Part 28

When emaciation takes place in any part of the body, it is commonly occasioned by long-protracted rest, or by bandaging for fractures. We must, therefore, stimulate their vital powers, and attract the blood to them, by using moderate friction, suitable exercise, and by the affusion of warm water upon them in moderate quantity. This must be done until the part becomes red and swells, and we must desist before it subsides. We must also use pitching, as formerly described. When there is a sense of cold in the part, it ought to be rubbed with linen cloths, or some calefacient medicine. For this purpose, I have sometimes used the thapsia, rubbing it in either with honey or cerate.

* * * * *

COMMENTARY. This is taken from Oribasius (Synops. v, 42), or Aëtius (iv, 34). See also Galen (de Sanit. tuendâ, v); Rhases (Contin. xiii); Haly Abbas (Pract. i, 16); Avicenna (i, 3, 4.) All recommend water to be poured on the part, and then it is to be rubbed with towels and hot stimulant oils, so as to produce a redness and glow in it. Most of them also approve of the pitch plaster.

SECT. LX.—THE DIAGNOSIS OF THE BEST TEMPERAMENT.

That man is in the best temperament of body when it is in a medium between all extremes, of leanness and obesity, of softness and hardness, of heat and cold, of moisture and dryness; and, in a word, who has all the natural and vital energies in a faultless state. His hair, also, should be neither thick nor thin, and in colour neither black nor white. When a boy, his locks should be rather tawny than black, but, when an adult, the contrariwise.

* * * * *

COMMENTARY. This Section is copied from Oribasius (Synops. v, 43), or Aëtius (iv, 53). See also Galen (de Temperam., de Opt. Corp. Constit., de Sanit. tuendâ, v, and Ars Med.) In the last mentioned, which was long the most celebrated of all his admired works, he has treated of the temperaments very systematically. Whatever Oribasius, Paulus, or any subsequent author, whether Greek or Arabian, have delivered on this subject is altogether derived from the works of Galen.

None of the Arabians has treated of the temperaments so learnedly as Haly Abbas. (Theor. i.) See also Averrhoes (Collig. vi); Alsaharavius (Theor. vi); Avicenna (Cant.)

SECT. LXI.—DIAGNOSIS OF THE TEMPERAMENTS.

Those bodies which are of a hotter temperament than the moderate will have their teeth earlier than usual, and will grow in like manner. They feel warmer to the touch, and have less fat; they are of a ruddy colour, have their hair black and moderately thick, and their veins are large. But if such a one be also fat and brawny, and have large veins, he is fat from habit and not from nature. The following are the marks of a cold temperament: Such bodies appear cold to the touch, are without hair, and are fat; their complexion, like their hair, being tawny. But when the coldness is great, they are pale, leaden-coloured, and have small veins; and if lean, this does not proceed from nature, but habit. The dry is harder and more slender than the temperate—the hardness, indeed, being inseparable from the dry temperament; but leanness not only follows the congenital temperaments, but also those which are acquired by long habit. It is a mark of hardness when the body is rendered unapt for motion, dry and parched, by drying applications. The humid, in all other respects, is like the temperate, but is softer and fatter, and the softness is inseparable from it; but the grossness not only follows the connate temperament, but also that acquired by long habit. It is peculiar to the humid temperament that the body is oppressed by things of a moist nature. The warm and dry temperament is extremely shaggy, having the hair of the head in early age of rapid growth, black, and thick; but, in after-life, baldness follows. The veins are large, as are likewise the arteries, which beat strongly. The whole body is firm, well articulated, muscular, and without obesity; and the skin is hard and dark. When the temperament is cold and humid, the chest is narrow, and, like the rest of the body, without hairs; the skin is soft and white, and its hairs somewhat tawny, especially in youth; and such persons do not get bald when they grow old; they are timid, spiritless, and inactive; their veins are invisible; they are gross and fat; their muscles and legs are feeble, and their joints ill-formed; and they are bandy-legged. But should the humidity and coldness increase, the colour of their skin and hair becomes tawny, or, if they increase still more, pale. The hot and humid temperament is softer and more fleshy than the best temperament, and, when it increases much, is subject to putrid disorders; but, if it be only a little more humid and much hotter than the moderate, the bodies of such persons are only a little more soft and fleshy than the moderate, but they are much more hairy and hotter to the touch. But if the cold and the dry grow equally together, such persons have naturally their bodies hard, slender, and white, with fine muscles, small joints, and little hair; and they are cold to the touch. Although slender, fat is mixed with their flesh. The colour of their hair is correspondent to the degree of constitutional coldness. As to disposition of mind, they are spiritless, timid, and desponding. To say all in a word, with regard to the compound temperaments, they are always to be distinguished by the marks of the prevailing quality.

* * * * *

COMMENTARY. This Section is taken from Oribasius (Synops. v, 44), who borrows from Galen (Ars Med. c. 15.) See also all the authorities referred to in the preceding chapter.

The ancients, it will be perceived, connected the passions and desires of the mind with the temperaments; and, to establish the alliance between them, Galen wrote a treatise, wherein he has handled the subject very ingeniously, and has delivered many profound views of the animal economy. Galen’s work, to which we allude, is entitled, ‘Quod Animi Mores Corporis Temperamenta sequuntur.’

SECT. LXII.—ON THE FORM OF THE HEAD.

A small head is the peculiar mark of a faulty configuration of the brain, but a large is not necessarily a good one; for if occasioned by the strength of the vital powers of the part fabricating an abundant and proper material, it is a good sign; but if occasioned by the quantity of matter alone, it is not good. We must judge of heads then from their shape, and from the processes which arise from them: from their shape, if well formed, for that is always a good sign; and from the processes of the brain, if they be in their proper state, and if the nervous parts be all properly nourished, have their suitable tone, and if the sight be acute. Sharp heads are defective in the protuberance of the front or hind-head, or else it is unnaturally increased. Now, in most cases we shall find that these last, like the large, are faulty, and yet some of them, though rarely, are good, the formative principle being strong.

* * * * *

COMMENTARY. This Section is taken from Oribasius (Synops. v, 45); Aëtius (iv, 63); or direct from Galen (Ars Med. c. 6.)

Psellus, like our author, remarks, that a small head, by contracting and binding, as it were, the brain, is necessarily a bad formation; whilst a large head, if it arises from excess of the natural powers, is good; but if it is occasioned by a collection of superfluous matter, the contrary. We would refer, in this place, to the curious account of the Macrocephali given by Hippocrates in his treatise ‘On Airs,’ &c. (§ 14), and to the interesting remarks in the same by M. Littré (t. iv, p. xi.)

SECT. LXIII.—THE MARKS OF THE TEMPERAMENT OF THE BRAIN.

A brain of the proper temperament has its vital energies and excretions moderate, and is not liable to be affected by any externals. Such persons, when infants, have the hair of their head somewhat tawny—when boys, yellowish—and when adults, a bright yellow; being also intermediate between the curly and the straight, and they do not readily fall out. When the temperament is hotter than moderate, all the parts about the head are hotter and redder, the veins in their eyes are perceptible, their hair is grown at birth; and if much hotter, it is black, strong, and curly; but if not much, it is yellowish at first, and then grows black, and in more advanced life such persons become bald; their excretions are small when they enjoy good health; their head becomes filled and oppressed by heating food, drink, and odours, or by any external casualties. Such temperaments are satisfied with little sleep, and even that is generally not profound. The following are the marks of a brain which is colder than proper: The excretions are excessive; the hairs are straight, yellow, and durable; and it is hurt readily by cold things. Such persons are constantly seized with catarrhs and defluxions, the veins of their eyes are not visible, and they are much given to drowsiness. The following are the marks of a brain which is drier than natural: In the excretions nothing redundant, the senses acute, not being given to drowsiness, the hair strong and soon formed, rather curly, and soon falling out. In the more humid temperament, the hairs are straight, do not readily drop out; the senses are muddy, and the excretions redundant, sleep long and profound. In the compound of the hot and dry, the excretions of the head are small, the senses acute, there is a disposition to watchfulness, and baldness. Their hair at first is formed quickly and abundantly, is of a black colour, hot to the touch, and they are ruddy until manhood. But if moisture be joined to heat, and they are not immoderate, the colour and heat are good, and the veins of the eyes large. The excretions are plenteous and moderately concocted. The hair is straight and yellowish, and does not readily drop out. The head is easily filled and oppressed by heating and moistening things. But should an increase of humidity and heat take place, the head becomes diseased, and easily affected by heating and diluent things. Such persons cannot endure long watchfulness, but their sleep is disturbed by fantastical dreams, their sight is dim, and their senses not distinct. The cold and dry temperaments of the brain conjoined together render the head cold and pale, the veins of their eyes do not appear, and they are readily hurt by cold things: wherefore, their health is precarious. Their senses in youth are distinct and faultless, but as they advance in life soon decay. In a word, as far as regards the head, they experience a premature old age; their hair after birth is of slow growth, stunted, and tawny. The humid and cold temperaments of the brain render those affected with them prone to lethargy and drowsiness; their senses are bad; they abound with recrementitious humours; are easily affected with cold and fulness of the head; and are liable to catarrhs and defluxions; but such persons do not readily become bald.

* * * * *

COMMENTARY. This is taken from Oribasius (Synops. v, 46), who abridges Galen. (Ars Med.)

As our author’s description of the temperaments is sufficiently intelligible, and the others, whether Greeks or Arabians, deliver exactly the same views of the subject, without any material improvement, we consider it unnecessary to multiply references to, and extracts from them, on the present occasion; and, therefore, instead of crowding our pages with superfluous repetitions, we shall give in this, and the five following Sections, a brief exposition of the physiological doctrines of the ancients, with regard to the principal organs of the human body:

The ancients divided the powers or faculties of the human body into the Natural, the Vital, and the Animal. The brain they held to be the seat of the animal powers—that is to say, they considered it to be the organ from which sensation and motion are derived, and these, they maintained, are the powers by which animals are distinguished from vegetables. This doctrine is fully explained by Galen, in his work, ‘De Facultatibus Naturalibus,’ and by several of the Arabian authors, among whom we will venture to mention Haly Abbas, as being particularly worthy of being consulted on this subject. The brain, then, was accounted the seat of the five external senses, and of muscular motion, which also was reckoned as one of the senses by Hippocrates. (De Insomniis, c. 1.) Galen and his followers decidedly taught that the nerves of the senses are distinct from those which impart the power of motion, that the former derive their origin from the anterior part of the brain or cerebrum, and the latter from the posterior, called by the Greeks encephalis (under this term they comprehended the cerebellum, tuber annulare, and medulla oblongata of modern anatomists), or from its process, the spinal cord. They maintained that the nerves of the finer senses are formed of matter too soft to be the vehicles of muscular motion; whereas, on the other hand, the nerves of motion are too hard to be susceptible of fine sensibility. See Galen (de Usu Partium, ix; de Administ. Anat. vii); Haly Abbas (Theor. iv); Averrhoes (Collig. iii, 33); Avenzoar (ii, 7); and Rhases (Contin. i.)

The ancients were also of opinion that the brain is the coldest viscus in the animal frame, being in this respect the antagonist of the heart, the heat of which they supposed that it counteracts. See Aristot. (De Part. Anim. ii, 7); and Pliny (Hist. Nat. xi, 49.) There appears to be some foundation for this opinion, since, as is remarked by Haly Abbas, those parts of the body which are vascular, and contain much blood, are naturally hot; whereas such as contain little blood are comparatively cold. Of this latter class are the brain, nerves, and fat. (Theor. i.)

The later Greek authorities, as, for example, Theophilus Protospatharius and Nemesius, adopt a division of the brain as regards its connexion with mind, to which Galen and his immediate followers appear to have been strangers. According to it, Fantasy is connected with the anterior part of the brain; Cogitation, or the discursus mentis, with the middle; and Memory with the posterior. See, in particular, Theophilus (p. 184, ed. Greenhill.) This hypothesis was received by all the Arabian writers on medicine. See, for example, Averrhoes (Collig. ii, 20.) It was evidently an approach to the arrangement adopted by the phrenologists of the present day, who maintain that intellect is seated in the anterior part of the brain; the moral feelings in the middle; and the animal appetites in the posterior.

SECT. LXIV.—THE MARKS OF THE TEMPERAMENTS OF THE STOMACH.

The marks of a preternatural dryness of the stomach are, that those affected with it are liable to thirst, but little drink satisfies them; and they feel heavy with much drink, as the superfluity occasions gurgling in the stomach, or floats upon it; of those of a more humid, that they are not addicted to thirst, and bear readily much liquids, and rejoice in humid food. A stomach preternaturally hot has a better digestion than appetite, particularly with regard to those things which are hard and difficult to digest; it delights in much food and drink; neither is it hurt by the moderate use of cold things. A preternaturally cold stomach has a good appetite but not a good digestion, in particular with regard to such things as are of difficult digestion, and are of a cold nature, which therefore are apt to turn acid in it. And it delights indeed in cold things, but is readily hurt by the immoderate use of them. The intemperaments proceeding from disease differ from the congenital in this, that they long for opposite things, and not always alike. If the stomach then digests properly, it is of a moderate temperament; and if it does not it is of a bad; but if its eructations are fetid, its heat is inordinate and inflammatory; but if acid, the contrary. And in those who digest properly things of difficult digestion, the heat of the stomach is inordinate, and weak in those who cannot digest those things, but digest fishes. It must also be observed, whether or not the symptom is occasioned by any humour flowing from another part; for in pituitous constitutions acid eructations are apt to occur; but in the bilious, fetid airs and other disagreeable qualities are apt to prevail. The common symptom of them all is nausea. If the depraved humours swim within the cavity of the stomach, they float on the surface, and are discharged by vomiting; but if they are contained in the substance of it within its coats, they annoy it with vain attempts to vomit.