SECT. IV.—ON SIMPLE PURGATIVE MEDICINES.
Give of aloes one drachm, with honeyed water, in the morning. But they who administer it in the evening or after food occasion mischief, for it makes the food spoil. It evacuates yellow bile, less if given to the extent of three oboli, for in that case it proves solely and entirely eccoprotic. But purgative medicines being generally bad for the stomach, aloes alone is stomachic. Those who cannot endure the bitterness of it may take it formed into pills. It is manifest that purgative medicines do not evacuate by any one simple temperament such as heat (for then all hot things would be evacuants, such as pepper), but by some specific property of their whole substance in like manner as the magnet attracts iron. Of purgative medicines those which are simply laxative have been treated of in the First Book. We are to use drastic purgatives either in order to transfer some matter, or to dislodge and remove an indurated diathesis, or as an alterative to the system, and in order to change the temperament of it, or to displace any offending humour. There are certain mixed modes complicated of the afore-mentioned. Purgative medicines are to be given to those whose powers are firm and their understanding strong; to such as have passed the first stage of life, and have not yet come to the last; to those who have a strong stomach, and have collections of superfluous matters in the body, and are not very sanguineous. The best seasons for purging, if there be no urgent necessity, are the spring and the autumn.
On those things which evacuate bile. We may give cholagogue medicines at any season except winter, to persons in the vigour of life and in the decline; to persons of dry and muscular habits, and who are of a dark or ruddy complexion; to men rather than to women; to those whose food is apt to spoil on their stomachs, and whose bellies are constipated; to such as abound in bitter bile, are irascible, pass little urine, and use hot and dry food: in icteric, hepatic, and pleuritic affections; in phrenitis, cynanche, mania, cephalæa, ophthalmy, erysipelas, leprosy, fevers, and to such as are troubled with collections of bile. Aloes is given to such as are troubled with heaviness of the head, with ophthalmy, with thirst, with disturbed dreams without fever; to such as have a sensation of departing rigor; to those who pass acrid flatus, and have gnawing pains of the intestines; to those who are seized with burning heat about the stomach, or nausea producing eversion of it; and to those who being troubled with a collection of excrementitious matters cannot bear evacuations by clysters. For it evacuates the whole body, and does not occasion disorder of it unless given in very great quantity, and brings along with it any bile lying in the intestines, stomach, and gullet.—Hellebore agrees both with those in acute diseases and those in chronic requiring a cholagogue medicine, such as maniacs, those troubled with hemicrania, and such as have defluxions of the eyes and complaints in the chest. But it suits most with such viscera as the uterus and bladder when they require a cholagogue remedy. It is also proper for chronic affections of the trachea, for jaundice, exanthemata, lichen, herpes, erysipelas, and leprosy. Black hellebore evacuates bile, especially yellow, from the whole body and without trouble. Hence it is given to those not affected with heavy fever, and more especially to such as are free from fever, in the quantity of one drachm of the roots triturated in honeyed water or plain water, while fasting, or with honey made into pills. Some mix with it pennyroyal, savoury, or some of the volatile stomachics.—Scammony purges like hellebore, and more especially yellow bile, but of all purgative medicines it is the most prejudicial to the stomach. It is, therefore, to be given to those who are free from fever, and such as have strong stomachs, to the amount of four oboli, with salts, pepper, ginger, or some one of the volatile stomachics, or along with honey. It is also formed into pills with gum.—The medullary part of the fruit of the Colocynth evacuates especially bile and mucous matters, not from the blood like hellebore and scammony, but from the nerves and nervous parts, when given to the amount of one drachm in two cyathi of honeyed water which has rue boiled in it. But it is to be triturated for a long time, because otherwise its rough particles sticking in the internal parts produce ulcerations and nervous affections by sympathy. It is to be given to those who have affections of the head, namely, when the meninx or the pericranium is affected, such as those labouring under vertigo or hemicrania, or those troubled with cephalæa; also in epilepsy, apoplexy, cynic spasms, chronic defluxions on the eyes, orthopnœa, asthma, and chronic coughs; likewise in arthritic cases to those who have affections about the kidneys or bladder.—Elaterium evacuates like scammony. Such as is green like leeks, light, and not older than a year, is to be chosen; and it is to be given to the amount of three oboli, triturated with one hemina of milk.—Tithymallus, spurge, evacuates bile like elaterium and scammony. Four or five drops of the juice are given, mixed with polenta and quickly swallowed. For if retained long in the mouth they ulcerate the tongue and surrounding parts.—Lathyrides (a species of spurge) purge bile like hellebore and scammony. They are to be given to the amount of seven, eight, or as many as fifteen grains to such as are robust and require much purging, who are to be directed to chew them. But those who are weaker and have bad stomachs, must swallow them whole.—The dried tops of the Peplium are to be given to the amount of eight oboli in honeyed water. They evacuate bile like hellebore, and occasion the breaking of wind.—Agaric has similar powers to the colocynth, but acts slowly and is not prejudicial to the stomach. It is given to the amount of two drachms with honeyed water. It should be very white, brittle, and not very woody nor carious.—Illyrian Iris purges in like manner when given to the amount of eight oboli in honeyed water. It ought not to be old nor carious.—The small Centaury by purging bile and mucus is particularly adapted for cases of ischiatic disease. The decoction is to be drunk of a drachm and a half of centaury, boiled in a hemina of water until it be reduced to the half.—The flower with the fruit of Tragoriganum is given to the amount of two drachms, in honeyed water, to the same class of persons as the black hellebore. It is more stomachic than the hellebore, but less purgative.—Four drachms of Chamelæa (mezereon?) boiled in two heminæ of honeyed water, until reduced to a fourth part, purge like hellebore. Some administer chamelæa by making it into pills with a double quantity of wormwood.—Aristolochia, birthwort, purges like colocynth, one drachm of the species called clematis being given in honeyed water.—The dried root of Polypody when pounded and sprinkled on honeyed water, or triturated along with it, has the same effects as colocynth.
Medicines which evacuate black bile. Medicines which evacuate black bile are to be given in an especial manner to melancholic persons, to such as are easily moved to paroxysms, to passionate persons, to misanthropists, to persons of solitary habits, or to such as during convalescence require purging, during the heat of autumn, in dry habits, and to such as are not muscular.—Epithymum, dodder of thyme, is the best of those medicines which evacuate black bile. It is to be given to the amount of five drachms triturated with a hemina of milk.
Epithymbrum, or the substance which grows upon savory, evacuates in like manner with the epithymum, but is weaker. Pennyroyal, when taken to the amount of an acetabulum, in honeyed water, evacuates black bile.—The Heracleatic Tragoriganum in the same dose evacuates like pennyroyal. But both must be dried. Alypum, the seeds of it have been said to purge black bile when given in the same quantity as the epithymum with salts and vinegar; but, as Dioscorides says, it occasions slight ulceration of the intestines. It is, I think, that substance which is now called alypias. It is to be given in honeyed water.—Parthenium (matricaria?), feverfew, when dried and drunk in like manner, evacuates the same humours. Alypon, madwort, drunk with salts, purges in like manner.
Medicines which evacuate phlegm. We are to administer phlegmagogues in cold habits; to aged persons, in winter; in paralytic and apoplectic cases; for loose œdematous swellings; to such persons as have great collections of phlegm in the belly, chest, or stomach; and in cases of the female flux. They agree also with those who have a copious running from the nose and thick expectoration, with cases of anorexia and ischiatic disease when the joint becomes mucous or pituitous; but they are particularly adapted for those cases of dropsy which are called anasarca.—One drachm of white Storax, drunk with an equal quantity of turpentine rosin, evacuates phlegm.—The bark of the root of Olive to the amount of one drachm, with wine or water; nine oboli of Pellitory, with water; two drachms of the seed of Lychnis (campion); one drachm of the root of Sow-bread, with hydromel; two drachms of Garlic, with honey; ground Pine, triturated and given in the form of pills; half a drachm of the flakes of copper, with an equal quantity of rosin, in pills, purges bile strongly.—A drachm and half of the green leaves of Bay; two oboli of the bark of the root of the wild Cucumber; forty seeds of that species of ricinus called Crotones stripped of their bark and eaten, do the same. A half of that part of Parsley connected with the root (which some call chamæraphanus), when eaten; two drachms of Bdellium, with hydromel; but Gum is particularly adapted for defluxions on the eyes.
Medicines which evacuate water. We are to give hydragogues in that variety of dropsical disease called ascites; to women troubled with the whites; and to those who have ulcers accompanied with a copious discharge.—One drachm of the flakes of Copper, when drunk with honeyed water evacuates water; but a little vinegar must also be swallowed lest it be vomited.—The Granum Cnidium when stripped of its bark, triturated, and drunk with boiled honey, that it may not touch the orifice of the stomach, evacuates water. Twenty, twenty-five, or thirty grains are to be given, and to those who are stronger, as many as forty.—One drachm of Euphorbium, drunk with boiled honey, evacuates phlegm, but more especially water.—Eight oboli of the seed of rough Spleenwort, with honeyed water, evacuate water.—Cneorum, in like manner, purges water when drunk with polenta.—Five drachms of the seed of Cnicus, when triturated together in ptisan, are swallowed with a small quantity of salts.—One drachm of Ammoniac perfume, drunk in honeyed water, evacuates water. Some give it in affections of the spleen with oxycrate.—The juice of the bark of the root of the Elder-tree, when drunk to the amount of two ounces with wine, evacuates water.
Commentary. The philosopher Aristotle thus explains his ideas respecting the action of purgatives: “When purgatives are conveyed to the stomach, and are there dissolved, they are carried by the same passages as the food, and when they cannot be digested, but their prevailing power remains unsubdued, they return, and carry with them whatever opposes them, and this is called purging.” (Problem. 43.) See also Alexander Aphrodisiensis (Probl. ii, 58.)
Hippocrates administered purgative medicines freely and boldly, but at the same time he cautions against the unseasonable and rash administration of them in several parts of his works. We do not find any theory, however, of the modus operandi of purgatives, nor any general remarks on the cases in which they are applicable, in any of the Hippocratic treatises which are now acknowledged to be genuine. Some ingenious remarks, however, may be found on this subject in the work ‘De Nat. humana.’
Celsus has a chapter on purgative medicines which contains much curious and valuable matter. He says the more ancient physicians gave various purgative medicines very freely, such as black hellebore, polypody, squama æris, the milky juice of lactuca marina (euphorbia paralias?), the milk of asses, with a little salt; but he holds that purgatives hurt the stomach, and are not to be given when any fever is present. The rules, which he lays down for the administration of them, are highly judicious, and deserving of consideration. He approves of them when the head feels heavy, when the eyes are misty, when there is obstruction of the bowels, and when there is pain there or in the hip-joint, when the stomach is oppressed with bile or phlegm, and when there is dyspnœa, when venesection is indicated, but the powers of the system will not admit of it, and in several other cases. (v, 12.) He mentions that Asclepiades totally rejected the use of purgative medicines. (i, 3.)
Galen has devoted a complete treatise to the discussion of the question regarding the modus operandi of purgatives. He decidedly inclines to the theory that every purgative by some specific property attracts, and as it were, sucks to it the humour to which it has a natural alliance, in like manner as the magnet attracts iron. He divides Purgatives into Cholagogues, Melanogogues, Hydragogues, and Phlegmagogues. He rejects the hypothesis of Erasistratus, who maintained that each medicine converts the juices presented to it, into its own specific nature: thus that cholagogues convert them into yellow bile, melanogogues into black bile, and so forth. Although Galen flatters himself that he effectually demolishes this hypothesis, we have long looked upon it as a very plausible one, and believe that at the present time the prevailing opinion in the profession inclines much in that direction. For example, the green and dark discharges which are brought off by mercurial purgatives, are now generally supposed to be occasioned by the fluids in the secretions entering into combination with the medicine administered. It is to be regretted that no ancient author has given us a clear exposition of the hypothesis of Erasistratus. Galen gives a long list of cases, in which purgatives prove beneficial, such as erysipelas, epilepsy, apoplexy, gout, rheumatism, melancholy, and many chronic complaints. He insists strongly on the benefit derived from cholagogues for the cure of jaundice. (De purg. Med. vi.)
Antyllus, in an extract preserved by Aëtius, espouses the theory which maintains the specific operation of purgatives, and that they act by attracting the humours to which they are allied. He recommends them for various complaints, as malignant cutaneous diseases, spontaneous ulceration, and rheumatic affections. (iii, 23.)
The account of this subject, given by Oribasius, is taken from the works of Galen and Ruffus. It is too lengthy for our limits. Ruffus directs the surgeon to consider well the patient’s constitution, and regulate the dose of the medicine accordingly, as there is a great difference in the susceptibility of persons to be acted upon by purgatives. The following is a list of the purgatives described by Ruffus in this fragment: Polypody, iris, colocynth, phacoides (a species of spurge olive?), peplos, peplium, aloe, hippophaes, hippophæstum, clematis, pycnocomon, vines, thyme, epithyme, marjoram, Greek savory, poppies, cucumber, the smaller heliotrope, the lesser sesamoides, the tithymalli or spurges, the chamelæa, lathyris, agaric, and euphorbium. His description of the operation of each medicine bespeaks a good acquaintance with the subject. (Med. Collect. vii, 26.) See also Actuarius (Meth. Med. iii, 7.)
Haly Abbas makes some acute remarks on the action of Cathartics. Every purgative, he says, attracts the humour, to which it is allied. Different opinions, he adds, have been entertained regarding the modus operandi in this case. Some maintain that, when such a medicine is swallowed, it goes to the members where its cognate humour is lodged, from which both are expelled by the expulsive faculty of the part, and return to the bowels together. This theory, however, he rejects. He mentions further that others maintain that the medicine attracts its peculiar fluid, as a magnet does iron; and of this theory he adopts a modification. He states it as his opinion that, when such a medicine has been swallowed, it attracts its cognate fluid from the surrounding parts, to which all the similar fluids in the body are afterwards determined, being conveyed thither by the veins. He gives a full account of all the purgatives known in his time. (Pract. iii, 53, 54.) Much the same theory is advocated, and fully explained by Serapion. (De Antidot. vii, 10.)
Avicenna and Rhases object to the doctrine of Galen that he appears to have maintained that there is a peculiar alliance between a purgative medicine of a certain class and the fluid or humour which it attracts, whereas they argue that, as there is no alliance between the magnet and the iron which it attracts, so is it in like manner with purgatives and the peculiar fluids which they evacuate. This, however, is only a more precise exposition of the theory advanced by Galen. Rhases (Cont. xii, 1); Avicenna (i, 4, 4.) The ancient theory is very acutely stated by Averrhoes (Collig. v, 21.) See also Mesue (Canones universales.) There appears to be some originality in the theory of Mesue. He says that a purgative medicine operates by occasioning a preternatural increase of the vital, or, as it is now called, animal heat of the part to which it is applied, whereby its attractive powers are increased. He maintains very ingeniously that purgation is an act of Nature, that is to say, an operation of the vis medicatrix naturæ, and that the medicine is merely the instrument of Nature in this case, for, he adds (as Hippocrates says), it is Nature, and not the physician, that cures diseases. A purgative medicine, then, he argues, acts by rousing the expulsive power of Nature. He joins the preceding authorities, however, in illustrating the attractive power of purgatives, by comparing it to the property which the magnet has of attracting iron, and amber of attracting straws. Purgative medicines, he says, have the faculty of clearing away the humours from the different parts of the body; from the stomach and intestines they do so readily; from the meseraic veins less easily; still more difficultly from the liver, and with the greatest possible difficulty from the joints, especially when the humours are impacted there. He forbids purgatives to be given in the extremes, either of hot or cold; in this practice observing the rule of Hippocrates. In hot weather, he says, emetics, and not purgatives, are indicated. The directions which he gives for correcting the noxious qualities of purgative medicines are highly important, but they are too lengthy for our limits. Aromatics added to purgatives, he says, dispel flatus; bitters do the same, and strengthen the stomach; saltish things increase their purgative powers; unctuous, by lubricating the intestines, accelerate their operation, and render it easier; and sweet substances render them less nauseous, and diminish their acrimony.
On the ancient arrangement of purgative medicines Dr. Paris makes the following pertinent remark: “It is impossible to concede to the opinion of Dr. Hamilton, that the different species of purgative medicines do not possess distinct powers over the different species of matter to be evacuated; on the contrary, there is reason for reviving the ancient theory, too inconsiderately abandoned, and which acknowledged these different distinctions in the operations of cathartic medicines under the appropriate names of hydragogues, cholagogues, &c.” (Pharmacop.) Dr. Alston likewise writes thus: “We have a very learned essay in confirmation of the ancient doctrine of the specific operation of purgatives by Dr. G. Martyn (Lond. 1740, in 8vo.) I shall not enter into the controversy, but only observe that there is nothing impossible, yea, nor improbable in the theory.” (Lectures.) See a learned dissertation on the action of purgatives in Mangeti ‘Bibliotheca Anatomica,’ i, 159. We may mention further that Dr. Murray in his Materia Medica inclines to the Galenic theory of the specific operation of purgatives. (c. viii.)
On Cholagogues. Most of these medicines are sufficiently well known, and therefore do not require to be treated of at greater length. See also Aëtius (iii) and Oribasius (M. Col. vii.)
The Arabian author Mesue gives the following table of Cholagogues:
| Clementer. | Valenter. | ||||||
|---|---|---|---|---|---|---|---|
| Cholagoga | { | Aloe | } | Trahendo et astringendo, flavæ: nam aliæ aliud vacuant. | Radices | { | Agaricus. |
| { | Absinthium | } | { | Asarum. | |||
| { | Rosa | } | { | Aristolochia. | |||
| { | Rhabarbarum | } | { | Bryonia. | |||
| { | Myrobalani | } | { | Cyclaminus. | |||
| { | Pruna. | { | Cucumer agrestis. | ||||
| { | Tamar Indi | } | Astringendo. | { | Dracunculus et arum. | ||
| { | Cassia | } | { | Elleborus. | |||
| { | Manna. | { | Esula. | ||||
| { | Viola nigra | } | Lubricando. | { | Hermodactylus. | ||
| { | Psyllium | } | { | Iris. | |||
| { | Adiantum etiam phl. | { | Scilla. | ||||
| { | Turbith. | ||||||
It will be perceived that this list contains several articles with which the Greeks were unacquainted, namely, myrobalani, tamarindi, manna, and turbith. Of all these substances we have already given some account in the [Appendix to the Third Section]. Mesue calls the tamarinds, the fruit of an Indian palm-tree, the word tamur signifying a date. He says, that they are excellent medicines for repressing the acrimony of the humours, purging bile, cooling the heat of the blood; that they prove useful in hot fevers, jaundice, inflammation of the stomach and liver, and that they stop vomiting. He calls them refrigerants and desiccants of the second order. To prevent them from hurting the stomach by their coldness, he recommends to give them with spikenard, mace, mastich, wormwood, fennel, or any such calefacients. Avicenna states their medicinal characters in the same terms. Serapion says, that they are desiccants and refrigerants in the third degree. Averrhoes ranks them among the refrigerants of the third, and desiccants of the second order. We have already mentioned, that the earlier commentators are decidedly of opinion, that the tripolium of the Greeks was turbith, but this is now generally acknowledged to have been a mistake. Mesue calls it the root of a milky herb, having leaves like a ferula, but smaller. Probably, however, as his commentator Manardus remarks, there is some mistake in the comparison of it to the ferula, as there is no resemblance between them. An accurate modern author, Moses Charras, calls it the bark of a milky root, which is chosen by its weight, dark-coloured without, white within, and clear from its pith, which is hard and fibrous. Mesue represents it to be a hot, nauseous purgative. It is given in powder, he says, to the amount of from one to two drachms.
Serapion recommends Cholagogues particularly in jaundice, inflammatory affections of the brain, mania, epilepsy, erysipelas, herpes, and tertian fever. He describes the following medicines as cholagogues: aloes, southernwood, black hellebore, scammony, colocynth, agaric, claterium, two species of mezereon, lathyris, the root of the lily, centaury, polypody, birthwort, myrobalaus (the yellow, the black, and the chebulic), pomegranate, cassia fistula, violet, ivy, and two Arabian substances anabac and alterariabin. We are unable to determine what the last two were.
A modern writer, Christianus Margravius, in his ‘Materia Medica Contracta,’ thus enumerates the cholagogues of his time.
Cholagoga,
Cassia, manna, tamarindi, succusque rosarum,
Scammonium, myrobalani, rhabarbarum, aloe.
Professor Alpinus gives an accurate account of the ancient cholagogues. (Meth. Med. iii, 9.) The following medicines are said to be used as purgatives by the Hindoos; we give the scientific names as given by Dr. Wise: 1. Convolvulus turpethum. 2. Panicum frumentaceum. 3. Croton polyandrum. 4. Anthericum tuberosum. 5. Abrus precatorius. 6. Cessampelos hexandra. 7. Asclepias geminata. 8. Clotoria ternata. 9. A kind of convolvulus. 10. Shabraba. 11. Cassia fistula. 12. Plumbago zeylanica. 13. Acheranthes aspera. 14. Poa cynosurides. 15. Saccharum spontaneum. 16. Jelaka?. 17. A variety of the convolvulus turpethum. 18. Ramaka. 19. Bignonia suaveolens. 20. Terminalia chebula. 21. Indigofera tinctoria. 22. Ricinus communis. 23. Costus speciosus. 24. Euphorbia. 25. Suptachetta. 26. Calotropis gigantea. 27. Halicacabum cardiospermum. Of these the turbet, myrobalans, and castor oil, are particularly commended. (On Hindoo Medicine.)
On Melanogogues. The other Greek authorities treat of nearly the same number of Melanogogues. They are treated of methodically by Galen, Oribasius, and Aëtius. The Alypias is supposed by Bernard (Nota in Nonni Epit.), and Prosper Alpinus, to have been the turbith; but, as is now maintained, erroneously. See Sprengel’s Notes on Dioscorides (iv, 177) and the preceding [Appendix].
The following is Mesue’s list of Melanogogues:
| Clementer. | Valenter. | ||||
|---|---|---|---|---|---|
| Melanogoga | { | Stæchas. | Fructus et Flores | { | Balanus Myrepsica. |
| { | Aqua lactis. | { | Centaurium. | ||
| { | Fumaria. | { | Colocynthis. | ||
| { | Epithymus. | { | Coccum Gnidium. | ||
| { | Thymus leviter, magis phleg. | { | Genista. | ||
| { | Polypodium. | { | Ricinus. | ||
| { | Jus gallorum phleg. cum phleg. | { | Senna. | ||
| { | melanogogum cum melanogog. | ||||
| Terrea | { | Armenus lapis. | |||
| { | Cyanus lapis. | ||||
| { | Nitrum. | ||||
| { | Salis genera. |
Of these medicines, the only one which we owe to the Arabians is Senna. Mesue, it is true, quotes Galen as an authority on it, but this is most probably a mistake, as no mention of it is now to be traced in any part of his works. Averrhoes, accordingly, ranks it among the newly-discovered medicines. He says, that it is both phlegmagogue and cholagogue. Serapion and Rhases give nearly the same account of it. They state the minimum dose of the powdered leaves at one drachm, and of the decoction at five drachms. Mesue directs us to prepare a vinous tincture by infusing the leaves in musk. He recommends us to correct its nauseousness and unpleasant effects by the addition of ginger, and other cordials. He says that it cleanses the liver and spleen. Actuarius briefly notices it. He says it evacuates bile and phlegm. (Meth. Med. v, 8.) See [Appendix]. The Arabian authors represent the lapis lazuli to be the same as the lapis armenus of the Greeks. We have stated what we believe to be the truth of the matter in the preceding commentary. Margravius, in his enumeration of melanogogues, makes a distinction between them:
Melanogoga—
Sunt ludiæ balani, lazuli lapis, armenusque,
Senna, polypodium quernum, helleborusque, epithymum.
Averrhoes states that the lapis lazuli is the most potent medicine of this class. (Collig. v, 43.)
On Phlegmagogues. Mesue’s list is as follows:
| Clementer. | Valenter. | ||||
|---|---|---|---|---|---|
| Phlegmagoga | { | Cnicus. | Lachryma | { | Euphorbium. |
| { | Lupulus. | { | Opoponax. | ||
| { | Hyssopus. | { | Scammonium. | ||
| { | Eupatorium etiam cholag. | { | Sagapenum. | ||
| { | Sarcocolla. |
Serapion directs us to administer these medicines to persons of a cold habit, in cold seasons of the year, to those affected with anasarca and apoplexy, in sciatica and hemorrhages. His list is little different from our author’s. Margravius enumerates the phlegmagogues as follows:
Phlegmagoga—
Carthamus, agaricus, turpeth, mechoaca, jalappa,
Emblica, belliricæ, chebulæ, colocynthis, amara,
Hermodactylus, euphorbium, opoponax, sagapenum.
On Hydragogues. The hydragogue properties of the elder-tree are commended by Boerhaave and Sydenham. See [the section on Dropsy in the Third Book].
There is some difficulty in determining what the cneoros was. We are inclined to think that it was the cassia fistula, the medicinal characters of which, as stated by Mesue among the Arabian, and Prosper Alpinus among the modern, authorities, correspond with the account of cneoros given by our author.
Gum ammoniac is an ingredient of the purgative salt, a receipt for which is given by Apicius. It also enters into the sales purgatorii of Myrepsus. (ii, 9 and 10.) See [the commentary on the next Section].
Prosper Alpinus says of the coccum gnidium, or fruit of the thymelæa, that in doses of fifteen grains it is a strong purgative, and evacuates principally serous humours in dropsy. He reckons the squama æris among the drastic purgatives.
Serapion’s account of the hydragogues is nearly the same as our author’s. The following is Margravius’s list of them:
Esula, gratiola, atque ireos succus, mechoaca,
Post ebuli semen, et succus, cortexcque elaterium,
Soldanella virens, et gummi gutta, jalappa.