Dr. Mac Calloch on Fevers, 41 



with intervals of better health, or real health, it may, in its 

 progress, become so mild as scarcely to display any striking 

 febrile symptoms, particularly when medical advice is not 

 sought : the appearances being then what we noted above, 

 namely, debility, and so forth ; while it is by no means 

 uncommon in this disease for the pulse, the appetite, &c. to 

 remain unaffected, or to be only partially and temporarily 

 disturbed — a fact, to excite no surprise, since, even in very 

 marked marsh fever, the pulse is sometimes not affected, or 

 at least not accelerated. Nor should the existence of such 

 a durable remittent be a matter of any doubt. It possesses 

 an exact analogy to the equally durable intermittent, little 

 known in this country; the difference being, in fact, unessen- 

 tial : while of its reality there can be no question, since it is 

 the very condition of ill health under which those suffer 

 perennially, who are the inhabitants of the insalubrious dis- 

 tricts of France and Italy. 



There are some interesting remarks in this chapter on the 

 state of the appetite and sleep, and also on the condition of 

 the mind. If we cannot, for want of room, venture to detail 

 them, we must notice, at least, one important conclusion 

 to which they lead : this is, that the hypochondriasis, so 

 common, is very generally or predominantly this very fever, 

 and nothing else ; while the author enters here, and else- 

 where, into some curious and important remarks on suicide, 

 showing how it is the occasional consequence of a febrile 

 delirium dependent on these chronic fevers, and not either 

 that state of insanity which it has often been considered, nor 

 the consequences of mere moral aberration. We need not 

 say how important this view is as it relates to the treatnient 

 of the mental diseases in question. The remarks on that 

 comatose state, which is so common a symptom in these 

 fevers, are scarcely less important: as they serve to rectify 

 those dangerous errors in practice which, by treating this as 

 lethargy, (a term to which no definite notions are attached,) 

 have often produced palsy, apoplexy, or death. 



Thus also is it shown, that, as derangement of the stomach 

 is a necessary attendant on this fever as on others, so, many 

 of the cases of dyspepsia which occur in society are nothing 

 else : the most marked affection, in this instance as in so 

 many others, attracting the attention both of the patient 

 and practitioner, when the febrile symptoms are, from their 

 obscurity, neglected ; while the possession of a name, a 

 term, such as dyspepsia, hysteria, or whatever else, helps 



