The object to be aimed at in practice, then, is clear: it is to prevent,
or to remove inflammation. Accomplish this, the fever will not be cured
at once; it will still go on for some time; but it will come sooner to a
close, and it will proceed mildly and safely to its termination. Fail to
accomplish this, and the fever, however mild at first, will increase
more and more in severity until it become truly formidable, and death
take place at last, in consequence of the destruction of the organs by
the process of inflammation.
If excitement be set up in an organ which has as invariable a tendency
to terminate in inflammation as a stone to fall to the ground, what is
the proper remedy to prevent the transition of excitement into
inflammation? Bleeding. Before we can say that inflammation is
established we may foresee that it will come: if the preceding
excitement be not stopped, we know that it will as surely come as that
blood will flow from a wounded blood-vessel. Because we cannot tell the
precise moment when increased vascular action passes into actual
inflammation, are we quietly to look on and do nothing until we have
made that discovery? We know that inflammation is at hand; we know what
will prevent it, or, at any rate, what has a powerful tendency to
prevent it: shall we not bring into immediate and vigorous use our means
of prevention, or shall we wait until the inflammatory action shall have
given unequivocal and alarming indications of its presence and operation
before we interfere? To trifle in such a manner, to lose these precious
moments when we have such a fearful, such an active, and, if once it be
allowed to become active, such a masterless enemy to contend with as
fever, is as great a folly as it would be when a building is on fire to
stand idle by as long as the fire is smouldering, and to take no measure
to extinguish it until it has burst into flame, nay, not until the flame
has spread from the floor to the ceiling, and from the ceiling to the
roof. We may not be able to see a single spark, but if we see the smoke
and feel the heat, we know that there is fire somewhere, and that
however concealed at present it will soon make itself visible enough,
and that it will consume not only the structure in which it originates,
but others with which it may come in contact if it be not put out. With
equal certainty we know that fever, though apparently mild in the
commencement, will excite inflammation in vital organs, and that that
inflammation, if it be allowed to establish itself, will place the
fabric of the body in the most imminent danger. The physician, in the
first stage of fever, armed with his lancet, is to his patient what the
fireman with his engine, before the flames have had time to kindle, is
to a building that has taken fire. At this early stage, the former can
check inflammation with almost as much ease and certainty as the latter
can prevent the flames from bursting out. On the contrary, the physician
Public-domain text, read in full here on John Shaqi.
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