I found obvious advantages, in many cases, from the use of pediluvia, every night.
In every case, I found the patients refreshed and relieved by frequent changes of their linen.
On the third or fourth day, in the forenoon, the pains in the head and back generally abated, with a sweat which was diffused over the whole body. The pulse at this time remained quick and weak. This was, however, no objection to the use of the bark, a few doses of which immediately abated its quickness, and prevented a return of the fever.
If the fever continued beyond the third or fourth day without an intermission, I always had recourse to blisters. Those which were applied to the neck, and behind the ears, produced the most immediate good effects. They seldom failed of producing an intermission in the fever, the day after they were applied. Where delirium or coma attended, I applied the blister to the neck on the first day of the disease. A worthy family in this city will always ascribe the life of a promising boy, of ten years old, to the early application of a blister to the neck, in this fever.
Where the fever did not yield to blisters, and assumed malignant, or typhus symptoms, I gave the medicines usually exhibited in both those states of fever.
I took notice, in the history of this fever, that it was sometimes accompanied with symptoms of a dysentery. Where this disease appeared, I prescribed lenient purges and opiates. Where these failed of success, I gave the bark in the intermissions of the pain in the bowels, and applied blisters to the wrists. The good effects of these remedies led me to conclude, that the dysentery was the febris introversa of Dr. Sydenham.
I am happy in having an opportunity, in this place, of bearing a testimony in favour of the usefulness of OPIUM in this disease, after the necessary evacuations had been made. I yielded, in prescribing it at first, to the earnest solicitations of my patients for something to give them relief from their insupportable pains, particularly when they were seated in the eyeballs and head. Its salutary effects in procuring sweat, and a remission of the fever, led me to prescribe it afterwards in almost every case, and always with the happiest effects. Those physicians enjoy but little pleasure in practising physic, who know not how much of the pain and anguish of fevers, of a certain kind, may be lessened by the judicious use of opium.
In treating of the remedies used in this disease, I have taken no notice of blood-letting. Out of several hundred patients whom I visited in this fever, I did not meet with a single case, before the 27th of September, in which the state of the pulse indicated this evacuation. It is true, the pulse was full, but never hard. I acknowledge that I was called to several patients who had been bled without the advice of a physician, who recovered afterwards on the usual days of the solution of the fever. This only can be ascribed to that disposition which Doctor Cleghorn attributes to fevers, to preserve their types under every variety of treatment, as well as constitution. But I am bound to declare further, that I heard of several cases in which bleeding was followed by a fatal termination of the disease.