Either of the following things must take place, that this fever may
terminate completely; the bilious humours must either be evacuated or
extinguished. They are evacuated then by sweating, vomiting, or purging
downwards; but they are extinguished by cold drink, with which we have
entirely cured ardent fevers. For diet, those in causus should not take
water alone, nor mead alone, but boiled mead much diluted with water; for
the food of such persons ought to consist entirely of drinks. The bath
will suit with those only affected with causus who are free from all
inflammatory and erysipelatous swelling. And if they exhibit signs of
concoction, it will suit still better with them; but not so if the fever
be occasioned by a saltish humour. These should be supported with the
juice of ptisan.
* * * * *
COMMENTARY. Our author’s directions respecting the treatment are
mostly taken from Hippocrates (de Rat. Vict. Acut.) Hippocrates allows
venesection only when the attack is violent. He approves of the
application of cold water to the surface. Archigenes, as Aëtius informs
us, sponged the head and chest with cold water during the acme of ardent
fevers. (iii. 159.) His own treatment, which is borrowed from Philumenus
and Galen, consisted of cooling remedies internally and externally, such
as drinking cold water and other things of a refrigerant nature, using
cold applications, and the cold bath, (v, 28.) Alexander, Oribasius,
Synesius, and Constantinus Africanus treat the causus upon the same plan
as our author. They say nothing of bleeding. Celsus likewise omits to
make mention of venesection, but recommends refrigerants, and especially
cold water to be given, even to satiety. He forbids it, however, when
there is any affection of the internal viscera, and when there is a
cough. He informs us that Asclepiades, of Bithynia, strongly recommended
gestation for the cure of this fever.
Averrhoes abstracts blood when there are symptoms of plethora, gives
gentle purgatives, such as tamarinds, and allows the patient cool drink
and cool air. Haly Abbas treats the causus entirely upon the refrigerant
plan, with cold drink, cooling fruits, fresh air, gentle laxatives, such
as prunes, and by cold applications to the skin. Alsaharavius conducts
the treatment upon much the same principles. When the patient is troubled
with protracted watchfulness, he directs us to rub the temples with the
juice of poppies, lettuces, and coriander. Avicenna also speaks favorably
of these soporifics, but does not in general approve of bleeding. The
treatment recommended by Rhases is altogether refrigerant. He directs
us to clear away the asperities of the tongue, and then to give cooling
and acid drinks. When there is no inflammation of any internal viscus,
he permits water cooled with snow. He says nothing of venesection.
However, some of his authorities, as quoted in his ‘Continens,’ recommend
bleeding. They seem in general to have approved of keeping the patient
in a cool room perfumed with aromatic and fragrant herbs. One of them
approves of applying over the stomach a robe moistened with a fluid
prepared from camphor, rose oil, &c.
We omitted to mention that Hippocrates states that children at the
breast are subject to attacks of causus, by which of course he meant the
infantile remittent fever, first well described some years ago by Dr.
Butter.