FEVERS. 625 



not so remarkable as might be wished, or as might have been 

 expected, from the first account of James's powder. Nay, this 

 goes so far, the effects are so seldom remarkable, that I know 

 practitioners of some rank who pretend to say that they have 

 never observed their good effects, and are willing to suppose 

 that it is more from fashion than from any real foundation that 

 they are so generally employed. 



" Such negative observations, indeed, have no great weight 

 with me. I, for my own part, in many instances, have seen 

 their effects very evident, and very remarkable, in giving a de- 

 cisive turn to the state of the fever ; in many other instances 

 they give some relief; though they do not put an end to the 

 fever, they make matters go on with more safety to the usual 

 time of the crisis ; and there is with me no doubt of their being 

 remedies of the most useful kind." 



CLXXII. Vomiting is in many respects useful in fevers; as 

 it evacuates the contents of the stomach ; as it emulges the 

 biliary and pancreatic ducts ; as it evacuates the contents of the 

 duodenum, and perhaps also of a larger portion of the intes- 

 tines ; as it agitates the whole of the abdominal viscera, expedes 

 the circulation in them, and promotes their several secretions ; 

 and lastly, as agitating also the viscera of the thorax, it has 

 like effects there. All these several effects are, in many cases 

 and circumstances of fever, procured with advantage ; but do 

 not properly fall under our view here, where we are to consider 

 only the effect of vomiting in determining to the surface of the 

 body. 



CLXXII I. This effect we do not impute to the exercise of 

 vomiting in agitating the whole frame, but to the particular 

 operation of emetics upon the muscular fibres of the stomach, 

 whereby they excite the action of the extreme arteries on the 

 surface of the body, so as thereby effectually to determine the 

 blood into these vessels, remove the atony, and take off the 

 spasm affecting them. 



CLXXIV. That such is the power of emetics will appear 

 from the several considerations mentioned above (XLIV.); 

 and, therefore, that they are remedies well suited to the cure of 

 fevers. 



CLXXV. Emetics, for that purpose, are administered in two 



