In the Epistle of Vindicianus, physician to the Emperor Valentinian, there is an interesting history of a fever, arising from indigestion and obstruction of the bowels, brought on by excess in eating and drinking. In this case Vindicianus, in opposition to the advice of the other professional attendants, would not administer a clyster, and gave his patient nothing but salt and water, which procured first copious perspirations, and afterwards free evacuations of the bowels. He then directed him to use the bath, and completed the cure by giving wormwood to remove obstructions. This is a well-marked case of intestinal fever. (Fabricii Bibl. Græc. t. xiii.)
We may state the general characters of the urine as given in an interesting little treatise, ‘On the Urine,’ lately published by Ideler. In synochous fevers, as being connected with fulness of blood, the urine is red, thick, and indicating by its colour and consistence the want of concoction. (De Urinis Commentatio.)
Haly Abbas, during the first three days, strongly recommends venesection, which, he says, will either have the effect of cutting short the fever at once, or of rendering it milder. His other remedies are altogether refrigerant, consisting of acidulated drinks, and gentle purgatives, such as prunes, tamarinds, and the like. Alsaharavius, in like manner, recommends depletion, and the refrigerant plan of treatment.
Serapion strongly recommends bleeding, ad deliquium animi, which, he says, will probably have the effect of procuring discharges from the bowels, and of promoting perspiration. He admits of venesection even after the sixth or seventh day, when other circumstances indicate it. He further prescribes refrigerant remedies, such as tamarinds, cassia-fistula, and the like.
Averrhoes, although he approves of venesection, condemns Galen’s direction to carry it the length of bringing on deliquium animi. He also cautions against carrying the administration of cold drink too far.
Avenzoar strongly recommends bleeding ad deliquium. Avicenna likewise approves of this practice. When the strength does not permit to carry depletion so far, he directs us to open the temporal veins, or to abstract blood by cupping. In such cases he also recommends purgatives and refrigerant medicines. Towards the conclusion of the fever he directs the trochisks of camphor to be given.
Rhases gives an excellent account of synochus. His remedies are bleeding, gentle purgatives, acidulated drinks, restricted diet, and complete abstinence from wine. He particularly recommends aloes as a purgative. (See, in particular, Contin. xxx, v, 2.) He approves of the bath, but prefers delaying the use of it until the decline of the fever. He is very decided in recommending bleeding, unless the patient be of a weak constitution, or his system loaded with crudities. After the fever is concocted, he approves of giving cold water freely for drink.
SECT. XXIX.—ON THE DIAGNOSIS OF ARDENT FEVERS.
The following symptoms accompany ardent fevers: tongue dry, rough, and black, griping of the stomach, excrements pale, strong thirst, watchfulness, and sometimes delirium.