118 MONTHLY JOURNAL OF AGRICULTURE. 



either immediate death or a total suspension of vital power in the parts depend- 

 ent upon the debilitated nerves."* 



The symptoms of debility, and especially the cold skin, point out to us the ne- 

 cessity of stimuli being required. The subsequent feebleness during convales- 

 cence — the extreme debility following tlie sanguine depletion in the cold stage of 

 intermittents, with the very doubtful success of that practice, should make prac- 

 titioners remember that the symptoms present may arise from a very opposite 

 state of the system than one calling for blood-letting. I believe liie pain in the 

 head in this affection is neuralgic. I have seen it relieved in a few hours by 

 laudanum, or camphor and opium ; and I have often given quinine and whisky 

 with advantage to it. The quick, soft pulse is one of irritation, not oppression, 

 (as some consider it) — indicative of an irritable condition of the nervous system, 

 and not an index of the amount of sub-acute inilanimatiun in the lungs. The 

 condition of the pulse alone will frequently mislead tiie praclitioner (as it too oft- 

 en does in scarlatina), if he depends on it as a guide in diagnosis; and I have 

 seen medical men differ in opinion about it, taking directly opposite views of the 

 indications. The small, weak pulse is often considered as that of oppression, and 

 the shattered thrill taken for wiriness and hardness. 



The case which the venerable Dr. Parrish was accustomed to relate as having 

 occurred while Dr. Wistar was in Edinburgh, here presents itself to me: 



A dog was bled to death by him and other students. Just before he expired, 

 an eminent practitioner stepped in ; not being aware of what experiments were 

 in progress, he was asked to place his hand on the dog's heart, and say whether 

 the action was sthenic or asthenic ? He did so, and declared the condition 

 sthenic. 



I have often noticed at the close of fatal diseases, especially in nervous consti- 

 tutions, the action of the heart and carotids, and been struck with their apparent 

 sthenic action for hours, when debility had been gradually increasing from stead- 

 ily failing nervous power, and the system becoming progressively exhausted. In 

 the disease of which I am treating, I have never known, in a single instance, the 

 pulse to rise and fill out after venesection, or become slower, which should be 

 the case if the frequency depended on inflammatory congestion. Often have I 

 known it become smaller and more rapid ; and I now never think of bleeding a 

 negro in this disease. Where the pain is pleuritic, and the cough dry, which is 

 sometimes the case, dry cups to the chest and free vesication usually give relief, 

 with the full and free use of opiates. As I mentioned above, negroes bear opi- 

 ates much better than Avhites, and seldom suffer from any of their bad effects. 



My object in the preceding paper being to give a practical article, and to lead 

 the profession to the notice of this disease, I have made no references to previous 

 accounts in the books of similar epidemics in other countries. I differ from some 

 of my professional brethren in my view of the treatment of this affection, and I 

 can only say that my success in the treatment will bear me out in my opinions, 

 whatever value may attach to the theory. During the winter of 1S40— 11, out of 

 fully two hundred cases, there were only five deaths. My experience since con- 

 firms my satisfaction with the practice. I find that special attention by the plant- 

 ers to keep the houses of the negroes dry and well supplied willi fuel, while they 

 are well provided with blankets and warm clothing, has greatly diminished the 

 number of cases on the plantations which I attend. 



In conclusion, I would ask the attention of practitioners to an extract from Dr. 

 Mott, who has had much experience in disease. He says : 



" Tliere is nothing more important in tlio walUs of medicine and surgory th;ni tor tlie prac- 

 titioner to make a clLstinctioii between two opposite st<vtos of tlie system " (irritation anil in- 

 flammation) ; " and, if great opportunities of obsorvation in various countries could authori/.p 

 me to form an opinion, tliere is no fact more Lncoiitostalily established than that the most fat;il 

 results in the practice of our profession are to be imputed to a toUil misconi-t-ption of thoso 

 lines of demarkation." [ Travels, p. 41. 



Note. — "Nurse" on a Southern Plantation. — The odice of " Xiirse," so fiiniiliarly referred 

 to by the writer, and vn hich he supposes every one understands, is one of no little responsibility 

 and importance on a southern plantation. On all tliese of any considerable force and extent, a 

 house of ample dimensions, and with all the proper appointments and appliances, is set apart aa 

 a regular iniirmary or hospital. For the duties of a nurse (to reside in the hospital constantly), an 



• Holland. 

 (262) 



