REMITTENT. 



have the teftimony of Sydenham and Morton, in ])niof of 

 thL- great prevalence of remittents in London ; and Morton 

 affirms tluit they were extremely dellriiftive for leveral years 

 hefore tlie i;reat plague, w's. from 1658 to 1664. He 

 ilates that Oliver Cromwell died of an attack of remittent 

 fever in the former of thefe years, and that he loll his own 

 father, who was liimlelf an experienced phyfician, from the 

 fame difeafe, which had gone through his whole family. 

 (Morton, I'yretologia, append, ad Exerc. ii.) "The re- 

 fult of the whole, therefore, is," to ufe the words of hr 

 John Pringle, " wherever the greateil caufes of moillure 

 and putrefaction in the air exift, there alfo will be feen the 

 greateil number and the worft kinds of the remitting and 

 intermitting fevers." This truth is farther confirmed by the 

 negative evidence, that thefe fevers have ceafed to exiil where 

 inardies have been drained, where towns hare become cleanly, 

 whea armies have moved to dry fituations, and wlien the 

 heats of particular feafons have cealed, or lailed to occur. 



What the nature of thefe mialmata is, the invelligations 

 of philofophers have not yet taught us. Dr. Bancroft has 

 entered at great length, and with great ability, into this 

 queilion, reafonmg from a large collection of important 

 evidence. He details a number of interelling fafts, vvhicli 

 feem to lead latisfaftorily to the conclulion, tiiat the mere 

 exhalations from putrefying animal matter, however ofFenfivc 

 to the fcnfes, are never produdtive of fevers. The fame in- 

 ference has been deduced, not lefs fatisfadtorily, by Dr. 

 Chifliolm, in a very elaborate and able diflertation upon this 

 topic, publilhed in the Edinburgh Medical and Surgical 

 .Journal for Oftober, 1810, vol. vi. p. 389, However 

 contrary to the general opinion, this doftrine, that mere 

 putrefattion is not the fource ot contagion and fever, ap- 

 pears, indeed, by thefe writers to be rllabliflted. Tlie ex- 

 periment, in fact, has been ti'ied on a large fcale in France, 

 in the cafe of the prodigious exhumations made in the 

 church-yard of St. Eloi, at Dunkirk, in 17^)3, and in that 

 of the laints Innocents at Paris, in 1786. in the latter cafe, 

 nearly 20,000 bodies were taken up, in every llage of putr.e- 

 faftion, and a confiderablepart of the work was carried on 

 during the greateil heats of fummer, rendering the whole 

 city offenfive ; yet no fever was occafioned by this immenfe 

 mafs of corruption. (See M. Thouret's Memoir in the 

 Journal de Phylique, for 1791, p. 253; and the Annales 

 de Chimie, vol. vi.) The good health of nightmen, of 

 perlons living in difleiling-rooms, of thofe employed in the 

 manufatfory near Bath of a fort of fpermaceti from putre- 

 fying flefh of all delcriptions, and many other ftriking iadls, 

 detailed by the two authors jult quoted, conilitute a llrong 

 evidence in proof of the abience of infalubrity from mere 

 putrefaction. 



Dr. Bancroft next proceeds to prove, by another ample 

 collection of fatts and teftimonies, that it is not the mere 

 aqueous vapour that conilitutes the morbiiic quality ot marlh- 

 miafms. Tlie principal proofs that mere moillure is inca- 

 pable of producing thefe fevers, are, that failors at fea tor, 

 many months are generally very healthy ; that no fct of men 

 are more uniformly fo than the Newfoundland fifhermen, 

 who are ufually enveloped in the dampell fogs for feveral 

 months together ; that while perfons living on (hore on un- 

 wholefomj iliands, as at Walcheren, are fpeedily attacked 

 with fevers, thofe who remain on fhip-board, at a little dif- 

 tanee from land, entirely efcape them ; and that the occur- 

 rence of thefe fevers has been frequently prevented by laying 

 fwampy ground under water, under which circumftances 

 the moillure of the atmofphere mull be highly augmented. 



Conlidering, then, that the mineral part of the foil is not 

 vaporizable in anv natural heat, and that animal fubilances 



in a Hate of putrefaftion are incapable of producing fever, 

 as well as the mere acjueons vapoiu-. Dr. Bancroft was dif- 

 pofedto conclude, that tlie morbific exhalations in queilion 

 arife wholly from "the mutual decompolition of vegetable 

 matters and water ;" and tliat thofe fivampy grounds arc 

 mod likely to emit them, which contain the largeft pro- 

 portion of fucli matters, and in wlilch the decompofition is 

 moll rapid and complete. This concluflon, he is of opinion, 

 is confirmed by the fadts that tlie exhalations from mace- 

 rating hemp and flax are well known in Italy to produce 

 fevers, and that thofe ariting from heaps of decaying indigo, 

 in the Eafl and Weft Indies, have produced the fame cfFeas, 

 See his Elfay on Yellow Fever, above quoted. 



Of the Treatment of Remittent Fevers. — As the violence 

 of tiie fymptoms, and confcqnently the adtual charadter of 

 thefe difeafes, vary materially in different feafons, climates, 

 and circumllances, under which they occur ; fo no uniform 

 rule of treatment can be purfued for their cure. The fame 

 remedies, indeed, which at one period of the fame fever 

 are beneficial, are hurtful if reforted to at another. This 

 obfervation, however, is applicable to all febrile difeafes, 

 and cannot be too often inculcated ; finco not only empiricifm, 

 but the routine of too many of the profefiion, tends to the 

 appropriation of fome leading remedy, whenever the name 

 of a particular fever is mentioned : with fome it is bark, 

 with others antimony, and with others mercury ; the indif- 

 criminate ufe of any of which mull be neceflarily produdtive 

 of injury. 



In the more violent forms of the difeafe, which are 

 common in hot climates, and in which the attack is marked 

 by a fudden and fevere affedtion of the head, with a hard, 

 full, and ftrong pulfe, indicating, with other fymptoms, an 

 inflammatory affedtion of the brain, perhaps the only re- 

 medy which is capable of arrelling the difeafe, is fpeedy and 

 tree blood-htting. In the moft violent forms of all, this 

 evacuation fliould be reforted to very early, as within the 

 firlt twenty-four hours, or the mifchief will liaTe advanced 

 beyond the reach of tliis remedy. In milder cafes, a mo- 

 derate bleeding from the temporal artery or jugular vein, 

 or even from the arm, within the firfl day or two, will often 

 remove the danger and feverity of the fever. The repe- 

 tition and extent of the bleedings mud be determined by a 

 conlideration of the violence of the fymptoms, the duration 

 of the difeafe, and the vigour of the patient. The notion 

 that thefe fevers of hot climates are of a putrid nature, be- 

 caufe they fpeedily run on to lymptoms of debility, or pu- 

 trefcency, as they have been called, appear to be altogether 

 erroneous ; and it is now generally admitted, that the only 

 effedtual mode of preventing thefe fymptoms, is by arreft- 

 ing the violent inflammatory excitement in the beginning, of 

 which they are the immediate efi:'edt. 



The next raoft effedtual remedy, if reforted to alfo fuf- 

 ficiently early, is purgation. The purgatives adminiftered 

 fliould be fuch as m bulk and quality are not calculated to 

 offend the flomach, which is ufually in an irritable Hate : 

 calomel, with jalap, anfwers the purpofe well ; and it is in 

 all probability by its purgative quahty alone, that mercury 

 has been found beneficial hi thefe fevers. The efficacy of 

 mercurial purgatives, indeed, feeras to have been fully efta- 

 blifhed by the recent experience of our naval and military 

 pradtitioners, in every quarter of the globe ; while the mer- 

 curial pradtice, which had for its objedl the excitement of 

 lahvation, is fhewn by Dr. Bancroft, from the tellimony of 

 Di-. Rufh and others, its advocates, to have been by no 

 means fuccefsfirl. 



This carljiexcitelnent is alfo conliderably alleviated by 

 the application of cald in every mode. Almoll all the mo- 

 dern 



