FEVER, 



183 



appears not a little singular, was the following : A 

 person in perfect health would suddenly feel a stiff- 

 ness, amounting almost to pain, in one of his fingers, 

 and most frequently his little finger. The stiffness 

 increased, and was accompanied with an intense 

 degree of pain, which spread rapidly over the whole 

 hand, and up the arm into the shoulder. The fingers 

 in both hands, in a few hours, became swelled, 

 stiff, and painful, preventing all attempts at bending 

 the joints." To this succeeded restlessness, depres- 

 sion of spirits, nausea, vomiting, shivering, great 

 heat, intense headache, most acute pain in every 

 joint. The most distressing symptoms were intense 

 pain in the eye balls and back, the eyes seeming to 

 the patient enlarged, filling the sockets, and as if 

 ready to burst. Quite a remarkable symptom was 

 the feeling of intense cold, while, at the same time, 

 the skin was intensely hot. These symptoms con- 

 tinued from twenty-four to thirty-six hours. The 

 patient now remained languid, irritable, and restless 

 for about three days, when it was not uncommon for 

 a new attack to come on, accompanied by an efflo- 

 rescence, beginning at the palms of the hands, and 

 extending tlience over the whole body. Secondary 

 symptom^, consisting principally in pain and stiffness 

 of the limbs and body, followed, which, in many 

 cases, continued even weeks, and made the patient 

 most uncomfortable. Sometimes there was distress- 

 ing itching ; and, in some cases, there was swelling 

 of the prepuce and scrotum, and, in others, a dis- 

 charge from the urethra, resembling gonorrhoea. 

 Dr Stedman considers the disease contagious. The 

 treatment was, for the most part, antiphlogistic. 

 Such means were used as would hasten the sweating 

 stage, evacuate the bowels, and render the patient 

 most comfortable. Where these means failed, the 

 more active depleting means were resorted to, and 

 much relief of local suffering was afforded by the 

 use of blisters and stimulating embrocations, mustard 

 poultices, and the like. The latter were applied to 

 the temples, to relieve the pain in the eyeballs, to 

 the back, the back of the neck, &c., as indicated, 

 and always with advantage. Dr Stedman found 

 benefit from blood-letting, in some severe cases. See 

 various accounts of this epidemic by Drs Dickson, 

 Daniell, Waring, &c. &c. in the American Journal 

 of Medical Sciences. 



Synochus (from ffvvi%u, to continue) ; a mixed 

 fever ; a species of continued fever, commencing 

 with symptoms of synocha, and terminating in ty- 

 phus, the former being apt to preponderate at its 

 commencement, and the latter towards its termina- 

 tion. Everything which has a tendency to enervate 

 the body may be looked upon as a remote cause of 

 this fever ; and, accordingly, we find it often arising 

 from great bodily fatigue, too great an indulgence in 

 sensual pleasures, violent exertions, intemperance in 

 drinking, and errors in diet, and now and then like- 

 wise from the suppression of some long accustomed 

 discharge. Certain passions of the mind (such as 

 grief, fear, anxiety, and joy,) have been enumerated 

 among the causes of fever, and, in a few instances, it 

 is probable they may have given rise to it, but the 

 concurrence of some other powers seems generally 

 necessary to produce this effect. The most usual 

 and universal cause of this fever is the application of 

 cold to the body ; as, for instance, when the body is 

 deprived of a part of its accustomed clothing, or a 

 particular part is exposed while the rest is kept at its 

 usual warmth, or a sudden and general exposure 

 to cold takes place when the body is heated much 

 above its usual temperature. Another frequent cause 

 of fever seems to be breathing air contaminated by 

 the vapours arising either directly or originally from 

 the body of a person labouring under the disease. A 



peculiar matter is supposed to generate in the body 

 of a person affected with fever, and this, floating in 

 the atmosphere, and being applied to one in health, 

 will, no doubt, often cause fever to take place in 

 him; which has induced many to suppose, that this 

 infectious matter is produced in all fevers whatever, 

 and that they are all more or less contagious. The 

 effluvia arising from the human body, if long con- 

 fined to one place, without being diffused in the 

 atmosphere, will, it is well known, acquire a singu- 

 lar virulence, and will, if applied to the bodies of 

 men, become the cause of fever. Exhalations, 

 arising from animal or vegetable substances in a 

 state of putrefaction, have been looked upon as an- 

 other general cause of fever; marshy or moist 

 grounds, acted upon by heat for any length of time 

 usually send forth exhalations, which prove a never- 

 failing source of fever, particularly in warm climates. 

 An attack of this fever is generally marked by the 

 patient's being seized with a considerable degree of 

 languor or sense of debility, together with a slug- 

 gislmess in motion, and frequent yawning and stretch- 

 ing ; the face and extremities at the same time be- 

 come pale, and the skin over the whole surface of 

 the body nppears constricted ; he then perceives a 

 sensation of cold in his back, passing from thence 

 over his whole frame ; and, this sense of cold continu- 

 ing to increase, tremors in the limbs and rigors of 

 the body succeed. With these there is a loss of ap- 

 petite, want of taste in the mouth, slight pains in the 

 head, back, and loins, small and frequent respira- 

 tions. The sense of cold and its effects, after a little 

 time, become less violent, and are alternated with 

 flushings ; and at last, going off altogether, they are 

 succeeded by great heat diffused generally over the 

 whole body ; the face looks flushed, the skin is dry, 

 as likewise the tongue ; universal restlessness pre- 

 vails, with a violent pain in the head, oppression at 

 the chest, sickness at the stomach, and an inclina- 

 tion to vomit. There is likewise a great thirst and 

 costiveness, and the pulse is full and frequent, beat- 

 ing, perhaps, 90 or 100 strokes in a minute. When 

 the symptoms run very high, and there is a consid- 

 erable determination of blood to the head, a delirium 

 will arise. In this fever, as well as most others, 

 there is generally an increase of symptoms towards 

 evening. As a fever once produced will go on, 

 although its cause be entirely removed, and as the 

 continued or fresh application of a cause of fevei 

 will neither increase that which is already produced, 

 nor occasion a new one, there can be no certainty as 

 to the duration of fever ; and it is only by attending 

 to certain appearances or changes which usually 

 take place on the approach of a crisis, that we can 

 form any opinion or decision. The symptoms 

 pointing out the approach of a crisis, are, the puls 

 becoming soft, moderate, and near its natural speed 

 the tongue losing its fur, and becoming clean, with 

 an abatement of thirst ; the skin being covered with 

 a gentle moisture, and feeling soft to the touch ; the 

 secretory organs performing their several offices ; and 

 the urine depositing flaky crystals of a dirty red col- 

 our, and becoming turbid on being allowed to stand 

 any time. A simple continued fever terminates al- 

 ways by a regular crisis in the manner before men- 

 tioned, or, from the febrile matter falling on some 

 particular parts, it excites inflammation, abscess, 

 eruption, or destroys the patient. This disease 

 being of a mixed nature, the treatment must be mo- 

 dified accordingly. In the beginning, the same plan 

 is to be pursued as in synocha, except that we must 

 be more sparing in the use of the lancet, in pro- 

 portion as there is less power in the system to main- 

 tain the increased action of the heart and arteries : 

 although, if any important part should be much. 



