All the Parts of the Fauces above-mention'd are liable to these Ulcerations; but they generally are first discernible in the Angles above the Tonsils, or on the Tonsils themselves; though they are often to be seen in the Arch form'd by the Uvula, and one of the Tonsils; also on the Pharynx behind, on the Inside of the Cheeks, and the Bale of the Tongue, which they cover in the manner of a thick Fur. Instead of these Sloughs, where the Disorder is mild, a superficial Ulcer of an irregular Figure appears in one or more of these Parts, scarce to be distinguish'd from the sound, but by the Inequality of Surface they occasion.
Towards Night, the Heat and Restlessness increase, and a Delirium frequently comes on. This Symptom, which appears in some even on the first Night, seems to differ considerably from the like Affection in other Diseases. They commonly answer the Questions put to them properly, but with an unusual Quickness; they talk to themselves incoherently when left alone, and frequently betray the first Tendency to this Disorder, by affecting too great a Composure: This for the most part happens to those who sleep but little; for some are comatous and stupid, and take little notice of any thing that passes.
In this manner they continue during two, three, or more Days; they commonly grow hot and restless towards Evening: which Symptoms increase as Night comes on; a Sweat more or less profuse breaks out towards Morning; and from this time they are easier during some Hours; a Faintness only continuing, of which they frequently complain more than of the rest of their Sufferings.
The Disease seems to have no stated Period which can properly be called its Ἀκμὴ or Height. Some grow easier from the first Day of the Attack; but, in general, the Symptoms of Recovery appear on the third, fourth, or fifth Day, and proceed in the following manner:
First, the Redness of the Skin disappears; the Heat grows less; the Pulse, which was hitherto very quick, becomes slower; the external Swellings of the Neck subside; the Sloughs in the Fauces cast off; the Ulcerations fill up; the Patient sleeps without Confusion, is composed when awake, and his Appetite begins to return towards more solid Nourishment, than has hitherto been allow'd him.
The parotid Glands on each Side, and the Parts about them, are commonly swell'd, and painful to the Touch; and if the Disease is violent, the Neck and Throat are surrounded with a large œdematous Tumor; which, by straitening the Fauces, increases the Danger.
The Pulse, during the whole Course of this Disease, is generally very quick; frequently 120 Strokes or more in a Minute: In some it is hard and small; in others soft and full; but without that Strength and Firmness which usually accompany equal Quickness and Heat in genuine inflammatory Disorders.
If a Vein is open'd soon after the Distemper is come on, the Blood generally appears of a fresh florid Red; the Crassamentum is rather of a lax gelatinous Texture, than dense or compact; the Serum yellow, and in a large Proportion.
The Urine is at first crude, and of a pale Whey-Colour: As the Disease advances, it turns yellower, as if Bile was diluted in it and soon after the Patient shews any Marks of Recovery, it commonly grows turbid, and deposits a farinaceous Sediment.
They seldom have any Stools, if the Symptoms are favourable, from the Time when the Purging, which generally attends the Accession, ceases. This Discharge is frequently bilious, and without any Pain: Tho' these Circumstances differ in different Habits.