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
From the accession of new stimuli, or an increase in the force of former
ones, this typhus state of fever sometimes assumes, on the 11th, 14th,
and even 20th days, the symptoms of the synocha state of fever. It will
be useful to remember this remark, not only because it establishes the
unity of fever, but because it will justify the use of a remedy, seldom
prescribed after the disease has acquired that name which associates it
with stimulating medicines.
The common name of this state of fever, is the _nervous_ fever. This name
is improper; for it invades the nervous system by pain, delirium, and
convulsions much less than several other states of fever. To prevent the
absurd and often fatal association of ideas upon the treatment of this
state of fever, I have called it, from its duration, the _low chronic_
state of fever. I have adopted the term _low_, from Dr. Butter's account
of the remitting fever of children, in order to distinguish it from
states of fever to be mentioned hereafter, in which the patient is not
confined to his bed. This new name of the typhus or nervous fever
establishes its analogy with several other diseases. We have the acute
and the chronic rheumatism; the acute and chronic pneumony, commonly
called the pleurisy and pulmonary consumption; the acute and chronic
inflammation of the brain, known unfortunately by the unrelated names of
phrenitis, madness, and internal dropsy of the brain. Why should we
hesitate, in like manner, in admitting acute and chronic fever, in all
those cases where no local inflammation attends?
8. The _typhoid_ state of fever is composed of the synocha and low
chronic states of fever. It is the _slow_ nervous fever of Dr. Butter.
The excitement of the blood-vessels is somewhat greater than in the _low_
chronic state of fever. Perhaps the muscular fibres of the blood-vessels,
in this state of fever, are affected by different degrees of stimulus and
excitement. Supposing a pulse to consist of eight cords, I think I have
frequently felt more or less of them tense or relaxed, according as the
fever partook more or less of the synocha, or low chronic states of
fever. This state of fever occurs most frequently in what are called the
hectic and puerperal fevers, and in the scarlatina.
9. The _hectic_ state of fever differs from all the other states of
fever, by the want of regularity in its paroxysms, in which chills,
fevers, and sweats are included; and by the brain, nerves, muscles, and
alimentary canal being but little impaired in their functions by it. It
appears to be an exclusive disease of the blood-vessels. It occurs in the
pulmonary consumption, in some cases of lues, of scrophula, and of the
gout, and after most of the states of fever which have been described.
The force of the pulse is various, being occasionally synochoid, typhoid,
and typhus.
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