TREATMENT OE ACUTE DISEASES. 373 



lv on the liver and gall-bladder. Sometimes the lungs arc- 

 greatly affected ; and extravasations have been found in the 

 brain after death. 



It is not my intention to delineate the progress and symp- 

 toms of this fever ; it will be sufficient to say that bilious 

 vomitings are amongst the concomitant and distressing symp- 

 toms of yellow fever ; and that what is called the Black Vo- 

 miting generally happens towards the fatal termination of the 

 disease. 



I hasten to the medical treatment as practised by Dr 

 James Clark, and others of my friends in the West Indies. 

 Dr Clark, in his letters to me on this subject, regrets his 

 being called so late to the sick in this fever, twenty-four hours 

 having often elapsed before he has seen them : but even at 

 this late period, says he, " I have been lucky enough to save 

 three out of four, or four out of five, of those who had the 

 yellow fever. 11 In cases where he has been called in on the 

 first day of the fever, he assures me he has seldom lost any 

 one. He first endeavours to purge briskly with ten grains of 

 jalap and ten grains of calomel every three hours. If the 

 vomiting continues, ten grains of calomel, by itself, are given, 

 till stools are procured ; and after this calomel, in doses of 

 five grains, with or without opium, every third or fourth 

 hour. In urgent cases he has recourse to mercurial friction, 

 till the violence of the symptoms has abated. " If, 11 says he, 

 " I can by any means introduce a sufficient quantity of mer- 

 cury into the habit in time, so as to affect the mouth and 

 gums, I have no hesitation in declaring that my patient is 

 out of danger. 11 



Dr Clark has given sixty or eighty grains of calomel in 

 three days ; Dr Drummond, a learned and eminent physician 

 in Jamaica, has given 200 grains in the same space of time, 

 besides friction with strong mercurial ointment, with suc- 

 cess. 



