Thoracic complaints amongst Natives, 23 



the third stage, or grey softening of the asthenic kind, was replaced by 

 cavities containing mud colored, foetid serum. The disease was most 

 frequently found in the posterior parts of the lungs, but this was by 

 no means always the case, as I have found both consolidation and 

 cavities near the nipple. When pleurisy is excited in this form, the 

 lymph exuded, is deficient in plasticity, and the adhesions that the 

 lung forms with the parietes, are easily broken down. In these cases, 

 antiphlogistic treatment cannot be thought of, stimulating medicines 

 are alone of use. When the disease is circumscribed, which it sel- 

 dom is, these means I think I have known to produce great benefit, 

 if time be allowed for them to be followed Up by tonic medicines. 

 I have generally found this complaint to arise in the ill-fed and ill- 

 clad. The existence of chest diseases in such numbers, will throw 

 some light on the reason of the mortality which so constantly attends 

 dysentery, &c. in the natives. 



Medical Report on the causes of the late Sickness at Akyab, accom- 

 panied with Sanatory Observations and Suggestions, in accord- 

 ance with instructions conveyed in a Letter from the Commissioner 

 of Arracan, No. 105 ; dated 4th June, 1844. 

 1 . In considering the causes which have operated in producing the 

 late fatal sickness in Akyab, of the first importance is the nature of 

 the disease from which the before-mentioned result arises, whether 

 Endemic or arising from locality, Epidemic or arising from adventi- 

 tious causes. Disease, when attacking a community generally, belongs 

 to one or both of these classes, distinct, however, as they appear, both 

 as respects origin and individual character. Yet when an Epidemic 

 disease has once made its appearance, its progress is accelerated or 

 impeded, by the same causes which influence the other form. Sana- 

 tory suggestions with regard to place, will, therefore, be equally effica- 

 cious in both instances ; but as these two divisions of disease have a 

 different origin, the preventive policy will be different ; and this more 

 especially refers to small-pox, which, as I shall hereafter prove, is 

 one of the most fatal Epidemics that ever attacked the people of 

 Arracan. With a view, therefore, of ascertaining the particular form 

 or class of disease which has lately been attacking the people of this 



