning to pus. When this is opened, and the pus is discharged, part of the flesh below appears converted into pus, part corrupted, of a whitish colour, and reddish; which some call the ventricle of the furuncle. There is no danger in it, though no means be used for its cure, for it maturates of itself, and breaks. But the pain makes a medicine, that can hasten the cure, eligible.

The proper medicine for it is galbanum, but other things have also been mentioned before. If none of these can be had, the first application ought to be a plaister not greasy, to repel it; then if that has not succeeded, something to promote a suppuration. If that cannot be got, either resin or leaven(85). When the pus is squeezed out, no further cure is necessary.

The name of phyma is given to a tubercle resembling a furuncle, but rounder, and flatter in the surface, and often larger. For a furuncle seldom rises to the bulk of half an egg, and never exceeds it: a phyma is commonly of greater extent; but the inflammation and pain in it are less. When it is broken, the pus appears in the same manner; no ventricle is found here, as in the furuncle; but all the corrupted flesh is turned into pus. Now this grows more frequently in children, and is more easily cured; in young men it occurs more seldom, and is more difficult to cure: when age has given firmness to the body, it does not appear at all. The proper medicines for discussing it have been mentioned before.

A phygethlon is a low, but broad tumour, in which there is something like to a pustule. The pain and tension are violent, and greater than in proportion to the size of the tumour; sometimes also attended with a slight fever. It ripens slowly, and no great part of it is converted into pus. It is formed chiefly either in the neck, or in the armpits, or the groin. From its figure our authors call it panus(86). The proper medicine for this also we have pointed out before.

But though all the foregoing are nothing else but small abscesses, yet a larger collection, that tends entirely to suppuration, appropriates to itself the general name of abscess. And this collection happens generally after fevers or pains of some particular parts, and especially after pains in the belly. It commonly shews itself externally, for it sometimes swells to a pretty large compass, like the phyma, and is red and hot, and in a little time contracts a hardness. It is more troublesome as it advances, and occasions thirst and watchfulness. But sometimes there is none of these appearances in the skin; and more especially when the suppuration is pretty deep; but inward prickings are felt, attended with thirst and watchfulness. It is more kindly when it does not become hard of a sudden; and when, though it be ruddy, yet it is changing to a white colour. Which symptoms occur when the suppuration is beginning; for the swelling and redness comes on long before.

If the abscess be forming in any of the nobler parts, the accession of matter there must be prevented by cataplasms, which are at the same time repellent and cooling; such as I have mentioned under the erysipelas and elsewhere. If it is grown pretty hard, we must have recourse to discutients and resolvents; such as a dry fig bruised, or lees of wine mixed with cerate, made up with hog’s lard; or the root of wild cucumber, with the addition of two parts of meal, first boiled in mulse. We may also mix equal parts of ammoniacum, galbanum, propolis, viscum, adding of myrrh not half the quantity of any of the other ingredients: and the plaisters and malagmas I have mentioned before, have the same effect.

What is not discussed by these, must necessarily maturate. And to hasten this, must be applied barley meal mixed with water; to which also it will be proper to add some herbs. The same applications(87) are fit for the lesser abscesses too, whose names and properties I have recited above. The general method of cure is the same in them all; and only differs in the degree. Now that tumour is crude, in which there appears a strong pulsation of the arteries, a weight, heat, tension, pain, redness, and hardness; and if the abscess be large, a shuddering, as also a slight fever continues; and the suppuration being pretty deep and concealed, instead of the marks, which otherwise shew themselves in the skin, there are prickings. When these have abated, and the part begins to itch, and either becomes somewhat livid or whitish, the suppuration, is perfected. And when it either breaks of itself, or is opened by medicines, or by incision, the pus ought to be discharged. And if it happens in the armpits or groin, it must be dressed without lint. In other parts too, if it is narrow at the bottom, if the suppuration has been moderate, if it has not penetrated deep, if there is no fever, if the patient be strong, lint is equally needless. In other circumstances it ought to be used, sparingly however, and not unless the wound be large. It does well to spread honey upon the lint; or without it, to apply lentils with honey, or pomegranate bark boiled with wine. And these things are proper both alone and mixed.

If any parts round it should be too hard, to soften them may be applied either mallows beat, or fenugreek, or lintseed boiled in passum. And then whatever is to be applied, ought to be secured not by a tight, but an easy bandage. Every body ought to know, that in this kind of disorder cerate may be used. What else belongs to the cleansing of the ulcer, filling it up, and bringing on a cicatrix, and equally relates to wounds, has been already pointed out.

But sometimes from abscesses of this kind and other ulcers, arise fistulas. That is the name of a deep, narrow and callous ulcer. It occurs almost in every part of the body; and it has some peculiarities in each place. I shall first treat of the general properties. There are then several kinds of fistulas; for some are short, others deeper; some point inward in a straight line; others, and by far the greatest part, are transverse; some are simple, others are double, or triple, which beginning from one orifice, branch out within, into three or more sinuses; some straight, others bent and tortuous; some end in the flesh, others penetrate to bones or a cartilage; or where neither of these lies beyond them, reach to the more internal parts; some again are easily cured, others with difficulty, and some are even found incurable.

The cure of a simple and recent fistula in the flesh is easy. It is an advantage to it, if the person be young, and the constitution firm: the contrary are very unfavourable circumstances; as also if the fistula has injured a bone, or cartilage, or nerve, or muscles; if it have seized upon a joint, or has penetrated either to the bladder, or the lungs, or to the womb, or to the large veins or arteries, or to the jaw-bones, throat, stomach, or thorax. When it points towards the intestines too, it is always dangerous, and often mortal. In these cases it greatly increases the malady, if the patient be either sick, or old, or of a bad habit.

First of all, it is proper to put a probe into the fistula, that we may find its direction and depth: and at the same time whether it be altogether moist, or drier than it should be, which appears upon drawing out the probe. It may also be determined, whether the bone be affected or not; and if the fistula has penetrated there, how far it has injured it. For if that part is soft, which is touched by the end of the probe, the disorder is confined to the flesh; if it resists more, it has made way to the bone. And again, if the probe slides, there is no caries begun: if it does not slip out(88) of the point where it is placed, the caries is begun, but is slight yet: if it feels unequal also, and rough, the bone is very much corroded. The situation itself shews when there is a cartilage below; and that the fistula has reached it, appears by its resistance.

Now from these circumstances may be learnt the seats and extents of fistulas, and what parts they have damaged. From the quantity of the pus it may be known, whether they be simple, or divided into more parts. If more of that comes away, than can issue from a single cavity, it is evident there are more sinuses. And as flesh, nerves, and some nervous substances, such as the greatest part of the coats and membranes are, commonly lie together, the nature of the pus will discover whether the several sinuses have eaten through these different sorts of bodies. For from flesh a smooth and white pus is discharged pretty copiously; from a nervous place the discharge is of the same colour indeed, but thinner, and less in quantity; from a nerve fat and not unlike to oil. Lastly, the posture of the body also discovers whether the fistulas have penetrated into several parts, because often, when one lies down with his body and limb in a different position, the pus begins to flow again, which had before stopped, and shews not only that there is another sinus, from whence it descends, but also that it proceeds in a different direction.

If it be confined to the flesh, and is recent and simple, neither consisting of sinuses, nor having a large cavity: also if it be not in a joint, but in a part, which is immoveable by itself, and is never put in motion but with the whole body, a plaister for recent wounds will be sufficient, if that contain either salt, or allum, or copper scales, or verdigrease, or any of the metallic substances. And of this a collyrium(89) ought to be made, at the one end smaller, and at the other somewhat thicker. And this ought to be introduced with the small end foremost into the fistula, till pure blood begins to appear. This is universal in the application of all collyriums for fistulas. And then the same plaister is to be put over it spread upon linen; and above that must be applied a sponge first dipt in vinegar; and it is sufficient to open the dressings on the fifth day. Such diet must be used, as I have recommended for generating flesh.

But if the fistula is at a distance from the prÆcordia, it is necessary for the patient now and then to eat radishes fasting and then to vomit.

When the fistula by time becomes callous (and it is impossible to be mistaken in a callosity, because it is hard, and either white or pale) then there is a necessity for stronger medicines. Such as that composition, which contains of poppy tears p. i. *. gum p. iii. *. cadmia p. iv. *. copperas p. viii. *. these are incorporated with water, and made into a collyrium. Or that, which consists of galls p. i. *. verdigrease, sandarach, Egyptian allum, each p. i. *. calcined copperas p. ii. *. Or that, which is composed of chalcitis and stone-lime, to which is added of orpiment less by one half than each of the other ingredients; and these are mixed up with boiled honey. The most expeditious is the prescription of Meges: to reduce to powder of rasile verdigrease p. ii. *. then to dissolve in vinegar, of ammoniacum thymiama p. ii. *. and with this to bring the verdigrease to a consistence: and this is one of the choicest medicines. But though the foregoing compositions are the most efficacious, yet if these are not to be had, it is easy to destroy the callosity by some caustic medicines: and it is sufficient to arm with these a twisted paper reed, or some part of a penecillum, formed after the manner of a collyrium. Squills also boiled, and mixed with lime consume a callus.

If the fistula happen to be pretty long, and transverse, after introducing a probe, it is very proper to make an incision over against its origin, and to put in any collyrium you chuse.

But if we judge the fistula to have two or more sinuses, provided it be short and confined to the flesh, we ought not to make use of a collyrium, which may cure one part, and not touch the rest; but the same medicines dry are to be put into a writing reed, which being applied to the orifice, the medicines must be blown into the fistula. Or the same things may be dissolved in wine; or if the fistula be somewhat foul, in mulse; if somewhat, callous, in vinegar; and whatever is injected, must be infused in this liquid form. Coolers and repellents must be applied above; for generally the parts about a fistula are a little inflamed. Neither is it improper, when one has removed the dressings, before he make another injection, to wash the fistula by means of a syringe; if there be much matter, with wine; if the callosity be pretty hard, with vinegar; if it is already cleansing, with mulse, or a decoction of vetches in water, with a little honey added to it. It commonly happens that the membrane, which is betwixt the orifice and the sound flesh, being overcome by so many medicines, casts off, and the ulcer is clean below. Whenever this happens, agglutinants are to be applied, and especially spunge armed with boiled honey. I know it is a practice approved of by many in this case, to have lint rolled up into the form of a collyrium, and dipt in honey, introduced for incarning. But this method more quickly agglutinates, than incarns. And there is no fear, that clean flesh brought into contact with clean flesh can fail to unite, especially when medicines proper for that purpose are made use of; since often an ulceration of the fingers, unless great care is taken to prevent it, will join them together in the healing.

There is also a kind of ulcer, which from its resemblance to a honeycomb, by the Greeks is called cerium[ FE ]. And of this there are two species: the one is of a whitish colour, and like to a furuncle, but larger, and attended with great pain. When it maturates, it has openings, through which is discharged a glutinous and purulent matter; nevertheless it does not come to a due ripeness. If it be divided by incision, there appears to be a great deal more corruption within, than in a furuncle, and it reaches deeper. It seldom occurs but amongst the hair of the head.

The other is less, and eminent upon the top of the head, hard, broad, of a pale green colour, and more ulcerated; for there are openings at the roots of each of the hairs, through which issues a glutinous, palish humour, in consistence like honey, or viscum, or sometimes oil; and if an incision be made upon it, the flesh within appears green. There is a great pain and inflammation, insomuch that they often bring on an acute fever.

To that kind, which has fewer openings, it is proper to apply dry figs, and lintseed boiled in mulse, and drawing plaisters and malagmas, or the medicines, of that quality above recited.

Upon the other, the same medicines, likewise meal boiled in mulse, and half the quantity of turpentine resin added to it; and a fig boiled in mulse; to which a little powdered hyssop is added; likewise a fourth part of stavesacre added to the fig. But if medicines do but little service in either kind, the whole ulcer must be cut out to the sound flesh. When the ulcer is taken away, medicines must be applied over the wound; first such as promote pus, next detergents, then such as incarn.

There are also some resembling warts, which have different names, as they are different disorders. The Greeks call that an acrochordon[ FF ], where a substance pretty hard is collected within the skin, which sometimes is rough, and of the same colour with the adjacent parts; near the skin it is narrow, and broader above. This is small, rarely exceeding the size of a bean. They are hardly found to grow single; generally a number together, and chiefly in children. They sometimes suddenly disappear, sometimes they excite a moderate inflammation. Some are also converted into pus.

That is called acrothymium[ FG ], which rises like a small wart above the flesh, broader at the skin, smaller above, hardish and very rough upon the top, where in colour it resembles thyme, whence it has its name; and it is easily divided there, and made bloody; sometimes it discharges some blood; and is generally about the bigness of an Egyptian bean, seldom larger, sometimes very small. Sometimes only one, at other times more grow in the palms of the hands, and soles of the feet; they are worst in the private parts, and aptest to bleed there.

Those called myrmecia[ FH ] are lower and harder than an acrothymium, fix their roots deeper, and occasion a greater pain; below they are broad, and above small, and less blood comes from them: in size they scarce ever exceed a lupine. These likewise grow either in the palms of the hands, or lower parts of the feet.

The clavus grows elsewhere sometimes, but chiefly in the feet, and principally form a contusion, though sometimes from other causes; and it gives pain, if not at other times, at least when one is walking.

Of these the acrochordon, and the acrothymium often terminate of themselves, and the more readily, the less they are. Myrmecia and clavi are scarce ever removed without medicine. If the acrochordon be cut off, it leaves no root, and for reason does not grow again. When the acrothymium and clavus are cut off, a small roundish root grows, which descends deep into the flesh, and that being left, they sprout up again. The myrmecia adhere by very broad roots, and therefore cannot be taken off without a great ulceration. It is very proper to pare the clavus now and then: for thus without any violence it grows soft: but if a little blood be let out, it often dies away. It is also removed, if one cleans it round, and then applies to it resin mixed with a little of the powder of a milstone. But the other kinds are to be eaten away by medicines. For the two first, that which is made from the lees of wine; for the myrmecia the most proper is that, which consists of alum and sandarach. But the contiguous parts ought to be covered with leaves, lest they also be corroded; and after that a lentil must be applied. A fig also boiled in water destroys an acrothymium.

Pustules break out chiefly in the spring season. Of these there are several kinds. For sometimes there is a certain asperity over the whole body, or a part, resembling those pustules, which are occasioned by a nettle, or from sweat; the Greeks call them exanthemata[ FI ]. And they are sometimes red, at other times of the same colour with the skin. Sometimes a great many grow resembling vari, sometimes larger. The pustules are livid or pale, or black, or otherwise different from the natural colour; and there is a humour contained in them. When they are broke, the flesh below appears as it were ulcerated. By the Greeks they are called phlyctÆnÆ helcodes[ FJ ]. They arise either from cold, or from fire, or from medicines.

The phlyzacium[ FK ] is a pustule somewhat harder, of a whitish colour, and sharp pointed. What is squeezed from it is moist. The pustules sometimes turn to small ulcers, either dry or moist; and sometimes attended only with an itching, at other times with an inflammation and pain: pus or sanies issues from them, or both. And this occurs in children chiefly; seldom in the trunk of the body; often in the extremities.

The worst kind of pustule is that, which is called epinyctis[ FL ]. Its colour either inclines to livid, or is a dark brown, or white. There is a violent inflammation round it; and when it is opened, a mucous ulceration is found within, in colour resembling its humour. The pain of this is greater than in proportion to its bulk; for it is not larger than a bean. And this likewise grows in the extremities, and generally in the night-time: whence the Greeks have given it the name of epinyctis.

Now in the cure of all pustules, the first thing is to walk much, and to take exercise: if that cannot be complied with, to use gestation. The second rule is, to lessen the quantity of food; to abstain from every thing acrid and extenuating. And nurses ought to observe the same rules, if their sucking child is thus affected. Besides these, one, that can bear it, if the pustules be small, ought to sweat in the bagnio; and at the same time to sprinkle nitre over them; and to anoint the part with a mixture of wine and oil; then to go into the bath. If no benefit accrues from these, or if the pustules be of a larger kind, a lentil must be applied, and when the surface of the skin is taken off, we must have recourse to lenient medicines. After the lentil, the epinyctis is to be treated with blood-herb, or green coriander.

The ulcers formed from pustules are cured by litharge mixed with fenugreek seed; and in compounding them, rose oil, or juice of endive, are used alternately, till the mixture have the consistence of honey. The proper composition for those pustules, which attack, infants, is of that stone, which the Greeks call pyrites p. viii. *. with fifty bitter almonds, and an addition of three cyathi of oil. But the pustules ought to be first rubbed with ceruss, and then anointed with this.

The scabies is a hardness of the skin, of a muddy colour, from whence pustules arise, some of them moist, others dry; from some of them issues a sanies; and in these there follows a continued itching ulceration, which in certain cases spreads very fast. In some people it goes entirely off, in others it returns at a certain season of the year; the greater its asperity, and the more it itches, the more difficult it is to cure. And therefore this species of it the Greeks call agria[ FM ], that is, cruel.

In this also the same diet is necessary, as above prescribed. The medicine proper for this in its beginning, consists of spodium, saffron, verdigrease, each p. i. *. white pepper, verjuice, each p. i. *. cadmia p. viii. *. But where there is already an ulceration, that, which is composed of sulphur p. i. *. wax p. iv. *. liquid pitch a hemina, two sextarii of oil. These must be boiled together to the consistence of honey. There is also another, which is said to have been invented by Protarchus. It contains a sextarius of lupine meal, four cyathi of nitre, a hemina of liquid pitch, half a pound of liquid resin, and three cyathi of vinegar. It is also proper to mix saffron, lycium, verdigrease, myrrh, ashes, in equal quantities, and boil them in passum. This heals every kind of scabies. And if there be nothing else at hand, lees of oil boiled to a third part, or sulphur mixed with liquid pitch, as I prescribed for cattle, relieve men also labouring under the scabies.

Of the impetigo there are four species. The least malignant is that, which resembles the scabies. For it is red, hardish, ulcerated, and corrosive. But it differs widely from that, which is more ulcerated(90), and has pustules like to vari; and there appear to be in it somewhat like air bubbles, from which, after a time, something like scales come off; and this is more certain in its returns.

The second kind is worse, and is not unlike the papula, but of greater asperity and a more ruddy colour, having various figures; scales fall off from the surface of the skin, there is a greater erosion, it spreads more quickly, and broader, and both comes and goes at more certain intervals than the former. It is called the red.

The third kind is still worse. For it is both thicker and harder, and more swelled; it causes fissures in the surface of the skin, and corrodes more vehemently. This also is scaly, but black; it spreads wide(91), and does not stay long at a time; but is less uncertain as to its periods of coming and going; and is not to be entirely removed. This has the epithet of the black.

There is a fourth kind absolutely incurable, very different from the rest in colour. For it is whitish, and resembling a recent cicatrix; it has scales of a pale colour, some whitish, others resembling a lentil; which being taken off, blood sometimes follows. Otherwise the humour of it is white, the skin is hard and chopped, and it spreads wider.

All these kinds happen chiefly in the feet and hands; and they also infest the nails. There is no medicine more efficacious than that I mentioned for the scabies, which bears the name of Protarchus. Serapion made use of the following composition, nitre p. ii. *. sulphur p. iv. *. incorporated with plenty of resin.

There are two species of the papula. One is, where the skin is made rough by very small pustules, and is both red, and gently corroded; in the midst of them is a space somewhat smoother; it spreads slowly. And this disorder is of a round form in its beginning, and proceeds in the same manner circularly.

The second, the Greeks call agria: which has a similar appearance, but the skin is more unequal and ulcerated, and it corrodes more vehemently, is redder, and sometimes also loosens the hairs.

That which is less round, heals with greater difficulty; and unless it be cured, it turns to an impetigo. But a slight papula, if it be rubbed every day with fasting spittle, will heal. The greater kind is very well cured by feverfew rubbed over it. But for the compound medicines, that same prescription abovementioned of Protarchus is so much the more powerful here, as the distemper is less. There is another of Mico’s for the same purpose; of red nitre, frankincense, each p. i. *. cantharides cleansed p. ii. *. crude sulphur a like quantity, liquid turpentine resin p. xx. *. meal of darnel three sextantes, three cyathi of git, and one sextans of crude pitch.

The vitiligo also, though of itself not dangerous, yet is both nasty, and proceeds from a bad habit of body. There are three species of it. It is called alphos[ FN ], when it is white; it is commonly a little rough, and not continued, but appears like drops dispersed here and there. Sometimes it spreads wider, leaving some, places between free. The melas[ FO ] differs from that in colour, being black, and like a shadow. In other respects it is the same. The leuce[ FP ] has some resemblance to the alphos, but is whiter, and penetrates deeper; and has white downy hairs in it. All these spread; but in some more quickly, in others slower. The alphos and melas come and go in some people without any regularity. The leuce does not easily quit a person it has once seized.

The two first are not very difficult to cure; the last scarce ever heals; and though the disorder be in some degree mitigated, yet the natural colour is never fully restored. Whether any of these be curable or not, is easily known from an experiment. For the skin should be cut, or pricked with a needle. If blood issues, which generally happens in the two former, there is room for a remedy; if a white humour starts, it will not admit of a cure. And therefore it should not he meddled with.

To the curable kinds must be applied lentils mixed with sulphur and frankincense, the lentils being bruised and dipped in vinegar. Another composition for the same purpose is that, which goes under the name of IrenÆus. Bastard spunge, nitre, cummin, dry fig-leaves, of each equal parts, are bruised with the addition of vinegar. With this the part affected is anointed in the sun; and in a little time, it is washed off, lest it corrode too much. Some following the practice of Mico, anoint the alphi with the following medicine; they mix of sulphur p. ii. *. nitre p. iv. *. dry myrrh powdered an acetabulum; then in the bath sprinkle upon the vitiligo bean flour, and afterwards put the other over it. Those which I called melanes, are cured by the following things beat up together; bastard spunge, frankincense, barley, and beans; these are sprinkled upon them without oil in the bagnio, before a sweat comes on, and then that species of vitiligo comes off by rubbing.

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A. CORNELIUS CELSUS

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MEDICINE.

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