526 PRACTICE OF PHYSIC. 



above explained, it more commonly attends intermittents, and 

 we believe it might have been enumerated (XXIX.) among the 

 marks distinguishing the latter kind of fevers 'from the former. 

 But though an unusual quantity of bile should appear with con- 

 tinued fevers, it is considered in this case, as in that of intermit- 

 tents, to be a coincidence only, owing to the state of the season, 

 and producing no different species or fundamental distinction, 

 but merely a variety of the disease. I think it proper to observe 

 here, that it is probable that the most part of the continued 

 fevers named Bilious, have been truly such as belong to the sec- 

 tion of intermittents. 



LXXII. Another effect of the circumstances occasionally 

 varying the appearance of typhus, is a putrescent state of the 

 fluids. The ancients, and likewise the moderns who are in ge- 

 neral much disposed to follow the former, have distinguished 

 fevers as putrid and non-putrid. But the notions of the ancients 

 on this subject were not sufficiently correct to deserve much no- 

 tice ; and it is only of late that the matter has been more accu- 

 rately observed and better explained. 



From the dissolved state of the blood, as it presents itself 

 when drawn out of the veins, or as it appears from the red blood 

 being disposed to be effused and run off by various outlets, and 

 from several other symptoms to be hereafter mentioned, I have 

 now no doubt, how much soever it has been disputed by some 

 ingenious men, that a putrescency of the fluids, to a certain de- 

 gree, does really take place in many cases of fever. This pu- 

 trescency, however, often attends intermittent, as well as con- 

 tinued fevers ; and, of the continued kind, both the synochus 

 and typhus, and all of them in very different degrees ; so that, 

 whatever attention it may deserve in practice, there is no fix- 

 ing such limits to it as to admit of establishing a species under 

 the title of Putrid. 



LXXIII. Beside differing by the circumstances already men- 

 tioned, fevers differ also by their being accompanied with symp- 

 toms which belong to diseases of the other orders of pyrexise. 

 This sometimes happens in such a manner as to render it diffi- 

 cult to determine which of the two is the primary disease. Com- 

 monly, however, it may be ascertained by the knowledge of the 

 remote cause, and of the prevailing epidemic, or by observing 



