As all the subsequent authorities, whether Greek or Arabian, adopt the views of Galen, we need not enter into the detail of their plans of treatment. See Psellus (Opus Medicum); Avicenna (i, 3, 2); Rhases (Contin. xxxi); Alsaharavius (Pract. xxxi, 11); Averrhoes (Collig. vi, 8; Collect. ii, 15.) The bath, emollient friction, diluent food, and quietude are the remedies generally recommended by all the ancient authorities; and they are directed with a nice discrimination that cannot be too much admired. Syrasis, one of Avicenna’s expositors, gives the rules of treatment with great judgment.
Prosper Alpinus gives a fair account of the ancient doctrines on this subject. (Meth. Med. iv, 16, and de Præsag. Vita et Morte, ii, 21.)
SECT. XXI.—ON CONSTRICTION OF THE SKIN.
Constriction is occasioned either by obstruction or contraction of the pores. Obstruction is produced either by the quantity or thickness of crude and indigested humours, and contraction by such things as are cold or astringent, or desiccative. Upon stripping the body, the affection is at once recognized by the paleness, hardness, and contraction of the skin, and by the body’s being heated with difficulty during exercise. Calefacient remedies are the proper cure for this state of body, and therefore we must have recourse to the strongest exercise and the hottest baths, and the time of remaining in the cold bath must not be long, nor must the water be very cold. And when about to put on their clothes, let their bodies be anointed with a sweet and thin oil, of a moderately heating quality. Obstructions of the skin are also properly cured by the oil of dill, (more particularly if the dill had been green,) and by the oil of black poplars.
Commentary. This Section is taken from Oribasius. (Synops. v, 16.) But a somewhat fuller account is given by Galen. (Hyg. iii, 10.) Like our author, he states, that this affection is occasioned, either by a collection of thick viscid humours in the body, or by contraction, that is to say, spasm of the cutaneous pores. It is generally brought on, he says, by exposure to cold, or going into an astringent bath. He gives very minute directions about the treatment, recommending hot baths, and friction with oils of a calefacient and attenuant nature. See also Aëtius (iv, 46); and Actuarius (Meth. Med. iii, 16.)
Avicenna treats of it in the same terms as Galen. (i, 3, 3, 15.)
SECT. XXII.—ON SPONTANEOUS LASSITUDE.
Since the Ulcerose lassitude is occasioned by the ill digestion of acrid superfluities, if the cacochymy be small, the restorative exercise will be sufficient; but if it be greater and deeper-seated, we must not permit such a one either to exercise or to take any motion whatever, but he must for one day remain without food, in a state of quietude and sleep; and then in the evening, when he has been rubbed with emollient unguents, and bathed in tepid water, we must give him wholesome food and some soup. And we must also not restrict him from wine, for nothing contributes so much to the digestion of half-digested humours as wine. Should the symptoms be removed by means of the aforesaid treatment, we may allow the man to return to his usual employments; but if on the following day they should still remain, we must bethink ourselves of a more potent remedy. If his strength be good, we must have recourse either to phlebotomy or purging, having first determined which of these remedies we shall try. If he be weak, we must not bleed, but may purge him moderately. If there be many crude humours in the system, we must neither bleed, nor purge, nor exercise, nor move at all, nor try the bath; but we must keep him in a state of perfect quietude, and give him food, drink, and medicines of attenuating and incisive qualities, without being of a manifestly heating nature. We may give vinegar and honey, and occasionally some ptisan or honied water. And since, in such persons, the lower belly is apt to become swelled and distended with wind, and whatever food is taken to be converted into flatulence, it will be better to give some pepper along with the food. It will be better, too, to use the composition called Diospoliticus, and that simple medicine which consists of three kinds of peppers. Oxymel is also most proper. Let them likewise use a drink made from honey, particularly when it begins to become acid; and such wines as are gently acid, and such articles of food as are attenuant without being heating, as capers, if taken with vinegar and honey, or vinegar and oil. When the Tensive species of lassitude takes place without exercise, it indicates that a plethora distends the solid parts of the body. If the fulness be occasioned by blood, it will be best to open a vein, or scarify the ankles. If the Inflammative lassitude be spontaneous, it will not endure a delay of a few hours, much less of two or three days, for it straightway induces a strong fever, unless one anticipate by letting blood. It will be best, if possible, to abstract blood twice in one day; for if care be taken that the first bleeding do not occasion swooning, it will be of less consequence whether or not it occur after the next. Those who are not bled will be fortunate indeed if they escape with the life.
Commentary. These judicious observations are taken from Oribasius (Synops. v, 21.) See also Galen (de Sanit. tuendâ, iv); Aëtius (iv, 41); Avicenna (i, 3, 3, 16); Alsaharavius (Pract. xxxi, 2, 11); Rhases (Contin. xxxi); Averrhoes (Collig. vi, 14.)
All the authorities recommend nearly the same methods of treatment. Galen’s account of the subject is full, complete, and satisfactory, but so lengthy, that we cannot venture even upon an abstract of it. He gives proper directions for the physician to endeavour to find out the cause of the lassitude, and to remedy it accordingly. It is often connected, he says, with retention of the menstrual or hemorrhoidal evacuation, or the stoppage of some customary discharge. When attended with inflammatory symptoms, he is very urgent in recommending immediate venesection, without which, as he remarks, the patient cannot escape with his life, unless he is saved by a critical evacuation, such as bleeding from the nose, or profuse sweating.