Book on Rules Regarding the Practical Part of the Medical Art

He said: My honorable master, the Pillar of Faith (may God protect him), enjoined me to compose a treatise on rules regarding the practical part of medicine using concise aphorisms. I carried out his command (may God grant him lasting happiness), and I followed the path whose goal came [to fruition] in writing it. I had intended, at the time that I wrote the treatise on the [illness] my master was suffering from [asthma], to put these aphorisms together with what was [in the treatise On Asthma], but I was prevented from doing so by illness and [thus] did not carry out [my intention] at that time. Now, however, I will begin [to do so], God willing.

(1) The first thing to consider is the improvement of the air, then the improvement of the water, and [then the improvement of] foods. [ . . . ]

(4) Pay attention to the preservation of health through exercise, massage, bathing, and other means that strengthen the organs, expel their residues, and preserve their temperament. [This holds good] especially for the major organs and for those organs that carry out an activity in the body that is of major importance, such as the heart, liver, stomach, and brain. These kinds of organs need more attention than the other ones. [ . . . ]

(75) If you want to stop a hemorrhage, you should first of all put a medicine on it that stops the bleeding; then apply a bandage and observe: if it still bleeds a little bit, you should not untie the bandage; but if it bleeds a lot, you should untie the first bandage and repeat this procedure after you let the patient rest for a little while. You should leave on the bandage until the third day, then untie it gently, and if you find the medicine [still] adhering to the wound, you should add [some more medicine] to it and put a [new] bandage on it. And if you find that [the wound] has healed, you should remove it [the bandage] gently and do the same thing again.

(76) If the blood is not contained with the bandage, one should scrape off the skin and catch the vein on a hook, pull it upward, and bind both edges with a silken thread while the vein is in the middle. When there is a hemorrhage, be careful with cauterization. Although cauterization stops the hemorrhage, it is not safe, because it takes away from the flesh of the spot. The bleeding is indeed contained as long as there is a scab on the spot [of the wound], but if the scab falls off, a [subsequent] bleeding is more difficult to treat. Apply cauterization only when it is necessary. Prefer caustic medicines to cauterization. Cauterization is good when bleeding is associated with putrefaction and when it concerns [wounds that] putrefy quickly, such as [those in] the anus and testicles. Caustic medicines that are beneficial for [these wounds] are arsenic, verdigris, lime, sulphur, green vitriol, and the like. [ . . . ]

(79) If there is a wound to the lower [part of the] belly and the omentum protrudes and some of it turns green or black, then do not hope [to heal] that which has turned green. Instead, after you have come to the aid of the healthy [part], cut off [the diseased part] by ligating it with a fine silken thread, so that the cut does not result in a hemorrhage from the blood vessels in the omentum. Let the ends of the thread come out from the wound so that it will be possible to extract it if the wound closes up. If the gut protrudes from a wound and becomes inflated and cold because of the air, place on it a hot compress with astringent, hot wine so that it is warmed and its strength is preserved. If that is not possible, take hot [pieces of cloth?] and put [them] on [the gut] in the bathhouse, or put a sponge or piece of wool [that has been soaked] in hot olive oil or hot water on it so that it returns to its [former] condition.

(80) If the omentum or intestines protrude, raise the patient by his hands and feet, in hot air and in a manner such that the abdomen is drawn upward and becomes clearly visible, while the organ does not become cold. Then the patient should be softly shaken and gently put to sleep in this position on a flat bed raised at its extremities. Once the patient has been put to sleep and tied up in the middle [?]‌, one should make efforts to return [the omentum or intestine] inside [the body]. Then one should draw the edges of the wound together and cut it carefully. If the patient needs to defecate, give him a clyster with [ingredients] that expel the feces, and alleviate the pain with astringent black wine or the like.

(81) If one needs [to] suture [the wound], one should bring both edges of the wound together and stitch them, then fasten the thread with a double knot and cut it off. Then skip over a small [part?] of the wound, join the two edges, and stitch them in the same way. Continue to operate in this manner until you reach the end of the wound. The threads should consist of [material] that does not decay quickly. [ . . . ]

(84) The setting of a broken bone is effected through straightening the limb [so that] the deflected part is brought into one line with the straight part above it. Then it should be put together by gently and carefully bringing in the splintered parts, one upon the other, and the fissure should be mended so that [the bone] returns to its initial shape. Then it should be bandaged, and splints should be put on it such that it reassumes its original shape. The splints should have the same shape as the [broken] limb so that they preserve [the shape]. To stop the bleeding, the bandage should be tighter on the site of the fracture and looser on the area around it; bind it high up on those sides. The broader the bandage, the better it is, for then it occupies a large area.