The following symptoms accompany ardent fevers: tongue dry, rough,
and black, griping of the stomach, excrements pale, strong thirst,
watchfulness, and sometimes delirium.
* * * * *
COMMENTARY. Our author’s description of the _causus_, or ardent fever,
is taken from Hippocrates (de Rat. Vic. Acut.), where the commentary
of Galen is worth consulting. According to Hippocrates, the causus is
generally produced in the summer season, owing to the veins becoming dry
and attracting bilious humours. In other parts of his works he gives an
account of several varieties of the disease, differing considerably in
character from that described in the above-mentioned work. For example,
one variety mentioned in his ‘Epidemics’ was distinguished by the absence
of thirst and delirium, and by the paroxyms occurring on the even days.
(See Galen’s Commentary, Opera, ed. Basil. t. v, 424; also, de Morbis,
i, 27; and Coacæ, 130.) He further describes, under the head of causus,
various cases of febrile complaints after childbirth and abortion, which
would now be called puerperal fevers. (Epidem. iii.)
Aretæus delivers a most striking description of ardent fevers, which
we regret that our limits prevent us from giving at full length. The
following are some of the most important symptoms: the heat acrid and
subtile, especially in the internal parts, desire of cold air and of
cold things, the extremities cold, the pulse dense and small, the eyes
clear, bright, and reddish; and, if the fever go on increasing, delirium,
oblivion of every thing, lividity of the nails, frequent respiration,
profuse perspiration about the forehead and neck, coldness of the body,
and at last a complete collapse marked by a return of the powers of
reason and certain indications of a prophetic spirit. This is but a
meagre outline of his matchless delineation of the phenomena of causus.
As all the Greek, Latin, and Arabian writers treat of causus in nearly
the same terms as Hippocrates, we shall be very brief in noticing their
descriptions. According to Alexander, there are two varieties of causus,
the true and the spurious, the former being marked by intense thirst,
bilious stools, tongue rough and black; and the latter by the thirst
being moderate, the tongue not black, and the stools consisting not of
bilious matters, but rather of corrupted food. The former kind is said to
be occasioned by a bilious, and the latter by a pituitous humour. Aëtius
describes the disease in the same terms as our author. He says that it
is produced by putrefaction of yellow bile. Palladius says that ardent
fevers are occasioned by an erysipelatous inflammation of the lungs, or
by the putrefaction of bilious humours which have become immoderately
heated. The Arabians describe it exactly as the Greeks. According to
Avicenna, there are two varieties of the disease, the bilious and
the pituitous. The inseparable symptoms of the disease are, he says,
concealed heat, roughness, and, at last, blackness of the tongue. There
is no perspiration until after the crisis. For the most part the heat is
not strong in the external parts, but is particularly so in the internal.
Rhases states that the ardent fever called καῦσος by the Greeks belongs
to the class of tertians, only that in the former the heat is more
intense, and the paroxysms do not terminate in a complete intermission
of the febrile symptoms. The symptoms, he adds, bear a considerable
resemblance to those of the tertian intermittent, but are more strongly
marked. According to Alsaharavius, the causus, or ardent fever, is
occasioned by heated bile collected in the veins adjoining to the heart,
stomach, or liver, and its symptoms resemble those of tertians, but are
more intense.
From the above exposition of the opinions of the ancients regarding the
causus, or ardent fever, the medical reader will readily recognize its
identity with the bilious remittent fever of Sir John Pringle and other
English authors. If there were any doubt on this head, it would be set
aside by the description of the symptoms of ardent fever which is given
by the late Dr. Robert Jackson, as they were manifested in his own person
during a severe attack of it. (On Fever, 403.)
Some late writers have confounded the causus of the ancients with
synocha, or inflammatory fever. But, as we have said, and as was
correctly stated by Baccius, the causus was decidedly of the continual
or remittent type, and nearly allied to the tertian intermittent. (De
Thermis.) Hoffman remarks that it seldom appears in the more temperate
parts of Europe, but is very common in Asia, Greece, and Italy; and
hence the frequent mention of it in the works of Hippocrates, Galen, and
Aretæus. (Oper. t. ii, § 2, c. 2.)
Homer says that the dog-star brings many fevers upon unhappy mortals
(Iliad, xxi, 31); and his commentator Eustathius remarks that the poet
correctly refers the origin of ardent fevers to the heat of the dog-days.