OF THE BILIOUS FEVER.

When a continual, remitting, or intermitting fever is accompanied with a frequent or copious evacuation of bile, either by vomit or stool, the fever is denominated bilious. In Britain the bilious fever generally makes its appearance about the end of summer, and ceases towards the approach of winter. It is most frequent and fatal in warm countries, especially where the soil is marshy, and when great rains are succeeded by sultry heats. Persons who work without doors, lie in camps, or who are exposed to the night air, are most liable to this kind of fever.

If there are symptoms of inflammation at the beginning of this fever, it will be necessary to bleed, and to put the patient upon the cool diluting regimen recommended in the inflammatory fever. The saline draught may likewise be frequently administered, and the patient’s body kept open by clysters or mild purgatives. But if the fever should remit or intermit, bleeding will seldom be necessary. In this case a vomit may be administered, and, if the body be bound, a gentle purge; after which the Peruvian bark will generally complete the cure.

In case of a violent looseness, the patient must be supported with chicken broth, jellies of hartshorn, and the like; and he may use the white decoction for his ordinary drink[[101]]. If a bloody flux should accompany this fever, it must be treated in the manner recommended under the article Dysentery.

When there is a burning heat, and the patient does not sweat, that evacuation may be promoted by giving him, three or four times a day, a table-spoonful of Mindererus’s spirit[[102]] mixed in a cup of his ordinary drink.

If the bilious fever be attended with the nervous, malignant, or putrid symptoms, which is sometimes the case, the patient must be treated in the same manner as directed under these diseases.

After this fever, proper care is necessary to prevent a relapse. For this purpose the patient, especially towards the end of autumn, ought to continue the use of the Peruvian bark for some time after he is well. He should likewise abstain from all trashy fruits, new liquors, and every kind of flatulent aliment.

CHAP. XXV.
OF THE ERYSIPELAS, or St. ANTHONY’S FIRE.

This disease, which in some parts of Britain is called the rose, attacks persons at any period of life, but is most common between the age of thirty and forty. Persons of a sanguine or plethoric habit are most liable to it. It often attacks young people, and pregnant women; and such as have once been afflicted with it are very liable to have it again. Sometimes it is a primary disease, and at other times only a symptom of some other malady. Every part of the body is liable to be attacked by an erysipelas, but it most frequently seizes the legs or face, especially the latter. It is most common in autumn, or when hot weather is succeeded by cold and wet.

CAUSES.——The erysipelas may be occasioned by violent passions or affections of the mind; as fear, anger, &c. When the body has been heated to a great degree, and is immediately exposed to the cold air, so that the perspiration is suddenly checked, an erysipelas will often ensue[[103]]. It may also be occasioned by drinking to excess, by continuing too long in a warm bath, or by any thing that overheats the blood. If any of the natural evacuations be obstructed, or in too small quantity, it may cause an erysipelas. The same effect will follow from the stoppage of artificial evacuations; as issues, setons, or the like.