550 PRACTICE 0V PHYSIC. 



2. The same inflammatory disposition accompanied with ca- 

 tarrh. 



3. A gangrene of particular parts. 



4. A palsy of a single member. 



5. A fever, or fever strictly so called (VIII.), which it often 

 produces by its own power alone ; but more commonly it is only 

 an exciting cause of fever, by concurring with the operation of 

 human or marsh effluvia. 



" I will not positively determine that cold may not of itself 

 produce fever, but it very seldom does so ; and I am persuaded 

 that if ever it produces any thing like fever, it is the simple and 

 mild Synocha. To this opinion on a point which is of some 

 consequence I am determined by the following considerations. 



" In those cases where we can distinctly observe the opera- 

 tion of cold, and where nothing else can be supposed to have 

 operated, we find that it universally produces topical affections 

 of the inflammatory or catarrhal kind. In those cases, there- 

 fore, in which neither the one nor the other, but proper fever is 

 produced, it may be doubted whether that is the effect of cold 

 alone. It is to be observed, that though miasma and contagion 

 are not always evident, they may operate more frequently than 

 has been imagined. In proof of this I say, that every coun- 

 try of which I have got a physical history, has upon certain 

 occasions heat enough to generate the marsh effluvia ; and from 

 any accounts I have had of these countries, they have been af- 

 fected with those epidemics which are the particular effects of 

 marsh effluvia. These effluvia may be more or less virulent ; 

 and though not in such quantity as to produce a remarkable 

 epidemic, yet they may attack persons in particular circumstan- 

 ces, and operate with the concurrence of cold and other causes ; 

 so that though they are not always evident, it would be rash to 

 put a negative upon their existence. With respect to the 

 human effluvia, the matter is still more evident. The poor 

 people in all countries wear the same body and bed clothes for a 

 considerable time, and live frequently in close unventilated 

 places, where putrid excrements are produced. This is particu- 

 larly the case in jails and hospitals, where the effluvia are ac- 

 cumulated in a remarkable degree ; and when we consider that 

 the cause exists so frequently, we may indeed wonder that the 



