Whitlow is an abscess forming about the root of the nail. When,
therefore, the whitlow is small and but commencing, galls with honey
repress it, and prevent the formation of an abscess; or the trochisk of
Musa, or the Here, in water. When a preternatural growth of flesh has
taken place, the object is to consume and break it with things that are
not of a corrosive nature. The sordes of the ears and lycium are also
good for whitlows. When it suppurates, having opened it and evacuated
the fluid, soak a sponge in water, and apply; or apply a cataplasm of
lentils pounded with water; or palm-plaster with wine; or green or dried
roses macerated in water, and pounded; or dried barley-flour with water.
The flour of lupines mixed with honey, or wine and honey is good for
whitlow. For ulcerated whitlows: Of verdigris, of litharge, of each, dr.
iv; of sarcocolla, dr. iv; sprinkle of it what is sufficient, and apply
externally a tent and sponge out of wine. And the flesh must be separated
from the nail all around.
_On pterygia._ Pterygium is fungous flesh covering part of the nail,
being caused by whitlow or the like; for which, sprinkle equal parts
of arsenic and manna, and apply a tent out of wine and a sponge
above it.—_Another_: Of chalcitis, of the flakes of copper, of
pomegranate-rind, equal parts; add to a roasted fig and honey, first
bathing the part with the decoction of the thickening matters put into
ointments; and clean away the part of the pterygium when dried up.
_For pterygia of the toes in a putrid state, and for ulcers of the
pudendum._ Of frankincense, dr. j; of the scales of copper, dr. j;
of scraped verdigris called _xyston_, dr. iv; of honey, one cyathus;
triturate in the sun until it become yellowish, and use upon a compress,
having first bathed with wine.
_A composition for quickly drying and curing pterygia._ Of burnt sori,
dr. ij; of frankincense, dr. ij; of verdigris called _xyston_, dr. j:
having triturated with honey, apply to the pterygia. It is useful for
the other malignant ulcers, and for lividity, and putridity of these
parts.—_Another_: Add the flakes of copper to the flesh of dates, or
of figs, and use.—_Another_: Having boiled and triturated pigeons’
dung in must with fine polenta, apply warm. And the flakes sprinkled
by themselves dry up pterygia. We must always raise and remove with
a scalpel the corner of the nail when it increases so as to hurt the
pterygium.
_For bruised nails._ Apply a cataplasm of myrtle and the tender leaves of
pomegranate.
_For bloody nails._ Mix fine flour with pitch, and apply.
_To remove diseased nails._ Add triturated sulphur to axunge, and apply.
_How to remove leprous nails._ Of mistletoe of the oak, of red arsenic,
of fenugreek, of each, oz. ij; of cantharides, of deadly carrot, of
each, oz. j; of vinegar, q. s.—_Another_: Of bee-glue, of Attic wax, of
bitumen, of each, dr. ij; of native sulphur, dr. j. Let only so much
oil be added that it may not stain. In using it, warm and apply it to
the nails.—_Another_: Of liquid pitch, of wax, of colophonian rosin,
of turpentine, of ammoniac perfume, of native sulphur, of aphronitrum,
equal parts; evaporate until it does not stain.—_Another, from the works
of Ruffus, for leprous nails_: Of cantharides, of native sulphur, of
copperas, of each, oz. ss; of liquid pitch, oz. ij: having made into a
plaster, apply to the nail, removing it every third day.
_Another for removing leprous nails without ulceration._ Of bitumen, of
arsenic, of red arsenic, of native sulphur, of each, dr. iv; add to rosin
and use, removing it every seven days.—_Another_: Mixing the flour of
bitter vetches with sheep’s gall, or sheep’s urine, use; or unslacked
lime with oil; or Chian mastich with opobalsum; or mixing copperas and
native sulphur with mistletoe, spread what is sufficient on a skin, and
apply; or triturate stavesacre with vinegar and use; or of turpentine
rosin, dr. j; of red arsenic, double the quantity; apply to the root
of the nail, and bind carefully. When the nail falls off, apply the
myrtle-cerate, containing a small quantity of the composition from rosin.
* * * * *
COMMENTARY. See most of the authorities referred to in Section LXXIX.
Aëtius and Oribasius treat whitlow upon the same plan as our author,
namely, by using cooling and astringent applications, such as galls,
alum, and pomegranate-rind at the commencement; and after it has burst
and fungous flesh has got up, by applying strong caustic and corrosive
medicines, such as arsenic, verdigris, quicklime, and the flakes of
copper. Neither of these authors, however, say anything about making
an early incision of the part affected with whitlow, which must be
considered a defect in their method of practice. Octavius Horatianus,
however, seems to have had it in view to recommend an early opening, when
he says, “Si saniem sanè collegerit, locum pungis.” In fact, it is as
soon as the part becomes gorged with blood, and before the matter has had
time to be properly formed, that an opening should be made.
Avicenna is exceedingly minute in his directions for treating whitlow.
He recommends at first the finger to be put into hot vinegar. Then
various astringent and repellent applications are to be used, among other
ingredients containing camphor. These are afterwards to be changed for
emollient and sedative applications prepared with opium. When matter
forms, it is to be let out by a small opening. Haly Abbas recommends
at first the seed of fleawort pounded in vinegar or snow, to cool and
deaden the sensibility of the part. When these do not answer, he advises
suppurative applications; and when the abscess does not open readily,
he approves of an incision with the edge of a lancet. When the pain is
violent and obstinate, he recommends opium, henbane, and vinegar to be
added to the applications. He mentions that Hippocrates recommends an
application of galls and vinegar for whitlow. Alsaharavius describes
whitlow by the name of _alcahas_. He recommends us to bleed at the
commencement, then to use a plaster of vinegar and opium, or a piece of
cloth moistened in snow or cold water, and frequently changed, or to put
the finger into hot oil. If these means do not succeed, suppuration is to
be encouraged; and as soon as matter forms it is to be let out. Avenzoar
describes a species of malignant whitlow, of which we have seen some few
cases. He says it spreads up the hand, and occasions corruption of it. He
recommends free incision, and relates a case in which very bad effects
resulted from neglecting this practice. (iii, 2, 37.) This is perhaps the
same disease that is described by Alsaharavius (Pract. xxix, 1, 25), and
by Albucasis (Chir. i.)
Rhases says that common people put the finger into hot oil. He also
recommends hot vinegar and hot water. (Contin. xxxvi.)
Celsus directs us to make an opening around _scabrous nails_, and then to
apply a composition consisting of red arsenic, nitre, common arsenic, and
liquid pitch. Under the use of this application, the diseased nails fall
off and healthy ones come in their place. Haly Abbas and Alsaharavius
also recommend applications containing arsenic. Alexander Aphrodisiensis
mentions that leuce occurs more commonly on the hands than the feet,
and in children rather than in adults. This arises, he says, from the
feet being more exercised than the hands, and from children eating more
voraciously than adults. (Probl. i, 146.) The compositions recommended in
the ‘Euporista’ of Dioscorides for leprous nails are arsenic and water,
sandarach, quicklime, and burnt lees of wine with pitch, the juice of
thapsia and mustard with vinegar, &c. See also M. M. v, 122.
_For bruised nails_, Aëtius strongly commends a mixture of fossil salt
with water and oil. Avenzoar speaks of privet (alcanna) with olive-oil.
_For bloody nails_, Nonnus recommends a mixture of verdigris and axunge.
Avicenna, among other applications resembling those of the Greeks,
recommends a plaster of cypress-nuts and savin.
_For pterygia_, Celsus, among other applications, makes mention of a
mixture of arsenic, quicklime, and chalcitis, in equal proportions. If
this application fail, he directs us to use the actual cautery. Aëtius
and Oribasius recommend the most powerful escharotics, such as verdigris,
misy, sori, chalcitis, and arsenic. These applications are mentioned
likewise by Rhases. (Contin. xxxvi.)
Pliny says of arsenic, “Tollit et pterygia digitorum,” &c. (H. N. xxxiv,
56.)