606 The Andes and the Amazons. 



his was a case in which the neuralgic pain about the ab- 

 domen was the most severe and protracted, causing liini, 

 at times, to beg his medical advisers to give him something 

 to put an end to life, rather than he should suffer. His 

 shrieks from pain were heard in adjoining streets even. 

 One or two cases had occurred here before his arrival. 

 He reported that some of the cases had proved fatal at the 

 points referred to abo\'e. There has been no fatal case 

 here, however. In the case of this young man, there was 

 a good deal of agitation. He would sometimes be perfect- 

 ly quiet while the doctors were preparing medicine at the 

 bedside, and even their presence would act in calming him 

 for a while. A dose of calomel and quinia, seven grains 

 to five, had a remarkable effect the first time it was tried 

 in arresting the pain ; the quinia being continued every 

 three hours witliout any regard to febrile accession. In 

 no case has any headache been annoying. The evacua- 

 tions for a few days after the bowels became moved were 

 almost tarry in color and consistence.* 



Incidentally it may be mentioned that at Para, and at 

 one or two points some two hundred miles up the Ama- 



* Tlie reader will find in Gvisolle's Pathologie Interne, under the head of 

 La Colique Vegetale, which is synonymous with colique de Madrid, de Poi- 

 tou, de Cayenne, de Surinam, etc., the symptoms detailed as were experienced 

 here. And one of the authors there referred to, M. Fonssagrives, suggests 

 whether "cette singuliere affection ne se de'velopperait point sous I'influenee 

 des miasmes analogues on identifiques avec les miasmes palustres." Grisolle 

 seems to more than question the probability, and thinks that the "colique 

 seche n'est qu'une colique de plorab." The epidemic, as it appeared here, is 

 so thoroughly freed from any suspicion of such a cause, that I can not but 

 be convinced of M. Fonssagrives's correctness in suggesting malarial-febrile 

 causes as producing the symptoms, and that the nervous susceptibilities of 

 the tropics will sufficiently account for any unusual amount of pain or great 

 debility consequent on the attack. I may mention that I had not read the 

 article in Grisolle until after my remarks in the text were written. Since 

 then other cases have occurred, following the same course, and getting well 

 under the same treatment. 



A more detailed account of this epidemic was published in the Am. Jour, 

 of Med. Sciences, April, 1872. 



