342 Essai/ on the Remittent and Intermittent Diseases. 



destroyed, the irritable and sensitive state, gives place to sadness— 

 the mind soon after becomes benumbed ; listlessness, and submission, 

 and indifference follow, and idiocy and mania close the scene. In hot 

 climates, the effects are proportionally severe. The attack often 

 commences with apoplexy or frenzy, but the usual progress of the 

 mental disorder, when apoplexy or stupor takes place of the cold fit, 

 is irritability, peevishness, restlessness anxiety, melancholy despair, 

 indifference, idiocy, and death. 



In severe cases. Dr. McC. remarks, that the irritability and des- 

 pair are often such as to stimulate the patient to suicide. " In the 

 intermission of the paroxysm, he will request windows to be screw- 

 ed down, and edge tools to be kept out of his reach," lest he should 

 comply with the insane desire, when the despairing, angry, and rag- 

 ing state of the fever returns. In some parts of the Mediterranean, 

 when these fevers prevail, fear is the predominating symptom — 

 while in fenny tracts in mild climates, despondency and low spirits 

 are concomitants of sluggish visceral affections, and sometimes the 

 only indications of disease. So various are the modifications of symp- 

 toms, that in some instances no disease appears to be present, but " a 

 languor and want of alacrity, which in the army has been taken /or 

 shamming among the soldiers, and treated accordingly ; and among 

 the opulent classes, particularly among delicate females, the same 

 symptoms are considered indolence and affectation." 



It is the opinion of Dr. M'C. that the severe mental and nervous af- 

 fections of mild climates, are the result of misapplied remedies. Thus 

 if a patient is seized with apoplexy or stupor, and bleeding is resort- 

 ed to, from an idea of a pressure of blood upon the brain, the con- 

 sequence is almost inevitably palsy or idiocy, if not sudden death. 

 In cases of ophthalmia, cupping and bleeding are often succeeded by 

 blindness, while successive attacks of remittent and intermittent, treat- 

 ed with calomel, blisters and low diet, terminate in some or all the 

 endless tortures of dyspepsia, nervous affection, headach, melan- 

 choly, convulsions, epilepsy and insanity. 



In short it appears that almost every form of disease may be elici- 

 ted by this wide spreading cause ; and that whenever disease accom- 

 panies that unknown condition of the nervous system produced by 

 Malaria, indicated by periodical returns and an obvious mental af- 

 fection, however severe, or however slender it may be, yet the effect 

 of remedies will be injurious or beneficial as they are appropriate 

 to the primary cause. It is hence easy to see why palsy should be 



