ON PROFESSIONAL IMPOSTORS.
Rhases has an interesting chapter on this head. The frauds of impostors, he says, are more numerous than could be contained in his whole work. Some of them, he adds, pretend to be able to cure epilepsy, and having made a crucial incision in the back part of the head, they extract from the wound something which they hold in their hands, and thus impose upon people. Others, in like manner, cause it to be believed that they extract a small lizard by the nostrils. Some of these characters, he says, make it be believed that they remove films from the eye, by secretly introducing a small membrane into the eye, and taking it out again. Others manage to create a belief that they suck water from the ear with a reed. Others also make it be believed that they extract worms from the ears or teeth. Others practice a trick by which they obtain the credit of extracting the ranula below the tongue. Why should I mention those, he adds, who introduce pieces of bone into wounds and ulcers, and afterwards extract them? He says, it is not uncommon for these impostors to sound a man for the stone, pretend to find one, perform the operation, and exhibit a calculus which they themselves had introduced secretly into the incision. Others pretend to cure piles, make incisions about the anus, and form ulcers there which did not exist before. Certain of them affect by scarifications and other means to suck the vitreous humour from the hip-joint, while they exhibit something of the kind which they themselves have introduced. There are some who undertake to collect all the infirmities of the body into one spot, and then extract them; for this pretended object they raise an itching and violent heat in some place by means of alkekengi (winter cherry); and having accomplished this they exact a fee for removing the uneasiness from the spot, which they do by anointing it with oil. There are others who will make a man believe that he has swallowed hairs, glass, or the like; and then tickling his throat with a feather, and making him vomit, they exhibit the substance in question as if it had been brought up. Thus, he adds, they often do much mischief, and sometimes are guilty of culpable homicide. He concludes by warning sensible people to be upon their guard against such wretches. (Ad Mansor. vii. 27.)
BOOK VI.
SECT. I.—PREFACE TO THE SURGICAL PART.
Having divided the treatise on the surgical matters into what relates to manual operations on the flesh, and the account of fractures and dislocations of bones, we shall begin with what relates to the flesh, observing there our accustomed brevity. Beginning therefore, again with the upper parts, we shall first give an account of the operations on the head, more particularly of the burning of the vertex.
Commentary. This book contains the most complete system of operative surgery which has come down to us from ancient times. We shall have occasion also to refer frequently to Celsus, who, in the last two books of his work, has treated of surgical operations with considerable accuracy. Our author appears to have been wholly unacquainted with him; but when did a Greek writer ever acknowledge himself under obligations to a Roman? Haly Abbas, in the 9th book of his ‘Practica,’ copies almost everything from Paulus. Albucasis gives more original matter on surgery than any other Arabian author, and yet, as will be seen from our commentary, he is indebted for whole chapters to Paulus. In the ‘Continens’ of Rhases, that precious repository of ancient opinions on medical subjects, if there be any surgical information not to be found in our author, it is mostly derived from Antyllus and Archigenes. As to the other authorities, although we will occasionally have to explain their opinions upon particular subjects, no one has treated of surgery in a systematical manner; for even Avicenna, who treats so fully of everything else connected with medicine, is defective in his account of surgical operations; and the descriptions which he does give of them are almost all borrowed from our author. The account of fractures and dislocations given by Hippocrates and his commentator Galen may be pronounced almost complete; but the information which they supply upon most other surgical subjects is scanty.
SECT. II.—ON BURNING OF THE HEAD FOR OPHTHALMIA, DYSPNŒA, AND ELEPHANTIASIS.
In ophthalmia, occasioned by a defluxion from above, and in dyspnœa, produced by a redundance of a recrementitious humour which is sent from the head down to the chest, and by lodging there proves injurious to the parts contained in it, they burn the middle of the head in this manner. Having first shaven the parts about the vertex, they apply cauteries shaped like olive-kernels and burn the skin down to the bone, scraping the bone after the falling off of the eschar. Some by burning even the bone itself make a small scale exfoliate from it, in order to allow the humours of the head to perspire and be evacuated the more readily; and for this purpose they keep the ulcer open for some time and then allow it to cicatrize. In treating elephantiasis some burn five eschars in the head, one anteriorly above the part called the bregma; another, below this, a little above the forehead, at the extremity of the hairs; another, at the part called the occiput; two others at the parts called the squamous plates, above the ears, one on the right side and another on the left; and thus, by the removal of several scales, they procure the evaporation and discharge of the collection of thick humours in the deep-seated parts of the head, and prevent the sight from being injured. They also apply another cautery on the spleen, in order to remedy the prime organ in the formation of the melancholic humour by the eschar formed in the skin.
Commentary. See Hippocrates (de Visu); Aretæus (de curat. Morb. Chron. i, 1); Celsus (iii, 23, and vi, 6); Cælius Aurelianus (Morb. Acut. i, i, and Morb. Chron. i, 4); Aëtius (vi, 50); Actuarius (Meth. Med. iii, 2); Rhases (Cont. xxvii, 1, 24); Albucasis (Chirurg. i); Mesue (de Ægr. Capitis); Avicenna (iii, 1); Haly Abbas (Pract. ix, 69); Avenzoar (I, 9, 17).