FEVERS. 507 



must now attend to this, that though I have constantly spoken 

 of them as separate and successive, this is not strictly true ; for 

 during each paroxysm, except in the beginning and at the end of 

 it, all the three different states are, in some measure, present at 

 one time. Thus, to take the most intermediate part : while the 

 hot fit continues without any sweating taking place, and while, 

 at the same time, the urine continues thin and limpid, we con- 

 clude that the extreme vessels are still under a state of constric- 

 tion, that is, the spasm does still remain so long ; but while the 

 spasm remains, the debility which occasioned it must remain 

 also ; we must infer, therefore, that the energy of the brain is 

 not restored to the extreme vessels. That this state of debility 

 does subsist for a great part of the time which a paroxysm oc- 

 cupies, is not only evident from this reasoning, but manifestly 

 appears from the extreme debility of the animal functions, and of 

 those of the senses, and, therefore, from the symptoms relative 

 to the stomach, the want of appetite, nausea, &c. which may 

 be considered as marks of the same debility. It is consequent- 

 ly the continuance of the debility and spasm which properly reg- 

 ulates the duration of fever. Now, if we can suppose that these 

 states subsist in a different degree and proportion in different 

 fevers, it will be a considerable step, as we will then have 

 found, in general, upon what the difference of fever especially 

 turns. But, before we proceed further, I must observe what 

 differences of fever are established by just observation, so that 

 our theory, as we call it, may correspond to matter of fact. 



" All physicians are agreed that fevers are of two kinds, the 

 Intermittent and Continued, constituting the first and second sec- 

 tions in our synopsis. The intermittents, in the most common 

 acceptation of the word, are such fevers as consist in a repeated 

 number of paroxysms, between which an intermission or apy- 

 rexia intervenes. The second kind, the continued fevers, are 

 with more difficulty explained. They consist also of repeated 

 paroxysms, but without the intervention of any perfect inter- 

 mission. When I say that they consist of paroxysms, it neces- 

 sarily follows that if they are not separated by an intermission 

 or state of apyrexia, they are at least distinguished by times of 

 exacerbation and remission, which are particularly to be observed 

 with respect to the hot fit. As these remissions have been more 



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