Celsus describes phyma as resembling furunculus, but as being larger, and turning to pus. According to Rayer, his description of phyma applies better to the boil than his account of anthrax. (Malad. de la Peau, p. 229.) The phygethlon, he says, is a tumour not high, but broad, and containing something resembling a pustule. It occurs mostly in the armpits, neck, or groins. He proposes applications of a repellent and refrigerant nature; but if the swelling is hard, digestives must be had recourse to, such as dried figs bruised, &c. He also recommends a composition of sal ammoniac, galbanum, bee-glue, and mistletoe, with a small proportion of myrrh. His treatment is considerably different from our author’s. When matter is formed, he directs us to let it out by medicines or the lancet, but he decidedly forbids the use of cerates. In another place, however, he recommends an application containing lime, spuma nitri, round pepper, galbanum, and salt mixed with rose cerate.
Scribonius Largus recommends a malagma containing pitch, aphronitum, pine-rosin, wax, bay-berries, axunge, ammoniac, Illyrian iris, galbanum, and white pepper, for discussing phygethlon.
Oribasius and Actuarius mark the distinction between these affections in the same terms as Galen, and direct us to treat them with emollient, concoctive, and discutient applications. For concocting phymata, the Pseudo-Dioscorides recommends southernwood, boiled with raw barley flour; figs, boiled with yeast, &c.; and for breaking them, the juice of thapsia, with sulphur; cantharides, mixed with turpentine, &c. (Euporist, i, 156.)
Nonnus’ account is mostly abridged from our author’s. Thus, he recommends at first venesection, and sponges squeezed out of oxycrate and the like; then digestives are to be applied; and afterwards cataplasms and such things as will favour the rupture of the abscess, namely, compositions containing bee-glue, bitter lupins, vinegar, nitre, yeast, or figs and pitch.
Avicenna describes these affections by the name of althaum. It is remarked by his translator that the Arabian recommends the same medicines as Paulus, but neglects the distinction which the latter properly makes between the bubo when attended with pestilential fever and when without it.
The phyma seems to have been merely an acute inflammation of a gland, terminating in suppuration. The phygethlon was an erysipelatous inflammation of a gland. These complaints are well defined and described by Fabricius ab Aquapendente (1, i, 23.) Dr. Willan uses the term phyma in a different sense from that of our author. The term occurs in Marcus Antoninus (ii, 16), where see the note of Gataker.
SECT. XXIII.—ON FURUNCULUS.
Furunculus is an apostematous swelling, formed of thick humours in the fleshy parts of the body most especially; being mild when it is formed in the skin only, but of a malignant character when it rises up from a deep-seated part. Furunculus may be discussed and concocted by wheat, chewed and applied; by Egyptian mastic; by raisins, deprived of their stones, and triturated with salts, and applied—(this either discusses or breaks the swelling); or apply dried figs boiled in hydromel; or rosin may be mixed with the figs and applied; or the figs themselves, when they are fat, may be split open and applied; or leaven with nitre; or linseed with honey; or the leaves of henbane, triturated with butter: of compound applications, that which is prepared from leaven and fine flour, and that which is particularly named Dothienicon, are very applicable. Foment with soft sponges frequently dipped in hot water, and then apply the medicines.
Commentary. In this and the two following Sections, see the authorities on phlegmon.