« 
1800. ] 
would prefent lifts of difeafes widely diffe. 
rent: gout and hyfteria might ftand foremoft 
jin the one; contagious fever, and dyfentery 
in the other. It isto be lamented, however, 
that from the fedentary life to which a great 
portion of the poor in large cities are fubjet- 
ed, and from the univerfal 
ufe of tea, and particularly of fpirituous li- 
quors, which prevails amongf them, a confi« 
derable number of complaints, which were 
once almoft peculiar to the rich, are now 
fuperadded to thofe which more efpecially 
attend a ftate of poverty; fo that a report 
of the difeafes of the lower clafs may, in 
too many inftances, be regarded as a general 
{pecimen. 
It is well known, that an acute difeafe is 
often epidemic in one part of an extenfive 
city, while in another few or no traces of it 
are to be found ; that frequently it does. not, 
till after a confiderable time, fpread itfelf 
uniyerfally ; or perhaps after a partial ex- 
tenfion only, it becomes extin@t, leaving 
many parts wholly untouched by its in- 
fluence. ; 
It is obvious alfo, that of many kinds of 
evidemics, a fmall proportion of cafes only 
fall under the notice of medical practitioners. 
This obfervation applies particularly to thofe 
difeafes of the poor which are of fhort dura- 
tion, or are mild in their nature. Hence, in 
a public difpenfary, it is found, that the cafes 
of meafles, of fcarlet fever, and of hooping- 
cough, bear not the fame ratio to the actual 
prevalence of thofe complaints, as the cafes of 
moft other difeafes which occur in fimilar 
practice. It may be noticed alfo, that an 
gnftance of fmall-pox is rarely to be met 
with ata difpenfary, owing probably to the 
general ufe of inoculation, and to the efta- 
blithment of a {mall-pox hofpital. 
Notwithftanding thefe circumftances, how- 
€ver, it is prefumed, from the example of 
fimilar reports lately prefented to the public, 
that fuch an one as that now propofed to be 
Siven, may afford fome ufeful information 
refpeciing many epidemic difeafes both chro- 
nic and acute, fuch for inftance as of fevers, 
pneumonia, dyfentery, diarrhea, rheumatifm, 
catarrhal affections, &c. 
Were a certain number of phyficians, in 
different parts of the metropolis, as well 
thofe who belong to medical charities, as 
thofe who are engaged in extenfive private 
practice, to unite in publifhing periodically 
the refult of their obfervations ; an accurate 
and comprehenfive view would then be regu- 
larly obtained of the ftate and progrefs of all 
the difeafes which prevail throughout Lon- 
don; and there is good reafon to’ believe, 
that, from fuch a plan well conduéted, a body 
of evidence might, in no long time, be pro- 
duced, which would elucidate many obfcure 
and intricate points relating to epidemic dif- 
eafes. That it would, in the mean time, 
prove a ufeful guide to practitioners in gene- 
zal, no one who is ignorant of the influence 
nd exceffive, 
Lift of Difeafes. | B89 
of epidemic diforders on each other will veqe 
ture to deny. “ye 
The moft important clafs of difeafes, enu« 
merated in the foregoing lift, is that of conti- 
nued fevers. Under this term are compre= 
hended the typhus and fynochus, in their 
different degrees and varieties, whether arif= 
ing from contagion, or from cold and other 
debilitating caufes. Fevers, we are happy 
to fay, have, for fome time paft, been gradu- 
all declining, both as to the frequency of 
-their occurrence, and the malignity of their 
fymptoms. The number of cafes during the 
months of Oétober, November, and Decem- 
ber of the laft year, were to thofe which 
have happened fince the beginning of the 
prefent, nearly im the proportion of four to 
OnE -sh ee) 
The accurate defcription of the fever 
which prevailed at the latter end of the an= 
tumn in another quarter of the town, infert= 
ed in the *Medical Journal for November, 
accords in general with the fymptoms of that 
which occurred within the fame period in 
the Finfbury diftri@ : there were, however, 
fome circumftances of diftin@tion. The latter 
was decidedlyof alefs malignant nature; for, oF 
between fifty and fixty cafes, which fell under 
theobfervation and treatment of one of the phy- 
ficians, in O€ober and November, three only 
terminated in death; whereas, in the for- 
mer, the proportion of fatal cafes was as one 
in four,—-ten out of forty-one having died. 
In the latter alfo, adiftin crifis was feldom 
or ever obfervable, the figns of amendment 
fhewing themfelves in the mof gradual man- 
ner, fo that it was difficult to mark the ex~ 
aét time of their appearanée. Thefe figns 
for the moft part were, the patient becoming 
compefed, and falling into an eafy and ree 
frefhing fleep, after a ftate of watchfulnefe 
and irritation 3 his exprefling himfelf to be 
more comfortable in his general feclings ; 
the eyes and countenance refuming their na- 
tural afpeét; the edges of the tongue begin- 
ning, to look clean; the pulfe becoming 
ftronger, more fteady, and lefs frequent ; 2 
diminution of the heat of the fkin, and a re~ 
turn of its ufual foftnefs. Of thefe beneg- 
cial changes, fometimes one, fometimes ano- 
ther, gave the earlieft notice of recovery 5 
but the firft ray of hope was generally te- 
flected from the eyes, and the features of the 
face. 
The moft common period of the termina- 
tion of this fever was the end of fecond week,” 
or about the fourteenth or fifteenth day. 
In a few cafes, the difeafe was protraéted to 
an unufual length, in one of which, a univer- 
fal yellownefs of the fkin, pain about the re- 
gion of the liver, and violent vomiting, 
twice occurred, at firft during the third week, 
and the fecond time at the end of the fixth, 
when it proved fatal. The patient, who 



* See Report of Difeafes, by aPhyfician at 
the Weft End of the Town. 
Was 



