of all that I have been able to ascertain with regard to this most important part of the subject. In the attempt to communicate this information, I am conscious that I may incur the charge of tediousness, on account of the number of repetitions which occur, and which I have allowed to remain because I could see no means of removing them without sacrificing clearness to brevity. Elegance and conciseness, in a work of this nature, ought not for a moment to be considered if they endanger its practical usefulness. A knowledge of the condition of the internal organs, in fever, can alone guide us to a rational and successful treatment of this most dangerous disease. It is only by examining the body after death that we can acquire this information: it is only by observing the symptoms during life and comparing them with the morbid appearances after death, that we can discover the signs which indicate the existence of these states. For these reasons I have not hesitated to give numerous cases and to detail many dissections. If after the study of these cases and dissections the practitioner be enabled at the bedside of the fever patient to discover with greater precision and certainty than heretofore the condition of the brain-the condition of the lungs-the condition of the intestines, he will not think the time he has devoted to the investigation ill spent, nor shall I think myself without reward for the labour it has cost me to draw up the record. It is only

when from external appearances we are able to see what is going on within each of the great cavities of the body, as clearly as we should do if their walls were transparent, that our interference can be sure of doing good, or secure from doing mischief: it is this kind and degree of knowledge alone which can teach us both when to act and what to do; and what is of almost equal importance, when to stop and to attempt nothing; and if the perusal of this work should contribute in any measure to the attainment of this knowledge, I shall not have laboured wholly in vain, "to add something to the treasury of physic."

CHAPTER II.

Varieties of Fever. Common Phenomena. Importance of this Analysis. Results of the Analysis. Organs always diseased in Fever: Functions always deranged in Fever. Fever not Inflammation: Distinction between these two States of Disease. Common Phenomena of Fever exemplified in Plague, in Yellow Fever, in the Varieties of the Fever of our own Country. Different Varieties produced by different Intensities of the same Affections. Received Classification and Nomenclature defective. What is really meant by Genera and Species of Fever. True Princiciple of Arrangement.

FEVER is a genus consisting of several species, and each species presents many varieties. The external characters of these varieties and the internal states upon which they depend, are so opposite, that no two diseases in any two parts of the catalogue of nosology present a more diversified appearance, or require a more varied treatment, than may be the case with two different types of fever. The fever of one country is not the same as the fever of any

other country; in the same country, the fever of one season is not the same as the fever of any other season; and even the fever of the same season is not the same in any two individuals. Many of the circumstances which constitute these varieties in the fevers of different seasons and of individual persons, are slight and trivial; but some of them are of the greatest possible importance, and those diversities, especially, which distinguish the fevers of different climates, are intimately connected with the causes, whatever they be, which render the disease mild or severe, and, consequently, comparatively innoxious or fearfully mortal.

Something there is, however, which, amidst this astonishing diversity, preserves the identity of the disease so completely and so obviously, that there never has existed any dispute about that identity, under any aspect which it has hitherto been observed to assume; so that all physicians, without exception, unhesitatingly accord the name of fever to the mildest form of the common fever of this country, to the yellow fever of the West Indies, and to the plague of Constantinople and of Egypt. Bring three persons, each exhibiting an exquisite specimen of one of these several forms of the disease into the same ward of an hospital, the external aspect presented by each would be so different, that an unprofessional observer would probably be able to discover in these modifications of the same malady

no common property: yet there is no physician who would not, in each case, instantly pronounce the disease to be fever. There must, therefore, be something that establishes the identity of the disease under this diversity of aspect. What is that something? Whatever it be, it must be common to all the varieties of fever. Thus we are led at once to the second inquiry which we proposed to keep before us in this investigation, namely, what are the particular phenomena which are common to all the varieties and combinations of the disease?

The importance of making this analysis has been felt by every person who has directed his attention to this subject from the remotest antiquity down to the present time. That it is not as easy to be made as the necessity of it is plainly to be perceived is abundantly attested by the want of success which has hitherto attended the efforts to perform it of the acutest minds, and the acutest minds, the pride and boast of our science have applied themselves to the task. Notwithstanding their labours however, the analysis made by Hippocrates has been received through succeeding ages with little variation, and continues to be received even in modern times with only slight modification. And yet that reflecting men of every age have not been satisfied with resolving all the essential phenomena of fever into heat, although they have all consented to designate the dis