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Dr. Bartlett has written wisely on medical philosophy, but perhaps this book on Fevers is his true "Philosophy of Medical Science." It is the practical application of his own precepts. The question may be fairly raised whether any book in our profession illustrates more clearly the beauties of sound reasoning, and the advantages of vigorous generalization from carefully selected facts. Certainly no author ever brought to his labor a more high-minded purpose of representing the truth, in its simplicity and in its fulness, while few have been possessed of higher gifts, to discern, and gracefully to exhibit it. Had I been prepared by previous reading for the duty which the partiality of Dr. Bartlett assigned to me, of preparing this edition for the press, the labor would have been inconsiderable. As it is, I have read extensively, to learn how little that the book contains can be advantageously altered. Scarcely a dozen phrases have been changed, and these chiefly to conform the language to the date of the new issue. Considerable matter has been added, it is true, because new facts have been observed, and new opinions have been expressed, which both add to our knowledge, and suggest new topics for investigation. This I have endeavored to select, and so far as it is original, to write, with the same respect for truth, and desire for usefulness, which influenced the mind of my endeared friend, the accomplished author. These additions will be found enclosed in brackets [-].



November, 1856.


I HAVE very little to say in sending to the press this third edi tion of my book on fevers, but to express my obligations to the profession of the United States for the very favorable reception which they have given to it. The general literature of fevers has, with one eminent exception, received no very important contributions since the date of the preceding Preface. The exception to which I refer, consists in a series of papers published within the last year or two by Dr. William Jenner, of London. Their leading purpose is to show by careful and rigorous study and comparison the wide and fundamental differences which the author believes to exist between the several forms, as they have generally been regarded, of continued fever, and especially between the typhoid and the typhus forms. Dr. Jenner's researches have enabled me to add largely to the fulness and completeness of the description of typhus fever; and I have availed myself liberally of his facts and arguments in elucidation of the important question of the true relations to each other of the two great forms, or species, of continued fever. I have given no account of the Relapsing Fever of Great Britain, as I do not know that it has ever been met with in the United States.


NEW YORK, June 1, 1852.


IT will be seen by those who have read the first edition of my book on fevers that the present is in some respects rather a new work than a new edition of the former. The History of Typhoid and of Typhus Fever remains much in the same state in the present as in the first edition, with such additions and developments only as further observation and study have enabled me to make. The History of Periodical, and of Yellow Fever, constituting onehalf of the volume, has been added to the present edition; thus rendering the work what it professes to be, a Systematic and Methodical Treatise on the Fevers of the United States.

NOVEMBER 1, 1847.


I HAVE written this book, because I thought that I saw a want in medical literature which it might supply. Our science, so far as the great subject of idiopathic fevers is concerned, is passing through a transition period; and many authorities, that were received as standard and classical only a few years ago, are fast becoming obsolete, at least for American readers. This is particularly true of the leading English treatises on Fever. Neither the works of Fordyce, Armstrong, Southwood Smith, nor Tweedie, nor the elaborate articles on Fever in the Medical. Cyclopedias, Libraries, and Dictionaries, can henceforth be regarded as sufficient or even safe guides for American practitioners; and the remark is applicable to them, not because they are not works of great excellence and value, but for other reasons, which will be abundantly obvious in the course of the following pages. I may simply say, here, that their authors describe principally a fever or form of fever which is rarely met with in this country, and that they do not represent the actual state of our knowledge upon this subject. It must be regarded as especially unfortunate that, until within a few years, the greater part of our information relating to continued fever, has been derived from writers who have treated mostly, and under the same name as that generally used by ourselves, of a disease, or form of disease, differing in many important respects from that which is most common with us, and that in this way so great a degree of confusion has been introduced into our notions of fever.

If the radical defect in our literature of continued fever thus indicated had not existed, and if the histories of the disease which have been given to us by Louis, Chomel, and Andral amongst the French, and by Nathan Smith, Dr. James Jackson, Dr. Hale, and some others amongst ourselves, were generally accessible, and gene

rally read, there would have been no want such as I have alluded to; and, certainly, I should not have added another to the long catalogue of books on fever. A translation, by Dr. Bowditch, of Louis's Researches, was published a few years ago under the auspices of the Massachusetts Medical Society, and has since been in the hands of most of its Fellows. But it is very far from being so generally and thoroughly known as it deserves to be. I may add, that the character of this remarkable work is hardly adapted to the actual wants and tastes of the great majority of our practical men. I may say this, I think, without any risk of giving offence; for no man's admiration of this work can be more unqualified and profound than my own. Constituting as it does one of the few imperishable monuments that have from time to time, and at distant intervals, been raised up along the pathway of our science, it is nevertheless true that, in the present state of the profession in this country-amidst the daily cares and duties of its active members-there are but few who will devote to this object the time and the labor which are necessary thoroughly to comprehend its principles and to master its accurate and minute details. Chomel's Clinical Lectures, so far as I know, have not been published here; Nathan Smith's Essay, excellent as it is, is still very incomplete; and the Reports of Dr. Jackson and Dr. Hale, besides not professing to treat systematically of the disease, are not generally accessible.

These, in brief, are the reasons which have prompted me to undertake the preparation of this treatise. I thought that the wants of medical science, here at least, demanded a history and comparison of the two chief forms of continued fever, as they are now ascertained to exist, fuller and more discriminating than had yet been written; and these wants I have endeavored to supply. My book aims at no other excellence, and no higher merit, than that of being a methodical and compendious summary of the actual state of our knowledge upon two most common and most important diseases. If it has reached this excellence, and if it possesses this merit, I am satisfied.

I have only to add in conclusion, that one of my leading purposes has been to bring out more clearly and strongly than has hitherto been done our means of diagnosis between the different species or forms of fever, and to ascertain and establish their nosological relations. It cannot be necessary to go into any formal vindication of the importance of this diagnosis. Setting it aside altogether, as a matter of science, it is the first essential condition.

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