observations will apply here as in the primary fe ver. These facts I consider as very strong arguments in favour of the doctrine we advocate, as it is not easy to conceive how relapses should, in such a great proportion of cases, observe critical days, and the same not occur in the primary fe

ver.

The following are the numbers of the relapse cases terminating on particular days, critical and non-critical. Of the 108 cases in which crisis happened on critical days, 38 had this change on the 3d day, 56 on the 5th, 10 on the 7th, 2 on the 9th, and 2 on the 11th. Of those ending on noncritical days, 6 had crisis on the 2d day, 13 on the 4th, and 4 on the 6th. In two cases the day of crisis could not be ascertained. (See Table, NO.12. Appendix, No. II.)

It is curious, and rather in confirmation of the general statement, to observe, that in the fatal cases the matter is reversed; for out of 34 patients whose cases terminated fatally, 22 died on noncritical days, and only 10 on critical days. In the remaining 2 the day of the disease could not be ascertained.

Of the 22 which terminated fatally on non-critical days, 2 died on the 10th day, 2 on the 12th, 4 on the 13th, 1 on the 15th, 1 on the 16th, 2 on the 19th, 3 on the 20th, 1 on the 22d, 1 on the

23d, 2 on the 24th, 1 on the 29th, and 2 on the 36th day. Of the 10 ending on critical days, 1 died on the 7th day, 2 on the 9th, 1 on the 11th, 1 on the 14th, 2 on the 17th, 1 on the 21st, 1 on the 31st, and 1 on the 34th day. (See Table No. 13. Appendix, No. II.)

I have, in the general description of the fever, noticed all the evacuations or evolutions which I have observed to accompany crisis; but I regret that I have not kept minutely accurate notes of their relative frequency. Sweat I mentioned to be by far the most frequent concomitant of crisis; and if we say that this evacuation accompanied it in about one-third of the cases of primary fever, and four-fifths of the relapse cases, I believe we will come pretty near the truth.

I am inclined to believe that the proportion of crises accompanied by sweat is pretty nearly alike, whether they happen on critical or non-critical days; and of all the non-critical days, the 6th is the one in which sweat most commonly accompanies crisis in the primary fever, and the 4th day in the relapse cases. I have not observed that sweat accompanies the crisis more constantly on one critical day than another, previous to the 11th, but certainly it is more frequently attended by this evacuation on this day, or the critical days previous to it, than afterwards.

SKETCH

OF THE

HISTORY OF VENESECTION IN FEVER.

THAT a free use of venesection, freer indeed than has hitherto come into general practice, is attended with great advantage in the treatment of the epidemic which at present prevails in many parts of the British Empire, is a truth that we shall endeavour to establish in this treatise.

Some time since, when the panic from the doctrine of debility had subsided, it was observed that moderate bleedings were often useful. When the headach, vertigo, flushing, or pain of the back and limbs, had been so violent as to demand a bleeding, at the admission of a patient into an hospital, it always appeared that these symptoms were for the time at least much relieved, even

when they returned again, as very frequently hap pens after small bleedings. The repetition of the evacuation very certainly suspended them for another indefinite period. Comparing this with the other modes of practice in use, it appeared to a few judicious persons to be possessed of considerable advantages; and the quantity taken was gradually augmented to the free venesection of either India. In this city, however, the practice, as might have been expected, made but slow progress; and as for large bleedings, as they are call, ed, that is, from 3 xx to 3 xl, they are still viewed with rooted aversion by the greater part of private practitioners.

During the time I acted as clerk to Dr Hamilton in the Royal Infirmary, the practice of venesection was pushed to a considerable extent; and always with manifest advantage. The nature of the patients' complaints generally indicated liberal evacuation, and the signal relief experienced by them after its use appeared sufficient to warrant its future employment. Accordingly, from the time that the new fever hospital was opened at Queensberry House, under the care of the above-mentioned gentleman and Dr Spens, the lancet has been steadily and freely employed, as will be seen from the cases hereafter to be detailed.

The hospital, from its first opening, has been under the immediate superintendance of the Author, who, so far from finding any thing to lessen his confidence in the expediency of the practice, is emboldened by its success to lay the more interesting details before the public. This he does with the greater willingness, that the practice he recommends, though certainly not novel in books, has still a large majority of the most eminent medical practitioners decidedly opposed to it; and a vast number of others, who, following no particular medical chief, look to experience, and a kind of universal consent of the profession, as the signal for submitting to trial a practice which they consider as hazardous. In such circumstances, it seems every man's duty to bear testimony to the results of his own experience. The Author is also under an impression, that the benefit thence accruing to mankind will not merely terminate in the decision of a difficult and agitated question in medical practice, but it may probably lessen the mortality in fever: at least we are warranted so to conclude, from the low ratio by which it is expressed in these tables, in comparison to most others that it has been our fortune to see, or even to the practice of the same able physicians Drs Hamilton and Spens, in the same fever, when directed on different principles. But