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.
When, in the inflammative lassitude, the head is affected, Aëtius directs
us to open the cephalic vein; when the chest or back, the basilic; and
when the whole body equally, the median. He recommends also cooling
herbs, such as beet, mallows, lettuce, and the like, with ptisan and
tepid water. He forbids the use of cold water. After the third day, if
the patient is convalescent, he allows a thin weak wine, much diluted.
Averrhoes approves very much of Galen’s directions respecting the
treatment, except that the peppers recommended by him had not been found
to answer in his climate (Cordova). Instead of them, he directs cinnamon,
amber, cassia lignea, and similar aromatics to be given.
Avicenna joins Galen in cautioning the physician to be guarded in
allowing his patient to take much food, as the veins being emptied by the
remedies applied for removing the lassitude, greedily absorb the chyle
before it is properly concocted.