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Gen. III.. The lighter bitters are certainly serviceable in many
cases, and may conveniently be employed in combinaHectica. tion with the acids; but bark, though tried in numerous Hectic
instances, and with great perseverance, has not been fever. The lighter 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 harmless;
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 cause is disease is dependent upon some local affection, the Bath local.
waters have often afforded relief; but in idiopathic cases they usually augment the fever, aggravate the patient's sufferings, and hasten his death.
ONE SERIES OF INCREASE AND DECREASE; WITH A TEN
DENCY TO EXACERBATION AND REMISSION, FOR THE
We now enter upon the important genus of continued
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 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 augmeritation 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 natural
evening parsome tendency to a little febrile affection every evening; oxysm. this he calls the natural evening paroxysm of fever ; and to this babit he ascribes the existence of an evening increase of continued fever.
GEN IV. Enecia. Continued fever.
The genus, thus defined and characterised, includes the three following species:
1. ENECIA CAUMA.
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 continued 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.
HEAT GREATLY INCREASED; PULSE QUICK, HARD, AND
STRONG ; URINE RED ; DISTURBANCE OF THE MIND
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 various names,
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 synocha.
for reasons stated in the comment to the Nosological
Synopsis, is the worst; it has no clear or correct etymo- Ges. IV.
name for it,
between inmations bear the same relations to each other as the flammatory idiopathic and symptomatic hectic: in both there may lever of inbe a general or a local remote cause, but the influence Alammations. 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 affirms that he has never seen inflammatory fever exist- its seat, as ing under the same circumstances : whence Dr. Clarke, contem
plated by of Newcastle-upon-Tyne, who has too much generalized the subject, has struck inflammatory fever entirely out supporters of 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
Gen. IV. local affection *: while Dr. Clutterbuck, as we have al-
ready observed t, has contended that this local cause is Cauma. at all times, and under every variety of fever, an inflamInflammatory fever.
mation of the brain. If, however, a cause of this kind 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, what.
who have recently examined the subject at considerable length, especially MM. Portal f, Dalbant, and Vaidy g; 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.
|| De Curandis Hominum Morbis Epitome. Lib. i. $ 118. 8vo. Mannhem,