SECT. XXXII.—ON REPLETION.
Excess in diet is a very great error; for, even if the stomach should digest it properly, the veins, being over-filled, become affected, are distended and burst; they are obstructed, or filled up with vapours, and become much oppressed. In diseases nothing is worse than plethora of the veins; for, in fulness of the stomach, the offending matters may be evacuated either upwards or downwards, so that it is less pernicious than the other, and yet it is by no means desirable. But if there be too much food in the stomach, it must be immediately evacuated by vomiting, for there is a danger lest being digested it fill up the veins, more particularly if the person who is guilty of the excess be not attentive to the necessary evacuations. Let him vomit, then, before the food become spoiled; or, if there be any objection to vomiting, it will be of great consequence to bring about frequent discharges from the bowels; or otherwise, he should indulge much in sleep, and drink often of tepid water. When he has digested properly, and more especially if he has had evacuations by the bowels, let him have baths and fomentations, and let him drink moderately of watery draughts, and eat some pickle. But should he neither have alvine evacuations, nor digest readily, and if his whole body be heavy, averse to motion, and sleepy, and if his mind be oppressed with unusual sluggishness, these symptoms indicate plethora of the veins; and, when lassitude supervenes to these, it will be proper to enjoin quietude until digestion in the stomach be accomplished, and then to evacuate by labour.
Commentary. Our author, as usual, copies from Oribasius. (Synops. v, 28.)
Hippocrates describes accurately the bad effects of plethora, but at so great length that we cannot venture to give an outline of his practice. We may mention, however, that purging with hellebore, emetics, the warm bath, and venesection are his most powerful remedies. (De Diæta, iii, 16 et seq.)
Galen has also a treatise of considerable length on the same subject. Among the causes of plethora enumerated by him, we remark that he mentions the use of the warm bath after meals, whereby he holds that the system is overloaded with imperfectly concocted chyle. (De Plenitudine, and Meth. Med. ix, 5.) See also Rhases (ad Mansor. ii); Haly Abbas (Pract. i, 12); Alsaharavius (Pract. v, 4); Averrhoes (Comment. in Cant. Avicennæ); Avicenna (i, 2, 3.)
Alsaharavius says that plethora is marked by ruddiness of the body, heaviness, torpor, large veins, somnolency, a large face, and brawny limbs. It is usually accompanied, he adds, by impairment of the understanding, forgetfulness, heaviness of the head, weakness of sight, great pulsation of the arteries, and a disposition to epistaxis. He recommends a restricted diet, consisting of articles not very nutritious, exercise, the bath, along with friction, and medicines calculated to evacuate the prevailing humour, whether blood, phlegm, or bile.
Haly’s account is very like our author’s.
Rhases gives a good description of repletion, which, he says, is generally brought on by excess in eating and drinking, along with too much indulgence in sleep. Avicenna’s description is similar.