Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author — John Shaqi
Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
Science
Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
The same cause, when it acts upon the extremities of the blood-vessels,
produces coldness and chills. This is obvious to any person, under the
first impression of the miasmata which bring on fevers, also under the
influence of fatigue, and debilitating passions of the mind. The absence
of chills indicates the sensibility of the external parts of the body to
be suspended or destroyed, as well as their irritability; hence when
death occurs in the fit of an intermittent, there is no chill. A chilly
fit, for the same reason, seldom occurs in the most malignant cases of
fever. It is sometimes excited by blood-letting, only because it weakens
those fevers to such a degree, as to carry the blood-vessels back to the
grade of depression. Coldness and chills are likewise removed by
blood-letting, only because it enables the arteries to re-act in such a
manner as to overcome the depression that induced it. It has been
remarked, that the chilly fit, in common fevers, seldom appears in its
full force until the patient approaches a fire, or lies down on a warm
bed; for in these situations sensibility is restored by the stimulus of
the heat acting upon the extremities of the blood-vessels. The first
impressions of the rays of the sun, in like manner, often produce
coldness and chills in the torpid bodies of old and weakly people.
Tremors are the natural consequence of the abstraction of that support
which the muscles receive from the fulness and tension of the
blood-vessels. It is from this retreat of the blood towards the viscera,
that the capillary arteries lose their fulness and tension; hence they
contract like other soft tubes that are emptied of their contents. This
contraction has been called a spasm, and has improperly been supposed to
be the proximate cause of fever. From the explanation that has been given
of its cause, it appears, like the coldness and chills, to be nothing but
an accidental concomitant, or effect of a paroxysm of fever.
The local pains in the head, breast, and bones in fever, appear to be the
effects of the irregular determination of the blood to those parts, and
to morbid action being thereby induced in them.
The want of appetite and costiveness are the consequences of a defect of
secretion of the gastric juice, and the abstraction of excitement or
natural action from the stomach and bowels.
The inability to rise out of bed, and to walk, is the effect of the
abstraction of excitement from the muscles of the lower limbs.
The dry skin or partial sweats appear to depend upon diminished or
partial action in the vessels which terminate on the surface of the
body.
The high-coloured and pale urine are occasioned by an excess or a
deficiency of excitement in the secretory vessels of the kidneys.
The suppression of the urine seems to arise from what Dr. Clark calls an
engorgement, or choaking of the vessels of the kidneys. It occurs most
frequently in malignant fevers.
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