In June 1762, this Fever began to appear again among the Sick, sent from the Army, to the Hospital at Natzungen; and it continued to be frequent through the Summer and Autumn; and the greatest Part of these Fevers this Year terminated in regular Agues, mostly in Tertians, and were cured by the Bark; whereas the Year before very few terminated this Way.
This Disorder in the Beginning had commonly the Appearance of a continued Fever; and many had a Sickness and Vomiting, and threw up a Quantity of yellow Bile, mixed with the Contents of the Stomach. In a few Days, especially after Bleeding, the Remissions became clear; tho’ on its first Appearance in June 1761 they were short, and rather obscure; and it seemed still to partake a good deal of the Nature of the common Inflammatory Fever, the Blood being very sizy; but as the Season advanced, the Remissions became more evident, and the Paroxysms more like those of an Ague; and the Blood less sizy, tho’ at all Seasons of the Year it had some Appearance of an inflammatory Buff in this Disorder. The Sick were restless and uneasy at Night; but commonly felt themselves cooler and lighter in the Day-Time: and although they had no cold Fit, as the Fever came on at Nights, and many of them no Breathing Sweat, as they became cooler and freer from the Fever in the Morning; yet the Fits were so remarkable, that many of the Patients used to say they had a regular Fit of an Ague every Night, or towards the Morning; and some few, that they had the Fit every second Night. As the Season advanced, the Remissions appeared more distinct. However, there was always a good Number in whom the Fever went on in a continued Form, through its whole Course, without any Signs of Remission; tho’ they had all the other Symptoms of this Fever. In a few Instances the Fever, after it came to remit, changed again into a continued Form.
The Heat in the Time of the Paroxysms rose high, and several were delirious during its Continuance[70]; but were quite sensible in the Intervals, though never wholly without the Fever.
At the End of July 1761, four or five were attacked with a Bleeding at the Nose, in the Time of the Paroxysms, and became cooler afterwards; but it did not prove a Crisis in any of them.
The Urine in the Beginning was commonly of a high Colour, though sometimes it was pale and limpid: At first it deposited no Sediment; but when the Fever came to remit, there was often a small Sediment after each Paroxysm; and as the Fever was going off, it let fall a Sediment in all[71].
Some at first were inclined to be costive; others had a Sickness and Purging; and several of those who were costive in the Beginning, were in the Course of the Disorder attacked with a Purging; and others, after some previous Complaint of the Stomach, were seized with both Vomiting and Purging. In general, after the Sick continued some Days in the Hospital, they were inclined to be loose; which was a favourable Circumstance, when this Evacuation was not so great as to be in Danger of sinking the Patient. Some were attacked with a Dysentery.
In this, as well as in most other Fevers, the Sick frequently passed by Stool Worms of the round Kind; and sometimes they vomited them up, or the Worms came up into their Mouth or Nostrils while they lay asleep in Bed; and some towards the Height were afflicted with Deafness, which was commonly a favourable Symptom.
Most of those ill of this Disorder had a yellowish Colour of the Countenance, which went off with the Fever. It was more observable in some than in others; in general, it was slight; some few became yellow all over[72]; particularly one Man, in the Hospital at Munster, who, after being seized with violent Vomiting and Purging, Convulsions, and Twitchings of the Tendons, and Hiccup, became yellow, as in the deepest Jaundice. This Symptom of Yellowness arises from a Redundancy and Absorption of Bile; and is sometimes observed in other Fevers as well as this[73]; for while we were at Paderborn in February 1761, two Men were brought to the Hospital in Fevers, attended with this Symptom. They were both delirious, with parched dry Tongues, slight Twitchings of the Tendons, and other bad Symptoms; and one of them had a continual Vomiting and Purging. They both died, and the Body of him who had the Purging was opened. All the Bowels, especially the Colon, were tinged with a yellow Bile, and had a slight Degree of Inflammation all over their Surface; the Gall-Bladder was distended with a very dark-coloured Bile; but no Concretions were found in its Cavity, or in the bilious Ducts; nor Mucus, or any other Thing obstructing these Passages. The Surface of the Lungs seemed slightly inflamed; and there was a small Quantity of greenish Serum in the Cavities of the Thorax. I could not learn the Histories of these two Mens Disorders, before they were brought to the Hospital; but, from the Symptoms, was inclined to believe, that the Fevers had been of the malignant or petechial Kind; and that the yellow Colour was only an accidental Symptom of it; for on one of the Men we could perceive obscure Traces of dun petechial Spots on his Breast and Arms; and the malignant Fever was frequent at this Time among the Troops, and the bilious autumnal Fevers had ceased long before.
I could not observe any certain critical Days, or Periods, when this Disorder terminated.—Some, who had it slightly, got well in a few Days; with others, it continued longer: Some continued long feverish, and would seem cooler and freer from Fever for a Day or two, and then grow worse again; and many had repeated Relapses.