FEVERS. 655 



degree of sweat should be raised, and that this diaphoresis 

 should be supported for a due length of time, as I formerly ex- 

 plained (See CLXVIII). The practice of sweating is under 

 a great deal of doubt and uncertainty, but that arises especially 

 from the degree to which the sweat is excited, as the heat the 

 patient is detained in, or any other stimulus may raise more or 

 less of the inflammatory diathesis, and form a more obstinate 

 spasm. I have no doubt, however, that if sweating is procured 

 by gentle means, or rather if nature seems to yield spontane- 

 ously and assist, it is a very probable means of obviating the 

 accession of fevers, especially if conducted in this way, and 

 continued for a length of time. If a person enters upon that 

 course of sweating, he ought to continue it for at least forty- 

 eight hours ; and any interruption is in hazard of converting 

 the remedy into a poison. 



" Now, what I have said with respect to this first case is very 

 applicable to the inflammatory as well as to the nervous fever ; 

 and the same regimen will be as useful in every catarrh, espe- 

 cially in the beginning, or in any other state attended with some 

 degree of pain ; for instance, in rheumatic affections, where an 

 antiphlogistic regimen, and encouraging moderate sweating will 

 be generally found useful. 



" II. The case of the formal attack of the disease, when 

 there is manifestly a cold fit in its different degrees, when there 

 are not only the sensibility to cold, and some degree of coldness 

 creeping along the surface, thrilling along the back like cold 

 water, and spreading along the body with some degree of shiver- 

 ing, but when there is the more formal attack of horror, tre- 

 mor, and rigor, and more distinctly when these are followed 

 more immediately by heat and flushing, by a considerable fre- 

 quency of pulse, and especially when they are attended with 

 headach. The latter symptom indeed may be joined with the 

 circumstances that mark the approach of fever, but when it 

 amounts to some degree, it is rather to be considered as a mark 

 of a formal attack. 



" With regard to the management : Where we have an op- 

 portunity of being present at the very beginning of the formal 

 attack, when the cold fit yet subsists, then, whatever may be the 

 nature of the fever, we may treat it in the same manner as the 



