80 



APPENDIX, No. IV. 



I may shortly observe, that to me it appears ex- 

 tremely probable, that the yellow or higher grades 

 of remittent fever, would seldom prove mortal, were 

 it met in the first stage by bold and decisive blood- 

 letting, and that blood-letting alone has any power 

 over it. For this purpose, however, we must not 

 be guided in our bleeding by the number of ounces 

 taken away, but by the effect produced upon the 

 disease. We must bleed at the commencement of 

 the attack until the pain be removed, the skin ren- 

 dered soft, and the morbid heat have disappeared ; 

 and when these symptoms return, as they often do, 

 we must again bleed until their removal. Dr. Rush 

 observes, and my experience confirms the observa- 

 tion, that, " in the use of this remedy, it may be 

 truly said, as in many of the enterprises of life, 

 that nothing is done while anything remains to be 

 done." In fevers and other diseases which run their 

 courses in a few days or hours, and which threaten 

 immediate dissolution, there can be no limits fixed 

 to the quantity of blood which may be drawn at 

 once, or in a short time. 



Whenever an extensive commerce shall attract 

 numbers of people from more temperate latitudes, 

 to this last division of the coast, there is no doubt 

 but the yellow-fever will prevail as extensively, 

 and prove as destructive, as it does on the eastern 

 coast. The heat and miasms, which only perpetuate 

 a general state of bad health and debility in the in- 

 habitants, will act upon these robust strangers with 

 great violence and rapidity, just as it happens on 

 the opposite coast. The inhabitants of this coast 



invariably remove, in the winter season, from the 

 shores to the high grounds. The winter, as it is 

 termed, is from June to November, inclusive, du- 

 ring which violent rains, storms, and excessive beat 

 prevail, rendering the neighbourhood of the sea 

 almost uninhabitable. 



" It has been long remarked, that the epidemics 

 at Callao and Panama have commenced on the ar- 

 rival of vessels from Chili ; not because that country, 

 which is one of the happiest and healthiest of the 

 earth, can transmit a disease which does not exist 

 there, but because its inhabitants, transplanted into 

 the torrid zone, experience, with the same violence 

 as the inhabitants of northern countries do, on 

 going to the West Indies or Vera Cruz, the fatal 

 effects of an air excessively warm, and vitiated by 

 a mixture of putrid emanations." * According to 

 Dr. Unanue, " Even black cattle reared on the 

 mountains cannot support the temperature of the 

 coast ; as soon as they come down to it they are 

 affected ; according to the vulgar expression, viz. 

 they grow stupid, and perish with frightful rapidity. 

 On opening them, the liver is found hardened, as 

 if it had been placed on coals. The butchers know 

 by experience, that cattle die much faster in sum- 

 mer than in winter ; and therefore choose the 

 latter season to provide their supply for the Lima 

 markets f." 



* Humboldt's New Spain, vol. 

 Unanue, " El Clima de Lima." 

 t El Clima de Lima, p. ti5. 



IV: 



153. See also 



THE END. 



LONDON ! 

 T1RADBURY AND KVANS, PHINTKKfl, WHtTKimtARS. 



