Aut avidæ fauces gelidum hausere liquorem.”
Among his internal remedies he mentions broom-seeds, the wine of squills, elder, and hellebore.
Alexander states that a coldness of the liver is the cause of dropsy, in consequence of which it is no longer able to form blood, but converts the fluids into water, phlegm, or air. Hence the distinction of dropsy into ascites, anasarca, and tympanites. In certain cases of anasarca he permits venesection, in order to relieve the depression of the system. He adds afterwards that, if not only the liver, but also the spleen and stomach appear hard, and especially if combined with plethora of blood, venesection is to be had recourse to before all other remedies. But in ascites and tympanites he agrees with Galen in condemning venesection, and trusts principally to purging and friction. Like our author, he commends copper and the leaves of elder. Exercise, he says, is adapted in an especial manner to dropsical complaints, either by sea, on horseback, or in a couch. Horace, by the way, no doubt, alludes to the established practice of taking exercise for the cure of dropsy in the following passage:
“Atqui
Si noles sanus, curres hydropicus.”
(Epist. i, 2.)
Alexander has stated correctly that the disease sometimes derives its origin from disease of the uterus, kidneys, spleen, liver, colon, heart, or other organ of the body. He remarks that dropsy is apt to come on in phthisical cases.
Our author has merely condensed the account given by Aëtius. His list of diuretics contains squills, spikenard, alum, spurge, burnt copper, &c. Like Hippocrates, he approves highly of scarifications at the inner ankle. Upon the authority of Antyllus, he recommends lying in heated salt. In like manner, Galen and some of the other authorities speak favorably of insolation while the patient lies on sand, wheat, or the like. The sand-bath is mentioned as a remedy for dropsy by the earlier modern writers on medicine. See Theodoricus (iii, 33).
Leo, like preceding authorities, refers all dropsies to a coldness of the liver, and says they are mostly incurable. We do not find that Avicenna, Rhases, Avenzoar, and Serapion make any material alteration on the practice of the Greeks. In certain cases of anasarca they permit venesection, but generally condemn it in ascites. They praise mezereon or the chamelæa strongly as a diuretic; and also make mention of colocynth and scammony. Haly Abbas treats separately of anasarca, ascites, tympanites, and dropsy from a hot cause. When anasarca is connected with an obstructed secretion, he approves of bleeding; and, in general, recommends abstinence from drink, exercise in the sun, friction with sand or hard towels, sulphureous baths and diuretics. He concludes with an advice not to persevere too long in the use of any one medicine. In the treatment of ascites, he recommends mezereon, colocynth, &c., but disapproves in general of paracentesis. For tympanitis he prescribes various carminatives, such as parsley, fennel, spikenard, mastich, southernwood, melilot, &c. Alsaharavius expresses himself strongly in favour of venesection for anasarca; and for all kinds of dropsy recommends the sand-bath, sudorifics, and the common remedies mentioned above. The general causes of dropsy upon which Rhases most insists are induration of the liver and debility of the kidneys, so that they no longer attract the aqueous superfluity of the blood. He approves of paracentesis and scarifications of the feet and testicles when they are much swelled. Among his hydragogues, the most powerful are white hellebore, elaterium, scammony, and euphorbium. He mentions that he had known several dropsical cases cured by a spontaneous diarrhœa, and hence he recommends us not to stop one when it comes on. When dropsy is connected with the retention of a natural evacuation, he approves of bleeding. He speaks favorably of the elder as a diuretic.