FEVERS. 631 



ous remedy ; and if it increases delirium, and does not readily 

 induce sleep, it may be very hurtful, and is therefore to be em- 

 ployed with great caution. 



In this advanced state of fevers, a circumstance occurs* 

 that we are assured of as a fact, though we cannot well ex- 

 plain it. The cause of fevers gives an irritation to the brain, 

 which is not of the inflammatory kind, but produces convul- 

 sive motions of the limbs to a considerable degree; and to 

 this irritation it is that we impute the e subsultus tendinum,'' so 

 much taken notice of as occurring in the advanced state of fe- 

 vers. The same irritation also frequently produces a delirium, 

 which, as not of the phrenitic and inflammatory kind, we name 

 the maniacal. Such an appearance of a maniacal delirium, and 

 attended with some impetuosity and furor, is in fevers generally 

 imputed to a phrenitic state, to more or less of inflammation in 

 the brain ; and it is to be acknowledged that it is very often 

 justly so ; but I have seen several instances of the impetuous 

 or furious delirium, which, from their suddenly admitting of a 

 solution, and from their being frequently cured by the use of 

 opium, I conclude for certain, whatever were the appearances, 

 were not truly of the inflammatory kind. I own, that though 

 in general I can distinguish between the mild and^furious deli- 

 rium, and am pretty confident that it is proper in the one to 

 reject, and in the other to admit of ogium, there is an uncer- 

 tainty attends the whole of this affair. Sir John Pringle marks 

 out the phrenitic delirium, when the eye becomes wild and the 

 voice quick ; but he does not go further, and leaves us to this 

 general view ; and there he very properly avoids wine, and 

 would certainly opiates too. But I have seen that wild look 

 and quick voice, with a languid and weak pulse, and with a 

 peculiar redness of the eyes, which were what I would call 

 decisive marks of inflammation; and yet I have seen these 

 cases pass away into a state of good tranquillity, and manifestly 

 cured by inflammatory medicines, by wine and by opium. It 

 appears therefore that there are such cases as will admit of these 

 remedies, and I must leave you, in the course of practice, to 

 find out other means of being more exact in this matter. 



There is still another circumstance in the advanced stage 

 of fevers that on this occasion requires to be taken notice of. 



