Commentary. These remarks are taken from Aëtius (xiv, 69, 70); or Oribasius (Synops. vii, 14); and they are copied by Nonnus (Epit. 254); and Actuarius (Meth. Med. iv, 16.)
The Arabians treat these accidents upon exactly the same principles. See in particular Avicenna, as quoted in [the preceding section].
SECT. XXXII.—ON SCIRRHUS.
Genuine scirrhus is a preternatural swelling, hard and devoid of sensibility; but that which is not genuine is only attended with diminished sensibility. That which is wholly insensible, then, is utterly incurable; but that which is attended only with diminished sensibility is not incurable, and yet it is not easily cured, for it is occasioned by a viscid and thick humour, which is fixed in the hardened parts, so as to be difficult to get discharged. Sometimes, then, the scirrhus is the original complaint, and goes on to increase; but for the most part, it is occasioned by the physicians applying too cooling and astringent remedies to erysipelas and phlegmon.
If one, therefore, apply strongly discutient medicines to indurations of the body, one will indeed produce a visible diminution of the scirrhus in a short time, but will leave the remainder of the complaint in an incurable state; for the thin moisture being dissipated, what remains is rendered dry and hard as a stone. The discutient application, then, ought to be in a certain degree emollient, without possessing manifestly heating and desiccant qualities. Such are all kinds of marrow, more especially that of a stag or of a calf, and the grease of a lion, of a panther, or of bears, or of a bull, and among birds, that of geese, of domestic fowls, or of pheasants: but that of bucks and he-goats is drier. And to these may be added, ammoniac perfume, bdellium, more especially the Scythian, the humid and fatty storax, and the Egyptian mastich. To all other parts of the body, when in a scirrhous state, these things may be applied singly, and in composition; but for tendons and ligaments, we are to dissolve in the strongest vinegar some stone that has been heated in the fire. If possible, the one to be used should be pyrites, or if not it, the lapis molaris or millstone. In this, therefore, the affected part is to be moved, so that it may receive the vapour which arises from it; and afterwards, an emollient medicine is to be applied. A thin oil then, and not water, is to be poured on the part, by all means once a day, and sometimes one may boil in the oil the root of marshmallows, or of wild cucumber. The patients ought to abstain from the use of the bath, at least from the frequent use of it. But when the scirrhus is moderately softened, the softest ammoniac is to be dissolved in very strong vinegar, and the part rubbed with it for several days in succession; after which, we must again have recourse to an emollient application, having the fattest galbanum and opoponax added to it. Such are that from bacon, that ascribed to Amythaon, and those which we are about to describe for scrofula.
Commentary. See Galen (De Tumoribus; Meth. Med. xiv; Therap. ad Glauc. ii); Oribasius (Synops. vii, 34); Aëtius (xv, 3, 4); Leo (vii, 4); Actuarius (Meth. Med. iv, 16); Serapion (v, 23); Avicenna (iv, 3, 2, 12); Haly Abbas (Pract. iii, 31); Alsaharavius (xxix, 1, 15); Rhases (Antid. i, Cont. xxvii, Antidot. i.)
This section is entirely taken from Galen (Ther. ad Glauc. l. c.) Galen’s account, however, is somewhat fuller than our author’s, and contains a case treated upon the principles which he lays down. It was a case of hard swelling in the thigh, arising from an erysipelas which had been improperly treated by astringent and cooling applications. Galen informs us that he began by pouring upon the limb an attenuant oil, namely, the Sabine; after which he caused it to be rubbed with marrows and fats medicated with bdellium, mastich, ammoniac perfume, and the like. After this he bathed the whole limb with a solution of ammoniac in very acrid vinegar. When the swelling had been lessened, but not completely removed by these means, he afterwards applied one of the pitch medicines, and at length effected a cure. In another place he states that scirrhus is sometimes allied to cancer.
Oribasius likewise recommends a combination of emollients with discutients; and Actuarius approves of the same practice.
Aëtius has a valuable chapter upon this subject. Besides the articles mentioned by our author, he recommends various rosins, turpentine, frankincense, and the like. He forbids the use of aluminous, sulphureous, and chalybeate baths. For indurations of tendons he recommends things possessed of attenuant and cutting properties combined with emollients, such as ammoniac dissolved in vinegar with melons.