FEVERS. 657 



a more violent disease (CXLIIL). So much I have to say 

 with regard to the management of the formal attack. 



"III. Let us next attend to the several circumstances of the 

 disease already formed and these may be supposed: 



" 1. Cases of the second day of fever ; and here, again, I 

 may put, 



" a. AJirst case, where the symptoms are remarkably mode- 

 rate ; some chilliness, some little horror, has occurred in the 

 evening, followed by some preternatural heat in the course of 

 the night ; sleep takes place, but is more disturbed, and after 

 such a night considerable lassitude and languor are felt in the 

 morning : the mouth is clammy, the tongue foul, some thirst, 

 but a small .degree of headach, the pulse more frequent than 

 natural, but to no great degree, from 80 to 90, neither full nor 

 hard. Such cases we have often seen ; and when they occur 

 the nature of the future disease is uncertain. 



" With regard to the practice, this is the first rule, and an uni- 

 versal one, that the antiphlogistic regimen is to be prescribed in 

 all its parts ; that it is universally proper to evacuate the stom- 

 ach by a full vomit, the intestines by a glyster, both of which 

 may be considered as a part of the antiphlogistic regimen. We 

 are sure that these measures are proper ; but whether or not 

 venesection is proper in the circumstances I have described, 

 may be doubted ; and I imagine that it is improper. For, 

 suppose the disease to be of the inflammatory kind, to judge 

 from the symptoms I have described, it will seemingly be a very 

 moderate one, and urging no haste in the measures that may 

 become necessary. But not only do we, from these symptoms, 

 presume a moderate synocha, but there is, perhaps, more prob- 

 ability that a fever beginning in this way may turn out a 

 typhus, and that pretty purely so, without any admixture of 

 synocha, where, accordingly, venesection is improper. Another 

 question may occur, whether or not sweating in the present cir- 

 cumstances may be employed ? but I reserve that question till 

 I can state it with respect to several other cases I am to men- 

 tion. 



" b. I put a second case, of the same period, viz. the second 

 day of the disease ; where the attack the evening before or the 

 day before is much more distinctly marked, the horror more evi- 



