Besides the pleasure, which attends the irritations produced by the objects of lust and hunger, there seems to be a sum of pleasurable affection accompanying the various secretions of the numerous glands, which constitute the pleasure of life, in contradistinction to the tedium vitæ. This quantity or sum of pleasurable affection, seems to contribute to the due or energetic performance of the whole moveable system, as well that of the heart and arteries, as of digestion and of absorption; since without the due quantity of pleasurable sensation, flatulency and hypochondriacism affect the intestines, and a languor seizes the arterial pulsations and secretions; as occurs in great and continued anxiety of the mind.
[2]. Besides the febrile motions occasioned by irritation, described in Sect. [XXXII]. and termed irritative fever, it frequently happens that pain is excited by the violence of the fibrous contractions; and other new motions are then superadded, in consequence of sensation, which we shall term febris sensitiva, or sensitive fever. It must be observed, that most irritative fevers begin with a decreased exertion of irritation, owing to defect of stimulus; but that on the contrary the sensitive fevers, or inflammations, generally begin with the increased exertion of sensation, as mentioned in Sect. [XXXI]. on temperaments: for though the cold fit, which introduces inflammation, commences with decreased irritation, yet the inflammation itself commences in the hot fit during the increase of sensation. Thus a common pustule, or phlegmon, in a part of little sensibility does not excite an inflammatory fever; but if the stomach, intestines, or the tender substance beneath the nails, be injured, great sensation is produced, and the whole system is thrown into that kind of exertion, which constitutes inflammation.
These sensitive fevers, like the irritative ones, resolve themselves into those with arterial strength, and those with arterial debility, that is with excess or defect of sensorial power; these may be termed the febris sensitiva pulsu forti, sensitive fever with strong pulse, which is the synocha, or inflammatory fever; and the febris sensitiva pulsu debili, sensitive fever with weak pulse, which is the typhus gravior, or putrid fever of some writers.
[3]. The inflammatory fevers, which are here termed sensitive fevers with strong pulse, are generally attended with some topical inflammation, as pleurisy, peripneumony, or rheumatism, which distinguishes them from irritative fevers with strong pulse. The pulse is strong, quick, and full; for in this fever there is great irritation, as well as great sensation, employed in moving the arterial system. The size, or coagulable lymph, which appears on the blood, is probably an increased secretion from the inflamed internal lining of the whole arterial system, the thinner part being taken away by the increased absorption of the inflamed lymphatics.
The sensitive fevers with weak pulse, which are termed putrid or malignant fevers, are distinguished from irritative fevers with weak pulse, called nervous fevers, described in the last section, as the former consist of inflammation joined with debility, and the latter of debility alone. Hence there is greater heat and more florid colour of the skin in the former, with petechiæ, or purple spots, and aphthæ, or sloughs in the throat, and generally with previous contagion.
When animal matter dies, as a slough in the throat, or the mortified part of a carbuncle, if it be kept moist and warm, as during its abhesion to a living body, it will soon putrify. This, and the origin of contagion from putrid animal substances, seem to have given rise to the septic and antiseptic theory of these fevers.
The matter in pustules and ulcers is thus liable to become putrid, and to produce microscopic animalcula; the urine, if too long retained, may also gain a putrescent smell, as well as the alvine feces; but some writers have gone so far as to believe, that the blood itself in these fevers has smelt putrid, when drawn from the arm of the patient: but this seems not well founded; since a single particle of putrid matter taken into the blood can produce fever, how can we conceive that the whole mass could continue a minute in a putrid state without destroying life? Add to this, that putrid animal substances give up air, as in gangrenes; and that hence if the blood was putrid, air should be given out, which in the blood-vessels is known to occasion immediate death.
In these sensitive fevers with strong pulse (or inflammations) there are two sensorial faculties concerned in producing the disease, viz. irritation and sensation; and hence, as their combined action is more violent, the general quantity of sensorial power becomes further exhausted during the exacerbation, and the system more rapidly weakened than in irritative fever with strong pulse; where the spirit of animation is weakened by but one mode of its exertion: so that this febris sensitiva pulsu forti (or inflammatory fever,) may be considered as the febris irritativa pulsu forti, with the addition of inflammation; and the febris sensitiva pulsu debili (or malignant fever) may be considered as the febris irritativa pulsu debili (or nervous fever), with the addition of inflammation.
[4]. In these putrid or malignant fevers a deficiency of irritability accompanies the increase of sensibility; and by this waste of sensorial power by the excess of sensation, which was already too small, arises the delirium and stupor which so perpetually attend these inflammatory fevers with arterial debility. In these cases the voluntary power first ceases to act from deficiency of sensorial spirit; and the stimuli from external bodies have no effect on the exhausted sensorial power, and a delirium like a dream is the consequence. At length the internal stimuli cease to excite sufficient irritation, and the secretions are either not produced at all, or too parsimonious in quantity. Amongst these the secretion of the brain, or production of the sensorial power, becomes deficient, till at last all sensorial power ceases, except what is just necessary to perform the vital motions, and a stupor succeeds; which is thus owing to the same cause as the preceding delirium exerted in a greater degree.
This kind of delirium is owing to a suspension of volition, and to the disobedience of the senses to external stimuli, and is always occasioned by great debility, or paucity of sensorial power; it is therefore a bad sign at the end of inflammatory fevers, which had previous arterial strength, as rheumatism, or pleurisy, as it shews the presence of great exhaustion of sensorial power in a system, which having lately been exposed to great excitement, is not so liable to be stimulated into its healthy action, either by additional stimulus of food and medicines, or by the accumulation of sensorial power during its present torpor. In inflammatory fevers with debility, as those termed putrid fevers, delirium is sometimes, as well as stupor, rather a favourable sign; as less sensorial power is wasted during its continuance (see Class II. 1. 6. 8.), and the constitution not having been previously exposed to excess of stimulation, is more liable to be excited after previous quiescence.