Part 30

Galen has very ingenious ideas respecting the first organization of the fœtus, which he ascribes to a certain power in the semen, like that which Blumenbach calls a nisus formativus. (De Form. Fœtus.)

SECT. LXIX.—ON THE PARTS THAT ARE OMITTED.

Each of our members has its own proper temperament and faculty; but it is not necessary for us to describe the characters of all, since they are unlimited, and we propose to give only a brief system of instruction. Having treated of those which principally affect the whole body, of the others we shall merely direct them to be judged of in the same way, forming an opinion of the temperaments from their excretions, their other energies and symptoms. It is now time to treat of the cure of the intemperaments of the whole body.

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COMMENTARY. On these consult Galen (de Temperamentis); Haly Abbas (Theor. iii); Avicenna (i, 1, 3.) We may mention that, generally speaking, all those parts which possess much blood were supposed to be of a hot temperament, and those which have little of a cold.

SECT. LXX.—THE CORRECTION OF HOT INTEMPERAMENTS OF THE BODY.

Since, in the hot intemperaments, the bile exceeds in quantity, if it pass downward, little, it is obvious, need be done; but, if carried upwards to the stomach, it ought to be evacuated by vomiting, by taking tepid water after exercise, and before food. It will be better that the exercise taken be not swift nor hard; but, on the contrary, rather slow and gentle. Some of those who are very hot do not at all require gymnastic exercises, but walking and the bath are sufficient for them. These delight, also in baths after a meal. But those who have heat combined with dryness, require a diluent regimen by means of succulent food, baths, and abstinence from much and hard exercise; so that in the season of summer they ought to bathe early, and after a meal a second time. Cold drink is of service to them. Venery is most inimical to dry temperaments. Such ought also to abstain from exertions producing lassitude, exposure to the sun, and to avoid cares and watchfulness. Those who are naturally humid are apt in infancy to be seized with rheumatic and plethoric complaints, and also with putrid. They stand in need of more exercise, of a proper digestion in the stomach, and of secretions by urine. Wherefore such persons are much benefited by taking before diet the bath two or three times, particularly the natural hot ones. They ought also to promote the secretions by means of exercises, and the bath, and by procuring the alvine and urinary discharges before taking food. And nothing hinders them to use masticatories and cathartics, as also a wholesome diet, and wine of a diuretic quality.

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COMMENTARY. See, in like manner, Galen (de Sanitate tuenda, vi); Oribasius (Synops. v, 51); Aëtius (iv, 9); Actuarius (de Diæta, c. 12.) Of the Arabians, Haly Abbas is the author who has delivered the treatment of the temperaments in the fullest manner. (Pract. i, 15.)

It is to be remarked that the condition of the body named the hot intemperament by the ancients is the same as that now generally called a bilious habit. Accordingly, Galen directs the physician to attend whether any pain or sense of weight be felt in the region of the liver, as, in that case, he judges it unsafe to take the bath after a meal, and recommends him rather to give deobstruents, and to proscribe food of a thick viscid nature. He particularly recommends an attenuant diet, and medicines of the same description, namely, wormwood, anise, bitter almonds, &c. His views of practice, in short, appear to have been very judicious.

SECT. LXXI.—THE CORRECTION OF THE COLD INTEMPERAMENTS OF THE BODY.

Of cold intemperaments there are three varieties, the worst of which is the dry; for such persons are from the first in that state which time brings upon old men. They ought, therefore, to use whatever is diluting and warming, such as moderate exercise, humid and warm food, the heating wines, and much sleep. Care should be taken by us, that all the excrementitious matters collected in the body be evacuated every day. Venery hurts all those who are affected with dryness, and more especially if joined to coldness, and is innocuous to the hot and humid alone. The cold and humid temperaments are bad, and are very subject to rheumatic affections. They are relieved by abstinence from the bath, by frequent and light exercises, and the use of moderately heating unguents. Those that are naturally colder, but are well regulated as to dryness and humidity of temperament, ought to stimulate and increase their heat, but to choose the medium between a humid and dry diet.

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COMMENTARY. See the authorities referred to in the preceding Section. All, in a word, copy from Galen. (l. c.)

SECT. LXXII.—THE CURE OF THE DRY INTEMPERAMENTS, OF THE STOMACH FOR EXAMPLE; THEN OF THE OTHER INTEMPERAMENTS.

A dry intemperament may either be occasioned by the parts of uniform texture being drier than natural, in their solid parts, which is incurable; or by the natural moisture from which these parts derive their nourishment being lost. It is contained in all parts of an animal, being diffused through them in the form of dew, and can only be supplied by means of the food. The former variety is utterly incurable; and even the latter is of all states of the body the most intractable. But when the dryness is seated in the small veins and arteries, the cure may be attempted by filling each of the parts of uniform texture with their proper juices by a humid diet. A tepid bath is therefore beneficial, and the patient ought to remain long in the water. Immediately after the bath, let him take the milk of an ass newly drawn, to which a little warm honey has been added. Afterwards he ought to rest until he take a second bath. He ought then to be moderately rubbed with oil, if the milk appears to be digested, which may be judged of from his eructations and the distension of his belly. The proper interval between the first and second bath may be four or five hours at the equinox, if he be to bathe a third time, but, if not, it may be greater. And he ought to be rubbed with oil before putting on his clothes after every bathing. If, therefore, the milk agreed with him, we may give it to him after the second time, or, if not, we may give, instead, a ptisan properly boiled, or alica made into a ptisan; he is then to rest until the third bathing, or otherwise until supper. His bread ought to be carefully prepared, baked in an oven, and of a fine quality; and as a seasoner, he may eat those fishes which are caught among rocks, or the hake in a white soup. In a word, his food ought to be of easy digestion and nutritious, not oily and excrementitious. His drink should be wine that is weak, white, clear, bearing little water, and having some astringency. Such is the mode of cure for the greatest degree of dryness; but the moderate does not require the same restriction as to diet, which may therefore be more generous. Let us suppose a dryness like the former, but mixed with a moderate coldness; and in this case, we must substitute certain calefacient articles; and, with regard to those mentioned above, we must add more honey to the milk, and give wine that is not so watery. We must also not only use things which are naturally heating, but which are so from their acquired qualities. And the body is to be rubbed frequently with the ointment of nard and mastich. When much coldness is joined to the dryness, know in the first place, that the complaint is difficult and intractable, but use the same remedies, and also by itself honey that has been boiled and scummed, along with very old wine. The best possible remedy in such cases is that which is much used by pitchers; and we must likewise rub the belly with it, and tear it away while it is yet warm. Such persons are also relieved by having a child of a full habit sleeping with them, so as to touch their belly. Let us next suppose that a moderate heat is joined to dryness. In this case, our first care ought to be, not to taste honey, and to use wine which is not aged, food which is tepid and milky, and to rub the belly with the oil of unripe olives, or with that of apples. But to cool such persons much is not devoid of danger, as their state is feverish when the heat prevails. Let us next suppose that a hot intemperament prevails, and that humidity is joined to it. Such an intemperament is to be cured by drinking cold water. The use of astringent food is also proper; namely, such things as are austere, without being heating. But when the humid intemperament alone prevails, such articles of food as are desiccant, without heating or cooling much are beneficial, and also abstinence from the common drinks. When the humid intemperament is joined with the cold, the best remedies are all acrid things, and they ought to be mixed with such things as are astringent, without being decidedly refrigerant. The drink should be in small quantity, and consist of some of the strongly heating wines. These are the modes of curing intemperaments proceeding from qualities. But since a humour contained within the cavity of the stomach, or being absorbed within its coats, often occasions intemperaments, it will be proper to treat also of these affections. If the former state occur at once, it may be easily removed by emetics; but if it be a defluxion, the parts it comes from will require very attentive consideration, and the cure will follow, of course; for it is to be applied entirely to the affected part; and of the other parts, we need only take care that they be not thereby affected. The cure is to be performed by astringents, and such things as will bring the whole body to its proper habit. Depraved humours in the coats of the stomach are to be evacuated by moderately cathartic medicines, such as aloes, and the powder prepared from it, called Picra. When a viscid phlegm is contained in the stomach, such persons ought first to take those things which will cut it, and then it may be purged off, or evacuated by vomiting with radishes. When the humour is neither viscid nor thick, a vomit from ptisan, or that from honied water, may be sufficient. The juice of wormwood with honied water may also be drunk. In like manner, intemperaments in other parts may be cured, by finding out the evacuation suited to the humours; or, if the part has no sensible discharge, the prevailing matters and humours may be evacuated in the form of vapour; and in like manner, if it proceed from flatulence.

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COMMENTARY. Galen supplies all the matter of this Section. (l. c.)

The modern ideas respecting the temperaments, appear to be founded upon the descriptions given by the Arabians of the symptoms which characterize the prevalence of the four humours, as they were called, namely, blood, yellow bile, black bile, and phlegm, in the body. In proof of this, we subjoin Rhases’ brief description of them: “De complexione autem infirmi scias, quod si fuerit albi coloris admixti rubedini, et si fuerit bonæ carnis, subtilis cutis, et quando locum fricaveris, rubescit statim, significatur quod materia est sanguinea. Et si corpus fuerit pingue, et albi coloris non mixti rubedini, et corpus nudum pilis, venis strictis, carne molli, occultarum juncturarum, gracilium ossium, et generaliter talis dispositio qualis est in corporibus mulierum, significatur quod materia est phlegmatica. Et si fuerit macrum, citrini coloris, pilosum, et cum crassis venis, et manifestis juncturis, ostendit quod materia est cholerica. Et si fuerit niger color, durities corporis, pilositas, asperitas cutis, significatur quod materia est melancholica.” (De Affect. Junct. 2.)

It is to be understood, however, that Galen’s system of the temperaments was not based, as has been often erroneously represented, upon any hypothesis respecting the humours.

SECT. LXXIII.—ON THE POWERS OF THE ARTICLES OF FOOD.

Since an account of the properties of food is a part of the doctrine of Hygiene, we shall add that to the preceding, having premised only a few remarks before delivering the particular rules on this head; for nothing is more indispensably necessary than to be well acquainted with the properties of food. Things of an attenuating power open the pores, and clear away the viscid humours which are impacted in them, and cut and attenuate the thick; but when persevered in as articles of food, they beget serous and bilious superfluities, or, if still longer continued, they render the blood melancholic. One ought therefore to abstain from the continued use of them, and in particular those who are of a bilious temperament; for they only suit with those who have collections of phlegm, and of crude, viscid, and thick humours. Those of incrassating powers are sufficiently nutritious, and, if properly digested in the stomach and liver, they form good blood, but occasion obstructions of the spleen and liver. Of these some have only thick juices, as the dried lentil, but some viscid, as the mallows; and in some they are both thick and viscid, as the testaceous fishes. An attenuating diet is safer than an incrassating for the preservation of health, but yet, as it supplies little nourishment, it does not impart tone or strength to the body. One ought, therefore, to take some moderately nutritious food, when experiencing the effects of a deficient diet. They may do so with the least danger who are given to exercises and can take as much rest as they please. But all those who cannot take exercise before food ought to avoid such things as are incrassating; and those who are of an indolent habit ought by no means to take such food. For complete inactivity is one of the greatest evils for the preservation of health, whereas moderate exercise is particularly good. Those articles of food which are intermediate between the incrassating and the attenuating are the best of all, producing blood of a proper consistency. Such a diet, then, agrees with our bodies, but that which produces a bad chyme ought to be shunned. It is better also to avoid variety of food, more particularly if it consist of contrary qualities; for such things, when taken together, do not digest properly.

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COMMENTARY. The ancient writers on Dietetics are, Hippocrates (de Diæta, de Affectionibus, et alibi); Celsus (ii); Dioscorides (Mat. Med. ii); Galen (de Facult. Alim., et de Probis Pravisque Aliment. Suc.); Xenocrates (de Aliment, ex aquat.); Oribasius (Med. Collect. i et seq.); Aëtius (ii); Simeon Seth (de Alimentis); Actuarius (de Spiritu Animali, p. ii); Anonymus (Tract, ap. Ermerins Anecdota Græca); Marcellus (Sideta de Piscibus); Psellus (Carmen de Re Medica); Rhases (ad Mansor. iii, Cont. xxxiii); Avicenna (Cantic. p. ii); Averrhoes (Comment. de Cantic); Haly Abbas (Theor. v, 15); Athenæus (Deipnos. passim); Plutarch (de Sanitate tuenda, Symposiacon); Macrobius (Saturnal. vii); Cælius Apicius (de Opsoniis); Geoponica (xii); Horace and Martial (pluries.)

Of all the ancient writers on Dietetics, Galen is beyond dispute the best. In the two treatises mentioned above, he has treated of everything connected with this subject so fully and so correctly, as to leave little to be supplied even at the present day. All the subsequent authorities in general are his servile copyists, with the exception of Averrhoes, who commonly differs from him only by deviating into error.

The ancient philosophers were at great pains to explain why a regular supply of food is necessary to the existence of animals. On this subject, Timæus Locrus, Plato, and Aristotle have philosophized with great acuteness and ingenuity. No one, however, has given a plainer account of the matter than the poet Lucretius in the following verses:

“Illud item non est mirandum, corporis ipsa Quod natura cibum quærit quoiusque animantis; Quippe etenim fluere, atque recedere corpora rebus Multa modis multis docui, sed plurima debent Ex animalibus iis, quæ sunt exercita motu; Multaque per sudorem ex alto pressa feruntur, Multa per os exhalantur, quam languida anhelant: His igitur rebus rarescit corpus; et omnis Subruitur natura dolor quam consequitur rem. Propterea capitur cibus, ut suffulceat artus, Et recreat vires interdatus, atque patentem Per membra ac venas ut amorem obturet edendi.”

(De Rerum Nat. iv, 856.)