Sprains of the joints and contusions are remedied by unwashed wool, or a sponge soaked in vinegar and oil, and applied; by the tender parts of boiled bulbous roots with honey, by the leaves of the chaste tree, salts, and roasted nitre, triturated with cerate. The affusion of sweet water, or of hot sea water, may be used. But after the inflammation and pains have subsided, apply rubbing to the sprained parts.
Commentary. See Aëtius (xiv, 71); Oribasius (Synops. vii, 14); Actuarius (Meth. Med. ii, 35); Scribonius Largus (§ 209); Rhases (Divis. i, 140.)
Aëtius makes mention of all the remedies recommended by our author, with the exception of the affusion of water; which, however, is a method of treatment deserving of attention. Oribasius mentions particularly the affusion of hot sea water. Scribonius Largus recommends a plaster containing litharge, alum, ærugo, ammoniac, &c. Rhases directs us to use attenuant ointments, sedative plasters, and loose bandages, with rest.
SECT. XXX.—ON CONTUSIONS OF THE FLESH AND ECCHYMOSIS.
The flesh being bruised by some weight falling upon it, and the small veins in it being ruptured, blood is poured out from them by exhalation, and collecting under the skin, is called ecchymoma. When the skin is not divided, a soft yielding tumour is the consequence; it is pale, and for the most part unattended with pain. Our object, therefore, is to discuss the contained blood, and that quickly, before it become black; and at first, astringents are to be mixed with the discutients, because the bruised coats of the veins stand in need of condensation. After these things, we must use those applications which are merely discutient without astringency. And by scarifying the ecchymomata at the commencement, we may thus apply the subsequent treatment. For chronic cases of ecchymoma, radish in the form of a cataplasm is a suitable remedy, but it must be taken away when it becomes pungent; or a cataplasm of the juice of radish with crumbs of bread, may be applied. The diseases called hypopion and hyposphagma, are species of ecchymosis, and also the effusion of blood below the nail from a blow; of these, the first two are treated of in their proper places in the [Third Book]; and the affection of the nail will be handled in the Surgical part of the work.
Commentary. This is taken almost word for word from Oribasius (Synops. vii, 14); Aëtius directs us to scarify the part affected with ecchymosis, and then to apply to it the inside of citrons (xiv, 68.)
Avicenna approves of scarifications, provided the extravasated blood cannot be got otherwise removed. (iv, 4, 2, 3.)
SECT. XXXI.—ON RUPTURE AND TEARING OF THE FLESH.
Rupture is altogether attended with ecchymosis. It is cured by medicines which are moderately heating, as the acopon from black poplars, and such as resemble it. But when the rupture is deep-seated, we must have recourse to such remedies as are more acrid and cutting. The use of the cupping instrument is likewise beneficial to them. Should therefore the whole ecchymosis be discussed, the separated flesh readily unites; but if it continue a long time, and sordes form under it, the ruptured flesh can no longer unite; and we must only apply the lips together, so that a small occasion may readily separate them, and that the intermediate space may be filled with some moisture, and in a certain manner an ecchymosis may be formed as at the commencement, except that it is sooner discussed, as containing a thin humour, whereas that at the commencement was formed of blood. Vulsion takes place when certain fibres are torn asunder, and it only requires soothing applications until the pain is removed; for they cannot be made to coalesce. Wherefore, the round birthwort, if any, is a convenient application to ruptured and torn parts; and in like manner, the root of the large centaury, and the juice of it, rhubarb, costus, and bdellium, drunk with oxymel.