FEVERS. 571 



explained how that form of fever, in a particular manner, pro- 

 duces this determination. But we must acknowledge, that how- 

 ever we establish this distinction, doubts and difficulties will 

 arise on particular occasions, as fevers constantly change their 

 form from the one to the other. But whenever any thing of the 

 intermittent has prevailed, and where there are other symptoms 

 of it, we have to suspect a determination to the abdomen ; and 

 we have a great number of instances from Morgagni, Cleghorn, 

 Lind, and Pringle, where marks of those affections in the ab- 

 dominal viscera were found in persons who had died of inter- 

 mittents. 



" I must add to all this, as I said at first, that these symp- 

 toms are very often obscure, but that we have more reason to 

 suspect them when the excess of stimulant power prevails, and 

 when those remote causes have been applied which induce the 

 inflammatory diathesis. Then it is to be suspected that this 

 particular determination, the marks of inflammatory tendency, 

 will be produced. Thus, the coldness of the climate and sea- 

 son gives a presumption; next to that the plethoric habit, 

 and especiaUy the more young and vigorous state of the system, 

 which is more liable to the inflammatory diathesis, and there- 

 fore to the exertion of its particular effects. I need not re- 

 peat what I said before with respect to the special effects of this 

 inflammatory tendency. They are in general the destroying an 

 important organ, or producing effusions which stagnate and pro- 

 duce a poison. 



" 6 A strong spasm formed? &c. The spasm prevailing in the 

 skin affects the extreme vessels, as is expressed by the dryness of 

 the skin, there being no sweat and even very little perspiration. 

 This dryness of the skin very often accompanies the symptoms 

 of increased heat, which in this case we distinguish by the feeling 

 of a scorched or dry heat. It is this state which distinguishes 

 that part of the paroxysms of fevers which we more strictly call 

 the hot fit, in distinction from the sweating fit which follows ; 

 and, as arising from the spasm, it is always understood as a 

 mark of the excess of stimulant power. 



" There is another circumstance we make more use of, viz. 

 the dryness of the tongue, which we have no doubt in referring 

 to a diminished secretion of mucus and saliva, and that to a 



2 s 2 *' 



