FEVERS. 579 



proceeds further to a state of actual somnolency or lethargy, it 

 comes to be a mark of debility by itself; but for some reasons 

 which I cannot well explain, the latter is not a mark of the 

 worst kind; for it is universally observed, that except in a 

 state of the utmost debility, a comatose state, in the more ad- 

 vanced state of fevers, is much safer than constant waking, or 

 any degree of typhomania. 



" I must mention another expression of Collapse, which 

 might go to another head, but which is frequently connected with 

 this, and may be explained upon the same footing; that is, a loss 

 of hearing, a degree of deafness occurring in fevers. It is not 

 easy to explain this from any topical affection of the organ ; it 

 must be referred to the sensorium, or to some degree of collapse 

 with respect to the organ of hearing. At the same time it is 

 for the most part a sign expressing no great danger ; nay, upon 

 the contrary, a degree of coma, and a loss of hearing coming on 

 in some fevers are rather favourable symptoms. More danger, 

 however, is to be apprehended from a loss of sense in the sev- 

 eral organs of sense ; as in the cold fit of fevers, when the in- 

 sensibility to touch may proceed to such a degree, that the soles 

 of the feet have been burnt, and an eschar produced, without 

 the patient perceiving it. In the advanced state of fevers 

 we have not an opportunity of observing this, but we observe 

 it with respect to other senses, as that of thirst, which is a 

 symptom almost inseparable from fevers ; and yet though all 

 the causes that we can assign for thirst occur, as dryness of 

 the fauces, heat of the internal parts, and a great degree of 

 putrescency going on in the stomach, which is a most power- 

 ful cause of thirst, the mind is very often insensible to it, and 

 no thirst appears. Somewhat perhaps might be imputed to 

 that crust which often covers the extremities of the nerves of 

 these organs, but this is confined to the tongue alone, and I 

 know no instance of its being extended to the fauces, which are 

 the chief parts which gives this sensation. The want of taste 

 therefore must be imputed to the loss of sensibility, and not to 

 the crust upon the tongue preventing the communication of the 

 sapient substances to that organ. This insensibility sometimes 

 appears even in the loss of sight. No organ is more sensible to 

 impression than the eye, so that when this occurs it is certainly 



