656 PRACTICE OF PHYSIC. 



cold fit of an intermittent, that is, a vomit is instantly to be ex- 

 hibited (CLXXVL). I have formerly referred to Dr. Lind with 

 regard to this practice, which he has established in his hospital. 

 I have spoken of its being applied more early upon certain feel- 

 ings of a received contagion, as when some degree of sickness 

 and nausea immediately affects a person who has been near con- 

 tagious diseases. The immediate exhibition of a vomit has 

 been found of service, and, as I have said, it is probable that 

 it operates by taking off the spasm. The patient should be 

 put to bed, and some degree of sweat raised immediately after 

 the operation of the vomit ; or, if you will, let it be one and the 

 same operation. The sweating is to be promoted by the means 

 I mentioned, by the use of warm liquors or the milder neutrals, 

 or it may be carried farther if to these more or less of the 

 opiate is joined. If these measures are pursued, and continued 

 to the time I mentioned, to forty-eight hours, or at least by the 

 patient's keeping in bed so long, to support the determination 

 to the surface ; and if, at the same time, all farther irritations 

 be carefully avoided ; this probably is a measure that would cut 

 short, if any can, a continued fever. 



" I must observe that it is extremely common in this country 

 as soon as there is any appearance of any formed fever, to fly to 

 venesection. It is a very curious circumstance which Dr. Lind 

 tells us, that where venesection was administered before the 

 vomit, the vomit had not the effect that it would have had, if it 

 had been administered first. I have marked the attack of 

 fever very distinctly : it is not made simul et semel, but a cold- 

 ness and shivering comes on ; that is very often succeeded by 

 some degree of heat, which is followed by a new shivering fit, 

 and these continue to alternate for a day or two together. In 

 many cases, the first cold fit of an evening is hardly observable, 

 till the disease has renewed its attack in the succeeding even- 

 ing, and is in all its circumstances more considerable. Now, in 

 all these cases where the disease is forming, but not yet pro- 

 perly formed, I hold it to be always hurtful to administer vene- 

 section, and it is never admissible but when the hot fit is steadily 

 formed ; nay, if we have any foundation for alleging that it 

 is a debility that lays the foundation of fevers, the blood-letting 

 may be one of the several circumstances which serve to give 



