[6]. A certain quantity of stimulus, less than that above mentioned, is succeeded by paralysis, first of the voluntary and sensitive motions, and afterwards of those of irritation, and of association, which constitutes death.
[VI]. Cure of increased Exertion.
[1]. The cure, which nature has provided for the increased exertion of any part of the system, consists in the consequent expenditure of the sensorial power. But as a greater torpor follows this exhaustion of sensorial power, as explained in the next paragraph, and a greater exertion succeeds this torpor, the constitution frequently sinks under these increasing librations between exertion and quiescence; till at length complete quiescence, that is, death, closes the scene.
For, during the great exertion of the system in the hot fit of fever, an increase of stimulus is produced from the greater momentum of the blood, the greater distention of the heart and arteries, and the increased production of heat, by the violent actions of the system occasioned by this augmentation of stimulus, the sensorial power becomes diminished in a few hours much beneath its natural quantity, the vessels at length cease to obey even these great degrees of stimulus, as shewn in Sect. [XL. 9. 1]. and a torpor of the whole or of a part of the system ensues.
Now as this second cold fit commences with a greater deficiency of sensorial power, it is also attended with a greater deficiency of stimulus than in the preceding cold fit, that is, with less momentum of blood, less distention of the heart. On this account the second cold fit becomes more violent and of longer duration than the first; and as a greater accumulation of sensorial power must be produced before the system of vessels will again obey the diminished stimulus, it follows, that the second hot fit of fever will be more violent than the former one. And that unless some other causes counteract either the violent exertions in the hot fit, or the great torpor in the cold fit, life will at length be extinguished by the expenditure of the whole of the sensorial power. And from hence it appears, that the true means of curing fevers must be such as decrease the action of the system in the hot fit, and increase it in the cold fit; that is, such as prevent the too great diminution of sensorial power in the hot fit, and the too great accumulation of it in the cold one.
[2]. Where the exertion of the sensorial powers is much increased, as in the hot fits of fever or inflammation, the following are the usual means of relieving it. Decrease the irritations by blood-letting, and other evacuations; by cold water taken into the stomach, or injected as an enema, or used externally; by cold air breathed into the lungs, and diffused over the skin; with food of less stimulus than the patient has been accustomed to.
[3]. As a cold fit, or paroxysm of inactivity of some parts of the system, generally precedes the hot fit, or paroxysm of exertion, by which the sensorial power becomes accumulated, this cold paroxysm should be prevented by stimulant medicines and diet, as wine, opium, bark, warmth, cheerfulness, anger, surprise.
[4]. Excite into greater action some other part of the system, by which means the spirit of animation may be in part expended, and thence the inordinate actions of the diseased part may be lessened. Hence when a part of the skin acts violently, as of the face in the eruption of the small-pox, if the feet be cold they should be covered. Hence the use of a blister applied near a topical inflammation. Hence opium and warm bath relieve pains both from excess and defect of stimulus.
[5]. First increase the general stimulation above its natural quantity, which may in some degree exhaust the spirit of animation, and then decrease the stimulation beneath its natural quantity. Hence after sudorific medicines and warm air, the application of refrigerants may have greater effect, if they could be administered without danger of producing too great torpor of some part of the system; as frequently happens to people in health from coming out of a warm room into the cold air, by which a topical inflammation in consequence of torpor of the mucous membrane of the nostril is produced, and is termed a cold in the head.
[VII]. Cure of decreased Exertion.