Alexander disagrees with Galen as to several of the points of treatment laid down by him. He insists that Galen’s rigid rules for applying strong friction, at the same time that abstinence is enjoined, are such as no ordinary powers of constitution could bear up under; and, therefore, he recommends to rub first, and then to give some light nourishment, such as thin ptisan, oxymel, and bread soaked in wine, when the strength is greatly overpowered. Nay, when the powers of the constitution are in danger of sinking under the weight of the load, he suggests the propriety of having recourse to venesection; and accounts for the benefit derived from this evacuation upon the same principle that a fire which is like to be extinguished by an excessive load of green fuel burns brighter when part is taken off. This is an ingenious explanation of the manner in which bleeding proves useful in cases of congestive fevers. Respecting the use of wine and the bath, his views are similar to those of Galen. He approves very much of administering a light-coloured diffusible wine when the powers of the system are much sunk.
Avicenna adheres closely to the principles of treatment laid down by Galen; and, therefore, says nothing of venesection. (iv, 1, 2, 58.) Rhases treats this complication of fever in like manner. He calls it “Febris syncoptica, ex humorum copiâ et cruditate nata.” (Ad Mansor. x, 14.) He mentions emetics, but approves most particularly of friction. (Contin. xxx.)
Averrhoes contends that, in such a case, it is lawful for a Mussulman to drink wine, although forbidden by the Prophet. He approves also of friction. (Collig. vii, 16.)
Prosper Alpinus informs us that the Methodists, in such cases, gave wine and aromatics, and used every means to rouse the system. (Med. Method, vi, 9.)
SECT. XXXVIII.—OF THOSE WHO HAVE FALLEN INTO SYNCOPE FROM THIN HUMOURS.
Those who have fallen into a state of syncope from thin humours, must be treated quite oppositely to the manner described, for you will find the diagnostic symptoms quite different. They must be supported by taking a little food frequently. And their case is to be thought hopeless when the liver or stomach is inflamed at the same time that the powers are gone. In these affections, the expression of the countenance speedily becomes death-like. It is necessary to support their strength with food, but their skin must be condensed instead of being rarefied as in the former case. The air must be cooled, and they must be rubbed with astringent ointments. They must be furnished with food not very laxative, also bread and gruels from chondrus, with autumnal fruits that are austere, and not apt to spoil; these, either by themselves or with bread. A watery wine taken from the beginning with the food will be beneficial.
Commentary. This is taken from Galen. (Meth. Med. xii, 6.) See also Oribasius (Synops. vi, 27); Aëtius (v, 98.) In this case Alexander recommends nearly the same plan of treatment as Galen. He recommends for food things which are incrassant and anti-discutient, such as the juice of halica, succory, lettuces, apples, pomegranates, pears, &c. They must be administered, however, in small quantities. He approves of giving a weak watery wine, not very old. He recommends friction with tonic and incrassant oils, such as the oil of apples, and other applications of a like nature.
Avicenna, Averrhoes, and Rhases treat the case exactly as our author.