important organs. They are both frequently ushered in by coldnefs and rigors, to which fucceed the symptoms of re-action, as they are termed, heat, thirft, dry and foul tongue, accelerated pulse, and fuppreffion of excretions, fymptoms which ordinarily accompany inflammation, whatever be its feat, provided the heart and general vafcular fyftem fympathize with it; an effect that takes place much fooner when certain organs are inflamed than others, and which alfo depends much upon the previous ftate of the patient, in regard to itrength and irritability. The acceffion of fever is often preceded by an unusual feeling of health and sprightliness. It was remarked of a certain patient of naturally a fluggish understanding, that on the attack of a febrile diforder his conceptions were raised in a manner far above what was cuftomary to him in health.Van Swieten mentions a fimilar fact. "Vidi et ingenii acumen auctum in fingulis paroxyfmis febris intermittentis*.' Thefe circumftances, trivial as they may feem, furnish an indirect proof of the nature of the disease. The first and flightest degree of inflammatory action heightens the fenfibility of an organ, and enables it to perform *Com. in Aph., 560, its functions with augmented vigour this is the natural effect of that excited vafcular action which makes an effential part of the character of all inflammations. It is only in the further progrefs of the disease, when the part becomes oppreffed and fuffocated, as it were, by the violent action of its veffels, and the confequent effufion into its fubftance, obftructing and impeding the proper action of the individual component parts of the organ, that its functions become impaired, or wholly obliterated. Sect. II.---Of the State of the Blood in Fever and in Inflammation. SIMILAR to what ufually takes place in other inflammations, the blood, in many fevers, fhews, when drawn, the inflammatory cruft or buff on its surface. This appearance is not peculiar to any one form of the disease, but is occafionally obferved, in fevers of widely different characters. In what are called inflammatory fevers, and in vernal intermittents, it is a very frequent occurrence. It has been often obferved, likewife, in malignant fevers at their commencement, and even in the plague itself*: in thofe fevers, for inftance, where, towards the end of the disease, the crafis of the fluids appears broken down, and a great tendency to putrefcency comes on. The abfence of the inflammatory cruft on the blood, in many cafes of fever, is eafily accounted for, and affords no argument against the existence of inflammation in this difeafe; for the fame thing occurs occa *Frank de Curat. Morb. Hum., tom. i, 185; and Sydenham de Morb. Acut., fect. 2, cap. 2. fionally in other inflammations, even in thofe of the most acute and dangerous kind. In violent peripneumony, for example, the blood is tranfmitted with difficulty through the lungs, and the left fide of the heart, in confequence, does not receive its ufual fupply of that fluid, which becomes accumufated in the great veins of the heart, impeding the free return of blood from the head by the jugulars, and thus producing diftenfion of the veffels of the brain and confequent ftupor. In this cafe, the pulfe neither beats ftrong, hard, nor full, as in many other acute inflammations of these parts, nor is the blood when drawn obferved to be covered with the fame buffy coat: the disease, indeed, affumes altogether a new appearance, and, there is reafon to believe, has often in this state been mistaken for afthma, or other chronic affection of thefe organs. Sect. III.---Of the exciting Caufes of Fever, as compared with thofe of Inflamma tion. THE exciting caufes of fever are, many of them, the fame with those which produce inflammation in other parts. Thus heat, cold, and ardent fpirits, which are reckoned among the occafional caufes of fever, are likewise powerful agents in inducing inflammation. And we have feen that fever may be fuddenly excited by external violence inflicted directly on the brain*: . The specific causes of fever all fhew a tendency to excite inflammation in fome part or other of the system: this is obfervable in plague, fmall-pox, measles, angina maligna, fcarlatina, influenza, and others which will readily fuggeft themselves to the mind of the reader. Even in thofe fevers where external inflammation makes no effential part of their character, as in fimple idiopathic fever, there is nevertheless ob * See |