FEVERS. 501 



effect of the debilitating cause, not purely as a mark of debility, 

 as it might at first appear, but of the effort of the system to- 

 wards a reaction to overcome the state of debility. This re- 

 action, I have remarked, is the effect of the spasm ; now in 

 proportion to the greater degree of tremor, the reaction proves 

 more considerable, and the spasm is more speedily resolved. This 

 is exactly agreeable to observation, for we find that in the be- 

 ginning of a paroxysm of an intermittent, the tremor is more 

 considerable than in the beginning of a continued fever ; and 

 intermittents admit of a solution more quickly, in proportion as 

 the reaction and the tremor are more violent. Senac (de re- 

 condita febrium natura), in treating of the febrile cold, observes, 

 that where the rigor and tremor in the beginning are very vio- 

 lent, there the fever certainly turns out an intermittent, and the 

 paroxysms then admit of a quick solution. He also remarks, 

 that the cold fit is sometimes extended to hours ; but whenever 

 the paroxysms are long protracted, the cold fit in the beginning 

 is in proportion less remarkable. But we also find, that the 

 cold stage is most considerable in those intermittent fevers 

 which have the shortest paroxysms. The horror, tremor, and 

 rigor, are always most considerable in quartans less so in ter- 

 tians least of all in quotidians and continued fevers are mark- 

 ed by almost no tremor at all. 



" It appears from this, that the horror and tremor are not to 

 be considered as purely symptoms of the first operating debili- 

 tating cause, but that they are the consequence of the reaction 

 of the system which follows : hence, from their condition, we 

 are enabled to judge of the condition of the disease that is to 

 follow, which is of great consequence in distinguishing fevers." 



XLVI. Upon the whole, our doctrine of fever is explicitly 

 this : The remote causes (XXXVI.) are certain sedative 

 powers applied to the nervous system, which, diminishing the 

 energy of the brain, thereby produce a debility in the whole, 

 of the functions (XXXV.), and particularly in the action of the 

 extreme vessels, (XLIII. XLIV.). Such, however, is, at the 

 same time, the nature of the animal economy (XXXVIII.), 

 that this debility proves an indirect stimulus to the sanguiferous 

 system; whence, by the intervention of the cold stage and 

 spasm connected with it (XXXIX. XL.), the action of the 



