A
TREATISE
ON
FEBRIS ASTHENICA GRAVIS,
OR THE
SEVERE ASTHENIC CONTINUED FEVER.
BY
PETER FAUGERES,
Surgeon and Practitioner of Physic, New-York.
OBSCURIS OMNIBUS REJECTIS.
NEW-YORK:
PRINT BY HARRISSON & PURDY, No. 3.
PECK-SLIP.
M.DCC.XCI.



To LEWIS FAUGERES, Esquire,
Surgeon and Practitioner of Physic, New-York.
Honoured Sir,
THE gratitude I owe you for the liberal
aid which you have always afforded me,
when in the pursuit of science is sufficient, inde-
pendent of any other consideration, to induce
me to offer you the following Treatise. On
perusing it, you will find I have considered,
under the same head, a variety of phenomena or
symptoms, which, by many Physicians, are ima-
gined to constitute very different and opposite
diseases: In this I trust I have followed nature,
instead of being misled by the false and unnatu-
ral distinctions every where to be found in sys-
tems of modern nosology. The false for divid-
ing diseases into a variety of species hath descen-

(vi)
ded from Aristotle, who taught men, with silly
pains, to subtilize away sense in terms and dis-
tinctions, when no difference in nature exists.
If it hath been found from experiment and ob-
servation, that two diseases (as they are com-
monly imagined to be) have been produced by
the same cause, and both afterwards cured by
the same remedy, would it not be absurd to sup-
pose them to be different, merely because the
symptoms were not alike in both?
The evidence, by which I have been led in
my enquiries on this subject (and the only kind
of evidence that can lead directly to truth and
certainty in medicine) is that, which appeared
on maturely considering both cause and effect.
THE method of cure which is recommended
is somewhat different from any that has been hi-
therto proposed, yet I trust you will not reject
it on that account, but first make trial of the
plan which is pointed out, and if it proves not
more prosperous than the common practice of
treating the disease, I will willingly accept of
a better.

(vii)
I cannot, in justice to myself, conclude this
dedicatory part, without acknowledging my
obligations to Doctor Gibbons, for the advan-
tages I have received from his valuable les-
sons in both the theory and practice of Medi-
cine. 
I have the honor, Sir, to be
your much obliged and
dutiful Son,
PETER FAUGERES.
New-York, 1791.



A TREATISE, &c.
DR. SYDENHAM hath justly observed,
that in writing the history of a disease,
every manifest and natural phenomenon should
be faithfully and accurately described, while eve-
ry hypothesis, which may have prepossessed the
writer in its favour, ought to be totally laid
aside.
With this idea therefore, I proceed to write
the history of a disease, considering it improper
to separate the necessary, peculiar and constant
phenomena or symptoms, which would consti-
tute the definition, from the common, natural,
and accidental ones, which ought to be com-
prehended in the general history.
I begin with a description of what has been
denominated the Typhus Mitior, or slow Nervous
Fever, and shall proceed to what I consider on-
ly higher degrees of the same disease, but known

(10)
and described by writers under different appel-
lations, and for reasons which I shall hereafter
mention.
Of the Character of the Disease.
THE person is affected, first with a langour,
or sense of debility, a weariness like what is felt
after great fatigue; soreness of the muscles, an
aversion to motion, and a sluggishness and unea-
siness in exerting it. The patient frequently
yawns, and stretches his limbs; there is a pale-
ness of the face and hands; a sensation of cold
alternating with sudden and uncertain flushings
of heat; the features shrink, and the bulk of
the external parts of the body is diminished, at-
tended with a loss of appetite, an aversion to food,
sickness and sometimes vomiting: These are
accompanied with an heaviness and dejection of
spirit, anxiety, inquietude and frequent sighing.
At this time there is a pain and giddiness in the
head, great trembling, a frequent, weak and
unequal pulse, anxious and oppressive respirati-
on, with a sense of tightness and oppression about

(11)
the præcordia, attended sometimes with a cough.
The person is commonly restless and cannot
sleep, though sometimes very drowsy and heavy;
and although he appears to bystanders to be ac-
tually sleeping, he is insensible of it, and often
denies that he was so.
In this condition the patient often continues
for five or six days, without an aggravation of
all the symptoms, especially towards night *. As
the disease continues, the symptoms which we
have enumerated, increase, while others, next
to be described, come on.
The giddiness, pain, and heaviness of the
head, are often attended with a noise in it,
termed Tinnitus Aurium; at this time there
is great sensibility to light and noise, the
skin is hot and dry; the tongue grows dry and
parched, especially in the middle; and trembles
very much when the patient attempts to put it
out; partial cold sweats frequently come out on
the forehead and backs of the hands, while the
cheeks and palms are dry and hot; the urine is
passed limpid and pale, the person grows faint
* Huxham on Fevers, Chap. vii. page 75.

(12)
when he attempts to sit up, an incoherence in
mental operation, and at length a confusion of
thought and action takes place; the sick falters
in his speech, appears in a dozing state, often
picking the bedclothes, and continually mut-
tering to himself, and when roused he some-
times thinks he is surrounded by muscæ volitan-
tes, little flies or small bodies floating in the
Chamber, but soon falls again into an insensible
state.
In the course of the disease the sweats become
more profuse, cold and clammy, a diarrhœa
often happens, the pulse becomes so weak and
quick as scarcely to be distinguished, while the
muscles tremble and are frequently moved by
feeble convulsive motions, which are termed
subsultus tendinum The sick is unable to
move his limbs or turn himself in bed, and is
continually slipping down in it: at this time ex-
coriations of the parts on which he lies, especi-
ally of his hips, are common.
In this insensible stupid state, he is scarcely
affected with the loudest noise or strongest light;
though at the beginning of the disease he was
very sensible to both; he gnashes his teeth; the

(13)
tears, urine, and stools, run off involuntarily;
the extremities become cold, and he appears to
be continually choaking or hiccuping is affected
with general tremblings and convulsions, to
which succeed a profound coma, and lastly
death.
Besides the symtoms just enumerated it is
proper that I should take notice of some others,
which frequently occur, and which, when ap-
pearing, have led physicians of great eminence
to believe, that a disease was constituted very
different, both as to the causes and method of
cure, from the one I have attempted to describe.
When the symptoms already mentioned in-
crease more rapidly: When the heat and thirst
seem to be greater, and the tongue and teeth
more furred, when blood happens to issue
from the pores of the skin or anus, but more
especially from the nose and gums; and when
the stools, urine, sweat, and breath of the pati-
ent are very fetid and offensive, the disease then
gets the name of Synochus or Putrid Fever. †
† It is difficult, says Dr. Cullen, to assign the limits between
Synochus and Typhus “and I am disposed to believe that the
Synochus arises from the same causes as Typhus and is therefore
only a variety of it" Practice of Physic. Chap iii. p. 70 sec. lxix. 

(14)
If to the symptoms described, black, livid,
dun, or greenish spots should happen to ap-
pear, the disease has taken the name of Petech-
ial ‡ but, if after a profuse sweating, a small
white or red eruption should break out, which
sometimes happens, the disease is then called the
Miliary Fever, when the disease attacks a great
number of persons, and proves very fatal, it is
denominated Malignant.§ When it appears
amongst soldiers, it is called the Camp; when
it happens in a prison, the Jail; and when in an
infirmary, the Hospital Fever.
I consider all these different denominations of
fevers one and the same disease, differing only
in degree, which affords, to be sure, some inessen-
tial difference in the phenomena, but none, ei-
ther in the cause or method of cure. Nay I will
not stop here, but venture an opinion, that
the Yellow Fever of the West-Indies, the An-
gina Ulcerosa of Dr. Fothergill, the Puer-
peral Fever, the Typhus Pestilens of authors,
and the Plague, are only varieties or different
degrees of the same disease, to which I have
‡ Huxham on Fevers, Chap. viii. page 93.
§ Monro on Military Hospitals.

(15)
given the name of the Febris Astthenica Gravis ‖ or
the Severe Asthenic Continued Fever, compre-
hending under that general appellation all the dis-
tinctions already mentioned. I shall, therefore,
constantly hereafter, employ the term Severe Asthe
nic Continued Fever, with a view to its proximate
cause, and intend to include all the phenome-
na, or symptoms comprehended in the several
disorders, known and described by different
writers by the names of Typhus, Synochus,
Petechial, Miliary, Malignant, Camp, Jail,
Hospital and Yellow Fevers, as also the putrid
Sore Throat and the Plague.
Therefore, little anxious about enquiring in-
to the particular causes of all the symptoms
which have been enumerated, I will proceed to
enquire into the causes of the disease in gene-
ral; for I consider the study of symptomatalogia,
or the explication of symptoms, far less useful,
than the one we are next to engage in, and altho'
I should not be able to offer a new idea on the
subject, yet I believe it is sometimes of advan-
tage to science and improvement, to throw
doubts in their way.
‖ I add Gravis to distinguish it from Intermittents.

(16)
Of the Causes.
THE Severe Asthenic Continued Fever is
frequently epidemic, and hence it has generally
been supposed, that some matter floating in the
atmosphere and applied to the bodies of men,
ought to be considered as the most common cause
of it. The matter has been denominated efflu-
via or contagion, it is supposed to arise from
infected clothes, or the body of a person la-
bouring under the same kind of a disease.
That the bodies of men, when crouded in a
confined place, but more especially when la-
bouring under a febrile disease, have a power of
generating a noxious effluvia, and that such ef-
fluvia may adhere to clothing, especially woollen
or cotton, and afterwards affect a sound person,
I will not positively deny.
It is true, that when men have been crouded
together in a jail, hospital, prison-ship, &c.
they have contracted fevers of the character of
which I am writing; but whether the fever arose
from any peculiar matter generated by the men's
bodies, or whether it arose from a deficiency of

(17)
pure atmospheric air, with other debilitating
powers co-oporating; such as a want of good
wholesome food and drink, too much filth and
dirt, fear, grief, &c. appears to me to be ve-
ry doubtful. But it may be asked; what proof
have we then of the contagion of the small pox
or measles? I answer, we have positive proof;
as nothing for example, but the matter or efflu-
via, arising or taken from the body of a person
labouring under the small pox, will produce
that specific disease: but this is not the case with
the disorder I am considering, for we have ma-
ny indubitable testimonies to prove, as I shall
hereafter shew, that fear and cold and a variety
of other causes have produced the disease, when
there was not even a suspicion that contagion
had been applied. However, to avoid argu-
ment, I will admit, that a noxious matter or
contagion may be generated by the body of a
man under a particular disease, and when appli-
ed to a sound person may communicate to him
a similar complaint. It will, I believe, be ad-
mitted, that the origin, and nature of contagion,
are involved in great doubts and difficulty, and
C

(18)
as to its operation, all we know about it, we
gain from obvious effects: these we find the
same as those arising from more certain and
more evident causes, we judge, therefore, that the
operation of contagion is no wise different from
the operation of other powers, as the effects are
the same.
The next cause to be mentioned, I think
much less doubtful, that is excessive heat.
Heat is one of the most powerful and uni-
versal stimulants in nature, and when applied
to the human body in a certain measure, it af-
fords that degree of excitement *, necessary to
constitute health from that particular stimulus,
but when either increased or diminished be-
yond a certain point, there is no power in na-
ture, capable of diminishing excitement, and
of inducing debility and death, more speedily
and more certainly. It appears from the most
* I shall make use of terms throughout that perhaps may not
be fully understood by every reader, but I presume no medical
one will be ignorant of their just meaning; if he should, let
him consult Dr. Brown's Elements of Medicine, and he
will there find them clearly and elegantly defined.

(19)
accurate experiments and observations, that
sixty-three degrees of external heat * is the most
healthy and agreeable point the human body can
possibly be placed in, although the relative de-
grees of the same power, are established be-
yond all possibility of doubt †. When the heat
of any body therefore is diminished considera-
bly below sixty-three degrees, we then say such
a body is cold, meaning thereby that it is depri-
ved of the agreeable quantity of heat, and
when applied in this condition to the human
body, it has the power of lessening the excite-
ment, and with this the strength and vigour of
the whole system, and that in exact proportion
to its diminution, even to death itself. Cold
therefore has been justly considered, as one of
the causes of the Severe Asthenic Continued
Fever ‡. Beside cold, there are other powers,
such as fear and grief, intemperance in drink-
ing, excessive evacuations, night watchings,
* When I speak of the degrees of heat, I mean as measured
by Farenheit's Thermometer.
† Dr. Gibbon’s Lectures on the Theory and Practice of Me-
dicine.
‡ Cullen's Practice of Physic, chap. iv.

(20)
excessive venery §, all of which lessen the vi-
gour and weaken the system, and are common
causes of this disease.
Of the Proximate Cause.
IF we may be allowed to judge from the uni-
versal and general operation of the powers pro-
ductive of this disease, but more certainly from
the symptoms attending it, and still more cer-
tainly from the remedies, which have been found
most effectual in removing it, I would say that
its proximate cause consists in a diminution of
healthy excitement over the whole system, or
in a state of debility: That this is really the
case appears evident from the general phenome-
na accompanying it; I will give a concise view
of them as proofs of what I assert, and at the
same time will explain such symptoms as ad-
mit of a more particular explication. I judge
it unnecessary to enter into any arguments
to prove that the doctrine of spasm, which has
been generally received, is incompatible with
§ Immoderata seminis profusio non tantum utilissimi humo-
ris jactura, sed ipso etiam motu convulsivo, quo emittitur,
frequentius repetito, imprimis lædit.
Gaubii. Patholog. sec. 562.

(21)
truth, and irreconcileable to reason; this would
extend the work far beyond what seems to me
to be necessary. Such of my readers as wish
to see that false fabric of medical learning fully
demolished, I must refer to the writings of the
illustrious Dr. Brown ‖, in them they may re-
ceive ample satisfaction, and save me the trou-
ble and pains of writing.
But to return.
What can prove debility more clearly
than is manifested by the languor and lasti-
tude of the patient in the onset of the disease?
Do not the want of appetite ¶, vomiting, fre-
quent weak tremblings, coldness of the ex-
tremities, cold clammy sweats, weakness and
slowness of the pulse *, frequent sighing, inabi-
lity to walk or even to sit up, or turn the body
in bed, as the disease continues, all prove the
‖ Particularly his observations.
¶ The cause of appetite in health, depends upon the strong
and vigorous contraction of the muscular fibres of the sto-
mach, and the emptiness of that organ; but when the fibres
are feebly and weakly contracted, the gastric fluid improperly
secreted, and the stomach unable to digest or evacuate its con-
tents, we have then anorexia or a want of appetite.
* Both depend on the want of a sufficient quantity of
blood to stimulate the heart and larger arteries to stronger con-
tractions.


(22)
same thing? And towards the end, are not con-
vulsions, deafness, loss of sight, blood issuing
from different parts of the body, great fœtor
of the breath, stools, and urine, livid spots
upon different parts, or a yellow suffusion over
the whole of the skin, asthenic swellings and
inflammations appearing in different parts of
the body, paralysis of particular muscles, total
insensibility and death, indubitable proofs of
the debility of the whole system?
Presuming therefore that debility, or a weak-
ened state of the body, is the immediate or
proximate cause of the disease I have been de-
scribing, the general indication of cure should
be to strengthen and invigorate the system by
every means in our power, and to fulfill that
purpose, the following plan should be care
fully and diligently pursued.
Of the Method of Cure.
WHEN a person is affected with the Severe
Asthenic Continued Fever, he should be remo-
ved as soon as possible to a well ventilated cham-
ber, the heat of which should be kept con-
stantly between sixty-three and seventy degrees;


(23)
his bed should be made as easy and as comfort-
able as circumstances will admit of.
If the patient should complain of great op-
pression, or, as is commonly expressed, a load,
heat, pain, and sickness of his stomach, and
has previously ate much solid or indigestible
food; or if the climate or season should be such,
as to favour an abundant secretion of bile, and
the contents of the stomach have not been fully
ejected by nature, vomiting should be excited
by art. For this purpose ipecacuanha or tartar
emetic may be used: the former I believe pre-
ferable.
After the vomiting is finished, a dose of li-
quidum laudanum should be administered.
If the bowels of the patient should happen
to be costive, the only remedy to be used to re-
move that complaint, is some mild laxative
medicine, or what is perhaps preferable,
frequent tepid injections; on the contrary, if
neither indigested matter nor bile be suspected
of oppressing the patient's stomach, nor costive-
ness his bowels; neither vomiting nor purging
should be excited by art, as both these opera-

(24)
tions from whatever cause they may be produ-
ced are highly debilitating powers, and as such?
never fail to increase the cause of the disease.
Therefore, after having the sick placed in as
comfortable and easy a posture as possible, with
the heat of the apartment regulated as I have
already recommended, the cure should com-
menceby giving him small doses of opium in
some way or other: The liquidum laudanum
is perhaps the best form.
Physicians differ widely in their opinions con-
cerning the nature, operation, and effects of opi-
um, but they seem generally to agree that it is
a very useful and important remedy in the vari-
ous forms and stages of the disease of which I
am writing It must be admitted, indeed, that
till very lately, opium has been considered ra-
ther as a palliative remedy, than one suited to
remove the cause of the disease; but since the
opinions and writings of the immortal Bruno
have become more generally known and consi-
dered, and Physicians have paid more attention
to this important article of the Materia Medica,
its operation and effects remain no longer
doubtful.

(25)
Opium is one of the most powerful stimulants
that the history of medicine affords, and as such
it is well suited to remove the cause of the dis-
ease in queftion. It should be given in a
liquid form in preference to any other, not only
as in that way it will act more suddenly, but in
general be freer from impurities of any kind
that might oppress or nauseate the patient's
stomach.
The best way of administering opium in this
disease, is as already observed in the form of li-
quidum laudanum, beginning by giving ten or
fifteen drops in some warm and agreeable cor-
dial, and repeating the dose every three or four
hours, until ease and a certain degree of excite-
ment are procured, after which the operation
should be kept up by renewing the dose occa-
sionally; but as soon as the patient's stomach is
able to bear the more natural stimulus of wine
or distilled spirits *, their use should immedi-
ately commence, by administering either the one
or the other in small potions at first, frequently
D
* I call wine and distilled spirits natural stimuli, and
for the propriety of the appellation, I rest on the authority of
a very judicious and ingenious teacher of medicine.


(26)
repeating them, and increasing the quantity at
every succecding dose. As the quantity of the
natural stimuli is increased, that of the lauda-
num should be diminished, but never entire-
ly witheld for any length of time until that
degree of excitement, strength, or vigour of
the system is restored, as will enable the patient
to desire, take, and digest the more durable
stimulus of food †.
It has been found that laudanum acts more
agreeably and quicker when warm than when
cold ‡; it ought therefore always to be given in
that state.
In the exhibition of opium, regard should
always be had to the age, ex, and habit of the
patient. Forty drops of liquidum laudanum I
consider as a moderate quantity to be taken in
twelve hours by an adult but little accustomed
to it, nor should the nature of the debility
constituting the cause of the disease,
overlooked. If it be of the direct kind, the
opium will operate with greater force,  and I
† See Dr. Brown's Elements of Medicine.
‡ See Dr. Leigh's Experiments on Opium.


(27)
may observe here that the same will happen, to
all the stimuli I am hereaster to mention, and
hence less should be administered at first, than
as if the debility was of a different or of the in-
direct kind.
The next most useful and important remedy
is wine or distilled spirits of some kind or other.
When the former is preferred, and perhaps it
will be in general, I would advise good old Ma-
deira or genuine Port, when the latter the pa-
tient's former habit should be consulted, and
that kind given him that he was before accus-
tomed to.
The wine may be given pure, but the spirits
should be diluted with water, and sweetened if
more agreeable to the patient's stomach; they
should be given warm, and if spiced they will
be more efficacious.
Musk is a stimulus of considerable efficacy,
and in some instances, as when the patient has
a troublesome singultus or hiccupping, it may
be used with advantage, but opium will in ge-
neral supercede the necessity of its use.

(28)
The same may be said of camphor.
The vitriolic æther is a very high and agree-
able stimulus, but it is too diffusible to be of
general utility in this disease; it however may
be occasionally used with advantage.
The volatile alkali is frequently used, and
much recommended by some Physicians, but
its operation like that of æther passes off too
quickly to be of much service, and if given in
large quantities may produce purging, an effect
which ought to be avoided, besides it is an un-
natural stimulus §, and as such it may diminish
the general excitement of the system, so that I
think it may with propriety be laid aside in or-
der to give place to a less doubtful remedy.
I have already observed, that as soon as the
patient's stomach craves, or can bear any food,
it should be administered, and in such a form
as that it will most probably be retained and
digested, and of such a nature as to afford a
great quantity of nourishment in a small bulk.
Fresh animal soups are well calculated to fulfil
§ Dr. Gibbon's Manuscript Lectures.


(29)
that purpose. They should be given warm,
well seasoned with salt and pepper and without
any fat or greasy matter. The best way is to
begin by giving a spoonful at a time, and encreas-
ing the quantity as the patient's stomach is able
to bear it, and that this organ may be rendered
more capable of performing the important of-
fice of digestion, the natural diffusible stimuli
should be thrown in, at the same time, taking
care not to extend their operation so far as to
induce indirect debility.
Beside the remedies recommended, there are
others of no less importance in the cure of the
disease.
The operation of the mind has a powerful
influence on the body. Hence the uncertain-
ty of life and the fear of death, is a very pow-
erful means of diminishing the excitement of
the system in general, and ought in this disease
to be carefully guarded against ‖. The patient's
mind ought to be inspired with hope as to the
curable nature of his disease, and with joy that
he has an attentive and skilful physician admini-
‖ Dr. Gibbon's Lectures on the Theory and Practice of
Medicine.

(30)
stering to his relief. The nurse or attendants
ought to be careful and soothing to the sick,
and entirely obedient to the physician ¶, and
every means should be contrived to raise the
hope and confidence of the sufferer.
That quantity of light, which excites nei-
ther pain nor uneasiness, should be admitted.
Would beautiful or agreeable objects presented
to the sick, be of advantage in the cure of the
disease.
The patient should be kept free from noise
except agreeable founds or soft harmonious mu-
sic; and how far those ought to be admitted, I
am unable to determine.
It is well known to physicians, that when a
patient in this disease, has been just falling into
a delirium, that by admitting a stronger light,
or by a perfon speaking to him, he has imme-
¶ I believe good physic and good advice have often failed
of success, not only in this, but in most other diseases, for
want of being properly administered. Nurses are very apt
to take it into their heads that they know as much about curing
a disease as the Doctor, and hence his potions and directions
are frequently thrown aside or neglected, nubile their igno-
rant and absurd notions are put into full practice at the imi-
nent risque of the patient's list.



(31)
diately been roused from his approaching
insensibility.
The patient's chamber should be kept free
from all fetid, nauseous, and excrementitious
matter. What advantage might be obtained
by fragrant agreeable odours?
The bed clothes and body linen should be
frequently changed, and the body bathed in
warm spirit (or brandy and water) taking care
that his linen be perfectly dry, and his body
well wiped after the application *.
Few things destroy the strength equal to per-
petual watching. Sleep is the sick man's ely-
sium, it is the state he most desires, and as it suf-
tains his hopes, it prevents delirium and con-
vulsions, and refreshes and recruits the strength
and vigour of his system. To procure it, there-
fore, is of great consequence; and if the gene-
ral plan which I have recommended for the cure
* I have been informed by a physician of experience, that
bathing the body with equal parts of brandy and water about
milk warm, and giving a dose of laudanum, is one of the
most powerful means of checking those profuse sweatings which
harrass and debilitate patients so excessively in this disease.



(32)
of the disease, be strictly followed, I apprehend,
freshing sleep will in general be a natural con-
fluence. Dr. Fordyce †, speaking of the
means of procuring sleep in putrid fevers, says,
"That opium given with lemon juice, one or
two grains of the one with a spoonful of the
other, has such wonderful effects as to deserve
the character of a cure wrought by the hand of
God, when every other remedy has failed;"
and he further says, "That Sir William Dun-
can, by giving him one hundred and seven drops
of laudanum, cured him (Dr. Fordyce) of a de-
lirium under which he had laboured for four
days, in a miliary fever."
It is of consequence that strict attention be
paid to the excretions by stool and urine, to ob-
viate costiveness, if it should happen, in the
way I have already recommended, and to check
diarrhoea by the proper remedy. I was led to
this observation by a circumstance which I have
either read or heard has actually happened, I
mean that by an accumulation of urine, and
† On Fevers, page 165.



(33)
from the imennble state of the patient and inat-
tention of the physician, the bladder has actual-
ly been bursted, and the contents discovered up-
on dissection in the cavity of the abdomen; if
therefore the urine should not be passed daily,
nor can be made to pass by rousing the sick, nor
by making a noise imitative of passing it, as
by pouring water from a tea kettle, &c. a cathe-
ter should be introduced to obviate what may
possibly happen, and when happening may put
it out of our power to remedy.
When the disease affects one part more than
another, as happens to the throat, in that form
of it termed cynanche maligna, or to the glands
in that disease denominated the plague, besides
the general method of cure already recommend-
ed, some attention should be paid to the suffer-
ing part, in order to prevent a general or uni-
versal affection, producing or degenerating into
a local one. Therefore warm stimulating gargles
and other applications of a similar nature, should
be occasionally used, but what are belt suited or
E


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this purpose, I confess l am at a loss to deter-
mine.
When the disease begins to go off, the patient
should increase the quantity of the durable, and
diminish the quantity of the diffusible stimuli, es-
pecially the less natural ones, until his strength
shall be so far restored as to enable him to use
gestation, or exercise: When this is accomplish-
ed, there will be little fear of a relapse, provided
care is taken to avoid debilitating powers;
such as contagion, cold, excessive venery, night
watching, blood letting, purging, vomiting,
grief, fatigue, eating indigestible or but weakly
stimulating vegetable food, taking cold watery
drinks, and lastly, suffering the mind to be op-
pressed by anxiety, fear, or grief.
I am well aware that it will be thought that I
have neglected mentioning in the cure of the
disease, a remedy of great and general utility,
that is blistering, I confess that therein I am not
quite satisfied. I could produce the testimonies
of many respectable medical practitioners, both
ancient and modern, to prove not only the inu-


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tility, but the actual diservice of blisters in this
disease ‡. I have also omitted recommending
the use of the peruvian bark, because I conceive
it to be a very weak and inefficacious remedy—
Besides when given in substance, it is apt to ex-
cite nausea, and frequently vomiting, effects
which ought to be carefully guarded against in
this disease.
I have no prejudice, nor have I taken the
pains and trouble to write from vanity, it
was from an ardent desire that truth in the
science of medicine may be discovered, and
that thereby we may be better able to preserve
the health and increase the happiness of man-
kind.
‡ See Tissot de Febris Biliosa, Baglivi Van Sweeten,
or Beerhaave's seventy-fifth aphorism, Carol, Richa on the
putrid fever of Turin, and Fordyce on fevers, page 146,
148—The latter writer, speaking on this subject, observes,
"That it is really shocking to see the manner in which the sick
are thrown upon the rack in most fevers, by having their
heated and agitated bodies almost embalmed with blister
plaisters, and that he pretests against their application in every
fever with loose blood and putrid symptoms—See Fordyce on
Fevers, page 172.
FINIS.