Since all the writers subsequent to Galen merely copy from him, we need not say more of their opinions. We may state, however, what Actuarius says regarding the characters of the urine in affections of the heart. In hot intemperaments of the organ the urine at first is more acrid and thinner, but as the disorder increases, it assumes an oily colour and consistence. The sediments become grumous, furfuraceous, scaly, and gritty. When it is affected with a cold intemperament, the colour of the urine is whiter, and the sediment at first moderate and crude, but afterwards it becomes black. (De Urin. vii, 4.)
The Arabians, especially Avicenna, treat of these complaints at great length, but without supplying much additional information. Avenzoar speaks obscurely of certain tumours resembling pellicles or cartilages on the pericardium. He mentions also hydrops pericardii, and abscess of the same. Pain of the heart, says Haly Abbas, may arise from an intemperament, organic disease, or a solution of continuity. The last two causes soon occasion death. He mentions that palpitation may be occasioned by dropsy of the pericardium. He recommends bleeding in cases of palpitation, upon the authority of Galen, and also things of a cold nature, such as seeds of cucumbers, citrons, gourds, roses, and camphor. Alsaharavius gives a similar account of these affections. Rhases also approves of venesection and cold applications. He mentions that palpitation is sometimes felt in the region of the stomach, for which he recommends bitters, such as wormwood.
The disease which Galen and his followers describe under the name of palpitation was no doubt that state of the heart now called hypertrophy with dilatation. In confirmation of the truth of Galen’s prognosis, we may quote the words of the celebrated translator of Laennec, as to the issue of the disease of the heart we have mentioned: “Such persons however are marked for destruction. After a certain time the disease obtains the mastery, and brings the strong man down, the sooner, alas! for the bold resistance made to his dominion.” (English Translation of Laennec, p. 62.)
SECT. XXXV.—ON AFFECTIONS OF THE BREASTS.
After childbirth, the milk frequently being converted into cheese in the breasts, produces inflammations. Wherefore at first we may use these applications: Having squeezed a soft sponge out of tepid oxycrate, apply it to the breasts, and bind it on in the proper form; or use dates triturated in oxycrate with bread, or a whole egg with rose-oil and some cerate; or alum, fleawort, with coriander and purslain, may be applied in the form of a cataplasm; or apply the firestone triturated with cerate, and bind it on. When there is distension or thrombus in the part, apply a cataplasm of bread with water and honey, or with wine and honey; or bread with the green herb perdicias (pellitory of the wall?), along with cerate twice a-day; or bean-flour with hydromel, or sodden must. But if they cannot bear the weight we must use an embrocation of hot sweet oil by means of soft wool. But we must foment them with the steam of hot water, or a decoction of fenugreek, or of marshmallows, or of linseed. And we are to apply to them a cataplasm made of fine flour with linseed, or fenugreek with hydromel, or sesame with honey, or pounded butter. But we must interdict sucking of the breasts, because it only attracts more milk to them. When the inflammation is on the decline we may apply the following cerates: Boil beet in oil until it is softened, throw it away, but add to the oil a moderate quantity of wax, and use.—Another: Mix the red parts of ten raw eggs in a cerate consisting of wax, oz. iiss, and of rose-oil, oz. iv; stir with a spatula, and add as much salt water as it can receive, and then again stir with a spatula, and use. For hardness of the breasts, the composition from honey is applicable, and all emollient applications. When the swelling is converted into pus, we must use those applications which have been mentioned for parotis, and those that will be mentioned afterwards for apostemes.
From Archigenes, for spreading ulcers of the breasts attended with malignity. Of good Adriatic wine, xx sextarii; of the sumach, lb. j; of cypress balls, lb. j; of black galls, called omphacitæ, oz. vj; of cassia, oz. vj; when bruised, macerate in wine for ten days, then boil down to one half, stirring with a cypress spatula; then throw away the herbs; and when the juice is boiled to the consistence of honey, lay it up in a glass vessel. Use it for spreading ulcers, undiluted, or, if it is too thick, let it be diluted with wine. It is so made as to apply to spreading ulcers in the breasts, to runnings of the ears, foul defluxions from the gums, and dysentery. When diluted with milk it acts as a paregoric in soothing pain. Other kinds of ulceration of the breasts must be treated like ulcers in general.
Preservatives of the breasts. Having pounded cumin with water, apply to the nipples, then lay upon the breasts a sponge squeezed out of oxymel, and bind it with a bandage. After three days, having taken away the cumin, put on a cataplasm of the bulbous roots of the lily upon the nipples, and having bandaged it let it remain again for three days, and do the same three times a month.—Another: Apply powdered hemlock for nine days, and the sponge externally, as mentioned above; and after an interval of a few days repeat the same. The rubbings from the Naxian whetstone act as a preservative of the breasts of virgins.
Commentary. See Oribasius (Synops. ix, 9); Aëtius (xvi, 35); Nonnus (151); Scribonius Largus (102); Avicenna (iii, 12); Haly Abbas (Theor. ix, 40; Pract. viii, 29); Alsaharavius (Pract. xiv); and Rhases (Contin. xv.)
A considerable part of this Section is copied from Oribasius. Aëtius, however, has treated of these complaints more fully than any other author. He gives from Philumenus various prescriptions for inflamed breasts, the most important ingredients in which seem to be ceruse and litharge, with wax or honey. One of them also contains the recent leaves of henbane, evidently for the purpose of allaying pain. For indurated mammæ he directs linseed, or the seed of fenugreek with hydromel to be applied. In short, his applications and our author’s are very similar. He describes a certain induration of the mamma under the name of chondriasis. This affection is alluded to by Aristotle (H. A. vi, 20.) When an abscess forms, he recommends us to open it and evacuate the pus. Nonnus, as usual, copies from our author.