SPASMODIC AFFECTIONS. 



MCCCCLVII. This is a disease attending a very warm 

 state of the air ; and in very warm climates it may perhaps ap- 

 pear at any time of the year ; but even in such climates it is 

 most frequent during their warmest seasons ; and in temperate 

 climates, it appears only in the warm seasons. Dr. Sydenham 

 considered the appearances of this disease in England to be 

 confined to the month of August ; but he himself observed it 

 to appear sometimes towards the end of summer, when the sea- 

 son was unusually warm ; and that, in proportion to the heat, 

 the violence of the disease was greater. Others have observed, 

 that it appeared more early in summer, and always sooner or 

 later, according as the great heats sooner or later set in. 



MCCCCLVIII. From all these circumstances, it is, I think, 

 very evident that this disease is the effect of a warm atmosphere, 

 producing some change in the state of the bile in the human 

 body ; and the change may consist, either in the matter of the 

 bile being rendered more acrid, and thereby fitted to excite a 

 more copious secretion ; or, in the same matter its being prepar- 

 ed to pass off in larger quantity than usual. 



MCCCCLIX. It has been remarked, that in warm climates 

 and seasons, after extremely hot and dry weather, a fall of rain 

 cooling the atmosphere seems especially to bring on this dis- 

 ease ; and it is very probable that an obstructed perspiration 

 may have also a share in this, though it is also certain that the 

 disease does appear when no change in the temperature of the 

 air, nor any application of cold, have been observed. 



MCCCCLX. It is possible, that, in some cases, the heat of 

 the season may give only a predisposition, and that the disease 

 may be excited by certain ingesta or other causes ; but it is 

 equally certain, that the disease has occurred without any pre- 

 vious change or error, either in diet, or in the manner of life, 

 that could be observed. 



" I give you these hints for your further inquiry : I do not 

 mean to discuss them. I touched them before in treating of- 

 bilious fevers (LI. LXXL), when I said indeed, that 

 there was a suspicion of a particular state of the bile prevailing 

 at that season, which allows us to suppose, that it may modify the 

 fever, operate in producing this cholera, and somewhat modify 

 dysentery." 





