630 PRACTICE OF PHYSIC. 



disposed with the most part of our present practitioners to con- 

 sider it. But that it is universally such, and, in every circum- 

 stance of fever, proper, we are very far from thinking. 



In very many of the fevers of this climate, there appears 

 in the beginning to be more or less of the inflammatory diathesis 

 in the system ; and, during this state, I hold, and have often 

 seen the use of opium to be hurtful. It does not then either 

 induce sleep or relieve pain, but aggravates the inflammatory 

 symptoms, and often determines to particular inflammations, 

 which prove afterwards fatal. 



In different fevers this inflammatory state is in different 

 degrees, and of different duration. In some cases of the most 

 powerful contagions it may appear very little, and such cases 

 may very possibly admit the early use of opium ; but, in most 

 of the cases in which cold so frequently concurs in the produc- 

 tion of the fever, we suppose that such inflammatory state com- 

 monly subsists for the first week of the disease ; and, therefore, 

 for that space of time, we hold opium to be a dangerous, and at 

 least an ambiguous remedy. M. M. 



" The principal writer upon this subject of opium, is Dr. 

 Tralles, who has given two quarto volumes upon it. He has 

 been at a great deal of pains to render it universal, that opium 

 is extremely hurtful in fevers ; but I am not much influenced 

 by his opinion ; if it Fas fit to enter into a particular criti- 

 cism, I could show that he forms most of his conclusions from 

 a few instances of its abuse in the cases I speak of, where the 

 disease was manifestly inflammatory ; and I have the less re- 

 gard to his judgment, that I think I could show certainly and 

 clearly that his reasoning is upon a bad foundation. He has, 

 indeed, in some measure, given us an useful work, by compiling 

 such a prodigious number of opinions, and such a multitude of 

 facts ; but with regard to his more general theory, I think it 

 universally wrong." 



As the fever advances, the inflammatory state generally dis- 

 appears in the second week, and the symptoms of debility become 

 more evident. In this condition opium may be employed, and 

 more or less as the symptoms of debility and irritation are more 

 distinctly apparent ; but even in this second stage it is an ambigu- 



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