REMOTE, EXCITING, AND PROXIMATE CAUSES. 1037 



by exposure to cold and moisture, or expended 

 by muscular exertion, faster than it is obtained 

 by respiration, the same general effect is pro- 

 duced.* 



Pathologists have usually reduced the causes 

 of disease to three classes, which they have termed 

 the remote, exciting, and proximate. But the 

 principal difference between the two first classes 

 is, that the one precedes the other in the order of 

 time ; while the proximate cause is the result of 

 their action, and implies that immediate condition 

 of the body in which the disease consists, or 

 what has been called ipse morbus. It has been 

 often asserted by modern authors, that no one 



* By far the most general exciting causes of fever, even in 

 hot climates and malarious situations, is exposure to cold and 

 moisture, after the body has been weakened by the predisposing 

 causes. And it may be asserted with confidence, that in nineteen 

 cases out of twenty, the chill might be prevented by due attention 

 to warm clothing, aided by a light but nutritious diet, and by 

 keeping up a fire at night to expel dampness. Grant Thorburn 

 states, in his Auto-biography, that during the yellow fever in 

 New York, he never saw a single case of the disease which was 

 not brought on by exposure to rain, cold night air without 

 sufficient clothing, fatigue, intemperance, or some other obvious 

 and avoidable cause that was overlooked by the faculty, who 

 seemed to regard only the vitiated state of the atmosphere. Many 

 interesting cases which he relates in detail, and the judicious 

 comments upon them, render his chapter on the subject highly 

 important in a practical point of view. He says that whenever the 

 epidemic made its appearance he put on his winter clothing ; and 

 that although constantly employed in attendance on the sick, he 

 enjoyed uninterrupted health. 



