Now as to the word Mentagra (Tetter, Scab). This was evidently a word first framed by the Romans, as is distinctly stated not alone by Pliny, but by Galen as well (De compos. medic. secundum locos Bk. V., edit. Kühn Vol. XII. p. 839.). The latter says: Ἐκδόριον λειχήνων· ταύτῃ Πάμφιλος χρησάμενος ἐπὶ Ῥώμης πλεῖστον ἐπορίσατο ἐπικρατούσης ἐν τῇ πόλει τῆς μεντάγρας λεγομένης. (Blister for Lichenes (Scabs); in this way Pamphilus in his practise at Rome made most headway against the Mentagra as it was called, then prevalent in the city). It is usually considered to be formed on the analogy of Podagra, Chiragra (gout of the feet, gout of the hands) etc. from mentum, the chin, and ἄγρα, the act of catching, seizing hold of,—so a disease that attacks the chin. But more probably all these words are compounded not with ἄγρα at all, but with ἄλγος (suffering). That is to say just as ἀλγαλέος, by Attic interchange of letters, becomes ἀργαλέος (grievous), κεφαλαλγία becomes κεφαλαργία (head-ache), and ληθαλγία, ληθαργία (drowsiness, lethargy), so from ποδαλγία we get ποδαργία, and then by metathesis ποδάγρα (gout). (Comp. Doederlein “Lateinische Synonyme und Etymologien”,—Latin Synonyms and Etymologies Pt. 4. p. 424.). The remark Pliny adds however “ioculari primum lascivia” (at first by way of jesting mockery) evidently points to some ambiguity underlying the word. But whether this consists in the recognition of the likeness in sound between mentum, the chin, and menta, or mentula, the virile member, or is to be looked for in the ἄγρα, it might be difficult to determine. Still it seems probable, but without wishing to entirely exclude the former hypothesis, that the latter is the case, as will appear directly.
Galen[97] distinguishes between λειχὴν ἁπλοῦς and λειχὴν ἄγριος (simple lichen, and malignant lichen) in his enumeration of Skin-diseases, and still more plainly in another place[98] he says: “λειχὴν is likewise a Skin-disease; there are two forms of it, ὁ μὲν ἥμερος καὶ πρᾳότερος, ὁ δὲ ἄγριος καὶ χαλεπώτερος (the one benignant and milder, the other malignant and more serious). But in both of them minute scales are detached from the skin, and the part of the skin underneath the scales is reddened and almost ulcerated. The affection arises from a salt phlegmatic humour (φλέγματος ἁλμυροῦ) and yellow gall, hence the scales fall from the skin as in glazed pottery-ware (? ἐπὶ τῶν ἁλμῶν τῶν κεραμίων). The affection is cured by internal phlegmagogues and external embrocations.” We have already on p. 139. above, in the footnote on ἄγριος (wild, savage) and χαλεπός (hard, harsh), noted how these words are used with special reference to the vice of paederastia, but they are also applied generally to the vice, the different forms of which we have been examining here. This follows from Plato[99] and Plutarch[100], at any rate so far as ἄγριος is concerned, which indeed we may conveniently render by vicious. The original meaning being overlooked, λείχην and λιχὴν had been taken as synonymous,—possibly the Latin lichenos first led to the mistake; then naturally enough an appropriate epithet was sought, to signify the lichen which was the result of licking in a vicious fashion. But this according to the already existing mode of speech could be nothing else than ἄγριος[101] again,—λειχὴν ἄγριος, with which λειχὴν ἁπλοῦς, lichen insons, (simple, innocent lichen) was naturally contrasted.
Yet while Criton, as cited in Aëtius, simply and quite correctly interpreted Mentagra by ἄγριος λειχὴν (fierce, malignant lichen), Galen appears to have been still ignorant of the special meaning. This is shown by the words ἥμερος and πρᾳότερος (gentle, benignant,—milder), which obviously are correct opposites of ἄγριος only if the latter is understood, as it is in Celsus, as equivalent to ferus (fierce, malignant), but in no way account for the ἁπλοῦς (simple, innocent), which Galen no doubt found already established as distinguishing epithet of λιχὴν. How little he fathomed the nature of the evil, is proved by his ætiology of it, which makes the complaint result from the φλέγμα ἁλμυρὸν (salt phlegmatic humour) and the χολὴ ξανθὴ (yellow gall). The unprofessional Martial had a better word to say on the subject when he wrote his sordidique lichenes (filthy, squalid-looking lichens). Similarly it would seem the agra in Mentagra should be taken as pointing to ἄγριος (fierce, malignant). Can it be perhaps that in this way the μολύνων τὴν ὑπήνην (polluting the hair on the upper lip) of Aristophanes, the Latin barbam inquinare (to pollute the beard), have come to be used as synonyms for cunnilingere? Martial seems to imply it by his triste mentum, mentum periculosum (disfigured chin, perilous chin). Perhaps too the Sycosis menti (Sycosis,—fig-like eruption, of the chin) of Celsus and the later Greek medical writers should likewise be regarded as coming under this head. At a matter of fact, Archigenes says so in so many words, as cited in Galen (De comp. med. secundum locos. Bk. V. edit. Kühn Vol. XII. p. 847.), ἐπὶ δὲ τῶν συκωδῶν τῶν ἐπὶ τοῦ γενείου, λεγομένων δὲ μενταγρῶν, ὑπὸ δέ τινων λειχήνων ἀγρίων, ποιεῖ κ. τ. λ. (but in the case of the sycotic, or fig-like, eruptions on the chin, which are called mentagrae, and by others malignant lichens, he proceeds as follows, etc.), and calls the affection of the chin, as do other Physicians, generally ἐξανθήματα ἐν τοῖς γενείοις (efflorescences, eruptions on the chin),—p. 824.
If we have thus succeeded in establishing the meanings of lichens and mentagra, the rest of the passage of Pliny will admit of easy explanation. The disease in many cases it seems invaded the whole face, in the same way as the atra lues (black contagion) in the passages quoted above from Martial under fellation. Perhaps all of these,—indeed, Pliny also says lues,—are the be referred, as is actually done by Farnabius in his notes, to mentagra, seeing that the disease could perfectly well, though certainly much seldomer, arise equally from the practise of fellation. The double entendre between mentum (the chin) and menta or mentula (the virile member) would so acquire all the more point.
The expression foedo cutis furfure (with a horrible scurf of the skin) appears to have led a number of authors to believe that this was the capital characteristic of the complaint, and that the distinction between λιχὴν and λείχην was merely one of degree. This view was advocated in particular by Willian[102], who ascribes it also to Paulus Aegineta[103] as well as to Oribasius[104] though both of these authors limit themselves to saying that the moderately siccative remedies are of no benefit in λείχην ἄγριος (malignant lichen), whereas the more violent ones aggravate it, and that for this reason it was called ἄγριος. Hence Willian’s Lichen agrius (malignant lichen) has nothing in common with the lichen of the Greeks and Romans but the mere name, for it follows clearly from the words foediore cicatrice (with a more horrible scar) that occur a little further down in Pliny, that a process of skinning over by ulceration was part of the disease, and did not owe its existence solely to the caustic remedies employed.
The immunity of women[105] equally admits of easy explanation, for in the first place women were not likely to have readily conceived the idea of acting after the manner of a cunnilingue[106], and even if fellation is admitted to be an occasionally concurrent cause of mentagra, still it would seem, as already stated, to supervene much less often as a consequence of the latter vice; while in cases where it does, it is of a milder form and it is rather the internal parts of the mouth that are imperilled. Besides, it is to be remembered that women generally speaking suffer less frequently from pustulous disorders of the cutaneous glands affecting the face than men do, as is well seen at the present day with Acne. In the parts neighbouring on the genitals this is exactly reversed. Still this immunity of women must not be insisted on too far, as those persons of the female sex who used to practise fellation, the Summoenianae (women of the suburbs) lay too completely outside the range of Pliny’s observation.
As to the servi (slaves) and Plebs humilis (Commons of humble station), these were surely unlikely, however little restraint they may have put on their sensual appetites, to have readily fallen into suchlike forms of vice,—forms which spring as a rule from the brain of unoccupied, rich idlers. We have only to appeal to modern experience to substantiate this. How many individuals of the lowest and middle classes have the records of forensic medicine to show as having been paederasts and so on? Wild aberrations in morals have at no period begun with the common man! So we see it was the Proceres (Nobles) who were in an especial degree attacked by the mentagra.
At the same time the most conspicuous cause of mentagra, the practice of cunnilingere was by no means the only way of getting it, for the malady, like condylomata on the genital organs, was evidently connected with a contagion,—a fact which is clearly enough brought out by the layman Pliny, whereas the Physicians say nothing about this. Accordingly the disorder was capable of being disseminated by kissing from one individual to another. But it was not the velox transitus osculi (swift transmission of a kiss) that was instrumental in spreading the disease, but rather the basium (wanton kiss),—which depended on some yet unidentified lascivious device[107], sucking, playing with the tongue or the like. Still we must remember that at the very time the mentagra was spreading with such terrible rapidity, a perfect mania for kissing had broken out at Rome. Martial describes this admirably in the two following Epigrams, which are of the very highest importance in connection with our subject:
Book XII. Epigram 59:
De importunis basiatoribus.