Encyclopaedia Britannica, or, a Dictionary of arts, sciences, and miscellaneous literature : enlarged and improved. Illustrated with nearly six hundred engravings > Volume 13, MAT-MIC

Pradice _ MED
Febres. ration and urine by the plentiful ufe of diluents. That
u—v 1 which remains in the body may be rendered more mild
and innocent by the ufe of diluents, or may be corredt-
ed by the ufe. of antifeptics. Thefe laft are of many
and various kinds; but which of them are conveniently
applicable, or more particularly fuited to the cafe of
fevers, is not well afcertained. Thofe moft certainly
applicable and ufeful are acefcent aliments, particularly
fruits, acids of all kinds, and neutral falts.
Ihe progrefs of putrefaction may be confiderably
retarded, and its effedls obviated, by fupporting the
tone of the veffels •, and this may be done by tonic
medicines, of which the chief are cold, and the Peru¬
vian . bark, as already mentioned. The violence of
readtion increafing the tendency to putrefadtion, may
be moderated by the means already mentioned under
Sijnochn.
1 hefe are the proper indications to be obferved in
the cure of the How nervous fever; and they are
chiefly fulfilled by cleanlinefs, cool air, and diluents;
which, perhaps, upon the whole, are more ufeful in
fevers, than all other pradlices put together. Dr
Huxham obferves, that evacuations (efpecially bleed-
^ng)> are improper even at the beginning. Even a
common purgative given at this time' hath been follow¬
ed by furprifing languors, fyncope, and a train of other
ill fymptoms. It may, however, fometimes be necef-
fary to cleanfe the ftomach and primae vise by a gentle
emetic, or a mild laxative. Indeed, where naufea, fick-
nels and load at ftomach are urgent, as is frequently
the cafe in the beginning of this fever, a vomit is ne-
ceflary. Clyfters of milk, fugar, and fait, may be
injedled with fafety and advantage every fecond or
third day, if nature wants to be prompted to ftool.
The . temperate,, cordial, diaphoretic medicines, are
certainly, according to our author, moft proper in thele
fevers; afid a well-regulated, fupporting, diluting diet
is neceflary. The latter of itfelf, judicioufly managed,
will go a great way in the cure, efpecially if aflifted by
well-timed and well-applied blifters, and a due care to
keep the patient as quiet as poftible both in body and
mind. But it ftiould be noted, that ftrong opiates are
commonly very pernicious, however much the want of
fleep and reftleflhefs may feem to demand them. Mild
diaphoretics, fuch as neutral draughts or elixir pare-
goricum, have much better efFedls 5 which, by raifing a
gentle ealy fweat, or at leaft a plentiful perfpiration,
calm the hurry of the fpirits, and a refrelhing fleep en-
fues. Where the confufion and dejedlion of fpirits are
very confiderable, blifters have been advifed to be ap¬
plied to the neck, occiput, or behind the ears 5 and dur¬
ing all this a free, ufe of thin wine whey, feme pleafant
ptifan or gruel, with a little pure wine* muft be directed.
Indeed the patients, in this cafe ftiould drink frequent¬
ly : though fuch quantities may not be neceflary as in
the ardent or even putrid malignant fevers 5 yet they
fliould be fufficient to carry on the work of dilution,
upport the fweats, and fupply the blood with frefli and
wholefome fluids, in place of that noxious matter which
is continually pallingoff. In this view alfo a thin chicken-
broth is of fervice, both as food and phyfic, efpecially
towards the. decline of the difeafe 5 and for the fame
realon thin, jellies of hartlhorn, fago, and panada, are
uietul, adding a little wine to them, and the iuice of
orange or lemon.
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it is oblervable, that the lick are never fo eafy as Typhus,
when they are in a gentle fweat} for this foon removes
the hurry of fpirits, exacerbations of heat, &c. But
profufe fweats Ihould never be encouraged, much lefs
induced, by very ftrong heating medicines, efpecially
in the beginning or advance of the fever ; for thev
too much exhauft the vital powers, and are followed
by a vaft dejedion of fpirits, tremors, ftartings of the
tendons, and fometimes end in rigors, cold° clammy
fweats,. fyncope, or a comatofe difpofition. Some¬
times irregular partial heats and flufhes fucceed, with
great anxiety, reftleflhefs, delirium, difficulty of breath-
ing, and a vaft load and oppreffion in the prsecor-
dia, fo as to incline the lefs cautious obferver to think
there may be fomething pneumonic in it 5 but even
here we muft beware of bleeding, as the pulfe will be
found very fmall and unequal, though very quick. Nor
is bleeding contraindicated only by the weaknefs and
fluttering of the pulfe, but alfo by the pale, limpid,
and watery urine which is commonly attendant. Thefe
fymptoms denote the load, anxiety, and oppreffion on
the prtecordia to proceed from an affedion of the ner¬
vous fyftem, and not from a pneumonic obftrudion or
inflammation, d he breathing in this cafe, though thick
and laborious, is not hot, but a kind of fighing or fob¬
bing refpiration, nor . is there often any kind of cough
concomitant; fo that it has been conjedured to proceed
from fome fpafm on the vitals. Here therefore the
nervous cordial medicines are indicated, and blifters to
the thighs, legs, or arms.
1 he above-mentioned difficulty of breathing, anxie¬
ty, and oppreffion, many times precede a miliary erup¬
tion, which often appears on the feventh, ninth, or
eleventh day ol the fever, and fometimes later. In¬
deed great anxiety and oppreffion on the prascordia al¬
ways precede puftular eruptions of any kind in all
forts of fevers. 1 his eruption fliould be promoted by
foft eafy cordials and proper diluents; to which ffiould
be fometimes added fome gentle aromatics. Thefe
tend to calm the univerfal uneafinefs commonly com¬
plained. of, and alfo very effeftually promote a diapho-
refis, with which the miliary eruptions freely and eafily
advance. But however advantageous thefe commonly
are, profule fweats are feldom or never fo, even though
attended with a. very large eruption. Two or three
crops of thefe miliary puftules have been known to fuc-
cecd one another, following profufe fweats, not only
without advantage, but with great detriment to the
patients, as they were thereby reduced to an extreme
degree of weaknefs ; fo that they may juftly be reckon¬
ed fymptomatic rather than any thing elfe, and the con-
fequent eruption is often merely the fymptom of a fymp-
tom. , r
In thefe profufe colliquative fweatings a little gener¬
ous red wine (diluted fomewhat, if necellarv) may be
given with the great eft advantage ; as it prefently mo¬
derates the fweats, fupports the patient, and keeps up
the miliary papulae if they happen to attend. Towards
the decline of the fever alfo, where the fweats are
abundant and weakening, fmall dofes of the tindlure of
cinchona with laffron and fnakeroot may be given with
the greateft advantage, frequently interpofmg a dofe
ox rhubarb to.carry. off the putrid colluvies in the firft
paflages ; which withal makes the remiffions or inter-
miffions that often happen in the decline of nervous
fevers
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