Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. VI. Of the Fever Ephemera.

THere are two sorts of Fevers whose heat are inherent in our bodies in habitude. * 1.1 For that the hot distemper of the parts is cherished either by the heat of the Spirits or humors; and the humors are inflamed either with or without putrefaction.

Those Fevers which are sustained by the heat of the Spirits and humours without putrefaction, * 1.2 are called Ephemerae and Humorales without putrefaction: Those which are kindled by putrifying humours are called putred Fevers.

That Fever which is cherished by the kindling of Spirits,

is called by the Greeks, Puretos Ephemeros, by the Lattines, Diaria and Ephemera, by a name not taken from the nature of the disease, but from it's duration. In respect of the Es∣sence thereof, it may be defined thus: * 1.3 It is a Fever arising from and depending on the heating and inflaming of the vital Spirits.

The proximate cause of this Fever is the heat of the vital Spirits kindled contrary to nature, * 1.4 which being spread over the whole body through the arteries, heats the whole against nature.

That heat is stirr'd up from all those causes before mention∣ed in the second Chapter, only except from putrefaction; * 1.5 which sometimes immediately, sometimes remotely, by means of the natural and animal Spirits heat the vital; to wit, perturbations of the mind, sadness, fear, sollitude, anger, over much watching, too much intentiveness of the mind; too much exercise of body, grief, hunger, thirst, hot meats and drinks, drunkenness, crudities in bodies cholerick, heat of air, fire, hot Baths, retention of the hot Effluvium, infla∣mations of Kernels and Buboes, from the which heat alone without putred vapours is conveyed to the heart according to the vulgar opinion. Yet it seemeth not impossible but that those putred vapours by the veins and arteries next to the part affected, may be communicated to the heart. And so these Fevers should rather be Symptomatical then absolute, putred then Ephemeral.

Those that are hot and dry easily fall into this Fever, * 1.6 in whom many hot dry vapours are coliected, which are easily inflamed by causes heating them more.

Amongst the Signs by which this Fever is known and dis∣cerned from others, in the first place, Galen. 1 de differ. * 1.7 Fe∣brium c. 7. saith, it beginneth from some procatartick or evi∣dent cause; which indeed is an inseperable sign, but not a proper sign; for although a Fever that doth not arise from a manifest cause is not an Ephemera, yet every Fever which ari∣seth from a manifest cause is not therefore an Ephemera. 2. Moreover the Urine in substance, colour, and contents, is most like unto the Urine of healthy men, or at least recedes not much from them, which in an Ephemera, which pro∣ceeds from crudity, it useth to do, in which the Urine useth to appear more crude and whiter. 3. The Pulse is neerer to a natural one, then in any other Fever; only that it useth to be extended in magnitude, celerity, and frequency. Yet in re∣gard of the cause which occasioned the Fever, some change

may be made in the Pulse. 4. The heat of this Fever is gen∣tle and weak in respect of other Fevers. 5. Nay in the very state and height thereof it is somewhat more gentle and mode∣rate. 6. This Fever invades without shakings, or tremb∣lings; it's increase and augmentation in heat and pulse is free and equal. 7. The declination is performed by moisture, or moist evaporation, by sweat like theirs who are sound in health, which by a little exercise more then ordinary comes forth, and a perfect apurexsie follows that moisture, so that after the decli∣nation no footing is left for the Fever, either discernable by Pulse or any other circumstances: And in case any footing be left, it is a sign that it will turn into another sort of Fever.

The causes are most perfectly to be known by the relation of the sick, which may instruct the Physician whether from passi∣on of the mind, exercise of the body, or any other evident cause this disease hath been occasioned. These causes also affords some signs of themselves, which the Physician cannot be ig∣norant of.

These Fevers are the shortest of all others, * 1.8 and continue not above twenty four hours: There is no danger in them, unless some error be committed, and for the most part they are con∣quered by nature, wherefore Physicians are seldom called to their cures. Yet according to the diversity of their causes some are cured more easily, others with more difficulty. For those causes which are hardly taken away, and the humours are ap•• to corrupt, a Fever introduced from such, easily degenerates in∣to a putred; which happeneth when it is extended above four and twenty hours, or no sweat appears, and pain in the head be present and persevere: And it degenerates either into a Sy∣nocha without putrefaction, if the body be youthful and ple∣thorick; or into a putred, if the body be cacochymick, or into a Hectick, if the body be hot, dry, and lean. And the pro∣per signs of those Fevers shew into what sort of them the trans∣mutation will be made.

Moreover sithence this Fever is a hot distemper of the whole depending on the heat of the Spirits inflamed: * 1.9 And seeing the heat of the Spirits, and the distemper thence introduced indi∣cate cooling, yet if the cause exciting the same be still present, that also ought to be taken away.

These Fevers are cured by good dyet, * 1.10 so that there is seldome any need of strong medicines; the food therefore ought to be cooling and moistning, the meat of good juyce, and easie of concoction, principally cream of Ba••ey, the rest may be mixed

with lettice, sorrel, juice of Citron or Lemmon, Vinegar. The drink should be barley-water, small beer or small white∣wine: Yet if pain in the head be present, or that the Fever be occasioned by anger, or from a bubo, then wine is to be refrai∣ned. The Ancients most frequently used Baths of warm wa∣ter, but at present, neither the same industry is used in prepa∣ration of them, neither are men in our age so accustomed and disposed to bathe.

In the first place diligent care is to be had of that Fever E∣phemeral, which ariset hfrom the clovure of the skin, * 1.11 or it's thickness, or crudity of the stomack, since they easily turn in∣to putred Fevers. And an Ephemera which is caused by stop∣page of the pores of the skin, since it comes to pass rather from plenty of blood, then ill habit of body, in that a vein is forth∣with to be opened, that the blood may be diminished and cool∣ed; but the thickness of the skin if occasioned by cold or a∣stringent things is cured by those things that rarifie and open the same, by a bath of fair water luke-warm, soft rubbings, tem∣perate and luke-warm oils, wherewith the body should be an∣nointed. But if the thickness of the skin be occasioned by dry∣ing things, use moistening dyet, and the body should be an∣nointed with temperate and moistening oils.

Lastly, if the Ephemera proceed from crudity, * 1.12 since that is twofold, the one called Acid, which proceeds from diminution of heat, the other Nitrous, which is caused by preter-natural heat: If from Acid crudity, which seldom happens, the E∣phemera proceed, and that crudity be less, so that meat may be reduced into a better state, rest and sleep are to be occasion∣ed, and before sleep meat of easie concoction in a small quan∣tity is to be taken, and the stomack to be comforted with hot oyls; But if the crudity be great, then the meat is to be ejec∣ted by vomit, or if the sick be not apt to vomit, with a lenitive, he should provoke a stool; before it be distributed into the veins he must then abstain from meat, and the stomack both with internal and external medicines is to be comforted. But if the crudity be unsavoury or nitrous, 'tis to be conected with cold things, wherewith if the concoction be not helped, the corrupt meat is either to be emitted by vomit, or to be purged by gentle medicines opening the first passages only, such as are good against cholar, and as corroborate the stomack.

Notes

• * 1.1

  Feavers in habi∣tude.
• * 1.2

  The name Epheme∣ros.
• * 1.3

  Definition
• * 1.4

  The next cause.
• * 1.5

  Remote cause.
• * 1.6

  Dispositi∣on of body.
• * 1.7

  Diagno∣stick signs.
• * 1.8

  Progno∣sticks.
• * 1.9

  Indicati∣on••.
• * 1.10

  The Cure.
• * 1.11

  Cure of an Ephemer a from clo∣sure of the skin.
• * 1.12

  From cru∣dity of the stomack.