Page:Cyclopaedia, Chambers - Supplement, Volume 1.djvu/714

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eliminate the catarrhal, acrid and a£tive matter. This is un- queftionably the fame fpecies of fever with the fimple one of this name, but extremely different in degree, and is often even epidemical. This is called by fome the febris Hun- garica, and febris cajirenfis, or camp fever: but the latter ap- pellation is ufed to exprefs it in its very worft ftate, and when attended with its moft terrible fymptoms. The petechia? or fpots in this yhw are to be carefully diftingu'ifhed from thole in the common fcorbutic cafes. Junker's Confp. Med. p. 317. Signs of it. Thefe are the fame with thofe of the fimple ca- tarrhal fever \ but with this only difference, that in this cafe there are alfo violent anxieties of the mind, a fudden refolu- tion of the flrength, a continual difficulty of breathing, and a loathing of all kinds of food. This laft fymptom ufually con- tinues till the eleventh day. The patients are alfo fubje<3 to frequent faintings, and are ufually delirious, and complain of very {harp pains in the back, and at the joints. After thefe fymptoms the petechias ufually appear; thefe are little red fpots on the breaft, &c. refembling fleabites. When hot me- dicines are given, the petechia? are enlarged. Aphthae and quinfeys are alfo very frequent attendants on this fever; and diarrhoeas fedom fail of appearing at fome ftage of the difeaie, and are often critical.

This fever feldom attacks the patient with a fhivering. It is very contagious, in the manner of other malignant fevers, and has this peculiar circumftance, that it is very often complica- ted with other difeafes, and according to the feafons and other accidents frequently appears under their form. In February, March and April, it often wears the appearance of a pleurlfy; in May and June, it often affecls the fymptoms of the chole- rica febris j and at this feafon of the year is often, in the be- ginning, attended with terrible haemorrhages. In July and Auguft, a dyfentery is frequently joined with it j and, in the winter months, it generally has a bad cough attending on it. Perfons of tender habits are much more fubjecl: to this difeafe from infection, than thofe who are of a hardy and robuft make. But, as it is contagious, it at times fpares no age, fex, or conftitution, that come in the way.

Caufes of it. The moft frequent caufes of this difeafe are, a fermentaceous and putrid exhalation in the air, and the con- tagion from the bodies and effluvia of the fick. And in this laft cafe, a natural terror of receiving the infection is often found to make people more fubjcct than ordinary to receive it. And to thefe are to be added the eating vitiated and ferment- ing provKions, and the fudden cooling of the body when very hot with labour or exercife, and frequent and violent paffions fuppreffed.

The fpots which appear on oertai'n days in this difeafe are not efTential to it, though common; and hence the fever is rather called by accurate writers, febris petechizans, than petecbiaUs : they are a relief to the patient, if they are not violently re- pelled, or fome other way improperly treated. When they appear earlier than the feventh day, they are alfo obferved to be worfe prefages than when they appear on, or after it. When the fpots appear in very great numbers, they ufually fly back again, and the patient is much endanger'd by it. And when they are of a bright red, and after three or four days appearance go off again, and leave the patient better than before, they are a fure good prognoftic. But if they are of a livid or black colour, they are a very bad omen; and when after the eruption the perfon does not find himfelf relieved, the confequence is often a miliary purple fever. Lighthead- ednefs before the feventh day is lefs dangerous than if it does not happen till after it. Diarrhaeas in all other eruptive fe- vers are a very bad fymptom, and often prefage the death of the patient. But that is not the cafe in this; they fometimes prove critical, and carry off the difeafe. But when that is not the cafe, they are of no bad effect, and are always better for the patient than an obftinate coftivenefs. But it is to be obferved, that though thefe Diarrheas, when they come na- turally, are of great relief in many cafes, and of no harm in others; yet art is not here to be ufed as nature, and no purg- ing medicines are by any means to be given to bring on a laxity of the bowels.

Method of cure. Gentle evacuations are to be brought on by fuch medicines as encourage perforation, and promote urine. Abforbents faturated with acids, as crab's eyes fated with lemon juice, are of fervice; and to thefe fhould be joined a fmall quantity of nitre. Cooling emulfions are alfo to be given at times, and fpirit of wine camphorated is to be rub- bed on the head to mitigate the violent head-achs. And Stahl greatly recommends, in the cafe of a too violent diarrhea, the ufe of powders made of purify'd nitre and mountain cry- iral. In cafes of obftinate coftivenefs, clyfters muft be in- jected as often as is found neceflary. And when there is a complaint of forenefs in the fauces, and difficulty of fwallow- ing, aftringent gargarifms are to be ufed. Junto's Confp. Med. p. 322. Choleric Fever, in medicine, the name of a fever, called alfo by fome a bilious fevtr, and by others a caufus; though the generality of writers diftinguifh the cholorica/^r;V from the

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caufus. All bilious/««rr are properly fpecies of acute fever. and owe their ongui to diftemperatures of the bile, at time! when the aliments are in a ftate of fermentation in the ftc- mach and inteftines.

The caufus is diftinguifhed from the cholerica/ifo-ir pronerlv fo called, by its being ever much more violent and daneerous and by the excretions which attend it. For in the cholerc fever, the vitiated gall and other bilious excretions are always plentifully voided, fometimes upward, fometimes downward and fometimes both ways. In the caufiis, the matter is more ufually detained in the body, and rarely voided otlu.wife than by vomiting, and that ufually only in fmall quantities and in the beginning of the diftemper.

Signi of it. The general figns of the cholerica/^ra and cair- fiis are a remarkable anxiety, and frequent complaints about the breaft, as of a ftraitnefs and painful heat. A violent heat on the infide of the mouth, and infatiable and intolerable thirft, trembling and convulfive motions of the joints, and violent deliriums. Drynefs of the mouth and tongue are of- ten fo terrible in this difeafe, that the skin cracks with it ■ and often the whites of the eyes, fometunes the whole body becomes yellowifh. The peculiar and appropriated fymptoms of a cbolenca/^m, ftriftly fo called, are an univerfal lan- guor and debility of the limbs.

A fevere fhivering firft feizes the patient, and is Coon fucceed- ed by a very violent heat, and raging pain in the head; and, after the two firft days, there ufually are very terrible ftrain- ings and Teachings lo vomit. The matter brought up at thefe times is cauftic, acrid, and bilious, and inflames and even ul- cerates the fauces; and, if voided upon a ftone floor, effer- vefces violently. If this vomiting abates, there immediately comes on a d.arrhaia attended with a tenefmus, occafioned by the irritation of this (harp matter in the reflum. Faintings alfo are very frequent in this difeafe, efpecially where the vo- mitings do not bring up a fufficient quantity of the offendin K T'Z'' r I? u and a PP r -P™<«l figns of the caufus,

ftriffly fo called, are thefe: a violent and infatiable thirft, greater than that in any other fever. The bowels are always bound, and it is but very feldom that there is any tendency to vomit The unne ,s redJifh and turbid, and alter ftandma; fome time depofits a red fediment. Often there is a fenfible

C 3 ,l - 1 T; T thC P r: f c °, rdia ' fo that the P a <™' cannot bear the leaft touch upon the breaft; and ufually, in the court of the difeafe there are fainting* and violent convulnons. Perfm -.moJIJuljea to this difeaie are fuch as eat largely, and dnnk heavy and imperfeaiy fermented liquors after it The chdenca/rfm, properly fo called, is moft frequent with thofe of a cholerico-fangumeous habit, and fuch as feed on high fea- fon d meats, and drink abundance of wine or other ftrone li- quors; and is often brought on fuch perfons by their falling into violent paffions after a full meal. The caufus peculiarfy at- tacks the people of melancholic habits, who are much incli ned to paffion, but fupprefi it, and who are naturally coftive! Junhr's Confp. Med. p. 273. ' " ,v,; -

Prognoftkt in it The fimple choleric/W is attended with great danger, ,f not timely undertaken to be cured. But the caufus is yet more fatal than it, and from as old time as Hip- pocratcss days has been accounted among the febres leliiL r*, or fevers that very frequently kill the patient

hT^ifT TT", '' S aW r, e '° hd P heMf > a " d ^ceeds beft of all when left alon* But thefe are of that number of diftempers in which the afliftance of art is abfulutely neceffary,

wh, „° Ut n°u-ft H rt UI l Ve 7i yd <"" brings the patient fafely when unaffifted The happieft turn this /wean take, is the copious difcharge of the peccant matter by vomit ■ for when it goes downward, the febrile heat always increafes', and the fymptoms in general ufually grow worfe. When the Teachings are violent, and the matter brought up is but fmall in quantity, then the patient is ufually fubieflcd to painful hiccoughs and dangerous fyncopes and convulnons. When much bile is thrown up by vomit, and that not very badly colour d and there is no diarrhea, there is then little danger from *e difeafe j and, in general, coftivenefs in the ftateV the difeafe is more eligible than a tendency to ftools The more violent the delirium is in thefe difeafes, and the longer continued, always the greater is the danger to the patient And if the pains and burning heat fuddenly ceafe, and a (hi' vermg and dejeaion of the fpirits fucceed, there is no doubt of a gangrene being coming on within. Jimhr's Confp Med p. 277.

Method of Cure. The cure of thefe difeafes confifts in the mitigating the violent iharpnefs of the humour, and promo- ting its evacuation. And, finally, in abating the burnine heat brought on by it. The utmoft endeavours are firft to be made to correfl and alter the morbific matter. To this pur- pofe the feyeral preparations of nitre, with the teftaceous powders and mucilaginous ptyfans, with fmall mixtures of lemon juice, and frequent draughts of cooling and diluting li- quors, are to be given moderately warm. If the coftivenefs be too violent, clyfters of broth muftbe injeaed, with the addition of a little oil and fait: and, if neceffary, fmall dofes

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