6QS ACUTE INFECTIOUS DISEASES. 



thema. This has been accounted for upon the obscure hypothesis of 

 a metastasis of the disease to internal organs. 



The most common complications of sweating-sickness observed 

 in the more accurately described epidemics are angina and a diphthe- 

 ritic stomatitis, generally termed aphthae. More rarely it is compli- 

 cated with bronchitis and pneumonia. In a few of the epidemics 

 dysentery was observed instead of the usually obstinate constipation. 

 When of very protracted duration, or unusual intensity, then, like 

 other tedious and very severe infectious disorders, it develops a 

 hsemorrhagic diathesis with abundant epistaxis and the appearance 

 of petechia, and in women by abnormal bleedings from the genitals. 



Unfortunately, no accurate measurements of the bodily tempera- 

 ture during sudor anglicus have as yet been taken. This circumstance 

 greatly embarrasses our estimate of the physiological value of the 

 symptoms. How, for instance, is the peculiar restlessness to be ac- 

 counted for ? Is it due to inspissation of the blood through enormous 

 sweating, and upon consequent impediment to its circulation through 

 the capillaries of the lungs, as in cholera, with which sudor anglicus 

 has been compared ? Or, is the calorification so much heightened 

 during the fever as to occasion a surcharge of carbonic acid which 

 cannot be neutralized by respiration ? Indeed, we are forced to the 

 inference (owing to the considerable cooling which the skin must 

 suffer through evaporation of the profuse perspiration) that the pro- 

 duction of heat is much more active in sudor anglicus than in infec- 

 tious diseases in which the skin remains dry, always supposing the 

 temperature of the diseases to be equal. Cooling of the body by 

 evaporation of the sweat may protect the patient from the perils aris- 

 ing from too high a temperature of the blood, but not from its over- 

 charge with carbonic acid one of the necessary results of excessive 

 calorification ; at all events, this would account for the apnoea of 

 sweating-sickness. Again, does the supposed danger of checking the 

 sweating depend upon the fact that, without the cooling effect of 

 rapid evaporation of the sweat, the temperature will reach a point at 

 which the brain and heart are palsied ? Such questions must be de- 

 ferred until our knowledge of the temperature in sudor anglicus shall 

 be made as exact as that of typhus and other disorders. 



TREATMENT. Until we shall have more thoroughly investigated 

 the conditions upon which the sweating-sickness depends, prophy- 

 lactic measures against its invasion and extension are out of the 

 question. 



At the outset of the attack an emetic is urgently recommended by 

 many. From all reports, however, it is by no means clear that the 

 disease has ever been cut short by this means; and we shall 



