A Treatise on the Smallpox and Measles

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Source: A Treatise on the Small-Pox and Measles, trans. William Alexander Greenhill (London: Sydenham Society, 1848), via the Internet Archive (atreatiseonsmal00rzgoog) Source URL: https://archive.org/details/atreatiseonsmal00rzgoog Translator: William Alexander Greenhill (1848) Public domain basis: Public-domain translation (1848). The treatise's fourteen chapters; Greenhill's introduction, notes and the appended Latin and Arabic material are omitted. OCR text.

p. 10. CHAPTER I.

Of the catises of the Small-Pox; how it comes to pass that hardly any one escapes the disease; and the sum of what Galen says concerning it.

As to any physician who says that the excellent Galen has made no mention of the Small-Pox, and was entirely ignorant of this disease, surely he must be one of those who have either never read his works at all, or who have passed over them very cursorily. For Gtden describes a plaster in the first book of his treatise Kara yivoq,^ and says that it is useful against this and that disease, " and also against the Small-Pox" ^ Again, in the beginning of the fourteenth book of his treatise " On ^' ' Pulses,'^ ^ at about the first leaf, he says, that *' the blood is sometimes putrefied in an extraordinary degree, and that the excess of inflammation runs so high that the skin is burned, and there break out in it the Small-Pox and excoriating erysipelas* by which it is eroded.^^^ Again, in the ninth book of his treatise ^^On the Use of the Members,'^* he says that " the superfluous parts of the food that remain, which are not converted into blood, and remain in the members, putrefy, and become more acid, in process of time, until there are generated the erysipelas, Small-Pox, and spreading inflammation.''^ Again, in the fourth book of " Timaeus''® he says that " the

> See below, Note D.

« This sentence occurs also below, Cont, §§ 56, 65, and each passage serves slightly to improve the text of the other. 9 See below. Note E. * See below. Note F.

^ This sentence also is quoted below, Cont. § 65. « See below. Note G.

^ This passage is quoted below, Cont. §§ 56, 65. « See below, Note H.

28 RHAZES ON THE [chap. i.

ancients applied the name ^Xey/iovyf to every thing in which there was inflammation, as the erysipelas, and Small- Pox, and that these diseases were in their opinion generated from bile/'^

(2.) If, however, any one says that Galen has not mentioned any peculiar and satisfactory mode of treatment for this disease, nor any complete cause, he is certainly correct ; for,^ imless he has done so in some of his works which have not been published in Arabic, he has made no farther mention of it than what we have just cited. As for my own part, I have most carefully inquired of those who use both the Syriac and Greek languages, and have asked them about this matter; but there was not one of them who could add anything to what I have mentioned; and indeed most of them did not know what he meant by those passages which I have distinctly quoted. This I was mudi surprised at, and also how it was that Galen passed over this disease which occurs 80 frequently and requires such carefrd treatment, when he is so eager in finding out the causes and treatment of other maladies.

(3.) As to the moderns, although they have certfdnly made some mention of the treatment of the Small-Pox, (but without much accuracy and distinctness,) yet there is not one of them who has mentioned the cause of the existence of the disease, and how it comes to pass that hardly any one escapes it, or who has disposed the modes of treatment in their right places. And for this reason we hope that the reward of that man who encouraged us to compose this treatise, and also our own, will be doubled, since we have mentioned whatever is necessary for the treatment of this disease, and have arranged and carefully disposed every thing in its right place, by GOD's permission. (4.) We will now begin therefore by mentioning the efficient cause of this distemper, and why hardly any one escapes it; and then we will treat of the other things that relate to it, section by section : and we will (with GOD's

^ This passage is quoted below, Cont. $ 56.

* Here and in one or two other places the expression ** Per DEUM" has been omitted, because, though perfectly natural and inoffensive in Arabic writers, it could not be used in English without the appearance of irreverence.

assistance^) speak on every one of these points with what we consider to be sufficient copiousness.

(5.) I say then^ that every man^ from the time of his birth till he arrives at old age, is continually tending to dryness ; and for this reason the blood of children and infants is much moister than the blood of young men, and still more so than that of old men. And besides this it is much hotter; as Gkden testifies in his Commentary on the ^^ Aphorisms/^ in which he says that ^^ the heat of children is greater in quantity than the heat of young men, and the heat of yoimg men is more intense in quality .^^^ And this also is evident from the force with which the natural processes, such as digestion and growth of body, are carried on in children. For this reason the blood of infants and children may be compared to must, in which the coction leading to perfect ripeness has not yet begun, nor the movement towards fermentation taken place; the blood of young men may be compared to must, which has already fermented and made a hissing noise, and has thrown out abundant vapours and its superfluous parts, like wine which is now still and quiet and arrived at its full strength ; and as to the blood of old men, it may be compared to wine which has now lost its strength and is beginning to grow vapid and sour.

(6.) Now the Small-Pox arises when the blood putrefies and ferments, so that the superfluous vapours are thrown out of it, and it is changed from the blood of infants, which is like must, into the blood of young men, which is like wine perfectly ripened : and the Small-Pox itself may be compared to the fermentation and the hissing noise which take place in must at that time. And this is the reason why children, especially males, rarely escape being seized with this disease, because it is impossible to prevent the blood's changing from this state into its second state, just as it is impossible to prevent must (whose nature it is to make a hissing noise and to ferment,) from changing into the state which happens to it after its making a hissing noise and its fermentation. And the temperament of an infant or child is seldom such that it

' Here begins the translation of the anonymous Greek Interpreter. 2 See below, Note I.

SAN f^-^^'"^' n from the

30 RHAZES ON THE [chap. i.

is possible for its blood to be changed from the first state into the second by little and little, and orderly, and slowly, so that this fermentation and hissing noise should not show itself in the blood : for a temperament, to change thus gradually, should be cold and dry; whereas that of children is just the contrary, as is also their diet, seeing that the food of infants consists of milk; and as for children, although their food does not consist of milk, yet it is nearer to it than is that of other ages ; there is also a greater mixture in their food, and more movement after it ; for which reason it is seldom that a child escapes this disease. Then afterwards alterations take place in their condition according to their temperaments, regimen, and natural disposition, the air that surrounds them, and the state of the vascular system both as to quantity and quality, for in some individuals the blood flows quickly, in others slowly, in some it is abundant, in others deficient, in some it is very bad in quality, in others less detericw^ted.

(7.) As to young men, whereas their blood is already passed into the second state, its maturation is established, and the superfluous particles of moisture which necessarily cause putrefaction are now exhaled ; hence it follows that this disease only happens to a few individuals among them, that is, to those whose vascular system abounds with too much moisture, or is corrupt in quality with a violent inflammation ; or who in their childhood have had the Chicken-Pox,' whereby the transition of the blood from the first into the second state has not been perfected. It takes place also in those who have a slight heat, or whose moisture is not copious ; and to those who had the Chicken-Pox^ in their childhood, and are of a dry, lean habit of body, with slight and gentle heat ; and who when they became young men, used a diet to strengthen and fatten their body, or a diet which corrupted their blood.

(8.) And as for old men, the Small-Pox seldom happens to them, except in pestilential, putrid, and malignant constitutions of the air, in which this disease is chiefly prevalent.

' Literally, a " light (or mild) Small-Pox/' tvipopog Aoifiucri in the Greek Translation.

' Literally, a " weak SmalUPox ;" but the word is not the same as in the previous sentence : — perhaps, however, in both cases the words merely signify a very slight attack of Small-Pox.

For a putrid air, which has an undue proportion of heat and moisture^ and also an inflamed air^ promotes the eruption of this disease^ by converting the spirit in the two ventricles of the heart to its own temperament, and then by means of the heart converting the whole of the blood in the arteries into a state of corruption like itself.^

(9.) Having thus suflSciently, though briefly and succinctly, treated of the causes of the Small-Pox, we shall now proceed to speak of the habits of body which are most disposed to this disease and to the Measles.

1 This sentence affords a clear proof, that the ancients, while they considered the arteries to contain air, were also (at least after the time of Galen,) fully aware that blood was likewise to be found in them.

32 RHAZES ON THE p. 30. CHAPTER II.

A specification of those habits of body which are most disposed to the SmalUPox ; and of the seasons in which these habits of body mostly abound.

The bodies most disposed to the Small-Pox are in general such as are moist^ pale^ and fleshy ; the well-coloured also, and ruddy, as likewise the swarthy when they we loaded with flesh; those who are frequently attacked by acute and continued fevers, bleeding at the nose, inflammation of the eyes, and white and red pustules, and vesicles j^ those that are very fond of sweet things, especially, dates, honey, figs, and grapes,^ and all those kinds of sweets in which there is a thick and dense substance, as thick gruel,^ and honey-cakes,* or a great quantity of wine and milk.

* The words « fttj Buthur and J^JLU Tanaffat^ are rendered pustulae and vesieulae by Channing, pimples and boils by Stack, ^XvKToivai and l^avOrifiaTa by the Greek Translator. It is probable that neither of them is used by the Arabic writers in the strict and definite sense attached to the words pustule and vesicle by modern physicians. 3 See below, Chap. v. § 5.

^ The word ^i^sK^iCS* 'Asidah is rendered as in the text by Stack, and aQiipii by the Greek Translator ; for the meaning of which term see Dioscorides, De Mat. Med, ii. 114, vol. i. p. 238, and Sprengel's Note, vol. ii. p. 456.

* The word — .j yl3 Fdluzq; (which is spelled in different ways, and is of Persian origin,) is left untranslated by Channing, and is rendered fiEXinijKrov by the Greek Translator. It is said to have been a sort of cake made of starch, flour, honey, and water. See CasteU, Lex, HeptagL p. 3004 ; Lex, Pers, p. 89.

(2.) Bodies that are lean, bilious, hot, and dry, are more disposed to the Measles^ than to the Small- Pox ; and if they are seized with the Small-Pox, the pustules are necessarily either few in number, distinct, and favorable, or, on the contrary, very bad, numerous, sterile, and dry, with putrefaction, and no maturation.

(3.) Lastly, those bodies that are lean and dry, and of a cold temperament, are neither disposed to the Small-Pox nor to the Measles -^ and if they are seized with the Small-Pox, the pustules are few, favorable, moderate, mild, without danger, and with a moderate light fever from first to last, because such constitutions extinguish the disease.

(4.) I am now to mention the seasons of the year in which the Small-Pox is most prevalent ; which are, the latter end of the autumn, and the beginning of the spring ; and when in the summer there are great and frequent rains with continued south winds, and when the winter is warm, and the winds southerly.

(5.) When the summer is excessively hot and dry, and the autumn is also hot and dry, and the rains come on very late, then the Measles quickly seize those who are disposed to them ; that is, those who are of a hot^ lean, and bilious habit of body.

(6.) But all these things admit of great diflferences by reason of the diversity of countries and dwellings, and occult dispositions in the air, which necessarily cause these diseases, and predispose bodies to them ; so that they happen in other seasons besides these. And therefore it is necessary to use great diligence in the preservation from them, as soon as you see them begin to prevail among the people ; as I shall mention in the sequel.

* Here follows in the Greek Translation the sort of note on the word ^ — ^^ Hasbah or c^Xoyia, which is given below, in Note A.

" The Greek Translator has toXc Svo sldB<n tovtoiq, ry re AoifjuKy xal ry BifXoyi^, using the word Aotfitic^ here in a specific f as above in a generic sense.

34 RHAZES ON THE p. 36. CHAPTER III.

On the symptoms which indicate the approaching eruption of the SmalUPox and Measles}

The eruption of the Small-Pox is preceded^ by a continued fever, pain in the back, itching in the nose, and terrors in sleep. These are the more peculiar symptoms of its approach, especially a pain in the back, with fever ; then also a pricking which the patient feels all over his body ; a fuUness of the face, which at times goes and comes ; an inflamed colour, and vehement redness in both the cheeks ; a redness of both the eyes ; a heaviness of the whole body ; great uneasiness, the symptoms of which are stretching and yawning ; a pain in the throat and chest, with a slight difficulty in breathing, and cough ; a dryness of the mouth, thick spittle, and hoarseness of the voice ; pain and heaviness of the head ; inquietude, distress of mind, nausea, and anxiety ; (with this diflference, that the inquietude, nausea, and anxiety are more frequent in the Measles than in the Small-Pox ; while, on the other hand, the pain in the back is more peculiar to the Small-Pox than to the Measles ;) heat of the whole body, an inflamed colour, and shining redness, and especially an intense redness of the gums.

(2.) When, therefore, you see these symptoms, or some of the worst of them, (such as the pain of the back, and the terrors in sleep, with the continued fever,) then you may be assured that the eruption of one or other of these diseases in the patient is nigh at hand ; except that there is not in the Measles so much pain of the back as in the Small- Pox ; nor in the Small- Pox so much anxiety and nausea as in the Measles, unless the

* Here again the Greek Translator has t&v Bvo eiS&v ttjq AoifiiKTjg. ^ The symptoms preceding the eruption of the Small-Pox and Measles are mentioned below, Almans. § 1.

Smdl-Pox be of a bad sort ; and this shows that the Measles come from a very bilious blood.

(3.) With respect to the safer kind of the Small-Pox, in this it is the quantity of the blood that is hurtful rather than its bad quality ; and hence arises the pain of the back, from the distension of the large vein and artery which are situated by the vertebrae of the spine. ^

* There is a similar passage below, Cont, § 67.

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(tir hvO'^

36 RHAZES ON THE p. 42. CHAPTER IV.

A specification of the articles of the regimen or treatment of the SmalUPox in general.

We will now specify the articles of the regimen or treatment of the Small-Pox in general.

The first of these is the preservation from the Small-Pox before the appearance of the symptoms of the disease, and the way to restrain it after the appearance of the symptoms. Chap. V. . . . . p. 37

The second, of those things which accelerate the eruption and its appearance. Chap. VI. . . p. 47

The third, of the care to be taken with regard to the eyes, eyelids, auditory canals, interior of the nose, throat, and joints, so that no putrescence may remain in them. Chap. VII p. 51

The fourth, of those things which hasten the ripening of the pustules. Chap. VIII. . . . p. 56

The fifth, of the hastening of the drying of the pustules.

The sixth, of the taking away the eschars. Chap. X. p. 59

The seventh, of those things which remove the marks of the SmaU-Pox. Chap. XI. ... p. 60

The eighth, of the patient's food in the SmaU-Pox. Chap. XII p. 64

The ninth, of the preservation of the bowels from diarrhoea after the Small-pox. Chap. XIII. . . p. 67

The tenth, of the signs of the mild and the fatal species of Small-Pox. Chap. XIV. . . . p. 71

Of all these articles, if GOD permit, I shall speak shortly and sufficiently.

p. 46. CHAPTER V.

On the preservation from the SmalUPox before the appearance of the disease, and the way to hinder the multiplying of the pustvies after their appearance.

It is necessary that blood should be taken from children, youths, and young men who have never had the Small-Pox, or have had only the Chicken-Pox, i (especially if the state of the air, and the season, and the temperament of the individuals be such as we have mentioned above,) before they are seized with a fever, and the symptoms of the Small-Pox appear in them.^ A vein may be opened in those who have reached the age of fourteen years ; and cupping-glasses must be applied to those who are younger ; and their bed-rooms should be kept cool.

(2.) Let their food be such as extinguishes heat; soup of yellow lentiles,^ broth seasoned with the juice of unripe grapes,* acid minced meat,^ kid^s-foot jelly, the strained

» See above, Notes (*»*), p. 30.

•• »•» ^ ^Cm^Os^ 'Adasiyah is said by Ibn Jazl4 (as quoted by Channing,) to have been made by boiling yellow lentiles in water till they were nearly dissolved, and then adding red vinegar, coriander, and salt.

A iX-w-C^iA^^ Hisrimiyah is said by Ibn Jazla (as quoted by Channing,) to have been a sort of broth or soup made of the flesh of kid, lamb, or fowl, and seasoned with hisrim, which is the juice expressed from the grape while unripe, and is said by Russell {Nat, Hist, of Aleppo, vol. i. pp. 80, 81), to be preferred by the Turks to vinegar.

^ ,^^_n>_iui? Sicbdj consisted of different kinds of minced flesh-meat, dressed with vinegar and honey, or with acid syrup, to which were sometimes added raisins, a few figs, and chiches. (See Castell, Lex. Heptagl. p. 2523 ; Lex. Pers. p. 347.) ^ Mr. Lane, in his translation of " The Thousand and One Nights," (vol. i. p. 435,) says it is '' a dish composed of meat, wheat-flour, and vinegar ;'* and in another place, (vol. ii. p. 495,) that there are other kinds than that which he had before mentioned, and that vinegar enters into the composition of all.

38 RHAZES ON THE [chap. v.

Kquor of sicbdj^ veal broth, broth^ made of woodcocks, hens, and pheasants, and the flesh of these birds minced and dressed with the juice of unripe grapes. Their drink should be water cooled with snow, or pure spring water cold, with which their dwellings may also be sprinkled. Let them frequently eat acid pomegranates, and suck the inspissated juices^ of acid and styptic fruits, as of pomegranates, warted-leaved rhubarb, acid juice of citrons, juice of unripe grapes, Syrian white mulberries, and the like. Where the temperament is hot, and there is much inflammation, the patient may take in the morning barley water carefully prepared, to which is added a fourth part of acid pomegranate juice. But if the heat be less, barley gruel* and sugar may be given in the morning, and vinegar, lentiles, and especially juice of unripe grapes, may be added to the food j for by means of these you will be able to thicken and cool the blood, so as to prevent the eruption breaking out. This regimen is of great service in all times of pestilence, for

* j^^Jb Huldm is said by Ibn Jazla (as quoted by Cbanning,) to be the cold liquor of the SicbdJ, with the fat strained off, and to be nearly the same as the Masus mentioned below. See also Castell, Lea;. Heptagl. p. 856.

' i jO tv^, -c ^^^8 is said to have been much the same as the Huldm just mentioned, and signified particularly broth made with the flesh of birds. See Castell, Lex. Heptagl. p. 2114.

* The Arabic word is i^ » 4 RvJtb or Robbj whence came the term Rob, which is

♦ J often met with in old works on pharmacy, but is now nearly out of use. The difference between iJl> * Rubby and d.^ i %-ii Shardb, "Syrup," is explained by Avicenna,

(v. i. § 6, vol. ii. p. 295, ed. Lat. ; vol. ii. p. 211. ed. Arab.) to be, that a rob is simply inspissated juice alone, and a syrup is juice boiled down and thickened with sugar. See also Sontheimer, Zusammengesetzte Heilmittel der Araber, &c. (Freiburg, Svo. 1845,) p. 108,

* Literally " roasted barley-meal." The Arabic word /SJ^^mJ iSatrf *, was the powder of seeds and berries, first roasted and afterwards ground in a mill. Lane, in the Notes to his Translation of the Arabian Nights, (vol. iii. p. 307,) says it is the meal of parched barley, and that the same name is also given to ptisan. It is rendered by the Greek translator aX^trov, the meaning of which word may be learned from Galen, De Aliment. Facult. i. 11, vol. vi. p. 506; Gloss. Hyjpocr. vol. xix. p. 76. (See Channing's Notes, pp. 51, 162.)

it diminishes the malignity of pestilential ulcers, and boils, ^ and prevents pleurisies, quinsies, and in general all distempers arising from yellow bile^ and from blood.

(3.) In the middle of the day let the patient wash himself in cold water, and go into it, and swim about in it. He should abstain from new milk, wine, dates, honey, and in general from sweet things ; and dishes made by a mixture of flesh, onions, oil, butter, and cheese;^ from lamb, beef,* locusts,^ young birds, high-seasoned things, and hot seeds. When the season is pestilential and malignant, or the temperament is hot and moist and liable to putrefaction, or hot and dry and liable to inflammation, together with this regimen the patient must take some of the remedies which we are about to describe. To those who are of a hot, dry, inflammable temperament give those garden herbs which are cooling, moist, and extinguish heat, such as purslain, JeVs mallow, strawberry blite, and also gourds, serpent cucumbers, cucumbers, and water melons.

(4.) As to melons, especially sweet ones, they are entirely forbidden ; and if the patient happen to take any, he should drink immediately after it the inspissated juices of some of the acid finiits. He may be allowed soft fish, and butter-milk.^

> See below, Note J.

1 ySUc Safrd, rendered by the Greek Translator, ^avB^ xoX^, yeUow bilCt to distinguish it from the ^ikXaiva x^^'hi or hlack bikf one of the four humours among the ancients.

• The Arabic word is ,_uOs-*ift-wJ l hftdabdj. A somewhat different mode of preparing it is given by Ibn Jazld in Channing's Note.

* The word d^ ) a 3 Dawdh is rendered Jce/by Stack, but is translated simply Jumenta by Channing, and bestiae in the Latin Version of Avicenna, vol. i. p. 159. 1. 7 : 171. 17 : 204. 40, ed. Arab., vol. i. pp. 368, 369, 354, ed. Lat.

^ That locusts are eaten as a common article of food in the east is well known. The whole subject is exhausted by Bochart, in his Hierozoicon, vol. iii. p. 326, &c. ed. 1796.

® The Greek Translation has, Ik tov d^cJdovQ yaXoKTOQ to d^tj^sffrepov Kal olov

It does not seem quite certain whether the word C-*0 1 « Raibf signifies skim-milk

. »* J or butter-milk; Channing retains the Arabic word. Stack translates it as in the text. See below, Note («), p. 40, and Note ('), p. 69.

40 RHAZES ON THE [chap. v.

(5.) With respect to those who are fat, fleshy, and of a white and red complexion, you may be content to let them eat such food as we first mentioned, consisting of any cooling and drying things. They should be restricted from labour, bathing, venery, walking, riding, exposure to the sun and dust, drinking of stagnant waters, and eating fruits or herbs that are blasted or mouldy. Let their bowels be kept open, when there is occasion for it, with the juice of Damask plums^ and sugar, and whey^ and sugar. And let them abstain from figs and grapes ; from the former, because they generate pustules,^ and drive the superfluous parts to the surface of the skin ; and from the latter, because they fill the blood with flatulent spirits, and render it liable to make a hissing noise, and to undergo fermentation. If the air be very malignant, putrid, and pestilential, their faces may be constantly bathed with sanders water and camphor, which (with GOD'S permission,) will have a good effect.*

(6.) As to sucking in&nf s, if they are above five months old, and fat, fair, and ruddy, let them be cupped ; and let the nurse be managed with regard to diet in the manner we have mentioned. And let those infants that are fed on bread have those things which we have mentioned in a proper quantity,

(7.) We will now mention those medicines which thicken and cool the blood, and check its putrefaction and ebullition.

(8.) These are checked by all acid things, such as vinegar, butter-milk water of extreme acidity,^ (that is, the thin, bitter

' Literally ** damask plum water," and so Channing in this place translates it : below, however, (p. 178,) he renders it " aqua, i.e. succus vel decoctum*^ Stack in both places translates it <* juice •" and the Greek Translator, xvXoc-

Channing; "humours" (apparently,) by Stack. See above, Note (*), p. 32.

* The latter part of this sentence is rather different from the Greek Translation, which is as follows: <i7r<5fcarr€ diSXov rb irpSffwirov did pddutv ffTokdyfiaros' dvahveffOai de dOSvva Tolig dtr^pavToXg jcai vypoiQ tovtoiq, Kal kiriTiOeffOai raig piaiv. aUrij nlv 17 trp6voia Kal 17 lirifisXeia ir&w iitp'skiiiSg koriv Iv rdic XoifiiKOic Kal httpQapfikvaiQ KaraffrcKTeffi rdv Stkpwv. xal ralQ ItrideSiifiriKvLaig vdaoig, Ofov ffwavTiXafipavofiivov,

* The Greek translation has, rb d^Hidig rov ydKaKroQ rv^Sfiivov paiir dk (i. e.

water wliich floats upon butter-milk when it is exposed to the sun,) and the acid juice of citrons ; and still more useful are those things wliich have an astringency joined to their acidity, such as the juice of unripe grapes, sumach, warted-leaved rhubarb, apples, quinces, and acid pomegranates ; and those things which by their nature thicken the blood, sach as jujubes, lentiles, cabbage, coriander, lettuce, poppy, endive, black night-shade, tabasheer,^ the seeds of fleawort, and common camphor.

(9.) The following is the description of a medicine which restrains the ebullition of the blood, and is useful against heat and inflammation of the liver, and eflfervescence of the yellow bile : — ^ p. 66. IForm. l.y Take of Red Roses ground fine, ten drachms, Tabasheer, twenty drachms,

WhiteLettuceSeed, ofeachfitft/dflctSisi^^ ,. * " ; - ,-,.y per SOU OT White Sanders, two drachms aDJQ,^,l)alf) -f ' ' ' \ '.j- , i-J 'i^OCT* Common Camphor, one drachm^; ,i\ y <' ■ j ^ ' p. 68. Let the patient take three drachms of this pow^r every morning in an ounce of the inspissated acid juice of citrons, or the inspissated juice of wartedleaved rhubarb, or the inspissated juice of pomegranates, or the juice of imripe grapes, and the like.

(10.) Oxymel,* prepared with sugar in the following manner, is also useful : —

* ^^k^yJSo Tabdshir, translated by Stack, " bambu-sugar ;" but this is not correct, and the word tabasheer is now sufficiently familiar to most readers to allow of its being used in the text.

2 See above. Note (*), p. 39.

3 In this and in most of the other prescriptions there are some differences between the Arabic text and the Greek translation, which do not deserve to be particularly specified.

* / . > v^.^ ln.^.ui-' Sicanjabin, derived from two Persian words, signifying vinegar and honey. It is rendered by the Greek Translator ^^otrdicxap, which is more strictly accurate, as no honey is used in the following prescription.

42 RHAZES ON THE [chap. v.

IForm, 2.] Take of best red Vinegar, depurated, one part,

Rose Water, two parts ; Mix them both together, and macerate in them for three days —

Of Red Rose leaves dried, one ounce.

Pomegranate flowers, half an ounce,

Pomegranate peel, two ounces ; Then strain the liquor ; afterwards boil it, and add to it, according to the original quantity of vinegar, twice or thrice as much white sugar candy ;* boil it sufficiently, and use it.

70. (11.) The following preparation will also be useful : —

[Form. 3.] Take of Roses,

Tabasheer, of each ten drachms,

White Sanders, three drachms.

Common Camphor, one drachm ; Knead them all together with the mucilage of Flea-wort seed, and make the mass into pills, or troches : of these at proper times three drachms may be given to drink in one ounce of the aforesaid oxymel.

(12.) Besides these the syrup of which the following is the description wiU be still more useful, and its virtue excels that of all the syrups which we have seen and tried ; unless it be the syrup of pearls/ which the Indians prepare in a diflferent manner known only to themselves ; for the Indians say, that if any one drinks of the syrup of pearls, even though nine pus-

* 3*4 yd^ Tabarzad, a Persian word, rendered simply osunxap by the Greek

Translator, but meaning probably white sugar candy. See Ibn Baitar, vol. ii. p. 152.

^ The Translator has here followed Channing and Stack, though there is reason to suspect that there is some error in the text. He has not been able to find the

" Syrup of Pearls" mentioned in any other Arabic author, nor has Professor Wilson met with it among the Sanscrit writers ; neither does the word ^ O Durrah occur among the medicinal substances enumerated by Avicenna and Ibn Baitar. The Greek Translator renders the word by dirwpdf which is the same word that he uses for ^"i \ ai Fawdcih, " fruits," in pp. 50. 1. 1 : 56. 3 : 58. 1 (ed. Arab.) ; and a syrup with this title is mentioned by Avicenna, v. 1. § 6, vol. ii. pp. 298, 299, ed. Lat. vol. ii. pp.215, 216, ed. Arab. See also Sontheimer, Zusammengesetzte Heilmittel der Araher, &c. pp. 121, 125.

tules have already come out on liim, there will not appear a tenth. The mode of preparing it is as follows : — p. 72. IForm. 4.] Take of the best old Vinegar depurated, three pints,

Acid Pomegranate juice,

Acid Juice of Citrons,

Juice of unripe Grapes,

Juice of warted-leaved Rhubarb,

Expressed juice of Syrian white Mulberries,

Infusion of Sumach, and of Berberries, of each one pint.

Expressed juice of Lettuce,

Expressed juice of Tarragon, of each one quarter of a pint.

Decoction of Jujubes,

Infusion of Lentiles, of each one pint and and a half; Mix them all together, add to them three pounds of sugar, and boil the whole | then take half a pound of tabasheer, and of common camphor, and put them into a clean mortar after they have been well pounded ; pour upon them a little of this syrup, hot, and work them quickly with a pestle, until they are dissolved ; then mix them with the whole ; and continue stirring it from beginning to end, with a stick of open cane, or willow wood, (but cane is preferable,) after having thrown in tabasheer and common camphor, until they are perfectly united.

This may be used both before the symptoms of the Small-Pox appear, and also after their appearance, as we shall mention presently. It is likewise proper in all diseases connected with the blood and the yellow bile, in pestilential ulcers, boils, quinsies, and the like : — for it is useful, with GOD'S permission.

(13.) This may in general suffice concerning preservation from the Small-Pox before the coming on of the fever which is attended by the symptoms of it. And by this means the Small-Pox is entirely repelled from one who is in such a condition that it can be repelled : and whatever pustules do come out must needs be favorable and few in number. By this means also it is brought about that the change in the blood from the first state into the second should not be effected all at once and in a short time, with ebullition and fermentation, which are accompanied by frightful and dangerous accidents, but by little and little, and in a long time, and gradually, by way of ripening, not putrefaction, and without

44 RHAZES ON THE [chap. v.

fevers that are either frightful^ malignant^ and dangerous^ or else hurtful and without doubt painfiil.

(14.) But when the fever arises which is accompanied by the symptoms of the Small-Pox, this regimen is not to be used, except after much observation, inquiry, and caution. For a mistake here is very dangerous ; and for this reason, because the blood, when it ferments, is inflated and increased, and Nature, according to the temperament of the patient, is endeavouring to expel all its superfluous parts to the surface or to the members of the body ; if, then, the cooling and thickening which you intend does not bring back the blood to a cooler and thicker state than it was in before its ebullition, the ebullition will break out a second or third time ; and thus it will happen that you will be acting against Nature, and disturbing her in her work. Nor is it possible for the ebullition, if it be vehement, to be checked but by remedies in which there is great danger, and which do in a manner greatly congeal and coagulate the blood, (such as opium, hemlock, a great quantity of the expressed juice of lettuce, black nightshade, and the like,) and by the constant and excessive use of the regimen which we have just mentioned. And the congelation of the blood and the extinction of the natural heat at the same time, from the excessive use of these remedies, is not safe. Besides, even if you do employ them to excess, you will not be able to extinguish the ebullition and to restrain the violence of the unnatural heat ; for by this excess you at the same time depress the power which the natural heat has of resisting what is hostile to itself; and you extinguish this and the unnatural heat together. And this I here mention to you (a matter which some physicians pass over from ignorance, and some from avarice, that they alone may receive profit from it,) in order that you may not oflfend against Nature, as do they : by permission of the Almighty and glorious GOD. (15.) When you perceive symptoms of the Small-Pox, and you see a distension of the body, frequent stretching, pain in the back, redness of the complexion and of the eyes, a very violent headache, a strong and full pulse, a shortness of breath,^ a red and turbid urine, and the body hot to the touch, like

' The Greek Translation adds here, Kal Tt) i]9ti riis ^vx^ie x"^*""*^* r that of a man who has been in a bath ; and when also the body is fleshy, and the patient^s diet has been such as produces plenty ef blood : then take from him a large quantity of blood, even until fainting comes on. It is best to take it from the basilic^ vein, or from some of its branches ; if this cannot be found, ^^ then from the inner^ vein : and if this cannot be found,

D 82 then from the cephalic.^ But when the basilic and its branches cannot be found, it is better to take the blood from the popliteal vein,^ or the saphena ;* because these draw the blood from the greater veins in the abdomen more than the cephalic does. When these symptoms do not run very high, although they are distinctly manifest, then take away less blood ; and when they have but slight force, then draw but little blood ; and afterwards proceed in the cure with extinguents, as I have already mentioned. When you find that by the use of extinguents the feverish heat is moderated, and the pulse and breathing are returned to their natural state, you should still continue to employ these remedies, — for by their means you will entirely drive away the ebullition of the Small- Pox.

(16.) In order more effectually to perform this extinction, let the patient drink water made cold in snow to the highest degree, several times and at short intervals, so that he may be oppressed by it, and feel the coldness of it in his bowels. If, after this, he should continue to be feverish, and the heat should return, then let him drink it a second time, to the quantity of two or three pints or more, and within the space of half an hour : and if the heat should still return, and the stomach be full of water, make him vomit it up, and then give him some more. If the water finds a passage, either by sweat or by the urine, then you may be sure that the patient is in a fair way of being restored to health ; but if you do not see that the water has found a passage, or you find that the heat is increased, and returns as it was at first, or even is more violent, then omit giving the cold water in large quantities at several

* See below, Note L.

* See below, Note K.

' Literally, the ham. The vein at this place is one of those enumerated by Albucasis as being sometimes opened in bloodletting. (Dc Chimrg. p. 460.)

* See below, Note M.

46 RHAZES ON THE [chap. v.

times, and have recourse to the other extinguents which I have described. And if you see them relieve the patient in the way I have mentioned, then persist in the use of them ; if, however, you see that there arises any anxiety and inquietude after taking them, or that the anxiety and inquietude is altogether vehement and immoderate, then you may be sure that it is impossible to prevent the eruption of the Small-Pox or Measles. You must, therefore, then quit this mode of treatment, and hasten to assist Nature in expelling and throwing out these superfluities, in the manner I shall describe in the following Chapter.

p. 88. CHAPTER VI.

Of those things which accelerate the eruption of the Small-Poa*.

The eruption of the Small-Pox and Measles is accelerated by well wrapping the patient up in clothes/ and rubbing his body, by keeping him in a room not very cold, and by sipping cold water, a little at a time, especially when the burning heat is very great ; for cold water, when it is sipped a little at a time, provokes sweat, and assists the protrusion of the superfluous humours to the surface of the body. Let the patient put on a double shirt, with the upper border closely buttoned ; and underneath let there be placed two small basins of boiling water, one before and the other behind him, so that the vapour may come to the whole body except the face ; and the skin may be rarefied, and disposed to receive and evaporate the superfluous humours. For when the surface of the body is in this state, the patient is suffiised with sweat, which is calculated to cool him and is very beneficial.^ And by thi^ management not only is the surface of the body rendered soft, but also the strength of the patient is preserved, so that in this state nothing is more beneficial. And this may be efifected by well wrapping the patient up in clothes, rubbing his body, and exposing it to the steam of hot water in the manner we have mentioned : for both the laver and the bath^ are injurious in this state, inasmuch as they overheat the superfluous humours, and depress the strength so much that a fainting fit comes on. And when this is the case. Nature is diverted from her work, and the patient is in danger, especially if the fit be violent and frequent; for nothing is a greater indication of the approach

' The Translator has here followed Channing's interpretation (though not entirely satisfactory,) as giving a better sense than either Stack's or the Greek Translation.

' A description of the Eastern baths may be found in various books of travels, &c. See, among others, RusselFs Nat, Hist, of AleppOf\o\, i. p. 131, &c. ; Lane's Modem EffyptiarUf vol. ii. p. 35, &c.

48 RHAZES ON THE [chap. vi.

of death, especially in thiscase, than violent and frequent fainting ; for it shows that Nature is (in a manner) routed/ and retires, and contracts her power into the inner parts of the body ; and when this takes place, it will immediately be oppressed and extinguished by the superfluous humours. Likewise after the hot vapour has been used, it must not be suffered to cool upon the body, but is to be wiped off with cloths, and dried with great care and diligence.

(2.) This method is sufficient to facilitate the expulsion of the superfluous humours to the exterior, when Nature is not languid, nor the superfluous humours too thick and viscid, and difficult to be expelled. When, however, the outward fever is mild and slight, but anxiety and inquietude continue, and the expulsion of the Small-Pox is slow and difficult, and delayed beyond the fifth day, you will then have to use those medicines which promote the eruption. But this is to be done with great caution and attention, in the way that I have already mentioned,^ when speaking of the conditions to observed in giving extinguents ; for the error here, even if it be not equally important with the other, is important nevertheless. And the way to be preserved from falling into error in this case is to be not too hasty in using these medicines, but to be content with the former regimen as long as there is any hope of your being able to do without them, and as long as you are^ pretty certain that the fever is as slight in the inward parts of the body as it is in the outward. This you will easily know, if neither the pulse nor the respiration be too quick, full, or irregular, and if on feeling the chest it be not found hot in the highest degree ; and hence you may be sure that even if the force of the fever be doubly or trebly increased, it will not prove fatal to the patient, on account cf the vehemence of its heat ; of which you may judge by comparing this with other fevers which you have seen in the same patient or in persons of a similar temperament and in a like degree of heat, who have entirely recovered.

(3.) These extinguishing remedies are also to be used when you see, that, as soon as any of the pustules come out and appear

' See aboTe, Chap. v.

3 The Translator has here followed the reading proposed by Channing m his note, in preference to that which he has introduced into his text.

in the skin^ the patient finds himself easier after it^ and his pulse and breathing are relieved in proportion ; but if you see that the eruption and appearance of the pustules goes on slowly and with difficulty, you must in this case avoid all very extinguishing medicines, for to use them would be acting contrary to Nature, and hindering her from throwing out the superfluous humours upon the skin. And when there follows, upon the use of extinguents^ any anxiety and inquietude which were not present before, and especially if there be a palpitation of the heart, then you may be sure that you have committed an error. You must, therefore, immediately take all possible pains to soften the skin, in the way I have mentioned ; and give to drink from time to time warm water, either alone, or that in which there have been first boiled the seeds of sweet fennel and smallage, and others of the same kind to be hereafter mentioned, which facilitate the eruption of the Small-Pox, according as you see the heat to be less or more inflamed, and as the patient is able to bear it ; regard being also had to the sluggishness of the Small-Pox, and the slowness of the pustules in coming out.

(4.) The following is an easy, gentle mode of treatment, which will not excite too much heat, and will facilitate the eruption of the pustules : —

IForm, 5.] Take yellow Figs, to the number of thirty, Of Raisins stoned, twenty drachms ; Pour upon them three pints of water, and let them boil gently until they are nearly dissolved : give the patient to drink half a pint of this decoction, at three several times ; then cover him up with clothes, and expose him to hot vapour, in the manner we have before mentioned.

(5.) The following preparation is more efficacious : — p. 100. IForm, 6.] Take of the aforesaid Decoction, four ounces.

Of the Decoction of Sweet Fennel Seed and Smallage, two ounces ; Give it to the patient to drink, in the way we have mentioned.

(6.) The following is still moire efficacious : —

IForm. 7.] Take of Sweet Fennel Seed,

Smallage Seed, of each ten drachms ; Boil them in the aforesaid decoction until the water is red, then strain it, and give the patient to drink three ounces of it.

50 BHAZES ON THE [chap, yi.

(7.) The following composition is very beneficial and useful at several times :^-

[Form, 8.]^ Take of Red Roses, four drachms, p. 102. Peeled Lentiles, nine drachmsy

Yellow Figs, to the number of ten,

Of Gum Tragacanth, three drachms.

White Raisins, stoned, ten drachms,

Lac, cleared from its stalks and washed, three drachms.

Sweet Fennel Seed,

Smallage Seed, of each five drachms ; Boil all these in two pints of water until it is reduced to one pint and a half; and give the patient half a pint of it, with half a scruple of saflhm, two or three times, as may be necessary.'

(8,) We shall now speak of those parta of the body of ' which it is necessary to take care.

* Two very similar formulae are given by Syneaiut, J)e Febr. eapp. 9, 10. ]^ 294, 296. See also below. Form. 21. > See below. Note N.

p. 106. CHAPTER VII.

Of the care to be taken of the throat , eyes, and those parts of which it is necessary to take care upon the appearance of the symptoms of the SmalUPox,

As soon as the symptoms of the Small-Pox appear^ we must take especial care of the eyes, then of the throat, and afterwards of the nose, ears, and joints, in the way I am about to describe. And besides these parts sometimes it will be necessary for us to extend our care to the soles of the feet, and the palms of the hands ; for occasionally violent pains arise in these parts from the eruption of the Small-Pox in them being difficult on account of the hardness of the skin.

(2.) As soon as the symptoms of the Small-Pox appear, drop rose-water into the eyes from time to time ; and wash the face with cold water several times in the day, and sprinkle the eyes with the same. For if the disease be favorable, and the pustules few in number, you will by this mode of treatment prevent their breaking out in the eyes. This indeed is to be done for greater caution ; for when the Small-Pox is favorable, and the matter of the disease is scanty, it seldom happens that any pustules break out in the eyes. But when you see that the ebullition is vehement, and the pustules numerous in the beginning of the eruption, with itching of the eye-lids and redness of the white of the eyes, some places of which are redder than others ; in this case pustules will certainly break out there unless very strong measures be adopted ; and therefore you should immediately drop into the eyes several times in the day rose-water, in which sumach has been macerated.^ It will be still more efficacious to make a coUyrium of galls in rose-water, and drop some of it into the eyes ; or to drop into them some of the juice of the pulp of the acid pomegranate, first ' chewed, or squeezed in a cloth. Then wash the eye-lids

52 RHAZES ON THE [chap. vii.

with a collyrium^ composed of red horn poppy, the juice of unripe grapes, rusot, aloe, and acacia, of each one part, and a tenth part of saffron ; and if you also drop some of this collyrium into the eyes, it will be useful at this time.

(3.) But if you see that the matter of the disease is violent, and the eruption very copious, so that you conclude that pustules will certainly break out in the eyes, because you see excessive redness in some parts of the tunica sclerotica, with a protuberance of the eye itself, and you find that when you have dropped into it some of the remedies I have prescribed, it does not altogether remove that redness, but only lessens it for .a time, after which it returns more violently than before, or at least continues in the same state as it was before you began this treatment ; you must not in this case proceed any longer in this method, but, instead of these things and the like, drop ' into the eyes a little Nabathaean caviare in which there is no vinegar, nor any other acid.

p. 116. (4.) [The pustules which break out in the tunica sclerotica do not injure the vision;]^ but those which come out in the cornea obstruct the sight, and are to be cured, according to the degree of their thickness or thinness, by means of such strongly dissolving medicines as we are about to mention ; which indeed are sometimes successful, and sometimes not, according as the matter is more or less thick, or the body more or less hard or aged. But if one large pustule breaks out in the tunica uvea,^ then rub cuhl* in rose-water, and drop it into the

» The Arabic word is C-5U-i3 Shidf, whence comes the name Sief foimd in old pharmaceutical works.

* These words have been supplied by .Channing from the Greek translation, and probably made part of the Arabic text originally, though they are not now to be found in the only MS. that has hitherto been used. The Greek term 6 iiriTct^vKtiiQ Xi'Tiov, tunica adnata, is explained to mean the tunica conjunctiva, which is probably in most cases correct ; here, however, it would rather seem to signify the tunica sclerotica. See Note and Index Verborum to the Oxford edition of Theophilus, De Corp. Hum. Fdbr,

' The Arabic word is ^ _•) ^^ Sawdf, which is rendered payoudric by the Greek

Translator, " timica uvea" by Stack, and " tunica rhagoides" by Channing, but which the Translator has not been able to find in this sense in any other Arabic writer or Lexicon.

* See below. Note 0.

eye several times during the day, and pnt over it a compress and bandage ; or else drop into it some of the coUyrium^

' above mentioned, after taking out the saffron and adding one part of haematite, that there may not happen any great prominence. And these things are what ought to be known concerning the eyes in this place.

(5.) Care is next to be taken of the throat and mouth, in order that no pustules may break out in them which may distress the patient, or hinder his breathing : for it often happens that in the bad kinds of Small-Pox obstinate and violent suffocations come on ; and when this is the case, there is no hope of the patient's recovery. For which reason, as soon as the symptoms of the Small-Pox begin to appear, the patient should gargle his mouth with acid pomegranate juice, or an infusion of sumach, or the inspissated juice of white mulberries, or with some of those things which we have mentioned in the chapter on extinguents f or, if nothing else is ready at hand, with pure cold water, and that very often, in order that there may either be no eruption at all in the throat and mouth, or that what there is may be but slight. And, therefore, you should strengthen these parts, in order that they may not be at-

* tacked by numerous pustules, giving rise to suffocation ; and be quick and diligent in applying this cure, when, besides the symptoms of the SmaU-Pox, there is a hoarseness of voice, straitness in breathing and about the fauces, and pain in the throat. And if you see these symptoms to be very violent, then take away blood from the cephalic vein, and that even after the whole eruption is over. And if the patient finds anything in his mouth or throat which hurts him, and there is not much heat there, neither are his bowels too loose, then let him lick by degrees butter mixed with white sugar-candy ; but if there be any heat and inflammation there, then give him a linctus^ of the mucilage of fleawort seed, peeled almonds, and white sugar-candy thus prepared : —

* C5U-i3 Shidf. See above, Note ('), p. 52.

^ The Arabic word is / iaXJ La^^k^ whence is derived the name LohoCf or Loochf to be found in old pharmaceutical works.

000T^^..^7Mr/.coo

54 ftHAZBS ON THE [chap. vii.

p. 122. IForm 9.] Take of Sweet Almonds peeled, one part, Gourd Seed, two parts, White Sagar Candy, three parts, MucUage of Fleawort Seed, a sufficient quantity ; Make it into a linctus.'

If the bowels be relaxed let the linctus be made of gum Arabic^ peeled almonds, the seed of serpent cucumber, and wheat-starch, mixed up with mucilage of quince seeds,

(6.) In the next place we must take care of the joints, for there often comes out upon these a number of very bad pustules, which corrupt them to such a degree that the bones, ligaments, and tendons lie bare. Hasten, therefore, as soon as you see any symptoms of the Small-Pox, and especially if they are violent and excessive, and the pustules filled with fluid, hasten to attend to the joints, and bathe them with sanders, red horn poppy, Armenian bole, roses, common camphor, vinegar, and rose-water; but in the bathing do not go much be- ' yond the joints. If the pustules that come out are very large, then open them at once, and let out the matter ; and do not put off this operation, for delay is very dangerous.

(7.) After this you should take care of the nose and the ear, that there may not be in them a great quantity of pustules ; for this is hurtful to the patient ; and an eruption in the internal part of the ear is clearly dangerous. Apply, therefore, to the nose daily warm oil of roses with common camphor dissolved in it : and drop into the inner ear warm red vinegar, mixed with a coUyrium^ of red horn poppy, or rusot, and then put in a piece of cotton ; and let this be done two or three times a day.

(8.) Lastly, if a severe pain arises in the soles of the feet,^ then take care to anoint them with tepid oil, and foment them with hot water and cotton. If this does not abate the * pain, nor facilitate the eruption of the pustules, then beat up peeled sesamum with milk ; anoint with it, bind it on with a cloth, and so leave it upon the part all night ; then bathe the foot in warm water, and repeat the same again. Or bruise

' See above. Note ('), p. 53.

dates with butter^ and apply them ; or anoint with the lees of oil of ben -} for these and the like things soften and relax the skin^ and thns facilitate the eruption of the pustules^ and lessen the pain.

> The reading here is doubtful, as the word is written corruptly in the Leyden MS., and the Greek Translator has vtiadfiov, which is followed by Stack.

56 RUAZES ON THE

Pi28. CHAPTER YIII.

Of those things v)hich ripen the pustules.

When, after their eruption is completed, you observe that the pustules tend too slowly to maturation, and that the state of the patient has been benefited by the eruption, and that his breathing and pulse are also favorable, and that he is free from inquietude and anxiety ; then it will be necessary to assist the maturation of the pustules. But if, together with a backwardness of ripening after their eruption, you perceive the pustules to be hard and warty, and the state of the patient to be not at all improved, or if his illness is increased, then you may be sure that the Small-Pox is mortal : in which case you need not aim at effecting their maturation, for they are of that kind which, cannot be ripened.

(2.) The maturation of the Small-Pox, when it is curable, is to be efifected by fomenting the body with the steam of hot water, or of a decoction of chamomile, violets, melilot, * marsh-mallows, and bran of wheat, either separate or mixed together in two basins, as we have mentioned^ above, when we were treating of the mode of facilitating the eruption of the Small-Pox. And if the patient finds rehef at this time from the fomentation, you may abstain from those fumigations which are commonly employed for drying up the pustules, until they are ripe, and capable of bearing those things which are necessary for drying them up ; of which we are now going to speak.

p. 132. CHAPTER IX.

Of those things which dry the pustules.

All those pustules that are very large should be pricked ; and the fluid that drops from them be soaked up with a soft clean rag in which there is nothing that may hurt or excoriate the patient*^ And at the same time let fumigations be made with dried rose leaves, or myrtle leaves, or sanders, or the leaves of the lily,^ or the tamarisk; roses being more suitable in summer, and the tamarisk in winter.

(2.) The Small-Pox sometimes abounds with too much moisture. When this is the case, order the patient to sleep upon a mattress of thin texture stufled with pounded roses,* or rice meal, or millet meal. If the patient^s body be excoriated, put under him the fresh leaves of the lily,^ and besprinkle ' him with an aromatic powder, roses, and myrtle ; and if any part be ulcerated, then sprinkle it with the red aromatic powder composed of aloe, frankincense, sarcocol, and dragon^s blood. When the pustules break, either spontaneously or from the abundance of fluid contained in them, and are slow in drying up, then treat them with salt in this manner : take one ounce of oil of sesamum, and mix with it two drachms of Andarene salt,* pounded like cuhl,^ and the same quantity of alum.

^ In both these passages Channing reads / wa^m) Su8f in the Arabic text, which signifies liqwtricef though he renders the word by Iris in his Latin translation : it is therefore most probable that he has confounded^ y^^^ <Su«, with r i;va? a^^ J Sihan. The Greek Translator has IpivS^vWov in the former place, and Kpivov in the latter. It was from this word that the ancient city of Susa derived its name ; trovtrov ydp ilvai ry 'EWrjvcitv 0a)vy rb Kpivov, (Athenaeus, Deipnos. zii. 8, p. 513.) Hence also came the ointment called oov<nvoVf mentioned by Dioscorides (De Mater, Med, i. 62), Athenaeus, {Deipnos, xv. 39, p. 689,) and others.

* See below. Note P.

* See below. Note 0.

58 RHAZBS ON THE [chap. ix.

Witli this liniment anoint the body^ avoiding those parts which are excoriated and ulcerated^ — ^for it must not be applied to those places^ as it would pain them extremely. Let it remain ' on the patient for the space of an hour, and then let him wash himself with a decoction of emblic myrobalans, the galls found on the white tamarisk^ myrtle leaves, and pomegranate peels. If the desiccation, be effected by these means, it is well ; but if not, take of white Susian bole,^ or any sort of white bole, (only do not take any red bole,) and mix with it about a tenth part of Andarene salt, and a tenth part of alum. Make this into a liniment, and apply it ; let it remain on for an hour or two, and then wash it off.

(3.) Next will follow the mode of taking away the eschars and dry scabs.

1 Set below, Note Q.

p. 138. CHAPTER X.

Of those things which take away the dry scabs and eschars}

When the desiccation of the pustules is effected, and scabs and dry eschars still remain upon the body, examine them well, and upon those that are thin and perfectly dried up, and under which there is no moisture, drop warm oil of sesamum every now and then, until they are softened and fall off; except, however, those which are on the face, for these are to be dressed with oD of pistachio.^ As for the larger sort which resemble eschars, if you see any moisture remaining in them, cut them off gently and remove them, without any application of oil. And if the places from which the eschars have been removed contain but httle moisture, you may soak it up with soft cotton rag, as I have already said f but if they contain much, * then besprinkle them with a little of the red aromatic powder,* especially if they begin to lessen and sink in ; and with alum and salt, if they are even with the surface of the body, and do not sink in : then wait until a new eschar is formed on them. If there be still any moisture, then repeat the same treatment ; and if there be no moisture, then anoint the scabs with oil, that they may be softened and fall off.

(2.) Next will follow a discourse on the mode of destroying the marks of the Small-Pox.

60 RHAZES ON THE p. 142. CHAPTER XI.

Of those things which remove the marks of the SmalUPox.

The marks of the Small-Pox are of two sorts ; viz. either in the eye, or on the rest of the body.

I. (2.) In the eye the part on which the Small-Pox broke ont is covered with an opaque whiteness, as we have already mentioned.^ When this happens in the eyes of children, of those, namely, who are of a moist constitution of body, and tender skin, it is the more easily deterged.

(8.) Now, the medicines which deterge the eye and take oflf the whiteness, are, sal prunella (?), Andarene

'salt, sal ammoniac, bastard sponge,* glass-gall (?),* the sea-crab, the dungs of sparrows, swallows, starlings,

'mice, and crocodiles, the common sweet flag, ebony, greater celandine, coral, tutty, haematite, verdigris, Arabian sugar,* the dregs of vinegar burnt, the sediment of urine, myrrh, juniper resin, olive gum, bitter almond gum, the milky juice of wild lettuce, glass, the dung of bats, and musk.^ It will be best to use these when the patient is just come out of the bath, or after holding his head over the steam of hot water ;

and it is right to make use of mild medicines alone, nay, the mildest of these, especially in soft and moist bodies.

p. 148. (4.) The description of a mild medicine which removes the white specks from the eye : —

[Form, 10.] Take of Sarcocol,

White Sugar Candy ; Sprinkle the powder in the eye.

» See above, Chap. vii. i 4. ' See below, Note R. 3 See below, Note S. ^ See below. Note T.

' This list of drugs may be compared with that in Avicenna, iii. 3. 2. § 18. vol. i. p. 547. ed. Lat., voL i. p. 342. ed. Arab. See also Rhazes, Almaru, ix. 16, 18.

NT '

IForm. 11.] Take of Bastard Sponge, Sarcocol, Sugar ; Sprinkle the powder in the eye.

(6.) Another still more efficacious :—

IForm. 12.] Take of Sal PruneUa (?), Bastard Sponge, 61as8.gall(?), Sarcocol, Sugar; Sprinkle the powder in the eye.

(7.) Another still more efficacious : —

[Form, 13.] Take of Verdigris, ten drachms.

Gum Sagapenum,

Gum Ammoniacum,

Sarcocol, of each two drachms and a half, p. 150. Bastard Sponge,

Glass-gaU (?),

Sal Prunella (?), of each three drachms ; Then take of common Sweet Flag,

Greater Celandine, of each ten drachms ; Boil them in ten times their weight of water, until the decoction hecomes thick ; then dissolve the gums in it, and knead the rest together, and make the whole into an ophthalmic coUyrium.

As occasion may arise, rub some of this paste with water in an ebony mortar,^ so that the mixture may be thick ; then put some of it on a style, and apply it frequently to the part affected. Both before and after the operation let the eye be several ' times licked with the tongue / and afterwards sprinkle it with the milder sort of aromatic powder. But be sure to look carefully and frequently into the eye ; and if it be painful and red, then omit this treatment for some days, and afterwards repeat it ; for it is a very efficacious mode of cure.

II. (8.) As to the medicines which remove the marks of the

* The Translator has here followed Channing*8 version, though the passage is certainly corrupt, as is allowed hy Channing himself. Stack's translation is very different. ' See helow, Note U.

62 RHAZES ON THE [chap. xi.

Small-Fox from the face and the rest of the bodj^ they are these : — ^white litharge^ dried reed roots, rotten bones, bastard sponge, coral,^ sarcocol, almonds, birthwort, the ben-nut, the seeds of radish, melon, and rocket, and the meal of beans, rice, lupines, and kidney beans : let the patient be anointed with these in rice water, or barley water.

(9.) The description of a liniment which removes the marks of the Small-Pox : —

IForm. 14.] Take of the Meal of common Chick Peas,

Bean Meal, of each three drachms,

Melon Seed, five drachms,

White Litharge, two drachms, p. 154. Reed Roots dried, three drachms ;

Pomid all of them together in barley-water ; then anoint the patient several times successively after he has held his head over the steam of hot water, or after coming out of the bath. Then wash him in a bath made of a decoction of melon rinds, dried violets, bran, and common chick peas pounded ; rub him well, and then apply the liniment a second time.

(10.) The description of another Hniment more efficacious than the former : —

IForm, 15.] Take of the meal of Beans resembling lupines, five drachms, p. 156. Bitter Almonds,

Sweet Costus,

Rocket Seed,

Radish Seed, of each two drachms and a half; Use the liniment as we have directed.

(11.) Another liniment still more efficacious : —

[Form, 16.] Take of Bitter Almonds, peeled, five drachms. Radish Seed, Rocket Seed, Costus,

1 Channing has in the text 4Xmm3 Fatad, which appears to be a typographical error for tX>*«.> Bauad, as he translates the word eorattium. The Greek Translator has KOTrSpptZov, and therefore probably read Lum3 JTtit/ in his An*ic MS., which is very similar in appearance to both the other words, and is not unlikely to be the true reading, as coral is not found in any of the following prescriptions, whereas Coihu (which, unless it be mentioned here, is omitted entirely in the present list,) occurs in Formm. 15 and 16.

Long Birtbworty of each two drachms and a half,

Sal Prunella (?), three drachms,

Pepi>er, one drachm and a half; Use them as we have directed; and anomt the parts with radish water, or with what we have before prescribed.

(12.) These, therefore, are the medicines which remove the marks and scars of the Small-Pox : and in order to efface the pock-holes, and render them even with the surface of the

^' * body, let the patient endeavour to grow fat and fleshy, and use the bath frequently, and have his body well rubbed.

(13.) We will now speak of what ought to be given to a patient in the Small-Pox by way of food, and of the medidnes to be used in the treatment of him.

64 RHAZES ON THE p. 160. CHAPTER XII.

Of the patient's food in the SmalUPox}

To a patient in the Small-Pox it is necessary to give to drink barley water prepared in the same manner and with the same art as that which is usually given to persons in acute diseases. K the fever be moderate and mild^ and the bowels somewhat costive, it must be sweetened with white sugar-candy ; but if the heat of the fever be intense, and the bowels relaxed, then pour to it half its quantity of acid pomegranate juice, pounded with the seeds, but avoiding the pulp and inward thin tunicles, for these are aperient. If the patient be also restless and cannot sleep, add to the peeled barley used in preparing the barley water about half the quantity of poppy. But if the

'bowels be very loose, then take equal parts of peeled barley, of dry seeds of acid pomegranate, and poppy. But if it be necessary to bind the bowels, then instead of peeled barley take parched barley meal previously prepared with the meal of parched pomegranate seeds ; boil these in the same manner as barley water is made, and let the patient drink

* of this, as he would of barley water, either alone, or mixed with tabasheer and gum Arabic, if a looseness of the bowels should make it necessary, or with the medicines which we shall describe anon. And barley water, mixed with acid pomegranate juice is very useful in the Small-Pox, and more especially in Measles. And also the juice of the gourd, of the Indian melon, and of the serpent cucumber, and the mucilage of fleawort seed, and the like, which make a mild phlegm and easy to be spit up ; these, I say, are more useful in the Measles than in the Small-Pox, unless it be in those sorts of Small-Pox which are accompanied with extreme malignity, intense heat firom the fever, and want of sleep.

(2.) But in those cases of the Small-Pox which are accompanied with fever wherein there is not so violent an inflammation^ the things above mentioned and others of the like kind render them much slower, and protract the length of the disease; so that you must use them, or not, as occasion shall

' require. For since the Small-Pox arises in most cases from heat and putrefaction acting upon moisture, those things are more suitable, which have a drying and thickening power together with a cooling power, such as water of pomegranates, juice of unripe grapes, and the like ; but since the Measles arise from a vehement ebullition of the bile in the blood, those things are most salutary, which, together with a cooling power, have a moistening power also, in order that the corrupted blood may be tempered and corrected by their means. For the blood of a person in the Measles, is like stagnant water, which has been long putrid, and which, having lost its sweetness by the action of the sun, has contracted a vicious acrimony ; but which, when it is mixed with rain water or running sweet water, recovers its former wholesomeness.

(3.) Moreover, in the Small-Pox the meal of parched

' barley is useful when it is washed and taken with sugar or in pomegranate water, or in julep,^ according as may be required by the loose or costive state of the patient's bowels, as likewise the greater or less ebullition of heat: except that barley water is lighter for him to take in the Small-Pox, easier to swallow, and more beneficial to his throat and chest. So that you must act according to circumstances, after you have been apprised that barley water is more suitable for persons in the Measles than in the Small-Fox, unless it be of a bad sort, in the manner we have mentioned.

(4.) Peeled lentiles are likewise useful in the Small-Pox, when a food is prepared of them with the water of acid pomegranates, or with vinegar : as is also the parched meal of lentiles, when it is taken in cold water. You should know also that the drinking cold water is more serviceable to a patient in the Measles than in the Small-Pox, as being safer,

* C^ jW Juldbj whence comes the Greek ZovXanov, the Latin Julapium, the English Julep, &c. is properly a Persian word, and signifies Rose-wafer, See Castell, Lex, Heptagl. p. 548.

66 RHAZES ON THE [chap. xii.

and of a more certain eflPect. However, when you see the Small-Pox attended with violent inflammation, and quickness or intermission of the pulse and respiration, then make use of extinguishing medicines in proportion to the symptoms ; if they are less urgent, employ few, and if very urgent, then give many. But do not allow the patient to eat young birds until the pulse and respiration have returned to their natural state ; nor till the pustules are dried up, and the scabs fallen oflf.

(5.) Next will follow the discourse on relaxing the bowels and confining them in the Small-Pox.

SMALL-POX AND MEASLES. ^7 p. 172. CHAPTER XIII.

Of the regulating the patient's bowels in the Small-Poo:.^

The bowels are generally relaxed in the Small-Pox and Measles towards their decline, and especially in the Measles ; for which reason, after these diseases have passed their crisis, everything must be avoided which opens the bowels, even ' if they should be confined. But if the bowels are relaxed, then you should from the first abstain from opening medicines, although it be necessary to employ them in the beginning of these two diseases, and before the crisis is passed. For it is sometimes necessary to open the bowels in the Small-Pox, either because of the excess of heat and headache, or in order to ease Nature of her load, and to lessen the morbific matter, when you have reason to think it over-abundant. And this will be the case when you find the body, both before and after the bloodletting, neither weakened nor wasted, but on the contrary bloated and fuU, with a paleness of colour, or but little of redness, and a fluctuation in the pulse. For sometimes in such a state it is not necessa-ry to take away blood, but to evacuate from the body the superabundant moisture ; and that especially when the aforesaid symptoms are very plain and evident, and the body is troubled with boils from the sluggishness of the fever, and is destitute of a red colour. In this state one of the best things is a decoction of yellow or chebule myrobalans alone, when it is drunk with white sugarcandy, and the water of an acid pomegranate bruised with its pulp, to which may be added one or two more pomegranates if there be occasion. For it is the property of these two medicines (especially pomegranate water,) to diminish the superabundant moisture of the body, together with part of the bile, without exciting any heat, and to leave nothing behind them in the bowels. And these are some of the best things that can happen in this stage of the disease.

68 RHAZES ON THE [chap. xiii.

p. 178. (2.) But in the Measles, give the water of damask plums, or the plums themselves, fresh gathered, and macerated in julep, with sugar added. But avoid the medicine called tarunjuhin} which is as prejudicial in the Measles as honey is in the Small- Pox, both on account of the surfeit which it occasions, and also because it increases the nausea and anxiety of the patient. In like manner you should carefully avoid giving them to drink milk and violets, for both of these will also increase the nausea and anxiety in those who already feel any,

(3.) Now whereas the &st and most necessary remedy in the Small-Pox is to draw blood when it is too much in ^' ' quantity, and there is no hope of checking its ebullition by extinguents ; (but it is necessary to take some away, as well for relieving Nature, as for abating the fullness of the bloodvessels, and their swelling and distension from the too great quantity of their contents, which must otherwise be productive of very bad consequences, especially when the blood is heated to that degree that the exhalation is too great ;) in like manner in the beginning of the Measles it is right to draw oflf some of the bile, when you see it to be over-abundant, and then to pursue what remains of it by extinguents. Now the sign of an excessive redundancy of the bile is the violence of the inflammation, and anxiety, together with the discharge of the same bile both by vomit and stool, and a bitter taste in the mouth. But if the quantity of the bile be not excessive, and yet there is anxiety and thirst and vehement heat, without any discharge of bile either by vomit or stool, though its * quantity, I say, be not excessive, we may judge it to be of a bad quality in proportion to the violence of the inflammation and anxiety,

(4.) And this is what you ought to know concerning the regiJating the discharges of the bowels in the beginning of these two diseases. Now when the bowels are relaxed, give nothing laxative ; for in either of these diseases the patient will be in danger from the excessive looseness of the bowels, if he drinks anything which increases their discharge. When,

* /.j-fbA^ *3 Taranjubin^ a Persian compound word, signifying moui (or dew) honey, (See Castell, Lex. Pers. p. 180.) It here probably means the manna of the \^ hdj, or CameVs thorn {Alhagi Mauromnif Tournef.).

therefore, the bowels are relaxed, give the patient barley gruel to drink, instead of barley water ; and, if it be necessary, boil with the barley gruel the parched meal of pomegranate seeds ; and if, notwithstanding, the looseness still continues, then mix in his drink gum^ Arabic and tabasheer, in this manner : — p. 184. [^Form, 17.] Take of Gum Arabic, two drachms, Tabasheer, one drachm ; Pound them as small as cuhl, and sprinkle the powder into four ounces of barley gruel, and give it to the patient to drink, if his bowels be much relaxed.

And give him also to drink, about an hour before the barley gruel, some of this medicine which I am going to describe j and then give him barley gruel.

The following is the description of it : —

[Form. 18.] Take of Red Roses ground fine,

Tabasheer,

Broad-leaved Dock Seed,

Sumach,

Barberries, of each equal parts,

Gum Arabic,

Lemnian Earth,

Poppy Rinds,

Pomegranate Flowers, of each half the quantity ; Giye the patient to drink three drachms of these* in one ounce of the inspissated juice of green and acid quinces.

p. 186. (5.) But if the looseness still continues, and the patient is weakened by it, let him drink sour butter-milk,^ from which the butter has been carefully removed, with the best sort of biscuits, and a little gum Arabic. Lastly, there often comes on a dysentery,* and when this is the case the mode of treatment

* The word X^^^O Samag, gum^ when used without any distinguishing epithet, signifies gum Arabic, See Ibn Baiter, vol. ii. p. 133.

' The Greek Translator has 'jrp6<fiptpt rb paiir (i.e. C^^ * Raib)y rovrktrrt ro

' The word ,^C^ Sa^ft means excoriation of the intestines and dysentery. The exact passage referred to by Rhazes is not quite clear. It is possible that it may be Almana, ix. 72 (71), but this does not seem likely, as that chapter is headed iJLftl^. Chalfahj not tf^*^ Sajy^ which is rendered in the Latm version Fluxm ventris. x^

70 RHAZES ON THE [chap. xiii.

must be taken from the place where we have treated of that subject.

(6.) And now we will speak of the mild and the fatal species of the Small-Pox and the Measles.

p. 188. CHAPTER XIV.

Of the fatal and the mild species of SmalUPox and Measles}

The Small-Fox and Measles are of the number of acute and hot diseases, and therefore they have many things in common with them, with respect to the symptoms which indicate the disease to be mild or fatal. Now the chief prognostic signs in . those who recover are, a freedom of respiration, soundness of mind, appetite for food, lightness of motion, a good state of the pulse, the patient's confident opinion respecting the event of his own illness, a convenient posture in bed, and but little tossing about and inquietude of body. Hence a judgment ^* * may be formed of the bad signs, some of which we have briefly but correctly mentioned in the book called ^ Al-Mansuri.'*

(2.) The circumstances which peculiarly regard the Small- Pox and Measles are the following. When the pustules of the Small-Pox are white, large, distinct, few in number, and easy in coming out, and the fever is without much violence and heat, or distress and anxiety ; and when the patient's heat and distress and anxiety diminish upon the very first eruption, and entirely cease after the eruption is completed ; that sort is the most curable and least dangerous. To these the next in goodness are those that are white and large, though they may be very numerous and close together, if the eruption has been easy, and has relieved the patient from his anxiety and heat, as we have already mentioned.

p. 192. (3.) But when the appearance of the pustules is brought about with diflSiculty, and the patient is not relieved upon their eruption, they are a bad sort ; although there is not so much reason to be afraid if the patient's condition be unfavorable during their appearance, as if it continues so afterwards. But

' An account of this work is given below, together with a translation of the chapter on the Small-Pox and Measles. The Greek Translator has iv rf ffvvrdynari

72 RHAZES ON THE [chap. xiv.

there is a bad and fatal sort of the white and large pustules, viz. those which become confluent and spread, so that many of them unite and occupy large spaces of the body, or become like broad circles, and in colour resemble fat.

(4.) As to those white pustules which- are very small, close to each other, hard, warty, and containing no fluid, they are of a bad kind, and their badness is in proportion to the degree 6f difficulty in their ripening. And if the patient be not relieved upon their eruption, but his condition continues unfavorable after it is finished, it is a mortal sign.^

(5.) And as to those which are of a greenish, or violet, ' or black colour, they are all of a bad and fatal kind ; and when, besides, a swooning^ and palpitation of the heart come on, they are worse and still more fatal. And when the fever increases after the appearance of the pustules, it is a bad sign ; but if it is lessened on their appearance, that is a good sign. Doubled pustules indicate an abundance of the matter of the disease, and if they are of the curable sort, they portend recovery ;* but if they are of the mortal kind, they portend death.

(6.) The safest kind of Measles is that where the redness is not very deep ; but the pale or tawny coloured are bad ; and the green and violet coloured are both mortal. When either the Small-Pox or Measles sink in suddenly after they have begun to come out, and then the patient is seized with * anxiety, and a swooning comes on, it is a sign of speedy death, unless they break out afresh.

(7.) When the pustules appear on the first day that the patient is feverish, they wiU hasten their progress and be of quicker motion ; if they appear on the third day, the eruption will advance moderately ; but if the first appearance is delayed beyond the fourth day, the eruption will be completed dully and slowly. When the eruption breaks out on the good critical

* The Greek Translator renders the word ^ ^ * ^ gaahyont here by vavridw, but both Stack and Channing consider the meaning in the text to be more probably correct in this place, though the word certainly signifies nausea in several other passages.

' The Translator is inclined to suspect, some error in the Arabic text in this place, and has accordingly followed Stack and the Greek translation in preference to Channing.

days,^ it is a salutary sign, especially if the patient is relieved at the end of it ; and so on the contrary.

(8.) When the pustules begin to be confluent and to spread, and the anxiety is very great, and the abdomen is inflated, then death is near at hand.

(9.) When the smaller sort of pustules, which contain no fluid, break, and at the same time a delirium comes on, then the patient is near his end.

(10.) When the Small-Pox and Measles first appear, and afterwards sink in again, and there comes on at the same time anxiety and delirium, this is a fatal sign, whatever their

' colour may be ; but this is seldom the case with the white pustules, and those which ripen, and contain fluid quickly.

(11.) When towards the end of the Small-Pox there is a great perturbation of the humours, and the patient is seized with a very violent pain in the leg, or hand, or any other limb, or the pustules turn to a green or black colour, and thereupon he becomes weaker than he was before, and the weakness still increases with the increase of the pain, or the limb is deeply coloured; these are signs of death.

(12.) But if, nevertheless, the patient^s strength increases, he will recover, but the limb will mortify. And if you scarify that limb quite at the beginning of the pain, if the patient grows stronger after it, you will do him great service, and the limb will thereby be preserved from mortification. But * in a case like this nothing cooling is to be applied to the limb, but it may either be scarified, or plunged into hot water, when you see that the state of the patient is able to bear it.

(13.) Now, therefore, as we have gone over all the articles which were proposed concerning the mode of treating this disease, and of preservation from it, we will here break off the thread of our discourse ; and to HIM Who hath given us understanding to accomplish the work be praise and glory without end, even as HE is most worthy and deserving thereof.

* See below, Note V.