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Show 9. 14 Temperature The effect of continued cold affords to me the strongest probability that "the solution of fever does not depend chiefly 'on the sudden, general, and powerful impression on the sensations" (Currie I. 68.) Unless we suppose that in a fever, requiring for its cure immersion for some time, and in one Ii where at'fusion suflices, cold operates differently, its effect must chiefly consist in extinguishing the confiagration of the system, beginning at the surface. Shocks, doubtless, work great changes, but cold water can hardly be said to l ‘, give shocks for a whole halfhour together. Does blood-letting then, " a still more refrigerating remedy, and only useful in fever, when it produces this effect" (II. 245), operate by a sudden impression on the sensations ? The use of cordials, as in external inflamma~ tion, while cold is applied, would, I suppose, be inadmissible. Blisters, perhaps, might prevent the transfer Qf susceptibility to vital parts. For it is this, according to its degree, I believe, and not any effect on sensation, that makes cold applications hurtful or beneficial, when they do not reduce general heat. I have noted down numerous facts in illustration of this important principle.--In Miss Geale, consumptive, the rigors, which were excessive, had ceased underthe use of digitalis-a blister applied-June 18th 1'805, said she had no chills at all but on and near the blistcred spot. If she drank cold liquor or if the body. 2 3.} or went against the wind, which was cold for the season, she felt chilly on the blister. 24th June, the first blister dried and another opened»the chill now confined to the new blister. it occurred when the wind blew on the face only.~---» I have sometimes thought of assembling a party of inveterate snuff-takers in order to try whether sneezing would not be produced in some by the application of snuff to the callous lining of the nostrils, while they were partly or totally imw mersed in cold water. Of blisters, I shall observe that when the ecce- sionfor counter-irritation is urgent, it is not the. best plan to raise them by cantharides. Boiling water is much better, and I suppose its superior efficacy somewhat in proportion to its quicker action. The effect is easily confined by a cloth, that rather more than fills a cup of any size, wetted with boiling water. No such blister needs to be large. It is raised by a momentary application. If the cloth be held on for half a minute or more the skin is destroyed. The objec- tion is intense pain. This ceases however in less than a minute, when the purpose is to produce an eschar -, and it is still by far, I believe, the most merciful sort of caustic. Isuspect, but without experience, that extreme cold would be yet more beneficial in this way. A blister is speedily produced .mt . .- a h H7 '3 MN) MO' |