81

ESSAY VI.

ON THE

ΚΑΥΣΟΣ OF ARE TAUS.

(THE BRAIN FEVER.)

I HAVE always considered the description of the Kavσos, or burning fever of Hippocrates, known by us under the name of the brain fever, given by Aretæus, one of the most interesting medical details which have come down to us from antiquity. The beauty of the language (Ionic Greek), but little inferior to that of the Father of History, is striking, and the truth of the picture to nature most correct, as I have had occasion to verify it in several instances in the course of my experience.

I do not ask your particular attention to the account of the disease in its first stage;

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for the symptoms described are such as present themselves in the early stages of most fevers, accompanied with inflammation of some important organ; but I would point out to your especial notice those expressions which describe the delirium under which the patient labours in a more advanced progress of the malady, and the termination of that delirium in a syncope, followed by cold sweats and a loosening of all the bonds by which being is held together in the human frame.

The author states that the first effect of the subsidence of the violent excitement is, that the patient's mind becomes clear, that all his sensations are now exquisitely keen; that he is the first person to discover that he is about to die, and announces this to his attendants; that he seems to hold converse with the spirits of those who have departed before him, as if they stood in his presence;

and that his soul acquires a prophetic

power.

The author, with all the appearance of being himself convinced that this power has really been acquired by the patient in the last hours of his life, remarks that the bystanders fancy him to be rambling and talking nonsense, but that they are afterwards astounded at the coming to pass of the events which had been predicted, τη αποβάσει δε τῶν ειρημένων θωυμάζεσι ὤνθρωποι. Indeed he attempts to account for it by supposing that the soul, whilst shuffling off this mortal coil,' whilst disengaging itself from the incumbrances of the body, becomes purer, more essential, entirely spiritual, as if it had already commenced its new exist

ence.

this

I will not stop here to comment upon alleged peculiarity which patients under the brain fever are said by Aretæus to manifest,

though I shall recur to it hereafter; but I will lay before you a case of this disease, the symptoms and progress of which, as they passed under my own immediate observation, justify me in bearing testimony to the general truth of that author's description of the malady.

age,

A young gentleman, twenty-four years of who had been using mercury very largely, caught cold, and became seriously ill with fever. His head appeared to be affected on the fifth day, and on the seventh, when I was first called into consultation with another physician who had attended him with great care and judgment from the commencement of his illness, we found him in the highest possible state of excitement. He was stark naked, standing upright in bed, his eyes flashing fire, exquisitely alive to every movement about him, and so irascible as not to be approached without in

creasing his irritation to a degree of fury. He was put under coercion, and amongst other expedients, emetic tartar was ordered to be administered to him, in doses of a grain each time, at proper intervals.

On the eleventh day of his disease I was informed by my colleague, when we met, and by the attendants, that he was become quite calm, and seemed much better. It was remarked, indeed, that he had said, repeatedly, that he should die; that under this conviction he had talked with great composure of his affairs; that he had mentioned several debts which he had contracted, and made provision for their payment; that he had dictated messages to his mother, who was abroad, expressive of his affection, and had talked much of a sister who had died the year before, and whom, he said, he knew he was about to follow immediately. To my questions, whether he