To fulfil the other indications may appear an easy task; the stomach and bowels are to be emptied, the bark and wine given, and the whole is at an end. Such is the easy track of the theorist. In practice, however, we find the stomach so highly irritated that we dare scarcely add to the irritation. To assist the vomiting with mild, diluent, nutritious fluids, as mutton and chicken broth; or, if the urgings are violent and ineffectual, to aid them with a small dose of ipecacuanha, or tartarised antimony, is all that can be allowed. We have already remarked, that all neutral salts possess an anti-emetic power, and a dilute solution of these with manna and tamarinds may be drunk frequently to evacuate the bowels. Some physicians have added a small proportion of tartarised antimony; and this medicine, in the dose of one-sixth or one-eighth of a grain, will sit easily on the stomach, and tend rather to produce a discharge downward than to vomit. In some instances where the vomiting and diarrhoea are dangerously violent, a slight opiate may be given to regulate rather than repress them.

When a sufficient discharge is procured where necessary, or regulated when excessive, warm cordials may be safely employed to support the strength; and wine cautiously given, observing its effects, and from these directing its repetition or omission. The discharge by stool must be kept up according to the symptoms and the nature of the evacuations. Respecting the cordials and tonics practitioners have differed: the bark irritates the stomach and bowels, and can seldom be retained. When it is so the effects have not often been salutary. The contrayerva and serpentaria have been employed; but the disease treated by Hillary and Lining seems scarcely to have been the violent fever, which has so lately forced itself on our attention, and animated our exertions. The columbo root may be useful in correcting putrid bile, but it has a very inconsiderable effect as a tonic. The quassia is by far more serviceable, and the cascarilla has been employed with advantage.

Practitioners have greatly differed respecting the propriety of applying blisters. The discharge from these is thin, acrid, and yellow; nor have they been seemingly of any utility. Indeed they are not apparendy indicated in any stage of the fever, except from the affection of the head, which is rather a mark of debility than of fulness. Theoretical views have occasioned the discussion rather than observation of their effects; and their power of attenuating the blood, of which there is not the slightest evidence, has been the chief subject of dispute. Acrid cataplasms to the feet have not been more useful; and the warm bath, though often employed, seems to have done little service. The whole plan of cure consists in evacuating the stomach and bowels with the least irritation, and supporting the force of the circulation.

Two other plans have engaged the attention of practitioners. The followers of Brown. with the rashness and indiscriminate violence of sectaries, urge their tonic plan of cure, and give at once the wannest stimulants.

If the view we have given of the disease be correct, we need not say with what success over distended vessels are thus excited to transitory and ineffectual action. In fact they have been very unsuccessful.

The second plan is that, we believe, now generally followed, viz. the mercurial. Calomel unites the different objects, since it not only evacuates the alimentary canal, but effectually stimulates the vessels of the biliary system, and supports the action of the smaller vessels. When the bowels are so irritable as not to bear its being given internally, frictions of mercurial ointment will supply its place. This practice is not yet unquestionably established, but it is rapidly gaining ground, and promises to be highly useful. The mercury must be introduced as usual into the system, until some sign of its action on the minuter vessels is observed.

The late fever in Spain and Gibraltar showed the same marks of asthenic venous accumulation, with a similar affection of the biliary system. We cannot perceive, from the very accurate description in one of the last volumes of Dr. Duncan's Annals, that it had any very peculiar or discriminating marks to distinguish it from the yellow fever of America. Nor have we found a single improvement in the conduct which requires a detail.

See Bisset on the Bilious Fever of the West Indies. London Med. Obs. and Inq. vol. iv. p. 156. Blicke on the Bilious Fever of Jamaica. Sir John Pringle, Drs. Chalmers, Lind, Towne, Warren, Cleghorn, and Rouppe. Of the more modern authors Dr. Rush, Dr. Chisholme, Drs. Mosely and Grant, merit the most considerable attention.