SECT. LXXIX.—ON CHILBLAINS AND AFFECTIONS OF THE FEET AND HEELS.
Chilblains are ulcerous affections forming about the fingers and toes in the season of winter. They should be bathed with tepid sea water, or the decoction of beet, or of lentil, or of bitter vetch, or of the root of kingspear. After this, triturate boiled lentils with wine, and apply in the form of a cataplasm; or, apply figs triturated with oil; or, triturate equal portions of alum and barley-flour in wine, and apply; or use a cataplasm of dried lees of wine or of fresh bulbi triturated with wine; or boil garlic in oil, and having thrown away the garlic, melt a moderate quantity of wax with the oil, and apply; or boil pomegranate-rind in wine, and having triturated, add to the rose-cerate, and use, having previously fomented the part with the decoction of lupines; or apply manna and native sulphur with boiled honey. The juice of henbane rubbed frequently into the part removes the inflammation and pain.
The Marcellian application for chilblains. Having scooped out the heart of a turnip, put into the cavity two ounces of wax, and the same quantity of lentisk oil; and having boiled them in a double vessel along with sea water, brine, or the decoction of lupines, bathe the part with the fluid; and having cooled the cerate which is melted in the turnip, apply it. For ulcerated chilblains: Of frankincense, of fissile alum, of reddle, of rosin, equal parts; dilute with axunge, and use. For ulcers with inflammation, use the application called Hexapharmacon: Of oil, oz. ix; of bull’s tallow and gall, of each, lb. ij; of litharge, oz. vj; of colophonian rosin, oz. iv; of honey, oz. vj.
For fissures of the toes and of the whole feet. Anoint with liquid pitch; or, having burnt a river or sea-crab on coals, scrape off the shell, and having triturated it with oil, and made of the consistence of honey, and having wiped the fissures, apply. The inner part of squill boiled in oil and triturated with turpentine also answers well; and a goat’s horn burnt and mixed with axunge. One must first clear the callous part, and then use the medicines.
The plaster called the florid for fissures of the heels and soles. Of quicklime, dr. x; of ceruse, dr. xx; of wax, dr. xx or xxx; of fresh axunge, oz. vij; of colophonian rosin, oz. ix; of the juice of linseed, one cyathus; of sweet oil, oz. xl; nothing is so efficacious for softening the sole.—Another: Of goats’ seam, of wax, of oil, equal parts; use.—Another: Having boiled pomegranate-rind in vinegar, apply for five days; then, having cleaned it away, apply quicklime with oil, or with bath sordes.—Another: Having boiled squill in oil, throw away the squill when boiled: having melted some turpentine in this oil, use.
For fretting of the heels from long confinement in bed. Of wax, of oil, of litharge, of honey, equal parts. It answers with every ulcer of the soles, heels, ankles, and inner part of the toes, more especially if the sore be near the nail.
For foul ulcers in the sole, and also for those in the pudendum; To be applied on a pledget. Of lees of oil, one cyathus; of vinegar, one cyathus; having boiled in a copper vessel until of the consistence of honey, and triturated separately with ij dr. of the flakes of copper, and ij dr. of manna, add the ashes of a handful of soft unwashed wool which has been wrapped round a torch and burnt: mix all together, and use, diluting it with wine for wounds, and with must for those of the pudendum and sole.—Another: Of lees of oil, of scummed honey, equal parts. This also cleans the gums.
For fretting of the skin by shoes. The lungs of a lamb, of a swine, or of a goat, make a good application. The burnt leather of old shoes does not answer when there is inflammation; but when the inflammation is over it answers well. Or, apply onions with the grease of a fowl; or sprinkle the part with burnt gall; or dissolve acacia in vinegar, and anoint with it.
Commentary. See Hippocrates (Epidem. vii, 38); Celsus (v, 28); Scribonius Largus (86); Oribasius (Morb. Curat. iii, 56); Octavius Horatianus (i, 28); Aëtius (xiv, 73); Actuarius (Meth. Med. vii, 8); Nonnus (224); Avicenna (iii, 22, 2, and iv, 3, 2); Haly Abbas (Pract. iv, 17); Rhases (Divis. 125); Alsaharavius (Pract. xxix, i, 27.)
These affections of the extremities Celsus recommends, in the first place, to be bathed with hot water in which rapes or vervain have been boiled. If ulceration has not taken place, copper, as hot as possible, is to be applied to the part. If ulcerated, equal proportions of alum and frankincense, with wine, or pomegranate-rind, boiled in water and pounded, are to be applied.
The following application, recommended by Scribonius, might be useful: Cerussæ, lb. j; ol. myrtei, lb. j; lithargyri, dr. xxiv; ceræ Ponticæ, lb. j. Cerussa et spuma argenti coquuntur cum oleo, donec coeant, postea adjicitur cera.
For pernio, Aëtius gives a long list of applications, several of which are copied by our author. The ordinary ingredients of them are stimulants and astringents. The following may be pointed out as likely to be useful: Aluminis scissi, dr. x; lithargyri, dr. iv; myrrhæ, dr. j; ovorum albumina duo; vino et oleo myrteo; m. Aëtius also gives a variety of prescriptions for fissures and the other complaints of the feet.
The turnip is mentioned by Pliny as an application to chilblains. See also Galen (de Optima Secta, 16.)
Octavius Horatianus lays down very judicious rules for the treatment of these complaints. His applications, however, are much the same as our author’s. Thus, for chilblains, he recommends fomentations with salt water, or the decoction of beet, containing also alum; after which the part is to be anointed with melted wax. He also mentions, as proper applications, galls pounded with vinegar; a mixture of wax and melted pitch; a cataplasm of boiled lentils; the grease of geese, with wax and oil, applied in a tepid state; and the like. When ulcerated, he directs us to apply an ointment of litharge and axunge. For fissures he particularly recommends liquid pitch; or litharge mixed with ceruse, alum, and wine. When hairs are troublesome, they are to be cleared away with a fine piece of iron.
For fissures Rhases recommends the fat of a cock with galls. Alsaharavius lays down the rules for treating chilblains in all their stages with great precision. If the parts become red or black, he recommends us to make deep scarifications with a scalpel; after which the foot is to be put into hot water and allowed to bleed freely. His dressings are similar to those of the others. Haly’s treatment is like our author’s.