De Medicina

3 Now the foregoing precepts indeed almost always hold good; but some particular notice requires to be taken of changes of surroundings and varieties of constitution and sex and age and seasons. For it is not safe to remove either from a salubrious to an oppressive locality, or from an oppressive to a salubrious one. It is better to make the move from a salubrious into an oppressive place at the beginning of winter, from an oppressive into a salubrious one in early summer. It is not good indeed to overeat after a long fast, nor to fast after overeating. And he runs a risk who goes contrary to his habit and eats immoderately whether once or twice in the day. Again, neither sudden idleness after excessive labour, nor sudden labour after excessive idleness, is without serious harm. Therefore when a man wishes to make a change, he ought to habituate himself little by little; indeed any work is easier even for a boy or an old man than for an unaccustomed adult. Hence also too idle a life is inexpedient, because there may come up some necessity for labour. But if at any time a man has had to undergo unaccustomed labour, or at any rate much more than he is used to, he should go to bed on an empty stomach, more especially if he has a bitter taste in his mouth, or his eyes are dimmed, or his bowels disturbed; for then he must not only sleep with his stomach empty, but even remain at rest over the next day, unless rest has quickly removed the trouble; in this case

he should get up and take slowly a short walk. But even when there has been no necessity for a sleep, because a man has only done more moderate work, still he ought, all the same, to take a little walk. This then should be the rule for everyone after incurring fatigue before taking food: first to walk about a little, then, if no bath is at hand, to undergo anointing and sweating in a warm place whether in the sun or before a fire; when there is a bath, he should first sit in the warm room, then, after resting there a while, go down into the tubs; next, after being anointed freely with oil and gently rubbed down, again descend into the tub; finally he should foment the face, first with warm, then with cold water. A very hot bath does not suit such cases. Therefore if one's excessive fatigue almost amounts to a fever, it is quite sufficient for him to sit in warm water, to which a little oil may be added, up to the groins, in a tepid room; next his whole body, and especially the parts which have been under water, should be rubbed gently with oil to which a little wine and pounded salt have been added. This done, anybody who has undergone fatigue is ready for food, in particular food of a fluid consistency; he should be content with water to drink, or if wine, certainly diluted, of the sort to promote diuresis. Further it should be recognized that after labour accompanied by sweating a cold drink is most pernicious, and even although sweating after a fatiguing journey has passed off, it is unserviceable. After coming out of the bath, too, Asclepiades held it unserviceable; and this is true in the case of those whose bowels are loose at uncertain moments, and who readily shiver; but it is not the universal rule in all cases, since it is more natural that a heated stomach should be cooled, and a cold one warmed by a drink. I grant so much, but I hesitate to give this as a rule, for as a matter of fact a cold drink is bad while sweating. It also happens that after a dinner of many courses and many drinks of diluted wine a vomit is even advantageous; the next day there should be a prolonged rest followed by exercise in moderation. If there is oppression due to a persistence of fatigue, water and wine should be drunk alternately, but the bath seldom used. A change of work, too, relieves lassitude; and when a novel form of customary work has tired a man, that form to which he is accustomed restores him. To one who is fatigued that couch is best which he uses every day; for whether soft or hard, one to which he is unaccustomed wearies him. Certain things are specially applicable to one who is fatigued whilst travelling on foot. To be rubbed often while actually on the way restores him; after the journey he should sit awhile, then undergo anointing; next at the bath foment with hot water his upper rather than his lower parts. But anyone who has become overheated in the sun should go at once to the bath, and there have oil poured over the head and body; next go down to a thoroughly hot tub; then have water poured over his head freely, first hot, next cold. On the other hand, he who has become much chilled should first sit in the calidarium, well wrapped up, until he sweats; next be anointed, afterwards laved, then take food in moderation and after that drinks of undiluted wine. He too who on a voyage is troubled by seasickness, if he has vomited out a quantity of bile, should fast or take very little food. If he has spewed out sour phlegm, he may take food notwithstanding, but lighter than usual; if he has nausea without vomiting, he should either fast, or after food excite a vomit. But he who has spent all day sitting in a carriage or at the games should not after that hurry but walk slowly; also it is of service to linger somewhat in the bath, and then take a small dinner afterwards. When overheated in the bath, taking vinegar and holding it in the mouth restores him; if that is not at hand, cold water may be taken in the same way.

But above all things everyone should be acquainted with the nature of his own body, for some are spare, others obese; some hot, others more frigid; some moist, others dry; some are costive, in others the bowels are loose. It is seldom but that a man has some part of his body weak. So then a thin man ought to fatten himself up, a stout one to thin himself down; a hot man to cool himself, a cold man to make himself warmer; the moist to dry himself up, the dry to moisten himself; he should render firmer his motions if loose, relax them if costive; treatment is to be always directed to the part which is mostly in trouble.

Now the body is fattened: by moderate exercise, by oftener resting, by anointing, and by the bath if after a meal at midday; by the bowels being confined, by winter cold in moderation, by sleep adequate but not over long, by a soft couch, by a tranquil spirit, by food whether solid or fluid which is sweet and fatty; by meals rather frequent and as large as it is possible to digest. The body is thinned: by hot water if one bathes in it and especially if salt; by the bath on an empty stomach, by a scorching sun, by heat of all kinds, by worry, by late nights; by sleep unduly short or overlong, by a hard bed throughout the summer; by running or much walking or any violent exercise; by a vomit, by purgation, by sour and harsh things consumed; by a single meal a day; by the custom of drinking wine not too cold upon an empty stomach.

But as I have mentioned a vomit and a purge among thinning measures, there are some things to be said in particular concerning them. I note that a vomit was rejected by Asclepiades in the book written by him, entitled De tuenda sanitate; I do not blame him for being disquieted with the custom of those, who by ejecting every day achieve a capacity for gormandizing. He has even gone somewhat further; for from the same volume he has expelled likewise purgings; which indeed are pernicious when procured by too powerful medicaments. Such measures, however, are not to be dispensed with entirely, because regard for different constitutions and times can make them necessary, provided that they are employed in moderation and only when needed. Hence Asclepiades has himself allowed that what is already corrupted ought to be expelled: so this kind of treatment is not wholly to be condemned. But there may be more than one reason for this too; and so a somewhat closer consideration may be given to the matter.

A vomit is more advantageous in winter than in summer, for then more phlegm and severer stuffiness in the head occur. It is unsuitable for the thin and for those with a weak stomach, but suitable for the plethoric, and all who have become bilious, whether after overeating or imperfect digestion. For if the meal has been larger than can be digested, it is not

well to risk its corruption; and if it has already become corrupted, nothing is more to the purpose than to eject it by whatever way its expulsion is first possible. When, therefore, there are bitter eructations, with pain and weight over the heart, recourse should be had at once to a vomit, which is likewise of service to anyone who has heartburn and copious salivation or nausea, or ringing in the ears, or watering of the eyes, or a bitter taste in the mouth; similarly in the case of one who is making a change of climate or locality; as well as in the case of those who become troubled by pain over the heart when they have not vomited for several days. Nor am I unaware that in such cases there is prescribed rest, but that is not always within the reach of those who are obliged to be busy; nor does rest act in the same way with everybody. Accordingly I allow that vomiting should not be practised for the sake of luxury; on account of health I believe from experiment that it is sometimes rightly practised, nevertheless with this reservation, that no one who wants to keep well, and live to old age, should make it a daily habit. He who after a meal wants to vomit, if he does so easily should first take tepid water by itself; when there is more difficulty, a little salt or honey should be added. To cause a vomit on getting up in the morning, he should first drink some honey or hyssop in wine, or eat a radish, and after that drink tepid water as described above. The other emetics prescribed by the ancient practitioners all disturb the stomach. After a vomit, when the stomach is weak, a little suitable food should be taken, and for drink, unless the vomiting has made the throat raw, three cupfuls of cold water. He who has provoked a vomit, if it be early in the day, should after that take a walk, next undergo anointing, then dine; if after dining, he should the next day bathe, or sweat in the baths. After that the following meal had better be a light one, consisting of bread a day old, harsh undiluted wine, roasted meat, all food being of the dryest. Whoever aims to provoke a vomit twice a month, had better arrange to do so on two consecutive days, rather than once a fortnight, unless this longer interval causes heaviness in the chest.

Now defaecation is to be procured also by a medicament, when, the bowels being costive, too little is passed, with the result that there is increase of flatulence, dizziness of vision, headaches, and other disturbances in the upper parts. For what can rest and fasting help in such circumstances which come about so much through them? He who wants to defaecate should in the first place make use of such food and wine as will promote it; then if these have little effect, he should take aloes. But purgatives also, whilst necessary at times, when frequently used entail danger; for the body becomes subject to malnutrition, since a weakened state leaves it exposed to maladies of all sorts.

The body is heated: by anointing, by salt-water affusion and the more so when hot; by all food which is salt, bitter and fleshy; and after meals by the bath and harsh wine. On the contrary it is cooled: by the bath and sleep on an empty stomach, if not too prolonged; by all sour food; by the coldest water to drink, by oil affusion when mixed with water.

The body is rendered humid: by more than customary exertion, by a frequent bath, by food in

increased amount, by copious drinking, followed by walking and late hours; much walking, early and forced, has by itself the same effect, food being taken not immediately after exercise; so also those classes of edibles which come from cold and rainy and irrigated localities. On the contrary the body is dried: by moderate exercise, hunger, anointing without the addition of water, summer heat with moderate exposure to the sun, cold water to drink, food immediately after exercise, and all edibles coming from hot and dry districts.

The bowels are confined by exertion, by sitting still, by besmearing the body with potter's clay, by a scanty diet, and that taken once a day in the case of one accustomed to two meals, by drinking little and that only after the consumption of whatever food is to be taken, also by rest after food. On the contrary they are rendered loose: by increasing the length of the walk, more food and drink; by moving about after the meal; by frequently drinking during the meal. This too should be recognized, that a vomit confines the bowels when relaxed, and relaxes them when costive: again, a vomit immediately after the meal confines the bowels, later it relaxes them.

As to what pertains to age: the middle-aged sustain hunger more easily, less so young people, and least of all children and old people. The less readily one supports it, the more often should food be taken; one who is growing needs it most. Children and the old should bathe in warm water. Wine should be diluted for children; for the old men it should be rather undilute: but at neither age be of a kind to cause flatulence. It matters less for the young what they take and the way they are treated. Those who

when young are relaxed, when old are generally costive; those constipated in youth are often relaxed when old. It is better to be rather relaxed when young, rather costive when old.

The season of the year also merits consideration. In winter it is fitting to eat more, and to drink less but of a stronger wine, to use much bread, meat preferably boiled, vegetables sparingly; to take a single meal unless the bowels are too costive. If a meal is taken at midday, it is better that it should be somewhat scanty, and that dry, without meat, and without drinking. At that season everything taken should be hot or heat-promoting. Venery then is not so pernicious. But in spring food should be reduced a little, the drink added to, but, however, of wine more diluted; more meat along with vegetables should be taken, passing gradually from boiled to roast. Venery is safest at this season of the year. But in summer the body requires both food and drink oftener, and so it is proper in addition to take a meal at midday. At that season both meat and vegetables are most appropriate; wine that is much diluted in order that thirst may be relieved without heating the body; laving with cold water, roasted meat, cold food or food which is cooling. But just as food is taken more frequently, so there should be less of it. In autumn owing to changes in the weather there is most danger. Hence it is not good to go out of doors unless well covered, and with thick shoes, especially on the colder days; nor at night to sleep in the open air, or at any rate to be well covered. A little more food may now be taken, the wine less in quantity but stronger. Some think orchard fruit injurious, which is generally the

case when eaten immoderately all day, without reducing more substantial food. Hence it is not the fruit but the heaping of all things together which does harm, but in none of them all is there less harm than in the fruit. But it is not fitting to eat of it oftener than other kinds of food, and when eaten, it is necessary to subtract some of the more substantial food. But venery is useful neither in summer nor in autumn; it is more tolerable nevertheless in autumn, in summer it is to be abstained from entirely, if that possibly be done.

4 I have next to speak of those who have some parts of the body weak. He whose head is infirm ought, after he has digested well, to rub it gently in the morning with his own hands; never if possible cover it with a wrap; have it shaved to the skin. It is well to avoid moonlight, and especially before the actual conjunction of the moon and sun, and to walk nowhere after dinner. If he has retained his hair, he should comb it every day, walk much, but, if possible, not under cover nor in the sun; everywhere, however, he should avoid the sun's blaze, especially after taking food and wine; undergo anointing rather than affusion, but that never before a flaming fire, on occasion before a brazier. If he goes owing to the bath he should first sweat for a while, in the tepidarium, wrapped up, and then undergo anointing there; next pass into the calidarium; after a further sweat he should not go down into the hot bath, but have himself sluiced freely from the head downwards, first with hot, next with tepid, then with cold water, which should be poured for longer on the head than upon other parts, after which it should be rubbed for a while, lastly wiped dry and anointed. Nothing is so

beneficial to the head as cold water, and so he who has a weak head every day throughout the summer hold it for a while under the stream from a large conduit. But even if he undergoes anointing without going into the bath, and cannot bear cooling of the whole body, he should always nevertheless douche his head with cold water; but since he does not want the rest of his body wetted, he bends forward for the water not to run down his neck, and with his hands directs the flow to his face, that his eyes or other parts may not be irritated. He must take food in moderation and such as he can easily digest; and if fasting affects his head, he should take a meal at midday; if it does not so suffer, the single meal is preferable. It is more expedient for him to drink a light wine, well diluted, rather than water, in order that he may have something in reserve when his head begins to become heavier; and to him, on the whole, neither wine nor water is proper always; each constitutes a remedy when taken in its turn. To write, to read, to argue, is not beneficial to him, particularly after dinner; after which, indeed, even cogitation is not sufficiently safe; worst of all, however, is a vomit.

5 Nor indeed is it only those who are troubled by a weakness of the head that find the use of cold water beneficial, but also those who suffer with persistent running from the eyes, choked nostrils and running from the nose, and tonsillar maladies. In these cases, not only is the head to be douched every day, but also the face bathed with abundance of cold water; especially should this be carried out by all those benefited by it, whenever the south wind renders the weather more oppressive. And whereas

after dinner either wrangling or mental worry is injurious to everybody, it is especially so to those who are disposed to pains in the head or windpipe, or to other forms of oral affections. Choked nostrils and running from the nose can be also avoided, or minimized, if one who is liable to these makes as little change as possible in respect to residence and water; if he protects the head, that it may not be scorched by the sun, or be chilled by a passing cloud; if the head be shaved after digestion and the stomach empty; if there be no reading or writing after a meal.