130

NERVOUS FEVER.

to give the patient a gentle vomit.* This may be repeated anytime before the third or fourth day, if the above symptoms contin*ue. Emetics not only clean the stomach, but, by the generalshock which they give, promote the perspiration, and have manyother excellent effects in slow fevers, where there are no signs ofinflammation, and nature wants rousing.

Such as dare not venture upon an emetic, may clear the bowelsby a small dose of Turkey rhubarb, or an infusion of senna andmanna, or sublimate of mercury.t

In all fevers, the great point is to regulate the symptoms, so asto prevent them from going to either extreme. Thus, in fevers ofthe inflammatory kind, where the force of the circulation is toogreat, or the blood dense, and the fibres too rigid, bleeding andother evacuations are necessary. But in nervous fevers, wherenature flags, where the blood is vapid and poor, and the solids re-laxed, the lancet must be spared, and wine, with other cordials,plentifully administered.

It is the more necessary to caution people against bleeding inthis disease, as there- is generally, at the beginning, an universalstricture upon the vessels, and sometimes an oppression and diffi-culty of breathing, which suggest the idea of a plethora, or toogreat a quantity of blood. I have known even some of the facultydeceived by their own feelings in this respect, so far as to insistupon being Wed, when it was evident, from the consequences, thatthe operation was improper.

Though venesection is generally improper in this disease, yettopical bleeding from the temples, at the commencement, to re-lieve cerebral congestion, will be advisable, in persons of delicateconstitutions ; although in full plethoric babits it may be moreproper to draw off six or eight ounces of blood from the arm, orjugular vein, on the first day of the attack. Cold affusions is oneof the most powerful and efficacious means that can be resortedto in typhus fever ; but its effects will be more salutary in propor-tion as it is adopted early, or during the first stage of the disease.The affusion may be repeated four or five times in the course ofthe twenty-four hours, using spring water impregnated with com-mon salt, when sea water is not at hand. At the same time thepatient's feet may be placed in a warm bath. This operation be-ing over, the feet dried, and the patient put to bed, some tepidbland fluid may be given to promote perspiration. In the moreadvanced stage a tepid affusion may be substituted for the cold,to which a small portion of ardent spirit may be added to the wa-ter, with the view of increasing the evaporative process. Vinegaris usually substituted, although the former is preferable. Blister-ing is also highly necessary. Blistering plasters may be applied,at all times of the fever, with great advantage. If the patient bedelirious, he ought to be blistered on the neck or head, and it willbe the safest course, when the insensibility continues, as soon a«

* See Simple continued Fevek.* Take Powdered Jalap, 10 grains.

Submuriate of Mercury, 3 grains.Syrup of Buckthorn, enough to make the

mass, which divide into three pilla for »dose.