Love is a self-perpetuating fever: the beloved feeds the disease while reason, like a frustrated physician, abandons the hopeless patient.
Shakespeare employs detailed medical language: fever (disease), nurseth (metaphor of feeding), physician (reason), prescriptions (rational counsel), physic (medicine/cure). Love actively works against healing because the lover craves the beloved as a fever patient craves what worsens the condition. The metaphor implies love is literally a sickness of the body, not merely emotion.
Lines 11–12 declare the speaker's thoughts 'as mad men's are,' expressed 'at random from the truth.' Yet madness reveals truth: in the couplet, he admits she is objectively 'black' and 'dark.' Irrationality and delusion are what allowed him to call her 'fair' and 'bright'; sanity reverses the lie. This is psychologically astute: love and madness are one.
Like someone addicted to a toxic relationship—they know it's poisoning them but they crave the poison. Each fight, each cruelty, paradoxically deepens the attachment. The rational part of them has given up; madness is all that's left.