582 PRACTICE OF PHYSIC. 



it is in any of the inflammatory, till the progress of the disease 

 has induced that weakness which lays the foundation of the 

 quick pulse. If the pulse, therefore, is less frequent than might 

 be expected in proportion to the affection we perceive in the 

 nervous system, as the thirst, heat, &c. this may be considered 

 as a mark of debility. One case of this kind, in which the pulse 

 becomes slow, and sometimes remarkably so, occurs in the Ter- 

 tiana comatosa or apoplectica, or a Tertian attended with stu- 

 por, coma, or apoplexy ; but even in this case it is extremely 

 rare in the beginning, though, upon the coma coming on, I 

 have found it slower than it was before, or was expected to be. 

 Now, here also it is to be considered as a mark of debility, 

 though, as I said before, it is a state of debility which is com- 

 monly attended with the least danger ; as a comatose state, ex- 

 cept when it is in very great excess, seldom portends half the 

 evil that a constant waking, or a degree of typhomania, does. 

 " We judge likewise of the state of vigour in the circulation 

 by the heat of the body. The ancients defined fever as being 

 a preternatural heat ; and this is indeed a common attendant 

 upon every quicker motion of the blood, and commonly occurs 

 in fever. But there are fevers in which increased heat does not 

 occur, or is inconsiderable ; and this is considered as a mark of 

 the nervous fever, in which debility prevails. Whenever, there- 

 fore, the heat is not in proportion to the frequency of the pulse, 

 or to other circumstances of the fever affecting the sensorium, 

 we consider it as a mark of prevalent debility, or at least of the 

 want of irritation. We judge of the increased heat from its ef- 

 fects ; the first of which is a dryness of the tongue ; the moist- 

 ness of the tongue is a mark of the absence of heat, and is a sign 

 of that fever to which this is most common, viz. the nervous 

 fever. The absence of heat often goes so far as to give place 

 to cold I was going to say, what perhaps is not so accurate, an 

 actual coldness. This, whenever it occurs in the system, may 

 constantly be considered, I think, as a mark of a weaker cir- 

 culation, or weaker impulse of the blood into those parts in 

 which the cold is felt. I formerly (VIII.) gave some remarks 

 with regard to cold occurring in the beginning of fever. Dr. 

 Boerhaave has not been quite so accurate in representing this 

 symptom. He has given a general Prognostic, that all the 



