Indeed, it is a subject that cannot be too minutely handled; because it is scarce possible that there is a disease void of a fever in some degree or other.—But preciseness and utility is the object I have in view.
SECT. II.
Of Accidental Fevers.
How uncertain is human life! One moment in a perfect state of health, the next perhaps no more; or confined under the painful sensations both of body and mind!
Every accident is liable, and unavoidably must bring on a fever; and this, like fire, should be extinguished in its earliest commencement. But in that, as I have before observed, the constitution should principally be consulted.
I have in the lecture of accidents, at every opportunity, recommended bleeding, but always with a proviso, if requisite; and, as this is of more consequence than generally is supposed, I find it necessary here to expatiate farther on it.
In the first place, no man should be bled who has lost a considerable quantity of blood, unless indeed he was known in his state of health to be very strong and robust; and that the fever sets on with such fury, that the system requires absolutely to be reduced; for the solids and fluids have such a strict dependance amongst themselves, that they keep each other in an equipoise. If therefore the blood is of an acrimonious nature, and at the same time impoverished by lessening its quantity, the coats of the arteries and veins will be the more stimulated; thence the fever will naturally encrease, and generate more acrimony; which at length will destroy the patient. I have been an eye witness more than once, that the fever has actually increased upon every repeated bleeding, till the whole supply of life was spent; and all my persuasions have not been listened to till too late. Nay, a fever is sometimes absolutely necessary; and proves to some constitutions a remedy on its own account, provided it is properly treated, and kept within due bounds.
Secondly, If the constitution of the patient before the accident was but slender, and of a phlegmatic nature, bleeding should be very little or cautiously performed; for the blood of itself being but poor, must naturally be impoverished by being lessened; and whilst the tenseness of the fibres is lost, it is the more acted upon and rendered more acrimonious, and still unable to strengthen the tone of the irritated fibres; whence a relaxed body, together with a poor acrimonious blood, and all its evil tendencies must be the consequence.
Let it once for all be observed, that all the benefit we can possibly hope and expect from bleeding, is to lessen the whole system, to reduce the quantity of the fluids, and to relax the solids. This lessening of the system I must own is very often highly necessary; But, let us not fall into the ridiculous notion to suppose that bleeding will draw off the bad blood, and leave the good behind; far otherwise; the quantity of the blood is soon replenished, but the quality becomes impoverished.