Our chief indications in fever are to lessen the fa to restore, as far as we can, the balance of the circulation; and to support the strength.

1. To lessen the heat.-we have considered the heat as the first change in the series of causes and effects, arising from the "quiescence of the capillaries:"i' must of course be the first object of our attention; and the numerous advantages arising from cool air and cool drinks evidently show that the increased action cannot be a salutary exertion. This subject includes the whole that we have to remark regarding the general management of fever, with respect to diet, air, etc.the chamber should be high and airy: the bed, if possible, neither between the door and the window, or the latter and the fire, so that the patient is never exposed to a current of air. No pictures, or other objects, should be on the walls, to fix their attention, or suggest incoherent images. It should be quiet and unconnected, if possible, with the house. The bed should have curtains, but they should not be drawn, except where the patient is exposed to the light. The window should be shaded rather than darkened. The bed clothes may be regulated according to the weather, and former habits; but should be cooler than usual, and still further diminished if the heal is considerable. Except in very severe weather, the sash should be a little open; nor need the door be solicitously closed. When tires are otherwise wanted, some may be kept up for the sake of the nurses rather than the patient. In general, when a person enters the room from the open air, he should neither feel it warm nor more close. In a long fever, the room may be occasionally mopped; but, on the whole, we disapprove of sprinkling it with vinegar. The professed object is to prevent infection; but we fear it is sometimes employed to conceal the bad smells of what ought to be removed. These should be counteracted by the most unremitting cleanliness in the bed and body linen; the former of which should be changed every two or three days, and the latter every day; in case of involuntary discharges, as often as may be necessary. It is not unusual for patients to throw aside the clothes, or to be anxious to come out of bed; and they are greatly irritated at being prevented from doing either. We have never found such indulgences injurious; and when they are no longer opposed, they seldom persist in their wish. If their clothes are immediately brought they will again lie down.

It has not been uncommon, in the early periods of fever, to carry persons into the air. If this can be done without any, or with very slight, bodily exertion on their side, it is generally useful; but to walk any distance, or to travel many miles, has been frequently injurious; and even fevers, apparently slight in their commencement, have ended fatally when considerable fatigue has been experienced in the early stages. The-ons of the army have given an opposite opinion, which we can only reconcile by reflecting, that we have very different constitutions as the objects of our practice. Generally, on the first attack of fever, patients should preserve the greatest tranquillity of mind and body. They should either keep in bed or on the sopha, with free air and in a moderate temperature. Few visitors should be admitted and no strangers; conversation should be general and easy; and those who come 1 be cautioned to stay only a short time. If, by the means lately stated, the fever should be crushed in the bud, the same precautions will be least, the first septenary period.

The diet should be equally calculated to avoid exciting heat. The appetite is lost, and solids cannot be swallowed. The liquids taken should be cool, and not highly nutritious: barley water, tea, toast and water, bread jelly, or weak broths, are sufficient for the early periods of fever; and this very light diet should be kept up during the first six days. If the debility is considerable, a diet somewhat more nourishing may be allowed earlier; but the loss of strength should be indeed very great to admit the use of wine during this period. The patient should be supplied frequently with these liquors; and if he complain of coldness they may be given warm. After about the sixth day the diet should be more nourishing, and good broths, jellies, and occasionally a little wine, may be allowed; but the latter should be in moderate quantities, lest we exhaust the powers of the best cordial that we can at a future period employ. The ancients gave the coldest water freely in the earlier stages of fever; and we have often indulged our patients in this practice, always without injury, and often with the most striking advantages.

Some late trials would suggest the question, whether, in the earlier stages, cold may not be employed more actively than in these plans. We allude to Dr. Currie's recommendation of cold affusions, and particularly their effects in scarlatina. In his practice they are only employed to counteract violent heat; and the heat is greatest in those inflammatory fevers which are generally accompanied with local inflammation, or where we expect hourly local inflammation to take place. We own that we have hesitated in using this remedy with that spirit and decision from which alone we can expect salutary consequences. In a less degree, sponging the body with cold water has been found useful in mitigating the heat. It is also highly refreshing and agreeable to the patient.

2. To restore the balance of the circulation.-this is the most important indication in the cure of fevers; and to this object our chief attention must be directed. The natural, and sometimes the bilious, vomiting will point out the necessity of giving emetics. These are our chief dependance in the early stage of fever; and from our view of their effects, the force of their benefits will be sufficiently obvious. (See Emetica). The chief advantages are, however, relieving congestions in the liver, and determining to the skin. The former is obtained by active vomiting; but it has been supposed that the latter may be secured by means less violent, and more permanent in their effects. Active vomiting is seldom employed more than once; but if the first emetic should not act completely, it must be repeated. The antimonials are preferred in fevers, but without sufficient reason, as we seem to gain all the benefit of full vomiting from the ipecacuanha. Dr. Fordyce attributes some of this benefit to the medicine; for the vomiting, he remarks, procured by squills, is not equally successful. On this subject we cannot speak from experience. In general, after the operation of vomiting, we should endeavour to secure the determination to the skin by some mild diaphoretic with which opium is combined. To support the action of the extreme vessels by nauseating doses of emetics, is a practice introduced from the theory of Dr. Cullen. There are no doubts of the utility of this practice; but we are confident that it has been carried too far in the Cullenian school. To explain the action of the nauseating doses of antimonials-for to these we would confine, with Dr. Fordyce, the advantages we derive from such medicines in fevers-is not easy, when have found that their relaxation is the effect of a sedative power, and that the spasm, if we may still use the expression, arises from debility. It must be, however, recollected, that when we spoke of the quiescence of the capillaries, we did not object to the spasmodic state of these vessels if considered as the effect of irregular action. From all the phenomena, from the effect of every remedy, it is not mere inactivity. Whatever becomes of theory, medicines exciting nausea really promote perspiration, often of a most salutary kind; and whatever fills the extreme vessels, and, more particularly, whatever promotes any discharge from them, relieves internal congestions. Experience, however, limits their use, and perhaps they should not be continued beyond the third or fourth day. They undoubtedly produce, after some time, debilitating effects; and in the long protracted fevers have been injurious when too far pursued.