Corpus of Electronic Texts Edition
A Treatise on Fevers (Author: [unknown])
Section 4
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Let it be asked here from which of the following the cure should commence, i.e. from the accidental ailment of the fever, or from the cause of the fever, or from the fever itself. It seems one should cure the cause of the fever first, as Galenus ssays in the book De ingenio sanitatis these words: ‘Ante ... ’ i.e. before everything the physician should be careful of the cause of the disease, according to that the cause of the fever should be cured first. Then Galenus says in the same book that the fever will continue if the cause continues, so the cause should be cured first. Then the same man says, when unfavourable complexion and cause and matter exist together, one should begin from the cause, and after it from the bad complexion, and then from the disease, so the cure should be begun from the cause. Then Galenus says in the commentary of the first section of the Aphorisms: ‘Medicus ... ’ i.e. the physician is the instrument of nature and should imitate it in every way, and so, since nature begins from the cause, as is clear is these words: ‘Natura’ i.e. nature first digesting and then dividing and afterwards expelling, as Avicenna says in the fourth section of the Aphorisms in this canon: ‘Incipientibus ... ’, so the cure should begin from the cause. Then Galenus says in De ingenio sanitatis ‘Omine ... ’ i.e. what Galenus says in this proverb is: O physician if you increase the cause, and lessen the fever, you do not cure the fever, so the cure should begin from the cause as Hippocrates said in this canon, ‘Digesta ... ’. Then Avicenna says in the fourth book in the chapter on putrid fever this saying: ‘Si uirtus ... ’ i.e. if the energy is strong the matter should be expelled first without moving the unfavourable complexion, for Galenus says the energy is strong in acute illnesses during two or three days, and so beginning should be made from the cause. Then Avicenna says in the fourth book these words: ‘Prius ...’ {TCD 1299 page and line 27b1}i.e. Avicenna says here the cure should begin
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with everything that cures ephemera and everything that follows it such as the cause and the fever, for Avicenna says, if the fever be cured and the cause continue, that the fever returns again, and if the cause is cured the fever is cured, so the cause should be cured first. Then Avicenna says in the fourth book these words: ‘Impossibile ... ’ i.e. it is impossible to expel the fever unless the cause be expelled, so beginning should be made from the cause. Then Galenus says De ingenio sanitatis this distinction that the cause is sometimes stronger and more vigorous than the disease, and at other times the disease is stronger than the cause, and at that time one should begin from the disease, and when the cause is stronger one should begin from it. This distinction is opposed according to Galenus who says there is no effect (?) of the thing which comes (perhaps ‘which does not come’). From a thing stronger than the thing itself, accordingly since the disease comes from the cause, as fever comes from corruption, the cause is stronger than the disease. Then it seems the fever is not stronger than the cause and the cause is not stronger than the fever, for Galenus says that fever injures only when the cause continues, and the cause injures only when the fever continues, so neither of them is stronger than the other. This is opposed on the authority of Aristotle who says these words: ‘Quod ultimum ... ’ i.e. everything which is last in composition is first in dissolution, so, since fever is later than the cause, the cure should begin from the fever. Then Galenus says in De ingenio sanitatis: ‘Febris sequitur ... ’ i.e. the fever follows the cause and the accidental ailment follows the fever, so the physician should begin first from the accidental ailment, and afterwards from the illness, and last from the cause. Then Galenus says in the tenth book of De ingenio sanitatis these words: ‘Si materiam ... ’ i.e. if we cure the cause first and the fever continue, the fever and the patient die together, so the cure should begin from the fever and not from the cause. Then Galenus says in De ingenio sanitatis these words: ‘In omne ... ’ i.e. in every fever let the cure begin from the unfavourable complexion, and Galenus says in the
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same passage that the unfavourable complexion is identical with the disease or the fever, so the cure begins from the fever or from the disease and not from the cause. Then Galenus says the cure should begin from everything which first and most injures the natural functions, and fever injures nature more than the cause of the fever does, so the cure should begin from the fever. Then Galenus says in the second book of Techne these words: ‘Cura debetur ... ’ i.e. the illness should be cured and the cause should be preserved, so the beginning should be from the fever. Then Galenus says in every illness which is throughout the body while the cause is local, beginning should be made with the illness and not with the cause, and that is how it is with fever, i.e. its cause local and itself universal, as is clear in intermittent fever the cause of which can be in the stomach or in the intestines, and in causon fever, for the cause of this fever is in the veins of the heart and of the liver, so one should begin with the fever and not with the cause. Then Galenus says in the twelfth book of De ingenio sanitatis, if the fever is due to fullness (or a humour), as synochus, and syncope ensues, the cure of this accidental ailment first is ordered, and then the fever, for Galenus says in the first canon these words: {TCD 1299 page and line 28a1} ‘Accidens ... ’ i.e. The accidental ailment tries to cure itself leaving the disease and the cause, as is clear in colica and ilica, for we should cure the pain first in these and leave the constrictions causing the pain, so the cure should begin from the accidental ailment. Then Galenus says in the ninth book of De ingenio sanitatis these words: ‘Curato ... ’ i.e. if the disease be cured the accidental ailment is cured, so the cure should begin from the disease and not from the accidental ailment. Then Galenus says that the one cure serves disease and the accidental ailment, so since the accidental ailment departs through the cure of the disease, the cure should begin from the disease and not from the accidental ailment. Then Galenus says medicine is not good except in an illness from which one recovers, and every illness from which one recovers has its cause decreasing until the status and the illness increasing, as Hippocrates says in the Aphorisms
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in this canon: ‘In quo antibus ... ’ and in this other canon: ‘Circa principio ... ’ so on account of that one should begin not from the cause but from the illness itself. We answer that question and say that corruption is the cause of fever, and one must examine three things with regard to the corruption, as Galenus says, quantity, motion and poisonous quality. Great or small quantity of the corruption; motion, namely the poisonous matter going from member to member; quality of the corruption is simply ebullition caused by corruption in the veins, so that on that account Galenus says here that the cause and the fever are equal with respect to the quality we mentioned, for if the ebullition of the corruption we have mentioned be very acute and violent, the fever will continue likewise, and, if the fever be violent, the quality of the corruption must be strong in the veins as we said, and it is not so with respect to quantity and motion, for the corrupting matter can be moving (recte dangerous) as to quantity and not dangerous as to quality. And Galenus says that matter like that does not easily prepare for its status, and the illness is chronic and the strength endangered by the length of the illness. And Galenus says the quantity of the corruption can be great as to action and not acute as to quality as Hippocrates says in the first book of Aphorisms: ‘Febribus ... ’ for it is thus Galenus understands Hippocrates here, that the matter of the fever can be great and the fever itself weak. And Galenus says here that the matter (omit) the motion we have mentioned can be dangerous and the unfavourable complexion not dangerous in the one fever, as Galenus says in the commentary of this aphorism: ‘In uallde ... ’ i.e. the quality indeed injures greatly through excessive ebullition in the veins, and this ebullition Galenus calls cauma incendium as is clear in pestilential fevers, as Galenus says pestilential fever is mild, gentle and not dangerous in the beginning as regards appearance, though it kills without delay through the dangerous character of the unfavourable complexion which is in it. The accidental ailment, indeed, for Galenus says it is of two kinds. The first kind, i.e. an accidental ailment which follows the nature of the
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disease and is like the cause of the discase, as an unfavourable quality engendered in the body after illness, and in the case of this accidental ailment, according to Galenus, cure should be given only with respect to the unfavourable quality from which it was engendered. The second kind, i.e. {TCD 1299 page and line 28b1} when the accidental ailment follows the nature of the disease, and after this disease the accidental ailment continues and is itself the cause of a disease, such as syncope, extreme pain, insomnia, light-headedness, and the like, and this accidental ailment demands a cure not needed by the disease, and the physician is compelled to cure these accidental ailments first and to leave the fever during that time. We answer this question and say the physician should begin from the cause when the fever does not weaken the strength, and when the fever is stronger, weakening the strength, than the cause, then one should begin from the fever, and we say the same with respect to the accidental ailment, and so we leave this question.