494 PRACTICE OF PHYSIC. 



a spasmodic constriction has taken place, that it subsists for 

 some time, and supports the hot stage ; for this stage ceases 

 with the flowing of the sweat, and the return of other excretions, 

 which are marks of the relaxation of vessels formerly constricted : 

 Hoffmann, Med. rat. System, torn iv. p. i. sect. i. cap. 1. art. 4. 

 " After Hoffmann, almost every one who has read his writ- 

 ings has acknowledged that a spasm of the extreme vessels takes 

 place in the beginning of fevers ; that the subsistence of this 

 gives their continuance ; and that upon the yielding of this the 

 fever has its solution. This is his system ; and the doctrine is 

 in a great measure perfectly well founded. It explains well 

 the purpose of the increased action of the heart and arteries, 

 which is to overcome the spasm, and thereby give a solution 

 of the disease, rather than for the concoction of morbific mat- 

 ter, &c. ; and it also explains well why evacuations do accom- 

 pany and seem to be the means of the solution of fevers, as the 

 relaxation of spasm must be attended with more or less eva- 

 cuation." 



XLI. The idea of fever then, may be, that a spasm of the 

 extreme vessels, however induced, proves an irritation to the 

 heart and arteries ; and that this continues till the spasm is re- 

 laxed or overcome. There are many appearances which sup- 

 port this opinion ; and there is little doubt that a spasm does 

 take place, which proves an irritation to the heart, and therefore 

 may be considered as a principal part in the proximate cause of 

 fever. It will still, however, remain a question what is the 

 cause of this spasm ; whether it be directly produced by the re- 

 mote causes of fever, or if it be only a part of the operation of 

 the vis medicatrioD natures. 



XLI I. I am disposed to be of the latter opinion, because, in 

 ihejirst place, while it remains still certain that a debility lays 

 the foundation of fever, it is not obvious in what manner the de- 

 bility produces the spasm, and, what seems to be its effect, the 

 increased action of the heart and arteries ; and, secondly, be- 

 cause, in almost all the cases in which an effort is made by the 

 vis medicatrix natures, a cold fit and a spasm of the extreme 

 vessels are almost always the beginning of such an effort. (See 

 Gaub. Pathol. Medicin. art. 750.) 



XLIII. It is therefore presumed, that such a cold fit and 



