The horror and rigor of the attack are violent, but short in their duration, and are followed by a violent hot fit, in which all the symptoms indicating increased action of the arterial system are very conspicuous. The fever is often terminated by topical inflammation, or a haemorrhage, and is alone fatal, though it may become rapidly so, when the inflammation falls on the brain, lungs, or intestines. If none of these consequences happen in the second week, the strength diminishes, and the fever goes off with a perfect crisis, or changes to a typhus. When attended with local inflammation, and this is removed, the same change sometimes takes place, and the typhus is rendered more dangerous, by the weakness induced from the necessary evacuations. This has been the reason of nosologists introducing the genus synochus; but synochus, the real disease, is very generally a typhus, and the previous inflammatory symptoms are accidental only. The cause of symptoms so dissimilar is not easily assigned. In some cases the infectious miasmata arc only excited to action by the previous inflammatory fever, and in others the irregular action subsequent to the spasm is directed to a particular organ, and the irritation excited by its inflammation increases the force of the circulation, so as to produce the symptoms described. See Febris and Inflammatio.

The causes of inflammatory fever arechicfly cold when the body is heated; but it may also arise from accumulations in the stomach, or topical irritations. The stomach and bowels are the chief sources of this disease in children; and, indeed, the most common causes, when it appears independent of topical affections. The other sources of irritation are obscure.

Bleeding, the common remedy with indiscriminating practitioners, must be employed with caution. If an inflammatory fever attacks a young, strong, robust labourer, it may be employed with freedom; but we should always recollect that though pneumonia, phrenitis, or any active inflammation, may come on, a typhus may be also at the bottom. The pulse may direct; but, as we have often observed, it requires peculiar judgment to distinguish between a strong and an irritated pulse, as well as between an apparently low and a labouring one. We have found the countenance a good criterion; and if the features are sunk, with any apparent anxiety in the countenance, whatever are the other symptoms, bleeding must be avoided. On the contrary, strong rigor, soon succeeded by violent heat, flushed face, a sparkling and a full eye, will require a free and active evacuation from the arm, which may be repeated according to circumstances.

Emetics are remedies of the utmost importance, and in children, where a foulness of the stomach is the principal cause, they will often carry off the fever. In general, the headach and fulness of the vessels appear to contraindicate this remedy; but we have already observed, that the increased fulness is temporary, the advantages permanent. Yet where the determination to the head is very violent, and the vessels have not been depleted by venesection, emetics should be avoided.

Cathartics are still more necessary than emetics, and less dangerous. They not only relieve the head, but they prevent determinations to the lungs and liver, and lessen the violence of typhus, should its fomes be latent. The saline purgatives, with senna, are, in this case, preferable. '

The cooling sedatives and inirritants must be freely employed. The antimonials, nitre, with all the other neutrals, are valuable remedies; and, where the head is affected, camphor, united to vinegar, has been employed with advantage. (See Phrenitis.) Opiates are often necessary when violent irritation and restlessness prevent sleep. They should be given with camphor and the antimonial powder.

When local pains come on, they are occasioned by topical inflammation, and must be treated according to their nature. See Inflammatio.

The diet should be chiefly gruel, or barley water, subacid fruits, water acidulated with lemon, the jelly of currants, or similar sharp fruits. It may be drunk warm or cold, as is most agreeable to the patient. Half a drachm of nitre may be dissolved in every pint of liquor in which no acid juice is mixed. The room should be high, large, and airy. The patient may sit up a little each day, according to his strength; for this will lessee the fever, headach, and delirium: but when a salutary perspiration comes on, it should be indulged in bed The sheets may be changed every two or three days. and all putrid matters should be removed.

See Fordyce's Elements of Physic, part ii. Fordyce's Inquiry into the Causes, etc. of Putrid and Inflammatory Fevers.