Most often, four-day bile is periodic, and continuous four-day bile occurs rarely. As for the causes of four-day bile, these are the reasons that generate black bile and then cause it to rot. You already know all this, and you know that black bile is either a sediment of blood, or burnt blood and the ash of burnt juices. You have already learned that such black bile can be bloody, sometimes mucous, sometimes yellow bile, and sometimes it can be burnt natural black bile, on its own. Some people claim that four-day fever does not arise from natural black bile, because black bile supposedly does not rot. One should not listen to such words; on the contrary, all moisture tends to rot, although the moistures are not similar in the degree of their ability to do this.
Most often, four-day fever appears after various diseases and after putrefactive fevers that arise due to various juices from which they are born due to their decay. If these juices turn into ash and are not excreted, then the black bile multiplies, and when the black bile rots, a four-day fever occurs. Often, four-day fever occurs after diseases of the spleen, and in most cases it does not occur without pain in the spleen or its hardening. The safest is a four-day fever that does not arise from a tumor of the spleen or other organ and is not accompanied by a tumor of the spleen, because a four-day fever that occurs from a tumor of the spleen or is accompanied by a tumor of the spleen often leads to dropsy and hernias. Benign four-day fever relieves malignant diseases, for example, melancholy and epilepsy, and protects against spasms, because the matter is dry. Most often, this disease is benign, and if there is no error in treatment, it does not last more than a year, although sometimes it does not leave the patient for twelve years or less. Prolonged four-day fever leads to dropsy. Know also that autumn is the enemy of those suffering from four-day fever.
Signs. Quadrennial fever strikes at first with a slight cold, then the cold begins to intensify and then decreases slightly again in a period of extremes, as with mucous fever. When the body flares up, the heat is not strong, although it is still stronger and more obvious than
heat during mucous fever, because the mucous membrane flares up with difficulty and, moreover, does not flare up to any significant extent, like fire in thick logs, and does not engulf the entire body. On the contrary, with it there is a fever, from which one feels goose bumps and heaviness, and the reason for this is the thickness of the juice. With four-day fever, along with the cold, there is a slight pain that seems to ache in the bones, and there is a chill that makes the teeth chatter, but not as much as with mucous fever. All this leads to weakening of vision, which, however, disappears when the matter ripens, for the malignancy of the juice then decreases and becomes insignificant, as at the beginning.
Signs of four-day fever are also previous causes - prolonged fevers, diseases of the spleen or its soreness. They indicate the four-day state of nature and signs of its black bile, as well as age, season, nutrition, appearance of the patient, his habits, and the like. Her attack lasts twenty-four hours; Often such a fever lasts three days in summer, and becomes four days in winter. Often, fevers dependent on different juices lead to mixed fevers with disordered attacks, since the remains of juices remaining after mixed fevers are different. When all these remains undoubtedly turn into ash, the fever is defined as four days.
With four-day fever from burnt mucus, the attacks last longer; This most often occurs after a continuous fever. In this case, sweat appears later, urine is thicker and the density of blood vessels is less; most often this occurs after mucous fevers.
With four-day fever from burnt blood, it is preceded by signs of blood putrefaction and blood fevers and redness of the urine; This is also indicated by the appearance of the patient, his age and time of year. Often this fever occurs after blood fevers.
During four-day fever from burnt-out yellow bile, the pulse is faster and more frequent; it begins with goose bumps and coldness in the meat, as well as with thirst and perspiration, and anger, rage, and burning are observed. Indications of such a fever are the appearance of the patient, age and time of year, and sometimes the fact that it occurs after yellow gall fever.
Due to the dryness of the matter, the pulse during four-day fever is hard - it seems to be drawn inward, like the pulse of an old man - and, until the matter begins to move, it is quite even; when it moves, the pulse becomes very uneven due to the thickness of the excess. The slowness of the pulse becomes noticeable as the attack subsides, and this serves as a final indication of a four-day fever. Often in this case there is a nervous expansion of the pulse and a very rapid compression of it, in contrast to what happens with a three-day pulse. With a four-day pulse, it is better than the mucous pulse in terms of smallness and frequency, but the same in terms of slowness; at the beginning of the attack, the slowness and frequency of the pulse increases, and its irregularity is greater than the irregularity in other fevers, but then it becomes larger, more frequent and faster. As for urine during four days, all periods of fever, except for the period of a good limit, are similar to each other in terms of its immaturity due to the coldness and thickness of the matter, but the quality and color of the urine are different, for black bile arises from a variety of juices. One of the signs of maturity in quartan fever is a weakening of the chills; the urine is at first white, bluish and raw, not digested, but after the initial period its quality changes and it becomes colored for the reason that most black bile arises from various juices; during the decline period, the urine turns black. Four-day perspiration is profuse compared to mucous fevers, but not profuse compared to others. There is little thirst in this fever, unless the fever arises from black bile, formed from yellow bile.
Treatment. In this disease, one looks to see whether it arose from bloody black bile, from mucous black bile, from black bile of yellow gall origin, or from natural black bile, and then treats each case with the most suitable of those remedies that we will mention below. However, all its varieties have qualities in common, in particular, the fact that all these fevers initially cause chills. It should be seen whether blood predominates, especially when the quartan fever is due to blood black bile. If this is the case, then bloodletting is performed and blood is taken in the required quantity; Often the abundance and poor quality of blood require that a lot of it be extracted. If there is no need to open the blood, but it is still opened, then this causes harm, since the patient weakens and something opposite to black bile is removed, and also because bloodletting moves the juices outward. If at first a certain amount of fever-causing juice is withdrawn not for cleansing, but for the sake of relief, then this should be done when the matter is ripe, in accordance with what we will indicate later, but a day after the attack.
You should not force urine at first, and you should use medicines that relax the tissues. If you do not approve of drinking medicines, then use suitable enemas instead, but they must be mild, and they can only be intensified when the disease reaches its limit. Sometimes the doctor, out of recklessness, forcefully removes black bile several times at the beginning of the disease and thus stops the disease at its roots, but this is luck due to a mistake.
On the day of the attack, the patient should not be fed anything and should be forced to fast; on this day it is also appropriate to abstain from cold water, and on other days they must give meat of mountain partridges or chickens. First, for three or four days, they give partridges, then chickens; It is better to feed the chickens at this time.
The medicine on days without attacks is julanjubin, dissolved in hot water, twice a day, or three dirhams of julanjubin in ten dirhams of sikanjubin. You already know that when black bile comes from yellow bile, then when removing it you should use something like myrobalans or violet, and if it is mucous, then when removing it you should first use something with the power of turbita. If it is burnt black gall matter, then when removing it, you must first use something that has the power of polypodium, dodder and similar medicines. You also know that cheese whey is an excellent conductor for the use of drugs with the mentioned powers, and sometimes even the use of whey alone gives success, especially if heat reigns in the body, and you know that julanjubin and its water, strained after a long boil, have such same dignity; they are all the more useful if the stomach is weak or cold juice predominates. Vomiting is also beneficial, especially before meals, and after meals it is also the most suitable remedy, and even more so on the day of an attack before an attack. When black bile is mucous, vomiting is one of the most useful remedies, and not only at the beginning, but at all times.
So, at the beginning of the disease and at the first time of maturation, before the matter perceives full maturity, one should not sharply empty the excess with strongly warming and strongly drying medications or by stopping the diet, as well as by debilitating relaxation or laxative relief of the regime at the beginning of the disease.
Know that if a four-day fever begins in summer or winter, you should first drink barley water with shikanjubin, so that the paths are opened for the expulsion of excess and the attack ends quickly; this should be done three to four hours after the previous attack. If the four-day period occurs in winter, then caution is necessary and in no way should you give laxative lozenges to drink.
Know that cold, moist, digestible things that give good chyme are sometimes suitable for this disease, since it is a fever and because they are the opposite of one of the qualities of black bile, which is dryness. Therefore, you should also use these things when there is no danger of harming the ripening, or use them in such quantities that do not threaten the ripening, or mix with them substances that moderate coldness and do not reduce moisture; These are substances that are hot to a moderate degree. Beware of anything cold and dry.
Cold and moist substances suitable for this disease are, for example, chicory, lettuce, melons and sometimes peaches; such things should be avoided only because of the strong coldness that exists, for example, in lettuce and does not exist in sweet melon, or because of the strong diuretic effect leading to thickening of the blood - this exists, for example, in melon - or, finally, for the reason that, when mixed with other substances, they predispose them to rotting - this property exists in peaches. You should keep all this in mind.
As for dishes that are moderate in heat and exceed moderation in moisture, they are very useful, especially when there is no desire to contribute to the ripening of matter with their warmth, and they want to moderate their warmth with cold and moist substances, mixing, for example, figs with chicory . At the beginning, it is not harmful to eat salty, caustic and corrosive substances if you are not afraid of a fever, and at the end of the illness it is even necessary. Wormwood cakes help until the end of the disease. One of the useful remedies is to sit every day, before meals, in hot fresh water, use a bath that moisturizes, but does not drive sweat and does not excite heat, constantly remain in the cold and at peace, avoid physical work, bodily and mental movements.
All these fevers require humectants, but they differ in the degree of cooling or warming required. And drying agents are needed not for the sake of drying, but because of their inherent tearing, cleansing and laxative properties.
You should take care of the condition of the stomach, using good strengthening medicinal dressings, from very hot to slightly warm, depending on what the circumstances require; also keep an eye on the liver and spleen and take measures to prevent the spleen from becoming hard and swollen. Sometimes for cleansing you need radish juice and its seeds, which are mixed with sikanjubin, and sometimes they resort to taking beets, salted fish, mustard and the like before sikanjubin. Often after this they force you to drink a lot of water and then give you shikanjubin and induce vomiting. One of the useful remedies is for the patient to take shikanjubin on the day of the attack and then induce vomiting: this will relieve the harmfulness of cold and chills and the rage of fever. Or let him eat garlic with honey, drink honey sikanjubin and fill his stomach with food, and then take hot water and vomit; when the attack is over, let him eat a little for dinner and take a bath in the morning. It is also good to take some food about five hours before the attack so that you can vomit; sometimes it helps even without vomiting. Vomiting before an attack, no matter what the juice causes the fever, alleviates the attack or ends it.
Here is one good measure: let the patient fast on the day of the attack, if there are no obstacles to this, and not eat until the attack is over. And the next day, let him go to the bathhouse, and if the disease has matured, let him bathe as usual, and if there is no maturity, then nothing should be done in the bathhouse except pouring hot water in an amount pleasant to the body and moisturizing it, but not to such an extent, so that it raises the juices. On the third day, vomiting is induced to remove the remaining food and matter dissolved in the bath, although the patient should be vomited on the day of the attack as well.
If black bile comes from the blood, then bloodletting from a vessel of basil and then gentle emptying with a medicine that includes blood-purifying plants with the power of tartar, milk thistle, polypodium, fumica and Kabul myrobalans are beneficial. This type of fever is quickly treatable.
If black bile comes from yellow bile, then use effective cooling and moisturizing with medicines and foods and use moderately warm water in which the patient sits or bathes. The softening of his nature at the beginning of his illness is carried out, for example, with laxatives prepared with violet or prepared from cheese whey with a small amount of polypodium,
or sikanjubin from dodder, or rose wine, bindweed juice, laxative cassia. As for complete absolution, sometimes it succeeds only after the twentieth day, for only on this day does maturity become apparent, I mean, if black bile comes from yellow bile. Then they gradually move on to medications that thin out and tear off the juices. If you need to correct a patient’s stomach, then use rubs and ointments that are not stronger than chamomile, wormwood leaves, sweet clover, and the like. Frequent fasting, even fasting on the day of an attack, is sometimes not beneficial for such patients, although on the day of the attack their food is limited to a small amount of something insignificant.
Among the useful cleansing remedies for such fever is a decoction of myrobalans, dodder and senna in sikanjubin, in which violets were boiled. Sometimes the patient is given asafoetida on an empty stomach, especially on the day of the attack, and is induced to vomit if he feels sick.
If black bile comes from mucus, then they resort to honey sikanjubin with the juices of celery, fennel and similar plants, and if it is necessary to soften the nature, then at the beginning of the disease something that expels mucus is mixed with sikanjubin, for example, substances with the strength of turbite and polypodium, and gradually move on to agaric, and also induce vomiting with honey sikanjubin with seeds and similar medicines, until the matter begins to ripen. Poultices and medicinal dressings for the stomach are made from stronger things, including dates, figs and the like, and hot oils are also rubbed in, even bush oil. It is often necessary to induce vomiting in a patient with sikanjubin with a small amount of white hellebore, and sometimes it is even necessary to give white hellebore with radish juice or a little hellebore with radish or hellebore alone, as it is, if you are not afraid that weakening of strength will occur.
If black bile comes from burnt pure black bile, which is related to blood sediments, then it is useful to remove it first with bindweed juice and faniz; It is also good to use honey and sugar julanjubin, and at the end it is removed, for example, with a decoction of yellow and black myrobalans, smoke and raisins. When the disease matures, then bloodletting also has a good place among the emptying means. Blood is drawn from the basil and vomiting is caused after eating, either sharply or gently, depending on the time and need. Vomiting must be constantly induced, for this is the basis of treatment, and emptied with strong medications and enemas. Medicines used at such times are dodder, polypodium, agaric, Greek lavender, Armenian stone and lapis lazuli - washed or unwashed, as well as squeezed juice of cinquefoil leaves with honey wine. Black hellebore is often needed, and sometimes for yellow gall fever, senna and fumifera with dodder are enough; vomiting is induced with sikanjubin, and then urine is expelled. Then, after bowel movement, for mucous and black-bilious fever, give teriyak, mithridate and medicine with asafoetida and sulfur. Pepper itself is given to drink with water; Medicines such as mustard are not used constantly, but every three days, at the beginning of the illness, and before that - at longer intervals. The same applies to falafili and similar juvarishnas.
Don't rush into any of this until the disease is ripe; If you first start giving teriyak and similar medicines, you will cause one four-day fever after another, and sometimes you can bring on other diseases, especially in winter. If bloodletting is required at the end of the illness, then go for it.
Galen says: I have cured many people of four-day fever by giving them a laxative to drink when the disease was ripe, after which I gave them squeezed wormwood juice and then teriyak. And I will say: asafoetida and pepper, taken separately, are very helpful when ripening appears and the disease reaches its limit. Feed the patient small fish, milk and sour caper sauces, as well as mustard, murree and all dishes that have the ability to dilute the juices.
Sometimes it is necessary after the fortieth day to give the patient, for example, one dose of medicine with asafoetida every morning and the same amount every evening, unless the fever is acute and the basis of the matter is not yellow bile. Among the flatbreads that are useful at such a time and during the decline of the disease are flatbreads according to the following recipe: take the squeezed juice of saplings and saffron - three dirhams each, scolopendra, lakka, rhubarb and bamboo nodules - each five dirhams, sorrel seeds, purslane seeds , roses, sumbul, dodder seeds, anise, celery seeds, caper root, ban seeds, fennel seeds - four of each. All this is kneaded with celery juice and turned into flat cakes; They are given to drink with the juice of fennel, chicory and dodder.
But here is a medicine that is useful in many ways, and especially when the matter is ripe. They take myrrh - twenty-seven dirhams, sumbul - thirteen dirhams, mountain pet
Rushki - fifteen dirhams, anise - ten dirhams, saliva, bush, rush inflorescences - five each; the composition is mixed with old wine or ginger honey and given to the reception near the javza.
Sometimes those recovering and sick at the end of the illness, when they suffer little from it, but the heat is still strong, although the matter is rarefied, are given a medicine of this kind: henbane or mandrake seeds - qirat and asafoetida - about three bakillas. The following medicine also belongs to this category: they take mint - four misqals, nettle seeds - twenty misqals, opium misqals and turn them into very small cakes; They give one dirham per appointment.
Among the remedies that are good to use for such patients, when signs of ripening appear and until the end of it, are the following: take Ghassanid or Herat raisins, wild garlic, fresh myrtle - one part of each, thoroughly boil the composition in water, after soaking it in it , boil thoroughly, strain and give one uqiya to drink. Also: take celery seeds, anise, wild cumin - each for five dirhams, wild satar, sapling - each for seven dirhams, azhgon - four, tartar - three, raisins - ten, and boil in three ritls of water until there is no more one rittl.
Here is one of the excellent medicines for such patients: take azhgon, sumbul, mint - each for ten dirhams, cumin, anise - each for seven dirhams, asafoetida - five dirhams, ginger - four dirhams, Ceylon cinnamon - three dirhams. All this is mixed with a sufficient amount of honey and given to drink one dirham with celery or fennel juice.
More flatbreads according to the following recipe: take squeezed sapwood juice - ten dirhams, scolopendra, bamboo nodules, fennel, sumbul, saffron - five dirhams each, lakka, rhubarb - four each, purslane seeds and kissa seeds - six each; The composition is turned into flat cakes with celery juice and can be drunk with sikanjubin.
Also against mucous fever: take myrrh - five parts and two thirds, saffron, mountain parsley - five each, sumbul - four and a half, beaver stream - three, anise - three and a half, celery seeds, caraway seeds - four each, amoma , Ceylon cinnamon crusts, maya - each for two dirhams with a third, tortuous gill, andruhurun in the form of porridge - each for a dirham with two thirds.
With severe chills, vomiting from warm water with shikanjubin helps, and if nature does not respond, then the medicine is strengthened with the substances mentioned above in accordance with the period of the disease. It is also useful to fumigate with water for irrigation, in which citvar wormwood, chamomile and the like were boiled, and the patient is wrapped in clothes that retain warmth.
Laxatives needed after the disease has matured. They take Kabul myrobalans - six dirhams, dodder, wormwood - five dirhams each, yellow myrobalans, squeezed sapling juice, emblic myrobalans - four each, celery seeds, anise, fennel seeds - two dirhams each - a decoction is prepared from this, and it gently relaxes.
Or they take raisin - ten dirhams, Kabul myrobalan, dodder - eight each, smoker - seven dirhams, tartar, large centaury - six dirhams each, sapling, rush root - five each; All this is boiled in five rittles of water until there is only one rittle left.
Light pills. If taken once every five days, they help against such fever, and this is a proven remedy. They take dodder and turbita - ten dirhams each, cumin, anise - seven each, azhgon - eight, celery and fennel seeds - three each, polypodium - six, white agaric - eight, Indian salt - five, iyaraja fikra - eleven dirhams. All this is turned into pills with mint juice and they give one and a half dirham per dose.
If the matter is mucous, then the following pills help: take dodder, azhgon, agaric - eight dirhams each, celery seeds, anise, fennel seeds - three each, petroleum salt - five, iyaraja, turbita - ten each; they give two dirhams and a half for the reception.
If the fever is accompanied by pain in the spleen, then a medicine that gently laxative is useful: take scolopendra - fifteen dirhams, agarica - twelve, black myrobalans, iyaraja - ten each, Kabul myrobalans, bitter wormwood - eight each, tartar, milk thistle, dubrovnik , squeezed sapwood juice - seven each, tamarisk fruits, caper roots - five, celery seeds, anise, fennel seeds - three each; From this they prepare medicinal porridge or pills.
Nutrition of patients with four-day fever. It is best to direct the regimen of such patients in the first weeks, up to three weeks, to some relief in nutrition without weakening their strength. Namely: they must abstain from meat and oily substances, since abstinence reduces the amount of matter, alleviates the disease and shortens the duration of the disease, but then it is necessary to revive their strength by giving, for example, fish from rivers with a rocky bottom, soft-boiled eggs, chickens, mountain partridges If the period equal to the period of prohibition of oily substances expires, but the disease does not improve, then it is necessary to monitor the patient’s state of strength and give him something more strengthening - chicken, lamb, goat meat or birds with soft meat - chickens or turrets, and also good small fish.
Know that the condition for food to be suitable for someone suffering from quartan fever is to combine a number of qualities in it. First: it should not make you swell, but on the contrary, it should dispel the swelling caused by black bile; second: it should not be thick, but on the contrary, thin out thick juices; third: let it not lock, but, on the contrary, let nature go; fourth: the blood generated from such food must be praiseworthy. Most dishes of this kind are dishes that have warmth and moisture.
You already know how to feed before an attack, and for how many hours, and why, and you also know that sometimes, for the reason already mentioned, it is necessary to feed during an attack and shortly before it, but it is best if the fever finds the patient with an empty stomach so that no matter, except the matter of disease, distracts nature until it expels this matter. Pure liquid white wine is beneficial for such a patient.
Treatment of persistent quartan fever. The qualities of this fever are as we described earlier, and the rules for its treatment are similar to the rules for the use of intermittent four-day fever, and they differ only in minor things. So, for example, the desire to use moderately warming medicines and to cool down with such a fever is preferable due to its inseparability, so to benefit from it, one should use, for example, sikanjubin, julanjubin, sikanjubin with seeds and the juices of the roots, balanced by nature, as well as rose syrups with honey; The differences also include the fact that bloodletting during persistent fever is more necessary, because the matter is locked in the vessels. Eating meat with this disease is less permissible.