The hectic fever should be distinguished from the intermittent, the common inflammation, and the slow or nervous fevers. The intermittent is more regular in its form, and in its attacks; and the slow nervous fevers have not such marked exacerbations or remissions. The fever of inflammation is of the continued kind. Dr. Reid distinguishes the hectic of a pulmonary consumption from the fever, in consequence of abscesses or ulcers in other parts, as in the liver, or under the psoas muscle, by the absence, in the latter, of remissions and morning sweats: on the contrary, it is more continued, less violent, and the skin is usually dry. But this distinction is apparently unfounded.

If the pulse runs on to above 100, or from this number to 120, in a minute, the danger is considerable; though sometimes the pulse will be little affected, while a variety of other fatal symptoms attends. In lying-in women it is generally fatal; and the fatal signs are, a continually weak, quick pulse, an entire loss of appetite and strength, an Hippocratic countenance, a little red or oily urine, a diarrhoea, immoderate sweats, with swelling of the feet and legs.

In most cases the principal intention is to relieve the symptoms, to moderate the heat, prevent costiveness, or its opposite, check the night sweats, and at the same time assist the general health, by exercise, air, and a proper diet; in other words, to support the strength, without adding any stimulus.

The remitting tendency of the disease has suggested the use of the bark; but this remedy is usually injurious, as it produces stricture on the skin, increases the heat, and, in pulmonary cases, the dyspnoea. In these cases neither antimonials, camphor, nor squills, will obviate the injurious tendency of this remedy. Though they appear to lessen the bad effects, they do not render the medicine beneficial. The eleutheria is more useful, but seldom produces any striking advantage. The purer bitters often succeed: of these we may mention the gentian, the camomile flowers, and perhaps the uva ursi. Of the angustura bark we cannot speak so decisively as we may be able to do under phthisis, as it is at present the subject of our trials. With these the neutral salts may often be combined with salutary effects, and together they will produce that gentle looseness which very essentially diminishes hectic heats.

The cooling medicines are in general preferable, and these united with mild doses of antimonials are often highly advantageous. The myrrh seems to act as a sedative in lessening feverish heat; but we find little advantage in combining it with chalybeates, as in Dr. Griffith's mixture; nor do we think the Pyrmont water so useful as the Seltzer. The steel may succeed in debilitated constitutions where the liver appears to be much affected, and in the Cheltenham waters it is said to be salutary, and to prevent the debilitating effects of the neutral salts.

The balsams have been highly commended in these diseases; and with nitre, or the citrat of potash, we have thought the Peruvian balsam, in slight doses, an useful corroborant: in larger doses it is too stimulating. The cicuta with mercury has been given as a deob-struent; and in the hectics from scirrhous livers, the production of the fevers of hot climates, it is said, with success. In some cases of hectic, from suppressed haemorrhoids, Bath waters have been advised. Should hectics arise from repelled gout, they may be also applicable; but in general these and all other stimulating remedies are injurious. When this disease is connected with wounds, asafoetida, with opium, has been useful.

In conformity to the most successful plan of treatment the diet should be mild and gently nutritious. Broths, milk, and vegetables, are the most useful; though a slight proportion of animal food, at an early dinner, may be not only allowed but recommended. A dry free air, with gentle exercise, particularly on horseback, is highly useful. An airy room, with light covering at night, is equally proper.

We have not mentioned bleeding; because, though sometimes employed in pulmonary hectics, it is not generally useful in this disease. We shall particularly mention it under Phthisis, q. v.

See Hippocrates de Internis Affectionibus; Aretaeus de Curatione Acutorum, lib. ii.; Fernelius; Hoffman; Heberden's Observations in the London Medical Transactions, vol. ii. p. 1-17; Fordyce's Enquiry into the Causes, etc. of Putrid Fevers; Cullen's First Lines, vol. ii. 221, etc.