If it be for life, that sleep, of the long absence of which we have
already spoken, returns; and nothing can more truly express its
character than its familiar name, “balmy;” and healing is its influence.
From two or three hours of such slumber, the patient awakens a new
being. Not that the change is at first striking to an inexperienced eye;
but there is no fever nurse who does not recognize it in a moment, and
it is not long before the patient tells you that he feels it. The
febrile uneasiness is now much diminished: the headache is greatly
relieved; and the skin is cooler and softer. The pulse may not yet be
altered, or it may be a few beats slower than before, but there is
almost always already an improved appearance in the tongue, which shews
a beginning disposition to clean. These favourable changes gradually
increase. If the sleep the next night be longer and more refreshing,
which it generally is, on the following morning a decided improvement is
visible in the countenance. The eye is clearer and more lively, and the
expression of the countenance is more natural. The skin continues cooler
and softer; the tongue is still cleaner, and the pulse, perhaps, slower
by a beat or two; and from this period, if no untoward event happen, the
convalescence proceeds just as has been described in the return of
health in the milder form of fever.
If, on the contrary, the case proceed unfavourably, a totally new train
of symptoms at this period sets in.
1. In the first place, the pain of the head obviously, and sometimes
strikingly, diminishes. Often it disappears altogether, or, if any
uneasiness remain, it is rather a sense of dullness and heaviness than
pain. In like manner the giddiness, if that were urgent, is no longer
perceptible: but it is remarkable that the pain in the back and loins
not unfrequently continues for some time after the headache has
disappeared: but, ultimately, that also ceases. The period at which this
important change takes place depends upon the severity of the attack,
and is materially influenced by the activity or inertness of the
treatment. In the subacute form, it usually takes place about the tenth
day from the commencement of the disease.
2. Simultaneously with the disappearance of the head-ache, there is a
remarkable diminution of the sensibility. The mind is duller and more
heavy. The patient may still be roused to answer with tolerable
coherence if spoken to; but when left to himself he is confused and
stupid. The eyes now become injected: often suffused; and the heaviness
and dullness of their expression is increased.
3. It is at this time that delirium, if it appear at all, most commonly
comes on. The increasing insensibility, if not attended with decided
delirium, is almost always accompanied with moaning or incoherent
muttering, especially during the short and interrupted slumbers which
form the substitute for sleep.
Public-domain text, read in full here on John Shaqi.
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