152

PUTRID OR SPOTTED FEVER.

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of fainting' away. His mind too is greatly dejected; he sighs,and is full of dreadful apprehensions.

There is a nausea, and sometimes a vomiting of bile ; aviolent pain of the head, with a strong pulsation or throbbingof the temporal arteries ; the eyes often appear red and in-flamed, with a pain at the bottom of the orbit ; there is anoise in the ears ; the breathing is laborious, and often inter-rupted with a sigh ; the patient complains of pain about theregion of the stomach and in his back and loins ; his tongueis at first white, but afterwards it appears black and chapped ;and his teeth are covered with a black crust. He sometimespasses worms both upwards and downwards, is affected withtremors or shaking, and often becomes delirious.

If blood be let, it appears dissolved, or with a very smalldegree of cohesion, and sometimes becomes putrid ; the stoolssmell extremely fetid, and are sometimes of a greenish, black,or reddish cast. Spots of a pale, purple, dun or black coloroften appear upon the skin. Sometimes there are violenthemorrhages, or discharges of blood from the mouth, eyes,nose, &c.

Putrid fevers may be distinguished from the inflammatoryby the smallness of the pulse, the great dejection of the mind,the dissolved state of the blood, the petechias, or purple spots,and the putrid smell of the excrements. They may likewisebe distinguished from the low or nervous fever by the heatand thirst being greater, the urine of a higher color, and allthe other symptoms more violent.

It sometimes happens, however, that the inflammatory,nervous, and putrid symptoms are so blended together as torender it very difficult to determine to which class the feverbelongs. In this case the greatest caution and skill are requi-site. All endeavors must be used to relieve the most urgentsymptoms ; and the efforts of nature ought carefully to bewatched, in order that we may give her what assistance wecan in expelling the cause of the disease in her own way.

Inflammatory and nervous fevers may be converted intomalignant and putrid, by too hot a regimen, or impropermedicines.

The duration of putrid fevers is extremely uncertain ; some-times they terminate betwixt the seventh and fourteenth day,and at other times they are prolonged for five or six weeks.Their duration depends greatly upon the constitution of thepatient and the manner of treating the disease.