A recent writer, otherwife of good obfervation, fays, "it is neceffary in typhus to ufe every means in our power to increase the quantity of blood." This, to me, appears quite hypothetical. The fuggeftion, indeed, is limited by the obfervation, "that the quantity taken at one time should be fmall, and only repeated as often as the patient can take it without oppreffion." If this rule is properly attended to, little harm will be done; but, at the fame time, very little food will be taken.

The obfervation of those we are moft accuftomed to rely on has fufficiently evinced, that there is very little room for the exhibition of food in fevers; and that, in general, our best guide will be the inclinations of the patient while no caufe is fo conducive to relapfe in convalefcents, as the too early permiffion to indulge in a ftimulant and nutritious diet.

RECAPITULATION.

MY object, in the foregoing pages, has been to establish the two following propofitions:

First, That fever is not originally a difease of the whole fyftem, as is commonly thought, but a topical affection of the brain.

Secondly, That this affection confifts in inflammation; the general diforder obferved in the system, or what is called the febrile ftate, being merely fymptomatic of this, the fame as in other inflammations.

In fupport of the former propofition, I have attempted to fhew, that all diseases are neceffarily local in their origin, or affections of fome one particular organ or part of the body, influencing the rest of the fyftem in a fecondary way only.

This might be inferred from the known laws of the human economy; according to

which, we find that different parts are endued with different fufceptibilities, which render them liable to impreffion from certain caufes only, and infenfible to others.

But it is proved, likewife, by attention to the hiftory of diseases themselves. For if what are called univerfal difeafes, or difeases of the whole fyftem, be traced to their origin, there will almost always be found marks fufficiently obvious of the disorder of fome particular organ, affecting either its fenfibility or the due performance of its functions, and commonly, indeed, both together; while the general affection of the fyftem may be observed to come on fubfequently to this.

This pofition will probably be disputed by many; because it has been remarked by fome of the most refpectable practical writers, that in inflammations, both internal and external, the general affection often appears to precede the local for feveral hours, or even days. Thus Dr. Cullen says, with regard to Pneumonia-" this disease almoft always comes on with a cold ftage, and is accompanied with the other fymptoms of pyrexia. Sometimes the pyrexia is from the beginning accompanied with the other

fymptoms (the local ones); but frequently it is formed for fome hours before the other fymptoms become confiderable, and particularly before the pain is felt*.”

Without prefuming to question the truth of this, I may be permitted to remark, that the obfervation has been chiefly made in regard to inflammation of the lungs, where it is very difficult to ascertain the precise period of attack locally, on account of the natural infenfibility of these organs. Inflammation, it is well known, may take place in the lungs in the most violent degree, without being attended by much pain; and till this arifes, or the functions of the organ become confiderably deranged, the disease is not fufpected to exist.

Another circumftance leading to error here is, that inflammation often comes on in the first days of fever, and the fever itself fubfides. In this cafe, the general affection obferved to precede the fecondary topical diforder is, in reality, another difeafe, and affords an instance, not unfrequent, of what has been called the converfion of diseases

*First Lines, § cccxxxvi.

into one another. This, therefore, furnishes no argument against the opinion propofed.

But whatever conclufion may be made upon this point, the iffue of the question with regard to the topical nature of fever is not neceffarily involved in it; for though it be admitted that there are fuch things as general or universal diseases ab origine, I fhould ftill be difpofed to contend for the locality of fever, and its feat in the brain; and that for the following reasons.

In the greater number of inftances, the firft attack of fever is imperceptible. It often happens that for many days before the difeafe is fully formed, that is, before it becomes a general affection, the patient is feeble and liftlefs; he is neither well nor ill. Afk him his complaint, and he always refers to the head as the chief feat of diforder which indeed his countenance fufficiently indicates. He has a dull pain or heaviness of the head, his fleep is disturbed and unrefreshing, and he is incapable of his usual mental exertions.

;

At this period, the disease is strictly local. The brain is the feat of the diforder,