SECT. XLIII.—ON LAXATIVES AND DIURETICS TO THOSE IN HEALTH.
Some of the ancients thought it sufficient for health that the bowels and urine should be evacuated once a day freely and fully, according to the quantity of food and drink which had been taken; and when the evacuations were agreeable to this rule, they were satisfied, or, if otherwise, they assisted them by taking, in order to increase the urinary discharge, shepherd’s needle, parsley, asparagus, Macedonian parsley, anise, calamint, marjoram, wormwood, the roots of couch-grass and of golden thistle, tree-medic, and of maiden-hair; all these being boiled in water, so that the decoction might be drunk with wine. For these things purify the blood by the mine, and are of no small efficacy. Alvine discharges are to be assisted by giving turpentine to the quantity of an olive when going to rest, or, when it is wished to purge more effectually, by adding a little rhubarb. Soft eggs, of pot-herbs the beet and mallows, and the soup of shell-fish are also laxative, and these probably will be sufficient. But if more powerful remedies be required, the herb mercury, boiled in water with salt, may be eaten, or the decoction drunk; and, in like manner, the leaves of the elder tree (sambucus), or the root of the oak-fern (polypodium) to the amount of two drachms, may be sprinkled upon pickle, or swallowed in a ptisan; or milk-whey, with salt; or honey, to the amount of three or four heminæ; or the broth of an old cock, by itself or with two drachms of bastard saffron, or aloes, to the amount of about three chick-peas, may be taken at supper-time. But the best remedy is dodder of thyme, taken in wine after a moderate supper. But he that wishes to purge more strongly must take, in the morning, a drachm of this medicine infused in vinegar and honey, if in the spring season.
Commentary. Oribasius treats fully of purgatives towards the end of the 8th book of ‘Med. Collect.’ He gives a list of gentle laxatives. (Euporist. i, 45.)
Hippocrates frequently recommends gentle purgatives for the preservation of the health. Of this class, the herb mercury appears to have been his favourite.
Galen has given two distinct treatises on purgatives, and the cases in which they are applicable. He dissuades those who are in good health from taking them, but says that they may often be used so as to prevent the recurrence of diseases. Hence, he says, that he had often prevented gout and rheumatism from relapsing, by the seasonable administration of purgatives. He forbids purgatives when the hypochondria are distended with flatulence.
Aëtius gives a very lengthy account of the preparation of purgative medicines, which will be noticed more properly in the [Seventh Book]. He states that all medicines of a cutting or penetrative nature are diuretic. He mentions plantain, fennel, parsley, seseli, anise, valerian, bitter almonds, &c. (iii.)
Celsus gives the following list of gentle diuretics: “Urinam movent quæcunque in horto nascentia boni odoris sunt, ut apium, ruta, anethum, ocimum, mentha, hyssopum, anisum, coriandrum, nasturtium, eruca, feniculum: præter hæc, asparagus, capparis, nepeta, thymum, saturcia, lapsana, pastinaca, magisque agrestis, radicula, siser, cepa; ex venatione, maximè lepus; vinum tenue, piper et rotundum et longum, sinapi, absinthium, nuclei pinei.” He also gives a long list of laxative articles, such as cabbage, mallows, sorrel, gourds, cherries, all ripe apples, green figs, cockles, oysters, muscles, milk, crude honey, and all fatty and salty substances. (ii, 29.) Horace makes mention of the laxative properties of oysters, cockles, dock, and white wine—
“Si dura morabitur alvus
Mitulus et viles pellent obstantia conchæ,
Et lapathi brevis herba; sed albo non sine Coo.”
(Sat. ii, 4.)
Avicenna gives very minute directions respecting the use of purgatives. He very properly recommends us when a purgative medicine has been taken, and instead of operating, has occasioned heat, vertigo, and headach, to administer an injection. (i, 4.)
Haly Abbas treats of these medicines in pretty much the same terms as our author. He remarks that obstruction of the bowels leads to colic, flatulence, difficult respiration, and vertigo. Retention of urine, he says, leads to ulcers in the bladder. He states that diuretics are useful in diseases of the joints and spine, dropsy, and various complaints, but are apt to render the body dry. (Pract. i, 12.) Diuretic medicines, he remarks in another place, are of a hot and sharp nature, so that they heat the kidneys, and thereby increase their attractive power. (ii, 27.)
Alsaharavius cautions against the indiscriminate use of purgatives, which, he says, in a dry temperament disposes to phthisis, and to dropsy when the stomach is weak. When a purgative medicine has induced hypercatharsis, he prescribes astringent powders, containing sumach, pomegranate, and the like. (Theor. x. 1.)
Rhases gives some very sensible observations on the use and abuse of purgatives. He says that persons who lead an indolent life, are of a gross habit, and live freely, are most benefited by them. To those of a dry temperament, on the other hand, they prove prejudicial, by predisposing to hectic fever. He recommends fat food and the warm bath before taking a purgative. (Ad. Mansor. iv, 15.)
See a full account of these laxative medicines, in Serapion (De Antidotis.)