The seven books of Paulus Ægineta, volume 2 (of 3) : $b translated from the Greek: with a commentary embracing a complete view of the knowledge possessed by the Greeks, Romans, and Arabians on all subjects connected with medicine and surgeryPaulus, Aegineta
History
The seven books of Paulus Ægineta, volume 2 (of 3) : $b translated from the Greek: with a commentary embracing a complete view of the knowledge possessed by the Greeks, Romans, and Arabians on all subjects connected with medicine and surgery
Paulus, Aegineta
Medicine; Medicine, Arab; Medicine, Greek and Roman
Enterocele arising from distension commences as bubonocele; for at first
the peritoneum being stretched the relaxed intestine is protruded as far
as the groin, and forms this disease, which the ancients operated upon in
this manner. After making the incision to the extent of three fingers’
breadth transversely across the tumour in the groin, and removing the
membranes and fat, and the peritoneum being exposed in the middle where
it is raised up to a point, let the knob of a probe be applied, by
which the intestines will be pressed deep down. The prominences, then,
of the peritoneum formed on each side of the knob of the probe are to be
united to one another by sutures, and then we extract the probe, neither
cutting the peritoneum nor removing the testicle, nor anything else,
but curing it with the applications for fresh wounds. But since burning
in cases of bubonocele is preferred by most of the moderns it will be
right for us to give an account of this operation. After the man has
undergone moderate exercise, let him cough violently and strain to keep
in his breath; and when the swelling appears at the groin we mark with
black ink or collyrium the place that is to be burned in a triangular
figure, making its transverse line above in the situation of the groin,
and we also make a mark in the middle of the triangle. Having laid the
patient in a recumbent posture we first apply to the mark in the middle
nail-shaped cauteries heated in the fire, afterwards burn the sides of
the triangle with gamma-shaped (Γ) cauteries, and afterward level the
triangle with cauteries shaped like tiles or lentils, an assistant during
the whole process of burning wiping away the ichorous discharges with a
rag; and in those who are of a moderate habit of body the burning should
be carried to such a depth as to touch the fat. But in those who are
lean we must not attend to this mark lest by mistake we should burn the
peritoneum; nor again in those who are grosser and fatter, for in them
the fat appears before a sufficient burning has taken place. We must,
therefore, be rather guided as to its extent by a skilful conjecture.
After the burning, having triturated salts with leeks we apply them to
the eschar, and use the inguinal bandage shaped like the Greek letter Χ.
On the following days we complete the cure with the dressings fitting for
eschars, such as lentils with honey, and the like.
* * * * *
COMMENTARY. Celsus directs us, when the inguinal tumour is moderate in
size, to make one incision; but if larger, he recommends two lines to be
made, so that the middle may be cut out; then, without extracting the
testicle, as advised in certain cases of prolapsed intestines, the veins
are to be bound together and tied where they adhere to the tunics, and
afterwards cut below the knots. (vii, 24.)
Avicenna speaks of astringent applications and the actual cautery, but
disapproves of the incision and suture. (iii, 22, 1.)
Public-domain text, read in full here on John Shaqi.
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