666 PRACTICE OF PHYSIC. 



and if it does bring out some degree of sweat, that is to have its 

 course during the time of the accession or paroxysm, without 

 being urged. I need not repeat that the use of the Emetic 

 Tartar is to be entirely confined to the times of accession ; given 

 at other times, at intervals through the course of the day, it is of 

 no manifest effect but to keep open the belly, which is inconsi- 

 derable compared with the keeping up of nausea in the sto- 

 mach. The use of this remedy is to be continued for some 

 days at the time of the accessions. I have formerly chosen the 

 -evening accessions, but I have of late found that the accession 

 a little after noon is almost equally certain, and that the Emetic 

 Tartar is employed then with equally good effects. If it is not 

 disposed to purge largely, I believe it may be used twice a day 

 with some advantage ; but where it gives a very great degree of 

 uneasiness and sickness, and is disposed to purge, there is dan- 

 ger from such repetition. I have thus put the disease, as I may 

 say, in a train. 



" 3. I now go on to consider cases somewhat more advanced, 

 as towards the fifth, sixth, or seventh day. Supposing the 

 practice I have described to be fully exhausted, the venesection 

 carried as far as it was proper, the emetic tartar used, &c. ; 

 and the disease still continuing much the same, at least without 

 much diminution, the frequency of the pulse being commonly 

 somewhat increased, the headach not so considerable, but at 

 the same time with more confusion of head, and some degree 

 of approaching delirium : what are the proper measures in 

 these circumstances ? We must not stand still if the disease does 

 not yield. It has been a very common practice after the vene- 

 section, vomiting, &c. immediately to have recourse to blister- 

 ing. I have told you my doubts with regard to that practice ; 

 I will farther observe upon this subject, that if the fever is at- 

 tended with any marks of topical determination ; if a delirium is 

 coming on with suffusion of face, redness of eyes, and phrenitic 

 affections attacking the head, then there is no sort of doubt but 

 blisters applied to the head are a proper remedy at any period of 

 the disease. If the lungs are attacked, and the catarrhal symp- 

 toms point now more at a peripneumonic affection, the blisters are 

 to be applied to the side. If there are rheumatic affections, and 

 not the common pains in the joints, that are pretty obstinate. 



