Wednesday, March 9

From the Medical Library


When a continual, remitting, or intermitting fever is accompanied with a frequent or copious evacuation of bile, cither by vomit or stool, the fever is denominated bilious. In Britain the bilious fever generally makes its appearance about the end of summer, and ceases towards the approach of winter. It is most frequent and fatal in warm countries, especially where the soil is marshy, and when great rains are succeeded by sultry heats. Persons who work without doors, lie in camps, or who are exposed to the night air, are most liable to this kind of fever.

If there are symptoms of inflammation at the beginning of this fever, it will be necessary to bleed, and to put the patient upon the cool diluting regimen recommended in the inflammatory fever. The saline draught may likewise be frequently administered, and the patient's body kept open by clysters or mild purgatives. But if the fever should remit or intermit, bleeding will seldom be necessary. In this case a vomit may be administered, and, if the body be bound, a gentle purge; after which the Peruvian bark will generally complete the cure.

*In the year 1774, during winter, a very bad species of this fever prevailed in Edinburgh. It raged chiefly among young people. The eruption was generally accompanied with a quinsey, and the inflamnatory symptoms were so blended with others of a putrid nature, as to render the treatment of the disease very difficult. Many of the patients, towards the decline of the fever, were afflicted with large swellings of the submaxillary glands, and not a few had a suppuration in one or both ears.

In case of a violent looseness, the patient must be supported with chicken broth, jellies of hartshorn, and the like; and he may use the white decoction for his ordinary drink. If a bloody flux should accompany this fever, it must be treated in the manner recommended under the article Dysentery.
When there is a burning heat, and the patient does not sweat, that evacuation may be promoted by giving him, three or four times a day, a tablespoonful of Mindererus's spirits mixed in a cup of his ordinary drink.

If the bilious fever be attended with the nervous, malignant, or putrid symptoms, which is sometimes the cafe, the patient must be treated in the same manner as directed under these diseases.

After this fever, proper care is necessary to prevent a relapse. For this purpose the patient, especially towards the end of autumn, ought to continue the use of the Peruvian bark for some time after he is well. He should likewise abstain from all trashy fruits, new liquors, and every kind of flatulent aliment.

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