I n the medical school at Salerno in the thirteenth century, the standard textbook of medicine, the Regimen san-itatis salernitanum—the Salernitan Regime of Health— was composed. A book of verses attributed to Arnald of Villanova (1240-1311), it provided practical guidelines for good living, but also definitions of the healthy and pathological bodies. Extraordinarily popular, it summarized and informed much of the later views of obesity. In a seventeenth-century English translation, it provided a snapshot of the humoral obese body in the light of the medieval reception of Greek medicine:
Men that be flegmatik, are weak of nature, Most commonly of thick and stubbed stature.
And fatnesse overtaketh them amain, For they are slothfull, and can take no pain. Their sences are but dull, shallow and slow, Much given to sleep, whence can no goodnesse grow,
They often spet: yet natures kind direction, Hath blest them with a competent complexion.
(Holland 1806: 35)
Thus phlegmatic fat persons cannot stand pain; they suffer from character flaws and are lazy, and nonproductive. But there is also a healthy fat that dines on "sweet wine, delicious meats, eggs that are rare / Over ripe figs and raisins, these appear. / To make the body fat, and nourish nature, / Procuring corpulence, and growth of stature" (Holland 1806: 7). This fat can itself become diseased but is of a different nature than the inherent obesity of the phlegmatic body because it comes from a different source. Food can cause illness, as Galen states, but there is also a "healthy" fat that is the result of eating without overindulgence. The cure for overindulgence is to eat foods with the antithetical humoral traits as the fat person. Thus, drinking vinegar (which is dry and cool) as therapy for the obese body (wet and cool), "unto fat folks, greatly doth no good" (Holland 1806: 19).
The sixteenth-century Italian physician Gerolamo Mercuriale also stressed that obesity is the result of internal and external factors, paraphrasing Galen. Yet, he also understands that the obese are not all stupid; indeed, they can be as intellectual as the thin person. Any given person can be born with the tendency towards obesitas. But adventitia, the acquired fat of a dissolute life, makes the mind crude. It is the result of an oily blood that turns to fat. Mercuriale's contemporary Tommaso Minadoi follows Galen's theory of the temperaments seeing damp and cold as the origin of fat. Such people are born not made; they are soft, hairless, pale and cold. Those who become fat are quite different. They are of a reddish complexion, hairy, have hard rather than soft flesh. They suffer from a constant hunger that drives them to become fat. Such theories build on the notion of a "natural" and an "unnatural" obesity, which demand different types of diets.
See also Brillat-Savarin; Ibn Sina; Roman Medicine and Dieting
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