Against Those Who Have Written on Disease Patterns

​Let us speak next of those who believe that there are only the three periods, not indeed diagnosing each from its own nature, but from the correspondences among the paroxysms. For this is how they themselves are accustomed to call the proportions of the paroxysms. Such people, even if they do not remain ignorant of the coming paroxysm forever like the former group, will necessarily be ignorant of it until the fourth or fifth day. For let it be assumed that on the first day one paroxysm occurred, on the second two, again on the third two, and on the fourth two. Now, it is possible for the complication of simple periods to be of such a kind that a quotidian began on the first day, a tertian on the second, and on the third day either a tertian or a quartan could begin (for this is unclear before the fifth day), and then on the fourth day there occurs the second paroxysm of the quartan that began on the first day and the second of the tertian that began on the second. And it is obvious that the fifth day will have two paroxysms: the second of the tertian that began on the third day, and the second of the quartan that began on the second day; and the sixth day will have the second of the quartan that began on the third, and the third of the tertian that began on the second. But, other things being the same, it is also possible that on the third day two other tertians or two other quartans began. For since the fourth day according to such a hypothesis has no connection with the third, it is possible for both two tertians and two quartans, or one tertian and one quartan, to begin on the third day. And one might wonder at those who construct such complications, if they never considered that it is possible for the paroxysms of two types to coincide at the same hour, which, if it should happen, destroys the signs of correspondence for them. At any rate, according to the proposed hypothesis, it is possible for the quartan beginning on the first day to occur at the second hour, and the other quartan at the eleventh hour. These things being so, there is only one paroxysm on the fourth day, the one at the second hour. Yet they never say that one occurs according to the assumed hypothesis, but always two. And see how it is possible for even three paroxysms to coincide at one hour, and how because of this the complication is not unknown to those who know how to diagnose the form of each of the simple types. For let it be assumed that on the first day a quartan began at the third hour; on the second, a tertian at the same hour; and on the third, a quotidian at the same hour. With these things assumed, it is necessary that on the fourth day at the third hour there occurs only one paroxysm, the three periods having arrived at the same point with one another. But none of them wrote this, and all, as if from one mouth, say that on the fourth day, under the hypothesis just mentioned, three paroxysms occur. And if, conversely, one assumes that the patient suffers a paroxysm once every day, some declare it simply a quotidian, while others say that it is possible to be both two tertians and three quartans.