FEVERS. 505 



he practised ; and Cleghom observes, that in Minorca it is the 

 produce of every warm season, and appears there sooner or later 

 as the heat is sooner or later in setting in, though, in general, 

 it extends from the middle of July to the middle of September. 



" Such is the fact ; but the theory is uncertain, in as much as 

 it is a question, whether the bile is secreted in greater quantity, 

 or in a more acrid state, occasioning a more copious afflux by its 

 stimulus. But it is a fact, also, that the cholera may happen 

 without any fever either preceding or accompanying it : what- 

 ever therefore may be the change affecting the bile, it does not 

 of itself necessarily produce fever. We observe, indeed, when 

 this state of the bile takes place, and a cause of fever occurs at 

 the same time, that then such fever will probably be attended 

 with an evacuation of bile. But this afflux is an effect of fever 

 rather than a cause. For it is obvious that the attack of fever 

 is attended with a constriction of the extreme vessels ; which, to- 

 gether with the debility of the body, certainly prevents the blood 

 from being sent in its usual quantity to the extreme vessels : 

 it will therefore be accumulated in the body, and particularly in 

 the venous system, where the circulation is more languid, and 

 the dilatation greater. Thus it will be more copiously deter- 

 mined to the vessels of the internal parts, and especially to what 

 I call the hypochondriac system, or system of the vena porta- 

 rum, in which there is not only the largest proportion of venous 

 blood, but where it is more difficultly transmitted ; for wher- 

 ever the blood is not determined to the surface of the body, we 

 find that it is in consequence collected in the vena portarum. 

 And that such congestions are in fact formed in fevers, is well 

 known ; the dissections of such as have died of intermittents, 

 have shewn a great increase in the bulk of the liver and spleen. 

 But if the blood is thus collected in that region, it must produce 

 a more copious secretion of bile. 



" Another circumstance, also, which attends the beginning of 

 fevers, has a share in producing this bile, viz. the vomiting, 

 which, when forcibly exerted, does emulge the biliary ducts, and 

 therefore produces a more copious afflux of bile into the intes- 

 tines, which, in consequence of the inverted peristaltic motion, is 

 thrown into the stomach. 



" Now, I think this unusual discharge of bile may appear with- 



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