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Cegetable, natuctions; wand the practmaking
ous and subtle property, and complete in the examination of the structure of many of the functions of his body in health and in disease, the course of the physician preparatory to his last and most important duty, the practice of his art. Chymistry then supplies from the mineral, botany from the vegetable, natural history from the animal kingdom, their respective productions; whilst the sciences of anatomy, of phy. siology, of pathology, and the practice of medicine, complete the circle of medical knowledge by making known successively and in order, the structure of our frame,—the functions in health and in disease, together with the application of remedies to remove it. · These sciences, confessedly among the most important which can claim the attention of our species, have appeared almost in every community. Deriving our support, when in health, from bodies around us, it is a sentiment as natural as it is uni. versal, that we should look for assistance in the same great store-house of supply. Accordingly we discover that even animals have their instincts; which prompt them to seek relief for their maladies, in articles of diet to which they are not accustomed; and among savages the knowledge of roots and of herbs, of charms, spells, and incantations, are as ancient as history itself. In the more authentic records of this science, however, we trace its origin to the shores of the Mediterranean, In Egypt, a country to which Greece looked for her most important assistance in every mental pursuit, this useful study was unquestionably cultivated; and though it was, at the best, little more than an empirical art, yet the knowledge of anatomy, acquired in the practice of embalming, and the regard paid by the laws to the administration of remedies, are data sufficient to prove that at least the practical part of the subject must have been considerably advanced. Greece must of course be mentioned next;—for while the Athenians took the lead of their cotemporaries in almost every thing else, they were by no means behind them in the practice of medicine. Hippocrates appeared when Athens was nearly at the height of her prosperity; and he enriched his profession with a vast body of facts and observations. He was succeeded by men of respectability; but they were overshadowed by the monuments which he had reared, and are hardly known in the history of their country. In Rome, also, towards its meridian there appeared many luminaries in medicine, who were pre-eminent from the splendour of their doctrines and the vast harvest of intellectual productions, which arose beneath their influence. They extended far over the empire, a medi
cal tyranny which free discussion, accurate experiment, and just induction have for some centuries subdued. To state their theories, would be to conjure up the gorgons of error, and to people the regions of truth with the visions of distempered science. In tracing generally the progress of medicine, it is sufficient to say that it arrives at its acme, in every kingdom where luxury diffuses its poisons; where wealth is abundant, and offers with liberality to reward the servants of its pleasures, or looks with anxiety and fear at the awful termination of those enjoyments, for which so much time and money are mispent. Such is the natural place of this study on the chart of history. In Europe, where vast resources of learning and industry have been employed, it appeared early. During the first periods of that wonderful assemblage of religious and civil establishments,—as if disjointed from its place in the progress of their policy, it received and wore the livery of every science which reared its head above the surface of discovery, It became successively mathematical, chymical, and electrical, according as each science gained the ascendency. But it has now acquired a more independent character. It is a subject of familiar conjecture, that the progressive melioration and refinement of the ways of life must gradually circumscribe and deteriorate the practice of medicine; but the fact is directly the reverse; and it seems, indeed, to be in the nature of things, that all the sciences should advance to certainty and perfection, exactly as mankind advance in the progress of civilization. Improvements in the ways of living appear generally to be nothing but the introduction of new luxuries, or the modification of old ones: in either case, they increase the demand for medical labour, by opening new avenues to disease; and as inventions and discoveries in any employment are always proportional to the number of labourers employed, the age of civilization is the very period in which medical science may be expected to approximate the highest stage of melioration. Such is its present state in the civilized world:--but we must now proceed to give an account of its particular state in that portion to which ourselves have the good fortune to belong.
This country stretches from the 30th to the 47th degree of north latitude; it embraces a vast diversity of climate and of soil;exhibits the animal and the vegetable kingdoms, in all their variety; and as the human frame is, in its various por-, tions, exposed to almost every species of temperature and treatment, there can hardly be named a single disease which does not exist in the United States. As they are flanked on one side by an impenetrable forest, and have an ocean VOL. IX.
equally extensive on the other, the comparatively narrow tract which they embrace is subject to the dominion of the winds produced by these two great natural magazines. Our seasons are accordingly in perpetual variation; though, at the same time, the cold predominate in the north, and the hot in the south;--while those of the middle states are constantly vibrating from the one to the other. Nothing, in short, can exceed the variableness of our climate; and we truly say with the Spectator, that we frequently lie down in July, and rise in December.'
In Pennsylvania, there are seldom more than thirty or forty days of summer or of winter, in which the mercury rises above eighty, or sinks below thirty degrees of Fahrenheit's thermometer. The winter generally commences about Christ. mas, and continues till the beginning of March: April is raw and often showery; May still retains the moderate coolness of spring; June introduces summer; July and August are the hottest months; but in September the mornings and evenings begin to be cool, whilst the days are pleasant and delightful. The season is then generally the most equable, and the country the most attractive. The trees are variegated with foliage of a great variety of colours; and instead of the sombre and melancholy drapery of European forests, they have a gay and enchanting appearance, which astonishes strangers who visit our country.
In summer we have days which are uncomfortable without fire, and in winter some which are disagreeable with it. Garlic, a vegetable which is common in the eastern parts of the states, has appeared in January; other plants have blossomed in December and in February; and yet in the very same months the thermometer has sunk as low as twenty-two degrees below 0. The autumn and spring exhibit all these varieties; more particularly the latter; which is still affected by the contests of the sun, growing every day more powerful, with the northern and western winds sweeping across the vast surface of the continent, between the United States and the Pacific ocean. Pennsylvania exhibits in the spring the moisture of the British isles; the heats of the tropical countries, in the summer; the sky of Barbary in the autumn; and the atmosphere of Russia in the winter. There is no month in which frost has not made its appearance, or in which fires have not been found necessary. Taking the climate of Pennsylvania, then, as our point of observation, we see a vast continent, surrounded on the north and west by extensive forests, stretching their almost immeasurable bounds to an ocean many thousand miles distant, and experiencing in its extent the cold of the arctic circle, the moderation of the middle latitudes, and the heat of the torrid zone; on the south a burning country, moderated and broken by huge mountains, and on the east by an ocean equally extensive as the forest on the west, and equally fruitful in storms and variable seasons. The consequence which naturally attends our position between these two great natural deserts, is, as was before observed, that unceasing changes are taking place in our climate. The north differs from the south in having a surface more vexed by winds,--though cold predominates; the middle vibrates alternately to both extremes; while the south is more under the climate influence of the sun.
As the western sections of the country are divided by the great mountains, they have in general a milder temperature than the eastern. The effects of the winds upon health are pretty accurately measured by the following arrangement: as the north and north-west are rendered severe in winter by passing over interminable snows,-but moderated and moistened in summer by accompanying rains, they alternately invi. gorate, and relax the inhabitants of the states and territories which lie in the line of the Mississippi. Proceeding to the south, the winds traversing the ocean in that direction, Mexico and the south-western states, lose some of their moisture, and have a still more debilitating effect; which increases as we proceed towards the east till we come to that quarter where cold and moisture both combine to affect the wind in the highest degree. We find few men above forty who are not susceptible of its chilling and depressing effects. The cold and dry air of the north latitudes, the moist and relaxing air of the south and west, the chilly raw currents from the eastward form, in general, then, the character of the winds which disturb and perplex our climates. .
Our mode of living, with regard to dress and diet entirely resembles that of our English brethren. Coffee, bread, meat, ' and butter, constitute our breakfast; domestic animals and ves
getables which are eaten by the Europeans, furnish our dinner; whilst the third and the last meal generally consists of tea and bread, with perhaps a little animal food. Our drinks are also nearly the same; the native liquor distilled from rye, constituting the beverage of the labourer; brandy, gin, spirits and Madeira wine, that, of the higher classes. We differ from our brethren over the water, however, in eating more' animal food, and drinking more spirituous liquors; though, as to the latter article, perhaps, it may safely be said, that the consumption of these destructive and pernicious stimulants increases
by degrees as we go from the north to the south. In the eastern states, the people are thrifty, active, and industrious,drinking little ardent liquor of any kind: but as we approach the middle states this vice augments, while the labour necessarily decreases; and when we come to the southern districts we see intemperance prostrating her victims on every side, and bringing along with her the usual train of lazy habits and dissolute morals. If we have any vice which can be called national, we believe it is intemperance. The quantity of liquors consumed yearly is prodigious; and, as it is no inconsiderable item in the diet of the labouring classes, an attempt to suppress its consumption by excise laws would only be covering an evil which it seems impossible to crush. The essay to suppress the Scotch distilleries should furnish a lesson on this subject.
With regard to our diseases, pleurisies, rheumatisms, inflammations generally prevail during winter in the northern states. Catarrh, too, is common, and often terminates in the consumption; which may be called the endemic of the country. In some districts and seasons one fourth of the number of deaths are from this cause. The various forms of quinsy occur frequently; nor are local inflammations of the internal parts of the body by any means uncommon.—The eruptive diseases, such as the scarlet fever, the measles, &c. occur generally at the interval of three, four, or more years:—but the small-pox, since the introduction of the vaccine, has certainly been suppressed as far as the irregularities of poverty, ignorance, and prejudice will permit. It is a lamentable truth, that this loathsome disease is still seen in our cities,—and that during the last year, the number of cases was numerous, and the deaths not infrequent. It pervaded many of the cities on the eastern coast, and was considerably fatal. The sailors conveyed it from one port to another; their desultory and wandering life rendering them liable to contagion from frequent exposure as well as from their not having received the benefit of the Jennerian discovery. The plague, exactly in the form which it wears in the old world has seldom appeared in our country. The disease of Pemphigus, and miliary fever, are not often seen. Apthæ and cholera, particularly among young children, appear in the summer, when the heats are great. The nettle rash is common among the adolescent --but more rare in adults. Hæmorrhages, both active and passive, are known in all climates of the country, and cannot perhaps be said to belong to one district more than to another,excepting that from the lungs; which is not uncommon in the northern districts, and most ge