till 



f>f an attack, while tht.se in greater comforl in the same neighborhood 

 • e Conjointly with these intermitting forms of fever we often 

 find, in the same families, some who are laboring under remitting forms 

 of fever, a more severe malady, though if thoroughly cured, more easi- 

 ly and speedily removed. These forms of fever are generaliy desti- 

 tute of danger, though occasionally they assume the pernicious or 

 congestive form, and are thus full of peril. The intensity of our fe- 

 brile attacks, compared with similar attacks elsewhere, was made the 

 subject of special inquiry of all the physicians to whom I wrote. The 

 testimony from the northern portion of the State has been uniform, 

 that they are milder and more manageable ; and in this opinion I en- 

 tirely concur, whilst Drs. Ford of Keokuk, and Flint of Van Buren, 

 represent them as more severe As I rely on the judgment of both 

 sets of Doctors, I presume the Des Moines Valley is afflicted with 

 severer forms of autumnal fevers than those observed north of Iowa 

 river 



Among our autumnal diseases, although they occur a month or two 

 earlier, must not be omitted dysentery and diarrhoea; nor should it be 

 overlooked that ill-cured intermittents and occasionally remittents, 

 greatly neglected, are merged into, visceral enlargements, which occa- 

 sionally terminate in hydropic effusions in both sexes, and also in am- 

 enorrhea in the female. Gastritis and enteritis are sporadic forms 

 of disease which may occur at any season, but are thought to be more 

 common at this season than at any other. Hepatitis is thought to be 

 verv rare I may mention one peculiarity of erysipelas as it lately 

 prevailed to some extent in this city, viz : the exemption of women in 

 childbed from puerperal peritonitis, which in the epidemics seen by 

 Gordon and Hay, and in a former one seen by myself, was so exceed- 

 ingly fatal. 



As cold weather advances, in addition to these maladies, and some- 

 times eonjoined with them, we have Catarrhal affections, pleuritis, 

 pneumonia, bronchitis, &c. ; many of these forms are manifestly com- 

 plicated with bilious symptoms, showing that the malarious influence 

 had not ceased to act. This is also the opinion of Dr. Flint, whilst 

 Dr Horr thinks that those who have actually suffered an attack of 

 autumnal fever, are, to some extent, exempt from the winter disease 

 Except in those whose health has been greatly impaired, these pulmo- 

 nary attacks are inflammatory in their character ; a neglected case, 

 or one supervening on a broken down constitution may assume the 

 character of pneumonia typhoides. As might be expected from our 

 rhmate. tuberculous formations are not uncommon, though from the 

 habits of our people living much in the open air, taking a large amount 





