SECT. XXXVI.—ON LEECHES.
If leeches have been swallowed with water, and have stuck to a part in deglutition, you may ascertain that this has happened from the mouth of the stomach being, as it were, sucked and bitten, which is a symptom of the leeches having been swallowed. Sometimes florid blood is spit up by hawking when the leeches have fixed to the windpipe. They may be rejected by swallowing brine, or the leaves of beet with vinegar, or by drinking snow with oxycrate. Let gargles of nitre (soda) with water be used, and of copperas with vinegar. When they have stuck to the throat, put the patient into a warm hip-bath and give him cold water to hold in his mouth, and they will readily come to the cold. Some give bugs to those who have swallowed leeches. I, says Galen, by using garlic in such cases, have not stood in need of bugs.
Commentary. Nicander judiciously recommends when leeches have been swallowed to drink vinegar, to take ice or snow, sea-water, fossil salt (sal gemmæ?), or salt prepared from sea-water. Dioscorides treats the case like our author. Celsus merely says, “acetum cum sale bibendum est.” Bugs are recommended by Anatolius. (Geopon. xiii 17.)
Aaron, one of the authorities quoted by Rhases, directs us to lay the patient in the sunshine and examine his throat carefully; and if the leech can be detected to extract it with a forceps. If this cannot be effected he recommends him to gargle the throat with some bitter decoction or to swallow the same, if the leech has descended to the stomach. He also directs him to hold snow in the mouth. (Contin. vii.)
Avicenna recommends nearly the same plan of treatment, and, like our author, mentions the following device in order to get a leech extracted that is fixed in the gullet. The patient is to go into a hot bath and hold cold water in his mouth, which will have the effect of attracting the leech towards it. (iii, 9, 5.)
When a leech has fastened in the throat of a beast of burden and cannot be got at by the hand, Columella directs hot oil to be poured in by means of a pipe, or if it has passed into the stomach, it is to be killed with hot vinegar. (vi, 18.) The vapour from pounded bugs was also a popular remedy in such cases. (Ibid. and Geopon. xiii, 17.)