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.