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of Malaria. Death here walks hand in hand with the sources of life, sparing none; the labourer reaps his harvest but to die, or he wanders amid the luxo ury of vegetation and wealth, the ghost of a man, a sufferer from his cradle to his impending grave; aged even in childhood, and laying down in misery, that life, which was but one disease.”
This eloquent representation, is fully corroborated by M. Chateauvieu, in his Account of the Agriculture of Italy, from Pisa, p. 87, to Naples, p. 102. See Rigby's Translation of Chateauvieu's Agricultural Travels into Italy.
The chances of life in England, are variously calculated from forty to fifty years. In many parts of Holland, they are not more than about twenty-five. In many places of France, they are reduced by malaria to twenty and eighteen years. Sicily and Sardinia, and much of Greece, are similarly affected. Lincolnshire, Essex, and Cambridgeshire, and the North Riding of Yorkshire, are known seats of this pestilence in England. Oliver Cromwell died of it: and although we are become much better acquainted with its effects, and its habits, than formerly, great ignorance still prevails, even in England, on this interesting subject. People are not yet aware of the many situations pregnant with latent disease, where danger is not suspected ; nor are they aware of the anomalous forms of indistinct, but painful suffering, attributable to this cause, where the absence of intermittent or remittent diseases induces a dangerous confidence and security.* Nor are the rich aware how much their own health and comfort depend on enforcing and maintaining cleanliness among the poor. They are not aware of the heavy price they pay for artificial lakes, and ornamental pieces of water, for reservoirs and fish ponds, and thick shrubberies, damp with luxuriant vegetation, near the principal mansion; or the danger too often attending the delightful rambles on the banks and borders of such places, in the cool of a summer's evening in August and September.
Nor are we sufficiently aware, either in England or in this country, that in travelling for health, the valetudinarian, in a majority of cases, on the continent of Europe, is apt to fix on situations exposed to this fertile source of disease and death. Nor has yet any good list of places on the continent been published, (Captain Smith's Statistical Tables of Sicily excepted,) the ac
* Dr. M'Culloch is inclined to ascribe to this cause, the following list of disorders.--Yellow, remittent, intermittent, and nervous fever. Dysentery, diarrhea, cholera, visceral obstructions. Dropsy, ædema, obstructions of the liver and spleen. Neuralgia, and, in particular, that form of it, the tic doloreux; to which we would be strongly inclined to add the dengue of the Havana and Charleston. Scrofula and goitre. Hebetude of intellect, and general lassitude; a Baotian diathesis. Rickets, hernia, rheumatism, sciatica, tooth-ache, asthma, peripneumony, dyspepsia. Palsy, phthisis, chlorosis, are doubtful. Not that these disorders, or any of them, do not in many cases originate from other causes, but that they are in many cases fairly ascribable to the effects of malaria or miasma. curate result of observations made with a medical eye, which the sick may consult with confidence, and in safety, without the hazard so often incurred, of meeting disease and death in an additional form abroad, while they are trying to escape them at home.
To be tolerably well informed of the nature and character of a poison so fatal when concentrated, so destructive of bodily comfort, when we are exposed to it, even in a diluted state, and to be aware of the places liable to produce it, cannot but be important to every member of society, without exception. It forms the most prominent feature in the police of health. To give some correct, but general ideas of this too common, but unsuspected source of so many disorders, the present volume has been written ; and, although many persons will be inclined to think that Dr. M'Culloch has carried his fears and denunciations to a need. ess extent, we are persuaded, that the fault, if a fault here be, is a fault on the right side; nor do we know of any medical treatise, (if this may be called one,) so generally interesting, and so much needed in the present state of public inattention, as the book now before us. Even in our own country, without recur ring to the swamps of the Carolinas, or the eastern shore of our seaboard, from Jersey to Georgia, how many of our cities, Phi. ladelphia and New-York, for instance, abound in their outskirts with marshy places, puddles, ponds, and receptacles of vegetable filth, to which, in addition to the banks of rivers and streams, no physician will hesitate to refer the intermittents and remittents of our autumnal seasons. In fact, what at New Orleans will produce yellow fever, in Virginia will give rise to bilious remittents; in Massachusetts and New Hampshire, to agues, dysenteries, cholera, and diarrhoea. We do not say, that the many of the numerous tribe of disorders originating from the cause now under consideration, are to be attributed to it exclusively, but it is the usual and general source of them; and it behooves the public to be aware of this : the treatise now under consideration, therefore, is, in our opinion, most important and most wel. come.
Nor is it the mere production of individual disease that forms the great mischief of malaria. Mr, Foderé, in his Traité de Medecine legale, t. v. ch. i. observes, that it stints and debilitates the population, even where there is no particular disease.
Ch. 2. Nature of the evidences respecting the production of Malaria in places of less suspected character.
Among travelled men of education, as well as among physicians, no doubt remains of intermittent and remittent fevers and dysenteries, being the consequence of moist and marshy places, where vegetables grow and die, and are enabled to putrefy by the warmth of the climate or season: but, among the common people, and those unused to reflect, these disorders are generally confounded with typhus, or attributed to exposure to cold, to damp, to fatigue, to too much indulgence in summer fruits, or to any cause but the true one. Not that improper diet may not easily aggravate the influence of other causes, or become of itself a source of disease, but the general and prevailing cause of our intermittent fevers is malaria ; and of this, among medical men, there is no doubt or dispute. Whenever, therefore, these, or analogous diseases, are observed to prevail, the source of them is the same, even if no marsh, swamp, or pond, be near the place. Some current of air blowing from a marsh, or some other collection of putrefying vegetable substance, less subject to common observation, is undoubtedly in the neighbourhood.
In addition to Dr. M'Culloch's remarks on this head, we would observe, that the stench so often arising in summer from the gutters and drains of all our Atlantic cities, from New York to Charleston—the practice of piling up damp wood in damp cellars, in the summer and autumn, when fuel is cheap—the carelessness of disposing of the waste vegetables of a family—the filth of alleys and by-places-and other unsuspected causes of this nature, may produce, if not actually fevers of a marked character, yet disorders, irritations, and obstructions of the funetions, that often render life uncomfortable, without having their nosological names precisely given. For want of diffused knowledge on this subject, attention is turned from the true to false causes, as giving rise to these disorders, and remedies are applied in vain. Much indefinable ill health, and many of the numerous complaints termed nervous and dyspeptic-many of the pains and aches attributed to rheumatism, would be referred to the cause in question, by physicians whose attention had been duly turned to it.
“An acute and unprejudiced observer," says Dr. M'Culloch, p. 22, " taking this view as his guide, may easily satisfy himself of the real nature of the id health, in the situations under review : but he will also find, that this does not constitute the whole of the diseases thus produced ; as, if he will review his own practice on such inhabitants, he will find dysentery, often or generally, called diarrhea, one of the prevailing elements, and, perhaps, cholera : together with headaches, periodical, or irregular rheumatism of the face or head, as it is called, tooth-ache, sciatica, with tic doloreux, or other varieties of neuralgia, (Dengue ?) bilious affections, as the phrase is, and a whole catalogue of all the nervous ailments, which, at different periods, under different fashions, have been attributed to various causes, to the nerves, the spleen, the stomach, the liver, and now, in the more convenient phraseology, to the chylopoietic organs.
“The whole condition, in fact, (p. 24,) of a people so situated as I have now sketched it, is precisely that of the inhabitants of the pestiferous districts of France, Italy, and elsewhere ; since in these, and independently of the noted epidemics, or the occasional severe or marked fevers, the population is, perennially, and even through life, subject to a whole catalogue of chronic ailments : the only difference being, that in our own, (British,) far less unwholesome districts, of a similar character, these are less violent, and commonly also less perennial and durable.”
· If the spots in question are known occasionally to produce the common intermittent, it is ground enough for us to ascribe the other forms of malady, observed in the same situations, to the same cause. But, the intermittent of spring, and the remittent of autumn, are not always produced in places where we should make no scruple to assign the usual cause of these disorders; visceral and glandular obstructions are frequent sub. stitutes: nor does this cause always produce the effect expected. This may arise from the state of health of the inhabitants, and from idiosyncracies; for, the rule is universal, quicquid recipitur, ad modum recipientis: every prevailing endemic and epidemic, is modified by the constitution and diathesis of the individual, and attacks usually the weakest system of organs. But our knowledge of marsh miasma, and its mode of operation, is at present too much in its infancy, to authorize a demand upon us to explain all the apparent anomalies.
As persons who have once been subject to the effects of malaria, and afflicted with the disorders it produces, are more susceptible than other people, of being again affected by similar causes, their being so affected in any particular locality, is reasonable ground to suspect the same cause operating there, though the common disorders produced by it, have not been observed among the inhabitants in general, in any precise way, or with marked character.
The effects of malaria are not always marked and sudden; they often come on gradually; they affect the functions, then the constitution, and induce at length a morbid diathesis, till constant exposure to the source of disease ends ultimately in death. In the fens of Lincolnshire and Essex, on the banks of the Rhone and the Loire, at Mantua, Ferrara, Syracuse, Cagliari; even in the Campania of Rome, and the banks of the Tiber, children are born, and live; but they live usually a life of suffering, and die long before the usual period of healthy old age. Such are the facts : why the cause is so tardy and gradual in its operation, we shall know better, in proportion as our observations are more frequently and accurately repeated.
Ch. 3. On the soils and situations that most commonly produce Malaria.
It has been supposed that salt marshes are not productive of malaria. This is a mistake. They are so in Normandy, on the French shores of the Mediterranean, on the Adriatic : they are so in Greece, Italy, Sicily, and Sardinia: in Spain, in the Crimea, and throughout the southern part of Europe. The proportion of salt in sea water, may contribute to resist putrefaction in cold climates, and it may have a different effect in warm ones. In Holland, the severest seasons of fever have succeeded irruptions of the sea. It is safer to be alive to the possible danger, sustained as it is, by so many facts of a positive nature.
Thick woods are productive of the malaria fevers. The Jungle is a low thicket of reeds and grass, where vegetation is rank, and where the ground is of course moist. Of the Jungle fever, it is superfluous to say more. According to Buchanan,
even the more open woods in Mysore and other parts of India, are not exempt from a similar objection. In our own country, (the United States,) we have never heard of open woods being liable to this objection; although in South Carolina, every body is alive to the danger of close, thick, and luxuriant vegetation. The pine barrens are always healthy, if no marsh or pond be near. But the neighbourhood of close and thick woods, producing putrefying vegetable matter, is every where found to be more or less unhealthy. No Southern man entertains a doubt of this.
Sometimes, woods are a screen, preventing the prop of malaria. The ancients held groves to be sacred, aware perhaps of this use of them. The unhealthiness of the Porta del populo at Rome, arose from cutting down a wood that served as a screen to that part of the city. The dreadful fever affecting the first settlers of the Genesee country, from 1796 to 1800, arose from their clearing and settling the rich bottom land. In the early part of our wooded country, unhealthy situations were limited in extent; at present, malaria is wasted to great distances, putting on an epidemic character: and it will be so, till accurate cultivation shall have drained all our marshy spots. The clearing and breaking up of new ground among us, is an operation often attended by the diseases of marsh miasma. Hence, we have no doubt, that, as the country is laid open, and the climate rendered warmer by more free exposure to the sun's rays, the diseases formerly limited and confined, will be not so severe, perhaps, owing to dilution, but more numerous, and extend over a much larger tract of country than heretofore. Such was the case of the fever of the Shenandoah valley, from Winchester through Carlisle, and to Easton, in 1804.
Rice grounds in India, in Italy, in our Southern country, are peculiarly unhealthy, though this has strangely been denied in India. No planter of our Southern states, would doubt it for a moment. Obstructions of the liver, and other viscera, may take place sometimes in lieu of bilious remittents, but what physician in the South has any doubts about the cause?
Ch. 4. The same subject continued.
Malaria may be concentrated in the spot where it is generated, or it may be diluted, when wasted to a distance. * The inten
Dr. Rush was of opinion, that the severe remittent and bilous fevers of a marsh, were converted into intermittents, when diluted and carried to elevated places in the neighbourhood.