The next subjects which demand investigation are
1. The comparison of the circulation, respiration, temperature, and chemical changes of the solids and fluids, especially of the urine in malarial fever, with similar phenomena in health, and in all other diseases.
2. The action of the medicines employed in the treatment of malarial fever.
3. The comparison of the methods and results of treatment in malarial fever with those of other diseases.
4. Nature of the causes of malarial fever.
5. Relations of malarial fever to soil, water, atmosphere, and climate.
The discussion of each one of these divisions would occupy as much space as the preceding imperfect investigation, and must, therefore, be deferred to a future time.
In concluding these "Observations on some of the Phenomena of Malarial Fever" (which have been the result of three years' labor and study, upon more than three hundred cases of the different forms of malarial fever, in Savannah, in Liberty County, in Athens, and in Augusta), we would again admit that they are incomplete —in fact, nothing more than beginnings in the right direction— and again express the hope that the statements, and relations, and laws deduced from these observations, will be tested by careful, conscientious observers; the errors eliminated, the imperfections removed, the results enlarged, and the positive knowledge of the phenomena of malarial fever, and of all fevers, established by observation, experiment, and reason.
ASTRONOMICAL PHENOMENA.
Affect all bodies, 9.
Gravity, 9.
Binary stars, and the revolution of our
sun around a distant centre, illustra- tions of the wide reign of the law of gravity, 9-11.
Stability of the solar system, 12.
Order and harmony of the planetary sys- tem, 12.
Relations of plants and animals to the force of gravity, and the size of our globe, 13.
Relations of the moon to the earth, with its plants and animals, 14. Heat of the sun and fixed stars, 16. Researches of Pouillet upon heat of fixed stars, 16.
Relations of the fixed stars to the motions upon the earth, and to the existence of plants and animals, 17-20. Acalephæ, blood of, 80. Andral, on the changes of the blood in typhoid fever, 198; in smallpox, 199; in measles, 199; in erysipelas, 200; in phthi- sis, 200; in acute rheumatism, 202; in pleuritis, 203; in peritonitis, 203; in bron- chitis, 203.
on the distinctions between the altera- tions of the blood in the pyrexiæ and phlegmasiæ, 208–210.
Anemia, changes of blood in, 201. Antony, Dr. Milton, on spinal irritation,
Arnold, Dr. Richard D., on the color of the liver in malarial fever, 244.
Imperfect state of our knowledge, 75. Importance and difficulty of establishing a standard formula of the constitution of the blood in health, 79.
The constitution of the blood varies not only with the class, but with each spe- cies of animals, and corresponds with the development and perfection of the organs and apparatus, 80. Blood of Protozoa, 80.
Polypi, 80. Acalephæ, 80. Echinodermata, 81. Cephalopoda, 82.
Amphioxus, 82.
Garfish (lepisosteous osseus), 83.
Birds and mammalia, 83.
Chemical constitution of moist blood cor- puscles, 84.
Chemical constitution of liquor sanguinis, 84.
Importance of establishing the typical
formula of the blood in starvation, 85. Difficulties of establishing the amount of blood in health and disease, 86. Estimates of the amount of blood in the human system by Blumenbach, Haller, Borelli, Young, Dumas, Fletcher, An- cell, Valentine, and Lehmann, and by the author, 86.
Changes of the blood in malarial fever, 88, 216.
Difficulties of investigations upon the blood in disease, 88.
Color of the blood and serum in malarial fever, 91.
Specific gravity of the blood and serum in various diseases, as determined by Becquerel, Rodier, Nasse, Zimmerman, Guenaud de Mussy, and Joseph Jones, 93. Coagulation of the blood, 93.
Table of blood-corpuscles in 1,000 parts of healthy and malarial blood, 94. Fibrin in healthy and diseased blood, as determined by Andral, Gavarret, Bec- querel, Rodier, Guenaud de Mussy, Popp, Wittstock, Simon, Glover, Heller, and Joseph Jones, 94, 95.
Cases illustrating the physical changes of the fibrin, and the formation of heart clots in malarial fever, 96-112. Observations of Hewson, Baillie, Mor- gagni, Albinus, Burns, Stewart, War- drop, Cruwell, Graham, Stenzel, Meckel, Stoerk, Petit, O'Halloran, Martial, Ba- ron, Virchow, Paget, Crampton, Louis, Bougen, Desault, Duncan, Reid, Hodg- son, Andral, Tiedemann, Otto, Lobstein, Cloquet, Carsewell, Langstaff, and Ri- chardson, on the formation of fibrinous concretions during life, 113-115. Conditions most favorable to the deposi- tion of fibrinous concretions, 115-117. Observations of Gairdner, Richardson, Gaspard, Lee, Hewson, Thackrah, Coo- per, and Brücke, upon the coagulation of the blood, 116, 117.
Symptoms and diagnosis of fibrinous con cretions in the heart and blood vessels, 118-124.
Observations of Dr. Wm. Senhouse Kirkes upon the effects of detachment of fibrin- ous concretions during life, 125. Discussion of the causes of the formation of fibrinous concretions in the heart and blood vessels in malarial fever, 126 -129.
Principles of treatment best adapted to
prevent the formation of fibrinous con- cretions in the heart and blood vessels, 129-132.
Method of analyzing the blood, 133. Table illustrating the composition of ven- ous blood in malarial fever, 135. History of the cases which furnished the blood for analyses, 136-171. Comparison of their results with the typi- cal formula of the blood in health and disease, 171-211.
Colored blood-corpuscles are diminished during malarial fevers, and the extent and rapidity of the diminution corre- spond to the severity and extent of the disease, 171.
Researches of Andral and Gavarret upon the blood of intermittent fever, 172. Composition of the blood in marsh cach-
exia, according to Becquerel & Rodier, 173.
Composition of the blood in mechanical dropsy, 174.
Composition of the blood in acute dropsy, 175.
Composition of the blood in cachectic drop- sies, 177.
The fixed saline constituents of the col- ored blood-corpuscles are diminished in malarial fever, 177.
The iron of the disintegrated blood-corpus- cles appears in the urine, 178.
Physiological, pathological, and thera- peutical bearing of the changes of the blood-corpuscles in malarial fevers, 178
-193. Researches of Schmidt upon the specific gravity of the colored blood-corpuscles in various diseases, 179. Relations of the colored blood-corpuscles to the muscular and nervous system, 179.
Principles of treatment, based upon the changes of the blood in malarial fever, 180-193.
Injurious effects of bloodletting in mala- rial fever, 180-186.
Active and excessive purgation should be avoided in malarial fever, 187. Importance of nutritious diet, and of the phosphates and iron, 188.
Principles which should govern the admin- istration of pepsin in malarial fever, 189.
The excretion of the products resulting from the dead disintegrated blood-cor- puscles should be promoted by diuretics and depurants, and the liver and spleen should be roused to throw off their per- verted secretions, 193.
Place of the destruction of the colored corpuscles in malarial fever, 194. Animal starch accumulates in the malarial liver; whilst grape sugar is absent,
Alterations of the blood, and especially of the blood-corpuscles in the spleen during malarial fever, 196.
Comparison of the changes of the blood in malarial fever, with the changes of the blood in typhoid fever, typhus fever, ephemeral fever, smallpox, scarlatina, measles, acute scurvy, chronic scurvy, erysipelas, cholera, phthisis, scrofula, carcinoma, Bright's disease, chlorosis, anemia, simple rheumatic fever, febrile arthritic rheumatism, rheumatism, puer- peral fever, pneumonia, pleuritis, peri- tonitis, angina tonsillaris, acute bron- chitis, carditis, pericarditis, inflamma- tion of brain, glanders, and lead poi- soning, 198-203.
The colored blood-corpuscles are more uni- formly and rapidly destroyed in mala- rial fever than in any other acute dis- ease, 204-207.
Comparison of the changes of the blood and organs in malarial fever, with the changes of the blood and organs in ty- phoid and typhus fevers, 205-207. The diminution of fibrin in malarial fever corresponds with the severity of the disease, 208
Observations of Andral upon the diminution of fibrin in fevers, 208-210. Discussion of the question, do these changes of the blood precede or suc- ceed, or are they simultaneous with, the aberration of the physical, chemical, vital, and nervous phenomena denomi- nated fever, 211–216.
CEREBRO-SPINAL NERVOUS SYSTEM, 217- 231.
Not the seat in malarial fever of any uni- form irritation or inflammation, 219. Discussion of the causes of the aberrated
nervous phenomena of malarial fever, 220.
Theory expressing the relations of the
physical, chemical, and nervous pheno- mena of malarial fever, 221. Malarial fever paroxysmal not because the action of the cerebro-spinal or of the sympathetic nervous system is parox- ysmal, 223.
Explanation of the paroxysmal character of malarial fever, 221-223. Post-mortem examinations of the cerebro- spinal nervous system in the various forms of malarial fever, 224-231.
CHEMICAL CHANGES.
Importance of determining the amounts and character in various disease, 271- 276.
Index of temperature, 271-276. Chemical changes of blood, 88-216.
liver, 195, 240. spleen, 196, 259. intermittent fever, 285. remittent fever, 312. congestive fever, 352.
Relations of, to respiration, temperature, state of skin, and changes of urine in intermittent, remittent, and congestive fever, 271-407.
Importance of its determination, 275. Table showing the variations of in differ- ent individuals, 277.
Effects of changes of temperature on, 282. Condition of, in the cold stage of intermit- tent fever, 285-293.
In the hot stage, and period of intermis- sion, 293-312.
Cases and tables illustrating the changes of
the circulation in intermittent, remit- tent, and congestive fevers, 301-407.
CORRELATION OF THE PHYSICAL AND VITAL FORCES, 24-48.
History of the establishment of the cor-
relation of the physical forces, 26-36. Views of the Hindoos, Sabians, Chinese, Persians, and Egyptians, of Thales, Parmenides, Archelaus, Democritus, Pythagoras, Hippocrates, and other an- cient philosophers, 26.
Labors, experiments, reasonings, and generalizations in astronomy, of Ar- chimedes, Anaximander, Aristotle, An- aximenes, Aristarchus, Hipparchus, Pto- lemy, Copernicus, Kepler, Stevinus, Galileo, Gassendi, Fermat, Riccioli, Grimaldi, Bacon, Descartes, Castelli, Huyghens, Hooke, Halley, Mersenne, Bernoulli, Hermann, Leibnitz, Euler, Clairaut, D'Alembert, Lagrange, Gas- sendi, Borelli, and Newton, 27, 28; in acoustics, of Pythagoras, Mersenne, Newton, Taylor, Bernoulli, D'Alembert, Euler, Lagrange, Laplace, Poisson, 28; in thermotics, of Bacon, Locke, Rum- ford, Davy, Leslie, Dulong, Clausius, Mayer, Magnus, Holtzmann, Regnault, Rankine, Thompson, Joule, 29; in optics, of Seneca, Ptolemy, Archimedes, Euclid, Alhazen, Vitello, Snell, Greg- ory, Descartes, De Dominis, Newton, Huyghens, Grimaldi, Biot, Arago, Hooke, Young, Fresnel, Brewster, 30; of Volta, Nicholson, Davy, Becquerel, Faraday, Oersted, Arago, Schweigger, 31-32; of Petit, Scheele, Senebier, Rumford, Meese, Priestley, Ingenhousz, Saussure, Ritter, Wollaston, Young, Vogel, Herschel, Seebeck, Gay-Lussac,
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