1 827.] Monthly Medical Report. 549 



The second form offerer which has lately appeared in London, is the true inflamma- 

 tory fever, or synocha. This disorder cannot reasonably be expected ever to become 

 epidemic in this climatethe range of atmospheric temperature being- too low for its 

 development. It can only occur, therefore, in persons of sanguine temperament, rich 

 blood, and general fulness of habit such circumstances operating as accessory causes 

 in seasons characterized by the general prevalence of fever. The Reporter has met 

 with several cases during the last month, to which these observations apply. One of 

 them, unhappily, proved fatal. It was ushered in by violent rigours, and excessive 

 irritability of stomach, lasting for four or five hours. To this succeeded swelling of 

 the parotid gland, and turgescence of the head and face, followed, soon after, by 

 excruciating pain of the forehead and temples. Delirium shewed itself on the fifth day 

 of the fever, and gradually increased in intensity : the pulse was frequent, strong, and 

 incompressible. On the seventh day, very severe pains attacked the arms and knees, 

 which were followed by cedematous swellings of those parts. The tongue, too, which 

 throughout the early stages of the disorder had been usually clean, now swelled, and 

 became dry and rough, like the rind of pomegranate. The most active treatment was 

 had recourse to. Bleeding was practised five times ; and the blood, on all occasions, 

 was cupped and sizy. The other parts of the antiphlogistic treatment were also vigo- 

 rously employed purgatives, cold lotions to the head, &c. ; notwithstanding which, 

 the patient sunk on the ninth day. 



The third, and by far the most common, of the several kinds of fever which have 

 lately prevailed, and which still continue to prevail extensively, is the common con- 

 tinued fever of this climate, so frequently alluded to in former Reports. Some of these 

 cases, though to appearance setting in with severity, admit of being cut short by 

 active evacuants such as emetic, followed by a brisk cathartic of calomel and jalap. 

 Others run on, in spite of every effort, for two or three weeks the crisis being so 

 obscure as hardly to be discerned, even by the careful eye of the physician. Among 

 the peculiarities of the fever of this season may be noticed a heat in the mouth, which 

 has proved a very general, and, in many cases, a most distressing symptom. One 

 patient complained to the Reporter of having flames of fire in his mouth, for which he 

 urgently desired relief. This symptom was always associated with proeternatural 

 redness of the tongue, and occasionally with superficial aphthous ulcerations of the 

 tongue and palate. There are not wanting those who would ascribe this form of fever, 

 equally with that which exhibits intermission and remission, to the influence of a 

 malaria ; but the Reporter has in vain sought for facts to support such an hypothesis. 

 The two forms of fever appear in different situations, are attended by a different class 

 of symptoms, and, above all, are benefited by a different system of treatment. The 

 tonic plan is almost, if not absolutely, essential to the cure of the one j whereas the 

 other will subside perfectly under the continued use of remedies of an evacuant cha- 

 racter. Simplicity in theory is no doubt very captivating; but, on that very account, 

 it is apt to mislead. The sweeping generalizations of some modern authors, with 

 regard to the noxious influences of malaria, furnish, we apprehend, the latest, but 

 not the least striking instance of the truth of this reflection. 



Measles and scarlet fever are both to be met with at the present time ; and, we regret 

 to add, that no diminution is yet perceptible in the quantity of small-pox, which con- 

 tinues to shew itself in all parts of the town, and to expend its virulence upon those 

 who have not secured themselves by vaccination. 



Coughs and colds have began to shew themselves within the last few days, and cases 

 of more active thoracic disease are not wanting. Several instances of very acute 

 pleurisy have lately been seen ; and the lancet has been more in requisition than for 

 many months past. Bowel complaints were very frequent towards the early part of the 

 mouth, but are gradually on the decline. 



GEORGE GREGORY, M.D. 

 8, Upper John Street, Golden Square, Oct. 23, X827. 



MONTHLY AGRICULTURAL REPORT. 



THE harvest throughout Britain, from north tosouth, may now be said to be universally 

 gathered and secured ; and the general average of corn, pulse, and root crops may 

 be pronounced most favourable. This may be safely understood to relate to both 

 quantity and quality j for if, in cold, damp, and exposed situations, part of the crops 

 have been affected by blight and mildew, and, during the harvest, have been drenched 

 with rain, and kept abroad by fogs and heavy dews the consequence of which has 

 been a great quantity of discoloured and sprouted corn on all our best and most pror 



