REM 



R E M 



In London it is cafy to get icinitlaiices upon any city in 

 the world ; in the country n is iitore diflitiult. 



Remittances, Book of. See Book. 



RKMlTTANCEis alfo uled in fpeaking of tin- payment of 

 a bill of exchange. 



Remte'Tance alfo denotes the due or fee allowed the 

 banker or merchant, both on account of his trouble, and 

 the different value of the fpccies in the place where you 

 pay the money, and where he remits it. 



This remittance is more uraally called f/;rtfifc Mid rechange. 



REMITTENT, in Medicine, implying alio the word 

 fever, is a fever which is charafterifcd by a regular de- 

 creafe and exacerbation of its fymptoms every day, and dif- 

 fers from an intennillent, inafmuch as the fymptoms never dif- 

 appear altogetiicr, and the exacerbation is neither begun 

 by the complete rigors, nor terminated by the profufe fweat, 

 which occur in the latter. The remittent fever, however, 

 originates, in common with the intermittent, from the in- 

 fluence of marfli effluvia, but under particular circumitances, 

 which will be ilated immediately. 



It is fcarcely neceilary to dcfcribe minutely the fymptoms 

 of the remittent fever after the ample detail which we have 

 given of thofe of fever in general (fee Fevek) ; and it 

 varies extremely in its charafter, according to the feafon, 

 climate, and other circumftances under which it appears. 

 In its milder forms, the remittent begins with chillinefs, 

 laffitude, pains in tiie bones, head-ache, and a difordered 

 condition of the ilomach, lofs of appetite, licknefs, and 

 even vomiting. At night the febrile fymptoms run high ; 

 the heat and thirlt are great, the tongue and mouth are 

 parched, the pain of the head is violent, the patient is 

 totally unable to fleep, and is continually tolling and tum- 

 bling about, and often becomes delirious. But generally in 

 the morning, an imperfect fweat brings on a remiflion of all 

 the fymptoms. In the evening, the paroxyfm returns, but 

 is not preceded by any cold lit or (hivering ; yet it is com- 

 monly more fevere than the former. Next morning it remits 

 as before ; and thefe periodical changes recur daily, be- 

 coming, however, lefs marked, if the difeafe be neglefted, 

 imtil the fever infenfibly ailumes a continued form. The 

 pulfe is full and quick during the exacerbations, and con- 

 tinues during the remiflions to indicate fever ; but rigors fel- 

 dom precede the fits after the firll attack. Many patients 

 difcharge a bilious matter from their ftomachs by vomiting, 

 and all are difordeved in that organ. In the more violent 

 foKms, which take place in hotter feafons and climates, the 

 difeafe often feizes the patient at once with a burning and 

 violent head-ache, with little or no fenfible chillinefs pre- 

 ceding it. The thirit and heat are intenfe, and acute paiiis 

 in the back and all the limbs, with extreme laffitude and in- 

 quietude, harafs the patient, and naufea, vomiting, and 

 pain of the ftomach enfue. In fome inilances, indeed, the 

 head becomes fo fuddcnly and violently aft'efted, that a vio- 

 lent delirium, all'uming the appearance of infanity, feizes 

 the patient without any previous indication, until the re- 

 miflion evinces the nature of the difeafe. Many of the fick 

 become yellow, as if affefted with jaundice. Indeed, the 

 remittent fever afTumes every degree of violence, from the 

 autumnal bilious fever of temperate climates, to the mod 

 ieveve ye//oiu fever of tropical countries. 



The circumftances under which thefe varieties of form 

 occur, have been amply afccrtained by experience. The 

 combination of marfli effluvia and great lieat are necefiary 

 to the prodnftion of thefe fevers; and they are violent, 

 nearly in proportion to the degree of the latter. In cold 

 climates, and in cool feafons, as the fpring, the miafmata 

 excite but the common mtermittent ague. But in the au- 



tumnal feafon, eipecially when the heat is confidcrable, and 

 the quantity of mialma great, as in the Low Countries, in 

 particular years, the production of thefe fevers is very ex- 

 teufive ; they become aftually endemic, and afFe£t efpe- 

 cially thofe perfons who are not accultomed to the climate. 

 The experience of all our military expeditions to Holland 

 and Flanders, in the autumnal feafon, aflords fatal proof of 

 this truth. (See the writings of fir John Pringle, Dr. 

 Home, Sic. on the Difeafes of the Army in the Campaigns 

 of 1742 — 1748, inclufive. And the fevere epidemic of 

 Walcheren, at a more recent period, cannot be forgotten.) 

 In thefe climates, 'the remittrni ufually commences at the 

 clofe of fummer, in a milder form, and gradually aflumes 

 a more violent and formidable charadter, as the heats of au- 

 tumn advance. But if we extend our inquiries to the hotter 

 regions of the globe, we find the difeafe under its mod fevere 

 and fatal forms: In the fouth of Europe, efpecially in 

 Spain, and thofe parts of the Mediterranean coalts where 

 miafmata are found, the autumnal remittent becomes a 

 formidable malady in particular feafons ; but we muft pro- 

 ceed to the Weft Indies and America to difcover the difeafe 

 in its moft terrific form ; for although there may be a con- 

 tagious fever, which puts on the yellow or bilious charadter. 

 Dr. Bancroft appears to have demonilrated, fatisfadtorily, 

 that the J'f//o•zuyi?^Icr, commonly lo called, isbut the leverelt 

 form of the endemic remittent of the hot feafons of hot cli- 

 mates. (See his able " Effay on the Difeafe called Yellow 

 Fever, &c." 1 8 1 1 ) . He affirms, indeed, that all fevers, oc- 

 curring in thofe countries in which the atmofpheric heat 

 rifes, during certain feafons, to the 85th degree of Fahren- 

 heit's thermometer, have a tendency to affume that violent 

 and dangerous appearance, which is ufually conlidered as 

 charadleriftic of the yellow fever. 



Tlie teltimony of all experienced medical obfervers con- 

 curs in proving the origin of remittent fevers from the in- 

 fluence of miafmata. Thus, among the hiilorians of difeafe, 

 as it occurs among feamen in warm climates, Drs. Lind, 

 Blane, Hunter, and others, have demonftrated the ex- 

 clufive attacks of thefe fevers to be among thole men who 

 have gone on fliore, in fwampy grounds, for water, &c. ; 

 and efpecially among thofe who fpend the night on (hore. 

 Many inftances are recorded, in which all the men fo em- 

 ployed have been feized with fevers, while the reft of the 

 ibip's company have remained in health. (See Dr. Lind, 

 on the Difeafes incidental to Europeans in Hot Climates, 

 p. 27. 221, &c. 5th edit. Dr. Blane, on the Difeafes of 

 Seamen, p. 92, and 392.) Again, lir John Pringle, in 

 his valuable work on the difeafes of the army, has not only 

 ftated many fadts which occurred under his own obferva- 

 tion, but has adduced many proofs from the writings of an- 

 cient phyficians and hiftorians, in corroboration of the evi- 

 dence that theie fevers have, every where, and at all times, 

 originated in hot feafons, in circumftances where miafmata 

 exifted. (Fart 3. chap. iv. fedt. 3.) In times, indeed, 

 not very remote, when the want of proper means of carry- 

 ing off the filth and refufe of large towns by proper drains, 

 and fcavengers were not employed, and when the materials 

 for the produdtion of miafmata were accumulated even in 

 the ftreets, the remittent and intermittent fevers were epi- 

 demic, in favourable feafons, for the generation of the miaf- 

 mata, and the fource of confiderable fatahty. Thus, even 

 in London, Dr. Short remarks that, early in the feventeenth 

 "tentury, " one of forty of the whole that died of fevers, 

 died of agues." (Sec his New Obfervations, &c. on Bills' 

 of Mortality, p. 203.) And Burnet, in his Hiftory of 

 the Reformation, fays, that in the laft year of queen Mary's 

 reign, they " raged like a plague." At a later period, we 



have 



