ble attempts, has never yet been adequately performed.
The work is divided under two heads. The first Part contains the General Doctrine of Fever, according to the principles here affumed. The fecond will contain its particular application to the various states of the disease, with a more minute examination of the effects of remedies.
In this, I flatter myself with the idea of being able to estimate, with greater precifion than has been hitherto done, the value of particular points of practice, the good effects of which, in a general way, are fufficiently ascertained, but which at present are applied with little difcrimination; and that from our not understanding the circumftances which may modify the effects of remedies, fo as to render that proper and useful at one
time of a difeafe which would be hurtful or
unneceffary at another.
The Doctrine here contended for, namely, that Fever confifts effentially in topical inflammation of the brain or its membranes, would feem, at first view, to indicate the neceffity of bloodletting to a great extent, as a general means of cure. A practice of this kind, however, is no juft or neceffary inference from the doctrine, as I truft will be fatisfactorily fhewn. Yet the keeping in our view the existence of a morbid vascular action in the brain, may be productive of advantage in various refpects; but most efpecially with regard to the use of heating and intoxicating medicines, as fpices, wine, opium, and the like, which are too often in modern practice carried to a dangerous length.
The most obfervant phyficians at prefent in this metropolis, and I believe alfo in other parts, are becoming daily more and
Sect. IV. Of the State of the Natural Functions in Fever, 69-the
natural functions liable to be variously affected--stomach al-
ways difordered, and why, 72-influence of the Brain on the
ftomach, and vice versa, 75
Sect. V. Of fome other Phenomena of Fever, 76-rigor and cold-
ness not peculiar to Fevers, but accompany Inflammation in
general-Petechie, Macula, and Vibices explained, 72, 80-the
Brain equally the feat of difeafe in the Eranthemata, 81
Se&t. VI. Of the remote Caufes, as indicating the Seat of Fever,
84-remote caufes of Fever numerous, 85-enumeration of
them, 85, 85-their mode of acting, 86
Sect. VII. Of Predifpofition to Fever, as contributing to indicate
its Seat, 91-idiots, maniacs, negroes, the very old, and the
very young, less liable to Fever than others, 91, 94
Sect. VIII. Of the Confequences of Fever, as indicating its Seat, 95
-the functions in immediate dependance upon the Brain, as
the external fenfes, the voluntary power, and mtellect, peculi-
arly liable to be impaired after Fevers, 95, 98
CHAP. III.- -OF THE NATURE OF FEVER, 99
Feyer is probably Inflammation in the Brain-proved by refer-
ence to the phenomena and caufes of the difcafe, the effects of
remedies, and the appearances on diffection.
Se&t. I. Of the Analogy between the Phenomena of Fever and
thofe of Inflammation, 101—heat, pain, and throbbing in the
head fenfibility preternaturally acute, 102, 106-furred
tongue, 109-introduced by the fame train of fymptoms, 110
Sect. II. Of the State of the Blood in Fever and in Inflammation,
112-the buffy coat often appears in both, 112-but not effen-
tial to either, 113
Sect. III. Of the exciting Causes of Fever, as compared with those
of Inflammation, 114-are, in both cafes, in a great measure
the fame
Sect. IV. Of the Way in which the Causes of Fever may be fup-
pofed to produce their Effect on the Brain, 116-difficulty of
the fubject-no ncceffity for supposing infectious matters to be
abforbed, 120-they may act on the extremities of nerves,
and affect the Brain by fympathy-no decifive proof that va-
riolous matter is abforbed, 121
Sect. VI. Analogy between Fever and Inflammation in regard to
the Cure generally, 125-natural progrefs and termination
alike, 125-both cured by the same artificial remedies, 126-
for inftance, bloodletting, vomiting, fweating, purging, blif-
tering, and the application of cold, 127, 128-Differences
obferved between Fever and Inflammation are referable to di-
versity of structure and laws of acting, 131
Sect. VII. of Predisposition to Fever, as indicating the Nature
of the Difeafe, 133-circumftances which predispose to inflam-
mation, predifpofe alfo to Fever-prevention alfo fimilar, 136,
Sect. VIII. Of Fever as compared with the Phrenitis of Authors,
138-comparison of the fymptoms of phrenitis with those of
Fever-characters of phrenitis very equivocal, 144—the term
phrenitis has been ufually confined to acute inflammation of
the Brain, 145-chronic inflammation of this organ has been
greatly overlooked, 150-phrenitis allowed on all hands to be
a frequent concomitant of Fever, 151—occafional causes of
Fever and phrenitis are the fame, as, certain poifons, and ex-
ternal violence
Sect. IX. Of Diffection, as illuftrating the Nature of Fever, 156
-diffections of the Brain unfatisfactory, and why, 157-few
competent to the inquiry, 159-the Brain has been feldom
examined after Fever, 161-Morgagni has few inftances of the
fort, 162-Inflammation has been frequently discovered in
the Brain after Fever, 168--inftances from Bonetus, Mor-
gagni, Lieutaud, Werlhoff, Haller, Sir John Pringle, Dr. D.
Monro, Vogel, Drs. Baillie, Jackson, &c., 168, 174
Sect. X. Opinions of Authors with regard to the Seat and Nature
of Fever, 179-great contrariety of fentiment on the fubject,
179-opinion of Hippocrates, 180-of Erafiftratus, 182—of
Afclepiades, 182-of Themifon, 183-of Galen, 183—of Di-
ocles Caryftius, 184-of Avicenna, and the other Arabians,
184 of the chemical and mechanical fećts, 185, 186-of
Hoffinan and Cullen, 187-of Van Swieten, 189-of Willis,
Sydenham, and Morton, 190-nature of Fever said to be un-
more convinced of the impropriety of an in-
difcriminate use of remedies of this descrip-
tion, in the treatment of Fever even of the
lowest kind. Yet there are ftill too many
practitioners who administer to their patients,
with an unsparing hand, wine and even al-
kohol, with other things of the fame general
nature, with little regard to time or other
important circumftances.
Debility feems to be their only dread;
and to counteract this (which is an effect
only, and not the essential part of the disease),
they refort to the ufe of means that are cal-
culated to increase the cause.
In this way,
they not only fail to effect their purpose, but
too often facrifice the patient in the attempt.
-If the only effect of the doctrine here incul-
cated were that of inducing a greater degree
of caution in the use of remedies of this fort,
I fhould think I had performed no fmall fer-
vice to fociety.
|