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.)