CHAP. XII. THE CURE OF A SHUDDERING BEFORE FEVERS.
A shuddering commonly precedes those fevers, that have a certain period, and a perfect remission, and for this reason are the most safe, and most easily admit of a cure: for where the periods are uncertain, neither clysters, nor the bath, nor wine, nor any other remedy can be duly administered. For it is uncertain when the fit will come: so that if it come on suddenly, the greatest detriment may happen to accrue from that, which was intended to give relief. And nothing else can be done, than that the patient practise a strict abstinence in the first days of the disease: then upon the decline of that fit, which is most severe, let him take food.
But where the period is certain, all these things are more easily tried; because we can more readily inform ourselves of the succession both of the fits and the intervals. Now in this kind, when they are of long standing, fasting is not good: in the first days only we are to make use of it to oppose the distemper; after that the cure is to be divided, and first the shuddering, then the fever is to be removed. Wherefore as soon as a person has shuddered, and after the shuddering has grown hot, it is fit to give him warm water to drink a little salt, and force him to vomit: for generally such a shuddering arises from something bilious oppressing the stomach. The same method is to be pursued, if at the next period also it has again appeared: for thus it is often removed. And by this time one may find out the species of the fever.
Wherefore when the third fit is expected, which may possibly come on, the patient must be brought to the bagnio, and care must be taken that he be in the bath at the time of shuddering. If he have felt it there also, let him do the same nevertheless, when the fourth fit is expected: for by this repetition it is often removed. If the bath proves unsuccessful, before the fit let him eat garlick, or drink hot water with pepper: for these too raise a heat, which repels the shuddering. After that, before the shuddering has time to come on, let him cover himself up in the manner above directed under the article of coldness: and it is proper immediately to apply all round his body pretty hot fomentations, and chiefly extinguished tiles, and coals wrapped up in cloths.
If notwithstanding the shuddering has broke out, he must be anointed within the cloaths plentifully with hot oil; to which also may be added some of the warming substances: and friction may be used, to as great a degree as he is able to bear, and especially in his hands and feet, and let him hold in his breath. And it must not be given over, although the shuddering do return: for often the perseverance of the physician overcomes the distemper of the body.
If he has vomited, warm water must be given, and he obliged to vomit again; and the same methods must be repeated, till the shuddering is removed. But beside these a clyster must be given, if the shuddering gives way slowly: for that has a good effect by exonerating the body. The last remedies after these are gestation and walking. Now in distempers of this kind, the fittest food is such as may prove laxative, and glutinous flesh. When wine is given, let it be austere.
CHAP. XIII. THE CURE OF A QUOTIDIAN FEVER,
Now these observations relate to the periodical returns of all fevers: but the several species of them are to be distinctly treated, according to their different natures. If it be a quotidian, for the first three days by all means abstinence should be observed; then food be taken every other day. If the distemper has become inveterate, after the fit it is proper to try the bath and wine, especially if, when the shuddering is removed, the fever remains.