The Canon of Medicine (Canon Medicinae), Vol. II

Chap. 8.

the opinion original: "sententiam" refers to) prefers hot and moist. But Galen, in book 8 of the Method of Medicine, asserts that hot and dry fevers become febrile more readily. Yet this discord is easily settled; those that are hot and moist are most of all prone to putrid fevers, while ephemeral ones, concerning which Galen writes in that same eighth book of the method, are hot and dry.

a B. And sometimes these are universal hours.
b B. according to each paroxysm.
c — B.
d B. it will be submerged.
e B. & it is an hour in which it does not appear. Another reading: in the hour in which it does not appear.

The hours of fevers are, just like those of other illnesses, the beginning, the increase, the acme flatus literally: blowing/climax, here denoting the peak of the fever, and the decline. a † [And sometimes they are] particular b [for the cause of each paroxysm.] And there is fear from the beginning up to the acme: but at the decline, the patient does not die from the fever itself, except for that which we will mention regarding the cause c [commonly.] And the beginning indeed is the hour in which the natural heat is suffocated by the matter d [submerged] in the member e [for so long, until there does not appear] a trace of maturation, or of its contrary maturation. And the beginning is indeed found in every illness: truly, it is sometimes hidden, just as its concealment is in fainting, epilepsy, and apoplexy. And when the beginning is hidden by few symptoms, it is thought that there is no beginning to it. And similarly, sometimes in the first day of acute fevers, clouds likely referring to signs in the urine and a sign of maturity are seen, and it is thought that there is no beginning to it, but it is not so. And the increase indeed is the hour in which the innate heat is moved to resist the matter with a manifest motion, and signs of digestion, or signs contrary to digestion, appear. And the acme is the hour in which the struggle between nature and the matter is vehement; and the victory of one of these over the other appears: and it is the hour of the struggle, and its duration in habits of acute paroxysms is one paroxysm; and it is not recognized except by that which follows it, or by two paroxysms, and it is recognized in the third of them, f [in that] it does not add to those two in most cases, except in long-lasting illnesses: for perhaps several paroxysms are assimilated in all their indications, and there, at the acme, the trace of digestion or of its contrary is completed. And the decline indeed is the hour in which the innate heat now dominates the matter g and h [overcomes] it, and it exists in the separation of its congregation f. thing after thing, and then the heat h [of the hidden heat] is alleviated, and is expelled to the extremities until it is resolved, and many times i [it thickens.] And the acme indeed is diversified in illnesses. For the status of very acute illnesses is long-lasting up to four days: and ephemeral fevers are of this sum; nevertheless, they are not counted as acute; since it does not suffice for the acuteness of an illness that its status be near; rather, it becomes one of the illnesses having fear, and there follow them absolute acute fevers k [not very;] and they are those whose status l † [reaches up to 14 days;] † [and what is above that. And the knowledge indeed of acute illnesses in their orders, and of chronic ones,

f B. &.
g B. Another reading: conquered.
h B. intrinsic.
i B. an error occurs. Another reading: an error occurs in the status.
k — B.
l † B. is up to the seventh day, such as a burning fever, or causon a type of inflammatory fever, and the annual ones recited. And among them are those that are

is helpful in the regimen of the patient's food, according to what we will say in the following. And most fevers complete the beginning, and the increase, and the status in one paroxysm, and make another paroxysm in declining. And fevers indeed are diversified in these times, for there are those among them whose increase is prolonged, and there are those whose decline is prolonged.

Chap. 3. & 4. Chap. 2.
Chap. 47.

Galen established that healthy diseases generally have all these periods in his book On the Times of All Diseases, which Avicenna also confirms here; but he states that unhealthy ones lack a decline in his book On Crises, which the author likewise confirms here. The same author, in his book On the Best Sect to Thrasybulus, says that the most acute diseases, such as apoplexy, ascend to their extreme vigor as soon as they have invaded, and that those which are indicated by an inclination are entirely mutilated: this must also happen in those diseases which are resolved by remedies applied either at the beginning or at the increase. However, since Galen thinks these things, they do not seem to be free from reproach. But first, the fact that healthy diseases have all periods is refuted because those which are cured by remedies applied at the beginning must lack the remaining periods, as Galen also writes. Whence he also seems to be noted for inconsistency. Furthermore, that some diseases arrive at vigor without an increase can in no way happen, since nothing ascends to the highest point except by degrees. Add that it is not always true that diseases solved by a crisis are primarily indicated by an inclination. Namely, when to those who are well indicated in the status, a decline also succeeds. Add yourself, so as to argue that Galen is in error: if it is his opinion that diseases which are indicated are judged in the status, they must therefore lack a decline; truly, many are judged from healthy ones which would have to be mutilated by a decline; therefore it seems to be true that even if the universal periods of diseases are four, not more, the same thing nevertheless holds in the parts or times of the accessions. For although it is true concerning the universal time of diseases that no one dies in the decline; in the accession itself, however, someone could die in a particular decline, having been vehemently shattered by the prior periods, to such an extent that he cannot sustain even the declining accession. To this may be added that in certain diseases, unequal accessions infest, besides those four periods: so that because of this, a time of inequality is added between the beginning and the increase. But also other diseases have no particular periods, those namely which have no accession. Others, however, which are of the genus of intermittent ones, besides the aforementioned four periods, also have a time of interval: so that diseases do not absolutely have four particular periods: but sometimes they lack them, either all or some: and sometimes they also obtain more. Therefore, Avicenna will also be noted, who, emulating Galen, enumerates four periods of fevers and other diseases, both universal and particular. But to satisfy these things briefly: the times of diseases in the sense they are perceived, and are from the use of the art, as Galen writes, are four, no more or fewer. Yet these are not in all diseases. Certainly, healthy diseases never lack beginning, increase, status, and decline, although it is not always obvious either to the sense or from the use of the art. Whether diseases are resolved through art or through nature, the decline is understood as the time of resolution. Thus also the other periods, even if the diseases were resolved immediately in the very beginning, by phlebotomy or by the exhibition of a medicine or otherwise. Yet they are never lacking. But then the times are to be measured from the magnitude of the symptoms, and that will be the status of the disease, which*

less acute, † those, and they are those whose status. m † B. and which are: after those are acute chronic ones, up to the 21st day; afterwards are chronic ones up to 40 and 60 days.