EPIDEMIC CATARRH. 263 



abode or approached him ; and if in a box, his head is often found during 

 his illness turned towards the door or window. Fever, without any disturb- 

 ance of the respiration, has always been present ; the pulse has been acce- 

 lerated, though rather small and weak in its beat than indicative of strength; 

 the mouth has been hot, sometimes burning hot, afterwards moist, and perhaps 

 saponaceous ; the skin and extremities in general have been warm. Now and 

 then the prostration and appearance of debility have been such, and so rapid in 

 their manifestation, that, shortly after being attacked, a horse has staggeringly 

 walked twenty yards only the distance from his stable into an infirmary-box. 

 The appetite, though impaired much, has seldom been altogether lost. Gene- 

 rally, if a little fresh hay has been offered, it has been taken and eaten ; but to 

 mashes there has been commonly great aversion. During the long continuance 

 of the wind in the east, the sore throat and cough have been unattended by any 

 flux from the nose ; but since the wind has shifted within this last fortnight or 

 three weeks, discharges from the nostrils have appeared, profuse even in quan- 

 tity, and purulent in their nature ; in fact, the disease has assumed a more 

 catarrhal character ergo, I might add, a more favourable one. . 



" The disorder has exhibited every phase and degree of intensity, from the 

 slightest perceivable dulness, which has passed off with simply a change in the 

 diet, to an insidious, unyielding, unsubduable pleurisy, ending in hydrothorax, 

 in spite of everything that could be done, and most timely done. So long as 

 the disease has confined itself to the throat, and that there has been along with 

 that only dejection, prostration, and fever, there has existed no cause for alarm ; 

 but when such symptoms have, after some days' continuance, not abated, and 

 have, on the contrary, rather increased, and others have arisen which but too 

 well have authorised suspicions that 'mischief was brewing in the chest,' 

 then there became the strongest reasons for alarm for the safety of the patient. 

 What is now to be done ? The practitioner durst not bleed a second time, at 

 least not generally, for the patient's strength would not endure it, although he 

 is certain a pleurisy is consuming his patient. He possesses no effectual means 

 for topical blood-letting. Neither blisters nor rowels, nor plugs nor setons, will 

 take any effect. Cathartic medicine he must not administer ; nauseants are 

 uncertain and doubtful in their efficacy ; sedatives, tonics, and stimulants, nnd 

 narcotics, appear counter-indicated, inflammation existing, and, when tried 

 under such circumstances, have, I believe, never failed to do harm. 



" Dissatisfied with one and all of these remedies in the late influenza though the 

 losses I have experienced have, after all, not been so very comparatively great, 

 being no more, since the beginning of the year, than three out of nearly forty cases 

 I repeat, having, as I thought, reason to be dissatisfied for losing even these three 

 cases, considering that they came under my care at the earliest period of indis- 

 position, I determined, in any similar cases that might occur, to have recourse 

 to that medicine which, in all membranous inflammations in particular, is the 

 physician's sheet-anchor, and which 1 had exhibited, and still continue to do. 

 myself, in other disorders, though I had never given it a fair trial in epidemics 

 having that tendency which I have described the present one uniformly to have 

 indicated, viz., the destruction of life by an inflammation attacking membranous 

 parts, of a nature over which, being forbidden to bleed, we appeared to possess 

 little or no power. Could we have drawn blood from the sides or breast, by 

 cupping or by leeches, in any tolerable quantity, we might have had some con- 

 trol over the internal disease ; but barred from this, and without any remedy 

 save a counter-irritant, which we could not make act, or an internal medi- 

 cine, whose action became extremely dubious, if not positively hurtful, what 

 was to be done? I repeat, I made up my mind to experiment with the 

 surgeon's remedy in the same disease, namely, mercury; and that I have 



