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Gen. III. . The lighter bitters are certainly serviceable in many Spec. III.

· cases, and may conveniently be employed in combinaHectica tion with the acids; but bark, though tried in numerous

instances, and with great perseverance, has not been fever.

found successful. Dr. Heberden, however, says that bitters he never saw it do any harm in the hectic fever, and his useful with acids.

opinion is confirmed by that of Sir Edward Hulse, after Bark, having prescribed it for forty years. Yet neither of

them ever obtained proofs of any beneficial result. but of no avail. A light and regular diet, regular hours, and gentle exBath waters ercise, are coadjutants of great importance. When the

disease is dependent upon some local affection, the Bath waters have often afforded relief; but in idiopathic cases they usually augment the fever, aggravate the patient's sufferings, and hasten his death.


where the cause is local.



Continued fever.



and even

We now enter upon the important genus of continued Gen. IV.

“ Alternated fevers, or those which run their course, not indeed with- by slight out any change or relaxation whatever, as many of them fluxes and

refluxes of were supposed to do formerly, and were distinguished symptoms. by the term continentes, but with occasional and slight fluxes and refluxes, which bear the same proportions to the exacerbations and remissions of the epanetus as these do to the paroxysms and intervals of the anetus or intermittent. When there are two tides or fluxes within the Morning twenty-four hours, the one occurs in the morning, and ing

ing often the other in the evening. The last is always the most distinguish

ed by fluxes, distinct; and takes place usually between five and six especially o'clock, which is somewhat later than the latest of the the latter. paroxysms of genuine intermitting fevers; that of the quartan, which is the latest of the whole, usually occurring before five o'clock. It should also be farther observed that where continued fever discovers but one augmentation in the twenty-four hours, it is always that of the evening. Dr. Fordyce attempts to show that, even Fordyce's in a state of the firmest health, we constantly discover

evening parsome tendency to a little febrile affection every evening; oxysm. this he calls the natural evening paroxysm of fever ; and to this habit he ascribes the existence of an evening increase of continued fever.




Gen IV. The genus, thus defined and characterised, includes
Continued the three following species:-


3. SYNOCHUS. SYNOCHAL FEVER. Sauvages's Sauvages draws a line of distinction between these three line of distinction be- from their respective duration, as well as from their more tween the

essential symptoms, affirming that the cauma terminates different species of in a week at the farthest; the typhus in two, though

sometimes protracted to three weeks; while the synochus fever.

reaches beyond the second, and often beyond the third

week. As a general rule, this remark is worth keeping Holds only in mind, but the deviations from it in all the species, generally.

are too frequent to enable us to lay hold of it in assigning their specific character.




Jnflammatory Fever.



various names,

Gen. IV. This species has been distinguished by a variety of names

Spec. I. Distin-" by different nosologists and other medical writers; the guished by chief of which are, imputrid synochus, which is that of

Galen; imputrid continued fever, which is that of Boerhaave; imputrid continent, which is that of Lommius; sanguineous continued fever, which is that of Hoffman;

and synocha, which is that of Sauvages, Linnéus, Cullen, of which and most writers of the present day. Of these, synocha, the worst is on synocha.

18 for reasons stated in the comment to the Nosological Synopsis, is the worst; it has no clear or correct etymo- Ges. IV.

Spec. I. logical meaning; it has been used in different senses by Enecia different writers, and approaches so nearly to synochus,

Inflammaused as extensively by most of the same writers, as to wory fever. create a perpetual confusion in the minds of young students; and the more so, as the disease before us is expressly denominated synochus by Vogel, whilst most writers employ this term to import a different species of fever. On all which accounts I have judged it right to And hence exchange synocha for cauma, a term already employed above for for the same purpose by Dr. Young, and which, derived cauma. from naiw, “uro”, is etymologically significant of the character of the disease it designates. The common English term inflammatory fever is excellent; and is, in truth, a direct translation of the Greek term cauma. Dr. Fordyce denominates it general inflammation : by Importing

general inwhich he clearly intimates that this species of fever bears Xammation. a near resemblance to the symptomatic fever produced Fordyce's..

name for it, by the local affections called pblegmasiæ, or phlogotica, which constitute the next order of the present class, to which the term inflammations is now commonly limited; but which Dr. Fordyce would distinguish by the term local inflammations. In effect, inflammatory fever and the fever of inflam- Difference

between inmations bear the same relations to each other as the flammatory idiopathic and symptomatic hectic: in both there may fever and

3 fever of inbe a general or a local remote cause, but the influence flammations. upon the constitution will be the same, whatever be the source of excitement. It has been doubted, however, Whether it whether cauma or inflammatory fever ever exists without cept from a a local cause; and Dr. Cullen, who does not allow that local cause. hectic fever is ever found without a local cause, distinctly Local cause

various in affirms that he has never seen inflammatory fever existing under the same circumstances : whence Dr. Clarke, contem

plated by of Newcastle-upon-Tyne, who has too much generalized Life the subject, has struck inflammatory fever entirely out supporters

of this docof the list of diseases, contending that even the term in- erine flammatory ought never to be applied to fever, excepting when fever itself only exists as a concomitant of some

exists, ex

its seat, as

we have al


es, and under entended that this

Gen. IV. local affection *: while Dr. Clutterbuck, as we have al-
Spec. I.

ready observed t, has contended that this local cause is
at all times, and under every variety of fever, an inflam-

mation of the brain. If, however, a cause of this kind tory fever.

be ever fairly made out, a variety of facts of late de

tection, will be far more likely to fix it in an inflammaArteritis,

tion of the arteries, the ARTERITIS of the French writers, who have recently examined the subject at considerable length, especially MM. Portal f, Dalbant, and Vaidys; and to which Dr. Frank has, indeed, already ascribed inflammatory fever in one of its forms ll. But the sub·ject is still involved in great obscurity, as it is doubtful whether the change of arterial structure which has been found after death in many cases of supposed arteritis, has been really an effect of inflammatory action. In acute rheumatism it is probably a frequent cause or concomitant; but this is a question we shall have occasion to return to under that disease. How far either hectic or inflammatory fever may, under particular circumstances of human or atmospherical constitutions, occasionally originate from marsh or contagious miasm, it is difficult to determine; but as Dr. Cullen was peculiarly desirous. of reducing all fevers to these two sources; and as, to say the least, they are not obvious sources of either of the diseases in question, his mind appears to have received some bias from this fact in rejecting them from the list of idiopathic fevers. And as it has already been shown that this decision has laid a foundation for much of that “ tug of war” in which many distinguished members of the profession have of late years been engaged, respecting the nature and treatment of particular species of fever, it is highly probable, also, that several of the more recent hypotheses concerning its proximate cause have originated from the same spring.


• Observations on Fevers, &c. 8vo. London 1779. + Vol. II. p. 61.

Cours d'Anatomie Medic. Tom. III. p. 127. 1804. $ Dict. des Sciences Médicales :--Journ. Compliment, vi. Août 1819.

A De Curandis Hominum Morbis Epitome. Lib. i. $ 118, 8vo. Mannhem,

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