MEDICINE. 
clysters must be ordered, the head should 
be shaved, and cooling applications, as 
vinegar and water, or a solution of the vola- 
tile salt of hartshorn in vinegar, and the 
like, must be employed ; blistering the 
head, and fomenting the lower extremities 
will also be of service. If the respiration 
should be much oppressed, and attended 
w ith a short, dry cough, we must immedi- 
ately have recourse to blood-letting, both 
general and local ; blisters should be ap- 
plied to the thorax, and we should direct a 
liberal use of mucilaginoris diluents. Should 
the abdominal viscera be attacked in the 
coiuse of the disease, the same general 
means of blood-letting and blistering must 
be employed, together with laxatives or 
fomentation of the lower extremities. In 
tliis climate, after a short period, the symp- 
toms generally begin to assume the typhoid 
form, therefore some degree of caution w'ill 
be indispensably necessary in the liberal 
employment of evacuations, lest we should 
induce a degree of fatal debility. 
Typhus. — Symptoms. An uneasy and pe- 
culiar sensation in the stomach, sometimes 
attended with nausea and giddiness, fre- 
quently denotes the approach of this fe- 
ver. In many cases, however, it is scarcely 
or not at all perceived, and the disease ge- 
nerally commences with lassitude, languor, 
some degree of debility, horripilatio or 
sense of cieeping, impaired appetite, alter- 
nate and irregular heats and chills, anxiety 
about the praecofdia, and great dejection of 
spirits, accompanied with frequent sighing. 
After these symptoms have continued for a 
few days, the patient is attacked with head- 
ach, or an uneasiness and confusion of head ; 
a deep-seated pain, or a sensation of cold- 
ness is perceived, particularly in the occi- 
put ; there is nausea, vomiting of insipid 
phlegm, and great prostration of strength ; 
the heat of the body is but little increased ; 
there is little or no thirst; the tongue at 
the commencement of the disease is moist 
and covered with a white crust; in the more 
advanced stages it becomes dry, brown, and 
chapped ; the countenance is pale and sunk, 
the pulse is small, weak, and frequent, the 
respiration is oppressed, and attended with 
great anxiety about the praecordia, the 
urine is pale, and secreted in too great a 
quantity. The uneasiness and confusion of 
head increase with the debility, and prevent 
the patient from going to sleep ; or, if he 
do, it does not refresh him, and on the 
second or third night some degree of deli- 
rium comes on,, which, however, goes off, in 
the morning, and returns in a more severe 
manner every evening, and during the day 
he lies in a confused state, or is constantly 
muttering to himself. All these symptoms 
go on gradually increasing, followed by 
tremor of the hands and tongue, muse® vo- 
litantes, picking of the bed-clothes; subsul- 
tus tendinum, and convulsions, which gene- 
rally close the scene. 
Causes. The depressing passions of fear, 
grief, and despair ; all excessive evacua- 
tions ; a relaxed habit of body ; immoderate 
venery ; a sedentary and studious life ; in- 
temperance in eating and drinking ; fatigue ; 
the abstraction of the usual quantity of 
nourishing food ; contagion, and paucity of 
blood. 
Diagnosis. The slow and insiduous ap- 
pearance of this fever will distinguish it 
from the typhus gravior: the rigors are 
less severe; there is a considerably less 
degree of heat and thirst, and no bilious 
vomiting ; there is also greater mildness in 
the symptoms, even in the first stage ; the 
skin is pale, and has a bluish and sunk ap- 
pearance. 
Prognosis. The favourable symptoms arc, 
an universal warm moisture of the skin ; the 
tongue from being dry and foul becoming 
moist ; the pulse being rendered more slow 
and full after a gentle diaphoresis, or the 
exhibition of cordials; the appearance of 
an eruption about the lips and nostrils ; a 
miliary eruption, neither preceded by, nor 
accompanied with, profuse sweating ; deaf- 
ness; a temporary insanity; an increased 
secretion of saliva without aphth® ; a spon- 
taneous but gentle diarrhma. The unfa- 
vourable symptoms are, a great degree of 
muscular debility ; the early appearance 
and obstinate continuance of delirium ; stu- 
pidity and listlessness of the eyes on the first 
days of the disease ; a morbid sensibility of 
the surface, and of all the organs of sense ; 
profuse evacuations, attended witli a weak 
pulse ; tremor of the hands and tongue ; 
feather - hunting ; a considerable degree 
of sighing, mumbling, and moaning ; con- 
stant watchfulness ; coma, accompanied 
with fulness of the vessels of the tunica ad- 
nata, and dilated pupils; a difficulty of 
swallowing, attended with hiccup ; an un- 
conscious discharge of the urine andficces. 
Dr. Fordyce observes, in his third Essay on 
Fevers, p. Ill, that, if the respiration and 
deglutition be free, the prognosis is seldom 
bad, although the disease may be attended 
with alarming symptonis. 
Treatment. The first step to be taken in 
