Commentary. See, in like manner, Galen (de Sanitate tuenda, vi); Oribasius (Synops. v, 51); Aëtius (iv, 9); Actuarius (de Diæta, c. 12.) Of the Arabians, Haly Abbas is the author who has delivered the treatment of the temperaments in the fullest manner. (Pract. i, 15.)
It is to be remarked that the condition of the body named the hot intemperament by the ancients is the same as that now generally called a bilious habit. Accordingly, Galen directs the physician to attend whether any pain or sense of weight be felt in the region of the liver, as, in that case, he judges it unsafe to take the bath after a meal, and recommends him rather to give deobstruents, and to proscribe food of a thick viscid nature. He particularly recommends an attenuant diet, and medicines of the same description, namely, wormwood, anise, bitter almonds, &c. His views of practice, in short, appear to have been very judicious.
SECT. LXXI.—THE CORRECTION OF THE COLD INTEMPERAMENTS OF THE BODY.
Of cold intemperaments there are three varieties, the worst of which is the dry; for such persons are from the first in that state which time brings upon old men. They ought, therefore, to use whatever is diluting and warming, such as moderate exercise, humid and warm food, the heating wines, and much sleep. Care should be taken by us, that all the excrementitious matters collected in the body be evacuated every day. Venery hurts all those who are affected with dryness, and more especially if joined to coldness, and is innocuous to the hot and humid alone. The cold and humid temperaments are bad, and are very subject to rheumatic affections. They are relieved by abstinence from the bath, by frequent and light exercises, and the use of moderately heating unguents. Those that are naturally colder, but are well regulated as to dryness and humidity of temperament, ought to stimulate and increase their heat, but to choose the medium between a humid and dry diet.
Commentary. See the authorities referred to in [the preceding Section]. All, in a word, copy from Galen. (l. c.)
SECT. LXXII.—THE CURE OF THE DRY INTEMPERAMENTS, OF THE STOMACH FOR EXAMPLE; THEN OF THE OTHER INTEMPERAMENTS.
A dry intemperament may either be occasioned by the parts of uniform texture being drier than natural, in their solid parts, which is incurable; or by the natural moisture from which these parts derive their nourishment being lost. It is contained in all parts of an animal, being diffused through them in the form of dew, and can only be supplied by means of the food. The former variety is utterly incurable; and even the latter is of all states of the body the most intractable. But when the dryness is seated in the small veins and arteries, the cure may be attempted by filling each of the parts of uniform texture with their proper juices by a humid diet. A tepid bath is therefore beneficial, and the patient ought to remain long in the water. Immediately after the bath, let him take the milk of an ass newly drawn, to which a little warm honey has been added. Afterwards he ought to rest until he take a second bath. He ought then to be moderately rubbed with oil, if the milk appears to be digested, which may be judged of from his eructations and the distension of his belly. The proper interval between the first and second bath may be four or five hours at the equinox, if he be to bathe a third time, but, if not, it may be greater. And he ought to be rubbed with oil before putting on his clothes after every bathing. If, therefore, the milk agreed with him, we may give it to him after the second time, or, if not, we may give, instead, a ptisan properly boiled, or alica made into a ptisan; he is then to rest until the third bathing, or otherwise until supper. His bread ought to be carefully prepared, baked in an oven, and of a fine quality; and as a seasoner, he may eat those fishes which are caught among rocks, or the hake in a white soup. In a word, his food ought to be of easy digestion and nutritious, not oily and excrementitious. His drink should be wine that is weak, white, clear, bearing little water, and having some astringency. Such is the mode of cure for the greatest degree of dryness; but the moderate does not require the same restriction as to diet, which may therefore be more generous. Let us suppose a dryness like the former, but mixed with a moderate coldness; and in this case, we must substitute certain calefacient articles; and, with regard to those mentioned above, we must add more honey to the milk, and give wine that is not so watery. We must also not only use things which are naturally heating, but which are so from their acquired qualities. And the body is to be rubbed frequently with the ointment of nard and mastich. When much coldness is joined to the dryness, know in the first place, that the complaint is difficult and intractable, but use the same remedies, and also by itself honey that has been boiled and scummed, along with very old wine. The best possible remedy in such cases is that which is much used by pitchers; and we must likewise rub the belly with it, and tear it away while it is yet warm. Such persons are also relieved by having a child of a full habit sleeping with them, so as to touch their belly. Let us next suppose that a moderate heat is joined to dryness. In this case, our first care ought to be, not to taste honey, and to use wine which is not aged, food which is tepid and milky, and to rub the belly with the oil of unripe olives, or with that of apples. But to cool such persons much is not devoid of danger, as their state is feverish when the heat prevails. Let us next suppose that a hot intemperament prevails, and that humidity is joined to it. Such an intemperament is to be cured by drinking cold water. The use of astringent food is also proper; namely, such things as are austere, without being heating. But when the humid intemperament alone prevails, such articles of food as are desiccant, without heating or cooling much are beneficial, and also abstinence from the common drinks. When the humid intemperament is joined with the cold, the best remedies are all acrid things, and they ought to be mixed with such things as are astringent, without being decidedly refrigerant. The drink should be in small quantity, and consist of some of the strongly heating wines. These are the modes of curing intemperaments proceeding from qualities. But since a humour contained within the cavity of the stomach, or being absorbed within its coats, often occasions intemperaments, it will be proper to treat also of these affections. If the former state occur at once, it may be easily removed by emetics; but if it be a defluxion, the parts it comes from will require very attentive consideration, and the cure will follow, of course; for it is to be applied entirely to the affected part; and of the other parts, we need only take care that they be not thereby affected. The cure is to be performed by astringents, and such things as will bring the whole body to its proper habit. Depraved humours in the coats of the stomach are to be evacuated by moderately cathartic medicines, such as aloes, and the powder prepared from it, called Picra. When a viscid phlegm is contained in the stomach, such persons ought first to take those things which will cut it, and then it may be purged off, or evacuated by vomiting with radishes. When the humour is neither viscid nor thick, a vomit from ptisan, or that from honied water, may be sufficient. The juice of wormwood with honied water may also be drunk. In like manner, intemperaments in other parts may be cured, by finding out the evacuation suited to the humours; or, if the part has no sensible discharge, the prevailing matters and humours may be evacuated in the form of vapour; and in like manner, if it proceed from flatulence.
Commentary. Galen supplies all the matter of this Section. (l. c.)
The modern ideas respecting the temperaments, appear to be founded upon the descriptions given by the Arabians of the symptoms which characterize the prevalence of the four humours, as they were called, namely, blood, yellow bile, black bile, and phlegm, in the body. In proof of this, we subjoin Rhases’ brief description of them: “De complexione autem infirmi scias, quod si fuerit albi coloris admixti rubedini, et si fuerit bonæ carnis, subtilis cutis, et quando locum fricaveris, rubescit statim, significatur quod materia est sanguinea. Et si corpus fuerit pingue, et albi coloris non mixti rubedini, et corpus nudum pilis, venis strictis, carne molli, occultarum juncturarum, gracilium ossium, et generaliter talis dispositio qualis est in corporibus mulierum, significatur quod materia est phlegmatica. Et si fuerit macrum, citrini coloris, pilosum, et cum crassis venis, et manifestis juncturis, ostendit quod materia est cholerica. Et si fuerit niger color, durities corporis, pilositas, asperitas cutis, significatur quod materia est melancholica.” (De Affect. Junct. 2.)
It is to be understood, however, that Galen’s system of the temperaments was not based, as has been often erroneously represented, upon any hypothesis respecting the humours.