Abū Bakr Muḥammad ibn Zakarīyā Rāzī.

A treatise on the small-pox and measles online

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usual in Asia Minor, to express a specific eruptive fever; and that
the probability is confirmed by a passage in the second book of
Epidemics, (which however was not the work of Hippocrates himself,)
which begins thus :* — '* Anthrakes appeared at Cranon, in a very hot
and rainy summer, mostly with a south wind ; ichors or humours
(iXbipes) collected under the skin, and these, being confined, became
hot, and excited itching ; then there arose phlyctaenides or blisters
(^Xi/irrair/des), as if caused by fire ; and the patients experienced a
sensation of burning under the skin." M. Littr^, on the other hand,
considers that we are not obliged to interpret the term to mean several
"anthrakes" which appeared on one and the same person, but that it
may equally well signify a single "anthrax" which broke out on
several individuals. Two other passages in the Hippocratic Collection
where the word occurs,* throw no more light on its precise meaning.

M. Littr6 proceeds to institute a careful and interesting compari-
son (too long to be extracted, and hardly admitting of abridgement,)

* MiaceUaneous WorJks, p. 52, &c.

* (Ewvres d*Hqfpocrate, tome v. p. 48, &c.

^ This is the common reading (p. 481), but M. Littre omits the important word
Xoifiiodfjg {(Euvres d*Hippocr, tome iii. p. xxxviL and Note (^) p. 66), and therefore
no argument can be founded on the use of the term.

* Epid, iii. 3. § 1. vol. iii. p. 487.
^ Epid, ii. 1. § 1. vol. iii. p. 428.

« Epid. iii. 3. § 3. vol. iii. p. 482 : De Affect, vol. ii. p. 409.


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between the passages relating to the "Anthrax" to be found in Galen
and other ancient writers posterior to Hippocrates, and the descrip-
tions of recent medical authors ; from which he draws the conclusion
(pp. 56, 57,) that in most cases ike term signified the malignant
carbuncle and malignant pustule of modem nosologists. Generally
the " Anthrax" was single, and therefore bore little or no resemblance
to the Small-Pox ; occasionally, however, we meet with the mention of
a carbunculous or anthrax-like eruption, which Willan and other emi-
nent medical antiquaries believe to signify the disease in question.
Thus Rufus Ephesus* (who lived in the first century after Christ)
says that " in the plague or pestilence (Xolfios) all the most dreadful
symptoms may occur, and nothing is withheld, as in any of the
diseases singly .2 The appearances are many and various ; there are
diflferent kinds of delirium, vomitings of bile, tension of the hypo-
chondria, a sense of anxiety, frequent sweats, coldness of the extremi-
ties, bilious diarrhoea, with thin flatulent discharges ; the urine, in
some cases thin and watery, in others bilious, in others black, with a
bad sediment, and enaeoremata of the worst kind ; haemorrhage from
the nostrils, heats in the, chest, a parched tongue, watchfulness, strong
convulsions ; and also there may take place in the plague evil ulcers,
carbunculous or anthrax-like (avOpaKwhrj), and most formidable, not
only on the rest of the body, but also on the face and tonsils." Thus
too Herodotus (who also lived in the first century after Christ,) when
treating of the eruptions (eJavO^/iara) in different kinds of fevers,*
first mentions the herpetic or vesicular eruption about the nose and
lips, considered as a frequent crisis of simple or catarrhal fever ; and,
secondly, the weals or molopes (/iwXwTres), resembling flea-bites or
gnat-bites, which appear at the commencement of fevers arising from
a vitiated state of the humours, and sometimes occur in the causos or
remittent fever. "In highly malignant and pestilential fevers," he
says, "the exanthemata are ulcerated, and some of them resemble
anthrakes or carbuncles; but tbey all denote the redundancy of a
corrupt and corrosive humour. Those which appear on the face are
the most troublesome of all : a great number is worse than a smaller ;
the larger ones * are worse than those more contracted ; those which

* Quoted by Aetius, ii. 1. 95. p. 223. ed. Lat., p. 92 b. ed. Gr.

' " He means that the diseases composing an epidemic Loimos display a greater
degree of malignity than is exhibited by them separately out of a pestilential con-
stitution." (Willan's Note, p. 27.)

^ Quoted by Aetius, ii. 1. 129. p. 234. ed. Lat., p. 96 a. ed. Gr.

^ *^ Compare Rhazes (Channing's edit.) Ve Variolis et MorhilliSf cap. xiv. p. 193.'*
(Willan's Note, p. 28.)


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suddenly disappear are worse than those which continue for a longer
time ;* and those which are inflamed are much worse than those which
only produce itching. Those which arise in a state of costiTcness, or
when the al?ine discharges are moderate, prove favorable ; but those
which take place with a diarrhoea or violent vomiting are bad ; if those
which supervene in the last case stay the flux, they are favorable.^
These exanthemata are attended with fevers of an untractable kind,
and with great faintness." At the beginning of the pestilential and
anthrax-hke eruption he recommends blood-letting, but afterwards
allows the patient a generous diet, in order to support his strength
through the fever. He thinks the cerates and ointments employed for
bums may be occasionally useful as external applications.^ ''The
eruptions on the face," he says, " may be soothed by washing with
warm water ;" he recommends that on the rest of the body they should
be sponged with diligence, especially when they are of the itching kind.
"Should the ulcerations extend in the herpetic form,"* he says, "a
small portion of quicklime may be added, for it has a wonderful effect
in drying, and in obviating their disposition to noma^ (to vo/jiubcs
alriav). After the height or maturation of the complaint (wapaKfifis
yevofiivns) he advises to evacuate the morbid matter by a suitable

> "Et quando Variolae et Morbilli de improviso intos subsidunt, postquam
coeperint emergere, et cum molcstia simul accidit deliquium, iuteritus dto sequetur,
nisi erumpant denuo. Rhazes, pp. 195, 197." (Willan's Note, p. 29.)

» «* Similar observations will be found in all the writers on Small-Pox, from Rhazes
to Sydenham." (Willan's Note, p. 29.)

3 " Compare Rhazes, Opera Parva, p. 202. ed. Lugd. 1511." (Willan's Note, p. 30.)

* "'EpirvffTiKd. This appearance is noticed in the Small-Pox by Rhazes: —
* Variolae quae ambulant ut formica [herpes] et quae faciunt superficiem corporis
sicut spasmata, malae sunt et mortales.' (Divis. c. 159. in Opera Parva, pp. 66, 7.
Gerardo Carmonensi interprete.) Rhazes has described in another place (Z)e Var, c. 14.)
white, confluent Variolae, forming large circles or rings, with an appearance of fat
or steatomatous matter under the skin. Channing*s edit. p. 193." (Willan's Note,
p. 30.)

* " Rhazes (cap. ix.) and Avicenna (p. 73. vol. ii.) have noted the tendency to
ulceration, at the decline of the SmalUPox. Dr. Alexander Russell observes on the
Small-Pox at Aleppo, * If the sick survived the eleventh day, few of them escaped
corrosive ulcers with carious bones, or hard swellings in the glandular parts.' Oct.
1742. \_Nat, Hist of Aleppo, vol. ii. p. 316.] This is not pecuUar to hot climates,
since it was frequently observed by Dr. Huxham in this country. * Variolae epidemicae
interdum crudo diffluunt ichore, qui subjectam camem erodit, imo et nonnunquam
ipsa gangraena afficit.' Julio, 1744.— Compare Pechlini Obs. p. 237, and Amat.
Lusitan. Cent. III. cur. xvii. p. 234." (WiUan's Note, p. 30.)

The meaning of the word vo/117 is explained below. Note HH.


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purgative, &c. An "anthrax-like" fever and eruption is mentioned
also by Galen* and Palladius,^ and the passages in question are quoted
by M. Littr^. (p. 58.)

It seemed due to WiUan's well-deserved reputation to quote at full
length the Notes in which he draws attention to the points of resem-
blance between this "anthrax-like" fever and the Small-Pox. His
conclusion is as follows : — " Since Herodotus and Rufus, in their
accounts of the Loimos or Fehris Loimodes, have omitted the charac-
teristic appearances of buboes and carbuncles, only observing that the
eruptions diffused over the face and the whole body were somewhat of
the nature of carbuncles or partly resembled them, we may conclude
that the disease they describe was not the Pestilence [or true Plague],
but an epidemical, contagious, destructive, and all-dreadful eruptive
Fever, of which history affords no parallel but in the Small-Pox."
(pp. 33, 34.)

It is useless to attempt to deny the resemblance that Willan has
pointed out, and at the time at which he wrote (probably about 1810)
he was perhaps justified in the conclusion at which he arrived. Ten
years, however, after the publication of his " Miscellaneous Works,"
a Greek fragment appeared, which is of the greatest importance in
determining the question as to the antiquity of the true Plague, and
which, at the same time, positively contradicts one of WiUan's state-
ments above, and therefore weakens in a great degree the validity of
his inference. It is now tolerably certain that Rufus Ephesius
was acquainted with "pestilential buboes" {ol \oifid}h€ts KaXovfjievoi
fiovfiuiyes),^ and he may therefore have been describing the true
Plague in the passage quoted above from Aetius. And with respect
to the passage from Herodotus, however easily and naturally the
" anthrax-like eruption" of which he speaks might be supposed to
describe a severe case of confluent Small-Pox, if it were but incon-
testably proved that this disease was known to the Greek physicians
of the first century after Christ ; yet, as this is a point on which the
most learned medical antiquaries are far from being agreed, this

* De Prob, et Prav. Aliment. SucciSf c. 1. vol. vi. p. 750.

* Comment, in Hippocr. " Epid," in Dietz's Scholia in Hippocr. et Gal. vol. ii.
p. 33.

3 See Cardinal Mai's CoUection of "Classici Auctores e Vaticanis Codicibus
editi," (Rom. 1831.) vol. iv. p. 11. Whoever has not an opportunity of consulting
this work may refer to M. Littre's Hippocrates, vol. ii. p. 585 : iii. 4 : v. 60. The
genuineness of the passage in question appears to be doubted by some persons (see
MedicO'Chirurgical Review for Oct. 1846. p. 290.), but probably without sufficient


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single passage cannot fairly be considered to settle the question : and
therefore the conclusion to which the Writer is led by his inquiries in
this Note, is : — 1, that the word avdpa^ never signified the Small-Pox
in ancient Greek writers; and 2, that, though the "anthrax-like"
(avdpantabrii) fever and eruption mentioned by a few authors msLj pos-
sibly have referred to that disease, yet this is a point which cannot be

(Note H. p. 27.)

That is, his Commentary on the " Timaeus" of Plato, which was
translated into Arabic by Honain Ibn Ishak.' Of this work only a
few fragments remain, which are to be found in a Latin version in the
fifth volume of Chartier's edition of Hippocrates and Qnlen ; but, as
the passage here quoted by Bhazes is not among these, we do not
know even the Latin translation of the Greek word supposed to signify
the Small-Pox. The same opinion is, however, expressed in several
parts of Galen's extant works, and from them, therefore, we may derive
some assistance. Perhaps the passages which bear most resemblance
to that in the text are the two following :^ — \eyfxoyas b' ol fikv
TToikaioX TCLS oiov ^Xoytiaeii dfvofxaSov ol bk yetirepoi oh wdoas'
ovre yap rov Ipiri^ra, ovre to epvolircXas, ovt 6,Wo ohb^v t&v toiovtuv
Toii ^XeyfAoyals avvapiOftovoiy. And, xal yap vavra ra ipXoytJbri koI
Oepfih briXovvrai tQv voorifiartav, (i. e. in the writings of Hippocrates,)
ipvoiiriXara, IpTriyrcs, avOpaxes, In both these passages the terms
^pTTfis and kpyaltreKas occur, which therefore tends somewhat to con-
firm the Translator's conjecture, that these are the two words which

are signified by L$ ^(^^s^ Jadari and i » ^^ Humrah.

> See Wenrich, De Auct, Graec. Vers, &c. p. 258.

' Ad Glauc. de Meth, Med, i. 16. torn. xL p. 69 ; and Comment, in Hippocr, **De
Rat, Vict, inMorh, Acut,** iv. 19. tom.xv. p. 769- See also DeDiffic. Respir. iii. 5.
torn. vii. p. 911; De Meth, Med. xiii. 1. torn. x. p. 875; Comment, in Hippocr.
**Epid. VI." iii. 29. torn. xvii. pt. ii. p. 121 ; Comment, in Hippocr. " De Fract."
iii. 8. torn, xviii. pt. ii. p. 548.


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(Note I. p. 29.)

Galen's Commentary on the "Aphorisms" of Hippocrates was
translated into Syriac by Honain Ibn Ishak, and thence into Arabic
by Kostk Ibn Lukd, who lived in the ninth and tenth centuries after
Christ.^ The passage here quoted by Bhazes is probably the follow-
ing i^ — ol anfiacovres eviois fjiev rCav iarptiy, €vioi$ bk ol xacdcs iholay
elvai OepfioTepoC ixovffi yap oi fjikv bptfiVTepoy ro depfiov, ol bk nXeov,
The same idea is expressed at greater length in his little work Adversus
Lycum,^ and there is a note on the expression c/i^wroK Oepfioy in the
fourth volume of M. Littr^'s Hippocrates, p. 427.

(Note J. p. 39.)

The word /.j^jCt?** WerasJidn is rendered boils by Stack, and
furunculorum by Channing, and may perhaps (for it is not certain,)
answer to (jkVfjiaTwy in the Greek Translation. It occurs again below,
§ 12. p. 74. (ed. Channing,) and Cont. §§ 11, 26, and perhaps 81 ;
but the Translator has as yet met with it in no other medical writer.
The meaning of the word is not much explained by the following
passage from Ibn Abi Osaibi'ah, (quoted by Channing,) in the Appendix
to Freind's History of Physic (p. 11.): — "Interrogatus Gabriel ab Abu
Isaac de morbo qui Wersekin appellatur, respondit, *Nomen hoc Persae
composuerunt e duabus vocibus, fractionis videlicet et pectoris ; nam
in puriori sermone Persarum nomen pectoris est trer, quod vulgo her
dicitur ; nomen autem fractionis esTdn \eshkin\ : si ambae voces una
conjungantur, efficiunt wersekin [potius wereshkiTi], i. e. morbus ille
in quo pectus necessario frangitur ; qui quidem si in aliquo firmetur,
ex illo non assurget, et is qui ex illo evadit, ne recrudescat morbus
annuo spatio verendum est, nisi tempore morbi vel postea vomitus
sanguinis, quem expellit natura per nares aut inferne, copiose accidat,
tunc salus speranda est.' " This passage would seem to indicate some
much more fonAidable disease than a mere boil.

> See Wenrich, De Auct, Graec, Vers, &c. p. 249; Wustenfeld, Geach, der Arab,
Aerzte, &c. p. 49.

« i. 14. torn. xvii. pt. 2. p. 404.
' torn. xviu. pt. i. p. 196, &c.


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(Note K. p. 45.)

The Arabic names here are ^J,jL^L3\ Al-bdsilik, and rj\.Q_xP3\
Al-kifAl, which are evidently the Greek words fiaaiXiKri and KetpaXiKii.
These names were quite unknown to Galen, and appear to be of com-
paratively modem origin, the only Greek writers in whom the Translator
has been able to find them being Synesius* and Leo :^ it is somewhat
singular that neither of them is used by the Greek Translator, though
they must of course have been known to him. The Arabic words are
found also in Avicenna,' Albucasis,^ and Haly Abbas/

(Note L. p. 45.)

There is some difficulty in the Arabic texthere,« which requires to be
examined, and which will be much illustrated by the following extracts
from Albucasis. In his chapter on Venesection^ he enumerates the
different veins and arteries from which blood is sometimes extracted,
and says that five of these are in the arm and hand. ^* One of them is

the cephalic vein ( /j\jt,^ij^ Al-ki/dt), which is on the outer side, and
is commonly called the 'vein of the head.' Another is the dark (?)
vein (jV^^S^\ Al-achat), which is in the middle, (i. e. the median
vein,) and is composed of a branch of the basilic and a branch of
the cephalic : this is commonly called the ' vein of the body.' The

third is the basilic, ( xSJu*jLj i Al-hdsilik,) which is situated on the
inner side, and is also called the 'axillary,' but more commonly the
* vein of the abdomen.' " (p. 460.)

" The use of opening the basilic vein is to take blood from the parts
near the thorax and abdomen in those diseases whose seat is lower
than the throat and neck." (p. 472.)

» De Febribu9f p. 278. ed. Bernard.

* Cofupect. Medic, ii. 1., in Ennerins, Aneed, Med, Graeca, p. 109.
■» torn. L p. 32. 1. 16 : 31. 44 : 32. 7.

* De CAirwr^. pp. 460, 472, 494.

* Pract. ix. 3. in MS. Arab.

' In the English text, for innevt read median.
7 ii. 95. p. 460 sq. ed. Arab.


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" The use of opening the median vein is to take blood from the
upper part of the head and the lower part of the body, because this
vein (as we have said,) is composed of a branch of the basilic and a
branch of the cephalic." (p. 474.)

" The use of opening the cephalic vein is to take blood from the
head." (p. 474.)

In the Arabic MS. of Bhazes, at Ley den, some words are omitted
in the text, which are written lengthways in the margin, and of which
one half of each letter has been cut off when the volume was rebound,
so as to render the whole clause almost illegible. Accordingly these
words are omitted and unnoticed by Stack ; and Channing (who never
had an opportunity of examining the Leyden MS. himself,) has stated
the fact, and endeavoured to supply the omission by the help of the
Greek Translation, which is as follows: — &pi<rTov be licx^iv lie rov
fiiaov kyKuivoSy ^ Ik twv izapai^vahtav tovtoV el h* a^ai^s cii?, iK Tfjs
€¥roi 0Xe/3os* el hk koX airri d^ar^s, ^k rfis KpavtaKfjs. Here we have
the distinct mention of three veins, in the words eic rod ftiaov'iiyKwvos,^
kK r^s kvTot ^Xc/Sos, and eic rfis KpaviaKfls, answering respectively to
the median, banlic, and cephalic; but the Greek Translator differs from
the Arabic text in recommending the median vein to be opened in
preference to either of the others,^ instead of the basilic. Channing
translates the whole passage thus : — " Porro optimum erit, si ex vena
basilica, vel quodam ejus ramo detraxeris ; quodsi haec occultetur, ex
interiore vena ; quodsi haec etiam non appareat, ex cephalica." This
is clearly wrong, as Channing means to speak of three veins, but does
in fact mention only two, the " vena basilica" being the same as the
" interior vena," as we know perfectly well, and as is plainly stated
in the first sentence quoted from Albucasis. By help of the context,
however, the mutilated words in the margin of the Arabic MS. can be
made out with tolerable certainty, and it appears most probable that

the last word is /V^^ ^\ AUachal, the term used by Albucasis,

Avicenna,^ and Haly Abbas,* to signify the median vein, which agrees
with the Greek translation, and is required by the sense. In this,
however, as in many other passages, the Venice MS. would probably
afford much assistance.

> In the sentence immediately following the quotation in the text, this vein is
called stiU more plainly, ri ikkcri.

« The quotations from Albucasis tend to support the Arabic text on this point,
rather than the Greek translation.

3 vol. i. p. 32. 1. 10, 16, 17 289. 32 : 588. 6.

* Pract, ix. 3, in MS. Arab.


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(Note M. p. 45.)

The Arabic name is ^^Ltf3\ As-sdfin, which is the word used by

Avicenna,^ Haly Abbas,^ and Albucasis,^ and is of course the same as
Saphena, It is commonly said to be a Greek word, or of Greek origin ;
but (as far as the Writer is aware,) it is not to be found in any Greek
author, and the deriyation from aa^r/s, or aafrivris, is (to say the least,)
extremely doubtful.

(Note N. p. 50.)

Channing here quotes from Casiri * a passage on the weights in use
among the Orientals, taken from an anonymous Arabic MS. in the
Escurial Library; but, as this extract is by no means sufficient to
exhaust the subject, (which is somewhat complicated and difficult,)
and as to discuss it completely would require greater details than most
of the readers of this book would care to find here, it has been thought
better merely to state that the Translator has used in the text the same
terms as Stack and Channing ; which, though perhaps none of them
exactly correspond with the weights designated by the same names
among ourselves, are yet sufficiently accurate and definite for our

(Note 0. p. 52.)

The Arabic word . Vc^i cwA^ has been retained in the text because
(spelled as it is sometimes, Kokol, Kohhl, Kohl, &c.) it is doubtless
familiar to many English readers. Ibn Baitlr says ' the word signifies

a black eye-salye in general, composed for the most part of 4X^3 1
Ithmid, or antimony. Dr. Russell's account of this substance, and
the mode of using it at Aleppo, is as foUows : — «

» vol. i. p. 32. L 48 : 106. 15.
a Pract. ix. 3, in MS. Arab.
3 Ve Chirurg. pp. 460, 486.

* BibUoth. ArabicO'Hisp. Escur, torn. i. p. 281.

* vol. ii. p. 351.

« NaL Hist, of Aleppo, vol. i. pp. Ill, 366.


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" Another uniyersal custom among the women, is blacking the inside
of the eyelids, by means of a short smooth probe of ivory, wood, or
silyer, charged with a powder named the black Kohol, The probe
being first dipt in water, a little of the powder is sprinkled on it ; the
middle part is then applied horizontally to the eye, and the eyelids
being shut upon it, the probe is drawn through between them, leaving
the inside tinged, and a black rim all round the edge.

" Kohol . V^^o is a general term for a medicine applied to the

eyeball, or the inside of the eyelids, in the form of a powder finely
levigated. That which is employed for ornament, is called simply

AUkohol Y . j^^lio 1 J or Isphahany Y ^\.^JLo\ J ; when other

ingredients (as flowers of olibanum, amber, or the like,) are added,
on account of particular disorders, the kohol is distinguished by some
appropriate epithet.

"The substance used at Aleppo for the ordinary kohol, is a kind of
lead ore brought from Persia, and is prepared by roasting it in a
quince, an apple, or a truffle ; then adding a few drops of oil of
almonds, it is ground to a subtile powder, on a marble. But of late
years the lead ore brought from England, under the name of Ardfoglio,
has been used instead of the Isphahany.

" The quantity of kohol consumed in the East is incredibly great.
It has been said by one of their poets, in allusion to the probe used for
applying the powder, and the mountains where the mineral is found,
* That the mountains of Isphahan have been worn away by a bodkin.'

"The probe or bodkin for the kohol is called L/ \ - ^ J ^^^^* ^^^ ^
of different sizes, from that of an ordinary quill downwards. It is straight,
but tapers a little, and is blunt at the point. If I am not mistaken, I
have seen some of ivory, found at Herculaneum, which very nearly
resembled those now used in Syria.

"The mineral used for the kohol is, by the Arabs, called Ithmed
(\^ \ or Isphahany ^\.g.i^b and is no doubt the stibium of the

Greeks : but it may be doubted whether by J.ri/jifii was always under-
stood what is now called antimony.

" Pure or crude antimony is not at present used at Aleppo for the
kohol, and probably never was. The substance most in request was

formerly the Isphahany ^l^JL^u evidently a lead, not an antimonial
ore : and it has already been remarked that large quantities of common
English lead ore have been imported to Aleppo, as a substitute;

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Isphabany having become scarce and dear. I have examined many
specimens of the antimonial and lead ores in the English collections,
bnt never saw anything resembling the antimonial ore in Syria.

" The En^ish antimony, in its native state, on account of particles
of lead ore being sometimes mixed with it, is thought to be less fit for
medicinal use. But this, with respect to the kohol, would be no ob-
jection ; for both Dioscorides and Pliny assert that stibium exposed in
the preparation, to too strong a heat, turns into lead.^ In the sub-
stance used at present for the kohol there is no mixture of antimony.

"The use of the kohol is of very ancient date. Passages relative to
it, in Sacred History, may be seen in Shaw,^ Harmer,^ and Bishop
Lowth's notes on Isaiah, iii. 16.

"The following passage from Naumachius* records the early prac-

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