244 PRACTICE OF'PHYSIC. 



purulency or ulceration in some external or internal part. It 

 was for this reason, that in LXXIV. I concluded it to be a 

 symptomatic fever only. Indeed, it appears to me to be always 

 the effect of an acrimony absorbed from abscesses or ulcers, 

 although it is not equally the eifect of every sort of acrimony ; 

 for the scorbutic and cancerous kinds often subsist long in the 

 body without producing a hectic. "In a pea issue also, kept up 

 for many years, no hectic occurs : where hectic appears there- 

 fore we must suppose some acrimony in the pus."" What is the 

 precise state of the acrimony producing this, I cannot deter- 

 mine; but it seems to be chiefly that of a vitiated puru- 

 lency. 



DCCCLXII. However this may be, it appears, that the 

 hectic's depending in general upon an acrimony, explains its 

 peculiar circumstances. The febrile state seems to be chiefly an 

 exacerbation of that frequency of the pulse which occurs twice 

 every day to persons in health, and may be produced by acri- 

 mony alone. " The frequency of the pulse being very great in an 

 erect, and abated in a horizontal posture, is a certain proof of the 

 frequency depending upon debility." These exacerbations, in- 

 deed, do not happen without the proper circumstances of py- 

 rexia ; but the spasm of the extreme vessels in a hectic does not 

 seem to be so considerable as in other fevers ; arid hence the 

 state of sweat and urine which appears so early and so con- 

 stantly in hectics. Upon the same supposition of an acrimony 

 corrupting the fluids, and debilitating the moving powers, I 

 think that most of the other symptoms may also be explained. 



DCCCLXIII. Having thus considered the characteristical 

 symptoms and chief part of the proximate cause of phthisis pul- 

 monalis, I proceed to observe, that an ulcer of the lungs, and 

 its concomitant circumstance of hectic fever, may arise from 

 different previous affections of the lungs ; all of which however 

 may, in my opinion, be referred to five heads ; that is, 1. To an 

 haemoptysis ; 2. To a suppuration of the lungs in consequence 

 of pneumonia ; 3. To catarrh ; 4. To asthma ; or, 5. To a 

 tubercle. These several affections, as causes of ulcers, shall 

 now be considered in the order mentioned. 



DCCCLXIV. It has been commonly supposed, that an hae- 

 moptysis was naturally, and almost necessarily, followed by an 



