MEDICINE. 
i ;j 
feve”, -a vs Dr. Darwin, consists of a torpor j 
v tot" the cutaneous capillaries, with their mu- 
cous and perspirative glands, which is ex- 
tended by dircotysYiiipathy to the heart and 
arteries, The torpor,- however, of the heart 
and arteries is coexistent with, and not conse- 
quent upon, the inaction of tire cutaneous 
vessels; the sensorial power residing in the 
former at the time of an attack of fever, must 
he affected in the same maimer as the sen- 
sorial power of the latter; and the admission 
of association, is the introduc tion of an un- 
necessary link in the chain of cause. That 
distant parts sympathize with each other, in 
.a manner which physiology has not hitherto 
been able to unfold, as the stomach with the 
surface of the body for example, is admitted; 
in the case of fever, however, we wish 
particularly to insist upon such sympathy as 
an explanation of .symptoms being super- 
lluous: the heart and" arteries, the stomach, 
the surface of the body, the secretory glands, 
all receive a diminution or sudden interrup- 
tion of their functions at the same moment 
of time, and from the same cause : they are 
simultaneous and not successive effects. 
l)r. Darwin seems equally unfortunate in 
referring the hot skin and remaining qui- 
escence of some internal organs, as of the 
stomach, in the second stage of fever, to re- 
verse sympathy. Sympathy cannot be di- 
rect in one instance, and reverse in another: 
“ I'he laws of association are invariable, or 
they do not exist.” 
What then is the cau^e of fever? It is an 
abrupt suspension and consequent disruption 
of all the connected movements of the ani- 
mal frame by which the balance of excite- 
ment is overthrown, “ the laws of excitabi- 
lity are changed, and in consequence of which 
the same agents ho longer produce the same 
effects. Fever differs from debility inasmuch 
as the latter is a gradual and regular ex- 
haustion, not an abrupt interruption of the 
powers of life; it differs from strength, as 
strength consists in a powerful and equable 
excitement, while fever, however i't may 
“ counterfeit vigour,” is never attended by 
the necessary constituent of vigour, regular 
and orderly display of power. 
The primary cold, or as the Latins term it, 
“ horror, ”is from the quiescence that lias been 
induced; during this state of quiescence, a 
new' and inordinate condition of the excita- 
bility is established, and by consequence 
both the external and internal stimuli excite 
perturbed in the place of orderly and usual 
actions: action without power commences; 
hence morbid heat is generated, diseased 
associations are formed, and without being 
in a state of actual weakness, the whole sys- 
tem sinks, oppressed. The plain indications of 
Treatment in fever, are therefore to. break 
the morbid associations on which this op- 
pression is established, or obviate the symp- 
toms by which it is continued; to diminish 
tiie cold in the cold stage, the heat in the hot 
stage, and not to await the sanative process 
of nature, ‘either of dissolving spasm, or of 
correcting and expelling morbific matter. 
The various remedies employed for these 
purposes are, the external and internal use of 
cold and warm water;' refrigerants, sudo- 
rifics, opiates, emetics, purgatives: on each 
of these, we shall introduce a few separate 
remarks; in the course of which -an oppor- 
tunity will be afforded, of enquiring more 
minutely into the pathology 01 the febrile 
state. 
OJ cold and tepid a fusion, and ablution . — 
Coid zvalir internally. — Cold air. — The me- 
dical reports of Dr. Currie, on the effects of 
water cold, and warm, in the treatment of fe- 
ver, are introduced in the following manner: 
Narrative of Dr. f Fright: 
“ In tlje Loudon Medical Journal for the 
year 1786, Dr. William Wright, formerly 
of the island of Jamaica, gave an account of 
the successful treatment of some cases of 
fever, by the ablution of the patient with cold 
water. 
“ On the 1st of August, 1777,” says Dr. 
Wright, “ I embarked in a ship bound to 
Liverpool, and sailed the same evening from 
Montego-bay. The master told me he had 
several sailors on the same day we took our 
j departure, one of w’hoin had been at sick 
quarters on shore, and was now but in a con- 
valescent state. On the 23d of August, we 
w r ere in the latitude of Bermudas, and had 
had a very heavy gale of wind for three days, 
when the above-mentioned man relapsed, 
and had a fever with symptoms of the greatest 
malignity. I attended this person often, but 
could not prevail on him to be removed from 
a dark and confined situation to a more airy 
and convenient part of the ship ; and as he 
refused medicine and even food, he died on 
the eighth day of his illness. 
“ By iny attention to the sick man, I 
caught the contagion, and began to be in- 
disposed on the 5th of September ; and the 
following is a narrative of my case, extracted 
from notes daily marked down : I had been 
many years in Jamaica, but except being 
somewhat relaxed by the climate and fatigue 
of business, 1 ailed nothing when I embark- 
ed. This circumstance, however, might 
perhaps dispose me move readily to receive 
the infection. 
“ Sept. 5th, 6th, 7th: Small rigours now 
and then ; a preternatural heat of tiie skin ; a 
dull pain in the forehead; the pulse small 
and quick; a loss of appetite, but no sickness 
at the stomach ; the tongue white and slimy; 
little or no thirst ; the belly regular ; the urine 
pale and rather scanty ; in the night restless 
with starting and delirium. 
“ Sept. 8th. Every symptom aggravated ; 
with pains in the loins and lower limbs, and 
stiffness in the thighs and hams. 
“ I took a gentle vomit on the second day 
of this illness, and next morning a decoction 
of tamarinds; at bed-time an opiate joined 
with antimonial wine; but this did not pro- 
cure sleep or open the pores of the skin. 
No inflammatory symptoms being present, 
a drachm of Peruvian bark was taken every 
hour for six hours successively, and now and 
then a glass of port-wine, but with no appa- 
rent benefit. When upon deck my pains 
were greatly mitigated, and the colder the 
air the better. T his circumstance, and the 
failure of every means I had tried, encou- 
raged me to put in practice on myself, what 
1 had often wished to try on others, in fevers 
similar to my own. 
“ Sept. 9th. Having given the necessary 
directions, about three o’clock in the after- 
noon L slipt off all my clothes, and threw a 
sea- cloak loosely about me till 1 got upon 
deck, when, the cloak also was laid aside: 
three buckets of salt water were then thrown 
at once upon me; the shock was great, but 
1 felt immediate relief, d he head-ache and 
other pains instantly abated, and a tine glow 
and diaphoresis succeeded; towards even- 
ing, however, the same febrile symptoms 
threatened a return, and 1 had again recourse 
to the same method as before, with the same 
good effect. 1 now took food with ail ap- 
petite, and for the lirst time bad a sound 
night's rest. 
• ! Sept. 10. No fever, but a little uneasi- 
ness on tiie hams and thighs ; used the cold 
bath twice. 
“Sept. 11. Every symptom vanished; 
but to prevent a relapse 1 used the cold bath 
twice. Mr. Thomas Kirk, a young gentle- 
man, passenger in the same ship, fell sick of 
a fever on the 9th day of August ; his symp- 
toms were nearly similar to mine, and having 
taken some medicines without experiencing 
relief, he was desirous of trying the cold 
bath; with my approbation he did on the 
11th and 12th ot September, and by this 
method w as happily restored to health. He 
lives at this time (Jan. 1786) near Liver- 
pool.” 
We have thus presented our readers with 
this important narration of Dr. Wright, both 
as it furnishes a history of fever, as it details 
the mode in which the cold affusions should 
be employed, and as it was confessedly the 
means ol introducing this most valuable re- 
medy into general practice. We shall now 
add from Dr. Currie the more particular 
rules which ought to govern the use of five 
affusion or aspersion of cold water in fevers, 
and then make one or two observations on 
the nature of its operation. 
“ The safest and most advantageous time, ” 
says Dr. Currie, “ for using tiie cold water 
is, when the exacerbation is at its height, or 
immediately after its declination has begun ; 
and this has led me almost always to direct 
it to be employed from six to nine in the 
evening; but it may be safely used at any 
time of the day, when there is no sense of 
chilliness present, when the heat of the sur- 
face is steadily above what is natural, and 
when there is no general or profuse perspi- 
ration. — These particulars are of the utmost 
importance: for, 1st. If the affusion be used 
during the cold stage, the respiration is 
nearly suspended ; the pulse becomes flut- 
tering, feeble, and of incalculable frequency ; 
the surface and tiie extremities become 
doubly cold and shrivelled, and the patient 
seems to struggle with the pangs of instant 
dissolution. 1 have no doubt, from what I 
have observed, that in such circumstances 
the repeated affusions of a few buckets of cold 
water would extinguish life. This remedy 
should therefore never be used when any 
' considerable sense of chilliness is present, 
even though the thermometer applied to the 
trunk of the body, should indicate a degree 
of heat greater than usual. 
“ 2nd. 'Neither ought it to be used, when 
the heat measured by the thermometer is 
less than, or even only equal to, the natural 
heat, though the patient should feel no degree 
of chilliness. This is sometimes the case to- 
wards the last stages of fever, when the pow- 
ers of life are too weak to sustain so powerful 
a stimulus. 
“ 3d. It is also necessary to abstain from 
the use of this remedy under profuse sen- 
