Celsus gives minute directions for conducting the treatment in all the stages of the complaint. He thus sums up the remedies which he recommends: “In ejusmodi valetudine medicamenta sunt, oleum, frictio, exercitatio, cibus, vinum.”
Serapion mentions black hellebore, agaric, and the lapis lazuli, as medicines which purge black bile. (De Antid. vi, 15.) Averrhoes, however, cautions against using black hellebore for the cure of quartans; expresses himself in dubious terms respecting venesection; and, upon the whole, seems to place his principal reliance in things of a diffusible, attenuant, and penetrating nature. Haly Abbas, Avicenna, and Rhases speak of venesection in much the same terms as Galen, that is to say, they recommend it when symptoms of plethora are present, but say that it may prove prejudicial in any other circumstances. They approve of emetics at the commencement, and of wormwood in the decline of the fever. Avicenna appeals to Galen in favour of the black and white hellebore. Several of Rhases’ authorities in his ‘Continens’ recommend bleeding. They in general approve of the early use of the bath, and of diuretics and sudorifics; and recommend, in the decline of the fever, things of a heating nature, such as pepper, anise, spikenard, ginger, &c.
It remains to be mentioned that amulets were very much used in ancient times for the cure of quartans. Alexander Trallian had great confidence in them. Galen supposed that they owed their virtues to the physical properties of the substances which were appended. Ælius Spartianus, one of the writers of the Augustan History, says, that the emperor Caracalla wished to punish those who made use of amulets. On the περίαπτα, περίαμματα, vel amuleta of the ancients, see Andreas Laurentius (de Mirab. Strum. sanat. p. 83); Rendtorfius (Notæ in Anatolii Fragment. ap. Fabricii Biblioth. Græc. iv, 305); and Wolfius (ap. Act. Lips. 1690.) The practice of using amulets for the cure of diseases must have been very ancient, for it is alluded to by Pindar (Pyth. iii), and Theophrastus (H. P. ix, 10.) The facts recently stated in support of the system of Animal Magnetism have been supposed to give some countenance to the ancient belief in the efficacy of amulets.
SECT. XXIV.—THE DIAGNOSIS OF THE QUOTIDIAN.
The quotidian does not make its attack with a rigor on the first day, but in progress of time, a chill rather than rigor takes place, which is, with difficulty, succeeded by heat, and it has a protracted increase. Yet, it does not make those affected hot, nor their respiration frequent and thick, nor does it make them pant or drink cold water. But they have vomitings of phlegm, and whatever is voided by the belly is cold, crude, and watery, in these fevers. And they have no sweats during the first days, neither have they an interval of freedom from fever. Their colour is white and pale; their urine thin and white, or thick, turbid, and red.
Commentary. We have stated, in [the 18th Section], that the ancients were of opinion that quotidians derive their origin from phlegm, that is to say, serum.
Our author’s description is abridged from Galen (Therap. ad Glauc. i.) The other authorities treat of it in much the same terms. Even Alexander, who aims at originality, agrees with Galen and Hippocrates, in referring the origin of quotidians to phlegm. Palladius, in his valuable little treatise on Fever, is at great pains to explain the manner in which putrid extravasated phlegm gives rise to quotidian. He represents the heat as being smothered and concealed like that of moist fuel. Celsus describes all the varieties of the disease very minutely. Constantinus Africanus gives an accurate description of this intermittent. He says that the paroxysm lasts for twenty-four (eighteen?) hours, and is followed by an interval of six hours. First, old persons, and then boys, are said to be peculiarly subject to the disease, which is apt to make its attack in cold countries and at cold seasons of the year. It is attended with a great degree of cold, especially of the extremities; the face is swelled, the colour pale, and no thirst is present.
As the Arabians give the same account of the origin and symptoms of quotidians, we need not enter upon a detail of their descriptions. All agree that they are connected with phlegm as an exciting cause, and that the fever is less ardent and well-marked than in the case of tertians.
SECT. XXV.—THE CURE OF QUOTIDIANS.
In curing the quotidian, we use oxymel during the first days, and those things which properly promote the discharge of urine. And, upon the whole, the diet ought to be incisive; but, at its acme, we must look to the stomach, particularly its orifice. We must also prescribe an emetic from radishes taken with food, and phlegmagogue cathartics in abundance, until it subside.