Part 27

Galen forbids travellers who have been exposed to great cold to take heating things immediately after a journey. (Meth. Med.)

Avicenna, Averrhoes, and Haly Abbas direct a traveller to get bled before entering upon a journey; and, in certain cases, this might be a very proper practice to prevent the blood from being inflamed by violent exercise, but, on the other hand, unless judiciously applied, it might bring on such debility as would render the traveller unable to undergo the necessary fatigue. They recommend him to hold in his mouth a small ball of the trochisk of camphor. The Arabians, it is to be recollected, maintained that the action of camphor is frigorific. Instead of the draught mentioned by our author, Avicenna recommends vinegar and water. He recommends little food, but of good nourishment; and forbids pot-herbs and fruit. With regard to the treatment of the feet, they are to be rubbed until they become warm, and then anointed with hot fragrant oils. When the feet have suffered from cold, some, he says, put them into cold water, and are thereby relieved, in like manner as congealed fruits are sometimes restored. When the water for drink is bad, he advises to get it distilled.

Haly Abbas gives very minute directions for the conduct of travellers. Like our author, he advises them to gird the body with a swath or band, and to use a staff. He forbids them to begin a journey either fasting, or in a state of repletion with food. Exposure to the sun, he says, is apt to occasion hectic fevers, headach, consumption, and dryness of the body. He directs them to have the head covered. When hurt by exposure to heat, he advises cold water, or any other thing of a cooling nature to be poured over the head. After exposure to cold, he recommends the hot bath. (Pract. i, 31.)

Rhases remarks that he had known all persons who had been exposed to great heat during a journey suffer from attacks of fever, except those of a humid and phlegmatic temperament. He forbids much food before setting out on a journey, and even approves of getting bled and purged, if the undertaking be severe. He recommends, if convenient, a bath at the close of the day; then the traveller is to eat and go to sleep. He and all the authorities quoted by him direct the body to be rubbed with oil before and after a journey. To preserve the eyes from the effects of snow and dust, he recommends them to be exposed to the vapours produced by pouring wine on a heated stone, or to those of chamomile, dill, or marjoram. To protect the feet, he directs them to be wrapped in cloths smeared with calefacient oils. When very hot, he cautions against swallowing much cold water at once, but recommends some cool liquid to be held in the mouth, and cold water to be poured on the hands and feet. He recommends travellers to chew pickled onions. During the prevalence of extreme cold he approves of drinking some hot wine before setting out on a journey. When the journey is over, he directs the traveller to go into a comfortable apartment, but not to approach the fire, nor enter the bath, nor allow himself to sleep during the space of an hour. After this he may go into the bath, and undergo friction until his body become ruddy, and then he may go to sleep on a soft bed; by which regimen he may be preserved from fever, if such be the will of God. (Cont. xxxiv, Ad Mansor. vi, 3 and 4.)

SECT. LVI.—OF THE REGIMEN OF PERSONS ON BOARD SHIP.

With regard to the vomitings which occur to people at sea, it is neither easy nor expedient to contend with those which happen first; for, upon the whole, they are generally beneficial. After vomiting, one ought not to partake of much nor of ordinary food, but either lentils, dried and boiled with a small quantity of pennyroyal, or bread pounded in a weak and fragrant wine. One ought also to use but little drink, and that containing a weak watery wine, or vinegar with honey. The lentils ought to be first boiled, and then when they become soft, to be triturated, and afterwards dried and put into an earthen vessel. When severe vomiting lasts for a long time, one should resolutely abstain from all kinds of food, and take only a little drink, which ought to be vinegar and honey with water, containing thyme infused in it, or pennyroyal water with some fine polenta, or some fragrant weak wine with fine polenta also. In order to overcome the disagreeable stench on board ships, one may smell to quinces, thyme, or pennyroyal. One ought also to look as seldom as possible upon the sea, until one has been accustomed to live in a ship. One must likewise attend, that the water which is drunk be not muddy, ill-smelled, or saltish.

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COMMENTARY. This Section likewise is taken from Oribasius (Synop. v, 33), who copies from Diocles. Similar directions are given by Rhases, Avicenna, and Haly Abbas. Haly remarks that persons on board of a ship are often infested with lice, which are engendered by want of cleanliness. For them he recommends mercury killed, with oil, the long bithwort, &c. (Pract. i, 31.) Avicenna says that, by wearing wool smeared with oil and mercury, the lice will be killed. (Cant. p. ii.)

When the vomiting is unusually severe and protracted, Rhases recommends it to be treated with anti-bilious remedies. (Ad Mansor. vi, 14, Contin. 34.)

SECT. LVII.—ON THE MEANS OF DIMINISHING OBESITY.

When the body gets to an immoderate degree of obesity, it will be necessary to melt it down and reduce it. It was mentioned formerly that the warm temperament renders the body lean, and therefore it ought to be superinduced, if possible, upon that of fat people, in order to reduce them to the proper state. You have also learned that active exercise, an attenuant regimen, medicines of the same class, and mental anxiety, bring on the dry temperament, and thereby render the body lean. What an attenuant diet consists of is perfectly obvious; but the more powerful medicines, such as the seed of rue, particularly the wild, with its tops, the round birthwort (aristolochia rotunda), the small centaury, gentian, poley, and the stronger diuretic medicines, as Macedonian parsley: all such medicines, either alone, or together, attenuate the humours, and evacuate the body. The salts also from burned vipers and the theriac attenuate the body. The body may also be reduced and attenuated, by having an oil rubbed into it, containing the root of the wild cucumber, marshmallows, gentian, and the root of the all-heal and birthwort, or the poley and centaury. One ought not to take food immediately after the bath, but should first sleep for a little time. And it will be better if the water of the bath possess diaphoretic properties, and, more particularly, if we can have recourse to a natural one, such as that in Mitylene. If it cannot be procured, the flower of salt may be mixed with sea water. Thin white wines ought to be used. Dry rubbing with thick towels is calculated to reduce the fat. A smaller quantity of food ought to be given in proportion to the exercise taken. Insolation also is of use for obesity. Fat persons ought not to take a fragrant draught before a meal; and it will be best if they eat only once in the day. The body ought to be rubbed with nitre (soda), and the rougher salts. A large quantity of nitre in the bath is attenuant, but a small quantity only stimulates to nourishment. The following mixture is attenuant: Of pepper and Macedonian parsley, two parts, of asarabacca and anise, one half. This acts well, both as a diuretic and a cathartic.

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COMMENTARY. This is taken from Oribasius. (Synops. v, 40.) Aëtius uses nearly the same words. (iv, 32.) Celsus recommends the tepid salt-water bath, hard exercise, food of an acid or austere kind, and restricted sleep. (i, 3.)

Galen gives an interesting account of the manner in which he cured a person of obesity in a very short space of time. He says, “I first made him take quick exercise, and afterwards wiped off the sweat with a linen cloth. I then rubbed his body with the volatile ointments called acopa, and after this friction I led him to the bath. I did not then give him food at once, but directed him either to rest, or to follow any occupation he was inclined for, and then repeated the bath; after which I gave him as much food, not of a very nourishing description, as he was disposed to take.” (De Sanit. tuendâ, vi, 8.)

Avicenna recommends hard exercise and frequent baths, and vinegar to drink. (i, 3, 4.) Rhases recommends fat persons to abstain from animal food, wine, milk, and all sweet things; to live upon pot-herbs, and such things as are saltish and sour; to take purgatives and diuretics, to use much hard exercise, and to remain long in the bath. (Ad Mansor. v, 61.) In another work he treats of this subject at great length. He recommends acids, and especially vinegar. In short, he agrees with Galen, that all things of a bitter, sour, and attenuant nature reduce obesity; and also that saltish things which have the property of opening the bowels do the same. Nothing, he says, tends more to reduce corpulency than frequent baths and hard friction. (Contin. iv.)

The directions given by Haly Abbas are to the same effect as those of Rhases, that is to say, he recommends fat persons to take hard exercise, to remain long in the bath, to use friction with oil of dill and the like, to live upon articles of food not too nutritious, not to indulge in protracted sleep, and to have frequent recourse to laxative and purgative medicines. (Pract. i, 16.)

Some remarkable cases of obesity are related by Athenæus. (Deipnos, xii, 12.)

The practice of the Methodists is described in a very circumstantial manner by Cælius Aurelianus. (Tard. Pass. v, 9.) They very properly condemned bleeding and purging, and depended principally upon strong exercise, hot baths, insolation, the sand-bath, hard friction, and a restricted diet.

SECT. LVIII.—HOW TO RECRUIT THOSE WHO ARE EMACIATED.

When we wish to recruit those who are reduced in flesh, we must give them thick wine and food containing thick juices, and prescribe slow exercise and moderate friction,—in a word, every thing contrary to the method we have been just describing. It may also be of use to be pitched for three or four days. If a person go into the bath with an empty stomach, he ought beforehand to get his body rubbed with linen cloths until it become ruddy, and afterwards, by hard but not frequent friction, the skin may be rendered thick and hard. Those who are pale, and not properly nourished, ought to be roused to anger and mental emotions.

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COMMENTARY. This is either copied from Oribasius (Synops. v, 41), or from Aëtius (iv, 58.) The process of pitching the body is thus described by Aëtius: “Dried pitch is melted in a moderate quantity of oil, and, while still warm, is to be rubbed into the skin (the part having been previously shaved), and before it cools completely it is to be torn away. The plaster is to be again heated at the fire, and spread upon the skin; and before it becomes cold it is to be torn away. This process is to be frequently repeated.” (iii, 180.) See Celsus (i, 3.)

Galen, in his Commentary on the second Aphorism of Hippocrates, expresses himself strongly on the danger of using precipitation in recruiting a person that has been emaciated. He evidently writes from ample experience, acquired in training the Athletæ. Hippocrates and his commentator repeat this rule the “ne quid nimis” in another place. See Galen (Op. t. v, 251, ed. Basil.)

Haly Abbas recommends moderate exercise, a short continuance in the bath, friction with emollient oils, much sleep, two or three meals every day, food consisting of fat meat, bread, almonds, &c. He also approves of pitching. (Pract. i, 16.)

Avicenna recommends pitching, the bath soon after taking food, soft friction, and the rest of the treatment recommended by Paulus. (i, 3, 4.)

Rhases treats of the same at great length. He approves of protracted sleep; of food consisting of fat meat, wheat, and pulse; after food, of the bath, friction with oil, and the affusion of tepid water over the body; and also of red, thick, and sweet wines. (Ad Mansor. v, 60.) In another work he delivers the opinions of preceding authorities, accompanied with his own remarks. He agrees with Galen, that emaciation generally depends upon the state of the liver. They recommend nutritive articles of food, such as boiled and roasted flesh, and the bath, without friction, after a meal. Both speak favorably of pitching. They also approve particularly of sulphureous and bituminous baths. With regard to the bath, they explain, in another place, that it is proper in these cases only after the food is digested; for, if taken too soon after, it loads the body with unconcocted chyle; and that, if had recourse to at other times, it rather induces emaciation. Rhases again repeats that many of the legumina are very nutritive. He states that the wine should be particularly thick. (Contin. xiv.) Galen further says, that emaciated persons are to be recruited by thick wines, food consisting of thick juices, short exercises, and moderate friction. (Meth. Med. xiv, 16.) In another place he gives a very striking description of the bad effects of inanition. (De Venesect. adv. Erasistrat.) We would further direct attention to the description given by Hippocrates of a febrile state of the system, attended with delirium, which is sometimes brought on by too restricted a regimen in disease. (De Diæta morb. acut. § 11.)

On the treatment of convalescents, consult Celsus (iv, 25); Galen (Hyg.); and particularly Rhases (Contin. xxxiv). We shall give Celsus’ directions in his own words: “Ex quocunque autem morbo quis convalescit, si tarde confirmatur, vigilare primâ luce debet; nihilominus in lecto conquiescere: circa tertiam horam leniter unctis manibus corpus permulcere: deinde delectationis causa, quantum juvat, ambulare, circumcisa omni negotiosa actione: tum gestari diu: multa frictione uti: loca, cœlum, cibos sæpe mutare: ubi triduo quatriduove vinum bibit, uno aut etiam altero die interponere aquam. Per hæc enim fiet, ne in vitia tabem inferentia incidat, et ut mature vires suas recipiat. Cum vero ex toto convaluerit, periculosè vitæ genus subito mutabit, et inordinatè aget. Paulatim ergo debebit, omissis his legibus, eo transire, ut arbitrio suo vivat.” Galen and Rhases particularly recommend to convalescents to drink white astringent wines diluted with water. Both enjoin a restricted diet at first, gentle exercise, and the bath in moderation. Haly Abbas cautions against premature friction and exercise, but recommends the tepid bath, and gentle unction with oils. (Pract. i, 25.) Syrasis recommends the warm bath, moderate friction with rough towels, and unction with a little oil. (Auctores de Balneis, p. 334.)

SECT. LIX.—HOW TO REMEDY EMACIATED PARTS OF THE BODY.