difpofition towards affection. Inftances of good conferred on others intereft us by fympathy. In good done to others, we rejoice as naturally, as in good done to ourselves; and our approbation of it originates in the inftinctive benevolence of our nature.When we have ourselves done good or evil to others, and reflect upon it, confcience informs us, that, by thofe actions, we have deserved the love or hatred of those perfons, and we feel fatisfaction or uneafinefs accordingly. All moral confiderations recal us to our natural union with our fellow-creatures; nor could we, as it seems, be otherwife than indifferent to whatever by any means promoted their happinefs, or occafioned their mifery, were it poffible that we should totally diveft ourselves of all affection for them, of all fympathy in their feelings, of all defire for their regard, or good opinion. From all which, it appears to be extremely evident that the chief, if not the only fource of moral feelings, or that which has been called the moral fenfe, is the natural attachment of human beings to each other: that principle of focial union, which is gratified and delighted naturally with all that tends to general good, hurt and wounded by every thing that tends to general evil. And thus alfo it appears that living according to nature, fo far as morality is concerned in it, is living according to the impulfes of natural and focial feelings." P. 250.

We forbear, for obvious reafons, to enter more at length into the contents of this volume; to expatiate on what we conceive to be its merits, or to animadvert on those defects, from which, perhaps, no literary production is wholly exempt. We difmifs it with wifhes for its fuccefs, before a tribunal more awful than our own; avowing at the fame time our opinion that it is calculated generally to promote the interests of virtue and religion.

ART. VI. A Differtation on fimple Fever, or on Fever confifting of one Paroxyfm only. By George Fordyce, M. D. F. R. S. Senior Phyfician, to St. Thomas's Hofpital, and Reader on the Practice of Phyfic in London. 8vo. pp. 238. 3s. 6d. Johnson, 1794.

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FEVER

EVER is a disease (the author fays) the exiftence of which no man could have the leaft fufpicion of, fuppofing him acquainted with the ftructure of the body, the properties of the folids and fluids, the various operations which go on in it in health, the manner in which they take place, the powers which produce them, the connection of the body and the mind, as well as these are known at this day by Phyfiologifts, Anatomifts, or thofe who have studied medicine itself, or any of the branches of knowledge conducive to it. It is, therefore only to be known by obferving it in the difeafed bodies of men afflicted with the distemper."

U u 2

Notwithstanding

Notwithstanding that fever is one of the most frequent difeases that occur, and has been treated of by almost an infinity of writers, no juft definition has yet been given, nor any certain method of treating it difcovered. This the author proves by showing the difcordant opinions, on these heads, of fome of the latest and most celebrated profeffors of Phyfic. Much, therefore, remains to be done. Dr. G. Fordyce does not pretend to have explored this vaft field of fcience, he has only begun his journey; but having taken a new and more direct road, he feems to think he fhall make advances beyond what former travellers have done; or, to adopt his own metaphor,

"He can measure a few bafes, carry on a few triangles, examine, perhaps, the foil of a few fields, cultivate fome yards on the furface, or bring out fome of those treafures which lie deeper. But many and many new obfervers, and many and many new labourers must be employed, to bring the whole knowledge and cultivation of it to perfection."

Fever has, in moft languages, derived its name from a word fignifying heat. In Greek, from ug, fire, and from fervere, to be hot, in Latin; and, in common fpeech in this country, when a perfon is very hot, he fays he is in a fe

Hence it might be imagined, that heat, difcoverable by the thermometer, would be always prefent or might be ac-, counted a pathognomic fymptom of fever. But this, our author fhows, from a variety of inftances, is not the cafe. He next examines if there are any other fymptoms that are always prefent in fever. Frequency of the pulle has, by many writers, been confidered as pathognomic of fever: but this frequently occurs in hyfteric and other affections not connected with fever on the other hand, Dr. F. has feen perfons in fever, with the pulfe beating only 60, 50, or 45 ftrokes in a minute.

"If we examine, (he adds) the reftlefsnefs, anxiety, ftate of the tongue, head-ach, or any other of the fymptoms which often take place in fever, we shall find that they alfo may be prefent when there is no fever, and abfent in a patient afflicted with this disease, and therefore, we cannot allow that there is any pathognomic fymptom of fever."

In giving a definition of fever, Dr. Fordyce begins by enumerating a large clafs of difeafes arifing from inflammation, or fpafmodic affection of particular parts of the body, attended with heat, quick pulfe, parched fkin, dry, furred tongue, headach, &c. which have been commonly denominated fever; as pleurify, inflammation of the bowels, eryfipelatous affections, &c. but as the fymptoms denominated febrile, disappear upon

the

the affection of the parts being removed and cured, these are not included in his idea of fevers. By these remarks he prepares his readers for his definition of fever, which he calls a disease affecting the whole fyftem, the head, the trunk, the extremities, the circulation, abforption, fecretion, the nervous system, the mind as well as the body. Fevers are of fhorter or longer duration. Sometimes they run their course in eight, ten, or twelve hours, and sometimes they take as many or more days before they are completely terminated, In the latter cafe, they appear at ftated or irregular periods to renew their courfe; but, although they remit their violence, they are never entirely abfent until the complete termination.

The first attack of fever is frequently fudden and inftantaneous, and ufually happens in the day.time. Ten fevers come on, the author fays, between eight in the morning and eight in the evening, to one that comes on between eight in the evening and eight in the morning. This has been observed, he fays, by other practitioners or authors, and has been attempted to be accounted for, but he declines affigning any reafon for it: the fact, he is certain, he has frequently observed.

The first appearance of fever is manifefted by a general uneafinefs and reftlefsness, affecting the mind as well as the body; the author thinks the mind may be affected first.This is attended with a fenfe of weaknefs or inability to change the posture or object of thought, for this weaknefs, alfo affects the mind as well as the body; fo that, although the sense of uneafinefs or reftlefsnefs would prompt the patient to change his pofition, or alter his train of thinking, his weakness or depreffion of ftrength, as the author chooses to call it, renders him incapable of doing the one or the other. Soon after the patient complains of being cold, and moves nearer the fire, or puts on warmer clothing. During this time, the real temperature of the fkin does not always accord with the feelings of the patient, as, on moving a thermometer to thofe parts of the body where the fenfe of cold is greatest, they are found to be hotter than in a healthy ftate. This is, however, not always the cafe, as the furface of the body is fometimes found to be colder than is natural. With these symptoms, a diminution of fenfation takes place. This, the author feems to think, is dependent on the weakness or depreffion of ftrength, in body and mind, which he had noticed before. A pain in the fmall of the back, feeming to occupy the lumbar vertebræ, is also a frequent and early fymptom of fever. With thefe appearances, a diminution of all the fecretions takes place; this, the author thinks, may be occafioned by a contraction of the fmall veffels entering the glands, preventing

them

them from carrying a fufficient quantity of blood to fupply the ufual fecretions. In a little time, and fometimes at the beginning of fever, the tongue is covered with a cruft, of a particular kind; fometimes white, fometimes verging towards brown. This is confined to the upper part of the tongue, and ufually to the middle and back part, leaving the edge and the tip free. There is frequently a fenfation as if fome light body, as fome infect, was moving over the hairs which rife from the fkin; this, for which we have no appropriate term in our language, is called in Latin horripilatio.The fkin looks fallow and dirty; it seems wrinkled or contracted, embracing the mufcles and other parts under it, closer than ufual; it becomes alfo benumbed, and less fenfible to external ftimuli. The eyes appear dull, heavy, and ftupid, and the white is lefs clear and brilliant than in health.

Dr. F. had obferved that the fecretions are diminished in quantity; they are alfo found to be changed or altered in their qualities. In health the urine is tranfparent when voided, but on cooling it becomes thick and depofits a fediment, but in fever, the mucilage which occafions the fediment is not fecreted, fo that the urine remains tranfparent when it has flood to cool. Coftiveness is a general attendant on fever. This is occafioned by the deficiency in the fecretions, whence a smaller portion of the ufual and neceffary juices are poured into the bowels, and by the liftlefsnefs and weakness of the whole frame, whence a more feeble peristaltic motion of the bowels. The contractions of the heart, and the confequent pulfations of the arteries, become more frequent, increafing from 73, the natural standard in adults, to 74, 75, 76, and fo on to 80, 90, 100, 120, 130, or 140 strokes in a minute. There is also another change takes place in the pulfation of the artery, which, from the manner of its ftriking the finger, gives the idea of being obftructed. This always happens in the beginning of fever, and is often taken for hardness of the pulfe, but is different, and clearly to be diftinguished, the author thinks, from hardness, which does not occur until another and later ftage of the fever. times the pulfe intermits on the first attack of fever; this, if not ufual to the perfon when in health, always portends, great danger.

Some

Pain in the head, accompanied with a fenfe of weight, affecting more generally the forehead, but fometimes every part of the head, attends alfo the early ftage of fever.This has been thought to be an affection of the brain, but the author thinks the feat is in the external parts or teguments. It is of the fame nature as the pain in the limbs which is com

plained

plained of at the fame time. These affections are accompanied or followed by great thirst, delirium, and various affections of the stomach, as lofs of appetite, naufea, vomiting, These symptoms are confidered feparately and explained. From the whole, the author concludes,

"That fever is a disease, the effence of which is not understood, manifefling itself by a depreffion of the powers of fenfation, irrita bility, and action in the body, and of the power of memory, imagination, and judgment in the mind, with contraction of the small veffels throughout the body, an accumulation of fluids in the large veffels, and fome peculiar affection of the ftomach."

The author next confiders the cause of fever; and rejecting all thofe that will not bear the teft of experience, he confines his obfervations to those that are strongly marked. The first he notices is infection. That there is a fubftance generated in the body of perfons affected with fever, which mixing with the atmosphere, and coming in contact with other perfons, is capable of communicating the infection, or of occafioning a fimilar fever in them, is too well known to admit of a doubt, although the vapour is too fubtle and minute to make itself fenfible to any of our organs. This infectious matter, the author thinks, is produced by all fevers whatsoever, although in different quantities, or, perhaps, of different degrees of ftrength or malignity, as he never knew a perfon infected by it from coming near a patient who had a fever of one pa roxyfm only. Intermittent fevers he has known to be fometimes, although rarely, infectious; but continued fevers produce the infectious matter in the greatest quantity, and in proportion to the violence of the symptoms.

But infectious matter, capable of producing fever, is known to be sometimes generated where a number of perfons live crowded together, even although attention is paid to cleanlinefs, but fooner, and in greater quantity, if they are fordid and dirty. It is alfo produced from dead animal or vegetable fubftances, lying long heaped together and becoming putrid; at the fame time it does not appear that putrefaction is neces fary to its production, as perfons affected with fever communicate the infection, although there are no appearances of putrefaction, either in the folids, the blood, or the fecreted fluids in them; but the presence of putrefaction feems to give additional vigour to the poison, and to make it more infectious.

Dr. F. next confiders the power of fudden exposure to cold, of moisture, of particular forts of food, and of the paffions of the mind, in producing fever, and explains the modes by which he thinks they may fometimes produce that

effect.