SECT. XLVII.—ON CACHEXIA.
We are accustomed to call the commencement of dropsical affections cachexia. Wherefore we must cure it by bleeding, if nothing prevent, at intervals, and continuing the abstraction until the third or fourth day. But, in an especial manner, we must evacuate those who have fallen into this affection from retention of the hemorrhoidal or menstrual discharge; as in those cases which arise from a copious evacuation, we must abstain from venesection, and by all means purge with the hiera from colocynth. The diet should be light and desiccative; and recourse must be had to natural baths, namely the aluminous, and more especially the nitrous, and then the sulphureous; but the other kind of baths may be taken at greater intervals. Let them be exercised in every way, more especially by those who are called jatraliptæ. At last they must be put under a course of hellebore. They are wonderfully remedied by a propoma of wormwood, and by sinapisms and dropaces. If the affection is converted into dropsy, we must have recourse to the treatment applicable for dropsical cases in the manner about to be explained.
Commentary. Almost all the authors referred to in [the preceding Section] may be consulted on cachexia and dropsy.
Aretæus gives an accurate account of this affection, which, he says, usually terminates in dropsy, phthisis, or wasting. He mentions many symptoms of it, such as œdema, difficulty of breathing, and so forth; and he correctly remarks that the alvine discharges are dry, white, crude, and without bile. His chapter on the treatment unfortunately is lost.
Cælius Aurelianus says that Themison was the first who explained the treatment of cachexia. He mentions as causes of the disease intemperance, the improper use of medicines, hardness of the liver or spleen, long-continued hemorrhoidal discharge, vomiting, protracted fevers, &c. His treatment is judiciously varied according to the cause of the disease, and is given at great length.
Aëtius gives a very interesting account of the views and practice of Archigenes. He says the disease is generally occasioned by scirrhus of the liver or spleen. Like our author, he recommends bleeding if not contra-indicated, and purging with drastic cathartics, such as the hiera from colocynth, friction, rubefacients, exercise, the bath, and thin white wines. Celsus admits of bleeding, but not until after purging, friction, unction, and exercise have failed to restore the health.
Serapion expresses himself in much the same terms as our author and Aëtius respecting venesection; but Avicenna recommends not to have recourse to it unless there be a sanguineous plethora. He also forbids baths of sweet water, but otherwise he adopts the treatment recommended by the Greeks.