XIX. Περὶ ἑλκῶν—On Ulcers.
This treatise is decidedly admitted as genuine by Galen,[177] Erotian, Celsus, and by Foës, Lemos, Mercuriali, Schulze,[178] and Vidus Vidius,[179] but is rejected by Haller, Gruner, Ackerman, and Kühn, on internal evidence, the nature of which we shall presently examine. M. Littré in so far concurs in the judgment of the authorities who reject it, although he does not admit the grounds of their decision. Gruner’s principal, indeed I may say his sole, argument against the authenticity of this work is founded on the nature of the substances recommended by the author for the treatment of ulcers; namely, such acrid and (as Gruner chooses to call them) absurd medicines as arsenic, black hellebore, and cantharides. But how does it appear that these are “absurd” applications to ulcers, when even at the present day the two strongest of them, namely, arsenic and cantharides, are the means often resorted to for the cure of indolent and malignant ulcers? The same articles are recommended by Celsus (v.), and by Paulus Ægineta.[180] It is true that the titles given to certain of the prescriptions contained in this treatise are not appropriate, such as emollient (μαλθακώδεα), applied to applications which contain many acrid ingredients. But in this case, as is remarked by Foës, we should consider the text to be in so far corrupt, for certainly this does not constitute a legitimate reason for rejecting the treatise in toto.
Vidus Vidius, in his interesting commentary on this work, mentions, as a proof of its authenticity, that most of the principles laid down by Galen for the treatment of ulcers, are taken from this part of the works of Hippocrates. In a word, agreeably to the rules laid down by me for testing the authenticity of these treatises, I do not see that I am warranted in refusing to admit the claims of this work to be considered genuine. I hold myself bound, therefore, to give a translation of it.
It may be proper in this place to mention that the term ulcer (ἕλκος) is used in this treatise to signify both a wound inflicted by an external body, and a solution of continuity from any internal cause. This usage of the word is sanctioned by the older poets, as, for example, Homer (Iliad, ii., 723; Ib., xiv., 130); Pindar (Nem., viii., 50; Pyth., iii., 84); and Bion (Adonis).
XX. Περὶ συρίγγων—On Fistulæ.
Though this work be acknowledged as genuine by Erotian, Dioscorides, Celsus, Paulus Ægineta, and by Foës and Vidus Vidius, it is set down for spurious by Haller, Gruner, and Ackerman; and even by Littré and Greenhill its claims are not fully recognized. I can see no good reason, however, for rejecting it, since, as I have stated, the ancient authority in favor of it is very strong, and I can detect nothing in the doctrines and rules of practice delivered in it which are at variance with those laid down in the treatises which all admit to be genuine. Ackerman, indeed, pretends that the theory of bile and phlegm, as being the cause of disease, does not belong to Hippocrates or his school. But this is evidently begging the question; and, moreover, Galen, who must be admitted to be a high authority in such a case, decidedly holds Hippocrates to be the author of the Theory of the Humors.[181] Galen seems to say that this treatise, and the following one on hemorrhoids, constituted one work in his time; and he does not throw out the slightest suspicion against the genuineness of either, as the words of Ackerman would lead one to suppose.[182]
Vidus Vidius, although he acknowledges Hippocrates as the author of this work, holds that it had not been published by him, but had been left in an unfinished state. The argument, however, which he uses in proof of this opinion, is by no means convincing; he contends that the part which relates to inflammation of the anus is quite out of place in a work devoted to the consideration of fistulæ. But few who have much practical acquaintance with the subject will agree with him on this point, for it is well known that fistulæ, for the most part, originate in inflammation and abscess about the verge of the anus.
XXI. Περὶ αἱμοῤῥοιδων—On Piles.
This little tract has experienced the same reception from the critics as the preceding one, that is to say, it is acknowledged as genuine by ErotianΠερὶ αἱμοῤῥοιδων and Galen, and by Foës and Vidus Vidius, but is decidedly rejected as such by Mercuriali, Gruner, Grimm, and Ackerman. I can remark nothing in it, however, which appears to me at all inconsistent with the doctrines contained in the genuine works, unless it be that in this tract the author appears to direct that in operating upon hemorrhoids they should be all extirpated, whereas in one of his Aphorisms, which is quoted by Paulus Ægineta, in his chapter on this subject, he recommends that one should be left, as an outlet to the superfluous blood. (vi., 79.) I do not know how this divergence of opinion is to be explained, but, at all events, such an apparent contradiction would not warrant us in rejecting the treatise altogether.
XXII. Περὶ ίερῆς νούσου—On the Sacred Disease.