66 PRACTICE OF PHYSIC. 



ous nervous fevers, which, during the cold season, come to be com- 

 plicated with more or less catarrh ; and in some cases I was dis- 

 posed to think that even peripneumony to some degree was 

 joined ; but I took it to be an accidental complication of the 

 fever from contagion with these symptoms from cold at a pleu- 

 ritic and peripneumonic season. 



" I own the treatment of this disease has often puzzled me. 

 I am certain that in fifty instances the disease was to be con- 

 sidered as a typhus or nervous fever, not admitting of venesec- 

 tion ; for I can say with confidence, that the few cases which 

 proved fatal, did not do so from want of bleeding, for some 

 were blooded very freely, and many others escaped the disease 

 without bleeding. I have at present in the clinical ward a case 

 which puzzled me : it came on with a fever, seemingly from 

 contagion, which the patient received from his wife whom he 

 had attended in a nervous fever, and who died from it two days 

 after he had been attacked. This man did not come in till the 

 ninth day of the disease, with considerable difficulty of breath- 

 ing, a hard ringing cough, and some fulness in his pulse ; so 

 that I, knowing nothing of the history of the contagion, order- 

 ed him to be blooded ; but that being accidentally delayed till 

 we had information of the contagion, we have abstained from it, 

 and the disease is going on in an easy and safe manner : still 

 I am not satisfied whether or not he ought to have been blood- 

 ed. This is certainly a case which occurs frequently among 

 those described by authors as violent peripneumony. In this 

 accidental combination we must be guided by the prevalence of 

 symptoms. If the inflammatory symptoms are very consider- 

 able, so that they induce a real phlogistic diathesis, bleeding 

 may be admitted ; but, in other cases, from the nature of the 

 contagion producing a typhus, we must act with caution. 1 ' 



CHAP. VII.OF THE PERIPNEUMONIA NOTHA, 

 OR BASTARD PERIPNEUMONY. 



CCCLXXVI. A disease under this name is mentioned in 

 some medical writings of the sixteenth century ; but it is very 



