BILIOUS FEVEK.

187

After the fever is gone off the patient ought to be purgedonce or twice.

BILIOUS FEVER.

When a continual, remitting, or intermitting fever is ac-companied with a frequent or copious evacuation of bile,either by vomit or stool, the fever is denominated bilious. InBritain the bilious fever generally makes its appearance aboutthe end of summer, and ceases towards the approach of win-ter. It is most frequent and fatal in warm countries, especiallywhere the soil is marshy, and when great rains are succeededby sultry heats. Persons who work without doors, lie incamps, or who are exposed to the night air, are most liable tothis kind of fever.

If there be symptoms of inflammation at the beginning ofthis fever, it will be necessary to bleed, and to put the patientupon the cool diluting regimen recommended in the inflam-matory fever. The saline draught, recommended page 156,may likewise be frequently administered, and the patient'«body may be kept open by clysters or mild purgatives. Butif the fever should remit or intermit, bleeding will seldom benecessary. In this case a vomit may be administered, and,if the body be bound, a gentle purge ; after which the Peru-vian bark will generally complete the cure.

In case of a violent looseness, the patient must be supportedwith chicken broth, jellies of hartshorn, and the like ; and hemay use the white decoction for his ordinary drink.* If abloody flux should accompany this fever, it must be treatedin the manner recommended under the article Dysentery.

When there is a burning heat, and the patient does notsweat, that evacuation may be promoted by giving him threeor four times a day a table-spoonful of Mindererus's spirit tmixed in a cup of his ordinary drink.

If the bilious fever be attended with the nervous, malignant,

* The white decoction is made by boiling two ounces of calcinedhartshorn prepared, and two or three drams of gum Arabic, in threeEnglish pints of water till only two remain, afterwards straining theliquor.

f Spirit of Mindererus is made by taking any quantity of the vola-tile sal ammoniac and gradually pouring upon it distilled vinegar tillthe effervescence ceases. The mixture may be occasionally stirred topromote the solution of the salt.