FEVERS. 573 



the symptoms, therefore, which we are now to mention, give the 

 most certain presages of death in fevers. 



" It is surprising that physicians have so long overlooked 

 debility as a considerable part of the proximate cause of fevers. 

 Nobody can fail to observe, that in the course of fevers many 

 symptoms of debility appear, and go on constantly increasing 

 with the disease till it proves fatal ; it may perhaps be said to 

 be the effect rather than any part of the cause ; but I maintain 

 that it has a considerable share, as arising immediately from the 

 remote cause. Thus miasmata and contagion, which are the 

 principal remote causes of fever, shew their sedative power not 

 only in as far as we presume that they are more or less of a pu- 

 trefactive nature, and, like all putrefactive powers, universally 

 sedative and debilitating, but they are often so powerful as to 

 kill the person immediately, of which we have frequent instances 

 in most plagues ; and, in other cases, the debility is truly among 

 the first symptoms which appear ; the body is languid, affected 

 with lassitude, or with a sense of debility on motion, and an 

 uneasiness in exerting it. The first symptoms are farther dis- 

 covered in the weaker action of the heart and arteries. I have 

 little doubt that repeated paroxysms may induce debility in 

 consequence of the violent excitement ; but this debility occurs 

 in the very beginning of the disease also in a very strong de- 

 gree ; and however difficult we may find it to explain how 

 debility produces reaction, yet we find that the one precedes 

 and the other follows, and we presume from the order of their 

 succession that they are connected as cause and effect. 



" A. Of the Symptoms of Debility as they occur in the Ani- 

 mal Functions; and, 



66 1. With regard to the voluntary motions; which we con- 

 sider as affected in two ways, either with a state of debility giving 

 merely a less degree of force in their several actions, or with the 

 common effect of this debility by which the motions appear irre- 

 gular in the intervals of their repetitions, and unequal in the 

 degree of force in the several repetitions. 



" a. With respect to the Debility of the voluntary motions, I 

 have already remarked that one of the very first symptoms which 

 appear in fevers, viz. Lassitude, or a sense of weariness like 

 that which follows long continued or violent labour and exercise, 



