A STUDY OF FEVER. 9 



second sound very strongly accentuated, both pulmonary and aortic. 

 There is no murmur. 



Was ordered to take, during day, ^ss citrate of potassium, in one-half 

 pint of water, every two hours ; ten drops tincture of digitalis, and two 

 grains quinine, every three hours ; one-half pint milk every four hours. 

 Temperature 100^°, pulse 120. 



At 12, temperature 101f°, pulse 124. 



3 P. M. Temperature 101°, pulse 120. 



8 P. M. Treatment all carried out, excepting the milk, which caused 

 great nausea and vomiting ; it was therefore given one ounce at a time, 

 and about one pint, with eight ounces of beef-tea, was retained during 

 the day. Medicine was all retained without difBculty. He has passed 

 urine freely during the day — about three pints in all. Temperature 

 102|^° F., pulse 122. He complains of severe pains in wrist-joints and 

 in the shoulders. Treatment continued during night, when awake. 

 Five-grain Dover's powder ordered ; the same dose to be repeated at 

 12 o'clock, if awake. 



April 10, 9 A. M. The patient slept during the past night, for the 

 first time since the 8th. Took his medicine without any nausea being 

 experienced. Says he feels much better. Ice-cloths to head discon- 

 tinued ; other treatment continued. The condition of joints of wrists 

 and shoulders is about the same as on the morning of the 8th ; they are 

 very swollen and painful. Pulse 120, temperature 101° P. 



6. P. M. Condition as in morning. Has taken one quart of milk 

 during the day. Temperature 100^° P., pulse 116. 



Aiyril 11. Temperature 100^° P., pulse 92. QuiniaB sulph., fifteen 

 grains daily, ordered. Digitalis and the potassium salt continued. 



April 12. Is very much improved. Pulse 96, temperature 100°. 

 Citrate of potassium ordered every three hours ; thirty drops tincture 

 of digitalis in twenty-four hours. 



April 14. Peels very little pain in joints, has good appetite, and 

 looks, indeed, almost well. Citrate of potassium discontinued. Iodide 

 of potassium, ten grains, t. d. ; tincture of chloride of iron, gtt. xx, t. d. 

 Quinine continued. Temperature 99°, pulse 72. Tincture of digitalis 

 stopped. 



May 4. Prom the time of previous note he steadily progressed towards 

 entire convalescence under a tonic treatment, and has been for some 

 days going about freely. To-day be is to be discharged, perfectly well. 

 There is no cardiac lesion whatever. 



Let me call your attention, gentlemen, to the rapidity with 

 which, under the influence of the cold bath, the symptoms 

 abated in our patient. He was not in more than a minute and 

 a half before he exhibited very distinct signs of returning con- 



