Схватање узрока и лечења куге према Хиландарском медицинском кодексу

Abstract

У раду се говори о узроцима, облицима лечења и превенције, као и правилној исхрани оболелих од куге, према спису о заразним болестима Хиландарског медицинског кодекса. Поменути рукопис представља лекарски зборник настао у виду прерађених превода најзначајнијих дела западноевропске средњовековне научне медицине, која највећим делом припадају медицинској школи у Салерну, заснованој на античким учењима и традицијама. Уочено је да спис о заразним болестима чумног рода (куга, велике и мале богиње) потиче из IV књиге Канона медицине, дела арапског лекара Авицене, из прве половине XI века. У Хиландарски медицински кодекс највероватније је доспео посредством одређеног латинског превода Авиценине књиге, насталог у периоду од половине XIV (тачније од 1347/1348. године) до краја XV века, који можда такође потиче из салернске школе. Посебна пажња посвећена је идентификацији, особинама и својствима лековитих дрога, претежно биљног порекла, које су имале своју примену, како у лечењу, тако и у оквиру превентивних мера, намењених здравим особама непосредно изложеним зарази. Такође је указано и на погрешне идентификације одређених лековитих биљака и материја у постојећем издању овог драгоценог извора српске средњовековне научне медицине.

The paper discusses the causes, forms of treatment, nutrition, and prevention of plague, based on the writings of infectious diseases, which is part of the medical collection called Hilandar Medical Codex (No 517). This Cyrillic manuscript was created at the beginning of the second decade of the 16th century, in the form of an Old Serbian translation of the most important medical records of the medical schools in Salerno and Montpellier, on which the entire Western European and Serbian medieval scientific medicine was based, established on ancient (Greco-Roman) and Arab traditions. The paper on simple medicines, mostly used in therapies for the treatment and prevention of plague, is a translation of the pharmacopeia of Matthaeus Platearius Circa instans – one of the most important writings from Salerno from the second half of the 12th century. The text on the causes, treatment, protection, and phenomena that were announcing the plague in the Hilandar manuscript comes from Book IV of the Canon of Medicine, the work of the Arab physician Avicenna (first half of the 11th century). This writing entered the Hilandar medical codex through a Latin translation of Avicenna’s work, which probably also originated from the medical school in Salerno. It is considered that the text about the plague of the Hilandar medical collection is a translation of some Latin document that was created in the period between the second half of the 14th century, that is, from the appearance of one of the biggest epidemics of this disease in 1347/1348, until the end of the 15th century. This is the period when Western European doctors and professors further improved the existing knowledge about this plague, within the framework of special treatises dedicated to the plague (cosilium), intended for a wider audience. In this paper, special attention was paid to the identification, characteristics, and properties of medicinal drugs, mainly of herbal origin, which were used in anti-plague therapies. According to the understandings of ancient and medieval medicine, the plague was caused by putrefaction (Serb. gnjilost; Lat. miasma) – a poisonous substance that enters the human body from infected air and water through the respiratory tract or open pores on the skin. It was also believed that the appearance of miasmatic vapors was facilitated by great conjunctions of the planets and southerly winds. The treatment of the plague was done in two ways – in the form of therapy for the sick, as well as in the form of preventive measures intended for healthy people who were in direct contact with the infected. Venesection (phlebotomy) was applied to sick persons, which, following the humoral theory, cleansed the blood of poisons, after which an enema was performed. Having in mind that air contamination was considered the main cause of the plague, the patient was advised to stay in a clean and ventilated room, which should be sprinkled with leaves and twigs of fragrant plants and sprinkled with scented water, while holding sweet-smelling fruit. Part of the therapy consisted of certain ointments and salves for anointing the face and body, made from rose water, camphor, sandal, etc. Those who suffered the plague were forbidden to do any kind of work and to bathe in steam. They were advised to drink cold water and eat light, acidified, bitter, and fasting foods. Complex medicinal substances with antidote properties, such as theriac and mithridatium, were considered the most effective anti-plague drugs. An electuarium (medicinal jam) made of myrrh, aloe, and saffron was also recommended. For the prevention of the plague, many medicines were recommended, mostly on an herbal basis. They should be smelled or burned and incensed, both in the room and on oneself, to disinfect and absorb the rot in the air, as well as to improve the mood. Of the medicinal drugs that were used for the aforementioned purposes, the most commonly mentioned were various plants with aromatic roots: aloe tree (lignum aloes), costus (costus), gladiolus (acorus), then aromatic plant resins: frankincense (boswellia), solid storax (storax calamit), berniz/verniz (French sandaraque), asa-foetida (assa-foetida), mastic (mastix), terebinth resin or pistachio resin (glutinum albotim), ladanum (laudanum), camphor (camphora), as well as other fragrant herbs: clove flowers (gariophylli), saffron (crocus), cypress (cipressus), laurel (laurus), juniper (juniperus), caper (capparus), camel grass (squinantum), savin (savina), bitter almond (amygdal amarum), asarabacca (asarum), myrtle (mirtus), sandal (sandal) and others. Among drugs of animal origin, ambergris and musk were used. The combination of ambergris and some of the mentioned ingredients, such as aloe tree powder, frankincense, musk, solid storax, ladanum, clove flowers, rose water and others, made a special, characteristic mixture called ambergris apples (pomum ambrae), which had to be worn with oneself and smelt, to strengthen the heart and brain and protect against poisoned air. Among the drugs belonging to the group of aromatics and fumigators, recommended as protection against the plague, there was also a complex drug of Arab origin, that reached Western European medicine through the school in Salerno. It is the so-called “musk gall” (gallia muscata). According to one of the recipes, this medicine consisted of musk, ambergris, aloe tree powder, tragacanth (dragagantum/dragantum) – resins of the astragal plant, honey, as well as rose water, which connected the other ingredients and gave the mixture its shape.