VmCF
 1834
« 
ARMY MEDICAL LIBRARY
FOUNDED 1836
WASHINGTON, D.C. 
 
 
.•J**8"
k)     ^/
THREE LECTURES
ON THE
ORIGIN AND PROPERTIES OF
MAL.ARIAOR MARSH MIASMA,
WITH THE BEST MEANS OP PREVENTING ITS FORMATION AND OP
   OBVIATING ITS EFFECTS ON THE HUMAN CONSTITUTION,
           WHEN THIS CANNOT BE DONE.
DELIVERED TO THE MEDICAL CLASS
OF THE
UNIVERSITY OF VIRGINIA.
BY
       AMfalED T. JJ.AGILL, M. D.
PROFESSOR OF PHYSjfcLOGY, PATHOLOGY, OBSTETRICS, AND MEDICAL JURIS-
           PRUDENCE, IN THAT INSTITUTION.
    CHARLOTTESVILLE:
PRINTED BY WATSON & TOMPKINS.

         1834. 
*"'VEJ[
i  m 
ON  MALARIA*
                   Causa latet, vis  est notissimma.

   The subject of Malaria, or marsh effluvium, has for a long time at-
tracted much of the attention of the Medical Profession, and interested
to a  high degree the feelings of society at large.   Physicians of all
countries have  tortured their  brains, and  exhausted all the known
resources  of the Chemical art, in attempting to discover the proper-
ties of  this invisible agent of disease and death, which prostrating in its
silent march whole  cities and  communities, bids defiance to all  the
measures hitherto suggested to  stay its destructive progress.  Unques-
tionably it is one of the most  important subjects which can be pre-
sented  to the contemplation of man;  to detect the  causes which ori-
ginate ; to ascertain and define the laws which regulate, and to discover
means by which the human family may be shielded from this " pesti-
lence which  walketh in darkness," would form  a suitable and  noble
employment for the Philosopher  and Philanthropist, as well as  the
Physician.
   None of  all the  many " ills which flesh is heir  to," has probably
been so prolific of destruction and misery to the race of mankind, as
miasmatic exhalation.*  In  all quarters ©f the world except the  fri-
gid and ice-bound north, where  perpetual winter " rules the year," this
scourge of  humanity, has been  occasionaly found, breathing disease
and death upon all within the range of  its morbific influence.  In the
east  and  in  the  west, its  withering and desolating  effects have been
felt in all their terrific severity.f   Along the classic shores of the Me-

  *It is computed that upwards of one half of the human race perish by fever in
one or other of its forms.)  Miasma is  the principal if not the only cause of fe-
brile disease.
  tAccording to the report of the committee, consisting'of Dr. W. Ainslie, PresL
dent, and Mr. A Smith, and Dr. M. Christie, the fever which  prevailed in the pro-
vinces of Coimbatore, Madura, Dindigul and Tinnivelly, in  the years 1809,1810
and 1811, consigned to the grave 106,789 persons, to which may be added the rujn
of the  constitutions of many thoueands. 
4
 diterranean it has pourd with a liberal hand the " vials of its wrath."*
 The shores of  Africa, that region of mental darkness, though harm-
 less to  the natives, are  fraught with the seeds of disease to  the  Eu-
 ropean and American constitution :   Witness the lives that have been
 and still are annually sacrificed upon the altar of  Colonization.  The
 extensive marshes of the Netherlands  have often proved the sources
 of  severe and wide-spread  disease.f   Our own highly favored land
 almost  throughout its entire extent, has  frequently been visited  by
 extensive and malignant epidemics, increasing in frequency and seve-
 rity as  we proceed southward.   The bold  and majestic rivers which
 flow  through our country, and beautify its  scenery, often prove the
 source  of destructive epidemics.   The " king  of rivers," the grand
 and magnificent Mississippi, like the Nile of Egypt, and the Ganges of
 the East, while it fertilizes the soil by its extensive annual inundations,
 spreads at the same time far and wide the seeds of  disease.
   Miasmatic exhalation  as a cause of disease seems to have entirely
 escaped the notice of the Ancient Physicians.   The keen and scru-
 tinizing mind of Hippocrates, confessedly the  first among the  ancients
 for talent  and observation ;  and in more modern  times, the sagacious
 intellect and unequalled observation  of  Sydenham, (both  of  whom
 paid especial attention to the causation of fever)  failed to  detect this
 prolific agent of disease.   The merit of its discovery  was reserved
 for Lancisi, and Italian physician, who, about  the  beginning of the last

  *Of all the countries lying along the Mediterranean, Italy  has probably suffered
 most from Malaria.  Rome once the proud" mistress of the world," in her career
 to greatness and splendour,  had often well nigh been annihilated by the blight-
 ing hand of pestilence.   Livy  mentions  the occurrence of fifteen plagues before
 the year Ab. Urbe Condita 59, and no one now doubts that they  were produced by the
 pestiferous exhalations from the neighbouring marshes. One would have supposed
 that these severe visitations, before she had acquired the bone and musele of matu-
 rity would have given a permanent check to her growth, but the cupidity and en-
 terprise  of man can triumph over apparently insuperable difficulties.   All that
 portion of Italy too, which is bounded on the one side by the Mediterranean, and by
 the Appennines on the other, and extending from Pisa on the north to Terracina
 on  the  south, has been rendered a complete desert by the  Malaria in which it
abounds.  This portion of the country (says Griffith,) is almost uninhabited, " and
 the appearance of the few wretched beings whom necessity detains there is fright-
 ful  in the extreme, exhibiting the effects of the noxious exhalations in every form
 of bilious disorder."  Other countries along the sea coast, have also occasionally
 suffered  from this scourge most severely.  In Gibralter, in 1804, out of a popula-
 tion of about 10,000, there perished from the 1st  of September to the 31st of De-
 cember inclusive, 5946 individuals, being more than one half of the inhabitants.
 In  1810 another destructive pestilence  ravaged the same place which is clearly
 proved by Dr. Buinett to have arisen from marsh exhalation.   In Cadiz in 1800,
 out of a population of about 60,000, the number of the affected from the beginning
 of August to the first week in November, amounted to 48,520.

  tThe  famous Walcheren expedition of the Biitish in the year 1809 is still fresh
 in the recollection  of many.  Out of sixteen  thousand  troops, constituting the
 whole Britiah force, thero was on the 23rd of September 9,800 prostrate with the
 fever. 
5
century published a work on the subject, entitled, De noxiis paludum,
Effluviis, eorumque remediis, in which its origin and characteristics ate
investigated with considerable minuteness.
   Malaria  has a two-fold operation  upon the human constitution.—
The first consists in the production of active disease, or fever strictly so
called ; the second relates to that gradual deterioration and undermin-
ing of the powers of the system, which is the result of an habitual ex-
posure to an atmosphere polluted by this deleterious principle, by which
premature  old age, with  its  usual attendants, imbecility of mind and
decreptitude of body, is brought on. This latter has been denominated
by M. Monfaleon,  the Physiological effect of Malaria.  " Man (ob-
serves he)  in marshy countries, is of small statue, and often deformed
from infancy  either in the trunk or members, with a remarkable dis-
proportion  in the splanchnic cavities.  His  skin is  pallid, and often
covered with spots of an earthy appearance.  His muscles are flabby,
his fat of a watery nature—his hair and beard fair—his complexion
pale  and sickly looking—his physiognomy exhibiting even in youth,
indications of age, as well as of melancholy, apathy and hebetude.  At
twenty-five the work of decay  commences, and the great majority die
between the age of 35 and 50 years."*
   " Travellers who  have visited  and  observed the inhabitants of the
Pontine marshes in  Italy, have drawn a most  melancholy picture of
these wretched  people.   They have compared them to spectres, and
could not find words to  convey the impressions which their  appear-
ance made on  the minds of  strangers.   M. Pioney assures us, (con-
tinues M. Monfaleon)  that in the  year 1777, when he visited the cen-
tre of the  Pontine fens, the greater part of  the inhabitants presented
such an oedematous  state of body, that the impression of the  fingers
would remain on any part of the body for hours together.  Many
peasants were seen on the road, apparently asleep.   They had  as it
were ceased  to exist.   He asked one of the  unfortunate sojourners
in the Campagna di Roma how  he could live  in such an  unhealthy
place?—"We do not live" he replied, " we die here."f   Such is the
dark picture drawn  by those who have  witnessed the ravages of  Ma-
laria upon  the constitution of the  unhappy wretches, who  from neces-
sity are habitually subjected to its influence.   Other writers,  mention
this slowly pernicious,  though  ultimately fatal operation  of Malaria.
Johnson in his invaluable work on tropical climates, remarks—"I have
myself, in rambling through the villages  of Beveland and Walcheren,
been struck with the conspicuous marks of premature old age, which
all beyond  maturity exhibited, particularly among the peasantry.   On
inquiring the ages of decrepid wretches, withered, sallow, and nppar-

  "Med. Chi. Review, October, 1825, p. 321.
  tlbid p. 322. 
6
rently on the borders of fourscore, I was surprised to  find that fifty-
five or sixty years were all they had  numbered in these noxious fens."
Dr. Robert Jackson, physician to the British army during the revolu-
ary war, says, "we plainly perceive that an habitual exposure to it, is
peculiarly unfriendly to the principle of life,  and in a very remarka-
ble degree shortens the period of  existence.  ******  There
is  not on  record, I am credibly informed,  an instance of  a per-
son born at Petersborough, Virginia, and constantly residing at the same
place, who has lived  to the age  of twenty-one.   When the  British
army marched through this province, in  the year 1781, I had the op-
portunity of seeing a  native of this  town, who  was in his twentieth
year, but he was said to be the first who had ever attained so  advan-
ced an age.  He was  decrepid as  if from  the effects of  time, and it
did not appear that  he could survive  many months.  Yet it is not a
little curious, that this  man had never been much confined with sick-
ness.   The  residing  constantly  in the  same pernicious air, seemed
alone to have been  sufficient  so remarkably  to accelerate  decrepi-
tude."*
   In the further consideration of this subject, for the sake  of conveni-
ence, we  will treat of it  under the following heads:—1st. What  are
the characteristics of  Malaria?   2d.  What  are  the   causes  which
produce it?   3rd.   What are the  best means to prevent its  for-
mation?   4th. When formed, what are the measures necessary to re-
move or  render inert the  sources of it?   5th. What are the  best
means  of obviating  its   effects upon the  human  system, when  the
cause cannot be removed.
   1st. What are the characteristics of Malaria ?   Though we  are as
yet totally  ignorant of the precise  or intimate nature of Malaria, we
are fortunately well acquainted with many of its  physical  qualities. I
say fortunately, because by this knowledge, we are enabled very often
to avoid  the attacks of this unseen  and silent enemy  to  our health;
whose step is as noiseless as the grave, and whose destroying presence
is  known only by its effects.
   The  first characteristic ©f Malaria which strikes us, is its superior
density, when contrasted with atmospheric air.   If not  exposed to
the action of a powerful sun, or heat from some other source, it rises
but a very short distance from the earth's surface.   It  has  been ob-

  *Petersburg in this state, the town alluded to by Dr. Jackson, is situated on tho
right bank of the Appomatox, which partially overflows  every year.  There are
also some marshes contiguous to the town.  This place suffers even now almost
every  year, more or loss from miasmatic diseases.  Malaria, however must have
abounded much more at the time Dr. Jackson speaks of (53 years ngo) than at pre-
sent, for Petersburg is now quite a large and flourisliing city, which could not well
be the case, if this cause of disease existed either in the same (juantity or intensity
now, that it did at that time.   We suspect the account given to Dr. Jackson was a
very exagerated one. 
7
served by  most writers upon the subject, that domestic animals are
the first to suffer from the presence  of  Malaria, and the fact of the
greater exemption from disease, of those  who live  in the upper sto-
ries of houses, where Miasmata abound is well known to those who
have paid any attention to the subject.   They  are not only less liable
to disease, but when attacked have it in  a milder shape.  In proof of
this, many facts may  be cited.   Dr. Ferguson states, that  " accor-
ding to the official returns during the last sickly season at Barbadoes,
the proportion of those taken ill with fever in the lower apartments of
the barracks,  exceeded  that of the upper  by one third,  throughout
the whole course of the epidemic."*   Dr. Hunter testifies to the same
fact in his work on diseases of the army  in Jamaica.  " The barracks
at Spanish-Town," says he, " consist of  two floors, the first  upon the
ground, the second on the first.   The difference in the health of  the
men on the two floors  was so striking as to engage the attention of the
assembly of the Island,  (of Jamaica,) and, upon investigation, it ap-
peared that three were  taken  ill  on the ground  floor, for one  on
the other.  The ground  floor was not, therefore, used as a barracks
afterwards.f Bancroft, Pringle and others mention  similar facts.   It is
also capable of being  driven by the wind, elevated situations  afford
on security against the  approach  of Miasma.  Where the ascent is easy
and not abrupt or precipitous, it may and has been propelled by  the
wind to the tops of high  mountains.   It may be carried, horizontally
by the same  agent a  very  considerable distance,  amounting,  in the
opinion of some to several  miles.  There is ,however, in relation  to
this much difference of opinion.   Bancroft limits its sphere of action
to " a quarter and perhaps half a mile."   We  cannot  but  think
however,  that  he is wrong; he appears to have formed his  opinion
from  the distance at which Malaria  ceases to produce disease when
driven over a body of water.  There can, however, be no doubt, from
the multitude of facts on  the subject, some of which we will presently
mention,  that it soon looses its deleterious qualities by contact with
water, and therefore, that the distance at which its  effects may be ex-
perienced under such circumstances, cannot  apply to its operation
under other circumstances.  The Pontine marshes are several miles
from Rome, and the  fevers which have for ages infested that city and
its vicinity, have  been universally ascribed to the  poisonous exhala-
tions from the  above mentioned  marshes.  " It would be a matter of
utility (says Dr. Jackson,)  could we determine with any certainty to
what distance from its source, the noxious Effluvia  extend ; but this is
a question which we cannot hope to ascertain  exactly.   It is not uni-
formly the same in all situations,  depending upon   the  concentrated

  •Phil. Journal, No. 13, p. 18.         fp. 300, as quoted by Bancroft. 
d
state of the exhalation at its source, the obstacles it meets with in its
progress, and the nature of the ground over which  is passes or is  di-
rected.   I have known its influence very remarkable at the distance
of a mile and a half, on the top  of a hill of very considerable eleva-
tion."   *But though it is sometimes thus extended in its operation, it
is also occasionally most remarkably and unaccountably circumscribed
in its influence.   Bancroft states a curious fact of this sort, " being at
the Horse Guards on  the 19th November, 1810, I saw.there Captain
McKoy, of  the 21st Regiment of foot, who had then just arrived with
despatches  from  Sicily, and  was informed by  him that, in July and
August,  1800, while  his  own and another company were quartered
at the post of Venetico, in a barracks of nearly 100 feet in length,
which consisted of one (ground) story, forty men  of the other company,
occupying one half of the barrack, were attacked by a violent Ma-
laria fever, which proved fatal-to eleven of them, but did not reach a
single man of  his own company,  occupying the other half of the bar-
rack, though there was no division between  the  parts or  halves occu-
pied by the two companies, nor any perceptible  difference in the soil
on which the different parts or  ends of the barrack stood. Each had,
indeed,  its  own door  to pass into and out of  the  barrack, but  both
doors opened on the same side;—nor was there any difference in the
discipline, diet, or management of the men of the two companies."!
  Malaria  is deprived of its febrific qualities by passing over even a
small surface of water.  In what manner this gas is thus  robbed of its
pernicious properties it is impossible to say, it is most probably absorbed
by the water, as we  know it has a great affinity for moisture, being most
frequently  found  entangled in fogs and dews.  There  can however
be no doubt of  the fact.  Bancroft  details many striking instances of
the immunity from disease enjoyed  by those whose duties kept  them
off the shore,  the entire crews of vessels, stationed within less than a
quarter of a mile  of the shore, where  disease was prevailing to a most
alarming extent,  escaping  without  the  slightest indisposition.  Dr.
Rush says " the Yellow fever has never been known to pass from  Phi-
ladelphia to the Jersey shore, and the miasmata generated on the east
side of'the Schuylkill  rarely infest the inhabitants of the opposite side
of the river.   Many persons found  safety from  the plague  of  Lon-
don, in 1665, by flying to ships  which lay in the middle of the Thames,
and, it is well known   no instance ©f  Yellow fever occurred in those
Philadelphia families that confined  themselves to ships in the  middle
of the Delaware,  in the year 1793.   But three or four  of four hun-
dred men, on  board of a ship of war  called the Jason, commanded
by Capt. Coteneuil, perished with  an epidemic Yellow  fever, in the
•On Fever,p. 268.
(On Fever, p. 1G7. 
9
year 1746, at  St. Domingo, in consequence, Dr. Desportes says, of
her hold being constantly half filled with water."*
   Another peculiarity of Miasmatic exhalation,  is the acquisition of
augmented virulence  and activity during the night.  Dispersed by the
rays of a powerful sun, it remains in the higher regions of the atmosphere
during the day, but when he withdraws his vivifying beams, and the
heated air begins to cool, no longer sustained by this rarifying princi-
ple,  in obedience to  the laws of gravitation it begins to descend, and
finally settles upon the  earth  in its greatest degree of concentration.
Its effects under such circumstances are often  appalling.   Dr. Fergu-
son, speaking of the  swamps at English Harbor, in the island of An-
tigua, remarks, that, " so pestiferous was their atmosphere, that it often
occurred to a well seasoned soldier, mounting the night guard in per-
fect  health, to be seized with furious delirium, while standing sentry,
and  when carried  back to his barracks, on Monk Hill, to expire in all
the horrors of  the black vomit, within less  than 30 hours from the first
attack."  Lancisi  the discoverer of this morbific principle, was well
aware of the aggravaied  virulence of this gas, during  the night, and
thought  that a  state of somnolency rendered the individuals exposed
to it much more susceptible of its bad  effects, and in consequence of
this belief, earnestly warns travellers against sleeping'or even journey-
ing during the  night through the Pontine marshes.  " Neque vero so-
lum dormientibus   noxius est per  noctem  palustris aer;  sed  etifm
iis qui vigilantes per  coenosa  loca interfaciawst.   Qua de re monitos
vellem,  quotquot vel  Neapoli Romam, vel Roma  Neapolim conten-
dunt, wt diurnos potius oestus subeant, quam nocturni frigoris voluptati
decepti contemeratam ambientis aeris vim excipiant."f  " Similar ad-
monitions (says Bancroft) are still given at  Rome to all strangers, and
they are founded on  the uniform experience of all ages, which has af-
forded numerous instances of travellers, who in consequence of their
passing  these fens during the night, (though the passage requires but
six or eight hours) have been attacked with violent and mortal fevers."§
Johnson in his  work on Tropical Climates details  some melancholy in-
stances of the dire effects of Malaria after  night fall.  " In the month
of November,  1804,  two parties of men,  belonging to  his  Majesty's
ship  Tremendous, were  employed on shore,  at the island of Mada-
gascar ;  one party, during the night, filling water, the  other cutting
wood during the day.  Four of the night party were attacked with
the endemic fever  of the country, and three of them died.   The
whole of the day  party  escaped the fever, though exposed to an  in-
tense sun in the laborious occupation of wood cutting."

  "Rush. Inquirios, vol. 2, p. 130.     .fPhil. Journal No. 13, p. 12.
  fl)e Nox Palu. Efllu. p. 80; as quoted by Bancroft     §On Fever p. 1G7
                      2 
10
     About two years after this, his Majesty's ship Sceptre, in the same
   place and upon a similar occasion, experienced a still greater disaster
   among her watering or night party, to whom the mortality was chiefly
  confined.
     Another instance of mortality unprecedented  in the annals of me-
   dicine occurred among the crew of his Majesty's ship Braave, which
   sailed from Madras in the month of June, 1800, in company with the
   ships Centurion, Daedalus and la Sybille, on a secret expedition against
   Batavia.  This  vessel at  first, " lay  at anchor under the small island
   Onrust, about three miles from the main  land of Java."  Some little
   sickness occurring among the men of the 12th  Regiment, stationed
   on the island,  " the commanding officer of the expedition, conceiving
   that the vicinity of the island to the  main land was the cause of the
   sickness, *  *  * ordered the sick to  be removed on the 28ih of Sep-
   tember, to the small island of Edam, situated  nine miles out  to sea ; a
   circumstance  that he  thought must  insure  its salubrity."  " Edam"
   (says Johnson) " is covered with  trees, long grass, and  jungle, having
   a  part of  the  island itself in a stagnant and marshy state."  *   *   *
   Of sixty soldiers (12th Regiment) landed at  different times, in healthy
   to do duty at  Edam  Hospital, and other buildings on the island, be-
   tween the 1st  of  October, and the 12th of November, thirty one died :
   Of the remaining twenty nine embarked on breaking up the blockade,
   twenty two died at sea; the other seven were sent to Malacca Hospi-
»  tal, where all,  or nearly aJl of  them shared the same fate."
     All the soldiers getting ill en  Edam, sixteen  marines were landed
   from the Centurion, to do night  duty, as they expected  an attack from
   the Dutch Gun  Boats.   The whole of  these men were seized with
   the fever, and thirteen died."   Such is the  sad history of the appal-
   ling effects of marsh exhalation  when in  a highly concentrated  state.
   In this instance too, the mortality was confined to those who spent the
   night on the island,  The surgeon who gives the account of the  dis-
   ease and  remarks, that  " from our first arrival at Batavia, in  August,
   until our return  to Malacca, in January following, we only buried one
   man of fever, who had not slept on the shore at Edam,  Cuypers, or
   Onrust island, whereas almost every  person, who slept even a single
   night at Edam died.   No ill  effects  were experienced from going on
   shore in the day time, or among  the sick  at the island, I myself regu-
   larly visited the hospital at Edam every day with perfect impunity, till
   one night that I staid rather late, attending the unfortunate surgeon of
   the Daedalus ; in consequence of which,  1 was three days afterwards
   sized with fever, but recovered by  mercury carried  to ptvalism.  I
   think it highly probable, however, that had 1 slept on shore," no medi-
   cine would  have saved my life."f
'On tropicil climates, vol 1, p 215
tlbid. p. 222. 
11
  In this account we have a striking examplification of the fact of the
entire dispersion of Malaria by the  heat of the sun during the day,
and of its subsequent descent at the approach of and during the night.
  The  period  of  time during  which it may remain inactive,  after its
reception into the system, is a subject of much difference of  opinion,
among medical men.  Johnson says, " the space of time which inter-
venes between the application of the poison to the system and its osten-
sible operation in the form of fever, depends on the degree of its con-
centration, and the predisposition of  the patient.  It will  for instance,
be found in some places so powerful, that a man in perfect health by
remaining on shore during the  night, in marshy situations, and wet or
autumnal seasons,  shall have the  fever violently the next day, and die
on the third or fourth.   On the other hand it may be applied  in so di-
lute a state, as to  require eighteen, twenty, or even thirty  days to bring
on a fever;  and even then, perhaps,  only in  consequence of  some of
the numerous predisposing or auxiliary causes concurring to enable the
original to develope itself.  If we take the medium of these  two ex-
tremes,  we  shall  have the ordinary  period, viz. twelve  or  fourteen
days, which elapses between the reception of vegeto-animal  Miasma-
ta into the  body,  and their manifestation in the shape  of actual dis-
ease*"*  Lind says that the attack in some is  protracted to the  10th
or 12th day.  The time mentioned by these authors may be, and we
doubt not, is, the  " ordinary period" at which its action is developed.
 We think however, that they fix much too short a limit to the  time
 during which it may remain inoperative.   We have not the shadow
 of a doubt  that it may lurk unperceived and unfelt in the system for
 a much longer time, and under the influence of strong exciting causes,
 may seize  its  unhappy victim  months after exposure to it, and at a
 time perhaps  when he is congratulating himself upon his fancied se-
 curity.  It is  most  frequently brought  into action during the winter
 subsequent  to its  reception into  the system;  the intense cold, and the
 vicissitudes  of this season, powerfully concurring with the lurking Ma-
 laria to excite disease ;  hence sickly winters  so often (we might say
 almost  invariably) succeed  sickly autumns, the prevalent disease ex-
 hibiting a mixed character of summer and winter disease, commonly
 known  by the name of bilious pleurisy, in which we have a local in-
 flammation exceedingly dangerous in itself, added to the usual symp-
 toms of miasmatic fevers.
   But though the winter after its reception generally brings it into ac-
 tion, we believe that the time of its incubation may be protracted to
 a much longer  period.   Dr. Hunter, in his work on the diseases of the
 army in Jamaica, relates two striking, and to us convincing, examples
 in proof of this.  The West Suffolk regiment of Militia, was  called in
fOn Tropical climates, vol I, p. 110. 
12
 ± T93, from their own county, one of the healthiest in England,  to
 Hilsea Barracks, of which the " low, marshy, and unhealthy situation
 has been  fatally known to the army since their  first erection."  The
 men were then  " all in perfeot health," but " became very sickly ;
 and twenty two died of fevers  before they left the barracks," about
 the end of June following.  In  July this regiment, with eleven other
 battalions,  was encamped at Waterdown, in  the  neighbourhood  of
 Tunbridge Wells, and  "their  sick list soon amounted  to 100 out  of
 500."  *  * *   « The  deaths  in this regiment exceeded the amount
 of those in all the eleven other battalions together,  on the same ground.
 But the point of most importance is, that some of this regiment  were
 taken ill of fever in the month of October,  who had never had it be-
 fore," nearly four months  after their removal from " the cause of the
 disease, at Hilsea barracks."
   The next instance related by  him is still stronger.   "The 18th re-
 giment of  foot, after having been stationed at Hilsea barracks  from
 the 22d June,  1783, to the 9th of October following, was then em-
 barked for Gibralter,  where, though the regiment consisted of only
 400 men,  the  number  of agues was increased  by the beginning of
 May, to 280, including women and children—of whom a considerable
 part  where then recently  attacked for  the first time, and whilst no
 agues existed in any other part of the garrison."  On these facts Dr.
 Hunter remarks,  "that the 18th regiment of foot, and the West Suf-
 folk regiment of  Militia, after leaving  Hilsea barracks, were both  in
 situations  where they could not  contract fevers, and the  regiment  en-
 camped with the latter, and those in garrison with the former had no
fevers.  There cannot therefore be a doubt, that the poison had  re-
 mained quiescent in their bodies for four, five, and six months."*   On
 these statements we do not deem it necessary to make any comments;
 even  the most prejudiced  and  incredulous must  admit that the evi-
 dence afforded by them  is of  the most  convincing and incontrovertible
 character.
   Extraordinary as these  facts  appeared to be (says Bancroft) when
 first made  known, the fullest confirmation of them has been since
 produced  by the late expedition to  Zealand; in which it has been in-
 disputably  ascertained, that considerable  numbers both of officers and
 soldiers, who  were employed  on that service, and who  escaped the
 sickness, whilst at Walcheren, and other parts of Zeland, were attack-
 ed by intermittent fevers, and some of them as late as six, seven, eight
 and even nine months, after being bioughtbackto this country; though
 care was taken to place them generally  in situations remote from all
 known sources of miasmata."f   Pringle, also, when speaking of the
 diseasesof the campaign of Dutch Brabant, in the years 1746 and 1747,

  'Dane* oft on fever, p 171 and "<    t lb id - p 17G 
13
 mentions "that  the detachments in Zealand  and Bergen-op-Zoom,
 suffered extremely from the bad air of the country, and in reference
 to this he afterwards remarks that the same battalions, in the beginning
 of the  next  campaign, were remarkably more sickly than any ol the
 rest."*
   Enough has been said, we think, to establish the point that Malaria
 may remain  in a quiescent state, during a period  extending  from the
 time of its first  reception into the system  to nine months, though the
 time of  its development in the shape of disease is usually much short-
 er.   One reason of this diversity in the operation of Malaria, both as
 to time and degree, may be found in the different degrees of its con-
 centration when  applied to the  system.  It generally possesses  most
 strength immediately at its source, and is there most speedy and ter-
 rible in its operation, but the farther it  travels from that point the more
 diluted it becomes, and the more tardy and milder  the disease produced
 by it.   Thus in  a  large city, or a poition  of  country, whose  atmos-
 phere is polluted by miasmatic  exhalation, at  different distances from
 its origin we may see all the grades of febrile  disease. Immediately at the
 'fons et origJb mali,' we may perhaps meet with the  malignant Yellow fe-
 ver; at a short remove from it, we may find  the same disease much
 mitigated in  its symptoms; still farther it will be found to produce only
 a mild  remittent,  until  reaching the  boundaries of its  influence we
 shall find the mildest form of fever namely  intermittent.
   Another reason of this diversity  in  its effects,  consists in the state
 of the system when exposed to its influence.  Constitutions  broken up
 by intemperance, or weakened by fatigue, or exposure to a hot sun, or
 great degrees of  cold, suffer soonest and most violently from Malaria.
 Thus in an army exposed to miasmata  we find the common soldiery in-
 vaded to a great  degree by disease,  while  the officers, who are well
 clothed  and  better protected from the inclemencies  of  weather, and
 indeed, are in a great measure exempt from the operation of  the de-
 bilitating causes to  which the common soldier is exposed,  compara-
 tively  healthy ;  and in large cities we find more  sickness and more
 mortality among  the wretched paupers, than in any other class of so-
 ciety.
  The moon, also,  appears from the testimony of  highly distinguished
 and veracious physicians, to exercise a marked influence over the hu-
 man frame, by which it is rendered more susceptible of the operation
of miasmata.   We have, heretofore,  been a total disbeliever  in all
such influence—looking upon it as the  mere dream of visionary theo-
rists, but candour compels the confession, that our incredulity has been
somewhat staggered by the strength and respectability of the evidence
in its favour advanced  by the  different authors, who have contended
'Pringle on disease*, p 121. 
1*1
 for it.   Dr. Robert Jackson, than whom no man had a sounder judg-
 ment, or more discriminating mind, gives the following account of the
 manner  in which he became convinced of the truth of lunar  influ-
 ence over disease.  " When I arrived in Jamaica," (says he) " in the
 year 1774, I had no other knowledge of the influence of the moon in
 fever, than what I retained from  a cursory reading of Dr. Lind's dis-
 sertation.   1 remember however  to have mentioned the  circumstance
 to several practitioners, who had  lived many years in the island.  As
 I conceived there was a similarity  between  the climates of Jamaica
 and Bengal, I thought it not improbable, that some of the practition-
 ers of the country in which I then was, might supply me with satisfac-
 tory information on the subject.  There were none of them, howev-
 er, who  acknowledged that they had ever  observed  any connexion
 between  the moon and  febrile diseases ; neither were there  many  of
 them, who seemed disposed  to give credit to its existence.  Twelve
 months or more elapsed without my having paid any further regard to
 the fact, when an  accidental relapse of fever, happening near the time
 of full moon, recalled Dr.  Lind's observation to  my  memory.  It
 likewise brought to my mind a circumstance which till then 1 had over-
 looked.   I had seen frequently, though without attending to it particu-
 larly, that three or four soldiers of a company of the 60th regiment,
 who were  quartered at Savanna la Mar, and  of  whom  I  had the
 care, were attacked with fever on the same day ; whilst it seldom hap-
 pened that any other febrile  illness made its appearance in the  garri-
 son for the ensuing fortnight.   This having been observed oftener than
 once, at  the time  the moon was  near full, a hint suggested itself, that
 the cause  which  was said  to  influence  relapses  in  India,  might
 have an effect on  the original invasion.   But in order to ascertain the
 truth of this  conjecture, I provided myself with the almanac of the
year 1776, and marked, in the blank leaf of it, the precise date  of at-
tack, of all those  fevers which came under my care.   In looking over
 those  memoranda at the end of the year, 1 found that I had put down
 thirty  cases of proper remitting fever, the invasion  of twenty-eight of
 which was on one or other of the  seven  days preceding  new or full
 moon ; that is in the second and last quarters."  The  next year, " of
twenty-eight cases which were found in the almanac, twenty-two were
 in the periods above mentioned."  Dr. Jackson, a year or two after
this, came to this country as one of the physicians to the British  army,
 and  continued  here the same  train of observation on  this subject,
which he had begun in the West  Indies, and with a striking confirma-
tion of the results  there obtained.   Of one hundred cases of fever
" which were found marked in the almanac, eighty were found to have
commenced in the usual period  of invasion, that is, in the second or
last quarters of the moon."   In conclusion he remarks, that " even in
times  of  greatest epidemic sickness, when the connexion was evident 
15
ly weakest, the number of  the sick was generally doubled in the peri-
ods approaching new or full moon."
   These certainly are striking facts, and fads upon this subject are what
we want, for it is in vain to reason about it.  The strongest  objection
against the belief  of  any such connexion between febrile diseases and
the moon, at certain periods (and to us it is a very strong objection) is
that those who contend for lunar influence owoindioaqsc, do net agree a3
to the precise stage or  period at which the moon is  supposed to exer-
cise this  noxious agency in the  production of disease.   Drs. Jackson
and Balfour being directly at issue in regard to  it.   " Non nostrum
tantas coioponere lites."
   The  question  may now  be  asked, what  are the avenues through
which this noxious principle invades the system ?  The cuticle, the
internal  surface of the nose, the tracheal  ramifications, and the mu-
cous  lining of the stomach, have each been held forth as the  exclusive
inlets for miasmata. The advocates of the sympathetic theory, and the
disciples of Broussais, contend that the stomach is the first point of at-
tack, while a more enlarged and comprehensive  view  of  the  subject
would suggest, that all the  parts of the body which have been  men-
tioned, may afford  the avenues through which Malaria gains admittance
into the system. If gaseous substances can* be absorbed by the epider-
mis, and by  the mucous lining of the respiratory apparatus, and the ex-
periment of Bichat, would appear to establish the fact, both reason and
common sense would point them  out as the chief inlets  for miasmata.
"A general idea prevails, (says Johnson) that the stomach is the medium
through  which the  matter of contagion acts ;  and,  by  anlaogy,  that
marsh miasmata  takes the same course.   But when we consider, that
at each  inspiration the atmosphere impregnated with this principle is
largely applied to the delicate texture of the lungs, it is not difficult to
conceive, that it  may pass in'.o  the blood, (if it is in any case absorb-
ed) as readily as Oxygen.   There are, besides, the Schneiderian, and
other membranes of the nares and fauces, to which it must have con-
stant  access, while there is but  one way for it to pass into the stomach,
viz. along with the saliva or food.  Further, when we  see this princi-
ple, in a concentrated state, produce fever in a few hours, with high de-
lirum, can we suppose  that it enters the system  by the circuitous route
of the alimentary canal and lacteal ?   If it be said that it acts through
the medium of the nerves of  the stomach, why not through  that of

  *It was ascertained by Bichat, that the faster from putrid animal matter gained
admittance through the skin.   Having disco/ered that the flatus of his bowels ac.
quired the smell of the air of his dissecting rooms, he respired for some hours
through a tubo which led into  the open air,  while he remained in a room contain.
ing highly putrid air.  The same effect was produced on the flatus,  as  when he
respired the  air of the room, and the same  effect was produced by  respiring the
nir of  the  room, through a tube while he remained some hours iu pure atmos-
phere."  Parsons on Malaria, American Journal, No 1:5, p 90. 
16
llie olfactories, which is a shorter road ?"*  The security which rubbing
the skin with oil,f is  said to  afford against the plague strengthens the
idea that the contagion or the cause of this fell disease, be it what it
what  it may, finds a  high road  into the  system through the pores of
the cuticle, and if the contagious essence of plague, (which in the opin-
ion of many is  neither more  nor less than miasmata)  can penetrate
the svstem through'this "medium, why may not miasmata?  Dr. Har-
rison, of Louisville, Kentucky, in an excellent  paper on the epidemic
bilious  fever, published a few years ago  in the Philadelphia Journal,
advances  a singular  argument against the supposition of the  cuticle
being the medium through which  Malaria enters  the  system,  " co-
vered, as the true skin is, (says he) with a comparatively dense, insensible
cuticle, which even warm fluids, and friction, with unctious substances
hardly  renders  permeable, how can an exceedingly subtle aeriform
substance penetrate it—or how  affect its nerves ?"   To this we would
reply, that miasmata can penetrate the pores of  the cuticle, so much the
more easily, because  it is " an exceedingly  subtle aeriform substance;"
if the Dr. had have reversed the question there might have been some
reason in it, but as it stands it has certainly no  force at all.
  What is its modus operandi in the production of disease, after it gets
into the  system  ?   The opinions upon this  subject have  been and  still
are as variant and discordant as upon  any connected with the science
of medicine.   The advocates of the doctrine  of sympathy, (if it has
any advocates now,  for it appears to  have completely succumbed to
its  more powerful  rival  of  French extraction,) and  the disciples of
Broussais, contend that its primary operation is  on the mucous lining of
the stomach, and that it there produces a local  inflammation or  irrita-

  "Tropical climates, vol. 1, p. 113.
  t" Mr. Tully has informed me ("says Dr, Good,) that there was no instance of an
attendant on the infected having received the contagion so long as ho was regular
in thoroughly illining himself with oil, wearing a dress soaked in oil, or a cover-
ing of oil skins.   And to the same effect is the evidence ot Sir Brooke  Faulkner,
physician to the forces at Malta, in 1813, before the select committee of the Ilouso
of Commons, June 14th, 1819, who, in ai.swer to  the question, " How were the
Military attendants  preserved?" replied, " with respect to tho Pest Hospital in
which I attended,  they were, in my opinion, preserved  by wearing a dress of oiled
silk, which  prevented the  possibility  of any contest of infected  matter with the
skin, and probably, also, by its promoting free and copious perspiiation, and in
consequence, preventing absorption,"
  " To the same effect it has been asserted by  Mr. Baldwin, of Cairo, that among
upwards of a million of inhabitants carried off by  the plague in Upper and Lower
Egypt, during the  space of four years, not a single dealer in oil, as far as he could
learn, had fallen a sacrifice to it."  Study of Medicine, vol. 2, p.  440.
  Ferguson  also in noticing the almost entire exemption of the negro from the fe •
vers of the torrid zone, remarks, " that one of the  most obvious peculiarities of tho
negro, compared with the European, is the texture of his skinj which is thick, oily,
and rank to a great degree ; and from this circumstance the theorist when he spec-
ulates on the modo of the reception of the marsh poison into the  system, whether
by the lungs, tho stomach, or the skin, maydiavv a plausible conjectural inference
in favour of the last." 
17
tion from which all the phenomena of fever result.  The stomach ac-
cording to this creed, is not only the puncium saliens of febrific dis-
ease, but is the organ chiefly and prominently affected during its whole
course, and that to cure it most effectually our remedies must be ad-
dressed to this  part,  the sole and whole object, being to extinguish the
inflammation which  has  been set up in the mucous membrane of this
organ.
   Waiving the many objections to  this theory, which present them-
selves  at its first blush, such as, the incompatibility of  the existence of
an inflammation of the mucous membrane of so important an organ as
the stomach,  with the incipient symptons of fever, viz: paleness, weak
pulse,  chilliness, and the  many other signs of diminished action of
the heart, we will proceed at  once to the main point in the argument,
(i. e. the assumed inflammation of the stomach) and deny the fact of
its being always, or even generally present.  To support us in this de-
nial we must appeal to the symptoms of fever during life, and to the
post-mortem examinations of those who  died of fever.  Wherever
there is inflammation there is,  and must be, pain and tenderness of the
inflamed part;  we! find this  to  be universally the case, in whatever
part of the body inflammation  is seated ;  at least we know of no excep-
tion to this, and can  imagine none, unless it can be proved that some
parts of the  body are destitute of  nerves.  Apply  this general rule
to fever, and what a number of cases do we meet with, in which there
is not the slightest tenderness  on  pressure—nay, we may  often press
the epigastrium, until the back bone can almost be felt, and  no com-
plaint of pain or soreness is made by the patient.  We will admit that
certain parts  may be inflamed, and  when perfectly quiescent and un-
disturbed,  may not  give  very great  pain; but if the same parts  be
roughly handled or compressed, the groans and contortions of the pa-
tient will tell how much he suffers.  Now even granting what the dis-
ciples  of  Broussais  claim when  they say, 11 a demontre que  les in-
testins  possedaient  fort peu de  sensibilite, they must indeed be en-
tirely dead  to feeling, not to  betray some sensibility, when  severely
compressed.  We  have made the existence or non-existence of this
symptom, a point of special inquiry in  the great number of cases of
bilious fever, which we treated during the last fall, and do not now re-
collect a single instance in which  it  was  present, whether early or late
in the  disease.
   Again, how seldom do we see even a loose state (not to say diarrhaea)
of the bowels,  in febrile  affections?  On the contrary,  have we not
much  more  frequently  to  contend with a dangerous torpor of the
bowels?  Should this be the  case  if the mucous membrane of the
stomach and bowels  was inflamed  ?  What takes place, when the mu-
cous membrane of the nose, trachea and bladder is inflamed ? is there
                      o
                      O 
18
not an increase in their respective secretions ?  and in dysentery when
this same membrane is known to be inflamed, do we not perceive the
same effect ?  It is incumbent, therefore, upon the friends of the doc-
trine, to show why this symptom should not be present in all cases, of
what  they call gastro-enteritis.
   We have elsewhere insisted  upon the soundness of  this argument,
and we still think it not only solid, but unanswerable.   What are the
symptoms which  present themselves, when  the mucous membrane of
the stomach and bowels is in a state of inflammation? Is not a diarrhea one
of the most prominent and invariable in its occurrence?  Listen to what
the ablest author of modern times says upon this subject.  I mean
Southwood Smith, of London, whose  treatise  on fever, well deserves
the high encomiums which  have been  lavished upon it.  He mentions
a purging of the  bowels as one of the  most  invariable attendants on, or
symptoms of fever, when the nucous  membrane of the stomach and
bowels is inflamed ; and he, let it be recollected was in the constant
habit  of connecting symptoms during life, with the appearances after
death.
  If  we examine the symptoms of fever as described  by Sydenham
and his successors down to  the promulgation of this doctrine, we shall
find no one so constantly present and of so predominant a character as to
claim special notice from them.   If any one symptom was more fre-
quently present than another, it was that of great determination of blood
to the brain, as indicated by headache, &lc*  Can we therefore do
so great injustice  to the memory, the talents and sagacity of the many
great  men, who have shone as bright stars in the medical firmament
during the last century  and a half, as to suppose that a symptom, which
is now pronounced to be so uniformly present as to constitute the ipse
morbus, (and which if so invariably present now,  must have  existed
theH,) should have escaped their observation and vigilant attention ?
  The practice too, which has been  found most  successfull in com-
batting fever in all parts of the world,  is irreconcilable with the idea
of inflammation of the stomach and bowels, as constituting an essential
and invariable ingredient in the pathology of  fever; it has consisted
essentially of active depletion, by venesection and continued purgation,
the latter of which is now reprobated  by Broussais and  his followers,
as pernicious in the extreme, and  as having a tendency to increase the
local inflammation. Sydenham followed this practice and contended with
great  success, against the fevers of his day by this course of treatment,

  *Dr. Crampton, in his medical report containing a brief account of the late epi-
demic  in Dublin, gives the following estimate of the relative proportion in which
different parts of the body were affected  in fever. Out of 755 cases, 550 complain-
ed of the head, 129 of the chest and 76 of the abdomen, and what let me ask, are
symptoms, but signs of internal disease ? 
                                 19

 for he expressly states that " the method of cure above delivered, which
 consists in Heeding and purging,  is the most effectual one to conquer
 most kinds of lever;"* and in later times, Hamilton was forced into an
 acknowledgment of the invaluable efficacy of purgatives even in Ty-
 phus fever, then considered a disease of debility. The ferocious diseases
 of the East and West Indies, can only be met and vanquished, by this
 practice,  pursued with  a single eye, and the  most unwavering energy.
 Our own great Rush, (whose memory ought to be dear to every Ame-
 rican Physician,) triumphed  over the Yellow fever of 1793, and of
 every subsequent year  of its appearance in Philadelphia, by venesec-
 tion and free  purging with the most powerful articles of the Mat. Me-
 dica. He adopted this mode of  treating the disease, after having tried
 every other then in vogue, and  pursued it with the steadfastness  and
 determination of one  who possessed the  mens conscia recti, regardless
 of  the obloquy and slanders which were heaped upon  him;  and  the
 result was an unparalleled degree of success, and a rich harvest of fame
 and gratitude from the numbers whose lives were saved by this practice;
 and if we take the collected experience of the Physicians scattered
 over the  wide expanse of our country, we shall find a vast preponde-
 rance in favour  of  depletion  by venesection and free purging in  the
 management of fever.f
   The theory of Broussais utterly fails to account for the phenomena
 of Intermittent fever.   Here we are left to the absurd supposition,
 that there is an intermittent inflammation, which suddenly begins and
 progresses  to a certain point, and  then as suddenly subsides, only to
 be regenerated after the lapse of some definite time, to run again  the
 same course.   We would now ask, " what kind of  inflammation must
 that be, which explodes, as it were, the moment the clock  strikes a
 particular hour, and vanishes the moment the clock strikes another hour
 —and thus for days or weeks together?  What kind of inflammation
 must that be which every second day, terminates in a profuse perspi-
 ration from head to foot, and  yet is  renewed, after an interval of 48
 hours, with  the same symptoms as before, and so on ?"
   The symptoms of fever, therefore, are not even generally, still less
 always, such as to warrant the belief that the mucous membrane of the
stomach is inflamed ; and the recorded post-mortem examinations  of
those who died of fever, corroborates the deductions drawn from a
  •Wallis1 Sydenham, vol. 2, p. 344.
  t We do not object to the practice of Broussais ; so far as it goes, we think it ex-
cellent.  Spare diet cannot be too much recommended, and leeching, if blood
enough is drawn, may do very well, though we certainly should prefer drawing it
pleno rivo from the arm.  But we should as soon think of attempting to bale the
water from a  leaky and sinking ship, with the hollow of the hand, as to trust alone
to leeching and eau sucree in the treatment of severe fevers. 
20
view of  the symptoms during life.  Autopsic examinations of those
who die of fever generally, indeed reveal the traces of inflammation,
deep and  indelible, in some part of the system, and there cannot  be
a doubt, that this in ninety-nine cases out of a hundred is the cause of
death from fever.   Sometimes the brain and spinal marrow are found
to have suffered from the disorganizing effects of inflammation, in some
cases the  viscera of the thorax present the marks of fatal inflamma-
tion: and in others the bowels; in many cases inflammation is found to
have existed in two of these vital portions of the system.   The brain
and thorax, the thorax and bowels, and the latter and  the brain, are
often  found to have suffered conjuctively,  and in a  few  cases, post-
mortem examinations, reveal the fact that the brain, thorax, and bowels
have  all suffered from inflammation;  but we deny,  that  this  in-
flammation is  discovered more  frequently  or as frequently  in  the
stomach as in the brain.   Seuthword  Smith, in his  work on  fever,
gives an account of  110 dissections, 51 of which, he  ranks under  the
head of Cerebral disease,  12 under that of Thoracic,  26 under that
of Abdominal, and  21  under that of " mixed disease."   Here  we
have, within  one of double as  many cerebral cases as  abdominal.
Some of the cerebral cases, were, it is true,  complicated with abdomi-
nal, and sometimes thoracic disease, and vice versa, but  many of them
show an entire exemption from inflammation of the mucous tissue of
the stomach and  bowels.   In those cerebral cases  too, which were
complicated with  inflammation of other parts, the  symptoms of brain
affection were predominant and first to occur; and yet we are to  be
told in the face of such facts, that inflammation of the mucous mem-
brane of the  stomach  exists in every case.   Such reckless assertions
it appears to   us, can only proceed from minds irreclaimably biassed
and blindly devoted to a particular theory or opinion.
   In the December  number of the  Medico-Chirurgical Review, for
the year 1823, is a review of M. Tacheron's Pathological Researches;
five dissections, of what were considered genuine  gastro-enteritis, with
the symptons before death, are there brought before the  eye  of the
reader.  In all these cases post mortem examination revealed  the ex-
istence of inflammation in the brain, stomach, and lungs.   The symp-
toms in all, during life, indicated  a high degree of cerebral excitement,
and the indications of disease in the stomach were comparatively slight
and unobtrusive.   The second case is a very curious one, and as the
reviewer remarks, shows in  a strong light, "the rage  for system which
pervades even those who swear they are entirely free from prejudice."
A young man aged 17, was seized with clearly marked symptoms of
 inflammation of the brain, which put an end to his life in eleven days.
 Dissection—the  vessels of  the brain  greatly gorged with blood—the
 right hemisphere disorganized by a sanguineous infiltration, so that the 
'21
 natural substance of the  brain  could not be recognized.  Two table
 spoonsful of effusion at the base of the brain.  In the abdomen some
 small tubercles were observed on  the intestines of a reddish colour."
   Reviewer's remarks: "Thus,  then,  a youth of 17 years of age,
 comes into hospital with  unequivocal symptoms of cerebral disease,
 and nasal  hemorrhage.   He is treated  first with tamarind  water,
 and, as the symptoms increased, with the decoction of cinchona.  He
 dies, and one hemisphere of the brain is found completely  disorgan-
 ized, (which is a mere bagatelle)—but (ldespetits tubercules d'une con-
 leur rouge" are  found in  the intestines—and lo ! the  great French
 1 (doctrine pathologique," is confirmed !  Half a brain destroyed, sinks
 into insignificance, when compared with  the tubercles in the intestines."
   If the  disciples of Broussais  exhibit  such cases  as  the   above,
 to  support the  French  doctrine, well  may he exclaim, " save me
 from my friends," they certainly would relieve  the opposers  of the
 doctrine from the trouble  of searching for evidence against it.
   But however frequently, and  in whatever organs, inflammation may
 be found after death to have existed, we think that with unprejudiced
 minds there cannot  be a  doubt, that it is the effect and not  the cause
 of  the exalted arterial action of  fever.  Neither is it an invariable ef-
fect of fever, because there are  many mild cases of fever which, from
 their commencement to  their  termination, present  no evidences or
 symptoms  of this state;  it is, indeed, a mere contingency which may
 or  may not happen  during the progress of  a fever.  If inflammation
 therefore does not exist in every fever, it follows that it is not essential
 to fever, and therefore cannot be an invariable cause of this state.  In
 many cases, too, in which it supervenes during the course of an idio-
 pathic fever, its first symptoms, its gradual and steady progression, in-
 creasing with the increase of the arterial action which originates it, and
 vice versa, evinces it to be a secondary  and not a primary affection.
   Again, in symptomatic  fevers strictly so called, if you remove the
 cause, you at the  same time remove  its effects, (i. e. increased  action
 the  heart,) " sublata causa, tollitur effectus."   Thus in  pleurisy, for
 example, we find  the febrile action  to diminish paripassu with the
 symptoms of  local inflammation : not  so, however, in miasmatic dis-
 eases, though  every symptom of local inflammation, wherever seated,
 may have disappeared, still the fever  pursues its course, checked, but
 not subdued, rendered  harmless but not entirely vanquished.   The
 primary  symptoms  of fever, weak pulse, chilliness, shrinking of the
 features and surface of the  body, are incompatible with the  idea of  a
 then existing inflammation of the stomach or any other  part.  But
 when the heart reacts and the blood  is propelled  with increased velo-
 city through every fibre of the   system,  we are then likely to see in-
 flammation developed in  whatever part is weakest, or  most predis- 
22
 posed to it.  It may be either in the stomach, brain, or thorax, or in
 any two of them, or perhaps, all three of them may suffer.  We have
 a striking  example  of this in our winter epidem.ics  or bilious  pleuri-
 sies, in which  the  fever, brought into  action by the lurking malaria,
 developes inflammation in the lungs, which are notoriously  predisposed
 to disease  at that season of the year.
   These are some of our objections to the French doctrine of fever.
 If it  were a mere  matter of opinion unconnected  with effects, we
 should  deem it  of  no  importance,  but  believing  that when  car-
 ried  into  practice,   it  is  fraught with  evil  consequences, we  shall
 consider it a paramount duty, (feeble  as is our opposition) to contend
 against a theory which in our opinion is not only radically wrong, but
 practically inefficient.
   The question of  the modus operandi of malaria, again  presents it-
 self.   We are  decidedly of opinion, that we  must look to the blood
 for the first operation of malaria.   However painful  the retrogression
 may be to  some, we  shall have  to  travel  back  to the old and much
 scouted humoral pathology for  the truth in this matter.   Far be it
 from us to advocate the many ridiculous  notions and glaring absurdi-
 ties, connected  with this subject in " olden times,"  but  we do think
 thateur rejection of it has been too indiscriminate, and that  amongst
 the  disjecta  membra of this antique edifice, something valuable might
 be here and there picked up;  in sweeping away the rubbish  we have
 swept away much that was  good.
   That the blood of those exposed to miasmatic  exhalation is vitiated,
 is obvious  from its  dark colour, and from the depravation of all  the
secretions.   If the  fountain is polluted, the streams  which  proceed
 from it must be impure.  The dark sallowness of the skin, the  furred
or dark tongue, the  unpleasant  breath, the  black and  offensive dis-
 charges from the bowels,* the high coloured urine, and  foetid sweats,
 all unequivocally indicate a contaminated  state of the  vital fluid.   The
 doctrine which attributes fever to a local inflammation of the stomach,
 and  what may be called the sympathetic  theory of fever, is  directly
opposed to the idea  of a vitiated or depraved state of the blood ; the
 latter.theory, indeed, is  based upon the supposition, (erroneous and un-
 founded,) that  no foreign substance ever reaches the circulation with a
 preservation of its characteristic properties.  We presume, however,

  * These are  common in miasmatic districts, oven where the individuals are ap-
 parently well, and can almost always be brought away by taking medicine ; and an
 attack of fever is always cured with most certainty and facility, when these discharg-
 es come away most copiously and easily.  A fever very often will not yield at all,
 until they are obtained.  No matter how copious and frequentthe discharges of ano-
 ther sort may be,£they are in many instances, attended with no relief, but as soon
 as dark evacuations are obtained, there is a great and marked  amelioration of the
 symptoms.  Rush as well as many others mention this. 
23
that even the most prejudiced must now surrender this point;  the great
number of experiments recently made, proving  beyond a doubt, that
medicines and other substances not only may, but actually do enter the
blood unchanged; and if so " gross and palpable" a material as medi-
cine, why may not  gaseous substances or malaria.  We know (from
the experiment of Bichat already mentioned) that tha fnetor of animal
substances in a state of putrefaction, reaches the  blood, and reasoning
from analogy, it is fair to suppose that other aeriform substances do
the same. Our opinion, then, of the modus operandi of malaria in the
production of fever, is succinctly this.  When mingled with the blood,
it either directly  or through the instrumentality of the nervous system,
produces a weakened action of the heart, from which results that pale-
ness and shrinking of the surface,  which  are most generally observed
at the onset of fevers, and which is directly  the  reverse of that flush-
ing of the skin and fulness of the  features, which is seen during the
exacerbation of  fever, when the heart's action is  exalted and vigorous.
This diminished action of the  heart soon works its own cure, for in
consequence of  it, a more than usual quantity of blood, must necessa-
rily accumulate about that organ, which being its  natural stimulus, soon
rouses it from its depressed state into preternatural activity, according
to the intensity and duration of which, we have  the different forms or
types of fever.   If the reaction be violent, and any part of the system
from previous disease or other cause be weakened, we shall  most pro-
bably have a local inflammation, superadded  to the existing excitement
of the heart and arteries; or if it  be mild, we may have  a fever  only
of  " simple excitement."
   Of the Chemical nature of Malaria.  Various and vain have been
all the attempts  heretofore made to,ascertain the constituents of this
active poison to  the  human frame ; it remains, as yet, one of nature's
arcana ; but may we not indulge the hope that practical chemistry will
one day add to its  already great and brilliant  achievements, that of
the discovery of the intimate nature of Malaria.
   But  though nothing is positively known of the chemical nature of
Malaria, many conjectures have been hazarded  in relation to it,  none
of  which in our opinion can be sustained.  Dr. Cooke, Professor of
the Theory and Practice of Medicine, in the Transylvania University,
suggests that Malaria is nothing more nor less than carbonic acid, and
supports the idea by a very close  and ingenious analogy  between the
known  effects and qualities of fixed air and those of Malaria.   But
there are many and insurmountable objections to their identity.  1st.  If
carbonic acid gas be the cause of fevers, they  ought to prevail in all
cities and towns every winter, as it " is produced in immense quantity
by the combustion of wood."  2d.  The  numerous distilleries in our
country, where  an immense quantity of this gas is extricated, should 
24
prove so many foci of disease ; but we know that not only those who
live near them, but those who live in them, are not  peculiarly subject
to fever.  3d. It is often taken  internally, in considerable quantity in
the shape of soda water, effervescent draught, &.c, without any febrile
effects.  4th. There  is not, (as  far as  we can discover)  on record a
single case of fever following the resuscitation of the many who have
suffered  asphyxia from  imprudently  going into  an  atmosphere of
fixed air.
   Dr.  Faust, in  a late essay on Malaria,* labours to prove that carbu-
retted  hydrogen  in combination with  vapour, is the gas  in question;
but the attempt has not even the  merit of ingenuity; the   very essay
itself furnishing incontrovertible arguments against the supposed identity.
"According to Dr. Beddoes (says he) the blood and muscles of animals
killed by confinement in this gas, have a red colour, less distinct than
that produced by oxygen,  but very different from the dark colour ex-
hibited by animals killed by drowning or carbonic acid."   Now it is a
notorious fact, that the blood of those exposed to miasmatic  exhalations,
instead of being redder, is darker than natural. "It is a matter of com-
mon  observation, (says Cooke) that the blood drawn from persons who
have been exposed to the exhalations arising  from marshes, is darker
than  usual.  It is often nearly black, even in  those persons  who are
not ill,  the darkness being in proportion to the degree of exposure."f
It is still more unfortunate for their identity, that the Doctor  should have
mentioned several instances in which this very gas was applied in a very
concentrated state to the system, without  even the production of an in-
termittent fever.   One instance is  that of  Sir Humphrey Davy, who
took three inspirations of the pure gas.  This perilous experiment was
near  depriving science of one of her favourite votaries, not, however,
by means of fever;  " for, (says he) I slept sound, and awoke in Ihe
morning very feeble  and  hungry.   If the carburetted  hydrogen  be
Malaria, and Malaria be  capable, as some contend, of producing the
plague, we think that Sir Humphrey Davy ought  certainly to have
fallen a victim to it.
   He also mentions  the case of Mr. Greenwood, who breathed four
quarts  of the air diluted, and though the effects were  highly distress-
ing, nothing like fever followed.
   " A person standing in a current of air, while about a cubic foot of
the gas was set free, felt as it passed him, very sensible depression with
vertigo."   No fever resulted.  " Another person was  thrown into a
state of complete syncope, by standing near a tube from   which the
gas issued for a short  time," still no fever.   If the Doctor's object had
been to disprove instead of to prove their identity, he could not have

  * American Jour. vol. xi. p. 38.  t Treatise on Pathol, and Therap. vel. i. p. 285. 
25
furnished  stronger evidence against  it, than he has exhibited in its
favour.
  Dr. William Currie, of Philadelphia, thought " that the unwhole-
someness  of  low  and  moist situations in  the summer and autumnal
months, is not owing  to  any invisible miasmata, or noxious  effluvia
which issue from  the soil and  lurk  in the air, but to a deficiency of
the oxygenous portion  of  the atmosphere in such situations, in conse-
quence of vegetable and animal putrefaction, in conjunction with  the
exhausting and debilitating heat of the days, and the sedative powers
of the cold and damp air of the nights.  "But, as Bancroft observes,
if the mere abstraction of a part of the ordinary proportion of oxygen
in the atmosphere could  occasion  intermittents and  remittents, those
fevers ought to be produced in  every crowded  assembly, and in a
multitude of situations where no such effect has been observed or sus-
pected.*"
   We have thus presented a few of the conjectures, which have been
advanced as to the nature of Malaria.  None of them will bear  the
test of examination, and consequently its discovery still remains a de-
sideratum.  We have  not even a conjecture of our own to offer.
   3d. What  are the sources of Malaria?  The most prolific sources
of  miasma, are unquestionably, swamps and marshes; hence the com-
 mon term Marsh  Miasma.  But though the diseases arising from Ma-
laria, prevail, most frequently and extensively in the neighbourhood of
swamps,  &c, they are by no means confined to them.   Wherever
they do  appear, however, we  shall  find  something equivalent  to  a
marsh.  " Mud  and  stagnant water, (says Jackson) in every climate
possess the materials of this species  of disease," hence fevers are so
often distinctly traceable to the exhalations arising from the slimy and
half  dried margins of  pools of stagnant water,  or of mill ponds, or the
exposed  banks or bottoms of rivers; and sometimes also to large heaps
of  decaying vegetable matter.    But in whatever situation this gas is
 exhaled,  whether from a  marsh strictly so called, or from the exposed
margins of ponds, rivers,  &zc, or  from heaps of vegetable matter, we
shall always find the co-operation of several circumstances necessary;
without which it is not produced ; these are heat, moisture, vegetable
 matter and the contact of air. Neither of these agents can separately gen-
 erate miasmata, nor can any two or even three of them, without the con-
currence of the fourth. From the repeated observations of this fact, phy-
sicians were led to suppose that Malaria was the result of a putrefactive
 process, the same circumstances being requisite to both. The co-exis-
tence of those causes which promote putrefaction in either vegetable or
animal matter, with those which give rise  to fevers,  are  uniform and
r On Fevers, p. 145.
                          4 
26
invariable.  Fevers like putrefaction, only prevail to any extent in the
hot season of the year; and as this process is most active and intense,
in the hottest countries, so are fevers there most violent and fatal; cool
weather which checks or mitigates putrefaction, renders much less nu-
merous and  milder the cases of fever; and severe cold which entirely
suspends it,  is followed by a complete disappearance of  disease. Ex-
cessive dryness and  excess  of moisture, both equally  unfriendly to
putrefaction  also procure an exemption from epidemics.
   We have  said above that marshes are the most prolific sources of
disease.   Wherever these exist to  any extent we shall invariably find
them under certain circumstances exhaling  this pestiferous  gas.—
Those countries where sickness prevails throughout the year, as Benin,
New and Old  Calabar,  Sic, are low and marshy.   Those  cities and
stations in Africa, Asia,  and America, which have been  the graves of
unnumbered thousands, are situated near marshes,  or at the  mouths,
or on the banks of rivers in flat countries, which in  the  rainy seasons
become one vast morrass."   In the East they prove almost the only
source of disease; the wide spread marshy surface left by the retiring
inundations of the Ganges, "exposed to the rays of a vertical sun, that
has  lost nothing of its power by a Southern declination," exhales in
profusion this morbific principle, which " spreads pestilence and death
in every direction."  In Egypt we  find fevers appearing as soon as the
country is brought into a marshy state, by the drying up of the inun-
dations of the Nile.
   If we look to the West Indies, we shall find the same  cause of dis-
ease, operating to a great extent; those  towns and situations in  the
neighbourhood  of marshes alone  being sickly.  In more temperate
climates we  shall find the same  efiect from marshes.  Italy affords  a
melancholy instance of their dire effect. The ancient Latium with her
hundred cities, the present Campagna diRoma, has been rendered almost
a desert by the miasmatic exhalations which are there generated by al-
most every foot of the soil.  The extensive  marshes of Holland are noto-
riously the cause, of the terrible epidemics which have  so frequently
ravaged that country.   Hungary has also  suffered extremely from the
the same source.
   In eur own country, we shall find the rice swamps of  the Southern
States  and the swampy countries of the sea coast from Delaware bay
southward, to prove fruitful sources of disease.   The annual  inunda-
tions of the Mississippi, leave avast extent of country  in a  marshy state,
from which miasmta in abundance proceed.
   Independently of the strong presumptive evidence of the  unhealthi-
nes3 of marshes, afforded by the almost invariable occurrence of dis-
ease in their neighbourhood, we have positive proof to the  same ef-
fect.  Thus  a place  has been  render«d  suddenly  unhealthy, by the 
27
shifting of the wind, so as to blow the atmosphere of marshes upon it.
Lind, speaking of a settlement formed by the English, on the island of
Balambangan, near Borneo, says, for a few months these people con-
tinued perfectly healthy ;  but no sooner did the monsoon change, than
sickness made  its appearance ; and it raged with such violence that
scarce one in ten survived this monsoon.   " The seasons of health and
sickness are here regulated by the  direction of the wind or monsoon ;
from October until  April, during the  northeast monsoon, the  wind
comes from the sea, and the settlement is perfectly healthy; but from
April, until  October, during the southeast monsoon, the  wind  blows
over the marshes, both of this Island and of Borneo, and produces fevers
of a most malignant nature, which frequently cut off even the stoutest
men in twelve or fourteen hours."*
   Lancisius relates that thirty  gentlemen and ladies of the first rank
in Rome, having made an excursion upon a party of pleasure towards
the mouth of the Tiber, the wind  suddenly shifted, and blew from the
South over the putrid marshes,  when twenty-nine were  immediately
seized with  a tertian fever, one only escaped."f
   The following account of the fatal fever which prevailed at Galli-
opolis, en the Ohio  river, in the summer of 1796, was furnished by
Major Prior of the  army, to Dr. Potter of Baltimore, who inserted it
in  his memoir  on contagion.  "As the garrison was  sorely afflicted
(says Major Prior,)  by this fever, I could but take great interest in it.
The fever,  was, I think, justly charged to a large pond, near the Can-
tonment.  An attempt had been made, two or  three years before, to
fill it up by felling a number of large trees,  that grew on, or near its
margin, and by covering the wood thus fallen with earth.   This  inten-
tion had not been fulfilled.  In August  the weather was extremely
hot and uncommonly dry;  the  water  had evaporated considerably,
leaving a great  quantity of muddy water, with a thick slimy mixture
of putrefying vegetables, which emitted a stench  almost  intolerable.
The inhabitants of the village, principally French, and very poor and
filthy in  their mode of living, began to suffer first, and  died so rapidly
that a general consternation seized the whole  settlement.  The  gar-
rison continued  healthy for some days, and we began to console our-
selves with the hope that we should escape altogether: we were how-
ever, soon undeceived, and  the reason of our exemption heretofore
was soon discovered.  The wind had blown the air arising from the
pond, from  the camp; but as soon as it shifted to the reverse point,
the soldiers began to sicken; in  five days half of the garrison was on
the sick  list, and in ten half of them were dead."
   In the year 1794, a fever broke out at  Rockfort, in  France,  which
"Lind on hot climates, p. 74.
{Ibid, p. 21, 
28
on account of the malignant symptoms and great mortality, was at first
believed to be the true plague.   But M. Chirac, who was sent by the
court te inquire  into its nature,  found the cause to arise  from  some
marshes that  had been made by an inundation of the sea, and observ-
ed that the corrupted steams, which smelled like gunpowder,  were
carried  to the town by the wind that had blown long from that quar-
ter."*  We have then positive evidence of the morbific principle con-
tained in the  air of marshes.
  We have now arrived at the much vexed question, of whether Ma-
laria proceeds equally from vegetable and animal putrefaction ?  or is
the exclusive product of the first ?  To the  first of these questions,
we  would answer in  the negative, to the last in the affirmative.    In
discussing this subject, we  will,  in the first place, endeavour to show
from the numerous facts on  record, that Malaria is produced by  vege-
table matter perse, in a state of putrefaction.  2d. That animal putre-
faction is not a source of Malaria, and therefore is never the cause of
epidemic disease.
   1st.  Malaria  is produced by vegetable matter per se in a state of pu-
trefaction.   Fevers  which appear  in vessels at sea, afford, perhaps,
the most unexceptionable proofs of the morbific principle generated
by vegetable putrefaction.  "The holds of all vessels, (says Bancroft)
particularly ships of war, contain large quantities of  vegetable matter
in casks, often insufficiently strong to prevent their contents from es-
caping ; such as  peas, oatmeal, cocoa, flour, sugar, and wood for fuel,
and when united with a due proportion of humidity, so as to produce
a given change by  putrefaction, a gas is evolved under certain circum-
stances of temperature, highly detrimental to animal life."f
  Many instances of most malignant fever arising under such circum-
stances might be mentioned.  "  The ship Antelope arrived at Barba-
does  in March.   Immediately  afterwards, when the  inhabitants  of
Bridgetown were perfectly healthy, a fever appeared on board ;  there
were one  hundred and ten  cases, of which thirty-one ended in death.
In consequence of this, she was  cleaned out, when it was found that a
" combination of the above vegetable substances," with the bark of
green-wood and  chips in a state of putrefaction, occupied a considera-
ble part of the hold ;  and those  individuals  who had  hitherto resisted
the influence of this miasma, now suffered in clearing away a mass of
highly putrid and offensive matter."|
  The ship  Regalia, left Guernsey in November, 1814, and arrived
on the coast of  Africa  in  February, 1815, full  of troops in  perfect
health.   She was employed from that time until the latter end of June

  *  Pringle on  Diseases of the army, p. 323.    t On Fever, p. 233.
  tBanciofton  Fever, p. 233, as quoted by Cooke. 
29
in removing troops and stores from one port to anothei.  At this time
she took in a supply of green wood, which was " cut down and brought
on board the same  day," in such quantity that after she had been in
the West Indies several weeks, there was enough left for a voyage to
Europe.  The ship was rather leaky.
   She sailed from Africa with black troops for Barbadoes on the 18th
of July, and arrived a little before the 24th of August.  There  was a
considerable mortality on  the  passage.   "At English harbour, An-
tigua, she was  fumigated, and after three days detention, returned to
Barbadoes.  During  this  short voyage, three  newly entered  hands
sickened; one died, and two were sent to the hospital; on her arrival
three more sickened, one of whom  had  lately entered, and one died."
   " The hold was  now ordered  to be cleared  out;  every  thing was
taken out, and the hold was exposed to the concentrated heat of stoves,
the hatchways being closed.  About the time this was commenced,
of three men, newly shipped,  two sickened, of  whom one died : and
the cook, upwards of fifty years of  age, sickened and died."
   " After having undergone the above thorough cleansing, she sailed
from Guadaloupe, crowded to a very great  degree with French pri-
soners and their families, from the jails, under the most dangerous cir-
cumstances to health, with a case of yellow fever actually dying on
board the day before she left Basse-Terre roads, but without commu-
nicating any such lo the unfortunate  passengers."*
   The two following instances of fever  of the  most malignant type
 generated on ship-board, by the putrefaction of vegetable matter, are
 very striking in  their character.   They  are from the official reports of
 Dr. Hartle, an English navy surgeon: "On the 31st of August last,
 (1821)  his Majesty's  armed transport Dasher, left Carlisle Bay for
 Barbadoes, bound for Tobago; but in consequence of severe gales of
wind,  she  was obliged to go  to St. Lucia.   From  thence  she pro-
ceeded to Tobago, and received on  board a company of the 9th Re-
 giment,  and conveyed them to Grenada, that they might avoid the en-
 demic  fever of the former place."  *   *   *   *  The Dasher,
after landing  this company at  Grenada, proceeded hither, (English
 Harbour,) but a few  days  before she  reached this port, yellow fe-
ver made its appearance among her crew, and previous to her arrival,
 six men had been attacked, two of whom died.  In the evening of the
22d of September, she arrived in English Harbour, and on the 23rd,
the assistant surgeon,  Mr. Maclean, reported two men ill of  yellow fe-
ver.   One died in a few hours.  On the following day, (24th)  seven
men were  attacked  through the day, all suddenly and seriously."  I
 immediately addressed his excellency Major  General, Sir B.  D'Ur-

    * Cooke's Fathology and Therapeutics, vol. i. p. 85. 
30
ban, reporting the circumstances, and recommending that, widiout loss
of time, the officers, crew, and marines  be ordered out of the ship,
and encamped on an isthmus of land at the north of the harbour: and
that black people he employed  to take out all her stores, tanks, ballast,
he."  This  was accordingly  done on the 26th September: "Black
people immediately commenced cleaning out the ship:  after removing
the stores, tanks, fuel, ballast, &c; the dirt was  scraped together, but
this amounted to no great quantity.   This did  not satisfy  my mind,
and I insisted upon having the  limber boards taken up.  Here, to the
astonishment  of every  one, lay  the  mischief.   On taking  up these
boards the noxious efiiuvia surpassed  any thing that I had  before ex-
perienced, and it was with difficulty that the blacks, who were accus-
tomed to this work, could remain.  Between the timbers there was a
collection of carpenter's shavings, he. in great quantities.   These had
so completely choked up the limber holes,  that the water could  not
pass to the well of the pumps,  and lay stagnant.  The vegetable mat-
ter, was therefore, in a state of decomposition, .and this acted on  by
high atmospheric temperature, became neither  more nor less than a
marsh in  the centre of  the ship."*
   "His Majesty's ship Pyrarnus left this port, (Englisji Harbour,) as I
understood, perfectly healthy, on the 19th October,  in company with
the flag ship of rear admiral Tackni,  for St. Kitts, where she remain-
ed until the 28th of October, when she sailed from thence for this isl-
and.  A  day or two prior to her arrival here,  fever of a most alarm-
ing type made its appearance  among  the officers and crew.   She
came into English Harbour early  in  the morning  of the  1st of No-
vember, and as soon as  she was anchored, Capt. Newcombe sent  a
lieutenant to inform me of the state of the ship, and to request medi-
cal assistance.   I immediately went on board,  and  was surprised to
find that an officer (lieutenant) had died the day  before, with  only a few
hours illness—that the purser and six men lay dangerously ill; the sur-
geon, who from his own account had been attacked himself, was una-
ble to perform any duty." After landing the sick, "the Pyrarnus pro-
ceeded in the afternoon of the  2d of November to Barbadoes.   Mr.
Freer, who  returned to this garrison on the 9th instant, having been
relieved by a naval surgeon, reports that many fresh cases had occur-
red in the passage up, but that he had landed most of them at Barba-
does in a  convalescent state; that when he left the  ship the fever still
prevailed."
   The fever continued to prevail on board this vessel,  and  finally be-
come so  alarming that a board  of  medical officers was ordered, at the
island of  Barbadoes, to "investigate the probable cause of the sick-

  * Med Chi. Review, March, 1824, p. 994. 
31
ness that prevails on board."   The board  of medical officers recom-
mended as a means of health, that the Pyrarnus should be taken out
to sea;  accordingly Capt. Newcombe left Carlisle Bay, Barbadoes,
and  cruised as far a 28°  north; "but, finding  this avail nothing, and
that  the disease became more alarming, he hastened to English Har-
bour, and arrived hereon the 3d of January,  1832.  I anxiously em-
braced the opportunity (says Dr. Hartle)to ascertain if my prediction
(viz: that the source of the sickness was in her hold,) was correct,
and  immediately visited the ship.  On finding that the sickness contin-
ued  with increased  violence, 1  requested  permission  to examine the
vessel, which I did in the most minute manner; and it is but truth when
I say, that no ship could  possibly appear cleaner or in better order;—
and  had I not been convinced that it was in her  hold,  I  should have
been at a loss, from the good order and apparent comfort of the peo-
ple, to  account for the cause of so malignant a fever.  I instantly re-
moved all the sick to the hosipitals, and wrote to Captain Newcombe,
recommending the removal, as soon as possible, of all the officers and
crew from the ship, and that  black people  should be employed to do
the  laborious work of removing  her  stores, shot, tanks, ballast, &c.
and cleanse (under my frequent inspection) the holds and every part
of the vessel."  The recommendation  of Dr. Hartle was acquiesced
in; and the officers and crew were landed on the 15th.  Anxious to
ascertain,  by ocular demonstration, the cause of this endemic, I daily
visited the snip, and was present at the opening of the holds—the ef-
fluvia from which surpassed any thing I had before experienced. Zeal
on the part of the first and second lieutenant, master and surgeon, in-
cited them  to  accompany  me, and they were accordingly with me
when the limber boards were taken up.   It is not in my power to de-
scribe the stench which  issued forth when they  were raised.  The
boatswain, curious to see what we were doing, did not come down,
but  lay on the lower deck to view us.   This confined gas rushed up
the  hatchway, where his head was hanging over, so oppressively offen-
sive that he fainted.  In  the night he was attacked by  the fever,  and
narrowly escaped.   On  the following day the first lieutenant was at-
tacked.   In the evening the second lieutenant was taken ill, and in a
few  hours after the master and surgeon.   On the  third day I was  my-
self very much indisposed,  but fortunately  diarrhcea removed  all  my
febrile sensations."   "Although (continues he) I was  fully persuaded,
in my own mind, that the cause of the disease lay  in the ship's bottom,
I had not an idea, that  such extensive bogs could have been found
under the limber boards, and between the timbers.   It would appear
scarcely credible, that four large mud  boats of filth  should be taken
out of this frigate, which had been only six months from England, and
1 believe  not long out of dock.  This, however, is easily  explained: 
32
The ship-wrights  had never taken out their chips and shavings—the
coal tar, from heat  of the climate, had run into all the limber holes, and
so cemented those chips and shavings, that no passage remained for the
water to go to the  well of the  pumps;  it, therefore,  lay stagnant un-
der a heat of  100° of Fahrenheit's thermometer."*
  The steeping of hemp and flax, in stagnant shallow water, ("ubi
palustres disident aquce,  ventique silent") in consequence of which it
has putrefied,  has  also been productive of disease.  Lancisi "gives the
history (says Bancroft) of an  epidemic  commonly  intermittent, and
often resembling  the tertiana  lethargica  of Forti,  which for several
summers infested,  and almost depopulated the ancient town of  Urbs
Vetus, in an elevated and salubrious part of Etruria; and which was oc-
casioned by ponds or stagnant waters in the lower part of the town, in
which hemp and flax were macerated: (in quibus linum, et cannabis
macerabantur,) but this being prohibited in  1705,  the fevers did not
afterwards occur."f
   Fevers have also  been known to arise from the putrefaction of "the
vast heaps of the  indigo plant,  which are negligently formed, (after
the colouring principle has been extracted) near the works and houses
of the labourers, and there left to decompose  and  become manure,
which  is  of an excellent  quality, after two or three years.  These
heaps wetted from time to time by heavy rains,  and afterwards heated
by  the powerful rays  of a vertical sun, emit, very copiously, vapour,
or miasmata,  resembling in their effects those  of marshes, for  those
persons who live near to, and especially on  the leeward side of  these
fermenting vegetable masses, are commonly attacked by fevers, chiefly
remittents, and similar to those which prevail in marshy situations.—
And according to  my  information (continues Bancroft) the connexion
of  these  fevers with  the heaps of  fermenting indigo plants is now so
well understood and believed in that part of the world, (East Indies,)
that the more intelligent indigo makers no longer  permit  such heaps
to be formed  near their works, or the habitations of the workmen, but
cause them to be  placed at considerable distances, and to the leeward
thereof, and thus  preserve  their labourers in health."J  Many  other
instances might be mentioned  in which Malaria was produced by ve-
getable putrefaction, but those cited  are deemed sufficient to prove the
position with which  we set out.
   2d. That animal putrefaction is not a source of Malaria, and there-
fore is never productive of epidemic disease:
    We had  supposed that the opinion of the harmless character of the
 exhalation arising  from animal putrefaction, at least so far as relates to

   * Med. Chi. Review, March, 1824, p. 997-8.
   t On Fever, page  1,  146 note.      ; Ibid. 
33
the production of "epidemic evils," was  so well established from the
numerous facts which have been brought to sustain it, as to defy all at-
tempts to contradict or impugn it.  A late writer, however, (Dr. Par-
sons) has endeavored to disarm the facts alluded to of all their force,
and by many other facts, to prove that epidemics have and may arise
from animal  putrefaction.
   His first attack is upon  the history of the exhumation at the church
yard of the St. Innocens, at Paris, contained in D. Bancroft's work on
fever.   This  place  " had been made the depository of so many bo-
dies, that, although its  area enclosed more than one thousand seven
hundred  square toises, or near two acres, yet the soil had been raised by
them eight or ten feet higher than the  level of the adjoining streets; and
upon the most moderate calculation,  considerably more than six hun-
dred thousand bodies had been buried in it, during the last six centu-
ries, previous  to which date  it was already a very ancient burying
ground.  Numerous complaints having been made concerning the of-
fensive smell?, which arose from this  spot, and sometimes penetrated
into the adjoining houses ; and the public mind being greatly alarmed,
it was at last determined to forbid all future burials there, and to re-
move so  much of the  superstratum  as would reduce the  surface to
the level of the  streets.   This work was undertaken in 1786, under
the superintendence  of M. Thouret, a physician of eminence in Paris,
and in two years he  accomplished the removal of that  superstratum,
almost the whole of  which was impregnated with the remains of car-
cases, and of quantities of  filth and ordure, thrown upon it from the ad-
joining houses."   "  The  exhumations were  principally executed in
the winter, but a considerable part of them was also carried on during
the greatest heals of  summer."
   " They were begun  with every possible care, and with every known
precaution ;  but they  were afterwards continued, almost for the whole
of the operation, without  employing, it may be said, any precaution
whatever ; yet no danger manifested itself during  the whole course
of our labours—no accident occurred to disturb the public tranquillity."
   " In referring to these and all "other cases of animal decomposition,
(says Parsons) we are to bear in mind the circumstances we have  al-
ready related, of vegetable matter, as necessary to constitute it a cause
of malignant, yellow, or putrid fever.  And in the first  place, in res-
pect to heat.  This it has been shown must range above 60° of Fah-
renheit, for several days, in order to generate  these fevers from vege-
table decomposition.   Now what was the temperature at the time the
exhumations took place?   They were commenced at Paris,  in Decem-
ber,  1785, and continued  till May, 1786—renewed  again in  the  fol-
lowing December, and continued till February, and from  the month
of August, 1787, to the month of October.   There were then only
                      5 
34
one or two months of the time in which malignant, putrid or yellow
(jpvers, from even vegetable putrefaction, or any other cause are sup-
posed to occur."
   He, (Bancroft) is cautiously silent, (says Parsons) as to the time of
the last interments, and also as to the time that animal matter is suppo-
sed to  retain its febrific qualities.  Now what is the fact in respect to
these particulars?  In respect to the duration of this  morbific princi-
ple Jn decomposing animal  bodies, Maret, an  eminent  French wri-
ter, states three years as the time for complete decomposition, when
the grave is four feet deep, and four years when it is six or seven."
" What says Fourcroy ?  This  gentleman, who  was  employed for
chemical  purposes in  the  exhumation  of St. Innocens, states, three
years as the time during which the septic poison must take place."
   V Speaking of  this very exhumation, he remarks, "  we had a  strong
desire to satisfy ourselves by  experiment, what was the nature of the
destructive air or septic principle, emitted from corrupting  bodies, but
we had no opportunity, in consequence of there having been no burials
there for  the three preceding years; the  last deposit there being  in
1782."   " Now,  the month of August,  1787, (says Parsons) was the
time when the bodies were removed in  the hottest weather, as Ban-
croft relates it, which was five years after the  last interment, and two
years after  morbific miasm,  according  to Maret  and  Fomeroy, had
ceased to exist.  Nor is it at all likely that the last interments five years
previous to said August, were especially reserved for  this hot month,
but most probably much older interments.  There were, therefore,
no bodies removed that were in a stage of decomposition favourable
for producing febrile diseases, in any  weather,  however hot, even
had the whole number been exposed to the air of  mid-day at once."*
   Notwithstanding what Dr. Parsons  has said in the above lengthy ex-
tract, against the  validity of this  extensive and unparalleled  exhuma-
tion, as proving the innoxious nature of the gases  arising  from animal
putrefaction, we are still of opinion that it is as strong a case as could
possibly be brought forward to support the doctrine.  The Doctor cer-
tainly has not weakened our  faith in it by his laboured criticism ; for
he has not advanced a solitary argument  against it.  His chief objec-
tion is based  upon the mere opinion of two distinguished men, (one  a
chemist of celebrity,) that the  septic principle ceases to be generated af-
ter three years' interment, and consequently that this removal of thou-
sands of dead bodies was unproductive  of  disease, because, forsooth,
there had been " no burials there for the preceding three years." Now
even granting this opinion to be true, to  give the opinion any force, it
must  be proved that this septic principle is the morbific ingredient, (if
there be any) in  the results of animal decomposition,  which certainly
cannot be done.
"Med Chi Review, April, 1825, p. 406. 
35
   Fourcroy confesses his ignorance'of the nature of this septic prin-
ciple, as he terms it; it had a mere ideal existence, and yet he speaks
of it with as much certainty as if it was both visible and  tangible.  If
it is not generated after three years' interment, pray, at what period is
it generated ?   If Fourcroy knew with so much certainty that it was
not produced after three years' interment, he must have known with
equal certainty that it was generated during the period extending from
the time of burial to  the  end of the three years, else he could not
have assigned so exact a limit to its production.   And how could he
arrive at this knowledge ? by one only of two ways; either by subject-
ing it to chemical analysis, and thus first ascertaining its existence, and
afterwards by repeated analysis of the exhalations from animal decom-
position within  the time specified, he might learn when it ceased to be
generated, or he might judge of its presence or absence by its effects
upon the human constitution. That he did not acquire the knowledge
in the  way first mentioned, is obvious, because he  remarks, " we had
a strong desire to satisfy ourselves by experiment what was the nature
of the destructive air or septic principle," and if he judged of its  exis-
tence, and the duration of that existence, by its effects,  we would re-
ply that those  very effects are the subject matter  of dispute, and we
would  ask, if  it is  probable that Fourcroy ever had the opportunity
to observe a single  example of animal decomposition for three suc-
cessive years, so as to tell when  this septic or morbific  principle was
and at what time it ceased to be generated.   The fact  is, it is a  mere
conjecture, and one loo fraught with absurdity; and even were this not
the case, it is by far too slender a foundation to build an argument upon
for the overthrow of an important fact.
   It is perfectly obvious to common sense aud reason, that so long as
there is matter to undergo decomposition, that  Malaria, (if  it be a pro-
duct of this decomposition) must be exhaled ; and that  there was  an
abundance of  putrefying materials is  evident from the  fact, that al-
most the whole of the removed  superstratum  " was impregnated  or
infested, as M. Thouret styles it, with the remains of carcases."  And
again,  " grave-diggers were thrown down suddenly and  deprived of
sense  and  motion, on breaking open with their spades, the abdominal
viscera of corpses."*   Here we  have the  extrication of  a gas, so
concentrated as  to produce  asphyxia, and yet we are to  be told that
fever was not produced, because the septic principle was wanting.
   We would ask Dr. Parsons, (who cannot consistently deny that Ma-
laria in abundance must have been generated at  some  period during
the progressive  decomposition of this immense  collection  of  dead
bodies,) what became  of the immense volume of it which must have
* American Journal, No. 3, p. 98 
36
been annually disengaged as long as it was used as a burying ground ?
It must either have  ecaped through the cracks in the superincumbent
earth, or it  must have lurked in the soil.   That it did  not do the first,
will be admitted by the advocates  for the febrific qualities  of animal
miasm; because the  consequence must have been an annual and  de-
structive epidemic in the neighbourhood; and no such thing has been
contended for.   It certinly at least did not constitute one of the reasons
for so  vast an  undertaking, " the offensive smells which arose from
this spot, and sometimes penetrated into the adjoining houses," being
the only reason mentioned for  removing the superstratum, and that it
did not remain in the earth we  may infer from its not producing a  sin-
gle case of fever during the exhumation.   The truth is, it had no ex
istence; for if Malaria be a product of  animal decomposition,  the whole
neighbourhood  of the St. Innocens would have been annually devas-
tated  by fever.   The offensive gas or gases of animal decomposition,
escaped from the soil and  pervaded the whole  neighbourhood; and if
there be a septic principle or morbific gas distinct from the former, we
 see no reason  why it also should not have escaped from the superja-
cent earth.
  " Another  fact particularly worthy of notice  (says Parsons) which
Bancroft ignorantly or unfairly omits to mention is"
  " The great number of torches and fires that lighted all parts of the
cemetry, and shed around a melancholy glare," and "the thick clouds
of smoke  that  surrounded  and covered  the  place of labor."   We
cannot subscribe to the charge either of unfairness or ignorance in Dr.
Brancroft, in failing to mention the above  circumstance; a much more
charitable  supposition would be, that  he might have considered it  per-
fectly immaterial and unimportant.
  Dr. Parsons  next  notices the  mission of M. Berthe, Professor in
the school of medicine of Montpelier, who with " two of his collea-
gues in that University, were sent by the Government of France,  into
Spain, to  examine and report  upon  the nature of  the  Yellow fever,
which had proved so  fatal in several  towns in Andalusia,  in 1800."
M. Berthe, states that he was at  Seville in the spring of the year suc-
ceeding the epidemic, and " frequently visited the burying places just
without the city, in which the victims  of the fever had been  interred."
" Many thousands of the inhabitants  of   Seville, also, came hither,
says he, some for curiosity, and others in processions,  to testify their
sorrow and respect for their departed friends.   In one of these grounds,
southwestward of the city, ten thousand  bodies had been buried  ; in
two others, seven or eight thousand ; and in that of Triana, about four
thousand."
  "The heats of spring, (says M. Berthe,) which 1 need not observe
are considerable at Seville,  were at this time beginning to be felt, and,
the ground of these burial places being clayey was already cracked 
37
 into wide and deep crevices, through which a foelor was exhaled, the
 result of the decomposition which was going on among these heaps of
 bodies."
   From Seville the commission went to Cadiz "where they found the
 churches filled with putrid emenations from the same cause," but as they
 did  not discover that these supposed fomites of infection were produc-
 tive of any  mischief, their fears  concerning them seem at length  to
 have  completely  subsided; for in their reply to the President and
 members of the board of health, who  had requested a statement  of
 their opinion,  they expressly declare their belief, that if  the Yellow
 fever could  be  produced by the effluvia  arising from putrefying bo-
 dies, it was evident that such a misfortune must have already taken place,
 through the imperfect manner in  which the tombs and vaults, pointed
 out  by them had been closed; a defect which they  had observed even
 in the churches most frequented."   "Thus it app'ears (says Bancroft,)
 that the putrid emenations from the bodies of many thousand persons
 who had recently died of Yellow fever, did not, and therefore could
 not  produce that disorder."
   To the preceding facts (says Bancroft) I may add  another, which
 is related by a man whose veracity is as little to he questioned as bis ex-
 alted philanthropy—I mean John  Howard, in his work on Lazarreto's,
 page 25."  " The  Governor of the French Hospital at Smyrna told
 me  (says Mr. Howard,) that in the last dreadful plague there, his house
 was rendered almost intolerable, by  an  offensive scent, especially if he
 opened any of the windows which  looked  toward the great burying
 ground where numbers were left every day unburied; but that it had no
 effect on the health of himself or his family.   An opulent merchant  in
 this city, (adds he) likewise told me that he and his family had felt the
 same inconvenience without any bad consequences."
   Dr. Parsons objects to  the conclusions arrived at by M. Berthe, and
 his  colleagues ol  the incapability  of animal decomposition  to pro-
 duce Yellow fever,  upon  the ground that the heat of the season was
 insufficient to generate the febrific miasmata, which he alleges to arise
 from that souice.  " And who, let me ask, (says he) will pretend that
 the thermometer ranges at Seville, so high as 80°  in the spring, for a
 succession of days,  or that Yellow fever ever prevails there till late  in
 the summer."*
   Now granting to Dr. Parsons, the full force  of his objection to this
 statement, upon the ground of insufficient  temperature, at the time al-
 luded  to, namely, the spring of the year.   Yet the fact that the pu-
 trefaction of thirty  thousand bodies, about the total number of deaths  in

  * We purposely omit copying the personal remarks of Dr. Parsons upon Dr. Ban-
croft ; they certainly would be out of place here, and Dr. Bancroft, if alive, is fully
competent to defend himself from all such aspersions. 
38
 Cadiz and Seville, in the summer and fall of  1800, did not produce
 another  wide-spread  and desolating pestilence,  during the excessive
 heat of the succeeding summer, when they must have  been  in every
 stage and degree of decomposition, is proof positive and irrefragible,
 that the putrid emanations from decomposing animal matter is incapable
 of producing ''epidemic desease."  M. Berthe, and his colleagues were
 at Seville,  in the spring  of  the year  1801.  It is stated by  him that
 the " earth was already cracked into wide and deep crevices," and  if
 the comparatively mild temperature of the spring had already "cracked
 the earth into wide  and  deep crevices," it is obvious  that the great
 heat of summer,  must have very much increased  and widened them.
 These cracks had no doubt a direct communication with the  putrefy-
 ing bodies—for M. Berthe mentions the foetor of the decomposing bo-
 dies escaping through them.
   At Cadiz we  have even a  worse state of things, all  the churches,
 &tc., being  filled with  the  stench by  the putrefying   bodies in the
 tombs  and  vaults, which were very imperfectly closed ; this condition
 of things too, must have been very much aggravated by the heat of
 the succeeding summer.  In these  instances then, we have thirty thou-
 sand bodies in a rapid state of decomposition, and in  a situation too al-
 most equivalent to that of laying on the surface of the earth, without
 the production of epidemic  disease in their neighbourhood.
  As to the statement of Mr. Howard, Dr. Parsons hardly honours  it
 with a passing notice.   The  febrific principle (says he) was probably
 in a great  measure  excluded by keeping the windows closed.   And
 again,  this story comes third handed, and without any statement of the
 distance  of the burying yard from  the houses, or  the temperature of
 the air.
  As to  the manner in which this  story,  as he terms it, comes to us,
we conceive it to  be perfectly unexceptionable, and entitled to full and
implicit belief.   It was made by the Governor of the Hospital at Smyr-
na to Mr.  Howard, who considered it so remarkable, as to  deserve
publication in his work on  Lazarretto's.  Neither of them had  any
prejudice to combat,  or theory to  sustain ; it was stated as  a simple
fact and  so recorded, and  if it is of any  importance  to correct the
Doctor in so trivial a matter, we would remark that  it comes second,
and not third handed, as he  states  it.   As to the distance of  the  bu-
rying ground from the  houses and the  temperature of the  air,  the
words  " almost  intolerable by an offensive scent,"  certainly implies
that  the  one could not have been  far, and that the other must have
been  high; the  scent  could not be  intolerable, without considerable
putrefaction in  the exposed  bodies,  and putrefaction could  not take
place to any extent, without the presence of a high  degree of heat.
 But besides this, if Dr. Parsons will consult the tables on the subject, he
 will find that the plague generally begins, increases, and declines, at the 
39
 same period that marsh fevers do, and  that consequently this affords
 an additional reason for supposing that the weather must have been
 hot.
   In this instance then we have a striking proof of the innoxious nature
 of animal miasma; "numbers were left every day unburied," and in that
 hot climate too, where putrefaction must have been very rapid and in-
 tense, and yet no ill consequences resulted from it.
   "In the appendix of Bancroft, (says  Parsons) is a long account  of
 the innoxious effects, of dissections.  But  are  these, (says he) ever
 prosecuted in the heats of summer, when yellow fever prevails ?  To
 this  question we would reply in the affirmative.  Dr. Cooke says, " I
 have known some students have in the very heart of a town, in the
 chief place of concourse, a number of dead bodies in the midst of sum-
 mer, in the most offensive state, so that  great complaint  was made  of
 the nuisance, without producing any ill  effect whatever.to  themselves
 or others, except some little nausea and  perhaps  head-ache  in one  of
 them."*
   " The account of an  3dipocise establishment  near Bristol, in Eng-
 land, is unaccompanied by any statement of the season of the year,
 or of the temperature  of the  atmosphere, or the number of persons
 exposed to the effluvia, or the  amount of putrid animal matter existing
 at the same time.   The same  imperfection attends the accounts of the
 dead bodies washed on shore near Aboukir; the glue,  soap, candle cat-
 gut and leather factories."
   It will  be  observed  from the above, that  Dr.  Parsons dismisses
 these cases illustrating the harmless  character of animal miasmata, in
 a  very summary and expeditious manner.  But he  will not be suffered
 thus to dispose of them without some better  and  more substantial rea-
 sons than he has given in the above  extract, not one of which we ven-
 ture  to say can be sustained.
   We will first give the accounts  entire, as  detailed by Bancroft, and
 then make our remarks upon them.
   " In the Edinburgh Medical and Surgical  Journal, for October 1st,
 1810, may be seen an  account given by  Dr.  Chisholm, of a manufac-
 tory, (of which I had some knowledge from  the time  of its first estab-
 lishment) at Conham, near Bristol, destined for the  conversion of ani-
 mal  flesh into a  substance resembling spermaceti, by cutting up dead
 horses, asses, dogs, &c, and putting their muscular parts into boxes
 with holes for the admission of water, and afterwards placing them in
 pits filled with water, while the entrails and useless parts of many hun-
dred carcases were left to putrefy on the surface of the earth.   And
it appears from Dr.  Chisholm's statement, as well as from other infor-

  "Treaties on Pathology and Therapeutics, vol. 1, p. 150. 
40
mation  which was given to me on the subject, that though  the efflu •
via from these putrefying animal matters was  highly offensive to the
overseer of this Manufactory, and to the  workmen employed under
him, as  well  as to others within their reach,  no injury was done  by
them to the health of any person, during the two years in which these
operations were continued."
   " During the time that our very numerous fleets of transports lay in
the bay of Aboukir, many  bodies  of sailors   who had died, or  had
been drowned, were washed on the  shore, where they remained unbu-
ried, exposed to the heat of the sun.   In  riding to Rosetta  it was ne-
cessary to keep along the shore ; and I passed  18 or 20 corpses in this
situation.  They were in various states of putrefaction ; but the stench
from all was offensive in the highest degree,  and often extended to
more than 100'yards.   My  curiosity led me to approach close to most
of them, that 1 might examine the changes they had undergone. Some
were swelled up to an enormous size, and the skin seemed so distend-
ed, that  it  appeared ready to burst.   These were often of a dark co-
lour ;  some had not yet come to that state, others had  passed it;  and
the skin having burst in several places, the air had escaped, and  they
had become more or less desiccated and of a black colour. Every per-
son who had occasion to pass from  the camp to Rosetta, was obliged
to come within reach  of the vapours emitted by these bodies.  There
were orderly dragoons constantly passing ; yet, neither  myself  or  any
one else was attacked with  fever, in consequence of our exposure to
these vapours; and my professional  situation would probably have ena-
bled me to learn if any such occurrence had followed."
   Now  we admit that in the  statement of Dr. Chisholm  about  the
Manufactory at Conham, it  is not said in so many woids, that the wea-
ther was very hot, or that a  given quantity, or what quantity  of animal
matter was exposed on the surface of the ground at  one  time,  but
from the expression " the entrails and useless  parts of many hundred
carcases were left to putrefy on the surface of the ground, it is obvi-
ous that it must have been considerable ; and  that it was in a state of
putrefaction, is equally evident  from the expression, that" the effluvia
of this putrefying animal matter was highly offensive  to the  overseer
of this Manufactory," &c.   It is mentioned, too, that these operations
were continued during two  years, from which  we must conclude that
they were  carried  on  in the  summer and autumn of these two years, as
well as during the other seasons. A part then, of these remains "of many
hundred carcases,"  must have  been exposed  to the hot sun of these
two seasons during two successive years, which surely must  have been
sufficient to have exhaled  even  the septic principle, which Dr. Par-
sons identifies with the noxious  miasm (if there  be any)  of animal
putrefaction;  and yet we are told that not the  slightest  febrile indispo-
sition was induced during the whole of this time. 
41
   As to the occurrence in Aboukir bay, we would observe that the
bodies " were in various states of putrefaction," which  certainly im-
plies that there was a sufficient degree of heat to bring them into that
state : and we may also presume there was from the expression "where
they remained unburied, exposed to the heat of the sun."*
   Bancroft mentions  an establishment at Greenland dock for boiling
blubber.   " Mr. Ritchie, (says he) had lived more than  fifty years  in
the neighbourhood of this dock, was well acquainted with the boiling
process, and assured me repeatedly, that  though the blubber is often
in a very offensive state, emitting  an highly putrid smell, neither him-
self, nor his people, nor  the crews  of the Greenland  ships, who per-
form the whole boiling, &c, nor the neighours, have ever to his know-
ledge suffered  in  their  healths from that operation."    " The stench
from the blubber  is universally admitted  to be  greatest when it  is
boiling."
   In noticing this fact, Dr. Parsons remarks, " that the  boiling of blub-
ber should be harmless  notwithstanding its offensive effluvia, is what
certainly might  be expected, considering the great power of fire  as
before stated on several authorities to destroy Malaria."
   The  heat  of fire, like that of sun, rarifies and disperses  Malaria.
It is not supposed by  any so far as  we know, that  any thing like de-
composition or destruction of this gas takes place.   Now if it takes an
upward  course under the  operation of heat, the  circumstance men-
tioned in the latter part of the statement under now  consideration, and
which Dr. Parsons either overlooked, or disengenuously omits to men-
tion, viz.,  that the effluvia  arising from the boiling blubber, (" so far
from  being unhealthy, are, on  the  contrary reckoned so wholesome
that it is very common for sick persons to come to the copper, as soon
as they arise from their beds, and  to hold  their heads over the steam,
as close  as they can") is perfectly conclusive against  the supposition
of the escape of the  Malaria upwards, during the  process of boiling
the putrid  blubber, and that so far from being destroyed by fire, there
is none  to  destroy.
   The last instance from Bancroft,  mentioned by Dr.  Parsons, is the
putrefaction of fish.   " The use of  fish for manure, such as herrings,
alewives, &c, is adverted  to, says Parsons,  byBancreft, and also by
the gentlemen before alluded to, in  Boston  and Philadelphia.  It should
be borne in mind, however, (continues he) that most of these fish are
buried, and that such of  them as are above ground,  are strewed over
it, and from their small size  are soon dried."
  The highly fertilizing qualities of fish manure, arises entirely from

  * We hope Dr. Parsons will pardoa us for italicising these words, and not mete
us the same measuie, he does to Bancroft for using a similar  liberty.
                        6 
42
 their undergoing the process of rotting, or decomposition in the soil,
 with which they have been slightly covered.  Without the taking place
 of this  process, they are of no avail as manure, and  that it does take
 place is obvious from the increased productiveness of the land after
 their application.   Now  we would  ask Dr.  Parsons,  if even he,
 would contend, that the covering of two or three inches of loose earth,
 could form an impenetrable barrier to the escape of Malaria, (if it be
 generated) into the surrounding atmosphere; and that none escapes is
 plain from the fact that the neighbourhood remains perfectly  healthy
 after the use of large quantities of fish in this way.  It does  not es-
 cape, because none is generated.
   But though most  generally spread upon the land, soon  after they
 are caught, this  is not always the case ; they are sometimes left to pu-
 trefy in large heaps upon the shore.   " Such is the plenty of fish in
 our  rivers, (says Cooke,) that at most fisheries, great heaps almost ev-
 ery  year, putrefy for want of purchasers.   But no  epidemic fever has
 ever been known to arise on such occasions."*
   We have thus got through the last example of animal  putrefaction
 cited by Bancroft, to show its innocency of producing epidemic  dis-
 ease, which  has been  criticised by  Dr.  Parsons,  we  think  his
 objections to  them  have been shown to be invalid,  and that they still
 stand the triumphant refutations of the theory of the febrific qualities
 of animal miasmata.
   There are  some ojher instances equally strong and convincing with
 these whose examination we have just finished, upon the negative side
 of this question, which, as'the subject is important,  we  will  bring be-
 fore  the eye of the reader.
   Dr. Gordon gives " an account of the putrefaction of  1000 barrels
 of salted beef, at the island of Santa Cruz, which was  finally ordered
 to be thrown  into the sea ;  and were thus disposed of without having
 occasioned sickness to  any person, in the house, store, or neighbour-
 hood where this putrefaction had taken place and  subsisted."!   He
 also  gives an account of a whale which putrefied very harmlessly at
 the same island.
   Dr. Merrill, after stating that the epidemic yellow fever which nearly
 depopulated Pensacola in the year 1822, was " attributed to the im-
 portation of damaged cod-fish," says " It is a remarkable fact, that
 came under my own observation, that the  United  States troops, sta-
tioned in fort  Barrancas, consisting of about one hundred persons, were
exposed in very  close,  uncomfortable quarters, almost  in the midst of
 a whole cargo of this putrid  fish, which had been wrecked upon the

  * Treatios on Pathology and Theraputics, vol. 1, p. 92.
  t Bancroft on Fever, p.* 422 
43
 beach, and yet not a single case of fever occurred among them during
 the four weeks they were thus situated, and not until three weeks af-
 ter the fish had been removed.   At the  same time  a battalion of in-
 fantry, that was cantoned one mile distant, in a dry, airy situation, was
 sorely afflicted with violent bilious fevers.  The sailors who had been
 living  on board this fish vessel for a number of months in the West
 India  seas and harbours, and in the midst of putrid exhalations, that
 were almost suffocating to a stranger, all arrived  in Pensacola in good
 health, and only suffered in common with the  other inhabitants, after a
 residence of three or four weeks in the city."*
   This case needs no comment, it speaks  for itself.  The concomitant
 circumstances of the putrefaction of nearly a  whole  cargo of fish, are
 such as we presume will satisfy, even Dr.  Parsons, as fastidious as ho
 is ;  it  being  very hot weather, and the fish having been wrecked and
 lying  upon the beach,  a sufficiency  of  moisture  was  undoubtedly
 present.
   " A committee has been engaged in France  in examining the cir-
 cumstances relative  to the Knackers operations.  His business con-
 sist  in killing old worn  out horses, and in turning  every part of their
 bodies te account.   The most singular results which the committee
 have obtained  relate to the innocuous nature of the exhalations ari-
 sing from the putrefying matters.   Every body agreed  that they were
 offensive and disgusting, but  none  that they were unwholesome : on
 the contrary, they  appeared to conduce to health.  All the men, wo-
 men and  children,  concerned in  works  of this kind,  had unvarying
 health, and were remarkably well in appearance and strong in body.
 The workmen commonly attained an old age,  and were generally free
 from the usual infirmities which accompany it.*   Sixty,  seventy, and
 even eighty were  common ages.   Persons who live close to these
 places, or go there daily, share  these advantages with  the workmen.
 During the time that an epidemic fever was in  full force at two neigh-
 bouring places, not one of the workmen in the  establishment at Mount
 Faucon  was  affwcted by it.  It did not  appear that it was only the
 men who were habituated  to  the work that were thus favoured; for
 when,  from press of business, new workmen were taken  in, they did
 not suffer in health from  the exhalations."
   " In confirmation of the above observations, similar cases are quoted.
Above two hundred  exhumations are made yearly at Paris, about three
or fonr months after death; not a single case  of injury to the work-
 men has been known."|

  * Phil. Journal, No. 18, p. 238.
  t Contrast this with the decrepitude and premature old age, brought on by living
 in an atmosphere impregnated with miasmatic Cihalaticns,
  t American Journal, No 9. p- 23o 
44
  This account and the one preceding it, show in the most conclusive
manner that putrefying animal  matters, not only  are not hurtful  in
themselves, but it would appear from them that they are actually en-
dowed with a sort of preservative efficacy from the effect of mias-
mata.  In  confirmation of this, we may  mention the fact stated by
Rush, that of nearly one hundred butchers who remained in the city
of Philadelphia, during the yellow  fever of 1793, only three died ;
and we are told by Ambrose Parey that the plague was checked  in a
city in Italy by killing  all the cats and dogs in  the place, and  leaving
them to putrefy in the streets.
   We will now proceed to examine some of the instances brought for-
ward by Dr. Parsons to prove the affirmative of this question; and pre-
vious t© entering upon this examination we will observe that  we have no
doubt that excessively  concentrated animal miasma suddenly burst-
ing  out from a confined situation, may not only produce asphyxia, but
also death in those immediately exposed to it.  Such were some of
the instances brought forward by Dr. Parsons;  and we can well  ima-
gine that " in  a wider  circle of dilution," they may produce nausea,
loss  of appetite, he., but that any thing like epidemic fever has  ever
originated from animal putrefaction, we totally disbelieve.
   The first instance of epidemic fever supposed to have originated
from putrefying animal matter referred to by Dr. Parsons, is that which
occurred in New London, in  1798.  This case has often  been refer-
red  to by other writers.   " Of the whole number of cases of fever
(246) two  hundred  and thirty-one were  clearly traced  to the spot
where the sickness commenced, that is, the persons were  conversant,
or had been in  that part of the city a few days before they were  seiz-
ed,  and scarcely a single person escaped the disorder who resided  in
that part of the city."
  "It appears (says Mr. Channing, in his letter to Dr. Mitchell) that there
was a large quantity of dried fish in a bad state, in four or  five stores,
within twenty or thirty rods of each other, and all  in the limits refer-
red  to."  " The heat of the summer having been very great, many of
these fish were found to be in a moist slimy state early in August last.
From a quantity lying in bulk in a store occupied by Mr. Jones, (who fell
a victim to the epidemic,) a quantity of green and yellow purulent mat-
ter ran upon the floor.  It was thought by the owners that if they were
spread in the sun, in the open air, the fish might be preserved ; which
was done, extending them a considerable distancp along the street and
wharves.   While thus exposed to the  excessive heat of the sun with
light winds, the effluvia in the neighbourhood were very offensive."*
   We have already mentioned an instance in which a whole cargo of
* Med. Repository, vol. 2, p. 402. 
15
putrid cod-fish, produced not the slightest injury to the health of those
exposed to its operation, though in a situation highly favourable to its
deleterious operation, they being confined in very close'uncomfortable
quarters ; we are constrained then in this case to look for some other
cause of this severe epidemic.
  Dr. Channing, speaking of the situation of New  London, says it is
elevated, " with scarcely any low grounds  to  generate miasma."  If
this expression means any thing at all, we must infer from it, that there
were some low grounds in the neighbourhood.  And here we suspect
will be  found the whole secret of the origin of this  fever.   The sum-
mer of this year, in the language of Mr.  Channing, exceeded " in in-
tenseness and duration what has ever been experienced by the oldest
inhabitants ;" and again he says, " I am  fully convinced, that had not
last summer exceeded what has ever been known before, in long-con-
tinued and intense heat, with no thunder or rain, and light winds  and
calms, neither the fish in its bad state, nor any other  subordinate cause,
would have produced our epidemic."
  This intense and  long-continued heat was certainly well calculated
to exhale Malaria from marshy grounds,  and that there was ground of
this nature in the neighbourhood, we cannot but  infer from Dr. Chan-
ning's letter.  The  situation  too, of the sickly parts of the  city was
such as to favour the approach of Malaria, " being  elevated and  dry,
and open to  the land and sea breezes."  Here then we have the  pre-
sence of  a known cause of epidemics, (i. e. low lands,) together with
intense heat, and the situation af the sickly part of the town such as
to favour miasmata being driven into it by  either  the  land or sea
breezes, according to the situation of the low land in the vicinity. These
considerations, together with the facts already detailed, in which a whole
cargo of  putrid  cod-fish, with  every circumstance  favourable to the
production of Malaria, failed to excite even the  slightest indisposition,
are well calculated to throw  doubt at least upon the  supposed origin of
this fever.
   But there is one  other circumstance connected with the account,
which we think  proves pretty clearly that  this fever did not originate
from the putrid fish.   Dr. Channing states that a captain of a coasting
vessel belonging to New London " took in about twenty quintals of the
fish from three  stores, on the 2lft er 22d  of August, and sailed for
Hartford.   He  had them  packed in hogsheads there, and  delivered
on  the  3rd. September, on board  a boat bound to a town  in  Ver-
mont."   This circumstance  undoubtedly proves that the fish were not
so far gone in a state of putrefaction, as to be rendered unfit for  traf-
fic ; this must be evident also from  their admitting of being packed
and repacked.  We now leave it to every unprejudiced mind to say
whether an extensive epidemic could justly be charged to the presence 
4G
of fish, so little tainted as not to be unsaleable ?   But again, let us pur-
sue this putrid fish in its journey, we ought  certainly to find  its course
marked by disease and death.   It was  first landed at Hartford, and
there packed in hogsheads ; yet no mention is made of its having pro-
duced disease in that place.  From thence it was placed on board a boat
and sent to a town in Vermont; and yet neither in the hands on board
the boat or  in  the town to  which it  was sent did it produce  fever.*
Let it be  recollected, that  this  very fish was " part  and parcel"  of
that which was said to be producing the most fatal and extensive dis-
ease at that very time, in New London.
   The Captain of this coasting vessel, a few days after his return to
New London, was seized with fever, which was charged to the  fish,
he had conveyed away in his vessel.   But if the putrid fish was  the
cause  of  his illness,  it certainly would have produced it in the other
hands on board the vessel, who  slept with  it under their very noses;
and inhaled the offensive  gases  arising from it, with every breath they
drew.
   We think therefore, that  the  fact of  their being some low-lands in
the neighbourhood of New  London, to generate miasma, and the state
of the weather being exactly such as to favour its production and the
situation of the sickly portion such that Malaria might be driven  into
it from all quarters, is strong evidence, in favour of the disease having
originated from this source.   On the other hand, the  fact that a whole
cargo of putrid fish, near Fort Barrancas,  produced  not the slightest
disease in  the  numbers exposed to its operation  day and  night, con-
nected with the other  fact, that a portion of the very putrid fish, which
was said to be producing violent  disease in New Londen, was removed
and carried to Hartford in the same state, and from thence sent to the
state  of Vermont, without producing disease along its circuit, affords
strong evidence against the supposition, that the fever  in New London,
arose from the putrid cod fish.
   The second instance of fever  referred to  by Dr. Parsons, as having
been caused by animal putrefaction, is related by Dr. Samuel Osborn,
in the Medical Repository, Vol.  1, page 210.   " The patient, a soldier,
was excused from duty, on account of  a violent and  obstinate  gonor-
rhoea, and  a lodging was assigned him in a house  without the garrison,
on Governor's  Island ; here in a few  days he was  attacked by symp-
toms of Yellow fever,  and  as his physician  observed, in  his visits, a
very offensive smell in the house, he ordered the celler under the  pa-

  * We are  fully warranted in saying that it produced no disease along its track ;
because if it had, so material a fact would havo been seized upon by those  who
attributed the fever in New London to this putrid fish, and they would have pre-
sented it as strong additional evidence in confirmation of the truth of their opinion 
47
licnt's bed to be examined, where were found three barrels of beef in
a state of extreme  putrefaction.  So exceedingly offensive was  the
smell emitted from  this mass of animal putrefaction, that  the  soldiers
who were employed to remove it, were several times forced to desist,
for the purpose  of  breathing  fresh  air, before they could  accomplish
their design.   On the removal of the beef, the patient gradually mend-
ed."
   To us there are  two insuperable objections to this being received as
an instance of the production of fever, by animal  putrefaction.   1st.
It is a solitary instance  of fever arising from this supposed  cause, while
many were exposed to its full influence, without any such effect.  The
physician,  his nurse,  or nurses—the soldiers of the garrison, who
doubtless had a free access to him, and  especially those persons em-
ployed to remove the putrid beef, and who were therefore exposed to
the immediate and concentrated influence of the gases arising from it, all
escaped the disease. 2d. Dr. Gordon relates an instance (already men-
tioned in a former part of the essay,) of the putrefaction of 1000 bar-
rels of beef,  which  did not produce disease, either in those immediately
exposed  to it, or in the  neighbourhood,  If  1000 barrels of putrid
beef  failed  to produce fever, we cannot  for a moment admit the be-
lief that three would have that effect.  We marvel very much, that
with this  conclusive fact before his eyes, Dr. Parsons had the  con-
science to pass it by unnoticed, and then to cite a solitary case of fe-
ver supposed to have  been produced by the exhalations  from three
barrels of putrid beef.
   As to the fact mentioned by Dr. C/ffin, of  the disinterment of a
corpse after  ten weeks burial, and of the consequent sickness of thir-
teen out of twenty  of  those exposed to the effluvia arising from it;  it
is too vague and unauthenticated to  be received as evidence upon  this
subject.   The man was killed in Orange, New Hampshire.  Dr. Cjtf-
fin, (if we mistake  not) resided in  Newburport, Massachusetts.   He
does  not mention his  authority for  the account, and we  should sup-
pose from the manner  in which the circumstances  are detailed, that it
was a mere  rumor.  Until,  therefore, we have a more  explicit and
authentic account of this case, we do not think it  can be  received as
an example  of the  febrific qualities of animal miasm.
  Moreover, we can mention a case of  disinterment  after thirty-two
days' burial,  when from the horrible stench emitted from the body, it
must have been in  a state of extreme putrefaction, which was unat-
tended by any such effects as are said to have arisen in  the instance
above mentioned.  M.  Orfilla was consulted by the police, whether poi-
son could be detected  in a body that had  been buried so long as thirty
days ?   He  answered in the affirmative, and  was directed to exhumate
a corpse and examine it in a medico-legal point of view.   The body 
43
had been buried thirty two days, and when exposed to the open air, exhal-
ed such a horrible foetor,that it could not be borne at two hundred yards
distance.  After three hours exposure, the foetor was a little diminish-
ed, and it was determined to try the  aspersion of  a solution of chloru-
ret of lime, (which had been recommended by M. Labarraque, as ef-
ficacious in removing foetor,) the mephitic exhalations ceased immedi-
ately, and Orfilla and his assistants were enabled to prosecute their in-
vestigation for several hours without  inconvenience."   Here we have
a case well  authenticated, and  striking in its character, in which no
fever resulted from exhumating  a corpse, the foetor of which could
scarcely be borne at  two hundred yards distance.
   It will also be recollected (as already quoted) that the committee en-
gaged in France in examining into the circumstances of the Knackers
operations, state that " above  two hundred exhumations are made
yearly at Paris, about three or four months after death ; and not a sin-
gle case of injury to  the workmen has been known."
   "Mr.  Samuel Russel, of New York, in a letter  to Dr. Mitchell,
states, that two hundred barrels of herrings in a considerably offensive
condition, were  shipped  in  July, 1801, to  St. Croix,  and the mar-
ket being  bad, were taken  to  Kingston, Jamaica, where they were
placed in store."
   " By this time (says Mr. Russel)  the fish were discovered to be fast
spoiling, and  advancing  rapidly through  the putrefactive process; the
master of the store and  his clerk  lived  and slept in a room directly
above that in which  the fish were now lying and corrupting.   They
were both invaded  by yellow fever."
   Here is an effect certainly not  commensurate  with the cause ;  but
two persons out of  all exposed to the putrid emanations from the  fish
being taken sick.  These  fish when first shipped, must have been  a
good deal spoiled,  being then in " a  considerably offensive condition;"
and by the time of their arrival at Kingston,  " were advancing rapidly
through the putrefactive process," and yet no indisposition is produced
among the sailors,  who inhaled the putrid effluvia arising from it night
and day during the voyage, but as soon as they are landed, they are
endowed with a  morbific quality.
   But independent of this, there is  an inconsistency in the account it-
self, which detracts from its weight.   If these two hundred barrels of
herrings " were advancing rapidly  through the putrefactive process"
by the time  they reached  Kingston, why were they stored for sale ?
It involves an absurdity  to suppose that their owner would encounter
the  expense  of storage, &c, for fish which were unsaleable, and
which must certainly have  been the  case, if they were at the  time
they were stored, "rapidly advancing through the putrefactive process."
It would have been much better to have cast them into the ocean, to 
49
be devoured by the " monsters of the great deep," than to have been
guilty  of such an  absurdity.  And we can  hardly  suppose that the
merchant would have received fish which were in a state of putrefac-
tion, to the constant annoyance of himself and of those who frequent-
ed the store.
   Independent, however, of these considerations, the fact of the fre-
quent  pievalence  of yellow fever  in Kingston, where no such cause
is ever suspected, as far as our information  extends, would require a
strong and irresistible concatenation of  circumstances to prove its ori-
gin in  this instance from animal  putrefaction; it would  be necessary
to show clearly the  non-existence of any other cause producing the
drsease.
   The next instance brought forward by Dr. Parsons, is the epidemic
which  prevailed  in Newburyport, in 1796.  One of the causes to
which  this fever was attributed, was the putrefaction of the entrails of
" a great quantity offish" which had been left exposed to the air. The
weather being uncommonly moist and warm, the exhalation was very
offensive to the neighbourhood.   In one of the  houses  nearest the
fish  offal, the  three first persons  were  seized with the disease; and
within twenty or thirty rods the greater number of its victims lived,
The majority of those who recovered lived in other parts of the town.
Most,  if not all, who had   it  at  a distance, had   frequented the in-
fected neighbourhood, but  did not communicate the infection  to their
attendants."*
  This fever commenced about the middle of June, and  terminated
towards the last of  October; thus following the usual course af mias-
matic diseases.  This  fact of the duration of the fever is important,
because upon it alone we  will ground our objection to the validity of
its supposed cause.  Dr.  Parsons, inadvertently,  not to say unfairly,
omits to mention that when  the fever made its appearance, the putre-
fying entraib, he., were removed, as is  obvious from the  statement of
Dr. Coffin, that " the committee  were very careful by removing  nuis-
ances to promote purity of air in all parts of the town." Now with this
statement before him, no rational  mind will contend that the putrefying
entrails, &c, were  the cause of this disease, which did not cease fer
at least three months after their removal.  In the  instance of the ship
Regalia, and other vessels mentioned in  this essay, the fever ceased to
spread immediately upon  the  removal of the cause, and  since  this
fever  not  only continued, but  like  emidemics  generally, probably
increased,  and  did  not terminate  until   between  three  and  four
months after the  removal  of its supposed cause, it is obvious that
there must  have been some other cause  more  latent in its nature,
" Med. Repository, vol. 1. p. 504. 
50
which from this circumstance had probably escaped the vigilance of the
committee.
   " In Washington, a small village, containing about four hundred in-
habitants, situated six miles from Natchez, and occupying a  high  situa-
tion, remote from any swampy ground, the yellow  fever prevailed in
1828, and was unquestionably occasioned by a quantity of putrid fish
and hams lodged in a grocer's  store."
   The history of this fever was written by Dr. Cartwright, of Natchez,
and published in the April No. of the Medical Recorder, for the year
1826.  It has been  minutely criticised  by Dr. Cooke, and  we ven-
ture to say that no unprejudiced mind, after reading his remarks, will
deny  that they contain a complete refutation of the origin of this  fever,
contended for by Dr. Cartwright.   We shall  be altogether indebted
to his able work for what is said upon this case.
   It will  be observed by reference to Dr. Cartwright's essay, that  in
the middle of the town of Washington, " is a hollow about fifty yards
wide, surrounded by high ground  on every side  but the  north-east.
On that side it contracts into a bayeu or ravine,  which empties  about
four or five hundred yards off into  a branch of St. Catharine's creek,
which flows between Washington and Natchez."*
   " In this hollow was  situated the  grocer's house and  lot."  " The
earth, (says Cartwright) had been  thrown up around the palings of the
lot, except at one  place, (left) to  serve as a drain in rainy  weather.
This  drain was choked up with weeds and  trash, when I examined it
during the progress of the epidemic about to be described, and served
but imperfectly the purpose for which it was intended."
   " In this case  then, (says Cooke) the body of the town is situated
in and about a bottom, closed in by  high ground on every side but one;
in which there is a narrow vent for  the  water and filth of the town,
into a small stream  four  or five  hundred yards  off.   The  drain
through this hollow is stated to have  been choked  up by  the weeds,
&c, abounding in that rich soil, so that it did  not answer the  purpose
intended."f
   " There was a succession of rains in every month  in  summer, and
the temperature was very high." " There were in particular foui days
of rain in the last week of August, and three  in the  first of  Septem-
ber;  during which time, until the commencement of  the last rain, the
mean  temperature was as high as 91°, at four o'clock in the afternoon,
and 82 1-2° during that rain."
  " The fever commenced in a week after the last rain, about the 15th
of September, and increased very rapidly  until  the 25th; the mean

  " Cooke'a Treatise, vol. 1, p. 141.
  t Treati«e on Path, and Ther. vol. 1, p 144. 
51
temperature at the same hour, for fifteen days at that time being 86 1-2
degrees.  It prevailed throughout the rest of September and  Octo-
ber, during  which  time the  weather continued clear and hot; there
being rain on four days only in  fifty-four, and the mean temperature
of September,  at four o'clock in the afternoon being 83 degrees, and
that of  October 80 degrees.   It ceased not until after  several severe
frosts in November."*
   " It is clear then that in this case heat, moisture, and vegetable mat-
ter were present; that  is, all the circumstances known to be essential
to the production of epidemics, and therefore there is not the slightest
necessity for seeking for any other cause.   And  even if there were
any difficulty in  the  case, how can we attribute this disease to the ex-
halations from  two  thousand pounds of bacon, so little putrid  that a
man  wanting to purchase,  examined the whole of it, to see if there
was any fit  for  use, when more than two hundred thousand pounds of
beef produced no such effect?   Or how attribute this effect  to two or
three barrels of putrid mackerel, when a putrid whale produced none
such?  Or when no epidemic follows where  whole  fields are covered
with putrid fish ?"f
   " One very remarkable circumstance In this case, is that  the bacon
when it was found to be disagreeable to  the neighbours, was privately
removed in one night for fear of a fine, before  the fever broke out."\
   " Here also,  (adds Cooke) after the  alleged cause is removed the
effect appears,  increases to a great height, affects the whole neighbour-
hood, and ceases not until the severe frosts of November put an end
to the exhalations from the vegetable matter still abounding;  not from
the animal  matter removed eight weeks before."^
   The last  instance adduced  by  Dr.  Parsons,  to show the febrific
qualities of animal putrefaction, which we  shall notice, is the  follow-
ing.  " In  the  mouth  of July, 17—, a very corpulent lady died  at
_____.  Before her death she begged as a particular favour to be bu-
ried in  the parochial church.  She had died on  Wednesday,  and on
the  following Saturday was  buried according to her desire.   The
weather at  the  time was very hot, and a great drought had  prevailed.
The succeeding Sunday, a week after the  lady had been buried, the
protestant  clergyman had a very full congregation, upwards of nine
hundred persons attending, that being  the day for administering the
holv sacrament."
   The account goes on to state, " there were about one hundred and
eighty communicants.  A quarter of an hour after the ceremony, be-
fore they had quitted the church, more than sixty of the communicants

 "^TW.seon Path and Ther. vol. 1: ?■  114.
   \ Cooke's Treatiese, vol. 1, p. 142.      X Ibid r  Ho.      § Ibid 
53
 were taken ill:  several died in the most  violent agonies, others of  a
 more vigorous constitution, survived by the help of medical assistance;
 a most violent consternation prevailed among the whole congregation
 and throughout the town.  It was concluded that the wine had been
 poisoned.   The sacristy and several  others  belonging to the vestry,
 were put in irons.  The persons accused underwent great hardships;
 during the  space of a week they were confined in a dungeen, and
 some of them were put to the torture, but they persisted in their inno-
 cence."
   " On the Sunday following, the magistrate ordered that a chalice of
 wine uncovered should be placed, for  the space of  one hour, upon
 the altar: the hour had scarcely elapsed, when they beheld the wine filled
 with  myriads of insects ; by tracing whence  they  came, it was per-
 ceived, by the rays of the sun, that they issued from the grave of the
 lady who had been buried the preceding fortnight.   The  people not
 belonging to the vestry were dismissed, and four mer\ were employed
 to open the vault and the coffin ; in doing this, two orthem dropped
 down and expired on the spot; the other two were only saved by the
 utmost   exeition of  medical talent.   It  is   beyond the power  of
 words to describe the horrid appearance of the corpse when the cof-
 fin was opened.  The whole was an  entire mass of  putrefaction ; and
 it was now clearly perceived  that the numerous insects, together with
 the effluvia which had issued from the body, had caused the  pestilen-
 tial infeetion which  was  a week before attributed to  poison.  It is but
justice to add, that on this discovery, the accused persons were liberat-
 ed and  every  atonement made  by the magistrates and clergyman for
 their misguided conduct."
   This is truly a singular and marvellous account, and  well calculated
 upon a  cursory perusal to produce the belief, that the effluvia from the
 body buried in the church was  the cause  of  the  violent illness with
 which  so  many were suddenly affected.   But we would ask, why,
 when there were about nine hundred persons present; sixty of the
communicants alone were seized  with severe sickness, and this within a
 quarter of on hour after the sacramental ceremony. The effluvia if present
at all, must  have pervaded every  part of the  church, and  out of up-
wards of nine hundred individuals present, all equally exposed to its
deleterious influence, but sixty individuals and those communicants were
affected.  Is not this much too partial an operation for a general cause
so virulent in its nature as to produce a sudden and dangerous illness  in
sixty individuals ? The unexampled rapidity and suddenness of the at-
tacks, the " violent agonies," he., are incompatible with the known ef-
fects of  Malaria, for when it destroys in a few  hours, its fatal presence
is never marked by the " violent agonies," he., said to have been pro-
duced in this instance.  There is always indeed  a want  of feeling the 
53
very sources of sensation, the brain and spinal marrow, being over-
whelmed by the pressure of disease.
   But there is strong reason to believe from the account itself, that the
effluvia from the putrefying body, had not even escaped into the church
and therefore could not have been the cause of the disease.   We are
justified in supposing that there was no fceior present, because if there
had been the attention of  every one would have been immediately di-
rected to its source; and if this be not the febrific principle, it at least
always accompanies it, and is prominently  remarked upon  in  every
supposed instance  of the sort.  But no one, we are to presume, attri-
buted  the sickness to the dead body, buried  one week before, for " it
was concluded  that the wine had been poisoned," and that this was the
cause of the disease.  If this supposition  then  be admitted, it is strong
evidence against the belief, that the putrid body was the  source of this
violent disease.
  On the following Sunday, when the people were again assembled, "the
magistrate (for what reason is not mentioned) ordered that a chalice of
wine uncovered, should be placed, for the  space of one hour upon the al-
tar; the hour had scarcely elapsed, when they  beheld the wine filled with
myriads of insects; by tracing whence they came, it was perceived, by
the rays of the sun, that they issued from the grave of  the  lady who
had been buried the preceding fortnight.   Light  now broke in  upon
their  minds—the mystery was solved—the sickness was at once  attri-
buted to the effluvia which had escaped from this mass of putrefaction;
but is it not very singular and unaccountable,  that at this time,  when pu-
trefaction,  must have progressed still further and  deeper in the  body,
and of course the atmosphere of the church more thoroughly impreg-
nated  with the noxious effluvia arising from it, the same  lamentable
catastrophe, or a worse one, which the preceding sabbath had witness-
ed, was  not at  this time repeated.   We are  certainly to  suppose from
the expression " the'people not belonging to the vestry were dismissed,"
that the congregation was  again assembled on  this sabbath, and yet no
disease is  produced in the hundreds, whom  we  may suppose,  were
present.
   What was the cause of the violent disease which so suddenly man-
ifested itself, we cannot pretend to determine;  but apart  from its  mar-
velous  and unauthenticated character, (for neither the time  when, or
the place where, nor the   name of the individual who reported it, is
mentioned,) there  are inconsistencies in the account itself, which  in our
opinion  clearly prove that the putrid body  buried in  the church was
not the cause of the disease.
   There are several other  instances brought forward by Dr. Parsons,
in his essay to prove the affirmative of this question; but  they are
mere isolated statements, unconnected with  any detail of circumstan- 
54
ces, and  therefore  not admitting  of examination.   The objections
which Dr. Parsons makes to the " often recited accounts of Bancroft,
and others," (as he terms  them)  of animal putrefaction, being  ad-
mitted, as valid  evidence on  the negative side of this question,  we
have endeavoured to refute; whether successfully or  not, others must
decide; and  the instances cited by him, will not, we think, bear the  test
of examination.
   In conclusion, we would remark, that animal miasm either is, or is
not, capable of producing epidemic  disease.  It cannot  at one time
possess this  febrific character,  and at another time,  under the  same
circumstances be  devoid  of  it.   It follows therefore, that  if even  a
solitary instance can be produced, where every circumstance and con-
tingency, claimed by the most fastidious  sticklers for the doctrine, as
necessary to develope  the morbific  principle,alleged to arise  from  an'
imal putrefaction are present and operating, without the production of
disease, then, the presumption is a  fair one, that animal miasma is  not
a cause of epidemic disease, and that in the  instances of its supposed
origin from that source, there must have been some  other cause ope-
rating, which was overlooked, because  less prominent and striking to
the senses ;  that some  such unexceptionable  cases are to be found in
this essay, must, we think be admitted by every one;  and a number
of others, sufficient to convince every  unprejudiced  and  impartial
mind, "that  animal putrefaction is not a source of Malaria, and there-
fore is never the cause of epidemic disease."
   We have  thus proved the positions with which we set out: namely,
"That vegetable matter perse in  a state of putrefaction  produces in
abundance  the morbific principle, which  is the subject of this essay ;
and that animal matter in the same state does not  produce it.  When
therefore, both animal and vegetable  matter, in a state of putrefac-
tion are present during  the prevflance of  an  epidemic disease, form-
ing by an union of the results of both processes what has been called
vegeto-animal miasmata, the  existing disease must be ascribed solely to
the Malaria arising from the vegetable putrefaction because the latter,
without the former is fully competent (as has been proved) to the  ef-
fect produced, and no additional effect results  from  a  combination
of the two miasms.   The phrase vegeto-animal miasm, therefore, is
incorrect when used to  designate the particular gas which produces  ep-
idemic fever;  the animal miasm having "no part nor lot" in the matter.
   3d.  What are the best means to prevent its formation?  This branch
of the subject is of vast  importance, and  heretofore has been by far
too little attended to.   Physicians, unfortunately, for  the cause of hu-
manity, in the  eager disputes about the precise  nature of the fever pro-
duced by Malaria, have had their minds loo much diverted  from  the
means necessary to prevent the formation of Jim deleterious principle, 
55
and thus have in some measure realized the fable of the doe and  his
shadow.                     *                          °
   We have already  mentioned that four things are necessary  to the
developement of  Malaria; namely, heat, moisiure, vegetable  matter,
and the contact of air; if any one of these requisites be absent, Ma-
laria is not produced.   From this fact then we may deduce many of
our preventive means; for by removing any one of them we arrest the
exhalation of  this  gas.
   Vegetable matter, with the  co-operation of  heat and  moisture will
every  where produce disease, hence the great necessity for enforcing
the utmost cleanliness in all large cities and towns, particularly the re-
moval of all collections of vegetable matter.   The streets, yards, cel-
lars, ponds, gardens,  stores, &c., should all  be made to pass through
the most rigid inspection.   Much good  has resulted from following this
course, and dreadful distress  has been occasioned  by neglecting it.
Dr. Rush observes, "in a manuscript of the life of Doctor, afterwards
Governor Colden, of New York,  there is the following fact:   It was
first communicated to the public in the daily Gazette of the capital of
that State, on  the 30th October, 1799."  « A malignant fever having
raged  with exceeding  violence for two summers successively in the
city of New York, about forty years ago, he communicated his thoughts
to the  public on the most probable cause  of the calamity; he publish-
ed a little  treatise on the occasion  in which he collected  the  senti-
ments of the  best authority, on  the bad effects of stagnating waters,
moist  air, damp cellars, Jilthy stores  and dirty streets.  He showed
how  much these  nuisances prevailed  in  many parts of the city, and
pointed out the remedies.  The corporation of the city voted him
their thanks, adopted  his reasoning, and established a plan for draining
and  cleaning the  city which was attended with the  the most  happy
effects."*
   The United  Provinces of Holland, (says Rush) hold their exemp-
tion from the plague only by the tenor  of their cleanliness. In the cha-
racter given by Luther of Pope Julius, he says " he kept the streets
of Rome so clean  and sweet, that  there were no plagues nor sickness
during his time."f
   Ponds of water should never be allowed to exist in cities or towns,
or even in their neighbourhood.    In such situations they too often be-
come the reservoirs of offal matter of every description ; which either
by gradual accumulation, may finally rise above the surface of the water,
as happened  in  the instance related  by Senac, or by  evaporation of
the water, may become  exposed  to the action of a hot sun, and in  ei-
ther event, may exhale miasmata in abundance.
* Rush's Inquirers, vol. 4, p. 135.    t Ibid. p. 134. 
i>6
   But as we have before observed, marshes, strictly so called, are the
most fruitful sources of miasmata.  These abodes of this pestiferous air,
from their great extent and other  circumstances, will often not  admit
even of any attempt to  change their  nature; and  all that  is left us in
such cases,  is to interpose between them and us, the  barriers  to the
progress of  Malaria  with  which  nature has  kindly furnished us, and
which  will be mentioned in a future part of this lecture.
   Though, however, in many cases no favourable change can be effect-
ed, in numerous other instances much has been done to redeem marshes
from their noxious state. The experience and industry of man have often
triumphed over these laboratories of Malaria, and from having been shun-
ned as the foci of disease, they have been converted into the abodes of
heahhand plenty. By a judicious use of ditching, so as to drain the soil
of its superabundant water and subsequent  cultivation, by which the
earth, being frequently turned up  to the drying action of the sun and
air, wonderful changes have been effected.   "  With the aid of thepn-
rifying sea breeze, this course, (says Ferguson,) at the British colony
of Demarara, within six degrees of the equator, has succeeded in ren-
dering the  cultivated portion of the deepest and  most extensive mo-
rass probably in  the  world, a  healthy, beautiful,  and  fertile  settle-
ment."*
   The  Campagna di Roma, now the abode of pestilence, was once
comparatively healthy, and was indebted for it in a  great  measure to
the "constant tillage," and "to the  extreme attention paid to draining the
deposites of stagnant water," and  to the aqueducts which then travers-
ed it in every direction.   " These, however, being broken down and
destroyed  by the Goths, by which the  country  became overflowed, it
soon became excessively sickly.
   " In the  neck below Philadelphia, since  it  has been  drained, its
agues have disappeared."f
   " Fourteen miles above  Calcutta, at Barrackspore, the position  is
healthy, but  it is owing to the ground  being in  high  cultivation, and
cleared and drained all around to a  great extent.  On  the opposite
shore of the Hoogly, at Serampore, for the same reason, the climate i?
salubrious.   But above all,  at Chandernagore, about five miles further
up, on  the west side, the health of Europeans is proverbial; but there
the French have taken great pains to drain the grounds.  The position
chosen for the settlement is elevated   above the bed of the water at
high tide  above  fifty feet, and those  ditches,  about which so  much
was  debated in  the  treaty of peace, of 1763, and which the Bri-
tish were so apprehensive of being converted into  a military fosse, ac-
tually drain off vast bodies  of water for four or five miles from the

  • Phil. Journal,  No. 13. p. 20.    I Mod Recorder, July, 132o. p. 493 
57
river.   These ditches are  admirable evidence of sagacitv and  indil-
ference to expense, as the ditches are lined and  bottomed'with the fi-
nest bricks, and convey to those volumes of water into the main river
which were before suffered to stagnate and infect the air.  Ohinsurah,
two miles further up, is a healthy  position, and  here great pains were
also taken to drain off the rains."*
   These examples present  in a striking point of view, the good effects
of draining marshy land by extensive ditching, he., by means of which
it   is brought  into  a  fit state for cultivation.   Without this latter ef-
fect, however, no good is effected, for so long as the land is too wet
for the  plough, it will under certain  circumstances exhale miasmata.
Draining and cultivation should therefore always go hand in  hand, the
first being generally nugatory without the co-operation of the latter.
   Many persons are deterred from  attempting  to rescue their  lands
from a marshy slate, by the trouble and expense necessarily attending
it;  but health should certainly be preferred before all other considera-
tions, and  independent  ef  the  attainment  of this grand  object, the
bountiful crops yielded by lands  thus redeemed, will most frequently
more than compensate for all the trouble and expense incurred.
   If, however, the situation of the marshy land  is such as not to ad-
mit of  draining, he., there  is one other expedient, whereby to prevent
the  exhalation of miasmata, of which we can av&il  ourselves in  cer-
tain situations, and that is to inundate the  marshy soil, and thus  pro-
tect its surface ~ from  the action  of  the sun.  This expedient will not
only certainly prevent the formation of Malaria, but when forming, will
immediately arrest its furtherproduction.
   Sir John Pringle informs us, that  the inhabitants of Beda,  in Dutch
Brabant, prevent the exhalations which give rise to fevers, by inunda-
ting the low grounds in the neighbourhood ; and " Purchas tells us,
(says Rush) 500 persons less died of the plague the day ofter the Nile
overflowed the grounds which had emitted the  putrid exhalations that
had pioduced it, than had  died the day before."f
   The clearing of wet land, should be followed up immediately by cul-
tivation.  Land  of this description   having on it a growth of timber,
should  never have its wood  cut down without the specific purpose and
power immediately to devote the soil so cleared to agricultural  uses ;
because experience has taught that the mere clearing of marshy land,
is almost certain  to be followed  by  disease in its  neighbourhood.   In
proof of this, Rush  says,  "it has often been observed, that families
enjoy good health, for many years, in the  swamps  of  Delaware and
North Carolina, while they are in their natural state, but that sickness
always follows the  action  of the sun upon  the moist surface of  the

  * Lind on Hot Climates, p. 65.     t Inquiries and Obser. vol. 4, p  123
                    8 
58
 earth, after they are  cleared.  For this  reason  the cultivation  of a
 country should always follow the cutting down of its timber, in order to
 prevent thenew ground becoming, by its exhalations, a source of dis-
 ease."*
   Dr. Robert Jackson also says, that "in this country, (America,) the
 unhealthinessof a  place is often obviously increased, by cutting down
 the woods of the neighbouring swamps;  therefore, no rule is more lia-
 ble to exceptions, than that  which has  been so generally enforced,
 namely, that clearing a country of its  woods  invariably  renders it
 healthy ; unless the grounds be drained and cultivated as well as clear-
 ed, the effect is likely to be the reverse."f
   4th. When formed, what  are  the measures necessary to remove or
 render inert the sources of it 9  Common sense would at once suggest
 the propriety of removing all obvious causes of disease, which  from
 their  nature  will admit of their removal.  Thus heaps  of decaying
 vegetable matter, may and certainly ought to  be removed; and where
 fevers arise from this source, they will cease to spread simultaneously
 with the removal of the cause.   We have striking instances of the
 immediate  efficiency of a removal of the  morbific cause, in putting a
 stop to fever,  in vessels in which it prevails, as soon as the holds are
 cleansed  and purified, it ceases.
   But when  Malaria is exhaled from extensive marshy ground, all at-
 tempts to put a stop to it for the time being are vain, unless it is so sit-
 uated as to admit of being flooded, which  as we  have  before said, is
 immediately effectual in producing this desirable event.  The only al-
 ternative  that is left, is to remove Irom the neighbourhood of the marsh
 until a kindly frost  shall have  stopped the exhalation, when persons
 may generally return to it with safety.  But a repetition of this unplea-
 sant and  with  many impracticable  alternative,  may be prevented by
 ditching and cultivation, where the circumstances of the ground admit
 of the employment of those remedies.   But where they do  not a very
 effectual barrier against the approach of  Malaria, may be  obtained by
 the interposition of trees  or a wood between the marsh and the af-
 fected spot.  This to be sure  is a slow  method, the  advantage of
which  we may not reap for years, but it is at the same time a sure one.
The trees or wood, no doubt, act mechanically  in obstructing the ap-
proach of  Malaria, since a high wall or a house has the same effect.
   Many places, previously healthy, have become immediately sickly
 upon cutting down an interposing  wood between them and  a marsh,
and on the other hand, many situations  before sickly have  been  ren-
dered healthy from  the growth of trees between them  and marshy
grounds.    Dr. Jackson  says,  " histories abound with  examples of

  ' Inquiriei and Obser. vol. 4, p. 136,     i On  Fever, p. 55. 
59
destructive  epidemics,  which  have  followed  the  cutting down  of
groves, which covered morasses or intercepted the approach of Ma-
laria,"*                                 n        n
   Dr. Lisle in his memoir on Malaria, translated by Dr. Johnson, and
incorporated in  his work on Tropical Climates, says  " upon  Mount
Argintal, above the village of St. Stephano, there is a convent which
has lost  all the  reputation  for salubrity it once  enjoyed, since the
lofty trees by which it was surrounded have  been cut down."f
   He also says, " I have been informed  by persons worthy of credit,
that in consequence of felling the wood before Asterna, near the Pon-
tine marshes, Veletri was visited for three successive years by disease
which made much greater  havoc than  usual  throughout the whole
country."J
   Again, he says, " I have seen the poor fishermen, who had taken up
their abode near the canal, which runs from Campo Salino to the sea;
they had built their huts close to a  wood that screened them from  the
direct access of the infected winds which pass over that morass; and
declared that they never suffered inconvenience  from them so long  as
they remained under that shelter."
   He states the  following fact from Volney, " Barrant, formerly very
unhealthy,  has ceased to be so  since the  Emir  Fakr-el-din planted a
wood  of fir trees, which  still exists  a league below the town.  The
monks of  Mark-anha, who are  not  systematic natural philosophers,
have  made the same observations respecting different convents."^
   These instances, and they might be multiplied,  plainly shew the ef-
fects of wood  or grove of trees in arresting the progress of Malaria, and
ought as well to warn us, never to destroy a wood  happily situated be-
tween us and a marsh, as to teach the salutary lesson to supply it when
absent by planting trees, &c.  This may seem to  some so slow a me-
thod of attaining the desired object, that they may on that  account
neglect to avail themselves of it, but though we may never enjoy the
benefit of if, we should have an eye to posterity, and  not selfishly re-
fuse to confer a blessing upon our children, because we could not live
to enjoy it,  and   thus leave them  estates cursed  with  unhealthiness,
which leaving the danger to life out of the question, withers and dries
up all the sources of earthly comfort.
   5th.  What are the best  means of obviating its effects upon  the hu~
man constitution,  when the cause cannot be removed ?
   These means  may, we think, be properly  divided into such as ope-
rate upon the  constitution, and  into those which are furnished us by
our knowledge of some  of the characteristics of Malaria.   Among
the most important and beneficial of the first  division may be men-

  'OnFever, p. 54.   I On diseases of Trop. Climates, vol, 2, p. 122.  jlbid.  § Ibid 
60
tioned a proper regimen.   This we think, if judiciously pursued, might
be rendered very efficient, if not in preventing, at least in ameliorat-
ing the effects of miasmata;  anc in our  opinion, has never yet been
presented in its full value and importance.   Entertaining this belief,
we regretted very much, to find, upon perusing Professor Caldwell's
essay upon febrile miasm, and his more recent prize essay on the  same
subject, that he disapproved of any change from the accustomed regi-
men, with a  view to counteract the effects of Malaria.  "Not a little
(says he) has been said about diet, drink, and  general regimen best
calculated to protect those who are exposed to febrile miasm.   Some
recommend a very moderate diet, consisting chiefly if not  exclusively,
of vegetables, with water as the only drink.  The object of this is sta-
ted to be so to purify the blood, that the miasm may find in it no suitable
matter on which to  act.   Others urge the propriety of a free, if not
a full diet of animal food, with a liberal  allowance of wine, or some
other stimulating beverage, with a view as they express it,  " to live
above the fever."
   "  The rule of wisdom (continues  he,) appears to be as follows.—
Let  those who are exposed to a febrile  miasm, persevere steadily  in
their usual  course  of diet, drink  and regimen,  provided they  have
found it by experience to agree with them; I  mean provided it has se-
cured  to them the  greatest amount of health,  strength, and general
comfort  of  which they  are susceptible.   For in proportion to these
will  be the resistance of their systems to the action of poison, any thing
that  may in the least derange their health or weaken their powers, in-
creases necessarily their liability to disease."  "During the prevalence of
an epidemic, then, let those whose habit it  is to eat animal food, and
drink  wine  or  spirits in moderation, continue to do so;  while those
whose diet  has been  vegetable, and their  potation  aqueous, should
persevere in them; provided, 1 say, they have  found them salutary."*
With all our deference and high respect for the opinion  of Professor
Caldwell, for no one do we entertain more, we conscientiously believe
that the a1x>ve extract is fraught  with error, and contains  advice not
only dangerous, but of fatal tendency.  It may be abused so as to af-
ford direct and positive encouragement to the  voluptuary, to continue
in his course of living,  regardless of the solemn warnings  of  death,
which in sickly  times, may constantly cross his path.  Ask, the devo-
tee  of the pleasures of the table whether he finds his course of living
injurious or not to his health, and in nine cases out of ten, you will be an-
swered in the negative, aye, and with truth too, very often  ; for free
living and drinking,  which unfortunately  too often go by  the name of
 moderate indulgence in such pleasures, (if pleasures they can be call-
"Transylvania Journal, Nov. 1830. p. 513. 
61
ed) and which misnomer lulls their unhappy victim into fatal security,
may be enjoyed for years without any perceptible effect  upon the health
and constitution ; they may be surely though with sure  and progressive
steps, undermining the very citadel of health, and no external beacon
be held out to warn the  victim  of the work going on within ; until  at
last the bloated face, the  indurated liver and swelled abdomen, tell
too plainly of the wreck  of  his constitution.   We need not say that
such individuals are not only more liable to fever, but have it in a more
aggravated  shape than others.
   Neither  reason, fact,  or analogy, we think will support  Professor
Caldwell in his notion as to the  regimen most proper to obviate the ef-
fects of  Malaria.   We would ask him, what it is that renders the " in-
oculated small pox" so much milder  than the " natural small pox ?"
Surely not the bare insertion of the poison into the arm; but rather the
low  diet, the frequent cathartics, and the refrigerating treatment which
are used to "prepare the system" for the disease. By this course of pre-
paratory treatment, small-pox,  even before the  discovery  of vacilla-
tion, was in a great measure robbed of its terrors,* and we have not
the shadow of a doubt,  that  could it be  known when the contagion
was received into the system,  the same  course of preparation would
be equally effectual in mitigating the symptoms of the " natural small-
 pox."   Why then, should not the same plan, be equally useful in ren-
dering milder the orperation of Malaria ?  Both are invisible poisons
 floating  in the atmosphere;  the primary symptoms produced by both
 are  alike,  and we have no doubt that both  destroy life through  the
 same  means, namely  by insufficiently controlled excitement, together
with the ravages of local inflammation.
   But independent of these considerations, we have positive and un-
 questionable evidence in favour of abstemiousness in rendering milder
the effects of miasmata.   Dr.  Jackson remarks, that the French and
 Spaniards,  who eat "less animal food," and drink their liquors greatly
 more  diluted than the natives of England, escape the diseases of tro-
 pical climates much  better  than  the latter; and  their safety I  might
 add, has been remarked  to  bear  some proportion to the different de-
 grees of abstemiousness, which they are known to observe. An idea
 prevails, (continues he)  with the generality of people who visit warmer
 or more  unhealthy climates, that it is necessary to eat and drink freely,
 as a security against the attacks of endemic fevers ; but a very narrow
 observation will  serve to show,  that good living as it is  called  has  no
 such effects, and we  may even soon perceive, unless  blinded by long
 established prejudices which flatter our appetites, that it is actually  at-

 ~~*it~was estimated that only one in  two hundred died, of those  who were inoculat-
 ed for the srnall-pwi. 
62
tended with pernicious consequences.   The most abstemious, as far as
I have observed, escaped the best, not only from the attacks, but par-
ticularly from the danger of disease."*
  Again, he says, " it is known to every medical man, that the fevers
of hot climates are generally most dangerous in  full and plethoric ha-
bits.  It ought to be an object of attention, therefore, to obviate  this
cause of mortality by spare living, and the cautious use of stimulating
liquors."
  Dr. Rush, in  his history of the Yellow Fever, of 1793, affords stri-
king evidence of the good effects of low diet, both in preventing and
mitigating the operation of miasmata.   In  a publication, (says he) da-
ted the 16th of September, I  recommended a diet of milk and  vege-
tables, and  cooling purges to be  taken once or twioe a week,  to the
citizens of Philadelphia.  This advice was the  result of the theory of
the disease 1 had adopted, and of the  successful practice which  had
arisen from it.   In my interview with my fellow-citizens, I  advised this
regimen to be  regulated by the degrees of fatigue and foul air to which
they were exposed.   1 likewise advised moderate blood letting to all
such persons as were of a plethoric habit.  To men, (continues he)
who weie influenced by the publication in favour of bark and  wine, and
who were unable at that time to grasp the extent and  force of the re-
mote cause of this terrible   fever, the  idea of dieting, purging  and
bleeding the inhabitants of a whole city,  appeared to be extravagant and
absurd.   But I  had not only  the analogy of the regimen made use of
to prepare the body for the small  pox, but  many precedents in  favour
of the advice.   The benefits of low diet, as a preventive of the plague
were established by many authors, long before they received the  tes-
timony of the benevolent  Mr. Howard in their favour."   " By  means
of the low diet, gentle physic, and occasional bleedings, which  I  thus
publicly recommended, the disease was prevented in many  instances,
or rendered mild when it was taken."f
   In another place, he says, that by following the above advice, " the
progress of the  fever  was  restrained  in  many families, or  it  was
rendered when taken as mild as inoculation does small pox."
  These  facts are strong, and certainly  outweigh the  mere  naked
and unsupported opinion of Professor Caldwell.
  The regimen  then, which we would strongly recommend to all  per-
sons during the  prevalence  of a  fatal epidemic, is such as will lower
the  inflammatory tone  and diathesis of the system and remove or di-
minish plethora; a diet consisting of vegetables and water alone, for drink
is precisely calculated to have such an effect, without in the least degree
impairing the strength or weakening the powers of the system: nay, we

  * On Fever, p. 258.       1 Inquiries and Obser. vol. 3, p, 160. 
63
believe it increases its powers of endurance.  If this be true, as we will
endeavour to prove, if a regimen consisting essentially of vegetables and
water lor drink, diminishes the plethora and inflammatory tendencies
of the system; and at the same time  preserves the  strength, it cannot
but be beneficial; and any course of living having a tendency  to keep
up or increase this state must be prejudicial, hence we deprecate the
use of much or any animal food, and alcohol in any shape, be  it either
in the nauseous potation of grog,  or the more fashionable glass of wine.
This  regimen is not recommended with the object in  view mentioned
by  Dr. Caldwell, namely,  " so to  purify the  blood,  that the miasm
may find in it no  suitable matter on which to  act;" thii, we consider
absurd and ridiculous; but because its effect is to diminish  plethora, and
to subdue inflammatory diathesis if present;  in fine, to put the system
in such a condition as  will best enable it to withstand the shocks  of
disease.
   We have said that a regimen  such as we have recommended,  so
far from enfeebling the powers of the system, added  to its capabilities
of endurance.   We  cite  Dr. Jackson as our authority.  Speaking
of a journey he performed while in  the  West Indies,  he  says : " I left
Kingston, on foot, about twelve o'clock, and  accomplished a  journey
before it was dark, of eighteen miles.   I did not find I was materially
fatigued, and still persisting in my resolution,  travelled a hundred miles
more in the space of the three following days.  It may not be impro-
per to remark that I carried baggage with me, equal in  weight to the
knapsack of a soldier."
   In the next page he says "I observed formerly, that abstemiousness
and temperance were among the best means of preserving health,  or
obviating the danger of the diseases  to which troops  are liable on their
first arrival in hot climates; but the  rules of temperance are little re-
garded  by English soldiers at any time, and  almost constantly trans-
gressed, whenever  extraordinary labour is required of them.  To
such  causes of excess, joined with the great heat of  the sun, we  may
attribute many of the bad effects of marching, or immoderate fat.gue,
in the West Indies. In thejourney which I have just mentioned, I pro-
bably owe my escape from sickness  to temperance and a spare living.
I breakfasted on  tea about ten in the  morning, and made a meal of
bread and sallad after  I had taken  up my lodgmg for the night.  If
I had occasion to drink  through the day, water or lernonade was  my
beverage.   In the year 1782, I walked between Edinburgh and Lon-
don in  eleven days and a half; and invariably observed, that I per-
formed  my journey  with greater ease  and pleasure, where  I drank
wau?r andyonly  breakfasted  and supped,  than when  I  made three
meals a day, and drank wine, ale, or porter.
*On Fever, p. 266. 
61
  Johnson, speaking of the Hindoos, remarks, that " the lower or in-
dustrious classes on the other hand, who live almost exclusively on ve-
getables, certainly have a striking  resemblance to " Pharoah's leaned
fleshed kine."  But though they have not the physical strength of nn
European, they make  up for this,  in what may be termed " bottom ;
for it is well known, that  a  native will go through three times as much
fatigue, under a burning sky, as would kill an  Englishman outright.—
Witness the palankeen bearers,"coolies, dandies, hircarrahs, he.
  These facts show plainly that a  vegetable diet is  amply sufficient to
sustain the strength under the severest exercise, and evince we  think the
futility of the objections to adopting a regimen such as recommended,
upon  the ground of its being too " sudden and great a change in diet
and drink, and such as would tend to weaken the system."
  It may be thought perhaps, that we have devoted too much space
to the consideration of regimen; we  do not however think so.   The
subject upon which we lecture is not confined in its bearing and interest
to a single community, it is co-extensive  with the  prevalence of Ma-
laria;  and thinking as we do. that a proper regimen  is one of  the most
powerful means of mitigating its  operation, we could not without  do-
ing  injustice to the subject have said less.   What enhances its impor-
tance, too, is, that it admits  of easy  and  universal application, and if
generally  followed during  severe  epidemic visitations, would unques-
tionably detract greatly from their mortality.
  Professor  Caldwell, is  also  unfriendly to  the  use  of medicines,
bleeding, &c, as a means of prevention  and amelioration of the ef-
fects of Malaria; but in this he  is  equally erroneous and unsupported
by facts, as  in the former.   Dr. Rush considered  bleeding very use-
ful, particularly  in  the  robust and plethoric, in warding  off, and in
mitigating the fever excited by Malaria. As precedents in favour of the
practice  he cites the authority of Dr. Haller, and Dr. Hodges, who
both  found it very beneficial  during lire  prevalence of  plague.   Dr.
Rush gives a remarkable instance of its good effects:  It was commu-
nicated  to  him in  the  year 1798, by Dr.  Boland,  physician to the
British  army.  The account is as follows:   " In  the  beginning o(
August,  1797,  109 Dutch Artillery,  arrived at Port-au-Prince,  in the
Bangalore Transport.  The florid appearance of the men, their cum-
bersome clothing, and the season  of the year, seemed all unfavourable
omens of the melancholy  fate we presumed  awaited  them.   It  was
however thought a favourable opportunity by  Dr. Jackson and myself,
to  try what could be  done in  warding off the fever.   It was  accor-
dingly suggested  to  Monsieur Conturier, the chief surgeon  of the
foreign troops, and the surgeon of the regiment, that the whole detach-
"Tropical Climates, vol. 2, p. *}.r.G. 
65
ment should be blooded freely,  and that the morning after a dose of
physic should  be administered  to  every man.  This was implicitly
complied  with a  day or two  after, and at this  moment  in which I
write, although a period of  four  months has elapsed, but two of that
detachment have died, one of whom  was in a  dangerous state when
he  landed.   A success unparalleled  during the war in  St. Domingo.
It is true several have been attacked by disease, but in those the symp-
toms were less violent, and readily subsided by the use of  the lancet."
  "The crew of the Bangalore, on her  arrival at Port-au-Prince, con-
sisted  of  twenty-eight men.   With them no preventive plan was fol-
lowed.   In a very few weeks eight died, and  at present, of the original
number, but fourteen remain."*
  We believe the use of medicine, so  as to preserve the bowels in a
laxative state, has proved very  beneficial in  warding off,  and render-
ing  milder, the  operation of Malaria ;  the same reason which would
induce us to recommend a spare diet,  would also suggest the use of
mild medicine  for  the  above  mentioned  object.   It is a powerful
means of both removing and preventing plethora and all local accumula-
tions and determination of blood.   Many writers mention their salu-
tary effect.   Dr. Edward Miller, in his observations on Yellow fever,
says, " of all  the  means of obviating the  approach of  this disease,
preserving regularity in the intestinal discharges, is perhaps, the most
important.  And, when indeed, this is completely done, it seems pro-
bable that nothing  short of the most  concentrated  and  virulent  as-
sault of miasmata will be  sufficient  to bring on diseases."f
   " Hundreds, perhaps thousands, of the citizens of Philadelphia (says
Rush) were indebted  for their preservation from the Yellow fever, to
the  occasional  use of a calomel pill, a few grains of Rhubarb, or a
table-spoonful  of sweet, or castor oil,  during the  prevalence of our
late pestilential fevers.  Even the air of Batavia,{ has been deprived
of its poisonous qualities by means of this"class  of medicines.   A cit-
izen of  Philadelphia, asked a Captain  of a New-England  ship,
whom he met at that island, how he preserved the whole  crew of his
ship in health,  while half of the sailors of  all  the other  ships in  the
harbour were sick or dead.   He informed  him, that it was by giving
each of them a gentle purge of sulphur every  day."§
   It would seem from some very remarkable facts on record, that ca-
lomel taken so  as to excite slight ptyalism, exercises a  preservative effi-
cacy from the diseases produced by Malaria.  Dr.  Rush says it pre-
served most of the  crew of a Russian  Ship, at  Plymouth, in the year
1777, from a fever  generated by filth in her hold."
  •Inquiries and observ. vol. 6 p 118.        tMed Repository, vol. 2 p 393
  tBataviais probably one of the most sickly places on the globe.  It has been
computed that one half of all now-comers die thereon the nrst year of their arrival.
  $ Inquiries and Observations, vol. 4, p. 117.
  s                      9 
6G
  "In a letter (says he) which I received from Capt. Thomas Trux-
ton,  in  the year 1797, he informed  me, that an old and respectable
merchant  at Batavia, had assured him, he had been preserved in good
health by calomel  taken in the way  that has been mentioned, during
the sickly seasons, for upwards of thirty years."*
  But the most astonishing fact in proof of the prophylactic powers
of calomel, occurred at  the fatal island  of  Edam, already  mention-
ed.   The  surgeon,  who wrote the  account of the fever which des-
troyed so many at that place, after describing the particulars of it, re-
marks: "One  circumstance more is so singular in itself, and  so much
attracted our notice at the time, that I think it deserves commemora-
tion.   Of all  the people or patients who slept at the fatal island  of
Edam, four only, to the best of my knowledge,  escaped the fever en-
tirely, and returned to Malacca. These were two obstinate venereals, and
two  chronic dysenteries; all under the influence oj mercury, for some
time before I sent them to the hospital.  Their complaints did not get
better in the least on shore, so that they continued to take mercury there.
They  slept in  the same  ward with the fever patients all the time, but
never had the slightest symptom of fever  themselves."f
  All the prophylactic measures mentioned, (with the exception per-
haps of the last,) namely: spare diet, occasional bleeding, and medicine,
owe their beneficial  effects to the same principle  of action; they all
reduce the quantity of the circulating fluids, and we contend that fever
supervening under such  circumstances, will be less high, less inflam-
matory, and therefore less dangerous, than under opposite circumstan-
ces: there may be a fulness or exuberance  of health (if the  expres-
sion is allowable)  which  will not  only  invite disease, but which will
render it vastly more severe than  it otherwise would have been: such
persons possess more  of the pabulum of fever, and hence it is that in
them we  often witness a violence and rapidity in the  march of dis-
ease, which frequently defies all our  efforts  to arrest it.
   Persons  exposed  to  an atmosphere  vitiated by Miasmata, should
avoid as far as practicable, fatigue or  exhaustion either by bodily labor
or walking,  or remaining much in the hot sun.  Fatigue often proves
a powerful  exciting  cause of Miasmatic  diseases, developing them
in all their fearful activity, and destroying life in a few hours.   Dr. John
Hunter says, that  in persons fatigued by hard labor and long fasting,
the poison gains admission more readily into the system, and  produces

  * Inquiries and observ. vol. 6, p. 121.
  f Dr. Johnson, in remarking upon the above occurrence, says; "It accords with
my own experience, for  I have not known a person fairly under the influence of
mercury, for  the cure of any other complaint, to be attacked either by endemic
or contagious fever."  And in allusion to the escape of the mercurial patients at
Edam, he says, "such an  immunity cannot be  attributed to chance.  The proofs
are both positive and negative.  They, and  thev onlv. escaped the fever." 
67
immediately the  worst kind of fever.   It is in this way (he adds) that
soldiers suffer so much on  actual service in  the West Indies: the few
cases of fever which proved fatal in twenty-four hours, that  occurred
to me, were all contracted in a similar manner."*
   Cold particularly, when united with dampness, is also a strong ex-
citing cause of disease in those whoce systems  are impregnated with
Malaria. Lind mentions particularly the pernicious effect of the damp,
cold easterly wind in increasing the number of the  sick.   An undue
exposure to it therefore, should be avoided as far as possible.
   The depressing passions, such as fear, grief, chagrin, despondency,
he. are powerful auxiliaries to Miasmata, in producing disease:  while
the opposite feelings of  hope, that "star of life's tremulous ocean,"
which shines though with sometimes dimmed, yet never  extinguished
lustre, over our path through life/brace the  system as it were  against
the attacks of Malaria.
   Johnson mentions some  striking  instances of the opposite effects
produced by these opposite states of feeling.  "1 have indeed (says
he) remarked that most  of  those, who were  of a timid disposition,
and easily  alarmed at the prevalence  of the  endemic diseases of the
country, fell under their  influence sooner than those of a contrary
temperament.   But grief, disappointment, and  chagrin, were the de-
pressing passions which universally induced the most decided and un-
equivocal  predisposition  to disease.   I saw many strong and melan-
choly  instances of this among that part of our crew, which we impres-
sed within sight of their own  shores,  and  probably of their own habi-
tations, when we were commencing our voyage to India.   They were
among the first and worst cases I had under my care, and afforded
ample proofs, that  mental despondency can accelerate the attack, and
render difficult the cure  of intertropical fevers  in particular.  I have
seen the influence of this predisposing cause on a large scale;—not
on the banks of the Ganges, but, much nearer home, on the banks of
the Scheldt."
   "When  our army (continues he) lay entrenched under the walls of
Flushing, without any other defence from the sun, the rains and  dews?
than some  brushwood or straw;—generally, indeed, with the humid
earth for their beds, and the canopy of Heaven for their curtains; still,
with all these disadvantages,  the animating  prospect of success, the
mental energy inspired by hope, united with corporeal activity, kept
the  whole  army in health.  When  Flushing surrendered, however,
and another object was not instantly held out for pursuit or attainment,
a fatal pause took place, and a kind  of  torpor, or rather exhaustion
ensued, during which the remote cause of fever, namely, vegeto ani-
* Diseases of the Army in Jamaica. 
68
mal miasmata, began to make some impression.   But  when from the
ramparts of Batz, we clearly discovered with our glasses, a strong boom
crossing the Scheldt from Fort Lillo,—the  surrounding country in a
state of inundation, and  various other insuperable obstacles  between
us and the  "ulterior objects" of the expedition; then, indeed, the de-
pressing  passions,  and  some other predisposing or exciting causes,
communicated a fearful  activity to marsh effluvium,  which rivalled in
its effects any thing that I had seen in tropical climates."*
   Dr. Rush, in speaking of those causes which  counteracted the ef-
fect of medicine, and increased the mortality of the yellow fever of
1793, mentions as one of them, " the universal  depression of  mind,
amounting in some instances to despair, which affected many people.
What medicine,  (says he) could act upon a patient who awoke  in the
night, and saw through the  broken and faint light of  a  candle, no  hu-
man creature, but a black nurse, perhaps asleep in a distant corner of
the room ;  and who heard  no noise, but that of  a hearse  conveying,
perhaps, a  neighbour or a friend  to the grave ?"
   We could easily multiply such instances as these,  but they are suffi-
cient to show the injurious  operation of the depressing passions upon
those exposed to miasmatic exhalation.  These causes, no doubt, ope-
rate extensively both in increasing and rendering more violent the cases
of disease, in every malignant and severe epidemic.  Few, unsupport-
ed by religious hopes and aspirations, have fortitude enough to  behold
with calmness and resignation, the fearful ravages of death among re-
lations  and  connexions, without a  feeling  of agonizing  distress, a
gloomy foreboding of ills yet to come, and alarm for  personal safety.
These feelings so natural, and we may say, so honorable to us, should
be struggled against as much as possible ; grief and  despair being too
of the most powerful co-operatives  with Malaria in  the developeraent
of disease.
   We will now mention those means of obviating the effects of  Mala-
ria,  which  are   furnished   us  by our  knowledge  of some  of its
properties.   The  first rule we would suggest under this head, and  it
is one of cardinal importance too, is by all  means to avoid the evening
or night air, as well  as an exposure to the  atmosphere of the morning
previous to sunrise.  The reason of this rule will be obvious, when it
is recollected that miasma is dispersed by heat of the  sun, during the
day, and that as soon as he withdraws his beams and  sinks below the
horizon, it begins to descend, and remains in the lower strata of atmos-
phere, until it is again rarified and dispersed by his kindly rays.  The
instances already cited, show  conclusively this characteristic of Mala-
ria, and will impress more strongly than any  words of mine can do, the
" Diseases of Tropical Climates, vol. 1, p. 118 
69
necessity and advantage of the caution suggested.  The fatal island of
±.dam, among many others, is a memorable  instance of the deleteri-
ous operation of night air charged with  this morbific principle, as well
as the complete  dispersion of it by the  heat of the sun during the
day.                                                        0
   De Lilse says, "the evening dew  is so much dreaded atRome,that
as  soon as  it  begins  to be  perceived, all the  inhabitants  shut
themselves up in their houses:" and again, " the people of Italy, and I
suppose of all countries where the air is bad, never go abroad, unless
absolutely obliged, till after sun rise,  when the heat has  dispersed the
pernicious vapours that have fallen during the night."*
   He gives a striking and curious example of the good effect ef avoid-
ing the night and early morning air. " In one of the most  unhealthy
corners of the Pontine marshes (says he) 1 found a man who had for
several years been employed there in making charcoal from turf. Du-
ring this period, he  had  never  been afflicted with any disease, and
when questioned respecting a circumstance so very  extraordinary  in
such a place, he ascribed the preservation of his  health, to the follow-
ing precautions :   He made a  particular  account of returning to his
hut by sunset, where they kept a continual fire ; he never left it again
till late in the morning,  and remained near his furnaces  in the day
time.  It is obvious that miasmata  either did  not penetrate  into his
hut, or if they did,  the vapours combined  with them were rarified  by
the heat of the fire, and carried off  by  the currents of air, which this
fire incessantly produced.   This man  so  well instructed in  experi-
ence, had  a florid  complexion, and a totally different look  from the
people  of the country, who, taking  no precautions, are annually ex-
posed to a mortal disease, and drag  on a truly pitiable existence."f
   In the next place we  would  recommend, that the upper apartments
of houses should be used for sleeping; experience clearly establishing
the fact, V that the lower you  are, the denser are the strata  of mias-
mata," and consequently the more violent  the effects arising  from it.
We have already mentioned several examples in  proof of the supe-
rior salubrity  of the second stories of houses, and  need not repeat
them here.
   The practice of  seclusion, keeping the doors and windows  shut, so
as to oppose a mechanical obstacle to the ingress of Malaria, has been
found useful and is well  worthy of a trial by  those at least whose cir-
cumstances will admit of it.  De Lilse  strongly recommends  it."  If
I had (says he) to direct the inhabitants of a town attacked with alarm-
ing epidemic disease, ***** I would immediately enjoin the ge-

  * Johnson on Tropical Climates, vol. 2, p. 120.
  *Ibib. p. 121. 
70
neral seclusion ef all the citizens.  I would enforce the older  by the
point of the bayonet; and until the purity  of the  atmosphere  should
appear to me to be completely restored,  public functionaries  should
supply the wants of the  inhabitants, and  keep up such communica-
tions, as are indispensably necessary."*
   The burning of a number of fires so as to disperse the Malaria, by
the artificial heat thus created, has often been used with good effect, in
warding  off its attacks.  Heat produced  in this way, no doubt ope-
rates in the same manner as the heat of the sun, dilating and ratifying
the gas in question,  and forming an upward current, by which it is car-
ried off.
   We  have now  concluded  our remarks upon this very interesting
subject. We might have lengthened them very much, but our wish and
aim has been to be  as brief,  as was deemed consistent with its value
and importance.
tJohnson on Trop. Cli. vol. 2, p. 128, 
 
timw. ?<*'