394 REPORT ON THE DISEASES AMONG THE 



unquenchable, the body costive, the urine scanty, high co- 

 loured, and burning or scalding the urethra. Universal pains, 

 especially in the joints, calves of the legs, and tip of the 

 shoulder, often took place. The sleep was disturbed, and the 

 patient inclined to delirium. The fever was without any sen- 

 sible intermission at first, but afterwards there were evident 

 remissions and exacerbations. 



The second stage of this fever commenced sooner or later, 

 in different cases ; and instances have occurred where it fi- 

 nished its course in twenty-four or forty-eight hours. Every 

 symptom rapidly increased, the senses were more disturbed, 

 delirium and coma were constant ; at times the delirium was 

 low, but sometimes furious. 



The vomiting of bile was incessant ; at last, whatever was 

 brought up had the colour of coffee ; and this was denominated 

 the Black Vomit. Haemorrhages from the nose, the mouth, 

 and even from the pores of the skin, were frequent and fatal 

 appearances. The body now became yellow or livid, with 

 cold and clammy sweats, the countenance hippocratic, the pulse 

 sunk, and death put an end to the patient's misery. 



Cure. — The Jirst intention was directed to a speedy evacua- 

 tion of the morbid matter ; the second intention, to prevent 

 the secretion and accumulation of more ; the third to relieve 

 the most urgent symptoms ; and the fourth to obviate the mis- 

 chief already done to the system. 



First, early and brisk purging was put in practice. After 

 some trials of various cathartics, we had recourse to large 

 doses of calomel, repeated at short intervals, until a plentiful 

 discharge by stool was obtained. By this means the vomiting, 

 instead of being increased, was gradually abated, and at last 

 subdued. By calomel, the pores of the skin were opened, a 

 resolution of the fever was brought about, and the patient 

 happily recovered. 



Where patients were received in the advanced stages of 

 yellow fever, we had still recourse to calomel, and at the same 



