That species of lassitude called the Ulcerose is occasioned by a
collection of thin and pungent superfluities in the body. In the
Tensive there is scarcely any superfluity in the system, but the state
of the muscles and nerves is such that they appear to be stretched. The
Inflammative, in which we feel as if the parts of the body were bruised
or inflamed, happens when, being much heated, the muscles attract the
surrounding superfluities. There is a fourth species, occasioned by
an unnatural dryness of the muscles, in which the body, when stripped
naked, appears squalid and constricted, and is averse to motion. The
cure of the ulcerose species consists in dispelling the superfluities
by much and soft friction with plenty of oil devoid of astringency. The
indication of cure in the second or tensive species is relaxation, which
may be accomplished by means of little and soft friction with oil heated
in the sun; by quietude and rest, by tepid baths, and remaining for a
considerable time in the warm water; for, if you repeat the bath two or
three times in succession, you will confer so much the greater benefit.
In the third species, or the inflammative, there are three indications of
cure: the discharge of the superfluity, the relaxing of the constriction,
and the cooling of the inflammatory state. Plenty of tepid oil, the
softest friction, and remaining long in a bath of a moderate temperature,
remove lassitudes of this description. Long-continued quietude is also
proper, and repeated inunction. The treatment of the fourth differs in
no respect, for the first day, from that of the third, except that the
water ought to be hotter, so as to contract gently; and on the second,
the restorative kind of exercise must be had recourse to; and when in the
bath, let the person straightway leap into the cistern of cold water. All
those affected with lassitude stand in need of wholesome food.
* * * * *
COMMENTARY. There is a short treatise on this subject, among the minor
works of Theophrastus. He states that, as the excess of motion in this
case has produced a preternatural dryness of the body, the indication of
cure is to humectate, that is to say, to dilute, by baths and drinks. The
work contains many ingenious observations; but our limits do not admit of
our giving a proper outline of it.
Our author copies from Oribasius (Synops. v, 15); see, also, Aëtius (iv,
55 et seq.) They all, however, are indebted to Galen. (De Sanit. tuend.
iii, 7.) The ulcerose lassitude, he says, arises from a collection of
excrementitious superfluities, which are produced by the melting of
fat and muscle. In the second species, called the tensive, there is no
collection of humours, but the muscular fibres are excessively stretched.
The third species, or the inflammative, is characterized by a sensation,
as if the parts affected were bruised or inflamed, and happens when the
muscles, being excessively heated, attract the superfluities from the
surrounding parts. From the pain being deep seated, it has been called
ostalgia. He adds a fourth species, being a case somewhat different from
all those we have been describing. It is the contrary state to that of
the inflammative, the body appearing squalid and contracted. The first
case, as it is connected with redundance of humours, is to be cured
by discutients; and hence the proper remedy for it is much friction,
with emollient oils wholly devoid of astringency. He also approves of
the gentle exercise called the restorative. The second species, or the
tensive, is to be cured by gentle friction, with emollient oils heated in
the sun; by complete quietude, and the frequent repetition of the tepid
bath. In particular, unction with oil is proper. The third species, as
it is occasioned by violent motions, and is attended with excruciating
pains, is to be cured by the gentlest friction, with the most emollient
oils; by the most perfect rest, and the tepid bath. The fourth species,
characterized by squalor and constriction of the skin, is to be treated
by the hot bath, to warm and invigorate the skin, then by soft and slow
motions and friction; and then again by the hot bath. But, he adds, the
patient must straightway leave the cistern of the hot bath, and plunge
into that of the cold, but not remain long in it. The diet, in all these
cases, is to be restricted and cooling, especially in the Inflammative.
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.)