SECT. VI.—ON WHITE AND BLACK ALPHI.
The formation of alphos is similar to that of leuce, but the latter produces a deep change of the skin, so that the hairs grow of a similar colour, whilst the alphi affect the skin superficially, except that when continued, they extend more deeply, so that the hairs grow white, owing to the humour which causes it. From the pituitous humour then they are produced white, but black from the melancholic. Wherefore, a common application for both is washed lime dissolved in water, or, the root of dracunculus applied with vinegar; in like manner, either species of hellebore, the decoction of bitter lupines poured on the part, and their flour when applied as a cataplasm with vinegar or oxymel, the bark of the root of capers with vinegar, the root of lily with honey, onions with vinegar rubbed into the part in the sun, the dung of the land crocodile, and in like manner, that of starlings, when they are fed solely upon rice, and the burnt shells of the cuttle-fish. The following is a compound application: of alcyonium, of natron, of each, oz. ij; of white hellebore, of sulphur vivum, of each, oz. j; and some also add the burnt lees of wine.—Another: Of sulphur vivum, of the spuma nitri, of each, dr. iv; rosemary seeds, vij; triturate with vinegar. But rub only the part affected with alphos, not touching the unaffected parts, and when dry, wash with cold water.—Another: Of the flour of lupines, of buccina, and natron, of each, a chænix; of white hellebore, dr. viij; rub with it in a dry state.—Another: Of the flour of bitter vetches, lb. ij; of the seeds of rocket, of bitter almonds, of the root of the wild cucumber, of each, lb. j; triturate with wine and honey and anoint, and after an interval of an hour wipe it away with a sponge. It applies also for freckles, warts, and other spots on the skin.
A tried remedy for white alphos: of sulphur vivum, ii sextarii, of quicklime whitened, oz. iv; five whites of eggs, of nard-oil and vinegar, a small quantity. The sulphur is first pounded, then we add to it the oil of nard, and again triturate; then the vinegar is poured in, and the mixture is again triturated. But the quicklime is to be washed separately, once, twice, and thrice, and then we add it to the sulphur with the white of the eggs and triturate; and we pour out the collected fluid; but leaving a small quantity so that the ointment may admit of anointing, we use it thus.—Another tried remedy: Take sulphur vivum, dried fig leaves, aphronitrum, alcyonium, Cimolian earth, and myrtle, use with vinegar.—Another of Archigenes: Rub in equal parts of fig leaves dried in the shade, of sulphur, and of alum with vinegar, or of fig leaves, dr. iv; of nitre, dr. ij; of burnt alcyonium, dr. ij; anoint with vinegar in the bath. But red arsenic with one half of sulphur is excellent for removing the black alphos; thus having cleansed the part with natron, anoint with it in the sun. For white alphos: of copperas, of verdigris equal parts, of natron the double, rub without fat: or, of rosemary seeds, of sulphur vivum, of adarce, equal parts; triturate with vinegar, rub, and anoint; but when it is dry, bathe by rubbing. This applies also to the white species.
Commentary. We have again to refer the reader to the second chapter for an account of these complaints, and an exposition of the differences between them and the affections to which they are allied. It will be seen that they are varieties of the genus vitiligo of Celsus, and that they bear a near resemblance to leuce, from which they are chiefly distinguished as being mere superficial affections of the skin. The Arabians treat of them under the names of morphea alba and nigra. Dr. Willan makes them to be varieties of lepra, in which opinion we fully coincide with him.
The description of the two diseases by Actuarius is so precise that we shall give it in lieu of all the others. The alphi, he says, are superficial, but sometimes extend in depth, so that the hairs appear of the same colour. The white species is tried as to the depth it has spread, by being pricked moderately with a needle; when blood flows though the needle has only penetrated the skin, the disease is curable, but if the discharge be milky it is incurable, inasmuch as the flesh is converted into the disease. Others, he adds, rub the part with rough towels, and if it become red they have good hopes, but if it remain of the same colour they abandon all hopes of recovery. They are of a more aggravated nature when they affect different parts of the body and are inveterate. The alphi, he says, are generally milder than leuce, and can be cured by gentler means, but when they become inveterate they require similar treatment. The difference between the white and the black alphos is produced by the colour of the prevailing humour.
There is scarcely any difference of opinion among the authorities respecting the general plan of treatment. Haly Abbas has correctly remarked, that the alphi are to be cured by the same sort of remedies as lepra (leuce?) only that they do not require so strong applications. The Arabians greatly commend their myrobalans with ginger, mastich, parsley, &c. Their internal applications are powerful detergents and escharotics, such as hellebore, natron, sulphur, vinegar, arsenic, copperas, &c. Celsus says nothing of internal remedies, but recommends external applications of a stimulant nature, containing sulphur, alum, nitre, frankincense, alcyonium, &c. In the ‘Isagoge’ it is said that all these complaints are to be cured by phlegmagogues, and by abstergent applications externally.
Guy of Cauliac, and the other medical authorities of that age, describe these diseases by the names of Morphea alba and M. nigra. They recommend applications containing sulphur, alum, natron, arsenic, and the like. As usual they are the mere copyists of the Arabians.