There is a nausea, and sometimes a vomiting of bile; a violent pain of the head, with a strong pulsation or throbbing of the temporal arteries; the eyes often appear red and inflamed, with a pain at the bottom of the orbit; there is a noise in the ears, the breathing is laborious, and often interrupted with a sigh; the patient complains of a pain about the region of the stomach, and in his back and loins; his tongue is at first white, but afterwards it appears black and chaped; and his teeth are covered with a black crust. He sometimes passes worms both upwards and downwards, is affected with tremors or shaking, and often becomes delirious. If blood is let, it appears dissolved, or with a very small degree of cohesion, and soon becomes putrid; the stools smell extremely fœtid, and are sometimes of a greenish, black, or reddish cast. Spots of a pale purple, dun, or black colour, often appear upon the skin, and sometimes there are violent hæmorrhages, or discharges of blood from the mouth, eyes, nose, &c. Putrid fevers may be distinguished from the inflammatory, by the smallness of the pulse, the great dejection of mind, the dissolved state of the blood, the petechiæ, or purple spots, and the putrid smell of the excrements. They may likewise be distinguished from the low or nervous fever by the heat and thirst being greater, the urine of a higher colour, and the loss of strength, dejection of mind, and all the other symptoms more violent. It sometimes happens, however, that the inflammatory, nervous, and putrid symptoms are so blended together, as to render it very difficult to determine to which class the fever belongs. In this case the greatest caution and skill are requisite. Attention must be paid to those symptoms which are most prevalent, and both the regimen and medicines adapted to them. Inflammatory and nervous fevers may be converted into malignant and putrid, by too hot a regimen or improper medicines. The duration of putrid fevers is extremely uncertain; sometimes they terminate between the seventh and fourteenth day, and at other times they are prolonged for five or six weeks. Their duration depends greatly upon the constitution of the patient, and the manner of treating the disease. The most favourable symptoms are, a gentle looseness after the fourth or fifth day, with a warm mild sweat. These, when continued for a considerable time, often carry off the fever, and should never be imprudently stopped. Small miliary pustules appearing between the petechiæ or purple spots are likewise favourable, as also hot scabby eruptions about the mouth and nose. It is a good sign when the pulse rises upon the use of wine, or other cordials, and the nervous symptoms abate; deafness coming on towards the decline of the fever, is likewise often a favourable symptom[83], as are abscesses in the groin or parotid glands.