SPEC. I. Enecia Cauma. Inflamma tory fever. Other remedies. Tea made with cold water. tory fever less common than formerly; GEN. IV. stimulants, are also indispensable toward recovery. The air should by all means be kept pure, by being constantly renewed, though without a sensible current, the temperature cool, the clothing light and as often changed as may Treatment. be necessary to maintain cleanliness, and the beverage, toast-water, lemonade, or cool tea; which last Professor Frank recommends to be made with cold instead of with boiling water," Infusum chinæ cum frigidâ paratum.”* After all, however, it is not often that examples of pure Inflamma- inflammatory fever are to be met with in the present day; and it is contended by very high authorities, and seems to be established by the medical records of earlier times compared with those of our own, that it is a disease far less common now than it was formerly; and that As conjec it is seldom, to adopt the words of Mr. J. Hunter, " that tured by Mr. Hunter, physicians are obliged to have recourse to the lancet, at least to that excess which is described by authors in former times. They are, now, more obliged", continues the same writer, "to have recourse to cordials than evacuations; and, indeed, the diseases called the putrid fever and putrid sore throat are but of late date. I remember when the last was called Fothergill's sore throat, because he first published upon it, and altered the mode of practice. I remember when practitioners uniformly bled in putrid fevers; but signs of debility and want of success made them alter their practice. Whether the same difference takes place in inflammation, I do not know, but I suspect that it does in some degree; for I am inclined to believe that fever and inflammation are very nearly allied, and that we have much less occasion for evacuations in inflammation than there were formerly; the lancet, therefore, in inflammation, and also purgatives, are much more laid aside."+ Whether owing to a change in It is not easy to account for this change in the national temperament. It is common, indeed, to ascribe it to an asserted to be "We may be the common alteration in our mode of life, which is mode of life. much fuller than that of our forefathers. *Ut suprà, Tom. 1. p. 197. † On Blood, &c. Part 11. p. 227. SPEC. I. Enecia said", says Mr. Hunter, "to live above par. At the full GEN. IV. stretch of living, therefore, when disease attacks us, our powers cannot be excited further, and we sink so as to require being supported and kept up to that mode of life to which we have been accustomed." If this be a correct view of the times in Mr. Hunter's day, they have greatly altered and improved within less than half a century: for there has never been a period, since wines and fermented liquors have been introduced among us, so temperate and sober as the present. Drunkenness, which was formerly common in our streets, is now rarely met with; suppers are almost entirely relinquished; and instead of its being disgraceful, as was the case in the olden time', for the master of the house to let his guests leave him either sad or sober, nothing is now so disgraceful as intoxication. It is true, we are got back again to a very free use of the lancet in many instances; which would seem to show that we had completed a revolution in our general temperament, as well as our general temperance; but it is not a little singular, that while the lancet is still used with comparative caution in inflammatory fever, it is chiefly employed and often unsparingly in typhus or putrid fever. And hence, there is more reason, I fear, for suspecting a revolution in the professional fashion than in national temperament; and that the bold and the timid plans have been alternately introduced, and alternately dropped, not so much from any radical change in the constitution, as from their being found to fail, because employed as popular means, or under the influence of some favourite hypothesis on all occasions, without a due degree of chemical discrimination, or attention to the habits or symptoms of individuals at their bed-side. Cauma. tory fever. of not answer SPEC. II. Specific expressive of the disease. SPECIES II. TYPHUS. Typhus Fever. PULSE SMALL, WEAK, AND UNEQUAL; USUALLY FRE- GEN. IV. THE term is derived from Hippocrates, who uses it, however, in a sense not exactly parallel with its applicaterm derived tion in modern times, but rather in reference to that low, from Hippocrates, and muttering, and stupid delirium, which so frequently acpeculiarly companies the disease. It is, nevertheless, admirably expressive of the general nature of the fever to which it was applied at first, and which it designates at present which burns, not with open violence as the cauma, but with a sort of concealed and smothered flame ;-for the Greek term Túow signifies "to smoulder," or "to burn and smoke without vent." May origi nate from causes of fever. Any of the ordinary causes of fever may be a cause of the ordinary typhus, for the typhoid form is often dependent upon the character of the constitution into which it is received, as evincing a great deficiency of sensorial power: and hence cold, mental agitation, excess of muscular labour, and even intemperance, which in a high entonic habit might generate synocha or inflammatory fever, will often in a debilitated constitution, and especially when the debility depends primarily upon the state of the nervous system, and the nervous fluid is recruited with difficulty, give a typhous complexiom to the disease from the first." But though all the causes of fever may in this way. from human give rise to typhus, its common cause, as we had occa But arises generally effluvium, 1 SPEC. II. under the sion to notice when treating of the remote causes of GEN. IV. fever, is febrile miasm, issuing from the decomposition Typhus. of human effluvium, under the influence of the ordinary Typhus auxiliaries of a close and stagnant atmosphere; still fever. farther corrupted by a load of foreign exhalations from influence of dirt or filth of any kind, and of that degree of warmth auxiliary and moisture which must always exist where society powers. exists, and especially where it exists in too crowded a state. Under these general circumstances a very low degree of warmth and moisture is sufficient, though there must be some proportion of both., And provided there be an adequacy of warmth, the lower the temperature the more certainly an individual becomes affected; not from a more abundant generation of febrile miasm, or from its being more volatile-for, on the contrary, it is here perhaps less abundant and even less volatile—but from the more depressed state of the living power, and the less resistance it is capable of offering to any morbid influence whatever. I have just remarked that under a depressed state of Miasm thus the living power, whatever be its cause, whether a want generated of cheerful warmth, cheerful passions, cheerful food, or power of cheerful and regular habits, typhus is often more likely vital energy. to take place than any other species of fever. But when febrile miasm, produced by a decomposition of effluvium from the living body, exists in co-operation with these, it is almost impossible for an individual to escape; as the miasm thus generated has a specific power-a power beyond all other febrile causes whatever-of lowering still farther the vital energy as soon as it is received into the system, and thus of confirming the previous tendency to this peculiar type. All this indeed has been observed already, though it is necessary to revert to it on the present occasion: it has also been farther observed that when a typhus has in this or any other manner once arisen, the effluvium from the living body during its action is loaded with miasm In what way typhus be comes con tagious. GEN. IV. SPEC. II. Typhus. Typhus fever. The contagion more limited in its range than marshmiasm. Becomes of the same kind, completely elaborated as it passes off, and standing in no need of the decomposition of the effluvium for its formation. In many cases, indeed, all the secretions are alike contaminated; and, hence, febrile miasm is often absorbed, in dissection, by an accidental wound on the hand, and excites its specific influence on the body of the anatomist; for in this way, also, typhus has been produced. Hence, typhus becomes infectious; but as the miasm it generates, though more suppressive or exhaustive of sensorial energy, is less volatile than that of marsh-lands or dead organized matter, its infectious power is confined to a much more limited atmosphere than that of fevers arising from this latter source. And on this account, fevers originating in jails, or other confined and crowded scenes, are less extensively communicable than the yellow fever, or that of hot climates and exhaling swamps. It may be also necessary to recal the reader's recoldissolved in lection to another remark that has also formerly been a pure at mosphere, but often not at all in a vitiated. Why more malignant in vitiated air. made, that in a pure atmosphere the miasmic materials, from whatever source derived, become dissolved or decomposed; but slowly and with great difficulty, perhaps not at all, in a vitiated atmosphere already saturated with foreign corpuscles*. In a state thus crowded, moreover, they less readily disperse or ascend beyond their proper periphery of action; and where they are less. volatile, as when issuing from human effluvium, they perhaps adhere by a peculiar tenacity to bodies more ponderous than themselves, and thus loiter for a still longer period within the stratum of human intercourse. And hence the fouler as well as the more stagnant the atmosphere, the more general, and, from the former cause, the more malignant the disease: for as nothing is so contributory to the preservation of sound health as pure air, so nothing tends so much as foul air to prolong or aggravate diseases of every kind. And hence, again, we have an obvious and sufficient reason why typhus should become more severe in proportion as it spreads and im |