Articella (The Little Art of Medicine)

purpose? fever? accession? signification? of disease?
ordering?
diet? beginning?
status?
restore?
to contend?
digestion?
exacerbations?
crude?

continuously for a short time after the beginning referring to the onset of the fever: which he also indicates in what follows. It is certain, therefore, that in such acute illnesses, when they exist immediately from the start, a thin diet should be given continuously in those cases where it is predicted. It is expedient for them to abstain slightly in the status the peak or critical phase of the disease and before the status. Meanwhile, however, while they are far from the status, one should restore them so that it is sufficient to reach the status. In the status, however, one should abstain, so that nature may be prepared to contend to fight the disease, and not be entirely intent on the digestion of food. Therefore, it is necessary, he says, in exacerbations—that is, in the onset and accession of the very force of the disease—to withdraw food. For food harms, because, being crude and indigestible, it increases crude and indigestible humors.

In paroxysms it is necessary to withdraw, to add to it is harmful. And whatever things are exacerbated according to their cycles, it is necessary to withdraw in the exacerbations.

Every? diet?
double? to be ordered?
strength? of the infirm?
insinuates?
hour? of accession?
acute? disease?

Every diet in individual diseases must be ordered in a twofold manner: either from the length or the proximity of the status, or from the strength of the infirm. But how the diet is to be ordered on individual days as it is expedient, he insinuates here. He directs us that food should not be given in the hour of the accession of a fever, nor before its day has arrived; which is better explained in the book On Acute Disease, where he says: It is not necessary to diet at the hour of the accession of a fever, nor before its day has arrived, but when it has already subsided and quieted down.

Paroxysms?
times? of year?
of cycles?
pleuritic? sputum?
urine?
sweats?

He declares the paroxysms and consistencies the patterns of the illness through the disease, the times of the year, and the mutual increases of the cycles, whether they occur daily, every other day, or over a longer time. But they are declared by what appears afterward; just as in a pleuritic case, if reddish sputum appears continuously, it shortens the beginning. But if it appears later, it prolongs it. And the expulsions of urine, and sweats, and the appearance of the end, and the long and short diseases declare the facts.

diet?
strength? of the infirm?
essence? of the disease?
triple? ordering?
visitation?
of the physician?
Hippocrates?
epidemia?

Although he spoke before about ordering the diet, this place nevertheless seeks a greater treatment. For since he considered the strength of the infirm and the times of the disease in the diet above, here he introduces a third thing to be understood: namely, the essence of the acute, peracute, or chronic disease, from which the daily diet must be ordered according to the cycles of their accessions. Thus, therefore, the ordering of the diet seems to be threefold: from the strength of the infirm, the essence of the disease, and the interpolatio intermission or interval of any particular disease, or part of the disease. The strength indeed can be easily understood in the first visitation of the sick person, through the pulses and other signs shown in the prognostics. Whence no one can say in reality that they are in no way able to know the strength of the infirm, since every physician is as it were disposed to this; although not naturally, yet artificially. Physicians judge that they cannot know diseases and their intermissions unless they are already present, to which Hippocrates is contrary. For these things are known just as other things that are held in medicine: sometimes certainly, sometimes by judgment bordering on the truth. The status of the disease and the intermission of the future fever must be foreseen for these, which Hippocrates has already perfectly shown in Epidemia Book of Epidemics and in the prognostics. But how it is said here before the status of the disease exists, or when it will be, and how it may be known...

is ordered: which Hippocrates strives to show briefly here, and we should strive to imitate brevity in explaining as much as possible. If, however, these things are not sufficient for anyone, let him investigate our book crileos on crises as much as possible. I say, therefore, that diseases declare the exacerbations and consistencies. For a tertian a fever recurring every three days shows itself to be short and periodic, and its crisis near; a quotidian a fever recurring every day shows itself to be long; a quartan a fever recurring every four days implies itself to be longer and lasting. Continuous and burning fevers signify that they are acute. Fevers alipiados painless fevers and emetriteus intermittent fevers are held between these. How these can be understood from the beginning is explained in the second part of the crileos treatise on crises. This is what I would say generally, so that we do not appear to repeat the same thing in different books. But if a tertian can be understood from the beginning, its brevity and the speed of its crisis ought to be noted, and its intermission is to be on every third day. This is what Hippocrates said: Exacerbations and consistencies declare diseases. For I have often noted quartans from the beginning, whence it was not necessary to wait for their second action. Thus, therefore, the diet was ordered from the beginning as it was to be ordered in a long disease. We did the same in quotidians and tertians according to the length and brevity of their status. But what we said about fevers should be understood for every disease. For pleurisy, peripneumonia, and phrenitis inflammation of the brain are to be understood as acute fevers; quinsy, diarrhea, and spasms should be taken as peracute; dropsy, mania, and empyema of the bowels, and phthisis—that is, a wound of the lung—are likened to chronic diseases. In pleurisy and phrenitis, therefore, there will be the greatest intermission on the third days. Those wounded in the stomach with empyema, whether in the liver or lung, have intermissions every day, and especially at night. Splenetic or melancholic persons have fevers every fourth day, or they have a fever one day and not the next.

He continued how he named the times of the year with the drinks, for this declares diseases and their intermissions. For it is not enough to order the diet in quartans according to the length of the disease, unless one also understands if, when the fever began, it was winter, summer, autumn, or spring. For a summer quartan is short, but an autumnal one is long, especially if it nears winter, which he will show in the following aphorisms. A tertian is swift and short and makes a near crisis: shorter in summer, longer in winter; and thus summer shortens diseases, and winter prolongs them. The intermissions of fevers in summer are very frequent in tertians; in autumn, in quartans; in winter, in quotidians. The complexions of bodies also designate diseases, just as the times of the year do, the diversities of which, because Hippocrates touched upon them in many places, he omitted here, because he thinks they are made plain from other books. Therefore, what summer implies, the same is portended by a hot and dry complexion. If the age of the infirm is also perfect youth, and the region is hot and also dry, and art and custom designate diseases in a similar way, likewise also the air by which the sick person is surrounded, which he will show later; judge the same concerning other diseases in other times. The consistency of a disease will be shown if the disease is acute and peracute or chronic, which it is necessary to know to discern the status of the disease. Daily intermissions are shown by tertians and quartans, and at what hour of the day or night it begins. He adds after: And the mutual increases of the cycles, whether they occur daily, every other day, or over a longer time; it is necessary to examine if through this the aforementioned can be understood. For through the mutual increases of the cycles of recurring fevers, the increases, diseases, intermissions, and status are signified. Through the increases of the intermissions in fevers also, the increase of the disease and the distance and proximity of the status are signified, as will be shown in the present. For the increase of the second accession is shown in three ways: either from the beginning time, or from the length, or from the magnitude. For magnitude, whether it is called strength or magnitude, is one and the same...