Of deleterious substances, the following animals are destructive: cantharis, buprestis, salamander, pine-caterpillar, the sea-hare, the toad, the mute marsh frog, and leeches when swallowed; and, of seeds, the henbane, coriander, fleawort, hemlock, and gith; of juices, meconium, opocarpasum, thapsia, elaterium, and mandragora; of roots, chamæleon, wolfsbane, thapsia, ixia, hellebore, black agaric, ephemeron, which some call colchicum, because it grows in Colchis; of trees and potherbs, smilax, which some call thymium, but the Romans called taxus, the strychnus furiosa, which is called dorycnium, the Sardoan herb, which is a species of ranunculus, horned poppy, pharicum, toxicum, wild rue, and mushrooms; of animal productions, fresh bull’s blood, coagulated milk, Heraclean honey; of metals, gypsum, ceruse, lime, arsenic, sandarach, litharge, adarce, lead, and that which is called mercury; and of domestic articles, much wine taken at a draught after the bath, or must, or cold water in like manner.
Commentary. Nicander, in his Alexipharmics, treats of the following deleterious substances:—1, Aconitum, or wolfsbane; 2, Argenti spuma, or litharge; 3, Buprestis; 4, Cantharides; 5, Ceruse, or whitelead; 6, Conium, or hemlock; 7, Coriander; 8, Dorycnium (see below); 9, Ephemeron, or meadow saffron; 10, Fungi, or poisonous mushrooms; 11, Hirudines, or leeches; 12, Hyoscyamus, or henbane; 13, Ixias, probably a species of chamæleon; 14, Coagulated milk; 15, The sea-hare; 16, Papaver, or poppy; 17, Pharicum, probably a composition from agaric (see Schneider’s note); 18, the red toad and marsh frog; 19, the salamander; 20, Bulls’ blood; 21, Taxus, or the yew-tree; 22, Toxicum, not ascertained. See Avicenna.
The lists of poisonous substances treated of by Dioscorides, Aëtius, and Actuarius are nearly the same as our author’s. Those of Nonnus and Scribonius Largus are less numerous. The Arabians treat of several substances, the nature of which it is now difficult to determine. The catalogues of Avicenna and Rhases are the fullest; those of Haly Abbas and Alsaharavius scarcely contain so many articles; all of them, however, contain several substances which are not treated of by the Greek writers on toxicology. Among these we may just mention that they treat of the gall of the viper, of the leopard, of an animal called leunza (leæna?), of the shark, and also of the extremity of the stag’s tail, and bad castor. The sweat of different animals is also included in their lists.
SECT. XXX.—ON CANTHARIDES.
The most grievous symptoms follow the administration of cantharides, for almost from the mouth to the bladder the parts are tormented with a gnawing pain. The taste resembles pitch or cedar rosin, and the patients have inflammation of the right hypochondrium, with dysuria, and frequently they pass blood by urine, and sometimes it is discharged by the intestines, as in dysentery: they fall into deliquium animi, nausea, and vertigo, and at last they become delirious. The proper remedies are vomiting with water and oil, drinking milk, taking four drachms of Cimolian earth with honied water, pine kernels, the seeds of cucumber, fat beef soup, or soup of geese or of mutton; the flesh of fowls, lambs, sheep, or pigs, being tender and fat, when boiled with linseed; much must; dr. iv of the bark of rosemary; and after the food inject by clyster the juice of rice, or of chondrus, or of spelt, or of ptisan, or of mallows, or of linseed, or of marshmallows, or of fenugreek. And sometimes having cleared out the intestine with honied water and nitre, we may then inject these things, and afterwards allay the inflammation with cataplasms of linseed and barley; for at first these things are pernicious. Then we may have recourse to baths of sweet water, and give the ointments of iris and of roses in a draught.
Commentary. The symptoms occasioned by taking cantharides, according to Nicander, are erosion of the whole intestinal canal, ulceration of the bladder, affection of the chest, and wild delirium. His remedies are emetics, such as fat, the oil of iris with rue, or Samian aster, laxatives, milk in clysters or taken by the mouth, and the decoction of vine-shoots with honey. Dioscorides describes the symptoms in the same terms as our author, and like him recommends emetics of oil and emollient clysters, such as the decoction of linseed or of mallows. Like our author, he disapproves of warm applications, such as cataplasms and the hot bath at the commencement, because by their heat they promote the distribution of the poison over the system; but after a time they are useful, he says, by allaying the pains and promoting the discharge of the poison by the cutaneous perspiration. His other remedies being the same as our author’s, we need not enumerate them. Galen states that the wings and feet of cantharides prove useful for removing the deleterious effects occasioned by taking their bodies. His treatment otherwise, which is borrowed from Asclepiades, is very similar to that of Dioscorides. He in particular recommends the Lemnian earth, or terra sigillata, as an emetic in this case. (De simpl. ix.) He also speaks favorably of milk. (Ib. and de antidot. ii.) He approves very much of animal and vegetable oils given in sweet wine or tepid water to produce vomiting. Galen states decidedly that the viscus upon which the action of cantharides is exerted is the bladder. (Ad Pison.) The treatment recommended by Scribonius Largus is little different. Aëtius, Oribasius, and Actuarius only copy from Dioscorides, without suggesting any improvement. Avicenna and Rhases mention that cantharides occasion inflammation of the penis and erections. They agree with the Greeks in recommending oily emetics, clysters of the same, and, what we believe is an improvement which we owe to the Arabians, injections of rose-oil into the bladder by means of a waxen tube (flexible catheter). Rhases approves of bleeding, provided it be long since the patient was bled, and violent pain be felt in the region of the thighs, that is to say, if the urinary organs are much affected. Haly Abbas mentions ardor urinæ, strangury, and bloody urine among the symptoms, and recommends oil by the mouth as an emetic and purgative, and by injection. Alsaharavius mentions swelling of the penis, bloody urine, and suppression thereof, and remarks that the same effects have been sometimes brought on by the external application of cantharides, in which case he recommends the tepid bath and emollient fomentations. His treatment is like that of his other countrymen; for example, he joins them in approving of injecting rose-oil into the bladder.
It would appear that cantharides were sometimes used by the ancients for the purpose of committing suicide. According to Cicero, it was by this means that C. Carbo destroyed himself. (Ad Familiar, ix, 21.)
Ambrose Paré, Matthiolus, and all the earlier modern writers on toxicology, follow the treatment laid down by the ancients. Notwithstanding the concurrent testimonies of all these authorities, Professor Orfila, in the last edition of his ‘Toxicologie,’ and Dr. Christison, in his late work on ‘Poisons,’ affirm “that oil is the reverse of an antidote.” Yet, in a case lately published, the free administration of olive-oil was followed by copious discharges, both upwards and downwards, of cantharides mixed with the oil. (Edinb. Med. and Surg. Journ. No. 104, p. 214.) And surely, if laxatives are to be administered at all, oily ones are to be preferred, as producing least irritation, and not being likely to be absorbed.
It can scarcely admit of dispute, that the mylabris cichorei is the same as the ancient cantharis. It is still used in Turkey and India for the composition of blistering plasters, being possessed of much the same properties as the Spanish fly.