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fever.

strongly recommended the same from personal expe- Gen. I.

Spec. I. rience nearly a century ago.*

Ephemera Gamesters, after sitting up all night, and being worked mitis.

their Mild diary up to madness by the chances and reverses of their ruinous stakes, are, peculiarly subject to this species. A Gamesters very cold and wet towel tied round the temples, seems to frequently

suffer segive some check to the violent excitement of the brain, verely from and diminishes the morbid excess of sensorial power it is this species. in the act of secreting; but, in the long run, I have gene-. rally found persons who have adopted this practice become debilitated and dropsical, and sink into an untimely grave, or creep on miserably through the fag end of a lingering life, that affords no retrospective comfort, with a hospital of diseases about them. But whether this proceed from the practice adverted to, or from the habitual exhaustion which necessarily accompanies a course of gambling, may admit of a doubt. Yet, the habit itself appears mischievous, however pleasant at the time, as having a strong tendency by frequent repetition to torpify the secretories of the brain by the rapid and violent change of action they are thus made to undergo.

SPECIES II.

EPHEMERA ACUTA.

Acute Diary-Fever.

SEVERE RIGOR; GREAT HEAT; PULSE AT FIRST SMALL

AND CONTRACTED, AFTERWARDS FULL AND STRONG ;
PERSPIRATION COPIOUS; GREAT LANGUOR.

In a few instances the accession is slightly marked, and there is little chilliness or rigour. The heat that succeeds,

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• Gianella, De admirabili Ipecacoanhæ virtute in curandis febribus, &c. Patav, 1754.--Vater, Diss. de Ipecacoanhæ virtute febrifugâ, &c. Witeb.

VOL. II.

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stomach.

species is

Gen, I. however, is always considerable; the face is red and Spec. II. b otad.

era bloated; and there are often pungent and throbbing pains acuta, in the head, corresponding with the pulsations of the arAcute diaryfever.

teries; though at times the pain in the head is dull and heavy. The high-coloured urine deposits a sediment with a tinge of orange-peel.

We cannot always trace the remote causes of this

or species; but it is usually produced by some morbid affection of the tion of the stomach or of the collatitious viscera. chylopoetic viscera or

The most obvious and common cause is that of a surfeit, whether of eating or drinking. And there is no great difficulty in interpreting the means by which this

cause operates. How the The stomach, in the language of Mr. John Hunter, present

and it is language confirmed by the experience of every thus excited. day, is the great seat of general sympathy, and associates

with almost every other organ in its action. The digestion of even an ordinary meal is a work of some labour to it, and especially in weakly constitutions; a greater degree of heat, as I took occasion to show, in the proem to our second class, is regularly expended upon it during this process, and unquestionably also a greater degree of sensorial power; both which, though taken directly from the brain, are taken indirectly from the system at large as from a common stock; and the consequence is that, in infirm habits, a considerable degree of chill and debility are felt during this process, and other organs become torpid while the stomach is in a state of increased action. Hence infants and old persons sleep during digestion; delicate females feel a coldness shooting over their extremities; and those of irritable fibres become flushed in the face, and show other signs of irregular action. Now if this be the case in the digestion of ordinary meals, what disturbance may we not expect during the digestion of a por that overloads the stomach, and with which the ...!.!." 'loof inpliwy? what, more especially, wach ai iu samu umu, wy on moderate use of wine or spirits, the brain becomes exhausted of its energy by the excess of stimulus applied to it? The general chill over

the surface, which, in the digestion of an ordinary meal, Gen. I.

* Spec. II. is only felt by the weak and delicate, is here often felt se

Ephemera verely, and sometimes amounts to a horripilation. The acuta.

2. under the heat Acute diary. first stage of fever is hence produced : and as the heat fer

fever. and perspiration are most probably a necessary result of the first stage, a foundation is hereby laid for the entire paroxysm. With the re-action that ensues a greater degree of sensorial power is again secreted; the general frame as well as the brain is roused to an increased energy; the diaphragm and its associate muscles, instinctively or remedially, contract, and the stomach disgorges its contents, or thrusts them forward half-digested into the duodenum.

The only and well known mode of cure consists, in the Treatment. first place, in imitating this process; in unloading the stomach of its mischievous freight by a powerful emetic, and the alvine canal of whatever portion of the heating and crapulous mass has passed into it by a brisk cathartic. The fever hereby excited will often subside in a diurnal revolution; and no tendency to a return of the paroxysm be produced.

If the species before us, however generated, do not sometimes subside within this period of time, or a few hours beyond becom it, the disease becomes a cauma, or inflammatory fever of the continued kind, and consequently belongs to the genus ENECIA,

There are, however, a few exceptions to this rule: for or assumes Forestus gives a case in which the paroxysm led to a fatal hectic*: and Borelli gives another of equal singularity, in which it kept true to a triennial revolution, returning punctually once every three years t.

cauma,

some other form.

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SPECIES III.

EPHEMERA SUDATORIA.

Swrating Fever.

TENSE PAINS IN THE NECK AND EXTREMITIES; PALPI

TATION; DYSPNEA; PULSE RAPID AND IRREGULAR ;
HEAT INTENSE; INTOLERABLE THIRST; DROWSINESS
OR DELIRIUM; EXCESSIVE SWEAT.

Gex. I. I have followed M. de Sauvages in introducing sweating-
Spec. III.
Description, fever, the ephemera maligna of Borsieri*, or Burserius,

as he is more commonly called, and the sudor Anglicus
of most foreign writers, into the present place.

Dr. Caius, who practised at the time of its appearance at Shrewsbury, and has written one of the best accounts of it extant, calls it “a contagious pestilential fever of one day.” “ It prevailed”, says he, “ with a mighty slaughter, and the description of it is as tremendous as that of the plague of Athens.” And we are told by Dr. Willis, “that its malignity was so extreme, that as soon as it entered a city it made a daily attack on five or six hundred persons, of whom scarcely one in a hundred recovered.” It was certainly a malignant fever of a most debilitating character, but without any tendency to buboes or carbuncles, as in the plague: though during some parts of its career as fatal. It ran its course in a single paroxysmt; the cold fit and hot fit were equally fatal ; but if the patient reached the sweating fit,

he commonly escaped. Mode of Hence the cure consisted in exciting the sweating treatment.

stage as quickly as possible, and in supporting the sys

* Institut. Med. Prac. 8vo. 4. Tomes, Ven. 1782-5.
+ Holinshed, vol. vit. 4to. Lond. 1808.

mera

fever.

tem with cordials throughout the whole of the short but Gen. I. vehement course of the fever. At Shrewsbury, it con

Srec. III. tinued to rage for seven months, and during that period sudatoria. of time a thousand fell victims to its violence. But after

Sweating the discovery of the benefit of the sweating-plan, it was certainly far less fatal.

It made its first appearance in London in 1480 or General 1483: Caius says in the latter year, first showing itself history. in the army of Henry VII. on his landing at MilfordHaven. In London, to which however it does not seem to have travelled till a year or two afterward, it took up its abode with various intermissions of activity for nearly forty years. It then visited the continent, overran Holland, Germany, Belgium, Flanders, France, Denmark, and Norway; among which countries it continued its ravages froin 1525 to 1530: it then returned to England, and was observed for the last time in 1551.

It commenced its attack with a pain in the muscles of the neck, shoulders, legs, or arms, through which a warın aura seemed to creep in many instances; and after these symptoms, broke forth a profuse sweat. The internal organs grew gradually hot, and at length burning, the pungent heat extending to the extremities; an intolerable thirst, sickness and jactitation followed speedily, occasionally with diarrhea, and always with extreme prostration of strength, head-ache, delirium, or coma, and a wonderful wasting of the whole body. The sweat was tenacious, saburral, and of an offensive smell; the urine thick and pale: the pulse quick, often irregular; and the breathing laborious from the first. The modes of treatment were often puerile, and offer nothing instructive. A good constitution and exposure to free air seem to have been most successful in promoting a cure.

Dr. Caius asserts, that a thick noisome fog preceded the distemper, especially in Shropshire, and that a black cloud uniformly took the lead, and moved from place to place; the pestilence in a regular march following its direction. There may be some fancy in this : but it is an unquestionable fact, that the most fatal pestilences of

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