much and bowels, are often both effect and 
cause of the persistanee of the febrile state ; 
for as tlrg powers of assimilation are weaken- 
ed by the induction of fever, so the conse- 
quent accumulations of foreign matter in 
the alimentary and intestinal canal, them- 
selves [wove direct sources of irritation and 
disorder. In the primary stages of fever, 
an emetic has been known abruptly to arrest 
its progress, and the same purpose is some- 
times accomplished, especially in ephemeral 
affections of the febrile kind, by the employ- 
ment of a brisk purgative. In the more ad- 
vanced periods however of the disorder, the 
object of the physician ought to be rather 
that of keeping the bowels gently open, and 
this is best effected by saline in place of 
drastic purgatives ; the fqrmer of which prin- 
cipally operate by exciting the exhalants on 
the internal surface of the intestines to pour 
out their contents, the latter by stimulating 
in a forcible manner the intestinal fibre. 
It is a fact worthy particular notice in the 
treatment of fevers especially, that where 
due attention is given to ensure regular eva- 
cuations from the bowels, those stimuli, the 
copious use of which is often necessary to 
support the sinking powers in the last stages 
of the disease, are mere freely admissible 
and abundantly more efficacious : this is in- 
deed an important principle in the treatment 
of diseases generally ; and it is perhaps 
chiefly bv virtue of preserving the excitabi- 
lity in an orderly and clue condition for 
the agenev of other' stimuli, that purgatives, 
like sudorifics, form so useful, and indeed 
the former, almost an indispensable, part of 
the remedial process in the greater number 
of aliments. In intermittent fevers it is ge- 
nerally necessary to evacuate the bowels by 
more stimulant' cathartics, more especially 
when the cure of these fevers is conducted 
bv the Peruvian bark. 
' Having thus discussed the nature, causes, 
and treatment of fever, it may be proper to 
present the reader with a recapitulatory view 
of the remedies which are required in the 
different forms of this affection: as a preli- 
minary, however, to such recapitulation, we 
shall make one or two remarks on the more 
unfavourable symptoms with which fever is 
sometimes attended, and on the periods in 
which the disorder displays a greater or less 
disposition to terminate. 
The unfavourable signs are, in the first 
place, an abrupt alteration of type. If dur- 
ing fever, indicating in its primary stages no 
particular severity of disease, a rapid change 
take place in the' feelings and expressions of 
the invalid; if upon the more ordinary symp- 
toms, suddenly and unexpectedly supervene 
delirium, prostration of strength, an observ- 
able change in the countenance, accompa- 
nied by irregular and partial alternations of 
heat and cold, without the intervention of 
the perspiring state, the patient’s life is in 
considerable danger. The above changes 
are often indeed preludes to a speedy death. 
Weakness, quickness, and irregularity of 
pulse, delirium, tendency to fainting when 
in an erect posture, prostration of strength, 
partial and irregular sweats, difficult respi- 
ration and deglutition, starting of the ten- 
dons, unusual foetor in the excretions, great 
foulness of the tongue and fauces, are all 
evidences of a fatal tendency in the com- 
plaint; in general likewise it may be ob- 
MEDICTNE, 
served, that in cases where marks of great 
nervous irritation attend the onset of a fever, 
even though the disorder may not assume 
what has error^ously been termed the pu- 
trid type, much danger is to be apprehend- 
ed, Indeed, the management of fever is not 
seldom rendered more difficult, and the in- 
dications of treatment less decided, from the 
absence of .such type. Genuine nervous 
fevers are often the' most obstinate and ma- 
lignant. 
In fevers of this kind, indeed, the heat is of- 
ten so partial and irregular as not to admit 
of the cold affusion. Dr. Currie in his Medi- 
cal Reports, describes a fever in which this 
remedy was tried without success. This fever, 
says Dr. Currie, does not appear to originate 
in contagion, or to be propagated by conta- 
gion. 
Calculations respecting critical days have 
been in some measure forced and systema- 
tic. It is worthy however of remark, that 
continued fevers as well as intermittent, 
in the successive stages of their course, are 
disposed to assume progressively the quo- 
tidian, tertian, and quartan aspect. 
Thus, if the fever has lasted more than a 
week, the ninth and eleventh days from its 
first attack are those on whicti we may anti- 
cipate its declination; after the second week 
the seventeenth and twentieth are the more 
usual days of termination. These, however, 
are by no means unexceptionable rules. 
RECAPITULATION OF THE TREATMENT 
OF FEVER. 
Treatment of continued fever during the 
first three or four days. Cold allusion. 
Water to be impregnated with salt, its ap- 
plication to be confined to the hot stages oi 
the paroxysm. Large draughts of cold wa- 
ter taken under the same limitation. Cold 
and pure air. Emetics. Purgatives. An- 
timonial and saline sudorifics. 
After the fifth or sixth day. Cold and 
tepid ablution. Water employed to be im- 
pregnated with salt or mixed with vinegar. 
In the urgency of debility, coldness, or deli- 
rium, pediluvium or the warm bath. Bowels 
to be kept gently but constantly open, by 
saline or mild purgatives and subacid drinks. 
While the skin is preserved moist by dia- 
phoretics, give opiates and wine ; these last 
are almost invariably improper when the 
skin is dry and Lot, and the bowels costive. 
For head-ache and other nervous affections, 
blisters, arther, camphor. In the last stages, 
when critical sweats break out, and the pow- 
ers of life appear to be shrinking from the 
contest, repeated glasses ol port wine with 
tincture of opium in. large quantities. Dur- 
ing the whole course of the disease, the 
apartment to be diligently preserved cool, 
clean, constantly ventilated, and free from 
all individuals but those who are necessary 
attendants on the sick. 
Treatment of intermittent fever. Cold 
affusion immediately upon the full accession 
of the hot fit. Warm bath, warm spiced 
wine, during the cold stage of the paroxysm. 
Tincture of opium, either previous to the 
accession of the cold, or towards the decline 
of the hot fit. Emetics, immediately pre- 
ceding the accession of the paroxysm. Calo- 
mel purges before the administration of 
tonics ; arsenic, zinc, Peruvian bark, quas- 
sia, and if any enlargement of one of the 
viscera (ague cake) appear, steel. Hope : 
sr 
539 
upon the excitation of hope the power of 
charms altogether depends ; these sometimes 
succeed in ague, when other remedies are 
counteracted by the violence of the com- 
plaint. 
Although we have judged it expedient to 
enumerate the different medicines which in 
the event of fever's protraction may be 
requisite, it is proper to observe that the 
progress of the complaint may for the most 
part be abruptly arrested, and the necessity 
of other means of cure, con sequently super- 
seded, by an early and judicious employment 
of the cold affusion. If the application of the 
water in the mode described in the narrative 
of Dr. Wright be objected to, a shower bath 
may be employed, or, what is an excellent 
and convenient substitute for the latter, u 
common gardener’s watering-pot ; the patient 
is to be taken out of his bed, if convenient, 
conducted or carried into an adjoining 
apartment, and the water poured from this 
instrument as hastily as it will admit of over 
Ins naked body ; the skin is then to be quick- 
ly and effectually dried w ith towels, and the 
invalid reconducted to his bed ; this course 
is to be repeated with the full recurrence of 
the hot paroxysm, even should this be on 
the same day, and continued, if requisite, on 
the following days, until the disorder’s de- 
cline ; or, in the pointed language of a mo- 
dern writer, until “ the fever be w ashed 
away.” (Reid’s Medical Reports, Monthly 
Magazine.) 
Fever Houses, &;c. 
The rapid and extended diffusion of fe- 
ver through families and districts might bo. 
deemed sufficient evidence in favour of mat- 
ter engendered by febrile action, having the 
power to produce a similar disorder in an- 
other individual. The fact, however, appears 
to have been placed beyond doubt by the 
unfortunate result of several experiments 
made with sceptical temerity in order to 
prove the negative of this assumption. 
While the writer of the present article 
was pursuing his studies in the Edinburgh 
university, several anti-contagionists, as these 
gentlemen were denominated, freely exposed 
themselves within what they regarded the 
imaginary sphere of contagion, in the wards of 
the infirmary of that city ; many in conse- 
quence became infected with fever, and in 
some instances the disorder had a fatal ter- 
mination. In these instances the production, 
of the disease could not be referred to want 
of cleanliness, or to any peculiar condition 
of the atmosphere ; for the fever did not ex- 
tend to those gentlemen attending the hos- 
pital, who were fortunate enough to remain 
satisfied with the previous evidence in favour 
of contagion. 
But with a knowledge of the evil, we have 
at length acquired a knowledge of ‘’its anti- 
dote ; and it has been demonstrated by ex- 
periments upon a most extensive scale, that, 
whether the matter producing fever be in- 
troduced into the system by the lungs, the 
surface of the body, or the stomach, its pow- 
er to infect extends but an exceedingly 
small distance — three feet at furthest - h— - 
from the patient in whom it is gen-rat- 
ed, “ when he is confined where the air 
has free entrance and egress.” This fact, 
it has been wel observed, “ cannot be cor- 
roborated by too great a variety of testi- 
mony, nor repeated too often, until it shall 
