As the Summer advanced, this Fever was often accompanied with bilious Symptoms, with Sickness, and vomiting of bilious Matter, and very frequently with a Purging: Towards the End of Summer it ceased, and was succeeded by the bilious remittent Fever.—And it was no uncommon Thing to see those Fevers, which originally were entirely of an inflammatory Nature, after the sick had been some Days in a crowded Hospital, partake a good deal of the Nature of the Malignant Fever, or be changed entirely into it.
We treated these Fevers in the common antiphlogistic Method.—We blooded freely in the Beginning; gave the saline Draughts with Nitre and other cooling Medicines; and made the Patients drink plentifully of small Liquors:—And when they were inclined to be costive, gave mild Purges, or emollient laxative Clysters. We afterwards applied Blisters; and if the Pulse began to sink, gave Cordials, Wine, and other Remedies commonly employed in such Cases;—and towards the Decline of the Fever endeavoured to promote such Evacuations as were pointed out by Nature, and likely to prove critical.
When the Case was complicated with bilious Symptoms in the Beginning, we were obliged to have particular Regard to the first Passages. If the Patient complained much of Sickness, we gave a gentle Vomit in the Evening, after bleeding; and a Purge next Day, to carry off any bilious or corrupted Humours that might be lodged in the Stomach or Intestines; and we found that these Evacuations gave Relief, and generally mitigated all the Symptoms.
If at any Time during the Fever a Looseness came on, especially when attended with Gripes, we gave a Dose of some gentle Physic, which made a free Evacuation; and an Opiate in the Evening after its Operation; and afterwards we found it answer better to attempt rather to moderate, than wholly stop the Purging by strong Astringents, and Opiates; unless where the Evacuation by Stool was so great as to be in Danger of sinking the Patient.
The pulvis antimonialis, composed of ten Parts of the pulvis e chelis, and one Part of the Tartar emetic, given in small Doses, was serviceable in many of these Fevers, after free Evacuations had been made.
Two Patients, one a Soldier of the Twentieth Regiment, the other a German Waggoner, were taken ill of this Fever about the 25th of December, 1762: They were both blooded freely, and had a Dose of Physic in the Beginning; and the saline Draughts with Nitre and other cooling Remedies; and had Blisters applied without producing any considerable Change in their Disorder.—On the 5th of January, 1763, they both complained much of Thirst, and were inclined to be costive; their Tongues were parched, their Pulses quick and small, and their Skins dry; they were restless at Nights, and the Soldier had a slight Delirium.—I ordered each of them four Grains of the pulvis antimonialis every four Hours.
6th. Next Day the Soldier told me, he had had four loose Stools; his Senses were much clearer, the Pulse calmer and slower, and he said he found himself lighter and easier, and less feverish, than he had been since he was first taken ill. The Medicine was continued, with the Addition of an anodyne Draught at Night.—7th. I found him in a fine breathing Sweat, and he told me he had slept well in the Night: p.—8th. The Sweat continued till this Morning, and on going off his Urine let fall a copious white Sediment, and left him free from the Fever; after which he mended daily.
The Waggoner, after taking the third Dose of the Powders, had a warm Moisture upon the Skin.—On the 6th was cooler and without much Fever, and had had one Stool.—7th. The warm Moisture ended in a profuse Sweat, which carried off the Fever, and he continued to recover daily.
OF THE
ANGINA;
OR,
Sore Throat.
Many of the Soldiers during the Campaign were seized with Inflammations of the Throat, especially when the Nights were cold and moist after warm Days; and when they did Duty in cold wet Nights in the Winter Season.—All of them I saw in Germany were of the inflammatory Kind; I did not observe any that were malignant.