Celsus recommends, “ad recenti vulnere contractos articulos, quas ἀγκυλας Græci nominant,” a malagma consisting of frankincense, rosin, galbanum, ammoniac, and bdellium, with wax. (v, 18.) Avicenna makes mention of a similar one. Scribonius Largus gives a prescription for ancylosis consisting of bdellium, opoponax, ammoniac, galbanum, calves’ fat, &c. (civ.)
SECT. LVI.—ON RELAXATION OF THE JOINTS.
The joints often become relaxed from protracted febrile complaints, and from colic, and paralytic affections, especially when a hot and humid intemperament seizes them; and hence the motion of the joint is impeded. In these cases the juice of acacia mixed with water may be poured upon the part; or a decoction of bramble, of myrtle, of lentisk, or of the bark of elm roots will answer well; or the rind of pomegranate may be formed into a cataplasm, or myrtle leaves with myrtle ointment may be applied. For the ligaments require to be strengthened by astringent and desiccative powers; and such applications are therefore to be made to the joints, as that from willows, that called oxyrum, and the phœnicinum, with the addition of an astringent wine or vinegar. Some imagining that the weakness of the joints proceeds from cold, and having had recourse to more heating remedies, have only increased the mischief.
Commentary. Our author has correctly stated that relaxation of the joints is to be cured by astringent desiccant applications. Aëtius makes mention of the simple articles enumerated here (xiv, 72), and Oribasius recommends a few of the same. (Synops. vii, 23.) Our author is much fuller than Oribasius on this head. (Ibid.)
SECT. LVII.—ON WORMS.
There are three different sorts of worms, the round, the broad, and thirdly, those called ascarides. They are all the offspring of crude and thick pituitous matters with a suitable putrefaction, such matters collect in children, and others who take too much food. But they do not grow from hot, acrid, or melancholic humours; for these being too strong for nutrition, are inapt for the generation of worms; and, on the contrary, bilious superfluities are particularly destructive of them. Or if at any time yellow bile be discharged along with worms, either downwards or by vomiting, you may be sure that they have been formed in the intestines, whereas the bilious humour had been collected at the mouth of the stomach, or in some other part. We shall now describe the form, generation, situation, diagnosis, and cure of each variety, beginning with the round.
Of the round worms. The form of the round worms must be known to everybody, because they are more common than any of the others. They are generated principally in the small intestines, and are very prevalent in the stomach; wherefore they are often discharged by the mouth, and sometimes by the nose. They are most common in children, more especially in fever. For they are formed about the commencement of fevers from a corruption of the matters; at their acme from the malignant nature of the disease; and during the decline from a change of the whole system to a better state. Wherefore Hippocrates says, “it is a good symptom when round worms are evacuated at the crisis of the disease, and these speedily die.” Those who have round worms experience pain of the intestines and stomach, small dry tickling cough, and in some cases hiccough, sleep with palpitations and irregular startings; and some start from their sleep with a scream, and again fall over asleep. The pulse is unequal, and the fever has irregular exacerbations, making its attacks with coldness of the joints, and coming on three and sometimes four times in the day or night without any stated form. Children have mastication and projection of the tongue without cause, and grinding of the teeth; they shut their eyes and wish to remain silent, and are offended when disturbed. Their eyes appear bloody, their cheeks red, and again change to pale. But these things occur at intervals in a short time. Sometimes the worms crawling up to the stomach occasion nausea, gnawing pain, and anorexia to the patients. When forced to take food they can scarcely swallow for nausea, or they vomit what they have taken, or their bowels are loose with corruption of the food, or are inflated like a bladder; but the rest of the body is wasted in an unaccountable manner, there being neither famine nor any extraordinary evacuation. But one must not expect to find all these symptoms in all cases, but certain ones, according to prevailing circumstances, and occasionally the most of them. These symptoms occur from the animals turning themselves about in the intestines and biting them, and the febrile heat raising noxious vapours to the brain from putrid humours collected in the belly, in which case we must sometimes pay attention alike both to the fever and the worms, and sometimes we must bestow little attention to the fever, and direct our efforts to remove the worms from the body. Many having neglected them have been eaten through by them, and have died convulsed. And others say that they have seen them come out from the groins of the patient. You may remove them from the body by killing them, and you may kill them principally by using bitter remedies. When both the treatment of the fever and of the worms is common, the simple remedies will be proper. Wherefore the patients must first drink a decoction of camomile, and of the fruit of the sebesten plum, or these medicines themselves may be given boiled. We may also give the juice of endive, or coriander seed, triturated with hot water or with oxycrate; or a decoction of the herb mouse-ear, or the shavings of hart’s horn, or sinopic vermilion finely levigated. And they may swallow by degrees two spoonfuls of the oil of bitter unripe olives, for by its bitterness it kills them, and by its lubricity it drags them along and evacuates them with the fæces. When inflammation and distension of the intestines are present, we must have recourse to a cataplasm of linseed and of the flower of lupines, and of wormwood, and of the roots of bryony in hydromel, or pour upon the hypochondria the oil of camomile, wine, and the infusions of the fruit of wormwood and aloes. When the fevers are not very troublesome we may mix with the sebesten plums some mint, and give them: and when there is no fever we may administer the more drastic medicines, such as the decoction of seriphum, or of calamint, or of fern, or the seed of cardamon, or a decoction of the root of acid pomegranate reduced to one third, or of toasted cumin, and of tawny-coloured natron, of each, scr. iij; or wormseed, or southernwood, or both made into pills with honey, or scr. iij of bitter lupines, or the levigated seed of cabbage or of rocket, or wormwood which is often sufficient alone. We may give of washed aloes to the amount of scr. iij; which is one of our most celebrated remedies; but to stronger persons we may give them unwashed. And since children will not take the aloes from a cup, they are to be secured upon their back, and their mouth being forced open by a spoon, we are to inject in spite of them the aloes by means of a syringe having a strong pipe, throwing it in as far as possible. This is an admirable method with children who can hardly be prevailed upon to take medicines, and in this way we may often inject soup in cases of anorexia. And cyphi and masuaphium may be properly administered, and burnt hart’s horn with pepper in honey or oxymel; and we may also endeavour to give the other medicines in oxymel. But the vinegar of squills will be still better, especially when given to adults. Or mustard with oil and vinegar may be given to the amount of a spoonful. Those whose bowels are troubled with a flux owing to worms may take a potion of the juice of plantain, or the plaintain itself may be given in a dry state, for it is of use both for the flux and the worms. We may apply to them cataplasms of crude barley flour, of fern, of wormwood, of the flower of lupines, of wormseed, and of southernwood, and likewise pomegranate rind, acacia, galls, and the flowers of the wild pomegranate are to be mixed with them. And since many people often loathe bitter draughts, we may give of those we have mentioned, such as are not decidedly bitter, and in addition, ground pine and horehound, elecampane, bay berries, cassia, thyme, pennyroyal, carpesium, cyperus, polypody, iris, bastard-saffron, madder, Egyptian thorn, with an equal quantity of pepper, to the amount of scr. vj, to a decoction of mint, the juice of the root of mulberry, or the decoction of stone parsley, or of other aromatic seeds. Externally we may use aloes with the oil of apples and wine. This also whets the appetite, which is a thing to be much attended to. With the aloes we may often mix wormwood; or the navel may be filled with bull’s gall along with some of the bitters formerly mentioned; or the oil of rose-bay may be constantly rubbed in, or cedar-pitch may be applied alone and along with cerate to the whole belly; or dried pitch may be levigated and sprinkled on it; or it may be anointed with mint and gith in rose-oil; or we may mix with them the decoction of seriphum; or we may triturate peach leaves and apply. We may use stag’s marrow in the form of an ointment to the navel, pubes, and loins; and, if necessary, we may apply the cerate of aloes, of wormwood, of the flour of lupines, of seriphum, of gith, of each, scr. vj; of wax, oz. jss; of oil of camomile q. s.; triturate the powders with bull’s gall. We may give them frequent injections of honied water, that the worms may be attracted downwards by the sweetness of the honey. But if they putrefy in the deep-seated parts, and are not discharged, but on the contrary raise effluvia, we must evacuate them by giving aloes, or the medicine called picra, prepared from it. In certain cases a moderate evacuation, by means of a suppository, is not unuseful to them.
Of the broad worm (tænia). The broad worm is (if I may say so) a conversion of the membrane which lines the inside of the intestine into a living body, which is often either discharged whole, when its size appears incredible to be seen; or it is evacuated in parts; but when loosed from its attachment it does not form again. It occurs most frequently without fever, but sometimes in fever after a protracted disease, when it brings on constant gnawing pains of the stomach, and an insatiable desire of food; for the animal which is formed in the intestines seize the food lying there, so that another supply is straightway required, and, if not furnished with it, the worm will bite the bowels. It is accompanied with emaciation of the body and loss of strength, with anomalous symptoms: but the most unerring symptom is when certain substances, like the seed of gourd, are discharged with the fæces. The cure resembles that of the former kind; taking the bitter draughts, eating garlic, drinking or injecting a decoction of fern, or of centaury, or of calamint, of dittany, or of pennyroyal. And we may also inject brine. The patient may also drink this potion, which is not unserviceable to those who are troubled with other worms, if they happen to have fever: Of red natron, of pepper, of cardamom, equal parts: the dose is gr. iij, with wine or hot water.—Another, a linctus: Of pepper, of pure bay berries, of Ethiopian cumin, of mastich, equal parts; of honey, q. s.; the dose is a spoonful taken in the morning and at bedtime. But if you wish to make it stronger, add an equal part of red natron.—Another: Of elecampane, of ammoniac perfume, of pepper, (in another formula, of fern,) of each, dr. v, with hot oxymel; and after an interval give adults one or two drachms of euphorbium in a draught.—Another: Of fern, an acetabulum; of natron, dr. ij; give it in a hemina of water, but it will be better if a little scammony be added to it.—Another: Of the bark of the roots of sour pomegranate stripped of its rind above, dr. iv; of pepper, dr. iv; of cardamom, dr. vj; of horehound, dr. ij; give it in honey to the patient after he has previously eaten of garlic, until the affection is completely removed. Give also of theriac, when not prevented by strong fever.