Celsus describes the epinyctis as a bad species of pustule, somewhat livid or red, about the size of a bean, very painful and inflamed, and coming on principally at night, whence it derives its name. Persons of all ages, even infants at the breast, are subject to it, and in treating them he directs the regimen of the nurse to be properly attended to. In laying down the rules of treatment he puts particular stress upon the hot bath.
Aëtius, Oribasius, and Actuarius treat of it as our author. Pollux defines it to be a vesicle of a palish colour, somewhat humid and bloody, and forming about the legs and feet in the night.
The Arabians give a similar account of epinyctis, under the names of Sare, Serie, and Essere. Thus Serapion recommends bleeding if required by the general symptoms, purging with myrobalans and prunes; and external applications, containing sumach, savin, &c. Haly Abbas, who describes it as one of his serie, approves of much the same treatment. Avicenna and Rhases in like manner recommend bleeding, gentle purgatives, cooling lotions, and the tepid bath. Rhases, in his ‘Continens,’ applies the directions given in this chapter by Paulus to the treatment of the cutaneous disease, which he calls sera. This establishes their identity (xxxvi, 6.) As stated in the preceding chapter, the epinyctis is also the “benat noctis,” i. e. “filia noctis” of the Arabians. Marcus Aurelius Severinus, therefore, is mistaken in distinguishing between the epinyctis and the benat noctis. Ingrassius admits their identity.
Fracastorius gives the following account of this affection: “Si inflammata et accensa sit cholera, pustulam illam facit, quæ ἐπινυκτις vocatur, quod sæpissime noctu nascatur, Arabes Essere appellant.” (De Morb. Cont. ii, 15.) Both Lorry and Rayer confess themselves unable to determine what the epinyctis of the ancients was. It would appear to have been some peculiar species of eczema, now extinct. It must have been a more formidable disease than the nettle-rash, which certain modern authorities have taken for the epinyctis of the ancients.
SECT. X.—ON PHLYCTÆNÆ OR BULLÆ.
As Bullæ when they burst spontaneously are attended with acute pain, it is proper to perforate at their under part with a sharp needle, and then to squeeze out the humour gently, suffering the skin which covers it to remain. And if the wound should close up and the bullæ fill up, it is to be evacuated again in like manner, and pressed out; and the incumbent skin is to be kept pressed down until the ulcer below be healed. Before the bullæ break, apply boiled lentils triturated with water; or, the shoots of pomegranate, having been warmed upon hot coals, are to be applied, so as to burn the parts. But if they burst and form an ulcer, having melted axunge, and mixed levigated litharge, put into a linen cloth, and apply; or, having boiled the root of lily in water, triturate it with cerate, and apply.
For epinyctis and phlyctæna. Having triturated equal portions of litharge and sulphur vivum with vinegar and myrtle-oil, until it become of the thickness of the sordes of baths, rub with oil and wine. For hot eruptions, warm papulæ, achores, incipient furunculus, and burns, the composition of plumbago, and that from eggs is applicable.
Commentary. See Aëtius (xiv, 63); Oribasius (Morb. Curat. iii, 23); Actuarius (Meth. Med. vi, 8); Avicenna (iii, 3, 1, 11.)
This appears to be the pompholyx of Drs. Willan and Bateman. Aëtius remarks, that the disease principally attacks women whose menses are obstructed. (Bateman says, “it seems to affect only women.”) He recommends emmenagogues, laxatives, and diuretics, and forbids all acrid things.
Our author copies the whole from Oribasius. Actuarius recommends nearly the same applications.