HuEMORRIIAGIES. 



then not till the patient has lain a considerable time awake : 

 but they gradually begin sooner till they appear before mid- 

 night/ 1 Almost from the first appearance of the hectic, the 

 urine is high-coloured, and deposites a copious branny red sedi- 

 ment, which hardly ever falls close to the bottom of the vessel. 

 " The lateritious sediment in agues is easily distinguished from 

 the furfuraceous or branny one in hectic fever." In the hectic, 

 the appetite for food is generally less impaired than in any other 

 kind of fever. The thirst is seldom considerable ; the mouth 

 is commonly moist ; and, as the disease advances, the tongue 

 becomes free from all fur, appears very clean ; and, in the ad- 

 vanced stages of the disease, the tongue and fauces appear to 

 be somewhat inflamed, and become more or less covered with 

 aphthae. As the disease advances, the red vessels of the adnata 

 of the eye disappear, and the whole of the adnata becomes of a 

 pearly white. The face is commonly pale ; but, during the 

 exacerbations, a florid red, and an almost circumscribed spot, ap- 

 pear on each cheek. For some time, in the course of a hectic, 

 the belly is bound ; but, in the advanced stages of it, a diarrhoea 

 almost always comes on, and continues to recur frequently du- 

 ring the rest of the disease, alternating in some measure with 

 the sweatings mentioned above. The disease is always attend- 

 ed with a debility, which gradually increases during the course 

 of it. During the same course an emaciation takes place, and 

 goes to a greater degree than in almost any other case. The 

 falling off of the hairs, and the adunque form of the nails, are 

 also symptoms of the want of nourishment. Towards the end 

 of the disease, the feet are often affected with oedematous swel- 

 lings. The exacerbations of the fever are seldom attended with 

 any headach, and scarcely ever with delirium. The senses and 

 judgment commonly remain entire to the very end of the dis- 

 ease ; and the mind, for the most part, is confident and full of 

 hope. Some days before death, a delirium comes on, and com- 

 monly continues to the end. 



DCCCLXI. The hectic fever now described (DCCCLVIIL- 

 DCCCLX.), as accompanying a purulent state of the lungs, 

 is perhaps the case in which it most frequently appears : but I 

 have never seen it in any case, when there was not evidently, 

 or when I had not ground to suppose there was a permanent 



Q2 



