Gilbert's sections on goitre (_bocium gulae_)[8] are interesting in
themselves, and characteristic of the method adopted by him in his
discussion of surgical or semi-surgical subjects. An introduction
relative to the pathology of the disease and which seems to be
original, is followed by a treatment, medical and surgical, adopted
almost literally from the Chirurgia of Roger. Thus he says: "Goiter
occurs most commonly among the inhabitants of mountainous regions,
and is due to an amplification and dilatation of the veins, arteries
and nerves, together with the soft tissues, occasioned by the north
wind (_ventum boreale_), or some other confined wind, which during
childhood has accumulated in (_coadunabatur_) and enlarged the part
to the size of the goiter." After suggesting an analogy between the
disease and the redness and turgidity of the neck produced by passion
or in singing, he adds that some cases are due to an accumulation
of spongy tissue between the veins and arteries, or to the use of
flatulent food, and he even tells us that some old women know how to
produce and remove goitrous swellings by means of certain suitable
herbs known to them.
[Footnote 8: Cf. the French _bosse de la gorge_.]
Under medical treatment we find the following: "Dig out of the ground
while chanting a pater noster, a nut which has never borne fruit. The
roots and other parts pound well with two hundred grains of pepper,
and boil down in the best wine until reduced in volume to one-half.
Let the patient take this freely on an empty stomach until cured."
Another more elaborate prescription consists of a long list of
ingredients, including burnt sponge, saponaria, the milk of a sow
raising her first litter, with numerous simple herbs, and the sole
object for which this nonsensical farrago is introduced here is to add
that both these prescriptions are copied from the surgery of Roger. It
is important too to remark here that we owe to Roger the introduction
of iodine, under the form of burnt sponge, into the treatment of
goiter.
In the failure of medical treatment, Gilbert directs the employment
of surgical means, e.g., the use of setons, or, in suitable cases,
extirpation of the goiter with the knife. If, however, the tumor is
very vascular, he prefers to leave the case to nature rather than
expose the patient to the dangers of a bloody operation. The whole
discussion of goiter is manifestly a paraphrase of the similar chapter
of Roger, who also introduced into surgical practice the use of the
seton.
Public-domain text, read in full here on John Shaqi.
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