cleanliness and ventilation,, with other cir- 
cumstances, are causes sufficiently adequate 
to produce the affection, without supposing 
the agency of a specific and occult power. 
V It is from nastiness,” says one of the most 
celebrated of the anticontagionists, “ dege- 
nerating into infection by chemical changes, 
that the bodies, clothes, beds, and apartments, 
of the poor in Great Britain, derive their poi- 
sonous, their pestilential charge. By a com- 
mon putrefactive process, this septic venom 
is formed, and derives none of its qualities 
from pulsating arteries or glands. Away 
then with this preposterous phrase, ‘ from 
the poison engendered by septic processes.’ 
Let human contagion for the future mean 
nothing but small -pox, vaccinia, and the 
kindred forms of morbid secretions.” (Dr. 
Kush.) 
Notwithstanding, however, the circum- 
stances here pointed out and rested upon, 
we conceive the general facts to be in favour 
of poison engendered, independant of mere 
putrefaction or tilth ; and we shall shortly state 
the grounds upon which our opinion is esta- 
blished, when upon the subject of preventing 
the spread of fever. That contagion, how- 
ever, is absolutely requisite to the production 
of this disorder, in every instance, does not 
seem an opinion authorized by facts, although 
it must be admitted that the negative is inca- 
pable of proof ; for when we refer to its ge- 
neration from mere tilth and sloth, under the 
circumstances just mentioned from Dr. Rush, 
it may be replied, that contagion in such 
cases might have been in some manner con- 
veyed without suspicion, and that the situa- 
tion of the recipient constituted merely a 
predisposition to suffer from its application. 
A contest has likewise arisen respecting the 
production of intermittent as well as conti- 
nued fever. Intermittent fevers are observed 
to prevail especially in situations the soil of 
which is marshy : on this account it has been 
imagined, that they are invariably conse- 
quent upon a certain taint or miasma arising 
from moist ground. “ The similarity of the 
climate, season, and soil, in the different 
countries in which intermittents arise, and 
the similarity of the disease, though arising in 
different regions, concur in proving that 
there is one common cause of these diseases, 
and that tills is the marsh miasma.” (Cul- 
len.) Dr. Brown and others have contend- 
ed, that the noxious influence of cold or of 
heat, “ when the common asthenic noxious 
powers accompany either,” are sufficient to 
occasion genuine intermittent. Jt however 
appears an established principle, that inter- 
mittent fevers are most frequently the off- 
spring of poison arising from marshes or moist 
ground. That other causes act in conjunc- 
tion, and augment the predisposition, is like- 
wise an established fact; for tiie agues of 
marshy countries occur most abundantly at 
cold seasons which have succeeded hot ones, 
and especially amongst those whose diet has 
been innutritions and unstimulating. It is 
also beyond dispute that mere cold or poor 
living will induce ague after the habit has 
be£n once established. 
Proximate cause of fever. On this sub- 
ject the following errors appear to have mis- 
led systematics. 1. A want of distinction 
between final and proximate cause ; between 
I enquiries instituted in order to divine the in- 
tentions of nature, and a careful examination of 
MEDICINE. 
the phenomena of nature as they occur in 
sequence. 2. The indivisibility of the 
body, and the universal nature of the disor- 
der, have been too much overlooked. Fever 
has been considered as an affection of parts 
rather than of tiie universal system. 3. An 
error which appears to result from the con- 
junction of the two former ; that shrinking 
and coldness of the external surface, which 
is merely a consequence and concomitant ef- 
fect resulting from a febrile attack, has been 
viewed as a cause of the other symptoms 
which present themselves in the course of the 
affection. 
“ The remote causes of fever,” says Dr. 
Cullen, “are certain sedative powers applied 
to the nervous system, which diminishing the 
energy of the brain, thereby produce a debi- 
lity in the whole of the functions, and parti- 
cularly in the action of the extreme vessels; 
this debility proves an indirect stimulus to the 
sanguiferous system, whence by the interven- 
the cold stage, and spasm connected 
with it, the action of the heart and larger ar- 
teries is increased, and continues till it has 
had the effect ot restoring the energy of the 
brain, of extending this energy to the ex- 
treme vessels, of restoring therefore, their ac- 
tion, and thereby especially overcoming the 
spasm affecting them.” 
In the historical sketch of the progress of 
medical theory with which we introduced 
the present article, it was observed that the 
spasmodic theory of Hoffman engendered 
that ot Dr. Cullen. In the hands, however, 
of this last systematist, the doctrine in ques- 
tion appears to have received mutilation ra- 
ther than amendment : Dr. Cullen added 
another set of entangled links to the pre- 
viously entangled chain. The shrinking, 
coldness, and general inactivity, observed at 
the commencement of fever fits, and which 
are the necessary consequences of the sudden 
quiescence throughout the system, induced 
by the peculiar action of the noxious powers 
producing fever, our author considers as one 
ot nature’s first steps in obtaining relief and 
obviating the progress of the disorder. 
On this theory we may in the first place 
remark, that when the progress of a febrile 
affection is arrested by remedies applied 
during the first or cold stage, both the torpor 
ot the brain and the shrinking of the surface 
may be removed without the intervention 
ot the hot fit. Indeed, obviating the recur- 
rence of this constitutes the cure of fever. 
The succession, then, of the hot fit is not a 
necessary consequence of the previous cold 
one, much less is it an agency contrived by 
nature to remedy this last. The theory is 
likewise “ erroneous, in as far as it enters into 
the supposed intentions of nature.” 
Secondly, the action of the heart and larger 
arteries is not, as is justly observed by Dr. 
Darwin, occasioned in the mechanical man- 
ner of reaction, which the theory we are can- 
vassing supposes. During the continuance- 
of the cold fit, the whole circulation is less- 
ened, or in a manner suspended, the blood 
is not retreating for safety to the centre, less 
blood passes through the lungs as well as 
through the vessels on the surface of the body ; 
the fortress, and not merely the outposts, has 
received the attack of the enemy.' Now, 
when the hot fit comes on, the marks of irri- 
tation, or as Dr. Browu happily terms it, of 
135 
M counterfeited vigour,” by which it is cha- 
racterized, are merely consequent upon the 
natural stimuli acting upon accumulated irri- 
tability, of irritability accumulated by the 
previous quiescence of the cold stage, and 
are not to be attributed to the blood’s react- 
ing and flowing back in order to influence 
and occupy the parts and cavities which it 
had deserted. This supposed action and re- 
action cannot indeed lake place in that mode 
and to that extent which our theorists ima- 
gine. The human body is a living and not 
an hydraulic machine. The blood is not 
dammed up at one part in order to rush with 
violence into another. To illustrate: When 
even a part of the body only, as the hand, is 
immersed in water, or in any other way ab- 
ruptly exposed to a diminished temperature 
for a short period, a lessened fibrous or vital 
action is the immediate consequence, the sen- 
sorial power or excitability accumulates in a 
corresponding ratio, and when the part is now 
again subjected to the influence of those 
powers which were previously operating, an 
irritative and disturbed, in place of regular 
and healthy, action succeeds ; the blood, 
however, does not flow into the empty ves- 
sels like the waters ot a river into lateral 
channels : not more than the same volume of 
blood, in cases of much weakness not so 
much, now circulates through parts, the ex- 
citability of which lias been changed, and 
an accelerated, but not, properly speaking, . 
increased motion, with febrile heat, is tiie 
consequence. 
We have perha; v conceded too- much to 
the spasmodic theory of fever, in likening 
the state of the surface in the cold fit to that 
produced in consequence of diminished tem- 
perature, for in this last the shrinking is di- 
rectly produced; whereas, in fever, it is oc- 
casioned indirectly, or, as we have previously 
noticed, is merely one of the effects arising 
from the general interruption of the func- 
tions. Fever does not commence bv attack- 
ing exclusively “ the extreme vessels and 
the capillaries of the surface.” 
Ths spasmodic theory of fever then, is not 
only a substitution of terms for an explanation 
of facts, hut even the phraseology which it 
employs in order to trace and connect the 
leading symptoms of the malady, appears to 
be deduced from defective knowledge of tiie 
laws and qualities of life. It - is physically, 
metaphysically, and practically wrong. 
“ Fever fits are not . efforts of nature to re- 
lieve herself.” Darwin. 
Before proceeding further, it may be pro- 
per to notice one or two defects, as they ap- 
pear to us, in the ingenious theory of the 
author, of Zoonomia. In our remarks on 
nosology, the mistakes which Dr. Darwin 
liad been led into from his untenable division 
of sensorial power, . were hinted at. These 
mistakes appear to its to be evident in the 
learned author’s attempts to form, a. sympa- 
thetic theory of the disorders under notice: 
a theory, .which,, in our opinion,, involves 
the second error which we liave. above 
stated, viz. that of overlooking the. indivisi- 
bility of the body, or tire universal distribu- 
tion of sensorial power, . and regarding fever 
rather as an affection of parts than of the 
whole frame. It likewise, by consequence, 
embraces the erroneous doctrine of ascribing 
the secondary actions in fevers to the cu- 
taneous torpor. The cold fit of simple 
