Zoonomia; Or, the Laws of Organic Life, Vol. I

by Erasmus Darwin

In those constitutions where the degree of inirritability, or of debility, is greater than natural, the coldness and paleness of the skin with the quick and weak pulse continue a long time after the patient leaves the bath; and the subsequent heat approaches by unequal flushings, and he feels himself disordered for many hours. Hence the bathing in a cold spring of water, where the heat is but forty-eight degrees on Fahrenheit's thermometer, much disagrees with those of weak or inirritable habits of body; who possess so little sensorial power, that they cannot without injury bear to have it diminished even for a short time; but who can nevertheless bear the more temperate coldness of Buxton bath, which is about eighty degrees of heat, and which strengthens them, and makes them by habit less liable to great quiescence from small variations of cold, and thence less liable to be disordered by the unavoidable accidents of life. Hence it appears, why people of these inirritable constitutions, which is another expression for sensorial deficiency, are often much injured by bathing in a cold spring of water; and why they should continue but a very short time in baths, which are colder than their bodies; and should gradually increase both the degree of coldness of the water, and the time of their continuance in it, if they would obtain salutary effects from cold immersions. See Sect. [XII. 2. 1].

On the other hand, in all cases where the heat of the external surface of the body, or of the internal surface of the lungs, is greater than natural, the use of exposure to cool air may be deduced. In fever-fits attended with strength, that is with great quantity of sensorial power, it removes the additional stimulus of heat from the surfaces above mentioned, and thus prevents their excess of useless motion; and in fever-fits attended with debility, that is with a deficiency of the quantity of sensorial power, it prevents the great and dangerous waste of sensorial power expended in the unnecessary increase of the actions of the glands and capillaries of the skin and lungs.

[4]. In the same manner, when any one is long exposed to very cold air, a quiescence is produced of the cutaneous and pulmonary capillaries and absorbents, owing to the deficiency of their usual stimulus of heat; and this quiescence of so great a quantity of vessels affects, by irritative association, the whole absorbent and glandular system, which becomes in a greater or less degree quiescent, and a cold fit of fever is produced.

If the deficiency of the stimulus of heat is very great, the quiescence becomes so general as to extinguish life, as in those who are frozen to death.

If the deficiency of heat be in less degree, but yet so great as in some measure to disorder the system, and should occur the succeeding day, it will induce a greater degree of quiescence than before, from its acting in concurrence with the period of the diurnal circle of actions, explained in Sect. [XXXVI]. Hence from a small beginning a greater and greater degree of quiescence may be induced, till a complete fever-fit is formed; and which will continue to recur at the periods by which it was produced. See Sect. [XVII. 3. 6].

If the degree of quiescence occasioned by defect of the stimulus of heat be very great, it will recur a second time by a slighter cause, than that which first induced it. If the cause, which induces the second fit of quiescence, recurs the succeeding day, the quotidian fever is produced; if not till the alternate day, the tertian fever; and if not till after seventy-two hours from the first fit of quiescence, the quartan fever is formed. This last kind of fever recurs less frequently than the other, as it is a disease only of those of the temperament of associability, as mentioned in Sect. [XXXI].; for in other constitutions the capability of forming a habit ceases, before the new cause of quiescence is again applied, if that does not occur sooner than in seventy-two hours.

And hence those fevers, whose cause is from cold air of the night or morning, are more liable to observe the solar day in their periods; while those from other causes frequently observe the lunar day in their periods, their paroxysms returning near an hour later every day, as explained in Sect. [XXXVI].

[IV]. Another frequent cause of the cold fits of fever is the defect of the stimulus of distention. The whole arterial system would appear, by the experiments of Haller, to be irritable by no other stimulus, and the motions of the heart and alimentary canal are certainly in some measure dependant on the same cause. See Sect. [XIV. 7]. Hence there can be no wonder, that the diminution of distention should frequently induce the quiescence, which constitutes the beginning of fever-fits.

Monsieur Leiutaud has judiciously mentioned the deficiency of the quantity of blood amongst the causes of diseases, which he says is frequently evident in dissections: fevers are hence brought on by great hæmorrhages, diarrhœas, or other evacuations; or from the continued use of diet, which contains but little nourishment; or from the exhaustion occasioned by violent fatigue, or by those chronic diseases in which the digestion is much impaired; as where the stomach has been long affected with the gout or schirrus; or in the paralysis of the liver, as described in Sect. [XXX]. Hence a paroxysm of gout is liable to recur on bleeding or purging; as the torpor of some viscus, which precedes the inflammation of the foot, is thus induced by the want of the stimulus of distention. And hence the extremities of the body, as the nose and fingers, are more liable to become cold, when we have long abstained from food; and hence the pulse is increased both in strength and velocity above the natural standard after a full meal by the stimulus of distention.

However, this stimulus of distention, like the stimulus of heat above described, though it contributes much to the due action not only of the heart, arteries, and alimentary canal, but seems necessary to the proper secretion of all the various glands; yet perhaps it is not the sole cause of any of these numerous motions: for as the lacteals, cutaneous absorbents, and the various glands appear to be stimulated into action by the peculiar pungency of the fluids they absorb, so in the intestinal canal the pungency of the digesting aliment, or the acrimony of the fæces, seem to contribute, as well as their bulk, to promote the peristaltic motions; and in the arterial system, the momentum of the particles of the circulating blood, and their acrimony, stimulate the arteries, as well as the distention occasioned by it. Where the pulse is small this defect of distention is present, and contributes much to produce the febris irritativa pulsu debili, or irritative fever with weak pulse, called by modern writers nervous fever, as a predisponent cause. See Sect. [XII. 1. 4]. Might not the transfusion of blood, suppose of four ounces daily from a strong man, or other healthful animal, as a sheep or an ass, be used in the early state of nervous or putrid fevers with great prospect of success?