For procidentia ani. Of the fruit of heath, of galls, of ceruse, of acacia, of the juice of hypocistis, of pine-bark, of frankincense, of Aminæan myrrh, equal parts; apply in a powder, having first bathed with austere wine.—Another: Of the dross of lead, of Syriac sumach, of each, oz. viij; of the flowers of roses, dr. iv; of Aminæan myrrh, dr. ij; use like the first.—Another: Of pine-bark, of manna, of litharge, of each, dr. viij; of dried cypress balls, of plumbago, of each, dr. ij; use as directed above. Bathing with the patient’s own urine while yet warm is also useful.
Commentary. Consult most of the works referred to in [the fifty-fourth Section].
The first part of this Section is almost entirely taken from Galen (sec. loc. ix); the remainder seems to be abridged from Aëtius (xiv.) Galen (Meth. Med. v, 15) insists strongly that diseases of the penis should be treated with desiccative instead of epulotic applications.
No ancient author has treated so fully of diseases of the genital member as Celsus (vi, 18.) His description of the ulcers upon it is very minute. Ulcers, he remarks, are found either upon the prepuce, or on the glans, or beyond it on the member itself. If dry, they are first to be bathed with warm water, and then lycium (catechu?) out of wine, or the lees of oil boiled with the same, or butter with roses is to be applied. If there is a slight discharge, they are to be washed with wine; then honey and a fourth part of turpentine-rosin are to be added to the butter and roses for an application. When there is a purulent discharge it is to be washed away, and the part dressed with an application containing pepper, myrrh, saffron, and misy, boiled in austere wine to the thickness of honey. He mentions various other escharotics containing ærugo, alum, and the like. When at any time inflammation comes on, a cataplasm must be applied. Spreading ulcers are to be treated with applications containing the escharotics we have just mentioned. When a watery sanies runs from the sore it is to be treated with basilicon (tetrapharmacon) melted with roses and some frankincense; and it is to be frequently bathed with hot water and covered up from the cold. The tubercles called phymata are to be burnt down with medicines or a cautery of iron, and when the crust falls off, the squama æris is to be sprinkled on the part. Cancerous sores are to be extirpated by escharotics, as by a composition of quicklime, chalcitis (sulphate of copper?) and arsenic; or they are to be cut out and the part burnt. Phagedænic sores in like manner are to be burnt with medicines or the actual cautery.
Avicenna approves of Galen’s rule of treatment stated above. When sores are recent, he recommends in particular aloes, and when more humid, burnt copper. When an incarnant is required, frankincense is to be mixed. Prurigo is to be cured by venesection, purging, and liniments containing nitre, alum, sal ammoniac, or even stavesacre with vinegar or rose-oil. For prurigo, Alsaharavius recommends lotions of sea-water, decoctions of chamomile, saffron, and camphor pounded with vinegar, and the like applications. For hard pustules he recommends various corrosive applications, some of which contain arsenic. Haly Abbas remarks that ulcers on the genital membranes are attended with the same symptoms as those on other parts.
On diseases of the anus. Celsus has likewise treated very fully of these complaints. For rhagadia or fissures he recommends first the hot bath, and afterwards cooling ointments, such as old oil with litharge, and unwashed wool spread with a composition of liquid cerate and roses. The regimen is thus tersely pointed out: “Liquida, lenia, pinguia, glutinosa, meliora sunt.” The tubercle called condyloma is said to derive its origin from inflammation, and is to be treated at first by making the patient sit in a hip-bath of water having vervain boiled in it; and then lentil with some honey, or a composition containing chalcitis, or alum with ceruse and litharge, or the like, is to be applied. If these do not succeed, the escharotics, such as verdigris, antimony, &c., or even the more powerful caustics are to be used. He treats hemorrhoids upon much the same plan as our author. He begins by inculcating that there is danger in suppressing them suddenly. They are to be treated at first upon the soothing plan, by baths, emollient applications, and those directed for fissures. When these fail, strong caustics are to be applied, such as the composition consisting of arsenic, squama æris, and quicklime. Next day they are to be pierced with a needle. In certain cases he prudently directs bleeding from the arm. Procidentia ani is to be treated in the first place by fomenting the gut with austere wine and the like, and replacing it; and then applying the leaves of willow boiled in vinegar, a linen compress, wool, and a bandage. Fungous ulcers are to be bathed with tepid water, if in winter, or with cold if at any other season; and then sprinkled with squama æris, or dressed with a cerate containing the same with quicklime, &c. If these do not succeed, the parts must be burnt with potential or actual cauteries.
Galen remarks that diseases of the anus are difficult to cure, because the part is possessed of great sensibility, and is exposed to be irritated by the alvine discharges, which contain bile, ichor, and the like. Styptic substances, which do not produce much irritation, are most proper for them, such in particular are many of the metals. He gives a long list of applications recommended by Andromachus, Asclepiades, and others, the principal ingredients of which are ceruse, litharge, alum, rose-oil, and the like. For procidentia ani he recommends various astringent applications containing galls, sumach, roses, pomegranate rind, burnt lead, litharge, &c.
Aëtius gives a long account of these complaints, but we must be content with a brief summary of it. He treats procidentia ani in the first place with astringent applications, containing galls, hypocistis, austere wine, and the like; but when these things do not succeed, he directs us to burn the verge of the anus with the actual cautery. Hemorrhoids he advises us to extirpate with the knife; but when the patient will not submit to this operation, he directs us to burn them with caustics, such as arsenic, quicklime, and the like. He recommends various combinations of these medicines for condyloma, acrochordon, and thymus.
Octavius Horatianus may be consulted with advantage; but as his general plan of treatment is not very different from that of Celsus, we shall not give an abstract of it.
For rhagadia Marcellus recommends a composition of litharge and rose-oil. He gives an interesting description of the process of curing hemorrhoids by an application containing arsenic, chalcitis, misy, and the like. This remedy is strongly recommended by the Pseudo-Dioscorides. He says that a mixture of equal parts of arsenic and sandarach will make them drop off in half an hour. (Eupor. i, 214.)