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Gex. III. well seasoned soldier mounting the night-guard in perB E. malig.
fect health, to be seized with furious, delirium while nus flavus. standing sentry, and when carried to his barracks on
Monk's Hill, to expire in all the horrors of the black vomit, within less than thirty hours from the first attack; but, during all this, not a single case of yellow fever, nor fever of any kind, occurred to the inhabitants of Monk's Hill (a rock rising perpendicularly above the marshes, to the height of six hundred feet). The result on the Ridge (a hill about a hundred feet lower) was not quite the same, but it was equally curious and instructive. The artillery soldiers, seventeen in number, never took any of the night guards, but they occupied a barrack about three hundred feet above the marshes, not perpendicularly above them, like Monk's Hill, but a little retired. Not a case of yellow fever or black vomit occurred amongst them; but every man, without a single exception, suffered an attack of the ordinary remittent, of which one of them died : and at the barrack on the top of the Ridge, at the height of five hundred feet, and still further retired from the marshes, there scarcely
occurred any fever worthy of notice."* Like the
There is another feature in which the miasm of the same equally attaches yellow fever shows its affinity to the febrile contagion of
the human frame, and evinces its less diffusibility; and neighbouring sub that is in readily attaching itself to whatever bodies it stances. meets with, though to some more than others. Even
the leaves and branches of trees, form powerful points of attraction, and, where they are in the immediate vicinity of a swamp, retain the contagious matter that rests upon them so effectually, as, in many cases, to keep the surrounding atmosphere free from pollution, and become a safe-guard against febrile attack. 6. The town of New Amsterdam, in Berbice," says the same writer, “is situated within a short musket-shot to leeward of a most offensive swamp, in the direct tract of a strong trade
* On the Nature and History of Marsh Poison, Medico-Chirurg. Rev. Dec. 1821 ; and compare with Chisholm, on Tropical Climates, p. 34.
wind that blows night and day, and pollutes even the Gen. III.
L SPEC. II. sleeping apartments of the inhabitants, with the stench of the marshes; yet it brings no fevers, though every one nus flavus. is well aware that it would be almost certain death for:
Yellow an European to sleep, or even to remain after night-fall, under the shade of the lofty trees that cover the marsh at so short a distance. All, too, are equally aware that to cut down the trees, would be a most dangerous operation in itself, and would certainly be productive of pestilence to the town.”*
As almost every territory in which the fever hereby Kaown produced, has committed its ravages has given it a new , name, it is as gorgeously arrayed with titles as the mightiest monarch of the east. From the depredations it has committed in the West Indies and on the American coast, it has been called the St. Domingo, Barbadoes, Jamaica, and American fever : and from its fatal visitations on the Guinea coast and its adjoining islands, the Bulam fever. In British India it is distinguished by the name of the jungle-fever, the hoogly-fever, or endemic of Bengal; and still further to the east by that of mal de Siam. Nearer home, in the lowlands of Hungary, and along the South of Spain, it is called the Hungarian or the Andalusian pestilence. From its rapid attack on ships' crews that are fresh to its influence, the French denominate it fièvre matellotte, as the Spanish and Portuguese call it fiebre amarilla, and still more frequently comito prieto, or black vomit, from the slaty or purplish and granular saburra thrown up from the stomach in the last stage of the disease; while, as its ordinary source is marsh lands, it has frequently been named paludal fever. Its more common name, however, in the present day, and for the reason already assigned, is yellow fever: and when the attack upon new-comers is slight, seasoning. It is the febris gastrico-nervosa of Pro- Febris gasfessor Frank t, who justly regards it as an intense va- vosa of
under various namnes,
Frank. • On the Nature and History of Marsh Poison, Medico-Chirurg. Rev. Dec. 1821; and compare with Chisholm on Tropical Climates, p. 34.
+ De Cur. Morb. Hom. Epit. Tom. 1. § 103. 8vo. Mannh. 1792.
Gen. III. riety of the ordinary autumnal malignant of temperate B E, malig
i climates, as already described under this name. I, nus flavus. From its showing itself in so many parts of the world,
and under circumstances so widely different, it is not to Exhibits be wondered at that it should often be accompanied with great diver- a considerable diversity of symptoms; and consequently sity of
mptoms. that the paludal fever of one quarter should be regarded Accounted by many writers of considerable authority as essentially
different from that of another. But an attentive perusal of the origin and laws of febrile miasm, as I have endeavoured to explain them, when treating of the remote cause of fever *, will, I trust, be sufficient to account for all such local distinctions; and, if not to prove, at least to render it highly probable that they depend “partly upon the state of the body at the time of attack, but chiefly upon some modification in the powers or qualities of the febrile miasm itself, by the varying proportions of the co-operative agents of moisture, heat, stagnant air, and other auxiliaries which have not yet been detected, in their relation to each other in different places and
seasons." Whether How far the yellow fever is capable of origination from capable of
any other cause than febrile miasm from marshy lands, from other or places subject to like decompositions and plays of causes than marsh
chemical affinity, we cannot at present determine. Such
places, however, are numerous, as damp unventilated Such causes stations, stagnant water, thick iinpervious jungles, and enumerated.
woods that arrest the miasm as it ascends; even high and arid hills after heat and rain, but above all a foul state of the hold on board ships, whatever be the cause of such impurity. “ Ships,” observes Dr. Chisholm, “containing wine in their holds in a state of decomposition, are generally extremely sickly, and the character of the prevalent disease is that of YELLOW REMITTENT FEVER. Several instances of this took place in Fort Royal Bay in the years 1797, 1798; and the situation of the ships in the open bay, far from the influence of marsh effluvia,
ot a cause.
precluded a suspicion of the fever from that cause.—The GEN. III. ship Nancy, Captain Needs, from Fyal, with a cargo of Srec..
' B E. maligwine for the army, arrived at Fort Royal, Martinico, in nus flavus, the month of October, 1798: she met with a gale of wind
fever: i. at sea on the 17th September, and several of the casks, from the motion of the ship, became leaky. The captain was taken sick at sea, and died with every symptom of the highest grade of yellow remittent fever. The mate and several of the crew were attacked with the same complaint: they recovered: but a mate, shipped at Fort Royal, fell ill on board and died. The ship lay out in the open bay; no vessel near her was sickly; and she herself became very healthy after the cargo was landed."*
Heat alone, however high the temperature, is not a Heat alone cause of the fever before us: there must be moisture; and as the result of both a rapid decomposition and exhalation of organic remains. Provided the air is dry, even tropical climates are often found salubrious. “ The burning province of Cumana," observes M. Humboldt, “ the coast of Cora, and the plains of Caraccas, prove that excessive heat alone is not unfavourable to human life”.
It has just been observed, however, that even high and But heat, arid situations, after heat and rain, may also furnish, by
y grounds, the chemical decomposition of their soil, the specific may become miasm of yellow fever: and it may here be added, that a
auxiliary, if, by the violence and redundancy of the rain, the other causes swampy low grounds be at the same time overflowed, se the latter will become an arena of health, while the heights are the seat of disease. Such the hilly ravines of Portugal were occasionally found by the British army, during its occupation of that country in the summer of 1809, when a most destructive remittent suddenly made its appearance, while the overflowed swamps at its feet, were more than usually free from disease: “and such is frequently the case”, as Mr. Irvine has justly observed, “on the lofty ridges of Sicily, when their fiumari or
• Essay on the Malignant Pestilential Fever, Vol. 1. p. 279. See also Dia Dickson's Topographical Remarks, &c. Seci. iii.
GEN. III. water-courses, which are ordinarily dry and used for SPEC. II. js E. malig
roads in the summer months, are filled and inundated nus flavus. with sudden torrents of rain. For here the malaria Yellow fever.
changes its station, and quits the overflowed low-lands for the heights of the primitive hills.”
But whatever be the original source of the fever before us, when once it has established itself and rages with severity, it is now very generally admitted that the effluvium from the body of the affected is loaded with
miasm of the same kind, completely elaborated as it Secondarily passes off,”—and that the disorder is from this time caproduced
pu- pable of communicating itself by contagion. And, from
0 and communicable by the statement already given *, it appears far more procontagion. bable that the fever at Cadiz in 1800, that at Malaga in Sometimes perhaps
1803, and that at both in 1820, had their origin in conprimarily tagion, or, in other words, in febrile miasm produced by thus produced.
a decomposition of the effluvium from the human body, than from the same miasm issuing from a decomposition of marsh-lands. And on this account I have rather preferred the trivial name of yellow to that of paludal fever, which is too limited to express its source in every instance. The yellow fever at Xeres is ascribed by Don J. A. Ferrari entirely to this cause, as produced by importation; but its primary source he attributes to the decomposition of swampy lands, or other sources of putrefaction, which he seems to suppose may exist even in some parts of Spaint.
In all instances it has a near approach to the autumnal remittent we have just described ; Dr. Rush contemplates them as merely different degrees of the same disorder ; but Dr. Bancroft is, as it appears to me, more correct in considering them, after Professor Frank, as 6 varieties of one disease" f, in unison with the present
arrangement. A certain It should be observed, however, that for the yellow height of
fever to become contagious, it seems necessary that the temperature necessary for it to becon
on • Ut suprà, p. 80-81. + Edin. Med. and Surg. Journ. July, 1823. p. 369. tagious.
Essay on the Disease called Yellow Fever, &c. 1811.