FEVERS. 569 



attended with some degree of infarction, and therefore with 

 some degree of resistance to the free motion of the blood in the 

 lungs ; and as all the inflammatory states of the lungs have con- 

 stantly more or less of cough attending as a symptom, this is to 

 be considered as a chief mark of the particular determination of 

 blood to the lungs. 



" I have only to add, that the degree of this determination 

 is especially expressed by the state of the countenance, by a 

 turgid, bloated, and purple suffusion of the face, which is only to 

 be explained by a resistance in the lungs preventing the return of 

 the venous blood to the right ventricle of the heart. This may 

 have its effects upon the Cava descendens as well as upon the 

 veins of the head ; but we may doubt if ever it is considerable 

 in the former, as there are no external symptoms which discover 

 it, as in the veins of the head." 



" C. The symptoms of a particular determination to the other 

 important viscera, those of the Abdomen. I have hinted that 

 this does not so frequently occur in continued fevers as the other 

 two determinations, but that it especially occurs in intermittent 

 fevers. Neither is it so easily discernible ; but for the most 

 part we may conclude, that a determination has taken place to 

 the abdomen, from the following circumstances : 



" 1. From a fulness and tension of the Hypochondria, a symp- 

 tom to which the ancients were extremely attentive, as we find 

 from Hippocrates, and which is more seldom attended to by the 

 moderns. We are sometimes, however, attentive to it, and we 

 can feel a manifest difference with respect to the tension of the 

 two hypochondria, which points out an accumulation of blood, 

 and an increased determination of it to the hypochondriac sys- 

 tem ; and this must first depend upon an accumulation of blood 

 in the system of the vena portarum, and some degree of in- 

 flammatory diathesis in the corresponding arteries. We may 

 join to this some degree of painful tension over the whole ab- 

 domen. It is difficult to suppose that the blood is ever accumu- 

 lated in such a manner as to give this external sensation of ten- 

 sion over the whole abdomen, but we may suppose that very 

 trivial and local affections of the abdominal viscera may be 

 communicated to the abdominal muscles, just as we find colics 

 may depend upon a spasm of the abdominal muscles ; if we 



VOL. i. 2 s 



