SECT. II.—ON BURNING OF THE HEAD FOR OPHTHALMIA, DYSPNŒA, AND ELEPHANTIASIS.
In ophthalmia, occasioned by a defluxion from above, and in dyspnœa, produced by a redundance of a recrementitious humour which is sent from the head down to the chest, and by lodging there proves injurious to the parts contained in it, they burn the middle of the head in this manner. Having first shaven the parts about the vertex, they apply cauteries shaped like olive-kernels and burn the skin down to the bone, scraping the bone after the falling off of the eschar. Some by burning even the bone itself make a small scale exfoliate from it, in order to allow the humours of the head to perspire and be evacuated the more readily; and for this purpose they keep the ulcer open for some time and then allow it to cicatrize. In treating elephantiasis some burn five eschars in the head, one anteriorly above the part called the bregma; another, below this, a little above the forehead, at the extremity of the hairs; another, at the part called the occiput; two others at the parts called the squamous plates, above the ears, one on the right side and another on the left; and thus, by the removal of several scales, they procure the evaporation and discharge of the collection of thick humours in the deep-seated parts of the head, and prevent the sight from being injured. They also apply another cautery on the spleen, in order to remedy the prime organ in the formation of the melancholic humour by the eschar formed in the skin.
Commentary. See Hippocrates (de Visu); Aretæus (de curat. Morb. Chron. i, 1); Celsus (iii, 23, and vi, 6); Cælius Aurelianus (Morb. Acut. i, i, and Morb. Chron. i, 4); Aëtius (vi, 50); Actuarius (Meth. Med. iii, 2); Rhases (Cont. xxvii, 1, 24); Albucasis (Chirurg. i); Mesue (de Ægr. Capitis); Avicenna (iii, 1); Haly Abbas (Pract. ix, 69); Avenzoar (I, 9, 17).
The use of the actual cautery in surgical practice is often alluded to by the classical authors. See a collection of these passages in Dr. Blomfield’s edition of the ‘Agamemnon’ of Æschylus (822.) Consult also Gataker’s ‘Marcus Antoninus’ (v. 193); and Boissonade’s ‘Anecdota Græca’ (vol. ii, p. 311.) A very elaborate and sensible account of the use of the cautery in the practice of surgery is given by Vegetius. (Malomed. i, 28.)
Hippocrates, or whoever was the author of the work referred to above, applied the cautery to the head very freely in diseases of the eyes and other complaints.
Aretæus directs us, in cases of cephalæa and epilepsy, to perforate the bone as far as the diploe, and afterwards to burn it until the dura mater is separated from the bone. He admits, however, that it is a harsh remedy.
Celsus directs us, as an ultimum remedium in epileptic cases, to form issues with a burning iron upon the occiput and at the juncture of the first vertebra with the head.
Aëtius speaks of burning the head in nearly the same terms as our author. He directs us to avoid the muscular parts. Actuarius does the same.
Cælius Aurelianus, however, disapproves of this practice in cases of cephalæa and epilepsy.
The Arabians were even more partial than the Greeks to burning the head in these and other complaints. See in particular Albucasis, whose description is very minute. In cases of cephalæa he recommends the cautery to be applied to the occiput, but cautions against touching the bone lest it produce violent pain. He directs us to be careful to avoid muscles, nerves, and arteries. Avicenna, Rhases, Mesue, and Haly Abbas recommend the operation, in the most unqualified terms, as a powerful remedy in the cases mentioned by our author. Avenzoar, however, condemns the unguarded application of the burning iron to the head.
Guido de Cauliaco recommends the cautery in cases of hydrocephalus (ii, 2, 10). Brunus also applied it for hydrocephalus, (ii, 17.) But see in particular Lanfrancus (III, iii, 18.)
Fabricius ab Aquapendente states that from the most ample experience he had ascertained the good effects of applying the cautery over the sutures of the skull in various complaints, especially asthma, consumption, and all cold defluxions from the head to the chest. He gives a full account of the operation. (Œuvres Chirurg. ii, 1.) But see De Haën. (Rat. Méd. t. iii, p. vi, c. 6.)