MEDICINE, 
appetite ; restless niglifs, and universal 
disinclination to motion or exercise ; tliis 
may be termed the inflammatory or first 
period. In a short time the lever be- 
comes more severe, with accessions in the 
afternoon or evening, and some remission 
in the morning ; the pulse, however, is even 
then quicker than natural : the cough is in- 
creased by a recumbent posture, and pre- 
vents sleep till towards morning, when a 
slight moisture appears upon the breast and 
upper parts of the body; the expectoration 
increases in quantity, is frothy, and some- 
times sti-e^ked w ith blood ; the face is com- 
monly pale, but during the fever the cheeks 
appear as if painted with an almost circum- 
scribed spot of pure fiorid red ; the feverish 
heat is augmented after eating, particularly 
solids, and on taking exercise ; the burning 
heat in the palms of the hands and soles of 
the feet becomes more perceptible ; there 
is difliculty of lying on one, more than the 
other side, wandering or fixed pains are felt 
in some part of the thorax, and the disease 
is accompanied with lassitude and asperity 
of the temper : the appetite becomes some- 
what impaired, and there is frequently vo- 
miting after eating. As the disease ad- 
vances, the hectic fever is established, and 
the remissions become more distinct, at- 
tended with colliquative morning svveats ; 
an exacerbation occurs about noon, and a 
slight remission happens about five in the 
afternoon: this is soon succeeded by ano- 
ther exacerbation, which gradually increases 
until after midnight, but after two o’clock 
in the morning, a second remission takes 
place, and is attended with more or less, 
sometimes profuse, sweating, vvhicli greatly 
debilitates the body ; sometimes, however,^ 
the second exacerbation in tlie evening is 
not observed, but the exacerbation, which 
took place about the middle of the day, in- 
creases till evening, continues violent until 
the morning sweat breaks out, when the pa- 
tient gets some unrefreshing sleep ; the ex- 
acerbations are frequently attended with 
some degree of cold shivering, or more fre- 
quently only a sense of chilliness, or in- 
creased sensibility to cold is perceived, 
when to the thermometer tlie skin is’ pre- 
ternaturally warm: the expectoration now 
becomes more viscid, copious, yellow, 
greenish, streaked with blood, disagreeable 
to the taste, and is discharged in small sphe- 
rical masses, resembling pus, and is fre- 
quently also of an ash-colour ; the cough 
abates in violence, but not in frequency, 
and is more distressing in the first part of 
■ VOL, IV. 
the night, the breathing is short and quick,' 
and the breath lias an offensive smell ; tlie 
pulse is trequent, full, and tense, or small 
and quick; the countenance now gives evi- 
dent signs of wasting, the eyes lose their 
lustre and brilliancy, sink, grow dull and 
languid, the cheeks appear prominent, the 
nose sharp, the temples depressed, and the 
strength rapidly declines ; this may be es- 
teemed the second period ; from the be- 
ginning the appetite is less affected than 
could he expected, the body is for the most 
part costive, particularly after the morning 
sweats have began to take place ; the mine 
is generally high-coloured, and deposits a 
curdly pink sediment; about this period, 
in females, sometimes sooner, the menstrual 
discharge ceases, in consequence of the in- 
creasing debility. The third stage com- 
mences with a slight purging, which soon 
becomes a colliquative diarrheea; when 
this takes place, the fever, heat, and morn- 
ing sweats abate, but the cough continues 
distressing through the night; the tunica 
adnata becomes of a pearly white, the 
tongue appears clean, and with the fauces 
is of a bright red colour, sometimes cover- 
ed with aphth®, and generally sore and 
tender ; the voice grows hoarse, and tliere 
is shortness of breath and hiccup, both Of 
which distress the patient greatly; the 
lower extremities swell, and retain the im- 
pression of the finger. At this stage of the 
disease, sometimes sooner, tlie appetite is 
observed to become unnaturally keen, 
which deludes the unhappy sufiFerer and 
friends : as the disease advances, the diar- 
rhoea becomes more violent, and sometimes 
alternates with the svveats, tlie strength ra- 
pidly decays, and memory and their affec- 
tions forsake them ; as the fatal period ap- 
proaches, they have frequent and loi^ fainj:- 
ings, the hairs fall off, the nails are incur- 
Vated; sometimes there are slight convul- 
sions, and a few days before death, delirium 
comes on, and continues till that event 
takes place, or the senses remain entire 
and the mind remains still confident and 
full of hope, till death steps in, and gently 
puts an end to their hopes and sufferings. 
As it is a matter of consequence to distin- 
guish pus from mucus, we shall subjoin the 
following ingenious experiments of the late 
Mr. Charles Darwin : 
1. Pus and mucus are both soluble in the 
sulphuric acid, though in very different pro- 
portions, pm being much the less soluble. 
2. The addition of water to either of tliese 
compounds decomposes it ; the mucus tints 
B b- 
