When the body gets to an immoderate degree of obesity, it will be
necessary to melt it down and reduce it. It was mentioned formerly that
the warm temperament renders the body lean, and therefore it ought to be
superinduced, if possible, upon that of fat people, in order to reduce
them to the proper state. You have also learned that active exercise,
an attenuant regimen, medicines of the same class, and mental anxiety,
bring on the dry temperament, and thereby render the body lean. What an
attenuant diet consists of is perfectly obvious; but the more powerful
medicines, such as the seed of rue, particularly the wild, with its
tops, the round birthwort (_aristolochia rotunda_), the small centaury,
gentian, poley, and the stronger diuretic medicines, as Macedonian
parsley: all such medicines, either alone, or together, attenuate the
humours, and evacuate the body. The salts also from burned vipers
and the theriac attenuate the body. The body may also be reduced and
attenuated, by having an oil rubbed into it, containing the root of
the wild cucumber, marshmallows, gentian, and the root of the all-heal
and birthwort, or the poley and centaury. One ought not to take food
immediately after the bath, but should first sleep for a little time.
And it will be better if the water of the bath possess diaphoretic
properties, and, more particularly, if we can have recourse to a natural
one, such as that in Mitylene. If it cannot be procured, the flower of
salt may be mixed with sea water. Thin white wines ought to be used. Dry
rubbing with thick towels is calculated to reduce the fat. A smaller
quantity of food ought to be given in proportion to the exercise taken.
Insolation also is of use for obesity. Fat persons ought not to take a
fragrant draught before a meal; and it will be best if they eat only
once in the day. The body ought to be rubbed with nitre (soda), and the
rougher salts. A large quantity of nitre in the bath is attenuant, but a
small quantity only stimulates to nourishment. The following mixture is
attenuant: Of pepper and Macedonian parsley, two parts, of asarabacca and
anise, one half. This acts well, both as a diuretic and a cathartic.
* * * * *
COMMENTARY. This is taken from Oribasius. (Synops. v, 40.) Aëtius uses
nearly the same words. (iv, 32.) Celsus recommends the tepid salt-water
bath, hard exercise, food of an acid or austere kind, and restricted
sleep. (i, 3.)
Galen gives an interesting account of the manner in which he cured a
person of obesity in a very short space of time. He says, “I first made
him take quick exercise, and afterwards wiped off the sweat with a
linen cloth. I then rubbed his body with the volatile ointments called
acopa, and after this friction I led him to the bath. I did not then
give him food at once, but directed him either to rest, or to follow any
occupation he was inclined for, and then repeated the bath; after which
I gave him as much food, not of a very nourishing description, as he was
disposed to take.” (De Sanit. tuendâ, vi, 8.)
Avicenna recommends hard exercise and frequent baths, and vinegar to
drink. (i, 3, 4.) Rhases recommends fat persons to abstain from animal
food, wine, milk, and all sweet things; to live upon pot-herbs, and such
things as are saltish and sour; to take purgatives and diuretics, to use
much hard exercise, and to remain long in the bath. (Ad Mansor. v, 61.)
In another work he treats of this subject at great length. He recommends
acids, and especially vinegar. In short, he agrees with Galen, that all
things of a bitter, sour, and attenuant nature reduce obesity; and also
that saltish things which have the property of opening the bowels do the
same. Nothing, he says, tends more to reduce corpulency than frequent
baths and hard friction. (Contin. iv.)
The directions given by Haly Abbas are to the same effect as those of
Rhases, that is to say, he recommends fat persons to take hard exercise,
to remain long in the bath, to use friction with oil of dill and the
like, to live upon articles of food not too nutritious, not to indulge in
protracted sleep, and to have frequent recourse to laxative and purgative
medicines. (Pract. i, 16.)
Some remarkable cases of obesity are related by Athenæus. (Deipnos, xii,
12.)
The practice of the Methodists is described in a very circumstantial
manner by Cælius Aurelianus. (Tard. Pass. v, 9.) They very properly
condemned bleeding and purging, and depended principally upon strong
exercise, hot baths, insolation, the sand-bath, hard friction, and a
restricted diet.