Note 77 — OF THE Autumnal Remitting Fever.

Mr. Cleghorn, after giving a very accurate Account of Tertian Fevers, as they appeared in their various Forms of true, of double, and triple Tertians, and of Semi-Tertians, in the Island of Minorca, tells us, that he first attempted the Cure by profuse Evacuations; but afterwards learnt from Experience, that they were unnecessary; and that Bleeding and Purging once or twice in the Beginning, was all that was in general requisite; and if on the fifth Day the third Revolution was not attended with more threatening Symptoms than the second, and the Patient bore it easily, he frequently trusted the whole Business to Nature; which commonly terminated the Fever about the fourth or fifth Revolution; and for the most part with an Increase of some natural Evacuation.—But if the Paroxysm on the fifth Day was the longest and most severe that happened, attended with any doubtful or dangerous Symptom, he ordered two Scruples of the Cortex to be given every two or three Hours; so that five or six Drachms may be taken before next Day at Noon; lest, if this Interval escaped, he should not have found a favourable Opportunity of giving a sufficient Quantity of the Medicine afterwards; as the Fits about this Period are wont to become double, subintrant, or continual.—This did not always put an immediate Stop to the Fever, but it invigorated the Powers of the Body, and prevented or removed the dangerous Symptoms. Having given the Bark on the fifth Day, if a Fit came on the sixth, and declined the same Evening, he gave some more Doses of the Bark to mitigate the Fit on the seventh; yet sometimes this Fit of the sixth united with that of the seventh, and the Patient had the Heat, Restlessness, Raving, and other Complaints, greatly augmented, and the Case seemed more desperate than ever; which, however, were more dangerous in Appearance than Reality, and went off with a profuse Sweat next Morning; after which he gave the Bark freely as before; and this either stopt the Fits, or made them so moderate, as that they yielded quickly to the same Sort of Management.—By this Method, when Assistance is called timely, Mr. Cleghorn says, the most formidable Intermitting and Remitting Tertians, may be certainly and speedily brought to a happy Conclusion about the End of the first Week, or Beginning of the second. See Observ. on the epidemic Diseases in Minorca, chap. iii. p. 187, &c.