[ 548 ] [May, 



MONTHLY aMEDICAL REPORT. 



The causes of disease are so infinitely yaiied, that under whatever circumstances we 

 may imagine mankind to be placed, there will always be found abundant employment for 

 the thoughts of the speculative, and the pen of the practical physician. The soil that we 

 tread on, the air that we breathe, the diet that supports us, the clothing that covers us, 

 the employments that occupy us, are all calculated, in different ways, to become the 

 sources of disorder. And when, setting aside these direct causes of ill health, we further 

 reflect upon the great variety in those more remote and indirect, but not less important 

 causes of disease wliich exist in hereditary disposition, in original u;eaine.sj of constitution, 

 in the diversities of bodily structure, in the temperament of mind, and even in the simple 

 influence of time, we shall have no difficulty in perceiving why the cup of human dis- 

 order is always full, and so often overflowing. We might even push the inquiry further, 

 and shew how, in different situations, these different causes of disease operate, and liow 

 curiously the best gifts of nature are blended v/ith the sources of sickness and death. 

 Where the atmosphere is pure and uniform, we often find the soil swampy, and preg- 

 nant with the seeds of ague. Here in London, where, thanks to the commissioners of 

 eewers, the earth itself offers no germ of disease, the climate is constantly rarying, both 

 in regard to heat and moisture, and exposing us at all times to the risk of coughs, colds, 

 hoarsenesses, rheumatisms, and that long train in " tlie painful family of death," which 

 have their origin in obstructed perspiration. A sect of physicians once existed, who be- 

 lieved that all diseases were traceable to obstructions in the ;)ores,- and if they could 

 reasonably maintain such a doctrine in Greece and Italy, how much more strenuous 

 would they liave been in its support, had they lived in our climate ! 



The last month has afforded its fair proportion of this class of complaints. It is true 

 that the weather has been for the greatest part fine and mild ; but every now and then 

 a sharp northerly wind would interpose, and suddenly constringe those pores, which the 

 mildness of the preceding day had greatly relaxed. Il is generally remarked, that there 

 is a greater variety of disease in cold than in hot countries, though of course in a less 

 degi-ee of intensity. This observation applies more especially to variable climates, such 

 BS that of England ; and the reporter has never witnessed the effects of cold in a 

 greater diversity of aspects than during the past month. Next to coughs and hoarseness 

 (which latter have been peculiarly troublesome and obstinate), rheiunatic affections have 

 certainly predominated. Rheumatism is always to be met with at this season of the 

 year : but one principal source of it is doubtless to be found in thee hange of dress which 

 it is usual to adopt in " the sweet spring time." Lambs-wool and flannel, by tlie encou- 

 ragement they afford to the functions of the skin, are the true antidotes to rheumatism ; and 

 when the period arrives for their being discarded, that foe to comfort and repose resumes 

 his reign. Fortunate is he who escapes with a crick in the neck, a lumbago, or a 

 swelled face and tooth-ache. It would be well for individuals were it better known that 

 this last but most distressing ailment is, in nine cases out of ten, nothing more than a 

 form of rheumatism, — one of the many shapes which that protean disorder occasionally 

 assumes. Like every other variety of rheumatic inflammation, it has its period of crisis 

 and decline ; and if the patient in name could but be persuaded to be patient in deed, he 

 would in most instances triumph over the disease, and the radical practice of the dentist 

 would be most materially abridged. 



Rheumatism, in its second degree of severity, (called by physicians suhacate,) has been 

 also very generally noticed. The reporter has met with it affecting several of the joints, 

 either together or in succession ; and also fixing itself with obstinacy upon one ,- and the 

 hip joint appears to be its favourite citadel. To dislodge it from this requires all the 

 skill, and the most powerful resources of tlie experienced physician, and a long siege 

 besides. The intensity of the pain in this severe disease (sciatica) cannot be adequately 

 judged of, except by those who have suffered from tooth-ache. In both, the nerve itself 

 appears to be the actual seat of disorder, with tliis disadvantage on the part of sciatica, 

 that the nerve there affected is above twenty times as large, and no summary process can 

 be practised for its removal. In the treatment of this disease, the reporter has derived 

 great benefit from the application of cupping glasses to the outside of the hip, taking 

 away from ten to twelve ounces of blood ; — also from the steady emploj'ment of the 

 meadow saffron, combined with active asperients. In very confirmed cases, wliere the 

 heavier artillery must be brought into play, mercury is to be administered constitutionally, 

 and repeated blisters locally. Under this system of discipline, the most obstinate cases 

 may ultimately be made to yield. 



The third grade, or species of rheumatism, is that which is known to the uninitiated 

 under the term of rheumatic fever, and to the medical world under that of acute rheumatism. 

 It is the most severe and formidable of all the varieties of this disorder, for, in addition to 

 the pain wliich characterizes the former, this species of the disease is attended by complete 

 loss of niotion in the limbs, and by a smart, and even at times a dangerous degree of 

 constitutional fever. lu all other kinds of rheumatism, the sufterer has at least the 

 comfort of an uninjured stomach ; his appetite is good, and his digestion perfect j 

 here however, in the acute rheumatism, fever rages through the blood ajid humours, the 



