All these fevers are regarded from the standpoint of Humoralism,
and depend upon variations in the quantity, quality, mixture or
location of the four humors, blood, phlegm, bile and black-bile
(_melancholia_).
In the general treatment of febrile diseases, so-called preparatives
and digestives are first employed to ripen the humors, after which
evacuatives (emetics, cathartics, sudorifics, and occasionally even
venesection) are utilized for the discharge of these peccant humors.
Much emphasis is laid upon the dietetics of fevers, and this branch of
treatment is highly elaborated. Complications are met by more or less
appropriate treatment, and the condition of the urine is studied with
great diligence. Venesection is recommended rather sparingly, and is
never to be employed during the _dies caniculares_ (dog-days) or _dies
Aegyptiaci_, nor during conjunctions of the moon and planets, nor upon
the 5th, 15th, 17th, 25th, 26th, or 27th days thereafter, etc.
Among the complications of fevers discussed by Gilbert, two seem
sufficiently important to justify special attention. On folio 74b we
find a section entitled "_De fluxu materie per parotidas venas_,"
in which he remarks that "Sometimes matter flows through the parotid
veins behind the ears down to the neck and nares, and obstructs the
passages for air, food and drink, so as to threaten suffocation." He
cautions us against the use of repressives, "lest the matter may run
to the heart," and recommends mollitives and dissolvents, such
as butter, dyaltea, hyssop and especially newly shorn wool (_lana
succida_), which, he says, is a strong solvent. Is this a reference
to the septic parotitis not unfrequently seen in low fevers?
The following section, "_De inflatione vesice et dolore ejus_,"
discusses the retention of urine in fevers, and its treatment. Gilbert
says: "Inflation of, and pain in the bladder are sometimes symptoms
of acute fevers, since the humors descend into and fill the bladder."
If this occurs in an interpolated (remittent) fever, he directs the
patient to be placed in a bath of a decoction of pellitory up to the
umbilicus, "_et effundet urinam_." If the complication occurs in one
suffering from a continued fever, the bath should be made of wormwood
and a poultice should be placed over the bladder and genitals, "_et
statim minget_." The same effect may be produced by poultice mixed
with levisticum (lovage) or leaves of parsley. Singularly enough the
catheter is not mentioned, though this instrument, under the medieval
name of _argalia_ (cf. French algalie), is noticed frequently in the
section devoted to vesical calculus.
Public-domain text, read in full here on John Shaqi.
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