488 PRACTICE OF PHYSIC. 



and the return of a new paroxysm is distinctly marked by the 

 symptoms of a cold stage at the beginning of it, such fevers retain 

 strictly the appellation of REMITTENTS. But when it happens, 

 as it does in certain cases, that the remission is not considerable, 

 is perhaps without sweat, and that the returning paroxysm is 

 not marked by the most usual symptoms of a cold stage, but 

 chiefly by the aggravation or EXACERBATION of a hot stage, 

 the disease is called a CONTINUED FEVER. " When the pulse 

 falls from 120 to 100 or 90, this is reckoned a considerable re- 

 mission ; when from 120 to 110 only, it is inconsiderable." 



XXVIII. In some cases of continued fever, the remissions and 

 exacerbations are so inconsiderable as not to be easily observed or 

 distinguished ; and this has led physicians to imagine that there 

 is a species of fever subsisting for several days together, and 

 seemingly consisting of one paroxysm only. This they have 

 called a CONTINENT FEVER; but, in a long course of practice, 

 I have not had an opportunity of observing such a fever. 



XXIX. It is, however, to be observed here, that the fevers 

 of a continued form are to be distinguished from one another ; 

 and that, while some of a very continued form do still belong to 

 the section of intermittents, there are others which, though still 

 consisting of separate and repeated paroxysms, yet, as being dif- 

 ferent by their causes and circumstances from intermittents, are 

 to be distinguished from the whole of these, and are more strictly 

 to be called and considered as CONTINUED. Such are most of 

 those which have been commonly supposed to be CONTINENT ; 

 and those which by most writers have been simply named CON- 

 TINUED, and which term I have employed as the title of a sec- 

 tion, to be distinguished from that of INTERMITTENT. 



I shall here add the marks by which, in practice, these dif- 

 ferent continued fevers may be distinguished from one another. 



Those fevers of a continued form, which, however, still be- 

 long to the section of intermittents, may be distinguished by 

 their having passed from an intermittent or remittent form, to 

 that of a continued ; by their shewing some tendency to become 

 intermittent, or at least remittent ; by their being known to have 

 been occasioned by marsh miasmata ; and, for the most part, 

 by their having but one paroxysm, or one exacerbation and re- 

 mission, in the course of twenty-four hours. 



