242 PRACTICE OF PHYSIC. 



character of the Phthisis pulmonalis as a mark of an ulceration 

 of the lungs ; and having just now said, that the other part of 

 the character, that is, the hectic fever, is a mark or indication 

 of the same thing ; it is proper now to consider this here, as I 

 had with that view omitted it before (LXXIV.). 



DCCCLVIII. A hectic fever has the form of a remittent, 

 which has exacerbations twice every day. The first of these 

 occurs about noon, sometimes a little sooner or later; and a 

 slight remission of it happens about five afternoon. This last 

 is soon succeeded by another exacerbation, gradually increasing 

 till after midnight ; but after two o'clock of the morning a re- 

 mission takes place, which becomes more and more considerable 

 as the morning advances. The exacerbations are frequently at- 

 tended with some degree of cold shivering ; or, at least, the pa- 

 tient is exceedingly sensible to any coolness of the air, seeks ex- 

 ternal heat, and often complains of a sense of cold, when, to the 

 thermometer, his skin is preternaturally warm. Of these exa- 

 cerbations, that of the evening is always the most considerable. 



DCCCLIX. It has commonly been given as a part of the 

 character of a hectic fever, that an exacerbation of it commonly 

 appears after the taking food ; and it is true that dinner, 

 which is taken at noon or after it, does seem to occasion some 

 exacerbation. But this must not make us judge the mid-day 

 exacerbation to be the effect of eating only ; for I have often 

 observed it come on an hour before noon, and often some hours 

 before dinner ; which, in this country at present, is not taken 

 till some time after noon. It is indeed to be observed, that, in 

 almost every person, the taking food occasions some degree of 

 fever ; but I am persuaded this would not appear so consider- 

 able in a hectic, were it not that an exacerbation of fever is pre- 

 sent from another cause ; and, accordingly, the taking food in 

 the morning has hardly any sensible effect. 



DCCCLX. I have thus described the general form of hectic 

 fever ; but many circumstances attending it are further to be 

 taken notice of. The fever I have described does not common- 

 ly subsist long, till the evening exacerbations become attended 

 with sweatings ; which continue to recur, and to prove more 

 and more profuse, through the whole course of the disease." In 

 many cases the sweats appear only in the morning at first, and 



