496 PRACTICE OF PHYSIC. 



the stomach from the muscular fibres of the extreme vessels on 

 ,the surface of the body. 



That the debility of the stomach which produces vomiting in 

 the beginning of fevers, actually depends upon an atony of the 

 extreme vessels on the surface of the body, appears particularly 

 from a fact observed by Dr. Sydenham. In the attack of the 

 plague, a vomiting happens which prevents any medicine from 

 remaining on the stomach ; and Dr. Sydenham tells us, that 

 in such cases he could not overcome this vomiting but by exter- 

 nal means applied to produce a sweat, that is, to excite the ac- 

 tion of the vessels on the surface of the body. 



The same connexion between the state of the stomach and 

 that of the extreme vessels on the surface of the body, appears 

 from this also, that the vomiting, which so frequently happens 

 in the cold stage of fevers, commonly ceases upon the coming 

 on of the hot, and very certainly upon any sweat coming out, 

 (XIV.). It is indeed probable, that the vomiting in the cold 

 stage of fevers, is one of the means employed by nature for re- 

 storing the determination to the surface of the body ; and it is 

 a circumstance affording proof, both of this and of the general 

 connexion between the stomach and surface of the body, that 

 emetics thrown into the stomach and operating there, in the 

 time of the cold stage, commonly put an end to it, and bring on 

 the hot stage. 



It also affords a proof of the same connexion, that cold water 

 taken into the stomach produces an increase of heat on the sur- 

 face of the body, and is very often a convenient and effectual 

 means of producing sweat. 



From the whole we have now said on this subject, I think it 

 is sufficiently probable, that the symptoms of anorexia, nausea, 

 and vomiting, depend upon, and are a proof of an atony sub- 

 sisting in the extreme vessels on the surface of the bojty ; and 

 that this atony, therefore, now ascertained as a matter of fact, 

 may be considered as a principal circumstance in the proximate 

 cause of fever. 



XLV. This atony we suppose to depend upon a diminution 

 of the energy of the brain ; and that this diminution takes place 

 in fevers, we conclude, not only from the debility prevailing in 

 so many of the functions of the body, mentioned above 





