RELATION OF FOOD TO WORK, AND 287 



})urging', vomiting, and bleeding the patient, with the view of eliminating 

 iia imaftiuary poison, and so helping nature to terminate the disease.* 



In modern times, thauk God, the i)hysieian either does not interfere 

 ai all, or adopts the rational process of retarding- the disintegration of 

 Ihe tissues consumed to supply the fever heat, by furnishing m their 

 stead fuel, in the form of wine and beef-tea, sufficient to maintain the 

 increase of temperature imperiously required.! This practice may be 

 justly considered rational, because the condition of the circulation admits 

 of its ap[)]ication ; and it is considered good, because it has been rewarded 

 V. ith success in the hands of the skillful clinical physician. In concluding 

 this sketch of the prominent symptom of typhus fever, and as an illus- 

 tration of the eagerness with Avhich every possible combustible in the 

 body is made use of, I may mention, on the high authority of Dr. Stokes, 

 of Dublin, that the very urea excreted by the kidneys is not permitted 

 to leave the body \«ithout first paying its tax to fever, by being burned 

 into carbonate of ammonia, thus rendering the urine of an advanced case 

 of bad typhus fever eminently alkaline. 



B. Asiatic cholera. — This remarkable disease presents, as every one 

 knows, three distinct stages, viz : 



1. The premonitory stage of diarrhoea. 



2. The stage of collapse. 



3. The stage of consecutive fever. 



The stage of collapse exhibits the following symptoms : Vomiting or 

 purging; muscular cramps; suppression of bile and urine; lowering of 



* i\ovao)V (pvaisc 'i-ri'poi. — EpiD. vi, Sect, v, 1. 



+ It is not iutendecl by this to assert that a high temperature, 104° to 108° F., must be 

 maintained in order that the disease may terminate favorably, for the very contrary 

 is the fact. The blood, in typhus, as in other pyrexies, is a liuid possessed of greater 

 oxidizing power than it has in health; in consequence of this, an increased ujetamor- 

 phosis of tissues takes place, accompanied, of course, by an elevation of temperature, 

 which measures i)recisely the oxidizing power of the blood, and the risk to life in typhus 

 is directly i)roportioual to the rise in temperature. The indications of the sphygmograph 

 are similar to those of the thermometer, a "/(/7/ dicrotic" pulse corresponding to a tem- 

 perature of 103° F., and the pulse of ^^ death agony," with the heart's first sound gone, 

 corresponding to a temperature of 109° F. There is no case on record of recovery from 

 a condition marked by such a iiulse and temperature. 



The effects of alcohol, administered in fever, when the temperature does not exceed 

 105° F., are twofold — immediate and secondary. The immediate effect is to supjily a 

 hydrocarbon to the blood, which is decomposed by it in preference to the body tissues. 

 The secondary effect of alcohol is to change the blood itself, which thus loses its oxidiz- 

 ing qualities ; in consequence of which the temperature falls, the hyperdicrotic character 

 of the pulse disappears, and the destructive metamorphosis of the tissues becomes les- 

 sened. The statement here given of the effects of alcohol given in tj'phus, to the exact 

 amount required by the condition of the blood, in narcotic doses, is borne out by clinical 

 observation, and is iudepeudent of any theory as to the cause of typhus. 



It is not at all improbable that the theory of contagious disease, that each such 

 disease owes its existence to a special living organism and not to an organic poison, 

 may ultimately prove to be correct. 



