PTRIXIM.
Frequent pulse, succeeded by shivering or horror ; increased heat ; disturbed func tions ; prostration of strength.
Pyrexy independent of local affection as its cause ; langour, lassitude, and other signs of debility.
This order is divided into two sections, an intermittent, including tertian, quer tans, and quotidian, with the different varieties of these distinct genera ; and continued, which include the genera of synchs, or simple inflammatory fever; typhus, putrid, or jail-fever ; and syno chus, a mixed fever, commencing like the first, and terminating like the second. The intermittent family are defined as fol lows : Fevers arising from the miasm of marshy grounds, with an evident remis sion, the returning fits being almost al ways ushered in by horror or trembling. One paroxysm only in the day. The con tinued !family are defined thus: fevers without intermission, not occasioned by marsh miasm, attended with exacerba tions and remissions, though not very per ceptible.
The remote causes of fever are not always to be easily or accurately distin guished, and of the proximate causes we may fairly be said to know nothing, since so many different conjectures, of ten in direct hostility to each other, have been offered, by writers of the first re putation, and the system of yesterday has so frequently fallen before that of to day. Without entering therefore into this controverted subject, we shall pro ceed to an account of the general symp toms and mode of treatment.
Intermittennr.—Synotoaa. A regular pa roxysm of this fever is divided into three stages—the cold, hot, and sweating stage.
The first stage commences with yawn ing and stretching; there is at the same time an uneasy sense of weariness, or in aptitude of motion, accompanied with some degree of debility; paleness and shrinking of the features and extremities are also observable; at this period some coldness of the extremities may be felt by another person, although the patient takes little or no notice of it ; the skin, however, becomes rough, as is tffe case in cold weather, and is less sensible than usual ; a sensation of coldness is now felt by the patient himself, which is at first referred to the back, and gradually spreads over the whole body, producing an universal shaking: after this has lasted for some time, the patient's sensation of cold still continuing, the warmth of his skin, to the feeling of another person, or measured by the thermometer, gradually increases; there is nausea, and frequently vomiting of a bilious matter; pains of the back, limbs, loins, and head-ach, or more commonly drowsiness, stupor, or a con siderable degree of coma, attend this stage ; the respiration is frequent and anxious ; the pulse is small, frequent, sometimes irregular, and often scarcely perceptible ; the urine is almost colour less, and without cloud or sediment.
As the cold and shivering, after alter nating for some time with warm flushings, gradually abate, the hot stage is ushered in by a preternatural heat, the pulse be comes full, strong, and hard, the respi ration is more free, but still frequent and anxious, the paleness and shrinking of the features, together with the constric tion of the skin, now disappear, and are succeeded by a general redness and tur gescence ; the tongue is white and dry, the thirst is considerable, the skin con tinues parched, the head-ach, if it was absent in the first stage, now comes on, is accompanied with throbbing of the temporal arteries, and frequently rises to delirium, and the urine is high coloured; as the hot stage advances, the nausea and vomiting abate, and on the appearance of moisture upon the skin, they generally cease altogether. The hot stage is at length terminated by a profuse sweat, which breaks out, first about the face and breast ; it gradually extends over the whole body, and terminates the paroxysm; most of the functions are restored to their natural state, the respiration becomes free, the urine deposits a lateritious se diment, the sweat gradually ceases, and with it the febrile symptoms: the patient is, however, left in a weak and varied state : between the paroxysms, the pa tient is more easily fatigued than usual, complains of want of appetite, and the skin is parched, or he is more liable to profuse perspiration than in health. The cold fit of this species is longer than that of the quotidian, but shorter than that of the quartan, and the whole paroxysm is shorter than that of the quotidian, but longer than that of the quartan.