posed by Broussais; but that the primary cause of these and all the other symptoms is a loss or deficient supply of the animating principle, and a consequent vitiated state of the blood, to which may be traced the universal debility of the brain, stomach, bowels, voluntary muscles, and the general feeling of soreness, with an aching in the back and limbs. Such are the cardinal symptoms that mark the cold stage of intermittents, which are invariably ushered in with diminished respiration, circulation, sanguification, secretion, nutrition, and of all the vital forces.

But as the process of breathing, although much impeded, is still carried on during the cold stage; and as very little of the heat thus obtained is employed in combining the blood with the solids, and in maintaining the various secretions, it gradually accumulates, until the temperature under the tongue rises to 104°, and sometimes to 107°, according to the observations of Currie, and some other pathologists. The immediate

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According to the observations of Dr. A. Donné, recorded in the Archives Générales de Medicine for July 1835, the temperature and pulse in various diseases were as follows:

AUGMENTATION OF RESPIRATION.

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consequence of which is, that the action of the heart becomes more frequent and vigorous, by which the blood is propelled with increased force into all parts of the body, and the general torpor that existed during the cold stage is gradually removed.

Moreover, it is worthy of special notice, that as a larger amount of blood is sent through the lungs, more carbon and hydrogen are given off to unite with atmospheric oxygen; so that more caloric is obtained by respiration during the hot stage, and imparted to the blood, than even during health, as proved by the experiments of Jurine,

But this table requires to be greatly extended, so as to embrace all the various forms of disease, during the cold and hot stages. In the Lancet of August 29, 1835, some experiments of Becquerel and Breschet are recorded, representing the temperature of patients labouring under various diseases at the Hotel Dieu, the results of which correspond with the above, as far so they go. In a scrofulous child during the febrile state, the thermometer in the mouth (it should always be under the tongue,) stood at 98.50°; while in an inflamed tumour it rose to 104°. They also found the temperature of a hemiplegic man 98.88° on the diseased side, and 98.07o on the sound side.

Nysten, and more recently by those of Mr. M'Grigor, who found that during the climax of scarlet fever, measles, and small-pox, from twenty to fifty per cent. more carbonic acid was exhaled from the lungs of patients in the Glasgow Infirmary than in a state of health. And it is a striking coincidence, that the pulsations of the heart are augmented in about the same ratio during the hot stage, the tendency of which is to improve the vital properties of the blood, by increasing the chemical function of the lungs in which it is formed and renovated, as shewn by the bright and florid hue which it assumes, the redness it imparts to the skin, and its increased power of coagulating when drawn from the body, compared with its dark, grumous, and vitiated state during the cold stage.

But as it is some time before the nutritive properties of the blood are restored, even after respiration is re-established, the caloric thus obtained is imperfectly transferred to the solids; so that there is often a feeling of chilliness while the patient feels preternaturally warm to another person, until the full development of the hot stage; attended with general debility, and a dull pain in the head, back, and limbs, not unlike that which is produced by the immediate influence of external cold; but with this difference, that in the former case it is more permanent and difficult to remove, because owing to a radical derangement in the vital properties of the blood.

RATIO SYMPTOMATUM.

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The consequences of which are, that the secretions remain for some time suspended, as shewn by the clammy state of the mouth, furred tongue, dry skin, and thirst. The urine is also scanty and high coloured during the hot stage, but contains a larger amount of urea and other nitrogenous compounds than in a state of health, according to the experiments of Dr. Prout and other chemists. Yet it must be observed, that whatever amount of animal heat may be obtained by respiration, it is incapable of performing its healthy vital office until the blood is restored to its natural state. Nor is it more strange that a diminished transfer of heat from the blood to the solids should induce general debility, torpor of the stomach, bowels, and liver, pains in the head, back, and limbs, than that exposure to a March east wind, or sitting for some time in a cold room, should cause an aching, stiffness, and numbness of the extremities, or that a rapid expenditure of animal heat by over exertion should cause a general soreness and stiffness of the muscles.

But in ordinary cases of intermittent fever, the natural tendency of the hot stage is to limit its own duration, and put an end to the paroxysm. This it does by augmenting the action of the heart and the quantity of respiration, by which the vital properties of the blood are improved, and sent freely into all parts of the body; when the

previous torpor of the brain, stomach, intestines, and voluntary muscles, is succeeded by an increased activity of all the functions. The effete matter of the system that had accumulated in, and still further vitiated the blood during the cold stage, together with the superfluous amount of caloric that marks the hot stage, are carried off through those natural sewers, the skin, kidneys, and bowels, when the sweating stage comes on, and puts an end to the paroxysm. Such are the leading symptoms that mark the progress of intermittent fever, which may be regarded as the type of all the other varieties.

But why do the paroxysms return at nearly regular periods of 24, 48, and 72 hours, as in the quotidian, tertian, and quartan forms of fever? Why is the cold stage longer, while the paroxysm is shorter, in the quartan than in the tertian, in which the cold stage is again longer, and the paroxysm shorter, than in the quotidian? Why is the chill shorter and less distinctly marked in fevers that continue, with slight remissions in the morning, for several days, or even weeks, than in intermittents? Why, in nearly all of them, should it come on more frequently in the early part of the day than after noon? And why, in continued fevers, does the remission occur in the morning? So far as I am aware, none of these important questions have ever yet been answered in a satisfactory and philosophical manner by pathologists.