g08 Monthly Medical Repo)i. [Feb. 



that one of the most powerful and direct tonics or strengthenere of the human frame 

 which we possess, is the temporary application of cold in the form of the sea bath, or 

 the shower bath ; but the very essence of this is, that the period of its operation is short. 

 The difference in the effects of temporary and of permanent cold upon the animal 

 economy is inconceivably great, and it is doubtless from want of proper attention to 

 this circumstance that those erroneous notions have crept into the public mind to which 

 allusion has just been made. The latter, or the permanent reduction of atmospheric 

 temperature, weakens the energies of the nervous system ; — the incessant demand for 

 animal heat depresses the vital powers: while, on the other hand, the contraction of 

 the vessels upon the surfece of the body forces the mass of blood upon internal parts, 

 in quantity greater than they are well able to sustain. Hence arise the two kinds or 

 classes of disease which present themselves at this season of the year — the chronic, and 

 the acute; both of which have been observed during the last month, though certainly 

 not to so great an extent nor in sucli extreme intensity as have been witnessed in former 

 years. The depressed condition of the nervous power has been strikingly manifested 

 in the prevalence among children of chorea, a disease which it has been too much the 

 fashion to associate with irregular states of the stomach and bowels. A more extended 

 survey of the disordered conditions of the body would shew, that the deranged functions 

 of these parts are but one in the series of effects, which permanent cold or some other 

 general source of debility gives rise to. In no disease is the value of a tonic system of 

 treatment more unequivocally manifested than in chorea; and its agency is easily ex- 

 plained in the simple pathological principle now laid down. Dyspeptic ailments have 

 also been very general : they have had their origin in a general want of tone through- 

 out the nervous 'system. Their appropiiate treatment is the daily use of some aromatic 

 aperient, such as the infusion of cascarilla and rhubarb, preceded by an ipecacuanha 

 vomit. 



Jaundice has prevailed to an unusual degree during the last month, and that it has 

 been one of the varied effects of permanent cold, the reporter cannot entertain a doubt. 

 It has uniformly been attended with anorexia, and other marks of atony of the stomach. 

 It is gradually yielding in several cases to the influence of time and of the milder wea- 

 ther which has now set in (January 22d), and has appeared to be very little, if at all, 

 under the control of medicine. 



Winter coughs, and asthmas, as they are commonly called, constitute, of course, the 

 great bulk of the cases of disease which have been lately met with. The tongue has 

 usually been very clean, and the inflammatory symptoms slight. Nevertheless, the 

 loss of a small quantity of blood (eight or ten ounces), merely to restore the balance of 

 circulation, has been pretty generally required. With this help, antimonial diapho- 

 retics, with an anodyne at bed-time, speedily and very effectually administer to the re- 

 lief of the patient. 



The reporter, in his capacity of physician to the Small- Pox Hospital, has had his 

 attention directed, in an especial manner, to that disease ; and he thinks he shall be 

 performing an acceptable service by offering a brief sketch of the history of small-pox, 

 as it has occurred in London dming the year 1825. This terrible malady, the scourge 

 of our ancestors, the minister of death, to whom it Mas thought that Jenner had given 

 the death-blow, has made its appearance in London, this last year, decidedly as an 

 epidemic. The deaths by small-pox in 1825, as reported in the bills of mortality, are 

 1,299 whereas the average of the four preceding years was but 653. At the Small- Pox 

 Hospital, the admissions during the year 1285 were 419, being considerably more than 

 double the average number of admissions in the last five and twenty years, and ap- 

 proaching very nearly the number admitted in 1796, when small-pox was supposed to 

 be more general and more fatal in London than in any former period. The influence 

 of vaccination, however, in lessening the general mortality of this epidemic, was great 

 and most unequivocal ; the deaths according to the bills of mortality are not more 

 than one-third of those in 1796, and consequently the disorder has occasioned but very 

 little public anxiety. In no town in the world, perhaps, is the proportion of vaccinated 

 children so large as in London. The reason is obvious : — the contagion of small-pox, 

 which only visits country towns occasionally, is always present in London, seeking 

 whom it may devour, and consequently the incentives to exertion on the part of parents 

 are here much greater than in the country. But besides this, the facilities of obtaining 

 the vaccine lymph are v ry great in London, and the trouble to parents therefore very 

 slight — while no expense whatever is incurred by those to whom expense is an object. 



During the months of July, August and September, small-pox was very fatal all over 

 London, and at that period many vaccinated persons took the disease. Of those ad- 

 mitted into the Small- Pox Hospital, one third had previously had the cow-pox. In 

 almost all these cases, where tiie evidence of the preceding vaccination was complete, 

 the subsequent disease was modified, that is, cut short in its progress, and rendered 

 milder in its character. Thirty of them had it so very mild, that it was rather chicken- 

 pox than small-pox, and would, without doubt, have been so designated thirty years 

 aigo, before vaccination was kno^vn. In about an equal number of cases the diseane 



