The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 6. Of Compounded or Complicated Feavers, and particularly of a Semi-Tertian.

GAlen in his second Book de Crisib. cap. 7. and 9. and in his second Book de Differ. Feb. Cap. 7. and Avicen. Fen 1. Lib 4. Tract 4. Cap. 16. Do propound many compositions of Feavers. Namely when putrid Feavers are compounded with non-putrid, as when an hectick is joyned with a putrid; or of a putrid with a putrid, which is done many wayes viz. Either con∣tinuall Feavers being complicated with continuall or intermittent with intermitent, or continu∣all with intermitent.

The Composition of two continual Feavers, is a thing controverted among authors, and a man shall hardly observe it in the course of his practice.

An intermitting Feaver or Ague is complicated with another intermittent, either of the same kind, or different: compound intermittents of the same kind are a double and triple Tertian, and a dou∣ble or triple quartan, which have been expounded in their proper places. Of several kinds are when a tertian is compounded with a Quotidian or quartan; which also is very rarely seen in Practice.

Intermittents are complicated with continuals two waies viz. An intermittent tertian with a continual Quotidian, or a Quotidian intermittent with a continual tertian. and each of these is termed a Semi-tertian, constituting Species or sorts thereof.

Yet that is properly and truly a Semi-tertian which is made of an intermitting Tertian and a continual quotidian: and consequently is caused from choller putrefying without and flegm putrefying within the vessels. By Hippocrates and Galen in 1 Epidem. it is named Horrifica, or the shaking Ague because it causes the patient to shake, not only at the first coming of the fit, but in the whol cours of the disease and especially in the beginning and augment, two fits being met and joyned in one, viz: Of the tertian and quotidian Ague, with many reduplications, which are nothing else but unequal shaking and shivering motions, returning divers time in one and the

same Ague Fit, by reason of the mutual fight of the two Feavers; in which, if Flegm overcome, there will follow shiverings, and coldness of the extream parts. And then again, when Choller doth van∣quish, the Body becomes warm, and the Feaver seems to tend towards the vigor; whenas flegm a∣gain getting the better, they are again brought into a cold and shivering condition; and this Con∣tention is wont to last til the Feaver comes to its height. Hence it is that those shaking fits come only every other day, viz. When the fit of the Tertian Ague is upon the Patient, being joyned with the Quotidian.

But while the Quotidian alone is present, there is wont to be no shivering Fit. Yet we must take notice, That there are some Malignant Feavers, which without a commixion of a Tertian and Quo∣tidian, without that same fight of Choller and Flegm, do shake the Patient; in which the Shive∣verings come from sharp Vapors, and malignant, which do arise out of the corrupt Matter of ma∣lignant Feavers, and do beat upon, and pull the sensitive parts, and nip or twitch them as it were.

Now this Semi-Tertian properly so called, is either exquisite, wherein an equal portion of pu∣trefying Choller and Flegm is redundant, such as hath been now described; or it is a bastard Semi-Tertian, which is again two-fold: For either it hath Choller abounding, or Flegm. In the former there are more Symptoms of a Tertian; in the latter of a Quotidian. And so if Choller abound, the whol Feaver is more horrid, and somtimes it hath a shaking fit accompanying the same; also it proves more fervent, and some portion of Choller is voided forth by vomit, stool, or sweat. But when Flegm prevails, a more vehement cold doth possess the extream parts of the Body, and there are few shiverings; and the pulse it more and longer depressed, and the fit is longer before it grow towards its height, and remains in its consistency a long time; yet doth it cause no great thirst, nor burning.

This Feaver is known by what hath been said thereof, being continual, and cold, with many re∣duplications, and very great Symptomes. Because it comes every other day with a shaking cold fit; but upon the even daies it comes only with a coldness in the extream parts of the Body. The Urines are crude, thin, and without color; somtimes troubled, with no Sediment, or that which bodes no good. The Pulse is frequent and unequal. The Differences are known by the Signs of more or less of Choller and Flegm, propounded.

As for the Prognostick of this Feaver, it is a dangerous Disease, and therein the Stomach and Ner∣vous parts are very much affected. And it is attended with dryness of the Tongue, Thirst, Swoo∣ning, Watching, and somtimes with Ravings, and dead Sleeps. Hippocrates reckons it among acute Diseases because of the Choller; and among Chronick Diseases because of the Flegm, in 1. Epidem. And Avicenna saith, That it lasts somtimes seven months, and somtimes ends in Chronick Diseases, and an Hectick.

The Cure of this Feaver is to be taken from what hath been formerly said of the Cure of a Tertian, and a Quotidian Ague; and seeing it is continual, it must be handled with the same Method which was set down in the first Chapter of this Section, as common to all putrid continual Feavers. So that when Choller chiefly bears sway, we must use most of those Simples which respect Choller; and when as flegm prevails, we must principally use such things as do prepare and purge that Humor. And finally, When both Humors are equal, the Remedies proper to each must be used in equal pro∣portion likewise.