Writers on fever in general have confined their account of the phenomena
of this disease to an explanation of the relation between the cold and
the hot fits. Were their success in establishing that relation as
complete as it is defective, they would still have done little or
nothing, by a view so incomprehensive, towards establishing the theory
of fever. Both the cold and the hot fits, about the exposition of which
such a theory is alone concerned, are themselves accidents, since in the
most formidable and dangerous forms of fever, the supposed relation
between these phenomena is not only constantly disturbed, but often the
phenomena themselves do not occur, it being one of the very characters
of some of the intensest fevers, that the temperature is little changed,
and that the diminished temperature which may be, or which may have been
present, is never succeeded by any increase of heat. The true theory of
this, as of every other disease, must be sought in the study of its
pathology, and can be found only by comparing the pathology of the
organs ascertained to be affected with their physiology. The cold stage
of fever, when it exists, is produced by a disturbance of the functions
of the circulation and of the respiration, and these functions are
disturbed, because the organs in which they have their seat no longer
receive their accustomed and their requisite supply of nervous influence
from the nervous system. The hot stage, when it exists, arises from a
disturbance of the same functions: and the reason why we cannot assign
with precision why the same cause produces in the one case a diminished,
and in the other an increased temperature, or why the temperature is
disturbed at all, is because we do not know with precision on what
circumstances in the animal economy the generation of heat depends: when
the physiologist has clearly and completely ascertained all the
circumstances upon which this process depends, the pathologist will
probably have but little difficulty in tracing with equal clearness and
completeness the connexion between the disturbance of that process, and
the commencement of the febrile state.
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