After having treated of those things which relate to the preservation of
health, we now come to the treatment of persons already in disease, and
shall begin with homogeneous disorders as being the most simple. These
are what are called Fevers. Wherefore, using again principally Oribasius’
Epitome of the Works of Galen and several others on this subject, we
shall add a very few things omitted by them.
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COMMENTARY. The following ancient authorities may be consulted on the
subject of fever: Hippocrates (Epidem. et alibi); Galen (Comment.
in Hippocr. Epidem., de Differentiis Febrium, Meth. Med. viii,
Therap. ad Glauc. i, De Typis, de Crisibus et alibi); Celsus (iii);
Pseudo-Dioscorides (Euporist. ii); Oribasius (Synop. vi, Euporist.);
Aretæus (Morb. Acut. ii, 4); Aëtius (v); C. Aurelianus (Pass. Acut. ii,
10); Alexander Trallian (xii); Alexander Aphrodisiensis (Probl. i, 84, de
Febribus); Actuarius (Meth. Med. iii); Pliny (Hist. Nat. xxviii, 66, xxx,
30); Palladius (de Febribus); Michael Psellus (Opus Medicum); Synesius
(de Febribus); Leo (ap. Ermerins Anecdota Græca); Stephanus (Comment. in
Prognost. Hippocrat. ed. Dietz); Constantinus Africanus (de Febribus);
Serenus Samonicus; Vindicianus (Epistola ap. Fabricii Bibl. Græc. tom.
xiii); Avicenna (iv, i); Syrasis, Avicennæ Expositor; Haly Abbas (Theor.
viii, Pract. viii); Alsaharavius (Theor. vi, Pract. xxxii); Serapion (tr.
vi); Avenzoar (iii, 7); Averrhoes (Collig. vii); Rhases (ad Mans. x,
Contin. xxx.)
All the ancient authorities held that a fever consists of a preternatural
increase of the Innate, or, as it is now called, Animal heat, which
they considered as the instrument by which the soul performs all the
functions of the body. See Alexander Aphrod. (de Feb.) Thus, Palladius
defines a fever to be “a preternatural heat, which begins in the heart,
and is diffused by the arteries over the whole body, sensibly injuring
the actions of the body.” Hippocrates, Galen, Aëtius, Alexander Trallian,
Psellus, Leo, and Actuarius give similar definitions. Cælius Aurelianus
says of Asclepiades: “Febrium ponit signum calorem plurimum.” (Morb.
Acut. i, 14.) Isidorus defines a fever thus: “Febris a fervore dicta est;
est enim abundantia caloris.” (Orig.) Hippocrates, however, the great
opponent of hypothesis in medicine, insists that there is more in a fever
than a simple excess of pure heat; or, in other words, that the essence
of fever is heat mixed up with noxious qualities. (De Vet. Med. § 17.)
The celebrated Erasistratus maintained an opinion, lately revived by
Clutterbuck and Broussais, that fevers and inflammations are identical.
See Milligan’s Celsus (p. 13 and 112); and Cælius Aurelianus (de Acut.
Morb. ii, 3.) He further taught that in fevers the blood of the veins is
thrown into the arteries. (Plutarch de Placit. Philos. v, 29.)
The Arabians adopt the opinions of Hippocrates, Alexander, and Galen.
Thus, for example, Haly Abbas defines fever to be a preternatural heat
proceeding from the heart, and diffused by the arteries over all parts of
the body. According to him there are three kinds of fevers. The first,
are seated in the spirits, and affect only the heat of the body: these
are called ephemeral fevers. The second, originate in a vitiated state
of the fluids, which impart a preternatural degree of heat to the heart,
whence it is diffused over all the body. The third arise in the vital
organs and solid parts, from which heat is transmitted to the heart.
(Pract. viii, 2.) See also, in particular, Rhases (Cont. xxx.)
SECT. II.—OF THE PRINCIPAL CONSIDERATIONS TO BE INQUIRED INTO WITH REGARD
TO FEBRILE AFFECTIONS.
The first thing to be considered is, whether the disease will prove fatal
or not; then, if it is not to prove fatal, whether it will be acute or
chronic (these considerations apply to other great disorders); and,
third, whether it will come to a crisis all at once (which is peculiar to
fevers), or be resolved gradually.
* * * * *
COMMENTARY. This Section, and great part of the contents of this book are
taken from Galen (Therap. ad Glauc. i,) or from Oribasius (Synops. vi.)