545 



ON THE PATHOLOGY OF NIGHT-SWEATING 

 IN PHTHISIS, AND THE MODE OF ACTION 

 OF STRYCHNIA AND OTHER REMEDIES 

 IN IT. 



(Reprinted from St. BarthoJo mew's Hospital Reports^ vol. xv, p. 119.) 



After the night-sweats which occur in phthisis the patients are 

 very exhausted, and not unfrequentlj feel a certain soreness of 

 the limbs similar to that which occurs in healthy persons after 

 great exertion. The exhaustion produced by the sweating is 

 sometimes attributed to the actual loss of material from the 

 body in the perspiration, but this can hardly be the case, as the 

 amount of nutritive matter contained in the sweat is very small, 

 and we notice that the perspiration which occurs in healthy 

 persons after exertion does not cause any feeling of weakness. 

 It occurred to me, therefore, that instead of the sweating being 

 tlie cause of the exhaustion in phthisis, the exhaustion and the 

 sweat were both consequences of one common cause. In order 

 to discover what this cause may be, it may be well to proceed 

 to track, as it were, the process of sweating backwards, until we 

 find some condition that may account both for it and for the 

 weakness. Xow, the production of sweat is due to the functional 

 activity of the secreting cells in the sweat glands, which remove 

 from the blood a quantity of water and salts, and pour it out 

 upon the surface of the skin. For the functional activity of 

 these cells two things are requisite : the one is a supply of blood 

 to them which will provide them with the fluid necessary to 

 form the sweat ; the second is the nervous stimulus imparted to 

 them by the secreting nerves, which excites them to functional 

 activity. It is only recently that the importance of these nerves 

 as a factor in the secretion of sweat has been fully recognised, 

 although various circumstances seemed to point to the fact that 

 sweat was not dependent merely upon a full supply of blood 

 to the sweat glands. In the perspiration which follows active 



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