8. Fainting after bleeding. This symptom is accidental in many people. No inference can be drawn from it against blood-letting. It often occurs after the first and second bleedings in a fever, but in no subsequent bleeding, though it be repeated a dozen times. Of this I saw several instances, in the yellow fever of 1794. The pulse, during the fainting, is often tense and full. 9. Coldness of the extremities, and of the whole body. This cold state of fever when it occurs early, yields more readily to bleeding, than to the most cordial medicines. 10. Sweats are supposed to forbid blood-letting. I have seen two instances of death, from leaving a paroxysm of malignant fever to terminate itself by sweating. Dr. Sydenham has taught a contrary practice in the following case. "While this constitution (says the doctor) prevailed, I was called to Dr. Morice, who then practised in London. He had this fever, attended with profuse sweats, and numerous petechiæ. By the consent of some other physicians, our joint friends, he was blooded, and rose from his bed, his body being first wiped dry. He found immediate relief from the use of a cooling diet and medicines, the dangerous symptoms soon going off; and by continuing this method he recovered in a few days[51]." In the same fever, the doctor adds further, "For though one might expect great advantages in pursuing an indication taken from what generally proves serviceable (viz. sweating), yet I have found, by constant experience, that the patient not only finds no relief, but, contrariwise, is more heated thereby; so that frequently a delirium, petechiæ, and other very dangerous symptoms immediately succeed such _sweats_[52]." [51] Wallis's edition, vol. i. p. 210. [52] Vol. i. p. 208. Morgagni describes a malignant fever which prevailed in Italy, in which the patients died in profuse sweats, while their physicians were looking for a crisis from them. Bleeding would probably have checked these sweats, and cured the fever. 11. Dissolved blood, and an absence of an inflammatory crust on its crassamentum. I shall hereafter place dissolved blood at the highest point of a scale, which is intended to mark the different degrees of morbid action in the system. I have mentioned, in the Outlines of a Theory of Fever, that it is the effect of a tendency to a palsy, induced by the violent force of impression upon the blood-vessels. This appearance of the blood in certain states of fever, instead of forbidding bleeding, is the most vehement call of the system for it. Nor is the absence of a crust on the crassamentum of the blood, a proof of the absence of great morbid diathesis, or a signal to lay aside the lancet. On the contrary, I shall show hereafter, that there are several appearances of the blood which indicate more morbid action in the blood-vessels than a sizy or inflammatory crust.