ing is excited for the cure of fever; and the want of attention to this has probably in fome degree contributed to bring the practice into difcredit. The ordinary mode of producing fweat by the exhibition of ftimulating medicines internally, is infallibly attended with the effect of increasing the action of the heart and arteries, before the fweating takes place; and where the sweat does not readily come on, as is fometimes the cafe, the increased action is communicated to the veffels of the affected part, and the disease is thus often aggravated, instead of being relieved. This not unfrequently happens in ftrong and vigorous habits.

Many, again, of the fudorific remedies in common ufe, contain fubftances which exert a specific action on the brain and its functions, and on this account might be termed fenforial ftimuli. Such are opium and narcotics in general, and alkohol in its various forms; all of which manifeftly excite the vascular fyftem of the brain, and, when carried to excefs, produce the very difeafe in question. These are undoubtedly useful in certain ftates and circumftances of fever, but are as certainly prejudicial in others.

The moft fimple mode of exciting fweat,

and the most free from the objections stated, appears to be by the application of external heat to the skin, by bathing or other ways. With proper management, it is probable that fweating might be thus produced, without materially increasing the action of the general fanguiferous fyftem. Thus among rude nations, fevers are commonly treated fuccefsfully by the vapour bath.

It may be remarked of the different evacuations above mentioned, as remedies for fever (and the fact is not difficult to be understood), that they mutually affift the operation of one another, fo as to render each more effectual. Thus bloodletting, where it does not abfolutely cure, often makes other remedies more fafe and efficacious. When, for example, the action of the heart and arteries is much increafed, fudorifics, which are generally of a heating and stimulating nature, are fometimes detrimental. In fuch cafes bloodletting is ufefully premifed. So alfo, where emetics, given at the commencement of fever, fail to cut fhort the disease, they are ftill of confiderable advantage as preparatory to fweating, which they serve to render more full and efficient.

Sydenham fays, that "it is found by

experience that purging, after bleeding, quells a fever fooner and better than any other remedy whatever*;" and again, in the following page, "for these reasons, I can, I trust, affert upon good grounds, that the above mentioned method of cure is more powerful than any other for the fubduing fevers of moft kinds."

Mr. Beane, an army furgeon, defcribing the fever of Demerara, one of the West India fettlements, obferves that bleeding, within twenty-four hours of the attack, or even after that time, relieved the headach immediately, and, followed up by an active purge, put a stop to the further progrefs of the diseaset.

The indications of cure laid down by Dr. Jackson in contagious fever (the fever of temperate climates), were, on the first day of the disease, to excite a new train of action, by vomiting, purging, and fweats. If this was done, he fays, within twelve hours from the commencement, the progrefs of the disease was either cut short ab

* Pechey's Sydenham, p. 432.

+ See Mem. of Med. Soc. of London, vol. 5, art. 35.

ruptly, or the threatened violence fo much mitigated, that accidents feldom occurred*.

The good effects of the combined use of bloodletting and purging in the cure of fever in the Weft Indies, are ftrikingly dif played in the following narration by Mr. Downey, a navy furgeon. "The ufual confequences of bleeding were," he fays, "an abatement of the pain of the head, ftomach, and loins. Though the pulse had no great degree of hardnefs or fulness, and though the patient was often liable to faint on the lofs of four or five ounces of blood, yet thefe circumstances did not in any cafe deter me from carrying on the evacuation, to twelve, fixteen, or even twenty ounces, if the pain in the head was very violent. The evacuating medicine having operated brifkly, fcarce any pain remained; but, in general, on the next morning, fome giddinefs was complained of, which was relieved by another dofe of calomel and jalap, or faits the fame medicine was repeated on the third day, or on the fourth, if the patient was tolerably free from complaint on the third. In many, the disease required bleeding two or three days fucceffively, or

Outlines of Fever, chap. xi, fect. 1.

even twice in the twenty-four hours, as the pain in the head or region of the ftomach. was more or less difpofed to give way; and the evacuations by ftool were always kept

up

in proportion to the bleedings. In relapfes which occurred at the end of feven or ten days, or later, the fame mode of treatment was used; and though it was not often neceffary to carry it to the fame extent as at first, yet the good effects were equally vifible*."

*See Dr. Trotter's Medicina Nautica, vol. 2.