Archigenes and Aëtius describe cæliac affection as an atony of the intestines, so that the food is not retained until it is digested. They treat of it at great length, their principal remedial measures being purging, vomiting, and astringent applications. According to Psellus it arises from superficial ulceration of the intestines. Psellus defines lientery to be a loss of the retentive faculty of the bowels, so that the food passes undigested in a liquid state.
Serapion for lientery directs us to give astringent decoctions, and to apply to the belly an astringent epitheme containing galls, roses, pomegranate-flowers, &c. the food to consist principally of millet and the like. He also recommends a mixture of goat’s milk and water boiled until the water evaporate. When the stomach is loaded he prescribes an emetic. In cæliac affection he directs us to strengthen the intestines by astringents internally and externally. Haly Abbas defines lientery to be a quick discharge of the food in an unchanged state. It arises, he adds, from immoderate debility of the retentive faculty of the intestines, or from excess of the expulsive. It is said to be generally caused by ulcers which, being irritated by the food, stimulate the intestines to expel it. He recommends a variety of remedies, most of which are either astringents or acids, such as balaustine, rind of acorns, mastich, sumach, galls, roses, &c.
SECT. XLI.—ON TENESMUS.
Tenesmus is sometimes the precursor of dysentery, but often it prevails alone for a short time, and then ceases. The affection is an irresistible desire of evacuation, discharging nothing but some bloody or mucous matter, which is the cause of the whole complaint, being an œdematous inflammation in the rectum, which creates the impression of fæces lodged in the intestine, and a desire of evacuation. And Galen relates that a stone has sometimes been discharged by the anus in attacks of tenesmus. But tenesmus often arises in consequence of fæces being retained in the small intestines, and is increased by astringents and obstruents, but immediately removed by acrid injections, such as honied-water with salts, or by any of the emollients taken by the mouth, such as damascenes, dried figs, the herb mercury, or the whey of milk; for when the fæces are evacuated, the complaint immediately ceases. When the tenesmus occurs without such a cause, it will be proper to allay the inflammation by barley-flour heated, the embrocations from wine, myrtle-oil, rose-oil, or the oil of unripe olives, applied to the loins and lower belly. The mucous matters shut up in the rectum must be cleared away by an injection of honied water. And salt and water when injected often effects the purpose, or six drachms of salts in a hemina of hot water. But we must mitigate the pain and intense sufferings by sitting in a hip-bath of fenugreek, mallows, or linseed. Sometimes the following hip-bath will effect the purpose: Of bramble, of myrtle, of the flowers of the pomegranate, of bays, and of green cypress shoots, mixing these in equal parts, boil in water. It is the Marcellian. When the inflammation and irritation are deep-seated, we must use injections of some of the juices of grain boiled with some of the astringents. And sweet oil injected and retained for several hours has the effect of removing the violent pain. When the desires to go to stool are frequent, we must apply a ball of warm threads to the anus, or warm bran in a bag, or a sponge, or some such thing.
Commentary. See the authors referred to in [the preceding Section].
Celsus recommends the tepid bath, emollient and astringent applications to the rectum, such as butter and roses, or alum wrapped in wool and applied, the remedies for tormina, and an austere wine every alternate day.
Aëtius may be referred to as an author who has treated of this affection in a very accurate manner, although nearly to the same effect as our author. Among other things he mentions the application to the anus of a sponge soaked in a solution of galls in vinegar.
Nonnus defines tenesmus to be an inflammation of the rectum, and says that it is to be benefited by injections of the oil of rue, or of wine and honey with brine; by hip-baths of astringent decoctions, such as myrtles, bays, &c. or by fomentations with a sponge.
Avicenna describes two varieties of tenesmus, the false, which is occasioned by the lodgment of hardened fæces in the intestines, and is to be cured by emollient clysters, &c.; and the true, which, if occasioned by cold, is to be relieved by fomenting the parts with a sponge or the like soaked in hot water; if by hard pressure, a sponge is to be squeezed out of hot oil and applied; if by an aposteme, it is to be treated upon general principles by bleeding and embrocations; if by a flux, remedies suited to that complaint are to be given; and, if by ulcers, the common applications to them are to be used. Haly Abbas treats fully of tenesmus, like Avicenna. In several of his prescriptions poppies and opium occur. When produced by retention of scybalæ, he recommends powerful evacuants, such as colocynth, prunes, turbit, scammony, &c. One of Serapion’s prescriptions contains burnt lead, sumach, myrrh, &c. By a stone, said by our author and Galen to be sometimes discharged in cases of tenesmus, must have been meant an alvine concretion of a hard nature.