GENUS [II].
With increased Actions of the Secerning System.
These are always attended with increase of partial or of general heat; for the secreted fluids are not simply separated from the blood, but are new combinations; as they did not previously exist as such in the blood vessels. But all new combinations give out heat chemically; hence the origin of animal heat, which is always increased in proportion to the secretion of the part affected, or to the general quantity of the secretions. Nevertheless there is reason to believe, that as we have a sense purposely to distinguish the presence of greater or less quantities of heat, as mentioned in Sect. XIV. 6. so we may have certain minute glands for the secretion of this fluid, as the brain is believed to secrete the sensorial power, which would more easily account for the instantaneous production of the blush of shame, and of anger. This subject deserves further investigation.
SPECIES.
[1]. Calor febrilis. The heat in fevers arises from the increase of some secretion, either of the natural fluids, as in irritative fevers; or of new fluids, as in infectious fevers; or of new vessels, as in inflammatory fevers. The pain of heat is a consequence of the increased extension or contraction of the fibres exposed to so great a stimulus. See Class [I. 1. 5. 6].
[2]. Rubor febrilis. Febrile redness. When the cold fit of fever terminates, and the pulsations of the heart and arteries become strong as well as quick from the increase of their irritability after their late quiescence, the blood is impelled forwards into the fine extremities of the arteries, and the anastomozing capillaries, quicker than the extremities of the veins can absorb and return it to the heart. Hence the pulse at the wrist becomes full, as well as quick and strong, and the skin glows with arterial blood, and the veins become empty and less visible.
In elderly people the force of the heart and arteries becomes less, while the absorbent power of the veins remains the same; whence the capillary vessels part with the blood, as soon as it is received, and the skin in consequence becomes paler; it is also probable, that in more advanced life some of the finer branches of the arteries coalesce, and become impervious, and thus add to the opacity of the skin.
[3]. Sudor calidus. Warm sweat may be divided into four varieties, according to their remote causes. First, the perspirable matter is secreted in as great quantity during the hot fit of fever, as towards the end of it, when the sweat is seen upon the skin. But during the hot fit the cutaneous absorbents act also with increased energy, and the exhalation is likewise increased by the greater heat of the skin; and hence it does not appear in drops on the surface, but is in part reabsorbed, and in part dissipated in the atmosphere. But as the mouths of the cutaneous absorbents are exposed to the cool air or bedclothes; whilst those of the capillary glands, which secrete the perspirable matter, are exposed to the warmth of the circulating blood; the former, as soon as the fever-fit begins to decline, lose their increased action first; and hence the absorption of the sweat is diminished, whilst the increased secretion of it continues for some hours afterwards, which occasions it to stand in drops upon the skin.
As the skin becomes cooler, the evaporation of the perspirable matter becomes less, as well as the absorption of it. And hence the dissipation of aqueous fluid from the body, and the consequent thirst, are perhaps greater during the hot fit, than during the subsequent sweat. For the sweats do not occur, according to Dr. Alexander's experiments, till the skin is cooled from 112 to 108 degrees of heat; that is, till the paroxysm begins to decline. From this it appears, that the sweats are not critical to the hot fit, any more than the hot fit can be called critical to the cold one; but simply, that they are the natural consequence of the decline of the hot fit, commencing with the decreased action of the absorbent system, and the decreased evaporation from the skin. And from hence it may be concluded, that a fever-fit is not in general an effort of nature to restore health, as Sydenham considered it, but a necessary consequence of the previous torpor; and that the causes of fevers would be less detrimental, if the fever itself could be prevented from existing; as appears in the cool treatment of the small-pox.
It must be noted that the profuse sweats on the skin are more frequent at the decline of fever-fits than the copious urine, or loose stools, which are mentioned below; as the cutaneous absorbents, being exposed to the cool air, lose their increased action sooner than the urinary or intestinal absorbents; which open into the warm cavities of the bladder and intestines; but which are nevertheless often affected by their sympathy with the cutaneous absorbents. Hence few fevers terminate without a moisture of the skin; whence arose the fatal practice of forcing sweats by the external warmth of air or bedclothes in fevers; for external warmth increases the action of the cutaneous capillaries more than that of the other secerning vessels; because the latter are habituated to 98 degrees of heat, the internal warmth of the body; whereas the cutaneous capillaries being nearer the surface are habitually kept cooler by the contact of the external air. Sweats thus produced by heat in confined rooms are still more detrimental; as the air becomes then not only deprived of a part of its oxygene by frequent respiration, but is loaded with animal effluvia as well as with moisture, till it can receive no more; and in consequence, while the cutaneous secretion stands upon the skin in drops for want of exhalation, the lungs are exposed to an insalubrious atmosphere.