Of Medicine, in Eight Books

by Aulus Cornelius Celsus

CHAP. XIV. THE CURE OF A TERTIAN FEVER.

But if the fever be either a tertian, which has a perfect intermission, or a quartan, on the intermediate days, it is proper to walk, and make use of other exercises and unctions. Cleophantus, one of the more ancient physicians, in these distempers used to pour a great quantity of hot water upon the head of the patient long before the fit, and then to give him wine. Yet Asclepiades, though he adopted most of his precepts, has justly omitted this: for it is of doubtful effect.

When there is a tertian fever, he says it is proper to administer a clyster the third day after the fit; on the fifth, after the shuddering to procure a vomiting; then after the fever, according to Cleophantus’s practice, to give the patients food and wine, while they are yet hot; on the sixth day to keep them in bed: for thus it will happen, that the fit will not return on the seventh day. That this may often answer is very probable. Yet it is safer in this order to make trial of these three remedies, vomiting, purging by clysters, and drinking of wine, for three days, that is, on the third, and fifth, and seventh; and not to drink wine, till after the fit upon the seventh day.

But if the distemper is not removed in these first days, and it grows inveterate, on the day the fit is expected, let the patient keep his bed; after the fit be rubbed; and after eating let him drink water: the day following, when he takes no food, let him intermit his exercise and unction, and rest content with water alone. And this indeed is best. But if his weakness bear hard upon him, he ought both to take wine after the fit, and a little food on the intermediate day.

CHAP. XV. THE CURE OF A QUARTAN FEVER.

The same method is to be followed in a quartan. But since this is very slowly terminated, unless it have been removed in the beginning, greater accuracy must be observed in prescribing from its first appearance, what ought to be done it. Wherefore if a person is attacked with a fever and shuddering, and it has gone off, all that day and the following, and the third, he ought to confine himself to a stricter regimen, and on the first day drink only warm water after the fever; the two following days to abstain from that as much as possible; on the fourth day, if the fever returns with the shuddering, to vomit, as has been directed before; then after the fit, to eat sparingly, and drink a quadrans of wine; the day after that, and the third to abstain; taking only warm water if he be thirsty. On the seventh day he should prevent the coldness, by going into the bath before its time, fast and observe the former regimen strictly[(12)]; if the fever has returned, have a clyster: when the body has rested after that, he should be anointed and brushed briskly; take food and wine in the same way, and for the two following fast, not neglecting the friction. On the tenth day he must try the bath again; and if the fit has come on after, brush in the same manner, and drink wine more plentifully. And thus the consequence is, that a rest of so many days, and abstinence, with the practice of the other injunctions, may remove the fever.

If notwithstanding these it continues, another method of cure entirely different is to be pursued; and all our measures must be directed to this point, that the body may easily bear what is to be long endured. For this reason the practice of Heraclides of Tarentum ought to be less approved, who prescribed clysters in the beginning, after that fasting to the seventh day. Which course though a person should be able to undergo, yet when he is even freed of the fever, he will scarcely have strength to recruit; and so if the fever frequently returns, he must sink under it. Wherefore if the distemper shall continue upon the thirteenth day, the bath must neither be tried before the fever nor after it, unless sometimes when the shuddering is already removed. Now the shuddering is to be repelled by the same means, as have been directed before. Then after the fever it is proper to be anointed, and rubbed briskly; to eat heartily of substantial food; to take as much wine as he inclines; the day following, when he has rested sufficiently, to walk, take exercise, be anointed, and stoutly brushed; to take food without wine; on the third day to abstain.

On the day that he shall expect the return of the fever, it is proper for him to rise before its hour, and exercise himself, and to endeavour to have its time coinciding with his exercise: for thus it is often dispelled. But if it has seized him in the midst of his exercise, in that case to give over. In a disorder of this kind the remedies are unction, friction, exercise, food and wine. If the belly is bound, it must be opened.

Now these things are easily performed by the more robust; but if the patient be grown weak, gestation must stand instead of exercise. If he cannot even bear this, yet friction must be used. If this also when vehement distresses him, the cure must be confined to rest, unction, and diet: and care must be taken, lest any crudity change the distemper into a quotidian. For a quartan kills no body: but if it be changed into a quotidian, the patient is in a bad way: which however never happens, unless by the fault either of the patient or the physician.