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AN 
 
 INAUGURAL DISSERTATION 
 
 ON THE 
 
 PERSPIRABLE FLUIDS 
 
 OF THE 
 
 HUMAN BODY; 
 
 SUBMITTED TO THE PUBLIC EXAMINATION OF THE 
 
 FACULTY OF PHYSIC 
 
 t?KDER THE AUTHORITY OF THE TRUSTEES OF COLUMBIA COLLEGE, 
 IN THE STATE OF NEW-YORK, 
 
 The Right Rev. BENJAMIN MOORE, D.D. President j 
 
 FOR THE DEGREE OF 
 
 DOCTOR OF PHYSIC, 
 
 On the <■")* Dav of November, 1802. 
 
 BY RICHARD L. WALKER, 
 
 Of New-York. 
 
 The plague Is not produced ivithin us, but arises from external causes. 
 Sancforiusf Med. Static. Aphorism 12^* 
 
 NEW-YORK: 
 
 Printed by T. & J. Swords, Printers to the Faculty of Physic 
 of Columbia College. 
 
 1802. 
 

TO 
 
 The Hon. DE WITT CLINTON, 
 RICHARD S. KISSAM, M.D. 
 
 AND 
 
 EDWARD MILLER, M.D. 
 
 THIS 
 
 DISSERTATION 
 
 Is most respectfully dedicated. 
 
TO 
 
 SAMUEL BORROWE, M,D, 
 
 Sir, 
 
 JL he time set apart for the completion of my medical edu- 
 cation being now terminated, it is with a heart overflowing 
 with the tenderest emotions that I view my separation from 
 you in the capacity of a pupil. In this separation, however, 
 I am supported by the pleasing reflection, that your efforts 
 will never be wanting to promote my future improvement 
 and usefulness. 
 
 Having experienced so much of your goodness hitherto, 
 I cannot but hope that your exertions to wrest me from 
 the whirlwind of thoughtless dissipation will be kindly con- 
 tinued. 
 
 If I have not improved in a manner equal to your wishes, 
 it cannot be charged to your neglect; and if my improve- 
 ments had even exceeded the most sanguine expectations of 
 my friends, it would be a return of but small consideration 
 for your faithfulness and attention. 
 
 In whatever situation accident or chance may place me, 
 I shall pray that Heaven may for ever confer upon you an 
 uninterrupted course of peace, happiness and success. 
 
 Permit me to say, that, during my residence at the New- 
 York Hospital as House-Surgeon, I was treated with that 
 politeness and affability by the visiting surgeons and physi- 
 cians, which justly claims my grateful thanks. 
 
 To the Governors of the Hospital I make grateful and 
 heartfelt acknowledgments. These gentlemen always dis- 
 
( 6 ) 
 
 played a disposition to cover the indiscretions of inexperienced 
 youth with the mantle of benevolence, and evinced their 
 friendship by a favourable construction of my conduct. 
 
 I have to regret, that neither opportunity nor language is 
 afforded me equal to my obligations to the several Medical 
 Professors. 
 
 It would here be a pleasing task to take a view of the state 
 of medical learning in Columbia College, but the limits which 
 I have prescribed to myself will not permit. I will, however, 
 observe, that our medical school has sustained an irreparable 
 loss, by the removal of that learned and sound philosopher. 
 Dr. MiTCHiLL, The young gentlemen of the College 
 sincerely mourn his absence, and think it will be long a suhr, 
 ject of regret to the Students of Medicine. I do not mean 
 to censure the proceedings of the Trustees, nor in any man-* 
 ner whatever to inquire into the causes or motives of the 
 removal of that gendeman. But there is no doubt of their 
 having struck oiF from the catalogue of professors a great 
 scientific guide, who always ably pointed out the road to 
 the candidate for fame, and was eminently calculated to 
 bend the tender mind of youth to improvement and useful- 
 ness. 
 
 These are not mere compliments lavished by flattery, but 
 truths extorted by the justice due to such an exalted cha«» 
 racter. 
 
 With high respect and esteem, 
 
 I acknowledge myself your hunjble servant, 
 
 KICHARD L. WALKER. 
 
AN 
 
 INAUGURAL DISSERTATION 
 
 ON THE 
 
 PERSPIRABLE FLUIDS 
 
 OF THE 
 
 HUMAN BODY, 
 
 JL HIS important function of living beings may 
 be advantageously considered in three points of 
 view^ to wit: 
 
 I. As respects the physiology of perspiration, 
 ox its condition during the continuance of health. 
 
 II. That part of the function which relates td 
 its pathology, or its state during disease. 
 
 III. Such alterations as the perspired fluids 
 undergo by chemical action, after secretion^ 
 changing to offensive, and often to noxious^ and 
 even pestilential compositions. 
 
 SECTION I. 
 
 Of the Perspiration in a State of Health, 
 IT is discovered by anatomy that the large 
 arteries of the body divide and subdivide until 
 
( 8 ) 
 
 they become almost inconceivably small tubes ^ 
 they are so wonderfully minute that they escape 
 the sharpest sight, and when divided, as in a fresh 
 wound, present to our view nothing but an ap- 
 pearance of gore. Injections, skilfully thrown 
 into the vessels of the dead subject, duly prepar- 
 ed, have demonstrated the wonderful intertex- 
 ture of them which exists in every part. These 
 hollow pipes, destined to conduct the blood 
 through the body^ circulate that vivifying fluid 
 to the viscera, to the organs of sense, to the 
 brain, to the muscles, and even to the bones, in 
 the requisite quantity, for the wants and uses of 
 these respective parts. To the exterior surface 
 of the body there is also a large distribution of 
 the vessels which transmit the blood. During 
 its passage from the right ventricle of the heart 
 through the pulmonary artery, and back again to 
 the left auricle through the pulmonary veins, this 
 ruddy fluid undergoes several striking changes ; 
 it loses its dark or purple colour, and turns to a 
 bright or crimson; it acquires caloric from the 
 decomposed oxygen gas of the atmosphere, and 
 becomes sensibly warmer. This caloric, conveyed 
 along with the vital current, through all its chan- 
 nels, imparts warmth to the whole frame, and 
 thus sustains animal heat even in the extreme 
 parts. During its passage through the lungs, 
 the blood also receives a portion of oxygen and 
 
( 9 ) 
 
 light ; these mingling with the sanguine current, 
 are the peculiar agents in striking the bright co- 
 lour, and of turning the blood to an animal oxyd. 
 And while this process is going on, the chyle 
 lately received from the thoracic duct, and not 
 yet effectually incorporated with the blood, is so 
 completely mingled as to be fairly assimilated with 
 its mass. 
 
 In passing through the pulmonic vessels the 
 blood also loses something; a portion of its phlo- 
 giston passes off, and, uniting with a part of the 
 oxygenous air within the bronchia, forms the 
 oxyd of phlogiston or Water. And a portion of 
 the superfluous carbone passing off and combine 
 ing with another part of the bronchial oxygen^ 
 turns to carbonic acid. The former of these, 
 %^olatilized by caloric, turns to halitus or watery 
 vapour ; while the latter, operated upon by the 
 same agent, is converted to carbonic acid gas. 
 Both of these are known to be formed plentifully 
 during the respiratory process. 
 
 Thus, while we breathe we receive into our 
 lungs some beneficial agents, to wit, chyle, oxy- 
 gen, light and heat; and we part with some 
 whose existence in too great quantity would in- 
 jure us, phlogiston and carbone. By these means 
 the venous blood is changed to arterious; and 
 beino^ thus chars^ed with both stimulant and 
 nutritive materials, it is carried by the left ven* 
 s 
 
( 10 ) 
 
 tficlc of the Jieart into the aorta, to excite, warm^ 
 ^nd nourish every part of the body. 
 
 From this fluid circulating through the arteries 
 and veins all -the secretions of the body are de- 
 rived. It contains the elements or material^ 
 whence the bile, semen, saliva, tears, lymph> 
 urine and other secreted humours are formed j 
 and from the same source proceed the fluids 
 which exhale from every pore and transuding 
 orifice of the skin. This exterior covering is 
 remarkably supplied with blood vessels; and 
 by the instrumentality of these, a very large 
 quantity of the aqueous part of the blood is car- 
 ried off into the surrounding air. While this 
 function is going on, the effete and vapid por- 
 tions of the blood are discharged from the vessels, 
 and no longer remain within them to overcharge 
 and oppress the constitution; while the super- 
 abundant caloric is carried off", converted from ^ 
 sensible into a latent state, whereby the body is 
 rendered cooler, an equilibrium of warmth i^ 
 preserved, and feverishness prevented. 
 
 These secreted fluids are of three kinds : 1st. 
 That which takes place from the whole surface 
 of the skin, called Cuticiilar Ferspiration; 2d. 
 The discharge from the trachea and bronchia? 
 denominated iht Pulmonary Evaporation; and, 
 3d. Those fluids which proceed from sores and ul- 
 cers, known by the name of Purulent Discharges. 
 
( 11 ) 
 
 On each of these I shall make sbtne remarks in 
 succession. 
 
 1 . Of Ciiticular Perspiration, 
 
 Physicians seem to have been a long tififfe igno- 
 fant of the quantity and extent of this evacua- 
 tion. If \vas known, indeed, that occasionally 
 the human body discharged a considerable quan- 
 tity of watery fluid by sweat; but until the time 
 of Sanctorius, the doctrine of insensible perspi- 
 ration seems not to have been understood. 
 
 This discerning physician first ascertained, by 
 Weight, the quantity of humours which the living 
 body lost through the perspiratory pores. For 
 this purpose he ascertained by the balance how 
 much food and drink he took in, and how much 
 Was discharged sensibly by the different excretory 
 outlets: And having found that the measurable 
 and palpable excreta fell considerably short of 
 the ingesta, he concluded that the principal part 
 of the deficient portion was carried off by the 
 cuticular exhalation. 
 
 This discharge from the surface of the skin has 
 been divided into two kinds. 1st. The Insensi- 
 ble or Sanctorian Perspiration. 2d. The Sensi- 
 ble Perspiration, or Sweat. 
 
 Of tJie Insensible Ferspiration. 
 
 When the cold edge of a polished razor, or 
 other bright metal, is applied to the surface of 
 
( 12 ) 
 
 the skin in dry winter weather, the insensible 
 perspiration can be sometimes seen to condense 
 on the side of the instrument: it even seems to 
 be protruded from the body with considerable 
 force. When horses are driven violently in very 
 cold weather, their insensible perspiration is con- 
 densed by the ambient air, and changed to visi-^ 
 ble vapour. This insensible perspiration can al- 
 so be smelled to considerable distances in certain 
 cases : for example ; when exhaling from the skin 
 of a Negro it is frequently very rank and offen- 
 sive 5 and even from the most delicate body, it is 
 strong and odorous enough to be scented by dogs. 
 A spaniel will follow his master's track among a 
 thousand men. In this probably he distinguishes 
 some peculiar effluvium not emitted by any other 
 man; and sportsmen remark that a pack of 
 hounds will pursue a fox very ^well when running 
 several rods to leeward of that animal's track. 
 The wind, in this case, seems to waft the per-, 
 spired matter to their nostrils. 
 
 Thus it appears that there is an exhalation 
 from the animal skin of considerable weight 
 and peculiar flavour : from this the shirts and 
 garments next the skin acquire their peculiar 
 taint and foulness. If a shirt be worn next the 
 skin of an healthy person, who perspires only, 
 "but without exuding sweat, in a sensible form, 
 it gradually grows unclean. This foulness is im^ 
 
( IS ) 
 
 parted to it from the skiri;, and to the skin it is 
 derived from the secretory arteries; whatever, 
 therefore, the exhaling vessels impart to the cu- 
 tis vera is communicated to the epidermis, and 
 from this latter to the shirt, drav^ers, stockings, 
 or other garment next to the body. By a long 
 series of wearing in contact, the cuticle and gar- 
 ment not only grow foul, but become very un- 
 comfortable and disagreeable to the cutis vera, 
 which is highly sensible. Hence arises irritation 
 of the surface, with sometimes an appearance of 
 pimples in various parts. Sometimes the confin- 
 ed perspiration excites fretting and chafing of 
 the skin; and not unfrequently a too long con- 
 finement of it upon the unclean body gives rise 
 to the itch, or increases the predisposition to that 
 disease. 
 
 The uncomfortableness of having the exhaled 
 fluids of the skin thus incessantly condensed upon 
 it, has led to the practice of anointing with oil 
 to counteract their degeneracy to poison, and of 
 purifying with alkalies to remove them entirely 
 away. 
 
 That sensation which is imparted to the hu- 
 man skin by unction with oil, is far more agree- 
 able to it than that which is communicated by its 
 own excretions. Indeed, a quantity of oiiy or 
 greasy matter is secreted by the healthy skin, and 
 feesmears its surface. Those parts of the body 
 
( H ) 
 
 which are not clothed nor washed, give ample 
 proof of this : the hairy scalp is always supplied 
 with an adipose secretion evident to any one; 
 and the like obtains in the other parts of the 
 skin. Savage nations, who are scantily clothed 
 and wrapped in furs and mantles of skins, daub 
 themselves with fat or oil to remove the disagree* 
 able sensations occasioned by their own filth, and 
 they find great relief and comfort in it: to a 
 person accustomed to clean linen, this seems 
 an extraordinary custom; but it was and is of 
 great utility among people who employed a dif- 
 ferent dress from that which is commonly worn 
 in more refined life : indeed, so strongly were 
 many of the ancients attached to these greasy 
 applications, that they made use of them at 
 length for the purposes of luxury. Their un- 
 guents were highly perfumed; they expended 
 great sums in the purchase of them; and there 
 was a class of persons, called latroalipt^, who 
 made it a profession to apply and rub them on ; 
 even in the time of our Saviour precious oint- 
 ments were in use. 
 
 The employment of oil after bathing, and to 
 soften the skin and limbs of the athletse and others 
 devoted to gymnastic exercises, evince the care 
 and assiduity with which they were applied in 
 ancient times; nor is it to be doubted that the 
 extreme unction recommended by St, James to- 
 
( 15 ) 
 
 be applied to a person desperately sick, might 
 have been serviceable by a medical as well as a 
 spiritual operation. 
 
 Where a more accurate system of cleanliness 
 than could be procured by oily and greasy things 
 was desired, water was employed; and hence 
 we derive the practical benefits of frequent wash- 
 ing of the body among many nations of the 
 earth. And where few clothes are worn, as 
 among the natives of some parts of Africa, and 
 of the warm South Sea Islands, washing with 
 water will answer all the purposes of cleansing 
 the skin and keeping it comfortable and healthy ; 
 but where it is fashionable to cover all t^e parts 
 of the body, except the face and hands, with 
 clothing, the perspired matter cannot escape free- 
 ly into the atmosphere, but must be entangled 
 ifi the texture of the garments ; the dress grows 
 rapidly foul, and water, in order to make them 
 clean and healthy, must be sharpened by soaps, 
 leys, and alkaline salts. Hence we become ac-^ 
 quainted with the qualities of the insensible per- 
 spiration, not commonly evident in the first in- 
 stance per se, but tincturing the cuticle and the 
 garments, and in process of time vitiating them 
 with the most foul and unhealthy taints. 
 Of the Sensible Perspij^ation, or Sweat. 
 
 When the body is exposed to more than ordi- 
 i\ary heat, or is made to undergo exercise more 
 
( 16 ) 
 
 severe than usual, the surface of the skin grows 
 moist, and if the heat or exercise be continued^ 
 it grows wet by the effusion of a watery fluid ; 
 this either overspreads the cuticle in the form of 
 dew, or gathers and trickles down in the con- 
 sistency of large drops ; these are often so copious 
 as to fall from the forehead and face to the 
 ground, and to render the clothes which enwrap 
 the body as w^et as if they had been dipped in 
 water. 
 
 This effusion is what is properly called sweat. 
 It is said to have been employed as the token of 
 exertion, exposure and toil, when man forfeited 
 his innocence and fell into a sinful state. Phy-* 
 siologically considered, sweating, when moderate, 
 has several salutary effects; it relieves the body 
 from too large a mass of circulating fluids, which, 
 if kept for ever in the vessels, would injure by in- 
 ducing a dangerous plethora. It has a happy: 
 tendency to relieve the kidneys and bladder front 
 secreting and carrying off excessive quantities of 
 urine; for, generally speaking, there is a great 
 sympathy between the skin and kidneys. When 
 sweat is copious, the quantity of urine is propor- 
 tionally small; and when the cuticular discharge 
 is lessened, the secretion by the kidneys suffers a 
 corresponding increase: by this correspondence 
 of the parts to each other great advantage is gain- 
 ed, and the wear and tear of the urinary passages 
 
( 17 ) 
 
 are so far lessened or prevented ; and this economy 
 is the more remarkable, as in men the urinary 
 organs are among the first to fail, or become unfit, 
 through natural decay, to perform their proper 
 functions. 
 
 Sweating also answers another important pur- 
 pose; it cools the body, and thereby obviates the 
 disagreeable consequences of the animal heat ac- 
 cumulating in the lungs. Suppose it to be true 
 that a gallon of atmospheric air is deprived of 
 its oxygen by a healthy man in the course of a 
 minute; one third of this air is supposed to be 
 oxygenous gas; in this gas, a great quantity of 
 caloric exists, though concealed in a latent state : 
 to this latent caloric, the oxygenous and even the 
 atmospheric air owe their permanent elasticity; 
 but in the function of respiration the oxygenous 
 gas is decomposed; and while its heat and light 
 pass through the membranes and vessels of the 
 lungSj to mingle with the blood and render it arte- 
 tious, its caloric, now converted from a latent to a 
 sensible state, accompanies the vital and crimson 
 current, and conveys warmth to every part of the 
 body, however remote. Thus the process of 
 breathing turns the latent heat of oxygenous air 
 to sensible heat, and bestows it upon the living 
 body, vivifying and cherishing the inward parts, 
 and thence travelling to the exterior surface. 
 
 This decomposition of oxygenous air, and the 
 
( IS ) 
 
 consequent evolution of caloric, goes on, unremit* 
 tingly, during the times both of sleeping and wak-^ 
 ing. The quantity of caloric extricated witliin 
 the lungs is prodigious. So great a quantity, and 
 so high ■ a degree of it is collected, that unless 
 some discharge or outlet was provided for its sur- 
 plus, the most dangerous consequences v^^ould 
 €nsue ; but the bounty of the Creator has provided 
 such an outlet. Every cuticular pore or duct 
 discharges a portion of insensible perspiration, 
 and at times pours forth a quantity of sweat, which 
 conveys from the system inordinate quantities of 
 heat. 
 
 The insensible perspiration, like other vapo- 
 rifle fluids, derives its aeriform quality from the. 
 latent heat which it contains : the quantity of this 
 is very considerable, and the whole of it is de- 
 rived from the sensible heat of the skin. In the 
 process of evaporation, therefore, there is a large 
 abstraction of ttie sensible heat of the body, and 
 this changing into a latent state, goes off with the 
 sanctorian halitus, and produces the sensation of 
 coolness or cold upon the surface from which it 
 escaped. 
 
 What happens to the perspiration, happens 
 eventually to sweat: though some of it may be 
 absorbed by the lymphatics, the greater part of 
 it, when not entangled by the clothing, gradually 
 changes to a vaporific form > in doing so it takes 
 
( 19 ) 
 
 Up a great proportion of sensible caloric, and ren- 
 ders it latent; and to this operation is to be ascrib- 
 ed the coolness, and even cold experienced by a 
 person who sits still, especially in a current of air, 
 after having been brought into a profuse sv^eat 
 by preceding exercise. By these means is the 
 human constitution enabled to dispose of the 
 superfluous caloric which would otherwise accu- 
 mulate and continually overheat, and eventually, 
 perhaps, consume the body. The inconvenience 
 of defective perspiration may be judged of by the 
 troublesome effects of the partial accumulation of 
 heat, during the hot fit of an intermitting fever, 
 and of the rapid cessation of it when sweat breaks 
 out. 
 
 The qualities of sweat, when chemically exa^ 
 mined, seem to be nearly the same with those 
 of the insensible perspiration. Indeed, the latter 
 appears to differ from the former but in degree, 
 being only a more gentle and moderate evacu^ 
 ation of the §ame kind, 
 
 2. Of the Evaporation or Respiratian from the 
 Lungs. 
 It has been computed that the area of all th^ 
 ramifications of the wind-pipe, its branches and 
 cells in the lungs, is equal to the area of the whole 
 external surface of the body: these are distributed 
 throughout that viscus in such great numbers, 
 
( 20 ) 
 
 that the calculation does probably not go beyond 
 the truth : into these openings within the thorax, 
 the atmospheric air is freely admitted through the 
 mouth and glottis, and agitates them with an aU 
 ternate rising and depression. Hence these in- 
 ternal extensive surfaces, visited and ventilated so 
 constantly and completely, are considered, in fact, 
 as external surfaces affected hy air. 
 
 Like the external parts of the body, these in-^ 
 ternal surfaces of the lungs exhale a watery 
 vapour; this is so considerable in quantity as to 
 be very perceptible in the form of mist in cool 
 weather; and when the air is very cold in northern 
 regions, during the rigour of winter, this halitus 
 turns to ice on the bed-clothes near the mouth 
 and nostrils, or even freezes into icicles in the 
 same vicinity. During the warmth of summer, 
 this watery vapour flies off in a form less evident 
 indeed to the eye, but still capable of imparting 
 its moisture to any bibulous and attractive mate^. 
 rial. It is not certain what the quantity thrown 
 off from the lungs may actually amount to, but 
 there can be no doubt that it is equally copious 
 with the exhalation from the whole of the cuti-? 
 cular surface. 
 
 It is probable that this secretion originated? 
 from two sources : 
 
 1st. A part of it is in all probability furnished 
 from the bronchial arteries. They seem to termi- 
 
( 21 ) 
 
 nate in glandular orifices or excretory ducts, or 
 open mouthed exhalents, as the blood vessels of 
 the skin do^ and there can be no reasonable 
 doubt that they perform a similar function. As far 
 then as the bronchial vessels contain and convey 
 bloodj may they be considered as furnishing their 
 quantum of perspired matter in the form of pul* 
 monary halitus. There is also the strongest ana- 
 logy to support a belief, that, as far as their powers 
 extend, the bronchial arteries are concerned in 
 preparing perspirable matter, exactly as the arte* 
 ries of the skin are 5 but these arteries are too 
 small to secrete the whole of the pulmonary hali* 
 tus: the quantity of blood which they convey is 
 not sufficient to afford so large an amount of aque* 
 ous vapour; therefore, in the economy of the 
 animal frame, it is wisely provided, that the lungs 
 may furnish an additional quantity of halitus or 
 perspiration by another process. 
 
 2d. The other part of the halitus of the lungs is ' 
 probably formed by a chemical process. Among 
 the researches of modern science, there is scarce- 
 ly a more brilliant discovery than that of the phy^ 
 sical constitution of water ; they who have made 
 experiments on the subject declare that if eighty- 
 five parts of oxygen are chemically combined 
 with fifteen of phlogiston (hydrogen), the product 
 will be clear and pure water; and the common 
 modes by which they are brought into this strict 
 
( 22 ) 
 
 connection are the processes, 1st. Of inflamma- 
 tion, where the phlogiston of blaze, combined 
 with a portion of atmospheric oxygen, turns to 
 water; and, 2d. Of electrical explosion, wherci 
 the artincial spark, or the natural lightning, pass-^ 
 ing through mixtures of inflammable and oxy- 
 genous gases, brings them into contact, by form-^, 
 ing the gaseous oxyd of phlogiston or water. 
 
 But in the animal body there seems to be 
 another mode of forming water. By means o£ 
 vascular agency in the living machine, the con-? 
 stituent parts of water are made so to approx- 
 imate as to be within the attractive distance of 
 each other, and the consequence of such coalition 
 is water. Now, if it can be shown that oxygen, 
 and phlogiston exist in the lungs, and come 
 within reach of each other, there will be no dif- 
 ficulty in comprehending how they may contri- 
 bute towards the formation of pulmonic halitus. 
 
 The blood gathered from all parts of the body 
 in the vena cava, and flowing back to the right 
 auricle of the heart, is loaded with a great sur- 
 plusage of phlogistic (hydrogenous) matter, which 
 the good of the constitution requires to be thrown 
 off in part, or disposed of. The retention of too 
 much of this would tend to deteriorate the health 
 of the animal, wdiose blood w^as thus overcharged 
 with phlogiston, or the basis of water. 
 
 To remedy this inconvenience the pulmonary. 
 
( 23 ) 
 
 Structure Is remarkably vascular, open and porous*; 
 and through outlets or passages too small for 
 blood and ordinary fluids to pass, the phlogiston 
 can go off in the most ready and easy manner^ 
 and through this vascular and membranous com- 
 pass it seems actually to make its escape from 
 the venous blood, w^ithout producing the smallest 
 disorganization or disturbance. 
 
 But if this v^^as all, the phlogiston so exhaling 
 from the blood of the vena cava now circulating: 
 through the pulmonary arteries, v^ould combine 
 with caloric, and escape through the glottis in 
 the form of inflammable air. But there is another 
 provision in this case; oxygenous air is inspired 
 through the mouth and nostrils, and penetrates the 
 innermost recesses of the lungs. Here this vivify- 
 ing gas, meeting with nascent phlogiston, in the 
 act of escaping from the blood, unites with it m 
 the most intimate connection, and thus forms an 
 additional quantity of water. This portion of water, 
 added to that produced by ordinary secretion^ 
 makes up the amount of the pulmonic halitus. 
 
 The water, so formed in the bronchial extre- 
 mities of the wind-pipe, does not remain long in 
 a Jiuid form ; for the heat of the thoracic region 
 is great enough almost instantly to convert it to 
 2l vaporific or gaseous state; and in this form it 
 piingles with the unconsumed and refluent por- 
 tion of inhaled atmosphere^ and passes, during 
 
( 24 ) 
 
 the act of expiration, through the natural outlets^ 
 to mingle with the great external ocean of air. 
 
 The halitus, so produced by a two-fold pro- 
 cess, contributes to the preservation of health iit 
 nearly the same manner that the perspiration and 
 sweat do. It evacuates superfluous humours; if 
 relieves the urinary organs; and, by carrying 
 away redundant caloric, tends to keep the body 
 cool and comfortable. 
 
 It is, however, always to be remembered, that 
 the water so formed by synthesis, instantly be- 
 comes the menstruum and vehicle of various ani- 
 mal matters, which impart to the halitus the pe- 
 culiar qualities for which it is distinguishable* 
 In these particulars it has a near resemblance to 
 the cutaneous perspiration. 
 
 3. Of the Fluids secreted from Sores and Ulcers* 
 
 Where the skin has been removed by wounds^ 
 ulceration, or otherwise, the injured and denuded 
 vessels do not dry up ; on the contrary, they pour 
 forth a larger quantity of fluids than they effused 
 in their healthy state. Some part of these are re- 
 absorbed, and some portion turn to a scab, but a 
 greater portion of this secretion evaporates and 
 escapes into the surrounding atmosphere. 
 
 Every person who approaches a patient labour- 
 ing under abscess or ulcer, can distinguish by the 
 
( 25 ) 
 
 smell that the exhalation is considerable, and 
 oftentimes extends to the distance of many feet^ 
 and more particularly surgeons and dressers know 
 what great quantities of humours are frequently 
 discharged from sores of this description. So great 
 are they, in many instances, as to taint the air of 
 the room vdiere the patient lies, and to make 
 washing and ventilation absolutely necessary to 
 keep the apartments clean and wholesome. 
 
 Finding that contradictory accounts had been 
 published of the qualities of this purulent dis- 
 charge from sores, I availed myself of my oppor- 
 tunities, as House Surgeon of the New- York Hos- 
 pital, to make some experiments on the subject. 
 Some had affirmed it to be an alkali^ while others 
 had declared it to be an acid. My experiments 
 have led me to adopt the latter opinion, and as I 
 flatter myself they may add to the mass of useful 
 facts, I here republish them from the Medical 
 Repository, (vol. v. p. 85.) They are a sequel 
 of certain experiments to the sam^e point, made 
 by Mr. H. C. Kunze. The result of my expe- 
 riments were summed up in the following Letter 
 
 to Dr. MiTCHILL. 
 
 " New-York HospitaU June 22, 1801. 
 
 ^^SlR, 
 
 ^^ I observe the experiments on the ackllty of 
 the pus discharged from foul and ill conditioned 
 
{ 26 ) 
 
 ulcers, made by Messrs. Kunze and Brovver, in 
 the New- York Hospital, last November, have 
 been published in London. They are contained 
 in vol. vi. p. 69, 70. of the Medical Review and 
 ^Magazine ; but the account is not near so ample 
 as in the Medical Repository, vol. iv. p. 297, 
 299. At the end of the account given of these 
 very interesting and instructive experiments, is 
 published a memorandum of some trials made 
 by Mr. Blair and Dr. Ingenkousz, a few years 
 ago, in the Lock Hospital, on syphilitic matter, 
 with a different result. These gentlemen con- 
 cluded that the discharges on which they made 
 experiments were of an alkaline quality, because 
 the litmus paper which they applied to the vene- 
 real pus turned of a hlueish hue.* 
 
 "It strikes me there must certainly be some mis- 
 take in the recital of these experiments, or in the 
 experiments themselves; for I never heard before 
 that an alkali would turn any delicate vegetable 
 calour to a blue or hlueish ; on the contrary, it com- 
 monly changes vegetable blues and purples to a 
 greeUy as acids turn them to a red. The natural 
 colour of litmus is blueish, and in the experiments 
 referred to by Mr. Blair, the matter applied 
 having neither an acid nor an alkaline quality, 
 which is often the case, the paper was taken out, 
 without having undergone any change of colour. 
 
 "^ Med. Rep. vol. iv. p. 76. 
 
( 27 ) 
 
 *^ The inference, therefore, from their experi- 
 ments is simply this, that in the trials made the lit- 
 mus paper gave no evidence of acidity. This is doubts 
 less very true, for it is well known to us here, 
 that pus is not always acid, but becomes so only 
 in certain circumstances., and these connected until 
 an unhealthy aspect of the ulcer. Considering 
 Mr. Blair^s experiments as not warranting the 
 conclusion he draws from them, and, when right- 
 ly understood, actually confirming, and not con- 
 tradicting those published by Mr. Kunze, I had 
 at first meditated to end my observations here, 
 but as further experiments w^ere called for within 
 a few days, I have made them on some of our 
 surgical patients, and these prove as plainly as 
 the former, that pus grows sour within a few 
 hours after secretion on the surfaces of malig- 
 nant ulcers, and that this appears in scrophula as 
 well as in lues and cancer. 
 
 " In the experiments litmus paper was employed 
 as the test, and this was very convertible to red 
 by the action of acetous, sulphuric and other 
 acids. To prevent mistakes, I guarded against 
 the possibility of acidity from lunar caustic, red 
 precipitate, saccharum, saturni, corrosive subli- 
 mate, and every thing else that occurred to me, 
 and dressed the ulcers during the experiments 
 with dry lint; I satisfied myself too, that blood 
 was not the cause of the red colour acquired by 
 the litmus. 
 
( 23 ) 
 
 " My first experiment was on the pus of a vene- 
 real ulcer, on the hand of two months continuance. 
 The patient had been three weeks under treat- 
 ment in the surgeons* ward, and the sore was 
 getting well ; yet a piece of the litmus paper put 
 in at ten in the morning, and suffered to remain 
 until half past five in the afternoon^, was consider- 
 ably reddened, 
 
 " I next tried an old ill-conditioned ulcer with 
 caries of the tibia. It had been under treatment 
 for a month, and was healing. A piece of papei 
 put upon the fleshy part at ten A. M. and taken 
 out at half past five P. M. was evidently turned 
 red, though perhaps a shade more faintly than the 
 preceding. Then a scrophulous ulcer on the arm 
 was tried, which discharged a great quantity of 
 pus from a sinus. It was of fourteen months dura- 
 tion, and not in a very favourable condition. Paper 
 inserted at ten in the forenoon, and removed at 
 half past five in the afternoon, was changed red, 
 and sensibly deeper than in the last experiment. 
 
 " Afterwards a trial was made on a syphilitic 
 ulcer on a woman's leg, of seven mionths standing, 
 and growing clean. Litmus paper put in at half 
 past eight in the morning, and examined at noon, 
 was evidently changed to a red. In all these in- 
 stances the blue colour of the litmus was restor- 
 ed by dipping the papers in a solution of carbo- 
 tiate of pot-ash. 
 
( 29 ) 
 
 *^ A man came into the hospital with a morti- 
 fied penis, occasioned by venereal virus, first show- 
 ing itself in the form of a small chancre not larger 
 than the head of a pin, and having spread, within 
 a few days, over a large portion of the prepuce. 
 This ulcer was in a most foul, offensive and gan- 
 grenous condition. Litmus paper put into it was 
 changed to a red in three hours and an half, and 
 the colour was brighter than in any of the former 
 experiments. 
 
 " In a case o^ common sore-shin, of eight years 
 standing, a paper put into the ulcer, and soaked 
 in its pus for several hours, underwent no change 
 at all. 
 
 ^^ The acidity of pus mentioned by Edward. 
 Home, may be opposed to the alkalinity supposed 
 to be detected in it by Adair Crowford. 
 
 '^ Indeed, Sir, the results of these and other 
 experiments were so steady and similar, that 
 I need not trouble you with further details. The 
 pus of certain ulcers appears to me to be an 
 acidifiable basis, and to attract oxygen from the 
 atmosphere : it therefore takes some time to be- 
 come acid, though this is commonly effected in 
 the course of a few hours. What modification 
 of the septic acid this will turn out to be, I must 
 leave to your consideration. I suppose it must 
 be septic acid, because, when concentrated and 
 plentiful, it corrodes the flesh, stirs up hectic 
 
( so ) 
 
 fever in the individual, and v^hen raised into gas 
 from numerous ulcerated surfaces (which are so 
 many local sources), by the heat of the living body 
 (96 or 98 Fahrenheit), breeds the infection of jail, 
 ship, and hospital fevers, to be communicated to 
 others within its reach. 
 
 " It is remarkable how near the truth some great 
 men may come and not quite reach it. Sir John 
 pRiNGLE, I observe, found that an austere acid 
 v/as produced by mingling putrid animal substan- 
 ces with bread and other vegetables. (Paper v.) 
 He was satisfied that the faeces humanse often con-r 
 tain an acid. (Paper vii.) He delivers it as his con- 
 viction, that there is a latent acid in the composi- 
 tion of all bodies. (Exp. 47.) In foul ulcers and 
 other sores, where the serum is left to stagnate 
 long, the matter, he says, is always acrimonious. 
 And he has proved sufficiently, (Paper i.) that 
 putrid substances are not alkaline, and that alka- 
 lies are powerful antiseptics. Yet the baronet could 
 not draw the conclusion from all these discoveries, 
 that putrid or septic exhalations were acid, nor 
 that the pus of foul idcers zvas an acid; but we 
 have done it for him, and shown that these, like 
 other effluvia from filth iness, are the exciting 
 causes of malignant and pestilential disease. I 
 think it not necessary to say more on the subject. 
 For my own part, I stand convinced, and I most 
 sincerely hope the above mentioned facts will 
 
( 31 ) 
 
 tend to clear up the doubts of the incredulous, ancl 
 universally to establish your doctrine. 
 
 " RICHARD L. WALKER, H, S. 
 *' Dr. Samuel L. Mitckill.'* 
 
 I afterwards reflected further on the subject, 
 and extended my inquiries to the discovery, whe- 
 ther the sweat was ever secreted in an acid state. 
 I have no reason to believe it is, but, on the con- 
 trary, am of opinion, that though it is possible a 
 morbid sweat may be sour, still generally the 
 acid quality of the sweat is not produced until 
 some time after secretion, when it has been a con- 
 siderable time exposed to the atmosphere and has 
 attracted oxygen from* it. The rusult of these in- 
 quiries are contained in the following letter to 
 Professor Hosack. 
 
 " New-York Hospital, Nov. 16, 1801. 
 '' Sir, 
 " In consequence of the publication of the ex- 
 periments which I made in June last, and com- 
 municated to Dr. MiTCHiLL, on jthe acidity 
 which the pus of venereal, cancerous, scrophulous 
 and other ill-conditioned ulcers acquired some 
 hours after secretion,* you have requested me 
 to make further experiments for ascertaining 
 whether other secreted fluids are not acid at the 
 
 * Med. Rep. vol. V. p. 85. 
 
I 
 
 ( 32 ) 
 
 time of their secretion, or whether they becom 
 so by exposure to the atmosphere. 
 
 " The perspirable matter of the skin was sug 
 gested as worthy of being made the subject of 
 experiment. 
 
 " I knew it was a common observation among 
 washerwomen, that the shirts and trov/sers ol 
 hard-working men, in the summer time, woul 
 smell sour in the course of a week's wearing:: 
 had read somewhere of sour sweats having been 
 observed in some diseases, and I had heard some 
 respectable physicians express a belief that th( 
 secretion of the skin Vv as naturally and always o 
 an acid quality. 
 
 " To ascertain the truth of these opinions, I put 
 a piece of delicate litmus paper upon the skin o: 
 a sailor near the arm -pit, who laboured under an 
 intermittent fever. He was just admitted into th( 
 Hospital, and was in a foul and filthy condition 
 To prevent any communication with the oxygen 
 of the atmosphere, I covered the paper accurately 
 with sticking-plaster, and suffered it to remain 
 on the skin for twenty-eight hours. On examina- 
 tion, at the end of that time, I found that it exhi- 
 bited signs of having been soaked or loosened a 
 little in its texture, but had not suffered any alter- 
 ation whatsoever of its colour. 
 
 " Afterwards I selected four other patients in 
 different diseases, whose skins were in a moist 
 
( 33 ) 
 
 state from perspirable matter, and carefully applied 
 litmus paper, as before described, to a portion of 
 skin on each of them ; but though I examined 
 them very exactly, and asked the opinion of several 
 other persons on some of them, I could not dis- 
 cover that there was any token of acidity. I am 
 hence apt to believe. Sir, that sweat is not sour 
 at the time of its secretion, and that it does not 
 become acid within less than one natural day after 
 it has been poured out from the vessels which 
 prepare it. The presence of the oxygenous air is, 
 without a doubt, necessary to the conversion of 
 this to the state of an acid, and as the adhesive 
 plaster which I put on was interposed between 
 the perspired fluid and the atmospheric oxygen, 
 the process of acidification must have been pro- 
 portionably retarded. 
 
 " In the case of seamen and labourers* clothes 
 long worn, soaked through and through with 
 sweat, exposed for a sufficient time to the air, 
 there is a conversion of the natural secreted 
 humour to an acid often possessing unhealthy 
 qualities. 
 
 ^^ The perspired matter never becomes veno- 
 mous that I know of, or believe, until it has been 
 exposed long enough to become oxydated : then, 
 and not till then, it seems to acquire its pernici- 
 ous and fever-producing qualities. Hence it will 
 appear, that v/hen a seaman's chest of clothes, or 
 
( 34 ) 
 
 any thing of that kind, is found to contain so muciy| 
 of this acid as can poison the persons who are 
 exposed to it in its recent and undiluted state, 
 there is frequent mistakes committed in affirm- 
 ing such a virus to have been imported from be- 
 yond the sea, or derived from distant countries; 
 for, in fact, the noxious agent is ^roduccdzvithi?i the 
 chest, and onboard the vessel, by chemical changes 
 going on among the particles of secreted matter 
 inhering in the cloathing therein contained. 
 *^ I remain. Sir, v^ith high respect, 
 " Yours, &c. 
 '^ RICHARD L. WALKER, H. S. 
 '' Dr. HosACK." 
 
 SECTION 11. 
 
 Of the Perspiration in a State of Disease. 
 
 HAVING given a summary account of the 
 perspiratory functions in a state of health, it is next 
 proper to consider its morbid conditions. These 
 may be arranged in three divisions, to wit: 
 
 I. Impeded perspiration; 
 
 II. Excessive excretion of natural sweat; and, 
 
 III. Morbid qualities of the perspired fluids. 
 
{ 35 ) 
 
 1. Of impeded Perspiration. 
 
 This state of the skin is judged of by its in- 
 creased heat and dryness; for, when the perspi- 
 ' ^^ble matter is not secreted and discharged as it 
 ought to be in health, the skin, ceasing to be be- 
 "dewed with moisture, becomes incapable of car- 
 rying off the redundant heat of the body as fast as 
 is necessary and comfortable. 
 
 The cases in which this takes place are two- 
 fold; first, dryness of the skin, accompanied with 
 diminished excitement of the arterious system; 
 and, secondly, dryness, attended with an increased 
 action of the blood vessels. To the former of 
 these heads belong the cold fit of fevers, palsy, 
 chronic rheumatism, syphilitic cachexy, and 
 that condition of the skin which accompanies old 
 age. To the latter are to be referred the hot fit 
 of fevers, acute catarrh, small-po::, measles, acute 
 rheumatism, pneumonia, the common diathesis 
 of yellow fever and plague, and that condition of 
 the cutaneous surface which accompanies the in- 
 cipient state of certain dropsical and diabetic dis- 
 orders. 
 
 When the skin becomes dry from foo little ar- 
 terious stimulus, it can frequently be relieved, in 
 some degree, by external \^ armth. A warm season 
 thus affords great relief in many such cases, and 
 the living in, or removal to, a more southern re* 
 
( 36 ) 
 
 gion, renders that benefit permanent to many 
 delicate constitutions. In cooler weather the 
 same effect may be produced or promoted by 
 warm cloathing, and particularly by flannel worn 
 next to the skin ; and more powerfully still by 
 the stimulant and detergent operation of the. 
 warm bath, or by watery vapours and fomenta- 
 tions admitted to the skin. An attempt has lately 
 been made to prom^ote the perspiratory discharge, 
 by putting an arm or a leg into a convenient ob- 
 long vessel, made very tight, and withdrawing a 
 part of the pressure of the atmosphere by means 
 of an air pump ; and this is said to have produced 
 remarkable effects. 
 
 Friction, either by the naked hand or by aid of 
 the flesh brush, may be ranked among the sudo- 
 rific remedies, operating by stimulating the cu- 
 taneous vessels, and making them, more promptly 
 and perfectly perform their functions. This ope- 
 ration of rubbing is rendered m^ore efficacious 
 when some mild ointment is at the same time ap- 
 plied. An unguent or oily application has the 
 powers of softening the cuticle, and lessening its 
 hard and horny stiffness; it prevents the chafing 
 and irritation which sometimes arise from dry 
 friction; and it frequently so relaxes spasm, sti- 
 mulates the vessels, and opens the pores, that the 
 sweat flows in abundant quantity. This is amply 
 proved by the late experiments for curing the 
 
( 37 ) 
 
 plague in Egypt and Asia Minor, bv unction 
 with olive oil, which, when discreetly and suffi- 
 ciently rubbed upon the whole surface of the 
 body, oftentimes causes a plentiful perspiration to 
 break out, to the great advantage of the sick. 
 And from some experiments made, anointing 
 with oil promises to be of great service as a sudo- 
 rific in yeliov/ fever. 
 
 In the Philosophical Magazine for December, 
 1798 (p. 257), the following description is given 
 from Von Berchtold, of the manner in Vv^hich 
 frictions with oil have been used at the hospital 
 at Smyrna with very great success. ^' This excel- 
 lent cure for the plague consists in rubbing olive 
 oil, with the strongest friction, into the whole 
 body of the infected person. When the body is 
 thus rubbed, the pores being opened, imbibe the 
 oil, and a profuse perspiration takes place, by 
 which the poisonous infection is again thrown out. 
 This operation must be performed the first day of 
 the infection; and if only a weak perspiration 
 ensues, it must be repeated till it is observed 
 that every particle of infection is removed, and 
 that the whole body of the patient is covered with 
 a profuse sweat. Neither the patient's shirt, nor 
 bed-clothes, must be changed till the perspiration 
 has entirely ceased. The operation must be per- 
 formed in a very close apartment; and at every 
 reason of the year there must be kept in it a fire- 
 
( S8 ) 
 
 pan^ over which sugar and juniper must be thrown 
 from time to time, that the vapour which thence 
 arises may promote the perspiration. The whole 
 body of the patient, the eyes alone excepted^ 
 must in this manner be anointed, or rather rubbed 
 over with the greatest care." 
 
 Hence we understand the use of friction and 
 unguents in diseases of debility, attended with a 
 dry skin; and where high stimulation is neces- 
 sary, the addition of sinapisms, rubefacients, 
 blisters, and cauteries can be explained. To the 
 same head of provoking a discharge from the 
 skin, in lieu of sweating, can a part of the effects 
 of setons and issues be ascribed. 
 
 If the skin becomes dry from too much ex- 
 citement, in disorders of the phlogistic diathesis, 
 it is a question of delicacy how the constitution 
 ought to be managed. There is a peculiar dread of 
 cold among all people v/ho speak the English lan- 
 guage. By a grievous mistake, incidental to no 
 other tongue spoken in the world, cold is consider- 
 ed as a word of similar import with the catarrh of 
 the Greek physicians ; and by a most unhappy per- 
 version and extension of the word " cold," it has 
 been considered by those v/ho think and speak in 
 English, as the cause and parent of almost all the 
 diseases of the human frame. And conformably 
 to this mode of considering the matter, we find 
 almost every malady referred by the speakers of 
 
( 39 ) 
 
 the English language and their physicians, " to 
 atching cold." This however is an unhappy 
 delusion, and much toil and difficulty must be 
 employed to shake it off; though it may be 
 ustly feared whether we shall ever get rid of the 
 deception entirely until the phraseology is al- 
 tered. 
 
 But though the phraseology remains, something 
 bas been done in fact. The introduction of the 
 cool regimen in small-pox has been adopted after 
 the most violent opposition that the strongest 
 prejudices of the great body of physicians and 
 people could raise against it. Here cool air pro- 
 motes perspiration, allays inflammation, and les- 
 sens febrile action. The beneficial effect of ex- 
 posure to the cool atmosphere in what has been 
 called the air-hath is wonderfully salutary and 
 refreshing. 
 
 In like manner the cool treatment of yellow 
 fever and other violent febrile affections, has re- 
 ceived of late the sanction of the most correct 
 and able practisers ; and the benefit done to the 
 sick, by frequently washing the whole body with 
 cool water, amply proves how agreeably it dis- 
 poses the fluids of the skin to transpire.* The 
 cooling regimen is coming into use in the measles, 
 and with great advantage to the patients; for it 
 
 * Dr. Hamersley's Lectures on the Practice of Physic, 
 
( 40 ) 
 
 may be observed, that much of the mortality o 
 that disease is owing less to an inherent mahg 
 nity in the morbilious poison, than to the pre 
 posterous, hot and stimulant manner of treating 
 it. In active catarrh also, cool air, cool v/ater 
 cool diet, and the adoption of a spare regimen, 
 are of Vv^onderous service, by promoting perspira 
 tion, unloading the blood vessels, and restoring 
 the equilibrium of the system; w^hile the most 
 pernicious consequences follow the heating, sti 
 mulating and violent method of cure vulgarly em- 
 ployed. Well might the author of the Brunonian 
 doctrine denominate this a " heat'' rather than a 
 cold! 
 
 From these facts, and from the benefit derived 
 from cold bathing in acute rheumatism, it will 
 be apparent that the dryness and huskiness of 
 the skin which arise from too great excitement, 
 may be best rem.oved by lowering the tempe- 
 rature, and thereby promoting the perspiratory 
 discharge. 
 
 Different is the case when the sweating sur- 
 face of the body is suddenly exposed to cold air or 
 cold water. Then the further secretion of per- 
 spirable fluid is quickly checked, the vessels be- 
 come torpid, the functions of the extreme arte- 
 ries of the skin are imperfectly performed, and 
 a universal refrigeration ensues. In these in- 
 stances, severe disorders often follow. Some- 
 
( 41 ) 
 
 times almost a sudden death has succeeded the 
 imprudent immersion of a heated and sweating 
 body in cold water. At other times, by an asso-» 
 ciation of internal with external morbid actions^ 
 the lungs have suffered from the injuries sustained 
 by the cuticular surface, or the intestines have 
 sympathized with the malady of the external 
 parts; or the muscles have become diseased by 
 a similar affection, derived from the contiguous 
 skin; and in these modes have a deadly torpor, 
 or pleurisy, peripneumony, an enteritis or dysen- 
 tery, a catarrh or a rheumatism, been excited in. 
 the constitution of healthy persons. 
 
 Thus may cold do direct injury when acting 
 upon a sweating surface ; but it may be asked 
 how catarrh, acute rheumatism, and other inflam- 
 matory affections can be accounted for without 
 having their origin in cold? The reply is easy and 
 plain* The refrigerated state of body is only a 
 predisposing cause, and renders the system more 
 Hable to be acted upon by succeeding heat. Now, 
 if the body is very cold, and in that condition sud- 
 denly receives the action of great external heat, it 
 will probably be excited to a morbid degree, and 
 coughing, sneezing, hoarseness, and perhaps ev^en 
 symptoms of pneumonia, as well as of catarrh, 
 may be the consequence. 
 
 The transition from cold to heat in such cases 
 ought to be slow and gradual, that the stimulus 
 
 F 
 
( 42 ) 
 
 may not be too violent, but the body pfepia.f ed for 
 its iaction by degrees 5 just as when limbs, noses 
 and ears are frozen, it is well known that great 
 and sudden heat will dispose them to gangrene 
 and mortification, but when admitted in gentle 
 and equal degrees, their recovery to health is al- 
 most certain: in common, therefore, cold is only 
 the predisposing cause of catarrh and the kindred 
 diseases, and the exciting causes are heat, and 
 other stimulants, such as gin, ardent spirits, and 
 the like. 
 
 2, Of the increased Secretion of Natural Sweat. 
 
 Labour is the most common and obvious mode 
 of increasing this discharge. A working man is 
 both depleted and cooled by his perspiration and 
 sweat. To supply the waste and loss occasioned by 
 them he grows thirsty and takes drink. The con- 
 stitution so replenished perspires the more, and 
 as this excreted matter passes off into vapour the 
 sensible heat of the body is turned to a latent state, 
 and an agreeable temperature preserved ; thereby 
 the system preserves its equipoize of heat. Ex- 
 cessive sweating by labour thins and impoverishes 
 the body. 
 
 Excessive sweating, though of a temporary du- 
 ration, is a frequent occurrence in intermittent 
 fevers. After the cold and hot stages are past>, 
 
{ 43 ) 
 
 there often comes on what is denominated the 
 sweating stage of the fit. In this the suspended 
 secretions are restored, and perform their func- 
 tions with such freedom, that some of the secre- 
 tions, especially the sweat, are prepared in more 
 than their accustomed quantity. This plentiful 
 flow of sweat cools the body after the hot stage, 
 restores moisture to the parched skin, and relieves 
 by a seasonable depletion of the vessels. Where 
 the quantity secreted is not very great, sweating 
 may be deemed g. wholesome evacuation 3 but it 
 sometimes proceeds so far as to debilitate and do 
 injury, as in hectic fever» For example: 
 
 Hectic fever is a form of intermittent; only in- 
 stead of deriving its exciting cause from the ex- 
 ternal air, or any outward source, it is engendered 
 within the body itself. On the surface of ulce- 
 rated tubercles, of large ulcers, and denuded sores, 
 there is often formed an acid material, whose 
 absorption stirs up fever; and from this fever- 
 producing stimulous does hectic fever acquire 
 its peculiar form and type, being but a modifi- 
 cation of intermittent. The sweat is produced in 
 the same way, and upon the same principle ; but 
 the frequent and profuse repetition of it frequently 
 weakens the patient excessively by its colliquative 
 discharge. 
 
 Sometimes the skin is prone to sweat, without 
 the presence of the febrile action or of labour. 
 
( 44 ) 
 
 The vessels are either too active or too lax, and 
 pour forth too great a quantity of perspirable 
 matter. This is so considerable as to render the 
 cloathing of the persons subject to it very v^et dur- 
 ing the hours of sleep, and even of waking. 
 When long continued it exhausts the system by 
 its debilitating effects, and renders the body cold, 
 chilly, and predisposed to various more serious 
 diseases. This excessive sweating, called EpU 
 drosis, is the object of various medical prescrip? 
 tions, bitters, sulphuric acid, friction, bathing, 
 and the like. 
 
 There is sometimes a " cold sweat ^^ which 
 ought here to be mentioned. This usually occurs 
 in diseases of great languor 3 and, on the approach 
 of death, it seems to be explicable in this way. 
 In a healthy state, part of th^ perspiration is doubt- 
 less absorbed into the body, and the rest, by far 
 the greatest part, exhaled into the atmosphere, or 
 imbibed by the cloathing; the absorbed part un- 
 questionably answers some valuable purpose in 
 the animal economy. In the case of cold sweat, 
 the vis vitse failing, and the vital heat diminish- 
 ing, the perspired matter cannot be completely 
 turned to vapour, and therefore remains in drops 
 on the cold skin : at the same time the oower of 
 the lymphatic absorbents becoming nearly ex- 
 tinct, little or none is inhaled, and, consequently^ 
 it remains stagnant on the surface. 
 
( 45 ) 
 
 S. Of Morbid Sweats. 
 
 Sometimes the arm-pits of healthy persons 
 afford a foetid and offensive discharge. Negroes 
 are remarkable for secreting a rank sweat from 
 every pore of their bodies. It is said that sweat 
 is sometimes of a phosphoric quality, rendering 
 the back and sides luminous when rubbed, and 
 imparting to the linen stars of phosphoric acid. 
 Indeed, pathologists have affirmed that sour 
 sweats have sometimes broke out in the course 
 of febrile diseases. At certain times the perspired 
 matter abounds with an uncommon quantity of 
 salt, as happened to a Negro man in the New- 
 York Hospital, whose skin, before death, WTtS 
 covered with a saline efflorescence, as if sprinkled 
 from a powdering box. 
 
 It is not necessary to affirm that acid svv^eats 
 never happen, but it is probable that a sourness, 
 acquired after secretion, has been mistaken for a 
 humour acid at the time of secretion. 
 
 SECTION III. 
 
 On the Degeneracy of perspired Fluids to Infec- 
 tion and Pestilence. 
 
 SANCTORIUS, inhisMedicinaStatica, apho- 
 rism 53, has these remarkable words : ^^Imper- 
 ceptible perspiration lightens the body more than 
 
( 46 ) 
 
 all the sensible evacuations put together; fpi 
 after sleep every one may perceive himself lighter, 
 without any of the sensible secretions, because he 
 is really so by about three pounds.'* This con- 
 clusion, which that correct experimenter drew, 
 was not a random guess, but a fact determined 
 with all the accuracy of the balance. 
 
 Such a vast quantity of perspired matter con- 
 stantly exhaling from the skin, would do little 
 more than unload or lighten the body if it went 
 fairly off. The human body, however, is gener 
 rally covered with cloathing, which hinders these 
 secreted fluids from making their entire escape. 
 Entangled in the woollen, cotton, or linen mate- 
 rials of which the garments are made, they re^ 
 main in contact with the body, and in time daub 
 and besmear it with filthiness. The perspired; 
 matter exposed to the influence of atmospheric 
 air, in a degree of heat equal to the human skin, 
 degenerates into various new compounds, and 
 certain parts of it turn to septic or pestilential 
 matter. Those poisonous compounds, so formed, 
 re-act upon the body which produces the ingre- 
 dients of which they are formed, and become 
 the exciting cause of various diseases. 
 
 But as this matter has been minutely investi- 
 gated by Dr. Mitchill, I shall pursue the inquiry 
 by quoting the words he has made use of in the 
 third volume of the Medical Repository, p. 161 
 ^:\seq. 
 
{ 4t ) 
 
 ^^ But this adipose secretion Is by no means a 
 pure oiL According to circumstances, it is occa- 
 sionally blended with phosphoiic, sulphuric, septic, 
 and a surplusage of carbonic matter. 
 
 " And it is further altered, as far as its nature 
 will permit, by the constant transmission of that 
 
 AQUEOFS FLUID, the INSENSIBLE PERSPIRATION^, 
 
 through the cuticle, and by the drops of sweat 
 into which it is sometimes condensed; both 
 formed by a coalition of a portion of the phlo- 
 giston (hydrogen) of the blood, with a parcel of 
 its oxygen, and this liquid serving as a men- 
 struum for certain other substances. The ex- 
 ceedingly great quantity of perspired matter inces- 
 santly passing off from every exhalant pore of the 
 skin, leaves behind, as it evaporates, some of its 
 more fixed, saline, and feculent parts, along with, 
 or upon, the greasy covering of the cuticle. A 
 portion of carbone, phosphorus, and septoUj 
 with, sometimes, an overplus of oxygen, seem 
 to accompany this effusion of the skin, and, in 
 some quantity, to remain behind, after the water 
 has evaporated. 
 
 " It was remarked before, that the cuticle was 
 insensible, bibulous, and, of course, exceedingly 
 apt to grow nasty. How can it be otherwise? 
 The cuticle has neither nerves nor blood-vessels, 
 and there is little or no reason to believe that it 
 possesses organization. It is, therefore, in strict- 
 
( 48 ) 
 
 ness, less a part of the living body than a kind 
 of tight shirt, or close-setting tunic, drawn over 
 the v/hole surface of the body. This shirt or tunic i 
 of cuticle may be considered as a foreign wrap- 
 per, or piece of natural cloathing ; and, like every 
 other foreign thing which enwraps the body, is 
 liable to become charged v/ith such substances 
 as are excreted from the true skin within it. 
 The foulness of this natural shirt is a frequent 
 occurrence. Almost every body lets it get nasty. 
 When the nastiness is very considerable, the poi- 
 sonous or stimulant matter entangled there, irri- 
 tates or inflames the organ of feeling, with which 
 it lies in contact, and produces various itchings, 
 pimples, eruptions, blotches, tetters, sores, &;c. 
 being a principal cause of the distempers* of the 
 skin. To a correct mind a dirty cuticle will ap- 
 pear to he a dirty shirt. If the former could be 
 stripped off, and cleansed in the wash-tub, like 
 the latter, there might possibly be a convenience 
 in it. This is, however, of small m.oment, since 
 we knov/ the cuticle can be well cleansed with- 
 out being taken off. 
 
 '^ The modern use of white linen and cotton, as 
 articles of raiment, enables us to judge, with 
 tolerable accuracy, what material it is which 
 shirts, made of those kinds of cloth, and worn 
 next the cuticle, receive from the perspiration 
 and sweat. What the garments imbibe must 
 
( *9 ) 
 
 have passed first through the exhalant arteries of 
 excretory ducts, then undergone a further change 
 while remaining in and about the cuticle or first 
 SHIRT, and afterwards have beerrtfansmittedy-by— __ 
 rubbing or wiping, to the linen fibres or cotton 
 filaments of the second. The animal matter 
 which befouls the outer shirt is a good indica- 
 tion of that which adheres to the inner: for, 
 as clean linen and cotton become soiled very soon 
 by lying in contact with any part of the human 
 body, what they receive must be principally de- 
 rived from the cuticle which they touch and ab- 
 sterge. 
 
 " The uncleanness of shirts, drawers, and 
 STOCKINGS, may, therefore, be deemed to be 
 matter wiped from the cuticle, and derived to 
 4he cuticle from the vessels and ducts of the sub- 
 jacent true skin. An examination, then, of 
 the facts relative to cloathing grown foul by long 
 wearing next the cuticle, may be considered as 
 virtually an examination of the cuticle itself, and 
 of the excreted matters which stick to it.'* 
 
 It is unnecessary to make larger quotations 
 from Dr. Mitchill's paper on this subject, as 
 every one can have access to the Medical Reposi- 
 tory. The Doctor attempts to prove that yellow 
 fcvcr is frequently produced by the accumulation 
 of the excreted perspiration on the surface of 
 living bodies, and its condensation into cloathing. 
 
( 50 ) 
 
 He also attempts to prove that from the local ope- 
 ration of this excretion on the surface, a variety 
 of local cuticular diseases may be produced, and 
 that alkalies are the sovereign cure for their re- 
 moval. There may be much truth in these ge- 
 neral remarks, which were certainly suggested 
 by other physicians lon^ before the Doctor wrote 
 upon the subje^jt. The Doctor apf>ears to have 
 very confused anfi incorrect ideas on the subjects 
 which he generally treats of; he endeavours to 
 prove that this excretion, thus vitiated, is febrile 
 infection -, but with all due respect to ^o great an 
 authority, I beg leave to remind the Doctor, that 
 the term infection must always be considered, in 
 the language of Dr. Jacksos, " as a diseased 
 anir lal secretion.** In other words, it is a process 
 of the living system under the operation of febrile 
 action; infection and cotttagion, therefore, con- 
 vey the same idea. The Doctor appears also to 
 have fallen into a very great mistake, in sup- 
 posing the vapours arising from putrid vegetable 
 and animal matter, and those from the lungs and 
 surface of the body in malignant fevers, to be pre- 
 cisely the same. An assertion of this kind, not 
 proved by any direct experiment, and scarcely 
 supported by loose analogical reasoning, can never 
 gain general credit. I am well convinced that 
 there is an essential difference between the infec- 
 tion of fc\ er and the specific infection of measles 
 
( 51 \ 
 
 or smali-p-ox ; but ik^ does attach u the terms 
 infection and contasi'ion a different meaningjr 
 Fevers mav be produced by an accumulation of 
 the perspired fluids collected in any considerable 
 quantity about the living system; so also may 
 they be produced by the vapour arising from 
 putrid matter. Nay, we may go still further, and 
 incontestlbly prove, by daily and repeated expe- 
 rience, that fevers ver\- generally arise from the 
 mere vicissitude of weather in relation to heat 
 or cold, moisture or dr^iiess ; yet it would be ex- 
 tremely incorrect to call all these causes of fever 
 infections. Chemists have yet to discover the 
 nature of febrile infection, and of the specific in- 
 fections of particular diseases. Were the perspi- 
 ration of the skin and of the lungs unaltered by 
 any particular process of the living system, to be 
 to commonly the cause of fever, as Dr. Mitchill 
 seems to think, we should as readily receive the 
 infection of {ever from a person sweating under 
 the use of sudorific medicines in a case of plcurisv 
 or acute rheumatism, as in the most malignant 
 fbiTO of fever; but this is not the fact. I appeal 
 to the experience of every physician for the truth 
 of what I now assert. In ordinary* cases we 
 enter the crowded apartments of the sick in jails, 
 hospitals, &c. without hazard i but wherever 
 malignant fevers prevail, the risk of giving to 
 the iick the attentions which our professional du- 
 
( 52 ) 
 
 tics require, becomes moi#>-«erious. It is true 
 Ithat, wherever cleanliness, ventilation, &c. can 
 be pursued In pure air and in spacious apartments, 
 the infection of fever may be entirely lost or 
 dissipated in the atmosphere ; but it has also been 
 obser\^ed in hospitals, where every attention has 
 been paid to keep the wards clean, to supply 
 plenty of clean bed linen and body linen to the 
 sick, and where the sick themselves have fre- 
 quently been washed j that even under these cir- 
 cumstances it has sometimes been very difficult 
 to destroy a highly malignant and concentrated 
 infection. In such cases it is usual to detacb 
 those labouring under any malignant form of 
 fever from the other patients; they are generally 
 placed in distinct apartments, or in a ward by 
 themselves, which is called a fever-ward. The 
 lUirses, physicians, and other attendants, may, 
 from the power of habit, resist the operation of 
 the febrile infection, and all perform their ap- 
 propriate duties to the sick. The infection spreads 
 to a very small distance from the body of the 
 patient, and the other apartments of the house 
 may be entirely exempt from it. Under these 
 circumstances the other wards may be visited, 
 where there aie numerous sick labouring under 
 other diseases, by persons coming from a much 
 purer air, without danger; but if such persons 
 liquid approach the sick in the fever-ward> and 
 
( 53 ) 
 
 remain near them even for a few minutes, they 
 will very generally become the victims of a 
 highly malignant and infectious fever. 
 
 All the theories and speculations of chemists 
 on the nature of the pestilential virus, or febrile 
 contagion, want more experience to establish any 
 one of them in general practice. Of these the 
 opinions of Morveau and Carmichael Smyth 
 are certainly entitled to most attention, and have 
 gained most credit among the well informed part 
 of the profession in our country, as well as in 
 Europe. In the writings of these gentlemen we 
 see correct reasoning supported by fair experi- 
 ment; they appear to be the result of candid and 
 fair inquiry ; yet, as I have before remarked, more 
 experience is required to establish them. 
 
 THE EHD. 
 
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