Protrusions of the bowels occasioned by rupture of the peritonæum are of
a very difficult nature, but those from relaxation are of easier cure;
for happening commonly to children of a humid temperament, they, for the
most part, can be cured without a surgical operation, by the application
of remedies and suitable bandages. The under-mentioned remedies are to
be applied; but I must mention, in the first place, that these diseases
differ in situation only; for, when the intestine remains in the groin,
it is called Bubonocele, and when it falls down into the scrotum, it
is named Enterocele. Wherefore, take of pomegranate-rind, dr. x; of
unripe gall-nuts, dr. v; boil in three cyathi of austere wine; pound
and apply, having previously reduced the intestine and bathed the part
with cold water. Loose it in ten days; the patient remaining on his
couch thirty days, and drinking of the decoction of cypress with wine;
or of cypress balls, three oboli, in diluted wine. This medicine is
applicable to children.—_Another agglutinative application_: Of the roots
of comfrey, of the juice of horehound, of bitter almonds, of gum, equal
parts.—_Another_: Of turpentine, oz. iss; of wax, of frankincense, of
myrrh, of isinglass, of snails with their shells, of each oz. j; macerate
the ichthyocolla previously in vinegar for three days.—_Another_:
Of cypress-balls, i. e. spherical fruit, oz. j; of galls, oz. j;
of pomegranate-rind, oz. ss; of taurocolla, oz. iij; of manna, of
frankincense, oz. ss; of comfrey, oz. ss; of snails with their shells,
oz. j; boil the balls and rind in astringent wine for a considerable
time; triturate; mix the other ingredients, and when they are added,
use.—_Another_: Of aloes, of pomegranate-rind, of frankincense, of the
juice of hypocistis, of artificers’ glue, of pitch, of bitumen, oz.
iss; of sweet wine, q. s.—_Another more complex application, which will
answer also with adults, when the disease is not of long standing_:
Of chrysocolla, of taurocolla, of sarcocolla, of ichthyocolla, of
gagate-stone, of blood-stone, of Syrian sumach, of manna, of acacia, of
each, oz. iss; of the stone pyrites, of native sulphur, of the breathing
magnet, of fissile alum, of manna, of frankincense, of each, oz. j; of
Brutian pitch, oz. v; of snails with their shells, oz. j; of the dross
of silver, oz. iv; of galls, oz. j; of squamæ stomomatis (_scales of
steel?_), oz. j; of copper, oz. j; of bitumen, oz. vj; of myrtle-oil, q.
s.; mix the dry things with astringent wine, until the preparation is of
such a thickness as not to stain, and then use. If they cannot lie in a
recumbent posture, bind the application firmly with a triangular bandage
of thick materials and sufficient to retain the intestine. Let them
abstain from flatulent food, much wine, frequent baths, strong motion,
such as running, leaping, loud crying, and the like. For hydrocele, so
as to evacuate the fluid: Of pepper, c grains; of bay-berries, lxxx;
of nitre, dr. xx; of wax, dr. xl; mix with half a hemina of oil, and
use.—_Another excellent application_: Of the flower of Assian stone,
dr. vj; of grapes deprived of their stones, dr. ij; of Ethiopian cumin,
dr. viij; of red nitre, dr. viij; having triturated, apply, fomenting
with it late and early. Some also add of sulphur, dr. viij.—_Another_:
Mixing unslaked lime with bath-sordes, apply with cerate; and mix some
nitre with the unslacked lime.—_Another_: Having burnt the root of a
cabbage, add the ashes to old axunge that has been melted, and remove
it every third day. To prevent a collection of water, use the following
malagma: Of wax, lb. iiss; of pitch, oz. iv; of ammoniac perfume, oz. iv;
of liquid alum, oz. iss. The plaster of the white poplars and the other
epispastics are also applicable.
* * * * *
COMMENTARY. As these diseases will be treated of more fully in the Sixth
Book, it is unnecessary to say much about them at present.
Our author is most indebted to Aëtius (xiv, 22.) Nonnus recommends
astringent applications of a similar nature. (192.) When there is
difficulty of reduction, Rhases directs the use of the warm bath
perseveringly. Haly Abbas remarks that protrusion of the bowels will
sometimes occasion constipation, pain, and death. He says nothing of an
operation for relieving the strangulation. Alsaharavius declares that
he had found all the applications recommended for the cure of these
complaints utterly ineffectual after they are fairly formed. He directs
us to return the protruded parts, and secure them by means of a bandage,
along with a pad of lead and a plaster of pitch, &c. The Surgical
treatment of these complaints is minutely described in the Sixth Book.
SECT. LIV.—ON INFLAMMATION OF THE TESTICLE AND SCROTUM, AND ON THE OTHER
DISEASES OF THESE PARTS.
You may recognize inflammation of the scrotum from the pain being felt at
the slightest touch of the hand, and from the heat and hardness appearing
intense; whereas, when the testicle is inflamed, a slight touch does
not give pain, which is only felt when the part is firmly pressed by
the fingers, while the redness and hardness appear less at the surface;
but, upon grasping it firmly, a deep-seated hardness meets the fingers;
and fever is sometimes present. To inflammations of the testicles, in
particular, venesection is applicable at the ancle; and to all these, in
general, cataplasms and cerates. Cataplasms are to be applied, of the
flour of beans boiled in diluted wine, with fat dried grapes deprived
of their stones; or, boil the root of cumin or asphodel, and, having
pounded, mix with an equal part of the flour of dried barley-meal,
and apply as a cataplasm; or, linseed in diluted wine; or, fenugreek
in honied water; or, the root in honied water; or, the recent lees of
wine, with the flour of barley-meal; or, groundsel and green coriander,
with dried grapes deprived of their stones. But if there is much heat,
apply a cataplasm of the leaves of henbane with wheat-flour, or that of
chick-peas; or, of the leaves of sweet-flag, or of unripe gourd. When
the affection is protracted, and attended with hardness, boil the root
of wild cucumber in honied water, and, having triturated with the flour
of darnel, apply as a cataplasm. And this is an excellent remedy: Of
dried grapes deprived of their stones, oz. v; of boiled chick-peas, oz.
iss; of cumin, oz. j; of sulphur, oz. ix; of nitre, oz. j; of rosin, oz.
iiiss; triturate altogether with honey, and apply as a cataplasm. The
following are convenient cerates: Of oil, one cyathus; of Colophonian
rosin, oz. vj; of plumbago, of cumin, of dried grapes, of the flour of
beans, of each, oz. iv; of wax, oz. ij; boil the plumbago with the oil
to a proper consistence, then add the wax and rosin, and, taking it off
the fire, pour it half cooled upon the pounded figs and flour.—_Another_:
Of the oil of dill and of roses, of wax, of pine-rosin, of each, oz. v;
of cumin, oz. iiss; of asses’ dung, oz. iss; triturate the cumin with
the asses’ dung, and when the cerate is cooled mix and levigate; then,
placing in a rag, use, applying above it wool out of oil from unripe
olives; or, use equal parts of butter and rosin. If from sweats there
be ulcers in the scrotum, sprinkle powdered gall or alum upon fat and
goats’ gall, and anoint. For testicles affected with aphthæ: Having first
anointed with Cimolian earth and water, allow it to dry, and wash with
warm water; then, having triturated dried myrtle and a small quantity of
alsander, apply as a cataplasm. Excrescences upon the testicles are cured
by the application of the lixivial ashes of the vine mixed with wine and
water. When there is pruritus of the scrotum, triturate finely nitre,
stavesacre, dried figs, and moist alum with vinegar and rose-oil, and
anoint with it in the bath; but after the bath, rub in the white of an
egg with honey.
* * * * *
COMMENTARY. On diseases of the obscene parts, consult Hippocrates
(Epidem. v, 4, et alibi); Galen (Sec. loc. ix; Loc. Affect. vi, 6);
Celsus (iv, 21, viii, 18, vi, 18); Aretæus (Morb. Chron. ii, 5);
Oribasius (Loc. Affect. iv, 102); Aëtius (xi, 32, xiv, passim); Actuarius
(Meth. Med. i, 15, iv, x); Nonnus (192); Alexander (viii, 9, 10); Cælius
Aurelianus (Pass. Tard. v, 5); Marcellus (32); Octavius Horatianus (ii,
11); Moschion (de Morbis Mulierum); Scribonius Largus (233); Avicenna
(iii, 20, 1, 2); Avenzoar (ii, 3); Haly Abbas (Theor. ix, 37; Pract.
viii); Alsaharavius (Pract. xxii); Rhases (Divis. 79; ad Mansor. ix, 101;
Contin. xxiv.)
Hippocrates relates a case of prurigo scroti which was removed by hot
baths, but the patient afterwards became dropsical and died.
Many of our author’s remedies are taken from Galen, but he has copied
most closely from Oribasius and Aëtius.
The treatment of inflammation of the testicles, as laid down by Celsus,
is very judicious, namely, bleeding at the ankle, a cataplasm of the
flour of beans boiled in mulse with pounded cumin and boiled honey, and
other similar applications. When it becomes indurated, linseed or the
seed of fenugreek boiled in mulse, or the like, are to be applied. When
the testicles swell from a blow, blood must necessarily be extracted from
them, more especially if they are livid.
Avicenna is particularly full upon these and all the other diseases
of the obscene parts. For pruritus of the testicles and scrotum he
recommends bleeding, cupping in the vicinity of these parts, the
application of leeches, hot fomentations with acacia, sal ammoniac, &c.,
and the other remedies mentioned by Paulus. For apostemes he directs
us to bleed in the arm and ankle, and to use applications similar to
those of our author. Rhases recommends bleeding in the arm and ankle,
and at first cold applications, consisting of vinegar and rose-water,
which, if the complaint does not abate, are afterwards to be exchanged
for suppurative ones. Haly’s treatment is nearly the same. Alsaharavius,
like Avicenna, treats inflammation of the testicles by bleeding in the
arm and ankle, and using various local applications of a cooling nature.
For pruritus he recommends applications containing ceruse, sulphur,
nitre, sal ammoniac, and strong vinegar. Rhases mentions that he had an
enlargement of the right testicle for which he took an emetic, whereby a
manifest reduction of the swelling was produced, and by a repetition of
this process the complaint was entirely removed.