1038 ALL FEVERS USHERED IN WITH A CHILL, 



symptom is always present at the beginning of 

 fever, and without which the disease could not 

 exist. But so far is this from being true, that 

 there never was a general fever without a previous 

 reduction of temperature, which is the first promi- 

 nent link in the chain of morbid phenomena, and 

 the invariable cause of all the following symptoms. 

 In accordance with this view, it was maintained 

 by Hippocrates, that fever is uniformly ushered 

 in with coldness or a loss of spirit, by which the 

 humours are thickened and determined to the 

 internal parts of the body.* (De Flatibus, sect, 

 iv. vii.) So far, his pathology was more clear 

 than that of the moderns, who have repeated 

 times without number, that " during the cold 

 stage, from causes unknown to us, the blood 

 leaves the surface, and becomes engorged in the 

 viscera." But as Hippocrates knew not how 

 animal heat is obtained by respiration, and trans- 

 ferred to the solids in combination with arterial 



* However diversified the remote and exciting causes of disease 

 may be, they all operate in the same way, modified, however, by 

 their intensity or duration, and by the constitution of the patient. 

 Some of them, as the narcotic and other poisons, not only dimi- 

 nish respiration, but disorganize the -fibrin and red particles, or 

 combine with and precipitate the albumen of the blood. That 

 exposure to bad air also produces a morbid state of .the blood 

 long before the symptoms of disease are actually developed, 

 would appear from some experiments of Dr. Potter, who found, 

 during the prevalence of yellow fever in Baltimore, that the blood 

 of individuals who lived in the infected parts of the city, (although 

 from every outward appearance and inward feeling they were in per- 



