The night in hospital, being on a drip, revitalised me but it all came back up again the next day.
The 35-year-old was now in sight of his first five-wicket haul in a Test innings at Old Trafford.
Flintoff played 79 tests for England, averaging 31.77 with the bat and took 226 wickets.
South Africa have not lost a Test series in England since 1998 and in their past 19 away Test series they have suffered just one campaign reverse - against India in 2015/16.
"It's a bit of a rollercoaster at the moment, the way it's been going and the margins of victory and defeat".
In many ways, the real damage to South Africa had been done in the morning when Jonny Bairstow added 50 for the last wicket with Anderson.
He was decisive and resolute initially to reach 21 from 44 balls at the close of day one, then picked the right time to up the tempo alongside Johnny Bairstow on day two, before smashing three consecutive sixes to go to his hundred when James Anderson was at the other end.
Elgar scored a fearless and battling century in the Third Test but he had no answer here to a pinpoint inswinger that crashed into his pad.
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Jonny Bairstow was 33 not out, with nightwatchman Toby Roland-Jones unbeaten on nought after Ben Stokes was bowled for 58 by Kagiso Rabada in the penulti-mate over.
Heino Kuhn struggled desperately with his timing, technique and a tight hamstring.
The England captain did not have it easy, twice surviving loud lbw shouts from Rabada and squirting a thick edge wide of third slip immediately after a 12-minute delay caused by a spectator taking ill in the members' area behind the bowler's arm.
Then Anderson returned for his deadly second spell.
His fitness has left skipper Faf du Plessis unsure about the balance of the team.
Theunis de Bruyn (11) did not last long before an edged drive off Anderson was held by England captain Joe Root at second slip. Maharaj, who would occupy the Brian Statham End all afternoon and most of the evening, had Cook caught behind for 46.
300 would be a great result, and with the ball relatively new it'll be up to the likes of Morkel, Rabada and Olivier to make the most of helpful conditions first up on Day 2.
England even dropped a couple of catches in successive overs.
Root made a courageous decision at the start of the day, choosing to bat after winning the toss with the knowledge that there's been rain in Manchester this week and the pitch was likely to give early help to the bowlers.