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The causes of difficult labor, according to Gilbert, are malposition, dropsy, immoderate size and death of the fetus, debility of the uterus and obstruction of the maternal passages. Adjuvant measures are hot baths, poultices, inunctions, fumigations and sternutatories, and the use of certain herbs.
During the first nine days the trouble had extended to the thighs, but only shortly before the examination had it attacked the arms. Inunctions of codliver oil were at first used, but with little improvement. Blue ointment was substituted, and improvement commenced. As the induration cleared up, outlying patches of the affected skin were left surrounded by normal integument.
To the homely altars, erected originally by sacred fountains in the neighbourhood of health-giving mineral springs, were later added magnificent temples, pleasure-grounds for festivals, gymnasia in which bodily ailments were treated by physical exercises, baths and inunctions, also, as is proved by excavations, living rooms for the patients.
Besides diet the Hippocratic physician had at his disposal a considerable variety of other remedies. Baths, inunctions, clysters, warm and cold suffusions, massage and gymnastic, as well as gentler exercise are among them.
Gilbert's medical treatment of vesical calculus consists generally in the administration of diuretics and lithontriptics and the local application of poultices, plasters and inunctions of various kinds. Of the lithontriptics, certain combinations, characterized by famous names or notable historical origin, are evident favorites.
The mouth of the patient is to be kept open by a wooden gag, a bandage passed beneath the jaw and held by the physician, who places his feet upon the shoulders of the patient and pressing down upon them while he elevates the head by the bandage, endeavors to restore the displaced bone to its normal position. Inunctions of various mollitives are then useful.
Or, which is safer and better, having used the preceding fomentations and inunctions, and having assured yourself that there is a stone in the bladder, introduce your fingers into the anus and compress the neck of the bladder with the fist of the left hand above the pubes, and cautiously remove the stone and guide it to the fundus.
It is entirely possible in a given case of syphilis to accomplish by a sufficient number of inunctions everything that mercury can accomplish, and with the least possible damage to the body. Treatment by mouth cannot compare with inunctions and cannot be made to replace them, when the only objection to the rubs is the patient's unwillingness to be bothered by them.
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