GEN. I. SPEC. III. Ephemera sudatoria. Sweating fever. Englishmen only said to have been sub ject to it. ancient and modern times have been ushered in by stinking fogs or mists, or some other intemperament of the atmosphere, of which the reader will find various instances in the sequel of this work. The disease is generally, however, supposed to have been produced by inclement harvests and vitiated grain, particularly wheat, which is less hardy than other grains and sooner infested with albigo (mildew), ustilago (smut), and clavus (ergot or spur). And in proof that this last was the actual cause, it is observed by Dr. Willan, that the contemporary inhabitants of Scotland and Wales, who fed on oaten or barley, instead of on wheaten bread, were not affected. Nevertheless whatever was the primary cause, a peculiar miasm or contagion seems to have been generated by the disease itself, which chiefly contributed to its spread and continuance. For we are told concurrently by all the writers, that Englishmen who withdrew from their own country into France and Flanders with the hope of escaping the attack of the disease, fared no better than their countrymen at home. To which Dr. Freind adds, that, while Englishmen abroad were thus subject to the contagion, foreigners and even the Scotch in England were rarely or never seized with it*; a feature that has been copied by Dr. Armstrong in his very forcible description of the complaint, which is perhaps better adapted for poetry than for sober prose. Some, sad at home, and, in the desert, some Abjur'd the fatal commerce of mankind; In vain where'er they fled, the fates pursued. Others, with hopes more specious, cross'd the main, To seek protection in far distant skies, But none they found. It seemed the general air, In foreign climes; nor did this fury taste The foreign blood which England then contained +. Something may, perhaps, be set down to the score of a Hist. of Physic. Vol. 11. p. 533. † Art of Preserving Health, B, ш. SPEC. III. national diathesis; but without examining very closely GEN. I. into the accuracy of this wonderful part of its history, Ephemera we may at least indulge a hope that this peculiar, most sudatoria. virulent and fatal contagion has long since worn itself Sweating out, and become decomposed; though it may be still only latent, and waiting for its proper auxiliaries once more to show itself in the field *. It is said, indeed, by Dr. Coste, the learned editor of Dr. Mead's works in French, that the disease continued to manifest itself occasionally as an epidemic in Picardy; but that, instead of terminating in a single day, it ran on to the third, fifth, and sometimes even to the seventh. It is hence sufficiently obvious that the two fevers, though possessing many points of resemblance, are not precisely the same. Yet M. Bellot, in his thesis "An febri putridæ Picardii SUETE dictæ, sudorifera?" has maintained Dr, Coste's opinion. Navier, Maladies Populaires, &c. fever. GIN. II. Type some times varies. United with remittents by Cullen. GENUS II. ANETUS. Intermittent Fever. Ague. PAROXYSM INTERMITTING, AND RETURNING DURING THE UNDER the preceding genus, the remote cause, whatever it consists in, lays a foundation for not more than one paroxysm. In the genus before us, the cause introduces a tendency to a recurrence of the paroxysm from the first; and, in most cases, with an interval that continues true to itself as long as the disease lasts. I say in most cases, because we shall see presently, that, when, intermittent fever has raged very extensively, it has not unfrequently established a type of one kind in one person, and of another kind in another; whilst in the same patient quotidians have changed to tertians, tertians to quartans, quartans to quotidians, and all of them in a few instances to continued fever, in the most capricious and anomalous manner. Dr. Cullen unites intermittents and remittents into one section of fevers, merely distinguishing them as intermittents with an interposed apyrexy, and intermittents with remission alone: and, as already observed, he makes it a part of the pathognomic character of both that they are derived from marsh-miasm-miasmate paludum orta -as though there were no other cause of their production, whence Dr. Young gives to intermittents and remittents the common name of paludal fever. The only ground then assumed for this union of intermittents and remittents, is the supposition that the Anetus. How far this union is well founded. tents from other than marsh miasm. cause which generates them is single, common to the two, GEN. II. and never generates any other fever. Now, although Intermit the febrile miasm issuing from marsh-lands is by far the tent fever. Ague. most common cause of intermittents, it is by no means the only cause; for we find intermittents, like all other species of fever, produced from various sources; exist ing in hot countries as well as in cold, in high lands as well as in low lands, sporadically as well as epidemically; sometimes excited by sympathy, sometimes by contagion. Even in tertians, Dr. Cullen is obliged to admit of instances in which other agents are necessary; but, then says he, they are only co-agents, and would not operate alone. "Has potestates excitantes pro parte principii hic admittimus, licet neutiquam excitassent, si miasma paludum non antea applicatum fuisset." But this is the very Intermitpoint of controversy; for in many instances they produce the disease where marsh-miasm cannot be suspected. I sources have seen an isolated case of a regular tertian on the highest part of Islington; and another on the dry and gravelly coast of Gosport, a situation so healthy that all the inhabitants escaped, when in the year 1765 a most fatal and epidemic fever, originating unquestionably from the miasm of swampy grounds, pervaded the whole island of Portsea, situate at not more than a mile distant on the other side of the water, and exhibiting, in different individuals, and often in the same person, all the diversities of the intermittent, remittent, and continued type. Dr. Fordyce affirms, that he has seen an intermittent communicated by infection, meaning the miasm from human effluvium; and where the yellow fever has long existed or become widely diffusive, this is common. Where it arises from sympathy or organic affection, the case is still clearer. "Two children", says Mr. J. Hunter, "had an ague from worms, which was not in the least relieved by the bark; but by destroying the worms, they were cured. We have in like manner agues from many diseases of particular parts, more especially of the liver and the spleen, and from an induration of the mesenteric Anetus. GEN. IL. glands."* De Meza gives an instance of an intermittent produced by a repelled herpest; and Baldertius, by suppressed lochia ‡. Intermit tent fever. Ague. Sometimes found in highlands, while lowlands escape. Illustrated in modern Greece. But one of the most singular and convincing proofs, that the decomposition of marsh-lands is not essential to the production of intermittent fever, is to be found in the epidemic intermittent of 1780, as described by Sir George Baker, and which we shall have occasion to advert to more particularly hereafter; for, during this, the intermittent harrassed very extensively the elevated parts of Lincolnshire, while the inhabitants of the neighbouring fens were free from its ravages §. And in like manner, the dry and healthy climate of Minorca is sometimes attacked with remittent or intermittent fever, while Sardinia, proverbial for its insalubrity and febrile epidemics, escapes . "In the year 1812", says Dr. Macmichael, "I was detained several months at Trichiri, a small seaport in the mouth of the gulf of Volo in Thessaly. The town is built on a dry lime-stone rock, but it is notorious for malaria. During my stay here, I made an excursion to visit the celebrated pass of Thermopyla, and slept one night near the marshy district in that neighbourhood. On my return, the friends whom I had been waiting for arrived from Athens, and we all embarked on board a Greek vessel, to cruize in the Archipelago. On the following day I was seized with a most severe fit of the ague; and at the same time a servant belonging to the party suffered a similar attack. It might be said that I had caught my intermittent at Thermopyla, but the servant had not quitted the dry rock of Trichiri, upon which he had remained more than a week."¶ In like manner Sir Gilbert Blane informs us that while the village of Green Hithe, nearly on a level with the marsh of * On Blood, Part 11. ch. IV. p. 411. Act. Soc. Med. Hafn. Tom. 1. N. 10. Cleghorn, Diseases of Minorca. S Med. Trans. Vol. 111. Art. xiii. New View of the Infection of Scarlet Fever, &c. 8vo. 1822. |