a, The impressions made upon our senses, particu a, Increased heat, whether arising from 68, The accumulation of the heat of the body. b, The exercise of the body, c, The exercise of the mind, d, The taking in of aliment. e, Particular irritations arising from a, The sense of thirst, 8, Crudities, or corrupted humours, in the stomach, 7, The preternatural retention of fæces, , A general acrimony of the fluids. B, Employing certain sedative powers; as, b, Refrigerants; the chief of which are, ß, Neutral salts, 7, Metallic salts. C, Diminishing the tension and tone of the arterial system, by a, Bloodletting, b, Purging. 2, Taking off the spasm of the extreme vessels, by A. Internal means; which are, Those remedies which determine to the surface, as, a, Diluents, 6. Neutral salts, 7, Sudorifics, , Emetics, b, Those remedies, named antispasmodics. B, External means; as, a, Blisterng, b, Warm bathing. II. To remove the causes, or obviate the effects, of debility, by 1, Supporting and increasing the action of the heart aa, Saccharum saturni, &c. or 8, Vegetable, as, aa, Peruvian bark. B, Stimulants, as, a, Aromatics, &c. b, Wine. III. To obviate or correct the tendency of the fluids to putrefaction, by 1, Avoiding the application of putrid or putrescent matter, by A, Removing the patient from places filled with corrupted air. B, Correcting the air from which he cannot be re moved. C, Avoiding the accumulation of the patient's own effluvia, by a, A constant ventilation, b, Frequently changing the bed-clothes and body linen. D, Removing carefully and speedily all excremental matters. E, Avoiding animal food, or correcting it. 2, Evacuating the putrid or putrescent matter already present in the body, by A, Evacuating frequently the intestines. B, Supporting the excretions of perspiration and urine, by a, Diluents, b, Neutral salts. 3, Correcting the putrid or putrescent matter remaining in the body, by A, Diluents, B, Antiseptics, C, Fixed air. 4, Resisting farther putrefaction, or obviating its cffects, by Supporting the tone of the vessels, by Tonic remedies. SECT. II. Of the Cure of Intermittent Fevers. 228. It still remains to consider the cure of intermittent fevers; and with respect to these, we form also three general indications. 1. In the time of intermission, to prevent the recurrence of paroxysms. 2, In the time of paroxysms, to conduct these so as to obtain a final solution of the disease. 3, To take off certain circumstances which might prevent the fulfilling of the two first indications. 229. The first indication may be answered in two ways. 1, By increasing the action of the heart and arteries sometime before the period of accession, and supporting that increased action till the period of the accession be over, so as thereby to prevent the recurrence of the atony and spasm of the extreme vessels which give occasion to the recurrence of paroxysms. 2, Without increasing the action of the heart and arteries, the recurrence of paroxysms may be prevented, by supporting the tone of the vessels, and thereby preventing atony, and the consequent spasm. 230. For the purpose mentioned in 229, 1, the action of the heart and arteries may be increased. 1, By various stimulant remedies, internally given, or externally applied, and that without exciting sweat. 2, By the same remedies, or others so managed as to excite sweating, and to support that sweating till the period of accession be for sometime past. 3, By nauseating doses of emetics, given about an hour before the time of accession, thereby supporting and increasing the tone and action of the extreme vessels. 231. The tone of the extreme vessels may be supported without increasing the action of the heart and arteries (229, 2), by various tonic me dicines; as, 1, Astringents alone; 2, Bitters alone; 3, Astringents and bitters conjoined; 4, Astringents and aromatics conjoined; 5, Certain metallic tonics; 6, Opiates; Lastly, an impression of horror. A good deal of exercise, and as full a diet as the condition of the patient's appetite and digestion may allow of, will be proper during the time of intermission, and may be considered as belonging to this head. 232. Of all the tonic remedies mentioned (231), the most celebrated, and perhaps the most certainly effectual, is the Peruvian bark, the tonic power of which we have endeavoured to demonstrate above (214), and have, at the same time, explained its use in continued fevers. The same observation as made in 216, is especially proper in the case of intermittents: and further, with respect to these, the following observations or rules are offered here. 1, That the bark may be employed with safety at any period of intermittent fevers, providing that, at the same time, there be neither a phlogistic diathesis prevailing in the system, nor any considerable or fixed congestion present in the abdominal viscera. |