PATHOLOGY. 
m 2 
tient’s panting or breathing fliort whenever he fpeaks; 
by the number of refpirations exceeding the natural 
amount in a given time; by the colour of the face, indi¬ 
cating fome impediment to the common changes of the 
blood in the lungs; and by the gradual increafe of the 
pulfe, and of the fever. When the inflammation ends in 
an abfcefs, the uneafinefs in the brealt abates, but the 
breathing becomes more laborious, and there are chilly 
and hot fits, with copious fweats, and great lofs of 
ftrength. The moll common termination, however, of 
inftances of this kind, is by an effufion of ferum into the 
cavities of the pleura. This calamity is not neceffarily 
fatal at once, fome patients lingering for fome time afterit. 
In this form of difeafe, the treatment of fever in gene¬ 
ral mull be conjoined with the ufual means for alleviat¬ 
ing local inflammation. It is feldom an accurate diag- 
nofis can be eftablilhed between inflammation as it affeCts 
the fubftance of the lungs, or as it affe&s the pleura. In 
either cafe bliftering may be confidered a meafure of 
great effeCt ; and, if there feems Itrong evidence of the 
exiftence of inflammation in the pleura, we may have 
recourfe more freely to the lancet than under ordinary 
circumftances. It is to be remembered that cold affulion 
is by no means to be allowed when the lungs are affedled 
in fever. The warm bath is often, however, of great ul'e 
when the temperature of the Ikin is unequal; and at the 
fame time diaphoretics are of much importance. Of 
this kind of medicine, large dofes of calomel, with as 
much opium as will counteract the purging property of 
the latter drug, are the molt advantageous. 
Another complication fomewhat analogous to the pre¬ 
ceding, is that of fever with bronchitis. The fever in 
this cafe is attended with a cough, at firft dry, but after¬ 
wards moift. In recent cafes the expedforated matter re- 
fembles the white of an egg, but in a more advanced 
ftage it appears vilcid and opake. The pulfe through¬ 
out is feeble and quick, the tongue foul, the heat 
variable, the bowels irregular, and the llomach prone to 
rejeft its contents ; and, although the patient frequently 
appears drowfy, for the molt part he obtains very little 
fleep. In fome perfons thus affeCted, thecomplaint con¬ 
tinues many weeks, and often acquires a confumptive 
character before death. When it ends favourably, the 
convalefcents remain long in an emaciated and enfeebled 
(late. An abatement of the vomiting, fome defire for 
light food, and a tendency to quiet fleep, are the appear¬ 
ances which augur recovery. 
The treatment of this complaint rnuft differ principally 
from that of Ample fever in that a minor degree of bleed¬ 
ing will fuffice, and in the exhibition of naufearing 
medicines, which are of very great ufe, notwithllanding 
the gaftric irritability which prevails. In a word, the 
treatment is that of Catarrhus, (to which the reader is 
therefore referred for more explicit details,) conjoined 
with the more aCtive and general treatment of fever. 
Abdominal inflammation is frequently complicated 
with the fever in queltion; and it is often difficult to 
diftinguifh the precife fituation of this occurrence; for 
the funClions are fo generally difordered, that their dif- 
turbance affords no diagnoltic, as in cafes of common in¬ 
flammation. It is not, however, of the utmoll import¬ 
ance to afcertain the precife feat of the inflammation, as 
the treatment does not vary eflentially. The inflamma¬ 
tion of the mucous membrane of the ftomach which ac¬ 
companies fever is fo common in fome countries abroad, 
that it has induced Biouflais and others, as we have be¬ 
fore feen, to infer its invariable prefence in febrile dif- 
eafes. In the works of the above author are to be found 
a variety of excellently-written cafes of the complication 
in queftion. J. P. Franck (De Curandis Hominum Mor- 
bis Epitome PraeieCt.onibus Academicis dicata, Ven. 
1805.) more properly confines the term gujbic fever to 
thole cafes in which the fever is accompanied and exaf- 
peraved, though nor caufed, by phlegm, bile, inteftinal 
worms, or other irritating matter capable of inducing an 
z 
inflamed ftate of the ftomach. We consequently generally 
meet with this difeafe in dyfpeptic patients when they 
become the fubjedts of fever. We copy from a tranfla- 
tion of Frank’s work the fymptoms of the gallric fever. 
“It begins, like other fevers, with alternate cold, fhi- 
vering, and heat, accompanied with laffitude, head-ache, 
and pains fimilar to rheumatifm in the back, the loins, 
and the joints. The face becomes pale, and the eyes yel- 
lowifh ; but the ftomach is chiefly affeCfed with inflation, 
tenfion, and a fenfe of weight, joined with anorexia, 
loathing of food, naufea, retching, and erudtation of 
difagreeable flatus, and of bilious, tenacious, acid, or 
acrid, matter. The ftate of the mouth is the belt indi¬ 
cation of the ftate of the ftomach, which is obfervable in 
the fcetid breath, the tongue loaded with tenacious white, 
or yellow mucus, fometimes talielefs, and at others bitter 
and difagreeable. Diforders in the abdomen fucceed, 
fuch as borborigmus, gripes, wandering pains, fenfe of. 
weight and fulnefs, with either conftipation, or bilious, 
fetid, or frothy, dejedtions. In this ftage of the affedtion 
the patient may not be fo ill as to be confined to bed ; 
but in a fhort time, though the cold fit be neither great, 
nor conftant, and fometimes may be abfent; the heat, 
thirft, giddinefs, and head-ache, increafe, the pulfe be¬ 
comes more frequent and often intermittent, the fymp¬ 
toms of the ftomach, naufea and retching, and of the ab¬ 
domen, are aggravated ; the flufhing of the face is greater, 
with greenifh palenefs towards the fides of the nofe ; the 
under lip quivers, the eyes are fuffufed with tears, the 
refpiration becomes hurried and difficult, often accompa¬ 
nied with a cough, either with or without expedloration; 
pain fimilar to that of rheumatil'in is felt in the thorax, 
lcapuiae, and fauces; there is often great apparent prof- 
tration of ftrength, with delirium, drowfinefs, or vigilia. 
“ After three or more days, remiffions occur in the 
morning, with a gentle fweat breaking on the forehead 
and breaft. The tongue is fometimes more loaded with 
yellow mucus, and fometimes dry in the middle, and of 
a brown colour; the urine is made with ardent pain, is, 
deeper yellow, or appears like that of cattle, or with a 
pink or furfuraceous fediment. Towards night, fome¬ 
times with a flight chillinefs, or (hivering, all thefe fymp¬ 
toms are aggravated ; the fkin becomes dry, harfh, and 
burning, and is fometimes fuffufed with a yellow tinge; 
blood often drops from the noftrils, mixed with yellowifh 
ferum; and the vigilia, reftleflnels, and delirum, are ex¬ 
ceedingly dift refling. 
“ As the difeafe advances, the morning remiffion al- 
moft difappears: the region of the liver and ftomach is 
more tenfe and painful; the anxiety, heat, thirft, and 
head ache, become much aggravated ; the delirium is 
almolt conftant; the fauces are parched; the tongue, 
brown, livid, approaching to black, and covered with a 
vifcid mucous, is almolf of a fragile hardnefs and chopped; 
and the fpeech is impaired and fluttering. The eyes are 
very red, the hearing is obtufe, and the temples throb. 
The circulation is quickened, while the blood-veflels are 
contracted ; the urine, fcanty, thicker, fetid, and voided 
unconl'cioufly; and the ftools, liquid, brown, or greenifh, 
and extremely fetid : the abdomen is inflated and founds 
to the touch, and the Ikin is parched or bathed in a vifcid 
fweat. 
“ If the fever in this ftage is either negleCfed or badly 
treated, or the patient is otherwife in unfavourable cir¬ 
cumftances, it will foon terminate fatally. On the other 
hand, if the force of the difeafe is fubdued either fponta- 
neoufly or by art, then the offending matters are thrown 
off by the bowels and fkin, the remiffions become longer 
and more diftind, the tongue more moift, and the mucus 
which covered it either floughs oft, or, as the tip of the 
tongue becomes redder, comes away from the edges in 
foftfcales. Sometimes a very fudden change now takes 
place: the vifcid matter almoft of a ligneous hardnefs, 
which was adhering to the palate, quickly foftens, and is 
bedewed with a bland moifture. At this period, the fe¬ 
ver 
