SECT. XLIII.—ON LAXATIVES AND DIURETICS TO THOSE IN HEALTH.
Some of the ancients thought it sufficient for health that the bowels and urine should be evacuated once a day freely and fully, according to the quantity of food and drink which had been taken; and when the evacuations were agreeable to this rule, they were satisfied, or, if otherwise, they assisted them by taking, in order to increase the urinary discharge, shepherd’s needle, parsley, asparagus, Macedonian parsley, anise, calamint, marjoram, wormwood, the roots of couch-grass and of golden thistle, tree-medic, and of maiden-hair; all these being boiled in water, so that the decoction might be drunk with wine. For these things purify the blood by the mine, and are of no small efficacy. Alvine discharges are to be assisted by giving turpentine to the quantity of an olive when going to rest, or, when it is wished to purge more effectually, by adding a little rhubarb. Soft eggs, of pot-herbs the beet and mallows, and the soup of shell-fish are also laxative, and these probably will be sufficient. But if more powerful remedies be required, the herb mercury, boiled in water with salt, may be eaten, or the decoction drunk; and, in like manner, the leaves of the elder tree (sambucus), or the root of the oak-fern (polypodium) to the amount of two drachms, may be sprinkled upon pickle, or swallowed in a ptisan; or milk-whey, with salt; or honey, to the amount of three or four heminæ; or the broth of an old cock, by itself or with two drachms of bastard saffron, or aloes, to the amount of about three chick-peas, may be taken at supper-time. But the best remedy is dodder of thyme, taken in wine after a moderate supper. But he that wishes to purge more strongly must take, in the morning, a drachm of this medicine infused in vinegar and honey, if in the spring season.
Commentary. Oribasius treats fully of purgatives towards the end of the 8th book of ‘Med. Collect.’ He gives a list of gentle laxatives. (Euporist. i, 45.)
Hippocrates frequently recommends gentle purgatives for the preservation of the health. Of this class, the herb mercury appears to have been his favourite.
Galen has given two distinct treatises on purgatives, and the cases in which they are applicable. He dissuades those who are in good health from taking them, but says that they may often be used so as to prevent the recurrence of diseases. Hence, he says, that he had often prevented gout and rheumatism from relapsing, by the seasonable administration of purgatives. He forbids purgatives when the hypochondria are distended with flatulence.
Aëtius gives a very lengthy account of the preparation of purgative medicines, which will be noticed more properly in the Seventh Book. He states that all medicines of a cutting or penetrative nature are diuretic. He mentions plantain, fennel, parsley, seseli, anise, valerian, bitter almonds, &c. (iii.)
Celsus gives the following list of gentle diuretics: “Urinam movent quæcunque in horto nascentia boni odoris sunt, ut apium, ruta, anethum, ocimum, mentha, hyssopum, anisum, coriandrum, nasturtium, eruca, feniculum: præter hæc, asparagus, capparis, nepeta, thymum, saturcia, lapsana, pastinaca, magisque agrestis, radicula, siser, cepa; ex venatione, maximè lepus; vinum tenue, piper et rotundum et longum, sinapi, absinthium, nuclei pinei.” He also gives a long list of laxative articles, such as cabbage, mallows, sorrel, gourds, cherries, all ripe apples, green figs, cockles, oysters, muscles, milk, crude honey, and all fatty and salty substances. (ii, 29.) Horace makes mention of the laxative properties of oysters, cockles, dock, and white wine—
Avicenna gives very minute directions respecting the use of purgatives. He very properly recommends us when a purgative medicine has been taken, and instead of operating, has occasioned heat, vertigo, and headach, to administer an injection. (i, 4.)
Haly Abbas treats of these medicines in pretty much the same terms as our author. He remarks that obstruction of the bowels leads to colic, flatulence, difficult respiration, and vertigo. Retention of urine, he says, leads to ulcers in the bladder. He states that diuretics are useful in diseases of the joints and spine, dropsy, and various complaints, but are apt to render the body dry. (Pract. i, 12.) Diuretic medicines, he remarks in another place, are of a hot and sharp nature, so that they heat the kidneys, and thereby increase their attractive power. (ii, 27.)
Alsaharavius cautions against the indiscriminate use of purgatives, which, he says, in a dry temperament disposes to phthisis, and to dropsy when the stomach is weak. When a purgative medicine has induced hypercatharsis, he prescribes astringent powders, containing sumach, pomegranate, and the like. (Theor. x. 1.)
Rhases gives some very sensible observations on the use and abuse of purgatives. He says that persons who lead an indolent life, are of a gross habit, and live freely, are most benefited by them. To those of a dry temperament, on the other hand, they prove prejudicial, by predisposing to hectic fever. He recommends fat food and the warm bath before taking a purgative. (Ad. Mansor. iv, 15.)
See a full account of these laxative medicines, in Serapion (De Antidotis.)
SECT. XLIV.—ON CLYSTERS.
In constipation of the bowels, when the stomach is naturally weak, and cannot bear purgatives, recourse must be had to clysters. When phlegm is contained in the intestines, the clyster may be composed of the decoctions of dried figs, and of beet, nitre, the root of the wild cucumber, honey, and the oil of chamomile or dill. But when the complaint proceeds from dryness they may be composed of those of marsh-mallows, fenugreek, chamomile, oil, and a small quantity of honey. And sometimes oil alone, injected to the amount of half a hemina, will produce the desired effect; but even this must not be repeated constantly, lest nature, becoming accustomed to these things, should forget to perform the evacuation spontaneously.
Commentary. Hippocrates frequently recommends the administration of clysters. Herodotus mentions that the ancient Egyptians had recourse to clysters at stated periods every month. (ii, 77.)
Oribasius has treated of the composition of clysters, and the cases in which they are to be applied so fully in the eighth book of his ‘Medica Collectanea,’ that he may be said to have exhausted the subject. It appears, from his account, that the ancients used a syringe for throwing up injections. A large clyster, he says, amounts to three heminæ, a small one to one hemina, and a moderate one to two heminæ (two pints). (Synops. i, 19.)
Celsus, after some very appropriate observations on the cases which are benefited by clysters, concludes with the following directions for the composition of them: Plain water may be injected, if the case be slight; or honied water, if stronger means be required; if emollients be indicated, the decoction of mallows, of fenugreek, or ptisan may be used; or if astringents be proper, vervain. Acrid clysters may be formed of sea-water, or with the addition of some salt, and their strength may be increased by boiling. Such a clyster may be rendered still more acrid by the addition of oil, nitre, or honey. He remarks that the more acrid a clyster is, the greater will be its purgative effect, but the more difficult will it be to bear. He says it ought to be neither hot nor cold. After the injection has been thrown up, he recommends the person to remain quiet, and to resist the first desire to go to stool. (ii, 12.)
Aëtius treats of clysters very fully. He prefaces his account of the mode of administering them, with a correct detail of the evils arising from constipation, which, he justly remarks, is the precursor of most of the ills which break out in the human frame. (iii, 159.)
See a long list of prescriptions for clysters in Serapion. (De Antidotis, tr. vii, 26.) Rhases and Avicenna give a full account of the nature of clysters, but supply no additional information on the subject.
SECT. XLV.—ON SUPPOSITORIES.
We often use suppositories for the discharge of scybalæ, or when injections are not properly evacuated. Suppositories are formed of roasted salt, honey, and nitre; or thyme may be mixed with boiled honey. They are also formed of turpentine rosin, and nitre, and sometimes with a moderate quantity of the seeds of the thymelæa (granum cnidium); but it irritates the parts, which, therefore, ought to be rubbed with oil. Pellitory and pepper are also added, and are particularly fitted for paralytics, and for the relief of flatulence from cold. Centaury is also mixed with pitch and cerate, and is very applicable for paralysis of the genital organs. For infants a lump of salt is applied. Figs also are mixed up with nitre.
Commentary. This Section is entirely taken from Oribasius. (Synops. i, 20.) See a fuller account in his ‘Med. Collect.’ (viii, 39), and Aëtius (iii, 160.) Aëtius, after mentioning the composition of certain suppositories similar to those of our author, speaks also of using for this purpose, figs mixed with nitre (soda?) and grapes deprived of their stones, with the addition of nitre and cumin.
Actuarius states that it is when the obstruction is seated in the rectum that suppositories are particularly applicable. (Meth. Med. iii, 5.)
See also Avicenna (iii, 20, 1), and Rhases (Contin. xxiv.)
The use of suppositories in the practice of medicine might be traced back to the earliest times. Mention of them occurs frequently in the works of Hippocrates.
SECT. XLVI.—ON MEDICINES WHICH EVACUATE PHLEGM FROM THE HEAD, MASTICATORIES, ERRHINES AND LINIMENTS TO THE NOSE.
We evacuate humours fixed in the head, with the saliva, by mixing some pepper with mastich, if a small discharge only be required; or, if a greater evacuation be wanted, by giving directions to chew pellitory or stavesacre. The root of every species of anemone, when chewed, also excites the secretion of saliva, and the rind of the root of cappers. Serous superfluities may be thus evacuated; but, for thicker phlegm, we must gargle with mustard in vinegar and honey, or with sodden wine, having marjoram and hyssop boiled in it. I also mix this with the gargle formed of mustard in vinegar and honey. When we want to clear the brain of mucus, we must stimulate it by means of acrid substances, of which kind some are sternutatories. The juice of either pimpernel, of the anemones, and of beet purge by the nose. The juice also of the leaves of the wild cucumber may be applied to the nostrils, either alone or with the decoction or juice of the beet. But sneezing is not at all applicable for crude humours contained in the chest, lungs, and head. The following ointment may be rubbed into the mouth: Anoint the roof of the mouth and uvula with a soap containing the juice of the beet. The same application may be used as an errhine. I have also often used the following composition, which is easily prepared: Macerate gith in strong vinegar for a day, then next day rub it with the vinegar, and pour it into the nose. Sometimes the gith may be rubbed with old oil; and I apply it in this manner. Archigenes used it in the same manner for obstruction of the nostrils. Crito used the former cure, along with vinegar, for jaundice.
Commentary. This Section is taken from Oribasius. (Synops. i, 21.)
Hippocrates makes frequent mention of the caput-purgia, or medicines which purge the head. On the composition of these medicines, see in particular Aëtius (iii, 140-1); Nonnus (Epit. 17); and Serapion (de Antidotis, vii, 31.) They contain such articles as these: pepper, nitre, white hellebore, spurge, gith, pellitory, mastich, turpentine, mustard, chalcitis, alum, and the like. The errhines were used principally in obstructions of the nose, and when the sense of smell was impaired. The apophlegmatismi were supposed to prove useful in chronic affections of the head, impairment of the senses of smell and sight, and also when the tongue and throat were affected.
Prosper Alpinus gives a full account of the errhines, masticatories, and cough medicines of the ancients. (Med. Meth. iii, 11.) He makes the caput-purgia to be the same as the errhines, and the apophlegmatismi the same as the masticatories of the moderns.
SECT. XLVII.—ON EMMENAGOGUES.
All diuretics promote also the flow of the menses, such as the decoction of the root of the cabbage, the root of the peach, rue, marigold, dittany, and the seed of rocket. The same effect may be produced by certain substances when applied to the mouth of the womb, as suppositories, such as rue rubbed with honey, or the juice of leeks, or finely-powdered germander, or myrrh, triturated in wine, or the rennet of a hare.
Commentary. This Section is taken from Oribasius. (Synops. i, 22.) A fuller list of the medicinal articles which were supposed by the ancients to promote the menstrual discharge is given by Aëtius. (iii, 153-4.) It contains cassia, myrrh, thyme, centaury, wormwood, nettle, elaterium, black hellebore, turpentine-rosin, cumin, sage, and the like. All these were used in injections and suppositories. The following were given by the mouth, and were held to be likewise diuretic: hedge-mustard, rue, marjoram, southernwood, sagapene, galbanum, spikenard, the herb mercury, savin, iris, birthwort, &c. See Albengnefit (Libellus.)
Dioscorides is censured by Dr. Cullen as being too credulous in assigning emmenagogue properties to a variety of articles in the Materia Medica. Perhaps, however, there is some foundation for the doctrine of the ancients, that all hot diuretic medicines are in so far emmenagogue. Prosper Alpinus maintains this opinion, but remarks that the action of the emmenagogues is more uncertain than that of the diuretics, and must be assisted by warm baths, pessaries, and fomentations. We shall have occasion to treat more fully of these medicines in the Third Book.
SECT. XLVIII.—ON SUDORIFICS.
The following medicines are sudorifics: The dried powder of chamomile, sprinkled upon oil, and rubbed briskly upon the skin, seseli, pellitory, the seed of the rosemary, anise; and in like manner, when sprinkled upon oil; nitre toasted, and not very fine, with oil; the flower of salt mixed with oil; Cyrenaic juice diluted with water, which may be rubbed into the body, and taken in a draught, to the amount of a chick-pea. Calamint, in like manner, when drunk with honied water, and rubbed externally with oil.
Commentary. This Section is mostly copied from Oribasius. (Synops. i, 23.) Aëtius enumerates a good many more medicines of this class. Of these some are to be taken by the mouth, as cumin, bay berries, Cyrenaic juice, castor, and lovage; some are to be rubbed into the skin, as nitre with common oil, the oil of dill, of chamomile, of bays, and of radishes; and some are to be used in fumigations, as pennyroyal, the seed of balsam, and so forth. He recommends these medicines in jaundice, and for coldness and constriction of the skin. (iii, 157.)
Celsus treats of the methods for producing free perspiration with more than his usual minuteness. Sweating, he says, may be produced either by dry heat or by baths. The modes of applying dry heat, which he mentions, are by heated sand, the laconicum or sweating apartment of the ancient bath (see Sect. LI), the clibanus or moveable furnace, and the vapour-baths of Baiæ. To these he adds strong exercise. He also treats minutely of the application of baths and fomentations for the cure of diseases, (ii, 17.) Consult Stobæus (100.)
Haly Abbas directs us to restore the perspiration, when stopped, by exercise, friction, baths, and the affusion of hot water over the body. He further recommends friction with the oil of violets, and such things as are mentioned by our author. (Pract. i, 12.)
Rhases recommends internally, castor, opoponax, or opium mixed with honey, and given in tepid water. Externally, he recommends friction, with the oil of chamomile, of pellitory, or the like. (Contin. 31.) Mesue mentions fumigations with calamint, cinquefoil, carpobalsam, and bdellium. Albengnefit recommends the same, and also friction with calefacient oils, and the internal administration of cumin, calamint, and the like.
The ancients, as Prosper Alpinus remarks, seem to have trusted more in external than in internal means for producing free perspiration. They were aware that when the system is greatly over-heated, a draught of cold water, by reducing the temperature of the body, may prove sudorific. This fact is distinctly stated by Galen; and, in accordance with this principle, Rhases prescribes cold water in the hot stage of the smallpox, to facilitate the eruption of the pustules.
On the sudatoria or vapour-baths of the ancients, see Baccius (de Thermis, iv), and Sect. LI, below. Horace thus alludes to the vapour-baths at Baiæ:
Upon which Sanadon remarks: “By sulphura, the poet means the stoves, where sulphureous vapours exhaling from the earth cause a dry heat, which provokes sweat.”
Among the artificial means used by the ancients for procuring perspiration, we may here mention the sand-bath, as it was called, which consisted in rolling the body in sand heated by the sun. (Cælius Aurel. Tard. Pass, iii, 4; Avicenna, i, 2, 2, 20.)
Strong friction in the sun was also used as a means for producing perspiration. See, in particular, Avicenna (i, 2, 2, 20.)
SECT. XLIX.—ON AIRS.
The best kind of air is that which is perfectly pure, such as that which is not defiled with the exhalation from lakes or marshes, nor from any pit which emits pestilential vapours. That also which is impregnated with the exhalations from a canal conveying the impurities of a city is deleterious, and indeed every kind which is loaded with vapours is not good; as also that which is contained within any hollow place, shut up on all sides by high mountains, and not admitting of ventilation. Those, therefore, which are thus deleterious, prove hurtful to all ages and temperaments, whereas the best kinds agree with all. But their differences as to quality—I mean heat, coldness, dryness, and humidity—have not the same effect upon all. Those of a proper temperament are benefited by temperate air, whereas those labouring under an intemperament derive benefit from the opposite kind.
Commentary. The first part of this Section is taken from Oribasius. (Synops. i, 24.) The remaining part will be found in the ‘Med. Collect.’ (ix, 1), where the subject is treated of at great length. See, also, Aëtius (iii, 162.) All these authors, however, are much indebted to Galen. (De Sanitate tuendâ, i.) According to Galen, the moon produces changes in the atmosphere, whereby she occasions putrefaction of dead bodies, impairs the colour, and hurts the head of living persons. (De Diebus Criticis, iii.) On the supposed causes why the moon occasions putrefaction, see Plutarch (Synops. iii.)
Antyllus says that there are many differences of airs: some arising from the season of the year; some from the changes of the moon; and some from the hour of the day or night; some from thickness or tenuity, motion or rest, or from the admixture of terrene exhalations. The sun, he adds, warms the body; but the moon rather humectates, and, therefore, she moistens the brain, and occasions the putrefaction of the flesh; renders the bodies of those who sleep in the open air more humid and obtuse; and, for the same cause, she induces epilepsy and heaviness of the head. Cold air, he says, produces plumpness, good nutrition, and the formation of fat; it promotes the growth of the body, and hence, the inhabitants of northern climates are remarked to possess this character. It is unsuitable, however, to all acute disorders; and is also improper for certain chronic diseases, such as consumption, cachexy, paralysis, apoplexy, and rheumatism. Warm air consumes the body, attenuating and wasting the system, but it is preferable to cold air for imparting vigour and agility; it tries the powers, is useful in affections of the nerves and chest, but not in those of other parts. Thick air has no other good property, except that it prevents the powers from being dissipated. Thin air is most conducive to health. The air of high situations is said by him to be more salubrious to all persons, except those labouring under diaphoresis or syncope, and the aged. The atmosphere of places near the sea, he remarks, is milder than that of inland parts. Places in the neighbourhood of marshes are at all times unhealthy; but, in summer, their atmosphere is pestilent. Those by a river side are cold and changeable. See more fully Stobæus. (Sermo xcix.)
Hippocrates gives many interesting observations on the effect of climate, and the state of the atmosphere, in influencing the health; but they are delivered so much in detail, that my limits do not admit of my entering into an exposition of them. (De Aëre Aquis, Locis.) The account there given of the effects of stagnant water when used as drink is particularly deserving of attention. He says it produces diseases of the spleen, dropsies, and the like. See Coray’s edition of this treatise.
Haly Abbas gives a very elaborate disquisition on this subject. He describes minutely the characters of salubrious airs, and the changes produced upon them by the seasons of the year, the state of the winds, the nature of countries, and the stars, that is to say, the sun and dog-star. (Theor. v.) See also Rhases (Contin. xxxiii); Avicenna (i, 2, 2.)
SECT. L.—ON WATERS.
It is necessary also to be skilled in the good and bad properties of waters, for of all things water is of most use in every mode of regimen. It is necessary to know that the best water is wholly devoid of quality, as regards taste and smell, is most pleasant to drink and pure to the sight; and when it passes through the præcordia quickly one cannot find a better drink. But such as remains long there, and proves pungent to the stomach, which it swells up with wind and loads, is to be reckoned pernicious. Such waters are neither soon heated nor cooled, and those things which are boiled in them are slowly and improperly boiled. It is better therefore to prove such water by trial, which he who wishes may do by attending to the following characters: Those which run to the north, and from the sun, pass slowly through the stomach, and are indigestible; they are slowly heated and cooled. Those which are strained through any passage or soil to the east are soon cooled and soon heated, and are to be supposed to be very good. Those also are good which are colder in summer and warmer in winter. Some judge of waters by weight, counting that the best which is lightest. This, if joined to the circumstances already mentioned, may be deserving of consideration, but is not of itself a sufficient criterion of goodness. Rain water, as Hippocrates remarks, is the lightest, the sweetest, the most limpid, and the thinnest, because that which is lightest and thinnest is attracted by the sun, who draws such particles to him, not only from all other waters, but also from the sea, and from bodies. Hence also it is the most prone to putrefaction, as being composed of many different qualities. Let no one suppose that the water which is most prone to putrefaction is the worst, for susceptibility of change is rather a good than a bad property; so that if it has the other characteristics of the best water, and is prone to putrefaction, it is to be reckoned the finest possible. When beginning to turn it proves the cause of hoarseness, coughs, and roughness of speech, to those who drink it. Of rain waters that which falls in summer and during thunder is preferable to that which falls in stormy weather. That from ice and snow is the worst, for during congelation the finest particles of the water are squeezed out. But waters which contain impurities, have a fetid smell, or any bad quality, may be so improved by boiling as to be fit to be drunk; or, by mixing them with wine, adding the astringent to that which is sweeter, and the others to the more austere. Some kinds of water it may be expedient to strain, such as the marshy, saltish, and bituminous. Those which are very cold are to be drunk after food, and not in great quantity. Some also have discovered certain articles of food and drink for correcting the bad properties of waters. Thus some beforehand drink of the decoction of chick-peas, or eat them; others, wild carrots boiled with some small fish, and fennel in like manner; whilst others again eat beet and gourds beforehand with salts and diluted wine.
Commentary. Our author has given an outline of Hippocrates’ opinions on this subject, and for fuller information, we must refer to his work quoted in the preceding Section.
The characters of the different kinds of water, are thus given by Celsus with his usual terseness: “Aqua levissima pluvialis est: deinde fontana; tum ex flumine, tum ex puteo; post hæc ex nive, aut glacie; gravior his ex lacu; gravissima ex palude.” (ii, 18.) Their characters are somewhat differently given by Athenæus. Thus, he states, that water from snow or ice is lighter and better than rain water; otherwise his remarks on the qualities of waters are very interesting. He recommends a moderate draught of water at the commencement of a feast, in order that the veins, being in so far filled by it, may not greedily absorb the chyle before it is properly concocted. (Deipnos, ii, and Pliny, Hist. Nat. xxxi, 21.)
Our author’s account is abridged from Galen and Oribasius (Collect. Med. x), or rather is copied entire from ‘Euporist.’ (i, 14.) Aëtius gives a fuller account extracted from Ruffus (iii, 165.)
Haly Abbas treats of this subject at great length. His characters of the different kinds of water agree very well with those given by our author. He states that rain water is the purest, and snow water the most impure. Haly Abbas condemns the indulgence in a copious draught after a meal. The reasons he assigns for its proving injurious are, that it prevents the surface of the stomach from coming into proper contact with the food, and also that it reduces the natural temperature of the stomach. He recommends a person, if thirst be urgent, to allay it by drinking a small quantity slowly. (Theor. v, 29.)
Alsaharavius advocates similar views. He also forbids drink during the night, as the sensation of thirst may be fallacious; and at all events, he says, it is only increased by indulgence. (Theor. xiii, 1, and xii, 2.)
Rhases, in like manner, states that a draught of water immediately after eating impairs digestion, but is proper after digestion has taken place. (Contin. xxxiii.) Rhases, in another place, states that ice is prejudicial to the health, especially of old persons, by congealing the stomach and hurting the nerves. He admits, however, of the use of water cooled in snow, but recommends its effects to be counteracted by a moderate allowance of wine. Water which has been drawn from a very deep well he directs to boil before using it. (xxxvii, i, 70.)
In an anonymous treatise on diet lately published by Ideler, the drinking of cold water immediately after a meal is strongly condemned, as being hurtful to the digestion. (Phys. et Med. Græc. Minor. vol. ii, p. 197.)
The following are the principal beverages of the Greeks and Romans: Wine diluted with water; Mulsum, or a composition of honey and wine, resembling the modern clary; Hydromel, or honied water; Zythi, or various kinds of ales; the Spathites, a wine prepared from palms, mentioned by our author (iii, 39); the Sicera, or cider, prepared from apples; Perry, prepared from pears; Posca or oxycrate, a mixture of vinegar and water; the Cyceon, a mixture of wine, honey, flour, and water, according to Hesychius; the Dodra of the Romans, very like the cyceon; Ptisan, prepared from polenta; Barley-water, mentioned by Hippocrates (de Morb. Acut.) and well described by the Arabians; the Lora, a small table-wine prepared from the husks of grapes.
SECT. LI.—ON BATHS.
I think well of the cold bath, and yet I do not say that it is proper for those who use no restriction as to diet, but only to those who live correctly, and take exercise and food seasonably. It may answer with most people very well, when they want to get much cooled, to swim in water during the season of summer, provided they are young and brawny, and have been previously heated by friction. They ought to attend, however, that they be not in a state of lassitude from venery, or any other cause, nor suffering from indigestion, nor after vomiting nor after evacuation of the bowels, nor when in want of sleep. It may be attended with danger, if used at random. But the warm bath is the safest and best, relieving lassitude, dispelling plethora, warming, soothing, softening, removing flatulence wherever it fixes, producing sleep and inducing plumpness. It is expedient for all, man and woman, young and old, rich and poor.
Commentary. We think ourselves called upon in the first place to give some account of the Thermæ, or Public Baths, of the ancients, as an acquaintance with their construction and many matters relating to them is indispensably necessary in order to understand the subject now in hand. We need scarcely mention that the Romans surpassed any nation that has ever existed in the magnificence of their public baths. An ancient Therma consisted of four distinct apartments for as many different purposes: 1, Tepidaria; 2, Laconicum; 3, Calidaria; 4, Frigidaria. The 1st, or Tepidaria, called also Apodyterium, derived its former name from its being filled with tepid air, and the latter from its being the place in which the bathers undressed. The 2d, or Laconicum, called also Sudatorium, was an apartment filled either with heated air or steam, that is to say, it was, according to different usages, an air-bath or a vapour-bath. The 3d, or Calidaria, was a cistern for containing warm water. The 4th, or Frigidaria, was a cistern for cold water. The mode in which the ancients went through the process of bathing was as follows. First they went into the Tepidaria, where they left their clothes, and proceeded to the Laconicum, and there they were carefully scrubbed with the flour of beans, soda, &c., and then went into the hot bath, where they remained for some time, and coming out of it, they took a plunge into the cold-water bath, and then returned to the Tepidaria, where they underwent the Restorative friction, that is to say, were rubbed with oils or ointments, and sprinkled with fragrant powders, and then they resumed their clothes. That the order in which the ancients took the different baths was that which we have described may be inferred from the construction of those now remaining, from a passage in Galen’s works (t. iv, p. 146, ed. Basil), and from Stephanus (Comment. p. 259, t. i, ed. Dietz.) See also Auctores de Balniis pluries, Baccius de Thermis pluries, and Robertellus Lacon. explic. Pisanæ urbis. In the public baths the ancients always made use of common water. The ordinary hour for the bath was about two o’clock in the afternoon, but no one was restricted to any hour from the dawn to sunset. Galen approves of taking the bath in the morning, provided one had supped sparingly. (De Sanit. tuendâ, vi.) All agreed in condemning the use of the bath after a full meal. (Persius, Sat. iii; Juvenal, Sat. i, 143; Horat. Epist. vi, 61; Avicenna, Libel, &c). The ancients had also various other modes of practising the bath in private, some of which we shall briefly notice. The Clibanus, mentioned by Celsus (ii, 17), was probably a portable stove. The Pensiles Balneæ were small baths suspended by ropes from the ceiling of the house, in which luxurious persons were rocked. (Pliny, xxvi, 3.) Hip-baths, either of plain water, or water medicated with herbs, or of oil and water, are repeatedly mentioned by all the medical authors, and are particularly described by Aëtius and Avicenna. The douche or dashing with water is recommended by Aëtius, in ardent fever, ophthalmy, &c.; but he directs that it should not be carried far. Sprinkling with plain water, or the decoctions of emollient herbs, is recommended when the patients are so weak that they cannot bear the bath.
Hippocrates thus explains his views as to the effects produced by baths: The bath of sweet waters humectates and cools, for it imparts moisture to the body. The salt bath is calefacient and desiccative; for, being naturally hot, it attracts moisture from the body. When the body is fasting the hot bath is attenuant and refrigerant; for by its heat it attracts the moisture from the body, and when the flesh is deprived of moisture the body is cooled. Put after a meal it heats and humectates, by expanding to a greater bulk whatever predominates in the body. The cold baths produce the contrary effects; for when the body is fasting they impart heat and moisture to it, and after a meal they abstract moisture, and being cold they fill it with dryness. Unction with oil is calefacient, moistening and emollient. (De Diæta, ii, 36.) In another place he states that the warm bath, in moderation, softens and enlarges the body; but when taken immoderately it humectates dry bodies, and dries humid bodies. (De Affectionibus, c. 47.)
Celsus gives some ingenious reflections on the effects of the bath, especially in fever. He thus states the purposes for which it is applied: “Fere adhibetur, ubi summam cutem relaxari, evocarique corruptum humorem, et habitum corporis mutari expedit.” He recommends friction with oil before going into the bath. (ii, 17.)
Our author copies from Oribasius (Euporist. i, 16.) See a fuller account in Med. Collect. (x, 6); Galen (de Sanitate tuendâ); Aëtius (iii, 169); and Avicenna (i, 3, 2.) Galen particularly recommends the cold bath to persons in the prime of life, and during the summer season. Before going into the bath they are to get well rubbed first with rough towels and then with oil. He recommends them to plunge into the water at once, and not descend gradually. After coming out of the water he directs them to get rubbed with oil, until the skin is warmed. Agathinus forbids infants to be bathed in cold water, but recommends the warm bath for them. (Oribasius, Med. Collect. x, 7.)
Galen and Aëtius direct the bath of oil to be formed by adding the fifth part of heated oil to a bath of water. They recommend it in protracted fevers attended with chills, convulsions, retention of urine, and to relieve lassitude, and nervous pains. The learned Bernard remarks that it must have been the expense with which it is attended that has led to the disuse of the bath of oil. (Ad Nonni Epitom.) Avicenna and his expositor, Gentilis Fulginas, particularly recommend it for retention of urine. Mengus Faventinas pronounces it to be highly anodyne. (Auctores de Balneis.)
Psellus says that the warm bath relaxes, softens, and induces sleep, occasioning plumpness of the body. (Opus Medicum.)
Actuarius forbids the use of the bath to those whose systems are loaded with superfluities and bad humours. (De Diæta, xi.) Averrhoes lays down the same prohibition. (Coll. ii, 4.)
The proper time for the bath, according to Haly Abbas, is after exercise, and before eating. If used before exercise, it proves injurious, by occasioning the distribution of any superfluities which may be remaining indigested in the body, and determining them to improper parts. If used immediately after a meal, he says, it proves hurtful, by promoting the absorption of unconcocted chyle, and sending humours to the head. But if used after exercise, and before a meal, it moistens the body, strengthens the vital heat, promotes digestion, opens the pores, mitigates pain, and dispels flatulence. He adds, a short continuance in the bath, warms and moistens the body, but a long warms and dries it. (Theor. v, 13.) In another place he says that the proper time for the bath is after exercise, yet not immediately, nor until the powers of the system are in some degree recruited; but the body is to be first rubbed with oil, and then the bath is to be taken. (Pract. i, 5.)
The uses of the bath, according to Alsaharavius, are, to moisten the body, open the pores, dispel flatulence, remove repletion, procure sleep, relieve pains, fluxes of the bowels and lassitude, to restore lean bodies to plumpness and obesity, if used after a full diet, to soften contracted limbs, moisten dry bodies, and dry humid. The evil effects of it when misapplied, are prostration of the vital powers, syncope, and determining the humours to weak parts. (Theor. xi, 1.)
Asclepiades, of Bithynia, was a distinguished advocate for the use of the bath. See Pliny (H. N. xxxvi, 3); Celsus (ii, 6); Apuleius (Florid. 4.)
SECT. LII.—ON THE NATURAL BATHS.
Of Natural baths, some are nitrous, some saline, some aluminous, some sulphureous, some bituminous, some copperish, some ferruginous, and some compounded of these. Of all the Natural waters the power is, upon the whole, desiccant and calefacient; and they are peculiarly fitted for those of a humid and cold habit. The nitrous and saltish are beneficial to the head, to defluxions of the chest, to a watery stomach, to dropsies, to swellings after diseases, and to collections of phlegm. The aluminous are fitted for spitting of blood, vomiting from the stomach, immoderate menstrual discharges of women, and repeated miscarriages. The sulphureous are soothing and warming to the nerves, and relieve lassitude, but weaken and upset the stomach. The bituminous occasion fulness of the head, and hurt the senses, but occasion a steady degree of heat, and soothe when persevered in. The copperish are peculiarly adapted for the mouth, tonsils, uvula, and eyes. The ferruginous are useful to the stomach and spleen. The descent into the water ought to be without precipitation, in order that its impression may sink deep into the body when in a relaxed state.
Commentary. This Section is taken from Oribasius. (Synops. i, 29.) A fuller account is given in the Med. Collect. (x, 3 et seq.) See further, Aëtius (iii, 167); Haly Abbas (Theor. v, 13); Rhases (Contin. xxxvii); Avicenna (ii, 2, 15.)
Hippocrates briefly mentions thermal springs of iron, copper, silver, gold, sulphur, alum, bitumen, and nitre. He speaks unfavorably of all such waters, as being hard and heating. (De Aër, &c. 35.) The ancient nitre or natron, it is now well known, was a native carbonate of soda. The alum, mentioned by Hippocrates and the other writers on the thermal springs, cannot have been the alum of modern commerce, since it is very rarely to be detected in mineral waters, but it must have been the alumen plumosum, or hair alum, which Klaproth found to consist principally of the sulphate of magnesia and iron.
By far the most interesting account which has been transmitted to us of the thermal springs of the ancients is that given by Pliny in the 31st book of his ‘Natural History.’ He more especially commends the medicinal waters near Baiæ, consisting of all the kinds mentioned by Hippocrates and our author, namely, sulphureous, bituminous, saline, &c. Some of them, he says, prove medicinal by their vapour. He speaks of their good effects in diseases of the nerves and joints, and mentions generally of them that they open the bowels. Pliny’s account of the virtues of medicinal springs in different parts of the world is curious, but mixed up and disfigured with his usual traits of credulity and love of the marvellous.
The tepid springs of Albula, in the vicinity of Rome, are briefly mentioned by Pliny (l. c.); Vitruvius (viii, 3); and Pausanias (Messeniaco.) Among the natural springs of the Romans the Fons Aponus, or Bagni d’Abano, near Padua, is particularly celebrated. Claudian’s poem in praise of its medicinal waters is well known. He calls it
Joannes de Dondis has given an elaborate disquisition on the hot springs of Padua, but it is not by any means so satisfactory as could be desired.
This would be the proper place to give some account of the ancient Temples of Health, most of which, there is reason to believe, were connected with medicinal springs. But our information respecting them is so scanty, that we can scarcely venture to touch upon the subject at all. We would refer, however, to what Pausanias says of the warm saline springs in the neighbourhood of the Asclepieion at Cenchreæ in Corinthiaca (ii, 2, 4), and of the springs near the temple of Æsculapius at Corone (iv, 34); and of the wells near the temple of Æsculapius at Pergamos (viii. 25.)
SECT. LIII.—ON THE REGIMEN FITTING TO THE DIFFERENT SEASONS.
It is proper to regulate the diet with a view to the season. In winter to take more fatigue, and eat more than usual, if the state of the weather be northerly; but if it be southerly, to take the same fatigue, but to use less food and drink. In fine, to make the body dry in the wet season, and warmer in the cold, to eat also warm fleshes and acrid pot-herbs, and drink more wine than usual. In the beginning of spring some may evacuate by emetics, and others by laxatives, and another may get a vein opened, according as habit or inclination directs. Rest is suitable to the season of summer, and also a diminution of labour and food; the food also ought to be more cooling and the drink abundant; and, in short, everything ought to be done which can contribute to cooling and dilution. In autumn, as it is a changeable, unsettled, and unhealthy season, the diet ought to be particularly attended to, that it be not too refrigerant; moderation as to venery and cold drink ought to be observed; and the cold breezes of morning and the heat of noon attentively guarded against. Too much fruit ought likewise not to be taken, being hurtful not only by the quantity, but also by the quality of the chyle which it supplies, and by engendering flatulence. Nay, even the best kinds of autumnal fruits, figs and grapes, engender flatulence, unless taken before any other food, for otherwise they spoil the other food; but if taken then, they neither are flatulent, nor spoil the other articles of food. When the air is cold the body must be warmed accordingly, and everything done, as in the commencement of winter. It may also be expedient, after the autumnal solstice, to have recourse to one of the afore-mentioned evacuations, lest any excrementitious particles being shut up in the system should prove hurtful during the winter.
Commentary. This is copied from Oribasius. (Euporist. i, 10.)
It is one of the aphorisms of Hippocrates that those who require bloodletting or medicine, should be bled or take medicine in the spring. (Aphor. sect. vi.) Galen, Rhases, Haly Abbas, and in short all the ancient authorities agree with him respecting this rule of practice. According to Alsaharavius, the pulse is stronger and fuller in spring than at any other season. (Theor. vii, 2.)
Hippocrates and Galen lay it down as a general rule that the fullest diet is most proper in winter, and the sparest in summer. (Aphor. i, 18.)
Rhases lays down very suitable directions for the regimen that is most proper during every season of the year, but they are scarcely at all different from our author’s. As we have mentioned, he recommends depletion in spring before the heat set in. In summer, he approves of cooling acid fruits with cold water for drink. In autumn he directs abstaining from cold baths, and the use of a restricted regimen. In winter, he recommends a full proportion of calefacients, such as pepper, cumin, mustard, and rocket. (Ad Mansor. iv, 26.) Winter, he says in another work, favours the formation of flesh and blood, braces the body, and strengthens the powers. Spring fills the system with humours. Summer dissolves the humours, and weakens the internal powers. Autumn engenders bad humours, bile, and blood. (Contin. xxxiv.)
Haly Abbas recommends purging or bleeding in spring, to evacuate the superfluities formed and shut up in the system during winter. In summer, the regimen is to be cooling and diluent; little exercise is to be taken; the cold bath is to be used, swimming in cold water is to be practised: for food, chickens, fish caught among rocks, grapes, apples, and the summer fruits will be proper; but wine is either not to be drunk at all, or much diluted with water and cooled in snow; and venery is to be avoided. In autumn, the regimen is to be cooling and desiccative, the exercise moderate, the cold bath is to be avoided, but the tepid is to be taken, and much fruit is to be avoided. In winter, the regimen is to be heating and desiccative, and wine is to be taken moderately. The wine, he adds, ought to be strong and heating, to counteract the cold of winter; but much must not be taken, because it will dilute and humectate the body which stands in need of desiccation. Wine, too, he says, possesses little nourishment, whereas the system requires much support in winter. He recommends the flesh of quadrupeds and fowls for food. (Pract. i.) See, in like manner, Avicenna (i, 3, 5); Alsaharavius (Theor. ix, 2.)
The poet Hesiod recommends a full diet in winter. (Opera et Dies, l. 558.)
Maximus Planudes, in a Declamation on winter, affirms that at this season the heat, being confined within the body, operates more strongly in performing the vital functions than at any other season. This season, he says, is favorable to all classes of men except doctors; but they are sick at heart to see that no other persons are sick, and, bewailing their own misery, undergo the thirst of Tantalus amidst the rains of winter! See Boissonade (Anecd. Græca, vol. ii.)
Among the works of the ‘Physici et Medici Græci Minores,’ published a few years ago by Ideler, there are several small treatises, one by Hierophilus Sophistes, in prose, one by Theodorus Prodromus in iambic verse, and two others, anonymous, in which the regimen adapted to every month of the year is carefully laid down, but the rules are too minute to admit of being given here. We may mention, however, that they generally recommend pork, with peppers, and pure wine, as the best course of diet in winter.
SECT. LIV.—OF THE REGIMEN OF PERSONS ACTIVELY EMPLOYED.
He who spends his time in business ought to consider whether, in the former period of life, he had been in the habit of taking exercise, or whether, though not taking exercise, he bears that habit well, and escapes from diseases by having free perspiration. Such a state of body is not to be suddenly changed to another habit, neither the mode of those who have long been in ill health. But if constantly ill and plethoric, the indication of cure ought to be by a healthful regimen, to supply moderate nourishment; or, if cacochymy was the cause, the indication will be to supply proper juices. Those who suffer from fulness are to be directed when they go into the bath to use friction, and to take some exercise, or, if they have already done so, to increase it a little, but to detract from their food, and use less nutritious kinds than formerly; but if from collections of bad humours, one indication of cure is not sufficient, because there is more than one kind of bad humours; for some have a collection of cold and pituitous, some of hot and bilious, and others of the melancholic. Every one, therefore, ought to avoid those articles of food and drink which are apt to engender that sort of humour which is collected. And in all these cases the common remedy is purging of the belly.
Commentary. This is taken from Oribasius (Synops. v, 29), who extracts it from the ‘Commentaries’ of Galen. See also Rhases (Cont. xxxiii.) Galen and Rhases remark that persons who lead an active life, such as ploughmen and labourers, digest gross food more readily than any others; but that, their bodies being wasted by excessive fatigue, the vessels take up the chyle before it is properly concocted, and carry it over the system. Hence, such persons seldom attain to an old age, as their bodies get loaded with improper juices.
SECT. LV.—ON THE REGIMEN OF TRAVELLERS.
In performing a journey, one will bear the fatigue best if anointed with oil, and by not making too violent efforts; and by having the body about the loins and to the hollow of the ribs, bound round, in summer, with a swath of a soft consistence, six or seven fingers broad, and in length not less than five cubits. A staff also is useful in a journey; for in going down a declivity it serves as a pole to support the body from falling forwards, and by leaning upon it in ascending acclivities it will greatly assist in raising the body. When a traveller stops on a journey he should get his body anointed, take some food adapted for the summer, and a moderate quantity of drink. After dinner he ought to rest awhile before proceeding. But if compelled to go on, and oppressed with thirst, water, having some polenta sprinkled upon it, with a moderate quantity of salt, will be of service to him. He should be careful of heat and of the sun, and have his body covered so as not to be exposed to the sun, lest, during the journey, his limbs become dry and stiff. With these precautions, he will be less liable to lassitude, and all its accompanying evils. In winter, when it is cold, before setting out he ought to evacuate, get his body rubbed with oil, and take plenty of the winter articles of food, and a little drink. He should also get not only his loins, but likewise his spine and chest, properly bound with a longer swath. When he stops, as sufficient coolness will be produced by the relaxation, it will be better that he neither anoint, nor take food or drink, nor any other refreshment, if he mean to remain there. But after long journeys, or excessive fatigue of any kind, even if a person do not complain of lassitude, it will be proper to treat him like those who do, for thereby there will be less danger of any bad consequences.
Commentary. This Section is taken from Oribasius (Synops. v, 31), who admits that he borrows, in his turn, from Diocles. The directions are, upon the whole, very judicious and proper.
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.
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.
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.
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.
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.