618 PRACTICE OF PHYSIC. 



and accumulations are formed in these viscera. Such are espe- 

 cially to be relieved by opening the excretories into the intes- 

 tines which immediately communicate with the affected viscera. 

 I think I have formerly (LI.) sufficiently explained, that in 

 most intermittents, especially the autumnal, this determina- 

 tion to the abdominal viscera, particularly to the hypochondriac 

 system, the liver and spleen occurs ; and certainly nothing can 

 more effectually obviate these congestions than opening the ex- 

 cretories of the intestines. The indication of opening the bowels 

 accordingly arises in all fevers which are bilious, or of the re- 

 mittent kind, where we know that purging is required. I may 

 farther observe that bilious and autumnal fevers are often of the 

 putrid kind, and accompanied with petechiae ; in that case purg- 

 ing is not only useful, but in a great measure necessary ; for in 

 these diseases especially the contents of the intestines have a ten- 

 dency to putrefaction. I do not apply this to the bile only, but 

 in a particular manner to the reliquiae of the aliment, and to all 

 the fluids contained in the intestines." 



CL. Another set of means (CXXVII. 2.) for moderating 

 the violence of reaction in fevers, are those suited to take off 

 the spasm of the extreme vessels, which we believe to be the 

 irritation that chiefly supports the reaction. 



Though I have put here this indication of taking off the 

 spasm of the extreme vessels, as subordinate to the general in- 

 dication of moderating the violence of reaction, it is however to 

 be observed here, that as fever universally consists in an in- 

 creased action of the heart, either in frequency or in force, which 

 in either case is supported by a spasm of the extreme vessels, 

 so the indication for removing this is a very general one, and 

 applicable in almost every circumstance of fever, or at least with 

 a few exceptions, to be taken notice of hereafter. 



CLI. For taking off the spasm of the extreme vessels, the 

 means to be employed are either internal or external. 



CLII. The internal means (CLI.) are, 



1. Those which determine the force of the circulation to the 

 extreme vessels on the surface of the body, and, by restoring 

 the tone and activity of these vessels, may overcome the spasm 

 on their extremities. 



2. Those medicines which have the power of taking off spasm 



