I do not deny, that sweating may be so managed as to be serviceable in preventing the return of the cold paroxysm of fevers; like the warm bath, or any other permanent stimulus, as wine, or opium, or the bark. For this purpose it should be continued till past the time of the expected cold fit, supported by moderate doses of wine-whey, with spirit of hartshorn, and moderate degrees of warmth. Its salutary effect, when thus managed, was probably one cause of its having been so much attended to; and the fetid smell, which when profuse is liable to accompany it, gave occasion to the belief, that the supposed material cause of the disease was thus eliminated from the circulation.
When too great external heat is applied, the system is weakened by excess of action, and the torpor which causes the cold paroxysm recurs sooner and more violently. For though some stimuli, as of opium and alcohol, at the same time that they exhaust the sensorial power by promoting increase of fibrous action, may also increase the production or secretion of it in the brain, yet experience teaches us, that the exhaustion far out-balances the increased production, as is evinced by the general debility, which succeeds intoxication.
In respect to the fetor attending copious continued sweats, it is owing to the animalized part of this fluid being kept in that degree of warmth, which most favours putrefaction, and not suffered to exhale into the atmosphere. Broth, or other animal mucus, kept in similar circumstances, would in the same time acquire a putrid smell; yet has this error frequently produced miliary eruptions, and increased every kind of inflammatory or sensitive fever.
The ease, which the patient experiences during sweating, if it be not produced by much external heat, is similar to that of the warm bath; which by its stimulus applied to the cutaneous vessels, which are generally cooler than the internal parts of the system, excites them into greater action; and pleasureable sensation is the consequence of these increased actions of the vessels of the skin. From considering all these circumstances, it appears that it is not the evacuation by sweats, but the continued stimulus, which causes and supports those sweats, which is serviceable in preventing the returns of fever-fits. And that sweats too long continued, or induced by too great stimulus of warmth, clothes, or medicines, greatly injure the patient by increasing inflammation, or by exhausting the sensorial power. See Class [I. 1. 2. 14].
Secondly, The sweats produced by exercise or labour are of the warm kind; as they originate from the increased action of the capillaries of the skin, owing to their being more powerfully stimulated by the greater velocity of the blood, and by a greater quantity of it passing through them in a given time. For the blood during violent exercise is carried forwards by the action of the muscles faster in the arteries, than it can be taken up by the veins; as appears by the redness of the skin. And from the consequent sweats, it is evinced, that the secretory vessels of the skin during exercise pour out the perspirable matter faster, than the mouths of the absorbent vessels can drink it up. Which mouths are not exposed to the increased muscular action, or to the stimulus of the increased velocity and quantity of the blood, but to the cool air.
Thirdly, the increased secretion of perspirable matter occasioned by the stimulus of external heat belongs likewise to this place; as it is caused by the increased motions of the capillary vessels; which thus separate from the blood more perspirable matter, than the mouths of their correspondent absorbent vessels can take up; though these also are stimulated by external heat into more energetic action. If the air be stationary, as in a small room, or bed with closed curtains, the sweat stands in drops on the skin for want of a quicker exhalation proportioned to the quicker secretion.
A fourth variety of warm perspiration is that occasioned by stimulating drugs, of which opium and alcohol are the most powerful; and next to these the spices, volatile alkali, and neutral salts, especially sea salt; that much of the aqueous part of the blood is dissipated by the use of these drugs, is evinced by the great thirst, which occurs a few hours after the use of them. See Art. III. 2. 12. and Art. [III. 2. 1].
We may from hence understand, that the increase of this secretion of perspirable matter by artificial means, must be followed by debility and emaciation. When this is done by taking much salt, or salted meat, the sea-scurvy is produced; which consists in the inirritability of the bibulous terminations of the veins arising from the capillaries; see Class [I. 2. 1. 14]. The scrophula, or inirritability of the lymphatic glands, seems also to be occasionally induced by an excess in eating salt added to food of bad nourishment. See Class [I. 2. 3. 21]. If an excess of perspiration is induced by warm or stimulant clothing, as by wearing flannel in contact with the skin in the summer months, a perpetual febricula is excited, both by the preventing the access of cool air to the skin, and by perpetually goading it by the numerous and hard points of the ends of the wool; which when applied to the tender skins of young children, frequently produce the red gum, as it is called; and in grown people, either an erysipelas, or a miliary eruption, attended with fever. See Class [II. 1. 3. 12].
Shirts made of cotton or calico stimulate the skin too much by the points of the fibres, though less than flannel; whence cotton handkerchiefs make the nose sore by frequent use. The fibres of cotton are, I suppose, ten times shorter than those of flax, and the number of points in consequence twenty times the number; and though the manufacturers singe their calicoes on a red-hot iron cylinder, yet I have more than once seen an erysipelas induced or increased by the stimulus of calico, as well as of flannel.
The increase of perspiration by heat either of clothes, or of fire, contributes much to emaciate the body; as is well known to jockeys, who, when they are a stone or two too heavy for riding, find the quickest way to lessen their weight is by sweating themselves between blankets in a warm room; but this likewise is a practice by no means to be recommended, as it weakens the system by the excess of so general a stimulus, brings on a premature old age, and shortens the span of life; as may be further deduced from the quick maturity, and shortness of the lives, of the inhabitants of Hindostan, and other tropical climates.