When rigors are critical, we must not interfere with them, nor attempt
to put an end to the struggle; and a chill succeeding to a sweat will
readily pass away and give no trouble. But when the rigor and chills
are protracted, and more particularly, if occasioned by a collection of
cold phlegm, we are first to apply ligatures round the limbs in various
ways, and then anoint them with the oil of chamomile, or of privet, or
of iris; or, if a stronger application be required, we may add to the
oil some pepper, or the seed of the rosemary, or adarce, or castor, and
the whole body is to be gently rubbed with these things. And in order
that the oil may not readily run off, a small quantity of wax may be
melted with it. Or, if it is the rigor not attended with heat, we must
use the most powerful restorative ointments (acopa), and also dropaces
and sinapisms. Proper fomentations ought likewise to be got ready. The
acrid-scented things are likewise proper, such as calamint, pennyroyal,
and hyssop. Before the attack, we should likewise give for drink honied
water, in which pepper and rue have been boiled. And we should likewise
give of the Cyrenaic juice, to the size of a millet, two hours before the
paroxysm, mixing it up with boiled honey; and we are to give the juice of
the laserwort in like manner. And the composition for quartans, made from
the Cyrenaic juice, has proved beneficial to many. And some, by going
into a bath of hot oil, have shaken off obstinate rigors, as Archigenes
affirms. But Galen recommends, before the attack, rubbing the skin with
southernwood, or dried calamint, or the leaves and flowers of flea-bane
(conyza), or with costus, or pellitory, these two last with oil. By these
means the rigors will nearly or altogether cease.
* * * * *
COMMENTARY. These febrile symptoms are treated of by Celsus at
considerable length. (iii, 11, 12.) He properly recommends fomentations
of a hot and dry nature, and friction with calefacient oils. When
produced by a bilious defluxion upon the stomach, he gives saltish water
so as to operate as an emetic. He makes mention of the bath, and in
certain cases allows wine. For Galen’s sentiments, see ‘de Diff. Febr.’
(ii), ‘de Causis Sympt.’ (ii, 5), ‘de Inequali Intemp.,’ ‘de Tremore,
Palp. et Rigore.’ The last-mentioned work, in particular, contains some
ingenious speculations on the nature of rigors. Our author has mentioned
Galen’s treatment. Hippocrates pronounces a rigor occurring in continued
fever, when the patient is become weak, a mortal symptom. (Aphor.)
Aëtius states that tremors take place in fevers for the most part owing
to errors in eating and drinking. Holding them to be connected with
disorder of the spinal marrow, he directs us to apply to the back wool
soaked in some stimulant oil, or to put the patient into a bath of oil.
He recommends castor, both when taken by the mouth and applied externally
with the embrocations. (v, 130.)
According to the explanation of Palladius, rigors and tremors are
occasioned by fumes or vapours arising in the internal parts, and being
diffused over the body. (24.)
The treatment recommended by Haly Abbas is simple and judicious. He
directs us to give draughts of hot water, to put the patient’s feet into
hot water, and to rub the feet, and, if necessary, the other parts of the
body, with calefacient oils and the like. (Pract. iii, 20.)
Avicenna gives a very accurate account of the different modes of
treatment, but they are much the same as our author’s. He approves of
ligatures to the extremities, of rubbing them with stimulant oils, or
even with liniments prepared with assafœtida and mustard. He says the
bath of hot oil is very beneficial. He also recommends draughts of hot
water, and potions containing opium, which, he remarks, will procure
sleep and perspiration. In certain cases he allows hot wine, which had
been recommended by Hippocrates. (Aph. vii, 56.) He directs us to open
the bowels with the hiera, or pills of assafœtida. (iv, i, 2.) Rhases
particularly commends a draught of hot water. (Cont. xxx.)