1800.] 
to a confiderable extent. The air is ren- 
dered further impure by the effluvia from 
common fewers and ftables, flaughter- 
houfes, many forts of offenfive manutagto- 
ries, the refufe of markets, provifion- 
fhops, &c. A quantity of duft is lixewife 
put in motion and diffufed abroad by the 
continual ftirring of the inhabitants, and 
by the operations of trade, and of domef= 
tic cleanlinefss The air thus deprived, in 
fome degree, of its falutary property, and 
impregnated with noxious fubftances both 
chemical and mechanical, is generally, at 
this period of the year, loaded alfo with 
a thick and fluggifh fog. When the agent 
immediately {ubfervient to the funtion of 
re(piration is fo contaminated, it is not won- 
derful that the fun&ion itfelf fhould, in 
confequence, be impeded and deranged.— 
Hence an habitual cough is remarkably 
frequent among the inhabitants of London ; 
Jaying a foundation, in fome for the 
phthifis pulmonalis, and degenerating in 
others to a con(tant ftate of dylpnoea, with 
increafed fecretion from the bronchial vef- 
fels. This morbid condition of the lungs 
becomes aggravated throughout the winter 
feafon, and on the fpecial application of 
cold, or other exifting caufes, is, accord- 
ing to the age, conftitution, S¢c. of the 
patient, often converted into one or other 
of the {pecies of pneumonia, but princi- 
pally into that which has been denominated 
peripneumonia notha. For the fame rea- 
fon alfo acute pulmonary difeafes are much 
retarded in their cure, or are protracted to 
a chronic ftate. ole ae 
Although the origin of fever among the 
poor may in general be eafily and diftinily 
traced, yet on foie occafions its fource 
is by no means obvious. Three children 
from the age of fix to twelve years, be- 
longing to a mechanic whofe apartments 
were remarkably clean, and in an airy fi- 
tuation, were attacked in the atternoon of 
the fame day with the cold paroxylm of 
fever, which was foon fucceeded by a per- 
manent ftate of heat, guicknefs of pulfe, 
and other ufual fymptoms. In two the 
difeafe terminated favourably in little more 
than a week, but in the.third it ended 
fatally about the 21{tday. The parents 
being minutely queftioned as to the circum- 
ffances to whiclt thefe patients had been 
expofed previoufly to the attack of fever, 
were perfectly fure that they had not been 
hear any perfon ill of the difeafe, but men- 
tioned that they fometimes ufed to play 
and wander about in a neighbouring 
church-yard (St. Luke’s), and that their 
curiofity often excited them to hover over, 
“MONTHLY Mag. No, 66, 
Lift of Difegfere 
457 
and look into the graves, at the time of, 
and immediately afier, the ceremony of in~ 
terring the dead, of whom a great number 
lately buried in that cemetery have been 
the victims of contagious fever. Of the 
difeafes of infants, that which moft fre~ 
quently engages our notice, and baffles our 
efforts for its removal, is the atrophia, 
The predifpotition to this morbid ftate 
confilts inthe weak {chrophulous and de- 
generated ftamina imparted to them by 
their parents. Its exciting caules are, a 
confined and corrupted air, the want of 
proper nurfing, unfit and deficient nutri- 
ment, and perhaps but too frequently the 
unnatural and premature adminiftration of 
ardent fpirits. An infant, after thriving 
tolerably well for fome time perhaps, be- 
gins to wafle. The abdomen gradually 
grows hard and tumid, the flefh, as it di- 
minifhes in quantity, becomes foft, and 
the fkin dry, loofe, and flaccid, the fea- 
tures fhrink and look pale and {qualid. 
The alvine dilcharges are fometimes too 
flow, fomeiimes too frequent, and {eldom 
natural in odour or appearance. The in- 
fant is extremely reftle!s and fretful, and has 
a burning hectic fever, efpecially in the 
night. A harraffing cough often attends, 
with much oppreffion of the breathing. 
The appetite is, for the moft part, keen 
tothe laft. ‘The immediate caule of this 
difeafe is generally an enlargement of the 
me‘enteric glands, and of other parts with. 
inthe abdomen. Sometimes there is 2 
tubercular ftate of the lungs. In the ear. 
lier period of this malady fome little good 
may be derived from medicinal means, par- 
ticularly from the judicious ule of calomel, 
rhubarb, &c. Butunlefs pure air and pro- 
per management at home co-operate with 
cur endeavours, itis but too common that 
they prove ultimately ineffeual. 
The late general deficiency of the effen- 
tial articles of nourifhment, has rendered 
the office of a phyfician who is employed’ 
to a great extent amoneft'the lower clafles 
of the community, not only unfpeakably 
painful to himfelf, but in too large a pro. 
portion of cafes almoft entirely unprofit- 
able to his patients. How ulelefs is it to 
adminifter phyiic to perfons whe are want- 
ing fool! Medicine is butea poor fubfi- 
(ute for meat : fo far indeed is the former 
from performing the office of the latter, 
that it often aggravates the fuffering that 
arifes from the want of it, by awakening 
an artificial appetite, the violence of whigh 
there are no natural means of fubduing. 
Waw, 
{pas 
REVIEW 
\ 
3 N 
