BOOK VII.

1. _Physician makes a wound._) An English reader may naturally suppose that the term should be _surgeon_; but as our author here uses the word _medicus_, I did not think myself at liberty to depart from it; especially as his not using _chirurgus_ was from choice, since this word occurred in the preceding paragraph. Celsus supposes an accomplished physician acquainted with all the branches.

2. _Nevertheless, it is not right to trust, &c._) In this translation I have followed Linden and Almeloveen. But the reading in most of the old editions, as Nicolaus, Pinzi, Junta, Aldus, Gryphius, &c. is _Neque tamen fas non est nihil cucurbitula agere_; that is, ‘Yet it is not an inviolable rule always to employ the cupping-vessel.’ Which I must own, appears most agreeable to the sense of this place; because our author immediately proceeds to consider a case, in which cupping can be of no service. See Morg. Ep. vi. p. 151.

3. _Even before the suppuration is formed._) I have here followed the old reading, _tum pure quoque maturior hæc interdum esse consuevit_, which seems to agree better with our author’s reasoning; for as he had just blamed Meges for introducing the new term _callus_ instead of _tunica_, without necessity; so he adds, that he was mistaken also in believing that it was never found but inclosing an old collection of matter. He on the contrary says, that it sometimes appears before the generation of pus. Linden and Almeloveen read _tum, pure quoque maturiore, hæc interdum esse consuevit_; that is, ‘And this is found, even when the suppuration is more ripened.’ Whether the connexion of this with what went before be natural, the reader may judge for himself. I do not know but these learned editors may have put another sense upon _maturiore, when the suppuration is sooner ripened_: which would be pretty much the same with the old reading. However the first is preferred by Morgagni, Ep. vi. p. 152.

4. _Lest convulsions follow, which may debilitate, &c._) This translation is agreeable to the reading in Linden and Almeloveen; but all the older editions read thus, _ne vel distendantur hi, vel membrum debilitent_; i. e. ‘Lest either convulsions follow, or the limb be disabled.’ And this appears the more probable, as one of them might happen without the other following. And so it is quoted by Fabricius ab Aquapendente.

5. _And some again require a wound, &c._) _Jamque alia rectam plagam desiderant, ut in carne: alia vero vehementer cutem extenuant, in quibus tota ea super pus excidenda est._ There are several variations in the reading of the copies of this paragraph, but they do not remove the difficulty. Morgagni[JO] very ingeniously conjectures, that after Celsus had considered such as were quite mature, he next mentioned such as were not quite ripe; and did not talk here of cutting off the whole skin, because he afterwards says, _Est etiam in rerum natura, ut cutis latius excidenda sit_; and that what is here said of the skin being extenuated, was repeated from above by carelessness. All the old editions and MSS. have _itemque_ for _jamque_; none of them _ut_; the MS. _tuto_ for _tota_. Upon the whole, he seems inclined to read it thus: _Itemque alia rectam plagam desiderant in carne; in quibus tuto ea super pus incidenda sit_; i. e. ‘Others again require a wound in a straight direction in the flesh, in which it may be proper and safe to make an incision above the pus.’

[JO] Ep. vii. p. 181.

6. _Crude lint._) Fabricius ab Aquapendente and Rhodius take this crude lint to be such as has not been boiled in a lixivium.

7. _Loosing this knot. Soluto nodo._) Morgagni[JP] here prefers the old reading, _salvo nodo_, _without loosing the knot_, for this reason, that our author immediately orders the knot to be loosed every third day, for changing the string. And thus also it is quoted by Aquapendente, De chirurg. operation. cap. 93.--Celsus has here followed Hippocrates, Lib. de fistul. where he orders the string to be drawn and twisted every day, as much as it is loosened by the putrefaction of the fistula; but he says nothing of untying the knot every day. The difference is not material; for if _salvo nodo_ be the reading, the string must be made tighter in the manner Hippocrates directs. According to the reading of Linden, the method is plain, nor does it seem to be attended with any difficulty; for it is untied twice a day to move the ligature; and also untied every third day, for the sake of introducing a fresh ligature, because the old one must not be suffered to rot.

[JP] Ep. vi. p. 151.

8. _A very small habenula may be cut out._) Linden and Almeloveen read here, _habenula tenuis admodum injiciatur_, which I think has no proper connection either with what goes before or follows. It is true, Aquapendente has given two explications of this passage, according to the same reading, De chirurg. operat. cap. 93. Neither of which appears to me consistent with the reasons Celsus gives for this method: I have therefore chosen to follow Nicolaus, Pachel, Pinzi, Junta, Aldus, and others, who have _ejiciatur_ for _injiciatur_, which seems to clear up the difficulties of this place.--Our author uses _habena_ often for a strap; but by _habenula_ here he must understand a small slip or stripe of flesh.

9. _Gum_ in this place (_pituita_) must signify a purulent fluid.

10. _Like a spatha._) A knife was said to resemble a spatha, when it ended in an acute point with sharp edges on both sides, which our author mentions chap. x. for the excision of a polypus in the nose.--The needle here described is thin and broad, so that it was more like this instrument than a common needle. Vid. Fabric. ab. Aquapend. de Oper. Chirurg. cap. 107.

11. _Of the colour of wax._) I have here departed from the reading of all the copies, and instead of it admit the correction of Mercurialis _cereus_ for _cæruleus_, which is approved by the best judges, and seems to be confirmed by its affinity to the gold colour immediately following. Vid. Mercurial. Var. Lect. lib. v. cap. 5. & Le Clerc. Hist. de la Medicine, p. 2. liv. 4. sect. 2. chap. 5.

12. _The needle sharp pointed, but not too slender._) The reading in Almeloveen is _Tum acus admovenda est, aut acuta, aut certe non nimium tenuis_. As I could find no sense from this reading, or any other that is proposed, I have taken the liberty to read thus, _Tum acus admovenda est acuta, at certe non nimium tenuis_.

13. _With timidity._ _Timide._) Though this reading may be defended, yet as what our author adds of the needle finding no resistance should make an operator more cautious, it is possible he wrote _temere_.

14. _Below the bone._) I have here followed the old reading _sub osse_, and not as Almeloveen has it _ab osse_, which plainly appears to be erroneous by what our author says, when he mentions this species again, _Manifestum sub osse descendere_.

15. _Humour still flows._) Here is a manifest error in Linden and Almeloveen, who read _tumor_ instead of _humor_, which all the old copies have. Morgagni, ep. 5. p. 150.

16. _And therefore cannot be separated._) In the original _Ideoque legi non possunt_. Our author here barely mentions the _lectio venarum_, and a little below speaks of it as a distinct operation in these words, _Sed nihil melius est, quam quod in Gallia quoque comata sit, ubi venas in temporibus, et in superiore capitis parte legunt_. In the conclusion of the chapter he promises a full explanation of it, when he comes to the varices of the legs. The place he refers to is the _31st_ chapter of this book, where the reader will find, he does not once use the word _lego_ through the whole: not that he forgot it, for he puts us in mind of this very passage in the beginning: _Huc autem et earum venularum, quæ in capite nocent,--curationem distuli_; he then proceeds to describe two methods of cure by the actual cautery, and excision. In the first process I find nothing applicable to _lego_, there as well as here, cauterizing being quite a different thing; but in the second, namely the excision, the veins are separated from the contiguous parts, and are taken up by several blunt hooks, at the distance of four fingers breadth from each other, then, one of these hooks being raised, the vein is cut through and pulled away: so in all the rest (the terms are _Excipitur_, _diducitur_, _attrahitur_, _evellitur_, _rursus abscinditur_.) Now from the various senses, which _lego_ bears in the classics, it seems without a strain capable of signifying any step of this operation. And as it is not uncommon among the ancients to include several known consequences under one term, I must own it appears to me our author intends them all, when he uses the word _lego_ in this chapter.

17. _Through what remains._) Instead of _super est_ in Linden and Almeloveen, which seems to be directly contrary to our author’s meaning, I read in one word _superest_, with the older editions.

18. _Defects in these three parts, if they be small, &c._) Linden and Almeloveen read _Curta igitur in his tribus, ac si qua parte parva sunt, &c._ The more ancient editions have _Ac si qua parva paria sunt_; neither of which seem to give the author’s meaning. I cannot help thinking the whole passage should run thus. _Curta igitur in his tribus, si qua parva sunt, curari possunt: si qua majora sunt, aut non accipiunt curationem, &c._ For neither _paria_ nor _parte_ appear to be at all proper after what was said in the conclusion of the last chapter, where he expressly confined these defects to the three parts abovementioned. I have therefore ventured to translate according to that reading; a liberty however I durst not take without advertising the reader.

19. _Sometimes however the skin--left deformed._) I have here translated according to the reading of Linden and Almeloveen, from which I find no other variety than that of _autem_ for _tamen_. But this observation by no means agrees with the general rule contained in the next words, _Hujusmodi loci altera pars incidenda, altera intacta habenda est._ If we are allowed to reject _haud_, it will run thus: _Sometimes however it happens, that to draw forward the skin on one of the sides, would effectually disfigure the part it has left._ This sense appears quite consistent both with the general rule, _Hujusmodi loci, &c._ and its application, _Ergo ex imis auribus, &c._

20. _Two regulæ._) _Regula_ is commonly taken for a ruler. Our author himself directs a single regula to be applied to a fractured bone, where there is a protuberance, to keep that down, Lib. viii. cap. 10. In this place he mentions the end proposed by them. It seems probable that they were two pieces of wood fixed together by a hinge, and used in the same manner as farriers use the instrument by them called barnacles.

21. _In two lines._) Instead of _duæ tunicæ_, I read here with Nicolaus, Aldus, Stephens, and others, _duæ lineæ_.

22. _Small glands_, _Glandulis_.) Most of the old copies have instead of this word, _medullis_. But Aquapendente in quoting this place, follows the same reading with Linden and Almeloveen.

23. _The coats however, &c._) I have here followed the old reading _tunicæ_, for _tunicarum_ in Linden and Almeloveen. According to which the translation would run, ‘They (_the testicles_) are pained however in wounds and inflammation of the coats, which contain them.’--Which must appear quite inconsistent with what our author had said the line before, so that Morgagni[JQ] very properly asks how they can be void of all sensation, and yet be pained in diseases of their coats?

[JQ] Ep. v. p. 135.

24. _By an assistant._) I read _ministro_ instead of _sinistro_, which is in Linden.--See Morgagni, Ep. vi. p. 147.

25. _Sometimes upon account of their health._ _Interdum valetudinis causa._) Some of the older editions insert before this, _Interdum vocis_, _Sometimes on account of their voice_. I do not know how this came to be dropped afterwards: for it is certain this was one very common reason for infibulating.

26. _Sticks where that grows narrower._) In Almeloveen and Linden, _Nonnunquam etiam prolapsus in ipsam fistulam calculus, qui subinde ea extenuatur._-----Which I think is capable of no sense, and have therefore taken the liberty to follow Morgagni’s conjecture _qua_ for _qui_. Ep. i. p. 38.

27. _Being first slightly anointed with oil, &c._ _Leniter prius unctos oleo simul in anum ejus demittit._) The old editions, without any mention of the oil, have, _Leniter prius unum deinde alterum in anum ejus demittit_; that is, _Introduces gently the fore and middle fingers, first the one and then the other_.

28. _Come out prone_, that is, _with its end foremost_, _ut pronus exeat_.) This Constantine changed in the margin into _Ut ne pronus exeat_, which Linden received into the text. Constantine explains _prone_ by lying on its side, and says it is hardly possible to extract an oblong stone in that posture, supposing, no doubt, that it must necessarily lie across the orifice. See Morgagni, Ep. v. p. 128.

29. _Then in that part where the bottom of the wound is straiter, &c._ _Deinde ea parte qua strictior ima plaga est._) Thus all the printed copies read. This passage has given rise to a variety of opinions on the nature of the first and second wound: some imagining that the first, which is called the lunated incision, was concave towards the rectum; others, on the contrary, from the word _coxæ_ being used for the ilia as well as the ischia, believed it was concave towards the scrotum.

Then, with respect to the transverse incision made through the neck of the bladder, some have thought that the word transverse was used as it regarded the first wound, so that the second incision was nearly perpendicular to the first, and the urethra was divided longitudinally; others again have supposed, that the incision was made transverse, with regard to the course of the urethra, that is, the neck of the bladder was opened transversely.

Though all the printed copies agree in the above reading, yet Morgagni informs us that instead of _Qua strictior ima plaga est_, his ancient MS has _Qua resima plaga est_, which would determine the convexity of the lunated incision to be towards the rectum; because in that case the cornua of the lunated incision would point to the superior part of the body. But this reading does not fix the direction of the _plaga transversa_, whether it was called so in respect of the parts, or the first incision: nor does that ingenious author favour us with his own opinion, but seems to prefer this to the common reading. Ep. vii. p. 189.

Now it should seem almost certain, that the lunated incision was meant to be concave towards the rectum; because when made in that direction, it would probably render the rectum much more loose and supple, than it is in its natural state, and thereby greatly facilitate the operation, by allowing the surgeon a much freer use of the two fingers, which are introduced into the rectum, and consequently admitting him to bring the stone more easily forwards into the neck of the bladder. One would suppose, however, that the benefit here suggested to arise from this lunated incision, was not extremely evident, or it would not have been dropped so early by succeeding surgeons: Ægineta makes not the least mention of this process, nor do we know when it was first discontinued. Perhaps, even in Celsus’s time, there were different methods of performing this operation; for does not he himself, when describing Meges’s manner of cutting upon a rough stone, omit the lunated incision? And does he not imply that there were different methods by saying, _Quocunque autem modo cervix ea parte secta est_, &c.?

With regard to the _transversa plaga_, it should seem by the use of that term, when he describes the manner of cutting women, that it was transverse with respect to the perineum; and indeed, it is natural to suppose, when the stone was brought forward by the fingers, and the neck only of the bladder was to be cut, that the incision should be made in that direction. But those, who contend that the _transversa plaga_ was made transverse with respect only to the first incision, may urge, that Celsus in this very passage orders the incision of the neck of the bladder to be made so large, that the opening in the _iter urinæ_ may exceed the dimensions of the stone. If, therefore, Celsus in this place intends that the urethra should be opened, one would suppose the incision must be made according to the length of that canal; but I believe it may be questioned, whether Celsus is sufficiently accurate in his notions of the anatomy of these parts, to determine his meaning by that expression.

It is very remarkable, that how much soever this operation of Celsus’s may have engaged the attention of later ages, neither Galen, Oribasius, nor Ægineta make the least mention of his method: nay Ægineta (lib. vi. cap. 60.) describes the cutting on the gripe nearly as it has been practised in our own age.

30. _A crotchet_, in the original _uncus_.) Our author here describes the instrument he mentions, and as the use is the same, and the form not very different from that once employed by modern surgeons, I have taken the liberty to use their term. But the reader will please to observe, that this _uncus_ is different from that mentioned in chapter xxix. used in extracting a dead fœtus.

31. _On the external part smooth._) As the ancient editions have _exteriori_, which is made extremely clear by our author’s description, _Qua corpori jungitur_, it is hardly worth while to observe that _interiori_ in Linden must be an error of the press.

32. _Knees._) Other copies have _inguinibus_, instead of _in genibus_.

33. _Which by pressing upon the bladder._) Instead of _Atque vesicam urgendo_, in Linden and Almeloveen, I read _Quæ vesicam urgendo_, with Nicolaus, Pachel, Pinzi, and several other old editions.

34. _Into the anus._ _In anum._) This is the reading of all the copies, which I have seen; but it is highly probable our author wrote _colem_ for _anum_. For as I see no propriety in introducing a pipe into the anus, so in the very case before us, a catheter in the urethra, is at present esteemed the best method of cure.

35. _Sore places._) It appears that in this place, Celsus uses the word _cicatrix_ for a wound as well as a scar, of which I do not remember another instance in his work.

36. _Which are brought to digestion._) I have here followed the old reading, _in quibus pus moveri debet_, because I think it more agreeable to our author’s practice.----Constantine had inserted _non_, in which he was followed by Linden and Almeloveen; he supported his correction by referring to p. 290. lib. 5. in the original, where Celsus gives directions about a hæmorrhage from wounds; but I own I can see nothing there to incline me to his opinion.

NOTES

TO