SECT. X.—ON APHTHÆ.
Infants are liable to an ulcer of the mouth called aphtha. It is either whitish, reddish, or black, like an eschar. That which is black is of the worst kind and most fatal. The iris mixed with honey is of use, or you may blow in the dry powder if you please; also, the pounded leaves of roses, or the flowers of roses, and crocus—a small quantity of myrrh, galls, frankincense, or the bark of the frankincense tree: all these together, or separately, may be mixed with honey; and, in addition to these, may be joined honied water and the juice of the sweet pomegranate.
Commentary. Hippocrates mentions aphthæ among the diseases of dentition. (De Dent.) Theophilus, the commentator on Hippocrates, says, that aphthæ are occasioned by the tenderness of the parts, which cannot bear the bad qualities of the milk. According to Aretæus, the land of Egypt is particularly prolific of these ulcers, which are engendered by the impurities of the water and the quality of the vegetables that grow there. (Morb. Acut. i, 9.) The aphthæ appear to be the oscedo of Isidorus. (Orig. iv, 8.)
Our author copies from Oribasius. (Synops. v, 10.) See also Aëtius, (viii, 39.) Aëtius borrows his account from Galen, who is very full upon the treatment of aphthæ. He remarks that recent superficial ulcers are easily cured, but that such as spread and are of a gangrenous nature are very dangerous. He gives, at great length, directions for the composition of applications, suited to every modification of the complaint. When the pustules are red, he prescribes washes of a moderately astringent and cooling nature; if yellowish, the same, but somewhat more refrigerant; if whitish and pituitous, detergents are to be used; and, if black, the most powerful discutients. For simple cases of the aphthæ infantium, he merely recommends the flowers of roses with honied water. Most of his remedies are astringents. (De Med. sec. Loc. lib. vi.) In another work, he says that aphthæ are occasioned by the acrimony of the milk, and are to be cured by astringents. (Comment. in III Epidem.)
Pliny mentions that the lapis melititis was used as an application in cases of ulceration of the fauces. (Hist. Nat., xxxvi.) There is reason to believe that it was Borax, or borate of soda.
Avicenna recommends at first washes prepared from the vegetable acids, and afterwards astringents, such as galls, sumach, balaustine, &c. (i, 3, 1.) See also Haly Abbas (Pract. i, 20.)
Alsaharavius states that aphthæ commonly arise from the sharpness of the milk. His general treatment consists in regulating the diet of the nurse, and using washes principally of an astringent nature for the child’s mouth. When they are very painful, he adds to the washes the juice of lettuce, endive, and the like. When they are whitish, he recommends a powder consisting of myrtle, saffron, and sugar. (Tr. xxvi, 20.) Rhases’ treatment is quite similar. (De Morbis Infantium, c. 14.)
The author of the following work, which has been falsely ascribed to Dioscorides, recommends certain applications of a strongly escharotic nature, such as this: Of arsenic, p. i; of burnt paper, p. iii; or this, of sandarach and rose-oil equal parts. (Euporist. i, 82.)
Psellus enumerates two kinds of aphthæ, namely, the white and the red; the former, he says, is mild, the latter very dangerous. (Poëma Medicum.)