Acute and chronic

Use in the book

The opening classification lists acute and chronic beside other distinctions: primary and secondary, fatal and nonfatal, wandering and fixed, simple and compound, established habit and passing disposition. These are several axes, not alternative names for one division. Burton does not equate chronic with fatal, or acute with a mere passing feeling. His chosen organising distinction for the moment is body and mind.

Phrenitis gives acute a specific medical setting. Its continual mental disturbance has an acute fever annexed; an alternative formulation makes inflammation of the brain or its membranes with fever the cause of the disturbance. The contrast with melancholy and madness is the presence of fever, not simply the intensity of distress. The adjoining account reports disagreement about grouping the conditions but says Burton will follow writers who handle them separately. Acute therefore helps distinguish a historical syndrome; it does not confer a modern diagnosis on that syndrome.

Chronick does more than mean unpleasant or severe. The melancholy fits from which Burton distinguishes his subject may themselves be violent and tyrannical, yet come and go in response to objects. The melancholy he will treat is established, “morbus sonticus, or Chronicus,” a settled humour that has been long increasing and is hard to remove. “Morbus sonticus” supplies seriousness or disabling force, while chronicus supplies persistence. Burton expressly allows the established condition to be pleasant as well as painful. Neither painfulness nor immediate violence alone makes his chronic category.

The distinction affects what authorities count as useful evidence and treatment. After describing pulse, Burton doubts the elaborate distinctions made about it in chronic disease; he regards urine as similarly uncertain because of differences among people, constitutions and circumstances. Later some physicians accept observing celestial conditions for bloodletting in acute diseases but not chronic ones. The grammatical scope matters: their disagreement concerns whether lunar motion or planetary aspects should be observed, not a blanket permission to bleed acute patients and prohibition on bleeding chronic ones.

Chronic disease also appears in disagreement over medicines. Burton reports Mattioli's strong approval of chemical distillation and claim that chronic diseases can scarcely be cured without mineral medicines. The margin includes both a qualification that some overrate the use and a Latin extension to corrupted blood. These are authorities and qualifications within a debate, not a general prescription for persistent illness. In a different register, the wealthy man described from Apuleius suffers a chronic disease amid abundance and cannot enjoy his food: Burton adds a causal explanation through rich diet and ease to sharpen the contrast with the merry household.

The nonmedical senses preserve the sharpness-image without the disease classification. Cardan's acute philosophers are penetrating thinkers, while the “acute & subtil Sophisters” of the satire are sharp disputants who nevertheless need hellebore. In the palmistry account an acute angle is a geometrical feature alleged to indicate melancholy. Finally, “acute incipit cernere” makes the mind's eye begin to see keenly as bodily vision fades. Intellectual acuity can thus be praised, satirised or contrasted with bodily weakness; it is not a fever hiding inside an adjective.

Related entries

Phrenitis owns the fever-associated disorder; Habit and disposition explains persistence and establishment; Prognostics concerns expected outcome rather than duration alone. Symptoms and signs develops the limits of inference; Disease and sickness gives the wider taxonomy.

Explained vocabulary: Additional Terms.

Places to read

1. Democritus Junior to the Reader · paragraph 27Intellectual penetration in Cardan’s ranking of philosophers.
2. Democritus Junior to the Reader · paragraph 42The satire’s sharp but supposedly deluded disputants.
3. Subsection 2. The Definition, Number and Classification of Diseases · paragraph 10Acute and chronic among several independent disease divisions.
4. Subsection 4. Mental Impairment, Frenzy, Madness, Hydrophobia, Lycanthropy, St Vitus’s Dance and Ecstasy · paragraph 19Acute fever in the definition of phrenitis.
5. Subsection 4. Mental Impairment, Frenzy, Madness, Hydrophobia, Lycanthropy, St Vitus’s Dance and Ecstasy · paragraph 20Disputed grouping of phrenitis, madness and melancholy.
6. Subsection 5. Melancholy as a Passing State, Loosely So Called; the Different Meanings of the Word · paragraph 19Chronic melancholy distinguished from transient but possibly violent fits.
7. Subsection 4. The Stars as a Cause. Signs From Physiognomy, Metoposcopy and Chiromancy · paragraph 20A geometrical angle within reported palmistry.
8. Section 3. Member 1. Subsection 1. Symptoms or Signs of Melancholy in the Body · paragraph 16The pulse description immediately before the qualification.
9. Section 3. Member 1. Subsection 1. Symptoms or Signs of Melancholy in the Body · paragraph 17Pulse distinctions questioned for chronic diseases.
10. Section 3. Member 1. Subsection 1. Symptoms or Signs of Melancholy in the Body · paragraph 18Urine similarly regarded as an uncertain chronic sign.
11. Member 2 Bodily Deformity, Sickness, Low Birth, and Particular Discontents · paragraph 43The mind’s eye seeing keenly, with Latin adverb acute.
12. Member 3 Against Poverty and Want and Other Such Adversities · paragraph 12Chronic illness in Burton’s expansion of a rich-man exemplum.
13. Subsection 4 Precious Stones Metals and Minerals as Alteratives · paragraph 43Authorities praising gold in the surrounding mineral-medicine discussion.
14. Subsection 4 Precious Stones Metals and Minerals as Alteratives · paragraph 44Mattioli’s strong claim about chronic disease and mineral medicines.
15. Member 3 Surgical Remedies · paragraph 3Bodily constitution governs the preceding bloodletting quantity.
16. Member 3 Surgical Remedies · paragraph 4Acute/chronic distinction within a dispute about astrological timing.

In this edition

The modern column preserves acute for the fever and angle, but gives “penetrating” for Cardan's philosophers and “sharp” for the sophists. It renders the chronic cluster as “a serious or chronic illness: a lasting disease, a settled humour,” preserving more than one component. The Latin adverb acute receives “keenly,” not the English medical adjective. These are local sense distinctions rather than interchangeable spellings of a single definition.

In the pulse passage the body attributes the criticism to Crato, while the margin identifies a letter from Andreas Dudith in Crato's collection. The edition retains that discrepancy. Its explanatory note also makes “respected” mean taken into account as a sign, not admired or treated respectfully. The same evaluative sense is explained at not to be respected under Urine.

Acute and Chronick

Contrasting disease classifications, distinct from the other divisions listed beside them.

Original wording: “Acute and Chronick”

Modern wording: “acute and chronic diseases”

The catalogue presents this opposition alongside fatal/nonfatal and habit/disposition. Those neighbouring oppositions are not synonyms for it.

Editorial access forms: acute; chronic; chronick. These are lookup aids, not additional claims of printed attestation.

acute feaver

The acute fever accompanying phrenitis in its historical definition.

Original wording: “an acute feaver annexed”

Modern wording: “accompanied by an acute fever”

Annexed means joined or accompanying. Fever separates this presentation from the feverless disturbance assigned to melancholy and madness.

Editorial access forms: acute fever. These are lookup aids, not additional claims of printed attestation.

morbus sonticus, or Chronicus

A serious or disabling illness, or one that persists as an established condition.

Original wording: “morbus sonticus, or Chronicus”

Modern wording: “a serious or chronic illness”

This phrase record preserves two distinguishable descriptions: sonticus qualifies seriousness; Chronicus qualifies continuing course. Burton then elaborates the latter with “Chronick or continuate.”

Editorial access forms: morbus sonticus; chronicus. These are lookup aids, not additional claims of printed attestation.

Chronick or continuate disease

A lasting disease, contrasted with fits that come and go.

Original wording: “a Chronick or continuate disease”

Modern wording: “a lasting disease”

Continuate explains persistence in the established melancholy under discussion. Burton allows pleasant or painful experience, so the phrase cannot be defined solely by severity.

Editorial access forms: continuate disease; chronic disease. These are lookup aids, not additional claims of printed attestation.

acute Philosophers

Penetrating or intellectually sharp thinkers.

Original wording: “acute Philosophers”

Modern wording: “penetrating philosophers”

Cardan’s reported list ranks thinkers for worth, subtlety and wisdom. The following satirical use of sharp sophists shows that acuity need not secure sound judgement.

Editorial access forms: intellectually acute. These are lookup aids, not additional claims of printed attestation.

Further checked attestations: the passage: “acute & subtil Sophisters”.

acute angle

An angle smaller than a right angle; here the geometry used in a palmistry claim.

Original wording: “the vital and natural make an acute angle”

Modern wording: “an acute angle between the life line and the natural line”

Vital and natural name the palm lines. The geometrical adjective describes their relation; the asserted inference to melancholy belongs to the quoted chiromancy. The ordinary geometrical definition explains the adjective; Burton does not give a numerical threshold in this passage.

Editorial access forms: geometrical acute. These are lookup aids, not additional claims of printed attestation.

acute (Latin adverb)

Keenly or sharply, describing an act of seeing.

Original wording: “mentis oculus acute incipit cernere”

Modern wording: “The mind’s eye begins to see keenly”

The Latin form modifies cernere, to perceive. The same letters as English acute do not give it the same grammatical role.

Editorial access forms: acute cernere; keenly. These are lookup aids, not additional claims of printed attestation.