Putrid Malignant Fevers, attended with Eruptions, are taken Notice of by Hippocrates[24], and other antient Authors[25]; but whether they meant that particular Sort of Eruption which we now call Petechiæ, is uncertain; as their Descriptions are not clear enough to distinguish it from the Miliary and other Kinds. But since the Year 1500, we have had many accurate Accounts of Fevers of this Kind, which have appeared in different Parts of the World: from all which it appears that such Fevers generally take their Rise either from some antecedent Acrimony of the Blood; or, what is more frequent, from some Source of Corruption or Contagion; from the Use of putrescent animal Food, and a Want of fresh Vegetables and acescent Liquors; from the putrid Steams of corrupted animal Substances; from the moist putrid Vapour of low marshy Places in Summer, where there is stagnating Water, which corrupts by the Heat; from the foul Air of crowded Hospitals, Jails, and Ships; and from such like Causes[26].
When once this Fever begins, it is observed to be of a contagious Nature, and (if proper Care is not taken) to affect those who attend the Sick, or who live in the same Room, and breathe the same Air with them.
Many Authors have reckoned the Malignant, Petechial, and Pestilential, to be distinct Species of Fevers; and have treated each of them under a particular Head. But Riverius[27] has very justly observed, that they all belong to the same pestilential Tribe, and only differ from one another in the Degree of Infection, and the Violence of the Symptoms[28]; and that they are to be cured by the same general Treatment, and the same Medicines.
FOOTNOTES:
[1] Dr. Huxham, in his Treatise on the ulcerous sore Throat, p. 36, says, “I have very often met with this buffy or sizy Appearance of the Blood in the Beginning of Malignant Fevers; and yet, Blood drawn two or three Days afterwards, from the same Persons, hath been quite loose, dissolved, and sanious as it were.” And in his Essay on Fevers, chap. viii. p. 108. says, “The first Blood frequently appears florid; what is drawn twenty four Hours after, is commonly livid, black, and too thin; a third quantity, livid, dissolved, and sanious. I have sometimes observed the Crasis of the Blood so broke as to deposite a black Powder, like Soot, at the Bottom, the superior Part being either a livid Gore, or a dark green, and exceedingly soft Jelly.”
[2] Observations on the Diseases of the Army, part III. chap. vii. sect. 3. third Edition, 1761.
[3] Ramazini, in his Treatise De Constitutionibus annorum, 1692, 3, 4, in Mutinensi civitate, Sect. 19. mentions the Petechial Fever which had been frequent the three foregoing Years; in which the Petechiæ appeared commonly on the fourth or seventh Days, and almost all those died in whom they appeared on the first Day. These Spots came out first on the Neck, the Back and Breast; and it was observed that none escaped unless these Spots extended themselves as far as the Nails of the Toes, vanishing by Degrees on the upper Parts. He tells us likewise, that this Fever was attended with an Inflammation of the Throat, which, about the Height of this Disorder, terminated in a white ulcerous Crust. This sore Throat should seem to be the same which we now call the malignant ulcerous sore Throat, which I never once saw while I was with the Troops in Germany.
[4] Dr. Huxham, in his Essay on Fevers, ch. viii. p. 97, tells us, that sometimes, about the eleventh or twelfth Day, on the coming on of profuse Sweats, the Petechiæ disappear, and vast Quantities of small white miliary pustules break out.
[5] Dr. Hasenohrl, in his Treatise De Febre Petechiali, cap. i. p. 12. relates a very particular Case, where the Petechiæ appeared on the fourth, and the white miliary Eruptions on the seventeenth Day of the Fever.
[6] Dr. Lind, in his second Paper on Fevers, p. 105. mentions Spots which rise above the Surface of the Skin, and are of the miliary kind, as common in contagious Fevers, as he observed among the French Prisoners in Winchester Castle, in the Beginning of the Year 1761.