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Order I. is, perhaps, generally supposed; it is an important
branch of meteorology, and, as such, is well worth stuFevers.
dying. Nor can there, I think, be a question in any impartial mind, that, under certain circumstances, and especially in tropical climates, many diseases are influenced by lunation, as we are sure they are, in all climates, by insolation. The concurrent observations of a host of candid and attentive pathologists, who have been witnesses of what they relate, are sufficient to impress us with this belief: but till we know more fully what these circumstances are, we cannot avail ourselves of their remarks, and can only treasure them up as so many isolated facts. And hence it is, that in no age or country whatever, has the study been turned to any practical advantage, expedited the cure of a disease, or enabled us to transform the type or interval of one kind of fever into that of another. Nor is it any exclusive reproach to the art of medicine that it should be so; for of all the subdivisions of general philosophy, there is none so little entitled to the name of a science as meteorology itself. And till the naturalist has explained the variations of the barometer, the physician need not blush at being incapable of turning to account the supposed influence of the planets, or of unfolding the origin or tracing the capricious courses of epidemies and pestilences.
ONE SÉRIES OF INCREASE AND DECREASE ; WITH A
TENDENCY TO EXACERBATION AND REMISSION, FOR
This is the simplest form in which fever at any time Gx. I. makes its attack; and hence Dr. Fordyce has distinguished it by the name of SIMPLE FEVER. It is probably Fordyce. that which is intended by the term essential fever, as Essential used by the French writers, and the subject of which was wrench lately chosen by the Medical Society of Paris for one of writers. their prize questions. It is in truth, the basis of all other fevers; which are hence arranged by Elsner as mere species of this *. For the purpose, however, of entering into the full character, not only of the present but of all the subsequent generà, and their respective species, it is necessary to bear in mind, that the ordinal definition forms a part of that character, and is essentially included in a less or greater degree in all the subdivisions that appertain to it.
The ephemera rarely exceeds a duration of twenty- The term four hours. Some practitioners, however, have called ha
e erroneously by this name a fever that has extended to three days; applied. and Sauvages has arranged this mode of fever under his own genus of ephemera, as has also Professor Frank, distinguishing the proper ephemera by the adjunct sim
Gen. I. plex, and its elongated form by that of protracta *. But Ephemera. this is to confound different species under one generic Diary fever.
name. Fordyce asserts that he has often seen the ephemera commence its attack with all the essential appearances of fever, and terminate in eight, ten, or twelve hours t. And hence, in defining ephemera, the symptom of duration ought not to exceed the limit here
allotted to it. Stages of In this simple shape of the disease, the pathognomic diary fever, three.
symptoms are few and striking; for, however violent, it is confined to a single paroxysm of three distinct stages, shivering or langour, heat, and perspiration; each most probably dependent on the other, and ceasing, when true to itself, after having followed up the movements of the animal frame through a single diurnal revolution. The cold stage, however, is often scarcely perceptible, and sometimes altogether imperceptible, the general languor taking place without it.
The genus exhibits two common and very distinct species; and if the ephemera sudatoria of Sauvages, the sweating-sickness or English plague of other authors, be regarded as belonging to it, as unquestionably it ought, it will then afford us another after the manner following: - 1. EPHEMERA MITIS.
MILD DIARY FEVER.
ACUTE DIARY FEVER. .
• De Cur. Morb. Hom. Epit. Tom. I. p. 156. 185, 8vo. Mannh. 1792. + On Simple Fever, Diss. I. p. 33.
Mild Diary Fever.
WITHOUT PRECEDING RIGOR; LASSITUDE AND DEBILITY
INCONSIDERABLE; PAINS OBTUSE, CHIEFLY ABOUT THE
The common exciting causes are excess of corporeal
Spec. I. and especially of muscular exertion; long protracted
Causes. study; violent passion; suppressed perspiration; sudden heat or cold. There are few persons who have not felt this species of The fever
frequent diary fever at times, from one or other of the causes just for enumerated. When a man has worked himself up into other of a violent and long continued fit of wrath, whether there have been reason or no reason, and more especially in the latter case; when he has taken a long and fatiguing journey on foot, walking with great speed, and suffering beneath great heat and perspiration; or when he has devoted the whole of the day to a particular study, so profound and abstracting as to exhaust almost the entire stock of sensorial power that can be drawn from other parts of the system, at the single outlet of the attention ;
—and when, beyond this, he still urges his abstruse and protracted train of thought into a late hour of the night or the morning—there is a general irritation or undue excitement produced, that simple rest cannot at once allay; his sleep is short, hurried, and interrupted if he Description. sleep at all; he yawns, stretches his limbs, turns himself again and again in his bed for an easy, perhaps for a cool place, for his skin is hot and dry; but for a long time he turns in vain. The morning strikes upon his
Spec. I. Ephemera mitis. Mild diary fever.
eyes, but he has had little sleep and no refreshment: he is indisposed to leave his bed; and if he rise, he is still feverish, and unfit for business. He passes the day in disquiet, which perhaps increases towards evening; but at night he feels a moisture breaking forth over his skin, and comfortably succeeding to the heat and dryness that have thus far distressed him ; he recovers perhaps even while sitting up; but if, as he ought to do, he goes to an early bed, a quiet and refreshing sleep supervenes, and he wakes to the health he before possessed.
It is not easy to explain why the febrile paroxysm should be more disposed to close its career sometimes towards the evening, but more generally later at night, except for the reason, whatever that reason may be, that all fevers are far more apt to commence their paroxysms in some part or other of the day-time, and especially intermittents, and consequently to drop them as the day declines. Thus the quotidian makes its assault in the morning, the tertian at noon, and the quartan in the afternoon: as though the diurnal revolution were somewhat regularly divided between febrile attack and febrile cessation or truce. It is possible indeed, that a fever of any kind may open its onset at any hour, but this is so contrary to the ordinary rule, that Dr. Fordyce affirms from his own observation that ten fevers commence in the day to one at night.
The species before us forms scarcely a case for medicine: since nature or that instinctive power which is ever operating to the general welfare of the animal frame, will be usually found competent to its object. So that if any thing remedially is attempted, it should be confined perhaps to a slight increase of the peristaltic action of the intestines by a dose of neutral salts, and to a removal of the dry heat of the skin by diluents and small doses of ipecacuan, which combines admirably with most aperients, and increases their power, while its own diaphoretic quality continues at least undiminished and is often improved. This is now well known, though not a discovery of recent date; for Gianella, Vater, and various writers of credit,