2. Sydenham’s Works, p. 1, 2, &c.

3. Cullen, First Lines, S. 46.

4. Pathological Observations, Part II. on Continued Fever, &c. By W. Stoker, M.D. p. 32.

5. Ibid. p. 34.

6. Pathological Observations, &c. pp. 73, 74.

7. A Practical Treatise on the Typhus or Adynamic Fever, by John Burne, M.D.

8. Pathological Observations on Continued Fever, &c. p. 110.

9. Practical Treatise, &c. p. 161.

10. A Lecture upon Typhus Fever, by W. R. Clanny, M.D. p. 12.

11. Ibid., p. 16.

12. Observations on the Prevention and Treatment of the Epidemic Fever, by Henry Clutterbuck, M.D. p. 5, 6.

13. See a paper in the Medico-Chirurgical Review, for 1828, entitled An Eclectic Review on Fever.

14. Broussais’ exposition of his own doctrine in his own words is as follows. On doit regarder comme nÉcessairement affectÉs, dans une maladie, les tissus dont l’irritation est constante durant la vie, et qui en offrent toujours des traces aprÈs la mort. Or, les phÉnomÈnes de la sur-excitation des muqueuses, et surtout de la gastrique, ne manquent jamais, dans le typhus fÉbrile, puisque leurs symptÔmes sont identiques avec ceux des gastro-entÉrites sporadiques; tandis que ceux des autres phlegmasies ne s’y montrent qu’accidentellement. Ensuite, lorsque les personnes affectÉes de typhus out le malheur de succomber, on trouve toujours ces membranes rouges, brunes ou noires, pendant que les autres tissus n’offrent d’alteration que dans certaines circonstances accidentelles: done l’irritation des membranes muqueuses est insÉparable du typhus fÉbrile.

Les typhus fÉbriles sont donc des gastro-entÉrites, ordinairement compliquÈes de catarrhes pulmonaires; ces deux phlegmasies sont le rÉsultat d’un vÉritable empoisonnement, plus ou moins analogue À celui des champignons et des poissons gÂtÉes, et qui en a tous les caractÈres.

Le foie, principal annexe du canal digestif, est irritÉ secondairement, et sa sÉcrÉtion est plus ou moins augmentÉe. Plus le miasme est actif, plus cette lÉsion est marquÉe le typhus carcÉraires plus la chaleur est intense, plus l’irritation du foie est inflammatoire (la fiÈvre jaune.)

Le cerveau n’est inflammÉ primitivement que par l’effet de certaines circonstances qui ont fait prÉdominer l’action dans son tissu; telles sont les affections morales, la nostalgie, les chaleurs, etc.; mais il souffre toujours beaucoup par sympathie et quelquefois au point que son irritation passe au degrÉ de la phlegmasie, et devient aussi grave que si elle Était primitive.—Examen. de la Doctrine Medicale, par F. J. V. Broussais, p. 112–114.

Il n’y a de difference entre les gastrites qui sont ici dÉpeintes et ces fiÈvres, que celle qui dÉpend du degrÉ; car les gastrites aigÜes qu’on ne peut pas arrÊter arrivent toujours ou À l’ataxic ou a l’adynamic, dont les symptÔmes ne different pas de ceux du typhus. D’ailleurs, la gastrite dont il est ici question est dÉjÀ pour les ontologists, une fiÈvre ataxique.—Histoire des Phlegmasies, par F. J. V. Broussais, Vol. III. p. 39.

15. Observations on the Prevention and Treatment of Epidemic Fever, &c. pp. 11–12.

16. Thus Dr. Stoker states that the remedies “may be arranged according to their relative importance in the treatment of fever, in the following order; viz. In mixed fever, 1. Cleanliness. 2. Ventilation. 3. Cool regimen. 4. Plentiful dilution. 5. Purgatives. 6. Topical bleeding. 7. Antimonial or James’s Powder. In Typhoid Fever. 1. Yeast or barm. 2. Wine. 3. Aperients. 4. Emetics. 5. Blisters. 6. Tepid or cold affusion. 7. Peruvian bark.”—Pathological Observations &c., p. 111. In neither of these catalogues is general bleeding mentioned at all: in the first, topical bleeding is mentioned, but it is placed the last but one in the list, while in the second, allusion even to topical bleeding is wholly omitted. And Dr. Clanny states that the first proposition relative to the cure is how to restore sanguification, or how to afford fresh chyle to the blood; that although in full habits, at the commencement of typhus fever, general blood-letting is often attended with good effects, yet we should remember that if we take one ounce too much, we may thereby prevent sanguification altogether; that therefore it is better to have a sufficient quantity of lymphatic blood in the system them to run the risk of having too little of the pabulum vitÆ, for the purpose of carrying on the functions of life, and that in fact venesection is not called for in nine cases out of ten of typhus fever. Let me caution young practitioners, he adds, against the repeated use of the lancet, when the buffy coat shews itself, for in many cases, which have come under my notice, I have observed the buffy coat to be present after repeated bleedings, AND WHICH COULD NOT BE ATTRIBUTED TO ANY OTHER CAUSE THAN DEBILITY.—Lecture on Fever, pp. 21–2–3.

17. It is remarkable that the word which expresses fever, both in the Greek and the Latin languages, signifies to burn or to boil, and it is probable that this state of the system is denoted in most modern languages by some term bearing a similar meaning.

18. A Treatise on Fevers, &c. By A. P. Wilson Philip, M.D. p. 10.

19. Treatise on Fever, &c. By A. P. Wilson Philip, M.D. p. 12.

20. Sydenham’s Works, Chap. 3, p. 11.

21. Sir John Pringle on the Diseases of the Army, p. 66, &c.

22. In scarlatina the affection of the skin modifies the febrile symptoms, as has just been said, considerably: in small-pox exceedingly. If, on this account, any one enamoured of nosological distinctions should wish to separate these varieties of disease, it might be done by dividing continued fever into—

and so on of all the Exanthemata.

Although the eruption may, and without doubt does give rise to some peculiar symptoms and so modifies the fever, yet the true character of the disease, or the disease as a subject of medical treatment, depends entirely on the nature, that is in truth on the intensity of the fever. If, therefore, the Exanthemata can find no place under the genus fever consistently with the principles of nosological arrangement, it appears to me that these artificial distinctions ought to be abandoned: because it is better to reject nosology, than to overlook or to mistake pathology.

23. Observations on the Prevention and Treatment of Epidemic Fever, by Henry Clutterbuck, M.D. p. 15.

24. See pathology—chest cases. John Potter.

25. See page 107.

26. See page 163, 1.

27. See page 163, 2.

28. Those morbid appearances which, not being constant in fever, must be considered as accidental, are placed in brackets throughout this chapter.

29. See Case L.

30. See page 51. et seq.

31. Observations on the Diseases of the Army, by Sir John Pringle, Bart., p. 11. et seq.

33. See a Memoir on Contagion, more especially as it respects the Yellow Fever, &c., by N. Potter, M.D., Baltimore.

34. In pursuing these researches, I hope to have the advantage of the co-operation of my friend Dr. Dill.

35. It would be trifling, while treating of so momentous a subject as the proper management of fever, which requires the prompt, vigorous, and yet cautious exhibition of the most powerful remedies, to spend any time in discussing the merits of saline, refrigerant, diaphoretic, antimonial medicines, and the rest of the apparatus, which unfortunately continues to hold the place of direct, honourable, and well-earned (if any thing can be well-earned) remuneration to the practitioner.

36. Watchful of the convalescence as experience had taught us it is necessary to be after so severe an attack, still he was allowed to put himself too forward. When to all appearance recovered, though still weak, he undertook a journey of fifty miles, that he might the more completely re-establish his health in the country. He had not arrived at his journey’s end an hour before he relapsed. He was again bled, and the cold dash was applied a second time with success. From the commencement to the termination of the disease, 120 pounds of blood were abstracted in this case.