532 THE TREATMENT OF DISEASES. 



fancies that he is two or three different people, each of whom is suffering from 

 inconceivable misery or torture. 



Loss of appetite and constipation are common accompaniments of fever. In 

 typhus the loathing for food may be so marked that it may be found necessary for 

 the maintenance of life to feed the patient by the bowel. In rheumatic fever, 

 curiously enough, the appetite is often retained. The diarrhoea, which is so prominent 

 a symptom in typhoid fever, is due to ulceration of the bowel, and is consequently 

 not an exception to the rule that fever is accompanied by constipation. 



The general appearance is in some fevers so characteristic that to the practised 

 eye a single glance may be sufficient to determine the nature of the complaint. This 

 is especially the case in typhus fever, where the general aspect is so peculiar that it 

 frequently forms an important element in deciding on the nature of a doubtful case. 



Weakness and loss of weight are necessary concomitants of long-continued fever. 

 It should always be remembered that fever does not mean strength, but weakness. 

 Many people seem to imagine that fever means power. 



In many fevers peculiar and characteristic odours are exhaled from the body of 

 the patient. A practised nose would instantly detect the presence of a case of 

 small-pox in a ward. The copious sweat in rheumatic fever has a strong acrid 

 odour. The smell from the motions is in some diseases almost insupportable. This 

 is especially the case in acute dysentery, the foetid, even cadaverous, odour filling not 

 only the room, but the whole house. 



Certain terms are applied to different varieties of fevers, according to the course 

 pursued by the temperature. When the temperature rises, and remains elevated 

 until the termination of the illness or the establishment of convalescence, the fever 

 \s said to be a " continued " fever. Most of our common fevers, such as scarlet 

 fever, measles, and small-pox, are continued fevers. When the fever comes 011 in 

 paroxysms first rising, then falling to the normal, then rising again, and so on 

 the fever is said to be an " intermittent " fever. Ague affords a typical example of 

 an intermittent fever. When the temperature first rises, tlieiiv|alls nearly, though 

 not quite, to the normal, then rises again, and so on, the fever is said to be a 

 " remittent " fever. Typhoid fever towards its termination is essentially a remit- 

 tent fever (vide CHART, p. 550). In a remittent fever the temperature in the 

 interval of the paroxysms falls, but does not return to the normal, whilst in an inter- 

 mittent fever it falls quite to the normal. In an intermittent fener there are periods 

 at which the patient is quite free from fever ; in a remittent fever, his fever never 

 leaves him until the termination of his illness, although at certain times it is less 

 marked than at others. 



Hectic fever is that form of fever which supervenes when there is an habitual 

 drain upon the system beyond what the nutriment taken in can supply and counter- 

 balance. It is commonly met with in cases in which there is extensive formation 

 and discharge of matter going on in some part of the body. It is a usual ac- 

 companiment of many chronic surgical complaints, such, for example, as a diseased 

 joint with an open sore ; and is sometimes met with in young mothers who have 

 suckled their children too long. Its progress is often very insidious, but its main 

 features are elevation of temperature, an abiding frequency of pulse, alternations of 



