FEVER. 



191 



with a frigid sensation creeping up the spine. 

 Then comes a mild cold fit, succeeded by flushed 

 face, full veins, an extensive thirst, dry, burning 

 heat of skin, a splitting headache, and nausea, 

 and by unusual restlessness, or by remarkable 

 torpor and drowsiness. The patient is unable to 

 stand ; the pulse is generally full and frequent, 

 sometimes thready, small, and quick ; the bowels 

 are constipated, and the tongue is furred and dis- 

 coloured; appetite is wholly wanting, During 

 my first attack, I ate nothing for seven days ; 

 and despite the perpetual craving thirst, no 

 liquid will remain upon the stomach. Through- 

 out the day extreme weakness causes anxiety and 

 depression ; the nights are worse, for restlessness 

 is aggravated by want of sleep. Delirium is 

 common in the nervous-bilious temperament. 

 These symptoms are sometimes present several 

 days before the attack, which is in fact their 

 exacerbation. A slight but distinctly marked 

 remission often occurs after the 4th or 5th hour 

 — in my own case they recurred regularly be- 

 tween 2 and 3 a.m. and p.m. — followed by a cor- 

 responding reaction. When an unfavourable 

 phase sets in, all the evils are aggravated ; great 

 anxiety, restlessness, and delirium wear out the 

 patient ; the mind wanders, the body loses all 



