We mean not, however, in every instance to discourage the use of tonics; but merely to allege that they are not alone adapted for the cure of fever, and often injurious before the infarction of the viscera is completely removed. In general, we think the simple bitters more useful than those medicines which, like the bark, unite an astringent principle. The gentian, the quassia, the camomile flowers, and even the cascarilla, if debility appears early, may be early employed; and with a neutral salt, so as to prove purgative, or sometimes with the kali only, they have appeared to be febrifuges. Though they are chiefly adapted to the slow fevers, apparently of the hectic kind, we have thought that, in many-cases, they act with sufficient energy as tonics, even in typhus, except in the desperate cases to be soon mentioned. The metallic tonics have not been fairly tried, and the most powerful, the arsenic, seems to require for its success a complete apyrexia.

Cordials are, however, often necessary; and we repeat only the opinion of the ablest practitioners, that the most efficacious cordial is wine. Unless called for by early debility, we seldom wish to give it till the eighth day, and very moderately till the tenth. Even between this and the fourteenth, unless in emergencies, we rarely order a pint in twenty-four hours. If the fever proceeds, it may be increased. Other cordials are the aromatics and ether; the former, in the usual preparation, the confectio cardiaca; the latter, except in cases of convulsons, in an occasional cordial mixture.

The strength is also for a time supported by the more simple stimulants. The contrayerva and the serpentaria, with ammonia, were the preparations formerly used, with a view of concocting the matter; and we once thought that we could support the strength for a day or two by their means, when a crisis was expected: but we have long learnt to "pull in resolution, and doubt the equivocation that palters with us in a double shape."these stimulants only contribute to destroy the excitability, and we fear to hasten the last fatal termination. They may be employed in cases of temporary debility; but should be carried no further than to bring back the previous state. The great errors in the management of fevers have been the ideas that tonics, which restore muscular energy, will equally restore the sensorial power; and that which confounds temporary heat and more rapid circulation with increased strength. Each is a fatal misapprehension. It has been an error equally dangerous, when debility comes on, to rouse the patient by light and noise. Life is a forced state, says the ignorant and mistaken Brown, and the lamp must be excited by additional powers: it will be excited only to exhaust more rapidly the pabulum which supplies its existence.

Among the more unexceptionable tonics we may mention the mineral acids. These are of importance when considerable debility comes on; and a German physician, M. Recht, has endeavoured to raise their value by representing the muriatic acid as a general remedy in fevers. The secret was magnified by interest or collusion till it became a national object, and it was purchased by the king of Prussia. The muriatic and vitriolic acids had been long used in this kingdom in low, nervous, or putrid fevers, and considered as useful, but by no means infallible, medicines.

There are cases, however, where the strength is greatly lessened, and where a putrid dissolution of the blood becomes a most dangerous symptom. The mineral acids are, in such cases, remedies of considerable importance; and the bark becomes an indispensable medicine in the largest doses. These circumstances, however, seldom occur in general fevers; and, indeed, within a few years, we have scarcely seen an instance of this kind, except when a topical gangrene, as in the ulcerated throat, has concurred. We cannot then be too active in the employment of cordials and tonics, among which the mineral acid must be ranked; for if we do not gain some ground within a few hours after the appearance of these symptoms, the patient is lost. The other tonics formerly mentioned are not of sufficient power for such emergencies.

We cannot leave this subject without noticing the necessity and the means of obviating some of the more troublesome symptoms. The chief of these, the want of sleep, has already been the subject of our notice. The state of the stomach is also the source of considerable inconvenience. Acid eructations and heart-burn are relieved by absorbents, as magnesia, chalk, or kali; but we must recollect that we have already distinguished a species of heart-burn arising from oily substances, not mixed with the contents of the stomach, relieved only by mucilages. Nidorous eructations show the stomach to be in a putrid state, and this is corrected generally by vegetable, but more effectually by mineral, acids. Flatulent distention will seldom be troublesome, if the discharge of the bowels be kept up. Should it be so, asafoetida and galbanum, or their tinctures, with peppermint water, will relieve. Hiccough, at the latter end of fever, is sometimes highly distressing; and for this we have no certain remedy. Oil of cinnamon, camphor, musk, and opium, are given by turns; and one or other of these occasionally succeeds, though often all fail. Applications of opium, or of a blistering plaster to the stomach, will, like the others, in turn succeed and fail. But though a distressing symptom, hiccough is not, as has been represented, a fatal one. Did it not fatigue and weaken the patient, we should scarcely think it dangerous.

Palpitation of the heart is sometimes troublesome, but not always dangerous in fevers. It sometimes proceeds from the state of the stomach and bowels, and may then be relieved: but it arises also, in many cases, from a diminution, or an irregular distribution, of the nervous power; and shows that the degree of debility is considerable. The low, muttering, wandering delirium, is a symptom of the same kind; but this is so strictly connected with the state and progress of fever, that it scarcely merits our notice in this place.