I was anxious to ascertain the nature of the tumour and a few other particulars, which Dr Fuller was so good as to give me in the following note: I have much pleasure in replying to your queries respecting the case of encephaloid disease reported in the last vol. of the Transactions of the Pathological Society. The tumour was not examined microscopically; for I performed the post-mortem examination only a short time before the meeting of the society, and from some mismanagement, I was unable to regain possession of the preparation when I sent for it on the following day. My other answers however, are more satisfactory. The poor child had frequent hemorrhage from the bowels, the nates, and the mucous membrane lining the trachea and bronchi; her gums, too, were spongy and bled occasionally. There was no enlargement of the mesenteric glands, or of the lymphatic glands in any part of the body; but she had great irregularity of bowels, which were occasionally relaxed but more generally costive. I have now discovered this condition of the blood in six cases,-four of which were cases of enlargement of the spleen, unconnected with ague or malarious influence. One was the case of encephaloid disease reported in the 'Pathological Transactions,' and one a case which I have now lost sight of,-of a tumour, still apparently solid and immoveable, situated on the left side of the epigastric region, which may possibly have been an enlarged spleen. This case, however, when I was watching it, about three years since, was in its early stage. The patient, a married woman, was apparently in good health; her digestive functions had not materially suffered, nor had her gums become spongy, nor had she had hemorrhage from any of the mucous membranes. Much difference of opinion existed among those who saw her as to the nature of the tumour; and this it was which induced me to examine the condition of the blood. The colourless corpuscles were not at that time numerous, but they were of very large size." CASE XI.1-Leucocythemia detected after Death.-Hypertrophy of the Spleen. The spleen measured about fourteen inches in length, and four or five in depth. Its structure was extremely dense, exhibiting, on section, a beautiful mottled appearance; but under the microscope presented no obvious deviation from the normal character. It was taken from a strumous subject. The heart was quite healthy. A peculiarity of the case was the fluidity of the blood after death, and the presence in this fluid of a large number of granular, irregular, spheroidal bodies, twice or three times the size of the blood corpuscles. This was the second case that had come under the notice of Dr Chambers, in which the post-mortem phenomena were analogous." The eleven cases now given are all those, so far as I can discover, which have yet been published. I have heard, however, of others, and entertain some expectations that my professional friends will kindly allow me to publish some of them in continuation of the present series. (To be continued.) 1 Proceedings of the Pathological Society of London. First Session, 1846-7. ARTICLE VII.-Notices of Ancient Roman Medicine-Stamps, &c., found in Great Britain. By J. Y. SIMPSON, M.D., Professor of Midwifery in the University of Edinburgh. MANY years ago Schmidt, in his work on the Antiquities of Nimiguen,' published an account of two small, thin, greenish-coloured, square-shaped stones, both of them engraved with intagliate inscriptions on their four sides or edges; but he failed in making out the nature of the inscriptions, or interpreting the object and uses of the stones. 3 Subsequently, Spon,2 Chishull, Caylus, Saxe," and Walche," published accounts of other stones exactly similar in their character to the two found at Nimiguen; and it came to be generally admitted, that the nature of the inscriptions upon them, the incuse and retrograde form of these inscriptions, and the localities in which they were found, all proved the stones to be medicine-stamps, employed for the purpose of marking their drugs, by the Roman doctors, who (some fifteen or sixteen centuries ago) practised at the various stations throughout Europe, that were in these olden times occupied by the colonists and soldiers of Rome. Latterly, various additional examples of these Roman medicine-stamps have been discovered, at different old Roman towns and stations in France, Germany, &c., and described by Tochon,' Sichel, Duchalais, and others. These medicine-stamps all agree in their general characters. They usually consist of small quadrilateral or oblong pieces of a greenish schist or steatite, engraved on one or more of their edges or borders. The inscriptions are in small capital Roman letters, cut intagliate (like the letters on modern seals and stamps), and consequently reading on the stone itself from right to left, but making an impression (when stamped upon wax or any other similar plastic material), which reads from left to right. The inscriptions themselves generally contain, and that engraved on each side, first, the name of the medical practitioner to whom the stamp pertained; then the name of some special medicine, or medical formula; and lastly, the disease or diseases for which that 8 1 Antiquitates Neomagenses, p. 98. 9 Letter in Preface. 4 Recueil d'Antiquités, tom. i., p. 224, and tom. vii., p. 261. 5 Christophori Saxii Epistola de Veteris Medici Ocularii Gemma Sphragide, prope Trajectum ad Mosam eruta. 1774. 6 Antiquitates Medica Selectæ. Jena, 1772. ? Dissertation sur l'Inscription Grecque IACONOC AYKION. Paris, 1826. 8 Cinq Cachets Inedits de Médécins-Oculistes Romains. Paris, 1845. To my friend, M. Sichel, one of the most learned of living physicians, I am much indebted for various valuable suggestions in collecting the materials for the present essay. 9 Observations sur les Cachets des Médécins-Oculistes Anciens, à-propos de Cinq Pierres Sigillaires inedites. Paris, 1846. medicine was prescribed. But sometimes the first and last of these items are omitted, and the stamps present merely the appellation of the medicine alone; and occasionally the modes and frequency of using the medicine are added. To this brief description one more curious fact remains to be added,—namely, that in almost all, if not in all, the Roman medicine-stamps hitherto discovered, the medicines inscribed upon them are drugs for affections of the eye and its appendages; and the diseases, when specified upon them, are always ophthalmic diseases. Hence it may, with great probability, be concluded, that either these stamps were used by oculists alone, or they were used by the general medical practitioner in marking his eye medicines only. Some authors, on this account, have described them under the designation of Roman oculist-stamps. The number of the stamps that have already been discovered amply proves that ophthalmic diseases must have been extremely frequent in the sites of the old Roman colonies spread throughout western Europe; and although only one or two such oculiststamps are as yet described as having been found within the bounds of Italy itself, yet the frequent references to individual oculists at Rome 2 by Celsus, Galen, and others, and the elaborate descriptions of eye diseases left us by the various Greek and Roman medical authors, who practised in the Eternal City during the time of the empire, sufficiently testify to the fact, that these diseases were also sufficiently common in the Roman capital, and that many of the fellow-citizens of Horace could probably personally apply the wellknown description which the poet gives of himself, Hic oculis ego nigra meis Collyria lippus Illinere. Galen, Celsus, Aetius, &c., all describe the different diseases of the eye with care and minuteness; and the Roman practitioners had evidently studied these affections, and their specific distinctions, with great attention. In modern times medical literature has been enriched with more complete and elaborate monographs upon the diseases of the eye, than upon the diseases of any other single organ of the body. But, perhaps, few of these monographs describe a larger 1 The two found in Italy have been discovered, the one at Sienna, the other at Verona. See Muratoris' Thesaurus Inscriptionum, D. viii. 4; and Maffei's Museum Veronense, p. 135. 2 Among the ancient Egyptians the medical practice seems, according to Herodotus, to have been subdivided, some three thousand years, into more specialities than we even have at the present day. "The art of medicine is (says he) thus divided amongst them: Each physician applies himself to one disease only, and not more. All places abound in physicians, some physicians are for the eyes, others for the head, others for the teeth, others for the parts about the belly, and others for internal disorders."-Cary's Herodotus, Enterpeii., § 84, p. 125. Most of the old Roman medical authors mention "medici ocularii," ," "medici ophthalmici," in such terms as to show that the department of eye diseases was cultivated by some medical men as a speciality of practice in their time. number of ophthalmic diseases than was professed to be known and discriminated in the times of Galen. This author, in the 16th chapter of his book, entitled "Introductio seu Medicus," enumerates not less than one hundred and nineteen diseases to which the eye and its appendages are liable. In the management of these diseases of the eyes, the Roman practitioners used, as their writings show, bleeding, scarification, and other appropriate constitutional and local treatment. But the practical part of their treatises, referring to ophthalmic affections, is specially loaded with collyria-professedly of use in almost every stage of every disease of the eye. Galen speaks of Asclepiades, describing in his works a perfect forest of collyria (collyriorum silvam). In his book "De Compositione Medicamentorum secundum Locos," Galen has himself left us formulæ for upwards of two hundred of the ancient collyria. Aetius gives as great, if not a greater, number. The "Opus de Compositione Medicamentorum" of Myrepsus, contains recipes for eighty-seven ophthalmic collyria; and the works of Scribonius Largus, Celsus, Actuarius, Alexander Trallianus, Marcellus, Paulus Aegineta, &c., present us with abundance of formulæ for the same class of preparations. These collyria were composed of very various,' and in some instances, of very numerous ingredients. But most of them which had attained any great degree of reputation, seem (like the compound formulæ, or prescriptions in our modern pharmacopoeias), to have each passed under a short specific name, by which they were, no doubt, readily and generally recognised by the profession, and perhaps also by the public, in these ancient times. The specific appellations of the individual collyria were derived from different sources. Some of them were known under the names of the oculists who invented or employed them. Thus Galen gives recipes for the collyria of Asclepiades, of Philoxenis, of Capiton, of Zoilus, of Antonius Musa, the collyrium of Sergius, the Babylonian oculist; and many others. Occasionally the appellation under which the collyria were known was derived from some of their more marked physical properties, as the "collyrium Chloron appellatum," from the green In the following passage Galen tersely enumerates the very varied general ingredients, and general therapeutic effects, of the numerous collyria used by the Roman practitioners of his day" Nam et liquores, et succi, et semina, et fructus, et plantarum particulæ, ocularibus compositionibus induntur, veluti etiam non pauca ex iis, quæ metallica appellantur; aliqua quidem extreme austera, et acerba, atque acria; aliqua vero his moderatiora et tamen fortia; quemadmodum item aliqua omnis mordacitatis expertia, ac lenissima per lotionem addita."-De Compositione Medicam: Secundum Locos, Cap. I. 2 Celsus, in the same way, enumerates and describes the collyria of Philon, of Dionysius, of Cleon, of Theodotius, of Euelipedes (qui ætate nostra maximus fuit ocularius medicus), of Nileus, of Hermon, &c. NEW SERIES.-NO. XIII. JANUARY 1851. F σμυρηα, colour of the preparation; the Cirrhon, from its yellowish tint; Euchron, from its agreeable hue (a colore bono dictum); the collyrium Cygnus, from its white or swan-like hue. One was termed Aromaticum, from its odour, and so forth. One or other of the principal ingredients entering into its composition seems to have given the name under which other collyria were known, as the Nardinum, from its containing spikenard; the collyrium Diasmyrnes (dia with, and σuvpna, myrrh), from its containing myrrh; the Diarrhodon, from its containing roses, &c. Occasionally the collyrium seems to have derived its name and fame from some great person whom it had been fortunate enough to benefit or to cure. Thus, for example, Galen gives a recipe for the collyrium which Phlorus used in the case of Antonia, the mother of Drusus; the "collyrium harmatium," which king Ptolemy used, &c. One was termed Achariston, from its cheapness: and this collyrium repeatedly occurs on the oculist-seals. Another was termed Atimeton, from its supposed great value. But perhaps the most common mode of appellation was the use of some recommendatory name, advertising the supposed high qualities of the drug. Thus the old Greek and Roman authors give various species of the collyrium Monohemeron,―so named from its being alleged to effect a cure in a single day; others are designated the Miraculum, the Mysterium, the nectar collyrium (Nectarium); the royal Indian collyrium (collyrium Indicum regale); the golden (Isochryson); the divine (Isotheon) &c., &c. And lastly, a collyrium was often known under some high sounding but unmeaning name, such as the collyrium Olympus, Proteus, Phoenix, Phynon, the "collyrium nominatum Sol," &c. Under such designations the principal collyria of the Roman oculists were known and used (like the one invented and boasted of by Galen) "per omnes gentes quibus imperant Romani ;" and it is under such special appellations that we find these different collyria mentioned in the inscriptions engraved upon the old oculist-stamps, and scattered among the ruins of their ancient colonial stations. Above sixty Roman oculist-stamps have been now discovered in different parts of western Europe, but particularly in Germany, France, and Holland. Some time ago one was found about ten miles east of Edinburgh; and it is principally with the view of describing this and the other specimens that have been detected in Britain that I have drawn up the present imperfect notes. I have been the more induced to do so because this Scottish stamp is remarkable, both as being found on almost the very frontier of the ancient Roman empire, and as being one of the most perfect yet discovered. Besides, I entertain a strong hope that a notice such as the present, in a Medical Journal, may perhaps be fortunate enough to lead, 1 Appellantur talia a medicis collyria libiana et cygni, ob colorem quidem album.-Galen. de Compos. Med: Secundum Locos, Cap. I. |