FEVERS. 511 



may still presume, that the general tendency of the economy 

 prevails, that the disease still consists of repeated paroxysms, 

 and, upon the whole, that there is no such disease as that which 

 schools have called a continent fever. " We observe, I say, 

 the most distinct intermittent changing into the most continued 

 form. Thus, the quartan, which has an interval of seventy- 

 two hours, gradually changes its form : it first has its paroxysm 

 lengthened out, then it becomes a double quartan, having a pa- 

 roxysm on one of the intermediate days which was free before ; 

 then it changes into a triple quartan, appearing every day, yet 

 being still a quartan, because it arises out of that form and often 

 passes back into it, and because the fits of every fourth day only 

 are similar. Then it changes into a remittent, the exacerbations 

 of which gradually become more obscure, till it puts on the form 

 of continued fever. So that a quartan may take the form of 

 what is called a continent, in which little exacerbation or none 

 at all can be observed ; yet, by its cure and by its frequent re- 

 turn back again, we know that it was originally an intermittent. 



" The same is the case with respect to the tertian, which, 

 doubling, has a fit every day, thus putting on the appearance 

 of a quotidian, and afterwards goes into the form of a remit- 

 tent, and into that of a continued fever. 



" Now, I say, from this change which so frequently occurs 

 in practice, I think it is to be suspected that, if in any case 

 physicians can allege that the exacerbations are not observed, 

 this is rather to be imputed to the difficulty of observing them, 

 or to the inaccuracy of physicians, than to any deviation of the 

 disease from what is so universal and so strongly determined by 

 a general law of our system. I would say, therefore, that there 

 is no such fever as the schools have agreed to call a Continent ; 

 but that every fever which runs out to more days than one, is 

 formed of repeated paroxysms, recurring in the course of twenty- 

 four hours, or truly consists of diurnal exacerbations. 



" I think I have rendered this conclusion very probable, but 

 it may still remain doubtful, as being a question about a matter 

 of fact, which has not been sufficiently attended to. And, to 

 excuse myself in giving this against the testimony of physicians 

 in all ages for few have admitted of the very doubt I must 

 beg leave to observe, that the observations of the greater num- 

 ber are but little to be regarded, being generally guided by 



