MEDICINE. 
structions in the diflerent viscera, particu-- 
I al ly in the liver and spleen ; dropsy, dy- 
sentery, jaundice, and various species of in- 
flammation. 
Treatment. In the paroxysms we are to 
endeavour to shorten tire different stages, and 
thus to obtain a final solution of the disease. 
In the intermissions we are to prevent the 
recurrence of the paroxysms, and endeavour 
to obviate certain circumstances, which may 
prevent the fulfilling of either of the two 
first indications. 
The first indication will be accomplished 
by the administration of an emetic at tire 
commencement of the paroxysm, or during 
the cold stage; for which purpose tartar 
emetic is tire best ; it should be given in di- 
vided, but pretty large doses, the patient 
should jt the same time be put to bed, kept 
in warm blankets, and allowed warm di- 
luent, but not stimulating liquors, except 
there is a considerable degree of debility ; 
and immediately the hot stage is formed, a 
gentle diaphoresis will be excited, and a 
final solution of the paroxysm procured, by 
the exhibition of opiates, assisted by mo- 
derate draughts of tepid, or, if the heat be 
preternaturally great, of cold liquids, and 
by the neutral salts. In the intermissions, 
the bark should be administered in doses of 
a drachm or more, every one, two, or three 
hours, so that an ounce, or an ounce and a 
half may be taken during the intermission ; 
when the apyrexy is long, as in the tertian, 
its exhibition may be delayed till within six 
or eight hours of tlie time when the next pa- 
roxysm is expected, which will frequently 
more effectually prevent its return than 
when given in small doses during a long in- 
termission ; but if there be a great degree 
of debility, or where the intermissions 
are short, as in the quotidian, the bark 
should be employed immediately after the 
termination of the paroxysm, at longer or 
shorter intervals, until the return of the next 
fit, in such doses as the stomach will bear, 
and the urgency of the case may require : 
when this invaluable medicine purges, a few 
drops of tlie tincture of opium may be 
added ; and if on the other hand, it induce 
costiveness, a few grains of rhubarb will 
obviate it, and at the same time give tone 
to the stomach and bowels ; it is sometimes 
of service to add about a scruple of snake- 
root to each dose of the bark ; where the 
stomach is habitually weak, it will be ad- 
visable to combine aromatics or bitters with 
the bark, as calamus, or canella alba, &c. 
The sulphate of copper may be employed 
in its usual dose : the oxide of arsenic 
combined with opiates, either in solution or 
in the form of pills, will frequently succeed, 
when bark and other remedies have, been 
tried without effect, If the disease should 
prove obstinate, and any pain can be per- 
ceived by the patient upon pressing the 
right hypochondrium, small doses of the ca- 
lomel, or friction with the unguentum hy- 
drargyri, continued until a slight soreness 
of the mouth is induced, will, in general, be 
attended with the most beneficial effects, as 
its continuance is most commonly the con- 
sequence of obstructed viscera. 
The circumstances which prevent our ful- 
filling the two first indications are, inflamma- 
toi-y diathesis, accumulation of bile in the 
stomach, and of that and faeces in the in- 
testinal canal. The first circumstance will 
be removed by blood-letting; and if, during 
the paroxysm, any urgent symptoms indi- 
cate the presence of that diathesis, it will be 
attended with the greatest prospect of suc- 
cess, if the operation is performed during 
the hot stage, when the excitement is most 
considerable. : the latter causes will be re- 
moved by the administration of emetics and 
cathartics : if there be a great degree of de- 
bility, the system must be strengthened by 
a generous diet, the moderate use of wine, 
gentle exercise, tlie cold bath, and change 
of air. As in this disease relapses very fre- 
quently occur, it will not only be advisable, 
but necessary, to continue the use of the 
bark in doses of a drachm four times a day, 
for two or three weeks, at the same time 
the patient must most studiously avoid all 
the exciting causes, and every irregularity 
in diet. Vernal are less liable than autum- 
nal intermittents, to become continued fe- 
vers, and are rarely attended with alarming 
symptoms, or followed by dangerous ob- 
structions. The taste of the bark will be 
concealed in a great measure, by exhibiting 
it in milk, butter-milk, or infusion of liquo- 
rice ; and if the stomach should possess a 
considerable degree of irritability, opium 
administered either by itself or combined 
witli camphor, will, in general, succeed in 
enabling that organ to retain the bark. 
The paroxysm may be generally prevented 
by administering a full dose of the tincture 
of opium, in mulled wine or hot diluted 
spirits, about an hour previous to its ex- 
pected return. 
Continued Fever. This is either infiam- 
matoi-y (synocha) , putrid or gaol (typhus) ; 
or mixed (synochus.) 
Symptomi of Synocha. This fever, which. 
