It is necessary also to observe, whether the distemper increases, or is at a stand, or abates: because some remedies are proper for disorders increasing, more for those, that are upon the decline. And those, which are suitable to increasing disorders, when an acute distemper is gaining ground, ought rather to be tried in the remissions. Now a distemper increases, while the pains and paroxysms grow more severe; when the paroxysms return after a shorter interval, and last longer than the preceding did. And even in chronic disorders, that have not such marks, we may know them to be increasing, if sleep is uncertain, if concoction grows worse, if the intestinal excretion is more fetid, if the senses are more heavy, the understanding more slow, if cold or heat runs over the body, if the skin grows more pale. But the contrary symptoms to these are marks of its decrease.
Besides in acute distempers, the patient must not be allowed nourishment so soon, not till they be upon the decline; that fasting by a diminution of matter may break its violence; in chronic disorders, sooner, that he may be able to endure the continuance of the disease. But if the distemper happens not to be in the whole body, but only in a particular part, yet it is more necessary to support the strength of the whole body, than of the part; since by means of that strength the diseased parts may be cured. It also makes a great difference, whether a person has been properly or wrong treated from the beginning: because a method of cure is less successful, where it has been often applied unsuccessfully. If one has been injudiciously treated, but still possesses his natural strength, he is quickly restored by a proper management.
But since I began with those symptoms, which afford marks of an approaching illness, I shall commence the methods of cure from the same period. Wherefore if any of those things[(1)], which have been mentioned, happen, rest and abstinence are best of all: if any thing is drunk, it should be water; and sometimes it is sufficient to do that for one day; sometimes for two days, if the alarming symptoms continue; and immediately after fasting, very little food must be taken, water must be drunk; the day after, wine; then every other day by turns water and wine, till all cause of fear be removed. For by these means often a dangerous distemper impending is averted. And a great many are deceived, while they hope upon the first day immediately to remove a langour either by exercise, or bathing, or a gentle purge, or vomiting, or sweating, or drinking wine. Not but this may sometimes happen, or answer their expectations, but that it more frequently fails; and abstinence alone may cure without any danger. Especially as that may be regulated according to the degree of one’s apprehensions: and if the symptoms are slight, it is sufficient only to abstain from wine; a diminution of which assists more than lessening the quantity of food: if they are somewhat more dangerous, it may serve the turn not only to drink water (as in the first case), but to forbear flesh too: and sometimes to take less bread than ordinary, and confine one’s self to moist food, especially greens. And it may be sufficient then only to abstain entirely from food, wine and all motion, when violent symptoms give the alarm. And without doubt scarce any body will fall into a distemper, who does not neglect it, but takes care by these means to oppose its beginning in due time.
CHAP. III. OF THE SEVERAL KINDS OF FEVERS.
These are the rules to be observed by such as are in health, that are only apprehensive of the cause. We next proceed to the cure of fevers, which is a kind of disease, that affects the whole body, and is the most common of all. Of these one is a quotidian, another a tertian, and a third a quartan. Sometimes some fevers also return after a longer period, but that seldom occurs. With regard to the former, they are both diseases in themselves, and a cure for others.
But quartan fevers are more simple. They begin commonly with a shuddering; then a heat breaks out; after the paroxysm is over, the patient is well for two days. So that it returns upon the fourth day.
Of tertians again there are two kinds. One of them both beginning and ending like the quartan; with this difference only, that there is one day’s intermission, and it returns upon the third. The other kind is much more fatal, which indeed returns upon the third day, but of forty-eight hours, thirty-six are occupied by the fit (and sometimes either less or more,) nor does it entirely cease in the remission; but is only mitigated. This kind most physicians call semitertian[ BB ].
But quotidians are various, and different in their appearances. For some of them begin with a heat, others with a coldness, others with a shuddering. I call that a coldness, when the extremities of the limbs are chilled; a shuddering, when the whole body trembles. Again, some end, so as to be followed by an interval quite free from indisposition; others so, as that though the fever somewhat abates, yet some relicks remain, till another paroxysm comes on; and others often remit little or nothing, but continue as they began. Some again are attended with a very vehement heat, others more tolerable; some are equal every day, others unequal, and alternately milder one day and more severe another: some return at the same time the following day, others either later or sooner: some by the fit and the intermission take up a day and a night, some less, others more: some, when they go off, cause a sweat, others do not; and in some a sweat leaves the patient well, in others it only renders the body weaker: sometimes also one fit comes on each day, sometimes two or more. Whence it frequently happens, that every day there are several both paroxysms and remissions; yet so as that each of them answers to some preceding one. Sometimes too the fits are so irregular, that neither their durations nor intermissions can be observed. Nor is it true, which is alledged by some, that no fever is irregular, unless it arise from a vomica, or an inflammation, or an ulcer. For the cure would always be easier, if this were fact. For what is occasioned by the evident causes, may also proceed from the occult. Nor do those dispute about things, but words, who alledge, that when feverish paroxysms come on in different manners in the same distemper, these are not irregular returns of the fever, but new and different fevers successively arising. Which however would have no relation to the method of cure, though it were true. The intervals also are sometimes pretty long, at other times scarce perceptible.