of the State of New-York. 75 



Answer. In dry summers, our fevers generally com- 

 mence about the first of July, and begin to abate about 

 the 15tli or 20th of October. Intermittents frequently 

 run into remittents, and, by proper treatment, vice versa. 



Query 8. " What are the first symptoms? and are 

 your patients very suddenly seized and confined to bed, 

 or are they complaining some days before ?" 



Answer. The symptoms, on the first attack, are not 

 always uniform, in every patient ; nor are they so in se- 

 veral successive seasons. The fever of tliis year (1803) 

 has been ushered in by cold chills, alternating with a 

 sense of heat, lassitude, soreness of the flesh and bones, 

 pain in the back part of the head, and, in some instances, 

 extending down the spine. In some cases, there was 

 pain under the frontal, and in others under the temporal, 

 bones : pain in the breast, with difficult respiration ; 

 while in many there was a dry becking cough. Some 

 patients were afiected ^vith a pain in the lumbar region; 

 others with a pain in the stomach, the lungs, the liver, 

 and the spleen. 



The large intestines, the diaphragm, and the medias- 

 tinum, have, in different patients, appeared to be the seat 

 of the local congestions. The pain in the head is often 

 periodical, and is accompanied with fever. The fever 

 sometimes commences with vomiting of green and yel- 

 low coloured bile. In some cases, there is a constipa- 

 tion of the bowels; in others, dysenteric symptoms 

 occur. 



