This section is from the book "The London Medical Dictionary", by Bartholomew Parr. Also available from Amazon: London Medical Dictionary.
The ardent fever, (from ardeo, to burn). It is also called febris deurens, cau-sodes, and cholerica; a burning, or highly ardent fever: by the Greeks called causus, (from
uro, to burn,) because it was attended with a burning heat. The ancients considered the extreme heat and unex-tinguishable thirst as characteristic symptoms of the disease. Hippocrates succinctly describes it, a fever attended with extreme heat, strong thirst, a rough and black tongue, complexion rather yellowish, and the sputum bilious. It is also elegantly described by Aretaeus and Lommius. Sauvages arranges it under tritaeophya, the second species; and Dr. Cullen places it among his examples of tertian remittents. At the beginning of this fever the heat to the touch is fiery, though unequal in different places; internally it is violent, though often the heat in the extremities is much less severe: sometimes indeed they are cold. The whole surface of the body, nose, mouth, and tongue, are dry; the breathing is short and quick; the tongue dry, yellow, sometimes black, rough, and chapped; the thirst is inextinguishable, and often goes off suddenly; there is a loathing of all solid food, nausea, accompanied often with a gnawing pain at the stomach, and heat of the precordia; vomiting, great anxiety, restlessness, and extreme lassitude; a slight cough also attends, with a hoarse voice, and, occasionally, delirium; to which succeed coma or convulsions: the exacerbations are not always on regular days. This fever, as it is very violent, is seldom of long continuance: if from the beginning the symptoms arc favourable, it generally terminates on the fourth day; seldom exceeds the seventh; and either a vomiting, diarrhoea, sweat, or nasal haemorrhage, proves critical. Young subjects are seized oftener, but bear it with more ease and safety, than older persons. The remote causes are debilitating ones of every kind, particularly when combined with hot weather; and the biliary system seems particularly affected; but the more immediate cause of this and all other remittent fevers is marsh effluvia. It is sometimes attended with an inflammation of the aorta and vena cava.
Cure. - We are first advised to bleed freely from a large orifice; and if the patient is robust, and the heat excessive, to support him on his feet until the operation is ended, that he may faint, if possible; as the heat is always less after fainting than when the same-quantity of blood is discharged without this accident happening. If the pulse and the heat do not contra-indicate it, the bleeding must be repeated at proper intervals.
Immediately after bleeding, let a brisk but cooling purgative be administered. Sydenham observes, that purging immediately after bleeding cools to a great degree; and that the method of curing fevers by perspiration is not only less certain, but more troublesome and tedious, nay, that it prolongs the disease, and endangers the patient. By this observation, however, he means that such inconveniences arise by the heating sudorifics. then employed, previous to evacuations. The proper purges are the saline, quickened, if necessary, by an infusion of senna. Glauber's salt, largely diluted in water gruel, with a small proportion of emetic tartar, should be frequently drunk till it operates either or both ways.
During the intervals of purging, frequent small draughts.of acidulated, subtepid, liquors should be taken, and nitre, kali acetatum, and sal ammon. crud. may be properly given: and if to each dose of these as much antimonium tatarisatum, or vin. antim. is added as the stomach will easily retain, their advantages will be increased. Barley and oatmeal gruels are the properest kinds of aliment, and all such as contribute to keep the habit cool, and dilute the fluids. After four or fire days, if no assistance has been obtained, the above method is improper; yet if the heat be great and the pulse strong, a moderate bleeding may be of use. A gentle laxative that is cooling may also be given by the mouth; and, until the crisis, let gentle diaphoretics and light broths be continued: for after the fifth or sixth day of an ardent fever, there is generally some difficulty to keep up the vital heat to that degree which is necessary to health, or the continuance of the necessary secretions.
If a nausea continues after the emetic is worked off, the common saline draughts may be given at proper intervals.
A diarrhoea may be critical, so should be attended to with care; and until the patient's strength is affected by it, nothing is required. If excessive, the cretaceous mixture, with the tinctura catechu, or the pulv. ipeca-cuanhae c. cum opio, will restrain it. If delirium come on early, with a strong pulse, the bleeding must be repeated and cooling laxatives continued: if, at a later period, with spasms, and a low pulse, warm cordials must be given, blisters applied to the neck, and sinapisms to the feet. Sydenham asserts, that garlic bruised and applied to the feet quiets the delirium more effectually and speedier than blisters. For the general management, see Febris. Hoffman's Syst. Rat. Med.. Boerhaav. Aphorism. § 738. Sauvages' Nosol. Method. Cullen's Pract, of Phys. on Remittents. Lommii Opus-culum Aureum.
 
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