Oribasius gives no description of the disease, but briefly recommends the theriac of vipers, and in certain cases purging and bleeding for the cure of it.
The account given by Aëtius is principally taken from Archigenes, and is very circumstantial. The disease, he remarks, has been called by the several names of elephantiasis, leontiasis, and satyriasis. Suspicions, he says, have been entertained of its being contagious, and he is of opinion that it is unsafe to hold intercourse with those who are ill of the disease, as the air becomes contaminated by the effluvia from their sores, and by their respiration. The disease, he says, is insidious, for it begins in a concealed manner internally, and does not make its appearance on the skin until it is confirmed. Men are more subject to it than women, and intemperate climates predispose to it. The first symptoms of the disease are torpor, slow respiration, constipated bowels, urine like that of cattle, continued eructations, and strong venereal appetites; and when it is determined to the skin, the cheeks and chin become thickened and of a livid colour, the veins below the tongue are varicose, and eminences are formed all over the body, but especially on the forehead and chin. The body becomes increased in bulk, and is borne down by an intolerable sense of heaviness. Those affected with it become pusillanimous, and shun the haunts of men. Though the disease, when confirmed, is of the most hopeless description, he forbids us to abandon the sick at the commencement. His treatment is almost the same as our author’s: venesection at the beginning, purging with colocynth or hiera, and vomiting with radishes or white hellebore. Some, he says, having remarked that eunuchs escaped taking this complaint, have castrated themselves as a preventive. He makes mention of all the medicinal substances recommended by our author, namely, iron-wort, Cyrenaic juice, the theriac of vipers, &c. For the cutaneous affections he recommends a great many external applications, containing white hellebore, sulphur, rue, natron, aloes, and even arsenic. He also speaks of cataplasms, depilatories, and detergent ointments. He is very particular in directing that the diet be light and wholesome.
Actuarius calls elephantiasis a cancer of the whole body, which preys upon all the flesh, and derives its origin from black bile corroding everything like fire. The first symptoms of it are a falling off of the hairs of the eyebrows and chin, tumours on the face, an alteration of the appearance of the eyes, a change of the voice, turgidity of the sublingual veins, and afterwards cutaneous eruptions of an intractable nature. He then states that elephantiasis, lepra, psora, and impetigo are diseases of different gradations of malignity. In another place he has given the treatment, which is exactly the same as that recommended by Aretæus, namely, bleeding, purging with hellebore, detergent and desiccative applications to the skin, &c.
Some applications, seemingly of little efficacy, are recommended for elephantiasis in the ‘Euporista’ of the Pseudo-Dioscorides.
Nonnus, as usual, abridges our author’s detail of the treatment, and omits the description. He says it arises from a melancholic humour, which corrodes the extremities. According to Psellus, the disease is produced by melancholy adust and the lees of putrid blood.
The account of elephantiasis given by Leo is brief and imperfect. The disease, he says, is produced by a melancholic humour, which has become putrid, and corrodes the extremities. It is, he adds, almost incurable, but may be benefited by purging with the dodder of thyme, by the theriac, and burning the head at the bregma. The affection, he says, is also called satyriasmus.
Myrepsus merely mentions some of the common remedies for elephantiasis, such as arsenic, turpentine, litharge, &c. He gives no description of the disease.
We now proceed to the Arabians.
Avicenna gives a very circumstantial account of elephantiasis, under the name of juzam or judam, which his translator renders by lepra. He calls it a cancer of the whole body, which arises from black bile, and is sometimes attended with ulceration, and is sometimes without it. The disease, he says, is contagious: it is produced by living upon the flesh of asses, lentils, &c., and is endemic in Alexandria. It is sometimes called leonina, because the face assumes the stern appearance of the lion’s. He states that, although it begins internally, its first symptoms are manifested on the extremities. He then describes minutely the symptoms, namely, redness of the face, inclining to lividity; falling off of the hairs, enlargement of the veins, affection of the breathing, thickening, and discoloration of the lips; and afterwards ulceration of different parts of the body, corrosion of the cartilages of the nose, then falling off of the nose and extremities, loss of voice, &c. The treatment he gives with great minuteness, but as it is little different from that of the Greeks, we need scarcely enter upon it. Suffice it to say that he mentions early bleeding, purging with hellebore, colocynth, scammony, &c.; the theriac of vipers, the application of the cautery to the head, and so forth. Enough has been said to show that this description applies to the elephantiasis of the Greeks. Considerable confusion, however, has arisen in consequence of his translator applying the term elephantia to a very different disease, namely, to an enlargement of the leg with varicose veins, now generally known by the name of the Barbadoes leg. This complaint he directs to be treated at first with local bleeding and astringents; but when ulceration takes place, it is to be remedied only by amputation.