MEDICINE. 
slb’e perspiration, and this caution is more 
important in proportion to the continuance 
ct this perspiration.” 
“ Under these restrictions,” our author 
f adds, “ the cold allusion may be used at any 
period of fever ; but its effects are more salu- 
tary in proportion as it is used eprly. When 
I employed in the advanced stages of fever, 
I where the heat is reduced and the debility 
[ great, some cordial should be given immedi- 
ately after, and the best is warm wine.” 
Observations. Chid water, as a remedy 
for fever, may be conceived to operate upon 
[ a twofold principle. In the earlier stages, 
[ and before the vital power is too much ha- 
j rassed and oppressed to endure a violent 
shock, the copious and sudden affusion of 
| cold water all over the naked body, appears 
to effect its beneficial pan poses in part by 
the abruptness of its agency ; it in a manner 
| severs the chain of diseased associations, and 
I restores the healthy and orderly movements 
of the frame. This operation is not, as has 
been suggested, mechanical: it is in some 
i measure similar to that produced by tlieope- 
! ration of an emetic, to which it is in every 
respect greatly preferable, or to sudden men- 
tal agitation. In the language of tjie schools, 
it cuts short fever. 
When, however, the diseased associations 
are more firmly established, and the vital 
power greatly oppressed by the disorder’s 
continuance, although the surface of the 
body retains its morbid heat, the water is to 
be applied, not in the way of sudden affusion, 
but by washing with a spunge, and this under 
the restrictions enjoined by Dr. Currie, or 
we may safely say, while itis found genial to 
j the patient’s feelings, ought to be resorted to 
in every case of simple fever. The action 
ofthe water at this time is somewhat different 
from that in the previous period, or under 
different circumstances of the disorder. It 
proves a direct stimulus. But how, it has 
been urged, can the negative of a power 
prove stimulative ? “ Darkness might as well 
be called a stimulus to the eye, or hunger 
a stimulus to the stomach, as cold to our 
I sense which perceives heat.” Darwin. 
To this it has been replied by Dr. Currie, 
i and before him by Dr. Beddoes, that the 
j objection is founded upon a disregard of the 
f sentient principle: “Cold,” says the latter 
I author, “ may very often be so applied as, 
bv removing the very disagreeable sense of 
| heat, that attends some diseases, to produce 
I an effect equivalent to stimulation. It is, I 
1 believe, exactly in this way, that bathing the 
? body with cold water proves serviceable in 
f low fevers.” 
From the urgency, however, of the de- 
I bilitv, or from the prejudices of the patient 
I or his friends, in some periods of fever, even 
j the application of cold water in the way of 
; ablution may be regarded as too severe, 
j In this case tepid ablution has been made to 
supply its place, and often with propriety 
and success; it is, however, particularly de- 
| serving of remark, that unless this last be 
used with precaution, the object of the prac- 
titioner in its choice is defeated, as the evapo- 
ration from the surface is more copious from 
the tepid affusion ; and this is one of the most 
powerful, indeed, strictly speaking, the only 
I means of abstracting heal. The term tepid 
: is anplied by Dr. Currie to water, from 87° to 
J 97 0 of Fahrenheit; from 87° to 75° the water 
VOL. II. 
4k m-0 rnt 
is denominated cool. Cold water mav lie 
"given internally, and with the utmost free- 
dom, in the hot stage of the hWrile paroxvsm. 
Its use, however, requires to be carefully 
regulated by the same restrictions as in the 
external application; it must never be given 
unless the heat of the surface be steadily above 
the natural standard. Draughts of cold 
water have been known, when properly ad- 
ministered, to procure a sudden solution of 
the disease. 
Cold air. The extraordinary melioration 
in the modern practice of medicine, as it re- 
lates to the treatment of fever and febrile 
diseases, is not confined to the copious use of 
affusion and ablution. '1 he terrors of our 
predecessors, in relation likewise to cold air, 
are fast departing; and the importance of 
its free admission in the apartments of the 
febrile sufferer especially, comes to be gene- 
rally acknowledged and applied. It has 
been slated by a physician, above all praise 
tor fidelity of observation and justness of 
remark, that the corrupted air of sick rooms, 
from neglect of ventilation, has been much 
. more fatal even among the higher classes of 
society, than the virulence of the disease 
itself : “ Vereor ne quidam a?groti non tarn 
morbo suo periermt, quam halitibus pulribus, 
quos discuti vetuit pnepostera amicorum 
cura.” Heberden. 
I he utility ot cold air in fever is re r erable 
to two principles: 1st. That of immediately 
lowering the heat of the surface, and thus 
taking off the oppression occasioned by such 
hegt : and 2ndly, from affording a larger 
quantity ot oxygen at each inspiration. The 
first of these principles is sufficiently evident, 
and does not require any further illustration: 
it cold ablution prove beneficial chiefly by 
virtue of diminishing the temperature of the 
body, it necessarily follows that coldness in 
the circumambient atmosphere must be at- 
tended with precisely similar effects: but 
on the purity, as connected with diminished 
temperature of the atmosphere, it may not 
be improper to embrace the present oppor- 
tunity of offering one or two remarks. A 
given bulk of air at an inferior temperature, 
contains more of the oxygenous principle 
than the same quantity at a superior degree 
of heat ; hence the greater refreshment which 
is experienced from the inhalation of a cold 
and dense, over that of a warm and rarefied 
atmosphere ; hence, in part, the more vigo- 
rous digestion and keen appetite of a healthy 
individual during the winter, than the sum- 
mer months ; and finally, by the relief 
a febrile patient experiences from the in- 
spiration of such air, it is rendered evident, 
both that the heat of fever originates, and is 
kept up, independently of those organs which 
modern chemistry and physiology have sup- 
posed to be the sole organs for the supply of 
heat to the livyig system. From this fact 
Dr. Ileid infers, and we think with justice, 
that the constant equality of animal tempera- 
ture in a condition of health, has more depen- 
dance upon living actions in general than upon 
the chemical evolution of caloric in the lungs, 
according to the ingenious theory first sug- 
gested by Dr. Crawford, but since materially 
modified. See Physiology. 
But the frigorific virtue of a more oxyge- 
nous atmosphere, when received into the 
lungs of a febrile invalid, is a further proof, 
that however violent the reaction, as it. has 
S 
been erroneously called, such reaction is, in 
every case of genuine fever, far from being 
an evidence of actual increase of power. 
Whatever theory we adopt respecting the 
precise mode in which [Hire air innueiices 
tiie animal economy, an uniformity of opi- 
nion mint pie vail, that it is, in the strictest 
sense of the word, an exciting agent. ‘ New 
as far as it operates beneficially in fever, it 
reduces the inordinate heat ; that power then 
which actually and properly excites, by thi> 
very ag. ncy moderates the turbulent action, 
and by consequence reduces the prevailing 
morbid heat. r lhe admission of cold air 
requires likewise to be restricted to the hot 
stage, and to be limited by the patient’s feel- 
ing-. ; a current of cold air passing rapidly 
over the body while in a state of perspirati ' 
may be productive of fatal consequences. 
Of rtfrigt rants in freer. Besides, how- 
ever, the employment of cold water, and the 
free admission of a cool and pure atmo- 
sphere, other agents have been had recourse 
to, and with considerable effect, in order to 
abate the inordinate heat of fever. From 
possessing the faculty of cooling the system, 
certain medicines have been distinguished 
by the term refrigerants: refrigerants are 
principally chosen from the vegetable acids, 
and the different neutral salts ; and so evi- 
dent is their power in reducing animal tempe- 
rature, that they have properly been made 
to constitute a considerable part of regimen 
in fever. Indeed nitre, and other neutral 
salts, with the vegetable acids, have been re- 
ceived into some systems of classification, 
under the distinct head of febrifuge medi- 
cines. The modus operandi of refrigerants 
lias not perhaps hitherto received explana- 
tion ; the substances of which they are com- 
posed are for the most part those which con- 
tain oxygen in a concentrated, and, at the 
same time, loose state of combination ; from 
this circumstance, their action has been in- 
geniously but not perhaps satisfactorily ac- 
counted for. “ It has been sufficiently es- 
tablished,” says a modern writer, “ that the 
consumption of oxygen in the lungs is materi- 
ally influenced by the nature of the ingesta 
received into the stomach ; that it is increas- 
ed by animal food and spirituous liquors, 
and, in general, by whatever substances con- 
tain a comparatively small quantity of oxy- 
gen in their composition. But the superior 
temperature of animals is derived from the 
consumption of oxygen gas by respiration ; 
an increase of that consumption must neces- 
sarily, therefore, occasion a greater evolution 
of caloric in the system, and of course an 
increase of temperature, while a diminution 
in the consumption of oxygen must have 
an opposite effect. If, therefore, when the 
temperature of the body is morbidly increas- 
ed, substances be introduced into the sto- 
mach, containing a large proportion of oxy- 
gen, especially in a state of loose combi- 
nation, and capable of being assimilated by 
the digestive powers, the nutritious matter 
received into the blood must contain a larger 
proportion of oxygen than usual ; less of that 
principle will be consumed in the lungs, by 
which means less caloric being evolved, the 
temperature of the body must be reduced * 
and this operating as a reduction of stimulus, 
will diminish the number and force of the 
contractions of the heart.” Murray’s Ma- 
teria Medina. 
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