The duration of the disease may be ascertained from four things: from
the movement of the disease itself, from the habit of the patient,
from the pulse, and from the species of the fever. From the movement
of the disease thus: if the four periods of a particular paroxysm have
passed over quickly and in the least possible time, the disease will
be an acute one, the furthest bound of which will be the seventh day,
and generally it will come to a crisis on the fourth. If the periods of
the first paroxysm occupy more time than this, but do not exceed twelve
hours, the disease will still be an acute one, which will terminate
within the fourteenth day. If it extend longer, so that the commencement
and augmentation of the paroxysm alone occupy a longer period than a
day or a night, such a disease will prove a long one. If the disease
have no particular paroxysms, but consist of one continued paroxysm, as
it were, from beginning to end, as in synochous fevers, even in this
case you may call the disease an acute one. It may be judged of from
the habit of the patient; for if the face and the rest of the body are
already considerably wasted, an acute disease is indicated; but if nowise
reduced, a chronic one; for a great collection of offending matter is
indicated, which will require a length of time for its concoction. It
may be judged of from the pulse: thus, a great, strong, quick, and dense
pulse, is indicative of an acute disease, but the contrary of a chronic.
From the species of the fever, inasmuch as hot and ardent fevers indicate
an acute, whereas gentler, and, as it were, smothered fevers indicate a
chronic one.
* * * * *
COMMENTARY. Celsus thus states the prognostics of a protracted fever:
“Signa quædam sunt, ex quibus colligere possumus, morbum, etsi non
interemerit, longius tamen tempus habiturum: ubi frigidus sudor inter
febres non acutas circa caput tantum, et cervices oritur: aut ubi, febre
non quiescente, corpus insudat: aut ubi corpus modo frigidum, modo
calidum est, et color alius ex alio fit: aut ubi, quod inter febres
aliqua parte abscessit, ad sanitatem non pervenit: aut ubi æger pro
spatio parum emacrescit: item si urina modo liquida et pura est, modo
habet quædam subsidentia; si lævia atque alba rubraque sunt, quæ in eâ
subsidunt; aut si quasdam quasi miculas repræsentet; aut si bullulas
excitat.”
Galen has given a full exposition of these symptoms in his Commentary
on the Prognostics of Hippocrates, from which Aëtius, Oribasius, and
our author have borrowed largely. Rhases, Avicenna, but most especially
Haly Abbas, treat at great length of this subject. See also Averrhoes
(Commentaries on the Cantica of Avicenna.)
SECT. VI.—HOW TO KNOW IF THE DISEASE WILL TERMINATE BY A CRISIS, OR BY
RESOLUTION.
This may be ascertained from what has been already said, namely, the
species of the fever and its duration, and perhaps from the species of
the fever alone. For hot and ardent fevers are of short duration, and
usually terminate with some critical evacuation; whereas the gentler
kinds prove more chronic, and have a tendency to abscess. From what has
been said, it appears that we may prognosticate not only when the disease
will come to a crisis, but also how it will terminate; for acute diseases
generally terminate by critical evacuation, and the chronic by abscess.
* * * * *
COMMENTARY. A similar statement is made by Aëtius (v, 22.) See also
Averrhoes (Comment. in Cantica Avicennæ.)